record_id,title,abstract,authors,year,doi,label_included,label_abstract_screening,duplicate_record_id
1,Treatment of generalized anxiety disorder in older adults.,"Older adults with generalized anxiety disorder (GAD; N = 75; M age = 67.1 years) were randomly assigned to cognitive-behavioral therapy (CBT), a discussion group (DG) organized around worry-provoking topics, or a waiting period. Participants in both active conditions improved relative to the waiting list. Although CBT participants improved on more measures than DG participants, the authors found only I significant difference immediately after treatment and no differences at 6-month follow-up. Effect sizes were smaller than in younger samples, but CBT showed large effects and DG showed medium-sized effects Overall, results indicate that brief treatment of late-life GAD is beneficial, but they provide only limited support for the superiority of CBT to a credible comparison intervention.",Wetherell JL.; Gatz M.; Craske MG.,2003.0,,1,1,
2,Applied relaxation vs. cognitive therapy in the treatment of generalized anxiety disorder.,"The present study investigated the efficacy of a coping-technique, applied relaxation (AR) and cognitive therapy (CT), in the treatment of generalized anxiety disorder. Thirty-six outpatients fulfilling the DSM-III-R criteria for generalized anxiety were assessed with independent assessor ratings and self-report scales before and after treatment and at a 1 yr follow-up. The patients were randomized and treated individually for 12 weekly sessions. The results showed that both treatments yielded large improvements, which were maintained, or furthered at follow-up. There was no difference between AR and CT on any measure. The drop-out rate was 12% for AR and 5% for CT. The proportions of clinically significantly improved patients were 53 and 62% at post-treatment and 67 and 56% at follow-up for AR and CT, respectively. Besides affecting generalized anxiety the treatments also yielded marked and lasting changes on ratings of worry, cognitive and somatic anxiety and depression. The conclusion that can be drawn is that both AR and CT have potential as treatments for generalized anxiety disorder but they have to be developed further in order to increase the efficacy to the level usually seen in panic disorder, 80-85% clinically improved.",Ost LG.; Breitholtz E.,2000.0,,1,1,
3,"A randomized, controlled proof-of-concept trial of an Internet-based, therapist-assisted self-management treatment for posttraumatic stress disorder.","Objective: The authors report an 8-week randomized, controlled proof-of-concept trial of a new therapist-assisted, Internet-based, self-management cognitive behavior therapy versus Internet-based supportive counseling for posttraumatic stress disorder (PTSD). Method: Service members with PTSD from the attack on the Pentagon on September 11th or the Iraq War were randomly assigned to self-management cognitive behavior therapy (N = 24) or supportive counseling (N = 21). Results: The dropout rate was similar to regular cognitive behavior therapy (30%) and unrelated to treatment arm. In the intent-to-treat group, self-management cognitive behavior therapy led to sharper declines in daily log-on ratings of PTSD symptoms and global depression. In the completer group, self-management cognitive behavior therapy led to greater reductions in PTSD, depression, and anxiety scores at 6 months. One-third of those who completed self-management cognitive behavior therapy achieved high-end state functioning at 6 months. Conclusions: Self-management cognitive behavior therapy may be a way of delivering effective treatment to large numbers with unmet needs and barriers to care. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Litz, Brett T; Engel, Charles C; Bryant, Richard A; Papa, Anthony; Beck, Beck, Blanchard, Bolton, Bryant, Bryk, Ehlers, Foa, Hoge, Keane, Litz, Litz, Monson, Rothbaum, Rothbaum, Schafer, Taylor, Taylor, Weathers, Zayfert",2007.0,,1,1,
4,Guided and unguided self-help for social anxiety disorder: randomised controlled trial.,"Internet-delivered self-help programmes with added therapist guidance have shown efficacy in social anxiety disorder, but unguided self-help has been insufficiently studied. To evaluate the efficacy of guided and unguided self-help for social anxiety disorder. Participants followed a cognitive-behavioural self-help programme in the form of either pure bibliotherapy or an internet-based treatment with therapist guidance and online group discussions. A subsequent trial was conducted to evaluate treatment specificity. Participants (n = 235) were randomised to one of three conditions in the first trial, or one of four conditions in the second. Pure bibliotherapy and the internet-based treatment were better than waiting list on measures of social anxiety, general anxiety, depression and quality of life. The internet-based therapy had the highest effect sizes, but directly comparable effects were noted for bibliotherapy augmented with online group discussions. Gains were well maintained a year later. Unguided self-help through bibliotherapy can produce enduring improvement for individuals with social anxiety disorder.",Furmark T.; Carlbring P.; Hedman E.; Sonnenstein A.; Clevberger P.; Bohman B.; Eriksson A.; Hållén A.; Frykman M.; Holmström A.; Sparthan E.; Tillfors M.; Ihrfelt EN.; Spak M.; Eriksson A.; Ekselius L.; Andersson G.,2009.0,10.1192/bjp.bp.108.060996,1,1,
5,A randomized controlled study of brief family-based intervention in obsessive compulsive disorder.,"Cognitive behaviour therapy (CBT) for Obsessive Compulsive Disorder (OCD) is therapist-intensive and prolonged making it less accessible to patients, particularly in resource-constrained situations. We examined the efficacy of a brief psychotherapeutic intervention as an adjunct to serotonin reuptake inhibitors (SRIs) in OCD. We randomized 64 adult OCD patients stabilized on SRIs to either the 6-session brief family-based intervention (BFBI; n = 30) that included psychoeducation, exposure and response prevention and family intervention or to a control arm of relaxation exercises (RE). Assessments were conducted at baseline and at 1- and 3- months post-intervention. Primary outcome measure was response to treatment defined as ≥ 35% reduction in the Yale-Brown Obsessive Compulsive Scale total score relative to baseline score plus a Clinical Global Impression- Improvement rating of very much improved or much improved. Family accommodation and expressed emotions were also assessed. At 3- month follow-up, the BFBI group responded better than the RE group (53% vs. 12%, p < 0.001). Illness severity, family accommodation and expressed emotion declined significantly over time in the BFBI group compared to the RE group. The BFBI (OR = 13.17, p < 0.001) and baseline illness severity (OR = 0.746, p < 0.011) predicted treatment response. Sample size was small and follow-up duration was short. Control group had less time with the therapist although number of sessions was identical in both the groups. Briefer intervention is effective in treating OCD. Briefer and inclusive format of intervention has important implications for clinical practice in resource-constrained circumstances.",Baruah U.; Pandian RD.; Narayanaswamy JC.; Bada Math S.; Kandavel T.; Reddy YCJ.,2018.0,10.1016/j.jad.2017.08.014,1,1,
6, The From Survivor to Thriver program: RCT of an online therapist-facilitated program for rape-related PTSD," This study evaluated the efficacy of the From Survivor to Thriver program, an interactive, online therapist‐facilitated cognitive‐behavioral program for rape‐related PTSD. Eighty‐seven college women with rape‐related PTSD were randomized to complete the interactive program (n=46) or a psycho‐educational self‐help website (n=41). Both programs led to large reductions in interview‐assessed PTSD at post‐treatment (interactive d=2.22, psycho‐educational d=1.10), which were maintained at three month follow‐up. Both also led to medium‐ to large‐sized reductions in self‐reported depressive and general anxiety symptoms. Follow‐up analyses supported that the therapist‐facilitated interactive program led to superior outcomes among those with higher pre‐treatment PTSD whereas the psycho‐educational self‐help website led to superior outcomes for individuals with lower pre‐treatment PTSD. Future research should examine the efficacy and effectiveness of online interventions for rape‐related PTSD including whether treatment intensity matching could be utilized to maximize outcomes and therapist resource efficiency."," Littleton, H;  Grills, AE;  Kline, KD;  Schoemann, AM;  Dodd, JC",2016.0, 10.1016/j.janxdis.2016.07.010,1,1,
7,Internet-based guided self-help for posttraumatic stress disorder (PTSD): Randomized controlled trial.,"Background There are numerous barriers that limit access to evidence-based treatment for posttraumatic stress disorder (PTSD). Internet-based guided self-help is a treatment option that may help widen access to effective intervention, but the approach has not been sufficiently explored for the treatment of PTSD. Methods Forty two adults with DSM-5 PTSD of mild to moderate severity were randomly allocated to internet-based self-help with up to 3 h of therapist assistance, or to a delayed treatment control group. The internet-based program included eight modules that focused on psychoeducation, grounding, relaxation, behavioural activation, real-life and imaginal exposure, cognitive therapy, and relapse prevention. The primary outcome measure was reduction in clinician-rated traumatic stress symptoms using the clinician administered PTSD scale for DSM-V (CAPS-5). Secondary outcomes were self-reported PTSD symptoms, depression, anxiety, alcohol use, perceived social support, and functional impairment. Results Posttreatment, the internet-based guided self-help group had significantly lower clinician assessed PTSD symptoms than the delayed treatment control group (between-group effect size Cohen's d = 1.86). The difference was maintained at 1-month follow-up and dissipated once both groups had received treatment. Similar patterns of difference between the two groups were found for depression, anxiety, and functional impairment. The average contact with treating clinicians was 21/2 h. Conclusions Internet-based trauma-focused guided self-help for PTSD is a promising treatment option that requires far less therapist time than current first line face-to-face psychological therapy. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Lewis, Catrin E; Farewell, Daniel; Groves, Vicky; Kitchiner, Neil J; Roberts, Neil P; Vick, Tracey; Bisson, Jonathan I",2017.0,http://dx.doi.org/10.1002/da.22645,1,1,
8,Cognitive behavioral treatment of PTSD in residents of battered women's shelters: results of a randomized clinical trial.,"This study was designed to explore the acceptability, feasibility, and initial efficacy of a new shelter-based treatment for victims of intimate partner violence (IPV; i.e., Helping to Overcome PTSD through Empowerment [HOPE]). A Phase I randomized clinical trial comparing HOPE (n = 35) with standard shelter services (SSS) (n = 35) was conducted. Primary outcome measures included the Clinician-Administered PTSD Scale (CAPS; D. D. Blake et al., 1995) and the Conflict Tactic Scales-Revised (M. A. Straus, S. L. Hamby, S. Boney-McCoy, & D. B. Sugarman, 1996). Participants were followed at 1-week, 3- and 6-months postshelter. Participants reported HOPE to be credible and indicated a high degree of satisfaction with treatment. Only 2 women withdrew from treatment. Both intent to treat (ITT) and minimal attendance (MA) analyses found that HOPE treatment relative to SSS was significantly associated with a lower likelihood of reabuse over the 6-month follow-up period (OR = 5.1, RR = 1.75; OR = 12.6, RR = 3.12, respectively). Results of hierarchical linear model analyses found a significant treatment effect for emotional numbing symptom severity in the ITT sample, t(67) = -2.046, p < .05, and significant treatment effects for effortful avoidance symptom severity, t(49) = -2.506, p < .05, and arousal symptom severity, t(49) = -2.04, p < .05, in the MA sample. Significant effects were also found for depression severity, empowerment, and social support. Results support the acceptability and feasibility of HOPE and suggest that HOPE may be a promising treatment for IPV victims in shelter. However, results also suggest that modifications to HOPE may be required to improve treatment outcomes.",Johnson DM.; Zlotnick C.; Perez S.,2011.0,10.1037/a0023822,1,1,
9,Comparison of Adding Treatment of PTSD During and After Shelter Stay to Standard Care in Residents of Battered Women's Shelters: Results of a Randomized Clinical Trial.,"This study explored the acceptability, feasibility, and initial efficacy of an expanded version of a PTSD treatment developed for residents of battered women's shelters, Helping to Overcome PTSD through Empowerment (HOPE) in women who received standard shelter services (SSSs). A Phase I randomized clinical trial comparing HOPE + SSSs (n = 30) to SSSs (n = 30) was conducted. Primary outcome measures included the Clinician-Administered PTSD Scale (Blake et al., 1995) and the Revised Conflict Tactic Scales (Straus, Hamby, Boney-McCoy, & Sugarman, ). Participants were followed at 1-week, and 3- and 6-months posttreatment. Only 2 women dropped out of HOPE + SSS treatment. Latent growth curve analyses found significant treatment effects for PTSD from intimate partner violence (IPV) (β = -.007, p = .021), but not for future IPV (β = .002, p = .709) across follow-up points. Significant effects were also found for secondary outcomes of depression severity (β = -.006, p = .052), empowerment (β = .155, p = .022), and resource gain (β = .158, p = .036). Additionally, more women in HOPE + SSSs were employed at 3- and 6-month follow-up compared to those in SSSs only. Results showed the acceptability and feasibility of adding IPV-related treatment to standard services. They also suggested that HOPE may be a promising treatment for residents of battered women's shelters. Further research with a larger sample, utilizing more diverse shelter settings and a more rigorous control condition, is needed to confirm these findings.",Johnson DM.; Johnson NL.; Perez SK.; Palmieri PA.; Zlotnick C.,2016.0,10.1002/jts.22117,1,1,
10,Group cognitive behavioral therapy targeting intolerance of uncertainty: a randomized trial for older Chinese adults with generalized anxiety disorder.,"China has entered the aging society, but the social support systems for the elderly are underdeveloped, which may make the elderly feel anxiety about their health and life quality. Given the prevalence of generalized anxiety disorder (GAD) in the elderly, it is very important to pay more attention to the treatment for old adults. Although cognitive behavioral therapy targeting intolerance of uncertainty (CBT-IU) has been applied to different groups of patients with GAD, few studies have been performed to date. In addition, the effects of CBT-IU are not well understood, especially when applied to older adults with GAD. Sixty-three Chinese older adults with a principal diagnosis of GAD were enrolled. Of these, 32 were randomized to receive group CBT-IU (intervention group) and 31 were untreated (control group). GAD and related symptoms were assessed using the Penn State Worry Questionnaire, Intolerance of Uncertainty Scale-Chinese Version, Beck Anxiety Inventory, Beck Depression Inventory, Why Worry-II scale, Cognitive Avoidance Questionnaire, Generalized Anxiety Disorder Questionnaire-IV, and Generalized Anxiety Disorder Severity Scale across the intervention. The changes between pre and after the intervention were collected, as well as the six-month follow-up. F test and repeated-measures ANOVA were conducted to analyze the data. Compared to control group, the measures' scores of experimental group decreased significantly after the intervention and six-month follow-up. Besides the main effects for time and group were significant, the interaction effect for group × time was also significant. These results indicated the improvement of the CBT-IU group and the persistence of effect after six months. Group CBT-IU is effective in Chinese older adults with GAD. The effects of CBT-IU on GAD symptoms persist for at least six months after treatment.",Hui C.; Zhihui Y.,2017.0,10.1080/13607863.2016.1222349,1,1,
11, Work-related CBT versus vocational services as usual for unemployed persons with social anxiety disorder: a randomized controlled pilot trial," We designed and pilot‐tested a group‐based, work‐related cognitive‐. behavioral therapy (WCBT) for unemployed individuals with social anxiety disorder (SAD). WCBT, delivered in a vocational service setting by vocational service professionals, aims to reduce social anxiety and enable individuals to seek, obtain, and retain employment. We compared WCBT to a vocational services as usual control condition (VSAU). Participants were unemployed, homeless, largely African American, vocational service‐seeking adults with SAD (N=58), randomized to receive either eight sessions of WCBT plus VSAU or VSAU alone and followed three months post‐treatment. Multilevel modeling revealed significantly greater reductions in social anxiety, general anxiety, depression, and functional impairment for WCBT compared to VSAU. Coefficients for job search activity and self‐efficacy indicated greater increases for WCBT. Hours worked per week in the follow‐up period did not differ between the groups, but small sample size and challenges associated with measuring work hours may have contributed to this finding. Overall, the results of this study suggest that unemployed persons with SAD can be effectively treated with specialized work‐related CBT administered by vocational service professionals. Future testing of WCBT with a larger sample, a longer follow‐up period, and adequate power to assess employment outcomes is warranted."," Himle, JA;  Bybee, D;  Steinberger, E;  Laviolette, WT;  Weaver, A;  Vlnka, S;  Golenberg, Z;  Levine, DS;  Heimberg, RG;  O'Donnell, LA",2014.0, 10.1016/j.brat.2014.10.005,1,1,
12, Face to face but not in the same place: a pilot study of prolonged exposure therapy," This pilot study examined use of smartphone technology to deliver prolonged exposure (PE) therapy to patients with posttraumatic stress disorder (PTSD) with geographic limitations hindering in‐person therapy. The primary goal was to examine the feasibility and acceptability of using video teleconferencing (i.e., computer‐based and iPhone 4 streaming technology), with a secondary goal of examining clinical outcomes of PE delivered via teleconferencing compared with treatment as usual (TAU) on PTSD and depressive/anxious symptom reduction. Rural veterans (N = 27) were randomized to receive PE by computer teleconferencing at a Veterans Administration community clinic, PE by an iPhone issued for the duration of the study, or TAU provided by a referring clinician. To examine the research goals, we collected data on the number of referrals to the study, number of patients entering the study, and number completing psychotherapy and documented pragmatic and technical issues interfering with the ability to use teleconferencing to deliver PE; results are discussed. In addition, measures of symptom change examined clinical outcomes. Results indicated decreases in PTSD symptoms in veterans who completed PE therapy via teleconferencing; however, there was significantly more attrition in these groups than in the TAU group."," Franklin, CL;  Cuccurullo, LA;  Walton, JL;  Arseneau, JR;  Petersen, NJ",2017.0, 10.1080/15299732.2016.1205704,1,1,
13,Long-Term Effects of Telephone-Delivered Psychotherapy for Late-Life GAD.,"To examine the long-term effects of telephone-delivered cognitive-behavioral therapy (CBT-T) compared with nondirective supportive therapy (NST-T) in rural older adults with generalized anxiety disorder (GAD). 141 adults aged 60 years and older with a principal/co-principal diagnosis of GAD were randomized to either CBT-T or NST-T. CBT-T consisted of up to 11 sessions (9 were required) focused on recognition of anxiety symptoms, relaxation, cognitive restructuring and use of coping statements, problem-solving, worry control, behavioral activation, exposure therapy, and relapse prevention, with optional chapters on sleep and pain. NST-T consisted of 10 sessions focused on providing a supportive atmosphere in which participants could share and discuss their feelings and did not provide any direct suggestions. Primary outcomes included interviewer-rated anxiety severity and self-report worry severity measured at 9 months and 15 months after randomization. Mood-specific secondary outcomes included self-report GAD symptoms and depressive symptoms. At 15 months, after adjustment for multiple testing, there was a significantly greater decline in general anxiety symptoms (difference in improvement: 3.31; 95% CI: 0.45-6.17; t = 2.29; df = 136; p = 0.024) and worry (difference in improvement: 3.13; 95% CI: 0.59-5.68; t = 2.43; df = 136; p = 0.016) among participants in CBT-T compared with those in the NST-T group. There were no significant differences between the conditions in terms of depressive symptoms (difference in improvement: 2.88; 95% CI: 0.17-5.60; t = 2.10; df = 136; p = 0.0376) and GAD symptoms (difference in improvement: 1.65; 95% CI: -0.20 to 3.50; t = 1.76; df = 136; p = 0.080). CBT-T is superior to NST-T in reducing worry and anxiety symptoms 1 year after completing treatment.",Brenes GA.; Danhauer SC.; Lyles MF.; Anderson A.; Miller ME.,2017.0,10.1016/j.jagp.2017.05.013,1,1,
14,Behavioral Treatment of Panic Disorder : A two-year follow-up,,"Brown, Timothy A; Low, David H B A S",1991.0,,1,1,
15,The effectiveness of an online e-health application compared to attention placebo or Sertraline in the treatment of Generalised Anxiety Disorder,"Background: Generalised Anxiety Disorder (GAD) is a high prevalence, chronic disorder that can be treated effectively through a number of web-based programs. However, online web programs for GAD have not been compared to standard pharmacological treatment. The present study compares an Internet Intervention (Active Website) for GAD and a selective serotonin re-uptake inhibitor (SSRI) (Sertraline), with an online attention placebo condition (Control Website). Objective: To evaluate the effectiveness of a web-based intervention for GAD in comparison to standard antidepressant medication and an online attention placebo condition over a 10. week period, and with a follow-up at 6 and at 12. months. Methods: The study was part of a larger scale prevention program. 152 people aged 18-30. years who met the criteria for GAD on the MINI received referrals to the treatment sub-study. The primary outcome was anxiety symptoms measured by the Generalised Anxiety Disorder 7-item Scale (GAD-7), and the secondary outcome was depression measured by the Center for Epidemiologic Studies Depression Scale (CES-D). Results: There was very poor uptake to the trial (around 14% of those referred). However, even in this small sample, Sertraline compared to the Control Website was significant at post-test and 6. months, and the Internet Intervention was significant at post-test. Relative to the Control Website condition at post-test, for the GAD-7 and CES-D respectively, the between group effect sizes were d=. 2.43 and d=. 0.68 for the Active Website condition, and 3.00 and 0.20 for the Sertraline condition. The within group effect size for the Control Website from baseline to post-test was -. 0.04 for the GAD-7 and 0.31 for CES-D respectively. Conclusions: The findings will need to be extended and confirmed in a larger trial. However, they do suggest that both standard pharmacological treatment and online interventions for GAD are effective in samples with a diagnosis of GAD recruited via online methods. The low rate of engagement for face-to-face treatment by those who opt first for a web program suggests that treatment preferences are important in help-seeking.","Christensen, Helen; Mackinnon, Andrew J.; Batterham, Philip J.; O'Dea, Bridianne; Guastella, Adam J.; Griffiths, Kathleen M.; Eagleson, Claire; Kalia Hehir, Kanupriya; Kenardy, Justin; Bennett, Kylie; Hickie, Ian",2014.0,10.1016/j.invent.2014.08.002,1,1,
16,A randomized controlled study of single-session behavioural treatment of earthquake-related post-traumatic stress disorder using an earthquake simulator.,"Background: Brief interventions are needed in dealing with traumatic stress problems in large survivor populations after devastating earthquakes. The present study examined the effectiveness of a single session of exposure to simulated tremors in an earthquake simulator and self-exposure instructions in reducing post-traumatic stress disorder (PTSD). Method: Participants were consecutively recruited from among survivors screened during field surveys in the disaster region in Turkey. Thirty-one earthquake survivors with PTSD were assigned either to a single session of behavioural treatment (n = 16) or to repeated assessments (RA; n = 15). Assessments in the treatment group were at 4, 8, 12, 24 weeks and 1-2 years post-treatment. The RA cases were assessed at baseline and 4 and 8 weeks after trial entry, after which they received the same treatment and were followed up at 4, 12, 24 weeks and 1-2 years. Results: Between-group treatment effects at week 8 were significant on measures of fear, PTSD and self- and assessor-rated global improvement. Improvement rates were 40% at week 4, 72% at week 12, 80% at week 24, and 80% at 1-2-years' follow-up, with large effect sizes on fear and PTSD measures. Post-session reduction in fear of earthquakes and increased sense of control over fear at follow-up related to improvement in PTSD. Conclusion: The study provided further evidence of the effectiveness of a single session of behavioural treatment in reducing fear and PTSD in earthquake survivors. Future research needs to examine the usefulness of earthquake simulators in increasing psychological preparedness for earthquakes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Basoglu, Metin; Salcioglu, Ebru; Livanou, Maria; Aker, Basoglu, Basoglu, Basoglu, Basoglu, Basoglu, Basoglu, Basoglu, Beck, Blake, Bryant, Cohen, Ehlers, First, Foa, Foa, Foa, Hisli, Jacobson, Kendall, Laupacis, Marks, Paunovic, Schnurr, Tarrier, van Etten, Weathers, Ost, Ost, Salcioglu, Salcioglu, Salcioglu",2007.0,,1,1,
17,"Fluvoxamine , Placebo , and Cognitive Behaviour Therapy Used Alone and in Combination in the Treatment of Panic Disorder and Agoraphobia",,"Sharp, Donald M",1996.0,,1,1,
18,Moclobemide in Social Phobia : A Controlled Study,,"Oosterbaan, B; Balkom, Anton J L M Van; Spinhoven, Philip; Oppen, Patricia Van; Dyck, Richard Van",2001.0,,1,1,
19,"fluvoxamine , Placebo , and Cognitive Behaviour Therapy Used Alone and in Combination in the Treatment of Panic Disorder and Agoraphobia",,"Lelliott, Paul",1989.0,,1,1,
20,Cognitive Behavioral Group Treatment for Social Phobia : Comparison with a Credible Placebo ControU,,"Heimberg, Richard G; Dodge, Cynthia S; Hope, Debra A; Kennedy, Charles R; Zollo, Linda J; Becket, Robert E",1990.0,,1,1,
21,Cognitive-Behavioral Group Treatment for Social Phobia : Effectiveness at Five-Year Followup I,,"Heimberg, Richard G; Salzman, Debra G; Holt, Craig S; Blendell, Karl A",1993.0,,1,1,
22,The impact of prolonged exposure on PTSD symptoms and associated psychopathology in people living with HIV: A randomized test of concept.,"People living with HIV (PLWH) report elevated levels of posttraumatic stress disorder symptoms (PTSS) and associated comorbidities. The present study tested the efficacy of prolonged exposure (PE) at reducing PTSS, depression, negative posttraumatic cognitions, and substance use in PLWH. Participants were randomly assigned to receive PE (n = 40) or to a weekly monitoring control group (n = 25). Assessments occurred at baseline, post-intervention and 3-months post-treatment. Following the 3-month assessment, controls were offered the intervention. All PE recipients (whether originally from the PE or control group) completed a 6-month assessment. Intent-to-treat mixed model repeated measures ANOVAs were conducted through 3-months post-treatment; within group analyses were conducted through 6-months. PE recipients reported fewer PTSS and negative posttraumatic cognitions and were more likely to achieve good end-state functioning; gains were maintained at 6-months. No between-group differences emerged for substance use. Overall, results support the efficacy of PE in PLWH. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pacella, Maria L; Armelie, Aaron; Boarts, Jessica; Wagner, Glenn; Jones, Tracy; Feeny, Norah; Delahanty, Douglas L; Ballenger, Basu, Boarts, Bradley, Brady, Breslau, Breslau, Breslau, Breslau, Brief, Bryant, Chander, Chandra, Cohen, Cook, Crum, Dansky, Deering, Delahanty, DiMatteo, First, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Frank, Friedman, Friedman, Gore-Felton, Hembree, Henslee, Himelhoch, Israelski, Jaycox, Kalichman, Katz, Keane, Kelly, Kessler, Kessler, Kimerling, Kuhn, Lauterbach, Leserman, Leserman, Leserman, Leserman, Leserman, Maia, Marshall, Martinez, Mugavero, Myers, Nemeroff, O'Cleirigh, Olatunji, Pence, Petry, Powers, Radcliffe, Radloff, Reilly, Reisner, Safren, Samet, Sareen, Schulz, Scott-Sheldon, Sledjeski, Sloan, Smith, Tedstone, Theuninck, Triffleman, Tsao, van Etten, van Minnen, Whetten, Whetten",2012.0,,1,1,
23,Emotion-focused psychotherapy for patients with panic disorder.,"Recent studies have suggested that most patients treated for panic disorder receive forms of psychotherapy other than cognitive behavior therapy, even though there is little information about the efficacy of such treatments or how they compare to proven active treatments. The authors compared one of these other forms, emotion-focused psychotherapy (given to 30 patients with panic disorder), to results obtained with recommended standard treatment (either cognitive behavior therapy [N=36] or imipramine [N=22]). The authors also compared emotion-focused psychotherapy to results obtained in subjects given pill placebo (N=24). Subjects met DSM-IV criteria for panic disorder with no more than mild agoraphobia. Treatment consisted of approximately 3 months of weekly visits followed by 6 monthly maintenance visits. Assessments were conducted after each treatment phase and at a follow-up visit after 6 months of no treatment. Emotion-focused psychotherapy was less effective for symptoms of panic disorder than treatment with either cognitive behavior therapy or imipramine; results obtained with emotion-focused psychotherapy after the acute and maintenance phases were similar to those seen with placebo. Treatment expectations were not different among the different groups. Patients receiving emotion-focused psychotherapy had the highest completion rate. The results suggest that emotion-focused psychotherapy (a supportive form of psychotherapy) has low efficacy for the treatment of panic disorder. However, emotion-focused psychotherapy may be superior to medical management in helping patients stay in treatment.",Shear MK.; Houck P.; Greeno C.; Masters S.,2001.0,10.1176/appi.ajp.158.12.1993,1,1,
24,"Outcome Predictors for Three PTSD Treatments: Exposure Therapy, EMDR, and Relaxation Training.","Several psychosocial treatments appear to be effective in treating posttraumatic stress disorder (PTSD). However, little is known about the predictors of treatment outcome. It is possible that some variables predict poor outcome for some treatments but not for other treatments. To investigate this issue, outcome predictors were investigated for three eight-session treatments: exposure therapy (entailing prolonged imaginal and in vivo exposure), relaxation training, and eye movement desensitization and reprocessing (EMDR). Sixty people with PTSD entered and 45 completed treatment. Treatments did not differ in attrition or perceived credibility. Exposure tended to be most effective, and EMDR and relaxation did not differ in efficacy. A number of clinical and cognitive variables were examined to identify predictors of treatment dropout as well as predictors of the likelihood that patients would be remitted from PTSD after treatment. These analyses were conducted by controlling for treatment condition. Low patient ratings of treatment credibility (assessed in session 2) predicted treatment dropout, regardless of treatment type. Severe reexperiencing symptoms (assessed prior to treatment) predicted poor outcome for relaxation training but not for the other therapies... (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Taylor, Steven; Asmundson, Beck, Blake, Borkovec, Chambless, Devilly, Fedoroff, First, Foa, Foa, Foa, Foa, Foa, King, Marks, Maxfield, Mayou, Neziroglu, Norusis, Overall, Peterson, Peterson, Pitman",2003.0,,1,1,
25,Efficacy of 2 interventions for panic disorder in patients presenting to the ED with chest pain.,"Brief and efficacious interventions for panic disorder (PD) in patients presenting to emergency departments (EDs) for chest pain are essential. This study assessed the effects of 2 interventions for this population: a brief cognitive-behavioral therapy delivered by psychologists, and a 6-month pharmacologic treatment initiated and managed by the ED physician. The relative efficacy of both interventions was also examined. Forty-seven adult patients meeting the diagnostic criteria for PD upon presentation to the ED were assigned to 1 of 3 experimental conditions: a brief cognitive-behavioral therapy (7 sessions), a pharmacologic intervention (paroxetine; 6 months); and a usual care control condition. The primary outcome was severity of PD on Anxiety Disorder Interview Schedule for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and secondary outcomes included measures of PD symptoms, depressive symptoms, and cardiac anxiety. Outcome measures were taken at baseline, postintervention, as well as at 3- and 6-month follow-ups. Patients receiving either intervention demonstrated significant reductions of PD severity (P = .012), frequency of panic attacks (P = .048), and depressive symptoms (P = .027). Taken together, these findings suggest that empirically validated interventions for PD initiated in an ED setting can be feasible and efficacious, and future studies should assess their impact on both the direct (ie, health care utilization) and indirect (ie, lost productivity) costs associated with PD morbidity in this population.",Pelland MÈ.; Marchand A.; Lessard MJ.; Belleville G.; Chauny JM.; Vadeboncoeur A.; Poitras J.; Foldes-Busque G.; Bacon SL.; Lavoie KL.,2011.0,10.1016/j.ajem.2010.06.027,1,1,
26,Augmenting in vivo exposure with fear antagonistic actions: A preliminary test.,"The current study investigated the efficacy of an exposure augmentation strategy in which the phobic individual is encouraged to enact actions that are in direct opposition to the fear action tendencies associated with acrophobia. Participants (N = 88) meeting DSM-IV criteria for specific phobia (acrophobia) were randomized to (a) exposure with oppositional actions (E+OA), (b) exposure only (EO), (c) a credible placebo consisting of pulsed audio-photic stimulation (APS), or (d) a waitlist control (WLC). Treatment consisted of six, 6-min exposure trials. Participants were assessed with questionnaire, behavioral, and physiologic measures at pre- and posttreatment, and at a 1-month follow-up session. Participants receiving E+OA showed significantly greater improvement on behavioral and questionnaire measures than those in the other 3 conditions at both posttreatment and follow-up. Further, whereas treatment improvement generalized to an untrained context for those receiving E+OA, such was not the case for EO- and APS-treated participants. Findings suggest augmenting exposure with oppositional actions may enhance treatment outcome and thus warrant additional investigation with clinical samples. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wolitzky, Kate B; Telch, Michael J; Bandura, Bandura, Barlow, Bates, Bryk, Cohen, Craske, Devilly, Dimberg, Emmelkamp, Foa, Foa, Foa, Gauthier, Gonzalez-Lima, Hellstrom, Hofmann, Huppert, Jacobson, Kamphuis, Kazdin, Kazdin, Kirsch, Kraemer, Ledgerwood, Ledoux, Ledoux, Masserman, Mineka, Mystkowski, Mystkowski, Otto, Pendleton, Powers, Ressler, Richardson, Rodriguez, Rothbaum, Rowe, Rowe, Roy-Byrne, Roy-Byrne, Salkovskis, Sloan, Smits, Szymanski, Telch, Telch, Telch, Telch, Telch, Tsao, Walker, Wells, Williams, Williams, Wolitzky-Taylor, Wolpe, Wolpe, Wolpe, Ost, Ost",2009.0,,1,1,
27,A pilot randomized trial of metacognitive therapy vs applied relaxation in the treatment of adults with generalized anxiety disorder.,"Metacognitive Therapy (MCT) and Applied Relaxation (AR) were compared in a pilot treatment trial of generalized anxiety disorder (GAD). Twenty outpatients meeting criteria for DSM-IV-TR GAD were assessed before treatment, after treatment and at 6 m and 12 m follow-up. The patients were randomized and treated individually for 8-12 weekly sessions. There was no drop-out from MCT and 10% at 6 m follow-up from AR. At post-treatment and at both follow-up points MCT was superior to AR. Standardized recovery rates for MCT at post-treatment were 80% on measures of worry and trait-anxiety compared with 10% following AR. At 6 m follow-up recovery rates for MCT were 70% on both measures compared with 10% and 20% for AR. At 12 m follow-up recovery rates for MCT were 80% (worry) and 60% (trait-anxiety) compared with 10% and 20% following AR. The recovery rates for MCT are similar to those obtained in an earlier uncontrolled trial (Wells & King, 2006). The effect sizes and standardized recovery rates for MCT suggest that it is a highly effective treatment.",Wells A.; Welford M.; King P.; Papageorgiou C.; Wisely J.; Mendel E.,2010.0,10.1016/j.brat.2009.11.013,1,1,
28,A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder.,"Thirty-six patients with PTSD were randomly allocated to individual treatment with imaginal exposure (image habituation training -- IHT), or applied muscle relaxation (AMR) or eye movement desensitization (EMD). Assessment by a blind independent rater and self-report instruments applied pre and posttreatment and at 3-month follow-up indicated that all groups improved significantly compared with a waiting list and that treatment benefits were maintained at follow-up. Despite a failure to demonstrate differences among groups, there was some suggestion that immediately after treatment EMD was superior for intrusive memories.",Vaughan K.; Armstrong MS.; Gold R.; O'Connor N.; Jenneke W.; Tarrier N.,1994.0,,1,1,
29,A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder.,"Effective treatments for obsessive-compulsive disorder (OCD) exist, but additional treatment options are needed. The effectiveness of 8 sessions of acceptance and commitment therapy (ACT) for adult OCD was compared with progressive relaxation training (PRT). Seventy-nine adults (61% female) diagnosed with OCD (mean age = 37 years; 89% Caucasian) participated in a randomized clinical trial of 8 sessions of ACT or PRT with no in-session exposure. The following assessments were completed at pretreatment, posttreatment, and 3-month follow-up by an assessor who was unaware of treatment conditions: Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Beck Depression Inventory-II, Quality of Life Scale, Acceptance and Action Questionnaire, Thought Action Fusion Scale, and Thought Control Questionnaire. Treatment Evaluation Inventory was completed at posttreatment. ACT produced greater changes at posttreatment and follow-up over PRT on OCD severity (Y-BOCS: ACT pretreatment = 24.22, posttreatment = 12.76, follow-up = 11.79; PRT pretreatment = 25.4, posttreatment = 18.67, follow-up = 16.23) and produced greater change on depression among those reporting at least mild depression before treatment. Clinically significant change in OCD severity occurred more in the ACT condition than PRT (clinical response rates: ACT posttreatment = 46%-56%, follow-up = 46%-66%; PRT posttreatment = 13%-18%, follow-up = 16%-18%). Quality of life improved in both conditions but was marginally in favor of ACT at posttreatment. Treatment refusal (2.4% ACT, 7.8% PRT) and dropout (9.8% ACT, 13.2% PRT) were low in both conditions. ACT is worth exploring as a treatment for OCD.",Twohig MP.; Hayes SC.; Plumb JC.; Pruitt LD.; Collins AB.; Hazlett-Stevens H.; Woidneck MR.,2010.0,10.1037/a0020508,1,1,
30,Applied relaxation vs cognitive behavior therapy in the treatment of panic disorder.,"The present study investigated the efficacy of a coping-technique, applied relaxation (AR) and cognitive behavior therapy (CBT), in the treatment of panic disorder. Thirty-eight outpatients fulfilling the DSM-III-R criteria for panic disorder with no (n = 30) or mild (n = 8) avoidance were assessed with independent assessor ratings, self-report scales and self-observation of panic attacks before and after treatment, and at a 1-yr follow-up. The patients were treated individually for 12 weekly sessions. The results showed that both treatments yielded very large improvements, which were maintained, or furthered at follow-up. There was no difference between AR and CBT on any measure. The proportion of panic-free patients were 65 and 74% at post-treatment, and 82 and 89% at follow-up, for AR and CBT, respectively. There were no relapses at follow-up, on the contrary 55% of the patients who still had panic attacks at post-treatment were panic-free at follow-up. Besides affecting panic attacks the treatments also yielded marked and lasting changes on generalized anxiety, depression and cognitive misinterpretations. The conclusion that can be drawn is that both AR and CBT are effective treatments for panic disorder without avoidance.",Ost LG.; Westling BE.,1995.0,,1,1,
31,Written exposure as an intervention for PTSD: A randomized clinical trial with motor vehicle accident survivors.,"The present study examined the efficacy of a brief, written exposure therapy (WET) for posttraumatic stress disorder (PTSD). Participants were 46 adults with a current primary diagnosis of motor vehicle accident-related PTSD. Participants were randomly assigned to either WET or a waitlist (WL) condition. Independent assessments took place at baseline and 6-, 18-, and 30-weeks post baseline (WL condition not assessed at 30 weeks). Participants assigned to WET showed significant reductions in PTSD symptom severity at 6- and 18-week post-baseline, relative to WL participants, with large between-group effect sizes. In addition, significantly fewer WET participants met diagnostic criteria for PTSD at both the 6- and 18-week post-baseline assessments, relative to WL participants. Treatment gains were maintained for the WET participants at the 30-week post baseline assessment. Notably, only 9% of participants dropped out of WET and the WET participants reported a high degree of satisfaction with the treatment. These findings suggest that a brief, written exposure treatment may efficaciously treat PTSD. Future research should examine whether WET is efficacious with other PTSD samples, as well as compare the efficacy of WET with that of evidence-based treatments for PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sloan, Denise M; Marx, Brian P; Bovin, Michelle J; Feinstein, Brian A; Gallagher, Matthew W; Beck, Blanchard, Blanchard, Blanchard, Borkovec, Bouton, Bradley, Bradley, Bryant, Cahill, Craske, Devilly, Ehlers, Foa, Foa, Foa, Frattaroli, Hamblen, Hedges, Hembree, Jacobson, Kessler, Kolassa, Kubany, Lang, Larsen, Mayou, Muthen, Nguyen, Pennebaker, Pennebaker, Raudenbush, Resick, Resick, Robjant, Schnurr, Scott, Sloan, Sloan, Sloan, Sloan, Sloan, Spitzer, van Emmerik, van Minnen, Waltz, Weathers",2012.0,,1,1,
32,Post-treatment effects of exposure therapy and clomipramine in obsessive-compulsive disorder.,"We sought to determine whether adults with obsessive-compulsive disorder (OCD) who respond to intensive exposure and response (ritual) prevention (EX/RP) with or without clomipramine (CMI) fare better 12 weeks after treatment discontinuation than responders receiving CMI alone. After receiving 12 weeks of treatment (EX/RP, CMI, EX/RP+CMI, or pill placebo [PBO] in a randomized clinical trial conducted at three outpatient research centers), 46 adults with OCD who responded to treatment (18 EX/RP, 11 CMI, 15 EX/RP+CMI, 2 PBO) were followed after treatment discontinuation for 12 weeks. Patients were assessed every 4 weeks with the Yale-Brown Obsessive-Compulsive Scale, the National Institutes of Health Global Obsessive-Compulsive Scale, and the Clinical Global Impressions scale by an evaluator who was blind to original treatment assignment. The primary hypothesis was that EX/RP and EX/RP+CMI responders would be less likely to relapse 12 weeks after treatment discontinuation than responders to CMI alone. Twelve weeks after treatment discontinuation, EX/RP and EX/RP+CMI responders, compared to CMI responders, had a significantly lower relapse rate (4/33 = 12% versus 5/11 = 45%) and a significantly longer time to relapse. The CMI relapse rate was lower than previously reported. Nonetheless, responders receiving intensive EX/RP with or without CMI fared significantly better 12 weeks after treatment discontinuation than responders receiving CMI alone.",Simpson HB.; Liebowitz MR.; Foa EB.; Kozak MJ.; Schmidt AB.; Rowan V.; Petkova E.; Kjernisted K.; Huppert JD.; Franklin ME.; Davies SO.; Campeas R.,2004.0,10.1002/da.20003,1,1,
33,Cognitive behavioral treatment compared with nonprescriptive treatment of panic disorder.,"The efficacy of cognitive behavioral treatment for panic disorder has been established in controlled studies. However, little is known about the efficacy of other psychological treatments. We report the results of a study comparing cognitive behavioral treatment with a focused nonprescriptive treatment for panic. Three sessions of panic-related information were provided in each treatment, followed by 12 sessions of either nonprescriptive, reflective listening (non-prescriptive treatment) or a treatment package that included breathing retraining, muscle relaxation, cognitive reframing, and exposure to interoceptive and agoraphobic stimuli (cognitive behavioral treatment). Posttreatment and 6-month follow-up assessments revealed a good response to both treatments. We observed a high rate of panic remission and significant improvement in associated symptoms in subjects in each treatment group. These findings raise questions about the specificity of cognitive behavioral treatment.",Shear MK.; Pilkonis PA.; Cloitre M.; Leon AC.,1994.0,,1,1,
34,"Applied relaxation, exposure in vivo and cognitive methods in the treatment of panic disorder with agoraphobia.","Forty-five psychiatric outpatients with DSM-III-R diagnosis of panic disorder with agoraphobia were assessed with a battery of self-report, behavioral and cognitive measures before and after therapy, and at a 1 yr follow-up. They were randomly assigned to either Applied Relaxation (AR; n = 15), Exposure in vivo (E; n = 15) or Cognitive Treatment (CT; n = 15) and received 12 individual therapy sessions, once weekly. All patients also had self-exposure instructions. The three treatments yielded significant improvements that were maintained at follow-up. One criterion of clinically significant improvement was fulfilled by 87% of the AR-, 80% of the E- and 60% of the CT-patients at the end of treatment, and 85, 79 and 67%, respectively, at follow-up. Between-group differences were observed on two measures only, both showing better results for AR than for CT. The conclusion that can be drawn is that the three treatments, focussed on different anxiety components, are about equally effective, and the results are maintained 1 yr after the end of treatment.",Ost LG.; Westling BE.; Hellström K.,1993.0,,1,1,
35,"Applied tension, exposure in vivo, and tension-only in the treatment of blood phobia.","Thirty patients with phobia for blood, wounds and injuries were treated individually with applied tension (AT), exposure in vivo (E), or tension-only (T) for 5 sessions. They were assessed on self-report, behavioral and physiological measures before and after treatment, and at a 1 yr follow-up. All groups improved significantly, and the improvements were maintained at follow-up. Applying stringent criteria, 90% of the AT-, 80% of the T-, and 40% of the E-patients were clinically improved at the end of treatment. The corresponding figures at follow-up were 100, 90 and 50%, respectively. AT differed significantly, and T marginally from E at both assessments. Applied tension, or tension-only should, from a clinical point of view, be considered the treatment of choice for blood phobia.",Ost LG.; Fellenius J.; Sterner U.,1991.0,,1,1,
36,Treatment of posttraumatic stress disorder by exposure and/or cognitive restructuring: a controlled study.,"Unanswered questions from controlled studies of posttraumatic stress disorder concern the value of cognitive restructuring alone without prolonged exposure therapy and whether its combination with prolonged exposure is enhancing. In a controlled study, 87 patients with posttraumatic stress disorder of at least 6 months' duration were randomly assigned to have 10 sessions of 1 of 4 treatments: prolonged exposure (imaginal and live) alone; cognitive restructuring alone; combined prolonged exposure and cognitive restructuring; or relaxation without prolonged exposure or cognitive restructuring. Integrity of audiotaped treatment sessions was satisfactory when rated by an assessor unaware of the treatment assignment. Seventy-seven patients completed treatment. The pattern of results was similar regardless of rater, statistical method, measure, occasion, and therapist. Exposure and cognitive restructuring, singly or combined, improved posttraumatic stress disorder markedly on a broad front. Gains continued to 6-month follow-up and were significantly greater than the moderate improvement from relaxation. Both prolonged exposure and cognitive restructuring were each therapeutic on their own, were not mutually enhancing when combined, and were each superior to relaxation.",Marks I.; Lovell K.; Noshirvani H.; Livanou M.; Thrasher S.,1998.0,,1,1,
37,Culturally adapted CBT (CA-CBT) for Latino women with treatment-resistant PTSD: a pilot study comparing CA-CBT to applied muscle relaxation.,"We examined the therapeutic efficacy of a culturally adapted form of CBT (CA-CBT) for PTSD as compared to applied muscle relaxation (AMR) for female Latino patients with treatment-resistant PTSD. Participants were randomized to receive either CA-CBT (n = 12) or AMR (n = 12), and were assessed before treatment, after treatment, and at a 12-week follow-up. The treatments were manualized and delivered in the form of group therapy across 14 weekly sessions. Assessments included a measure of PTSD, anxiety, culturally relevant idioms of distress (nervios and ataque de nervios), and emotion regulation ability. Patients receiving CA-CBT improved significantly more than in the AMR condition. Effect size estimates showed very large reductions in PTSD symptoms from pretreatment to posttreatment in the CA-CBT group (Cohen's d = 2.6) but only modest improvements in the AMR group (0.8). These results suggest that CA-CBT can be beneficial for previously treatment-resistant PTSD in Latino women.",Hinton DE.; Hofmann SG.; Rivera E.; Otto MW.; Pollack MH.,2011.0,10.1016/j.brat.2011.01.005,1,1,
38,Treatment of posttraumatic stress disorder in rape victims: a comparison between cognitive-behavioral procedures and counseling.,"Rape victims with posttraumatic stress disorder (PTSD; N = 45) were randomly assigned to one of four conditions: stress inoculation training (SIT), prolonged exposure (PE), supportive counseling (SC), or wait-list control (WL). Treatments consisted of nine biweekly 90-min individual sessions conducted by a female therapist. Measures of PTSD symptoms, rape-related distress, general anxiety, and depression were administered at pretreatment, posttreatment, and follow-up (M = 3.5 months posttreatment). All conditions produced improvement on all measures immediately post-treatment and at follow-up. However, SIT produced significantly more improvement on PTSD symptoms than did SC and WL immediately following treatment. At follow-up, PE produced superior outcome on PTSD symptoms. The implications of these findings and direction for treatment and future research are discussed.",Foa EB.; Rothbaum BO.; Riggs DS.; Murdock TB.,1991.0,,1,1,
39,Psychological treatment of comorbid asthma and panic disorder in Latino adults: Results from a randomized controlled trial.,"Confusion between panic and asthma symptoms can result in serious self-management errors. A cognitive behavior psychophysiological therapy (CBPT) intervention was culturally adapted for Latinos consisting of CBT for panic disorder (PD), asthma education, differentiation between panic and asthma symptoms, and heart rate variability biofeedback. An RCT compared CBPT to music and relaxation therapy (MRT), which included listening to relaxing music and paced breathing at resting respiration rates. Fifty-three Latino (primarily Puerto Rican) adults with asthma and PD were randomly assigned to CBPT or MRT for 8 weekly sessions. Both groups showed improvements in PD severity, asthma control, and several other anxiety and asthma outcome measures from baseline to post-treatment and 3-month follow-up. CBPT showed an advantage over MRT for improvement in adherence to inhaled corticosteroids. Improvements in PD severity were mediated by anxiety sensitivity in CBPT and by depression in MRT, although earlier levels of these mediators did not predict subsequent improvements. Attrition was high (40%) in both groups, albeit comparable to CBT studies targeting anxiety in Latinos. Additional strategies are needed to improve retention in this high-risk population. Both CBPT and MRT may be efficacious interventions for comorbid asthma-PD, and CBPT may offer additional benefits for improving medication adherence. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Feldman, Jonathan M; Matte, Lynne; Interian, Alejandro; Lehrer, Paul M; Lu, Shou-En; Scheckner, Bari; Steinberg, Dara M; Oken, Tanya; Kotay, Anu; Sinha, Sumita; Shim, Chang; Akinbami, Alegria, Alonso, Avallone, Barlow, Beck, Bjornsson, Buffum, Carr, Chambless, Chan, Chavira, Cohen, Craske, Devilly, Dozois, Favreau, Feldman, Feldman, Feldman, First, Hasler, Hayano, Hinton, Hofmann, Horikawa, Ibrahim, Jacobson, Jennings, Juniper, Juniper, Juniper, Kotses, Labbe, Lavoie, Lehrer, Lehrer, Lehrer, Lehrer, Lehrer, Lehrer, MacKinnon, McCulloch, McLeish, Mendoza, Meuret, Meuret, Meuret, Miranda, Nielsen, Olthuis, Parry, Picado, Porter, Put, Rihmer, Ritz, Ross, Safren, Safren, Sanjuas, Shear, Shear, Simoni, Sliwka, Sliwka, Spitzer, Strauss, Taylor, Vaschillo, Wheaton, White, Wiebe, Wilhelm, Wong, Yates, Yellowlees",2016.0,,1,1,
40,Psychological treatment of chronic posttraumatic stress disorder in victims of sexual aggression,"ER The aim of this research was to test the comparative effectiveness of two therapeutic modalities in the treatment of chronic posttraumatic stress disorder in victims of sexual aggression: (a) self-exposure and cognitive restructuring and (b) progressive relaxation training. The sample consisted of 20 patients (victims of rape in adulthood or adult victims of childhood sexual abuse) selected according to DSM-III-R criteria. A multigroup experimental design with repeated measures (pretreatment, posttreatment, and 1-, 3-, 6-, and 12-month follow-up) was used. Most treated patients improved, but the success rate was higher in all measures in the exposure and cognitive restructuring group immediately on posttreatment and at follow-up. Implications of this study for clinical practice and future research in this field are commented on.","Echeburúa, E; Corral, P; Zubizarreta, I; Sarasua, B",1997.0,10.1177/01454455970214003,1,1,
41,A randomized clinical trial of cognitive-behavioral therapy and applied relaxation for adults with generalized anxiety disorder.,"This randomized clinical trial compared cognitive-behavioral therapy (CBT), applied relaxation (AR), and wait-list control (WL) in a sample of 65 adults with a primary diagnosis of generalized anxiety disorder (GAD). The CBT condition was based on the intolerance of uncertainty model of GAD, whereas the AR condition was based on general theories of anxiety. Both manualized treatments were administered over 12 weekly 1-hour sessions. Standardized clinician ratings and self-report questionnaires were used to assess GAD and related symptoms at pretest, posttest, and at 6-, 12-, and 24-month follow-ups. At posttest, CBT was clearly superior to WL, AR was marginally superior to WL, and CBT was marginally superior to AR. Over follow-up, CBT and AR were equivalent, but only CBT led to continued improvement. Thus, direct comparisons of CBT and AR indicated that the treatments were comparable; however, comparisons of each treatment with another point of reference (either waiting list or no change over follow-up) provided greater support for the efficacy of CBT than AR.",Dugas MJ.; Brillon P.; Savard P.; Turcotte J.; Gaudet A.; Ladouceur R.; Leblanc R.; Gervais NJ.,2010.0,10.1016/j.beth.2008.12.004,1,1,
42,A component analysis of cognitive-behavioral therapy for generalized anxiety disorder and the role of interpersonal problems.,"Clients with generalized anxiety disorder (GAD) received either (a) applied relaxation and self-control desensitization, (b) cognitive therapy, or (c) a combination of these methods. Treatment resulted in significant improvement in anxiety and depression that was maintained for 2 years. The large majority no longer met diagnostic criteria; a minority sought further treatment during follow-up. No differences in outcome were found between conditions; review of the GAD therapy literature suggested that this may have been due to strong effects generated by each component condition. Finally, interpersonal difficulties remaining at posttherapy, measured by the Inventory of Interpersonal Problems Circumplex Scales (L. E. Alden, J. S. Wiggins, & A. L. Pincus, 1990) in a subset of clients, were negatively associated with posttherapy and follow-up improvement, suggesting the possible utility of adding interpersonal treatment to cognitive-behavioral therapy to increase therapeutic effectiveness.",Borkovec TD.; Newman MG.; Pincus AL.; Lytle R.,2002.0,,1,1,
43,Prolonged exposure vs eye movement desensitization and reprocessing vs waiting list for posttraumatic stress disorder in patients with a psychotic disorder: a randomized clinical trial.,"The efficacy of posttraumatic stress disorder (PTSD) treatments in psychosis has not been examined in a randomized clinical trial to our knowledge. Psychosis is an exclusion criterion in most PTSD trials. To examine the efficacy and safety of prolonged exposure (PE) therapy and eye movement desensitization and reprocessing (EMDR) therapy in patients with psychotic disorders and comorbid PTSD. A single-blind randomized clinical trial with 3 arms (N = 155), including PE therapy, EMDR therapy, and waiting list (WL) of 13 outpatient mental health services among patients with a lifetime psychotic disorder and current chronic PTSD. Baseline, posttreatment, and 6-month follow-up assessments were made. Participants were randomized to receive 8 weekly 90-minute sessions of PE (n = 53), EMDR (n = 55), or WL (n = 47). Standard protocols were used, and treatment was not preceded by stabilizing psychotherapeutic interventions. Clinician-rated severity of PTSD symptoms, PTSD diagnosis, and full remission (on the Clinician-Administered PTSD Scale) were primary outcomes. Self-reported PTSD symptoms and posttraumatic cognitions were secondary outcomes. Data were analyzed as intent to treat with linear mixed models and generalized estimating equations. Participants in the PE and EMDR conditions showed a greater reduction of PTSD symptoms than those in the WL condition. Between-group effect sizes were 0.78 (P < .001) in PE and 0.65 (P = .001) in EMDR. Participants in the PE condition (56.6%; odds ratio [OR], 3.41; P = .006) or the EMDR condition (60.0%; OR, 3.92; P < .001) were significantly more likely to achieve loss of diagnosis during treatment than those in the WL condition (27.7%). Participants in the PE condition (28.3%; OR, 5.79; P = .01), but not those in the EMDR condition (16.4%; OR, 2.87; P = .10), were more likely to gain full remission than those in the WL condition (6.4%). Treatment effects were maintained at the 6-month follow-up in PE and EMDR. Similar results were obtained regarding secondary outcomes. There were no differences in severe adverse events between conditions (2 in PE, 1 in EMDR, and 4 in WL). The PE therapy and EMDR therapy showed no difference in any of the outcomes and no difference in participant dropout (24.5% in PE and 20.0% in EMDR, P = .57). Standard PE and EMDR protocols are effective, safe, and feasible in patients with PTSD and severe psychotic disorders, including current symptoms. A priori exclusion of individuals with psychosis from evidence-based PTSD treatments may not be justifiable. isrctn.com Identifier: ISRCTN79584912.",van den Berg DP.; de Bont PA.; van der Vleugel BM.; de Roos C.; de Jongh A.; Van Minnen A.; van der Gaag M.,2015.0,10.1001/jamapsychiatry.2014.2637,1,1,
44,Comparison between one-session psychological treatment and benzodiazepine in dental phobia.,"To compare the effects of a single session of psychological treatment and acute administration of benzodiazepine, 50 dental phobic patients were allocated either to psychological treatment, benzodiazepine, or no treatment for anxiety. Psychological treatment consisted of stress management training and imaginal exposure to phobic stimuli with homework assignments. Benzodiazepine was administered 30 min before dental treatment. Both treatment conditions led to less anxiety during dental surgery than did the control condition. Phobic patients in the benzodiazepine condition showed a relapse after dental treatment, whereas those in the psychological treatment condition showed further improvement until the follow-up 2 months later. Of the latter group, 70% continued dental treatment; only 20% and 10% returned in the benzodiazepine and control conditions, respectively.",Thom A.; Sartory G.; Jöhren P.,2000.0,,1,1,
45,Treating PTSD in refugees and asylum seekers within the general health care system. A randomized controlled multicenter study.,"There has been uncertainty about whether refugees and asylum seekers with PTSD can be treated effectively in standard psychiatric settings in industrialized countries. In this study, Narrative Exposure Therapy (NET) was compared to Treatment As Usual (TAU) in 11 general psychiatric health care units in Norway. The focus was on changes in symptom severity and in the diagnostic status for PTSD and depression. Refugees and asylum seekers fulfilling the DSM-IV criteria for PTSD (N = 81) were randomized with an a-priori probability of 2:1 to either NET (N = 51) or TAU (N = 30). The patients were assessed with Clinician Administered PTSD Scale, Hamilton rating scale for depression and the MINI Neuropsychiatric Interview before treatment, and again at one and six months after the completion. Both NET and TAU gave clinically relevant symptom reduction both in PTSD and in depression. NET gave significantly more symptom reduction compared to TAU as well as significantly more reduction in participants with PTSD diagnoses. No difference in treatment efficacy was found between refugees and asylum seekers. The study indicated that refugees and asylum seekers can be treated successfully for PTSD and depression in the general psychiatric health care system; NET appeared to be a promising treatment for both groups.",Stenmark H.; Catani C.; Neuner F.; Elbert T.; Holen A.,2013.0,10.1016/j.brat.2013.07.002,1,1,
46,Cognitive behavior therapy for generalized anxiety disorder among older adults in primary care: a randomized clinical trial.,"Cognitive behavior therapy (CBT) can be effective for late-life generalized anxiety disorder (GAD), but only pilot studies have been conducted in primary care, where older adults most often seek treatment. To examine effects of CBT relative to enhanced usual care (EUC) in older adults with GAD in primary care. Randomized clinical trial recruiting 134 older adults (mean age, 66.9 years) from March 2004 to August 2006 in 2 primary care settings. Treatment was provided for 3 months; assessments were conducted at baseline, posttreatment (3 months), and over 12 months of follow-up, with assessments at 6, 9, 12, and 15 months. Cognitive behavior therapy (n = 70) conducted in the primary care clinics. Treatment included education and awareness, motivational interviewing, relaxation training, cognitive therapy, exposure, problem-solving skills training, and behavioral sleep management. Patients assigned to receive EUC (n = 64) received biweekly telephone calls to ensure patient safety and provide minimal support. Primary outcomes included worry severity (Penn State Worry Questionnaire) and GAD severity (GAD Severity Scale). Secondary outcomes included anxiety ratings (Hamilton Anxiety Rating Scale, Beck Anxiety Inventory), coexistent depressive symptoms (Beck Depression Inventory II), and physical/mental health quality of life (12-Item Short Form Health Survey). Cognitive behavior therapy compared with EUC significantly improved worry severity (45.6 [95% confidence interval {CI}, 43.4-47.8] vs 54.4 [95% CI, 51.4-57.3], respectively; P < .001), depressive symptoms (10.2 [95% CI, 8.5-11.9] vs 12.8 [95% CI, 10.5-15.1], P = .02), and general mental health (49.6 [95% CI, 47.4-51.8] vs 45.3 [95% CI, 42.6-47.9], P = .008). There was no difference in GAD severity in patients receiving CBT vs those receiving EUC (8.6 [95% CI, 7.7-9.5] vs 9.9 [95% CI, 8.7-11.1], P = .19). In intention-to-treat analyses, response rates defined according to worry severity were higher following CBT compared with EUC at 3 months (40.0% [28/70] vs 21.9% [14/64], P = .02). Compared with EUC, CBT resulted in greater improvement in worry severity, depressive symptoms, and general mental health for older patients with GAD in primary care. However, a measure of GAD severity did not indicate greater improvement with CBT. clinicaltrials.gov Identifier: NCT00308724.",Stanley MA.; Wilson NL.; Novy DM.; Rhoades HM.; Wagener PD.; Greisinger AJ.; Cully JA.; Kunik ME.,2009.0,10.1001/jama.2009.458,1,1,
47,The efficacy of videotape feedback for enhancing the effects of exposure-based treatment for social anxiety disorder: a controlled investigation.,"Correcting patients' faulty beliefs concerning social evaluative threats is the hallmark of cognitive-behavioral treatment of social anxiety disorder. The current study examined the efficacy of two videotape feedback procedures as adjuncts to exposure-based treatment. Participants suffering from social phobia (N=77) were randomly assigned to one of four conditions: (a) credible placebo treatment (PLA); (b) exposure + no feedback (EXP); (c) exposure + videotape feedback of performance (PER); or (d) exposure + videotape feedback of audience responses (AUD). Contrary to prediction, the videotape feedback procedures did not enhance the effects of exposure-based treatment. Clinical and theoretical implications are discussed.",Smits JA.; Powers MB.; Buxkamper R.; Telch MJ.,2006.0,10.1016/j.brat.2006.01.001,1,1,
48,Effects of cognitive behavioral therapy with relaxation vs. Imagery rescripting on test anxiety: A randomized controlled trial.,"Background: Test anxiety is a common condition in students, which may lead to impaired academic performance as well as to distress. The primary objective of this study was to evaluate the effectiveness of two cognitive-behavioral interventions designed to reduce test anxiety. Test anxiety in the participants was diagnosed as social or specific phobia according to DSM-IV. Subsequently subjects were randomized to three groups: a moderated self-help group, which served as a control group, and two treatment groups, where either relaxation techniques or imagery rescripting were applied. Methods: Students suffering from test anxiety were recruited at two German universities (n = 180). The randomized controlled design comprised three groups which received test anxiety treatment in weekly three-hour sessions over a period of five weeks. Treatment outcome was assessed with a test anxiety questionnaire, which was administered before and after treatment, as well as in a six-month follow-up. Results: A repeated-measures ANOVA for participants with complete data (n = 59) revealed a significant reduction of test anxiety from baseline to six-month follow-up in all three treatment groups (p < .001). Limitations: Participants were included if they had a clinical diagnosis of test anxiety. The sample may therefore represent only more severe forms of text anxiety . Moreover, the sample size in this study was small, the numbers of participants per group differed, and treatment results were based on self-report. Due to the length of the treatment, an implementation of the group treatments used in this study might not be feasible in all settings. Conclusions: Group treatments constitute an effective method of treating test anxiety, e.g. in university settings. Imagery rescripting may particularly contribute to treatment efficacy. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Reiss, Neele; Warnecke, Irene; Tolgou, Theano; Krampen, Dorothea; Luka-Krausgrill, Ursula; Rohrmann, Sonja; Aderka, Aderka, Arntz, Arntz, Bijl, Cassady, Chapell, Cizek, Cuijpers, Enders, Ergene, Farrell, Fehm, Frets, Gould, Hackmann, Hembree, Hirai, Hirsch, Hodapp, Hofmann, Holmes, Jacobson, Lee, Lewis, Marrs, Messer, Mortberg, Nilsson, Panayiotou, Powers, Rodebaugh, Sani, Sapp, Spielberger, Spielberger, Stangier, Stopa, Wells, Wild, Wild, Wittchen, Yalom, Young, Zeidner",2017.0,,1,1,
49,Brief strategic therapy in patients with social phobia with or without personality disorder.,"The aim of this study was to test the effects of brief strategic therapy in people with social phobia distinguished by the presence or absence of DSM anxious personality disorder. A group of 120 outpatients with social phobia, 60 of them with comorbid DSM anxious personality disorder, were randomly assigned to 10 weeks of brief strategic therapy or minimal supportive therapy. Outcome analyses were conducted on the intent-to-treat sample at posttreatment and 3-month follow-up using self-report interpersonal sensitivity and phobic anxiety measures, and at 6-month follow-up using social phobia diagnostic status. Brief strategic therapy was superior to minimal supportive therapy in patients with social phobia only. It was not significantly better in patients with comorbid personality disorder. It was concluded that 10 weeks of brief strategic therapy shows promise as a cost-effective method for management of social phobia. It has limited value as a method for management of social phobia with personality disorder.",Rakowska JM.,2011.0,10.1080/10503307.2011.581707,1,1,
50,Controlled comparison of pharmacological and psychological treatment of generalized anxiety disorder in primary care.,"A sample of 101 patients with generalized anxiety disorder were randomly allocated to one of five groups--diazepam, placebo, cognitive-behaviour therapy, diazepam plus cognitive-behaviour therapy, or placebo plus cognitive-behaviour therapy--and treated over 10 weeks in a primary care setting. All groups received a similar amount of contact with the psychologist and general practitioner. The greatest improvement in ratings of severity of symptoms and overall change in symptoms occurred with cognitive-behaviour therapy combined with diazepam; cognitive-behaviour therapy alone also performed well and cognitive-behaviour therapy plus placebo performed slightly less well. Diazepam alone showed improvement relative to placebo alone. There was a high level of agreement between ratings by the general practitioners, psychologist, and the patients of the response to treatment. At six months follow-up there was no difference between treatment groups in the proportion of patients receiving psychotropic medication after the end of the study. However, cognitive-behaviour therapy, either alone or in combination with drug or placebo, showed the lowest incidence of referral for psychological or psychiatric treatment at six months follow-up.",Power KG.; Simpson RJ.; Swanson V.; Wallace LA.,1990.0,,1,1,
51,"A comparison of narrative exposure therapy, supportive counseling, and psychoeducation for treating posttraumatic stress disorder in an african refugee settlement.","Little is known about the usefulness of psychotherapeutic approaches for traumatized refugees who continue to live in dangerous conditions. Narrative exposure therapy (NET) is a short-term approach based on cognitive-behavioral therapy and testimony therapy. The efficacy of narrative exposure therapy was evaluated in a randomized controlled trial. Sudanese refugees living in a Ugandan refugee settlement (N = 43) who were diagnosed as suffering from posttraumatic stress disorder (PTSD) either received 4 sessions of NET, 4 sessions of supportive counseling (SC), or psychoeducation (PE) completed in 1 session. One year after treatment, only 29% of the NET participants but 79% of the SC group and 80% of the PE group still fulfilled PTSD criteria. These results indicate that NET is a promising approach for the treatment of PTSD for refugees living in unsafe conditions.",Neuner F.; Schauer M.; Klaschik C.; Karunakara U.; Elbert T.,2004.0,10.1037/0022-006X.72.4.579,1,1,
52,Prolonged exposure therapy for combat- and terror-related posttraumatic stress disorder: a randomized control comparison with treatment as usual.,"Empirically based studies have demonstrated that prolonged exposure therapy effectively reduces posttraumatic stress disorder (PTSD) symptoms in a vast range of traumas, yet reports of the efficacy of such therapies in combat- and terror-related PTSD are scarce. In this article, we examine the efficacy of prolonged exposure therapy in combat- and terror-related PTSD in comparison to treatment as usual (TAU). Between July 2002 and October 2005, 30 patients of a trauma unit within a psychiatric outpatient clinic were recruited and randomized into prolonged exposure versus TAU therapies. Patients were diagnosed with chronic PTSD (Mini-International Neuropsychiatric Interview criteria) related to combat- (n = 19) or terror-related (n = 11) trauma. Main outcome measures included symptoms of PTSD and depression, as measured by the PTSD Symptom Scale-Interview Version and the Beck Depression Inventory. Posttraumatic stress disorder symptom severity was significantly lower in patients who received prolonged exposure therapy in comparison to patients who received TAU (F(1,24) = 35.3, P < .001). Similar results have emerged in measures of depression and state and trait anxiety. In addition, a significant change from pretreatment to follow-up was found for the prolonged exposure group (F(1,14) = 80.5, P < .0001), but not for the TAU group (F(1,10.3) = 0.6, P = .44). Findings indicate that, similar to PTSD related to other types of trauma, prolonged exposure therapy is beneficial in the amelioration of combat- and terror-related PTSD symptoms. In addition, prolonged exposure was superior to TAU in the short- and long-term reduction of PTSD and depression symptoms. clinicaltrials.gov Identifier: NCT00229372.",Nacasch N.; Foa EB.; Huppert JD.; Tzur D.; Fostick L.; Dinstein Y.; Polliack M.; Zohar J.,2011.0,10.4088/JCP.09m05682blu,1,1,
53,A randomized controlled trial of cognitive-behavioral treatment for posttraumatic stress disorder in severe mental illness.,"A cognitive-behavioral therapy (CBT) program for posttraumatic stress disorder (PTSD) was developed to address its high prevalence in persons with severe mental illness receiving treatment at community mental health centers. CBT was compared with treatment as usual (TAU) in a randomized controlled trial with 108 clients with PTSD and either major mood disorder (85%) or schizophrenia or schizoaffective disorder (15%), of whom 25% also had borderline personality disorder. Eighty-one percent of clients assigned to CBT participated in the program. Intent-to-treat analyses showed that CBT clients improved significantly more than did clients in TAU at blinded posttreatment and 3- and 6-month follow-up assessments in PTSD symptoms, other symptoms, perceived health, negative trauma-related beliefs, knowledge about PTSD, and case manager working alliance. The effects of CBT on PTSD were strongest in clients with severe PTSD. Homework completion in CBT predicted greater reductions in symptoms. Changes in trauma-related beliefs in CBT mediated improvements in PTSD. The findings suggest that clients with severe mental illness and PTSD can benefit from CBT, despite severe symptoms, suicidal thinking, psychosis, and vulnerability to hospitalizations.",Mueser KT.; Rosenberg SD.; Xie H.; Jankowski MK.; Bolton EE.; Lu W.; Hamblen JL.; Rosenberg HJ.; McHugo GJ.; Wolfe R.,2008.0,10.1037/0022-006X.76.2.259,1,1,
54,Cognitive processing therapy for veterans with military-related posttraumatic stress disorder.,"Sixty veterans (54 men, 6 women) with chronic military-related posttraumatic stress disorder (PTSD) participated in a wait-list controlled trial of cognitive processing therapy (CPT). The overall dropout rate was 16.6% (20% from CPT, 13% from waiting list). Random regression analyses of the intention-to-treat sample revealed significant improvements in PTSD and comorbid symptoms in the CPT condition compared with the wait-list condition. Forty percent of the intention-to-treat sample receiving CPT did not meet criteria for a PTSD diagnosis, and 50% had a reliable change in their PTSD symptoms at posttreatment assessment. There was no relationship between PTSD disability status and outcomes. This trial provides some of the most encouraging results of PTSD treatment for veterans with chronic PTSD and supports increased use of cognitive- behavioral treatments in this population.",Monson CM.; Schnurr PP.; Resick PA.; Friedman MJ.; Young-Xu Y.; Stevens SP.,2006.0,10.1037/0022-006X.74.5.898,1,1,
55,Comparing two brief psychological interventions to usual care in panic disorder patients presenting to the emergency department with chest pain.,"Panic disorder (PD) is a common, often unrecognized condition among patients presenting with chest pain to the emergency departments (ED). Nevertheless, psychological treatment is rarely initiated. We are unaware of studies that evaluated the efficacy of brief cognitive-behavioural therapy (CBT) for this population. Evaluate the efficacy of two brief CBT interventions in PD patients presenting to the ED with chest pain. Fifty-eight PD patients were assigned to either a 1-session CBT-based panic management intervention (PMI) (n = 24), a 7-session CBT intervention (n = 19), or a usual-care control condition (n = 15). A structured diagnostic interview and self-reported questionnaires were administered at pre-test, post-test, 3- and 6-month follow-ups. Statistical analysis showed significant reduction in PD severity following both interventions compared to usual care control condition, but with neither showing superiority compared to the other. CBT-based interventions as brief as a single session initiated within 2 weeks after an ED visit for chest pain appear to be effective for PD. Given the high prevalence of PD in emergency care settings, greater efforts should be made to implement these interventions in the ED and/or primary care setting.",Lessard MJ.; Marchand A.; Pelland MÈ.; Belleville G.; Vadeboncoeur A.; Chauny JM.; Poitras J.; Dupuis G.; Fleet R.; Foldes-Busque G.; Lavoie KL.,2012.0,10.1017/S1352465811000506,1,1,
56,Multisite randomized trial of behavioral interventions for women with co-occurring PTSD and substance use disorders.,"The authors compared the effectiveness of the Seeking Safety group, cognitive-behavioral treatment for substance use disorder and posttraumatic stress disorder (PTSD), to an active comparison health education group (Women's Health Education [WHE]) within the National Institute on Drug Abuse's Clinical Trials Network. The authors randomized 353 women to receive 12 sessions of Seeking Safety (M = 6.2 sessions) or WHE (M = 6.0 sessions) with follow-up assessment 1 week and 3, 6, and 12 months posttreatment. Primary outcomes were the Clinician Administered PTSD Scale (CAPS), the PTSD Symptom Scale-Self Report (PSS-SR), and a substance use inventory (self-reported abstinence and percentage of days of use over 7 days). Intention-to-treat analysis showed large, clinically significant reductions in CAPS and PSS-SR symptoms (d = 1.94 and 1.12, respectively) but no reliable difference between conditions. Substance use outcomes were not significantly different over time between the two treatments and at follow-up showed no significant change from baseline. Study results do not favor Seeking Safety over WHE as an adjunct to substance use disorder treatment for women with PTSD and reflect considerable opportunity to improve clinical outcomes in community-based treatments for these co-occurring conditions.",Hien DA.; Wells EA.; Jiang H.; Suarez-Morales L.; Campbell AN.; Cohen LR.; Miele GM.; Killeen T.; Brigham GS.; Zhang Y.; Hansen C.; Hodgkins C.; Hatch-Maillette M.; Brown C.; Kulaga A.; Kristman-Valente A.; Chu M.; Sage R.; Robinson JA.; Liu D.; Nunes EV.,2009.0,10.1037/a0016227,1,1,
57,Randomized clinical trial of brief eclectic psychotherapy for police officers with posttraumatic stress disorder.,"The authors report on a randomized, controlled clinical trial on the treatment of posttraumatic stress disorder (PTSD), comparing manualized psychotherapy to wait-list control. This is the first study to evaluate Brief Eclectic Psychotherapy (BEP), which combines cognitive-behavioral and psychodynamic approaches within one treatment method. Forty-two police officers with the diagnosis of PTSD participated in the study; 22 were randomly assigned to the treatment group and 20 to the wait-list control group. Assessments of PTSD and comorbid conditions were made 1 week before treatment, after treatment session 4, upon termination of treatment (16 sessions), and at follow-up 3 months later. As expected, no significant differences between groups were observed at pretest or at session 4. At posttest and at follow-up, BEP had produced significant improvement in PTSD, in work resumption, and in some comorbid conditions.",Gersons BP.; Carlier IV.; Lamberts RD.; van der Kolk BA.,2000.0,10.1023/A:1007793803627,1,1,
58,Treating low-income and minority women with posttraumatic stress disorder: a pilot study comparing prolonged exposure and treatment as usual conducted by community therapists.,"Twenty-one female psychiatric outpatients with chronic posttraumatic stress disorder (PTSD) are randomly assigned to prolonged exposure (PE; n = 9) for PTSD or treatment as usual (TAU; n = 12). Participants are predominantly low income and African American with complex trauma and psychiatric histories. Treatment is delivered by community therapists with no prior training in behavior therapy for anxiety disorders. Clients who completed PE show a greater improvement in PTSD symptoms, general anxiety, and depression than clients who completed TAU. These findings provide preliminary evidence suggesting that PE is an effective treatment for core PTSD symptoms, even when delivered by community therapists in a front-line services clinic.",Feske U.,2008.0,10.1177/0886260507313967,1,1,
59,Delivery of self training and education for stressful situations (DESTRESS-PC): a randomized trial of nurse assisted online self-management for PTSD in primary care,"ER OBJECTIVE: This randomized controlled trial examined the effectiveness of a nurse assisted online cognitive-behavioral self-management intervention for war-related posttraumatic stress disorder (PTSD), compared to optimized usual primary care PTSD Treatment (OUC) to reduce PTSD symptoms.METHOD: Participants were 80 veterans of recent military conflicts with PTSD as assessed by the PTSD Checklist (PCL) seeking primary care treatment at one of three Veterans Affairs (VA) and four Army clinics. DESTRESS-PC consisted of logins to a secure website three times per week for 6 weeks with monitoring by a study nurse. All participants received nurse care management in the form of phone check-ins every two weeks and feedback to their primary care providers. Blinded raters assessed outcomes 6, 12, and 18 weeks post-randomization.RESULTS: DESTRESS-PC was associated with a significantly greater decrease in PTSD symptoms compared to OUC (F(3, 186)=3.72, p=.012). The effect was largest at the 12-week assessment (?PCL=12.6±16.6 versus 5.7±12.5, p<0.05) with the treatment effect disappearing by the 18-week follow-up. Notably, there was a dose effect; number of logins correlated significantly with PTSD outcomes, with more logins associated with greater PTSD symptom improvement. None of the secondary outcomes (depression, anxiety, somatic symptoms, and functional status) showed statistically significant improvement; however, the treatment effect on depression approached significance (F(3, 186)=2.17, p=.093).CONCLUSIONS: DESTRESS-PC shows promise as a means of delivering effective, early PTSD treatment in primary care. Larger trials are needed.","Engel, C C; Litz, B; Magruder, K M; Harper, E; Gore, K; Stein, N; Yeager, D; Liu, X; Coe, T R",2015.0,10.1016/j.genhosppsych.2015.04.007,1,1,
60,A randomized controlled trial of 7-day intensive and standard weekly cognitive therapy for PTSD and emotion-focused supportive therapy.,"Psychological treatments for posttraumatic stress disorder (PTSD) are usually delivered once or twice a week over several months. It is unclear whether they can be successfully delivered over a shorter period of time. This clinical trial had two goals: to investigate the acceptability and efficacy of a 7-day intensive version of cognitive therapy for PTSD and to investigate whether cognitive therapy has specific treatment effects by comparing intensive and standard weekly cognitive therapy with an equally credible alternative treatment. Patients with chronic PTSD (N=121) were randomly allocated to 7-day intensive cognitive therapy for PTSD, 3 months of standard weekly cognitive therapy, 3 months of weekly emotion-focused supportive therapy, or a 14-week waiting list condition. The primary outcomes were change in PTSD symptoms and diagnosis as measured by independent assessor ratings and self-report. The secondary outcomes were change in disability, anxiety, depression, and quality of life. Evaluations were conducted at the baseline assessment and at 6 and 14 weeks (the posttreatment/wait assessment). For groups receiving treatment, evaluations were also conducted at 3 weeks and follow-up assessments at 27 and 40 weeks after randomization. All analyses were intent-to-treat. At the posttreatment/wait assessment, 73% of the intensive cognitive therapy group, 77% of the standard cognitive therapy group, 43% of the supportive therapy group, and 7% of the waiting list group had recovered from PTSD. All treatments were well tolerated and were superior to waiting list on nearly all outcome measures; no difference was observed between supportive therapy and waiting list on quality of life. For primary outcomes, disability, and general anxiety, intensive and standard cognitive therapy were superior to supportive therapy. Intensive cognitive therapy achieved faster symptom reduction and comparable overall outcomes to standard cognitive therapy. Cognitive therapy for PTSD delivered intensively over little more than a week was as effective as cognitive therapy delivered over 3 months. Both had specific effects and were superior to supportive therapy. Intensive cognitive therapy for PTSD is a feasible and promising alternative to traditional weekly treatment.",Ehlers A.; Hackmann A.; Grey N.; Wild J.; Liness S.; Albert I.; Deale A.; Stott R.; Clark DM.,2014.0,10.1176/appi.ajp.2013.13040552,1,1,
61,"A randomized controlled trial of cognitive therapy, a self-help booklet, and repeated assessments as early interventions for posttraumatic stress disorder.","It is unclear what psychological help should be offered in the aftermath of traumatic events. Similarly, there is a lack of clarity about the best way of identifying people who are unlikely to recover from early posttraumatic symptoms without intervention. To determine whether cognitive therapy or a self-help booklet given in the initial months after a traumatic event is more effective in preventing chronic posttraumatic stress disorder (PTSD) than repeated assessments. Randomized controlled trial. Patients Motor vehicle accident survivors (n = 97) who had PTSD in the initial months after the accident and met symptom criteria that had predicted persistent PTSD in a large naturalistic prospective study of a comparable population. Patients were recruited from attendees at local accident and emergency departments. Patients completed a 3-week self-monitoring phase. Those who did not recover with self-monitoring (n = 85) were randomly assigned to receive cognitive therapy (n = 28), a self-help booklet based on principles of cognitive behavioral therapy (n = 28), or repeated assessments (n = 29). Symptoms of PTSD as assessed by self-report and independent assessors unaware of the patient's allocation. Main assessments were at 3 months (posttreatment, n = 80) and 9 months (follow-up, n = 79). Twelve percent (n = 12) of patients recovered with self-monitoring. Cognitive therapy was more effective in reducing symptoms of PTSD, depression, anxiety, and disability than the self-help booklet or repeated assessments. At follow-up, fewer cognitive therapy patients (3 [11%]) had PTSD compared with those receiving the self-help booklet (17 [61%]; odds ratio, 12.9; 95% confidence interval, 3.1-53.1) or repeated assessments (16 [55%]; odds ratio, 10.3; 95% confidence interval, 2.5-41.7). There was no indication that the self-help booklet was superior to repeated assessments. On 2 measures, high end-state functioning at follow-up and request for treatment, the outcome for the self-help group was worse than for the repeated assessments group. Cognitive therapy is an effective intervention for recent-onset PTSD. A self-help booklet was not effective. The combination of an elevated initial symptom score and failure to improve with self-monitoring was effective in identifying a group of patients with early PTSD symptoms who were unlikely to recover without intervention.",Ehlers A.; Clark DM.; Hackmann A.; McManus F.; Fennell M.; Herbert C.; Mayou R.,2003.0,10.1001/archpsyc.60.10.1024,1,1,
62,Does cognitive-behavioural therapy influence the long-term outcome of generalized anxiety disorder? An 8-14 year follow-up of two clinical trials.,"Generalized anxiety disorder is a common condition of excessive worry and tension which tends to run a chronic course associated with significant psychiatric and medical problems. Cognitive behaviour therapy (CBT) has been shown to be of clinical value in about 50% of cases with treatment gains maintained over follow-up periods ranging from 6 to 12 months. The potential value of CBT over the longer term has not been subject to rigorous investigation. Results are reported of 8-14 year follow-up of two randomized controlled trials of cognitive-behaviour therapy for generalized anxiety disorder employing structured interview with an assessor blind to initial treatment condition. Comparison groups included medication and placebo in one study based in primary care, and analytical psychotherapy in the other based in secondary care. Follow-up samples (30% and 55% of trial entrants) were broadly representative of the original cohorts. Overall, 50% of participants were markedly improved of whom 30-40% were recovered (i.e. free of symptoms). Outcome was significantly worse for the study based in secondary care in which the clinical presentation of participants was more complex and severe. For a minority (30-40%), mainly from the secondary care study, outcome was poor. Treatment with CBT was associated with significantly lower overall severity of symptomatology and less interim treatment, in comparison with non-CBT conditions, but there was no evidence that CBT influenced diagnostic status, probability of recovery or patient perceptions of overall improvement. Both CBT and the complexity and severity of presenting problems appear to influence the long-term outcome of GAD.",Durham RC.; Chambers JA.; MacDonald RR.; Power KG.; Major K.,2003.0,,1,1,
63,Randomized clinical trial of telephone-administered cognitive-behavioral therapy to reduce post-traumatic stress disorder and distress symptoms after hematopoietic stem-cell transplantation.,"A significant number of survivors of hematopoietic stem-cell transplantation (HSCT) report enduring adverse effects of treatment, including illness-related post-traumatic stress disorder (PTSD) symptoms and general distress. We report results of a randomized clinical trial that tested the effects of a 10-session, telephone-administered cognitive-behavioral therapy (CBT) intervention on PTSD, depression, and distress symptoms. Survivors who had undergone HSCT 1 to 3 years earlier (N = 408) were assessed for study eligibility. Those who met study eligibility criteria (n = 89) completed a baseline assessment that included a clinical interview and self-report measures of PTSD symptoms (the primary outcome) and depression and general distress (the secondary outcomes). Next, they were randomly assigned to CBT or an assessment-only condition. Survivors in the CBT group completed 10 individual telephone-based CBT sessions (T-CBT) that included strategies to reduce PTSD symptoms, depression, and general distress. Follow-up assessments occurred at 6, 9, and 12 months after the baseline assessment. Linear mixed-model analyses revealed that, compared with HSCT survivors in the assessment-only condition, survivors who completed T-CBT reported fewer illness-related PTSD symptoms, including less avoidance (P < .001) and fewer intrusive thoughts (P < .05) as well as less general distress and fewer depressive symptoms (P < .05) even after controlling for potential demographic and medical covariates. These results were consistent across the three follow-up assessments. A brief, telephone-administered CBT intervention developed for HSCT survivors is an efficacious treatment for reducing illness-related PTSD symptoms and general distress.",DuHamel KN.; Mosher CE.; Winkel G.; Labay LE.; Rini C.; Meschian YM.; Austin J.; Greene PB.; Lawsin CR.; Rusiewicz A.; Grosskreutz CL.; Isola L.; Moskowitz CH.; Papadopoulos EB.; Rowley S.; Scigliano E.; Burkhalter JE.; Hurley KE.; Bollinger AR.; Redd WH.,2010.0,10.1200/JCO.2009.26.8722,1,1,
64,Randomized controlled comparison of cognitive behavior therapy with Rogerian supportive therapy in chronic post-traumatic stress disorder: a 2-year follow-up.,"To date, there have been no studies comparing cognitive behavior therapy (CBT) with Rogerian therapy in post-traumatic stress disorder. Sixty outpatients with DSM-IV chronic post-traumatic stress disorder were randomized into two groups for 16 weekly individual sessions of CBT or Rogerian supportive therapy (ST) at two centers. No medication was prescribed. Measures included the Post-Traumatic Stress Disorder Checklist Scale (PCLS), the Hamilton Anxiety Scale, Beck Depression Inventory, and Quality of Life. The general criterion of improvement (GCI) was a score of less than 44 on the PCLS. Forty-two patients were evaluated at post-test, 38 at week 52 and 25 at week 104. At post-test, the rate of patients leaving the trial due to worsening or lack of effectiveness was significantly higher in the ST group (p = 0.004). At this point, no between-group difference was found on the GCI and any of the rating scales. Intent-to-treat analysis found no difference for the GCI, but patients in the CBT group showed greater improvement on the PCLS and Hamilton Anxiety Scale. Naturalistic follow-up showed sustained improvement without between-group differences at weeks 52 and 104. CBT retained significantly more patients in treatment than ST, but its effects were equivalent to those of ST in the completers. CBT was better in the dimensional intent-to-treat analysis at post-test.",Cottraux J.; Note I.; Yao SN.; de Mey-Guillard C.; Bonasse F.; Djamoussian D.; Mollard E.; Note B.; Chen Y.,2008.0,10.1159/000112887,1,1,
65,Telephone-Delivered Cognitive Behavioral Therapy and Telephone-Delivered Nondirective Supportive Therapy for Rural Older Adults With Generalized Anxiety Disorder: A Randomized Clinical Trial.,"Generalized anxiety disorder (GAD) is common in older adults; however, access to treatment may be limited, particularly in rural areas. To examine the effects of telephone-delivered cognitive behavioral therapy (CBT) compared with telephone-delivered nondirective supportive therapy (NST) in rural older adults with GAD. Randomized clinical trial in the participants' homes of 141 adults aged 60 years and older with a principal or coprincipal diagnosis of GAD who were recruited between January 27, 2011, and October 22, 2013. Telephone-delivered CBT consisted of as many as 11 sessions (9 were required) focused on recognition of anxiety symptoms, relaxation, cognitive restructuring, the use of coping statements, problem solving, worry control, behavioral activation, exposure therapy, and relapse prevention, with optional chapters on sleep and pain. Telephone-delivered NST consisted of 10 sessions focused on providing a supportive atmosphere in which participants could share and discuss their feelings and did not provide any direct suggestions for coping. Primary outcomes included interviewer-rated anxiety severity (Hamilton Anxiety Rating Scale) and self-reported worry severity (Penn State Worry Questionnaire-Abbreviated) measured at baseline, 2 months' follow-up, and 4 months' follow-up. Mood-specific secondary outcomes included self-reported GAD symptoms (GAD Scale 7 Item) measured at baseline and 4 months' follow-up and depressive symptoms (Beck Depression Inventory) measured at baseline, 2 months' follow-up, and 4 months' follow-up. Among the 141 participants, 70 were randomized to receive CBT and 71 to receive NST. At 4 months' follow-up, there was a significantly greater decline in worry severity among participants in the telephone-delivered CBT group (difference in improvement, -4.07; 95% CI, -6.26 to -1.87; P = .004) but no significant differences in general anxiety symptoms (difference in improvement, -1.52; 95% CI, -4.07 to 1.03; P = .24). At 4 months' follow-up, there was a significantly greater decline in GAD symptoms (difference in improvement, -2.36; 95% CI, -4.00 to -0.72; P = .005) and depressive symptoms (difference in improvement, -3.23; 95% CI, -5.97 to -0.50; P = .02) among participants in the telephone-delivered CBT group. In this trial, telephone-delivered CBT was superior to telephone-delivered NST in reducing worry, GAD symptoms, and depressive symptoms in older adults with GAD. clinicaltrials.gov Identifier: NCT01259596.",Brenes GA.; Danhauer SC.; Lyles MF.; Hogan PE.; Miller ME.,2015.0,10.1001/jamapsychiatry.2015.1154,1,1,
66,Psychological treatments of panic disorder without agoraphobia: cognitive therapy versus applied relaxation.,"This study compared two psychological treatments of panic disorder and tested whether cognitive therapy (CT) was superior to applied relaxation (AR); and whether treatment was superior to waiting. Thirty-six outpatients of the community mental health center with the DSM-III-R diagnosis of panic disorder with no or mild agoraphobia were randomly assigned to CT or AR. Eighteen similar patients who were referred after the treatment conditions were complete constituted a waiting-list group. Treatment consisted of 12 weekly sessions. Patients self-monitored panic attacks during the whole treatment period, and the following 4 weeks, and during 1 week at a half-year follow-up. Questionnaires were filled out before and after treatment, and at 4-week and half-year follow-ups. After the first follow-up additional treatment was provided if clinically indicated. One patient dropped out of AR and was replaced. Treatment was superior to waiting in reducing panic and questionnaire scores. CT was clearly superior to AR in reducing panic frequency, and somewhat less strongly superior to AR in reducing the questionnaire scores. Depending on the assessment point, 77.8-83.3% of the CT patients was panic-free after treatment, compared to 50% of the AR and 27.7% of the waiting-list patients. In conclusion, cognitive therapy for panic is especially effective in reducing the incidence of panic attacks.",Arntz A.; van den Hout M.,1996.0,,1,1,
67,Cognitive therapy versus applied relaxation as treatment of generalized anxiety disorder.,"Cognitive therapy (CT) and applied relaxation (AR) as treatments of generalized anxiety disorder (GAD) were compared in a sample of 45 patients of a community mental health center, randomly allocated to condition. Patients were assessed before and after a 12-session treatment, and at one and six months follow-ups. There was a 20% drop out from CT and 15% from AR (NS), with some drop outs being considerably improved. Both completers and intention-to-treat analyses revealed that both treatments were effective (ESs of composite and specific measures ranging from 0.53 to 1.14). At one-month follow-up AR tended to do better than CT, with CT catching up with AR at six months. Recovery rates and proportions of patients showing reliable change were comparable to other studies on AR and CT, with 55% of CT and 53.3% of AR patients recovered on the STAI-trait at six-month follow-up. These results confirm that both CT and AR are effective treatments for GAD, and also that there is still room for improvement.",Arntz A.,2003.0,,1,1,
68,Comparison of cognitive therapy and relaxation training for panic disorder.,"Current approaches to the treatment of panic disorder (PD) include a treatment package consisting of relaxation training (RT), cognitive therapy (CT), and exposure-based components. In an examination of the separate effects of RT and CT without formally taught exposure of any form, 64 PD patients were assigned randomly to one of these treatment protocols or to a minimal-contact control (MCC) condition. Both RT and CT were superior to the MCC condition on a variety of measures pertaining to panic, global psychological functioning, agoraphobic fear, and other associated fears. A significantly greater percentage of patients were classified as treatment responders (based on a composite index) after CT (82%) and RT (68%), compared with the control group (36%). On measures of agoraphobic fear, CT patients fared slightly better than RT patients. Some support was demonstrated for specific cognitive changes after CT, although treatment specificity was not strongly supported overall. These results are discussed in light of current theories of PD and the presumed importance of exposure in its treatment.",Beck JG.; Stanley MA.; Baldwin LE.; Deagle EA.; Averill PM.,1994.0,,1,1,
69,Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder.,"Nondirective (ND), applied relaxation (AR), and cognitive behavioral (CBT) therapies for generalized anxiety disorder (GAD) were compared. The latter 2 conditions were generally equivalent in outcome but superior to ND at postassessment. The 3 conditions did not differ on several process measures, and ND created the greatest depth of emotional processing. Follow-up results indicated losses in gains in ND, maintained gains in the other 2 conditions, especially CBT, and highest endstate functioning for CBT. AR and CBT thus contain active ingredients in the treatment of GAD; support exists for further development of imagery exposure methods or cognitive therapy because of their likely role in promoting maintenance of change with this disorder. Expectancy for improvement was also associated with outcome, suggesting the need for further research on this construct for understanding the nature of GAD and its amelioration.",Borkovec TD.; Costello E.,1993.0,,1,1,
70,"Cognitive-behavioral therapy, imipramine, or their combination for panic disorder: A randomized controlled trial.","Panic disorder (PD) may be treated with drugs, psychosocial intervention, or both, but the relative and combined efficacies have not been evaluated in an unbiased fashion. To evaluate whether drug and psychosocial therapies for PD are each more effective than placebo, whether one treatment is more effective than the other, and whether combined therapy is more effective than either therapy alone. Randomized, double-blind, placebo-controlled clinical trial conducted in 4 anxiety research clinics from May 1991 to April 1998. A total of 312 patients with PD were included in the analysis. Patients were randomly assigned to receive imipramine, up to 300 mg/d, only (n=83); cognitive-behavioral therapy (CBT) only (n=77); placebo only (n=24); CBT plus imipramine (n=65); or CBT plus placebo (n=63). Patients were treated weekly for 3 months (acute phase); responders were then seen monthly for 6 months (maintenance phase) and then followed up for 6 months after treatment discontinuation. Treatment response based on the Panic Disorder Severity Scale (PDSS) and the Clinical Global Impression Scale (CGI) by treatment group. Both imipramine and CBT were significantly superior to placebo for the acute treatment phase as assessed by the PDSS (response rates for the intent-to-treat [ITT] analysis, 45.8%, 48.7%, and 21.7%; P=.05 and P=.03, respectively), but were not significantly different for the CGI (48. 2%, 53.9%, and 37.5%, respectively). After 6 months of maintenance, imipramine and CBT were significantly more effective than placebo for both the PDSS (response rates, 37.8%, 39.5%, and 13.0%, respectively; P=.02 for both) and the CGI (37.8%, 42.1%, and 13.0%, respectively). Among responders, imipramine produced a response of higher quality. The acute response rate for the combined treatment was 60.3% for the PDSS and 64.1% for the CGI; neither was significantly different from the other groups. The 6-month maintenance response rate for combined therapy was 57.1% for the PDSS (P=.04 vs CBT alone and P=.03 vs imipramine alone) and 56.3% for the CGI (P=.03 vs imipramine alone), but not significantly better than CBT plus placebo in either analysis. Six months after treatment discontinuation, in the ITT analysis CGI response rates were 41.0% for CBT plus placebo, 31.9% for CBT alone, 19.7% for imipramine alone, 13% for placebo, and 26.3% for CBT combined with imipramine. Combining imipramine and CBT appeared to confer limited advantage acutely but more substantial advantage by the end of maintenance. Each treatment worked well immediately following treatment and during maintenance; CBT appeared durable in follow-up. JAMA. 2000;283:2529-2536",Barlow DH.; Gorman JM.; Shear MK.; Woods SW.,2000.0,,1,1,
71,Internet-based psychodynamic versus cognitive behavioral guided self-help for generalized anxiety disorder: a randomized controlled trial.,"Guided Internet-based cognitive behavior therapy (ICBT) has been tested in many trials and found to be effective in the treatment of anxiety and mood disorders. Generalized anxiety disorder (GAD) has also been treated with ICBT, but there are no controlled trials on guided Internet-based psychodynamic treatment (IPDT). Since there is preliminary support for psychodynamic treatment for GAD, we decided to test if a psychodynamically informed self-help treatment could be delivered via the Internet. The aim of the study was to investigate the efficacy of IPDT for GAD and to compare against ICBT and a waiting list control group. A randomized controlled superiority trial with individuals diagnosed with GAD comparing guided ICBT (n = 27) and IPDT (n = 27) against a no treatment waiting list control group (n = 27). The primary outcome measure was the Penn State Worry Questionnaire. While there were no significant between-group differences immediately after treatment on the main outcome measure, both IPDT and ICBT resulted in improvements with moderate to large within-group effect sizes at 3 and 18 months follow-up on the primary measure in the completer analyses. The differences against the control group, although smaller, were still significant for both PDT and CBT when conforming to the criteria of clinically significant improvement. The active treatments did not differ significantly. There was a significant group by time interaction regarding GAD symptoms, but not immediately after treatment. IPDT and ICBT both led to modest symptom reduction in GAD, and more research is needed.",Andersson G.; Paxling B.; Roch-Norlund P.; Östman G.; Norgren A.; Almlöv J.; Georén L.; Breitholtz E.; Dahlin M.; Cuijpers P.; Carlbring P.; Silverberg F.,2012.0,10.1159/000339371,1,1,
72,Web-delivered CBT reduces heavy drinking in OEF-OIF veterans in primary care with symptomatic substance use and PTSD.,"Veterans from conflicts such as the wars in Iraq and Afghanistan commonly return with behavioral health problems, including posttraumatic stress disorder (PTSD) and hazardous or harmful substance use. Unfortunately, many veterans experience significant barriers to receiving evidence-based treatment, including poor treatment motivation, concerns about stigma, and lack of access to appropriate care. To address this need, the current study developed and evaluated a web-based self-management intervention based on cognitive behavioral therapy (CBT), targeting PTSD symptoms and hazardous substance use in a group of symptomatic combat veterans enrolled in VA primary care. Veterans with PTSD/subthreshold PTSD and hazardous substance use were randomized to primary care treatment as usual (TAU; n = 81) or to TAU plus a web-based CBT intervention called Thinking Forward (n = 81). Thinking Forward consisted of 24 sections (approximately 20 minutes each), accessible over 12 weeks. Participants completed baseline and 4-, 8-, 12-, 16-, and 24-week follow-up assessments. Three primary outcomes of PTSD, alcohol and other drug use, and quality of life were examined. Significant treatment effects were found for heavy drinking, but not for PTSD or quality of life. The effect of the intervention on heavy drinking was mediated by intervening increases in coping, social support, self-efficacy, and hope for the future. These results demonstrate the promise of a web-based, self-management intervention for difficult-to-engage OEF/OIF veterans with behavioral health and substance use concerns. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Acosta, Michelle C; Possemato, Kyle; Maisto, Stephen A; Marsch, Lisa A; Barrie, Kimberly; Lantinga, Larry; Fong, Chunki; Xie, Haiyi; Grabinski, Michael; Rosenblum, Andrew; Babor, Babor, Back, Beck, Bickel, Blake, Bradley, Breslin, Brief, Carroll, Carroll, Condiotte, Connor, Danaher, DeMarce, Dunn, Erbes, Fals-Stewart, Grubaugh, Hayes, Hellstrom, Hellstrom, Helmer, Hendricks, Hoge, Hoge, Jacobsen, Jakupcak, Jakupcak, Kaskutas, Khantzian, Kiluk, Kleim, Klein, Knaevelsrud, Kuester, Lee, Litt, Litt, Litz, MacKinnon, Magura, Maisto, Marsch, McCauley, McDevitt-Murphy, McGovern, Morgenstern, Morland, Muresan, Murphy, Newman, Pietrzak, Possemato, Prins, Riper, Rollnick, Roy-Byrne, Schnurr, Seal, Seal, Sheehan, Sherbourne, Skinner, Sobell, Stecker, Stein, Weathers, Weathers, Wilson, Wooten, Zlotnick",2017.0,,1,1,
73,Behavioral Treatment of Panic Disorder ,,,1989.0,,1,1,
74,Mindfulness-based cognitive therapy v. group psychoeducation for people with generalised anxiety disorder: Randomised controlled trial.,"Background: Research suggests that an 8-week mindfulness-based cognitive therapy (MBCT) course may be effective for generalised anxiety disorder (GAD). Aims: To compare changes in anxiety levels among participants with GAD randomly assigned to MBCT, cognitive-behavioural therapy-based psychoeducation and usual care. Method: In total, 182 participants with GAD were recruited (trial registration number: CUHK_CCT00267) and assigned to the three groups and followed for 5 months after baseline assessment with the two intervention groups followed for an additional 6 months. Primary outcomes were anxiety and worry levels. Results: Linear mixed models demonstrated significant group x time interaction (F(4,148) = 5.10, P = 0.001) effects for decreased anxiety for both the intervention groups relative to usual care. Significant group6time interaction effects were observed for worry and depressive symptoms and mental health-related quality of life for the psychoeducation group only. Conclusions: These results suggest that both of the interventions appear to be superior to usual care for the reduction of anxiety symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wong, Samuel Yeung Shan; Yip, Benjamin Hon Kei; Mak, Winnie Wing Sze; Mercer, Stewart; Cheung, Eliza Yee Lai; Ling, Candy Yuet Man; Lui, Wacy Wai Sze; Tang, Wai Kwong; Lo, Herman Hay Ming; Wu, Justin Che Yuen; Lee, Tatia Mei Chun; Gao, Ting; Griffiths, Sian M; Chan, Peter Hoi Sing; Ma, Helen Shuk Wah; Angrist, Arch, Baer, Beck, Beck, Cheng, Cheung, Chiesa, Chiesa, Chiesa, Craigie, Cuijpers, Dodd, Dunn, Evans, Fjorback, Frangakis, Greenberg, Hernan, Hoge, Hou, Kabat-Zinn, Kabat-Zinn, Kam, Kessler, Kim, Koszycki, Lam, Ledesma, Meyer, Park, Segal, Spiter, Sundquist, Vollestad, Vollestad, Waters, Wetherell, White, Williams, Wong, Yook, Zhong",2016.0,,0,1,
75,Treatment of obsessions: a randomized controlled trial.,"This study tested Rachman's cognitive behavioral method for treating obsessions not accompanied by prominent overt compulsions. The cognitive behavioral treatment was compared to waitlist control and an active and credible comparison of stress management training (SMT). Of the 73 adults who were randomized, 67 completed treatment, and 58 were available for one-year follow-up. The active treatments, compared to waitlist, resulted in substantially lower YBOCS scores, OCD-related cognitions and depression as well as improved social functioning. Overall, CBT and SMT showed large and similar reductions in symptoms. Pre-post effect sizes on YBOCS Obsessions for CBT and SMT completers was d = 2.34 and 1.90, respectively. Although CBT showed small advantages over SMT on some symptom measures immediately after treatment, these differences were no longer apparent in the follow-up period. CBT resulted in larger changes on most OCD-related cognitions compared to SMT. The cognitive changes were stable at 12 months follow-up, but the differences in the cognitive measures faded. The robust and enduring effects of both treatments contradict the long-standing belief that obsessions are resistant to treatment.",Whittal ML.; Woody SR.; McLean PD.; Rachman SJ.; Robichaud M.,2010.0,10.1016/j.brat.2009.11.010,0,1,
76,The Nottingham study of neurotic disorder: comparison of drug and psychological treatments.,"210 psychiatric outpatients with generalised anxiety disorder (71), or panic disorder (74), or dysthymic disorder (65) diagnosed by an interview schedule for DSM-III were allocated by constrained randomisation to one of five treatments: diazepam (28), dothiepin (28), placebo (28), cognitive and behaviour therapy (84), and a self-help treatment programme (42). All treatments were given for 6 weeks and then withdrawn by 10 weeks. Ratings of psychopathology were made by psychiatric assessors blind to both treatment and diagnosis before treatment and at 2, 4, 6, and 10 weeks after randomisation. 18 patients had insufficient data for analysis because of early drop-out. There were no important differences in treatment response between the diagnostic groups, but diazepam was less effective than dothiepin, cognitive and behaviour therapy, or self-help, these three treatments being of similar efficacy. Significantly more patients in the placebo group took additional psychotropic drugs in the 10 week period, and those allocated to dothiepin and cognitive and behaviour therapy took the least.",Tyrer P.; Seivewright N.; Murphy S.; Ferguson B.; Kingdon D.; Barczak P.; Brothwell J.; Darling C.; Gregory S.; Johnson AL.,1988.0,,0,1,
77,"Cognitive , Behavioral , and Psychophysiological Treatments of Agoraphobia : A Comparative Outcome Investigation The cognitive dimensions of agoraphobia have generated much theoretical",,"Testa, Sandra",1988.0,,0,1,
78,Efficacy of structured approach therapy in reducing PTSD in returning veterans: A randomized clinical trial.,"The U.S. military deployed in support to Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) show high rates of posttraumatic stress disorder (PTSD) and relationship, partner, and parenting distress. Given the pervasive effect of combat-related PTSD on returning veterans and its effect on their loved ones, the investigators have developed a couples-based treatment, structured approach therapy (SAT), to reduce PTSD while simultaneously decreasing relationship and partner distress. This study presents treatment outcome data measuring PTSD and relationship outcomes from a randomized clinical trial (RCT) comparing SAT, a manualized 12-session novel couples-based PTSD treatment, to a manualized 12-session couples-based educational intervention (PTSD Family Education [PFE]). Data were collected from 57 returning veterans meeting Diagnostic and Statistical Manual of Mental Disorders (fourth edition, text revision; DSM-IV-TR) criteria for PTSD and their cohabiting partners; data collection was scheduled for pretreatment, posttreatment, and 3-month follow-up. Findings from an intent-to-treat analysis revealed that veterans receiving SAT showed significantly greater reductions in self-rated (PTSD Checklist; p < .0006) and Clinician-Administered PTSD Scale (CAPS)-rated PTSD (p < .0001) through the 3-month follow-up compared with veterans receiving PFE; 15 of 29 (52%) veterans receiving SAT and 2 of 28 (7%) receiving PFE no longer met DSM-IV-TR criteria for PTSD. Furthermore, SAT was associated with significant improvements in veteran relationship adjustment, attachment avoidance, and state anxiety. Partners showed significant reductions in attachment anxiety. This couples-based treatment for combat-related PTSD appears to have a strong therapeutic effect on combat-related PTSD in recently returned veterans.",Sautter FJ.; Glynn SM.; Cretu JB.; Senturk D.; Vaught AS.,2015.0,10.1037/ser0000032,0,1,
79,Intensive cognitive-behavioral group treatment (CBGT) of social phobia: a randomized controlled study.,"The effects of intensive cognitive-behavioral group treatment (CBGT) for social phobia (DSM-IV) were studied in 26 patients randomly assigned either to a treatment group (TG) or to a 6-month waiting list control group (WG). Treatment involved 2 weeks of daily treatment sessions separated by 1 week of homework assignments. TG was superior to WG at all assessment points, i.e., at 3 weeks and at 3 and 6 months of post-treatment. After 6 months, significant treatment effects were found in the majority of social phobia measures indicating decreased levels of social anxiety and avoidance, safety-behaviors and symptoms influence on daily life. The WG received treatment following the waiting list period and was combined with the TG in order to evaluate the outcome in a larger sample. Treatment gains at 3 weeks were maintained or improved at 1-year follow-up. Average effect sizes of social phobia measures ranged from 0.56 at post-treatment, 0.68 at 3 months and 0.81 at 6 months and 1 year, respectively.",Mörtberg E.; Karlsson A.; Fyring C.; Sundin O.,2006.0,10.1016/j.janxdis.2005.07.005,0,1,
80,Role of Exposure Homework in Phobia Reduction : A Controlled Study,,"Marks, Isaac M",1992.0,,0,1,
81,A comparative treatment outcome study of social phobia,,"Lucas, RA",1994.0,,0,1,
82,Group CBT versus MBSR for social anxiety disorder: A randomized controlled trial.,"The goal of this study was to investigate treatment outcome and mediators of cognitive-behavioral group therapy (CBGT) versus mindfulness-based stress reduction (MBSR) versus waitlist (WL) in patients with generalized social anxiety disorder (SAD). One hundred eight unmedicated patients (55.6% female; mean age = 32.7 years, SD = 8.0; 43.5% Caucasian, 39% Asian, 9.3% Hispanic, 8.3% other) were randomized to CBGT versus MBSR versus WL and completed assessments at baseline, posttreatment/WL, and at 1-year follow-up, including the Liebowitz Social Anxiety Scale-Self-Report (primary outcome; Liebowitz, 1987) as well as measures of treatment-related processes. Linear mixed model analysis showed that CBGT and MBSR both produced greater improvements on most measures compared with WL. Both treatments yielded similar improvements in social anxiety symptoms, cognitive reappraisal frequency and self-efficacy, cognitive distortions, mindfulness skills, attention focusing, and rumination. There were greater decreases in subtle avoidance behaviors following CBGT than MBSR. Mediation analyses revealed that increases in reappraisal frequency, mindfulness skills, attention focusing, and attention shifting, and decreases in subtle avoidance behaviors and cognitive distortions, mediated the impact of both CBGT and MBSR on social anxiety symptoms. However, increases in reappraisal self-efficacy and decreases in avoidance behaviors mediated the impact of CBGT (vs. MBSR) on social anxiety symptoms. CBGT and MBSR both appear to be efficacious for SAD. However, their effects may be a result of both shared and unique changes in underlying psychological processes.",Goldin PR.; Morrison A.; Jazaieri H.; Brozovich F.; Heimberg R.; Gross JJ.,2016.0,10.1037/ccp0000092,0,1,
83,A treatment model for the effectiveness of dialectical behavioral therapy and prolonged exposure for post-traumatic stress disorder in treating borderline personality disorder.,"Dr. Marsha Linehan created the term, ""A Life Worth Living"". This term is the overarching end goal in treating individuals who are suffering from chronic depression, suicidal ideation and Borderline Personality Disorder. Although research has shown a correlation between Post-Traumatic Stress Disorder and trauma among individuals with Borderline Personality Disorder no studies have specifically evaluated the treatment of PTSD in a BPD population. Recently, it has been shown to be effective to do Prolonged Exposure (PE) with these individuals in conjunction with Dialectical Behavioral Therapy (DBT). In this dissertation, the topic and its effectiveness will be addressed. The purpose of this dissertation is to view the effectiveness of using Dialectical Behavioral Therapy with Prolonged Exposure to treat individuals with Borderline Personality Disorder and complex Post Traumatic Stress Disorder through the use of a treatment model. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Ghadishah, Jennifer",2018.0,,0,1,
84,An evaluation of three brief programs for facilitating recovery after assault.,"Ninety female recent assault survivors who met symptom criteria for posttraumatic stress disorder (PTSD) were randomized to one of three interventions: Brief Cognitive Behavioral Intervention, which focused on processing the traumatic event (B-CBT); assessment condition (AC); or supportive counseling (SC). Within 4 weeks of an assault, participants met weekly with a therapist for four 2-hr sessions. Across all interventions, participants reported decreases in PTSD symptoms, depression, and anxiety over time. At postintervention, participants in B-CBT reported greater decreases in self-reported PTSD severity and a trend toward lower anxiety than those in SC. At 3-month follow-up, participants in B-CBT evidenced lower general anxiety than those in SC and a trend toward lower self-reported PTSD severity. At last available follow-up (on average, 9-months postassault), all three interventions were generally similar in outcome. These findings suggest that a trauma-focused intervention aimed at those with severe PTSD symptoms after an assault can accelerate recovery.",Foa EB.; Zoellner LA.; Feeny NC.,2006.0,10.1002/jts.20096,0,1,
85,Concurrent varenicline and prolonged exposure for patients with nicotine dependence and PTSD: A randomized controlled trial.,"Prevalence of smoking among individuals with posttraumatic stress disorder (PTSD) is disproportionately high, and PTSD is associated with especially poor response to smoking cessation treatment. The current study examined whether integrating treatments for smoking cessation (varenicline plus smoking cessation counseling; VARCC) and PTSD (prolonged exposure therapy; PE) enhances smoking outcomes among smokers diagnosed with PTSD. 142 adults with nicotine dependence (ND) and PTSD were randomized to a treatment program consisting of varenicline, smoking cessation counseling, and PE (VARCC + PE) or to VARCC only. Seven-day point prevalence abstinence (PPA) at posttreatment (3-months postquit day) and follow-up (6-months postquit day), verified by serum cotinine levels and exhaled carbon monoxide, was the primary smoking outcome. Psychological outcomes were PTSD and depression severity. Mixed effects models included baseline PTSD severity as a moderator of treatment condition effects. Overall, VARCC + PE participants did not show greater PPA than VARCC participants. However, treatment effects were moderated by baseline PTSD severity. For participants with moderate and high PTSD severity, VARCC + PE led to significantly higher PPA than VARCC alone (ps<.05). No differences between treatment conditions emerged for participants with low baseline PTSD severity. Participants who received PE showed significantly greater reduction of PTSD and depression symptoms than those who did not receive PE. Integrating psychological treatment for PTSD and smoking cessation treatment enhances smoking cessation for participants with moderate or severe PTSD symptom severity, but does not enhance smoking cessation for participants with low baseline PTSD severity. (PsycINFO Database Record",Foa EB.; Asnaani A.; Rosenfield D.; Zandberg LJ.; Gariti P.; Imms P.,2017.0,10.1037/ccp0000213,0,1,
86, Testimony Therapy With Ritual: a Pilot Randomized Controlled Trial," Testimony therapy can provide low‐cost, brief, simple, and culturally adaptable psychosocial services in low‐income countries (Agger, Raghuvanshi, Khan, Polatin, & Laursen, 2009). Nonetheless, there have been no well‐controlled studies of testimony therapy. We report the analyses of a randomized controlled trial designed to assess the effectiveness of testimony therapy plus a culturally adapted ceremony in reducing mental health symptoms among Khmer Rouge torture survivors from across Cambodia. Using multilevel modeling, we compared symptoms of posttraumatic stress disorder, anxiety, and depression between a treatment (n = 45) and a control group (n = 43) at baseline, 3 months, and 6 months. We found that testimony therapy plus ceremony significantly reduced symptoms of posttraumatic stress disorder (d = 0.49), anxiety (d = 0.44), and depression (d = 0.53)."," Esala, JJ;  Taing, S",2017.0, 10.1002/jts.22163,0,1,
87," Prolonged exposure and EMDR for PTSD v. a PTSD waiting-list condition: effects on symptoms of psychosis, depression and social functioning in patients with chronic psychotic disorders"," BACKGROUND: In patients with psychotic disorders, the effects of psychological post‐traumatic stress disorder (PTSD) treatment on symptoms of psychosis, depression and social functioning are largely unknown METHOD: In a single‐blind randomized controlled trial (RCT) 155 outpatients in treatment for psychosis (61.3% schizophrenic disorder, 29% schizoaffective disorder) were randomized to eight sessions prolonged exposure (PE; n = 53) or eye movement desensitization and reprocessing (EMDR) (n = 55), or a waiting‐list condition (WL, n = 47) for treatment of their co‐morbid PTSD. Measures were performed on (1) psychosis: severity of delusions (PSYRATS‐DRS), paranoid thoughts (GPTS), auditory verbal hallucinations (PSYRATS‐AHRS), and remission from psychotic disorder (SCI‐SR‐PANSS); (2) depression (BDI‐II); (3) social functioning (PSP). Outcomes were compared at baseline, post‐treatment, 6‐month follow‐up and over all data points. RESULTS: Both PE and EMDR were significantly associated with less severe paranoid thoughts post‐treatment and at 6‐month follow‐up, and with more patients remitting from schizophrenia, at post‐treatment (PE and EMDR) and over time (PE). Moreover, PE was significantly associated with a greater reduction of depression at post‐treatment and at 6‐month follow‐up. Auditory verbal hallucinations and social functioning remained unchanged. CONCLUSIONS: In patients with chronic psychotic disorders PE and EMDR not only reduced PTSD symptoms, but also paranoid thoughts. Importantly, in PE and EMDR more patients accomplished the status of their psychotic disorder in remission. Clinically, these effects are highly relevant and provide empirical support to the notion that delivering PTSD treatment to patients with psychotic disorders and PTSD deserves increasing recognition and acceptance among clinicians."," de Bont, PA;  van den Berg, DP;  van der Vleugel, BM;  de Roos, C;  de Jongh, A;  van der Gaag, M;  van Minnen, AM",2016.0, 10.1017/S0033291716001094,0,1,
88,"Memory functions, alprazolam and exposure therapy: a controlled longitudinal study of agoraphobia with panic disorder.","Benzodiazepines (BZs) produce transient anterograde amnesia when given to normal subjects. The present longitudinal study assessed whether BZs impair memory functions in a clinically anxious group. Eighty-two agoraphobics with panic disorder were randomly allocated to one of four treatment groups resulting from a combination of two drug treatments (alprazolam or placebo) and two psychological treatments (exposure or relaxation). Of these, 38 subjects were assessed on a range of objective and subjective indices of memory and mood at three time points: before treatment, after 8 weeks of treatment and again at 24 weeks when patients had been free of medication from 5-8 weeks. Alprazolam produced pronounced impairments on a word recall task. At the 24-week medication-free follow-up, alprazolam patients were still impaired on the task compared with placebo patients. Alprazolam did not impair performance on an implicit memory task and did not affect digit span. Differences between psychological treatments emerged mainly in subjective memory effects. Findings are discussed in terms of the specificity of BZ-induced amnesia and differential tolerance to the varying effects of BZs. Implications are drawn out for the patient's ability to function optimally in daily life while taking alprazolam.",Curran HV.; Bond A.; O'Sullivan G.; Bruce M.; Marks I.; Lelliot P.; Shine P.; Lader M.,1994.0,,0,1,
89,Disorder-specific impact of coordinated anxiety learning and management treatment for anxiety disorders in primary care.,"Anxiety disorders commonly present in primary care, where evidence-based mental health treatments often are unavailable or suboptimally delivered. To compare evidence-based treatment for anxiety disorders with usual care (UC) in primary care for principal and comorbid generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (SAD), and posttraumatic stress disorder (PTSD). A randomized controlled trial comparing the Coordinated Anxiety Learning and Management (CALM) intervention with UC at baseline and at 6-, 12-, and 18-month follow-up assessments. Seventeen US primary care clinics. Referred primary care sample, 1004 patients, with principal DSM-IV diagnoses of GAD (n = 549), PD (n = 262), SAD (n = 132), or PTSD (n = 61) (mean [SD] age, 43.7 [13.7] years; 70.9% were female). Eighty percent of the participants completed 18-month follow-up. CALM (cognitive behavior therapy and pharmacotherapy recommendations) and UC. Generalized Anxiety Disorder Severity Scale, Panic Disorder Severity-Self-report Scale, Social Phobia Inventory, and PTSD Checklist-Civilian Version scores. CALM was superior to UC for principal GAD at 6-month (-1.61; 95% confidence interval [CI], -2.42 to -0.79), 12-month (-2.34; -3.22 to -1.45), and 18-month (-2.37; -3.24 to -1.50), PD at 6-month (-2.00; -3.55 to -0.44) and 12-month (-2.71; -4.29 to -1.14), and SAD at 6-month (-7.05; -12.11 to -2.00) outcomes. CALM was superior to UC for comorbid SAD at 6-month (-4.26; 95% CI, -7.96 to -0.56), 12-month (-8.12, -11.84 to -4.40), and 18- month (-6.23, -9.90 to -2.55) outcomes. Effect sizes favored CALM but were not statistically significant for other comorbid disorders. CALM (cognitive behavior therapy and pharmacotherapy medication recommendations) is more effective than is UC for principal anxiety disorders and, to a lesser extent, comorbid anxiety disorders that present in primary care.",Craske MG.; Stein MB.; Sullivan G.; Sherbourne C.; Bystritsky A.; Rose RD.; Lang AJ.; Welch S.; Campbell-Sills L.; Golinelli D.; Roy-Byrne P.,2011.0,10.1001/archgenpsychiatry.2011.25,0,1,
90,The psychophysiology of generalized anxiety disorder: 2. Effects of applied relaxation.,"Muscle relaxation therapy assumes that generalized anxiety disorder (GAD) patients lack the ability to relax but can learn this in therapy. We tested this by randomizing 49 GAD patients to 12 weeks of Applied Relaxation (AR) or waiting. Before, during, and after treatment participants underwent relaxation tests. Before treatment, GAD patients were more worried than healthy controls (n=21) and had higher heart rates and lower end-tidal pCO2, but not higher muscle tension (A. Conrad, L. Isaac, & W.T. Roth, 2008). AR resulted in greater symptomatic improvement than waiting. However, 28% of the AR group dropped out of treatment and some patients relapsed at the 6-week follow-up. There was little evidence that AR participants learned to relax in therapy or that a reduction in anxiety was associated with a decrease in activation. We conclude that the clinical effects of AR in improving GAD symptoms are moderate at most and cannot be attributed to reducing muscle tension or autonomic activation.",Conrad A.; Isaac L.; Roth WT.,2008.0,10.1111/j.1469-8986.2007.00644.x,0,1,
91,Symptom and Cognitive Predictors of Treatment Response in CBT for Social Anxiety Disorder,,"Collimore, KC; Rector NA",2012.0,,0,1,
92,Eye movement desensitization and reprocessing (EDMR) treatment for combat-related posttraumatic stress disorder.,"Despite the clinical and social impact of posttraumatic stress disorder (PTSD), there are few controlled studies investigating its treatment. In this investigation, the effectiveness of two psychotherapeutic interventions for PTSD were compared using a randomized controlled outcome group design. Thirty five combat veterans diagnosed with combat-related PTSD were treated with either (a) 12 sessions of eye movement desensitization and reprocessing, EMDR (n = 10), (b) 12 sessions of biofeedback-assisted relaxation (n = 13), or (c) routine clinical care, serving as a control (n = 12). Compared with the other conditions, significant treatment effects in the EMDR condition were obtained at posttreatment on a number of self-report, psychometric, and standardized interview measures. Relative to the other treatment group, these effects were generally maintained at 3-month follow-up. Psychophysiological measures reflected an apparent habituation effect from pretreatment to posttreatment but were not differentially affected by treatment condition.",Carlson JG.; Chemtob CM.; Rusnak K.; Hedlund NL.; Muraoka MY.,1998.0,10.1023/A:1024448814268,0,1,
93,Treating post-traumatic stress disorder in patients with multiple sclerosis: A randomized controlled trial comparing the efficacy of eye movement desensitization and reprocessing and relaxation therapy.,"Objective: Multiple Sclerosis (MS) is a demyelinating autoimmune disease that imposes a significant emotional burden with heavy psychosocial consequences. Several studies have investigated the association between MS and mental disorders such as depression and anxiety, and recently researchers have focused also on Post-traumatic Stress Disorder (PTSD). This is the first study that investigates the usefulness of proposing a treatment for PTSD to patients with MS. Methods: A randomized controlled trial with patients with MS diagnosed with PTSD comparing Eye Movement Desensitization and Reprocessing (EMDR; n = 20) and Relaxation Therapy (RT; n = 22). The primary outcome measure was the proportion of participants that no longer meet PTSD diagnosis as measured with Clinician Administered PTSD Scale 6-months after the treatment. Results: The majority of patients were able to overcome their PTSD diagnosis after only 10 therapy sessions. EMDR treatment appears to be more effective than RT in reducing the proportion of patients with MS suffering from PTSD. Both treatments are effective in reducing PTSD severity, anxiety and depression symptoms, and to improve Quality of Life. Conclusion: Although our results can only be considered preliminary, this study suggests that it is essential that PTSD symptoms are detected and that brief and costeffective interventions to reduce PTSD and associated psychological symptoms are offered to patients, in order to help them to reduce the psychological burden associated with their neurological condition. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Carletto, Sara; Borghi, Martina; Bertino, Gabriella; Oliva, Francesco; Cavallo, Marco; Hofmann, Arne; Zennaro, Alessandro; Malucchi, Simona; Ostacoli, Luca; Alonzo, Andrykowski, Andrykowski, Arabia, Beiske, Bisson, Bisson, Bjelland, Blake, Brewin, Brown, Capezzani, Cella, Chalfant, Chang, Counsell, Crawford, Creamer, Einsle, Feinstein, First, Flachenecker, Foa, Friedberg, Galatzer-Levy, Garieballa, Goncalves, Grant, Honarmand, Horowitz, Jackson, Jacobsen, Janssens, Jose Sa, Kangas, Kangas, Karagkouni, Kern, Kessler, Koch, Krupp, Kurtzke, Kurtzke, Kwakkenbos, Mitsonis, Mohr, Mohr, Moore, Nisipeanu, Ostacoli, Patti, Peris, Polman, Quelhas, Schneider, Shapiro, Siegert, Silver, Smith, Solari, Taylor, Tedstone, Theadom, Tol, Tuerk, Turner, Van Etten, Van Kessel, Wallin, Weathers, Weiss, Whalley, Yoo, Zigmond, Zorzon",2016.0,,0,1,
94,Generalised anxiety: a controlled treatment study.,,Blowers C.; Cobb J.; Mathews A.,1987.0,,0,1,
95,Behavioral treatment of generalized anxiety disorder,"Sixty-five carefully diagnosed patients with generalized anxiety disorder were treated with either relaxation, cognitive therapy, or their combination. These three active treatment conditions were compared to a wait-list control group. On several measures, in-cluding measures of worry, treated patients were significantly better than those in the wait-list control group at post treatment. These gains were maintained across the two-year follow-up period. Notably, these therapeutic gains were accompanied by substantial reductions in anxiolytic medication use over the period of follow-up. No differences emerged, however, among treatments at any point of comparison. In addition, drop-out rates among the active treatment groups were high (range = 5% to 38%). Moreover, most patients were left with residual anxiety suggesting the need for the development of more focused and efficient psychological treatments for generalized anxiety disorder.","Barlow, David H.; Rapee, Ronald M.; Brown, Timothy A.",1992.0,https://doi.org/10.1016/S0005-7894(05)80221-7,0,1,
96,The efficacy of eye movement desensitization and reprocessing for post-traumatic stress disorder and depression among Syrian refugees: Results of a randomized controlled trial.,"Background: Previous research indicates a high prevalence of post-traumatic stress disorder (PTSD) and depression among refugees. Eye movement desensitization and reprocessing (EMDR) is an effective treatment for PTSD for victims of natural disasters, car accidents or other traumatic events. The current study examined the effect of EMDR on symptoms of PTSD and depression by comparing the treatment with a wait-list control condition in Syrian refugees. Method: Adult refugees located in Kilis Refugee Camp at the Turkish-Syrian border with a PTSD diagnosis were randomly allocated to either EMDR (n = 37) or wait-list control (n = 33) conditions. All participants were assessed with the Mini-International Neuropsychiatric Interview Plus at pre-intervention, at 1 week after finishing the intervention and at 5 weeks after finishing the intervention. The main outcome measures were the Harvard Trauma Questionnaire (HTQ) and the Impact of Event Scale-Revised. The Beck Depression Inventory and the Hopkins Symptoms Checklist-25 were included as secondary outcome measures. The Trial Registration no. is NCT01847742. Results: Mixed-model analyses adjusted for the baseline scores indicated a significant effect of group at post-treatment indicating that the EMDR therapy group showed a significantly larger reduction of PTSD symptoms as assessed with the HTQ. Similar findings were found on the other outcome measures. There was no effect of time or group x time interaction on any measure, showing that the difference between the groups at the post-treatment was maintained to the 5-week follow-up. Conclusions: EMDR may be effective in reducing PTSD and depression symptoms among Syrian refugees with PTSD located in a refugee camp. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Acarturk, C; Konuk, E; Cetinkaya, M; Senay, I; Sijbrandij, M; Gulen, B; Cuijpers, P; Acarturk, Alpak, Bader, Beck, Bisson, Bradley, Engeler, Engelhard, Fazel, Furukawa, Ghareeb, Gunter, Herbert, Ho, Kessler, Kobeissi, Lee, Leer, McFarlane, Mollica, Mollica, Mollica, Morina, Murray, Neuner, Neuner, Nickerson, Palic, Panahi, Porter, Rasmussen, Seidler, Shapiro, Shapiro, Shapiro, Shapiro, Sheehan, Shoeb, Stickgold, Ter Heide, Tol, Van der Hout, Vukovic, Weiss, Xu",2016.0,,0,1,
97,Treating acute stress disorder and posttraumatic stress disorder with cognitive behavioral therapy or structured writing therapy: a randomized controlled trial.,"Writing assignments have shown promising results in treating traumatic symptomatology. Yet no studies have compared their efficacy to the current treatment of choice, cognitive behavior therapy (CBT). The present study evaluated the efficacy of structured writing therapy (SWT) and CBT as compared to a waitlist control condition in treating acute stress disorder (ASD) and posttraumatic stress disorder (PTSD). A randomized controlled trial was conducted at an outpatient clinic. Participants (n = 125) (a) satisfied DSM-IV criteria for ASD or PTSD, (b) were 16 years or older, (c) were sufficiently fluent in Dutch or English, (d) had no psychiatric problems except ASD or PTSD that would hinder participation or required alternative clinical care, and (e) received no concurrent psychotherapy. Treatment consisted of five 1.5-hour sessions of CBT or SWT for participants with ASD or acute PTSD and ten 1.5-hour sessions for participants with chronic PTSD. Outcome measures included the Structured Clinical Interview for DSM-IV, Impact of Event Scale, Beck Depression Inventory, State-Trait Anxiety Inventory and the Dissociative Experiences Scale. At posttest and follow-up, treatment was associated with improved diagnostic status and lower levels of intrusive symptoms, depression and state anxiety, while a trend was noted for the reduction of avoidance symptoms. Treatment did not result in lower levels of trait anxiety or dissociation. No differences in efficacy were detected between CBT and SWT. The present study confirmed the efficacy of CBT for ASD and PTSD and identified SWT as a promising alternative treatment.",van Emmerik AA.; Kamphuis JH.; Emmelkamp PM.,2008.0,10.1159/000112886,0,1,
98,A group mental health randomized controlled trial for female refugees in Malaysia.,"Forcibly displaced persons confront multiple stressors while awaiting permanent asylum or resettlement and often experience high levels of emotional distress. This study assessed an 8-week somatic-focused culturally adapted cognitive-behavioral therapy (CBT) group intervention with 39 female refugees from Afghanistan living in Kuala Lumpur, Malaysia. Twenty-nine participants were randomly assigned to treatment conditions, resulting in 20 participants in two separate treatment groups and 9 in a waitlist control group. An additional 10 participants were not randomly assigned and therefore were treated as an additional treatment group and analyzed separately. A three-group piecewise linear growth model was specified in Mplus using Bayesian estimation. Dependent variables included emotional distress, anxiety, depression, posttraumatic stress, and social support. From baseline to posttreatment assessments, initial intervention participants experienced significant declines in emotional distress (b = -16.90, p < .001), anxiety (b = -.80, p < .001), depression (b = -.59, p < .001), and posttraumatic stress (b = -.24, p < .05). Gains were maintained three months posttreatment, with similar trends observed among nonrandomized participants. Subsequent to receiving treatment, the waitlist control participants also showed significant declines in emotional distress (b = -20.88, p < .001), anxiety (b = -1.10, p < .001), depression (b = -.79, p < .001), and posttraumatic stress scores (b = -.82, p < .001). Comparing the treatment groups to the waitlist control group revealed large effect sizes: Cohen's d was 2.14 for emotional distress, 2.31 for anxiety, 2.42 for depression, and 2.07 for posttraumatic stress. Relevant public health findings include low drop out, group format, and facilitation by a trained community member. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement Public Policy Relevance Statement-A somatic focused culturally adapted cognitive-behavioral group intervention led to reductions in symptoms of emotional distress, depression, anxiety, and PTSD among female Afghan refugees residing in Malaysia. Findings suggest mental health supports should be provided in countries of first asylum and additional funding is needed to ensure services are available to a larger number of forced migrants. Individual and community supports are needed as are long-term solutions for forced migrants. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Shaw, Stacey A; Ward, Kaitlin P; Pillai, Veena; Hinton, Devon E",2018.0,http://dx.doi.org/10.1037/ort0000346,0,1,
99,A Randomised controlled trial of Metacognitive Therapy and exposure Therapy for post-traumatic Stress Disorder: psychological Mechanisms Involved,"Post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder effecting an individual's occupational and social functioning. Psychological theories have attempted to explore the underlying mechanisms that are thought to be involved in the development and maintenance of PTSD. From these theories several treatment approacherhavrbeen developed with the majority relying on exposure. To date the effectiveness of exposure treatment has not been surpassed but outcomes vary, with room for improvement. Few studies have examined predictors of change. The study reported here compared a new treatment metacognitive therapy (MCT) with exposure therapy (EXP) and waitlist control condition (WL) and assessed psychological predictors' of treatment outcome.",Walton,2008.0,,0,1,
100,Psychosocial rehabilitation after war trauma with adaptive disclosure: Design and rationale of a comparative efficacy trial.,"Posttraumatic stress disorder (PTSD) from warzone exposure is associated with chronic and disabling social and occupational problems. However, functional impairment is rarely assessed or targeted directly in PTSD treatments, which instead focus on symptom reduction. Trauma-related contributors to diminished functioning, including guilt, shame, and anger resulting from morally compromising or loss-based war experiences, are also underemphasized. The goal of this clinical trial is to fill a substantial gap in the treatment of military-related PTSD by testing a modified Adaptive Disclosure (AD) therapy for war-related PTSD stemming from moral injury and traumatic loss focused on improving psychosocial functioning AD. This paper describes the rationale and design of a multi-site randomized controlled trial comparing AD to Present-Centered Therapy (PCT). We will recruit 186 veterans with PTSD, who will be assessed at baseline, post-treatment, and 3- and 6-months post-treatment. Primary outcomes are functional changes (i.e., functioning/disability and quality of life). Secondary outcomes are mental health variables (i.e., PTSD, depression, guilt, shame). We hypothesize that veterans treated with AD will experience greater improvements in all outcomes compared to those treated with PCT. This trial will advance knowledge in rehabilitation research by testing the first therapy specifically designed to address psychosocial functioning among veterans with war-related PTSD. The results may improve the quality of mental health care for veterans by offering an ecologically sound treatment for experiences that are uniquely impactful for war veterans.",Yeterian JD.; Berke DS.; Litz BT.,2017.0,10.1016/j.cct.2017.07.012,0,1,
101, Mindfulness-based cognitive therapy v. group psychoeducation for people with generalised anxiety disorder: randomised controlled trial," AIMS: To compare changes in anxiety levels among participants with GAD randomly assigned to MBCT, cognitive‐behavioural therapy‐based psychoeducation and usual care. METHOD: In total, 182 participants with GAD were recruited (trial registration number: CUHK_CCT00267) and assigned to the three groups and followed for 5 months after baseline assessment with the two intervention groups followed for an additional 6 months. Primary outcomes were anxiety and worry levels. RESULTS: Linear mixed models demonstrated significant group × time interaction (F(4,148) = 5.10, P = 0.001) effects for decreased anxiety for both the intervention groups relative to usual care. Significant group × time interaction effects were observed for worry and depressive symptoms and mental health‐related quality of life for the psychoeducation group only. CONCLUSIONS: These results suggest that both of the interventions appear to be superior to usual care for the reduction of anxiety symptoms. BACKGROUND: Research suggests that an 8‐week mindfulness‐based cognitive therapy (MBCT) course may be effective for generalised anxiety disorder (GAD)."," Wong, SY;  Yip, BH;  Mak, WW;  Mercer, S;  Cheung, EY;  Ling, CY;  Lui, WW;  Tang, WK;  Lo, HH;  Wu, JC;  et al.",2016.0, 10.1192/bjp.bp.115.166124,0,1,
102,The Trauma Collaborative Care Study (TCCS).,"Previous research suggests that the care provided to trauma patients could be improved by including early screening and management of emotional distress and psychological comorbidity. The Trauma Collaborative Care (TCC) program, which is based on the principles of well-established models of collaborative care, was designed to address this gap in trauma center care. This article describes the TCC program and the design of a multicenter study to evaluate its effectiveness for improving patient outcomes after major, high-energy orthopaedic trauma at level 1 trauma centers. The TCC program was evaluated by comparing outcomes of patients treated at 6 intervention sites (n = 481) with 6 trauma centers where care was delivered as usual (control sites, n = 419). Compared with standard treatment alone, it is hypothesized that access to the TCC program plus standard treatment will result in lower rates of poor patient-reported function, depression, and posttraumatic stress disorder.",Wegener ST.; Pollak AN.; Frey KP.; Hymes RA.; Archer KR.; Jones CB.; Seymour RB.; OʼToole RV.; Castillo RC.; Huang Y.; Scharfstein DO.; MacKenzie EJ.;  .,2017.0,10.1097/BOT.0000000000000792,0,1,
103,Alliance across group treatment for veterans with posttraumatic stress disorder: The role of interpersonal trauma and treatment type.,"The authors examined initial levels and pattern of change of alliance in group treatment for posttraumatic stress disorder (PTSD) for veterans. One hundred and 78 male veterans with PTSD were recruited for this study. Participants were randomly assigned to either group cognitive-behavioral therapy (GCBT) or to group present-centered therapy (GPCT). Alliance with fellow group members was assessed every other session throughout the group (total of seven assessments). Hierarchical linear modeling was used to determine whether treatment condition or index trauma type (interpersonal or noninterpersonal) impacted initial levels of alliance or change in alliance over time. Alliance increased significantly throughout treatment in both conditions. The presence of an interpersonal index event, compared to a noninterpersonal index event, did not significantly impact either initial levels of alliance or change in alliance over time. Participants in the GCBT condition experienced significantly greater growth in alliance over time compared to those in the GPCT condition (p > .05) but did not have significantly different initial alliance ratings. The components and focus of the GCBT treatment may have facilitated more rapid bonding among members. Interpersonal traumatic experience did not negatively impact group alliance. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Thompson-Hollands, Johanna; Litwack, Scott D; Ryabchenko, Karen A; Niles, Barbara L; Beck, J. Gayle; Unger, William; Sloan, Denise M",2018.0,http://dx.doi.org/10.1037/gdn0000077,0,1,
104,Changes of attachment characteristics during psychotherapy of patients with social anxiety disorder: Results from the SOPHO-Net trial.,"Within a randomized controlled trial contrasting the outcome of manualized cognitive-behavioral (CBT) and short term psychodynamic therapy (PDT) compared to a waiting list condition (the SOPHO-Net trial), we set out to test whether self-reported attachment characteristics change during the treatments and if these changes differ between treatments. 495 patients from the SOPHO-Net trial (54.5% female, mean age 35.2 years) who were randomized to either CBT, PDT or waiting list (WL) completed the partner-related revised Experiences in Close Relationships Questionnaire (ECR-R) before and after treatment and at 6 and 12 months follow-up. The Liebowitz Social Anxiety Scale (LSAS) was administered at pre-treatment, post-treatment, and at 6-month and 1-year follow-up. ECR-R scores were first compared to a representative healthy sample (n = 2508) in order to demonstrate that the clinical sample differed significantly from the non-clinical sample with respect to attachment anxiety and avoidance. LSAS scores correlated significantly with both ECR-R subscales. Post-therapy, patients treated with CBT revealed significant changes in attachment anxiety and avoidance whereas patients treated with PDT showed no significant changes. Changes between post-treatment and the two follow-ups were significant in both conditions, with minimal (insignificant) differences between treatments at the 12- month follow-up. The current study supports recent reviews of mostly naturalistic studies indicating changes in attachment as a result of psychotherapy. Although there were differences between conditions at the end of treatment, these largely disappeared during the follow-up period which is line with the other results of the SOPHO-NET trial. Controlled-trials.com ISRCTN53517394.",Strauß B.; Altmann U.; Manes S.; Tholl A.; Koranyi S.; Nolte T.; Beutel ME.; Wiltink J.; Herpertz S.; Hiller W.; Hoyer J.; Joraschky P.; Nolting B.; Ritter V.; Stangier U.; Willutzki U.; Salzer S.; Leibing E.; Leichsenring F.; Kirchmann H.,2018.0,10.1371/journal.pone.0192802,0,1,
105,Early EMDR intervention following intense rocket attacks on a town: A randomised clinical trial.,"Objective: The aim of the study is to investigate the efficacy of EMDR R-TEP interventions with residents suffering from post-traumatic symptoms. Method: The study employed a waitlist/delayed treatment control group design and participants were randomly allocated to either immediate or wait-list/delayed treatment conditions. The measures used included the PCL-5 post-trauma checklist for DSM-5; the PHQ-9 depression scale; the Subjective Unit of Disturbance (SUD) scale and the Brief Resilience Coping Scale (BRCS). The clinical staff of the Resilience Center (HOSEN) offered EMDR therapy treatment using the Recent Traumatic Episode Protocol (R-TEP) for 25 trauma-stricken residents referred to their center. The study began within three months after the 2014 round of hostilities. Three 90 minute sessions were given first to the intervention group and a month later to the delayed treatment control group. The follow-up measures were taken six months later. Results: The immediate treatment group had significantly improved scores on post-trauma and depression measures compared to the waitlist/delayed treatment group, who showed no improvement prior to their treatment. There were significant interactions between group and time for PCL-5, PHQ-9 and SUD. Post hoc testing of the interaction revealed that within group A, participants exhibited a significant decrease in PCL-5, PHQ-9 and SUD scores (one-tailed p: < 0.001, 0.006, 0.03). The results in resilience scores over time showed an increasing trend in group A that failed to reach significance. Repeated measures analysis of group B revealed a borderline statistically significant difference in resilience scores over time. Conclusions: This study provides further evidence, supporting the efficacy of Early EMDR Intervention for reducing post-traumatic stress and depression symptoms among civilian victims of hostility. The evidence for resilience was indecisive and requires further research. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Shapiro, Elan; Laub, Brurit; Rosenblat, Ornit",2018.0,,0,1,
106, A sorrow shared is a sorrow halved? A three-arm randomized controlled trial comparing internet-based clinician-guided individual versus group treatment for social anxiety disorder," A growing body of evidence suggests that internet‐based cognitive behavioural treatments (ICBT) are effective to treat social anxiety disorder (SAD). Whereas the efficacy of clinician‐guided ICBT has been established, ICBT in a group format has not yet been systematically investigated. This three‐arm RCT compared the efficacy of clinician‐guided group ICBT (GT) with clinician guided individual ICBT (IT) and a wait‐list (WL). A total of 149 individuals meeting the diagnostic criteria for SAD were randomly assigned to one of three conditions. Primary endpoints were self‐report measures of SAD and diagnostic status taken at baseline, after the twelve‐week intervention and at six‐month follow‐up. Secondary endpoints were symptoms of depression, interpersonal problems and general symptomatology. At post‐treatment, both active conditions showed superior outcome regarding SAD symptoms (GT vs. WL: d = 0.84‐0.74; IT vs. WL: d = 0.94‐1.22). The two active conditions did not differ significantly in symptom reduction (d = 0.12‐0.26, all ps > 0.63), diagnostic response rate or attrition. Treatment gains were maintained at follow‐up. The group format reduced weekly therapist time per participant by 71% (IT: 17 min, GT: 5 min). Findings indicate that a clinician‐guided group format is a promising approach in treating SAD."," Schulz, A;  Stolz, T;  Vincent, A;  Krieger, T;  Andersson, G;  Berger, T",2016.0, 10.1016/j.brat.2016.07.001,0,1,
107,Evaluation of the effect of Spiritual care on patients with generalized anxiety and depression: a randomized controlled study.,"The present study was conducted to assess the effect of spiritual care in patients with depression, anxiety or both in a randomized controlled design. The participants were randomized either to receive spiritual care or not and Hamilton anxiety rating scale-A (HAM-A), Hamilton depression rating scale-D (HAM-D), WHO-quality of life-Brief (WHOQOL-BREF) and Functional assessment of chronic illness therapy - Spiritual well-being (FACIT-Sp) were assessed before therapy and two follow-ups at 3 and 6 week. However, with regard to the spiritual care therapy group, statistically significant differences were observed in both HAM-A and HAM-D scales between the baseline and visit 2 (p < 0.001), thus significantly reducing symptoms of anxiety and depression, respectively. No statistically significant differences were observed for any of the scales during the follow-up periods for the control group of participants. When the scores were compared between the study groups, HAM-A, HAM-D and FACIT-Sp 12 scores were significantly lower in the interventional group as compared to the control group at both third and sixth weeks. This suggests a significant improvement in symptoms of anxiety and depression in the spiritual care therapy group than the control group; however, large randomized controlled trials with robust design are needed to confirm the same.",Sankhe A.; Dalal K.; Save D.; Sarve P.,2017.0,10.1080/13548506.2017.1290260,0,1,
108,Treatment of sleep disturbances in trauma-affected refugees: Study protocol for a randomised controlled trial.,"Sleep disturbances are often referred to as a hallmark and as core symptoms of post-traumatic stress disorder (PTSD). Untreated sleep disturbances can contribute to the maintenance and exacerbation of PTSD symptoms, which may diminish treatment response and constitute a risk factor for poor treatment outcome. Controlled trials on treatment of sleep disturbances in refugees suffering from PTSD are scarce. The present study aims to examine sleep-enhancing treatment in refugees with PTSD. We aim to assess if add-on treatment with mianserin and/or Imagery Rehearsal Therapy (IRT) to treatment as usual (TAU) for PTSD improves sleep disturbances. We will study the relation between sleep disturbances, PTSD symptoms, psychosocial functioning and quality of life. The study is a randomised controlled superiority trial with a 2 × 2 factorial design. The study will include 230 trauma-affected refugees. The patients are randomised into four groups. All four groups receive TAU - an interdisciplinary treatment approach covering a period of 6-8 months with pharmacological treatment, physiotherapy, psychoeducation and manual-based cognitive behavioural therapy within a framework of weekly sessions with a physician, physiotherapist or psychologist. One group receives solely TAU, serving as a control group, while the three remaining groups are active-treatment groups receiving add-on treatment with either mianserin, IRT or a combination of both. Treatment outcome is evaluated using self-administered rating scales, observer ratings and actigraph measurements at baseline, during treatment and post treatment. The primary outcome is subjective sleep quality using the Pittsburgh Sleep Quality Index. Secondary outcome measures are objective sleep length, nightmares, PTSD severity, symptoms of depression and anxiety, pain, quality of life and psychosocial functioning. This trial will be the first randomised controlled trial to examine sleep-enhancing treatment in trauma-affected refugees, as well as the first trial to investigate the effect of IRT and mianserin in this population. Therefore, this trial may optimise treatment recommendations for sleep disturbances in trauma-affected refugees. Based on our findings, we expect to discuss the effect of treatment, focussing on sleep disturbances. Furthermore, the results will provide new information regarding the association between sleep disturbances, PTSD symptoms, psychosocial functioning and quality of life in trauma-affected refugees. EudraCT registration under the name 'Treatment of sleep disturbances in trauma-affected refugees - a randomised controlled trial', registration number: 2015-004153-40 , registered on 13 November 2015. ClinicalTrials.gov, ID: NCT02761161. Registered on 27 April 2016.",Sandahl H.; Jennum P.; Baandrup L.; Poschmann IS.; Carlsson J.,2017.0,10.1186/s13063-017-2260-5,0,1,
109,Effectiveness of Cognitive-Behavioural Group Therapy in Patients with Anxiety Disorders.,"This study evaluates the data obtained from 44 patients with different anxiety disorders for whom cognitive-behavioural group therapy was prescribed. No significant differences were appreciated between treatment participants and controls with regard to sociodemographic, previous stress, alexithymia, coping styles and diagnosis variables. The results indicate that the clinical course in those who attended the majority of the sessions is significantly more favourable than in controls: the follow-up at one year shows that more of them were discharged (73.68% vs. 28%) and more had their benzodiazepine dose reduced (44.44% vs. 10.52%) compared to those in the control group. Among the post-treatment measures obtained were reduced values in state-anxiety, depression and emotional distress (p < .05); there was also an improvement, albeit less statistically significant, in subjective appreciation of physical state, while frequency of perceived physical distress decreased. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sanchez-Garcia, Manuel",2004.0,,0,1,
110, Telephone-Delivered Stepped Collaborative Care for Treating Anxiety in Primary Care: a Randomized Controlled Trial," BACKGROUND: Collaborative care for depression is more effective in improving treatment outcomes than primary care physicians' (PCPs) usual care (UC). However, few trials of collaborative care have targeted anxiety. OBJECTIVE: To examine the impact and 12‐month durability of a centralized, telephone‐delivered, stepped collaborative care intervention (CC) for treating anxiety disorders across a network of primary care practices. DESIGN: Randomized controlled trial with blinded outcome assessments. PARTICIPANTS: A total of 329 patients aged 18‐64 referred by their PCPs in response to an electronic medical record (EMR) prompt. They include 250 highly anxious patients randomized to either CC or to UC, and 79 moderately anxious patients who were triaged to a watchful waiting (WW) cohort and later randomized if their conditions clinically deteriorated. INTERVENTION: Twelve months of telephone‐delivered CC involving non‐mental health professionals who provided patients with basic psycho‐education, assessed preferences for guideline‐based pharmacotherapy, monitored treatment responses, and informed PCPs of their patients' care preferences and progress via the EMR. MAIN MEASURES: Mental health‐related quality of life ([HRQoL]; SF‐36 MCS); secondary outcomes: anxiety (Hamilton Anxiety Rating Scale [SIGH‐A], Panic Disorder Severity Scale) and mood (PHQ‐9). KEY RESULTS: At 12‐month follow‐up, highly anxious patients randomized to CC reported improved mental HRQoL (effect size [ES]: 0.38 [95 % CI: 0.13‐0.63]; P = 0.003), anxiety (SIGH‐A ES: 0.30 [0.05‐0.55]; P = 0.02), and mood (ES: 0.45 [0.19‐0.71] P = 0.001) versus UC. These improvements were sustained for 12 months among African‐Americans (ES: 0.70‐1.14) and men (ES: 0.43‐0.93). Of the 79 WW patients, 29 % met severity criteria for randomization, and regardless of treatment assignment, WW patients reported fewer anxiety and mood symptoms and better mental HRQoL over the full 24‐month follow‐up period than highly anxious patients who were randomized at baseline. CONCLUSIONS: Telephone‐delivered, centralized, stepped CC improves mental HRQoL, anxiety and mood symptoms. These improvements were durable and particularly evident among those most anxious at baseline, and among African‐Americans and men."," Rollman, BL;  Belnap, BH;  Mazumdar, S;  Abebe, KZ;  Karp, JF;  Lenze, EJ;  Schulberg, HC",2017.0, 10.1007/s11606-016-3873-1,0,1,
111,Digital IAPT: the effectiveness & cost-effectiveness of internet-delivered interventions for depression and anxiety disorders in the Improving Access to Psychological Therapies programme: study protocol for a randomised control trial.,"Depression and anxiety are common mental health disorders worldwide. The UK's Improving Access to Psychological Therapies (IAPT) programme is part of the National Health Service (NHS) designed to provide a stepped care approach to treating people with anxiety and depressive disorders. Cognitive Behavioural Therapy (CBT) is widely used, with computerised and internet-delivered cognitive behavioural therapy (cCBT and iCBT, respectively) being a suitable IAPT approved treatment alternative for step 2, low- intensity treatment. iCBT has accumulated a large empirical base for treating depression and anxiety disorders. However, the cost-effectiveness and impact of these interventions in the longer-term is not routinely assessed by IAPT services. The current study aims to evaluate the clinical and cost-effectiveness of internet-delivered interventions for symptoms of depression and anxiety disorders in IAPT. The study is a parallel-groups, randomised controlled trial examining the effectiveness and cost-effectiveness of iCBT interventions for depression and anxiety disorders, against a waitlist control group. The iCBT treatments are of 8 weeks duration and will be supported by regular post-session feedback by Psychological Wellbeing Practitioners. Assessments will be conducted at baseline, during, and at the end of the 8-week treatment and at 3, 6, 9, and 12-month follow-up. A diagnostic interview will be employed at baseline and 3-month follow-up. Participants in the waitlist control group will complete measures at baseline and week 8, at which point they will receive access to the treatment. All adult users of the Berkshire NHS Trust IAPT Talking Therapies Step 2 services will be approached to participate and measured against set eligibility criteria. Primary outcome measures will assess anxiety and depressive symptoms using the GAD-7 and PHQ-9, respectively. Secondary outcome measures will allow for the evaluation of long-term outcomes, mediators and moderators of outcome, and cost-effectiveness of treatment. Analysis will be conducted on a per protocol and intention-to-treat basis. This study seeks to evaluate the immediate and longer-term impact, as well as the cost effectiveness of internet-delivered interventions for depression and anxiety. This study will contribute to the already established literature on internet-delivered interventions worldwide. The study has the potential to show how iCBT can enhance service provision, and the findings will likely be generalisable to other health services. Current Controlled Trials ISRCTN ISRCTN91967124. DOI: https://doi.org/10.1186/ISRCTN91967124 . Web: http://www.isrctn.com/ISRCTN91967124 . Clinicaltrials.gov : NCT03188575. Trial registration date: June 8, 2017 (prospectively registered).",Richards D.; Duffy D.; Blackburn B.; Earley C.; Enrique A.; Palacios J.; Franklin M.; Clarke G.; Sollesse S.; Connell S.; Timulak L.,2018.0,10.1186/s12888-018-1639-5,0,1,
112, Internet-based self-help treatment for panic disorder: a randomized controlled trial comparing mandatory versus optional complementary psychological support," Panic disorder (PD) is one of the most common psychiatric disorders. Web‐based self‐help treatments for PD have had promising results. These online treatments seem to have larger effect sizes (ESs) when professional support is added. However, the amount of support or how it should be administered is not yet clear. The aim of this trial was to study two ways of administering psychological support provided by phone as a part of Internet‐based self‐help treatment for PD based on cognitive behavioral therapy. Seventy‐seven participants diagnosed with PD were randomly assigned to one of three experimental conditions: a waiting list control group; a treatment group with non‐scheduled psychological support; or a treatment group with scheduled psychological support. PD symptoms of participants who received treatment improved significantly compared to the control group (mean ES d = 1.18, p < .05). In addition, there were statistically and clinically significant differences between treatment groups (Mean difference = ‐3.20, p = .005, 95% CI [‐5.62, ‐.79]). The scheduled group showed a larger ES, a lower dropout rate, and better adherence to treatment than the non‐scheduled group. Scheduled support seems to be indicated for patients who seek Web‐based treatment for PD, and their symptoms of panic, anxiety, and depression improve at post‐treatment and six‐month follow‐up. In contrast, when support depends on patient demand, they receive less support and so, the therapeutic effect is poorer."," Oromendia, P;  Orrego, J;  Bonillo, A;  Molinuevo, B",2016.0, 10.1080/16506073.2016.1163615,0,1,
113, iCanADAPT Early protocol: randomised controlled trial (RCT) of clinician supervised transdiagnostic internet-delivered cognitive behaviour therapy (iCBT) for depression and/or anxiety in early stage cancer survivors -vs- treatment as usual," BACKGROUND: This RCT with two parallel arms will evaluate the efficacy of an internet‐delivered transdiagnostic cognitive behavioural therapy (iCBT) intervention for the treatment of clinical depression and/or anxiety in early stage cancer survivors. METHODS/DESIGN: Early stage cancer survivors will be recruited via the research arm of a not‐for‐profit clinical research unit and randomised to an intervention (iCBT) group or a 'treatment as usual' (TAU) control group. The minimum sample size for each group is 45 people (assuming effect size > 0.6, power of 80%, and alpha at .05), but 10% more will be recruited to account for attrition. A solitary or cumulative diagnosis(es) of Major Depressive Episode (current), Generalised Anxiety Disorder, Illness Anxiety Disorder, Panic Disorder, Agoraphobia, and/or Adjustment disorder will be determined using modules from the Anxiety Disorders Interview Schedule for DSM‐5. Depression and anxiety levels with be measured via the total score of the Hospital Anxiety and Depression scale (HADS‐T), the primary outcome measure. Secondary measures will include the Kessler 10 to measure general distress, the Fear of Cancer Recurrence Inventory (FCRI) to measure the specific fear of cancer recurrence and the Functional Assessment of Cancer Therapy, General Version 4 (FACT‐G) for self‐report of physical, social, emotional and functional well‐being. iCBT participants will complete the measures before lessons 1 and 5, at post‐treatment and at 3‐month follow‐up. The TAU group will complete similar measures at weeks 1, 8 and 16 of the waiting period. Program efficacy will be determined using intent‐to‐treat mixed models. Maintenance of gains will be assessed at 3‐month follow‐up. Mediation analyses using PROCESS will be used to examine the association between change in depressive and anxious symptoms over time and changes in FCRI and FACT‐G QOL in separate analysis. DISCUSSION: This is the first RCT looking at iCBT specifically for clinical depression and/or anxiety in a cancer population. Findings will help to direct the role of iCBT in streamlined psycho‐social care pathways. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12616000231448, registered 19"," Murphy, MJ;  Newby, JM;  Butow, P;  Kirsten, L;  Allison, K;  Loughnan, S;  Price, MA;  Shaw, J;  Shepherd, H;  Smith, J;  et al.",2017.0, 10.1186/s12885-017-3182-z,0,1,
114,Web-based trauma intervention for veterans has physical health payoff in randomized trial.,"PTSD and depression are related to perceived physical health impairment in veterans, but little is known about the effects of psychological treatment on impairment. We examined the impact of an interactive online treatment for veterans with trauma-related distress, including (a) whether treatment effects include reduced perceived physical impairment, and (b) how these treatment effects are related to symptoms of PTSD and depression. A randomized controlled trial assessed the impact on perceived physical health impairment of interactive online treatment for veterans with symptoms of PTSD and depression. Veterans were randomized to either the Vets Prevail program (n = 209), or a no-treatment control (n = 94) completing measures of depression and PTSD symptomology as well as perceived physical health impairment at 6 and 12 weeks following baseline assessment We conducted a series of multiple and single mediation analyses to examine how the effects of Vets Prevail on these outcomes are related. Compared with control, Vets Prevail was (a) associated with significant reductions in perceived physical health impairment, and (b) this relationship was mediated by reductions in symptoms of PTSD, but not depression. Further analysis showed that perceived physical health impairment also mediated the relationships between intervention and PTSD and depression symptoms. Findings indicate that Vets Prevail reduces perceptions of physical health impairment by reducing PTSD symptomology. It is also possible that treatment initiated more complex, bidirectional relationships such that improvements in psychological distress and in perceived physical health impairment reinforced each other over time. Findings demonstrate that Vets Prevail may help veterans overcome traditional barriers to care and achieve improvements in multiple areas of functioning. (PsycINFO Database Record",Stevens NR.; Holmgreen L.; Walt L.; Gengler R.; Hobfoll SE.,2017.0,10.1037/tra0000184,0,1,
115,A mobile app for social anxiety disorder: A three-arm randomized controlled trial comparing mobile and PC-based guided self-help interventions.,"Objective: Internet-based cognitive-behavioral treatments (ICBT) have shown promise for various mental disorders, including social anxiety disorder (SAD). Most of these treatments have been delivered on desktop computers. However, the use of smartphones is becoming ubiquitous and could extend the reach of ICBT into users' everyday life. Only a few studies have empirically examined the efficacy of ICBT delivered through a smartphone app and there is no published study on mobile app delivered ICBT for SAD. This three-arm randomized-controlled trial (RCT) is the first to compare the efficacy of guided ICBT for smartphones (app) and conventional computers (PC) with a wait list control group (WL). Method: A total of 150 individuals meeting the diagnostic criteria for SAD were randomly assigned to one of the three conditions. Primary endpoints were self-report measures and diagnostic status of SAD. Results: After 12 weeks of treatment, both active conditions showed superior outcome on the composite of all SAD measures (PC vs. WL: d = 0.74; App vs. WL: d = 0.89) and promising diagnostic response rates (NNTPC = 3.33; NNTApp = 6.00) compared to the WL. No significant between-groups effects were found between the two active conditions on the composite score (Cohen's d = 0.07). Treatment gains were maintained at 3-month follow-up. Program use was more evenly spread throughout the day in the mobile condition, indicating an integration of the program into daily routines. Conclusions: ICBT can be delivered effectively using smartphones. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement What is the public health significance of this article?-This study demonstrates that internet-based cognitive-behavioral treatments can be implemented by mobile devices, extending the reach into daily routines and fostering dissemination beyond the prevalence of desktop computers, for example in developing countries. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Stolz, Timo; Schulz, Ava; Krieger, Tobias; Vincent, Alessia; Urech, Antoine; Moser, Christian; Westermann, Stefan; Berger, Thomas",2018.0,http://dx.doi.org/10.1037/ccp0000301,0,1,
116,Upregulating the positive affect system in anxiety and depression: Outcomes of a positive activity intervention.,"Background: Research suggests that the positive affect system may be an important yet underexplored treatment target in anxiety and depression. Existing interventions primarily target the negative affect system, yielding modest effects on measures of positive emotions and associated outcomes (e.g., psychological well-being). The objective of the present pilot study was to evaluate the efficacy of a new transdiagnostic positive activity intervention (PAI) for anxiety and depression. Method: Twenty-nine treatment-seeking individuals presenting with clinically impairing symptoms of anxiety and/or depression were randomly allocated to a 10-session protocol comprised of PAIs previously shown in nonclinical samples to improve positive thinking, emotions, and behaviors (e.g., gratitude, acts of kindness, optimism; n = 16) or a waitlist (WL) condition (n = 13). Participants were assessed at pre- and posttreatment, as well as 3- and 6-month follow-up, on measures of positive and negative affect, symptoms, and psychological well-being. Results: The PAI group displayed significantly larger improvements in positive affect and psychological well-being from pre- to posttreatment compared to WL. Posttreatment and followup scores in the PAI group were comparable to general population norms. The PAI regimen also resulted in significantly larger reductions in negative affect, as well as anxiety and depression symptoms, compared to WL. Improvements across all outcomes were large in magnitude and maintained over a 6-month follow-up period. Conclusions: Targeting the positive affect system through a multicomponent PAI regimen may be beneficial for generating improvements in positive emotions and well-being, as well as reducing negative affect and symptoms, in individuals with clinically impairing anxiety or depression. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Taylor, Charles T; Lyubomirsky, Sonja; Stein, Murray B",2017.0,http://dx.doi.org/10.1002/da.22593,0,1,
117, Effects of a brief anxiety sensitivity reduction intervention on obsessive compulsive spectrum symptoms in a young adult sample," METHOD: Non‐treatment seeking young adults (N = 104; 83.7% female; 81.7% Caucasian) were selected for having elevated levels of AS, and were then randomized into a single‐session, computer‐assisted AS intervention or a control condition. OC and hoarding symptoms were assessed at post‐treatment, as well as at one week and one month follow‐ups. RESULTS: Results revealed that the intervention, but not the control condition, reduced OC symptoms across the post‐intervention follow‐up period. Mediation analysis demonstrated that changes in AS mediated changes in OC symptoms due to the intervention. In contrast, the intervention did not have a specific effect on reducing hoarding symptoms. CONCLUSIONS: These findings have important ramifications for understanding the relationship between AS and OC spectrum symptoms, and raise interesting treatment and prevention implications. OBJECTIVE: Anxiety sensitivity (AS) has been identified as a transdiagnostic cognitive risk factor for a wide range of affective disorders, including conditions within the obsessive compulsive (OC) spectrum. A growing body of research has demonstrated that directly reducing AS leads to subsequent reductions of other psychiatric symptoms, including anxiety, worry, and mood. To date, no study has examined the efficacy of a brief AS intervention on reducing OC and hoarding symptoms."," Timpano, KR;  Raines, AM;  Shaw, AM;  Keough, ME;  Schmidt, NB",2016.0, 10.1016/j.jpsychires.2016.07.022,0,1,
118, An integrated intervention to reduce intimate partner violence and psychological distress with refugees in low-resource settings: study protocol for the Nguvu cluster randomized trial," BACKGROUND: Intimate partner violence (IPV) is a critical public health and human rights concern globally, including for refugee women in low‐resource settings. Little is known about effective interventions for this population. IPV and psychological distress have a bi‐directional relationship, indicating the potential benefit of a structured psychological component as part of efforts to reduce IPV for women currently in violent relationships. METHODS: This protocol describes a cluster randomized controlled trial aimed at evaluating an 8‐session integrated psychological and advocacy intervention (Nguvu) with female adult survivors of past‐year IPV displaying moderate to severe psychological distress. Outcomes are reductions in: recurrence of IPV; symptoms of anxiety, depression and post‐traumatic stress (primary); and functional impairment (secondary). Hypothesized mediators of the intervention are improvements in social support, coping skills and support seeking. We will recruit 400 participants from existing women's support groups operating within villages in Nyarugusu refugee camp, Tanzania. Women's groups will be randomized to receive the intervention (Nguvu and usual care) or usual care alone. All eligible women will complete a baseline assessment (week 0) followed by a post‐treatment (week 9) and a 3‐month post‐treatment assessment (week 20). The efficacy of the intervention will be determined by between‐group differences in the longitudinal trajectories of primary outcomes evaluated using mixed‐effects models. Study procedures have been approved by Institutional Review Boards in the United States and Tanzania. DISCUSSION: This trial will provide evidence on the efficacy of a novel integrated group intervention aimed at secondary prevention of IPV that includes a structured psychological component to address psychological distress. The psychological and advocacy components of the proposed intervention have been shown to be efficacious for their respective outcomes when delivered in isolation; however, administering these approaches through a single, integrated intervention may result in synergistic effects given the interrelated, bidirectional relationship between IPV and mental health. Furthermore, this trial will provide information regarding the feasibility of implementing a structured intervention for IPV and mental health in a protracted humanitarian setting. TRIAL REGISTRATION: ISRCTN65771265 , June 27, 2016."," Tol, WA;  Greene, MC;  Likindikoki, S;  Misinzo, L;  Ventevogel, P;  Bonz, AG;  Bass, JK;  Mbwambo, JKK",2017.0, 10.1186/s12888-017-1338-7,0,1,
119,"Symptom reduction without remoralization: A randomized, waiting-list controlled study aimed at separating two beneficial psychotherapy outcome effects.","Objective: Treatment effects in psychotherapy outcome research are generally based on the reduction of symptoms. Standard inclusion of other beneficial treatment effects such as remoralization (increase of hope, self-efficacy, well-being) might lead to more elaborate findings in the field of psychotherapy. On the other hand, it is also possible that symptom reduction and remoralization always go hand in hand in the experience of patients. The present study sought to experimentally test this assumption. Method: A total of 78 patients suffering from panic disorder were randomly assigned to brief remoralization treatment, brief exposure treatment, or waiting list (WL). Results: Both treatments increased remoralization and both reduced symptoms of panic disorder as compared to WL. Conclusion: It is unlikely that patients experience remoralization without symptom reduction or symptom reduction without remoralization. These findings do not favor the assumption that conclusions within psychotherapy outcome research are flawed because of its heavy reliance on measurements of symptom reduction. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Vissers, Wiede; Keijsers, Ger P. J; Kampman, Mirjam; Hendriks, Gert-Jan; Rijnders, Paul; Hutschemaekers, Giel J. M",2017.0,http://dx.doi.org/10.1002/jclp.22380,0,1,
120,"Rationale, design, and implementation of a clinical trial of a mindfulness-based relapse prevention protocol for the treatment of women with comorbid post traumatic stress disorder and substance use disorder.","Comorbid post-traumatic stress disorder (PTSD) and substance use disorders (SUD) commonly co-occur and is associated with a more complex clinical presentation with poorer clinical outcomes when compared with either disorder alone, and untreated PTSD can predict relapse to substance abuse. A number of integrated treatment approaches addressing symptoms of both PTSD and SUD concurrently demonstrate that both disorders can safely and effectively be treated concurrently. However, attrition and SUD relapse rates remain high and there is need to further develop new treatment approaches. Innovative approaches such as mindfulness meditation (MM) successfully used in the treatment of SUD may offer additional benefits for individuals with SUD complicated with PTSD. Specifically, Mindfulness-based Relapse Prevention (MBRP) integrates coping skills from cognitive-behavioral relapse prevention therapy with MM practices, raising awareness of substance use triggers and reactive behavioral patterns, and teaching skillful coping responses. Here we present the design and methods for the ""Mindfulness Meditation for the Treatment of Women with comorbid PTSD and SUD"" study, a Stage 1b behavioral development study that modifies MBRP treatment to address both PTSD and SUD in a community setting. This study is divided into three parts: revising the existing evidence-based manual, piloting the intervention, and testing the new manual in a randomized controlled pilot trial in women with comorbid PTSD and SUD enrolled in a community-based SUD treatment program.",Vrana C.; Killeen T.; Brant V.; Mastrogiovanni J.; Baker NL.,2017.0,10.1016/j.cct.2017.07.024,0,1,
121,Pretreatment Cardiac Vagal Tone Predicts Dropout from and Residual Symptoms after Exposure Therapy in Patients with Panic Disorder and Agoraphobia.,,Wendt J.; Hamm AO.; Pané-Farré CA.; Thayer JF.; Gerlach A.; Gloster AT.; Lang T.; Helbig-Lang S.; Pauli P.; Fydrich T.; Ströhle A.; Kircher T.; Arolt V.; Deckert J.; Wittchen HU.; Richter J.,2018.0,10.1159/000487599,0,1,
122,Randomized clinical trial evaluating the preliminary effectiveness of an integrated anxiety disorder treatment in substance use disorder specialty clinics.,"Objective: Anxiety and substance use disorders are highly comorbid and mutually maintain each other. Treatments for anxiety disorders that are well integrated into substance use disorder treatment have the potential to improve both anxiety and substance use outcomes. Method: Ninety-seven individuals seeking treatment at a community-based, evidence-based intensive outpatient program for substance use disorders who also had anxiety disorders were randomized to either (a) usual care (UC) at the intensive outpatient program; or (b) UC + coordinated anxiety learning and management for addiction recovery centers (CALM ARC), a 7-session, group-based, computer-assisted but therapist-directed treatment for anxiety disorders adapted for individuals with anxiety disorder and substance use disorder comorbidity. Results: CALM ARC + UC outperformed UC on measures of anxiety and substance use at posttreatment and at a 6-month follow-up. Conclusions: Adding CALM ARC to UC for patients with comorbid anxiety disorders and substance use disorders is superior to UC alone. Implications for future research and clinical practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement What is the public health significance of this article?-Patients with comorbid anxiety and substance use disorders who received an adjunctive cognitive-behavioral intervention for anxiety during substance use disorder treatment showed greater improvement in anxiety and substance use outcomes than those who with this comorbidity who received only substance use disorder treatment. This intervention was feasible for delivery in real-world substance use disorder clinics. Its delivery platform, brevity, and adaptation to meet the needs of this population increases the likelihood of adoption in community practices. Treating substance use disorder patients for comorbid anxiety disorders using an integrated approach has a significant impact on clinical outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Wolitzky-Taylor, Kate; Krull, Jennifer; Rawson, Richard; Roy-Byrne, Peter; Ries, Richard; Craske, Michelle G",2018.0,http://dx.doi.org/10.1037/ccp0000276,0,1,
123,Acupuncture for posttraumatic stress disorder: a randomized controlled pilot trial.,"The purpose of the study was to evaluate the potential efficacy and acceptability of accupuncture for posttraumatic stress disorder (PTSD). People diagnosed with PTSD were randomized to either an empirically developed accupuncture treatment (ACU), a group cognitive-behavioral therapy (CBT), or a wait-list control (WLC). The primary outcome measure was self-reported PTSD symptoms at baseline, end treatment, and 3-month follow-up. Repeated measures MANOVA was used to detect predicted Group X Time effects in both intent-to-treat (ITT) and treatment completion models. Compared with the WLC condition in the ITT model, accupuncture provided large treatment effects for PTSD (F [1, 46] = 12.60; p < 0.01; Cohen's d = 1.29), similar in magnitude to group CBT (F [1, 47] = 12.45; p < 0.01; d = 1.42) (ACU vs. CBT, d = 0.29). Symptom reductions at end treatment were maintained at 3-month follow-up for both interventions. Accupuncture may be an efficacious and acceptable nonexposure treatment option for PTSD. Larger trials with additional controls and methods are warranted to replicate and extend these findings.",Hollifield M.; Sinclair-Lian N.; Warner TD.; Hammerschlag R.,2007.0,10.1097/NMD.0b013e31803044f8,0,1,
124,Long-term outcome of early interventions to prevent posttraumatic stress disorder.,"Failing to prevent posttraumatic stress disorder (PTSD) has major clinical and public health consequences. This work evaluates the 3-year outcome of offering early interventions to survivors with acute PTSD. Adults admitted consecutively to the hospital with acute DSM-IV PTSD were randomized, between June 2003 and October 2007, to 12 weeks of prolonged exposure (n = 63) or cognitive therapy (n = 40) or concealed SSRI (escitalopram; n = 23) versus placebo (n = 23). Eighty-two participants who declined treatment were followed as well. Treatment started 1 month after the traumatic event, and participants were reassessed 5 and 36 months later. Assessors were blinded to treatment allocation and acceptance. The Clinician-Administered PTSD Scale (CAPS) evaluated PTSD and PTSD symptoms. Self-reported symptoms, general functioning, and employment status were secondary outcomes. Participants lost to follow-up were missing completely at random. Prolonged exposure and cognitive therapy significantly reduced PTSD and PTSD symptoms between 1 and 5 months (mean CAPS total scores [95% CI] at 1 month: prolonged exposure = 73.59 [68.21-78.96] and cognitive therapy = 71.78 [66.92-78.93]; mean CAPS total scores [95% CI] at 5 months: prolonged exposure = 28.59 [21.89-35.29] and cognitive therapy = 29.48 [21.32-37.95], P < .001), and their results remained stable. At 3 years, however, the study groups had similar levels of PTSD symptoms (mean CAPS total scores [95% CI]: prolonged exposure = 31.51 [20.25-42.78]; cognitive therapy = 32.08 [20.74-43.42]; SSRI = 34.31 [16.54-52.07]; placebo = 32.13 [20.15-44.12]; and no intervention = 30.59 [19.40-41.78]), similar prevalence of PTSD (28.6%-46.2%), and similar secondary outcomes. Early prolonged exposure and cognitive therapy accelerated the recovery from acute PTSD. Their effect remained stable, however, without reducing the 3-year prevalence of the disorder. The lingering prevalence of PTSD, despite efficient interventions, illustrates a nonremitting, treatment-refractory subset of survivors and outlines a major clinical and public health challenge. ClinicalTrials.gov identifier: NCT00146900.",Shalev AY.; Ankri Y.; Gilad M.; Israeli-Shalev Y.; Adessky R.; Qian M.; Freedman S.,2016.0,10.4088/JCP.15m09932,0,1,
125,Prevention of posttraumatic stress disorder by early treatment: results from the Jerusalem Trauma Outreach And Prevention study.,"Preventing posttraumatic stress disorder (PTSD) is a pressing public health need. To compare early and delayed exposure-based, cognitive, and pharmacological interventions for preventing PTSD. Equipoise-stratified randomized controlled study. Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity. Consecutively admitted survivors of traumatic events were assessed by use of structured telephone interviews a mean (SD) 9.61 (3.91) days after the traumatic event. Survivors with symptoms of acute stress disorder were referred for clinical assessment. Survivors who met PTSD symptom criteria during the clinical assessment were invited to receive treatment. Twelve weekly sessions of prolonged exposure (PE; n = 63), or cognitive therapy (CT; n = 40), or double blind treatment with 2 daily tablets of either escitalopram (10 mg) or placebo (selective serotonin reuptake inhibitor/placebo; n = 46), or 12 weeks in a waiting list group (n = 93). Treatment started a mean (SD) 29.8 (5.7) days after the traumatic event. Waiting list participants with PTSD after 12 weeks received PE a mean (SD) 151.8 (42.4) days after the traumatic event (delayed PE). Proportion of participants with PTSD after treatment, as determined by the use of the Clinician-Administered PTSD Scale (CAPS) 5 and 9 months after the traumatic event. Treatment assignment and attendance were concealed from the clinicians who used the CAPS. At 5 months, 21.6% of participants who received PE and 57.1% of comparable participants on the waiting list had PTSD (odds ratio [OR], 0.21 [95% CI, 0.09-0.46]). At 5 months, 20.0% of participants who received CT and 58.7% of comparable participants on the waiting list had PTSD (OR, 0.18 [CI, 0.06-0.48]). The PE group did not differ from the CT group with regard to PTSD outcome (OR, 0.87 [95% CI, 0.29-2.62]). The PTSD prevalence rates did not differ between the escitalopram and placebo subgroups (61.9% vs 55.6%; OR, 0.77 [95% CI, 0.21-2.77]). At 9 months, 20.8% of participants who received PE and 21.4% of participants on the waiting list had PTSD (OR, 1.04 [95% CI, 0.40-2.67]). Participants with partial PTSD before treatment onset did similarly well with and without treatment. Prolonged exposure, CT, and delayed PE effectively prevent chronic PTSD in recent survivors. The lack of improvement from treatment with escitalopram requires further evaluation. Trauma-focused clinical interventions have no added benefit to survivors with subthreshold PTSD symptoms. Trial Registration clinicaltrials.gov Identifier: NCT00146900.",Shalev AY.; Ankri Y.; Israeli-Shalev Y.; Peleg T.; Adessky R.; Freedman S.,2012.0,10.1001/archgenpsychiatry.2011.127,0,1,
126,Treatment of acute posttraumatic stress disorder with brief cognitive behavioral therapy: a randomized controlled trial.,"The purpose of this study was to evaluate the efficacy of brief cognitive behavioral therapy for patients with acute posttraumatic stress disorder (PTSD) resulting from various types of psychological trauma. The authors randomly assigned 143 patients with acute PTSD (irrespective of the time criterion), within 3 months after experiencing a traumatic incident, to either brief cognitive behavioral therapy (N=79) or a waiting list comparison group (N=64). Cognitive behavioral therapy consisted of four weekly sessions containing education, relaxation exercises, imaginal exposure, in vivo exposure, and cognitive restructuring. Main outcome measure was PTSD score measured by structured interview; secondary outcomes were anxiety and depression measured by questionnaire. Assessments took place before the intervention and 1 week and 4 months after the intervention. Symptoms of PTSD, anxiety, and depression decreased in both groups over time. One week after the intervention, the cognitive behavioral therapy group had significantly fewer symptoms of PTSD than the comparison group, but this difference was smaller and no longer significant 4 months after the intervention. Similar results were found for anxiety and depression scores. Subgroup analyses showed that cognitive behavioral therapy led to significantly lower PTSD scores at 4 months in patients with baseline comorbid major depression and in patients who were included within the first month after the traumatic incident both at 1 week and at 4 months. Brief early cognitive behavioral therapy accelerated recovery from symptoms of acute PTSD but did not influence long-term results. Brief early cognitive behavioral therapy showed enhanced efficacy in patients with baseline comorbid depression and patients who were included within 1 month after their traumatic experience.",Sijbrandij M.; Olff M.; Reitsma JB.; Carlier IV.; de Vries MH.; Gersons BP.,2007.0,10.1176/ajp.2007.164.1.82,0,1,
127,Virtual reality exposure therapy for the treatment of fear of flying: a controlled investigation.,"Forty-five participants who refused to fly during a screening test and who also met Diagnostic and Statistical Manual of Mental Disorders criteria for specific phobia, agoraphobia, or panic disorder with agoraphobia were randomly assigned to 5 sessions of either virtual reality exposure (VRE) or attention-placebo group treatment (GT). At posttreatment, 65% of VRE participants and 57% of GT participants flew during a test flight. Both groups showed significant improvement following treatment on standardized self-report measures of flight anxiety, with a better outcome for the VRE group on 4 of 5 of these measures. At 6-month follow-up, however, most group differences had disappeared; VRE resulted in a better outcome on only 1 of 5 standardized flight anxiety measures.",Maltby N.; Kirsch I.; Mayers M.; Allen GJ.,2002.0,,0,1,
128, A pilot randomized controlled trial of videoconference-assisted treatment for obsessive-compulsive disorder," Evidence‐based exposure and response prevention (ERP) treatment for obsessive‐compulsive disorder (OCD) is not always easily accessible. Long distances from specialist treatment and other practical or motivational difficulties can interfere with ERP access and outcome. Delivery of ERP through telepsychology can help ""fill the gap"". The current study included 30 patients with OCD who were randomized to 12 weeks of either videoconference‐assisted ERP (VCT; N=10), self‐help ERP (S‐H, N=10), or a wait‐list condition (W‐L, N=10). The VCT format included use of tablet‐based videoconferencing sessions (N=6) or studio‐based videoconference (N=4), as well as telephone calls. Patients rated the VCT format as natural and reported strong working alliances with their therapists. VCT treatment produced significantly greater reductions in obsessive‐compulsive symptoms compared to the two control conditions. Treatment outcomes were similar to that of regular face‐to‐face ERP and improvements in symptom scores remained stable at follow‐up. The study indicated that ERP for OCD can be delivered efficiently with videoconferencing technology along with telephone calls. The use of such technology in psychological treatment is likely to become more common in the future and it holds promise as a method to make evidence‐based treatment more accessible."," Vogel, PA;  Solem, S;  Hagen, K;  Moen, EM;  Launes, G;  Håland, ÅT;  Hansen, B;  Himle, JA",2014.0, 10.1016/j.brat.2014.10.007,0,1,
129, Eye movement desensitisation and reprocessing therapy v. stabilisation as usual for refugees: randomised controlled trial," BACKGROUND: Eye movement desensitisation and reprocessing (EMDR) therapy is a first‐line treatment for adults with post‐traumatic stress disorder (PTSD). Some clinicians argue that with refugees, directly targeting traumatic memories through EMDR may be harmful or ineffective. AIMS: To determine the safety and efficacy of EMDR in adult refugees with PTSD (trial registration: ISRCTN20310201). METHOD: In total, 72 refugees referred for specialised treatment were randomly assigned to 12 h of EMDR (3×60 min planning/preparation followed by 6×90 min desensitisation/reprocessing) or 12 h (12×60 min) of stabilisation. The Clinician‐Administered PTSD Scale (CAPS) and Harvard Trauma Questionnaire (HTQ) were primary outcome measures. RESULTS: Intention‐to‐treat analyses found no differences in safety (one severe adverse event in the stabilisation condition only) or efficacy (effect sizes: CAPS ‐0.04 and HTQ 0.20) between the two conditions. CONCLUSIONS: Directly targeting traumatic memories through 12 h of EMDR in refugee patients needing specialised treatment is safe, but is only of limited efficacy."," Ter Heide, FJ;  Mooren, TM;  van de Schoot, R;  de Jongh, A;  Kleber, RJ",2016.0, 10.1192/bjp.bp.115.167775,0,1,
130,Individually tailored internet-based cognitive behaviour therapy for older adults with anxiety and depression: A randomised controlled trial.,"Mixed anxiety and depression is common among older adults. The aim of the study was to compare the effects of an eight-week-long tailored internet-supported cognitive behaviour therapy (ICBT) programme and to compare against the provision of weekly general support. A second aim was to investigate if pre-treatment cognitive flexibility and self-reported cognitive problems would predict outcome. We included 66 older adults (aged over 60 years) with mixed anxiety/depression following media recruitment and randomised them into treatment and control groups. We also included a one-year follow-up. As a measure of executive function, we used the Wisconsin Card Sorting Test (perseverative errors) and the Cognitive Failures Questionnaire during the pre-treatment phase. Results showed a moderate between-group effect on the main outcome measure, the Beck Anxiety Inventory (BAI) (d = .50), favouring the treatment group. Nearly half (45.5%) of that group were classified as responders. One person (3%) in the treatment group deteriorated. There were significant correlations between perseverative errors and outcome (on the BAI r = -.45), but not among self-reported cognitive function. We conclude that guided, tailored ICBT may be effective for some older adults and that the role of cognitive function needs to be investigated further. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Silfvernagel, Kristin; Westlinder, Anna; Andersson, Stina; Bergman, Kajsa; Hernandez, Rosario Diaz; Fallhagen, Line; Lundqvist, Ida; Masri, Nicole; Viberg, Linda; Forsberg, Marie-Louise; Lind, Maria; Berger, Thomas; Carlbring, Per; Andersson, Gerhard",2018.0,http://dx.doi.org/10.1080/16506073.2017.1388276,0,1,
131,Neuropsychological predictors of response to cognitive behavioral therapy for posttraumatic stress disorder in persons with severe mental illness.,"This study examined whether cognitive functioning was related to treatment outcomes in persons with severe mental illness who received a cognitive behavioral therapy (CBT) program for co-occurring posttraumatic stress disorder (PTSD). The study sample was drawn from a larger controlled trial of 108 persons with severe mental illness and PTSD comparing the effects of CBT with treatment as usual on PTSD and related outcomes, with assessments conducted at baseline, post-treatment, and 3- and 6-month follow-ups. Among the 54 persons in CBT, 49 were administered a neuropsychological battery at baseline and 40 were exposed to the CBT program. Statistical analyses of these 40 participants were conducted to evaluate whether cognitive functioning was related to participation in the CBT program, completion of homework assignments, and improvements in PTSD, and other outcomes. Cognitive functioning was not related to participation in CBT or completion of homework. Lower cognitive functioning predicted less learning of information about PTSD at post-treatment and follow-up, but not less clinical benefit from CBT in PTSD diagnosis or symptoms, other symptoms, or health. The results suggest that cognitive impairment does not attenuate response to the CBT for PTSD program in persons with severe mental illness. Clinical Trials.gov Identifier: NCT00053690.",Mueser KT.; McGurk SR.; Xie H.; Bolton EE.; Jankowski MK.; Lu W.; Rosenberg SD.; Wolfe R.,2018.0,10.1016/j.psychres.2017.10.016,0,1,
132,Effectiveness of EMDR in patients with substance use disorder and comorbid PTSD: study protocol for a randomized controlled trial.,"Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment for PTSD. However, it is unclear whether EMDR shows the same effectiveness in patients with substance use disorders (SUD) and comorbid PTSD. In this trial, we examine the effectiveness of EMDR in reducing PTSD symptoms in patients with SUD and PTSD. We conduct a single-blinded RCT among 158 patients with SUD and comorbid PTSD admitted to a German addiction rehabilitation center specialized for the treatment of patients with SUD and comorbid PTSD. Patients are randomized to receive either EMDR, added to SUD rehabilitation and non-trauma-focused PTSD treatment (TAU), or TAU alone. The primary outcome is change from baseline in PTSD symptom severity as measured by the Clinician-Administered PTSD Scale at 6-month follow-up. Secondary outcomes are change from baseline in substance use, addiction-related problems, depressive symptoms, dissociative symptoms, emotion dysregulation and quality of life. Assessments are carried out by blinded raters at admission, at end of treatment, and at 3- and 6-month follow-up. We expect that EMDR plus TAU will be more effective in reducing PTSD symptoms than TAU alone. Mixed models will be conducted using an intention-to-treat and per-protocol approach. This study aims to expand the knowledge about the effectiveness of EMDR in patients with SUD and comorbid PTSD. The expected finding of the superiority of EMDR in reducing PTSD symptoms compared to non-trauma-focused PTSD treatment may enhance the use of trauma-focused treatment approaches for patients with SUD and co-morbid PTSD. German Clinical Trials Register: DRKS00009007 ; U1111-1172-9213. Retrospectively registered 01 Juni 2016.",Schäfer I.; Chuey-Ferrer L.; Hofmann A.; Lieberman P.; Mainusch G.; Lotzin A.,2017.0,10.1186/s12888-017-1255-9,0,1,
133,Non-trauma-focused meditation versus exposure therapy in veterans with post-traumatic stress disorder: A randomised controlled trial.,"Background: Post-traumatic stress disorder (PTSD) is a complex and difficult-to-treat disorder, affecting 10-20% of military veterans. Previous research has raised the question of whether a non-trauma-focused treatment can be as effective as trauma exposure therapy in reducing PTSD symptoms. This study aimed to compare the non-trauma-focused practice of Transcendental Meditation (TM) with prolonged exposure therapy (PE) in a non-inferiority clinical trial, and to compare both therapies with a control of PTSD health education (HE). Methods: We did a randomised controlled trial at the Department of Veterans Affairs San Diego Healthcare System in CA, USA. We included 203 veterans with a current diagnosis of PTSD resulting from active military service randomly assigned to a TM or PE group, or an active control group of HE, using stratified block randomisation. Each treatment provided 12 sessions over 12 weeks, with daily home practice. TM and HE were mainly given in a group setting and PE was given individually. The primary outcome was change in PTSD symptom severity over 3 months, assessed by the Clinician-Administered PTSD Scale (CAPS). Analysis was by intention to treat. We hypothesised that TM would show non-inferiority to PE in improvement of CAPS score (DELTA = 10), with TM and PE superior to PTSD HE. This study is registered with ClinicalTrials.gov, number NCT01865123. Findings: Between June 10, 2013, and Oct 7, 2016, 203 veterans were randomly assigned to an intervention group (68 to the TM group, 68 to the PE group, and 67 to the PTSD HE group). TM was significantly non-inferior to PE on change in CAPS score from baseline to 3-month post-test (difference between groups in mean change -5.9, 95% CI -14.3 to 2.4, p = 0.0002). In standard superiority comparisons, significant reductions in CAPS scores were found for TM versus PTSD HE (-14.6 95% CI, -23.3 to -5.9, p = 0.0009), and PE versus PTSD HE (-8.7 95% CI, -17.0 to -0.32, p = 0.041). 61% of those receiving TM, 42% of those receiving PE, and 32% of those receiving HE showed clinically significant improvements on the CAPS score. Interpretation: A non-trauma-focused-therapy, TM, might be a viable option for decreasing the severity of PTSD symptoms in veterans and represents an efficacious alternative for veterans who prefer not to receive or who do not respond to traditional exposure-based treatments of PTSD. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Nidich, Sanford; Mills, Paul J; Rainforth, Maxwell; Heppner, Pia; Schneider, Robert H; Rosenthal, Norman E; Salerno, John; Gaylord-King, Carolyn; Rutledge, Thomas",2018.0,http://dx.doi.org/10.1016/S2215-0366%2818%2930384-5,0,1,
134, Concurrent Treatment with Prolonged Exposure for Co-Occurring Full or Subthreshold Posttraumatic Stress Disorder and Substance Use Disorders: a Randomized Clinical Trial," BACKGROUND: To test whether an integrated prolonged exposure (PE) approach could address posttraumatic stress disorder (PTSD) symptoms effectively in individuals with co‐occurring substance use disorders (SUD), we compared concurrent treatment of PTSD and SUD using PE (COPE) to relapse prevention therapy (RPT) for SUD and an active monitoring control group (AMCG). METHODS: We conducted a randomized 12‐week trial with participants (n = 110; 64% males; 59% African Americans) who met Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision criteria for full or subthreshold PTSD and SUD. Participants were randomly assigned to COPE (n = 39), RPT (n = 43), or AMCG (n = 28). RESULTS: At the end‐of‐treatment, COPE and RPT demonstrated greater reduction in PTSD symptom severity relative to AMCG (COPE‐AMCG = ‐34.06, p < 0.001; RPT‐AMCG = ‐22.58, p = 0.002). Although the difference between COPE and RPT was not significant in the complete sample, the subset of participants with full (vs. subthreshold) PTSD demonstrated significantly greater reduction of PTSD severity in COPE relative to RPT. Both treatments were superior to AMCG in reducing the days of primary substance use (COPE‐AMCG = ‐0.97, p = 0.01; RPT‐AMCG = ‐2.07, p < 0.001). Relative to COPE, RPT showed significantly more improvement in SUD outcome at end‐of‐treatment (RPT‐COPE = ‐1.10, p = 0.047). At 3‐month follow‐up, COPE and RPT maintained their treatment gains and were not significantly different in PTSD severity or days of primary substance use. CONCLUSION: COPE and RPT reduced PTSD and SUD severity in participants with PTSD + SUD. Findings suggest that among those with full PTSD, COPE improves PTSD symptoms more than a SUD‐only treatment. The use of PE for PTSD was associated with significant decreases in PTSD symptoms without worsening of substance use."," Ruglass, LM;  Lopez-Castro, T;  Papini, S;  Killeen, T;  Back, SE;  Hien, DA",2017.0, 10.1159/000462977,0,1,
135,An RCT of effects of telephone care management on treatment adherence and clinical outcomes among veterans with PTSD.,"Objective: This study assessed whether adding telephone care management to usual outpatient mental health care improved treatment attendance, medication compliance, and clinical outcomes of veterans with posttraumatic stress disorder (PTSD). Methods: In a multisite randomized controlled trial, 358 veterans were assigned to either usual outpatient mental health treatment (N = 165) or usual care plus twice-a-month telephone care management (TCM) and support in the first three months of treatment (N = 193). Treatment utilization and medication refills were determined from U.S. Department of Veterans Affairs administrative data. PTSD, depression, quality of life, aggressive behavior, and substance use were assessed with self-report questionnaires at intake, four months, and 12 months. Results: Telephone care managers reached 95% of TCM participants (N = 182), completing an average 5.1 of 6.0 planned telephone calls. During the three-month intervention period, TCM participants completed 43% more mental health visits (M +/- SD = 5.9 +/- 6.8) than did those in usual care (4.1 +/- 4.2) (incident rate ratio = 1.36, chi2 = 6.56, df = 1, p < .01). Treatment visits in the nine-month follow-up period and medication refills did not differ by condition. Only 9% of participants were scheduled to receive evidence-based psychotherapy. Slopes of improvement in PTSD, depression, alcohol misuse, drug problems, aggressive behavior, and quality of life did not differ by condition or treatment attendance. Conclusions: TCM improved PTSD patients' treatment attendance but not their outcomes. TCM can enhance treatment engagement, but outcomes depend on the effectiveness of the treatments that patients receive. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Rosen, Craig S; Azevedo, Kathryn J; Tiet, Quyen Q; Greene, Carolyn J; Wood, Amanda E; Calhoun, Patrick; Bowe, Thomas; Capehart, Bruce P; Crawford, Eric F; Greenbaum, Mark A; Harris, Alex H. S; Hertzberg, Michael; Lindley, Steven E; Smith, Brandy N; Schnurr, Paula P",2017.0,http://dx.doi.org/10.1176/appi.ps.201600069,0,1,
136,Effectiveness of online collaborative care for treating mood and anxiety disorders in primary care: A randomized clinical trial.,"[Correction Notice: An Erratum for this article was reported in Vol 75(1) of JAMA Psychiatry (see record 2018-04043-018). In the original article, there was an error in Figure 3. The corrections are provided in the erratum, and the article was corrected online.] Importance: Collaborative care for depression and anxiety is superior to usual care from primary care physicians for these conditions; however, challenges limit its provision in routine practice and at scale. Advances in technology may overcome these barriers but have yet to be tested. Objective: To examine the effectiveness of combining an internet support group (ISG) with an online computerized cognitive behavioral therapy (CCBT) provided via a collaborative care program for treating depression and anxiety vs CCBT alone and whether providing CCBT in this manner is more effective than usual care. Design, Setting, and Participants: In this 3-arm randomized clinical trial with blinded outcome assessments, primary care physicians from 26 primary care practices in Pittsburgh, Pennsylvania, referred 2884 patients aged 18 to 75 years in response to an electronic medical record prompt from August 2012 to September 2014. Overall, 704 patients (24.4%) met all eligibility criteria and were randomized to CCBT alone (n = 301), CCBT + ISG (n = 302), or usual care (n = 101). Intent-to-treat analyses were conducted November 2015 to January 2017. Interventions: Six months of guided access to an 8-session CCBT program provided by care managers who informed primary care physicians of their patients' progress and promoted patient engagement with our online programs. Main Outcomes and Measures: Mental health-related quality of life (12-Item Short-Form Health Survey Mental Health Composite Scale) and depression and anxiety symptoms (Patient-Reported Outcomes Measurement Information System) at 6-month follow-up, with treatment durability assessed 6 months later. Results: Of the 704 randomized patients, 562 patients (79.8%) were female, and the mean (SD) age was 42.7 (14.3) years. A total of 604 patients (85.8%) completed our primary 6-month outcome assessment. At 6-month assessment, 254 of 301 patients (84.4%) receiving CCBT alone started the program (mean [SD] sessions completed, 5.4 [2.8]), and 228 of 302 patients (75.5%) in the CCBT+ISG cohort logged into the ISG at least once, of whom 141 (61.8%) provided 1 or more comments or posts (mean, 10.5; median [range], 3 [1-306]). Patients receiving CCBT+ISG reported similar 6-month improvements in mental health-related quality of life, mood, and anxiety symptoms compared with patients receiving CCBT alone. However, compared with patients receiving usual care, patients in the CCBT alone cohort reported significant 6-month effect size improvements in mood (effect size, 0.31; 95% CI, 0.09-0.53) and anxiety (effect size, 0.26; 95% CI, 0.05-0.48) that persisted 6 months later, and completing more CCBT sessions produced greater effect size improvements in mental health-related quality of life and symptoms. Conclusions and Relevance: While providing moderated access to an ISG provided no additional benefit over guided CCBT at improving mental health-related quality of life, mood, and anxiety symptoms, guided CCBT alone is more effective than usual care for these conditions. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Rollman, Bruce L; Belnap, Bea Herbeck; Hum, Biol; Abebe, Kaleab Z; Spring, Michael B; Rotondi, Armando J; Rothenberger, Scott D; Karp, Jordan F",2018.0,http://dx.doi.org/10.1001/jamapsychiatry.2017.3379,0,1,
137,A pragmatic randomized controlled trial of group transdiagnostic cognitive-behaviour therapy for anxiety disorders in primary care: Study protocol.,"Background: Anxiety disorders are the most common mental disorders in community settings, and they are associated with significant psychological distress, functional and social impairment. While cognitive behaviour therapy (CBT) is the most consistently efficacious psychological treatment for anxiety disorders, barriers preclude widespread implementation of CBT in primary care. Transdiagnostic group CBT (tCBT) focuses on cognitive and behavioural processes and intervention strategies common to different anxiety disorders, and could be a promising alternative to conventional CBT. This study aims to examine the effectiveness of a transdiagnostic group CBT for anxiety disorders program as a complement to treatment-as-usual (TAU) in primary mental health care. Methods/Design: The trial is a multicentre pragmatic randomized controlled trial with a pre-treatment, post-treatment, and follow-up at 4, 8 and 12-months design. Treatment and control groups . a) tCBT (12 weekly 2-h group sessions following a manualized treatment protocol); b) TAU for anxiety disorders. Inclusion criteria comprise meeting DSM-5 criteria for primary Panic Disorder, Agoraphobia, Social Anxiety Disorder and/or Generalized Anxiety Disorder. Patients are recruited in three regions in the province of Quebec, Canada. The primary outcome measures are the self-reported Beck Anxiety Inventory and the clinician-administered Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5); secondary outcome measures include treatment responder status based on the ADIS-5, and self-reported instruments for specific anxiety and depression symptoms, quality of life, functioning, and service utilisation. Statistical analysis: Intention-to-treat analysis. A mixed effects regression model will be used to account for between- and within-subject variations in the analysis of the longitudinal effects of the intervention. Discussion: This rigorous evaluation of tCBT in the real world will provide invaluable information to decision makers, health care managers, clinicians and patients regarding the effectiveness of the intervention. Widespread implementation of tCBT protocols in primary care could lead to better effectiveness, efficiency, access and equity for the large number of patients suffering from anxiety disorders that are currently not obtaining evidence-based psychotherapy. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Roberge, Pasquale; Provencher, Martin D; Gosselin, Patrick; Vasiliadis, Helen-Maria; Gaboury, Isabelle; Benoit, Annie; Antony, Martin M; Chaillet, Nils; Houle, Janie; Hudon, Catherine; Norton, Peter J",2018.0,,0,1,
138, False Safety Behavior Elimination Therapy: a randomized study of a brief individual transdiagnostic treatment for anxiety disorders," In response to the ever‐growing number of CBT based therapy protocols, transdiagnostic approaches to anxiety treatment, based on models of anxiety emphasizing common elements across anxiety disorders, have been increasingly explored. The aim of the current study was to test the efficacy of an individually administered, brief (5‐session) transdiagnostic treatment for anxiety disorders. The current treatment (called F‐SET) focuses chiefly on the elimination of anxiety maintaining behaviors and cognitive strategies (so‐called ""safety"" aids) among individuals suffering from a range of anxiety disorders including generalized anxiety disorder (GAD), social anxiety disorder (SAD) and panic disorder (PD). Patients (N=28; mean age=28.5years; 75% female; 71% White) were randomly assigned to F‐SET or waitlist control conditions. Participants were assessed prior to, immediately after, and 1‐month following treatment. In addition to independent assessments of diagnostic status, standardized self‐report measures and assessor ratings of severity and distress associated with anxiety symptoms were used. Participants in the F‐SET condition experienced significantly less anxiety (Cohen's d=2.01) and depression (Cohen's d=2.16) than those in the WL condition. Mediational analysis showed that change in avoidance strategies mediated the group changes in anxiety symptoms. The results from the current study are an important first step in identifying a simpler, focused form of CBT that can be delivered with minimal therapist training, at a low cost and with minimal client contact time."," Riccardi, CJ;  Korte, KJ;  Schmidt, NB",2017.0, 10.1016/j.janxdis.2016.06.003,0,1,
139, Efficacy of virtual reality exposure therapy for treatment of dental phobia: a randomized control trial," BACKGROUND: Virtual Reality Exposure Therapy (VRET) is found to be a promising and a viable alternative for in vivo exposure in the treatment of specific phobias. However, its usefulness for treating dental phobia is unexplored. The aims of the present study are to determine: (a) the efficacy of VRET versus informational pamphlet (IP) control group in terms of dental trait and state anxiety reductions at 1 week, 3 months and 6 months follow‐up (b) the real‐time physiological arousal [heart rate (HR)] of VRET group participants during and following therapy (c) the relation between subjective (presence) and objective (HR) measures during VRET. METHODS: This study is a single blind, randomized controlled trial with two parallel arms in which participants will be allocated to VRET or IP with a ratio of 1:1. Thirty participants (18‐50 years) meeting the Phobia Checklist criteria of dental phobia will undergo block randomization with allocation concealment. The primary outcome measures include participants' dental trait anxiety (Modified Dental Anxiety Scale and Dental Fear Survey) and state anxiety (Visual Analogue Scale) measured at baseline (T0), at intervention (T1), 1‐week (T2), 3 months (T3) and 6 months (T4) follow‐up. A behavior test will be conducted before and after the intervention. The secondary outcome measures are real‐time evaluation of HR and VR (Virtual Reality) experience (presence, realism, nausea) during and following the VRET intervention respectively. The data will be analyzed using intention‐to‐treat and per‐protocol analysis. DISCUSSION: This study uses novel non‐invasive VRET, which may provide a possible alternative treatment for dental anxiety and phobia. TRIAL REGISTRATION NUMBER: ISRCTN25824611 , Date of registration: 26 October 2015."," Raghav, K;  Van Wijk, AJ;  Abdullah, F;  Islam, MN;  Bernatchez, M;  De Jongh, A",2016.0, 10.1186/s12903-016-0186-z,0,1,
140, Healing through giving testimony: an empirical study with Sri Lankan torture survivors," Sri Lanka has recently emerged from a three decade long civil war between government forces and the Liberation Tigers of Tamil Eelam. Behind the actual arena of conflict, forms of organised violence were often perpetrated on ordinary Sri Lankans who came into contact with law enforcement officials and other state authorities. The effects of these encounters on mental health, well‐being, and community participation can be severe and long‐lasting. Considering the generally poor availability of mental health services in many low‐income countries, brief efficient interventions are required to enhance the lives of individuals and their families affected by torture, trauma, or displacement. In this context, the present study evaluated the effectiveness of testimonial therapy in ameliorating the distress of Sri Lankan survivors of torture and ill‐treatment. The results indicated that over a 2‐ to 3‐month period, psychosocial functioning was significantly enhanced in the therapy group compared to the waitlist control group. The general benefits of testimonial therapy, the ease with which it can be incorporated into ongoing human rights activities, and its application by trained nonprofessionals encourage greater use of the approach."," Puvimanasinghe, TS;  Price, IR",2016.0, 10.1177/1363461516651361,0,1,
141, Efficacy of smoking cessation therapy alone or integrated with prolonged exposure therapy for smokers with PTSD: study protocol for a randomized controlled trial," Posttraumatic stress disorder (PTSD) is related to an increased risk of smoking cessation failure. In fact, the quit rate in smokers with PTSD (23.2%) is one of the lowest of all mental disorders. Features of PTSD that contribute to smokers' progression to nicotine dependence and cessation relapse include negative affect, fear, increased arousal, irritability, anger, distress intolerance, and anxiety sensitivity. Anxiety sensitivity is higher in people with PTSD than in any other anxiety disorder except for panic disorder. High anxiety sensitivity is uniquely associated with greater odds of lapse and relapse during quit attempts. Distress intolerance, a perceived or behavioral tendency to not tolerate distress, is related to both the maintenance of PTSD and problems in quitting smoking. Prolonged exposure (PE) and interoceptive exposure (IE) reduce PTSD symptoms, distress intolerance, and anxiety sensitivity. Thus, they emerge as promising candidates to augment standard smoking cessation interventions for individuals with PTSD. The present study tests a 12‐session specialized treatment for smokers with PTSD. This Integrated PTSD and Smoking Treatment (IPST) combines cognitive‐behavioral therapy and nicotine replacement treatment for smoking cessation (standard care; SC) with PE to target PTSD symptoms and IE to reduce anxiety sensitivity and distress intolerance. Adult smokers (N=80) with PTSD will be randomly assigned to either: (1) IPST or (2) SC. Primary outcomes are assessed at weeks 0, 6, 8, 10, 14, 16, 22, and 30."," Powers, MB;  Kauffman, BY;  Kleinsasser, AL;  Lee-Furman, E;  Smits, JA;  Zvolensky, MJ;  Rosenfield, D",2016.0, 10.1016/j.cct.2016.08.012,0,1,
142,"Efficacy of the unified protocol for the treatment of emotional disorders in the Spanish public mental health system using a group format: study protocol for a multicenter, randomized, non-inferiority controlled trial.","Emotional disorders, which include both anxiety and depressive disorders, are the most prevalent psychological disorders according to recent epidemiological studies. Consequently, public costs associated with their treatment have become a matter of concern for public health systems, which face long waiting lists. Because of their high prevalence in the population, finding an effective treatment for emotional disorders has become a key goal of today's clinical psychology. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders might serve the aforementioned purpose, as it can be applied to a variety of disorders simultaneously and it can be easily performed in a group format. The study is a multicenter, randomized, non-inferiority controlled clinical trial. Participants will be 220 individuals with emotional disorders, who are randomized to either a treatment as usual (individual cognitive behavioral therapy) or to a Unified Protocol condition in group format. Depression, anxiety, and diagnostic criteria are the primary outcome measures. Secondary measures include the assessment of positive and negative affect, anxiety control, personality traits, overall adjustment, and quality of life. An analysis of treatment satisfaction is also conducted. Assessment points include baseline, post-treatment, and three follow-ups at 3, 6, and 12 months. To control for missing data and possible biases, intention-to-treat and per-protocol analyses will be performed. This is the first randomized, controlled clinical trial to test the effectiveness of a transdiagnostic intervention in a group format for the treatment of emotional disorders in public settings in Spain. Results obtained from this study may have important clinical, social, and economic implications for public mental health settings in Spain. Retrospectively registered at https://clinicaltrials.gov/ . Trial NCT03064477 (March 10, 2017). The trial is active and recruitment is ongoing. Recruitment is expected to finish by January 2020.",Osma J.; Suso-Ribera C.; García-Palacios A.; Crespo-Delgado E.; Robert-Flor C.; Sánchez-Guerrero A.; Ferreres-Galan V.; Pérez-Ayerra L.; Malea-Fernández A.; Torres-Alfosea MÁ.,2018.0,10.1186/s12955-018-0866-2,0,1,
143,"A pragmatic, unblinded randomised controlled trial and economic evaluation of an occupational therapy-led lifestyle approach and routine GP care of panic disorder presenting in primary care",,Lambert,2006.0,,0,1,
144,"A comparative study on effectiveness of acceptance and commitment therapy and logotherapy on symptoms of depression, anxiety and stress of women suffering relapsing remitting multiple sclerosis: A randomized controlled trial study","Introduction: In recent years, psychological therapies increasingly used as complementary treatment along medication to help clinicians. The purpose of this study was to compare the effectiveness of two methods of group psychotherapy: Acceptance and commitment therapy (ACT) and logo therapy (LT) on the symptoms of anxiety, depression and stress in women with relapsing-remitting Multiple Sclerosis (RRMS). Materials and Methods: A sampling method was used to select 45 women from multiple sclerosis patients in Kermanshah (Iran). They were randomly assigned into two groups of experimental and one control group (n = 15 in each group). The first experimental group received 8 group sessions of ACT treatment. The second experimental group received 10 group sessions of LT as well, while the control group had just 8 simple group meeting with the therapist. All subjects completed Anxiety, Depression, and Stress Scales (DASS-42) before, after and three months after the application. Results: The mean of symptoms of anxiety, depression and stress in both experimental groups after intervention was significantly different with the mean of control group. However, no significant difference was observed between two experimental groups. Conclusion: Logo therapy and ACT are effective in decreasing the symptoms of depression, anxiety and stress in women with RRMS and could be recommended as adjunct therapies along with their medication.",Azimi A.; Hoseini S.M.; Najafi M.; Rafieenia P.,2018.0,,0,1,
145,A randomized controlled trial of emotion regulation therapy for generalized anxiety disorder with and without co-occurring depression.,"Objective: Generalized anxiety disorder (GAD) and major depression (MDD), especially when they co-occur, are associated with suboptimal treatment response. One common feature of these disorders is negative self-referential processing (NSRP; i.e., worry, rumination), which worsens treatment outcome. Emotion Regulation Therapy (ERT) integrates principles from affect science with traditional and contemporary cognitive-behavioral treatments to identify and modify the functional nature of NSRP by targeting motivational and regulatory mechanisms, as well as behavioral consequences. Method: Building on encouraging open trial findings, 53 patients with a primary diagnosis of GAD (43% with comorbid MDD) were randomly assigned to immediate treatment with ERT (n = 28) or a modified attention control condition (MAC, n = 25). Results: ERT patients, as compared with MAC patients, evidenced statistically and clinically meaningful improvement on clinical indicators of GAD and MDD, worry, rumination, comorbid disorder severity, functional impairment, quality of life, as well as hypothesized mechanisms reflecting mindful attentional, metacognitive, and overall emotion regulation, which all demonstrated mediation of primary outcomes. This superiority of ERT exceeded medium effect sizes with most outcomes surpassing conventions for a large effect. Treatment effects were maintained for nine months following the end of acute treatment. Overall, ERT resulted in high rates of high endstate functioning for both GAD and MDD that were maintained into the follow-up period. Conclusions: Findings provide encouraging support for the efficacy and hypothesized mechanisms underlying ERT and point to fruitful directions for improving our understanding and treatment of complex clinical conditions such as GAD with co-occurring MDD. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement What is the public health significance of this article?-Generalized anxiety disorder and major depressive disorder are associated with significant role impairment and poor life quality satisfaction. Yet, treatments have not produced sizable gains into the long-term. Emotion Regulation Therapy (ERT), whose framework is drawn from basic and translational affect sciences, demonstrates superior improvement on clinician rated and self-reported anxiety and depression, satisfaction with life, worrying and ruminating, and in self-perceived ability to manage emotions with mindfulness and perspective taking, relative to patients receiving delayed treatment. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Mennin, Douglas S; Fresco, David M; O'Toole, Mia Skytte; Heimberg, Richard G",2018.0,http://dx.doi.org/10.1037/ccp0000289,0,1,
146,Affect-focused body psychotherapy in patients with generalized anxiety disorder: Evaluation of an integrative method.,"The aim of this study was to explore the long-term effects of affect-focused body psychotherapy (ABP) for patients with generalized anxiety disorder (GAD). A group of 61 consecutive patients, 21-55 years old, were randomized to ABP and psychiatric treatment as usual (TAU). The patients were assessed before treatment and followed up 1 and 2 years after inclusion. The ABP patients received one session of treatment per week during 1 year. Three self-report questionnaires were administered; Symptom Checklist-90, Beck Anxiety Inventory, and the WHO (Ten) Well-Being Index. In both groups, there was a significant improvement. On termination, the ABP group had improved significantly more on the SCL-90 Global Symptom Index than the TAU group, whereas the differences were short of significance on the other two scales. The integration of bodily techniques with a focus on affects in a psychodynamically informed treatment seems to be a viable treatment alternative for patients with GAD. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Levy Berg, Adrienne; Sandell, Rolf; Sandahl, Christer",2009.0,http://dx.doi.org/10.1037/a0015324,0,1,
147," Study adaptation, design, and methods of a web-based PTSD intervention for women Veterans"," Women Veterans are a rapidly growing population with high risk of exposure to potentially traumatizing events and PTSD diagnoses. Despite the dissemination of evidence‐based treatments for PTSD in the VA, most women Veteran VA users underutilize these treatments. Web‐based PTSD treatment has the potential to reach and engage women Veterans with PTSD who do not receive treatment in VA settings. Our objective is to modify and evaluate Delivery of Self Training and Education for Stressful Situations (DESTRESSS), a web‐based cognitive‐behavioral intervention for PTSD, to target PTSD symptoms among women Veterans. The specific aims are to: (1) obtain feedback about DESTRESS, particularly on its relevance and sensitivity to women, using semi‐structured interviews with expert clinicians and women Veterans with PTSD, and make modifications based on this feedback; (2) conduct a pilot study to finalize study procedures and make further refinements to the intervention; and (3) conduct a randomized clinical trial (RCT) evaluating a revised, telephone‐assisted DESTRESS compared to telephone monitoring only. We describe the results from the first two aims, and the study design and procedures for the ongoing RCT. This line of research has the potential to result in a gender‐sensitive, empirically‐based, online treatment option for women Veterans with PTSD."," Lehavot, K;  Litz, B;  Millard, SP;  Hamilton, AB;  Sadler, A;  Simpson, T",2017.0, 10.1016/j.cct.2016.12.002,0,1,
148," Study protocol for a randomised controlled trial of cognitive processing therapy for post-traumatic stress disorder among Japanese patients: the Safety, Power, Intimacy, Esteem, Trust (SPINET) study"," INTRODUCTION: Cognitive processing therapy (CPT) is widely regarded as a safe and effective first‐line treatment for individuals with post‐traumatic stress disorder (PTSD); however, no comparative studies have been conducted to examine the treatment outcomes in an Asian population. The aim of the present trial is to investigate the efficacy of CPT (individual format) as a treatment for PTSD in a population of Japanese patients. METHODS AND ANALYSIS: A 16‐week, single‐centre, assessor‐masked, randomised, parallel‐group superiority trial has been designed to compare the efficacy of CPT in conjunction with treatment as usual (mostly pharmacotherapy and clinical monitoring) versus treatment as usual alone. The Clinician‐Administered PTSD Scale for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) will be our primary outcome measure of the post‐traumatic stress symptoms at 17 weeks, whereas the PTSD Checklist for DSM‐5 and determination of the operationally defined responder status will be used to assess the secondary outcomes. An estimated sample size of 29 participants in each group will be required to detect an expected effect size of 1.4 (95% CI 0.85 to 1.95). ETHICS AND DISSEMINATION: The institutional review board at the National Center of Neurology and Psychiatry in Japan approved this study. The results of this clinical trial will be presented at conferences and disseminated through publication in a peer‐reviewed journal. TRIAL REGISTRATION NUMBER: UMIN000021670 (registered on 1 April 2016)."," Ito, M;  Horikoshi, M;  Resick, PA;  Katayanagi, A;  Miyamae, M;  Takagishi, Y;  Takebayashi, Y;  Kanie, A;  Hirabayashi, N;  Furukawa, TA",2017.0, 10.1136/bmjopen-2016-014292,0,1,
149,"The role of cognitive processing therapy in improving psychosocial functioning, health, and quality of life in veterans with military sexual trauma-related posttraumatic stress disorder.","Although research has identified evidence-based treatments (EBTs) for military sexual trauma (MST)-related posttraumatic stress disorder (PTSD), few studies have examined the effect of such treatments on psychosocial functioning, health or quality of life in individuals with MST-related PTSD. Male and female veterans (N = 45) with MST-related PTSD took part in a randomized clinical trial that included either 12 weeks of an evidence-based psychotherapeutic treatment (cognitive processing therapy; [CPT]) or a standard control condition (present centered therapy) and 6 months of follow-up. To assess quality of life and psychosocial functioning, each participant was administered the Quality of Life Inventory and the Short Form (36) Health Survey. Using a hierarchical linear modeling approach, results demonstrated that participants treated with CPT reported significantly higher physical functioning over time than did participants treated with PCT. Implications are discussed with regard to the role of psychotherapy in improving a patient's psychosocial and health functioning.",Holliday R.; Williams R.; Bird J.; Mullen K.; Surís A.,2015.0,10.1037/ser0000058,0,1,
150,"Randomized-controlled trial on a novel (meta-)cognitive self-help approach for obsessive-compulsive disorder (""myMCT"").","Effective treatment strategies exist for obsessive-compulsive disorder (OCD), however, many individuals do not receive professional help. Media-delivered self-help is increasingly sought to narrow the treatment gap. Previous studies included personal contact with a clinician, making it difficult to delineate the specific effect of the medium. We developed ""myMCT"" for OCD, a (meta-)cognitive manual for self-application. We conducted a randomized-controlled trial with 128 OCD participants receiving myMCT versus psychoeducation, adopting low-threshold recruitment approaches without any face-to-face contact. Diagnoses were verified with telephone interviews paralleling online surveys at pre, post (4 weeks) and follow-up (6 months). Participants benefited significantly from both interventions. MyMCT showed stronger reduction of OCD symptoms on Y-BOCS total score (p = .023, eta2partial=.04), obsessions (p = .002, eta2partial = .07), depression (BDI: p=.022, eta2partial = .04), and cognitive biases (OBQ: p = .016, eta2partial = .05) after 4 weeks. After 6 months, individuals with myMCT showed decreased levels of cognitive biases (OBQ). The current study provides further evidence that myMCT is a promising approach to target OCD-related psychopathology as mere self-help. Although effect sizes were below those usually found in (therapist-)guided self-help, myMCT could be of value for the large subgroup of individuals without treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hauschildt, Marit; Schroder, Johanna; Moritz, Steffen",2016.0,http://dx.doi.org/10.1016/j.jocrd.2016.04.010,0,1,
151,Behavior therapy for obsessive-compulsive disorder guided by a computer or by a clinician compared with relaxation as a control.,"The demand for effective behavior therapy for obsessive-compulsive disorder (OCD) by exposure and ritual prevention exceeds its supply by trained therapists. A computer-guided behavior therapy self-help system (BT STEPS) was created that patients access by telephone from home via interactive voice response technology. This study compared the value of computer-guided behavior therapy value with that of clinician-guided behavior therapy and systematic relaxation as a control treatment. After screening by a clinician, 218 patients with DSM-IV OCD at 8 North American sites were randomly assigned to 10 weeks of behavior therapy treatment guided by (1) a computer accessed by telephone and a user workbook (N = 74) or (2) a behavior therapist (N = 69) or (3) systematic relaxation guided by an audiotape and manual (N = 75). By week 10, in an intent-to-treat analysis, mean change in score on the Yale-Brown Obsessive Compulsive Scale was significantly greater in clinician-guided behavior therapy (8.0) than in computer-guided (5.6), and changes in scores with both clinician-guided and computer-guided behavior therapy were significantly greater than with relaxation (1.7), which was ineffective. Similarly, the percentage of responders on the Clinical Global Impressions scale was significantly (p < .05) greater with clinician-guided (60%) than computer-guided behavior therapy (38%), and both were significantly greater than with relaxation (14%). Clinician-guided was superior to computer-guided behavior therapy overall, but not when patients completed at least 1 self-exposure session (N = 36 [65%]). At endpoint, patients were more satisfied with either behavior therapy group than with relaxation. Patients assigned to computer-guided behavior therapy improved more the longer they spent telephoning the computer (mostly outside usual office hours) and doing self-exposure. They improved slightly further by week 26 follow-up, unlike the other 2 groups. For OCD, computer-guided behavior therapy was effective, although clinician-guided behavior therapy was even more effective. Systematic relaxation was ineffective. Computer-guided behavior therapy can be a helpful first step in treating patients with OCD when clinician-guided behavior therapy is unavailable.",Greist JH.; Marks IM.; Baer L.; Kobak KA.; Wenzel KW.; Hirsch MJ.; Mantle JM.; Clary CM.,2002.0,,0,1,
152,Obsessive-compulsive disorder and family accommodation: A 3-year follow-up.,"The present study assessed 3-year maintenance of family accommodation (FA) reduction in a sample from a randomized clinical trial that assessed the impact of 12 sessions of cognitive-behavioral group therapy (CBGT) for obsessive-compulsive disorder (OCD), with the involvement of family members in two sessions. Of the 46 original pairs of patients/family members, 35 were assessed at 3 years. Demographic and clinical characteristics remained similar. Post-CBGT improvement of OCD symptoms remained significant; FA reduced 39% after the therapy and 51% at follow-up. FA reduction remained over time, underscoring the importance of permanently assessing FA and involving family members when treating OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Gomes, Juliana Braga; Cordioli, Aristides Volpato; Heldt, Elizeth",2017.0,http://dx.doi.org/10.1016/j.psychres.2017.03.043,0,1,
153,Impact of cognitive-behavioral group therapy for obsessive-compulsive disorder on family accommodation: A randomized clinical trial.,"The aim of this study was to assess the impact of cognitive-behavioral group therapy (CBGT) with the brief involvement of family members on family accommodation and to identify predictors of family accommodation reduction (patient and family member characteristics). This randomized clinical trial assessed 98 pairs of patients with obsessive-compulsive disorder (OCD) and their family members: 52 (53.1%) were allocated to the intervention group (12 CBGT sessions - two with the family member), and 46 (46.9%) to a waiting list (control group). Symptom severity and family accommodation were assessed before and after CBGT. There was significant improvement of OCD symptoms and family accommodation scores after CBGT in the intervention group vs. the control group. The following variables were significant predictors of family accommodation reduction after multivariate analysis: patient characteristics - absence of comorbid unipolar disorder, lower obsession score, and higher education level; family member characteristics - higher hoarding score. The model explained 47.2% of the variance in family accommodation scores after treatment. CBGT for patients with OCD and the brief involvement of family members contributed to reduce family accommodation. Both patient and family member characteristics were predictors of family accommodation reduction. This finding can help qualify CBGT protocols.",Gomes JB.; Cordioli AV.; Bortoncello CF.; Braga DT.; Gonçalves F.; Heldt E.,2016.0,10.1016/j.psychres.2016.09.019,0,1,
154,PTSD symptoms predict outcome in trauma-informed treatment of intimate partner aggression.,"This study sought to extend findings from a randomized controlled trial of the Strength at Home Men's Program (SAH-M) for intimate partner aggression (IPA) in military veterans by examining the impact of pretreatment posttraumatic stress disorder (PTSD) symptoms on treatment efficacy, and by examining new data on postintervention follow-up for individuals who received SAH-M after completing the enhanced treatment as usual (ETAU) wait-list control condition. Using data from 125 male veterans who attended the SAH-M program immediately after an intake assessment or after waiting 6-month in the ETAU condition, this study used generalized linear modeling to examine predictors of physical and psychological IPA over a 9-month period of time. PTSD symptoms at intake significantly predicted both physical and psychological IPA use, even after accounting for the effects of treatment condition, time, and number of sessions attended. PTSD had a strong association with both physical and psychological IPA. An interaction between PTSD and SAH-M was observed for psychological IPA but not physical IPA, and the magnitude of the effect was not clinically significant. There was a significant effect of SAH-M in reducing IPA in the full sample, including previously unanalyzed outcome data from the ETAU condition. The study results suggest that while SAH-M does not need to be modified to address the interaction between PTSD and treatment, outcomes could be enhanced through additional direct treatment of PTSD symptoms. Results extend prior analyses by demonstrating the effectiveness of SAH-M in reducing use of IPA in both the treatment and ETAU conditions. (PsycINFO Database Record",Creech SK.; Macdonald A.; Benzer JK.; Poole GM.; Murphy CM.; Taft CT.,2017.0,10.1037/ccp0000228,0,1,
155, Evaluating effectiveness and cost-effectiveness of a group psychological intervention using cognitive behavioural strategies for women with common mental disorders in conflict-affected rural Pakistan: study protocol for a randomised controlled trial," BACKGROUND: The impact of humanitarian disasters upon mental health is well recognised. The evidence for psychological interventions for mental health is mounting, but few interventions have been rigorously tested in humanitarian settings. To be sustainable in humanitarian settings interventions need to be short, simple, deliverable by nonspecialists under supervision, and adopt a transdiagnostic approach where an array of mental health outcomes are addressed simultaneously. These elements have been incorporated into the newly developed WHO Problem Management Plus (PM+) Group intervention. The aim of this trial is to evaluate the locally adapted PM+ Group intervention for women in Swat, Pakistan. METHODS: This PM+ Group trial is a two‐arm, single‐blind, cluster randomised controlled trial conducted in a community‐based setting with women in rural Pakistan. PM+ is delivered in partnership with the Lady Health Worker (LHW) Programme which provides community‐based health care to women in Pakistan. Thirty‐four LHW clusters will be randomised in a 1:1 allocation ratio using a permuted‐block randomisation method. Participants screened and found to meet the inclusion criteria will be allocated to either the PM+ intervention group (n = 306), or the control arm (n = 306). The manualised PM+ intervention involves five sessions, each lasting 3 h, and introduces four strategies applied by participants to problems that they are facing. It is delivered by local female facilitators with a minimum of 16 years of education who are provided with targeted training and supervision. The primary outcome is individual psychological distress, measured by levels of anxiety and depression on the Hospital Anxiety and Depression Scale at 20 weeks after baseline. Secondary outcomes include major depression, post‐traumatic stress disorder, levels of social support, levels of functioning, and economic effectiveness. Intervention acceptability will be explored through an embedded qualitative study. DISCUSSION: The PM+ Group trial will provide important evidence on the effectiveness of an empirically supported psychological treatment delivered by nonspecialists in a humanitarian setting. If proven effective, the qualitative component will inform strategies for PM+ Group scale‐up in health systems in other humanitarian settings. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, identifier: ACTRN12616000037404. Registered on 19 January 2016; WHO Protocol ID RPC705, v.4, 2 November 2015."," Chiumento, A;  Hamdani, SU;  Khan, MN;  Dawson, K;  Bryant, RA;  Sijbrandij, M;  Nazir, H;  Akhtar, P;  Masood, A;  Wang, D;  et al.",2017.0, 10.1186/s13063-017-1905-8,0,1,
156,Grey matter density changes of structures involved in Posttraumatic Stress Disorder (PTSD) after recovery following Eye Movement Desensitization and Reprocessing (EMDR) therapy.,"Recovery of stress-induced structural alterations in Posttraumatic Stress Disorder (PTSD) remains largely unexplored. This study aimed to determine whether symptoms improvement is associated with grey matter (GM) density changes of brain structures involved in PTSD. Two groups of PTSD patients were involved in this study. The first group was treated with Eye Movement Desensitization and Reprocessing (EMDR) therapy and recovered from their symptoms (recovery group) (n = 11); Patients were scanned prior to therapy (T1), one week (T2) and five months after the end of therapy (T3). The second group included patients which followed a supportive therapy and remained symptomatic (wait-list group) (n = 7). They were scanned at three time-steps mimicking the same inter-scan intervals. Voxel-based morphometry (VBM) was used to characterize GM density evolution. GM density values showed a significant group-by-time interaction effect between T1 and T3 in prefrontal cortex areas. These interaction effects were driven by a GM density increase in the recovery group with respect to the wait-list group. Symptoms removal goes hand-in-hand with GM density enhancement of structures involved in emotional regulation.",Boukezzi S.; El Khoury-Malhame M.; Auzias G.; Reynaud E.; Rousseau PF.; Richard E.; Zendjidjian X.; Roques J.; Castelli N.; Correard N.; Guyon V.; Gellato C.; Samuelian JC.; Cancel A.; Comte M.; Latinus M.; Guedj E.; Khalfa S.,2017.0,10.1016/j.pscychresns.2017.06.009,0,1,
157,The OptiMUM-study: EMDR therapy in pregnant women with posttraumatic stress disorder after previous childbirth and pregnant women with fear of childbirth: design of a multicentre randomized controlled trial.,"Background: Approximately 3% of women develop posttraumatic stress disorder (PTSD) after giving birth, and 7.5% of pregnant women show a pathological fear of childbirth (FoC). FoC or childbirth-related PTSD during (a subsequent) pregnancy can lead to a request for an elective caesarean section as well as adverse obstetrical and neonatal outcomes. For PTSD in general, and several subtypes of specific phobia, eye movement desensitization and reprocessing (EMDR) therapy has been proven effective, but little is known about the effects of applying EMDR during pregnancy. Objective: To describe the protocol of the OptiMUM-study. The main aim of the study is to determine whether EMDR therapy is an effective and safe treatment for pregnant women with childbirth-related PTSD or FoC. In addition, the cost-effectiveness of this approach will be analysed. Method: The single-blind OptiMUM-study consists of two two-armed randomized controlled trials (RCTs) with overlapping design. In several hospitals and community midwifery practices in Amsterdam, the Netherlands, all eligible pregnant women with a gestational age between eight and 20 weeks will be administered the Wijma delivery expectations questionnaire (WDEQ) to asses FoC. Multiparous women will also receive the PTSD checklist for DSM-5 (PCL-5) to screen for possible PTSD. The clinician administered PTSD scale (CAPS-5) will be used for assessing PTSD according to DSM-5 in women scoring above the PCL-5 cut-off value. Fifty women with childbirth-related PTSD and 120 women with FoC will be randomly allocated to either EMDR therapy carried out by a psychologist or care-as-usual. Women currently undergoing psychological treatment or women younger than 18 years will not be included. Primary outcome measures are severity of childbirth-related PTSD or FoC symptoms. Secondary outcomes are percentage of PTSD diagnoses, percentage caesarean sections, subjective childbirth experience, obstetrical and neonatal complications, and health care costs. Results: The results are meant to provide more insight about the safety and possible effectiveness of EMDR therapy during pregnancy for women with PTSD or FoC. Conclusion: This study is the first RCT studying efficacy and safety of EMDR in pregnant women with PTSD after childbirth or Fear of Childbirth. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Baas, M. A. M; Stramrood, C. A. I; Dijksman, L. M; de Jongh, A; van Pampus, M. G",2017.0,http://dx.doi.org/10.1080/20008198.2017.1293315,0,1,
158,"A comparison of cognitive therapy, applied relaxation and imipramine in the treatment of panic disorder.","Recent studies have shown that cognitive therapy is an effective treatment for panic disorder. However, little is known about how cognitive therapy compares with other psychological and pharmacological treatments. To investigate this question 64 panic disorder patients were initially assigned to cognitive therapy, applied relaxation, imipramine (mean 233 mg/day), or a 3-month wait followed by allocation to treatment. During treatment patients had up to 12 sessions in the first 3 months and up to three booster sessions in the next 3 months. Imipramine was gradually withdrawn after 6 months. Each treatment included self-exposure homework assignments. Cognitive therapy and applied relaxation sessions lasted one hour. Imipramine sessions lasted 25 minutes. Assessments were before treatment/wait and at 3, 6, and 15 months. Comparisons with waiting-list showed all three treatments were effective. Comparisons between treatments showed that at 3 months cognitive therapy was superior to both applied relaxation and imipramine on most measures. At 6 months cognitive therapy did not differ from imipramine and both were superior to applied relaxation on several measures. Between 6 and 15 months a number of imipramine patients relapsed. At 15 months cognitive therapy was again superior to both applied relaxation and imipramine but on fewer measures than at 3 months. Cognitive measures taken at the end of treatment were significant predictors of outcome at follow-up.",Clark DM.; Salkovskis PM.; Hackmann A.; Middleton H.; Anastasiades P.; Gelder M.,1994.0,,0,1,
159,Randomized controlled trial of cognitive behaviour therapy for comorbid post-traumatic stress disorder and alcohol use disorders.,"Aims This study aimed to test the efficacy of integrated cognitive behaviour therapy (CBT) for coexisting post traumatic stress disorder (PTSD) and alcohol use disorders (AUD). Setting Clinics across Sydney, Australia.Design Randomized controlled trial of 12 once-weekly individual sessions of either integrated CBT for PTSD and AUD(integrated therapy, IT; n = 33) or CBT for AUD plus supportive counselling (alcohol-support, AS; n = 29). Blind assessments were conducted at baseline and post-treatment and at 5 [standard deviation (SD) = 2.25] and 9.16(SD = 3.45) months post-treatment. Participants Sixty-two adults with concurrent PTSD and AUD. Measurements Outcomes included changes in alcohol consumption (time-line follow-back), PTSD severity [clinician-administered PTSD scale (CAPS)], alcohol dependence and problems, and depression and anxiety. Findings Reductions in PTSD severity were evident in both groups. IT participants who had received one or more sessions of exposure therapy exhibited a twofold greater rate of clinically significant change in CAPS severity at follow-up than AS participants [IT60%, AS 39%, odds ratio (OR): 2.31, 95% confidence interval (CI): 1.06, 5.01]. AS participants exhibited larger reductions than IT participants in alcohol consumption, dependence and problems within the context of greater treatment from other services during follow-up. Results lend support to a mutually maintaining effect between AUD and PTSD. Conclusions Individuals with severe and complex presentations of coexisting post-traumatic stress disorder(PTSD) and alcohol use disorders (AUD) can derive substantial benefit from cognitive behaviour therapy targeting AUD, with greater benefits associated with exposure for PTSD. Among individuals with dual disorders, these therapies can generate significant, well-maintained treatment effects on PTSD, AUD and psychopathology.",Sannibale C.; Teesson M.; Creamer M.; Sitharthan T.; Bryant RA.; Sutherland K.; Taylor K.; Bostock-Matusko D.; Visser A.; Peek-O'Leary M.,2013.0,,0,1,
160,Concurrent alcoholism and social anxiety disorder: a first step toward developing effective treatments.,"Social anxiety disorder (also called social phobia) is an anxiety disorder in which affected individuals fear the scrutiny of others. Clinical reports suggest that individuals with social anxiety disorder often use alcohol to alleviate anxiety symptoms, a practice that leads to alcohol abuse and/or dependence in approximately 20% of affected individuals. The present study investigated whether simultaneous treatment of social phobia and alcoholism, compared with treatment of alcoholism alone, improved alcohol use and social anxiety for clients with dual diagnoses of social anxiety disorder and alcohol dependence. The design was a two-group, randomized clinical trial that used 12 weeks of individual cognitive behavioral therapy for alcoholism only (n = 44) or concurrent treatment for both alcohol and social anxiety problems (n = 49). Outcome data were collected at the end of 12 weeks of treatment and at 3 months after the end of treatment. Results with intent-to-treat analyses showed that both groups improved on alcohol-related outcomes and social anxiety after treatment. With baseline scores covaried, there was a significant effect of treatment group on several drinking measures. Counter to the hypothesis, the group treated for both alcohol and social anxiety problems had worse outcomes on three of the four alcohol use indices. No treatment group effects were observed on social anxiety indices. Implications for the staging of treatments for coexisting social phobia and alcoholism are discussed, as well as ways that modality of treatments might impact outcomes.",Randall CL.; Thomas S.; Thevos AK.,2001.0,,0,1,
161, Internet cognitive behavioural treatment for obsessive compulsive disorder: a randomised controlled trial," Internet‐based cognitive behaviour therapy (iCBT) is becoming increasing accepted as an efficacious and effective treatment for the anxiety and depressive disorders. However few studies have examined the efficacy of iCBT for obsessive compulsive disorder (OCD). This randomised controlled trial compared technician‐administered iCBT (n=32) to a treatment as usual (TAU) control group (n=35) in patients with OCD. The primary outcome measures were the Dimensional Obsessive‐Compulsive Scale (DOCS) and the Obsessional Beliefs Questionnaire (OBQ‐20) administered at pre‐ and post‐treatment (or matched time points). The iCBT group was followed‐up at 3‐months post‐treatment when diagnostic status was assessed at clinical interview. The iCBT program was more efficacious than TAU in reducing maladaptive OC beliefs as well as symptoms of OCD, distress, and depression, with large within‐ and between‐groups effect sizes found (>.78). Adherence was high (75%) and gains were maintained at 3 month‐follow‐up with 54% of treatment completers no longer meeting diagnostic criteria for OCD at follow‐up. These results are comparable to outcomes obtained by clinician‐administered face‐to‐face and internet‐based programs and suggest that iCBT for OCD is efficacious when administered by a clinically‐supervised technician. Future research is now needed to evaluate how effective iCBT for OCD is in routine clinical settings."," Mahoney, AE;  Mackenzie, A;  Williams, AD;  Smith, J;  Andrews, G",2014.0, 10.1016/j.brat.2014.09.012,0,1,
162,Treatment of Storm Fears Using Virtual Reality and Progressive Muscle Relaxation.,"The present study examined the efficacy of virtual reality (VR) exposure therapy for treating individuals with storm fears by comparing a one-session VR exposure treatment with a one-session progressive muscle relaxation (PMR) and psychoeducation session. It was predicted that there would be a reduction in storm-related fear post-treatment for individuals in both conditions, but that this reduction would be greater for those in the VR exposure condition. It was predicted that improvements would be maintained at 30-day follow-up only for those in the VR exposure condition. Thirty-six participants each received one of the two treatment conditions. Those in the PMR treatment group received approximately 30 minutes of PMR and approximately 15 minutes of psychoeducation regarding storms. Those in the VR treatment group received approximately 1 hour of VR exposure. Additionally, participants were asked to complete a pre-treatment and post-treatment 5-minute behavioural approach test to assess changes in storm fears. They were also asked to complete a measure assessing storm phobia. There was a significant interaction between treatment group and self-reported fear at post-treatment, such that fear decreased for both groups, although the reduction was stronger in the VR group. Results also showed that reductions in storm fear were maintained at 30-day follow-up for both groups. Although this study used a small non-clinical sample, these results offer preliminary support for the use of VR exposure therapy in the treatment of storm-related fear.",Lima J.; McCabe-Bennett H.; Antony MM.,2018.0,10.1017/S1352465817000674,0,1,
163,Interapy: Treatment of post-traumatic stress via the Internet.,"This paper describes the theoretical background and procedures (including psycho-education, screening, treatment protocol and outcome measurement) involved in a protocol-driven internet treatment of post-traumatic stress and grief in a group of people who have suffered from mild to relatively severe trauma. The paper examines the results of 3 outcome and process studies, which were carried out initially in a student population and subsequently in the general population of highly traumatized people. In the latter study, participants in the experimental condition (n = 69) improved significantly more than participants in the waiting list control condition (n = 32), with respect to trauma-related symptoms and general psychopathology. The effect sizes were large. More than 50% of the participants treated showed reliable change and clinically significant improvement after treatment for avoidance and depression. Treatment proved most beneficial for participants who had suffered from intentional trauma and those who had not previously discussed the traumatic events with significant others. Content analysis of the publications indicates a remarkable increase in cognitive coping during treatment... (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lange, Alfred; van de Ven, Jean-Pierre; Schrieken, Bart",2003.0,http://dx.doi.org/10.1080/16506070302317,0,1,
164, Randomized controlled trial of acceptance and commitment therapy for distress and impairment in OEF/OIF/OND veterans," METHOD: One hundred sixty veterans (80% male, Mage = 34 years) with anxiety or depressive disorder according to the RESULTS: There was improvement following treatment in the whole sample across a variety of measures, including general distress (d = 0.74, 95% confidence interval [CI: 0.52, 0.96]) and functioning (d = 0.71, 95% CI [0.50, 0.93]) and moderate to high levels of satisfaction with treatment. Response to the 2 interventions did not differ on the primary outcome or most secondary outcomes, although ACT led to greater improvement in insomnia than did PCT (ds = 0.63 and 0.08, respectively). Treatment dropout did not differ by condition but was high (41.9%). CONCLUSIONS: ACT's efficacy in this group was modest and generally did not differ from that for PCT. Additional work is needed to understand the reasons that ACT did not perform as well as predicted in this veteran sample. (PsycINFO Database Record OBJECTIVE: Acceptance and commitment therapy (ACT) is a widely utilized psychotherapeutic approach, but randomized, controlled studies are lacking in veterans. This study evaluated the efficacy of ACT for emotional distress among veterans of the conflicts in Iraq and Afghanistan."," Lang, AJ;  Schnurr, PP;  Jain, S;  He, F;  Walser, RD;  Bolton, E;  Benedek, DM;  Norman, SB;  Sylvers, P;  Flashman, L;  et al.",2017.0, 10.1037/tra0000127,0,1,
165,A randomized controlled trial of a smartphone app for posttraumatic stress disorder symptoms.,"Posttraumatic stress disorder (PTSD) is highly prevalent in the population, but relatively few affected individuals receive treatment for it. Smartphone applications (apps) could help address this unmet need by offering sound psychoeducational information and evidence-based cognitive behavioral coping tools. We conducted a randomized controlled trial to assess the efficacy of a free, publicly available smartphone app (PTSD Coach) for self-management of PTSD symptoms. One hundred 20 participants who were an average of 39 years old, mostly women (69.2%) and White (66.7%), recruited primarily through online advertisements, were randomized to either a PTSD Coach (n = 62) or a waitlist condition (n = 58) for 3 months. Web-administered self-report measures of PTSD, PTSD symptom coping self-efficacy, depression, and psychosocial functioning were conducted at baseline, posttreatment, and 3 months following treatment. Following the intent-to-treat principle, repeated-measures analyses of variance (ANOVAs) revealed that at posttreatment, PTSD Coach participants had significantly greater improvements in PTSD symptoms (p = .035), depression symptoms (p = .005), and psychosocial functioning (p = .007) than did waitlist participants; however, at posttreatment, there were no significant mean differences in outcomes between conditions. A greater proportion of PTSD Coach participants achieved clinically significant PTSD symptom improvement (p = .018) than waitlist participants. PTSD Coach use resulted in significantly greater improvements in PTSD symptoms and other outcomes relative to a waitlist condition. Given the ubiquity of smartphones, PTSD Coach may provide a wide-reaching, convenient public health intervention for individuals with PTSD symptoms who are not receiving care. (PsycINFO Database Record",Kuhn E.; Kanuri N.; Hoffman JE.; Garvert DW.; Ruzek JI.; Taylor CB.,2017.0,10.1037/ccp0000163,0,1,
166,Efficacy of imagery rescripting and imaginal exposure for nightmares: A randomized wait-list controlled trial.,"Nightmares can be effectively treated with cognitive-behavioral therapies. Though it remains elusive which therapeutic elements are responsible for the beneficial effects on nightmare symptoms, imagery rescripting (IR) and imaginal exposure (IE) are commonly identified as active treatment components of nightmare therapies. With this randomized controlled trial, we compared IR and IE as individual treatments to a wait-list (WL) condition to determine whether these particular therapeutic elements ameliorate nightmare symptoms. For this purpose, 104 patients with a primary DSM-5 diagnosis of nightmare disorder were randomly assigned to three weekly individual sessions of either IR or IE, or WL. Results showed that compared to WL, both interventions effectively reduced nightmare frequency (ΔdIR-WL = 0.74; ΔdIE-WL = 0.70) and distress (ΔdIR-WL = 0.98; ΔdIE-WL = 1.35) in a sample that predominantly consisted of idiopathic nightmare sufferers. The effects of IR and IE were comparable to those observed for other psychological nightmare treatments. Initial effects at post-treatment were sustained at 3- and 6-months follow-up, indicating that IR and IE both seem to be efficacious treatment components of nightmare therapies. Additional research is needed to directly compare IR and IE among both idiographic and posttraumatic nightmare sufferers with respect to treatment expectancy, acceptability, and effectiveness.",Kunze AE.; Arntz A.; Morina N.; Kindt M.; Lancee J.,2017.0,10.1016/j.brat.2017.06.005,0,1,
167,An Internet-based writing intervention for PTSD in veterans: A feasibility and pilot effectiveness trial.,"[Correction Notice: An Erratum for this article was reported in Vol 9(4) of Psychological Trauma: Theory, Research, Practice, and Policy (see record 2016-54154-001). In the article, the names of authors Adil Alaoui and Anas Belouali were misspelled as Adil Aloui and Anas Beloui respectively. All versions of this article have been corrected.] Objective: Veterans suffering from posttraumatic stress disorder (PTSD) may avoid or fail to follow through with a full course of face-to-face mental health treatment for a variety of reasons. We conducted a pilot effectiveness trial of an online intervention for veterans with current PTSD to determine the feasibility, safety, and preliminary effectiveness of an online writing intervention (i.e., Warriors Internet Recovery & EDucation [WIRED]) as an adjunct to face-to-face psychotherapy. Method: Veterans (N = 34) who had served in Iraq or Afghanistan with current PTSD subsequent to deployment-related trauma were randomized to Veterans Affairs (VA) mental health treatment as usual (TAU) or to treatment as usual plus the online intervention (TAU + WIRED). All research participants were recruited from the Trauma Services Program, VA Medical Center, Washington, DC. They completed baseline assessments as well as assessments 12 weeks and 24 weeks after the baseline assessment. The online intervention consisted of therapist-guided writing, using principles of prolonged exposure and cognitive therapy. The intervention was adapted from an evidence-based treatment used in The Netherlands and Germany for individuals who had been exposed to nonmilitary traumas. Results: In addition to showing that the online intervention was both feasible to develop and implement, as well as being safe, the results showed preliminary evidence of the effectiveness of the TAU + WIRED intervention in this patient population, with particular evidence in reducing PTSD symptoms of hyperarousal. Conclusion: With minor modifications to enhance the therapeutic alliance, this intervention should be tested in a larger clinical trial to determine whether this method of online intervention might provide another alternative to face-to-face treatment for veterans with PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Krupnick, Janice L; Green, Bonnie L; Amdur, Richard; Alaoui, Adil; Belouali, Anas; Roberge, Erika; Cueva, David; Roberts, Miguel; Melnikoff, Elizabeth; Dutton, Mary Ann",2017.0,http://dx.doi.org/10.1037/tra0000176,0,1,
168, Cognitive behavioral therapy for posttraumatic stress disorder in individuals with severe mental illness and borderline personality disorder," Secondary analyses were performed on data from two randomized controlled trials of a cognitive behavioral therapy (CBT) program for posttraumatic stress disorder (PTSD) in individuals with severe mental illness (SMI) to examine the feasibility, tolerability, and effectiveness for individuals with borderline personality disorder (BPD). In Study 1, 27 participants received CBT or treatment as usual. In Study 2, 55 participants received CBT or a Brief treatment. Feasibility and tolerability of CBT, PTSD symptoms, and other mental health and functional outcomes were examined, with assessments at baseline, post‐treatment, and two follow‐up time points. CBT was feasible and tolerable in this population. Study 1 participants in CBT improved significantly more in PTSD symptoms, depression, and self‐reported physical health. Study 2 participants in both CBT and Brief improved significantly in PTSD symptoms, posttraumatic cognitions, depression, and overall functioning, with those in CBT acquiring significantly more PTSD knowledge, and having marginally significantly greater improvement in PTSD symptoms. CBT for PTSD was feasible and tolerated in individuals with SMI, BPD, and PTSD, and associated with improvements in PTSD symptoms and related outcomes. Prospective research is needed to evaluate CBT in individuals with BPD, including comparing it with staged interventions for this population."," Kredlow, MA;  Szuhany, KL;  Lo, S;  Xie, H;  Gottlieb, JD;  Rosenberg, SD;  Mueser, KT",2017.0, 10.1016/j.psychres.2016.12.045,0,1,
169,Efficacy and Feasibility of a Therapist-Guided Internet-Based Intervention for Older Persons with Childhood Traumatization: A Randomized Controlled Trial.,"Although cognitive-behavioral treatment approaches for post-traumatic stress disorder (PTSD) exist, only a small proportion of older adults seeks psychological treatment. Alternative treatment approaches are thus needed to fill the gap between provision and use of psychological interventions. This study aimed to investigate the efficacy and feasibility of an Internet-based, therapist-guided cognitive-behavioral therapy (Internet-based CBT) for older individuals with PTSD symptoms. Patients with clinically meaningful (i.e., subsyndromal or greater) PTSD symptoms were randomly assigned to a 6-week treatment group of therapist-guided Internet-based CBT (N = 47; treatment group) or a wait-list group (N = 47; WL). The treatment group was assessed pre- and post-treatment as well as at 3-, 6- and 12-month follow-ups. Linear mixed-effects analyses showed a significant interaction between group (treatment versus WL) and time (pre versus post) for PTSD symptoms with a moderate between-group effect size in favor of the treatment group (d = 0.42). Effects in the treatment group were maintained up to the 12-month follow-up. Findings indicate a significant interaction (group × time) for quality of life (d = 0.39) and self-efficacy (d = 0.38). With regard to the feasibility, attrition rate was very low in both groups (treatment group: 12.8%, WL: 6.4%) and working alliance was very high. Results suggest that therapist-guided Internet-based CBT is associated with a substantial reduction in PTSD symptoms, and increase in resource-related variables in older adults with (subsyndromal) PTSD. This Internet-based intervention may offer a promising option in a stepped-care approach for older trauma-affected persons who may otherwise not pursue mental health treatment.",Knaevelsrud C.; Böttche M.; Pietrzak RH.; Freyberger HJ.; Kuwert P.,2017.0,10.1016/j.jagp.2017.02.024,0,1,
170,Manualized cognitive therapy versus cognitive-behavioral treatment-as-usual for social anxiety disorder in routine practice: A cluster-randomized controlled trial.,"This study examined the effectiveness of manualized cognitive therapy (mCT) following the Clark-Wells approach versus non-manualized cognitive-behavioral treatment-as-usual (CBTAU) for social anxiety disorder (SAD) in routine practice. Forty-eight private practitioners were recruited within a multi-center trial and either received training in manualized CT for SAD or no such training. Practitioners treated 162 patients with SAD in routine practice (N = 107 completers, n = 57 for mCT, n = 50 for CBTAU). Social anxiety symptoms (Liebowitz Social Anxiety Scale; LSAS) and secondary measures were assessed before treatment, at treatment-hour 8, 15, and 25, at end of treatment, as well as 6 and 12 months after treatment. Patients in both groups showed significant reductions of SAD severity after treatment (d = 1.91 [mCT] and d = 1.80 [CBTAU], within-group effect sizes, intent-to-treat analyses, LSAS observer ratings), which remained stable at follow-up. There were no differences between groups in terms of symptom reduction and treatment duration. The present trial confirms the high effectiveness of CBTAU and mCT for SAD when practitioners conduct the treatments in routine practice. Additional training in the CT manual did not result in significant between-group effects on therapy outcome. Explanations for this unexpected result are discussed.",Hoyer J.; Čolić J.; Pittig A.; Crawcour S.; Moeser M.; Ginzburg D.; Lin J.; Wiltink J.; Leibing E.; Stangier U.,2017.0,10.1016/j.brat.2017.05.012,0,1,
171, Improving Maternal Mental Health Following Preterm Birth Using an Expressive Writing Intervention: a Randomized Controlled Trial," Evaluations of evidence‐based, easily accessible, psychological interventions to improve maternal mental health following very preterm birth are scarce. This study investigated the efficacy and acceptability of the expressive writing paradigm for mothers of very preterm infants. The level of maternal posttraumatic stress and depressive symptoms was the primary outcome. Participants were 67 mothers of very preterm babies who were randomly allocated into the intervention (expressive writing; n = 33) or control group (treatment‐as‐usual; n = 32) when their infant was aged 3 months (corrected age, CA). Measurements were taken at 3 months (pre‐intervention), 4 months (post‐intervention), and 6 months CA (follow‐up). Results showed reduced maternal posttraumatic stress (d = 0.42), depressive symptoms (d = 0.67), and an improved mental health status (d = 1.20) in the intervention group, which were maintained at follow‐up. Expressive writing is a brief, cost‐effective, and acceptable therapeutic approach that could be offered as part of the NICU care."," Horsch, A;  Tolsa, JF;  Gilbert, L;  du Chêne, LJ;  Müller-Nix, C;  Bickle Graz, M",2016.0, 10.1007/s10578-015-0611-6,0,1,
172,Effects of cognitive processing therapy on PTSD-related negative cognitions in veterans with military sexual trauma.,"Treating post-traumatic stress disorder (PTSD) related to military sexual trauma (MST) continues to be a priority in veteran populations. Because negative cognitions (NCs) contribute to PTSD severity and treatment, further understanding of how PTSD and related NCs can be addressed and changed within an MST sample is important. Our study analyzed 45 participants who received either cognitive processing therapy (n = 32) or present centered therapy (n = 13). Participants who received cognitive processing therapy had significantly lower NCs scores post-treatment and at follow-up sessions than participants in the present centered therapy condition (p < 0.05). In addition, NCs were positively correlated with PTSD severity (p < 0.05). Implications for future research are discussed for both MST-related and non-MST-related PTSD.",Holliday R.; Link-Malcolm J.; Morris EE.; Surís A.,2014.0,10.7205/MILMED-D-13-00309,0,1,
173,Promising treatments for women with comorbid PTSD and substance use disorders.,"The authors' goal was to compare the efficacy of a manualized cognitive behavior therapy that addresses both posttraumatic stress disorder (PTSD) and substance abuse (seeking safety) with a manualized cognitive behavior therapy that addresses only substance abuse (relapse prevention) and with standard community care for the treatment of comorbid posttraumatic stress disorder (PTSD) and substance use disorder. One hundred seven women from an urban, low-income population who had comorbid PTSD and substance use disorder were randomly assigned to receive the two kinds of cognitive behavior therapy or received standard community treatment. Participants were recruited from both community and clinical populations and evaluated with structured clinical instruments. Forty-one women received seeking safety therapy, 34 received relapse prevention therapy, and 32 received standard community care. At the end of 3 months of treatment, participants in both cognitive behavior therapy conditions had significant reductions in substance use, PTSD, and psychiatric symptoms, but community care participants worsened over time. Both groups receiving cognitive behavior therapy sustained greater improvement in substance use and PTSD symptoms at 6-month and 9-month follow-ups than subjects in the community care group. Seeking safety and relapse prevention are efficacious short-term treatments for low-income urban women with PTSD, substance use disorder, and other psychiatric symptoms.",Hien DA.; Cohen LR.; Miele GM.; Litt LC.; Capstick C.,2004.0,10.1176/appi.ajp.161.8.1426,0,1,
174, Telephone-supported computerised cognitive-behavioural therapy: rEEACT-2 large-scale pragmatic randomised controlled trial, null," Gilbody, S;  Brabyn, S;  Lovell, K;  Kessler, D;  Devlin, T;  Smith, L;  Araya, R;  Barkham, M;  Bower, P;  Cooper, C;  et al.",2017.0, 10.1192/bjp.bp.116.192435,0,1,
175,Posttraumatic stress disorder in Latina women: Examining the efficacy of the Moms' Empowerment Program.,"Intimate partner violence (IPV) is a serious public health problem, affecting every 1 in 4 women in their lifetime. Latinas have been found to experience IPV at rates equal to or even higher than rates in the general population. The consequences of experiencing such violence can be severe, and result in increased risk for developing both physical and mental health problems, notably, posttraumatic stress disorder (PTSD). Although treatments for PTSD in IPV-exposed women have been developed and evaluated, this is the first study to test the efficacy of a program tailored specifically to meet the needs of Latinas who experience IPV. This study examines the efficacy of a Spanish-language adaptation of the Moms' Empowerment Program, a 10-week group treatment program for IPV-exposed women. A total of 93 low-income, mostly immigrant Latinas were included in this community trial. All women were Spanish-speaking, and information about violence exposure and PTSD symptoms were collected immediately before and after the implementation of the intervention. Findings show that women who participated in the intervention had a significantly greater reduction in PTSD symptoms than women in the wait-list comparison group. Specific reductions by symptom domains were also analyzed. This adaptation of a program designed to reduce problems associated with experiencing IPV addressed several mental health treatment needs for Latinas, particularly the need for services in Spanish. These findings demonstrate that it is possible to tailor current treatment programs for IPV in ways that are both effective and culturally sensitive. (PsycINFO Database Record",Galano MM.; Grogan-Kaylor AC.; Stein SF.; Clark HM.; Graham-Bermann SA.,2017.0,10.1037/tra0000218,0,1,
176," A Randomized Controlled Trial of a Trauma-Informed Support, Skills, and Psychoeducation Intervention for Survivors of Torture and Related Trauma in Kurdistan, Northern Iraq"," Supportive counseling type interventions are frequently provided to meet the mental health needs of populations in emergency and post‐conflicts contexts, but it has seldom been rigorously evaluated. Existing evaluations from low‐ and middle‐income countries provide mixed evidence of effectiveness. While Iraqi Kurdistan experienced relative stability following the fall of Saddam Hussein's government, the population in the northern Dohuk region has continued to experience periodic violence due to conflicts with neighboring Turkey as well as more recent ISIS‐associated violence. We evaluated the impact of a trauma‐informed support, skills, and psychoeducation intervention provided by community mental health workers (CMHWs) on depressive symptoms and dysfunction (primary outcomes) as well as post‐traumatic stress, traumatic grief, and anxiety symptoms (secondary outcomes). Between June 2009 and June 2010, 295 adults were screened; 209 (71%) met eligibility criteria (trauma exposure and a symptom severity score indicating significant distress and functional impairment, among others) and consented to participate. Of these, 159 were randomized to supportive counseling while 50 were randomized to a waitlist control condition. Comparing average symptom severity scores post‐treatment among those in the intervention group with those in the waitlist control group, the supportive counseling program had statistically and clinically significant impacts on the primary outcomes of depression (Cohen's d, 0.57; P = .02) and dysfunction (Cohen's d, 0.53; P = .03) and significant but smaller impacts on anxiety. Although studies by the same research team of psychotherapeutic interventions in other parts of Kurdistan and in southern Iraq found larger effects, this study adds to the global research literature on mental health and psychosocial support and shows that a well‐trained and supervised program of trauma‐informed support, skills, and psychoeducation that emphasizes the therapeutic relationship can also be effective."," Bass, J;  Murray, SM;  Mohammed, TA;  Bunn, M;  Gorman, W;  Ahmed, AM;  Murray, L;  Bolton, P",2016.0, 10.9745/GHSP-D-16-00017,0,1,
177,The efficacy of Trauma Management Therapy: A controlled pilot investigation of a three-week intensive outpatient program for combat-related PTSD.,"Despite the 8-18.5% of returning Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF) and Operation New Dawn (OND) veterans who are suffering from posttraumatic stress disorder (PTSD), few receive empirically supported treatments. Among those that do, the dropout rate is high and more than 50% retain their diagnosis after treatment. This study evaluated the efficacy of Trauma Management Therapy (TMT), delivered in a 3-week intensive outpatient (IOP) format. TMT combines virtual-reality augmented individual exposure therapy with a group intervention to address social isolation, anger, and depression. One hundred twelve (112) OIF/OEF/OND veterans and active duty personnel participated. Assessment included measures of PTSD, sleep, depression, anger, guilt, and social isolation, administered at post-treatment, 3-month, and 6-month follow-up. The effect size for TMT delivered in an IOP format was 2.06, with 65.9% no longer meeting diagnostic criteria for PTSD. There were similar positive effects in other domains and treatment gains were maintained at 6-month follow-up. The results are discussed regarding the need for efficacious, multi-component interventions that can be delivered safely and rapidly, and the potential of this approach towards that end.",Beidel DC.; Frueh BC.; Neer SM.; Lejuez CW.,2017.0,10.1016/j.janxdis.2017.05.001,0,1,
178, Pilot of a randomised controlled trial of the selective serotonin reuptake inhibitor sertraline versus cognitive behavioural therapy for anxiety symptoms in people with generalised anxiety disorder who have failed to respond to low-intensity psychological treatments as defined by the National Institute for Health and Care Excellence guidelines," BACKGROUND: Generalised anxiety disorder (GAD) is common, causing unpleasant symptoms and impaired functioning. The National Institute for Health and Care Excellence (NICE) guidelines have established good evidence for low‐intensity psychological interventions, but a significant number of patients will not respond and require more intensive step 3 interventions, recommended as either high‐intensity cognitive behavioural therapy (CBT) or a pharmacological treatment such as sertraline. However, there are no head‐to‐head comparisons evaluating which is more clinically effective and cost‐effective, and current guidelines suggest that treatment choice at step 3 is based mainly on patient preference. OBJECTIVES: To assess clinical effectiveness and cost‐effectiveness at 12 months of treatment with the selective serotonin reuptake inhibitor (SSRI) sertraline compared with CBT for patients with persistent GAD not improved with NICE‐defined low‐intensity psychological interventions. DESIGN: Participant randomised trial comparing treatment with sertraline with high‐intensity CBT for patients with GAD who had not responded to low‐intensity psychological interventions. SETTING: Community‐based recruitment from local Improving Access to Psychological Therapies (IAPT) services. Four pilot services located in urban, suburban and semirural settings. PARTICIPANTS: People considered likely to have GAD and not responding to low‐intensity psychological interventions identified at review by IAPT psychological well‐being practitioners (PWPs). Those scoring ≥ 10 on the Generalised Anxiety Disorder‐7 (GAD‐7) anxiety measure were asked to consider involvement in the trial. INCLUSION CRITERIA: Aged ≥ 18 years, a score of ≥ 10 on the GAD‐7, a primary diagnosis of GAD diagnosed on the Mini International Neuropsychiatric Interview questionnaire and failure to respond to NICE‐defined low‐intensity interventions. EXCLUSION CRITERIA: Inability to participate because of insufficient English or cognitive impairment, current major depression, comorbid anxiety disorder(s) causing greater distress than GAD, significant dependence on alcohol or illicit drugs, comorbid psychotic disorder, received antidepressants in past 8 weeks or high‐intensity psychological therapy in previous 6 months and any contraindications to treatment with sertraline. RANDOMISATION: Consenting eligible participants randomised via an independent, web‐based, computerised system. INTERVENTIONS: (1) The SSRI sertraline prescribed in therapeutic doses by the patient's general practitioner for 12 months and (2) 14 (± 2) CBT sessions delivered by high‐intensity IAPT psychological therapists in accordance with a standardised manual designed for GAD. MAIN OUTCOME MEASURES: The primary outcome was the Hospital Anxiety and Depression Scale ‐ Anxiety component at 12 months. Secondary outcomes included measures of depression, social functioning, comorbid anxiety disorders, patient satisfaction and economic evaluation, collected by postal self‐completion questionnaires. RESULTS: Only seven internal pilot participants were recruited against a target of 40 participants at 7 months. Far fewer potential participants were identified than anticipated from IAPT services, probably because PWPs rarely considered GAD the main treatment priority. Of those identified, three‐quarters declined participation; the majority (30/45) were reluctant to consider the possibility of randomisation to medication. LIMITATIONS: Poor recruitment was the main limiting factor, and the trial closed prematurely. CONCLUSIONS: It is unclear how much of the recruitment difficulty was a result of conducting the trial within a psychological therapy service and how much was possibly a result of difficulty identifying participants with primary GAD. FUTURE WORK: It may be easier to answer this important question by recruiting people from primary care rather than from those already engaged in a psychological treatment service. TRIAL REGISTRATION: Current Controlled Trials ISCRTN14845583. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in"," Buszewicz, M;  Cape, J;  Serfaty, M;  Shafran, R;  Kabir, T;  Tyrer, P;  Clarke, CS;  Nazareth, I",2017.0, 10.3310/hta21450,0,1,
179," A pilot randomized controlled trial of time-intensive cognitive-behaviour therapy for postpartum obsessive-compulsive disorder: effects on maternal symptoms, mother-infant interactions and attachment"," BACKGROUND: There is increasing recognition that perinatal anxiety disorders are both common and potentially serious for mother and child. Obsessive‐compulsive disorder (OCD) can be triggered or exacerbated in the postpartum period, with mothers reporting significant effects on parenting tasks. However, there is little evidence concerning their effective treatment or the impact of successful treatment on parenting. METHOD: A total of 34 mothers with OCD and a baby of 6 months old were randomized into either time‐intensive cognitive‐behaviour therapy (iCBT) or treatment as usual (TAU). iCBT took place after randomization at 6 months postpartum and was completed by 9 months. Maternal symptomatology, sensitivity in mother‐infant interactions and parenting were assessed at baseline and reassessed at 12 months postpartum. At 12 months attachment was also assessed using Ainsworth's Strange Situation Procedure. A healthy control group of mothers and infants (n = 37) underwent the same assessments as a benchmark. RESULTS: iCBT was successful in ameliorating maternal symptoms of OCD (controlled effect size = 1.31‐1.90). However, mother‐infant interactions were unchanged by treatment and remained less sensitive in both OCD groups than a healthy control group. The distribution of attachment categories was similar across both clinical groups and healthy controls with approximately 72% classified as secure in each group. CONCLUSIONS: iCBT is an effective intervention for postpartum OCD. Sensitive parenting interactions are affected by the presence of postpartum OCD and this is not improved by successful treatment of OCD symptoms. However, the overall attachment bond appears to be unaffected. Longitudinal studies are needed to explore the impact of postpartum OCD as the child develops."," Challacombe, FL;  Salkovskis, PM;  Woolgar, M;  Wilkinson, EL;  Read, J;  Acheson, R",2017.0, 10.1017/S0033291716003573,0,1,
180,An evaluation of two clinically-derived treatments for technophobia.,"Technology is ubiquitous in our occupational, educational and leisure lives. A fear of interacting with technology can therefore have a major impact on the quality of an individual's life. This is particularly salient within education as an inability to maximise the benefits of technology may limit academic achievement and subsequent opportunities in life. The severity of the anxiety induced by technology has lead to a plethora of research into the prevalence of 'technophobia'. This term may have clinical relevance and has been found to be comparable in severity to more traditional phobias [Thorpe, S. J. & Brosnan, M. (in press). Does computer anxiety reach levels which conform to DSM IV criteria for specific phobia? Computers in Human Behavior]. This paper presents two studies examining the effect of clinically-derived treatments upon levels of anxiety induced by technology. Study 1 was a 10-week selective desensitisation programme with 16 participants (eight computer anxious, eight non-anxious). Over this period computer anxiety and coping cognitions were significantly improved in the computer anxious group and become comparable to those of the matched non-anxious controls. Study 2 was a single treatment session for anxiety. Thirty individuals identified as anxious were assigned to either a one-session treatment (n = 9) or non-treatment (n = 21) group. Initially, both groups were significantly more anxious than the non-anxious control group (n = 59). Subsequent testing established that over the period of an academic year the reduction in anxiety was three times greater in the treated group than the non-treated group such that by the end of the year the treated group no longer differed from the control group, whereas the non-treated group remained significantly more anxious. The implications and limitations of the studies are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Brosnan, M. J; Thorpe, S. J",2006.0,http://dx.doi.org/10.1016/j.chb.2006.02.001,0,1,
181,Group Metacognitive Therapy vs. Mindfulness Meditation Therapy in a Transdiagnostic Patient Sample: A Randomised Feasibility Trial.,"Two transdiagnostic therapies for treating psychological disorder are Metacognitive Therapy (MCT) and Mindfulness Based Stress Reduction (MBSR). These two approaches have yet to be compared and therefore the current study aimed to evaluate the feasibility of a study of group MCT and MBSR in treating anxiety and depression. A feasibility trial with 40 participants (aged 19-56) was conducted. Patients were randomly assigned to receive either eight weeks of group MCT or MBSR. The primary outcome was feasibility which included recruitment rates, retention and treatment acceptability. The primary symptom outcome was the Hospital Anxiety and Depression Scale (HADS) total score, which provided an overall measure of distress. Both treatments were found to be acceptable with low attrition and similar ratings of acceptability. Changes in outcomes were analyzed based on the intention-to-treat principle using mixed effect models. Preliminary analyses revealed that MCT was more effective in treating anxiety and depression in comparison to MBSR, and in reducing both positive and negative metacognitive beliefs. Reliable improvement rates favoured MCT at post-treatment and 6-month follow up. Both treatments appeared to be feasible and acceptable in treating transdiagnostic samples; however, a larger, definitive trial is required. The limitations and directions for future research are discussed.",Capobianco L.; Reeves D.; Morrison AP.; Wells A.,2018.0,10.1016/j.psychres.2017.11.045,0,1,
182,Twelve-month follow-up of a randomized controlled trial of internet-based guided self-help for parents of children on cancer treatment.,"Background: A substantial proportion of parents of children on cancer treatment report psychological distress such as symptoms of post-traumatic stress (PTSS), depression, and anxiety. During their child's treatment many parents also experience an economic burden. Objective: The aim of this study was to evaluate the long-term efficacy of Internet-based guided self-help for parents of children on cancer treatment. Methods: This study was a parallel randomized controlled trial comparing a 10-week Internet-based guided self-help program, including weekly support from a therapist via encrypted email, with a wait-list control condition. The intervention was based on cognitive behavior therapy (CBT) and focused on psychoeducation and skills to cope with difficult thoughts and feelings. Primary outcome was self-reported PTSS. Secondary outcomes were self-reported symptoms of depression, anxiety, health care consumption, and sick leave during the past month. Outcomes were assessed pre- and postintervention and at 12-month follow-up. Parents of children on cancer treatment were invited by health care personnel at pediatric oncology centers, and parents meeting the modified symptom criteria on the PCL-C were included in the study. Self-report assessments were provided on the Web. Results: A total of 58 parents of children on cancer treatment (median months since diagnosis = 3) were included in the study (intervention n = 31 and control n = 27). A total of 18 participants completed the intervention, and 16 participants in each group participated in the 12-month follow-up. Intention-to-treat analyses revealed significant effects in favor of the intervention on the primary outcome PTSS, with large between-group effect sizes at postassessment (d = 0.89; 95% CI 0.35-1.43) and at 12-month follow-up (d = 0.78; 95% CI 0.25-1.32). Significant effects in favor of the intervention on the secondary outcomes depression and anxiety were also observed. However, there was no evidence for intervention efficacy on health care consumption or sick leave. Conclusions: Using the Internet to provide psychological interventions shows promise as an effective mode of delivery for parents reporting an increased level of PTSS and who consider Internet-based interventions as a viable option. Future research should corroborate these findings and also develop and evaluate interventions and policies that may help ameliorate the economic burden that parents may face during their child's treatment for cancer. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Cernvall, Martin; Carlbring, Per; Wikman, Anna; Ljungman, Lisa; Ljungman, Gustaf; von Essen, Louise",2017.0,http://dx.doi.org/10.2196/jmir.6852,0,1,
183, Internet-based self-help therapy with FearFighter™ versus no intervention for anxiety disorders in adults: study protocol for a randomised controlled trial," BACKGROUND: Internet‐based self‐help psychotherapy (IBT) could be an important alternative or supplement to ordinary face‐to‐face therapy. The findings of randomised controlled trials indicate that the effects of various IBT programmes for anxiety disorders seem better than no intervention and in some instances are equivalent to usual therapy. In Denmark, IBT is part of future treatment plans in mental health care services, but the verification level of the current clinical scientific knowledge is insufficient. The objective of this trial is feasibility assessment of benefits and harms of the Internet‐based cognitive behavioural therapy (ICBT) programme FearFighter™ versus no intervention for anxiety disorders in adults. METHODS AND DESIGN: We will conduct an investigator‐initiated, feasibility randomised controlled trial. Sixty‐four participants are expected to be recruited via an advertisement posted on the homepage of the Student Counselling Service in Denmark. The inclusion criterion for participation in the trial will be the presence of anxiety disorder as assessed with the Mini International Neuropsychiatric Interview. The exclusion criteria will be suicidal risk, an ongoing episode of bipolar disorder or psychosis, concurrent psychological treatment for the anxiety disorder, considered unable to attend the intervention as planned (due to vacation, work/study placement, sickness, or similar occurrences), or lack of informed consent. The intervention group will be offered nine sessions with the ICBT programme FearFighter™ and a weekly telephone contact to support compliance. The control group will receive no intervention. We define the feasibility outcomes as follows: the fraction of randomised participants out of the eligible people (the lower 95 % confidence interval (CI) ≥ 50 %); and the fraction of compliant participants (those receiving at least six out of nine sessions) in the intervention group (the lower 95 % CI ≥ 60 %). The exploratory clinical outcomes are the number of participants no longer meeting the diagnostic criteria for an anxiety disorder at the end of the trial and level of distress (Beck Anxiety Inventory, Symptom Checklist‐90‐R, WHO Well‐Being Index, Sheehan Disability Scale); the number of severe adverse events; and the occurrence of any psychological treatment outside the trial. To prevent bias in design, and in the gathering and analysis of data throughout the trial, we will follow the SPIRIT 2013 statement which defines standard protocol items for clinical trials. DISCUSSION: Based on our findings, we will discuss the feasibility of a future randomised controlled trial examining the benefits and harms of FearFighter™ versus no intervention for anxiety disorders in adults. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02499055 , registered on 1 July 2015."," Fenger, M;  Lindschou, J;  Gluud, C;  Winkel, P;  Jørgensen, L;  Kruse-Blinkenberg, S;  Lau, M",2016.0, 10.1186/s13063-016-1619-3,0,1,
184,Veterans individual placement and support towards advancing recovery: Methods and baseline clinical characteristics of a multisite study.,"This article describes the methodology and the baseline characteristics of veterans with posttraumatic stress disorder (PTSD) enrolled in a multisite trial comparing supported employment individual placement and support (IPS) to a stepwise vocational transitional work program (TWP). The Veterans Affairs Cooperative Studies Program randomized 541 veterans with PTSD across 12 Veterans Affairs Medical Centers to either IPS or TWP. Demographic and clinical characteristics were evaluated at baseline. Participants averaged 42 (SD ± 11) years of age and had PTSD for 13 (SD ± 11) years. The group was comprised of 18% female, 42% African Americans, and 16% Latino participants. Approximately 60% of participants served in the military since 2001, 89% were receiving or applying for service-connected disability, 60% had PTSD from nonsexual combat-related trauma, and 17% had PTSD from military sexual trauma. One third had not held a competitive job in the past 3 years; the average length of unemployment was 2.8 (SD ± 4) years. Unique study features included the focus on veterans with PTSD, a comparison of a promising practice with a usual-care practice, and the outcome criterion of achieving steady competitive employment. Conclusions and Implication for Practice: This study is the first large-scale randomized trial of IPS in a PTSD population. These baseline findings illustrate the characteristics of the study sample, which are representative of a veteran population in need of vocational rehabilitation services and can be used to help guide the implementation of tailored veteran-centered programs. (PsycINFO Database Record",Davis LL.; Kyriakides TC.; Suris A.; Ottomanelli L.; Drake RE.; Parker PE.; Mueller L.; Resnick SG.; Toscano R.; Blansett CM.; McCall KP.; Huang GD.,2018.0,10.1037/prj0000250,0,1,
185,Internet-based affect-focused psychodynamic therapy for social anxiety disorder: A randomized controlled trial with 2-year follow-up.,"Social anxiety disorder (SAD) is associated with considerable individual suffering and societal costs. Although there is ample evidence for the efficacy of cognitive behavior therapy, recent studies suggest psychodynamic therapy may also be effective in treating SAD. Furthermore, Internet-based psychodynamic therapy (IPDT) has shown promising results for addressing mixed depression and anxiety disorders. However, no study has yet investigated the effects of IPDT specifically for SAD. This paper describes a randomized controlled trial testing the efficacy of a 10-week, affect-focused IPDT protocol for SAD, compared with a wait-list control group. Long-term effects were also estimated by collecting follow-up data, 6, 12, and 24 months after the end of therapy. A total of 72 individuals meeting diagnostic criteria for DSM-IV social anxiety disorder were included. The primary outcome was the self-report version of Liebowitz Social Anxiety Scale. Mixed model analyses using the full intention-to-treat sample revealed a significant interaction effect of group and time, suggesting a larger effect in the treatment group than in the wait-list control. A between-group effect size Cohen's d = 1.05 (95% [CI]: [0.62, 1.53]) was observed at termination. Treatment gains were maintained at the 2-year follow-up, as symptom levels in the treated group continued to decrease significantly. The findings suggest that Internet-based affect-focused psychodynamic therapy is a promising treatment for social anxiety disorder. (PsycINFO Database Record",Johansson R.; Hesslow T.; Ljótsson B.; Jansson A.; Jonsson L.; Färdig S.; Karlsson J.; Hesser H.; Frederick RJ.; Lilliengren P.; Carlbring P.; Andersson G.,2017.0,10.1037/pst0000147,0,1,
186,Effects of mindfulness meditation on occupational functioning and health care utilization in individuals with anxiety.,"Objectives: To examine the effect of mindfulness meditation on occupational functioning in individuals with Generalized anxiety disorder (GAD). Methods: Fifty-seven individuals with GAD (mean (SD) age = 39 (13); 56% women) participated in an 8-week clinical trial in which they were randomized to mindfulness-based stress reduction (MBSR) or an attention control class. In this secondary analysis, absenteeism, entire workdays missed, partial workdays missed, and healthcare utilization patterns were assessed before and after treatment. Results: Compared to the attention control class, participation in MBSR was associated with a significantly greater decrease in partial work days missed for adults with GAD (t = 2.734, df = 51, p = 0.009). Interestingly, a dose effect was observed during the 24-week post-treatment follow-up period: among MBSR participants, greater home mindfulness meditation practice was associated with less work loss and with fewer mental health professional visits. Conclusion: Mindfulness meditation training may improve occupational functioning and decrease healthcare utilization in adults with GAD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Hoge, Elizabeth A; Guidos, Brittany M; Mete, Mihriye; Bui, Eric; Pollack, Mark H; Simon, Naomi M; Dutton, Mary Ann",2017.0,http://dx.doi.org/10.1016/j.jpsychores.2017.01.011,0,1,
187,Outcomes of trauma treatment using the TARGET model.,"In a randomized trial of a group intervention for co-occurring substance abuse and traumatic stress disorders ""Trauma Adaptive Recovery Group Education and Therapy"" (TARGET) was compared to trauma-sensitive usual care (TSU) with 213 clients in three adult outpatient clinics. Improvement at 6- and 12-month assessments occurred across conditions. TARGET was superior to TSU in maintaining sobriety self-efficacy. However, ethnic differences emerged. White TARGET participants reported more improvement than non-White participants on post-traumatic cognitions, and fewer non-White men reported relapses in TSU than in TARGET. TARGET appears to enhance sustained sobriety, but may require culturally specific adaptations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Frisman, Linda; Ford, Julian; Lin, Hsiu-Ju; Mallon, Sharon; Chang, Rocio; Beck, Blake, Brown, Brown, Bryk, Bryk, Dansky, Dansky, Dennis, Deykin, Foa, Ford, Goff, Hedeker, Hedeker, Kelly, Kessler, Liang, McKay, Najavits, Ouimette, Palacios, Pelcovitz, Read, Rose, Institute, Steinberg, Stewart, Stewart, Triffleman, Wasserman",2008.0,,0,1,
188,Effect of Prolonged Exposure Therapy Delivered Over 2 Weeks vs 8 Weeks vs Present-Centered Therapy on PTSD Symptom Severity in Military Personnel: A Randomized Clinical Trial.,"Effective and efficient treatment is needed for posttraumatic stress disorder (PTSD) in active duty military personnel. To examine the effects of massed prolonged exposure therapy (massed therapy), spaced prolonged exposure therapy (spaced therapy), present-centered therapy (PCT), and a minimal-contact control (MCC) on PTSD severity. Randomized clinical trial conducted at Fort Hood, Texas, from January 2011 through July 2016 and enrolling 370 military personnel with PTSD who had returned from Iraq, Afghanistan, or both. Final follow-up was July 11, 2016. Prolonged exposure therapy, cognitive behavioral therapy involving exposure to trauma memories/reminders, administered as massed therapy (n = 110; 10 sessions over 2 weeks) or spaced therapy (n = 109; 10 sessions over 8 weeks); PCT, a non-trauma-focused therapy involving identifying/discussing daily stressors (n = 107; 10 sessions over 8 weeks); or MCC, telephone calls from therapists (n = 40; once weekly for 4 weeks). Outcomes were assessed before and after treatment and at 2-week, 12-week, and 6-month follow-up. Primary outcome was interviewer-assessed PTSD symptom severity, measured by the PTSD Symptom Scale-Interview (PSS-I; range, 0-51; higher scores indicate greater PTSD severity; MCID, 3.18), used to assess efficacy of massed therapy at 2 weeks posttreatment vs MCC at week 4; noninferiority of massed therapy vs spaced therapy at 2 weeks and 12 weeks posttreatment (noninferiority margin, 50% [2.3 points on PSS-I, with 1-sided α = .05]); and efficacy of spaced therapy vs PCT at posttreatment. Among 370 randomized participants, data were analyzed for 366 (mean age, 32.7 [SD, 7.3] years; 44 women [12.0%]; mean baseline PSS-I score, 25.49 [6.36]), and 216 (59.0%) completed the study. At 2 weeks posttreatment, mean PSS-I score was 17.62 (mean decrease from baseline, 7.13) for massed therapy and 21.41 (mean decrease, 3.43) for MCC (difference in decrease, 3.70 [95% CI,0.72 to 6.68]; P = .02). At 2 weeks posttreatment, mean PSS-I score was 18.03 for spaced therapy (decrease, 7.29; difference in means vs massed therapy, 0.79 [1-sided 95% CI, -∞ to 2.29; P = .049 for noninferiority]) and at 12 weeks posttreatment was 18.88 for massed therapy (decrease, 6.32) and 18.34 for spaced therapy (decrease, 6.97; difference, 0.55 [1-sided 95% CI, -∞ to 2.05; P = .03 for noninferiority]). At posttreatment, PSS-I scores for PCT were 18.65 (decrease, 7.31; difference in decrease vs spaced therapy, 0.10 [95% CI, -2.48 to 2.27]; P = .93). Among active duty military personnel with PTSD, massed therapy (10 sessions over 2 weeks) reduced PTSD symptom severity more than MCC at 2-week follow-up and was noninferior to spaced therapy (10 sessions over 8 weeks), and there was no significant difference between spaced therapy and PCT. The reductions in PTSD symptom severity with all treatments were relatively modest, suggesting that further research is needed to determine the clinical importance of these findings. clinicaltrials.gov Identifier: NCT01049516.",Foa EB.; McLean CP.; Zang Y.; Rosenfield D.; Yadin E.; Yarvis JS.; Mintz J.; Young-McCaughan S.; Borah EV.; Dondanville KA.; Fina BA.; Hall-Clark BN.; Lichner T.; Litz BT.; Roache J.; Wright EC.; Peterson AL.;  .,2018.0,10.1001/jama.2017.21242,0,1,
189, Self-focused attention and safety behaviors across group therapies for social anxiety disorder," BACKGROUND: Self‐focused attention (SFA) and safety behaviors are two variables implicated in the maintenance of social anxiety disorder (SAD). DESIGN: The present study examined SFA and safety behaviors across two therapies for SAD, cognitive behavioral group therapy (CBGT) and mindfulness and acceptance‐based group therapy (MAGT). METHOD: Participants with symptoms meeting criteria for SAD (N = 137) were randomly assigned to the 12‐week‐treatment groups (n = 53 for each condition) or a waitlist control (n = 31). Variables were assessed at baseline, midtreatment, posttreatment, and a 3‐month follow‐up. RESULTS: Both treatment conditions reported significantly lower SFA and safety behaviors compared to control, but did not differ from one another at posttreatment. Mediation analyses supported the following models: (1) safety behaviors mediating the relationship between SFA and social anxiety, and (2) SFA mediating the relationship between safety behaviors and social anxiety. These models were supported for both treatment groups. CONCLUSIONS: Both treatments may have the potential to reduce the SFA and safety behaviors that serve to maintain SAD."," Desnoyers, AJ;  Kocovski, NL;  Fleming, JE;  Antony, MM",2017.0, 10.1080/10615806.2016.1239083,0,1,
190,"Collaborative care for panic disorder, generalised anxiety disorder and social phobia in general practice: study protocol for three cluster-randomised, superiority trials.","People with anxiety disorders represent a significant part of a general practitioner's patient population. However, there are organisational obstacles for optimal treatment, such as a lack of coordination of illness management and limited access to evidence-based treatment such as cognitive behavioral therapy. A limited number of studies suggest that collaborative care has a positive effect on symptoms for people with anxiety disorders. However, most studies are carried out in the USA and none have reported results for social phobia or generalised anxiety disorder separately. Thus, there is a need for studies carried out in different settings for specific anxiety populations. A Danish model for collaborative care (the Collabri model) has been developed for people diagnosed with depression or anxiety disorders. The model is evaluated through four trials, of which three will be outlined in this protocol and focus on panic disorder, generalised anxiety disorder and social phobia. The aim is to investigate whether treatment according to the Collabri model has a better effect than usual treatment on symptoms when provided to people with anxiety disorders. Three cluster-randomised, clinical superiority trials are set up to investigate treatment according to the Collabri model for collaborative care compared to treatment-as-usual for 364 patients diagnosed with panic disorder, generalised anxiety disorder and social phobia, respectively (total n = 1092). Patients are recruited from general practices located in the Capital Region of Denmark. For all trials, the primary outcome is anxiety symptoms (Beck Anxiety Inventory (BAI)) 6 months after baseline. Secondary outcomes include BAI after 15 months, depression symptoms (Beck Depression Inventory) after 6 months, level of psychosocial functioning (Global Assessment of Functioning) and general psychological symptoms (Symptom Checklist-90-R) after 6 and 15 months. Results will add to the limited pool of information about collaborative care for patients with anxiety disorders. To our knowledge, these will be the first carried out in a Danish context and the first to report results for generalised anxiety and social phobia separately. If the trials show positive results, they could contribute to the improvement of future treatment of anxiety disorders. ClinicalTrials.gov, ID: NCT02678624 . Retrospectively registered 7 February 2016; last updated 15 August 2016.",Curth NK.; Brinck-Claussen UØ.; Davidsen AS.; Lau ME.; Lundsteen M.; Mikkelsen JH.; Csillag C.; Hjorthøj C.; Nordentoft M.; Eplov LF.,2017.0,10.1186/s13063-017-2120-3,0,1,
191,Impact and cultural acceptance of the Narrative Exposure Therapy in the aftermath of a natural disaster in Burundi.,"Background: In the aftermath of natural disasters, affected populations are at risk of suffering from trauma-related mental health disorders such as posttraumatic stress disorder (PTSD) or depression. Particularly in poor post-conflict regions, these mental disorders have the potential to impair the ability of individuals to move on with their lives. We aimed to evaluate the feasibility, cultural acceptance, and effect of a trauma-focused psychotherapy, Narrative Exposure Therapy (NET), in the aftermath of a flood disaster in Burundi. Methods: Fifty-one individuals who were living in emergency camps overseen by the Burundian Red Cross in the aftermath of a flood disaster, and who had lost homes and close relatives, were invited to participate in semi-structured diagnostic interviews. Trained Burundian psychology students conducted these interviews, and six sessions of NET were offered to the 15 individuals most affected by trauma-related symptoms. An additional group of psychology students, blind to the treatment conditions, conducted three and 9 months follow-ups with them including also 25 participants who had reported significant but less severe trauma-related symptoms, assessing mental health symptoms, acceptance of NET, stigmatization due to trauma symptoms, and participants' economic well-being. Results: Between baseline and 9-months post-intervention assessment, symptoms of PTSD (Hedges' g = 3.44) and depression (Hedges' g = 1.88) improved significantly within participants who received NET and within those who received no treatment (Hedges' gPTSD = 2.55; Hedges' gdepression = 0.72). Furthermore, those who received NET felt less stigmatized by their participation in the intervention than by the trauma-related mental health symptoms they experienced. Overall, participants reported that they would be willing to forego as much as 1 month's worth of income in exchange for receiving trauma-focused interventions in the months following the disaster. Conclusions: Individuals severely affected by trauma-related mental health symptoms might benefit significantly from NET in the aftermath of natural disasters, while less affected individuals seem to recover spontaneously. Despite significant challenges conducting NET in emergency camps in the aftermath of natural disaster in a post-conflict country, such interventions are feasible, appreciated and might have long-lasting impacts on the lives of survivors if conducted with due respect to participants' privacy. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Crombach, Anselm; Siehl, Sebastian",2018.0,,0,1,
192,Moving effective treatment for posttraumatic stress disorder to primary care: A randomized controlled trial with active duty military.,"Many military service members with PTSD do not receive evidence-based specialty behavioral health treatment because of perceived barriers and stigma. Behavioral health providers in primary care can deliver brief, effective treatments expanding access and reducing barriers and stigma. The purpose of this randomized clinical trial was to determine if a brief cognitive-behavior therapy delivered in primary care using the Primary Care Behavioral Health model would be effective at reducing PTSD and co-occurring symptoms. A total of 67 service members (50 men, 17 women) were randomized to receive a brief, trauma-focused intervention developed for the primary care setting called Prolonged Exposure for Primary Care (PE-PC) or a delayed treatment minimal contact control condition. Inclusion criteria were significant PTSD symptoms following military deployment, medication stability, and interest in receiving treatment for PTSD symptoms in primary care. Exclusion criteria were moderate or greater risk of suicide, severe brain injury, or alcohol/substance use at a level that required immediate treatment. Assessments were completed at baseline, posttreatment/postminimal contact control, and at 8-week and 6-month posttreatment follow-up points. Primary measures were the PTSD Symptom Scale-Interview and the PTSD Checklist-Stressor-Specific. PE-PC resulted in larger reduction in PTSD severity and general distress than the minimal contact control. Delayed treatment evidenced medium to large effects comparable to the immediate intervention group. Treatment benefits persisted through the 6-month follow-up of the study. PE-PC delivered in integrated primary care is effective for the treatment of PTSD and co-occurring symptoms and may help reduce barriers and stigma found in specialty care settings. (PsycINFO Database Record",Cigrang JA.; Rauch SA.; Mintz J.; Brundige AR.; Mitchell JA.; Najera E.; Litz BT.; Young-McCaughan S.; Roache JD.; Hembree EA.; Goodie JL.; Sonnek SM.; Peterson AL.;  .,2017.0,10.1037/fsh0000315,0,1,
193,Is integrated CBT effective in reducing PTSD symptoms and substance use in Iraq and Afghanistan veterans? Results from a randomized clinical trial.,"This study is the first to examine integrated cognitive behavioral therapy (ICBT) in a sample of military veterans with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders (SUD). Generalized linear mixed models were used to examine primary outcomes from a small, randomized clinical trial comparing ICBT plus treatment as usual (TAU) to TAU only in a sample (N = 44) of U.S. veterans who served in Iraq and/or Afghanistan. A significant reduction in PTSD and SUD symptoms over time was detected in both conditions. One significant time-by-condition interaction effect for re-experiencing symptoms was observed, with ICBT showing greater reductions from baseline to post-treatment. Overall, the efficacy of ICBT in this veteran sample was not as robust as outcomes with non-veteran patients. Challenges to engagement and retention in treatment and further intervention adaptations for veterans are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Capone, Christy; Presseau, Candice; Saunders, Elizabeth; Eaton, Erica; Hamblen, Jessica; McGovern, Mark",2018.0,http://dx.doi.org/10.1007/s10608-018-9931-8,0,1,
194,Virtual reality compared with in vivo exposure in the treatment of social anxiety disorder: A three-arm randomised controlled trial.,"Background: People with social anxiety disorder (SAD) fear social interactions and may be reluctant to seek treatments involving exposure to social situations. Social exposure conducted in virtual reality (VR), embedded in individual cognitive-behavioural therapy (CBT), could be an answer. Aims: To show that conducting VR exposure in CBT for SAD is effective and is more practical for therapists than conducting exposure in vivo. Method: Participants were randomly assigned to either VR exposure (n = 17), in vivo exposure (n = 22) or waiting list (n = 20). Participants in the active arms received individual CBT for 14 weekly sessions and outcome was assessed with questionnaires and a behaviour avoidance test. Results: Improvements were found on the primary (Liebowitz Social Anxiety Scale) and all five secondary outcome measures in both CBT groups compared with the waiting list. Conducting exposure in VR was more effective at post-treatment than in vivo on the primary outcome measure and on one secondary measure. Improvements were maintained at the 6-month follow-up. VR was significantly more practical for therapists than in vivo exposure. Conclusions: Using VR can be advantageous over standard CBT as a potential solution for treatment avoidance and as an efficient, cost-effective and practical medium of exposure. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Bouchard, Stephane; Dumoulin, Stephanie; Robillard, Genevieve; Guitard, Tanya; Klinger, Evelyne; Forget, Helene; Loranger, Claudie; Roucaut, Francois Xavier",2017.0,http://dx.doi.org/10.1192/bjp.bp.116.184234,0,1,
195,Treatment of social phobia through pure self-help and therapist-augmented self-help.,"Self-help for social phobia has not received controlled empirical evaluation. To evaluate the efficacy of pure self-help through written materials for severe social phobia and self-help augmented by five group sessions with a therapist. These conditions were compared with a waiting-list control and standard, therapist-led group therapy. Participants with severe generalised social phobia (n=224) were randomised to one of four conditions. Assessment included diagnoses, symptoms and life interference at pretreatment, 12 weeks and at 24 weeks. A larger percentage of patients no longer had a diagnosis of social phobia at post-intervention in the pure self-help group than in the waiting-list group, although this percentage decreased slightly over the next 3 months. Symptoms of social anxiety and life interference did not differ significantly between these groups. Augmented self-help was better than waiting list on all measures and did not differ significantly from group treatment. Self-help augmented by therapist assistance shows promise as a less resource-intensive method for the management of social phobia. Pure self-help shows limited efficacy for this disorder.",Rapee RM.; Abbott MJ.; Baillie AJ.; Gaston JE.,2007.0,10.1192/bjp.bp.106.028167,0,1,
196,Low-intensity internet-delivered treatment for generalized anxiety symptoms in routine care: protocol for a randomized controlled trial.,"Worldwide prevalence of generalized anxiety disorder (GAD) is considered high; in Europe lifetime prevalence has been estimated at 4.3 to 5.9%. High levels of anxiety disorders have been reported in university students, affecting 25 to 30% of the population. Young adults are some of the most vulnerable for the onset of mental health disorders and any stressors may act as a catalyst for their onset. The absence of resources can often mean that many do not seek treatment. Other factors that impede access to resources include such things as a lack of trained professionals, personal stigma, and waiting lists. Anxiety disorders can be treated successfully; indeed brief forms of cognitive-behavior therapy have been recommended. One potential avenue for research and development is that of delivering low-intensity interventions online for students with GAD. Therefore, the current study seeks to investigate the potential effectiveness for a low-intensity online CBT-based treatment for GAD in a service-based setting; implemented as one step in a stepped-care model. The research is a service-based effectiveness study utilizing a randomized waiting-list controlled design. The active intervention consists of six weekly modules of online CBT. Participants are assigned a supporter who provides weekly post-session feedback on progress and exercises. Participants will complete the GAD-7 as the primary outcome measure. Secondary outcomes include pathological worry, depression and measures of well-being. At three-months follow-up data will be collected using the GAD-7, BDI-II, PSWQ, ED-Q5 and WSAS. Post-session data will be collected on significant in-session events in treatment (HAT). A satisfaction with treatment measure will be administered post-treatment (SAT). The study will be a contribution to the potential for a low-intensity internet-delivered program implemented in a service-based setting; implemented as one step in a stepped-care model. The study will be a contribution to the already established work in online treatments for anxiety worldwide. The study will assess the utility of an innovative digital health solution (SilverCloud) to deliver such interventions. Current Controlled Trials ISRCTN16303842.",Richards D.; Timulak L.; Doherty G.; Sharry J.; McLoughlin O.; Rashleigh C.; Colla A.; Joyce C.,2014.0,10.1186/1745-6215-15-145,0,1,
197,Internet-based individually versus group guided self-help treatment for social anxiety disorder: protocol of a randomized controlled trial.,"Social anxiety disorder (SAD) is one of the most common mental disorders and causes subjective suffering and economic burden worldwide. Although effective treatments are available, a lot of cases go untreated. Internet-based self-help is a low-threshold and flexible treatment alternative for SAD. Various studies have already shown that internet-based self-help can be effective to reduce social phobic symptoms significantly. Most of the interventions tested include therapist support, whereas the role of peer support within internet-based self-help has not yet been fully understood. There is evidence suggesting that patients' mutual exchange via integrated discussion forums can increase the efficacy of internet-based treatments. This study aims at investigating the added value of therapist-guided group support on the treatment outcome of internet-based self-help for SAD. The study is conducted as a randomized controlled trial. A total of 150 adults with a diagnosis of SAD are randomly assigned to either a waiting-list control group or one of the active conditions. The participants in the two active conditions use the same internet-based self-help program, either with individual support by a psychologist or therapist-guided group support. In the group guided condition, participants can communicate with each other via an integrated, protected discussion forum. Subjects are recruited via topic related websites and links; diagnostic status will be assessed with a telephone interview. The primary outcome variables are symptoms of SAD and diagnostic status after the intervention. Secondary endpoints are general symptomology, depression, quality of life, as well as the primary outcome variables 6 months later. Furthermore, process variables such as group processes, the change in symptoms and working alliance will be studied. The results of this study should indicate whether group-guided support could enhance the efficacy of an internet-based self-help treatment for SAD. This novel treatment format, if shown effective, could represent a cost-effective option and could further be modified to treat other conditions, as well. ISRCTN75894275.",Schulz A.; Stolz T.; Berger T.,2014.0,10.1186/1471-244X-14-115,0,1,
198,Stepped care for depression and anxiety: from primary care to specialized mental health care: a randomised controlled trial testing the effectiveness of a stepped care program among primary care patients with mood or anxiety disorders.,"Mood and anxiety disorders are highly prevalent and have a large impact on the lives of the affected individuals. Therefore, optimal treatment of these disorders is highly important. In this study we will examine the effectiveness of a stepped care program for primary care patients with mood and anxiety disorders. A stepped care program is characterized by different treatment steps that are arranged in order of increasing intensity. This study is a randomised controlled trial with two conditions: stepped care and care as usual, whereby the latter forms the control group. The stepped care program consists of four evidence based interventions: (1) Watchful waiting, (2) Guided self-help, (3) Problem Solving Treatment and (4) Medication and/or specialized mental health care. The study population consists of primary care attendees aged 18-65 years. Screeners are sent to all patients of the participating general practitioners. Individuals with a Diagnostic and Statistical Manual of mental disorders (DSM) diagnosis of major depression, dysthymia, panic disorder (with or without agoraphobia), generalized anxiety disorder, or social phobia are included as well as individuals with minor depression and anxiety disorders. Primary focus is the reduction of depressive and anxiety symptoms. Both conditions are monitored at 8, 16 and 24 weeks. This study evaluates the effectiveness of a stepped care program for patients with depressive and anxiety disorder. If effective, a stepped care program can form a worthwhile alternative for care as usual. Strengths and limitations of this study are discussed. Current Controlled Trails: ISRCTN17831610.",Seekles W.; van Straten A.; Beekman A.; van Marwijk H.; Cuijpers P.,2009.0,10.1186/1472-6963-9-90,0,1,
199,Treating youth depression and anxiety: A randomised controlled trial examining the efficacy of computerised versus face-to-face cognitive behaviour therapy.,"Barriers to accessing psychologists for the treatment of depression and anxiety include a shortage of specialised therapists, long waiting lists, and the affordability of therapy. This study examined the efficacy of a computerised-based self-help program (MoodGYM) delivered in-conjunction with face-to-face cognitive behavioural therapy (CBT) to expand the delivery avenues of psychological treatment for young adults (aged 18-25 years). Eighty-nine participants suffering from depression and/or generalised anxiety were randomly allocated to a control intervention or to one of three experimental groups: receiving face-to-face CBT, receiving computerised CBT (cCBT), or receiving treatment in-conjunction (face-to-face CBT and cCBT). While MoodGYM did not significantly decrease depression in comparison to the control group, significant decreases were found for anxiety. MoodGYM delivered in-conjunction with face-to-face CBT is more effective in treating symptoms of depression and anxiety compared with standalone face-to-face or cCBT. This study suggests that for youth who are unable to access face-to-face therapy-such as those in rural or remote regions, or for communities in which there is stigma attached to seeking help-computerised therapy may be a viable option. This is an important finding, especially in light of the current capacity-to-treat and accessibility problems faced by youth when seeking treatment for depression and/or anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sethi, Suvena; Andersson, Andrews, Bambling, Barak, Beck, Bendelin, Berger, Bilich, Bull, Butler, Christensen, Christensen, Christensen, Christensen, Churchill, Cuijpers, Cunningham, Eysenbach, Farvolden, Fenichel, Griffiths, Kenwright, Kessler, Khanna, Klein, Leach, Lovibond, Meadows, Menzies, O'Kearney, O'Kearney, Oetzel, Paxling, Proudfoot, Proudfoot, Proudfoot, Pull, Reavley, Sethi, Spek, Spence, Tabachnick, van Dulmen, Weersing, Wright",2013.0,,0,1,
200,Efficacy of motivational interviewing and cognitive behavioral therapy for anxiety and depression symptoms following traumatic brain injury.,"Anxiety and depression are common following traumatic brain injury (TBI), often co-occurring. This study evaluated the efficacy of a 9-week cognitive behavioral therapy (CBT) program in reducing anxiety and depression and whether a three-session motivational interviewing (MI) preparatory intervention increased treatment response. A randomized parallel three-group design was employed. Following diagnosis of anxiety and/or depression using the Structured Clinical Interview for DSM-IV, 75 participants with mild-severe TBI (mean age 42.2 years, mean post-traumatic amnesia 22 days) were randomly assigned to an Adapted CBT group: (1) MI + CBT (n = 26), or (2) non-directive counseling (NDC) + CBT (n = 26); or a (3) waitlist control (WC, n = 23) group. Groups did not differ in baseline demographics, injury severity, anxiety or depression. MI and CBT interventions were guided by manuals adapted for individuals with TBI. Three CBT booster sessions were provided at week 21 to intervention groups. Using intention-to-treat analyses, random-effects regressions controlling for baseline scores revealed that Adapted CBT groups (MI + CBT and NDC + CBT) showed significantly greater reduction in anxiety on the Hospital Anxiety and Depression Scale [95% confidence interval (CI) -2.07 to -0.06] and depression on the Depression Anxiety and Stress Scale (95% CI -5.61 to -0.12) (primary outcomes), and greater gains in psychosocial functioning on Sydney Psychosocial Reintegration Scale (95% CI 0.04-3.69) (secondary outcome) over 30 weeks post-baseline relative to WC. The group receiving MI + CBT did not show greater gains than the group receiving NDC + CBT. Findings suggest that modified CBT with booster sessions over extended periods may alleviate anxiety and depression following TBI.",Ponsford J.; Lee NK.; Wong D.; McKay A.; Haines K.; Alway Y.; Downing M.; Furtado C.; O'Donnell ML.,2016.0,10.1017/S0033291715002640,0,1,
201,Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder: evaluation in a randomized controlled trial.,"Generalized anxiety disorder (GAD) is a chronic anxiety disorder, associated with comorbidity and impairment in quality of life, for which improved psychosocial treatments are needed. GAD is also associated with reactivity to and avoidance of internal experiences. The current study examined the efficacy of an acceptance-based behavioral therapy aimed at increasing acceptance of internal experiences and encouraging action in valued domains for GAD. Clients were randomly assigned to immediate (n = 15) or delayed (n = 16) treatment. Acceptance-based behavior therapy led to statistically significant reductions in clinician-rated and self-reported GAD symptoms that were maintained at 3- and 9-month follow-up assessments; significant reductions in depressive symptoms were also observed. At posttreatment assessment 78% of treated participants no longer met criteria for GAD and 77% achieved high end-state functioning; these proportions stayed constant or increased over time. As predicted, treatment was associated with decreases in experiential avoidance and increases in mindfulness.",Roemer L.; Orsillo SM.; Salters-Pedneault K.,2008.0,10.1037/a0012720,0,1,
202,Effect of a Multicomponent Behavioral Intervention in Adults Impaired by Psychological Distress in a Conflict-Affected Area of Pakistan: A Randomized Clinical Trial.,"The mental health consequences of conflict and violence are wide-ranging and pervasive. Scalable interventions to address a range of mental health problems are needed. To test the effectiveness of a multicomponent behavioral intervention delivered by lay health workers to adults with psychological distress in primary care settings. A randomized clinical trial was conducted from November 1, 2014, through January 28, 2016, in 3 primary care centers in Peshawar, Pakistan, that included 346 adult primary care attendees with high levels of both psychological distress and functional impairment according to the 12-item General Health Questionnaire and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Lay health workers administered 5 weekly 90-minute individual sessions that included empirically supported strategies of problem solving, behavioral activation, strengthening social support, and stress management. The control was enhanced usual care. Primary outcomes, anxiety and depression symptoms, were independently measured at 3 months with the Hospital Anxiety and Depression Scale (HADS). Secondary outcomes were posttraumatic stress symptoms (Posttraumatic Stress Disorder Checklist for DSM-5), functional impairment (WHODAS 2.0), progress on problems for which the person sought help (Psychological Outcome Profiles), and symptoms of depressive disorder (9-item Patient Health Questionnaire). Among 346 patients (mean [SD] age, 33.0 [11.8] years; 78.9% women), 172 were randomly assigned to the intervention and 174 to enhanced usual care; among them, 146 and 160 completed the study, respectively. At baseline, the intervention and control groups had similar mean (SD) HADS scores on symptoms of anxiety (14.16 [3.17] vs 13.64 [3.20]; adjusted mean difference [AMD], 0.52; 95% CI, -0.22 to 1.27) and depression (12.67 [3.27] vs 12.49 [3.34]; AMD, 0.17, 95% CI, -0.54 to 0.89). After 3 months of treatment, the intervention group had significantly lower mean (SD) HADS scores than the control group for anxiety (7.25 [3.63] vs 10.03 [3.87]; AMD, -2.77; 95% CI, -3.56 to -1.98) and depression (6.30 [3.40] vs 9.27 [3.56]; AMD, -2.98; 95% CI, -3.74 to -2.22). At 3 months, there were also significant differences in scores of posttraumatic stress (AMD, -5.86; 95% CI, -8.53 to -3.19), functional impairment (AMD, -4.17; 95% CI, -5.84 to -2.51), problems for which the person sought help (AMD, -1.58; 95% CI, -2.40 to -0.77), and symptoms of depressive disorder (AMD, -3.41; 95% CI, -4.49 to -2.34). Among adults impaired by psychological distress in a conflict-affected area, lay health worker administration of a brief multicomponent intervention based on established behavioral strategies, compared with enhanced usual care, resulted in clinically significant reductions in anxiety and depressive symptoms at 3 months. anzctr.org.au Identifier: ANZCTR12614001235695.",Rahman A.; Hamdani SU.; Awan NR.; Bryant RA.; Dawson KS.; Khan MF.; Azeemi MM.; Akhtar P.; Nazir H.; Chiumento A.; Sijbrandij M.; Wang D.; Farooq S.; van Ommeren M.,2016.0,10.1001/jama.2016.17165,0,1,
203,Effect of a long-lasting multidisciplinary program on disability and fear-avoidance behaviors in patients with chronic low back pain: results of a randomized controlled trial,"ER OBJECTIVE: To evaluate the effect on disability, kinesiophobia, pain, and the quality of life of a long-lasting multidisciplinary program based on cognitive-behavioral therapy and targeted against fear-avoidance beliefs in patients with chronic low back pain.METHODS:STUDY DESIGN: parallel-group, randomized, superiority controlled study. Ninety patients were randomly assigned to a multidisciplinary program consisting of cognitive-behavior therapy and exercise training (experimental group, 45 patients) or exercise training alone (control group, 45 patients). Before treatment (T1), 5 weeks later (instructive phase, T2), and 12 (posttreatment analysis, T3) and 24 months after the end of the instructive phase (1-year follow-up, T4), all of the patients completed a booklet containing the Roland-Morris Disability Questionnaire Scale (primary outcome), the Tampa Scale for Kinesiophobia, a pain numerical rating scale, and the Short-Form Health Survey. A linear mixed model for repeated measures was used to analyze each outcome measure, and the reliable change index/clinically significant change method was used to assess the clinical significance of the changes.RESULTS: The linear mixed model analysis showed a remarkable group, time, and interaction effect for group * time in all of the primary and secondary outcomes (P always <0.001). The majority of the patients in the experimental group achieved a reliable and clinically significant improvement, whereas the majority of those in the control group experienced no change.CONCLUSIONS: The long-lasting multidisciplinary program was superior to the exercise program in reducing disability, fear-avoidance beliefs and pain, and enhancing the quality of life of patients with chronic low back pain. The effects were clinically tangible and lasted for at least 1 year after the intervention ended.","Monticone, M; Ferrante, S; Rocca, B; Baiardi, P; Farra, F D; Foti, C",2013.0,10.1097/AJP.0b013e31827fef7e,0,1,
204,Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: A pilot randomized controlled trial.,"Difficulties with emotions are common across mood and anxiety disorders. Dialectical behavior therapy skills training (DBT-ST) reduces emotion dysregulation in borderline personality disorder (BPD). Preliminary evidence suggests that use of DBT skills mediates changes seen in BPD treatments. Therefore, we assessed DBT-ST as a stand-alone, transdiagnostic treatment for emotion dysregulation and DBT skills use as a mediator of outcome. Forty-four anxious and/or depressed, non-BPD adults with high emotion dysregulation were randomized to 16 weeks of either DBT-ST or an activities-based support group (ASG). Participants completed measures of emotion dysregulation, DBT skills use, and psychopathology every 2 months through 2 months posttreatment. Longitudinal analyses indicated that DBT-ST was superior to ASG in decreasing emotion dysregulation (d = 1.86), increasing skills use (d = 1.02), and decreasing anxiety (d = 1.37) but not depression (d = 0.73). Skills use mediated these differential changes. Participants found DBT-ST acceptable. Thirty-two percent of DBT-ST and 59% of ASG participants dropped treatment. Fifty-nine percent of DBT-ST and 50% of ASG participants complied with the research protocol of avoiding ancillary psychotherapy and/or medication changes. In summary, DBT-ST is a promising treatment for emotion dysregulation for depressed and anxious transdiagnostic adults, although more assessment of feasibility is needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Neacsiu, Andrada D; Eberle, Jeremy W; Kramer, Rachel; Wiesmann, Taylor; Linehan, Marsha M; Aldao, Bagby, Barlow, Beck, Bohus, Borkovec, Borkovec, Bryk, Cameron, Campbell-Sills, Campbell-Sills, Ciarrochi, Cisler, Cohen, Cohn, Dimidjian, Dum, Dunn, Ellard, Etkin, Fava, Feingold, First, First, Fox, Garland, Gratz, Gratz, Hamilton, Harley, Harrison, Iverson, Jacobson, Koole, Kramer, Kring, Kring, Kroenke, Kross, Krull, Kwan, Landis, Linehan, Linehan, Linehan, Linehan, Linehan, MacKinnon, McEvoy, McLellan, McMillan, Mennin, Neacsiu, Neacsiu, Neacsiu, Neacsiu, Nelson-Gray, Norman, Norman, Norton, Pocock, Raudenbush, Rottenberg, Safer, Salters-Pedneault, Schafer, Schmidt, Soler, Stewart, Taylor, Titov, Tofighi, van Ingen, Verbeke, Vogel, Wampold, Westbrook, Whiteside",2014.0,,0,1,
205,Design of Department of Veterans Affairs Cooperative Study no. 420: group treatment of posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) is a significant problem for a large number of veterans who receive treatment from the Department of Veterans Affairs (VA) health-care system. VA Cooperative Study 420 is a randomized clinical trial of group psychotherapy for treating PTSD among veterans who sought VA care. Participants at ten sites were randomly assigned to receive one of the two treatments: active treatment that embedded exposure therapy in a group context or comparison treatment that avoided trauma focus and instead addressed current interpersonal problems. Treatment was delivered weekly to groups of six participants for 30 weeks, followed by five monthly booster sessions. Follow-up assessments were conducted at the end of treatment (7 months) and the end of boosters (12 months) for all participants. Long-term follow-up data were collected for a subset of participants at 18 and 24 months. The primary outcome is PTSD severity; other symptoms, functional status, quality of life, physical health, and service utilization also were assessed. Data analysis will account for the clustering introduced by the group nature of the intervention. The pivotal comparison was at the end of treatment. Analyses of subsequent outcomes will concentrate on the question of the durability of effects. The study provides an example of how to address the unique challenges posed by multisite trials of group psychotherapy through attention to methodological and statistical issues. This article discusses these challenges and describes the design and methods of the study. Control Clin Trials 2001;22:74-88",Schnurr PP.; Friedman MJ.; Lavori PW.; Hsieh FY.,2001.0,,0,1,
206,Transdiagnostic Internet treatment for anxiety disorders: A randomized controlled trial.,"Clinician-guided Internet-based cognitive behavioral therapy (iCBT) programs are clinically effective at treating specific anxiety disorders. The present study examined the efficacy of a transdiagnostic Internet-based cognitive behavioral treatment (iCBT) program to treat more than one anxiety disorder within the same program (the Anxiety Program). Eighty six individuals meeting diagnostic criteria for generalized anxiety disorder (GAD), panic disorder, and/or social phobia were randomly assigned to a treatment group, or to a waitlist control group. Treatment consisted of CBT based online educational lessons and homework assignments, weekly email or telephone contact from a clinical psychologist, access to a moderated online discussion forum, and automated emails. An intention-to-treat model using the baseline-observation-carried-forward principle was employed for data analyses. Seventy-five percent of treatment group participants completed all 6 lessons within the 8 week program. Post-treatment data was collected from 38/40 treatment group and 38/38 control group participants, and 3-month follow-up data was collected from 32/40 treatment group participants. Relative to controls, treatment group participants reported significantly reduced symptoms of anxiety as measured by the Generalized Anxiety Disorder-7 Item, Social Phobia Screening Questionnaire, and the Panic Disorder Severity Rating Scale-Self Report Scale, but not on the Penn State Worry Questionnaire, with corresponding between-groups effect sizes (Cohen's d) at post-treatment of 0.78, 0.43, 0.43, and 0.20, respectively. The clinician spent a total mean time of 46 min per person over the program, participants rated the procedure as moderately acceptable, and gains were sustained at follow-up. Modifications to the Anxiety program, based on post-treatment feedback from treatment group participants, were associated with improved outcomes in the control group. These results indicate that transdiagnostic programs for anxiety disorders may be successfully administered via the Internet. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Titov, Nickolai; Andrews, Gavin; Johnston, Luke; Robinson, Emma; Spence, Jay; Andersson, Andersson, Andersson, Andrews, Andrews, Barlow, Berger, Carlbring, Carlbring, Carlbring, Clark, Costa, Craske, Cuijpers, Cuijpers, Devilly, Erickson, Furmark, Garb, Houck, Kessler, Kiropoulos, Klein, Kroenke, Kroenke, Lovibond, Lowe, Marks, McEvoy, Meyer, Moher, Norton, Perini, Richards, Robinson, Ruwaard, Shandley, Sheehan, Sheehan, Spek, Spinhoven, Spitzer, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Vernmark, Vickers, Vickers, Wims",2010.0,,0,1,
207,Transdiagnostic Internet treatment for anxiety disorders: A randomized controlled trial.,"Clinician-guided Internet-based cognitive behavioural therapy (iCBT) programs are clinically effective at treating specific anxiety disorders. The present study examined the efficacy of a transdiagnostic Internet-based cognitive behavioural treatment (iCBT) program to treat more than one anxiety disorder within the same program (the Anxiety Program). Eighty six individuals meeting diagnostic criteria for generalized anxiety disorder (GAD), panic disorder, and/or social phobia were randomly assigned to a treatment group, or to a waitlist control group. Treatment consisted of CBT based online educational lessons and homework assignments, weekly email or telephone contact from a clinical psychologist, access to a moderated online discussion forum, and automated emails. An intention-to-treat model using the baseline-observation-carried-forward principle was employed for data analyses. Seventy-five percent of treatment group participants completed all 6 lessons within the 8 week program. Post-treatment data was collected from 38/40 treatment group and 38/38 control group participants, and 3-month follow-up data was collected from 32/40 treatment group participants. Relative to controls, treatment group participants reported significantly reduced symptoms of anxiety as measured by the Generalized Anxiety Disorder - 7 Item, Social Phobia Screening Questionnaire, and the Panic Disorder Severity Rating Scale - Self Report Scale, but not on the Penn State Worry Questionnaire, with corresponding between-groups effect sizes (Cohen's d) at post-treatment of 0.78, 0.43, 0.43, and 0.20, respectively. The clinician spent a total mean time of 46min per person over the program, participants rated the procedure as moderately acceptable, and gains were sustained at follow-up. Modifications to the Anxiety program, based on post-treatment feedback from treatment group participants, were associated with improved outcomes in the control group. These results indicate that transdiagnostic programs for anxiety disorders may be successfully administered via the Internet.",Titov N.; Andrews G.; Johnston L.; Robinson E.; Spence J.,2010.0,10.1016/j.brat.2010.05.014,0,1,
208,Effectiveness of a manualized imagery rehearsal therapy for patients suffering from nightmare disorders with and without a comorbidity of depression or PTSD.,"Nightmares are a common and serious problem in psychotherapeutic practice, although they are seldom considered as independent mental disorders. There are some promising approaches to the treatment of nightmares, notably Imagery Rehearsal Therapy, a cognitive-restructuring treatment. The core of this approach is the modification of the nightmare script and repeated imagination of the new script. However, most evaluation surveys have been conducted only with trauma patients, and thus far there is no standardized manual in the German language. 69 participants were examined using self-rating questionnaires. Participants belonged to three groups: 22 primarily nightmare sufferers, 21 patients with major depression and nightmares, 26 with PTSD and nightmares. 12 of the PTSD patients were randomly assigned to a control condition. Primary outcome measures were nightmare frequency and anxiety during nightmares. Overall, nightmare frequency and the anxiety they caused decreased following the treatment. Nightmare frequency and anxiety during the nightmares were highest in the PTSD group initially. Nightmare frequency decreased in all groups. Anxiety scores decreased least in PTSD patients, in depressive patients and primarily nightmare sufferers anxiety scores decreased during intervention. In primarily nightmare sufferers anxiety remained low up to the catamnesis period as well. Thus, those who suffered primarily from nightmares showed the strongest benefit from the nightmare treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Thunker, Johanna; Pietrowsky, Reinhard; Belicki, Bishay, Blagrove, Burgess, Cellucci, Davis, Davis, Forbes, Forbes, Germain, Grandi, Hartmann, Hautzinger, Kennedy, Krakow, Krakow, Krakow, Krakow, Krakow, Krakow, Levin, Levin, Levin, Lu, Margraf, Miller, Neidhardt, Schredl, Schredl, Schredl, Schredl, Schredl, Seif, Spoormaker, Spoormaker, Thunker, Zadra",2012.0,,0,1,
209,Effectiveness of a manualized imagery rehearsal therapy for patients suffering from nightmare disorders with and without a comorbidity of depression or PTSD.,"Nightmares are a common and serious problem in psychotherapeutic practice, although they are seldom considered as independent mental disorders. There are some promising approaches to the treatment of nightmares, notably Imagery Rehearsal Therapy, a cognitive-restructuring treatment. The core of this approach is the modification of the nightmare script and repeated imagination of the new script. However, most evaluation surveys have been conducted only with trauma patients, and thus far there is no standardized manual in the German language. 69 participants were examined using self-rating questionnaires. Participants belonged to three groups: 22 primarily nightmare sufferers, 21 patients with major depression and nightmares, 26 with PTSD and nightmares. 12 of the PTSD patients were randomly assigned to a control condition. Primary outcome measures were nightmare frequency and anxiety during nightmares. Overall, nightmare frequency and the anxiety they caused decreased following the treatment. Nightmare frequency and anxiety during the nightmares were highest in the PTSD group initially. Nightmare frequency decreased in all groups. Anxiety scores decreased least in PTSD patients, in depressive patients and primarily nightmare sufferers anxiety scores decreased during intervention. In primarily nightmare sufferers anxiety remained low up to the catamnesis period as well. Thus, those who suffered primarily from nightmares showed the strongest benefit from the nightmare treatment.",Thünker J.; Pietrowsky R.,2012.0,10.1016/j.brat.2012.05.006,0,1,
210,Cognitive behavioral therapy delays relapse in female socially phobic alcoholics.,"The present study was conducted to test the hypothesis that socially phobic alcoholics treated with Cognitive Behavioral therapy (CBT) will have better drinking outcomes than those treated with Twelve-Step Facilitation therapy (TSF). Three hundred ninety-seven treatment-seeking alcoholics with concurrent social phobia were compared retrospectively to a matched sample of 397 alcoholics without social phobia. Treatment was delivered in an outpatient setting, and patients were randomized to either CBT, TSF, or Motivational Enhancement therapy (MET). The groups were compared on self-reported drinking measures (e.g., quantity and frequency of drinking, and time-to-event measures) during treatment period and monthly for 1 year following treatment. Survival analyses revealed that female outpatients with social phobia showed delayed relapse to drinking when treated with CBT rather than TSF; the reverse was true for female outpatients without social phobia. Survival analyses in male outpatients with and without social phobia revealed an opposite trend, though it was not statistically significant. These data suggest that Cognitive Behavioral therapy is superior to Twelve-Step Facilitation therapy for the treatment of alcohol problems in specific populations. namely socially phobic women seeking outpatient treatment.",Thevos AK.; Roberts JS.; Thomas SE.; Randall CL.,,,0,1,
211,Group cognitive-behavioral treatment of panic disorder.,"The present study examined the efficacy of an 8-wk, cognitive-behavioral group treatment for panic disorder. Patients meeting DSM-III-R criteria for panic disorder with or without agoraphobia were randomly assigned to treatment (N = 34) or delayed treatment control (N = 33). The treatment consisted of: (a) education and corrective information; (b) cognitive therapy; (c) training in diaphragmatic breathing; and (d) interoceptive exposure. At posttreatment, 85% of treated Ss were panic free, compared to 30% of controls. Treated Ss also showed clinically significant improvement on indices of anxiety, agoraphobia, depression and fear of fear. Recovery, as estimated conservatively by the attainment of normal levels of functioning on each of the major clinical dimensions of the disorder (i.e. panic, anxiety and avoidance), was achieved in 64% of the treated Ss and 9% of the controls. At the 6 month follow-up, 63% of the treated patients met criteria for recovery. These findings mirror those from recently-completed trials of individually-administered cognitive-behavioral treatment, and suggest that CBT is a viable alternative to pharmacotherapy in the treatment of panic disorder.",Telch MJ.; Lucas JA.; Schmidt NB.; Hanna HH.; LaNae Jaimez T.; Lucas RA.,1993.0,,0,1,
212,"Efficacy and Outcome Predictors for Three PTSD Treatments: Exposure Therapy, EMDR, and Relaxation Training.","In recent years there has been a rapidly growing amount of research on the treatment of post traumatic stress disorder (PTSD). Our recent metaanalysis suggested that exposure therapy and eye movement desensitization and reprocessing (EMDR) are among the most effective treatments for PTSD. In this chapter we take the opportunity to summarize our previously reported findings and to present some hitherto unpublished results. Compared to EMDR and relaxation training: (1) exposure therapy tended to yield a greater proportion of participants who no longer met criteria for PTSD after treatment, as assessed by structured interview, (2) EMDR and relaxation did not differ from one another on any outcome variable, (3) exposure produced significantly larger reductions in avoidance and reexperiencing symptoms, as assessed before and after treatment via structured interview, and (4) exposure was faster at reducing avoidance, as assessed by a questionnaire administered at the beginning of each session. Our findings suggest that exposure is a first-line psychosocial treatment for PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Taylor, Steven; Asmundson, Beck, Blake, Borkovec, Chambless, Cohen, Devilly, Devilly, Fedoroff, First, Foa, Foa, Foa, Foa, Foa, Foa, Ironson, King, Lee, Marks, Maxfield, Mayou, Neziroglu, Norusis, Overall, Peterson, Peterson, Pitman, Power, Purdon, Rogers, Shapiro, Shapiro, Spector, Stein, Tarrier, Tarrier, Taylor, Taylor, Taylor, Taylor, Taylor, Taylor, van Etten, Vaughan, Wells; Taylor, Steven [Ed]",2004.0,,0,1,
213,Applied relaxation training for generalised anxiety and panic attacks: the efficacy of a learnt coping strategy on subjective reports.,"The results of applied relaxation training in patients with generalised anxiety and panic attacks are reported. ART was taught during one session, by means of participant demonstration, written instructions, taped instructions, or a combination of all three, with instructions to practice at home. All four methods proved superior to a waiting list control, but there were no differences between the treatment groups. There was some evidence for the non-specific effect of expectancy, but this did not completely explain the treatment effect.",Tarrier N.; Main CJ.,1986.0,,0,1,
214,Cognitive behavioral therapy for insomnia in posttraumatic stress disorder: a randomized controlled trial.,"Examine whether cognitive behavioral therapy for insomnia (CBT-I) improves sleep in posttraumatic stress disorder (PTSD) as well as nightmares, nonsleep PTSD symptoms, depression symptoms, and psychosocial functioning. RANDOMIZED CONTROLLED TRIAL WITH TWO ARMS: CBT-I and monitor-only waitlist control. Department of Veterans Affairs (VA) Medical Center. Forty-five adults (31 females: [mean age 37 y (22-59 y)] with PTSD meeting research diagnostic criteria for insomnia, randomly assigned to CBT-I (n = 29; 22 females) or monitor-only waitlist control (n = 16; nine females). Eight-session weekly individual CBT-I delivered by a licensed clinical psychologist or a board-certified psychiatrist. Measures included continuous monitoring of sleep with diary and actigraphy; prepolysomnography and postpolysomnography and Clinician-Administered PTSD Scale (CAPS); and pre, mid, and post self-report questionnaires, with follow-up of CBT-I participants 6 mo later. CBT-I was superior to the waitlist control condition in all sleep diary outcomes and in polysomnography-measured total sleep time. Compared to waitlist participants, CBT-I participants reported improved subjective sleep (41% full remission versus 0%), disruptive nocturnal behaviors (based on the Pittsburgh Sleep Quality Index-Addendum), and overall work and interpersonal functioning. These effects were maintained at 6-mo follow-up. Both CBT-I and waitlist control participants reported reductions in PTSD symptoms and CAPS-measured nightmares. Cognitive behavioral therapy for insomnia (CBT-I) improved sleep in individuals with posttraumatic stress disorder, with durable gains at 6 mo. Overall psychosocial functioning improved following CBT-I. The initial evidence regarding CBT-I and nightmares is promising but further research is needed. Results suggest that a comprehensive approach to treatment of posttraumatic stress disorder should include behavioral sleep medicine. TRIAL NAME: Cognitive Behavioral Treatment Of Insomnia In Posttraumatic Stress Disorder. URL: http://clinicaltrials.gov/ct2/show/NCT00881647. NCT00881647.",Talbot LS.; Maguen S.; Metzler TJ.; Schmitz M.; McCaslin SE.; Richards A.; Perlis ML.; Posner DA.; Weiss B.; Ruoff L.; Varbel J.; Neylan TC.,2014.0,10.5665/sleep.3408,0,1,
215,Efficacy of telephone-administered behavioral therapy for panic disorder with agoraphobia.,The purpose of this study was to determine the efficacy of a structured exposure-based behavior therapy program delivered by telephone to agoraphobic individuals who were isolated from specialized treatment centres. Forty-two individuals with a DSM-III-R diagnosis of panic disorder with agoraphobia who were living in rural areas of Ontario were assigned to either an eight-session telephone behavior therapy program or wait-list control condition. There were significant treatment x time interaction effects on several outcome variables. Patients originally in the wait-list group then received the same type of therapy and they also significantly improved. All treatment gains were maintained at three-month and six-month follow-up. Telephone behavior therapy appears to be a cost-effective and efficacious treatment for agoraphobics living in remote regions where specialized anxiety disorder services are not readily available.,Swinson RP.; Fergus KD.; Cox BJ.; Wickwire K.,1995.0,,0,1,
216,Changing core beliefs with trial-based cognitive therapy may improve quality of life in social phobia: a randomized study,"ER OBJECTIVE: To determine whether there are differences in quality of life (QoL) improvement after treatment with the trial-based thought record (TBTR) versus conventional cognitive therapy (CCT) in patients with social anxiety disorder (SAD).METHOD: A randomized trial comparing TBTR with a set of CCT techniques, which included the standard 7-column dysfunctional thought record (DTR) and the positive data log (PDL) in patients with SAD, generalized type.RESULTS: Repeated measures analysis of variance (ANOVA) revealed a significant time effect in the general health, vitality, social functioning, and mental health domains of the Short Form 36. It also indicated significant treatment effects on the bodily pain, social functioning, role-emotional, and mental health domains, with higher scores in the TBTR group. One-way analysis of covariance (ANCOVA), using pretreatment values as covariates, showed that TBTR was associated with significantly better QoL post-treatment (bodily pain, social functioning and role-emotional) and at follow-up (role-emotional). A significant treatment effect on the role-emotional domain at 12-month follow-up denoted a sustained effect of TBTR relative to CCT.CONCLUSION: This study provided preliminary evidence that TBTR is at least as effective as CCT in improving several domains of QoL in SAD, specifically when the standard 7-column DTR and the PDL are used.","Powell, V B; Oliveira, O H; Seixas, C; Almeida, C; Grangeon, M C; Caldas, M; Bonfim, T D; Castro, M; Galvão-de, Almeida A; Galvão-de, Almeida null; Moraes, Rde O; Sudak, D; de-Oliveira, I R",2013.0,10.1590/1516-4446-2012-0863,0,1,
217,"Applied tension, applied relaxation, and the combination in the treatment of blood phobia.","Thirty patients with phobia for blood, wounds and injuries were treated individually with applied tension, applied relaxation, or the combination of these two methods for 5, 9 and 10 sessions, respectively. They were assessed on self-report, behavioral and physiological measures before and after treatment, and at a 6-month follow-up. All groups improved significantly on 11/12 measures, and the improvements were maintained at follow-up. Applying stringent criteria, 73% of the patients were clinically improved at the end of treatment and 77% were so at follow-up. Despite a failure to find between-group differences, on many measures there was a trend favoring applied tension. Since this method is as effective as the other treatments in only half the time, applied tension should clinically be the treatment of choice for blood phobia.",Ost LG.; Sterner U.; Fellenius J.,1989.0,,0,1,
218,RCT of a brief phone-based CBT intervention to improve PTSD treatment utilization by returning service members.,"Many service members do not seek care for mental health and addiction problems, often with serious consequences for them, their families, and their communities. This study tested the effectiveness of a brief, telephone-based, cognitive-behavioral intervention designed to improve treatment engagement among returning service members who screened positive for posttraumatic stress disorder (PTSD). Service members who had served in Operation Enduring Freedom or Operation Iraqi Freedom who screened positive for PTSD but had not engaged in PTSD treatment were recruited (N=300), randomly assigned to either control or intervention conditions, and administered a baseline interview. Intervention participants received a brief cognitive-behavioral therapy intervention; participants in the control condition had access to usual services. All participants received follow-up phone calls at months 1, 3, and 6 to assess symptoms and service utilization. Participants in both conditions had comparable rates of treatment engagement and PTSD symptom reduction over the course of the six-month trial, but receiving the telephone-based intervention accelerated service utilization (treatment engagement and number of sessions) and PTSD symptom reduction. A one-time brief telephone intervention can engage service members in PTSD treatment earlier than conventional methods and can lead to immediate symptom reduction. There were no differences at longer-term follow-up, suggesting the need for additional intervention to build upon initial gains.",Stecker T.; McHugo G.; Xie H.; Whyman K.; Jones M.,2014.0,10.1176/appi.ps.201300433,0,1,
219,Cognitive therapy vs interpersonal psychotherapy in social anxiety disorder: a randomized controlled trial.,"Cognitive therapy (CT) focuses on the modification of biased information processing and dysfunctional beliefs of social anxiety disorder (SAD). Interpersonal psychotherapy (IPT) aims to change problematic interpersonal behavior patterns that may have an important role in the maintenance of SAD. No direct comparisons of the treatments for SAD in an outpatient setting exist. To compare the efficacy of CT, IPT, and a waiting-list control (WLC) condition. Randomized controlled trial. Two academic outpatient treatment sites. Patients  Of 254 potential participants screened, 117 had a primary diagnosis of SAD and were eligible for randomization; 106 participants completed the treatment or waiting phase. Treatment comprised 16 individual sessions of either CT or IPT and 1 booster session. Twenty weeks after randomization, posttreatment assessment was conducted and participants in the WLC received 1 of the treatments. The primary outcome was treatment response on the Clinical Global Impression Improvement Scale as assessed by independent masked evaluators. The secondary outcome measures were independent assessor ratings using the Liebowitz Social Anxiety Scale, the Hamilton Rating Scale for Depression, and patient self-ratings of SAD symptoms. At the posttreatment assessment, response rates were 65.8% for CT, 42.1% for IPT, and 7.3% for WLC. Regarding response rates and Liebowitz Social Anxiety Scale scores, CT performed significantly better than did IPT, and both treatments were superior to WLC. At 1-year follow-up, the differences between CT and IPT were largely maintained, with significantly higher response rates in the CT vs the IPT group (68.4% vs 31.6%) and better outcomes on the Liebowitz Social Anxiety Scale. No significant treatment × site interactions were noted. Cognitive therapy and IPT led to considerable improvements that were maintained 1 year after treatment; CT was more efficacious than was IPT in reducing social phobia symptoms.",Stangier U.; Schramm E.; Heidenreich T.; Berger M.; Clark DM.,2011.0,10.1001/archgenpsychiatry.2011.67,0,1,
220,Randomized controlled trial of Internet-delivered cognitive behavioral therapy for posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) is a severe and disabling condition and few receive appropriate care. Internet-based treatment of PTSD shows promise in reducing barriers to care and preliminary evidence suggests it is efficacious in treating symptoms of PTSD. Forty-two individuals with a diagnosis of PTSD confirmed by clinician interview completed a randomized controlled comparison of Internet-based cognitive behavioral therapy (CBT) with a waitlist control condition. Large pre- to posttreatment effect sizes (ESs) were found for the Treatment group on measures of PTSD symptoms, depression, anxiety, and disability. A small between-group ES was found for PTSD symptoms and moderate between-group ESs were found for depression, anxiety, and disability. Results provide preliminary support for Internet-based CBT as an efficacious treatment for individuals with a confirmed primary diagnosis of PTSD.",Spence J.; Titov N.; Dear BF.; Johnston L.; Solley K.; Lorian C.; Wootton B.; Zou J.; Schwenke G.,2011.0,10.1002/da.20835,0,1,
221,Written exposure as an intervention for PTSD: a randomized clinical trial with motor vehicle accident survivors.,"The present study examined the efficacy of a brief, written exposure therapy (WET) for posttraumatic stress disorder (PTSD). Participants were 46 adults with a current primary diagnosis of motor vehicle accident-related PTSD. Participants were randomly assigned to either WET or a waitlist (WL) condition. Independent assessments took place at baseline and 6-, 18-, and 30-weeks post baseline (WL condition not assessed at 30 weeks). Participants assigned to WET showed significant reductions in PTSD symptom severity at 6- and 18-week post-baseline, relative to WL participants, with large between-group effect sizes. In addition, significantly fewer WET participants met diagnostic criteria for PTSD at both the 6- and 18-week post-baseline assessments, relative to WL participants. Treatment gains were maintained for the WET participants at the 30-week post baseline assessment. Notably, only 9% of participants dropped out of WET and the WET participants reported a high degree of satisfaction with the treatment. These findings suggest that a brief, written exposure treatment may efficaciously treat PTSD. Future research should examine whether WET is efficacious with other PTSD samples, as well as compare the efficacy of WET with that of evidence-based treatments for PTSD.",Sloan DM.; Marx BP.; Bovin MJ.; Feinstein BA.; Gallagher MW.,2012.0,10.1016/j.brat.2012.07.001,0,1,
222,Cognitive-behavioral therapy vs risperidone for augmenting serotonin reuptake inhibitors in obsessive-compulsive disorder: a randomized clinical trial.,"Obsessive-compulsive disorder (OCD) is one of the world's most disabling illnesses according to the World Health Organization. Serotonin reuptake inhibitors (SRIs) are the only medications approved by the Food and Drug Administration to treat OCD, but few patients achieve minimal symptoms from an SRI alone. In such cases, practice guidelines recommend adding antipsychotics or cognitive-behavioral therapy consisting of exposure and ritual prevention (EX/RP). To compare the effects of these 2 SRI augmentation strategies vs pill placebo for the first time, to our knowledge, in adults with OCD. A randomized clinical trial (conducted January 2007-August 2012) at 2 academic outpatient research clinics that specialize in OCD and anxiety disorders. Patients (aged 18-70 years) were eligible if they had OCD of at least moderate severity despite a therapeutic SRI dose for at least 12 weeks prior to entry. Of 163 who were eligible, 100 were randomized (risperidone, n = 40; EX/RP, n = 40; and placebo, n = 20), and 86 completed the trial. While continuing their SRI at the same dose, patients were randomized to the addition of 8 weeks of risperidone (up to 4 mg/d), EX/RP (17 sessions delivered twice weekly), or pill placebo. Independent assessments were conducted every 4 weeks. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) to measure OCD severity. Patients randomized to EX/RP had significantly greater reduction in week 8 Y-BOCS scores based on mixed-effects models (vs risperidone: mean [SE], -9.72 [1.38]; P < .001 vs placebo: mean [SE], -10.10 [1.68]; P < .001). Patients receiving risperidone did not significantly differ from those receiving placebo (mean [SE], -0.38 [1.72]; P = .83). More patients receiving EX/RP responded (Y-BOCS score decrease ≥25%: 80% for EX/RP, 23% for risperidone, and 15% for placebo; P < .001). More patients receiving EX/RP achieved minimal symptoms (Y-BOCS score ≤12: 43% for EX/RP, 13% for risperidone, and 5% for placebo; P = .001). Adding EX/RP was also superior to risperidone and placebo in improving insight, functioning, and quality of life. Adding EX/RP to SRIs was superior to both risperidone and pill placebo. Patients with OCD receiving SRIs who continue to have clinically significant symptoms should be offered EX/RP before antipsychotics given its superior efficacy and less negative adverse effect profile. clinicaltrials.gov Identifier: NCT00389493.",Simpson HB.; Foa EB.; Liebowitz MR.; Huppert JD.; Cahill S.; Maher MJ.; McLean CP.; Bender J.; Marcus SM.; Williams MT.; Weaver J.; Vermes D.; Van Meter PE.; Rodriguez CI.; Powers M.; Pinto A.; Imms P.; Hahn CG.; Campeas R.,2013.0,10.1001/jamapsychiatry.2013.1932,0,1,
223,Individually tailored internet-based treatment for young adults and adults with panic attacks: randomized controlled trial.,"Previous studies on Internet-based treatment with minimal therapist guidance have shown promising results for several specific diagnoses. To (1) investigate the effects of a tailored, therapist-guided, Internet-based treatment for individuals with reoccurring panic attacks, and (2) to examine whether people in different age groups (18-30 years and 31-45 years) would respond differently to the treatment. We recruited 149 participants from an online list of individuals having expressed an interest in Internet treatment. Screening consisted of online questionnaires followed by a telephone interview. A total of 57 participants were included after a semistructured diagnostic interview, and they were randomly assigned to an 8-week treatment program (n = 29) or to a control condition (n = 28). Treatment consisted of individually prescribed cognitive behavior therapy text modules in conjunction with online therapist guidance. The control group consisted of people on a waitlist who later received treatment. All dependent measures improved significantly immediately following treatment and at the 12-month follow-up. The between-group effect size on the primary outcome measure, the Panic Disorder Severity Scale, was d = 1.41 (95% confidence interval 0.81-1.95) at posttreatment. The within-group effect size from pretreatment to 12-month follow-up was d = 1.66 (95% confidence interval 1.14-2.35). Age group had no effect, suggesting that age did not influence the outcome. Tailoring an Internet-based treatment can be a feasible approach in the treatment of panic symptoms and comorbid anxiety and depressive symptoms. Younger adults benefit as much as adults over 30 years and up to 45 years of age. Clinicaltrials.gov NCT01296321; http://www.clinicaltrials.gov/ct2/show/NCT01296321 (Archived by WebCite at http://www.webcitation.org/65wddsqlL).",Silfvernagel K.; Carlbring P.; Kabo J.; Edström S.; Eriksson J.; Månson L.; Andersson G.,2012.0,10.2196/jmir.1853,0,1,
224,Early EMDR intervention following a community critical incident: A randomized clinical trial.,"The aim of this study was to investigate the efficacy of early eye movement desensitization and reprocessing (EMDR) intervention using the EMDR recent traumatic episode protocol (R-TEP) after a traumatic community event whereby a missile hit a building in a crowded area of a town. In a waitlist/delayed treatment parallel-group randomized controlled trial, 17 survivors with posttraumatic distress were treated with EMDR therapy using the R-TEP protocol. Volunteer EMDR practitioners conducted treatment on 2 consecutive days. Participants were randomly allocated to either immediate or waitlist/delayed treatment conditions. Assessments with Impact of Event Scale-Revised (IES-R) and the Patient Health Questionnaire (PHQ-9) brief depression inventory took place at pre- and posttreatment and at 3 months follow-up. At 1 week posttreatment, the scores of the immediate treatment group were significantly improved on the IES-R compared to the waitlist/delayed treatment group, who showed no improvement prior to their treatment. At 3 months follow-up, results on the IES-R were maintained and there was a significant improvement on PHQ-9 scores. This pilot study provides preliminary evidence, supporting the efficacy of EMDR R-TEP for reducing posttrauma stress among civilian victims of hostility, and shows that this model of intervention briefly augmenting local mental health services following large-scale traumatic incidents, using an EMDR intervention on 2 consecutive days may be effective. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Shapiro, Elan; Laub, Brurit; Andrews, Bisson, Bleich, Brewin, Bryant, Bryant, Buydens, Colelli, Creamer, Fernandez, Gelbach, Grainger, Jarero, Jarero, Jarero, Kaya, Kroenke,, Kutz, Laub, Luber, Maxfield, Maxfield, McFarlane, McFarlane, McFarlane, Natha, Rash, Roberts, Roberts, Roberts, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Silver, Spitzer, Thomas, Tofani, Weiss, Yurtsever",2015.0,,0,1,
225,"A randomized, controlled trial of the effectiveness of cognitive-behavioral therapy and sertraline versus a waitlist control group for anxiety disorders in older adults.","This study is the first to investigate the relative effectiveness of cognitive-behavioral therapy (CBT) compared with a selective serotonin reuptake inhibitor (SSRI; sertraline) in a randomized, controlled trial on the treatment of anxiety disorders in older adults. Eighty-four patients 60 years of age and over with a principal diagnosis of generalized anxiety disorder, panic disorder, agoraphobia, or social phobia were randomly assigned to one of three conditions: 15 sessions of CBT, pharmacologic treatment with an SSRI (sertraline; maximum dosage 150 mg), or a waitlist control group. Participants completed measures of primary outcome (anxiety) and coexistent worry and depressive symptoms at baseline, posttreatment, and at three-month follow up. Attrition rates were high in both treatment groups. Consequently, findings are based on a relatively small sample of completers (N = 52). Although both CBT and sertraline led to significant improvement in anxiety, worry, and depressive symptoms both at posttreatment and at three-month follow up, sertraline showed superior results on worry symptoms. Effect size estimates for CBT were in the small to medium range both at posttreatment (mean d = 0.42) and at three-month follow up (mean d = 0.35), whereas effect sizes for sertraline fell into the large range (posttreatment mean d = 0.94 and three-month follow up mean d = 1.02). The waitlist condition showed virtually no effects (posttreatment mean d = .03). Our findings strongly suggest that the pharmacologic treatment of late-life anxiety with SSRIs has not been given the proper attention in research to date.",Schuurmans J.; Comijs H.; Emmelkamp PM.; Gundy CM.; Weijnen I.; van den Hout M.; van Dyck R.,2006.0,10.1097/01.JGP.0000196629.19634.00,0,1,
226,A sorrow shared is a sorrow halved? A three-arm randomized controlled trial comparing internet-based clinician-guided individual versus group treatment for social anxiety disorder.,"A growing body of evidence suggests that internet-based cognitive behavioural treatments (ICBT) are effective to treat social anxiety disorder (SAD). Whereas the efficacy of clinician-guided ICBT has been established, ICBT in a group format has not yet been systematically investigated. This three-arm RCT compared the efficacy of clinician-guided group ICBT (GT) with clinician guided individual ICBT (IT) and a wait-list (WL). A total of 149 individuals meeting the diagnostic criteria for SAD were randomly assigned to one of three conditions. Primary endpoints were self-report measures of SAD and diagnostic status taken at baseline, after the twelve-week intervention and at six-month follow-up. Secondary endpoints were symptoms of depression, interpersonal problems and general symptomatology. At post-treatment, both active conditions showed superior outcome regarding SAD symptoms (GT vs. WL: d = 0.84-0.74; IT vs. WL: d = 0.94-1.22). The two active conditions did not differ significantly in symptom reduction (d = 0.12-0.26, all ps > 0.63), diagnostic response rate or attrition. Treatment gains were maintained at follow-up. The group format reduced weekly therapist time per participant by 71% (IT: 17 min, GT: 5 min). Findings indicate that a clinician-guided group format is a promising approach in treating SAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schulz, Ava; Stolz, Timo; Vincent, Alessia; Krieger, Tobias; Andersson, Gerhard; Berger, Thomas; Acarturk, Andersson, Andersson, Andersson, Andersson, Andersson, Andrade, Andrews, Andrews, Attkisson, Aydos, Baumeister, Berger, Berger, Berger, Berger, Berger, Berger, Berger, Berger, Beutler, Boettcher, Boettcher, Botella, Buntrock, Calear, Carlbring, Clark, Derogatis, El Alaoui, Eskildsen, Faul, Fehm, First, Franke, Furmark, Gandek, Gross, Gueorguieva, Hautzinger, Hedman, Hedman, Hedman, Hedman, Hedman, Hedman, Horowitz, Horowitz, Jacobson, Johansson, Keller, Kessler, Lee, Lincoln, Mattick, Mayo-Wilson, Nordmo, Olfson, Otto, Richards, Rohde, Schmidt, Schulz, Shafran, Spek, Stangier, Stangier, Stein, Steketee, Titov, Titov, Titov, Titov, Titov, Tulbure, Wittchen, Yonkers",2016.0,,0,1,
227,The effectiveness of eye movement desensitization and reprocessing therapy to treat symptoms following trauma in timor leste.,"The effectiveness of eye movement desensitization and reprocessing (EMDR) therapy for treating trauma symptoms was examined in a postwar/conflict, developing nation, Timor Leste. Participants were 21 Timorese adults with symptoms of posttraumatic stress disorder (PTSD), assessed as those who scored >=2 on the Harvard Trauma Questionnaire (HTQ). Participants were treated with EMDR therapy. Depression and anxiety symptoms were assessed using the Hopkins Symptom Checklist. Symptom changes post-EMDR treatment were compared to a stabilization control intervention period in which participants served as their own waitlist control. Sessions were 60-90 mins. The average number of sessions was 4.15 (SD = 2.06). Despite difficulties providing treatment cross-culturally (i.e., language barriers), EMDR therapy was followed by significant and large reductions in trauma symptoms (Cohen's d = 2.48), depression (d = 2.09), and anxiety (d = 1.77). At posttreatment, 20 (95.2%) participants scored below the HTQ PTSD cutoff of 2. Reliable reductions in trauma symptoms were reported by 18 participants (85.7%) posttreatment and 16 (76.2%) at 3-month follow-up. Symptoms did not improve during the control period. Findings support the use of EMDR therapy for treatment of adults with PTSD in a cross-cultural, postwar/conflict setting, and suggest that structured trauma treatments can be applied in Timor Leste. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schubert, Sarah J; Lee, Christopher W; de Araujo, Guilhermina; Butler, Susan R; Taylor, Graham; Drummond, Peter D; Ager, Basoglu, Borkovec, Bracken, Butler, Carlson, Devilly, Dossa, Errebo, Foa, Gelbach, Ho, Jacobson, Janoff-Bulman, Jarero, Kienzler, Kim, Konuk, Kutz, Lee, Maxfield, Modvig, Mollica, Mollica, Mollica, Nunnaly, Sack, Schubert, Schubert, Shapiro, Silove, Silove, Silove, Singal, van den Hout, Wadaa, Wilson, Wolpe, Zaghrout-Hodali, Zang",2016.0,,0,1,
228,Brief eclectic psychotherapy for PTSD: a randomized controlled trial.,,Schnyder U.; Müller J.; Maercker A.; Wittmann L.,2011.0,10.4088/JCP.10l06247blu,0,1,
229,Randomized controlled trial of false safety behavior elimination therapy: a unified cognitive behavioral treatment for anxiety psychopathology.,"We tested the efficacy of a unified cognitive-behavioral therapy protocol for anxiety disorders. This group treatment protocol, termed false safety behavior elimination therapy (F-SET), is a cognitive-behavioral approach designed for use across various anxiety disorders such as panic disorder (PD), social anxiety disorder (SAD), and generalized anxiety disorder (GAD). F-SET simplifies, as well as broadens, key therapeutic elements of empirically validated treatments for anxiety disorders to allow for easier delivery to heterogeneous groups of patients with anxiety psychopathology. Patients with a primary anxiety disorder diagnosis (N=96) were randomly assigned to F-SET or a wait-list control. Data indicate that F-SET shows good efficacy and durability when delivered to mixed groups of patients with anxieties (i.e., PD, SAD, GAD) by relatively inexperienced clinicians. Findings are discussed in the context of balancing treatment efficacy and clinical utility.",Schmidt NB.; Buckner JD.; Pusser A.; Woolaway-Bickel K.; Preston JL.; Norr A.,2012.0,10.1016/j.beth.2012.02.004,0,1,
230,A randomized effectiveness trial of cognitive-behavioral therapy and medication for primary care panic disorder.,"Panic disorder is a prevalent, often disabling condition among patients in the primary care setting. Although numerous studies have assessed the effectiveness of treatments for depression in primary care, few such studies have been conducted for panic disorder. To implement and test the effectiveness of a combined pharmacotherapy and cognitive-behavioral intervention for panic disorder tailored to the primary care setting. Randomized, controlled study comparing intervention to treatment as usual. Six primary care clinics associated with 3 university medical schools, serving an ethnically and socioeconomically diverse patient population. Two hundred thirty-two primary care patients meeting DSM-IV criteria for panic disorder. Comorbid mental and physical disorders were permitted, provided these did not contraindicate the treatment to be provided and were not acutely life threatening. Patients were randomized to receive either treatment as usual or an intervention consisting of a combination of up to 6 sessions (across 12 weeks) of cognitive-behavioral therapy (CBT) modified for the primary care setting, with up to 6 follow-up telephone contacts during the next 9 months, and algorithm-based pharmacotherapy provided by the primary care physician with guidance from a psychiatrist. Behavioral health specialists, the majority inexperienced in CBT for panic disorder, were trained to deliver the CBT and coordinated overall care, including pharmacotherapy. Proportion of subjects remitted (no panic attacks in the past month, minimal anticipatory anxiety, and agoraphobia subscale score <10 on Fear Questionnaire) and responding (Anxiety Sensitivity Index score <20) and change over time in World Health Organization Disability Scale and short form 12 scores. The combined cognitive-behavioral and pharmacotherapeutic intervention resulted in sustained and gradually increasing improvement relative to treatment as usual, with significantly higher rates at all points of both the proportion of subjects remitted (3 months, 20% vs 12%; 12 months, 29% vs 16%) and responding (3 months, 46% vs 27%; 12 months, 63% vs 38%) and significantly greater improvements in World Health Organization Disability Scale (all points) and short form 12 mental health functioning (3 and 6 months) scores. These effects were obtained in spite of similar rates of delivery of guideline-concordant pharmacotherapy to the 2 groups. Delivery of evidence-based CBT and medication using the collaborative care model and a CBT-naive, midlevel behavioral health specialist is feasible and significantly more effective than usual care for primary care panic disorder.",Roy-Byrne PP.; Craske MG.; Stein MB.; Sullivan G.; Bystritsky A.; Katon W.; Golinelli D.; Sherbourne CD.,2005.0,10.1001/archpsyc.62.3.290,0,1,
231,Effectiveness of computer-generated (virtual reality) graded exposure in the treatment of acrophobia.,"The authors' goal was to examine the efficacy of computer-generated (virtual reality) graded exposure in the treatment of acrophobia (fear of heights). Twenty college students with acrophobia were randomly assigned to virtual reality graded exposure treatment (N = 12) or to a waiting-list comparison group (N = 8). Seventeen students completed the study. Sessions were conducted individually over 8 weeks. Outcome was assessed by using measures of anxiety, avoidance, attitudes, and distress associated with exposure to heights before and after treatment. Significant differences between the students who completed the virtual reality treatment (N = 10) and those on the waiting list (N = 7) were found on all measures. The treatment group was significantly improved after 8 weeks, but the comparison group was unchanged. The authors conclude that treatment with virtual reality graded exposure was successful in reducing fear of heights.",Rothbaum BO.; Hodges LF.; Kooper R.; Opdyke D.; Williford JS.; North M.,1995.0,10.1176/ajp.152.4.626,0,1,
232,Early interpersonal relations: experience of four treatment methods in phobic women.,"One hundred and three phobic women not suitable for insight-oriented psychotherapy were randomized to either therapist-directed prolonged exposure in vivo (PE), supportive therapy of dynamic type (ST), relaxation therapy (R), or basal therapy (B). History taking was lengthy and included ratings of early interpersonal relations. These were combined into a scale with a range from 0, least favourable, to 13 most favourable. The patients filled in an inventory with regard to their experience of the therapist and the therapy at the beginning of the treatment, at midtreatment, and at the end of treatment, 3 months later. This inventory, the ETI, comprises different scales with ranges from least to most favourable experiences. The associations between the scales on the experience of early interpersonal relations and the ETI scales were studied. Most correlations were positive, indicating a similarity between the experience of early personal relations and the experience of the therapist and the therapy. The associations were significant at the start of therapy with B, and at the termination of therapy with R. These results are taken to indicate that when the desire for a personal relation with the therapist is frustrated the nature of the relation is interpreted according to the nature of the early relations. The fact that there was no association in ST indicates that when the patient is helped to express her reactions to current relations there is no need to fall back on early relations for the interpretation of the current ones. The opinion that it is possible to predict the character of the therapeutic relation from the character of early relations was supported.",Persson G.,1984.0,,0,1,
233,Stresspac: A controlled trial of a self-help package for the anxiety disorders.,"In order to test the efficacy of a self-help anxiety management package (Stresspac), 62 individuals meeting Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) criteria for an anxiety disorder were randomly allocated to 1 of 3 conditions: Stresspac, Advice Only, or No Intervention. Stresspac patients were given a self-help/information package. Advice only patients were offered verbal advice on ways of coping with anxiety. Patients in both conditions were seen on one occasion shortly after referral for assessment and management advice. They were then placed back on the waiting list for a three month period. Patients in the No Intervention condition also completed measures during this time. They were not seen until the end of this period when formal assessment took place. All patients were then followed through individual therapy and to 12 month follow-up. Results clearly support the superiority of the Stresspac condition after the waiting period, at post therapy and at follow-up on a range of measures. Possible explanations for the results are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","White, Jim",1995.0,,0,1,
234,Cognitive-behavioral and pharmacological treatments of social phobia. A controlled study.,"Sixty-five patients with social phobia were treated in a study that compared a cognitive-behavioral group treatment program with pharmacotherapy with alprazolam, phenelzine sulfate, or pill-placebo plus instructions for self-directed exposure to phobic stimuli. Statistically significant repeated-measures effects were shown on all measures, indicating that the treatments studied were associated with substantial improvements in patients with severe and chronic social phobia. Patients who were treated with phenelzine were rated by clinicians as more improved on a measure of work and social disability than patients who were treated with alprazolam or placebo (patients in the cognitive-behavior therapy group were not rated on this measure). Subjects showed positive cognitive changes from before to after treatment, and there were no differences between treatment groups on the cognitive measure. We discuss the implications of these findings within the context of demographic and clinical predictors of response.",Gelernter CS.; Uhde TW.; Cimbolic P.; Arnkoff DB.; Vittone BJ.; Tancer ME.; Bartko JJ.,1991.0,,0,1,
235,Clomipramine treatment and behaviour therapy with agoraphobic women.,"The separate and combined effects of clomipramine hydrochlorzide and behaviour therapy on agoraphobic symptoms were investigated in a 28-week placebo-controlled double-blind clinical trial. One hundred and eight women diagnosed as agoraphobic were randomly assigned to one of four treatment conditions: clomipramine alone, behaviour therapy alone, clomipramine and behaviour therapy or placebo. Sixty women completed the assigned treatment. Clomipramine was prescribed in weekly increments to a maximum of 300 mg per day, with a mean dosage at week 8 of 94.6 mg per day. Behaviour therapy focused on graded in vivo exposure therapy. Assessments of patients were performed at six points prior to and during the trial and included standardized questionnaires, daily diaries and a Behavioral Approach Test. Significant main effects for both clomipramine and behaviour therapy on 15 and 12 of the dependent measures respectively were found but no interaction of treatments emerged.",Johnston DG.; Troyer IE.; Whitsett SF.; Dalby JT.,1995.0,,0,1,
236,A controlled study of eye movement desensitization and reprocessing in the treatment of posttraumatic stress disordered sexual assault victims.,"Eye movement desensitization and reprocessing (EMDR) is a new method developed to treat posttraumatic stress disorder (PTSD). This study evaluated the efficacy of EMDR compared to a no-treatment wait-list control in the treatment of PTSD in adult female sexual assault victims. Twenty-one subjects were entered, and 18 completed. Treatment was delivered in four weekly individual sessions. Assessments were conducted pre- and posttreatment and 3 months following treatment termination by an independent assessor kept blind to treatment condition. Measures included standard clinician- and self-administered PTSD and related psychopathology scales. Results indicated that subjects treated with EMDR improved significantly more on PTSD and depression from pre- to posttreatment than control subjects, leading to the conclusion that EMDR was effective in alleviating PTSD in this study.",Rothbaum BO.,1997.0,,0,1,
237,The benefit of an insight-oriented and experiential approach on panic and agoraphobia symptoms. Results of a controlled comparison of client-centered therapy alone and in combination with behavioral exposure.,"It is a common view that psychodynamic treatment does not help much to ameliorate the symptoms of panic and agoraphobia. The effects of an insight-oriented treatment on central anxiety symptoms are the subject of the present controlled study. Forty patients with severe panic and agoraphobia were admitted to an inpatient anxiety treatment program. Most of the patients had been treated by pharmacological means unsuccessfully. The patients were randomly assigned to pure client-centered therapy or to additional behavioral exposure treatment. Client-centered and behavioral agoraphobia manuals were used. The patients were examined on admission, at discharge and at 3, 6, and 12 months follow-up for panic (Structured Clinical Interview for DSM III-R--SCID), anxiety (Hamilton Anxiety Scale), agoraphobia (SCID, Fear Survey Schedule), and depressive (Hamilton Depression Scale) symptoms. Both client-centered treatment and a combination with exposure treatment reduced panic, avoidance and depressive symptoms significantly. For a short period the combined treatment was superior in patients' coping actively with anxiety and improving agoraphobic symptoms. However, at 1-year follow-up there was no further difference in the reduction of anxiety and depressive symptoms. The results are discussed with regard to the combination of these forms of therapy and to widespread skepticism about the efficacy of insight-oriented treatment.",Teusch L.; Böhme H.; Gastpar M.,1997.0,,0,1,
238,Six-year follow-up after exposure and clomipramine therapy for obsessive compulsive disorder.,"To determine whether gains from exposure therapy are lasting in patients with chronic obsessive compulsive disorder, the authors followed up 34 (85%) of 40 such patients who had been treated 6 years earlier with exposure therapy for 3 or 6 weeks and with clomipramine or placebo for 36 weeks. Severity of obsessive compulsive disorder was assessed by rating the discomfort caused by the time devoted to four target rituals, the Behavioral Avoidance Test, and the Compulsion Checklist. Mood was assessed by the 17-item Hamilton Rating Scale for Depression, the Wakefield Self-Assessment Depression Inventory, and the Anxiety scale. In addition, the patients' general adjustment was assessed. The authors found that the group as a whole remained significantly improved on obsessive compulsive symptoms, work and social adjustment, and depression; however, the group returned to pretreatment levels (slight to moderate) of general anxiety. They found that neither clomipramine nor placebo affected long-term outcome and that the majority of patients who were taking clomipramine or other antidepressants at follow-up were no more improved that those who were not taking antidepressants. Better long-term outcome correlated with more exposure therapy (6 weeks of therapy vs. 3 weeks) and with better compliance with the exposure therapy homework. The best predictor of long-term outcome was improvement at the end of treatment. Subjects who had initially been most depressed were more likely to receive psychotropic medication during follow-up. Initial severity of illness did not preclude benefit from exposure therapy.",O'Sullivan G.; Noshirvani H.; Marks I.; Monteiro W.; Lelliott P.,1991.0,,0,1,
239,Relation between outcome and the patient's initial experience of the therapist and therapeutic conditions in four treatment methods for phobic disorders.,"One hundred and three phobic women not suitable for insight-oriented psychotherapy were randomized to either therapist-directed prolonged exposure therapy (PE), supportive therapy of dynamic type (ST), relaxation therapy (R), or basal therapy (B). Immediately after seeing their therapist for history taking and beginning of treatment, the patients were asked to report their experience of the therapist, of themselves in relation to the therapist, and of the therapy (Experience of Therapy Inventory, ETI). The patients were informed that the therapists would not see the ETI. The patients were rated by an independent rater with regard to symptoms and functions at the beginning of treatment, at termination of treatment 3 months later, and at a follow-up 1 year after the commencement of the study. 1) Patients treated with PE and R were more satisfied with their therapists than patients treated with ST or B. The PE patients considered their therapists provided better contact, were more assured and knowledgeable, and gave what seemed to be the correct therapy, the R patients considered their therapist showed more warmth. Both PE and R patients felt their therapists were more interested than the ST and B therapists. These differences were probably due to differences in the amount of time offered, in the attitudes of the therapists, and in the characteristics of the therapies. 2) In the PE group there were positive associations between outcome and the initial experience of the therapist. There is, thus, empirical evidence that a good therapist-patient relation is of importance to a good outcome in this type of behaviour therapy. In the ST group there was an association between a good outcome and a positive experience of the rather conflict-centred beginning of the procedure. A positive experience of a conflict-centred approach may thus be regarded as an indication for dynamic therapy.",Persson G.; Alström JE.; Nordlund CL.,1984.0,,0,1,
240,How well does cognitive-behavioral therapy treat symptoms of complex PTSD? An examination of child sexual abuse survivors within a clinical trial,"ER Are brief cognitive-behavioral treatments for posttraumatic stress disorder (PTSD) also effective for the wider range of symptoms conceptualized as complex PTSD? Female rape victims, most of whom had extensive histories of trauma, were randomly assigned to cognitive-processing therapy, prolonged exposure, or a delayed-treatment waiting-list condition. After determining that both types of treatment were equally effective for treating complex PTSD symptoms, we divided the sample of 121 participants into two groups depending upon whether they had a history of child sexual abuse. Both groups improved significantly over the course of treatment with regard to PTSD, depression, and the symptoms of complex PTSD as measured by the Trauma Symptom Inventory. Improvements were maintained for at least 9 months. Although there were group main effects on the Self and Trauma factors, there were no differences between the two groups at posttreatment once pretreatment scores were covaried. These findings indicate that cognitive-behavioral therapies are effective for patients with complex trauma histories and symptoms patterns.","Resick, P A; Nishith, P; Griffin, M G",2003.0,,0,1,
241,A controlled study of virtual reality exposure therapy for the fear of flying.,"Fear of flying (FOF) affects an estimated 10-25% of the population. Patients with FOF (N = 49) were randomly assigned to virtual reality exposure (VRE) therapy, standard exposure (SE) therapy, or a wait-list (WL) control. Treatment consisted of 8 sessions over 6 weeks, with 4 sessions of anxiety management training followed by either exposure to a virtual airplane (VRE) or exposure to an actual airplane at the airport (SE). A posttreatment flight on a commercial airline measured participants' willingness to fly and anxiety during flight immediately after treatment. The results indicated that VRE and SE were both superior to WL, with no differences between VRE and SE. The gains observed in treatment were maintained at a 6-month follow up. By 6 months posttreatment, 93% of VRE participants and 93% of SE participants had flown. VRE therapy and SE therapy for treatment of FOF were unequivocally supported in this controlled study.",Rothbaum BO.; Hodges L.; Smith S.; Lee JH.; Price L.,2000.0,,0,1,
242,Prolonged Exposure versus Eye Movement Desensitization and Reprocessing (EMDR) for PTSD rape victims.,"This controlled study evaluated the relative efficacy of Prolonged Exposure (PE) and Eye Movement Desensitization and Reprocessing (EMDR) compared to a no-treatment wait-list control (WAIT) in the treatment of PTSD in adult female rape victims (n = 74). Improvement in PTSD as assessed by blind independent assessors, depression, dissociation, and state anxiety was significantly greater in both the PE and EMDR group than the WAIT group (n = 20 completers per group). PE and EMDR did not differ significantly for change from baseline to either posttreatment or 6-month follow-up measurement for any quantitative scale.",Rothbaum BO.; Astin MC.; Marsteller F.,2005.0,10.1002/jts.20069,0,1,
243,Virtual reality exposure therapy and standard (in vivo) exposure therapy in the treatment of fear of flying.,"This controlled clinical trial tested virtual reality exposure (VRE) therapy for the fear of flying (FOF), a relatively new and innovative way to do exposure therapy, and compared it to standard (in vivo) exposure therapy (SE) and a wait list (WL) control with a 6- and 12-month follow-up. Eighty-three participants with FOF were randomly assigned to VRE, SE, or WL. Seventy-five participants, 25 per group, completed the study. Twenty-three WL participants completed randomly assigned treatment following the waiting period. Treatment consisted of 4 sessions of anxiety management training followed either by exposure to a virtual airplane (VRE) or an actual airplane at the airport (SE) conducted over 6 weeks. Results indicate that VRE was superior to WL on all measures, including willingness to fly on the posttreatment flight (76% for VRE and SE; 20% for WL). VRE and SE were essentially equivalent on standardized questionnaires, willingness to fly, anxiety ratings during the flight, self-ratings of improvement, and patient satisfaction with treatment. Follow-up assessments at 6 and 12 months indicated that treatment gains were maintained, with more than 70% of respondents from both groups reporting continued flying at follow-up. Based on these findings, the use of VRE in the treatment of FOF was supported in this controlled study, suggesting that experiences in the virtual world can change experiences in the real world.",Rothbaum BO.; Anderson P.; Zimand E.; Hodges L.; Lang D.; Wilson J.,2006.0,10.1016/j.beth.2005.04.004,0,1,
244,Cognitive-behavioral treatment combined with asthma education for adults with asthma and coexisting panic disorder.,This study tested the efficacy of a nurse-administered 8-week group treatment program for adults with asthma suffering from coexisting panic disorder. The program consisted of cognitive behavioral treatment (CBT) for panic disorder combined with asthma education (AE). Forty-eight women with a confirmed diagnosis of asthma and panic disorder were randomly allocated to a treatment condition (n=25) and a wait-list control condition (n=23). Twenty-five participants--15 in the treatment group and 10 in the wait-list control group--completed treatment. Repeated measures ANOVA procedures were used to compare the groups on panic and asthma outcomes at posttreatment and 6-month follow-up. The results demonstrate that the CBT-AE program is capable of producing substantial and durable antipanic and antianxiety treatment effects and led to substantial but nonsustained improvement in morning peak-flow expiratory rate and asthma-related quality of life. Implications of these findings for this clinical population are addressed.,Ross CJ.; Davis TM.; MacDonald GF.,2005.0,10.1177/1054773804273863,0,1,
245,Changes in implicit and explicit self-esteem following cognitive and psychodynamic therapy in social anxiety disorder.,"The present investigation is the first to analyse changes in implicit and explicit self-esteem following cognitive therapy (CT) and psychodynamic therapy (PDT) in social anxiety disorder (SAD). We assessed a sub-sample of patients with SAD (n=27 per treatment group, n=12 waitlist condition) in the course of a randomized controlled trial prior to and following individual treatment or wait assessment with an Implicit Association Test and the Rosenberg Self-Esteem Scale. Both CT and PDT consisted of 25 sessions. Treatments were effective in enhancing implicit and explicit self-esteem. In CT and PDT, changes in explicit self-esteem were associated with SAD symptom change. No such relationships were found in implicit self-esteem. The results seem to indicate that both CT and PDT are effective in establishing a positive implicit and explicit self-esteem in SAD. The differential relationships of changes in implicit and explicit self-esteem to treatment effects on social phobic symptoms are discussed.",Ritter V.; Leichsenring F.; Strauss BM.; Stangier U.,2013.0,10.1080/10503307.2013.802824,0,1,
246,Cognitive behaviour therapy for specific phobia of vomiting (Emetophobia): A pilot randomized controlled trial.,"This is the first randomised controlled trial to evaluate a protocol for cognitive behaviour therapy (CBT) for a Specific Phobia of Vomiting (SPOV) compared with a wait list and to use assessment scales that are specific for a SPOV. Method: 24 participants (23 women and 1 man) were randomly allocated to either 12 sessions of CBT or a wait list. Results: At the end of the treatment, CBT was significantly more efficacious than the wait list with a large effect size (Cohen's d = 1.53) on the Specific Phobia of Vomiting Inventory between the two groups after 12 sessions. Six (50%) of the participants receiving CBT achieved clinically significant change compared to 2 (16%) participants in the wait list group. Eight (58.3%) participants receiving CBT achieved reliable improvement compared to 2 (16%) participants in the wait list group. Conclusions: A SPOV is a condition treatable by CBT but further developments are required to increase efficacy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Riddle-Walker, Lori; Veale, David; Chapman, Cynthia; Ogle, Frank; Rosko, Donna; Najmi, Sadia; Walker, Lana M; Maceachern, Pete; Hicks, Thomas; Ahlen, Becker, Boschen, Boschen, Boyd, Davis, Faye, First, Graziano, Holmes, Hunter, Jacobson, Kessler, Kobori, Kroenke, Lesage, Lipsitz, Maack, Manassis, McFadyen, McKenzie, McNally, Moran, O'Connor, Phillips, Price, Reiss, Ritow, Salkovskis, Sheehan, Stinson, van Hout, Veale, Veale, Veale, Veale, Veale, Veale, Veale, Veale, Vujanovic, Wijesinghe, Williams, Wolitzky-Taylor",2016.0,,0,1,
247,How well does cognitive-behavioral therapy treat symptoms of complex PTSD? An examination of child sexual abuse survivors within a clinical trial.,"Are brief cognitive-behavioral treatments for posttraumatic stress disorder (PTSD) also effective for the wider range of symptoms conceptualized as complex PTSD? Female rape victims, most of whom had extensive histories of trauma, were randomly assigned to cognitive-processing therapy, prolonged exposure, or a delayed-treatment waiting- list condition. After determining that both types of treatment were equally effective for treating complex PTSD symptoms, we divided the sample of 121 participants into two groups depending upon whether they had a history of child sexual abuse. Both groups improved significantly over the course of treatment with regard to PTSD, depression, and the symptoms of complex PTSD as measured by the Trauma Symptom Inventory. Improvements were maintained for at least 9 months. Although there were group main effects on the Self and Trauma factors, there were no differences between the two groups at posttreatment once pretreatment scores were covaried. These findings indicate that cognitive-behavioral therapies are effective for patients with complex trauma histories and symptoms patterns. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Resick, Patricia A; Nishith, Pallavi; Griffin, Michael G; Abueg, Beck, Beck, Blake, Blake, Briere, Briere, Briere, Cloitre, Donaldson, Erdfelder, Foa, Foa, Foa, Frank, Frank, Gershenson, Herman, Herman, Herzog, Jackson, Kendall-Tackett, Kessler, Koss, Kramer, Lindberg, Nishith, Norris, Norris, Ogata, Pelcovitz, Resick, Resick, Resick, Resick, Resnick, Rodriguez, Ross, Roth, Rowan, Saxe, Saxe, van der Kolk, Wyatt, Zaidi",2003.0,,0,1,
248,Randomized controlled trial of prolonged exposure using imaginal exposure vs. virtual reality exposure in active duty soldiers with deployment-related posttraumatic stress disorder (PTSD).,"Objective: Prolonged exposure (PE) is an evidence-based psychotherapy for posttraumatic stress disorder (PTSD) but there is limited research with active-duty military populations. Virtual reality exposure (VRE) has shown promise but randomized trials are needed to evaluate efficacy relative to existing standards of care. This study evaluated the efficacy of VRE and PE for active duty soldiers with PTSD from deployments to Iraq and Afghanistan. Method: Active-duty soldiers (N = 162) were randomized to 10-sessions of PE, VRE, or a minimal attention waitlist (WL). Blinded assessors evaluated symptoms at baseline, halfway through treatment, at posttreatment, and at 3- and 6-month follow-ups using the Clinician Administered PTSD Scale (CAPS). Results: Intent-to-treat analyses found that both PE and VRE resulted in significant reductions in PTSD symptoms relative to those in the WL. The majority of patients demonstrated reliable change in PTSD symptoms. There was no difference between PE and VRE regarding treatment drop out before completing 10 sessions (44 and 41% for VRE and PE, respectively). Contrary to hypotheses, analyses at posttreatment did not show that VRE was superior to PE. Post hoc analyses found that PE resulted in significantly greater symptom reductions than VRE at 3- and 6-month follow-up. Both treatments significantly reduced self-reported stigma. Conclusions: PE is an efficacious treatment for active-duty Army soldiers with PTSD from deployments to Iraq or Afghanistan. Results extend previous evidence supporting the efficacy of PE to active-duty military personnel and raise important questions for future research on VRE. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Impact Statement What is the public health significance of this article?-Results provide convergent evidence suggesting that exposure therapy is an effective treatment for active duty U.S. Army soldiers with posttraumatic stress disorder from deployments to Iraq and Afghanistan. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Reger, Greg M; Koenen-Woods, Patricia; Zetocha, Kimberlee; Smolenski, Derek J; Holloway, Kevin M; Rothbaum, Barbara O; Difede, JoAnn; Rizzo, Albert A; Edwards-Stewart, Amanda; Skopp, Nancy A; Mishkind, Matthew; Reger, Mark A; Gahm, Gregory A; Attkisson, Barber, Beck, Beck, Beck, Beck, Beck, Bisson, Blake, Blanchard, Bliese, Blount, Bradley, Brown, Bush, Cahill, Cigrang, Difede, Difede, Eftekhari, Enders, Feingold, Foa, Foa, Foa, Foa, Foa, Foa, Gerardi, Hageman, Hembree, Hoge, Hoge, Hoge, Jaycox, Kehle-Forbes, Komiya, Larsen, Mackenzie, McCann, McDonagh, McLay, Milliken, Mott, Muthen, Nguyen, Parsons, Powers, Powers, Proschan, Rauch, Reger, Reger, Reger, Resick, Riva, Rizzo, Rizzo, Rothbaum, Rothbaum, Rothbaum, Rothbaum, Schnurr, Singer, Smith, Tuerk, Tuerk, Weathers, Weathers, Webb, Wilson",2016.0,,0,1,
249,Testing the efficacy of theoretically derived improvements in the treatment of social phobia.,"Recent theoretical models of social phobia suggest that targeting several specific cognitive factors in treatment should enhance treatment efficacy over that of more traditional skills-based treatment programs. In the current study, 195 people with social phobia were randomly allocated to 1 of 3 treatments: standard cognitive restructuring plus in vivo exposure, an ""enhanced"" treatment that augmented the standard program with several additional treatment techniques (e.g., performance feedback, attention retraining), and a nonspecific (stress management) treatment. The enhanced treatment demonstrated significantly greater effects on diagnoses, diagnostic severity, and anxiety during a speech. The specific treatments failed to differ significantly on self-report measures of social anxiety symptoms and life interference, although they were both significantly better than the nonspecific treatment. The enhanced treatment also showed significantly greater effects than standard treatment on 2 putative process measures: cost of negative evaluation and negative views of one's skills and appearance. Changes on these process variables mediated differences between the treatments on changes in diagnostic severity. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rapee, Ronald M; Gaston, Jonathan E; Abbott, Maree J; Abbott, Amir, Beck, Borkovec, Brown, Butler, Bogels, Clark, Clark, Clark, Cuming, Di Nardo, Evans, Faul, Fedoroff, Fenigstein, Feske, Foa, Garcia-Palacios, Gibbons, Gould, Hackmann, Harvey, Heimberg, Heinrichs, Hirsch, Hirsch, Hofmann, Hofmann, Horvath, Jacobson, Kim, Massion, Mattick, Mattick, Mortberg, Murphy, Musa, Norton, Peters, Pinto-Gouveia, Preacher, Preacher, Rapee, Rapee, Rapee, Rapee, Rapee, Rapee, Rapee, Rodebaugh, Rodebaugh, Schmidt, Smits, Stangier, Ware, Wild, Wilson, Wilson",2009.0,,0,1,
250,Process evaluation in an intervention designed to promote physical activity among adults with anxiety disorders: evidence of acceptability and adherence.,"To assess the adherence and acceptability of a physical activity program delivered as an adjunct to the usual cognitive behavioural group therapy (CBGT) for adults with anxiety disorders. Seventy-three participants with either a generalised anxiety disorder, social phobia or panic disorder were randomised to either exercise-enhanced CBGT (CBGT+EX) or the usual CBGT plus nutrition education (CBGT+ED) group. Physical activity, stress, anxiety, depression were assessed at baseline; session attendance, compliance and satisfaction were assessed during the eight-week intervention. Forty-five per cent of participants achieved the recommended levels of physical activity for health at baseline. The proportions of participants attending group meetings declined over time across both groups. In the intervention groups (CBGT+EX), a slightly higher proportion of participants attended the CBGT session than the physical activity sessions. Individuals with social phobia were significantly more likely than those with panic or generalised anxiety disorder to adhere to the physical activity program. Among the remaining adherers, most reported satisfaction with their skills development and better understanding of the benefits of physical activity. Time constraints and participants viewing physical activities as irrelevant or detracting them from their psychological treatment are potential factors contributing to low adherence and present as challenges in implementing a physical activity program as adjunctive to psychological treatment. Process evaluation data helped profile participants who adhered or not adhered to the physical activity program and will inform future physical activity promotion to individuals with anxiety disorders.",Phongsavan P.; Merom D.; Wagner R.; Chey T.; von Hofe B.; Silove D.; Bauman A.,2008.0,,0,1,
251,Guided internet-delivered cognitive behavior therapy for generalized anxiety disorder: a randomized controlled trial.,"Generalized anxiety disorder (GAD) has been effectively treated with cognitive behavioural therapy (CBT) in face-to face settings. Internet-delivered CBT could be a way to increase the accessibility and affordability of CBT for people suffering from GAD. The aim of this study was to evaluate the efficacy of guided Internet-delivered CBT for GAD in a controlled trial with a wait-list control group. A total of 89 participants were included following online screening and a structured psychiatric telephone interview. Participants were randomized to either an 8-week treatment group (n = 44) or a wait-list control group (n = 45). Treatment consisted of a self-help program based on CBT principles and applied relaxation along with therapist guidance. The main outcome measure was the Penn State Worry Questionnaire. Ratings of clinical improvement and symptoms were included as well as secondary outcome measures dealing with anxiety, depression, and quality of life. Among the treatment group participants, 13.6% did not complete the posttreatment measures. The treatment group showed significant improvement compared with the control group on all outcome measures. Large effect sizes (Cohen's d > 0.8) were found both within the treatment group and between the groups in favor of the treatment on all outcome measures except on a measure of quality of life. Results at 1- and 3-year follow-up indicated that treatment results improved or were maintained. The authors conclude that Internet-delivered CBT with therapist support can reduce symptoms and problems related to GAD.",Paxling B.; Almlöv J.; Dahlin M.; Carlbring P.; Breitholtz E.; Eriksson T.; Andersson G.,2011.0,10.1080/16506073.2011.576699,0,1,
252,Cognitive behavior therapy vs exposure in vivo in the treatment of panic disorder with agoraphobia (corrected from agrophobia).,"Seventy-three psychiatric outpatients with DSM-IV diagnosis of panic disorder with agoraphobia were assessed with a battery of independent assessor, self-observation, self-report and behavioral measures before and after therapy, and at a 1-yr follow-up. They were randomly assigned to Exposure in vivo (E; n = 25), Cognitive Behavior Therapy (CBT; n = 26), or a Wait-list control (WLC; n = 22) and received 12-16 individual therapy sessions, once weekly. The treatments yielded significant improvements, both on panic/agoraphobia measures and on measures of general anxiety, depression, social adjustment and quality of life, which were maintained at follow-up. However, there were no significant differences between E and CBT. The three criteria of clinically significant improvement were achieved by 67% of the E-patients and 79% of the CBT-patients at post-treatment, and 74% and 76%, respectively, at follow-up. The conclusion that can be drawn is that adding cognitive therapy to exposure did not yield significantly better results than for exposure alone.",Ost LG.; Thulin U.; Ramnerö J.,2004.0,10.1016/j.brat.2003.07.004,0,1,
253,One vs five sessions of exposure and five sessions of cognitive therapy in the treatment of claustrophobia.,"Forty-six patients fulfilling the DSM-IV criteria for claustrophobia were assessed with behavioral, physiological, and self-report measures. They were randomly assigned to four conditions: (1) one-session (E1); or (2) five-sessions of exposure (E5); (3) five-sessions of cognitive therapy (C5); and (4) Wait-list for 5 weeks. The first condition consisted of a single 3 h session of massed exposure, and condition 2 and 3 of 5 h of gradual treatment, which was done individually by very experienced therapists. The results showed that treatment was significantly better than the wait-list condition, and the three treatments did equally well with no differences between them. At post-treatment 79% of treatment patients vs 18% of the wait-list controls had improved to a clinically significant extent. When the three treatments were compared 80% in the E1-group, 81% in the E5-group, and 79% in the C5-group were clinically improved. At the 1 year follow-up the corresponding figures were 100%, 81%, and 93%, respectively. The implications of these results are discussed.",Ost LG.; Alm T.; Brandberg M.; Breitholtz E.,2001.0,,0,1,
254,Internet-based self-help treatment for panic disorder: A randomized controlled trial comparing mandatory versus optional complementary psychological support.,"Panic disorder (PD) is one of the most common psychiatric disorders. Web-based self-help treatments for PD have had promising results. These online treatments seem to have larger effect sizes (ESs) when professional support is added. However, the amount of support or how it should be administered is not yet clear. The aim of this trial was to study two ways of administering psychological support provided by phone as a part of Internet-based self-help treatment for PD based on cognitive behavioral therapy. Seventy-seven participants diagnosed with PD were randomly assigned to one of three experimental conditions: a waiting list control group; a treatment group with non-scheduled psychological support; or a treatment group with scheduled psychological support. PD symptoms of participants who received treatment improved significantly compared to the control group (mean ES d = 1.18, p < .05). In addition, there were statistically and clinically significant differences between treatment groups (Mean difference = -3.20, p = .005, 95% CI [-5.62, -.79]). The scheduled group showed a larger ES, a lower dropout rate, and better adherence to treatment than the non-scheduled group. Scheduled support seems to be indicated for patients who seek Web-based treatment for PD, and their symptoms of panic, anxiety, and depression improve at post-treatment and six-month follow-up. In contrast, when support depends on patient demand, they receive less support and so, the therapeutic effect is poorer. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Oromendia, Pablo; Orrego, Jorge; Bonillo, Albert; Molinuevo, Beatriz; Andersson, Andrews, Barlow, Beck, Beck, Bergstrom, Bobes, Bobes, Carlbring, Carlbring, Carlbring, Carlbring, Christensen, Cohen, Craske, Cuijpers, Donker, Farrand, Farvolden, Fullana, Furukawa, Glasgow, Goisman, Haug, Hedman, Houck, Jacobson, Kenwright, Kenwright, King, Klein, Klein, Lecrubier, Lewis, Lindner, Magan, Marks, Marks, Marks, McHugh, Newman, Olesen, Oromendia, Palmqvist, Pier, Roca, Rozental, Ruwaard, Sandin, Santacana, Sanz, Schneider, Sheehan, Silfvernagel, Spek, Strom, Taylor, Titov, van Ballegooijen, Wims, Wittchen, Yamamoto",2016.0,,0,1,
255,Effectiveness and cost-effectiveness of individually tailored Internet-delivered cognitive behavior therapy for anxiety disorders in a primary care population: a randomized controlled trial.,"A significant proportion of the general population suffers from anxiety disorders, often with comorbid psychiatric conditions. Internet-delivered cognitive behavior therapy (ICBT) has been found to be a potent treatment for patients with specific psychiatric conditions. The aim of this trial was to investigate the effectiveness and cost-effectiveness of ICBT when tailoring the treatment to address comorbidities and preferences for primary-care patients with a principal anxiety disorder. One hundred participants were recruited through their primary-care contact and randomized to either treatment or an active control group. The treatment consisted of 7-10 weekly individually assigned modules guided by online therapists. At post-treatment, 46% of the treatment group had achieved clinically significant improvement on the primary outcome measure (CORE-OM) and between-group effect sizes ranged from d = 0.20 to 0.86, with a mean effect of d = 0.59. At one-year follow-up, within-group effect sizes varied between d = 0.53 to 1.00. Cost analysis showed significant reduction of total costs for the ICBT group, the results were maintained at one-year follow-up and the incremental cost-effectiveness ratio favored ICBT compared to control group. Individually tailored ICBT is an effective and cost-effective treatment for primary-care patients with anxiety disorders with or without comorbidities. Clinicaltrials.gov: NCT01390168.",Nordgren LB.; Hedman E.; Etienne J.; Bodin J.; Kadowaki A.; Eriksson S.; Lindkvist E.; Andersson G.; Carlbring P.,2014.0,10.1016/j.brat.2014.05.007,0,1,
256,Internet cognitive behavioural therapy for mixed anxiety and depression: a randomized controlled trial and evidence of effectiveness in primary care.,"Major depressive disorder (MDD) and generalized anxiety disorder (GAD) have the highest co-morbidity rates within the internalizing disorders cluster, yet no Internet-based cognitive behavioural therapy (iCBT) programme exists for their combined treatment. We designed a six-lesson therapist-assisted iCBT programme for mixed anxiety and depression. Study 1 was a randomized controlled trial (RCT) comparing the iCBT programme (n = 46) versus wait-list control (WLC; n = 53) for patients diagnosed by structured clinical interview with MDD, GAD or co-morbid GAD/MDD. Primary outcome measures were the Patient Health Questionnaire nine-item scale (depression), Generalized Anxiety Disorder seven-item scale (generalized anxiety), Kessler 10-item Psychological Distress scale (distress) and 12-item World Health Organization Disability Assessment Schedule II (disability). The iCBT group was followed up at 3 months post-treatment. In study 2, we investigated the adherence to, and efficacy of the same programme in a primary care setting, where patients (n = 136) completed the programme under the supervision of primary care clinicians. The RCT showed that the iCBT programme was more effective than WLC, with large within- and between-groups effect sizes found (>0.8). Adherence was also high (89%), and gains were maintained at 3-month follow-up. In study 2 in primary care, adherence to the iCBT programme was low (41%), yet effect sizes were large (>0.8). Of the non-completers, 30% experienced benefit. Together, the results show that iCBT is effective and adherence is high in research settings, but there is a problem of adherence when translated into the 'real world'. Future efforts need to be placed on developing improved adherence to iCBT in primary care settings.",Newby JM.; Mackenzie A.; Williams AD.; McIntyre K.; Watts S.; Wong N.; Andrews G.,2013.0,10.1017/S0033291713000111,0,1,
257,Reductions in negative repetitive thinking and metacognitive beliefs during transdiagnostic internet cognitive behavioural therapy (iCBT) for mixed anxiety and depression.,"We explored whether transdiagnostic internet-delivered cognitive behavioural therapy (iCBT) for mixed anxiety and depression effectively reduces repetitive negative thinking (RNT), and whether reductions in RNT and positive metacognitive beliefs mediate symptom improvement during iCBT. Participants with generalized anxiety disorder (GAD), major depressive disorder (MDD), or mixed GAD/MDD diagnoses were randomly allocated to a 6-lesson clinician-guided iCBT anxiety and depression program ( n = 46) or wait-list control (WLC, n = 53). Depression (PHQ-9), generalized anxiety (GAD-7), RNT (Repetitive Thinking Questionnaire) and positive beliefs about RNT (Positive Beliefs about Rumination Scale) were assessed at pre-, mid-, and post-treatment or matched time points for WLC. Tests of serial indirect effects explored the potential meditating role of RNT and positive belief reductions on the impact of iCBT on depression and anxiety symptoms post-treatment. Results showed that both RNT frequency and positive beliefs about the value of RNT reduced significantly following iCBT compared to WLC, with gains maintained at 3-month follow-up. Reductions between pre- and mid-treatment in positive beliefs and RNT mediated improvements in depression symptoms post-iCBT, and reductions in positive beliefs mediated improvements in GAD symptoms. These findings indicate that iCBT is an effective treatment for RNT and positive metacognitive beliefs. Future dismantling studies are needed to assess the most effective treatment components. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Newby, Jill M; Williams, Alishia D; Andrews, Gavin; Aldao, Andersson, Andrews, Andrews, Andrews, Barlow, Baron, Brown, Carlbring, Cartwright-Hatton, Covin, Crane, Dugas, Dupuy, Ehring, Gueorguieva, Harvey, Hayes, Hayes, Hayes, Hedman, Hettema, Hunt, Jacobson, Jones, Kessler, Kroenke, Lyubomirsky, Mahoney, Manicavasagar, McEvoy, McLaughlin, Newby, Nolen-Hoeksema, Nolen-Hoeksema, Nolen-Hoeksema, Norton, Papageorgiou, Preacher, Robinson, Salim, Schmaling, Schulz, Segerstrom, Sheehan, Spek, Spitzer, Titov, Watkins, Watkins, Watkins, Watkins, Watkins, Watson, Wells, Wells, Wells",2014.0,,0,1,
258,Intensive group cognitive treatment and individual cognitive therapy vs. treatment as usual in social phobia: a randomized controlled trial.,"To compare the effects of an intensive group cognitive treatment (IGCT) to individual cognitive therapy (ICT) and treatment as usual (TAU) in social phobia (DSM-IV). Hundred patients were randomized to: IGCT involving 16 group sessions spread over three weeks; ICT involving 16 shorter weekly sessions in 4 months and; TAU involving an indicated selective serotonin reuptake inhibitor (SSRI) with therapy sessions as required for 1 year. The main outcome measure was a Social Phobia Composite that combined several standardized self-report measures. Diagnostic assessment was repeated at 1-year follow-up. Significant improvements were observed with all treatments. ICT was superior to IGCT and TAU, which did not differ in overall effectiveness. The study confirms and extends previously reported findings that ICT is more effective than group cognitive treatment and treatment with SSRIs. IGCT lasts only 3 weeks, and is as effective as more protracted TAU.",Mörtberg E.; Clark DM.; Sundin O.; Aberg Wistedt A.,2007.0,10.1111/j.1600-0447.2006.00839.x,0,1,
259,A pilot randomized controlled trial investigating the efficacy of MEmory Specificity Training in improving symptoms of posttraumatic stress disorder.,"Poor autobiographical memory specificity is a cognitive marker of posttraumatic stress disorder (PTSD) and an independent predictor of poor prognosis. This pilot randomized controlled trial investigated the efficacy of MEmory Specificity Training (MEST) (an intervention aimed at ameliorating specificity problems) on autobiographical memory recall and PTSD symptoms. Iranian combat veterans with PTSD were randomly assigned into the MEST (n = 12) or control (n = 12) group. At baseline, groups completed Farsi versions of the Autobiographical Memory Test and Impact of Event Scale-Revised. The intervention group then had four, weekly, group sessions of MEST. The control group had no additional contact. All measures were re-administered post-intervention and at three-month follow-up. The MEST group generated significantly more specific memories and had significantly fewer PTSD symptoms following training and at follow-up than the control group. Findings suggest MEST is a promising intervention for the treatment of PTSD.",Moradi AR.; Moshirpanahi S.; Parhon H.; Mirzaei J.; Dalgleish T.; Jobson L.,2014.0,10.1016/j.brat.2014.03.002,0,1,
260,Effect of cognitive-behavioral couple therapy for PTSD: a randomized controlled trial.,"Posttraumatic stress disorder (PTSD) is a prevalent condition associated with intimate relationship problems, and intimate relationship factors have been shown to affect individual PTSD treatment outcomes. To compare cognitive-behavioral conjoint therapy for PTSD (a manualized couple therapy delivered to patients with PTSD and their significant others to simultaneously treat PTSD symptoms and enhance relationship satisfaction) with a wait-list condition. Randomized controlled trial of heterosexual and same-sex couples (n = 40 couples; n = 80 individuals) in which one partner met criteria for PTSD according to the Clinician-Administered PTSD Scale, conducted from 2008 to 2012 in a Department of Veterans Affairs outpatient hospital setting in Boston, Massachusetts, and a university-based research center in Toronto, Ontario, Canada. Symptoms of PTSD, comorbid conditions, and relationship satisfaction were collected by blinded assessors at baseline, at mid treatment (median, 8.00 weeks [range, 1.71-20.43 weeks] after baseline), and at posttreatment (median, 15.86 weeks [range, 7.14-38.57 weeks] after baseline). An uncontrolled 3-month follow-up (median, 38.21 weeks [range, 28.43-50.57 weeks] after baseline) was also completed. Couples were randomly assigned to take part in the 15-session cognitive-behavioral conjoint therapy for PTSD protocol immediately (n = 20) or were placed on a wait list for the therapy (n = 20). Clinician-rated PTSD symptom severity was the primary outcome and was assessed with the Clinician-Administered PTSD Scale. Intimate relationship satisfaction, assessed with the Dyadic Adjustment Scale, patient- and partner-rated PTSD symptoms, and comorbid symptoms were secondary outcomes. PTSD symptom severity (score range, 0-136) was significantly more improved in the couple therapy condition than in the wait-list condition (mean change difference, -23.21; 95% CI, -37.87 to -8.55). Similarly, patients' intimate relationship satisfaction (score range, 0-151) was significantly more improved in couple therapy than in the wait-list condition (mean change difference, 9.43; 95% CI, 0.04-18.83). The time × condition interaction effect in the multilevel model predicting PTSD symptoms (t37.5 = -3.09; P = .004) and patient-reported relationship satisfaction (t68.5 = 2.00; P = .049) revealed superiority of the couple therapy compared with the wait list. Treatment effects were maintained at 3-month follow-up. Among couples in which one partner was diagnosed as having PTSD, a disorder-specific couple therapy, compared with a wait list for the therapy, resulted in decreased PTSD symptom severity and patient comorbid symptom severity and increased patient relationship satisfaction. clinicaltrials.gov Identifier: NCT00669981.",Monson CM.; Fredman SJ.; Macdonald A.; Pukay-Martin ND.; Resick PA.; Schnurr PP.,2012.0,10.1001/jama.2012.9307,0,1,
261,A randomized controlled clinical trial of psychoanalytic psychotherapy for panic disorder.,"The purpose of this study was to determine the efficacy of panic-focused psychodynamic psychotherapy relative to applied relaxation training, a credible psychotherapy comparison condition. Despite the widespread clinical use of psychodynamic psychotherapies, randomized controlled clinical trials evaluating such psychotherapies for axis I disorders have lagged. To the authors' knowledge, this is the first efficacy randomized controlled clinical trial of panic-focused psychodynamic psychotherapy, a manualized psychoanalytical psychotherapy for patients with DSM-IV panic disorder. This was a randomized controlled clinical trial of subjects with primary DSM-IV panic disorder. Participants were recruited over 5 years in the New York City metropolitan area. Subjects were 49 adults ages 18-55 with primary DSM-IV panic disorder. All subjects received assigned treatment, panic-focused psychodynamic psychotherapy or applied relaxation training in twice-weekly sessions for 12 weeks. The Panic Disorder Severity Scale, rated by blinded independent evaluators, was the primary outcome measure. Subjects in panic-focused psychodynamic psychotherapy had significantly greater reduction in severity of panic symptoms. Furthermore, those receiving panic-focused psychodynamic psychotherapy were significantly more likely to respond at treatment termination (73% versus 39%), using the Multicenter Panic Disorder Study response criteria. The secondary outcome, change in psychosocial functioning, mirrored these results. Despite the small cohort size of this trial, it has demonstrated preliminary efficacy of panic-focused psychodynamic psychotherapy for panic disorder.",Milrod B.; Leon AC.; Busch F.; Rudden M.; Schwalberg M.; Clarkin J.; Aronson A.; Singer M.; Turchin W.; Klass ET.; Graf E.; Teres JJ.; Shear MK.,2007.0,10.1176/ajp.2007.164.2.265,0,1,
262,"Interpersonal Problems, Mindfulness, and Therapy Outcome in an Acceptance-Based Behavior Therapy for Generalized Anxiety Disorder.","To better understand the role interpersonal problems play in response to two treatments for generalized anxiety disorder (GAD); an acceptance-based behavior therapy (ABBT) and applied relaxation (AR), and to examine how the development of mindfulness may be related to change in interpersonal problems over treatment and at follow-up. Eighty-one individuals diagnosed with GAD (65.4% female, 80.2% identified as white, average age 32.92) were randomized to receive 16 sessions of either ABBT or AR. GAD severity, interpersonal problems, and mindfulness were measured at pre-treatment, post-treatment, 6-month follow-up, and 12-month follow-up. Mixed effect regression models did not reveal any significant effects of pre-treatment interpersonal problems on GAD severity over treatment. After controlling for post-treatment GAD severity, remaining post-treatment interpersonal problems predicted 6- but not 12-month GAD severity. Participants in both conditions experienced a large decrease in interpersonal problems over treatment. Increases in mindfulness over treatment and through follow-up were associated with decreases in interpersonal problems, even when accounting for reductions in overall GAD severity. Interpersonal problems may be an important target of treatment in GAD, even if pre-treatment interpersonal problems are not predictive of outcome. Developing mindfulness in individuals with GAD may help ameliorate interpersonal difficulties among this population.",Millstein DJ.; Orsillo SM.; Hayes-Skelton SA.; Roemer L.,2015.0,10.1080/16506073.2015.1060255,0,1,
263,Implosive (flooding) therapy reduces symptoms of PTSD in Vietnam combat veterans.,"In a randomized clinical trial, 24 male Vietnam veterans with a diagnosis of posttraumatic stress disorder (PTSD) were randomly assigned either to a group receiving 14 to 16 sessions of implosive (flooding) therapy or to a waiting-list control group. Standard psychometrics were administered before, following, and 6 mo after treatment, and therapist ratings of symptomatology were concurrently obtained in personal interviews. Compared with the waiting-list controls, Ss receiving implosive therapy showed significant improvement across many of the psychometric measures and the therapist ratings of psychopathology. Specific changes in the re-experiencing dimension of PTSD, anxiety, and depression were notable, and treatment did not seem to influence the numbing and social avoidance aspects of PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Keane, Terence M; Fairbank, John A; Caddell, Juesta M; Zimering, Rose T",1989.0,,0,1,
264,Web-based psychotherapy for posttraumatic stress disorder in war-traumatized Arab patients: randomized controlled trial.,"In recent years, armed conflicts in the Middle East have resulted in high rates of exposure to traumatic events. Despite the increasing demand of mental health care provision, ongoing violence limits conventional approaches of mental health care provision. Internet-based interventions for posttraumatic stress disorder (PTSD) have proved feasible and effective in Western countries, but their applicability and efficacy in war and conflict regions remains unknown. This study investigated the efficacy of a cognitive behavioral Internet-based intervention for war-traumatized Arab patients, with focus on Iraq. A total of 159 individuals with PTSD participated in a parallel group randomized trial. Participants were randomly allocated by a computer-generated sequence to a treatment group (n=79) or a waiting list control group (n=80). The treatment group received 2 weekly 45-minute cognitive behavioral interventions via Internet over a 5-week period (10 sessions in total). The primary outcome was recovery from posttraumatic stress symptoms. Posttraumatic stress symptoms were significantly reduced from baseline to posttreatment (intention-to-treat analysis) in the treatment group relative to the control group (F1,157=44.29, P<.001, d=0.92). Treatment effects were sustained at 3-month follow-up. Completer analysis indicated that 29 of 47 patients (62%) in the treatment group had recovered from posttraumatic stress symptoms at posttreatment (reliable change and Posttraumatic Stress Diagnostic Scale score <20) versus 1 patient (2%) in the control group (OR 74.19, 95% CI 9.93-585.8, P<.001) indicating that the chance of recovering was 74.19 times higher in the treatment than in the control group. The results indicate, even in unstable and insecure settings with ongoing exposure to human rights violations through war and dictatorships, people with posttraumatic stress symptoms benefit from a cognitive behavioral treatment provided entirely through the Internet. This method of delivery could improve patients' access to humanitarian aid in the form of e-mental health services. Australian New Zealand Clinical Trial Registry, ACTRN12611001019998; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347505 (Archived by WebCite at http://www.webcitation.org/6Wto4HCdH).",Knaevelsrud C.; Brand J.; Lange A.; Ruwaard J.; Wagner B.,2015.0,10.2196/jmir.3582,0,1,
265,A comparison of delivery methods of cognitive-behavioral therapy for panic disorder: an international multicenter trial.,"Cognitive-behavioral therapy (CBT) is the psychological treatment of choice for panic disorder (PD). However, given limited access to CBT, it must be delivered with maximal cost-effectiveness. Previous researchers have found that a brief computer-augmented CBT was as effective as extended therapist-delivered CBT. To test this finding, this study randomly allocated 186 patients with PD across 2 sites in Scotland and Australia to 12 sessions of therapist-delivered CBT (CBT12), 6 sessions of therapist-delivered (CBT6) or computer-augmented CBT (CBT6-CA), or a waitlist control. On a composite measure, at posttreatment, the outcome for CBT 12 was statistically better than the outcome for CBT6. The outcome for CBT6-CA fell between CBT12 and CBT6, but could not be statistically distinguished from either treatment. The active treatments did not differ statistically at 6-month follow-up. The study provided some support for the use of computers as an innovative adjunctive-therapy tool and merits further investigation.",Kenardy JA.; Dow MG.; Johnston DW.; Newman MG.; Thomson A.; Taylor CB.,2003.0,10.1037/0022-006X.71.6.1068,0,1,
266,Efficacy of internet therapy for panic disorder.,"Fifty-five people with panic disorder (PD) were randomised to internet-based cognitive behavioural panic treatment (CBT) (with email contact), therapist-assisted CBT manual or information-only control (both with telephone contact). Both CBT treatments were more effective in reducing PD symptomatology, panic-related cognition, negative affect, and number of GP visits and improving physical health ratings. Internet treatment was more effective than CBT manual in reducing clinician-rated agoraphobia and number of GP visits at post-assessment. At follow-up, these effects were maintained for both CBT groups, with internet CBT better at improving physical health ratings and reducing GP visits. This study provides support for the efficacy of internet-based CBT.",Klein B.; Richards JC.; Austin DW.,2006.0,10.1016/j.jbtep.2005.07.001,0,1,
267,Mindfulness and acceptance-based group therapy versus traditional cognitive behavioral group therapy for social anxiety disorder: a randomized controlled trial.,"Recent research has supported the use of mindfulness and acceptance-based interventions for Social Anxiety Disorder (SAD). The purpose of the present study was to compare mindfulness and acceptance-based group therapy (MAGT) with cognitive behavioral group therapy (CBGT) with respect to outcome. It was hypothesized that MAGT and CBGT would both be superior to a control group but not significantly different from one another. Individuals (N = 137, mean age = 34 years, 54% female, 62% White, 20% Asian) diagnosed with SAD were randomly assigned to MAGT (n = 53), CBGT (n = 53) or a waitlist control group (n = 31). The primary outcome was social anxiety symptom severity assessed at baseline, treatment midpoint, treatment completion, and 3-month follow-up. Secondary outcomes were cognitive reappraisal, mindfulness, acceptance, and rumination. Depression, valued living, and group cohesion were also assessed. As hypothesized, MAGT and CBGT were both more effective than the control group but not significantly different from one another on social anxiety reduction and most other variables assessed. The present research provides additional support for the use of mindfulness and acceptance-based treatments for SAD, and future research should examine the processes by which these treatments lead to change.",Kocovski NL.; Fleming JE.; Hawley LL.; Huta V.; Antony MM.,2013.0,10.1016/j.brat.2013.10.007,0,1,
268,"A randomized, controlled clinical trial of in virtuo and in vivo exposure for spider phobia.","The present study compared the efficacy of virtual reality (VR) in virtuo exposure and in vivo exposure in the treatment of spider phobia. Two treatment conditions were compared to a waiting-list condition. A 3-month follow-up evaluation was conducted in order to assess the durability of the treatment effects. Participants were randomly assigned to the treatment groups. A total of 16 participants received the in virtuo treatment, and 16 received the in vivo treatment. The waiting-list condition included 11 participants. Participants received eight 1.5-hour treatment sessions. Efficacy was measured with the Fear of Spiders Questionnaire, the Spider Beliefs Questionnaire (SBQ-F), and a Behavioral Avoidance Test (BAT). In addition, a clinician administered the Structured Interview for DSM-IV to assess DSM-IV's criteria for specific phobia and severity. Clinical and statistically significant improvements were found for both groups. Differences in treatment groups were found on one of five measures of fear: greater improvement on the SBQ-F beliefs subscale was associated with in vivo exposure.",Michaliszyn D.; Marchand A.; Bouchard S.; Martel MO.; Poirier-Bisson J.,2010.0,10.1089/cyber.2009.0277,0,1,
269,Early intervention in panic: pragmatic randomised controlled trial.,"Many people suffer from subthreshold and mild panic disorder and are at risk of developing more severe panic disorder. This study (trial registration: ISRCTN33407455) was conducted to evaluate the effectiveness of an early group intervention based on cognitive-behavioural principles to reduce panic disorder symptomatology. Participants with subthreshold or mild panic disorder were recruited from the general population and randomised to the intervention (n = 109) or a waiting-list control group (n = 108). The course was offered by 17 community mental health centres. In the early intervention group, 43/109 (39%) participants presented with a clinically significant change on the Panic Disorder Severity Scale-Self Report (PDSS-SR) v. 17/108 (16%) in the control group (odds ratio (OR) for favourable treatment response 3.49, 95% CI 1.77-6.88, P = 0.001). The course also had a positive effect on DSM-IV panic disorder status (OR = 1.96, 95% CI=1.05-3.66, P = 0.037). The PDSS-SR symptom reduction was also substantial (between-group standardised mean difference of 0.68). The effects were maintained at 6-month follow-up. People presenting with subthreshold and mild panic disorder benefit from this brief intervention.",Meulenbeek P.; Willemse G.; Smit F.; van Balkom A.; Spinhoven P.; Cuijpers P.,2010.0,10.1192/bjp.bp.109.072504,0,1,
270,The clinical effectiveness of concise cognitive behavioral therapy with or without pharmacotherapy for depressive and anxiety disorders; a pragmatic randomized controlled equivalence trial in clinical practice.,"Depressive and anxiety disorders contribute to a high disease burden. This paper investigates whether concise formats of cognitive behavioral- and/or pharmacotherapy are equivalent with longer standard care in the treatment of depressive and/or anxiety disorders in secondary mental health care. A pragmatic randomized controlled equivalence trial was conducted at five Dutch outpatient Mental Healthcare Centers (MHCs) of the Regional Mental Health Provider (RMHP) 'Rivierduinen'. Patients (aged 18-65 years) with a mild to moderate anxiety and/or depressive disorder, were randomly allocated to concise or standard care. Data were collected at baseline, 3, 6 and 12 months by Routine Outcome Monitoring (ROM). Primary outcomes were the Brief Symptom Inventory (BSI) and the Web Screening Questionnaire (WSQ). We used Generalized Estimating Equations (GEE) to assess outcomes. Between March 2010 and December 2012, 182 patients, were enrolled (n=89 standard care; n=93 concise care). Both intention-to-treat and per-protocol analyses demonstrated equivalence of concise care and standard care at all time points. Severity of illness reduced, and both treatments improved patient's general health status and subdomains of quality of life. Moreover, in concise care, the beneficial effects started earlier. Concise care has the potential to be a feasible and promising alternative to longer standard secondary mental health care in the treatment of outpatients with a mild to moderate depressive and/or anxiety disorder. For future research, we recommend adhering more strictly to the concise treatment protocols to further explore the beneficial effects of the concise treatment. The study is registered in the Netherlands Trial Register, number NTR2590. Clinicaltrials.gov identifier: NCT01643642.",Meuldijk D.; Carlier IV.; van Vliet IM.; van Veen T.; Wolterbeek R.; van Hemert AM.; Zitman FG.,2016.0,10.1016/j.cct.2015.12.021,0,1,
271,"The treatment of social phobia: the differential effectiveness of exposure in vivo and an integration of exposure in vivo, rational emotive therapy and social skills training.","Thirty-four social phobic patients were treated with either exposure in vivo or an integrated treatment, consisting of rational emotive therapy, social skills training and exposure in vivo. Comparison with a waiting-list control group showed the effectiveness of both treatments. Contrary to expectations, the integrated approach was not superior over exposure in vivo alone. Also, the long-term effectiveness of both treatments was equally good.",Mersch PP.,1995.0,,0,1,
272,Design of the Violence and Stress Assessment (ViStA) study: a randomized controlled trial of care management for PTSD among predominantly Latino patients in safety net health centers.,"Posttraumatic stress disorder (PTSD) is a common problem in primary care. Although effective treatments are available, little is known about whether such treatments are effective within the context of Federally Qualified Health Centers (FQHCs) that serve as national ""safety nets"" for providing primary care for low income and underinsured patients. The Violence and Stress Assessment (ViStA) study is the first randomized controlled trial (RCT) to test the impact of a care management intervention for treating PTSD in FQHCs. To develop a PTSD management intervention appropriate for lower resource FQHCs and the predominantly Latino patients they serve, formative work was conducted through a collaborative effort between researchers and an FQHC practice-based research network. This article describes how FQHC stakeholders were convened to review, assess, and prioritize evidence-based strategies for addressing patient, clinician, and system-level barriers to care. This multi-component care management intervention incorporates diagnosis with feedback, patient education and activation; navigation and linkage to community resources; clinician education and medication guidance; and structured cross-disciplinary communication and continuity of care, all facilitated by care managers with FQHC experience. We also describe the evaluation design of this five-year RCT and the characteristics of the 404 English or Spanish speaking patients enrolled in the study and randomized to either the intervention or to usual care. Patients are assessed at baseline, six months, and 12 months to examine intervention effectiveness on PTSD, other mental health symptoms, health-related quality-of-life, health care service use; and perceived barriers to care and satisfaction with care.",Meredith LS.; Eisenman DP.; Green BL.; Kaltman S.; Wong EC.; Han B.; Cassells A.; Tobin JN.,2014.0,10.1016/j.cct.2014.04.005,0,1,
273,Cognitive versus behavior therapy in the group treatment of obsessive-compulsive disorder.,"This study examined the effects of cognitive-behavior therapy (CBT) compared with traditional behavior therapy (exposure and response prevention [ERP]) in the group treatment of obsessive-compulsive disorder. Of the 76 participants who started treatment, 38 were wait-listed for 3 months before treatment to assess possible course effects. Both treatments were superior to the control condition in symptom reduction, with ERP being marginally more effective than CBT by end of treatment and again at 3-month follow-up. In terms of clinically significant improvement, treatment groups were equivalent on the conclusion of treatment, but 3 months later significantly more ERP participants met criteria for recovered status. Only 1 of 7 belief measures changed with treatment improvement, and the extent of this cognitive change was similar between CBT and ERP groups. Discussion includes consideration of optimal formats for the delivery of different types of treatment.",McLean PD.; Whittal ML.; Thordarson DS.; Taylor S.; Söchting I.; Koch WJ.; Paterson R.; Anderson KW.,2001.0,,0,1,
274,A randomized controlled trial of treatments for co-occurring substance use disorders and post-traumatic stress disorder.,"Post-traumatic stress disorder (PTSD) is common among people with substance use disorders, and the comorbidity is associated with negative outcomes. We report on a randomized controlled trial comparing the effect of integrated cognitive-behavioral therapy (ICBT) plus standard care, individual addiction counseling plus standard care and standard care alone on substance use and PTSD symptoms. Three-group, multi-site randomized controlled trial. Seven addiction treatment programs in Vermont and New Hampshire, USA. Recruitment took place between December 2010 and January 2013. In this single-blind study, 221 participants were randomized to one of three conditions: ICBT plus standard care (SC) (n = 73), individual addiction counseling (IAC) plus SC (n = 75) or SC only (n = 73). One hundred and seventy-two patients were assessed at 6-month follow-up (58 ICBT; 61 IAC; 53 SC). Intervention and comparators: ICBT is a manual-guided therapy focused on PTSD and substance use symptom reduction with three main components: patient education, mindful relaxation and flexible thinking. IAC is a manual-guided therapy focused exclusively on substance use and recovery with modules organized in a stage-based approach: treatment initiation, early abstinence, maintaining abstinence and recovery. SC are intensive out-patient program services that include 9-12 hours of face-to-face contact per week over 2-4 days of group and individual therapies plus medication management. Primary outcomes were PTSD severity and substance use severity at 6 months. Secondary outcomes were therapy retention. PTSD symptoms reduced in all conditions with no difference between them. In analyses of covariance, ICBT produced more favorable outcomes on toxicology than IAC or SC [comparison with IAC, parameter estimate: 1.10; confidence interval (CI) = 0.17-2.04; comparison with SC, parameter estimate: 1.13; CI = 0.18-2.08] and had a greater reduction in reported drug use than SC (parameter estimate: -9.92; CI = -18.14 to -1.70). ICBT patients had better therapy continuation versus IAC (P<0.001). There were no unexpected or study-related adverse events. Integrated cognitive behavioral therapy may improve drug-related outcomes in post-traumatic stress disorder sufferers with substance use disorder more than drug-focused counseling, but probably not by reducing post-traumatic stress disorder symptoms to a greater extent.",McGovern MP.; Lambert-Harris C.; Xie H.; Meier A.; McLeman B.; Saunders E.,2015.0,10.1111/add.12943,0,1,
275,Exposure and cognitive restructuring for social phobia: A controlled study.,"43 social-phobic adults were assigned to exposure (EXP), cognitive restructuring without exposure (CR-alone), or to an intervention combining these techniques (COMB), in a wait-list controlled trial. Within-group analyses showed that the COMB and CR-alone groups improved significantly on all measures, whereas the EXP group showed changes on phobia but not attitudinal measures. Between-group analyses showed COMB to be superior to EXP on 2 phobia measures. CR-alone was inferior to EXP and COMB on behavioral approach after treatment, but showed continued improvement relative to the exposure groups on this and other variables at follow-up. Treatment-induced changes in fear of negative evaluation (FNE) locus of control, and irrational beliefs were predictive of long-term improvement, with changes in FNE accounting for most of the variance in improvement. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mattick, Richard P; Peters, Lorna; Clarke, J. Christopher",1989.0,,0,1,
276,Saving clinicians' time by delegating routine aspects of therapy to a computer: a randomized controlled trial in phobia/panic disorder.,"The demand for time-consuming psychotherapy of phobia/panic exceeds the supply of trained therapists. Delegating routine therapy aspects to a computer might ease this problem. Ninety-three out-patients with phobia or panic disorder were randomized in a 2: 2 : 1 ratio to have self-exposure therapy guided either mainly by a stand-alone computer system (FearFighter) or entirely face-to-face by a clinician, or to have mainly computer-guided self-relaxation as a placebo. Both computer groups (FearFighter and relaxation) had brief back-up advice from a clinician. Primary outcome measures were self- and blind-assessor ratings of Main Problem and Goals, and Global Phobia. Drop-outs occurred significantly more often in the two self-exposure groups (43% if mainly computer-guided, 24% if entirely clinician-guided) than with self-relaxation (6%); the difference between the two self-exposure groups was not significant. Even with all drop-outs included, the mainly computer-guided exposure group and the relaxation group had 73% less clinician time per patient than did the entirely clinician-guided exposure group. The two self-exposure groups had comparable improvement and satisfaction at post-treatment and at 1-month follow-up, while relaxation was ineffective. Mean improvement on the primary outcome measures (self- and assessor-rated) was 46% computer, 49% clinician, 9% relaxation at post-treatment (week 10) and 58% computer, 53% clinician and -4% relaxation at 1-month follow-up (week 14). Mean effect sizes on the primary outcome measures were 2.9 computer, 3.5 clinician and 0.5 relaxation at post-treatment; and 3.7 computer, 3.5 clinician and 0.5 relaxation at 1-month follow-up. The assessor did not rate patients at follow-up. Despite its (non-significantly) higher dropout rate, self-exposure therapy for panic/ phobia cut clinician time per patient by 73% without losing efficacy when guided mainly by a computer rather than entirely by a clinician. The finding needs confirmation at a follow-up that is longer and includes a blind assessor. Self-relaxation had the highest rate of completers but was ineffective.",Marks IM.; Kenwright M.; McDonough M.; Whittaker M.; Mataix-Cols D.,2004.0,,0,1,
277,Virtual reality exposure therapy for the treatment of fear of flying: A controlled investigation.,"Forty-five participants who refused to fly during a screening test and who also met Diagnostic and Statistical Manual of Mental Disorders criteria for specific phobia, agoraphobia, or panic disorder with agoraphobia were randomly assigned to 5 sessions of either virtual reality exposure (VRE) or attention-placebo group treatment (GT). At posttreatment, 65% of VRE participants and 57% of GT participants flew during a test flight. Both groups showed significant improvement following treatment on standardized self-report measures of flight anxiety, with a better outcome for the VRE group on 4 of 5 of these measures. At 6-month follow-up, however, most group differences had disappeared; VRE resulted in a better outcome on only 1 of 5 standardized flight anxiety measures. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Maltby, Nicholas; Kirsch, Irving; Mayers, Michael; Allen, George J; Beckham, Botella, Brown, Carlin, Cohen, Denholtz, Dunlop, Emmelkamp, Forsyth, Greco, Haug, Howard, Jacobson, Nash, Nichols, Ost, Regenbrecht, Rothbaum, Rothbaum, Solyom, Van Gerwen, Walder, Wilhelm, Wilhelm",2002.0,,0,1,
278,Dresden PTSD treatment study: randomized controlled trial of motor vehicle accident survivors.,"We translated, modified, and extended a cognitive behavioral treatment (CBT) protocol by Blanchard and Hickling (2003) for the purpose of treating survivors of MVA with full or subsyndromal posttraumatic stress disorder (PTSD) whose native language is German. The treatment manual included some additional elements, e. g. cognitive procedures, imaginal reliving, and facilitating of posttraumatic growth. The current study was conducted in order to test the efficacy of the modified manual by administering randomized controlled trial in which a CBT was compared to a wait-list control condition. Forty-two motor vehicle accident survivors with chronic or severe subsyndromal posttraumatic stress disorder (PTSD) completed the treatment trial with two or three detailed assessments (pre, post, and 3-month follow-up). CAPS-scores showed significantly greater improvement in the CBT condition as compared to the wait list condition (group x time interaction effect size d = 1.61). Intent-to-treat analysis supported the outcome (d = 1.34). Categorical diagnostic data indicated clinical recovery of 67% (post-treatment) and 76% (3 months FU) in the treatment group. Additionally, patients of the CBT condition showed significantly greater reductions in co-morbid major depression than the control condition. At follow-up the improvements were stable in the active treatment condition. The degree of improvement in our treatment group was comparable to that in previously reported treatment trials of PTSD with cognitive behavioral therapy. ISRCTN66456536.",Maercker A.; Zöllner T.; Menning H.; Rabe S.; Karl A.,2006.0,10.1186/1471-244X-6-29,0,1,
279,Do cognitive and exposure treatments improve various PTSD symptoms differently? A randomized controlled trial.,"This study (part of a larger one whose main outcomes were reported by Marks, Lovell, Noshirvani, Thrasher, & Livanou, 1998) investigated the impact of exposure therapy and cognitive restructuring alone and combined on the individual symptoms of PTSD and on associated features. Exposure therapy was expected to act mainly on fear and avoidance, and cognitive restructuring mainly on detachment, restricted range of affect, and associated features of PTSD. 77 PTSD outpatients were randomly allocated to one of four treatments: (1) exposure alone; (2) cognitive restructuring alone; (3) combined exposure and cognitive restructuring; or (4) relaxation (placebo control). The active treatments were superior to relaxation in improving clusters of PTSD symptoms and associated features and some but not all individual symptoms and associated features of PTSD. Exposure and cognitive restructuring improved almost all individual symptoms similarly. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lovell, Karina; Marks, Isaac M; Noshirvani, Homa; Thrasher, Sian; Livanou, Maria",2001.0,,0,1,
280,Low-intensity cognitive-behaviour therapy interventions for obsessive-compulsive disorder compared to waiting list for therapist-led cognitive-behaviour therapy: 3-arm randomised controlled trial of clinical effectiveness.,"Obsessive-compulsive disorder (OCD) is prevalent and without adequate treatment usually follows a chronic course. ""High-intensity"" cognitive-behaviour therapy (CBT) from a specialist therapist is current ""best practice."" However, access is difficult because of limited numbers of therapists and because of the disabling effects of OCD symptoms. There is a potential role for ""low-intensity"" interventions as part of a stepped care model. Low-intensity interventions (written or web-based materials with limited therapist support) can be provided remotely, which has the potential to increase access. However, current evidence concerning low-intensity interventions is insufficient. We aimed to determine the clinical effectiveness of 2 forms of low-intensity CBT prior to high-intensity CBT, in adults meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for OCD. This study was approved by the National Research Ethics Service Committee North West-Lancaster (reference number 11/NW/0276). All participants provided informed consent to take part in the trial. We conducted a 3-arm, multicentre randomised controlled trial in primary- and secondary-care United Kingdom mental health services. All patients were on a waiting list for therapist-led CBT (treatment as usual). Four hundred and seventy-three eligible patients were recruited and randomised. Patients had a median age of 33 years, and 60% were female. The majority were experiencing severe OCD. Patients received 1 of 2 low-intensity interventions: computerised CBT (cCBT; web-based CBT materials and limited telephone support) through ""OCFighter"" or guided self-help (written CBT materials with limited telephone or face-to-face support). Primary comparisons concerned OCD symptoms, measured using the Yale-Brown Obsessive Compulsive Scale-Observer-Rated (Y-BOCS-OR) at 3, 6, and 12 months. Secondary outcomes included health-related quality of life, depression, anxiety, and functioning. At 3 months, guided self-help demonstrated modest benefits over the waiting list in reducing OCD symptoms (adjusted mean difference = -1.91, 95% CI -3.27 to -0.55). These effects did not reach a prespecified level of ""clinically significant benefit."" cCBT did not demonstrate significant benefit (adjusted mean difference = -0.71, 95% CI -2.12 to 0.70). At 12 months, neither guided self-help nor cCBT led to differences in OCD symptoms. Early access to low-intensity interventions led to significant reductions in uptake of high-intensity CBT over 12 months; 86% of the patients allocated to the waiting list for high-intensity CBT started treatment by the end of the trial, compared to 62% in supported cCBT and 57% in guided self-help. These reductions did not compromise longer-term patient outcomes. Data suggested small differences in satisfaction at 3 months, with patients more satisfied with guided self-help than supported cCBT. A significant issue in the interpretation of the results concerns the level of access to high-intensity CBT before the primary outcome assessment. We have demonstrated that providing low-intensity interventions does not lead to clinically significant benefits but may reduce uptake of therapist-led CBT. International Standard Randomized Controlled Trial Number (ISRCTN) Registry ISRCTN73535163.",Lovell K.; Bower P.; Gellatly J.; Byford S.; Bee P.; McMillan D.; Arundel C.; Gilbody S.; Gega L.; Hardy G.; Reynolds S.; Barkham M.; Mottram P.; Lidbetter N.; Pedley R.; Molle J.; Peckham E.; Knopp-Hoffer J.; Price O.; Connell J.; Heslin M.; Foley C.; Plummer F.; Roberts C.,2017.0,10.1371/journal.pmed.1002337,0,1,
281,Efficacy of cognitive behaviour therapy in generalized anxiety disorders. Results of a controlled clinical trial (Berlin CBT-GAD Study).,"Generalized anxiety disorders (GAD) are amongst the most prevalent mental disorders. Recent studies have suggested that cognitive behaviour therapy (CBT) is an effective treatment for GAD. A controlled clinical trial was done to evaluate the efficacy of CBT treatment in outpatients with pure GAD who were treated by a therapist working in routine care. Seventy-two outpatients, fulfilling GAD criteria according to DSM-IV, were included in the study. From this group, 36 patients (CBT-A) were randomly assigned to 25 sessions of CBT and the other 36 formed a contact control group (CCG). After the contact control period (CC period), these patients were also treated with CBT (CBT-B), allowing not only a parallel group comparison but also an A-B comparison. Therapists were licensed full-time psychologists who worked routinely in outpatient care and had a professional training in CBT. Treatment was done in accordance with a manual, and treatment conformity was controlled by several methods. The reduction in the score on the Hamilton Anxiety Observer Rating Scale was 6.4% (1.5 points) in the CCG, 35.4% (9.5 points) in the CBT-A and 47.3% (10.3 points) in the CBT-B. In the self-rating Spielberger State-Trait Anxiety Inventory, a reduction of 2.7% was seen in CCG, 14.6% in CBT-A, and 11.6% in CBT-B. According to the Clinical Global Impression Rating, 65.6% of patients were still at least moderately ill at the end of the CC period, while this rate was 33.4% at the end of CBT-A, or 15.7% at the end of CBT-B. All these differences between treatment and control group are statistically highly significant. The clinical improvement remained stable over a follow-up period of 8 months. CBT is an effective method of treatment for GAD. Differences between control and treatment group are comparable to or larger than those reported in studies on antidepressant drugs.",Linden M.; Zubraegel D.; Baer T.; Franke U.; Schlattmann P.,2005.0,10.1159/000082025,0,1,
282,Effectiveness of the cognitive behavior therapy in the treatment of Generalized Anxiety Disorders--Results of the Berlin GAD-KVT-study.,"In recent years generalized anxiety disorders (GAD) have become a focus of clinical research. There is some empirical evidence that cognitive behavior therapy (CBT) is an effective treatment. In a multicenter controlled clinical trial supported by the Deutsche Forschungsgemeinschaft, efficacy of manual-guided CBT was studied in cooperation with behavior therapists who work in private practice. Patients treated with CBT (TA) were compared with those of a waiting contact group (KKG). Because the control group patients were also treated with CBT after the waiting period (TB), a validation of treatment results has been possible. 72 outpatients (age 18-65 years, Hamilton Anxiety Scale (HAM-A) >= 18, GAD according to DSM-IV, no co-morbid axis-I or axis-II disorders, no co-medication) were included and randomized into the study arms. In TA HAM-A showed a reduction pre-post of 10.64 (39.6%) and State Trait Anxiety Inventory (STAI) state of 7.96 (15.1%). In TB (those patients with delayed start of therapy) the reduction in the HAM-A was 12.08 (56.9%) and in the STAI state 6.62 (13.5%). In KKG the reduction was 1.22 (5.3%) in the HAM-A and 1.63 (3.2%) in the STAI state. The data show that manual-guided CBT is effective in GAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Linden, M; Bar, T; Zubragel, D; Ahrens, B; Schlattmann, P; Ballenger, Barlow, Beck, Borkovec, Borkovec, Borkovec, Brawman Mintzer, Brawman Mintzer, Brown, Butler, Chambless, Davidson, Dugas, Durham, Durham, Dyck, Fisher, Gelenberg, Gould, Hackett, Hamilton, Kessler, Ladouceur, Linden, Linden, Linden, Linden, Linden, Linden, Pollack, Rickels, Ricktes, Rocca, Roerig, Ruhmland, Shear, Sheehan, Spielberger, Wittchen, Wittchen, Zubragel, Ost",2002.0,,0,1,
283,Physical activity within a CBT intervention improves coping with pain in traumatized refugees: results of a randomized controlled design.,"Many traumatized refugees experience both posttraumatic stress disorder and chronic pain. Based on Mutual Maintenance Theory and the Perpetual Avoidance Model, this study examined the additional effect of physical activity within a biofeedback-based cognitive behavioral therapy (CBT-BF) for traumatized refugees. In a controlled design, 36 patients were randomized into one of three conditions (CBT-BF, CBT-BF with physical activity [CBT-BF+active], and a waiting list control group [WL]). Thirty patients (n=10 in each group) completed the treatment and a follow-up assessment 3 months later. Participants' coping strategies, pain and mental health status, and physiological reactivity were assessed before and after the intervention and at 3-month follow-up. Treatment effects were analyzed using analyses of variance with baseline scores as covariates (ANCOVAs) and the Reliable Change Index. The CBT-BF and CBT-BF+active groups showed improvements in all outcome measures relative to the WL group. The effect sizes for the main outcome measures were higher in the CBT-BF+active group than in the CBT-BF group. Repeated measures analyses of covariance showed significant group effects for coping strategies--in particular, for the ""cognitive restructuring"" and ""counter-activities"" subscales as well as a marginally significant group effect for ""perceived self-competence""--with the CBT-BF+active group showing more favorable outcomes than the CBT-BF group. Moreover, 60% of participants in the CBT-BF+active group showed clinically reliable intraindividual change in at least one subscale of the pain coping strategies questionnaire, compared with just 30% of participants in the CBT-BF group. Findings of improved coping strategies, larger effect sizes, and higher rates of clinical improvement in the CBT-BF+active group suggest that physical activity adds value to pain management interventions for traumatized refugees. Given the small sample size, however, these preliminary results need replication in a larger trial.",Liedl A.; Müller J.; Morina N.; Karl A.; Denke C.; Knaevelsrud C.,2011.0,10.1111/j.1526-4637.2010.01040.x,0,1,
284,A comparison of bibliotherapy and group therapy in the treatment of panic disorder.,"This study investigated 2 methods of disseminating a cognitive-behavioral intervention for panic disorder (PD). Thirty-six Ss who met diagnostic criteria for PD according to the Anxiety Disorders Interview Schedule-Revised were randomly assigned to 1 of 3 conditions: bibliotherapy (BT), group therapy (GT), or a waiting-list control (WL) condition. Interventions lasted 8 weeks and were followed by a posttest, along with 3- and 6-month follow-up assessments. Results indicated that both the BT and GT treatments were more effective than the WL condition in reducing frequency of panic attacks, severity of physical panic symptoms, catastrophic cognitions, agoraphobic avoidance, and depression and that the BT and GT treatments were more effective in increasing self-efficacy. Both interventions maintained their effects throughout the follow-up periods and produced clinically significant levels of change among the majority of treated Ss.",Lidren DM.; Watkins PL.; Gould RA.; Clum GA.; Asterino M.; Tulloch HL.,1994.0,,0,1,
285,Affect-focused body psychotherapy in patients with generalized anxiety disorder: Evaluation of an integrative method.,"The aim of this study was to explore the long-term effects of affect-focused body psychotherapy (ABP) for patients with generalized anxiety disorder (GAD). A group of 61 consecutive patients, 21-55 years old, were randomized to ABP and psychiatric treatment as usual (TAU). The patients were assessed before treatment and followed up 1 and 2 years after inclusion. The ABP patients received one session of treatment per week during 1 year. Three self-report questionnaires were administered; Symptom Checklist-90, Beck Anxiety Inventory, and the WHO (Ten) Well-Being Index. In both groups, there was a significant improvement. On termination, the ABP group had improved significantly more on the SCL-90 Global Symptom Index than the TAU group, whereas the differences were short of significance on the other two scales. The integration of bodily techniques with a focus on affects in a psychodynamically informed treatment seems to be a viable treatment alternative for patients with GAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Levy Berg, Adrienne; Sandell, Rolf; Sandahl, Christer; Allgulander, Andersson, Ansseau, Arntz, Ballenger, Bech, Beck, Becker, Borkovec, Borkovec, Braatoy, Bunkan, Bunkan, Bunkan, Butler, Cohen, Crits-Christoph, Crits-Christoph, Crits-Christoph, Derogatis, Derogatis, Downing, Durham, Dyck, Ekerholt, Ekselius, Falsetti, Fridell, Friis, Gold, Hoyer, Johansson, Kringlen, Kubzansky, Leichsenring, Lydiard, Malan, Miller, Monsen, Monsen, Monsen, Nathanson, Ramberg, Reich, Roemer, Sanderson, Sanderson, Sanderson, Stricker, Stricker, Thornquist, Tomkins, Tomkins, Vinnars, Walley, Wittchen, Wolfe, Wolfe, Wolfe, Wolfe, Wolfe, Woodman, Yonkers, Ost",2009.0,,0,1,
286,The efficacy of imagery rescripting (IR) for social phobia: A randomized controlled trial.,"Background and objectives: There is a need for brief effective treatment of social phobia and Imagery Rescripting (IR) is a potential candidate. The purpose of this study was to examine the efficacy of IR preceded by cognitive restructuring as a stand-alone brief treatment using a randomized controlled design. Methods: Twenty-three individuals with social phobia were randomly assigned to an IR group or to a control group. Participants in the IR group were provided with one session of imagery interviewing and two sessions of cognitive restructuring and Imagery Rescripting. Those in the control group had one session of clinical interviewing and two sessions of supportive therapy. Outcome measures including the Korean version of the Social Avoidance and Distress Scale (K-SADS) were administered before and after treatment, and at three-month follow-up. The short version of the Questionnaire upon Mental Imagery and the Traumatic Experience Scale were also administered before treatment. Results: Participants in the IR group improved significantly on K-SADS and other outcome measures, compared to the control group. The beneficial effects of IR were maintained at three-month follow-up. It was also found that mental imagery ability and the severity of the traumatic experience did not moderate the outcome of IR. Limitations: Further studies are needed to replicate the findings of our study using a large sample. Conclusions: The efficacy of IR as a stand-alone brief treatment was demonstrated for social phobia. The findings indicate that IR could be utilized as a cost-effective intervention for social phobia. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lee, Seung Won; Kwon, Jung-Hye; Arntz, Arntz, Arntz, Brewin, Butler, Carver, Clark, Cohen, Conway, Dewit, Edwards, Erwin, First, Foa, Giesen-Bloo, Grunert, Hackmann, Hackmann, Hirsch, Holmes, Holmes, Hunt, James, Lee, Liebowitz, Nilsson, Oh, Pratt, Rapee, Sheehan, Teasdale, Vassilopoulos, Vrana, Watson, Weertman, Wheatley, Wild, Wild, Yoon",2013.0,,0,1,
287,Efficacy of a cognitive-behavioral treatment for generalized anxiety disorder: evaluation in a controlled clinical trial.,"Recent advances in the understanding of worry have led to the development of treatments for generalized anxiety disorder (GAD). The present study tested a GAD treatment that targeted intolerance of uncertainty, erroneous beliefs about worry, poor problem orientation, and cognitive avoidance. Twenty-six primary GAD patients were randomly allocated to a treatment condition (n = 14) or a delayed treatment control condition (n = 12). Self-report, clinician, and significant other ratings assessed GAD and associated symptoms. The results show that the treatment led to statistically and clinically significant change at posttest and that gains were maintained at 6- and 12-month follow-ups. Furthermore, 20 of 26 participants (77%) no longer met GAD diagnostic criteria following treatment. With regard to the treatment's underlying model, the results show that intolerance of uncertainty significantly decreased over treatment and that gains were maintained at both follow-ups. Although nonspecific factors were not significant predictors of treatment outcome, their role in the treatment of GAD requires further investigation.",Ladouceur R.; Dugas MJ.; Freeston MH.; Léger E.; Gagnon F.; Thibodeau N.,2000.0,,0,1,
288,Hybrid cognitive behavioral therapy versus relaxation training for co-occurring anxiety and alcohol disorder: a randomized clinical trial.,"Treatment for alcohol use disorder (AUD) is far less effective for those with a co-occurring anxiety disorder. Surprisingly, adding an independent anxiety treatment to AUD treatment does not substantially improve the poor alcohol outcomes of these patients. This may reflect the lack of attention from independent treatments to the dynamic interaction of anxiety symptoms with alcohol use and drinking motivation. On the basis of this view, we assembled a cognitive behavioral therapy (CBT) program designed to both reduce anxiety symptoms and weaken the links between the experience of anxiety and the motivation to drink. 344 patients undergoing residential AUD treatment with current social phobia, generalized anxiety disorder, or panic disorder were randomly assigned to receive either the CBT or an active comparison treatment, progressive muscle relaxation training (PMRT). Assessments took place immediately following treatment and 4 months later (n = 247). As predicted, the CBT group demonstrated significantly better alcohol outcomes 4 months following treatment than did the PMRT group. Although both groups experienced a substantial degree of anxiety reduction following treatment, there were no significant group differences immediately after treatment and only a slight advantage for the CBT group 4 months after treatment. These findings suggest that specific interventions aimed at weakening the association between the experience of anxiety and drinking motivation play an important role in improving the alcohol outcomes of these difficult-to-treat patients beyond that of anxiety reduction alone.",Kushner MG.; Maurer EW.; Thuras P.; Donahue C.; Frye B.; Menary KR.; Hobbs J.; Haeny AM.; Van Demark J.,2013.0,10.1037/a0031301,0,1,
289,A randomized controlled trial of a smartphone app for posttraumatic stress disorder symptoms.,"Objective: Posttraumatic stress disorder (PTSD) is highly prevalent in the population, but relatively few affected individuals receive treatment for it. Smartphone applications (apps) could help address this unmet need by offering sound psychoeducational information and evidence-based cognitive behavioral coping tools. We conducted a randomized controlled trial to assess the efficacy of a free, publicly available smartphone app (PTSD Coach) for self-management of PTSD symptoms. Method: One hundred 20 participants who were an average of 39 years old, mostly women (69.2%) and White (66.7%), recruited primarily through online advertisements, were randomized to either a PTSD Coach (n = 62) or a waitlist condition (n = 58) for 3 months. Web-administered self-report measures of PTSD, PTSD symptom coping self-efficacy, depression, and psychosocial functioning were conducted at baseline, posttreatment, and 3 months following treatment. Results: Following the intent-to-treat principle, repeated-measures analyses of variance (ANOVAs) revealed that at posttreatment, PTSD Coach participants had significantly greater improvements in PTSD symptoms (p = .035), depression symptoms (p = .005), and psychosocial functioning (p = .007) than did waitlist participants; however, at posttreatment, there were no significant mean differences in outcomes between conditions. A greater proportion of PTSD Coach participants achieved clinically significant PTSD symptom improvement (p = .018) than waitlist participants. Conclusion: PTSD Coach use resulted in significantly greater improvements in PTSD symptoms and other outcomes relative to a waitlist condition. Given the ubiquity of smartphones, PTSD Coach may provide a wide-reaching, convenient public health intervention for individuals with PTSD symptoms who are not receiving care. (PsycINFO Database Record (c) 2017 APA, all rights reserved) Impact Statement What is the public health significance of this article?-There is a tremendous unmet need for care among trauma survivors with posttraumatic stress symptoms. This randomized controlled trial suggests that a self-management mobile app may be an efficacious intervention that can reduce PTSD and depression symptom severity and improve psychosocial functioning to help address this unmet need in the population. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kuhn, Eric; Kanuri, Nitya; Hoffman, Julia E; Garvert, Donn W; Ruzek, Josef I; Taylor, C. Barr; Abrams, Anderson, Bandura, Boscarino, Brancu, Coach, Donker, Erb, Faul, Foa, Foa, Gavrilovic, Gould, Hoffman, Kazdin, Kessler, Kessler, Kroenke, Kuhn, Lewinsohn, Lindhiem, Linehan, Martell, Meichenbaum, Miner, Monson, Najavits, Possemato, Resick, Ruggiero, Schuler, Shiner, Torous, Torous, Vogt, Wang, Weathers, Weathers, Weathers, Wilkins",2017.0,,0,1,
290,Preliminary investigation of a mindfulness-based intervention for social anxiety disorder that integrates compassion meditation and mindful exposure.,"Objectives: This study evaluated the feasibility and initial efficacy of a 12-week group mindfulness-based intervention tailored for persons with social anxiety disorder (MBI-SAD). The intervention includes elements of the standard mindfulness-based stress reduction program, explicit training in self-compassion aimed at cultivating a more accepting and kinder stance toward oneself, and use of exposure procedures to help participants practice responding mindfully to internal experiences evoked by feared social situations. Methods: Participants were randomly assigned to the MBI-SAD (n = 21) or a waitlist (WL) (n = 18) control group. Feasibility was assessed by the number of participants who completed at least 75% of the 12 weekly group sessions. Primary efficacy outcomes were clinician- and self-rated measures of social anxiety. Other outcomes included clinician ratings of illness severity and self-rated depression, social adjustment, mindfulness, and self-compassion. Results: The MBI-SAD was acceptable and feasible, with 81% of participants attending at least 75% of sessions. The MBI-SAD fared better than WL in improving social anxiety symptom severity (p <= 0.0001), depression (p <= 0.05), and social adjustment (p <= 0.05). The intervention also enhanced self-compassion (p <= 0.05), and facets of mindfulness (observe and aware; p <= .05). MBI-SAD treatment gains were maintained at 3-month follow-up. Conclusions: These preliminary findings suggest that an MBI that integrates explicit training in self-compassion and mindful exposure is a feasible and promising intervention for social anxiety disorder. The next step is to compare the MBI-SAD to the gold standard of cognitive-behavior therapy to determine equivalence or noninferiority and to explore mediators and moderators of treatment outcome. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Koszycki, Diana; Thake, Jennifer; Mavounza, Celine; Daoust, Jean-Philippe; Taljaard, Monica; Bradwejn, Jacques; Arch, Arch, Baer, Baer, Barnard, Beck, Birnie, Brach, Breines, Carmody, Chiesa, Combs, Connor, Del Re, Edwards, Farb, Faucher, First, Fjorback, Fresco, Germer, Gilbert, Gilbert, Goldin, Goldin, Goldin, Goyal, Guy, Hamer, Heimberg, Heimberg, Hofmann, Hofmann, Hofmann, Jazaieri, Kabat-Zinn, Kabat-Zinn, Khoury, Koszycki, Kuyken, Leon, Liebowitz, Little, MacBeth, Malinowski, Marchand, Montgomery, Mortberg, Neff, Neff, Neff, Neff, Pace, Piet, Powers, Raes, Rosenzweig, Salzberg, Segal, Shapiro, Sipe, Storch, Teasdale, Teasdale, Toneatto,, Van Dam, Vettese, Weissman, Werner, Wersebe, Wiebe",2016.0,,0,1,
291,Cost-effectiveness of a primary care model for anxiety disorders.,"Individuals with anxiety disorders often do not receive an accurate diagnosis or adequate treatment in primary care. To analyse the cost-effectiveness of an optimised care model for people with anxiety disorders in primary care. In a cluster randomised controlled trial, 46 primary care practices with 389 individuals positively screened with anxiety were randomised to intervention (23 practices, 201 participants) or usual care (23 practices, 188 participants). Physicians in the intervention group received training on diagnosis and treatment of anxiety disorders combined with the offer of a psychiatric consultation-liaison service for 6 months. Anxiety, depression, quality of life, service utilisation and costs were assessed at baseline, 6-month and 9-month follow-up. No significant differences were observed between intervention and control group on the Beck Anxiety Inventory, Beck Depression Inventory and EQ-5D during follow-up. Total costs were higher in the intervention group (euro4911 v. euro3453, P = 0.09). The probability of an incremental cost-effectiveness ratio <euro50 000 per quality-adjusted life year was below 10%. The optimised care model did not prove to be cost-effective.",König HH.; Born A.; Heider D.; Matschinger H.; Heinrich S.; Riedel-Heller SG.; Surall D.; Angermeyer MC.; Roick C.,2009.0,10.1192/bjp.bp.108.058032,0,1,
292,Internet-based treatment for PTSD reduces distress and facilitates the development of a strong therapeutic alliance: A randomized controlled clinical trial.,"Background: The present study was designed to evaluate the efficacy of an internet-based therapy (Interapy) for Posttraumatic Stress Disorder (PTSD) in a German speaking population. Also, the quality of the online therapeutic relationship, its development and its relevance as potential moderator of the treatment effects was investigated. Method: Ninety-six patients with posttraumatic stress reactions were allocated at random to ten sessions of Internet-based cognitive behavioural therapy (CBT) conducted over a 5-week period or a waiting list control group. Severity of PTSD was the primary outcome. Secondary outcome variables were depression, anxiety, dissociation and physical health. Follow-up assessments were conducted at the end of treatment and 3 months after treatment. Results: From baseline to post-treatment assessment, PTSD severity and other psychopathological symptoms were significantly improved for the treatment group (intent-to-treat group x time interaction effect size d = 1.40). Additionally, patients of the treatment condition showed significantly greater reduction of co-morbid depression and anxiety as compared to the waiting list condition. These effects were sustained during the 3-months follow-up period. High ratings of the therapeutic alliance and low drop-out rates indicated that a positive and stable therapeutic relationship could be established online. Significant improvement of the online working alliance in the course of treatment and a substantial correlation between the quality of the online relationship at the end of treatment and treatment outcome emerged. Conclusion: Interapy proved to be a viable treatment alternative for PTSD with large effect sizes and sustained treatment effects. A stable and positive online therapeutic relationship can be established through the Internet which improved during the treatment process. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Knaevelsrud, Christine; Maercker, Andreas; Bordin, Bradley, Busseri, Callahan, Cohen, Cook, Derogatis, Gaston, Hatcher, Hopps, Horvath, Horvath, Kendall, Kivlighan, Kleber, Knaevelsrud, Knaevelsrud, Kubany, Lange, Lange, Lange, Maercker, Maercker, Maercker, Martin, Neal, Nijenhuis, Rauch, Ritterband, Suler, Tracey, Vanderwerker, Wagner, Walter, Ware, Weiss",2007.0,,0,1,
293,"Posttraumatic growth, optimism and openness as outcomes of a cognitive-behavioural intervention for posttraumatic stress reactions.","The aim of this study was to examine the effect of an Internet-based CBT intervention on posttraumatic growth, openness and optimism. Ninety-six participants suffering from posttraumatic stress reactions were randomly assigned to either the treatment or a waiting-list control condition. We assessed posttraumatic stress reactions, depression and anxiety, posttraumatic growth, optimism and openness to new experiences. We found significant changes in posttraumatic growth in the treatment group. In addition regression analysis revealed that symptom improvements in posttraumatic stress reactions significantly predicted posttraumatic growth post-treatment. Our findings indicate the potential of psychotherapy to stimulate posttraumatic growth. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Knaevelsrud, Christine; Liedl, Alexandra; Maercker, Andreas; Borkenau, Bostock, Costa, Costa, Davis, Derogatis, Franke, Frazier, Glaesmer, Knaevelsrud, Lange, Lange, Linley, Maercker, Maercker, Maercker, McCrae, McMillen, Park, Park, Scheier, Taku, Tedeschi, Tedeschi, Wagner, Weiss, Zoellner",2010.0,,0,1,
294,[Psychodynamic group treatment for generalized social phobia].,"The aim of this study is to assess the effectiveness of psychodynamic group therapy in patients with generalized social phobia. Thirty patients were included in a randomized single-blind clinical trial comparing psychodynamic group treatment (PGT) with a credible placebo control group (CPC). PGT was carried out within a 12-session psychodynamically-oriented group psychotherapy. Control patients received a treatment package of lecture-discussion and support group for 12 weeks which was compared to PGT. Each participant completed the Liebowitz Social Anxiety Scale (LSAS), the Hamilton Anxiety Scale (HAS) and the Clinical Global Impression Scale(CGI) at pretreatment assessment and after 12 weeks of treatment. Data analysis was carried out using a repeated measures ANOVA. Patients were excluded if they were under any kind of pharmacotherapy or psychotherapic treatment. Both groups demonstrated significant pretreatment-to-posttreatment change on most measures. On the LSAS, PGT patients were rated as more improved than controls at posttest assessment (F(1,28)=4.84, p=0.036). Baseline data of completers did not show differences between both groups in the demographic variables and outcome variables used. The present study showed that PGT was [corrected] superior to a credible placebo control group in the treatment of generalized social phobia, in a 12-week randomized single-blind clinical trial.",Knijnik DZ.; Kapczinski F.; Chachamovich E.; Margis R.; Eizirik CL.,2004.0,/S1516-44462004000200003,0,1,
295,"Mindfulness-based Stress Reduction in Addition to Usual Care Is Associated with Improvements in Pain, Fatigue, and Cognitive Failures Among Veterans with Gulf War Illness.","Many Gulf War I veterans report ongoing negative health consequences. The constellation of pain, fatigue, and concentration/memory disturbances is referred to as ""Gulf War illness."" Prior research suggests that mindfulness-based stress reduction may be beneficial for these symptoms, but mindfulness-based stress reduction has not been studied for veterans with Gulf War illness. The objective of this trial was to conduct a pilot study of mindfulness-based stress reduction for veterans with Gulf War illness. Veterans (N = 55) with Gulf War illness were randomly assigned to treatment as usual plus mindfulness-based stress reduction or treatment as usual only. Mindfulness-based stress reduction was delivered in 8 weekly 2.5-hour sessions plus a single 7-hour weekend session. Pain, fatigue, and cognitive failures were the primary outcomes, assessed at baseline, after mindfulness-based stress reduction, and 6 months follow-up. Secondary outcomes included symptoms of posttraumatic stress disorder and depression. In intention-to-treat analyses, at 6-month follow-up, veterans randomized to mindfulness-based stress reduction plus treatment as usual reported greater reductions in pain (f = 0.33; P = .049), fatigue (f = 0.32; P = .027), and cognitive failures (f = 0.40; P < .001). Depressive symptoms showed a greater decline after mindfulness-based stress reduction (f = 0.22; P = .050) and at 6 months (f = 0.27; P = .031) relative to treatment as usual only. Veterans with posttraumatic stress disorder at baseline randomized to mindfulness-based stress reduction plus treatment as usual experienced significantly greater reductions in symptoms of posttraumatic stress disorder after mindfulness-based stress reduction (f = 0.44; P = .005) but not at 6 months follow-up (f = 0.31; P = .082). Mindfulness-based stress reduction in addition to treatment as usual is associated with significant improvements in self-reported symptoms of Gulf War illness, including pain, fatigue, cognitive failures, and depression.",Kearney DJ.; Simpson TL.; Malte CA.; Felleman B.; Martinez ME.; Hunt SC.,2016.0,10.1016/j.amjmed.2015.09.015,0,1,
296,Japan Unified Protocol Clinical Trial for Depressive and Anxiety Disorders (JUNP study): Study protocol for a randomized controlled trial.,"Background: The unified protocol for the transdiagnostic treatment of emotional disorders is a promising treatment approach that could be applicable to a broad range of mental disorders, including depressive, anxiety, trauma-related, and obsessive-compulsive disorders. However, no randomized controlled trial has been conducted to verify the efficacy of the unified protocol on the heterogeneous clinical population with depressive and anxiety disorders. Methods/design: The trial was designed as a single-center, assessor-blinded, randomized, 20-week, parallel-group superiority study in order to compare the efficacy of the combination of unified protocol and treatment-as-usual versus waiting-list with treatment-as-usual for patients with depressive and/or anxiety disorders. The primary outcome was depression at 21 weeks, assessed by the 17-item version of the GRID-Hamilton Rating Scale for Depression. Estimated minimum sample size was 27 participants in each group. We will also examine the treatment mechanisms, treatment processes, and neuropsychological correlates. Discussion: The results of this study will clarify the efficacy of the unified protocol for depressive and anxiety disorders, and the treatment mechanism, process, and neurological correlates for the effectiveness of the unified protocol. If its efficacy can be confirmed, the unified protocol may be of high clinical value for Japan, a country in which cognitive behavioral treatment has not yet been widely adopted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ito, Masaya; Okumura, Yasuyuki; Horikoshi, Masaru; Kato, Noriko; Oe, Yuki; Miyamae, Mitsuhiro; Hirabayashi, Naotsugu; Kanie, Ayako; Nakagawa, Atsuo; Ono, Yutaka; Asukai, Ball, Barlow, Barlow, Barlow, Barlow, Barth, Beck, Bentley, Berking, Berking, Boswell, Boswell, Busner, Butler, Cammin-Nowak, Carl, Clark, Conklin, Cuijpers, de Ornelas Maia, Devilly, Duncan, Ehrenreich, Ellard, Ellard, Eysenck, Fairholme, Farchione, First, Fluckiger, Fonzo, Frank, Gelenberg, Glenn, Gloaguen, Goodman, Gould, Gould, Gould, Greenberg, Greenberg, Gros, Guy, Haby, Hamilton, Hofmann, Hofmann, Hogue, Holdsworth, Horvath, Hosokawa, Ikeda, Inada, Insel, Ito, Ito, Ito, Ito, Ito, Jonas, Joseph, Kawakami, Kazantzis, Keijsers, Kernis, Kessler, Kessler, Kojima, Koran, Krueger, Liebowitz, Mansell, Marks, Mausbach, McHugh, McIntosh, McManus, Meyer, Nakagawa, Nakagawa, Newby, Norman, Norton, Okumura, Ono, Porto, Primakoff, Rabin, Reinholt, Roll, Rosellini, Sado, Sado, Sauer-Zavala, Sauer-Zavala, Sharp, Shear, Shear, Sheehan, Singer, Stein, Tabuse, Taylor, Thabane, Vos, Watanabe, Watkins, Webb, Webb, Weiss, Wilamowska, Williams, Yoshida",2016.0,,0,1,
297,Thought Field Therapy (TFT) as a treatment for anxiety symptoms: a randomized controlled trial.,"To investigate whether thought field therapy (TFT) has an impact on anxiety symptoms in patients with a variety of anxiety disorders. Forty-five patients were randomized to either TFT (n = 23) or a waiting list (n = 22) condition. The wait-list group was reassessed and compared with the TFT group two and a half months after the initial evaluation. After the reassessment, the wait-list patients received treatment with TFT. All 45 patients were followed up one to two weeks after TFT treatment, as well as at three and 12 months after treatment. Patients with an anxiety disorder, mostly outpatients. TFT aims to influence the body's bioenergy field by tapping on specific points along energy meridians, thereby relieving anxiety and other symptoms. Symptom Checklist 90-Revised, Hospital Anxiety and Depression Scale, the Sheehan Disability Scale. Repeated-measures analysis of variance was used to compare the TFT and the wait-list group. The TFT group had a significantly better outcome on two measures of anxiety and one measure of function. Follow-up data for all patients taken together showed a significant decrease in all symptoms during the one to two weeks between the pretreatment and the post-treatment assessments. The significant improvement seen after treatment was maintained at the three- and 12-month assessments. The results suggest that TFT may have an enduring anxiety-reducing effect.",Irgens A.; Dammen T.; Nysæter TE.; Hoffart A.,,10.1016/j.explore.2012.08.002,0,1,
298,Cognitive reappraisal self-efficacy mediates the effects of individual cognitive-behavioral therapy for social anxiety disorder.,"To examine whether changes in cognitive reappraisal self-efficacy (CR-SE) mediate the effects of individually administered cognitive-behavioral therapy (I-CBT) for social anxiety disorder (SAD) on severity of social anxiety symptoms. A randomized controlled trial in which 75 adult patients (21-55 years of age; 53% male; 57% Caucasian) with a principal diagnosis of generalized SAD were randomly assigned to 16 sessions of I-CBT (n = 38) or a wait-list control (WL) group (n = 37). All patients completed self-report inventories measuring CR-SE and social anxiety symptoms at baseline and post-I-CBT/post-WL, and I-CBT completers were also assessed at 1-year posttreatment. Compared with WL, I-CBT resulted in greater increases in CR-SE and greater decreases in social anxiety. Increases in CR-SE during I-CBT mediated the effect of I-CBT on social anxiety. Gains achieved by patients receiving I-CBT were maintained 1-year posttreatment, and I-CBT-related increases in CR-SE were also associated with reduction in social anxiety at the 1-year follow-up. Increasing CR-SE may be an important mechanism by which I-CBT for SAD produces both immediate and long-term reductions in social anxiety.",Goldin PR.; Ziv M.; Jazaieri H.; Werner K.; Kraemer H.; Heimberg RG.; Gross JJ.,2012.0,10.1037/a0028555,0,1,
299,Cognitive behavioral group therapy vs phenelzine therapy for social phobia: 12-week outcome.,"This article presents results of the acute treatment phase of a 2-site study comparing cognitive behavioral group therapy (CBGT) and treatment with the monoamine oxidase inhibitor phenelzine sulfate for social phobia. One hundred thirty-three patients from 2 sites received 12 weeks of CBGT, phenelzine therapy, pill placebo administration, or educational-supportive group therapy (an attention-placebo treatment of equal credibility to CBGT). The ""allegiance effect,"" ie, the tendency for treatments to seem most efficacious in settings of similar theoretical orientation and less efficacious in theoretically divergent settings, was also examined by comparing responses to the treatment conditions at both sites: 1 known for pharmacological treatment of anxiety disorders and the other for cognitive behavioral treatment. After 12 weeks, phenelzine therapy and CBGT led to superior response rates and greater change on dimensional measures than did either control condition. However, response to phenelzine therapy was more evident after 6 weeks, and phenelzine therapy was also superior to CBGT after 12 weeks on some measures. There were few differences between sites, suggesting that these treatments can be efficacious at facilities with differing theoretical allegiances. After 12 weeks, both phenelzine therapy and CBGT were associated with marked positive response. Although phenelzine therapy was superior to CBGT on some measures, both were more efficacious than the control conditions. More extended cognitive behavioral treatment and the combination of modalities may enhance treatment effect.",Heimberg RG.; Liebowitz MR.; Hope DA.; Schneier FR.; Holt CS.; Welkowitz LA.; Juster HR.; Campeas R.; Bruch MA.; Cloitre M.; Fallon B.; Klein DF.,1998.0,,0,1,
300,Cognitive mediation of treatment change in social phobia.,"Ninety individuals with social phobia (social anxiety disorder) participated in a randomized controlled trial and completed cognitive-behavioral group therapy, exposure group therapy without explicit cognitive interventions, or a wait-list control condition. Both treatments were superior to the wait-list group in reducing social anxiety but did not differ from one another at posttest. Changes in estimated social cost mediated treatment changes in both treatment conditions from pre- to posttest. However, only participants who received cognitive-behavioral therapy showed continued improvement from posttest to 6-month follow-up, which was associated with a reduction of estimated social cost from pretest to posttest. These results suggest that cognitive intervention leads to better maintenance of treatment gains, which is mediated through changes in estimated social cost.",Hofmann SG.,2004.0,10.1037/0022-006X.72.3.393,0,1,
301,Dismantling cognitive-behavioral group therapy for social phobia.,"The efficacy of Heimberg's (1991) Cognitive-Behavioral Group Therapy (CBGT) [Unpublished manuscript] for social phobia has been demonstrated in several studies in recent years. However, little is known about the mechanisms underlying the treatment's success. In order to determine whether the cognitive restructuring component of CBGT is essential, this study compared CBGT to an exposure-based treatment without formal cognitive restructuring. A wait-list control was also included. In general, Ss in the active treatment conditions improved and control Ss did not improve on a variety of self-report, clinician, and behavioral measures. Limited evidence indicated that Ss in the non-cognitive treatment may have made somewhat greater gains on some measures. Although CBGT Ss reported more improvement than exposure-alone Ss in subjective anxiety during an individualized behavioral test at posttreatment, this difference disappeared at 6-month follow-up. Surprisingly, CBGT was less effective than in previous controlled trials, and possible reasons for this are discussed. Implications of the results for cognitive theory and cognitive-behavioral therapy for social phobia are addressed.",Hope DA.; Heimberg RG.; Bruch MA.,1995.0,,0,1,
302,Cognitive and Guided Mastery Therapies for Panic Disorder with Agoraphobia: 18-Year Long-Term Outcome and Predictors of Long-Term Change.,"In this study, we wished to compare the long-term outcome of (medication-free) panic disorder with agoraphobia patients randomized to cognitive or guided mastery therapy. Thirty-one (67.4%) of 46 patients who had completed treatment were followed up about 18 years after end of treatment. In the combined sample and using intent-to-follow-up analyses, there were large within-group effect sizes of -1.79 and -1.63 on the primary interview-based and self-report outcome measures of avoidance of situations when alone, and 56.5% no longer had a panic disorder and/or agoraphobia diagnosis. No outcome differences between the two treatments emerged. Guided mastery was associated with greater beneficial changes in catastrophic beliefs and self-efficacy. For two of five outcome measures, more reduction in panic-related beliefs about physical and mental catastrophes from pre- to post-treatment predicted lower level of anxiety from post-treatment to 18-year follow-up when the effect of treatment changes in (a) self-efficacy and (b) anxiety was controlled. However, for one of the outcome measures, this effect attenuated with time. Copyright © 2014 John Wiley & Sons, Ltd. The results suggest that the very-long-term outcome of both cognitive therapy and guided mastery therapy for agoraphobia is positive. The results support the role of catastrophic beliefs as mediator of change. The pattern of results suggests that learning processes other than catastrophic beliefs may be important for long-term outcome as well.",Hoffart A.; Hedley LM.; Svanøe K.; Sexton H.,,10.1002/cpp.1934,0,1,
303,Design challenges in transdiagnostic psychotherapy research: Comparing Transdiagnostic Behavior Therapy (TBT) to existing evidence-based psychotherapy in veterans with affective disorders.,"To address the limitations of disorder-specific approaches, newer transdiagnostic approaches to psychotherapy have been developed to provide a single treatment that is capable of addressing several, related disorders. However, the recruitment of multiple diagnoses presents many challenges to the traditional design of psychotherapy randomized controlled trials (RCTs). The goal of the manuscript is to present the challenges and rationale for designing a RCT for transdiagnostic treatment to inform and aid in the development of future investigations. A recently funded and ongoing RCT for Transdiagnostic Behavior Therapy (TBT) is used as an example to discuss the related design challenges. The TBT study involves the recruitment of 96 veteran participants with any of the following eight principal diagnoses: posttraumatic stress disorder, panic disorder, social anxiety disorder, obsessive compulsive disorder, generalized anxiety disorder, specific phobia, major depressive disorder, or persistent depressive disorder. Within the TBT study, participants will complete a semi-structured diagnostic interview and a series of transdiagnostic self-report measures to determine eligibility and assess baseline symptomatology. Qualifying participants will be randomized to TBT or control psychotherapy. Additional assessments will be completed at post-treatment and 6-month follow-up. Due to the transdiagnostic nature of the sample, adjustments to the recruitment and randomization procedures, selection of measures, selection of control psychotherapy, and analysis plan were required. These adjustments have implications to future trials on transdiagnostic psychotherapy protocols as well as future research in line with the transdiagnostic focus of the National Institute of Mental Health's Research Domain Criteria (RDoC) funding strategy.",Gros DF.,2015.0,10.1016/j.cct.2015.05.011,0,1,
304,Virtual reality in the treatment of generalized anxiety disorders.,"Generalized anxiety disorder (GAD) is a common anxiety disorder characterized by 6 months of ""excessive anxiety and worry"" about a variety of events and situations. Anxiety and worry are often accompanied by additional symptoms like restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension and disturbed sleep. GAD is usually treated with medications and/or psychotherapy. In particular, the two most promising treatments seem to be cognitive therapy and applied relaxation. In this study we integrated these approaches through the use of a biofeedback enhanced virtual reality (VR) system used both for relaxation and controlled exposure. Moreover, this experience is strengthened by the use of a mobile phone that allows patients to perform the virtual experience even in an outpatient setting. This paper describe the results of a controlled trial (NCT00602212) involving 20 GAD patients randomly assigned to the following groups: (1) the VR and Mobile group (VRMB) including biofeedback; (2) the VR and Mobile group (VRM) without biofeedback; (3) the waiting list (WL) group. The clinical data underlined that (a) VR can be used also in the treatment of GAD; (b) in a VR treatment, patients take advantage of a mobile device that delivers in an outpatient setting guided experiences, similar to the one experienced in VR.",Gorini A.; Pallavicini F.; Algeri D.; Repetto C.; Gaggioli A.; Riva G.,2010.0,,0,1,
305,EMDR for panic disorder with agoraphobia: comparison with waiting list and credible attention-placebo control conditions.,"In a randomized controlled trial, eye movement desensitization and reprocessing (EMDR) for panic disorder with agoraphobia (PDA) was compared with both waiting list and credible attention-placebo control groups. EMDR was significantly better than waiting list for some outcome measures (questionnaire, diary, and interview measures of severity of anxiety, panic disorder, and agoraphobia) but not for others (panic attack frequency and anxious cognitions). However, low power and, for panic frequency, floor effects may account for these negative results. Differences between EMDR and the attention-placebo control condition were not statistically significant on any measure, and, in this case, the effect sizes were generally small (eta2 = .00-.06), suggesting the poor results for EMDR were not due to lack of power. Because there are established effective treatments such as cognitive-behavior therapy for PDA, these data, unless contradicted by future research, indicate EMDR should not be the first-line treatment for this disorder.",Goldstein AJ.; de Beurs E.; Chambless DL.; Wilson KA.,2000.0,,0,1,
306,MBSR vs aerobic exercise in social anxiety: fMRI of emotion regulation of negative self-beliefs.,"Mindfulness-based stress reduction (MBSR) is thought to reduce emotional reactivity and enhance emotion regulation in patients with social anxiety disorder (SAD). The goal of this study was to examine the neural correlates of deploying attention to regulate responses to negative self-beliefs using functional magnetic resonance imaging. Participants were 56 patients with generalized SAD in a randomized controlled trial who were assigned to MBSR or a comparison aerobic exercise (AE) stress reduction program. Compared to AE, MBSR yielded greater (i) reductions in negative emotion when implementing regulation and (ii) increases in attention-related parietal cortical regions. Meditation practice was associated with decreases in negative emotion and social anxiety symptom severity, and increases in attention-related parietal cortex neural responses when implementing attention regulation of negative self-beliefs. Changes in attention regulation during MBSR may be an important psychological factor that helps to explain how mindfulness meditation training benefits patients with anxiety disorders.",Goldin P.; Ziv M.; Jazaieri H.; Hahn K.; Gross JJ.,2013.0,10.1093/scan/nss054,0,1,
307,Enhancing the population impact of collaborative care interventions: mixed method development and implementation of stepped care targeting posttraumatic stress disorder and related comorbidities after acute trauma.,"The objective of the study was to develop and implement a stepped collaborative care intervention targeting posttraumatic stress disorder (PTSD) and related comorbidities to enhance the population impact of early trauma-focused interventions. We describe the design and implementation of the Trauma Survivors Outcomes and Support study. An interdisciplinary treatment development team was composed of trauma surgical, clinical psychiatric and mental health services ""change agents"" who spanned the boundaries between frontline trauma center clinical care and acute care policy. Mixed method clinical epidemiologic and clinical ethnographic studies informed the development of PTSD screening and intervention procedures. Two hundred seven acutely injured trauma survivors with high early PTSD symptom levels were randomized into the study. The stepped collaborative care model integrated care management (i.e., posttraumatic concern elicitation and amelioration, motivational interviewing and behavioral activation) with cognitive behavioral therapy and pharmacotherapy targeting PTSD. The model was feasibly implemented by frontline acute care masters in social work and nurse practioner providers. Stepped care protocols targeting PTSD may enhance the population impact of early interventions developed for survivors of individual and mass trauma by extending the reach of collaborative care interventions to acute care medical settings and other nonspecialty posttraumatic contexts.",Zatzick D.; Rivara F.; Jurkovich G.; Russo J.; Trusz SG.; Wang J.; Wagner A.; Stephens K.; Dunn C.; Uehara E.; Petrie M.; Engel C.; Davydow D.; Katon W.,,10.1016/j.genhosppsych.2011.01.001,0,1,
308,One- and two-year prospective follow-up of cognitive behavior therapy or supportive psychotherapy.,"We followed up over 90% of 57 motor vehicle accident survivors, who completed a controlled comparison of cognitive behavioral therapy (CBT) to supportive psychotherapy (SUPPORT). One-year results showed a continued significant advantage on categorical diagnosis (PTSD or not) and structured interview measures (CAPS) for CBT over SUPPORT. Other measures generally showed the same results. At two years, we were able to follow-up only 75% of one-year completers. Although there continued to be arithmetic differences favoring CBT over SUPPORT, with these attenuated samples only differences on PTSD Checklist and Impact of Event Scale scores and in overall categorical diagnoses were significant. There was very modest improvement from end of treatment to the two-year follow-up.",Blanchard EB.; Hickling EJ.; Malta LS.; Freidenberg BM.; Canna MA.; Kuhn E.; Sykes MA.; Galovski TE.,2004.0,10.1016/S0005-7967(03)00201-8,0,1,
309,Virtual reality exposure in the treatment of panic disorder and agoraphobia: A controlled study.,"The main goal of this study was to offer data about the efficacy of virtual reality exposure (VRE) in the treatment of panic disorder with or without agoraphobia (PDA). The study was a between-subject design with three experimental conditions (VRE group, in vivo exposure [IVE] group and waiting-list [WL] group) and repeated measures (pre-treatment, post treatment and 12 month follow-up). The treatment programmes lasted 9 weekly sessions. Thirty-seven patients meeting DSM-IV criteria for PDA participated in this study. The improvement achieved using virtual exposure was superior to a WL condition and similar to that achieved using IVE. Our results support the efficacy of VRE in the treatment of PDA at short and long term. The advantages of VRE for the treatment of PDA regarding cost-benefit issues are described. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Botella, C; Garcia-Palacios, A; Villa, H; Banos, R. M; Quero, S; Alcaniz, M; Riva, G; Alcaniz, Anderson, Barlow, Barlow, Barlow, Barlow, Barlow, Banos, Bebbington, Beck, Borkovec, Botella, Botella, Botella, Botella, Botella, Clum, Conde, Di Nardo, Di Nardo, Difede, Echeburua, Emmelkamp, Garcia-Palacios, Garci-a-Palacios, Gould, Guy, Hofmann, Jang, Kendall, Klinger, Krijn, Marks, Marks, Marks, Marks, McFall, Moore, North, Rapee, Reiss, Rothbaum, Rothbaum, Rothbaum, Rothbaum, Salkovskis, Sandin, Sandin, Sandin, Schmidt, Shear, Shear, Telch, Villa, Vincelli, Vincelli, Wade, Wald, Wiederhold",2007.0,,0,1,
310,An Internet-based self-help treatment for fear of public speaking: a controlled trial.,"This study offers data about the efficacy of ""Talk to Me,"" an Internet-based telepsychology program for the treatment of fear of public speaking that includes the most active components in cognitive-behavior therapy (CBT) for social phobia (exposure and cognitive therapies). One hundred twenty-seven participants with social phobia were randomly assigned to three experimental conditions: (a) an Internet-based self-administered program; (b) the same program applied by a therapist; (c) a waiting-list control group. Results showed that both treatment conditions were equally efficacious. In addition, Talk to Me and the same treatment applied by a therapist were more efficacious than the waiting-list condition. Treatment gains were maintained at 1-year follow-up. The results from this study support the utility of Internet-delivered CBT programs in order to reach a higher number of people who could benefit from CBT. Internet-delivered CBT programs could also play a valuable role in the dissemination of CBT.",Botella C.; Gallego MJ.; Garcia-Palacios A.; Guillen V.; Baños RM.; Quero S.; Alcañiz M.,2010.0,10.1089/cyber.2009.0224,0,1,
311,Brief psychotherapy for posttraumatic stress disorders.,"A large-scale study of the effectiveness of psychotherapeutic methods for the treatment of posttraumatic stress disorders was conducted. The sample consisted of 112 persons suffering from serious disorders resulting from traumatic events (bereavement, acts of violence, and traffic accidents) that had taken place not more than 5 years before. Trauma desensitization, hypnotherapy, and psychodynamic therapy were tested for their effectiveness in comparison with a waiting-list control group. The results indicated that treated cases were significantly lower in trauma-related symptoms than the control group.",Brom D.; Kleber RJ.; Defares PB.,1989.0,,0,1,
312,Comparison of behavior therapy and cognitive behavior therapy in the treatment of generalized anxiety disorder.,"In a controlled clinical trial, 57 Ss meeting DSM-III-R criteria for generalized anxiety disorder, and fulfilling an additional severity criterion, were randomly allocated to cognitive behavior therapy (CBT), behavior therapy (BT), or a waiting-list control group. Individual treatment lasted 4-12 sessions; independent assessments were made before treatment, after treatment, and 6 months later, and additional follow-up data were collected after an interval of approximately 18 months. Results show a clear advantage for CBT over BT. A consistent pattern of change favoring CBT was evident in measures of anxiety, depression, and cognition. Ss were lost from the BT group, but there was no attrition from the CBT group. Treatment integrity was double-checked in England and in Holland, and special efforts were made to reduce error variance. Possible explanations for the superiority of CBT are discussed.",Butler G.; Fennell M.; Robson P.; Gelder M.,1991.0,,0,1,
313,Treatment of panic disorder via the Internet: a randomized trial of CBT vs. applied relaxation.,"A randomized trial was conducted of two different self-help programs for panic disorder (PD) on the Internet. After confirming the PD-diagnosis with an in-person structured clinical interview for DSM-IV (SCID) interview 22 participants were randomized to either applied relaxation (AR) or a multimodal treatment package based on cognitive behavioral therapy (CBT). Overall, the results suggest that Internet-administered self-help plus minimal therapist contact via e-mail has a significant medium to large effect (Cohen's d=0.71 for AR and d=0.42 for CBT). The results from this study generally provide evidence to support the continued use and development of Internet-distributed self-help programs.",Carlbring P.; Ekselius L.; Andersson G.,2003.0,,0,1,
314,Remote treatment of panic disorder: a randomized trial of internet-based cognitive behavior therapy supplemented with telephone calls.,"This study evaluated a 10-week Internet-based bibliotherapy self-help program with short weekly telephone calls for people suffering from panic disorder with or without agoraphobia. After the authors confirmed the diagnosis by administering the Structured Clinical Interview for DSM-IV by telephone, 60 participants were randomly assigned to either a wait-listed control group or a multimodal treatment package based on cognitive behavior therapy plus minimal therapist contact via e-mail. A 10-minute telephone call was made each week to support each participant. Total mean time spent on each participant during the 10 weeks was 3.9 hours. The participants were required to send in homework assignments before receiving the next treatment module. Analyses were conducted on an intention-to-treat basis, which included all randomly assigned participants. From pretreatment to posttreatment, all treated participants improved significantly on all measured dimensions (bodily interpretations, maladaptive cognitions, avoidance, general anxiety and depression levels, and quality of life). Treatment gains on self-report measures were maintained at the 9-month follow-up. A blind telephone interview after the end of treatment revealed that 77% of the treated patients no longer fulfilled the criteria for panic disorder, whereas all of the wait-listed subjects still suffered from it. This study provides evidence to support the use of treatment distributed via the Internet with the addition of short weekly telephone calls to treat panic disorder. Replication should be made to compare self-help and telephone treatment based on cognitive behavior methods with nonspecific interventions.",Carlbring P.; Bohman S.; Brunt S.; Buhrman M.; Westling BE.; Ekselius L.; Andersson G.,2006.0,10.1176/ajp.2006.163.12.2119,0,1,
315,"Individually-tailored, Internet-based treatment for anxiety disorders: A randomized controlled trial.","Previous studies on Internet-based treatment with minimal to moderate therapist guidance have shown promising results for a number of specific diagnoses. The aim of this study was to test a new approach to Internet treatment that involves tailoring the treatment according to the patient's unique characteristics and comorbidities. A total of 54 participants, regardless of specific anxiety diagnosis, were included after an in-person, semi-structured diagnostic interview and randomized to a 10 week treatment program or to a control group. Treatment consisted of a number of individually-prescribed modules in conjunction with online therapist guidance. Significant results were found for all dependent measures both immediately following treatment and at 1 and 2 year intervals. Mean between-group effect size including measures of anxiety, depression and quality of life was Cohen's d = 0.69 at post-treatment, while the mean within-group effect size was d = 1.15 at post-treatment and d = 1.13 and d = 1.04 at 1 and 2 year follow-up respectively. The tentative conclusion drawn from these results is that tailoring the Internet-based therapy can be a feasible approach in the treatment of anxiety in a homogeneous population.",Carlbring P.; Maurin L.; Törngren C.; Linna E.; Eriksson T.; Sparthan E.; Strååt M.; Marquez von Hage C.; Bergman-Nordgren L.; Andersson G.,2011.0,10.1016/j.brat.2010.10.002,0,1,
316,Group-delivered cognitive/exposure therapy for PTSD in women veterans: A randomized controlled trial.,"Objective: Group delivery of posttraumatic stress disorder (PTSD) treatment has several advantages, however group research is not comparable to individual trials. This study extends the group literature by improving methodology in examining the efficacy of a 3-module (cognitive, exposure, skills) group treatment for PTSD, establishes a format for the delivery of group exposure therapy, and compares 3 treatment modules within the group. Method: Eighty-six Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) women veterans were randomized to a 16-week, 3-member group treatment (Tx) or a waitlist (WL) condition. The primary (Clinician Administered PTSD Scale [CAPS]) and secondary (Medical Outcomes Study Short Form-36 [SF-36], Quality of Life Inventory [QOLI], and PTSD Checklist [PCL]) outcome measures were administered at baseline, post Tx/WL, and at 3- and 6-months post Tx (PCL additionally at pre/post for each treatment module). Results: PTSD symptoms significantly improved in Tx arm participants (p < .001, ES = 1.72; unit of analysis group: n = 14), as did mental and physical life functioning (SF-36; p < .001), and quality of life (QOLI; p < .001). The WL significantly improved on the SF-36 (mental; p = .04) and QOLI (p = .02). Clinical improvement (CAPS) in the Tx arm reflected a treatment response (>=10-point decrease) in 77% and loss of PTSD diagnosis (<45) in 52% of participants, comparable to individual prolonged exposure (PE) treatment. Finally, PCL scores significantly lowered in exposure and cognitive modules. Conclusions: This study supports the use of group format for PTSD with 3 modules using improved methodology, with a novel, 3-member group which allows repeated in-session weekly imaginal exposures. The results suggest future examination of group delivered PE. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Castillo, Diane T; Chee, Christine L; Nason, Erica; Keller, Jenna; C'de Baca, Janet; Qualls, Clifford; Fallon, Stephanie K; Haaland, Kathleen Y; Miller, Mark W; Keane, Terence M; Baldwin, Ball, Beck, Blake, Blanchard, Cahill, Castillo, Castillo, Castillo, Chard, Foa, Fontana, Frisch, Frisch, Gray, Jacobsberg, Keane, Lange, Lobbestael, Ramirez Basco, Resick, Schnurr, Schnurr, Shea, Shiner, Sloan, Spitzer, Ware, Weathers, Weathers, Yalom, Zlotnick",2016.0,,0,1,
317,An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse.,"This study compared the effectiveness of cognitive processing therapy for sexual abuse survivors (CPT-SA) with that of the minimal attention (MA) given to a wait-listed control group. Seventy-one women were randomly assigned to 1 of the 2 groups. Participants were assessed at pretreatment and 3 times during posttreatment: immediately after treatment and at 3-month and 1-year follow-up, using the Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale (D. Blake et al., 1995), the Beck Depression Inventory (A. T. Beck, R. A. Steer, & G. K. Brown, 1996), the Structured Clinical Interview for the DSM-IV (R. L. Spitzer, J. B. W. Williams, & M. Gibbon, 1995; M. B. First et al., 1995), the Dissociative Experiences Scale-II (E. M. Bernstein & F. W. Putnam, 1986), and the Modified PTSD Symptom Scale (S. A. Falsetti, H. S. Resnick, P. A. Resick, & D. G. Kilpatrick, 1993). Analyses suggested that CPT-SA is more effective for reducing trauma-related symptoms than is MA, and the results were maintained for at least 1 year.",Chard KM.,2005.0,10.1037/0022-006X.73.5.965,0,1,
318,Brief cognitive therapy for panic disorder: a randomized controlled trial.,"Cognitive therapy (CT) is a specific and highly effective treatment for panic disorder (PD). Treatment normally involves 12-15 1-hr sessions. In an attempt to produce a more cost-effective version, a briefer treatment that made extensive use of between-sessions patient self-study modules was created. Forty-three PD patients were randomly allocated to full CT (FCT), brief CT (BCT), or a 3-month wait list. FCT and BCT were superior to wait list on all measures, and the gains obtained in treatment were maintained at 12-month follow-up. There were no significant differences between FCT and BCT. Both treatments had large (approximately 3.0) and essentially identical effect sizes. BCT required 6.5 hr of therapist time, including booster sessions. Patients' initial expectation of therapy success was negatively correlated with posttreatment panic-anxiety. Cognitive measures at the end of treatment predicted panic-anxiety at 12-month follow-up.",Clark DM.; Salkovskis PM.; Hackmann A.; Wells A.; Ludgate J.; Gelder M.,1999.0,,0,1,
319,Cognitive therapy versus exposure and applied relaxation in social phobia: A randomized controlled trial.,"A new cognitive therapy (CT) program was compared with an established behavioral treatment. Sixty-two patients meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for social phobia were randomly assigned to CT, exposure plus applied relaxation (EXP = AR), or wait-list (WAIT). CT and EXP = AR were superior to WAIT on all measures. On measures of social phobia, CT led to greater improvement than did EXP = AR. Percentages of patients who no longer met diagnostic criteria for social phobia at posttreatment-wait were as follows: 84% in CT, 42% in EXP = AR, and 0% in WAIT. At the 1-year follow-up, differences in outcome persisted. In addition, patients in EXP = AR were more likely to have sought additional treatment. Therapist effects were small and nonsignificant. CT appears to be superior to EXP = AR in the treatment of social phobia.",Clark DM.; Ehlers A.; Hackmann A.; McManus F.; Fennell M.; Grey N.; Waddington L.; Wild J.,2006.0,10.1037/0022-006X.74.3.568,0,1,
320,Efficacy of a trauma-focused treatment approach for dental phobia: a randomized clinical trial.,"It has been hypothesized that treatment specifically focused on resolving memories of negative dental events might be efficacious for the alleviation of anxiety in patients with dental phobia. Thirty-one medication-free patients who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria of dental phobia were randomly assigned to either Eye Movement Desensitization and Reprocessing (EMDR) or a waitlist control condition. Dental anxiety was assessed using the Dental Anxiety Questionnaire (DAS), the Dental Fear Survey (DFS), a behavior test, and dental attendance at 1-yr of follow up. Eye Movement Desensitization and Reprocessing was associated with significant reductions of dental anxiety and avoidance behavior as well as in symptoms of post-traumatic stress disorder (PTSD). The effect sizes for the primary outcome measures were d = 2.52 (DAS) and d = 1.87 (DFS). These effects were still significant 3 months (d = 3.28 and d = 2.28, respectively) and 12 months (d = 3.75 and d = 1.79, respectively) after treatment. After 1 yr, 83.3% of the patients were in regular dental treatment (d = 3.20). The findings suggest that therapy aimed at processing memories of past dental events can be helpful for patients with dental phobia.",Doering S.; Ohlmeier MC.; de Jongh A.; Hofmann A.; Bisping V.,2013.0,10.1111/eos.12090,0,1,
321,Post-traumatic stress disorder in the context of terrorism and other civil conflict in Northern Ireland: randomised controlled trial.,"To evaluate the effectiveness of cognitive therapy for post-traumatic stress disorder related to terrorism and other civil conflict in Northern Ireland. Randomised controlled trial. Community treatment centre, Northern Ireland. 58 consecutive patients with chronic post-traumatic stress disorder (median 5.2 years, range 3 months to 32 years) mostly resulting from multiple traumas linked to terrorism and other civil conflict. Immediate cognitive therapy compared with a waiting list control condition for 12 weeks followed by treatment. Treatment comprised a mean of 5.9 sessions during 12 weeks and 2.0 sessions thereafter. Primary outcome measures were patients' scores for post-traumatic stress disorder (post-traumatic stress diagnostic scale) and depression (Beck depression inventory). The secondary outcome measure was scores for occupational and social functioning (work related disability, social disability, and family related disability) on the Sheehan disability scale. At 12 weeks after randomisation, immediate cognitive therapy was associated with significantly greater improvement than the waiting list control group in the symptoms of post-traumatic stress disorder (mean difference 9.6, 95% confidence interval 3.6 to 15.6), depression (mean difference 10.1, 4.8 to 15.3), and self reported occupational and social functioning (mean difference 1.3, 0.3 to 2.5). Effect sizes from before to after treatment were large: post-traumatic stress disorder 1.25, depression 1.05, and occupational and social functioning 1.17. No change was observed in the control group. Cognitive therapy is an effective treatment for post-traumatic stress disorder related to terrorism and other civil conflict. Current Controlled Trials ISRCTN16228473 [controlled-trials.com].",Duffy M.; Gillespie K.; Clark DM.,2007.0,10.1136/bmj.39021.846852.BE,0,1,
322,"Virtual reality exposure therapy for the treatment of posttraumatic stress disorder following September 11, 2001.","This preliminary study endeavored to evaluate the use of virtual reality (VR) enhanced exposure therapy for the treatment of posttraumatic stress disorder (PTSD) consequent to the World Trade Center attacks of September 11, 2001. Participants were assigned to a VR treatment (N = 13) or a waitlist control (N = 8) group and were mostly middle-aged, male disaster workers. All participants were diagnosed with PTSD according to DSM-IV-TR criteria using the Clinician-Administered PTSD Scale (CAPS). The study was conducted between February 2002 and August 2005 in offices located in outpatient buildings of a hospital campus. Analysis of variance showed a significant interaction of time by group (p < .01) on CAPS scores, with a between-groups posttreatment effect size of 1.54. The VR group showed a significant decline in CAPS scores compared with the waitlist group (p < .01). Our preliminary data suggest that VR is an effective treatment tool for enhancing exposure therapy for both civilians and disaster workers with PTSD and may be especially useful for those patients who cannot engage in imaginal exposure therapy.",Difede J.; Cukor J.; Jayasinghe N.; Patt I.; Jedel S.; Spielman L.; Giosan C.; Hoffman HG.,2007.0,,0,1,
323,A randomized controlled trial of cognitive-behavioral therapy for the treatment of PTSD in the context of chronic whiplash.,"Objectives: Whiplash-associated disorders (WAD) are common and involve both physical and psychological impairments. Research has shown that persistent posttraumatic stress symptoms are associated with poorer functional recovery and physical therapy outcomes. Trauma-focused cognitive-behavioral therapy (TFCBT) has shown moderate effectiveness in chronic pain samples. However, to date, there have been no clinical trials within WAD. Thus, this study will report on the effectiveness of TF-CBT in individuals meeting the criteria for current chronic WAD and posttraumatic stress disorder (PTSD). Method: Twenty-six participants were randomly assigned to either TF-CBT or a waitlist control, and treatment effects were evaluated at posttreatment and 6-month follow-up using a structured clinical interview, self-report questionnaires, and measures of physiological arousal and sensory pain thresholds. Results: Clinically significant reductions in PTSD symptoms were found in the TF-CBT group compared with the waitlist at post-assessment, with further gains noted at the follow-up. The treatment of PTSD was also associated with clinically significant improvements in neck disability, physical, emotional, and social functioning and physiological reactivity to trauma cues, whereas limited changes were found in sensory pain thresholds. Discussion: This study provides support for the effectiveness of TFCBT to target PTSD symptoms within chronic WAD. The finding that treatment of PTSD resulted in improvements in neck disability and quality of life and changes in cold pain thresholds highlights the complex and interrelating mechanisms that underlie both WAD and PTSD. Clinical implications of the findings and future research directions are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dunne, Rachael Louise; Kenardy, Justin; Sterling, Michele; Altman, Beck, Bisson, Blanchard, Bradley, Brennum, Bryant, Buitenhuis, Chesterton, Cohen, Edwards, Ehlers, Elliott, Fecteau, Field, First, Fischer, Foa, Freidenberg, Geuze, Goolkasian, Harvey, Heilman, Jaspers, Jenewein, Jensen, Jull, Kori, Kuch, Liberzon, Liedl, Liedl, Lovibond, Maercker, Maquet, Mcfarlane, Moher, Morris, Muller, Nederhand, Newman, Norman, Park, Pool, Schulz, Scott, Sharp, Shipherd, Smith, Soderlund, Spertus, Spitzer, Sterling, Sterling, Sterling, Sterling, Sterling, Sterling, Vernon, Vernon, Vernon, Visscher, Vlaeyen, Vlaeyen, Vlaeyen, Wald, Wald, Ware, Weiss, Wicksell, Ylinen",2012.0,,0,1,
324,Multiple Channel Exposure Therapy of PTSD: Impact of Treatment on Functioning and Resources.,"The present study examined whether female patients diagnosed with PTSD and comorbid panic attacks evidenced improvement in functioning following treatment with Multiple Channel Exposure Therapy (MCET). Based on several reviews, Sheehan and colleagues (1996) argue that, at minimum, three domains of functioning should be included when assessing disability: work impairment, social impairment, and family life/home responsibilities. Thus, participants treated with MCET and control participants were compared on measures of satisfaction with, resources for and quality of work, social life and, family at baseline and at 12 weeks (posttreatment for, the treatment condition). In addition, the treatment group was followed and assessed at 3 months and 6 months to examine further changes in functioning. It was expected that the treatment group would exhibit greater improvement in social functioning and material and emotional resources than control participants. It was also expected that the treatment group would evidence continued improvement in these areas at follow-up assessments. The treatment and control conditions evidenced improvement in work, marital, economic, and overall adjustment from pretreatment to posttreatment, and did not differ. In addition, the treatment group evidenced continued improvement in work, marital, economic, and overall adjustment from pretreatment to 3-month follow-up and from pretreatment to 6-month follow-up. The treatment group evidenced the most consistent amount of change on parental functioning, evidencing improvement among all assessment points. The treatment and control conditions reported having fewer overall family resources than did a normative sample; however, there was a trend for the treatment group to evidence improvement in time for self between the pretreatment and the 6-month follow-up assessment. Otherwise, neither group reported change in basic needs, money, time for self, time for family, or overall family resources at any assessment point. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Falsetti, Sherry A; Erwin, Brigette A; Resnick, Heidi S; Davis, Joanne; Combs-Lane, Amy M; Barlow, Blake, Brady, Brown, Byrne, Dancu, Deykin, DiNardo, Dunst, Erwin, Falsetti, Foa, Frueh, Jordan, Keane, Kessler, Kimerling, King, King, King, King, Leon, Malik, Marks, Niles, Resick, Resick, Sheehan, Spitzer, van Horn, Wagner, Weathers, Weissman, Weissman, Zatzick, Zatzick; Taylor, Steven [Ed]",2004.0,,0,1,
325,Long term follow-up of agoraphobics treated by brief intensive group cognitive behavioural therapy.,"This study reports the long term efficacy of a brief intensive (2 days) group cognitive behavioural programme for the treatment of agoraphobia with panic attacks. A total of 97 patients was included in the study. Seventy-four patients were in the treated group and 23 were on the waiting list control group. The Fear Questionnaire (FQ), Fear Survey Schedule (FSS), Maudsley Personality Inventory (MPI), the Hostility and Direction of Hostility Questionnaire (HDHQ) and a clinical assessment based on structured interview to assess current levels of functioning were used as dependent measures. The results show that patients in the treated group show significant improvement on FSS and FQ when compared with the patients in the control group. Clinical rating shows that 85% of the patients were either symptom free or their symptoms had been reduced and these effects of treatment were shown to be maintained at follow-up which was on average 1 year after the treatment.",Evans L.; Holt C.; Oei TP.,1991.0,10.3109/00048679109062635,0,1,
326,Eye movement desensitization and reprocessing treatment for panic disorder: a controlled outcome and partial dismantling study.,"Forty-three outpatients with DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders, 3rd Ed., revised; American Psychiatric Association, 1987) panic disorder were randomly assigned to receive 6 sessions of eye movement desensitization and reprocessing (EMDR), the same treatment but omitting the eye movement, or to a waiting list. Posttest comparisons showed EMDR to be more effective in alleviating panic and panic-related symptoms than the waiting-list procedure. Compared with the same treatment without the eye movement, EMDR led to greater improvement on 2 of 5 primary outcome measures at posttest. However, EMDR's advantages had dissipated 3 months after treatment, thereby failing to firmly support the usefulness of the eye movement component in EMDR treatment for panic disorder.",Feske U.; Goldstein AJ.,1997.0,,0,1,
327,"A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims.","Ninety-six female assault victims with chronic posttraumatic stress disorder (PTSD) were randomly assigned to 4 treatment conditions: prolonged exposure (PE), stress inoculation training (SIT), combined treatment (PE-SIT), or wait-list control (WL). Treatment consisted of 9 twice-weekly, individual sessions. Independent evaluations were conducted at pretreatment; posttreatment; and 3-, 6-, and 12-month follow-ups. All 3 active treatments reduced severity of PTSD and depression compared with WL but did not differ significantly from each other, and these gains were maintained throughout the follow-up period. However, in the intent-to-treat sample, PE was superior to SIT and PE-SIT on posttreatment anxiety and global social adjustment at follow-up and had larger effect sizes on PTSD severity, depression, and anxiety. SIT and PE-SIT did not differ significantly from each other on any outcome measure.",Foa EB.; Dancu CV.; Hembree EA.; Jaycox LH.; Meadows EA.; Street GP.,1999.0,,0,1,
328,A test of behavioral family therapy to augment exposure for combat-related posttraumatic stress disorder.,"This study tested a family-based skills-building intervention in veterans with chronic combat-related posttraumatic stress disorder (PTSD). Veterans and a family member were randomly assigned to 1 of 3 conditions: (a) waiting list, (b) 18 sessions of twice-weekly exposure therapy, or (c) 18 sessions of twice-weekly exposure therapy followed by 16 sessions of behavioral family therapy (BFT). Participation in exposure therapy reduced PTSD positive symptoms (e.g., reexperiencing and hyperarousal) but not PTSD negative symptoms. Positive symptom gains were maintained at 6-month follow-up. However, participation in BFT had no additional impact on PTSD symptoms.",Glynn SM.; Eth S.; Randolph ET.; Foy DW.; Urbaitis M.; Boxer L.; Paz GG.; Leong GB.; Firman G.; Salk JD.; Katzman JW.; Crothers J.,1999.0,,0,1,
329,Psychological treatment for panic disorder with agoraphobia: a randomized controlled trial to examine the role of therapist-guided exposure in situ in CBT.,"Cognitive-behavioral therapy (CBT) is a first-line treatment for panic disorder with agoraphobia (PD/AG). Nevertheless, an understanding of its mechanisms and particularly the role of therapist-guided exposure is lacking. This study was aimed to evaluate whether therapist-guided exposure in situ is associated with more pervasive and long-lasting effects than therapist-prescribed exposure in situ. A multicenter randomized controlled trial, in which 369 PD/AG patients were treated and followed up for 6 months. Patients were randomized to 2 manual-based variants of CBT (T+/T-) or a wait-list control group (WL; n = 68) and were treated twice weekly for 12 sessions. CBT variants were identical in content, structure, and length, except for implementation of exposure in situ: In the T+ variant (n = 163), therapists planned and supervised exposure in situ exercises outside the therapy room; in the T- group (n = 138), therapists planned and discussed patients' in situ exposure exercises but did not accompany them. Primary outcome measures were (a) Hamilton Anxiety Scale, (b) Clinical Global Impression, (c) number of panic attacks, and (d) agoraphobic avoidance (Mobility Inventory). For T+ and T- compared with WL, all outcome measures improved significantly with large effect sizes from baseline to post (range = -0.5 to -2.5) and from post to follow-up (range = -0.02 to -1.0). T+ improved more than T- on the Clinical Global Impression and Mobility Inventory at post and follow-up and had greater reduction in panic attacks during the follow-up period. Reduction in agoraphobic avoidance accelerated after exposure was introduced. A dose-response relation was found for Time × Frequency of Exposure and reduction in agoraphobic avoidance. Therapist-guided exposure is more effective for agoraphobic avoidance, overall functioning, and panic attacks in the follow-up period than is CBT without therapist-guided exposure. Therapist-guided exposure promotes additional therapeutic improvement--possibly mediated by increased physical engagement in feared situations--beyond the effects of a CBT treatment in which exposure is simply instructed.",Gloster AT.; Wittchen HU.; Einsle F.; Lang T.; Helbig-Lang S.; Fydrich T.; Fehm L.; Hamm AO.; Richter J.; Alpers GW.; Alpers GW.; Gerlach AL.; Ströhle A.; Kircher T.; Deckert J.; Zwanzger P.; Höfler M.; Arolt V.,2011.0,10.1037/a0023584,0,1,
330,"Shame, guilt, and posttraumatic stress disorder in adult survivors of childhood sexual abuse at risk for human immunodeficiency virus: Outcomes of a randomized clinical trial of group psychotherapy treatment.","This study evaluated the effectiveness of group psychotherapy in reducing levels of shame and guilt in adult survivors of childhood sexual abuse at risk for HIV, and whether such reductions would mediate the effects of treatment on posttraumatic stress disorder (PTSD) symptoms. One hundred sixty-six women were randomized into 3 conditions: a trauma-focused group, a present-focused group, and a waitlist group. Women received 6 months of treatment and were assessed at pretreatment (T1), immediately posttreatment (T2), and 6 months posttreatment (T3). Both treatment conditions resulted in reduced shame and guilt. The treatment effect on PTSD symptoms was mediated by changes in shame, but it was not associated with changes in guilt. These findings suggest that, when treating childhood sexual abuse survivors' PTSD, it is important to address the negative self-appraisals, such as shame, that commonly accompany such symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ginzburg, Karni; Butler, Lisa D; Giese-Davis, Janine; Cavanaugh, Courtenay E; Neri, Eric; Koopman, Cheryl; Classen, Catherine C; Spiegel, David; Andrews, Baron, Chard, Classen, Classen, Clements, Coffey, Farber, Feiring, Feiring, Gibson, Ginzburg, Hook, Kraemer, Kraemer, Kraemer, Kraemer, Kubany, Leskela, McMillen, Rahm, Rodriguez, Sikkema, Spiegel, Street, Swan, Tangney, Ullman, Weathers, Weathers, Wilson, Yalom, Zlotnick",2009.0,,0,1,
331,Effectiveness of eye movement desensitization and reprocessing treatment in post-traumatic stress disorder after childbirth: a randomized controlled trial protocol.,,George A.; Thilly N.; Rydberg JA.; Luz R.; Spitz E.,2013.0,10.1111/aogs.12132,0,1,
332,Nature adventure rehabilitation for combat-related posttraumatic chronic stress disorder: A randomized control trial.,"Chronic combat-related posttraumatic stress disorder (CR-PTSD) is a condition with many treatment barriers. Nature Adventure Rehabilitation (NAR) as a second line or as a supplemental intervention has the potential to overcome some of these barriers and incorporate aspects of successful treatment modalities for PTSD within an experiential learning paradigm. In a pre-post controlled trial, CR-PTSD veterans (n = 22) underwent a 1-year NAR intervention compared to a waiting list (WL) control group (n = 20). Posttraumatic symptoms (PTS), depression, functional problems, quality of life, perceived control over illness (PCI) and hope were measured by self report measures. PTS, emotional and social quality of life, PCI, hope and functioning improved significantly. Change in PTS was contingent upon change in PCI. The current study is the first to present NAR as a promising supplemental intervention for chronic CR-PTSD. NAR seems to work through a process of behavioral activation, desensitization, gradual exposure to anxiety evoking situations and gaining control over symptomatology. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gelkopf, Marc; Hasson-Ohayon, Ilanit; Bikman, Menashe; Kravetz, Shlomo; Affleck, Antonovsky, Axelrod, Banaka, Beck, Benotsch, Berger, Berger, Berger, Berman, Bisson, Bleich, Bollinger, Britvic, Bryant, Card, Cardena, Cason, Chakravorty, Chemtob, Crisp, Davidson, Dunn, Ewert, Figley, Foa, Foy, Frazier, Frazier, Frueh, Frueh, Frueh, Frueh, Gass, Gelkopf, Gelkopf, Gelkopf, Gelkopf, Gillis, Glover, Glover, Gold, Hasson-Ohayon, Hasson-Ohayon, Helblig, Hembree, Herbert, Hill, Hoge, Hussain, Hyer, Jakupcak, Jerstad, Katz, Keane, Kelley, Kravetz, Kravetz, Kubany, Kulka, Kushner, Lakshmi, Linden, Makler, Marks, Mason, McDonagh-Coyle, Nadler, Poole, Rauch, Roe, Roe, Samuel, Schnurr, Silver, Snyder, Solomon, Solomon, Southwick, Southwick, Van der Kolk, Van Minnen, Wagner, Walsh, Yoder",2013.0,,0,1,
333,Nature adventure rehabilitation for combat-related posttraumatic chronic stress disorder: a randomized control trial.,"Chronic combat-related posttraumatic stress disorder (CR-PTSD) is a condition with many treatment barriers. Nature Adventure Rehabilitation (NAR) as a second line or as a supplemental intervention has the potential to overcome some of these barriers and incorporate aspects of successful treatment modalities for PTSD within an experiential learning paradigm. In a pre-post controlled trial, CR-PTSD veterans (n=22) underwent a 1-year NAR intervention compared to a waiting list (WL) control group (n=20). Posttraumatic symptoms (PTS), depression, functional problems, quality of life, perceived control over illness (PCI) and hope were measured by self report measures. PTS, emotional and social quality of life, PCI, hope and functioning improved significantly. Change in PTS was contingent upon change in PCI. The current study is the first to present NAR as a promising supplemental intervention for chronic CR-PTSD. NAR seems to work through a process of behavioral activation, desensitization, gradual exposure to anxiety evoking situations and gaining control over symptomatology.",Gelkopf M.; Hasson-Ohayon I.; Bikman M.; Kravetz S.,2013.0,10.1016/j.psychres.2013.01.026,0,1,
334,Effectiveness of a counseling intervention after a traumatic childbirth: a randomized controlled trial.,"Adverse childbirth experiences can evoke fear and overwhelming anxiety for some women and precipitate posttraumatic stress disorder. The objective of this study was to assess a midwife-led brief counseling intervention for postpartum women at risk of developing psychological trauma symptoms. Of 348 women screened for trauma symptoms, 103 met inclusion criteria and were randomized into an intervention (n = 50) or a control (n = 53) group. The intervention group received face-to-face counseling within 72 hours of birth and again via telephone at 4 to 6 weeks postpartum. Main outcome measures were posttraumatic stress symptoms, depression, self-blame, and confidence about a future pregnancy. At 3-month follow-up, intervention group women reported decreased trauma symptoms, low relative risk of depression, low relative risk of stress, and low feelings of self-blame. Confidence about a future pregnancy was higher for these women than for control group women. Three intervention group women compared with 9 control group women met the diagnostic criteria for posttraumatic stress disorder at 3 months postpartum, but this result was not statistically significant. A high prevalence of postpartum depression and trauma symptoms occurred after childbirth. Although most women improved over time, the intervention markedly affected participants' trajectory toward recovery compared with women who did not receive counseling. A brief, midwife-led counseling intervention for women who report a distressing birth experience was effective in reducing symptoms of trauma, depression, stress, and feelings of self-blame. The intervention is within the scope of midwifery practice, caused no harm to participants, was perceived as helpful, and enhanced women's confidence about a future pregnancy.",Gamble J.; Creedy D.; Moyle W.; Webster J.; McAllister M.; Dickson P.,2005.0,10.1111/j.0730-7659.2005.00340.x,0,1,
335,The effects of a Dutch version of an Internet-based treatment program for fear of public speaking: A controlled study.,"The present research is a randomized controlled trial in which the effects of a Dutch version of ""Talk to me"", an Internet-based cognitive-behavioral treatment for fear of public speaking were investigated. Forty one participants with a formal diagnosis of social phobia were assigned at random to either ""Talk to me"", or a waiting list control group. The group treated by an Internet-based cognitive-behavioral treatment resulted in significant improvement from pre-test to pos-test on ail social phobia measures and in social and work impairment. ""Talk to me"" was significantly more effective than the control group on a number of measures: fear and avoidance to the target behaviors, fear of public speaking and work impairment. Regarding to the effect size (Cohen-d) for the measures related to social phobia the Internet treatment had a high within-group (d = 1.13) and between-groups effect size (d = .86). Results achieved with the ""Talk to me"" program are comparable to results of face-to-face treatment of social phobia. Finally, it is important to emphasize that ""Talk to me"" was well accepted by the participants. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gallego, Maria Jose; Gerardus Emmelkamp, Paul Maria; van der Kooij, Marjoke; Mees, Hilde; Andersson, Bados, Beidel, Berger, Botella, Botella, Botella, Botella, Brown, Carlbring, Echeburua, Emmelkamp, Gallego, Gallego, Gallego, Gallego, Gallego, Gallego, Gallego, Gonzalez-Castro, Guy, Hofmann, Lange, Leary, Marks, Melville, Miranda, Montero, Olivares, Paul, Powers, Ramos-Alvarez, Sue, Titov, Titov, Watson",2011.0,,0,1,
336,Telemedicine-based collaborative care for posttraumatic stress disorder: a randomized clinical trial.,"Posttraumatic stress disorder (PTSD) is prevalent, persistent, and disabling. Although psychotherapy and pharmacotherapy have proven efficacious in randomized clinical trials, geographic barriers impede rural veterans from engaging in these evidence-based treatments. To test a telemedicine-based collaborative care model designed to improve engagement in evidence-based treatment of PTSD. The Telemedicine Outreach for PTSD (TOP) study used a pragmatic randomized effectiveness trial design with intention-to-treat analyses. Outpatients were recruited from 11 Department of Veterans Affairs (VA) community-based outpatient clinics serving predominantly rural veterans. Inclusion required meeting diagnostic criteria for current PTSD according to the Clinician-Administered PTSD Scale. Exclusion criteria included receiving PTSD treatment at a VA medical center or a current diagnosis of schizophrenia, bipolar disorder, or substance dependence. Two hundred sixty-five veterans were enrolled from November 23, 2009, through September 28, 2011, randomized to usual care (UC) or the TOP intervention, and followed up for 12 months. Off-site PTSD care teams located at VA medical centers supported on-site community-based outpatient clinic providers. Off-site PTSD care teams included telephone nurse care managers, telephone pharmacists, telepsychologists, and telepsychiatrists. Nurses conducted care management activities. Pharmacists reviewed medication histories. Psychologists delivered cognitive processing therapy via interactive video. Psychiatrists supervised the team and conducted interactive video psychiatric consultations. The primary outcome was PTSD severity as measured by the Posttraumatic Diagnostic Scale. Process-of-care outcomes included medication prescribing and regimen adherence and initiation of and adherence to cognitive processing therapy. During the 12-month follow-up period, 73 of the 133 patients randomized to TOP (54.9%) received cognitive processing therapy compared with 16 of 132 randomized to UC (12.1%) (odds ratio, 18.08 [95% CI, 7.96-41.06]; P < .001). Patients in the TOP arm had significantly larger decreases in Posttraumatic Diagnostic Scale scores (from 35.0 to 29.1) compared with those in the UC arm (from 33.5 to 32.1) at 6 months (β = -3.81; P = .002). Patients in the TOP arm also had significantly larger decreases in Posttraumatic Diagnostic Scale scores (from 35.0 to 30.1) compared with those in the UC arm (from 33.5 to 31.7) at 12 months (β = -2.49; P=.04). There were no significant group differences in the number of PTSD medications prescribed and adherence to medication regimens were not significant. Attendance at 8 or more sessions of cognitive processing therapy significantly predicted improvement in Posttraumatic Diagnostic Scale scores (β = -3.86 [95% CI, -7.19 to -0.54]; P = .02) and fully mediated the intervention effect at 12 months. Telemedicine-based collaborative care can successfully engage rural veterans in evidence-based psychotherapy to improve PTSD outcomes. clinicaltrials.gov Identifier: NCT00821678.",Fortney JC.; Pyne JM.; Kimbrell TA.; Hudson TJ.; Robinson DE.; Schneider R.; Moore WM.; Custer PJ.; Grubbs KM.; Schnurr PP.,2015.0,10.1001/jamapsychiatry.2014.1575,0,1,
337,Randomized clinical trial comparing affect regulation and supportive group therapies for victimization-related PTSD with incarcerated women.,"Traumatic victimization and associated problems with posttraumatic stress disorder (PTSD) and affect dysregulation are prevalent among incarcerated women, but there is limited evidence to support psychotherapeutic interventions for these problems in this underserved population. A group psychotherapy designed to enhance affect regulation without trauma memory processing-Trauma Affect Regulation: Guide for Education and Therapy (TARGET)-was compared to a supportive group therapy (SGT) in a randomized clinical trial with 72 incarcerated women with full or partial PTSD. Both interventions achieved statistically significant reductions in PTSD and associated symptom severity and increased self-efficacy. Dropout rates for both interventions were low (<5%). TARGET was more effective than SGT in increasing sense of forgiveness toward others who have caused harm in the past. Group therapy that teaches affect regulation may enhance incarcerated women's ability to achieve affective resolution (forgiveness) while also reducing their victimization-related PTSD and associated symptoms. Experiential-focused supportive group therapy also may reduce victimization-related PTSD and associated symptoms. Both group therapy approaches warrant further study with this vulnerable population.",Ford JD.; Chang R.; Levine J.; Zhang W.,2013.0,10.1016/j.beth.2012.10.003,0,1,
338,The role of psychological flexibility in a self-help acceptance and commitment therapy intervention for psychological distress in a randomized controlled trial.,"This study examined the role of psychological flexibility, as a risk factor and as a process of change, in a self-help Acceptance and Commitment Therapy (ACT) intervention for adults with mild to moderate depression and anxiety. Participants were randomized to the self-help programme with e-mail support (n=250), or to a waiting list control group (n=126). All participants completed measures before and after the intervention to assess depression, anxiety and psychological flexibility. Participants in the experimental condition also completed these measures during the intervention (after three and six weeks) and at a three-month follow-up. With multilevel modelling, it was shown that the effects of the intervention on psychological distress were stronger for participants with higher levels of psychological flexibility. Furthermore, our study showed that improved psychological flexibility mediated the effects of the ACT intervention. With a cross-lagged panel design, it was shown that especially improvements in psychological flexibility in the last three sessions of the intervention were important for further reductions in anxiety. To conclude, our study showed the importance of targeting psychological flexibility during an ACT intervention for a reduction in depressive and anxiety symptoms.",Fledderus M.; Bohlmeijer ET.; Fox JP.; Schreurs KM.; Spinhoven P.,2013.0,10.1016/j.brat.2012.11.007,0,1,
339,Multiple Channel Exposure Therapy of PTSD: Impact of Treatment on Functioning and Resources.,"Posttraumatic stress disorder (PTSD) is associated with significant impairment in functioning. Although improvement in PTSD symptoms following cognitive-behavioral treatment of PTSD has been demonstrated in numerous studies, improvement in functioning has yet to be fully explored. In addition to measures of PTSD, measures of functioning may help to identify more reliably broad-based change following cognitive- behavioral treatment of PTSD. A few studies have demonstrated short-term improvement in functioning following pharmacotherapy of PTSD. The current study is the first investigation to examine short- and long-term changes in adjustment and resources following cognitive-behavioral treatment of PTSD. 24 of 47 women with anxiety and related symptoms subsequent to exposure to at least one traumatic event were randomly assigned to 12 weekly group sessions (90 min each) of Multiple Channel Exposure Therapy (MCET). Ss' ethnicity was noted. Findings suggest that, immediately following, female trauma victims with PTSD and comorbid panic attacks reported improvement in work, marital, economic, and overall adjustment. In addition, 3 and 6 months following MCET, patients continued to experience improvement in work, marital, economic, parental, and overall adjustment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Falsetti, Sherry A; Erwin, Brigette A; Resnick, Heidi S; Davis, Joanne; Combs-Lane, Amy M; Barlow, Blake, Brady, Brown, Byrne, Dancu, Deykin, DiNardo, Dunst, Erwin, Falsetti, Foa, Frueh, Jordan, Keane, Kessler, Kimerling, King, King, King, King, Leon, Malik, Marks, Niles, Resick, Resnick, Sheehan, Spitzer, Van Horn, Wagner, Weathers, Weissman, Weissman, Zatzick, Zatzick",2003.0,,0,1,
340,Depression does not affect the treatment outcome of CBT for panic and agoraphobia: results from a multicenter randomized trial.,"Controversy surrounds the questions whether co-occurring depression has negative effects on cognitive-behavioral therapy (CBT) outcomes in patients with panic disorder (PD) and agoraphobia (AG) and whether treatment for PD and AG (PD/AG) also reduces depressive symptomatology. Post-hoc analyses of randomized clinical trial data of 369 outpatients with primary PD/AG (DSM-IV-TR criteria) treated with a 12-session manualized CBT (n = 301) and a waitlist control group (n = 68). Patients with comorbid depression (DSM-IV-TR major depression, dysthymia, or both: 43.2% CBT, 42.7% controls) were compared to patients without depression regarding anxiety and depression outcomes (Clinical Global Impression Scale [CGI], Hamilton Anxiety Rating Scale [HAM-A], number of panic attacks, Mobility Inventory [MI], Panic and Agoraphobia Scale, Beck Depression Inventory) at post-treatment and follow-up (categorical). Further, the role of severity of depressive symptoms on anxiety/depression outcome measures was examined (dimensional). Comorbid depression did not have a significant overall effect on anxiety outcomes at post-treatment and follow-up, except for slightly diminished post-treatment effect sizes for clinician-rated CGI (p = 0.03) and HAM-A (p = 0.008) when adjusting for baseline anxiety severity. In the dimensional model, higher baseline depression scores were associated with lower effect sizes at post-treatment (except for MI), but not at follow-up (except for HAM-A). Depressive symptoms improved irrespective of the presence of depression. Exposure-based CBT for primary PD/AG effectively reduces anxiety and depressive symptoms, irrespective of comorbid depression or depressive symptomatology.",Emmrich A.; Beesdo-Baum K.; Gloster AT.; Knappe S.; Höfler M.; Arolt V.; Deckert J.; Gerlach AL.; Hamm A.; Kircher T.; Lang T.; Richter J.; Ströhle A.; Zwanzger P.; Wittchen HU.,2012.0,10.1159/000335246,0,1,
341,Cognitive self-therapy for chronic depression and anxiety: a multi-centre randomized controlled study.,"Non-professional treatment programmes are presumed to relieve the extensive need for care of anxiety and depression disorders. This study investigates the effectiveness of cognitive self- therapy (CST) in the treatment of depression or generalized anxiety disorder. Patients (n=151) were randomized to receive CST or treatment as usual (TAU) in a trial lasting for 18 months, measuring symptoms (SCL-90; main outcome), social functions, quality of life and utilization of care. Patients in both conditions improved significantly, but no difference was found between the conditions. Reduction of symptoms, improvement of social functions and medical utilization were maintained at the end of the 18 months. Medical care utilization (therapist contact and hospitalization) was lower for CST than for TAU. No suicides occurred. Cognitive self-therapy is likely to decrease the need for care of chronic depression and anxiety disorders, but it has not been proven to be more effective than treatment as usual.",den Boer PC.; Wiersma D.; Ten Vaarwerk I.; Span MM.; Stant AD.; Van den Bosch RJ.,2007.0,10.1017/S0033291706009214,0,1,
342,Cognitive behavior therapy versus supportive therapy in social phobia: a randomized controlled trial.,"The efficacy of cognitive behaviour therapy (CBT) in social phobia has been demonstrated in several controlled trials and meta-analyses, but no comparison of CBT with supportive therapy (ST) can be found in the literature. The aim of the trial was to study the effectiveness of CBT versus ST carried out 'as usual'. Sixty-seven DSM-4 social phobic patients (89% generalized subtype, most with avoidant personality) were randomly allocated into two groups. Group 1 (CBT) received 8 1-hour sessions of individual cognitive therapy (CT) for 6 weeks, followed by 6 2-hour sessions of social skills training (SST) in group weekly. Group 2 received ST for 12 weeks (6 half-hour sessions), then the patients were switched to CBT. All patients agreed not to take any medication during the whole trial. In group 1, 29 patients reached week 6, 27 reached week 12, and 24 weeks 36 and 60 (endpoint). In group 2, 29 patients reached week 6, 28 reached weeks 12 and 18, 26 week 24, and 23 reached weeks 48 and 72 (endpoint). At week 6, after CT, group 1 was better than group 2 on the main social phobia measure. At week 12, after SST, group 1 was better than group 2 on most of the measures and demonstrated a significantly higher rate of responders. This finding was replicated after switching group 2 to CBT. Sustained improvement was observed in both groups at follow-up. Compliance with abstinence from medication increased over time. CBT was more effective than ST and demonstrated long-lasting effects. This may suggest that social phobia management requires more than a simple and inexpensive psychological intervention.",Cottraux J.; Note I.; Albuisson E.; Yao SN.; Note B.; Mollard E.; Bonasse F.; Jalenques I.; Guérin J.; Coudert AJ.,,12382,0,1,
343,Imagery rehearsal for posttraumatic nightmares: a randomized controlled trial.,"One hundred twenty-four male Vietnam War veterans with chronic, severe posttraumatic stress disorder (PTSD) were randomly assigned to imagery rehearsal (n = 61) or a credible active comparison condition (n = 63) for the treatment of combat-related nightmares. There was pre-post change in overall sleep quality and PTSD symptoms for both groups, but not in nightmare frequency. Intent-to-treat analyses showed that veterans who received imagery rehearsal had not improved significantly more than veterans in the comparison condition for the primary outcomes (nightmare frequency and sleep quality), or for a number of secondary outcomes, including PTSD. Six sessions of imagery rehearsal delivered in group format did not produce substantive improvement in Vietnam War veterans with chronic, severe PTSD. Possible explanations for findings are discussed.",Cook JM.; Harb GC.; Gehrman PR.; Cary MS.; Gamble GM.; Forbes D.; Ross RJ.,2010.0,10.1002/jts.20569,0,1,
344,"Efficacy of abreactive ego state therapy for PTSD: trauma resolution, depression, and anxiety.","Using manualized abreactive Ego State Therapy (EST), 30 subjects meeting DSM-IV-TR and Clinician-Administered PTSD Scale (CAPS) criteria were exposed to either 5-6 hours of treatment or the Ochberg Counting Method (placebo) in a single session. EST emphasized repeated hypnotically activated abreactive ""reliving"" of the trauma and ego strengthening by the cotherapists. Posttreatment 1-month and 3-month follow-ups showed EST to be an effective treatment for PTSD. Using the Davidson Trauma Scale, Beck Depression II, and Beck Anxiety Scales, EST subjects showed significant positive effects from pretreatment levels at all posttreatment measurement periods in contrast to the placebo treatment. Most of the EST subjects responded and showed further improvement over time.",Christensen C.; Barabasz A.; Barabasz M.,2013.0,10.1080/00207144.2013.729386,0,1,
345,Predictors of clinical improvement in a randomized effectiveness trial for primary care patients with panic disorder.,"This study's aim was to prospectively examine and identify a model of demographic, clinical, and attitudinal variables that impact improvement among patients with panic disorder. Subjects were 232 primary care patients meeting criteria for DSM-IV panic disorder. Eligible patients were randomly assigned to a collaborative care intervention or to treatment as usual. Assessments occurred at 3-month intervals during the course of 1 year. In final multivariate logistic regression models, patients with higher anxiety sensitivity and higher neuroticism scores at baseline were less likely to show clinical improvement (using a criterion of 20 or less on the Anxiety Sensitivity Index) at 3 months. Those who were non-white, had higher anxiety sensitivity, and higher overall phobic avoidance at baseline were less likely to show clinical improvement at 12 months. A greater understanding of these predictors may help clinicians identify who is at greatest risk for persistent panic-related symptoms and to plan the intensity of interventions accordingly.",Chavira DA.; Stein MB.; Golinelli D.; Sherbourne CD.; Craske MG.; Sullivan G.; Bystritsky A.; Roy-Byrne PP.,2009.0,10.1097/NMD.0b013e3181b97d4d,0,1,
346,Treatment of panic disorder via the Internet: A randomized trial of a self-help program.,"This controlled study evaluated an Internet-delivered self-help program plus minimal therapist contact via e-mail for people suffering from panic disorder. Out of the 500 individuals screened using the self-administered diagnostic instrument Composite International Diagnostic Interview in shortened form (World Health Organization, 1999), 41 fulfilled the inclusion criteria. These participants (aged 21-51 yrs) were randomized to either treatment via the Internet or to a waiting-list control. The main components of the treatment were psychoeducation, breathing retraining, cognitive restructuring, interoceptive exposure, in vivo exposure, and relapse prevention. From pre- to posttest self-help, participants improved significantly more on almost all dimensions. The results from this experiment generally provide evidence for the continued use and development of self-help programs for panic disorder distributed via the Internet. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Carlbring, Per; Westling, Bengt E; Ljungstrand, Peter; Ekselius, Lisa; Andersson, Gerhard; Andrews, Barlow, Barlow, Beck, Beck, Borkovec, Botella, Chambless, Chambless, Clark, Clark, Clum, Di Nardo, Febbraro, Franklin, Frisch, Gould, Gould, Gould, Hecker, Horowitz, Jacobson, Joinson, Kessler, Lange, Lidren, Marks, Murphy, Oravec, Ost, Ost, Strom, Svanborg, Swinson, Tsao, Westling, Zuercher-White, Zuercher-White",2001.0,,0,1,
347,Treatment of social phobia: randomised trial of internet-delivered cognitive-behavioural therapy with telephone support.,"Although effective therapies for social phobia exist, many individuals refrain from seeking treatment owing to the embarrassment associated with help-seeking. Internet-based cognitive-behavioural self-help can be an alternative, but adherence is a problem. To evaluate a 9-week programme of internet-based therapy designed to increase treatment adherence by the addition of short weekly telephone calls, nine in all, with a total duration of 95 min. In a randomised controlled trial the effects of internet-based cognitive-behavioural therapy in the treatment group (n=29) were compared with a waiting-list control group (n=28). Compared with the control group the treated participants experienced greater reductions on measures of general and social anxiety, avoidance and depression. Adherence to treatment was high, with 93% finishing the complete treatment package. One year later all improvements were maintained. This study provides evidence to support the use of internet-based treatment supplemented by short, weekly telephone calls.",Carlbring P.; Gunnarsdóttir M.; Hedensjö L.; Andersson G.; Ekselius L.; Furmark T.,2007.0,10.1192/bjp.bp.105.020107,0,1,
348,Economic evaluation of a task-shifting intervention for common mental disorders in India.,"To carry out an economic evaluation of a task-shifting intervention for the treatment of depressive and anxiety disorders in primary-care settings in Goa, India. Cost-utility and cost-effectiveness analyses based on generalized linear models were performed within a trial set in 24 public and private primary-care facilities. Subjects were randomly assigned to an intervention or a control arm. Eligible subjects in the intervention arm were given psycho-education, case management, interpersonal psychotherapy and/or antidepressants by lay health workers. Subjects in the control arm were treated by physicians. The use of health-care resources, the disability of each subject and degree of psychiatric morbidity, as measured by the Revised Clinical Interview Schedule, were determined at 2, 6 and 12 months. Complete data, from all three follow-ups, were collected from 1243 (75.4%) and 938 (81.7%) of the subjects enrolled in the study facilities from the public and private sectors, respectively. Within the public facilities, subjects in the intervention arm showed greater improvement in all the health outcomes investigated than those in the control arm. Time costs were also significantly lower in the intervention arm than in the control arm, whereas health system costs in the two arms were similar. Within the private facilities, however, the effectiveness and costs recorded in the two arms were similar. Within public primary-care facilities in Goa, the use of lay health workers in the care of subjects with common mental disorders was not only cost-effective but also cost-saving.",Buttorff C.; Hock RS.; Weiss HA.; Naik S.; Araya R.; Kirkwood BR.; Chisholm D.; Patel V.,2012.0,10.2471/BLT.12.104133,0,1,
349,"A study demonstrating efficacy of a psychoanalytic psychotherapy for panic disorder: Implications for psychoanalytic research, theory, and practice.","Systematic research on psychoanalytic treatments has been limited by several factors, including a belief that clinical experience can demonstrate the effectiveness of psychoanalysis, rendering systematic research unnecessary, the view that psychoanalytic research would be difficult or impossible to accomplish, and a concern that research would distort the treatment being delivered. In recent years, however, many psychoanalysts have recognized the necessity of research in order to obtain a more balanced assessment of the role of psychodynamic psychotherapy and psychoanalysis in a contemporary treatment armamentarium, as well as to allow appropriate evaluation and potentially greater acceptance by the broader mental health and medical communities. In this context, studies were conducted of a psychodynamic treatment, Panic-Focused Psychodynamic Psychotherapy (PFPP), initially in an open trial and then in a randomized controlled trial (RCT) in comparison with a less active treatment, Applied Relaxation Training (ART; Cerny et al. 1984), for adults with primary DSM-IV panic disorder. The results of the RCT demonstrated the efficacy of PFPP in treating panic disorder, and also demonstrated that a psychoanalytic treatment can be systematically evaluated in a mode consistent with the principles of evidence-based medicine. Two specific features of the methodology, the development of the treatment manual and the operationalization of the adherence instrument, both core building blocks of contemporary psychotherapy outcome research, and their implications for psychoanalytic research are discussed in greater depth. The theoretical, clinical, and educational implications of the PFPP studies are elaborated, and suggestions are made for pursuing further outcome research of psychoanalytic treatments. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Busch, Fredric N; Milrod, Barbara L; Sandberg, Larry S; Arrindell, Bailey, Barlow, Beck, Blatt, Breuer, Bucci, Busch, Cerny, Clarkin, Craske, Deutsch, Fonagy, Freud, Gabbard, Gerber, Green, Green, Huber, Jimenez, Kernberg, Kernberg, Kernberg, Kleiner, Knekt, Leichsenring, Malan, Milrod, Parker, Rutherford, Shear, Shedler, Sheehan, Stein, Svartberg, Vinnars, Westen, Ost",2009.0,,0,1,
350,The relation between mindfulness and fear of negative evaluation over the course of cognitive behavioral therapy for social anxiety disorder.,"This study examined the relation between mindfulness and fear of negative evaluation over the course of nonmindfulness based cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD). We expected that higher levels of mindfulness would be associated with a more positive response to treatment. This study is a secondary report from a randomized controlled trial in which participants (N = 65) diagnosed with SAD were randomly assigned to receive 8 weeks of 1 of 2 manualized treatments (exposure group therapy, n = 33; or virtual reality exposure therapy, n = 32) either immediately or following an 8 week waiting period. Fear of negative evaluation decreased following treatment and was negatively related to mindfulness throughout treatment and follow-up. Mindfulness did not moderate treatment outcome. These findings indicate that while mindfulness is related to fear, it is not a moderator of symptom reduction in nonmindfulness-based treatment. Implications for treatment and future research are discussed.",Burton M.; Schmertz SK.; Price M.; Masuda A.; Anderson PL.,2013.0,10.1002/jclp.21929,0,1,
351,Web intervention for OEF/OIF veterans with problem drinking and PTSD symptoms: a randomized clinical trial.,"Veterans who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) commonly experience alcohol misuse and symptoms of posttraumatic stress disorder (PTSD) following their return from deployment to a war zone. We conducted a randomized clinical trial to evaluate the efficacy of a newly developed, 8-module, self-management web intervention (VetChange) based on motivational and cognitive-behavioral principles to reduce alcohol consumption, alcohol-related problems, and PTSD symptoms in returning combat veterans. Six hundred participants, recruited through targeted Facebook ads, were randomized to either an Initial Intervention Group (IIG; n = 404) or a Delayed Intervention Group (DIG; n = 196) that waited 8 weeks for access to VetChange. Primary outcome measures were Drinks per Drinking Day, Average Weekly Drinks, Percent Heavy Drinking Days, and PTSD symptoms. Intent-to-treat analyses compared changes in outcome measures over time between IIG and DIG as well as within-group changes. IIG participants demonstrated greater reductions in drinking (p < .001 for each measure) and PTSD symptoms (p = .009) between baseline and end-of-intervention than did DIG participants between baseline and the end of the waiting period. DIG participants showed similar improvements to those in IIG following participation in VetChange. Alcohol problems were also reduced within each group between baseline and 3-month follow-up. Results indicate that VetChange is effective in reducing drinking and PTSD symptoms in OIF/OEF veterans. Further studies of VetChange are needed to assess web-based recruitment and retention methods and to determine VetChange's effectiveness in demographic and clinical sub-populations of returning veterans.",Brief DJ.; Rubin A.; Keane TM.; Enggasser JL.; Roy M.; Helmuth E.; Hermos J.; Lachowicz M.; Rybin D.; Rosenbloom D.,2013.0,10.1037/a0033697,0,1,
352,Short-term psychodynamic psychotherapy versus treatment as usual for depressive and anxiety disorders: A randomized clinical trial of efficacy.,"This randomized clinical trial aimed to evaluate the clinical efficacy of short-term psychodynamic psychotherapy (STPP) in the treatment of patients suffering from anxiety or depressive disorders, as compared with a control case sample composed of patients undergoing treatment as usual (TAU). Sixty patients with depressive or anxiety disorders according to DSM IV-TR were randomly assigned in a 1:1 ratio to an intervention group (STPP) or control group for 12 months (T1). Primary outcome measures were the Symptom Checklist 90-Revised (SCL-90-R), the Inventory of Interpersonal Problems (IIP), and the Clinical Global Impression Improvement Scale. Intention to treat analysis revealed that patients who received STPP showed significantly more improvements in comparison with those who were in the TAU group on Clinical Global Impression Improvement Scale and IIP measures. This study offers evidence that STPP is an effective treatment for patients with anxiety or depressive disorders, and it could be more effective than TAU in improving interpersonal problems as measured by IIP. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bressi, Cinzia; Porcellana, Matteo; Marinaccio, Paola Marianna; Nocito, Emanuela Paola; Magri, Lorenzo; Abbass, Anderson, Blagys, Blagys, Clementel Jones, Cohen, Christoph, Derogatis, Derogatis, First, Guy, Hilsenroth, Hoeglend, Horowitz, Jacobson, Jacobson, Leichsenring, Leichsenring, Lewis, Maina, Malan, Malan, Perry, Pfohl, Svartberg, Svartberg, Valbak, Woodward",2010.0,,0,1,
353,Efficacy of short-term psychodynamic psychotherapy vs treatment as usual in a sample of patients with anxiety and depressive disorders,"ER INTRODUCTION: The aim of this study is to evaluate the clinical efficacy of short-term psychodynamic psychotherapy (STPP) in comparison with treatment as usual (TAU) in treatment of patients suffering from anxiety and depressive disorders.METHODS: Sixty patients were recruited from the Psychotherapy Service, University of Milan, Department of Psychiatry, at Milan's IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico with the diagnosis of depressive or anxiety disorders according to DSM-IV-TR criteria. These subjects were randomly assigned in a 1:1 ratio to an intervention group (STPP) or control group (TAU) for 12 months (T1). Each patient was clinically evaluated at the moment of recruitment (T0) and after 12 months using a battery composed of these scales: Clinical Global Impression Scale (CGI), Symptom Checklist-90-Revised (SCL-90-R), Inventory of Interpersonal Problems (IIP).RESULTS: Statistical analysis highlighted significant improvements (p<0.05) for the group treated with STPP in every clinical scale. Instead control group revealed significant changes (p<0.05) only for SCL-90 scale scores. We noticed a clinical improvement in both groups without particular differences, but the IIP scores went through a significant higher enhancement only in STPP group.CONCLUSIONS: Our results suggest that STPP is so effective as TAU in treatment of anxiety and depressive disorders. Moreover STPP leads to a better recover of relational functioning.","Bressi, C; Nocito, E P; Milanese, E A; Fronza, S; Della, Valentina P; Castagna, L; Porcellana, M; Bruzzese, M; Baratta, L R; Minacapelli, E; Dipasquale, E; Capra, G A",2014.0,10.1708/1407.15622,0,1,
354,A randomized controlled trial of telephone-delivered cognitive-behavioral therapy for late-life anxiety disorders.,"Older adults face a number of barriers to receiving psychotherapy, such as a lack of transportation and access to providers. One way to overcome such barriers is to provide treatment by telephone. The purpose of this study was to examine the effects of cognitive behavioral therapy delivered by telephone (CBT-T) to older adults diagnosed with an anxiety disorder. Randomized controlled trial. Participants' homes. Sixty participants age 60 and older with a diagnosis of generalized anxiety disorder, panic disorder, or anxiety disorder not otherwise specified. CBT-T versus information-only comparison. Coprimary outcomes included worry (Penn State Worry Questionnaire) and general anxiety (State Trait Anxiety Inventory). Secondary outcomes included clinician-rated anxiety (Hamilton Anxiety Rating Scale), anxiety sensitivity (Anxiety Sensitivity Index), depressive symptoms (Beck Depression Inventory), quality of life (SF-36), and sleep (Insomnia Severity Index). Assessments were completed prior to randomization, immediately upon completion of treatment, and 6 months after completing treatment. CBT-T was superior to information-only in reducing general anxiety (ES = 0.71), worry (ES = 0.61), anxiety sensitivity (ES = 0.85), and insomnia (ES = 0.82) at the posttreatment assessment; however, only the reductions in worry were maintained by the 6-month follow-up assessment (ES = 0.80). These results suggest that CBT-T may be efficacious in reducing anxiety and worry in older adults, but additional sessions may be needed to maintain these effects.",Brenes GA.; Miller ME.; Williamson JD.; McCall WV.; Knudson M.; Stanley MA.,2012.0,10.1097/JGP.0b013e31822ccd3e,0,1,
355,Telephone-delivered psychotherapy for late-life anxiety.,"A randomized controlled trial (RCT) of telephone-delivered cognitive-behavioral therapy (CBT) was compared with usual care for late-life anxiety disorders. Client satisfaction, as assessed by the Client Satisfaction Questionnaire, was high (M = 27.4, range 8-32), and attrition rates were low (8.3%). Preliminary results suggest that participants receiving CBT, compared with usual care, experience declines in general anxiety, worry, anxiety sensitivity, and insomnia.",Brenes GA.; Ingram CW.; Danhauer SC.,2012.0,10.1037/a0025950,0,1,
356,Acute treatment response in outpatients with panic disorder: high versus low depressive symptoms.,"The authors studied 75 outpatients with DSM-III-R panic disorder who had participated in a clinical trial and had been randomly assigned to receive fluvoxamine, cognitive therapy, or placebo for an 8-week period. They compared a group with high levels of depressive symptoms and a group with low levels of depressive symptoms. At baseline, patients with high levels of depressive symptoms were more likely to have severe phobic avoidance and to have higher scores on measures of anxiety, hyochondriasis, and disability. An important finding was that depressive symptoms improved at a rate which paralleled improvement in panic and anxiety. Likewise, the presence of depressive symptoms did not interfere with treatment response in panic disorder. Clinical implications of the findings are discussed.",Black DW.; Wesner R.; Bowers W.; Monahan P.; Gabel J.,1995.0,,0,1,
357,A randomized controlled trial of the safety and promise of cognitive-behavioral therapy using imaginal exposure in patients with posttraumatic stress disorder resulting from cardiovascular illness.,"We investigated the physical safety of cognitive-behavioral therapy (CBT) utilizing imaginal exposure in patients who suffered from posttraumatic stress disorder (PTSD) following a life-threatening cardiovascular event. In this phase I, prospective, single-blind trial conducted from April 2006 through April 2008, we randomly assigned 60 patients to receive either 3 to 5 sessions of imaginal exposure therapy (experimental group) or 1 to 3 educational sessions only (control group). Criteria for PTSD and other mental health disorders were evaluated according to DSM-IV using the full Structured Clinical Interview for DSM-IV (SCID). Safety assessments included patients' blood pressure and pulse before and after each study session and the occurrence of deaths, hospitalizations, repeat myocardial infarctions, or invasive procedures. We also investigated the effects of the treatment on PTSD symptoms (Impact of Event Scale and Posttraumatic Stress Disorder Scale), depression (Beck Depression Inventory-II), and the Clinical Global Impressions-Severity of Illness (CGI-S) scale. There were no significant differences between the experimental and control groups and between exposure and nonexposure sessions in any of the safety measures. In addition, confidence intervals were such that the nonsignificant effects of exposure therapy were not of clinical concern. For example, the mean difference in systolic pressure between control and exposure sessions was 0.5 mm Hg (95% CI, -6.1 to 7.1 mm Hg). Nonsignificant improvements were found on all psychiatric measures in the experimental group, with a significant improvement in CGI-S in the entire cohort (mean score difference, -0.6; 95% CI, -1.1 to -0.1; P = .02) and a significant improvement in PTSD symptoms in a subgroup of patients with acute unscheduled cardiovascular events and high baseline PTSD symptoms (mean score difference, -1.2; 95% CI, -2.0 to -0.3; P = .01). Cognitive-behavioral therapy that includes imaginal exposure is safe and promising for the treatment of posttraumatic stress in patients with cardiovascular illnesses who are traumatized by their illness. clinicaltrials.gov Identifier: NCT00364910.",Shemesh E.; Annunziato RA.; Weatherley BD.; Cotter G.; Feaganes JR.; Santra M.; Yehuda R.; Rubinstein D.,2011.0,10.4088/JCP.09m05116blu,0,1,
358,Less is still more: maintenance of the very brief exposure effect 1 year later.,"This study tested the hypothesis that an immediate effect of exposure to masked phobic stimuli on avoidance of the corresponding feared object would be maintained 1 year later. Fifty-three spider-phobic participants were identified with a questionnaire and a Behavioral Avoidance Test (BAT) with a live tarantula. One week later, they were administered 1 of 3 types of exposure: very brief (25-ms, masked) or clearly visible (125-ms, unmasked) images of spiders, or very brief images of flowers. They engaged in the BAT again immediately thereafter. One year later, they returned for a follow-up BAT. The immediate effect of exposure to very brief spiders on reducing avoidance of the tarantula was still evident 1 year later. Endurance of an effect by masked stimuli of this duration has not been reported before. Potential theoretical implications are discussed.",Siegel P.; Warren R.,2013.0,10.1037/a0030833,0,1,
359,Self-help cognitive-behavioral therapy with minimal therapist contact for social phobia: a controlled trial.,"Due to treatment accessibility and cost issues, interest in self-help programs (e.g., bibliotherapy, telehealth) for common psychological disorders is growing. Research supporting the efficacy of such a program for social anxiety, however, is limited. The present study examined the efficacy of an 8-week self-directed cognitive behavioral treatment with minimal therapist involvement for social phobia based on a widely available self-help book. Twenty-one adults with social phobia initially received either treatment (i.e. assigned readings in the workbook with limited therapist contact) or were wait-listed. Wait-listed patients eventually received the same self-directed treatment. Results revealed that the self-help/minimal therapist contact treatment was superior to wait-list on most outcome measures. Across the entire sample, reductions in social anxiety, global severity, general anxiety, and depression were observed at posttest and 3-month follow-up. These findings provide preliminary support for using this self-help workbook for individuals with mild to moderate social anxiety in conjunction with infrequent therapist visits to reinforce the treatment principles. Study limitations and future directions are discussed.",Abramowitz JS.; Moore EL.; Braddock AE.; Harrington DL.,2009.0,10.1016/j.jbtep.2008.04.004,0,1,
360,Short-term intensive psychodynamic group therapy versus cognitive-behavioral group therapy in day treatment of anxiety disorders and comorbid depressive or personality disorders: study protocol for a randomized controlled trial.,"Psychodynamic and cognitive-behavioral group therapies are frequently applied in day hospitals for the treatment of anxiety disorders and comorbid depressive or personality disorders in Poland and other Eastern European countries. Yet there is not enough evidence as to their effectiveness in this environment; this study addresses this gap. The aim of the study is to determine the effectiveness of these two kinds of day treatment care consisting of intensive, short-term group psychodynamic and cognitive-behavioral therapy, for patients with anxiety disorders and/or comorbid depressive or personality disorders. Our objectives are to: 1) show the effectiveness of each treatment in a day-care setting relative to the wait-list control group; 2) demonstrate the relative short- and long-term effectiveness of the two active treatments; 3) carry out a preliminary examination of the predictors and moderators of treatment response; 4) carry out a preliminary examination of the mediators of therapeutic change; and 5) compare the impact of both methods of treatment on the outcome of the measures used in this study. In this randomized controlled trial, a total of 199 patients with anxiety disorders and comorbid depressive and/or personality disorders will be assigned to one of three conditions: 1) psychodynamic group therapy; 2) cognitive-behavioral group therapy; or 3) wait-list control group. The therapy will last 12 weeks. Both treatments will be manualized (the manuals will address comorbidity). Primary outcome measures will include self-reported symptoms of anxiety, observer-rated symptoms of anxiety, global improvement, and recovery rate. Secondary outcome measures will include the number of pathological personality traits, depression, self-esteem, defense mechanisms, beliefs about self and others, interpersonal problems, object relations, parental bonding, meta-cognition, and quality of life. Measures will be taken at baseline, post-treatment, and at six months following the end of therapy. The rationale is to investigate how effectively anxiety disorders and/or comorbid depressive or personality disorders can be treated in a day hospital setting, typical of the Polish health care system, during a three-month treatment period. Clinicaltrials.gov identifier NCT02126787 , registered on 28 April 2014.",Suszek H.; Holas P.; Wyrzykowski T.; Lorentzen S.; Kokoszka A.,2015.0,10.1186/s13063-015-0827-6,0,1,
361,Upregulating the positive affect system in anxiety and depression: Outcomes of a positive activity intervention.,"Background: Research suggests that the positive affect system may be an important yet underexplored treatment target in anxiety and depression. Existing interventions primarily target the negative affect system, yielding modest effects on measures of positive emotions and associated outcomes (e.g., psychological well-being). The objective of the present pilot study was to evaluate the efficacy of a new transdiagnostic positive activity intervention (PAI) for anxiety and depression. Method: Twenty-nine treatment-seeking individuals presenting with clinically impairing symptoms of anxiety and/or depression were randomly allocated to a 10-session protocol comprised of PAIs previously shown in nonclinical samples to improve positive thinking, emotions, and behaviors (e.g., gratitude, acts of kindness, optimism; n = 16) or a waitlist (WL) condition (n = 13). Participants were assessed at pre- and posttreatment, as well as 3- and 6-month follow-up, on measures of positive and negative affect, symptoms, and psychological well-being. Results: The PAI group displayed significantly larger improvements in positive affect and psychological well-being from pre- to posttreatment compared to WL. Posttreatment and followup scores in the PAI group were comparable to general population norms. The PAI regimen also resulted in significantly larger reductions in negative affect, as well as anxiety and depression symptoms, compared to WL. Improvements across all outcomes were large in magnitude and maintained over a 6-month follow-up period. Conclusions: Targeting the positive affect system through a multicomponent PAI regimen may be beneficial for generating improvements in positive emotions and well-being, as well as reducing negative affect and symptoms, in individuals with clinically impairing anxiety or depression. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Taylor, Charles T; Lyubomirsky, Sonja; Stein, Murray B; Alden, Barlow, Barlow, Baxter, Beck, Boehm, Bolier, Brown, Campbell, Campbell-Sills, Carl, Chancellor, Clark, Clark, Clausen, Craske, Craske, Crawford, Csikszentmihalyi, Cuijpers, Cunningham, Davidson, Davidson, Devilly, Devilly, Diener, Dillon, Dozois, Dunn, Dunn, Dunn, Elliot, Elliot, Elman, Emmons, Endicott, Farchione, Forman, Fredrickson, Fredrickson, Fredrickson, Fredrickson, Fredrickson, Fredrickson, Fredrickson, Fredrickson, Fredrickson, Gable, Gable, Gable, Garland, Gray, Heuer, Hofmann, Hollon, Huffman, Huffman, Insel, Isen, Jacobson, Joormann, Joormann, Jose, Kashdan, Kashdan, Kessler, Kessler, Keyes, Kring, Kroenke, Kuppens, Lakens, Lang, Layous, Layous, Layous, Layous, Layous, Layous, Lyubomirsky, Lyubomirsky, Lyubomirsky, Lyubomirsky, Lyubomirsky, Maas, Mansell, Mazzucchelli, McMakin, Moskowitz, Naragon-Gainey, Nawijn, Nelson, Nelson, Nelson, Norman, Norton, Norton, Oei, Olatunji, Ozomaro, Park, Pavot, Pavot, Pavot, Pizzagalli, Pizzagalli, Rapaport, Richey, Rosenthal, Safren, Sailer, Seligman, Seligman, Sheehan, Sherdell, Sin, Spielberger, Stevanovic, Taylor, Taylor, Taylor, Trew, Tugade, Van Breukelen, Vickers, Wadlinger, Watson, Watson, Watson, Whiteford",2017.0,,0,1,
362,Clinician-assisted Internet-based treatment is effective for generalized anxiety disorder: Randomized controlled trial.,"Objective: The aim of the present study was to determine the efficacy of an Internet-based clinician-assisted computerized cognitive behavioural treatment (CaCCBT) programme for generalized anxiety disorder (the Worry programme). Methods: Forty-eight individuals meeting diagnostic criteria for generalized anxiety disorder (GAD) were randomly assigned to the Worry programme or to a waitlist control group. In the clinician-assisted Worry programme, participants complete six online lessons, weekly homework assignments, receive weekly email contact from a clinical psychologist, and contribute to a moderated online discussion forum with other participants. An intention-to-treat model was used for data analyses. The main outcome measures were Generalized Anxiety Disorder-7 Item Scale (GAD-7) and the Penn State Worry Questionnaire (PSWQ). Results: A total of 75% of treatment group participants completed all six lessons within the 9 week programme and post-treatment data were collected from 21/24 treatment group and 19/21 control group participants. Treatment group participants reported significantly reduced symptoms of worry as measured on the GAD-7 and PSWQ and reduced symptoms of depression as measured on the Patient Health Questionnaire-9 Item Scale (PHQ-9). Mean within- and between-groups effect sizes (Cohen's d) across the two measures of GAD were 1.3 and 1.1, respectively. Participants found the treatment programme acceptable and satisfactory. The clinician spent a total mean of 130 min per person over the programme. Conclusions: The Worry programme, the first randomized controlled trial of CaCCBT for GAD, resulted in clinically significant improvements. These results are consistent with literature indicating that Internet-based programmes, when combined with clinical guidance, can significantly reduce the symptoms of common mental disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Titov, Nickolai; Andrews, Gavin; Robinson, Emma; Schwencke, Genevieve; Johnston, Luke; Solley, Karen; Choi, Isabella; Andersson, Andersson, Aydos, Ball, Brown, Carlbring, Carlbring, Carlbring, Devilly, Draper, Dugas, Hoffman, Hofmann, Hunt, Kessler, Kessler, Kiropoulos, Klein, Kroenke, Ladouceur, Lang, Lowe, Marks, Marks, Meyer, Mitte, Moher, Perini, Perini, Sanderson, Shandley, Sheehan, Sheehan, Spek, Spitzer, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Vickers, Vickers, Wells, Wims, Wittchen",2009.0,,0,1,
363,Coping among military veterans with PTSD in substance use disorder treatment.,"We longitudinally investigated coping among male military veterans (n = 98) with posttraumatic stress disorder (PTSD) symptomatology and a co-occurring substance use disorder (SUD) who participated in a randomized controlled trial of seeking safety (SS). Participants were randomized to SS or intensive treatment-as-usual (TAU) for SUD. Coping (active, avoidant, emotional discharge), and PTSD and SUD symptomatology were measured prior to and at the end of treatment, and at 6- and 12-month follow-ups. Among the total sample, we found that: (a) avoidant and emotional discharge, but not active, coping tended to be positively associated with PTSD and SUD symptomatology at baseline; (b) active coping increased and avoidant and emotional discharge coping decreased during the 12-month time-period; and (c) avoidant and emotional discharge, but not active, coping longitudinally covaried with PTSD and SUD symptomatology. Results suggest the utility of targeting maladaptive coping in treatments for individuals with co-occurring PTSD and SUD.",Tyler Boden M.; Kimerling R.; Kulkarni M.; Bonn-Miller MO.; Weaver C.; Trafton J.,2014.0,10.1016/j.jsat.2014.03.006,0,1,
364,Guided mastery and performance desensitization treatments for severe acrophobia.,,Williams SL.; Turner SM.; Peer DF.,1985.0,,0,1,
365,Cognitive restructuring treatment: a controlled trail with anxious patients.,,Woodward R.; Jones RB.,1980.0,,0,1,
366,Effectiveness and cost-effectiveness of a self-management training for patients with chronic and treatment resistant anxiety or depressive disorders: Design of a multicenter randomized controlled trial.,"Background: Many patients with anxiety or depressive disorders achieve no remission of their symptoms after evidence-based treatment algorithms. They develop a chronic course of the disorder. Current care for these patients usually consists of long-term supportive contacts with a community psychiatric nurse and pharmacological management by a psychiatrist. Data on the effectiveness of these treatments is lacking. A psychosocial rehabilitation approach, where self-management is an increasingly important part, could be more suitable. It focuses on the restoration of functioning and enhancement of patients' autonomy and responsibility. Treatment with this focus, followed by referral to primary care, may be more (cost-)effective. Methods: A multicenter randomized controlled trial is designed for twelve participating specialized outpatient mental health services in the Netherlands. Patients with chronic and treatment resistant anxiety or depressive disorders, currently receiving supportive care in specialized outpatient mental health care, are asked to participate. After inclusion, patients receive the baseline questionnaire and are randomized to the intervention group or the usual care control group. The intervention focuses on rehabilitation and self-management and is provided by a trained community psychiatric nurse, followed by referral to primary care. Measurements take place at 6, 12, and 18 months after baseline. This study evaluates both the effectiveness (on quality of life, symptom severity, and empowerment), and cost-effectiveness of the intervention compared to usual care. In addition, a questionnaire is designed to get insight in which self-management strategies patients use to manage their disorder, and in the experiences of patients with the change of care setting. Discussion: In this study we evaluate the effectiveness and cost-effectiveness of a self-management intervention for patients with chronic and treatment resistant anxiety or depressive disorders in specialized outpatient mental health care. The results of this study may provide a first 'proof-of-concept' in this under-researched but important field, and might be relevant for a large group of patients in the context of a transition of the Dutch health care system. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zoun, Maringa H. H; Koekkoek, Bauke; Sinnema, Henny; Muntingh, Anna D. T; van Balkom, Anton J. L. M; Schene, Aart H; Smit, Filip; Spijker, Jan; Beck, Boevink, Bruce, de Graaf, de Graaf, Delfgaauw, Exterkate, Hakkaart-van Roijen, Hakkaart-van Roijen, Husereau, Kane, Keitner, Kessler, Klein Hofmeijer-Sevink, Klein Hofmeijer-Sevink, Koekkoek, Koekkoek, Kroenke, Merikangas, Michon, Penninx, Polder, Ruhe, Rush, Schulz, Skevington, Spitzer, Ustun, van Dijk, van Vliet, Visser",2016.0,,0,1,
367,Group versus individual cognitive-behavioural treatment for obsessive-compulsive disorder: a controlled trial.,"The efficacy of group cognitive behaviour therapy (CBT) for obsessive-compulsive disorder (OCD) has received relatively little research attention compared with the large number of studies that have investigated individual CBT. The current study is the first controlled study to compare an identical CBT protocol, containing both cognitive and behavioural elements, delivered either individually or in a group. Participants were randomly assigned to either 10 weeks of individual CBT, 10 weeks of group CBT or a 10 week wait-list. Participants with significant rates of secondary comorbidity were included in the study to enhance the generalisability of results. Intention-to-treat and completer analyses were carried out and indicated no differences between the group and individual treatments on outcome measures. Large effect sizes were found for both conditions. Analysis of clinically significant change indicated that the individual treatment was associated with a more rapid response but that both treatments had equivalent rates of recovered participants by brief follow-up. The importance of further investigations of the efficacy of group CBT for OCD is discussed.",Anderson RA.; Rees CS.,2007.0,10.1016/j.brat.2006.01.016,0,1,
368,Virtual reality exposure therapy for social anxiety disorder: a randomized controlled trial.,"This is the first randomized trial comparing virtual reality exposure therapy to in vivo exposure for social anxiety disorder. Participants with a principal diagnosis of social anxiety disorder who identified public speaking as their primary fear (N = 97) were recruited from the community, resulting in an ethnically diverse sample (M age = 39 years) of mostly women (62%). Participants were randomly assigned to and completed 8 sessions of manualized virtual reality exposure therapy, exposure group therapy, or wait list. Standardized self-report measures were collected at pretreatment, posttreatment, and 12-month follow-up, and process measures were collected during treatment. A standardized speech task was delivered at pre- and posttreatment, and diagnostic status was reassessed at 3-month follow-up. Analysis of covariance showed that, relative to wait list, people completing either active treatment significantly improved on all but one measure (length of speech for exposure group therapy and self-reported fear of negative evaluation for virtual reality exposure therapy). At 12-month follow-up, people showed significant improvement from pretreatment on all measures. There were no differences between the active treatments on any process or outcome measure at any time, nor differences on achieving partial or full remission. Virtual reality exposure therapy is effective for treating social fears, and improvement is maintained for 1 year. Virtual reality exposure therapy is equally effective as exposure group therapy; further research with a larger sample is needed, however, to better control and statistically test differences between the treatments.",Anderson PL.; Price M.; Edwards SM.; Obasaju MA.; Schmertz SK.; Zimand E.; Calamaras MR.,2013.0,10.1037/a0033559,0,1,
369,Relational treatment strategies increase social approach behaviors in patients with Generalized Social Anxiety Disorder.,"We incorporated strategies based on relational and interpersonal circumplex research within a standard cognitive-behavioral regimen for Generalized Social Anxiety Disorder (GSAD, Generalized Social Phobia) to determine whether these techniques increased the social approach behaviors that facilitate relationship development. Individuals seeking treatment for GSAD were randomly assigned to either the integrated interpersonal cognitive-behavioral group treatment (ICBT) or a wait list condition (WL). Results revealed that the interpersonal techniques were readily implemented by the majority of patients. ICBT produced significant increases in frequency of social approach behaviors and relationship satisfaction, in addition to GSAD symptom reductions comparable to other group CBT regimens. The current research highlights the feasibility and potential benefit of incorporating strategies based on relational and circumplex theories into cognitive-behavioral regimens for GSAD.",Alden LE.; Taylor CT.,2011.0,10.1016/j.janxdis.2010.10.003,0,1,
370,Post-traumatic growth as outcome of a cognitive-behavioural therapy trial for motor vehicle accident survivors with PTSD.,"Objectives: Treatment effects on post-traumatic growth (PTG) and its subdomains were investigated together with predictors of the Janus-face model of PTG. Design: Effects were investigated within a randomized controlled trial of cognitive-behavioural theropy (CBT) for post-traumatic stress disorder (PTSD). Method: Forty motor vehicle accident survivors were randomly assigned to a treatment or waiting condition. PTG was measured by the Post-traumatic Growth Inventory and complemented by its possible predictors (optimism, openness). Results: The CBT treatment proved to be highly effective in terms of PTSD symptom reduction. In contrast to previous findings, however, there was no treatment effect on PTG in general. The CBT group showed, however, increases in PTG subdomains 'new possiblities' and 'personal strength'. Conclusions: The results of this study caution researchers to naively expect PTG as a uniformly positive outcome to evaluate treatment effectiveness. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zoellner, Tanja; Rabe, Sirko; Karl, Anke; Maercker, Andreas; Antoni, Blake, Blanchard, Borkenau, Costa, Falsetti, Glaesmer, Helgeson, Hickling, Kissane, Lechner, Lieberman, Maercker, Maercker, Maercker, McFarland, Saakvitne, Scheier, Schnyder, Schuetzwohl, Taylor, Taylor, Tedeschi, Tedeschi, Tomich, Wagner, Wald, Wilkinson, Zoellner, Zoellner, Zoellner",2011.0,,0,1,
371,An affect-management group for women with posttraumatic stress disorder and histories of childhood sexual abuse,"ER Systematic research on effective treatment for survivors of childhood sexual abuse with posttraumatic stress disorder (PTSD) is virtually non-existent. The aim of the present study was to compare the effectiveness of an affect-management treatment (AM) group to a wait list control condition for female survivors of childhood sexual abuse with PTSD. Forty-eight female survivors of childhood sexual abuse with PTSD were randomly assigned to either a 15-week affect-management treatment group or to a wait list control condition. All subjects received individual psychotherapy and pharmacotherapy for the duration of the study, and for at least 1-month prior to the study. Controlling for pretreatment scores, subjects who completed the affect-management treatment group (n = 17) reported significantly fewer posttreatment symptoms of PTSD and dissociation than subjects in the wait list control condition (n = 16). Our findings suggest that an affect-management group treatment is beneficial as an adjunct to individual psychotherapy and pharmacotherapy for survivors of childhood sexual abuse with PTSD.","Zlotnick, C; Shea, T M; Rosen, K; Simpson, E; Mulrenin, K; Begin, A; Pearlstein, T",1997.0,,0,1,
372,Technology-Enhanced Stepped Collaborative Care Targeting Posttraumatic Stress Disorder and Comorbidity After Injury: A Randomized Controlled Trial.,"Posttraumatic stress disorder (PTSD) and its comorbidities are endemic among injured trauma survivors. Previous collaborative care trials targeting PTSD after injury have been effective, but they have required intensive clinical resources. The present pragmatic clinical trial randomized acutely injured trauma survivors who screened positive on an automated electronic medical record PTSD assessment to collaborative care intervention (n = 60) and usual care control (n = 61) conditions. The stepped measurement-based intervention included care management, psychopharmacology, and psychotherapy elements. Embedded within the intervention were a series of information technology (IT) components. PTSD symptoms were assessed with the PTSD Checklist at baseline prerandomization and again, 1-, 3-, and 6-months postinjury. IT utilization was also assessed. The technology-assisted intervention required a median of 2.25 hours (interquartile range = 1.57 hours) per patient. The intervention was associated with modest symptom reductions, but beyond the margin of statistical significance in the unadjusted model: F(2, 204) = 2.95, p = .055. The covariate adjusted regression was significant: F(2, 204) = 3.06, p = .049. The PTSD intervention effect was greatest at the 3-month (Cohen's effect size d = 0.35, F(1, 204) = 4.11, p = .044) and 6-month (d = 0.38, F(1, 204) = 4.10, p = .044) time points. IT-enhanced collaborative care was associated with modest PTSD symptom reductions and reduced delivery times; the intervention model could potentially facilitate efficient PTSD treatment after injury.",Zatzick D.; O'Connor SS.; Russo J.; Wang J.; Bush N.; Love J.; Peterson R.; Ingraham L.; Darnell D.; Whiteside L.; Van Eaton E.,2015.0,10.1002/jts.22041,0,1,
373,"Cognitive Behavioral Therapy for Patients with Social Anxiety Disorder Who Remain Symptomatic following Antidepressant Treatment: a Randomized, Assessor-Blinded, Controlled Trial","ER Background: Although antidepressants are still a commonly used treatment for social anxiety disorder (SAD), a significant proportion of patients fail to remit following antidepressants. However, no standard approach has been established for managing such patients. This study aimed to examine the effectiveness of cognitive behavioral therapy (CBT) as an adjunct to usual care (UC) compared with UC alone in SAD patients who remain symptomatic following antidepressant treatment. Methods: This was a prospective randomized open-blinded end-point study with two parallel groups (CBT + UC, and UC alone, both for 16 weeks) conducted from June 2012 to March 2014. SAD patients who remain symptomatic following antidepressant treatment were recruited, and a total sample size of 42 was set based on pilot results. Results: Patients were randomly allocated to CBT + UC (n = 21) or UC alone (n = 21). After 16 weeks, adjusted mean reduction in the Liebowitz Social Anxiety Scale from baseline for CBT + UC and UC alone was ? 40.87 and 0.68, respectively; the between-group difference was ? 41.55 ( ? 53.68 to ? 29.42, p < 0.0001). Response rates were 85.7 and 10.0% for CBT + UC and UC alone, respectively (p < 0.0001). The corresponding remission rates were 47.6 and 0.0%, respectively (p = 0.0005). Significant differences were also found in favor of CBT + UC for social anxiety symptoms, depressive symptoms, and functional impairment. Conclusions: Our results suggest that in SAD patients who have been ineffectively treated with antidepressants, CBT is an effective treatment adjunct to UC over 16 weeks in reducing social anxiety and related symptoms.","Yoshinaga, N; Matsuki, S; Niitsu, T; Sato, Y; Tanaka, M; Ibuki, H; Takanashi, R; Ohshiro, K; Ohshima, F; Asano, K; Kobori, O; Yoshimura, K; Hirano, Y; Sawaguchi, K; Koshizaka, M; Hanaoka, H; Nakagawa, A; Nakazato, M; Iyo, M; Shimizu, E",2016.0,10.1159/000444221,0,1,
374,Randomized controlled trial of group cognitive behavioral therapy compared to a discussion group for co-morbid anxiety and depression in older adults.,"Co-morbid anxiety and depression in older adults is associated with worse physical and mental health outcomes and poorer response to psychological and pharmacological treatments in older adults. However, there is a paucity of research focused on testing the efficacy of the co-morbid treatment of anxiety and depression in older adults using psychological interventions. Accordingly, the primary objective of the current study was to test the effects of a group cognitive behavior therapy (CBT) program in treating co-morbid anxiety and depression in a sample of older age adults. A total of 133 community-dwelling participants aged ⩾60 years (mean age = 67.35, s.d. = 5.44, male = 59) with both an anxiety disorder and unipolar mood disorder, as assessed on the Anxiety Disorder Interview Schedule (ADIS), were randomly allocated to an 11-week CBT group or discussion group. Participants with Mini-Mental State Examination scores <26 were excluded. Participants were assessed pre-treatment, post-treatment and at 6 months follow-up on the ADIS, a brief measure of well-being, Geriatric Anxiety Inventory and Geriatric Depression Scale. Both conditions resulted in significant improvements over time on all diagnostic, symptom and wellbeing measures. Significant group × time interaction effects emerged at post-treatment only for diagnostic severity of the primary disorder, mean severity of all anxiety disorders, mood disorders, and all disorders, and recovery rates on primary disorder. Group CBT produced faster and sustained improvements in anxiety and depression on diagnostic severity and recovery rates compared to an active control in older adults.",Wuthrich VM.; Rapee RM.; Kangas M.; Perini S.,2016.0,10.1017/S0033291715002251,0,1,
375,Adapting narrative exposure therapy for Chinese earthquake survivors: A pilot randomised controlled feasibility study.,"Background: Narrative exposure therapy (NET) is a brief, manualised treatment for Posttraumatic Stress Disorder (PTSD). It has been shown to have therapeutic benefits for a wide range of individuals and settings. This study, following our previous work applying the original NET in earthquake survivors, aimed to revise NET to be adaptable for treating PTSD after a natural disaster. Methods: A randomised waiting-list controlled study was conducted with 30 adult participants with PTSD who were randomly allocated to NET (n = 10), revised NET (NET-R; n = 10) or a waiting list condition (WL; n = 10). Participants in NET and NET-R received treatment immediately; those in the WL condition received NET-R treatment after a waiting period. All groups were assessed on PTSD, general distress, anxiety, depression, social support, coping and posttraumatic change before and after treatment and three-month follow-up. Results: Compared with WL, both NET and NET-R groups showed significant reductions in PTSD and related symptoms. Significant increases were found in posttraumatic growth, active coping and perceived social support. The WL group showed similar improvements after treatment. Further reductions on PTSD symptoms were found at three months, showing that NET-R is as effective as the original NET in treating post-earthquake traumatic symptoms in adult Chinese earthquake survivors. Conclusions: NET-R is a feasible and cost-effective intervention for Chinese earthquake survivors. Further studies are needed to replicate these findings in other survivor populations, and with larger samples and over longer periods. This study highlighted the value of oral narrative approach, which is well-accepted and useful in the context of single natural disaster and lower- income area. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zang, Yinyin; Hunt, Nigel; Cox, Tom; Bai, Basoglu, Bichescu, Bichescu, Brewin, Bryant, Butler, Cao, Carver, Chan, Chou, Ehlers, Ehlers, Foa, Foa, Goldberg, Guay, Huang, Hunt, Hunt, Janoff-Bullman, Jenkins, Joseph, Joseph, Kaniasty, Kearney, Neuner, Neuner, Neuner, Norris, Pennebaker, Robjant, Rothbaum, Schauer, Schauer, Seidler, Smyth, Spurrell, Tarrier, Weiss, Wu, Wu, Zang, Zang, Zheng, Zigmond, Zimet",2014.0,,0,1,
376,A randomised controlled pilot study: The effectiveness of narrative exposure therapy with adult survivors of the Sichuan earthquake.,"Background: Post-Traumatic Stress Disorder (PTSD) is a common psychological reaction after large-scale natural disasters. Given the number of people involved and shortage of resources in any major disaster, brief, pragmatic and easily trainable interventions are needed. The aim of this study is to evaluate the efficacy of Narrative Exposure Therapy (NET) as a short-term treatment for PTSD using Chinese earthquake survivors. Methods: A randomized waiting-list control pilot study was conducted between December 2009 and March 2010, at the site of the Sichuan earthquake in Beichuan County, China. Adult participants with newly diagnosed Post Traumatic Stress Disorder (PTSD) were randomly allocated to Narrative Exposure Therapy (NET) or a Waiting-List (WL) condition. The latter received NET treatment after a two-week waiting period. To compare the effectiveness of NET in traumatised earthquake survivors, both groups were assessed on PTSD symptoms, general mental health, anxiety and depression, social support, coping style and posttraumatic change before and after treatment and two months post treatment. Results: Adult participants (n = 22) were randomly allocated to receive NET (n = 11) or WL (n = 11). Twenty two participants (11 in NET group, 11 in WL) were included in the analysis of primary outcomes. Compared with WL, NET showed significant reductions in PTSD symptoms, anxiety and depression, general mental stress and increased posttraumatic growth. The WL group later showed similar improvements after treatment. These changes remained stable for a two-month follow-up. Measures of social support and coping showed no stable effects. Conclusions: NET is effective in treating post-earthquake traumatic symptoms in adult Chinese earthquake survivors. The findings help advance current knowledge in the management of PTSD after natural disasters and inform future research. Larger sample sizes are needed to extend the present findings. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zang, Yinyin; Hunt, Nigel; Cox, Tom; Armenian, Bichescu, Bichescu, Briere, Cao, Chan, Chou, Clark, Dalgleish, Edwards, Foa, Foa, Goldberg, Guay, Hagenaars, Huang, Hunt, Joffe, Joseph, Joseph, Kaniasty, Kaniasty, Kun, Lepore, Linley, Neuner, Neuner, Neuner, Robjant, Rothbaum, Schauer, Seidler, Spurrell, Steel, Tarrier, Tiet, Uscher-pines, Vickers, Vickers, Wang, Wang, Weiss, Wu, Wu, Xie, Zang, Zheng, Zigmond, Zimet",2013.0,,0,1,
377,Clinician-assisted Internet-based treatment is effective for panic: A randomized controlled trial.,"Objective: To determine the efficacy of an Internet-based clinician-assisted cognitive behavioural treatment program (the Panic program) for panic disorder (with or without agoraphobia). Method: Fifty-nine individuals meeting diagnostic criteria for panic disorder with agoraphobia were randomly assigned to a treatment group or to a waitlist control group. Treatment group participants completed the Panic program, comprising six on-line lessons, weekly homework assignments, received weekly email contact from a psychiatry registrar, and contributed to a moderated online discussion forum with other participants. An intention-to-treat model was used for data analyses. Results: Twenty-three (79%) of treatment group participants completed all lessons within the 8-week program, and post-treatment data were collected from 22/29 treatment group and 22/25 waitlist group participants. Compared to the control group, treatment group participants reported significantly reduced symptoms of panic as measured by the Panic Disorder Severity Scale, Body Sensation Questionnaire, and Agoraphobic Cognitions Questionnaires. Significant reductions were also reported on measures of disability and depression. The mean within- and between-group effect size (Cohen's d) on the Panic Disorder Severity Scale was 0.93 and 0.59, respectively, and effects were sustained at 1-month follow-up. Mean therapist time per participant was 75 minutes for the program. Conclusions: These results replicate those from the open trial of the Panic Program indicating the efficacy of the Internet-based clinician-assisted cognitive behavioural treatment program for panic disorder with agoraphobia. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Wims, Edward; Titov, Nickolai; Andrews, Gavin; Choi, Isabella; Barlow, Butler, Chambless, Chambless, Cuijpers, Garb, Gould, Huppert, Kiropoulos, Klein, Kroenke, Leon, Moher, Otto, Perini, Perini, Robinson, Sanderson, Shandley, Shear, Shear, Sheehan, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Vickers, Vickers, Wims",2010.0,,0,1,
378,Guided mastery and stimulus exposure treatments for severe performance anxiety in agoraphobics.,"The present experiment compared two models of treatment for high performance-related anxiety in agoraphobics: the stimulus exposure model, which emphasizes extinguishing anxiety by promoting prolonged exposure to phobic stimuli, and the self-efficacy model, which emphasizes building a sense of mastery by promoting rapid proficient performance accomplishments. Subjects were 26 agoraphobics who could perform phobic activities when behaviorally tested, but who became highly anxious when doing so. Subjects were assigned at random to either (a) guided mastery treatment based on self-efficacy theory, (b) stimulus exposure treatment, or (c) delayed treatment. The results showed that guided mastery was significantly more effective than stimulus exposure in reducing performance anxiety, and this difference increased over the follow-up period. The findings indicate that therapists can implement performance-based treatment more effectively by assisting clients to achieve proficient performance than by simply encouraging them to expose themselves to phobic stimuli.",Williams SL.; Zane G.,1989.0,,0,1,
379,A Randomized Controlled Trial of a Brief Intervention for Delayed Psychological Effects in Snakebite Victims.,"Snakebite results in delayed psychological morbidity and negative psycho-social impact. However, psychological support is rarely provided to victims. To assess the effectiveness of a brief intervention which can be provided by non-specialist doctors aimed at reducing psychological morbidity following snakebite envenoming. In a single blind, randomized controlled trial, snakebite victims with systemic envenoming [n = 225, 168 males, mean age 42.1 (SD 12.4) years] were randomized into three arms. One arm received no intervention (n = 68, Group A), the second received psychological first aid and psychoeducation (dispelling prevalent cultural beliefs related to snakebite which promote development of a sick role) at discharge from hospital (n = 65, Group B), while the third received psychological first aid and psychoeducation at discharge and a second intervention one month later based on cognitive behavioural principles (n = 69, Group C). All patients were assessed six months after hospital discharge for the presence of psychological symptoms and level of functioning using standardized tools. At six months, there was a decreasing trend in the proportion of patients who were positive for psychiatric symptoms of depression and anxiety from Group A through Group B to Group C (Chi square test for trend = 7.901, p = 0.005). This was mainly due to a decreasing trend for symptoms of anxiety (chi-square for trend = 11.256, p = 0.001). There was also decreasing trend in the overall prevalence of disability from Group A through Group B to Group C (chi square for trend = 7.551, p = 0.006), predominantly in relation to disability in family life (p = 0.006) and social life (p = 0.005). However, there was no difference in the proportion of patients diagnosed with depression between the three groups (chi square for trend = 0.391, p = 0.532), and the intervention also had no effect on post-traumatic stress disorder. A brief psychological intervention, which included psychological first aid and psychoeducation plus cognitive behavioural therapy that can be provided by non-specialist doctors appeared to reduce psychiatric symptoms and disability after snakebite envenoming, but not depression or post-traumatic stress disorder. Sri Lanka Clinical Trials Registry: SLCTR/2011/003.",Wijesinghe CA.; Williams SS.; Kasturiratne A.; Dolawaththa N.; Wimalaratne P.; Wijewickrema B.; Jayamanne SF.; Isbister GK.; Dawson AH.; Lalloo DG.; de Silva HJ.,2015.0,10.1371/journal.pntd.0003989,0,1,
380,A randomized controlled clinical trial of a patient decision aid for posttraumatic stress disorder.,"Patient decision aids have been used in many clinical situations to improve the patient centeredness of care. A patient decision aid for patients with posttraumatic stress disorder (PTSD) has not been developed or tested. The authors evaluated the effects of a patient decision aid on the patient centeredness of PTSD treatment. The study was a randomized trial of a patient decision aid for PTSD versus treatment as usual (control group). The participants were 132 male and female veterans who presented to a single U.S. Department of Veterans Affairs hospital with a new diagnosis of PTSD. Patient centeredness was assessed by knowledge of PTSD and its treatment, level of decisional uncertainty, and ability to state a preferred treatment option. Secondary outcomes included treatments received and PTSD symptoms in the six months after study entry. Compared with the control group (N=65), participants who reviewed the patient decision aid (N=63) had higher scores for PTSD knowledge (p=.002) and less conflict about their choice of treatment (p=.003). In addition, participants who reviewed the patient decision aid were more likely to select and receive an evidence-based treatment for PTSD (p=.04) and had superior PTSD outcomes (p=.004) compared with the control group. Use of a patient decision aid was associated with improvements in patient-centered PTSD treatment. The patient decision aid was also associated with greater use of evidence-based treatments and improvement of PTSD symptoms. This study suggests that clinics should consider using a patient decision aid for patients with PTSD.",Watts BV.; Schnurr PP.; Zayed M.; Young-Xu Y.; Stender P.; Llewellyn-Thomas H.,2015.0,10.1176/appi.ps.201400062,0,1,
381,Virtual reality cognitive behavior therapy for public speaking anxiety: a randomized clinical trial.,"Public speaking anxiety (PSA) is a common phobia. Although cognitive behavior therapy (CBT) is preferred, difficulties arise with the exposure component (lack of therapist control, patient's inability to imagine, self-flooding, loss of confidentiality resulting from public exposure). Virtual reality CBT (VRCBT) enables a high degree of therapist control, thus overcoming these difficulties. This study examined whether VRCBT is an alternative to CBT. Participants with PSA were randomly assigned to VRCBT (28 participants), CBT (30 participants), and wait list control (WLC; 30 participants). VRCBT and CBT were significantly more effective than WLC in anxiety reduction on four of five anxiety measures, and on subject's self-rating of anxiety during a behavioral task. No significant differences were found on observer ratings of the behavioral task. However, twice as many participants dropped out from CBT than from VRCBT. Our results demonstrated that VRCBT is an effective and brief treatment regimen, equal to CBT.",Wallach HS.; Safir MP.; Bar-Zvi M.,2009.0,10.1177/0145445509331926,0,1,
382,Cognitive-behavioral group therapy in obsessive-compulsive disorder: a randomized clinical trial.,"The present study was designed to verify the efficacy of cognitive-behavioral group therapy (CBGT) in reducing obsessive-compulsive symptoms and the intensity of overvalued ideas, as well as in improving the patient's quality of life. Forty-seven patients meeting DSM-IV criteria for obsessive-compulsive disorder (OCD) were randomly assigned to either 12 weekly CBGT sessions or a waiting list (control group). Treated patients were followed for three months. There was a significant reduction in the Yale-Brown Obsessive-Compulsive Scale (p < 0.001), in the National Institute of Mental Health Obsessive-Compulsive Scale (p < 0.001), in the Overvalued Ideas Scale (p < 0.001), and a significant improvement in the quality of life in the four domains of the World Health Organization Quality of Life Assessment Scale: physical (p < 0.001), psychological (p < 0.017), social (p < 0.018) and environmental (p < 0.04). No significant reduction was found in the Hamilton Rating Scale for Anxiety (p = 0.111) and the Hamilton Rating Scale for Depression (p = 0.271). The concomitant use of anti-obsessional medications did not influence the results. The rate of improved patients was 69.6% in the treated group and 4.2% in the control group (p < 0.001). The therapeutic gains were maintained and an additional reduction in symptoms was observed during the 3-month follow-up period. The results suggest that CBGT is effective in reducing the intensity of OCD symptoms and of overvalued ideas, and that it improves the OCD patient's quality of life in a short period of time.",Volpato Cordioli A.; Heldt E.; Braga Bochi D.; Margis R.; Basso de Sousa M.; Fonseca Tonello J.; Gus Manfro G.; Kapczinski F.,,70785,0,1,
383,Mindfulness-based stress reduction for patients with anxiety disorders: Evaluation in a randomized controlled trial.,"The aim of this study was to investigate the effect of mindfulness-based stress reduction (MBSR) for patients with heterogeneous anxiety disorders. Seventy-six self-referred patients were randomized to MBSR or a waiting-list control condition. Eight participants did not complete the eight-week MBSR intervention. Treatment completers improved significantly on all outcome measures compared to controls. The completer sample showed medium to large effect sizes on measures of anxiety (Cohen's d = 0.55-0.97), and a large effect size for symptoms of depression (Cohen's d = 0.97). Intention-to-treat analyses yielded effect sizes in the small to moderate range (Cohen's d = 0.32-0.76). Gains were maintained at six months follow-up. The percentage of participants reaching recovered status was highest for symptom measures of depression and anxiety, and lower for worry and trait anxiety. Mediation analyses indicated that mindfulness fully mediated changes in acute anxiety symptoms, and partially mediated changes in worry and trait anxiety. However, the present study did not find evidence of temporal precedence for the proposed mediator. In the absence of true mediation and an active control condition, it cannot be ruled out that results are due to non-specific aspects of treatment. Despite these and other limitations, we conclude that MBSR is an effective treatment for anxiety disorders and related symptomatology. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Vollestad, Jon; Sivertsen, Borge; Nielsen, Geir Hostmark; Baer, Baer, Baron, Beck, Beck, Campbell-Sills, Craske, Derogatis, Deyo, Ehring, Fisher, Fisher, Hofmann, Hofmann, Jacobson, Jain, Kabat-Zinn, Kabat-Zinn, Kim, Koszycki, Lee, Leiknes, Mansell, Mathews, Meyer, Mor, Norton, Pallesen, Preacher, Roemer, Segal, Seggar, Shear, Sheehan, Spielberger, Westbrook",2011.0,,0,1,
384,Experiential cognitive therapy in the treatment of panic disorders with agoraphobia: a controlled study.,"The use of a multicomponent cognitive-behavioral treatment strategy for panic disorder with agoraphobia is actually one of the preferred therapeutic approaches for this disturbance. This method involves a mixture of cognitive and behavioral techniques that are intended to help patients identify and modify their dysfunctional anxiety-related thoughts, beliefs and behavior. The paper presents a new treatment protocol for Panic Disorder and Agoraphobia, named Experiential-Cognitive Therapy (ECT) that integrates the use of virtual reality (VR) in a multicomponent cognitive-behavioral treatment strategy. The VR software used for the trial is freely downloadable: www.cyberpsychology.info/try.htm. Moreover, the paper presents the result of a controlled study involving 12 consecutive patients aged 35-53. The selected subjects were randomly divided in three groups: ECT group, that experienced the Cognitive Behavioral Therapy-Virtual Reality assisted treatment (eight sessions), a CBT group that experienced the traditional Cognitive Behavioral approach (12 sessions) and a waiting list control group. The data showed that both CBT and ECT could significantly reduce the number of panic attacks, the level of depression and both state and trait anxiety. However, ECT procured these results using 33% fewer sessions than CBT. This datum suggests that ECT could be better than CBT in relation to the ""cost of administration,"" justifying the added use of VR equipment in the treatment of panic disorders.",Vincelli F.; Anolli L.; Bouchard S.; Wiederhold BK.; Zurloni V.; Riva G.,2003.0,10.1089/109493103322011632,0,1,
385,Cognitive remediation therapy (CRT) as a treatment enhancer of eating disorders and obsessive compulsive disorders: study protocol for a randomized controlled trial.,"Anorexia nervosa (AN) and Obsessive Compulsive Disorder (OCD) are among the most incapacitating and costly of mental disorders. Cognitive Behaviour Therapy (CBT), medication, and combination regimens, to which in AN personalised guidance on weight control is added, are moderately successful, leaving room for more effective treatment algorithms. An underlying deficit which the two disorders share is cognitive inflexibility, a trait that is likely to impede treatment engagement and reduce patients' ability to benefit from treatment. Cognitive remediation therapy (CRT) is an easy-to-use intervention aimed at reducing cognitive inflexibility and thereby enhancing treatment outcome, which we aim to test in a controled study. In a randomized-controlled multicenter clinical trial 64 adult patients with AN and 64 with OCD are randomized to 10 bi-weekly sessions with either CRT or a control condition, after which Treatment As Usual (TAU) is started. All patients are evaluated during single-blind assessments at baseline, post-CRT/control intervention, and after 6 months. Indices of treatment effect are disorder-specific symptom severity, quality of life, and cost-effectivity. Also, moderators and mediators of treatment effects will be studied. To our knowledge, this is the first randomized controlled trial using an control condition evaluating the efficacy and effectiveness of CRT as a treatment enhancer preceding TAU for AN, and the first study to investigate CRT in OCD, moreover taking cost-effectiveness of CRT in AN and OCD into account. The Netherlands Trial Register NTR3865 . Registered 20 february 2013.",van Passel B.; Danner U.; Dingemans A.; van Furth E.; Sternheim L.; van Elburg A.; van Minnen A.; van den Hout M.; Hendriks GJ.; Cath D.,2016.0,10.1186/s12888-016-1109-x,0,1,
386,Behavioral and cognitive group treatment for fear of flying: A randomized controlled trial.,"In a long-standing fear-of-flying program, persons with fear of flying (N=150) were after a diagnostic assessment and individual preparation phase randomly assigned to either a 1-day behavioral group treatment (BGT) program, a 2-day cognitive-behavioral group treatment (CBGT) program or a waiting list (WL) control group. A post-treatment flight on a commercial airline measured participants' ability to fly. Different self-report flight anxiety questionnaires were completed before, during and after treatment at 3-, 6- and 12-month follow-up. Results indicated that both treatments were superior to the WL, and equally effective on the flying test and later independent flying, but also that the 2-day CBGT program was significantly more effective than the 1-day BGT program on subjective measures of fear and self-efficacy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Van Gerwen, Lucas J; Spinhoven, Philip; Van Dyck, Richard; Arrindell, Bandura, Beckham, Clark, Cohen, Derogatis, Diekstra, Ellis, Fodor, Greco, Haug, Howard, Jacobson, Maltby, Muhlberger, Roberts, Rothbaum, Van de Wal, Van Gerwen, Van Gerwen, Van Gerwen, Van Gerwen, Walder",2006.0,,0,1,
387,Randomized controlled trial on the effectiveness of metacognitive therapy and intolerance-of-uncertainty therapy for generalized anxiety disorder.,"This randomized controlled trial compared the effectiveness of metacognitive therapy (MCT) and intolerance-of-uncertainty therapy (IUT) for generalized anxiety disorder (GAD) in an outpatient context. Patients with GAD (N = 126) consecutively referred to an outpatient treatment center for anxiety disorder were randomly allocated to MCT, IUT, or a delayed treatment (DT) condition. Patients were treated individually for up to 14 sessions. Assessments were conducted before treatment (pretreatment), after the last treatment session (posttreatment), and six months after treatment had ended (follow-up). At posttreatment and follow-up assessments, substantial improvements were observed in both treatment conditions across all outcome variables. Both MCT and IUT, but not DT, produced significant reductions in GAD-specific symptoms with large effect sizes (ranging between 0.94 and 2.39) and high proportions of clinically significant change (ranging between 77% and 95%) on various outcome measures, and the vast majority of the patients (i.e., 91% in the MCT group, and 80% in the IUT group) no longer fulfilled the diagnostic criteria for GAD. Results further indicate that MCT produced better results than IUT. This was evident on most outcome measures, and also reflected in effect sizes and degree of clinical response and recovery. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","van der Heiden, Colin; Muris, Peter; van der Molen, Henk T; Arrindell, Ballenger, Beck, Behar, Borkovec, Borkovec, Butler, Cartwright-Hatton, Cohen, Covin, D'Zurilla, Davey, De Bruin, Derogatis, Dugas, Dugas, Dugas, Dugas, Dugas, Dugas, First, Fisher, Freeston, Gosselin, Hamilton, Hermans, Hoyer, Hunot, Jacobson, Kazdin, Kehle, Kessler, Kessler, Kotov, Ladouceur, Ladouceur, Lieb, Meyer, Mitte, Segal, Spielberger, Van der Does, Van der Heiden, Van der Heiden, Van der Heiden, Van der Ploeg, Van Groenestijn, Van Rijsoort, Van Rijsoort, Wells, Wells, Wells, Wells, Wells, Wells, Wells, Wierzbicki, Wittchen, Wittchen, Yonkers, Yonkers",2012.0,,0,1,
388,Treatment of anxiety disorders in primary care practice: a randomised controlled trial.,"Anxiety disorders are prevalent in primary care. Psychological treatment is effective but time-consuming, and there are waiting lists for secondary care. Interest has therefore grown in developing guidelines for treatment that would be feasible in primary care. To compare the effectiveness and feasibility of guided self-help, the Anxiety Disorder Guidelines of the Netherlands College of General Practitioners and cognitive behavioural therapy (CBT). Randomised controlled study lasting 12 weeks with follow-up at 3 and 9 months for primary care patients with panic disorder and/or generalised anxiety disorder. The first two forms of treatment were carried out by 46 GPs who were randomly assigned to one or the other form. CBT was carried out by cognitive behaviour therapists in a psychiatric outpatient clinic. Participants (n = 154) were randomly assigned to one of the three forms of treatment. The main outcome measure used was the state subscale of the Spielberger Anxiety Inventory. All three forms of treatment gave significant improvement between pre-test and post-test, and this improvement remained stable between post-test and the follow-ups. The results obtained with the three treatment forms did not differ significantly over time. The feasibility of the Anxiety Disorder Guidelines was low compared with that of guided self-help. Our results indicate that primary care patients with prevalent anxiety disorders for whom the GP does not find referral necessary can be adequately treated by the GP. Psychiatric outpatient clinic referral does not give superior results. Guided self-help is easier for the GP to carry out than a less highly-structured treatment like that laid down in the Anxiety Disorder Guidelines.",van Boeijen CA.; van Oppen P.; van Balkom AJ.; Visser S.; Kempe PT.; Blankenstein N.; van Dyck R.,2005.0,,0,1,
389,Evaluating traumatic incident reduction therapy with female inmates: A randomized controlled clinical trial.,"An experimental outcome study with trauma-related symptoms was conducted to examine the effectiveness of traumatic incident reduction (TIR). It is a brief memory-based therapeutic intervention and was used to treat symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, and low expectancy of success (i.e., low self-efficacy). A randomized pretest-postest control group design with 123 female inmates (mean age 32 yrs) in a federal prison, was used to evaluate the efficacy of the interventive procedure. Results showed significant differences between treatment and comparison control conditions on all measures at postest and 3-mo follow-up intervals except for the PTSD Intrusion subscale at the postest interval. The marked improvement of the treatment condition by comparison to those in the control condition supports the contention that TIR is an effective intervention with female inmates. The significant results on all measures at the follow-up time interval provide persuasive evidence of the stability of the interventive effects. The significance of this therapy model for use by practitioners with social work populations is highlighted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Valentine, Pamela Vest; Smith, Thomas Edward",2001.0,,0,1,
390,Impact of cognitive-behavioral therapy for panic disorder on comorbidity: a controlled investigation.,"This study examined the effects of cognitive-behavioral therapy (CBT) for principal panic disorder with or without agoraphobia, on comorbidity in 30 individuals (16 female). To test the hypothesis that improvements in co-existing conditions were not due to spontaneous fluctuations across time, patients receiving immediate CBT were compared to those assigned to wait list (n = 11). Results indicated clinician-rated severity of comorbid specific phobia declined significantly following immediate CBT compared to no change after wait list. The number of patients without comorbidity of any severity increased after immediate CBT, with no such increase following wait list. However, the groups did not differ in the frequency of additional diagnoses or overall severity of comorbidity. In the total sample, results indicated reductions in comorbidity by 9-month follow-up, with marked declines in the severity of comorbid generalized anxiety disorder (GAD), social and specific phobia. Our findings suggest that targeted CBT for panic disorder has beneficial effects on comorbidity over the longer term and that some of its immediate effects exceed those due to the passage of time alone.",Tsao JC.; Mystkowski JL.; Zucker BG.; Craske MG.,2005.0,10.1016/j.brat.2004.11.013,0,1,
391,Shyness 3: randomized controlled trial of guided versus unguided Internet-based CBT for social phobia.,"In two previous randomized controlled trials Titov et al. demonstrated significant benefit from an Internet- and email-based treatment programme for social phobia. The present study (Shyness 3) explores whether participants are able to complete this programme independently. A total of 98 individuals with social phobia were randomly assigned to a clinician-assisted computerized cognitive behavioural treatment (CaCCBT) group, a self-guided computerized CBT (CCBT) group, or to a waitlist control group. CaCCBT group participants completed the usual Shyness programme consisting of six online lessons, cognitive behavioural homework assignments, email contact with a therapist, and participation in an online discussion forum. CCBT group participants accessed the same resources except for therapist emails. An intention-to-treat model was used for data analyses. A total of 77% of CaCCBT and 33% of CCBT group participants completed all lessons. Significant differences were found after treatment between CaCCBT and control groups (mean between-groups effect size (ES) for the social phobia measures=1.04), and between the CaCCBT and CCBT groups (mean between-groups ES for the social phobia measures=0.66). No significant differences were found after treatment between the CCBT and control groups (mean between-groups ES for the social phobia measures=0.38). CCBT participants, however, who completed the six lessons made good progress (mean within-group ES for the social phobia measures=0.62). Quantitative and qualitative data indicate that both the CaCCBT and CCBT procedures were acceptable to participants. The reliability of this Internet-based treatment programme for social phobia has been confirmed. The therapist-guided condition was superior to the self-guided condition, but a subgroup of participants still benefited considerably from the latter. These data confirm that self-guided education or treatment programmes for common anxiety disorders can result in significant improvements.",Titov N.; Andrews G.; Choi I.; Schwencke G.; Mahoney A.,2008.0,10.1080/00048670802512107,0,1,
392,Lay providers can deliver effective cognitive behavior therapy for older adults with generalized anxiety disorder: a randomized trial.,"The Institute of Medicine recommends developing a broader workforce of mental health providers, including nontraditional providers, to expand services for older adults. Cognitive behavior therapy (CBT) is effective for late-life generalized anxiety disorder (GAD), but no study has examined outcomes with delivery by lay providers working under the supervision of licensed providers. The current study examined the effects of CBT delivered by lay, bachelor-level providers (BLP) relative to Ph.D.-level expert providers (PLP), and usual care (UC) in older adults with GAD. Participants were 223 older adults (mean age, 66.9 years) with GAD recruited from primary care clinics at two sites and assigned randomly to BLP (n = 76), PLP (n = 74), or UC (n = 73). Assessments occurred at baseline and 6 months. CBT in BLP and PLP included core and elective modules (3 months: skills training; 3 months: skills review) delivered in person and by telephone, according to patient choice. CBT in both BLP and PLP groups significantly improved GAD severity (GAD Severity Scale), anxiety (Spielberger State-Trait Anxiety Inventory; Structured Interview Guide for the Hamilton Anxiety Scale), depression (Patient Health Questionnaire), insomnia (Insomnia Severity Index), and mental health quality of life (Short-Form-12), relative to UC. Response rates defined by 20% reduction from pre- to posttreatment in at least three of four primary outcomes were higher for study completers in BLP and PLP relative to UC (BLP: 38.5%; PLP: 40.0%; UC: 19.1%). Lay providers, working under the supervision of licensed providers, can deliver effective CBT.",Stanley MA.; Wilson NL.; Amspoker AB.; Kraus-Schuman C.; Wagener PD.; Calleo JS.; Cully JA.; Teng E.; Rhoades HM.; Williams S.; Masozera N.; Horsfield M.; Kunik ME.,2014.0,10.1002/da.22239,0,1,
393,Cognitive-behavior therapy for late-life generalized anxiety disorder in primary care: preliminary findings.,"The authors present data from a pilot research program initiated to develop, refine, and test the outcomes of CBT-GAD/PC, a version of cognitive-behavior therapy (CBT) that targets the needs of older adults with generalized anxiety disorder (GAD) in primary care (PC). The study involved a small, randomized clinical trial comparing the impact of CBT-GAD/PC to usual care (UC) in a sample of 12 older medical patients with GAD. Outcome data suggested significant improvements in worry and depression after CBT-GAD/PC, relative to UC. Authors discuss results in terms of the ""real-world"" applicability of this treatment for late-life GAD, and present implications for future research.",Stanley MA.; Hopko DR.; Diefenbach GJ.; Bourland SL.; Rodriguez H.; Wagener P.,,,0,1,
394,RCT of a brief phone-based CBT intervention to improve PTSD treatment utilization by returning service members.,"Objectives: Many service members do not seek care for mental health and addiction problems, often with serious consequences for them, their families, and their communities. This study tested the effectiveness of a brief, telephone-based, cognitive-behavioral intervention designed to improve treatment engagement among returning service members who screened positive for posttraumatic stress disorder (PTSD). Methods: Service members who had served in Operation Enduring Freedom or Operation Iraqi Freedom who screened positive for PTSD but had not engaged in PTSD treatment were recruited (N = 300), randomly assigned to either control or intervention conditions, and administered a baseline interview. Intervention participants received a brief cognitive-behavioral therapy intervention; participants in the control condition had access to usual services. All participants received follow-up phone calls at months 1, 3, and 6 to assess symptoms and service utilization. Results: Participants in both conditions had comparable rates of treatment engagement and PTSD symptom reduction over the course of the six-month trial, but receiving the telephone-based intervention accelerated service utilization (treatment engagement and number of sessions) and PTSD symptom reduction. Conclusions: A one-time brief telephone intervention can engage service members in PTSD treatment earlier than conventional methods and can lead to immediate symptom reduction. There were no differences at longer-term follow-up, suggesting the need for additional intervention to build upon initial gains. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stecker, Tracy; McHugo, Gregory; Xie, Haiyi; Whyman, Katrina; Jones, Meissa; Ajzen, Blanchard, Britt, Brown, Harpaz-Rotem, Hoge, Kim, Kulka, Lu, Milliken, Oldham, Pietrzak, Rae Olmsted, Ramchand, Reger, Rosenheck, Schell, Schnurr, Seal, Seal, Sheehan, Solomon, Spitzer, Stecker, Stecker, Stecker, Sundin, Tanielian, Vogt, Weathers",2014.0,,0,1,
395,Cognitive-behavior therapy for late-life generalized anxiety disorder in primary care: Preliminary findings.,"The authors present data from a pilot research program initiated to develop, refine, and test the outcomes of CBT-GAD/PC, a version of cognitive-behavior therapy (CBT) that targets the needs of older adults with generalized anxiety disorder (GAD) in primary care (PC). The study involved a small, randomized clinical trial comparing the impact of CBT-GAD/PC to usual care (UC) in a sample of 12 older medical patients (aged 62-79 yrs) with GAD. Outcome data suggested significant improvements in worry and depression after CBT-GAD/PC, relative to UC Authors discuss results in terms of the ""real-world"" applicability of this treatment for late-life GAD, and present implications for future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stanley, Melinda A; Hopko, Derek R; Diefenbach, Gretchen J; Bourland, Stacey L; Rodriguez, Hector; Wagener, Paula; Barlow, Brown, De Beurs, Kim, Meichenbaum, Morin, Stanley, Stanley, Stanley, Wetherell",2003.0,,0,1,
396,Cognitive therapy vs interpersonal psychotherapy in social anxiety disorder: A randomized controlled trial.,"Context: Cognitive therapy (CT) focuses on the modification of biased information processing and dysfunctional beliefs of social anxiety disorder (SAD). Interpersonal psychotherapy (IPT) aims to change problematic interpersonal behavior patterns that may have an important role in the maintenance of SAD. No direct comparisons of the treatments for SAD in an outpatient setting exist. Objective: To compare the efficacy of CT, IPT, and a waiting-list control (WLC) condition. Design: Randomized controlled trial. Setting: Two academic outpatient treatment sites. Patients: Of 254 potential participants screened, 117 had a primary diagnosis of SAD and were eligible for randomization; 106 participants completed the treatment or waiting phase. Interventions: Treatment comprised 16 individual sessions of either CT or IPT and 1 booster session. Twenty weeks after randomization, posttreatment assessment was conducted and participants in the WLC received 1 of the treatments. Main Outcome Measures: The primary outcome was treatment response on the Clinical Global Impression Improvement Scale as assessed by independent masked evaluators. The secondary outcome measures were independent assessor ratings using the Liebowitz Social Anxiety Scale, the Hamilton Rating Scale for Depression, and patient self-ratings of SAD symptoms. Results: At the posttreatment assessment, response rates were 65.8% for CT, 42.1% for IPT, and 7.3% for WLC. Regarding response rates and Liebowitz Social Anxiety Scale scores, CT performed significantly better than did IPT, and both treatments were superior to WLC. At 1-year follow-up, the differences between CT and IPT were largely maintained, with significantly higher response rates in the CT vs the IPT group (68.4% vs 31.6%) and better outcomes on the Liebowitz Social Anxiety Scale. No significant treatment x site interactions were noted. Conclusions: Cognitive therapy and IPT led to considerable improvements that were maintained 1 year after treatment; CT was more efficacious than was IPT in reducing social phobia symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stangier, Ulrich; Schramm, Elisabeth; Heidenreich, Thomas; Berger, Matthias; Clark, David M; Acarturk, Agras, Alden, Amir, Borge, Borkovec, Clark, Clark, Clark, Connor, Davidson, Elkin, Elkin, Fairburn, First, First, Fluckiger, Hamilton, Hamilton, Harvey, Heimberg, Hirsch, Hofmann, Hofmann, Hofmann, Ipser, Jacobson, Keller, Kessler, Klerman, Liebowitz, Liebowitz, Liebowitz, Lincoln, Lipsitz, Lipsitz, Luborsky, Markowitz, Mathew, McManus, McManus, Mennin, Mortberg, Neal, Parker, Rapee, Ruscio, Stangier, Stangier, Stangier, Turner, Weissman, Wild, Wittchen, Zaider",2011.0,,0,1,
397,The efficacy of videotape feedback for enhancing the effects of exposure-based treatment for social anxiety disorder: A controlled investigation.,"Correcting patients' faulty beliefs concerning social evaluative threats is the hallmark of cognitive-behavioral treatment of social anxiety disorder. The current study examined the efficacy of two videotape feedback procedures as adjuncts to exposure-based treatment. Participants suffering from social phobia (N = 77) were randomly assigned to one of four conditions: (a) credible placebo treatment (PLA); (b) exposure+no feedback (EXP); (c) exposure+videotape feedback of performance (PER); or (d) exposure+videotape feedback of audience responses (AUD). Contrary to prediction, the videotape feedback procedures did not enhance the effects of exposure-based treatment. Clinical and theoretical implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Smits, Jasper A. J; Powers, Mark B; Buxkamper, Rachel; Telch, Michael J; Amir, Andrews, Baker, Borkovec, Clark, Clark, Cohen, Davidson, Foa, Glass, Gould, Harvey, Hazlett-Stevens, Heimberg, Hofmann, Jacobson, Kessler, Kraemer, Leonard, Leonard, Liebowitz, Lincoln, Means-Christensen, Mennin, Powers, Rapee, Rapee, Rodebaugh, Roy-Byrne, Roy-Byrne, Salkovskis, Sanchez-Meca, Sloan, Stopa, Taylor, Telch, van Ameringen, van Vliet, Wells, Wittchen, Wittchen",2006.0,,0,1,
398,Outcomes from a group intervention for coping with HIV/AIDS and childhood sexual abuse: reductions in traumatic stress,"ER Childhood sexual abuse is common among HIV-infected persons, though few empirically supported treatments addressing sexual abuse are available for men and women with HIV/AIDS. This study reports the outcome from a randomized controlled trial of a group intervention for coping with HIV and sexual abuse. A diverse sample of 202 HIV-positive men and women who were sexually abused as children was randomly assigned to one of three conditions: a 15-session HIV and trauma coping group intervention, a 15-session support group comparison condition, or a waitlist control (later randomly assigned to an intervention condition). Traumatic stress symptoms were assessed at baseline and post-intervention, with analysis conducted for the three-condition comparison followed by analysis of the two-condition comparison between the coping and support group interventions. Participants in the coping group intervention exhibited reductions in intrusive traumatic stress symptoms compared to the waitlist condition and in avoidant traumatic stress symptoms compared to the support group condition. No differences were found between the support group intervention and waitlist conditions. Tests of clinical significance documented the meaningfulness of change in symptoms.","Sikkema, K J; Hansen, N B; Kochman, A; Tarakeshwar, N; Neufeld, S; Meade, C S; Fox, A M",2007.0,10.1007/s10461-006-9149-8,0,1,
399,The Effectiveness of Eye Movement Desensitization and Reprocessing Therapy to Treat Symptoms Following Trauma in Timor Leste.,"The effectiveness of eye movement desensitization and reprocessing (EMDR) therapy for treating trauma symptoms was examined in a postwar/conflict, developing nation, Timor Leste. Participants were 21 Timorese adults with symptoms of posttraumatic stress disorder (PTSD), assessed as those who scored ≥2 on the Harvard Trauma Questionnaire (HTQ). Participants were treated with EMDR therapy. Depression and anxiety symptoms were assessed using the Hopkins Symptom Checklist. Symptom changes post-EMDR treatment were compared to a stabilization control intervention period in which participants served as their own waitlist control. Sessions were 60-90 mins. The average number of sessions was 4.15 (SD = 2.06). Despite difficulties providing treatment cross-culturally (i.e., language barriers), EMDR therapy was followed by significant and large reductions in trauma symptoms (Cohen's d = 2.48), depression (d = 2.09), and anxiety (d = 1.77). At posttreatment, 20 (95.2%) participants scored below the HTQ PTSD cutoff of 2. Reliable reductions in trauma symptoms were reported by 18 participants (85.7%) posttreatment and 16 (76.2%) at 3-month follow-up. Symptoms did not improve during the control period. Findings support the use of EMDR therapy for treatment of adults with PTSD in a cross-cultural, postwar/conflict setting, and suggest that structured trauma treatments can be applied in Timor Leste.",Schubert SJ.; Lee CW.; de Araujo G.; Butler SR.; Taylor G.; Drummond PD.,2016.0,10.1002/jts.22084,0,1,
400,Attentional bias modification in posttraumatic stress disorder: A randomized controlled trial.,"Background: Attentional bias modification (ABM) is a new treatment for anxiety disorders. Three randomized controlled clinical trials have shown positive effects of ABM in social anxiety disorder and generalized anxiety disorder. This study investigated the efficacy of ABM in outpatients with chronic posttraumatic stress disorder (PTSD). Methods: Randomized controlled double-blind trial (n = 102). ABM and control treatment consisted of eight 20-min sessions over the course of 3 weeks. Symptoms and attentional bias were assessed before and after treatment and at 3-week follow-up. Results: ABM and the control treatment were equally effective in reducing the symptoms of PTSD. The effect sizes of the improvement (from before to after treatment) were 0.66 for ABM and 0.46 for the control treatment, which is comparable to the effect sizes of pill-placebos in pharmacotherapy trials of chronic PTSD. Both treatments did not affect attentional bias. The acceptability and tolerability of ABM was moderate. Conclusions: This version of ABM is not an effective treatment of PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schoorl, Maartje; Putman, Peter; van Der Does, Willem; Amir, Amir, Bar Haim, Blake, Brady, Davidson, Dorrepaal, Hakamata, Hensel-Dittmann, Hovens, Hovens, Lang, Marshall, Mathews, Mersch, Mogg, Schmidt, Sheehan, Spinhoven, Van Emmerik, Williams, Zigmond",2013.0,,0,1,
401,Attentional bias modification in posttraumatic stress disorder: a randomized controlled trial.,"Attentional bias modification (ABM) is a new treatment for anxiety disorders. Three randomized controlled clinical trials have shown positive effects of ABM in social anxiety disorder and generalized anxiety disorder. This study investigated the efficacy of ABM in outpatients with chronic posttraumatic stress disorder (PTSD). Randomized controlled double-blind trial (n = 102). ABM and control treatment consisted of eight 20-min sessions over the course of 3 weeks. Symptoms and attentional bias were assessed before and after treatment and at 3-week follow-up. ABM and the control treatment were equally effective in reducing the symptoms of PTSD. The effect sizes of the improvement (from before to after treatment) were 0.66 for ABM and 0.46 for the control treatment, which is comparable to the effect sizes of pill-placebos in pharmacotherapy trials of chronic PTSD. Both treatments did not affect attentional bias. The acceptability and tolerability of ABM was moderate. This version of ABM is not an effective treatment of PTSD.",Schoorl M.; Putman P.; Van Der Does W.,2013.0,10.1159/000341920,0,1,
402,"RESPECT-PTSD: re-engineering systems for the primary care treatment of PTSD, a randomized controlled trial.","Although collaborative care is effective for treating depression and other mental disorders in primary care, there have been no randomized trials of collaborative care specifically for patients with Posttraumatic stress disorder (PTSD). To compare a collaborative approach, the Three Component Model (3CM), with usual care for treating PTSD in primary care. The study was a two-arm, parallel randomized clinical trial. PTSD patients were recruited from five primary care clinics at four Veterans Affairs healthcare facilities and randomized to receive usual care or usual care plus 3CM. Blinded assessors collected data at baseline and 3-month and 6-month follow-up. Participants were 195 Veterans. Their average age was 45 years, 91% were male, 58% were white, 40% served in Iraq or Afghanistan, and 42% served in Vietnam. All participants received usual care. Participants assigned to 3CM also received telephone care management. Care managers received supervision from a psychiatrist. PTSD symptom severity was the primary outcome. Depression, functioning, perceived quality of care, utilization, and costs were secondary outcomes. There were no differences between 3CM and usual care in symptoms or functioning. Participants assigned to 3CM were more likely to have a mental health visit, fill an antidepressant prescription, and have adequate antidepressant refills. 3CM participants also had more mental health visits and higher outpatient pharmacy costs. Results suggest the need for careful examination of the way that collaborative care models are implemented for treating PTSD, and for additional supports to encourage primary care providers to manage PTSD.",Schnurr PP.; Friedman MJ.; Oxman TE.; Dietrich AJ.; Smith MW.; Shiner B.; Forshay E.; Gui J.; Thurston V.,2013.0,10.1007/s11606-012-2166-6,0,1,
403,Randomized controlled trial of false safety behavior elimination therapy: A unified cognitive behavioral treatment for anxiety psychopathology.,"We tested the efficacy of a unified cognitive-behavioral therapy protocol for anxiety disorders. This group treatment protocol, termed false safety behavior elimination therapy (F-SET), is a cognitive-behavioral approach designed for use across various anxiety disorders such as panic disorder (PD), social anxiety disorder (SAD), and generalized anxiety disorder (GAD). F-SET simplifies, as well as broadens, key therapeutic elements of empirically validated treatments for anxiety disorders to allow for easier delivery to heterogeneous groups of patients with anxiety psychopathology. Patients with a primary anxiety disorder diagnosis (N=96) were randomly assigned to F-SET or a wait-list control. Data indicate that F-SET shows good efficacy and durability when delivered to mixed groups of patients with anxieties (i.e., PD, SAD, GAD) by relatively inexperienced clinicians. Findings are discussed in the context of balancing treatment efficacy and clinical utility. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schmidt, Norman B; Buckner, Julia D; Pusser, Andrea; Woolaway-Bickel, Kelly; Preston, Jennifer L; Norr, Aaron; Allen, Amir, Asmundson, Ballenger, Barlow, Barlow, Beck, Bjornsson, Bobes, Borkovec, Breier, Butler, Carter, Chambless, Cox, Davis, DeRubeis, Dugas, Fedoroff, Feske, First, Foa, Gloster, Goisman, Gould, Gould, Grant, Guy, Hambrick, Heimberg, Heimberg, Heimberg, Hope, Hoyer, Jacobson, Kamphuis, Kessler, Kessler, Kline, Maxwell, Mineka, Nathan, Norton, Norton, Norton, Olatunji, Olfson, Otto, Peterson, Peterson, Rodebaugh, Salkovskis, Salkovskis, Salkovskis, Schmidt, Schmidt, Schmidt, Schmidt, Schmidt, Schmidt, Sheehan, Shortt, Siddle, Sloan, Smits, Taylor, Taylor, Taylor, Telch, van Balkom, Wade, Wells, Woody, Yen, Young",2012.0,,0,1,
404,Effectiveness of EMDR in patients with substance use disorder and comorbid PTSD: Study protocol for a randomized controlled trial.,"Background: Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment for PTSD. However, it is unclear whether EMDR shows the same effectiveness in patients with substance use disorders (SUD) and comorbid PTSD. In this trial, we examine the effectiveness of EMDR in reducing PTSD symptoms in patients with SUD and PTSD. Methods/Design: We conduct a single-blinded RCT among 158 patients with SUD and comorbid PTSD admitted to a German addiction rehabilitation center specialized for the treatment of patients with SUD and comorbid PTSD. Patients are randomized to receive either EMDR, added to SUD rehabilitation and non-trauma-focused PTSD treatment (TAU), or TAU alone. The primary outcome is change from baseline in PTSD symptom severity as measured by the Clinician-Administered PTSD Scale at 6-month follow-up. Secondary outcomes are change from baseline in substance use, addiction-related problems, depressive symptoms, dissociative symptoms, emotion dysregulation and quality of life. Assessments are carried out by blinded raters at admission, at end of treatment, and at 3- and 6-month follow-up. We expect that EMDR plus TAU will be more effective in reducing PTSD symptoms than TAU alone. Mixed models will be conducted using an intention-to-treat and per-protocol approach. Discussion: This study aims to expand the knowledge about the effectiveness of EMDR in patients with SUD and comorbid PTSD. The expected finding of the superiority of EMDR in reducing PTSD symptoms compared to non-trauma-focused PTSD treatment may enhance the use of trauma-focused treatment approaches for patients with SUD and co-morbid PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Schafer, Ingo; Chuey-Ferrer, Laycen; Hofmann, Arne; Lieberman, Peter; Mainusch, Gunter; Lotzin, Annett; Back, Becker, Berman, Bernstein, Bradley, Coffey, Dore, Driessen, Dybek, Flatten, Foa, Gratz, Hautzinger, Hien, Hiller, Hiller, Jacobsen, Korn, McGahan, McGovern, Mills, Mills, Missel, Najavits, Najavits, Ouimette, Potthast, Reddemann, Regel, Saladin, Saunders, Schnyder, Schafer, Shapiro, Shapiro, Sobell, Spitzer, Thormann, van Dam, van Minnen, Wagner, Waldrop, Ware Jr, Watts, Weathers, Weathers, Weiss, Zobel",2017.0,,0,1,
405,A prospective study of the effectiveness of group and individual psychotherapy for women CSA survivors,"ER DESIGNThis study used a patient preference design with random allocation to one of two treatment modalities (individual or group treatment). There was a waiting list control.METHODA group of 48 women patients were assessed on 4 psychological measures when entering a waiting list condition, immediately before treatment and after completion of 12 sessions of psychotherapy, either in a group or individually. Follow-up data were collected at 4 months and 8 months.RESULTSBoth individual and group patients showed highly statistically and clinically significant improvements after treatment. These gains were maintained at follow-up with the exception of one measure that indicated a significant decline from post-treatment levels for the group patients.CONCLUSIONSThis model of psychotherapy is highly effective, when delivered by chartered clinical psychologists to patients whose preferences for individual or group therapy have been met.OBJECTIVESThere is little empirical evidence to guide clinical practice in treating adult patients presenting to adult mental health and primary care services with severe psychological difficulties consequent on childhood sexual abuse. The aim of this study was to determine the effectiveness of a model of short term, focal, integrative psychotherapy with this population of patients and to compare outcomes when the model is delivered on an individual or group basis.","Ryan, M; Nitsun, M; Gilbert, L; Mason, H",2005.0,10.1348/147608305X42226,0,1,
406,Design and rationale of a comparative effectiveness trial evaluating transcendental meditation against established therapies for PTSD.,"Although meditation therapies such as the Transcendental Meditation (TM) technique are commonly used to assist with stress and stress-related diseases, there remains a lack of rigorous clinical trial research establishing the relative efficacy of these treatments overall and for populations with psychiatric illness. This study uses a comparative effectiveness design to assess the relative benefits of TM to those obtained from a gold-standard cognitive behavioral therapy for posttraumatic stress disorder (PTSD) in a Veteran population. This paper describes the rationale and design of an in progress randomized controlled trial comparing TM to an established cognitive behavioral treatment - Prolonged Exposure (PE) - and an active control condition (health education [HE]) for PTSD. This trial will recruit 210 Veterans meeting DSM-IV criteria for PTSD, with testing conducted at 0 and 3 months for PTSD symptoms, depression, mood disturbance, quality of life, behavioral factors, and physiological/biochemical and gene expression mechanisms using validated measures. The study hypothesis is that TM will be noninferior to PE and superior to HE on changes in PTSD symptoms, using the Clinician Administered PTSD Scale (CAPS). The described study represents a methodologically rigorous protocol evaluating the benefits of TM for PTSD. The projected results will help to establish the overall efficacy of TM for PTSD among Veterans, identify bio-behavioral mechanisms through which TM and PE may improve PTSD symptoms, and will permit conclusions regarding the relative value of TM against currently established therapies for PTSD.",Rutledge T.; Nidich S.; Schneider RH.; Mills PJ.; Salerno J.; Heppner P.; Gomez MA.; Gaylord-King C.; Rainforth M.,2014.0,10.1016/j.cct.2014.07.005,0,1,
407,A randomized trial to improve the quality of treatment for panic and generalized anxiety disorders in primary care.,"Panic disorder and generalized anxiety disorder are prevalent in primary care, associated with poor functional outcomes, and are often unrecognized and ineffectively treated by primary care physicians. To examine whether telephone-based collaborative care for panic and generalized anxiety disorders improves clinical and functional outcomes more than the usual care provided by primary care physicians. Randomized controlled trial. Four Pittsburgh area primary care practices linked by a common electronic medical record system. Patients A total of 191 adults aged 18 to 64 years with panic and/or generalized anxiety disorder who were recruited from July 2000 to April 2002. Intervention Patients were randomly assigned to a telephone-based care management intervention (n = 116) or to notification alone of the anxiety disorder to patients and their physicians (usual care, n = 75). The intervention involved non-mental health professionals who provided patients with psychoeducation, assessed preferences for guideline-based care, monitored treatment responses, and informed physicians of their patients' care preferences and progress via an electronic medical record system under the direction of study investigators. Independent blinded assessments of anxiety and depressive symptoms, mental health-related quality of life, and employment status at baseline, 2-, 4-, 8-, and 12-month follow-up. At 12-month follow-up, intervention patients reported reduced anxiety (effect size [ES], 0.33-0.38; 95% confidence interval [CI], 0.04 to 0.67; P</=.02) and depressive symptoms (ES, 0.35; 95% CI, 0.25-0.46; P = .03); improved mental health-related quality of life (ES, 0.39; 95% CI, 0.10 to 0.68; P = .01); and larger improvements relative to baseline in hours worked per week (5.7; 95% CI, 0.1 to 11.3; P = .05) and fewer work days absent in the past month (-2.6; 95% CI, - 4.8 to -0.3; P = .03) than usual care patients. If working at baseline, more intervention patients than usual care patients remained working at 12-month follow-up (94% vs 79% [15% absolute difference, 0.7%-28.6%]; P = .04). Telephone-based collaborative care for panic disorder and generalized anxiety disorder is more effective than usual care at improving anxiety symptoms, health-related quality of life, and work-related outcomes.",Rollman BL.; Belnap BH.; Mazumdar S.; Houck PR.; Zhu F.; Gardner W.; Reynolds CF.; Schulberg HC.; Shear MK.,2005.0,10.1001/archpsyc.62.12.1332,0,1,
408,Disentangling the Effects of Safety-Behavior Utilization and Safety-Behavior Availability During Exposure-Based Treatment: A Placebo-Controlled Trial.,"The primary aim of the current study was to further investigate the deleterious effects of safety-seeking behaviors on fear reduction by disentangling the effects of perceived availability of threat-relevant safety behaviors during treatment versus their actual use. Participants (N=72) displaying marked claustrophobic fear were randomly assigned to 1 of 5 conditions: (a) exposure only (EO), (b) exposure with phobic safety-behavior availability (SBA), (c) exposure with safety-behavior utilization (SBU), (d) credible placebo treatment (PL), or (e) wait list (WL). High end-state functioning rates at posttreatment were as follows: EO=94%, SBA=45%, SBU=44%, PL=25%, and WL=0%. Findings suggest that it is the perception of the availability of safety aids as opposed to their actual use that exerts a disruptive effect on fear reduction. Clinical implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Powers, Mark B; Smits, Jasper A. J; Telch, Michael J; Cohen, Devilly, Jacobson, Kamphuis, Kraemer, Leonard, Leonard, Peters, Rachman, Radomsky, Salkovskis, Salkovskis, Salkovskis, Sloan, Sloan, Telch, Telch, Wells, Williams, Woody",2004.0,,0,1,
409,A Randomized Clinical Trial of Primary Care Brief Mindfulness Training for Veterans with PTSD.,"Primary care (PC) patients typically do not receive adequate posttraumatic stress disorder (PTSD) treatment. This study tested if a brief mindfulness training (BMT) offered in PC can decrease PTSD severity. VA PC patients with PTSD (N = 62) were recruited for a randomized clinical trial comparing PCBMT with PC treatment as usual. PCBMT is a 4-session program adapted from mindfulness-based stress reduction. PTSD severity decreased in both conditions, although PCBMT completers reported significantly larger decreases in PTSD and depression from pre- to posttreatment and maintained gains at the 8-week follow-up compared with the control group. Exploratory analyses revealed that the describing, nonjudging, and acting with awareness facets of mindfulness may account for decreases in PTSD. Our data support preliminary efficacy of BMT for Veterans with PTSD. Whether PCBMT facilitates engagement into, or improves outcomes of, full-length empirically supported treatment for PTSD remains to be evaluated.",Possemato K.; Bergen-Cico D.; Treatman S.; Allen C.; Wade M.; Pigeon W.,2016.0,10.1002/jclp.22241,0,1,
410,Mindfulness-Based Stress Reduction for Posttraumatic Stress Disorder Among Veterans: A Randomized Clinical Trial.,"Mindfulness-based interventions may be acceptable to veterans who have poor adherence to existing evidence-based treatments for posttraumatic stress disorder (PTSD). To compare mindfulness-based stress reduction with present-centered group therapy for treatment of PTSD. Randomized clinical trial of 116 veterans with PTSD recruited at the Minneapolis Veterans Affairs Medical Center from March 2012 to December 2013. Outcomes were assessed before, during, and after treatment and at 2-month follow-up. Data collection was completed on April 22, 2014. Participants were randomly assigned to receive mindfulness-based stress reduction therapy (n = 58), consisting of 9 sessions (8 weekly 2.5-hour group sessions and a daylong retreat) focused on teaching patients to attend to the present moment in a nonjudgmental, accepting manner; or present-centered group therapy (n = 58), an active-control condition consisting of 9 weekly 1.5-hour group sessions focused on current life problems. The primary outcome, change in PTSD symptom severity over time, was assessed using the PTSD Checklist (range, 17-85; higher scores indicate greater severity; reduction of 10 or more considered a minimal clinically important difference) at baseline and weeks 3, 6, 9, and 17. Secondary outcomes included PTSD diagnosis and symptom severity assessed by independent evaluators using the Clinician-Administered PTSD Scale along with improvements in depressive symptoms, quality of life, and mindfulness. Participants in the mindfulness-based stress reduction group demonstrated greater improvement in self-reported PTSD symptom severity during treatment (change in mean PTSD Checklist scores from 63.6 to 55.7 vs 58.8 to 55.8 with present-centered group therapy; between-group difference, 4.95; 95% CI, 1.92-7.99; P=.002) and at 2-month follow-up (change in mean scores from 63.6 to 54.4 vs 58.8 to 56.0, respectively; difference, 6.44; 95% CI, 3.34-9.53, P < .001). Although participants in the mindfulness-based stress reduction group were more likely to show clinically significant improvement in self-reported PTSD symptom severity (48.9% vs 28.1% with present-centered group therapy; difference, 20.9%; 95% CI, 2.2%-39.5%; P = .03) at 2-month follow-up, they were no more likely to have loss of PTSD diagnosis (53.3% vs 47.3%, respectively; difference, 6.0%; 95% CI, -14.1% to 26.2%; P = .55). Among veterans with PTSD, mindfulness-based stress reduction therapy, compared with present-centered group therapy, resulted in a greater decrease in PTSD symptom severity. However, the magnitude of the average improvement suggests a modest effect. clinicaltrials.gov Identifier: NCT01548742.",Polusny MA.; Erbes CR.; Thuras P.; Moran A.; Lamberty GJ.; Collins RC.; Rodman JL.; Lim KO.,2015.0,10.1001/jama.2015.8361,0,1,
411,A comparison of negative practice and systematic desensitization in the treatment of acrophobia.,"The purpose of this study was to evaluate the effectiveness of a symptom scheduling technique in reducing excessive fear. Acrophobic subjects were randomly assigned to one of three treatment conditions (negative practice, desensitization, and relaxation only) or to a waiting list control. Results from four self-report measures and a behavioral measure indicated that negative practice and desensitization were comparably effective. The relaxation only treatment was generally less effective, but did produce some improvement. It was concluded that symptom scheduling can be an effective treatment for acrophobia, and that these results are likely to generalize to clinical populations.",Pendleton MG.; Higgins RL.,1983.0,,0,1,
412,"Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): a cluster randomised controlled trial.","Depression and anxiety disorders are common mental disorders worldwide. The MANAS trial aimed to test the effectiveness of an intervention led by lay health counsellors in primary care settings to improve outcomes of people with these disorders. In this cluster randomised trial, primary care facilities in Goa, India, were assigned (1:1) by computer-generated randomised sequence to intervention or control (enhanced usual care) groups. All adults who screened positive for common mental disorders were eligible. The collaborative stepped-care intervention offered case management and psychosocial interventions, provided by a trained lay health counsellor, supplemented by antidepressant drugs by the primary care physician and supervision by a mental health specialist. The research assessor was masked. The primary outcome was recovery from common mental disorders as defined by the International Statistical Classification of Diseases and Related Health Problems-10th revision (ICD-10) at 6 months. This study is registered with ClinicalTrials.gov, number NCT00446407. 24 study clusters, with an equal proportion of public and private facilities, were randomised equally between groups. 1160 of 1360 (85%) patients in the intervention group and 1269 of 1436 (88%) in the control group completed the outcome assessment. Patients with ICD-10-confirmed common mental disorders in the intervention group were more likely to have recovered at 6 months than were those in the control group (n=620 [65·0%] vs 553 [52·9%]; risk ratio 1·22, 95% CI 1·00-1·47; risk difference=12·1%, 95% CI 1·6%-22·5%). The intervention had strong evidence of an effect in public facility attenders (369 [65·9%] vs 267 [42·5%], risk ratio 1·55, 95% CI 1·02-2·35) but no evidence for an effect in private facility attenders (251 [64·1%] vs 286 [65·9%], risk ratio 0·95, 0·74-1·22). There were three deaths and four suicide attempts in the collaborative stepped-care group and six deaths and six suicide attempts in the enhanced usual care group. None of the deaths were from suicide. A trained lay counsellor-led collaborative care intervention can lead to an improvement in recovery from CMD among patients attending public primary care facilities. The Wellcome Trust.",Patel V.; Weiss HA.; Chowdhary N.; Naik S.; Pednekar S.; Chatterjee S.; De Silva MJ.; Bhat B.; Araya R.; King M.; Simon G.; Verdeli H.; Kirkwood BR.,2010.0,10.1016/S0140-6736(10)61508-5,0,1,
413,Two-year follow-up after a randomised controlled trial of self- and clinician-accompanied exposure for phobia/panic disorders.,"Long-term follow-up has rarely been reported after self-exposure therapy for phobias. Completion of such a follow-up. Two-year follow-up was achieved in 68 (85%) of 80 patients with phobias who had completed a previous 14-week randomised controlled trial comparing therapist-accompanied self-exposure, self-exposure or self-relaxation. Measures were self-reported ratings of symptoms, satisfaction and use of other treatment. Improvement at week 14 was maintained 2 years later. Clinician-accompanied exposure and self-exposure did not differ on any measure. Compliance with self-exposure homework during weeks 0-8 predicted more improvement 2 years later. Patients who failed to improve with relaxation by week 14 improved after subsequent crossover to exposure. A need for more treatment for their phobias was still felt by 33 patients (49%). Patients with phobias maintained their improvement to 2-year follow-up after the end of self-exposure therapy.",Park JM.; Mataix-Cols D.; Marks IM.; Ngamthipwatthana T.; Marks M.; Araya R.; Al-Kubaisy T.,2001.0,,0,1,
414,The impact of prolonged exposure on PTSD symptoms and associated psychopathology in people living with HIV: a randomized test of concept.,"People living with HIV (PLWH) report elevated levels of posttraumatic stress disorder symptoms (PTSS) and associated comorbidities. The present study tested the efficacy of prolonged exposure (PE) at reducing PTSS, depression, negative posttraumatic cognitions, and substance use in PLWH. Participants were randomly assigned to receive PE (n = 40) or to a weekly monitoring control group (n = 25). Assessments occurred at baseline, post-intervention and 3-months post-treatment. Following the 3-month assessment, controls were offered the intervention. All PE recipients (whether originally from the PE or control group) completed a 6-month assessment. Intent-to-treat mixed model repeated measures ANOVAs were conducted through 3-months post-treatment; within group analyses were conducted through 6-months. PE recipients reported fewer PTSS and negative posttraumatic cognitions and were more likely to achieve good end-state functioning; gains were maintained at 6-months. No between-group differences emerged for substance use. Overall, results support the efficacy of PE in PLWH.",Pacella ML.; Armelie A.; Boarts J.; Wagner G.; Jones T.; Feeny N.; Delahanty DL.,2012.0,10.1007/s10461-011-0076-y,0,1,
415,One versus five sessions of exposure in the treatment of flying phobia.,"Twenty-eight patients with flying phobia, fulfilling the DSM-IV criteria for specific phobia, were assessed with behavioral, and self-report measures. They were randomly assigned to two treatment conditions: (1) 1-session, or (2) 5-sessions of exposure and cognitive restructuring. The first condition consisted of a single 3 hr session of massed treatment, and the second condition of 6 hr of gradual treatment. Treatment was done individually by very experienced therapists. The results showed that the two treatment conditions did equally well and there were no differences between them. At post-treatment 93% of the 1-session group and 79% of the 5-session group managed to take an unaccompanied return fight. At the 1-yr follow-up assessment the effects were maintained on all measures except the behavioral test; in both groups 64% of the patients took the flight. The most plausible reason for this deterioration is that during the follow-up year the subjects who relapsed didn't have the opportunity to fly as a job requirement with the employer paying the expenses. The implications of these results are discussed.",Ost LG.; Brandberg M.; Alm T.,1997.0,,0,1,
416,"Interpersonal psychotherapy for depression and posttraumatic stress disorder among HIV-positive women in Kisumu, Kenya: study protocol for a randomized controlled trial.","Mental disorders are the leading global cause of years lived with disability; the majority of this burden exists in low and middle income countries (LMICs). Over half of mental illness is attributable to depression and anxiety disorders, both of which have known treatments. While the scarcity of mental health care providers is recognized as a major contributor to the magnitude of untreated disorders in LMICs, studies in LMICs find that evidence-based treatments for depression and anxiety disorders, such as brief, structured psychotherapies, are feasible, acceptable and have strong efficacy when delivered by local non-specialist personnel. However, most mental health treatment studies using non-specialist providers in LMICs deploy traditional efficacy designs (T1) without the benefit of integrated mental health treatment models shown to succeed over vertical interventions or methods derived from new implementation science to speed policy change. Here, we describe an effectiveness-implementation hybrid study that evaluates non-specialist delivery of mental health treatment within an HIV clinic for HIV-positive (HIV+) women affected by gender- based violence (GBV) (HIV+ GBV+) in the Nyanza region of Kenya. In this effectiveness-implementation hybrid type I design, 200 HIV+ women with major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) who are receiving care at a Family AIDS Care Education and Services (FACES)-supported clinic in Kisumu, Kenya will be randomized to: (1) interpersonal psychotherapy (IPT) + treatment as usual (TAU) or (2) TAU, both delivered within the HIV clinic. IPT will consist of 12 weekly 60-minute individual IPT sessions, delivered by non-specialists trained to provide IPT. Primary effectiveness outcomes will include MDD and PTSD diagnosis on the Mini International Diagnostic Interview (MINI). Primary implementation outcomes will include treatment cost-benefit, acceptability, appropriateness, feasibility and fidelity of the IPT delivery within an HIV clinic. This trial leverages newly defined effectiveness-implementation hybrid designs to gather data on mental health treatment implementation within an HIV care clinic, while testing the effectiveness of an evidence-based treatment for use with a large underserved population (HIV+ GBV+ women) in Kenya.  NCT02320799, registered on 9 September 2014.",Onu C.; Ongeri L.; Bukusi E.; Cohen CR.; Neylan TC.; Oyaro P.; Rota G.; Otewa F.; Delucchi KL.; Meffert SM.,2016.0,10.1186/s13063-016-1187-6,0,1,
417,A randomized clinical trial of transdiagnostic cognitve-behavioral treatments for anxiety disorder by comparison to relaxation training.,"Transdiagnostic cognitive-behavioral treatments (CBT) for anxiety disorders have been gaining increased attention and empirical study in recent years. Despite this, all of the research on transdiagnostic anxiety treatments to date have either not used a control condition, or have relied on no-treatment or delayed-treatment controls, thus limiting inferences about comparative efficacy. The current study was a randomized clinical trial examining the efficacy of a 12-week transdiagnostic cognitive-behavioral group treatment in comparison to a 12-week comprehensive relaxation training program. Results from 87 treatment initiators suggested significant and statistically equivalent/noninterferior outcomes across conditions, although relaxation was associated with a greater rate of dropout despite no differences in treatment credibility. No evidence was found for any differential effects of transdiagnostic CBT for any primary or comorbid diagnoses. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Norton, Peter J; Andrews, Antony, Arntz, Barlow, Barlow, Beck, Beck, Bernstein, Borkovec, Borkovec, Borkovec, Borkovec, Brown, Brown, Brown, Brown, Butler, Chorpita, Clark, Clark, Craske, Craske, Craske, Craske, de Ruiter, Erickson, Erickson, Fairburn, Fedoroff, Fisher, Foa, Foa, Greist, Hedeker, Heimberg, Hofmann, Hope, Jang, Jerremalm, Kendall, Ledley, Lumpkin, Marks, McEvoy, McEvoy, Moses, Muthen, Newman, Norton, Norton, Norton, Norton, Norton, Norton, Norton, Norton, Norton, Ost, Ost, Paterson, Persons, Piaggio, Resick, Roemer, Schmidt, Schmidt, Shear, Siev, Spielberger, Spielberger, Tyrer, Wiens, Wolitzky-Taylor, Zollo",2012.0,,0,1,
418,A randomized clinical trial of transdiagnostic cognitve-behavioral treatments for anxiety disorder by comparison to relaxation training.,"Transdiagnostic cognitive-behavioral treatments (CBT) for anxiety disorders have been gaining increased attention and empirical study in recent years. Despite this, all of the research on transdiagnostic anxiety treatments to date have either not used a control condition, or have relied on no-treatment or delayed-treatment controls, thus limiting inferences about comparative efficacy. The current study was a randomized clinical trial examining the efficacy of a 12-week transdiagnostic cognitive-behavioral group treatment in comparison to a 12-week comprehensive relaxation training program. Results from 87 treatment initiators suggested significant and statistically equivalent/noninferior outcomes across conditions, although relaxation was associated with a greater rate of dropout despite no differences in treatment credibility. No evidence was found for any differential effects of transdiagnostic CBT for any primary or comorbid diagnoses.",Norton PJ.,2012.0,10.1016/j.beth.2010.08.011,0,1,
419,Reductions in negative repetitive thinking and metacognitive beliefs during transdiagnostic internet cognitive behavioural therapy (iCBT) for mixed anxiety and depression.,"We explored whether transdiagnostic internet-delivered cognitive behavioural therapy (iCBT) for mixed anxiety and depression effectively reduces repetitive negative thinking (RNT), and whether reductions in RNT and positive metacognitive beliefs mediate symptom improvement during iCBT. Participants with generalized anxiety disorder (GAD), major depressive disorder (MDD), or mixed GAD/MDD diagnoses were randomly allocated to a 6-lesson clinician-guided iCBT anxiety and depression program (n = 46) or wait-list control (WLC, n = 53). Depression (PHQ-9), generalized anxiety (GAD-7), RNT (Repetitive Thinking Questionnaire) and positive beliefs about RNT (Positive Beliefs about Rumination Scale) were assessed at pre-, mid-, and post-treatment or matched time points for WLC. Tests of serial indirect effects explored the potential meditating role of RNT and positive belief reductions on the impact of iCBT on depression and anxiety symptoms post-treatment. Results showed that both RNT frequency and positive beliefs about the value of RNT reduced significantly following iCBT compared to WLC, with gains maintained at 3-month follow-up. Reductions between pre- and mid-treatment in positive beliefs and RNT mediated improvements in depression symptoms post-iCBT, and reductions in positive beliefs mediated improvements in GAD symptoms. These findings indicate that iCBT is an effective treatment for RNT and positive metacognitive beliefs. Future dismantling studies are needed to assess the most effective treatment components.",Newby JM.; Williams AD.; Andrews G.,2014.0,10.1016/j.brat.2014.05.009,0,1,
420,Can asylum-seekers with posttraumatic stress disorder be successfully treated? A randomized controlled pilot study.,"Rates of posttraumatic stress disorder (PTSD) are exceptionally high among asylum-seekers. Reportedly, stressors caused by the asylum procedure and psychological consequences of torture contribute to the maintenance of symptoms and interfere with treatment. In a pilot randomized controlled trial, the authors examined the efficacy of trauma-focused treatment in 32 asylum-seekers with PTSD resulting from state-sponsored violence and other traumatic events. Narrative exposure therapy (NET) was compared with treatment as usual (TAU), with a focus on stabilization and psychoactive medication. Six months after treatment, a significant reduction of posttraumatic stress symptoms was found in the NET participants but not in the TAU group. Although treatment gains were moderate, these results indicate that NET is a promising approach for the treatment of PTSD in asylum-seekers living in unstable conditions.",Neuner F.; Kurreck S.; Ruf M.; Odenwald M.; Elbert T.; Schauer M.,2010.0,10.1080/16506070903121042,0,1,
421,Internet-delivered attention modification training as a treatment for social phobia: a randomized controlled trial.,"Attentional biases toward social threat are a well-known phenomenon in social phobia. Recently, computer-delivered trainings have been developed to modify these patterns of attention and thereby reduce anxiety symptoms. Distribution of such attention trainings (ATs) via internet might be a promising approach in overcoming obstacles in health care utilization. However, there is no evidence supporting the effectiveness of internet-based ATs in clinical populations. The current trial examined effects of an internet-based AT on self-report measures, behavioral data and diagnostic status in individuals with social phobia (N = 56). Participants were randomly assigned to either AT using a modified dot probe paradigm or a control condition without attention modification. After training and at a 4-month follow-up, both groups showed small, albeit significant reductions in social anxiety and depression, but there was no evidence for superiority of the AT condition. The present findings question the effectiveness of internet-based ATs in social phobia. Future studies need to investigate effective variants of internet-based ATs before they can be widely applied.",Neubauer K.; von Auer M.; Murray E.; Petermann F.; Helbig-Lang S.; Gerlach AL.,2013.0,10.1016/j.brat.2012.10.006,0,1,
422,"A 3-year comparison of dental anxiety treatment outcomes: hypnosis, group therapy and individual desensitization vs. no specialist treatment.","Outcomes of hypnotherapy (HT), group therapy (GT) and individual systematic desensitization (SD) on extreme dental anxiety in adults aged 19-65 yr were compared by regular attendance behaviors, changes in dental anxiety and changes in beliefs about dentists and treatment after 3 yr. Treatment groups were comparable with a static reference control group of 65 anxious patients (Dental Anxiety Scale > or = 15) who were followed for a mean of nearly 6 yr. After 3 yr, 54.5% of HT patients, 69.6% of GT patients and 65.5% of SD patients were maintaining regular dental care habits. This was better than the 46.1% of the reference group, who reported going regularly to the dentist again within the cohort follow-up period, and 38.9% of a control subgroup with observation for 3 yr. Women were better regular attenders than men at 3 yr. Specialist-treated regular attenders were significantly less anxious and had more positive beliefs than regular attenders from reference groups. There were few differences between HT, GT and SD after 3 yr. It was concluded that many patients can, on their own, successfully start and maintain regular dental treatment habits with dentists despite years of avoidance associated with phobic or extreme anxiety. However, it also appears that these patients had less success in reducing dental anxiety and improving beliefs about dentists long-term than did patients who were treated at the specialist clinic with psychological strategies.",Moore R.; Brødsgaard I.; Abrahamsen R.,2002.0,,0,1,
423,"Psychophysiological outcome of cognitive, behavioral and psychophysiologically-based treatments of agoraphobia.","Psychophysiological process and outcome phenomena were analyzed to examine differential temporal patterns within and across cognitive, behavioral and physiologically-based treatments of agoraphobia. Eighty-eight severe and chronic agoraphobics with panic attacks (DSM-III) were randomly assigned to one of three treatments: Paradoxical Intention, Graduated Exposure or Progressive Deep Muscle Relaxation Training. Protocol therapists, whose treatment integrity was objectively monitored, conducted 12 two-hour weekly sessions. All subjects received programmed practice instructions concurrent with their primary treatment. Analyses revealed numerous significant reductions on in vivo psychophysiological measures for the relaxation condition, a few improvements for the exposure treatment and no effects for the paradoxical intention modality. The mediating role of pretreatment physiological reactivity in treatment outcome and follow-up status was examined and revealed no significant associations. Synchrony-desynchrony patterns were found to vary widely according to both treatment phase and the time interval between assessments. No between-group differences were observed on the proportion of synchronizers. However, synchronizers exhibited superior outcome and follow-up compared to desynchronizers on all domains except the physiological measures. Conceptual, methodological and clinical implications of these findings are discussed with recommendations for future research.",Michelson L.; Mavissakalian M.; Marchione K.; Ulrich RF.; Marchione N.; Testa S.,1990.0,,0,1,
424,Virtual reality exposure therapy does not provide any additional value in agoraphobic patients: a randomized controlled trial.,"A number of studies have demonstrated the efficacy of virtual reality exposure therapy (VRET) in specific phobias, but research in seriously impaired patients with agoraphobia is lacking. In this randomized controlled trial with patients with agoraphobia and panic disorder, VRET and exposure in vivo were compared in terms of outcome and processes involved. Patients with panic disorder with agoraphobia (n = 55) were randomly assigned to receive 4 sessions of cognitive behavioral therapy (CBT) followed by either 6 sessions of VRET or 6 sessions of exposure in vivo or to a waiting list control condition. Analyses showed that both active treatment packages were significantly more effective than no treatment and that no differences between VRET and exposure in vivo were found in three out of four outcome measures. On the panic disorder severity scale, however, CBT plus exposure in vivo was more effective than CBT plus VRET. The results show clear synchrony of temporal processes involved in VRET and exposure in vivo on weekly avoidance measures and cognitive measures. Further, it was shown that initial changes in agoraphobic cognitions during the CBT phase predicted later changes in agoraphobic avoidance behavior. These data support the notion that therapeutic processes involved might be the same in VRET and exposure in vivo. However, given the slight superiority of exposure in vivo above VRET, the costs involved in the implementation of VRET and the lack of long-term follow-up, VRET cannot yet be recommended for patients with agoraphobia.",Meyerbroeker K.; Morina N.; Kerkhof GA.; Emmelkamp PM.,2013.0,10.1159/000342715,0,1,
425,A randomized controlled trial of the efficacy and cost-effectiveness of a brief intensified cognitive behavioral therapy and/or pharmacotherapy for mood and anxiety disorders: design and methods.,"Anxiety and mood disorders involve a high disease burden and are associated with high economic costs. A stepped-care approach intervention and abbreviated diagnostic method are assumed to increase effectiveness and efficiency of the mental healthcare and are expected to reduce economic costs. Presented are the rationale, design, and methods of a two-armed randomized controlled trial comparing 'treatment as usual' (TAU) with a brief intensified cognitive behavioral therapy (CBT) and/or pharmacotherapy. Eligible participants (N=500) of five Dutch outpatient Mental Healthcare Centers are randomly assigned to either TAU or to the experimental condition (brief CBT and/or pharmacotherapy). Data on patients' progress and clinical effectiveness of treatment are assessed at baseline, post-treatment (3 months after baseline), and at 6 and 12 months post-treatment by Routine Outcome Monitoring (ROM). Cost analysis is performed on the obtained data. Since few studies have investigated both the clinical and cost effectiveness of a stepped-care approach intervention and a shortened diagnostic ROM method in both anxiety and/or mood disorders within secondary mental health care, the results of this study might contribute to the improvement of (cost)-effective treatment options and diagnostic methods for these disorders.",Meuldijk D.; Carlier IV.; van Vliet IM.; van den Akker-Marle ME.; Zitman FG.,2012.0,10.1016/j.cct.2012.05.002,0,1,
426,Impact of Collaborative Care for Underserved Patients with PTSD in Primary Care: a Randomized Controlled Trial.,"The effectiveness of collaborative care of mental health problems is clear for depression and growing but mixed for anxiety disorders, including posttraumatic stress disorder (PTSD). We know little about whether collaborative care can be effective in settings that serve low-income patients such as Federally Qualified Health Centers (FQHCs). We compared the effectiveness of minimally enhanced usual care (MEU) versus collaborative care for PTSD with a care manager (PCM). This was a multi-site patient randomized controlled trial of PTSD care improvement over 1 year. We recruited and enrolled 404 patients in six FQHCs from June 2010 to October 2012. Patients were eligible if they had a primary care appointment, no obvious physical or cognitive obstacles to participation, were age 18-65 years, planned to continue care at the study location for 1 year, and met criteria for a past month diagnosis of PTSD. The main outcomes were PTSD diagnosis and symptom severity (range, 0-136) based on the Clinician-Administered PTSD Scale (CAPS). Secondary outcomes were medication and counseling for mental health problems, and health-related quality of life assessed at baseline, 6 months, and 12 months. Patients in both conditions improved similarly over the 1-year evaluation period. At 12 months, PTSD diagnoses had an absolute decrease of 56.7% for PCM patients and 60.6% for MEU patients. PTSD symptoms decreased by 26.8 and 24.2 points, respectively. MEU and PCM patients also did not differ in process of care outcomes or health-related quality of life. Patients who actually engaged in care management had mental health care visits that were 14% higher (p < 0.01) and mental health medication prescription rates that were 15.2% higher (p < 0.01) than patients with no engagement. A minimally enhanced usual care intervention was similarly effective as collaborative care for patients in FQHCs.",Meredith LS.; Eisenman DP.; Han B.; Green BL.; Kaltman S.; Wong EC.; Sorbero M.; Vaughan C.; Cassells A.; Zatzick D.; Diaz C.; Hickey S.; Kurz JR.; Tobin JN.,2016.0,10.1007/s11606-016-3588-3,0,1,
427,Is Exposure Necessary? A Randomized Clinical Trial of Interpersonal Psychotherapy for PTSD.,"Exposure to trauma reminders has been considered imperative in psychotherapy for posttraumatic stress disorder (PTSD). The authors tested interpersonal psychotherapy (IPT), which has demonstrated antidepressant efficacy and shown promise in pilot PTSD research as a non-exposure-based non-cognitive-behavioral PTSD treatment. The authors conducted a randomized 14-week trial comparing IPT, prolonged exposure (an exposure-based exemplar), and relaxation therapy (an active control psychotherapy) in 110 unmedicated patients who had chronic PTSD and a score >50 on the Clinician-Administered PTSD Scale (CAPS). Randomization stratified for comorbid major depression. The authors hypothesized that IPT would be no more than minimally inferior (a difference <12.5 points in CAPS score) to prolonged exposure. All therapies had large within-group effect sizes (d values, 1.32-1.88). Rates of response, defined as an improvement of >30% in CAPS score, were 63% for IPT, 47% for prolonged exposure, and 38% for relaxation therapy (not significantly different between groups). CAPS outcomes for IPT and prolonged exposure differed by 5.5 points (not significant), and the null hypothesis of more than minimal IPT inferiority was rejected (p=0.035). Patients with comorbid major depression were nine times more likely than nondepressed patients to drop out of prolonged exposure therapy. IPT and prolonged exposure improved quality of life and social functioning more than relaxation therapy. This study demonstrated noninferiority of individual IPT for PTSD compared with the gold-standard treatment. IPT had (nonsignificantly) lower attrition and higher response rates than prolonged exposure. Contrary to widespread clinical belief, PTSD treatment may not require cognitive-behavioral exposure to trauma reminders. Moreover, patients with comorbid major depression may fare better with IPT than with prolonged exposure.",Markowitz JC.; Petkova E.; Neria Y.; Van Meter PE.; Zhao Y.; Hembree E.; Lovell K.; Biyanova T.; Marshall RD.,2015.0,10.1176/appi.ajp.2014.14070908,0,1,
428,Efficacy of a cognitive-behavioral treatment for insomnia and nightmares in Afghanistan and Iraq veterans with PTSD.,"Sleep disturbances are a core and salient feature of posttraumatic stress disorder (PTSD). Pilot studies have indicated that combined cognitive-behavioral therapy for insomnia (CBT-I) and imagery rehearsal therapy (IRT) for nightmares improves sleep as well as PTSD symptoms. The present study randomized 40 combat veterans (mean age 37.7 years; 90% male and 60% African American) who served in Afghanistan and/or Iraq (Operation Enduring Freedom [OEF]/Operation Iraqi Freedom [OIF]) to 4 sessions of CBT-I with adjunctive IRT or a waitlist control group. Two thirds of participants had nightmares at least once per week and received the optional IRT module. At posttreatment, veterans who participated in CBT-I/IRT reported improved subjectively and objectively measured sleep, a reduction in PTSD symptom severity and PTSD-related nighttime symptoms, and a reduction in depression and distressed mood compared to the waitlist control group. The findings from this first controlled study with OEF/OIF veterans suggest that CBT-I combined with adjunctive IRT may hold promise for reducing both insomnia and PTSD symptoms. Given the fact that only half of the patients with nightmares fully implemented the brief IRT protocol, future studies should determine if this supplement adds differential efficacy to CBT-I alone.",Margolies SO.; Rybarczyk B.; Vrana SR.; Leszczyszyn DJ.; Lynch J.,2013.0,10.1002/jclp.21970,0,1,
429,Exposure to virtual social interactions in the treatment of social anxiety disorder: A randomized controlled trial.,"This randomized controlled trial investigated the efficacy of a stand-alone virtual reality exposure intervention comprising verbal interaction with virtual humans to target heterogeneous social fears in participants with social anxiety disorder. Sixty participants (Mage = 36.9 years; 63.3% women) diagnosed with social anxiety disorder were randomly assigned to individual virtual reality exposure therapy (VRET), individual in vivo exposure therapy (iVET), or waiting-list. Multilevel regression analyses revealed that both treatment groups improved from pre-to postassessment on social anxiety symptoms, speech duration, perceived stress, and avoidant personality disorder related beliefs when compared to the waiting-list. Participants receiving iVET, but not VRET, improved on fear of negative evaluation, speech performance, general anxiety, depression, and quality of life relative to those on waiting-list. The iVET condition was further superior to the VRET condition regarding decreases in social anxiety symptoms at post- and follow-up assessments, and avoidant personality disorder related beliefs at follow-up. At follow-up, all improvements were significant for iVET. For VRET, only the effect for perceived stress was significant. VRET containing extensive verbal interaction without any cognitive components can effectively reduce complaints of generalized social anxiety disorder. Future technological and psychological improvements of virtual social interactions might further enhance the efficacy of VRET for social anxiety disorder.",Kampmann IL.; Emmelkamp PM.; Hartanto D.; Brinkman WP.; Zijlstra BJ.; Morina N.,2016.0,10.1016/j.brat.2015.12.016,0,1,
430,A randomized controlled trial of guided internet-delivered cognitive behaviour therapy for older adults with generalized anxiety.,"This study aimed to establish the efficacy of guided Internet-delivered cognitive-behaviour therapy (ICBT) for older adults with generalized anxiety disorder (GAD) or subclinical GAD. Participants were randomized to receive seven modules of ICBT (n = 24) or to a waiting list condition (WLC; n = 22). Faster improvements in symptoms of anxiety and depression were observed for participants in the ICBT condition relative to the WLC, with large between-group effect sizes on the Generalized anxiety disorder-7 (d = .85) and the Patient health questionnaire (d = 1.17) obtained at post-treatment. Further reduction in generalized anxiety symptoms was reported over the one-month follow-up. Treatment effects were replicated when control participants subsequently underwent treatment. Higher ratings of treatment credibility, but not expectancy, prior to ICBT predicted improvements over time. The results support the efficacy of ICBT as treatment for older adults with GAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Jones, Shannon L; Hadjistavropoulos, Heather D; Soucy, Joelle N; Callahan, Cameron, Carlbring, Cheung, Crittendon, Dear, Dear, DeSouza, Devilly, Diefenbach, Diefenbach, Dozois, Gega, Hedman, Hedman, Heun, Hoifodt, Hollis, Hopko, Kessler, Klein, Kroenke, Lin, Lowe, Lowe, Mehta, Mohlman, Pachana, Porensky, Rubin, Sheehan, Sirey, Skevington, Spitzer, Stanley, Stanley, Stanley, Titov, Titov, Veenhof, Wancata, Westen, Wetherell, Yesavage, Zou",2016.0,,0,1,
431,A RCT of a transdiagnostic internet-delivered treatment for three anxiety disorders: examination of support roles and disorder-specific outcomes.,"Anxiety disorders share common vulnerabilities and symptoms. Disorder-specific treatment is efficacious, but few access evidence-based care. Administering transdiagnostic cognitive-behavioral therapy via the internet (iCBT) may increase access to evidence-based treatment, with a recent randomized controlled trial (RCT) providing preliminary support for this approach. This study extends those findings and aims to answer three questions: Is a transdiagnostic iCBT program for anxiety disorders efficacious and acceptable? Does it result in change for specific disorders? Can good clinical outcomes be obtained when guidance is provided via a Coach rather than a Clinician? RCT (N = 131) comparing three groups: Clinician-supported (CL) vs. Coach-supported (CO) vs. waitlist control (Control). Individuals met DSM-IV criteria for a principal diagnosis of generalized anxiety disorder (GAD), social phobia (SP) or panic disorder with or without agoraphobia (Pan/Ag). Treatment consisted of an 8-lesson/10 week iCBT program with weekly contact from a Clinician or Coach, and follow-up at 3-months post-treatment. Outcomes for the pooled treatment groups (CL+CO) were superior to the Control group on measures of anxiety, depression and disability, were associated with medium to large effect sizes (Cohen's d = .76-1.44) (response rate = 89-100%), and were maintained at follow-up. Significant reductions were found on disorder-specific outcomes for each of the target diagnoses, and were associated with large effect sizes. CO participants achieved similar outcomes to CL participants at post-treatment, yet had significantly lower symptom severity scores on general anxiety, panic-disorder, depression and disability at follow-up (d = .45-.46). Seventy-four percent of CO and 76% of CL participants completed the program. Less than 70 minutes of Clinician or Coach time was required per participant during the program. This transdiagnostic iCBT course for anxiety appears to be efficacious, associated with significant change for three target disorders, and is efficacious when guided by either a Clinician or Coach. Australian New Zealand Clinical Trials Registry ACTRN12610000242022.",Johnston L.; Titov N.; Andrews G.; Spence J.; Dear BF.,2011.0,10.1371/journal.pone.0028079,0,1,
432,A randomized controlled trial of cognitive-behavior therapy for Cambodian refugees with treatment-resistant PTSD and panic attacks: a cross-over design.,"We examined the therapeutic efficacy of a culturally adapted cognitive-behavior therapy for Cambodian refugees with treatment-resistant posttraumatic stress disorder (PTSD) and comordid panic attacks. We used a cross-over design, with 20 patients in the initial treatment (IT) condition and 20 in delayed treatment (DT). Repeated measures MANOVA, Group & times; Time ANOVAs, and planned contrasts indicated significantly greater improvement in the IT condition, with large effect sizes (Cohen's d) for all outcome measures: Anxiety Sensitivity Index (d = 3.78), Clinician-Administered PTSD Scale (d = 2.17), and Symptom Checklist 90-R subscales (d = 2.77). Likewise, the severity of (culturally related) neck-focused and orthostasis-cued panic attacks, including flashbacks associated with these subtypes, improved across treatment.",Hinton DE.; Chhean D.; Pich V.; Safren SA.; Hofmann SG.; Pollack MH.,2005.0,10.1002/jts.20070,0,1,
433,"No talking, just writing! Efficacy of an Internet-based cognitive behavioral therapy with exposure and response prevention in obsessive compulsive disorder.","Many patients with obsessive-compulsive disorder (OCD) do not receive first-line treatment according to the current guidelines (cognitive behavioral therapy with exposure and response prevention, CBT with ERP) due to barriers to treatment. Internet-based therapy is designed to overcome these barriers. The present study evaluates the efficacy of an Internet-based writing therapy with therapeutic interaction based on the concept of CBT with ERP for patients with OCD. Thirty-four volunteers with OCD according to DSM-IV-criteria were included in the trial and randomized according to a waiting-list control design with follow-up measures at 8 weeks and 6 months. The intervention consisted of 14 sessions, either starting directly after randomization or with an 8-week delay. Main outcome measure was the change in the severity of OCD symptoms (Yale-Brown Obsessive Compulsive Scale Self-Rating, Y-BOCS SR, and Obsessive-Compulsive Inventory-Revised, OCI-R). Obsessive-compulsive symptoms were significantly improved in the treatment group compared to the waiting-list control group with large effect sizes of Cohen's d = 0.82 (Y-BOCS SR) and d = 0.87 (OCI-R), using an intention-to-treat analysis. This effect remained stable at 6-month follow-up. Only 4 participants (12%) dropped out prematurely from the study. Of the 30 completers, 90% rated their condition as improved and would recommend the program to their friends. Internet-based writing therapy led to a significant improvement of obsessive-compulsive symptoms. Even though replications with larger sample sizes are needed, the results support the notion that Internet-based approaches have the potential for improving the treatment situation for patients with OCD.",Herbst N.; Voderholzer U.; Thiel N.; Schaub R.; Knaevelsrud C.; Stracke S.; Hertenstein E.; Nissen C.; Külz AK.,2014.0,10.1159/000357570,0,1,
434,A randomized controlled study of paroxetine and cognitive-behavioural therapy for late-life panic disorder.,"To examine the effectiveness of paroxetine and cognitive-behavioural therapy (CBT) in elderly patients suffering from panic disorder with or without agoraphobia (PD(A)). Forty-nine patients aged 60+ years with confirmed PD(A) were randomly assigned to 40 mg paroxetine, individual CBT, or to a 14-week waiting list. Outcomes, with avoidance behaviour and agoraphobic cognitions being the primary measures, were assessed at baseline and at weeks 8, 14 (conclusion CBT/waiting list), and at week 26 (treated patients only) and analysed using mixed models. All outcome measures showed that the patients having received CBT and those treated with paroxetine had significantly better improvement compared with those in the waiting-list condition. With one patient (1/20, 5%) in the CBT and three (3/14, 17.6%) in the paroxetine condition dropping out, attrition rates were low. Patients with late-life panic disorder respond well to both paroxetine and CBT. Although promising, the outcomes warrant replication in larger study groups.",Hendriks GJ.; Keijsers GP.; Kampman M.; Oude Voshaar RC.; Verbraak MJ.; Broekman TG.; Hoogduin CA.,2010.0,10.1111/j.1600-0447.2009.01517.x,0,1,
435,One- vs. five-session treatment of dental phobia: a randomized controlled study.,"Forty participants fulfilling the DSM-IV criteria for dental phobia were randomly assigned to a waitlist group, one-session or five-session exposure treatment. Assessment occurred pre-, post-waitlist/treatment, and after 1 year. Mean avoidance of dental care before treatment was 11.4 years. A total of 77% sought dental care in the follow-up year. Both treatments were equally effective at reducing avoidance behavior and changing cognitions during the feared situation. Post-treatment, the five-session group scored lower on the dental anxiety scales, but at follow-up, both groups reported the same level of dental anxiety. Both treatment conditions enable a return to ordinary dental treatment.",Haukebø K.; Skaret E.; Ost LG.; Raadal M.; Berg E.; Sundberg H.; Kvale G.,2008.0,10.1016/j.jbtep.2007.09.006,0,1,
436,Cognitive Therapy and Task Concentration Training Applied as Intensified Group Therapies for Social Anxiety Disorder with Fear of Blushing-A Randomized Controlled Trial.,"The current study examines the efficacy of intensified group therapy for social anxiety disorder with fear of blushing. Task concentration training (TCT) and cognitive therapy (CT) were applied during one weekend and compared with a waiting list condition in a randomized controlled trial including 82 patients. On a second weekend, another intervention was added (resulting in TCT-CT and CT-TCT sequences) to examine order effects. Task concentration training and CT were both superior to the waiting list and equally effective after the first therapy weekend. Also, no differences were found between the sequences TCT-CT and CT-TCT at post-assessment. At 6- and 12-month follow-up, effects remained stable or further improved. At the 6-month follow-up, remission rates in completers, established by diagnostic status, were between 69% and 73%. Intensified group therapy is highly effective in treating social anxiety disorder with fear of blushing. Group formats for patients sharing a common primary concern may contribute to the dissemination of cognitive-behavioural therapy. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message: This study focuses on blushing from fearful individuals within the SAD spectrum to improve evidence for treatment efficacy in those whose social fears are centred around observable bodily sensations. This study integrates task concentration training into the SAD model of Clark and Wells to combine two evidence-based treatments for SAD under one treatment model. This study uses an innovative format of brief, intensified group therapy, conducted on two full-day weekend group sessions delivered over two weekends, with strong observed effect sizes.",Härtling S.; Klotsche J.; Heinrich A.; Hoyer J.,2016.0,10.1002/cpp.1975,0,1,
437,Manualized therapy for PTSD: flexing the structure of cognitive processing therapy.,"This study tested a modified cognitive processing therapy (MCPT) intervention designed as a more flexible administration of the protocol. Number of sessions was determined by client progress toward a priori defined end-state criteria, ""stressor sessions"" were inserted when necessary, and therapy was conducted by novice CPT clinicians. A randomized, controlled, repeated measures, semicrossover design was utilized (a) to test the relative efficacy of the MCPT intervention compared with a symptom-monitoring delayed treatment (SMDT) condition and (b) to assess within-group variation in change with a sample of 100 male and female interpersonal trauma survivors with posttraumatic stress disorder (PTSD). Hierarchical linear modeling analyses revealed that MCPT evidenced greater improvement on all primary (PTSD and depression) and secondary (guilt, quality of life, general mental health, social functioning, and health perceptions) outcomes compared with SMDT. After the conclusion of SMDT, participants crossed over to MCPT, resulting in a combined MCPT sample (n = 69). Of the 50 participants who completed MCPT, 58% reached end-state criteria prior to the 12th session, 8% at Session 12, and 34% between Sessions 12 and 18. Maintenance of treatment gains was found at the 3-month follow-up, with only 2 of the treated sample meeting criteria for PTSD. Use of stressor sessions did not result in poorer treatment outcomes. Findings suggest that individuals respond at a variable rate to CPT, with significant benefit from additional therapy when indicated and excellent maintenance of gains. Insertion of stressor sessions did not alter the efficacy of the therapy.",Galovski TE.; Blain LM.; Mott JM.; Elwood L.; Houle T.,2012.0,10.1037/a0030600,0,1,
438,Cognitive-behavioral treatment of obsessive thoughts: a controlled study.,"Twenty-nine patients with obsessive-compulsive disorder as diagnosed in accordance with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; American Psychiatric Association, 1987) who did not have overt compulsive rituals were randomly assigned to treatment and waiting-list conditions. Patients in the treatment condition received cognitive-behavioral therapy consisting of a detailed explanation of the occurrence and maintenance of obsessive thoughts, exposure to obsessive thoughts, response prevention of all neutralizing strategies, cognitive restructuring, and relapse prevention. Compared with waiting-list patients, treated patients improved significantly on measures of severity of obsessions, current functioning, self-report obsessive-compulsive symptoms, and anxiety. When waiting-list patients were subsequently treated, the combined group improved on all outcome measures. Treatment gains were maintained at 6-month follow-up. Results indicate that cognitive-behavioral therapy is effective in the treatment of patients with obsessive thoughts, a group that has often been considered resistant to treatment.",Freeston MH.; Ladouceur R.; Gagnon F.; Thibodeau N.; Rhéaume J.; Letarte H.; Bujold A.,1997.0,,0,1,
439,Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: outcome at academic and community clinics.,"Female assault survivors (N=171) with chronic posttraumatic stress disorder (PTSD) were randomly assigned to prolonged exposure (PE) alone, PE plus cognitive restructuring (PE/CR), or wait-list (WL). Treatment, which consisted of 9-12 sessions, was conducted at an academic treatment center or at a community clinic for rape survivors. Evaluations were conducted before and after therapy and at 3-, 6-, and 12-month follow-ups. Both treatments reduced PTSD and depression in intent-to-treat and completer samples compared with the WL condition; social functioning improved in the completer sample. The addition of CR did not enhance treatment outcome. No site differences were found: Treatment in the hands of counselors with minimal cognitive- behavioral therapy (CBT) experience was as efficacious as that of CBT experts. Treatment gains were maintained at follow-up, although a minority of patients received additional treatment.",Foa EB.; Hembree EA.; Cahill SP.; Rauch SA.; Riggs DS.; Feeny NC.; Yadin E.,2005.0,10.1037/0022-006X.73.5.953,0,1,
440,Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial.,"This study further evaluates the efficacy of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP). A diagnostically heterogeneous clinical sample of 37 patients with a principal anxiety disorder diagnosis was enrolled in a randomized controlled trial (RCT) involving up to 18 sessions of treatment and a 6-month follow-up period. Patients were randomly assigned to receive either immediate treatment with the UP (n=26) or delayed treatment, following a 16-week wait-list control period (WLC; n=11). The UP resulted in significant improvement on measures of clinical severity, general symptoms of depression and anxiety, levels of negative and positive affect, and a measure of symptom interference in daily functioning across diagnoses. In comparison, participants in the WLC condition exhibited little to no change following the 16-week wait-list period. The effects of UP treatment were maintained over the 6-month follow-up period. Results from this RCT provide additional evidence for the efficacy of the UP in the treatment of anxiety and comorbid depressive disorders, and provide additional support for a transdiagnostic approach to the treatment of emotional disorders.",Farchione TJ.; Fairholme CP.; Ellard KK.; Boisseau CL.; Thompson-Hollands J.; Carl JR.; Gallagher MW.; Barlow DH.,2012.0,10.1016/j.beth.2012.01.001,0,1,
441,Cognitive therapy for post-traumatic stress disorder: development and evaluation.,"The paper describes the development of a cognitive therapy (CT) program for post-traumatic stress disorder (PTSD) that is based on a recent cognitive model (Behav. Res. Therapy 38 (2000) 319). In a consecutive case series, 20 PTSD patients treated with CT showed highly significant improvement in symptoms of PTSD, depression and anxiety. A subsequent randomized controlled trial compared CT (N = 14) and a 3-month waitlist condition (WL, N = 14). CT led to large reductions in PTSD symptoms, disability, depression and anxiety, whereas the waitlist group did not improve. In both studies, treatment gains were well maintained at 6-month follow-up. CT was highly acceptable, with an overall dropout rate of only 3%. The intent-to-treat effect sizes for the degree of change in PTSD symptoms from pre to post-treatment were 2.70-2.82 (self-report), and 2.07 (assessor-rated). The controlled effect sizes for CT versus WL post-treatment scores were 2.25 (self-report) and 2.18 (assessor-rated). As predicted by the cognitive model, good treatment outcome was related to greater changes in dysfunctional post-traumatic cognitions. Patient characteristics such as comorbidity, type of trauma, history of previous trauma, or time since the traumatic event did not predict treatment response, however, low educational attainment and low socioeconomic status were related to better outcome.",Ehlers A.; Clark DM.; Hackmann A.; McManus F.; Fennell M.,2005.0,10.1016/j.brat.2004.03.006,0,1,
442,Group cognitive-behavioral therapy for generalized anxiety disorder: treatment outcome and long-term follow-up.,"A recently developed cognitive-behavioral treatment for generalized anxiety disorder (GAD) targets intolerance of uncertainty by the reevaluation of positive beliefs about worry, problem-solving training, and cognitive exposure. As previous studies have established the treatment's efficacy when delivered individually, the present study tests the treatment in a group format as a way to enhance its cost-benefit ratio. A total of 52 GAD patients received 14 sessions of cognitive-behavioral therapy in small groups of 4 to 6 participants. A wait-list control design was used, and standardized clinician ratings and self-report questionnaires assessed GAD symptoms, intolerance of uncertainty, anxiety, depression, and social adjustment. Results show that the treatment group, relative to the wait-list group, had greater posttest improvement on all dependent variables and that treated participants made further gains over the 2-year follow-up phase of the study.",Dugas MJ.; Ladouceur R.; Léger E.; Freeston MH.; Langlois F.; Provencher MD.; Boisvert JM.,2003.0,,0,1,
443,Internet-delivered acceptance-based behaviour therapy for generalized anxiety disorder: A randomized controlled trial.,"Generalized anxiety disorder (GAD) is a disabling condition which can be treated with cognitive behaviour therapy (CBT). The present study tested the effects of therapist-guided internet-delivered acceptance-based behaviour therapy on symptoms of GAD and quality of life. An audio CD with acceptance and mindfulness exercises and a separate workbook were also included in the treatment. Participants diagnosed with GAD (N = 103) were randomly allocated to immediate therapist-guided internet-delivered acceptance-based behaviour therapy or to a waiting-list control condition. A six month follow-up was also included. Results using hierarchical linear modelling showed moderate to large effects on symptoms of GAD (Cohen's d = 0.70 to 0.98), moderate effects on depressive symptoms (Cohen's d = 0.51 to 0.56), and no effect on quality of life. Follow-up data showed maintained effects. While there was a 20% dropout rate, sensitivity analyses showed that dropouts did not differ in their degree of change during treatment. To conclude, our study suggests that internet-delivered acceptance-based behaviour therapy can be effective in reducing the symptoms of GAD.",Dahlin M.; Andersson G.; Magnusson K.; Johansson T.; Sjögren J.; Håkansson A.; Pettersson M.; Kadowaki Å.; Cuijpers P.; Carlbring P.,2016.0,10.1016/j.brat.2015.12.007,0,1,
444,Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators.,"Cognitive behavioral therapy (CBT) is an empirically supported treatment for social phobia. However, not all individuals respond to treatment and many who show improvement do not maintain their gains over the long-term. Thus, alternative treatments are needed. The current study (N = 87) was a 3-arm randomized clinical trial comparing CBT, acceptance and commitment therapy (ACT), and a wait-list control group (WL) in participants with a diagnosis of social phobia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). Participants completed 12 sessions of CBT or ACT or a 12-week waiting period. All participants completed assessments at baseline and posttreatment, and participants assigned to CBT and ACT also completed assessments 6 and 12 months following baseline. Assessments consisted of self-report measures, a public-speaking task, and clinician ratings. Multilevel modeling was used to examine between-group differences on outcomes measures. Both treatment groups outperformed WL, with no differences observed between CBT and ACT on self-report, independent clinician, or public-speaking outcomes. Lower self-reported psychological flexibility at baseline was associated with greater improvement by the 12-month follow-up in CBT compared with ACT. Self-reported fear of negative evaluation significantly moderated outcomes as well, with trends for both extremes to be associated with superior outcomes from CBT and inferior outcomes from ACT. Across treatment groups, higher perceived control and extraversion were associated with greater improvement, whereas comorbid depression was associated with poorer outcomes. Implications for clinical practice and future research are discussed.",Craske MG.; Niles AN.; Burklund LJ.; Wolitzky-Taylor KB.; Vilardaga JC.; Arch JJ.; Saxbe DE.; Lieberman MD.,2014.0,10.1037/a0037212,0,1,
445,Cognitive behavior therapy versus supportive therapy in social phobia: A randomized controlled trial.,"The efficacy of cognitive behavior therapy (CBT) in social phobia has been demonstrated in several controlled trials and meta-analyses, but no comparison of CBT with supportive therapy (ST) can be found in the literature. The aim of the trial was to study the effectiveness of CBT vs ST carried out ""as usual."" 67 Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) social phobic patients (89% generalized subtype, most with avoidant personality) were randomly allocated into 2 groups. Group 1 (CBT) received 8 1-hr sessions of individual cognitive therapy (CT) for 6 wks, followed by 6 2-hr sessions of social skills training (SST) in group weekly. Group 2 received ST for 12 wks (6 half-hour sessions), then the patients were switched to CBT. All patients agreed not to take any medication during the whole trial. In group 1, 29 patients reached week 6, 27 reached week 12, and 24 weeks 36 and 60 (endpoint). In group 2, 29 patients reached week 6, 28 reached weeks 12 and 18, 26 week 24, and 23 reached weeks 48 and 72 (endpoint). Results show that at week 6, after CT, group 1 was better than group 2 on the main social phobia measure. At week 12, after SST, group 1 was better than group 2 on most of the measures and demonstrated a significantly higher rate of responders. This finding was replicated after switching group 2 to CBT. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cottraux, Jean; Note, Ivan; Albuisson, Eliane; Yao, Sai Nan; Note, Brigitte; Mollard, Evelyne; Bonasse, Francoise; Jalenques, Isabelle; Guerin, Janine; Coudert, Andre Julien",2000.0,,0,1,
446,Skills training in affective and interpersonal regulation followed by exposure: A phase-based treatment for PTSD related to childhood abuse.,"Fifty-eight women with posttraumatic stress disorder (PTSD) related to childhood abuse were randomly assigned to a 2-phase cognitive-behavioral treatment or a minimal attention wait list. Phase 1 of treatment included 8 weekly sessions of skills training in affect and interpersonal regulation; Phase 2 included 8 sessions of modified prolonged exposure. Compared with those on wait list, participants in active treatment showed significant improvement in affect regulation problems, interpersonal skills deficits, and PTSD symptoms. Gains were maintained at 3- and 9-month follow-up. Phase 1 therapeutic alliance and negative mood regulation skills predicted Phase 2 exposure success in reducing PTSD, suggesting the value of establishing a strong therapeutic relationship and emotion regulation skills before exposure work among chronic PTSD populations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cloitre, Marylene; Koenen, Karestan C; Cohen, Lisa R; Han, Hyemee; Bagby, Beck, Blake, Briere, Briere, Briere, Burnstein, Cantanzaro, Chemtob, Cloitre, Cloitre, Cohen, Cohen, Falsetti, Finkelhor, First, Foa, Foa, Foa, Ford, Herman, Horowitz, Jaycox, Kessler, Linehan, Marks, McDonough-Coyle, Pitman, Resick, Resick, Rorty, Roth, Scott, Speilberger, Speilberger, Spitzer, Tarrier, Tracey, Turner, van der Kolk, van der Kolk, Weissman, Zlotnick, Zlotnick",2002.0,,0,1,
447,Psychodynamic psychotherapy versus cognitive behavior therapy for social anxiety disorder: an efficacy and partial effectiveness trial.,"Comparing the overall and differential effects of psychodynamic psychotherapy (PDT) versus cognitive behavior therapy (CBT) for social anxiety disorder (SAD). Patients with a primary SAD (N = 47) were randomly assigned to PDT (N = 22) or CBT (N = 27). Both PDT and CBT consisted of up to 36 sessions (average PDT 31.4 and CBT 19.8 sessions). Assessments took place at waitlist: pretest, after 12 and 24 weeks for those who received longer treatment: posttest, 3-month and 1-year follow-up. Changes in the main outcome measure self-reported social anxiety composite, as well as in other psychopathology, social skills, negative social beliefs, public self-consciousness, defense mechanisms, personal goals, independent rater's judgments of SAD and general improvement, and approach behavior during an objective test, were analyzed using multilevel analysis. No improvement occurred during waitlist. Treatments were highly efficacious, with large within-subject effect sizes for social anxiety, but no differences between PDT and CBT on general and treatment-specific measures occurred. Remission rates were over 50% and similar for PDT and CBT. Personality disorders did not influence the effects of PDT or CBT. PDT and CBT are both effective approaches for SAD. Further research is needed on the cost-effectiveness of PDT versus CBT, on different lengths PDT, and on patient preferences and their relationship to outcome of PDT versus CBT.",Bögels SM.; Wijts P.; Oort FJ.; Sallaerts SJ.,2014.0,10.1002/da.22246,0,1,
448,A controlled evaluation of cognitive behavioural therapy for posttraumatic stress in motor vehicle accident survivors.,"Seventy-eight motor vehicle accident survivors with chronic (greater than 6 months) PTSD, or severe sub-syndromal PTSD, completed a randomized controlled comparison of cognitive behavioral therapy (CBT), supportive psychotherapy (SUPPORT), or a Wait List control condition with two detailed assessments. Scores on the CAPS showed significantly greater improvement for those in CBT in comparison to the Wait List and to the SUPPORT conditions. The SUPPORT condition in turn was superior (p=0.012) to the Wait List. Categorical diagnostic data showed the same results. An analysis of CAPS scores including drop-outs (n=98) also showed CBT to be superior to Wait List and to SUPPORT with a trend for SUPPORT to be superior to Wait List. The CBT condition led to significantly greater reductions in co-morbid major depression and GAD than the other two conditions. Results held up well at a 3-month follow-up on the two active treatment conditions.",Blanchard EB.; Hickling EJ.; Devineni T.; Veazey CH.; Galovski TE.; Mundy E.; Malta LS.; Buckley TC.,2003.0,,0,1,
449,Internet-based guided self-help for several anxiety disorders: a randomized controlled trial comparing a tailored with a standardized disorder-specific approach.,"Internet-delivered self-help with minimal therapist guidance has shown promising results for a number of diagnoses. Most of the evidence comes from studies evaluating standardized disorder-specific treatments. A recent development in the field includes transdiagnostic and tailored Internet-based treatments that address comorbid symptoms and a broader range of patients. This study evaluated an Internet-based tailored guided self-help treatment, which targeted symptoms of social anxiety disorder, panic disorder with or without agoraphobia, and generalized anxiety disorder. The tailored treatment was compared both with standardized disorder-specific Internet-based treatment and with a wait-list control group. Both active treatment conditions were based on cognitive-behavioral therapy and lasted for 8 weeks. A total of 132 individuals meeting diagnostic criteria for at least one of the anxiety disorders were randomly assigned to 1 of the 3 conditions. Both treatment groups showed significant symptom reductions as compared with the wait-list control group on primary disorder-unspecific measures of anxiety, depression, and general symptomatology and on secondary anxiety disorder-specific measures. Based on the intention-to-treat sample, mean between-group effect sizes were d = 0.80 for the tailored treatment and d = 0.82 for the standardized treatment, versus wait-list controls. Treatment gains were maintained at 6-month follow-up. No differences were found between the 2 active treatment conditions on any of the measures, including a telephone-administered diagnostic interview conducted at posttreatment. The findings suggest that both Internet-based tailored guided self-help treatments and Internet-based standardized treatments are promising treatment options for several anxiety disorders.",Berger T.; Boettcher J.; Caspar F.,2014.0,10.1037/a0032527,0,1,
450,The impact of social skills training for social anxiety disorder: a randomized controlled trial.,"Social anxiety disorder (SAD) impacts social, occupational and academic functioning. Although many interventions report change in social distress, improvement in social behavior remains under-addressed. This investigation examined the additive impact of social skills training (SST) for the treatment of SAD. Using a sample of 106 adults who endorsed SAD across numerous social settings, participants were randomized to exposure therapy (imaginal and in vivo) alone, a combination of SST and exposure therapy known as Social Effectiveness Therapy (SET), or a wait list control. The assessment strategy included self-report measures, blinded clinical ratings and blinded assessment of social behavior. Both interventions significantly reduced distress in comparison to the wait list control and at post-treatment, 67% of patients treated with SET and 54% of patients treated with exposure therapy alone no longer met diagnostic criteria for SAD, a difference that was not statistically significant. When compared to exposure therapy alone, SET produced superior outcomes (p<.05) on measures of social skill and general clinical status. In addition to statistical significance, participants treated with SET or exposure reported clinically significant decreases on two measures of self-reported social anxiety and several measures of observed social behavior (all ps<.05). Both interventions produced efficacious treatment outcome, although SET may provide additional benefit on measures of social distress and social behavior.",Beidel DC.; Alfano CA.; Kofler MJ.; Rao PA.; Scharfstein L.; Wong Sarver N.,2014.0,10.1016/j.janxdis.2014.09.016,0,1,
451,Efficacy of exposure therapy for Japanese patients with posttraumatic stress disorder due to mixed traumatic events: A randomized controlled study.,"The authors examined the efficacy of Prolonged Exposure (PE) therapy in Japanese patients with posttraumatic stress disorder (PTSD). Twenty-four patients (21 women, 3 men) with PTSD due to mixed trauma were randomly assigned to the PE group (PE with or without treatment as usual [TAU]) or the control group (TAU) only. The control group received PE after a 10-week period. Intention-to-treat analysis showed the PE group achieved significantly greater reduction than the control group at posttreatment in either PTSD or depressive symptoms. The control group had significantly decreased symptom severity after PE treatment. Symptom levels of 19 PE completers in the both groups remained low in 12-month follow-up assessments. The study's findings will promote the future dissemination and implementation of evidence-based treatment for PTSD in non-Western settings.",Asukai N.; Saito A.; Tsuruta N.; Kishimoto J.; Nishikawa T.,2010.0,10.1002/jts.20589,0,1,
452,Cognitive-behavioral conjoint therapy for PTSD improves various PTSD symptoms and trauma-related cognitions: Results from a randomized controlled trial.,"Numerous studies document an association between posttraumatic stress disorder (PTSD) and impairments in intimate relationship functioning, and there is evidence that PTSD symptoms and associated impairments are improved by cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD; Monson & Fredman, 2012). The present study investigated changes across treatment in clinician-rated PTSD symptom clusters and patient-rated trauma-related cognitions in a randomized controlled trial comparing CBCT for PTSD with waitlist in a sample of 40 individuals with PTSD and their partners (N = 40; Monson et al., 2012). Compared with waitlist, patients who received CBCT for PTSD immediately demonstrated greater improvements in all PTSD symptom clusters, trauma-related beliefs, and guilt cognitions (Hedge's gs -.33 to -1.51). Results suggest that CBCT for PTSD improves all PTSD symptom clusters and trauma-related cognitions among individuals with PTSD and further supports the value of utilizing a couple-based approach to the treatment of PTSD.",Macdonald A.; Pukay-Martin ND.; Wagner AC.; Fredman SJ.; Monson CM.,2016.0,10.1037/fam0000177,0,1,
453,Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders.,"Despite advances towards integration of care for women with co-occurring substance use disorder (SUD) and post-traumatic stress disorder (PTSD), low abstinence rates following SUD/PTSD treatment remain the norm. The utility of investigating distinct substance use trajectories is a critical innovation in the detection and refining of effective interventions for this clinical population. The present study reanalysed data from the largest randomised clinical trial to date for co-occurring SUD and PTSD in women (National Drug Abuse Treatment Clinical Trials Network; Women and Trauma Study). Randomised participants (n = 353) received one of two interventions in addition to treatment as usual for SUD: (i) trauma-informed integrative treatment for PTSD/SUD; or (ii) an active control psychoeducation course on women's health. The present study utilised latent growth mixture models (LGMM) with multiple groups to estimate women's substance use patterns during the 12-month follow-up period. Findings provided support for three different trajectories of substance use in the post-treatment year: (i) consistently low likelihood and use frequency; (ii) consistently high likelihood and use frequency; and (iii) high likelihood and moderate use frequency. Covariate analyses revealed improvement in PTSD severity was associated with membership in a specific substance use trajectory, although receiving trauma-informed treatment was not. Additionally, SUD severity, age and after-care efforts were shown to be related to trajectory membership. Findings highlight the necessity of accounting for heterogeneity in post-treatment substance use, relevance of trauma-informed care in SUD recovery and benefits of incorporating methodologies like LGMM when evaluating SUD treatment outcomes.",López-Castro T.; Hu MC.; Papini S.; Ruglass LM.; Hien DA.,2015.0,10.1111/dar.12230,0,1,
454,A randomized trial of interpersonal therapy versus supportive therapy for social anxiety disorder.,"Seventy patients seeking treatment for social anxiety disorder (SAD) were randomly assigned to 14 weekly individual sessions of interpersonal therapy (IPT) or supportive therapy (ST). We hypothesized that IPT, a psychotherapy with established efficacy for depression and other psychiatric disorders, would lead to greater improvement than ST. Patients in both groups experienced significant improvement from pretreatment to posttreatment. However, improvement with IPT was not superior to improvement with ST. Mean scores on the Liebowitz Social Anxiety Scale decreased from 67.7 to 46.9 in the IPT group and 64.5 to 49.8 in the ST group. There were also no differences in proportion of responders between IPT and ST. Only for a scale measuring concern about negative evaluation (Brief Fear of Negative Evaluation Scale) was IPT superior. Limitations of this initial controlled trial of IPT include a nonsequential recruitment strategy and overlap in the administration of the two therapies. It is recommended that future studies of IPT for SAD include a more carefully defined control therapy condition, different therapists administering each therapy, a larger sample, and a more rigorous strategy for long-term follow-up assessments.",Lipsitz JD.; Gur M.; Vermes D.; Petkova E.; Cheng J.; Miller N.; Laino J.; Liebowitz MR.; Fyer AJ.,2008.0,10.1002/da.20364,0,1,
455,Guided and unguided CBT for social anxiety disorder and/or panic disorder via the Internet and a smartphone application: study protocol for a randomised controlled trial.,"Smartphone technology presents a novel and promising opportunity to extend the reach of psychotherapeutic interventions by moving selected parts of the therapy into the real-life situations causing distress. This randomised controlled trial will investigate the effects of a transdiagnostic, Internet-administered cognitive behavioural (iCBT) self-help program for anxiety, supplemented with a smartphone application. The effect of added therapist support will also be studied. One hundred and fifty participants meeting diagnostic criteria for social anxiety disorder and/or panic disorder will be evenly randomised to either one of three study groups: 1, smartphone-supplemented iCBT with therapist support; 2, smartphone-supplemented iCBT without therapist support; or 3, an active waiting list control group with delayed treatment. Primary outcome measure will be the Generalised Anxiety Disorder 7-item self-rating scale. Secondary measures include other anxiety, depression and quality of life measures. In addition to pre- and post-treatment measurements, the study includes two mid-treatment (days 24 and 48) and two follow-up assessments (12 and 36 months) to assess rapid and long-term effects. To our knowledge, this is the first study to investigate the effectiveness of smartphone-supplemented iCBT for anxiety disorders. Hence, the findings from this trial will constitute great advancements in the burgeoning and promising field of smartphone-administered psychological interventions. Limitations are discussed. Clinicaltrials.gov: NCT01963806.",Lindner P.; Ivanova E.; Ly KH.; Andersson G.; Carlbring P.,2013.0,10.1186/1745-6215-14-437,0,1,
456,Effects of brief eclectic psychotherapy in patients with posttraumatic stress disorder: randomized clinical trial.,"Brief Eclectic Psychotherapy (BEP) is a manualized psychotherapy for posttraumatic stress disorder (PTSD) which has proven effective for police officers. This article reports on a randomized clinical trial using BEP to treat other types of PTSD patients recruited from an outpatient clinic. Twenty-four patients were randomly assigned to a treatment or a waitlist group. Assessment of PTSD was made before and after the treatment period (4 months). No significant differences between the groups were observed at pretest. By posttest, BEP had effectively reduced PTSD as well as general anxiety symptoms in the treated group of outpatients as compared to the waitlist group.",Lindauer RJ.; Gersons BP.; van Meijel EP.; Blom K.; Carlier IV.; Vrijlandt I.; Olff M.,2005.0,10.1002/jts.20029,0,1,
457,Heart rate responsivity to script-driven imagery in posttraumatic stress disorder: specificity of response and effects of psychotherapy,"ER METHODSThirty-nine subjects with PTSD (24 civilian outpatients and 15 police officers) and 15 trauma-exposed, non-PTSD control subjects underwent psychophysiological assessment while listening to neutral, stressful, and trauma scripts. Psychophysiological measures were heart rate (HR) and blood pressure in combination with subjective anxiety ratings. In a randomized clinical trial, 20 of the civilians were then assigned to treatment or waitlist groups. Psychophysiological assessment was repeated on them after the treatment stage.RESULTSBoth civilians and police with PTSD showed significantly higher HR responses to trauma scripts than the control subjects. After successful psychotherapy with the civilians, HR responsivity to the trauma scripts was significantly reduced, and it correlated positively with PTSD clinical symptoms.CONCLUSIONSWe confirmed previous findings of heightened psychophysiological responses in PTSD for two new populations while minimizing comorbidity and medication as confounding factors. Successful psychotherapy normalized HR response to trauma imagery.OBJECTIVEPrevious psychophysiological studies of posttraumatic stress disorder (PTSD) have found heightened physiological responsivity to trauma-specific stimuli, but mostly in combat veterans with high comorbidity rates and with psychiatric medication. Our aim was to investigate psychophysiological responses in two new populations while excluding those confounding influences and to assess the effects of psychotherapy on such responses.","Lindauer, R T; Meijel, E P; Jalink, M; Olff, M; Carlier, I V; Gersons, B P",2006.0,10.1097/01.psy.0000188566.35902.e7,0,1,
458,Psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: a multicenter randomized controlled trial.,"OBJECTIVE Various approaches to cognitive-behavioral therapy (CBT) have been shown to be effective for social anxiety disorder. For psychodynamic therapy, evidence for efficacy in this disorder is scant. The authors tested the efficacy of psychodynamic therapy and CBT in social anxiety disorder in a multicenter randomized controlled trial. METHOD In an outpatient setting, 495 patients with social anxiety disorder were randomly assigned to manual-guided CBT (N=209), manual-guided psychodynamic therapy (N=207), or a waiting list condition (N=79). Assessments were made at baseline and at end of treatment. Primary outcome measures were rates of remission and response, based on the Liebowitz Social Anxiety Scale applied by raters blind to group assignment. Several secondary measures were assessed as well. RESULTS Remission rates in the CBT, psychodynamic therapy, and waiting list groups were 36%, 26%, and 9%, respectively. Response rates were 60%, 52%, and 15%, respectively. CBT and psychodynamic therapy were significantly superior to waiting list for both remission and response. CBT was significantly superior to psychodynamic therapy for remission but not for response. Between-group effect sizes for remission and response were small. Secondary outcome measures showed significant differences in favor of CBT for measures of social phobia and interpersonal problems, but not for depression. CONCLUSIONS CBT and psychodynamic therapy were both efficacious in treating social anxiety disorder, but there were significant differences in favor of CBT. For CBT, the response rate was comparable to rates reported in Swedish and German studies in recent years. For psychodynamic therapy, the response rate was comparable to rates reported for pharmacotherapy and cognitive-behavioral group therapy.",Leichsenring F.; Salzer S.; Beutel ME.; Herpertz S.; Hiller W.; Hoyer J.; Huesing J.; Joraschky P.; Nolting B.; Poehlmann K.; Ritter V.; Stangier U.; Strauss B.; Stuhldreher N.; Tefikow S.; Teismann T.; Willutzki U.; Wiltink J.; Leibing E.,2013.0,10.1176/appi.ajp.2013.12081125,0,1,
459,A randomized trial of a brief mental health intervention for primary care patients.,"This randomized trial is a first evaluation of a brief psychotherapeutic intervention for primary care patients. Sixty-two participants were randomly assigned to the intervention or to treatment as usual. As compared with treatment as usual, the intervention led to significant reductions in symptoms of anxiety and depression. The reduction was maintained for 3 months after the end of treatment, but some return of symptoms occurred by 6 months after treatment. The treatment was well accepted by patients. This study provides good preliminary evidence for the effectiveness of this intervention.",Lang AJ.; Norman GJ.; Casmar PV.,2006.0,10.1037/0022-006X.74.6.1173,0,1,
460,Study protocol for a randomised controlled trial of internet-based cognitive-behavioural therapy for obsessive-compulsive disorder.,"Obsessive-Compulsive Disorder (OCD) is a common chronic psychiatric disorder that constitutes a leading cause of disability. Although Cognitive-Behaviour Therapy (CBT) has been shown to be an effective treatment for OCD, this specialised treatment is unavailable to many due to access issues and the social stigma associated with seeing a mental health specialist. Internet-based psychological treatments have shown to provide effective, accessible and affordable treatment for a range of anxiety disorders, and two Randomised Controlled Trials (RCTs) have demonstrated the efficacy and acceptability of internet-based CBT (iCBT) for OCD, as compared to waitlist or supportive therapy. Although these initial findings are promising, they do not isolate the specific effect of iCBT. This paper details the study protocol for the first randomised control trial evaluating the efficacy of therapist-assisted iCBT for OCD, as compared to a matched control intervention; internet-based therapist-assisted progressive relaxation training (iPRT). It will aim to examine whether therapist-assisted iCBT is an acceptable and efficacious treatment, and to examine how effectiveness is influenced by patient characteristics. A randomised controlled trial using repeated measures with two arms (intervention and matched control) will be used to evaluate the efficacy and acceptability of iCBT for OCD. The RCT will randomise 212 Australian adults with a primary diagnosis of OCD into either the active intervention or control condition, for 12 weeks duration. Outcomes for participants in both study arms will be assessed at baseline and post-intervention. Participants in iCBT will be further assessed at six month follow-up, while participants in the control condition will be crossed over to receive the iCBT intervention and reassessed at post-intervention and six month follow-up. The primary outcome will be clinically significant change in obsessive-compulsive symptom scores. This will be the first known therapist assisted internet-based trial of a comprehensive CBT treatment for OCD as compared to a matched control intervention. Demonstrating the efficacy of an internet-based treatment for OCD will allow the development of models of care for broad-based access to an evidence-based but complex treatment.",Kyrios M.; Nedeljkovic M.; Moulding R.; Klein B.; Austin D.; Meyer D.; Ahern C.,2014.0,10.1186/1471-244X-14-209,0,1,
461,Mindfulness-based cognitive therapy in obsessive-compulsive disorder: protocol of a randomized controlled trial.,"Obsessive-compulsive disorder (OCD) is a very disabling condition with a chronic course, if left untreated. Though cognitive behavioral treatment (CBT) with or without selective serotonin reuptake inhibitors (SSRI) is the method of choice, up to one third of individuals with obsessive-compulsive disorder (OCD) do not respond to treatment in terms of at least 35% improvement of symptoms. Mindfulness based cognitive therapy (MBCT) is an 8-week group program that could help OCD patients with no or only partial response to CBT to reduce OC symptoms and develop a helpful attitude towards obsessions and compulsive urges. This study is a prospective, bicentric, assessor-blinded, randomized, actively-controlled clinical trial. 128 patients with primary diagnosis of OCD according to DSM-IV and no or only partial response to CBT will be recruited from in- and outpatient services as well as online forums and the media. Patients will be randomized to either an MBCT intervention group or to a psycho-educative coaching group (OCD-EP) as an active control condition. All participants will undergo eight weekly sessions with a length of 120 minutes each of a structured group program. We hypothesize that MBCT will be superior to OCD-EP in reducing obsessive-compulsive symptoms as measured by the Yale-Brown-Obsessive-Compulsive Scale (Y-BOCS) following the intervention and at 6- and 12-months-follow-up. Secondary outcome measures include depressive symptoms, quality of life, metacognitive beliefs, self-compassion, mindful awareness and approach-avoidance tendencies as measured by an approach avoidance task. The results of this study will elucidate the benefits of MBCT for OCD patients who did not sufficiently benefit from CBT. To our knowledge, this is the first randomized controlled study assessing the effects of MBCT on symptom severity and associated parameters in OCD. German Clinical Trials Register DRKS00004525 . Registered 19 March 2013.",Külz AK.; Landmann S.; Cludius B.; Hottenrott B.; Rose N.; Heidenreich T.; Hertenstein E.; Voderholzer U.; Moritz S.,2014.0,10.1186/s12888-014-0314-8,0,1,
462,Group interpersonal psychotherapy for low-income women with posttraumatic stress disorder,"ER The aim of this study was to assess the efficacy of group interpersonal psychotherapy (IPT) for low-income women with chronic posttraumatic stress disorder (PTSD) subsequent to interpersonal trauma. Non-treatment-seeking predominantly minority women were recruited in family planning and gynecology clinics. Individuals with interpersonal trauma histories (e.g., assault, abuse, and molestation) who met criteria for current PTSD (N=48) were randomly assigned to treatment or a wait list. Assessments were conducted at baseline, treatment termination, and 4-month follow-up; data analysis used a mixed-effects regression approach with an intent-to-treat sample. The results showed that IPT was significantly more effective than the wait list in reducing PTSD and depression symptom severity. IPT participants also had significantly lower scores than waitlist individuals on four interpersonal functioning subscales: Interpersonal Sensitivity, Need for Social Approval, Lack of Sociability, and Interpersonal Ambivalence.","Krupnick, J L; Green, B L; Stockton, P; Miranda, J; Krause, E; Mete, M",2008.0,10.1080/10503300802183678,0,1,
463,"The effects of expressive writing on pain, depression and posttraumatic stress disorder symptoms in survivors of intimate partner violence.","This study examined the effects of expressive writing on depression, posttraumatic stress disorder (PTSD) and pain symptoms among women who have survived intimate partner violence (IPV). Forty-seven women completed baseline and four-month follow-up assessments and were randomly assigned to four writing sessions of either expressive writing focused on traumatic life events or writing about a neutral topic. Main effects were not significant for changes in depression, pain or PTSD symptoms. However, among depressed women, those assigned to expressive writing showed a significantly greater drop in depression. For depressed women with IPV histories, expressive writing may lead to reduced depression.",Koopman C.; Ismailji T.; Holmes D.; Classen CC.; Palesh O.; Wales T.,2005.0,10.1177/1359105305049769,0,1,
464,A comparison of alprazolam and behavior therapy in treatment of panic disorder.,"The results of a clinical outcome study (N = 57) comparing behavior therapy directed at panic disorder (panic control treatment [PCT]) with alprazolam were reported. These conditions were compared with a medication placebo and a waiting-list control group. Patterns of results on measures of panic attacks, generalized anxiety, and global clinical ratings reveal that PCT was significantly more effective than placebo and waiting-list conditions on most measures. The alprazolam group differed significantly from neither PCT nor placebo. The percentage of clients completing the study who were free of panic attacks following PCT was 87%, compared with 50% for alprazolam, 36% for placebo, and 33% for the waiting-list group. Since alprazolam may work more quickly than PCT but may also interfere with the effects of behavioral treatment, these data suggest a series of studies on the feasibility of integrating these treatments and on the precise patterns and mechanisms of action of various successful treatment approaches to panic disorder.",Klosko JS.; Barlow DH.; Tassinari R.; Cerny JA.,1990.0,,0,1,
465,Randomized controlled trial of accelerated resolution therapy (ART) for symptoms of combat-related post-traumatic stress disorder (PTSD).,"Therapies for post-traumatic stress disorder (PTSD) endorsed by the Department of Defense and Veterans Administration are relatively lengthy, costly, and yield variable success. We evaluated Accelerated Resolution Therapy (ART) for the treatment of combat-related psychological trauma. A randomized controlled trial of ART versus an Attention Control (AC) regimen was conducted among 57 U.S. service members/veterans. After random assignment, those assigned to AC were offered crossover to ART, with 3-month follow-up on all participants. Self-report symptoms of PTSD and comorbidities were analyzed among study completers and by the intention-to-treat principle. Mean age was 41 ± 13 years with 19% female, 54% Army, and 68% with prior PTSD treatment. The ART was delivered in 3.7 ± 1.1 sessions with a 94% completion rate. Mean reductions in symptoms of PTSD, depression, anxiety, and trauma-related guilt were significantly greater (p < 0.001) with ART compared to AC. Favorable results for those treated with ART persisted at 3 months, including reduction in aggression (p < 0.0001). Adverse treatment-related events were rare and not serious. ART appears to be a safe and effective treatment for symptoms of combat-related PTSD, including refractory PTSD, and is delivered in significantly less time than therapies endorsed by the Department of Defense and Veterans Administration.",Kip KE.; Rosenzweig L.; Hernandez DF.; Shuman A.; Sullivan KL.; Long CJ.; Taylor J.; McGhee S.; Girling SA.; Wittenberg T.; Sahebzamani FM.; Lengacher CA.; Kadel R.; Diamond DM.,2013.0,10.7205/MILMED-D-13-00298,0,1,
466,A resilience-oriented treatment for posttraumatic stress disorder: Results of a preliminary randomized clinical trial.,"This preliminary randomized trial examined the effect of a resilience-oriented intervention for posttraumatic stress disorder (PTSD) versus a waitlist control on anxiety and depressive symptoms, positive emotional health, and cognitive performance in 39 veterans with a variety of traumatic exposures. From pre- to posttreatment, the intervention but not the control group showed improvements that were large in magnitude for affective symptoms and positive emotional health (ds = 0.73-1.18), moderate in magnitude for memory (ds = 0.50-0.54), and small-to-moderate in magnitude for executive function (ds = 0.30-0.35). Findings suggest that treatment explicitly targeting resilience resources (e.g., positive emotional engagement, social connectedness) may provide broad benefits, including alleviation of anxiety and depressive symptoms and improved positive emotional and cognitive function. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kent, Martha; Davis, Mary C; Stark, Shannon L; Stewart, Laura A; Aupperle, Beck, Blake, Cohen, Delis, Foa, Foa, Fredrickson, Kashdan, Masten, Powers, Randolph, Ryff, Spielberger, Stern, Tugade, Vasterling, Walter, Ware",2011.0,,0,1,
467,Cognitive Behaviour Therapy for Panic Disorder: Long-term Follow-up.,"This paper describes a long-term follow-up of patients with panic disorder who received cognitive behaviour therapy within a randomized controlled trial. Of 89 patients eligible for follow-up, 28 (31.5%) were reassessed 6-8 years after commencement of treatment in the trial. No differences were found between those who were followed up and those lost to follow-up on most baseline measures including measures of panic-related psychopathology, or depression. Outcomes at long-term follow-up were significantly better than baseline measures of panic, avoidance and depression. In this sub-sample the effect of cognitive behaviour therapy for panic disorder appears to maintain over the long-term. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kenardy, Justin; Robinson, Susan; Dob, Rian; Andersch, Beck, Brown, Clark, Fava, First, Katschnig, Kenardy, Marks, O'Rourke, Shear, Swodoba",2005.0,,0,1,
468,Effects of participation in a mindfulness program for veterans with posttraumatic stress disorder: A randomized controlled pilot study.,"Objective: To assess outcomes associated with Mindfulness-Based Stress Reduction (MBSR) for veterans with PTSD. Methods: Forty-seven veterans with posttraumatic stress disorder (PTSD; 37 male, 32 Caucasian) were randomized to treatment as usual (TAU; n = 22), or MBSR plus TAU (n = 25). PTSD, depression, and mental health-related quality of life (HRQOL) were assessed at baseline, posttreatment, and 4-month follow-up. Standardized effect sizes and the proportion with clinically meaningful changes in outcomes were calculated. Results: Intention-to-treat analyses found no reliable effects of MBSR on PTSD or depression. Mental HRQOL improved posttreatment but there was no reliable effect at 4 months. At 4-month follow-up, more veterans randomized to MBSR had clinically meaningful change in mental HRQOL, and in both mental HRQOL and PTSD symptoms. Completer analyses (>= 4 classes attended) showed medium to large between group effect sizes for depression, mental HRQOL, and mindfulness skills. Conclusions: Additional studies are warranted to assess MBSR for veterans with PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kearney, David J; McDermott, Kelly; Malte, Carol; Martinez, Michelle; Simpson, Tracy L; Baer, Baer, Bennett, Biegel, Blake, Bowen, Carmody, Davidson, Davidson, Davidson, Dobie, Ehlers, Eisen, Ferguson, Foa, Foa, Gladis, Gray, Holzel, Holzel, Jacobson, Kabat-Zinn, Kabat-Zinn, Kabat-Zinn, Kanter, Kearney, Kessler, Kessler, Kessler, Kessler, Kimbrough, Kroenke, Lunney, Milad, Mogotsi, Monson, Monson, Owens, Rapaport, Ravindran, Resick, Schnurr, Schnurr, Schnurr, Schoenfeld, Shapiro, Shipherd, Smith, Teasdale, Thomas, Vujanovic, Ware, Weathers, Williams",2013.0,,0,1,
469,Cognitive and physiological reactivity and the effects of different behavioral methods in the treatment of social phobia.,,Jerremalm A.; Jansson L.; Ost LG.,1986.0,,0,1,
470,A randomized trial of MBSR versus aerobic exercise for social anxiety disorder.,"Effective treatments for social anxiety disorder (SAD) exist, but additional treatment options are needed for nonresponders as well as those who are either unable or unwilling to engage in traditional treatments. Mindfulness-based stress reduction (MBSR) is one nontraditional treatment that has demonstrated efficacy in treating other mood and anxiety disorders, and preliminary data suggest its efficacy in SAD as well. Fifty-six adults (52% female; 41% Caucasian; age mean [M] ± standard deviation [SD]: 32.8 ± 8.4) with SAD were randomized to MBSR or an active comparison condition, aerobic exercise (AE). At baseline and post-intervention, participants completed measures of clinical symptoms (Liebowitz Social Anxiety Scale, Social Interaction Anxiety Scale, Beck Depression Inventory-II, and Perceived Stress Scale) and subjective well-being (Rosenberg Self-Esteem Scale, Satisfaction with Life Scale, Self-Compassion Scale, and UCLA-8 Loneliness Scale). At 3 months post-intervention, a subset of these measures was readministered. For clinical significance analyses, 48 healthy adults (52.1% female; 56.3% Caucasian; age [M ± SD]: 33.9 ± 9.8) were recruited. MBSR and AE participants were also compared with a separate untreated group of 29 adults (44.8% female; 48.3% Caucasian; age [M ± SD]: 32.3 ± 9.4) with generalized SAD who completed assessments over a comparable time period with no intervening treatment. A 2 (Group) x 2 (Time) repeated measures analyses of variance (ANOVAs) on measures of clinical symptoms and well-being were conducted to examine pre-intervention to post-intervention and pre-intervention to 3-month follow-up. Both MBSR and AE were associated with reductions in social anxiety and depression and increases in subjective well-being, both immediately post-intervention and at 3 months post-intervention. When participants in the randomized controlled trial were compared with the untreated SAD group, participants in both interventions exhibited improvements on measures of clinical symptoms and well-being. Nontraditional interventions such as MBSR and AE merit further exploration as alternative or complementary treatments for SAD.",Jazaieri H.; Goldin PR.; Werner K.; Ziv M.; Gross JJ.,2012.0,10.1002/jclp.21863,0,1,
471,Efficacy of a cognitive and behavioural psychotherapy applied by primary care psychologists in patients with mixed anxiety-depressive disorder: a research protocol.,"In contrast with the recommendations of clinical practice guidelines, the most common treatment for anxiety and depressive disorders in primary care is pharmacological. The aim of this study is to assess the efficacy of a cognitive-behavioural psychological intervention, delivered by primary care psychologists in patients with mixed anxiety-depressive disorder compared to usual care. This is an open-label, multicentre, randomized, and controlled study with two parallel groups. A random sample of 246 patients will be recruited with mild-to-moderate mixed anxiety-depressive disorder, from the target population on the lists of 41 primary care doctors. Patients will be randomly assigned to the intervention group, who will receive standardised cognitive-behavioural therapy delivered by psychologists together with usual care, or to a control group, who will receive usual care alone. The cognitive-behavioural therapy intervention is composed of eight individual 60-minute face-to face sessions conducted in eight consecutive weeks. A follow-up session will be conducted over the telephone, for reinforcement or referral as appropriate, 6 months after the intervention, as required. The primary outcome variable will be the change in scores on the Short Form-36 General Health Survey. We will also measure the change in the frequency and intensity of anxiety symptoms (State-Trait Anxiety Inventory) and depression (Beck Depression Inventory) at baseline, and 3, 6 and 12 months later. Additionally, we will collect information on the use of drugs and health care services. The aim of this study is to assess the efficacy of a primary care-based cognitive-behavioural psychological intervention in patients with mixed anxiety-depressive disorder. The international scientific evidence has demonstrated the need for psychologists in primary care. However, given the differences between health policies and health services, it is important to test the effect of these psychological interventions in our geographical setting. NCT01907035 (July 22, 2013).",Jauregui A.; Ponte J.; Salgueiro M.; Unanue S.; Donaire C.; Gómez MC.; Burgos-Alonso N.; Grandes G.;  .,2015.0,10.1186/s12875-015-0248-3,0,1,
472,Dissemination of psychotherapy for trauma spectrum disorders in postconflict settings: a randomized controlled trial in Rwanda.,"Dissemination of psychotherapeutic modules to local counselors seems a key requirement for coping with mental health disasters in conflict regions. We tested a train-the-trainer (TTT) dissemination model for the treatment of posttraumatic stress disorder (PTSD). We randomly assigned widowed or orphaned survivors of the 1994 Rwandan genocide with a PTSD diagnosis to narrative exposure therapy (NET) treatment (NET-1, n = 38) or to a 6-month waiting list (WL) condition to be followed by treatment (WL/NET-2, n = 38). Expert therapists trained a first dissemination generation of local Rwandan psychologists in NET complemented by 2 sessions of interpersonal psychotherapy modules. Under the supervision of the experts, these Rwandan psychologists (a) provided NET to the NET-1 participants and (b) subsequently trained and supervised a second generation of local psychologists. This second dissemination generation provided treatment to the WL/NET-2 group. The primary outcome measure was the Clinician-Administered PTSD Scale total score before therapy and at 3- and 12-month follow-ups. At the 3-month follow-up, the NET-1 participants suffered significantly and substantially less from PTSD symptoms than the participants in the WL group. The treatment gains of NET-1 were maintained and increased at follow-up, with a within-group effect size of Cohen's d = 1.47 at the 12-month follow-up. After treatment by the second dissemination generation of therapists, the WL/NET-2 participants improved to an extent similar to that of the NET-1 group at follow-ups, with an effect size of Cohen's d = 1.37 at the 12-month follow-up. A TTT model of PTSD treatment dissemination can be effective in resource-poor postconflict societies.",Jacob N.; Neuner F.; Maedl A.; Schaal S.; Elbert T.,2014.0,10.1159/000365114,0,1,
473,Self-exposure therapy for panic disorder with agoraphobia: randomised controlled study of external v. interoceptive self-exposure.,"Exposure to external phobic cues is an effective therapy for panic/agoraphobia but the value of exposure to interoceptive cues is unclear. Randomised controlled comparison in panic/agoraphobia of the effects of (a) external, (b) interceptive or (c) combined external and interoceptive self-exposure to (d) control subjects. Eighty out-patients were randomised to a control group or to one of three forms of self-exposure treatment (external, interoceptive, or combined). Each treatment included seven sessions over 10 weeks and daily self-exposure homework. Assessments were at pre- and post-treatment and up to 1 year post-entry. Assessors remained blind during treatment. The three self-exposure groups improved significantly and similarly at post-treatment and up to 1-year followup, and significantly more than did the control subjects. Rates of improvement on main outcome measures averaged 60% at post-treatment and 77% at follow-up. The three methods of self-exposure were equally effective in reducing panic and agoraphobic symptoms in the short- and long-term.",Ito LM.; de Araujo LA.; Tess VL.; de Barros-Neto TP.; Asbahr FR.; Marks I.,2001.0,,0,1,
474,A randomized controlled trial of cognitive behavioral therapy for anxiety and depression in COPD.,"Previous research indicates a high prevalence of untreated anxiety and depression in patients with chronic obstructive pulmonary disease (COPD). The current study examined the effect of cognitive behavioral therapy (CBT) in groups for co-morbid, clinically significant anxiety and depression in COPD outpatients of both sexes. In a randomized, controlled trial, CBT (n = 25) was compared with enhanced standard care (n = 26). Participants in both conditions were followed up at 2 and 8 months from baseline. Main outcome measures comprised the Beck Anxiety Inventory and the Beck Depression Inventory-II. Measures of health status and sleep were included as secondary outcomes. The effects of sex and age were also investigated. CBT resulted in improvement in symptoms of anxiety and depression, with effect sizes of 1.1 and 0.9 at post-treatment, respectively. The improvement was maintained at the 8-month follow-up, with effect sizes of 1.4 and 0.9. In the control group, there was no significant change. Compared to men, women had higher symptom levels throughout the whole study period. Younger patients had more anxiety and depression, age had also differential effects in the two groups on change in depressive symptoms. Changes in sleep and health status were small in both groups. The findings indicate that CBT may provide rapid symptom relief for COPD patients with clinically significant anxiety and depression, and underline the need for integrating mental health care into the overall medical regimen for COPD.",Hynninen MJ.; Bjerke N.; Pallesen S.; Bakke PS.; Nordhus IH.,2010.0,10.1016/j.rmed.2010.02.020,0,1,
475,Comparing systemic therapy and cognitive behavioral therapy for social anxiety disorders: study protocol for a randomized controlled pilot trial.,"Social anxiety disorders are among the most prevalent anxiety disorders in the general population. The efficacy of cognitive behavioral therapy (CBT) for social anxiety disorders is well demonstrated. However, only three studies point to the efficacy of systemic therapy (ST) in anxiety disorders, and only two of them especially focus on social anxiety disorders. These ST studies either do not use a good comparator but minimal supportive therapy, they do not use a multi-person ST but a combined therapy, or they do not especially focus on social anxiety disorders but mood and anxiety disorders in general. Though ST was approved as evidence based in Germany for a variety of disorders in 2008, evidence did not include anxiety disorders. This is the first pilot study that will investigate multi-person ST, integrating a broad range of systemic methods, specifically for social anxiety disorders and that will compare ST to the ""gold standard"" CBT. This article describes the rationale and protocol of a prospective, open, interventive, balanced, bi-centric, pilot randomized controlled trial (RCT). A total of 32 patients with a primary SCID diagnosis of social anxiety disorder will be randomized to either CBT or ST. Both treatments will be manualized. The primary outcome will include social anxiety symptoms at the end of therapy. Therapy will be restricted to no more than 26 hours (primary endpoint). Secondary outcomes will include psychological, social systems and interpersonal functioning, symptom adjustment, and caregiver burden, in addition to change measures, therapist variables and treatment adherence. At the secondary endpoints, 9 and 12 months after the beginning of therapy, we will again assess all outcomes. The study is expected to pilot test a RCT which will be the first to directly compare CBT and multi-person ST, integrating a broad range of systemic methods, for social anxiety disorders, and it will provide empirical evidence for the calculation of the number of patients needed for a confirmatory RCT. ClinicalTrials.gov: NCT02360033 ; date of registration: 21 January 2015.",Hunger C.; Hilzinger R.; Koch T.; Mander J.; Sander A.; Bents H.; Schweitzer J.,2016.0,10.1186/s13063-016-1252-1,0,1,
476,Vets prevail online intervention reduces PTSD and depression in veterans with mild-to-moderate symptoms.,"Despite heightened rates of depression and posttraumatic stress disorder (PTSD) among in Iraq/Afghanistan veterans, the majority of distressed veterans will not receive mental health care. Overcoming barriers to mental health services requires innovative approaches to broaden the reach of evidence-based treatment. The current study examined the efficacy and acceptability of an innovative and dynamic online cognitive-behavioral therapy intervention for PTSD and depression called Vets Prevail. A randomized clinical trial conducted between 2011 and 2013 assessed changes in PTSD and depression in veterans with mild-to-moderate distress. Veterans randomized to Vets Prevail (n = 209) were aged 34.2 ± 7.6 years, mostly male (81.3%), and nonminority (73.7%). Veterans randomized to adjustment as usual (n = 94) were aged 34.7 ± 8.9, mostly male (81.9%), and White (67.0%). Veterans completed the PTSD Checklist-Military Version and the Center for Epidemiological Studies Depression scale (10-item version) postintervention and at 12-week follow-up. Veterans in the Vets Prevail condition reported significantly greater reductions in PTSD, t(250) = 3.24, p = .001 (Mreduction = 5.51, SD = 9.63), and depression, t(252) = 4.37, p = .001 (Mreduction = 2.31, SD = 5.34), at 12-week follow-up compared with veterans in the adjustment as usual condition (PTSD Mreduction = 1.00, SD = 7.32; depression Mreduction = 0.48, SD = 4.95), with moderate effect sizes for PTSD (Cohen's d = 0.42) and depression (Cohen's d = 0.56). Exploratory analysis shows that Vets Prevail may be effective regardless of combat trauma exposure, gender, and ethnic minority status. Vets Prevail circumvents many barriers to care and effectively addresses the dire mental health needs of veterans.",Hobfoll SE.; Blais RK.; Stevens NR.; Walt L.; Gengler R.,2016.0,10.1037/ccp0000041,0,1,
477,Brief narrative exposure therapy for posttraumatic stress in Iraqi refugees: a preliminary randomized clinical trial.,"Many Iraqi refugees suffer from posttraumatic stress. Efficient, culturally sensitive interventions are needed, and so we adapted narrative exposure therapy into a brief version (brief NET) and tested its effects in a sample of traumatized Iraqi refugees. Iraqi refugees in the United States reporting elevated posttraumatic stress (N = 63) were randomized to brief NET or waitlist control conditions in a 2:1 ratio; brief NET was 3 sessions, conducted individually, in Arabic. Positive indicators (posttraumatic growth and well-being) and symptoms (posttraumatic stress, depressive, and somatic) were assessed at baseline and 2- and 4-month follow-up. Treatment participation (95.1% completion) and study retention (98.4% provided follow-up data) were very high. Significant condition by time interactions showed that those receiving brief NET had greater posttraumatic growth (d = 0.83) and well-being (d = 0.54) through 4 months than controls. Brief NET reduced symptoms of posttraumatic stress (d = -0.48) and depression (d = -0.46) more, but only at 2 months; symptoms of controls also decreased from 2 to 4 months, eliminating condition differences at 4 months. Three sessions of brief NET increased growth and well-being and led to symptom reduction in highly traumatized Iraqi refugees. This preliminary study suggests that brief NET is both acceptable and potentially efficacious in traumatized Iraqi refugees.",Hijazi AM.; Lumley MA.; Ziadni MS.; Haddad L.; Rapport LJ.; Arnetz BB.,2014.0,10.1002/jts.21922,0,1,
478,Treatment of traumatized victims of war and torture: a randomized controlled comparison of narrative exposure therapy and stress inoculation training.,"The aim of the present randomized controlled trial was to compare the outcome of 2 active treatments for posttraumatic stress disorder (PTSD) as a consequence of war and torture: narrative exposure therapy (NET) and stress inoculation training (SIT). Twenty-eight PTSD patients who had experienced war and torture, most of them asylum seekers, received 10 treatment sessions of either NET or SIT at the Outpatient Clinic for Refugees, University of Konstanz, Germany. Posttests were carried out 4 weeks after treatment, and follow-up tests were performed 6 months and 1 year after treatment. The main outcome measure was the PTSD severity score according to the Clinician-Administered PTSD Scale (CAPS) at each time point. A significant reduction in PTSD severity was found for NET, but not for SIT. A symptom reduction in the NET group occurred between pretest and the 6-month follow-up examination, the effect size being d = 1.42 (for SIT: d = 0.12), and between pretest and the 1-year follow-up, the effect size being d = 1.59 (for SIT: d = 0.19). The rates and scores of major depression and other comorbid disorders did not decrease significantly over time in either of the 2 treatment groups. The results indicate that exposure treatments like NET lead to a significant PTSD symptom reduction even in severely traumatized refugees and asylum seekers.",Hensel-Dittmann D.; Schauer M.; Ruf M.; Catani C.; Odenwald M.; Elbert T.; Neuner F.,2011.0,10.1159/000327253,0,1,
479,Predictors of outcome of pharmacological and psychological treatment of late-life panic disorder with agoraphobia.,"This study aims to evaluate the differential predictive values of age, age of onset and duration of illness on paroxetine and cognitive-behavioural therapy (CBT) outcome in late-life panic disorder with agoraphobia. Patients 60 years and older with a confirmed diagnosis of panic disorder with agoraphobia (n = 49) were randomly assigned to paroxetine (40 mg/day) treatment, individual CBT or a waiting-list control condition. Multiple regression analyses were conducted per treatment arm with post-treatment avoidance behaviour and agoraphobic cognitions as the dependent variables. Higher age at onset and shorter duration of illness were predictors of superior outcomes following CBT, although these variables did not influence the treatment effects of paroxetine. In late-life agoraphobic panic disorder, chronological age has no impact on treatment modality outcome. In older patients with a late disease onset or shorter duration of illness, CBT is to be preferred over paroxetine, whereas paroxetine might be the treatment of choice for older people with an early onset and short duration of illness.",Hendriks GJ.; Keijsers GP.; Kampman M.; Hoogduin CA.; Oude Voshaar RC.,2012.0,10.1002/gps.2700,0,1,
480,One-session therapist directed exposure vs two forms of manual directed self-exposure in the treatment of spider phobia.,"Fifty-two patients with spider phobia, fulfilling the DSM-III-R criteria for simple phobia, were assessed with behavioral, physiological and self-report measures. They were randomly assigned to five different treatment conditions: (1) one session therapist-directed exposure (maximum 3 hours), (2) specific manual-based treatment in the home, (3) specific manual-based treatment at the clinic, (4) general manual-based treatment in the home and (5) general manual-based treatment at the clinic. The results show that therapist-directed one-session treatment was significantly more effective than three of the manual-based treatments, both at the post-treatment and follow-up stages. Specific manual-based treatment at the clinic was significantly more successful than the other manual-based treatments, but only at follow-up. The proportion of clinically significant improved patients at follow-up was 80% in the therapist-directed group compared to 63% for the specific manual-based treatment at the clinic, 10% for specific manual-based treatment in the home, 9% for general manual-based treatment in the home, and 10% for general manual-based treatment at the clinic. The conclusion that can be drawn is that one-session therapist-directed treatment is the treatment of choice for spider phobia but manual-based treatment is a good alternative in some cases.",Hellström K.; Ost LG.,1995.0,,0,1,
481,Semantic desensitization: a paradigmatic intervention approach to anxiety disorders.,"Studied the effectiveness of semantic desensitization in alleviating public speaking anxiety. Thirty speech-anxious clients, matched on the severity of their problem, were assigned randomly to one of the following treatment conditions: (a) semantic desensitization; (b) attention placebo; and (c) waiting list control. The semantic desensitization group received a self-instructional, anticipatory-anxiety hierarchy paired with visually induced, relaxing, pleasant scenes. Semantic desensitization therapy resulted in significant reductions of both the affective and behavioral components of anxiety as compared to the two controls. The placebo control also showed improvement in several indices of subjective anxiety as compared to the no-treatment waiting list control. The beneficial effects of semantic desensitization therapy were maintained on follow-up.",Hekmat H.; Lubitz R.; Deal R.,1984.0,,0,1,
482,The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Compared With Diagnosis-Specific Protocols for Anxiety Disorders: A Randomized Clinical Trial.,"Transdiagnostic interventions have been developed to address barriers to the dissemination of evidence-based psychological treatments, but only a few preliminary studies have compared these approaches with existing evidence-based psychological treatments. To determine whether the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is at least as efficacious as single-disorder protocols (SDPs) in the treatment of anxiety disorders. From June 23, 2011, to March 5, 2015, a total of 223 patients at an outpatient treatment center with a principal diagnosis of panic disorder with or without agoraphobia, generalized anxiety disorder, obsessive-compulsive disorder, or social anxiety disorder were randomly assigned by principal diagnosis to the UP, an SDP, or a waitlist control condition. Patients received up to 16 sessions of the UP or an SDP for 16 to 21 weeks. Outcomes were assessed at baseline, after treatment, and at 6-month follow-up. Analysis in this equivalence trial was based on intention to treat. The UP or SDPs. Blinded evaluations of principal diagnosis clinical severity rating were used to evaluate an a priori hypothesis of equivalence between the UP and SDPs. Among the 223 patients (124 women and 99 men; mean [SD] age, 31.1 [11.0] years), 88 were randomized to receive the UP, 91 to receive an SDP, and 44 to the waitlist control condition. Patients were more likely to complete treatment with the UP than with SDPs (odds ratio, 3.11; 95% CI, 1.44-6.74). Both the UP (Cohen d, -0.93; 95% CI, -1.29 to -0.57) and SDPs (Cohen d, -1.08; 95% CI, -1.43 to -0.73) were superior to the waitlist control condition at acute outcome. Reductions in clinical severity rating from baseline to the end of treatment (β, 0.25; 95% CI, -0.26 to 0.75) and from baseline to the 6-month follow-up (β, 0.16; 95% CI, -0.39 to 0.70) indicated statistical equivalence between the UP and SDPs. The UP produces symptom reduction equivalent to criterion standard evidence-based psychological treatments for anxiety disorders with less attrition. Thus, it may be possible to use 1 protocol instead of multiple SDPs to more efficiently treat the most commonly occurring anxiety and depressive disorders. clinicaltrials.gov Identifier: NCT01243606.",Barlow DH.; Farchione TJ.; Bullis JR.; Gallagher MW.; Murray-Latin H.; Sauer-Zavala S.; Bentley KH.; Thompson-Hollands J.; Conklin LR.; Boswell JF.; Ametaj A.; Carl JR.; Boettcher HT.; Cassiello-Robbins C.,2017.0,10.1001/jamapsychiatry.2017.2164,0,1,
483, A brief treatment for fear of heights," Objective To assess the effectiveness of a novel imaginal intervention for people with acrophobia. Methods The design was a randomized controlled trial with concealed randomization and blinded to other participants' intervention. The intervention was a single novel imaginal intervention session or a 15‐min meditation. The setting was in Auckland, New Zealand. The participants were a convenience sample of the public with a score >29 on the Heights Interpretation Questionnaire (HIQ), a questionnaire validated against actual height exposure. The primary outcomes were the proportion of participants with a score <26 on the HIQ at eight weeks and difference between the HIQ scores between the two arms of the study. Results Ninety‐eight participants (92%) returned their questionnaire and were included in the intention to treat analysis. The HIQ score <26 was 34.6% (18/52) in the intervention group and 15.2% (7/46) in the control group RR = 2.26, 95% CI (1.05, 4.95) and p = 0.028. The numbers needed to treat is six 95% CI (3 to 36). Participants with scores <26 report their fear of heights is very much improved. There was a 4.5‐point difference in the HIQ score at eight weeks (p = 0.055) on the multiple regression analysis. Conclusions This is the first randomized trial of this novel imaginal intervention which is probably effective, brief, easily learnt, and safe. It may be worth considering doing this prior to some of the longer or more expensive exposure therapies. This study will be of interest to family doctors, psychiatrists, and psychologists."," Arroll, B;  Henwood, SM;  Sundram, FI;  Kingsford, DW;  Mount, V;  Humm, SP;  Wallace, HB;  Pillai, A",2017.0, 10.1177/0091217417703285,0,1,
484,A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder.,"To examine whether an empirically and theoretically derived treatment combining mindfulness- and acceptance-based strategies with behavioral approaches would improve outcomes in generalized anxiety disorder (GAD) over an empirically supported treatment. This trial randomized 81 individuals (65.4% female, 80.2% identified as White, average age 32.92) diagnosed with GAD to receive 16 sessions of either an acceptance-based behavior therapy (ABBT) or applied relaxation (AR). Assessments at pretreatment, posttreatment, and 6-month follow-up included the following primary outcome measures: GAD clinician severity rating, Structured Interview Guide for the Hamilton Anxiety Rating Scale, Penn State Worry Questionnaire, Depression Anxiety Stress Scale, and the State-Trait Anxiety Inventory. Secondary outcomes included the Beck Depression Inventory-II, Quality of Life Inventory, and number of comorbid diagnoses. Mixed effect regression models showed significant, large effects for time for all primary outcome measures (ds = 1.27 to 1.61) but nonsignificant, small effects for condition and Condition × Time (ds = 0.002 to 0.20), indicating that clients in the 2 treatments improved comparably over treatment. For secondary outcomes, time was significant (ds = 0.74 to 1.38), but condition and Condition × Time effects were not (ds = 0.004 to 0.31). No significant differences emerged over follow-up (ds = 0.03 to 0.39), indicating maintenance of gains. Between 63.3 and 80.0% of clients in ABBT and 60.6 and 78.8% of clients in AR experienced clinically significant change across 5 calculations of change at posttreatment and follow-up. ABBT is a viable alternative for treating GAD. (PsycINFO Database Record (c) 2013 APA, all rights reserved).",Hayes-Skelton SA.; Roemer L.; Orsillo SM.,2013.0,10.1037/a0032871,0,1,
485,Computerized Tool to Manage Dental Anxiety: A Randomized Clinical Trial.,"Anxiety regarding dental and physical health is a common and potentially distressing problem, for both patients and health care providers. Anxiety has been identified as a barrier to regular dental visits and as an important target for enhancement of oral health-related quality of life. The study aimed to develop and evaluate a computerized cognitive-behavioral therapy dental anxiety intervention that could be easily implemented in dental health care settings. A cognitive-behavioral protocol based on psychoeducation, exposure to feared dental procedures, and cognitive restructuring was developed. A randomized controlled trial was conducted (N = 151) to test its efficacy. Consenting adult dental patients who met inclusion criteria (e.g., high dental anxiety) were randomized to 1 of 2 groups: immediate treatment (n = 74) or a wait-list control (n = 77). Analyses of covariance based on intention-to-treat analyses were used to compare the 2 groups on dental anxiety, fear, avoidance, and overall severity of dental phobia. Baseline scores on these outcomes were entered into the analyses as covariates. Groups were equivalent at baseline but differed at 1-mo follow-up. Both groups showed improvement in outcomes, but analyses of covariance demonstrated significant differences in dental anxiety, fear, avoidance, and overall severity of dental phobia in favor of immediate treatment at the follow-up assessment. Of the patients who met diagnostic criteria for phobia at baseline, fewer patients in the immediate treatment group continued to meet criteria for dental phobia at follow-up as compared with the wait-list group. A new computer-based tool seems to be efficacious in reducing dental anxiety and fear/avoidance of dental procedures. Examination of its effectiveness when administered in dental offices under less controlled conditions is warranted (ClinicalTrials.gov NCT02081365).",Tellez M.; Potter CM.; Kinner DG.; Jensen D.; Waldron E.; Heimberg RG.; Myers Virtue S.; Zhao H.; Ismail AI.,2015.0,10.1177/0022034515598134,0,1,
486,A controlled examination of two coping skills for daily alcohol use and PTSD symptom severity among dually diagnosed individuals.,"Investigations of targeted coping skills could help guide initial treatment decisions for individuals with co-occurring posttraumatic stress disorder (PTSD) and alcohol dependence (AD) who often endorse worse coping skills than those with AD but not PTSD. Although improvement in coping skills is associated with enhanced alcohol use outcomes, no study has evaluated the utility of teaching specific coping skills in the context of comorbid PTSD/AD. We compared the effects of teaching two coping skills (cognitive restructuring [CR] and experiential acceptance [EA]) or an attention control condition on drinking and PTSD symptoms among 78 men and women with comorbid PTSD/AD during a 5-week daily follow-up assessment. Both CR and EA skills were associated with decreased drinking compared to control, and that change in drinking over time did not significantly differ between those who received CR and EA. Individuals who received CR skills, however, consumed less alcohol on a given day than those who received EA skills. Neither CR nor EA was associated with a decrease in PTSD symptom severity. These results provide preliminary support for clinicians to prioritize CR and EA skills during initial treatment sessions when working with individuals with PTSD/AD, and offer ideas for continued investigation and intervention refinement. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stappenbeck, Cynthia A; Luterek, Jane A; Kaysen, Debra; Rosenthal, Christina F; Gurrad, Bethann; Simpson, Tracy L; Abramowitz, Allison, Baer, Bandura, Berenz, Blanco, Bowen, Butler, Conrod, Drapkin, First, Foa, Foa, Foa, Hamilton, Hamilton, Hardin, Hayes, Hayes, Hester, Hruska, Kaysen, Kessler, Khantzian, King, Krause, Kubany, Larimer, Lewinsohn, Linehan, Marlatt, Marlatt, McCauley, McDermott, Miller, Mills, Monti, Monti, Morgenstern, Najavits, Najavits, Orsillo, Ouimette, Ouimette, Palmieri, Read, Resick, Rohsenow, Sannibale, Simon, Simon, Simpson, Torchalla, Tull, van Dam, Vik, Weathers, Wegner, Williams, Witkiewitz, Wolitzky-Taylor",2015.0,,0,1,
487,"Expressive writing and post-traumatic stress disorder: effects on trauma symptoms, mood states, and cortisol reactivity","ER DESIGNRandomized trial with baseline and 3-month follow-up measures of PTSD severity and symptoms, mood states, post-traumatic growth, and (post-only) cortisol reactivity to trauma-related stress.METHODSVolunteers with a verified diagnosis of PTSD (N=25) were randomly assigned to an experimental group (writing about their traumatic experience) or control group (writing about time management).RESULTSExpressive writing was acceptable to patients with PTSD and appeared safe to utilize. No changes in PTSD diagnosis or symptoms were observed, but significant improvements in mood and post-traumatic growth were observed in the expressive writing group. Finally, expressive writing greatly attenuated neuroendocrine (cortisol) responses to trauma-related memories.CONCLUSIONSThe present study provides insight into several boundary conditions of expressive writing. Writing did not decrease PTSD-related symptom severity. Although patients continue to exhibit the core features of PTSD, their capacity to regulate those responses appears improved following expressive writing. Dysphoric mood decreased after writing and when exposed to traumatic memories, participants' physiological response is reduced and their recovery enhanced.OBJECTIVESThis study investigates the boundary conditions (feasibility, safety, and efficacy) of an expressive writing intervention for individuals with post-traumatic stress disorder [PTSD].","Smyth, J M; Hockemeyer, J R; Tulloch, H",2008.0,10.1348/135910707X250866,0,1,
488,A test of written emotional disclosure as an intervention for posttraumatic stress disorder.,"This study examined the efficacy of the written emotional disclosure (WED) procedure with a sample of young adults who met diagnostic criteria for posttraumatic stress disorder (PTSD). Participants were randomly assigned to either WED or a control writing condition and were assessed at baseline and one month following the writing sessions. During each writing session, participants' heart rate was recorded; participants also provided self-report ratings of emotional responding. Findings indicated no significant group differences for PTSD and depression symptom severity at follow-up assessment. Relative to control participants, WED participants displayed significantly greater heart rate activity and reported greater emotional responding during the first writing session; however, no reduction in emotional responding occurred for either condition from the first to the last writing session. Taken together, these findings indicate that WED may not be an efficacious intervention for PTSD. Suggestions are made for future work in this area.",Sloan DM.; Marx BP.; Greenberg EM.,2011.0,10.1016/j.brat.2011.02.001,0,1,
489,"A randomized controlled trial to dismantle components of exposure, relaxation, and rescripting therapy for chronic nightmares and sleep disturbances in trauma-exposed persons.","Nightmares and sleep disturbances have come to be considered the hallmark of posttraumatic stress disorder (PTSD) and tend to be intractable in the face of trauma-focused interventions. Moreover, some studies show significant relationships between sleep disturbances and poorer PTSD treatment outcomes as well as higher symptom severity levels compared to trauma-exposed individuals without significant sleep disturbances. Exposure, Relaxation, and Rescripting Thearpy (ERRT) is a brief cognitive behavioral treatment developed to treat trauma-related nightmares and sleep disturbances. Studies utilizing ERRT have demonstrated efficacy of the treatment in both civilian and veteran samples. To date, two randomized control studies have been conducted comparing ERRT to waitlist controls. Both trials have demonstrated superiority of ERRT compared to waitlist on psychological and physiological outcomes. However, as ERRT is a multi-component treatment empirical questions remained with regard to the mechanism of change. The underlying theory of ERRT suggests that each component of the treatment provides direct and indirect pathways targeting multiple factors in the development and maintenance of the nightmare and sleep disturbance cycle. Among these treatment components, exposure and rescripting was thought to be the driving force for change. Pruiksma (2011) presented preliminary findings from the present randomized control study comparing ERRT with exposure and rescripting (EX) to ERRT without exposure and rescripting (NEX). The present study sought to extend preliminary dismantling findings through replication with a larger sample size and expansion by examining treatment and group effects across all time points (i.e., baseline, 1-week, 3-month, and 6-month). Robust analysis of covariance methods were used to examine group differences at 1-week post-treatment. Results indicated a significant main effect for time on sleep quality, PTSD symptoms and symptom severity, sleep impairment, daytime sleepiness, fear of sleep, nightmare frequency, nightmare severity, and number of nights with nightmares with no significant difference between groups. Mixed models analysis of variance and robust percentile bootstrap split-plots were utilized to examine between- and within-subject effects. Results revealed no significant group differences on any outcome variable. Significant main effects for time were found for nightmare frequency, number of nights with nightmares, sleep quality, daytime sleepiness, sleep impairment, and PTSD symptom severity. Although no group differences were observed, both treatments contain the same psychoeducation, sleep hygiene, and relaxation techniques as well as common therapeutic factors, which target multiple factors thought to contribute to the development and maintenance of trauma-related nightmares. These findings suggest that ERRT (with and without nightmare exposure and rescripting) can significantly alleviate nightmares and related distress. Implications, limitations, and future directions are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cranston, Christopher C",2016.0,,0,1,
490,A randomized clinical trial comparing affect regulation and social problem-solving psychotherapies for mothers with victimization-related PTSD.,"Addressing affect dysregulation may provide a complementary alternative or adjunctive approach to the empirically supported trauma memory processing models of cognitive behavior therapy (CBT) for posttraumatic stress disorder (PTSD). A CBT designed to enhance affect regulation without trauma memory processing--trauma affect regulation: guide for education and therapy (TARGET)--was compared to present centered therapy (PCT) and wait-list (WL) conditions in a randomized clinical trial with 146 primarily low-income and ethnoracial minority mothers with PTSD. TARGET achieved statistically and clinically significant improvement on PTSD and affect regulation measures compared to WL, with more consistent and sustained (over a 6-month follow-up period) evidence of improvement than PCT. Drop-out rates (~25%) were comparable in TARGET and PCT, similar to those previously reported for trauma memory processing CBTs. Symptom worsening was rare (2-8%) and transient. Affect regulation-based CBT without trauma memory processing warrants further research as a potentially efficacious therapy for victimization-related PTSD.",Ford JD.; Steinberg KL.; Zhang W.,2011.0,10.1016/j.beth.2010.12.005,0,1,
491,Comparing physical exercise in groups to group cognitive behaviour therapy for the treatment of panic disorder in a randomized controlled trial.,"Previous studies have suggested that physical exercise can reduce symptoms for subjects suffering from panic disorder (PD). The efficacy of this intervention has so far not been compared to an established psychotherapy, such as cognitive behaviour therapy (CBT). Assessment of controlled long-term effects and the clinical significance of the treatment are also lacking. To compare physical exercise to CBT as treatment for PD, and assess controlled long-term and clinically significant effects. PD-patients were randomized to either three weekly sessions of physical exercise (n = 17), or one weekly session of CBT (n = 19). Both treatments ran for 12 weeks, were manualized and administered in groups. Patients were assessed twice before the start of treatment, at post-treatment and at 6 and 12 months thereafter. Primary outcome-measures consisted of the Mobility Inventory (MI), the Agoraphobia Cognitions Questionnaire (ACQ) and the Body Sensations Questionnaire (BSQ). A two-way repeated measures MANOVA of these measures demonstrated a significant effect of time, F(16, 544) = 7.28, p < .01, as well as a significant interaction effect, F(16, 544) = 1.71, p < .05, in favour of CBT. This finding was supported by the assessment of clinically significant changes of avoidant behaviour and of treatment-seeking one year later. Group CBT is more effective than group physical exercise as treatment of panic disorder, both immediately following treatment and at follow-up assessments.",Hovland A.; Nordhus IH.; Sjøbø T.; Gjestad BA.; Birknes B.; Martinsen EW.; Torsheim T.; Pallesen S.,2013.0,10.1017/S1352465812000446,0,1,
492,A randomized clinical trial of cognitive processing therapy for veterans with PTSD related to military sexual trauma.,"In this randomized controlled clinical trial, the authors evaluated the effectiveness of cognitive processing therapy (CPT) in the treatment of self-reported and clinician-assessed posttraumatic stress disorder (PTSD) related to military sexual trauma (MST), along with depressive symptoms. Eighty-six veterans (73 female, 13 male) randomly assigned to receive 12 individual sessions of either CPT or present-centered therapy (PCT) were included in analyses. Blinded assessments occurred at baseline, posttreatment, and 2, 4, and 6 months posttreatment. Mixed-effects model analysis revealed a significant interaction between groups (p = .05, d = -0.85): At posttreatment, veterans who received CPT had a significantly greater reduction in self-reported, but not clinician-assessed, PTSD symptom severity compared to veterans who received PCT. All three primary outcome measures improved significantly, both clinically and statistically, across time in both treatment groups. Pre- and posttreatment effect sizes were mostly moderate to large (d = 0.30-1.02) and trended larger in the CPT group. Although the study was impacted by treatment fidelity issues, results provide preliminary evidence for the effectiveness of CPT in reducing self-reported PTSD symptoms in a population of veterans with MST, expanding on established literature that has demonstrated the effectiveness of CPT in treating PTSD related to sexual assault in civilian populations.",Surís A.; Link-Malcolm J.; Chard K.; Ahn C.; North C.,2013.0,10.1002/jts.21765,0,1,
493,A Randomised Controlled Trial of a Cognitive-Behavioural Therapy Program for Managing Social Anxiety After Acquired Brain Injury.,"Despite the prevalence of psychiatric illness in people with acquired brain injury (ABI), there are very few empirically validated studies examining the efficacy of treatments targeting commonly occurring disorders such as depression and anxiety. Using a randomised controlled trial, this study evaluated the efficacy of a cognitive behavioural intervention specifically designed for managing social anxiety following ABI. Twelve brain-injured participants were screened, randomly allocated to either treatment group (TG) or a wait list group (WLG), and proceeded through to the final stages of therapy. The TG received between 9 and 14 hourly, individual sessions of cognitive behavioural therapy. Repeated measures analyses revealed significant improvements in general anxiety, depression and a transient mood measure, tension-anxiety, for the TG when compared to the WLG at posttreatment. These treatment gains were maintained at one-month follow-up. Although in the predicted direction, postintervention improvements in social anxiety and self-esteem for the TG were not significant in comparison with the WLG. This study lends support to the small body of literature highlighting the potential of cognitive behavioural interventions for managing the psychological problems that serve as a barrier to rehabilitation following ABI. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hodgson, Janet; McDonald, Skye; Tate, Robyn; Gertler, Paul; Adams, Andrews, Beck, Beck, Bock, Bryant, Bryant, Cohen, Coopersmith, Fann, Federoff, Feske, Geffen, Gillis, Gould, Heaton, Heimberg, Hibbard, Horton, Khan-Bourne, Koponen, Kroese, Lewis, Liappas, McDonald, McGrath, McMillan, McNair, McNeil, Medd, Meichenbaum, Newton, O'Neill, Perna, Ponsford, Rey, Saunders, Scheutzow, Schlund, Skinner, Sohlberg, Tate, Taylor, Turner, Wechsler, Williams, Williams, Williams, Zigmond",2005.0,,0,1,
494,Alcoholism with and without social phobia: A comparison of pre and post treatment differences in drinking and social support.,"There is a high rate of comorbidity between social phobia and alcoholism and the problems associated with both disorders can combine exponentially to compromise success in treatment. Social phobia and social support can intuitively be thought to be related in that people with social phobia, by definition, have difficulty in their social interactions. Yet it is well established that social support is important in well being and health and can affect treatment outcome. The purpose of this study was to compare treatment seeking alcoholics with and without social phobia on demographic, drinking, and social support variables at baseline prior to treatment, within 12 weeks of treatment, and during the subsequent 12 following treatment. Differential treatment effects on drinking and social support outcomes between alcoholics with and without social phobia were examined for three treatments: cognitive-behavioral therapy, twelve step facilitation therapy, and motivational enhancement therapy. The sample population was selected from a multisite study of treatment matching which was funded by the National Institute on Alcohol Abuse and Alcoholism. Results revealed no group differences on outcome measures for quantity and frequency of drinking between the two diagnostic groups in any of the three treatment groups at any timepoint. All three treatments studied had a beneficial effect on drinking for both diagnostic groups. Statistically significant differences were identified in two measures of social support at baseline but these differences have little clinical significance. Follow-up levels of social support reported between the diagnostic groups showed no differences in any of the measures. In all three of the treatment under study, the social phobia group had increased social support at follow-up to the levels of the non social phobia group. This study indicates that once alcohol use in individuals with social phobia reaches the level of alcohol dependence, treatment for alcoholism works, regardless of the theoretical orientation of the treatment. Assessment and prevention may be the areas that are most important with regard to the dual diagnosis of social phobia and alcoholism. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Thevos, Angelica Kathryn",1998.0,,0,1,
495,Comparison of adding treatment of PTSD during and after shelter stay to standard care in residents of battered women's shelters: Results of a randomized clinical trial.,"This study explored the acceptability, feasibility, and initial efficacy of an expanded version of a PTSD treatment developed for residents of battered women's shelters, Helping to Overcome PTSD through Empowerment (HOPE) in women who received standard shelter services (SSSs). A Phase I randomized clinical trial comparing HOPE + SSSs (n = 30) to SSSs (n = 30) was conducted. Primary outcome measures included the Clinician-Administered PTSD Scale (Blake et al., 1995) and the Revised Conflict Tactic Scales (Straus, Hamby, Boney-McCoy, & Sugarman, ). Participants were followed at 1-week, and 3- and 6-months posttreatment. Only 2 women dropped out of HOPE + SSS treatment. Latent growth curve analyses found significant treatment effects for PTSD from intimate partner violence (IPV) (beta = -.007, p = .021), but not for future IPV (beta = .002, p = .709) across follow-up points. Significant effects were also found for secondary outcomes of depression severity (beta = -.006, p = .052), empowerment (beta = .155, p = .022), and resource gain (beta = .158, p = .036). Additionally, more women in HOPE + SSSs were employed at 3- and 6-month follow-up compared to those in SSSs only. Results showed the acceptability and feasibility of adding IPV-related treatment to standard services. They also suggested that HOPE may be a promising treatment for residents of battered women's shelters. Further research with a larger sample, utilizing more diverse shelter settings and a more rigorous control condition, is needed to confirm these findings. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Johnson, Dawn M; Johnson, Nicole L; Perez, Sara K; Palmieri, Patrick A; Zlotnick, Caron; Attkisson, Beck, Black, Blake, First, Foa, George, Hien, Hobfoll, Iverson, Jacobson, Johnson, Johnson, Johnson, Johnson, Johnson, Jones, Jonker, Kubany, Little, Lobbestael, Monson, Perez, Preacher, Regan, Resick, Sarason, Stein, Stout, Straus, Weathers",2016.0,,0,1,
496,Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder: a randomized controlled trial.,"Chronic nightmares occur frequently in patients with posttraumatic stress disorder (PTSD) but are not usually a primary target of treatment. To determine if treating chronic nightmares with imagery rehearsal therapy (IRT) reduces the frequency of disturbing dreams, improves sleep quality, and decreases PTSD symptom severity. Randomized controlled trial conducted from 1995 to 1999 among 168 women in New Mexico; 95% had moderate-to-severe PTSD, 97% had experienced rape or other sexual assault, 77% reported life-threatening sexual assault, and 58% reported repeated exposure to sexual abuse in childhood or adolescence. Participants were randomized to receive treatment (n = 88) or to the wait-list control group (n = 80). The treatment group received IRT in 3 sessions; controls received no additional intervention, but continued any ongoing treatment. Scores on the Nightmare Frequency Questionnaire (NFQ), Pittsburgh Sleep Quality Index (PSQI), PTSD Symptom Scale (PSS), and Clinician-Administered PTSD Scale (CAPS) at 3- and 6-month follow-up. A total of 114 participants completed follow-up at 3 and/or 6 months. Comparing baseline to follow-up (n = 97-114), treatment significantly reduced nights per week with nightmares (Cohen d = 1.24; P<.001) and number of nightmares per week (Cohen d = 0.85; P<.001) on the NFQ and improved sleep (on the PSQI, Cohen d = 0.67; P<.001) and PTSD symptoms (on the PSS, Cohen d = 1.00; P<.001 and on the CAPS, Cohen d = 1.53; P<.001). Control participants showed small, nonsignificant improvements for the same measures (mean Cohen d = 0.21). In a 3-point analysis (n = 66-77), improvements occurred in the treatment group at 3-month follow-up (treatment vs control group, Cohen d = 1.15 vs 0.07 for nights per week with nightmares; 0.95 vs -0.06 for nightmares per week; 0.77 vs 0.31 on the PSQI, and 1.06 vs 0.31 on the PSS) and were sustained without further intervention or contact between 3 and 6 months. An intent-to-treat analysis (n = 168) confirmed significant differences between treatment and control groups for nightmares, sleep, and PTSD (all P<.02) with moderate effect sizes for treatment (mean Cohen d = 0.60) and small effect sizes for controls (mean Cohen d = 0.14). Posttraumatic stress symptoms decreased by at least 1 level of clinical severity in 65% of the treatment group compared with symptoms worsening or not changing in 69% of controls (chi(2)(1) = 12.80; P<.001). Imagery rehearsal therapy is a brief, well-tolerated treatment that appears to decrease chronic nightmares, improve sleep quality, and decrease PTSD symptom severity.",Krakow B.; Hollifield M.; Johnston L.; Koss M.; Schrader R.; Warner TD.; Tandberg D.; Lauriello J.; McBride L.; Cutchen L.; Cheng D.; Emmons S.; Germain A.; Melendrez D.; Sandoval D.; Prince H.,2001.0,,0,1,
497,A controlled study of imagery rehearsal for chronic nightmares in sexual assault survivors with PTSD: a preliminary report.,"Imagery-rehearsal therapy for chronic nightmares was assessed in a randomized, controlled study of sexual assault survivors with posttraumatic stress disorder (PTSD). Nightmares, sleep quality, and PTSD were assessed at baseline for 169 women, who were randomized into two groups: treatment (n = 87) and wait-list control (n = 82). Treatment consisted of two 3-hr sessions and one 1-hr session conducted over 5 weeks. Of 169 participants, 91 women (Treatment, n = 43, Control, n = 48) completed a 3-month follow-up and 78 did not. At follow-up, nightmare frequency and PTSD severity decreased and sleep quality improved in the treatment group with small to minimal changes in the control group. Treatment effects were moderate to high (Cohen's d ranged from 0.57 to 1.26). Notwithstanding the large dropout rate, imagery-rehearsal therapy is an effective treatment for chronic nightmares in sexual assault survivors with PTSD and is associated with improvement in sleep quality and decreases in PTSD severity.",Krakow B.; Hollifield M.; Schrader R.; Koss M.; Tandberg D.; Lauriello J.; McBride L.; Warner TD.; Cheng D.; Edmond T.; Kellner R.,2000.0,10.1023/A:1007854015481,0,1,
498,The effect of trauma-focused therapy on the altered T cell distribution in individuals with PTSD: evidence from a randomized controlled trial.,"Posttraumatic stress disorder (PTSD) is associated with a reduced ratio of naïve cytotoxic T lymphocytes, an increased ratio of memory cytotoxic T lymphocytes, and a reduced proportion of FoxP3(+) regulatory T lymphocytes. This study investigated whether these immunological alterations are reversible through an evidence-based psychotherapeutic treatment. Therefore, 34 individuals with PTSD were randomly assigned to either a treatment condition of 12 sessions narrative exposure therapy (NET) or a waitlist control (WLC) group. PTSD symptoms were significantly reduced in the NET group, but not in the WLC group, four months post-therapy (effect size: Hedges' g = -1.61). One year after therapy, PTSD symptoms were improved even further in the NET group compared to baseline (Hedges' g = -1.96). This symptom improvement was mirrored in an increase in the originally reduced proportion of regulatory T cells (Tregs) in the NET group at the one-year follow-up, when comparing subgroups matched for baseline Treg numbers. However, no changes were found for the initially reduced proportion of CD45RA(+)CCR7(+) naïve T lymphocytes. In conclusion, NET was effective in reducing trauma-related PTSD symptoms and had a positive effect on the proportion of Tregs cells, thus demonstrating an effect of psychotherapy on an immunological level. Yet, the shift in the proportion of naïve and memory T lymphocytes in individuals with PTSD, discussed in the literature as a correlate of premature immunosenescence, was not reversible and thus might render these patients permanently more susceptible to infectious diseases.",Morath J.; Gola H.; Sommershof A.; Hamuni G.; Kolassa S.; Catani C.; Adenauer H.; Ruf-Leuschner M.; Schauer M.; Elbert T.; Groettrup M.; Kolassa IT.,2014.0,10.1016/j.jpsychires.2014.03.016,0,1,
499,Randomized Trial of Cognitive-Behavioral Therapy for Chronic Posttraumatic Stress Disorder in Adult Female Survivors of Childhood Sexual Abuse.,"The authors conducted a randomized clinical trial of individual psychotherapy for women with posttraumatic stress disorder (PTSD) related to childhood sexual abuse (n = 74), comparing cognitive-behavioral therapy (CBT) with a problem-solving therapy (present-centered therapy; PCT) and to a wait-list (WL). The authors hypothesized that CBT would be more effective than PCT and WL in decreasing PTSD and related symptoms. CBT participants were significantly more likely than PCT participants to no longer meet criteria for a PTSD diagnosis at follow-up assessments. CBT and PCT were superior to WL in decreasing PTSD symptoms and secondary measures. CBT had a significantly greater dropout rate than PCT and WL. Both CBT and PCT were associated with sustained symptom reduction in this sample. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","McDonagh, Annmarie; Friedman, Matthew; McHugo, Gregory; Ford, Julian; Sengupta, Anjana; Mueser, Kim; Demment, Christine Carney; Fournier, Debra; Schnurr, Paula P; Descamps, Monica; Amir, Beck, Blanchard, Boudewyns, Briere, Briere, Briere, Briere, Briere, Carlson, Cloitre, Cohen, Cook, Cooper, Corcoran, Courtois, D'Zurilla, D'Zurilla, DeShazer, Driscoll, Ehlers, Elhai, Finkelhor, Foa, Foa, Frisch, Herman, Herman, Johnson, Keane, Kessler, Krinsley, Lawrence, Lee, Livanous, Marks, Meador, Nezu, Nezu, Nezu, Nezu, Nezu, Pearlman, Resick, Resick, Saunders, Schnurr, Spaccarelli, Spielberger, Spielberger, Spitzer, Tarrier, Tarrier, Tarrier, Weathers",2005.0,,0,1,
500,Comparing virtual reality exposure therapy to present-centered therapy with 11 U.S. Vietnam veterans with PTSD.,"Eleven Vietnam veterans with war-related posttraumatic stress disorder (PTSD) were randomly assigned to 10 sessions of either virtual reality exposure (VRE) therapy within a computer-generated virtual Vietnam environment or present-centered therapy (PCT) that avoided traumatic content and utilized a problem-solving approach. Participants were assessed at pretreatment, posttreatment, and 6 months posttreatment by an independent assessor blind to treatment condition. Nine participants completed treatment with one dropout per condition. No significant differences emerged between treatments, likely due to insufficient power. Although comparison of mean changes in PTSD symptoms for the VRE and PCT conditions yielded a moderate effect size (d = 0.56) in favor of VRE at 6 months posttreatment, changes in PTSD scores were more variable, and therefore less reliable, within the VRE condition. The utility of VRE with older veterans with PTSD is discussed.",Ready DJ.; Gerardi RJ.; Backscheider AG.; Mascaro N.; Rothbaum BO.,2010.0,,0,1,
501,"Paroxetine, Cognitive Therapy or Their Combination in the Treatment of Social Anxiety Disorder with and without Avoidant Personality Disorder: A Randomized Clinical Trial.","The most efficacious treatments for social anxiety disorder (SAD) are the SSRIs and cognitive therapy (CT). Combined treatment is advocated for SAD but has not been evaluated in randomized trials using CT and SSRI. Our aim was to evaluate whether one treatment is more effective than the other and whether combined treatment is more effective than the single treatments. A total of 102 patients were randomly assigned to paroxetine, CT, the combination of CT and paroxetine, or pill placebo. The medication treatment lasted 26 weeks. Of the 102 patients, 54% fulfilled the criteria for an additional diagnosis of avoidant personality disorder. Outcomes were measured at posttreatment and 12-month follow-up assessments. CT was superior to paroxetine alone and to pill placebo at the end of treatment, but it was not superior to the combination treatment. At the 12-month follow-up, the CT group maintained benefits and was significantly better than placebo and paroxetine alone, whereas there were no significant differences among combination treatment, paroxetine alone, and placebo. Recovery rates at 12 months were much higher in the CT group (68%) compared to 40% in the combination group, 24% in the paroxetine group, and 4% in the pill placebo group. CT was the most effective treatment for SAD at both posttreatment and follow-up compared to paroxetine and better than combined treatment at the 12-month follow-up on the Liebowitz Social Anxiety Scale. Combined treatment provided no advantage over single treatments; rather there was less effect of the combined treatment compared to CT alone.",Nordahl HM.; Vogel PA.; Morken G.; Stiles TC.; Sandvik P.; Wells A.,2016.0,10.1159/000447013,0,1,
502,Treatment of posttraumatic stress disorder by trained lay counselors in an African refugee settlement: a randomized controlled trial.,"Traumatic stress due to conflict and war causes major mental health problems in many resource-poor countries. The objective of this study was to examine whether trained lay counselors can carry out effective treatment of posttraumatic stress disorder (PTSD) in a refugee settlement. In a randomized controlled dissemination trial in Uganda with 277 Rwandan and Somalian refugees who were diagnosed with PTSD the authors investigated the effectiveness of psychotherapy administered by lay counselors. Strictly manualized narrative exposure therapy (NET) was compared with more flexible trauma counseling (TC) and a no-treatment monitoring group (MG). Fewer participants (4%) dropped out of NET treatment than TC (21%). Both active treatment groups were statistically and clinically superior to MG on PTSD symptoms and physical health but did not differ from each other. At follow-up, a PTSD diagnosis could not be established anymore in 70% of NET and 65% TC participants, whereas only 37% in MG did not meet PTSD criteria anymore. Short-term psychotherapy carried out by lay counselors with limited training can be effective to treat war-related PTSD in a refugee settlement.",Neuner F.; Onyut PL.; Ertl V.; Odenwald M.; Schauer E.; Elbert T.,2008.0,10.1037/0022-006X.76.4.686,0,1,
503,Randomized trial of trauma-focused group therapy for posttraumatic stress disorder: results from a department of veterans affairs cooperative study.,"Department of Veterans Affairs Cooperative Study 420 is a randomized clinical trial of 2 methods of group psychotherapy for treating posttraumatic stress disorder (PTSD) in male Vietnam veterans. Vietnam veterans (360 men) were randomly assigned to receive trauma-focused group psychotherapy or a present-centered comparison treatment that avoided trauma focus. Treatment was provided weekly to groups of 6 members for 30 weeks, followed by 5 monthly booster sessions. Severity of PTSD was the primary outcome. Additional measures were other psychiatric symptoms, functional status, quality of life, physical health, and service utilization. Follow-up assessments were conducted at the end of treatment (7 months) and at the end of the booster sessions (12 months); 325 individuals participated in 1 or both assessments. Additional follow-up for PTSD severity was performed in a subset of participants at 18 and 24 months. Although posttreatment assessments of PTSD severity and other measures were significantly improved from baseline, intention-to-treat analyses found no overall differences between therapy groups on any outcome. Analyses of data from participants who received an adequate dose of treatment suggested that trauma-focused group therapy reduced avoidance and numbing and, possibly, PTSD symptoms. Dropout from treatment was higher in trauma-focused group treatment. Average improvement was modest in both treatments, although approximately 40% of participants showed clinically significant change. This study did not find a treatment effect for trauma-focused group therapy. The difference between the effectiveness and adequate dose findings suggests the possible value of methods to enhance the delivery of cognitive-behavioral treatments in clinical practice settings.",Schnurr PP.; Friedman MJ.; Foy DW.; Shea MT.; Hsieh FY.; Lavori PW.; Glynn SM.; Wattenberg M.; Bernardy NC.,2003.0,10.1001/archpsyc.60.5.481,0,1,
504,Cognitive behavioral therapy for posttraumatic stress disorder in women: a randomized controlled trial.,"The prevalence of posttraumatic stress disorder (PTSD) is elevated among women who have served in the military, but no prior study has evaluated treatment for PTSD in this population. Prior research suggests that cognitive behavioral therapy is a particularly effective treatment for PTSD. To compare prolonged exposure, a type of cognitive behavioral therapy, with present-centered therapy, a supportive intervention, for the treatment of PTSD. A randomized controlled trial of female veterans (n=277) and active-duty personnel (n=7) with PTSD recruited from 9 VA medical centers, 2 VA readjustment counseling centers, and 1 military hospital from August 2002 through October 2005. Participants were randomly assigned to receive prolonged exposure (n = 141) or present-centered therapy (n = 143), delivered according to standard protocols in 10 weekly 90-minute sessions. Posttraumatic stress disorder symptom severity was the primary outcome. Comorbid symptoms, functioning, and quality of life were secondary outcomes. Blinded assessors collected data before and after treatment and at 3- and 6-month follow-up. Women who received prolonged exposure experienced greater reduction of PTSD symptoms relative to women who received present-centered therapy (effect size, 0.27; P = .03). The prolonged exposure group was more likely than the present-centered therapy group to no longer meet PTSD diagnostic criteria (41.0% vs 27.8%; odds ratio, 1.80; 95% confidence interval, 1.10-2.96; P = .01) and achieve total remission (15.2% vs 6.9%; odds ratio, 2.43; 95% confidence interval, 1.10-5.37; P = .01). Effects were consistent over time in longitudinal analyses, although in cross-sectional analyses most differences occurred immediately after treatment. Prolonged exposure is an effective treatment for PTSD in female veterans and active-duty military personnel. It is feasible to implement prolonged exposure across a range of clinical settings. clinicaltrials.gov Identifier: NCT00032617.",Schnurr PP.; Friedman MJ.; Engel CC.; Foa EB.; Shea MT.; Chow BK.; Resick PA.; Thurston V.; Orsillo SM.; Haug R.; Turner C.; Bernardy N.,2007.0,10.1001/jama.297.8.820,0,1,
505,A randomized clinical trial of group cognitive processing therapy compared with group present-centered therapy for PTSD among active duty military personnel.,"To determine whether group therapy improves symptoms of posttraumatic stress disorder (PTSD), this randomized clinical trial compared efficacy of group cognitive processing therapy (cognitive only version; CPT-C) with group present-centered therapy (PCT) for active duty military personnel. Patients attended 90-min groups twice weekly for 6 weeks at Fort Hood, Texas. Independent assessments were administered at baseline, weekly before sessions, and 2 weeks, 6 months, and 12 months posttreatment. A total of 108 service members (100 men, 8 women) were randomized. Inclusion criteria included PTSD following military deployment and medication stability. Exclusion criteria included suicidal/homicidal intent or other severe mental disorders requiring immediate treatment. Follow-up assessments were administered regardless of treatment completion. Primary outcome measures were the PTSD Checklist (Stressor Specific Version; PCL-S) and Beck Depression Inventory-II. The Posttraumatic Stress Symptom Interview (PSS-1) was a secondary measure. Both treatments resulted in large reductions in PTSD severity, but improvement was greater in CPT-C. CPT-C also reduced depression, with gains remaining during follow-up. In PCT, depression only improved between baseline and before Session 1. There were few adverse events associated with either treatment. Both CPT-C and PCT were tolerated well and reduced PTSD symptoms in group format, but only CPT-C improved depression. This study has public policy implications because of the number of active military needing PTSD treatment, and demonstrates that group format of treatment of PTSD results in significant improvement and is well tolerated. Group therapy may an important format in settings in which therapists are limited.",Resick PA.; Wachen JS.; Mintz J.; Young-McCaughan S.; Roache JD.; Borah AM.; Borah EV.; Dondanville KA.; Hembree EA.; Litz BT.; Peterson AL.,2015.0,10.1037/ccp0000016,0,1,
506,Long-term outcome of cognitive therapy's contribution to self-exposure in vivo to the treatment of generalized social phobia.,"The aim of this work was to test the contribution of cognitive therapy to exposure in vivo in the group treatment of generalized social phobia. Seventy-one severely disabled social phobics, selected according to DSM-III-R criteria, were assigned at random to: (a) self-exposure in vivo, (b) self-exposure in vivo with cognitive therapy, or (c) a waiting-list control group. A multigroup experimental design with repeated measures of assessment (pretreatment, posttreatment, and 1-, 3-, 6-, and 12-month follow-ups) was used. Additionally, half of the patients in both therapeutic groups were given self-help manuals for managing anxiety. Most patients that were treated (64%) showed significant improvement at the 12-month follow-up, but there were no differences between the two therapeutic models. No improvement was shown by the control-group participants at the 6-month follow-up. The results of the present trial do not support the beneficial effects of adding cognitive therapy or a self-help manual to exposure alone. Finally, several topics that may contribute to future research in this field are discussed.",Salaberría K.; Echeburúa E.,1998.0,10.1177/01454455980223003,0,1,
507,Enhancing outcomes in the treatment of generalised anxiety disorder.,"Describes the rationale and content for each of the treatment modules in our cognitive-behavioural treatment (CBT) for generalised anxiety disorder (GAD). In addition, mindfulness training for GAD is discussed and some results from our randomised controlled trial comparing mindfulness training with CBT for GAD are described. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Abbott, Maree; Abbott, Abbott, Bennett-Levy, Borkovec, Borkovec, Borkovec, DiNardo, Dugas, Dugas, Durham, Gould, Greenberger, Huxter, Kabat-Zinn, Kessler, Kessler, Leahy, Mathers, Mennin, Miller, Newman, Noyes, Olfson, Pennebaker, Purer, Roemer, Rygh, Segal, Teasdale, Turk, Wells, Wells, Wittchen; Einstein, Danielle A [Ed]",2007.0,,0,1,
508,Internet-based treatment for social phobia: A 6-month follow-up.,"Theoretical background: Internet-based psychotherapeutic interventions have proven to be efficacious for various anxiety disorders, including social phobia. Objective: The aim of this study was to investigate the mid-term treatment efficacy of an internet-based cognitive-behavioural program in a 6-month-follow-up. Method: 52 patients with a primary diagnosis of social phobia who participated in a randomized controlled trial (Berger, Hohl & Caspar, 2009) were contacted 6 months after completing the internet-based program. 71.2% (37/52) responded to the self-report questionnaires. Results: Significant pre- to post-treatment improvements persisted at the 6-month follow-up on all primary and secondary outcome measures (intent-to-treat sample). Large pretreatment to follow-up within group effect sizes for the primary social phobia measures were found (Cohen's d = 1.19-1.37; completers sample). Conclusions: The data suggest mid-term positive effects of the internet-based program to social phobia. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Berger, Thomas; Hohl, Eleonore; Caspar, Franz; Andersson, Barak, Beck, Berger, Berger, Berger, Carlbring, Carlbring, Clark, Derogatis, Erwina, Franke, Fydrich, Gueorguieva, Hautzinger, Horowitz, Kiresuk, Liebowitz, Mattick, Spek, Stangier, Stangier, Stangier, Titov, Titov, Wittchen, Yonkers",2010.0,,0,1,
509,Randomized controlled trial of imagery rehearsal for posttraumatic nightmares in Vietnam veterans,"Introduction: There is evidence that posttraumatic nightmares respond to an empirically promising cognitive-behavioral therapy called Imagery Rehearsal (IR). In IR, patients choose a repetitive nightmare, create a changed version that is less distressing, and then mentally rehearse the changed script. Several studies support the efficacy of IR, but to date no randomized controlled trial (RCT) has been conducted to compare IR against a credible psychotherapy comparison condition. This report describes the outcome of a RCT in Vietnam War veterans with PTSD. Methods: Male Vietnam War veterans with combat-related PTSD were randomized to receive 6 group sessions of IR (n=61) or Sleep and Nightmare Management (SN), a psychoeducational intervention (n=63). Mean (SD) age was 59.4 (3.6). Veterans were assessed pretreatment and 1-month post treatment with the Clinician Administered PTSD Scale (CAPS), Nightmare Frequency Questionnaire (NFQ), Nightmare Effects Survey (NES), and Pittsburgh Sleep Quality Index (PSQI). Intent- to-treat analyses were conducted using mixed effects models. Results: Neither treatment had a statistically significant effect on CAPS total or subscale scores, or on the PSQI. Similarly, there was no change in either the NFQ or the NES, although there was a reduction in nightmare intensity on the CAPS item for the IR group only (IR: 5.7 to 4.9; SN 5.8 to 5.5; p<0.01). Treatment dropout was significantly greater in the IR group (n=16) compared to the SN group (n=7). Conclusion: This RCT did not find a significant effect of IR, except for a reduction in nightmare intensity. Veteran populations with chronic, severe PTSD may be less responsive to treatments that are effective for other groups, as has been observed in previous RCTs. Positive results that we have found with Operation Iraqi Freedom and Operation Enduring Freedom veterans support this possibility. Additional RCTs in samples including younger veterans with PTSD are needed before conclusions about treatment efficacy can be made.",Ross R.J.; Gehrman P.; Cook J.M.; Harb G.C.; Gamble G.M.,2009.0,,0,1,
510,A controlled trial of treatments for generalized anxiety.,"Treatments for chronic anxiety have received considerable interest recently. Firstly, there is a body of research which has shown problems of dependence and habituation in the long-term use of anti-anxiety drugs. A second development is that of psychological treatments for anxiety. Because of the problems involved in the use of benzodiazepines, it is important to determine whether or not psychological treatments are a reasonable alternative when treating chronic anxiety. This study was designed to test the relative effectiveness of cognitive-behavioural therapy, anxiety management training and treatment by benzodiazepines against a waiting list control. Measures were taken on both the process and outcome of treatment. The most immediate and greatest improvements in anxiety were seen in the group receiving drugs. However, these improvements reduced as the trial progressed and were minimal at the end of therapy. Both psychological treatment groups improved as the trial progressed with the most significant and consistent changes seen in the cognitive-behaviour therapy group. However, at follow-up there was no difference between the two groups receiving psychological treatments. Because of their lack of sustained improvement, over half of the group receiving drugs refused to wait without treatment until the follow-up assessment.",Lindsay WR.; Gamsu CV.; McLaughlin E.; Hood EM.; Espie CA.,1987.0,,0,1,
511,Cognitive and Relaxation Coping Skills in Stress Inoculation,,"Deffenbacher, Jerry L",1981.0,,0,1,
512,Treatment of posttraumatic stress reactions to traffic accidents.,"Post traumatic stress disorder and other reactions including driving phobias and depression have in recent years been clearly identified as common accident sequelae. These disorders affect a sizeable minority of those involved in traffic accidents of sufficient severity to necessitate medical attention. This minority can be conservatively estimated at 20 to 25% of accident victims after one year. Their psychological symptoms and distress can be persistent over years, and disabling. Unfortunately, no treatment outcome data exist beyond case study reports and only one pilot investigation has been published upon which to base clinical practice. For post traumatic stress disorder (PTSD) in general, and for non-combat related trauma, in particular, controlled therapy outcome research is sparse. The present research was a randomized control clinical therapy outcome study for PTSD in motor vehicle accident victims. Twenty volunteer participants who had motor vehicle accidents resulting in physical injury requiring medical attention and PTSD were recruited through rehabilitation service providers, other psychologists, community physicians, and lawyers. Participants completed assessments including a structured interview for diagnosis of post traumatic stress disorder (Clinician Administered PTSD Scale) by an independent rater, a range of self-report symptom questionnaires and a behavioural test wherein they had their heart rate and subjective distress measured in reaction to idiosyncratic audio descriptions of their accident. They were then randomly assigned to eight to ten hours of individual cognitive-behavioural therapy (n = 10) or to a wait list control group (n = 10). Treatment included education about post-trauma reactions, relaxation training, exposure therapy with cognitive restructuring and instruction for self-directed graduated behaviour practice. The assessments were conducted both prior to and upon completion of therapy or equivalent time for wait-list controls. A mail follow-up of symptom questionnaires was also completed three months and six months after the end of therapy. Results demonstrated statistically significant treatment effects across structured interviews, self-report questionnaires and the behavioural test. Analysis of clinical significance also supported the efficacy of treatment. Treatment gains were maintained over the six month follow-up period. The vast majority of participants also experienced chronic pain often with concurrent depression. These depressive symptoms, which were not targeted by treatment, were resistant to change. In addition to efficacy of treatment, potential predictors of initial PTSD symptom levels were explored by multiple regression. Avoidant coping style, fear level experienced during the trauma, and, crisis support were found to be significant variables related to PTSD symptoms. The present research is the first controlled therapy trial with this treatment population and the findings are discussed in terms of the therapeutic needs of this group and PTSD outcome research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fecteau, Gary William",2000.0,,0,1,
513,Individual response patterns and the effects of different behavioral methods in the treatment of claustrophobia.,,Ost LG.; Johansson J.; Jerremalm A.,1982.0,,0,1,
514,Effectiveness of an internet-delivered intervention for generalized anxiety disorder in routine care: A randomised controlled trial in a student population,"Background Cognitive behavioural therapy is one of the main and preferred treatments for generalized anxiety disorder. Numerous barriers can hinder an individual from seeking or receiving appropriate treatment; internet-delivered CBT interventions offer a relatively new means of increasing access to treatment. Methods A service-based effectiveness randomised waiting list control trial examined the impact of an internet-delivered CBT intervention, Calming Anxiety, amongst Irish university students (N�=�137). Primary outcome was self-reported GAD and secondary outcomes included depression and work and social functioning. Results Analyses returned inconclusive results. Both treatment and waiting list conditions displayed significant decreases in anxiety symptoms post-treatment, but we did not observe a significant between-group effect (p�=�0.076). Significant within-group differences from pre to post time points were observed for depression (BDI-II) and work and social functioning (WASA), and between group differences were also significant for depression (d�=�0.46) and functioning (d�=�0.36). Both groups demonstrated cases of remission and recovery from anxiety, however differences in the number of cases reaching clinically meaningful change between conditions were non-significant. Conclusions Several explanations regarding the results are presented, examining issues related to active waiting lists, study limitations and treatment expectancies. Trial registration: Current Controlled Trials ISRCTN16303842.","Richards, Derek; Timulak, Ladislav; Rashleigh, Chuck; McLoughlin, Orla; Colla, Amy; Joyce, Ciara; Doherty, Gavin; Sharry, John; Duffy, Daniel; Anderson-Gibbons, Melissa",2016.0,10.1016/j.invent.2016.10.003,0,1,
515,Cognitive-Behavior Therapy (CBT) for Panic Disorder: Relationship of Anxiety and Depression Comorbidity with Treatment Outcome.,"Research evaluating the relationship of comorbidity to treatment outcome for panic disorder has produced mixed results. The current study examined the relationship of comorbid depression and anxiety to treatment outcome in a large-scale, multi-site clinical trial for cognitive-behavior therapy (CBT) for panic disorder. Comorbidity was associated with more severe panic disorder symptoms, although comorbid diagnoses were not associated with treatment response. Comorbid generalized anxiety disorder (GAD) and major depressive disorder (MDD) were not associated with differential improvement on a measure of panic disorder severity, although only rates of comorbid GAD were significantly lower at posttreatment. Treatment responders showed greater reductions on measures of anxiety and depressive symptoms. These data suggest that comorbid anxiety and depression are not an impediment to treatment response, and successful treatment of panic disorder is associated with reductions of comorbid anxiety and depressive symptoms. Implications for treatment specificity and conceptual understandings of comorbidity are discussed.",Allen LB.; White KS.; Barlow DH.; Shear MK.; Gorman JM.; Woods SW.,2010.0,10.1007/s10862-009-9151-3,0,1,
516,Cognitive-behavioral group therapy versus phenelzine in social phobia: long-term outcome.,"To evaluate the effects of maintenance treatment and durability of gains after treatment discontinuation, responders to either phenelzine (PZ) or cognitive-behavioral group therapy (CBGT) from an acute trial comparing these two treatments as well as pill placebo and a psychotherapy control (educational supportive group therapy) were enrolled into maintenance and treatment-free follow-up phases. Responders to an acute trial contrasting PZ and CBGT entered a six-month maintenance phase. Patients who continued to respond through the maintenance phase entered a six-month treatment free phase. Patients receiving pill placebo or educational supportive group therapy in the acute trial did not enter the long term study. PZ patients entered maintenance more improved than CBGT patients, and nonrelapsing PZ patients maintained their superior gains throughout the study. Relapse during maintenance did not differ between treatments. However, PZ patients showed a trend toward greater relapse during treatment-free follow-up. There was a greater relapse among patients with generalized social phobia with phenelzine. PZ and cognitive-behavioral group therapy may differ in their long term effects. The superiority seen with PZ on some measures in the acute study persisted in patients who maintained their gains over the course of maintenance and treatment-free follow-up. However, CBGT may lead to a greater likelihood of maintaining response after treatment has terminated. Replication with larger samples is needed, as is a study of the acute and long-term efficacy of combined PZ and CBGT.",Liebowitz MR.; Heimberg RG.; Schneier FR.; Hope DA.; Davies S.; Holt CS.; Goetz D.; Juster HR.; Lin SH.; Bruch MA.; Marshall RD.; Klein DF.,1999.0,,0,1,
517,"A comparison of cognitive therapy, applied relaxation, and nitrous oxide sedation in the treatment of dental fear.","The aim of this study was to investigate the short-term efficacy of cognitive therapy and applied relaxation in dental fear treatment and to compare these methods with conventional pharmacological sedation (nitrous oxide sedation). Patients (n = 65) with severe dental fear were randomly assigned to the different treatment methods and received 10 weekly sessions of individual therapy. Dropout rates were low, and all patients who completed the therapy sessions were able to receive dental treatment. Scores on dental fear tests were significantly reduced compared with pretreatment level for all treatment groups. There were no major differences between treatment methods in this short-term perspective.",Willumsen T.; Vassend O.; Hoffart A.,2001.0,,0,1,
518,Evaluation of the Effectiveness and Transportability of Panic Control Treatment in a Private Practice Setting: Acute and Long Term Effects,,"Fairholme, Christopher P.; Strand, Jon; Thomas, Jay C.; Warren, Ricks",2017.0,10.1007/s10942-017-0265-3,0,1,
519,Effectiveness of cognitive behavior therapy for diagnostically heterogeneous groups: a benchmarking study.,"Researchers have recently suggested that the commonalities across the emotional disorders outweigh the differences, and thus similar treatment principles could be applied in unified interventions. In this study, the authors used a benchmarking strategy to investigate the transportability of cognitive-behavioral therapy (CBT) for anxiety and depression to mixed-diagnosis groups. Patients (N = 143) attended 10 2-hour sessions of group CBT plus a 1-month follow-up. Changes in anxiety and depression were indexed by effect sizes, reliable change, and clinically significant change and then benchmarked to previous efficacy and effectiveness studies. Symptoms of depression and anxiety significantly improved, and mixed-diagnosis groups compared favorably with diagnosis-specific CBT, suggesting that unified treatments are an effective, efficient, and practical method of treatment delivery.",McEvoy PM.; Nathan P.,2007.0,10.1037/0022-006X.75.2.344,0,1,
520,"Cognitive therapy, analytic psychotherapy and anxiety management training for generalised anxiety disorder.","We test the hypotheses that (a) cognitive therapy is of comparable efficacy to psychodynamic psychotherapy, (b) 8-10 sessions of therapy is as effective as 16-20 sessions, and (c) brief therapist training is as effective as intensive training. Of 178 out-patients referred to a clinical trial of psychological treatment for generalised anxiety, 110 patients met DSM-III-R criteria for generalised anxiety disorder and were randomly assigned to three different forms of psychotherapy. The main comparison was between cognitive therapy and analytic psychotherapy, delivered by experienced therapists at weekly or fortnightly intervals over six months. A third treatment, anxiety management training, was delivered at fortnightly intervals by registrars in psychiatry after a brief period of training. Eighty patients completed treatment and were assessed before treatment, after treatment, and at six-month follow-up. Cognitive therapy was significantly more effective than analytic psychotherapy, with about 50% of patients considerably better at follow-up. Analytic psychotherapy gave significant improvement but to a lesser degree than cognitive therapy. There was no significant effect for level of contact. Patients receiving anxiety management training showed similar improvements to cognitive therapy after treatment, with rather lower proportions showing clinically significant change. Cognitive therapy is likely to be more effective than psychodynamic psychotherapy with chronically anxious patients. Significant improvements in symptoms can be achieved by trainee psychiatrists after only brief instruction in behaviourally based anxiety management. However, the superiority of cognitive therapy at follow-up suggests that the greater investment of resources required for this approach is likely to pay off in terms of more sustained improvement. There is no evidence that 16-20 sessions of treatment is more effective, on average, than 8-10 sessions.",Durham RC.; Murphy T.; Allan T.; Richard K.; Treliving LR.; Fenton GW.,1994.0,,0,1,
521,Narrative exposure therapy for PTSD increases top-down processing of aversive stimuli--evidence from a randomized controlled treatment trial.,"Little is known about the neurobiological foundations of psychotherapy for Posttraumatic Stress Disorder (PTSD). Prior studies have shown that PTSD is associated with altered processing of threatening and aversive stimuli. It remains unclear whether this functional abnormality can be changed by psychotherapy. This is the first randomized controlled treatment trial that examines whether narrative exposure therapy (NET) causes changes in affective stimulus processing in patients with chronic PTSD. 34 refugees with PTSD were randomly assigned to a NET group or to a waitlist control (WLC) group. At pre-test and at four-months follow-up, the diagnostics included the assessment of clinical variables and measurements of neuromagnetic oscillatory brain activity (steady-state visual evoked fields, ssVEF) resulting from exposure to aversive pictures compared to neutral pictures. PTSD as well as depressive symptom severity scores declined in the NET group, whereas symptoms persisted in the WLC group. Only in the NET group, parietal and occipital activity towards threatening pictures increased significantly after therapy. Our results indicate that NET causes an increase of activity associated with cortical top-down regulation of attention towards aversive pictures. The increase of attention allocation to potential threat cues might allow treated patients to re-appraise the actual danger of the current situation and, thereby, reducing PTSD symptoms. REGISTRATION OF THE CLINICAL TRIAL: Number: NCT00563888Name: ""Change of Neural Network Indicators Through Narrative Treatment of PTSD in Torture Victims"" ULR: http://www.clinicaltrials.gov/ct2/show/NCT00563888.",Adenauer H.; Catani C.; Gola H.; Keil J.; Ruf M.; Schauer M.; Neuner F.,2011.0,10.1186/1471-2202-12-127,0,1,
522,Effectiveness of computerised cognitive behaviour therapy for anxiety disorders in secondary care.,"This study aimed to compare the effectiveness of computerised cognitive behaviour therapy (CCBT) with a wait list control (WLC) for the treatment of patients with an anxiety disorder (social phobia, panic disorder, generalised anxiety disorder) referred to a specialist, publically funded, outpatient anxiety service. Patients with social phobia (n = 37), panic disorder (n = 32) or generalised anxiety disorder (n = 14) were randomised to treatment with either CCBT (n = 40) or WLC (n = 43). Self-report rating scale assessments were conducted at baseline, 12 and 24 weeks. Compared with WLC, the CCBT group improved significantly on approximately half of the self-report primary (the Work and Social Adjustment Scale) and approximately half of the secondary measures at both 12 and 24 weeks (the Liebowitz Social Anxiety Scale, the Penn State Worry Questionnaire, the Generalised Anxiety inventory and the Fear Questionnaire). Effect sizes in this study were moderate. This is one of the few studies to investigate CCBT for anxiety disorders in patients in a secondary care service. The results show that CCBT in this secondary care setting has the potential to be beneficial and confirms and extends the findings from previous studies of self-referral or primary care settings.",Bell CJ.; Colhoun HC.; Carter FA.; Frampton CM.,2012.0,10.1177/0004867412437345,0,1,
523,Adding cognitive therapy elements to exposure therapy for obsessive compulsive disorder: A controlled study,"Thirty-five outpatients (25 women, 10 men) with a DSM-III-R principal diagnosis of OCD accepted exposure treatment at a psychiatric outpatient clinic. They were randomly assigned to one of two individual treatments for a 6-week exposure therapy treatment based on a treatment manual or to a 6-week waiting list condition. The 12 patients assigned to the waiting list were subsequently randomly assigned to one of the active treatments. Both treatment groups received in vivo or imaginal exposure in each of the 10 twice-weekly treatment sessions held after two assessment sessions. One group (n = 16) received cognitive therapy interventions for comorbidity problems or to alter beliefs underlying patients' OCD. The other group (n = 19) received relaxation training as an attention placebo control. Both groups received relapse prevention follow-up contacts. Twenty-seven patients completed intensive treatment. Both treatments overall showed satisfactory levels of clinical improvement and large effect sizes. ANCOVAS for treatment completers showed non-significantly lower levels of OCD symptoms, depression and state anxiety in the treatment condition that did not include cognitive interventions. The patients receiving additional cognitive therapy showed significantly lesser dropout than those in the other treatment condition, but there were no significant differences in the intention-to-treat analyses.","Vogel, Patrick A.; Stiles, Tore C.; Götestam, K. Gunnar",2004.0,10.1017/S1352465804001353,0,1,
524,A controlled comparison of Eye Movement Desensitization and Reprocess- ing versus exposure plus cognitive restructuring versus waiting list in the treatment of Post-traumatic Stress Disorder.,"A total of 105 patients with post-traumatic stress disorder (PTSD) were randomly allocated to eye-movement desensitization and reprocessing (EMDR) (n = 39) versus exposure plus cognitive restructuring (E + CR) (n = 37) versus waiting list (WL) (n = 29) in a primary care setting. EMDR and E + CR patients received a maximum of 10 treatment sessions over a 10-week period. All patients were assessed by blind raters prior to randomization and at end of the 10-week treatment or waiting list period. EMDR and E + CR patients were also assessed by therapists at the mid-point of the 10-week treatment period and on average at 15 months follow-up. Patients were assessed on a variety of assessor-rated and self-report measures of PTSD symptomatology including the Clinician Administered PTSD Scale (CAPS), the Impact of Events Scale (IOE) and a self-report version of the SI-PTSD Checklist. Measures of anxiety and depression included the Montgomery Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Scale (HAM-A) and the Hospital Anxiety and Depression Scale (HADS). A measure of social function, the Sheehan Disability Scale was also used. Drop-out rates between the three groups were 12 EMDR, 16 E + CR and five WL. Treatment end-point analyses were conducted on the remaining 72 patients. Repeated measures analysis of variance of treatment outcome at 10 weeks revealed significant time, interaction and group effects for all the above measures. In general there were significant and substantial pre–post reductions for EMDR and E + CR groups but no change for the WL patients. Both treatments were effective over WL. The only indication of superiority of either active treatment, in relation to measures of clinically significant change, was a greater reduction in patient self-reported depression ratings and improved social functioning for EMDR in comparison to E + CR at the end of the treatment period and for fewer number of treatment sessions for EMDR (mean 4.2) than E + CR (mean 6.4) patients. At 15 months follow-up treatment gains were generally well-maintained with the only difference, in favour of EMDR over E + CR, occurring in relation to assessor-rated levels of clinically significant change in depression. However, exclusion of patients who had subsequent treatment during the follow-up period diminished the proportion of patients achieving long-term clinically significant change. In summary, at end of treatment and at follow-up, both EMDR and E + CR are effective in the treatment of PTSD with only a slight advantage in favour of EMDR. Copyright © 2002 John Wiley & Sons, Ltd.","Power, K.; McGoldrick, T.; Brown, K.; Buchanan, R.; Sharp, D.; Swanson, V.; Karatzias, a.",2002.0,10.1002/cpp.341,0,1,
525,"A multi-site single blind clinical study to compare the effects of prolonged exposure, eye movement desensitization and reprocessing and waiting list on patients with a current diagnosis of psychosis and co morbid post traumatic stress disorder: study pro","Trauma contributes to psychosis and in psychotic disorders post-traumatic stress disorder (PTSD) is often a comorbid disorder. A problem is that PTSD is underdiagnosed and undertreated in people with psychotic disorders. This study's primary goal is to examine the efficacy and safety of prolonged exposure and eye movement desensitization and reprocessing (EMDR) for PTSD in patients with both psychotic disorders and PTSD, as compared to a waiting list. Secondly, the effects of both treatments are determined on (a) symptoms of psychosis, in particular verbal hallucinations, (b) depression and social performance, and (c) economic costs. Thirdly, goals concern links between trauma exposure and psychotic symptomatology and the prevalence of exposure to traumatic events, and of PTSD. Fourthly predictors, moderators, and mediators for treatment success will be explored. These include cognitions and experiences concerning treatment harm, credibility and burden in both participants and therapists. A short PTSD-screener assesses the possible presence of PTSD in adult patients (21- to 65- years old) with psychotic disorders, while the Clinician Administered PTSD Scale interview will be used for the diagnosis of current PTSD. The M.I.N.I. Plus interview will be used for diagnosing lifetime psychotic disorders and mood disorders with psychotic features. The purpose is to include consenting participants (N = 240) in a multi-site single blind randomized clinical trial. Patients will be allocated to one of three treatment conditions (N = 80 each): prolonged exposure or EMDR (both consisting of eight weekly sessions of 90 minutes each) or a six-month waiting list. All participants are subjected to blind assessments at pre-treatment, two months post treatment, and six months post treatment. In addition, participants in the experimental conditions will have assessments at mid treatment and at 12 months follow-up. The results from the post treatment measurement can be considered strong empirical indicators of the safety and effectiveness of prolonged exposure and EMDR. The six-month and twelve-month follow-up data have the potential of reliably providing documentation of the long-term effects of both treatments on the various outcome variables. Data from pre-treatment and midtreatment can be used to reveal possible pathways of change. Trial registration: ISRCTN79584912.",de Bont PA.; van den Berg DP.; van der Vleugel BM.; de Roos C.; Mulder CL.; Becker ES.; de Jongh A.; van der Gaag M.; van Minnen A.,2013.0,10.1186/1745-6215-14-151,0,1,
526,"One-year follow-up of patients treated for dental fear: effects of cognitive therapy, applied relaxation, and nitrous oxide sedation.","The effects of dental fear treatments were assessed in a 1-year follow-up study. Sixty-two patients had finished a controlled study in which they were randomly allocated to nitrous oxide sedation (NO), cognitive therapy (CT), or applied relaxation (AR). During the trial highly significant reductions in dental fear and general distress were observed. One year later a majority (95%) of the participants had attended dental treatment in general practice. On the whole, continued favorable effects with regard to dental fear and general distress were observed. Patients in the applied relaxation group evidenced the largest reductions on the dental fear measures. All patients judged the dental fear treatment to have been beneficial, and 80% judged the treatment given in the year after the dental fear treatment successful. All three treatment groups scored in the normative range for general distress both at the end of treatment and at follow-up.",Willumsen T.; Vassend O.; Hoffart A.,2001.0,,0,1,
527,Efficacy of a manualized and workbook-driven individual treatment for social anxiety disorder.,"Social anxiety disorder is a prevalent and impairing disorder for which viable cognitive-behavioral therapies exist. However, these treatments have not been easily packaged for dissemination and may be underutilized as a result. The current study reports on the findings of a randomized controlled trial of a manualized and workbook-driven individual cognitive-behavioral treatment for social anxiety disorder (Hope, Heimberg, Juster, & Turk, 2000; Hope, Heimberg, & Turk, 2006). This treatment package was derived from an empirically supported group treatment for social anxiety disorder and intended for broad dissemination, but it has not previously been subjected to empirical examination on its own. As a first step in that examination, 38 clients seeking treatment for social anxiety disorder at either the Adult Anxiety Clinic of Temple University or the Anxiety Disorders Clinic of the University of Nebraska-Lincoln were randomly assigned to receive either immediate treatment with this cognitive-behavioral treatment package or treatment delayed for 20 weeks. Evaluation at the posttreatment/postdelay period revealed substantially greater improvements among immediate treatment clients on interviewer-rated and self-report measures of social anxiety and impairment. Three-month follow-up assessment revealed maintenance of gains. Clinical implications and directions for future research are discussed.",Ledley DR.; Heimberg RG.; Hope DA.; Hayes SA.; Zaider TI.; Dyke MV.; Turk CL.; Kraus C.; Fresco DM.,2009.0,10.1016/j.beth.2008.12.001,0,1,
528,Guided and unguided Acceptance and Commitment Therapy for social anxiety disorder and/or panic disorder provided via the Internet and a smartphone application: A randomized controlled trial,"Acceptance and Commitment Therapy (ACT) can be effective in treating anxiety disorders, yet there has been no study on Internet-delivered ACT for social anxiety disorder (SAD) and panic disorder (PD), nor any study investigating whether therapist guidance is superior to unguided self-help when supplemented with a smartphone application. In the current trial, n = 152 participants diagnosed with SAD and/or PD were randomized to therapist-guided or unguided treatment, or a waiting-list control group. Both treatment groups used an Internet-delivered ACT-based treatment program and a smartphone application. Outcome measures were self-rated general and social anxiety and panic symptoms. Treatment groups saw reduced general (d = 0.39) and social anxiety (d = 0.70), but not panic symptoms (d = 0.05) compared to the waiting-list group, yet no differences in outcomes were observed between guided and unguided interventions. We conclude that Internet-delivered ACT is appropriate for treating SAD and potentially PD. Smartphone applications may partially compensate for lack of therapist support.","Ivanova, Ekaterina; Lindner, Philip; Ly, Kien Hoa; Dahlin, Mats; Vernmark, Kristofer; Andersson, Gerhard; Carlbring, Per",2016.0,10.1016/j.janxdis.2016.09.012,0,1,
529,Internet-based treatment for panic disorder: A three-arm randomized controlled trial comparing guided (via real-time video sessions) with unguided self-help treatment and a waitlist control. PAXPD study results,"A growing body of evidence suggests that Internet-based cognitive behavioral treatments (ICBT) are effective to treat anxiety disorders. However, the effect of therapist guidance in ICBT is still under debate and guided ICBT offered in a real-time audio-video communication format has not yet been systematically investigated. This three-arm RCT compared the efficacy of guided with unguided ICBT (12 weeks intervention) and a waitlist (WL). A total of 111 individuals meeting the diagnostic criteria for panic disorder (PD) were randomly assigned to one of three conditions. Primary outcomes were the severity of self-report panic symptoms and diagnostic status. Secondary outcomes were symptoms of depression, functional impairment, catastrophic cognitions, fear of sensations and body vigilance. At post-treatment, both active conditions showed superior outcomes regarding PD and associated symptoms (guided ICBT vs. WL: d = 1.04–1.36; unguided ICBT vs. WL: d = 0.70–1.06). At post-treatment, the two active conditions did not differ significantly in self-reported symptom reduction (d = 0.21–0.54, all ps > 0.05), but the guided treatment was superior to the unguided treatment in terms of diagnostic status (χ2(1) = 13.15, p < 0.01). Treatment gains were maintained at successive follow-ups and the guided treatment became superior to the unguided treatment at 6 months follow-up (d = 0.72–1.05, all ps < 0.05).","Ciuca, Amalia M.; Berger, Thomas; Crişan, Liviu G.; Miclea, Mircea",2018.0,10.1016/j.janxdis.2018.03.009,0,1,
530,Cognitive – Behavioral Group Therapy Versus a Wait-List Control in the Treatment of African American Women With Panic Disorder,"This study examined the efficacy of groupPanic Control Therapy (PCT;D.H. Barlow &M.G. Craske, 1994) for African Americans. Twenty-five African American women were assigned to either a treatment or wait-list control (WLC).Treatment was 11 group sessions, and wait-list participants did not receive any treatment for the same duration. At pretreatment, both groups were moderately anxious and depressed. At posttreat- ment, thePCTgroup experienced a significant reduction in panic frequency, avoidance behavior, state and trait anxiety, and anxiety sensitivity. There wasnosignificant change on these variables for theWLC. There was a trend for change in depression among the PCT group only. On average, 54% of the treated group was classified as recovered, 17% as improved but not recovered, and 27% as unimproved. As many as 95% of the WLC were unimproved. The overall effect size of the study was comparable to that reported in previous studies of cognitive treatments incorporating interoceptive exposure with White Americans. These preliminary results suggest that CBT for panic is effective with African American women with panic disorder.","Carter, Michele M; Sbrocco, Tracy; Gore, Kristie L; Marin, Nancy Watt; Lewis, Evelyn L",2003.0,,0,1,
531,Internet cognitive behavioural therapy for panic disorder: Does the inclusion of stress management information improve end-state functioning?,"Previous research has established Internet-based cognitive behavioural therapy (CBT) for panic disorder (PD) as effective in reducing panic severity and frequency. There is evidence, however, that such programs are less effective at improving overall end-state functioning, defined by a PD clinician severity rating of ≤ 2 and panic free. In order to test the effect on end-state functioning of the incorporation of stress management material within a CBT program for PD, 32 people with PD were randomised to either Internet-based CBT (PO1), Internet-based CBT plus stress management (PO2) or an Internet-based information-only control condition (1C). Both CBT treatments were more effective at posttreatment assessment than the control condition in reducing PD severity, panic and agoraphobia-related cognition, negative affect and self-ratings of health. PO2 was more effective than PO1 at posttreatment assessment on PD severity and general anxiety, although at 3-month follow-up these differences were no longer apparent. This study provides further support for the efficacy of Internet-based CBT for PD and suggests that although the incorporation of stress management material confers short-term advantages over a standard program, it is not associated with any longer term improvements on panic severity and related cognitions, negative affect, general wellbeing and end-state functioning.","Richards, Jeffrey C.; Klein, Britt; Austin, David W.",2006.0,10.1080/13284200500378795,0,1,
532,Computer-Assisted Cognitive Behavioral Group Therapy for Social Phobia,,"Gruber, Karin",2001.0,,0,1,
533,Effects of four treatment methods on social phobic patients not suitable for insight-oriented psychotherapy.,"Forty-two social phobic men and women, rated unsuitable for insight-oriented psychotherapy, received one of four randomly assigned types of treatment for 3 months. All patients received basal therapy (B) in the form of standardized information, self-exposure instructions, and anxiolytic medication. One group received this treatment only, with monthly appointments. The others, in addition, received either therapist-directed prolonged exposure in vivo, in some cases supplemented with exposure in imagination (PE), dynamically oriented supportive therapy (ST) or relaxation therapy (R). There was a 9 months' follow-up period. The phobia variables were more improved in the PE and ST groups than in the R and B groups at the termination of treatment. Although improvement had deteriorated somewhat in the PE group during follow-up, the improvement in target phobia was better than in the other groups. There were almost no improvements in the R and B groups. ST and PE groups also showed improved social function while the global rating showed most improvement in the PE group. The B group was not improved at all and the R group only showed a short-lived drop in muscular tension.",Alström JE.; Nordlund CL.; Persson G.; Hårding M.; Ljungqvist C.,1984.0,,0,1,
534,Effects of three non-insight-oriented treatment methods on agoraphobic women suitable for insight-oriented psychotherapy.,"Twenty-three agoraphobic women rated suitable for insight-oriented psychotherapy received one of three randomly assigned non-insight-oriented types of treatment for 3 months and the effect was followed up after 9 months. All patients received basal therapy (B) in the form of standardized information, self-exposure instructions and anxiolytic medication. One group received this treatment only with monthly appointments. The others, in addition, received either therapist-directed prolonged exposure in vivo (PE) or relaxation therapy (R). The effects of insight-oriented psychotherapy could not be studied due to the small numbers in this group. All groups showed clinically relevant improvement, which indicates a favourable prognosis of patients suitable for insight-oriented psychotherapy irrespective of mode of treatment. However, since the PE group was least improved in some neurotic symptoms and had two treatment drop-outs and two cases of symptom substitution this mode of treatment cannot be recommended for insight-suitable patients. R patients came out favourably, which was contrary to the poor outcome with this therapy in patients not suitable for insight-oriented psychotherapy.",Alström JE.; Nordlund CL.; Persson G.; Ljungqvist C.,1984.0,,0,1,
535,Effects of four treatment methods on agoraphobic women not suitable for insight-oriented psychotherapy.,"Seventy-three agoraphobic women rated unsuitable for insight-oriented psychotherapy, entered one of four randomly assigned types of treatment for 3 months. All patients received basal therapy in the form of standardized information, self-exposure instructions and anxiolytic medication. One group received this treatment only at monthly appointments (B). The others, in addition, received either therapist-directed prolonged exposure in vivo (PE), dynamically oriented supportive therapy (ST) or relaxation therapy (R). There was a 9-month follow-up period. All groups were about equally improved at the termination of treatment, with some advantage for PE and ST. At follow-up the ST group was more improved than the other groups, R was least improved, and PE showed some deterioration between the termination of treatment and the follow-up. ST, which took into account the overall adjustment as well as the symptoms, was thus the most successful treatment, but the superiority of the treatment did not manifest itself until at the end of the follow-up period.",Alström JE.; Nordlund CL.; Persson G.; Hårding M.; Ljungqvist C.,1984.0,,0,1,
536,Narrative exposure therapy for political imprisonment-related chronic posttraumatic stress disorder and depression.,"The psychological consequences of traumatic stress may last even into old age. In persons in their 60s and 70s who had been victims of political detention and torture four decades ago, we compared the outcome of narrative exposure therapy (NET) to that of psychoeducation (PED) only. From a group of 59 former political detainees, 18 who fulfilled the full PTSD criteria according to the Composite International Diagnostic Interview (CIDI) were offered and accepted participation in the treatment study. The participants were randomly assigned to either one session of PED (n=9) or five sessions of NET (n=9). Symptoms of PTSD (CIDI) and depression (Beck Depression Inventory, BDI) were assessed prior to treatment and after a 6-month follow-up. NET but not PED produced a significant reduction in post-traumatic symptoms and depression scores. Four out of 9 of those who completed NET, compared to 8/9 of those within the PED group, still had PTSD 6 months after the treatment had ended. These results indicate that NET may lead to the alleviation of post-traumatic and depression symptoms even when the conditions persist for excessive time periods.",Bichescu D.; Neuner F.; Schauer M.; Elbert T.,2007.0,10.1016/j.brat.2006.12.006,0,1,
537,"Treatment of nonphobic anxiety disorders: a comparison of nondirective, cognitive, and coping desensitization therapy.",,Borkovec TD.; Mathews AM.,1988.0,,0,1,
538,Long-term outcomes of trauma-focused treatment in psychosis.,"We present 12-month follow-up results for a randomised controlled trial of prolonged exposure and eye movement desensitisation and reprocessing (EMDR) therapy in 85 (78.8%) participants with psychotic disorder and comorbid post-traumatic stress disorder (PTSD). Positive effects on clinician-rated PTSD, self-rated PTSD, depression, paranoid-referential thinking and remission from schizophrenia were maintained up to 12-month follow-up. Negative post-traumatic cognitions declined in prolonged exposure and were stable in EMDR. A significant decline in social functioning was found, whereas reductions in interference of PTSD symptoms with social functioning were maintained. These results support that current PTSD guidelines apply to individuals with psychosis. Declaration of interest M.v.d.G. and D.v.d.B. receive income for published books on psychotic disorders and for the training of postdoctoral professionals in the treatment of psychotic disorders. A.d.J. receives income for published books on EMDR therapy and for the training of postdoctoral professionals in this method. A.v.M. receives income for published book chapters on PTSD and for the training of postdoctoral professionals in prolonged exposure. C.d.R. receives income for the training of postdoctoral professionals in EMDR therapy.",van den Berg D.; de Bont PAJM.; van der Vleugel BM.; de Roos C.; de Jongh A.; van Minnen A.; van der Gaag M.,2018.0,10.1192/bjp.2017.30,0,1,
539,A Comparison of the Efficacy and Acceptability of Group versus Individual Cognitive Behaviour Therapy in the Treatment of Panic Disorder and Agoraphobia in Primary Care,,"Sharp, D M; Power, K G; Swanson, V",2004.0,,0,1,
540,Stepped care treatment for depression and anxiety in primary care: A randomized controlled trial,"BACKGROUND: Depressive and anxiety disorders are common in general practice but not always treated adequately. Introducing stepped care might improve this. In this randomized trial we examined the effectiveness of such a stepped care model. METHODS: The study population consisted of primary care attendees aged 18-65 years with minor or major DSM-IV depressive and/or anxiety disorders, recruited through screening. We randomized 120 patients to either stepped care or care as usual. The stepped care program consisted of (1) watchful waiting, (2) guided self-help, (3) short face-to-face Problem Solving Treatment and (4) pharmacotherapy and/or specialized mental health care. Patients were assessed at baseline and after 8, 16 and 24 weeks. RESULTS: Symptoms of depression and anxiety decreased significantly over time for both groups. However, there was no statistically significant difference between the two groups (IDS: P = 0.35 and HADS: P = 0.64). The largest, but not significant, effect (d = -0.21) was found for anxiety on T3. In both groups approximately 48% of the patients were recovered from their DSM-IV diagnosis at the final 6 months assessment. CONCLUSIONS: In summary we could not demonstrate that stepped care for depression and anxiety in general practice was more effective than care as usual. Possible reasons are discussed. TRIAL REGISTRATION: Current Controlled Trails: ISRCTN17831610","Seekles, W; Van, Straten A; Beekman, A; Van, Marwijk H; Cuijpers, P",2011.0,10.1186/1745-6215-12-171,0,1,
541,Therapist contact in cognitive behaviour therapy for panic disorder and agoraphobia in primary care,,"Power KG Swanson, Sharp D M",2000.0,,0,1,
542,Community versus Clinical Cognitive-Behavioral Intervention in Young-Adult Spanish Population with Generalized Social Phobia,,Olivares,2016.0,,0,1,
543,Therapist-assisted Internet-based Cognitive-behavioral Therapy versus Progressive Relaxation in Obsessive-Compulsive Disorder: A Randomized Controlled Trial (Preprint),,"Kyrios, Michael; Ahern, Claire; Fassnacht, Daniel B.; Nedeljkovic, Maja; Moulding, Richard; Meyer, Denny",2017.0,10.2196/jmir.9566,0,1,
544,"An investigator-blinded, randomized study to compare the efficacy of combined CBT for alcohol use disorders and social anxiety disorder versus CBT focused on alcohol alone in adults with comorbid disorders: The Combined Alcohol Social Phobia (CASP) trial protocol.","Background: Alcohol use disorders and social anxiety disorder are common and disabling conditions that frequently co-exist. Although there are efficacious treatments for each disorder, only two randomized controlled trials of interventions for these combined problems have been published. We developed a new integrated treatment for comorbid Social Anxiety Disorder and Alcohol Use Disorder based on established Motivational Interviewing (MI) and Cognitive Behaviour Therapy (CBT) interventions for the separate disorders. Compared to established MI/CBT for alcohol use disorders this new intervention is hypothesised to lead to greater reductions in symptoms of social anxiety and alcohol use disorder and to produce greater improvements in quality of life. Higher levels of alcohol dependence will result in relatively poorer outcomes for the new integrated treatment. Methods/design: A randomised controlled trial comparing 9 sessions of individual integrated treatment for alcohol and social phobia with 9 sessions of treatment for alcohol use problems alone is proposed. Randomisation will be stratified for stable antidepressant use. Post treatment clinical assessments of alcohol consumption and diagnostic status at 3 and 6 month follow-up will be blind to allocation. Discussion: The proposed trial addresses a serious gap in treatment evidence and could potentially define the appropriate treatment for a large proportion of adults affected by these problems. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Baillie, Andrew J; Sannibale, Claudia; Stapinski, Lexine A; Teesson, Maree; Rapee, Ronald M; Haber, Paul S; Allan, Anton, Babor, Baillie, Baillie, Baillie, Bakken, Bakken, Barlow, Bebbington, Berglund, Brown, Brown, Brown, Bruch, Burns, Carrigan, Clark, Connor, Cox, Darke, Darke, Degenhardt, DiClemente, DiClemente, Driessen, Farrell, Flannery, Gibbons, Greeley, Heimberg, Jones, Kadden, Kessler, Kessler, Khantizian, Kranzler, Krystal, Kushner, Kushner, Loranger, Lovibond, Marquenie, Mattick, Mattick, Mattick, McEvoy, McLellan, Merikangas, Miller, Miller, Miller, Monti, Morley, Morris, O'Malley, Osman, Randall, Rapee, Rapee, Rapee, Rapee, Rapee, Rapee, Regier, Reiss, Ross, Rosner, Rosner, Saladin, Sannibale, Sannibale, Schade, Schneider, Schuckit, Schuckit, Schuckit, Shand, Sheehan, Sobell, Sobell, Sobell, Stapinski, Stockwell, Sullivan, Teesson, Teesson, Terra, Turk, Tomasson, Tomasson, Tomasson, Tomasson, Volpicelli, von Korff, Ware, Young",2013.0,,0,1,
545,A randomized clinical trial of cognitive processing therapy for veterans with PTSD related to military sexual trauma.,"In this randomized controlled clinical trial, the authors evaluated the effectiveness of cognitive processing therapy (CPT) in the treatment of self-reported and clinician-assessed posttraumatic stress disorder (PTSD) related to military sexual trauma (MST), along with depressive symptoms. Eighty-six veterans (73 female, 13 male) randomly assigned to receive 12 individual sessions of either CPT or present-centered therapy (PCT) were included in analyses. Blinded assessments occurred at baseline, posttreatment, and 2, 4, and 6 months posttreatment. Mixed-effects model analysis revealed a significant interaction between groups (p = .05, d = -0.85): At posttreatment, veterans who received CPT had a significantly greater reduction in self-reported, but not clinician-assessed, PTSD symptom severity compared to veterans who received PCT. All three primary outcome measures improved significantly, both clinically and statistically, across time in both treatment groups. Pre- and posttreatment effect sizes were mostly moderate to large (d = 0.30-1.02) and trended larger in the CPT group. Although the study was impacted by treatment fidelity issues, results provide preliminary evidence for the effectiveness of CPT in reducing self-reported PTSD symptoms in a population of veterans with MST, expanding on established literature that has demonstrated the effectiveness of CPT in treating PTSD related to sexual assault in civilian populations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Suris, Alina; Link-Malcolm, Jessica; Chard, Kathleen; Ahn, Chul; North, Carol; Algina, Blake, Blake, Chang, Chard, Foa, Frayne, Hamilton, Hankin, Himmelfarb, Kang, Keane, Kimerling, Kimerling, McDonagh, Monson, Norwood, Resick, Resick, Resick, Resick, Resick, Rush, Schnurr, Skinner, Suris, Suris, Suris, Suris, Turchik, Weathers, Weathers, Weathers, Yaeger",2013.0,,0,1,
546,The effects of the cognitive-behavioral and exposure therapy for social phobia.,"Evaluated the effect of cognitive therapy for social phobia with 51 male and female socially anxious adults in Korea. The cognitive-behavioral therapy (CBT) was compared to an exposure therapy (ET) alone and with a waiting list (WL) control. Pre- and posttreatment assessments included self-ratings, behavioral ratings, and clinical ratings; 3-month follow-up assessments included only self-report measures. Among the 51 Ss, 32 Ss completed the posttreatment assessment in which Ss who received CBT reported lower scores on self-report measures than ET Ss, and 17 Ss completed the 3-month followup in which Ss who received CBT reported lower scores on self-report measure than ET Ss only on the Social Avoidance and Distress (SAD) scale. No significant differences were found between the CBT and the ET Ss on behavioral and clinical ratings. The between-group analyses showed that Ss who received CBT reported lower social anxiety on self-report measure than ET Ss. Regression analysis revealed that reducing the fear of negative evaluation is an important mediator of overall improvement. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lee, Jung Yoon; Choy, Chung Hoon",1997.0,,0,1,
547,Pilot test of seeking safety treatment with male veterans.,,Weaver CM.; Trafton JA.; Walser RD.; Kimerling RE.,2007.0,10.1176/ps.2007.58.7.1012,0,1,
548,Randomized controlled pilot study of cognitive-behavioral therapy in a sample of incarcerated women with substance use disorder and PTSD.,"This randomized controlled pilot study compared a cognitive-behavioral therapy (Seeking Safety; SS) plus treatment-as-usual (TAU) to TAU-alone in 49 incarcerated women with substance use disorder (SUD) and posttraumatic stress disorder (PTSD; full or subthreshold). Seeking Safety consisted of a voluntary group treatment during incarceration and individual treatment after prison release. TAU was required in the prison and comprised 180 to 240 hours of individual and group treatment over 6 to 8 weeks. Assessments occurred at intake, 12 weeks after intake, and 3 and 6 months after release from prison. There were no significant differences between conditions on all key domains (PTSD, SUD, psychopathology, and legal problems); but both conditions showed significant improvements from intake to later time points on all of these outcomes across time. Secondary analyses at follow-up found trends for SS participants improving on clinician-rated PTSD symptoms and TAU participants worsening on self-reported PTSD symptoms. Also, SS demonstrated continued improvement on psychopathology at 3 and 6 months, whereas TAU did not. However, alcohol use improved more for TAU during follow-up. Satisfaction with SS was high, and a greater number of SS sessions was associated with greater improvement on PTSD and drug use. Six months after release from prison, 53% of the women in both conditions reported a remission in PTSD. Study limitations include lack of assessment of SS outcomes at end of group treatment; lack of blind assessment; omission of the SS case management component; and possible contamination between the two conditions. The complex needs of this population are discussed.",Zlotnick C.; Johnson J.; Najavits LM.,2009.0,10.1016/j.beth.2008.09.004,0,1,
549,A randomized effectiveness trial of stepped collaborative care for acutely injured trauma survivors.,"Although posttraumatic stress disorder (PTSD) and alcohol abuse frequently occur among acutely injured trauma survivors, few real-world interventions have targeted these disorders. We tested the effectiveness of a multifaceted collaborative care (CC) intervention for PTSD and alcohol abuse. Randomized effectiveness trial. We recruited a population-based sample of 120 male and female injured surgical inpatients 18 or older at a level I trauma center. Patients were randomly assigned to the CC intervention (n = 59) or the usual care (UC) control condition (n = 61). The CC patients received stepped care that consisted of (1) continuous postinjury case management, (2) motivational interviews targeting alcohol abuse/dependence, and (3) evidence-based pharmacotherapy and/or cognitive behavioral therapy for patients with persistent PTSD at 3 months after injury. We used the PTSD symptomatic criteria (PTSD Checklist) at baseline and 1, 3, 6, and 12 months after injury, and alcohol abuse/dependence (Composite International Diagnostic Interview) at baseline and 6 and 12 months after injury. Random-coefficient regression analyses demonstrated that over time, CC patients were significantly less symptomatic compared with UC patients with regard to PTSD (P =.01) and alcohol abuse/dependence (P =.048). The CC group demonstrated no difference (-0.07%; 95% confidence interval [CI], -4.2% to 4.3%) in the adjusted rates of change in PTSD from baseline to 12 months, whereas the UC group had a 6% increase (95% CI, 3.1%-9.3%) during the year. The CC group showed on average a decrease in the rate of alcohol abuse/dependence of -24.2% (95% CI, -19.9% to -28.6%), whereas the UC group had on average a 12.9% increase (95% CI, 8.2%-17.7%) during the year. Early mental health care interventions can be feasibly and effectively delivered from trauma centers. Future investigations that refine routine acute care treatment procedures may improve the quality of mental health care for Americans injured in the wake of individual and mass trauma.",Zatzick D.; Roy-Byrne P.; Russo J.; Rivara F.; Droesch R.; Wagner A.; Dunn C.; Jurkovich G.; Uehara E.; Katon W.,2004.0,10.1001/archpsyc.61.5.498,0,1,
550,A randomized stepped care intervention trial targeting posttraumatic stress disorder for surgically hospitalized injury survivors.,"To test the effectiveness of a stepped care intervention model targeting posttraumatic stress disorder (PTSD) symptoms after injury. Few investigations have evaluated interventions for injured patients with PTSD and related impairments that can be feasibly implemented in trauma surgical settings. The investigation was a pragmatic effectiveness trial in which 207 acutely injured hospitalized trauma survivors were screened for high PTSD symptom levels and then randomized to a stepped combined care management, psychopharmacology, and cognitive behavioral psychotherapy intervention (n = 104) or usual care control (n = 103) conditions. The symptoms of PTSD and functional limitations were reassessed at 1, 3, 6, 9, and 12 months after the index injury admission. Regression analyses demonstrated that over the course of the year after injury, intervention patients had significantly reduced PTSD symptoms when compared with controls [group by time effect, CAPS (Clinician-Administered PTSD Scale): F(2, 185) = 5.50, P < 0.01; PCL-C (PTSD Checklist Civilian Version): F(4, 185) = 5.45, P < 0.001]. Clinically and statistically significant PTSD treatment effects were observed at the 6-, 9-, and 12-month postinjury assessments. Over the course of the year after injury, intervention patients also demonstrated significant improvements in physical function [MOS SF-36 PCS (Medical Outcomes Study Short Form 36 Physical Component Summary) main effect: F(1, 172) = 9.87, P < 0.01]. Stepped care interventions can reduce PTSD symptoms and improve functioning over the course of the year after surgical injury hospitalization. Orchestrated investigative and policy efforts could systematically introduce and evaluate screening and intervention procedures for PTSD at US trauma centers. ( clinicaltrials.gov identifier: NCT00270959).",Zatzick D.; Jurkovich G.; Rivara FP.; Russo J.; Wagner A.; Wang J.; Dunn C.; Lord SP.; Petrie M.; Oʼconnor SS.; Katon W.,2013.0,10.1097/SLA.0b013e31826bc313,0,1,
551,A randomised controlled pilot study: the effectiveness of narrative exposure therapy with adult survivors of the Sichuan earthquake.,"Post-Traumatic Stress Disorder (PTSD) is a common psychological reaction after large-scale natural disasters. Given the number of people involved and shortage of resources in any major disaster, brief, pragmatic and easily trainable interventions are needed. The aim of this study is to evaluate the efficacy of Narrative Exposure Therapy (NET) as a short-term treatment for PTSD using Chinese earthquake survivors. A randomized waiting-list control pilot study was conducted between December 2009 and March 2010, at the site of the Sichuan earthquake in Beichuan County, China. Adult participants with newly diagnosed Post Traumatic Stress Disorder (PTSD) were randomly allocated to Narrative Exposure Therapy (NET) or a Waiting-List (WL) condition. The latter received NET treatment after a two-week waiting period. To compare the effectiveness of NET in traumatised earthquake survivors, both groups were assessed on PTSD symptoms, general mental health, anxiety and depression, social support, coping style and posttraumatic change before and after treatment and two months post treatment. Adult participants (n=22) were randomly allocated to receive NET (n=11) or WL (n=11). Twenty two participants (11 in NET group, 11 in WL) were included in the analysis of primary outcomes. Compared with WL, NET showed significant reductions in PTSD symptoms, anxiety and depression, general mental stress and increased posttraumatic growth. The WL group later showed similar improvements after treatment. These changes remained stable for a two-month follow-up. Measures of social support and coping showed no stable effects. NET is effective in treating post-earthquake traumatic symptoms in adult Chinese earthquake survivors. The findings help advance current knowledge in the management of PTSD after natural disasters and inform future research. Larger sample sizes are needed to extend the present findings. Chinese Clinical Trial Registry ChiCTR-TRC-12002473.",Zang Y.; Hunt N.; Cox T.,2013.0,10.1186/1471-244X-13-41,0,1,
552,"A new psychological intervention: ""512 Psychological Intervention Model"" used for military rescuers in Wenchuan Earthquake in China.","We sought to compare the efficacy of the ""512 Psychological Intervention Model"" (that is, ""512 PIM"", a new psychological intervention) with debriefing on symptoms of post-traumatic stress disorder (PTSD), anxiety and depression of Chinese military rescuers in relation to a control group that had no intervention. We conducted a randomized controlled trial with 2,368 military rescuers 1 month after this event and then at follow-up 1, 2 and 4 months later to evaluate changes in symptoms of PTSD, anxiety and depression based on DSM-IV criteria, respectively. Baseline analysis suggested no significant differences between the study groups. Severity of PTSD, anxiety and depression decreased over time in all three groups, with significant differences between the groups in symptoms of PTSD (P < 0.01). Compared with the debriefing and control group, significant lower scores of PTSD and positive efficacy in improving symptoms of re-experiencing, avoidance and hyperarousal were found in the ""512 PIM"" group. ""512 PIM"" was an effective psychological intervention for military rescuers in reducing symptoms of PTSD, anxiety and depression after a crisis.",Wu S.; Zhu X.; Zhang Y.; Liang J.; Liu X.; Yang Y.; Yang H.; Miao D.,2012.0,10.1007/s00127-011-0416-2,0,1,
553,A bibliotherapy approach to relapse prevention in individuals with panic attacks.,"The present study examined a relapse prevention (RP) program delivered via bibliotherapy in the treatment of individuals with panic attacks. Compared with a wait list control group, individuals receiving RP exhibited significant reductions on measures of frequency of panic attacks, panic cognitions, anticipatory anxiety, avoidance, and depression. In addition, individuals in the RP group were more likely to attain a ""clinically significant change"" in status on both panic-free status and level of avoidance more frequently than individuals in the control group. When compared with treatment effects evaluated in two prior phases of the study, the obtained results appear to be the product of a synchronous effect of bibliotherapy and minimal phone contact during the 6-month follow-up period. The results reflect the importance of brief therapist contact in increasing motivation for active participation in bibliotherapy interventions.",Wright J.; Clum GA.; Roodman A.; Febbraro GA.,,,0,1,
554,Cognitive behavioral group therapy and phenelzine both effective in social phobia.,,Thyer BA.,1999.0,,0,1,
555,Global measures of outcome in a controlled comparison of pharmacological and psychological treatment of panic disorder and agoraphobia in primary care.,"Panic disorder, with and without agoraphobia, is a prevalent condition which presents primarily in general practice. Previous clinical outcome studies have been conducted mainly in specialist university departments or hospital settings, and have tended to employ complex rating scales that are not well suited for use as outcome measures in primary care. To evaluate the outcome, in a primary care setting, of fluvoxamine versus cognitive behaviour therapy, each used alone and in combination in a double-blind placebo-controlled framework, balanced for therapist contact. A total of 149 patients satisfying DSMIII-R criteria for panic disorder were randomly allocated to receive one of the following: fluvoxamine, placebo, fluvoxamine plus cognitive behaviour therapy, placebo plus cognitive behaviour therapy, and cognitive behaviour therapy alone. These five treatment groups represent the minimum number acceptable for such a comparison to be made. All patients received an identical schedule of contact over 13 weeks. Measures of symptom severity, general health and social disruption were taken at entry point and end point; measures of change in symptoms were taken at end point only. Outcome was reported in terms of brief global ratings of severity of illness and change in symptoms, and of ratings of general health and social disruption that are suitable for use in general practice. All active treatment groups showed statistically significant advantages over placebo over a range of outcome ratings. The groups employing cognitive behaviour therapy showed the most robust and consistent response. The brief global measures reported here proved adequate to the task of assessing treatment outcome. Results indicate that treatments including cognitive behaviour therapy can be effective in the treatment of panic disorder and agoraphobia in primary care.",Sharp DM.; Power KG.; Simpson RJ.; Swanson V.; Anstee JA.,1997.0,,0,1,
556,Long-term effectiveness and prediction of treatment outcome in cognitive behavioral therapy and sertraline for late-life anxiety disorders.,"Although anxiety disorders are prevalent in older adults, randomized controlled trials of treatment effectiveness for late-life anxiety are scarce and have focused primarily on the effectiveness of psychotherapeutic interventions. However, recent findings suggest that in some cases, pharmacological treatment may be more beneficial for late-life anxiety disorders. As yet, there have been no systematic studies investigating prognostic factors for the outcome of cognitive behavioral therapy (CBT) and pharmacotherapy for late-life anxiety. The objective of the present study was to study long-term treatment outcomes and to explore differential predictors for both short-term and long-term treatment outcomes of sertraline and CBT for late-life anxiety disorders. Participants of a randomized controlled trial (RCT) comparing sertraline and CBT for the treatment of late-life anxiety were contacted one year after completing their treatment, so that predictors for both short-term and long-term treatment outcome could be established. Sertraline showed a greater reduction of symptoms than CBT on anxiety (Hamilton Anxiety Rating Scale; HARS) and worry (Worry Domain Questionnaire) ratings at one-year follow-up. The strongest predictor for short-term CBT outcome was poor perceived health, explaining 40% of the variance in post-treatment residual gain scores on the HARS. The strongest predictor for long-term CBT outcome was neuroticism, explaining 20% of the variance in residual gain scores at one-year follow-up. Analyses revealed no significant predictors for treatment outcome in sertraline participants. Our study suggests that long-term use of sertraline might be more beneficial for late-life anxiety than a 15-week CBT program. Poor perceived health and neuroticism are predictive of less improvement after CBT in anxious older adults. Implications of these findings are discussed.",Schuurmans J.; Comijs H.; Emmelkamp PM.; Weijnen IJ.; van den Hout M.; van Dyck R.,2009.0,10.1017/S1041610209990536,0,1,
557,Randomized controlled trial of CBT with virtual reality exposure therapy for PTSD.,"Background: Posttraumatic stress disorder (PTSD) has frequently been identified in U.S. service members returning from Operation Iraqi Freedom. Untreated or undertreated, PTSD is associated with significant adverse health and life consequences. Unfortunately, PTSD is relatively resistant to therapy, with even first-line treatments failing half the time. Cognitive behavioral therapy (CBT) with exposure therapy is the preferred non-pharmacologic therapy, but it can be difficult to get patients to engage in traditional imaginal exposure. Virtual reality (VR) may overcome this obstacle, enabling therapist-guided exposure to progressively present more intense trauma-associated stimuli. VR exposure therapy (VRET) has shown promise for PTSD treatment in prior small studies. The ""Virtual Iraq"" environment, adapted from the Microsoft X-box game Full Spectrum Warrior, is the most realistic and sophisticated ever applied to PTSD treatment; we present plans for blinded controlled comparisons of its performance versus other therapies. Objective: To compare the efficacy of CBT/VRET vs. supportive psychotherapy in conjunction with a relaxation virtual environment, as well as vs. CBT with imaginal exposure, with blinded outcome measures. We hope to establish a feasible control for CBTA/RET, to get an initial measure of the efficacy of CBTA/RET, and to assess the added value of VRET vs. traditional imaginal exposure. Methods and Design: Consenting combat veterans with PTSD will be randomized to CBTA/RET or supportive psychotherapy/relaxation VR in one study, and CBT/imaginal exposure vs. CBTA/RET in a parallel trial. An experienced psychotherapist will train study therapists in CBT, imaginal exposure, and VRET. A blinded, independent investigator will assess response to therapy, using the gold standard Clinician-Administered PTSD Scale (CAPS) to compare outcomes. The study using supportive therapy and relaxation VR as the control will be conducted on outpatients with newly diagnosed PTSD. The trial using imaginal exposure as the control will be in the partial hospitalization program on the psychiatry service at Walter Reed Army Medical Center, where it is expected to have more severe illness with higher rates of comorbidity, so that the more active control arm will be important. Assessment of CBT/VRET in two different populations should enhance the generalizability of the results. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Roy, M. J; Law, W; Patt, I; Difede, J; Rizzo, A; Graap, K; Rothbaum, B; Aziz, Ballenger, Bisson, Botella, Carlin, Davidson, Difede, Difede, Emmelkamp, Foa, Freuh, Garcia-Palacios, Hoge, Kessler, Marmar, Rothbaum, Rothbaum, Rothbaum, Roy, Spitzer, Ullman, Wagner, Walker, Walshe, Ware",2006.0,,0,1,
558,Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial.,"Improving the quality of mental health care requires moving clinical interventions from controlled research settings into real-world practice settings. Although such advances have been made for depression, little work has been performed for anxiety disorders. To determine whether a flexible treatment-delivery model for multiple primary care anxiety disorders (panic, generalized anxiety, social anxiety, and posttraumatic stress disorders) would be better than usual care (UC). A randomized controlled effectiveness trial of Coordinated Anxiety Learning and Management (CALM) compared with UC in 17 primary care clinics in 4 US cities. Between June 2006 and April 2008, 1004 patients with anxiety disorders (with or without major depression), aged 18 to 75 years, English- or Spanish-speaking, were enrolled and subsequently received treatment for 3 to 12 months. Blinded follow-up assessments at 6, 12, and 18 months after baseline were completed in October 2009. CALM allowed choice of cognitive behavioral therapy (CBT), medication, or both; included real-time Web-based outcomes monitoring to optimize treatment decisions; and a computer-assisted program to optimize delivery of CBT by nonexpert care managers who also assisted primary care clinicians in promoting adherence and optimizing medications. Twelve-item Brief Symptom Inventory (BSI-12) anxiety and somatic symptoms score. Secondary outcomes included proportion of responders (> or = 50% reduction from pretreatment BSI-12 score) and remitters (total BSI-12 score < 6). A significantly greater improvement for CALM vs UC in global anxiety symptoms was found (BSI-12 group mean differences of -2.49 [95% confidence interval {CI}, -3.59 to -1.40], -2.63 [95% CI, -3.73 to -1.54], and -1.63 [95% CI, -2.73 to -0.53] at 6, 12, and 18 months, respectively). At 12 months, response and remission rates (CALM vs UC) were 63.66% (95% CI, 58.95%-68.37%) vs 44.68% (95% CI, 39.76%-49.59%), and 51.49% (95% CI, 46.60%-56.38%) vs 33.28% (95% CI, 28.62%-37.93%), with a number needed to treat of 5.27 (95% CI, 4.18-7.13) for response and 5.50 (95% CI, 4.32-7.55) for remission. For patients with anxiety disorders treated in primary care clinics, CALM compared with UC resulted in greater improvement in anxiety symptoms, depression symptoms, functional disability, and quality of care during 18 months of follow-up. clinicaltrials.gov Identifier: NCT00347269.",Roy-Byrne P.; Craske MG.; Sullivan G.; Rose RD.; Edlund MJ.; Lang AJ.; Bystritsky A.; Welch SS.; Chavira DA.; Golinelli D.; Campbell-Sills L.; Sherbourne CD.; Stein MB.,2010.0,10.1001/jama.2010.608,0,1,
559,Stepped care in the treatment of trichotillomania,"ER METHOD: Participants were 60 (95% women, 75% Caucasian, 2% Hispanic) adults (M = 33.18 years) with TTM. They were randomly assigned to immediate versus waitlist (WL) conditions for Step 1 (10 weeks of web-based self-help via StopPulling.com). After Step 1, participants chose whether to engage in Step 2 (8 sessions of in-person habit reversal training [HRT]).RESULTS: In Step 1, the immediate condition had a small (d = .21) but significant advantage, relative to WL, in reducing TTM symptom ratings by interviewers (masked to experimental condition but not to assessment point); there were no differences in self-reported TTM symptoms, alopecia, functional impairment, or quality of life. Step 1 was more effective for those who used the site more often. Stepped care was highly acceptable: Motivation did not decrease during Step 1; treatment satisfaction was high, and 76% enrolled in Step 2. More symptomatic patients self-selected into HRT, and on average they improved significantly. Over one third (36%) made clinically significant improvement in self-reported TTM symptoms. Considering the entire stepped care program, participants significantly reduced symptoms, alopecia, and impairment, and increased quality of life. For quality of life and symptom severity, there was some relapse by 3-month follow-up.CONCLUSIONS: Stepped care is acceptable, and HRT was associated with improvement. Further work is needed to determine which patients with TTM can benefit from self-help and how to reduce relapse.OBJECTIVE: There are effective treatments of trichotillomania (TTM), but access to expert providers is limited. This study tested a stepped care model aimed at improving access.","Rogers, K; Banis, M; Falkenstein, M J; Malloy, E J; McDonough, L; Nelson, S O; Rusch, N; Haaga, D A",2014.0,10.1037/a0035744,0,1,
560,Patient suitability and outcome in short-term individual psychotherapy.,"The effects of short-term (time-limited), dynamically oriented individual therapy and the patient characteristic quality of object relations (QOR) were studied in a controlled clinical trial involving 8 experienced therapists and 144 psychiatric outpatients. A comprehensive set of outcome scores was monitored at 5-month intervals including a follow-up assessment. A strong treatment effect that was maintained at follow-up was found. The effect was evident in terms of statistical significance, effect size, and clinical significance. Evidence for an additive effect of the combination of treatment and QOR was also found. The best results were attained by high QOR therapy patients, and the worst results were attained by low QOR control patients. The results were suggestive of an optimal match between type of patient and type of therapy.",Piper WE.; Azim HF.; McCallum M.; Joyce AS.,1990.0,,0,1,
561,Lay health worker led intervention for depressive and anxiety disorders in India: impact on clinical and disability outcomes over 12 months.,"Depressive and anxiety disorders (common mental disorders) are the most common psychiatric condition encountered in primary healthcare. To test the effectiveness of an intervention led by lay health counsellors in primary care settings (the MANAS intervention) to improve the outcomes of people with common mental disorders. Twenty-four primary care facilities (12 public, 12 private) in Goa (India) were randomised to provide either collaborative stepped care or enhanced usual care to adults who screened positive for common mental disorders. Participants were assessed at 2, 6 and 12 months for presence of ICD-10 common mental disorders, the severity of symptoms of depression and anxiety, suicidal behaviour and disability levels. All analyses were intention to treat and carried out separately for private and public facilities and adjusted for the design. The trial has been registered with clinical trials.gov (NCT00446407). A total of 2796 participants were recruited. In public facilities, the intervention was consistently associated with strong beneficial effects over the 12 months on all outcomes. There was a 30% decrease in the prevalence of common mental disorders among those with baseline ICD-10 diagnoses (risk ratio (RR) = 0.70, 95% CI 0.53-0.92); and a similar effect among the subgroup of participants with depression (RR = 0.76, 95% CI 0.59-0.98). Suicide attempts/plans showed a 36% reduction over 12 months (RR=0.64, 95% CI0.42–0.98) among baseline ICD-10 cases. Strong effects were observed on days out of work and psychological morbidity, and modest effects on overall disability [corrected]. In contrast, there was little evidence of impact of the intervention on any outcome among participants attending private facilities. Trained lay counsellors working within a collaborative-care model can reduce prevalence of common mental disorders, suicidal behaviour, psychological morbidity and disability days among those attending public primary care facilities.",Patel V.; Weiss HA.; Chowdhary N.; Naik S.; Pednekar S.; Chatterjee S.; Bhat B.; Araya R.; King M.; Simon G.; Verdeli H.; Kirkwood BR.,2011.0,10.1192/bjp.bp.111.092155,0,1,
562,Exposure in vivo vs applied relaxation in the treatment of blood phobia.,,Ost LG.; Lindahl IL.; Sterner U.; Jerremalm A.,1984.0,,0,1,
563,Effectiveness of collaborative stepped care for anxiety disorders in primary care: a pragmatic cluster randomised controlled trial.,"Collaborative stepped care (CSC) may be an appropriate model to provide evidence-based treatment for anxiety disorders in primary care. In a cluster randomised controlled trial, the effectiveness of CSC compared to care as usual (CAU) for adults with panic disorder (PD) or generalised anxiety disorder (GAD) in primary care was evaluated. Thirty-one psychiatric nurses who provided their services to 43 primary care practices in the Netherlands were randomised to deliver CSC (16 psychiatric nurses, 23 practices) or CAU (15 psychiatric nurses, 20 practices). CSC was provided by the psychiatric nurses (care managers) in collaboration with the general practitioner and a consultant psychiatrist. The intervention consisted of 3 steps, namely guided self-help, cognitive behavioural therapy and antidepressants. Anxiety symptoms were measured with the Beck Anxiety Inventory (BAI) at baseline and after 3, 6, 9 and 12 months. We recruited 180 patients with a DSM-IV diagnosis of PD or GAD, of whom 114 received CSC and 66 received usual primary care. On the BAI, CSC was superior to CAU [difference in gain scores from baseline to 3 months: -5.11, 95% confidence interval (CI) -8.28 to -1.94; 6 months: -4.65, 95% CI -7.93 to -1.38; 9 months: -5.67, 95% CI -8.97 to -2.36; 12 months: -6.84, 95% CI -10.13 to -3.55]. CSC, with guided self-help as a first step, was more effective than CAU for primary care patients with PD or GAD.",Muntingh A.; van der Feltz-Cornelis C.; van Marwijk H.; Spinhoven P.; Assendelft W.; de Waal M.; Adèr H.; van Balkom A.,2014.0,10.1159/000353682,0,1,
564,Intensive group cognitive therapy and individual cognitive therapy for social phobia: sustained improvement at 5-year follow-up.,"Little is known about the long-term outcome of treatments for social phobia. At 5 years post-treatment we contacted the 67 patients who had been treated with intensive group cognitive therapy (IGCT) or individual cognitive therapy (ICT) in a randomized controlled trial (Mörtberg, Clark, Sundin, & Åberg Wistedt, 2007) that originally compared IGCT, ICT, and treatment as usual (n=100 for the full trial). Seventy-two percent (48 patients) who received IGCT or ICT agreed to participate in the follow-up assessment. All re-completed the original self-report measures of symptoms and disability and a quality of life measure. A subset was also interviewed. Seventy-five percent (36 patients) had sought no further treatment for social phobia. Comparisons between post-treatment and 5-year follow-up indicated that patients who had received either treatment showed further improvement in social phobia symptoms and disability during the follow-up period. These improvements were present in patients who had no additional treatment, as well as in the total sample. In conclusion, it appears that the effects of IGCT and ICT are maintained and improved upon at 5 years post-treatment.",Mörtberg E.; Clark DM.; Bejerot S.,2011.0,10.1016/j.janxdis.2011.06.007,0,1,
565,One versus five sessions of applied tension in the treatment of blood phobia.,"Thirty patients with blood phobia, fulfilling the DSM-III-R criteria for simple phobia, were assessed with behavioral, physiological and self-report measures. They were randomly assigned to 3 different conditions: (1) 5 sessions of applied tension; (2) 1 session of applied tension (maximum 2 h); and (3) I session of tension-only (maximum 2 h). The results showed that the patients in the 3 treatments were all significantly improved at post-treatment and the effects were maintained at the 1 yr follow-up. At post-treatment and follow-up the proportions of clinically improved patients were: AT5 50 and 60%, AT1 0 and 70%, and T1 30 and 60%, respectively. The conclusion that can be drawn is that I-session therapist-directed applied tension or tension-only is the treatment of choice for blood phobia, but completed with a maintenance program of self-exposure.",Hellström K.; Fellenius J.; Ost LG.,1996.0,,0,1,
566,Eye movement desensitization and reprocessing (EMDR) treatment for combat-related posttraumatic stress disorder.,"Studied the efficacy of eye movement desensitization and reprocessing (EMDR) treatment for combat-related posttraumatic stress disorder (PTSD). Human Ss: 35 male American adults (aged 41-70 yrs) (PTSD) (34 Vietnam War veterans and 1 Korean War veteran). Tests used: The Clinician Administered PTSD Scale (D. D. Blake et al, 1995), the restandardized MMPI, the Mississippi Scale for Combat Related PTSD (T. M. Keane et al, 1988), the State-Trait Anxiety Inventory, the Beck Depression Inventory, the Impact of Events Scale and the Initial Screening Questionnaire. Treatments: 10 Ss were administered 12 EMDR sessions, 13 Ss were administered 12 sessions of biofeedback and relaxation, and 12 Ss were administered standard treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Carlson, John G; Chemtob, Claude M; Rusnak, Kristin; Hedlund, Nancy L; Muraoka, Miles Y",1997.0,,0,1,
567,"Physiological predictors of response to exposure, relaxation, and rescripting therapy for chronic nightmares in a randomized clinical trial.","Evidence supports the use of cognitive behavioral therapies for nightmares in trauma-exposed individuals. This randomized clinical trial replicated a study of exposure, relaxation, and rescripting therapy(ERRT) and extended prior research by including broad measures of mental health difficulties, self-reported physical health problems, and quality of life. Additionally, physiological correlates of treatment-related change assessed from a script-driven imagery paradigm were examined. Forty-seven individuals were randomized to treatment or waitlist control. The treatment group demonstrated improvements relative to the control group at the one-week post-treatment assessment. At the 6-month follow-up assessment, significant improvements were found for frequency and severity of nightmares, posttraumatic stress disorder symptoms, depression, sleep quality and quantity, physical health symptoms, anger, dissociation, and tension reduction behaviors. Participants also reported improved quality of life. Treatment-related decreases in heart rate to nightmare imagery were correlated with improvements in sleep quality and quantity; treatment-related decreases in skin conductance to nightmare imagery were correlated with improvements in nightmare severity, posttraumatic stress disorder symptom severity, sleep quality, and fear of sleep; and treatment-related decreases in corrugator activity to nightmare imagery were correlated with improved physical health. Findings provide additional support for the use of ERRT in treating nightmares and related difficulties and improving sleep.",Davis JL.; Rhudy JL.; Pruiksma KE.; Byrd P.; Williams AE.; McCabe KM.; Bartley EJ.,2011.0,10.5664/jcsm.1466,0,1,
568,Single-session behavioral treatment of earthquake-related posttraumatic stress disorder: a randomized waiting list controlled trial.,"In an attempt to develop a brief treatment for disaster survivors, the present study examined the effectiveness of a single session of modified behavioral treatment in earthquake-related posttraumatic stress disorder. Fifty-nine earthquake survivors in Turkey were randomized into either single-session modified behavioral treatment (SSBT) designed to enhance sense of control over earthquake-related fears or waiting list control condition (WL). The WL group received SSBT after a second baseline assessment. Follow-ups were at weeks 6, 12, 24, and at 1-2 years posttreatment. Significant treatment effects were found on all measures at posttreatment. The improvement rate was 49% at week 6; it rose to 80% by week 12, 85% by week 24, and 83% by the 1-2-year follow-up. Brief behavioral treatment has promise as a cost-effective intervention for disaster survivors.",Başoğlu M.; Salcioğlu E.; Livanou M.; Kalender D.; Acar G.,2005.0,10.1002/jts.20011,0,1,
569,A Crossover Evaluation of Supportive Psychotherapy and Cognitive Behavioral Therapy for Chronic PTSD in Motor Vehicle Accident Survivors.,"Using a complex crossover design we evaluated brief Supportive Psychotherapy in comparison to a wait-list condition and a cognitive-behavioral treatment (CBT) program in the treatment of motor vehicle accident survivors with chronic PTSD or sub-syndromal PTSD. Supportive Psychotherapy was superior to wait-list on measures of posttraumatic stress symptoms (PTSS) and on change in diagnosis. However, CBT led to more consistent improvement in PTSS and in symptoms of anxiety and depression than did Supportive Psychotherapy. The results from CBT held up well at a 3-month follow-up. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Holzapfel, Susanne; Blanchard, Edward B; Hickling, Edward J; Malta, Loretta S; Barlow, Beck, Beck, Blake, Blanchard, Blanchard, Blanchard, Blanchard, Blanchard, Bryant, Bryant, Derogatis, Fecteau, First, First, Foa, Foa, Harvey, Hickling, Hickling, Keller, Lewinsohn, Meichenbaum, Shear, Spielberger, Taylor; Abelian, M. E [Ed]",2005.0,,0,1,
570,The impact of borderline personality disorder on process group outcome among women with posttraumatic stress disorder related to childhood abuse.,"The outcome of a 12-wk interpersonal process group therapy for women (aged 18+ yrs) with posttraumatic stress disorder (PTSD) related to childhood sexual abuse with and without borderline personality disorder (BPD) was assessed by comparing 3 naturally occurring treatment conditions: groups that did not have any members with borderline personality disorder (BPD-) (n = 18), groups in which at least 1 member carried the diagnosis (BPD+) (n = 16), and a 12-wk waitlist (WL) (n = 15). PTSD, anger, depression, and other symptoms were significantly reduced in the BPD- groups. However, the BPD+ and WL conditions did not show any pre- to posttreatment improvements. Furthermore, the BPD+ condition showed a significant worsening on measures of anger. Analyses within the BPD+ condition indicate that women with and without the diagnosis experience equal posttreatment increases in anger problems. These latter results suggest the presence of an anger ""contagion"" effect. That is, women without BPD do well in the BPD- groups but show increased anger similar to the BPD+ women when treated in groups with them. Implications for client-treatment matching considerations in PTSD group therapy are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cloitre, Marylene; Koenen, Karestan C; Alexander, Alexander, Beck, Briere, Chemtob, Cloitre, Cohen, Courtois, Courtois, Derogatis, Finkelhor, Finkelhor, Foa, Foa, Follette, Ford, Ford, Funari, Goodman, Hazzard, Heffernan, Herman, Horowitz, Hummel, Johnson, Lubin, Lubin, Neimeyer, Resick, Roth, Russell, Spielberger, Spielberger, Spitzer, Spitzer, van der Kolk, Wyatt, Yalom, Yalom, Zlotnick",2001.0,,0,1,
571,No longer a victim: A treatment outcome study for crime victims with post-traumatic stress disorder.,"Crime victims diagnosed with PTSD (N = 57), were blocked for relationship status (in a committed relationship: married/living with or no relationship: single, no relationship, divorced) and then randomly assigned to one of three conditions: direct therapeutic exposure (DTE), traumatic incident reduction (TIR), or a waiting list control. The DTE condition involved teaching subjects progressive muscle relaxation (PMR) and then conducting sessions which began with PMR, then contained an imaginal flooding script and ended with PMR. The TIR condition involved a series of questions that asked subjects to repetitively review the trauma from beginning to end silently and then tell the therapist what happened until a point of closure was reached. Additional questions asked the subject to examine the cognitive content in the incident and to make connections to earlier associated incidents (if there were any). Treatment was done bi-weekly by one of four therapists, in approximately 2 hour sessions for a period of about 5 weeks (maximum of 20 hours). Measures of PTSD-related symptoms, relationship satisfaction, job satisfaction, and general psychological symptoms were administered pre-test and post-test (two weeks following termination of treatment). Both treatment groups significantly improved on all PTSD-related measures while the control group did not. The TIR group improved significantly more than the DTE group on all PTSD-related measures. None of the groups improved on the relationship satisfaction and job satisfaction measures. Both treatment groups significantly improved on the depression, obsessive-compulsive and psychoticism subscales while the control group did not. The TIR group improved significantly more on the obsessive-compulsive subscale than the DTE group. The TIR group significantly improved on the paranoid ideation subscale while the DTE and control groups did not. The outcome of this study supports the notion that treatment involving repeated exposure to th (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bisbey, Lori Beth",1995.0,,0,1,
572,Eye-movement desensitization and reprocessing: A new treatment for trauma?,"Eye-movement desensitization and reprocessing (EMDR) has been hailed as a new experimental treatment for survivors of trauma that can provide rapid relief from the debilitating symptoms associated with post-traumatic stress disorder. EMDR's efficacy reportedly stems from the use of eye-movements that are postulated to stimulate physiological changes in brain activity to produce cognitive restructuring and desensitization of emotional discomfort. This novel procedure has become more prominent with reported benefits for an increasing range of clinical applications. Since there is minimal controlled research, especially in a civilian population, on psychological methods to treat the ill effects of trauma and because EMDR has limited empirical support, further controlled investigation was warranted to supplement this limited body of scientific knowledge. Consequently, the specific goals of this controlled study were to evaluate (1) the efficacy of EMDR in the treatment of civilian trauma survivors, (2) whether or not eye-movements are instrumental to the therapeutic process, and (3) the treatment impact on intrusive and avoidant symptoms. It was hypothesized that (1) an EMDR treatment group would demonstrate greater efficacy when compared to an Alternative group which followed the same treatment protocol except for the substitution of deep breathing for the eye-movements, (2) both the EMDR and Alternative treatments would show significant improvement over a Control group, and (3) there would be similar changes in intrusive and avoidant symptoms. Findings at two month follow-up indicated the EMDR group had significant reductions in intrusive/avoidant symptoms (using the Impact of Event Scale), decreased emotional discomfort related to traumatic memories (rated by Subjective Units of Distress), and improvements in positive self-evaluations (measured by the Validity of Cognition Scale). There were similar results in the Alternative group with the exception of no significa (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Alatalo, Gerald Lee",1995.0,,0,1,
573,Standard and enhanced cognitive-behavior therapy for late-life generalized anxiety disorder: Two pilot investigations.,"Although cognitive-behavior therapy (CBT) is an efficacious treatment for generalized anxiety disorder (GAD) in younger adults, little is known about its efficacy in older patients. Investigations to date have tested group format or otherwise non-standard versions of CBT. The studies described here are the first to test the efficacy of individual format CBT administered in a mental health clinic for treatment of late-life GAD. Study 1 tested a standard version, and Study 2 tested an enhanced version (ECBT) that included learning and memory aids designed to make the therapy more effective with elderly patients (e.g., homework reminder and troubleshooting calls, weekly review of all concepts and techniques). Study 1 CBT participants (aged 60-74 yrs) showed significant improvement on GAD severity ratings. Study 2 ECBT participants (aged 60-79 yrs) showed significant improvement on two self-report measures, rates of posttreatment GAD, and GAD severity ratings. ECBT resulted in improvement on more measures and yielded larger effect sizes than standard CB2; when each was compared against a wait-list control group. Results suggest that standard individual format CBT may not be optimally effective for treating late-life GAD; thus, ECBT should be tested further in randomized trials. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mohlman, Jan; Gorenstein, Ethan E; Kleber, Marc; de Jesus, Marybeth; Gorman, Jack M; Papp, Lazlo A; Akkerman, Arean, Barlow, Barrowclough, Beck, Beck, Beck, Craske, Craske, Derogatis, First, Fisher, Gallagher-Thompson, Gorenstein, Gould, Himadi, Knight, Mattis, Meyer, Otto, Schmidt, Spielberger, Stanley, Stanley, Stanley, Stanley, Stanley, Tabachnick, Wetherell",2003.0,,0,1,
574,Group-based task-oriented exercises aimed at managing kinesiophobia improved disability in chronic low back pain.,"There are still doubts concerning the clinical impact of multidisciplinary cognitive behavioural rehabilitation programmes conducted in group-based settings and about their long-term effects on subjects with chronic low back pain (CLBP). This randomized, parallel-group superiority-controlled trial aimed at evaluating the effect of such a programme on disability, kinesiophobia, catastrophizing, pain and quality of life in CLBP. One hundred and fifty patients were randomly assigned to a 5-week group-based multidisciplinary programme of task-oriented exercises integrated with cognitive behavioural therapy mainly aimed at managing kinesiophobia (experimental group, 75 subjects) or group-based traditional exercises (control group, 75 subjects). Before treatment, 5 weeks later (post-treatment), 12 and 24 months after the end of treatment, the Oswestry Disability Index, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, a pain Numerical Rating Scale and the Short Form Health Survey were assessed. A linear mixed model for repeated measures was used for each outcome measure. Significant group (p < 0.001), time (p < 0.001) and time-by-group interaction (p < 0.001) effects were found on disability, with a between-group difference (95% confidence interval) after training in favour of the experimental group of -10 (-12; -8). Also kinesiophobia, catastrophizing, pain, and quality of life improved to a significantly greater extent in the experimental group. The improvements of the experimental group were maintained at follow-ups. This light group-based multidisciplinary cognitive behavioural rehabilitation programme was superior to traditional exercises in reducing disability, kinesiophobia, catastrophizing, and enhancing the quality of life of subjects with CLBP. The effects lasted for at least 2 years after the end of the intervention.",Monticone M.; Ambrosini E.; Rocca B.; Cazzaniga D.; Liquori V.; Foti C.,2016.0,10.1002/ejp.756,0,1,
575,Management of catastrophising and kinesiophobia improves rehabilitation after fusion for lumbar spondylolisthesis and stenosis. A randomised controlled trial.,"To evaluate the effect of a rehabilitation programme including the management of catastrophising and kinesiophobia on disability, dysfunctional thoughts, pain, and the quality of life in patients after lumbar fusion for degenerative spondylolisthesis and/or lumbar spinal stenosis. This was a parallel-group, randomised, superiority-controlled study in which 130 patients were randomly assigned to a programme consisting of exercises and cognitive-behavioural therapy (experimental group, 65 subjects) or exercises alone (control group, 65 subjects). Before treatment (T1), 4 weeks later (post-treatment analysis, T2) and 12 months after the end of treatment (follow-up, T3), all the patients completed a booklet containing the Oswestry Disability Index (ODI, primary outcome), the Tampa Scale for Kinesiophobia, the Pain Catastrophising Scale, a pain Numerical Rating Scale, and the Short-Form Health Survey. A linear mixed model for repeated measures was used for each outcome measure. The ODI linear mixed model revealed significant main effects of group (F(1,122.8) = 95.78, p < 0.001) and time (F(2,120.1) = 432.02, p < 0.001) in favour of the experimental group. There was a significant group × time interaction effect (F(2,120.1) = 20.37, p < 0.001). The analyses of all of the secondary outcome measures revealed a significant effect of time, group and interaction in favour of the experimental group. The rehabilitation programme, including the management of catastrophising and kinesiophobia, was superior to the exercise programme in reducing disability, dysfunctional thoughts, and pain, and enhancing the quality of life of patients after lumbar fusion for degenerative spondylolisthesis and/or LSS. The effects lasted for at least 1 year after the intervention ended.",Monticone M.; Ferrante S.; Teli M.; Rocca B.; Foti C.; Lovi A.; Brayda Bruno M.,2014.0,10.1007/s00586-013-2889-z,0,1,
576,Tailored internet-administered treatment of anxiety disorders for primary care patients: study protocol for a randomised controlled trial.,"Internet-administered cognitive behavioural therapy (ICBT) has been found to be effective for a range of anxiety disorders. However, most studies have focused on one specific primary diagnosis and co-morbidity has not been considered. In primary care settings, patients with anxiety often suffer from more than one psychiatric condition, making it difficult to disseminate ICBT for specific conditions. The aim of this study will be to investigate if ICBT tailored according to symptom profile can be a feasible treatment for primary care patients with anxiety disorders. It is a randomised controlled trial aimed to evaluate the treatment against an active control group. Participants with anxiety disorders and co-morbid conditions (N = 128), will be recruited from a primary care population. The Clinical Outcome in Routine Evaluation (CORE-OM) will serve as the primary outcome measure. Secondary measures include self-reported depression, anxiety, quality of life and loss of production and the use of health care. All assessments will be collected via the Internet and measure points will be baseline, post treatment and 12 months post treatment. This trial will add to the body of knowledge on the effectiveness of ICBT for anxiety disorders in primary care. The trial will also add knowledge on the long term effects of ICBT when delivered for regular clinic patients ClinicalTrials.gov: NCT01390168.",Nordgren LB.; Andersson G.; Kadowaki Å.; Carlbring P.,2012.0,10.1186/1745-6215-13-16,0,1,
577,The efficacy of imagery rescripting compared to cognitive restructuring for social anxiety disorder.,"Imagery rescripting (IR) aims to alter negative meanings associated with distressing autobiographical memories. The current study aimed to extend demonstrated benefits of IR for social anxiety disorder (SAD), including direct comparison of IR with cognitive restructuring (CR) to assess the relative impact of these interventions on symptoms and processes. SAD individuals (N=60) were randomly allocated to IR, CR or Control conditions, and completed two speech tasks (before and after) their assigned intervention. Participants completed measures of symptomatology and state affective/cognitive variables in relation to the intervention and speech tasks. Results support the benefits of IR for SAD, with both IR and CR yielding large and equivalent reductions in trait social anxiety. However, IR and CR may function via differing pathways. Outcomes suggest that IR may be most effective in the treatment of SAD when delivered across multiple sessions or preceded by CR to target verbal and imaginal self-representations.",Norton AR.; Abbott MJ.,2016.0,10.1016/j.janxdis.2016.03.009,0,1,
578,Evaluation of an inference-based approach to treating obsessive-compulsive disorder.,"This study evaluated an inference-based approach (IBA) to the treatment of obsessive-compulsive disorder (OCD) by comparing its efficacy with a treatment based on the cognitive appraisal model (CAM) and exposure and response prevention (ERP). IBA considers initial intrusions in OCD (e.g. ""Maybe the door is open"", ""My hands could be dirty"") as idiosyncratic inferences about possible states of affairs arrived at through inductive reasoning. In IBA such primary inferences represent the starting point of obsessional doubt, and the reasoning maintaining the doubt forms the focus for therapy. This is unlike CAM, which regards appraisals of intrusions as the maintaining factors in OCD. Fifty-four OCD participants, of whom 44 completed, were randomly allocated to CAM, ERP or IBA. After 20 weeks of treatment all groups showed a significant reduction in scores on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Padua Inventory. Participants with high levels of obsessional conviction showed greater benefit from IBA than CAM. Appraisals of intrusions changed in all treatment conditions. Strength of primary inference was not correlated with symptom measures except in the case of strong obsessional conviction. Strength of primary inference correlated significantly with the Y-BOCS insight item. Treatment matching for high and low conviction levels to IBA and CAM, respectively, may optimize therapy outcome.",O'Connor KP.; Aardema F.; Bouthillier D.; Fournier S.; Guay S.; Robillard S.; Pélissier MC.; Landry P.; Todorov C.; Tremblay M.; Pitre D.,2005.0,10.1080/16506070510041211,0,1,
579,Treatment of specific phobia in older adults.,"Phobias are common in later life, yet treatment research in this population remains scant. The efficacy of exposure therapy, in combination with other Cognitive-Behavioral Therapy (CBT) components, in the treatment of specific phobia with a middle and older aged sample was examined. Sixteen adults aged 45-68 with DSM-IV diagnosis of a specific phobia received a manualized intervention over ten weeks, and were compared with a control group. Results indicated significant time effects in the treatment group for the primary outcome variables of phobic severity and avoidance as well as secondary outcome variables including depression and anxiety. Symptom presence and severity also significantly declined in the treatment group. No significant changes in state anxiety were noted across the treatment period. Such results provide support for the efficacy of exposure combined with CBT treatment for specific phobia in middle to older aged adults.",Pachana NA.; Woodward RM.; Byrne GJ.,2007.0,,0,1,
580,Incremental cost-effectiveness of pharmacotherapy and two brief cognitive-behavioral therapies compared with usual care for panic disorder and noncardiac chest pain.,"The aim of this study was to assess the incremental cost-effectiveness ratios (ICERs) of two brief cognitive-behavioral therapy (CBT)-based interventions and a pharmacological treatment, compared with usual care, initiated in the emergency department (ED) for individuals with panic disorder (PD) with a chief complaint of noncardiac chest pain. A total of 69 patients were followed up to 6 months. The primary outcome variables were direct and indirect costs of treatment and PD severity. Panic management (PM) had an ICER of $124.05, per the Anxiety Disorders Interview Schedule for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, severity score change (95% confidence interval [CI], $54.63-$314.57), compared with pharmacotherapy (paroxetine), with an ICER of $213.90 (95% CI, $133.51-$394.94), and brief CBT, with an ICER of $309.31 (95% CI, $151.27-$548.28). The pharmacological and CBT interventions were associated with a greater clinical improvement compared with usual care at posttest. PM presented a superior ICER, suggesting that it may be a promising treatment option to implement in EDs.",Poirier-Bisson J.; Marchand A.; Pelland ME.; Lessard MJ.; Dupuis G.; Fleet R.; Roberge P.,2013.0,10.1097/NMD.0b013e3182a2127d,0,1,
581,Generalization of effects of dental fear treatment in a self-referred population of odontophobics.,"Effects of dental fear treatment on general anxiety and mood in 60 dental phobics with high and low general anxiety were compared with ""attention"" effects in 75 dental phobics on a waiting list using the Dental Anxiety Scale, a State-Trait Anxiety Inventory and a modified Fear Survey Schedule. Positive effects of the treatment were apparent in reduced dental and general fearfulness as well as elevated mood on numerous measures that paralleled dentist ratings of patient behavior. Ss had less fear of going to the next dentist after the program than before, according to a visual analogue measure. Ninety-three percent of Ss started dental treatment with private dentists within 1 year.",Moore R.; Brødsgaard I.; Berggren U.; Carlsson SG.,1991.0,,0,1,
582,Getsmart: Guided education and training via smart phones to promote resilience,"Posttraumatic stress disorder (PTSD) is common in U.S. military service members (SMs) returning from Afghanistan and Iraq. SMs with PTSD symptoms that fall short of meeting full diagnostic criteria also experience devastating effects on their quality of life and daily functioning. Though evidence based treatments are indicated for those meeting diagnostic criteria, less attention has been given to interventions for those with subthreshold symptoms. The advent of novel technologies affords a unique opportunity to meet these intervention needs. Here we describe the feasibility and preliminary findings testing a smartphonebased intervention program to reduce PTSD symptoms in postdeployment SMs. Participants were randomized to a control or intervention condition. Those in the intervention condition engaged in one Skype session and six weeks of daily directive text messages guiding application (app) use. Apps primarily included those developed by the Department of Defense or VA. Participants completed the PTSD Checklist online at baseline, post-intervention, and 3- month follow-up. Overall, participant feedback was positive, regardless of treatment condition. Preliminary findings (with 10% of the overall target population having enrolled) indicate PCL scores decrease significantly from baseline to post-intervention, and these effects are maintained at 3-month follow-up. Additional analyses will be performed upon completion of the study. The present findings demonstrate the feasibility and acceptability of a smartphone based resiliency training program for those with subthreshold PTSD.",Roy M.J.; Highland K.B.; Costanzo M.A.,2015.0,,0,1,
583,Internet-based cognitive behaviour therapy for obsessive-compulsive disorder: a randomized controlled trial.,"Cognitive behaviour therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD) but access to CBT is limited. Internet-based CBT (ICBT) with therapist support is potentially a more accessible treatment. There are no randomized controlled trials testing ICBT for OCD. The aim of this study was to investigate the efficacy of ICBT for OCD in a randomized controlled trial. Participants (n=101) diagnosed with OCD were randomized to either 10 weeks of ICBT or to an attention control condition, consisting of online supportive therapy. The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (YBOCS) administered by blinded assessors. Both treatments lead to significant improvements in OCD symptoms, but ICBT resulted in larger improvements than the control condition on the YBOCS, with a significant between-group effect size (Cohen's d) of 1.12 (95% CI 0.69-1.53) at post-treatment. The proportion of participants showing clinically significant improvement was 60% (95% CI 46-72) in the ICBT group compared to 6% (95% CI 1-17) in the control condition. The results were sustained at follow-up. ICBT is an efficacious treatment for OCD that could substantially increase access to CBT for OCD patients. Replication studies are warranted.",Andersson E.; Enander J.; Andrén P.; Hedman E.; Ljótsson B.; Hursti T.; Bergström J.; Kaldo V.; Lindefors N.; Andersson G.; Rück C.,2012.0,10.1017/S0033291712000244,0,1,
584,Therapist experience and knowledge acquisition in internet-delivered CBT for social anxiety disorder: a randomized controlled trial.,"Guided internet-delivered cognitive behavior therapy (ICBT) has been tested in several trials on social anxiety disorder (SAD) with moderate to large effects. The aims of this study were threefold. First, to compare the effects of ICBT including online discussion forum with a moderated online discussion forum only. Second, to investigate if knowledge about SAD increased following treatment and third to compare the effects of inexperienced versus experienced therapists on patient outcomes. A total of 204 participants with a primary diagnosis of SAD were included and randomized to either guided ICBT or the control condition. ICBT consisted of a 9-week treatment program which was guided by either psychology students at MSc level (n = 6) or by licensed psychologists with previous experience of ICBT (n = 7). A knowledge test dealing with social anxiety was administered before and after treatment. Measures of social anxiety and secondary outcomes dealing with general anxiety, depression, and quality of life were administered before and after treatment. In addition, a 1-year follow-up was conducted on the treated individuals. Immediately following treatment, the ICBT group showed superior outcome on the Liebowitz Social Anxiety Scale self-report version with a between group posttreatment Hedges g effect size of g = 0.75. In addition, significant differences on all the secondary outcomes were observed. Gains were well maintained one year later. Knowledge, as assessed by the knowledge test, increased following treatment with little gain in the control group. Therapist experience did not result in different outcomes, but experienced therapists logged in less frequently compared to the inexperienced therapists, suggesting that they needed less time to support patients. We conclude that guided ICBT reduce symptoms of SAD, increase knowledge about SAD and that therapist experience does not make a difference apart from the finding that experienced therapist may require less time to guide patients. UMIN.ac.jp UMIN000001383.",Andersson G.; Carlbring P.; Furmark T.;  .,2012.0,10.1371/journal.pone.0037411,0,1,
585,Internet-based self-help with therapist feedback and in vivo group exposure for social phobia: a randomized controlled trial.,"Sixty-four individuals with social phobia (social anxiety disorder) were assigned to a multimodal cognitive-behavioral treatment package or to a waiting list control group. Treatment consisted of a 9-week, Internet-delivered, self-help program that was combined with 2 group exposure sessions in real life and minimal therapist contact via e-mail. Results were analyzed on an intention-to-treat basis, including all randomized participants. From pre- to posttest, treated participants in contrast to controls showed significant improvement on most measured dimensions (social anxiety scales, general anxiety and depression levels, quality of life). The overall within- and between-groups effect sizes were Cohen's d = 0.87 and 0.70, respectively. Treatment gains were maintained at 1-year follow-up. The results from this study support the continued use and development of Internet-distributed, self-help programs for people diagnosed with social phobia.",Andersson G.; Carlbring P.; Holmström A.; Sparthan E.; Furmark T.; Nilsson-Ihrfelt E.; Buhrman M.; Ekselius L.,2006.0,10.1037/0022-006X.74.4.677,0,1,
586,Adapting narrative exposure therapy for Chinese earthquake survivors: a pilot randomised controlled feasibility study.,"Narrative exposure therapy (NET) is a brief, manualised treatment for Posttraumatic Stress Disorder (PTSD). It has been shown to have therapeutic benefits for a wide range of individuals and settings. This study, following our previous work applying the original NET in earthquake survivors, aimed to revise NET to be adaptable for treating PTSD after a natural disaster. A randomised waiting-list controlled study was conducted with 30 adult participants with PTSD who were randomly allocated to NET (n = 10), revised NET (NET-R; n = 10) or a waiting list condition (WL; n = 10). Participants in NET and NET-R received treatment immediately; those in the WL condition received NET-R treatment after a waiting period. All groups were assessed on PTSD, general distress, anxiety, depression, social support, coping and posttraumatic change before and after treatment and three-month follow-up. Compared with WL, both NET and NET-R groups showed significant reductions in PTSD and related symptoms. Significant increases were found in posttraumatic growth, active coping and perceived social support. The WL group showed similar improvements after treatment. Further reductions on PTSD symptoms were found at three months, showing that NET-R is as effective as the original NET in treating post-earthquake traumatic symptoms in adult Chinese earthquake survivors. NET-R is a feasible and cost-effective intervention for Chinese earthquake survivors. Further studies are needed to replicate these findings in other survivor populations, and with larger samples and over longer periods. This study highlighted the value of oral narrative approach, which is well-accepted and useful in the context of single natural disaster and lower- income area. Chinese Clinical Trial Registry: ChiCTR-TRC-12002931.",Zang Y.; Hunt N.; Cox T.,2014.0,10.1186/s12888-014-0262-3,0,1,
587,Randomised controlled trial of group cognitive behavioural therapy for comorbid anxiety and depression in older adults.,"Anxiety and depression are commonly comorbid in older adults and are associated with worse physical and mental health outcomes and poorer response to psychological and pharmacological treatments. However, little research has examined the effectiveness of psychological programs to treat comorbid anxiety and depression in older adults. Sixty-two community dwelling adults aged over 60 years with comorbid anxiety and depression were randomly allocated to group cognitive behavioural therapy or a waitlist condition and were assessed immediately following and three months after treatment. After controlling for cognitive ability at pre-treatment, cognitive behaviour therapy resulted in significantly greater reductions, than waitlist, on symptoms of anxiety and depression based on a semi-structured diagnostic interview rated by clinicians unaware of treatment condition. Significant time by treatment interactions were also found for self-report measures of anxiety and depression and these gains were maintained at the three month follow up period. In contrast no significant differences were found between groups on measures of worry and well-being. In conclusion, group cognitive behavioural therapy is efficacious in reducing comorbid anxiety and depression in geriatric populations and gains maintain for at least three months.",Wuthrich VM.; Rapee RM.,2013.0,10.1016/j.brat.2013.09.002,0,1,
588,A bibliotherapy approach to relapse prevention in individuals with panic attacks,"ER The present study examined a relapse prevention (RP) program delivered via bibliotherapy in the treatment of individuals with panic attacks. Compared with a wait list control group, individuals receiving RP exhibited significant reductions on measures of frequency of panic attacks, panic cognitions, anticipatory anxiety, avoidance, and depression. In addition, individuals in the RP group were more likely to attain a ""clinically significant change"" in status on both panic-free status and level of avoidance more frequently than individuals in the control group. When compared with treatment effects evaluated in two prior phases of the study, the obtained results appear to be the product of a synchronous effect of bibliotherapy and minimal phone contact during the 6-month follow-up period. The results reflect the importance of brief therapist contact in increasing motivation for active participation in bibliotherapy interventions.","Wright, J; Clum, G A; Roodman, A; Febbraro, G A",2000.0,,0,1,553
589,Clinician-assisted Internet-based treatment is effective for panic: A randomized controlled trial.,"To determine the efficacy of an Internet-based clinician-assisted cognitive behavioural treatment program (the Panic program) for panic disorder (with or without agoraphobia). Fifty-nine individuals meeting diagnostic criteria for panic disorder with agoraphobia were randomly assigned to a treatment group or to a waitlist control group. Treatment group participants completed the Panic program, comprising six on-line lessons, weekly homework assignments, received weekly email contact from a psychiatry registrar, and contributed to a moderated online discussion forum with other participants. An intention-to-treat model was used for data analyses. Twenty-three (79%) of treatment group participants completed all lessons within the 8-week program, and post-treatment data were collected from 22/29 treatment group and 22/25 waitlist group participants. Compared to the control group, treatment group participants reported significantly reduced symptoms of panic as measured by the Panic Disorder Severity Scale, Body Sensation Questionnaire, and Agoraphobic Cognitions Questionnaires. Significant reductions were also reported on measures of disability and depression. The mean within- and between-group effect size (Cohen's d) on the Panic Disorder Severity Scale was 0.93 and 0.59, respectively, and effects were sustained at 1-month follow-up. Mean therapist time per participant was 75 minutes for the program. These results replicate those from the open trial of the Panic Program indicating the efficacy of the Internet-based clinician-assisted cognitive behavioural treatment program for panic disorder with agoraphobia.",Wims E.; Titov N.; Andrews G.; Choi I.,2010.0,10.3109/00048671003614171,0,1,
590,Transfer of manualized Short Term Psychodynamic Psychotherapy (STPP) for social phobia into clinical practice: study protocol for a cluster-randomised controlled trial.,"Psychodynamic psychotherapy is frequently applied in the treatment of social phobia. Nevertheless, there has been a lack of studies on the transfer of manualized treatments to routine psychodynamic practice. Our study is the first one to examine the effects of additional training in a manualized Short Term Psychodynamic Psychotherapy (STPP) procedure on outcome in routine psychotherapy for social phobia. This study is an extension to a large multi-site RCT (N = 512) comparing the efficacy of STPP to Cognitive-Behavioral Therapy (CBT) of Social Phobia. The manualized treatment is designed for a time limited approach with 25 individual sessions of STPP over 6 months. Private practitioners will be randomized to training in manualized STPP vs. treatment as usual without a specific training (control condition). We plan to enrol a total of 105 patients (84 completers). Assessments will be conducted before treatment starts, after 8 and 15 weeks, after 25 treatment sessions, at the end of treatment, 6 months and 12 months after termination of treatment. The primary outcome measure is the Liebowitz Social Anxiety Scale. Remission from social phobia is defined scoring with 30 or less points on this scale. We will investigate how the treatment can be transferred from a controlled trial into the less structured setting of routine clinical care. This question represents Phase IV of psychotherapy research. It combines the benefits of randomized controlled and naturalistic research. The study is genuinely designed to promote faster and more widespread dissemination of effective interventions. It will answer the questions whether manualized STPP can be implemented into routine outpatient care, whether the new methods improve treatment courses and outcomes and whether treatment effects reached in routine psychotherapeutic treatments are comparable to those of the controlled, strictly manualized treatment of the main study. German Clinical Trials Register (DRKS) DRKS00000570.",Wiltink J.; Ruckes C.; Haselbacher A.; Canterino M.; Leichsenring F.; Joraschky P.; Leweke F.; Pöhlmann K.; Beutel ME.,2011.0,10.1186/1745-6215-12-142,0,1,
591,Cognitive and performance-based treatments for panic attacks in people with varying degrees of agoraphobic disability.,"Compared the effectiveness of cognitive therapy and performance-based exposure as treatments for panic attacks. Subjects were 48 panicky individuals selected without regard to agoraphobic disability, and who varied widely in that respect. Subjects were assigned randomly to either cognitive treatment, performance-based exposure treatment, a combined cognitive/performance treatment, or a no-treatment control condition. All three treatments led to marked and enduring improvements in panic, and did not differ from one another in effectiveness, whereas the control condition produced little benefit. However, on several measures of phobia and panic-related cognitions, performance exposure was significantly more effective than cognitive therapy. Degree of agoraphobic disability had a significant bearing on panic treatment effectiveness. Whereas 94% of the low agoraphobia Ss were free of panic after treatment, only 52% of the high agoraphobia Ss became panic-free. The findings suggest that when panic treatment research excludes people with serious phobias, as it has routinely done in recent years, an overly positive estimate of panic treatment effectiveness can result.",Williams SL.; Falbo J.,1996.0,,0,1,
592,Comparative effectiveness of guided mastery and exposure treatments for intractable phobias.,,Williams SL.; Dooseman G.; Kleinfield E.,1984.0,,0,1,
593,Augmenting serotonin reuptake inhibitors in obsessive-compulsive disorder: What moderates improvement?,"Patients with obsessive-compulsive disorder (OCD) often only partially respond to serotonin reuptake inhibitors (SRIs). In such cases, American Psychiatric Association practice guidelines suggest augmenting SRIs with cognitive-behavioral therapy consisting of exposure and ritual prevention (EX/RP) or antipsychotic medication (i.e., risperidone). We examined moderators and predictors of these 2 augmentation strategies. Data came from a randomized controlled trial that compared adding EX/RP or risperidone to SRIs in adults with OCD. Patients entered the study on a stable SRI dosage and were randomized to EX/RP (N = 40), risperidone (N = 40), or placebo (N = 20). Data were analyzed using multilevel modeling. Pretreatment OCD severity, age, and depression were significant moderators. Although OCD severity was unrelated to EX/RP response, individuals with more severe OCD had poorer outcomes and slower improvement with risperidone. Increasing age predicted better response to risperidone, but not EX/RP. Increased depression predicted poorer response to placebo, but not EX/RP or risperidone. Poorer functioning predicted worse outcome across all 3 conditions. Together, these moderators and predictor accounted for 33% of the variance in outcomes, above and beyond the 30.8% accounted for by treatment condition. SRI augmentation with EX/RP was more effective than risperidone across all of the demographic and clinical variables tested. EX/RP's superiority over risperidone increased with baseline OCD severity and with younger age. These data indicate that EX/RP should be the recommended SRI augmentation strategy, even for severe OCD. What determines the degree of EX/RP response in individual patients deserves further study.",Wheaton MG.; Rosenfield D.; Foa EB.; Simpson HB.,2015.0,10.1037/ccp0000025,0,1,
594,Changes of valued behaviors and functioning during an Acceptance and Commitment Therapy Intervention.,"Background: Living in line with one's values is believed to be beneficial for a person's well-being. Working with values in the therapeutic context often reveals that individuals do no live congruent with their chosen values. This study aimed to investigate how patients' valued behaviors change during an Acceptance and Commitment Therapy (ACT) and how these changes are associated with functioning. Further, this study aimed to examine whether valued behaviors changed depending on pre-treatment levels of symptomatology. Methods: This was a standardized randomized controlled trial with an ACT intervention. Participants were 41 adult patients with treatment-resistant panic disorder. Measurements were completed at pre-treatment, 4-weeks-post-treatment, as well as 6-months after treatment. Results: The discrepancy between how important something is and how much someone does in accordance to their values decreased across treatment. Higher pre-treatment panic symptomatology led to higher improvements in valued action, compared to lower pre-treatment symptomatology. Yet, all patients reached comparable end-points. Functioning increased over the entire study period and increases in functioning were associated with increases in importance and valued action. Discussion: Our study extends prior findings about valued behaviors in ACT by showing that treatment-resistant patients with panic disorder decreased the discrepancy between what is considered important and valued action. Further studies investigating changes in valued behaviors across various diagnoses and treatments are clearly necessary. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Wersebe, Hanna; Lieb, Roselind; Meyer, Andrea H; Hoyer, Jurgen; Wittchen, Hans-Ulrich; Gloster, Andrew T; Arch, Bandelow, Brown, Clarke, Clarke, Czech, Davies-Osterkamp, Domschke, Eifert, Fava, Flaxman, Garin, Gloster, Gloster, Gloster, Gloster, Gloster, Gloster, Gloster, Grosse, Hayes, Hayes, Juarascio, Little, Lundgren, Luoma, Lutz, McCracken, McCracken, McCracken, McCracken, Michalak, Michelson, Moffitt, Parks, Reif, Richter, Rogers, Steiner, Straube, Taylor, Ustun, Vowles, Vowles, Vowles, Wilson, Wilson, Wilson",2017.0,,0,1,
595,"Evaluation of a meridian-based intervention, Emotional Freedom Techniques (EFT), for reducing specific phobias of small animals.","This study explored whether a meridian-based procedure, Emotional Freedom Techniques (EFT), can reduce specific phobias of small animals under laboratory-controlled conditions. Randomly assigned participants were treated individually for 30 min with EFT (n = 18) or a comparison condition, diaphragmatic breathing (DB) (n = 17). ANOVAS revealed that EFT produced significantly greater improvement than did DB behaviorally and on three self-report measures, but not on pulse rate. The greater improvement for EFT was maintained, and possibly enhanced, at six- to nine-months follow-up on the behavioral measure. These findings suggest that a single treatment session using EFT to reduce specific phobias can produce valid behavioral and subjective effects. Some limitations of the study also are noted and clarifying research suggested.",Wells S.; Polglase K.; Andrews HB.; Carrington P.; Baker AH.,2003.0,10.1002/jclp.10189,0,1,
596,Metacognitive therapy versus prolonged exposure in adults with chronic post-traumatic stress disorder: A parallel randomized controlled trial.,"A parallel randomized controlled trial compared metacognitive therapy (MCT) with prolonged exposure (PE) in 32 patients with PTSD of >=3 months duration. Participants were assigned to; eight sessions of therapy (MCT or PE) or an 8-week wait period (WL). There was only one drop-out from each treatment. Both active treatments were effective, resulting in significantly lower symptoms of PTSD, anxiety and depression compared with the WL. At post-treatment MCT was superior to PE on self-report symptoms of PTSD and superior to WL on objective measures of hyper-arousal (heart-rate). Recovery rates and reliable improvement in both MCT and PE were high. MCT exerted effects more rapidly and within group effect sizes in MCT were much larger than those in PE at the end of treatment. Clinical gains remained evident at follow-up by which time the treated groups did not differ. In conclusion; both treatments were effective but MCT had a clear advantage. The clinical implications and suggestions for future research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wells, Adrian; Walton, Deborah; Lovell, Karina; Proctor, Dawn; Beck, Beck, Benish, Bennett, Bradley, Cahill, Cohen, First, Foa, Foa, Foa, Fydrich, Guthrie, Hedges, Holeva, Horowitz, Jacobson, Marks, Nassif, Nolen-Hoeksema, Powers, Reynolds, Rosenthal, Roussis, Schwartz, Van Etten, Warda, Wells, Wells, Wells, Wells, Wells, Wells",2015.0,,0,1,
597,Treating posttraumatic stress disorder with metacognitive therapy: a preliminary controlled trial.,"Exposure, trauma-focused cognitive therapy and eye-movement desensitisation and re-processing (EMDR) are effective treatments for posttraumatic stress disorder (PTSD) producing equivalent outcomes. How might the field advance? One way is to base new treatments on PTSD maintenance mechanisms. A treatment that does this, metacognitive therapy (MCT), underwent preliminary controlled evaluation in this study. Twenty participants aged 18 to 65 years with chronic PTSD were randomly allocated to either a total of 8 sessions of MCT or a delayed treatment control. Measures of PTSD, emotional symptoms, and underlying metacognitive variables were obtained at pretreatment and posttreatment. Patients were followed-up at 3 and 6 months postintervention. Statistically significant reductions in PTSD symptoms, depression, and anxiety at posttreatment were observed in the MCT group but not in the control group. Changes were maintained over follow-up. The average number of sessions delivered was 6.4. Eighty percent of patients (intention to treat) met clinical significance criteria for recovery based on the IES. Treatment was well tolerated with only one (10%) dropout. Changes in thought control strategy hypothesized to be involved in the maintenance of PTSD were found. MCT appeared to be a brief treatment producing high recovery rates. The data add to existing uncontrolled evaluations and provide strong justification for future evaluation of this treatment against existing evidence-based interventions.",Wells A.; Colbear JS.,2012.0,10.1002/jclp.20871,0,1,
598,"Chinese My Trauma Recovery, a Web-based intervention for traumatized persons in two parallel samples: randomized controlled trial.","Guided self-help interventions for PTSD (post-traumatic stress disorder) are a promising tool for the dissemination of contemporary psychological treatment. This study investigated the efficacy of the Chinese version of the My Trauma Recovery (CMTR) website. In an urban context, 90 survivors of different trauma types were recruited via Internet advertisements and allocated to a randomized controlled trial (RCT) with a waiting list control condition. In addition, in a rural context, 93 survivors mainly of the 2008 Sichuan earthquake were recruited in-person for a parallel RCT in which the website intervention was conducted in a counseling center and guided by volunteers. Assessment was completed online on a professional Chinese survey website. The primary outcome measure was the Post-traumatic Diagnostic Scale (PDS); secondary outcome measures were Symptom Checklist 90-Depression (SCL-D), Trauma Coping Self-Efficacy Scale (CSE), Post-traumatic Cognitive Changes (PCC), and Social Functioning Impairment (SFI) questionnaires adopted from the My Trauma Recovery website. For the urban sample, findings indicated a significant group×time interaction in post-traumatic symptom severity (F₁,₈₈=7.65, P=.007). CMTR reduced post-traumatic symptoms significantly with high effect size after one month of treatment (F₁,₄₅=15.13, Cohen's d=0.81, P<.001) and the reduction was sustained over a 3-month follow-up (F₁,₄₅=17.29, Cohen's d=0.87, P<.001). In the rural sample, the group×time interaction was also significant in post-traumatic symptom severity (F₁,₉₁=5.35, P=.02). Post-traumatic symptoms decreased significantly after treatment (F₁,₄₈=43.97, Cohen's d=1.34, P<.001) and during the follow-up period (F₁,₄₈=24.22, Cohen's d=0.99, P<.001). Additional outcome measures (post-traumatic cognitive changes, depression) indicated a range of positive effects, in particular in the urban sample (group×time interactions: F₁,₈₈=5.32-8.37, all Ps<.03), contributing to the positive evidence for self-help interventions. Differences in the effects in the two RCTs are exploratorily explained by sociodemographic, motivational, and setting feature differences between the two samples. These findings give support for the short-term efficacy of CMTR in the two Chinese populations and contribute to the literature that self-help Web-based programs can be used to provide mental health help for traumatized persons. Australia New Zealand Clinical Trials Registry (ANZCTR): ACTRN12611000951954; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000951954 (Archived by WebCite at http://www.webcitation.org/6G7WyNODk).",Wang Z.; Wang J.; Maercker A.,2013.0,10.2196/jmir.2690,0,1,
599,Virtual reality cognitive behavior therapy for public speaking anxiety: A randomized clinical trial.,"Public speaking anxiety (PSA) is a common phobia. Although cognitive behavior therapy (CBT) is preferred, difficulties arise with the exposure component (lack of therapist control, patient's inability to imagine, self-flooding, loss of confidentiality resulting from public exposure). Virtual reality CBT (VRCBT) enables a high degree of therapist control, thus overcoming these difficulties. This study examined whether VRCBT is an alternative to CBT. Participants with PSA were randomly assigned to VRCBT (28 participants), CBT (30 participants), and wait list control (WLC; 30 participants). VRCBT and CBT were significantly more effective than WLC in anxiety reduction on four of five anxiety measures, and on subject's self-rating of anxiety during a behavioral task. No significant differences were found on observer ratings of the behavioral task. However, twice as many participants dropped out from CBT than from VRCBT. Our results demonstrated that VRCBT is an effective and brief treatment regimen, equal to CBT. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wallach, Helene S; Safir, Marilyn P; Bar-Zvi, Margalit; Anderson, Anderson, Beck, Beck, Botella, Botella, Botella, Carlin, Casati, Craske, Freeman, Fresco, Glantz, Goldberg, Harris, Heimberg, Heimberg, Hofmann, Hope, Iancu, Kendall, Klinger, Marks, Marks, Optale, Otto, Pollack, Rothbaum, Rothbaum, Rothbaum, Ruscio, Sadock, Salaberria, Sanchez-Vives, Shapiro, Silverman, Smits, Stever, Wallach, Wiederhold",2009.0,,0,1,
600,A preliminary investigation of cognitive and relaxation treatment of panic disorder: effects on intense anxiety vs 'background' anxiety.,,Waddell MT.; Barlow DH.; O'Brien GT.,1984.0,,0,1,
601,Cognitive-behavioral group therapy in obsessive-compulsive disorder: a randomized clinical trial,"ER METHODSForty-seven patients meeting DSM-IV criteria for obsessive-compulsive disorder (OCD) were randomly assigned to either 12 weekly CBGT sessions or a waiting list (control group). Treated patients were followed for three months.RESULTSThere was a significant reduction in the Yale-Brown Obsessive-Compulsive Scale (p < 0.001), in the National Institute of Mental Health Obsessive-Compulsive Scale (p < 0.001), in the Overvalued Ideas Scale (p < 0.001), and a significant improvement in the quality of life in the four domains of the World Health Organization Quality of Life Assessment Scale: physical (p < 0.001), psychological (p < 0.017), social (p < 0.018) and environmental (p < 0.04). No significant reduction was found in the Hamilton Rating Scale for Anxiety (p = 0.111) and the Hamilton Rating Scale for Depression (p = 0.271). The concomitant use of anti-obsessional medications did not influence the results. The rate of improved patients was 69.6% in the treated group and 4.2% in the control group (p < 0.001). The therapeutic gains were maintained and an additional reduction in symptoms was observed during the 3-month follow-up period.CONCLUSIONSThe results suggest that CBGT is effective in reducing the intensity of OCD symptoms and of overvalued ideas, and that it improves the OCD patient's quality of life in a short period of time.BACKGROUNDThe present study was designed to verify the efficacy of cognitive-behavioral group therapy (CBGT) in reducing obsessive-compulsive symptoms and the intensity of overvalued ideas, as well as in improving the patient's quality of life.","Volpato, Cordioli A; Heldt, E; Braga, Bochi D; Margis, R; Basso de, Sousa M; Fonseca, Tonello J; Gus, Manfro G; Kapczinski, F",2003.0,,0,1,382
602,Mindfulness-based stress reduction for patients with anxiety disorders: evaluation in a randomized controlled trial.,"The aim of this study was to investigate the effect of mindfulness-based stress reduction (MBSR) for patients with heterogeneous anxiety disorders. Seventy-six self-referred patients were randomized to MBSR or a waiting-list control condition. Eight participants did not complete the eight-week MBSR intervention. Treatment completers improved significantly on all outcome measures compared to controls. The completer sample showed medium to large effect sizes on measures of anxiety (Cohen's d = 0.55-0.97), and a large effect size for symptoms of depression (Cohen's d = 0.97). Intention-to-treat analyses yielded effect sizes in the small to moderate range (Cohen's d = 0.32-0.76). Gains were maintained at six months follow-up. The percentage of participants reaching recovered status was highest for symptom measures of depression and anxiety, and lower for worry and trait anxiety. Mediation analyses indicated that mindfulness fully mediated changes in acute anxiety symptoms, and partially mediated changes in worry and trait anxiety. However, the present study did not find evidence of temporal precedence for the proposed mediator. In the absence of true mediation and an active control condition, it cannot be ruled out that results are due to non-specific aspects of treatment. Despite these and other limitations, we conclude that MBSR is an effective treatment for anxiety disorders and related symptomatology.",Vøllestad J.; Sivertsen B.; Nielsen GH.,2011.0,10.1016/j.brat.2011.01.007,0,1,
603,Stepped care vs. matched care for mood and anxiety disorders: a randomized trial in routine practice.,"The effectiveness of two versions of stepped care [with either brief therapy (BT) or cognitive behavioural therapy (CBT) as a first step] is studied in comparison with the traditional matched care approach (CAU) for patients with mood and anxiety disorders. A randomized trial was performed in routine mental health care in 12 settings, including 702 patients. Patients were interviewed once in 3 months for 18-24 months (response rate 69%). Overall, patients' health improved significantly over time: 51% had achieved recovery from the DSM-IV disorder(s) after 1 year and 66% at the end of the study. Respectively, 50% and 60% had 'normal' SCL90 and SF36 scores. Cognitive behavioural therapy and BT patients achieved recovery more often than CAU patients (ORs between 1.26 and 1.48), although these results were not statistically significant. Stepped care, with BT or CBT as a first step, is at least as effective as matched care.",van Straten A.; Tiemens B.; Hakkaart L.; Nolen WA.; Donker MC.,2006.0,10.1111/j.1600-0447.2005.00731.x,0,1,
604,"A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance.","The relative short-term efficacy and long-term benefits of pharmacologic versus psychotherapeutic interventions have not been studied for posttraumatic stress disorder (PTSD). This study compared the efficacy of a selective serotonin reup-take inhibitor (SSRI), fluoxetine, with a psychotherapeutic treatment, eye movement desensitization and reprocessing (EMDR), and pill placebo and measured maintenance of treatment gains at 6-month follow-up. Eighty-eight PTSD subjects diagnosed according to DSM-IV criteria were randomly assigned to EMDR, fluoxetine, or pill placebo. They received 8 weeks of treatment and were assessed by blind raters posttreatment and at 6-month follow-up. The primary outcome measure was the Clinician-Administered PTSD Scale, DSM-IV version, and the secondary outcome measure was the Beck Depression Inventory-II. The study ran from July 2000 through July 2003. The psychotherapy intervention was more successful than pharmacotherapy in achieving sustained reductions in PTSD and depression symptoms, but this benefit accrued primarily for adult-onset trauma survivors. At 6-month follow-up, 75.0% of adult-onset versus 33.3% of child-onset trauma subjects receiving EMDR achieved asymptomatic end-state functioning compared with none in the fluoxetine group. For most childhood-onset trauma patients, neither treatment produced complete symptom remission. This study supports the efficacy of brief EMDR treatment to produce substantial and sustained reduction of PTSD and depression in most victims of adult-onset trauma. It suggests a role for SSRIs as a reliable first-line intervention to achieve moderate symptom relief for adult victims of childhood-onset trauma. Future research should assess the impact of lengthier intervention, combination treatments, and treatment sequencing on the resolution of PTSD in adults with childhood-onset trauma.",van der Kolk BA.; Spinazzola J.; Blaustein ME.; Hopper JW.; Hopper EK.; Korn DL.; Simpson WB.,2007.0,,0,1,
605,Treatment of generalized anxiety disorder: Changing metacognitions or targeting intolerance of uncertainty? A randomized controlled trial.,"Preliminary evidence indicates that metacognitive therapy (MCT) and intolerance-of-uncertainty therapy (IUT) are efficacious treatments for generalized anxiety disorder (CAD). In this study we compared the effectiveness of MCT and IUT for GAD in an outpatient context in a randomized controlled trial. Adult patients diagnosed with CAD (N = 126) were randomly allocated to MCT, IUT, or a delayed treatment (DT) condition. Patients in the treatment conditions received up to 14 weekly sessions, patients in the DT condition received no treatment for 14 weeks. Assessments were conducted before treatment (pretreatment), after the last treatment session (posttreatment), and six months after treatment had ended (followup). Outcome measures were the Penn State Worry Questionnaire (PSWQ) and the trait version of the State-Trait Anxiety Inventory (STAI-T). At posttreatment and follow-up assessments, both MCT and IUT, but not DT, produced significant reductions on both outcome measures, with large effect sizes and high proportions of clinically significant change. Results further indicate that MCT produced better results than IUT. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","van der Heiden, Colin; Muris, Peter; van der Molen, Henk T; Cohen, Covin, D'Zurilla, Dugas, Dugas, Fisher, Groenestljn, Heiden, Heiden, Heiden, Heiden, Hunot, Jacobson, Mitte, Ploeg, Rijsoort, Wells, Wells",2012.0,,0,1,
606,Randomized controlled trial on the effectiveness of metacognitive therapy and intolerance-of-uncertainty therapy for generalized anxiety disorder.,"This randomized controlled trial compared the effectiveness of metacognitive therapy (MCT) and intolerance-of-uncertainty therapy (IUT) for generalized anxiety disorder (GAD) in an outpatient context. Patients with GAD (N = 126) consecutively referred to an outpatient treatment center for anxiety disorder were randomly allocated to MCT, IUT, or a delayed treatment (DT) condition. Patients were treated individually for up to 14 sessions. Assessments were conducted before treatment (pretreatment), after the last treatment session (posttreatment), and six months after treatment had ended (follow-up). At posttreatment and follow-up assessments, substantial improvements were observed in both treatment conditions across all outcome variables. Both MCT and IUT, but not DT, produced significant reductions in GAD-specific symptoms with large effect sizes (ranging between 0.94 and 2.39) and high proportions of clinically significant change (ranging between 77% and 95%) on various outcome measures, and the vast majority of the patients (i.e., 91% in the MCT group, and 80% in the IUT group) no longer fulfilled the diagnostic criteria for GAD. Results further indicate that MCT produced better results than IUT. This was evident on most outcome measures, and also reflected in effect sizes and degree of clinical response and recovery.",van der Heiden C.; Muris P.; van der Molen HT.,2012.0,10.1016/j.brat.2011.12.005,0,1,
607,Social phobia: a comparison of behavior therapy and atenolol.,"Seventy-two social phobics were randomly assigned to behavioral (flooding) or drug treatment with atenolol or placebo. Treatment was administered over a 3-month period of time, and duration of treatment effects was determined at a 6-month follow-up assessment. Multiple measures of outcome were used, including self-report, clinician ratings (including assessment by independent evaluators), behavioral assessment, and performance on composite indexes. The results indicated that flooding consistently was superior to placebo, whereas atenolol was not. Flooding also was superior to atenolol on behavioral measures and composite indexes. Those subjects who improved during treatment maintained gains at the 6-month follow-up regardless of whether they received flooding or atenolol. The variability of outcome on different measures in social phobia research is discussed, and the need for broad-based treatment strategies to address the pervasive deficits associated with social phobia is noted.",Turner SM.; Beidel DC.; Jacob RG.,1994.0,,0,1,
608,Internet-delivered cognitive-behavioral therapy for social anxiety disorder in Romania: a randomized controlled trial.,"Internet-based cognitive-behavioral therapy (iCBT) for social anxiety disorder has been found effective, as attested by independently conducted randomized controlled trials in four languages. The study aim is to test the efficacy of an iCBT program in a culture where it was not tested before (i.e. Romania). Participants (n = 76) were recruited, screened and randomized to either a nine-week guided iCBT or a wait-list control group in April and May 2012. Self-report measures were collected before (April 2012) and after the intervention (July 2012), as well as six months later (January 2013). Although social anxiety was assessed with multiple measures, the Liebowitz Social Anxiety Scale - Self Report version (LSAS-SR) and Social Phobia Inventory (SPIN) were used as the primary outcome measures. A significant difference with a large between-group effect size in favor of iCBT was found (Cohen's d = 1.19 for LSAS-SR and d = 1.27 for SPIN). Recovery rates show that 36.8% (n = 14) in the treatment group score below the SPIN clinical cut-off compared to only 2.6% (n = 1) in the wait-list control group. Post-intervention clinical interviews also revealed that 34.2% (n = 13) of the treatment group was completely recovered (full remission) while additionally 36.8% (n = 14) retained some social anxiety symptoms (partial remission). However, an important study limitation is that post-intervention interviewers were not blinded to the study conditions. The program also effectively reduced depression and dysfunctional thinking (between-group Cohen's d = 0.84 for depression and d = 0.63 for dysfunctional thinking). Moreover, the iCBT intervention appears to have a long-term impact for participants' functioning, as the treatment gains were maintained six months later. Internet-delivered interventions display a high potential to quickly and widely disseminate effective evidence-based programs around the world. This study provides support for guided iCBT as a promising treatment approach in Romania. ClinicalTrials.gov NCT01557894.",Tulbure BT.; Szentagotai A.; David O.; Ștefan S.; Månsson KN.; David D.; Andersson G.,2015.0,10.1371/journal.pone.0123997,0,1,
609,Acceptance-based behavioral therapy for GAD: effects on outcomes from three theoretical models.,"Although cognitive-behavioral therapy (CBT) is efficacious in the treatment of generalized anxiety disorder (GAD), many individuals remain symptomatic following treatment, indicating a need for further treatment development. As a result, many researchers have developed unique cognitive-behavioral therapies that highlight specific targets for intervention. The current study examined the effect of an acceptance-based behavioral therapy for GAD on the proposed targets for intervention highlighted in several theoretical models: emotion regulation difficulties, intolerance of uncertainty, and low perceptions of control. Clients were randomly assigned to immediate (n=15) or delayed (n=16) treatment. Individuals treated with the acceptance-based behavioral therapy reported significantly fewer difficulties in emotion regulation and fear of emotional responses, as well as greater tolerance of uncertainty and perceived control over anxiety than individuals in the waitlist control condition. In addition, these effects were maintained at 3- and 9-month follow-up assessments. The present study provides promising evidence that an acceptance-based behavioral therapy for GAD has significant effects on the unique targets of intervention highlighted in several prominent theoretical models of GAD.",Treanor M.; Erisman SM.; Salters-Pedneault K.; Roemer L.; Orsillo SM.,2011.0,10.1002/da.20766,0,1,
610,Transdiagnostic internet treatment for anxiety and depression: a randomised controlled trial.,"Disorder-specific cognitive behavioural therapy programs delivered over the internet (iCBT) with clinician guidance are effective at treating specific anxiety disorders and depression. The present study examined the efficacy of a transdiagnostic iCBT protocol to treat three anxiety disorders and/or depression within the same program (the Wellbeing Program). Seventy-seven individuals with a principal diagnosis of major depression, generalised anxiety disorder, panic disorder, and/or social phobia were randomly assigned to a Treatment or Waitlist Control group. Treatment consisted of CBT-based online educational lessons and homework assignments, weekly email or telephone contact from a clinical psychologist, access to a moderated online discussion forum, and automated emails. Eighty one percent of Treatment group participants completed all 8 lessons within the 10 week program. Post-treatment data were collected from 34/37 Treatment group and 35/37 Control group participants, and 3-month follow-up data were collected from 32/37 Treatment group participants. Relative to Controls, Treatment group participants reported significantly reduced symptoms of anxiety and depression as measured by the Depression Anxiety and Stress Scales-21 item, Patient Health Questionnaire-9 item, and Generalised Anxiety Disorder-7 item scales, with corresponding between-groups effect sizes (Cohen's d) at post treatment of.56,.58, and.52, respectively. The clinician spent a mean time of 84.76 min (SD=50.37) per person over the program. Participants rated the procedure as highly acceptable, and gains were sustained at follow-up. These results provide preliminary support for the efficacy of transdiagnostic iCBT in the treatment of anxiety and depressive disorders.",Titov N.; Dear BF.; Schwencke G.; Andrews G.; Johnston L.; Craske MG.; McEvoy P.,2011.0,10.1016/j.brat.2011.03.007,0,1,
611,Shyness 1: distance treatment of social phobia over the Internet.,"The purpose of the present study was to examine the effectiveness of an Internet-based clinician-assisted computerized cognitive behavioural therapy programme for social phobia. A total of 105 individuals with social phobia were randomly assigned to a six-lesson cognitive behavioural treatment programme or to a waitlist control group. Treatment consisted of four components: six online lessons; homework assignments; participation in an online discussion forum; and regular email contact with a therapist. An intention-to-treat model was used for data analyses. A total of 78% of treatment group participants completed all lessons, and post-treatment data were obtained from 93/105 participants. Significant post-treatment differences between treatment and waitlist participants were found on two measures of symptoms of social phobia. Mean within- and between-group effect sizes (Cohen's d) for the primary social phobia outcome measures were 1.15, and 0.95, respectively. These results were comparable with those obtained in exemplary face-to-face treatment programmes. They provide further positive data about the utility of Internet-based guided self-help programmes for people with common mental disorders.",Titov N.; Andrews G.; Schwencke G.; Drobny J.; Einstein D.,2008.0,10.1080/00048670802119762,0,1,
612,Shyness 2: treating social phobia online: replication and extension.,"In a randomized controlled trial Titov et al. (2008) demonstrated significant benefit from an Internet- and email-based treatment programme for social phobia. The present study (Shyness 2) seeks to replicate that finding and compares results with benchmark data. Eighty-eight individuals with social phobia were randomly assigned to a clinician-assisted computerized cognitive behavioural treatment programme or to a waitlist control group. Participants completed the same treatment programme used in Shyness 1, consisting of six online lessons, cognitive behavioural homework assignments, email contact with a therapist, and participation in an online discussion forum. An intention-to-treat model was used for data analyses. A total of 80% of treatment group participants completed all lessons, and post-treatment data were obtained from 78/81 participants. Treatment group participants each had an average of 127 min of therapist contact over the 10 week programme, including an average of 22 email contacts plus therapist responses to forum postings. Pre- to post-treatment differences were seen between treatment and waitlist participants across two measures of symptoms of social phobia, and across a measure of disability. Mean within- and between-group effect sizes (Cohen's d) across the two primary outcome measures were 1.18, and 1.20, respectively. Quantitative and qualitative data indicate that the procedure is very acceptable to participants. These results closely replicate those obtained in Shyness 1, indicating that the treatment procedure is reliable. These results compare favourably with outcomes reported in benchmarking studies from high-quality face-to-face treatment programmes for social phobia. These results provide further positive data about the utility of Internet-based guided self-help programmes for people with social phobia.",Titov N.; Andrews G.; Schwencke G.,2008.0,10.1080/00048670802119820,0,1,
613,Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial.,"Preliminary results have demonstrated the clinical efficacy of computerised cognitive-behavioural therapy (CBT) in the treatment of anxiety and depression in primary care. To determine, in an expanded sample, the dependence of the efficacy of this therapy upon clinical and demographic variables. A sample of 274 patients with anxiety and/or depression were randomly allocated to receive, with or without medication, computerised CBT or treatment as usual, with follow-up assessment at 6 months. The computerised therapy improved depression, negative attributional style, work and social adjustment, without interaction with drug treatment, duration of preexisting illness or severity of existing illness. For anxiety and positive attributional style, treatment interacted with severity such that computerised therapy did better than usual treatment for more disturbed patients. Computerised therapy also led to greater satisfaction with treatment. Computer-delivered CBT is a widely applicable treatment for anxiety and/or depression in general practice.",Proudfoot J.; Ryden C.; Everitt B.; Shapiro DA.; Goldberg D.; Mann A.; Tylee A.; Marks I.; Gray JA.,2004.0,,0,1,
614,A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence.,"The purpose of this experiment was to conduct a dismantling study of cognitive processing therapy in which the full protocol was compared with its constituent components--cognitive therapy only (CPT-C) and written accounts (WA)--for the treatment of posttraumatic stress disorder (PTSD) and comorbid symptoms. The intent-to-treat (ITT) sample included 150 adult women with PTSD who were randomized into 1 of the 3 conditions. Each condition consisted of 2 hr of therapy per week for 6 weeks; blind assessments were conducted before treatment, 2 weeks following the last session, and 6 months following treatment. Measures of PTSD and depression were collected weekly to examine the course of recovery during treatment as well as before and after treatment. Secondary measures assessed anxiety, anger, shame, guilt, and dysfunctional cognitions. Independent ratings of adherence and competence were also conducted. Analyses with the ITT sample and with study completers indicate that patients in all 3 treatments improved substantially on PTSD and depression, the primary measures, and improved on other indices of adjustment. However, there were significant group differences in symptom reduction during the course of treatment whereby the CPT-C condition reported greater improvement in PTSD than the WA condition. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Resick, Patricia A; Galovski, Tara E; Uhlmansiek, Mary O'Brien; Scher, Christine D; Clum, Gretchen A; Young-Xu, Yinong; Ahrens, Andrews, Beck, Berger, Blake, Blake, Borkovec, Brewin, Bryant, Cahill, Chard, Cohen, Dalgleish, Ehlers, Ehlers, Feindler, First, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Hedges, Keane, Kubany, Lange, Marks, Mechanic, Monson, Nishith, Nishith, Nishith, Orth, Owens, Paunovic, Pitman, Resick, Resick, Resick, Resick, Resick, Resick, Resick, Rowan, Schnurr, Schnurr, Schulz, Speilberger, Speilberger, Spielberger, Straus, Straus, Tarrier, Tarrier, Weathers, Weaver, Zanarini",2008.0,,0,1,
615,"A multidisciplinary rehabilitation programme improves disability, kinesiophobia and walking ability in subjects with chronic low back pain: results of a randomised controlled pilot study","ER PURPOSE: To evaluate the effect of a multidisciplinary rehabilitation programme on disability, kinesiophobia, catastrophizing, pain, quality of life and gait disturbances in patients with chronic low back pain (CLBP).METHODS: This was a parallel-group, randomised, superiority-controlled pilot study in which 20 patients were randomly assigned to a programme consisting of motor training (spinal stabilising exercises plus usual-care) and cognitive-behavioural therapy (experimental group, 10 subjects) or usual-care alone (control group, 10 subjects). Before treatment, 8 weeks later (post-treatment), and 3 months after the end of treatment, the Oswestry Disability Index, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, a pain numerical rating scale, and the Short-Form Health Survey were assessed. Spatio-temporal gait parameters were also measured by means of an electronic walking mat. A linear mixed model for repeated measures was used for each outcome measure.RESULTS: The programme had significant group (p = 0.027), time (p < 0.001), and time-by-group interaction (p < 0.001) effects on disability, with the experimental group showing an improvement after training of about 61 % (25 % in the control group). The analyses of kinesiophobia, catastrophizing, and the quality of life also revealed significant time, group, and time-by-group interaction effects in favour of the experimental group, and there was a significant effect of time on pain. Both groups showed a general improvement in gait parameters, with the experimental group increasing cadence significantly more.CONCLUSION: The multidisciplinary rehabilitation programme including cognitive-behavioural therapy was superior to the exercise programme in reducing disability, kinesiophobia, catastrophizing, and enhancing the quality of life and gait cadence of patients with CLBP.","Monticone, M; Ambrosini, E; Rocca, B; Magni, S; Brivio, F; Ferrante, S",2014.0,10.1007/s00586-014-3478-5,0,1,
616,Social phobia treated as a problem in social functioning: a controlled comparison of two behavioural group approaches.,"Treatments for social phobia result typically in significant anxiety and avoidance reduction; the repercussions in terms of social functioning, however, are not clear. This controlled study compared two approaches designed to improve the social functioning of social phobics. Sixty-eight socially phobic patients were randomly assigned to two treatments focused on improving interpersonal relationships either with or without social skills training or a waiting list; 60 completed treatment and 59 a 1-year follow-up. Treatment was administered in small groups, 14 sessions altogether. No clinically meaningful change was observed during the waiting period. A statistically significant and equivalent improvement obtained in both treatment conditions. Both treatments resulted in reduced anxiety, avoidance, general psychopathology and better social functioning that maintained over follow-up. Continuing improvement in remission rates was noted; fully 60% of the patients no longer fulfilled criteria for social phobia at the end of 1-year follow-up.",Stravynski A.; Arbel N.; Bounader J.; Gaudette G.; Lachance L.; Borgeat F.; Fabian J.; Lamontagne Y.; Sidoun P.; Todorov C.,2000.0,,0,1,
617,Anxiety sensitivity and treatment outcome in panic disorder.,"The purpose of this study was to examine the relationship between change in anxiety sensitivity, as measured by the Anxiety Sensitivity Index (ASI), and treatment outcome in a sample of 106 subjects with a DSM-III-R diagnosis of panic disorder (with or without agoraphobia) who were participants in an evaluation study of cognitive-behavioral treatment. Results revealed that subjects who received active treatment had significantly lower anxiety sensitivity scores at post-treatment than the wait-list control group. We also examined change in anxiety sensitivity from pre- to post-treatment in reference to Clinical Global Improvement (CGI) ratings and with the effect size statistic. Subjects who showed improvement based on CGI ratings also demonstrated a reduction in anxiety sensitivity. Furthermore, the effect sizes obtained with the ASI were greater in magnitude than those obtained with other widely used anxiety self-report measures. Taken together, the finds supported the use of the Anxiety Sensitivity Index as a treatment outcome measure in panic disorder research.",Hazen AL.; Walker JR.; Eldridge GD.,1996.0,10.1002/(SICI)1522-7154(1996)2:1<34::AID-ANXI5>3.0.CO;2-D,0,1,
618,A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder.,"Objective: To examine whether an empirically and theoretically derived treatment combining mindfulness- and acceptance-based strategies with behavioral approaches would improve outcomes in generalized anxiety disorder (GAD) over an empirically supported treatment. Method: This trial randomized 81 individuals (65.4% female, 80.2% identified as White, average age 32.92) diagnosed with GAD to receive 16 sessions of either an acceptance-based behavior therapy (ABBT) or applied relaxation (AR). Assessments at pretreatment, posttreatment, and 6-month follow-up included the following primary outcome measures: GAD clinician severity rating, Structured Interview Guide for the Hamilton Anxiety Rating Scale, Penn State Worry Questionnaire, Depression Anxiety Stress Scale, and the State-Trait Anxiety Inventory. Secondary outcomes included the Beck Depression Inventory-II, Quality of Life Inventory, and number of comorbid diagnoses. Results: Mixed effect regression models showed significant, large effects for time for all primary outcome measures (ds = 1.27 to 1.61) but nonsignificant, small effects for condition and Condition x Time (ds = 0.002 to 0.20), indicating that clients in the 2 treatments improved comparably over treatment. For secondary outcomes, time was significant (ds = 0.74 to 1.38), but condition and Condition x Time effects were not (ds = 0.004 to 0.31). No significant differences emerged over follow-up (ds = 0.03 to 0.39), indicating maintenance of gains. Between 63.3 and 80.0% of clients in ABBT and 60.6 and 78.8% of clients in AR experienced clinically significant change across 5 calculations of change at posttreatment and follow-up. Conclusion: ABBT is a viable alternative for treating GAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hayes-Skelton, Sarah A; Roemer, Lizabeth; Orsillo, Susan M; Antony, Arch, Arntz, Bar-Haim, Barnard, Beck, Behar, Bernstein, Blevins, Borkovec, Borkovec, Borkovec, Borkovec, Borkovec, Brown, Brown, Bruce, Chambless, Cohen, Covin, Craigie, Di Nardo, Dugas, Dunlap, Evans, Frisch, Fuchs, Fuchs, Hamilton, Hayes, Hayes, Hayes, Hayes-Skelton, Hayes-Skelton, Hedeker, Hedeker, Hoffman, Hofmann, Hoyer, Ladouceur, Lee, Linehan, Llera, Lovibond, Mennin, Meyer, Michelson, Newman, Orsillo, Ost, Ost, Roemer, Roemer, Roemer, Roemer, Roemer, Rucker Sobczak, Segal, Shear, Siev, Spielberger, Tracey, Treanor, Waters, Wells, Wells, Wetherell",2013.0,,0,1,
619,"Randomized-controlled trial on a novel (meta-)cognitive self-help approach for obsessive-compulsive disorder (""myMCT"").","Effective treatment strategies exist for obsessive-compulsive disorder (OCD), however, many individuals do not receive professional help. Media-delivered self-help is increasingly sought to narrow the treatment gap. Previous studies included personal contact with a clinician, making it difficult to delineate the specific effect of the medium. We developed ""myMCT"" for OCD, a (meta-)cognitive manual for self-application. We conducted a randomized-controlled trial with 128 OCD participants receiving myMCT versus psychoeducation, adopting low-threshold recruitment approaches without any face-to-face contact. Diagnoses were verified with telephone interviews paralleling online surveys at pre, post (4 weeks) and follow-up (6 months). Participants benefited significantly from both interventions. MyMCT showed stronger reduction of OCD symptoms on Y-BOCS total score (p = .023, eta2partial=.04), obsessions (p = .002, eta2partial = .07), depression (BDI: p=.022, eta2partial = .04), and cognitive biases (OBQ: p = .016, eta2partial = .05) after 4 weeks. After 6 months, individuals with myMCT showed decreased levels of cognitive biases (OBQ). The current study provides further evidence that myMCT is a promising approach to target OCD-related psychopathology as mere self-help. Although effect sizes were below those usually found in (therapist-)guided self-help, myMCT could be of value for the large subgroup of individuals without treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hauschildt, Marit; Schroder, Johanna; Moritz, Steffen; Abramowitz, Alvarez-Jimenez, Andersson, Andersson, Andersson, Andersson, Beck, Belloch, Blanco, Carlbring, Carlbring, Cuijpers, Cuijpers, Demet, Depp, Eells, Fisher, Foa, Furlanetto, Gonzales, Goodman, Goodwin, Greist, Grist, Gunter, Haug, Hauschildt, Hedman, Herbst, Herbst, Hohagen, Jacobi, Jelinek, Kessler, Kinnear, Kobak, Kulz, Levy, MacLeod, Macy, Mancebo, Marks, Marques, Mataix-Cols, Mataix-Cols, Mayerovitch, Mayo-Wilson, Moritz, Moritz, Moritz, Moritz, Moritz, Moritz, Nordgreen, Olatunji, Olatunji, Riedel, Salkovskis, Salkovskis, Sheehan, Simonds, Skoog, Titov, Tolin, Torres, Voderholzer, Wahl, Wootton, Wootton, Wootton, Wootton, Wootton, Wootton",2016.0,,0,1,
620,Cognitive behaviour therapy (CBT) for anxiety and depression in adults with mild intellectual disabilities (ID): a pilot randomised controlled trial,"ER METHODSThirty participants with mild ID will be allocated randomly to either CBT or treatment as usual (TAU). The CBT group will receive up to 20 hourly individual CBT over a period of 4 months. TAU is the standard treatment which is available to any adult with an intellectual disability who is referred to the intellectual disability service (including care management, community support, medical, nursing or social support). Beck Youth Inventories (Beck Anxiety Inventory & Beck Depression Inventory) will be administered at baseline; end of treatment (4 months) and at six months to evaluate the changes in depression and anxiety. Client satisfaction, quality of life and the health economics will be secondary outcomes.DISCUSSIONThe broad outcome of the study will be to produce clear guidance for therapists to apply an established psychological intervention and identify how and whether it works with people with intellectual disabilities.TRIAL REGISTRATIONISRCTN: ISRCTN38099525.BACKGROUNDSeveral studies have showed that people with intellectual disabilities (ID) have suitable skills to undergo cognitive behavioural therapy (CBT). Case studies have reported successful use of cognitive behavioural therapy techniques (with adaptations) in people with ID. Modified cognitive behavioural therapy may be a feasible and effective approach for the treatment of depression, anxiety, and other mood disorders in ID. To date, two studies have reported group-based manaulised cognitive behavioural treatment programs for depression in people with mild ID. However, there is no individual manualised programme for anxiety or depression in people with intellectual disabilities. The aims of the study are to determine the feasibility of conducting a randomised controlled trial for CBT in people with ID. The data will inform the power calculation and other aspects of carrying out a definitive randomised controlled trial.","Hassiotis, A; Serfaty, M; Azam, K; Strydom, A; Martin, S; Parkes, C; Blizard, R; King, M",2011.0,10.1186/1745-6215-12-95,0,1,
621,"A cognitive-behavioural, group-based intervention for social anxiety in schizophrenia.","The objective of this study was to investigate the efficacy of group-based cognitive-behavioural therapy (CBT) for social anxiety in schizophrenia. Patients with schizophrenia (20) with comorbid social anxiety were randomly assigned to the group-based CBT or wait-list control condition. Pre-, post- and 6-week follow-up ratings included measures of social anxiety and avoidance, mood and quality of life. The intervention group improved on all outcome measures and the control group showed no change in symptomatology. Group-based CBT is effective in treating social anxiety in schizophrenia.",Halperin S.; Nathan P.; Drummond P.; Castle D.,2000.0,10.1080/j.1440-1614.2000.00820.x,0,1,
622,A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims.,"The purpose of this study was to compare cognitive-processing therapy (CPT) with prolonged exposure and a minimal attention condition (MA) for the treatment of posttraumatic stress disorder (PTSD) and depression. One hundred seventy-one female rape victims were randomized into 1 of the 3 conditions, and 121 completed treatment. Participants were assessed with the Clinician-Administered PTSD Scale, the PTSD Symptom Scale, the Structured Clinical Interview for DSM-IV, the Beck Depression Inventory, and the Trauma-Related Guilt Inventory. Independent assessments were made at pretreatment, posttreatment, and 3 and 9 months posttreatment. Analyses indicated that both treatments were highly efficacious and superior to MA. The 2 therapies had similar results except that CPT produced better scores on 2 of 4 guilt subscales.",Resick PA.; Nishith P.; Weaver TL.; Astin MC.; Feuer CA.,2002.0,,0,1,
623,Change in sleep symptoms across Cognitive Processing Therapy and Prolonged Exposure: a longitudinal perspective.,"Sleep disturbance is a core component in posttraumatic stress disorder (PTSD). Although cognitive-behavioral treatments for PTSD reduce the severity of sleep symptoms, they do not lead to complete remission. The present study examines the impact of Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) on subjective measures of sleep disturbance from treatment randomization through long-term follow-up (LTFU). Participants were 171 female rape victims with PTSD who were randomly assigned to CPT, PE, or Minimal Attention (MA). After 6-weeks, the MA group was randomized to CPT or PE. Sleep symptoms were assessed at baseline, post-MA, post-treatment, 3-months, 9-months and LTFU using the Pittsburgh Sleep Quality Index (PSQI) and nightmare and insomnia items from the Clinician Administered PTSD Scale. Change in sleep during MA, from pre- to post-treatment for CPT and PE, and from post-treatment through LTFU was assessed using piecewise hierarchical linear modeling with the intent-to-treat sample. Controlling for medication, sleep improved during CPT and PE compared to MA, and treatment gains were maintained through LTFU. CPT and PE were equally efficacious and improvements persist over LTFU, yet, neither produced remission of sleep disturbance. Overall, sleep symptoms do not remit and may warrant sleep-specific treatments.",Gutner CA.; Casement MD.; Stavitsky Gilbert K.; Resick PA.,2013.0,10.1016/j.brat.2013.09.008,0,1,
624,Change in sleep symptoms across Cognitive Processing Therapy and Prolonged Exposure: A longitudinal perspective.,"Sleep disturbance is a core component in posttraumatic stress disorder (PTSD). Although cognitive-behavioral treatments for PTSD reduce the severity of sleep symptoms, they do not lead to complete remission. The present study examines the impact of Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) on subjective measures of sleep disturbance from treatment randomization through long-term follow-up (LTFU). Participants were 171 female rape victims with PTSD who were randomly assigned to CPT, PE, or Minimal Attention (MA). After 6-weeks, the MA group was randomized to CPT or PE. Sleep symptoms were assessed at baseline, post-MA, post-treatment, 3-months, 9-months and LTFU using the Pittsburgh Sleep Quality Index (PSQI) and nightmare and insomnia items from the Clinician Administered PTSD Scale. Change in sleep during MA, from pre- to post-treatment for CPT and PE, and from post-treatment through LTFU was assessed using piecewise hierarchical linear modeling with the intent-to-treat sample. Controlling for medication, sleep improved during CPT and PE compared to MA, and treatment gains were maintained through LTFU. CPT and PE were equally efficacious and improvements persist over LTFU, yet, neither produced remission of sleep disturbance. Overall, sleep symptoms do not remit and may warrant sleep-specific treatments. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gutner, Cassidy A; Casement, Melynda D; Gilbert, Karina Stavitsky; Resick, Patricia A; Aderka, Babson, Babson, Belleville, Blake, Blechert, Bradley, Buysse, Buysse, Clum, Drummond, Fernandez-Mendoza, Foa, Gallagher, Galovski, Galovski, Germain, Harvey, Holland, Koren, Krakow, Kramer, Leskin, Liverant, Mellman, Milad, Miller, Mong, Nappi, Neylan, Nishith, Orr, Pace-Schott, Perlis, Raudenbush, Resick, Resick, Resick, Singer, Spoormaker, Stickgold, Takano, van der Helm, Wagner, Walker, Weathers, Zayfert",2013.0,,0,1,
625,"Psychotic depression, posttraumatic stress disorder, and engagement in cognitive-behavioral therapy within an outpatient sample of adults with serious mental illness.","Depression with psychotic features afflicts a substantial number of people and has been characterized by significantly greater impairment, higher levels of dysfunctional beliefs, and poorer response to psychopharmacologic and psychosocial interventions than nonpsychotic depression. Those with psychotic depression also experience a host of co-occurring disorders, including posttraumatic stress disorder (PTSD), which is not surprising given the established relationships between trauma exposure and increased rates of psychosis and between PTSD and major depression. To date, there has been very limited research on the psychosocial treatment of psychotic depression; and even less is known about those who also suffer from PTSD. The purpose of this study was to better understand the rates and clinical correlates of psychotic depression in those with PTSD. Clinical and symptom characteristics of 20 individuals with psychotic depression and 46 with nonpsychotic depression, all with PTSD, were compared before receiving cognitive-behavioral therapy for PTSD treatment or treatment as usual. Patients with psychotic depression exhibited significantly higher levels of depression and anxiety, a weaker perceived therapeutic alliance with their case managers, more exposure to traumatic events, and more negative beliefs related to their traumatic experiences, as well as increased levels of maladaptive cognitions about themselves and the world, compared with participants without psychosis. Implications for cognitive-behavioral therapy treatment aimed at dysfunctional thinking for this population are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gottlieb, Jennifer D; Mueser, Kim T; Rosenberg, Stanley D; Xie, Haiyi; Wolfe, Rosemarie S; Aronson, Beck, Beck, Blake, Briere, Calhoun, Carmen, Cascardi, Charney, Coryell, Coryell, Craine, Elkin, First, Foa, Franklin, Gaudiano, Gaudiano, Gaudiano, Gaudiano, Gaudiano, Gaudiano, Goodman, Green, Greenfield, Gruzelier, Hollon, Hollon, Horvath, Janssen, Johnson, Kastelan, Kessler, Lange, Lattuada, Lukoff, Marks, Mueser, Mueser, Mueser, Mueser, Mueser, Ohayon, Owens, Pratt, Read, Read, Resick, Rosenberg, Rothschild, Salyers, Schatzberg, Seedat, Shafer, Shalev, Shevlin, Stylianos, Switzer, Tarrier, Vega, Velligan, Ware, Whiffen, Wykes, Zimmerman",2011.0,,0,1,
626,"Psychotic depression, posttraumatic stress disorder, and engagement in cognitive-behavioral therapy within an outpatient sample of adults with serious mental illness","ER Depression with psychotic features afflicts a substantial number of people and has been characterized by significantly greater impairment, higher levels of dysfunctional beliefs, and poorer response to psychopharmacologic and psychosocial interventions than nonpsychotic depression. Those with psychotic depression also experience a host of co-occurring disorders, including posttraumatic stress disorder (PTSD), which is not surprising given the established relationships between trauma exposure and increased rates of psychosis and between PTSD and major depression. To date, there has been very limited research on the psychosocial treatment of psychotic depression; and even less is known about those who also suffer from PTSD. The purpose of this study was to better understand the rates and clinical correlates of psychotic depression in those with PTSD. Clinical and symptom characteristics of 20 individuals with psychotic depression and 46 with nonpsychotic depression, all with PTSD, were compared before receiving cognitive-behavioral therapy for PTSD treatment or treatment as usual. Patients with psychotic depression exhibited significantly higher levels of depression and anxiety, a weaker perceived therapeutic alliance with their case managers, more exposure to traumatic events, and more negative beliefs related to their traumatic experiences, as well as increased levels of maladaptive cognitions about themselves and the world, compared with participants without psychosis. Implications for cognitive-behavioral therapy treatment aimed at dysfunctional thinking for this population are discussed.","Gottlieb, J D; Mueser, K T; Rosenberg, S D; Xie, H; Wolfe, R S",2011.0,10.1016/j.comppsych.2010.04.012,0,1,
627,Effectiveness of a transdiagnostic internet-based protocol for the treatment of emotional disorders versus treatment as usual in specialized care: study protocol for a randomized controlled trial.,"Emotional disorders (depression and anxiety disorders) are highly prevalent mental health problems. Although evidence showing the effectiveness of disorder-specific treatments exists, high comorbidity rates among emotional disorders limit the utility of these protocols. This has led some researchers to focus their interest on transdiagnostic interventions, a treatment perspective that might be more widely effective across these disorders. Also, the current way of delivering treatments makes it difficult provide assistance to all of the population in need. The use of the Internet in the delivery of evidence-based treatments may help to disseminate treatments among the population. In this study, we aim to test the effectiveness of EmotionRegulation, a new transdiagnostic Internet-based protocol for unipolar mood disorders, five anxiety disorders (panic disorder, agoraphobia, social anxiety disorder, generalized anxiety disorder and anxiety disorder not otherwise specified), and obsessive-compulsive disorder in comparison to treatment as usual as provided in Spanish public specialized mental health care. We will also study its potential impact on basic temperament dimensions (neuroticism/behavioral inhibition and extraversion/behavioral activation). Expectations and opinions of patients about this protocol will also be studied. The study is a randomized controlled trial. 200 participants recruited in specialized care will be allocated to one of two treatment conditions: a) EmotionRegulation or b) treatment as usual. Primary outcome measures will be the BAI and the BDI-II. Secondary outcomes will include a specific measure of the principal disorder, and measures of neuroticism/behavioral inhibition and extraversion/behavioral activation. Patients will be assessed at baseline, post-treatment, and 3- and 12-month follow-ups. Intention to treat and per protocol analyses will be performed. Although the effectiveness of face-to-face transdiagnostic protocols has been investigated in previous studies, the number of published transdiagnostic Internet-based programs is still quite low. To our knowledge, this is the first randomized controlled trial studying the effectiveness of a transdiagnostic Internet-based treatment for several emotional disorders in public specialized care. Combining both a transdiagnostic approach with an Internet-based therapy format may help to decrease the burden of mental disorders, reducing the difficulties associated with disorder-specific treatments and facilitating access to people in need of treatment. Strengths and limitations are discussed. ClinicalTrials.gov NCT02345668 . Registered 27 July 2015.",González-Robles A.; García-Palacios A.; Baños R.; Riera A.; Llorca G.; Traver F.; Haro G.; Palop V.; Lera G.; Romeu JE.; Botella C.,2015.0,10.1186/s13063-015-1024-3,0,1,
628,Trajectories of change in emotion regulation and social anxiety during cognitive-behavioral therapy for social anxiety disorder.,"Cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD) may decrease social anxiety by training emotion regulation skills. This randomized controlled trial of CBT for SAD examined changes in weekly frequency and success of cognitive reappraisal and expressive suppression, as well as weekly intensity of social anxiety among patients receiving 16 weekly sessions of individual CBT. We expected these variables to (1) differ from pre-to-post-CBT vs. Waitlist, (2) have differential trajectories during CBT, and (3) covary during CBT. We also expected that weekly changes in emotion regulation would predict (4) subsequent weekly changes in social anxiety, and (5) changes in social anxiety both during and post-CBT. Compared to Waitlist, CBT increased cognitive reappraisal frequency and success, decreased social anxiety, but had no impact on expressive suppression. During CBT, weekly cognitive reappraisal frequency and success increased, whereas weekly expressive suppression frequency and social anxiety decreased. Weekly decreases in social anxiety were associated with concurrent increases in reappraisal success and decreases in suppression frequency. Granger causality analysis showed that only reappraisal success increases predicted decreases in subsequent social anxiety during CBT. Reappraisal success increases pre-to-post-CBT predicted reductions in social anxiety symptom severity post-CBT. The trajectory of weekly changes in emotion regulation strategies may help clinicians understand whether CBT is effective and predict decreases in social anxiety. ClinicalTrials.gov identifier: NCT00380731; http://www.clinicaltrials.gov/ct2/show/NCT00380731?term=social+anxiety+cognitive+behavioral+therapy+Stanford&rank=1 (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Goldin, Philippe R; Lee, Ihno; Ziv, Michal; Jazaieri, Hooria; Heimberg, Richard G; Gross, James J; Acarturk, Andersson, Barlow, Boden, Brown, Bruce, Butler, Campbell-Sills, Cheung, Clark, Clark, Di Nardo, Efron, Enders, Fresco, Goldin, Goldin, Goldin, Goldin, Goldin, Goldstein, Grant, Gross, Heimberg, Hertzog, Hoffart, Hofmann, Hofmann, Hofmann, Hope, Hope, Hox, Jazaieri, Kessler, Ledley, Leichsenring, Liebowitz, Little, MacCallum, Meredith, Moscovitch, Moscovitch, Muthen, Norton, Oldfield, Otto, Pierce, Piet, Raudenbush, Rytwinski, Smits, Snijders, Stangier, Stangier, Stein, Stein, Titov, Vogele, Werner, Willett, Yuen",2014.0,,0,1,
629,Trajectories of change in emotion regulation and social anxiety during cognitive-behavioral therapy for social anxiety disorder.,"Cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD) may decrease social anxiety by training emotion regulation skills. This randomized controlled trial of CBT for SAD examined changes in weekly frequency and success of cognitive reappraisal and expressive suppression, as well as weekly intensity of social anxiety among patients receiving 16 weekly sessions of individual CBT. We expected these variables to (1) differ from pre-to-post-CBT vs. Waitlist, (2) have differential trajectories during CBT, and (3) covary during CBT. We also expected that weekly changes in emotion regulation would predict (4) subsequent weekly changes in social anxiety, and (5) changes in social anxiety both during and post-CBT. Compared to Waitlist, CBT increased cognitive reappraisal frequency and success, decreased social anxiety, but had no impact on expressive suppression. During CBT, weekly cognitive reappraisal frequency and success increased, whereas weekly expressive suppression frequency and social anxiety decreased. Weekly decreases in social anxiety were associated with concurrent increases in reappraisal success and decreases in suppression frequency. Granger causality analysis showed that only reappraisal success increases predicted decreases in subsequent social anxiety during CBT. Reappraisal success increases pre-to-post-CBT predicted reductions in social anxiety symptom severity post-CBT. The trajectory of weekly changes in emotion regulation strategies may help clinicians understand whether CBT is effective and predict decreases in social anxiety. NCT00380731; http://www.clinicaltrials.gov/ct2/show/NCT00380731?term=social+anxiety+cognitive+behavioral+therapy+Stanford&rank=1.",Goldin PR.; Lee I.; Ziv M.; Jazaieri H.; Heimberg RG.; Gross JJ.,2014.0,10.1016/j.brat.2014.02.005,0,1,
630,Evaluation of a practice team-supported exposure training for patients with panic disorder with or without agoraphobia in primary care - study protocol of a cluster randomised controlled superiority trial.,"Panic disorder and agoraphobia are debilitating and frequently comorbid anxiety disorders. A large number of patients with these conditions are treated by general practitioners in primary care. Cognitive behavioural exposure exercises have been shown to be effective in reducing anxiety symptoms. Practice team-based case management can improve clinical outcomes for patients with chronic diseases in primary care. The present study compares a practice team-supported, self-managed exposure programme for patients with panic disorder with or without agoraphobia in small general practices to usual care in terms of clinical efficacy and cost-effectiveness. This is a cluster randomised controlled superiority trial with a two-arm parallel group design. General practices represent the units of randomisation. General practitioners recruit adult patients with panic disorder with or without agoraphobia according to the International Classification of Diseases, version 10 (ICD-10). In the intervention group, patients receive cognitive behaviour therapy-oriented psychoeducation and instructions to self-managed exposure exercises in four manual-based appointments with the general practitioner. A trained health care assistant from the practice team delivers case management and is continuously monitoring symptoms and treatment progress in ten protocol-based telephone contacts with patients. In the control group, patients receive usual care from general practitioners. Outcomes are measured at baseline (T0), at follow-up after six months (T1), and at follow-up after twelve months (T2). The primary outcome is clinical severity of anxiety of patients as measured by the Beck Anxiety Inventory (BAI). To detect a standardised effect size of 0.35 at T1, 222 patients from 37 general practices are included in each group. Secondary outcomes include anxiety-related clinical parameters and health-economic costs. Current Controlled Trials [http://ISCRTN64669297].",Gensichen J.; Hiller TS.; Breitbart J.; Teismann T.; Brettschneider C.; Schumacher U.; Piwtorak A.; König HH.; Hoyer H.; Schneider N.; Schelle M.; Blank W.; Thiel P.; Wensing M.; Margraf J.,2014.0,10.1186/1745-6215-15-112,0,1,
631,Cognitive-behavioral treatment of posttraumatic stress in patients with implantable cardioverter defibrillators: Results from a randomized controlled trial.,"Approximately 20% of patients with implantable cardioverter defibrillators (ICDs) suffer from posttraumatic stress disorder (PTSD) due to a history of cardiac arrest, device implantation, and ICD shock. There has been very little examination of treatment of PTSD symptoms in these patients. This study evaluated the effect of a specific cognitive-behavioral therapy (CBT) intervention for ICD patients with high levels of PTSD symptoms: a manualized program consisting of 8 telephone sessions with a trained counselor, a patient education book, and a stress management procedure on compact disc. Participants were 193 ICD patients, who were randomized to CBT or usual cardiac care (UCC) who completed self-report surveys at the time of recruitment and 6 and 12 months after initial measurement. Previous publication on the primary research evaluation questions reported that the CBT condition resulted in greater improvement on PTSD and depression symptoms than the UCC for the general population of ICD patients, but did not evaluate the effect on those with elevated symptoms of PTSD. The authors conducted secondary analyses of the effect of treatment on high and low PTSD symptom groups based on a cutoff for the Impact of Event Scale-Revised (Weiss & Marmar, 1997). Participants in the CBT group who had high symptoms experienced significantly greater symptom reduction from baseline to 12 months (d = 2.44, p = .021) than the UCC group (d = 1.12). Participants with low symptoms had small reductions regardless of group assignment (d = 0.16, p = .031). ICD-focused CBT was sufficient to produce a large, statistically significant reduction in PTSD symptoms in ICD patients with indications for treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ford, Jessica; Rosman, Lindsey; Wuensch, Karl; Irvine, Jane; Sears, Samuel F; Creamer, Dunbar, Habibovic, Hays, Irvine, Jacobson, Jacobson, Kao, Ladwig, Matchett, Resick, Santangeli, Sears, Shemesh, Weiss",2016.0,,0,1,
632,Effects of imaginal exposure to feared disasters in obsessive-compulsive checkers.,,Foa EB.; Steketee G.; Turner RM.; Fischer SC.,1980.0,,0,1,
633,"Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder.","The purpose of the study was to test the relative and combined efficacy of clomipramine and exposure and ritual prevention in the treatment of obsessive-compulsive disorder (OCD) in adults. Serotonin reuptake inhibitors (SRIs) and cognitive behavior therapy by exposure and ritual prevention are both established treatments for OCD, yet their relative and combined efficacy have not been demonstrated conclusively. A double-blind, randomized, placebo-controlled trial comparing exposure and ritual prevention, clomipramine, their combination (exposure and ritual prevention plus clomipramine), and pill placebo was conducted at one center expert in pharmacotherapy, another with expertise in exposure and ritual prevention, and a third with expertise in both modalities. Participants were adult outpatients (N=122 entrants) with OCD. Interventions included intensive exposure and ritual prevention for 4 weeks, followed by eight weekly maintenance sessions, and/or clomipramine administered for 12 weeks, with a maximum dose of 250 mg/day. The main outcome measures were the Yale-Brown Obsessive Compulsive Scale total score and response rates determined by the Clinical Global Impression improvement scale. At week 12, the effects of all active treatments were superior to placebo. The effect of exposure and ritual prevention did not differ from that of exposure and ritual prevention plus clomipramine, and both were superior to clomipramine only. Treated and completer response rates were, respectively, 62% and 86% for exposure and ritual prevention, 42% and 48% for clomipramine, 70% and 79% for exposure and ritual prevention plus clomipramine, and 8% and 10% for placebo. Clomipramine, exposure and ritual prevention, and their combination are all efficacious treatments for OCD. Intensive exposure and ritual prevention may be superior to clomipramine and, by implication, to monotherapy with the other SRIs.",Foa EB.; Liebowitz MR.; Kozak MJ.; Davies S.; Campeas R.; Franklin ME.; Huppert JD.; Kjernisted K.; Rowan V.; Schmidt AB.; Simpson HB.; Tu X.,2005.0,10.1176/appi.ajp.162.1.151,0,1,
634,Treatment outcome for chronic PTSD among female assault victims with borderline personality characteristics: a preliminary examination.,"The present study examined the effect of the presence of borderline personality disorder characteristics (BPC) on patients' responses to cognitive behavioral treatment for chronic PTSD. Seventy-two female victims of sexual and non-sexual assault were randomly assigned to one of four treatment conditions: prolonged exposure (PE), stress inoculation training (SIT), combined treatment (PE/SIT), and wait list control (WL). Treatment consisted of nine bi-weekly individual sessions. Seventeen percent of the patients met full (10%) or partial criteria (7%) for borderline personality disorder. A greater number of patients with BPC reported sexual assault in childhood compared to those without the symptomatology. Patients with BPC also reported more pre-treatment anger. In general, those with BPC benefited significantly from treatment, although at post-treatment, they were less likely to achieve good end-state functioning than those without such symptomatology. The relationship between BPC and treatment response will be discussed.",Feeny NC.; Zoellner LA.; Foa EB.,2002.0,,0,1,
635,The treatment of substance abusers diagnosed with obsessive-compulsive disorder: an outcome study.,"Sixty substance abusers dually diagnosed with obsessive-compulsive disorder (OCD) and voluntarily admitted to a drug-free therapeutic community were randomly assigned to one of three treatment conditions. One group received a combined intervention that addressed their obsessive-compulsive symptoms and substance abuse; a second group received only substance abuse treatment; and an attention control group received treatment for their substance abuse and training in progressive muscle relaxation. Patients who received treatment for their OCD and substance abuse stayed in treatment longer, showed greater reductions in OCD symptom severity, and had higher overall abstinence rates at 12-month follow-up.",Fals-Stewart W.; Schafer J.,1992.0,,0,1,
636,A comparison of behavioral group therapy and individual behavior therapy in treating obsessive-compulsive disorder.,"Outpatients with a primary DSM-III axis I diagnosis of obsessive-compulsive disorder (OCD: N = 93) were randomly assigned to one of three treatment groups: One group (N = 30) received 24 sessions of behavioral group therapy over a 12-week period; a second group (N = 31) received 24 individual behavior therapy sessions over the same treatment interval; and members of a control group (N = 32) received 24 individual sessions of progressive muscle relaxation. The Yale-Brown Obsessive-Compulsive Scale was administered before treatment at 2-week intervals during treatment, and at 6-month follow-up to measure changes in distress caused by OCD symptoms. The Beck Depression Inventory and the Self-Rating Anxiety Scale were also administered at pretreatment, posttreatment, and 6-month follow-up. Both individual and group interventions proved to be equally effective at reducing distress caused by OCD symptoms, general depression, and anxiety by the end of treatment, although patients in the individual behavior therapy condition demonstrated faster reductions in OCD symptom severity. Patients in the group and individual behavioral interventions were able to maintain their gains at 6-month follow-up. Implications of these findings for outpatient treatment are discussed.",Fals-Stewart W.; Marks AP.; Schafer J.,1993.0,,0,1,
637,A cognitive-behavioral group for patients with various anxiety disorders.,"Cognitive-behavioral therapy (CBT) protocols for each of the anxiety disorders are robust and effective but are best suited for specialty clinics. This study assessed a format more suitable for general clinics: a single protocol based on standard CBT techniques designed to treat patients who have different anxiety disorders in the same group. Potential participants in Vancouver, British Columbia, were administered a structured clinical interview to identify those with major anxiety disorders: panic disorder, with or without agoraphobia; obsessive-compulsive disorder; social phobia; generalized anxiety disorder; specific phobia; and posttraumatic stress disorder. Forty-three percent of participants had more than one current anxiety diagnosis. Those with active substance abuse or dependence or with psychosis were excluded. A total of 152 patients were randomly assigned to immediate treatment in the 11-week CBT group or to a wait-list control group. The Beck Anxiety Inventory (BAI) was administered at baseline, at the end of treatment or of the waiting period, and six months later. Reductions in BAI scores for participants in the immediate-treatment groups were greater than those for the control group participants. Patients with panic disorder in particular appeared to benefit. Outcomes for the immediate-treatment group were superior in terms of clinically significant changes, defined as a 20% or 40% improvement. Reductions in BAI scores continued to be present six months later. The improvements correspond to a medium effect size (Cohen's d=.50). A group CBT protocol for mixed anxiety disorders may make effective treatment more widely available.",Erickson DH.; Janeck AS.; Tallman K.,2007.0,10.1176/ps.2007.58.9.1205,0,1,
638,Delivery of self training and education for stressful situations (DESTRESS-PC): a randomized trial of nurse assisted online self-management for PTSD in primary care.,"This randomized controlled trial examined the effectiveness of a nurse assisted online cognitive-behavioral self-management intervention for war-related posttraumatic stress disorder (PTSD), compared to optimized usual primary care PTSD Treatment (OUC) to reduce PTSD symptoms. Participants were 80 veterans of recent military conflicts with PTSD as assessed by the PTSD Checklist (PCL) seeking primary care treatment at one of three Veterans Affairs (VA) and four Army clinics. DESTRESS-PC consisted of logins to a secure website three times per week for 6 weeks with monitoring by a study nurse. All participants received nurse care management in the form of phone check-ins every two weeks and feedback to their primary care providers. Blinded raters assessed outcomes 6, 12, and 18 weeks post-randomization. DESTRESS-PC was associated with a significantly greater decrease in PTSD symptoms compared to OUC (F(3, 186)=3.72, p=.012). The effect was largest at the 12-week assessment (∆PCL=12.6±16.6 versus 5.7±12.5, p<0.05) with the treatment effect disappearing by the 18-week follow-up. Notably, there was a dose effect; number of logins correlated significantly with PTSD outcomes, with more logins associated with greater PTSD symptom improvement. None of the secondary outcomes (depression, anxiety, somatic symptoms, and functional status) showed statistically significant improvement; however, the treatment effect on depression approached significance (F(3, 186)=2.17, p=.093). DESTRESS-PC shows promise as a means of delivering effective, early PTSD treatment in primary care. Larger trials are needed.",Engel CC.; Litz B.; Magruder KM.; Harper E.; Gore K.; Stein N.; Yeager D.; Liu X.; Coe TR.,,10.1016/j.genhosppsych.2015.04.007,0,1,59
639,Randomized controlled trial of transdiagnostic group treatments for primary care patients with common mental disorders.,"The purpose was to test the effectiveness of two transdiagnostic group interventions compared to care as usual (CAU) for patients with anxiety, depressive or stress-related disorders within a primary health care context. To compare the effects of cognitive-based-behavioural therapy (CBT) and multimodal intervention (MMI) on the quality of life and relief of psychological symptoms of patients with common mental disorders or problems attending primary health care centre. Patients (n = 278), aged 18-65 years, were referred to the study by the GPs and 245 were randomized to CAU or one of two group interventions in addition to CAU: (i) group CBT administered by psychologists and (ii) group MMI administered by assistant nurses. The primary outcome measure was the Mental Component Summary score of short form 36. Secondary outcome measures were Perceived Stress Scale and Self-Rating Scale for Affective Syndromes. The data were analysed using intention-to-treat with a linear mixed model. On the primary outcome measure, the mean improvement based on mixed model analyses across post- and follow-up assessment was significantly larger for the MMI group than for the CBT (4.0; P = 0.020) and CAU (7.5; P = .001) groups. Participants receiving CBT were significantly more improved than those in the CAU group. On four of the secondary outcome measures, the MMI group was significantly more improved than the CBT and CAU groups. The course of improvement did not differ between the CBT group and the CAU group on these measures. Transdiagnostic group treatment can be effective for patients with common mental disorders when delivered in a primary care setting. The group format and transdiagnostic approach fit well with the requirements of primary care.",Ejeby K.; Savitskij R.; Ost LG.; Ekbom A.; Brandt L.; Ramnerö J.; Asberg M.; Backlund LG.,2014.0,10.1093/fampra/cmu006,0,1,
640,A randomized trial of self-management and psychoeducational group therapies for comorbid chronic posttraumatic stress disorder and depressive disorder.,"The authors randomized 101 male veterans with chronic combat-related posttraumatic stress disorder (PTSD) and depressive disorder to an evidence-based depression treatment (self-management therapy; n = 51) or active-control therapy (n = 50). Main outcome measures for efficacy, using intention-to-treat analyses, were subjective and objective PTSD and depression scales at pretest, posttest, and 3-, 6-, and 12-month follow-up. Other measures included treatment compliance, satisfaction, treatment-targeted constructs, functioning, service utilization, and costs. Self-management therapy's modestly greater improvement on depression symptoms at treatment completion disappeared on follow-up. No other differences on symptoms or functioning appeared, although psychiatric outpatient utilization and overall outpatient costs were lower with self-management therapy. Despite success in other depressed populations, self-management therapy produced no clinically significant effect in depression with chronic PTSD.",Dunn NJ.; Rehm LP.; Schillaci J.; Souchek J.; Mehta P.; Ashton CM.; Yanasak E.; Hamilton JD.,2007.0,10.1002/jts.20214,0,1,
641,Stabilizing group treatment for complex posttraumatic stress disorder related to child abuse based on psychoeducation and cognitive behavioural therapy: A multisite randomized controlled trial.,"Background: Evidence-based treatments for complex post-traumatic stress disorder (PTSD) related to childhood abuse are scarce. This is the first randomized controlled trial to test the efficacy of psycho-educational and cognitive behavioural stabilizing group treatment in terms of both PTSD and complex PTSD symptom severity. Methods: Seventy-one patients with complex PTSD and severe comorbidity (e.g. 74% axis II comorbidity) were randomly assigned to either a 20-week group treatment in addition to treatment as usual or to treatment as usual only. Primary outcome measures were the Davidson Trauma Scale (DTS) for PTSD and the Structured Interview for Disorders of Extreme Stress (SIDES) for complex PTSD symptoms. Statistical analysis was conducted in the intention-to-treat (ITT) and in the completer sample. Subjects were considered responders when scoring at 20 weeks at least 1 standard deviation below pretest findings. Results: The 16% attrition was relatively low. After 20 weeks, the experimental condition (large effect sizes) and control condition (medium effect sizes) both showed significant decreases on the DTS and SIDES, but differences between the conditions were not significant. The secondary responder analysis (ITT) revealed significantly more responders on the DTS (45 vs. 21%), but not on the SIDES (61 vs. 42%). Conclusions: Adding psycho-educational and cognitive behavioural stabilizing group treatment for complex PTSD related to child abuse to treatment as usual showed an equivocal outcome. Patients in both conditions improved substantially during stabilizing treatment, and while significant superiority on change scores was absent, responder analysis suggested clinical meaningfulness of adding group treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H; van Balkom, Anton J. L. M; Veltman, Dick J; Hoogendoorn, Adriaan W; Draijer, Nel; Altman, Arntz, Belaise, Bernstein, Bisson, Bouma, Bradley, Burns, Chard, Cloitre, Cloitre, Cloitre, Cohen, Davidson, Dorrepaal, Dorrepaal, Dorrepaal, Draijer, First, Foa, Ford, Ford, Ford, Greeven, Herman, Jacobson, Kessler, Korsten, Lanius, Linehan, Lubin, Matsakis, McDonnagh, McKay, Meichenbaum, Mohr, Nishith, Pelcovitz, Peleikis, Pfohl, Resick, Resick, Rutherford, Schnyder, Steinberg, Taylor, Thomaes, van Der Kolk, van der Kolk, Wolfsdorf, Zlotnick, Zlotnick, Zlotnick",2012.0,,0,1,
642,Generalized anxiety disorder: A comparison of symptom change in adults receiving cognitive-behavioral therapy or applied relaxation.,"Objective: Generalized anxiety disorder (GAD) is characterized by excessive worry and somatic symptoms of anxiety (e.g., restlessness, muscle tension). Several psychological treatments lead to significant reductions in GAD symptoms by posttreatment. However, little is known about how GAD symptoms change over time. Our main goal was to examine how GAD symptoms changed in relation to one another during 2 distinct but efficacious psychological treatments: cognitive-behavioral therapy (CBT) and applied relaxation (AR). Specifically, we asked whether change in worry accounted for change over time in somatic anxiety (or the reverse) to the same degree in CBT and AR. Method: We examined data from 57 individuals with GAD enrolled in a randomized controlled trial. Self-report measures of worry and somatic anxiety were obtained daily during treatment. Results: Although the direction of influence between changes in worry and somatic anxiety was bidirectional to some extent in both treatments, a significant difference was also observed: Change in worry accounted for subsequent change in somatic anxiety to a greater extent in CBT than in AR. Conclusions: These findings allowed us to identify differences in a mechanism of change in GAD symptoms during 2 treatments and to provide some support for the idea that similarly efficacious treatments may produce symptom change via different mechanisms in a manner that is consistent with the theoretical rationales on which the treatments are based. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Donegan, Eleanor; Dugas, Michel J; Aderka, Andrews, Beck, Bernstein, Borkovec, Di Nardo, Dugas, Dugas, Dugas, Dugas, Dupuy, Gosselin, Kenny, Ladouceur, MacKinnon, Meyer, Moscovitch, Ost, Ost, Preacher, Raudenbush, Sheehan, Shrout",2012.0,,0,1,
643,Generalized anxiety disorder: a comparison of symptom change in adults receiving cognitive-behavioral therapy or applied relaxation.,"Generalized anxiety disorder (GAD) is characterized by excessive worry and somatic symptoms of anxiety (e.g., restlessness, muscle tension). Several psychological treatments lead to significant reductions in GAD symptoms by posttreatment. However, little is known about how GAD symptoms change over time. Our main goal was to examine how GAD symptoms changed in relation to one another during 2 distinct but efficacious psychological treatments: cognitive-behavioral therapy (CBT) and applied relaxation (AR). Specifically, we asked whether change in worry accounted for change over time in somatic anxiety (or the reverse) to the same degree in CBT and AR. We examined data from 57 individuals with GAD enrolled in a randomized controlled trial. Self-report measures of worry and somatic anxiety were obtained daily during treatment. Although the direction of influence between changes in worry and somatic anxiety was bidirectional to some extent in both treatments, a significant difference was also observed: Change in worry accounted for subsequent change in somatic anxiety to a greater extent in CBT than in AR. These findings allowed us to identify differences in a mechanism of change in GAD symptoms during 2 treatments and to provide some support for the idea that similarly efficacious treatments may produce symptom change via different mechanisms in a manner that is consistent with the theoretical rationales on which the treatments are based.",Donegan E.; Dugas MJ.,2012.0,10.1037/a0028132,0,1,
644,A randomized controlled clinical treatment trial for World Trade Center attack-related PTSD in disaster workers.,"This article describes a controlled clinical trial of cognitive-behavioral treatment (CBT) for disaster workers. Despite high rates of PTSD in disaster workers worldwide, there have been no randomized trials of PTSD treatment. Participants were randomly assigned to a 12-week cognitive-behavioral exposure treatment (CBT, N = 15) or a treatment-as-usual (N = 16) condition. Eight CBT and 14 treatment-as-usual participants completed treatment. An ANOVA examining changes in Clinician-Administered PTSD Scale scores found significant main effects of Time, Group, and a Time x Group interaction (p's < 0.010) with a significantly greater decline in symptom scores in the CBT group. Between-group effect sizes were large. Dropout was associated with lower income, less education, and higher alcohol consumption. This project demonstrates the feasibility of recruitment in the aftermath of a catastrophic event, the relevance of a brief focused intervention comprised of CBT and exposure, and the need to eliminate barriers to treatment retention associated with income and education.",Difede J.; Malta LS.; Best S.; Henn-Haase C.; Metzler T.; Bryant R.; Marmar C.,2007.0,10.1097/NMD.0b013e3181568612,0,1,
645,One-session cognitive treatment of dental phobia: preparing dental phobics for treatment by restructuring negative cognitions.,"The purpose of this study was to investigate the effectiveness of a single session of cognitive restructuring in a sample of phobic dental patients. Fifty-two patients were randomly assigned to one of three conditions: cognitive restructuring (modification of negative cognitions), provision of information (about oral health and dental treatment), and a waiting list control condition. Both interventions maximally lasted one hour. In comparison with the waiting list control condition and the information intervention condition, the cognitive intervention condition not only showed a large decrease in frequency and believability of negative cognitions, but also exhibited a clear decline in dental trait anxiety. Analysis at a follow-up of one year demonstrated a further, drastic reduction in dental anxiety in both intervention conditions, wherein the difference among these conditions was not maintained. It is concluded that it is possible to obtain substantial reductions of dental trait anxiety through a single session of cognitive restructuring. Nevertheless, repeated exposure to the dental situation seems necessary for a further reduction of anxiety.",de Jongh A.; Muris P.; ter Horst G.; van Zuuren F.; Schoenmakers N.; Makkes P.,1995.0,,0,1,
646,Imagery rescripting and eye movement desensitisation and reprocessing for treatment of adults with childhood trauma-related post-traumatic stress disorder: IREM study design.,"Background: Post-traumatic stress disorder (PTSD) that originates from childhood trauma experiences can develop into a chronic condition that has lasting effects on an individual's functioning and quality of life. While there are evidence-based guidelines for treating adult onset PTSD, treatments for adults with childhood trauma-related PTSD (Ch-PTSD) are varied and subject to ongoing debate. This study will test the effectiveness of two trauma-focused treatments, imagery rescripting (ImRs) and eye movement desensitisation and reprocessing (EMDR) in participants with Ch-PTSD. Both have been found effective in treatment of adult PTSD or mixed onset PTSD and previous research indicates they are well-tolerated treatments. However, we know less about their effectiveness for treating Ch-PTSD or their underlying working mechanisms. Methods: IREM is an international multicentre randomised controlled trial involving seven sites across Australia, Germany and the Netherlands. We aim to recruit 142 participants (minimum of n = 20 per site), who will be randomly assigned to treatment condition. Assessments will be conducted before treatment until 1-year follow-up. Assessments before and after the waitlist will assess change in time only. The primary outcome measure is change in PTSD symptom severity from pre-treatment to 8-weeks post-treatment. Secondary outcome measures include change in severity of depression, anger, trauma-related cognitions, guilt, shame, dissociation and quality of life. Underlying mechanisms of treatment will be assessed on changes in vividness, valence and encapsulated belief of a worst trauma memory. Additional sub-studies will include qualitative investigation of treatment experiences from the participant and therapists' perspective, changes in memory and the impact of treatment fidelity on outcome measures. Discussion: The primary aims of this study are to compare the effectiveness of EMDR and ImRs in treating Ch-PTSD and to investigate the underlying working mechanisms of the two treatments. The large-scale international design will make a significant contribution to our understanding of how these treatments address the needs of individuals with Ch-PTSD and therefore, potentially improve their effectiveness. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","de Haan, Katrina L. Boterhoven; Lee, Christopher W; Fassbinder, Eva; Voncken, Marisol J; Meewisse, Mariel; Van Es, Saskia M; Menninga, Simone; Kousemaker, Margriet; Arntz, Arnoud; Alliger-Horn, Andrade, Andrews, Arntz, Arntz, Arntz, Arntz, Arntz, Beck, Bisson, Bohus, Cloitre, Cloitre, Cloitre, Cloitre, Courtois, de Jongh, Derogatis, Dibbets, Dorrepaal, Dorrepaal, Edmond, Edmond, Ehring, Engelhard, First, Foa, Hackmann, Hornsveld, Korn, Korn, Kubany, Lee, Lee, Lee, Leer, Lobbestael, McDonagh, Morina, Raabe, Resick, Rogers, Scheck, Seidler, Shapiro, Shapiro, Sheehan, Slofstra, Spinazzola, van den Hout, van Elderen, van Minnen, van Minnen, Vissers, Waller, Weathers, Weathers, Weiss, Wild, Wolfsdorf, Oktedalen",2017.0,,0,1,
647,Emotion beliefs and cognitive behavioural therapy for social anxiety disorder.,"Despite strong support for the efficacy of cognitive behavioural therapy (CBT) for social anxiety disorder (SAD), little is known about mechanisms of change in treatment. Within the context of a randomized controlled trial of CBT, this study examined patients' beliefs about the fixed versus malleable nature of anxiety-their 'implicit theories'-as a key variable in CBT for SAD. Compared to waitlist (n = 29; 58% female), CBT (n = 24; 52% female) led to significantly lower levels of fixed beliefs about anxiety (Mbaseline = 11.70 vs. MPost = 7.08, d = 1.27). These implicit beliefs indirectly explained CBT-related changes in social anxiety symptoms (κ(2) = .28, [95% CI = 0.12, 0.46]). Implicit beliefs also uniquely predicted treatment outcomes when controlling for baseline social anxiety and other kinds of maladaptive beliefs (perceived social costs, perceived social self-efficacy, and maladaptive interpersonal beliefs). Finally, implicit beliefs continued to predict social anxiety symptoms at 12 months post-treatment. These findings suggest that changes in patients' beliefs about their emotions may play an important role in CBT for SAD.",De Castella K.; Goldin P.; Jazaieri H.; Heimberg RG.; Dweck CS.; Gross JJ.,2015.0,10.1080/16506073.2014.974665,0,1,
648,Randomized clinical trial for treatment of chronic nightmares in trauma-exposed adults.,"Nightmares and sleep disturbance are fundamental concerns for victims of trauma. This study examined the efficacy of a manualized cognitive-behavioral treatment (CBT) for chronic nightmares in trauma-exposed individuals via a randomized clinical trial. Participants were randomly assigned to a treatment group or wait-list control group, with 27 participants completing the treatment. At the 6-month follow-up assessment, 84% of treated participants reported an absence of nightmares in the previous week. Significant decreases were also reported in symptoms of depression and posttraumatic stress, fear of sleep, and number of sleep problems, while sleep quality and quantity improved. The present study adds to the growing literature indicating this brief CBT as a first-line treatment for trauma-exposed individuals with chronic nightmares.",Davis JL.; Wright DC.,2007.0,10.1002/jts.20199,0,1,
649,"Fluoxetine, comprehensive cognitive behavioral therapy, and placebo in generalized social phobia.","Generalized social phobia is common, persistent, and disabling and is often treated with selective serotonin reuptake inhibitor drugs or cognitive behavioral therapy. We compared fluoxetine (FLU), comprehensive cognitive behavioral group therapy (CCBT), placebo (PBO), and the combinations of CCBT/FLU and CCBT/PBO. Randomized, double-blind, placebo-controlled trial. Two academic outpatient psychiatric centers. Subjects meeting a primary diagnosis of generalized social phobia were recruited via advertisement. Seven hundred twenty-two were screened, and 295 were randomized and available for inclusion in an intention-to-treat efficacy analysis; 156 (52.9%) were male, 226 (76.3%) were white, and mean age was 37.1 years. Treatment lasted for 14 weeks. Fluoxetine and PBO were administered at doses from 10 mg/d to 60 mg/d (or equivalent). Group comprehensive cognitive behavioral therapy was administered weekly for 14 sessions. An independent blinded evaluator assessed response with the Brief Social Phobia Scale and Clinical Global Impressions scales as primary outcomes. A videotaped behavioral assessment served as a secondary outcome, using the Subjective Units of Distress Scale. Adverse effects were measured by self-rating. Each treatment was compared by means of chi2 tests and piecewise linear mixed-effects models. Clinical Global Impressions scales response rates in the intention-to-treat sample were 29 (50.9%) (FLU), 31 (51.7%) (CCBT), 32 (54.2%) (CCBT/FLU), 30 (50.8%) (CCBT/PBO), and 19 (31.7%) (PBO), with all treatments being significantly better than PBO. On the Brief Social Phobia Scale, all active treatments were superior to PBO. In the linear mixed-effects models analysis, FLU was more effective than CCBT/FLU, CCBT/PBO, and PBO at week 4; CCBT was also more effective than CCBT/FLU and CCBT/PBO. By the final visit, all active treatments were superior to PBO but did not differ from each other. Site effects were found for the Subjective Units of Distress Scale assessment, with FLU and CCBT/FLU superior to PBO at Duke University Medical Center, Durham, NC. Treatments were well tolerated. All active treatments were superior to PBO on primary outcomes. Combined treatment did not yield any further advantage. Notwithstanding the benefits of treatment, many patients remained symptomatic after 14 weeks.",Davidson JR.; Foa EB.; Huppert JD.; Keefe FJ.; Franklin ME.; Compton JS.; Zhao N.; Connor KM.; Lynch TR.; Gadde KM.,2004.0,10.1001/archpsyc.61.10.1005,0,1,
650,The cognitive dismantling of Eye Movement Desensitization and Reprocessing (EMDR) treatment of posttraumatic stress disorder (PTSD).,"27 Ss (aged 18-51 yrs) were exposed to standard EMDR treatment or a similar treatment without the explicit cognitive elements found in EMDR. Standardized psychometric assessments were administered (Structured Interview for Post Traumatic Stress Disorder, Impact of Event Scale, Revised Symptom Checklist-90) by independent assessors at pretest, posttest, and 2 separate follow-up periods. Potential Ss met specific inclusion/exclusion criteria. Subjective measures including Subjective Units of Disturbance and Validity of Cognition assessments were also conducted. A 2-factor repeated measures ANOVA revealed that both treatments produced significant symptom reductions and were comparable on all dependent measures across assessment phases. The present findings are discussed in light of previous dismantling research that converges to suggest that several elements in the EMDR protocol may be superfluous in terms of the contribution to treatment outcome. These same elements have nevertheless entered unparsimoniously into consideration as possible explanatory variables. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cusack, Karen; Spates, C. Richard",1999.0,,0,1,
651,The cognitive dismantling of Eye Movement Desensitization and Reprocessing (EMDR) treatment of Posttraumatic Stress Disorder (PTSD).,"Twenty-seven subjects were exposed to standard Eye Movement Desensitization and Reprocessing (EMDR) treatment or a similar treatment without the explicit cognitive elements found in EMDR. Standardized psychometric assessments were administered (Structured Interview for Post Traumatic Stress Disorder, Impact of Event Scale, Revised Symptom Checklist-90) by independent assessors at pretest, posttest and two separate follow-up periods. Potential subjects met specific inclusion/exclusion criteria. Subjective measures including Subjective Units of Disturbance and Validity of Cognition assessments were also conducted. A two-factor repeated measures analysis of variance revealed that both treatments produced significant symptom reductions and were comparable on all dependent measures across assessment phases. The present findings are discussed in light of previous dismantling research that converges to suggest that several elements in the EMDR protocol may be superfluous in terms of the contribution to treatment outcome. These same elements have nevertheless entered unparsimoniously into consideration as possible explanatory variables.",Cusack K.; Spates CR.,,,0,1,
652,Panic control treatment for agoraphobia.,"The goal of the present study was to compare the efficacy of cognitive-behavioral treatment for panic control alone versus this treatment containing an additional in vivo exposure component. The sample was comprised of 68 individuals who met diagnosis for panic disorder with agoraphobia. Participants were randomly assigned to one of two 16-week treatment conditions, panic control only and panic control with in vivo exposure. Assessments were repeated at baseline, mid-treatment, posttreatment, and 6-month follow-up using diagnostic and behavioral measures. Results indicated that the two treatment conditions were equally efficacious for both panic disorder and agoraphobia. The intervention explicitly targeting agoraphobia appeared superfluous given the efficacy of panic control alone. On the other hand, reduction in panic frequency predicted reduction in agoraphobic avoidance overall. The practical and theoretical implications are discussed, as are limitations and directions for future research.",Craske MG.; DeCola JP.; Sachs AD.; Pontillo DC.,2003.0,,0,1,
653,Brief trauma intervention with Rwandan genocide-survivors using thought field therapy.,"This randomized waitlist control study examined the efficacy of Thought Field Therapy (TFT) in reducing Posttraumatic Stress Disorder symptoms in survivors of the 1994 genocide in Rwanda. Participants included 145 adult genocide survivors randomly assigned to an immediate TFT treatment group or a waitlist control group. Group differences adjusted for pretest scores and repeated measures anovas were statistically significant at p < .001 for 9 of 10 TSI trauma subscales and for both severity and frequency on the MPSS, with moderate to large effect sizes. Reduced trauma symptoms for the group receiving TFT were found for all scales. Reductions in trauma symptoms were sustained at a 2-year follow-up assessment. Limitations, clinical implications, and future research are discussed.",Connolly S.; Sakai C.,2011.0,,0,1,
654,"Intimate partner violence outcomes in women with PTSD and substance use: a secondary analysis of NIDA Clinical Trials Network ""Women and Trauma"" Multi-site Study.","Studies have shown strong associations between intimate partner violence (IPV) and both posttraumatic stress disorder (PTSD) and substance use disorders (SUD). Despite these linkages, research on the dual diagnosis of PTSD-SUD and its relationship to IPV is in an early stage, and little is known about how PTSD-SUD treatment might influence IPV outcomes. The current study is a secondary analysis of a larger NIDA Clinical Trials Network study exploring the effectiveness of two behavioral interventions for women with comorbid PTSD-SUD. Participants (n=288) were randomly assigned to Seeking Safety (SS), a cognitive-behavioral treatment that focuses on trauma and substance abuse symptoms, or to Women's Health Education, a psychoeducational group. Logistic regressions were used to examine how treatment condition, identified risk factors and their interactions were related to IPV. Results showed that participants who were abstinent at baseline were significantly less likely to experience IPV over the 12-month follow-up period, whereas participants living with someone with an alcohol problem were significantly more likely to experience IPV over follow-up. Findings also showed that at a trend level participants with recent interpersonal trauma at baseline and higher total of lifetime trauma exposures were more likely to report IPV during follow-up. Although there was no main effect for treatment condition, a significant interaction between treatment condition and baseline abstinence was found. Participants who were abstinent at baseline and in the SS condition were significantly less likely to report IPV over follow-up. These findings indicate that an integrated treatment for PTSD and SUD was associated with significantly better IPV outcomes for a subset of individuals. The possibility that women with PTSD-SUD may differentially benefit from SS has important clinical implications. Further research examining the intersection of PTSD, SUD and IPV, and the impact of treatment on a range of outcomes is needed.",Cohen LR.; Field C.; Campbell AN.; Hien DA.,2013.0,10.1016/j.addbeh.2013.03.006,0,1,
655,Trauma-focused exposure therapy for chronic posttraumatic stress disorder in alcohol and drug dependent patients: A randomized controlled trial.,"To test whether a modified version of prolonged exposure (mPE) can effectively treat posttraumatic stress disorder (PTSD) in individuals with co-occurring PTSD and substance dependence, an efficacy trial was conducted in which substance dependent treatment-seekers with PTSD (N = 126, male = 54.0%, White = 79.4%) were randomly assigned to mPE, mPE + trauma-focused motivational enhancement session (mPE + MET-PTSD), or a health information-based control condition (HLS). All participants were multiply traumatized; the median number of reported traumas that satisfied DSM-IV Criterion A for PTSD was 8. Treatment consisted of 9-12 60-min individual therapy sessions plus substance abuse treatment-as-usual. Participants were assessed at baseline, end-of-treatment, and at 3- and 6-months posttreatment. Both the mPE and mPE + MET-PTSD conditions achieved significantly better PTSD outcome than the control condition. The mPE + MET-PTSD and mPE conditions did not differ from one another on PTSD symptoms at end of treatment, 3-, or 6-month follow-up. Substance use outcomes did not differ between groups with all groups achieving 85.7%-97.9% days abstinent at follow-up. In regard to clinically significant improvement in trauma symptoms, 75.8% of the mPE participants, 60.0% of the mPE + MET-PTSD participants, and 44.4% of the HLS participants experienced clinically significant improvement at the end-of-treatment. Results indicate mPE, with or without an MET-PTSD session, can effectively treat PTSD in patients with co-occurring PTSD and substance dependence. In addition, mPE session lengths may better suit standard clinical practice and are associated with medium effect sizes. (PsycINFO Database Record",Coffey SF.; Schumacher JA.; Nosen E.; Littlefield AK.; Henslee AM.; Lappen A.; Stasiewicz PR.,2016.0,10.1037/adb0000201,0,1,
656,A multi-site single-blind clinical study to compare the effects of STAIR Narrative Therapy to treatment as usual among women with PTSD in public sector mental health settings: study protocol for a randomized controlled trial.,"This article provides a description of the rationale, design, and methods of a multisite clinical trial which evaluates the potential benefits of an evidence-based psychosocial treatment, STAIR Narrative Therapy, among women with posttraumatic stress disorder (PTSD) related to interpersonal violence who are seeking services in public sector community mental health clinics. This is the first large multisite trial of an evidence-based treatment for PTSD provided in the context of community settings that are dedicated to the treatment of poverty-level patient populations. The study is enrolling 352 participants in a minimum of 4 community clinics. Participants are randomized into either STAIR Narrative Therapy or Treatment As Usual (TAU). Primary outcomes are PTSD, emotion management and interpersonal problems. The study will allow a flexible application of the protocol determined by patient need and preferences. Secondary analyses will assess the relationship of outcomes to different patterns of treatment implementation for different levels of baseline symptom severity. The article discusses the rationale and study issues related to the use of a flexible delivery of a protocol treatment and of the selection of treatment as it is actually practiced in the community as the comparator. Clinicaltrials.gov identifier: NCT01488539.",Cloitre M.; Henn-Haase C.; Herman JL.; Jackson C.; Kaslow N.; Klein C.; Mendelsohn M.; Petkova E.,2014.0,10.1186/1745-6215-15-197,0,1,
657,A comparison of trauma-focused and present-focused group therapy for survivors of childhood sexual abuse: A randomized controlled trial.,"This randomized controlled trial compared trauma-focused group psychotherapy (TFGT) with present-focused group psychotherapy (PFGT) and a waitlist condition for 166 survivors of childhood sexual abuse who were at risk for HIV infection. Primary outcomes included risk for HIV infection (based on sexual revictimization, drug and alcohol use, and risky sex) and posttraumatic stress disorder (PTSD) symptoms. It was hypothesized that TFGT would be superior to the PFGT and waitlist conditions and that receiving either treatment (combining both TFGT and PFGT) would be superior to no treatment (waitlist condition). Intention-to-treat analyses for HIV risk found that all conditions reduced risk; however, there was no effect for condition on HIV risk. Intention-to-treat analyses for PTSD symptoms found a reduction for all conditions. There was no advantage for either TFGT or PFGT in reducing PTSD symptoms; however, there was an effect for treatment compared with the waitlist condition. On secondary outcomes, there was a greater reduction in anger for TFGT compared with PFGT, and when comparing treatment with the waitlist condition, there was a greater reduction in hyperarousal, reexperiencing, anger, and impaired self-reference for the treatment condition. Adequate dose analyses generally confirmed the intention-to-treat findings and additionally found that treatment led to reductions in depression, dissociation, and sexual concerns. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Classen, Catherine C; Palesh, Oxana Gronskaya; Cavanaugh, Courtenay E; Koopman, Cheryl; Kaupp, Jennifer W; Kraemer, Helena C; Aggarwal, Rashi; Spiegel, David; Alexander, Arriola, Benish, Bradley, Briere, Classen, Classen, DiLillo, First, Heath, Herman, Herman, Horowitz, Huba, Kessler, Koopman, Koss, Koss, Lau, Leonard, Meyer-Bahlburg, Molnar, Morrill, Murray, Rees, Roche, Rodriguez, Rotheram-Borus, Schnurr, Seligman, Senn, Shipman, Sikkema, Sikkema, Spiegel, Stalker, Tedeschi, Testa, Tucker, Weathers, Weiss, Wyatt, Zierler, Zlotnick",2011.0,,0,1,
658,Cognitive therapy versus fluoxetine in generalized social phobia: a randomized placebo-controlled trial.,"Sixty patients meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.: American Psychiatric Association, 1994) criteria for generalized social phobia were assigned to cognitive therapy (CT), fluoxetine plus self-exposure (FLU + SE), or placebo plus self-exposure (PLA + SE). At posttreatment (16 weeks), the medication blind was broken. CT and FLU + SE patients then entered a 3-month booster phase. Assessments were at pretreatment, midtreatment, posttreatment, end of booster phase, and 12-month follow-up. Significant improvements were observed on most measures in all 3 treatments. On measures of social phobia, CT was superior to FLU + SE and PLA + SE at midtreatment and at posttreatment. FLU + SE and PLA + SE did not differ. CT remained superior to FLU + SE at the end of the booster period and at 12-month follow-up. On general mood measures, there were few differences between the treatments",Clark DM.; Ehlers A.; McManus F.; Hackmann A.; Fennell M.; Campbell H.; Flower T.; Davenport C.; Louis B.,2003.0,10.1037/0022-006X.71.6.1058,0,1,
659,Internet-based treatment for Romanian adults with panic disorder: protocol of a randomized controlled trial comparing a Skype-guided with an unguided self-help intervention (the PAXPD study).,"Efficacy of self-help internet-based cognitive behavior therapy (ICBT) for anxiety disorders has been confirmed in several randomized controlled trials. However, the amount and type of therapist guidance needed in ICBT are still under debate. Previous studies have shown divergent results regarding the role of therapist guidance and its impact on treatment outcome. This issue is central to the development of ICBT programs and needs to be addressed directly. The present study aims to compare the benefits of regular therapist guidance via online real-time audio-video communication (i.e. Skype) to no therapist guidance during a 12-week Romanian self-help ICBT program for Panic Disorder. Both treatments are compared to a waiting-list control group. A parallel group randomized controlled trial is proposed. The participants, 192 Romanian adults fulfilling diagnostic criteria for panic disorder according to a diagnostic interview, conducted via secured Skype or telephone, are randomly assigned to one of the three conditions: independent use of the internet-based self-help program PAXonline, the same self-help treatment with regular therapist support via secured Skype, and waiting-list control group. The primary outcomes are severity of self-report panic symptoms (PDSS-SR) and diagnostic status (assessors are blind to group assignment), at the end of the intervention (12 weeks) and at follow-up (months 3 and 6). The secondary measures address symptoms of comorbid anxiety disorders, depression, quality of life, adherence and satisfaction with ICBT. Additional measures of socio-demographic characteristics, personality traits, treatment expectancies, catastrophic cognitions, body vigilance and working alliance are considered as potential moderators and/ or mediators of treatment outcome. To the best of our knowledge, the present study is the first effort to investigate the efficacy of a self-help internet-based intervention with therapist guidance via real-time video communication. A direct comparison between therapist guided versus unguided self-directed intervention for panic disorder will also be addressed for the first time. Findings from this study will inform researchers and practitioners about the added value of online video-therapy guidance sessions and the type of patients who may benefit the most from guided and unguided ICBT for Panic disorder. ACTRN12614000547640 (Australian New Zealand Clinical Trials Registry). Registered 22/05/2014.",Ciuca AM.; Berger T.; Crişan LG.; Miclea M.,2016.0,10.1186/s12888-016-0709-9,0,1,
660,Psychological trauma symptom improvement in veterans using emotional freedom techniques: a randomized controlled trial.,"This study examined the effect of Emotional Freedom Techniques (EFT), a brief exposure therapy combining cognitive and somatic elements, on posttraumatic stress disorder (PTSD) and psychological distress symptoms in veterans receiving mental health services. Veterans meeting the clinical criteria for PTSD were randomized to EFT (n = 30) or standard of care wait list (SOC/WL; n = 29). The EFT intervention consisted of 6-hour-long EFT coaching sessions concurrent with standard care. The SOC/WL and EFT groups were compared before and after the intervention (at 1 month for the SOC/WL group and after six sessions for the EFT group). The EFT subjects had significantly reduced psychological distress (p < 0.0012) and PTSD symptom levels (p < 0.0001) after the test. In addition, 90% of the EFT group no longer met PTSD clinical criteria, compared with 4% in the SOC/WL group. After the wait period, the SOC/WL subjects received EFT. In a within-subjects longitudinal analysis, 60% no longer met the PTSD clinical criteria after three sessions. This increased to 86% after six sessions for the 49 subjects who ultimately received EFT and remained at 86% at 3 months and at 80% at 6 months. The results are consistent with that of other published reports showing EFT's efficacy in treating PTSD and comorbid symptoms and its long-term effects.",Church D.; Hawk C.; Brooks AJ.; Toukolehto O.; Wren M.; Dinter I.; Stein P.,2013.0,10.1097/NMD.0b013e31827f6351,0,1,
661,Protocol for a randomised controlled trial investigating the effectiveness of an online e-health application compared to attention placebo or sertraline in the treatment of generalised anxiety disorder.,"Generalised anxiety disorder (GAD) is a high prevalence, chronic psychiatric disorder which commonly presents early in the lifespan. Internet e-health applications have been found to be successful in reducing symptoms of anxiety and stress for post traumatic stress disorder (PTSD), panic disorder, social phobia and depression. However, to date, there is little evidence for the effectiveness of e-health applications in adult GAD. There are no studies which have directly compared e-health applications with recognised evidence-based medication. This study aims to determine the effectiveness of a web-based program for treating GAD relative to sertraline and attention placebo. 120 community-dwelling participants, aged 18-30 years with a clinical diagnosis of GAD will be recruited from the Australian Electoral Roll. They will be randomly allocated to one of three conditions: (i) an online treatment program for GAD, E-couch (ii) pharmacological treatment with a selective serotonin re-uptake inhibitor (SSRI), sertraline (a fixed-flexible dose of 25-100 mg/day) or (iii) an attention control placebo, HealthWatch. The treatment program will be completed over a 10 week period with a 12 month follow-up. As of February 2010, there were no registered trials evaluating the effectiveness of an e-health application for GAD for young adults. Similarly to date, this will be the first trial to compare an e-health intervention with a pharmacological treatment. Current Controlled Trials ISRCTN76298775.",Christensen H.; Guastella AJ.; Mackinnon AJ.; Griffiths KM.; Eagleson C.; Batterham PJ.; Kalia K.; Kenardy J.; Bennett K.; Hickie IB.,2010.0,10.1186/1745-6215-11-48,0,1,
662,Suitability and acceptability of computerised cognitive behaviour therapy for anxiety disorders in secondary care.,"To evaluate the suitability and acceptability of computerised cognitive behaviour therapy (CCBT). Participants were patients who had been referred to a secondary care service in the usual manner, and then offered participation in a randomised controlled trial comparing the efficacy of CCBT with a control condition (waitlist) for patients with a current primary diagnosis of generalised anxiety disorder, panic disorder or social phobia. Data were collected regarding the recruitment and retention of patients, and patient ratings (anchored Likert scales) of treatment credibility, treatment satisfaction, treatment acceptability and telephone support. A total of 1141 referrals were received by the secondary care service. Of the 1141, 748 (66%) were not suitable for the study, 178 (16%) declined to participate and 127 (11%) were not contactable. Therefore, of the 1141 patients referred to the secondary care service, only 88 patients (8%) were eligible and consenting for the study. The single most common reason for patients not being suitable for the study was that the referral was urgent. In a clinical setting where CCBT could be used alongside clinical management, many of these patients may have been suitable for CCBT. Of the patients randomised to treatment (n = 40), 65% completed treatment. Drop-out rates were not significantly different across diagnostic groups. The single most commonly cited reason for not completing treatment was 'too busy'. Patient ratings of treatment were typically favourable (credibility, satisfaction, acceptability and telephone support). CCBT was typically rated favourably by patients referred to a secondary care service and randomised to treatment. However, only a small minority of patients was eligible and consenting for the trial. Therefore, while CCBT may be an acceptable treatment, its suitability for secondary care settings remains unclear.",Carter FA.; Bell CJ.; Colhoun HC.,2013.0,10.1177/0004867412461384,0,1,
663,Online attention modification for social anxiety disorder: Replication of a randomized controlled trial.,"Social anxiety disorder (SAD) models posit vigilance for external social threat cues and exacerbated self-focused attention as key in disorder development and maintenance. Evidence indicates a modified dot-probe protocol may reduce symptoms of SAD; however, the efficacy when compared to a standard protocol and long-term maintenance of treatment gains remains unclear. Furthermore, the efficacy of such protocols on SAD-related constructs remains relatively unknown. The current investigation clarified these associations using a randomized control trial replicating and extending previous research. Participants with SAD (n = 113; 71% women) were randomized to complete a standard (i.e. control) or modified (i.e. active) dot-probe protocol consisting of 15-min sessions twice weekly for four weeks. Self-reported symptoms were measured at baseline, post-treatment, and 4-month and 8-month follow-ups. Hierarchical linear modeling indicated significant self-reported reductions in symptoms of social anxiety, fear of negative evaluation, trait anxiety, and depression, but no such reductions in fear of positive evaluation. Symptom changes did not differ based on condition and were maintained at 8-month follow-up. Attentional biases during the dot-probe task were not related to symptom change. Overall, our results replicate support for the efficacy of both protocols in reducing symptoms of SAD and specific related constructs, and suggest a role of exposure, expectancy, or practice effects, rather than attention modification, in effecting such reductions. The current results also support distinct relationships between fears of negative and positive evaluation and social anxiety. Further research focused on identifying the mechanisms of change in attention modification protocols appears warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Carleton, R. Nicholas; Teale Sapach, Michelle J. N; Oriet, Chris; LeBouthillier, Daniel M; Amir, Amir, Amir, Amir, Asmundson, Barnes, Boettcher, Boettcher, Boettcher, Boettcher, Bogels, Carlbring, Carleton, Carleton, Carleton, Carleton, Carleton, Cisler, Clarke, Crippa, Enock, Fergus, First, Heeren, Heeren, Heimberg, High, Hirsch, Hofmann, Julian, Klumpp, Koster, Kuckertz, Kwok, Leary, Lee, Mallinckrodt, Menatti, Miloff, Mogoase, Neubauer, Notebaert, Oei, Pashler, Peugh, Radloff, Rapee, Reilly, Riemann, Schmidt, Sheehan, Spielberger, Tabachnick, Waechter, Watson, Weeks, Weeks, Zanarini",2017.0,,0,1,
664,Treatment of panic disorder: live therapy vs. self-help via the Internet.,"A randomized trial was conducted comparing 10 individual weekly sessions of cognitive behaviour therapy for panic disorder (PD) with or without agoraphobia with a 10-module self-help program on the Internet. After confirming the PD diagnosis with an in-person structured clinical interview (SCID) 49 participants were randomized. Overall, the results suggest that Internet-administered self-help plus minimal therapist contact via e-mail can be equally effective as traditional individual cognitive behaviour therapy. Composite within-group effect sizes were high in both groups, while the between-group effect size was small (Cohen's d=16). One-year follow-up confirmed the results, with a within-group effect size of Cohen's d=0.80 for the Internet group and d=0.93 for the live group. The results from this study generally provide evidence to support the continued use and development of Internet-distributed self-help programs.",Carlbring P.; Nilsson-Ihrfelt E.; Waara J.; Kollenstam C.; Buhrman M.; Kaldo V.; Söderberg M.; Ekselius L.; Andersson G.,2005.0,10.1016/j.brat.2004.10.002,0,1,
665,Internet-delivered attention bias modification training in individuals with social anxiety disorder--a double blind randomized controlled trial.,"Computerized cognitive bias modification for social anxiety disorder has in several well conducted trials shown great promise with as many as 72% no longer fulfilling diagnostic criteria after a 4 week training program. To test if the same program can be transferred from a clinical setting to an internet delivered home based treatment the authors conducted a randomized, double-blind placebo-controlled trial. After a diagnostic interview 79 participants were randomized to one of two attention training programs using a probe detection task. In the active condition the participant was trained to direct attention away from threat, whereas in the placebo condition the probe appeared with equal frequency in the position of the threatening and neutral faces. Results were analyzed on an intention-to-treat basis, including all randomized participants. Immediate and 4-month follow-up results revealed a significant time effect on all measured dimensions (social anxiety scales, general anxiety and depression levels, quality of life). However, there were no time x group interactions. The lack of differences in the two groups was also mirrored by the infinitesimal between group effect size both at post test and at 4-month follow-up. We conclude that computerized attention bias modification may need to be altered before dissemination for the Internet. ISRCTN01715124.",Carlbring P.; Apelstrand M.; Sehlin H.; Amir N.; Rousseau A.; Hofmann SG.; Andersson G.,2012.0,10.1186/1471-244X-12-66,0,1,
666,An internet-based treatment for flying phobia (NO-FEAR Airlines): Study protocol for a randomized controlled trial.,"Background: Flying phobia (FP) is a common and disabling mental disorder. Although in vivo exposure is the treatment of choice, it is linked to a number of limitations in its implementation. Particularly important, is the limited access to the feared stimulus (i.e., plane). Moreover, the economic cost of in vivo exposure should be specially considered as well as the difficulty of applying the exposure technique in an appropriate way; controlling important variables such as the duration of the exposure or the number of sessions. ICTs could help to reduce these limitations. Computer-assisted treatments have remarkable advantages in treating FP. Furthermore, they can be delivered through the Internet, increasing their advantages and reaching more people in need. The Internet has been established as an effective way to treat a wide range of mental disorders. However, as far as we know, no controlled studies exist on FP treatment via the Internet. This study aims to evaluate the efficacy of an Internet-based treatment for FP (NO-FEAR Airlines) versus a waiting list control group. Secondary objectives will be to explore two ways of delivering NO-FEAR Airlines, with or without therapist guidance, and study the patients' acceptance of the program. This paper presents the study protocol. Methods/design: The study is a randomized controlled trial. A minimum of 57 participants will be randomly assigned to three conditions: a) NO-FEAR Airlines totally self-applied, b) NO-FEAR Airlines with therapist guidance, or c) a waiting list control group (6 weeks). Primary outcomes measures will be the Fear of Flying Questionnaire-II and the Fear of Flying Scale. Secondary outcomes will be included to assess other relevant clinical measures, such as the Fear and Avoidance Scales, Clinician Severity Scale, and Patient's Improvement scale. Analyses of post-treatment flights will be conducted. Treatment acceptance and preference measures will also be included. Intention-to-treat and per protocol analyses will be conducted. Discussion: An Internet-based treatment for FP could have considerable advantages in managing in vivo exposure limitations, specifically in terms of access to treatment, acceptance, adherence, and the cost-effectiveness of the intervention. This is the first randomized controlled trial to study this issue. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Campos, Daniel; Breton-Lopez, Juana; Botella, Cristina; Mira, Adriana; Castilla, Diana; Banos, Rosa; Tortella-Feliu, Miquel; Quero, Soledad; Agras, Andersson, Andersson, Andersson, Andersson, Andersson, Andrews, Andrews, Antony, Baumeister, Banos, Berger, Bor, Borkovec, Bornas, Bornas, Bornas, Botella, Botella, Botella, Boyd, Brown, Brunton-Smith, Buchanan, Busscher, Campos, Carlbring, Chan, Chan, Clark, Cuijpers, Cumming, Cumming, Deacon, Di Nardo, Diemer, Emmelkamp, Eysenbach, Farrer, Garcia-Palacios, Gregg, Guy, Haug, Hedman, Iljon Foreman, Iljon Foreman, Johansson, Karyotaki, Kazdin, Kazdin, Kazdin, Kelders, Mackenzie, Marks, McCann, Meyer, Meyerbroker, Oakes, Olatunji, Quero, Quero, Richards, Roberts, Rothbaum, Rothbaum, Spek, Stinson, Titov, Titov, Tortella-Feliu, Tortella-Feliu, Van Ballegooijen, Van Gerwen, Van Gerwen, Van Gerwen, Wiederhold",2016.0,,0,1,
667,A randomized controlled clinical trial of dialogical exposure therapy versus cognitive processing therapy for adult outpatients suffering from PTSD after type I trauma in adulthood.,"Background: Although there are effective treatments for posttraumatic stress disorder (PTSD), there is little research on treatments with non-cognitive-behavioural backgrounds, such as gestalt therapy. We tested an integrative gestalt-derived intervention, dialogical exposure therapy (DET), against an established cognitive-behavioural treatment (cognitive processing therapy, CPT) for possible differential effects in terms of symptomatic outcome and drop-out rates. Methods: We randomized 141 treatment-seeking individuals with a diagnosis of PTSD to receive either DET or CPT. Therapy length in both treatments was flexible with a maximum duration of 24 sessions. Results: Dropout rates were 12.2% in DET and 14.9% in CPT. Patients in both conditions achieved significant and large reductions in PTSD symptoms (Impact of Event Scale - Revised; Hedges' g = 1.14 for DET and d = 1.57 for CPT) which were largely stable at the 6-month follow-up. At the posttreatment assessment, CPT performed statistically better than DET on symptom and cognition measures. For several outcome measures, younger patients profited better from CPT than older ones, while there was no age effect for DET. Conclusions: Our results indicate that DET merits further research and may be an alternative to established treatments for PTSD. It remains to be seen whether DET confers advantages in areas of functioning beyond PTSD symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Butollo, Willi; Karl, Regina; Konig, Julia; Rosner, Rita; Bisson, Bisson, Bradley, Brahler, Butollo, Butollo, Butollo, Butollo, Cloitre, Cohen, Derogatis, Ehring, Fahrenberg, Faul, Foa, Foa, Franke, Geisheim, Griesel, Hagl, Hiller, Horowitz, Horowitz, Imel, Jacob, Jacobson, Jung, Kersting, Klauer, Konig, Konig, Konig, Lenhart, Maercker, Nickerson, Paivio, Paivio, Plouffe, Resick, Resick, Resick, Rizvi, Rosner, Schmitt, Schnyder, Seidler, Sloan, Strauss, Van Emmerik, Watts, Weiss, Wittchen, Wittchen, Wittchen, Yontef",2016.0,,0,1,
668,Treatment choice for agoraphobic women: exposure or cognitive-behaviour therapy?,"The paper describes a treatment trial where exposure was compared with cognitive-behaviour therapy in the treatment of 39 female participants with a diagnosis of agoraphobia (DSM-111-R). The primary objective of the study was to see if cognitive therapy enhanced the effectiveness of exposure in the treatment of agoraphobia. Participants were randomly assigned to either exposure or cognitive-behaviour therapy. The two treatment groups were balanced for severity and duration of agoraphobia, presence of panic disorder, and age. The exposure and the cognitive-behaviour therapy groups received the same amount of therapist-assisted exposure to feared situations but the participants in the cognitive-behaviour therapy group were, additionally, taught to identify and challenge negative automatic thoughts and dysfunctional assumptions. In the cognitive-behaviour therapy condition exposure was presented as an opportunity to identify and challenge negative thoughts. In the exposure condition, participants were given a behavioural rationale for doing exposure. Participants were seen individually for 10 sessions. Assessments were carried out before and after the treatment programme and, also, six months later. Assessments included self-reports of fear and avoidance, a behavioural test and questionnaire measures of relevant cognitions. Thirteen participants dropped out of treatment leaving 14 in the exposure condition and 12 in the cognitive-behaviour condition. Therapy sessions were taped and a sample of tapes was given to a judge who rated the quality of the cognitive-behaviour therapy. Substantial improvement was seen on virtually all measures irrespective of treatment condition both at the end of treatment and six months later. The cognitive-behaviour therapy group and the exposure group did not differ significantly at post-treatment or at six-month follow-up.",Burke M.; Drummond LM.; Johnston DW.,1997.0,,0,1,
669,A randomized trial of attention training for generalized social phobia: does attention training change social behavior?,"The use of attention training protocols for the treatment of generalized social anxiety disorder (SAD) is undergoing increased examination. Initial investigations were positive but more recent investigations have been less supportive of the treatment paradigm. One significant limitation of current investigations is overreliance on self-report. In this investigation, we expanded on initial investigations by using a multimodal assessment of patient functioning (i.e., including behavioral assessment). Patients with a primary diagnosis of SAD (n=31) were randomly assigned to eight sessions of attention training (n=15) or placebo/control (n=16). Participants were assessed at pre- and posttreatment via self- and clinician-report of social anxiety as well as anxious and behavioral response to two in vivo social interactions. Results revealed no differences between groups at posttreatment for all study outcome variables, suggesting a lack of effect for the attention training condition. The results are concordant with recent investigations finding a lack of support for the use of attention training as an efficacious treatment for patients with SAD.",Bunnell BE.; Beidel DC.; Mesa F.,2013.0,10.1016/j.beth.2013.04.010,0,1,
670,"The effect of flexible cognitive-behavioural therapy and medical treatment, including antidepressants on post-traumatic stress disorder and depression in traumatised refugees: pragmatic randomised controlled clinical trial.","Little evidence exists on the treatment of traumatised refugees. To estimate treatment effects of flexible cognitive-behavioural therapy (CBT) and antidepressants (sertraline and mianserin) in traumatised refugees. Randomised controlled clinical trial with 2 × 2 factorial design (registered with Clinicaltrials.gov, NCT00917397, EUDRACT no. 2008-006714-15). Participants were refugees with war-related traumatic experiences, post-traumatic stress disorder (PTSD) and without psychotic disorder. Treatment was weekly sessions with a physician and/or psychologist over 6 months. A total of 217 of 280 patients completed treatment (78%). There was no effect on PTSD symptoms, no effect of psychotherapy and no interaction between psychotherapy and medicine. A small but significant effect of treatment with antidepressants was found on depression. In a pragmatic clinical setting, there was no effect of flexible CBT and antidepressants on PTSD, and there was a small-to-moderate effect of antidepressants and psychoeducation on depression in traumatised refugees.",Buhmann CB.; Nordentoft M.; Ekstroem M.; Carlsson J.; Mortensen EL.,2016.0,10.1192/bjp.bp.114.150961,0,1,
671,Evaluating potential iatrogenic suicide risk in trauma-focused group cognitive behavioral therapy for the treatment of PTSD in active duty military personnel.,"Objective: To determine whether group cognitive processing therapy-cognitive only version (CPT-C) is associated with iatrogenic suicide risk in a sample of active duty US Army personnel diagnosed with posttraumatic stress disorder (PTSD). Possible iatrogenic effects considered include the incidence and severity of suicide ideation, worsening of preexisting suicide ideation, incidence of new-onset suicide ideation, and incidence of suicide attempts among soldiers receiving group CPT-C. Comparison with group present-centered therapy (PCT) was made to contextualize findings. Method: One hundred eight soldiers (100 men, eight women) diagnosed with PTSD were randomized to receive either group CPT-C or group PCT. PTSD diagnosis was confirmed via structured clinician interview. Suicide ideation, depression severity, and PTSD severity were assessed at pretreatment, weekly during treatment, and 2 weeks, 6 months, and 12 months posttreatment. Results: Rates of suicide ideation significantly decreased across both treatments. Among soldiers with pretreatment suicide ideation, severity of suicide ideation significantly decreased across both treatments and was maintained for up to 12 months posttreatment. Exacerbation of preexisting suicide ideation was uncommon in both treatments. New-onset suicide ideation was rare and similar across both treatments (<16%). There were no suicide attempts during treatment or follow-up in either group. Change in depression symptoms predicted change in suicide risk. Conclusions: Suicide-related outcomes were similar across both treatments and primarily associated with comorbid depression. Suicide-related outcomes in group CPT-C were rare and comparable to patterns observed in an active, nontrauma-focused therapy, even among soldiers who entered treatment with suicide ideation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bryan, Craig J; Clemans, Tracy A; Hernandez, Ann Marie; Mintz, Jim; Peterson, Alan L; Yarvis, Jeffrey S; Resick, Patricia A; STRONG STAR Consortium; Beck, Beck, Becker, Bray, Bryan, Bryan, Bryan, Cloitre, Crosby, Foa, Foa, Forbes, Forbes, Frost, Gradus, Gradus, Guerra, Jacobson, Kaloupek, Kessler, Monson, Morland, Nock, Panagioti, Posner, Powers, Ramchand, Resick, Resick, Rosellini, Rudd, Tanielian, Trockel, van Minnen, Weathers",2016.0,,0,1,
672,A comparison of focused and standard cognitive therapy for panic disorder.,"The relative efficacy of two psychotherapeutic approaches to panic disorder, namely, focused cognitive therapy (FCT) and standard cognitive therapy (SCT) was examined. FCT focused specifically on the ""catastrophic misinterpretation"" of physical and psychological sensations experienced during panic attacks induced in the office or occurring spontaneously between sessions. SCT focused primarily on the cognitions and beliefs relevant to interpersonal concerns involved in generalized anxiety. We hypothesized that FCT would be more effective than SCT since the latter did not include an induced panic exercise (exposure condition) specific to the patient's panicogenic cognitions. Forty patients diagnosed with panic disorder were randomly assigned to the SCT and FCT groups for approximately 12 to 18 sessions of treatment. Both groups reported significant decreases in the severity of the clinical measures at termination. Moreover, 89.5% of the SCT group and 84.2% of the FCT group were free of panic attacks at 1-year follow-up. Contrary to the predictions, the results for measures of panic attack frequency, anxiety, and depression did not reveal any significant differences between the two groups. Results suggest that in-office ""exposure"" is not necessary for improvement and that a primary focus on cognitions associated with generalized anxiety may be an effective intervention. However, since improvement in panic was correlated with normalizing of panic-related beliefs in both conditions, it is suggested that cognitive change may be a crucial ingredient of improvement in panic episodes.",Brown GK.; Beck AT.; Newman CF.; Beck JS.; Tran GQ.,,,0,1,
673,A randomized controlled trial of attention modification for social anxiety disorder.,"Social Anxiety Disorder (SAD) models implicate social threat cue vigilance (i.e., attentional biases) in symptom development and maintenance. A modified dot-probe protocol has been shown to reduce SAD symptoms, in some but not all studies, presumably by modifying an attentional bias. The current randomized controlled trial was designed to replicate and extend such research. Participants included treatment-seeking adults (n = 108; 58% women) who met diagnostic criteria for SAD. Participants were randomly assigned to a standard (i.e., control) or modified (i.e., active) dot-probe protocol condition and to participate in-lab or at home. The protocol involved twice-weekly 15-min sessions, for 4 weeks, with questionnaires completed at baseline, post-treatment, 4-month follow-up, and 8-month follow-up. Symptom reports were assessed with repeated measures mixed hierarchical modeling. There was a main effect of time from baseline to post-treatment wherein social anxiety symptoms declined significantly (p < .05) but depression and trait anxiety did not (p > .05). There were no significant interactions based on condition or participation location (ps > .05). Reductions were maintained at 8-month follow-up. Symptom reductions were not correlated with threat biases as indexed by the dot-probe task. The modified and standard protocol both produced significant sustained symptom reductions, whether administered in-lab or at home. There were no robust differences based on protocol type. As such, the mechanisms for benefits associated with modified dot-probe protocols warrant additional research.",Carleton RN.; Teale Sapach MJ.; Oriet C.; Duranceau S.; Lix LM.; Thibodeau MA.; Horswill SC.; Ubbens JR.; Asmundson GJ.,2015.0,10.1016/j.janxdis.2015.03.011,0,1,
674,An evaluation of two clinically-derived treatments for technophobia.,"Technology is ubiquitous in our occupational, educational and leisure lives. A fear of interacting with technology can therefore have a major impact on the quality of an individual's life. This is particularly salient within education as an inability to maximise the benefits of technology may limit academic achievement and subsequent opportunities in life. The severity of the anxiety induced by technology has lead to a plethora of research into the prevalence of 'technophobia'. This term may have clinical relevance and has been found to be comparable in severity to more traditional phobias [Thorpe, S. J. & Brosnan, M. (in press). Does computer anxiety reach levels which conform to DSM IV criteria for specific phobia? Computers in Human Behavior]. This paper presents two studies examining the effect of clinically-derived treatments upon levels of anxiety induced by technology. Study 1 was a 10-week selective desensitisation programme with 16 participants (eight computer anxious, eight non-anxious). Over this period computer anxiety and coping cognitions were significantly improved in the computer anxious group and become comparable to those of the matched non-anxious controls. Study 2 was a single treatment session for anxiety. Thirty individuals identified as anxious were assigned to either a one-session treatment (n = 9) or non-treatment (n = 21) group. Initially, both groups were significantly more anxious than the non-anxious control group (n = 59). Subsequent testing established that over the period of an academic year the reduction in anxiety was three times greater in the treated group than the non-treated group such that by the end of the year the treated group no longer differed from the control group, whereas the non-treated group remained significantly more anxious. The implications and limitations of the studies are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Brosnan, M. J; Thorpe, S. J; Anthony, Bozionelos, Bozionelos, Brosnan, Brosnan, Brosnan, Brosnan, Brosnan, Browndyke, Chambless, Chua, Cooper, Crable, Dukes, Fennell, Gist, Gurcan-Namlu, Heinssen, Keeler, Leso, Marcoulides, Martocchio, Maurer, Moldafsky, Radford, Radford, Rosen, Rosen, Rosen, Rosen, Rosen, Seligman, Smith, Spielberger, Summerskill, Thorpe, Thorpe, Thorpe, Thorpe, Thorpe, Todman, Todman, Weil, Weil, Whitely, Wolpe, Wolpe, Ost, Ost, Ost, Ost",2006.0,,0,1,
675,[Efficacy of short-term psychodynamic psychotherapy vs treatment as usual in a sample of patients with anxiety and depressive disorders].,"The aim of this study is to evaluate the clinical efficacy of short-term psychodynamic psychotherapy (STPP) in comparison with treatment as usual (TAU) in treatment of patients suffering from anxiety and depressive disorders. Sixty patients were recruited from the Psychotherapy Service, University of Milan, Department of Psychiatry, at Milan's IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico with the diagnosis of depressive or anxiety disorders according to DSM-IV-TR criteria. These subjects were randomly assigned in a 1:1 ratio to an intervention group (STPP) or control group (TAU) for 12 months (T1). Each patient was clinically evaluated at the moment of recruitment (T0) and after 12 months using a battery composed of these scales: Clinical Global Impression Scale (CGI), Symptom Checklist-90-Revised (SCL-90-R), Inventory of Interpersonal Problems (IIP). Statistical analysis highlighted significant improvements (p<0.05) for the group treated with STPP in every clinical scale. Instead control group revealed significant changes (p<0.05) only for SCL-90 scale scores. We noticed a clinical improvement in both groups without particular differences, but the IIP scores went through a significant higher enhancement only in STPP group. Our results suggest that STPP is so effective as TAU in treatment of anxiety and depressive disorders. Moreover STPP leads to a better recover of relational functioning.",Bressi C.; Nocito EP.; Milanese EA.; Fronza S.; Della Valentina P.; Castagna L.; Porcellana M.; Bruzzese M.; Baratta LR.; Minacapelli E.; Dipasquale E.; Capra GA.,,10.1708/1407.15622,0,1,353
676,Cognitive-behavioral group therapy for obsessive-compulsive disorder: A 1-year follow-up.,"Objective: The aim of this study was to evaluate the results of cognitive-behavioral group therapy (CBGT) for obsessive-compulsive disorder (OCD) over a 1-year follow-up period. Method: Forty-two OCD patients, who completed 12 sessions of CBGT, were followed for 1 year. Measures of the severity of symptoms were obtained at the end of the acute treatment and at 3, 6, and 12 months post-treatment using the Yale-Brown obsessive-compulsive scale (Y-BOCS) and the clinical global impression (CGI). Results: The reduction in the severity of symptoms observed at the end of the treatment was maintained during 1 year (F2,41=1.1; P=0.342). Eleven patients (35.5%) relapsed in the follow-up period. The intensity of improvement (log rank=12.97, GL=1, P=0.0003) and full remission (log rank=6.17; GL=1; P=0.001) were strong predictors for non-relapsing. Conclusion: The CBGT is an effective treatment for OCD and its results are maintained for 1 year. However, further long-term randomized controlled trials are needed in order to confirm this finding. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Braga, D. T; Cordioli, A. V; Niederauer, K; Manfro, G. G; Ackerman, Amorin, Barrett, Basoglu, Cordigli, De Araujo, De Haan, Eisen, Fava, Foa, Foa, Foa, Ger, Goodman, Guy, Ito, Kapman, Kennedy, Lensi, Marks, Marks, Mawson, McIntyre, Mclean, Neziroglu, O'Sullivan, Pato, Piccinelli, Rasmussen, Romano, Salkovskis, Sheehan, Simpson, Skoog, Steketee, Stewart, Van Balkom, Van Noppen, Warren",2005.0,,0,1,
677,Early response to psychotherapy and long-term change in worry symptoms in older adults with generalized anxiety disorder.,"To determine the association of early and long-term reductions in worry symptoms after cognitive behavior therapy (CBT) for generalized anxiety disorder (GAD) in older adults. Substudy of larger randomized controlled trial. Family medicine clinic and large multispecialty health organization in Houston, TX, between March 2004 and August 2006. Patients (N = 76) aged 60 years or older with a principal or coprincipal diagnosis of GAD, excluding those with significant cognitive impairment, bipolar disorder, psychosis, or active substance abuse. CBT, up to 10 sessions for 12 weeks, or enhanced usual care (regular, brief telephone calls, and referrals to primary care provider as needed). Penn State Worry Questionnaire (PSWQ) administered by telephone at baseline, 1 month (mid treatment), 3 months (posttreatment), and at 3-month intervals through 15 months (1-year follow-up). The authors used binary logistic regression analysis to determine the association between early (1 month) response and treatment responder status (reduction of more than 8.5 points on the PSWQ) at 3 and 15 months. The authors also used hierarchical linear modeling to determine the relationship of early response to the trajectory of score change after posttreatment. Reduction in PSWQ scores after the first month predicted treatment response at posttreatment and follow-up, controlling for treatment arm and baseline PSWQ score. The magnitude of early reduction also predicted the slope of score change from posttreatment through the 15-month assessment. Early symptom reduction is associated with long-term outcomes after psychotherapy in older adults with GAD.",Bradford A.; Cully J.; Rhoades H.; Kunik M.; Kraus-Schuman C.; Wilson N.; Stanley M.,2011.0,10.1097/JGP.0b013e3181f18061,0,1,
678,Do all treatments work for flight phobia? Computer-assisted exposure versus a brief multicomponent nonexposure treatment.,"Computer-assisted treatments have proven to be effective in the treatment of several anxiety disorders and depression, but the role of exposure remains unclear. This study compares the efficacy of a computer-assisted exposure treatment (CAE) with a brief multicomponent nonexposure treatment (MNE) for flight phobia. Outcome measure assessments were conducted at posttreatment and at 6-month follow-up. No differences were found between CAE and MNE in reducing fear of flying. In both conditions patients improved significantly and clinically meaningfully, and results were maintained at 6-month follow-up. These findings challenge the idea that exposure is essential in reducing phobic anxiety and support the idea that specific phobias may be well suited for brief cognitive-behavioral treatments. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bornas, Xavier; Tortella-Feliu, Miquel; Llabres, Jordi; Barcelo, Bornas, Bornas, Bornas, Bornas, Brown, Coldwell, Doctor, Ekeberg, Greist, Haug, Hazlett-Stevens, Hellstrom, Jacobson, Kelso, Lewis, Makeig, Maltby, Marks, Marks, Marks, Muhlberger, Muhlberger, Nelissen, Osgood-Hynes, Pikovsky, Rothbaum, van Gerwen, Ost, Ost, Ost",2006.0,,0,1,
679,Hoarding and treatment response in 38 nondepressed subjects with obsessive-compulsive disorder.,"The authors studied factors associated with short-term treatment response in 38 nondepressed subjects with DSM-III-R obsessive-compulsive disorder (OCD). The subjects completed 12 weeks of treatment with paroxetine (N = 20), placebo (N = 8), or cognitive-behavioral therapy (N = 10). Clinician and self-rated measures were gathered at baseline, during treatment, and after treatment. Seventeen (45%) subjects had ""much"" or ""very much"" improvement and achieved at least a 40% decrease in their total Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score. Responders had lower obsessive-compulsive scores on the Symptom Checklist 90-Revised, had a lower checking score on the Maudsley Obsessive-Compulsive Inventory, were less likely to have had prior drug therapy, and in general suffered more obsessive-compulsive symptoms. They were significantly less likely to have hoarding obsessions and corresponding compulsions. The latter finding was confirmed using multiple regression analysis. Hoarding is an important symptom that predicts poor treatment response in patients with OCD.",Black DW.; Monahan P.; Gable J.; Blum N.; Clancy G.; Baker P.,1998.0,,0,1,
680,Preliminary Investigation of a Mindfulness-Based Intervention for Social Anxiety Disorder That Integrates Compassion Meditation and Mindful Exposure.,"This study evaluated the feasibility and initial efficacy of a 12-week group mindfulness-based intervention tailored for persons with social anxiety disorder (MBI-SAD). The intervention includes elements of the standard mindfulness-based stress reduction program, explicit training in self-compassion aimed at cultivating a more accepting and kinder stance toward oneself, and use of exposure procedures to help participants practice responding mindfully to internal experiences evoked by feared social situations. Participants were randomly assigned to the MBI-SAD (n = 21) or a waitlist (WL) (n = 18) control group. Feasibility was assessed by the number of participants who completed at least 75% of the 12 weekly group sessions. Primary efficacy outcomes were clinician- and self-rated measures of social anxiety. Other outcomes included clinician ratings of illness severity and self-rated depression, social adjustment, mindfulness, and self-compassion. The MBI-SAD was acceptable and feasible, with 81% of participants attending at least 75% of sessions. The MBI-SAD fared better than WL in improving social anxiety symptom severity (p ≤ 0.0001), depression (p ≤ 0.05), and social adjustment (p ≤ 0.05). The intervention also enhanced self-compassion (p ≤ 0.05), and facets of mindfulness (observe and aware; p ≤ .05). MBI-SAD treatment gains were maintained at 3-month follow-up. These preliminary findings suggest that an MBI that integrates explicit training in self-compassion and mindful exposure is a feasible and promising intervention for social anxiety disorder. The next step is to compare the MBI-SAD to the gold standard of cognitive-behavior therapy to determine equivalence or noninferiority and to explore mediators and moderators of treatment outcome.",Koszycki D.; Thake J.; Mavounza C.; Daoust JP.; Taljaard M.; Bradwejn J.,2016.0,10.1089/acm.2015.0108,0,1,
681,Psychodynamic group treatment for generalized social phobia,"ER METHODSThirty patients were included in a randomized single-blind clinical trial comparing psychodynamic group treatment (PGT) with a credible placebo control group (CPC). PGT was carried out within a 12-session psychodynamically-oriented group psychotherapy. Control patients received a treatment package of lecture-discussion and support group for 12 weeks which was compared to PGT. Each participant completed the Liebowitz Social Anxiety Scale (LSAS), the Hamilton Anxiety Scale (HAS) and the Clinical Global Impression Scale(CGI) at pretreatment assessment and after 12 weeks of treatment. Data analysis was carried out using a repeated measures ANOVA. Patients were excluded if they were under any kind of pharmacotherapy or psychotherapic treatment.RESULTSBoth groups demonstrated significant pretreatment-to-posttreatment change on most measures. On the LSAS, PGT patients were rated as more improved than controls at posttest assessment (F(1,28)=4.84, p=0.036). Baseline data of completers did not show differences between both groups in the demographic variables and outcome variables used.CONCLUSIONSThe present study showed that PGT was [corrected] superior to a credible placebo control group in the treatment of generalized social phobia, in a 12-week randomized single-blind clinical trial.OBJECTIVESThe aim of this study is to assess the effectiveness of psychodynamic group therapy in patients with generalized social phobia.","Knijnik, D Z; Kapczinski, F; Chachamovich, E; Margis, R; Eizirik, C L",2004.0,,0,1,294
682,Internet-based treatment for PTSD reduces distress and facilitates the development of a strong therapeutic alliance: a randomized controlled clinical trial.,"The present study was designed to evaluate the efficacy of an internet-based therapy (Interapy) for Posttraumatic Stress Disorder (PTSD) in a German speaking population. Also, the quality of the online therapeutic relationship, its development and its relevance as potential moderator of the treatment effects was investigated. Ninety-six patients with posttraumatic stress reactions were allocated at random to ten sessions of Internet-based cognitive behavioural therapy (CBT) conducted over a 5-week period or a waiting list control group. Severity of PTSD was the primary outcome. Secondary outcome variables were depression, anxiety, dissociation and physical health. Follow-up assessments were conducted at the end of treatment and 3 months after treatment. From baseline to post-treatment assessment, PTSD severity and other psychopathological symptoms were significantly improved for the treatment group (intent-to-treat group x time interaction effect size d = 1.40). Additionally, patients of the treatment condition showed significantly greater reduction of co-morbid depression and anxiety as compared to the waiting list condition. These effects were sustained during the 3-months follow-up period. High ratings of the therapeutic alliance and low drop-out rates indicated that a positive and stable therapeutic relationship could be established online. Significant improvement of the online working alliance in the course of treatment and a substantial correlation between the quality of the online relationship at the end of treatment and treatment outcome emerged. Interapy proved to be a viable treatment alternative for PTSD with large effect sizes and sustained treatment effects. A stable and positive online therapeutic relationship can be established through the Internet which improved during the treatment process. Australian Clinical Trials Registry ACTRN012606000401550.",Knaevelsrud C.; Maercker A.,2007.0,10.1186/1471-244X-7-13,0,1,
683,"Posttraumatic growth, optimism and openness as outcomes of a cognitive-behavioural intervention for posttraumatic stress reactions.","The aim of this study was to examine the effect of an Internet-based CBT intervention on posttraumatic growth, openness and optimism. Ninety-six participants suffering from posttraumatic stress reactions were randomly assigned to either the treatment or a waiting-list control condition. We assessed posttraumatic stress reactions, depression and anxiety, posttraumatic growth, optimism and openness to new experiences. We found significant changes in posttraumatic growth in the treatment group. In addition regression analysis revealed that symptom improvements in posttraumatic stress reactions significantly predicted posttraumatic growth post-treatment. Our findings indicate the potential of psychotherapy to stimulate posttraumatic growth.",Knaevelsrud C.; Liedl A.; Maercker A.,2010.0,10.1177/1359105309360073,0,1,
684,Japan Unified Protocol Clinical Trial for Depressive and Anxiety Disorders (JUNP study): study protocol for a randomized controlled trial.,"The unified protocol for the transdiagnostic treatment of emotional disorders is a promising treatment approach that could be applicable to a broad range of mental disorders, including depressive, anxiety, trauma-related, and obsessive-compulsive disorders. However, no randomized controlled trial has been conducted to verify the efficacy of the unified protocol on the heterogeneous clinical population with depressive and anxiety disorders. The trial was designed as a single-center, assessor-blinded, randomized, 20-week, parallel-group superiority study in order to compare the efficacy of the combination of unified protocol and treatment-as-usual versus waiting-list with treatment-as-usual for patients with depressive and/or anxiety disorders. The primary outcome was depression at 21 weeks, assessed by the 17-item version of the GRID-Hamilton Rating Scale for Depression. Estimated minimum sample size was 27 participants in each group. We will also examine the treatment mechanisms, treatment processes, and neuropsychological correlates. The results of this study will clarify the efficacy of the unified protocol for depressive and anxiety disorders, and the treatment mechanism, process, and neurological correlates for the effectiveness of the unified protocol. If its efficacy can be confirmed, the unified protocol may be of high clinical value for Japan, a country in which cognitive behavioral treatment has not yet been widely adopted. ClinicalTrials.gov NCT02003261 (registered on December 2, 2013).",Ito M.; Okumura Y.; Horikoshi M.; Kato N.; Oe Y.; Miyamae M.; Hirabayashi N.; Kanie A.; Nakagawa A.; Ono Y.,2016.0,10.1186/s12888-016-0779-8,0,1,
685,Thought Field Therapy (TFT) as a treatment for anxiety symptoms: a randomized controlled trial,"ER OBJECTIVE: To investigate whether thought field therapy (TFT) has an impact on anxiety symptoms in patients with a variety of anxiety disorders.DESIGN: Forty-five patients were randomized to either TFT (n = 23) or a waiting list (n = 22) condition. The wait-list group was reassessed and compared with the TFT group two and a half months after the initial evaluation. After the reassessment, the wait-list patients received treatment with TFT. All 45 patients were followed up one to two weeks after TFT treatment, as well as at three and 12 months after treatment.SUBJECTS: Patients with an anxiety disorder, mostly outpatients.INTERVENTION: TFT aims to influence the body's bioenergy field by tapping on specific points along energy meridians, thereby relieving anxiety and other symptoms.OUTCOME MEASURES: Symptom Checklist 90-Revised, Hospital Anxiety and Depression Scale, the Sheehan Disability Scale.RESULTS: Repeated-measures analysis of variance was used to compare the TFT and the wait-list group. The TFT group had a significantly better outcome on two measures of anxiety and one measure of function. Follow-up data for all patients taken together showed a significant decrease in all symptoms during the one to two weeks between the pretreatment and the post-treatment assessments. The significant improvement seen after treatment was maintained at the three- and 12-month assessments.CONCLUSIONS: The results suggest that TFT may have an enduring anxiety-reducing effect.","Irgens, A; Dammen, T; Nysæter, T E; Hoffart, A",2012.0,10.1016/j.explore.2012.08.002,0,1,297
686,Cognitive and Guided Mastery Therapies for Panic Disorder with Agoraphobia: 18-Year Long-Term Outcome and Predictors of Long-Term Change,"ER KEY PRACTITIONER MESSAGEThe results suggest that the very-long-term outcome of both cognitive therapy and guided mastery therapy for agoraphobia is positive. The results support the role of catastrophic beliefs as mediator of change. The pattern of results suggests that learning processes other than catastrophic beliefs may be important for long-term outcome as well.UNLABELLEDIn this study, we wished to compare the long-term outcome of (medication-free) panic disorder with agoraphobia patients randomized to cognitive or guided mastery therapy. Thirty-one (67.4%) of 46 patients who had completed treatment were followed up about 18 years after end of treatment. In the combined sample and using intent-to-follow-up analyses, there were large within-group effect sizes of -1.79 and -1.63 on the primary interview-based and self-report outcome measures of avoidance of situations when alone, and 56.5% no longer had a panic disorder and/or agoraphobia diagnosis. No outcome differences between the two treatments emerged. Guided mastery was associated with greater beneficial changes in catastrophic beliefs and self-efficacy. For two of five outcome measures, more reduction in panic-related beliefs about physical and mental catastrophes from pre- to post-treatment predicted lower level of anxiety from post-treatment to 18-year follow-up when the effect of treatment changes in (a) self-efficacy and (b) anxiety was controlled. However, for one of the outcome measures, this effect attenuated with time. Copyright © 2014 John Wiley & Sons, Ltd.","Hoffart, A; Hedley, L M; Svanøe, K; Sexton, H",2016.0,10.1002/cpp.1934,0,1,302
687,"A placebo-controlled trial of phenelzine, cognitive behavioral group therapy, and their combination for social anxiety disorder.","Medication and cognitive behavioral treatment are the best-established treatments for social anxiety disorder, yet many individuals remain symptomatic after treatment. To determine whether combined medication and cognitive behavioral treatment is superior to either monotherapy or pill placebo. Randomized, double-blind, placebo-controlled trial. Research clinics at Columbia University and Temple University. One hundred twenty-eight individuals with a primary DSM-IV diagnosis of social anxiety disorder. Cognitive behavioral group therapy (CBGT), phenelzine sulfate, pill placebo, and combined CBGT plus phenelzine. Liebowitz Social Anxiety Scale and Clinical Global Impression (CGI) scale scores at weeks 12 and 24. Linear mixed-effects models showed a specific order of effects, with steepest reductions in Liebowitz Social Anxiety Scale scores for the combined group, followed by the monotherapies, and the least reduction in the placebo group (Williams test = 4.97, P < .01). The CGI response rates in the intention-to-treat sample at week 12 were 9 of 27 (33.3%) (placebo), 16 of 34 (47.1%) (CBGT), 19 of 35 (54.3%) (phenelzine), and 23 of 32 (71.9%) (combined treatment) (chi(2)(1) = 8.76, P < .01). Corresponding remission rates (CGI = 1) were 2 of 27 (7.4%), 3 of 34 (8.8%), 8 of 35 (22.9%), and 15 of 32 (46.9%) (chi(2)(1) = 15.92, P < .01). At week 24, response rates were 9 of 27 (33.3%), 18 of 34 (52.9%), 17 of 35 (48.6%), and 25 of 32 (78.1%) (chi(2)(1) = 12.02, P = .001). Remission rates were 4 of 27 (14.8%), 8 of 34 (23.5%), 9 of 35 (25.7%), and 17 of 32 (53.1%) (chi(2)(1) = 10.72, P = .001). Combined phenelzine and CBGT treatment is superior to either treatment alone and to placebo on dimensional measures and on rates of response and remission.",Blanco C.; Heimberg RG.; Schneier FR.; Fresco DM.; Chen H.; Turk CL.; Vermes D.; Erwin BA.; Schmidt AB.; Juster HR.; Campeas R.; Liebowitz MR.,2010.0,10.1001/archgenpsychiatry.2010.11,0,1,
688,Group cognitive behavior therapy for chronic posttraumatic stress disorder: An initial randomized pilot study.,"Individuals with posttraumatic stress disorder (PTSD) related to a serious motor vehicle accident were randomly assigned to either group cognitive behavioral treatment (GCBT) or a minimum contact comparison group (MCC). Compared to the MCC participants (n = 16), individuals who completed GCBT (n = 17) showed significant reductions in PTSD symptoms, whether assessed using clinical interview or a self-report measure. Among treatment completers, 88.3% of GCBT participants did not satisfy criteria for PTSD at posttreatment assessment, relative to 31.3% of the MCC participants. Examination of anxiety, depression, and pain measures did not show a unique advantage of GCBT. Treatment-related gains were maintained over a 3-month follow-up interval. Patients reported satisfaction with GCBT, and attrition from this treatment was comparable with individually administered CBTs. Results are discussed in light of modifications necessitated by the group treatment format, with suggestions for future study of this group intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Beck, J. Gayle; Coffey, Scott F; Foy, David W; Keane, Terence M; Blanchard, Edward B; Beck, Beck, Beck, Beck, Beck, Blake, Blanchard, Blanchard, Blanchard, Blanchard, Blanchard, Brown, Bryant, deBeurs, Ehlers, Ehlers, Fairbank, Fecteau, Foa, Fontana, Foy, Foy, Greenwald, Hedges, Hickling, Jacobson, Keane, Kerns, Kessler, Kessler, Larsen, Maercker, Miller, Monson, Norris, Resick, Resick, Rothbaum, Rounsaville, Rowe, Rowe, Schnurr, Shipherd, Steer, Taylor, Turk, Vasey, Waltz, Weathers, Weiss",2009.0,,0,1,
689,A randomized controlled trial of cognitive-behavioral therapy for the treatment of PTSD in the context of chronic whiplash,"ER OBJECTIVES: Whiplash-associated disorders (WAD) are common and involve both physical and psychological impairments. Research has shown that persistent posttraumatic stress symptoms are associated with poorer functional recovery and physical therapy outcomes. Trauma-focused cognitive-behavioral therapy (TF-CBT) has shown moderate effectiveness in chronic pain samples. However, to date, there have been no clinical trials within WAD. Thus, this study will report on the effectiveness of TF-CBT in individuals meeting the criteria for current chronic WAD and posttraumatic stress disorder (PTSD).METHOD: Twenty-six participants were randomly assigned to either TF-CBT or a waitlist control, and treatment effects were evaluated at posttreatment and 6-month follow-up using a structured clinical interview, self-report questionnaires, and measures of physiological arousal and sensory pain thresholds.RESULTS: Clinically significant reductions in PTSD symptoms were found in the TF-CBT group compared with the waitlist at postassessment, with further gains noted at the follow-up. The treatment of PTSD was also associated with clinically significant improvements in neck disability, physical, emotional, and social functioning and physiological reactivity to trauma cues, whereas limited changes were found in sensory pain thresholds.DISCUSSION: This study provides support for the effectiveness of TF-CBT to target PTSD symptoms within chronic WAD. The finding that treatment of PTSD resulted in improvements in neck disability and quality of life and changes in cold pain thresholds highlights the complex and interrelating mechanisms that underlie both WAD and PTSD. Clinical implications of the findings and future research directions are discussed.","Dunne, R L; Kenardy, J; Sterling, M",2012.0,10.1097/AJP.0b013e318243e16b,0,1,
690,Short-term psychodynamic psychotherapy versus treatment as usual for depressive and anxiety disorders: a randomized clinical trial of efficacy.,"This randomized clinical trial aimed to evaluate the clinical efficacy of short-term psychodynamic psychotherapy (STPP) in the treatment of patients suffering from anxiety or depressive disorders, as compared with a control case sample composed of patients undergoing treatment as usual (TAU). Sixty patients with depressive or anxiety disorders according to DSM IV-TR were randomly assigned in a 1:1 ratio to an intervention group (STPP) or control group for 12 months (T1). Primary outcome measures were the Symptom Checklist 90-Revised (SCL-90-R), the Inventory of Interpersonal Problems (IIP), and the Clinical Global Impression Improvement Scale. Intention to treat analysis revealed that patients who received STPP showed significantly more improvements in comparison with those who were in the TAU group on Clinical Global Impression Improvement Scale and IIP measures. This study offers evidence that STPP is an effective treatment for patients with anxiety or depressive disorders, and it could be more effective than TAU in improving interpersonal problems as measured by IIP.",Bressi C.; Porcellana M.; Marinaccio PM.; Nocito EP.; Magri L.,2010.0,10.1097/NMD.0b013e3181ef3ebb,0,1,
691,The effects of mindfulness training on post-traumatic stress disorder symptoms and heart rate variability in combat veterans.,,Bhatnagar R.; Phelps L.; Rietz K.; Juergens T.; Russell D.; Miller N.; Ahearn E.,2013.0,10.1089/acm.2012.0602,0,1,
692,A behavioral intervention for war-affected youth in Sierra Leone: a randomized controlled trial.,"Youth in war-affected regions are at risk for poor psychological, social, and educational outcomes. Effective interventions are needed to improve mental health, social behavior, and school functioning. This randomized controlled trial tested the effectiveness of a 10-session cognitive-behavioral therapy (CBT)-based group mental health intervention for multisymptomatic war-affected youth (aged 15-24 years) in Sierra Leone. War-affected youth identified by elevated distress and impairment via community screening were randomized (stratified by sex and age) to the Youth Readiness Intervention (YRI) (n = 222) or to a control condition (n = 214). After treatment, youth were again randomized and offered an education subsidy immediately (n = 220) or waitlisted (n = 216). Emotion regulation, psychological distress, prosocial attitudes/behaviors, social support, functional impairment, and posttraumatic stress disorder (PTSD) symptoms were assessed at pre- and postintervention and at 6-month follow-up. For youth in school, enrollment, attendance, and classroom performance were assessed after 8 months. Linear mixed-effects regressions evaluated outcomes. The YRI showed significant postintervention effects on emotion regulation, prosocial attitudes/behaviors, social support, and reduced functional impairment, and significant follow-up effects on school enrollment, school attendance, and classroom behavior. In contrast, education subsidy was associated with better attendance but had no effect on mental health or functioning, school retention, or classroom behavior. Interactions between education subsidy and YRI were not significant. YRI produced acute improvements in mental health and functioning as well as longer-term effects on school engagement and behavior, suggesting potential to prepare war-affected youth for educational and other opportunities. Clinical trial registration information-Trial of the Youth Readiness Intervention (YRI); http://clinicaltrials.gov; NCT01684488.",Betancourt TS.; McBain R.; Newnham EA.; Akinsulure-Smith AM.; Brennan RT.; Weisz JR.; Hansen NB.,2014.0,10.1016/j.jaac.2014.09.011,0,1,
693,Pre-treatment predictors of treatment outcome in panic disorder and agoraphobia treated with alprazolam and exposure.,"Pre-treatment predictors of treatment outcome were examined in a group of 144 patients with panic disorder and agoraphobia randomly allocated to alprazolam+exposure (AE), placebo+exposure (PE), alprazolam+relaxation (AR), and placebo+relaxation (PR). First-time psychotropic medication use, severity of agoraphobic disability, and longer duration of illness predicted less global improvement at post-treatment. Pre-treatment severity of agoraphobia predicted less improvement both in the short- and the long-term. Predictors of poorer outcome at 6-month follow-up were older age, past history of depression, severity of phobia targets, and longer duration of illness. Sex, source of referral, pre-treatment depression-anxiety-panic, and expectancy from treatment did not relate to outcome.",Başoğlu M.; Marks IM.; Swinson RP.; Noshirvani H.; O'Sullivan G.; Kuch K.,1994.0,,0,1,
694,Locus of control orientation in panic disorder and the differential effects of treatment,"ER METHODSA Multidimensional Anxiety Locus of Control scale (MALC) was developed and completed with other measures (ACQ and BSQ) before and after treatment. Patients also kept a panic diary.RESULTSFour subscales were derived from the MALC: one Internal, and three external (a Chance, a Medication, and a Therapist) locus of anxiety control orientation scales. Cognitive therapy was superior over pill-placebo on most outcome measures whereas antidepressants were only superior in reducing the number of panic attacks. Treatment with cognitive therapy resulted in an increase of 'internal' anxiety control orientation and a decrease of 'chance' and 'medication' orientation, in comparison with antidepressant therapy. The residualized gain scores on the MALC subscales correlated with clinical improvement in subjects treated with cognitive therapy only.CONCLUSIONSResults suggest that the locus of control orientation is important in evaluating the differential effects of treatments in panic disorder. A differential effect on panic locus of control in favor of cognitive therapy in comparison to medication was found.BACKGROUNDIn this study the effects of treatment with cognitive therapy, antidepressants or pill-placebo on the locus of control orientation in panic disorder patients were analysed, as well as the relation of this panic locus of control with panic frequency and cognitive measures of panic.","Bakker, A; Spinhoven, P; Does, A J; Balkom, A J; Dyck, R",2002.0,,0,1,
695,The effect of treatment on quality of life and functioning in OCD.,"Background: Given that obsessive compulsive disorder (OCD) is associated with impaired quality of life (QoL) and functioning, it is important examine whether therapeutic recovery from OCD leads to improvements on these important secondary outcomes. Only a few studies have examined how measures of OCD symptom severity relate to QoL and functioning among patients receiving treatment for OCD. Methods: OCD severity was measured with the Obsessive-Compulsive Inventory-Revised (OCI-R), a self-report scale of OCD, and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), an interview measure of OCD. Participants were 100 adults with a primary diagnosis of OCD on serotonin reuptake inhibitors (SRIs) enrolled in a randomized clinical trial comparing SRI augmentation with either exposure and response prevention (EX/RP) therapy, risperidone, or pill placebo. At baseline, mid-treatment, and post-treatment, patients completed assessments for OCD symptoms and QoL/functioning measures. Multilevel modeling was used to assess changes in QoL/functioning over the course of treatment and to compare such changes across treatment conditions. Results: Improvements in QoL/functioning were significantly greater among those receiving EX/RP compared to those receiving risperidone. Compared to pill placebo, EX/RP performed better on measures of functioning but not QoL. Greater improvement in individual OCI-R scores was associated with greater improvements in QoL/functioning, regardless of condition. In addition, Y-BOCS scores appeared to moderate improvements in QoL over the course of all treatment conditions, such that those with higher Y-BOCS scores showed the greatest improvements in QoL over time. Conclusions: Improvements in QoL/functioning were associated with reduction in OCD symptom severity. The implications on OCD treatment and clinical research are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Asnaani, Anu; Kaczkurkin, Antonia N; Alpert, Elizabeth; McLean, Carmen P; Simpson, H. Blair; Foa, Edna B; Abramowitz, Albert, Bystritsky, Diefenbach, Eisen, Endicott, Farris, First, Fischer, Foa, Fontenelle, Goodman, Goodman, Grabe, Heck, Hollander, Knapp, Kong, Koran, Koran, Kugler, Leon, Liu, Prabhu, Preedy, Ruscio, Saricam, Sheehan, Shek, Simpson, Srivastava, Subramaniam, Wang, Weidle, Weissman, Woody, Wootton",2017.0,,0,1,
696,Treatment of PTSD: a comparison of imaginal exposure with and without imagery rescripting.,"We tested whether the effectiveness of imaginal exposure (IE) treatment for posttraumatic stress disorder (PTSD) was enhanced by combining IE with imagery rescripting (IE+IR). It was hypothesized that IE+IR would be more effective than IE by (1) providing more corrective information so that more trauma-related problems can be addressed, and (2) allowing patients to express emotions that they had been inhibiting, such as anger. In a controlled study 71 chronic PTSD patients were randomly assigned to IE or IE+IR. Data of 67 patients were available. Treatment consisted of 10 weekly individual therapy sessions and treatment evaluation was conducted post-treatment and at 1-month follow-up. Results show that when compared with wait-list, treatment reduced severity of PTSD symptoms. More patients dropped out of IE than out of IE+IR before the 8th sessions, 51% vs. 25%, p=.03. Completers and intention-to-treat analyses indicated that both conditions did not differ significantly in reduction of PTSD severity. IE+IR was more effective for anger control, externalization of anger, hostility and guilt, especially at follow-up. Less strong effects were found on shame and internalized anger. Therapists tended to favor IE+IR as it decreased their feelings of helplessness compared to IE. Results suggest that the addition of rescripting to IE makes the treatment more acceptable for both patients and therapists, and leads to better effects on non-fear problems like anger and guilt.",Arntz A.; Tiesema M.; Kindt M.,2007.0,10.1016/j.jbtep.2007.10.006,0,1,
697,Testing the Mediating Effects of Obsessive Beliefs in Internet-Based Cognitive Behaviour Therapy for Obsessive-Compulsive Disorder: Results from a Randomized Controlled Trial.,"Although cognitive interventions for obsessive-compulsive disorder (OCD) have been tested in randomized trials, there are few trials that have tested the specific mechanisms of cognitive interventions, i.e. how they achieve their effects. In this study, we aimed to investigate the mediating effects of a short cognitive intervention in the treatment of OCD and used data from a recently conducted randomized controlled trial where 101 participants were allocated to either Internet-based CBT (ICBT) or to a control condition. Obsessive beliefs were measured at pre-treatment, at the time they had received the cognitive intervention, and also at post-treatment. Weekly OCD symptoms were measured throughout the 10 weeks of treatment. We hypothesized that (1) the ICBT group would have greater reductions in obsessive beliefs (controlling for change in OCD symptoms) after completing the cognitive intervention, and that (2) this reduction would, in turn, predict greater OCD symptom reduction throughout the rest of the treatment period. Contrary to our expectations, the longitudinal mediation analysis indicated that (1) being randomized to ICBT actually increased the degree of obsessive beliefs after receiving the cognitive intervention at weeks 1-3, and (2) increase in obsessive beliefs predicted better outcome later in treatment. However, when repeating the analysis using cross-sectional data at post-treatment, the results were in line with the initial hypotheses. Results were replicated when the control condition received ICBT. We conclude that, although obsessive beliefs were significantly reduced at post-treatment for the ICBT group, early increase rather than decrease in obsessive beliefs predicted favourable outcome. This study investigated the impact of cognitive interventions on obsessive beliefs for patients with obsessive-compulsive disorder. Results showed that a sudden increase in obsessive beliefs is not an indicator of worse treatment response. On the contrary, it is more likely that the patient is better off when having this sudden increase. Clinicians should not be alarmed if the patient has a sudden increase in obsessive beliefs, but we do recommend the clinician to investigate the reasons for this further.",Andersson E.; Ljótsson B.; Hedman E.; Hesser H.; Enander J.; Kaldo V.; Andersson G.; Lindefors N.; Rück C.,,10.1002/cpp.1931,0,1,
698,Testing the Mediating Effects of Obsessive Beliefs in Internet-Based Cognitive Behaviour Therapy for Obsessive-Compulsive Disorder: results from a Randomized Controlled Trial,"ER KEY PRACTITIONER MESSAGEThis study investigated the impact of cognitive interventions on obsessive beliefs for patients with obsessive-compulsive disorder. Results showed that a sudden increase in obsessive beliefs is not an indicator of worse treatment response. On the contrary, it is more likely that the patient is better off when having this sudden increase. Clinicians should not be alarmed if the patient has a sudden increase in obsessive beliefs, but we do recommend the clinician to investigate the reasons for this further.UNLABELLEDAlthough cognitive interventions for obsessive-compulsive disorder (OCD) have been tested in randomized trials, there are few trials that have tested the specific mechanisms of cognitive interventions, i.e. how they achieve their effects. In this study, we aimed to investigate the mediating effects of a short cognitive intervention in the treatment of OCD and used data from a recently conducted randomized controlled trial where 101 participants were allocated to either Internet-based CBT (ICBT) or to a control condition. Obsessive beliefs were measured at pre-treatment, at the time they had received the cognitive intervention, and also at post-treatment. Weekly OCD symptoms were measured throughout the 10?weeks of treatment. We hypothesized that (1) the ICBT group would have greater reductions in obsessive beliefs (controlling for change in OCD symptoms) after completing the cognitive intervention, and that (2) this reduction would, in turn, predict greater OCD symptom reduction throughout the rest of the treatment period. Contrary to our expectations, the longitudinal mediation analysis indicated that (1) being randomized to ICBT actually increased the degree of obsessive beliefs after receiving the cognitive intervention at weeks 1-3, and (2) increase in obsessive beliefs predicted better outcome later in treatment. However, when repeating the analysis using cross-sectional data at post-treatment, the results were in line with the initial hypotheses. Results were replicated when the control condition received ICBT. We conclude that, although obsessive beliefs were significantly reduced at post-treatment for the ICBT group, early increase rather than decrease in obsessive beliefs predicted favourable outcome.","Andersson, E; Ljótsson, B; Hedman, E; Hesser, H; Enander, J; Kaldo, V; Andersson, G; Lindefors, N; Rück, C",2015.0,10.1002/cpp.1931,0,1,697
699,Direct and Mediating Effects of an Anxiety Sensitivity Intervention on Posttraumatic Stress Disorder Symptoms in Trauma-Exposed Individuals.,"Anxiety sensitivity (AS), or fear of anxious arousal, is a higher-order cognitive risk-factor for posttraumatic stress disorder (PTSD) composed of lower-order physical, cognitive, and social concerns regarding anxiety symptoms. Brief and effective interventions have been developed targeting AS and its constituent components. However, there is limited evidence as to whether an intervention aimed at targeting AS would result in reductions in PTS symptoms and whether the effects on PTS symptoms would be mediated by reductions in AS. Furthermore, there is no evidence whether these mediation effects would be because of the global or more specific components of AS. The direct and indirect effects of an AS intervention on PTS symptoms were examined in a sample of 82 trauma-exposed individuals (M age = 18.84 years, SD = 1.50) selected based on elevated AS levels (i.e., 1 SD above the mean) and assigned to either a treatment (n = 40) or an active control (n = 42) condition. Results indicated that the intervention led to reductions in Month 1 PTS symptoms, controlling for baseline PTS symptoms. Furthermore, this effect was mediated by changes in global AS and AS social concerns, occurring from intervention to Week 1. These findings provide an initial support for an AS intervention in amelioration of PTS symptoms and demonstrate that it is primarily reductions in the higher-order component of AS contributing to PTS symptom reduction.",Allan NP.; Short NA.; Albanese BJ.; Keough ME.; Schmidt NB.,2015.0,10.1080/16506073.2015.1075227,0,1,
700,The effectiveness of Narrative Exposure Therapy with traumatised firefighters in Saudi Arabia: a randomized controlled study.,"Firefighters are exposed to many traumatic events. The psychological costs of this exposure increase the risk of Post-Traumatic Stress disorder (PTSD), depression and anxiety. This study examined the effectiveness of Narrative Exposure Therapy (NET) as a short-term treatment for reducing PTSD symptoms among Saudi firefighters. A randomized waiting-list control study was conducted with 34 traumatized firefighters were randomly allocated to NET or Waiting-list Control (WLC). The NET group received four therapy sessions of 60-90 min over a three-week period; those in the WLC condition received the same sessions after a three-week waiting period. Participants in both groups were assessed at baseline, immediately post-intervention and at 3 and 6 month follow ups. NET led to significant reductions in PTSD symptoms, anxiety and depression compared with WLC. After the WLC group received treatment, it showed the same improvements as the NET group. This occurred immediately post-treatment in both groups, but was not sustained at 3 and 6 month follow ups. Coping strategies and social support led to significant changes only in follow up times. NET was effective in reducing PTSD symptoms in traumatised Saudi firefighters. This finding could be helpful in the management of PTSD among people who work as first responders such as firefighters, police officers and emergency medical personal, as well as security officers.",Alghamdi M.; Hunt N.; Thomas S.,2015.0,10.1016/j.brat.2015.01.008,0,1,
701,Efficacy of autogenic training as the group therapy in the patients with panic disorder.,"Investigated the efficacy and applicability of group autogenic training (AT) to panic disorder. Ss were 29 male and 26 female outpatients (mean age 37.3 yrs) with panic disorder who received group AT (AT+), and 19 male and 13 female outpatients (mean age 37.8 yrs) with panic disorder who did not receive group AT (AT-) in Chubu-Rosai Hospital, Japan. Ss were administered the State-Trait Anxiety Inventory (STAI) in order to evaluate their anxiety, and were classified by effect of group AT. The results show: (1) that the STAI scores in the AT+ tended to be lower than those in the AT-; (2) that the effect of group AT on panic disorder resulted in 76.4% of Ss in AT+ with a score of ""somewhat effective"" or better; and (3) that the ratio of overall treatment efficacy for panic disorder was 90.9% for AT+ and 84.5% for AT-. These results suggest that group AT is effective for panic disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ashihara, Mutsumi; Tsutsumi, Mikiko; Osawa, Asako; Sata, Akimi",2000.0,,0,1,
702,[Controlled study of outcome after 6 months to early intervention of bus driver victims of aggression].,"The aftermath of psychological trauma, long since studied in the context of war (""soldier's heart"", ""shell shock"", etc.) can also occur as a result of trauma in civilian life. Bus drivers in large urban area are frequently aggressed. Over a period of 5 months, bus drivers who had been aggressed, employees of the largest French urban transport company (RATP), participated in a study designed to evaluate the effects of cognitive behavior treatment provided shortly after such aggression. A total of 132 bus drivers were included in the study divided into 2 randomized groups: a control group (67 subjects) received the usual medical-social care offered by the company, and a treatment group (65 subjects) who, in addition, benefited from 1 to 6 sessions of cognitive behavior intervention, including:evocation of the aggression, relaxation, role plays, cognitive restructuring. Subjects were evaluated by self-questionnaires a few days post-aggression and re-evaluated 6 months later. At follow-up, results showed a statistically significant decrease in anxiety levels (measured by the HAD scale) and intrusion of the traumatic memory (as evaluated by the Horowitz scale) in the treatment group. Hence, early and structured intervention appears to lessen the impact of the traumatic event on bus drivers attacked at work.",André C.; Lelord F.; Légeron P.; Reignier A.; Delattre A.,,,0,1,
703,Neuropsychological predictors of treatment response to cognitive behavioral group therapy in obsessive-compulsive disorder.,"Background: The available research on the relationship between neuropsychological functioning and the therapeutic outcome of obsessive-compulsive disorder (OCD) has yielded inconsistent results. In this study, our aim was twofold. First, we sought to evaluate the effects of cognitive behavioral group therapy (CBGT) on neurocognitive functions in OCD patients. Second, we assessed the viability of neuropsychological test performance as a predictor of treatment response to CBGT. Methods: One hundred fifty carefully screened OCD patients were randomized to receive either 12-week CBGT (n = 75) or to remain on a waiting list (WL; n = 75) for the corresponding time. Forty-seven participants dropped out of the study, leaving 103 participants that were included in the analysis (CBGT, n = 61; WL, n = 42). Participants had several neuropsychological domains evaluated both at baseline and at end-point. Results: A significant difference in obsessive-compulsive, anxiety, and depression symptoms was observed between treated patients and controls favoring the CBGT group, but no significant differences were found on neuropsychological measures after 3 months of CBGT. In addition, there were no differences between treatment responders and nonresponders on all neuropsychological outcome measures. Employing a conservative alpha, neuropsychological test performance did not predict CBGT treatment response. Conclusions: Although the CBGT group demonstrated significant improvement in OCD symptoms, no significant difference was found on all neuropsychological domains, and test performance did not predict treatment response. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Braga, Daniela T; Abramovitch, Amitai; Fontenelle, Leonardo F; Ferrao, Ygor A; Gomes, Juliana B; Vivan, Analise S; Ecker, Kimberly K; Bortoncello, Cristiane F; Mittelman, Andrew; Miguel, Euripides C; Trentini, Clarissa M; Cordioli, Aristides V; Abramovitch, Abramovitch, Abramovitch, Abramovitch, Anderson, Asbahr, Aycicegi, Bannon, Bannon, Beck, Beck, Beck, Bedard, Benedict, Bolton, Cacilhas, Caspi, Cavedini, Chamberlain, Cordioli, Cordioli, Crowe, Cunha, D'Alcante, First, Fitzgerald, Flessner, Foa, Foa, Foa, Foa, Foa, Fontenelle, Fontenelle, Golden, Goodman, Guy, Haraguchi, Harrison, Haut, Henry, Jaurriesta, Jonsson, Kim, Mccullagh, Menzies, Meyer, Miguel, Moritz, Moritz, Moritz, Moritz, Muscatello, Nielen, Osterrieth, Park, Pauls, Penades, Penades, Penades, Reitan, Roh, Rotge, Ruscio, Sakai, Savage, Savage, Savage, Saxena, Shin, Snyder, Sousa, Thienemann, Vandborg, Vandborg, Wechsler, Wechsler, Wright, Yalom",2016.0,,0,1,
704,Cognitive-behavioral group therapy versus sertraline for obsessive-compulsive disorder: five-year follow-up.,,Borges CP.; Meyer E.; Ferrão YA.; Souza FP.; Sousa MB.; Cordioli AV.,2011.0,10.1159/000322028,0,1,
705,Does the form or the amount of exposure make a difference in the cognitive-behavioral therapy treatment of social phobia?,"Exposure is considered to be an essential ingredient of cognitive-behavioral therapy treatment of social phobia and of most anxiety disorders. To assess the impact of the amount of exposure on outcome, 30 social phobic patients were randomly allocated to 1 of 2 group treatments of 8 weekly sessions: Self-Focused Exposure Therapy which is based essentially on prolonged exposure to public speaking combined with positive feedback or a more standard cognitive and behavioral method encompassing psychoeducation, cognitive work, working through exposure hierarchies of feared situations for exposure within and outside the group. The results show that the 2 methods led to significant and equivalent symptomatic improvements which were maintained at 1-year follow-up. There was a more rapid and initially more pronounced decrease in negative cognitions with the Self-Focused Exposure Therapy, which included no formal cognitive work, than with the more standard approach in which approximately a third of the content was cognitive. In contrast, decrease in social avoidance was more persistent with standard cognitive-behavior therapy which involved less exposure. The results indicate that positive cognitive change can be achieved more rapidly with non cognitive methods while avoidance decreases more reliably with a standard approach rather than an approach with an exclusive focus on exposure.",Borgeat F.; Stankovic M.; Khazaal Y.; Rouget BW.; Baumann MC.; Riquier F.; O'Connor K.; Jermann F.; Zullino D.; Bondolfi G.,2009.0,10.1097/NMD.0b013e3181aacc08,0,1,
706,"A multi-site single blind clinical study to compare the effects of prolonged exposure, eye movement desensitization and reprocessing and waiting list on patients with a current diagnosis of psychosis and co morbid post traumatic stress disorder: study protocol for the randomized controlled trial Treating Trauma in Psychosis","ER METHODS/DESIGN: A short PTSD-screener assesses the possible presence of PTSD in adult patients (21- to 65- years old) with psychotic disorders, while the Clinician Administered PTSD Scale interview will be used for the diagnosis of current PTSD. The M.I.N.I. Plus interview will be used for diagnosing lifetime psychotic disorders and mood disorders with psychotic features. The purpose is to include consenting participants (N = 240) in a multi-site single blind randomized clinical trial. Patients will be allocated to one of three treatment conditions (N = 80 each): prolonged exposure or EMDR (both consisting of eight weekly sessions of 90 minutes each) or a six-month waiting list. All participants are subjected to blind assessments at pre-treatment, two months post treatment, and six months post treatment. In addition, participants in the experimental conditions will have assessments at mid treatment and at 12 months follow-up.DISCUSSION: The results from the post treatment measurement can be considered strong empirical indicators of the safety and effectiveness of prolonged exposure and EMDR. The six-month and twelve-month follow-up data have the potential of reliably providing documentation of the long-term effects of both treatments on the various outcome variables. Data from pre-treatment and midtreatment can be used to reveal possible pathways of change.TRIAL REGISTRATION: Trial registration: ISRCTN79584912.BACKGROUND: Trauma contributes to psychosis and in psychotic disorders post-traumatic stress disorder (PTSD) is often a comorbid disorder. A problem is that PTSD is underdiagnosed and undertreated in people with psychotic disorders. This study's primary goal is to examine the efficacy and safety of prolonged exposure and eye movement desensitization and reprocessing (EMDR) for PTSD in patients with both psychotic disorders and PTSD, as compared to a waiting list. Secondly, the effects of both treatments are determined on (a) symptoms of psychosis, in particular verbal hallucinations, (b) depression and social performance, and (c) economic costs. Thirdly, goals concern links between trauma exposure and psychotic symptomatology and the prevalence of exposure to traumatic events, and of PTSD. Fourthly predictors, moderators, and mediators for treatment success will be explored. These include cognitions and experiences concerning treatment harm, credibility and burden in both participants and therapists.","Bont, P A; Berg, D P; Vleugel, B M; Roos, C; Mulder, C L; Becker, E S; Jongh, A; Gaag, M; Minnen, A",2013.0,10.1186/1745-6215-14-151,0,1,
707,Interference control training for PTSD: A randomized controlled trial of a novel computer-based intervention.,"Post-traumatic stress disorder (PTSD) is a chronic and debilitating condition characterized by persistent intrusive memories. Although effective treatments exist for PTSD, there is a need for development of alternative treatments. Diminished ability to control proactive interference may contribute to re-experiencing symptoms and may be a novel intervention target. The present study tested an intervention designed to modify proactive interference control clinicaltrials.gov identifier: (NCT02139137). Forty-two women with PTSD were randomly assigned to a computerized cognitive training or a control condition. The impact of these programs on cognitive performance and symptoms was assessed. PTSD re-experiencing symptoms and interference control performance improved significantly more for individuals in the training group relative to those in the control group. Other PTSD and general distress symptoms improved equally over time in both groups. Cognitive training of this type may hold promise as a novel intervention for reducing PTSD symptoms, although the mechanism of action and implications for models of PTSD requires future study. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bomyea, Jessica; Stein, Murray B; Lang, Ariel J; Amir, Amir, Amir, Anderson, Aupperle, Baron, Beard, Beck, Blake, Bomyea, Bomyea, Borkovec, Bradley, Breslau, Breslau, Brewin, Brewin, Bunting, Buschkuehl, Chard, Cohen, Conway, Daneman, Dickinson, Eren-Kocak, Etkin, First, Fox, Friedman, Gray, Hallion, Harrison, Jaeggi, Joormann, Keshayan, Kessler, Klingberg, Lustig, MacKinnon, Macleod, Macleod, Mahncke, May, McFarlane, McNally, Melby-Lervag, Miyake, Morrison, Olesen, Ponniah, Preacher, Redick, Rothbaum, Schnurr, Schottenbauer, Schweizer, Shipstead, Siegle, Spielberger, Stein, Tabachnick, Unsworth, Unsworth, Van Breukelen, Vasterling, Verwoerd, Verwoerd, Verwoerd, Vickers, Vinogradov, Weathers, Weathers, Wessel",2015.0,,0,1,
708,A transdiagnostic community-based mental health treatment for comorbid disorders: development and outcomes of a randomized controlled trial among Burmese refugees in Thailand.,"Existing studies of mental health interventions in low-resource settings have employed highly structured interventions delivered by non-professionals that typically do not vary by client. Given high comorbidity among mental health problems and implementation challenges with scaling up multiple structured evidence-based treatments (EBTs), a transdiagnostic treatment could provide an additional option for approaching community-based treatment of mental health problems. Our objective was to test such an approach specifically designed for flexible treatments of varying and comorbid disorders among trauma survivors in a low-resource setting. We conducted a single-blinded, wait-list randomized controlled trial of a newly developed transdiagnostic psychotherapy, Common Elements Treatment Approach (CETA), for low-resource settings, compared with wait-list control (WLC). CETA was delivered by lay workers to Burmese survivors of imprisonment, torture, and related traumas, with flexibility based on client presentation. Eligible participants reported trauma exposure and met severity criteria for depression and/or posttraumatic stress (PTS). Participants were randomly assigned to CETA (n = 182) or WLC (n = 165). Outcomes were assessed by interviewers blinded to participant allocation using locally adapted standard measures of depression and PTS (primary outcomes) and functional impairment, anxiety symptoms, aggression, and alcohol use (secondary outcomes). Primary analysis was intent-to-treat (n = 347), including 73 participants lost to follow-up. CETA participants experienced significantly greater reductions of baseline symptoms across all outcomes with the exception of alcohol use (alcohol use analysis was confined to problem drinkers). The difference in mean change from pre-intervention to post-intervention between intervention and control groups was -0.49 (95% CI: -0.59, -0.40) for depression, -0.43 (95% CI: -0.51, -0.35) for PTS, -0.42 (95% CI: -0.58, -0.27) for functional impairment, -0.48 (95% CI: -0.61, -0.34) for anxiety, -0.24 (95% CI: -0.34, -0.15) for aggression, and -0.03 (95% CI: -0.44, 0.50) for alcohol use. This corresponds to a 77% reduction in mean baseline depression score among CETA participants compared to a 40% reduction among controls, with respective values for the other outcomes of 76% and 41% for anxiety, 75% and 37% for PTS, 67% and 22% for functional impairment, and 71% and 32% for aggression. Effect sizes (Cohen's d) were large for depression (d = 1.16) and PTS (d = 1.19); moderate for impaired function (d = 0.63), anxiety (d = 0.79), and aggression (d = 0.58); and none for alcohol use. There were no adverse events. Limitations of the study include the lack of long-term follow-up, non-blinding of service providers and participants, and no placebo or active comparison intervention. CETA provided by lay counselors was highly effective across disorders among trauma survivors compared to WLCs. These results support the further development and testing of transdiagnostic approaches as possible treatment options alongside existing EBTs. ClinicalTrials.gov NCT01459068 Please see later in the article for the Editors' Summary.",Bolton P.; Lee C.; Haroz EE.; Murray L.; Dorsey S.; Robinson C.; Ugueto AM.; Bass J.,2014.0,10.1371/journal.pmed.1001757,0,1,
709,"A randomized controlled trial of mental health interventions for survivors of systematic violence in Kurdistan, Northern Iraq.","Experiencing systematic violence and trauma increases the risk of poor mental health outcomes; few interventions for these types of exposures have been evaluated in low resource contexts. The objective of this randomized controlled trial was to assess the effectiveness of two psychotherapeutic interventions, Behavioral Activation Treatment for Depression (BATD) and Cognitive Processing Therapy (CPT), in reducing depression symptoms using a locally adapted and validated version of the Hopkins Symptom Checklist and dysfunction measured with a locally developed scale. Secondary outcomes included posttraumatic stress, anxiety, and traumatic grief symptoms. Twenty community mental health workers, working in rural health clinics, were randomly assigned to training in one of the two interventions. The community mental health workers conducted baseline assessments, enrolled survivors of systematic violence based on severity of depression symptoms, and randomly assigned them to treatment or waitlist-control. Blinded community mental health workers conducted post-intervention assessments on average five months later. Adult survivors of systematic violence were screened (N = 732) with 281 enrolled in the trial; 215 randomized to an intervention (114 to BATD; 101 to CPT) and 66 to waitlist-control (33 to BATD; 33 to CPT). Nearly 70% (n = 149) of the intervention participants completed treatment and post-intervention assessments; 53 (80%) waitlist-controls completed post-intervention assessments. Estimated effect sizes for depression and dysfunction were 0.60 and 0.55 respectively, comparing BATD participants to all controls and 0.84 and 0.79 respectively, compared to BATD controls only. Estimated effect sizes for depression and dysfunction were 0.70 and 0.90 respectively comparing CPT participants to all controls and 0.44 and 0.63 respectively compared to CPT controls only. Using a permutation-based hypothesis test that is robust to the model assumptions implicit in regression models, BATD had significant effects on depression (p = .003) and dysfunction (p = .007), while CPT had a significant effect on dysfunction only (p = .004). Both interventions showed moderate to strong effects on most outcomes. This study demonstrates effectiveness of these interventions in low resource environments by mental health workers with limited prior experience. ClinicalTrials.Gov NCT00925262 . Registered June 3, 2009.",Bolton P.; Bass JK.; Zangana GA.; Kamal T.; Murray SM.; Kaysen D.; Lejuez CW.; Lindgren K.; Pagoto S.; Murray LK.; Van Wyk SS.; Ahmed AM.; Amin NM.; Rosenblum M.,2014.0,10.1186/s12888-014-0360-2,0,1,
710,Dialectical behaviour therapy for post-traumatic stress disorder after childhood sexual abuse in patients with and without borderline personality disorder: a randomised controlled trial,"ER BACKGROUND: Post-traumatic stress disorder (PTSD) with co-occurring severe psychopathology such as borderline personality disorder (BPD) is a frequent sequel of childhood sexual abuse (CSA). CSA-related PTSD has been effectively treated through cognitive-behavioural treatments, but it remains unclear whether success can be achieved in patients with co-occurring BPD. The aim of the present study was to determine the efficacy of a newly developed modular treatment programme (DBT-PTSD) that combines principles of dialectical behaviour therapy (DBT) and trauma-focused interventions.METHODS: Female patients (n = 74) with CSA-related PTSD were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. About half of the participants met the criteria for co-occurring BPD. Individuals with ongoing self-harm were not excluded. The primary outcomes were reduction of PTSD symptoms as assessed by the Clinician-Administered PTSD Scale (CAPS) and by the Posttraumatic Stress Diagnostic Scale (PDS). Hierarchical linear models were used to compare improvements across treatment groups. Assessments were carried out by blinded raters at admission, at end of treatment, and at 6 and 12 weeks post-treatment.RESULTS: Under DBT-PTSD the mean change was significantly greater than in the control group on both the CAPS (33.16 vs. 2.08) and the PDS (0.70 vs. 0.14). Between-group effect sizes were large and highly significant. Neither a diagnosis of BPD nor the severity or the number of BPD symptoms was significantly related to treatment outcome. Safety analyses indicated no increase in dysfunctional behaviours during the trial.CONCLUSION: DBT-PTSD is an efficacious treatment of CSA-related PTSD, even in the presence of severe co-occurring psychopathology such as BPD.","Bohus, M; Dyer, A S; Priebe, K; Krüger, A; Kleindienst, N; Schmahl, C; Niedtfeld, I; Steil, R",2013.0,10.1159/000348451,0,1,
711,Internet-based attention training for social anxiety: A randomized controlled trial.,"Several studies suggest that computer-based attention modification programmes can be a promising new approach for the treatment of various anxiety disorders, including social anxiety disorder (SAD). The current study investigates the efficacy of a four-week Internet-delivered version of an attentional training for SAD in a randomized controlled double-blind study. Sixty-eight individuals seeking treatment for SAD were randomly assigned to either an attention training group (ATG, N = 33) or a control group (CG, N = 35). Participants of the ATG completed modified dot-probe tasks designed to facilitate attentional disengagement from threat. Participants in the CG completed control dot-probe tasks. At post-assessment, participants in both groups showed significant symptom reductions with medium to large within-group effect sizes on social anxiety measures (ATG: Cohen's d = .47-.80; CG: d = .56-.63). However, no significant differences between groups were found at post-treatment for any outcome measure. These findings will be discussed along with the results of a 4-months follow-up assessment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Boettcher, Johanna; Berger, Thomas; Renneberg, Babette; Amir, Amir, Amir, Andersson, Asmundson, Baker, Bar-Haim, Beck, Berger, Berger, Bradley, Buckner, Carlbring, Carlbring, Chen, Clark, Clark, Cohen, Constans, Derogatis, Derogatis, Fedoroff, Franke, Fresco, Fydrich, Gotlib, Gould, Hakamata, Hautzinger, Heimberg, Helfinstein, Hollandare, Hope, Horenstein, Issakidis, Jacobson, Joels, Keller, Kessler, Kuhner, Lincoln, Lundh, Maidenberg, Mattia, Mattick, Mogg, Mogg, Musa, Muhlberger, Olfson, Pineles, Pishyar, Posner, Powers, Rapee, Renneberg, Roberts, Rodebaugh, Rosnow, Saile, Schiller, Schmidt, Stangier, Stangier, Stopa, Titov, Titov, Tottenham, Vassilopoulos, Wang, Wittchen, Wittchen",2012.0,,0,1,
712,Internet-based mindfulness treatment for anxiety disorders: a randomized controlled trial.,"Mindfulness-based interventions have proven effective for the transdiagnostic treatment of heterogeneous anxiety disorders. So far, no study has investigated the potential of mindfulness-based treatments when delivered remotely via the Internet. The current trial aims at evaluating the efficacy of a stand-alone, unguided, Internet-based mindfulness treatment program for anxiety. Ninety-one participants diagnosed with social anxiety disorder, generalized anxiety disorder, panic disorder, or anxiety disorder not otherwise specified were randomly assigned to a mindfulness treatment group (MTG) or to an online discussion forum control group (CG). Mindfulness treatment consisted of 96 audio files with instructions for various mindfulness meditation exercises. Primary and secondary outcome measures were assessed at pre-, posttreatment, and at 6-months follow-up. Participants of the MTG showed a larger decrease of symptoms of anxiety, depression, and insomnia from pre- to postassessment than participants of the CG (Cohen's d(between)=0.36-0.99). Within effect sizes were large in the MTG (d=0.82-1.58) and small to moderate in the CG (d=0.45-0.76). In contrast to participants of the CG, participants of the MTG also achieved a moderate improvement in their quality of life. The study provided encouraging results for an Internet-based mindfulness protocol in the treatment of primary anxiety disorders. Future replications of these results will show whether Web-based mindfulness meditation can constitute a valid alternative to existing, evidence-based cognitive-behavioural Internet treatments. The trial was registered at ClinicalTrials.gov (NCT01577290).",Boettcher J.; Aström V.; Påhlsson D.; Schenström O.; Andersson G.; Carlbring P.,2014.0,10.1016/j.beth.2013.11.003,0,1,
713,I am > trauma: Experimentally reducing event centrality and PTSD symptoms in a clinical trial.,"Event centrality has been one of the strongest predictors of PTSD symptoms. We attempted to experimentally reduce event centrality using a modified version of Acceptance and Commitment Therapy (ACT) in a sample of traumatized participants from a community outreach center. Relative to a control group, participants who received ACT evidenced significant decreases in PTSD symptoms, depression, and event centrality. A mediation analysis revealed that the effect of condition on PTSD symptoms was mediated by decreases in event centrality. Only the effect of condition on depression was still significant at six weeks posttreatment. This study is the first to manipulate event centrality and suggests that components of ACT may be effective at reducing event centrality. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Boals, Adriel; Murrell, Amy R; Beck, Berntsen, Blanchard, Boals, Boals, Boals, Boelen, Brown, Gold, Hayes, Hayes, Livheim, McNally, Murrell, Preacher, Robinaugh, Rubin, Rubin, Schuettler, Shrout, Twohig, Weathers",2016.0,,0,1,
714,Early cognitive-behavioural therapy for post-traumatic stress symptoms after physical injury. Randomised controlled trial.,"Early single-session psychological interventions, including psychological debriefing following trauma, have not been shown to reduce psychological distress. Longer early psychological interventions have shown some promise. To examine the efficacy of a four-session cognitive-behavioural intervention following physical injury. A total of 152 patients attending an accident and emergency department displaying psychological distress following physical injury were randomised 1-3 weeks post-injury to a four-session cognitive-behavioural intervention that started 5-10 weeks after the injury or to no intervention and then followed up for 13 months. At 13 months, the total Impact of Event Scale score was significantly more reduced in the intervention group (adjusted mean difference=8.4,95% CI 2.4-14.36). Other differences were not statistically significant. A brief cognitive-behavioural intervention reduces symptoms of post-traumatic stress disorder in individuals with physical injury who display initial distress.",Bisson JI.; Shepherd JP.; Joy D.; Probert R.; Newcombe RG.,2004.0,,0,1,
715,Effects of a transdiagnostic unguided internet intervention ('velibra') for anxiety disorders in primary care: Results of a randomized controlled trial.,"Background: Internet-based cognitive-behavioural treatment (ICBT) for anxiety disorders has shown some promise, but no study has yet examined unguided ICBT in primary care. This randomized controlled trial (RCT) investigated whether a transdiagnostic, unguided ICBT programme for anxiety disorders is effective in primary care settings, after a face-to-face consultation with a physician (MD). We hypothesized that care as usual (CAU) plus unguided ICBT would be superior to CAU in reducing anxiety and related symptoms among patients with social anxiety disorder (SAD), panic disorder with or without agoraphobia (PDA) and/or generalized anxiety disorder (GAD). Method: Adults (n = 139) with at least one of these anxiety disorders, as reported by their MD and confirmed by a structured diagnostic interview, were randomized. Unguided ICBT was provided by a novel transdiagnostic ICBT programme ('velibra'). Primary outcomes were generic measures, such as anxiety and depression symptom severity, and diagnostic status at post-treatment (9 weeks). Secondary outcomes included anxiety disorder-specific measures, quality of life, treatment adherence, satisfaction, and general psychiatric symptomatology at follow-up (6 months after randomization). Results: CAU plus unguided ICBT was more effective than CAU at post-treatment, with small to medium between-group effect sizes on primary (Cohen's d = 0.41-0.47) and secondary (Cohen's d = 0.16-0.61) outcomes. Treatment gains were maintained at follow-up. In the treatment group, 28.2% of those with a SAD diagnosis, 38.3% with a PDA diagnosis, and 44.8% with a GAD diagnosis at pretreatment no longer fulfilled diagnostic criteria at post-treatment. Conclusions: The unguided ICBT intervention examined is effective for anxiety disorders when delivered in primary care. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Berger, T; Urech, A; Krieger, T; Stolz, T; Schulz, A; Vincent, A; Moser, C. T; Moritz, S; Meyer, B; Andersson, Andrews, Attkisson, Aydos, Baldwin, Ball, Barlow, Barlow, Bateson, Beard, Beck, Beck, Berger, Berger, Berger, Bergstrom, Bijl, Butler, Carlbring, Carver, Chambless, Chambless, Dear, Derogatis, El Alaoui, Emmelkamp, First, Fogliati, Grawe, Gueorguieva, Hedman, Hedman, Issakidis, Katz, Kessler, Kessler, Klein, Kroenke, Lovibond, Lowe, Mattick, McManus, Mendlowicz, Meyer, Meyer, Mogg, Moritz, Newby, Newby, Nordgren, Regier, Richards, Ruwaard, Spek, Stein, Titov, Titov, van Schaik, Waller, Wang, Wang, Ware, Weiller, Williams",2017.0,,0,1,
716,Internet-based treatment for social phobia: a randomized controlled trial.,"In this study conducted in the French-speaking part of Switzerland, 52 individuals with social phobia were randomly assigned either to an Internet-based cognitive-behavioral treatment with minimal contact with therapists via e-mail or to a waiting-list control group. Significant differences between the two groups were found at posttreatment on all primary outcome measures (social anxiety measures) and on two of the secondary outcome measures (general symptomatology, therapy goal attainment). On average, within-groups effect sizes were large for the primary outcomes (Cohen's d=0.82) and for secondary outcomes (Cohen's d=1.04). Moreover, subjects in the treatment group fulfilled the criteria of clinically significant improvement significantly more often than subjects in the control group on all measured dimensions (58% vs. 20%). Users' acceptance of the program was high. The results from the present study lend further support to the hypothesis that Internet-delivered interventions with minimal therapist contact are a promising treatment approach to social phobia.",Berger T.; Hohl E.; Caspar F.,2009.0,10.1002/jclp.20603,0,1,
717,Reductions in cortisol associated with primary care brief mindfulness program for veterans with PTSD.,"Patients with posttraumatic stress disorder (PTSD) have significant medical morbidity, which may be mediated by hypothalamic pituitary axis (HPA) dysfunction and reflected in cortisol output. Many veterans with PTSD are hesitant to engage in trauma-focused exposure treatments; therefore briefer, non-exposure-based treatments are needed; one such promising approach is an abbreviated Primary Care brief Mindfulness Program (PCbMP). This study investigated the relationship between dose-response to participation in a veterans PCbMP program and diurnal cortisol. Cortisol reflects HPA function and PTSD is associated with HPA dysregulation. Veterans with PTSD were identified in PC and randomly assigned to treatment as usual (TAU, n=21) or participation in brief 4-week Mindfulness Based Stress Reduction program (n=19). Veterans (n=40) (mean age, 48±16 y; 90% men) with PTSD referred through their VA PC provider and randomly assigned to PCbMP or TAU. As an objective indicator of HPA function, salivary diurnal cortisol was measured from samples collected across 2 consecutive days at baseline and follow-up. Analyses revealed that significant changes in cortisol were associated with PCbMP treatment engagement and dosing (number of mindfulness program sessions completed). Veterans completing 4 mindfulness-based meditation sessions significantly reduced their cortisol awakening response (P≤0.05); and had significant changes in cortisol area under the curve increase compared with TAU participants (P≤0.05). Results indicate that PCbMP has a beneficial physiological impact on veterans with PTSD with a minimum of 4 weeks of practice.",Bergen-Cico D.; Possemato K.; Pigeon W.,2014.0,10.1097/MLR.0000000000000224,0,1,
718,"Avoidance, safety behavior, and reassurance seeking in generalized anxiety disorder.","Background: The behavioral symptoms of Generalized Anxiety Disorder (GAD) are not well characterized. This study examines behavioral symptoms in patients with GAD compared to healthy participants, their change during behavioral therapy, and their role for predicting short- and long-term outcome. Methods: Secondary data analysis of 56 patients with DSM-IV GAD from a randomized controlled trial testing worry exposure (n = 29) and applied relaxation (n = 27), compared to 33 demographically matched healthy participants. Participants reported on attempts to control or prevent worry, specifically cognitive and behavioral avoidance, safety behavior, and reassurance, along with other GAD symptoms. The Hamilton Anxiety Scale served as immediate (post therapy) and the Penn State Worry Questionnaire as immediate and long-term (6-/12-month follow-up) treatment outcome measure. Results: GAD patients engage significantly more in attempts to control or prevent worry as reflected in cognitive and behavioral avoidance, safety behavior, and reassurance seeking than healthy comparison participants. Behavior therapy significantly reduces these behavioral strategies without substantial indication of differential effects of treatment type. However, only patients remitting from GAD reach the low symptom level of healthy participants. The initial level of behavioral symptoms is irrelevant for immediate treatment success, but higher degrees of cognitive and behavioral avoidance and safety behavior at the end of treatment predict worse long-term outcome. Conclusions: Behavioral symptoms appear to be relevant features in GAD that improve with successful treatment. Further research is warranted to examine whether inclusion of behavioral symptoms in the definition of GAD would have beneficial effects on diagnostic recognition and treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Beesdo-Baum, Katja; Jenjahn, Elsa; Hofler, Michael; Lueken, Ulrike; Becker, Eni S; Hoyer, Jurgen; Andrews, Becker, Becker, Beesdo, Beesdo-Baum, Behar, Borkovec, Borkovec, Coleman, Dugas, Dugas, Dugas, Efron, Fisher, Hamilton, Hazlett-Stevens, Hettema, Hoyer, Hoyer, Hoyer, Hunot, Kessler, Mennin, Meyer, Mitte, Rygh, Schut, Stober, Tallis, Townsend, Watson, Wells, Wittchen, Wittchen, Ost",2012.0,,0,1,
719,Controlled trial of psychotherapy for Congolese survivors of sexual violence.,"Survivors of sexual violence have high rates of depression, anxiety, and post-traumatic stress disorder (PTSD). Although treatment for symptoms related to sexual violence has been shown to be effective in high-income countries, evidence is lacking in low-income, conflict-affected countries. In this trial in the Democratic Republic of Congo, we randomly assigned 16 villages to provide cognitive processing therapy (1 individual session and 11 group sessions) or individual support to female sexual-violence survivors with high levels of PTSD symptoms and combined depression and anxiety symptoms. One village was excluded owing to concern about the competency of the psychosocial assistant, resulting in 7 villages that provided therapy (157 women) and 8 villages that provided individual support (248 women). Assessments of combined depression and anxiety symptoms (average score on the Hopkins Symptom Checklist [range, 0 to 3, with higher scores indicating worse symptoms]), PTSD symptoms (average score on the PTSD Checklist [range, 0 to 3, with higher scores indicating worse symptoms]), and functional impairment (average score across 20 tasks [range, 0 to 4, with higher scores indicating greater impairment]) were performed at baseline, at the end of treatment, and 6 months after treatment ended. A total of 65% of participants in the therapy group and 52% of participants in the individual-support group completed all three assessments. Mean scores for combined depression and anxiety improved in the individual-support group (2.2 at baseline, 1.7 at the end of treatment, and 1.5 at 6 months after treatment), but improvements were significantly greater in the therapy group (2.0 at baseline, 0.8 at the end of treatment, and 0.7 at 6 months after treatment) (P<0.001 for all comparisons). Similar patterns were observed for PTSD and functional impairment. At 6 months after treatment, 9% of participants in the therapy group and 42% of participants in the individual-support group met criteria for probable depression or anxiety (P<0.001), with similar results for PTSD. In this study of sexual-violence survivors in a low-income, conflict-affected country, group psychotherapy reduced PTSD symptoms and combined depression and anxiety symptoms and improved functioning. (Funded by the U.S. Agency for International Development Victims of Torture Fund and the World Bank; ClinicalTrials.gov number, NCT01385163.).",Bass JK.; Annan J.; McIvor Murray S.; Kaysen D.; Griffiths S.; Cetinoglu T.; Wachter K.; Murray LK.; Bolton PA.,2013.0,10.1056/NEJMoa1211853,0,1,
720,A randomized trial of the effectiveness of cognitive-behavioral therapy and supportive counseling for anxiety symptoms in older adults.,"The authors used a randomized trial to compare cognitive-behavioral therapy (CBT) and supportive counseling (SC) in the treatment of anxiety symptoms in older adults who met Diagnostic and Statistical Manual of Mental Disorders (4th ed.: American Psychiatric Association, 1994) criteria for anxiety disorders. Both conditions had a 6-week baseline no-treatment phase. Treatment was delivered primarily in patients' own homes and in an individual format. Outcomes were assessed at posttreatment and at 3-, 6-, and 12-month follow-ups. There was no spontaneous improvement during the baseline phase. Both groups showed improvement on anxiety measures following treatment, with a better outcome for the CBT group on self-rating of anxiety and depression. Over the follow-up period, the CBT group maintained improvement and had significantly greater improvement than the SC group on anxiety and 1 depression measure. Treatment response for anxiety was also superior for the CBT group, although there was no difference between groups in endstate functioning.",Barrowclough C.; King P.; Colville J.; Russell E.; Burns A.; Tarrier N.,2001.0,,0,1,
721,Cognitive-behavioral therapy for late-life anxiety: Similarities and differences between Veteran and community participants.,"Cognitive-behavioral therapy (CBT) is an evidence-based treatment for anxiety; however, a growing body of research suggests that CBT effect sizes are smaller in Veteran samples. The aim of this study was to perform secondary data analyses of a randomized controlled trial of CBT for late-life generalized anxiety disorder compared with treatment as usual (TAU) in a Veteran (n = 101) and community-based (n = 122) sample. Veterans had lower income and less education than community participants, greater severity on baseline measures of anxiety and depression, poorer physical health, and higher rates of psychiatric comorbidity. Treatment effects were statistically significant in the community sample (all ps < 0.01), but not in Veterans (all ps > 0.05). Further analyses in Veterans revealed that poorer perceived social support significantly predicted poorer outcomes (all ps < 0.05). Our results underscore the complexity of treating Veterans with anxiety, and suggest that additional work is needed to improve the efficacy of CBT for Veterans, with particular attention to social support.",Barrera TL.; Cully JA.; Amspoker AB.; Wilson NL.; Kraus-Schuman C.; Wagener PD.; Calleo JS.; Teng EJ.; Rhoades HM.; Masozera N.; Kunik ME.; Stanley MA.,2015.0,10.1016/j.janxdis.2015.04.005,0,1,
722,"Efficacy of single-session abreactive ego state therapy for combat stress injury, PTSD, and ASD.","Using abreactive Ego State Therapy (EST), 36 patients meeting DSM-IV-TR and PTSD checklist (PCL) criteria were exposed to either 5-6 hours of manualized treatment or placebo in a single session. EST emphasizes repeated hypnotically activated abreactive ""reliving"" of the trauma experience combined with therapists' ego strength. Both the placebo and EST treatment groups showed significant reductions in PTSD checklist scores immediately posttreatment (placebo: mean 17.34 points; EST: mean 53.11 points) but only the EST patients maintained significant treatment effect at 4-week and 16- to 18-week follow-ups. Abreactive EST appears to be an effective and durable treatment for PTSD inclusive of combat stress injury and acute stress disorder.",Barabasz A.; Barabasz M.; Christensen C.; French B.; Watkins JG.,2013.0,10.1080/00207144.2013.729377,0,1,
723,Efficacy of Cognitive Behaviour Therapy in Generalized Anxiety Disorders.,"Background: Generalized anxiety disorders (GAD) are amongst the most prevalent mental disorders. Recent studies have suggested that cognitive behaviour therapy (CBT) is an effective treatment for GAD. A controlled clinical trial was done to evaluate the efficacy of CBT treatment in outpatients with pure GAD who were treated by a therapist working in routine care. Methods: Seventy-two outpatients, fulfilling GAD criteria according to DSMIV, were included in the study. From this group, 36 patients (CBT-A) were randomly assigned to 25 sessions of CBT and the other 36 formed a contact control group (CCG). After the contact control period (CC period), these patients were also treated with CBT (CBT-B), allowing not only a parallel group comparison but also an A-B comparison. Therapists were licensed full-time psychologists who worked routinely in outpatient care and had a professional training in CBT. Treatment was done in accordance with a manual, and treatment conformity was controlled by several methods. Results: The reduction in the score on the Hamilton Anxiety Observer Rating Scale was 6.4% (1.5 points) in the CCG, 35.4% (9.5 points) in the CBT-A and 47.3% (10.3 points) in the CBTB. In the self-rating Spielberger State-Trait Anxiety Inventory, a reduction of 2.7% was seen in CCG, 14.6% in CBT-A, and 11.6% in CBT-B. According to the Clinical Global Impression Rating, 65.6% of patients were still at least moderately ill at the end of the CC period, while this rate was 33.4% at the end of CBT-A, or 15.7% at the end of CBT-B. All these differences between treatment and control group are statistically highly significant. The clinical improvement remained stable over a follow-up period of 8 months. Conclusions: CBT is an effective method of treatment for GAD. Differences between control and treatment group are comparable to or larger than those reported in studies on antidepressant drugs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Linden, M; Zubraegel, D; Baer, T; Franke, U; Schlattmann, P; Ballenger, Barlow, Borkovec, Borkovec, Borkovec, Brawman-Mintzer, Brawman-Mintzer, Butler, Carter, Couvee, Davidson, Dugas, Durham, Durham, Dyck, Fava, Fisher, Gelenberg, Gould, Hackett, Hamilton, Hautzinger, Kessler, Ladouceur, Linden, Linden, Linden, Linden, Linden, Linden, McCullagh, Pollack, Rickels, Rickels, Rocca, Roerig, Ruhmland, Sharpe, Sheehan, Sheehan, Spielberger, Wittchen, Zubragel, Ost",2005.0,,0,1,
724,Effects of participation in a mindfulness program for veterans with posttraumatic stress disorder: a randomized controlled pilot study.,"To assess outcomes associated with Mindfulness-Based Stress Reduction (MBSR) for veterans with PTSD. Forty-seven veterans with posttraumatic stress disorder (PTSD; 37 male, 32 Caucasian) were randomized to treatment as usual (TAU; n = 22), or MBSR plus TAU (n = 25). PTSD, depression, and mental health-related quality of life (HRQOL) were assessed at baseline, posttreatment, and 4-month follow-up. Standardized effect sizes and the proportion with clinically meaningful changes in outcomes were calculated. Intention-to-treat analyses found no reliable effects of MBSR on PTSD or depression. Mental HRQOL improved posttreatment but there was no reliable effect at 4 months. At 4-month follow-up, more veterans randomized to MBSR had clinically meaningful change in mental HRQOL, and in both mental HRQOL and PTSD symptoms. Completer analyses (≥ 4 classes attended) showed medium to large between group effect sizes for depression, mental HRQOL, and mindfulness skills. Additional studies are warranted to assess MBSR for veterans with PTSD.",Kearney DJ.; McDermott K.; Malte C.; Martinez M.; Simpson TL.,2013.0,10.1002/jclp.21911,0,1,
725,A randomized controlled trial of guided internet-delivered cognitive behaviour therapy for older adults with generalized anxiety.,"This study aimed to establish the efficacy of guided Internet-delivered cognitive-behaviour therapy (ICBT) for older adults with generalized anxiety disorder (GAD) or subclinical GAD. Participants were randomized to receive seven modules of ICBT (n=24) or to a waiting list condition (WLC; n=22). Faster improvements in symptoms of anxiety and depression were observed for participants in the ICBT condition relative to the WLC, with large between-group effect sizes on the Generalized anxiety disorder-7 (d=.85) and the Patient health questionnaire (d=1.17) obtained at post-treatment. Further reduction in generalized anxiety symptoms was reported over the one-month follow-up. Treatment effects were replicated when control participants subsequently underwent treatment. Higher ratings of treatment credibility, but not expectancy, prior to ICBT predicted improvements over time. The results support the efficacy of ICBT as treatment for older adults with GAD.",Jones SL.; Hadjistavropoulos HD.; Soucy JN.,2016.0,10.1016/j.janxdis.2015.10.006,0,1,
726,A RCT of a transdiagnostic Internet-delivered treatment for three anxiety disorders: Examination of support roles and disorder-specific outcomes.,"Background: Anxiety disorders share common vulnerabilities and symptoms. Disorder-specific treatment is efficacious, but few access evidence-based care. Administering transdiagnostic cognitive-behavioral therapy via the internet (iCBT) may increase access to evidence-based treatment, with a recent randomized controlled trial (RCT) providing preliminary support for this approach. This study extends those findings and aims to answer three questions: Is a transdiagnostic iCBT program for anxiety disorders efficacious and acceptable? Does it result in change for specific disorders? Can good clinical outcomes be obtained when guidance is provided via a Coach rather than a Clinician? Method: RCT (N = 131) comparing three groups: Clinician-supported (CL) vs. Coach-supported (CO) vs. waitlist control (Control). Individuals met DSM-IV criteria for a principal diagnosis of generalized anxiety disorder (GAD), social phobia (SP) or panic disorder with or without agoraphobia (Pan/Ag). Treatment consisted of an 8-lesson/10 week iCBT program with weekly contact from a Clinician or Coach, and follow-up at 3-months post-treatment. Results: Outcomes for the pooled treatment groups (CL+CO) were superior to the Control group on measures of anxiety, depression and disability, were associated with medium to large effect sizes (Cohen's d = .76-1.44) (response rate = 89-100%), and were maintained at follow-up. Significant reductions were found on disorder-specific outcomes for each of the target diagnoses, and were associated with large effect sizes. CO participants achieved similar outcomes to CL participants at post-treatment, yet had significantly lower symptom severity scores on general anxiety, panic-disorder, depression and disability at follow-up (d = .45-.46). Seventy-four percent of CO and 76% of CL participants completed the program. Less than 70 minutes of Clinician or Coach time was required per participant during the program. Discussion: This transdiagnostic iCBT course for anxiety appears to be efficacious, associated with significant change for three target disorders, and is efficacious when guided by either a Clinician or Coach. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Johnston, Luke; Titov, Nickolai; Andrews, Gavin; Spence, Jay; Dear, Blake F; Andersson, Andersson, Andersson, Andrews, Andrews, Antony, Barlow, Bennet-Levy, Brown, Burgess, Carlbring, Carlbring, Clark, Clark, Cuijpers, Devilly, Donker, Erickson, Garb, Goldberg, Hedman, Houck, Kroenke, Kroenke, Lecrubier, Leon, Lovibond, Lowe, Mansell, Marks, Mattick, McEvoy, Meyer, Norton, Norton, Norton, Page, Peters, Proudfoot, Richards, Robinson, Sheehan, Sheehan, Spitzer, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Vickers, Vickers, Wilamowska, Wims",2011.0,,0,1,
727,A randomized trial of MBSR versus aerobic exercise for social anxiety disorder.,"Objective: Effective treatments for social anxiety disorder (SAD) exist, but additional treatment options are needed for non responders as well as those who are either unable or unwilling to engage in traditional treatments. Mindfulness-based stress reduction (MBSR) is one nontraditional treatment that has demonstrated efficacy in treating other mood and anxiety disorders, and preliminary data suggest its efficacy in SAD as well. Method Fifty-six adults (52% female; 41% Caucasian; age mean [M] +/- standard deviation [SD]: 32.8 +/- 8.4) with SAD were randomized to MBSR or an active comparison condition, aerobic exercise (AE). At baseline and post-intervention, participants completed measures of clinical symptoms (Liebowitz Social Anxiety Scale, Social Interaction Anxiety Scale, Beck Depression Inventory-II, and Perceived Stress Scale) and subjective well-being (Rosenberg Self-Esteem Scale, Satisfaction with Life Scale, Self-Compassion Scale, and UCLA-8 Loneliness Scale). At 3 months post-intervention, a subset of these measures was re administered. For clinical significance analyses, 48 healthy adults (52.1% female; 56.3% Caucasian; age [M +/- SD]: 33.9 +/- 9.8) were recruited. MBSR and AE participants were also compared with a separate untreated group of 29 adults (44.8% female; 48.3% Caucasian; age [M +/- SD]: 32.3 +/- 9.4) with generalized SAD who completed assessments over a comparable time period with no intervening treatment. Results A 2 (Group) x 2 (Time) repeated measures analyses of variance (ANOVAs) on measures of clinical symptoms and well-being were conducted to examine pre-intervention to post-intervention and pre-intervention to 3-month follow-up. Both MBSR and AE were associated with reductions in social anxiety and depression and increases in subjective well-being, both immediately post-intervention and at 3 months post-intervention. When participants in the randomized controlled trial were compared with the untreated SAD group, participants in both interventions exhibited improvements on measures of clinical symptoms and well-being. Conclusion Nontraditional interventions such as MBSR and AE merit further exploration as alternative or complementary treatments for SAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Jazaieri, Hooria; Goldin, Philippe R; Werner, Kelly; Ziv, Michal; Gross, James J; Baer, Baer, Baker, Beck, Birnie, Borge, Broman-Fulks, Broocks, Brown, Bogels, Cairney, Cohen, Cordon, Cox, Craigie, Di Nardo, Diener, Dratcu, Evans, Fresco, Goldin, Goldin, Goldin, Grossman, Hays, Heimberg, Herring, Hewitt, Hofmann, Jacobson, Jacobson, Kabat-Zinn, Kabat-Zinn, Kessler, Kim, Knapen, Kocovski, Koszycki, Kuo, Lee, Liebowitz, Magee, Marks, Martinsen, McEntee, McIntyre, Merom, Miller, Moscovitch, Neff, Neff, Olfson, Otto, Pavot, Penedo, Petruzzello, Pontoski, Rodebaugh, Rodebaugh, Rosenberg, Russell, Salmon, Segal, Smits, Smits, Stathopoulou, Stein, Steptoe, Stich, Strohle, Vollestad, Wang, Werner",2012.0,,0,1,
728,"Comparison of Fluvoxamine alone, Fluvoxamine and cognitive psychotherapy and psychotherapy alone in the treatment of panic disorder in Kelantan--implications for management by family doctors.","This paper reports the result of a brief therapy attempt at treating panic in a busy outpatient psychiatric clinic. The patients were cases of panic referred from the various outpatient clinics within the hospital complex. The patients were divided into three groups at random using one of three modalities of treatment, i.e. cognitive behaviour therapy (CBT), CBT and Fluvoxamine (FVX), and FVX alone. The therapy was aimed for a maximum of nine sessions after which the patients were to be discharged. There were 14 patients in each group. The results show that all the groups were similar in the severity and scores pre treatment but after the different types of treatment there was a significant difference among them. The FVX alone group, showed significant improvement from the pretreatment levels but did not show as much improvement as the other groups and the mean score was only 9.07 after nine sessions. The best group was the CBT in combination with FVX. This indicates that the best way to treat panic is to combine drug treatment and psychological treatment. It is also shown from the study that the combination group requires less FVX than the FVX alone group. This finding has implications for the treatment of panic at the family physician clinic.",Azhar MZ.,2000.0,,0,1,
729,Web-based psychotherapy for posttraumatic stress disorder in war-traumatized Arab patients: Randomized controlled trial.,"Background: In recent years, armed conflicts in the Middle East have resulted in high rates of exposure to traumatic events. Despite the increasing demand of mental health care provision, ongoing violence limits conventional approaches of mental health care provision. Internet-based interventions for posttraumatic stress disorder (PTSD) have proved feasible and effective in Western countries, but their applicability and efficacy in war and conflict regions remains unknown. Objective: This study investigated the efficacy of a cognitive behavioral Internet-based intervention for war-traumatized Arab patients, with focus on Iraq. Methods: A total of 159 individuals with PTSD participated in a parallel group randomized trial. Participants were randomly allocated by a computer-generated sequence to a treatment group (n = 79) or a waiting list control group (n = 80). The treatment group received 2 weekly 45-minute cognitive behavioral interventions via Internet over a 5-week period (10 sessions in total). The primary outcome was recovery from posttraumatic stress symptoms. Results: Posttraumatic stress symptoms were significantly reduced from baseline to posttreatment (intention-to-treat analysis) in the treatment group relative to the control group (F1,157 = 44.29, P < .001, d = 0.92). Treatment effects were sustained at 3-month follow-up. Completer analysis indicated that 29 of 47 patients (62%) in the treatment group had recovered from posttraumatic stress symptoms at posttreatment (reliable change and Posttraumatic Stress Diagnostic Scale score <20) versus 1 patient (2%) in the control group (OR 74.19, 95% CI 9.93-585.8, P < .001) indicating that the chance of recovering was 74.19 times higher in the treatment than in the control group. Conclusions: The results indicate, even in unstable and insecure settings with ongoing exposure to human rights violations through war and dictatorships, people with posttraumatic stress symptoms benefit from a cognitive behavioral treatment provided entirely through the Internet. This method of delivery could improve patients' access to humanitarian aid in the form of e-mental health services. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Knaevelsrud, Christine; Brand, Janine; Lange, Alfred; Ruwaard, Jeroen; Wagner, Birgit; Al Sheibani, Al-Jawadi, Amoldi, Benight, Bradley, Burnham, Cohen, Derogatis, Devilly, el Sarraj, Everitt, Eysenbach, Foa, Griffiths, Guillemin, Hicks, Hicks, Jacobson, Klein, Knaevelsrud, Knaevelsrud, Knaevelsrud, Laban, Lampe, Lange, Lange, Lange, Lange, Litz, Mollica, Myers, Neuner, Norris, Schaal, Schmidt, Steel, Titov, Wagner, Wagner, Wagner, Wagner, Webster",2015.0,,0,1,
730,Cognitive and guided mastery therapies for panic disorder with agoraphobia: 18-year long-term outcome and predictors of long-term change.,"In this study, we wished to compare the long-term outcome of (medication-free) panic disorder with agoraphobia patients randomized to cognitive or guided mastery therapy. Thirty-one (67.4%) of 46 patients who had completed treatment were followed up about 18 years after end of treatment. In the combined sample and using intent-to-follow-up analyses, there were large within-group effect sizes of -1.79 and -1.63 on the primary interview-based and self-report outcome measures of avoidance of situations when alone, and 56.5% no longer had a panic disorder and/or agoraphobia diagnosis. No outcome differences between the two treatments emerged. Guided mastery was associated with greater beneficial changes in catastrophic beliefs and self-efficacy. For two of five outcome measures, more reduction in panic-related beliefs about physical and mental catastrophes from pre- to post-treatment predicted lower level of anxiety from post-treatment to 18-year follow-up when the effect of treatment changes in (a) self-efficacy and (b) anxiety was controlled. However, for one of the outcome measures, this effect attenuated with time. Key Practitioner Message: 1. The results suggest that the very-long-term outcome of both cognitive therapy and guided mastery therapy for agoraphobia is positive. 2. The results support the role of catastrophic beliefs as mediator of change. 3. The pattern of results suggests that learning processes other than catastrophic beliefs may be important for long-term outcome as well. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hoffart, Asle; Hedley, Liv M; Svanoe, Karol; Sexton, Harold; Beck, Borenstein, Bouchard, Bruce, Chambless, Chambless, Chambless, Clark, Clark, Clark, Clum, Craske, Durham, Emmelkamp, Fava, Fitzmaurice, Gloster, Gloster, Hoffart, Hoffart, Hoffart, Kessler, Marchand, Mavissakalian, Michelson, Milrod, Norton, Ost, Ost, Peter, Sanches-Meca, Shrout, Smits, Spielberger, Spitzer, Stewart, Vallis, Williams, Wittchen",2016.0,,0,1,
731,Vets prevail online intervention reduces PTSD and depression in veterans with mild-to-moderate symptoms.,"Objective: Despite heightened rates of depression and posttraumatic stress disorder (PTSD) among in Iraq/Afghanistan veterans, the majority of distressed veterans will not receive mental health care. Overcoming barriers to mental health services requires innovative approaches to broaden the reach of evidence-based treatment. The current study examined the efficacy and acceptability of an innovative and dynamic online cognitive-behavioral therapy intervention for PTSD and depression called Vets Prevail. Method: A randomized clinical trial conducted between 2011 and 2013 assessed changes in PTSD and depression in veterans with mild-to-moderate distress. Veterans randomized to Vets Prevail (n = 209) were aged 34.2 +/- 7.6 years, mostly male (81.3%), and nonminority (73.7%). Veterans randomized to adjustment as usual (n = 94) were aged 34.7 +/- 8.9, mostly male (81.9%), and White (67.0%). Veterans completed the PTSD Checklist-Military Version and the Center for Epidemiological Studies Depression scale (10-item version) postintervention and at 12-week follow-up. Results: Veterans in the Vets Prevail condition reported significantly greater reductions in PTSD, t(250) = 3.24, p = .001 (Mreduction = 5.51, SD = 9.63), and depression, t(252) = 4.37, p = .001 (Mreduction = 2.31, SD = 5.34), at 12-week follow-up compared with veterans in the adjustment as usual condition (PTSD Mreduction = 1.00, SD = 7.32; depression Mreduction = 0.48, SD = 4.95), with moderate effect sizes for PTSD (Cohen's d = 0.42) and depression (Cohen's d = 0.56). Exploratory analysis shows that Vets Prevail may be effective regardless of combat trauma exposure, gender, and ethnic minority status. Conclusion: Vets Prevail circumvents many barriers to care and effectively addresses the dire mental health needs of veterans. (PsycINFO Database Record (c) 2017 APA, all rights reserved) Impact Statement What is the public health significance of this article?-This study describes one of the first interactive online programs (Vets Prevail) offered anonymously to veterans. The study shows that Vets Prevail is effective for treating mild-to-moderate symptoms of PTSD and depression and may be effective for veterans with high combat exposure, female veterans, and veterans from ethnic minority groups. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Hobfoll, Stevan E; Blais, Rebecca K; Stevens, Natalie R; Walt, Lisa; Gengler, Richard; Andresen, Andrews, Belsher, Bisson, Blais, Blais, Bliese, Bradley, Brief, Brinkerhoff, Cleary, Dickstein, Dumville, Eftekhari, Goodson, Hirai, Hoge, Jakupcak, Kemp, Kessler, Lane, Lange, Le, Litz, Mello, Monson, Muresan, Owens, Radloff, Sayer, Schnurr, Seal, Simon-Arndt, Sohn, Spence, Sutherland, Tanielian, van Straten, Vogt, Vogt, Weathers, Weeks, Whealin",2016.0,,0,1,
732,EMDR for panic disorder with agoraphobia: Comparison with waiting list and credible attention-placebo control conditions.,"In a randomized controlled trial, eye movement desensitization and reprocessing (EMDR) for panic disorder with agoraphobia (PDA) was compared with both waiting list and credible attention-placebo control groups. EMDR was significantly better than waiting list for some outcome measure, (questionnaire, diary, and interview measures of severity of anxiety, panic disorder, and agoraphobia) but not for others (panic attack frequency and anxious cognitions). However, low power and, for panic frequency, floor effects may account for these negative results. Differences between EMDR and the attention placebo control condition were not statistically significant on any measure, and, in this case, the effect sizes were generally small (eta = .00-.06), suggesting the poor results for EMDR were not due to lack of power. Because there are established effective treatments such as cognitive-behavior therapy for PDA, these data, unless contradicted by future research, indicate EMDR should not be the first-line treatment for this disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Goldstein, Alan J; de Beurs, Edwin; Chambless, Dianne L; Wilson, Kimberly A; Bates, Beck, Beck, Bernstein, Borkovec, Butler, Chambless, Chambless, Chambless, Chambless, Chambless, Chambless, Clark, Clark, Cohen, de Beurs, de Jongh, Derogatis, DeRubeis, Feske, Feske, First, First, Foley, Gelder, Gillis, Goldstein, Hollingshead, Kendall, Lipke, Marcus, Margraf, Marks, Marquis, Mavissakalian, McGlynn, Muris, Muris, Muris, Ost, Rogers, Rothbaum, Scheck, Shapiro, Shear, Shear, Steketee, Taylor, Telch, van Balkom, van Etten, Weissman, Williams, Wilson",2000.0,,0,1,
733,Treating low-income and minority women with posttraumatic stress disorder: A pilot study comparing prolonged exposure and treatment as usual conducted by community therapists.,"Twenty-one female psychiatric outpatients with chronic posttraumatic stress disorder (PTSD) are randomly assigned to prolonged exposure (PE; n = 9) for PTSD or treatment as usual (TAU; n = 12). Participants are predominately low income and African American with complex trauma and psychiatric histories. Treatment is delivered by community therapists with no prior training in behavior therapy for anxiety disorders. Clients who completed PE show a greater improvement in PTSD symptoms, general anxiety, and depression than clients who completed TAU. These findings provide preliminary evidence suggesting that PE is an effective treatment for core PTSD symptoms, even when delivered by community therapists in a front-line services clinic. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Feske, Ulrike; Beck, Beck, Becker, Bradley, Chambless, Cloitre, Cohen, Derogatis, Feske, First, First, Foa, Foa, Foa, Foa, Gillespie, Hembree, Jacobson, Linehan, Linehan, Miranda, Miranda, Najavits, Spielberger, Switzer, Verheul, Weiss",2008.0,,0,1,
734,Treatment outcome for chronic PTSD among female assault victims with borderline personality characteristics: A preliminary examination.,"The present study examined the effect of the presence of borderline personality disorder characteristics (BPC) on patients' responses to cognitive behavioral treatment for chronic PTSD. Seventy-two female victims (mean age 34.9 yrs) of sexual and non-sexual assault were randomly assigned to one of four treatment conditions: prolonged exposure, stress inoculation training, combined treatment and wait list control. Treatment consisted of nine bi-weekly individual sessions. Seventeen percent of the patients met full (10%) or partial criteria (7%) for borderline personality disorder. A greater number of patients with BPC reported sexual assault in childhood compared to those without the symptomatology. Patients with BPC also reported more pre-treatment anger. In general, those with BPC benefited significantly from treatment, although at post-treatment, they were less likely to achieve good end-state functioning than those without such symptomatology. The relationship between BPC and treatment response is discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Feeny, Norah C; Zoellner, Lori A; Foa, Edna B; Alden, Beck, Brown, Dreessen, Dreessen, Faustman, Feske, Foa, Foa, Foa, Foa, Foa, Fossati, Hersen, Jaycox, Linehan, Marks, Mersch, Pitman, Rathus, Rothbaum, Southwick, Spielberger, Spielberger, Spitzer, Van Velzen, Weissman, Zanarini",2002.0,,0,1,
735,"Paroxetine, clomipramine, and cognitive therapy in the treatment of panic disorder.","This 12-week, placebo-controlled study was carried out to compare the relative efficacy of paroxetine, clomipramine, and cognitive therapy in the treatment of DSM-III-R-defined panic disorder with or without agoraphobia. After a 3-week single-blind, placebo run-in period, 131 patients were randomly assigned to receive double-blind medication or 12 sessions of cognitive therapy based on the model of Clark. Efficacy assessments included the daily panic attack diary, the Clinical Global Impression scale, the Patient Global Evaluation, the Hamilton Rating Scale for Anxiety, the Marks-Sheehan Phobia Scale, the Montgomery-Asberg Depression Rating Scale, and the Sheehan Disability Scale. Comparisons with placebo revealed significant superiority of paroxetine (20-60 mg/day) and clomipramine (50-150 mg/day) on nearly all outcome measures. On most measures, paroxetine also showed higher efficacy than cognitive therapy. With few exceptions, cognitive therapy did not differ significantly from placebo. The number of subjects becoming panic-free (66%) was higher and the onset of action was faster in the paroxetine-treated group. Treatment with cognitive therapy yielded the highest drop-out rate (26%). In this short-term study assessing treatment of panic disorder and agoraphobia, paroxetine and clomipramine were consistently superior to pill placebo, whereas cognitive therapy was superior on only a few measures.",Bakker A.; van Dyck R.; Spinhoven P.; van Balkom AJ.,1999.0,,0,1,
736,Predicting who benefits from psychoeducation and self help for panic attacks.,"Self-help and psychoeducation have been identified as effective methods for delivering treatment, yet not everyone benefits from these brief interventions. Therefore it is clinically and economically useful to identify who is likely to require more intensive assistance. This paper develops a prognostic scale which predicts who will recover from panic attacks and who will require more assistance. Random regression models were used to evaluate the relationship between predictive variables, baseline severity, and the rate of improvement in 117 people with DSMIV panic attacks who participated in a trial of a psycho-educational booklet, a self-help workbook, and brief group CBT over a 9-month period. ROC analysis was used to choose cut-off points on a scale made up of significant predictors. Panic disorder and agoraphobia symptom measures were predicted by baseline social anxiety, and general mental health. There was no significant effect on the outcome for baseline depression or anxiety sensitivity. While general mental health (SF12 Mental Component scores) was predicted by the age at first panic attack, neuroticism, panic disorder and/or agoraphobia symptoms and a positive screen for alcohol use disorders. A prognostic scale based on simple additive scoring was equivalent to standard scores and significantly better than chance at predicting who would recover and who required face-to-face therapy. The prognostic scale may be used to guide the choice of psychoeducation, self-help or face-to-face therapy as the first step in stepped care.",Baillie AJ.; Rapee RM.,2004.0,10.1016/S0005-7967(03)00157-8,0,1,
737,"An investigator-blinded, randomized study to compare the efficacy of combined CBT for alcohol use disorders and social anxiety disorder versus CBT focused on alcohol alone in adults with comorbid disorders: the Combined Alcohol Social Phobia (CASP) trial protocol","ER BACKGROUND: Alcohol use disorders and social anxiety disorder are common and disabling conditions that frequently co-exist. Although there are efficacious treatments for each disorder, only two randomized controlled trials of interventions for these combined problems have been published. We developed a new integrated treatment for comorbid Social Anxiety Disorder and Alcohol Use Disorder based on established Motivational Interviewing (MI) and Cognitive Behaviour Therapy (CBT) interventions for the separate disorders. Compared to established MI/CBT for alcohol use disorders this new intervention is hypothesised to lead to greater reductions in symptoms of social anxiety and alcohol use disorder and to produce greater improvements in quality of life. Higher levels of alcohol dependence will result in relatively poorer outcomes for the new integrated treatment.METHODS/DESIGN: A randomised controlled trial comparing 9 sessions of individual integrated treatment for alcohol and social phobia with 9 sessions of treatment for alcohol use problems alone is proposed. Randomisation will be stratified for stable antidepressant use. Post treatment clinical assessments of alcohol consumption and diagnostic status at 3 and 6 month follow-up will be blind to allocation.DISCUSSION: The proposed trial addresses a serious gap in treatment evidence and could potentially define the appropriate treatment for a large proportion of adults affected by these problems.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12608000228381.","Baillie, A J; Sannibale, C; Stapinski, L A; Teesson, M; Rapee, R M; Haber, P S",2013.0,10.1186/1471-244X-13-199,0,1,
738,Psychotherapy integration under scrutiny: investigating the impact of integrating emotion-focused components into a CBT-based approach: a study protocol of a randomized controlled trial.,"This currently recruiting randomized controlled trial investigates the effects of integrating components of Emotion-Focused Therapy (EFT) into Psychological Therapy (PT), an integrative form of cognitive-behavioral therapy in a manner that is directly mirroring common integrative practice in the sense of assimilative integration. Aims of the study are to understand how both, an existing therapy approach as well as the elements to be integrated, are affected by the integration and to clarify the role of emotional processing as a mediator of therapy outcome. A total of 130 adults with a diagnosed unipolar depressive, anxiety or adjustment disorder (seeking treatment at a psychotherapy outpatient clinic) are randomized to either treatment as usual (PT) with integrated emotion-focused components (TAU + EFT) or PT (TAU). Primary outcome variables are psychopathology and symptom severity at the end of therapy and at follow up; secondary outcome variables are interpersonal problems, psychological wellbeing, quality of life, attainment of individual therapy goals, and emotional competency. Furthermore, process variables such as the quality of the therapeutic relationship are studied as well as aptitude-treatment interactions. Variables are assessed at baseline, after 8 and 16 sessions, at the end of therapy, after 25 ± 3 sessions, and at 6, 12 and 36 month follow-up. Underlying mechanisms of change are investigated. Statistical analyses will be conducted using the appropriate multilevel approaches, mainly two-level regression and growth analysis. The results of this study will indicate whether the integration of emotion-focused elements into treatment as usual increases the effectiveness of Psychological Therapy. If advantages are found, which may be limited to particular variables or subgroups of patients, recommendations for a systematic integration, and caveats if also disadvantages are detected, can be formulated. On a more abstract level, a cognitive behavioral (represented by PT) and humanistic/experiential (represented by EFT) approach will be integrated. It must be emphasized that mimicking common practice in the development and continued education of psychotherapists, EFT is not integrated as a whole, but only elements of EFT that are considered particularly important, and can be trained in an 8-day training plus supervision of therapies. ClinicalTrials.gov, NCT02822443 , 22 June 2016, retrospectively registered.",Babl A.; Grosse Holtforth M.; Heer S.; Lin M.; Stähli A.; Holstein D.; Belz M.; Egenolf Y.; Frischknecht E.; Ramseyer F.; Regli D.; Schmied E.; Flückiger C.; Brodbeck J.; Berger T.; Caspar F.,2016.0,10.1186/s12888-016-1136-7,0,1,
739,Effectiveness of Acceptance and Commitment Therapy on Interpersonal Problems and Psychological Flexibility in Female High School Students With Social Anxiety Disorder.,"Social anxiety is a psychological disorder which has devastative and pernicious effects on interpersonal relationships and one's psychological flexibility. The aim of this research was to determine the effectiveness of Acceptance and Commitment Therapy on interpersonal problems and psychological flexibility in female high school students with social anxiety disorder. With a semi-experimental design, the subjects were assessed using the Social Anxiety Scale and clinical interview. The statistical population of the research was high school female students studying in 5 areas of Isfahan. 30 individuals were purposively selected as the sample. The subjects of the research were randomly assigned to the experimental and control groups. Acceptance and Commitment Therapy was given in 10 sessions of 90 minutes in the experimental group and the control group did not receive any treatment. Pre-test and post-test scores of Inventory of Interpersonal Problems, and Acceptance and Action Questionnaire were analyzed using multivariate analysis of variance & the results showed that after the intervention, there was a significant difference between the scores of the subjects in the experimental and control groups. This means that Acceptance and Commitment Therapy can influence interpersonal problems and their six dimensions and psychological flexibility as well.",Azadeh SM.; Kazemi-Zahrani H.; Besharat MA.,2015.0,10.5539/gjhs.v8n3p131,0,1,
740,A randomised controlled trial of acceptance and commitment therapy and cognitive-behaviour therapy for generalised anxiety disorder.,"The study examined the relative efficacy of group acceptance and commitment therapy (ACT) for generalised anxiety disorder (GAD) compared to group cognitive-behavioural therapy (CBT). Fifty-one individuals with GAD were randomly allocated to a 6-week intervention, either ACT or CBT. Participants were assessed at pre-treatment, post-treatment, and 3-month follow-up on symptom measures, quality of life, and process measures. Data from 38 participants (19 in each group) were available at post-assessment, indicating significant improvements on all measures for both treatment conditions. Treatment gains were maintained at follow-up, with significant further improvements in anxiety, depression and stress symptoms for both groups. While no between-group differences were found at treatment completion, a significant interaction indicating steeper reduction in worrying symptoms (d = .79) from pre- to post-assessment was found for the ACT group compared to the CBT group. Furthermore, in relation to worrying, at treatment completion 78.9% of participants in the ACT group achieved reliable change compared to 47.4% of participants in the CBT group. However, both groups showed equivalent reliable change rates of 60% at the follow-up assessment. The results suggest that group ACT was as efficacious as group CBT. While participants in the ACT group maintained treatment gains at follow-up, participants in the CBT group continued to improve between post-assessment and follow-up. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Avdagic, Elbina; Morrissey, Shirley A; Boschen, Mark J; Arch, Ballenger, Bond, Borkovec, Boschen, Brown, Brown, Brown, Buhr, Covin, Devilly, Di Nardo, Eifert, Erickson, Forman, Forman, Forsyth, Frish, Frish, Glaser, Gould, Hayes, Hayes, Hayes, Hayes-Skelton, Herbert, Holowka, Jacobson, Kazdin, Kessler, Lovibond, McGrath, Meyer, Moher, Molina, Newman, Powers, Roemer, Roemer, Roemer, Sexton, Westen, Wetherell, Wittchen, Yonkers, Zinbarg, Ost",2014.0,,0,1,
741,Randomized clinical trial comparing affect regulation and supportive group therapies for victimization-related PTSD with incarcerated women.,"Traumatic victimization and associated problems with posttraumatic stress disorder (PTSD) and affect dysregulation are prevalent among incarcerated women, but there is limited evidence to support psychotherapeutic interventions for these problems in this underserved population. A group psychotherapy designed to enhance affect regulation without trauma memory processing-Trauma Affect Regulation: Guide for Education and Therapy (TARGET)-was compared to a supportive group therapy (SGT) in a randomized clinical trial with 72 incarcerated women with full or partial PTSD. Both interventions achieved statistically significant reductions in PTSD and associated symptom severity and increased self-efficacy. Dropout rates for both interventions were low (<5%). TARGET was more effective than SGT in increasing sense of forgiveness toward others who have caused harm in the past. Group therapy that teaches affect regulation may enhance incarcerated women's ability to achieve affective resolution (forgiveness) while also reducing their victimization-related PTSD and associated symptoms. Experiential-focused supportive group therapy also may reduce victimization-related PTSD and associated symptoms. Both group therapy approaches warrant further study with this vulnerable population. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Ford, Julian D; Chang, Rocio; Levine, Joan; Zhang, Wanli; Barkham, Beck, Benish, Blake, Bonanno, Bosgelmez, Bradley, Briere, Browne, Bryk, Cahill, Campanini, Catanzaro, Charuvastra, Cloitre, Cloitre, Cohen, Cole, Colosetti, Cook, Dietrich, Ehring, Eisner, Folstein, Ford, Ford, Ford, Ford, Ford, Ford, Frisman, Gratz, Green, Haglund, Hare, Hebert, Humeniuk, Islam-Zwart, Jaycox, Jordan, Jordan, Kamath, Kessler, Koons, Manderscheid, Marrow, Maughan, McDonagh-Coyle, Messman-Moore, Morgan, Neale, Osher, Prins, Rauch, Ready, Reed, Resick, Sabol, Salgado, Schnurr, Schnurr, Scragg, Shea, Singer, Snyder, Snyder, Steadman, Stein, Taylor, Teplin, Teplin, Teplin, Thompson, Trestman, Tull, van der Kolk, Van Dijke, Wallis, Wampold, Weathers, Wolff, Zlotnick, Zlotnick, Zlotnick",2013.0,,0,1,
742,Cognitive therapy versus interoceptive exposure as treatment of panic disorder without agoraphobia.,"Cognitive therapy (CT) and interoceptive exposure (IE) as treatments of panic disorder without agoraphobia were compared in a sample of 69 patients, randomly allocated to condition. There were no significant differences between treatments as to reductions in panic frequency, daily anxiety levels and a composite questionnaire score, at posttest after the 12-session treatment, and at both follow-ups (4 weeks, 6 months). In both conditions, high percentages of patients were panic free at post and follow-up tests (range 75-92%). Although the reduction in idiosyncratic beliefs about the catastrophic nature of bodily sensations was equally strong in both conditions, post-treatment beliefs correlated strongly with symptoms at post and follow-up tests in the CT condition, but not in the IE condition. Reduction of beliefs may be essential in CT, but not in IE. This suggests that the two treatments utilize different change mechanisms.",Arntz A.,2002.0,,0,1,
743,"Transdiagnostic group CBT vs. standard group CBT for depression, social anxiety disorder and agoraphobia/panic disorder: Study protocol for a pragmatic, multicenter non-inferiority randomized controlled trial.","Transdiagnostic Cognitive Behavior Therapy (TCBT) manuals delivered in individual format have been reported to be just as effective as traditional diagnosis specific CBT manuals. We have translated and modified the ""The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders"" (UP-CBT) for group delivery in Mental Health Service (MHS), and shown effects comparable to traditional CBT in a naturalistic study. As the use of one manual instead of several diagnosis-specific manuals could simplify logistics, reduce waiting time, and increase therapist expertise compared to diagnosis specific CBT, we aim to test the relative efficacy of group UP-CBT and diagnosis specific group CBT. The study is a partially blinded, pragmatic, non-inferiority, parallel, multi-center randomized controlled trial (RCT) of UP-CBT vs diagnosis specific CBT for Unipolar Depression, Social Anxiety Disorder and Agoraphobia/Panic Disorder. In total, 248 patients are recruited from three regional MHS centers across Denmark and included in two intervention arms. The primary outcome is patient-ratings of well-being (WHO Well-being Index, WHO-5), secondary outcomes include level of depressive and anxious symptoms, personality variables, emotion regulation, reflective functioning, and social adjustment. Assessments are conducted before and after therapy and at 6 months follow-up. Weekly patient-rated outcomes and group evaluations are collected for every session. Outcome assessors, blind to treatment allocation, will perform the observer-based symptom ratings, and fidelity assessors will monitor manual adherence. The current study will be the first RCT investigating the dissemination of the UP in a MHS setting, the UP delivered in groups, and with depressive patients included. Hence the results are expected to add substantially to the evidence base for rational group psychotherapy in MHS. The planned moderator and mediator analyses could spur new hypotheses about mechanisms of change in psychotherapy and the association between patient characteristics and treatment effect. Clinicaltrials.gov NCT02954731 . Registered 25 October 2016.",Arnfred SM.; Aharoni R.; Hvenegaard M.; Poulsen S.; Bach B.; Arendt M.; Rosenberg NK.; Reinholt N.,2017.0,10.1186/s12888-016-1175-0,0,1,
744,Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders.,"Randomized comparisons of acceptance-based treatments with traditional cognitive behavioral therapy (CBT) for anxiety disorders are lacking. To address this gap, we compared acceptance and commitment therapy (ACT) to CBT for heterogeneous anxiety disorders. One hundred twenty-eight individuals (52% female, mean age = 38, 33% minority) with 1 or more DSM-IV anxiety disorders began treatment following randomization to CBT or ACT; both treatments included behavioral exposure. Assessments at pre-treatment, post-treatment, and 6- and 12-month follow-up measured anxiety-specific (principal disorder Clinical Severity Ratings [CSRs], Anxiety Sensitivity Index, Penn State Worry Questionnaire, Fear Questionnaire avoidance) and non-anxiety-specific (Quality of Life Index [QOLI], Acceptance and Action Questionnaire-16 [AAQ]) outcomes. Treatment adherence, therapist competency ratings, treatment credibility, and co-occurring mood and anxiety disorders were investigated. CBT and ACT improved similarly across all outcomes from pre- to post-treatment. During follow-up, ACT showed steeper linear CSR improvements than CBT (p < .05, d = 1.26), and at 12-month follow-up, ACT showed lower CSRs than CBT among completers (p < .05, d = 1.10). At 12-month follow-up, ACT reported higher AAQ than CBT (p = .08, d = 0.42; completers: p < .05, d = 0.56), whereas CBT reported higher QOLI than ACT (p < .05, d = 0.42). Attrition and comorbidity improvements were similar; ACT used more non-study psychotherapy at 6-month follow-up. Therapist adherence and competency were good; treatment credibility was higher in CBT. Overall improvement was similar between ACT and CBT, indicating that ACT is a highly viable treatment for anxiety disorders.",Arch JJ.; Eifert GH.; Davies C.; Plumb Vilardaga JC.; Rose RD.; Craske MG.,2012.0,10.1037/a0028310,0,1,
745,Randomized clinical trial of adapted mindfulness-based stress reduction versus group cognitive behavioral therapy for heterogeneous anxiety disorders.,"To compare a mindfulness-based intervention with cognitive behavioral therapy (CBT) for the group treatment of anxiety disorders. One hundred five veterans (83% male, mean age=46 years, 30% minority) with one or more DSM-IV anxiety disorders began group treatment following randomization to adapted mindfulness-based stress reduction (MBSR) or CBT. Both groups showed large and equivalent improvements on principal disorder severity thru 3-month follow up (ps<.001, d=-4.08 for adapted MBSR; d=-3.52 for CBT). CBT outperformed adapted MBSR on anxious arousal outcomes at follow up (p<.01, d=.49) whereas adapted MBSR reduced worry at a greater rate than CBT (p<.05, d=.64) and resulted in greater reduction of comorbid emotional disorders (p<.05, d=.49). The adapted MBSR group evidenced greater mood disorders and worry at Pre, however. Groups showed equivalent treatment credibility, therapist adherence and competency, and reliable improvement. CBT and adapted MBSR were both effective at reducing principal diagnosis severity and somewhat effective at reducing self-reported anxiety symptoms within a complex sample. CBT was more effective at reducing anxious arousal, whereas adapted MBSR may be more effective at reducing worry and comorbid disorders.",Arch JJ.; Ayers CR.; Baker A.; Almklov E.; Dean DJ.; Craske MG.,2013.0,10.1016/j.brat.2013.01.003,0,1,
746,Which treatment worked better for whom? Moderators of group cognitive behavioral therapy versus adapted mindfulness based stress reduction for anxiety disorders.,"Identifying treatment moderators facilitates treatment matching and personalized medicine. No previous studies have investigated treatment moderators for a mindfulness-based versus traditional cognitive behavioral therapy (CBT) for anxiety disorders to determine for whom each is most effective. The current study examined three putative moderators of principal anxiety disorder severity outcomes for adapted mindfulness based stress reduction (MBSR) and group CBT - baseline depression symptoms, anxiety sensitivity, and diagnostic severity. Seventy-one patients with a DSM-IV anxiety disorder were randomized to adapted MBSR or group CBT and assessed at baseline, post-treatment, and 3-month follow up. CBT outperformed adapted MBSR among those with no to mild depressive symptoms and, at post-treatment only, among those with very high anxiety sensitivity. At follow up, adapted MBSR outperformed CBT among those with moderate to severe depressive symptoms and among those with average anxiety sensitivity (for this sample). Baseline severity affected post-treatment outcomes differently in CBT than in adapted MBSR. Baseline levels of depression, anxiety sensitivity, and to some extent diagnostic severity, differentially moderated outcomes in CBT and adapted MBSR for anxiety disorders. Recommendations and clinical implications are discussed.",Arch JJ.; Ayers CR.,2013.0,10.1016/j.brat.2013.04.004,0,1,
747,Predictors and moderators of Internet-based cognitive behavior therapy for obsessive-compulsive disorder: Results from a randomized trial.,"Internet-based cognitive behavior therapy (ICBT) for obsessive-compulsive disorder (OCD) has shown efficacy in randomized trials but many patients do not respond to the treatment, we therefore need to find predictors and moderators of treatment response. In this study, we analyzed predictors of ICBT response using both post-treatment as well as 24-month outcome data. As half of the participants were randomized to receive an Internet-based booster program as an adjunct to ICBT, we also investigated moderators of ICBT with or without booster. Results showed that more severe baseline OCD symptoms predicted worse end state outcome but also higher degree of change. Furthermore, high degree of working alliance predicted better outcome but patients with primary disgust emotions had worse treatment effects. The moderator analysis also indicated that scoring high on the obsessing subscale on the Obsessive-Compulsive Inventory-Revised predicted worse treatment outcome in the booster group. In conclusion, there are some possible predictors and moderators of ICBT for OCD but more research is needed with larger and clinically representative samples. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Andersson, Erik; Ljotsson, Brjann; Hedman, Erik; Enander, Jesper; Kaldo, Viktor; Andersson, Gerhard; Lindefors, Nils; Ruck, Christian; Andersson, Andersson, Andersson, Andersson, Andersson, Bergman Nordgren, Bower, Chapman, de Graaf, Fisher, Foa, Goodman, Greist, Jacobson, Jaurrieta, Kazdin, Keeley, Kessler, Knopp, Kraemer, Mason, Mataix-Cols, McKay, Olatunji, Olatunji, Rozin, Simpson, Skoog, Smits, Stark, Sucala, Tolin, Tracey, Vogel, Vogel, Weissman, Whittal, Wootton, Wootton",2015.0,,0,1,
748,Effects of clinician-assisted emotional disclosure for sexual assault survivors: a pilot study.,"This study assessed the effects of clinician-assisted emotional disclosure (CAED), an integration of emotion focused therapy (Greenberg, Rice, & Elliott, 1993) and emotional disclosure, in ameliorating distress experienced by survivors of sexual assault. A total of 670 female university students were screened for both histories of sexual victimization and clinically significant levels of global psychological distress. Twenty-eight females entered the treatment phase of the study and were randomly assigned to participate in either treatment or no-treatment control conditions. Participants completed a battery of instruments at each evaluation to assess interpersonal, global, and traumatic stress symptoms. At termination and 1-month follow-up, there were no significant differences between CAED and control group on any of the outcome variables. However, there were several differences between the CAED treatment and control groups at 3 month posttreatment. Specifically, individuals in the CAED group reported significant reductions in interpersonal distress, namely, hostility and dependency and reductions in avoidance symptoms associated with posttraumatic stress disorder. These findings are useful for the development of emotion-focused therapies and, specifically, toward psychotherapy integration strategies that combine imaginal exposure with experiential techniques for emotional processing of previously avoided experience.",Anderson T.; Fende Guajardo J.; Luthra R.; Edwards KM.,2010.0,10.1177/0886260509340542,0,1,
749,Interpretation training in individuals with generalized social anxiety disorder: a randomized controlled trial.,"To examine the efficacy of a multisession computerized interpretation modification program (IMP) in the treatment of generalized social anxiety disorder (GSAD). The sample comprised 49 individuals meeting diagnostic criteria for GSAD who were enrolled in a randomized, double-blind placebo-controlled trial comparing IMP (n = 23) with an interpretation control condition (ICC; n = 26). The interpretation training procedures comprised a word-sentence association task in which participants decided whether a word implying a threatening or benign meaning was related to an ambiguous social scenario. In the IMP group, participants were reinforced for interpreting ambiguous social information in a nonthreatening and more benign manner. In the ICC group, participants were reinforced with equal frequency for interpreting ambiguous social information in either a threatening or benign manner. Intent-to-treat and completer analyses revealed that IMP significantly decreased threat interpretations and increased benign interpretations from pre- to post-assessment relative to the ICC group. Moreover, IMP participants displayed significantly larger reductions in clinician-rated social anxiety symptoms and functional impairment as well as self-reported trait anxiety and depression relative to ICC participants. Groups did not differ on change in self-rated social anxiety symptoms. Participants no longer meeting DSM-IV criteria for GSAD at post-assessment were 65% in IMP and 13% in ICC. These results suggest that computerized interpretation training procedures may be beneficial for treating social anxiety disorder.",Amir N.; Taylor CT.,2012.0,10.1037/a0026928,0,1,
750,Attention training in individuals with generalized social phobia: A randomized controlled trial.,"The authors conducted a randomized, double-blind placebo-controlled trial to examine the efficacy of an attention training procedure in reducing symptoms of social anxiety in 44 individuals diagnosed with generalized social phobia (GSP). Attention training comprised a probe detection task in which pictures of faces with either a threatening or neutral emotional expression cued different locations on the computer screen. In the attention modification program (AMP), participants responded to a probe that always followed neutral faces when paired with a threatening face, thereby directing attention away from threat. In the attention control condition (ACC), the probe appeared with equal frequency in the position of the threatening and neutral faces. Results revealed that the AMP facilitated attention disengagement from threat from pre- to postassessment and reduced clinician- and self-reported symptoms of social anxiety relative to the ACC. The percentage of participants no longer meeting Diagnostic and Statistical Manual (4th ed.) criteria for GSP at postassessment was 50% in the AMP and 14% in the ACC. Symptom reduction in the AMP group was maintained during 4-month follow-up assessment. These results suggest that computerized attention training procedures may be beneficial for treating social phobia.",Amir N.; Beard C.; Taylor CT.; Klumpp H.; Elias J.; Burns M.; Chen X.,2009.0,10.1037/a0016685,0,1,
751,Internet-based cognitive behavioural therapy (iCBT) for posttraumatic stress disorder versus waitlist control: study protocol for a randomised controlled trial.,"This randomised controlled trial (RCT) with two parallel arms will evaluate the efficacy of an internet-delivered six-lesson 10-week cognitive behavioural therapy (iCBT) intervention for posttraumatic stress disorder (PTSD). It will also investigate the association between changes in PTSD symptoms, intolerance of uncertainty (IU) and emotion regulation. Patients with PTSD will be recruited via the research arm of a not-for-profit clinical and research unit in Australia and randomised to a treatment group or waitlist control group. The minimum sample size for each group (alpha 0.05, power 0.80 for a g of 0.47) was identified as 72, but 10 % more will be recruited to hedge against expected attrition. PTSD diagnosis will be determined using the PTSD module from the Mini International Neuropsychiatric Interview version 5.0.0. The PTSD Checklist - Civilian version (PCL-C) will be used to measure PTSD symptoms (the primary outcome measure), with the Intolerance of Uncertainty Scale 12-item version (IUS-12) and the Emotion Regulation Questionnaire (ERQ) used to measure intolerance of uncertainty and emotion regulation, respectively. The PCL-C will be administered to the treatment group before each lesson of the PTSD program and at 3-month follow-up. The IUS-12 and ERQ will be administered before lessons 1 and 4, at post-treatment and at 3-month follow-up. The waitlist control group will complete these measures at week 1, week 5 and week 11 of the waitlist period. PTSD program efficacy will be determined using intent-to-treat mixed models. Maintenance of gains will be assessed at 3-month follow-up. Mediation analyses using PROCESS will be used to examine the association between change in PTSD symptoms over treatment and change in each of IU and emotion regulation ability in separate analyses. The current RCT seeks to replicate previous efficacy findings of iCBT for PTSD in a formally assessed PTSD sample from the general population. Findings may point to future lines of enquiry for the role of IU and emotion regulation in the mechanism of PTSD symptom change during CBT. Australian New Zealand Clinical Trials Registry: ACTRN12614001213639 , registered 18 November 2014. This trial protocol is written in compliance with the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines.",Allen AR.; Newby JM.; Smith J.; Andrews G.,2015.0,10.1186/s13063-015-1059-5,0,1,
752,Project Stride: An Equine-Assisted Intervention to Reduce Symptoms of Social Anxiety in Young Women.,"Although there is evidence supporting the use of equine-assisted activities to treat mental disorders, its efficacy in reducing signs and symptoms of social anxiety in young women has not been examined. We developed and pilot tested Project Stride, a brief, six-session intervention combining equine-assisted activities and cognitive-behavioral strategies to reduce symptoms of social anxiety. A total of 12 women, 18-29 years of age, were randomly assigned to Project Stride or a no-treatment control. Participants completed the Liebowitz Social Anxiety Scale at baseline, immediate-post, and 6 weeks after treatment. Project Stride was highly acceptable and feasible. Compared to control participants, those in Project Stride had significantly greater reductions in social anxiety scores from baseline to immediate-post [decrease of 24.8 points; t (9) = 3.40, P = .008)] and from baseline to follow-up [decrease of 31.8 points; t (9) = 4.12, P = .003)]. These findings support conducting a full-scale efficacy trial of Project Stride.",Alfonso SV.; Alfonso LA.; Llabre MM.; Fernandez MI.,,10.1016/j.explore.2015.08.003,0,1,
753,The comparison of the efficacy of Transdiagnostic Therapy Based on Repetitive Negative Thoughts with Unified Transdiagnostic therapy in treatment of patients with co-occurrence anxiety and depressive disorders: A randomized clinical trial.,"Objectives: The aim of the present study was comparison between the efficacy of Transdiagnostic Therapy Based on Repetitive Negative Thoughts (TTRNT) with Unified Transdiagnostic (UT) therapy in treatment of patients with cooccurrence anxiety and depressive disorders. Method: In the present study, 45 patients with at least one principle diagnosis and one co-principle in the field of anxiety and depressive disorders randomly assigned to three groups of TTRNT, UT as well as waiting list group. Two treatment groups received correspondent treatments. For data collection, the participants completed the Beck Depression Inventory-second edition (BDI-II), Beck Anxiety Inventory (BAI), Positive and Negative Affect Scale (PANAS) and the Work and Social Adjustment Scale (WSAS) during the three stages of pre-test, post-test and a period of six-month follow-up. The data of the study were analyzed through analysis variance with mixed repeated measures, post-hoc main effect, and clinical significance changes criteria. Results: The results of the present study demonstrated that both treatments in comparison with waiting list decreased the symptoms of the patients with co-occurrence anxiety and depressive disorders (p < 0.001). However, the TTRNT was more effective than UT in improvement of anxiety, general function, and negative affect (p < 0.05), but there was not any meaningful difference between these two treatments in decreased the depression (p > 0.05). Also, the UT has better function in increasing the positive affect (p < 0.05). Furthermore, evaluation of the clinical significance changes criteria indicated that the group of TTRNT for principle and co-principle diagnosis achieved to 23% and 29% more than UT group in high end-state functioning (HESF) at the end of follow-up period, respectively. Conclusion: The transdiagnostic therapy based on repetitive negative thoughts is more effective than unified transdiagnostic therapy in improving the symptoms of the patients with the co-occurrence anxiety and depressive disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Akbari, Mehdi; Roshan, Rasool; Shabani, Amir; Fata, Ladan; Shairi, Mohammad Reza; Zarghami, Firouzeh; Akbari, Akbari, Akbari, Aldao, Bakhshipour Roodsari, Bakhtiari, Barlow, Barlow, Barlow, Beck, Beck, Boisseau, Broeren, Brown, Brown, Brown, Brown, Butler, Clark, Conybeare, Craske, Davidson, Dobson, Dozois, Ehring, Ellard, Farchione, Fata, First, Gould, Gross, Harvey, Hayes, Lewinsohn, Linton, Mansell, Mansell, Mansell, McEvoy, McEvoy, McEvoy, McEvoy, McHugh, McLaughlin, Mohammadi, Mundt, Norton, Norton, Raes, Ruscio, Sadock, Spasojevic, Staines, Tsao, Van der Heiden, Watkins, Watson, Wells, Westra, Wilamowska",2015.0,,0,1,
754,"Effects of psychotherapy in combination with pharmacotherapy, when compared to pharmacotherapy only on blood pressure, depression, and anxiety in female patients with hypertension.","We investigated effects of metacognitive detached mindfulness therapy and stress management training on hypertension and symptoms of depression and anxiety, as compared to a control condition. A total of 45 female patients (mean age: M = 36.49 years) were randomly assigned to one of three conditions: metacognitive detached mindfulness therapy, stress management training, and the control condition. Blood pressure and symptoms of depression and anxiety decreased from baseline to post-test, to follow-up. Group comparisons showed that blood pressure and symptoms of depression and anxiety decreased more in psychotherapeutic groups than in the control group. Psychotherapeutic treatment of hypertension reduced blood pressure and symptoms of depression and anxiety. Positive effects were observable at follow-up 8 weeks later. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ahmadpanah, Mohammad; Paghale, Somaye Jamali; Bakhtyari, Azadeh; Kaikhavani, Sattar; Aghaei, Elham; Nazaribadie, Marzieh; Holsboer-Trachsler, Edith; Brand, Serge; Abbott, Albright, Arredondo, Babu, Bacon, Baer, Barnes, Beck, Beevers, Bhattacharya, Botha, Chambers, Cohn, Cukrowicz, Davison, Davydov, Denni, Dickinson, Ditto, Dusek, Genta-Pereira, Holsboer, Kagee, Kanfer, Kang, Katzung, Khatib, Lazar, Lohaus, Lowe, Marks, McGinnis, Meng, Netterstrom, Ott, Ott, Petermann, Ringoir, Rueda, Sheehan, Snoek, Soo, Stein, Sullivan, Symonides, Tacon, Taylor, Trevisol, Trivedi, Trudel, Trudel-Fitzgerald, Valk, Van Wijk, Wells, Wolpe, Yung",2016.0,,0,1,
755,REM desensitization as a new therapeutic method for post-traumatic stress disorder: a randomized controlled trial.,"to evaluate potential efficacy of a new therapeutic approach in posttraumatic stress disorder in comparison with eye movement desensitization and reprocessing (EMDR), a standard treatment approach and controls. the study was designed using a randomized controlled trial methodology. Participants were recruited from military servicemen aged between 25 to 50 years who were admitting hospitals of Bushehr, Iran, with the final diagnosis of PTSD. Finally 33 male patients were devided into three subgroups: G1: EMDR; G2: REM Desensitization; and group 3: controls who received no therapy. Mississippi Scale for Posttraumatic Stress Disorder, Pittsburgh Sleep Quality Index (PSQI) and a 37 item death anxiety questionnaire were used for measures. multiple comparisons showed that intrusive thoughts were significantly more likely to improve with REM Desensitization versus EMDR (P=0.03), while depression was more responsive to EMDR (p=0.03). Among the Pittsburgh scale for the quality of sleep items, sleep quality (p=0.02), sleep duration (p=0.001), and total sleep quality score (p=0.002) were significantly more likely to improve in the REM Desensitization group. Change in the absolute death anxiety scores was not different between subgroups excepting EMDR versus control group (p=0.05). REM, desensitization, the new therapeutic approach to PTSD is a highly effective strategy, even more than EMDR, the standard treatment, in most of the evaluated subjects, with special emphasis on sleep symptoms, and also in the management of intrusive thoughts. Depression is the only factor in which, REM Desensitization was significantly less likely to represent a superior therapeutic effect than EMDR.",Ahmadi K.; Hazrati M.; Ahmadizadeh M.; Noohi S.,2015.0,,0,1,
756,The Cares of Life Project (CoLP): an exploratory randomised controlled trial of a community-based intervention for black people with common mental disorder.,"To investigate the feasibility and effectiveness of a needs-led, community-based intervention for treating individuals from black minority ethnic (BME) groups with common mental disorders. Forty eligible individuals from BME groups were randomised to a needs-led package of care (therapy based on the principles of cognitive behaviour therapy and ethnically matched therapists, advocacy and mentoring; 'rapid access') or to a 3-month waiting list control with information on local mental health services ('standard access'). At 3-month follow-up, individuals in the rapid access group showed significantly improved levels of depression (GHQ-28 adjusted p<0.05) although there was no evidence for difference in general functioning (GAF, p=0.87). The intervention was found to be culturally appropriate and acceptable among users and did not result in significantly increased costs. The exploratory study sample was small with low power and therefore the statistical certainty may be limited. Effective and culturally acceptable psychosocial interventions can be delivered in the community to individuals from BME groups with anxiety and depression with no significant cost implications.",Afuwape SA.; Craig TK.; Harris T.; Clarke M.; Flood A.; Olajide D.; Cole E.; Leese M.; McCrone P.; Thornicroft G.,2010.0,10.1016/j.jad.2010.05.017,0,1,
757,"Fear, avoidance and physiological symptoms during cognitive-behavioral therapy for social anxiety disorder.","We examined fear, avoidance and physiological symptoms during cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD). Participants were 177 individuals with generalized SAD who underwent a 14-week group CBT as part of a randomized controlled treatment trial. Participants filled out self-report measures of SAD symptoms at pre-treatment, week 4 of treatment, week 8 of treatment, and week 14 of treatment (post-treatment). Cross-lagged Structural Equation Modeling indicated that during the first 8 weeks of treatment avoidance predicted subsequent fear above and beyond previous fear, but fear did not predict subsequent avoidance beyond previous avoidance. However, during the last 6 weeks of treatment both fear and avoidance predicted changes in each other. In addition, changes in physiological symptoms occurred independently of changes in fear and avoidance. Our findings suggest that changes in avoidance spark the cycle of change in treatment of SAD, but the cycle may continue to maintain itself through reciprocal relationships between avoidance and fear. In addition, physiological symptoms may change through distinct processes that are independent from those involved in changes of fear and avoidance. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Aderka, Idan M; McLean, Carmen P; Huppert, Jonathan D; Davidson, Jonathan R. T; Foa, Edna B; Acarturk, Alden, Bentler, Bentler, Bentler, Blanco, Bogels, Bogels, Borkovec, Clark, Clark, Clark, Clark, Connor, Davidson, Davidson, Davidson, Davidson, Eckman, Fedoroff, First, Gerlach, Guy, Hedges, Hofmann, Hofmann, Holt, Hu, Kashdan, Kessler, Kim, Kline, Little, McManus, McManus, McManus, Meng, Messer, Morgan, Moscovitch, Moscovitch, Mulkens, Preacher, Preacher, Preacher, Rapee, Rapee, Rodebaugh, Rubin, Rubin, Safren, Satorra, Satorra, Schell, Stangier, Steiger, Tabachnick, Taylor, Voncken, Wallace, Wallace, Wells",2013.0,,0,1,
758,Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders.,"Objective: Randomized comparisons of acceptance-based treatments with traditional cognitive behavioral therapy (CBT) for anxiety disorders are lacking. To address this gap, we compared acceptance and commitment therapy (ACT) to CBT for heterogeneous anxiety disorders. Method: One hundred twenty-eight individuals (52% female, mean age = 38, 33% minority) with 1 or more DSM-IV anxiety disorders began treatment following randomization to CBT or ACT; both treatments included behavioral exposure. Assessments at pre-treatment, post-treatment, and 6- and 12-month follow-up measured anxiety-specific (principal disorder Clinical Severity Ratings [CSRs], Anxiety Sensitivity Index, Penn State Worry Questionnaire, Fear Questionnaire avoidance) and non-anxiety-specific (Quality of Life Index [QOLI], Acceptance and Action Questionnaire-16 [AAQ]) outcomes. Treatment adherence, therapist competency ratings, treatment credibility, and co-occurring mood and anxiety disorders were investigated. Results: CBT and ACT improved similarly across all outcomes from pre- to post-treatment. During follow-up, ACT showed steeper linear CSR improvements than CBT (p < .05, d = 1.26), and at 12-month follow-up, ACT showed lower CSRs than CBT among completers (p < .05, d = 1.10). At 12-month follow-up, ACT reported higher AAQ than CBT (p = .08, d = 0.42; completers: p < .05, d = 0.56), whereas CBT reported higher QOLI than ACT (p < .05, d = 0.42). Attrition and comorbidity improvements were similar; ACT used more non-study psychotherapy at 6-month follow-up. Therapist adherence and competency were good; treatment credibility was higher in CBT. Conclusions: Overall improvement was similar between ACT and CBT, indicating that ACT is a highly viable treatment for anxiety disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Arch, Joanna J; Eifert, Georg H; Davies, Carolyn; Vilardaga, Jennifer C. Plumb; Rose, Raphael D; Craske, Michelle G; Addis, Arch, Barlow, Barlow, Barlow, Beck, Bond, Bond, Bond, Borkovec, Borkovec, Brewin, Brown, Brown, Brown, Butler, Carter, Chambless, Cohen, Craske, Craske, Craske, Craske, Craske, Craske, Dalrymple, Eifert, Eifert, Feingold, Forman, Frisch, Frisch, Frisch, Guttman, Hayes, Hayes, Hedeker, Hofmann, Jacobson, Kazdin, Lappalainen, Loerinc, Longmore, Maassen, Marks, McGrath, Meyer, Newman, Norton, Odgaard, Orsillo, Peterson, Rapee, Raudenbush, Raudenbush, Raudenbush, Reiss, Roemer, Roemer, Taylor, Taylor, Tolin, Tsao, Twohig, Wetherell",2012.0,,0,1,
759,Randomized clinical trial of adapted mindfulness-based stress reduction versus group cognitive behavioral therapy for heterogeneous anxiety disorders.,"Objective: To compare a mindfulness-based intervention with cognitive behavioral therapy (CBT) for the group treatment of anxiety disorders. Method: One hundred five veterans (83% male, mean age 1/4 46 years, 30% minority) with one or more DSM-IV anxiety disorders began group treatment following randomization to adapted mindfulness-based stress reduction (MBSR) or CBT. Results: Both groups showed large and equivalent improvements on principal disorder severity thru 3-month follow up (ps < .001, d = - 4.08 for adapted MBSR; d = - 3.52 for CBT). CBT outperformed adapted MBSR on anxious arousal outcomes at follow up (p < .01, d = .49) whereas adapted MBSR reduced worry at a greater rate than CBT (p < .05, d = .64) and resulted in greater reduction of comorbid emotional disorders (p < .05, d = .49). The adapted MBSR group evidenced greater mood disorders and worry at Pre, however. Groups showed equivalent treatment credibility, therapist adherence and competency, and reliable improvement. Conclusions: CBT and adapted MBSR were both effective at reducing principal diagnosis severity and somewhat effective at reducing self-reported anxiety symptoms within a complex sample. CBT was more effective at reducing anxious arousal, whereas adapted MBSR may be more effective at reducing worry and comorbid disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Arch, Joanna J; Ayers, Catherine R; Baker, Aaron; Almklov, Erin; Dean, Derek J; Craske, Michelle G; Arch, Barlow, Beck, Borkovec, Brown, Brown, Brown, Butler, Casillas, Chambless, Chemtob, Clark, Craigie, Craske, Craske, Craske, Craske, Craske, Craske, Craske, Craske, DiNardo, Edlund, Escalona, Evans, Fairburn, Feingold, Hofmann, Hofmann, Jacobson, Jain, Kabat-Zinn, Kabat-Zinn, Kazdin, Kessler, Koszycki, Maassen, McGrath, McGrath, Meyer, Miller, Molina, Newman, Norton, Norton, Odgaard, Pitman, Ramel, Raudenbush, Raudenbush, Roemer, Roy-Byrne, Roy-Byrne, Sheehan, Spitzer, Tolin, Trepka, Vollestad, Wang, Watson, Wierzbicki",2013.0,,0,1,
760,Testing the mediating effects of obsessive beliefs in internet-based cognitive behaviour therapy for obsessive-compulsive disorder: Results from a randomized controlled trial.,"Although cognitive interventions for obsessive-compulsive disorder (OCD) have been tested in randomized trials, there are few trials that have tested the specific mechanisms of cognitive interventions, i.e. how they achieve their effects. In this study, we aimed to investigate the mediating effects of a short cognitive intervention in the treatment of OCD and used data from a recently conducted randomized controlled trial where 101 participants were allocated to either Internet-based CBT (ICBT) or to a control condition. Obsessive beliefs were measured at pre-treatment, at the time they had received the cognitive intervention, and also at post-treatment. Weekly OCD symptoms were measured throughout the 10 weeks of treatment. We hypothesized that (1) the ICBT group would have greater reductions in obsessive beliefs (controlling for change in OCD symptoms) after completing the cognitive intervention, and that (2) this reduction would, in turn, predict greater OCD symptom reduction throughout the rest of the treatment period. Contrary to our expectations, the longitudinal mediation analysis indicated that (1) being randomized to ICBT actually increased the degree of obsessive beliefs after receiving the cognitive intervention at weeks 1-3, and (2) increase in obsessive beliefs predicted better outcome later in treatment. However, when repeating the analysis using cross-sectional data at post-treatment, the results were in line with the initial hypotheses. Results were replicated when the control condition received ICBT. We conclude that, although obsessive beliefs were significantly reduced at post-treatment for the ICBT group, early increase rather than decrease in obsessive beliefs predicted favourable outcome. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Andersson, Erik; Ljotsson, Brjann; Hedman, Erik; Hesser, Hugo; Enander, Jesper; Kaldo, Viktor; Andersson, Gerhard; Lindefors, Nils; Ruck, Christian; Aardema, Abramowitz, Abramowitz, Abramowitz, Abramowitz, Alcolado, Altin, Andersson, Andersson, Andersson, Andersson, Andersson, Andersson, Baron, Berman, Bradbury, Cottraux, Cuttler, Emmelkamp, Enander, Exner, Foa, Goodman, Hayes, Hunot, Kraemer, Litz, Ljotsson, Lopatka, Ly, MacKinnon, Maxwell, Obsessive Compulsive Cognitions Working, Olatunji, Polman, Preacher, Rachman, Rachman, Radomsky, Rahat, Rheaume, Salkovskis, Storchheim, Taylor, Ward, Wheaton, Whittal, Wilhelm, Woody",2015.0,,0,1,
761,Behavioral activation and therapeutic exposure for posttraumatic stress disorder: A noninferiority trial of treatment delivered in person versus home-based telehealth.,"Objective: Combat veterans returning to society with impairing mental health conditions such as PTSD and major depression (MD) report significant barriers to care related to aspects of traditional psychotherapy service delivery (e.g., stigma, travel time, and cost). Hence, alternate treatment delivery methods are needed. Home-based telehealth (HBT) is one such option; however, this delivery mode has not been compared to in person, clinic-based care for PTSD in adequately powered trials. The present study was designed to compare relative noninferiority of evidence-based psychotherapies for PTSD and MD, specifically Behavioral Activation and Therapeutic Exposure (BA-TE), when delivered via HBT versus in person, in clinic delivery. Method: A repeated measures (i.e., baseline, posttreatment, 3-, 6-month follow-up) randomized controlled design powered for noninferiority analyses was used to compare PTSD and MD symptom improvement in response to BA-TE delivered via HBT versus in person, in clinic conditions. Participants were 232 veterans diagnosed with full criteria or predefined subthreshold PTSD. Results: PTSD and MD symptom improvement following BA-TE delivered by HBT was comparable to that of BA-TE delivered in person at posttreatment and at 3- and 12-month follow-up. Conclusion: Evidence-based psychotherapy for PTSD and depression can be safely and effectively delivered via HBT with clinical outcomes paralleling those of clinic-based care delivered in person. HBT, thereby, addresses barriers to care related to both logistics and stigma. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Acierno, Ron; Gros, Daniel F; Ruggiero, Kenneth J; Hernandez-Tejada, B. Melba A; Knapp, Rebecca G; Lejuez, Carl W; Muzzy, Wendy; Frueh, Christopher B; Egede, Leonard E; Tuerk, Peter W; Beck, Blake, Blanchard, Bolton, Bose, Cohen, Dworkin, Egede, Foa, Fulton, Greene, Gros, Gros, Gros, Gros, Gros, Hernandez-Tejada, Hoge, Hoge, Luxton, Rowa, Steer, Strachan, Trott, Weathers, Weathers, Yuen",2016.0,,0,1,
762,EMDR for Syrian refugees with posttraumatic stress disorder symptoms: Results of a pilot randomized controlled trial.,"Background: The most common mental health problems among refugees are depression and posttraumatic stress disorder (PTSD). Eye movement desensitization and reprocessing (EMDR) is an effective treatment for PTSD. However, no previous randomized controlled trial (RCT) has been published on treating PTSD symptoms in a refugee camp population. Objective: Examining the effect of EMDR to reduce the PTSD and depression symptoms compared to a wait-list condition among Syrian refugees. Method: Twenty-nine adult participants with PTSD symptoms were randomly allocated to either EMDR sessions (n = 15) or wait-list control (n = 14). The main outcome measures were Impact of Event Scale- Revised (IES-R) and Beck Depression Inventory (BDI-II) at posttreatment and 4-week follow-up. Results: Analysis of covariance showed that the EMDR group had significantly lower trauma scores at posttreatment as compared with the wait-list group (d = 1.78, 95% CI: 0.92-2.64). The EMDR group also had a lower depression score after treatment as compared with the wait-list group (d = 1.14, 95% CI: 0.35-1.92). Conclusion: The pilot RCT indicated that EMDR may be effective in reducing PTSD and depression symptoms among Syrian refugees located in a camp. Larger RCTs to verify the (cost-) effectiveness of EMDR in similar populations are needed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Acarturk, Ceren; Konuk, Emre; Cetinkaya, Mustafa; Senay, Ibrahim; Sijbrandij, Marit; Cuijpers, Pim; Aker, Tamer; Bader, Beck, Bhugra, Bisson, Bradley, Creamer, De Jong, Ghareeb, Mollica, Mollica, Neuner, Nickerson, Panahi, Rousseau, Shapiro, Shapiro, Teodorescu, Ter Heide, Trautman, Van der Kolk, Weiss, Zaghrout",2015.0,,0,1,
763,The effect of the magical hour on post-traumatic stress disorder (PTSD) in traumatic childbirth: A clinical trial.,"Objective: This study aimed to investigate the influence of the magical first hour after birth on post-traumatic stress in traumatic childbirths. Background: Traumatic childbirth with disturbing memories can have negative impacts on the mental health of postpartum mothers. Due to the growing trend of post-traumatic stress, the emphasis of recent research is on the identification and prevention of this kind of stress and the enhancement of maternal mental health. Methods: In this randomised clinical trial, which was carried out with 84 newly delivered mothers who were diagnosed with traumatic childbirth, participants were first randomly assigned into intervention (magical first hour) and control groups. Then, the nine instinctive stages were implemented to the intervention group while the control group received routine after-birth procedures. Then, using the Impact of Event Scale-Revised (IES-R), stress was measured at three intervals of 2 weeks, 4-6 weeks and 3 months after childbirth. The collected data were analysed using a mixed analysis of variance. Results: The mean total score of post-traumatic stress in the intervention group was 16.83 +/- 1.1 and in the control group 21.04 +/- 1.1, which showed a statistically significant difference between the two groups (P < 0.01). With the passage of time, the average scores of post-traumatic stress in both groups decreased and no interaction was observed between time and intervention. Conclusion: Implementation of the magical hour stages is recommended as a preventive and therapeutic guideline for relieving post-traumatic stress in women with traumatic childbirth experiences. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Abdollahpour, Sedigheh; Khosravi, Ahmad; Bolbolhaghighi, Nahid; Andersen, Arzani, Ayers, Bastos, Beck, Beck, Beck, Beck, Beck, Bergman, Bohnhorst, Brimdyr, Creamer, de Alencar, Feldman, Fenech, Firouzkouhi Moghadam, Johnson, Josefsson, Kendall-Tackett, Kleiman, Maercker, Mikiel-Kostyra, Moore, Panaghi, Phillips, Ryding, Taghizadeh, Troy, Weiss, Zauderer",2016.0,,0,1,
764,Controlled study of outcome after 6 months to early intervention of bus driver victims of aggression,"ER The aftermath of psychological trauma, long since studied in the context of war (""soldier's heart"", ""shell shock"", etc.) can also occur as a result of trauma in civilian life. Bus drivers in large urban area are frequently aggressed. Over a period of 5 months, bus drivers who had been aggressed, employees of the largest French urban transport company (RATP), participated in a study designed to evaluate the effects of cognitive behavior treatment provided shortly after such aggression. A total of 132 bus drivers were included in the study divided into 2 randomized groups: a control group (67 subjects) received the usual medical-social care offered by the company, and a treatment group (65 subjects) who, in addition, benefited from 1 to 6 sessions of cognitive behavior intervention, including:evocation of the aggression, relaxation, role plays, cognitive restructuring. Subjects were evaluated by self-questionnaires a few days post-aggression and re-evaluated 6 months later. At follow-up, results showed a statistically significant decrease in anxiety levels (measured by the HAD scale) and intrusion of the traumatic memory (as evaluated by the Horowitz scale) in the treatment group. Hence, early and structured intervention appears to lessen the impact of the traumatic event on bus drivers attacked at work.","André, C; Lelord, F; Légeron, P; Reignier, A; Delattre, A",1997.0,,0,1,702
765,A comparison of focused and standard cognitive therapy for panic disorder,"ER The relative efficacy of two psychotherapeutic approaches to panic disorder, namely, focused cognitive therapy (FCT) and standard cognitive therapy (SCT) was examined. FCT focused specifically on the ""catastrophic misinterpretation"" of physical and psychological sensations experienced during panic attacks induced in the office or occurring spontaneously between sessions. SCT focused primarily on the cognitions and beliefs relevant to interpersonal concerns involved in generalized anxiety. We hypothesized that FCT would be more effective than SCT since the latter did not include an induced panic exercise (exposure condition) specific to the patient's panicogenic cognitions. Forty patients diagnosed with panic disorder were randomly assigned to the SCT and FCT groups for approximately 12 to 18 sessions of treatment. Both groups reported significant decreases in the severity of the clinical measures at termination. Moreover, 89.5% of the SCT group and 84.2% of the FCT group were free of panic attacks at 1-year follow-up. Contrary to the predictions, the results for measures of panic attack frequency, anxiety, and depression did not reveal any significant differences between the two groups. Results suggest that in-office ""exposure"" is not necessary for improvement and that a primary focus on cognitions associated with generalized anxiety may be an effective intervention. However, since improvement in panic was correlated with normalizing of panic-related beliefs in both conditions, it is suggested that cognitive change may be a crucial ingredient of improvement in panic episodes.","Brown, G K; Beck, A T; Newman, C F; Beck, J S; Tran, G Q",1997.0,,0,1,672
766,Skills training in affective and interpersonal regulation followed by exposure: a phase-based treatment for PTSD related to childhood abuse,"ER Fifty-eight women with posttraumatic stress disorder (PTSD) related to childhood abuse were randomly assigned to a 2-phase cognitive-behavioral treatment or a minimal attention wait list. Phase 1 of treatment included 8 weekly sessions of skills training in affect and interpersonal regulation; Phase 2 included 8 sessions of modified prolonged exposure. Compared with those on wait list, participants in active treatment showed significant improvement in affect regulation problems, interpersonal skills deficits, and PTSD symptoms. Gains were maintained at 3- and 9-month follow-up. Phase 1 therapeutic alliance and negative mood regulation skills predicted Phase 2 exposure success in reducing PTSD, suggesting the value of establishing a strong therapeutic relationship and emotion regulation skills before exposure work among chronic PTSD populations.","Cloitre, M; Koenen, K C; Cohen, L R; Han, H",2002.0,,0,1,
767,Comparison of behavior therapy and cognitive behavior therapy in the treatment of generalized anxiety disorder.,"In a controlled clinical trial, 57 Ss meeting Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) criteria for generalized anxiety disorder, and fulfilling an additional severity criterion, were randomly allocated to cognitive behavior therapy (CBT), behavior therapy (BT), or a waiting-list control group. Individual treatment lasted 4-22 sessions; independent assessments were made before treatment, after treatment, and 6 mos later, and additional follow-up data were collected after an interval of approximately 18 mos. Results show a clear advantage for CBT over BT. A consistent pattern of change favoring CBT was evident in measures of anxiety, depression, and cognition. Ss were lost from the BT group, but there was no attrition from the CBT group. Treatment integrity was double-checked in England and in Holland, and special efforts were made to reduce error variance. Possible explanations for the superiority of CBT are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Butler, Gillian; Fennell, Melanie; Robson, Philip; Gelder, Michael; Barlow, Barlow, Beck, Beck, Beck, Beck, Beck, Beck, Bernstein, Borkovec, Borkovec, Butler, Butler, Butler, Butler, Butler, Clark, Clark, Di Nardo, Durham, Foa, Hamilton, Hibbert, Lindsay, McNally, Rush, Snaith, Spielberger, Watson, Watson, Woodward, Ost",1991.0,,0,1,
768,A component analysis of cognitive-behavioral therapy for generalized anxiety disorder and the role of interpersonal problems.,"Clients with generalized anxiety disorder (GAD) received either (1) applied relaxation and self-control desensitization, (2) cognitive therapy, or (3) a combination of these methods. Treatment resulted in significant improvement in anxiety and depression that was maintained for 2 yrs. The large majority no longer met diagnostic criteria; a minority sought further treatment during follow-up. No differences in outcome were found between conditions; review of the GAD therapy literature suggested that this may have been due to strong effects generated by each component condition. Finally, interpersonal difficulties remaining at posttherapy, measured by the Inventory of Interpersonal Problems Circumplex Scales (L. E. Alden, J. S. Wiggins, & A. L. Pincus, 1990) in a subset of clients, were negatively associated with posttherapy and follow-up improvement, suggesting the possible utility of adding interpersonal treatment to cognitive-behavioral therapy to increase therapeutic effectiveness. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Borkovec, T. D; Newman, Michelle G; Pincus, Aaron L; Lytle, Richard; Alden, Alden, Barlow, Barlow, Barlow, Barrett-Lennard, Beck, Beck, Bernstein, Borkovec, Borkovec, Borkovec, Borkovec, Borkovec, Borkovec, Borkovec, Brosschot, Brown, Brown, Brown, Butler, Campbell, Chambless, Chambless, Crits-Christoph, DiNardo, Durham, Durham, Gould, Hamilton, Hamilton, Heide, Hoehn-Saric, Hoehn-Saric, Horowitz, Horowitz, Horowitz, Horvath, Kachin, Kendler, Ladouceur, Meyer, Newman, Newman, Ost, Roemer, Sanderson, Siegel, Sime, Spielberger, Wells, White, Wittchen, Zuellig",2002.0,,0,1,
769,Does maintenance CBT contribute to long-term treatment response of panic disorder with or without agoraphobia? A randomized controlled clinical trial.,"We examined the possibility that maintenance cognitive behavior therapy (M-CBT) may improve the likelihood of sustained improvement and reduced relapse in a multi-site randomized controlled clinical trial of patients who met criteria for panic disorder with or without agoraphobia. Participants were all patients (N = 379) who first began an open trial of acute-phase CBT. Patients completing and responding to acute-phase treatment were randomized to receive either 9 monthly sessions of M-CBT (n = 79) or assessment only (n = 78) and were then followed for an additional 12 months without treatment. M-CBT produced significantly lower relapse rates (5.2%) and reduced work and social impairment compared to the assessment only condition (18.4%) at a 21-month follow-up. Multivariate Cox proportional hazards models showed that residual symptoms of agoraphobia at the end of acute-phase treatment were independently predictive of time to relapse during 21-month follow-up (hazards ratio = 1.15, p < .01). M-CBT aimed at reinforcing acute treatment gains to prevent relapse and offset disorder recurrence may improve long-term outcome for panic disorder with and without agoraphobia.",White KS.; Payne LA.; Gorman JM.; Shear MK.; Woods SW.; Saksa JR.; Barlow DH.,2013.0,10.1037/a0030666,0,1,
770,Brief treatment of emergency room patients with panic attacks.,"Most research on treatment for panic disorder has involved chronic forms of the illness. To determine the efficacy of early intervention, the authors examined the effects of treatment for patients with panic attacks who were seen in the emergency room, which is the first point of contact with the health delivery system for many persons with panic attacks. The subjects were 33 patients with panic attacks seen in two emergency rooms. The presence of panic attacks was confirmed with a modified version of the Structured Clinical Interview for DSM-III-R; approximately 40% of the patients met the DSM-III-R criteria for panic disorder with agoraphobia. The patients were randomly assigned to groups receiving reassurance (N = 16) or exposure instruction (N = 17). Scores on the Fear Questionnaire agoraphobia subscale, Mobility Inventory, and Beck Depression Inventory and the frequency of panic attacks were determined at baseline, 3 months, and 6 months. The subjects who received exposure instruction significantly improved over the 6-month period on depression, avoidance, and panic frequency. The reassurance subjects did not improve on any measure and eventually reported more agoraphobic avoidance. These results suggest that early intervention with exposure instruction may reduce the long-term consequences of panic attacks. The exposure instruction was of value even though the subjects had relatively low levels of avoidance at the outset of the study.",Swinson RP.; Soulios C.; Cox BJ.; Kuch K.,1992.0,10.1176/ajp.149.7.944,0,1,
771,Cognitive-behaviour therapy for post-traumatic stress in schizophrenia. A randomized controlled trial.,"Background: There is limited evidence for effective interventions in the treatment of post-traumatic stress symptoms within individuals diagnosed with schizophrenia. Clinicians have concerns about using exposure treatments with this patient group. The current trial was designed to evaluate a 16-session cognitive restructuring programme, without direct exposure, for the treatment of post-traumatic stress symptoms specifically within individuals diagnosed with schizophrenia. Method: A multicentre randomized controlled single-blinded trial with assessments at 0 months, 6 months (post-treatment) and 12 months (follow-up) was conducted. A total of 61 participants diagnosed with schizophrenia and exhibiting post-traumatic stress symptoms were recruited. Those randomized to treatment were offered up to 16 sessions of cognitive-behaviour therapy (CBT, including psychoeducation, breathing training and cognitive restructuring) over a 6-month period, with the control group offered routine clinical services. The main outcome was blind rating of post-traumatic stress symptoms using the Clinician Administered PTSD Scale for Schizophrenia. Secondary outcomes were psychotic symptoms as measured by the Positive and Negative Symptom Scale and the Psychotic Symptom Rating Scale. Results: Both the treatment and control groups experienced a significant decrease in post-traumatic stress symptoms over time but there was no effect of the addition of CBT on either the primary or secondary outcomes. Conclusions: The current trial did not demonstrate any effect in favour of CBT. Cognitive restructuring programmes may require further adaptation to promote emotional processing of traumatic memories within people diagnosed with a psychotic disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Steel, C; Hardy, A; Smith, B; Wykes, T; Rose, S; Enright, S; Hardcastle, M; Landau, S; Baksh, M. F; Gottlieb, J. D; Rose, D; Mueser, K. T; Achim, Bebbington, Beck, Beck, Blake, Blanchard, Clark, de Bont, Foa, Foa, Foa, Gearon, Green, Grubaugh, Haddock, Hall, Heinrichs, Kay, Lataster, Longden, Marks, Matheson, Meyer, Morrison, Mueser, Mueser, Mueser, Mueser, O'Driscoll, Picken, Read, Resnick, Rose, Rosenberg, Sin, Smith, Steel, Steel, Switzer, Tarrier, van den Berg, van der Gaag, Weathers, Wykes",2017.0,,0,1,
772,Cognitive behavior therapy for comorbid obsessive-compulsive disorder in high-functioning autism spectrum disorders: a randomized controlled trial.,"High rates of anxiety disorders, particularly obsessive compulsive disorder (OCD) are reported in people with Autism spectrum disorders (ASD). Group cognitive behavioral treatment (CBT) has been found effective for anxiety in young people with ASD but not been OCD specific. One uncontrolled pilot study of individual CBT for OCD for adults with ASD showed good treatment efficacy. Forty-six adolescents and adults (mean age 26.9 years, 35 Males) with ASD and comorbid OCD were randomized to CBT for OCD or anxiety management (AM), a plausible control treatment. Treatments were matched in duration (mean of 17.4 sessions CBT; 14.4 sessions AM), the Yale-Brown Obsessive Compulsive Severity Scale (YBOCS) as primary outcome measure and evaluations blind to treatment group. Treatment response was defined as > 25% reduction in YBOCS total severity scores. Both treatments produced a significant reduction in OCD symptoms, within-group effect sizes of 1.01 CBT group and 0.6 for the AM group. There were no statistically significant differences between the two groups at end of treatment, although more responders in the CBT group (45 versus 20%). Effect sizes for self-rated improvement were small (0.33 CBT group; -0.05 AM group). Mild symptom severity was associated with improvement in the AM but not the CBT group. Family/carer factors were important for both groups, in that increased family accommodation was associated with poorer outcome. Evidence-based psychological interventions, both AM and CBT, were effective in treating comorbid OCD in young people and adults with ASD.",Russell AJ.; Jassi A.; Fullana MA.; Mack H.; Johnston K.; Heyman I.; Murphy DG.; Mataix-Cols D.,2013.0,10.1002/da.22053,0,1,
773,Evaluation of cognitive restructuring for post-traumatic stress disorder in people with severe mental illness.,"A cognitive-behavioural therapy (CBT) programme designed for post-traumatic stress disorder (PTSD) in people with severe mental illness, including breathing retraining, education and cognitive restructuring, was shown to be more effective than usual services. To evaluate the incremental benefit of adding cognitive restructuring to the breathing retraining and education components of the CBT programme (trial registration: clinicaltrials.gov identifier: NCT00494650). In all, 201 people with severe mental illness and PTSD were randomised to 12- to 16-session CBT or a 3-session brief treatment programme (breathing retraining and education). The primary outcome was PTSD symptom severity. Secondary outcomes were PTSD diagnosis, other symptoms, functioning and quality of life. There was greater improvement in PTSD symptoms and functioning in the CBT group than in the brief treatment group, with both groups improving on other outcomes and effects maintained 1-year post-treatment. Cognitive restructuring has a significant impact beyond breathing retraining and education in the CBT programme, reducing PTSD symptoms and improving functioning in people with severe mental illness.",Mueser KT.; Gottlieb JD.; Xie H.; Lu W.; Yanos PT.; Rosenberg SD.; Silverstein SM.; Duva SM.; Minsky S.; Wolfe RS.; McHugo GJ.,2015.0,10.1192/bjp.bp.114.147926,0,1,
774,Integrated exposure-based therapy for co-occurring posttraumatic stress disorder and substance dependence: a randomized controlled trial.,"There is concern that exposure therapy, an evidence-based cognitive-behavioral treatment for posttraumatic stress disorder (PTSD), may be inappropriate because of risk of relapse for patients with co-occurring substance dependence. To determine whether an integrated treatment for PTSD and substance dependence, Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE), can achieve greater reductions in PTSD and substance dependence symptom severity compared with usual treatment for substance dependence. Randomized controlled trial enrolling 103 participants who met DSM-IV-TR criteria for both PTSD and substance dependence. Participants were recruited from 2007-2009 in Sydney, Australia; outcomes were assessed at 9 months postbaseline, with interim measures collected at 6 weeks and 3 months postbaseline. Participants were randomized to receive COPE plus usual treatment (n = 55) or usual treatment alone (control) (n = 48). COPE consists of 13 individual 90-minute sessions (ie, 19.5 hours) with a clinical psychologist. Change in PTSD symptom severity as measured by the Clinician-Administered PTSD Scale (CAPS; scale range, 0-240) and change in severity of substance dependence as measured by the number of dependence criteria met according to the Composite International Diagnostic Interview version 3.0 (CIDI; range, 0-7), from baseline to 9-month follow-up. A change of 15 points on the CAPS scale and 1 dependence criterion on the CIDI were considered clinically significant. From baseline to 9-month follow-up, significant reductions in PTSD symptom severity were found for both the treatment group (mean difference, -38.24 [95% CI, -47.93 to -28.54]) and the control group (mean difference, -22.14 [95% CI, -30.33 to -13.95]); however, the treatment group demonstrated a significantly greater reduction in PTSD symptom severity (mean difference, -16.09 [95% CI, -29.00 to -3.19]). No significant between-group difference was found in relation to improvement in severity of substance dependence (0.43 vs 0.52; incidence rate ratio, 0.85 [95% CI, 0.60 to 1.21), nor were there any significant between-group differences in relation to changes in substance use, depression, or anxiety. Among patients with PTSD and substance dependence, the combined use of COPE plus usual treatment, compared with usual treatment alone, resulted in improvement in PTSD symptom severity without an increase in severity of substance dependence. isrctn.org Identifier: ISRCTN12908171.",Mills KL.; Teesson M.; Back SE.; Brady KT.; Baker AL.; Hopwood S.; Sannibale C.; Barrett EL.; Merz S.; Rosenfeld J.; Ewer PL.,2012.0,10.1001/jama.2012.9071,0,1,
775,Worry exposure versus applied relaxation in the treatment of generalized anxiety disorder.,"Worry exposure (WE) is a core element of cognitive-behavioral treatment for generalized anxiety disorder (GAD). Its efficacy as a stand-alone treatment method (without further cognitive-behavioral therapy interventions) has never been tested.We aimed to examine whether WE alone is as efficacious as the empirically supported stand-alone treatment for GAD, applied relaxation (AR). In a randomized controlled study, 73 outpatients meeting DSM-IV criteria for GAD as primary diagnosis were allocated to either WE or AR or a waiting list control group; in a 2nd randomization procedure the waiting list subjects were reallocated to WE or AR. The treatment was manualized (15 sessions with WE or AR), included 6-month and 1-year follow-ups, as well as last observation carried forward and completer analyses, and was controlled for allegiance effects.The Hamilton Anxiety Rating Scale and the State-Trait Anxiety Scale were used as primary outcome measures. Self-report scales of anxiety, worrying and depression including negative metacognition about worrying and thought suppression served as secondary outcome measures. The dropout rate was moderate. The pre-/posttreatment effects were high for the Hamilton Anxiety Rating Scale (standardized mean difference >1) and for the State-Trait Anxiety Inventory (standardized mean difference >0.87). The proportion of patients reaching high end state functioning was 48% (WE) and 56% (AR). WE and AR did not differ with regard to dropout rate or treatment effects. The treatment effects were stable at 6 month and 1 year follow-up. This is the first study to show that a stand-alone exposure in sensu technique--WE--is efficacious in the treatment of GAD. Both AR and WE seem to represent effective principles of change in GAD.",Hoyer J.; Beesdo K.; Gloster AT.; Runge J.; Höfler M.; Becker ES.,2009.0,10.1159/000201936,0,1,
776,Relapse prevention program for treatment of obsessive-compulsive disorder.,"Eighteen participants with obsessive-compulsive disorder received 3 weeks of intensive treatment by exposure and response prevention, which were followed by either a relapse prevention (RP) program or associative therapy (AT; an attention-control program). Independent evaluators conducted assessments of obsessive-compulsive symptoms, anxiety, and depression, before and after intensive behavior therapy, after the week of intensive RP or AT and at a 6-month follow-up. Results indicated that the RP program was effective in preventing relapse: Both treatment groups improved immediately after the intensive treatment, but the RP group remained improved at follow-up, whereas the AT group showed some return of symptoms.",Hiss H.; Foa EB.; Kozak MJ.,1994.0,,0,1,
777,Behavioral and cognitive group treatment for fear of flying: a randomized controlled trial.,"In a long-standing fear-of-flying program, persons with fear of flying (N=150) were after a diagnostic assessment and individual preparation phase randomly assigned to either a 1-day behavioral group treatment (BGT) program, a 2-day cognitive-behavioral group treatment (CBGT) program or a waiting list (WL) control group. A post-treatment flight on a commercial airline measured participants' ability to fly. Different self-report flight anxiety questionnaires were completed before, during and after treatment at 3-, 6- and 12-month follow-up. Results indicated that both treatments were superior to the WL, and equally effective on the flying test and later independent flying, but also that the 2-day CBGT program was significantly more effective than the 1-day BGT program on subjective measures of fear and self-efficacy.",Van Gerwen LJ.; Spinhoven P.; Van Dyck R.,2006.0,10.1016/j.jbtep.2006.05.002,0,1,
778,A brief cognitive-behavioral intervention for treating depression and panic disorder in patients with noncardiac chest pain: a 24-week randomized controlled trial.,"Most patients with noncardiac chest pain experience anxiety and depressive symptoms. Commonly they are reassured and referred back to primary care, leaving them undiagnosed and untreated. Some small studies have suggested efficacy of 12 cognitive behavioral therapy (CBT) sessions. Our aim was to examine efficacy of brief CBT in reducing anxiety and depressive symptoms in patients with noncardiac chest pain and comorbid panic and/or depressive disorders. In this 24-week randomized controlled trial comparing CBT (n = 60) versus treatment as usual (TAU, n = 53), we included all adults who presented at the cardiac emergency unit of a university hospital with noncardiac chest pain, scored ≥8 on the hospital anxiety and depression scale (HADS) and were diagnosed with a comorbid panic and/or depressive disorder with the Mini International Neuropsychiatric Interview. CBT consisted of six individual sessions. Main outcome was disease severity assessed with the clinical global inventory (CGI) by a blinded independent rater. ANCOVA in the intention-to-treat and completer sample showed that CBT was superior to TAU after 24 weeks in reducing disease severity assessed with CGI (P < .001). Secondary outcomes on anxiety (HADS-anxiety, state trait anxiety inventory (STAI)-trait) and depressive symptoms (Hamilton depression rating scale) were in line with these results except for HADS-depression (P = .10), fear questionnaire (P = .13), and STAI-state (P = .11). Brief CBT significantly reduces anxiety and depressive symptoms in patients with noncardiac chest pain who are diagnosed with panic and/or depressive disorders. Patients presenting with noncardiac chest pain should be screened for psychopathology and if positive, CBT should be considered.",van Beek MH.; Oude Voshaar RC.; Beek AM.; van Zijderveld GA.; Visser S.; Speckens AE.; Batelaan N.; van Balkom AJ.,2013.0,10.1002/da.22106,0,1,
779,Treating comorbid panic disorder in veterans with posttraumatic stress disorder.,"This study compares the effectiveness of panic control treatment (PCT) with that of a psychoeducational supportive treatment (PE-SUP) in treating panic disorder among a veteran sample with a primary diagnosis of chronic posttraumatic stress disorder (PTSD). Thirty-five patients randomized to receive 10 individual sessions of either PCT or PE-SUP underwent assessments at pretreatment, at 1-week posttreatment, and at a 3-month follow-up. Intent-to-treat analyses of covariance showed that PCT participants significantly improved on panic severity at posttreatment and panic fear at the 3-month follow-up. The PCT group also showed significant reductions in anxiety sensitivity at posttreatment and follow-up compared with that of the PE-SUP group. A significantly higher proportion of persons (63%) in the PCT group was panic free by the follow-up period compared with that of the PE-SUP group (19%). Patient self-report and clinician ratings showed no changes in general anxiety, depression, and PTSD symptoms in either group. These findings indicated that PCT was superior to an active control therapy in reducing the frequency, severity, and distress associated with panic disorder and suggested that brief cognitive-behavioral therapy for panic is effective for persons with chronic PTSD.",Teng EJ.; Bailey SD.; Chaison AD.; Petersen NJ.; Hamilton JD.; Dunn NJ.,2008.0,10.1037/0022-006X.76.4.710,0,1,
780,Effectiveness of cognitive-behavioral treatment for panic disorder versus treatment as usual in a managed care setting: 2-year follow-up.,"Eighty clients meeting criteria for panic disorder and receiving either panic control therapy (PCT; M. G. Craske, E. Meadows, & D. H. Barlow, 1994) or treatment as usual (TAU) in a managed care setting were assessed 1 and 2 years following acute treatment. PCT was provided by therapists with little or no previous exposure to cognitive-behavioral therapies. Analyses of the full intent-to-treat sample revealed no significant differences between the treatments across the follow-up period. However, when treatment completer status was added as a moderator, those receiving PCT showed lower levels of panic severity and phobic avoidance and a greater likelihood of achieving and maintaining clinically significant change. Benzodiazepine use during follow-up was associated with greater panic severity for those clients who received PCT, but no such relationship was found for TAU clients. Results are discussed in relation to the dissemination and effectiveness of PCT as well as evidence-based psychotherapies more generally.",Addis ME.; Hatgis C.; Cardemil E.; Jacob K.; Krasnow AD.; Mansfield A.,2006.0,10.1037/0022-006X.74.2.377,0,1,
781,Effectiveness of cognitive--behavioral treatment for panic disorder versus treatment as usual in a managed care setting.,"Eighty clients enrolled in a managed care health plan who identified panic disorder as their primary presenting problem were randomly assigned to treatment by a therapist recently trained in a manual-based empirically supported psychotherapy or a therapist conducting treatment as usual (TAU). Participants in both conditions showed significant change from pre- to posttreatment on a number of measures. Those receiving panic control therapy (PCT) showed greater levels of change than those receiving TAU. Among treatment completers, an average of 42.9% of those in PCT and 18.8% in TAU achieved clinically significant change across measures. The results are discussed with reference to the dissemination of PCT and other evidence-based psychotherapies to clinical practice settings.",Addis ME.; Hatgis C.; Krasnow AD.; Jacob K.; Bourne L.; Mansfield A.,2004.0,10.1037/0022-006X.72.4.625,0,1,
782,Seeking Safety treatment for male veterans with a substance use disorder and post-traumatic stress disorder symptomatology.,"To determine whether substituting Seeking Safety (SS), a manualized therapy for comorbid substance use disorders (SUD) and post-traumatic stress disorder (PTSD) for part of treatment-as-usual (TAU) improves substance use outcomes. Randomized controlled effectiveness trial. Out-patient Veterans Administration Health Care System SUD clinic. Ninety-eight male military Veterans with a SUD and co-occurring PTSD symptomatology. Drug and alcohol use and PTSD severity, measured on the first day of treatment, and 3 (i.e. the planned end of SS sessions) and 6 months following the baseline assessment. Treatment attendance and patient satisfaction were measured following treatment (3-month follow-up). Active coping was measured at treatment intake and following treatment. SS compared to TAU was associated with better drug use outcomes (P < 0.05), but alcohol use and PTSD severity decreased equally under both treatments (P's < 0.01). SS versus TAU was associated with increased treatment attendance, client satisfaction and active coping (all P's < 0.01). However, neither these factors nor decreases in PTSD severity mediated the effect of treatment on drug use. The manualized treatment approach for substance use disorder, Seeking Safety, is well received and associated with better drug use outcomes than 'treatment as usual' in male veterans with post-traumatic stress disorder. However, the mechanism of its effect is unclear.",Boden MT.; Kimerling R.; Jacobs-Lentz J.; Bowman D.; Weaver C.; Carney D.; Walser R.; Trafton JA.,2012.0,10.1111/j.1360-0443.2011.03658.x,0,1,
783,Treatment for PTSD related to childhood abuse: a randomized controlled trial,"ER METHODParticipants were women with PTSD related to childhood abuse (N=104) who were randomly assigned to the STAIR/Exposure condition, Support/Exposure condition (exposure comparator), or STAIR/Support condition (skills comparator) and assessed at posttreatment, 3 months, and 6 months.RESULTSThe STAIR/Exposure group was more likely to achieve sustained and full PTSD remission relative to the exposure comparator, while the skills comparator condition fell in the middle (27% versus 13% versus 0%). STAIR/Exposure produced greater improvements in emotion regulation than the exposure comparator and greater improvements in interpersonal problems than both conditions. The STAIR/Exposure dropout rate was lower than the rate for the exposure comparator and similar to the rate for the skills comparator. There were significantly lower session-to-session PTSD symptoms during the exposure phase in the STAIR/Exposure condition than in the Support/Exposure condition. STAIR/Exposure was associated with fewer cases of PTSD worsening relative to both of the other two conditions.CONCLUSIONSFor a PTSD population with chronic and early-life trauma, a phase-based skills-to-exposure treatment was associated with greater benefits and fewer adverse effects than treatments that excluded either skills training or exposure.OBJECTIVEPosttraumatic stress disorder (PTSD) related to childhood abuse is associated with features of affect regulation and interpersonal disturbances that substantially contribute to impairment. Existing treatments do not address these problems or the difficulties they may pose in the exploration of trauma memories, an efficacious and frequently recommended approach to resolving PTSD. The authors evaluated the benefits and risks of a treatment combining an initial preparatory phase of skills training in affect and interpersonal regulation (STAIR) followed by exposure by comparing it against two control conditions: Supportive Counseling followed by Exposure (Support/Exposure) and skills training followed by Supportive Counseling (STAIR/Support).","Cloitre, M; Stovall-McClough, K C; Nooner, K; Zorbas, P; Cherry, S; Jackson, C L; Gan, W; Petkova, E",2010.0,10.1176/appi.ajp.2010.09081247,0,1,
784,A multisite randomized controlled effectiveness trial of cognitive processing therapy for military-related posttraumatic stress disorder.,"Cognitive processing therapy (CPT) is currently applied in military veteran mental health services in many countries. This study tests the effectiveness of community-administered CPT for military-related PTSD under randomized controlled conditions. Fifty-nine treatment-seeking veterans with military-related PTSD were randomly allocated to receive 12 twice-weekly 60 min sessions of CPT or an equivalent period of usual treatment at veterans' community based counseling services. Intent to treat analyses found significantly greater improvement for participants receiving CPT over usual treatment at post-treatment and 3 month follow-up. CPT also produced greater improvements in anxiety, depression, social and dyadic relationships than usual treatment. No CPT related adverse events occurred during the trial. This trial reports the first randomized controlled trial evidence that CPT is an effective treatment for military PTSD and co-morbid conditions when compared to usual treatment and delivered in community settings by clinicians from diverse disciplines, preferred treatment orientation and levels of experience.",Forbes D.; Lloyd D.; Nixon RD.; Elliott P.; Varker T.; Perry D.; Bryant RA.; Creamer M.,2012.0,10.1016/j.janxdis.2012.01.006,0,1,
785,Effect of Cognitive-Behavioral Treatments for PTSD on Anger.,"We investigated three questions related to anger and the treatment of chronic posttraumatic stress disorder (PTSD), utilizing data from a previously published study of cognitive behavioral therapies (CBTs) with female assault victims (Foa, Dancu, Hembree, Jaycox, Meadows, & Street, 1999). The questions were: (1) Do CBTs targeted at PTSD result in a concomitant reduction in anger?, (2) If so, how do these treatments compare with one another?, And (3) Do high levels of pretreatment anger predict poorer outcome on measures of PTSD symptom severity, depression, and general anxiety? Data from the State-Trait Anger Expression Inventory at pretreatment and posttreatment assessments were available for 67 participants randomly assigned to receive prolonged exposure (PE:n=19), stress inoculation training (SIT:n=18), combined treatment (PE/SIT;n=17), or waitlist control (WL:n=13). Compared to WL, treatments significantly lowered levels of state-anger. Comparisons among active treatments indicated significantly lower state-anger for SIT compared to PE/SIT, but PE did not differ from SIT or PE/SIT. Treatment gains were maintained at follow-up. Pretreatment state-anger was correlated with posttreatment PTSD symptom severity and depression, but multiple regression analyses revealed that... (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Cahill, Shawn P; Rauch, Sheila A; Hembree, Elizabeth A; Foa, Edna B; Andrews, Atkeson, Beck, Brom, Butler, Cason, Chemtob, Chemtob, Cohen, Fecteau, Feeny, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Frueh, Goldstein, Hembree, Jacobson, Jaycox, Keane, Kubany, Marks, Paunovic, Pitman, Pitman, Resick, Riggs, Rothbaum, Spielberger, Spielberger, Spielberger, Spitzer, Tarrier, Taylor, Veronen, Watson",2003.0,,0,1,
786,A controlled evaluation of cognitive behavioral therapy for posttraumatic stress in motor vehicle accident survivors.,"Seventy-eight motor vehicle accident survivors with chronic (greater than 6 months) posttraumatic stress disorder (PTSD), or severe subsyndromal PTSD, completed a randomized controlled comparison of cognitive behavioral therapy (CBT), supportive psychotherapy (SUPPORT), or a Wait List control condition with two detailed assessments. Scores on the CAPS showed significantly greater improvement for those in CBT in comparison to the Wait List and to the SUPPORT conditions. The SUPPORT condition in turn was superior to the Wait List. Categorical diagnostic data showed the same results. An analysis of CAPS scores including 98 drop-outs also showed CBT to be superior to Wait List and to SUPPORT with a trend for SUPPORT to be superior to Wait List. The CBT condition led to significantly greater reductions in co-morbid major depression and GAD than the other two conditions. Results held up well at a 3 mo follow-up on the two active treatment conditions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Blanchard, Edward B; Hickling, Edward J; Devineni, Trishul; Veazey, Connie H; Galovski, Tara E; Mundy, Elizabeth; Malta, Loretta S; Buckley, Todd C; Beck, Beck, Blake, Blanchard, Blanchard, Blanchard, Bryant, Bryant, Derogatis, Endicott, Epstein, Fecteau, First, Foa, Foa, Harvey, Hickling, Hickling, Hobbs, Horowitz, Jacobson, Keller, Kessler, Lewinsohn, Marks, Mayou, Meichenbaum, Norris, Spielberger, Taylor, Weathers",2003.0,,0,1,
787,Group versus individual cognitive-behavioural treatment for obsessive-compulsive disorder: A controlled trial.,"The efficacy of group cognitive behaviour therapy (CBT) for obsessive-compulsive disorder (OCD) has received relatively little research attention compared with the large number of studies that have investigated individual CBT. The current study is the first controlled study to compare an identical CBT protocol, containing both cognitive and behavioural elements, delivered either individually or in a group. Participants were randomly assigned to either 10 weeks of individual CBT, 10 weeks of group CBT or a 10 week wait-list. Participants with significant rates of secondary comorbidity were included in the study to enhance the generalisability of results. Intention-to-treat and completer analyses were carried out and indicated no differences between the group and individual treatments on outcome measures. Large effect sizes were found for both conditions. Analysis of clinically significant change indicated that the individual treatment was associated with a more rapid response but that both treatments had equivalent rates of recovered participants by brief follow-up. The importance of further investigations of the efficacy of group CBT for OCD is discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Anderson, Rebecca A; Rees, Clare S; Beck, Beck, Beck, Bishop, Coakes, Cohen, Cordioli, Cottraux, Emmelkamp, Endicott, Enright, Espie, Fals-Stewart, First, First, Fisher, Franklin, Freeston, French, Goodman, Himle, Jacobson, Jones, Killip, Krone, Lindsay, March, McLean, Rees, Salkovskis, Steketee, Van Noppen, Van Noppen, van Oppen, van Oppen, Wells, Whittal, Whittal",2007.0,,0,1,
788,Internet-based treatment for social phobia: A randomized controlled trial.,"In this study conducted in the French-speaking part of Switzerland, 52 individuals with social phobia were randomly assigned either to an Internet-based cognitive-behavioral treatment with minimal contact with therapists via e-mail or to a waiting-list control group. Significant differences between the two groups were found at posttreatment on all primary outcome measures (social anxiety measures) and on two of the secondary outcome measures (general symptomatology, therapy goal attainment). On average, within-groups effect sizes were large for the primary outcomes (Cohen's d = 0.82) and for secondary outcomes (Cohen's d = 1.04). Moreover, subjects in the treatment group fulfilled the criteria of clinically significant improvement significantly more often than subjects in the control group on all measured dimensions (58% vs. 20%). Users' acceptance of the program was high. The results from the present study lend further support to the hypothesis that Internet-delivered interventions with minimal therapist contact are a promising treatment approach to social phobia. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Berger, Thomas; Hohl, Eleonore; Caspar, Franz; Acarturk, Altman, Andersson, Andersson, Andersson, Baker, Barak, Bauer, Beck, Berger, Botella, Budman, Carlbring, Carlbring, Carlbring, Caspar, Clark, Clark, Clark, Degonda, Derogatis, Erwina, First, First, Hart, Heimberg, Horowitz, Huberty, Jacobson, Kessler, Kiesler, King, Kiresuk, Kiropoulos, Liebowitz, Lincoln, Magee, Marks, Mattick, Newman, Nguyen, Rapee, Rochlen, Rodebaugh, Spek, Stangier, Stangier, Tillfors, Titov, Titov, Titov",2009.0,,0,1,
789,Imagery rehearsal for posttraumatic nightmares: A randomized controlled trial.,"One hundred twenty-four male Vietnam War veterans with chronic, severe posttraumatic stress disorder (PTSD) were randomly assigned to imagery rehearsal (n = 61) or a credible active comparison condition (n = 63) for the treatment of combat-related nightmares. There was pre-post change in overall sleep quality and PTSD symptoms for both groups, but not in nightmare frequency. Intent-to-treat analyses showed that veterans who received imagery rehearsal had not improved significantly more than veterans in the comparison condition for the primary outcomes (nightmare frequency and sleep quality), or for a number of secondary outcomes, including PTSD. Six sessions of imagery rehearsal delivered in group format did not produce substantive improvement in Vietnam War veterans with chronic, severe PTSD. Possible explanations for findings are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cook, Joan M; Harb, Gerlinde C; Gehrman, Philip R; Cary, Mark S; Gamble, Geraldine M; Forbes, David; Ross, Richard J; Arntz, Baldwin, Beck, Blake, Borkovec, Borkovec, Bradley, Brewin, Buysse, Carpenter, Cason, Cohen, David, Davis, Davis, Erdfelder, First, Fitzmaurice, Fontana, Forbes, Forbes, Friedman, Galovski, Germain, Guanghan, Harb, Krakow, Krakow, Krakow, Levin, Levin, Lu, Maislin, Marks, Monson, Moore, Morin, Nappi, Neylan, Phelps, Piantadosi, Ross, Schnurr, Schnurr, Spoormaker, St-Onge, Ware, Weathers, Weathers, Wood, Zadra, Zayfert",2010.0,,0,1,
790,A randomized clinical trial comparing affect regulation and social problem-solving psychotherapies for mothers with victimization-related PTSD.,"Addressing affect dysregulation may provide a complementary alternative or adjunctive approach to the empirically supported trauma memory processing models of cognitive behavior therapy (CBT) for posttraumatic stress disorder (PTSD). A CBT designed to enhance affect regulation without trauma memory processing-trauma affect regulation: guide for education and therapy (TARGET)-was compared to present centered therapy (PCT) and wait-list (WL) conditions in a randomized clinical trial with 146 primarily low-income and ethnoracial minority mothers with PTSD. TARGET achieved statistically and clinically significant improvement on PTSD and affect regulation measures compared to WL, with more consistent and sustained (over a 6-month follow-up period) evidence of improvement than PCT. Drop-out rates (~25%) were comparable in TARGET and PCT, similar to those previously reported for trauma memory processing CBTs. Symptom worsening was rare (2-8%) and transient. Affect regulation-based CBT without trauma memory processing warrants further research as a potentially efficacious therapy for victimization-related PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ford, Julian D; Steinberg, Karen L; Zhang, Wanli; Abidin, Barkham, Beck, Benish, Berking, Berking, Blake, Bryk, Cahill, Carver, Catanzaro, Charuvastra, Cloitre, Cloitre, Cloitre, Cohen, Cook, Courtois, Dalgleish, Desai, Eisner, Finkelhor, First, Foa, Foa, Foa, Foa, Folstein, Ford, Ford, Ford, Ford, Frisman, Gill, Gill, Griffin, Halligan, Harris, Hien, Jacobson, Jaycox, Kaneda, Kessler, Kubany, Lieberman, McDonagh-Coyle, Murphy, Najavits, Neale, Newcomb, Nezu, Pole, Rauch, Rayburn, Resick, Resick, Schechter, Schnurr, Schnurr, Schumm, Scragg, Seedat, Seidler, Shahar, Singer, Spielberger, Stein, Taylor, Tull, Weathers, Yehuda, Zlotnick",2011.0,,0,1,
791,Depression does not affect the treatment outcome of CBT for panic and agoraphobia: Results from a multicenter randomized trail.,"Background: Controversy surrounds the questions whether co-occurring depression has negative effects on cognitive behavioral therapy (CBT) outcomes in patients with panic disorder(PD) and agoraphobia (AG) and whether treatment for PD and AG (PD/AG) also reduces depressive symptomatology. Methods: Post-hoc analyses of randomized clinical trial data of 369 outpatients with primary PD/AG (DSM-IV-TR criteria)treated with a 12-session manualized CBT (n = 301) and a wait list control group (n = 68). Patients with comorbid depression (DSM-IV-TR major depression, dysthymia, or both: 43.2% CBT, 42.7% controls) were compared to patients without depression regarding anxiety and depression out-comes (Clinical Global Impression Scale [CGI], Hamilton Anxiety Rating Scale [HAM-A], number of panic attacks, Mobility Inventory [MI], Panic and Agoraphobia Scale, Beck Depression Inventory) at post-treatment and follow-up (categorical).Further, the role of severity of depressive symptoms on anxiety/depression outcome measures was examined (dimensional).Results: Comorbid depression did not have a significant overall effect on anxiety outcomes at post-treatment and follow-up, except for slightly diminished post-treatment effect sizes for clinician-rated CGI (p = 0.03) and HAM-A (p = 0.008) when adjusting for baseline anxiety severity. In the dimensional model, higher baseline depression scores were associated with lower effect sizes at post-treatment (except for MI), but not at follow-up (except for HAM-A). Depressive symptoms improved irrespective of the presence of depression. Conclusions: Exposure-based CBT for primary PD/AG effectively reduces anxiety and depressive symptoms, irrespective of comorbid depression or depressive symptomatology. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Emmrich, Angela; Beesdo-Baum, Katja; Gloster, Andrew T; Knappe, Susanne; Hofler, Michael; Arolt, Volker; Deckert, Jurgen; Gerlach, Alexander L; Hamm, Alfons; Kircher, Tilo; Lang, Thomas; Richter, Jan; Strohle, Andreas; Zwanzger, Peter; Wittchen, Hans-Ulrich; Albus, Allen, Arch, Baldwin, Bandelow, Barlow, Basoglu, Beesdo, Beesdo, Bittner, Brown, Bruce, Chambless, Chambless, Clum, Craske, Davis, Dow, Fava, Fava, Fava, Gloster, Gloster, Gloster, Goodwin, Goodwin, Goodwin, Guy, Hamilton, Hautzinger, Hopko, Hardle, Jacobson, Johnson, Keijsers, Keller, Kessler, Laberge, Lang, Lang, Maddock, McHugh, McLean, Noyes, Pigott, Pine, Pollack, Rief, Rief, Roy-Byrne, Scheibe, Shear, Starcevic, Steketee, Tsao, Tsao, Tsao, Van Balkom, Van Valkenburg, Wittchen, Wittchen, Wittchen, Wittchen, Wittchen, Wittchen, Wittchen, Woody",2012.0,,0,1,
792,Suitability and acceptability of computerised cognitive behaviour therapy for anxiety disorders in secondary care.,"Objective: To evaluate the suitability and acceptability of computerised cognitive behaviour therapy (CCBT). Method: Participants were patients who had been referred to a secondary care service in the usual manner, and then offered participation in a randomised controlled trial comparing the efficacy of CCBT with a control condition (waitlist) for patients with a current primary diagnosis of generalised anxiety disorder, panic disorder or social phobia. Data were collected regarding the recruitment and retention of patients, and patient ratings (anchored Likert scales) of treatment credibility, treatment satisfaction, treatment acceptability and telephone support. Results: A total of 1141 referrals were received by the secondary care service. Of the 1141, 748 (66%) were not suitable for the study, 178 (16%) declined to participate and 127 (11%) were not contactable. Therefore, of the 1141 patients referred to the secondary care service, only 88 patients (8%) were eligible and consenting for the study. The single most common reason for patients not being suitable for the study was that the referral was urgent. In a clinical setting where CCBT could be used alongside clinical management, many of these patients may have been suitable for CCBT. Of the patients randomised to treatment (n = 40), 65% completed treatment. Drop-out rates were not significantly different across diagnostic groups. The single most commonly cited reason for not completing treatment was 'too busy'. Patient ratings of treatment were typically favourable (credibility, satisfaction, acceptability and telephone support). Conclusions: CCBT was typically rated favourably by patients referred to a secondary care service and randomised to treatment. However, only a small minority of patients was eligible and consenting for the trial. Therefore, while CCBT may be an acceptable treatment, its suitability for secondary care settings remains unclear. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Carter, Frances A; Bell, Caroline J; Colhoun, Helen C; Andrews, Andrews, Argyropoulos, Beck, Bell, Bergstrom, Carlbring, Cavanagh, Farvolden, Gega, Green, Griffiths, Hedman, Kaltenthaler, Kaltenthaler, Learmonth, Marks, Marks, McCrone, Meyer, Mundt, Proudfoot, Przeworski, Safren, Spek, Titov, Titov, Waller",2013.0,,0,1,
793,A randomized trial of attention training for generalized social phobia: Does attention training change social behavior?,"The use of attention training protocols for the treatment of generalized social anxiety disorder (SAD) is undergoing increased examination. Initial investigations were positive but more recent investigations have been less supportive of the treatment paradigm. One significant limitation of current investigations is overreliance on self-report. In this investigation, we expanded on initial investigations by using a multimodal assessment of patient functioning (i.e., including behavioral assessment). Patients with a primary diagnosis of SAD (n = 31) were randomly assigned to eight sessions of attention training (n = 15) or placebo/control (n = 16). Participants were assessed at pre- and posttreatment via self- and clinician-report of social anxiety as well as anxious and behavioral response to two in vivo social interactions. Results revealed no differences between groups at posttreatment for all study outcome variables, suggesting a lack of effect for the attention training condition. The results are concordant with recent investigations finding a lack of support for the use of attention training as an efficacious treatment for patients with SAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bunnell, Brian E; Beidel, Deborah C; Mesa, Franklin; Amir, Amir, Amir, Asmundson, Baker, Beck, Beck, Becker, Beidel, Beidel, Beidel, Beidel, Boettcher, Borkovec, Bradley, Bradley, Brown, Bunnell, Calamaras, Carlbring, Costello, Costello, Davidson, Davidson, DeWit, Dozois, Edelman, Emmelkamp, Eysenck, Fresco, Grant, Guy, Heeren, Heimberg, Heimberg, Herbert, Holle, Hope, Kazdin, Kessler, Lecrubier, Liebowitz, Macleod, Maidenberg, Matsumoto, Mattia, McNeil, Mogg, Mogg, Mogg, Neubauer, Norton, Ononaiye, Patterson, Pishyar, Pishyar, Price, Rapee, Rytwinski, Schmidt, Silverman, Spector, Sposari, Stroop, Turner, Turner, Turner, Turner, Van Bruekelen, Weiss, Williams, Wittchen",2013.0,,0,1,
794,Internet-based guided self-help for several anxiety disorders: A randomized controlled trial comparing a tailored with a standardized disorder-specific approach.,"Internet-delivered self-help with minimal therapist guidance has shown promising results for a number of diagnoses. Most of the evidence comes from studies evaluating standardized disorder-specific treatments. A recent development in the field includes transdiagnostic and tailored Internet-based treatments that address comorbid symptoms and a broader range of patients. This study evaluated an Internet-based tailored guided self-help treatment, which targeted symptoms of social anxiety disorder, panic disorder with or without agoraphobia, and generalized anxiety disorder. The tailored treatment was compared both with standardized disorder-specific Internet-based treatment and with a wait-list control group. Both active treatment conditions were based on cognitive-behavioral therapy and lasted for 8 weeks. A total of 132 individuals meeting diagnostic criteria for at least one of the anxiety disorders were randomly assigned to 1 of the 3 conditions. Both treatment groups showed significant symptom reductions as compared with the wait-list control group on primary disorder-unspecific measures of anxiety, depression, and general symptomatology and on secondary anxiety disorder-specific measures. Based on the intention-to-treat sample, mean between-group effect sizes were d = 0.80 for the tailored treatment and d = 0.82 for the standardized treatment, versus wait-list controls. Treatment gains were maintained at 6-month follow-up. No differences were found between the 2 active treatment conditions on any of the measures, including a telephone-administered diagnostic interview conducted at posttreatment. The findings suggest that both Internet-based tailored guided self-help treatments and Internet-based standardized treatments are promising treatment options for several anxiety disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Berger, Thomas; Boettcher, Johanna; Caspar, Franz; Almlov, Andersson, Andersson, Andersson, Andersson, Andersson, Andersson, Andrews, Andrews, Attkisson, Austin, Aydos, Barak, Barlow, Barlow, Beck, Beck, Becker, Berger, Berger, Berger, Berger, Berger, Bergstrom, Botella, Carlbring, Carlbring, Carlbring, Carlbring, Carlbring, Carlbring, Chambless, Chambless, Clark, Covin, Cuijpers, Derogatis, Farvolden, First, Gueorguieva, Hedman, Hedman, Hollandare, Hollon, Johansson, Kazdin, Kessler, Kessler, Kiropoulos, Klein, Knaevelsrud, Knaevelsrud, Knaevelsrud, Lange, Lincoln, Litz, Margraf, Mattick, Meyer, Munder, Munoz, Palmqvist, Paxling, Robinson, Rochlen, Schneider, Spek, Stangier, Stangier, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Wang, Wilmers",2014.0,,0,1,
795,Telephone-delivered cognitive behavioral therapy and telephone- delivered nondirective supportive therapy for rural older adults with generalized anxiety disorder: A randomized clinical trial.,"Importance: Generalized anxiety disorder (GAD) is common in older adults; however, access to treatment may be limited, particularly in rural areas. Objective: To examine the effects of telephone-delivered cognitive behavioral therapy (CBT) compared with telephone-delivered nondirective supportive therapy (NST) in rural older adults with GAD. Design, Setting, and Participants: Randomized clinical trial in the participants' homes of 141 adults aged 60 years and older with a principal or coprincipal diagnosis of GAD who were recruited between January 27, 2011, and October 22, 2013. Interventions: Telephone-delivered CBT consisted of as many as 11 sessions (9 were required) focused on recognition of anxiety symptoms, relaxation, cognitive restructuring, the use of coping statements, problem solving, worry control, behavioral activation, exposure therapy, and relapse prevention, with optional chapters on sleep and pain. Telephone-delivered NST consisted of 10 sessions focused on providing a supportive atmosphere in which participants could share and discuss their feelings and did not provide any direct suggestions for coping. Main Outcomes and Measures: Primary outcomes included interviewer-rated anxiety severity (Hamilton Anxiety Rating Scale) and self-reported worry severity (Penn State Worry Questionnaire-Abbreviated) measured at baseline, 2 months' follow-up, and 4 months' follow-up. Mood-specific secondary outcomes included self-reported GAD symptoms (GAD Scale 7 Item) measured at baseline and 4 months' follow-up and depressive symptoms (Beck Depression Inventory) measured at baseline, 2 months' follow-up, and 4 months' follow-up. Among the 141 participants, 70 were randomized to receive CBT and 71 to receive NST. Results: At 4 months' follow-up, there was a significantly greater decline in worry severity among participants in the telephone-delivered CBT group (difference in improvement, -4.07; 95%CI, -6.26 to -1.87; P = .004) but no significant differences in general anxiety symptoms (difference in improvement, -1.52; 95%CI, -4.07 to 1.03; P = .24). At 4 months' follow-up, there was a significantly greater decline in GAD symptoms (difference in improvement, -2.36; 95%CI, -4.00 to -0.72; P = .005) and depressive symptoms (difference in improvement, -3.23; 95%CI, -5.97 to -0.50; P = .02) among participants in the telephone-delivered CBT group. Conclusions and Relevance: In this trial, telephone-delivered CBT was superior to telephone-delivered NST in reducing worry, GAD symptoms, and depressive symptoms in older adults with GAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Brenes, Gretchen A; Danhauer, Suzanne C; Lyles, Mary F; Hogan, Patricia E; Miller, Michael E; Barrera, Barrowclough, Baskin, Beck, Beck, Borkovec, Borkovec, Borkovec, Borkovec, Brenes, Brenes, Carriere, Craske, Crittendon, deVries, First, Gould, Hamilton, Hopko, Larsen, Lenze, Lenze, Lenze, Lowe, Mantella, Martens, Meyer, Mohlman, Mohr, Molenberghs, Moye, Pepin, Phillips, Porensky, Roseman, Shear, Spitzer, Stanley, Stanley, Stanley, Stanley, Stanley, Stanley, van Strien, Wei, Welsh, Wetherell, Wetherell, Wetherell",2015.0,,0,1,
796,Exposure to virtual social interactions in the treatment of social anxiety disorder: A randomized controlled trial.,"This randomized controlled trial investigated the efficacy of a stand-alone virtual reality exposure intervention comprising verbal interaction with virtual humans to target heterogeneous social fears in participants with social anxiety disorder. Sixty participants (Mage = 36.9 years; 63.3% women) diagnosed with social anxiety disorder were randomly assigned to individual virtual reality exposure therapy (VRET), individual in vivo exposure therapy (iVET), or waiting-list. Multilevel regression analyses revealed that both treatment groups improved from pre-to postassessment on social anxiety symptoms, speech duration, perceived stress, and avoidant personality disorder related beliefs when compared to the waiting-list. Participants receiving iVET, but not VRET, improved on fear of negative evaluation, speech performance, general anxiety, depression, and quality of life relative to those on waiting-list. The iVET condition was further superior to the VRET condition regarding decreases in social anxiety symptoms at post- and follow-up assessments, and avoidant personality disorder related beliefs at follow-up. At follow-up, all improvements were significant for iVET. For VRET, only the effect for perceived stress was significant. VRET containing extensive verbal interaction without any cognitive components can effectively reduce complaints of generalized social anxiety disorder. Future technological and psychological improvements of virtual social interactions might further enhance the efficacy of VRET for social anxiety disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kampmann, Isabel L; Emmelkamp, Paul M. G; Hartanto, Dwi; Brinkman, Willem-Paul; Zijlstra, Bonne J. H; Morina, Nexhmedin; Amir, Anderson, Anderson, Anderson, Antony, Baker, Beidel, Boelen, Bouchard, Brinkman, Busscher, Carleton, Da Rocha, Dreessen, Emmelkamp, First, First, Garcia-Palacios, Hartanto, Heimberg, Henry, Hofmann, Hofmann, Klinger, Leary, Liebowitz, Lovibond, Mattick, Mayo-Wilson, Meyerbroker, Morina, Morina, Morris, Newell, Opris, Parsons, Powers, Powers, Qu, Rapee, Reich, Ruscio, Schmidt, Scholing, Wallach, Weeks, Wittchen",2016.0,,0,1,
797,A randomized controlled study of single-session behavioural treatment of earthquake-related post-traumatic stress disorder using an earthquake simulator.,"Brief interventions are needed in dealing with traumatic stress problems in large survivor populations after devastating earthquakes. The present study examined the effectiveness of a single session of exposure to simulated tremors in an earthquake simulator and self-exposure instructions in reducing post-traumatic stress disorder (PTSD). Participants were consecutively recruited from among survivors screened during field surveys in the disaster region in Turkey. Thirty-one earthquake survivors with PTSD were assigned either to a single session of behavioural treatment (n=16) or to repeated assessments (RA; n=15). Assessments in the treatment group were at 4, 8, 12, 24 weeks and 1-2 years post-treatment. The RA cases were assessed at baseline and 4 and 8 weeks after trial entry, after which they received the same treatment and were followed up at 4, 12, 24 weeks and 1-2 years. Between-group treatment effects at week 8 were significant on measures of fear, PTSD and self- and assessor-rated global improvement. Improvement rates were 40% at week 4, 72% at week 12, 80% at week 24, and 80% at 1-2-years' follow-up, with large effect sizes on fear and PTSD measures. Post-session reduction in fear of earthquakes and increased sense of control over fear at follow-up related to improvement in PTSD. The study provided further evidence of the effectiveness of a single session of behavioural treatment in reducing fear and PTSD in earthquake survivors. Future research needs to examine the usefulness of earthquake simulators in increasing psychological preparedness for earthquakes.",Başoglu M.; Salcioglu E.; Livanou M.,2007.0,10.1017/S0033291706009123,0,1,
798,"A randomized, controlled proof-of-concept trial of an Internet-based, therapist-assisted self-management treatment for posttraumatic stress disorder.","The authors report an 8-week randomized, controlled proof-of-concept trial of a new therapist-assisted, Internet-based, self-management cognitive behavior therapy versus Internet-based supportive counseling for posttraumatic stress disorder (PTSD). Service members with PTSD from the attack on the Pentagon on September 11th or the Iraq War were randomly assigned to self-management cognitive behavior therapy (N=24) or supportive counseling (N=21). The dropout rate was similar to regular cognitive behavior therapy (30%) and unrelated to treatment arm. In the intent-to-treat group, self-management cognitive behavior therapy led to sharper declines in daily log-on ratings of PTSD symptoms and global depression. In the completer group, self-management cognitive behavior therapy led to greater reductions in PTSD, depression, and anxiety scores at 6 months. One-third of those who completed self-management cognitive behavior therapy achieved high-end state functioning at 6 months. Self-management cognitive behavior therapy may be a way of delivering effective treatment to large numbers with unmet needs and barriers to care.",Litz BT.; Engel CC.; Bryant RA.; Papa A.,2007.0,10.1176/appi.ajp.2007.06122057,0,1,
799,Group cognitive behavior therapy for chronic posttraumatic stress disorder: an initial randomized pilot study.,"Individuals with posttraumatic stress disorder (PTSD) related to a serious motor vehicle accident were randomly assigned to either group cognitive behavioral treatment(GCBT) or a minimum contact comparison group (MCC).Compared to the MCC participants (n=16), individuals who completed GCBT (n=17) showed significant reductions in PTSD symptoms, whether assessed using clinical interview or a self-report measure. Among treatment completers, 88.3% of GCBT participants did not satisfy criteria for PTSD at posttreatment assessment, relative to31.3% of the MCC participants. Examination of anxiety,depression, and pain measures did not show a unique advantage of GCBT. Treatment-related gains were maintained over a 3-month follow-up interval. Patients reported satisfaction with GCBT, and attrition from this treatment was comparable with individually administered CBTs.Results are discussed in light of modifications necessitated by the group treatment format, with suggestions for future study of this group intervention.",Beck JG.; Coffey SF.; Foy DW.; Keane TM.; Blanchard EB.,2009.0,10.1016/j.beth.2008.01.003,0,1,
800,A resilience-oriented treatment for posttraumatic stress disorder: results of a preliminary randomized clinical trial.,"This preliminary randomized trial examined the effect of a resilience-oriented intervention for posttraumatic stress disorder (PTSD) versus a waitlist control on anxiety and depressive symptoms, positive emotional health, and cognitive performance in 39 veterans with a variety of traumatic exposures. From pre- to posttreatment, the intervention but not the control group showed improvements that were large in magnitude for affective symptoms and positive emotional health (ds = 0.73-1.18), moderate in magnitude for memory (ds = 0.50-0.54), and small-to-moderate in magnitude for executive function (ds = 0.30-0.35). Findings suggest that treatment explicitly targeting resilience resources (e.g., positive emotional engagement, social connectedness) may provide broad benefits, including alleviation of anxiety and depressive symptoms and improved positive emotional and cognitive function.",Kent M.; Davis MC.; Stark SL.; Stewart LA.,2011.0,10.1002/jts.20685,0,1,
801,A randomized controlled trial of cognitive-behavioral therapy for the treatment of PTSD in the context of chronic whiplash.,"Whiplash-associated disorders (WAD) are common and involve both physical and psychological impairments. Research has shown that persistent posttraumatic stress symptoms are associated with poorer functional recovery and physical therapy outcomes. Trauma-focused cognitive-behavioral therapy (TF-CBT) has shown moderate effectiveness in chronic pain samples. However, to date, there have been no clinical trials within WAD. Thus, this study will report on the effectiveness of TF-CBT in individuals meeting the criteria for current chronic WAD and posttraumatic stress disorder (PTSD). Twenty-six participants were randomly assigned to either TF-CBT or a waitlist control, and treatment effects were evaluated at posttreatment and 6-month follow-up using a structured clinical interview, self-report questionnaires, and measures of physiological arousal and sensory pain thresholds. Clinically significant reductions in PTSD symptoms were found in the TF-CBT group compared with the waitlist at postassessment, with further gains noted at the follow-up. The treatment of PTSD was also associated with clinically significant improvements in neck disability, physical, emotional, and social functioning and physiological reactivity to trauma cues, whereas limited changes were found in sensory pain thresholds. This study provides support for the effectiveness of TF-CBT to target PTSD symptoms within chronic WAD. The finding that treatment of PTSD resulted in improvements in neck disability and quality of life and changes in cold pain thresholds highlights the complex and interrelating mechanisms that underlie both WAD and PTSD. Clinical implications of the findings and future research directions are discussed.",Dunne RL.; Kenardy J.; Sterling M.,,10.1097/AJP.0b013e318243e16b,0,1,689
802,The efficacy of imagery rescripting (IR) for social phobia: a randomized controlled trial.,"There is a need for brief effective treatment of social phobia and Imagery Rescripting (IR) is a potential candidate. The purpose of this study was to examine the efficacy of IR preceded by cognitive restructuring as a stand-alone brief treatment using a randomized controlled design. Twenty-three individuals with social phobia were randomly assigned to an IR group or to a control group. Participants in the IR group were provided with one session of imagery interviewing and two sessions of cognitive restructuring and Imagery Rescripting. Those in the control group had one session of clinical interviewing and two sessions of supportive therapy. Outcome measures including the Korean version of the social avoidance and distress scale (K-SADS) were administered before and after treatment, and at three-month follow-up. The short version of the Questionnaire upon Mental Imagery and the Traumatic Experience Scale were also administered before treatment. Participants in the IR group improved significantly on K-SADS and other outcome measures, compared to the control group. The beneficial effects of IR were maintained at three-month follow-up. It was also found that mental imagery ability and the severity of the traumatic experience did not moderate the outcome of IR. Further studies are needed to replicate the findings of our study using a large sample. The efficacy of IR as a stand-alone brief treatment was demonstrated for social phobia. The findings indicate that IR could be utilized as a cost-effective intervention for social phobia.",Lee SW.; Kwon JH.,2013.0,10.1016/j.jbtep.2013.03.001,0,1,
803,"Fear, avoidance and physiological symptoms during cognitive-behavioral therapy for social anxiety disorder.","We examined fear, avoidance and physiological symptoms during cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD). Participants were 177 individuals with generalized SAD who underwent a 14-week group CBT as part of a randomized controlled treatment trial. Participants filled out self-report measures of SAD symptoms at pre-treatment, week 4 of treatment, week 8 of treatment, and week 14 of treatment (post-treatment). Cross-lagged Structural Equation Modeling indicated that during the first 8 weeks of treatment avoidance predicted subsequent fear above and beyond previous fear, but fear did not predict subsequent avoidance beyond previous avoidance. However, during the last 6 weeks of treatment both fear and avoidance predicted changes in each other. In addition, changes in physiological symptoms occurred independently of changes in fear and avoidance. Our findings suggest that changes in avoidance spark the cycle of change in treatment of SAD, but the cycle may continue to maintain itself through reciprocal relationships between avoidance and fear. In addition, physiological symptoms may change through distinct processes that are independent from those involved in changes of fear and avoidance.",Aderka IM.; McLean CP.; Huppert JD.; Davidson JR.; Foa EB.,2013.0,10.1016/j.brat.2013.03.007,0,1,
804,Interference control training for PTSD: A randomized controlled trial of a novel computer-based intervention.,"Post-traumatic stress disorder (PTSD) is a chronic and debilitating condition characterized by persistent intrusive memories. Although effective treatments exist for PTSD, there is a need for development of alternative treatments. Diminished ability to control proactive interference may contribute to re-experiencing symptoms and may be a novel intervention target. The present study tested an intervention designed to modify proactive interference control clinicaltrials.gov identifier: (NCT02139137). Forty-two women with PTSD were randomly assigned to a computerized cognitive training or a control condition. The impact of these programs on cognitive performance and symptoms was assessed. PTSD re-experiencing symptoms and interference control performance improved significantly more for individuals in the training group relative to those in the control group. Other PTSD and general distress symptoms improved equally over time in both groups. Cognitive training of this type may hold promise as a novel intervention for reducing PTSD symptoms, although the mechanism of action and implications for models of PTSD requires future study.",Bomyea J.; Stein MB.; Lang AJ.,2015.0,10.1016/j.janxdis.2015.05.010,0,1,
805,A Randomized Controlled Clinical Trial of Dialogical Exposure Therapy versus Cognitive Processing Therapy for Adult Outpatients Suffering from PTSD after Type I Trauma in Adulthood.,"Although there are effective treatments for posttraumatic stress disorder (PTSD), there is little research on treatments with non-cognitive-behavioural backgrounds, such as gestalt therapy. We tested an integrative gestalt-derived intervention, dialogical exposure therapy (DET), against an established cognitive-behavioural treatment (cognitive processing therapy, CPT) for possible differential effects in terms of symptomatic outcome and drop-out rates. We randomized 141 treatment-seeking individuals with a diagnosis of PTSD to receive either DET or CPT. Therapy length in both treatments was flexible with a maximum duration of 24 sessions. Dropout rates were 12.2% in DET and 14.9% in CPT. Patients in both conditions achieved significant and large reductions in PTSD symptoms (Impact of Event Scale - Revised; Hedges' g = 1.14 for DET and d = 1.57 for CPT) which were largely stable at the 6-month follow-up. At the posttreatment assessment, CPT performed statistically better than DET on symptom and cognition measures. For several outcome measures, younger patients profited better from CPT than older ones, while there was no age effect for DET. Our results indicate that DET merits further research and may be an alternative to established treatments for PTSD. It remains to be seen whether DET confers advantages in areas of functioning beyond PTSD symptoms.",Butollo W.; Karl R.; König J.; Rosner R.,2016.0,10.1159/000440726,0,1,
806,Locus of control orientation in panic disorder and the differential effects of treatment.,"In this study the effects of treatment with cognitive therapy, antidepressants or pill-placebo on the locus of control orientation in panic disorder patients were analysed, as well as the relation of this panic locus of control with panic frequency and cognitive measures of panic. A Multidimensional Anxiety Locus of Control scale (MALC) was developed and completed with other measures (ACQ and BSQ) before and after treatment. Patients also kept a panic diary. Four subscales were derived from the MALC: one Internal, and three external (a Chance, a Medication, and a Therapist) locus of anxiety control orientation scales. Cognitive therapy was superior over pill-placebo on most outcome measures whereas antidepressants were only superior in reducing the number of panic attacks. Treatment with cognitive therapy resulted in an increase of 'internal' anxiety control orientation and a decrease of 'chance' and 'medication' orientation, in comparison with antidepressant therapy. The residualized gain scores on the MALC subscales correlated with clinical improvement in subjects treated with cognitive therapy only. Results suggest that the locus of control orientation is important in evaluating the differential effects of treatments in panic disorder. A differential effect on panic locus of control in favor of cognitive therapy in comparison to medication was found.",Bakker A.; Spinhoven P.; van der Does AJ.; van Balkom AJ.; van Dyck R.,,49350,0,1,
807,Expressive relaxation training and anxiety disorders.,"Assessed the feasibility and outcome of expressive relaxation training (ERT) in 37 male and female psychiatric outpatients (18-65 yrs old) with Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) anxiety disorders. Ratings of anxiety, depression, avoidance behavior, social impairment disability, and quality of interpersonal relationships were markedly improved at ERT termination. Better ERT outcome was also correlated with DSM-III-R diagnosis of agoraphobia and social phobia, and severe phobic symptoms. These results suggest that ERT may be used to treat patients with anxiety disorders both in community psychiatry and consultation-liaison psychiatric settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Andreoli, A; Casolari, L; Rigatelli, M",1995.0,,0,0,
808,An analysis of the nature and treatment of worry.,"This thesis investigated worry as the cognitive component of anxiety. Based on a review of the empirical and theoretical literature, worry was defined as chains of intrusive, relatively controllable, negative thoughts. Research conducted for this thesis investigated personality factors associated with chronic worry, the relationship between worry and attention, and the treatment of worry in both student and clinical populations. In Study 1, individual differences in the worry experiences of ""worriers"" and ""non-worriers"" were examined. Worriers showed higher scores on neuroticism than non-worriers, and neuroticism strongly predicted levels of worry. In Study 2, the frequency and controllability of intrusive thoughts was examined in students with high levels of chronic worry using a task that required sustained attention. Under four different instructional sets, the frequency of non-negative intrusions covaried with the frequency of negative intrusions, and the number of intrusions was correlated with levels of worry. In Study 3, the effectiveness of Attention Control Therapy (ACT) in reducing worry and test anxiety was compared with Progressive Muscle Relaxation (PMR) and an Attentional Placebo (PLO) in students with high levels of chronic worry. Subjects who received ACT showed greater improvement at a 5-week post-treatment assessment and a 6-month follow-up than the PLO group on measures of worry, test anxiety, and intrusive thoughts. Notably, the PMR group did not differ from either the ACT or PLO groups. To further examine differences between ACT and PMR, Study 4 investigated the efficacy of Cognitive Restructuring plus ACT (CT/ACT), Cognitive Restructuring plus PMR (CR/PMR), and Cognitive Restructuring alone (CR) in the treatment of Generalised Anxiety Disorder. There was a clear advantage of CR/ACT over both CR/PMR and CR on measures of worry, generalised anxiety, and intrusive thoughts immediately after treatment and at a 6-week follow-up. The findings of this program of research are discussed in terms of contemporary cognitive models of worry. It is proposed that a comprehensive model of worry should provide a more explicit account of the role of attentional focus in the maintenance and reduction of worry. Further, attentional techniques should be integrated into traditional cognitive-behavioral treatments of worry. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sabebi, Ali",1997.0,,0,0,
809,Efficacy of self-administered treatments for pathological academic worry: A randomized controlled trial.,"Research on treatments for reducing pathological worry is limited. In particular, academic worry is a common theme in generalized anxiety disorder (GAD) samples as well as non-clinical student samples. Given the high cost of anxiety disorders to society, research is needed to examine the efficacy of self-administered treatments designed to reduce pathological worry. The primary goal of this study was to investigate the benefits of three self-administered interventions for reducing academic worry. College students (N = 113) experiencing clinically significant academic worry were randomized to either: (a) worry exposure (WE); (b) expressive writing (EW); (c) relaxation consisting of pulsed audio-photic stimulation (APS); or (d) waitlist control (WLC). Participants were instructed to practice their interventions three times per week for one month and completed home practice logs online to track treatment adherence. Academic worry, general anxiety, and perceived stress were assessed at baseline and post-treatment. Academic worry and general anxiety were also assessed at a three-month follow-up. Those assigned to the WE and APS conditions showed significant improvement relative to EW and WLC at post-treatment. All treatment conditions showed continued improvement by follow-up, with no between-group differences. Treatment and public health implications are discussed.",Wolitzky-Taylor KB.; Telch MJ.,2010.0,10.1016/j.brat.2010.03.019,0,0,
810,Anxiety management in alcoholics: a study of generalized effects of relaxation techniques,,"Parker, J C; Gilbert, G S; Thoreson, R W",1978.0,,0,0,
811,The psychophysiology of generalized anxiety disorder: 2. Effects of applied relaxation.,"Muscle relaxation therapy assumes that generalized anxiety disorder (GAD) patients lack the ability to relax but can learn this in therapy. We tested this by randomizing 49 GAD patients to 12 weeks of Applied Relaxation (AR) or waiting. Before, during, and after treatment participants underwent relaxation tests. Before treatment, GAD patients were more worried than healthy controls (n = 21) and had higher heart rates and lower end-tidal pCO2, but not higher muscle tension (A. Conrad, L. Isaac, & W. T. Roth, 2008). AR resulted in greater symptomatic improvement than waiting. However, 28% of the AR group dropped out of treatment and some patients relapsed at the 6-week follow-up. There was little evidence that AR participants learned to relax in therapy or that a reduction in anxiety was associated with a decrease in activation. We conclude that the clinical effects of AR in improving GAD symptoms are moderate at most and cannot be attributed to reducing muscle tension or autonomic activation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Conrad, Ansgar; Isaac, Linda; Roth, Walton T; Arntz, Arntz, Bagiella, Barlow, Barrett-Lennard, Beck, Beck, Bernstein, Bonferroni, Borkovec, Borkovec, Borkovec, Carlbring, Chatoor, Cohen, Cohen, Conrad, Conrad, DiNardo, Freeston, Grawe, Grawe, Greist, Heide, Hochberg, Horvath, Hyman, Jacobson, Jacobson, Jacobson, Jacobson, Jacobson, Jacobson, Jorm, King, Lohr, Marks, Marks, Mauss, Meyer, Ost, Ost, Park, Rottenberg, Saul, Schwartz, Vossel, Wollburg, Wolpe, Wolpe, Wolpe",2008.0,,0,0,
812,The psychophysiology of generalized anxiety disorder: 1. Pretreatment characteristics,"ER Generalized anxiety disorder (GAD) patients have been reported to have more muscle tension than controls, which has provided a rationale for treating them with muscle relaxation therapies (MRT). We tested this rationale by comparing 49 GAD patients with 21 controls. Participants underwent 5-min relaxation tests, during which they either just sat quietly (QS) or sat quietly and tried to relax (R). GAD patients reported themselves to be more worried during the assessment than the controls, had higher heart rates and lower end-tidal pCO2, but not higher muscle tension as measured by multiple EMGs. QS and R did not differ on most psychological and physiological measures, indicating that intention to relax did not affect speed of relaxation. In the GAD group, self-reported anxiety was not associated with electromyographic or autonomic measures. We conclude that GAD is not necessarily characterized by chronic muscle tension, and that this rationale for MRT should be reconsidered.","Conrad, A; Isaac, L; Roth, W T",2008.0,10.1111/j.1469-8986.2007.00601.x,0,0,
813, Changes in coping behavior in a randomized controlled trial of concurrent treatment for PTSD and alcohol dependence," OBJECTIVE: The current study examines changes in coping among 165 adults meeting DSM‚ÄêIV criteria for co‚Äêmorbid posttraumatic stress disorder (PTSD) and alcohol dependence (AD). METHOD: Participants were randomized to receive naltrexone or placebo, with or without prolonged exposure (PE). All participants received supportive counseling focused on alcohol use (BRENDA). Assessments of coping, PTSD, and AD were conducted at pre‚Äêtreatment, mid‚Äêtreatment, post‚Äêtreatment, 3‚Äêmonth follow‚Äêup, and 6‚Äêmonth follow‚Äêup. RESULTS: Participants exhibited significant decreases in both avoidant coping and adaptive coping from pre‚Äêtreatment to 6‚Äêmonth follow‚Äêup across all groups. Participants who received PE showed faster decreases in avoidant coping during this period than participants who did not receive PE. PTSD symptom reduction was associated with changes in both avoidant and adaptive coping across groups. Improvement in PTSD symptoms was related to a faster rate of reduction in avoidant coping in the PE groups compared to those receiving BRENDA alone. CONCLUSIONS: The current results suggest that concurrent treatment for co‚Äêmorbid PTSD‚ÄêAD decreases avoidant and adaptive coping, and participants who show greater reductions in PTSD symptoms also show greater changes in coping style. Consistent with theorized mechanisms of change in PE, the addition of PE to supportive counseling for AD was associated with a greater reduction of avoidant coping than supportive counseling alone."," Zang, Y;  Yu, J;  Chazin, D;  Asnaani, A;  Zandberg, LJ;  Foa, EB",2017.0, 10.1016/j.brat.2016.11.013,0,0,
814,Effects of psychotherapies for posttraumatic stress disorder on sleep disturbances: Results from a randomized clinical trial.,"The effectiveness and mechanisms of psychotherapies for posttraumatic stress disorder (PTSD) in treating sleep problems is of interest. This study compared the effects of a trauma-focused and a non-trauma-focused psychotherapy on sleep, to investigate whether 1) sleep improves with psychotherapy for PTSD; 2) the degree of sleep improvement depends on whether the intervention is trauma or nontrauma-focused; 3) the memory-updating procedure in cognitive therapy for PTSD (CT-PTSD) is associated with sleep improvements; 4) initial sleep duration affects PTSD treatment outcome; and 5) which symptom changes are associated with sleep duration improvements. Self-reported sleep was assessed during a randomized controlled trial (Ehlers et al., 2014) comparing CT-PTSD (delivered weekly or intensively over 7-days) with emotion-focused supportive therapy, and a waitlist. Sleep duration was reported daily in sleep diaries during intensive CT-PTSD. CT-PTSD led to greater increases in sleep duration (55.2 min) and reductions in insomnia symptoms and nightmares than supportive therapy and the waitlist. In intensive CT-PTSD, sleep duration improved within 7 days, and sleep diaries indicated a 40-min sleep duration increase after updating trauma memories. Initial sleep duration was not related to CT-PTSD treatment outcome when initial PTSD symptom severity was controlled. The results suggest that trauma-focused psychotherapy for PTSD is more effective than nontrauma-focused therapy in improving self-reported sleep, and that CT-PTSD can still be effective in the presence of reduced sleep duration.",Woodward E.; Hackmann A.; Wild J.; Grey N.; Clark DM.; Ehlers A.,2017.0,10.1016/j.brat.2017.07.001,0,0,
815," Mindfulness-based cognitive therapy for generalised anxiety disorder and health service utilisation among Chinese patients in primary care: a randomised, controlled trial",," Wong, SY;  Tang, WK;  Mercer, SW;  Kung, K;  Mak, WW;  Griffiths, SM;  Lee, TM",2016.0,,0,0,
816,Behavioral avoidance predicts treatment outcome with exposure and response prevention for obsessive-compulsive disorder.,"Many individuals with obsessive-compulsive disorder (OCD) display behavioral avoidance related to their obsessional thoughts and compulsive behaviors. However, how these avoidance behaviors impact treatment outcomes with exposure and response prevention (EX/RP) remains unclear. We examined pretreatment avoidance behaviors as predictors of EX/RP outcomes. Data came from a randomized controlled trial of augmentation strategies for inadequate response to serotonin reuptake inhibitors comparing EX/RP (N = 40), risperidone (N = 40), and placebo (N = 20). Baseline avoidance was rated with the avoidance item from the Yale-Brown Obsessive-Compulsive Scale (YBOCS). Primary analyses examined avoidance behaviors as predictors of EX/RP outcomes. To test specificity, we explored whether avoidance also related to outcomes among patients receiving risperidone and placebo. More than half (69%) of the full sample had moderate or severe avoidance behaviors at baseline. In EX/RP, controlling for baseline severity, pretreatment avoidance predicted posttreatment YBOCS symptoms (β = 0.45, P < .01). Avoidant individuals were less likely to achieve remission with EX/RP (odds ratio = 0.04, 95% confidence interval [CI] range 0.01-0.28, P = .001). Baseline avoidance was also associated with degree of patient adherence to between-session EX/RP assignments, which mediated the relationship between baseline avoidance and EX/RP outcomes (P < .05). Baseline avoidance did not predict outcomes or wellness among patients receiving risperidone or placebo. These results suggest that avoidance behaviors are an important clinical factor in EX/RP outcomes and indicate that assessing avoidance may provide an efficient method for predicting EX/RP outcomes. Avoidance may be particularly relevant in EX/RP as compared to medication treatment, though future replication of these initial results is required.",Wheaton MG.; Gershkovich M.; Gallagher T.; Foa EB.; Simpson HB.,2018.0,10.1002/da.22720,0,0,
817,A pilot randomized trial of metacognitive therapy vs applied relaxation in the treatment of adults with generalized anxiety disorder.,"This reprinted article originally appeared in Behaviour Research and Therapy 48, 5, 2010, pp. 429-434. Metacognitive Therapy (MCT) and Applied Relaxation (AR) were compared in a pilot treatment trial of generalized anxiety disorder (GAD). Twenty outpatients meeting criteria for DSM-IV-TR GAD were assessed before treatment, after treatment and at 6 m and 12 m follow-up. The patients were randomized and treated individually for 8-12 weekly sessions. There was no drop-out from MCT and 10% at 6 m follow-up from AR. At post-treatment and at both follow-up points MCT was superior to AR. Standardized recovery rates for MCT at post-treatment were 80% on measures of worry and trait-anxiety compared with 10% following AR. At 6 m follow-up recovery rates for MCT were 70% on both measures compared with 10% and 20% for AR. At 12 m follow-up recovery rates for MCT were 80% (worry) and 60% (trait-anxiety) compared with 10% and 20% following AR. The recovery rates for MCT are similar to those obtained in an earlier uncontrolled trial (Wells & King, 2006). The effect sizes and standardized recovery rates for MCT suggest that it is a highly effective treatment. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Wells, Adrian; Welford, Mary; King, Paul; Papageorgiou, Costas; Wisely, Julie; Mendel, Elizabeth",2017.0,,0,0,
818, Enhancing need satisfaction to reduce psychological distress in Syrian refugees," METHOD: Forty‚Äêone refugees who fled Syria during the past 24 months and resettled in Jordan participated in the study and were randomly assigned to receive the intervention or a neutral comparison. RESULTS: The 1‚Äêweek‚Äêlong intervention alleviated some of the need frustration likely associated with refugee status, a major aim of the intervention, and also lowered refugees' self‚Äêreported symptoms of depression and generalized stress as compared to the comparison condition, though it did not reduce symptoms of PTSD. CONCLUSIONS: Discussion focuses on how these findings speak to the universal importance of need satisfaction for mental health, and how need‚Äêsatisfying experiences can help buffer against the profound stress of being a refugee. Avenues for longer‚Äêterm or more intensive interventions that may target more severe outcomes of refugee experiences, such as PTSD symptoms, are also discussed. (PsycINFO Database Record OBJECTIVE: Becoming a refugee is a potent risk factor for indicators of psychological distress such as depression, generalized stress, and posttraumatic stress disorder (PTSD), though research into this vulnerable population has been scant, with even less work focusing on interventions. The current study applied principles from self‚Äêdetermination theory (SDT; Ryan & Deci, 2000) to develop and test an intervention aimed at increasing need‚Äêsatisfying experiences in refugees of Syrian civil unrest."," Weinstein, N;  Khabbaz, F;  Legate, N",2016.0, 10.1037/ccp0000095,0,0,
819,Cognitive behavioral therapy in pharmacoresistant obsessive-compulsive disorder.,"Background: The aim of the study was to determine whether patients with obsessive-compulsive disorder (OCD) resistant to drug therapy may improve their condition using intensive, systematic cognitive behavioral therapy (CBT) lasting for 6 weeks, and whether it is possible to predict the therapeutic effect using demographic, clinical, and selected psychological characteristics at baseline. Methods: Sixty-six OCD patients were included in the study, of which 57 completed the program. The diagnosis was confirmed using the structured Mini International Neuropsychiatric Interview. Patients were rated using the objective and subjective forms of the Yale-Brown Obsessive Compulsive Scale, objective and subjective forms of the Clinical Global Impression, Beck Anxiety Inventory, Beck Depression Inventory, Dissociative Experiences Scale, 20-item Somatoform Dissociation Questionnaire, and the Sheehan Disability Scale before their treatment, and with subjective Yale-Brown Obsessive Compulsive Scale, objective and subjective Clinical Global Impression, Beck Anxiety Inventory, and Beck Depression Inventory at the end of the treatment. Patients were treated with antidepressants and daily intensive group CBT for the 6-week period. Results: During the 6-week intensive CBT program in combination with pharmacotherapy, there was a significant improvement in patients suffering from OCD resistant to drug treatment. There were statistically significantly decrease in the scores assessing the severity of OCD symptoms, anxiety, and depressive feelings. A lower treatment effect was achieved specifically in patients who 1) showed fewer OCD themes in symptomatology, 2) showed a higher level of somatoform dissociation, 3) had poor insight, and 4) had a higher initial level of overall severity of the disorder. Remission of the disorder was more likely in patients who had 1) good insight, 2) a lower initial level of anxiety, and 3) no comorbid depressive disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Vyskocilova, Jana; Prasko, Jan; Sipek, Jiri",2016.0,,0,0,
820,Early Psychological Counseling for the Prevention of Posttraumatic Stress Induced by Acute Coronary Syndrome: The MI-SPRINT Randomized Controlled Trial.,"Acute coronary syndrome (ACS)-induced posttraumatic stress disorder (PTSD) and clinically significant PTSD symptoms (PTSS) are found in 4 and 12% of patients, respectively. We hypothesized that trauma-focused counseling prevents the incidence of ACS-induced PTSS. Within 48 h of hospital admission, 190 patients with high distress during ACS were randomized to a single-session intervention of either trauma-focused counseling or an active control intervention targeting the general role of stress in patients with heart disease. Blind interviewer-rated PTSS (primary outcome) and additional health outcomes were assessed at 3 months of follow-up. Trial results about prevalence were compared with data from previous studies on the natural incidence of ACS-induced PTSS/PTSD. Intention-to-treat analyses revealed no difference in interviewer-rated PTSS between trauma-focused counseling (mean, 11.33; 95% Cl, 9.23-13.43) and stress counseling (9.88; 7.36-12.40; p = 0.40), depressive symptoms (6.01, 4.98-7.03, vs. 4.71, 3.65-5.77; p = 0.08), global psychological distress (5.15, 4.07-6.23, vs. 3.80, 2.60-5.00; p = 0.11), and the risk for cardiovascular-related hospitalization/all-cause mortality (OR, 0.67; 95% CI, 0.37-1.23). Self-rated PTSS indicated less beneficial effects with trauma-focused (6.54; 4.95-8.14) versus stress counseling (3.74; 2.39-5.08; p = 0.017). The completer analysis (154 cases) confirmed these findings. The prevalence rates of interviewer-rated PTSD (0.5%, 1/190) and self-rated PTSS were in this trial much lower than in meta-analyses and observation studies from the same cardiology department. Benefits were not seen for trauma-focused counseling when compared with an active control intervention. Nonetheless, in distressed ACS patients, individual, single-session, early psychological counseling shows potential as a means to prevent posttraumatic responses, but trauma-focused early treatments should probably be avoided.",von Känel R.; Barth J.; Princip M.; Meister-Langraf RE.; Schmid JP.; Znoj H.; Herbert C.; Schnyder U.,2018.0,10.1159/000486099,0,0,
821, Self-views in social anxiety disorder: the impact of CBT versus MBSR," This study examines the impact of Cognitive‚ÄêBehavioral Group Therapy (CBGT) versus Mindfulness‚ÄêBased Stress Reduction (MBSR) versus Waitlist (WL) on self‚Äêviews in patients with social anxiety disorder (SAD). One hundred eight unmedicated patients with SAD were randomly assigned to 12 weeks of CBGT, MBSR, or WL, and completed a self‚Äêreferential encoding task (SRET) that assessed self‚Äêendorsement of positive and negative self‚Äêviews pre‚Äê and post‚Äêtreatment. At baseline, 40 healthy controls (HCs) also completed the SRET. At baseline, patients with SAD endorsed greater negative and lesser positive self‚Äêviews than HCs. Compared to baseline, patients in both CBGT and MBSR decreased negative self‚Äêviews and increased positive self‚Äêviews. Improvement in self‚Äêviews, specifically increases in positive (but not decreases in negative) self‚Äêviews, predicted CBGT‚Äê and MBSR‚Äêrelated decreases in social anxiety symptoms. Enhancement of positive self‚Äêviews may be a shared therapeutic process for both CBGT and MBSR for SAD."," Thurston, MD;  Goldin, P;  Heimberg, R;  Gross, JJ",2017.0, 10.1016/j.janxdis.2017.01.001,0,0,
822,Increased skills usage statistically mediates symptom reduction in self-guided internet-delivered cognitive-behavioural therapy for depression and anxiety: a randomised controlled trial.,"Cognitive-behavioural therapy (CBT) is an effective treatment for clinical and subclinical symptoms of depression and general anxiety, and increases life satisfaction. Patients' usage of CBT skills is a core aspect of treatment but there is insufficient empirical evidence suggesting that skills usage behaviours are a mechanism of clinical change. This study investigated if an internet-delivered CBT (iCBT) intervention increased the frequency of CBT skills usage behaviours and if this statistically mediated reductions in symptoms and increased life satisfaction. A two-group randomised controlled trial was conducted comparing internet-delivered CBT (n = 65) with a waitlist control group (n = 75). Participants were individuals experiencing clinically significant symptoms of depression or general anxiety. Mixed-linear models analyses revealed that the treatment group reported a significantly higher frequency of skills usage, lower symptoms, and higher life satisfaction by the end of treatment compared with the control group. Results from bootstrapping mediation analyses revealed that the increased skills usage behaviours statistically mediated symptom reductions and increased life satisfaction. Although skills usage and symptom outcomes were assessed concurrently, these findings support the notion that iCBT increases the frequency of skills usage behaviours and suggest that this may be an important mechanism of change.",Terides MD.; Dear BF.; Fogliati VJ.; Gandy M.; Karin E.; Jones MP.; Titov N.,2018.0,10.1080/16506073.2017.1347195,0,0,
823,Quality of life outcomes following transdiagnostic group cognitive-behavioral therapy for anxiety.,"Individuals with anxiety disorders experience decrements in quality of life (QoL), though it is seldom assessed as an outcome in treatment studies. This study examined QoL as an outcome following transdiagnostic group cognitive-behavioral therapy (TGCBT) for anxiety. Treatment-seeking adults (N = 129; Mage = 33.1; 47.4% female) with social phobia, panic disorder, and/or generalized anxiety disorder rated their QoL by self-report before and after participating in TGCBT. Using general linear modeling, QoL was found to be similar across diagnostic groups both prior to and following treatment, with the exception that individuals diagnosed with social phobia scored significantly lower than the others in social functioning- related QoL following treatment. Otherwise, these groups improved similarly in overall QoL and achievement-, social functioning-, and personal growth-related QoL following 12 weeks of TGCBT. Thus, QoL significantly improves following transdiagnostic group treatment and represents a valuable outcome measure that can contribute to clinical assessment. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Talkovsky, Alexander M; Paulus, Daniel J; Kuang, Fanny; Norton, Peter J",2017.0,http://dx.doi.org/10.1521/ijct_2017_10_01,0,0,
824,"Resource activation for treating post-traumatic stress disorder, co-morbid symptoms and impaired functioning: A randomized controlled trial in Cambodia.","Background: Mental health morbidity in post-conflict settings is high. Nevertheless, randomized controlled trials of psychotherapy on site are rare. Our aim was to integrate rigorous research procedures into a humanitarian programme and test the efficacy of resource activation (ROTATE) in treating post-traumatic stress disorder (PTSD), co-morbid symptoms and impaired functioning in Cambodia. Method: A total of 86 out-patients with PTSD were randomly assigned to five sessions of ROTATE (n = 53) or a 5-week waiting-list control (WLC) condition (n = 33). Treatment was provided by six Cambodian psychologists who had received extensive training in ROTATE. Masked assessments were made before and after therapy. Results: PTSD remission rates according to the DSM-IV algorithm of the Harvard Trauma Questionnaire were 95.9% in ROTATE and 24.1% in the WLC condition. Thus, patients receiving ROTATE had a significantly higher likelihood of PTSD remission (odds ratio 0.012, 95% confidence interval 0.002-0.071, p < 0.00001). Additionally, levels of anxiety, depression and impaired functioning were significantly reduced compared with the WLC condition (p < 0.00001, between-group effect sizes d = 2.41, 2.26 and 2.54, respectively). No harms were reported. Conclusions: ROTATE was efficacious in treating Cambodian patients with high symptom levels of PTSD, emotional distress and impaired functioning. ROTATE is a brief, culturally adaptable intervention focusing on stabilization and strengthening resources rather than trauma confrontation. It can be taught to local professionals and paraprofessionals and enhance access to mental health care for patients in need. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Steinert, C; Bumke, P. J; Hollekamp, R. L; Larisch, A; Leichsenring, F; Matthes, H; Sek, S; Sodemann, U; Stingl, M; Ret, T; Vojtova, H; Woller, W; Kruse, J",2017.0,http://dx.doi.org/10.1017/S0033291716002592,0,0,
825,Early EMDR intervention following a community critical incident: A randomized clinical trial.,"The aim of this study was to investigate the efficacy of early eye movement desensitization and reprocessing (EMDR) intervention using the EMDR recent traumatic episode protocol (R-TEP) after a traumatic community event whereby a missile hit a building in a crowded area of a town. In a waitlist/delayed treatment parallel-group randomized controlled trial, 17 survivors with posttraumatic distress were treated with EMDR therapy using the R-TEP protocol. Volunteer EMDR practitioners conducted treatment on 2 consecutive days. Participants were randomly allocated to either immediate or waitlist/delayed treatment conditions. Assessments with Impact of Event Scale-Revised (IES-R) and the Patient Health Questionnaire (PHQ-9) brief depression inventory took place at pre- and posttreatment and at 3 months follow-up. At 1 week posttreatment, the scores of the immediate treatment group were significantly improved on the IES-R compared to the waitlist/delayed treatment group, who showed no improvement prior to their treatment. At 3 months follow-up, results on the IES-R were maintained and there was a significant improvement on PHQ-9 scores. This pilot study provides preliminary evidence, supporting the efficacy of EMDR R-TEP for reducing posttrauma stress among civilian victims of hostility, and shows that this model of intervention briefly augmenting local mental health services following large-scale traumatic incidents, using an EMDR intervention on 2 consecutive days may be effective. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Shapiro, Elan; Laub, Brurit",2015.0,http://dx.doi.org/10.1891/1933-3196.9.1.17,0,0,
826,The Efficacy of a Group CBT Relapse Prevention Program for Remitted Anxiety Disorder Patients Who Discontinue Antidepressant Medication: A Randomized Controlled Trial.,,Scholten WD.; Batelaan NM.; van Oppen P.; Smit JH.; Hoogendoorn AW.; van Megen HJGM.; Cath DC.; van Balkom AJLM.,2018.0,10.1159/000489498,0,0,
827, Enhancing Extinction Learning in Posttraumatic Stress Disorder With Brief Daily Imaginal Exposure and Methylene Blue: a Randomized Controlled Trial," OBJECTIVE: The memory‚Äêenhancing drug methylene blue (MB) administered after extinction training improves fear extinction retention in rats and humans with claustrophobia. Robust findings from animal research, in combination with established safety and data showing MB‚Äêenhanced extinction in humans, provide a foundation to extend this work to extinction‚Äêbased therapies for posttraumatic stress disorder (PTSD) such as prolonged exposure (PE). METHODS: Patients with chronic PTSD (DSM‚ÄêIV‚ÄêTR; N = 42) were randomly assigned to imaginal exposure plus MB (IE + MB), imaginal exposure plus placebo (IE + PBO), or waitlist (WL/standard PE) from September 2011 to April 2013. Following 5 daily, 50‚Äêminute imaginal exposure sessions, 260 mg of MB or PBO was administered. Waitlist controls received PE following 1‚Äêmonth follow‚Äêup. Patients were assessed using the independent evaluator‚Äêrated PTSD Symptom Scale‚ÄêInterview version (primary outcome), patient‚Äêrated PTSD, trauma‚Äêrelated psychopathology, and functioning through 3‚Äêmonth follow‚Äêup. RESULTS: Both IE + MB and IE + PBO showed strong clinical gains that did not differ from standard PE at 3‚Äêmonth follow‚Äêup. MB‚Äêaugmented exposure specifically enhanced independent evaluator‚Äêrated treatment response (number needed to treat = 7.5) and quality of life compared to placebo (effect size d = 0.58). Rate of change for IE + MB showed a delayed initial response followed by accelerated recovery, which differed from the linear pattern seen in IE + PBO. MB effects were facilitated by better working memory but not by changes in beliefs. CONCLUSIONS: The findings provide preliminary efficacy for a brief IE treatment for PTSD and point to the potential utility of MB for enhancing outcome. Brief interventions and better tailoring of MB augmentation strategies, adjusting for observed patterns, may have the potential to reduce dropout, accelerate change, and improve outcomes. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01188694."," Zoellner, LA;  Telch, M;  Foa, EB;  Farach, FJ;  McLean, CP;  Gallop, R;  Bluett, EJ;  Cobb, A;  Gonzalez-Lima, F",2017.0, 10.4088/JCP.16m10936,0,0,
828,Immediate therapist self-disclosure bolsters the effect of brief integrative psychotherapy on psychiatric symptoms and the perceptions of therapists: A randomized clinical trial.,"We report a first randomized clinical trial examining the effect of immediate and non-immediate therapist self-disclosure in the context of a brief integrative psychotherapy for mild to moderate distress. A total of 86 patients with mild to moderate forms of distress were randomly divided into three 12-session integrative psychotherapy conditions based primarily on [Hill, C. E. (2009). Helping skills: Facilitating, exploration, insight, and action (3rd ed.). Washington, DC: American Psychological Association.] three-stage model. Therapists trained in this treatment modality were instructed to use either immediate self-disclosure (expressing feelings towards the patient/treatment/therapeutic relationship) or non-immediate self-disclosure (expressing personal or factual information regarding the therapist's life outside the treatment). In the comparison condition, the therapists were instructed to refrain from self-disclosure altogether. Immediate therapist self-disclosure reduced psychiatric symptoms among patients with elevated pretreatment symptoms (as assessed by the Brief Symptoms Inventory) and bolstered a favorable perception of the therapist. Therapists in both the immediate and non-immediate self-disclosure group evaluated themselves more favorably than their counterparts in the non-disclosure group. Therapist self-disclosure, particularly of the immediate type, might enhance the effect of brief integrative treatment on psychiatric symptoms of high symptomatic patients and contribute to favorable perception of therapists.",Ziv-Beiman S.; Keinan G.; Livneh E.; Malone PS.; Shahar G.,2017.0,10.1080/10503307.2016.1138334,0,0,
829," Collaborative nurse-led self-management support for primary care patients with anxiety, depressive or somatic symptoms: cluster-randomised controlled trial (findings of the SMADS study)"," BACKGROUND: Collaborative, nurse‚Äêled care is a well‚Äêestablished model of ambulatory care in many healthcare systems. Nurses play a key role in managing patients' conditions as well as in enhancing symptom‚Äê and self‚Äêmanagement skills. OBJECTIVE: The SMADS trial evaluated the effectiveness of a primary care‚Äêbased, nurse‚Äêled, complex intervention to promote self‚Äêmanagement in patients with anxiety, depressive or somatic symptoms. Change in self‚Äêefficacy 12 months post baseline was used as the primary outcome. DESIGN: The SMADS trial set up a two‚Äêarm, cluster randomised controlled trial in the city of Hamburg, a large metropolitan area in the North West of Germany. SETTING: We randomly allocated participating primary care practices to either the intervention group (IG), implementing a nurse‚Äêled collaborative care model, or to the control group (CG), where patients with the above psychosomatic symptoms received routine treatment. PARTICIPANTS: Patients from 18 to 65 years of age, regularly consulting a participating primary care practice, scoring‚â•5 on the anxiety, depressive or somatic symptom scales of the Patient Health Questionnaire (PHQ‚ÄêD), German version. METHODS: A mixed model regression approach was used to analyse the outcome data. Analyses were based on the intention‚Äêto‚Äêtreat population: All enrolled patients were analysed at their follow‚Äêup. Additionally, we reported results as effect sizes. The robustness of the results was investigated by performing an observed cases analysis. RESULTS: 325 participants (IG N=134, CG N=191) from ten practices in each study arm consented to take part and completed a baseline assessment. The mean group difference (ITT‚ÄêLOCF, IG vs. CG) in self‚Äêefficacy at the post baseline follow‚Äêup (median 406days) was 1.65 points (95% CI 0.50‚Äê2.8) in favour of IG (p=0.004). This amounts to a small Cohen's d effect size of 0.33. An observed cases analysis (168 participants, IG=56, CG=105) resulted in a mean difference of 3.13 (95% CI 1.07‚Äê5.18, p=0.003) between the groups, amounting to a moderate effect size of d=0.51. CONCLUSION: A complex, nurse‚Äêled intervention, implemented as a collaborative care model, increased perceived self‚Äêefficacy in patients with symptoms of anxiety, depression or somatisation compare to control patients. For the first time in the German healthcare system, the SMADS trial validated the belief that a nurse can successfully complement the work of a general practitioner ‚Äê particularly in supporting self‚Äêmanagement of patients with psychosomatic symptoms and their psychosocial needs."," Zimmermann, T;  Puschmann, E;  van den Bussche, H;  Wiese, B;  Ernst, A;  Porzelt, S;  Daubmann, A;  Scherer, M",2016.0, 10.1016/j.ijnurstu.2016.08.007,0,0,
830, Emotional Arousal (Voice Stress) and Posttraumatic Growth as well as Relationship Satisfaction of Partners of Women with Breast Cancer in the Context of Social Support, null," Zimmermann, T;  Krüger, JH;  Weusthoff, S",2017.0, 10.1055/s-0043-108193,0,0,
831,A prospective multicenter study to compare the precision of posttraumatic internal orbital reconstruction with standard preformed and individualized orbital implants.,"A variety of implants are available for orbital reconstruction. Titanium orbital mesh plates are available either as standard preformed implants or able to be individualized for the patient. The aim of this study was to analyze whether individualized orbital implants allow a more precise reconstruction of the orbit than standard preformed implants. A total of 195 patients treated between 2010 and 2014 were followed up to 12 weeks after surgery. Of the patients, 100 had received standardized preformed and 95 individualized implants. The precision of orbital reconstruction with the different implants was determined by comparing the variances in the volume difference between the reconstructed and the contralateral orbit on the postoperative computed tomographic scans. Clinical volume-related parameters including globe position, vision, motility, and diplopia and surgical details including approach, timing and technique of implant modification, use of navigation, duration of surgery, as well as adverse events were documented. Orbital reconstruction was significantly more precise when individualized implants were used. The same was seen with intraoperative navigation. An overlap in the use of individualized implants and navigation makes it difficult to attribute the improved precision to a single factor. This study demonstrated that individualization and navigation provide clinical benefit.",Zimmerer RM.; Ellis E.; Aniceto GS.; Schramm A.; Wagner ME.; Grant MP.; Cornelius CP.; Strong EB.; Rana M.; Chye LT.; Calle AR.; Wilde F.; Perez D.; Tavassol F.; Bittermann G.; Mahoney NR.; Alamillos MR.; Bašić J.; Dittmann J.; Rasse M.; Gellrich NC.,2016.0,10.1016/j.jcms.2016.07.014,0,0,
832, A mobile application of breast cancer e-support program versus routine Care in the treatment of Chinese women with breast cancer undergoing chemotherapy: study protocol for a randomized controlled trial," BACKGROUND: Women with breast cancer undergoing chemotherapy suffer from a number of symptoms and report receiving inadequate support from health care professionals. Innovative and easily accessible interventions are lacking. Breast Cancer e‚ÄêSupport is a mobile Application program (App) that provides patients with individually tailored information and a support group of peers and health care professionals. Breast Cancer e‚ÄêSupport aims to promote women's self‚Äêefficacy, social support and symptom management, thus improving their quality of life and psychological well‚Äêbeing. METHODS: A single‚Äêblinded, multi‚Äêcentre, randomised, 6‚Äêmonth, parallel‚Äêgroup superiority design will be used. Based on Bandura's self‚Äêefficacy theory and the social exchange theory, Breast Cancer e‚ÄêSupport has four modules: 1) a Learning forum; 2) a Discussion forum; 3) an Ask‚Äêthe‚ÄêExpert forum; and 4) a Personal Stories forum. Women with breast cancer (n = 108) who are commencing chemotherapy will be recruited from two university‚Äêaffiliated hospitals in China. They will be randomly assigned to either control group that receives routine care or intervention group that receives routine care plus access to Breast Cancer e‚ÄêSupport program during their four cycles of chemotherapy. Self‚Äêefficacy, social support, symptom distress, quality of life, and anxiety and depression will be measured at baseline, then one week and 12 weeks post‚Äêintervention. DISCUSSION: This is the first study of its kind in China to evaluate the use of a mobile application intervention with a rigorous research design and theoretical framework. This study will contribute to evidence regarding the effectiveness of a theory‚Äêbased mobile application to support women with breast cancer undergoing chemotherapy. The results should provide a better understanding of the role of self‚Äêefficacy and social support in reducing symptom distress and of the credibility of using a theoretical framework to develop internet‚Äêbased interventions. The results will provide evidence to support the implementation of an innovative and easily accessible intervention that enhances health outcomes. TRIAL REGISTRATION: ACTRN: ACTRN12616000639426 , Registered 17 May, 2016."," Zhu, J;  Ebert, L;  Liu, X;  Chan, SW",2017.0, 10.1186/s12885-017-3276-7,0,0,
833, Research of TCM synthetic rehabilitation on the recovery of wrist joint after distal radius fractures," OBJECTIVE: To evaluate efficacy and advantages of the Traditional Chinese Medicine (TCM) synthetic rehabilitation therapy in the treatment of wrist dysfunction after distal radius fractures. METHODS: From May 2014 to October 2015, 72 patients with distal radius fracture meeting standards were treated using central randomization system for clinical research. All the patients were divided into two groups: 36 patients in test group and 36 in control group. Sixty‚Äênine cases were finished treatment and followed up in the end. The test group fell off 1 case, and the control group fell off 2 cases. The test group was given TCM synthetic rehabilitation (manipulative therapy, joint mobilization, soaking‚Äêwashing with Chinese medicinal herbs, functional exercise), and the control group was given functional exercise as well as soaking‚Äêwashing with Chinese medicinal herbs, 3 weeks for both. Five evaluation standards were used in this research, which were grip strength, patient‚Äêrated wrist evaluation (PRWE), Gartland and Werley wrist score, self‚Äêrating anxiety scale(SAS) and the overall curative effect evaluation. Before treatment(baseline), after 3 weeks of treatment and 3 months after fracture were the three points in time when collected the data. RESULTS: After 3 weeks of treatment and 3 months after fracture, the test group had a significantly better results than those of control group in the PRWE, G‚ÄêW wrist score and the overall curative effect evaluation( CONCLUSIONS: The TCM synthetic rehabilitation therapy has better curative effects on the treatment of functional disability of wrist joints after distal radius fractures than the general therapy of soaking‚Äêwashing with Chinese medicinal herbs and functional exercise."," Zhao, Y;  Dong, QQ;  Qin, WK;  Yan, A;  Zhang, K;  Zhao, GD;  Wang, G;  Geng, JC;  Wang, ZF;  Lu, ZM",2017.0, 10.3969/j.issn.1003-0034.2017.01.010,0,0,
834, Effectiveness of cognitive-coping therapy and alteration of resting-state brain function in obsessive-compulsive disorder," BACKGROUND: Cognitive‚Äêcoping therapy (CCT), integrating cognitive theory with stress‚Äêcoping theory, is an efficacious therapy for obsessive‚Äêcompulsive disorder (OCD). However, the potential brain mediation for the effectiveness remains unclear. We sought to investigate differences of resting‚Äêstate brain function between OCD and healthy controls and if such differences would be changed by a four‚Äêweek CCT. PATIENTS AND METHODS: Thirty‚Äêone OCD patients were recruited and randomized into CCT (n=15) and pharmacotherapy plus CCT (pCCT, n=16) groups, together with 25 age‚Äê, gender‚Äê and education‚Äêmatched healthy controls. The Yale‚ÄêBrown Obsessive Compulsive Scale (Y‚ÄêBOCS) was scored to evaluate the severity in symptoms. Resting‚Äêstate functional magnetic resonance imaging was scanned pre‚Äê and post‚Äêtreatment. RESULTS: For patients, Y‚ÄêBOCS scores were reduced during four‚Äêweek treatment for CCT and pCCT (P<0.001), but no group difference was observed. No differences in amplitude of low‚Äêfrequency fluctuation (ALFF) values were found between CCT and pCCT either pre‚Äê or post‚Äêtreatment. Compared to controls, ALFF in OCD patients was higher in the left hippocampus, parahippocampus, and temporal lobes, but lower in the right orbitofrontal cortex, rectus, bilateral calcarine, cuneus, lingual, occipital, left parietal, postcentral, precentral, and parietal (corrected P<0.05). The ALFF in those regions was not significantly correlated to the severity of OCD symptoms. After a 4‚Äêweek treatment, the ALFF differences between OCD patients and controls disappeared. LIMITATIONS: The pharmacotherapy group was not included since OCD patients generally do not respond to pharmacotherapy in four weeks. CONCLUSIONS: Our data indicated that resting‚Äêstate brain function was different between OCD and controls; such differences disappeared after OCD symptoms were relieved."," Zhao, HZ;  Wang, CH;  Gao, ZZ;  Ma, JD;  Huang, P;  Li, HF;  Sang, DE;  Shan, XW;  Kou, SJ;  Li, ZR;  et al.",2017.0, 10.1016/j.jad.2016.10.015,0,0,
835,"Effect of HBM Rehabilitation Exercises on Depression, Anxiety and Health Belief in Elderly Patients with Osteoporotic Fracture.","Guided by the health belief model (HBM), this study provided elderly patients with osteoporotic fracture with health education concerning osteoporosis (OP) prevention, carried out rehabilitation exercises based on HBM, and evaluated the intervention effect of HBM rehabilitation exercises, to offer a scientific basis for improving the prognosis of elderly patients with OP fracture. A total of 162 elderly patients with OP fracture treated in three third-grade general hospitals of Jiangsu Province from January 2016 to September 2016 participated in this study. According to the minimization random allocation method, the patients were divided into two groups: the conventional rehabilitation group and the HBM rehabilitation group, with 81 patients in each group. After three months of intervention, the two groups were compared in terms of anxiety, depression, OP knowledge, and OP health belief. After 3 months of intervention, the anxiety and depression scores decreased in both groups. Both anxiety and depression scores of the HBM rehabilitation group were higher than those of the conventional rehabilitation group, with statistically significant differences (P<0.001). The increases in the OP knowledge score and OP health belief score of the HBM rehabilitation group were higher than those of the conventional rehabilitation group, with statistically significant differences (P<0.001). HBM-based rehabilitation exercises alleviate negative emotions in elderly patients with osteoporotic fracture and improve their OP knowledge and health belief scores.",Zhang M.,2017.0,10.24869/psyd.2017.466,0,0,
836, Randomized controlled trial of mindfulness-based stress reduction (MBSR) on posttraumatic growth of Chinese breast cancer survivors," Breast cancer (BC) patients in China suffered from a variety of psychology stress such as perceived stress and anxiety, posttraumatic growth (PTG) as a positive factor could promote their psychology health and quality of life. This study aimed to investigate the efficacy of mindfulness‚Äêbased stress reduction (MBSR) on promoting PTG, decreasing perceived stress and anxiety of Chinese BC patients. A randomized controlled trial of 60 BC patients (Stages I‚ÄêIII) was conducted. They were randomly divided to the 8‚Äêweek MBSR group or usual care (UC) group. PTG inventory, Perceived Stress Scale of Chinese version (CPSS) and State Trait Anxiety Inventory (STAI) evaluated the PTG level, perceived stress and anxiety at three times(before intervention‚ÄêT1, after intervention‚ÄêT2 and follow up at 3 months‚ÄêT3). A repeated‚Äêmeasures analysis of variance model was used to compare each outcome measure of two groups at the three times. There was one patient discontinued the intervention and one lose to follow up in MBSR group, finally 58 BC patients completed the research. There was no difference between two groups before the intervention. The results showed significant improvements in MBSR group comparing with the UC group that PTG level was much higher after the 8‚Äêweek intervention and the follow up (F = 34.73, p < .00). At the same time, CPSS (F = 14.41, p < .00) and STAI (F = 15.24, p < .00) scores were significant decreased at T2 and T3. The results showed that MBSR promoted the level of PTG and decreased perceived stress and anxiety state of Chinese BC patients, and the results persisted at three months after intervention. The research preliminary proved that MBSR was suitable to Chinese BC patients. MBSR should be recommending to BC survivors in China."," Zhang, JY;  Zhou, YQ;  Feng, ZW;  Fan, YN;  Zeng, GC;  Wei, L",2017.0, 10.1080/13548506.2016.1146405,0,0,
837, Psychological effects of the intensified follow-up of the CEAwatch trial after treatment for colorectal cancer," BACKGROUND: The aim of the study was to evaluate psychological effects of the state‚Äêof‚Äêart intensified follow‚Äêup protocol for colorectal cancer patients in the CEAwatch trial. METHOD: At two time points during the CEAwatch trial questionnaires regarding patients' attitude towards follow‚Äêup, patients' psychological functioning and patients' experiences and expectations were sent to participants by post. Linear mixed models were fitted to assess the influences and secular trends of the intensified follow‚Äêup on patients' attitude towards follow‚Äêup and psychological functioning. As secondary outcome, odds ratios were calculated using ordinal logistic mixed model to compare patients' experiences to their expectations, as well as their experiences at two different time points. RESULTS: No statistical significant effects of the intensified follow‚Äêup were found on patients' attitude towards the follow‚Äêup and psychological functioning variables. Patients had high expectations of the intensified follow‚Äêup and their experiences at the second time point were more positive compared to the scores at the first time point. CONCLUSION: The intensified follow‚Äêup protocol posed no adverse effects on patients' attitude towards follow‚Äêup and psychological functioning. In general, patients were more nervous and anxious at the start of the new follow‚Äêup protocol, had high expectations of the new follow‚Äêup protocol and were troubled by the nuisances of the blood sample testing. As they spent more time in the follow‚Äêup and became more adapted to it, the nervousness and anxiety decreased and the preference for the frequent blood test became high in replacement of conversations with the doctors."," Zhan, Z;  Verberne, CJ;  van den Heuvel, ER;  Grossmann, I;  Ranchor, AV;  Wiggers, T;  de Bock, GH",2017.0, 10.1371/journal.pone.0184740,0,0,
838," Electro-acupuncture improves psychiatric symptoms, anxiety and depression in methamphetamine addicts during abstinence: a randomized controlled trial"," BACKGROUND: It aimed to observe the effect of electro‚Äêacupuncture on the improvement of psychiatric symptoms, as well as anxiety and depression in methamphetamine (MA) addicts during abstinence using randomized controlled trials. METHODS: All patients in the present study received compulsory drug detoxification in Shanghai Drug Rehabilitation Center. All patients were enrolled consecutively from June 2014 to February 2015; data collection was completed in March 2015. According to the randomized, single‚Äêblind and control principle, 68 men MA addicts were randomly divided into 2 groups: electro‚Äêacupuncture (EA) and sham electro‚Äêacupuncture (sham‚ÄêEA) groups. Patients were given 20‚Ääminutes EA or sham‚ÄêEA treatment every Monday, Wednesday, and Friday, with a total of 4 weeks. Positive and Negative Syndrome Scale (PANSS), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) were used to evaluate the patients' psychotic symptoms, anxiety and depression before treatment and after receiving treatment with 1 to 4 weeks, respectively. RESULTS: EA could effectively improve the symptoms of psychosis, anxiety, and depression during abstinence in patients with MA addiction. In terms of PANSS score, the scores for positive symptoms and general psychopathological symptoms in patients after receiving 1 to 4 weeks of treatment were significantly decreased compared with the control group, while the score for negative symptoms was significantly decreased after receiving 2 and 4 weeks of treatment. For the HAMA score, the psychotic anxiety scores in patients receiving 1 to 4 weeks of treatment were significant lower than the control group. In terms of HAMD score, there was a significant reduction in anxiety/somatization and sleep disturbance scores after the 4 weeks of EA treatment. CONCLUSION: Electroacupuncture helps to improve psychiatric symptoms and anxiety and depression in MA addicts during abstinence, and promote rehabilitation of patients."," Zeng, L;  Tao, Y;  Hou, W;  Zong, L;  Yu, L",2018.0, 10.1097/MD.0000000000011905,0,0,
839,"Pavlovian extinction of fear with the original conditional stimulus, a generalization stimulus, or multiple generalization stimuli","Exposure therapy for anxiety disorders is derived from Pavlovian extinction learning. With the aim of optimizing exposure therapy, the present study evaluated the effects of multiple extinction stimuli on inhibitory learning. In a differential fear conditioning procedure, participants were randomized to one of three extinction conditions: Extinction_CS+ received nine presentations of the original conditional stimulus (CS+); Extinction_Singular received nine presentations of a generalization stimulus (GS; stimulus similar to the CS+); and Extinction_Variety received one presentation each of nine GSs. One week later, participants returned for extinction test to the CS+, CS-, a GS from Extinction_Variety (Variable_GS), the GS from Extinction_Singular (Single_GS), and a novel GS (Novel_GS). Results showed that Extinction_CS+ exhibited less fear of the CS+ than Extinction_Singular (two dependent measures) and Extinction_Variety (three dependent measures). Additionally, Extinction_Singular had more fear of the Variable_GS than Extinction_Variety (two dependent measures) and Extinction_CS+ (one dependent measure). The results suggest that conducting extinction to the CS+ lessens conditional fear of the CS + more than extinction with GSs. Additionally, extinction with a variety of GSs lessens fear of those GSs more than repeated extinction with one GS. Results are discussed with relevance to exposure therapy for anxiety disorders.",Zbozinek T.D.; Craske M.G.,2018.0,10.1016/j.brat.2018.05.009,0,0,
840,Developing effective narrative interventions for earthquake survivors,"Disasters are events that challenge both the social and individual ability to adapt, carrying the risk of adverse mental health outcomes. High prevalence rates of Post Traumatic Stress Disorder (PTSD), anxiety, and depression have been found after disasters among affected adults and children, and PTSD is the most distinct and common disorder. However, the challenge of providing sufficient numbers of mental health professionals is the most critical issue facing health-care systems throughout the world, and especially in developing countries. The 2008 Sichuan earthquake in China had enormous destructive power and affected millions of people. Given the large number of people involved – and the shortage of resources in any major disaster – brief, pragmatic, and easily trainable interventions are needed for both adult and child survivors. In the context of the Sichuan earthquake, this thesis describes a research work aimed at: (1) investigating the extent and nature of earthquake-related distress and positive change experienced by the targeted survivor population, and exploring the factors that predict these distresses and changes, (2) examining the effectiveness of narrative exposure therapy (NET) in adult survivors, and (3) examining the effectiveness of written narrative strategies for child survivors in the school setting. To achieve these aims, a cross-sectional survey (N=120) was conducted to explore the psychological morbidities, risk, and protective factors as well as predictive models of PTSD and positive change at 1.5 years after the Sichuan earthquake. It highlights the mental health problems after the earthquake, and provides the background information for the subsequent intervention studies. Sequentially, effectiveness of the narrative exposure therapy was assessed within Chinese adult survivors and modified appropriately via two RCT studies using waiting list control. In the NET-1 study, 22 survivors with diagnosed PTSD were recruited and received the NET treatment. The results supported the effectiveness of NET for treating Chinese earthquake survivors. In the NET-2 study, NET was adapted according to the feedback and practical implications from the NET-1 study. Thirty participants with newly diagnosed PTSD were recruited. Twenty of them were treated by the NET-R, and the other 10 participants were treated by the original NET. The revised NET showed a similar intervention effect to the original NET in reducing PTSD symptoms anxiety, depression, general distress, and negative change, and promoting positive change following adversity. In the child intervention studies, a short, inexpensive and easily applied written narrative intervention called Guided Narrative Techniques (GNT) was developed and evaluated with traumatised children in the school setting through two studies. The first study was conducted with 108 sixth grade children (11-12-years old) from three classes in a single primary school, in the earthquake area. Two classes were randomly assigned to the GNT group, and one class was assigned to the expressive writing group that was given simple verbal instruction. The results indicated that if the writing instructions of the programme were fully followed through by the children, GNT might function better on reducing the posttraumatic symptoms than the expressive writing in a short time. However, a low level of writing adherence was reported, indicating that written narrative strategies may not be suitable for traumatised early adolescents. In the second child study, the GNT protocol was improved to enhance the writing adherence of children. Eighty-two Chinese fourth grade children (9-10-years-old) from three classes were recruited as participants in the writing programme. One class was randomly assigned to the GNT group; one class was assigned to the GNT condition with encouragement (GNTE group); and one class was assigned to the control group with mixed expressive writing and painting (MEWP) without specific guidelines. The results indicated that all three written narrative strategies appeared to be efficient concerning post-disaster resilience for Chinese school children. The GNTE showed most rapid, stable and extensive effects, indicating its advantages over the other two conditions. The research provides evidence for the applicability and effectiveness of narrative interventions in the Chinese earthquake survivor population. It attempted to facilitate the wider dissemination of psychological interventions to promote recovery from traumatic stress after major disasters. The findings help advance current knowledge in the management of PTSD after natural disasters in developing areas, contribute to the validation of PTSD theories, and inform future research.",Zang,2013.0,,0,0,
841, Treatment of Adolescent PTSD: the Impact of Prolonged Exposure Versus Client-Centered Therapy on Co-Occurring Emotional and Behavioral Problems," The present study evaluated secondary emotional and behavioral outcomes among adolescents who received prolonged exposure (PE‚ÄêA) or client‚Äêcentered therapy (CCT) for posttraumatic stress disorder (PTSD) in a randomized controlled trial. Participants were 61 adolescent girls (age: M = 15.33, SD = 1.50 years) with sexual abuse related PTSD seeking treatment at a community mental health clinic. Multilevel modeling was employed to evaluate group differences on the Youth Self‚ÄêReport (YSR) over acute treatment and 12‚Äêmonth follow‚Äêup. Both treatment groups showed significant improvements on all YSR scales from baseline to 12‚Äêmonth follow‚Äêup. Adolescents who received PE‚ÄêA showed significantly greater reductions than those receiving CCT on the Externalizing subscale (d = 0.70), rule‚Äêbreaking behavior (d = 0.63), aggressive behavior (d = 0.62), and conduct problems (d = 0.78). No treatment differences were found on the Internalizing subscale or among other YSR problem areas. Both PE‚ÄêA and CCT effectively reduced many co‚Äêoccurring problems among adolescents with PTSD. Although PE‚ÄêA focuses on PTSD and not on disruptive behaviors, PE‚ÄêA was associated with greater sustained changes in externalizing symptoms, supporting broad effects of trauma‚Äêfocused treatment on associated problem areas."," Zandberg, L;  Kaczkurkin, AN;  McLean, CP;  Rescorla, L;  Yadin, E;  Foa, EB",2016.0, 10.1002/jts.22138,0,0,
842,Using the research domain criteria framework to track domains of change in comorbid PTSD and SUD.,"Comorbidity in diagnosis raises critical challenges for psychological assessment and treatment. The Research Domain Criteria (RDoC) Project, launched by the National Institutes of Mental Health, proposes domains of functioning as a way to conceptualize the overlap between comorbid conditions and inform treatment selection. However, further research is needed to understand common comorbidities (e.g., posttraumatic stress disorder [PTSD] and substance use disorder [SUD]) from an RDoC framework and how existing evidence-based treatments would be expected to promote change in the RDoC domains of functioning. To address these gaps, the current study examined change in 3 RDoC domains (Negative Valence Systems, Arousal/Regulatory Systems, and Cognitive Systems) during concurrent prolonged exposure (PE) and substance use treatment. Participants were 85 individuals with co-occurring PTSD and SUD who received PE in a residential substance use treatment facility. They completed an experimental task to assess physiological reactivity to trauma and alcohol cues at pre- and posttreatment. Results showed decreased severity in all 3 RDoC domains of interest across the study period. Pairwise comparisons between domains revealed that Arousal/Regulatory Systems had the lowest severity at posttreatment. Subsequent hierarchical linear regression analyses showed that posttreatment domain scores were associated with posttreatment cue reactivity for trauma and alcohol cues. The findings provide preliminary evidence of how the RDoC domains of functioning may change with evidence-based treatments and are discussed in terms of the assessment and treatment of mental health problems using the RDoC framework. (PsycINFO Database Record",Zambrano-Vazquez L.; Levy HC.; Belleau EL.; Dworkin ER.; Howard Sharp KM.; Pittenger SL.; Schumacher JA.; Coffey SF.,2017.0,10.1037/tra0000257,0,0,
843, A Pilot Study of Tailored Cognitive-Behavioral Resilience Training for Trauma Survivors With Subthreshold Distress," This pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of tailored cognitive‚Äêbehavioral resilience training (TCBRT) for trauma‚Äêexposed individuals with a variety of subsyndromal psychological symptoms. TCBRT is a brief, flexible intervention that allows individuals to select the areas they wish to target using common cognitive‚Äêbehavioral change principles. There were 14 individuals (78.6% female) who were recruited from a major medical center and enrolled in the 5‚Äêsession intervention. There were 12 (85.7%) who completed all TCBRT sessions, and 2 (14.3%) who dropped out after 3 sessions. All participants reported that they received benefit from, were engaged in, and were satisfied with the intervention. Of the 12 with postintervention data, 5 of the participants demonstrated reliable increases in resilience and 6 demonstrated reliable decreases in anxiety. These improvements appeared to be maintained at 2‚Äêmonth follow‚Äêup; of the 11 participants with follow‚Äêup data, 5 demonstrated reliable increases in resilience and 6 demonstrated reliable decreases in anxiety. Our findings suggested that TCRBT was acceptable to trauma‚Äêexposed individuals with varying types of subthreshold distress."," Zalta, AK;  Tirone, V;  Siedjak, J;  Boley, RA;  Vechiu, C;  Pollack, MH;  Hobfoll, SE",2016.0, 10.1002/jts.22094,0,0,
844,Worry amplifies theory-of-mind reasoning for negatively valenced social stimuli in generalized anxiety disorder.,"Theory-of-mind (ToM) is the ability to accurately infer others' thoughts and feelings. In generalized anxiety disorder (GAD), cognitive and emotion regulation theories allude to the plausibility that ToM is conditional on the degree of individuals' state worry, a hallmark symptom. GAD and state worry may interact to predict ToM constructs. However, no experiments have directly tested such interactional hypotheses, and used ToM as a framework to advance understanding of social cognition in GAD. This study therefore aimed to address this gap. 171 participants (69 GAD, 102 Controls) were randomly assigned to either a Worry or Relaxation induction and completed well-validated ToM decoding (Reading the Mind in the Eyes Test) and reasoning (Movie for the Assessment of Social Cognition) tasks. GAD status significantly interacted with state worry to predict accuracy of overall reasoning, cognitive-reasoning, positive-reasoning, and negative-reasoning ToM. Worry, as opposed to relaxation, led sufferers of GAD to display more accurate overall reasoning and cognitive-reasoning ToM than controls, especially for negative signals. Participants with GAD who worried, but not relaxed, were also significantly better than the norm at interpreting negative signals. These findings remained after controlling for gender, executive function, social anxiety, and depressive symptoms. For other ToM abilities, mean scores of persons with and without GAD who either worried or relaxed were normative. The ToM reasoning measure lacked self-reference, and these preliminary findings warrant replication. Theoretical implications, such as the state worry-contingent nature of ToM in GAD, and clinical implications are discussed.",Zainal NH.; Newman MG.,2018.0,10.1016/j.jad.2017.11.084,0,0,
845," A randomized controlled trial of physical activity, dietary habit, and distress management with the Leadership and Coaching for Health (LEACH) program for disease-free cancer survivors"," BACKGROUND: We aimed to evaluate the potential benefits of the Leadership and Coaching for Health (LEACH) program on physical activity (PA), dietary habits, and distress management in cancer survivors. METHODS: We randomly assigned 248 cancer survivors with an allocation ratio of two‚Äêto‚Äêone to the LEACH program (LP) group, coached by long‚Äêterm survivors, or the usual care (UC) group. At baseline, 3, 6, and 12 months, we used PA scores, the intake of vegetables and fruits (VF), and the Post Traumatic Growth Inventory (PTGI) as primary outcomes and, for secondary outcomes, the Ten Rules for Highly Effective Health Behavior adhered to and quality of life (QOL), the Hospital Anxiety and Depression Scale (HADS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ‚ÄêC30). RESULTS: For primary outcomes, the two groups did not significantly differ in PA scores or VF intake but differed marginally in PTGI. For secondary outcomes, the LP group showed a significantly greater improvement in the HADS anxiety score, the social functioning score, and the appetite loss and financial difficulties scores of the EORTC QLQ‚ÄêC30 scales from baseline to 3 months. From baseline to 12 months, the LP group showed a significantly greater decrease in the EORTC QLQ‚ÄêC30 fatigue score and a significantly greater increase in the number of the Ten Rules for Highly Effective Health Behavior. CONCLUSION: Our findings indicate that the LEACH program, coached by long‚Äêterm survivors, can provide effective management of the QOL of cancer survivors but not of their PA or dietary habits. TRIAL REGISTRATION: Clinical trial information can be found for the following: NCT01527409 (the date when the trial was registered: February 2012)."," Yun, YH;  Kim, YA;  Lee, MK;  Sim, JA;  Nam, BH;  Kim, S;  Lee, ES;  Noh, DY;  Lim, JY;  et al.",2017.0, 10.1186/s12885-017-3290-9,0,0,
846, Baseline EEG abnormalities in mild traumatic brain injury from the BIMA study," The Brain Injury and Mechanisms of Action of HBO‚ÇÇ for Persistent Post‚ÄêConcussive Symptoms after Mild Traumatic Brain Injury (BIMA), sponsored by the Department of Defense, is a randomized, double‚Äêblind, sham‚Äêcontrolled trial of hyperbaric oxygen (HBO‚ÇÇ) in service members with persistent post‚Äêconcussive symptoms following mild TBI, undergoing comprehensive assessments. The clinical EEG was assessed by neurologists for slow wave activity, ictal/interictal epileptiform abnormalities, and background periodic discharges. There is scant literature about EEG findings in this population, so we report baseline clinical EEG results and explore associations with other evaluations, including demographics, medication, neurological assessments, and clinical MRI outcomes. Seventy‚Äêone participants were enrolled: median age 32 years, 99% male, 49% comorbid PTSD, 28% with mTBI in the previous year, 32% blast injuries only, and 73% multiple injuries. All participants reported medication use (mean medications = 8, SD = 5). Slowing was present in 39%: generalized 37%, localized 8%, both 6%. No other abnormalities were identified. Slowing was not significantly associated with demographics, medication or neurological evaluation. Participants without EEG abnormalities paradoxically had significantly higher number of white matter hyperintensities as identified on MRI (p = 0.003). EEG slowing is present in more than one‚Äêthird of participants in this study without evidence of associations with demographics, medications or neurological findings. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01611194; https://clinicaltrials.gov/show/NCT01611194."," Williams, CS;  Spitz, MC;  Foley, JF;  Weaver, LK;  Lindblad, AS;  Wierzbicki, MR",2016.0,,0,0,
847," Short-term effectiveness of a web-based tailored intervention for cancer survivors on quality of life, anxiety, depression, and fatigue: randomized controlled trial"," BACKGROUND: The aim of this study was to evaluate the short‐term effectiveness of the web‐based computer‐tailored intervention Kanker Nazorg Wijzer (Cancer Aftercare Guide). The intervention aims to support cancer survivors with managing psychosocial and lifestyle‐related issues. In this study, the impact on quality of life, anxiety, depression, and fatigue were evaluated. METHODS: Cancer survivors were recruited through 21 Dutch hospitals (November 2013‐June 2014). Outcome measures included quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire‐C30), anxiety and depression (Hospital Anxiety and Depression Scale), and fatigue (Checklist Individual Strength). In a randomized controlled trial with an intervention group (n = 231) and a waiting list control group (n = 231), the short‐term effectiveness was evaluated through multilevel linear regression analyses, controlling for selective dropout, baseline differences, and several demographic and disease‐related characteristics. RESULTS: In total, 188 participants of the intervention group and 221 of the control group completed the 6‐month measurement (dropout = 11.5%). The intervention was effective in reducing depression (B = ‐0.63, p = 0.007, f CONCLUSIONS: While effect sizes were small, they can be considered as clinically relevant. With the Cancer Aftercare Guide being an effective, low‐intensive, and easy accessible intervention, it could serve as a first step in stepped care for needs assessment and initial support for psychosocial problems that are present after cancer treatment. Copyright © 2016 John Wiley & Sons, Ltd."," Willems, RA;  Bolman, CA;  Mesters, I;  Kanera, IM;  Beaulen, AA;  Lechner, L",2017.0, 10.1002/pon.4113,0,0,
848, Upright posture improves affect and fatigue in people with depressive symptoms," BACKGROUND AND OBJECTIVES: Slumped posture is a diagnostic feature of depression. While research shows upright posture improves self‚Äêesteem and mood in healthy samples, little research has investigated this in depressed samples. This study aimed to investigate whether changing posture could reduce negative affect and fatigue in people with mild to moderate depression undergoing a stressful task. METHODS: Sixty‚Äêone community participants who screened positive for mild to moderate depression were recruited into a study purportedly on the effects of physiotherapy tape on cognitive function. They were randomized to sit with usual posture or upright posture and physiotherapy tape was applied. Participants completed the Trier Social Stress Test speech task. Changes in affect and fatigue were assessed. The words spoken by the participants during their speeches were analysed. RESULTS: At baseline, all participants had significantly more slumped posture than normative data. The postural manipulation significantly improved posture and increased high arousal positive affect and fatigue compared to usual posture. The upright group spoke significantly more words than the usual posture group, used fewer first person singular personal pronouns, but more sadness words. Upright shoulder angle was associated with lower negative affect and lower anxiety across both groups. LIMITATIONS: The experiment was only brief and a non‚Äêclinical sample was used. CONCLUSIONS: This preliminary study suggests that adopting an upright posture may increase positive affect, reduce fatigue, and decrease self‚Äêfocus in people with mild‚Äêto‚Äêmoderate depression. Future research should investigate postural manipulations over a longer time period and in samples with clinically diagnosed depression."," Wilkes, C;  Kydd, R;  Sagar, M;  Broadbent, E",2017.0, 10.1016/j.jbtep.2016.07.015,0,0,
849,"Attend or defend? Sex differences in behavioral, autonomic, and respiratory response patterns to emotion–eliciting films","Sex differences in emotional reactivity have been studied primarily for negative but less so for positive stimuli; likewise, sex differences in the psychophysiological response-patterning during such stimuli are poorly understood. Thus, the present study examined sex differences in response to negative/positive and high/low arousing films (classified as threat-, loss-, achievement-, and recreation-related, vs. neutral films), while measuring 18 muscular, autonomic, and respiratory parameters. Sex differences emerged for all films, but were most prominent for threat-related films: Despite equivalent valence and arousal ratings, women displayed more facial-muscular and respiratory responding than men and pronounced sympathetic activation (preejection period, other cardiovascular and electrodermal measures), while men showed coactivated sympathetic/parasympathetic responding (including increased respiratory sinus arrhythmia). This indicates a prototypical threat-related defense response in women, while men showed a pattern of sustained orienting, which can be understood as a shift toward less threat proximity in the defense cascade model. Clinical implications are discussed within a socio-evolutionary framework.",Wilhelm F.H.; Rattel J.A.; Wegerer M.; Liedlgruber M.; Schweighofer S.; Kreibig S.D.; Kolodyazhniy V.; Blechert J.,2017.0,10.1016/j.biopsycho.2017.10.006,0,0,
850,Neurophysiological correlates of attentional bias for emotional faces in socially anxious individuals – Evidence from a visual search task and N2pc,"Visual search paradigms have provided evidence for the enhanced capture of attention by threatening faces. Especially in social anxiety, hypervigilance for threatening faces has been found repeatedly across behavioral paradigms, whose reliability however have been questioned recently. In this EEG study, we sought to determine whether the detection of threat (angry faces) is specifically enhanced in individuals with high (HSA) compared to low social anxiety (LSA). In a visual search paradigm, the N2pc component of the event-related brain potential was measured as an electrophysiological indicator of attentional selection. Twenty-one HSA and twenty-one LSA participants were investigated while searching for threatening or friendly targets within an array of neutral faces, or neutral targets within threatening or friendly distractors. Whereas no differences were found in reaction times, HSA showed significant higher detection rates for angry faces, whereas LSA showed a clear ‘happiness bias’. HSA also showed enhanced N2pc amplitudes in response to emotional facial expressions (angry and happy), indicating a general attentional bias for emotional faces. Overall, the results show that social anxiety may be characterized not only by a spatial attentional bias for threatening faces, but for emotional faces in general. In addition, the results further demonstrate the utility of the N2pc component in capturing subtle attentional biases.",Wieser M.J.; Hambach A.; Weymar M.,2018.0,10.1016/j.biopsycho.2018.01.004,0,0,
851,A Randomized Double-Blind Trial of Paroxetine and/or Dextroamphetamine and Problem-Focused Therapy for Attention-Deficit/Hyperactivity Disorder in Adults.,"Objective: To determine the effect of psychotherapy, dextroamphetamine, and/or paroxetine on attention-deficit/hyperactivity-disorder (ADHD) in adults. Method: Ninety-eight adults with DSM-IV ADHD were randomly assigned to receive psychotherapy and dextroamphetamine, paroxetine, both, or placebo for 20 weeks. A 2 x 2 factorial design compared patients who received dextroamphetamine versus no dextroamphetamine with patients who received paroxetine versus no paroxetine. Data were collected from August 2000 until May 2002. Results: One half of the 98 enrolled subjects were found to have at least 1 lifetime mood or anxiety disorder on the Structured Clinical Interview for DSM-IV. Sixty percent of patients who received medication and 80% of those who received placebo completed the 5-month trial. ADHD symptoms were significantly (p = .012) lower in patients in the completer group who received dextroamphetamine. Paroxetine had no effect on ADHD. Hamilton Rating Scales for Anxiety (HAM-A) and Depression (HAM-D) scores were low to start, and no treatment differences were evident at endpoint. Significantly (p < .001) more patients in the completer group were rated by clinicians as ADHD responders if they received dextroamphetamine (85.7%) or combined treatment (66.7%) versus paroxetine (20.0%) or placebo (21.1%). Significantly (p = .003) more patients in the completer group were rated by clinicians as mood/anxiety responders if they received paroxetine (100%) or combined treatment (73.3%) versus those receiving dextroamphetamine (57.15%) or placebo (47.4%). Clinicians rated any patient who received medication and psychological therapy as significantly more improved overall than those who received placebo and psychological therapy (intent to treat: p = .033; completers: p = .001). Conclusion: ADHD symptoms improved with dextroamphetamine. Mood and internalizing symptoms were seen as improved with paroxetine by clinicians, despite absence of response on the HAM-A and HAMD. The presence of a lifetime internalizing disorder attenuated the response to dextroamphetamine. Patients who received both dextroamphetamine and paroxetine had more severe adverse events but did not show greater improvement overall than patients treated with 1 medication. Clinical Trials Registry #GSK707. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Weiss, Margaret; Hechtman, Lily",2006.0,http://dx.doi.org/10.4088/JCP.v67n0412,0,0,
852," Mentors Offering Maternal Support Reduces Prenatal, Pregnancy-Specific Anxiety in a Sample of Military Women"," OBJECTIVE: To determine the efficacy of the Mentors Offering Maternal Support (MOMS) program to reduce pregnancy‚Äêspecific anxiety and depression and build self‚Äêesteem and resilience in military women. DESIGN: Randomized controlled trial with repeated measures. SETTING: Large military community in Texas. PARTICIPANTS: Pregnant women (N = 246) in a military sample defined as active duty or spouse of military personnel. METHODS: Participants were randomized in the first trimester to the MOMS program or normal prenatal care. Participants attended eight 1‚Äêhour sessions every other week during the first, second, and third trimesters of pregnancy. Pregnancy‚Äêspecific anxiety, depression, self‚Äêesteem, and resilience were measured in each trimester. Linear mixed models were used to compare the two‚Äêgroup difference in slope for prenatal anxiety, depression, self‚Äêesteem, and resilience. RESULTS: The Prenatal Self‚ÄêEvaluation Questionnaire was used to measure perinatal anxiety. Rates of prenatal anxiety on the Identification With a Motherhood Role (p = .049) scale and the Preparation for Labor (p = .017) scale were significantly reduced for participants in MOMS. Nulliparous participants showed significantly lower anxiety on the Acceptance of Pregnancy scale and significantly greater anxiety on the Preparation for Labor scale. Single participants had significantly greater anxiety on the Well‚ÄêBeing of Self and Baby in Labor scale, and participants with deployed husbands had significantly greater anxiety on the Identification With a Motherhood Role scale. CONCLUSION: Participation in the MOMS program reduced pregnancy‚Äêspecific prenatal anxiety for the dimensions of Identification With a Motherhood Role and Preparation for Labor. Both dimensions of anxiety were previously found to be significantly associated with preterm birth and low birth weight. Military leaders have recognized the urgent need to support military families."," Weis, KL;  Lederman, RP;  Walker, KC;  Chan, W",2017.0, 10.1016/j.jogn.2017.07.003,0,0,
853,Postpartum outcomes of a pilot prenatal care-based psychosocial intervention for PTSD during pregnancy.,"This study examines postpartum posttraumatic stress disorder (PTSD) symptoms and secondary outcomes including postpartum depression and birth outcomes for pregnant women who screened positive for PTSD and received a psychosocial education intervention compared to women with PTSD in the usual prenatal care setting. All women entering prenatal care at two federally qualified health centers were screened for symptoms of current PTSD; one site was selected randomly to have prenatal care advocates deliver eight Seeking Safety topics for women with clinical or subclinical PTSD. Women were not blind to condition. Baseline and postpartum interviews, including demographic characteristics and assessment of mental health, social support, and coping skills, were conducted. Medical record data was collected to document preterm delivery and low birth weight. Of the 149 participants at baseline, 128 (86%) participated in the postpartum interview. Intervention women, compared to controls, significantly decreased PTSD symptoms, and showed a non-significant trend for improved social support. However, depression, coping, and birth outcomes did not differ. This study suggests some initial support for the Seeking Safety intervention in prenatal care settings and requires further research to determine the best approaches to its implementation.",Weinreb L.; Wenz-Gross M.; Upshur C.,2018.0,10.1007/s00737-017-0794-x,0,0,
854, Brief Behavioral Therapy for Pediatric Anxiety and Depression in Primary Care: a Randomized Clinical Trial," Importance: Anxiety and depression affect 30% of youth but are markedly undertreated compared with other mental disorders, especially in Hispanic populations. Objective: To examine whether a pediatrics‐based behavioral intervention targeting anxiety and depression improves clinical outcome compared with referral to outpatient community mental health care. Design, Setting, and Participants: This 2‐center randomized clinical trial with masked outcome assessment conducted between brief behavioral therapy (BBT) and assisted referral to care (ARC) studied 185 youths (aged 8.0‐16.9 years) from 9 pediatric clinics in San Diego, California, and Pittsburgh, Pennsylvania, recruited from October 6, 2010, through December 5, 2014. Youths who met DSM‐IV criteria for full or probable diagnoses of separation anxiety disorder, generalized anxiety disorder, social phobia, major depression, dysthymic disorder, and/or minor depression; lived with a consenting legal guardian for at least 6 months; and spoke English were included in the study. Exclusions included receipt of alternate treatment for anxiety or depression, presence of a suicidal plan, bipolar disorder, psychosis, posttraumatic stress disorder, substance dependence, current abuse, intellectual disability, or unstable serious physical illness. Interventions: The BBT consisted of 8 to 12 weekly 45‐minute sessions of behavioral therapy delivered in pediatric clinics by master's‐level clinicians. The ARC families received personalized referrals to mental health care and check‐in calls to support accessing care from master's‐level coordinators. Main Outcomes and Measures: The primary outcome was clinically significant improvement on the Clinical Global Impression‐Improvement scale (score ≤2). Secondary outcomes included the Pediatric Anxiety Rating Scale, Children's Depression Rating Scale‐Revised, and functioning. Results: A total of 185 patients were enrolled in the study (mean [SD] age, 11.3 [2.6] years; 107 [57.8%] female; 144 [77.8%] white; and 38 [20.7%] Hispanic). Youths in the BBT group (n = 95), compared with those in the ARC group (n = 90), had significantly higher rates of clinical improvement (56.8% vs 28.2%; χ21 = 13.09, P < .001; number needed to treat, 4), greater reductions in symptoms (F2,146 = 5.72; P = .004; Cohen f = 0.28), and better functioning (mean [SD], 68.5 [10.7] vs 61.9 [11.9]; t156 = 3.64; P < .001; Cohen d = 0.58). Ethnicity moderated outcomes, with Hispanic youth having substantially stronger response to BBT (76.5%) than ARC (7.1%) (χ21 = 14.90; P < .001; number needed to treat, 2). Effects were robust across sites. Conclusions and Relevance: A pediatric‐based brief behavioral intervention for anxiety and depression is associated with benefits superior to those of assisted referral to outpatient mental health care. Effects were especially strong for Hispanic participants, suggesting that the protocol may be a useful tool in addressing ethnic disparities in care. Trial Registration: clinicaltrials.gov Identifier: NCT01147614."," Weersing, VR;  Brent, DA;  Rozenman, MS;  Gonzalez, A;  Jeffreys, M;  Dickerson, JF;  Lynch, FL;  Porta, G;  Iyengar, S",2017.0, 10.1001/jamapsychiatry.2017.0429,0,0,
855, Hyperbaric oxygen for mild traumatic brain injury: design and baseline summary," The Brain Injury and Mechanisms of Action of Hyperbaric Oxygen for Persistent Post‚ÄêConcussive Symptoms after Mild Traumatic Brain Injury (mTBI) (BIMA) study, sponsored by the Department of Defense, is a randomized double‚Äêblind, sham‚Äêcontrolled clinical trial that has a longer duration of follow‚Äêup and more comprehensive assessment battery compared to recent HBO‚ÇÇ studies. BIMA randomized 71 participants from September 2012 to May 2014. Primary results are expected in 2017. Randomized military personnel received hyperbaric oxygen (HBO‚ÇÇ) at 1.5 atmospheres absolute (ATA) or sham chamber sessions at 1.2 ATA, air, for 60 minutes daily for 40 sessions. Outcomes include neuropsychological, neuroimaging, neurological, vestibular, autonomic function, electroencephalography, and visual systems evaluated at baseline, immediately following intervention at 13 weeks and six months with self‚Äêreport symptom and quality of life questionnaires at 12 months, 24 months and 36 months. Characteristics include: median age 33 years (range 21‚Äê53); 99% male; 82% Caucasian; 49% diagnosed post‚Äêtraumatic stress disorder; 28% with most recent injury three months to one year prior to enrollment; 32% blast injuries; and 73% multiple injuries. This manuscript describes the study design, outcome assessment battery, and baseline characteristics. Independent of a therapeutic role of HBO‚ÇÇ, results of BIMA will aid understanding of mTBI. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01611194; https://clinicaltrials.gov/show/NCT01611194."," Weaver, LK;  Chhoeu, A;  Lindblad, AS;  Churchill, S;  Wilson, SH",2016.0,,0,0,
856,"""A unique little microcosm"": Exploring a self-sustaining community project which harnessed social action in a public space","Government policy in England encourages communities to capacity build from within. Community psychology has explored the role of community resilience in this process. But what happens if a community appears to lack formalized resources? This article considers such a community in which a grassroots community center thrives outside the boundaries of formalized community organizations. It aimed to find out how this community mobilized, the benefits for those connected, and how the center survives. A grounded theory 'center as a living organism' was constructed from the accounts of eleven participants. Results indicate how community centers play a role in promoting individual and community level well-being and preventing distress. The importance of learning from progressive community initiatives and more partnership working between National Health Service, statutory, voluntary, and community groups is indicated. Effective engagement with and across communities to promote resilience and well-being is also a theme of the responses to recent events in England, such as the terrorist attacks and the Grenfell Tower fire.",Waters H.C.; Davidson S.,2018.0,10.1002/jcop.22090,0,0,
857, Look for good and never give up: a novel attention training treatment for childhood anxiety disorders," Attention bias modification training (ABMT) is a promising treatment for anxiety disorders. Recent evidence suggests that attention training towards positive stimuli, using visual‚Äêsearch based ABMT, has beneficial effects on anxiety and attention biases in children. The present study extends this prior research using distinctive techniques designed to increase participant learning, memory consolidation, and treatment engagement. Fifty‚Äênine clinically anxious children were randomly assigned to the active treatment condition (ATC) (N = 31) or waitlist control condition (WLC) (N = 28). In the ATC, children completed 12 treatment sessions at home on computer in which they searched matrices for a pleasant or calm target amongst unpleasant background pictures, while also engaging in techniques designed to consolidate learning and memory for these search strategies. No contact was made with children in the WLC during the wait period. Diagnostic, parent‚Äê and child‚Äêreports of anxiety and depressive symptoms, externalising behaviour problems and attention biases were assessed pre‚Äê and post‚Äêcondition and sixmonths after treatment. Children in the ATC showed greater improvements on multiple clinical measures compared to children in the WLC. Post‚Äêtreatment gains improved six‚Äêmonths after treatment. Attention biases for angry and happy faces did not change significantly from pre‚Äêto post‚Äêcondition. However, larger pre‚Äêtreatment attention bias towards threat was associated with greater reduction in anxiety at post‚Äêtreatment. Also, children who showed greater consolidation of learning and memory strategies during treatment achieved greater improvement in global functioning at post‚Äêtreatment. Attention training towards positive stimuli using enhanced visual‚Äêsearch procedures appears to be a promising treatment for childhood anxiety disorders."," Waters, AM;  Zimmer-Gembeck, MJ;  Craske, MG;  Pine, DS;  Bradley, BP;  Mogg, K",2015.0, 10.1016/j.brat.2015.08.005,0,0,
858,Research in private practice.,"The authors discuss designing an empirically oriented practice and choosing outcome measures for a private practice. In addition, the authors illustrate research in a private practice setting by examining a study they conducted on effectiveness of cognitive-behavioral therapy treatment for panic disorder. Participants were 36 female and 14 male clients (aged 18-59 yrs) of The Anxiety Disorders Clinic in Lake Oswego, Oregon. All clients received panic control treatment and manuals. Overall, the clients showed substantial improvement in their symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Warren, Ricks; Thomas, Jay C",2003.0,,0,0,
859,Taking the pulse of prolonged exposure therapy: Physiological reactivity to trauma imagery as an objective measure of treatment response.,"Background: Physiological reactivity to trauma-related cues is a primary symptom of PTSD and can be assessed objectively using script-driven imagery paradigms. However, subjective self-reported symptom measures are the most common outcome indices utilized in PTSD treatment trials and clinic settings. We examined physiological reactivity during a short trauma imagery task as an objective index of response to PTSD treatment, optimized for use in routine clinical care settings. Methods: Participants were 35 male combat veterans receiving prolonged exposure (PE) therapy in a Veterans Affairs outpatient clinic. In addition to traditional subjective self-reported and clinician-rated symptom measures, patients also completed a script-driven imagery task in which heart rate (HR) and skin conductance (SC) were recorded at three assessment points across treatment. We examined changes in subjective symptom measures and objective trauma-specific physiological reactivity over the course of PE, and investigated the association between pretreatment physiological reactivity and treatment response. Results: Patients who completed PE showed significantly diminished HR and SC reactivity to trauma imagery across therapy. Additionally, individuals showing greater trauma-specific HR reactivity at pretreatment showed greater reductions in subjectively reported PTSD symptoms at posttreatment. Conclusions: Findings support the utility of physiological reactivity during trauma imagery as an objective outcome measure that has the potential to be incorporated into evidence-based PTSD treatment in routine clinical settings, or prospective studies related to the individualization of care at pretreatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wangelin, Bethany C; Tuerk, Peter W",2015.0,http://dx.doi.org/10.1002/da.22449,0,0,
860,Program Use and Outcome Change in a Web-Based Trauma Intervention: Individual and Social Factors.,"Insight into user adherence to Web-based intervention programs and into its relationship to intervention effect is needed. The objective of this study was to examine use of a Web-based self-help intervention program, the Chinese version of My Trauma Recovery (CMTR), among Chinese traumatized individuals, and to investigate the relationship between program use and user characteristics before the intervention and change in outcomes after the intervention and at 3-months' follow-up. The sample consisted of 56 urban survivors of different trauma types and 90 rural survivors of the 2008 Sichuan earthquake, who used the CMTR in 1 month on their own or guided by volunteers in a counseling center. Predictors were demographics (sex, age, highest education, marital status, and annual family income), health problems (trauma duration, posttraumatic symptoms, and depression), psychological factors (coping self-efficacy), and social factors (social functioning impairment and social support). Program use was assessed by general program usage (eg, number of visiting days) and program adherence (eg, webpages completed in modules). Outcome measures were the Posttraumatic Diagnostic Scale (PDS), Symptom Checklist 90-Depression (SCL-D), Trauma Coping Self-Efficacy scale (CSE), Crisis Support Scale (CSS), and Social Functioning Impairment questionnaire (SFI) adopted from the CMTR. (1) Program use: rural participants had a larger total number of visiting days (F1,144=40.50, P<.001) and visited more program modules in 1 month (χ(2)3=73.67, P<.001) than urban participants. (2) Predictors and program use: total number of visiting days was correlated with CSS at pretest (r=.22, P=.009), and total number of completed webpages was associated with SFI at pretest (r=.19, P=.02). Number of webpages completed in modules was correlated with all demographic, disease severity, psychological, and social factors at pretest. (3) Program use and outcomes change: in general, use of the triggers and self-talk modules showed a consistent positive association with improvement in PDS, SCL-D, SFI, and CSE. The relaxation module was associated with positive change in PDS, but with negative change in CSS and SFI. The professional help module was associated with positive change in SCL-D, but its use on the first day was associated with negative change in CSS and CSE. The unhelpful coping module was associated with negative change in SFI. The mastery tools module showed a consistent association with negative change in PDS and SCL-D. These findings suggest that both individual (eg, demographic, health problems, psychological) and social factors (eg, social functioning, social support) should be considered when delivering Web-based interventions, particularly in collectivist cultures. Specific program adherence indicators (eg, webpages completed in each module, activity types completed), rather than general program usage indicators (eg, total number or time of visiting), should be developed to examine the effectiveness of various program modules or elements. Australian New Zealand Clinical Trials Registry: ACTRN12611000951954; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=343399 (Archived by WebCite at http://www.webcitation.org/6G7WyNODk).",Wang Z.; Wang J.; Maercker A.,2016.0,10.2196/jmir.5839,0,0,
861," Leukocyte telomere length and depression, anxiety and stress and adjustment disorders in primary health care patients"," BACKGROUND: The primary aim was to examine possible differences in telomere length between primary health care patients, with depression, anxiety or stress and adjustment disorders, and healthy controls. The second aim was to examine the association between telomere length and baseline characteristics in the patients. The third aim was to examine the potential effects of the 8‐week treatments (mindfulness‐based group therapy or treatment as usual, i.e. mostly cognitive‐based therapy) on telomere length, and to examine whether there was a difference in the potential effect on telomere length between the two groups. METHODS: A total of 501 individuals including 181 patients (aged 20‐64 years), with depression, anxiety and stress and adjustment disorders, and 320 healthy controls (aged 19‐70 years) were recruited in the study. Patient data were collected from a randomized controlled trial comparing mindfulness‐based group therapy with treatment as usual. We isolated genomic DNA from blood samples, collected at baseline and after the 8‐week follow‐up. Telomere length was measured by quantitative real‐time (qRT)‐PCR. RESULTS: Telomere length was significantly shorter in the patients (mean = 0.77 ± 0.12,), compared to the controls (mean = 0.81 ± 0.14) (p = 0.006). The difference in telomere length remained significant after controlling for age and sex. Old age, male sex and being overweight were associated with shorter telomere length. There was no significant difference in telomere length between baseline and at the 8‐week follow‐up in any of the treatment groups and no difference between the two groups. CONCLUSION: Our findings confirm that telomere length, as compared with healthy controls, is shortened in patients with depression, anxiety and stress and adjustment disorders. In both groups (mindfulness‐based group therapy or treatment as usual), the telomere length remained unchanged after the 8‐week treatment/follow‐up and there was no difference between the two groups. TRIAL REGISTRATION: (ClinicalTrials.gov ID: NCT01476371 ) Registered November 11, 2011."," Wang, X;  Sundquist, K;  Hedelius, A;  Palmér, K;  Memon, AA;  Sundquist, J",2017.0, 10.1186/s12888-017-1308-0,0,0,
862, Effect of emotion regulation training in patients with panic disorder: evidenced by heart rate variability measures," Objective: We aimed to examine the effect of emotion regulation training in patients with panic disorder (PD) by measuring heart rate variability (HRV). Methods: Forty‚Äêeight patients with PD were randomly divided into emotion regulation group (n = 25) and no‚Äêregulation group (n = 23). Three five‚Äêminute ECG recordings were taken in the following states: 1) baseline, 2) while subjects viewed 15 aversive pictures (active stimulus), 3) resting state after aversive pictures (post‚Äêstimulus). The emotion regulation group briefly received acceptance technique training for five minutes before performing the experimental task. Spectral analysis measures included a high‚Äêfrequency (HF; 0.15‚Äê0.4 HZ) component, a low‚Äêfrequency (LF; 0.04‚Äê0.15 Hz) component, and an LF/HF ratio. Results: The mean change in LF/HF ratio from baseline to active stimulus was significantly lower in the emotion regulation group than in the no‚Äêregulation group (emotion regulation group, 0.13; no‚Äêregulation group, 2.31; t =‚Äê2.67; P <.05). Conclusion: This suggests that brief emotion acceptance training could decrease aversive stimulus‚Äêinduced sympathetic hyperactivity in patients with PD."," Wang, SM;  Lee, HK;  Kweon, YS;  Lee, CT;  Chae, JH;  Kim, JJ;  Lee, KU",2016.0, 10.1016/j.genhosppsych.2016.01.003,0,0,
863,Post-Intensive Care Unit Psychiatric Comorbidity and Quality of Life.,"The prevalence of psychiatric symptoms ranges from 17% to 44% in intensive care unit (ICU) survivors. The relationship between the comorbidity of psychiatric symptoms and quality of life (QoL) in ICU survivors has not been carefully examined. This study examined the relationship between psychiatric comorbidities and QoL in 58 survivors of ICU delirium. Patients completed 3 psychiatric screens at 3 months after discharge from the hospital, including the Patient Health Questionnaire-9 (PHQ-9) for depression, the Generalized Anxiety Disorder-7 (GAD-7) questionnaire for anxiety, and the Post-Traumatic Stress Syndrome (PTSS- 10) questionnaire for posttraumatic stress disorder. Patients with 3 positive screens (PHQ-9 = 10; GAD-7 = 10; and PTSS-10 > 35) comprised the high psychiatric comorbidity group. Patients with 1 to 2 positive screens were labeled the low to moderate (low-moderate) psychiatric comorbidity group. Patients with 3 negative screens were labeled the no psychiatric morbidity group. Thirty-one percent of patients met the criteria for high psychiatric comorbidity. After adjusting for age, gender, Charlson Comorbidity Index, discharge status, and prior history of depression and anxiety, patients who had high psychiatric comorbidity were more likely to have a poorer QoL compared with the low-moderate comorbidity and no morbidity groups, as measured by a lower EuroQol 5 dimensions questionnaire 3-level Index (no, 0.69 ± 0.25; low-moderate, 0.70 ± 0.19; high, 0.48 ± 0.24; P = 0.017). Future studies should confirm these findings and examine whether survivors of ICU delirium with high psychiatric comorbidity have different treatment needs from survivors with lower psychiatric comorbidity.",Wang S.; Mosher C.; Perkins AJ.; Gao S.; Lasiter S.; Khan S.; Boustani M.; Khan B.,2017.0,10.12788/jhm.2827,0,0,
864," The effects of a lifestyle intervention program on physical outcomes, depression, and quality of life in adults with metabolic syndrome: a randomized clinical trial"," METHODS: A randomized control trial design was used. A three‚Äêmonth LIP guided by the Health Promotion Model was developed, including a lifestyle modification booklet, one session of discharge education, and six telephone follow‚Äêups. Patients with MetS were recruited from the inpatient departments of a hospital and were randomized to receive either the LIP or usual care. The physical outcomes, depression (Depression subscale of Hospital Anxiety and Depression Scale), and QoL (Medical Outcome Study Short Form‚Äê12, SF‚Äê12) were measured at baseline, one‚Äêmonth (T1) and three‚Äêmonth (T2). The effects of the LIP were examined by the generalized estimating equation (GEE) model. RESULTS: The study recruited 173 participants, with 86 in the intervention group and 87 in the control. Continuous improvements were observed in all the study outcomes in the intervention group. The GEE model revealed significant improvements in body weight (T1: p=0.017, T2: p=0.007), body mass index (T1: p=0.015, T2: p=0.009), depression (T1: p=0.027, T2: p<0.001), and physical aspects of QoL at T2 (p=0.02). CONCLUSIONS: The current LIP was effective in losing body weight, improving depression and QoL of MetS populations in three‚Äêmonth observation. Considering its low‚Äêcost and convenience, the LIP could be applied in clinical practice to improve patient outcomes. BACKGROUND/OBJECTIVES: Lifestyle modification is recommended as the primary intervention for metabolic syndrome (MetS). The study was to examine the effects of a lifestyle intervention program (LIP) on physical outcomes, depression, and quality of life (QoL) in Chinese adults with MetS."," Wang, Q;  Chair, SY;  Wong, EM",2017.0, 10.1016/j.ijcard.2016.12.084,0,0,
865, Promoting physical activity in COPD: insights from a randomized trial of a web-based intervention and pedometer use," RATIONALE: Low physical activity is highly prevalent among COPD patients and is associated with increased healthcare utilization and mortality and reduced HRQL. The addition of a website to pedometer use is effective at increasing physical activity; however, the timeline of change and impact of environmental factors on efficacy is unknown. METHODS: U.S. Veterans with COPD were randomized (1:1) to receive either (1) a pedometer and website which provided goal‐setting, feedback, disease‐specific education, and an online community forum or (2) pedometer alone for 3 months. Primary outcome was change in daily step count. Secondary outcomes included 6MWT distance, HRQL, dyspnea, depression, COPD knowledge, exercise self‐efficacy, social support, motivation, and confidence to exercise. Generalized linear mixed‐effects models evaluated the effect of the pedometer plus website compared to pedometer alone. RESULTS: Data from 109 subjects (98.5% male, mean age 68.6 ± 8.3 years) were analyzed. At 13 weeks, subjects in the pedometer plus website group had significant increases daily step count from baseline relative to the pedometer alone group (804 ± 356.5 steps per day, p = 0.02). The pedometer plus website group had significant improvements in daily step count from baseline beginning in week 3 which were sustained until week 13. In subgroup analyses, the pedometer plus website attenuated declines in daily step count during the transition from summer to fall. No significant differences in secondary outcomes were noted between groups. CONCLUSIONS: A website added to pedometer use improves daily step counts, sustains walking over 3 months, and attenuates declines in physical activity due to season."," Wan, ES;  Kantorowski, A;  Homsy, D;  Teylan, M;  Kadri, R;  Richardson, CR;  Gagnon, DR;  Garshick, E;  Moy, ML",2017.0, 10.1016/j.rmed.2017.07.057,0,0,
866, A Randomized Clinical Trial Examining the Effect of Video-Based Prevention of Alcohol and Marijuana Use Among Recent Sexual Assault Victims," BACKGROUND: This study examined whether a brief video intervention (Prevention of Post‚ÄêRape Stress [PPRS]) delivered in the emergency department to recent sexual assault (SA) victims reduced alcohol and marijuana use at 3 points over the course of a 6‚Äêmonth follow‚Äêup compared to treatment as usual (TAU) and an active control condition (Pleasant Imagery and Relaxation Instruction [PIRI]). Prior assault history, minority status, and pre‚ÄêSA substance use also were examined as moderators of intervention efficacy. METHODS: Women aged 15 and older (N = 154) who participated in a post‚ÄêSA medical forensic examination were randomly assigned to watch the PPRS video (n = 54) or the PIRI video (n = 48) or receive TAU (n = 52) and completed at least 1 follow‚Äêup assessment targeted at 1.5 (T1), 3 (T2), or 6 (T3) months following the examination. RESULTS: Regression analyses revealed that, relative to TAU, PPRS was associated with less frequent alcohol use at 6 months post‚ÄêSA among women reporting pre‚ÄêSA binge drinking and minority women. Relative to TAU, PPRS also was associated with fewer days of marijuana use at T1 among those who did not report pre‚ÄêSA marijuana use and prior SA. Findings for pre‚ÄêSA marijuana use were maintained at T3; however, findings for prior SA shifted such that PPRS was associated with fewer days of marijuana use at T3 for women with a prior SA. CONCLUSIONS: PPRS may be effective at reducing substance use for some recent SA victims, including those with a prior SA history, a prior substance use history, and minority women."," Walsh, K;  Gilmore, AK;  Frazier, P;  Ledray, L;  Acierno, R;  Ruggiero, KJ;  Kilpatrick, DG;  Resnick, HS",2017.0, 10.1111/acer.13505,0,0,
867,Development of glucocorticoid resistance over one year among mothers of children newly diagnosed with cancer.,"Chronic distress associates with peripheral release of cortisol and a parallel upregulation of innate inflammation. Typically, cortisol functions to down-regulate inflammatory processes. However, in the context of chronic stress, it is hypothesized that glucocorticoid receptors within immune cells become less sensitive to the anti-inflammatory effects of cortisol, resulting in increased systemic inflammation. Caring for a child newly diagnosed with cancer is a particularly provocative chronic stressor. Here, we examine evidence for the development of cellular resistance to glucocorticoids among 120 mothers (Aged 18-56 years; 86% Caucasian) across the 12 months following their child's new diagnosis with cancer. Measures of psychological distress, interleukin (IL)-6, and glucocorticoid resistance (GCR) were assessed 1, 6, and 12 months after the diagnosis. A latent factor for distress was derived from the covariation among symptoms of anxiety, depression, and post-traumatic stress. Latent change score models revealed a significant positive association between change in distress and change in GCR from 0 to 6 months, and 6 months-1 year. This finding provides initial evidence for a longitudinal association between change in maternal distress and change in GCR from the onset of a chronic stressor through one year. Although levels of IL-6 increased during the first six months after the child's diagnosis, the magnitude of this change was not related to change in distress or change in GCR. Given the possible health consequences of reduced immune sensitivity to glucocorticoids, future work should further explore this stress response and its clinical significance. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Walsh, Catherine P; Ewing, Linda J; Cleary, Jennifer L; Vaisleib, Alina D; Farrell, Chelsea H; Wright, Aidan G. C; Gray, Katarina; Marsland, Anna L",2018.0,http://dx.doi.org/10.1016/j.bbi.2017.12.011,0,0,
868,The Effects of Mind Subtraction Meditation on Breast Cancer Survivors' Psychological and Spiritual Well-being and Sleep Quality: A Randomized Controlled Trial in South Korea.,"Most breast cancer survivors experience psychological and spiritual distress, including depression, anxiety, perceived stress, and loss of meaningfulness in life. This distress can negatively impact physical health, quality of life, and quality of sleep. The aim of this study was to compare and examine the effectiveness of mind subtraction meditation (MSM) and a self-management education (SME) group on breast cancer survivors. A randomized controlled trial was conducted with South Korean female breast cancer survivors (stages I-III). Self-reported questionnaires were administered to both MSM group (n = 22) and SME group (n = 24) to measure psychological and spiritual well-being, as well as quality of sleep. Compared with the SME group, the MSM group reported a significant decrease in depression (P = .034), anxiety (P = .036), and perceived stress (P = .009) and an increase in quality of life (P < .001), satisfaction with life (P < .001), posttraumatic growth (P = .007), and quality of sleep (P = .010). Mind subtraction meditation may have positive therapeutic effects among breast cancer survivors. This meditation program may be useful to manage psychological and spiritual distress, as well as improve quality of life and sleep, in clinical settings among breast cancer survivors. This study demonstrated the clinical effectiveness and the feasibility of applying the MSM method to breast cancer survivors. The participants had a high attendance rate in the program, which speaks to the likelihood of the applicability of the meditation program on an outpatient basis.",Yun MR.; Song M.; Jung KH.; Yu BJ.; Lee KJ.,,10.1097/NCC.0000000000000443,0,0,
869," Outcomes of 6.5-mm Hydrophilic Implants and Long Implants Placed with Lateral Sinus Floor Elevation in the Atrophic Posterior Maxilla: a Prospective, Randomized Controlled Clinical Comparison"," BACKGROUND: Very few controlled studies have compared short and long implants placed with appropriate sinus floor elevation techniques. PURPOSE: To compare the 2‐year outcomes of 6.5‐mm hydrophilic implants placed with osteotome sinus floor elevation (OSFE) and standard implants placed with lateral sinus floor elevation in patients with a severely atrophic posterior maxilla. MATERIALS AND METHODS: Thirty‐eight patients with a residual bone height of 4‐5 mm were randomized to receive one of the two above‐mentioned treatments. Intra‐ and postoperative complications were recorded. The implant survival rate, peri‐implant bone level, and periapical endosinus bone gain were assessed. RESULTS: Of the 80 inserted implants, one in the long implant group failed because of abscess formation. The peri‐implant bone level change (0.35 ± 0.60 mm vs 0.40 ± 0.71 mm) was not significantly different between the two groups. The endosinus bone gain was 2.94 ± 0.81 mm and 10.19 ± 0.95 mm in the short and long implant groups, respectively. No serious adverse events related to implant surgery were recorded. CONCLUSIONS: The results suggest that the placement of 6.5‐mm short implants with OSFE is an effective alternative for the rehabilitation of a severely atrophic posterior maxilla."," Yu, H;  Wang, X;  Qiu, L",2017.0, 10.1111/cid.12439,0,0,
870,A latent genetic subtype of major depression identified by whole-exome genotyping data in a Mexican-American cohort.,"Identifying data-driven subtypes of major depressive disorder (MDD) is an important topic of psychiatric research. Currently, MDD subtypes are based on clinically defined depression symptom patterns. Although a few data-driven attempts have been made to identify more homogenous subgroups within MDD, other studies have not focused on using human genetic data for MDD subtyping. Here we used a computational strategy to identify MDD subtypes based on single-nucleotide polymorphism genotyping data from MDD cases and controls using Hamming distance and cluster analysis. We examined a cohort of Mexican-American participants from Los Angeles, including MDD patients (n=203) and healthy controls (n=196). The results in cluster trees indicate that a significant latent subtype exists in the Mexican-American MDD group. The individuals in this hidden subtype have increased common genetic substrates related to major depression and they also have more anxiety and less middle insomnia, depersonalization and derealisation, and paranoid symptoms. Advances in this line of research to validate this strategy in other patient groups of different ethnicities will have the potential to eventually be translated to clinical practice, with the tantalising possibility that in the future it may be possible to refine MDD diagnosis based on genetic data.",Yu C.; Arcos-Burgos M.; Licinio J.; Wong ML.,2017.0,10.1038/tp.2017.102,0,0,
871,The impact of social support and spirituality on the association between stressful life events and resilience among older hispanics and non-hispanic whites,"Introduction: Hispanics/Latinos/as (hereafter referred to as Hispanics) are the fastest growing ethnic group among the older adult population in the U.S. Several studies have revealed a phenomenon known as the “Hispanic Paradox,” which describes the trend of Hispanics showing equal or better health outcomes and increased life expectancy compared to non-Hispanic Whites despite facing a number of disadvantages. While historically, the field of psychiatry has focused on mental illness, recently there has been increased interest in investigating positive mental health, including resilience and its correlates. The experience of stressful life events has been linked to resilience among older adults, yet research among older Hispanics in this area is scarce. The link between stressful life events and resilience may be influenced by many potential factors. Among them, social support and spirituality are both increased among Hispanics, with prior findings suggesting that these factors may buffer the negative effect of stress on resilience among older adults. The present study examined (1) the association between stressful life events and resilience among older Hispanics and non-Hispanic Whites; and (2) the impact of social support and daily spirituality on this association by ethnic group.We hypothesized that (1) increased stressful life events would be associated with lower resilience among both ethnic groups, but that the association would be weaker among Hispanics; and (2) social support and spirituality would buffer against the negative impact of life events on resilience among Hispanics, among whom both factors are increased. Methods: Participants included 240 community-dwelling older adults from the Successful AGing Evaluation (SAGE) study at the University of California, San Diego (UCSD) Stein Institute for Research on Aging. For the present analyses, we selected all SAGE study participants who were Hispanic and aged 50 years or older (n=120).We then randomly selected the same number of non-Hispanic White study participants with similar age, gender, and years of education. Participants were mailed a selfreport survey of successful aging, which included measures of resilience (10-item Connor-Davidson Resilience Scale), stressful life events over the past year and level of associated distress (Life Events Scale), spirituality (Brief Multi-Dimensional Measure of Religiousness/Spirituality-Daily Spiritual Experiences subscale) and social support (Duke Social Support Index-Social Interaction subscale). Results: Hispanics reported significantly higher stress associated with recent life events and higher spirituality than non-Hispanic Whites, with no significant ethnic differences on income, marital status, resilience or social support (Table 1). A multivariable linear regression analysis showed that Hispanics and non-Hispanic Whites had comparable associations between stressful life events and resilience; across the entire sample, higher degree of stress associated with life events was significantly associated with lower resilience (p=.004). Separate multivariable models by ethnic group showed that among Hispanics, there was a significant interaction between life events and both spirituality and social support on resilience. Specifically, among Hispanics with low social support or low spirituality, stressful life events were associated with decreased resilience, but among Hispanics with high spirituality or high social support, stressful life events and resilience exhibited no significant association (Figure 1a). Non-Hispanic Whites showed a similar pattern of performance on spirituality, but there was no significant interaction between social support and life events on resilience (Figure 1b). (Table Presented) Conclusions: Contrary to our primary hypothesis, higher degree of stress associated with life events was similarly associated with decreased resilience in both ethnic groups. In regards to our second aim, we found that while both social support and spirituality appeared to buffer the potential detrimental impact of stressful life events on resilience among Hispanics, only spirituality did among non-Hispanic Whites. Findings from this study lend support to the practice of encouraging the use of social supports and spirituality to help older adults, particularly Hispanics, cope with stressful life experiences. For researchers, present findings highlight the importance of considering social support and spirituality when developing interventions aimed at promoting resilience among older persons, particularly Hispanics. There are likely to be other major determinants of resilience among older persons, but these two factors are particularly prominent among Hispanics and appear to have powerful protective effects on resilience in this group. Thus, considering these factors might be key for the development of targeted culturally relevant interventions.",Yu B.; Marquine M.J.; Moore R.C.; Martin A.S.; Yassai-Gonzalez D.; Kaufmann C.N.; Jeste D.V.,2018.0,,0,0,
872, Treatment for social anxiety disorder alters functional connectivity in emotion regulation neural circuitry," Social anxiety disorder (SAD) is characterized at a neurobiological level by disrupted activity in emotion regulation neural circuitry. Previous work has demonstrated amygdala hyperreactivity and disrupted prefrontal responses to social cues in individuals with SAD (Kim et al., 2011). While exposure‚Äêbased psychological treatments effectively reduce SAD symptoms, not all individuals respond to treatment. Better understanding of the neural mechanisms involved offers the potential to improve treatment efficacy. In this study, we investigated functional connectivity in emotion regulation neural circuitry in a randomized controlled treatment trial for SAD. Participants with SAD underwent fMRI scanning while performing an implicit emotion regulation task prior to treatment (n=62). Following 12 weeks of cognitive behavioral therapy, acceptance and commitment therapy, or wait‚Äêlist, participants completed a second scan (n=42). Psychophysiological interaction analyses using amygdala seed regions demonstrated differences between SAD and healthy control participants (HC; n=16) in right amygdala‚ÄêvmPFC connectivity. SAD participants demonstrated more negative amygdala‚Äêto‚ÄêvmPFC connectivity, compared to HC participants, an effect that was correlated with SAD symptom severity. Post‚Äêtreatment symptom reduction was correlated with altered amygdala‚Äêto‚Äêvm/vlPFC connectivity, independent of treatment type. Greater symptom reduction was associated with more negative amygdala‚Äêto‚Äêvm/vlPFC connectivity. These findings suggest that effective psychological treatment for SAD enhances amygdala‚Äêprefrontal functional connectivity."," Young, KS;  Burklund, LJ;  Torre, JB;  Saxbe, D;  Lieberman, MD;  Craske, MG",2017.0, 10.1016/j.pscychresns.2017.01.005,0,0,
873,"Anticipatory Processing, Maladaptive Attentional Focus, and Postevent Processing for Interactional and Performance Situations: Treatment Response and Relationships With Symptom Change for Individuals With Social Anxiety Disorder.","Anticipatory processing, maladaptive attentional focus, and postevent processing are key cognitive constructs implicated in the maintenance of social anxiety disorder (SAD). The current study examined how treatment for SAD concurrently affects these three cognitive maintaining processes and how these processes are associated with each other as well as with symptom change from pre- to posttreatment. The sample consisted of 116 participants with SAD receiving group cognitive behavioral therapy. All three cognitive maintaining processes were measured relative to a speech task and again relative to a conversation task. Across both tasks, the three cognitive process variables demonstrated decreases from pre- to posttreatment. Within the same task, a slower rate of decrease in a specific cognitive process variable from pre- to posttreatment was predicted from higher pretreatment levels of either one or both of the other cognitive process variables. Additionally, higher levels of pretreatment conversation-related anticipatory processing and maladaptive attentional focus predicted a slower rate of decrease in social anxiety symptoms from pre- to posttreatment. Results are consistent with cognitive models of SAD and have important implications for enhancing existing treatments.",Wong QJJ.; Gregory B.; McLellan LF.; Kangas M.; Abbott MJ.; Carpenter L.; McEvoy PM.; Peters L.; Rapee RM.,2017.0,10.1016/j.beth.2017.03.004,0,0,
874, Smoking Is So Ew!: college Smokers' Reactions to Health- Versus Social-Focused Antismoking Threat Messages," This study utilizes Terror Management Theory (TMT) to examine differences between eliciting social death and physical death anxiety related to smoking, smoking attitudes, and quitting intent among college students. Moreover, an important TMT variable‚Äêself‚Äêesteem‚Äêwas used as a moderator. A 2 √ó 3 between‚Äêsubjects factorial design crossed smoking‚Äêbased self‚Äêesteem (low, high) with mortality salience manipulation (health‚Äêfocused, social‚Äêfocused, control). Results suggest while both making health‚Äêfocused salient and making social‚Äêfocused mortality salient were effective at getting smokers to quit, there was less effect for health‚Äêfocused mortality salience on those whose self‚Äêesteem is strongly tied to smoking. Effect of social‚Äêfocused mortality salience was more pronounced among participants who highly linked self‚Äêesteem with smoking. For smokers with low smoking‚Äêbased self‚Äêesteem, both health‚Äêfocused and social‚Äêfocused mortality salience were effective at motivating attitude change toward smoking and quitting intentions. Implications for smoking cessation ad design and TMT are discussed."," Wong, NC;  Nisbett, GS;  Harvell, LA",2017.0, 10.1080/10410236.2016.1140264,0,0,
875, Pathways to anxiety-depression comorbidity: a longitudinal examination of childhood anxiety disorders," BACKGROUND: Anxiety disorders are prevalent in youth and associated with later depressive disorders. A recent model posits three distinct anxiety‚Äêdepression pathways. Pathway 1 represents youth with a diathesis to anxiety that increases risk for depressive disorders; Pathway 2 describes youth with a shared anxiety‚Äêdepression diathesis; and Pathway 3 consists of youth with a diathesis for depression who develop anxiety as a consequence of depression impairment. This is the first partial test of this model following cognitive‚Äêbehavioral treatment (CBT) for child anxiety. METHOD: The present study included individuals (N = 66; M age = 27.23 years, SD = 3.54) treated with CBT for childhood anxiety disorders 7‚Äê19 years (M = 16.24; SD = 3.56) earlier. Information regarding anxiety (i.e., social phobia (SoP), separation anxiety disorder (SAD), generalized anxiety disorder (GAD)) and mood disorders (i.e., major depressive disorder (MDD) and dysthymic disorders) was obtained at pretreatment, posttreatment, and one or more follow‚Äêup intervals via interviews and self‚Äêreports. RESULTS: Evidence of pathways from SoP, SAD, and GAD to later depressive disorders was not observed. Treatment responders evidenced reduced GAD and SoP over time, although SoP was observed to have a more chronic and enduring pattern. CONCLUSIONS: Evidence for typically observed pathways from childhood anxiety disorders was not observed. Future research should prospectively examine if CBT treatment response disrupts commonly observed pathways."," Wolk, CB;  Carper, MM;  Kendall, PC;  Olino, TM;  Marcus, SC;  Beidas, RS",2016.0, 10.1002/da.22544,0,0,
876,Effects of Cognitive Behavioral Therapy on Neural Processing of Agoraphobia-Specific Stimuli in Panic Disorder and Agoraphobia.,"Patients suffering from panic disorder and agoraphobia are significantly impaired in daily life due to anxiety about getting into a situation due to apprehension about experiencing a panic attack, especially if escape may be difficult. Dysfunctional beliefs and behavior can be changed with cognitive behavioral therapy; however, the neurobiological effects of such an intervention on the anticipation and observation of agoraphobia-specific stimuli are unknown. We compared changes in neural activation by measuring the blood oxygen level-dependent signal of 51 patients and 51 healthy controls between scans before and those after treatment (group by time interaction) during anticipation and observation of agoraphobia-specific compared to neutral pictures using 3-T fMRI. A significant group by time interaction was observed in the ventral striatum during anticipation and in the right amygdala during observation of agoraphobia-specific pictures; the patients displayed a decrease in ventral striatal activation during anticipation from pre- to posttreatment scans, which correlated with clinical improvement measured with the Mobility Inventory. During observation, the patients displayed decreased activation in the amygdala. These activational changes were not observed in the matched healthy controls. For the first time, neural effects of cognitive behavioral therapy were shown in patients suffering from panic disorder and agoraphobia using disorder-specific stimuli. The decrease in activation in the ventral striatum indicates that cognitive behavioral therapy modifies anticipatory anxiety and may ameliorate abnormally heightened salience attribution to expected threatening stimuli. The decreased amygdala activation in response to agoraphobia-specific stimuli indicates that cognitive behavioral therapy can alter the basal processing of agoraphobia-specific stimuli in a core region of the fear network.",Wittmann A.; Schlagenhauf F.; Guhn A.; Lueken U.; Elle M.; Stoy M.; Liebscher C.; Bermpohl F.; Fydrich T.; Pfleiderer B.; Bruhn H.; Gerlach AL.; Straube B.; Wittchen HU.; Arolt V.; Heinz A.; Kircher T.; Ströhle A.,2018.0,10.1159/000493146,0,0,
877," Performance in a blocked versus randomized emotional Stroop task in an aged, early traumatized group with and without posttraumatic stress symptoms"," BACKGROUND AND OBJECTIVES: Attentional biases (AB) for trauma‚Äêrelated stimuli have been examined in many studies assessing different trauma samples. In emotional Stroop tasks (EST), blocked and single‚Äêtrial formats are used almost interchangeably in clinical research. There is reason to believe that different designs yield different results and assess different processes, which, however, has been hardly examined in studies. Furthermore, there is a dearth of information about AB in older trauma survivors with posttraumatic stress symptoms. METHODS: Older adults with (n = 20) and without PTSD symptoms (n = 26) as well as non‚Äêtraumatized controls (n = 21) completed an EST, in which words were presented both blocked and randomized. RESULTS: Analyses revealed that individuals with PTSD symptoms showed AB for trauma‚Äê and depression‚Äêrelated words; however, mode of administration did not significantly influence reaction times. LIMITATIONS: The emotional Stroop task cannot disentangle the underlying cognitive mechanism (i.e., facilitation, interference, avoidance). CONCLUSIONS: PTSD symptoms in older trauma survivors are associated with AB. Overall, participants with PTSD symptoms did not show greater impairment of cognitive control in comparison to both control groups. Results also illustrate that methodological differences between task versions need to be considered more thoroughly."," Wittekind, CE;  Muhtz, C;  Moritz, S;  Jelinek, L",2017.0, 10.1016/j.jbtep.2016.06.003,0,0,
878, POSITIVE study: physical exercise program in non-operable lung cancer patients undergoing palliative treatment," BACKGROUND: Patients with advanced stage non‚Äêsmall cell lung cancer (NSCLC) or small cell lung cancer (SCLC) often experience multidimensional impairments, affecting quality of life during their course of disease. In lung cancer patients with operable disease, several studies have shown that exercise has a positive impact on quality of life and physical functioning. There is limited evidence regarding efficacy for advanced lung cancer patients undergoing palliative treatment. Therefore, the POSITIVE study aims to evaluate the benefit of a 24‚Äêweek exercise intervention during palliative treatment in a randomized controlled setting. METHODS/DESIGN: The POSITIVE study is a randomized, controlled trial investigating the effects of a 24‚Äêweek exercise intervention during palliative treatment on quality of life, physical performance and immune function in advanced, non‚Äêoperable lung cancer patients. 250 patients will be recruited in the Clinic for Thoracic Diseases in Heidelberg, enrolment begun in November 2013. Main inclusion criterion is histologically confirmed NSCLC (stage IIIa, IIIb, IV) or SCLC (Limited Disease‚ÄêSCLC, Extensive Disease‚ÄêSCLC) not amenable to surgery. Patients are randomized into two groups. Both groups receive weekly care management phone calls (CMPCs) with the goal to assess symptoms and side effects. Additionally, one group receives a combined resistance and endurance training (3x/week). Primary endpoints are quality of life assessed by the Functional Assessment of Cancer Therapy for patients with lung cancer (FACT‚ÄêL, subcategory Physical Well‚ÄêBeing) and General Fatigue measured by the Multidimensional Fatigue Inventory (MFI‚Äê20). Secondary endpoints are physical performance (maximal voluntary isometric contraction, 6‚Äêmin walk distance), psychosocial (depression and anxiety) and immunological parameters and overall survival. DISCUSSION: The aim of the POSITIVE trial is the evaluation of effects of a 24‚Äêweek structured and guided exercise intervention during palliative treatment stages. Analysis of various outcomes (such as quality of life, physical performance, self‚Äêefficacy, psychosocial and immunological parameters) will contribute to a better understanding of the potential of exercise in advanced lung cancer patients. In contrast to other studies with advanced oncological patients the POSITIVE trial provides weekly phone calls to support patients both in the intervention and control group and to segregate the impact of physical activity on quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT02055508 (Date: December 12, 2013)."," Wiskemann, J;  Hummler, S;  Diepold, C;  Keil, M;  Abel, U;  Steindorf, K;  Beckhove, P;  Ulrich, CM;  Steins, M;  Thomas, M",2016.0, 10.1186/s12885-016-2561-1,0,0,
879,"Hiding Feelings for Whose Sake? Attachment avoidance, relationship connectedness, and protective buffering intentions","Why do some people refrain from disclosing distress, even to those they feel closest to? Protective buffering, a coping strategy that involves hiding worries from one's partner, may carry mental health costs for those enacting it and the target of their protection. Although the strategy is often assumed to be targeted at a partner to shield him or her from distress (i.e., used with partner-protective intentions), it can also be used for one's own benefit (i.e., with self-protective intentions). Guided by attachment theory, the current research identified dispositional and relational factors that may explain and predict when people use the strategy to what end. In addition, this research tested whether self-protective and partnerprotective intentions are associated with distinct outcomes for mental health. Study 1 showed that highly avoidant individuals deem it wrong to burden their partner with distress expressions and that such beliefs increase with greater dependence on the relationship. Accordingly, across 3 studies (Studies 2-4), highly avoidant individuals reported using protective buffering to spare their partner when feeling strongly connected to him or her. However, when feeling less connected, highly avoidant individuals used protective buffering to minimize their own distress. Moreover, individuals who intended to self-protect reported more depressive symptoms (Study 3), and at the dyadic level, individuals also reported more mental health symptoms when their partner had greater self-protective intentions (Study 4). By contrast, partner-protective intentions (individuals' own or their partners') were unrelated to mental health. Theoretical and applied implications and future directions are discussed.",Winterheld H.A.,2017.0,10.1037/emo0000291,0,0,
880,Acute Effects of Electrical Stimulation of the Bed Nucleus of the Stria Terminalis/Internal Capsule in Obsessive-Compulsive Disorder.,"Deep brain stimulation (DBS) has been introduced as a treatment option for treatment-resistant obsessive-compulsive disorder (OCD). However, the optimal stimulation target and the corresponding stimulation settings remain unclear. Furthermore, there is limited knowledge about the acute effects of DBS. In 3 patients with treatment-resistant OCD, DBS electrodes were implanted in the bed nucleus of the stria terminalis (BNST)/internal capsule (IC). On the next day, different electrode pairs (BNST only, IC only, and BNST/IC) were stimulated at different voltages (1, 2, and 3.5 V) for 5 minutes each. Afterwards, patients rated their perceived OCD symptoms and various emotional states on corresponding visual analog scales. Across locations, low voltage stimulation (1 and 2 V) was associated with reduction of OCD symptoms (i.e., anxiety and tension), in particular when the IC was stimulated. High voltage stimulation (3.5 V), in particular when BNST was involved, led to less reduction of OCD symptoms. Moreover, 3.5-V stimulation of the BNST (BNST only and BNST/IC) induced higher levels of anxiety, tension, and discomfort. Subjects also reported an increase in vegetative sensations. In summary, we demonstrate that both stimulation site and voltage settings show sweet spots (2 V at IC or BNST/IC) at which OCD symptom severity decreased while negative effects were minimal. Stimulation of IC fibers might be relevant both for acute and chronic effects. Whether acute effects are useful for outcome prediction remains to be shown in future studies.",Winter L.; Heitland I.; Saryyeva A.; Lütjens G.; Schwabe K.; Heissler HE.; Alam M.; Kahl KG.; Krauss JK.,2018.0,10.1016/j.wneu.2017.12.084,0,0,
881, Improving and sustaining delivery of CPT for PTSD in mental health systems: a cluster randomized trial," BACKGROUND: Large‚Äêscale implementation of evidence‚Äêbased psychotherapies (EBPs) such as cognitive processing therapy (CPT) for posttraumatic stress disorder can have a tremendous impact on mental and physical health, healthcare utilization, and quality of life. While many mental health systems (MHS) have invested heavily in programs to implement EBPs, few eligible patients receive EBPs in routine care settings, and clinicians do not appear to deliver the full treatment protocol to many of their patients. Emerging evidence suggests that when CPT and other EBPs are delivered at low levels of fidelity, clinical outcomes are negatively impacted. Thus, identifying strategies to improve and sustain the delivery of CPT and other EBPs is critical. Existing literature has suggested two competing strategies to promote sustainability. One emphasizes fidelity to the treatment protocol through ongoing consultation and fidelity monitoring. The other focuses on improving the fit and effectiveness of these treatments through appropriate adaptations to the treatment or the clinical setting through a process of data‚Äêdriven, continuous quality improvement. Neither has been evaluated in terms of impact on sustained implementation. METHODS: To compare these approaches on the key sustainability outcomes and provide initial guidance on sustainability strategies, we propose a cluster randomized trial with mental health clinics (n‚Äâ=‚Äâ32) in three diverse MHSs that have implemented CPT. Cohorts of clinicians and clinical managers will participate in 1 year of a fidelity oriented learning collaborative or 1 year of a continuous quality improvement‚Äêoriented learning collaborative. Patient‚Äêlevel PTSD symptom change, CPT fidelity and adaptation, penetration, and clinics' capacity to deliver EBP will be examined. Survey and interview data will also be collected to investigate multilevel influences on the success of the two learning collaborative strategies. This research will be conducted by a team of investigators with expertise in CPT implementation, mixed method research strategies, quality improvement, and implementation science, with input from stakeholders in each participating MHS. DISCUSSION: It will have broad implications for supporting ongoing delivery of EBPs in mental health and healthcare systems and settings. The resulting products have the potential to significantly improve efforts to ensure ongoing high quality implementation and consumer access to EBPs. TRIAL REGISTRATION: NCT02449421 . Registered 02/09/2015."," Wiltsey Stirman, S;  Finley, EP;  Shields, N;  Cook, J;  Haine-Schlagel, R;  Burgess, JF;  Dimeff, L;  Koerner, K;  Suvak, M;  Gutner, CA;  et al.",2017.0, 10.1186/s13012-017-0544-5,0,0,
882, Study protocol of the YP Face IT feasibility study: comparing an online psychosocial intervention versus treatment as usual for adolescents distressed by appearance-altering conditions/injuries," INTRODUCTION: A significant number of adolescents suffer extensive and enduring difficulties such as social anxiety, body image dissatisfaction, low self‚Äêesteem and bullying as a result of conditions or injuries that affect their appearance (eg, craniofacial and skin conditions, treatment side effects and scarring). Evidence‚Äêbased psychosocial interventions to meet their specific needs are currently lacking. YP Face IT, developed by the UK's Centre for Appearance Research in collaboration with clinical experts and young people, is an innovative online psychosocial intervention designed to offer this group immediate support, advice and coping strategies. It has been endorsed by young people, their parents/carers, GPs, clinical psychologists and health professionals working with those affected by appearance‚Äêrelated conditions. METHODS AND ANALYSIS: Young people aged 12‚Äê17 with an appearance‚Äêaltering condition/injury that self‚Äêidentify as experiencing appearance‚Äêrelated distress, teasing or bullying will be invited to participate via GP practices and UK charities. Consenting participants will be randomised to the intervention (YP Face IT) or the treatment as usual (TAU) control group. Outcome measures will be completed by young people and their parents/carers at baseline, 13, 26 and 52‚ÄÖweeks. Primary outcome measures will be the Body Esteem Scale and the Social Anxiety Scale for Adolescents. Participants will complete other health‚Äêrelated outcome measures and resource use questionnaires for health economic analysis. We will assess recruitment rates, acceptability of the YP Face IT programme, adherence and retention to treatment, questionnaire completion rates, variation of TAU in Primary Care and the feasibility of GP practice staff supervising young people's use of YP Face IT. ETHICS AND DISSEMINATION: This feasibility trial protocol (V.1, 3 March 2014), received a favourable ethical opinion from the NRES Committee South West‚ÄêFrenchay (reference number 14/SW/0058). Findings will be disseminated through academic peer‚Äêreviewed publications, conferences and to participating GP practices and charities supporting those with conditions affecting appearance. TRIAL REGISTRATION NUMBER: ISRCTN40650639; Pre‚Äêresults."," Williamson, H;  Hamlet, C;  White, P;  Marques, EM;  Cadogan, J;  Perera, R;  Rumsey, N;  Hayward, L;  Harcourt, D",2016.0, 10.1136/bmjopen-2016-012423,0,0,
883,Borderline personality disorder and military sexual trauma: Analysis of previous traumatization and current psychiatric presentation.,"Military sexual trauma (MST) increases vulnerability for posttraumatic stress disorder (PTSD). Sexual trauma is also associated with increased risk for developing borderline personality disorder (BPD). Research has also documented a significant link between PTSD and BPD; however, there is a paucity of information examining this relationship among veterans with MST-related PTSD. In particular, we sought to examine whether comorbid BPD-PTSD compared with veterans with PTSD and no BPD resulted in increased PTSD and depression symptomatology. We also examined psychiatric, previous sexual trauma, and demographic factors to determine what-if any-factors were associated with comorbid BPD diagnosis. Using data from a recently conducted randomized clinical trial, we examined electronic medical records of the local Veterans Affairs Medical Center. Data from 90 veterans with MST-related PTSD were obtained. More than 22% (n = 20) of the sample had a historical diagnosis of BPD. Participants were administered measures to assess psychiatric symptomatology (PTSD and depression), trauma-related negative cognitions (NCs), and previous sexual traumatization (e.g., childhood and civilian sexual exposure). An analysis of variance was conducted, which found that veterans with comorbid MST-related PTSD and BPD had significantly greater PTSD criterion B (avoidance) symptoms, depressive symptomatology, and NC scores than participants without comorbid BPD. In addition, a binary stepwise logistic regression found that veterans' BPD was also positively associated with NCs about self and the world; however, self-blame, depression, PTSD, sociodemographic variables (e.g., gender, age), and previous sexual traumatizations were not significant predictors. Implications are discussed with regard to clinical care and future research directions. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Williams, Rush; Holliday, Ryan; Clem, Matthew; Anderson, Elizabeth; Morris, Elizabeth E; Suris, Alina",2017.0,http://dx.doi.org/10.1177/0886260515596149,0,0,
884,"Childhood sexual assault, quality of life, and psychiatric comorbidity in veterans with military and civilian sexual trauma.","Veterans with military sexual trauma (MST) are at risk for a variety of psychiatric conditions, including posttraumatic stress disorder (PTSD) and depression. Survivors of MST are also likely to experience diminished quality of life (QoL). Individuals with higher lifetime incidence of sexual trauma may also be at increased risk for poorer outcomes in QoL and psychiatric symptomatology. The differences in psychological sequelae among those who have experienced sexual trauma as children, and those whose sexual trauma exposure is limited to adulthood are relatively understudied. The majority of sexual trauma literature has focused primarily on civilian trauma, and comparatively few studies have specifically examined psychosocial sequelae (e.g., QoL) in veterans with MST. This study examined how childhood sexual abuse (CSA) affects overall QoL as well as severity of PTSD and depressive symptoms. Veterans who reported CSA had significantly greater depression symptom severity than veterans who did not. No significant differences in PTSD symptom severity or QoL were found between veterans who did and did not report CSA. Results highlight the need for further examination of the relationship between CSA and depression in veterans with MST-related PTSD who also report CSA. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement What is the public significance of this article?-This study examined how childhood sexual abuse (CSA) affects overall quality of life and severity of posttraumatic stress disorder (PTSD) and depressive symptoms in veterans with military sexual trauma. Veterans who reported CSA had significantly greater depression symptom severity than veterans who did not. No significant differences in PTSD symptom severity or quality of life were found between veterans who did and did not report CSA. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Williams, Rush C; Holliday, Ryan; Holder, Nicholas; Suris, Alina",2017.0,http://dx.doi.org/10.1037/mil0000166,0,0,
885, Developing a multidisciplinary rehabilitation package following hip fracture and testing in a randomised feasibility study: fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR)," BACKGROUND: Proximal femoral fracture is a major health problem in old age, with annual UK health and social care costs of £2.3B. Rehabilitation has the potential to maximise functional recovery and maintain independent living, but evidence of clinical effectiveness and cost‐effectiveness is lacking. OBJECTIVES: To develop an enhanced community‐based rehabilitation package following surgical treatment for proximal femoral fracture and to assess acceptability and feasibility for a future definitive randomised controlled trial (RCT) and economic evaluation. DESIGN: Phase I ‐ realist review, survey and focus groups to develop the rehabilitation package. Phase II ‐ parallel‐group, randomised (using a dynamic adaptive algorithm) feasibility study with focus groups and an anonymised cohort study. SETTING: Recruitment was from orthopaedic wards of three acute hospitals in the Betsi Cadwaladr University Health Board, North Wales. The intervention was delivered in the community following hospital discharge. PARTICIPANTS: Older adults (aged ≥ 65 years) who had received surgical treatment for hip fracture, lived independently prior to fracture, had mental capacity (assessed by the clinical team) and received rehabilitation in the North Wales area. INTERVENTIONS: Participants received usual care (control) or usual care plus an enhanced rehabilitation package (intervention). Usual care was variable and consisted of multidisciplinary rehabilitation delivered by the acute hospital, community hospital and community services depending on need and availability. The intervention was designed to enhance rehabilitation by improving patients' self‐efficacy and increasing the amount and quality of patients' practice of physical exercise and activities of daily living. It consisted of a patient‐held information workbook, a goal‐setting diary and six additional therapy sessions. MAIN OUTCOME MEASURES: The primary outcome measure was the Barthel Activities of Daily Living (BADL) index. The secondary outcome measures included the Nottingham Extended Activities of Daily Living (NEADL) scale, EuroQol‐5 Dimensions, ICEpop CAPability measure for Older people, General Self‐Efficacy Scale, Falls Efficacy Scale ‐ International (FES‐I), Self‐Efficacy for Exercise scale, Hospital Anxiety and Depression Scale (HADS) and service use measures. Outcome measures were assessed at baseline and at 3‐month follow‐up by blinded researchers. RESULTS: Sixty‐two participants were recruited (23% of those who were eligible), 61 were randomised (control, CONCLUSIONS: Trial methods were feasible in terms of eligibility, recruitment and retention, although recruitment was challenging. The NEADL scale was more responsive than the BADL index, suggesting that the intervention could enable participants to regain better levels of independence compared with usual care. This should be tested in a definitive Phase III RCT. There were two main limitations of the study: the feasibility study lacked power to test for differences between the groups and a ceiling effect was observed in the primary measure. TRIAL REGISTRATION: Current Controlled Trials ISRCTN22464643. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in"," Williams, NH;  Roberts, JL;  Din, NU;  Charles, JM;  Totton, N;  Williams, M;  Mawdesley, K;  Hawkes, CA;  Morrison, V;  Lemmey, A;  et al.",2017.0, 10.3310/hta21440,0,0,
886,Anxiety symptoms bias memory assessment in older adults.,"Older adults with anxiety and/or depression experience additional memory dysfunction beyond that of the normal aging process. However, few studies have examined test bias in memory assessments due to anxiety and/or depressive symptoms. The current study investigated the influence of self-reported symptoms of anxiety and depression on the measurement equivalence of memory tests in older adults. This is a secondary analysis of the Advanced Cognitive Training for Independent and Vital Elderly dataset, a randomized controlled trial of community-dwelling older adults. Baseline data were included in this study (n = 2802). Multiple indicators multiple causes modeling was employed to assess for measurement equivalence, differential item functioning (DIF), in memory tests. The DIF was present for anxiety symptoms but not for depressive symptoms, such that higher anxiety placed older adults at a disadvantage on measures of memory performance. Analysis of DIF impact showed that compared with participants scoring in the bottom quartile of anxious symptoms, participants in the upper quartile exhibited memory performance scores that were 0.26 standard deviation lower. Anxious but not depressive symptoms introduce test bias into the measurement of memory in older adults. This indicates that memory models for research and clinical purposes should account for the direct relationship between anxiety symptoms and memory tests in addition to the true relationship between anxiety symptoms and memory construct. These findings support routine assessments of anxiety symptoms among older adults in settings in which cognitive testing is being conducted. Copyright © 2016 John Wiley & Sons, Ltd.",Williams MW.; Kueider AM.; Dmitrieva NO.; Manly JJ.; Pieper CF.; Verney SP.; Gibbons LE.,2017.0,10.1002/gps.4557,0,0,
887," Randomized, Controlled Trial of Intravenous Immunoglobulin for Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections"," OBJECTIVE: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are hypothesized to occur as a result of cross‐reactive antibodies produced in response to group A streptococcal infections. Previous research suggests that immunomodulatory therapies, such as intravenous immunoglobulin (IVIG), may lead to rapid and sustained symptom improvement in patients with PANDAS. METHOD: A total of 35 children meeting criteria for PANDAS and moderate to severe obsessive‐compulsive disorder (OCD) were enrolled in a randomized‐entry, double‐blind, placebo‐controlled, 6‐week trial of IVIG (1 g/kg/day on 2 consecutive days), followed by optional open‐label treatment for nonresponders, with follow‐up at 12 and 24 weeks. Primary outcome measures were the Children's Yale‐Brown Obsessive Compulsive Scale (CY‐BOCS) and the Clinical Global Impressions‐Improvement (CGI‐I) rating. ""Responders"" were defined, a priori, by a ≥ 30% decrease in CY‐BOCS total score, and a ""much"" or ""very much"" improved rating on CGI‐I. RESULTS: During the double‐blind phase, the mean decrease in CY‐BOCS score was 24% ± 31% in the IVIG group (n = 17) and 12% ± 27% in the placebo group (n = 18), with six responders in the IVIG group (35%) versus four (22%) in the placebo group; these differences were not statistically significant. Twenty‐four participants met criteria for nonresponse to double‐blind infusion and received open‐label IVIG at week 6. Among all participants, the mean CY‐BOCS improvement from baseline was 55% ± 33% at week 12 and 62% ± 33% at week 24. CONCLUSION: IVIG was safe and well tolerated. Between‐group differences were smaller than anticipated, and the double‐blind comparison failed to demonstrate superiority of IVIG over placebo. The observed open‐label improvements indicate that future trials would benefit from larger sample sizes designed in part to aid in the identification of biomarkers predictive of a positive response to immunotherapy. Future investigations focused on the natural history of PANDAS are also warranted. Clinical trial registration information‐Intravenous Immunoglobulin for PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections); http://clinicaltrials.gov/; NCT01281969ZIAMH002666."," Williams, KA;  Swedo, SE;  Farmer, CA;  Grantz, H;  Grant, PJ;  D'Souza, P;  Hommer, R;  Katsovich, L;  King, RA;  Leckman, JF",2016.0, 10.1016/j.jaac.2016.06.017,0,0,
888, A randomized trial using telehealth technology to link caregivers with dementia care experts for in-home caregiving support: famTechCare protocol," The number of persons with dementia (PWD) in the United States is expected to reach 16 million by 2050. Due to the behavioral and psychological symptoms of dementia, caregivers face challenging in‚Äêhome care situations that lead to a range of negative health outcomes such as anxiety and depression for the caregivers and nursing home placement for PWD. Supporting Family Caregivers with Technology for Dementia Home Care (FamTechCare) is a multisite randomized controlled trial evaluating the effects of a telehealth intervention on caregiver well‚Äêbeing and PWD behavioral symptoms. The FamTechCare intervention provides individualized dementia‚Äêcare strategies to in‚Äêhome caregivers based on video recordings that the caregiver creates of challenging care situations. A team of dementia care experts review videos submitted by caregivers and provide interventions to improve care weekly for the experimental group. Caregivers in the control group receive feedback for improving care based on a weekly phone call with the interventionist and receive feedback on their videos at the end of the 3‚Äêmonth study. Using linear mixed modeling, we will compare experimental and control group outcomes (PWD behavioral symptoms and caregiver burden) after 1 and 3 months. An exploratory descriptive design will identify a typology of interventions for telehealth support for in‚Äêhome dementia caregivers. Finally, the cost for FamTechCare will be determined and examined in relation to hypothesized effects on PWD behavioral symptoms, placement rates, and caregiver burden. This research will provide the foundation for future research for telehealth interventions with this population, especially for families in rural or remote locations."," Williams, K;  Blyler, D;  Vidoni, ED;  Shaw, C;  Wurth, J;  Seabold, D;  Perkhounkova, Y;  Van Sciver, A",2018.0, 10.1002/nur.21869,0,0,
889," Vitamin D levels and perinatal depressive symptoms in women at risk: a secondary analysis of the mothers, omega-3, and mental health study"," BACKGROUND: Vitamin D insufficiency may be associated with depressive symptoms in non‚Äêpregnant adults. We performed this study to evaluate whether low maternal vitamin D levels are associated with depressive symptoms in pregnancy. METHODS: This study was a secondary analysis of a randomized trial designed to assess whether prenatal omega‚Äê3 fatty acid supplementation would prevent depressive symptoms. Pregnant women from Michigan who were at risk for depression based on Edinburgh Postnatal Depression Scale Score or history of depression were enrolled. Participants completed the Beck Depression Inventory (BDI) and Mini International Neuropsychiatric Interview at 12‚Äê20 weeks, 26‚Äê28 weeks, 34‚Äê36 weeks, and 6‚Äê8 weeks postpartum. Vitamin D levels were measured at 12‚Äê20 weeks (N‚Äâ=‚Äâ117) and 34‚Äê36 weeks (N‚Äâ=‚Äâ112). Complete datasets were available on 105 subjects. Using regression analyses, we evaluated the relationship between vitamin D levels with BDI scores as well as with MINI diagnoses of major depressive disorder and generalized anxiety disorder. Our primary outcome measure was the association of maternal vitamin D levels with BDI scores during early and late pregnancy and postpartum. RESULTS: We found that vitamin D levels at 12‚Äê20 weeks were inversely associated with BDI scores both at 12‚Äê20 and at 34‚Äê36 weeks' gestation (P‚Äâ<‚Äâ0.05, both). For every one unit increase in vitamin D in early pregnancy, the average decrease in the mean BDI score was .14 units. Vitamin D levels were not associated with diagnoses of major depressive disorder or generalized anxiety disorder. CONCLUSIONS: In women at risk for depression, early pregnancy low vitamin D levels are associated with higher depressive symptom scores in early and late pregnancy. Future investigations should study whether vitamin D supplementation in early pregnancy may prevent perinatal depressive symptoms. TRIAL REGISTRATION: https://clinicaltrials.gov/ REGISTRATION NUMBER: NCT00711971."," Williams, JA;  Romero, VC;  Clinton, CM;  Vazquez, DM;  Marcus, SM;  Chilimigras, JL;  Hamilton, SE;  Allbaugh, LJ;  Vahratian, AM;  Schrader, RM;  et al.",2016.0, 10.1186/s12884-016-0988-7,0,0,
890, Baseline neurological evaluations in a hyperbaric trial of post-concussive syndrome," Standard neurologic examinations may not detect abnormalities in U.S. military service members with persistent post‐concussive symptoms following mild traumatic brain injury. The Brain Injury and Mechanisms of Action of Hyperbaric Oxygen for Persistent Post‐Concussive Symptoms after Mild Traumatic Brain Injury Study (BIMA) enrolled 71 participants September 2012‐May 2014. Participants received: comprehensive neurological and oculomotor exam; balance testing (Berg Balance Scale‐BBS; Romberg Test‐RT, Sharpened Romberg Test‐SRT); olfactory function (Brief Smell Identification Test‐BSIT). Two trained neurologists conducted the examinations at a central facility in Colorado Springs. Median age was 32 years (range 21‐53), 99% male, 82% Caucasian, 49% PTSD, 28% most recent qualifying injury three months to one year prior to enrollment, 32% blast injuries only, and 73% multiple injuries. Some participants presented with abnormal facial sensation (15%), abnormal tandem gait (13%), and tremor (11%). 54% had abnormal near point of convergence (abnormal range 13‐80 cm). 86% scored ≥ 55 on the BBS, with no participant scoring ⟨ 50. 49% scored ⟨ 30 seconds on the best trial of the SRT. RT was abnormal in 10%. 15% of participants scored ≤ 9 (out of 12) on BSIT, about twice what is expected in a normal population. The neurological examination found abnormalities across a range of testing, with convergence insufficiency and SRT having the most sensitivity. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01611194; https://clinicaltrials.gov/show/NCT01611194."," Williams, CS;  Weaver, LK;  Lindblad, AS;  Kumar, S;  Langford, DR",2016.0,,0,0,
891," Effects of patient-centered communication on anxiety, negative affect, and trust in the physician in delivering a cancer diagnosis: a randomized, experimental study"," BACKGROUND: When bad news about a cancer diagnosis is being delivered, patient‐centered communication (PCC) has been considered important for patients' adjustment and well‐being. However, few studies have explored how interpersonal skills might help cancer patients cope with anxiety and distress during bad‐news encounters. METHODS: A prospective, experimental design was used to investigate the impact of the physician communication style during a bad‐news encounter. Ninety‐eight cancer patients and 92 unaffected subjects of both sexes were randomly assigned to view a video of a clinician delivering a first cancer diagnosis with either an enhanced patient‐centered communication (E‐PCC) style or a low patient‐centered communication (L‐PCC) style. Participants rated state anxiety and negative affect before and immediately after the video exposure, whereas trust in the physician was rated after the video exposure only. Main and interaction effects were analyzed with generalized linear models. RESULTS: Viewing the disclosure of a cancer diagnosis resulted in a substantial increase in state anxiety and negative affect among all participants. This emotional response was moderated by the physician's communication style: Participants viewing an oncologist displaying an E‐PCC style were significantly less anxious than those watching an oncologist displaying an L‐PCC style. They also reported significantly higher trust in the physician. CONCLUSIONS: Under a threatening, anxiety‐provoking disclosure of bad news, a short sequence of empathic PCC influences subjects' psychological state, insofar that they report feeling less anxious and more trustful of the oncologist. Video exposure appears to be a valuable method for investigating the impact of a physician's communication style during critical encounters. Cancer 2017;123:3167‐75. © 2017 American Cancer Society."," Zwingmann, J;  Baile, WF;  Schmier, JW;  Bernhard, J;  Keller, M",2017.0, 10.1002/cncr.30694,0,0,
892,Effects of anxiety sensitivity reduction on smoking abstinence: An analysis from a panic prevention program.,"Objective: Scientific evidence implicates anxiety sensitivity (AS) as a risk factor for poor smoking cessation outcomes. Integrated smoking cessation programs that target AS may lead to improved smoking cessation outcomes, potentially through AS reduction. Yet, little work has evaluated the efficacy of integrated smoking cessation treatment on smoking abstinence. The present study prospectively examined treatment effects of a novel AS reduction-smoking cessation intervention relative to a standard smoking cessation intervention on smoking abstinence. Method: Participants (N = 529; 45.9% male; Mage = 38.23, SD = 13.56) included treatment-seeking smokers who received either a 4-session integrated anxiety-reduction and smoking cessation intervention (Smoking Treatment and Anxiety Management Program; [STAMP]) or a 4-session standard smoking cessation program (SCP). The primary aims focused on examining the effects of STAMP on (a) AS reduction during treatment, (b) early and late smoking point prevalence abstinence, and (c) the mechanistic function of AS reduction on treatment effects across early and late smoking abstinence. Results: Results indicated a significantly greater decline in AS in STAMP relative to SCP (B = -.72, p < .001). Treatment condition did not significantly directly predict early or late abstinence. However, the effect of STAMP on early abstinence was significantly mediated by reductions in AS (indirect = .16, 95% CI [.02, .40]). Conclusions: Findings provide evidence for the efficacy of a novel, integrated anxiety and smoking cessation treatment to reduce AS. Moreover, the meditation pathway from STAMP to early abstinence through reductions in AS suggest that AS is a clinically important mechanism of change for smoking cessation treatment and research. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement What is the public health significance of this article?-There is a high need for developing and testing brief integrated smoking cessation treatments. In the present efficacy study, treatment-seeking smokers who received a novel, integrated anxiety sensitivity-smoking cessation evinced decreased anxiety sensitivity during the course of treatment, which lead to increased likelihood of abstinence during the 2 weeks posttreatment. Findings underscore the importance and necessity for integrated treatments to address the unique needs of current smokers. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Zvolensky, Michael J; Garey, Lorra; Allan, Nicolas P; Farris, Samantha G; Raines, Amanda M; Smits, Jasper A. J; Kauffman, Brooke Y; Manning, Kara; Schmidt, Norman B",2018.0,http://dx.doi.org/10.1037/ccp0000288,0,0,
893, Effect of an Intensive Outpatient Program to Augment Primary Care for High-Need Veterans Affairs Patients: a Randomized Clinical Trial," Importance: Many organizations are adopting intensive outpatient care programs for high‚Äêneed patients, yet little is known about their effectiveness in integrated systems with established patient‚Äêcentered medical homes. Objective: To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high‚Äêneed patients' costs, health care utilization, and experience. Design, Setting, and Participants: Randomized clinical trial at a single VA facility. Among 583 eligible high‚Äêneed outpatients whose health care costs or hospitalization risk were in the top 5% for the facility, 150 were randomly selected for ImPACT; the remaining 433 received standard PACT care. Interventions: The ImPACT multidisciplinary team addressed health care needs and quality of life through comprehensive patient assessments, intensive case management, care coordination, and social and recreational services. Main Outcomes and Measures: Primary difference‚Äêin‚Äêdifference analyses examined changes in health care costs and acute and extended care utilization over a 16‚Äêmonth baseline and 17‚Äêmonth follow‚Äêup period. Secondary analyses estimated the intervention's effect on ImPACT participants (using randomization as an instrument) and for patients with key sociodemographic and clinical characteristics. ImPACT participants' satisfaction and activation levels were assessed using responses to quality improvement surveys administered at baseline and 6 months. Results: Of 140 patients assigned to ImPACT, 96 (69%) engaged in the program (mean [SD] age, 68.3 [14.2] years; 89 [93%] male; mean [SD] number of chronic conditions, 10 [4]; 62 [65%] had a mental health diagnosis; 21 [22%] had a history of homelessness). After accounting for program costs, adjusted person‚Äêlevel monthly health care expenditures decreased similarly for ImPACT and PACT patients (difference‚Äêin‚Äêdifference [SE] ‚Äê$101 [$623]), as did acute and extended care utilization rates. Among respondents to the ImPACT follow‚Äêup survey (n‚Äâ=‚Äâ54 [56% response rate]), 52 (96%) reported that they would recommend the program to others, and pre‚Äêpost analyses revealed modest increases in satisfaction with VA care (mean [SD] increased from 2.90 [0.72] to 3.16 [0.60]; P‚Äâ=‚Äâ.04) and communication (mean [SD] increased from 2.99 [0.74] to 3.18 [0.60]; P‚Äâ=‚Äâ.03). Conclusions and Relevance: Intensive outpatient care for high‚Äêneed patients did not reduce acute care utilization or costs compared with standard VA care, although there were positive effects on experience among patients who participated. Implementing intensive outpatient care programs in integrated settings with well‚Äêestablished medical homes may not prevent hospitalizations or achieve substantial cost savings. Trial Registration: clinicaltrials.gov Identifier: NCT02932228."," Zulman, DM;  Pal Chee, C;  Ezeji-Okoye, SC;  Shaw, JG;  Holmes, TH;  Kahn, JS;  Asch, SM",2017.0, 10.1001/jamainternmed.2016.8021,0,0,
894,Predicting age from brain EEG signals-a machine learning approach,"Objective: The brain age gap estimate (BrainAGE) is the difference between the estimated age and the individual chronological age. BrainAGE was studied primarily using MRI techniques. EEG signals in combination with machine learning (ML) approaches were not commonly used for the human age prediction, and BrainAGE. We investigated whether age-related changes are affecting brain EEG signals, and whether we can predict the chronological age and obtain BrainAGE estimates using a rigorous ML framework with a novel and extensive EEG features extraction. Methods: EEG data were obtained from 468 healthy, mood/anxiety, eating and substance use disorder participants (297 females) from the Tulsa-1000, a naturalistic longitudinal study based on Research Domain Criteria framework. Five sets of preprocessed EEG features across channels and frequency bands were used with different ML methods to predict age. Using a nested-cross-validation (NCV) approach and stack-ensemble learning from EEG features, the predicted age was estimated. The important features and their spatial distributions were deduced. Results: The stack-ensemble age prediction model achieved R2 = 0.37 (0.06), Mean Absolute Error (MAE) = 6.87(0.69) and RMSE = 8.46(0.59) in years. The age and predicted age correlation was r = 0.6. The feature importance revealed that age predictors are spread out across different feature types. The NCV approach produced a reliable age estimation, with features consistent behavior across different folds. Conclusion: Our rigorous ML framework and extensive EEG signal features allow a reliable estimation of chronological age, and BrainAGE. This general framework can be extended to test EEG association with and to predict/study other physiological relevant responses.",Zoubi O.A.; Wong C.K.; Kuplicki R.T.; Yeh H.; Mayeli A.; Refai H.; Paulus M.; Bodurka J.,2018.0,10.3389/fnagi.2018.00184,0,0,
895,High dose hydrocortisone immediately after trauma may alter the trajectory of PTSD: Interplay between clinical and animal studies.,"High-dose corticosteroids have been reported to reduce symptoms of acute stress and post-traumatic stress in polytrauma patients and in animal studies. The underlying mechanism of action remains largely unclear. These issues were addressed in parallel in the clinical and preclinical studies below. In this preliminary study, 25 patients with acute stress symptoms were administered a single intravenous bolus of high-dose hydrocortisone (100-140 mg) or placebo within 6 h of a traumatic event in a prospective, randomized, double-blind, placebo-controlled pilot study. Early single high-dose hydrocortisone intervention attenuated the core symptoms of both the acute stress and of subsequent PTSD in patients. High-dose hydrocortisone treatment given in the first few hours after a traumatic experience was associated with significant favorable changes in the trajectory of exposure to trauma, as expressed by the reduced risk of the development of PTSD post-trauma. In parallel, a comparative study of morphological arborization in dentate gyrus and its modulating molecules was performed in stress-exposed animals treated with high-dose hydrocortisone. Steroid-treated stressed animals displayed significantly increased dendritic growth and spine density, with increased levels of brain-derived neurotrophic factor (BDNF) and obtunded postsynaptic density-95 (PSD-95) levels. The animal study provided insights into the potential mechanism of this intervention, as it identified relevant morphological and biochemical associations to the clinical observations. Thus, evidence from clinical and animal studies suggests that there is a ""window of opportunity"" in the early aftermath of trauma to help those who are vulnerable to the development of chronic PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Zohar, Joseph; Yahalom, Hila; Kozlovsky, Nitsan; Cwikel-Hamzany, Shlomit; Matar, Michael A; Kaplan, Zeev; Yehuda, Rachel; Cohen, Hagit",2011.0,http://dx.doi.org/10.1016/j.euroneuro.2011.06.001,0,0,
896,Neural connectivity during affect labeling predicts treatment response to psychological therapies for social anxiety disorder.,"Background: Although psychological treatments for social anxiety disorder (SAD) can be highly effective, many individuals do not respond to treatment. Identifying factors associated with improved outcomes can facilitate individualized treatment choices. We investigated whether patterns of neural connectivity predicted treatment responses and whether treatment type, cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT), moderated this effect. Methods: Participants with SAD (n = 34) underwent fMRI prior to treatment and completed implicit and explicit emotion regulation tasks. Neural connectivity measures were estimates of amygdala-prefrontal cortex connectivity. Treatment responder status was defined using the 'clinically significant change index' (Loerinc et al., 2015). Results: Right amygdala-right ventrolateral prefrontal cortex connectivity during implicit emotion regulation was a significant predictor of treatment response (OR = 9.01, 95% CI = 1.77, 46.0, p = .008). Stronger inverse connectivity was associated with greater likelihood of treatment response. There were no significant neural moderators of treatment response to CBT versus ACT. Limitations: The primary limitation of this work was the small sample size which restricted the power to detect significant moderation effects, and results should be interpreted as preliminary. Conclusions: Amygdala-vlPFC connectivity during affect labeling predicted treatment responder status following CBT or ACT for social anxiety disorder. This suggests that the functioning of neural circuitry supporting emotion regulation capacities may be a 'gateway' to receiving benefit from psychological treatments. Future work should aim to replicate this effect in a larger sample and consider methods for enhancing functional connectivity within this circuitry as a potential treatment adjunct. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Young, Katherine S; LeBeau, Richard T; Niles, Andrea N; Hsu, Kean J; Burklund, Lisa J; Mesri, Bita; Saxbe, Darby; Lieberman, Matthew D; Craske, Michelle G",2019.0,http://dx.doi.org/10.1016/j.jad.2018.08.016,0,0,
897, Pretreatment attrition and childhood social phobia: parental concerns about medication," Pretreatment attrition, the systematic self‚Äêexclusion of potential participants during the recruitment phase of a study, poses a significant threat to the external validity of randomized clinical trials. Very little is known about the factors that contribute to pretreatment attrition, especially among families seeking treatment for a child. The current study assessed pretreatment attrition in a randomized clinical trial of behavior therapy, fluoxetine, and placebo for child and adolescent social phobia. Reluctance toward medication treatment accounted for 44.7% of study refusals and was disproportionately common among ethnic minority families. Parents were particularly worried about the potential for side effects or physical/psychological dependency upon the medication. Results are discussed in terms of the implications for external validity in future psychopharmacological clinical trials."," Young, BJ;  Beidel, DC;  Turner, SM;  Ammerman, RT;  McGraw, K;  Coaston, SC",2006.0, 10.1016/j.janxdis.2006.03.007,0,0,
898, Improving Weight in People with Serious Mental Illness: the Effectiveness of Computerized Services with Peer Coaches," BACKGROUND: People with serious mental illness have high rates of obesity and related medical problems, and die years prematurely, most commonly from cardiovascular disease. Specialized, in‐person weight management interventions result in weight loss in efficacy trials with highly motivated patients. In usual care, patient enrollment and retention are low with these interventions, and effectiveness has been inconsistent. OBJECTIVE: To determine whether computerized provision of weight management with peer coaching is feasible to deliver, is acceptable to patients, and is more effective than in‐person delivery or usual care. DESIGN: Mixed‐methods randomized controlled trial. PARTICIPANTS: Two hundred seventy‐six overweight patients with serious mental illness receiving care at a Veterans Administration medical center. INTERVENTIONS: Patients were randomized to 1) computerized weight management with peer coaching (WebMOVE), 2) in‐person clinician‐led weight services, or 3) usual care. Both active interventions offered the same educational content. MAIN MEASURES: Body mass index; and feasibility and acceptability of the intervention. KEY RESULTS: At 6 months, in obese patients (n = 200), there was a significant condition by visit effect (F = 4.02, p = 0.02). The WebMOVE group had an average estimated BMI change from baseline to 6 months of 34.9 ± 0.4 to 34.1 ± 0.4. This corresponds to 2.8 kg (6.2 lbs) weight loss (t = 3.2, p = 0.001). No significant change in BMI was seen with either in‐person services (t = 0.10, p = 0.92), or usual care (t = ‐0.25, p = 0.80). The average percentage of modules completed in the WebMOVE group was 49% and in the in‐person group was 41% (t = 1.4, p = 0.17). When non‐obese patients were included in the analyses, there was a trend towards a condition by visit effect (F = 2.8, p = 0.06). WebMOVE was well received, while the acceptability of in‐person services was mixed. CONCLUSIONS: Computerized weight management with peer support results in lower weight, and can have greater effectiveness than clinician‐led in‐person services. This intervention is well received, and could be feasible to disseminate."," Young, AS;  Cohen, AN;  Goldberg, R;  Hellemann, G;  Kreyenbuhl, J;  Niv, N;  Nowlin-Finch, N;  Oberman, R;  Whelan, F",2017.0, 10.1007/s11606-016-3963-0,0,0,
899,Emotional cues and social anxiety resolve ambiguous perception of biological motion,"Perceptions of ambiguous biological motion are modulated by different individual cognitive abilities (such as inhibition and empathy) and emotional states (such as anxiety). This study explored facing-the-viewer bias (FTV) in perceiving ambiguous directions of biological motion, and investigated whether task-irrelevant simultaneous face emotional cues in the background and the individual social anxiety traits could affect FTV. We found that facial motion cues as background affect sociobiologically relevant scenarios, including biological motion, but not non-biological situations (conveyed through random dot motion). Individuals with high anxiety traits demonstrated a more dominant FTV bias than individuals with low anxiety traits. Ensemble coding-like processing of task-irrelevant multiple emotional cues could magnify the facing-the-viewer bias than did in the single emotional cue. Overall, those findings suggest a correlation between high-level emotional processing and high-level motion perception (subjective to attentional control) contributes to facing-the-viewer bias.",Yiltiz H.; Chen L.,2018.0,10.1007/s00221-018-5233-3,0,0,
900," Is physiotherapy integrated virtual walking effective on pain, function, and kinesiophobia in patients with non-specific low-back pain? Randomised controlled trial"," PURPOSE: According to literature, virtual reality was found to reduce pain and kinesiophobia in patients with chronic pain. The purpose of the study was to investigate short‐term effect of the virtual reality on pain, function, and kinesiophobia in patients with subacute and chronic non‐specific low‐back pain METHODS: This randomised controlled study in which 44 patients were randomly assigned to the traditional physiotherapy (control group, 22 subjects) or virtual walking integrated physiotherapy (experimental group, 22 subjects). Before and after treatment, Visual Analog Scale (VAS), TAMPA Kinesiophobia Scale (TKS), Oswestry Disability Index (ODI), Nottingham Health Profile (NHP), Timed‐up and go Test (TUG), 6‐Minute Walk Test (6MWT), and Single‐Leg Balance Test were assessed. The interaction effect between group and time was assessed by using repeated‐measures analysis of covariance. RESULTS: After treatment, both groups showed improvement in all parameters. However, VAS, TKS, TUG, and 6MWT scores showed significant differences in favor of the experimental group. CONCLUSION: Virtual walking integrated physiotherapy reduces pain and kinesiophobia, and improved function in patients with subacute and chronic non‐specific low‐back pain in short term."," Yilmaz Yelvar, GD;  Çırak, Y;  Dalkılınç, M;  Parlak Demir, Y;  Guner, Z;  Boydak, A",2017.0, 10.1007/s00586-016-4892-7,0,0,
901, Histopathological assessment of OASIS Ultra on critical-sized wound healing: a pilot study," BACKGROUND: Dermatopathologists assess wounds secondary to trauma, infection, or oncologic resection that can be challenging to reconstruct. OASIS Ultra, an extracellular matrix, has been described for use in chronic and burn wounds. The aim of this pilot study is to assess wound healing in post‚Äêtraumatic and infective wounds treated with OASIS using histological markers of repair. MATERIALS AND METHODS: Adults with traumatic, infective or iatrogenic wound defects with size precluding primary closure were eligible. Half the wound was randomly assigned to receive OASIS plus standard therapy; the other half received standard of care (SOC) therapy. During dressing changes, standardized‚Äêscale photographs were taken and biopsies obtained. Histologic sections were reviewed for degree of acute inflammation and extent of tissue repair. Neutrophils, edema, hemorrhage, necrosis, fibroblasts, collagen density and neovascularization were semi‚Äêquantitatively assessed. RESULTS: Forty‚Äêfour skin biopsies from 7 patients with 10 acute wounds met eligibility criteria. Histologically, OASIS samples demonstrated improved acute inflammation scores compared to SOC. No patients experienced OASIS‚Äêrelated complications. OASIS‚Äêtreated wound halves trended toward more wound contraction and improved tissue repair. CONCLUSION: Our scoring system aids histopathological wound assessment. Treatment of critical‚Äêsized, post‚Äêtraumatic, acute wounds with OASIS resulted in decreased inflammation, and potentially more advanced wound healing, compared to SOC."," Yeh, DD;  Nazarian, RM;  Demetri, L;  Mesar, T;  Dijkink, S;  Larentzakis, A;  Velmahos, G;  Sadik, KW",2017.0, 10.1111/cup.12925,0,0,
902," Effect of a multidiscipline mentor-based program, Be Resilient to Breast Cancer (BRBC), on female breast cancer survivors in mainland China-A randomized, controlled, theoretically-derived intervention trial"," To reduce the risk of adjustment problems for breast cancer patients in mainland China, we examined the efficacy of a multidiscipline mentor‚Äêbased program, Be Resilient to Breast Cancer (BRBC), delivered after breast surgery to (a) increase protective factors of social support, hope for the future, etc.; (b) decrease risk factors of Physical and Emotional Distress; and (c) increase outcomes of Resilience, Transcendence and Quality of Life (QOL). A multisite randomized controlled trial was conducted at 6 specialist cancer hospitals. 101 and 103 breast cancer patients were allocated to intervention group (IG) and control group (CG), respectively, and 112 general females (without breast cancer) were allocated to the norm group (NG). Participants completed measures that were related to latent variables derived from the Resilience Model for Breast Cancer (RM‚ÄêBC) at baseline (T1), 2 months (T2), 6 months (T3), and 12 months (T4) after intervention. At T2, the IG reported significantly lower Depression (ES = 0.65,P = 0.0019) and Illness Uncertainty (ES = 0.57, P = 0.004), better Hope (ES = 0.81, P < 0.001) and QOL (ES = 0.60, P = 0.002) than did the CG. At T3, the IG reported significantly lower Anxiety (ES = 0.74, P < 0.001), better Social Support (ES = 0.51,P = 0.009), Transcendence (ES = 0.87, P < 0.001), and Resilience (ES = 0.83, P < 0.001) compared with the CG. At T4, the IG reported better Resilience though not significant (P = 0.085) and better Transcendence (P = 0.0243) than did the NG. The BRBC intervention improves the positive health outcomes and decreases the risk factors of illness‚Äêrelated distress of breast cancer patients during the high‚Äêrisk cancer treatment."," Ye, ZJ;  Liang, MZ;  Qiu, HZ;  Liu, ML;  Hu, GY;  Zhu, YF;  Zeng, Z;  Zhao, JJ;  Quan, XM",2016.0, 10.1007/s10549-016-3881-1,0,0,
903, Long-term effects of high-intensity interval training in heart transplant recipients: a 5-year follow-up study of a randomized controlled trial," BACKGROUND: Previous studies have demonstrated that high‐intensity interval training (HIT) is superior to moderate‐continuous exercise in general and in cardiovascular diseases. Recently, we also found HIT safe and efficient after heart transplantation (HTx). This study reports the 5‐year long‐term effects. DESIGN AND METHODS: Forty‐one HTx patients who had completed the previous 12‐month randomized controlled trial, comparing HIT intervention with usual care, were eligible. In particular, we measured VO RESULTS: The baseline mean±SD values were as follows: age; 49.1±16.5 years, men; 68%, time since HTx: 4.1±2.2 years. Within the HIT group, initial VO CONCLUSION: Our findings suggest that intermittent periods of HIT may be necessary to maintain the initial benefits gained from the intervention. However, HIT probably reduces the burden of anxiety, which is a frequent health issue following HTx."," Yardley, M;  Gullestad, L;  Bendz, B;  Bjørkelund, E;  Rolid, K;  Arora, S;  Nytrøen, K",2017.0, 10.1111/ctr.12868,0,0,
904,"Acculturative stress, poor mental health and condom-use intention among international students in China","Objectives: Engaging in sexual risk behaviour can be a maladaptive strategy for international students to deal with stress. This study examined the role of poor mental health in mediating the relationship between acculturative stress and condom-use intention among international students in Beijing, China. Methods: The study used a cross-sectional design, and the participants were enrolled through convenience sampling. The mediation effects of poor mental health were assessed using structural equation modelling. Setting: Participants included 299 international students (143 men, mean age = 21.87 ± 3.23) who were studying in Beijing, China. Results: Correlation analysis revealed that acculturative stress was negatively associated with condom-use intentions (r = –.250, p <.01) and positively associated with poor mental health (r =.458, p <.01). Condom-use intentions were negatively related to poor mental health (r = –.258, p <.01). Structural equation model analysis showed that overall poor mental health, as well as anxiety, phobic anxiety and psychoticism, mediated the relationship between acculturative stress and condom-use intentions among men. The same mediation effects for women were not statistically significant. Conclusions: Poor mental health can mediate the relationship between acculturative stress and condom-use intention among male international students in Beijing, China. Findings suggest that programmes and interventions to target acculturative stress and psychological problems may be useful in preventing international students from engaging in sexual risk behaviour.",Yang N.; Xu Y.; Chen X.; Yu B.; Yan H.; Li S.,2018.0,10.1177/0017896917739443,0,0,
905, Happier Healers: randomized Controlled Trial of Mobile Mindfulness for Stress Management," PURPOSE: Medical students have higher rates of depression and psychologic distress than the general population, which may negatively impact academic performance and professional conduct. This study assessed whether 10‚Äê20‚Äâmin of daily mindfulness meditation for 30 days, using a mobile phone application, could decrease perceived stress and improve well‚Äêbeing for medical students. METHODS: Eighty‚Äêeight medical students were stratified by class year and randomized to either intervention or control groups to use the mobile application Headspace, an audio‚Äêguided mindfulness meditation program, for 30 days. All participants completed the Perceived Stress Scale (PSS), Five‚ÄêFacet Mindfulness Questionnaire (FFMQ), and General Well‚ÄêBeing Schedule (GWBS) at baseline (T1), 30 days (T2), and 60 days (T3). Repeated measures analysis of variance (rANOVA) was conducted for intervention versus control groups across T1, T2, and T3 to examine differences in stress, mindfulness, and well‚Äêbeing. RESULTS: There was a significant interaction between time and treatment group for perceived stress and well‚Äêbeing. Perceived stress significantly decreased for the intervention group from T1 to T3 (F[2,142]‚Äâ=‚Äâ3.98, p‚Äâ<‚Äâ0.05). General well‚Äêbeing significantly increased for the intervention group compared to the control group from T1 to T2, and the increase was sustained through T3 (F[2,144]‚Äâ=‚Äâ3.36, p‚Äâ<‚Äâ0.05). CONCLUSIONS: These results highlight that a mobile audio‚Äêguided mindfulness meditation program is an effective means to decrease perceived stress in medical students, which may have implications on patient care. Integrating mindfulness training into medical school curricula for management of school‚Äê and work‚Äêrelated stress may lead to fewer negative physician outcomes (e.g., burnout, anxiety, and depression) and improved physician and patient outcomes. This has implications for a broad group of therapists and healthcare providers, ultimately improving quality of healing and patient care."," Yang, E;  Schamber, E;  Meyer, RML;  Gold, JI",2018.0, 10.1089/acm.2015.0301,0,0,
906,Placebo treatment facilitates social trust and approach behavior,"Placebo effect refers to beneficial changes induced by the use of inert treatment, such as placebo-induced relief of physical pain and attenuation of negative affect. To date, we know little about whether placebo treatment could facilitate social functioning, a crucial aspect for well-being of a social species. In the present study, we develop and validate a paradigm to induce placebo effects on social trust and approach behavior (social placebo effect), and show robust evidence that placebo treatment promotes trust in others and increases preference for a closer interpersonal distance. We further examine placebo effects in real-life social interaction and show that placebo treatment makes single, but not pair-bonded, males keep closer to an attractive first-met female and perceive less social anxiety in the female. Finally, we show evidence that the effects of placebo treatment on social trust and approach behavior can be as strong as the effect of intranasal administration of oxytocin, a neuropeptide known for its function in facilitating social cognition and behavior. The finding of the social placebo effect extends our understanding of placebo effects on improvement of physical, mental, and social well-being and suggests clinical potentials in the treatment of social dysfunction.",Yan X.; Yong X.; Huang W.; Ma Y.,2018.0,10.1073/pnas.1800779115,0,0,
907," Efficacy of a Peer-Led, Recovery-Oriented Shared Decision-Making System: a Pilot Randomized Controlled Trial", Objective: The effects of a comprehensive shared decisionmaking system based on the CommonGround approach and incorporating peer support and a computerized decision aid were investigated. Methods: A pilot randomized controlled trial with six‚Äêmonth follow‚Äêup was conducted in Japan. Fifty‚Äêsix outpatients with mental illness were randomly allocated to a shared decisionmaking system (intervention) group or treatment as usual (control) group. The implementation process and several outcomes were compared between groups. Results: The core components and processes of shared decision making were observed in the intervention group more frequently than in the control group. The intervention group also reported a significantly more positive participants' view of the relationship with their doctor than the control group. The intervention did not have a significant effect on most clinical and recovery‚Äêrelated outcomes. Conclusions: The shared decision‚Äêmaking system appeared to partly improve patients' perceptions of communication and relationships with doctors but did not have a significant effect on other patient‚Äêlevel outcomes.," Yamaguchi, S;  Taneda, A;  Matsunaga, A;  Sasaki, N;  Mizuno, M;  Sawada, Y;  Sakata, M;  Fukui, S;  Hisanaga, F;  Bernick, P;  et al.",2017.0, 10.1176/appi.ps.201600544,0,0,
908,Changes in Physicians' Intrapersonal Empathy After a Communication Skills Training in Japan,"PURPOSE: To investigate whether physicians' intrapersonal empathy increased after a communication skills training (CST) workshop. METHOD: Participants were oncologists from across Japan with three or more years of clinical experience in oncology. They were recruited through the Internet and via direct contact by the workshop organizers. Participants attended 1 of 132 two-day CST workshops, held between November 2007 and March 2011. Prior to the workshop (baseline/T1), participants completed a survey with demographic questions, the Jefferson Scale of Physician Empathy (JSPE), and the Interpersonal Reactivity Index (IRI). The JSPE was administered again immediately after completion of the workshop (follow-up/T2). Then the JSPE and IRI were administered as part of a three-month follow-up (T3) survey. Changes in participants' mean total JSPE scores, JSPE subscale scores, and IRI subscale scores were compared using multivariate analysis of variance. RESULTS: Of the 507 workshop participants who received the three-month follow-up survey, 383 responded (response rate: 75.5%). Total JSPE scores and JSPE subscale scores at T2 and T3 were significantly higher than those at T1 (P < .01). IRI-Perspective Taking and IRI-Empathic Concern subscale scores increased significantly from T1 to T3 (P < .01), whereas IRI-Fantasy and IRI-Personal Distress subscale scores showed no significant changes. The JSPE scores of palliative care physician participants were significantly higher than those of medical oncologist participants at T1 and T3. No signifi cant differences were found by specialty at T2. CONCLUSIONS: The intrapersonal empathy of oncologists in Japan increased after a two-day CST workshop.",Yamada Y.; Fujimori M.; Shirai Y.; Ninomiya H.; Oka T.; Uchitomi Y.,2018.0,10.1097/ACM.0000000000002426,0,0,
909,Relationship between symptom dimensions and white matter alterations in obsessive-compulsive disorder.,"To investigate the relationship between the severities of symptom dimensions in obsessive-compulsive disorder (OCD) and white matter alterations. We applied tract-based spatial statistics for diffusion tensor imaging (DTI) acquired by 3T magnetic resonance imaging. First, we compared fractional anisotropy (FA) between 20 OCD patients and 30 healthy controls (HC). Then, applying whole brain analysis, we searched the brain regions showing correlations between the severities of symptom dimensions assessed by Obsessive-Compulsive Inventory-Revised and FA in all participants. Finally, we calculated the correlations between the six symptom dimensions and multiple DTI measures [FA, axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD)] in a region-of-interest (ROI) analysis and explored the differences between OCD patients and HC. There were no between-group differences in FA or brain region correlations between the severities of symptom dimensions and FA in any of the participants. ROI analysis revealed negative correlations between checking severity and left inferior frontal gyrus white matter and left middle temporal gyrus white matter and a positive correlation between ordering severity and right precuneus in FA in OCD compared with HC. We also found negative correlations between ordering severity and right precuneus in RD, between obsessing severities and right supramarginal gyrus in AD and MD, and between hoarding severity and right insular gyrus in AD. Our study supported the hypothesis that the severities of respective symptom dimensions are associated with different patterns of white matter alterations.",Yagi M.; Hirano Y.; Nakazato M.; Nemoto K.; Ishikawa K.; Sutoh C.; Miyata H.; Matsumoto J.; Matsumoto K.; Masuda Y.; Obata T.; Iyo M.; Shimizu E.; Nakagawa A.,2017.0,10.1017/neu.2016.45,0,0,
910, Feasibility of Studying a Brief Intervention to Help Chinese Villagers with Problem Alcohol Use After an Earthquake," Aim: To evaluate the feasibility of conducting a study of structured brief intervention (BI) for reducing problem alcohol use among individuals who experienced earthquake. Methods: Following the Wenchuan earthquake, 1336 clients from 18 local hospitals were invited to complete the Alcohol Use Disorders Identification Test (AUDIT). Of those, 239 individuals (AUDIT score of greater than or equal to 7) were included in the study. The participants from intervention village hospitals who were assigned to the BI group (n = 118) received a structured BI lasting 15‚Äê30 min plus general health education. The participants from the control village hospitals were assigned to the control group (n = 121) only received general health education. Baseline and post‚Äêintervention assessments at 12 weeks were conducted using the AUDIT, Substance Abuse Knowledge Scale (SAKS), Self‚Äêrating Depression Scale (SDS), Self‚Äêrating Anxiety Scale (SAS) and General Well‚Äêbeing Schedule. Results: At 3 months follow‚Äêup, the BI group had reduced scores on AUDIT (F = 65.84; P < 0.001) and increased on SAKS (F = 44.45; P < 0.001), but the control group had increased scores on SAS (F = 10.76; P = 0.001) and SDS (F = 18.43; P < 0.001) compared with baseline. BI group showed more decreases for AUDIT scores (group √ó time effect, F = 34.8; P < 0.001), and had mores increases for SAKS scores (group √ó time effect, F = 15.7; P < 0.001) compared with control group. Conclusion: The study demonstrated the feasibility of a study of BI in problem alcohol users who experienced traumatic events. Further research need to be done to test the effectiveness of BI over a longer period of time, and provide evidence in support of BI as an effective technique in China."," Xiaolu, R;  Wenwen, W;  Ali, R;  Xu, L;  Hong, W;  Min, Z;  Jiang, D",2017.0, 10.1093/alcalc/agx014,0,0,
911," A single-blinded, randomized, parallel group superiority trial investigating the effects of footwear and custom foot orthoses versus footwear alone in individuals with patellofemoral joint osteoarthritis: a phase II pilot trial protocol"," BACKGROUND: Patellofemoral joint osteoarthritis is a common condition, yet information regarding conservative management is lacking. Foot orthoses are an effective intervention for improving pain and function in younger individuals with patellofemoral pain and may be effective in those with patellofemoral osteoarthritis. This pilot study will seek to establish the feasibility of a phase III randomised controlled trial to investigate whether foot orthoses worn in prescribed motion controlled footwear are superior to prescribed motion control footwear alone in the management of patellofemoral osteoarthritis. METHODS/DESIGN: This phase II pilot clinical trial is designed as a randomized, single‚Äêblind, parallel group, two arm, superiority trial. The trial will recruit 44 participants from Queensland and Tasmania, Australia. Volunteers aged 40 years and over must have clinical symptoms and radiographic evidence of patellofemoral osteoarthritis to be eligible for inclusion. Those eligible will be randomized to receive either foot orthoses and prescribed motion control shoes, or prescribed motion control shoes alone, to be worn for a period of 4 months. The feasibility of a phase III clinical trial will be evaluated by assessing factors such as recruitment rate, number of eligible participants, participant compliance with the study protocol, adverse events, and drop‚Äêout rate. A secondary aim of the study will be to determine completion rates and calculate effect sizes for patient reported outcome measures such as knee‚Äêrelated symptoms, function, quality of life, kinesiophobia, self‚Äêefficacy, general and mental health, and physical activity at 2 and 4 months. Primary outcomes will be reported descriptively while effect sizes and 95% confidence intervals will be calculated for the secondary outcome measures. Data will be analysed using an intention‚Äêto‚Äêtreat principle. DISCUSSION: The results of this pilot trial will help determine the feasibility of a phase III clinical trial investigating whether foot orthoses plus motion control footwear are superior to motion control footwear alone in individuals with patellofemoral osteoarthritis. A Phase III clinical trial will help guide footwear and foot orthoses recommendations in the clinical management of this disorder. TRIAL REGISTRATION: Retrospectively registered with the Australian New Zealand Clinical Trials Registry: ACTRN12615000002583. Date registered: 07/01/15."," Wyndow, N;  Crossley, KM;  Vicenzino, B;  Tucker, K;  Collins, NJ",2017.0, 10.1186/s13047-017-0200-y,0,0,
912, Effectiveness and cost-effectiveness of outpatient physiotherapy after knee replacement for osteoarthritis: study protocol for a randomised controlled trial," BACKGROUND: Primary total knee replacement is a common operation that is performed to provide pain relief and restore functional ability. Inpatient physiotherapy is routinely provided after surgery to enhance recovery prior to hospital discharge. However, international variation exists in the provision of outpatient physiotherapy after hospital discharge. While evidence indicates that outpatient physiotherapy can improve short‚Äêterm function, the longer term benefits are unknown. The aim of this randomised controlled trial is to evaluate the long‚Äêterm clinical effectiveness and cost‚Äêeffectiveness of a 6‚Äêweek group‚Äêbased outpatient physiotherapy intervention following knee replacement. METHODS/DESIGN: Two hundred and fifty‚Äêsix patients waiting for knee replacement because of osteoarthritis will be recruited from two orthopaedic centres. Participants randomised to the usual‚Äêcare group (n‚Äâ=‚Äâ128) will be given a booklet about exercise and referred for physiotherapy if deemed appropriate by the clinical care team. The intervention group (n‚Äâ=‚Äâ128) will receive the same usual care and additionally be invited to attend a group‚Äêbased outpatient physiotherapy class starting 6 weeks after surgery. The 1‚Äêhour class will be run on a weekly basis over 6 weeks and will involve task‚Äêorientated and individualised exercises. The primary outcome will be the Lower Extremity Functional Scale at 12 months post‚Äêoperative. Secondary outcomes include: quality of life, knee pain and function, depression, anxiety and satisfaction. Data collection will be by questionnaire prior to surgery and 3, 6 and 12 months after surgery and will include a resource‚Äêuse questionnaire to enable a trial‚Äêbased economic evaluation. Trial participation and satisfaction with the classes will be evaluated through structured telephone interviews. The primary statistical and economic analyses will be conducted on an intention‚Äêto‚Äêtreat basis with and without imputation of missing data. The primary economic result will estimate the incremental cost per quality‚Äêadjusted life year gained from this intervention from a National Health Services (NHS) and personal social services perspective. DISCUSSION: This research aims to benefit patients and the NHS by providing evidence on the long‚Äêterm effectiveness and cost‚Äêeffectiveness of outpatient physiotherapy after knee replacement. If the intervention is found to be effective and cost‚Äêeffective, implementation into clinical practice could lead to improvement in patients' outcomes and improved health care resource efficiency. TRIAL REGISTRATION: ISRCTN32087234 , registered on 11 February 2015."," Wylde, V;  Artz, N;  Marques, E;  Lenguerrand, E;  Dixon, S;  Beswick, AD;  Burston, A;  Murray, J;  Parwez, T;  Blom, AW;  et al.",2016.0, 10.1186/s13063-016-1418-x,0,0,
913, Is Cognitive Behavioural Therapy focusing on Depression and Anxiety Effective for People with Long-Term Physical Health Conditions? A Controlled Trial in the Context of Type 2 Diabetes Mellitus," BACKGROUND: It is unclear as to the extent to which psychological interventions focusing specifically on depression and anxiety are helpful for people with physical health conditions, with respect to mood and condition management. AIMS: To evaluate the effectiveness of a modified evidence‚Äêbased psychological intervention focusing on depression and anxiety for people with type 2 diabetes mellitus (T2DM), compared with a control intervention. METHOD: Clients (n = 140) who experienced mild to moderate depression and/or anxiety and had a diagnosis of T2DM were allocated to either diabetes specific treatment condition (n = 52) or standard intervention (control condition, n = 63), which were run in parallel. Each condition received a group intervention offering evidence‚Äêbased psychological interventions for people with depression and anxiety. Those running the diabetes specific treatment group received additional training and supervision on working with people with T2DM from a clinical health psychologist and a general practitioner. The diabetes specific treatment intervention helped patients to link mood with management of T2DM. RESULTS: Both conditions demonstrated improvements in primary outcomes of mood and secondary outcome of adjustment [95% confidence interval (CI) between 0.25 and 5.06; p < 0.05 in all cases]. The diabetes specific treatment condition also demonstrated improvements in secondary outcomes of self‚Äêreport management of T2DM for diet, checking blood and checking feet, compared with the control condition (95% CIs between 0.04 and 2.05; p < 0.05 in all cases) and in glycaemic control (95% CI: 0.67 to 8.22). The findings also suggested a non‚Äêsignificant reduction in NHS resources in the diabetes specific treatment condition. These changes appeared to be maintained in the diabetes specific treatment condition. CONCLUSIONS: It is concluded that a modified intervention, with input from specialist services, may offer additional benefits in terms of improved diabetic self‚Äêmanagement and tighter glycaemic control."," Wroe, AL;  Rennie, EW;  Sollesse, S;  Chapman, J;  Hassy, A",2018.0, 10.1017/S1352465817000492,0,0,
914, Predictors of knee joint loading after anterior cruciate ligament reconstruction," Anterior cruciate ligament (ACL) injury results in altered knee joint mechanics which frequently continue even after ACL reconstruction. The persistence of altered mechanical loading of the knee is of concern due to its likely role in the development of post‐traumatic osteoarthritis (OA). Joint contact forces are associated with post‐traumatic OA development, but evaluation of factors influencing the magnitude of contact forces after ACL injury is needed to advance current strategies aimed at preventing post‐traumatic OA. Therefore, the purpose of this study was to identify predictive factors of knee joint contact forces after ACL reconstruction. Thirty athletes completed standard gait analysis with surface electromyography 6 months after ACL reconstruction. An electromyographic‐driven musculoskeletal model was used to estimate joint contact forces. External knee adduction moment was a significant predictor of medial compartment contact forces in both limbs, while vertical ground reaction force and co‐contraction only contributed significantly in the uninvolved limb. The large influence of the knee adduction moment on joint contact forces provides mechanistic clues to understanding the mechanical pathway of post‐traumatic OA after ACL injury. Statement of Clinical Significance: This study provides critical information in improving the understanding of mechanisms influencing the development of post‐traumatic OA after ACL injury. Further work is needed to identify additional driving factors of joint loading in the ACL‐injured limb and develop treatment strategies to avert the deleterious consequences of post‐traumatic OA. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:651‐656, 2017."," Wellsandt, E;  Khandha, A;  Manal, K;  Axe, MJ;  Buchanan, TS;  Snyder-Mackler, L",2017.0, 10.1002/jor.23408,0,0,
915,Metacognitive therapy for PTSD: A preliminary investigation of a new brief treatment.,"The effectiveness of a new treatment for post traumatic stress disorder (PTSD) is addressed. Treatment was based on a metacognitive theory of mechanisms by which natural traumatic processing is enabled or hindered by coping strategies. It suggests that elimination of worry/rumination, of maladaptive attention strategies, and enhancing metacognitive flexibility, will permit natural processing and a return to normal cognition. An A-B direct replication series (n=6) with follow-up assessments at 3, 6, and 18-41 months was implemented. Treatment commenced 3-10 months post-trauma. All patients showed large and statistically significant improvements in general emotion and specific PTSD measures. Gains were maintained at follow-up. Two further consecutively referred patients were treated at 8 and 12 months posttrauma to add to sample size (n=8). Overall post treatment effect sizes were large, ranging from 3.0 to 5.0. Further evaluations are clearly warranted. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Wells, Adrian; Sembi, Sundeep",2004.0,http://dx.doi.org/10.1016/j.jbtep.2004.07.001,0,0,
916, Cognitive-behavioral therapy for youth anxiety: an effectiveness evaluation in community practice," OBJECTIVE: To compare the effectiveness of individual cognitive‚Äêbehavioral therapy (ICBT) and group CBT (GCBT) for referred children with anxiety disorders within community mental health clinics. METHOD: Children (N = 165; ages 7‚Äê13 years) referred to 5 clinics in Norway because of primary separation anxiety disorder (SAD), social anxiety disorder (SOC), or generalized anxiety disorder (GAD) based on Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) criteria participated in a randomized clinical trial. Participants were randomized to ICBT, GCBT, or wait list (WL). WL participants were randomized to 1 of the 2 active treatment conditions following the wait period. Primary outcome was loss of principal anxiety disorder over 12 weeks and 2‚Äêyear follow‚Äêup. RESULTS: Both ICBT and GCBT were superior to WL on all outcomes. In the intent‚Äêto‚Äêtreat analysis, 52% in ICBT, 65% in GCBT, and 14% in WL were treatment responders. Planned pairwise comparisons found no significant differences between ICBT and GCBT. GCBT was superior to ICBT for children diagnosed with SOC. Improvement continued during 2‚Äêyear follow‚Äêup with no significant between‚Äêgroups differences. CONCLUSIONS: Among anxiety disordered children, both individual and group CBT can be effectively delivered in community clinics. Response rates were similar to those reported in efficacy trials. Although GCBT was more effective than ICBT for children with SOC following treatment, both treatments were comparable at 2‚Äêyear follow‚Äêup. Dropout rates were lower in GCBT than in ICBT, suggesting that GCBT may be better tolerated. Response rates continued to improve over the follow‚Äêup period, with low rates of relapse. (PsycINFO Database Record"," Villab√∏, MA;  Narayanan, M;  Compton, SN;  Kendall, PC;  Neumer, SP",2018.0, 10.1037/ccp0000326,0,0,
917," Depressed patients treated by homeopaths: a randomised controlled trial using the ""cohort multiple randomised controlled trial"" (cmRCT) design"," BACKGROUND: Despite controversy regarding homeopathy, some patients consult homeopaths for depression. Evidence is required to determine whether this is an effective, acceptable and safe intervention for these patients. METHODS: A pragmatic trial using the ""cohort multiple randomised controlled trial"" design was used to test the effectiveness of adjunctive treatment by homeopaths compared to usual care alone, over a period of 12 months in patients with self‚Äêreported depression. One third of patients were randomly selected for an offer of treatment provided by a homeopath. The primary outcome measure was the Patient Health Questionnaire (PHQ‚Äê9) at 6 months. Secondary outcomes included depression scores at 12 months; and the Generalised Anxiety Disorder (GAD‚Äê7) outcome at 6 and 12 months. RESULTS: The trial over‚Äêrecruited by 17% with a total of 566 patients. Forty percent took up the offer and received treatment. An intention‚Äêto‚Äêtreat analysis of the offer group at 6 months reported a 1.4‚Äêpoint lower mean depression score than the no offer group (95% CI 0.2, 2.5, p‚Äâ=‚Äâ0.019), with a small standardized treatment effect size (d‚Äâ=‚Äâ0.30). Using instrumental variables analysis, a moderate treatment effect size in favour of those treated was found (d‚Äâ=‚Äâ0.57) with a between group difference of 2.6 points (95% CI 0.5, 4.7, p‚Äâ=‚Äâ0.018). Results were maintained at 12 months. Secondary analyses showed similar results. Similar results were found for anxiety (GAD‚Äê7). No evidence suggested any important risk involved with the intervention. CONCLUSION: This trial provides preliminary support for both the acceptability and the effectiveness of treatment by a homeopath for patients with self‚Äêreported depression. Our results provide support for further pragmatic research to provide more precise estimates of treatment effect. TRIAL REGISTRATION: ISRCTN registry, ISRCTN02484593 . Registered on 7 January 2013."," Viksveen, P;  Relton, C;  Nicholl, J",2017.0, 10.1186/s13063-017-2040-2,0,0,
918, A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD," METHODS: A group of 579 children with ADHD Combined Type, aged 7 to 9.9 years, were assigned to 14 months of medication management (titration followed by monthly visits); intensive behavioral treatment (parent, school, and child components, with therapist involvement gradually reduced over time); the two combined; or standard community care (treatments by community providers). Outcomes were assessed in multiple domains before and during treatment and at treatment end point (with the combined treatment and medication management groups continuing medication at all assessment points). Data were analyzed through intent‚Äêto‚Äêtreat random‚Äêeffects regression procedures. RESULTS: All 4 groups showed sizable reductions in symptoms over time, with significant differences among them in degrees of change. For most ADHD symptoms, children in the combined treatment and medication management groups showed significantly greater improvement than those given intensive behavioral treatment and community care. Combined and medication management treatments did not differ significantly on any direct comparisons, but in several instances (oppositional/aggressive symptoms, internalizing symptoms, teacher‚Äêrated social skills, parent‚Äêchild relations, and reading achievement) combined treatment proved superior to intensive behavioral treatment and/or community care while medication management did not. Study medication strategies were superior to community care treatments, despite the fact that two thirds of community‚Äêtreated subjects received medication during the study period. CONCLUSIONS: For ADHD symptoms, our carefully crafted medication management was superior to behavioral treatment and to routine community care that included medication. Our combined treatment did not yield significantly greater benefits than medication management for core ADHD symptoms, but may have provided modest advantages for non‚ÄêADHD symptom and positive functioning outcomes. BACKGROUND: Previous studies have demonstrated the short‚Äêterm efficacy of pharmacotherapy and behavior therapy for attention‚Äêdeficit/hyperactivity disorder (ADHD), but no longer‚Äêterm (i.e., >4 months) investigations have compared these 2 treatments or their combination.",,1999.0,,0,0,
919, Fluvoxamine for the treatment of anxiety disorders in children and adolescents. The Research Unit on Pediatric Psychopharmacology Anxiety Study Group," METHODS: We studied 128 children who were 6 to 17 years of age; who met the criteria for social phobia, separation anxiety disorder, or generalized anxiety disorder; and who had received psychological treatment for three weeks without improvement. The children were randomly assigned to receive fluvoxamine (at a maximum of 300 mg per day) or placebo for eight weeks and were evaluated with rating scales designed to assess the degree of anxiety and impairment. RESULTS: Children in the fluvoxamine group had a mean (+/‚ÄêSD) decrease of 9.7+/‚Äê6.9 points in symptoms of anxiety on the Pediatric Anxiety Rating Scale (range of possible scores, 0 to 25, with higher scores indicating greater anxiety), as compared with a decrease of 3.1+/‚Äê4.8 points among children in the placebo group (P<0.001). On the Clinical Global Impressions‚ÄêImprovement scale, 48 of 63 children in the fluvoxamine group (76 percent) responded to the treatment, as indicated by a score of less than 4, as compared with 19 of 65 children in the placebo group (29 percent, P<0.001). Five children in the fluvoxamine group (8 percent) discontinued treatment because of adverse events, as compared with one child in the placebo group (2 percent). CONCLUSIONS: Fluvoxamine is an effective treatment for children and adolescents with social phobia, separation anxiety disorder, or generalized anxiety disorder. BACKGROUND: Drugs that selectively inhibit serotonin reuptake are effective treatments for adults with mood and anxiety disorders, but limited data are available on the safety and efficacy of serotonin‚Äêreuptake inhibitors in children with anxiety disorders.",,2001.0, 10.1056/NEJM200104263441703,0,0,
920,"QuickStats: Percentage* of Adults Aged ≥18 Years With or Without Psychological Distress† Who Were Current Smokers,§ by Age Group and Level of Distress - National Health Interview Survey,¶ 2014-2016",,,2018.0,10.15585/mmwr.mm6723a6,0,0,
921,The dynamics of persisting through distress: Development of a momentary distress intolerance scale using ecological momentary assessment,"Distress tolerance, or the ability to withstand uncomfortable states, is thought to be a transdiagnostic risk factor for psychopathology. Distress tolerance is typically measured using self-report questionnaires or behavioral tasks, both of which construe distress tolerance as a trait and downplay the potential variability in distress tolerance across time and situation. The aim of the current study was to provide a method for assessing momentary distress tolerance using ecological momentary assessment to capture both withinand between-individual information. Participants (n = 86) responded to random prompts on their cell phones seven times per day for one week, which included 10 momentary distress tolerance items as well as momentary emotion. After examining item distributions and interclass correlations, we conducted a multilevel exploratory factor analysis using both within-individual and between-individual data to arrive at a brief, 3-item measure we call the Momentary Distress Intolerance Scale. Model fit and reliability indices were good for both within- A nd between-individual approaches. We found that distress tolerance varied significantly over time, and that average momentary distress intolerance and instability in momentary distress intolerance were associated with trait distress tolerance, emotion dysregulation and tendencies to use experiential avoidance. Neither average momentary distress intolerance nor instability in momentary distress intolerance correlated with behavioral distress tolerance tasks. We discuss the importance of construing distress tolerance from a dynamic perspective and provide recommendations toward future research.",Veilleux J.C.; Hill M.A.; Skinner K.D.; Pollert G.A.; Baker D.E.; Spero K.D.,2018.0,10.1037/pas0000593,0,0,
922,Predicting return of fear following exposure therapy with an implicit measure of attitudes,"We sought to advance understanding of the processes underlying the efficacy of exposure therapy and particularly the phenomenon of return of fear (ROF) following treatment by drawing on a social psychological view of phobias as attitudes. Specifically, a dual process theory of attitude-related behavior predicts that a positive response to exposure therapy may reflect change in either the automatic (the attitude representation itself) or controlled (skills and confidence at coping with the fear) responses to the phobic stimulus, or both. However, if the attitude representation remains negative following treatment, ROF should be more likely. We tested this hypothesis in a clinical sample of individuals with public speaking phobia using a single-session exposure therapy protocol previously shown to be efficacious but also associated with some ROF. Consistent with predictions, a post-treatment implicit measure of attitudes toward public speaking (the Personalized Implicit Association Test [PIAT]) predicted ROF at 1-month follow-up. These results suggest that change in the automatically activated attitude toward the phobic stimulus is an important goal of exposure therapy and that an implicit measure like the PIAT can provide a useful measure of such change by which to gauge the adequacy of exposure treatment and predict its long-term efficacy. © 2012 Elsevier Ltd.",Vasey M.W.; Harbaugh C.N.; Buffington A.G.; Jones C.R.; Fazio R.H.,2012.0,10.1016/j.brat.2012.08.007,0,0,
923," Melatonin Treatment in Patients with Burning Mouth Syndrome: a Triple-Blind, Placebo-Controlled, Crossover Randomized Clinical Trial"," AIMS: To evaluate the efficacy of melatonin compared to placebo in reducing pain associated with burning mouth syndrome (BMS), as well as side effects of treatment and effects on sleep quality, anxiety, and serum and salivary melatonin levels. METHODS: In this triple‐blind, randomized clinical trial, 20 BMS patients (mean age ± standard deviation: 64.4 ± 11.5 years; range: 35 to 82 years) were enrolled to receive melatonin (12 mg/day) or placebo for 8 weeks in a crossover design. After treatment, changes in pain from baseline were ascertained by patient self‐assessment with a verbal category scale and a visual analog scale. Secondary outcomes included evaluation of changes in sleep quality and anxiety. Data were subjected to analysis of variance (ANOVA), Fisher exact test, paired t test, Wilcoxon signed rank test, or chi‐square test, as appropriate. RESULTS: Melatonin was not superior to placebo in reducing pain. Melatonin significantly improved anxiety scores, though without strong clinical relevance. Independent of treatment, sleep quality did not significantly change during the trial, although melatonin slightly increased the number of hours slept. After active treatment, the mean ± standard error serum melatonin level peaked at 1,520 ± 646 pg/mL. A generally safe pharmacologic profile of melatonin was observed, and the placebo and melatonin treatments resulted in similar adverse effects. CONCLUSION: Within the limitations of this study, melatonin did not exhibit higher efficacy than placebo in relieving pain in BMS patients."," Varoni, EM;  Lo Faro, AF;  Lodi, G;  Carrassi, A;  Iriti, M;  Sardella, A",2018.0, 10.11607/ofph.1913,0,0,
924,Predicting treatment response to cognitive rehabilitation in military service members with mild traumatic brain injury.,"Objective: Determine factors that affect responsiveness to cognitive rehabilitation (CR) interventions in service members (SMs) who sustained mild traumatic brain injury (mTBI). Method: 126 SMs with a history of mTBI 3 to 24 months postinjury participated in a randomized clinical trial of one of four, 6-week treatment arms: (a) psychoeducation, (b) computer-based CR, (c) therapist-directed manualized CR, and (d) therapist-directed CR integrated with cognitive-behavioral psychotherapy. Practice-adjusted reliable change scores (RCS) were calculated for the three primary outcome measures: Paced Auditory Serial Addition Test (PASAT), Symptom Checklist-90 Revised (SCL-90-R) Global Severity Index (GSI), and Key Behaviors Change Inventory (KBCI). Hierarchical logistic regression was used to predict RCS. Variables considered were: (a) demographic, (b) injury characteristics, (c) comorbid mental health conditions, (d) nonspecific treatment variables (i.e., team vs. no-team milieu), and (e) specific treatment elements. Results: No predictor variables were associated with RCS improvements on the PASAT or the SCL-90-R. Comorbid depression (p < .02) and team-treatment milieu (p < .02) were associated with RCS improvement on the KBCI. Specific CR (ps > .65) and psychotherapy treatments (p > .26) were not associated with improvements on any outcome. There was evidence that self-administered computer CR was not only not beneficial, but negatively associated with cognitive and neurobehavioral improvement. Conclusions: Although reliable improvements were found on the PASAT and KBCI, no specific treatment intervention effects were found. Rather, comorbid depression and team-milieu treatment environment were associated with improvement, but only on the KBCI. Comorbid depression was associated with higher rates of improvement. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement Impact and Implications-This article examines factors contributing to treatment response in the Study of Cognitive Rehabilitation Effectiveness (SCORE) trial, one of the largest randomized clinical trials of cognitive rehabilitation after mild traumatic brain injury. The current study adds to the literature by identifying factors that may potentiate treatment response, such as a team-milieu treatment environment and identifying characteristics of those individuals who may show the greatest benefit from such an intervention (i.e., those with comorbid depression). An important finding in the current study was that self-administered or independent use of computerized cognitive rehabilitation activities may be harmful. This finding is disconcerting because such independent computerized activities are a frequent treatment recommendation by health care providers. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Vanderploeg, Rodney D; Cooper, Douglas B; Curtiss, Glenn; Kennedy, Jan E; Tate, David F; Bowles, Amy O",2018.0,http://dx.doi.org/10.1037/rep0000215,0,0,
925,Intranasal oxytocin to prevent posttraumatic stress disorder symptoms: A randomized controlled trial in emergency department patients.,"Background: There are currently few preventive interventions available for posttraumatic stress disorder (PTSD). Intranasal oxytocin administration early after trauma may prevent PTSD, because oxytocin administration was previously found to beneficially impact PTSD vulnerability factors, including neural fear responsiveness, peripheral stress reactivity, and socioemotional functioning. Therefore, we investigated the effects of intranasal oxytocin administration early after trauma on subsequent clinician-rated PTSD symptoms. We then assessed whether baseline characteristics moderated the intervention's effects. Methods: We performed a multicenter, randomized, double-blind, placebo-controlled clinical trial. Adult emergency department patients with moderate to severe acute distress (n = 120; 85% accident victims) were randomized to intranasal oxytocin (8 days/40 IU twice daily) or placebo (8 days/10 puffs twice daily), initiated within 12 days posttrauma. The Clinician-Administered PTSD Scale (CAPS) was administered at baseline (within 10 days posttrauma) and at 1.5, 3, and 6 months posttrauma. The intention-to-treat sample included 107 participants (oxytocin: n = 53; placebo: n = 54). Results: We did not observe a significant group difference in CAPS total score at 1.5 months posttrauma (primary outcome) or across follow-up (secondary outcome). Secondary analyses showed that participants with high baseline CAPS scores receiving oxytocin had significantly lower CAPS scores across follow-up than participants with high baseline CAPS scores receiving placebo. Conclusions: Oxytocin administration early after trauma did not attenuate clinician-rated PTSD symptoms in all trauma-exposed participants with acute distress. However, participants with high acute clinician-rated PTSD symptom severity did show beneficial effects of oxytocin. Although replication is warranted, these findings suggest that oxytocin administration is a promising preventive intervention for PTSD for individuals with high acute PTSD symptoms. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","van Zuiden, Mirjam; Frijling, Jessie L; Nawijn, Laura; Koch, Saskia B. J; Goslings, J. Carel; Luitse, Jan S; Biesheuvel, Tessa H; Honig, Adriaan; Veltman, Dick J; Olff, Miranda",2017.0,http://dx.doi.org/10.1016/j.biopsych.2016.11.012,0,0,
926, The impact of cardiac arrest on the long-term wellbeing and caregiver burden of family caregivers: a prospective cohort study," OBJECTIVE: The purpose was to gain insight in the functioning of caregivers of cardiac arrest survivors at 12 months after a cardiac arrest. Secondly, the course of the wellbeing of the caregivers during the first year was studied. Finally, factors that are associated with a higher care burden at 12 months after the cardiac arrest were investigated. SUBJECTS: A total of 195 family caregivers of cardiac arrest survivors were included. MAIN MEASURES: Quality of life (SF‚Äê36, EuroQol‚ÄêVAS), caregiver strain (CSI) and emotional functioning (HADS, IES) were measured at two weeks, three months and one year after the cardiac arrest. Thereby, the caregiver was asked to fill out the cognitive failure questionnaire (CFQ) to evaluate their view on the cognitive status of the patient. RESULTS: Caregiver strain was high in 16 (15%) of the caregivers at 12 months. Anxiety was present in 33 (25%) caregivers and depression in 18 (14%) caregivers at 12 months. The repeated measures MANOVA showed that during the first year the following variables improved significantly: SF‚Äê36 domains social and mental health, role physical, role emotional and vitality, caregiver strain, HADS and IES ( P<0.001). At 12 months caregiver strain correlated significantly (explained variance 63%, P=0.03) with caregiver HADS ( P=0.01), EuroQol‚ÄêVAS ( P=0.02), and the CFQ ( P<0.001), all measured at 12 months after the cardiac arrest. CONCLUSIONS: Overall wellbeing of the caregivers improves during the first year up to normal levels, but caregivers with emotional problems or perceived cognitive problems at 12 months are at risk for developing a higher care burden."," van Wijnen, HG;  Rasquin, SM;  van Heugten, CM;  Verbunt, JA;  Moulaert, VR",2017.0, 10.1177/0269215516686155,0,0,
927,Stress-reducing function of matcha green tea in animal experiments and clinical trials,"Theanine, a major amino acid in green tea, exhibits a stress-reducing effect in mice and humans. Matcha, which is essentially theanine-rich powdered green tea, is abundant in caffeine. Caffeine has a strong antagonistic effect against theanine. The stress-reducing effect of matcha was examined with an animal experiment and a clinical trial. The stress-reducing effect of matcha marketed in Japan and abroad was assessed based on its composition. The stress-reducing effect of matcha in mice was evaluated as suppressed adrenal hypertrophy using territorially-based loaded stress. High contents of theanine and arginine in matcha exhibited a high stress-reducing effect. However, an effective stress-reducing outcome was only possible when the molar ratio of caffeine and epigallocatechin gallate (EGCG) to theanine and arginine was less than two. Participants (n = 39) consumed test-matcha, which was expected to have a stress-reducing effect, or placebo-matcha, where no effect was expected. Anxiety, a reaction to stress, was significantly lower in the test-matcha group than in the placebo group. To predict mental function of each matcha, both the quantity of theanine and the ratios of caffeine, EGCG, and arginine against theanine need to be verified.",Unno K.; Furushima D.; Hamamoto S.; Iguchi K.; Yamada H.; Morita A.; Horie H.; Nakamura Y.,2018.0,10.3390/nu10101468,0,0,
928, Comparison of a peer facilitated support group to cognitive behavior therapy: study protocol for a randomized controlled trial for hoarding disorder," Although individual and group cognitive‚Äêbehavioral therapy (CBT) is the standard treatment approach for hoarding disorder (HD), it requires trained mental health professionals with specialization in HD. There is a need to offer additional options and services due to the limited number of professionals with advanced training, combined with the high prevalence rate of individuals with HD. A structured support group led by trained facilitators or lay professionals using a facilitator's manual and participant workbook (Buried in Treasures or BiT), addresses this need and increases accessibility. Prior studies of BiT groups have shown decreased hoarding symptoms. Only one retrospective study compared BiT and CBT outcomes in a naturalistic setting and showed no difference. Thus, a well‚Äêpowered randomized controlled trial is needed to directly compare these forms of treatment. This paper presents a non‚Äêinferiority controlled trial protocol that compares group CBT to group BiT. Three hundred participants with HD, 18years or older, are being recruited for a 16‚Äêweek treatment study. Participants are randomly assigned to either the CBT or BiT group. The primary outcome is reduction in hoarding symptom severity. Secondary outcomes include reduction in other indices of hoarding symptomology, including functional impairment, physical clutter, cognition, and changes in neuropsychological functioning."," Uhm, SY;  Tsoh, JY;  Mackin, RS;  Gause, M;  Chan, J;  Franklin, J;  Eckfield, M;  Salazar, M;  Vigil, O;  Bain, D;  et al.",2016.0, 10.1016/j.cct.2016.07.018,0,0,
929,The effect of different types of music on patients' preoperative anxiety: A randomized controlled trial.,"The purpose of this study was to determine effect of three different types of music on patients' preoperative anxiety. This randomized controlled trial included 180 patients who were randomly divided into four groups. While the control group didn't listen to music, the experimental groups respectively listened to natural sounds, Classical Turkish or Western Music for 30 min. The State Anxiety Inventory (STAI-S), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and cortisol levels were checked. The post-music STAI-S, SBP, DBP, HR and cortisol levels of the patients in music groups were significantly lower than pre-music time. All types of music decreased STAI-S, SBP, and cortisol levels; additionally natural sounds reduced DBP; Classical Turkish Music also decreased DBP, and HR. All types of music had an effect on reducing patients' preoperative anxiety, and listening to Classical Turkish Music was particularly the most effective one.",Uğraş GA.; Yıldırım G.; Yüksel S.; Öztürkçü Y.; Kuzdere M.; Öztekin SD.,2018.0,10.1016/j.ctcp.2018.02.012,0,0,
930, Dimensions of dependence and their influence on the outcome of cognitive behaviour therapy for health anxiety: randomized controlled trial," BACKGROUND: The personality trait of dependence is common in health‐seeking behaviour. We therefore examined its impact in a large randomized controlled trial of psychological treatment for health anxiety. AIMS: To test whether dependent personality traits were positive or negative in determining the outcome of an adapted form of cognitive behaviour therapy for health anxiety (CBT‐HA) over the course of 5 years and whether dependent personality dysfunction could be viewed dimensionally in a similar way to the new ICD‐11 diagnostic system for general personality disorder. METHOD: Dependent personality dysfunction was assessed using a self‐rated questionnaire, the Dependent Personality Questionnaire, at baseline in a randomized controlled trial of 444 patients from medical clinics with pathological health anxiety treated with a modified form of CBT‐HA or standard treatment in the medical clinics, with assessment on five occasions over 5 years. Dependent personality dysfunction was assessed using four severity groups. RESULTS: Patients with mild and moderate dependent personality disorder treated with CBT‐HA showed the greatest reduction in health anxiety compared with standard care, and those with no dependent dysfunction showed the least benefit. Patients with higher dependent traits received significantly more treatment sessions (8.6) than those with low trait levels (5.4) (p < 0.01). CONCLUSION: The results suggest that patients treated with cognitive behaviour therapy for health anxiety respond better if they have moderate dependent personality. The reasons for this may be related to better adherence to psychological treatment and greater negative effects of frequent reassurance and excessive consultation in those treated in standard care. Copyright © 2016 John Wiley & Sons, Ltd."," Tyrer, P;  Wang, D;  Tyrer, H;  Crawford, M;  Cooper, S",2016.0, 10.1002/pmh.1339,0,0,
931,Cognitive-behaviour therapy for health anxiety in medical patients (CHAMP): a randomised controlled trial with outcomes to 5 years.,"Health anxiety is an under-recognised but frequent cause of distress that is potentially treatable, but there are few studies in secondary care. To determine the clinical effectiveness and cost-effectiveness of a modified form of cognitive-behaviour therapy (CBT) for health anxiety (CBT-HA) compared with standard care in medical outpatients. Randomised controlled trial. Five general hospitals in London, Middlesex and Nottinghamshire. A total of 444 patients aged 16-75 years seen in cardiology, endocrinology, gastroenterology, neurology and respiratory medicine clinics who scored ≥ 20 points on the Health Anxiety Inventory (HAI) and satisfied diagnostic requirements for hypochondriasis. Those with current psychiatric disorders were excluded, but those with concurrent medical illnesses were not. Cognitive-behaviour therapy for health anxiety - between 4 and 10 1-hour sessions of CBT-HA from a health professional or psychologist trained in the treatment. Standard care was normal practice in primary and secondary care. Primary - researchers masked to allocation assessed patients at baseline, 3, 6, 12, 24 months and 5 years. The primary outcome was change in the HAI score between baseline and 12 months. Main secondary outcomes - costs of care in the two groups after 24 and 60 months, change in health anxiety (HAI), generalised anxiety and depression [Hospital Anxiety and Depression Scale (HADS)] scores, social functioning using the Social Functioning Questionnaire and quality of life using the EuroQol-5 Dimensions (EQ-5D), at 6, 12, 24 and 60 months, and deaths over 5 years. Of the 28,991 patients screened over 21 months, 5769 had HAI scores of ≥ 20 points. Improvement in HAI scores at 3 months was significantly greater in the CBT-HA group (mean number of sessions = 6) than in the standard care, and this was maintained over the 5-year period (overall p < 0.0001), with no loss of efficacy between 2 and 5 years. Differences in the generalised anxiety (p = 0.0018) and depression scores (p = 0.0065) on the HADS were similar in both groups over the 5-year period. Gastroenterology and cardiology patients showed the greatest CBT gains. The outcomes for nurses were superior to those of other therapists. Deaths (n = 24) were similar in both groups; those in standard care died earlier than those in CBT-HA. Patients with mild personality disturbance and higher dependence levels had the best outcome with CBT-HA. Total costs were similar in both groups over the 5-year period (£12,590.58 for CBT-HA; £13,334.94 for standard care). CBT-HA was not cost-effective in terms of quality-adjusted life-years, as measured using the EQ-5D, but was cost-effective in terms of HAI outcomes, and offset the cost of treatment. Many eligible patients were not randomised and the population treated may not be representative. CBT-HA is a highly effective treatment for pathological health anxiety with lasting benefit over 5 years. It also improves generalised anxiety and depressive symptoms more than standard care. The presence of personality abnormality is not a bar to successful outcome. CBT-HA may also be cost-effective, but the high costs of concurrent medical illnesses obscure potential savings. This treatment deserves further research in medical settings. Current Controlled Trials ISRCTN14565822. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 50. See the NIHR Journals Library website for further project information.",Tyrer P.; Salkovskis P.; Tyrer H.; Wang D.; Crawford MJ.; Dupont S.; Cooper S.; Green J.; Murphy D.; Smith G.; Bhogal S.; Nourmand S.; Lazarevic V.; Loebenberg G.; Evered R.; Kings S.; McNulty A.; Lisseman-Stones Y.; McAllister S.; Kramo K.; Nagar J.; Reid S.; Sanatinia R.; Whittamore K.; Walker G.; Philip A.; Warwick H.; Byford S.; Barrett B.,2017.0,10.3310/hta21500,0,0,
932,Adding acceptance and commitment therapy to exposure and response prevention for obsessive-compulsive disorder: A randomized controlled trial.,"The objective of this study was to test whether treatment acceptability, exposure engagement, and completion rates could be increased by integrating acceptance and commitment therapy (ACT) with traditional exposure and response prevention (ERP). 58 adults (68% female) diagnosed with obsessive-compulsive disorder (OCD; M age = 27, 80% white) engaged in a multisite randomized controlled trial of 16 individual twice-weekly sessions of either ERP or ACT + ERP. Assessors unaware of treatment condition administered assessments of OCD, depression, psychological flexibility, and obsessional beliefs at pretreatment, posttreatment, and six-month follow-up. Treatment acceptability, credibility/expectancy, and exposure engagement were also assessed. Exposure engagement was high in both conditions and there were no significant differences in exposure engagement, treatment acceptability, or dropout rates between ACT + ERP and ERP. OCD symptoms, depression, psychological inflexibility, and obsessional beliefs decreased significantly at posttreatment and were maintained at follow-up in both conditions. No between-group differences in outcome were observed using intent to treat and predicted data from multilevel modeling. ACT + ERP and ERP were both highly effective treatments for OCD, and no differences were found in outcomes, processes of change, acceptability, or exposure engagement. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Twohig, Michael P; Abramowitz, Jonathan S; Smith, Brooke M; Fabricant, Laura E; Jacoby, Ryan J; Morrison, Kate L; Bluett, Ellen J; Reuman, Lillian; Blakey, Shannon M; Ledermann, Thomas",2018.0,http://dx.doi.org/10.1016/j.brat.2018.06.005,0,0,
933, Sustainability of Treatment Effects of Trauma-Focused Cognitive-Behavioral Therapy for Children and Adolescents: findings from 6- and 12-Month Follow-Ups,," Tutus, D;  Pfeiffer, E;  Rosner, R;  Sachser, C;  Goldbeck, L",2017.0, 10.1159/000481198,0,0,
934, Change in Parental Depressive Symptoms in Trauma-Focused Cognitive-Behavioral Therapy: results from a Randomized Controlled Trial," OBJECTIVES: Depressive symptoms are frequently described in parents whose children have been exposed to traumatic events. Hence, including nonoffending parents in trauma‐focused cognitive‐behavioral therapy (TF‐CBT) for children and adolescents may help both children and their parents to cope with the trauma. Up to now, three randomized controlled trials have investigated parental depressive symptoms after TF‐CBT. Given the ambiguous results, further effectiveness trials are needed to investigate parental benefit from TF‐CBT. The aim of this study is to determine whether TF‐CBT is superior to waitlist (WL) regarding change in parental depressive symptoms. METHODS: Parents, N = 84, whose children (age 6‐17 years) were randomly assigned to either 12 sessions of TF‐CBT (n = 40) or to WL condition (n = 44) completed the Beck Depression Inventory‐Second Edition (BDI‐II) for pre‐post comparison. The group difference was tested through repeated‐measures analyses of variance (ANOVA). The change in parental depressive symptoms was additionally categorized using the reliable change index. RESULTS: Repeated‐measures ANOVA indicated a significant time effect F(1, 82) = 2.55, p = 0.02, and no significant time‐group interaction F(1, 82) = 1.09, p = 0.30, suggesting a similar reduction in parental depressive symptoms in both groups. Across both conditions, most of the parents remained unchanged (n = 62), some of them improved (n = 17), and a few deteriorated (n = 5). There was no significant difference between the conditions (χ CONCLUSION: Contrary to findings of several previous studies, our results suggest no superiority of TF‐CBT in comparison with WL regarding change in depressive symptoms in parents. This might be due to different types of the child's trauma. Parental benefit from TF‐CBT was found in samples of sexually abused, but not in children and adolescents exposed to diverse trauma types."," Tutus, D;  Keller, F;  Sachser, C;  Pfeiffer, E;  Goldbeck, L",2017.0, 10.1089/cap.2016.0136,0,0,
935,A brief intervention for preparing ICU families to be proxies: A phase I study.,"Family members of critically ill patients report high levels of conflict with clinicians, have poor understanding of prognosis, struggle to make decisions, and experience substantial symptoms of anxiety, depression, and post-traumatic stress regardless of patient survival status. Efficient interventions are needed to prepare these families to act as patient proxies. To assess a brief ""patient activation"" intervention designed to set expectations and prepare families of adult intensive care unit (ICU) patients to communicate effectively with the clinical team. Phase I study of acceptability and immediate side effects. 122 healthcare proxies of 111 consecutive patients with a stay of ‚â•24 hours in the Johns Hopkins Hospital Medical ICU (MICU), in Baltimore, Maryland. Reading aloud to proxies from a booklet (Flesch-Kincard reading grade level 3.8) designed with multidisciplinary input including from former MICU proxies. Enrolled proxies had a median age of 51 years old with 83 (68%) female, and 55 (45%) African-American. MICU mortality was 18%, and 37 patients (33%) died in hospital or were discharged to hospice. Among proxies 98% (95% CI: 94% - 100%) agreed or strongly agreed that the intervention was appropriate, 98% (95% CI: 92% - 99%) agreed or strongly agreed that it is important for families to know the information in the booklet, and 54 (44%, 95% CI 35%- 54%) agreed or strongly agreed that parts of the booklet are upsetting. Upset vs. non-upset proxies were not statistically or substantially different in terms of age, sex, education level, race, relation to the patient, or perceived decision-making authority. This patient activation intervention was acceptable and important to nearly all proxies. Frequently, the intervention was simultaneously rated as both acceptable/important and upsetting. Proxies who rated the intervention as upsetting were not identifiable based on readily available proxy or patient characteristics.",Turnbull AE.; Chessare CM.; Coffin RK.; Needham DM.,2017.0,10.1371/journal.pone.0185483,0,0,
936,Association of BDNF Val66Met polymorphism with HPA and SAM axis reactivity to psychological and physical stress,"Background: Decreased expression of brain-derived neurotrophic factor (BDNF) is implicated in enhanced stress responses. The BDNF Val66Met polymorphism is associated with psychological changes; for example, carriers of the Met allele exhibit increased harm avoidance as well as a higher prevalence of depression and anxiety disorder. Methods: To analyze the effects of BDNF Val66Met on stress responses, we tested 226 university students (88 women and 138 men) using a social stress procedure (Trier Social Stress Test [TSST]) and an electrical stimulation stress test. Stress indices were derived from repeated measurements of salivary α-amylase, salivary cortisol, heart rate, and psychological testing during the stress tests. All subjects were genotyped for the Val66Met polymorphism (G196A). Results: A significant three-way interaction (time [3 levels] × BDNF [Val/Val, Val/Met, Met/Met]; P<0.05) was demonstrated that revealed different salivary cortisol responses in the TSST but not in electrical stimulation. Met/Met women had stronger cortisol responses than Val/Met and Val/Val individuals in the TSST. Met/Met men exhibited stronger salivary cortisol responses than Val/Met and Val/Val individuals in the TSST. Conclusion: These results indicate that a common, functionally significant polymorphism in BDNF had different effects on hypothalamic-pituitary-adrenocortical axis reactivity but not on sympathetic adrenomedullary reactivity in TSST and electrical stimulation tests.",Tsuru J.; Tanaka Y.; Ishitobi Y.; Maruyama Y.; Inoue A.; Kawano A.; Ikeda R.; Ando T.; Oshita H.; Aizawa S.; Masuda K.; Higuma H.; Kanehisa M.; Ninomiya T.; Akiyosh J.,2014.0,10.2147/NDT.S68629,0,0,
937," In-patient psychiatric-psychotherapeutic treatment of mothers with a generalized anxiety disorder--does the co-admission of their children influence the treatment results? A prospective, controlled study"," METHODS: The monitored results of 29 female patients diagnosed with generalized anxiety disorder, 15 of whom were admitted with accompanying children and 14 without, were compared (response rate 95.3%). The period of observation amounted to six weeks. The System Checklist (SCL‚Äê90‚ÄêR) and The Questionnaire of Changes in Experience and Behavior (VEV) were used as instruments of assessment. RESULTS: With respect to co‚Äêmorbidity and socio‚Äêdemographic data, both groups were initially comparable. During the course of six weeks' treatment, no statistically significant differences between the results for mothers with and mothers without accompanying children were measured in any of the tests we used, namely, the VEV (Difference = 0.3; 95%‚ÄêCI [‚Äê5.4; 6.1]; p = 0.66) and the SCL‚Äê90‚ÄêR, which includes the Global Severity Index (Difference = 4.0; 95%‚ÄêCI [‚Äê1.4; 9.4]; p = 0.15), and the Anxiety Scale (Difference = 0.5; 95%‚ÄêCI [‚Äê2.0; 1.0]; p = 0.63). CONCLUSION: The results indicate that mothers with generalized anxiety disorder who were accompanied by their children during in‚Äêpatient psychotherapeutic treatment achieved treatment results that were just as good as mothers with the same diagnosis who were admitted without children. INTRODUCTION: Whether women who are admitted together with their children achieve inpatient psychotherapeutic treatment results that differ significantly from the results for women who are admitted alone, is a subject of controversy. We compared both groups in a prospective, randomized, controlled study."," Tritt, K;  Nickel, M;  Nickel, C;  Lahmann, C;  Mitterlehner, F;  Leiberich, P;  Loew, T;  Rother, W",2004.0,,0,0,
938,Low-Intensity Cognitive Behavioural Therapy-Based Music Group (CBT-Music) for the Treatment of Symptoms of Anxiety and Depression: A Feasibility Study.,"Music has the potential to be an effective and engaging therapeutic intervention in the treatment of mental illness. This research area remains underdeveloped. This paper reports the feasibility of an innovative low-intensity CBT-based music (CBT-Music) group targeted to symptoms of depression and anxiety. A total of 28 participants with symptoms of depression and anxiety who were attending community mental health services were recruited for the study and randomized into TAU (treatment as usual) plus low-intensity CBT-Music (treatment) or to TAU alone (control). The treatment group consisted of a 9-week music group that incorporated various components of CBT material into a musical context. Feasibility was the primary outcome. The secondary outcomes were a reduction in depression, anxiety (Hospital Anxiety and Depression Scale) and disability (WHO Disability Assessment Schedule 2.0) assessed at baseline and 10 weeks. Recruitment proved feasible, retention rates were high, and the participants reported a high level of acceptability. A randomized control study design was successfully implemented as there were no significant differences between treatment and control groups at baseline. Participants in the treatment group showed improvement in disability (p = 0.027). Despite a reduction in depression and anxiety scores, these differences were not statistically significant. A low-intensity CBT-based music group can be successfully administered to clients of community mental health services. There are indications of effectiveness in reducing disability, although there appears to be negligible effect on symptoms of anxiety and depression. This is the first report of a trial of a low-intensity CBT-based music group intervention.",Trimmer C.; Tyo R.; Pikard J.; McKenna C.; Naeem F.,2018.0,10.1017/S1352465817000480,0,0,
939, Depression: an exploratory parallel-group randomised controlled trial of Antenatal guided self help for WomeN (DAWN): study protocol for a randomised controlled trial," BACKGROUND: Depression is a common antenatal mental disorder and is associated with an increased risk of adverse effects on the fetus and significant morbidity for the mother; if untreated it can also continue into the post‚Äênatal period and affect mother‚Äêinfant interactions. There has been little research evaluating the effectiveness or cost‚Äêeffectiveness of antenatal psychological interventions for antenatal depression, particularly for mild to moderate disorders. International guidelines recommend a stepped care approach starting with Guided Self Help, and the aim of this exploratory trial is to investigate Guided Self Help modified for pregnancy. METHODS: The DAWN trial is an exploratory randomised controlled trial of the effectiveness and cost‚Äêeffectiveness of antenatal Guided Self Help, modified for pregnancy and delivered by National Health Service Psychological Wellbeing Practitioners. Antenatal Guided Self Help, in addition to usual care, is compared with usual care for pregnant women diagnosed with mild to moderate depression and mixed anxiety and depression, using the Structured Clinical Interview for DSM‚ÄêIV Disorders. Modifications for pregnancy include perinatal mental health training, addressing pregnancy‚Äêspecific worries and including sections on health issues in pregnancy and planning for parenthood. Women allocated to Guided Self Help will be seen for up to eight sessions by a Psychological Wellbeing Practitioner (including an initial assessment session); there will also be an appointment at 12 weeks after delivery. Research measures including the Edinburgh Postnatal Depression Scale (primary outcome) and other measures of depression, anxiety, quality of life and service use will be collected from women before random allocation, 14 weeks after random allocation and at 12 weeks after delivery. Potential psychological mechanisms of the intervention will be explored using the Pregnancy‚ÄêRelated Thoughts Questionnaire and the Metacognitive Awareness Questionnaire. DISCUSSION: The DAWN trial is the first exploratory trial to investigate the efficacy of antenatal Guided Self Help for pregnant women with mild to moderate depression meeting DSM‚ÄêIV diagnostic criteria. Recruitment started January 2015 and is expected to be completed by July 2016. TRIAL REGISTRATION: ISRCTN registry: ISRCTN83768230 . Registered on 8 August 2014."," Trevillion, K;  Domoney, J;  Pickles, A;  Bick, D;  Byford, S;  Heslin, M;  Milgrom, J;  Mycroft, R;  Pariante, C;  Ryan, E;  et al.",2016.0, 10.1186/s13063-016-1632-6,0,0,
940,Efficacy of Activities of Daily Living Retraining During Posttraumatic Amnesia: A Randomized Controlled Trial.,"To assess the efficacy of activities of daily living (ADL) retraining during posttraumatic amnesia (PTA) compared with ADL retraining commencing after emergence from PTA. Randomized controlled trial. Inpatient rehabilitation center. Participants with severe TBI (N=104), admitted to rehabilitation and remaining in PTA for >7 days, were randomized to receive either treatment as usual (TAU) with daily ADL retraining (treatment), or TAU alone (physiotherapy and/or necessary speech therapy) during PTA. ADL retraining was manualized, followed errorless and procedural learning principles, and included individualized goals. Both groups received occupational therapy as usual after PTA. Primary outcome was the FIM completed at admission, PTA emergence, discharge, and 2-month follow-up. Secondary outcomes included length of rehabilitation inpatient stay, PTA duration, Agitated Behavior Scale scores, and Community Integration Questionnaire (CIQ) scores at follow-up. Groups did not significantly differ in baseline characteristics. On the primary outcome, FIM total change, random effects regression revealed a significant interaction of group and time (P<.01). The treatment group had greater improvement in FIM scores from baseline to PTA emergence, which was maintained at discharge, but not at follow-up. Twenty-seven percent more of the treatment group reliably changed on FIM scores at PTA emergence. Group differences in length of stay, PTA duration, agitation, and CIQ scores were not significant; however, TAU trended toward longer length of stay and PTA duration. Individuals in PTA can benefit from skill retraining.",Trevena-Peters J.; McKay A.; Spitz G.; Suda R.; Renison B.; Ponsford J.,2018.0,10.1016/j.apmr.2017.08.486,0,0,
941,S-ketamine reduces marble burying behaviour: Involvement of ventromedial orbitofrontal cortex and AMPA receptors,"Previous clinical and pre-clinical studies suggest the involvement of ventromedial orbitofrontal cortex (vmOFC) and glutamatergic neurotransmission in obsessive-compulsive disorder (OCD). Ketamine, an NMDA glutamatergic receptor antagonist, has shown a rapid and long-lasting antidepressant effect, but its anti-compulsive effect has been scarcely investigated. The antidepressant effect of ketamine involves NMDA receptor blockade, AMPA receptor activation, increased serotonin (5-HT) release and attenuation of nitric oxide (NO) synthesis. It is not known if these mechanisms are involved in ketamine-induced anti-compulsive effect. Therefore, we firstly investigated the effect of S-ketamine in the marble-burying test (MBT), a model for screening of drugs with potential to treat OCD. Then, we evaluated whether ketamine effects in the MBT would involve the vmOFC, be dependent on AMPA receptors, facilitation of serotonergic neurotransmission and inhibition of nitrergic pathway. Our results showed that single systemic (10 mg/kg) and intra-vmOFC (10 nmol/side) administration of S-ketamine reduces marble burying behaviour (MBB) without affecting spontaneous locomotors activity. Pre-treatment with NBQX (3 mg/kg; AMPA receptor antagonist) blocked the reduction of MBB induced by S-ketamine. However, pre-treatment with p-CPA (150 mg/kg/day; a 5-HT synthesis inhibitor), WAY100635 (3 mg/kg; a 5-HT1A receptor antagonist), or L-arginine (500 mg/kg; a nitric oxide precursor) did not counteract S-ketamine effect in the MBT. In contrast, associating sub-effective doses of L-NAME (10 mg/kg; NOS inhibitor) and S-ketamine (3 mg/kg) decreased MBB. In conclusion, the reduction of MBB by S-ketamine strengthens its possible anti-compulsive effect. The vmOFC is involved in this S-ketamine effect, which is dependent on the activation of AMPA receptors.",Tosta C.L.; Silote G.P.; Fracalossi M.P.; Sartim A.G.; Andreatini R.; Joca S.R.L.; Beijamini V.,2019.0,10.1016/j.neuropharm.2018.10.039,0,0,
942,Sudarshan Kriya Yoga improves cardiac autonomic control in patients with anxiety-depression disorders.,"Background: Several studies have demonstrated that adjuvant therapies as exercise and breathing training are effective in improving cardiac autonomic control (CAC) in patients with affective spectrum disorders. However, the effects of Sudarshan Kriya Yoga (SKY) on autonomic function in this population is unknown. Our objective was to test the hypothesis that SKY training improves CAC and cardiorespiratory coupling in patients with anxiety and/or depression disorders. Methods: Forty-six patients with a diagnosis of anxiety and/or depression disorders (DSM-IV) were consecutively enrolled and divided in two groups: 1) conventional therapy (Control) and 2) conventional therapy associated with SKY (Treatment) for 15 days. Anxiety and depression levels were determined using quantitative questionnaires. For the assessment of CAC and cardiorespiratory coupling, cardiorespiratory traces were analyzed using monovariate and bivariate autoregressive spectral analysis, respectively. Results: After 15-days, we observed a reduction of anxiety and depression levels only in Treatment group. Moreover, sympathetic modulation and CAC were significantly lower while parasympathetic modulation and cardiorespiratory coupling were significantly higher in the Treatment compared to Control group. Conclusions: Intensive breathing training using SKY approach improves anxiety and/or depressive disorders as well as CAC and cardiorespiratory coupling. These finding suggest that the SKY training may be a useful non-pharmacological intervention to improve symptoms and reduce cardiovascular risk in patients with anxiety/depression disorders. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Toschi-Dias, Edgar; Tobaldini, Eleonora; Solbiati, Monica; Costantino, Giorgio; Sanlorenzo, Roberto; Doria, Stefania; Irtelli, Floriana; Mencacci, Claudio; Montano, Nicola",2017.0,http://dx.doi.org/10.1016/j.jad.2017.03.017,0,0,
943,Increasing resilience to traumatic stress: Understanding the protective role of well-being,"The brain maintains homeostasis in part through a network of feedback and feed-forward mechanisms, where neurochemicals and immune markers act as mediators. Using a previously constructed model of biobehavioral feedback, we found that in addition to healthy equilibrium another stable regulatory program supported chronic depression and anxiety. Exploring mechanisms that might underlie the contributions of subjective well-being to improved therapeutic outcomes in depression, we iteratively screened 288 candidate feedback patterns linking well-being to molecular signaling networks for those that maintained the original homeostatic regimes. Simulating stressful trigger events on each candidate network while maintaining high levels of subjective well-being isolated a specific feedback network where well-being was promoted by dopamine and acetylcholine, and itself promoted norepinephrine while inhibiting cortisol expression. This biobehavioral feedback mechanism was especially effective in reproducing well-being’s clinically documented ability to promote resilience and protect against onset of depression and anxiety.",Tory Toole J.; Rice M.A.; Cargill J.; Craddock T.J.A.; Nierenberg B.; Klimas N.G.; Fletcher M.A.; Morris M.; Zysman J.; Broderick G.,2018.0,10.1007/978-1-4939-7828-1_6,0,0,
944,Implicit memory and psychological disturbance in intensive care unit patients,"Part One: Literature Review - Background: People who experience an intensive care unit admission may also experience post-traumatic stress and other forms of psychological distress. Such phenomena are only partly explained by the reason for admission. This distress can impede physical recovery and full participation in everyday life. Method: Using specified criteria, several databases were systematically searched and 279 abstracts highlighted; 215 articles were subsequently screened with a total of 104 articles being retained for specified quality criteria screening and critique. Results: Following critique, a total of 19 articles were retained for their relevance to the research question. Conclusions: The literature presented sufficient information to enable the investigator to propose a model describing the mechanism for PTSD development in ICU. Despite the extensive selection and screening process, most articles contained methodological flaws, however the investigator advocates that the information provided by the literature should not be dismissed and that future research might be directed towards replication of such research to RCT standards. Part Two: Research Report - Introduction: Despite the literature indicating that PTSD and other forms of psychological distress are significant problems for intensive care unit patients, the mechanisms involved in the development of PTSD remain largely unexplained. The investigator hypothesised that PTSD may occur as a result of implicit learning/classical conditioning/pairing of auditory stimuli to emotional distress experienced in the intensive care unit. Aim: To test the hypothesis that classical conditioning (pairing) of ICU environment sounds to patient distress or anxiety in the ICU which can then be detected after discharge as an emotional conditioned response to the presentation of a range of sounds (Train/Rain and ICU) sounds whilst monitoring skin conductance. Method: Thirty-three patients were recruited into the study and twenty participants were able to provide data to permit testing relating to the main hypothesis at 4-5 weeks post-ICU discharge. Results: A non-significant trend was noted in the relationship between presentation of ICU sounds and increased skin conductance responses, but the investigator was unable to find significant evidence of any relationship between skin conductance responses to ICU sounds and measures of psychological distress. There was significant evidence to suggest that the presence of memories as measured by the ICU Memory Tool at one-to-two weeks post-discharged from ICU were related to PTSD development. Conclusion: Patients demonstrating increased memories of feelings at one-to-two weeks, should be monitored carefully for any subsequent signs of PTSD and other forms of psychological distress. Future research should perhaps attempt to replicate the ICU sounds findings in a larger sample size with comprehensive recording of ICU sedation and memory phenomena details. Any attempts to find evidence of implicit memory using prompted recall questions should plan to capture this within 24 hours of stimuli presentation. Part Three: Critical Appraisal - Reflections regarding the research process and content are discussed.",Tordoff,2010.0,,0,0,
945, Prevention of anxiety disorders and depression by targeting excessive worry and rumination in adolescents and young adults: a randomized controlled trial," METHODS: Participants (N = 251, 83.7% female) showing elevated levels of RNT were randomly allocated to a 6‚Äêweek cognitive‚Äêbehavioral training delivered in a group, via the internet, or to a waitlist control condition. Self‚Äêreport measures were collected at pre‚Äêintervention, post‚Äêintervention, 3 m and 12 m follow‚Äêup. RESULTS: Both versions of the preventive intervention significantly reduced RNT (d = 0.53 to 0.89), and symptom levels of anxiety and depression (d = 0.36 to 0.72). Effects were maintained until 12 m follow‚Äêup. The interventions resulted in a significantly lower 12 m prevalence rate of depression (group intervention: 15.3%, internet intervention: 14.7%) and generalized anxiety disorder (group intervention: 18.0%, internet intervention: 16.0%), compared to the waitlist (32.4% and 42.2%, respectively). Mediation analyses demonstrated that reductions in RNT mediated the effect of the interventions on the prevalence of depression and generalized anxiety disorder. CONCLUSIONS: Results provide evidence for the efficacy of this preventive intervention targeting RNT and support a selective prevention approach that specifically targets a known risk factor to prevent multiple disorders. BACKGROUND: This randomized controlled trial evaluated the efficacy of a preventive intervention for anxiety disorders and depression by targeting excessive levels of repetitive negative thinking (RNT; worry and rumination) in adolescents and young adults."," Topper, M;  Emmelkamp, PM;  Watkins, E;  Ehring, T",2017.0, 10.1016/j.brat.2016.12.015,0,0,
946, The high burden of traumatic brain injury and comorbidities amongst homeless adults with mental illness," OBJECTIVE: characterize the prevalence of self‐reported head injury with loss of consciousness (LOC) and associated demographic, clinical and service use factors in a sample of homeless adults with mental illness. METHOD: Participants in the At Home/Chez Soi study were interviewed at the time of study enrollment regarding their history of head injuries, mental and physical health diagnoses and justice system and healthcare interactions. Sociodemographic and clinical data were also collected. RESULTS: Over half of the 2088 study respondents (52.6%, n = 1098) reported a history of head injury with a LOC, which was associated with several demographic, clinical and service use variables in this population. With respect to specific mental health conditions, a history of head injury with LOC was associated with higher odds of current depression (OR = 2.18, CI: 1.83‐2.60), manic episode or hypomanic episode (OR = 1.91, CI: 1.45‐2.50), PTSD (OR = 2.98, CI: 2.44‐3.65), panic disorder (OR = 2.37, CI:1.91‐2.93), mood disorder (OR = 1.78, CI: 1.40‐2.26) and alcohol (OR = 2.09, CI: 1.75‐2.49) and drug (OR = 1.73, CI: 1.46‐2.06) misuse disorders, but reduced odds of having diagnosis of a psychotic disorder (OR = 0.63, CI: 0.53‐0.76). A history of head injury with LOC was also associated with increased use of variety of services, including family medicine (OR = 1.33, CI: 1.12‐1.59), criminal justice system (OR = 1.50, CI: 1.25‐1.80) and the emergency department (OR = 1.03, CI: 1.01‐1.05). CONCLUSIONS: Amongst homeless adults with mental illness having a history of head injuries with LOC was independently associated with various adverse outcomes. These individuals constitute a high‐risk group who may benefit from specialized services."," Topolovec-Vranic, J;  Schuler, A;  Gozdzik, A;  Somers, J;  Bourque, PÉ;  Frankish, CJ;  Jbilou, J;  Pakzad, S;  Palma Lazgare, LI;  Hwang, SW",2017.0, 10.1016/j.jpsychires.2016.12.004,0,0,
947,"Distress, Psychotic Symptom Exacerbation, and Relief in Reaction to Talking about Trauma in the Context of Beneficial Trauma Therapy: Perspectives from Young People with Post-Traumatic Stress Disorder and First Episode Psychosis.","Of young people with first episode psychosis (FEP), over half report exposure to childhood trauma and consequent co-morbid post-traumatic stress disorder (PTSD) or symptoms. Currently no evidence-based interventions exist for PTSD in FEP. Clinicians report concerns that trauma-focused interventions with young people with FEP could result in distress and symptom exacerbation. Scant research suggests that talking about trauma in therapy can be distressing for some people. To explore young people's reactions to a trauma-focused treatment for PTSD in FEP. Semi-structured interviews were conducted with eight participants (age 18-27 years) with co-morbid PTSD and FEP, after completing a trauma-focused intervention. Transcripts were analysed using an interpretative phenomenological approach. Participants' baseline and end-of-treatment PTSD and psychotic symptoms were assessed. Three themes related to participants' reactions were identified from the analysis: (1) distress in session; (2) feeling relieved in and out of session; and (3) symptom exacerbation out of session. All but one participant reported experiencing increased distress in session. Four participants described PTSD, psychotic symptoms and/or suicidal ideation worsening in immediate reaction to talking about trauma in therapy sessions. 86% of participants showed improvement in their PTSD and psychotic symptoms at end of treatment. All participants described the intervention as beneficial and worthwhile. Results suggest that feelings of distress are to be expected from individuals with PTSD and FEP during trauma-focused treatment. Psychotic and PTSD symptom exacerbation can occur in PTSD treatment in FEP. Clinicians should be aware of, plan for, and clearly inform their clients of treatment risks.",Tong J.; Simpson K.; Alvarez-Jimenez M.; Bendall S.,2017.0,10.1017/S1352465817000236,0,0,
948,Cognitive-behavior therapy for concurrent anxiety and alcohol use disorder: A randomized control trial.,"Alcohol dependent individuals also diagnosed with an anxiety disorder were treated with one of two cognitive-behavioral treatments. Treatment ALC, consisting of 6 sessions of alcohol-specific treatment was compared to treatment ALCANX consisting of 6 sessions of alcohol-specific treatment followed by 4 anxiety-specific sessions. At the end-of-treatment no significant differences were found on measures of alcohol consumption or psychiatric (including anxiety) symptoms. Both groups improved to a significant degree. Implications for the cognitive-behavioral treatment of concurrent alcohol dependence and anxiety disorder are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Toneatto, Tony; Calderwood, Kim",2015.0,http://dx.doi.org/10.1007/s11469-014-9529-7,0,0,
949," Rhythm and orthopedics: the effect of music therapy in cast room procedures, a prospective clinical trial"," INTRODUCTION: Cast room procedures generally cause anxiety in patients. Anxiety complicates the procedure as well as increases the risk of a complication. Listening to music was found to be the safest and most common non‚Äêdrug treatment method. The aim of this study is to evaluate the effect of listening to music on adult patients in cast room procedures. This study points out the relation between anxiety and anxiety relevant cardiac arrhythmia. MATERIALS AND METHODS: The study was performed on 199 patients with stable general condition, aged above 18. The patients were divided into two groups. Randomization method used in the study was coin flip. The first group (Group 1) listened to music during cast room procedures whereby the second group (Group 2) did not listen to music. Length of the procedure, complication, blood pressure and heart rate evaluations before and after the procedure, Visual Analogue Scale (VAS scores for pain), State‚ÄêTrait Anxiety Inventory (STAI) anxiety score, patient satisfaction, willingness of the patient to repeat the procedure, P wave dispersion (Pd) and corrected QT interval dispersion (QTcd) as electrocardiographic arrhythmia predictors were evaluated. The Clinical Research Ethics Committee approval was obtained for this study. RESULTS: Significant difference was shown between the two groups for the following criteria: VAS scores (p‚ÄØ=‚ÄØ0.005), anxiety scores (p‚ÄØ=‚ÄØ0.032), processing time (p‚ÄØ=‚ÄØ0.027), and QTcd values (p‚ÄØ=‚ÄØ0.031). Patient satisfaction (p‚ÄØ<‚ÄØ0.001) and willingness to repeat the procedure (p‚ÄØ<‚ÄØ0.001) were higher for the group who listened to music. No significant difference in Pd values, blood pressure and heart rate was reported within the groups. CONCLUSION: Music therapy is a non‚Äêinvasive, safe, nonpharmacologic, anxiolytic, and analgesic treatment. Music therapy should become standard protocol in cast room procedures. One of the most important achievements of this study was the fact that music decreases anxiety and anxiety‚Äêrelated cardiac arrhythmia. Therefore, conducting further prospective studies including high cardiac risk patients especially with arrhythmia is crucial."," Tolunay, T;  Bicici, V;  Tolunay, H;  Akkurt, MO;  Arslan, AK;  Aydogdu, A;  Bingol, I",2018.0, 10.1016/j.injury.2018.02.008,0,0,
950,Low pre-treatment end-tidal CO2 predicts dropout from cognitive-behavioral therapy for anxiety and related disorders.,"Recent clinical trial research suggests that baseline low end-tidal CO2 (ETCO2, the biological marker of hyperventilation) may predict poorer response to cognitive-behavioral therapy (CBT) for anxiety-related disorders. The present study examined the predictive value of baseline ETCO2 among patients treated for such disorders in a naturalistic clinical setting. Sixty-nine adults with a primary diagnosis of a DSM-5 anxiety disorder, obsessive-compulsive disorder, or posttraumatic stress disorder completed a 4-min assessment of resting ETCO2, and respiration rate (the first minute was analyzed). Lower ETCO2 was not associated with a diagnosis of panic disorder, and was associated with lower subjective distress ratings on certain measures. Baseline ETCO2 significantly predicted treatment dropout: those meeting cutoff criteria for hypocapnia were more than twice as likely to drop out of treatment, and ETCO2 significantly predicted dropout beyond other pre-treatment variables. Weekly measurement suggested that the lower-ETCO2 patients who dropped out were not responding well to treatment prior to dropout. The present results, along with previous clinical trial data, suggest that lower pre-treatment ETCO2 is a negative prognostic indicator for CBT for anxiety-related disorders. It is suggested that patients with lower ETCO2 might benefit from additional intervention that targets respiratory abnormality.",Tolin DF.; Billingsley AL.; Hallion LS.; Diefenbach GJ.,2017.0,10.1016/j.brat.2016.12.005,0,0,
951,Subjective cognitive function in hoarding disorder.,"The aim of the present study was to examine subjective cognitive impairment among adult patients with hoarding disorder (HD). Eighty-three patients with HD and 46 age- and gender-matched healthy control (HC) participants received a diagnostic interview and completed measures of subjective cognitive functioning and motivations for saving behavior, as well as measures of hoarding severity, depression, anxiety, stress, and obsessive-compulsive disorder (OCD) symptoms. The HD group reported more impairment than did the HC group in domains of memory, distractibility, blunders, memory for names, and inattention. These differences generally remained significant when controlling for comorbid symptoms. In the HD group, the degree of cognitive impairment was significantly correlated with severity of saving and acquiring behaviors, although results were attenuated when controlling for comorbid symptoms (overall HD severity, but not saving behavior specifically, remained significantly correlated with cognitive impairment). Subjective cognitive impairment was further associated with a desire to save possessions in order to avoid forgetting, and these results remained significant when controlling for comorbid symptoms. These results comport with current behavioral models of HD that emphasize decision-making deficits, as well as clinician observations suggestive of impaired cognitive function, and complement a growing body of neuropsychological testing studies. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Tolin, David F; Hallion, Lauren S; Wootton, Bethany M; Levy, Hannah C; Billingsley, Amber L; Das, Akanksha; Katz, Benjamin W; Stevens, Michael C",2018.0,http://dx.doi.org/10.1016/j.psychres.2018.05.003,0,0,
952,Physiological and psychological effects of imagery techniques on health anxiety.,"Previous research has shown that intrusions are part of the psychopathology of mental disorders. Imagery techniques seem to be an effective treatment of negative intrusions. Since negative mental imagery is part of health anxiety, the present study investigated the impact of imagery techniques on health anxiety. A total of 159 students with elevated scores in a health anxiety questionnaire watched an aversive film concerning a cancer patient and were randomly allocated to one of three interventions (positive imagery, imagery reexperiencing, imagery rescripting) or the control group. The intervention lasted 9 min. Physiological data (heart rate and cortisol) as well as psychological measures, such as mood ratings, health anxiety scores, and intrusions, were assessed during the appointment, while psychological measures were assessed over a period of 1 week after the intervention. Cortisol levels changed over time depending on the intervention. Heart rate changed during the 9-min interventions as well, with the fastest decrease during imagery rescripting. Moreover, negative mood and distress decreased after the intervention, while intrusions were reduced 1 week after the intervention in all groups equally. The results suggest that imagery rescripting is a promising technique that seems to activate a process of deep elaboration. Therefore, it might be an adequate way to target health anxiety symptoms such as anxiety, intrusions, and avoidance or safety-seeking behavior. Further studies should focus on imagery rescripting in clinical samples with health anxiety and target individual intrusive images to increase effectiveness. Nevertheless, the development of a long-term explanatory model of rescripting is needed.",Tolgou T.; Rohrmann S.; Stockhausen C.; Krampen D.; Warnecke I.; Reiss N.,2018.0,10.1111/psyp.12984,0,0,
953,Coracoid bone block transfer procedure: Correlation between subscapularis volume below the bone graft and shoulder stability.,"Coracoid bone graft transfer has become the gold standard in patients with recurrent anterior shoulder instability associated with bony defect. Several studies have shown that the main stabilizing component of this procedure is the sling effect by the conjoint tendon and the lower portion of subscapularis (SS). The purpose of this study was to determine whether a larger SS volume below the bone block was correlated to greater postoperative shoulder stability. This prospective study included a cohort of patients who underwent open coracoid bone graft transfer for post-traumatic recurrent anterior shoulder instability. Forty patients were reviewed at 2 years with a clinical and CT scan evaluation. A correlation analysis assessed the relation between the SS volume index (ratio of SS volume below the bone block to volume over the bone block) and Rowe and Walch-Duplay instability scores. There exists a positive and significant correlation between SS volume index and postoperative Rowe score, r=0.37 (P=0.03). The same trend was observed for Walch-Duplay score without statistical significance. A larger inferior SS volume did not result in a limitation of external rotation, greater fatty infiltration, or malposition of the coracoid graft. A larger SS volume below the bone block is related to greater postoperative shoulder stability. We recommend performing the split in the middle of the SS or higher instead of the junction of the superior two-thirds and inferior one-third as usually reported. III, prospective study.",Toffoli A.; Teissier J.; Lenoir H.; Lazerges C.; Coulet B.; Cyteval C.; Chammas M.,2017.0,10.1016/j.otsr.2017.03.030,0,0,
954,Developing and applying Discrete Choice Experiments (DCEs) to inform pharmacy policy,"Introduction. In the United Kingdom (UK), recent policy developments include an increased role for the community phannacist in the management of drug therapy in primary care. When embarking on such service redesign, it is recognised that. patient preferences must be considered. The quality adjusted life years (QALY) approach is the common economic approach ~o 1'. considering preferences in economic evaluations. However, it is limited to consideration of - ·only health outcomes. Other approaches widely used in health services research, such as · satisfaction surveys, do not find a place in the economic eval~tion framework because they' do not incorporate any notion of opportunity cost or strength of preference. Another measure of benefit is required to go beyond the scope of the QALY and pla~e a value on non-health outcomes (e.g. information, reassurance, regret, anxiety) and process attributes (e.g. waiting · time at the ~ealth care centre, staff involyed, waiting time for test res!llts), as well as estimate trade-offs between such aspects ofcare. . . One technique adopted over the past decade in health economics to go beyond health outcome is Discrete Choice Experiment (DCEs). This is an attribute-based technique for eliciting preferenc~s. ~en a price proxy is included, willingness to pay (WTP), a monetary measure of benefit, can be estimated for both marginal changes in service characteristics and changes in the overall service. Whilst the last 15 years has seen an increased uSe of DeEs in health care, there has been limited application in pharmacy. The Community Pharmacy Medicines Management Project (Medman study) constituted the perfect platfonn for this PhD thesis. It was a large, randomised, controlled trial (ReT) to evaluate the introduction of a pharmacy-led medicines management service for patients with 'cQronary- heart -disease-(CHD): It- allowed comparison of results between traditional outcome measures (such as clinical outcomes, QALYs and satisfaction) and a broader measure of benefit llsing the DCE. As well as considering the relevance of DCE ·to policy making, methodological issues in their development were also considered. Aim and ·objectives. The aims of this PhD programme are: to consider the implications of ..taking a .broader patient centred approach (which goes beyond he~th outcomes) to ev~luating ' . a proposed policy change in community pharmacy; and to develop' and apply the DCE '. ' ~ . methodology to pharmacy. The specific objectives ofthe thesis are: • to conduct a review ofthe literature relating to benefit evaluation and its application to the economic evaluation framework in pharmacy; ' • to apply traditional benefit evaluation approaches, including' clinical outcomes, - . QALYs and a satisfaction survey to a' pharmacy setting;. jI ' i .J I' • to develop an alternative approach, DCEs, to value benefits, looking at different design appr?ache~ \\,~en defining multiple choice· DCEs and addressing welfare . estimation issJles when.analysing the data; • to apply DCE to phaimacy within the Medman .study and to compare the results with _these ofclinical and QALY approaches within an economic evaluation framework; • to consider the impact on policy when different approaches are applied. Methods. A fully comprehensive review of the health care literature was conducted to . identify possible methods for valuing community pharmacy-based services and their integration into economic evaluation.",Tinelli,2007.0,,0,0,
955,Clinical psychologist-administered cognitive behavioural therapy: Effectiveness for older adults in cognitive rehabilitation.,"Examined the effectiveness of clinical psychologist-administered cognitive behavioral therapy (CBT) for older adults in cognitive rehabilitation. 2 male and 5 female (aged 54-79 yrs) Ss who had been diagnosed with unipolar depression and generalized anxiety were selected. All Ss were offered a minimum of 2 hourly sessions of CBT. In practice, the mean duration of CBT was 6 hours according to clinical judgement of need. Ss were assessed at 2 points separated by a mean interval of 263 days. The Beck Depression Inventory II (BDI-II), and for 2 patients, the Hospital Anxiety and Depression Scale (HADS), was administered in addition to 9 orientation questions. All 7 patients showed improvements on their BD-II scores. In addition, 2 patients also showed improvement in their depression scores on the HADS. Using the Wilcoxon Signed Ranks test, all 7 Ss were found to have improved BD-II scores between assessments. BD-II scores and the number of hours of CBT were analyzed using the Spearman Rank Correlation but no significant correlation was found. Results of this small-scale study have shown that it is particularly worthwhile to consider CBT in cognitive rehabilitation for the treatment of depression and anxiety disorders in older adults in cognitive rehabilitation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Thompson, Simon B. N",2001.0,,0,0,
956, Modification of Fear Memory by Pharmacological and Behavioural Interventions during Reconsolidation," BACKGROUND: Dysfunctional fear responses play a central role in many mental disorders. New insights in learning and memory suggest that pharmacological and behavioural interventions during the reconsolidation of reactivated fear memories may increase the efficacy of therapeutic interventions. It has been proposed that interventions applied during reconsolidation may modify the original fear memory, and thus prevent the spontaneous recovery and reinstatement of the fear response. METHODS: We investigated whether pharmacological (propranolol) and behavioural (reappraisal, multisensory stimulation) interventions reduce fear memory, and prevent reinstatement of fear in comparison to a placebo control group. Eighty healthy female subjects underwent a differential fear conditioning procedure with three stimuli (CS). Two of these (CS+) were paired with an electric shock on day 1. On day 2, 20 subjects were pseudo‚Äêrandomly assigned to either the propranolol or placebo condition, or underwent one of the two behavioural interventions after one of the two CS+ was reactivated. On day 3, all subjects underwent an extinction phase, followed by a reinstatement test. Dependent variables were US expectancy ratings, fear‚Äêpotentiated startle, and skin conductance response. RESULTS: Differential fear responses to the reactivated and non‚Äêreactivated CS+ were observed only in the propranolol condition. Here, the non‚Äêreactivated CS+ evoked stronger fear‚Äêpotentiated startle‚Äêresponses compared to the placebo group. None of the interventions prevented the return of the extinguished fear response after re‚Äêexposure to the unconditioned stimulus. CONCLUSIONS: Our data are in line with an increasing body of research stating that the occurrence of reconsolidation may be constrained by boundary conditions such as subtle differences in experimental manipulations and instructions. In conclusion, our findings do not support a beneficial effect in using reconsolidation processes to enhance effects of psychotherapeutic interventions. This implies that more research is required before therapeutic interventions may benefit from a combination with reconsolidation processes."," Thome, J;  Koppe, G;  Hauschild, S;  Liebke, L;  Schmahl, C;  Lis, S;  Bohus, M",2016.0, 10.1371/journal.pone.0161044,0,0,
957, A randomised controlled study of the effectiveness of breathing retraining exercises taught by a physiotherapist either by instructional DVD or in face-to-face sessions in the management of asthma in adults," BACKGROUND: Asthma control is suboptimal, resulting in quality of life (QoL) impairment and costs. Breathing retraining exercises have evidence of effectiveness as adjuvant treatment, but are infrequently used. OBJECTIVES: To transfer the contents of a brief (three‚Äêsession) physiotherapist‚Äêdelivered breathing retraining programme to a digital versatile disc (DVD) and booklet format; to compare the effectiveness of the self‚Äêguided intervention with that of 'face‚Äêto‚Äêface' physiotherapy and usual care for QoL and other asthma‚Äêrelated outcomes; to perform a health economic assessment of both interventions; and to perform a process evaluation using quantitative and qualitative methods. DESIGN: Parallel‚Äêgroup three‚Äêarm randomised controlled trial. SETTING: General practice surgeries in the UK. PARTICIPANTS: In total, 655 adults currently receiving asthma treatment with impaired asthma‚Äêrelated QoL were randomly allocated to the DVD ( INTERVENTIONS: Physiotherapy‚Äêbased breathing retraining delivered through three 'face‚Äêto‚Äêface' respiratory physiotherapist sessions or a self‚Äêguided programme (DVD plus our theory‚Äêbased behaviour change booklet) developed by the research team, with a control of usual care. MAIN OUTCOME MEASURES: The primary outcome measure was asthma‚Äêspecific QoL, measured using the Asthma Quality of Life Questionnaire (AQLQ). Secondary outcomes included asthma symptom control [Asthma Control Questionnaire (ACQ)], psychological state [Hospital Anxiety and Depression Scale (HADS)], hyperventilation symptoms (Nijmegen questionnaire), generic QoL [EuroQol‚Äê5 Dimensions (EQ‚Äê5D)], assessments of airway physiology (spirometry) and inflammation (exhaled nitric oxide) and health resource use and costs. Assessments were carried out at baseline and at 3, 6 and 12 months post randomisation. Patient engagement and experience were also assessed using quantitative and qualitative methods. RESULTS: Primary efficacy analysis was between‚Äêgroup comparison of changes in AQLQ scores from baseline to 12 months in the intention‚Äêto‚Äêtreat population with adjustments for prespecified covariates. Significant improvements occurred in the DVD group compared with the control group [adjusted mean difference 0.28, 95% confidence interval (CI) 0.11 to 0.44; CONCLUSIONS: Only 10% of the potentially eligible population responded to the study invitation. However, breathing retraining exercises improved QoL and reduced health‚Äêcare costs in adults with asthma whose condition remains uncontrolled despite standard pharmacological therapy, were engaged with well by patients and can be delivered effectively as a self‚Äêguided intervention. The intervention should now be transferred to an internet‚Äêbased platform and implementation studies performed. Interventions for younger patients should be developed and trialled. TRIAL REGISTRATION: Current Controlled Trials ISRCTN88318003. FUNDING: This project was primarily funded by the NIHR Health Technology Assessment programme and will be published in full in"," Thomas, M;  Bruton, A;  Little, P;  Holgate, S;  Lee, A;  Yardley, L;  George, S;  Raftery, J;  Versnel, J;  Price, D;  et al.",2017.0, 10.3310/hta21530,0,0,
958, Feasibility and Safety of a Virtual Reality Dodgeball Intervention for Chronic Low Back Pain: a Randomized Clinical Trial," Whereas the fear‚Äêavoidance model of chronic low back pain (CLBP) posits a generic avoidance of movement that is perceived as threatening, we have repeatedly shown that individuals with high fear and CLBP specifically avoid flexion of the lumbar spine. Accordingly, we developed a virtual dodgeball intervention designed to elicit graded increases in lumbar spine flexion while reducing expectations of fear and harm by engaging participants in a competitive game that is entertaining and distracting. We recruited 52 participants (48% female) with CLBP and high fear of movement and randomized them to either a game group (n = 26) or a control group (n = 26). All participants completed a pregame baseline and a follow‚Äêup assessment (4‚Äê6 days later) of lumbar spine motion and expectations of pain and harm during standardized reaches to high (easier), middle, and low (hardest to reach) targets. For 3 consecutive days, participants in the game group completed 15 minutes of virtual dodgeball between baseline and follow‚Äêup. For the standardized reaching tests, there were no significant effects of group on changes in lumbar spine flexion, expected pain, or expected harm. However, virtual dodgeball was effective at increasing lumbar flexion within and across gameplay sessions. Participants reported strong positive endorsement of the game, no increases in medication use, pain, or disability, and no adverse events. Although these findings indicate that very brief exposure to this game did not translate to significant changes outside the game environment, this was not surprising because graded exposure therapy for fear of movement among individuals with low back pain typically last 8 to 12 sessions. Because of the demonstration of safety, feasibility, and ability to encourage lumbar flexion within gameplay, these findings provide support for a clinical trial wherein the treatment dose is more consistent with traditional graded exposure approaches to CLBP. PERSPECTIVE: This study of a virtual reality dodgeball intervention provides evidence of feasibility, safety, and utility to encourage lumbar spine flexion among individuals with CLBP and high fear of movement."," Thomas, JS;  France, CR;  Applegate, ME;  Leitkam, ST;  Walkowski, S",2016.0, 10.1016/j.jpain.2016.08.011,0,0,
959,Factors relating to emotional distress after stroke,"Emotional distress is common after stroke and has a negative impact on rehabilitation outcome. The aim of this thesis was to identify factors relating to emotional distress after stroke to inform future interventions. This thesis developed a theoretical framework to guide the study of emotional distress and included stroke and demographic characteristics, background information, disability (personal and extended activities of daily living and aphasia) and psychosocial factors (coping, locus of control and social support). This thesis consisted of three studies. The first study developed and validated the Stroke Cognitions Questionnaire Revised (SCQR), as previous studies used cognitions assessments not appropriate for this population. The SCQR assesses the frequency of positive and negative stroke-related cognitions. The scale was developed from treatment notes of depressed stroke patients. The scale had high internal consistency, inter-rater and test retest reliability, and concurrent validity. Depression (Beck Depression Inventory; BDI) was characterized by a preponderance of negative cognitions and, to a lesser extent, a decrement in positive cognitions. This supports the cognitive model of depression. The second study evaluated factors that predicted the severity of depression in a sample of 112 depressed patients recruited to a randomised controlled trial of cognitive behaviour therapy between one and six months post-stroke. Communication impairment (Sheffield Screening Test for Acquired Language Disorders; SST) at recruitment was predictive of severe depression (BDI) at recruitment. Patients with greater communication impairment (SST) and a more external locus of control (Recovery Locus of Control Scale; RLOC) at recruitment were more likely to remain depressed at six months follow-up. Patients who remained depressed at follow-up were more severely depressed at recruitment. The main study of this thesis evaluated the proposed theoretical framework of emotional distress. In a prospective longitudinal study, 100 patients were recruited from hospital at one month post-stroke and assessed on communication (SST), personal activities of daily living (ADL; Barthel Index), distress (Visual Analogue Mood Scales, Visual Analogue Self-Esteem Scale and Stroke Aphasic Depression Questionnaire). Patients who were not aphasic completed additional assessments of distress (Hospital Anxiety and Depression Scale, Beck Depression Inventory II), recovery locus of control (RLOC), coping (Brief COPE) and cognitions (SCQR). Patients were reassessed on the same measures at six months (n=92), in addition to extended ADL (Extended ADL Index) and social support (Significant Others Scale; SOS). Communication impairment and dependence in personal ADL were predictive of distress at one month. Communication impairment and dependence in extended ADL were predictive of distress at six months. In non aphasic patients, externality of locus of control was also predictive of distress at one months and six months and actual social support was predictive of distress at six months. The relationship between coping and distress was mediated by locus of control. Distress remained persistent at six months post-stroke. The factors found to predict distress (communication impairment, recovery locus of control and activity level) will help identify patients at risk of distress. Also, this demonstrates the need to include aphasic patients. The risk factors are amenable to psychological intervention, such as cognitive behaviour therapy and coping skills training. Future research should evaluate the proposed interventions.",Thomas,2006.0,,0,0,
960,"Exclusive, conflict-centered treatment or integration: Different mechanisms of change in panic and agoraphobia by client-centered therapy alone and in combination with behavioral exposure.","The mechanisms of change due to different psychotherapeutic treatments of anxiety disorders are the subject of the present study. Sixty-eight patients with agoraphobia and panic (DSM III R No. 300.21, ICD 10 No. F 40.01) were included, exclusively treated with client-centered treatment (n = 28) or with additional behavioral exposure treatment (n = 40) in an inpatient setting. The patients were examined on admission, at discharge, and at 6 and 12 months follow-ups with the Structured Clinical Interview for DSM III R (SKID), the Freiburg Personality Inventory (FPI R), and the Giessen Test (GIESS). Both treatment modalities significantly reduced panic and avoidance. Differences were found in personality scales. The support of autonomy was superior by client-centered treatment alone: client-centered treated (CCT) patients felt less dependent on the expectations of others, less under stress, and had fewer psychosomatic complaints. Patients with additional exposure treatment feel accepted by their social environment earlier. The results are discussed with regard to open questions of therapy integration and different mechanisms of change. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Teusch, L; Bohme, H; Finke, J",2001.0,http://dx.doi.org/10.1007/s001150050709,0,0,
961, The Cognitive Remediation in Bipolar (CRiB) pilot study: study protocol for a randomised controlled trial," BACKGROUND: People with bipolar disorder often show difficulties with cognitive functioning, and though these difficulties are identified as important targets for intervention, few treatment options are available. Preliminary evidence suggests that cognitive remediation therapy (a psychological treatment proven beneficial for people diagnosed as having schizophrenia) is helpful for people with bipolar disorders. We are conducting a pilot trial to determine whether individual, computerised, cognitive remediation therapy (CRT) for people with bipolar disorder 1) increases cognitive function; 2) improves global functioning, goal attainment and mood symptoms; 3) is acceptable and feasible for participants; and 4) can be addressed in a comprehensive, larger, randomised, controlled trial. METHODS/DESIGN: The study is designed as a two‚Äêarm, randomised, controlled trial comparing cognitive remediation therapy with treatment‚Äêas‚Äêusual (TAU) for euthymic bipolar patients. Participants are eligible to take part if aged between 18 and 65 with a diagnosis of bipolar disorder (type I) and currently in euthymic state, and no neurological, substance or personality disorder diagnoses. Sixty participants will be recruited (mainly through secondary and tertiary care) and will be block‚Äêrandomised to receive either treatment‚Äêas‚Äêusual alone or in addition to a 12‚Äêweek course of cognitive remediation therapy totalling 20‚Äê40 therapy hours. The intervention will comprise regular sessions with a therapist and computer‚Äêbased training. Research assessments will take place before and after the intervention period and at a 12‚Äêweek follow‚Äêup, and will include evaluation of neuropsychological, symptom‚Äêrelated, demographic and social factors, as well as collecting qualitative data regarding CRT expectations and satisfaction. Intention‚Äêto‚Äêtreat analyses will examine the efficacy of cognitive remediation therapy primarily on cognition and additionally on functioning, quality of life and mood symptoms. Furthermore, we will examine the acceptability of CRT and undertake a preliminary health economics analysis to ascertain the cost of delivering the intervention. DISCUSSION: The results of this trial will provide valuable information about whether cognitive remediation therapy may be beneficial for people diagnosed with bipolar disorder in a euthymic state. TRIAL REGISTRATION: ISRCTN registry, ISRCTN32290525 . Registered on 2 March 2016."," Strawbridge, R;  Fish, J;  Halari, R;  Hodsoll, J;  Reeder, C;  Macritchie, K;  McCrone, P;  Wykes, T;  Young, AH",2016.0, 10.1186/s13063-016-1472-4,0,0,
962, Compensatory Cognitive Training for Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans With Mild Traumatic Brain Injury," METHOD: One hundred nineteen OEF/OIF/OND Veterans with history of mild traumatic brain injury participated at 3 sites, and 50 of the Veterans were randomized to CCT group, while 69 Veterans were randomized to the usual care control group. The CCT group participated in 10 weeks of CCT. Both CCT and usual care groups were assessed at baseline, 5 weeks (midway through CCT), 10 weeks (immediately following CCT), and 15 weeks (5‚Äêweek follow‚Äêup) on measures of subjective cognitive complaints, use of cognitive strategies, psychological functioning, and objective cognitive performance. RESULTS: Veterans who participated in CCT reported significantly fewer cognitive and memory difficulties and greater use of cognitive strategies. They also demonstrated significant improvements on neurocognitive tests of attention, learning, and executive functioning, which were 3 of the cognitive domains targeted in CCT. CONCLUSIONS: Findings indicate that training in compensatory cognitive strategies facilitates behavioral change (ie, use of cognitive strategies) as well as both subjective and objective improvements in targeted cognitive domains. OBJECTIVE: The purpose of the study was to evaluate the efficacy of group‚Äêbased compensatory cognitive training (CCT) for Operation Enduring Freedom (OEF)/Operation Iraqi Freedom(OIF)/Operation New Dawn (OND) Veterans with a history of mild traumatic brain injury."," Storzbach, D;  Twamley, EW;  Roost, MS;  Golshan, S;  Williams, RM;  O ºNeil, M;  Jak, AJ;  Turner, AP;  Kowalski, HM;  Pagulayan, KF;  et al.",2017.0, 10.1097/HTR.0000000000000228,0,0,
963,Individual differences in emotion-cognition interactions: Emotional valence interacts with serotonin transporter genotype to influence brain systems involved in emotional reactivity and cognitive control,"The serotonin transporter gene (5-HTTLPR) influences emotional reactivity and attentional bias towards or away from emotional stimuli, and has been implicated in psychopathological states, such as depression and anxiety disorder. The short allele is associated with increased reactivity and attention towards negatively-valenced emotional information, whereas the long allele is associated with increased reactivity and attention towards positively-valenced emotional information. The neural basis for individual differences in the ability to exert cognitive control over these bottom-up biases in emotional reactivity and attention is unknown, an issue investigated in the present study. Healthy adult participants were divided into two groups, either homozygous carriers of the 5-HTTLPR long allele or homozygous carriers of the short allele, and underwent functional magnetic resonance imaging (fMRI) while completing an Emotional Strooplike task that varied in the congruency of task-relevant and task-irrelevant information and the emotional valence of the task-irrelevant information. Behaviorally, participants demonstrated the classic ""Stroop effect"" (responses were slower for incongruent than congruent trials), which did not differ by 5-HTTLPR genotype. However, fMRI results revealed that genotype influenced the degree to which neural systems were engaged depending on the valence of the conflicting task-irrelevant information. While the ""Long"" group recruited prefrontal control regions and superior temporal sulcus during conflict when the task-irrelevant information was positively-valenced, the Short group recruited these regions during conflict when the task-irrelevant information was negatively valenced. Thus, participants successfully engaged cognitive control to overcome conflict in an emotional context using similar neural circuitry, but the engagement of this circuitry depended on emotional valence and 5-HTTLPR status. These results suggest that the interplay between emotion and cognition is modulated, in part, by a genetic polymorphism that influences serotonin neurotransmission. © 2013 Stollstorff, Munakata, Jensen, Guild, Smolker, Devaney and Banich.",Stollstorff M.; Munakata Y.; Jensen A.P.C.; Guild R.M.; Smolker H.R.; Devaney J.M.; Banich M.T.,2013.0,10.3389/fnhum.2013.00327,0,0,
964, Effectiveness of a Self-Care Toolkit for Surgical Breast Cancer Patients in a Military Treatment Facility," OBJECTIVE: To assess whether a self‐care toolkit (SCT) provided to breast cancer patients undergoing surgery could mitigate distress and lessen symptoms associated with surgery. DESIGN: One hundred women with breast cancer, planning to undergo initial surgery, were randomly assigned to either one of two groups: treatment as usual (TAU; n = 49) or TAU with the addition of an SCT (n = 51). The SCT contained an MP3 player with audio‐files of guided mind‐body techniques (breathing, progressive muscle relaxation, meditation, guided imagery, and self‐hypnosis) and acupressure antinausea wristbands. Anxiety, pain, nausea, sleep, fatigue, global health, and quality of life (QOL) were assessed using validated outcome measures. Two inflammatory blood markers (erythrocyte sedimentation rate [ESR] and C‐reactive protein [CRP]) were measured serially. Data were collected at baseline (T1), immediately before surgery (T2), within 10 h postoperatively (T3), and ∼2 weeks postsurgery (T4). SETTINGS: Numerous studies have shown that psychological distress associated with a cancer diagnosis can affect pain perception and QOL. RESULTS: Between T1 and T4, there were significant between‐group differences in Patient‐Reported Outcomes Measurement Information System (PROMIS)‐57 scores of Pain Interference, Fatigue, and Satisfaction with Social Roles, favoring the SCT group compared with TAU (p = 0.005, p = 0.023, and p = 0.021, respectively). There was a significant mean change in Defense and Veterans Pain Rating Scale (DVPRS) scores from T2 to T3, with the SCT group having significantly smaller increases in postoperative pain (p = 0.008) and in postoperative ESR (p = 0.0197) compared with the TAU group. Clinically significant reductions in anxiety occurred in the SCT group during the main intervention period. CONCLUSION: These results suggest that using the SCT in the perioperative period decreased pain perceptions, fatigue, and inflammatory cytokine secretion."," Stoerkel, E;  Bellanti, D;  Paat, C;  Peacock, K;  Aden, J;  Setlik, R;  Walter, J;  Inman, A",2018.0, 10.1089/acm.2018.0069,0,0,
965,Cognitive-behavioral therapy for adult anxiety disorders in clinical practice: A meta-analysis of effectiveness studies.,"The efficacy of cognitive-behavioral therapy (CBT) for anxiety in adults is well established. In the present study, the authors examined whether CBT tested under well-controlled conditions generalizes to less-controlled, real-world circumstances. Fifty-six effectiveness studies of CBT for adult anxiety disorders were located and synthesized. Meta-analytic effect sizes are presented for disorder-specific symptom measures as well as symptoms of generalized anxiety and depression for each disorder, and benchmarked to results from randomized controlled trials. All pretest-posttest effect sizes for disorder-specific symptom measures were large, suggesting that CBT for adult anxiety disorders is effective in clinically representative conditions. Six studies included a control group, and between-groups comparisons yielded large effect sizes for disorder-specific symptoms in favor of CBT. Benchmarking indicated that results from effectiveness studies were in the range of those obtained in selected efficacy trials. To test whether studies that are more representative of clinical settings have smaller effect sizes, the authors coded studies for 9 criteria for clinical representativeness. Results indicate an inverse relationship between clinical representativeness and outcome, but the magnitude of the relationship is quite small. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stewart, Rebecca E; Chambless, Dianne L",2009.0,http://dx.doi.org/10.1037/a0016032,0,0,
966,Hermeneutical phenomenology : girls with Asperger's syndrome and anxiety and Western herbal medicine,"Anxiety in young people with Asperger's syndrome (AS) is of serious concern. With a greater prevalence of girls with AS than previously considered, there is a paucity of research into experiences of anxiety in this population. Girls with AS and their parents may seek help through professional Western Herbal Medicine (WHM), the practice of which has little research evidence. The aim of this study is to explore experiences of girls in Scotland with AS and anxiety during a course of WHM treatment, described by the girls, their mothers and the herbalists. A Hermeneutical or Interpretive Phenomenological longitudinal case-study approach included a purposive sample of 3 girls, their mothers and 3 Western Medical Herbalists (WMH) (n=9). Innovative methods developed to address specific needs of the girls comprised of licensed computer interview software ‘In My Shoes' and an online diary facility. Individual interviews took place with all participants, second interviews held with girls and mothers, were transcribed verbatim and thematic analysis carried out. The study was endorsed by Edinburgh Napier University Faculty of Health, Life and Social Sciences Research Ethic and Governance Committee and the National Autistic Society. Informed consent was given by all participants. Where can we be what we are? was identified as a theme within a narrative of marginalisation in which individuals whose needs are marginalised turn to a treatment marginalised within the prevailing biomedical health care model. Anxiety manifests in girls with AS in a number of ways including chronic insomnia, emotional outbursts and school refusal. The WHM treatment had beneficial effects. However, access to, and compliance with, the treatment, may be inequitable. There is an urgent need for greater support for girls with AS and families, with an evidence base underpinning appropriate intervention. Diagnosis needs to be accompanied by acceptance in society and the availability of future opportunities. Further qualitative research in this area would increase insight and understanding and provide support for the development of larger scale studies. The creation of ‘best practice' guidelines in WHM for the treatment of girls with AS is recommended as is a pragmatic clinical trial of WHM for girls with AS and anxiety. key terms: Girls, Asperger's, anxiety, Western Herbal Medicine, hermeneutic interpretive phenomenology, methods, In My Shoes",Stewart,2010.0,,0,0,
967,A transdiagnostic examination of decreased intolerance of uncertainty and treatment outcome.,"Intolerance of uncertainty (IU) is characterized by negative beliefs and reactions to uncertainty. IU is present in emotional disorders and may be a mechanism of change in treatment . There are two components of IU, prospective and inhibitory IU, that may be differentially associated with outcome. The current study tested associations between pre- and post-treatment changes in the components of IU, symptoms of anxiety and depression, and treatment outcome in a large diagnostically heterogeneous partial hospital sample. Results suggested that social anxiety disorder was associated with greater pre-treatment prospective and inhibitory IU scores than those without the diagnosis. Results also showed that inhibitory IU predicted change in anxiety and depression symptoms and prospective IU and depression reductions predicted improvements in overall psychological health and psychological inflexibility. Only change in depression predicted improvement in interpersonal relationships throughout treatment. Clinical and theoretical implications of the findings are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Stevens, Kimberly; Rogers, Travis; Campbell, Moselle; Bjorgvinsson, Throstur; Kertz, Sarah",2018.0,http://dx.doi.org/10.1080/16506073.2017.1338311,0,0,
968,Enhancing the Efficacy of Cognitive Bias Modification for Social Anxiety,"Cognitive bias modification for interpretation (CBM-I) is a promising treatment modality for social anxiety disorder, but effect sizes are relatively small across investigations (Hallion & Ruscio, 2011). Additionally, the extent to which CBM-I impacts other cognitive, emotional, and behavioral outcomes is unclear. This study investigated whether two empirically supported treatment components for anxiety disorders, imaginal exposure (IE) and relaxation, augment the effects of CBM-I and increase the extent to which the effects of CBM-I generalize to behavioral and affective outcomes. We randomly assigned 111 undergraduate students with social anxiety to undergo IE, relaxation, or neutral thinking prior to CBM-I, then measured their interpretation biases, as well as their speaking time, anxiety, and subjective evaluations of performance during a speech task. Results indicated that individuals who received IE prior to CBM-I evidenced more adaptive interpretation biases and less behavioral avoidance during the speech task than did individuals who engaged in relaxation or neutral thinking. However, they did not report differential anxiety, habituation, or evaluations of their performance on the speech task. These findings suggest that the combination of CBM-I with adjunct components that target behavioral, rather than cognitive, mechanisms can facilitate transfer of the effects of CBM-I to reducing behavioral avoidance.",Stevens E.S.; Behar E.; Jendrusina A.A.,2018.0,10.1016/j.beth.2018.02.004,0,0,
969,Effectiveness and feasibility of Narrative Exposure Therapy (NET) in patients with borderline personality disorder and posttraumatic stress disorder - a pilot study.,"This pilot study focused on the feasibility and potential effectiveness of a protocol based on Narrative Exposure Therapy (NET) that was integrated into a standard inpatient program to treat patients with comorbid Borderline Personality Disorder (BPD) and Posttraumatic Stress Disorder (PTSD). Eleven patients (1 male, 10 female) without previous stabilization periods or the absence of intentional self-injury received NET during a ten-week inpatient program. Patients were assessed again at post-treatment and a 12-month follow-up. Drop-out rates during treatment were low, with 90.9 % completing NET. Furthermore, acceptance of NET was high, with only one patient rejecting treatment. The program was safe because it did not lead to aggravations in symptom severity at either the post-treatment or 12-month follow-up. Additionally, the rate of self-harming behaviors throughout the treatment phase was low (18.2 %). In fact, treatment was associated with positive effects on PTSD and BPD symptom severity as well as secondary outcome measures, including depression, dissociation and quality of life. The present study found that NET is feasible and safe in an inpatient setting for treating highly burdened patients with BPD and PTSD. There is also evidence for the potential effectiveness of NET in this highly burdened population. ClinicalTrials.gov Identifier: NCT02517723 . Registered 6 January 2014.",Steuwe C.; Rullkötter N.; Ertl V.; Berg M.; Neuner F.; Beblo T.; Driessen M.,2016.0,10.1186/s12888-016-0969-4,0,0,
970,Changes in Mindfulness and Posttraumatic Stress Disorder Symptoms Among Veterans Enrolled in Mindfulness-Based Stress Reduction.,"The current study assessed associations between changes in 5 facets of mindfulness (Acting With Awareness, Observing, Describing, Non-Reactivity, and Nonjudgment) and changes in 4 posttraumatic stress disorder (PTSD) symptom clusters (Re-Experiencing, Avoidance, Emotional Numbing, and Hyperarousal symptoms) among veterans participating in mindfulness-based stress reduction (MBSR). Secondary analyses were performed with a combined data set consisting of 2 published and 2 unpublished trials of MBSR conducted at a large Veterans Affairs hospital. The combined sample included 113 veterans enrolled in MBSR who screened positive for PTSD and completed measures of mindfulness and PTSD symptoms before and after the 8-week intervention. Increases in mindfulness were significantly associated with reduced PTSD symptoms. Increases in Acting With Awareness and Non-Reactivity were the facets of mindfulness most strongly and consistently associated with reduced PTSD symptoms. Increases in mindfulness were most strongly related to decreases in Hyperarousal and Emotional Numbing. These results extend previous research, provide preliminary support for changes in mindfulness as a viable mechanism of treatment, and have a number of potential practical and theoretical implications.",Stephenson KR.; Simpson TL.; Martinez ME.; Kearney DJ.,2017.0,10.1002/jclp.22323,0,0,
971, Addressing Patient Emotional and Existential Needs During Serious Illness: results of the Outlook Randomized Controlled Trial," CONTEXT: Few interventions exist to address patients' existential needs. OBJECTIVES: Determine whether an intervention to address seriously ill patients' existential concerns improves preparation, completion (elements of quality of life [QOL] at end of life), and reduces anxiety and depression. METHODS: A randomized controlled trial comparing outlook intervention, relaxation meditation (RM), and usual care (UC). Measures included primary‚Äêa validated measure of QOL at the end of life and secondary‚ÄêFunctional Assessment of Cancer Therapy‚ÄêGeneral, anxiety (Profile of Mood States), depression (Center for Epidemiological Studies‚ÄêDepression Scale), and spiritual well‚Äêbeing (Functional Assessment of Chronic Illness Therapy‚ÄêSpiritual Well‚ÄêBeing). Qualitative interviews assessed outlook intervention acceptability. Enrolled patients were nonhospice eligible veterans with advanced cancer, congestive heart failure, chronic obstructive pulmonary disease, end‚Äêstage renal disease, or end‚Äêstage liver disease. RESULTS: Patients (n = 221) were randomly assigned 1:1:1 to outlook, RM, and UC. Patients were 96% males, 46% with cancer, 58.4% married, and 43.9% of African American origin. Compared with UC, outlook participants had higher preparation (a validated measure of QOL at the end of life) (mean difference 1.1; 95% CI 0.2, 2.0; P = 0.02) and mean completion (1.6; 95% CI 0.05, 3.1; P = 0.04) at the first but not second postassessment. Compared with RM, outlook participants did not show significant differences over time. Exploratory analyses indicated that in subgroups with cancer and low sense of peace, outlook participants had improved preparation at first and not second postassessment, as compared with UC (mean difference 1.4; 95% CI 0.03, 2.7; P = 0.04) (mean difference = 1.8; 95% CI 0.3, 3.3; P = 0.02), respectively. CONCLUSION: Outlook had an impact on social well‚Äêbeing and preparation compared with UC. The lack of impact on anxiety and depression differs from previous results among hospice patients. Results suggest that outlook is not demonstratively effective in populations not experiencing existential or emotional distress."," Steinhauser, KE;  Alexander, S;  Olsen, MK;  Stechuchak, KM;  Zervakis, J;  Ammarell, N;  Byock, I;  Tulsky, JA",2017.0, 10.1016/j.jpainsymman.2017.06.003,0,0,
972,Comorbid social phobia and major depressive disorder: The influence of remission from depression on quality of life and functioning.,"Social phobia (SP) and major depressive disorder (MDD) are frequently concurrent, which negatively affects quality of life (QOL), functioning, and depressive symptom severity. We hypothesized individuals with comorbid SP and MDD (MDD + SP) would have worse treatment outcomes than those with MDD alone (MDDnoSP), but that both groups would have significant responses to treatment, and those who achieved MDD remission would have the best increases in QOL and functioning. We analyzed data for 2280 adults who received citalopram monotherapy in phase 1 of the NIH-funded Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Participants (82 MDD + SP and 2198 MDDnoSP) with complete entry and exit scores across QOL, functioning, and depressive symptom severity were examined. MDD remission status following treatment was determined. Patient-reported QOL and functioning scores were classified as within-normal or severely-impaired. No significant between-group differences were observed across all outcomes at entry or exit. Both groups experienced significant improvements in QOL and functioning (all p values < .01, Cohen's d values > .77). Although non-significant, the MDD + SP group was more likely to achieve within-normal scores and MDD remission post-treatment. Findings were interesting as we initially expected the MDD + SP participants to have worse outcomes, yet those with MDD alone had a more chronic course. Regardless, participants who were able to achieve MDD remission post-treatment had significantly better improvements in QOL and functioning. Accordingly, researchers and clinicians should utilize QOL and functioning measures when examining treatment effectiveness, while also considering the role of remission from major depressive disorder on quality of life. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Steiner, Alexander Joseph; Wright, Stephanie Marie; Kuhn, Taylor; IsHak, Waguih William",2017.0,http://dx.doi.org/10.1007/s11482-016-9485-4,0,0,
973, Intervention Efficacy in Engaging Black and White Veterans with Post-traumatic Stress Disorder into Treatment," This study examined racial differences among Black and White Veterans who screened positive for post‚Äêtraumatic stress disorder (PTSD) but were not in PTSD treatment and were participating in an intervention trial. Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans with PTSD but not yet engaged in treatment were recruited and randomly assigned to control or intervention conditions. Intervention participants received a cognitive‚Äêbehavioral engagement intervention by phone. All participants received follow‚Äêup calls to assess symptoms and utilization of treatment. Black and White participants were compared to assess differences in treatment utilization. Intervention session notes were analyzed qualitatively for explanatory themes. Participants of both races who received the intervention had higher PTSD treatment initiation than their respective control groups (Blacks: 85% vs. 58% and Whites: 53% vs. 45%, respectively). However, Blacks completed fewer PTSD treatment sessions compared to Whites overall (M = 2.06 [SD = 2.3] vs. M = 3.77 [SD = 9.9]; p < .05). Within the intervention condition, Blacks were significantly more likely to initiate treatment (odds ratio = 2.3, p < .04), and had a greater reduction in PTSD symptom compared to Whites (PTSD Checklist ‚Äê Military Version [PCL] scores: 12.75 vs. 9.68). Based on qualitative analysis of intervention session notes, themes emerged that may suggest cultural differences involving social connection, attitudes towards treatment, and the desire to appear ""okay."" Blacks had a higher initiation rate and greater reduction in PTSD severity but completed fewer treatment sessions than Whites. These are promising results with respect to other studies which demonstrate that Black Veterans are less likely to seek treatment for PTSD."," Stecker, T;  Adams, L;  Carpenter-Song, E;  Nicholson, J;  Streltzov, N;  Xie, H",2016.0, 10.1080/19371918.2016.1160340,0,0,
974,Modifying obsessive-compulsive beliefs about controlling one's thoughts.,"Cognitive models of obsessive-compulsive disorder propose that beliefs about the importance of and need to control thoughts (ICT) are central to the maintenance of the disorder. Cognitive Bias Modification for Interpretation (CBM-I) can be used to experimentally test this theory and may also have clinical utility as an adjunct therapeutic tool. The current study extended previous research to investigate whether two CBM-I sessions (one within and one outside the laboratory) would augment effects on obsessive-compulsive beliefs and behavior. We randomly allocated undergraduate participants high in ICT beliefs to a Positive (n = 30) or Control (n = 36) CBM-I condition and conducted multi-modal assessments immediately following the first training and at one-week follow-up. As predicted, participants in the Positive condition reported a reduction in obsessive-compulsive beliefs from baseline to follow-up (partial eta2 = .42), whereas those in the Control condition did not. Participants responded more adaptively to the ICT relevant stressor task at follow-up compared to post-intervention, but there was no significant difference between conditions. Likewise, participants reported a reduction in obsessive symptoms over time that did not differ between conditions. The findings are considered in light of cognitive models of OCD, and clinical implications are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Stech, Eileen P; Grisham, Jessica R",2017.0,http://dx.doi.org/10.1007/s10862-017-9603-0,0,0,
975,Secondary psychological outcomes in a controlled trial of Emotional Freedom Techniques and cognitive behaviour therapy in the treatment of food cravings.,"Examining the effectiveness of psychological interventions in treating secondary psychological outcomes of obesity has become prioritized in recent times. The objective of the present study was to compare an eight-week Cognitive-Behavioural Therapy (CBT) and Emotional Freedom Techniques (EFT) intervention program, in the treatment of food cravings and secondary psychological outcomes among overweight or obese adults (N = 83). A controlled non-inferiority trial was performed comparing group-delivered CBT to group-delivered EFT. Participants completed the Patient Health Questionnaire at pre- and post-intervention, and at six and 12-months follow-up. The CBT group did not report any significant changes in anxiety scores over time, but the decrease in depression symptoms pre-to post-intervention was significant and this was maintained at 6-and 12-months. Anxiety and depression scores significantly decreased from pre-to post-intervention for the EFT group, and was maintained at 6- and 12-month follow-up. Somatoform scores significantly decreased from pre-intervention to all follow-up points for the CBT group, while the EFT group did not report any significant changes in somatoform symptoms. Results also revealed that EFT is capable of producing reductions in anxiety and depression symptoms, and may be comparable to gold standard approaches such as CBT. The current study supports the hypothesis that psychological intervention is beneficial for treating psychological comorbidities of obesity and points to the role mental health issues may play in this area.",Stapleton P.; Bannatyne A.; Chatwin H.; Urzi KC.; Porter B.; Sheldon T.,2017.0,10.1016/j.ctcp.2017.06.004,0,0,
976," Anxiety, depression and risk of cannabis use: examining the internalising pathway to use among Chilean adolescents"," METHOD: Longitudinal cohort study of participants (n=2508; 45% female; mean age 14.5 years) recruited from the 9th grade at 22 low‚Äêincome secondary schools in Santiago, Chile. Baseline internalising symptoms were assessed using the Beck Depression Inventory and the Revised Child Anxiety and Depression Scale. Frequency of cannabis was assessed at baseline, 6 month and 18 month follow‚Äêup. RESULTS: High rates of use were observed in this sample, with 40.3% reporting cannabis use at least once over the study period. Adjusted for baseline cannabis use, symptoms of depression, panic and generalised anxiety were associated with greater cannabis use frequency 18 months later. When all predictors were considered simultaneously, only generalised anxiety symptoms showed an independent association with subsequent cannabis use frequency (OR: 1.23, 95% CI: 1.08‚Äê1.41). Generalised anxiety symptoms were also associated with a 25% increased risk of transitioning from non‚Äêuser to use of cannabis during the study (OR: 1.25, 95% CI: 1.09‚Äê1.44). CONCLUSIONS: Internalising symptoms, and in particular symptoms of generalised anxiety, increase risk of cannabis use during adolescence. Targeted interventions that promote adaptive anxiety management among high‚Äêrisk adolescents may represent a promising strategy to prevent uptake of cannabis use during adolescence. BACKGROUND: Adolescents who experience internalising symptoms may be susceptible to the use of alcohol and other substances in an attempt to alleviate or cope with these symptoms. We examined the hypothesised internalising pathway from symptoms of depression, generalised anxiety, social anxiety and panic, to incidence and frequency of cannabis use 18 months later."," Stapinski, LA;  Montgomery, AA;  Araya, R",2016.0, 10.1016/j.drugalcdep.2016.06.032,0,0,
977, A randomized controlled study comparing internet-based cognitive behavioral therapy and counselling by standard care for fear of birth - A study protocol," Fear of birth is a concern that requires evidence based treatment. The aim of this study is to present the protocol of a randomized controlled multi‐center trial to compare internet‐based cognitive therapy with counseling as standard care for pregnant women reporting fear of birth. Participants will be recruited in mid‐pregnancy. Women who score 60 or above on the Fear of Birth Scale will be offered to participate in this study. Data will be collected by questionnaires including validated instruments at baseline and follow‐ups at gestational weeks 30 and 36, two months and one year after birth. The primary outcome will be level of fear of birth measured with the Fear of Birth Scale at 36 weeks of gestation. Secondary outcome measures are level of fear of birth at two months and one year after giving birth, preferences for mode of birth, requests for elective cesarean section, compliance and satisfaction with treatment and birth outcomes. A power calculation based on a 20% reduction of fear implies that approximately 200 will be included in the trial. The study outlined in this protocol will be the first randomized controlled trial comparing internet‐based cognitive therapy with counseling for women reporting fear of birth. An effective treatment may result in better overall health for women with fear of birth and a reduction in cesarean sections for non‐medical reasons. Evidence regarding treatment options of fear of birth will also provide a greater choice for women."," Ternström, E;  Hildingsson, I;  Haines, H;  Karlström, A;  Sundin, Ö;  Ekdahl, J;  Segeblad, B;  Larsson, B;  Rondung, E;  Rubertsson, C",2017.0, 10.1016/j.srhc.2017.06.001,0,0,
978,Perceived burdensomeness and suicide ideation in adult outpatients receiving exposure therapy for anxiety disorders.,"Perceived burdensomeness is considered a proximal risk factor for suicide ideation. However, there is a lack of prospective studies. Furthermore, it is unclear in as much psychotherapy for anxiety disorders is associated with a decrease in suicide ideation. A total of 105 adult outpatients suffering from panic disorder, agoraphobia, or specific phobia received manualized exposure-therapy. Perceived burdensomeness was considered as predictor of suicide ideation concurrently, after the fourth and the tenth therapy session and posttreatment - controlling for baseline symptom distress, suicide ideation, number of therapy sessions and age. Furthermore, pre-to post-changes in suicide ideation and perceived burdensomeness were assessed. Perceived burdensomeness emerged as a significant predictor of suicidal ideation concurrently and after the fourth and the tenth therapy session, but not at the end of therapy. Treatment had no effect on suicide ideation and only a marginal effect on perceptions of burdensomeness. In conclusion, the current study highlights the importance of perceptions of burdensomeness in understanding suicide ideation.",Teismann T.; Forkmann T.; Rath D.; Glaesmer H.; Margraf J.,2016.0,10.1016/j.brat.2016.07.011,0,0,
979,"Efficacy and Outcome Predictors for Three PTSD Treatments: Exposure Therapy, EMDR, and Relaxation Training.","In recent years there has been a rapidly growing amount of research on the treatment of post traumatic stress disorder (PTSD). Our recent metaanalysis suggested that exposure therapy and eye movement desensitization and reprocessing (EMDR) are among the most effective treatments for PTSD. In this chapter we take the opportunity to summarize our previously reported findings and to present some hitherto unpublished results. Compared to EMDR and relaxation training: (1) exposure therapy tended to yield a greater proportion of participants who no longer met criteria for PTSD after treatment, as assessed by structured interview, (2) EMDR and relaxation did not differ from one another on any outcome variable, (3) exposure produced significantly larger reductions in avoidance and reexperiencing symptoms, as assessed before and after treatment via structured interview, and (4) exposure was faster at reducing avoidance, as assessed by a questionnaire administered at the beginning of each session. Our findings suggest that exposure is a first-line psychosocial treatment for PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Taylor, Steven",2004.0,,0,0,
980,"Outcome Predictors for Three PTSD Treatments: Exposure Therapy, EMDR, and Relaxation Training.","Several psychosocial treatments appear to be effective in treating posttraumatic stress disorder (PTSD). However, little is known about the predictors of treatment outcome. It is possible that some variables predict poor outcome for some treatments but not for other treatments. To investigate this issue, outcome predictors were investigated for three eight-session treatments: exposure therapy (entailing prolonged imaginal and in vivo exposure), relaxation training, and eye movement desensitization and reprocessing (EMDR). Sixty people with PTSD entered and 45 completed treatment. Treatments did not differ in attrition or perceived credibility. Exposure tended to be most effective, and EMDR and relaxation did not differ in efficacy. A number of clinical and cognitive variables were examined to identify predictors of treatment dropout as well as predictors of the likelihood that patients would be remitted from PTSD after treatment. These analyses were conducted by controlling for treatment condition. Low patient ratings of treatment credibility (assessed in session 2) predicted treatment dropout, regardless of treatment type. Severe reexperiencing symptoms (assessed prior to treatment) predicted poor outcome for relaxation training but not for the other therapies... (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Taylor, Steven",2003.0,http://dx.doi.org/10.1891/jcop.17.2.149.57432,0,0,
981, Protocol for Care After Lymphoma (CALy) trial: a phase II pilot randomised controlled trial of a lymphoma nurse-led model of survivorship care," INTRODUCTION: Lymphoma is the sixth most common cancer diagnosed in Australia and internationally. Owing to the aggressive nature of the disease and intensity of treatment, survivors face long‚Äêterm effects that impact on quality of life. Current models of follow‚Äêup post‚Äêtreatment fail to address these complex issues. Given that 74% of patients with lymphoma cancer now survive 5‚ÄÖyears beyond diagnosis and treatment, it is important to address this gap in care. AIM: To determine self‚Äêreported informational and practical needs, anxiety, depression, stress, coping and empowerment at baseline, 3 and 6‚ÄÖmonths. METHODS AND ANALYSIS: A pilot randomised controlled trial will test the effect of a nurse‚Äêled lymphoma survivorship clinic compared with usual post‚Äêtreatment care at a large tertiary cancer centre in Western Australia. The intervention will comprise three face‚Äêto‚Äêface appointments with delivery of tailored resources, a survivorship care plan and treatment summary (SCP TS). The SCP TS will be given to the participant and general practitioner (GP). Intervention participants will be interviewed at completion to explore the perceived value of the intervention components and preferred dose. An evaluation developed for GPs will assess receipt and use of SCP TS. The primary intent of analysis will be to address the feasibility of a larger trial and requisite effect and sample size. ETHICS AND DISSEMINATION: Ethics approval has been granted by the University of Notre Dame Australia and Sir Charles Gairdner Hospital in Western Australia. Peer‚Äêreviewed publications and conference presentations will report the results of this phase II trial. TRIAL REGISTRATION NUMBER: ANZCTRN12615000530527; Pre‚Äêresults."," Taylor, K;  Joske, D;  Bulsara, M;  Bulsara, C;  Monterosso, L",2016.0, 10.1136/bmjopen-2015-010817,0,0,
982,"Ketamine for social anxiety disorder: A randomized, placebo-controlled crossover trial.","Many patients with social anxiety disorder (SAD) experience inadequate symptom relief from available treatments. Ketamine is a potent Nmethyl- D-aspartate receptor antagonist with a potentially novel mechanism of action for the treatment of anxiety disorders. Therefore, we conducted a double-blind, randomized, placebo-controlled crossover trial in 18 adults with DSM-5 SAD and compared the effects between intravenous ketamine (0.5 mg/kg over 40 min) and placebo (normal saline) on social phobia symptoms. Ketamine and placebo infusions were administered in a random order with a 28-day washout period between infusions. Ratings of anxiety were assessed 3-h post-infusion and followed for 14 days. We used linear mixed models to assess the impact of ketamine and placebo on anxiety symptoms. Outcomes were blinded ratings on the Liebowitz Social Anxiety Scale (LSAS) and self-reported anxiety on a visual analog scale (VAS-Anxiety). We also used the Wilcoxon signed-rank test to compare the proportion of treatment responders. Based on prior studies, we defined response as a greater than 35% LSAS reduction and 50% VAS-Anxiety reduction. We found ketamine resulted in a significantly greater reduction in anxiety relative to placebo on the LSAS (Time x Treatment: F9,115 = 2.6, p = 0.01) but not the VAS-Anxiety (Time x Treatment: F10,141 = 0.4, p = 0.95). Participants were significantly more likely to exhibit a treatment response after ketamine infusion relative to placebo in the first 2 weeks following infusion measured on the LSAS (33.33% response ketamine vs 0% response placebo, Wilcoxon signed-rank test z = 2.24, p = 0.025) and VAS (88.89% response ketamine vs 52.94% response placebo, Wilcoxon signed-rank test z = 2.12, p = 0.034). In conclusion, this proof-of-concept trial provides initial evidence that ketamine may be effective in reducing anxiety. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Taylor, Jerome H; Landeros-Weisenberger, Angeli; Coughlin, Catherine; Mulqueen, Jilian; Johnson, Jessica A; Gabriel, Daniel; Reed, Margot O; Jakubovski, Ewgeni; Bloch, Michael H",2018.0,http://dx.doi.org/10.1038/npp.2017.194,0,0,
983, The affective tie that binds: examining the contribution of positive emotions and anxiety to relationship formation in social anxiety disorder," Individuals with social anxiety disorder (SAD) have difficulty forming social relationships. The prevailing clinical perspective is that negative emotions such as anxiety inhibit one's capacity to develop satisfying social connections. However, empirical findings from social psychology and affective neuroscience suggest that positive emotional experiences are fundamental to establishing new social bonds. To reconcile these perspectives, we collected repeated measurements of anxiety, positive emotions (pleasantness), and connectedness over the course of a controlled relationship formation encounter in 56 participants diagnosed with SAD (64% female; M"," Taylor, CT;  Pearlstein, SL;  Stein, MB",2017.0, 10.1016/j.janxdis.2017.03.007,0,0,
984, Early Psychological Preventive Intervention For Workplace Violence: a Randomized Controlled Explorative and Comparative Study Between EMDR-Recent Event and Critical Incident Stress Debriefing," This randomized controlled trial study aims to investigate the efficacy of an early psychological intervention called EMDR‐RE compared to Critical Incident Stress Debriefing on 60 victims of workplace violence, which were divided into three groups: 'EMDR‐RE' (n = 19), 'CISD' (n = 23), and 'delayed EMDR‐RE' (n = 18). EMDR‐RE and CISD took place 48 hours after the event, whilst third intervention was delayed by an additional 48 hours. Results showed that after 3 months PCLS and SUDS scores were significantly lower with EMDR‐RE and delayed EMDR‐RE compared to CISD. After 48 hours and 3 months, none of the EMDR‐RE‐treated victims showed PTSD symptoms."," Tarquinio, C;  Rotonda, C;  Houllé, WA;  Montel, S;  Rydberg, JA;  Minary, L;  Dellucci, H;  Tarquinio, P;  Fayard, A;  Alla, F",2016.0, 10.1080/01612840.2016.1224282,0,0,
985, Excess weight gain prevention in adolescents: three-year outcome following a randomized controlled trial," OBJECTIVE: Interpersonal psychotherapy (IPT) prevents weight gain in adults with obesity and binge‐eating‐disorder, and is especially effective among those with increased psychosocial problems. However, IPT was not superior to health education (HE) to prevent excess weight gain at 1‐year follow‐up in 113 adolescent girls at high‐risk for excess weight gain because of loss‐of‐control eating and high body mass index (BMI; kg/m2; Tanofsky‐Kraff et al., 2014). METHOD: Participants from the original trial were recontacted 3 years later for assessment. At baseline, adolescent‐ and parent‐reported social‐adjustment problems and trait anxiety were evaluated. At baseline and follow‐ups, BMIz and adiposity by dual‐energy x‐ray absorptiometry were obtained. RESULTS: Nearly 60% were reassessed at 3 years, with no group differences in participation (ps ≥ .70). Consistent with 1 year, there was no main effect of group on change in BMIz/adiposity (ps ≥ .18). In exploratory analyses, baseline social‐adjustment problems and trait‐anxiety moderated outcome (ps < .01). Among girls with high self‐reported baseline social‐adjustment problems or anxiety, IPT, compared to HE, was associated with the steepest declines in BMIz (p < .001). For adiposity, girls with high or low anxiety in HE and girls with low anxiety in IPT experienced gains (ps ≤ .03), while girls in IPT with high anxiety stabilized. Parent‐reports yielded complementary findings. CONCLUSION: In obesity‐prone adolescent girls, IPT was not superior to HE in preventing excess weight gain at 3 years. Consistent with theory, exploratory analyses suggested that IPT was associated with improvements in BMIz over 3 years among youth with high social‐adjustment problems or trait anxiety. Future studies should test the efficacy of IPT for obesity prevention among at‐risk girls with social‐adjustment problems and/or anxiety. (PsycINFO Database Record"," Tanofsky-Kraff, M;  Shomaker, LB;  Wilfley, DE;  Young, JF;  Sbrocco, T;  Stephens, M;  Brady, SM;  Galescu, O;  Demidowich, A;  Olsen, CH;  et al.",2017.0, 10.1037/ccp0000153,0,0,
986, Psychological and Physical Health in Military Amputees During Rehabilitation: secondary Analysis of a Randomized Controlled Trial," BACKGROUND: Service members who have experienced combat trauma with resulting amputation are at risk for compromised quality of life postamputation. Monitoring mental and physical health in amputees returning from the war is of paramount importance. This study examined changes in physical and mental health‚Äêrelated quality of life in service members following traumatic unilateral, transtibial amputation (TTA) during a 12‚Äêweek period of rehabilitation before and after receiving a prosthesis. METHOD: This study is a secondary analysis from a randomized controlled trial (RCT) of military service members starting Military Amputee Rehabilitation Program (MARP) following a traumatic TTA. The study examined change in SF‚Äê36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores as two aspects of health‚Äêrelated quality of life. Forty‚Äêfour injured service members, aged 19 to 46, were recruited into the RCT. Participants were randomized into 12 weeks of MARP plus home neuromuscular electrical stimulation therapy (n = 23) or MARP alone (N = 21) and compared at baseline, 6, and 12 weeks on: SF‚Äê36 PCS and MCS scores. Linear mixed models examined time and group differences and their interaction for the MCS and PCS scores. A multivariate mixed model tested whether MCS and PCS scores differed. RESULTS: For the combined rehabilitation cohort, MCS did not differ over 12 weeks (p = 0.27) with scores at week 0 of M = 56.7 (SD = 11.9) and at week 12 of M = 52.7 (SD = 11.4), similar to healthy controls (age = 25‚Äê34, M = 51.0, SD = 7.6). Scores did not differ between treatment groups (p = 0.28) with no group by time interaction (p = 0.34). The MCS significantly declined over time (p = 0.05) after adjustment for covariates. PCS improved over 12 weeks (p < 0.0001) in the total rehabilitation group with scores at week 0 of M = 34.0 (SD = 8.1) to M = 41.8 (SD = 8.4) at week 12, significantly lower than healthy controls (age = 25‚Äê34, M = 54.1, SD = 6.6). Scores did not differ between treatment groups (p = 0.89), and there was no group by time interaction (p = 0.34). An interaction between the PCS and MCS was observed such that the PCS improved over time, whereas the MCS did not significantly change (p = 0.0005). DISCUSSION: War‚Äêinjured transtibial amputees are at risk for compromised quality of life during rehabilitation. Self‚Äêperceived physical health improved as might be expected from rehabilitation. Self‚Äêperceived mental health did not. During rehabilitation, physical healing, psychological adjustment, and lifestyle adaptation are occurring simultaneously. However, more attention may need to be directed toward mental health during rehabilitation."," Talbot, LA;  Brede, E;  Metter, EJ",2017.0, 10.7205/MILMED-D-16-00328,0,0,
987,Complicated grief after suicide bereavement and other causes of death.,"The authors compared baseline demographic characteristics, clinical features, and grief-related thoughts, feelings, and behaviors of individuals bereaved by suicide, accident/homicide and natural causes participating in a complicated grief (CG) treatment clinical trial. Severity of CG and depression and current depression diagnosis did not vary by loss type. After adjusting for baseline demographic features, time since death and relationship to the deceased, those with CG after suicide had the highest rates of lifetime depression, preloss passive suicidal ideation, self-blaming thoughts, and impaired work and social adjustment. Even among this treatment-seeking sample of research participants with CG, suicide survivors may face unique challenges.",Tal I.; Mauro C.; Reynolds CF.; Shear MK.; Simon N.; Lebowitz B.; Skritskaya N.; Wang Y.; Qiu X.; Iglewicz A.; Glorioso D.; Avanzino J.; Wetherell JL.; Karp JF.; Robinaugh D.; Zisook S.,,10.1080/07481187.2016.1265028,0,0,
988,The development of mental health literacy - Program educational program for university students,"Background: A variety of problems in mental health occur in youth. Early intervention is preferable to obtain good results. But education concerning early prevention is insufficient in Japanese curriculums. Purpose: The purpose of this study is the development and practice, and effects evaluation of program in order to improve mental health literacy for University school students. Methods: We developed three educational programs in a University in Japan. Program A was focusing on usual student's life stress and coping with it and was administered by a mental health professional. Program B focused on WRAP and was administered by a mental health consumer and Program C focused on types of distress and benefits of the counseling and was administered by a psychologist. We evaluated pre- and post- intervention focusing on help-seeking attitudes scale (ASPH) as related scales of mental health literacy between intervention groups and control groups. Results: Intervention group consisted of 200 students, with a control group of 108 students. Program A significantly improved to an ASPH of 31.2 to 33.1 on average pre- and post- intervention (p < 0.001). Program B also improved significantly from 33 to 36.2(p = 0.026)and C from 29 to 31.8(p = 0.001). But there were no significant differences in the control groups. Conclusion: In each program we found the effect of improvement mental health literacy, especially in program C. The message from the standpoint of consultant was clearly positive. Considering the effect of each program there is a need to develop even more various programs.",Takamura S.; Kondo M.; Nagasawa R.; Nekoda Y.,2018.0,10.1111/eip.12724,0,0,
989,"A common brain network among state, trait, and pathological anxiety from whole-brain functional connectivity","Anxiety is one of the most common mental states of humans. Although it drives us to avoid frightening situations and to achieve our goals, it may also impose significant suffering and burden if it becomes extreme. Because we experience anxiety in a variety of forms, previous studies investigated neural substrates of anxiety in a variety of ways. These studies revealed that individuals with high state, trait, or pathological anxiety showed altered neural substrates. However, no studies have directly investigated whether the different dimensions of anxiety share a common neural substrate, despite its theoretical and practical importance. Here, we investigated a brain network of anxiety shared by different dimensions of anxiety in a unified analytical framework using functional magnetic resonance imaging (fMRI). We analyzed different datasets in a single scale, which was defined by an anxiety-related brain network derived from whole brain. We first conducted the anxiety provocation task with healthy participants who tended to feel anxiety related to obsessive-compulsive disorder (OCD) in their daily life. We found a common state anxiety brain network across participants (1585 trials obtained from 10 participants). Then, using the resting-state fMRI in combination with the participants' behavioral trait anxiety scale scores (879 participants from the Human Connectome Project), we demonstrated that trait anxiety shared the same brain network as state anxiety. Furthermore, the brain network between common to state and trait anxiety could detect patients with OCD, which is characterized by pathological anxiety-driven behaviors (174 participants from multi-site datasets). Our findings provide direct evidence that different dimensions of anxiety have a substantial biological inter-relationship. Our results also provide a biologically defined dimension of anxiety, which may promote further investigation of various human characteristics, including psychiatric disorders, from the perspective of anxiety.",Takagi Y.; Sakai Y.; Abe Y.; Nishida S.; Harrison B.J.; Martínez-Zalacaín I.; Soriano-Mas C.; Narumoto J.; Tanaka S.C.,2018.0,10.1016/j.neuroimage.2018.01.080,0,0,
990, Placebo Response in Pediatric Anxiety Disorders: results from the Child/Adolescent Anxiety Multimodal Study," OBJECTIVES: The aim of this study is to identify predictors of pill placebo response and to characterize the temporal course of pill placebo response in anxious youth. METHODS: Data from placebo‐treated patients (N = 76) in the Child/Adolescent Anxiety Multimodal Study (CAMS), a multisite, randomized controlled trial that examined the efficacy of cognitive‐behavioral therapy, sertraline, their combination, and placebo for the treatment of separation, generalized, and social anxiety disorders, were evaluated. Multiple linear regression models identified features associated with placebo response and models were confirmed with leave‐one‐out cross‐validation. The likelihood of improvement in patients receiving pill placebo‐over time‐relative to improvement associated with active treatment was determined using probabilistic Bayesian analyses. RESULTS: Based on a categorical definition of response (Clinical Global Impressions‐Improvement Scale score ≤2), nonresponders (n = 48), and pill placebo responders (n = 18) did not differ in age (p = 0.217), sex (p = 0.980), race (p = 0.743), or primary diagnosis (all ps > 0.659). In terms of change in anxiety symptoms, separation anxiety disorder and treatment expectation were associated with the degree of pill placebo response. Greater probability of placebo‐related anxiety symptom improvement was observed early in the course of treatment (baseline to week 4, p < 0.0001). No significant change in the probability of placebo‐related improvement was observed after week 4 (weeks 4‐8, p = 0.07; weeks 8‐12, p = 0.85), whereas the probability of improvement, in general, significantly increased week over week with active treatment. CONCLUSIONS: Pill placebo‐related improvement occurs early in the course of treatment and both clinical factors and expectation predict this improvement. Additionally, probabilistic approaches may refine our understanding and prediction of pill placebo response."," Strawn, JR;  Dobson, ET;  Mills, JA;  Cornwall, GJ;  Sakolsky, D;  Birmaher, B;  Compton, SN;  Piacentini, J;  McCracken, JT;  Ginsburg, GS;  et al.",2017.0, 10.1089/cap.2016.0198,0,0,
991, Drinking to Cope: a Latent Class Analysis of Coping Motives for Alcohol Use in a Large Cohort of Adolescents," Alcohol consumption during adolescence is widespread, although there is considerable variation in patterns of use. The aim of this study was to identify patterns of coping‚Äêmotivated alcohol use in a UK birth cohort and examine individual and family characteristics associated with the resulting drinker profiles. At age 17, participants (n=3957; 56 % female) reported their alcohol and drug use, internalising symptoms and use of alcohol to cope with a range of emotions. Socio‚Äêdemographic data were collected via maternal report. Latent class analysis identified drinker subtypes based on the coping motives reported. Association between these profiles and socio‚Äêdemographic characteristics and internalising disorders was examined. The vast majority (92 %) of adolescents reported alcohol consumption in the past year, and 26 % of those drank weekly or more often. Four distinct motive profiles were identified. These profiles were associated with different socio‚Äêdemographic characteristics: adolescents from higher socio‚Äêeconomic backgrounds drank primarily for increased confidence, whereas adolescents from low socio‚Äêeconomic backgrounds were more likely to drink to cope with low mood. Adolescents with an anxiety or depressive disorder were six times more likely to fall within the high‚Äêrisk subtype, characterised by a generalised pattern of drinking to cope with emotions across the board. Coping motives for drinking vary with individual and family factors. Adolescents from low versus high socio‚Äêeconomic backgrounds were characterised by distinct drinking profiles; thus, prevention messages may need to be tailored accordingly. Internalising disorders were strongly associated with a high‚Äêrisk profile of coping‚Äêmotivated drinking."," Stapinski, LA;  Edwards, AC;  Hickman, M;  Araya, R;  Teesson, M;  Newton, NC;  Kendler, KS;  Heron, J",2016.0, 10.1007/s11121-016-0652-5,0,0,
992, Comorbid sleep disorders and suicide risk among children and adolescents with bipolar disorder," Children and adolescents with bipolar disorder are at increased risk for suicide. Sleep disturbances are common among youth with bipolar disorder and are also independently implicated in suicide risk; thus, comorbid sleep disorders may amplify suicide risk in this clinical population. This study examined the effects of comorbid sleep disorders on suicide risk among youth with bipolar disorder. We conducted secondary analyses of baseline data from the Treatment of Early Age Mania (TEAM) study, a randomized controlled trial of individuals aged 6‐15 years (mean ± SD = 10.2 ± 2.7 years) with DSM‐IV bipolar I disorder (N = 379). Sleep disorders (i.e., nightmare, sleep terror, and sleepwalking disorders) and suicide risk were assessed via the WASH‐U‐KSADS and the CDRS‐R, respectively. We constructed uncontrolled logistic regression models as well as models controlling for trauma history, a generalized anxiety disorder (GAD) diagnosis, and depression symptoms. Participants with a current comorbid nightmare disorder versus those without were nearly twice as likely to screen positive for suicide risk in an uncontrolled model and models controlling for trauma history, a GAD diagnosis, and depression symptoms. Neither a current comorbid sleep terror disorder nor a sleepwalking disorder was significantly associated with suicide risk. This pattern of findings remained consistent for both current and lifetime sleep disorder diagnoses. Youth with bipolar I disorder and a comorbid nightmare disorder appear to be at heightened suicide risk. Implications for assessment and treatment are discussed."," Stanley, IH;  Hom, MA;  Luby, JL;  Joshi, PT;  Wagner, KD;  Emslie, GJ;  Walkup, JT;  Axelson, DA;  Joiner, TE",2017.0, 10.1016/j.jpsychires.2017.07.027,0,0,
993,"Symptom management in complex post-traumatic stress disorder (ICD-11), view and experience of patients and their relatives: a mixed methods approach (Research Proposal).","Using the framework of IDC-11, complex post-traumatic stress disorder will be diagnosed using the core criteria of a post-traumatic stress disorder and the presence of at least one symptom from the following three domains: symptoms of emotional dysregulation, negative self-concept, and problems in interpersonal relationships. In the literature, these symptoms are discussed as a common reason for seeking treatment. The symptoms can influence and impair the quality of life. This article describes a mixed methods study with a sequential exploratory design. The aim is to describe specific patient characteristics, levels of symptom burden and perspectives of adult inpatients and to describe the experiences, views and needs of patients' relatives. The study will also investigate facilitators of and barriers to symptom management. The research will be conducted in four phases. The first phase will assess patients' symptom burdens. The second phase will use semi-structured interviews to explore attitudes to symptom management and perceptions of patients and their relatives. The third phase will statistically explore hypotheses generated after the qualitative interviews. The fourth phase will mix the quantitative and qualitative results and interpret critically. The present study will add new results to the growing literature on complex post-traumatic stress disorder. These results could serve as the basis for further research into the development of interventions to improve symptom management. Trial registration Ethical approval has been obtained from the Swiss cantonal ethic commission (Nr. 201500096). This research was also registered to the World Health Organization Clinical Trials Search Portal through the German Clinical Trial Register, Trial DRKS00012268 (21/04/2017).",Stadtmann MP.; Maercker A.; Binder J.; Schnepp W.,2017.0,10.1186/s13104-017-2790-7,0,0,
994, The role of social risk in an early preventative care programme for infants born very preterm: a randomized controlled trial," METHOD: One hundred and twenty infants born earlier than 30 weeks' gestation were randomized to early intervention (n=61) or control groups (n=59). Cognitive, language, and motor outcomes were assessed by blinded assessors at 2 years, 4 years, and 8 years, and primary caregivers completed questionnaires on their anxiety and depression. Outcomes at each time point were compared between groups using linear regression with an interaction term for social risk (higher/lower). RESULTS: There was evidence of interactions between intervention group and social risk for cognition at 2 years and 4 years, motor function at 4 years, and language at 8 years, with a greater intervention effect in children from higher social risk environments. In contrast, the impact of early intervention on parental depressive symptoms was greater for parents of lower social risk than for those of higher social risk. INTERPRETATION: Effects of early intervention on outcomes for children born preterm and their caregivers varied according to family social risk. Family social risk should be considered when implementing early intervention programmes for children born preterm and their families. WHAT THIS PAPER ADDS: Intervention is associated with better early cognitive functioning for children in higher social risk families. Positive effects of intervention for the high risk group were not sustained at school‚Äêage. Intervention has a greater effect on primary caregiver mental health in the lower social risk group compared with higher social risk. AIM: To examine the differential effects of an early intervention programme for infants born preterm on neurodevelopment and parental mental health according to family social risk."," Spittle, AJ;  Treyvaud, K;  Lee, KJ;  Anderson, PJ;  Doyle, LW",2018.0, 10.1111/dmcn.13594,0,0,
995,Improvement of mindfulness skills during Mindfulness-Based Cognitive Therapy predicts long-term reductions of neuroticism in persons with recurrent depression in remission.,"This study examined whether changes in mindfulness skills following Mindfulness-based Cognitive Therapy (MBCT) are predictive of long-term changes in personality traits. Using data from the MOMENT study, we included 278 participants with recurrent depression in remission allocated to Mindfulness-Based Cognitive Therapy (MBCT). Mindfulness skills were measured with the FFMQ at baseline, after treatment and at 15-month follow-up and personality traits with the NEO-PI-R at baseline and follow-up. For 138 participants, complete repeated assessments of mindfulness and personality traits were available. Following MBCT participants manifested significant improvement of mindfulness skills. Moreover, at 15-month follow-up participants showed significantly lower levels of neuroticism and higher levels of conscientiousness. Large improvements in mindfulness skills after treatment predicted the long-term changes in neuroticism but not in conscientiousness, while controlling for use of maintenance antidepressant medication, baseline depression severity and change in depression severity during follow-up (IDS-C). In particular improvements in the facets of acting with awareness predicted lower levels of neuroticism. Sensitivity analyses with multiple data imputation yielded similar results. Uncontrolled clinical study with substantial attrition based on data of two randomized controlled trials. The design of the present study precludes to establish whether there is any causal association between changes in mindfulness and subsequent changes in neuroticism. MBCT could be a viable intervention to directly target one of the most important risk factors for onset and maintenance of recurrent depression and other mental disorders, i.e. neuroticism.",Spinhoven P.; Huijbers MJ.; Ormel J.; Speckens AEM.,2017.0,10.1016/j.jad.2017.02.011,0,0,
996, Effects of stepped psychooncological care on referral to psychosocial services and emotional well-being in cancer patients: a cluster-randomized phase III trial," METHODS: In a cluster‐randomized trial, wards were randomly allocated to stepped versus standard care. Stepped care comprised screening for distress, consultation between doctor and patient about the patient's need for CL services, and provision of CL service. Primary outcomes were referral to psychosocial services and emotional well‐being half a year after baseline, measured with the Hospital Anxiety and Depression Scale. A secondary endpoint was uptake of outpatient health care. Analysis employed mixed‐effects multivariate regression modeling. RESULTS: Thirteen wards were randomized; 1012 patients participated. With stepped care (N = 570; 7 wards), 22% of the patients were referred to CL services and 3% with standard care (N = 442; 6 wards; odds ratio [OR] 10.0; P < .001). Well‐being 6 months after baseline was 9.5 after stepped care (N = 341) and 9.4 after standard care (N = 234, β ‐0.3; P = .71). After stepped care, patients with psychiatric comorbidity went more often to psychotherapists (OR 4.0, P = .05) and to psychiatrists (OR 2.3, P = .12), whereas patients without comorbidity used psychiatrists less often (OR 0.4, P = .04) than in standard care. CONCLUSIONS: Stepped care resulted in better referral to CL services. The patients' emotional well‐being was not improved, but uptake of outpatient psychiatric help was increased in patients with psychiatric comorbidity and decreased in patients without. OBJECTIVE: Emotional distress in cancer patients often goes unnoticed in daily routine; therefore, distress screening is now recommended in many national guidelines. However, screening alone does not necessarily translate into better well‐being. We examined whether stepped psychooncological care improves referral to consultation‐liaison (CL) services and improves well‐being."," Singer, S;  Danker, H;  Roick, J;  Einenkel, J;  Briest, S;  Spieker, H;  Dietz, A;  Hoffmann, I;  Papsdorf, K;  Meixensberger, J;  et al.",2017.0, 10.1002/pon.4492,0,0,
997,Exposure to interpersonal violence and risk of post-traumatic stress disorder among women with borderline personality disorder.,"This study aims to determine the validity of the Karolinska Interpersonal Violence Scale (KIVS), as a screening tool for PTSD, among women with borderline personality disorder (BPD) and severe suicidal behavior. 106 women with BPD and at least two suicide attempts were assessed with the KIVS for exposure to interpersonal violence as a child and as an adult. The screening ability of the KIVS for the diagnosis of PTSD was analyzed using receiver operating characteristic curve analysis. PTSD diagnosis was valid for 61 (58%) women with BPD. The KIVS - exposure of lifetime interpersonal violence, displayed fair accuracy of predicting diagnosis of PTSD (area under the curve 0.79, confidence interval [0.71, 0.88]) and performed well (sensitivity 0.90 and specificity 0.62), with a cut-off score of 4 (range 0-10). Poly-traumatization was not significantly related to PTSD diagnosis as compared to single traumatization, whereas sexual victimization was significantly more prevalent in women with PTSD diagnosis, as compared to other types of traumatic events. A score of 4 or more on the KIVS - exposure to interpersonal lifetime violence presents well as a screening instrument for risk of PTSD, among women with BPD.",Sinai C.; Hirvikoski T.; Wiklander M.; Nordström AL.; Nordström P.; Nilsonne Å.; Wilczek A.; Åsberg M.; Jokinen J.,2018.0,10.1016/j.psychres.2018.01.047,0,0,
998,The loss of a fellow service member: Complicated grief in post-9/11 service members and veterans with combat-related posttraumatic stress disorder.,"Bereavement is a potent and highly prevalent stressor among service members and veterans. However, the psychological consequences of bereavement, including complicated grief (CG), have been minimally examined. Loss was assessed in 204 post-9/11, when service members and veterans with combat-related posttraumatic stress disorder (PTSD) took part in a multicenter treatment study. Those who reported the loss of an important person completed the inventory of complicated grief (ICG; n‚Äâ=‚Äâ160). Over three quarters (79.41%) of the sample reported an important lifetime loss, with close to half (47.06%) reporting the loss of a fellow service member (FSM). The prevalence of CG was 24.75% overall, and nearly one third (31.25%) among the bereaved. CG was more prevalent among veterans who lost a fellow service member (FSM) (41.05%, n‚Äâ=‚Äâ39) compared to those bereaved who did not (16.92%, n‚Äâ=‚Äâ11; OR‚Äâ=‚Äâ3.41, 95% CI: 1.59, 7.36). CG was associated with significantly greater PTSD severity, functional impairment, trauma-related guilt, and lifetime suicide attempts. Complicated grief was prevalent and associated with adverse psychosocial outcomes in veterans and service members with combat-related PTSD. Clinicians working with this population should inquire about bereavement, including loss of a FSM, and screen for CG. Additional research examining CG in this population is needed.",Simon NM.; O'Day EB.; Hellberg SN.; Hoeppner SS.; Charney ME.; Robinaugh DJ.; Bui E.; Goetter EM.; Baker AW.; Rogers AH.; Nadal-Vicens M.; Venners MR.; Kim HM.; Rauch SAM.,2018.0,10.1002/jnr.24094,0,0,
999,H2O2 as a central redox signaling molecule in physiological oxidative stress,"In 1818, Louis Jacques Thénard (1777-1857) in Paris discovered and synthesized hydrogen peroxide, so we can celebrate a Bicentennial1. Using near-infrared organ spectroscopy of catalase Compound I, hydrogen peroxide was identified as a normal oxygen metabolite in the intact cell noninvasively, almost 50 years ago2. Hydrogen peroxide now is considered as a central redox signaling molecule by targeting specific redox sensors in physiological oxidative stress, “oxidative eustress”3. While large gradients exist towards the outside of cells as well as between different compartments within cells, an overall range of cellular hydrogen peroxide concentrations in the physiological steady-state is estimated to be 1-100 nM Higher concentrations elicit oxidative stress responses for adaptation, using molecular redox switches such as Nrf2 and NF-kB. If overburdened by exposure to even higher concentrations of hydrogen peroxide, in “oxidative distress”, unspecific damage to biomolecules ensues, ultimately leading to growth arrest and cell death.",Sies H.,2018.0,10.1016/j.freeradbiomed.2018.04.030,0,0,
1000,"Examining changes in negative mood regulation expectancies, posttraumatic stress disorder, depression, and substance use following integrated cognitive-behavioral therapy.","The comorbidity of depression, posttraumatic stress disorder (PTSD), and substance use disorder (SUD) is common among veterans. Some research indicates that poor expectancies for negative mood regulation (NMR) may be associated with depression, trauma symptoms, and substance abuse. However, little is known about whether NMR expectancies can be changed through psychotherapy and if so, whether changes in NMR expectancies are related to changes in depression, PTSD, and SUD. Therefore, this study examined (1) whether NMR expectancies correlate with depression, PTSD, and SUD symptoms; (2) whether NMR expectancies improve after group integrated cognitive-behavioral therapy (ICBT); and (3) whether these changes were associated with improvements in depression, PTSD, and SUD symptoms in a sample of 123 veterans (89% male, 64% non-Hispanic Caucasian) recruited from a Department of Veteran Affairs (VA) Healthcare System. Findings indicated that (1) NMR expectancies were significantly associated with depression and PTSD symptoms but not substance use at baseline; (2) NMR expectancies significantly improved following group ICBT treatment; (3) following treatment, improvements in NMR expectancies were associated with decreases in depression and PTSD symptoms but were unrelated to changes in substance use outcomes; and (4) baseline NMR expectancies did not predict treatment outcomes. Similarly, pre-post NMR expectancies change scores were significantly associated with changes in depression and PTSD symptoms, but not percentage days using or percentage days heavy drinking. In conclusion, this study suggests that group ICBT is associated with improvements in NMR expectancies among veterans with depression, PTSD, and SUD, which are associated with improvements in depression and PTSD symptoms.",Siegel EY.; Haller M.; Cui R.; Trim RS.; Tate SR.; Norman SB.,,10.1080/08897077.2017.1342736,0,0,
1001,Randomized clinical trial investigating the effects of an anxiety sensitivity intervention on posttraumatic stress symptoms: A replication and extension.,"A growing body of research suggests the importance of anxiety sensitivity (AS) in the development and maintenance of posttraumatic stress symptoms (PTSS). Specifically, AS cognitive concerns (fears of cognitive dyscontrol) may be particularly relevant for those with elevated PTSS. Preliminary research has suggested that interventions targeting AS may be beneficial in decreasing PTSS, but to date there has been no randomized controlled trial testing the direct and indirect effects of an AS cognitive concerns intervention among a clinical sample of trauma-exposed individuals. The current study tested these effects among a sample 63 trauma-exposed participants who were randomized to either an AS cognitive concerns intervention or a repeated contact control. Results indicated a direct effect of the intervention on PTSS 1 month postintervention, and that this effect was mediated by changes in AS, specifically AS cognitive concerns, during the intervention period. Effect sizes were in the small-to-medium range (variance accounted for ranged from .05 to .15; odds ratio for diagnostic change = .06). These findings provide further evidence that targeting AS may be beneficial in the treatment of PTSS, and expansion upon this area of research by demonstrating these effects may be specific to AS cognitive concerns and can be achieved within a mixed clinical sample. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Short, Nicole A; Boffa, Joseph W; Norr, Aaron M; Albanese, Brian J; Allan, Nicholas P; Schmidt, Norman B",2017.0,http://dx.doi.org/10.1002/jts.22194,0,0,
1002,MAP Training My Brain‚Ñ¢: Meditation plus aerobic exercise lessens trauma of sexual violence more than either activity alone,"Sexual violence against women often leads to post-traumatic stress disorder (PTSD), a mental illness characterized by intrusive thoughts and memories about the traumatic event (Shors and Millon, 2016). These mental processes are obviously generated by the brain but often felt in the body. MAP Training My Brain‚Ñ¢ is a novel clinical intervention that combines mental training of the brain with physical training of the body (Curlik and Shors, 2013; Shors et al., 2014). Each training session begins with 20-min of sitting meditation, followed by 10-min of slow-walking meditation, and ending with 30-min of aerobic exercise at 60-80% of the maximum heart rate (see maptrainmybrain.com). In previous studies, the combination of mental and physical (MAP) training together significantly reduced symptoms of depression and ruminative thoughts, while reducing anxiety (Shors et al., 2014, 2017; Alderman et al., 2016). We also documented positive changes in brain activity during cognitive control and whole-body oxygen consumption in various populations. In the present pilot study, we asked whether the combination of meditation and aerobic exercise during MAP Training would reduce trauma-related thoughts, ruminations, and memories in women and if so, whether the combination would be more effective than either activity alone. To test this hypothesis, interventions were provided to a group of women (n = 105), many of whom had a history of sexual violence (n = 32). Groups were trained with (1) MAP Training, (2) meditation alone, (3) aerobic exercise alone, or (4) not trained. Individuals in training groups completed two sessions a week for at least 6 weeks. MAP Training My Brain‚Ñ¢ significantly reduced post-traumatic cognitions and ruminative thoughts in women with a history of sexual violence, whereas meditation alone, and exercise alone did not. MAP Training significantly enhanced a measure of self-worth, whereas meditation and exercise alone did not. Similar positive effects were observed for all participants, although meditation alone was also effective in reducing trauma-related thoughts. Overall, these data indicate the combination of meditation and exercise is synergistic. As a consequence, MAP Training is preferable and especially so for women who have experienced sexual violence in their past. Simply put, the whole is greater than the sum of its parts.",Shors T.J.; Chang H.Y.M.; Millon E.M.,2018.0,10.3389/fnins.2018.00211,0,0,
1003," A randomized, comparative pilot trial of family-based interpersonal psychotherapy for reducing psychosocial symptoms, disordered-eating, and excess weight gain in at-risk preadolescents with loss-of-control-eating"," OBJECTIVE: Preadolescent loss‚Äêof‚Äêcontrol‚Äêeating (LOC‚Äêeating) is a risk factor for excess weight gain and binge‚Äêeating‚Äêdisorder. We evaluated feasibility and acceptability of a preventive family‚Äêbased interpersonal psychotherapy (FB‚ÄêIPT) program. FB‚ÄêIPT was compared to family‚Äêbased health education (FB‚ÄêHE) to evaluate changes in children's psychosocial functioning, LOC‚Äêeating, and body mass. METHOD: A randomized, controlled pilot trial was conducted with 29 children, 8 to 13 years who had overweight/obesity and LOC‚Äêeating. Youth‚Äêparent dyads were randomized to 12‚Äêweek FB‚ÄêIPT (n‚Äâ=‚Äâ15) or FB‚ÄêHE (n‚Äâ=‚Äâ14) and evaluated at post‚Äêtreatment, six‚Äêmonths, and one‚Äêyear. Changes in child psychosocial functioning, LOC‚Äêeating, BMI, and adiposity by dual‚Äêenergy‚ÄêX‚Äêray‚Äêabsorptiometry were assessed. Missing follow‚Äêup data were multiply imputed. RESULTS: FB‚ÄêIPT feasibility and acceptability were indicated by good attendance (83%) and perceived benefits to social interactions and eating. Follow‚Äêup assessments were completed by 73% FB‚ÄêIPT and 86% FB‚ÄêHE at post‚Äêtreatment, 60% and 64% at six‚Äêmonths, and 47% and 57% at one‚Äêyear. At post‚Äêtreatment, children in FB‚ÄêIPT reported greater decreases in depression (95% CI ‚Äê7.23, ‚Äê2.01, Cohen's d‚Äâ=‚Äâ1.23) and anxiety (95% CI ‚Äê6.08, ‚Äê0.70, Cohen's d‚Äâ=‚Äâ.79) and less odds of LOC‚Äêeating (95% CI ‚Äê3.93, ‚Äê0.03, Cohen's d‚Äâ=‚Äâ.38) than FB‚ÄêHE. At six‚Äêmonths, children in FB‚ÄêIPT had greater reductions in disordered‚Äêeating attitudes (95% CI ‚Äê0.72, ‚Äê0.05, Cohen's d‚Äâ=‚Äâ.66) and at one‚Äêyear, tended to have greater decreases in depressive symptoms (95% CI ‚Äê8.82, 0.44, Cohen's d‚Äâ=‚Äâ.69) than FB‚ÄêHE. There was no difference in BMI gain between the groups. DISCUSSION: Family‚Äêbased approaches that address interpersonal and emotional underpinnings of LOC‚Äêeating in preadolescents with overweight/obesity show preliminary promise, particularly for reducing internalizing symptoms. Whether observed psychological benefits translate into sustained prevention of disordered‚Äêeating or excess weight gain requires further study."," Shomaker, LB;  Tanofsky-Kraff, M;  Matherne, CE;  Mehari, RD;  Olsen, CH;  Marwitz, SE;  Bakalar, JL;  Ranzenhofer, LM;  Kelly, NR;  Schvey, NA;  et al.",2017.0, 10.1002/eat.22741,0,0,
1004, The Role of Social Support in Cognitive-Behavioral Conjoint Therapy for Posttraumatic Stress Disorder," The current study examined the effect of total, as well as different sources (i.e., family, friends, significant other) of, pretreatment/baseline social support on posttraumatic stress disorder (PTSD) severity and treatment response to cognitive‚Äêbehavioral conjoint therapy (CBCT) for PTSD. Thirty‚Äêsix patients were randomized to receive treatment immediately or to a waitlist condition. Those in the treatment condition were offered CBCT for PTSD, a couple‚Äêbased therapy aimed at reducing PTSD symptoms and improving relationship functioning. PTSD symptoms were assessed at pre‚Äê/baseline, mid‚Äê/4 weeks of waiting, and posttreatment/12 weeks of waiting using the Clinician‚ÄêAdministered PTSD Scale, and patients self‚Äêreported on their levels of pretreatment/baseline social support using the Multidimensional Scale of Perceived Social Support. Total support, as well as social support from family and friends, was not associated with initial PTSD severity or treatment response. However, there was a significant positive association between social support from a significant other and initial PTSD severity (g = .92). Additionally, significant other social support moderated treatment outcomes, such that higher initial significant other support was associated with larger decreases in PTSD severity for those in the treatment condition (g = ‚Äê1.14) but not the waitlist condition (g = ‚Äê.04). Social support from a significant other may influence PTSD treatment outcomes within couple therapy for PTSD. The inclusion of intimate partners and other family members may be a fruitful avenue for improving PTSD treatment outcomes; however, future studies are needed to examine whether support can be increased with treatment and whether those improvements lead to greater PTSD symptom response."," Shnaider, P;  Sijercic, I;  Wanklyn, SG;  Suvak, MK;  Monson, CM",2017.0, 10.1016/j.beth.2016.05.003,0,0,
1005,Pilot study of exposure and response prevention for Japanese patients with obsessive-compulsive disorder.,"This pilot study was conducted to evaluate the feasibility and efficacy of exposure and response prevention therapy in Japanese patients with obsessive-compulsive disorder. This study was the first to examine the effectiveness of exposure and response prevention therapy provided by Japanese clinical psychologists. The sample comprised 37 adults (male = 17, female = 20, mean age = 35.7 years, standard deviation [SD] = 10, mean Yale-Brown Obsessive Compulsive Scale score = 26.9, SD = 23.35) with a diagnosis of obsessive-compulsive disorder receiving treatment. Individually administrated exposure and response prevention was provided to the 37 patients with obsessive-compulsive disorder. We evaluated the feasibility and safety of the program using the dropout rate and adverse events. The primary outcome was the reduction of the Yale-Brown Obsessive Compulsive Scale score between the pre- and post-treatment periods. Secondary outcomes were depression, anxiety, and quality of life. Of the 37 patients, 5 (14%) dropped out and 32 (86%) completed the entire program. No severe adverse event was observed. The patients reported significant reductions in the Yale-Brown Obsessive Compulsive Scale score (obsession: Hedges' g = 2.11, 95% CI [1.57, 2.68]; compulsion: Hedges' g = 2.05, 95% CI [1.41, 2.56]). Some secondary outcomes (depression and quality of life) also showed significant change. The results suggest that the exposure and response prevention program provided by Japanese clinical psychologists is an efficacious and feasible treatment approach for Japanese patients with obsessive-compulsive disorder. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Shinmei, Issei; Kanie, Ayako; Kobayashi, Yuki; Nakayama, Noriko; Takagishi, Yuriko; Iijima, Sonoko; Takebayashi, Yoshitake; Horikoshi, Masaru",2017.0,http://dx.doi.org/10.1016/j.jocrd.2017.08.002,0,0,
1006,Using Retrieval Cues to Attenuate Return of Fear in Individuals With Public Speaking Anxiety.,"Even after successful exposure, relapse is not uncommon. Based on the retrieval model of fear extinction (e.g., Vervliet, Craske, & Hermans, 2013), return of fear can occur after exposure due to an elapse of time (spontaneous recovery) or change in context (contextual renewal). The use of external salient stimuli presented throughout extinction (i.e., retrieval cues [RCs]) has been suggested as a potential solution to this problem (Bouton, 2002). The current study examined whether RCs attenuated return of fear in individuals with public speaking anxiety. Sixty-five participants completed a brief exposure while presented with two RC stimuli aimed at a variety of senses (visual, tactile, olfactory, and auditory). Later, half the participants were tested for return of fear in a context different from the exposure context, and the other half in the same context. Half of each context group were presented with the same cues as in exposure, while the other half were not. Return of fear due to an elapse of time, change in context, and effects of RCs were evaluated on subjective, behavioral, and physiological measures of anxiety. Although contextual renewal was not observed, results supported effects of RCs in reducing spontaneous recovery on behavioral and physiological measures of anxiety. There was also evidence that participants who were reminded of feeling anxious during exposure by the RCs benefited more from using them at follow-up, whereas those who perceived the cues as comforting (safety signals) benefited less. Clinical implications of the findings are discussed.",Shin KE.; Newman MG.,2018.0,10.1016/j.beth.2017.07.011,0,0,
1007,Diaphragmatic breathing during virtual reality exposure therapy for aviophobia: functional coping strategy or avoidance behavior? a pilot study.,"Although there is solid evidence for the efficacy of in vivo and virtual reality (VR) exposure therapy for a specific phobia, there is a significant debate over whether techniques promoting distraction or relaxation have impairing or enhancing effects on treatment outcome. In the present pilot study, we investigated the effect of diaphragmatic breathing (DB) as a relaxation technique during VR exposure treatment. Twenty-nine patients with aviophobia were randomly assigned to VR exposure treatment either with or without diaphragmatic breathing (six cycles per minute). Subjective fear ratings, heart rate and skin conductance were assessed as indicators of fear during both the exposure and the test session one week later. The group that experienced VR exposure combined with diaphragmatic breathing showed a higher tendency to effectively overcome the fear of flying. Psychophysiological measures of fear decreased and self-efficacy increased in both groups with no significant difference between the groups. Our findings indicate that diaphragmatic breathing during VR exposure does not interfere with the treatment outcome and may even enhance treatment effects of VR exposure therapy for aviophobic patients. Retrospectively registered. ClinicalTrials.gov NCT02990208 . Registered 07 December 2016.",Shiban Y.; Diemer J.; Müller J.; Brütting-Schick J.; Pauli P.; Mühlberger A.,2017.0,10.1186/s12888-016-1181-2,0,0,
1008,ADRB2 gene polymorphism modulates the retention of fear extinction memory,"Individual differences in regulation of fear and extinction memory play significant roles in the aetiology development of post-traumatic stress disorder (PTSD). Previous animal based studies showed that the activity of β-adrenergic receptors (β-ARs) are involved in memory modulation. However in humans it is not clear that whether genetic variability in β-ARs contributes to individual differences of fear and extinction memory. In the current study, we investigated the role of a common single-nucleotide polymorphism of β2-adrenergic receptor (ADRB2) gene in fear memory acquisition, fear memory extinction, extinction recall and fear generalization in human participants. Ninety-one male participants were exposed to a Pavlovian fear conditioning and their fear responses were assessed by the skin conductance response. Participants were genotyped for a polymorphism (rs2400207) located within the promoter region of the human ADRB2. Differences between genotypes were observed in the extinction memory recall test but not in fear acquisition, extinction learning and fear generalization. Particularly, A-allele carriers of rs2400707 displayed successful retention of extinction memory and prevented the return of fear during recall test. The results revealed the involvement of human noradrenergic system in the retention of extinction memory and genetic variability in this system may underlie individual differences in PTSD. Furthermore, rs2400207 polymorphism of ADRB2 gene may play a key role in the treatment efficacy of PTSD and can be a basis for future studies investigating a personalized medicine for fear memory related disorders.",Shi L.; Chen S.-J.; Deng J.-H.; Que J.-Y.; Lin X.; Sun Y.; Bao Y.-P.; Shi J.; Lu L.,2018.0,10.1016/j.nlm.2018.11.004,0,0,
1009, Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial," BACKGROUND: Despite effective assessment methods and medications targeting osteoporosis and related fractures, screening for fracture risk is not currently advocated in the UK. We tested whether a community‐based screening intervention could reduce fractures in older women. METHODS: We did a two‐arm randomised controlled trial in women aged 70‐85 years to compare a screening programme using the Fracture Risk Assessment Tool (FRAX) with usual management. Women were recruited from 100 general practitioner (GP) practices in seven regions of the UK: Birmingham, Bristol, Manchester, Norwich, Sheffield, Southampton, and York. We excluded women who were currently on prescription anti‐osteoporotic drugs and any individuals deemed to be unsuitable to enter a research study (eg, known dementia, terminally ill, or recently bereaved). The primary outcome was the proportion of individuals who had one or more osteoporosis‐related fractures over a 5‐year period. In the screening group, treatment was recommended in women identified to be at high risk of hip fracture, according to the FRAX 10‐year hip fracture probability. Prespecified secondary outcomes were the proportions of participants who had at least one hip fracture, any clinical fracture, or mortality; and the effect of screening on anxiety and health‐related quality of life. This trial is registered with the International Standard Randomised Controlled Trial registry, number ISRCTN 55814835. FINDINGS: 12 483 eligible women were identified and participated in the trial, and 6233 women randomly assigned to the screening group between April 15, 2008, and July 2, 2009. Treatment was recommended in 898 (14%) of 6233 women. Use of osteoporosis medication was higher at the end of year 1 in the screening group compared with controls (15% vs 4%), with uptake particularly high (78% at 6 months) in the screening high‐risk subgroup. Screening did not reduce the primary outcome of incidence of all osteoporosis‐related fractures (hazard ratio [HR] 0·94, 95% CI 0·85‐1·03, p=0·178), nor the overall incidence of all clinical fractures (0·94, 0·86‐1·03, p=0·183), but screening reduced the incidence of hip fractures (0·72, 0·59‐0·89, p=0·002). There was no evidence of differences in mortality, anxiety levels, or quality of life. INTERPRETATION: Systematic, community‐based screening programme of fracture risk in older women in the UK is feasible, and could be effective in reducing hip fractures. FUNDING: Arthritis Research UK and Medical Research Council."," Shepstone, L;  Lenaghan, E;  Cooper, C;  Clarke, S;  Fong-Soe-Khioe, R;  Fordham, R;  Gittoes, N;  Harvey, I;  Harvey, N;  Heawood, A;  et al.",2018.0, 10.1016/S0140-6736(17)32640-5,0,0,
1010,Computational investigation of binding mechanism of substituted pyrazinones targeting corticotropin releasing factor-1 receptor deliberated for anti-depressant drug design,"In spite of various research investigations towards anti-depressant drug discovery program, no one drug has not yet launched last 20 years. Corticotropin-releasing factor-1 (CRF-1) is one of the most validated targets for the development of antagonists against depression, anxiety and post-traumatic stress disorders. Various research studies suggest that pyrazinone based CRF-1 receptor antagonists were found to be highly potent and efficacious. In this research investigation, we identified the pharmacophore and binding pattern through 2D and 3D-QSAR and molecular docking respectively. Molecular dynamics studies were also performed to explore the binding pattern recognition. We establish the relationship between activity and pharmacophoric features to design new potent compounds. The best 2D-QSAR model was generated through multiple linear regression method with r2 value of 0.97 and q2 value of 0.89. Also 3D-QSAR model was obtained through k-nearest neighbor molecular field analysis method with q2 value of 0.52 and q2_se value of 0.36. Molecular docking and binding energy were also evaluated to define binding patterns and pharmacophoric groups, including (i) hydrogen bond with residue Asp284, Glu305 and (ii) π–π stacking with residue Trp9. Compound 11i has the highest binding affinity compared to reference compounds, so this compound could be a potent drug for stress related disorders. Most of the compounds, including reference compounds were found within acceptable range of physicochemical parameters. These observations could be provided the leads for the design and optimization of novel CRF-1 receptor antagonists. Communicated by Ramaswamy H. Sarma.",Shekhar M.S.; Venkatachalam T.; Sharma C.S.; Pratap Singh H.; Kalra S.; Kumar N.,2018.0,10.1080/07391102.2018.1513379,0,0,
1011, A Randomized Controlled Study of Cognitive-Behavioral Therapy for Posttraumatic Stress in Street Children in Mexico City," The study aimed to evaluate cognitive‚Äêbehavioral therapy (CBT) for posttraumatic stress (PTS), depression, anxiety, and anger in street children by a randomized controlled trial of CBT versus a waitlist control. It was conducted in 8 residential facilities for street children in Mexico City, with assessments at baseline, posttreatment, and 3 months later. Children who reported at least moderate posttraumatic stress, and fulfilled the study requirement were enrolled in the study (N = 100, 12‚Äê18 years old, 36 boys). There were 51 children randomized to CBT and 49 to the waitlist condition. Randomization was stratified by gender. CBT consisted of 12 individual 1‚Äêhour sessions administered weekly by 2 trained, master's‚Äêlevel clinicians. Outcome measures included self‚Äêreports of PTS, depression, anxiety, and anger; global improvement was assessed by the independent evaluator. Compared to participants in the waitlist condition participants in CBT showed a significant reduction in all symptoms, with effects sizes of 1.73 to 1.75. At follow up there was attrition (n = 36), and no change from posttreatment scores. The study did find statistically significant improvement in symptoms in the CBT group compared to the waitlist condition; symptoms remained stable at 3 months. The study found that CBT for trauma in a sample of street children provided a reduction of a broad range of mental health symptoms."," Shein-Szydlo, J;  Sukhodolsky, DG;  Kon, DS;  Tejeda, MM;  Ramirez, E;  Ruchkin, V",2016.0, 10.1002/jts.22124,0,0,
1012,"The Genetics and Epigenetics of PTSD: Overview, Recent Advances, and Future Directions","This paper provides a brief summary and commentary on the growing literature and current developments related to the genetic underpinnings of posttraumatic stress disorder (PTSD). We first briefly provide an overview of the behavioral genetic literature on PTSD, followed by a short synopsis of the substantial candidate gene literature with a focus on genes that have been meta-analyzed. We then discuss the genome-wide association studies (GWAS) that have been conducted, followed by an introduction to other molecular platforms used in PTSD genomic studies, such as epigenetic and expression approaches. We close with a discussion of developments in the field that include the creation of the PTSD workgroup of the Psychiatric Genomics Consortium, statistical advances that can be applied to GWAS data to answer questions of heritability and genetic overlap across phenotypes, and bioinformatics techniques such as gene pathway analyses which will further advance our understanding of the etiology of PTSD.",Sheerin C.M.; Lind M.J.; Bountress K.; Nugent N.R.; Amstadter A.B.,2017.0,10.1016/j.copsyc.2016.09.003,0,0,
1013,Repetitive transcranial magnetic stimulation improved symptoms of obsessive-compulsive disorders but not executive functions: Results from a randomized clinical trial with crossover design and sham condition.,"Objective: Whereas there is growing evidence that repetitive transcranial magnetic stimulation (rTMS) favorably impacts on symptoms of obsessive-compulsive disorders (OCD), less is known regarding the influence of rTMS on cognitive performance of patients with OCD. Here, we tested the hypothesis that rTMS has a positive impact both on symptom severity and executive functions in such patients. Methods: We assessed 10 patients diagnosed with OCD (mean age: 33.5 years) and treated with a standard medication; they were randomly assigned either to a treatment-first or to a sham-first condition. Symptom severity (experts' ratings) and executive functions (Wisconsin Card Sorting Test) were assessed by independent raters unaware of the patients' group assignments at baseline, after 2 and 4 weeks. After 2 weeks, treatment switched to sham condition, and sham condition switched to treatment condition. Results: Under treatment but not under sham conditions, symptom severity decreased. Performance on the executive function test increased continuously with every new assessment and was unrelated to rTMS treatment. Conclusion: Whereas the present study confirmed previous research suggesting that rTMS improved symptoms of OCD, rTMS did not improve executive functions to a greater degree than sham treatment. More research is needed to investigate the effect of rTMS on executive functions in patients with OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Shayganfard, Mehran; Jahangard, Leila; Nazaribadie, Marzieh; Haghighi, Mohammad; Ahmadpanah, Mohammad; Sadeghi Bahmani, Dena; Bajoghli, Hafez; Holsboer-Trachsler, Edith; Brand, Serge",2017.0,http://dx.doi.org/10.1159/000457128,0,0,
1014, Association of Mood Disorders with Serum Zinc Concentrations in Adolescent Female Students," Among various factors influencing mood disorders, the impact of micronutrient deficiencies has attracted a great attention. Zinc deficiency is considered to play a crucial role in the onset and progression of mood disorders in different stages of life. The main objective of this study was to assess the correlation between serum zinc levels and mood disorders in high school female students. This cross‐sectional study was conducted on a random sample of 100 representative high school female students. The participants completed 24‐h food recall questionnaires to assess the daily zinc intakes. Serum zinc status was assessed using flame atomic absorption spectrometry, and zinc deficiency was defined accordingly. Mood disorders were estimated by calculating the sum of two test scores including Beck's depression inventory (BDI) and hospital anxiety depression scale (HADS) tests. General linear model (GLM) and Pearson's regression test were applied to show the correlation of serum zinc levels and mood disorder scores and the correlation between zinc serum levels and BDI scores, respectively. Dietary zinc intake was higher in subjects with normal zinc concentrations than that of zinc‐deficient group (p = 0.001). Serum zinc levels were inversely correlated with BDI and HADS scores (p < 0.05). Each 10 μg/dL increment in serum zinc levels led to 0.3 and 0.01 decrease in depression and anxiety scores, respectively (p < 0.05). Serum zinc levels were inversely correlated with mood disorders including depression and anxiety in adolescent female students. Increasing serum levels of zinc in female students could improve their mood disorders."," Tahmasebi, K;  Amani, R;  Nazari, Z;  Ahmadi, K;  Moazzen, S;  Mostafavi, SA",2017.0, 10.1007/s12011-016-0917-7,0,0,
1015,Tensor decomposition-based unsupervised feature extraction identifies candidate genes that induce post-traumatic stress disorder-mediated heart diseases,"Background: Although post-traumatic stress disorder (PTSD) is primarily a mental disorder, it can cause additional symptoms that do not seem to be directly related to the central nervous system, which PTSD is assumed to directly affect. PTSD-mediated heart diseases are some of such secondary disorders. In spite of the significant correlations between PTSD and heart diseases, spatial separation between the heart and brain (where PTSD is primarily active) prevents researchers from elucidating the mechanisms that bridge the two disorders. Our purpose was to identify genes linking PTSD and heart diseases. Methods: In this study, gene expression profiles of various murine tissues observed under various types of stress or without stress were analyzed in an integrated manner using tensor decomposition (TD). Results: Based upon the obtained features, 400 genes were identified as candidate genes that may mediate heart diseases associated with PTSD. Various gene enrichment analyses supported biological reliability of the identified genes. Ten genes encoding protein-, DNA-, or mRNA-interacting proteins - ILF2, ILF3, ESR1, ESR2, RAD21, HTT, ATF2, NR3C1, TP53, and TP63 - were found to be likely to regulate expression of most of these 400 genes and therefore are candidate primary genes that cause PTSD-mediated heart diseases. Approximately 400 genes in the heart were also found to be strongly affected by various drugs whose known adverse effects are related to heart diseases and/or fear memory conditioning; these data support the reliability of our findings. Conclusions: TD-based unsupervised feature extraction turned out to be a useful method for gene selection and successfully identified possible genes causing PTSD-mediated heart diseases.",Taguchi Y.-H.,2017.0,10.1186/s12920-017-0302-1,0,0,
1016,"A randomised, clinical trial of a psycho-educational nursing intervention in patients receiving an Implantable Cardioverter Defibrillator","Implantable cardioverter defibrillators prevent Sudden Cardiac Death (SCD) in at-risk populations. Coming to terms with having an ICD, risk of SCD and a long-term condition may be impeded by negative psycho-social effects. Nurse-led psychoeducative support interventions have been trialled with mixed outcomes. As neither usual care or skills and knowledge of nurses delivering interventions were detailed, applicability within UK healthcare was unclear. This clinical trial tested a psychoeducational support intervention with usual care using arrhythmia clinical nurse specialists. Method Sixty-three people awaiting first ICD implant were randomised to usual care (n=33) or intervention (n=30) in one English cardiac centre between April 2009 and July 2011 . 'Treat-and-return' cases could not reliably access arrhythmia nurses preimplant and were therefore excluded. Participants completed validated self-report questionnaires (State Trait Anxiety Inventory-STAI; Beck Depression Inventory-Fast Screen- BDI-FS; COPE inventory; World Health Organisation Quality of Life tool- WHOQoL) pre-implant (T1), 6-weeks (T2) and 6-months (T3) post implant. The intervention was delivered 7-10 days post hospital discharge and following 6-week device check . 110 , Results Forty-nine participants (81 .6% male) completed pre-implant questionnaires (usual care n=25, intervention n=24) and 32/49 repeated these at T2 and T3. No significant differences were found between intervention and usual care groups postintervention. Both groups demonstrated increasing trait anxiety and altered coping over time (intervention group revealed increasing planning [p=0.037] and decreasing mental disengagement [p=0.008] but usual care group demonstrated increased denial [p=0.019]). At T3, denial significantly correlated with heightened state (r=0.573, p=0.010) and trait (r=0.577, p=0.010) anxiety for usual care, likewise BDIFS past failure (r=0.502, p=0.029 STAI-State; r=0.634, p=0.004 STAI-Trait) and selfcriticism (r=0.484, p=0.036 STAI-S; r=0.567, p=0.011 STAI-T). Conclusions and implications for practice Whilst small sample size limits generalisability, correlations between coping, anxiety and depression outcomes warrant further investigation with larger samples. Usual care for people having ICOs revealed inequitable access to psycho-educational support. Nurses are well placed to address these inequalities if appropriately resourced.",Tagney,2013.0,,0,0,
1017,High rates of PTSD treatment dropout: A possible red herring?,"Few studies have examined symptom change among dropouts from posttraumatic stress disorder (PTSD) treatment. However, dropout is widely considered a negative event needing to be addressed. The present study investigated PTSD and depression symptom change in patients with PTSD who discontinued psychotherapy. Female civilians (n = 321) diagnosed with PTSD participated in two randomized clinical trials examining PTSD treatment outcomes. Of those, 53 were identified as dropouts and included in this study. Symptom change was assessed by clinically significant change (CSC) criteria and symptom end-state criteria. Results demonstrated that considerable proportions of participants (35.85-55.56%) displayed significant improvement and/or met good end-state criteria for PTSD and depression. Results also revealed that participants who displayed symptom improvement were younger, attended more treatment sessions, were married or partnered, and had higher annual household income. Although preliminary, these findings contradict belief that treatment dropouts do not display symptom improvement. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Szafranski, Derek D; Smith, Brian N; Gros, Daniel F; Resick, Patricia A",2017.0,http://dx.doi.org/10.1016/j.janxdis.2017.01.002,0,0,
1018,"Integrated, exposure-based treatment for PTSD and comorbid substance use disorders: Predictors of treatment dropout.","High rates of comorbid posttraumatic stress disorder (PTSD) and substance use disorders (SUD) have been noted in veteran populations. Fortunately, there are a number of evidence-based psychotherapies designed to address comorbid PTSD and SUD. However, treatments targeting PTSD and SUD simultaneously often report high dropout rates. To date, only one study has examined predictors of dropout from PTSD/SUD treatment. To address this gap in the literature, this study aimed to 1) examine when in the course of treatment dropout occurred, and 2) identify predictors of dropout from a concurrent treatment for PTSD and SUD. Participants were 51 male and female veterans diagnosed with current PTSD and SUD. All participants completed at least one session of a cognitive-behavioral treatment (COPE) designed to simultaneously address PTSD and SUD symptoms. Of the 51 participants, 22 (43.1%) dropped out of treatment prior to completing the full 12 session COPE protocol. Results indicated that the majority of dropout (55%) occurred after session 6, with the largest amount of dropout occurring between sessions 9 and 10. Results also indicated a marginally significant relationship between greater baseline PTSD symptom severity and premature dropout. These findings highlight inconsistencies related to timing and predictors of dropout, as well as the dearth of information noted about treatment dropout within PTSD and SUD literature. Suggestions for procedural changes, such as implementing continual symptom assessments during treatment and increasing dialog between provider and patient about dropout were made with the hopes of increasing consistency of findings and eventually reducing treatment dropout.",Szafranski DD.; Snead A.; Allan NP.; Gros DF.; Killeen T.; Flanagan J.; Pericot-Valverde I.; Back SE.,2017.0,10.1016/j.addbeh.2017.04.005,0,0,
1019, Results from the Child/Adolescent Anxiety Multimodal Longitudinal Study (CAMELS): functional outcomes," OBJECTIVE: To report functional outcomes from the multisite Child/Adolescent Anxiety Multimodal Extended Long‚Äêterm Study (CAMELS), which examined the impact of youth anxiety treatment (cognitive‚Äêbehavioral therapy [CBT], coping cat; Sertraline, SRT; COMB [CBT + SRT]; pill placebo) on (a) global and (b) domain‚Äêspecific functioning assessed an average of 3.1 times, 3‚Äê to 12‚Äêyears postrandomization (first assessment = mean 6.5 years postrandomization). METHOD: Three‚Äêhundred and 19 of 488 families from the Child/Adolescent Anxiety Multimodal Study (CAMS; Walkup et al., 2008) participated. Growth curve modeling examined the impact of treatment condition and acute treatment outcomes (i.e., response, remission) on global functioning, global and domain‚Äêspecific impairment, and life satisfaction across follow‚Äêup visits. Logistic regressions explored the impact of treatment remission and condition on low frequency events (arrests/convictions) and education. RESULTS: Treatment responders and remitters demonstrated better global functioning, decreased overall impairment, and increased life satisfaction at follow‚Äêup. Treatment remission, but not response, predicted decreased domain‚Äêspecific impairment (social relationships, self‚Äêcare/independence, academic functioning), and maintenance of increased life satisfaction across follow‚Äêups. Participants in the CBT condition, compared with pill placebo, demonstrated improved trajectories pertaining to life satisfaction, overall impairment, and impairment in academic functioning. Randomization to CBT or COMB treatment was associated with increasing employment rates. Trajectories for participants randomized to SRT was not significantly different from placebo. Treatment outcome and condition did not predict legal outcomes, school/work variables, or family life. CONCLUSION: Positive early intervention outcomes are associated with improved overall functioning, life satisfaction, and functioning within specific domains 6.5 years posttreatment. Treatment type differentially predicted trajectories of functioning. Findings support the positive impact of pediatric anxiety treatment into adolescence and early adulthood. (PsycINFO Database Record"," Swan, AJ;  Kendall, PC;  Olino, T;  Ginsburg, G;  Keeton, C;  Compton, S;  Piacentini, J;  Peris, T;  Sakolsky, D;  Birmaher, B;  et al.",2018.0, 10.1037/ccp0000334,0,0,
1020, Internet-based information and support program for parents of children with burns: a randomized controlled trial," METHODS: Participants were parents of children treated for burns between 2009‐2013 at either of the two specialized Swedish Burn centers. Sixty‐two parents were included in a two‐armed, randomized controlled trial with a six‐week intervention group and a wait‐list control group, including a pre and post‐assessment, as well as a 3 and 12‐month follow‐up. The intervention contained psychoeducation, exercises and homework assignments, and the intervention group received weekly written feedback from a therapist. The main outcome was stress (post‐traumatic stress, general stress and parental stress). RESULTS: The program had a beneficial effect on posttraumatic stress in the short term, but did not affect general stress or parental stress. The parents rated the program as being informative and meaningful, but some of them thought it was time‐consuming. CONCLUSION: The program has the potential to support parents of children with burns. The intervention is easily accessible, cost‐effective and could be implemented in burn care rehabilitation. BACKGROUND: The aim of the study was to evaluate the feasibility and effects of an internet‐based information and self‐help program with therapist contact for parents of children and adolescents with burns. The program aimed to reduce parents' symptoms of general and posttraumatic stress."," Sveen, J;  Andersson, G;  Buhrman, B;  Sjöberg, F;  Willebrand, M",2017.0, 10.1016/j.burns.2016.08.039,0,0,
1021, Still lonely: social adjustment of youth with and without social anxiety disorder following cognitive behavioral therapy," Social experiences are an integral part of normative development for youth and social functioning difficulties are related to poor outcomes. Youth with anxiety disorders, and particularly social anxiety disorder, experience difficulties across many aspects of social functioning that may place them at risk for maladjustment. The goal of this paper was to compare social experiences of youth across anxiety diagnoses and examine whether treatment is helpful in improving social functioning. Ninety‚Äêtwo children (age 7‚Äê12 years; 58% male; 87.0% White) with a primary diagnosis of generalized anxiety disorder, separation anxiety disorder, and/or social anxiety disorder participated in cognitive behavioral therapy. At both pre‚Äê and post‚Äêtreatment, children with social anxiety disorder self‚Äêreported greater loneliness than youth without social anxiety disorder, though levels of peer victimization and receipt of prosocial behavior were similar across groups. Parents reported greater social problems for youth with social anxiety disorder compared to those without social anxiety disorder. All youth experienced improved social functioning following treatment per child‚Äê and parent‚Äêreports. The results call for an increased focus on the social experiences of youth with anxiety disorders, and particularly loneliness, for children with social anxiety disorder. The results document ways that evidenced‚Äêbased practice can improve social functioning for youth with anxiety disorders."," Suveg, C;  Kingery, JN;  Davis, M;  Jones, A;  Whitehead, M;  Jacob, ML",2017.0, 10.1016/j.janxdis.2017.10.005,0,0,
1022,Generalizability of Findings from a Randomized Controlled Trial of Fish Oil Supplementation for Attenuating Posttraumatic Stress Symptoms among Rescue Workers in Japan,,Susukida R.; Nishi D.; Kawashima Y.; Koido Y.; Mojtabai R.; Matsuoka Y.J.,2018.0,10.1159/000485105,0,0,
1023,Phytochemical and biological evaluation of cucumis sativus leaf extract,"Cucumber (Cucumis sativus) is a widely cultivated plant (Family: Cucurbitaceae). It is a creeping vine that bears cucumiform, fruits that are used as vegetables. Traditionally, Cucumis sativus possesses anti-diarrhoeal, antiurolithiatic, anti-inflammatory, anti-hypertensive, proteolytic, anti fungal, antioxidant and anti panic activities. The leaves of this plant is used for headache, seeds as diuretic, the fruit juice of this plant is used as nutritive and as a demulcent in anti-acne lotions. In the present study the ethanolic leaf extract of Cucumis sativus is screened for its phytochemical and biological activities (anti-urolithiatic and anti-oxidant activity). The results concluded that the ethanolic leaf extract of Cucumis sativus possessed significant anti-urolithiatic and anti-oxidant activity when compared with the standard cystone tablets and ascorbic acid.",Supriya J.; Sai K.Y.; Amrutha P.R.; Komali M.; Babu A.N.,2018.0,,0,0,
1024, The effect of mindfulness group therapy on a broad range of psychiatric symptoms: a randomised controlled trial in primary health care," BACKGROUND: The need for psychotherapy in primary health care is on the increase but individual‐based treatment is costly. The main aim of this randomised controlled trial (RCT) was to compare the effect of mindfulness‐based group therapy (MGT) with treatment as usual (TAU), mainly individual‐based cognitive behavioural therapy (CBT), on a broad range of psychiatric symptoms in primary care patients diagnosed with depressive, anxiety and/or stress and adjustment disorders. An additional aim was to compare the effect of MGT with TAU on mindful attention awareness. METHODS: This 8‐week RCT took place in 2012 at 16 primary care centres in southern Sweden. The study population included both men and women, aged 20‐64years (n=215). A broad range of psychiatric symptoms were evaluated at baseline and at the 8‐week follow‐up using the Symptom Checklist‐90 (SCL‐90). Mindful attention awareness was also evaluated using the Mindful Attention Awareness Scale (MAAS). RESULTS: In both groups, the scores decreased significantly for all subscales and indexes in SCL‐90, while the MAAS scores increased significantly. There were no significant differences in the change in psychiatric symptoms between the two groups. The mindfulness group had a somewhat larger change in scores than the control group on the MAAS (P=0.06, non‐significant). CONCLUSIONS: No significant differences between MGT and TAU, mainly individual‐based CBT, were found in treatment effect. Both types of therapies could be used in primary care patients with depressive, anxiety and/or stress and adjustment disorders, where MGT has a potential to save limited resources. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01476371."," Sundquist, J;  Palmér, K;  Johansson, LM;  Sundquist, K",2017.0, 10.1016/j.eurpsy.2017.01.328,0,0,
1025,Support vector machine analysis of functional magnetic resonance imaging of interoception does not reliably predict individual outcomes of cognitive behavioral therapy in panic disorder with agoraphobia.,"Background: The approach to apply multivariate pattern analyses based on neuro imaging data for outcome prediction holds out the prospect to improve therapeutic decisions in mental disorders. Patients suffering from panic disorder with agoraphobia (PD/AG) often exhibit an increased perception of bodily sensations. The purpose of this investigation was to assess whether multivariate classification applied to a functional magnetic resonance imaging (fMRI) interoception paradigm can predict individual responses to cognitive behavioral therapy (CBT) in PD/AG. Methods: This analysis is based on pretreatment fMRI data during an interoceptive challenge from a multicenter trial of the German PANIC-NET. Patients with DSM-IV PD/AG were dichotomized as responders (n = 30) or non-responders (n = 29) based on the primary outcome (Hamilton Anxiety Scale Reduction >= 50%) after 6 weeks of CBT (2 h/week). fMRI parametric maps were used as features for response classification with linear support vector machines (SVM) with or without automated feature selection. Predictive accuracies were assessed using cross validation and permutation testing. The influence of methodological parameters and the predictive ability for specific interoception-related symptom reduction were further evaluated. Results: SVM did not reach sufficient overall predictive accuracies (38.0-54.2%) for anxiety reduction in the primary outcome. In the exploratory analyses, better accuracies (66.7%) were achieved for predicting interoception-specific symptom relief as an alternative outcome domain. Subtle information regarding this alternative response criterion but not the primary outcome was revealed by post hoc univariate comparisons. Conclusion: In contrast to reports on other neurofunctional probes, SVM based on an interoception paradigm was not able to reliably predict individual response to CBT. Results speak against the clinical applicability of this technique. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Sundermann, Benedikt; Bode, Jens; Lueken, Ulrike; Westphal, Dorte; Gerlach, Alexander L; Straube, Benjamin; Wittchen, Hans-Ulrich; Strohle, Andreas; Wittmann, Andre; Konrad, Carsten; Kircher, Tilo; Arolt, Volker; Pfleiderer, Bettina",2017.0,http://dx.doi.org/10.3389/fpsyt.2017.00099,0,0,
1026,Effects of a family-support programme for pregnant women with foetal abnormalities requiring pregnancy termination: A randomized controlled trial in China.,"We examined the effects of a family-support programme for pregnant women with foetal abnormalities in terms of family support, depression, and post-traumatic stress symptoms. A randomized controlled trial was conducted from November 2016 to June 2017. A total of 124 pregnant women with foetal abnormalities were recruited and randomly assigned to the intervention group that received a family-support programme or control group that received only routine care. Self-reported questionnaires including the Family Adaptation Partnership Growth Affection and Resolve Index, the Edinburgh Postnatal Depression Scale, and the Impact of Event Scale-Revised were administered before and after intervention. Relative to the control group, posttest Family Adaptation Partnership Growth Affection and Resolve Index scores and scores on the intimacy domain were significantly higher in the intervention group, the Edinburgh Postnatal Depression Scale and Impact of Event Scale-Revised scores and the scores on all subscales except the intrusion subscale were significantly lower in the intervention group. The findings of this study suggest that family-support programme represents an effective and feasible support approach of improving family support and reducing depression and post-traumatic stress symptoms for pregnant women with foetal abnormalities requiring pregnancy termination.",Sun S.; Li J.; Ma Y.; Bu H.; Luo Q.; Yu X.,2018.0,10.1111/ijn.12614,0,0,
1027, Does the cause of the mild traumatic brain injury affect the expectation of persistent postconcussion symptoms and psychological trauma?," INTRODUCTION: A controlled experiment of the effect of injury cause on expectations of outcome from mild traumatic brain injury (TBI) was conducted. METHOD: Ninety‐three participants were randomly assigned to one of four conditions. The participants read a vignette that described a mild TBI (with fixed injury parameters) from a different cause (sport, domestic assault, fall, or motor vehicle accident). The effect of the manipulation on expectations of persistent postconcussion symptoms and psychological trauma was assessed with standard measures and a novel ""threat‐to‐life"" measure. RESULTS: The Kruskal‐Wallis H test for group differences revealed a significant but selective effect of group on symptom and trauma outcomes (ŋ CONCLUSION: Expectations were selectively altered by an experimental manipulation of injury cause. Given that expectations of outcome are known to affect mild TBI prognosis, the findings suggest the need for greater attention to injury cause."," Sullivan, KA;  Wade, C",2017.0, 10.1080/13803395.2016.1230597,0,0,
1028, Trauma in Hispanic youth with psychiatric symptoms: investigating gender and family effects," OBJECTIVE: Hispanic youth in the general community experience traumatic events and display symptoms of psychological distress more frequently than do Caucasian youth. However, little is known about how traumatic experiences in this ethnic minority population relate to psychopathology in clinical samples and whether these outcomes vary by gender and are impacted by family functioning. We hypothesized that traumatic stress reactions, including posttraumatic stress disorder (PTSD) and internalizing and externalizing symptoms, would vary by gender and by family functioning in a clinical sample of Hispanic youth. METHOD: The current study utilized baseline data from a randomized clinical trial (RCT) involving 200 Hispanic adolescents (122 boys and 78 girls) referred to treatment for experiencing clinical symptoms of 1 or more behavioral disorders and conflictual family relations. The rate of traumatic events, differences in outcomes depending on trauma exposure, and the effects gender, family functioning, and trauma on psychopathology and PTSD symptoms were examined. RESULTS: Analyses revealed that 61% of Hispanic youth in this clinical sample experienced at least 1 traumatic event. Although only 12% of the sample reported PTSD scores in the clinical range, girls reported higher PTSD scores than did boys. Poor family cohesion was particularly detrimental to girls compared with boys and related to internalizing and PTSD symptoms. High family conflict predicted PTSD symptoms in boys but not in girls. CONCLUSIONS: These findings have clinical implications for working with Hispanic populations, suggesting that culturally sensitive interventions should incorporate family‚Äêbased interventions for individuals who experience trauma to strengthen family bonds and decrease family conflict. (PsycINFO Database Record"," Suarez-Morales, L;  Mena, M;  Schlaudt, VA;  Santisteban, DA",2017.0, 10.1037/tra0000216,0,0,
1029, Cognitive Mediation of Symptom Change in Exposure and Response Prevention for Obsessive-Compulsive Disorder," This study examined cognitive mediators of symptom change during exposure and response prevention (EX/RP) for obsessive‚Äêcompulsive disorder (OCD). Based on cognitive models of OCD, obsessive beliefs were hypothesized as a mediator of symptom change. Participants were 70 patients with primary OCD receiving EX/RP either as part of a randomized controlled trial (n=38) or in open treatment following nonresponse to risperidone or placebo in the same trial (n=32). Blinded evaluations of OCD severity and self‚Äêreport assessments of three domains of obsessive beliefs (i.e., responsibility/threat of harm, importance/control of thoughts, and perfectionism/intolerance of uncertainty) were administered during acute (Weeks 0, 4 and 8) and maintenance treatment (Weeks 12 and 24). Study hypotheses were examined using cross‚Äêlagged multilevel modeling. Contrary to predictions, the obsessive beliefs domains investigated did not mediate subsequent OCD symptom reduction. In addition, OCD symptoms did not significantly mediate subsequent change in obsessive beliefs. The present study did not find evidence of cognitive mediation during EX/RP for OCD, highlighting the need to investigate other plausible mediators of symptom improvement."," Su, YJ;  Carpenter, JK;  Zandberg, LJ;  Simpson, HB;  Foa, EB",2016.0, 10.1016/j.beth.2016.03.003,0,0,
1030,Normal intrathecal leukocyte cell number and composition do not decrease the incidence of post-lumbar puncture headache.,"The pathogenesis of post-lumbar puncture headache (PLPH) has remained unclear. A beneficial role of CSF cells in the repair of a post-traumatic dural CSF leak has been suggested. The primary purpose of this study was to investigate the effects of 8weeks of induction therapy with high-dose PF-00547659 on the cellular elements of CNS immune surveillance in patients with active Crohn's Disease and a history of immunosuppressive therapy (Clinicaltrials.gov NCT01387594). PF-00547659 is a human monoclonal antibody that binds to mucosal addressin-cell adhesion molecule 1 (MAdCAM-1) on endothelial cells and blocks its interaction with beta7-integrin expressing lymphocytes. The study was executed in three parts or cohorts under two protocols. The incidence of a PLPH was 35% after the initial lumbar puncture, and 26% following the second lumbar puncture. After initiation of PF-00547659 anti-MAdCAM-1 therapy, there was a small and non-significant increase in the numbers of overall CSF leukocytes, and in lymphocyte subsets (CD3+, CD4+, and CD8+ T cells). The lymphocyte composition was unaltered by PF-00547659 anti-MAdCAM-1 therapy. Our observations suggest that normal numbers and composition of intrathecal leukocytes do not decrease the incidence of PLPH. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Stuve, Olaf; Cataldi, Fabio; Pradhan, Vivek; Gorelick, Kenneth J",2017.0,http://dx.doi.org/10.1016/j.jneuroim.2017.06.011,0,0,
1031,Comparing in-person to videoconference-based cognitive behavioral therapy for mood and anxiety disorders: Randomized controlled trial.,"Background: Cognitive-behavioral therapy (CBT) has demonstrated efficacy and effectiveness for treating mood and anxiety disorders. Dissemination of CBT via videoconference may help improve access to treatment. Objective: The present study aimed to compare the effectiveness of CBT administered via videoconference to in-person therapy for a mixed diagnostic cohort. Methods: A total of 26 primarily Caucasian clients (mean age 30 years, SD 11) who had a primary Diagnostic and Statistical Manual of Mental Disorders, 4th edition text revision (DSM-IV-TR) diagnosis of a mood or anxiety disorder were randomly assigned to receive 12 sessions of CBT either in-person or via videoconference. Treatment involved individualized CBT formulations specific to the presenting diagnosis; all sessions were provided by the same therapist. Participants were recruited through a university clinic. Symptoms of depression, anxiety, stress, and quality of life were assessed using questionnaires before, after, and 6 weeks following treatment. Secondary outcomes at posttreatment included working alliance and client satisfaction. Results: Retention was similar across treatment conditions; there was one more client in the videoconferencing condition at posttreatment and at follow-up. Statistical analysis using multilevel mixed effects linear regression indicated a significant reduction in client symptoms across time for symptoms of depression (P < .001, d = 1.41), anxiety (P < .001, d = 1.14), stress (P < .001, d = 1.81), and quality of life (P < .001, d = 1.17). There were no significant differences between treatment conditions regarding symptoms of depression (P = .165, d = 0.37), anxiety (P = .41, d = 0.22), stress (P = .15, d = 0.38), or quality of life (P = .62, d = 0.13). There were no significant differences in client rating of the working alliance (P = .53, one-tailed, d = -0.26), therapist ratings of the working alliance (P = .60, one-tailed, d = 0.23), or client ratings of satisfaction (P = .77, one-tailed, d = -0.12). Fisher's Exact P was not significant regarding differences in reliable change from pre- to posttreatment or from pretreatment to follow-up for symptoms of depression (P = .41, P = .26), anxiety (P = .60, P = .99), or quality of life (P = .65, P = .99) but was significant for symptoms of stress in favor of the videoconferencing condition (P = .03, P = .035). Difference between conditions regarding clinically significant change was also not observed from pre- to posttreatment or from pretreatment to follow-up for symptoms of depression (P = .67, P = .30), anxiety (P = .99, P = .99), stress (P = .19, P = .13), or quality of life (P = .99, P = .62). Conclusions: The findings of this controlled trial indicate that CBT was effective in significantly reducing symptoms of depression, anxiety, and stress and increasing quality of life in both in-person and videoconferencing conditions, with no significant differences being observed between the two. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Stubbings, Daniel R; Rees, Clare S; Roberts, Lynne D; Kane, Robert T",2013.0,http://dx.doi.org/10.2196/jmir.2564,0,0,
1032,"The influence of hazardous drinking on psychological functioning, stress and sleep during and after treatment in patients with mental health problems: a secondary analysis of a randomised controlled intervention study.","Hazardous drinking could negatively affect health and lead to alcohol use disorders, but it is unclear how hazardous drinking affects treatment outcomes of depression and anxiety and stress-related mental health problems. The aim of this study was to examine whether hazardous drinking, measured by Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), influences the outcomes of repeated assessments of psychological functioning (Outcome Questionnaire-45), stress (Perceived Stress Scale) and sleep (Karolinska Sleep Questionnaire), during and after treatment in patients with mental ill health. The study was conducted within REGASSA, a randomised controlled trial aimed at comparing Internet-based cognitive-behaviour therapy and physical exercise with treatment as usual on primary care patients with mental ill health. The study involved 871 participants who completed the AUDIT at baseline and who were assessed repeatedly during and after treatment on psychological functioning, stress and sleep by interactive voice response, a computerised, automated telephone technology. At baseline, hazardous drinkers were more depressed and had lower scores on psychological functioning than non-hazardous drinkers, while there were no differences on stress and sleep. During the follow-ups, hazardous drinking negatively influenced perceived stress, that is, hazardous drinkers seemed to have less treatment effect on stress, and the results remained after controlling for depression. There were no differences during the follow-ups regarding psychological functioning and sleep. Hazardous drinking negatively influenced perceived stress. The findings of the study emphasise the importance of screening for alcohol habits in mental ill-health patients, since risky drinking may affect the outcomes of treatment. DRKS00008745; Post-results.",Strid C.; Andersson C.; Öjehagen A.,2018.0,10.1136/bmjopen-2017-019128,0,0,
1033," Psychiatric Symptoms in Survivors of Acute Respiratory Distress Syndrome. Effects of Age, Sex, and Immune Modulation"," RATIONALE: Psychiatric morbidity after acute respiratory distress syndrome (ARDS) is common, and our current ability to predict psychiatric symptoms based on patient‚Äê and illness‚Äêspecific factors is limited. OBJECTIVES: We assessed symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) in long‚Äêterm survivors of ARDS, as well as the associated changes in cortisol levels. METHODS: The participants were enrolled in a randomized, double‚Äêblind, placebo‚Äêcontrolled trial of granulocyte macrophage‚Äêcolony stimulating factor (GM‚ÄêCSF) or placebo conducted at three academic medical centers. There were 132 patients enrolled, and 44 patients completed 6‚Äêmonth follow‚Äêup questionnaires (45% of survivors). RESULTS: Six months after enrollment, survivors completed the Post‚ÄêTraumatic Stress Syndrome 10 Questions Inventory, Impact of Event Scale, and Hospital Anxiety and Depression Scale to assess psychiatric symptoms. Plasma cortisol levels during treatment were measured by immunoassay. Thirty‚Äêsix percent of patients reported significant psychiatric symptoms on at least one scale. GM‚ÄêCSF‚Äêtreated patients reported more severe posttraumatic stress and depression symptoms than patients in the placebo group. In multiple regression analyses, younger age, female sex, higher severity of illness, fewer steroid treatment days, and GM‚ÄêCSF treatment were all independently associated with more severe psychiatric symptoms on at least one scale. CONCLUSIONS: 6 months after ARDS, age, sex, illness severity, steroids, and GM‚ÄêCSF treatment were associated with psychiatric symptom scores. These associations should be confirmed in a larger population. Clinical Trial registered with clinicaltrials.gov (NCT00201409)."," Spencer-Segal, JL;  Hyzy, RC;  Iwashyna, TJ;  Standiford, TJ",2017.0, 10.1513/AnnalsATS.201606-468OC,0,0,
1034, Generic versus disorder specific cognitive behavior therapy for social anxiety disorder in youth: a randomized controlled trial using internet delivery," The study examined whether the efficacy of cognitive behavioral treatment for Social Anxiety Disorder for children and adolescents is increased if intervention addresses specific cognitive and behavioral factors linked to the development and maintenance of SAD in young people, over and above the traditional generic CBT approach. Participants were 125 youth, aged 8‚Äê17 years, with a primary diagnosis of SAD, who were randomly assigned to generic CBT (CBT‚ÄêGEN), social anxiety specific CBT (CBT‚ÄêSAD) or a wait list control (WLC). Intervention was delivered using a therapist‚Äêsupported online program. After 12‚Äêweeks, participants who received treatment (CBT‚ÄêSAD or CBT‚ÄêGEN) showed significantly greater reduction in social anxiety and post‚Äêevent processing, and greater improvement in global functioning than the WLC but there was no significant difference between CBT‚ÄêSAD and CBT‚ÄêGEN on any outcome variable at 12‚Äêweeks or 6‚Äêmonth follow‚Äêup. Despite significant reductions in anxiety, the majority in both treatment conditions continued to meet diagnostic criteria for SAD at 6‚Äêmonth follow‚Äêup. Decreases in social anxiety were associated with decreases in post‚Äêevent processing. Future research should continue to investigate disorder‚Äêspecific interventions for SAD in young people, drawing on evidence regarding causal or maintaining factors, in order to enhance treatment outcomes for this debilitating condition."," Spence, SH;  Donovan, CL;  March, S;  Kenardy, JA;  Hearn, CS",2017.0, 10.1016/j.brat.2016.12.003,0,0,
1035,Evaluation of drug provocation test-related anxiety in patients with drug hypersensitivity.,"Drug provocation tests (DPTs) are important in the treatment of patients with drug hypersensitivity (DH), but they carry certain hypersensitivity reaction risks, which lead to procedure-related concerns in patients. To investigate DPT-related anxiety and its effect on long-term use of tested drugs. The study included patients who underwent DPT from July 1, 2009, to July 1, 2012. After recording the patients' history and characteristics, a variety of psychiatric (Hospital Anxiety and Depression Scale, Panic and Agoraphobia Scale, and the Maudsley Obsessive-Compulsive Inventory) and quality-of-life (36-item Short Form Health Survey) tests were performed. DPT-related anxiety was also evaluated using a visual analog scale. The patients were requestioned about whether they had used the tested drug within 1 year. A total of 126 patients were included in the study. According to the Hospital Anxiety and Depression Scale, 23.4% and 30.6% of the patients had depression and anxiety symptoms, respectively. The mean (SD) visual analog scale anxiety scores after a negative DPT result were lower than those before DPTs (2 [2.5] after vs 5.2 [3.4] before; P < .001). In the long term, 15.9% of the patients did not use the drug because of ongoing anxiety related to drug reactions, despite negative DPT results and symptoms indicated for use of the drug. Our findings suggest that DPTs in themselves cause significant anxiety in patients with DH. Importantly, anxiety levels decreased after a negative test result. However, our results also suggested that a negative DPT result is not convincing enough for some patients to use the tested drug when needed in the future. Therefore, supporting strategies appear to be the most effective way to eliminate DH-related anxiety of patients.",Soyyiğit Ş.; Aydın Ö.; Yılmaz İ.; Özdemir SK.; Cankorur VŞ.; Atbaşoğlu C.; Çelik GE.,2016.0,10.1016/j.anai.2016.06.016,0,0,
1036, Correlates of nicotine withdrawal severity in smokers during a smoke-free psychiatric hospitalization," Psychiatric hospitals are increasingly adopting smoke‐free policies. Tobacco use is common among persons with mental illness, and nicotine withdrawal (NW), which includes symptoms of depression, anxiety, anger/irritability, and sleep disturbance, may confound psychiatric assessment and treatment in the inpatient setting. This study aimed to characterize NW and correlates of NW severity in a sample of smokers hospitalized for treatment of mental illness in California. Participants (N=754) were enrolled between 2009 and 2013, and averaged 17 (SD=10) cigarettes/day prior to hospitalization. Though most (70%) received nicotine replacement therapy (NRT) during hospitalization, a majority (65%) reported experiencing moderate to severe NW. In a general linear regression model, NW symptoms were more severe for women, African American patients, and polysubstance abusers. Though invariant by psychiatric diagnostic category, greater NW was associated with more severe overall psychopathology and greater cigarette dependence. The full model explained 46% of the total variation in NW symptom severity (F [19, 470]=23.03 p<0.001). A minority of participants (13%) refused NRT during hospitalization. Those who refused NRT reported milder cigarette dependence and stated no prior use of NRT. Among smokers hospitalized for mental illness, NW severity appears multidetermined, related to cigarette dependence, demographic variables, psychiatric symptom severity, and other substance use. Assessment and treatment of NW in the psychiatric hospital is clinically warranted and with extra attention to groups that may be more vulnerable or naïve to cessation pharmacotherapy."," Soyster, P;  Anzai, NE;  Fromont, SC;  Prochaska, JJ",2016.0, 10.1016/j.ypmed.2016.01.026,0,0,
1037,Explicit instructions facilitate performance of OCD participants but impair performance of non-OCD participants on a serial reaction time task,"Previous studies have shown that individuals diagnosed with OCD tend to rely on explicit processing while performing implicit learning tasks. We sought to investigate whether individuals with OCD are capable of implicit learning, but would demonstrate improved performance when explicit processing strategies are enhanced. Twenty-four participants with OCD and 24 non-psychiatric control (NPC) participants performed an implicit learning task in which they responded to a single target stimulus that successively appears at one of four locations according to an underlying sequence. We manipulated the learning strategy by informing half of the participants that the target stimulus location was determined by an underlying sequence, which they should identify (intentional learning). The other half of the participants was not informed of the existence of the underlying sequence, and was expected to learn the sequence implicitly (standard learning). We predicted that OCD participants will exhibit inferior performance compared to NPC participants in the standard learning condition, and that intentional learning instructions would impair the performance of NPC participants, but enhance the performance of OCD participants. The results supported these predictions and suggest that individuals with OCD prefer controlled to automatic processing. We discuss the implications of this conclusion to our understanding of OCD.",Soref A.; Liberman N.; Abramovitch A.; Dar R.,2018.0,10.1016/j.janxdis.2018.02.003,0,0,
1038,Early Cranioplasty in Patients With Posttraumatic Decompressive Craniectomy and Its Correlation with Changes in Cerebral Perfusion Parameters and Neurocognitive Outcome.,"Decompressive craniectomy is a life-saving procedure in many patients after traumatic brain injury. Delayed recovery in such patients can be attributed to various causes. Cranioplasty (CP) helps in early improvement of neurocognitive function along with better brain protection and cosmesis. The mechanism responsible for this functional improvement and the ideal time to perform cranial reconstruction is less understood. We studied 16 patients who underwent CP after decompressive craniectomy (DC) for traumatic brain injury. These patients were divided in 2 groups, early and late CP, depending on the interval between DC and CP. Three months was the cutoff time for early CP. Neurocognitive status was assessed by Glasgow Coma Scale, Glasgow Outcome Scale, and Mini-Mental State Examination scores prior to and after CP. Computed tomography (CT) perfusion was done to correlate the improvement in neurologic status and CT perfusion parameters. We observed that there was a positive influence of CP on neurologic and psychologic function in all of the patients. The neurocognitive improvement after CP was more remarkable in the early CP group. More complications were noted in patients in the late CP group. Brain perfusion after CP showed improvement in all parameters in both of the groups, both on the operated and contralateral side. Neurocognitive improvement is noted after CP in all of the patients. CP should be offered once the brain edema subsides, at the earliest. Improved cerebral perfusion may be the key factor for the improved functional outcome.",Songara A.; Gupta R.; Jain N.; Rege S.; Masand R.,2016.0,10.1016/j.wneu.2016.07.003,0,0,
1039,Stimulation of the noradrenergic system during memory formation impairs extinction learning but not the disruption of reconsolidation.,"The noradrenergic system plays a critical role in the 'consolidation' of emotional memory. If we are to target 'reconsolidation' in patients with anxiety disorders, the noradrenergic strengthening of fear memory should not impair the disruption of reconsolidation. In Experiment I, we addressed this issue using a differential fear conditioning procedure allowing selective reactivation of one of two fear associations. First, we strengthened fear memory by administering an alpha(2)-adrenergic receptor antagonist (ie, yohimbine HCl; double-blind placebo-controlled study) 30 min before acquisition (time for peak value yohimbine HCl < 1 h). Next, the reconsolidation of one of the fear associations was manipulated by administering a beta-adrenergic receptor antagonist (ie, propranolol HCl) 90 min before its selective reactivation (time for peak value propranolol HCl < 2 h). In Experiment II, we administered propranolol HCl after reactivation of the memory to rule out a possible effect of the pharmacological manipulation on the memory retrieval itself. The excessive release of noradrenaline during memory formation not only delayed the process of extinction 48 h later, but also triggered broader fear generalization. Yet, the beta-adrenergic receptor blocker during reconsolidation selectively 'neutralized' the fear-arousing aspects of the noradrenergic-strengthened memory and undermined the generalization of fear. We observed a similar reduction in fear responding when propranolol HCl was administered after reactivation of the memory. The present findings demonstrate the involvement of noradrenergic modulation in the formation as well as generalization of human fear memory. Given that the noradrenergic strengthening of fear memory impaired extinction learning but not the disruption of reconsolidation, our findings may have implications for the treatment of anxiety disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Soeter, Marieke; Kindt, Merel",2012.0,http://dx.doi.org/10.1038/npp.2011.307,0,0,
1040, A Pilot Study on Telephone Cognitive Behavioral Therapy for Patients Six-Months Post-Bariatric Surgery," OBJECTIVE: This study aimed to determine the feasibility and preliminary efficacy of a post‐operative telephone‐based cognitive behavioral therapy intervention (Tele‐CBT) in improving eating pathology and psychosocial functioning. METHODS: Six‐month post‐operative bariatric surgery patients (n = 19) received six sessions of Tele‐CBT. Study outcome variables included binge eating (BES), emotional eating (EES), depressive symptoms (PHQ‐9), and anxiety symptoms (GAD‐7). RESULTS: Retention was 73.7 % post‐intervention. Tele‐CBT resulted in significant reductions in mean difference scores on BES, EES‐Total, EES‐Anxiety, EES‐Anger, PHQ9, and GAD7. Tele‐CBT patients experienced a mean weight loss of 8.62 ± 15.02 kg between 6‐months post‐surgery (pre‐Tele‐CBT) and 12‐months post‐surgery. CONCLUSIONS: These preliminary results suggest that post‐surgery Tele‐CBT is feasible and can improve post‐surgery symptoms of psychopathology in this uncontrolled study, supporting the need for a randomized controlled trial."," Sockalingam, S;  Cassin, SE;  Wnuk, S;  Du, C;  Jackson, T;  Hawa, R;  Parikh, SV",2017.0, 10.1007/s11695-016-2322-x,0,0,
1041,"Relationship between neuroticism, childhood trauma and cognitive-affective responses to auditory verbal hallucinations.","Neuroticism has been shown to adversely influence the development and outcome of psychosis. However, how this personality trait associates with the individual's responses to psychotic symptoms is less well known. Auditory verbal hallucinations (AVHs) have been reported by patients with psychosis and non-clinical individuals. There is evidence that voice-hearers who are more distressed by and resistant against the voices, as well as those who appraise the voices as malevolent and powerful, have poorer outcome. This study aimed to examine the mechanistic association of neuroticism with the cognitive-affective reactions to AVH. We assessed 40 psychotic patients experiencing frequent AVHs, 135 non-clinical participants experiencing frequent AVHs, and 126 healthy individuals. In both clinical and non-clinical voice-hearers alike, a higher level of neuroticism was associated with more distress and behavioral resistance in response to AVHs, as well as a stronger tendency to perceive voices as malevolent and powerful. Neuroticism fully mediated the found associations between childhood trauma and the individuals' cognitive-affective reactions to voices. Our results supported the role of neurotic personality in shaping maladaptive reactions to voices. Neuroticism may also serve as a putative mechanism linking childhood trauma and psychological reactions to voices. Implications for psychological models of hallucinations are discussed.",So SH.; Begemann MJ.; Gong X.; Sommer IE.,2016.0,10.1038/srep34401,0,0,
1042,Negotiating the Interpretation of Depression Shared Among Kin,"Kinship processes contribute to the experience and interpretation of depression-generating empathy as well as silencing. We explore intersubjective experiences of depression among kin with the aim of understanding how depression can reveal kinship expectations and evolving concepts of distress. In interviews with 28 low-income rural Appalachian women about their depression, participants articulated depression as a social process that neither starts nor ends in themselves. Yet kinship obligations to recognize family members' depression limited women's ability to admit distress, let alone request care. The intersubjective experience of depression among kin can challenge the individual expression of distress.",Snell-Rood C.; Merkel R.; Schoenberg N.,2018.0,10.1080/01459740.2018.1424151,0,0,
1043, Enhancing panic and smoking reduction treatment with d-cycloserine: study protocol for a randomized controlled trial," There has been relatively little attention focused on treatment strategies for smokers with panic attacks despite their increased risk of relapse. Panic and Smoking Reduction Treatment (PSRT) integrates standard smoking cessation treatment with an exposure‚Äêbased intervention targeting the mechanisms underlying panic‚Äêsmoking relations. Building upon emerging evidence supporting the efficacy of d‚Äêcycloserine (DCS) for augmenting exposure‚Äêbased therapy, we are conducting an initial test of the efficacy of DCS for enhancing PSRT outcomes. Utilizing a randomized, double‚Äêblind trial comparing PSRT + DCS to PSRT + placebo, we will obtain initial effect sizes for short‚Äêterm and long‚Äêterm smoking cessation outcomes and perform an initial test of putative mechanisms."," Smits, JA;  Kauffman, BY;  Lee-Furman, E;  Zvolensky, MJ;  Otto, MW;  Piper, ME;  Powers, MB;  Rosenfield, D",2016.0, 10.1016/j.cct.2016.03.011,0,0,
1044,Increased illness burden in women with comorbid bipolar and premenstrual dysphoric disorder: Data from 1 099 women from STEP-BD study.,"Background: The impact of comorbid premenstrual dysphoric disorder (PMDD) in women with bipolar disorder (BD) is largely unknown. Aims: We compared illness characteristics and female-specific mental health problems between women with BD with and without PMDD. Materials & Methods: A total of 1 099 women with BD who participated in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) were studied. Psychiatric diagnoses and illness characteristics were assessed using the Mini International Neuropsychiatric Interview. Female-specific mental health was assessed using a self-report questionnaire developed for STEP-BD. PMDD diagnosis was based on DSM-5 criteria. Results: Women with comorbid BD and PMDD had an earlier onset of bipolar illness (P < 0.001) and higher rates of rapid cycling (P = 0.039), and increased number of past-year hypo/manic (P = 0.003), and lifetime/past-year depressive episodes (P < 0.05). Comorbid PMDD was also associated with higher proportion of panic disorder, post-traumatic stress disorder, generalized anxiety disorder, bulimia nervosa, substance abuse, and adult attention deficit disorder (all P < 0.05). There was a closer gap between BD onset and age of menarche in women with comorbid PMDD (P = 0.003). Women with comorbid PMDD reported more severe mood symptoms during the perinatal period and while taking oral contraceptives (P < 0.001). Discussion: The results from this study is consistent with research suggesting that sensitivity to endogenous hormones may impact the onset and the clinical course of BD. Conclusions: The comorbidity between PMDD and BD is associated with worse clinical outcomes and increased illness burden. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Slyepchenko, A; Frey, B. N; Lafer, B; Nierenberg, A. A; Sachs, G. S; Dias, R. S",2017.0,http://dx.doi.org/10.1111/acps.12797,0,0,
1045,Imagery Rescripting: The Impact of Conceptual and Perceptual Changes on Aversive Autobiographical Memories.,"Imagery rescripting (ImRs) is a process by which aversive autobiographical memories are rendered less unpleasant or emotional. ImRs is thought only to be effective if a change in the meaning-relevant (semantic) content of the mental image is produced, according to a cognitive hypothesis of ImRs. We propose an additional hypothesis: that ImRs can also be effective by the manipulation of perceptual features of the memory, without explicitly targeting meaning-relevant content. In two experiments using a within-subjects design (both N = 48, community samples), both Conceptual-ImRs-focusing on changing meaning-relevant content-and Perceptual-ImRs-focusing on changing perceptual features-were compared to Recall-only of aversive autobiographical image-based memories. An active control condition, Recall + Attentional Breathing (Recall+AB) was added in the first experiment. In the second experiment, a Positive-ImRs condition was added-changing the aversive image into a positive image that was unrelated to the aversive autobiographical memory. Effects on the aversive memory's unpleasantness, vividness and emotionality were investigated. In Experiment 1, compared to Recall-only, both Conceptual-ImRs and Perceptual-ImRs led to greater decreases in unpleasantness, and Perceptual-ImRs led to greater decreases in emotionality of memories. In Experiment 2, the effects on unpleasantness were not replicated, and both Conceptual-ImRs and Perceptual-ImRs led to greater decreases in emotionality, compared to Recall-only, as did Positive-ImRs. There were no effects on vividness, and the ImRs conditions did not differ significantly from Recall+AB. Results suggest that, in addition to traditional forms of ImRs, targeting the meaning-relevant content of an image during ImRs, relatively simple techniques focusing on perceptual aspects or positive imagery might also yield benefits. Findings require replication and extension to clinical samples.",Slofstra C.; Nauta MH.; Holmes EA.; Bockting CL.,2016.0,10.1371/journal.pone.0160235,0,0,
1046, Brief treatment for PTSD: a non-inferiority trial," Prior studies have identified several psychosocial treatment approaches as effective for posttraumatic stress disorder (PTSD). Unfortunately, a substantial minority of individuals who receive these treatments drop out prematurely. Moreover, a considerable number of individuals in need of PTSD treatment do not present for treatment due to time constraints and other barriers to care. Thus, there is a need to develop alternative evidence‚Äêbased PTSD treatments that have lower treatment dropout rates and address current barriers to receiving care. One recently developed PTSD treatment that has demonstrated efficacy and potentially meets these criteria is Written Exposure Therapy (WET), a 5‚Äêsession treatment protocol that promotes recovery through writing about the trauma event as well as one's thoughts and feelings about it without any assigned homework. In an ongoing randomized controlled trial (RCT) we are investigating whether WET is equally efficacious as Cognitive Processing Therapy (CPT), a treatment that typically requires more therapist training and more therapy sessions. The study sample consists of 126 adults diagnosed with PTSD who are randomly assigned to either WET (n = 63) or CPT (n = 63). Participants are assessed prior to treatment and 6‚Äê, 12‚Äê, 24‚Äê, 36‚Äê, and 60‚Äêweeks after the first treatment session. The primary outcome measure is PTSD symptom severity assessed with the Clinician Administered PTSD Scale for DSM‚Äê5. Given the prevalence of PTSD and the aforementioned limitations of currently available first‚Äêline PTSD treatments, the identification of a brief, efficacious treatment that is associated with reduced patient dropout would represent a significant public health development."," Sloan, DM;  Marx, BP;  Resick, PA",2016.0, 10.1016/j.cct.2016.04.003,0,0,
1047,Assessing sleep quality using self-report and actigraphy in PTSD.,"Sleep disturbance is commonly reported by participants with post-traumatic stress disorder, but objective evidence of poor sleep is often absent. Here we compared self-report and actigraphic evaluations of sleep between veterans with post-traumatic stress disorder and controls. Participants reported their sleep retrospectively for the month before the recording night and on the recording night. On the recording night, they wore an Actiwatch-64 and were instructed to press the marker button upon getting into bed, each time they awoke, and at their final awakening. The post-traumatic stress disorder group reported much worse sleep than controls on the Pittsburgh Sleep Quality Index for the previous month and somewhat poorer sleep on the recording night. However, on the recording night, neither diary nor actigraphic measures of number of awakenings, total time in bed, nor time lying awake after sleep onset differed between participants with and without post-traumatic stress disorder. Diary-reported number of awakenings was fewer than actigraphically captured awakenings. These results suggest a memory bias towards remembering worse sleep on the nights before the recording night. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Slightam, Cindie; Petrowski, Katja; Jamison, Andrea L; Keller, Marius; Bertram, Franziska; Kim, Sunyoung; Roth, Walton T",2018.0,http://dx.doi.org/10.1111/jsr.12632,0,0,
1048,Evaluating the effectiveness of a brief mindful self-care and resiliency (MSCR) intervention for nurses: A controlled trial.,"It has been well documented that workplace stress can have a negative impact on nurse well-being and productivity, and can result in the syndrome of compassion fatigue, which is comprised of secondary traumatic stress and burnout. Identifying effective and practical workplace interventions to help improve nurse resilience to prevent compassion fatigue is therefore a high priority. This study trialled the effectiveness of a brief mindful self-care and resiliency intervention for nurses working in an Australian tertiary hospital compared to nurses in a wait list control condition. A total of 91 nurses participated in the study (n = 65 intervention condition; n = 26 control condition). The intervention involved a 1-day workshop followed by three weekly mindfulness practice sessions. Nurses completed measures of burnout, secondary traumatic stress, negative mood, self-compassion, compassion satisfaction, subjective quality of life and general self-efficacy at pre-test, post-test and 6-month follow-up. Analysis revealed that compared to the control group, the intervention group had significant reductions in burnout and depressed mood upon completion of the MSCR. Follow-up data indicated that these reductions persisted at 6-month post-MSCR for the intervention group. While interactions between intervention and control conditions for other measures failed to reach statistical significance, follow-up analysis revealed significant improvements in compassion satisfaction, self-compassion and subjective quality of life for nurses completing the intervention. As a whole, the findings demonstrate that a brief mindfulness-based self-care intervention is effective at improving the emotional functioning of nurses. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Slatyer, Susan; Craigie, Mark; Heritage, Brody; Davis, Sue; Rees, Clare",2018.0,http://dx.doi.org/10.1007/s12671-017-0795-x,0,0,
1049,A programme for the prevention of post-traumatic stress disorder in midwifery (POPPY): Indications of effectiveness from a feasibility study.,"Background: Midwives can experience events they perceive as traumatic when providing care. As a result, some will develop post-traumatic stress disorder (PTSD), with adverse implications for their mental health, the quality of care provided for women and the employing organizations. POPPY (Programme for the prevention of PTSD in midwifery) is a package of educational and supportive resources comprising an educational workshop, information leaflet, peer support and access to trauma-focused clinical psychology intervention. A feasibility study of POPPY implementation was completed. Objective: This study aimed to identify potential impacts of POPPY on midwives' understanding of trauma, their psychological well-being and job satisfaction. Method: POPPY was implemented in one hospital site. Before taking part in the POPPY workshop (T1) midwives (N = 153) completed self-report questionnaires, which measured exposure to work-related trauma, knowledge and confidence of managing trauma responses, professional impacts, symptoms of PTSD, burnout and job satisfaction. Measures were repeated (T2) approximately 6 months after training (n = 91, 62%). Results: Midwives' confidence in recognizing (p = .001) and managing early trauma responses in themselves and their colleagues significantly improved (both p < .001). There was a trend towards reduced levels of PTSD symptomatology, and fewer midwives reported sub clinical levels of PTSD (from 10% at T1 to 7% at T2). The proportion of midwives reporting high and moderate levels of depersonalization towards care was reduced (33% to 20%) and midwives reported significantly higher levels of job satisfaction at T2 (p < .001). Reductions in self-reported stress-related absenteeism (12% to 5%), long-term changes to clinical allocation (10% to 5%) and considerations about leaving midwifery (34% to 27%) were identified. Conclusions: In conclusion, POPPY shows very positive potential to improve midwives' mental health and the sensitivity of care they provide, and reduce service disruption and costs for trusts. Large-scale longitudinal evaluation is required. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Abstract (Spanish) Antecedentes: las matronas pueden experimentar eventos que perciben como traumaticos cuando proporcionan atencion clinica. Como resultado, algunas desarrollaran trastorno de estres postraumatico (TEPT) con efectos adversos para la salud mental de las matronas, la calidad de la atencion brindada a las mujeres y las organizaciones en donde trabajan. El POPPY (Programa para la prevencion del TEPT en obstetricia) es un conjunto de recursos educativos y de apoyo que comprende un taller educativo, folletos informativos, soporte de pares y acceso a intervenciones psicologicas centradas en el trauma. Se realizo un estudio de factibilidad de la implementacion de POPPY. Objetivo: Identificar el impacto de POPPY en la comprension del trauma por parte de las matronas, su bienestar psicologico y la satisfaccion en el trabajo. Metodo: Se implemento POPPY en un sitio del hospital entre octubre de 2016 y septiembre de 2017. Las matronas (n = 153) empleadas en el sitio anfitrion completaron cuestionarios de auto-reporte antes de participar en el taller POPPY (T1), que midio la exposicion al trauma relacionado al trabajo, conocimiento y confianza en el manejo de respuesta al trauma, impacto profesional, sintomas de TEPT, agotamiento y satisfaccion en el trabajo. Las mediciones se repitieron (T2) aproximadamente 6 meses despues del entrenamiento (n = 91, 62%). Resultados: la confianza de las matronas en el reconocimiento (p = .001) y el manejo de las respuestas tempranas al trauma en si mismas (p <.001) y colegas mejoro significativamente (p <.001). Hubo una tendencia en la reduccion de los niveles de sintomatologia de TEPT, y menos matronas informaron niveles subclinicos de TEPT (10% a 7%). La proporcion de matronas que informaron niveles altos y moderados de despersonalizacion hacia la atencion se redujo (33% a 20%) y las matronas informaron niveles significativamente mas altos de satisfaccion laboral en T2 (p <.001). Se identificaron: reducciones en el ausentismo auto-reportado relacionado con el estres (12% a 5%), cambios a largo plazo en la asignacion clinica (10% a 5%) y razones para dejar la profesion de matrona (34% a 27%). Conclusiones: los hallazgos resaltan un potencial muy positivo del programa POPPY para mejorar la salud mental de las matronas, la sensibilidad de la atencion que brindan y reducir la interrupcion del servicio y los costos para los proveedores de servicios. Se requiere una evaluacion a gran escala. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Slade, Pauline; Sheen, Kayleigh; Collinge, Sarah; Butters, Jenny; Spiby, Helen",2018.0,http://dx.doi.org/10.1080/20008198.2018.1518069,0,0,
1050,Cost-Effectiveness of a PTSD Intervention Tailored for Individuals With Severe Mental Illness.,"This study examined the cost-effectiveness of a cognitive-behavioral therapy (CBT) intervention for posttraumatic stress disorder (PTSD) that is tailored for adults with a co-occurring severe mental illness. Data were from a randomized trial involving 183 adult clients of two outpatient clinics and three partial hospitalization programs. All had a severe mental illness diagnosis (major mood disorder, schizophrenia, or schizoaffective disorder) and severe PTSD. Participants were randomly assigned to the tailored 12- to 16-session CBT intervention for PTSD (CBT-P) or a three-session breathing retraining and psychoeducation intervention (BRF). Cost estimates included intervention costs for training, supervision, fidelity assessment, personnel, and overhead and related mental health care costs for outpatient, inpatient, and emergency department services and for medications. The incremental cost-effectiveness ratio comparing CBT-P with BRF measured the added cost or savings per remission from PTSD at 12 months postintervention. Generalized linear models were used to estimate intervention effects on annual mental health care costs and the likelihood of a remission from PTSD. Ten thousand bootstrap replications were used to assess uncertainty. Annual mean mental health care costs were $25,539 per client (in 2010 dollars) for BRF participants and $29,530 per client for CBT-P participants, a nonsignificant difference. The mean incremental cost-effectiveness ratio was $36,893 per additional PTSD remission yielded by CBT-P compared with BRF (95% confidence interval=-$33,523 to $158,914). Remissions were associated with improvements in quality of life and functioning. An effective CBT intervention tailored for adults with severe mental illness and PTSD was not found to be more cost-effective than a brief three-session intervention.",Slade EP.; Gottlieb JD.; Lu W.; Yanos PT.; Rosenberg S.; Silverstein SM.; Minsky SK.; Mueser KT.,2017.0,10.1176/appi.ps.201600474,0,0,
1051, Effect of a universal anxiety prevention programme (FRIENDS) on children's academic performance: results from a randomised controlled trial," BACKGROUND: Evaluations of school‚Äêbased anxiety prevention programmes have reported improvements in psychological functioning although little is known about their effect upon educational outcomes. METHODS: One thousand three hundred and sixty‚Äêtwo children from 40 primary schools in England took part in the randomised controlled trial, Preventing Anxiety in Children through Education in Schools. The trial investigated the effectiveness of a universal school‚Äêbased cognitive behaviour therapy prevention programme, FRIENDS, delivered by health care staff or school staff compared with usual personal, social, health and education (PSHE) lessons. Self‚Äêreport psychological outcomes and educational attainment on national standardised attainment tests in reading, writing and maths were collected 12 months postintervention. Analysis was performed at individual level using multivariable mixed effect models controlling for gender, type of intervention and school effect. Registered trial: ISRCTN: 23563048. RESULTS: At 12 months, anxiety reduced in the health‚Äêled FRIENDS group compared to school‚Äêled FRIENDS and PSHE. There were no between‚Äêgroup differences in academic performance regardless of gender, deprivation, ethnicity and additional educational needs. CONCLUSIONS: School‚Äêbased mental health interventions should assess psychological and educational outcomes. Further research should directly compare the effects of interventions led by health and school staff."," Skryabina, E;  Taylor, G;  Stallard, P",2016.0, 10.1111/jcpp.12593,0,0,
1052, The Primary Prevention of PTSD in Firefighters: preliminary Results of an RCT with 12-Month Follow-Up," AIM: To develop and evaluate an evidence‚Äêbased and theory driven program for the primary prevention of Post‚Äêtraumatic Stress Disorder (PTSD). DESIGN: A pre‚Äêintervention / post‚Äêintervention / follow up control group design with clustered random allocation of participants to groups was used. The ""control"" group received ""Training as Usual"" (TAU). METHOD: Participants were 45 career recruits within the recruit school at the Department of Fire and Emergency Services (DFES) in Western Australia. The intervention group received a four‚Äêhour resilience training intervention (Mental Agility and Psychological Strength training) as part of their recruit training school curriculum. Data was collected at baseline and at 6‚Äê and 12‚Äêmonths post intervention. RESULTS: We found no evidence that the intervention was effective in the primary prevention of mental health issues, nor did we find any significant impact of MAPS training on social support or coping strategies. A significant difference across conditions in trauma knowledge is indicative of some impact of the MAPS program. CONCLUSION: While the key hypotheses were not supported, this study is the first randomised control trial investigating the primary prevention of PTSD. Practical barriers around the implementation of this program, including constraints within the recruit school, may inform the design and implementation of similar programs in the future. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12615001362583."," Skeffington, PM;  Rees, CS;  Mazzucchelli, TG;  Kane, RT",2016.0, 10.1371/journal.pone.0155873,0,0,
1053, Continued cognitive-behavior therapy versus sertraline for children and adolescents with obsessive-compulsive disorder that were non-responders to cognitive-behavior therapy: a randomized controlled trial," Expert guidelines recommend cognitive‐behavior therapy (CBT) as a first‐line treatment in pediatric obsessive‐compulsive disorder (OCD) and the addition of selective serotonin reuptake inhibitors when CBT is not effective. However, the recommendations for CBT non‐responders are not supported by empirical data. Our objective was to investigate the effectiveness of sertraline (SRT) versus continued CBT in children and adolescents that did not respond to an initial course of CBT. Randomized controlled trial conducted in five sites in Denmark, Sweden and Norway, 54 children and adolescents, age 7‐17 years, with DSM‐IV primary OCD were randomized to SRT or continued CBT for 16 weeks. These participants had been classified as non‐responders to CBT following 14 weekly sessions. Primary outcomes were the CY‐BOCS total score and clinical response (CY‐BOCS <16). The study was a part of the Nordic Long‐Term OCD Treatment Study (NordLOTS). Intent‐to‐treat sample included 50 participants, mean age 14.0 (SD = 2.7) and 48 (n = 24) males. Twenty‐one of 28 participants (75%) completed continued CBT and 15 of 22 participants (69.2%) completed SRT. Planned pairwise comparison of the CY‐BOCS total score did not reveal a significant difference between the treatments (p = .351), the response rate was 50.0% in the CBT group and 45.4% in the SRT group. The multivariate χ (2) test suggested that there were no statistically significant differences between groups (p = .727). Within‐group effect sizes were large and significant across both treatments. These large within‐group effect sizes suggest that continued treatment for CBT non‐responders is beneficial. However, there was no significant between‐group differences in SRT or continued CBT at post‐treatment."," Skarphedinsson, G;  Weidle, B;  Thomsen, PH;  Dahl, K;  Torp, NC;  Nissen, JB;  Melin, KH;  Hybel, K;  Valderhaug, R;  Wentzel-Larsen, T;  et al.",2015.0, 10.1007/s00787-014-0613-0,0,0,
1054, Sertraline Treatment of Nonresponders to Extended Cognitive-Behavior Therapy in Pediatric Obsessive-Compulsive Disorder," OBJECTIVE: The purpose of this study was to investigate the effect of sertraline (SRT) in children and adolescents with obsessive‚Äêcompulsive disorder (OCD) who did not respond to two consecutive courses of cognitive‚Äêbehavior therapy (CBT). METHODS: Observational study with 11 participants (males, n=6), 7‚Äê17 years of age with Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM‚ÄêIV) primary OCD. All had received 14 plus 10 sessions of CBT over the course of 218‚Äê532 days (mean=342.2, SD=85.5). Outcome measures were mean reduction of the Children's Yale‚ÄêBrown Obsessive Compulsive Scale (CY‚ÄêBOCS) total score and adequate clinical response (CY‚ÄêBOCS<16). All participants received SRT (maximum dose 200‚Äâmg/day). The study was a part of the Nordic Long‚ÄêTerm OCD Treatment Study (NordLOTS). RESULTS: Participants were treated with SRT over 72‚Äê300 days (mean=164.2, SD=68.3). The mean CY‚ÄêBOCS score was reduced from 21.5 (SD=2.6) to 17.5 (SD=3.3). Only three participants obtained adequate clinical response (27.2%), and only two obtained >25% CY‚ÄêBOCS total score reduction (close to 50%). CONCLUSIONS: A clinical response in approximately one third of the participants suggests that SRT treatment might be beneficial to a minority of patients who have consistently failed CBT."," Skarphedinsson, G;  Weidle, B;  Ivarsson, T",2015.0, 10.1089/cap.2015.0041,0,0,
1055,Cognitive behavioural therapy and mindfulness based stress reduction may be equally effective in reducing anxiety and depression in adults with autism spectrum disorders.,"Anxiety and depression co-occur in 50-70% of adults with autism spectrum disorder (ASD) but treatment methods for these comorbid problems have not been systematically studied. Recently, two ASD-tailored protocols were published: mindfulness based stress reduction (MBSR) and cognitive behavioural therapy (CBT). We wanted to investigate if both methods are equally effective in reducing anxiety and depression symptoms among adults with ASD. 59 adults with ASD and anxiety or depression scores above 7 on the Hospital Anxiety and Depression Scale, gave informed consent to participate; 27 followed the CBT protocol, and 32 the MBSR treatment protocol. Anxiety and depression scores, autism symptoms, rumination, and global mood were registered at the start, at the end of the 13-week treatment period, and at 3-months follow-up. Irrational beliefs and mindful attention awareness were used as process measures during treatment and at follow-up. Results indicate that both MBSR and CBT are associated with a reduction in anxiety and depressive symptoms among adults with ASD, with a sustained effect at follow-up, but without a main effect for treatment group. A similar pattern was seen for the reduction of autistic symptoms, rumination and the improvement in global mood. There are some indications that MBSR may be preferred over CBT with respect to the treatment effect on anxiety when the scores on measures of irrational beliefs or positive global mood at baseline are high. Mindfulness and cognitive behavioral therapies are both promising treatment methods for reducing comorbid anxiety and depression in adults with ASD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Sizoo, Bram B; Kuiper, Erik",2017.0,http://dx.doi.org/10.1016/j.ridd.2017.03.004,0,0,
1056," The CIPRUS study, a nurse-led psychological treatment for patients with undifferentiated somatoform disorder in primary care: study protocol for a randomised controlled trial"," BACKGROUND: Up to a third of patients presenting medically unexplained physical symptoms in primary care may have a somatoform disorder, of which undifferentiated somatoform disorder (USD) is the most common type. Psychological interventions can reduce symptoms associated with USD and improve functioning. Previous research has either been conducted in secondary care or interventions have been provided by general practitioners (GPs) or psychologists in primary care. As efficiency and cost‚Äêeffectiveness are imperative in primary care, it is important to investigate whether nurse‚Äêled interventions are effective as well. The aim of this study is to examine the effectiveness and cost‚Äêeffectiveness of a short cognitive behavioural therapy (CBT)‚Äêbased treatment for patients with USD provided by mental health nurse practitioners (MHNPs), compared to usual care. METHODS: In a cluster randomised controlled trial, 212 adult patients with USD will be assigned to the intervention or care as usual. The intervention group will be offered a short, individual CBT‚Äêbased treatment by the MHNP in addition to usual GP care. The main goal of the intervention is that patients become less impaired by their physical symptoms and cope with symptoms in a more effective way. In six sessions patients will receive problem‚Äêsolving treatment. The primary outcome is improvement in physical functioning, measured by the physical component summary score of the RAND‚Äê36. Secondary outcomes include health‚Äêrelated quality of life measured by the separate subscales of the RAND‚Äê36, somatization (PHQ‚Äê15) and symptoms of depression and anxiety (HADS). Problem‚Äêsolving skills, health anxiety, illness perceptions, coping, mastery and working alliance will be assessed as potential mediators. Assessments will be done at 0, 2, 4, 8 and 12 months. An economic evaluation will be conducted from a societal perspective with quality of life as the primary outcome measure assessed by the EQ‚Äê5D‚Äê5L. Health care, patient and lost productivity costs will be assessed with the Tic‚ÄêP. DISCUSSION: We expect that the intervention will improve physical functioning and is cost‚Äêeffective compared to usual care. If so, more patients might successfully be treated in general practice, decreasing the number of referrals to specialist care. TRIAL REGISTRATION: Dutch Trial Registry, identifier: NTR4686 , Registered on 14 July 2014."," Sitnikova, K;  Leone, SS;  Zonneveld, LNL;  van Marwijk, HWJ;  Bosmans, JE;  van der Wouden, JC;  van der Horst, HE",2017.0, 10.1186/s13063-017-1951-2,0,0,
1057,"Combining relaxation, exposure and cognitive restructuring in the outpatient treatment of chronic social phobia: A single case study.","Cognitive-behaviour therapy has been mentioned as the choice of treatment for social phobias. A majority of the studies in this area have used exposure and cognitive restructuring together and have compared them against either of the two. The use of relaxation in the treatment of social phobia has not received much importance despite it being very effective in managing autonomic symptoms. Similarly, there is little mention about what dimension of social phobia is responsive to the cognitive-behavioural techniques. In this study of a 42-yr-old man with social phobia the combination as well as the specific efficacy of relaxation, exposure, and cognitive restructuring is analyzed in regard to treatment. The combination of therapies was very effective in reducing symptoms of social phobia. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sinha, Uday K; Jalan, Rekha K",2001.0,,0,0,
1058, Increased circulating stem cells and better cognitive performance in traumatic brain injury subjects following hyperbaric oxygen therapy," Traumatic brain injury (TBI) may cause persistent cognitive dysfunction. A pilot clinical study was performed to determine if hyperbaric oxygen (HBO‚ÇÇ) treatment improves cognitive performance. It was hypothesized that stem cells, mobilized by HBO‚ÇÇ treatment, are recruited to repair damaged neuronal tissue. This hypothesis was tested by measuring the relative abundance of stem cells in peripheral blood and cognitive performance during this clinical trial. The subject population consisted of 28 subjects with persistent cognitive impairment caused by mild to moderate TBI suffered during military deployment to Iraq or Afghanistan. Fluorescence‚Äêactivated cell sorting (FACS) analysis was performed for stem cell markers in peripheral blood and correlated with variables resulting from standard tests of cognitive performance and post‚Äêtraumatic stress disorder: ImPACT, BrainCheckers and PCL‚ÄêM test results. HBO‚ÇÇ treatment correlated with stem cell mobilization as well as increased cognitive performance. Together these results support the hypothesis that stem cell mobilization may be required for cognitive improvement in this population."," Shandley, S;  Wolf, EG;  Schubert-Kappan, CM;  Baugh, LM;  Richards, MF;  Prye, J;  Arizpe, HM;  Kalns, J",2017.0,,0,0,
1059,Is the devil in the detail? A randomised controlled trial of guided internet-based CBT for perfectionism.,"An internet guided self-help cognitive-behavioural treatment (ICBT) for perfectionism was recently found to be effective (see this issue). Such studies stand in need of replication. The aim of this study was to report the outcomes and predictors of change when the treatment is delivered in a UK setting. A total of 120 people (Mean = 28.9 years; 79% female) were randomised to receive ICBT or wait-list control over 12 weeks (trial registration: NCT02756871). While there were strong similarities between the current study and its Swedish counterpart, there were also important differences in procedural details. There was a significant impact of the intervention on the primary outcome measure (Frost Multidimensional Perfectionism Scale, Concern over Mistakes subscale) and also on the Clinical Perfectionism Questionnaire (between group effect sizes d = 0.98 (95% CI: 0.60-1.36) and d = 1.04 (95% CI: 0.66-1.43) respectively using intent-to-treat analyses). Unlike the Swedish study, there was significant non-engagement and non-completion of modules with 71% of participants completing fewer than half the modules. The number of modules completed moderated the rate of change in clinical perfectionism over time. In conclusion, the study indicates the intervention is effective in a UK setting but highlighted the importance of procedural details to optimise retention.",Shafran R.; Wade TD.; Egan SJ.; Kothari R.; Allcott-Watson H.; Carlbring P.; Rozental A.; Andersson G.,2017.0,10.1016/j.brat.2017.05.014,0,0,
1060, Use of Play Therapy in Nursing Process: a Prospective Randomized Controlled Study," PURPOSE: Play therapy is a nursing intervention employed in multidisciplinary approaches to develop the social, emotional, and behavioral skills of children. In this study, we aim to determine the effects of play therapy on the social, emotional, and behavioral skills of pre‚Äêschool children through the nursing process. DESIGN: A single‚Äêblind, prospective, randomized controlled study was undertaken. The design, conduct, and reporting of this study adhere to the Consolidated Standards of Reporting Trials (CONSORT) guidelines. METHODS: The participants included 4‚Äê to 5‚Äêyear‚Äêold kindergarten children with no oral or aural disabilities and parents who agreed to participate in the study. The Pre‚Äêschool Child and Family Identification Form and Social Competence and the Behavior Evaluation Scale were used to gather data. Games in the play therapy literature about nursing diagnoses (fear, social disturbance, impaired social interactions, ineffective coping, anxiety), which were determined after the preliminary test, constituted the application of the study. FINDINGS: There was no difference in the average scores of the children in the experimental and control groups in their Anger‚ÄêAggression (AA), Social Competence (SC), and Anxiety‚ÄêWithdrawal (AW) scores beforehand (t = 0.015, p = .988; t = 0.084, p = .933; t = 0.214, p = .831, respectively). The difference between the average AA and SC scores in the post‚Äêtest (t = 2.041, p = .045; t = 2.692, p = .009, respectively), and the retests were statistically significant in AA and SC average scores in the experimental and control groups (t = 4.538, p = .000; t = 4.693; p = .000, respectively). In AW average scores, no statistical difference was found in the post‚Äêtest (t = 0.700, p = .486), whereas in the retest, a significant difference was identified (t = 5.839, p = .000). CONCLUSIONS: Play therapy helped pre‚Äêschool children to improve their social, emotional, and behavioral skills. It also provided benefits for the children to decrease their fear and anxiety levels, to improve their communication and coping skills, and to increase their self‚Äêesteem. CLINICAL RELEVANCE: The study concluded that play therapy helps develop the social, emotional, and behavioral skills of pre‚Äêschool children. It has also helped children lower their fear and anxiety levels, improve their communication and coping skills, and promote their self‚Äêesteem. Pediatric nurses are recommended to include play therapy in their profession and in the nursing process."," Sezici, E;  Ocakci, AF;  Kadioglu, H",2017.0, 10.1111/jnu.12277,0,0,
1061," The Effectiveness of Cognitive Behavioral Therapy, Medication, or Combined Treatment For Child Hood Anxiety Disorders"," METHOD: A total of 46 participants (aged 8 to 12) that applied to the Ege University, Faculty of Medicine, Child and Adolescent Psychiatry clinic and had a diagnosis of anxiety disorder were recruited for the study. The participants were randomly assigned to cognitive behavioral therapy (CBT), standard drug treatment (ST), or combined treatment (CBT+ ST) groups according to the order of application. Subjects were evaluated using pretest, posttest and 3 months follow‚Äêup measurements. The participants were assessed by the researcher using The Screen for Child Anxiety Related Emotional Disorders (SCARED), The Children's Negative Cognitive Errors Questionnaire (CNCEQ), Health Related Quality of Life in Children (Kid‚ÄêKINDL), and Children's Depression Inventory (CDI). RESULTS: The results of repeated measures ANOVA showed that, although general anxiety scores of all treatment conditions significantly decreased at posttest and follow up, a combination of two therapies (CBT+ST) had a significantly superior response rate. Moreover, all treatment conditions including CBT (CBT+ST and CBT) were superior to ST in terms of negative cognitive errors, quality of life, and depression. CONCLUSION: It is thought that The Fear Hunter Therapy Program is an effective treatment technique because; it provides significant improvement in the primary and secondary symptoms (e.g. quality of life, depression, negative automatic thoughts) of childhood anxiety disorders. OBJECTIVE: The aims of this study were to evaluate the effectiveness of the Fear Hunter cognitive behavioral therapy program, which was developed for the treatment of childhood anxiety disorders, and to compare its effectiveness with standard medication treatment."," Sevi Tok, ES;  Arkar, H;  Bildik, T",2016.0,,0,0,
1062,Treating youth depression and anxiety: A randomised controlled trial examining the efficacy of computerised versus face-to-face cognitive behaviour therapy.,"Barriers to accessing psychologists for the treatment of depression and anxiety include a shortage of specialised therapists, long waiting lists, and the affordability of therapy. This study examined the efficacy of a computerised-based self-help program (MoodGYM) delivered in-conjunction with face-to-face cognitive behavioural therapy (CBT) to expand the delivery avenues of psychological treatment for young adults (aged 18-25 years). Eighty-nine participants suffering from depression and/or generalised anxiety were randomly allocated to a control intervention or to one of three experimental groups: receiving face-to-face CBT, receiving computerised CBT (cCBT), or receiving treatment in-conjunction (face-to-face CBT and cCBT). While MoodGYM did not significantly decrease depression in comparison to the control group, significant decreases were found for anxiety. MoodGYM delivered in-conjunction with face-to-face CBT is more effective in treating symptoms of depression and anxiety compared with standalone face-to-face or cCBT. This study suggests that for youth who are unable to access face-to-face therapy-such as those in rural or remote regions, or for communities in which there is stigma attached to seeking help-computerised therapy may be a viable option. This is an important finding, especially in light of the current capacity-to-treat and accessibility problems faced by youth when seeking treatment for depression and/or anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sethi, Suvena",2013.0,http://dx.doi.org/10.1111/ap.12006,0,0,
1063,Development of the migraine symptom severity score (MSSS): A latent variable model for migraine definition,"Objectives: To develop a latent variable model for defining migraine and a scoring algorithm providing fixed scores with optimal statistical and psychometric properties. Such a scoring scale would be useful for clinical practice, epidemiologic studies, and clinical trials. Background: Migraine is defined by a constellation of interrelated symptoms which vary between and within individuals over time. While the severity of individual migraine symptoms is routinely measured using ordinal scales, there have been few systematic efforts to produce a single symptom score. Methods: In 2005, we assessed a representative sample of 11,388 respondents who met ICHD-2 criteria for episodic migraine (EM). An Item Response Theory (IRT) model was used for determining the optimal latent variable model structure for eight ICHD-2 migraine diagnostic features including 4 pain features, photophobia, phonophobia, nausea, and aura. With the exception of aura, all items were scored on a 4-point ordinal scale. Aura was a binary variable (present, absent). Item parameters obtained from the final IRT model were employed to obtain latent variable score (LV) estimates corresponding to all possible sum scores associated with the ICHD-2 items. Results: One and two-factor IRT models were fit. Both models fit the data equally well and reflected a perfect model fit. A single-factor model was retained for parsimony. The 8 items were strongly associated with the latent variable, with loadings ranging from 0.42 to 4.0. Only 3 items had loadings less than 1. Latent variable scores corresponding to each sum score were obtained by calculating the mean of the posterior distribution of the latent variable corresponding to each sum score. These latent variable score (LV) estimates have known properties: they are model based, free of measurement error and asymptotically distributed as standardized Gaussian variates. Because of high symptom severity in this sample, low sum scores, which reflect low symptom severity, were exceedingly rare, therefore, in order to have low sum scores, the LV score had to fall below the LV mean, and consequently the LV scores corresponding to low sum scores were negative. For ease of interpretation the LV scores were rescaled to have an asymptotic distribution with mean of 32.8 and standard deviation of 10, yielding a range of scores from 0 to 43.5. This variable has a meaningful minimum score and values interpreted in standard deviation units. Conclusions: Herein, we demonstrated that ICHD-2 criteria for migraine can be conceptualized as a single score (MSSS) representing the severity of migraine pain and associated symptoms. Future work will optimize a scoring procedure for measuring longitudinal change in symptom severity in population studies and clinical trials. Analyses were restricted to cases meeting ICHD-2 criteria for migraine, future work will focus on a heterogeneous sample in order to identify scores corresponding to Migraine-dominant latent classes.",Serrano D.; Buse D.C.; Reed M.L.; Runken M.C.; Lipton R.B.,2010.0,10.1111/j.1526-4610.2010.01737.x,0,0,
1064,Migraine true disease state estimates (MTDSE): Improving sensitivity in migraine definition and drug-efficacy detection,"Background: Migraine is defined by a constellation of inter-related symptoms which vary among and within individuals over time. For acute treatment trials the FDA requires separation from placebo on 4 co-primary measures of migraine pain intensity, nausea, photophobia, and phonophobia. This approach is inconsistent with true-diseasestate theory, dramatically increases sample size requirements, and fails to measure the migraine symptom complex. Objective: To develop scoring procedures capturing estimates of the true disease state, thereby increasing precision and sensitivity in migraine definition and drug efficacy detection. Methods: In 2005, we assessed a representative sample of 14,936 respondents who met ICHD-2 criteria for episodic headache. Latent class models were employed to identify natural subclasses of headache sufferers with migraine-dominant symptom patterns. Item Response Theory (IRT) models were used for assessing item quality. IRT parameters were employed to obtain adjusted true-disease-state scores corresponding to all possible ICHD-2 sum scores. Results: A four class model revealed two migraine-dominant classes. A single-factor IRT model optimally fit the data. The ICHD-2 items strongly measured the underlying disease state, with loadings ranging from 0.28 to 1.2. The odds of endorsing the items given the MTDSE ranged from 1.32 to 3.32. These underlying disease state score estimates are model-based, free of measurement error and asymptotically normal. MTDSE scores were obtained by calculating the mean of the posterior distribution of the IRT model corresponding to each sum score. Scores were rescaled to have mean of 2 and SD of 1.22, yielding 21 scores ranging from 0 to 4.17. Conclusions: ICHD-2 migraine-defining features can be scaled to produce an MTDSE capturing severity of migraine pain and associated symptoms. MTDSE scores are normally distributed with fixed mean and SD. Statistical tests using this scoring method should more powerfully detect the benefits of migraine treatments both in clinical trials and clinical practice.",Serrano D.; Buse D.C.; Reed M.L.; Runken C.M.; Lipton R.B.,2010.0,10.1007/s10194-010-0259-3,0,0,
1065,"An Overview of SSR 149415, a Selective Nonpeptide Vasopressin V1b Receptor Antagonist for the Treatment of Stress-Related Disorders.","Vasopressin (AVP) and corticotropin-releasing factor (CRF) are key mediators in the organism's neuro-adaptive response to stress. Through pituitary and central vasopressin V1b receptors, AVP participates in the control of the hypothalamic-pituitary-adrenal axis (HPA) and is involved in various emotional processes. SSR149415 is the first selective, orally active vasopressin V1b receptor antagonist yet described. It is a competitive antagonist with nanomolar affinity for animal and human V1b receptors and displays a highly selective profile with regard to a large number of receptors or enzymes. In vitro, SSR149415 potently antagonizes functional cellular events associated with V1b receptor activation by AVP, such as intracellular Ca2+ increase or proliferation in various cell systems. Pharmacological studies, performed by measuring ACTH secretion induced by various stimulants such as hormones (AVP or AVP + CRF) or physical stress (restraint or forced swimming stress and dehydration) in conscious rats or mice, confirm the antagonist profile of SSR149415 and its efficacy in normalizing ACTH secretion in vivo. SSR149415 is active by the oral route, at doses from 3 mg/kg, it potentiates CRF effect and displays a long-lasting oral effect in the different models. At 10 mg/kg p.o. its duration of action is longer than 4 h. This molecule also decreases anxiety and exerts marked antidepressant- like activity in several predictive animal models. The anxiolytic effects of SSR149415 have been demonstrated in various Generalized Anxiety Disorders (GAD) models (four-plate, punished drinking, elevated plus-maze, light dark, mouse defense test battery, fear-potentiated startle and social interaction tests). It is as effective as the benzodiazepine diazepam in the acute stress exposure test. SSR149415 has similar efficacy to the reference antidepressant drug, fluoxetine, in acute (forced-swimming) and chronic (chronic mild stress and subordination stress) situations in rodents. SSR149415 also reduces offensive aggression in the resident-intruder model in mice and hamsters. Depending on the model, the minimal effective doses are in the range of 1-10 mg/kg i.p. or 3-10 mg/kg p.o.. SSR149415 is devoid of adverse effects on motor activity, sedation, memory or cognitive functions and produces no tachyphylaxis when administered repeatedly. It is well-tolerated in animals and humans and exhibits an adequate ADME profile. Thus, SSR149415 is a new dual anxiolytic/antidepressant compound, which appears to be free of the known side effects of classical anxiolytic/antidepressant drugs. Clinical trials are in progress, they will hopefully demonstrate its therapeutical potential for treating stress-related disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Serradeil-Le Gal, Claudine; Wagnon, Jean; Tonnerre, Bernard; Roux, Richard; Garcia, Georges; Griebel, Guy; Aulombard, Alain",2005.0,,0,0,
1066," Habit reversal training in children and adolescents with chronic tic disorders: an Italian randomized, single-blind pilot study"," BACKGROUND: The aim of the present study was to test the possibility to apply habit reversal training (HRT) in Italy and to evaluate the effectiveness of HRT in reducing tic severity compared with the ""usual care"" (UC) in Italian children and adolescents with Tourette Syndrome. METHODS: We performed a single blind, randomized, pilot study comparing HRT (active treatment) and UC (usual treatment). Out of 69 patients seen during the study period, we were able to enroll 21 patients (11 randomized to HRT e 10 to UC). Assessment included in‚Äêdepth neurological and psychiatric examination, K‚ÄêSADS‚ÄêPL, YGTSS, KIDSCREEN, GTS‚ÄêQOL, CGI and C‚ÄêGAS. All these evaluations but the K‚ÄêSADS‚ÄêPL were used for baseline assessment but also one week after the end of treatment (T1) and then 3, 6 and 9 months later (respectively T2, T3, and T4). RESULTS: The sample was largely composed of patients of relevant clinical severity (CGI‚â•3: 85%). OCD and ADHD were the most frequent comorbidities (30% each). Only minor differences in terms of treatment effectiveness were found, although the HRT group turned out to include patients with more tics and a more compromised general functioning despite randomization. CONCLUSIONS: We had a high number of patients who refused to be randomized (23 out of 69) and a high number of drop outs (27% in the HRT group, 50% in the UC group). There was an improvement in terms of reduced tics and improved global functioning in both groups, without significant changes in terms of Quality of Life."," Seragni, G;  Chiappedi, M;  Bettinardi, B;  Zibordi, F;  Colombo, T;  Reina, C;  Angelini, L",2018.0, 10.23736/S0026-4946.16.04344-9,0,0,
1067,Adjunctive low-frequency repetitive transcranial magnetic stimulation over the right dorsolateral prefrontal cortex in patients with treatment-resistant obsessive-compulsive disorder: A randomized controlled trial.,"Objective: The present study aimed to evaluate the efficacy of low frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the right dorsolateral prefrontal cortex (DLPFC) for the treatment of obsessive-compulsive disorder (OCD). Methods: Twenty-seven patients with treatment resistant OCD were randomly assigned to 3 week either active (n = 14) or sham (n = 13) rTMS. The active rTMS parameters consisted of 1 Hz, 20-minute trains (1,200 pulses/day) at 100% of the resting motor threshold (MT). OCD symptoms, mood, and anxiety were assessed at baseline and every week throughout the treatment period. Results: A repeated-measures analysis of variance (ANOVA) was used to evaluate changes on the Yale-Brown Obsessive Compulsive Scale (YBOCS). Our results revealed a significant reduction in YBOCS scores in the active group compared with the sham group after 3 weeks. Similarly, a repeated-measures ANOVA revealed significant effect of time and time x group interaction on scores on the Hamilton Depression Rating Scale and the Clinical Global Impression-Severity scale. There were no reports of any serious adverse effects following the active and sham rTMS treatments. Conclusion: LF rTMS over the right DLPFC appeared to be superior to sham rTMS for relieving OCD symptoms and depression in patients with treatment-resistant OCD. Further trials with larger sample sizes should be conducted to confirm the present findings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Seo, Ho-Jun; Jung, Young-Eun; Lim, Hyun Kook; Um, Yoo-Hyun; Lee, Chang Uk; Chae, Jeong-Ho",2016.0,http://dx.doi.org/10.9758/cpn.2016.14.2.153,0,0,
1068,"Establishing a common metric for self-reported anxiety: Linking the MASQ, PANAS, and GAD-7 to PROMIS Anxiety","Researchers and clinicians wishing to assess anxiety must choose from among numerous assessment options, many of which purport to measure the same or a similar construct. A common reporting metric would have great value and can be achieved when similar instruments are administered to a single sample and then linked to each other to produce cross-walk score tables. Using item response theory (IRT), we produced cross-walk tables linking three popular ""legacy"" anxiety instruments - MASQ (N=743), GAD-7 (N=748), and PANAS (N=1120) - to the anxiety metric of the NIH Patient Reported Outcomes Measurement Information System (PROMIS®). The linking relationships were evaluated by resampling small subsets and estimating confidence intervals for the differences between the observed and linked PROMIS scores. Our results allow clinical researchers to retrofit existing data of three commonly used anxiety measures to the PROMIS Anxiety metric and to compare clinical cut-off scores. © 2013 Elsevier Ltd.",Schalet B.D.; Cook K.F.; Choi S.W.; Cella D.,2014.0,10.1016/j.janxdis.2013.11.006,0,0,
1069,A randomized controlled trial of a nursing psychotherapeutic intervention for anxiety in adult psychiatric outpatients.,"To evaluate the short-term efficacy of a psychotherapeutic intervention in nursing on Portuguese adult psychiatric outpatients with the nursing diagnosis ""anxiety."" Several efficacious forms of treatment for anxiety are available, including different forms of psychotherapy and pharmacotherapy. However, literature tends to favour findings from studies on the efficacy of psychotherapies and therapies provided by nurses to the detriment of those arising from studies on the efficacy of nursing psychotherapeutic interventions (interventions which are classified, for instance, on Nursing Interventions Classification). Randomized controlled trial. The study was performed, between November 2016 - April 2017, at a psychiatry outpatient ward. Participants were randomly allocated to an intervention group (N = 29) or a treatment-as-usual control group (N = 31). Patients in the intervention group received psychopharmacotherapy with interventions integrated in the Nursing Interventions Classification for the nursing diagnosis ""anxiety."" A treatment-as-usual control group received only psychopharmacotherapy (if applicable). Anxiety level and anxiety self-control were the primary outcomes. Patients from both groups had reduced anxiety levels, between the pre-test and the posttest assessment; however, according to analysis of means, patients in the intervention group displayed significantly better results than those of the control group. Furthermore, only patients in the intervention group presented significant improvements in anxiety self-control. This study demonstrated the short-term efficacy of this psychotherapeutic intervention model in nursing in the decrease of anxiety level and improvement of anxiety self-control in a group of psychiatric outpatients with pathological anxiety. NCT02930473.",Sampaio FMC.; Araújo O.; Sequeira C.; Lluch Canut MT.; Martins T.,2018.0,10.1111/jan.13520,0,0,
1070,"Randomized controlled trial to dismantle exposure, relaxation, and rescripting therapy (ERRT) for trauma-related nightmares.","The aim of this study was to conduct a preliminary dismantling study of exposure, relaxation, and rescripting therapy (ERRT) for nightmares. Participants (N = 70) were randomized to 1 of 2 conditions: ERRT with nightmare exposure and rescripting (full protocol; EX) or ERRT without nightmare exposure and rescripting (NEX). Participants completed follow-ups at 1 week, 3 months, and 6 months posttreatment. Both conditions yielded statistically significant improvements with medium to large effect sizes on primary outcomes related to nightmares (i.e., nights with nightmares, nightmares per week, and nightmare severity). Both conditions also yielded statistically significant improvements on secondary outcomes with medium to large effect sizes on fear of sleep, sleep quality, insomnia severity, daytime sleepiness, posttraumatic stress disorder symptom severity, and depression severity. The conditions did not differ at any time point. Findings indicate that ERRT with and without nightmare exposure and rescripting can significantly alleviate nightmares and related distress. The addition of nightmare exposure and rescription did not contribute incrementally to outcomes in this sample. It is possible that the dose of exposure was not sufficient to result in group differences or that the treatment components included in both conditions (i.e., psychoeducation about trauma, nightmares, and sleep; sleep habit modification; and relaxation training) may adequately treat factors that maintain nightmares for some individuals. Theoretical implications of findings are discussed. The reduction of symptoms of other conditions following this brief intervention provides further evidence for the primary role of nightmares and sleep disturbances posttrauma. (PsycINFO Database Record",Pruiksma KE.; Cranston CC.; Rhudy JL.; Micol RL.; Davis JL.,2018.0,10.1037/tra0000238,0,0,
1071, Integrated mental health care and vocational rehabilitation to improve return to work rates for people on sick leave because of depression and anxiety (the Danish IBBIS trial): study protocol for a randomized controlled trial," BACKGROUND: Depression and anxiety are among the largest contributors to the global burden of disease and have negative effects on both the individual and society. Depression and anxiety are very likely to influence the individual's work ability, and up to 40% of the people on sick leave in Denmark have depression and/or anxiety. There is no clear evidence that treatment alone will provide sufficient support for vocational recovery in this group. Integrated vocational and health care services have shown good effects on return to work in other, similar welfare contexts. The purpose of the IBBIS (Integrated Mental Health Care and Vocational Rehabilitation to Individuals on Sick Leave Due to Anxiety and Depression) interventions is to improve and hasten the process of return to employment for people in Denmark on sick leave because of depression and anxiety. METHODS/DESIGN: This three‚Äêarm, parallel‚Äêgroup, randomized superiority trial has been set up to investigate the effectiveness of the IBBIS mental health care intervention and the integrated IBBIS mental health care and IBBIS vocational rehabilitation intervention for people on sick leave because of depression and/or anxiety in Denmark. The trial has an investigator‚Äêinitiated multicenter design. A total of 603 patients will be recruited from Danish job centers in 4 municipalities and randomly assigned to one of 3 groups: (1) IBBIS mental health care integrated with IBBIS vocational rehabilitation, (2) IBBIS mental health care and standard vocational rehabilitation, and (3) standard mental health care and standard vocational rehabilitation. The primary outcome is register‚Äêbased return to work at 12 months. The secondary outcome measures are self‚Äêassessed level of depression (Beck Depression Inventory II), anxiety (Beck Anxiety Inventory), stress symptoms (Four‚ÄêDimensional Symptom Questionnaire), work and social functioning (Work and Social Adjustment Scale), and register‚Äêbased recurrent sickness absence. DISCUSSION: This study will provide new knowledge on vocational recovery, integrated vocational and health care interventions, and prevention of recurrent sickness absence among people with depression and anxiety. If the effect on return to work is different in the intervention groups, this study can contribute to current knowledge on shared care models for health care and vocational rehabilitation services. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02872051 . Retrospectively registered on 15 August 2016."," Poulsen, R;  Hoff, A;  Fisker, J;  Hjorth√∏j, C;  Eplov, LF",2017.0, 10.1186/s13063-017-2272-1,0,0,
1072,Testing the efficacy of theoretically derived improvements in the treatment of social phobia.,"Recent theoretical models of social phobia suggest that targeting several specific cognitive factors in treatment should enhance treatment efficacy over that of more traditional skills-based treatment programs. In the current study, 195 people with social phobia were randomly allocated to 1 of 3 treatments: standard cognitive restructuring plus in vivo exposure, an ""enhanced"" treatment that augmented the standard program with several additional treatment techniques (e.g., performance feedback, attention retraining), and a nonspecific (stress management) treatment. The enhanced treatment demonstrated significantly greater effects on diagnoses, diagnostic severity, and anxiety during a speech. The specific treatments failed to differ significantly on self-report measures of social anxiety symptoms and life interference, although they were both significantly better than the nonspecific treatment. The enhanced treatment also showed significantly greater effects than standard treatment on 2 putative process measures: cost of negative evaluation and negative views of one's skills and appearance. Changes on these process variables mediated differences between the treatments on changes in diagnostic severity. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rapee, Ronald M; Gaston, Jonathan E; Abbott, Maree J",2009.0,http://dx.doi.org/10.1037/a0014800,0,0,
1073,Attention and interpretation bias modification treatment for social anxiety disorder: A randomized clinical trial of efficacy and synergy.,"Background and objectives: Attention bias modification treatment (ABMT) and cognitive bias modification of interpretation (CBM-I) both have demonstrated efficacy in alleviating social anxiety, but how they compare with each other, their combination, and with a combined control condition has not been studied. We examined their relative and combined efficacy compared to control conditions in a randomized controlled trial (RCT). Methods: Ninety-five adults diagnosed with social anxiety disorder (SAD), were randomly allocated to 4 groups: ABMT + CBM-I control (hereafter ABMT; n = 23), CBM-I + ABMT control (hereafter CBM-I; n = 24), combined ABMT + CBM-I (n = 23), and combined control (n = 25). Treatment included eight sessions over four weeks. Clinician-rated and self-reported measures of social anxiety symptoms, functional impairment, and threat-related attention and interpretive biases were evaluated at baseline, post-treatment, and 3-month follow-up. Results: ABMT yielded greater symptom reduction as measured by both clinician-ratings (Cohen's ds = 0.57-0.70) and self-reports (ds = 0.70-0.85) compared with the CBM-I, the combined ABMT + CBM-I, and the combined control conditions. Neither of the other conditions demonstrated superior symptom change compared to the control condition. No group differences were found for functioning or cognitive biases measures. Limitations: Limitations mainly include the mix of active and control treatments applied across the different groups. Therefore, the net effect of each of the treatments by itself could not be clearly tested. Conclusions: Results suggest superiority of ABMT compared to CBM-I and their combination in terms of symptom reduction. Possible interpretations and methodological issues underlying the observed findings are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Naim, Reut; Kivity, Yogev; Bar-Haim, Yair; Huppert, Jonathan D",2018.0,http://dx.doi.org/10.1016/j.jbtep.2017.10.006,0,0,
1074, Evaluation of a cognitive remediation intervention for college students with psychiatric conditions," OBJECTIVE: Given the poor educational outcomes associated with psychiatric conditions, we developed Focused Academic Strength Training (FAST), a 12‚Äêweek strategy‚Äêfocused cognitive remediation intervention designed to improve academic functioning among college students with psychiatric conditions. Here we report initial results from a randomized controlled trial of FAST. METHOD: Seventy‚Äêtwo college students with mood, anxiety, and/or psychotic disorders were randomized to receive FAST or services as usual and were assessed at baseline and 4 months (posttreatment). RESULTS: Repeated‚Äêmeasures analyses of variance indicated FAST‚Äêassociated improvements in self‚Äêreported cognitive strategy use (p < .001), self‚Äêefficacy (p = .001), and academic difficulties (p = .025). There were no significant treatment‚Äêrelated improvements in neuropsychological performance. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: FAST may lead to an increase in self‚Äêefficacy and cognitive strategy use, as well as a reduction in academic difficulties among students with psychiatric conditions. Future analyses with follow‚Äêup data through 12 months will address the potential of FAST to improve academic functioning among this population. (PsycINFO Database Record"," Mullen, MG;  Thompson, JL;  Murphy, AA;  Malenczak, D;  Giacobbe, G;  Karyczak, S;  Holloway, KE;  Twamley, EW;  Silverstein, SM;  Gill, KJ",2017.0, 10.1037/prj0000254,0,0,
1075, Attention training to pleasant stimuli in anxiety," Attentional bias for threatening stimuli in anxiety is a common finding in the literature. The present study addressed whether attention training toward pleasant stimuli can reduce anxiety symptoms and induce a processing bias in favor of pleasant information in nonpatients who were selected to score similarly to individuals with generalized anxiety or panic disorder on a measure of worry or physiological arousal, respectively. Participants were randomly assigned to attention training to pleasant (ATP) stimuli or to a placebo control (PC) condition. All participants completed baseline and post‚Äêtest dot‚Äêprobe measures of attentional bias while event‚Äêrelated brain potentials were recorded. As expected, worry symptoms decreased in the ATP and not PC condition. ATP was also associated with early evidence (P100 amplitude) of greater attentional prioritization of probes replacing neutral stimuli within threat‚Äêneutral word pairs from pre‚Äêto‚Äêpost intervention and later RT evidence of facilitated processing of probes replacing pleasant stimuli within pleasant‚Äêthreat word pairs at post compared to PC. PC was associated with later evidence (P300 latency) of less efficient evaluation of probes following pleasant stimuli within pleasant‚Äêthreat word pairs from pre‚Äêto‚Äêpost and later RT evidence of facilitated processing of probes following threat stimuli within pleasant‚Äêthreat word pairs at post compared to ATP. Results highlight early and later mechanisms of attention processing changes and underscore the potential of pleasant stimuli in optimizing attention‚Äêtraining interventions for anxiety."," Sass, SM;  Evans, TC;  Xiong, K;  Mirghassemi, F;  Tran, H",2017.0, 10.1016/j.biopsycho.2016.03.003,0,0,
1076,Effectiveness of acceptance and commitment therapy on the fear of cancer recurrence and post-traumatic growth among patients with breast cancer,"Introduction: Breast cancer is one of the most common chronic diseases and the second leading cause of death among women with many physical and psychological complications requiring appropriate treatment. Therefore, the aim of this study was to evaluate the efficacy of acceptance and commitment therapy on the fear of cancer recurrence and post-traumatic growth in patients with breast cancer. Materials and Methods: This study was a quasi-experimental design with pretest, posttest in the experimental and control groups. Among breast cancer patients referred to the Association of Cancer Patients Koomesh, 20 breast cancer patients were selected and randomly assigned into experimental(n=10)and control(n=10)groups. Fear of cancer recurrence ((FCRI) and post-traumatic growth (PTG) questionnaires completed by patients in two stages: before and after intervention. Results: Results of multivariate covariance analysis showed significant differences in the fear of cancer recurrence (P = 0.026) and Post-traumatic growth (P = 0.005) among two groups. Conclusion: Considering the impact on acceptance and commitment therapy in fear of cancer recurrence and posttraumatic growth on the breast cancer patients can used this intervention to improve the psychological problems of patients with breast cancer.",Sarizadeh M.-S.; Mozaffari S.; Boogar I.R.,2018.0,,0,0,
1077,Predicting response trajectories during cognitive-behavioural therapy for panic disorder: No association with the BDNF gene or childhood maltreatment.,"Background: Anxiety disorders are highly prevalent and result in low quality of life and a high social and economic cost. The efficacy of cognitive-behavioural therapy (CBT) for anxiety disorders is well established, but a substantial proportion of patients do not respond to this treatment. Understanding which genetic and environmental factors are responsible for this differential response to treatment is a key step towards ""personalized medicine"". Based on previous research, our objective was to test whether the BDNF Val66Met polymorphism and/or childhood maltreatment are associated with response trajectories during exposure-based CBT for panic disorder (PD). Method: We used Growth Mixture Modeling to identify latent classes of change (response trajectories) in patients with PD (N = 97) who underwent group manualized exposure-based CBT.We conducted logistic regression to investigate the effect on these trajectories of the BDNF Val66Met polymorphism and two different types of childhood maltreatment, abuse and neglect. Results: We identified two response trajectories (""high response"" and ""low response""), and found that they were not significantly associated with either the genetic (BDNF Val66Met polymorphism) or childhood trauma-related variables of interest, nor with an interaction between these variables. Conclusions: We found no evidence to support an effect of the BDNF gene or childhood trauma-related variables on CBT outcome in PD. Future studies in this field may benefit from looking at other genotypes or using different (e.g. whole-genome) approaches. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Santacana, Marti; Arias, Barbara; Mitjans, Marina; Bonillo, Albert; Montoro, Maria; Rosado, Silvia; Guillamat, Roser; Valles, Vicenc; Perez, Victor; Forero, Carlos G; Fullana, Miquel A",2016.0,,0,0,
1078,"Feasibility, acceptability, and safety of the Recapture Life videoconferencing intervention for adolescent and young adult cancer survivors","Objective: Online psychological therapies provide a way to connect adolescent and young adult (AYA) cancer survivors to evidence-based support. We aimed to establish the feasibility, acceptability, and safety of Recapture life, a six-session group-based online cognitive-behavioural intervention, led by a facilitator, for AYAs in the early post-treatment period. Methods: A randomised-controlled trial compared Recapture Life to an online peer-support group control and a waitlist control. Participants could nominate a support person. Acceptability was assessed using study opt-in and retention rates, participant-reported benefits/burdens of participation, and group facilitator burden. We also assessed the feasibility (eg, frequency/impact of technological difficulties) and psychological safety (ie, occurrence of clinically concerning distress) of the program. Results: Sixty-one participants took part (45 AYAs, 51.1% female; 19 support people). The opt-in rate was 30%, the enrolment rate was 87%, and 75% of participants took part in ≥5/6 sessions. AYAs reported high benefit and low burden of participation. Overall, 95 online group sessions were conducted; few required rescheduling by group facilitators (3%), but many took place outside of office hours (~90 hours). It took 40 days on average to create online groups, but established weekly sessions commenced quickly (M = 4.0 minutes). Technological difficulties were common but had a low impact on intervention delivery. Although 54% of AYAs returned a clinically concerning distress screen at some point, none reflected acute mental health risks. Conclusions: The data largely indicate that Recapture Life is an acceptable, feasible, and safe model of evidence-based psychological support for AYAs during early survivorship, which nevertheless experienced common challenges in online/AYA intervention delivery.",Sansom-Daly U.M.; Wakefield C.E.; Bryant R.A.; Patterson P.; Anazodo A.; Butow P.; Sawyer S.M.; McGill B.C.; Evans H.E.; Cohn R.J.,2018.0,10.1002/pon.4938,0,0,
1079, Group-Based Trajectory Modeling of Distress and Well-Being Among Caregivers of Children Undergoing Hematopoetic Stem Cell Transplant," Objective: To examine the trajectories of caregiver psychological responses in the year following their child's hematopoetic stem cell transplant (HSCT), and whether cognitive and social processing strategies differentiated between trajectories. Method: One hundred and eight caregivers randomized to the control condition of a cognitive‚Äêbehavioral intervention study completed measures of distress, coping, and social support at baseline, 1 month, 6 months, and 1 year post HSCT of their child. Results: The majority reported moderate or low anxiety, depression, or distress that decreased over time, but a small group demonstrated high anxiety, depression, or distress that persisted or increased over time. Maladaptive coping was highest among caregivers in the high‚Äêpersistent distress subgroup compared with the moderate‚Äêdecreasing and low‚Äêstable groups. Adaptive coping was minimally associated with trajectory subgroups. Conclusions: Screening HSCT caregivers for distress and maladaptive coping may be useful in identifying caregivers likely to experience persistently high distress who may benefit from psychological intervention."," Sands, SA;  Mee, L;  Bartell, A;  Manne, S;  Devine, KA;  Savone, M;  Kashy, DA",2017.0, 10.1093/jpepsy/jsw064,0,0,
1080, Improving Children's Mental Health with a Digital Social Skills Development Game: a Randomized Controlled Efficacy Trial of Adventures aboard the S.S. GRIN," OBJECTIVE: The purpose of this study was to investigate whether a computer‚Äêbased game to improve social skills and mental health in children with social skills deficits would be efficacious. The program, Adventures aboard the S.S. GRIN, translates a proven in‚Äêperson intervention into a nine‚Äêepisode interactive online adventure game that provides opportunity for knowledge acquisition and skill practice. MATERIALS AND METHODS: Participants (children aged 7‚Äê11 years with social skills challenges) were randomly assigned to immediate treatment group (n‚Äâ=‚Äâ33) or waitlist control group (n‚Äâ=‚Äâ36). Children in the immediate treatment condition completed the game at home over the course of 9 weeks. Before playing the game and again within 1 week of game completion, children completed surveys about social literacy, social anxiety, bullying, social self‚Äêefficacy, and social satisfaction. RESULTS: Children who played Adventures improved significantly more from pretest to posttest than children who did not play the game in social literacy, social anxiety, bullying victimization, and social satisfaction. CONCLUSION: Online interactive games can be effective in improving mental health for children who struggle with social skills. For children who can access them, serious games have the potential to increase the reach of effective programs by overcoming the logistical and implementation barriers (such as cost, travel, and accessibility) that limit traditionally delivered mental health interventions."," Sanchez, R;  Brown, E;  Kocher, K;  DeRosier, M",2017.0, 10.1089/g4h.2015.0108,0,0,
1081,Go/No-Go task performance predicts differences in compulsivity but not in impulsivity personality traits,"Lack of inhibitory control is present in impulsive and compulsive personality traits. The Go/No-Go task is one of the most effective means to assess response inhibition measured by the ability to appropriately withhold responding to No-Go stimuli. The aim of this work was to study whether differences in performance of Go/No-Go task predicts differences in personality traits related to inhibitory control. For this purpose 63 healthy participants divided into two groups based on the median split of false alarms on the Go/No-Go task completed Barratt Impulsiveness Scale (BIS-11) and the Maudsley Obsessional Compulsive Questionnaire (MOCI). Results showed that participants with high false alarms (H-FA) displayed a high-risk strategy of responding, and higher scores in the MOCI Total and MOCI Checking subscale compared to participants with low false alarms (L-FA). The results show for the first time a relation between the execution of the Go/No-Go task and the MOCI scale. Surprisingly, no relation was found between the Go/No-Go task and the BIS-11 scale. Further studies are needed to define the heterogeneous constructs of compulsivity and impulsivity, and to improve the convergence of the clinical scales and the behavioral measures of these two personality traits.",Sánchez-Kuhn A.; León J.J.; Gôngora K.; Pérez-Fernández C.; Sánchez-Santed F.; Moreno M.; Flores P.,2017.0,10.1016/j.psychres.2017.07.064,0,0,
1082," Measurement, Education and Tracking in Integrated Care (METRIC): use of a culturally adapted education tool versus standard education to increase engagement in depression treatment among Hispanic patients: study protocol for a randomized control trial"," BACKGROUND: Significant mental health disparities exist for Hispanic populations, especially with regard to depression treatment. Stigma and poor communication between patients and their providers result in low use of antidepressant medications and early treatment withdrawal. Cultural factors which influence treatment decisions among Hispanics include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking medications. Primary care settings often are the gateway to identifying undiagnosed or untreated mental health disorders, particularly for people with co‚Äêmorbid physical health conditions. Hispanics, in particular, are more likely to receive mental healthcare in primary care settings. Recent recommendations from the U.S. Preventive Services Task Force are that primary care providers screen adult patients for depression only if systems are in place to ensure adequate treatment and follow‚Äêup. METHODS: We are conducting a randomized controlled trial among 150 depressed adult Hispanics in a primary care safety net setting, testing the effectiveness of a culturally appropriate depression education intervention to reduce stigma and increase uptake in depression treatment among Hispanics, and implement a Measurement‚ÄêBased Integrated Care (MBIC) model with collaborative, multidisciplinary treatment and culturally tailored care management strategies. DISCUSSION: This study protocol represents the first randomized control trial of the culturally adapted depression education fotonovela, Secret Feelings, among Hispanics in a primary care setting. The education intervention will be implemented after diagnosis using an innovative screening technology and enrolled in measurement‚Äêbased integrated care for the treatment of depression, which will help build the evidence around cultural adaptations in treatment to reduce mental health disparities. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02702596. Registered on 20 March 2016."," Sanchez, K;  Eghaneyan, BH;  Killian, MO;  Cabassa, L;  Trivedi, MH",2017.0, 10.1186/s13063-017-2109-y,0,0,
1083, Impact of personality status on the outcomes and cost of cognitive-behavioural therapy for health anxiety," BACKGROUND: Health anxiety, hypochondriasis and personality disturbance commonly coexist. The impact of personality status was assessed in a secondary analysis of a randomised controlled trial (RCT). AIMS: To test the impact of personality status using ICD‚Äê11 criteria on the clinical and cost outcomes of treatment with cognitive‚Äêbehavioural therapy for health anxiety (CBT‚ÄêHA) and standard care over 2 years. METHOD: Personality dysfunction was assessed at baseline in 444 patients before randomisation and independent assessment of costs and outcomes made on four occasions over 2 years. RESULTS: In total, 381 patients (86%) had some personality dysfunction with 184 (41%) satisfying the ICD criteria for personality disorder. Those with no personality dysfunction showed no treatment differences (P = 0.90) and worse social function with CBT‚ÄêHA compared with standard care (P<0.03) whereas all other personality groups showed greater improvement with CBT‚ÄêHA maintained over 2 years (P<0.001). Less benefit was shown in those with more severe personality disorder (P<0.05). Costs were less with CBT‚ÄêHA except for non‚Äêsignificant greater differences in those with moderate or severe personality disorder. CONCLUSIONS: The results contradict the hypothesis that personality disorder impairs response to CBT in health anxiety in both the short and medium term."," Sanatinia, R;  Wang, D;  Tyrer, P;  Tyrer, H;  Crawford, M;  Cooper, S;  Loebenberg, G;  Barrett, B",2016.0, 10.1192/bjp.bp.115.173526,0,0,
1084,A randomized controlled pilot intervention study of a mindfulness-based self-leadership training (MBSLT) on stress and performance.,"The present randomized pilot intervention study examines the effects of a mindfulness-based self-leadership training (MBSLT) specifically developed for academic achievement situations. Both mindfulness and self-leadership have a strong self-regulatory focus and are helpful in terms of stress resilience and performance enhancements. Based on several theoretical points of contact and a specific interplay between mindfulness and self-leadership, the authors developed an innovative intervention program that improves mood as well as performance in a real academic setting. The intervention was conducted as a randomized controlled study over 10 weeks. The purpose was to analyze the effects on perceived stress, test anxiety, academic self-efficacy, and the performance of students by comparing an intervention and control group (n = 109). Findings demonstrated significant effects on mindfulness, self-leadership, academic self-efficacy, and academic performance improvements in the intervention group. Results showed that the intervention group reached significantly better grade point averages than the control group. Moreover, the MBSLT over time led to a reduction of test anxiety in the intervention group compared to the control group. Furthermore, while participants of the control group showed an increase in stress over time, participants of the intervention group maintained constant stress levels over time. The combination of mindfulness and self-leadership addressed both positive effects on moods and on objective academic performance. The effects demonstrate the great potential of combining mindfulness with self-leadership to develop a healthy self-regulatory way of attaining achievement-related goals and succeeding in high-stress academic environments. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Sampl, Juliane; Maran, Thomas; Furtner, Marco R",2017.0,http://dx.doi.org/10.1007/s12671-017-0715-0,0,0,
1085,Cognitive-Behavioral and Psychodynamic Therapy in Adolescents with Social Anxiety Disorder: A Multicenter Randomized Controlled Trial.,"Although social anxiety disorder (SAD) has an early onset and is frequently found in adolescence, evidence for psychotherapeutic treatments of SAD in adolescents is rather scarce. Within the Social Phobia Psychotherapy Research Network (SOPHO-NET), we examined the efficacy of cognitive-behavioral (CBT) and psychodynamic therapy (PDT) compared to a waiting list (WL) in these patients. In a multicenter randomized controlled superiority trial, 107 patients, aged 14-20 years, were randomized to CBT (n = 34), PDT (n = 34), or WL (n = 39). Assessments were made at baseline, at the end of treatment, and 6 and 12 months after termination. The Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA) applied by raters masked to the treatment condition was used as the primary outcome. As secondary outcomes, rates of response and remission and the Social Phobia Anxiety Inventory (SPAI) were used. Both treatments were superior to WL in the LSAS-CA (CBT: p = 0.0112, d = 0.61, 95% CI 0.14-1.08; PDT: p = 0.0261, d = 0.53, 95% CI 0.06-1.00). At the end of treatment, response rates were 66, 54, and 20% for CBT, PDT, and WL. The corresponding remission rates were 47, 34, and 6%, respectively. CBT and PDT were significantly superior to WL regarding remission (CBT: p = 0.0009, h = 1.0; PDT: p = 0.0135, h = 0.74), response (CBT: p = 0.0004, h = 0.97; PDT: p = 0.0056, h = 0.72), and the SPAI (CBT: p = 0.0021, d = 0.75, 95% CI 0.27-1.22; PDT: p = 0.0060, d = 0.66, 95% CI 0.19-1.13). Treatment effects were stable at 6- and 12-month follow-ups. These results are comparable to the large SOPHO-NET trial in adults (n = 495). Early treatments for social anxiety are needed in order to prevent chronic manifestation of SAD.",Salzer S.; Stefini A.; Kronmüller KT.; Leibing E.; Leichsenring F.; Henningsen P.; Peseschkian H.; Reich G.; Rosner R.; Ruhl U.; Schopf Y.; Steinert C.; Vonderlin E.; Steil R.,2018.0,10.1159/000488990,0,0,
1086,"Surviving and thriving: Pilot interventions to promote psychological well-being, resilience, and posttraumatic growth in AYAs","Adolescents and young adults (AYAs) represent an important underserved group of patients with cancer. AYAs experience multiple psychosocial challenges and report clinically significant levels of psychological distress compared to pediatric and older adults with cancer. Interestingly, a growing body of research describes positive psychosocial changes among AYAs and interventions are being tested to promote healthy adaptation among AYAs. This symposium will feature 3 speakers whose research focuses on the development and implementation of psychosocial interventions to promote positive psychological outcomes among AYAs with cancer. The first presentation will highlight emerging findings from a single arm pilot study of a multicomponent emotion regulation intervention to promote psychological well-being in post-treatment AYAs. The second presentation will describe results from a pilot randomized controlled trial (RCT) of a cognitive-behavioral stress management intervention to promote resilience in AYAs newly diagnosed with cancer. The final presentation will focus on the results of a pilot RCT to examine the effects of a mindfulness based stress reduction intervention on posttraumatic growth in AYAs receiving active treatment and post-treatment survivors. The symposium will conclude with a discussion about the implications of these studies for enhancing positive psychosocial adaptation in AYAs as well as recommendations for future directions to advance the clinical significance of this work.",Salsman J.,2018.0,10.1002/pon.4622,0,0,
1087, Exploring synergistic effects of aerobic exercise and mindfulness training on cognitive function in older adults: protocol for a pilot randomized controlled trial," INTRODUCTION: Despite increasing evidence that aerobic exercise and cognitive training improve cognitive function among patients with cognitive impairment and dementia, few studies have focused on the effect of a combination of these approaches. This study will explore whether combining aerobic training (AT) with mindfulness training (MT), an intervention promoting the moment‚Äêto‚Äêmoment awareness of physical sensations, affective states, and thoughts, improves cognitive function in individuals at risk of dementia. The primary objective is to determine the feasibility and acceptability of the intervention(s). The secondary objective is to obtain estimates of effect sizes on cognitive function and on possible mediators. METHODS AND ANALYSIS: Forty participants with at least 2 risk factors for dementia will be randomized (2‚Ää√ó‚Ää2 factorial design) to either AT (3‚Ääsessions/week for 12 weeks), MT (1‚Ääsession/week for 8 weeks), both, or usual care. Assessments of cognitive function (attention, executive function, episodic, and working memory); physical activity (accelerometry), aerobic capacity (6‚Äêminute walk test), waist‚Äêto‚Äêhip ratio, blood pressure, social support (Multidimensional Scale of Perceived Social Support), depression (Hospital Anxiety and Depression Scale), and mindfulness (Five Facets of Mindfulness) will be conducted at baseline, end of treatment, and 6‚Äêmonths postbaseline. Rates of retention, attendance, and program satisfaction will be calculated for each of the 4 groups to determine the feasibility and acceptability of each intervention. ETHICS AND DISSEMINATION: This study has full ethical approval by The Miriam Hospital Institutional Review Board and adheres to the Standard Protocol Items: Recommendations for Interventional Trials reporting recommendations. If results from this exploratory, proof‚Äêof‚Äêconcept study support our hypotheses, we will conduct a large randomized controlled trial (RCT) to determine the efficacy of combined MT and AT in improving cognitive function in individuals at risk of dementia. Results from the study will be disseminated through peer‚Äêreviewed journals and conference presentations. REGISTRATION DETAILS:: http://www.clinicalstrials.gov identifier NCT03289546."," Salmoirago-Blotcher, E;  DeCosta, J;  Harris, K;  Breault, C;  Dunsiger, S;  Santos, C;  Snyder, P",2018.0, 10.1097/MD.0000000000010626,0,0,
1088,Spatiotemporal brain dynamics underlying attentional bias modifications,"Exaggerated attentional biases toward specific elements of the environment contribute to the maintenance of several psychiatric conditions, such as biases to threatening faces in social anxiety. Although recent literature indicates that attentional bias modification may constitute an effective approach for psychiatric remediation, the underlying neurophysiological mechanisms remain unclear. We addressed this question by recording EEG in 24 healthy participants performing a modified dot-probe task in which pairs of neutral cues (colored shapes) were replaced by probe stimuli requiring a discrimination judgment. To induce an attentional bias toward or away from the cues, the probes were systematically presented either at the same or at the opposite position of a specific cue color. This paradigm enabled participants to spontaneously develop biases to initially unbiased, neutral cues, as measured by the response speed to the probe presented after the cues. Behavioral result indicated that the ABM procedure induced approach and avoidance biases. The influence of ABM on inhibitory control was assessed in a separated Go/NoGo task: changes in AB did not influence participants’ capacity to inhibit their responses to the cues. Attentional bias modification was associated with a topographic modulation of event-related potentials already 50–84 ms following the onset of the cues. Statistical analyses of distributed electrical source estimations revealed that the development of attentional biases was associated with decreased activity in the left temporo-parieto-occipital junction. These findings suggest that attentional bias modification affects early sensory processing phases related to the extraction of information based on stimulus saliency.",Sallard E.; Hartmann L.; Ptak R.; Spierer L.,2018.0,10.1016/j.ijpsycho.2018.06.001,0,0,
1089, Effectiveness of Matricaria chamomilla (chamomile) extract on pain control of cyclic mastalgia: a double-blind randomised controlled trial," Breast pain (mastalgia) often precedes menstrual period, which is of mild to moderate severity. This study was performed to determine the effectiveness of chamomile on pain control of cyclic mastalgia. This double‚Äêblind randomised controlled clinical trial was conducted on 60 patients with mastalgia referred to the breast clinic of an academic hospital, Mashhad University of Medical Sciences. The patients were randomly allocated into two groups: chamomile (n‚Äâ=‚Äâ30) and placebo (n‚Äâ=‚Äâ30). Primary outcomes were: (1) assessment of the visual analogue scale (VAS) and (2) assessment of the breast pain chart (BPC) 8‚Äâweeks after initial intervention. All the participants were asked to take drops three times a day each time having five drops for two consecutive months. Significant decline was observed in both the groups (chamomile and placebo) after two months (p‚Äâ<‚Äâ.0001 and p‚Äâ=‚Äâ.048, respectively) compared to baseline and between two groups (p‚Äâ=‚Äâ.007). Chamomile was a well‚Äêtolerated, secure and effective drug for treating women with mild to moderate mastalgia. Impact statement What is already known on this subject: Breast pain (mastalgia) is a common chief complaint reported by many women. The 'cyclic' type, which usually occurs monthly prior to the onset of menstrual period, is of moderate severity. In 30% of the cases, mastalgia is severe and disturbs normal life, leading to sexual, physical, and social dysfunction as well as depression and anxiety. The cause of cyclical mastalgia is not known, but given the fact that it begins in the luteal phase, it can be caused by hormonal stimulation. A variety of therapies have been recommended. Such therapies include prescription of vitamin B2, B6, E and C, non‚Äêsteroidal anti‚Äêinflammatory drugs (NSAIDs), diuretics, thyroxin, progesterone, Tamoxifen, Danazol, Bromocriptine and plant extracts like vitexagnus castus, evening primrose oil (EPO). However, given the side effects of hormonal treatment, many women have developed a propensity towards the use of herbal medicine. What do the results of this study add: Chamomile presents a safe, well‚Äêtolerated and effective treatment for women with moderate mastalgia. What are the implications of these finding for clinical practice and/or further research: Considering that Danazol, Bromocriptine and Tamoxifen are standard treatments for mastalgia, it would be helpful to carry out a trial study to compare the effect of chamomile extract versus standard treatments. The physicians can prescribe chamomile as a safe alternative treatment for mastalgia."," Saghafi, N;  Rhkhshandeh, H;  Pourmoghadam, N;  Pourali, L;  Ghazanfarpour, M;  Behrooznia, A;  Vafisani, F",2018.0, 10.1080/01443615.2017.1322045,0,0,
1090,The Relationship between Obsessive Compulsive Personality and Obsessive Compulsive Disorder Treatment Outcomes: Predictive Utility and Clinically Significant Change.,"The evidence regarding whether co-morbid obsessive compulsive personality disorder (OCPD) is associated with treatment outcomes in obsessive compulsive disorder (OCD) is mixed, with some research indicating that OCPD is associated with poorer response, and some showing that it is associated with improved response. We sought to explore the role of OCPD diagnosis and the personality domain of conscientiousness on treatment outcomes for exposure and response prevention for OCD. The impact of co-morbid OCPD and conscientiousness on treatment outcomes was examined in a clinical sample of 46 participants with OCD. OCPD diagnosis and scores on conscientiousness were not associated with poorer post-treatment OCD severity, as indexed by Yale-Brown Obsessive Compulsive Scale (YBOCS) scores, although the relative sample size of OCPD was small and thus generalizability is limited. This study found no evidence that OCPD or conscientiousness were associated with treatment outcomes for OCD. Further research with larger clinical samples is required.",Sadri SK.; McEvoy PM.; Egan SJ.; Kane RT.; Rees CS.; Anderson RA.,2017.0,10.1017/S1352465817000194,0,0,
1091, A Pilot Investigation of Cognitive Behavioural Therapy for Clinical Perfectionism in Obsessive Compulsive Disorder," BACKGROUND: Perfectionism is strongly associated with obsessive compulsive disorder (OCD). Cognitive behavioural therapy for perfectionism (CBT‚ÄêP) has been found to result in reductions in a range of symptoms in individuals with anxiety disorders, depression and eating disorders. AIM: To pilot‚Äêtest the efficacy of group CBT for perfectionism in participants with OCD and elevated perfectionism. METHOD: Participants were randomized to receive immediate 8‚Äêweek group CBT‚ÄêP (n = 4) or an 8‚Äêweek waitlist followed by CBT‚ÄêP (n = 7). RESULTS: Reliable reductions and a large effect size indicated that CBT‚ÄêP was associated with improvements in perfectionism and OCD severity at post‚Äêtest. However, these changes were not clinically significant and drop‚Äêout was high, resulting in a small final sample. CONCLUSIONS: CBT‚ÄêP may be effective in reducing perfectionism and disorder‚Äêspecific OCD symptoms. However, the high drop‚Äêout rate and lack of clinically significant findings suggest that further research needs to be conducted to determine the efficacy of CBT for perfectionism in OCD."," Sadri, SK;  Anderson, RA;  McEvoy, PM;  Kane, RT;  Egan, SJ",2017.0, 10.1017/S1352465816000618,0,0,
1092,Feasibility study of mindfulness-based cognitive therapy for anxiety disorders in a Japanese setting.,"Mindfulness-based cognitive therapy (MBCT) could be a treatment option for anxiety disorders. Although its effectiveness under conditions of low pharmacotherapy rates has been demonstrated, its effectiveness under condition of high pharmacotherapy rate is still unknown. The aim of the study was to evaluate effectiveness of MBCT under the context of high pharmacotherapy rates. A single arm with pre-post comparison design was adopted. Those who had any diagnosis of anxiety disorders, between the ages of 20 and 74, were included. Participants attended 8 weekly 2-hour-long sessions followed by 2 monthly boosters. Evaluation was conducted at baseline, in the middle, at end of the intervention, and at follow-up. The State-Trait Anxiety Inventory (STAI)-state was set as the primary outcome. Pre-post analyses with mixed-effect models repeated measures were conducted. Fourteen patients were involved. The mean age was 45.0, and 71.4% were female. The mean change in the STAI-state at every point showed statistically significant improvement. The STAI-trait also showed improvement at a high significance level from the very early stages. The participants showed significant improvement at least one point in some other secondary outcomes. Trial registration Retrospectively registered at the University Hospital Medical Information Network on 1st August 2013 (ID: UMIN000011347).",Sado M.; Park S.; Ninomiya A.; Sato Y.; Fujisawa D.; Shirahase J.; Mimura M.,2018.0,10.1186/s13104-018-3744-4,0,0,
1093, Complex PTSD as proposed for ICD-11: validation of a new disorder in children and adolescents and their response to Trauma-Focused Cognitive Behavioral Therapy," BACKGROUND: To evaluate whether the symptoms of children and adolescents with clinically significant posttraumatic stress symptoms (PTSS) form classes consistent with the diagnostic criteria of complex PTSD (CPTSD) as proposed for the ICD‚Äê11, and to relate the emerging classes with treatment outcome of Trauma‚ÄêFocused Cognitive Behavioral Therapy (TF‚ÄêCBT). METHODS: Latent classes analysis (LCA) was used to explore the symptom profiles of the clinical baseline assessment of N = 155 children and adolescents participating in a randomized controlled trial of TF‚ÄêCBT. The treatment outcomes of patients with posttraumatic stress disorder (PTSD) and of patients with CPTSD were compared by a t‚Äêtest for depended samples and a repeated‚Äêmeasures ANOVA. RESULTS: The LCA revealed two distinct classes: a PTSD class characterized by elevated core symptoms of PTSD (n = 62) and low symptoms of disturbances in self‚Äêorganization versus a complex PTSD class with elevated PTSD core symptoms and elevated symptoms of disturbances in self‚Äêorganization (n = 93). The Group √ó Time interaction regarding posttraumatic stress symptoms was not significant. Pre‚Äêpost effect sizes regarding posttraumatic stress symptoms were large for both groups (PTSD: d = 2.81; CPTSD: d = 1.37). For disturbances in self‚Äêorganization in the CPTSD class, we found medium to large effect sizes (d = 0.40‚Äê1.16) after treatment with TF‚ÄêCBT. CONCLUSIONS: The results provide empirical evidence of the ICD‚Äê11 CPTSD and PTSD distinction in a clinical sample of children and adolescents. In terms of relative improvement from their respective baseline posttraumatic stress symptoms, patients with PTSD and CPTSD responded equally to TF‚ÄêCBT; however, those with CPTSD ended treatment with clinically and statistically greater symptoms than those with PTSD."," Sachser, C;  Keller, F;  Goldbeck, L",2017.0, 10.1111/jcpp.12640,0,0,
1094, Randomized clinical trial of immersive virtual reality tour of the operating theatre in children before anaesthesia," METHODS: Children scheduled for elective surgery under general anaesthesia were randomized into a control or VR group. The control group received conventional information regarding anaesthesia and surgery. The VR group watched a 4‐min video showing Pororo, the famous little penguin, visiting the operating theatre and explaining what is in it. The main outcome was preoperative anxiety, assessed using the modified Yale Preoperative Anxiety Scale (m‐YPAS) before entering the operating theatre. Secondary outcomes included induction compliance checklist (ICC) and procedural behaviour rating scale (PBRS) scores during anaesthesia. RESULTS: A total of 69 children were included in the analysis, 35 in the control group and 34 in the VR group. Demographic data and induction time were similar in the two groups. Children in the VR group had a significantly lower m‐YPAS score than those in the control group (median 31·7 (i.q.r. 23·3‐37·9) and 51·7 (28·3‐63·3) respectively; P < 0·001). During anaesthesia, the VR group had lower ICC and PBRS scores than the control group. CONCLUSION: This preoperative VR tour of the operating theatre was effective in alleviating preoperative anxiety and increasing compliance during induction of anaesthesia in children undergoing elective surgery. Registration number: UMIN000025232 (http://www.umin.ac.jp/ctr). BACKGROUND: A virtual reality (VR) tour of the operating theatre before anaesthesia could provide a realistic experience for children. This study was designed to determine whether a preoperative VR tour could reduce preoperative anxiety in children."," Ryu, JH;  Park, SJ;  Park, JW;  Kim, JW;  Yoo, HJ;  Kim, TW;  Hong, JS;  Han, SH",2017.0, 10.1002/bjs.10684,0,0,
1095, Evaluation of a hydrophobic gel adhering to the gingiva in comparison with a standard water-soluble 1% chlorhexidine gel after scaling and root planing in patients with moderate chronic periodontitis. A randomized clinical trial," METHODS: A total of 34 subjects participated in this 6‚Äêmonth blinded randomized parallel controlled trial (ISRCTN35210084). After scaling and root planing (SRP), test group received the gel, by rubbing on the gingiva, once every second day, for 14 days. The control group received the control gel twice daily. Clinical parameters considered were the approximal plaque index, simplified oral hygiene index, modified gingival index, bleeding on probing, probing depth and clinical attachment level (primary outcome), assessed at baseline, 3 and 6 months, together with the frequency of detection of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis (P.g.), Prevotella intermedia, Treponema denticola (T.d.), Tannerella forsythia (T.f.), and activity of neutrophil elastase and myeloperoxidase (secondary outcomes). RESULTS: At 3 and 6 months, all clinical parameters improved significantly, without significant intergroup differences, except OHI‚ÄêS, which improved at 3 months (P < 0.05). Microbiological data resulted in no significant intergroup differences at baseline and 6 months. At 3 months, significant differences for P.g., T.f. and T.d. were noted. A significant reduction of neutrophil elastase after 3 and 6 months was observed (P < 0.005), without significant intergroup differences. For myeloperoxidase, significant reductions were noted in both groups (P < 0.005 and P < 0.05), but no significant intergroup differences. The tested product seemed to have an increased efficacy, due to longer persistence on the gingiva, with reduced application frequency. CONCLUSIONS: Both products had a relatively similar influence on the clinical, microbiological and enzymatic outcomes at 3 and 6 months after SRP. OBJECTIVES: To evaluate the clinical, microbiological and enzymatic activity of a hydrophobic chlorhexidine‚Äêbased gingiva‚Äêadhering gel containing herbal ingredients, compared with a commercially available 1% chlorhexidine water‚Äêsoluble gel, during non‚Äêsurgical therapy of moderate chronic periodontitis."," Rusu, D;  Stratul, SI;  Sarbu, C;  Roman, A;  Anghel, A;  Didilescu, A;  Jentsch, H",2017.0, 10.1111/idh.12155,0,0,
1096,"Experience and psychological impact of anal cancer screening in gay, bisexual and other men who have sex with men: a qualitative study","Objective: Human papillomavirus–related anal cancer rates are increasing and are particularly high in gay, bisexual and other men who have sex with men (GBM/MSM), especially HIV-positive individuals. Although screening programs for high-risk populations have been advocated, concerns about possible adverse psychological consequences exist. This study aimed to investigate GBM/MSM's experience, understanding and emotional response to screening techniques for anal cancer to determine how best to minimise psychological distress in future programs. Methods: In-depth qualitative face-to-face interviews were conducted with 21 GBM/MSM participating in the “Study of the Prevention of Anal Cancer” in Sydney, Australia, between June 2013 and June 2014. Nonrandom, purposive sampling was used to ensure heterogeneity with respect to HIV status and screening test results. Framework analysis method was used to organise the data and identify emerging themes. Results: Knowledge about anal cancer, human papillomavirus and the link between them was limited. Abnormal screening results affected participants' sense of well-being and were associated with anxiety and concern about developing anal cancer. HIV-negative men receiving abnormal results showed higher levels of distress compared to their HIV-positive counterparts. Consultations with general practitioners about abnormal results had an important role in increasing participants' understanding and in moderating their anxiety. Conclusion: Anal cancer screening should be accompanied by health education around anal cancer, its aetiology and the meaning of associated test results. Simple and effective communication strategies should be encouraged. Collaboration with general practitioners could assist the process of education and reporting test results.",Russo S.; Mccaffery K.; Ellard J.; Poynten M.; Prestage G.; Templeton D.J.; Hillman R.; Law C.; Grulich A.E.,2018.0,10.1002/pon.4480,0,0,
1097, Protocol for a feasibility study and randomised pilot trial of a low-intensity psychological intervention for depression in adults with autism: the Autism Depression Trial (ADEPT)," INTRODUCTION: High rates of co‚Äêoccurring depression are reported in autism spectrum disorder (ASD), a neurodevelopmental condition characterised by social communication impairments and repetitive behaviours. Cognitive‚Äêbehavioural interventions adapted for ASD have been effective for anxiety problems. There have been evaluation studies of group cognitive‚Äêbehavioural therapy for co‚Äêoccurring depression, but no randomised trials investigating low‚Äêintensity psychological interventions as recommended in clinical guidelines for mild‚Äêmoderate depression. METHODS AND ANALYSIS: A feasibility study comprising a randomised controlled trial (RCT) and nested qualitative evaluation is under way as preparation for a definitive RCT. Participants (n=70) will be randomised to Guided Self‚ÄêHelp: a low‚Äêintensity psychological intervention based on behavioural activation adapted for ASD or treatment as usual. Outcomes including depression symptoms, anxiety, social function and service use will be measured at 10, 16 and 24 weeks postrandomisation and will be blind to group allocation for measures that are not self‚Äêadministered. The analysis will aim to establish the rates of recruitment and retention for a larger‚Äêscale RCT as well as the most appropriate measure of depression to serve as primary outcome. The qualitative study will purposively sample up to 24 participants from each treatment group to consider the acceptability and feasibility of the intervention and the trial design. ETHICS AND DISSEMINATION: Ethical approval has been received from WALES REC 3 (IRAS project ID: 191558) and the Health Research Authority with R&D approval from Avon and Wiltshire Mental Health Partnership and Northumberland, Tyne and Wear Foundation NHS Trusts. To our knowledge, this is the first study of a low‚Äêintensity intervention for depression in adults with autism. The results will inform the design of a definitive RCT. Dissemination will include peer‚Äêreviewed journal publications reporting the quantitative and qualitative research findings of the study and presentations at national and international conferences. TRIAL REGISTRATION NUMBER: ISRCTN54650760; Pre‚Äêresults."," Russell, A;  Cooper, K;  Barton, S;  Ensum, I;  Gaunt, D;  Horwood, J;  Ingham, B;  Kessler, D;  Metcalfe, C;  Parr, J;  et al.",2017.0, 10.1136/bmjopen-2017-019545,0,0,
1098,Racial differences in adherence and response to combined treatment for full and subthreshold post-traumatic stress disorder and alcohol use disorders: A secondary analysis.,"We conducted a secondary data analysis to examine whether there were racial differences in adherence and treatment outcomes for participants with co-occurring full and subthreshold post-traumatic stress disorder (PTSD) and alcohol/substance use disorders (A/SUD) who were treated with Seeking Safety (a cognitive-behavioral therapy) and sertraline or Seeking Safety and placebo as part of a clinical trial. Bivarate analyses examined the association between race and adherence, and generalized estimating equations assessed whether race moderated the effect of combination treatment on PTSD and alcohol use outcomes. Except for education, there were no statistically significant racial differences in baseline demographic and psychiatric characteristics. African Americans and Caucasians were equally adherent in number of psychotherapy and medication sessions attended and medication compliance. After controlling for baseline demographics and psychiatric symptoms, however, a race by treatment condition interaction emerged suggesting that African Americans who received the Seeking Safety and sertraline treatment had significantly lower PTSD symptom severity posttreatment and at six months follow-up compared to their counterparts who received Seeking Safety and placebo. No differential effect of treatment condition was found for Caucasians. Moreover, results indicated that a diagnosis of major depressive disorder negatively impacted PTSD symptom recovery for African American participants but not for Caucasians. In conclusion, no differences emerged between African Americans and Caucasians in adherence to combination treatments for PTSD and A/SUD. Findings also suggest assessment and treatment of MDD among African Americans may improve treatment outcomes. More research is needed to determine whether the differential response to Seeking Safety and sertraline among African Americans compared to Caucasians can be replicated.",Ruglass LM.; Pedersen A.; Cheref S.; Hu MC.; Hien DA.,,10.1080/15332640.2015.1056927,0,0,
1099,Symptom dimensions in obsessive- compulsive disorder: Prediction of cognitive-behavior therapy outcome.,"Objective: A significant number of patients with obsessive-compulsive disorder (OCD) fail to benefit sufficiently from treatments. This study aimed to evaluate whether certain OCD symptom dimensions were associated with cognitive-behavioral therapy (CBT) outcome. Method: Symptoms of 104 CBT-treated in-patients with OCD were assessed with the clinician-rated Yale-Brown Obsessive-Compulsive Scale symptom checklist. Logistic regression analyses examined outcome predictors. Results: The most frequent OCD symptoms were aggressive and contamination obsessions, and compulsive checking and cleaning. Patients with hoarding symptoms at baseline (n = 19) were significantly less likely to become treatment responders as compared to patients without these symptoms. Patients with sexual and religious obsessions tended to respond less frequently, although this failed to reach statistical significance (P = 0.07). Regression analyses revealed that higher scores on the hoarding dimension were predictive of nonresponse, even after controlling for possible confounding variables. Conclusion: Our results strongly indicate that in-patients with obsessive-compulsive hoarding respond poorly to CBT. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Rufer, M; Fricke, S; Moritz, S; Kloss, M; Hand, I",2006.0,http://dx.doi.org/10.1111/j.1600-0447.2005.00682.x,0,0,
1100, Inclusion of Alcoholic Associations Into a Public Treatment Programme for Alcoholism Improves Outcomes During the Treatment and Continuing Care Period: a 6-Year Experience," Aims: To investigate whether inclusion of self‐help groups into the hospital treatment programme improves the prognosis of alcohol dependence through the treatment period; and to examine therapeutic adherence and prognosis during continuing care. Method: Patients attending the treatment programme at the 'Hospital 12 de Octubre' were randomized into two groups. In Group A (n = 123), patients received the usual treatment included in our programme, whereas in Group B (n = 126), patients also attended self‐help groups. Patients were assessed with psychological scales at baseline, at the end of the treatment period and after completing the continuing care visits. Data were collected over a total of 6 years. Results: During the treatment period, patients in Group B accumulated more months of abstinence and dropped out less. During continuing care, patients in Group B accumulated more months of abstinence and therapeutic adherence was higher. Variables that were associated with these results during the continuing care period were: visits to the GP, scores on anxiety, impulsivity and meaning of life scales, and belonging to the group that attended the alcoholic associations. Conclusions: Mutual help groups incorporated into a public treatment programme appear to improve outcomes during treatment and on into continuing care. This experience supports cooperation between public health centres and alcoholic associations in treating alcoholism. Short Summary: Including alcoholic associations into the public treatment programme for alcoholism of the 'Hospital 12 de Octubre' in Madrid was shown to be associated with better outcomes in terms of months of accumulated abstinence, dropout rates and therapeutic adherence, during the treatment and continuing care periods."," Rubio, G;  Marín, M;  Arias, F;  López-Trabada, JR;  Iribarren, M;  Alfonso, S;  Prieto, R;  Blanco, A;  Urosa, B;  Montes, V;  et al.",2018.0, 10.1093/alcalc/agx078,0,0,
1101,A randomized controlled trial of Internet-Based Cognitive Behavior Therapy for perfectionism including an investigation of outcome predictors.,"Being highly attentive to details can be a positive feature. However, for some individuals, perfectionism can lead to distress and is associated with many psychiatric disorders. Cognitive behavior therapy has been shown to yield many benefits for those experiencing problems with perfectionism, but the access to evidence-based care is limited. The current study investigated the efficacy of guided Internet-based Cognitive Behavior Therapy (ICBT) and predictors of treatment outcome. In total, 156 individuals were included and randomized to an eight-week treatment or wait-list control. Self-report measures of perfectionism, depression, anxiety, self-criticism, self-compassion, and quality of life were distributed during screening and at post-treatment. Intention-to-treat were used for all statistical analyses. Moderate to large between-group effect sizes were obtained for the primary outcome measures, Frost Multidimensional Perfectionism Scale, subscales Concerns over Mistakes and Personal Standards, Cohen's d = 0.68-1.00, 95% Confidence Interval (CI) [0.36-1.33], with 35 (44.9%) of the patients in treatment being improved. Predictors were also explored, but none were related to treatment outcome. In sum, guided ICBT can be helpful for addressing problems with clinical perfectionism, but research of its long-term benefits is warranted.",Rozental A.; Shafran R.; Wade T.; Egan S.; Nordgren LB.; Carlbring P.; Landström A.; Roos S.; Skoglund M.; Thelander E.; Trosell L.; Örtenholm A.; Andersson G.,2017.0,10.1016/j.brat.2017.05.015,0,0,
1102, GETSmart: guided Education and Training via Smart Phones to Promote Resilience," Posttraumatic stress disorder (PTSD) is common in U.S. military service members (SMs) returning from Afghanistan and Iraq. SMs with PTSD symptoms that fall short of meeting full diagnostic criteria also experience devastating effects on their quality of life and daily functioning. Though evidence based treatments are indicated for those meeting diagnostic criteria, less attention has been given to interventions for those with subthreshold symptoms. The advent of novel technologies affords a unique opportunity to meet these intervention needs. Here we describe the feasibility and preliminary findings testing a smartphone‚Äêbased intervention program to reduce PTSD symptoms in post‚Äêdeployment SMs. Participants were randomized to a control or intervention condition. Those in the intervention condition engaged in one Skype session and six weeks of daily directive text messages guiding application (app) use. Apps primarily included those developed by the Department of Defense or VA. Participants completed the PTSD Checklist online at baseline, post‚Äêintervention, and 3‚Äêmonth follow‚Äêup. Overall, participant feedback was positive, regardless of treatment condition. Preliminary findings (with 10% of the overall target population having enrolled) indicate PCL scores decrease significantly from baseline to post‚Äêintervention, and these effects are maintained at 3‚Äêmonth follow‚Äêup. Additional analyses will be performed upon completion of the study. The present findings demonstrate the feasibility and acceptability of a smartphone‚Äêbased resiliency training program for those with subthreshold PTSD."," Roy, MJ;  Highland, KB;  Costanzo, MA",2015.0,,0,0,582
1103,Placebo Effect: A New Approach to Explanation of its Psychophysiological Mechanisms,In this theoretical overview will be reconsidered basic mechanisms of placebo effect with a purpose to examine a hypothesis that the generally accepted psycho-physiological mechanisms of the placebo effect that explain many clinical and experimental data are related to search activity. Search related activity in general is a behavioral attitude that is capable to restore mental and physical health in different conditions that may explain basic mechanisms of placebo effect.,Rotenberg V.,2016.0,10.1007/BF03379947,0,0,
1104," A pilot and feasibility randomised controlled study of Prolonged Exposure Treatment and supportive counselling for post-traumatic stress disorder in adolescents: a third world, task-shifting, community-based sample"," BACKGROUND: There is a dearth of empirical evidence on the effectiveness of pharmacological and nonpharmacological treatments for adolescents with post‐traumatic stress disorder (PTSD) in developing country settings. The primary aim of this study was to demonstrate that Prolonged Exposure Treatment for Adolescents (PE‐A) and supportive counselling (SC) are implementable by nurses in a South African context. A secondary aim was to perform a preliminary analysis of the effectiveness of registered nurses delivering either PE‐A or SC treatment to adolescents with PTSD. It is hypothesised that PE‐A will be superior to SC in terms of improvements in PTSD symptoms and depression. METHOD: A pilot, single‐blind, randomised clinical trial of 11 adolescents with PTSD. Nurses previously naïve to Prolonged Exposure (PE) Treatment and SC provided these treatments at the adolescents' high schools. Data collection lasted from March 2013 to October 2014. Participants received twelve 60‐90‐min sessions of PE (n = 6) or SC (n = 5). All outcomes were assessed before treatment, at mid‐treatment, immediately after treatment completion and at 12‐month follow‐up. The primary outcome, PTSD symptom severity, was assessed with the Child PTSD Symptom Scale‐Interview (CPSS‐I) (range, 0‐51; higher scores indicate greater severity). The secondary outcome, depression severity, was assessed with the Beck Depression Inventory (BDI) (range, 0‐41; higher scores indicate greater severity). RESULTS: Data were analysed as intention to treat. During treatment, participants in both the PE‐A and SC treatment arms experienced significant improvement on the CPSS‐I as well as on the BDI. There was a significant difference between the PE‐A and SC groups in maintaining PTSD and depression at the 12‐month post‐treatment assessment, with the participants in the PE‐A group maintaining their gains both on PTSD and depression measures. CONCLUSION: The treatment was adequately implemented by the nurses and well‐tolerated by the participants. Preliminary results suggest that the delivery of either intervention led to a significant improvement in PTSD and depression symptoms immediately post treatment. The important difference was that improvement gains in PTSD and depression in the PE‐A group were maintained at 12‐month follow‐up. The results of this pilot and feasibility study are discussed. TRIAL REGISTRATION: Pan African Clinical Trials Registry: PACTR201511001345372 , registered on 11 November 2015."," Rossouw, J;  Yadin, E;  Alexander, D;  Mbanga, I;  Jacobs, T;  Seedat, S",2016.0, 10.1186/s13063-016-1677-6,0,0,
1105,Complex trauma reactions in chronically traumatized youth receiving trauma-specific cognitive behavioral therapy.,"Over 60% of youth report experiencing at least one traumatic event (McLaughlin et al., 2013), and trauma-exposed youth experience more functional impairment in psychological, social, behavioral, cognitive and academic domains than non-exposed youth (Copeland et al., 2007; DeBellis et al., 2009; DeBellis et al., 2013; Paolucci et al., 2001; Scheeringa et al., 2003). The most commonly-studied outcome in treatments for youth trauma survivors is posttraumatic stress disorder (PTSD). The term ""complex trauma"" has been used to describe chronic exposure to multiple forms of trauma, often perpetrated by adults who are expected to be trustworthy protectors. The NCTSN's Complex Trauma Task Force noted seven domains of dysfunction associated with complex trauma experience: attachment, biology, affect regulation, dissociation, behavioral regulation, cognition, and self-concept (Cook et al., 2003; Cook et al., 2005). Currently, there are no studies that evaluate all of these domains in the context of evidence-based trauma treatments. It has been suggested that such youth may require more emphasis on specific, or additional, treatment components (Courtois, 2009); however, there are limited data to support this assertion. The aim of this study was to evaluate the effectiveness of evidence-based, trauma-specific treatment in a community sample of youth. It was hypothesized that PTSD and dysfunction in the seven complex trauma domains would decrease over the course of treatment. 122 youth completed treatment and experienced on average 3 different types of traumatic events. Multilevel modeling was used to evaluate change while accounting for nesting of evaluations (pre-, mid-, and post-treatment) within subjects, and the interaction of trauma chronicity with time point was assessed. Analyses suggested statistically significant improvement in functioning in the majority of the outcome variables. PTSD and emotion dysregulation were elevated for chronically traumatized youth at pre-treatment; however by mid-treatment these youth were indistinguishable from acutely traumatized youth. Findings suggest that differentiating chronic and acute trauma exposure may not be as important as previously suggested, and that well-established CBT for PTSD is also appropriate for youth who have experienced chronic trauma. Limitations and recommendations for further study are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Ross, Stephanie",2017.0,,0,0,
1106, A community-based randomized controlled trial of Mom Power parenting intervention for mothers with interpersonal trauma histories and their young children," We conducted a study to evaluate the effectiveness of Mom Power, a multifamily parenting intervention to improve mental health and parenting among high‚Äêrisk mothers with young children in a community‚Äêbased randomized controlled trial (CB‚ÄêRCT) design. Participants (N = 122) were high‚Äêrisk mothers (e.g., interpersonal trauma histories, mental health problems, poverty) and their young children (age <6 years), randomized either to Mom Power, a parenting intervention (treatment condition), or weekly mailings of parenting information (control condition). In this study, the 13‚Äêsession intervention was delivered by community clinicians trained to fidelity. Pre‚Äê and post‚Äêtrial assessments included mothers' mental health symptoms, parenting stress and helplessness, and connection to care. Mom Power was delivered in the community with fidelity and had good uptake (>65%) despite the risk nature of the sample. Overall, we found improvements in mental health and parenting stress for Mom Power participants but not for controls; in contrast, control mothers increased in parent‚Äêchild role reversal across the trial period. The benefits of Mom Power treatment (vs. control) were accentuated for mothers with interpersonal trauma histories. Results of this CB‚ÄêRCT confirm the effectiveness of Mom Power for improving mental health and parenting outcomes for high‚Äêrisk, trauma‚Äêexposed women with young children. ClinicalTrials.gov Identifier: NCT01554215."," Rosenblum, KL;  Muzik, M;  Morelen, DM;  Alfafara, EA;  Miller, NM;  Waddell, RM;  Schuster, MM;  Ribaudo, J",2017.0, 10.1007/s00737-017-0734-9,0,0,
1107,The prevalence of mental health difficulties in a sample of prisoners in Trinidadian prisons referred for anger management,"Purpose: The purpose of this paper is to evaluate the prevalence of mental health disorder symptoms in a sample of prisoners in Trinidadian prisons who volunteered to attend anger management groups. Design/methodology/approach: A survey was conducted using the 90-item Symptom Check-List revised (SCL-90-R) which was administered to prisoners in groups within the prison system. In total 132 prisoners (about 9 per cent of the prison population) completed the measure. The effect sizes of prisoners’ similarities to a psychiatric inpatient group and their differences from a non-patient group were used to identify symptoms most indicative of pathology in these prisoners. Findings: The results on the SCL-90-R indicate that this group of prisoners (77.3 per cent male) had scores of psychiatric symptomatology that were much closer to a psychiatric inpatient population rather than to a general community population. Practical implications: These results suggest there may be unmet psychiatric need among the population served by the prison services in Trinidad. It is not known how this sample differs from the general prison population. However, the unmet psychiatric need in this specific population suggests that a greater mental health focus in health services within prisons is to be considered to meet these needs. Originality/value: These data suggest that there are significant mental health issues for some prisoners in Trinidad and possibly more generally in similar prison systems within the Caribbean and this may have significant implications for the treatment of prisoners and the delivery of mental health services in these prisons.",Rose J.; Hutchinson G.; Willner P.; Bastick T.,2018.0,10.1108/JFP-03-2018-0011,0,0,
1108,Heterogeneity in childbirth related fear or anxiety.,"Many pregnant women experience fear, worry or anxiety relating to the upcoming childbirth. The aim of this cross-sectional study was to investigate possible subgroups in a sample of 206 pregnant women (mean age 29.4 years), reporting fear of birth in mid-pregnancy. Comparisons were made between nulliparous and parous women. In a series of cluster analyses, validated psychological instruments were used to cluster women based on their psychological profiles. A five-cluster solution was suggested, with the clusters characterized by: overall low symptom load, general high symptom load, medium symptom load with high performance-based self-esteem, blood- and injection phobic anxiety, and specific anxiety symptoms. Nulliparous women were more likely to report clinically relevant levels of blood- and injection phobia (OR = 2.57, 95% CI 1.09-6.01), while parous women more often reported previous negative experiences in health care (OR 1.93, 95% CI 1.09-3.39) or previous trauma (OR 2.90, 95% CI 1.58-5.32). The results indicate that women reporting fear of birth are a heterogeneous group. In order to individualize treatment, psychological characteristics may be of greater importance than parity in identifying relevant subgroups.",Rondung E.; Ekdahl J.; Hildingsson I.; Rubertsson C.; Sundin Ö.,2018.0,10.1111/sjop.12481,0,0,
1109,Impact of stress response systems on forced choice recognition in an experimental trauma film paradigm,"Introduction: Traumatic events are often followed by memory impairments of key features of the trauma. Stress hormones are involved in emotional memory formation. However, little is known about their influence during trauma on subsequent recognition memory. Material and methods: A pooled analysis of two double-blind, placebo-controlled studies (N = 175) was performed to assess the influence of the noradrenergic system and the hypothalamus-pituitaryadrenal (HPA) axis on intrusion formation. Participants received either 10 mg yohimbine (stimulating noradrenergic activity), 0.15 mg clonidine (inhibiting noradrenergic activity), or placebo (noradrenergic manipulation study) or 20 mg hydrocortisone or placebo (hydrocortisone manipulation study), each 60 min before watching a distressing film depicting severe sexual and physical violence. After seven days, the participants performed a 24-item forced choice recognition test. Memory was assessed for pre-, peri-, and post-trauma film scenes. Results: A significant film scene by intervention interaction indicated a differential influence of drug intervention on the number of correct pre-, peri-, and post-trauma film scene memories one week after the distressing film. Post hoc tests revealed that clonidine led to significantly fewer correct peri-trauma film scene memories compared to placebo and, on a trend level, to yohimbine. Discussion: Pharmacological inhibition of noradrenaline during a distressing film leads to impaired emotional recognition memory for the peri-trauma film scene.",Rombold-Bruehl F.; Otte C.; Renneberg B.; Hellmann-Regen J.; Bruch L.; Wingenfeld K.; Roepke S.,2018.0,10.1016/j.nlm.2018.10.010,0,0,
1110, Therapist and Client Interactions in Motivational Interviewing for Social Anxiety Disorder," OBJECTIVE: The aim of the present study is to assess the bidirectional associations between therapist and client speech during a treatment based on motivational interviewing (MI) for social anxiety disorder. METHOD: Participants were 85 adults diagnosed with social anxiety who received MI prior to entering cognitive behavioral therapy. MI sessions were sequentially coded using the Motivational Interviewing Skill Code 2.5. RESULTS: Therapist MI‚Äêconsistent behaviors, including open questions as well as positive and negative reflections, were more likely to be followed by client change exploration (change talk and counter‚Äêchange talk). Therapist MI‚Äêinconsistent behaviors were more likely to precede client neutral language. Client language was also found to influence therapist likelihood of responding in an MI‚Äêconsistent manner. CONCLUSION: The findings support the first step of the MI causal model in the context of social anxiety and direct future research into the effect of therapist and client behaviors on MI treatment outcome."," Romano, M;  Arambasic, J;  Peters, L",2017.0, 10.1002/jclp.22405,0,0,
1111," Probiotics for fibromyalgia: study design for a pilot double-blind, randomized controlled trial"," BACKGROUND: Fibromyalgia syndrome (FMS) is a chronic, generalized and diffuse pain disorder accompanied by other symptoms such as emotional and cognitive deficits. The FMS patients show a high prevalence of gastrointestinal symptoms. Recently it has been found that microbes in the gut may regulate brain processes through the gut‐microbiota‐brain axis, modulating thus affection, motivation and higher cognitive functions. Therefore, the use of probiotics might be a new treatment that could improve the physical, psychological and cognitive state in FMS; however, no evidence about this issue is available. METHODS: This paper describes the design and protocol of a double‐blind, placebo‐controlled and randomized pilot study. We use validated questionnaires, cognitive task through E‐Prime and biological measures like urine cortisol and stool fecal samples. The trial aim is to explore the effects of eight weeks of probiotics therapy in physical (pain, impact of the FMS and quality of life), emotional (depression, and anxiety) and cognitive symptoms (attention, memory, and impulsivity) in FMS patients as compared to placebo. CONCLUSION: This pilot study is the first, to our knowledge, to evaluate the effects of probiotics in FMS. The primary hypothesis was that FMS patients will show a better performance on cognitive tasks, and an improvement in emotional and physical symptoms. These results will contribute to a better understanding in the gut‐brain axis. Here we present the design and protocol of the study."," Roman, P;  Estévez, ÁF;  Sánchez-Labraca, N;  Cañadas, F;  Miras, A;  Cardona, D",2017.0, 10.20960/nh.1300,0,0,
1112,"Effects of a multicomponent physical activity behavior change intervention on fatigue, anxiety, and depressive symptomatology in breast cancer survivors: randomized trial.","To determine the effects of the 3-month multicomponent Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) physical activity behavior change intervention on fatigue, depressive symptomatology, and anxiety. Postprimary treatment breast cancer survivors (n = 222) were randomized to BEAT Cancer or usual care. Fatigue Symptom Inventory and Hospital Anxiety and Depression Scale were assessed at baseline, postintervention (month 3; M3), and follow-up (month 6; M6). Adjusted linear mixed-model analyses demonstrated significant effects of BEAT Cancer vs usual care on fatigue intensity (M3 mean between group difference [M] = -0.6; 95% confidence interval [CI] = -1.0 to -0.2; effect size [d] = -0.32; P = .004), fatigue interference (M3 M = -0.8; CI = -1.3 to -0.4; d = -0.40; P < .001), depressive symptomatology (M3 M = -1.3; CI = -2.0 to -0.6; d = -0.38; P < .001), and anxiety (M3 M = -1.3; CI = -2.0 to -0.5; d = -0.33; P < .001). BEAT Cancer effects remained significant at M6 for all outcomes (all P values <.05; d = -0.21 to -.35). Clinically meaningful effects were noted for fatigue intensity, fatigue interference, and depressive symptomatology. BEAT Cancer reduces fatigue, depressive symptomatology, and anxiety up to 3 months postintervention in postprimary treatment breast cancer survivors. Further study is needed to determine sustainable methods for disseminating and implementing the beneficial intervention components.",Rogers LQ.; Courneya KS.; Anton PM.; Verhulst S.; Vicari SK.; Robbs RS.; McAuley E.,2017.0,10.1002/pon.4254,0,0,
1113,"Randomized controlled trial of SecondStory, an intervention targeting posttraumatic growth, with bereaved adults.","Objective: People often report positive psychological changes after adversity, a phenomenon known as posttraumatic growth (PTG). Few PTG-focused interventions have been rigorously tested, and measurement strategies have had significant limitations. This study evaluated the effects of a new group-format psychosocial intervention, SecondStory, aimed at facilitating PTG by helping participants make meaning of the past and plan a purposeful future. Method: In a randomized controlled trial, adults (N = 112, 64% women) bereaved within 5 years were randomly assigned to SecondStory or an active control, expressive writing. The primary outcome, PTG, was measured using two contrasting methods: the Posttraumatic Growth Inventory, which asks participants retrospectively how much they believe they have changed due to struggling with adversity, and the Current-Standing Posttraumatic Growth Inventory, which tracks quantifiable change in participants' standing in PTG domains over time. Secondary outcomes included depression symptoms, posttraumatic stress symptoms, and life satisfaction. Outcomes were measured at 2-week intervals: pretest, posttest, and three follow-up occasions. Hierarchical linear modeling was used to assess whether SecondStory participants experienced greater gains in primary and/or secondary outcomes over the 8-week trial. Results: Results indicated that SecondStory participants did not show significantly greater improvements than control participants on measures of PTG, posttraumatic stress, or life satisfaction, but they did show greater decreases in depression symptoms by the first follow-up. Conclusions: These findings suggest that SecondStory may not facilitate PTG more effectively than existing interventions but may be promising for addressing depression. Positive interventions may productively be refined to support people experiencing trauma and loss. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement What is the public health significance of this article?-This study highlights the potential of positive psychology interventions to support mental health after serious adversity. Results suggest that although SecondStory may not foster posttraumatic growth more effectively than existing interventions do, it may be a promising approach for addressing depression symptoms in adults who have lost a loved one. These findings also suggest that bereaved adults showing mild/subclinical distress may experience increases in self-perceived posttraumatic growth and decreases in posttraumatic stress after participating in either expressive writing or SecondStory. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Roepke, Ann Marie; Tsukayama, Eli; Forgeard, Marie; Blackie, Laura; Jayawickreme, Eranda",2018.0,http://dx.doi.org/10.1037/ccp0000307,0,0,
1114,Prospective writing: Randomized controlled trial of an intervention for facilitating growth after adversity.,"Little is known about how posttraumatic growth (PTG) can be fostered and controversy surrounds how it is best measured. We designed and tested an intervention, prospective writing, to facilitate PTG by encouraging people to explore new possibilities after adversity. Adults (N = 188) with recent adverse experiences were randomly assigned to do prospective writing, factual writing, or no writing weekly for one month. PTG was assessed with both retrospective and current-standing measures. Hierarchical linear modeling and response profile analysis were used to assess the intervention's impact, and latent growth curve modeling was used to test mediation. Prospective writing participants showed the greatest gains in PTG as assessed by the current-standing measure, but did not reliably show greater retrospective PTG than controls. Although large effect sizes for the mediation paths suggested that engagement with new possibilities may be a plausible mechanism, this result fell short of statistical significance. Prospection-based interventions merit further investigation. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Roepke, Ann Marie; Benson, Lizbeth; Tsukayama, Eli; Yaden, David Bryce",2018.0,,0,0,
1115,Expressive flexibility in combat veterans with posttraumatic stress disorder and depression.,"A growing body of evidence suggests that the ability to flexibly express and suppress emotions (""expressive flexibility"") supports successful adaptation to trauma and loss. However, studies have yet to examine whether individuals that meet criteria for posttraumatic stress disorder (PTSD) or depression exhibit alterations in expressive flexibility. The present study aims to test whether lower levels of expressive flexibility are associated with PTSD and depression in combat-exposed veterans. Fifty-nine combat veterans with and without PTSD completed self-report measures assessing symptoms of depression, PTSD, and combat exposure. Participants also completed an expressive flexibility task in which they were asked to either enhance or suppress their expressions of emotion while viewing affective images on a computer screen. Expressive flexibility was assessed by both expressive enhancement ability and expressive suppression ability. Repeated measures ANOVA's showed that both PTSD and depression were associated with lower levels of emotional enhancement ability. In addition, a series of linear regressions demonstrated that lower levels of emotional enhancement ability were associated with greater symptom severity of PTSD and depression. The ability to suppress emotional responses did not differ among individuals with and without PTSD or depression. of the study include a cross-sectional design, precluding causality; the lack of a non-trauma exposed group and predominantly male participants limit the generalizability to other populations. Alterations in expressive flexibility is a previously unrecognized affective mechanism associated with PTSD and depression. Clinical strategies aimed at enhancing emotional expression may aid in the treatment of these disorders.",Rodin R.; Bonanno GA.; Rahman N.; Kouri NA.; Bryant RA.; Marmar CR.; Brown AD.,2017.0,10.1016/j.jad.2016.09.027,0,0,
1116,Couples with Intimate Partner Violence Seeking Relationship Help: Associations and Implications for Self-Help and Online Interventions,"In-person conjoint treatments for relationship distress are effective at increasing relationship satisfaction, and newly developed online programs are showing promising results. However, couples reporting even low levels intimate partner violence (IPV) are traditionally excluded from these interventions. To improve the availability of couple-based treatment for couples with IPV, the present study sought to determine whether associations with IPV found in community samples generalized to couples seeking help for their relationship and whether web-based interventions for relationship distressed worked equally well for couples with IPV. In the first aim, in a sample of 2,797 individuals who were seeking online help for their relationship, the levels and correlates of both low-intensity and clinically significant IPV largely matched what is found in community samples. In the second aim, in a sample of 300 couples who were randomly assigned to a web-based intervention or a waitlist control group, low-impact IPV did not moderate the effects of the intervention for relationship distress. Therefore, web-based interventions may be an effective (and easily accessible) intervention for relationship distress for couples with low-intensity IPV.",Roddy M.K.; Georgia E.J.; Doss B.D.,2018.0,10.1111/famp.12291,0,0,
1117,Treating posttraumatic stress disorder in female victims of trafficking using narrative exposure therapy: A retrospective audit.,"Background: Human trafficking is a form of modern slavery that involves the forced movement of people internally within countries, or externally across borders. Victims who are trafficked for sexual exploitation are subject to repeated, multiple trauma, and high rates of mental health problems including posttraumatic stress disorder (PTSD) have been found. Narrative exposure therapy (NET) is an evidence-based treatment for PTSD. Methods: In this retrospective audit, we record the results of NET to treat 10 women who had been trafficked for sexual exploitation who were diagnosed with PTSD. Results: All 10 women completed the therapy and experienced a reduction in PTSD severity scores at posttreatment, with improvements that were maintained or further improved at 3-month follow-up. General distress was also significantly reduced following treatment. Conclusion: Although limited by sample size and retrospective design, this audit demonstrates that NET is a feasible treatment for PTSD in this population and warrants further evaluation in a randomized controlled trial. Further adjunctive interventions may also be necessary to treat the additional psychological problems experienced by this population. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Robjant, Katy; Roberts, Jackie; Katona, Cornelius",2017.0,http://dx.doi.org/10.3389/fpsyt.2017.00063,0,0,
1118, Couple-Based Psychosexual Support Following Prostate Cancer Surgery: results of a Feasibility Pilot Randomized Control Trial," AIMS: To develop and test the feasibility and acceptability of relational psychosexual treatment for couples with prostate cancer, determine whether a relational‚Äêpsychosexual intervention is feasible and acceptable for couples affected by prostate cancer, and determine the parameters for a full‚Äêscale trial. METHODS: Forty‚Äêthree couples were recruited for this pilot randomized controlled trial and received a six‚Äêsession manual‚Äêbased psychosexual intervention or usual care. Outcomes were measured before, after, and 6 months after the intervention. Acceptability and feasibility were established from recruitment and retention rates and adherence to the manual. MAIN OUTCOME MEASURES: The primary outcome measurement was the sexual bother subdomain of the Expanded Prostate Cancer Index Composite. The Hospital Anxiety and Depression Scale and the 15‚Äêitem Systemic Clinical Outcome and Routine Evaluation (SCORE‚Äê15) were used to measure emotional and relational functioning, respectively. RESULTS: The intervention was feasible and acceptable. The trial achieved adequate recruitment (38%) and retention (74%) rates. The intervention had a clinically and statistically significant effect on sexual bother immediately after the intervention. Small decreases in anxiety and depression were observed for the intervention couples, although these were not statistically significant. Practitioners reported high levels of adherence to the manual. CONCLUSION: The clinically significant impact on sexual bother and positive feedback on the study's feasibility and acceptability indicate that the intervention should be tested in a multicenter trial. The SCORE‚Äê15 lacked specificity for this intervention, and future trials would benefit from a couple‚Äêfocused measurement. INTRODUCTION: Surgery for prostate cancer can result in distressing side effects such as sexual difficulties, which are associated with lower levels of dyadic functioning. The study developed and tested an intervention to address sexual, relational, and emotional aspects of the relationship after prostate cancer by incorporating elements of family systems theory and sex therapy."," Robertson, J;  McNamee, P;  Molloy, G;  Hubbard, G;  McNeill, A;  Bollina, P;  Kelly, D;  Forbat, L",2016.0, 10.1016/j.jsxm.2016.05.013,0,0,
1119,Acceptance and Commitment Therapy with older adults: Rationale and case study of an 89-year-old with depression and generalized anxiety disorder.,"Acceptance and Commitment Therapy (ACT) is gaining traction as an effective therapy for a wide range of presenting concerns. Limited research and discussion has been published focused on utilizing ACT with older adults. The ACT model is proposed to be a good fit for this population because many older adults may already be values orientated due to awareness that their lifetime is limited. A trans-diagnostic approach that normalizes experiences common to older age may be advantageous given older adults often present with heterogeneous issues and life experiences. A case study of an 89-year-old woman experiencing late-life clinical depression and generalized anxiety disorder is presented. A significant factor contributing to her distress was her struggle with the cognitive and physical changes associated with aging. Results suggest that a brief ACT course implemented by a relative novice ACT therapist was effective in reducing psychological inflexibility as well as reducing distress to non-clinical levels at 6 weeks post therapy. Potential implications for adapting ACT with older adults are discussed, as well as reflections on some of the potential challenges for clinicians who are ACT beginners. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Roberts, Sarah L; Sedley, Ben",2016.0,http://dx.doi.org/10.1177/1534650115589754,0,0,
1120,The effectiveness of pursed lips breathing in the management of breathlessness in stable chronic obstructive pulmonary disease,"Introduction: This dissertation aims to explore, in a clinical setting, the effectiveness of pursed lips breathing (PLB), in the management of dyspnoea in stable COPD. Methodology: A mixed methodology that comprised a randomised controlled trial (RCT), a predominantly qualitative follow-up (FU) study and two measurement studies was used. The RCT intervention group was taught PLB at home over 8 weeks. Primary outcome measures were the Self Report Chronic Respiratory Disease Questionnaire (CRQ-SR) dyspnoea and mastery domains and Endurance Shuttle Walk Test (ESWT). The FU study investigated the long-term experience of PLB in a subset of RCT participants through telephone interview, focus group and observation of PLB technique at home visit. Prior to the RCT a study using limits of agreement (LoA) methodology was conducted to investigate reliability of hand-held spirometric measurement of inspiratory capacity (IC) with a view to using it as an outcome measure. Following the RCT a retrospective analysis of data collected from the ESWT was performed comparing a 1-walk protocol with the published 2-walk protocol. Results: Forty-one patients with COPD were recruited to the RCT (PLB n = 22, control n =19); mean age 68 years (SD 11), mean FEV1% predicted 47% (SD 15.80) and 13 were approached to participate in the FU; 11 of 13 agreed to telephone interview, 5 to attend the focus group and 6 to home visit. The median time since learning PLB was 17 months (6 - 23). The RCT found no statistically significant difference between groups in the primary outcome measures and in retrospect was insufficiently powered. Post hoc analysis found effect sizes for primary outcome measures were: CRQ-SR dyspnoea 0.05, CRQ-SR mastery 0.48 and ESWT 0.44. For secondary outcome measures the PLB group showed a significant (p = 0.02) improvement in oxygen saturation on ESWT. Long-term follow-up found 9 of 11 still used PLB, 8 reported definite benefit. Those using PLB used it for breathlessness with four themes identified: use of PLB with physical activity (8/11), to increase confidence and reduce panic (4/11), as an exercise (3/11), at night (3/11). Discontinuation of PLB (2/11) was due to no benefit. Hand-held spirometric measurement of IC found LoA for same-day IC measurement in healthy volunteers (n = 20) ± 0.630L (95%CI ± 0.255) and over 3 weeks (n = 11) ± 0.560L (95%CI ± 0.326). In COPD, same day LoA (n = 26) were ± 0.582L (95%CI ± 0.169) and over 6 weeks (n = 8) ± 0.486L (95%CI ± 0.302). Retrospective analysis of ESWT data identified that completion rates improved by 17% for the 1-walk protocol but that the ceiling-effect was 12.2% compared to 7.3% for the 2-walk protocol. LoA between protocols when measuring change over time (n = 31) was ±80% (95%CI 25.56); less than the difference described as ""somewhat better"" (113%) following pulmonary rehabilitation (PR) but greater than the m.c.i.d. of 68%. Conclusions: LoA for IC exceeded the clinically significant reported 0.3L; the protocol tested here was not sufficiently reliable for use as an outcome measure. Analysis of ESWT data showed the 1-walk protocol was adequate for identify change in clinical practice but, for research purposes the 2-walk protocol should be retained. From the RCT learning PLB resulted in reduced physiological stress with respect to oxygen desaturation when performing ESWT compared to the control group. Long-term follow-up showed that, in severe COPD perceived benefits persisted in 62% of patients.",Roberts,2011.0,,0,0,
1121," Treating thermally injured children suffering symptoms of acute stress with imipramine and fluoxetine: a randomized, double-blind study"," METHOD: Patients 4‚Äê18 years of age with symptoms of ASD were randomized to 1 of 3 groups: imipramine, fluoxetine, or placebo for 1 week. Daily imipramine dose was 1mg/kg, with the maximum dose being 100mg. Daily fluoxetine dose was 5mg for children weighing >or=40 kg; 10mg for those weighing between 40 and 60 kg; 20mg for those weighing >60 kg. RESULTS: Sixty participants, 16 females and 44 males, had an average body surface area burn of 53% (S.D.=18) and average age of 11 years (S.D.=4). Imipramine subjects received an average daily dose of 1.00+/‚Äê0.29 mg/kg. Fluoxetine subjects received an average daily dose of 0.29+/‚Äê0.16 mg/kg. Between group differences were not detected. Fifty‚Äêfive percent responded positively to placebo; 60% responded positively to imipramine; and 72% responded positively to fluoxetine. CONCLUSION: Within the parameters of this study design and sample, placebo was statistically as effective as either drug in treating symptoms of ASD. INTRODUCTION: For pediatric burn patients with the symptoms of acute stress disorder (ASD) a first line medication is not widely agreed upon. A prospective, randomized, placebo controlled, double‚Äêblind design was used to test the efficacy of imipramine and fluoxetine."," Robert, R;  Tcheung, WJ;  Rosenberg, L;  Rosenberg, M;  Mitchell, C;  Villarreal, C;  Thomas, C;  Holzer, C;  Meyer, WJ",2008.0, 10.1016/j.burns.2008.04.009,0,0,
1122,Analysis of recruitment strategies: Enrolling veterans with PTSD into a clinical trial.,"This analysis evaluated the efficacy of a variety of recruitment methods employed in a medication trial in a veteran population. Recruitment and demographic data were collected over the course of a randomized controlled trial (RCT) assessing the efficacy of an experimental medication for posttraumatic stress disorder (PTSD). Multivariate logistic regression was used to identify demographic and recruitment variables predictive of consenting to participation in the trial. Data were collected for 1,050 potential study participants. As compared with individuals contacted by mail based on chart review, potential participants who were referred by a clinician were 3 times more likely to consent to participate, and individuals who responded to an advertisement were 5 times more likely to consent to participate. Females were more likely to respond to advertisements, whereas males were more likely to be referred. Those who were referred were significantly older than potential participants identified via the directed mailing. Clinician referral was the method most likely to lead to identifying an eligible and willing participant. When designing a recruitment plan for a clinical trial, factors such as the target sample and available staff should be carefully considered. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement What is the public significance of this article?-The validity of clinical research aimed at evaluating the efficacy of new and existing interventions hinges on the ability of investigators to successfully recruit a sufficient number of appropriate participants. Efficacy of recruitment strategies and demographic predictors of successful recruitment are presented in this manuscript. Investigators are urged to systematically track recruitment data and report these statistics as to contribute to our knowledge of recruitment and ability to do so effectively. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Roberge, Erika M; Benedek, David M; Marx, Christine E; Rasmusson, Ann M; Lang, Ariel J",2017.0,http://dx.doi.org/10.1037/mil0000178,0,0,
1123, Pilot Randomized Trial of Active Music Engagement Intervention Parent Delivery for Young Children With Cancer," Objectives: To examine the feasibility/acceptability of a parent‚Äêdelivered Active Music Engagement (AME‚Äâ+‚ÄâP) intervention for young children with cancer and their parents. Secondary aim to explore changes in AME‚Äâ+‚ÄâP child emotional distress (facial affect) and parent emotional distress (mood; traumatic stress symptoms) relative to controls. Methods: A pilot two‚Äêgroup randomized trial was conducted with parents/children (ages 3‚Äê8 years) receiving AME‚Äâ+‚ÄâP ( n ‚Äâ= ‚Äâ9) or attention control ( n ‚Äâ= ‚Äâ7). Feasibility of parent delivery was assessed using a delivery checklist and child engagement; acceptability through parent interviews; preliminary outcomes at baseline, postintervention, 30 days postintervention. Results: Parent delivery was feasible, as they successfully delivered AME activities, but interviews indicated parent delivery was not acceptable to parents. Emotional distress was lower for AME‚Äâ+‚ÄâP children, but parents derived no benefit. Conclusions: Despite child benefit, findings do not support parent delivery of AME‚Äâ+‚ÄâP."," Robb, SL;  Haase, JE;  Perkins, SM;  Haut, PR;  Henley, AK;  Knafl, KA;  Tong, Y",2017.0, 10.1093/jpepsy/jsw050,0,0,
1124, A RCT of telehealth for COPD patient's quality of life: the whole system demonstrator evaluation," METHODS: The Chronic Obstructive Pulmonary Disease (COPD) cohort of the Whole Systems Demonstrator Trial is a pragmatic General Practitioner (GP) clustered randomised controlled trial (RCT) evaluating TH in the UK from three regions in England. All patients at a participating GP practice were deemed eligible for inclusion in the study if they were diagnosed with COPD. RESULTS: 447 participants completed baseline and either a short (4 months) or long term (12 months) follow‚Äêup. There was a trend of improved QoL and mood in the TH group at longer‚Äêterm follow‚Äêup, but not short term follow‚Äêup. Emotional functioning (g‚Äâ= 0.280 95%CI, 0.051‚Äê0.510) and mastery reached (g‚Äâ= 2.979 95%CI, 0‚Äê0.46) significance at P‚Äâ<‚Äâ0.05 (all Hedges g <0.3). CONCLUSIONS: TH showed minimal benefit to QoL in COPD patients who were not preselected to be at increased risk of acute exacerbations. Benefits were more likely in disease specific measures at longer term follow‚Äêup. TH is a complex intervention and should be embedded in a service that is evidenced based. Outcome measures must be sensitive enough to detect changes in the target population for the specific intervention. INTRODUCTION/OBJECTIVES: Despite some concerns that the introduction of telehealth (TH) may lead to reductions in quality of life (QoL), lower mood and increased anxiety in response to using assistive technologies to reduce health care utilisation and manage long term conditions, this research focuses on the extent to which providing people with tools to monitor their condition can improve QoL."," Rixon, L;  Hirani, SP;  Cartwright, M;  Beynon, M;  Doll, H;  Steventon, A;  Henderson, C;  Newman, SP",2017.0, 10.1111/crj.12359,0,0,
1125, Evaluating the Effectiveness of ACT for Anxiety Disorders in a Self-Help Context: outcomes From a Randomized Wait-List Controlled Trial," Rigorous evaluations of cognitive behavioral self‚Äêhelp books for anxiety in pure self‚Äêhelp contexts are lacking. The present study evaluated the effectiveness of an Acceptance and Commitment Therapy (ACT) self‚Äêhelp workbook for anxiety‚Äêrelated concerns, with no therapist contact, in an international sample. Participants (N=503; 94% mental health diagnosis) were randomized to an immediate workbook (n=256) or wait‚Äêlist condition (n=247). Assessments at pretreatment, 12weeks, 6months, and 9months evaluated anxiety and related symptoms, quality of life, and ACT treatment processes (e.g., psychological flexibility). Participants in the wait‚Äêlist arm crossed over to the workbook following the 12‚Äêweek assessment. The workbook condition yielded significant improvements on all assessments from pre‚Äê to posttreatment relative to wait‚Äêlist, and these gains were maintained at follow‚Äêups. The pattern observed in the wait‚Äêlist condition was virtually identical to the active treatment arm after receiving the workbook, but not before. Attrition was notable, but supplemental analyses suggested dropout did not influence treatment effects for all but one measure. Overall, findings provide preliminary support for the effectiveness of this self‚Äêhelp workbook and suggest ACT‚Äêbased self‚Äêhelp bibliotherapy might be a promising low‚Äêcost intervention for people experiencing significant anxiety‚Äêrelated concerns."," Ritzert, TR;  Forsyth, JP;  Sheppard, SC;  Boswell, JF;  Berghoff, CR;  Eifert, GH",2016.0, 10.1016/j.beth.2016.03.001,0,0,
1126, Visual exposure and categorization performance positively influence 3- to 6-year-old children's willingness to taste unfamiliar vegetables," The present research focuses on the effectiveness of visual exposure to vegetables in reducing food neophobia and pickiness among young children. We tested the hypotheses that (1) simple visual exposure to vegetables leads to an increase in the consumption of this food category, (2) diverse visual exposure to vegetables (i.e., vegetables varying in color are shown to children) leads to a greater increase in the consumption of this food category than classical exposure paradigms (i.e. the same mode of presentation of a given food across exposure sessions) and (3) visual exposure to vegetables leads to an increase in the consumption of this food category through a mediating effect of an increase in ease of categorization. We recruited 70 children aged 3‚Äê6 years who performed a 4‚Äêweek study consisting of three phases: a 2‚Äêweek visual exposure phase where place mats with pictures of vegetables were set on tables in school cafeterias, and pre and post intervention phases where willingness to try vegetables as well as cognitive performances were assessed for each child. Results indicated that visual exposure led to an increased consumption of exposed and non‚Äêexposed vegetables after the intervention period. Nevertheless, the exposure intervention where vegetables varying in color were shown to children was no more effective. Finally, results showed that an ease of categorization led to a larger impact after the exposure manipulation. The findings suggest that vegetable pictures might help parents to deal with some of the difficulties associated with the introduction of novel vegetables and furthermore that focusing on conceptual development could be an efficient way to tackle food neophobia and pickiness."," Rioux, C;  Lafraire, J;  Picard, D",2018.0, 10.1016/j.appet.2017.08.016,0,0,
1127,Comparing the Efficacy of CBASP with Two Versions of CBT for Depression in a Routine Care Center: A Randomized Clinical Trial.,"The cognitive-behavioral analysis system of psychotherapy (CBASP) was developed for the treatment of chronic, early-onset depression. However, it is unclear whether this approach can be recommended for depression in general (episodic and chronic), and no direct comparisons between CBASP with different versions of cognitive-behavioral therapy (CBT) exist. A randomized controlled trial compared 3 treatment conditions (all lasting 16 sessions) with a waiting list group (WL): CBASP, CBT with a focus on physical exercise (CBT-E), and CBT with a focus on pleasurable, low-energy and mindful activities (CBT-M). We included 173 patients and involved 41 therapists. Assessments were at baseline, after session 8, and at the end of treatment. Our primary outcome Beck Depression Inventory-II indicated a general advantage of the CBT arms compared to CBASP [F(6, 154.5) = 4.2, p = 0.001], with significant contrasts in particular in favor of CBT-E. Effect sizes against WL were d = 0.91 (CBT-E), 0.87 (CBT-M), and 0.47 (CBASP). A triple interaction with an additional factor ""chronic versus episodic depression"" [F(6, 142.7) = 2.2, p = 0.048] indicated that the treatments resulted in different outcomes, with best results again for CBT-E in particular in episodic depression. Responder rates indicated significant improvements (56% in both CBT arms, 34% in the CBASP arm, 3.4% in WL; intention-to-treat samples). As compared to CBASP, response rates were significantly higher for CBT-E (OR = 2.48; 95% CI = 1.02-6.00) and CBT-M (OR = 2.46; 95% CI = 1.01-6.01). CBASP was more effective than WL, but less effective than the 2 CBT arms. This was mainly caused by an advantage of CBT interventions in episodic depression.",Rief W.; Bleichhardt G.; Dannehl K.; Euteneuer F.; Wambach K.,2018.0,10.1159/000487893,0,0,
1128, Preventing postnatal maternal mental health problems using a psychoeducational intervention: the cost-effectiveness of What Were We Thinking," OBJECTIVES: Postnatal maternal mental health problems, including depression and anxiety, entail a significant burden globally, and finding cost‚Äêeffective preventive solutions is a public policy priority. This paper presents a cost‚Äêeffectiveness analysis of the intervention, What Were We Thinking (WWWT), for the prevention of postnatal maternal mental health problems. DESIGN: The economic evaluation, including cost‚Äêeffectiveness and cost‚Äêutility analyses, was conducted alongside a cluster‚Äêrandomised trial. SETTING: 48 Maternal and Child Health Centres in Victoria, Australia. PARTICIPANTS: Participants were English‚Äêspeaking first‚Äêtime mothers attending participating Maternal and Child Health Centres. Full data were collected for 175 participants in the control arm and 184 in the intervention arm. INTERVENTION: WWWT is a psychoeducational intervention targeted at the partner relationship, management of infant behaviour and parental fatigue. OUTCOME MEASURES: The evaluation considered public sector plus participant out‚Äêof‚Äêpocket costs, while outcomes were expressed in the 30‚Äêday prevalence of depression, anxiety and adjustment disorders, and quality‚Äêadjusted life years (QALYs). Incremental costs and outcomes were estimated using regression analyses to account for relevant sociodemographic, prognostic and clinical characteristics. RESULTS: The intervention was estimated to cost $A118.16 per participant. The analysis showed no statistically significant difference between the intervention and control groups in costs or outcomes. The incremental cost‚Äêeffectiveness ratios were $A36‚ÄÖ451 per QALY gained and $A152 per percentage‚Äêpoint reduction in 30‚Äêday prevalence of depression, anxiety and adjustment disorders. The estimate lies under the unofficial cost‚Äêeffectiveness threshold of $A55‚ÄÖ000 per QALY; however, there was considerable uncertainty surrounding the results, with a 55% probability that WWWT would be considered cost‚Äêeffective at that threshold. CONCLUSIONS: The results suggest that, although WWWT shows promise as a preventive intervention for postnatal maternal mental health problems, further research is required to reduce the uncertainty over its cost‚Äêeffectiveness as there were no statistically significant differences in costs or outcomes. TRIAL REGISTRATION NUMBER: ACTRN12613000506796; results."," Ride, J;  Lorgelly, P;  Tran, T;  Wynter, K;  Rowe, H;  Fisher, J",2016.0, 10.1136/bmjopen-2016-012086,0,0,
1129,The effect of affordable daycare on women's mental health: Evidence from a cluster randomized trial in rural India,"Access to affordable daycare might improve population mental health. However, evidence is sparse and restricted to middle- and high-income country settings. We conducted a cluster-randomized controlled trial in one low-income setting, rural Rajasthan, India. Communities lacking daycare facilities were identified (n‚ÄØ=‚ÄØ160) and randomly selected for assistance in setting up a community-based daycare program (n‚ÄØ=‚ÄØ80) or not (n‚ÄØ=‚ÄØ80). Women eligible for the daycare program living in these communities completed structured interviews before the intervention (participation rate‚ÄØ=‚ÄØ89%) and approximately one year after rollout of the intervention (participation rate‚ÄØ=‚ÄØ96%), resulting in a final analytic sample of 3041. Mental distress was measured with the Hindi version of the 12-item General Health Questionnaire (score range: 0-12). We modeled the relation between access to daycare and number of mental distress symptoms (GHQ-12 score) with negative binomial regression using an intention-to-treat approach, which groups women according to if they lived in communities randomized to affordable daycare. We also evaluated the effect of access to daycare on secondary outcomes that may be related to mental distress, including women's work burden, agency, and intimate partner violence (IPV). We found that access to daycare resulted in modest reductions in symptoms of mental distress (mean difference‚ÄØ=‚ÄØ0.21, 95% CI: -0.43, 0.02). We found some evidence that daycare reduced IPV, but virtually no change in women's work burden or agency. Our results provide some indication that access to affordable daycare might be one policy lever to improve population mental health.",Richardson R.A.; Harper S.; Schmitz N.; Nandi A.,2018.0,10.1016/j.socscimed.2018.09.061,0,0,
1130,Cost and Outcome of BehaviouRal Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive-behavioural therapy for depression.,"Depression is a common, debilitating and costly disorder. The best-evidenced psychological therapy - cognitive-behavioural therapy (CBT) - is complex and costly. A simpler therapy, behavioural activation (BA), may be an effective alternative. To determine the clinical effectiveness and cost-effectiveness of BA compared with CBT for depressed adults at 12 and 18 months' follow-up, and to investigate the processes of treatments. Randomised controlled, non-inferiority trial stratified by depression severity, antidepressant use and recruitment site, with embedded process evaluation; and randomisation by remote computer-generated allocation. Three community mental health services in England. Adults aged ≥ 18 years with major depressive disorder (MDD) recruited from primary care and psychological therapy services. BA delivered by NHS junior mental health workers (MHWs); CBT by NHS psychological therapists. Primary: depression severity (as measured via the Patient Health Questionnaire-9; PHQ-9) at 12 months. Secondary: MDD status; number of depression-free days; anxiety (as measured via the Generalised Anxiety Disorder-7); health-related quality of life (as measured via the Short Form questionnaire-36 items) at 6, 12 and 18 months; and PHQ-9 at 6 and 18 months, all collected by assessors blinded to treatment allocation. Non-inferiority margin was 1.9 PHQ-9 points. We undertook intention-to-treat (ITT) and per protocol (PP) analyses. We explored cost-effectiveness by collecting direct treatment and other health- and social-care costs and calculating quality-adjusted life-years (QALYs) using the EuroQol-5 Dimensions, three-level version, at 18 months. We recruited 440 participants (BA, n = 221; CBT, n = 219); 175 (79%) BA and 189 (86%) CBT participants provided ITT data and 135 (61%) BA and 151 (69%) CBT participants provided PP data. At 12 months we found that BA was non-inferior to CBT {ITT: CBT 8.4 PHQ-9 points [standard deviation (SD) 7.5 PHQ-9 points], BA 8.4 PHQ-9 points (SD 7.0 PHQ-9 points), mean difference 0.1 PHQ-9 points, 95% confidence interval (CI) -1.3 to 1.5 PHQ-9 points, p = 0.89; PP: CBT 7.9 PHQ-9 points (SD 7.3 PHQ-9 points), BA 7.8 PHQ-9 points (SD 6.5 PHQ-9 points), mean difference 0.0 PHQ-9 points, 95% CI -1.5 to 1.6 PHQ-9 points, p = 0.99}. We found no differences in secondary outcomes. We found a significant difference in mean intervention costs (BA, £975; CBT, £1235; p < 0.001), but no differences in non-intervention (hospital, community health, social care and medication costs) or total (non-intervention plus intervention) costs. Costs were lower and QALY outcomes better in the BA group, generating an incremental cost-effectiveness ratio of -£6865. The probability of BA being cost-effective compared with CBT was almost 80% at the National Institute for Health and Care Excellence's preferred willingness-to-pay threshold of £20,000-30,000 per QALY. There were no trial-related adverse events. In this pragmatic trial many depressed participants in both groups were also taking antidepressant medication, although most had been doing so for a considerable time before entering the trial. Around one-third of participants chose not to complete a PP dose of treatment, a finding common in both psychotherapy trials and routine practice. We found that BA is as effective as CBT, more cost-effective and can be delivered by MHWs with no professional training in psychological therapies. Settings and countries with a paucity of professionally qualified psychological therapists, might choose to investigate the delivery of effective psychological therapy for depression without the need to develop an extensive and costly professional infrastructure. Current Controlled Trials ISRCTN27473954. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 46. See the NIHR Journals Library website for further project information.",Richards DA.; Rhodes S.; Ekers D.; McMillan D.; Taylor RS.; Byford S.; Barrett B.; Finning K.; Ganguli P.; Warren F.; Farrand P.; Gilbody S.; Kuyken W.; O'Mahen H.; Watkins E.; Wright K.; Reed N.; Fletcher E.; Hollon SD.; Moore L.; Backhouse A.; Farrow C.; Garry J.; Kemp D.; Plummer F.; Warner F.; Woodhouse R.,2017.0,10.3310/hta21460,0,0,
1131,Psychological Outcomes following a nurse-led Preventative Psychological Intervention for critically ill patients (POPPI): protocol for a cluster-randomised clinical trial of a complex intervention.,"Acute psychological stress, as well as unusual experiences including hallucinations and delusions, are common in critical care unit patients and have been linked to post-critical care psychological morbidity such as post-traumatic stress disorder (PTSD), depression and anxiety. Little high-quality research has been conducted to evaluate psychological interventions that could alleviate longer-term psychological morbidity in the critical care unit setting. Our research team developed and piloted a nurse-led psychological intervention, aimed at reducing patient-reported PTSD symptom severity and other adverse psychological outcomes at 6‚Äâmonths, for evaluation in the POPPI trial. This is a multicentre, parallel group, cluster-randomised clinical trial with a staggered roll-out of the intervention. The trial is being carried out at 24 (12 intervention, 12 control) NHS adult, general, critical care units in the UK and is evaluating the clinical effectiveness and cost-effectiveness of a nurse-led preventative psychological intervention in reducing patient-reported PTSD symptom severity and other psychological morbidity at 6‚Äâmonths. All sites deliver usual care for 5‚Äâmonths (baseline period). Intervention group sites are then trained to carry out the POPPI intervention, and transition to delivering the intervention for the rest of the recruitment period. Control group sites deliver usual care for the duration of the recruitment period. The trial also includes a process evaluation conducted independently of the trial team. This protocol was reviewed and approved by the National Research Ethics Service South Central - Oxford B Research Ethics Committee (reference: 15/SC/0287). The first patient was recruited in September 2015 and results will be disseminated in 2018. The results will be presented at national and international conferences and published in peer reviewed medical journals. ISRCTN53448131; Pre-results.",Richards-Belle A.; Mouncey PR.; Wade D.; Brewin CR.; Emerson LM.; Grieve R.; Harrison DA.; Harvey S.; Howell D.; Mythen M.; Sadique Z.; Smyth D.; Weinman J.; Welch J.; Rowan KM.;  .,2018.0,10.1136/bmjopen-2017-020908,0,0,
1132, Repetitive Transcranial Magnetic Stimulation/Behavioral Intervention Clinical Trial: long-Term Follow-Up of Outcomes in Congenital Hemiparesis," OBJECTIVE: The purpose of this study was to examine long‚Äêterm outcomes of nonpharmacological intervention in children and adolescents with stroke utilizing repetitive transcranial magnetic stimulation (rTMS) to the primary motor cortex combined with constraint‚Äê induced movement therapy (CIMT) to improve motor function in the paretic hand. Outcome measures included function, satisfaction, and medical status review. METHODS: Fourteen of the original 19 participants (74%) from our rTMS/CIMT clinical trial (real rTMS+CIMT, n‚Äâ=‚Äâ8; and sham rTMS+CIMT, n‚Äâ=‚Äâ6) were evaluated. The median age of the subjects at follow up was 13.4 years (range 11‚Äê20 years old, 50% male). Median time to follow‚Äêup was 47.5 months (range 21‚Äê57 months). Descriptive statistics were conducted using frequencies and counts. Motor performance was measured using the Assisting Hand Assessment (AHA) and Canadian Occupational Performance Measure (COPM). Satisfaction was reported with use of the COPM and TMS Tolerance Survey. Open‚Äêended interview was conducted for feedback on study experience and subjective perspectives of current functional status. RESULTS: Overall, seven of eight individuals who received real rTMS and five of six individuals who received sham rTMS maintained or improved AHA scores. Six of 14 participants reported new onset of co‚Äêoccurring conditions (four individuals in the real rTMS group, two individuals in the sham rTMS group). The majority (86%) of participants reported study satisfaction. Review of medical status revealed co‚Äêoccurring conditions including: Epilepsy, obsessive‚Äêcompulsive disorder, anxiety, depression, unspecified mood disorder, and undiagnosed inattentiveness. CONCLUSIONS: Long‚Äêterm outcomes of rTMS/CIMT in pediatric stroke were investigated. Variability in performance and unattributed symptoms were noted. Considering the prevalence of co‚Äêoccurring conditions in children and adolescents with stroke, new‚Äêonset symptoms were not attributed to original intervention. With the small sample size, the impact of rTMS on long‚Äêterm outcomes cannot be fully determined from these data. Characterizing long‚Äêterm outcomes through performance, participant perspectives, and medical status allows comprehensive assessment of rTMS/CIMT intervention efficacy."," Rich, TL;  Menk, J;  Krach, LE;  Feyma, T;  Gillick, BT",2016.0, 10.1089/cap.2015.0157,0,0,
1133,"A randomized, placebo-controlled study of high-dose baclofen in alcohol-dependent patients-The ALPADIR study.","Aims: Alcohol dependence is a major public health issue with a need for new pharmacological treatments. The ALPADIR study assessed the efficacy and safety of baclofen at the target dose of 180 mg/day for the maintenance of abstinence and the reduction in alcohol consumption in alcohol-dependent patients. Methods: Three hundred and twenty adult patients (158 baclofen and 162 placebo) were randomized after alcohol detoxification. After a 7-week titration, the maintenance dose was provided for 17 weeks, then progressively decreased over 2 weeks before stopping. Results: The percentage of abstinent patients during 20 consecutive weeks (primary endpoint) was low (baclofen: 11.9%; placebo: 10.5%) and not significantly different between groups (OR 1.20; 95%CI: 0.58 to 2.50; P = 0.618). A reduction in alcohol consumption was observed from month 1 in both groups, but the difference of 10.9 g/day at month 6 between groups, in favour of baclofen, was not statistically significant (P = 0.095). In a subgroup of patients with high drinking risk level at baseline, the reduction was greater with a difference at month 6 of 15.6 g/day between groups in favour of baclofen (P = 0.089). The craving assessed with Obsessive-Compulsive Drinking Scale significantly decreased in the baclofen group (P = 0.017). No major safety concern was observed. Conclusions: This study did not demonstrate the superiority of baclofen in the maintenance of abstinence at the target dose of 180 mg/day. A tendency towards a reduction in alcohol consumption and a significantly decreased craving were observed in favour of baclofen. Short summary: Baclofen was assessed versus placebo for maintenance of abstinence and reduction in alcohol consumption in alcohol-dependent patients. This study did not demonstrate the superiority of baclofen in the maintenance of abstinence. A tendency towards a reduction in alcohol consumption and a significantly decreased craving were observed in favour of baclofen. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Reynaud, Michel; Aubin, Henri-Jean; Trinquet, Francoise; Zakine, Benjamin; Dano, Corinne; Dematteis, Maurice; Trojak, Benoit; Paille, Francois; Detilleux, Michel",2017.0,http://dx.doi.org/10.1093/alcalc/agx030,0,0,
1134,Clinical improvement in patients with borderline personality disorder after treatment with repetitive transcranial magnetic stimulation: preliminary results.,"Current treatment of borderline personality disorder (BPD) consists of psychotherapy and pharmacological interventions. However, the use of repetitive transcranial magnetic stimulation (rTMS) could be beneficial to improve some BPD symptoms. The objective of this study was to evaluate clinical improvement in patients with BPD after application of rTMS over the right or left dorsolateral prefrontal cortex (DLPFC). Twenty-nine patients with BPD from the National Institute of Psychiatry, Mexico, were randomized in two groups to receive 15 sessions of rTMS applied over the right (1 Hz, n=15) or left (5 Hz, n=14) DLPFC. Improvement was measured by the Clinical Global Impression Scale for BPD (CGI-BPD), Borderline Evaluation of Severity Over Time (BEST), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), and Barratt Impulsiveness Scale (BIS). Intragroup comparison showed significant (p < 0.05) reductions in every psychopathologic domain of the CGI-BPD and in the total scores of all scales in both groups. Both protocols produced global improvement in severity and symptoms of BPD, particularly in impulsiveness, affective instability, and anger. Further studies are warranted to explore the therapeutic effect of rTMS in BPD. NCT02273674",Reyes-López J.; Ricardo-Garcell J.; Armas-Castañeda G.; García-Anaya M.; Arango-De Montis I.; González-Olvera JJ.; Pellicer F.,,10.1590/1516-4446-2016-2112,0,0,
1135, Self-management education for rehabilitation inpatients suffering from inflammatory bowel disease: a cluster-randomized controlled trial," Although inflammatory bowel disease (IBD) affects patients' psychological well‚Äêbeing, previous educational programs have failed to demonstrate effects on psychosocial outcomes and quality of life. Therefore, we developed a group‚Äêbased psychoeducational program that combined provision of both medical information and psychological self‚Äêmanagement skills, delivered in an interactive manner, and evaluated it in a large, cluster‚Äêrandomized trial. We assigned 540 rehabilitation inpatients suffering from IBD (mean age 43 years, 66% female) to either the new intervention or a control group comprising the same overall intensity and the same medical information, but only general psychosocial information. The primary outcome was patient‚Äêreported IBD‚Äêrelated concerns. Secondary outcomes included disease knowledge, coping, self‚Äêmanagement skills, fear of progression, anxiety, depression and quality of life. Assessments took place at baseline, end of rehabilitation and after 3 and 12 months.The psychoeducational self‚Äêmanagement program did not prove superior to the control group regarding primary and secondary outcomes. However, positive changes over time occurred in both groups regarding most outcomes. The superior effectiveness of the newly developed psychoeducational program could not be demonstrated. Since the intervention and control groups may have been too similar, this trial may have been too conservative to produce between‚Äêgroup effects."," Reusch, A;  Weiland, R;  Gerlich, C;  Dreger, K;  Derra, C;  Mainos, D;  Tuschhoff, T;  Berding, A;  Witte, C;  Kaltz, B;  et al.",2016.0, 10.1093/her/cyw042,0,0,
1136,Which Homeless Veterans Benefit From a Peer Mentor and How?,"Veterans Affairs (VA) is expanding peer support. Research is limited on Veterans' perspective on benefits from peer services. We describe homeless Veteran perceptions of value and examine characteristics associated with benefit. From a sample of Veterans in a multisite randomized control trial, we studied addition of peers in VA Primary Care and homeless-oriented primary care clinics. We used qualitative methods to study the perceptions of peer services among a subsample of homeless Veterans. Quantitative methods were used to validate findings in both samples. Sixty-five percent of the subsample and 83% of the full sample benefited from a peer mentor. Participants who benefited had more peer visits and minutes of intervention (p<.05), were more likely to be minority, and were less likely to have posttraumatic stress disorder. The majority of Veteran participants in this study benefited from receiving peer mentor intervention. African American Veterans were more likely to benefit and Veterans with PTSD were less likely to benefit. Client endorsement of the peer's role influenced outcomes.",Resnik L.; Ekerholm S.; Johnson EE.; Ellison ML.; O'Toole TP.,2017.0,10.1002/jclp.22407,0,0,
1137,Early attrition from treatment among women with cooccurring substance use disorders and PTSD.,"Participant retention is one of the more challenging issues in the treatment of substance use disorders. Using data from the National Institute on Drug Abuse Clinical Trials Network's Women and Trauma Study (recruitment in 2004-2005), we examine prominent factors associated with early attrition among women with cooccurring substance use disorders and posttraumatic stress disorder (N = 340). Early treatment attrition is associated with a history of youth partner violence, perceived need for psychological treatment, and abuse of alcohol, opioids, and stimulants. Logistical barriers (e.g., transportation, having children) were not significantly associated with early attrition. Findings provide insight into characteristics of women who might need additional supports to engage in treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Resko, Stella M; Mendoza, Natasha S",2012.0,http://dx.doi.org/10.1080/1533256X.2012.728104,0,0,
1138, Focus-of-attention behavioral experiment: an examination of a therapeutic procedure to reduce social anxiety," A clinical protocol based on contemporary cognitive behavioral treatment for social anxiety was developed and examined. Previously published instructions for conducting a focus‚Äêof‚Äêattention behavioral experiment targeting self‚Äêfocused attention and safety behaviors during exposure were used to create a structured protocol. Individuals (n = 45) with high levels of social anxiety and public‚Äêspeaking anxiety were randomly assigned to either a focus‚Äêof‚Äêattention behavioral experiment (FABE) or an Exposure‚ÄêOnly Control (EOC) condition. During four exposure trials, those in the FABE condition (n = 24) were alternately instructed to engage in self‚Äêfocused attention vs. externally focused attention and to eliminate safety behaviors. Those in the EOC condition (n = 21) were not so instructed. At post‚Äêintervention, individuals in the FABE condition showed significantly less self‚Äêfocused attention and anxiety, and better observed performance as rated by audience members. Focus‚Äêof‚Äêattention statistically mediated the effect of condition on anxiety. For those in the FABE condition, the degree of association between focus‚Äêof‚Äêattention and anxiety during the intervention predicted less self‚Äêfocused attention post‚Äêintervention. The FABE appears to be a useful procedure for implementing part of the contemporary cognitive behavioral treatment model."," Renner, KA;  Valentiner, DP;  Holzman, JB",2017.0, 10.1080/16506073.2016.1225814,0,0,
1139,A Pilot Study of Emotion Regulation Therapy for Generalized Anxiety and Depression: Findings From a Diverse Sample of Young Adults.,"Emotion regulation therapy (ERT) for generalized anxiety disorder (GAD) and accompanying major depressive disorder (MDD) is a theoretically derived, evidence-based treatment that integrates principles from traditional and contemporary cognitive-behavioral and experiential approaches with basic and translational findings from affect science to offer a blueprint for improving intervention by focusing on the motivational responses and corresponding self-referential regulatory characteristics. Preliminary evidence supports the efficacy of a 20-session version of ERT. However, previous trials of ERT and other traditional and contemporary cognitive-behavioral therapies have often utilized relatively homogeneous samples. Various contextual and demographic factors may be associated with challenges that increase risk for negative mental and social outcomes for young adults ages 18-29, particularly for individuals from diverse backgrounds. The aim of this pilot study was to examine the effectiveness of a briefer 16-session version of ERT in a racially and ethnically diverse sample of young adults. Participants (N = 31) were enrolled at an urban-based, commuter college who consented to treatment for anxiety, worry, or depression at an on-campus counseling center. Open-trial results demonstrate strong ameliorative changes in worry, rumination, self-reported and clinician-rated GAD and MDD severity, social disability, quality of life, attentional flexibility, decentering/distancing, reappraisal, trait mindfulness, and negative emotionality from pre- to posttreatment. These gains were maintained throughout a 3- and 9-month follow-up. These findings provide preliminary evidence for the efficacy of ERT in treating a racially and ethnically heterogeneous population. Further, this study highlights comparable effectiveness of a briefer 16-session version of ERT.",Renna ME.; Quintero JM.; Soffer A.; Pino M.; Ader L.; Fresco DM.; Mennin DS.,2018.0,10.1016/j.beth.2017.09.001,0,0,
1140, Behavioral and Neural Signatures of Reduced Updating of Alternative Options in Alcohol-Dependent Patients during Flexible Decision-Making," Addicted individuals continue substance use despite the knowledge of harmful consequences and often report having no choice but to consume. Computational psychiatry accounts have linked this clinical observation to difficulties in making flexible and goal‚Äêdirected decisions in dynamic environments via consideration of potential alternative choices. To probe this in alcohol‚Äêdependent patients (n = 43) versus healthy volunteers (n = 35), human participants performed an anticorrelated decision‚Äêmaking task during functional neuroimaging. Via computational modeling, we investigated behavioral and neural signatures of inference regarding the alternative option. While healthy control subjects exploited the anticorrelated structure of the task to guide decision‚Äêmaking, alcohol‚Äêdependent patients were relatively better explained by a model‚Äêfree strategy due to reduced inference on the alternative option after punishment. Whereas model‚Äêfree prediction error signals were preserved, alcohol‚Äêdependent patients exhibited blunted medial prefrontal signatures of inference on the alternative option. This reduction was associated with patients' behavioral deficit in updating the alternative choice option and their obsessive‚Äêcompulsive drinking habits. All results remained significant when adjusting for potential confounders (e.g., neuropsychological measures and gray matter density). A disturbed integration of alternative choice options implemented by the medial prefrontal cortex appears to be one important explanation for the puzzling question of why addicted individuals continue drug consumption despite negative consequences. SIGNIFICANCE STATEMENT: In addiction, patients maintain substance use despite devastating consequences and often report having no choice but to consume. These clinical observations have been theoretically linked to disturbed mechanisms of inference, for example, to difficulties when learning statistical regularities of the environmental structure to guide decisions. Using computational modeling, we demonstrate disturbed inference on alternative choice options in alcohol addiction. Patients neglecting ""what might have happened"" was accompanied by blunted coding of inference regarding alternative choice options in the medial prefrontal cortex. An impaired integration of alternative choice options implemented by the medial prefrontal cortex might contribute to ongoing drug consumption in the face of evident negative consequences."," Reiter, AM;  Deserno, L;  Kallert, T;  Heinze, HJ;  Heinz, A;  Schlagenhauf, F",2016.0, 10.1523/JNEUROSCI.4322-15.2016,0,0,
1141,Transdiagnostic group CBT for anxiety disorders: the unified protocol in mental health services.,"Comorbidity among the anxiety disorders is common and may negatively impact treatment outcome. Potentially, transdiagnostic cognitive-behavioral treatments (CBT) deal more effectively with comorbidity than standard CBT. The present study tested the effectiveness of The Unified Protocol (UP) applied to Mental Health Services. Pre-post-treatment effects were examined for psychiatric outpatients with anxiety disorders receiving UP treatment in groups. Forty-seven patients (mean-age = 34.1 (SD = 9.92), 77% females) with a principal diagnosis of anxiety were included. We found significant and clinically meaningful changes in the primary outcomes Clinical Global Impression Severity Scale (CGI-S; d = 1.36), Hamilton Anxiety Scale (HARS; d = .71), and WHO-5 Well-being Index (WHO-5; d = .54). Also, comorbid depressive symptoms and levels of positive and negative affect changed significantly after treatment. Patients with high levels of comorbidity profited as much as patients with less comorbidity; however, these patients had higher scores after treatment due to higher symptom burden at onset. Patients with comorbid depression profited more from treatment than patients without comorbid depression. The treatment effects found in the present study correspond to treatment effects of other TCBT studies, other UP group studies, and effectiveness studies on standard CBT for outpatients. The results indicate that the UP can be successfully applied to a MHS group setting, demonstrating positive effects on anxiety and depressive symptoms for even highly comorbid cases.",Reinholt N.; Aharoni R.; Winding C.; Rosenberg N.; Rosenbaum B.; Arnfred S.,2017.0,10.1080/16506073.2016.1227360,0,0,
1142,Kripalu Yoga for Military Veterans With PTSD: A Randomized Trial.,"This randomized controlled trial of yoga for military veterans and active duty personnel with posttraumatic stress disorder (PTSD) evaluated the efficacy of a 10-week yoga intervention on PTSD. Fifty-one participants were randomized into yoga or no-treatment assessment-only control groups. Primary outcome measures included questionnaires and the Clinician Administered PTSD Scale. Both yoga (n = 9) and control (n = 6) participants showed significant decreases in reexperiencing symptoms, with no significant between-group differences. Secondary within-group analyses of a self-selected wait-list yoga group (n = 7) showed significant reductions in PTSD symptoms after yoga participation, in contrast to their control group participation. Consistent with current literature regarding high rates of PTSD treatment dropout for veterans, this study faced challenges retaining participants across conditions. These results are consistent with recent literature indicating that yoga may have potential as a PTSD therapy in a veteran or military population. However, additional larger sample size trials are necessary to confirm this conclusion.",Reinhardt KM.; Noggle Taylor JJ.; Johnston J.; Zameer A.; Cheema S.; Khalsa SBS.,2018.0,10.1002/jclp.22483,0,0,
1143,Integrating a portable biofeedback device into clinical practice for patients with anxiety disorders: Results of a pilot study.,"This study examined the effectiveness of a portable Respiratory Sinus Arrhythmia (RSA) biofeedback device as an adjunct to CBT in persons with anxiety disorders and other disorders associated with autonomic dysfunction attending outpatient treatment. Participants were 24 individuals attending outpatient cognitive behavioral treatment for a range of anxiety disorders. Participants were assessed over a 3 week period. Outcomes included measures of anxiety (STAI-Y), sleep disturbances (PSQI), anger (STAEI), and subjective questions about the effectiveness of the device as a treatment adjunct. Significant reductions were found for anxiety and anger and for certain sleep variables (e.g. sleep latency). There was a significant dos-effect in that those who were more compliant had significantly greater reductions in most domains including sleep, anger and trait anxiety. Overall, participants found the device more helpful than other relaxation techniques such as mediation, yoga and unassisted breathing techniques but less helpful than exercise. The most frequently endorsed side effects were dizziness (15%) and sleepiness (55%). These preliminary results suggest that portable RSA biofeedback appears to be a promising treatment adjunct for disorders of autonomic arousal and is easily integrated into treatment. Results support the need for further investigation with more rigorous experimental designs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Reiner, Robert",2008.0,http://dx.doi.org/10.1007/s10484-007-9046-6,0,0,
1144," Effects of Pulsed Electromagnetic Fields on Return to Sports After Arthroscopic Debridement and Microfracture of Osteochondral Talar Defects: a Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial"," BACKGROUND: Osteochondral defects (OCDs) of the talus usually affect athletic patients. The primary surgical treatment consists of arthroscopic debridement and microfracture. Various possibilities have been suggested to improve the recovery process after debridement and microfracture. A potential solution to obtain this goal is the application of pulsed electromagnetic fields (PEMFs), which stimulate the repair process of bone and cartilage. HYPOTHESIS: The use of PEMFs after arthroscopic debridement and microfracture of an OCD of the talus leads to earlier resumption of sports and an increased number of patients that resume sports. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: A total of 68 patients were randomized to receive either PEMFs (n = 36) or placebo (n = 32) after arthroscopic treatment of an OCD of the talus. The primary outcomes (ie, the number of patients who resumed sports and time to resumption of sports) were analyzed with Kaplan‚ÄêMeier curves as well as Mann‚ÄêWhitney U, chi‚Äêsquare, and log‚Äêrank tests. Secondary functional outcomes were assessed with questionnaires (American Orthopaedic Foot and Ankle Society ankle‚Äêhindfoot score, Foot and Ankle Outcome Score, EuroQol, and numeric rating scales for pain and satisfaction) at multiple time points up to 1‚Äêyear follow‚Äêup. To assess bone repair, computed tomography scans were obtained at 2 weeks and 1 year postoperatively. RESULTS: Almost all outcome measures improved significantly in both groups. The percentage of sport resumption (PEMF, 79%; placebo, 80%; P = .95) and median time to sport resumption (PEMF, 17 weeks; placebo, 16 weeks; P = .69) did not differ significantly between the treatment groups. Likewise, there were no significant between‚Äêgroup differences with regard to the secondary functional outcomes and the computed tomography results. CONCLUSION: PEMF does not lead to a higher percentage of patients who resume sports or to earlier resumption of sports after arthroscopic debridement and microfracture of talar OCDs. Furthermore, no differences were found in bone repair between groups. REGISTRATION: Netherlands Trial Register NTR1636."," Reilingh, ML;  van Bergen, CJ;  Gerards, RM;  van Eekeren, IC;  de Haan, RJ;  Sierevelt, IN;  Kerkhoffs, GM;  Krips, R;  Meuffels, DE;  van Dijk, CN;  et al.",2016.0, 10.1177/0363546515626544,0,0,
1145,Rapid prefrontal cortex activation towards aversively paired faces and enhanced contingency detection are observed in highly trait-anxious women under challenging conditions,"Relative to healthy controls, anxiety-disorder patients show anomalies in classical conditioning that may either result from, or provide a risk factor for, clinically relevant anxiety. Here, we investigated whether healthy participants with enhanced anxiety vulnerability show abnormalities in a challenging affective-conditioning paradigm, in which many stimulus-reinforcer associations had to be acquired with only few learning trials. Forty-seven high and low trait-anxious females underwent MultiCS conditioning, in which 52 different neutral faces (CS+) were paired with an aversive noise (US), while further 52 faces (CS−) remained unpaired. Emotional learning was assessed by evaluative (rating), behavioral (dot-probe, contingency report), and neurophysiological (magnetoencephalography) measures before, during, and after learning. High and low trait-anxious groups did not differ in evaluative ratings or response priming before or after conditioning. High trait-anxious women, however, were better than low trait-anxious women at reporting CS+/US contingencies after conditioning, and showed an enhanced prefrontal cortex (PFC) activation towards CS+ in the M1 (i.e., 80–117 ms) and M170 time intervals (i.e., 140–160 ms) during acquisition. These effects in MultiCS conditioning observed in individuals with elevated trait anxiety are consistent with theories of enhanced conditionability in anxiety vulnerability. Furthermore, they point towards increased threat monitoring and detection in highly trait-anxious females, possibly mediated by alterations in visual working memory.",Rehbein M.A.; Wessing I.; Zwitserlood P.; Steinberg C.; Eden A.S.; Dobel C.; Junghöfer M.,2015.0,10.3389/fnbeh.2015.00155,0,0,
1146,Outcomes following mindfulness-based cognitive therapy in a heterogeneous sample of adult outpatients.,"Research on mindfulness-based cognitive therapy (MBCT; Segal, Williams, & Teasdale, 2002a) has supported the effectiveness of this approach for use with preventing relapse in recurrent depression. This study evaluated the use of MBCT in a heterogeneous sample of 26 psychiatric outpatients with mood and/or anxiety disorders. Results from both completer and intent to treat analyses showed that MBCT was associated with statistically significant improvements in depression, anxiety, stress, and insomnia symptoms. Rates of clinically significant improvement were comparable with effectiveness studies of cognitive behaviour therapy and mindfulness-based stress reduction in heterogeneous samples. It is concluded that MBCT may be of value for a range of psychological presentations, administered in heterogeneous groups. Future, controlled, research is required to further evaluate this conclusion and to investigate mechanisms of change. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ree, Melissa J; Craigie, Mark A",2007.0,http://dx.doi.org/10.1375/bech.24.2.70,0,0,
1147,Effectiveness of eLearning and blended modes of delivery of Mental Health First Aid training in the workplace: Randomised controlled trial.,"Background: The aim of the WorkplaceAid study was to compare the effects of eLearning or blended (eLearning plus face-to-face course delivery) Mental Health First Aid (MHFA) courses on public servants' knowledge, stigmatising attitudes, confidence in providing support and intentions to provide support to a person with depression or post-traumatic stress disorder (PTSD). Methods: A randomized controlled trial was carried out with 608 Australian public servants. Participants were randomly assigned to complete an eLearning MHFA course, a blended MHFA course or Red Cross eLearning Provide First Aid (PFA) (the control). The effects of the interventions were evaluated using online questionnaires pre- and post-training. The questionnaires centred around vignettes describing a person meeting the criteria for depression or PTSD. Primary outcomes were mental health first aid knowledge and desire for social distance. Secondary outcomes were recognition of mental health problems, beliefs about treatment, helping intentions and confidence and personal stigma. Feedback on the usefulness of the courses was also collected. Results: Both the eLearning MHFA and blended MHFA courses had positive effects compared to PFA eLearning on mental health first aid knowledge, desire for social distance, beliefs about professional treatments, intentions and confidence in helping a person and personal stigma towards a person with depression or PTSD. There were very small non-significant differences between the eLearning MHFA and blended MHFA courses on these outcome measures. However, users were more likely to highly rate the blended MHFA course in terms of usefulness, amount learned and intentions to recommend the course to others. Conclusions: The blended MHFA course was only minimally more effective than eLearning MHFA in improving knowledge and attitudes. However, course satisfaction ratings were higher from participants in the blended MHFA course, potentially leading to greater benefits in the future. Longer-term follow-up is needed to explore this. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Reavley, Nicola J; Morgan, Amy J; Fischer, Julie-Anne; Kitchener, Betty; Bovopoulos, Nataly; Jorm, Anthony F",2018.0,,0,0,
1148, West Indies Glaucoma Laser Study (WIGLS): 1. 12-Month Efficacy of Selective Laser Trabeculoplasty in Afro-Caribbeans With Glaucoma," DESIGN: Stepped‐wedge trial. METHODS: Subjects in St. Lucia and Dominica with established POAG were randomized to prompt washout of IOP‐lowering medications followed by SLT, 3‐month delay followed by washout and SLT, or 6‐month delay followed by washout and SLT. Baseline IOP was obtained on 2 different days after washout. Bilateral 360‐degree SLT was performed in 1 session. Posttreatment assessments took place 1 hour, 1 week, and 3, 6, 9, and 12 months post‐SLT. The main outcome measure was SLT success (defined as IOP ≤ target IOP in both eyes) at 12 months. Target IOP was a 20% or greater reduction in IOP from postwashout baseline. RESULTS: Overall, 72 patients underwent SLT treatment. Mean IOP at enrollment was 15.4 ± 3.6 mm Hg in right eyes and 15.4 ± 3.6 mm Hg in left eyes, which rose to 21.0 ± 3.3 mm Hg and 20.9 ± 3.0 mm Hg, respectively, after washout. Mean IOP at 3, 6, 9, and 12 months ranged from 12.5 mm Hg to 14.5 mm Hg (29.7% to 39.5%; P < .0001 in each eye at each time point). The 12‐month success rate was 78%. Transient photophobia and discomfort were common. CONCLUSIONS: SLT monotherapy safely provides significant IOP reduction in Afro‐Caribbean eyes with POAG. This treatment can play a significant role in preventing glaucoma vision loss and blindness in people of African descent living in resource‐limited regions. PURPOSE: To characterize the 12‐month intraocular pressure (IOP)‐lowering efficacy of selective laser trabeculoplasty (SLT) as sole therapy for primary open‐angle glaucoma (POAG) in an Afro‐Caribbean population."," Realini, T;  Shillingford-Ricketts, H;  Burt, D;  Balasubramani, GK",2017.0, 10.1016/j.ajo.2017.09.022,0,0,
1149, Take A Breath: study protocol for a randomized controlled trial of an online group intervention to reduce traumatic stress in parents of children with a life threatening illness or injury," BACKGROUND: A substantial proportion of parents whose child is diagnosed with a life‚Äêthreatening illness, experience high levels of distress that can lead to long‚Äêterm difficulties in mental health, family functioning and child adjustment. This study evaluates the efficacy of an Acceptance Commitment Therapy‚Äêbased group intervention designed to reduce distress symptoms in these parents. The program is delivered using videoconferencing to overcome factors that prevent participation in traditional face‚Äêto‚Äêface therapy. METHOD/DESIGN: The study is a randomized control trial of the Take A Breath group intervention for parents demonstrating elevated symptoms of acute stress, delivered via videoconferencing in six 90 min group sessions. Participants are the primary caregivers of children aged 0 to 18 years admitted for a life threatening illness or injury to the Oncology, Cardiology, Neurology or Intensive Care Departments of a tertiary pediatric hospital. Parents will be randomized to intervention or waitlist control 4‚Äê10 months after their child's diagnosis. Measures will be collected prior to and immediately post intervention for intervention and waitlist parents to assess program efficacy. Intervention parents will be followed up at 6 months to assess the maintenance of program effects. We predict that intervention parents will show fewer symptoms post intervention than waitlist parents (primary outcomes: traumatic stress, depression, anxiety, stress symptoms), reflecting improvements in the psychological skills addressed in the intervention (mediating factors). It is anticipated that reductions in mental health difficulties for intervention parents will be maintained up to 6 months post‚Äêintervention and will be associated with broader improvements in parents' adjustment, child adjustment and child wellbeing (secondary outcomes). DISCUSSION: This study is unique in evaluating a group intervention delivered to parents of children affected by of a diverse range life‚Äêthreatening illness or injury. Online communication technology is employed to reduce participation barriers. If proven efficacious, this trans‚Äêdiagnostic approach offers the potential for broad use as part of the suite of psychosocial services provided to families through tertiary pediatric settings. TRIAL REGISTRATION: ACTRN12611000090910 . Trial Registration Date: 14/09/2011 Protocol Date/version: September 2015, version M Study Status: Ongoing."," Rayner, M;  Muscara, F;  Dimovski, A;  McCarthy, MC;  Yamada, J;  Anderson, VA;  Burke, K;  Walser, R;  Nicholson, JM",2016.0, 10.1186/s12888-016-0861-2,0,0,
1150,Deep brain stimulation for treatment-resistant major depressive disorder: a comparison of two targets and long-term follow-up.,"We previously found that electrical stimulation in the anterior limb of the internal capsule/bed nucleus of the stria terminalis (IC/BST) alleviates depressive symptoms in severe treatment-resistant obsessive-compulsive disorder (OCD) patients. Here we tested the hypothesis that electrical stimulation in either IC/BST or in the inferior thalamic peduncle (ITP) effectively reduces depressive symptoms in treatment-resistant major depressive disorder (TRD). In a double-blind crossover design, the effects of electrical stimulation at both targets were compared in TRD patients. The 17-item Hamilton Depression Rating scale (HAM-D) was the primary outcome measure. During the first crossover, patients received IC/BST stimulation versus no stimulation in random order (2 × 1 weeks). During the second crossover (3 × 2 months), patients received IC/BST versus ITP versus no stimulation. Patients and evaluators were blinded for stimulation conditions. All patients (n=7) were followed up for at least 3 years (3-8 years) after implantation. Six patients completed the first crossover and five patients completed the second. During the first crossover, mean (s.d.) HAM-D scores were 21.5 (2.7) for no stimulation and 11.5 (8.8) for IC/BST stimulation. During the second crossover, HAM-D scores were 15.4 (7.5) for no stimulation, 7.6 (3.8) for IC/BST stimulation and 11.2 (7.5) for ITP stimulation. The final sample size was too small to statistically analyze this second crossover. At last follow-up, only one patient preferred ITP over IC/BST stimulation. Two patients, with a history of suicide attempts before implantation, committed suicide during the follow-up phases of this study. Our data indicate that, in the long term, both ITP and IC/BST stimulation may alleviate depressive symptoms in patients suffering from TRD.",Raymaekers S.; Luyten L.; Bervoets C.; Gabriëls L.; Nuttin B.,2017.0,10.1038/tp.2017.66,0,0,
1151,An investigation of emotion recognition training to reduce symptoms of social anxiety in adolescence.,"This study aimed to examine the effect of emotion recognition training on social anxiety symptoms among adolescents, aged 15-18 years. The study included a screening session, which identified participants who scored above a cut-off on a self-report measure of social anxiety for enrolment into a randomized controlled trial (Clinical Trials ID: NCT02550379). Participants were randomized to an intervention condition designed to increase the perception of happiness over disgust in ambiguous facial expressions or a sham intervention control condition, and completed self-report measures of social anxiety, fear of negative evaluation, anxiety-related disorders, and depressive symptoms. The intervention group demonstrated a strong shift in the balance point at which they perceived happiness over disgust in ambiguous facial expressions. This increase in positive perception was not associated with any changes in the primary outcome of social anxiety; however, some evidence of improvement in symptomatology was observed on one of a number of secondary outcomes. Those in the intervention group had lower depression symptoms at 2-week follow-up, compared to those in the control group who received the sham intervention training. Potential reasons for why the shift in balance point measurement was not associated with a concurrent shift in symptoms of social anxiety are discussed.",Rawdon C.; Murphy D.; Motyer G.; Munafò MR.; Penton-Voak I.; Fitzgerald A.,2018.0,10.1016/j.psychres.2018.02.023,0,0,
1152, Examining Mediators and Moderators of Yoga for Women With Breast Cancer Undergoing Radiotherapy," Hypothesis This study examines moderators and mediators of a yoga intervention targeting quality‚Äêof‚Äêlife (QOL) outcomes in women with breast cancer receiving radiotherapy.Methods Women undergoing 6 weeks of radiotherapy were randomized to a yoga (YG; n = 53) or stretching (ST; n = 56) intervention or a waitlist control group (WL; n = 54). Depressive symptoms and sleep disturbances were measured at baseline. Mediator (posttraumatic stress symptoms, benefit finding, and cortisol slope) and outcome (36‚Äêitem Short Form [SF]‚Äê36 mental and physical component scales [MCS and PCS]) variables were assessed at baseline, end‚Äêof‚Äêtreatment, and 1‚Äê, 3‚Äê, and 6‚Äêmonths posttreatment. Results Baseline depressive symptoms (P = .03) and sleep disturbances (P < .01) moderated the Group √ó Time effect on MCS, but not PCS. Women with high baseline depressive symptoms in YG reported marginally higher 3‚Äêmonth MCS than their counterparts in WL (P = .11). Women with high baseline sleep disturbances in YG reported higher 3‚Äêmonths MCS than their counterparts in WL (P < .01) and higher 6‚Äêmonth MCS than their counterparts in ST (P = .01). YG led to greater benefit finding than ST and WL across the follow‚Äêup (P = .01). Three‚Äêmonth benefit finding partially mediated the effect of YG on 6‚Äêmonth PCS. Posttraumatic stress symptoms and cortisol slope did not mediate treatment effect on QOL. Conclusion Yoga may provide the greatest mental‚Äêhealth‚Äêrelated QOL benefits for those experiencing pre‚Äêradiotherapy sleep disturbance and depressive symptoms. Yoga may improve physical‚Äêhealth‚Äêrelated QOL by increasing ability to find benefit in the cancer experience."," Ratcliff, CG;  Milbury, K;  Chandwani, KD;  Chaoul, A;  Perkins, G;  Nagarathna, R;  Haddad, R;  Nagendra, HR;  Raghuram, NV;  Spelman, A;  et al.",2016.0, 10.1177/1534735415624141,0,0,
1153," Recognition of anxiety, depression, and PTSD in patients with COPD and CHF: who gets missed?"," OBJECTIVE: This study sought to identify patient factors associated with mental health (MH) recognition and treatment in medically ill Veterans. METHOD: Retrospective data from patient electronic medical records (EMR) and self‚Äêreport data were reviewed for 180 Veterans with cardiopulmonary conditions who met diagnostic criteria for anxiety, depression, or posttraumatic stress disorder on the Mini‚ÄêInternational Neuropsychiatric Interview. Multivariate logistic regression examined the association of medical record MH recognition and MH service use with patient factors, including anxiety and depression severity, self‚Äêefficacy, locus of control, coping, illness intrusiveness, and health‚Äêrelated quality of life (QOL). RESULTS: Seventy veterans (39%) had an MH diagnosis documented in their EMR, and 101 (56%) received at least one MH service (‚â•1 MH encounter or psychiatric medications). Greater depression (p=0.047) and adaptive coping (p=0.012) were associated with increased likelihood of EMR documentation of MH diagnoses. EMR MH diagnosis (p<0.001), higher internal locus of control (p=0.037), and poorer physical health‚Äêrelated QOL (p=0.014) were associated with greater likelihood of MH service use. DISCUSSION: Veterans with cardiopulmonary conditions experiencing MH problems are under‚Äêrecognized. Improved MH screening is needed, particularly for patients with poor adaptive coping skills, low internal locus of control, or poor physical health‚Äêrelated QOL."," Ratcliff, CG;  Barrera, TL;  Petersen, NJ;  Sansgiry, S;  Kauth, MR;  Kunik, ME;  Stanley, MA;  Cully, JA",2017.0, 10.1016/j.genhosppsych.2017.05.004,0,0,
1154, A randomized controlled trial of ganaxolone in posttraumatic stress disorder," Preclinical and clinical research supports a role for neuroactive steroids in the pathophysiology of posttraumatic stress disorder (PTSD). We investigated ganaxolone (a synthetic 3β‐methylated derivative of allopregnanolone, a GABAergic neuroactive steroid) for treatment of PTSD in a proof‐of‐concept, multisite, double‐blind, placebo‐controlled trial. Veteran and non‐veteran participants (n = 112) were randomized to ganaxolone or placebo at biweekly escalating doses of 200, 400, and 600 mg twice daily for 6 weeks. During an open‐label 6‐week extension phase, the initial ganaxolone group continued ganaxolone, while the placebo group crossed over to ganaxolone. Eighty‐six and 59 participants, respectively, completed the placebo‐controlled and open‐label phases. A modified intent‐to‐treat mixed model repeated measures analysis revealed no significant differences between the effects of ganaxolone and placebo on Clinician Administered PTSD Symptom (CAPS) scores, global well‐being, negative mood, or sleep. Dropout rates did not differ between groups, and ganaxolone was generally well tolerated. Trough blood levels of ganaxolone at the end of the double‐blind phase were, however, lower than the anticipated therapeutic level of ganaxolone in >35% of participants on active drug. Pharmacokinetic profiling of the ganaxolone dose regimen used in the trial and adverse event sensitivity analyses suggest that under‐dosing may have contributed to the failure of ganaxolone to out‐perform placebo. Future investigations of ganaxolone may benefit from higher dosing, rigorous monitoring of dosing adherence, a longer length of placebo‐controlled testing, and targeting of treatment to PTSD subpopulations with demonstrably dysregulated pre‐treatment neuroactive steroid levels. Clinicaltrials.gov identifier: NCT01339689."," Rasmusson, AM;  Marx, CE;  Jain, S;  Farfel, GM;  Tsai, J;  Sun, X;  Geracioti, TD;  Hamner, MB;  Lohr, J;  Rosse, R;  et al.",2017.0, 10.1007/s00213-017-4649-y,0,0,
1155,Trial of Prazosin for Post-Traumatic Stress Disorder in Military Veterans.,"In randomized trials, prazosin, an α1-adrenoreceptor antagonist, has been effective in alleviating nightmares associated with post-traumatic stress disorder (PTSD) in military veterans. We recruited veterans from 13 Department of Veterans Affairs medical centers who had chronic PTSD and reported frequent nightmares. Participants were randomly assigned to receive prazosin or placebo for 26 weeks; the drug or placebo was administered in escalating divided doses over the course of 5 weeks to a daily maximum of 20 mg in men and 12 mg in women. After week 10, participants continued to receive prazosin or placebo in a double-blind fashion for an additional 16 weeks. The three primary outcome measures were the change in score from baseline to 10 weeks on the Clinician-Administered PTSD Scale (CAPS) item B2 (""recurrent distressing dreams""; scores range from 0 to 8, with higher scores indicating more frequent and more distressing dreams); the change in score from baseline to 10 weeks on the Pittsburgh Sleep Quality Index (PSQI; scores range from 0 to 21, with higher scores indicating worse sleep quality); and the Clinical Global Impression of Change (CGIC) score at 10 weeks (scores range from 1 to 7, with lower scores indicating greater improvement and a score of 4 indicating no change). A total of 304 participants underwent randomization; 152 were assigned to prazosin, and 152 to placebo. At 10 weeks, there were no significant differences between the prazosin group and the placebo group in the mean change from baseline in the CAPS item B2 score (between-group difference, 0.2; 95% confidence interval [CI], -0.3 to 0.8; P=0.38), in the mean change in PSQI score (between-group difference, 0.1; 95% CI, -0.9 to 1.1; P=0.80), or in the CGIC score (between-group difference, 0; 95% CI, -0.3 to 0.3; P=0.96). There were no significant differences in these measures at 26 weeks (a secondary outcome) or in other secondary outcomes. At 10 weeks, the mean difference between the prazosin group and the placebo group in the change from baseline in supine systolic blood pressure was a decrease of 6.7 mm Hg. The adverse event of new or worsening suicidal ideation occurred in 8% of the participants assigned to prazosin versus 15% of those assigned to placebo. In this trial involving military veterans who had chronic PTSD, prazosin did not alleviate distressing dreams or improve sleep quality. (Funded by the Department of Veterans Affairs Cooperative Studies Program; PACT ClinicalTrials.gov number, NCT00532493 .).",Raskind MA.; Peskind ER.; Chow B.; Harris C.; Davis-Karim A.; Holmes HA.; Hart KL.; McFall M.; Mellman TA.; Reist C.; Romesser J.; Rosenheck R.; Shih MC.; Stein MB.; Swift R.; Gleason T.; Lu Y.; Huang GD.,2018.0,10.1056/NEJMoa1507598,0,0,
1156,"Affect, interpersonal behaviour and interpersonal perception during open-label, uncontrolled paroxetine treatment of people with social anxiety disorder: A pilot study","Background: Laboratory-based research with community samples has suggested changes in affective, behavioural and cognitive processes as possible explanations for the effects of serotonergic medications. Examining the effects of serotonergic medications using an ecological momentary measure (such as event-contingent recording) in the daily lives of people with social anxiety disorder would contribute to establishing the effects of these medications on affect, behaviour and one form of cognition: perception of others’ behaviour. Methods: The present study assessed changes in affect, interpersonal behaviour and perception of others’ behaviour in adults with social anxiety disorder using ecological momentary assessment at baseline and over 4 months of a single-arm, uncontrolled, open-label trial of treatment with the selective serotonin reuptake inhibitor paroxetine. Results: Anxiety and concurrent depressive symptoms decreased. Participants also reported increased positive and decreased negative affect; increased agreeable and decreased quarrelsome behaviour; increased dominant and decreased submissive behaviour; and increased perception that others behaved agreeably toward them. Moreover, participants demonstrated reduced intraindividual variability in affect, interpersonal behaviour and perception of others’ behaviour. Limitations: Limitations included the lack of a placebo group, the inability to identify the temporal order of changes and the restricted assessment of extreme behaviour. Conclusion: The results of the present study demonstrate changes during pharmacotherapy in the manifestation of affect, interpersonal behaviour and interpersonal perception in the daily lives of people with social anxiety disorder. Given the importance of interpersonal processes to social anxiety disorder, these results may guide future research seeking to clarify mechanisms of action for serotonergic medications.",Rappaport L.M.; Russell J.J.; Hedeker D.; Pinard G.; Bleau P.; Moskowitz D.S.,2018.0,10.1503/jpn.170141,0,0,
1157," Comparison of Stepped Care Delivery Against a Single, Empirically Validated Cognitive-Behavioral Therapy Program for Youth With Anxiety: a Randomized Clinical Trial"," OBJECTIVE: Stepped care is embraced as an ideal model of service delivery but is minimally evaluated. The aim of this study was to evaluate the efficacy of cognitive‚Äêbehavioral therapy (CBT) for child anxiety delivered via a stepped‚Äêcare framework compared against a single, empirically validated program. METHOD: A total of 281 youth with anxiety disorders (6‚Äê17 years of age) were randomly allocated to receive either empirically validated treatment or stepped care involving the following: (1) low intensity; (2) standard CBT; and (3) individually tailored treatment. Therapist qualifications increased at each step. RESULTS: Interventions did not differ significantly on any outcome measures. Total therapist time per child was significantly shorter to deliver stepped care (774 minutes) compared with best practice (897 minutes). Within stepped care, the first 2 steps returned the strongest treatment gains. CONCLUSION: Stepped care and a single empirically validated program for youth with anxiety produced similar efficacy, but stepped care required slightly less therapist time. Restricting stepped care to only steps 1 and 2 would have led to considerable time saving with modest loss in efficacy. Clinical trial registration information‚ÄêA Randomised Controlled Trial of Standard Care Versus Stepped Care for Children and Adolescents With Anxiety Disorders; http://anzctr.org.au/; ACTRN12612000351819."," Rapee, RM;  Lyneham, HJ;  Wuthrich, V;  Chatterton, ML;  Hudson, JL;  Kangas, M;  Mihalopoulos, C",2017.0, 10.1016/j.jaac.2017.08.001,0,0,
1158, d-Cycloserine does not enhance the effects of in vivo exposure among young people with broad-based anxiety disorders," Use of the partial NMDA receptor agonist d‚ÄêCycloserine (DCS) to increase extinction to feared cues among anxious adults has shown mixed, although overall positive effects. Few studies have extended this effect to youth and none have addressed young people with broad‚Äêbased anxiety such as separation anxiety, social anxiety, or generalised anxiety. In the current trial 51 children and adolescents with diagnosed anxiety disorders, aged 7‚Äê14 years received four sessions of graduated, experimenter‚Äêled, in vivo exposure to a hierarchy of feared cues relevant to their primary fear. They were randomly allocated to receive either 50 mg of DCS or a matched placebo capsule in a fully double‚Äêblind design. Both groups showed large reductions across sessions in their primary fear according to both parent and child report, but there were no significant differences between conditions at any session. The results are consistent with most studies to date of DCS‚Äêaugmented exposure in young people."," Rapee, RM;  Jones, MP;  Hudson, JL;  Malhi, GS;  Lyneham, HJ;  Schneider, SC",2016.0, 10.1016/j.brat.2016.10.004,0,0,
1159,The effectiveness of a group intervention to facilitate posttraumatic growth among women with breast cancer.,"Objective: This longitudinal study tested the effectiveness of a group intervention designed to facilitate posttraumatic growth (PTG). Methods: Sample consisted of 205 women diagnosed with non-metastatic breast cancer who were either assigned to an intervention group (n = 58) or to a control group (n = 147). PTG, challenge to core beliefs, and rumination (intrusive and deliberate) were assessed at baseline (T1), at 6 months (T2), and at 12 months after baseline (T3). Results: Results from the Latent Growth Modeling suggested that participants from the intervention group have higher levels of PTG. The challenge to core beliefs and the intrusive rumination have a moderator role on PTG, since group intervention is also linked to the enhancement of both variables. Conclusions: Participation in the intervention group increase PTG. Challenge to core beliefs and intrusive rumination are improved by group intervention, which to a certain extent facilitate PTG. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Ramos, Catarina; Costa, Pedro Alexandre; Rudnicki, Tania; Maroco, Ana Lucia; Leal, Isabel; Guimaraes, Raquel; Fougo, Jose Luis; Tedeschi, Richard G",2018.0,http://dx.doi.org/10.1002/pon.4501,0,0,
1160, Protocol for the psychotherapeutic group intervention for facilitating posttraumatic growth in nonmetastatic breast cancer patients," BACKGROUND: Breast cancer can be perceived as a traumatic event with disturbing effects on psychological domains such as depression, anxiety, and Posttraumatic Stress Disorder. In contrast, growing evidence has shown that posttraumatic growth can occur as a result of coping with breast cancer. Challenging the assumptive world, deliberate rumination, and emotional disclosure are recognized as strong predictors of posttraumatic growth. Group interventions may also increase social support, distress disclosure, and posttraumatic growth. The aim of this study is to evaluate how group‚Äêbased interventions can facilitate posttraumatic growth and promote improved psychosocial adjustment to breast cancer. This article describes the study protocol and the applied research methods. METHODS: To measure the impact of a group‚Äêbased intervention on posttraumatic growth, a multi‚Äêcenter randomized control trial was developed for Portuguese breast cancer patients. 205 women with nonmetastatic breast cancer (stages 1 to 3) were recruited for the study and were randomly assigned either to the experimental group, which participated in an 8‚Äêsession group intervention, or to the control group. Psychosocial variables, which consisted of posttraumatic growth, illness perception, stressfulness of the event, Posttraumatic Stress Disorder, core beliefs, rumination, social support, and distress disclosure were measured at three time points. The designated points in time for the assessments were baseline, 6 months post‚Äêintervention, and follow‚Äêup (12 months after baseline). DISCUSSION: This study is the first trial to assess the efficacy of a group‚Äêbased intervention designed to facilitate posttraumatic growth following a breast cancer diagnosis. If proven to be effective, group‚Äêbased intervention could be recommended as a complementary program to be included in hospital health‚Äêcare and clinical practice. TRIAL REGISTRATION: The trial was registered on 28/10/2013 at the Current Controlled Trials ( ISRCTN02221709 )."," Ramos, C;  Leal, I;  Tedeschi, RG",2016.0, 10.1186/s12905-016-0302-x,0,0,
1161, Trauma- and Stress-Induced Response in Veterans with Alcohol Dependence and Comorbid Post-Traumatic Stress Disorder," BACKGROUND: Alcohol dependence (AD) and post‚Äêtraumatic stress disorder (PTSD) commonly co‚Äêoccur, and the co‚Äêoccurrence is associated with worse prognosis than either disorder absent the other. Craving is an important construct related to relapse, but the relationship between PTSD symptoms, craving, and relapse is not well understood. Several studies have documented the relationship between stress and craving in individuals without comorbid PTSD, but the effect on those with comorbid PTSD is not well known. A small literature suggests that trauma imagery affects craving. This is the first study to explore the effects of trauma‚Äêinduced and stress‚Äêinduced scripts on alcohol craving, affect, cardiovascular, and cortisol responses in the laboratory. METHODS: Veterans (n = 25) diagnosed with AD and PTSD who were participating in a randomized clinical treatment trial took part in this laboratory study. Baseline assessment included PTSD symptoms and drinking quantity and frequency over 3 months before study initiation. In the laboratory, participants were exposed to neutral, stressful, and trauma scripts randomly assigned. Main outcomes included craving, anxiety, mood states, salivary cortisol, and cardiovascular responses. RESULTS: Both stress and trauma scripts produced greater increases in craving, negative affect, and cardiovascular reactivity, compared to neutral scripts. Trauma scripts produced significantly stronger craving for alcohol and greater cardiovascular reactivity than stress scripts. Also, trauma‚Äêinduced but not stress‚Äêinduced craving was positively correlated with baseline levels of drinking. There were no changes in cortisol levels from pre‚Äê to postexposure of any scripts. CONCLUSIONS: The results highlight that trauma cues are more salient in inducing alcohol craving than stress cues and higher reactivity is related to more baseline drinking. This finding is consistent with clinical observations that show an association between PTSD symptoms and alcohol relapse. It also underscores the importance of adequate treatment of PTSD as reactivity related to trauma cues and reminders may be an important factor in craving and relapse."," Ralevski, E;  Southwick, S;  Jackson, E;  Jane, JS;  Russo, M;  Petrakis, I",2016.0, 10.1111/acer.13120,0,0,
1162, Feasibility of a Cognitive Behavioral Intervention to Manage Fatigue in Individuals With Traumatic Brain Injury: a Pilot Study," OBJECTIVE: To evaluate the feasibility of conducting a randomized clinical trial of an Internet‚Äêbased manualized intervention to teach individuals with traumatic brain injury to manage their fatigue. SETTING: Community dwelling. PARTICIPANTS: Forty‚Äêone participants randomized to Maximizing Energy (MAX) intervention group (n = 20) and Health Education group (n = 21). INTERVENTION: The experimental group (MAX intervention) received an 8‚Äêweek program that combined education and Problem‚ÄêSolving Therapy to teach individuals to manage fatigue‚Äêrelated problems. The attention control group received health education. MEASURES: Primary outcome measures pertained to the feasibility of conducting the trial. Secondary outcomes were fatigue impact and fatigue severity assessed at baseline and postintervention. RESULTS: Of the 65 participants referred, 41 were enrolled (63% recruitment rate), of which 3 withdrew (92% retention rate). Participants in the experimental and control groups completed their homework 75% and 85% of the time, respectively, and were equally engaged in the sessions. Participants in the experimental group were able to learn and implement the MAX intervention steps. Effect sizes for all measures ranged from small (‚Äê0.17) to medium (‚Äê0.58) in favor of the intervention group. CONCLUSION: Findings from the study suggest that the MAX intervention is feasible to administer to individuals with post‚Äêtraumatic brain injury fatigue."," Raina, KD;  Morse, JQ;  Chisholm, D;  Leibold, ML;  Shen, J;  Whyte, E",2016.0, 10.1097/HTR.0000000000000196,0,0,
1163,Immediate and delayed neuroendocrine responses to social exclusion in males and females,"Social exclusion is a complex phenomenon, with wide-ranging immediate and delayed effects on well-being, hormone levels, brain activation and motivational behavior. Building upon previous work, the current fMRI study investigated affective, endocrine and neural responses to social exclusion in a more naturalistic Cyberball task in 40 males and 40 females. As expected, social exclusion elicited well-documented affective and neural responses, i.e., increased anger and distress, as well as increased exclusion-related activation of the anterior insula, the posterior-medial frontal cortex and the orbitofrontal cortex. Cortisol and testosterone decreased over the course of the experiment, whereas progesterone showed no changes. Hormone levels were not correlated with subjective affect, but they were related to exclusion-induced neural responses. Exclusion-related activation in frontal areas was associated with decreases in cortisol and increases in testosterone until recovery. Given that results were largely independent of sex, the current findings have important implications regarding between-sex vs. within-sex variations and the conceptualization of state vs. trait neuroendocrine functions in social neuroscience.",Radke S.; Seidel E.M.; Boubela R.N.; Thaler H.; Metzler H.; Kryspin-Exner I.; Moser E.; Habel U.; Derntl B.,2018.0,10.1016/j.psyneuen.2018.04.005,0,0,
1164,An internet-based intervention for adjustment disorder (TAO): Study protocol for a randomized controlled trial.,"Background: Adjustment Disorder (AjD) is a common and disabling mental health problem. The lack of research on this disorder has led to the absence of evidence-based interventions for its treatment. Moreover, because the available data indicate that a high percentage of people with mental illness are not treated, it is necessary to develop new ways to provide psychological assistance. The present study describes a Randomized Controlled Trial (RCT) aimed at assessing the effectiveness and acceptance of a linear internet-delivered cognitive-behavioral therapy (ICBT) intervention for AjD. Methods: A two-armed RCT was designed to compare an intervention group to a waiting list control group. Participants from the intervention group will receive TAO, an internet-based program for AjD composed of seven modules. TAO combines CBT and Positive Psychology strategies in order to provide patients with complete support, reducing their clinical symptoms and enhancing their capacity to overcome everyday adversity. Participants will also receive short weekly telephone support. Participants in the control group will be assessed before and after a seven-week waiting period, and then they will be offered the same intervention. Participants will be randomly assigned to one of the 2 groups. Measurements will be taken at five different moments: baseline, post-intervention, and three follow-up periods (3-, 6- and 12-month). BDI-II and BAI will be used as primary outcome measures. Secondary outcomes will be symptoms of AjD, posttraumatic growth, positive and negative affect, and quality of life. Discussion: The development of ICBT programs like TAO responds to a need for evidence-based interventions that can reach most of the people who need them, reducing the burden and cost of mental disorders. More specifically, TAO targets AjD and will entail a step forward in the treatment of this prevalent but under-researched disorder. Finally, it should be noted that this is the first RCT focusing on an internet-based intervention for AjD in the Spanish population. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Rachyla, Iryna; Perez-Ara, Marian; Moles, Mar; Campos, Daniel; Mira, Adriana; Botella, Cristina; Quero, Soledad",2018.0,,0,0,
1165,Neural correlates of heart rate variability in PTSD during sub-and supraliminal processing of trauma-related cues,"Background: Posttraumatic stress disorder (PTSD) is characterized by dysregulated arousal that is associated with altered cardiac autonomic response evidenced by decreased high-frequency heart rate variability (HF-HRV), an indirect measure of parasympathetic modulation of the heart. Examining the neural correlates underlying altered parasympathetic responses in PTSD is critical to understanding PTSD symptomatology during supraliminal and subliminal exposure to trauma-related stimuli. Methods: We compared the BOLD fMRI response associated with HF-HRV between a PTSD group (n518) and a healthy control group (n517) during sub-and supraliminal processing of personalized trauma-related cues. Results: In comparison to controls, the PTSD group showed decreased HF-HRV reactivity in response to both sub-and supraliminal cues. During subliminal processing of trauma-related vs. neutral words, as compared to controls, the PTSD group showed a decreased neural response associated with HF-HRV within the left dorsal anterior insula and the posterior cingulate cortex. By contrast, as compared to controls, the PTSD group showed decreased neural activity associated with HF-HRV within the posterior insula/superior temporal cortex and increased neural activity associated with HF-HRV within the left centromedial amygdala and the subgenual cingulate cortex during supraliminal processing of trauma-related vs. neutral words. Conclusions: Cortical and subcortical areas crucial to the central autonomic network were associated with compromised parasympathetic modulation of autonomic arousal in PTSD. Remarkably, the contribution of both supraliminal and subliminal trauma-related stimuli to dysregulated arousal points clearly to their key role in the maintenance of hyperarousal symptoms in PTSD.",Rabellino D.; D'Andrea W.; Siegle G.; Frewen P.; Minshew R.; Densmore M.; Neufeld R.W.J.; Theberge J.; Lanius R.,2017.0,,0,0,
1166, General Anesthesia Versus Local Anesthesia in Stereotactic Biopsies of Brain Lesions: a Prospective Randomized Study," BACKGROUND: Stereotactic biopsy of brain lesions with unknown entities is a common neurosurgical procedure to obtain tumor tissue. Pathologists can then provide an exact diagnosis on which further therapy, such as resection, radiotherapy, or chemotherapy, can be based. These procedures can be performed under local or general anesthesia. In this prospective study, we aim to show whether stress levels are higher for patients who undergo stereotactic biopsy under local or general anesthesia. METHODS: Between January 2013 and December 2014, we screened 157 patients. Of these, 43 were included and evaluated in this study. Twenty‚Äêone patients gave their written consent and were randomized for either local or general anesthesia. A Post Traumatic Stress Score (PTSS) questionnaire was filled out by the patients preoperatively and postoperatively. Also, patients who did not agree to randomization had an opportunity to fill out the PTSS questionnaire. Twenty‚Äêtwo patients agreed only to fill out the stress‚Äêlevel questionnaire but refused randomization. These patients were evaluated as a subgroup. Scores achieved in the PTSS were compared by using the Fisher exact test. RESULTS: Among the randomized patients, 9 underwent the procedure under local anesthesia and 12 under general anesthesia. Median PTSS was 24 preoperatively in the patients who received local anesthesia versus 20 among the patients with general anesthesia (P = 0.37; Fisher exact test). Postoperatively, PTSS was 29.5 in median for patients with local anesthesia versus 23 for patients with general anesthesia (P = 0.30; Fisher exact test). Postoperatively, the PTSS showed a median increase of 5.5 points in the LA and 3 points in the GA group (P = 0.87; Fisher exact test). P values of 0.05 and lower were considered statistically significant. CONCLUSIONS: The willingness of patients to undergo randomization in this setting was low (13.3%). Within this highly selective group of patients, there was no significant difference for stress levels in patients who underwent stereotactic biopsy under local anesthesia versus general anesthesia. However, median values indicate a trend for higher stress‚Äêlevel values for patients undergoing local anesthesia."," Quick-Weller, J;  Konczalla, J;  Duetzmann, S;  Franz-Jaeger, C;  Strouhal, U;  Brawanski, N;  Setzer, M;  Lescher, S;  Seifert, V;  Marquardt, G;  et al.",2017.0, 10.1016/j.wneu.2016.09.064,0,0,
1167, NO-FEAR Airlines: a Computer-aided Self-help Treatment for Flying Phobia," In vivo exposure is the treatment of choice for specific phobias. However, this treatment is linked to a number of limitations in its implementation. Therefore, it is important to develop strategies for improving treatment adherence, acceptance, and dissemination of evidence‐based treatments. Information and Communication Technologies, specifically, computerized programs boast advantages in treating flying phobia. NO‐FEAR Airlines is a Computer‐aided Self‐help Treatment for this problem, which can be self‐applied via Internet. NO‐FEAR Airlines treatment protocol comprises three therapeutic components: psychoeducation, exposure and overlearning. Exposure is carried out through 6 scenarios that are composed by images and real sounds related to a flight in process. The aim of the present work is to describe NO‐FEAR Airlines program."," Quero, S;  Campos, D;  Riera Del Amo, A;  Bretón-López, J;  Tortella-Feliu, M;  Baños, RM;  Botella, C",2015.0,,0,0,
1168," Effect of an art brut therapy program called go beyond the schizophrenia (GBTS) on prison inmates with schizophrenia in mainland China-A randomized, longitudinal, and controlled trial"," Creative arts therapies are proven to promote an interconnection between body and mind, but there are major obstacles for providing therapeutic services in prisons due to inmates' inherent mistrust for verbal disclosure and rigid self‚Äêdefenses, especially among inmates with schizophrenia. Thus, we developed a structured and quantitative art brut therapy program called go beyond the schizophrenia to actually measure the benefits of art therapy on prison inmates in mainland China. Upon completion of the program, the intervention group reported a decrease in anxiety, depression, anger, and negative psychiatric symptoms and showed better compliance with rules, socialization with peers, compliance with medications, and regular sleeping patterns after 16 weekly sessions of go beyond the schizophrenia. This article concludes that the art brut therapy was effective for the inmates with schizophrenia in mainland China and provides encouraging data on how to enhance mental health for inmates with schizophrenia. KEY PRACTITIONER MESSAGE: Art brut therapy can reduce emotional distress and negative psychiatric symptoms among Chinese inmates. Arts brut therapy can enhance Chinese inmates' compliance with rules, socialization with peers, compliance with medicines, and regular sleeping patterns. Arts brut therapy in conjunction with medication is highly recommended for recovery of Chinese inmates with schizophrenia, especially for patients with negative symptoms."," Qiu, HZ;  Ye, ZJ;  Liang, MZ;  Huang, YQ;  Liu, W;  Lu, ZD",2017.0, 10.1002/cpp.2069,0,0,
1169,Categorical perception of facial expressions in individuals with non-clinical social anxiety,"Background and objectives According to the well-established categorical perception (CP) of facial expressions, we decode complicated expression signals into simplified categories to facilitate expression processing. Expression processing deficits have been widely described in social anxiety (SA), but it remains to be investigated whether CP of expressions are affected by SA. The present study examined whether individuals with SA had an interpretation bias when processing ambiguous expressions and whether the sensitivity of their CP was affected by their SA. Methods Sixty-four participants (high SA, 30; low SA, 34) were selected from 658 undergraduates using the Interaction Anxiousness Scale (IAS). With the CP paradigm, specifically with the analysis method of the logistic function model, we derived the categorical boundaries (reflecting interpretation bias) and slopes (reflecting sensitivity of CP) of both high- and low-SA groups while recognizing angry-fearful, happy-angry, and happy-fearful expression continua. Results Based on a comparison of the categorical boundaries and slopes between the high- and low-SA groups, the results showed that the categorical boundaries between the two groups were not different for any of the three continua, which means that the SA does not affect the interpretation bias for any of the three continua. The slopes for the high-SA group were flatter than those for the low-SA group for both the angry-fearful and happy-angry continua, indicating that the high-SA group is insensitive to the subtle changes that occur from angry to fearful faces and from happy to angry faces. Limitations Since participants were selected from a sample of undergraduates based on their IAS scores, the results cannot be directly generalized to individuals with clinical SA disorder. Conclusions The study indicates that SA does not affect interpretation biases in the processing of anger, fear, and happiness, but does modulate the sensitivity of individuals’ CP when anger appears. High-SA individuals perceive angry expressions in a less categorical manner than the low-SA group, but no such difference was found in the perception of happy or fearful expressions.",Qiu F.; Han M.; Zhai Y.; Jia S.,2018.0,10.1016/j.jbtep.2017.09.001,0,0,
1170,Cortisol acutely reduces selective attention for erotic words in healthy young men,"Psychological stress prompts activity of the hypothalamic-pituitary-adrenal (HPA) axis resulting in increased release of cortisol. Long-term HPA aberrations have been observed for stress-related affective disorders but research into acute effects of cortisol on affect-regulation has only recently begun. Previous studies reported that exogenous cortisol acutely attenuated automatic attentional processing of task-irrelevant threatening information. This has been taken to suggest that cortisol may have acute anxiolytic properties, possibly through facilitating inhibition of threatening information. However, the role of cortisol in attentional inhibition of non-threatening arousing stimuli remained unclear. Therefore acute effects of 40. mg cortisol on performance of a masked and unmasked emotional Stroop task (EST) were assessed. Results for only the unmasked task demonstrated EST interference (interpreted as increased automatic attention) for erotic stimuli which was abolished by cortisol administration. This implies that effects of cortisol may not be restricted to attenuation of specifically anxiogenic information processing, as previously suggested. © 2011 Elsevier Ltd.",Putman P.; Berling S.,2011.0,10.1016/j.psyneuen.2011.03.015,0,0,
1171,Identifying patterns of co-occurring substance use disorders and mental illness in a jail population.,"Although the co-occurrence of mental health and substance use disorders (SUDs) is well documented among correctional populations, less explored are the actual patterns that exist between specific SUDs and additional mental health disorders in combination. This study examines prevalence and correlates of psychiatric comorbidity in incarcerated men who screened positive for a SUD and the ability of a practical structured interview to document diagnostic indications of SUDs and co-occurring disorders. Comprehensive Addictions and Psychological Evaluation (CAAPE) interview data from 176 substance-dependent male inmates incarcerated in a local jail facility were analyzed. The most common substance dependence diagnoses were for alcohol (81%) and cocaine (35%). Posttraumatic stress disorder (PTSD) was the most common co-occurring mental health condition (55%), followed by antisocial personality disorder and major depressive episodes (51% each). Patterns related to the presence of PTSD and major depressive episodes accounted for a vast majority of inmates with both two and three diagnostic indications. Cronbach's alphas for the individual CAAPE diagnostic subscales ranged from 0.74 to 0.97. The design and implementation of treatment programs for substance-dependent inmates must consider co-occurring mental health issues. Several of the diagnostic categories evinced a bimodal pattern of responses in terms of severity. Negative correlations among many of the SUDs suggest that those with a greater level of severity involving some substances are less likely to manifest dependence and high severity for other substances. The observed Cronbach's alphas for the various subscales demonstrated acceptable preliminary support for the use of the CAAPE as a practical instrument in indentifying co-occurring disorders in a jail setting. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Proctor, Steven L; Hoffmann, Norman G",2012.0,http://dx.doi.org/10.3109/16066359.2012.667853,0,0,
1172,A randomised controlled-trial of metacognitive therapy versus exposure therapy for post-traumatic stress disorder,"Background: Chronic post-traumatic stress disorder (PTSD) occurs frequently and is characterised by an unremitting course (Kessler et al. 1995). Despite the availability of effective treatments a significant proportion of clients remain symptomatic following intervention (Cahill & Foa, 2004). Existing approaches seem inadequate to tackle this growing problem. Metacognitive therapy (MCT) is a novel approach and has demonstrated efficacy (Wells et al. 2008). This research compared MCT with Exposure therapy and a waitlist control condition (WL). Method: Participants (N=32) with symptom chronicity of~ 3 months were recruited for this . randomised controlled trial (RCT) from four Clinical Psychology Departments across the North West of England. Following an initial assessment those opting into the trial were randomly assigned to one of the three conditions, eight sessions of therapy (MCT v. Exposure) or an eight week wait period (WL) followed by a second randomisation to receive one of the active treatments. It was hypothesised that both active treatments would lead to significant reductions in PTSD, depression and anxiety symptoms compared with the WL and MCT would generate a faster rate of change compared with Exposure. The Impact of Events Scale (IES) was the primary outcome measure. Evaluations were conducted at pre-treatment and post-treatment time points. Results: Both MCT and Exposure resulted in statistically significant reductions in symptoms of PTSD, anxiety and depression compared with the WL control. MCT led to greater reductions than Exposure across symptoms of psychological distress and physiological arousal. Eighty-two percent of those completing MCT and 64% of the Exposure group met clinical significance criteria for recovery at post-treatment. In conclusion, MCT appears to be a highly effective treatment for PTSD when compared with traditional approaches. The clinical implications and suggestions for future research are discussed.",Proctor,2008.0,,0,0,
1173, Costs of Mental Health Care in Patients with Posttraumatic Stress Disorder Related to Sexual Abuse One Year Before and After Inpatient DBT-PTSD, null," Priebe, K;  Roth, M;  Krüger, A;  Glöckner-Fink, K;  Dyer, A;  Steil, R;  Salize, HJ;  Kleindienst, N;  Bohus, M",2017.0, 10.1055/s-0042-106068,0,0,
1174,Generalization of Extinguished Fear to Untreated Fear Stimuli after Exposure.,"Exposure therapy is highly effective in treating excessive fear related to specific objects and/or situations. However, patients with anxiety disorders often display a generalization of fear responses toward conceptually and perceptually related stimuli and situations. It is unclear whether the beneficial effects of exposure on fear reduction toward treated fear stimuli can extend to untreated fear stimuli. Here, we investigated whether basic principles of extinction generalization apply to exposure. Spider-phobic participants were randomly assigned to either two sessions of exposure treatment (n=23) with spiders or no-treatment (n=24). Prior to and after treatment, behavioral approach tests (BATs) were conducted to examine avoidance, fear and disgust responses toward the treated phobic stimulus (spider as the extinction stimulus). Likewise, BATs with the untreated fear stimulus (cockroach) were conducted to dissect the generalization of treatment effects. Treatment was highly effective in increasing approach behavior toward both treated and untreated fear stimuli. Generalization of treatment effects were evident on the behavioral (approach distance during the BAT), subjective (fear levels during the BAT) and psychophysiological level (heart rate during the BAT). However, a stronger decline in disgust was only evident for the treated fear stimulus. Notably, the herein attained generalization effects were not context-dependent. Hence, exposure therapy for spider phobia was effective in reducing fear of untreated stimuli which share common fear-evoking characteristics with spiders but were never presented during the respective exposure treatment. These findings provide clinical evidence for extinction generalization across different fear-evoking stimuli mediated via exposure.",Preusser F.; Margraf J.; Zlomuzica A.,2017.0,10.1038/npp.2017.119,0,0,
1175,"d-Serine is a potential biomarker for clinical response in treatment of post-traumatic stress disorder using (R,S)-ketamine infusion and TIMBER psychotherapy: A pilot study.","Post-traumatic stress disorder (PTSD) is a chronic and debilitating condition that is often refractory to standard frontline antidepressant therapy. A promising new approach to PTSD therapy is administration of a single sub-anesthetic dose of (R,S)-ketamine (Ket). The treatment produces rapid and significant therapeutic response, which lasts for only 4-7 days. In one of our studies, the mean duration of response was increased to 33 days when Ket administration was combined with a mindfulness-based cognitive therapy, Trauma Interventions using Mindfulness Based Extinction and Reconsolidation (TIMBER). We now report the results from a 20-patient study, which examined the duration of sustained response with combined TIMBER-Ket therapy, TIMBER-K arm, relative to the response observed in a placebo-controlled arm, TIMBER-P. A significant difference in the duration of response was observed between TIMBER-K and TIMBER-P arms: 34.44 ± 19.12 days and 16.50 ± 11.39 days, respectively (p = 0.022). Previous studies identified a negative correlation between antidepressant response to Ket and basal plasma concentrations of d-serine (DSR). In this study, the basal DSR levels positively correlated with the pre-treatment severity of PTSD symptoms (Pearson's r = 0.42, p = 0.07) and patients with basal DSR level ≥ 3.5 μM displayed not only higher PTSD severity but also shorter duration of response. The data indicate that basal DSR levels may serve as a biomarker of the severity of PTSD symptoms and as a predictor of clinical response. This article is part of a Special Issue entitled: d-Amino acids: biology in the mirror, edited by Dr. Loredano Pollegioni, Dr. Jean-Pierre Mothet and Dr. Molla Gianluca.",Pradhan B.; Mitrev L.; Moaddell R.; Wainer IW.,2018.0,10.1016/j.bbapap.2018.03.006,0,0,
1176,Stress among central industrial security force personnel-a comprehensive assessment and action plan,"Introduction Central Industrial Security Force (CISF) protects critical installations in the country. Though this para-military force were given requisite training to handle stressful jobs but In drawing upon recent incidents and some of the empirical studies in CISF, a wide range of issues including factors intrinsic to the job, organisation culture, and managerial style, style of work in organisation and home/work interface create unmanageable stress and impact on personnel psychological health and overall well-being. In CISF, there are well-defined practices and procedures that govern the way an employee should conduct but it depends on how effectively these policies and practices are implemented in the organisation. Methods Investigator used Stress Audit Scale adapted from Udaya Kumar Reddy (2005) to assess the perceived distress, personality traits, and all connected stressful demands was used. The present study was undertaken on a total of 326 CISF Personnel in three major work location of Goa (i.e. Airport, Shipyard and Port Trust). Sub officers (i.e. Inspectors, Sub-inspectors, Asst. Sub Inspectors) and Constables participated in the study. Stress awareness session was delivered before administering the questionnaire. Focused group discussions conducted for capturing qualitative data. Result Most of the CISF Personnel were under high overall distress across the cadre in all three units. Personality traits are significantly correlated with distress. Subjects' Distress was significantly correlated to their Role Stress variables and Psychosocial Safety Climate. Some specific organisational variables emerged has the significant impact on perceived distress. Discussion CISF Personnel requires a comprehensive Stress Assessment that helps to focus on required behavioural competencies to improve upon and also will enable effective implementation and continual improvement of the policies and practices. It necessitates stress safety net which will in turn provide necessary stress management programmes, counselling services and staff welfare planning to promote employee work-life balance and organisational excellence.",Prabhu G.V.; Joshi M.; Reddy B.K.,2018.0,10.1136/oemed-2018-ICOHabstracts.1639,0,0,
1177, Evaluation of efficacy and efficiency of a pragmatic intervention by a social worker to support informal caregivers of elderly patients (The ICE Study): study protocol for a randomized controlled trial," BACKGROUND: Medical progress and the lifestyle modification have prolonged life expectancy, despite the development of chronic diseases. Support and care for older subjects are often provided by a network of informal caregivers composed of family, friends and neighbors, who are essential in helping older persons to continue living at home. It has been shown that the extent and diversity of informal tasks may jeopardize the physical, mental and social wellbeing of caregivers. METHODS/DESIGN: The aim of the Informal Carers of Elderly cohort is to define, through a longitudinal study, profiles of caregivers of older patients with a diagnosis of one of the following diseases: cancer (breast, prostate, colorectal), neurodegenerative diseases (Parkinson's disease, Alzheimer's disease and similar diseases), neurovascular diseases (stroke), sensory diseases (age‚Äêrelated macular degeneration (AMD)) and heart disease (heart failure). Patients must be at least 60 years old and living in the region of Burgundy‚ÄêFranche‚ÄêComte (France). By following the different phases of the caregiving relationship from the announcement of the diagnosis, it will be possible to assess the quality of life of caregivers, coping strategies, levels of anxiety and depression, social support and the extent of their burden. We will also evaluate the efficacy and efficiency of the implementation of a pragmatic intervention by a social worker to help informal caregivers, through a randomized interventional trial nested in the cohort. Qualitative approaches aimed at studying the caregiver/patient relationship, and situations leading to breakdown of the caregiver relationship will be also undertaken. DISCUSSION: Through an analytical and longitudinal definition of profiles of informal caregivers, this study will gather detailed information on their life courses and their health trajectory by identifying consequences associated with the concept of their role as carers. In addition, the randomized interventional trial will explore the relevance of the implementation of a supportive intervention by a social worker to help caregivers. These data will help to identify strategies that could be used to improve the existing sources of aid and to propose new approaches to help caregivers. This study will provide the opportunity to identify the most relevant means of support adapted to caregivers, and provide an impulse for new health care policies. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02626377 . Retrospectively registered on 9 December 2015. Protocol date/version: 23 October 2014/version 2."," Pozet, A;  Lejeune, C;  Bonnet, M;  Dabakuyo, S;  Dion, M;  Fagnoni, P;  Gaimard, M;  Imbert, G;  Nerich, V;  Foubert, A;  et al.",2016.0, 10.1186/s13063-016-1622-8,0,0,
1178," Integrated mental health care and vocational rehabilitation to improve return to work rates for people on sick leave because of exhaustion disorder, adjustment disorder, and distress (the Danish IBBIS trial): study protocol for a randomized controlled trial"," BACKGROUND: Common mental disorders are important contributors to the global burden of disease and cause negative effects on both the individual and society. Stress‐related disorders influence the individual's workability and cause early retirement pensions in Denmark. There is no clear evidence that mental health care alone will provide sufficient support for vocational recovery for this group. Integrated vocational and health care services have shown good effects on return to work in other similar welfare contexts. The purpose of the Danish IBBIS (Integreret Behandlings‐ og BeskæftigelsesIndsats til Sygemeldte) study is to examine the efficacy of (1) a stepped mental health care intervention with individual stress coaching and/or group‐based MBSR and (2) an integrated stepped mental health care with individual stress coaching and/or group‐based MBSR and vocational rehabilitation intervention for people on sick leave because of exhaustion disorder, adjustment disorder or distress in Denmark. METHOD/DESIGN: This three‐armed, parallel‐group, randomized superiority trial is set up to investigate the effectiveness of a stepped mental health care intervention and an integrated mental health care and vocational rehabilitation intervention for people on sick leave because of exhaustion disorder, adjustment disorder or distress in Denmark. The trial has an investigator‐initiated multicenter design. Six hundred and three patients will be recruited from Danish vocational rehabilitation centers in four municipalities and randomly assigned into three groups: (1) IBBIS mental health care integrated with IBBIS vocational rehabilitation, (2) IBBIS mental health care and standard vocational rehabilitation, and (3) standard mental health care and standard vocational rehabilitation. The primary outcome is register‐based return to work at 12 months. The secondary outcome measures are self‐assessed level of depression (BDI), anxiety (BAI), distress symptoms (4DSQ), work‐ and social functioning (WSAS), and register‐based recurrent sickness absence. DISCUSSION: This study will contribute with knowledge on the consequence of the current organizational separation of health care interventions and vocational rehabilitation regarding the individual's process of returning to work after sick leave because of exhaustion disorder, adjustment disorder or distress. If the effect on return to work, symptom level, and recurrent sick leave is different in the intervention groups, this study can contribute with new knowledge on shared care models and the potential for preventing deterioration in stress symptoms, prolonged sick leave, and recurrent sick leave. TRIAL REGISTRATION: ClinicalTrials.gov, registration number: NCT02885519 . Retrospectively registered on 15 August 2016). Participants have been included in the IBBIS trial for distress, adjustment disorder and exhaustion disorder since April 2016."," Poulsen, R;  Fisker, J;  Hoff, A;  Hjorthøj, C;  Eplov, LF",2017.0, 10.1186/s13063-017-2273-0,0,0,
1179, How and for whom does web-based acceptance and commitment therapy work? Mediation and moderation analyses of web-based ACT for depressive symptoms," BACKGROUND: Acceptance and Commitment Therapy (ACT) has been demonstrated to be effective in reducing depressive symptoms. However, little is known how and for whom therapeutic change occurs, specifically in web‚Äêbased interventions. This study focuses on the mediators, moderators and predictors of change during a web‚Äêbased ACT intervention. METHODS: Data from 236 adults from the general population with mild to moderate depressive symptoms, randomized to either web‚Äêbased ACT (n‚Äâ=‚Äâ82) or one of two control conditions (web‚Äêbased Expressive Writing (EW; n‚Äâ=‚Äâ67) and a waiting list (n‚Äâ=‚Äâ87)), were analysed. Single and multiple mediation analyses, and exploratory linear regression analyses were performed using PROCESS and linear regression analyses, to examine mediators, moderators and predictors on pre‚Äê to post‚Äê and follow‚Äêup treatment change of depressive symptoms. RESULTS: The treatment effect of ACT versus the waiting list was mediated by psychological flexibility and two mindfulness facets. The treatment effect of ACT versus EW was not significantly mediated. The moderator analyses demonstrated that the effects of web‚Äêbased ACT did not vary according to baseline patient characteristics when compared to both control groups. However, higher baseline depressive symptoms and positive mental health and lower baseline anxiety were identified as predictors of outcome across all conditions. Similar results are found for follow‚Äêup. CONCLUSIONS: The findings of this study corroborate the evidence that psychological flexibility and mindfulness are distinct process mechanisms that mediate the effects of web‚Äêbased ACT intervention. The results indicate that there are no restrictions to the allocation of web‚Äêbased ACT intervention and that web‚Äêbased ACT can work for different subpopulations. TRIAL REGISTRATION: Netherlands Trial Register NTR2736 . Registered 6 February 2011."," Pots, WT;  Trompetter, HR;  Schreurs, KM;  Bohlmeijer, ET",2016.0, 10.1186/s12888-016-0841-6,0,0,
1180,GABA(A) benzodiazepine receptor (GBzR) sensitivity: Test-retest reliability in normal volunteers,"Rationale: Alcohol, benzodiazepines and barbiturates act through the GABA(A) benzodiazepine receptor (GBzR). Patients with some forms of anxiety disorder have reduced GBzR sensivity, although it is not clear whether this is a state or a trait phenomenon. We have developed a paradigm for assessing GBzR sensitivity using slowing of saccadic eye movements in response to intravenous midazolam. Objectives: To obtain reliability data for GBzR sensitivity in normal volunteers and to look at factors that might influence sensitivity. Methods: Five male volunteers received an intravenous infusion of midazolam (50 μ/kg) given over 10 min. Saccadic eye movement velocity (SEMV) was recorded at baseline and at 15 min intervals up to 120 min post infusion. Blood was taken at these times for mixazolam assay. The study was repeated at 4 weeks. Pharmacodynamic (PD) effect was calculated by measuring area under the curve (AUC) of SEMV plot versus time for each individual on both study days. Pharmacokinetic (PK) effect was calculated by measuring AUC from t = 0 to t = 120 min. Ratio of PD/PK effect was then calculated to give a measure of GBzR sensitivity. Results: There was a very strong correlation between individual GBzR sensitivity on both study days (r = 0.99; P = 0.008). Conclusion: The results suggest that GBzR sensitivity is relatively stable over time in normal volunteers and that the paradigm described has good reliability. Copyright (C) 2000 John Wiley and Sons, Ltd.",Potokar J.; Nash J.; Sandford J.; Rich A.; Nutt D.,2000.0,10.1002/1099-1077(200006)15:4<281::AID-HUP172>3.0.CO;2-B,0,0,
1181,A pilot study comparing peer supported web-based CBT to self-managed web CBT for primary care veterans with PTSD and hazardous alcohol use.,"Objective: Many combat veterans struggle with posttraumatic stress disorder (PTSD) and hazardous alcohol use and are hesitant to engage in behavioral health services. Combining peer support with an eHealth intervention may overcome many barriers to care. This pilot study investigated the feasibility of adding peer support to a web-based cognitive behavior therapy (CBT) targeting PTSD symptoms and hazardous drinking, called Thinking Forward. Method: Thirty primary care patients with PTSD and hazardous alcohol use were randomized to receive Thinking Forward with or without peer support. Participants were assessed at pretreatment, posttreatment, and 24-week follow-up. Feasibility was analyzed with descriptive statistics. Preliminary outcomes were analyzed with multilevel modeling and effect sizes are presented. Results: Peer support specialists can be feasibly trained to support the Thinking Forward intervention with good fidelity. Both participants and peers reported good satisfaction with the protocol; although peers discussed a mismatch between the philosophies of peer support and diagnostically focused CBT. All participants experienced significant improvements in PTSD, quality of life, resiliency, and coping from pre- to posttreatment, with no differences between conditions. Pretreatment patient activation predicted outcomes regardless of whether participants received peer support. Conclusions and Implications for Practice: Peer support interventions to facilitate eHealth programs should strive to be consistent with the person-centered, recovery orientation of peer support, explicitly focus on patient activation, and consider characteristics of the patients, such as their level of problem recognition and willingness to engage in traditional behavioral health modalities. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement Impact and Implications: Peer support specialists can provide high fidelity support for an eHealth program focused on PTSD and hazardous alcohol use and this support is associated with high patient satisfaction. Further development of peer support services to facilitate eHealth programs should strive to be consistent with the person-centered, recovery orientation of peer support and explicitly focus on patient activation. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Possemato, Kyle; Johnson, Emily M; Emery, J. Bronte; Wade, Michael; Acosta, Michelle C; Marsch, Lisa A; Rosenblum, Andrew; Maisto, Stephen A",2018.0,http://dx.doi.org/10.1037/prj0000334,0,0,
1182, Music therapy for children and adolescents with behavioural and emotional problems: a randomised controlled trial," METHODS: Two hundred and fifty‚Äêone child (8‚Äê16 years, with social, emotional, behavioural and developmental difficulties) and parent dyads from six Child and Adolescent Mental Health Service community care facilities in Northern Ireland were randomised to 12 weekly sessions of MT plus usual care [n = 123; 76 in final analyses] or usual care alone [n = 128; 105 in final analyses]. Follow‚Äêup occurred at 13 weeks and 26 weeks postrandomisation. Primary outcome was improvement in communication (Social Skills Improvement System Rating Scales) (SSIS) at 13 weeks. Secondary outcomes included social functioning, self‚Äêesteem, depression and family functioning. RESULTS: There was no significant difference for the child SSIS at week 13 (adjusted difference in mean 2.4; 95% CI ‚Äê1.2 to 6.1; p = .19) or for the guardian SSIS (0.5; 95% CI ‚Äê2.9 to 3.8; p = .78). However, for participants aged 13 and over in the intervention group, the child SSIS communication was significantly improved (6.1, 95% CI 1.6 to 10.5; p = .007) but not the guardian SSIS (1.1; 95% CI ‚Äê2.9 to 5.2; p = .59). Overall, self‚Äêesteem was significantly improved and depression scores were significantly lower at week 13. There was no significant difference in family or social functioning at week 13. CONCLUSIONS: While the findings provide some evidence for the integration of music therapy into clinical practice, differences relating to subgroups and secondary outcomes indicate the need for further study. ISRCTN Register; ISRCTN96352204. BACKGROUND: Although music therapy (MT) is considered an effective intervention for young people with mental health needs, its efficacy in clinical settings is unclear. We therefore examined the efficacy of MT in clinical practice."," Porter, S;  McConnell, T;  McLaughlin, K;  Lynn, F;  Cardwell, C;  Braiden, HJ;  Boylan, J;  Holmes, V",2017.0, 10.1111/jcpp.12656,0,0,
1183,Olfactory cleft evaluation: a predictor for olfactory function in smell-impaired patients?,"In this study, we introduce an extension of previous work by Soler et al. (Int Forum Allergy Rhinol 6(3):293-298, 2016) on a modified endoscopic scoring system of the Lund-Kennedy Score (focusing on the olfactory cleft) to evaluate its correlation with the olfactory function in patients with various smell disorders. A prospective cohort study. Two-hundred and eighty-eight participants were included and categorized in five groups according to the cause of their olfactory disorder: (0) control, (1) idiopathic, (2) sino-nasal, (3) postinfectious and (4) post traumatic olfactory loss. Olfaction was evaluated using the ""Sniffin' Sticks"" test. The classical Lund-Kennedy scoring and a new olfactory cleft specific Lund-Kennedy scoring (OC-LK) were performed to evaluate mucosal changes. Significantly higher OC-LK scores on both sides were found in smell-impaired patients as compared to normosmic controls. When comparing the 4 groups, a significant difference of the OC-LK score were present between the sino-nasal and all other groups. Most importantly, significant negative correlations with strong effects were shown in the sino-nasal group between the OC-LK score and odor discrimination and odor identification. However, no such correlation emerged between the classical LK score and smell function. Olfactory cleft evaluation using the OC-LK score correlates with the olfactory function in patients with sino-nasal smell disorder. This diagnostic tool may reflect the underlying pathophysiological mechanism of sino-nasal smell loss, and therefore, should complement olfactory diagnostics in patients with sino-nasal smell disorder.",Poletti SC.; Murta G.; Hähner A.; Hummel T.,2018.0,10.1007/s00405-018-4913-8,0,0,
1184,The Use of E-Learning in Medical Education for Mountain Rescuers Concerning Hypothermia,"Podsiadło, Paweł, Sylweriusz Kosiński, Tomasz Darocha, Kinga Sałapa, Tomasz Sanak, and Hermann Brugger. The use of e-learning in medical education for mountain rescuers concerning hypothermia. High Alt Med Biol 19:272-277, 2018. OBJECTIVE: Victims of mountain accidents are often exposed to wet and cold environments which may increase the risk of hypothermia. Mountain rescuers should be able to recognize and manage hypothermia. We aimed to assess relevant knowledge in professional and volunteer mountain rescuers, as well as to evaluate the efficacy of an e-learning platform for continuing medical education. METHODS: An e-learning platform was developed to provide access to updated information about hypothermia. Volunteer and professional mountain rescuers participated in an e-learning course. Pretest, post-test, and specific lesson test scores were compared. After 1 year, a follow-up course was performed. RESULTS: In total, 187 rescuers, comprising 136 (72.7%) volunteers and 51 (27.3%) professionals, were enrolled. Ahead of the course, no difference in knowledge was found between professionals and volunteers. After the course, one's knowledge of hypothermia increased significantly (p < 0.001). The scores achieved in the field management of hypothermia were better among professional rescuers than among volunteer rescuers (p = 0.003), whereas in post-traumatic hypothermia half of the results were insufficient in both groups. Moreover, 57 rescuers repeated the course after 12 months. While professionals partially retained the achieved level of knowledge, the volunteers had dropped back to their initial level. CONCLUSIONS: The e-learning course increased the knowledge of hypothermia among mountain rescuers. The poor retention after 1 year indicates that the interval between lectures should be reduced. An e-learning platform is an effective tool for the medical education of mountain rescuers.",Podsiadło P.; Kosiński S.; Darocha T.; Sałapa K.; Sanak T.; Brugger H.,2018.0,10.1089/ham.2018.0050,0,0,
1185,Avoiding math on a rapid timescale: Emotional responsivity and anxious attention in math anxiety,"Math anxiety (MA) is characterized by negative feelings towards mathematics, resulting in avoidance of math classes and of careers that rely on mathematical skills. Focused on a long timescale, this research may miss important cognitive and affective processes that operate moment-to-moment, changing rapid reactions even when a student simply sees a math problem. Here, using fMRI with an attentional deployment paradigm, we show that MA influences rapid spontaneous emotional and attentional responses to mathematical stimuli upon brief presentation. Critically, participants viewed but did not attempt to solve the problems. Indicating increased threat reactivity to even brief presentations of math problems, increased MA was associated with increased amygdala response during math viewing trials. Functionally and anatomically defined amygdala ROIs yielded similar results, indicating robustness of the finding. Similar to the pattern of vigilance and avoidance observed in specific phobia, behavioral results of the attentional paradigm demonstrated that MA is associated with attentional disengagement for mathematical symbols. This attentional avoidance is specific to math stimuli; when viewing negatively-valenced images, MA is correlated with attentional engagement, similar to other forms of anxiety. These results indicate that even brief exposure to mathematics triggers a neural response related to threat avoidance in highly MA individuals.",Pizzie R.G.; Kraemer D.J.M.,2017.0,10.1016/j.bandc.2017.08.004,0,0,
1186, Randomized Controlled Trial of Group Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder in Children and Adolescents Exposed to Tsunami in Thailand," BACKGROUND: Post‚Äêtraumatic stress disorder (PTSD) is a common and debilitating consequence of natural disaster in children and adolescents. Accumulating data show that cognitive behavioural therapy (CBT) is an effective treatment for PTSD. However, application of CBT in a large‚Äêscale disaster in a setting with limited resources, such as when the tsunami hit several Asian countries in 2004, poses a major problem. AIMS: This randomized controlled trial aimed to test for the efficacy of the modified version of CBT for children and adolescents with PSTD. METHOD: Thirty‚Äêsix children (aged 10‚Äê15 years) who had been diagnosed with PSTD 4 years after the tsunami were randomly allocated to either CBT or wait list. CBT was delivered in 3‚Äêday, 2‚Äêhour‚Äêdaily, group format followed by 1‚Äêmonth posttreatment self‚Äêmonitoring and daily homework. RESULTS: Compared to the wait list, participants who received CBT demonstrated significantly greater improvement in symptoms of PTSD at 1‚Äêmonth follow‚Äêup, although no significant improvement was observed when the measures were done immediately posttreatment. CONCLUSIONS: Brief, group CBT is an effective treatment for PTSD in children and adolescents when delivered in conjunction with posttreatment self‚Äêmonitoring and daily homework."," Pityaratstian, N;  Piyasil, V;  Ketumarn, P;  Sitdhiraksa, N;  Ularntinon, S;  Pariwatcharakul, P",2015.0, 10.1017/S1352465813001197,0,0,
1187, The combined use of virtual reality exposure in the treatment of agoraphobia," INTRODUCTION: This study compares the differential efficacy of three groups of treatments for agoraphobia: paroxetine combined with cognitive‐behavioral therapy, paroxetine combined with cognitive‐behavioral therapy and virtual reality exposure, and a group with only paroxetine. METHODOLOGY: 99 patients with agoraphobia were finally selected. Both combined treatment groups received 11 sessions of cognitive‐behavioral therapy, and one of the groups was also exposed to 4 sessions of virtual reality treatment. Treatments were applied in individual sessions once a week for 3 months. RESULTS: The three treatment groups showed statistically significant improvements. In some measures, combined treatment groups showed greater improvements. The virtual reality exposure group showed greater improvement confronting phobic stimuli. CONCLUSIONS: Treatments combining psychopharmacological and psychological therapy showed greater efficacy. Although the use of new technologies led to greater improvement, treatment adherence problems still remain."," Pitti, CT;  Peñate, W;  de la Fuente, J;  Bethencourt, JM;  Roca-Sánchez, MJ;  Acosta, L;  Villaverde, ML;  Gracia, R",2015.0,,0,0,
1188,Interpersonal subtypes of anxiety disorder patients: Relationship to assessment and treatment variables.,"We attempted to replicate earlier findings of interpersonal subtypes in patients with anxiety disorder (Psychotherapy. 2011;48:304-310) and examine whether these subtypes are characterized by different types of pathology and respond differently to treatment. Interpersonal problems were measured by the Inventory of Interpersonal Problems (Inventory of Interpersonal Problems Manual. San Antonio, TX: Psychological Cooperation; 2000) in a sample of 31 patients with anxiety disorder. Results demonstrated the existence of 4 interpersonal subtypes. The subtypes did not differ in severity of anxiety and global levels of symptoms at pretreatment or in Reliable Change Index of anxiety symptoms over the course of treatment. However, they were significantly different in terms of overall interpersonal problems (p = 0.004). Regarding treatment variables, half of the patients in the nonassertive cluster discontinued treatment prematurely. The number of psychotherapy sessions attended was significantly different across the 4 clusters (p = 0.04), with socially avoidant patients attending significantly greater number of sessions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pitman, Seth R; Hilsenroth, Mark J",2016.0,http://dx.doi.org/10.1097/NMD.0000000000000503,0,0,
1189, Global Postural Reeducation in patients with chronic nonspecific neck pain: cross-over analysis of a randomized controlled trial," OBJECTIVE: To compare the effects of Global Postural Reeducation (GPR) with Manual Therapy (MT) in participants with chronic nonspecific neck pain (NP). // METHODS: Pre‚Äê and post‚Äêtreatment analysis of cross‚Äêover data from an RCT was done. Seventy‚Äêeight subjects with chronic nonspecific NP aged 18 to 80 years completed the trial. The group who had received GPR crossed‚Äêover to MT and the previous MT group received GPR for 9 sessions once or twice a week. Measures were assessed at pre‚Äêtreatment and post‚Äêtreatment. Outcome measures included pain intensity [Visual Analogue Scale (VAS)], disability (Neck Disability Index), cervical Range of Motion (ROM), and kinesiophobia [Tampa Scale of Kinesiophobia (TSK)]. // RESULTS: GPR targeted to crossed‚Äêover participants produced greater improvements in pain [Diff=‚Äê8.6; 95%CI=(‚Äê13.3; ‚Äê3.8)], disability [Diff=‚Äê1.5; 95%CI=‚Äê2.8; ‚Äê0.1], kinesiophobia [Diff=‚Äê1.8; 95%CI=(‚Äê3.2; ‚Äê0.3)], and flexion/extension neck ROM [Diff=5.6; 95%CI=(1.8; 9.3)] at post‚Äêtreatment compared to the MT group. When evaluating clinical improvement, by means of Minimal Clinically Important Differences, we found that GPR relevantly reduced neck disability with respect to MT [OR=2.13; 95% CI=(1.05; 4.35)], whereas the improvement of pain did not differ between groups [OR=1.84; 95%CI=0.85; 3.99)]. // CONCLUSIONS: These results within the crossed‚Äêover group confirm previous findings from an RCT with the same sample. Sequence of treatment (GPR‚Äêto‚ÄêMT vs MT‚Äêto‚ÄêGPR) does not seem to weaken the greater effects of GPR compared to MT approach for chronic NP. Our findings suggest that GPR can induce hypoalgesic effects, reduce disability and kinesiophobia, and improve flexion/extension in neck ROM."," Pillastrini, P;  Banchelli, F;  Guccione, A;  Di Ciaccio, E;  Violante, FS;  Brugnettini, M;  Vanti, C",2018.0, 10.23749/mdl.v109i1.6677,0,0,
1190,The experience of non-invasive ventilation in motor neurone disease : a qualitative exploration,"Motor neurone disease (MND) is a fatal neuromuscular illness defined by progressive muscle weakness and wastage. Death typically occurs within 2-3 years from symptom onset and is most often attributable to respiratory complications. Weakness in the respiratory muscles increases the risk of mortality and is also a significant predictor of quality of life in MND, which makes management of respiratory aspects of the condition a vital component of care. The first signs of respiratory insufficiency are typically related to the onset of nocturnal hypoventilation, which can disturb sleep and lead to waking headaches, somnolence, fatigue, impaired concentration, cognitive impairment, reduced appetite, and low mood. The primary means of managing these symptoms is through the use of non-invasive ventilation (NIV). There is a vast quantitative research base charting the impact of NIV. It is known to decrease the number of arousals from sleep, reduce somnolence/fatigue, eliminate waking-headaches, improve cognitive functioning, and may also exert a positive impact on emotional/social functioning in some patients. NIV can also benefit daytime respiratory performance, improving self-rated dyspnoea and slowing the rate of respiratory decline as the illness progresses. Crucially, NIV also affords selected MND patients a significant survival advantage. Existing research offers limited insight into the lived experience of respiratory impairment and NIV use; it is unknown how patients themselves feel about using a ventilator or how they receive the positive clinical outcomes associated with the treatment. This thesis presents a body of qualitative research using interpretative phenomenological analysis (IPA) to explore MND patients' experiences of respiratory impairment and NIV use. The first study, a small cross- sectional enquiry (11=5), reports the experiences of patients already established on the ventilator. This study found complex emotional •and psychological responses to NIV, including reluctance to initiate, fear of dependence and threats to control. Respiratory masks were also found to have a significant negative impact on identity and self-esteem. However, patients felt that the positive physical effects of NIV made this experience acceptable. This cross-sectional study was a preparative step for a subsequent longitudinal study, recruiting patients (11=26) and carers (n=26) prior to ventilation and interviewing them over time as they started using NIV. Two data sets are reported: 'pre-ventilation' and 'post-ventilation' analysis. Pre-ventilation analysis also explored the lived experience of respiratory impairment and treatment decision-making. This longitudinal study found that referral into a respiratory service was an emotionally stressful event for patients; most had been unaware of the prospect of respiratory impairment and were vulnerable to anxiety. Patients seemed to lack insight into their own respiratory status, which appeared to be attributable to both a lack of understanding of respiratory aspects of the condition and difficulties in making sense of respiratory changes within the wider physical context of the illness. Most patients responded negatively to the idea of ventilation, seeing it both as a 'defeat' and as an ominous sign of illness progression, yet they were also comforted by the idea that there was 'help' available to prevent suffering. Patients typically elected not to think about NIV ahead of time, which appeared to be part of a wider 'one day at a time' approach to MND. Patients who went on to trial NIV (11= 12) reported markedly different responses to initiation and variable degrees of involvement in treatment decision-making. Many patients did not feel that intervention was needed. Positive physiological! clinical outcomes did not necessary lead to positive psychological and emotional responses to the treatment and did not ensure that the experience of using a ventilator was a positive one. There were a number of practical and psychological challenges that determined tolerance and compliance with the treatment; however, the same challenges were often perceived differently by different patients. It was not possible to predict 'success' on NIV based on clinical or demographic variables alone. Patients' experiences of NIV were best understood in the individual context of each patient and in light of their personal illness experiences. These findings make a significant contribution to the established research base, providing an alternative perspective to substantiate the quantitative evidence. It is intended that the research presented in this thesis will be of direct practical utility, helping clinicians who are supporting MND patients to ensure that patients' experiences of respiratory care and NIV use are as positive as they can be.",Piggin,2011.0,,0,0,
1191,The effect of mindfulness-based therapy on symptoms of anxiety and depression in adult cancer patients and survivors: A systematic review and meta-analysis.,"Objective: The use of mindfulness-based therapy (MBT) in oncology settings has become increasingly popular, and research in the field has rapidly expanded. The objective was by means of a systematic review and meta-analysis to evaluate the current evidence for the effect of MBT on symptoms of anxiety and depression in adult cancer patients and survivors. Method: Electronic databases were searched, and researchers were contacted for further relevant studies. Twenty-two independent studies with a total of 1,403 participants were included. Studies were coded for quality (range: 0-4), and overall effect size analyses were performed separately for nonrandomized studies (K = 13, n = 448) and randomized controlled trials (RCTs; K = 9, n = 955). Effect sizes were combined using the random-effects model. Results: In the aggregated sample of nonrandomized studies (average quality score: 0.5), MBT was associated with significantly reduced symptoms of anxiety and depression from pre- to posttreatment corresponding to moderate effect sizes (Hedges\'s g) of 0.60 and 0.42, respectively. The pooled controlled effect sizes (Hedges\'s g) of RCTs (average quality score: 2.9) were 0.37 for anxiety symptoms (p < .001) and 0.44 for symptoms of depression (p < .001). These effect sizes appeared robust. Furthermore, in RCTs, MBT significantly improved mindfulness skills (Hedges\'s g = 0.39). Conclusion: While the overall quality of existing clinical trials varies considerably, there appears to be some positive evidence from relatively high-quality RCTs to support the use of MBT for cancer patients and survivors with symptoms of anxiety and depression. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Piet, Jacob; Wurtzen, Hanne; Zachariae, Robert",2012.0,http://dx.doi.org/10.1037/a0028329,0,0,
1192,Continuous environmental changes may enhance topographic memory skills. Evidence from l’aquila earthquake-exposed survivors,"Exposure to environmental contextual changes, such as those occurring after an earthquake, requires individuals to learn novel routes around their environment, landmarks and spatial layout. In this study, we aimed to uncover whether contextual changes that occurred after the 2009 L’Aquila earthquake affected topographic memory in exposed survivors. We hypothesized that individuals exposed to environmental changes—individuals living in L’Aquila before, during and after the earthquake (hereafter called exposed participants, EPs)—improved their topographic memory skills compared with non-exposed participants (NEPs) who moved to L’Aquila after the earthquake, as only EPs had to modify their previous cognitive map of L’Aquila. We also hypothesized that memory improvement was selective for the navigational space and did not generalize across other spatial and verbal domains. To test these hypotheses, we compared the topographic and spatial memory skills of 56 EPs without post-traumatic stress disorder (PTSD) symptoms to the skills of 47 NEPs using the Walking Corsi Test (WalCT; memory test in the navigational space) and the Corsi Block-Tapping Test (CBT; visuospatial memory test in the reaching space); EPs and NEPs were matched for gender, education and general navigational skills. A sub-group of participants also underwent the Rey-Auditory Verbal Learning Test (RAVLT; verbal memory test). The results showed that only EPs had better performances on topographic learning (TL) assessed using the WalCT rather than spatial learning assessed by the CBT. This outcome suggests the possibility that EPs specifically improved topographic memory. This effect may be due to continuous exposure to environmental changes that have required individuals to learn novel paths within the city and integrate novel information, such as “new towns,” into their pre-existing mental representation of the city. Implications and limitations of the study are discussed.",Piccardi L.; Palmiero M.; Bocchi A.; Giannini A.M.; Boccia M.; Baralla F.; Cordellieri P.; D’Amico S.,2018.0,10.3389/fnhum.2018.00318,0,0,
1193,Does napping enhance the effects of cognitive bias modification-appraisal training? An experimental study,"Posttraumatic Stress Disorder (PTSD) is characterised by dysfunctional appraisals of the trauma and its consequences including one’s own symptoms. Experimental studies have shown that Cognitive Bias Modification—Appraisal (CBM-App) training can reduce dysfunctional interpretations and analog trauma symptoms. One important question is how to enhance the effects of CBM-App. Following work suggesting that sleep has beneficial effects on consolidation processes and can thus improve learning, the present study investigated whether a brief period of sleep (i.e., a nap) enhances the effects of CBM-App. All participants watched a stressful movie as an analogue trauma induction. After that, participants received either positive or negative CBM-App training. Within each training, half of the participants then had a 90-minute nap or watched a neutral movie. Results showed that the CBM training induced training-congruent appraisals. Sleep did not enhance this effect. Participants who slept, however, experienced fewer intrusive memories of the analogue trauma, but this effect was independent of the CBM condition. These results provide valuable information about the effects of sleep during a 90-minute nap period on encoding of analogue trauma and emotional learning in the context of appraisal, and highlight the importance of sleep as a focus for continued research.",Woud M.L.; Cwik J.C.; Blackwell S.E.; Kleim B.; Holmes E.A.; Adolph D.; Zhang H.; Margraf J.,2018.0,10.1371/journal.pone.0192837,0,0,
1194, Brief multimodal psychosomatic therapy in patients with medically unexplained symptoms: feasibility and treatment effects," BACKGROUND: Patients repeatedly presenting with medically unexplained symptoms (MUS) to their GPs, suffer from their symptoms. Experts in the field suggest a multicomponent approach for these patients. Brief multimodal psychosomatic therapy (BMPT) is such an intervention. OBJECTIVES: To test the systematic identification of eligible patients, acceptability of BMPT and potential treatment effects of BMPT. METHODS: The participants in this randomized pilot trial, patients consulting their GPs more than once with MUS, were randomized to intervention [usual care (UC) and additional BMPT] or control condition (UC alone).We monitored the number of patients identified and recruited, trial recruitment and retention. Potential treatment effects were measured with perceived symptom severity [Visual Analogue Scale (VAS)]; patients' self‚Äêrated symptoms of distress, depression, anxiety and somatization [Four‚ÄêDimensional Symptom Questionnaire (4DSQ)]; symptoms of hyperventilation [Nijmegen Hyperventilation List (NHL)]; physical and mental health status and quality of life [Short‚ÄêForm Health Survey‚Äê36 items (SF‚Äê36)]; and level of functioning (measure of general functioning). Follow‚Äêup was 1 year. RESULTS: A total of 42 patients could be included in the trial. Four patients withdrew after randomization and two patients were lost to follow‚Äêup, resulting in 36 patients (86%). During the 12‚Äêmonth follow‚Äêup after BMPT, there was an improvement in perceived symptom severity [adjusted mean difference ‚Äê2.0, 95% confidence interval (CI) ‚Äê3.6 to ‚Äê0.3], in somatization (adjusted mean difference ‚Äê4.4, 95% CI ‚Äê7.5 to ‚Äê1.4) and in symptoms of hyperventilation (adjusted mean difference ‚Äê5.7, 95% CI ‚Äê10.5 to ‚Äê0.8). CONCLUSIONS: This randomized pilot study shows that a larger trial studying the effectiveness of BMPT in patients with MUS in primary care is feasible and useful."," Wortman, MS;  Lucassen, PL;  van Ravesteijn, HJ;  Bor, H;  Assendelft, PJ;  Lucas, C;  Olde Hartman, TC",2016.0, 10.1093/fampra/cmw023,0,0,
1195,Randomized Pilot of an Anxiety Sensitivity-Based Intervention for Individuals in a Substance Use Day Program.,"Anxiety sensitivity (AS), or the tendency to appraise physical symptoms as intolerable or dangerous, may maintain the cycle between co-occurring anxiety and substance use disorders. This study examined preliminary efficacy of a brief intervention targeting AS for individuals with heterogeneous substance use disorders. Forty-one patients with high AS entering an addictions day program were randomized to treatment as usual (TAU) or to TAU plus a nine-hour AS-focused intervention that consisted of interoceptive exposures, psychoeducation about the cycle of problematic substance use and anxiety, and a single session of cognitive challenging (e.g., reviewing common cognitive distortions and decatastrophizing anxiety symptoms). Mixed-effects intent-to-treat models suggested that participants in the AS condition showed greater decreases in AS at post-treatment, but this effect was lost at follow-up three months later. Intervention conditions did not differ in change in percent days abstinent or self-reported anxiety, with both conditions showing significant improvement at post-treatment. Results suggest that the nine-hour AS-focused intervention led to a short-term benefit over TAU alone, but this benefit was not sustained at three months' follow-up. Future AS interventions may need to target specific subconstructs of AS for selected populations, or target emotional distress tolerance more broadly.",Worden BL.; Genova M.; Tolin DF.,,10.1080/02791072.2017.1329570,0,0,
1196,Undergraduate medical education in Sierra Leone: a qualitative study of the student experience,"BACKGROUND: Sierra Leone, a low-income and post-conflict country, has an extreme shortage of qualified medical doctors. Given the complex challenges facing medical education in this country and the need for context-specific knowledge, the aim of this paper is to explore the undergraduate medical education experience in Sierra Leone through qualitative interviews with recent graduates. METHODS: In-depth interviews were conducted with purposively sampled junior doctors (n‚Äâ=‚Äâ15) who had graduated from the only medical school in Sierra Leone. Additionally, semi-structured interviews were held with senior teaching staff at the School (n‚Äâ=‚Äâ7). Interviews were conducted in October 2013. Results were thematically analysed. RESULTS: The analytical framework consisted of four themes. Medical school experiences (Theme 1) were described as 'stressful and tedious' but also 'interesting and enjoyable'. Various constraints were experienced linked to the Medical school capacity (Theme 2), including human (limited number of teachers, teaching skills), organisational (departmental differences, curriculum related challenges), physical (lacking teaching facilities on campus, transportation problems) and financial capacity (inadequate remunerations for teachers, most students receive scholarships). Medical school culture (Theme 3) was by some participants perceived as fearful and unfair. Findings suggest various coping strategies (Theme 4) were used at school ('creatively' hire extra teaching staff, teaching schedule upon availability of staff), staff (juggle multiple roles, teach flexibly), and student levels (comply with 'hidden' rules, negotiate teaching support from less qualified health personnel). CONCLUSIONS: This study has provided an insight into the student perspective on medical education in Sierra Leone. Numerous capacity related concerns were identified; which are unsurprising for an educational institution in a low-income and conflict affected country. While the School, staff and students have found creative ways to deal with these constraints, participants' accounts of stress imply more is needed. For example, findings suggest that: students could be better supported in their self-directed learning, more effort is required to ensure basic needs of students are met (like shelter and food), and the power imbalance between staff and students could be addressed. Also better alignment amongst learning objectives and assessment methods will likely diminish student distress and may, consequently, reduce exam failure and possibly drop-out.",Woodward A.; McLernon-Billows D.,2018.0,10.1186/s12909-018-1397-6,0,0,
1197,"Comorbid psychopathology and everyday functioning in a brief intervention study to reduce khat use among Somalis living in Kenya: description of baseline multimorbidity, its effects of intervention and its moderation effects on substance use.","Migration and khat use were found to correlate with high rates of psychopathology. In this paper we aimed for assessing baseline multimorbidity and its interactions with a Brief Intervention. In the RCT, 330 male Somali khat users were assigned to treatment conditions (khat use is a predominantly male habit). The ASSIST-linked BI for khat users was administered. Using the TLFB Calendar, the PHQ-9, a Somali short version of the PDS and parts from the CIDI, khat use and comorbidity was assessed. With a regression analysis we tested for the influence of comorbidity and with mixed effect models group differences over time in sleep duration, khat use-time and everyday functioning. We found high rates of baseline multimorbidity: 51% (N = 168) for depression, 22% (N = 74) for PTSD and 23% (N = 73) for khat-psychotic symptoms. Depression and khat-psychotic symptoms, but not PTSD symptoms decreased without group differences. Khat use-time decreased and functional time increased with significant time × group interactions (p ≤ 0.046). Depression and PTSD did not influence therapy success but in participants without comorbid psychopathology, more khat use reduction after the intervention was found (p = 0.024). Somali khat users in Kenya are highly burdened by multimorbidity of depression, PTSD and khat-psychotic symptoms. The main effects for time and differences in healthy vs. mentally ill khat users indicate potential of unspecific support and the specific need for mental health care in combination with substance abuse treatment. The increase of everyday functioning promises more options for alternative activities, preventing excessive use and addiction.",Widmann M.; Apondi B.; Musau A.; Warsame AH.; Isse M.; Mutiso V.; Veltrup C.; Ndetei D.; Odenwald M.,2017.0,10.1007/s00127-017-1368-y,0,0,
1198, The feasibility of improving CBT for childhood anxiety disorders through a dismantling study," This preliminary randomized controlled trial (RCT) examines the feasibility of dismantling cognitive behavioral therapy (CBT) for childhood anxiety disorders. Fourteen children (10 girls) ages 7 to 14 (. m = 10.2) with social phobia, generalized anxiety disorder, separation anxiety disorder, or panic disorder were randomized to receive 6 sessions of either a) the pre‚Äêexposure anxiety management strategies presented in traditional CBT, or b) parent‚Äêcoached exposure therapy. The sample was selected from a treatment seeking population and is representative of children in clinical settings. Examination of fidelity ratings, dropouts, and satisfaction ratings indicated that the interventions were distinguishable, safe, and tolerable. The overall sample improved significantly with pre‚Äêpost effect sizes generally in the large range for both conditions. Between‚Äêgroup effect sizes indicating greater improvement with parent‚Äêcoached exposure therapy were moderate or large for ten of 12 variables (i.e., 0.53 to 1.52). Re‚Äêevaluation after three months of open treatment suggested that the intervention emphasizing exposure early maintained its superiority while requiring fewer appointments."," Whiteside, SP;  Ale, CM;  Young, B;  Dammann, JE;  Tiede, MS;  Biggs, BK",2015.0, 10.1016/j.brat.2015.07.011,0,0,
1199," ""Why"" or ""How"": the Effect of Concrete Versus Abstract Processing on Intrusive Memories Following Analogue Trauma"," Emergency service workers, military personnel, and journalists working in conflict zones are regularly exposed to trauma as part of their jobs and suffer higher rates of posttraumatic stress compared with the general population. These individuals often know that they will be exposed to trauma and therefore have the opportunity to adopt potentially protective cognitive strategies. One cognitive strategy linked to better mood and recovery from upsetting events is concrete information processing. Conversely, abstract information processing is linked to the development of anxiety and depression. We trained 50 healthy participants to apply an abstract or concrete mode of processing to six traumatic film clips and to apply this mode of processing to a posttraining traumatic film. Intrusive memories of the films were recorded for 1week and the Impact of Events Scale‚ÄêRevised (IES‚ÄêR; Weiss & Marmar, 1997) was completed at 1‚Äêweek follow‚Äêup. As predicted, participants in the concrete condition reported significantly fewer intrusive memories in response to the films and had lower IES‚ÄêR scores compared with those in the abstract condition. They also showed reduced emotional reactivity to the posttraining film. Self‚Äêreported proneness to intrusive memories in everyday life was significantly correlated with intrusive memories of the films, whereas trait rumination, trait dissociation, and sleep difficulties were not. Findings suggest that training individuals to adopt a concrete mode of information processing during analogue trauma may protect against the development of intrusive memories."," White, R;  Wild, J",2016.0, 10.1016/j.beth.2016.02.004,0,0,
1200, Complementary Features of Attention Bias Modification Therapy and Cognitive-Behavioral Therapy in Pediatric Anxiety Disorders," OBJECTIVE: In the treatment of anxiety disorders, attention bias modification therapy (ABMT) and cognitive‚Äêbehavioral therapy (CBT) may have complementary effects by targeting different aspects of perturbed threat responses and behaviors. ABMT may target rapid, implicit threat reactions, whereas CBT may target slowly deployed threat responses. The authors used amygdala‚Äêbased connectivity during a threat‚Äêattention task and a randomized controlled trial design to evaluate potential complementary features of these treatments in pediatric anxiety disorders. METHOD: Prior to treatment, youths (8‚Äê17 years old) with anxiety disorders (N=54), as well as healthy comparison youths (N=51), performed a threat‚Äêattention task during functional MRI acquisition. Task‚Äêrelated amygdala‚Äêbased functional connectivity was assessed. Patients with and without imaging data (N=85) were then randomly assigned to receive CBT paired with either active or placebo ABMT. Clinical response was evaluated, and pretreatment amygdala‚Äêbased connectivity profiles were compared among patients with varying levels of clinical response. RESULTS: Compared with the CBT plus placebo ABMT group, the CBT plus active ABMT group exhibited less severe anxiety after treatment. The patient and healthy comparison groups differed in amygdala‚Äêinsula connectivity during the threat‚Äêattention task. Patients whose connectivity profiles were most different from those of the healthy comparison group exhibited the poorest response to treatment, particularly those who received CBT plus placebo ABMT. CONCLUSIONS: The study provides evidence of enhanced clinical effects for patients receiving active ABMT. Moreover, ABMT appears to be most effective for patients with abnormal amygdala‚Äêinsula connectivity. ABMT may target specific threat processes associated with dysfunctional amygdala‚Äêinsula connectivity that are not targeted by CBT alone. This may explain the observation of enhanced clinical response to CBT plus active ABMT."," White, LK;  Sequeira, S;  Britton, JC;  Brotman, MA;  Gold, AL;  Berman, E;  Towbin, K;  Abend, R;  Fox, NA;  Bar-Haim, Y;  et al.",2017.0, 10.1176/appi.ajp.2017.16070847,0,0,
1201,Repetitive transcranial magnetic stimulation for treatment of major depressive disorder with comorbid generalized anxiety disorder.,"Background: Repetitive transcranial magnetic stimulation (rTMS) has shown promising results in treating individuals with behavioral disorders such as major depressive disorder (MDD), posttraumatic stress disorder, obsessive-compulsive disorder, and social anxiety disorder. A number of applications of rTMS to different regions of the left and right prefrontal cortex have been used to treat these disorders, but no study of treatment for MDD with generalized anxiety disorder (GAD) has been conducted with application of rTMS to both the left and right prefrontal cortex. We hypothesized that applying low-frequency rTMS to the right dorsolateral prefrontal cortex (DLPFC) before applying it to the left DLPFC for the treatment of depression would be anxiolytic in patients with MDD with GAD. Methods: Thirteen adult patients with comorbid MDD and GAD received treatment with rTMS in an outpatient setting. The number of treatments ranged from 24 to 36 over 5 to 6 weeks. Response was defined as a >=50% reduction in symptoms from baseline, and remission was defined as a score of <5 for anxiety symptoms on the 7-item Generalized Anxiety Disorder (GAD-7) scale and <8 for depressive symptoms on the 21-item Hamilton Rating Scale for Depression (HAM-D-21). Results: At the end of the treatment period, for the GAD-7 scale, 11 out of 13 (84.6%) patients' anxiety symptoms were in remission, achieving a score of <5 on the GAD-7, and 10 out of 13 patients (76.9%) achieved a HAM-D-21 score of <8 for depressive symptoms. Conclusions: In this small pilot study of 13 patients with comorbid MDD and GAD, significant improvement in anxiety symptoms along with depressive symptoms was achieved in a majority of patients after bilateral rTMS application. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","White, Daniela; Tavakoli, Sason",2015.0,,0,0,
1202,Identifying patterns in complex field data: Clustering heart rate responses of agoraphobic patients undertaking situational exposure.,"Ambulatory assessment methods are well suited to examine how patients with panic disorder and agoraphobia (PD/A) undertake situational exposure. But under complex field conditions of a complex treatment protocol, the variability of data can be so high that conventional analytic approaches based on group averages inadequately describe individual variability. To understand how fear responses change throughout exposure, we aimed to demonstrate the incremental value of sorting HR responses (an index of fear) prior to applying averaging procedures. As part of their panic treatment, 85 patients with PD/A completed a total of 233 bus exposure exercises. Heart rate (HR), global positioning system (GPS) location, and self-report data were collected. Patients were randomized to one of two active treatment conditions (standard exposure or fear-augmented exposure) and completed multiple exposures in four consecutive exposure sessions. We used latent class cluster analysis (CA) to cluster heart rate (HR) responses collected at the start of bus exposure exercises (5 min long, centered on bus boarding). Intra-individual patterns of assignment across exposure repetitions were examined to explore the relative influence of individual and situational factors on HR responses. The association between response types and panic disorder symptoms was determined by examining how clusters were related to self-reported anxiety, concordance between HR and self-report measures, and bodily symptom tolerance. These analyses were contrasted with a conventional analysis based on averages across experimental conditions. HR responses were sorted according to form and level criteria and yielded nine clusters, seven of which were interpretable. Cluster assignment was not stable across sessions or treatment condition. Clusters characterized by a low absolute HR level that slowly decayed corresponded with low self-reported anxiety and greater self-rated tolerance of bodily symptoms. Inconsistent individual factors influenced HR responses less than situational factors. Applying clustering can help to extend the conventional analysis of highly variable data collected in the field. We discuss the merits of this approach and reasons for the non-stereotypical pattern of cluster assignment across exposures. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","White, Andrew J; Kleinbohl, Dieter; Lang, Thomas; Hamm, Alfons O; Gerlach, Alexander L; Alpers, Georg W",2017.0,http://dx.doi.org/10.1027/2151-2604/a000310,0,0,
1203, Patient adherence and treatment outcome with exposure and response prevention for OCD: which components of adherence matter and who becomes well?," Exposure and response prevention (EX/RP) is an evidence‚Äêbased treatment for obsessive‚Äêcompulsive disorder (OCD), yet not all patients achieve wellness with EX/RP. The degree to which patients adhere to EX/RP procedures outside of sessions has been found to predict therapy outcomes, including who achieves post‚Äêtreatment wellness. We sought to investigate which components of treatment adherence most relate to outcome and to develop adherence benchmarks to identify who does and does not become well to provide clinicians with prognostic tools. Adherence data came from 37 adult patients with DSM‚ÄêIV OCD who received 17 sessions of EX/RP as part of a randomized controlled trial of augmentation strategies for incomplete response to serotonin reuptake inhibitors (SRIs). Therapists rated between‚Äêsession patient adherence at each exposure session by quantifying: 1) the quantity of homework exposures attempted; 2) the quality of attempted exposures; and 3) the degree of success with response prevention. Each adherence item significantly correlated with post‚Äêtreatment OCD severity. Success with response prevention proved particularly strongly linked to therapy outcome. Time course analysis of this item accurately identified, relatively early in treatment, who would achieve post‚Äêtreatment wellness. These data provide an efficient method for differentiating between those patients who will and will not achieve wellness after EX/RP augmentation of SRIs. Limitations and clinical implications of the current findings are discussed."," Wheaton, MG;  Galfalvy, H;  Steinman, SA;  Wall, MM;  Foa, EB;  Simpson, HB",2016.0, 10.1016/j.brat.2016.07.010,0,0,
1204, Augmenting SRIs for Obsessive-Compulsive Disorder: patient Preference for Risperidone Does Not Limit Effectiveness of Exposure and Ritual Prevention,," Wheaton, MG;  Carpenter, JK;  Kalanthroff, E;  Foa, EB;  Simpson, HB",2016.0, 10.1159/000445356,0,0,
1205, Mindfulness-Based Stress Reduction for Older Adults With Stress Disorders and Neurocognitive Difficulties: a Randomized Controlled Trial," OBJECTIVE: To determine whether neurocognitive performance and clinical outcomes can be enhanced by a mindfulness intervention in older adults with stress disorders and cognitive complaints. To explore decreased hypothalamic‐pituitary‐adrenal (HPA) axis activity as a possible mechanism. METHODS: 103 adults aged 65 years or older with an anxiety or depressive disorder (diagnosed according to DSM‐IV criteria) and subjective neurocognitive difficulties were recruited in St. Louis, Missouri, or San Diego, California, from September 2012 through August 2013 and randomly assigned in groups of 5‐8 to mindfulness‐based stress reduction (MBSR) or a health education control condition matched for time, attention, and credibility. The primary outcomes were memory (assessed by immediate and delayed paragraph and list recall) and cognitive control (Delis‐Kaplan Executive Function System Verbal Fluency Test and Color Word Interference Test). Other outcomes included clinical symptoms (worry, depression, anxiety, and global improvement). HPA axis activity was assessed using peak salivary cortisol. Outcomes were measured immediately post‐intervention and (for clinical outcomes only) at 3‐ and 6‐month follow up. RESULTS: On the basis of intent‐to‐treat principles using data from all 103 participants, the mindfulness group experienced greater improvement on a memory composite score (P = .046). Groups did not differ on change in cognitive control. Participants receiving MBSR also improved more on measures of worry (P = .042) and depression (P = .049) at posttreatment and on worry (P = .02), depression (P = .002), and anxiety (P = .002) at follow‐up and were more likely to be rated as much or very much improved as rated by the Clinical Global Impressions‐Improvement scale (47% vs 27%, χ² = 4.5, P = .03). Cortisol level decreased to a greater extent in the mindfulness group, but only among those participants with high baseline cortisol. CONCLUSIONS: In this population of older adults with stress disorders and neurocognitive difficulties, a mindfulness intervention improves clinical outcomes such as excessive worry and depression and may include some forms of immediate memory performance. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01693874."," Wetherell, JL;  Hershey, T;  Hickman, S;  Tate, SR;  Dixon, D;  Bower, ES;  Lenze, EJ",2017.0, 10.4088/JCP.16m10947,0,0,
1206,Preparing Clients for Cognitive Behavioral Therapy: A Randomized Pilot Study of Motivational Interviewing for Anxiety.,"Although CBT is a well-supported treatment for anxiety, recovery rates and compliance with treatment procedures are less than optimal. Using adjunctive brief preparatory interventions may help bolster response rates and engagement with therapy procedures. Motivational Interviewing (MI: Miller, W. R., & Rollnick, S. (1991, 2002). Motivational interviewing: preparing people to change addictive behavior. New York: Guilford) is a client-centered, directive method for enhancing motivation for change and has been demonstrated to be a valuable treatment prelude in the addictions domain. Prior to group cognitive behavioral therapy, 55 individuals with a principal anxiety diagnosis (45% panic disorder, 31% social phobia, and 24% generalized anxiety disorder) were randomly assigned to receive either three sessions of MI adapted for anxiety or no pretreatment (NPT). The MI pretreatment group, compared to NPT, showed significantly higher expectancy for anxiety control and greater homework compliance in CBT. Although both groups demonstrated clinically significant anxiety symptom improvements, the MI pretreatment group had a significantly higher number of CBT responders compared to NPT. At 6-month follow-up, both groups evidenced maintenance of gains. These results provide suggestive evidence that brief pretreatments, such as MI, may enhance engagement with and outcome from CBT. The promising results also justify the future investigation of these effects using more powerful designs which may discern whether the effects are specific to MI or to some type of pretreatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Westra, Henny A; Dozois, David J. A",2006.0,http://dx.doi.org/10.1007/s10608-006-9016-y,0,0,
1207,Comparing the predictive capacity of observed in-session resistance to self-reported motivation in cognitive behavioral therapy.,"Self-report measures of motivation for changing anxiety have been weakly and inconsistently related to outcome in cognitive behavioral therapy (CBT). While clients may not be able to accurately report their motivation, ambivalence about change may nonetheless be expressed in actual therapy sessions as opposition to the direction set by the therapist (i.e., resistance). In the context of CBT for generalized anxiety disorder, the present study compared the ability of observed in-session resistance in CBT session 1 and two self-report measures of motivation for changing anxiety (the Change Questionnaire & the Client Motivational for Therapy Scale) to (1) predict client and therapist rated homework compliance (2) predict post-CBT and one-year post-treatment worry reduction, and (3) differentiate those who received motivational interviewing prior to CBT from those who received no pre-treatment. Observed in-session resistance performed very well on each index, compared to the performance of self-reported motivation which was inconsistent and weaker relative to observed resistance. These findings strongly support both clinician sensitivity to moments of client resistance in actual therapy sessions as early as session 1, and the inclusion of observational process measures in CBT research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Westra, Henny A",2011.0,http://dx.doi.org/10.1016/j.brat.2010.11.007,0,0,
1208, Integrating motivational interviewing with cognitive-behavioral therapy for severe generalized anxiety disorder: an allegiance-controlled randomized clinical trial," METHOD: In the present randomized trial for severe generalized anxiety disorder (GAD), we compared the efficacy of 15 sessions of CBT alone (N = 43) versus 4 MI sessions followed by 11 CBT sessions integrated with MI to address client resistance/ambivalence (N = 42). Clients were adults, predominantly female and Caucasian, with a high rate of diagnostic comorbidity. To control for allegiance, therapists were nested within treatment group and supervised separately by experts in the respective treatments. RESULTS: Piecewise multilevel models revealed no between‐groups differences in outcomes from pre‐ to posttreatment; however, there were treatment effects over the follow‐up period with MI‐CBT clients demonstrating a steeper rate of worry decline (γ = ‐0.13, p = .03) and general distress reduction (γ = ‐0.12, p = .01) than CBT alone clients. Also, the odds of no longer meeting GAD diagnostic criteria were ∼5 times higher at 12‐months for clients receiving MI‐CBT compared with CBT alone. There were also twice as many dropouts in CBT alone compared with MI‐CBT (23% vs. 10%); a difference that approached significance (p = .09). The treatments were competently delivered, and intraclass correlations revealed negligible between‐therapist effects on the outcomes. CONCLUSIONS: The findings support the integration of MI with CBT for severe GAD and point to the importance of training therapists in appropriate responsivity to in‐session markers of resistance and ambivalence. (PsycINFO Database Record OBJECTIVE: Although integrating motivational interviewing (MI) and cognitive‐behavioral therapy (CBT) has been recommended for treating anxiety, few well‐controlled tests of such integration exist."," Westra, HA;  Constantino, MJ;  Antony, MM",2016.0, 10.1037/ccp0000098,0,0,
1209, Evaluation of a Technology-Based Adaptive Learning and Prevention Program for Stress Response-A Randomized Controlled Trial," To prevent deployment‐related disorders, Chaos Driven Situations Management Retrieval System (CHARLY), a computer‐aided training platform with a biofeedback interface has been developed. It simulates critical situations photorealistic for certain target and occupational groups. CHARLY was evaluated as a 1.5 days predeployment training method comparing it with the routine training. The evaluation was carried out for a matched random sample of N = 67 soldiers deployed in Afghanistan (International Security Assistance Force). Data collection took place before and after the prevention program and 4 to 6 weeks after deployment, which included mental state, post‐traumatic stress disorder (PTSD) symptoms, knowledge of and attitude toward PTSD, and deployment‐specific stressors. CHARLY has been significantly superior to the control group in terms of psychoeducation and attitude change. As to the mental state, both groups showed a significant increase in stress after deployment with significant lower increase in CHARLY. For PTSD‐specific symptoms, CHARLY achieved a significant superiority. The fact that PTSD‐specific scales showed significant differences at the end of deployment substantiates the validity of a specifically preventive effect of CHARLY. The study results tentatively indicate that highly standardized, computer‐based primary prevention of mental disorders in soldiers on deployment might be superior to other more personal and less standardized forms of prevention."," Wesemann, U;  Kowalski, JT;  Jacobsen, T;  Beudt, S;  Jacobs, H;  Fehr, J;  Büchler, J;  Zimmermann, PL",2016.0, 10.7205/MILMED-D-15-00100,0,0,
1210," Economic evaluation of a manual-based, multimodal cognitive behavioural therapy for school avoiding children with psychiatric disorder"," Objective: Untreated school refusal increases the risk of a premature discontinuation of the educational career. The aim of this study is the economic evaluation of a manual‐based treatment for school refusal in comparison to the standard treatment. Method: Within the cost‐minimisation analysis, resource use is measured retrospectively for six months using the CSSRI questionnaire. Unit costs for most health care services are derived from published standard prices. Costs are calculated from the societal perspective based on prices compiled in 2011. The cost comparison during the one‐year intervention period applies a difference in differences Approach. Results: The most common diagnoses among the 112 participants are phobic and emotional disorders. The average cost per patient during the intervention period amounts to 7197 € (95 %‐CI: 4746 € – 10 079 €) for the manual group and 9294 € (95 %‐CI: 6313 € – 12 878 €) for the control group. The difference in adjusted costs of 1453 € in favour of the manual group is not statistically relevant. Conclusions: The manual‐based treatment is equivalent if not slightly advantageous compared to the standard treatment considering the clinical outcomes and cost of illness."," Weschenfelder, AK;  Reissner, V;  Knollmann, M;  Hebebrand, J;  Wasem, J;  Neumann, A",2018.0, 10.1024/1422-4917/a000501,0,0,
1211, A randomised crossover trial of minimising medical terminology in secondary care correspondence in patients with chronic health conditions: impact on understanding and patient reported outcomes," AIM: To determine whether minimising the use of medical terminology in medical correspondence improved patient understanding and anxiety/depression scores. METHODS: A single‚Äêcentre, non‚Äêblinded, randomised crossover design assessed health literacy, EQ‚Äê5D scores and the impact of the 'translated' letter on the doctor's professionalism, the patient's relationship with their general practitioner (GP) and their perceived impact on chronic disease management. Patients were crossed over between their 'translated' and original letter. RESULTS: Sixty patients were recruited. Use of a 'translated' letter reduced mean terms not understood from 7.78 to 1.76 (t(58) = 4.706, P < 0.001). Most patients (78.0%) preferred the 'translated' letter, with 69.5% patients perceiving an enhancement in their doctor's professionalism (z = 2.864, P = 0.004), 69.0% reporting a positive influence on relationship with their GP (z = 2.943, P = 0.003) and 79.7% reporting an increase in perceived ability to manage their chronic health condition with the 'translated' letter (z = 4.601, P < 0.001). There was no effect on EQ‚Äê5D depression/anxiety scores. CONCLUSION: Minimising the use of medical terminology in medical correspondence significantly improved patient understanding and perception of their ability to manage their chronic health condition. Although there was no impact on EQ‚Äê5D depression/anxiety scores, overwhelming patient preference for the 'translated' letter indicates a need for minimisation of medical terminology in medical correspondence for patients with chronic health conditions. BACKGROUND: There is little existing research on the role that secondary care letters have in ensuring patient understanding of chronic health conditions."," Wernick, M;  Hale, P;  Anticich, N;  Busch, S;  Merriman, L;  King, B;  Pegg, T",2016.0, 10.1111/imj.13062,0,0,
1212," Anterior pallidal deep brain stimulation for Tourette's syndrome: a randomised, double-blind, controlled trial"," BACKGROUND: Deep brain stimulation (DBS) has been proposed to treat patients with severe Tourette's syndrome, and open‐label trials and two small double‐blind trials have tested DBS of the posterior and the anterior internal globus pallidus (aGPi). We aimed to specifically assess the efficacy of aGPi DBS for severe Tourette's syndrome. METHODS: In this randomised, double‐blind, controlled trial, we recruited patients aged 18‐60 years with severe and medically refractory Tourette's syndrome from eight hospitals specialised in movement disorders in France. Enrolled patients received surgery to implant bilateral electrodes for aGPi DBS; 3 months later they were randomly assigned (1:1 ratio with a block size of eight; computer‐generated pairwise randomisation according to order of enrolment) to receive either active or sham stimulation for the subsequent 3 months in a double‐blind fashion. All patients then received open‐label active stimulation for the subsequent 6 months. Patients and clinicians assessing outcomes were masked to treatment allocation; an unmasked clinician was responsible for stimulation parameter programming, with intensity set below the side‐effect threshold. The primary endpoint was difference in Yale Global Tic Severity Scale (YGTSS) score between the beginning and end of the 3 month double‐blind period, as assessed with a Mann‐Whitney‐Wilcoxon test in all randomly allocated patients who received active or sham stimulation during the double‐blind period. We assessed safety in all patients who were enrolled and received surgery for aGPi DBS. This trial is registered with ClinicalTrials.gov, number NCT00478842. FINDINGS: Between Dec 6, 2007, and Dec 13, 2012, we enrolled 19 patients. We randomly assigned 17 (89%) patients, with 16 completing blinded assessments (seven [44%] in the active stimulation group and nine [56%] in the sham stimulation group). We noted no significant difference in YGTSS score change between the beginning and the end of the 3 month double‐blind period between groups (active group median YGTSS score 68·5 [IQR 34·0 to 83·5] at the beginning and 62·5 [51·5 to 72·0] at the end, median change 1·1% [IQR ‐23·9 to 38·1]; sham group 73·0 [69·0 to 79·0] and 79·0 [59·0 to 81·5], median change 0·0% [‐10·6 to 4·8]; p=0·39). 15 serious adverse events (three in patients who withdrew before stimulation and six each in the active and sham stimulation groups) occurred in 13 patients (three who withdrew before randomisation, four in the active group, and six in the sham group), with infections in DBS hardware in four patients (two who withdrew before randomisation, one in the sham stimulation group, and one in the active stimulation group). Other serious adverse events included one electrode misplacement (active stimulation group), one episode of depressive signs (active stimulation group), and three episodes of increased tic severity and anxiety (two in the sham stimulation group and one in the active stimulation group). INTERPRETATION: 3 months of aGPi DBS is insufficient to decrease tic severity for patients with Tourette's syndrome. Future research is needed to investigate the efficacy of aGPi DBS for patients over longer periods with optimal stimulation parameters and to identify potential predictors of the therapeutic response. FUNDING: French Ministry of Health."," Welter, ML;  Houeto, JL;  Thobois, S;  Bataille, B;  Guenot, M;  Worbe, Y;  Hartmann, A;  Czernecki, V;  Bardinet, E;  Yelnik, J;  et al.",2017.0, 10.1016/S1474-4422(17)30160-6,0,0,
1213,Hip joint biomechanics in those with and without post-traumatic knee osteoarthritis after anterior cruciate ligament injury.,"Anterior cruciate ligament injury results in altered kinematics and kinetics in the knee and hip joints that persist despite surgical reconstruction and rehabilitation. Abnormal movement patterns and a history of osteoarthritis are risk factors for articular cartilage degeneration in additional joints. The purpose of this study was to determine if hip joint biomechanics early after anterior cruciate ligament injury and reconstruction differ between patients with and without post-traumatic knee osteoarthritis 5years after reconstruction. The study's rationale was that individuals who develop knee osteoarthritis after anterior cruciate ligament injury may also demonstrate large alterations in hip joint biomechanics. Nineteen athletes with anterior cruciate ligament injury completed standard gait analysis before (baseline) and after (post-training) extended pre-operative rehabilitation and at 6months, 1year, and 2years after reconstruction. Weightbearing knee radiographs were completed 5years after reconstruction to identify medial compartment osteoarthritis. Five of 19 patients had knee osteoarthritis at 5years after anterior cruciate ligament reconstruction. Patients with knee osteoarthritis at 5years walked with smaller sagittal plane hip angles (P: 0.043) and lower sagittal (P: 0.021) and frontal plane (P: 0.042) external hip moments in the injured limb before and after reconstruction compared to those without knee osteoarthritis. The current findings suggest hip joint biomechanics may be altered in patients who develop post-traumatic knee osteoarthritis. Further study is needed to confirm whether the risk of non-traumatic hip pathology is increased after anterior cruciate ligament injury and if hip joint biomechanics influence its development.",Wellsandt E.; Zeni JA.; Axe MJ.; Snyder-Mackler L.,2017.0,10.1016/j.clinbiomech.2017.10.001,0,0,
1214," Does Employment-Related Resilience Affect the Relationship between Childhood Adversity, Community Violence, and Depression?"," Depression is a barrier to employment among low‚Äêincome caregivers receiving Temporary Assistance for Needy Families (TANF), and adverse childhood experiences (ACEs) and exposure to community violence (ECV) are often associated with depression. Using baseline data of 103 TANF caregivers of young children of the Building Wealth and Health Network Randomized Controlled Trial Pilot, this study investigated associations of two forms of employment‚Äêrelated resilience‚Äêself‚Äêefficacy and employment hope‚Äêwith exposure to adversity/violence and depression, measured by the Center for Epidemiologic Studies Depression (CES‚ÄêD) short form. Using contingency table analysis and regression analysis, we identified associations between ACEs and depression [OR=1.70 (1.25‚Äê2.32), p=0.0008] and having high levels of ECV with a 6.9‚Äêfold increased risk for depression when compared with those without ECV [OR=6.86 (1.43‚Äê33.01), p=0.02]. While self‚Äêefficacy and employment hope were significantly associated with depression, neither resilience factor impacted the association of ACE level and depression, whereas self‚Äêefficacy and employment hope modestly reduced the associations between ECV and depression, 13 and 16%, respectively. Results suggest that self‚Äêefficacy and employment hope may not have an impact on the strong associations between adversity, violence, and depression."," Welles, SL;  Patel, F;  Chilton, M",2017.0, 10.1007/s11524-016-0117-y,0,0,
1215," When the torch is passed, does the flame still burn? Testing a ""train the supervisor"" model for the Child STEPs treatment program"," OBJECTIVE: We assessed sustainability of an empirically supported, transdiagnostic youth psychotherapy program when therapist supervision was shifted from external experts to internal clinic staff. METHOD: One hundred sixty‚Äêeight youths, aged 6‚Äê15 years, 59.5% male, 85.1% Caucasian, were treated for anxiety, depression, traumatic stress, or conduct problems by clinicians employed in community mental health clinics. In Phase 1 (2.7 years), 1 group of clinicians, the Sustain group, received training in Child STEPs (a modular transdiagnostic treatment + weekly feedback on youth response) and treated clinic‚Äêreferred youths, guided by weekly supervision from external STEPs experts. In Phase 2 (2.9 years), Sustain clinicians treated additional youths but with supervision by clinic staff who had been trained to supervise STEPs. Also in Phase 2, a new group, External Supervision clinicians, received training and supervision from external STEPs experts and treated referred youths. Phase 2 youths were randomized to Sustain or External Supervision clinicians. Groups were compared on 3 therapist fidelity measures and 14 clinical outcome measures. RESULTS: Sustain clinicians maintained their previous levels of fidelity and youth outcomes after switching from external to internal supervision; and in Phase 2, the Sustain and External Supervision groups also did not differ on fidelity or youth outcomes. Whereas all 34 group comparisons were nonsignificant, trends with the largest effect sizes showed better clinical outcomes for internal than external supervision. CONCLUSIONS: Implementation of empirically supported transdiagnostic treatment may be sustained when supervision is transferred from external experts to trained clinic staff, potentially enhancing cost‚Äêeffectiveness and staying power in clinical practice. (PsycINFO Database Record"," Weisz, JR;  Ugueto, AM;  Herren, J;  Marchette, LK;  Bearman, SK;  Lee, EH;  Thomassin, K;  Alleyne, A;  Cheron, DM;  Tweed, JL;  et al.",2018.0, 10.1037/ccp0000331,0,0,
1216,Identifying feigning in trauma-exposed African immigrants.,"As the populations of Western countries become more diverse, the risk of inaccurately generalizing knowledge from majority ethnic groups to minority groups is increasing. However, few of the measures used in forensic assessment are based on normative samples that represent the considerable diversity present in forensic settings. This study examined 4 commonly used measures of feigning: the Dot Counting Test (DCT; Boone, Lu, & Herzberg, 2002); the Miller Forensic Assessment of Symptoms (M-FAST; Miller, 2001); the Test of Memory Malingering (TOMM; Tombaugh, 1996); and a validity scale (atypical responding; ATR) on the Trauma Symptom Inventory-2 (Briere, 2011). The study compared performance on these measures of feigning among 3 groups of African immigrants: honest participants with and without posttraumatic stress disorder, and participants asked to feign distress-related symptoms. The data were used to assess the classification accuracy of each measure and the effect of demographic and cultural variables. Three of the 4 measures (M-FAST, TOMM, and ATR) significantly differentiated between participants asked to respond honestly and those asked to feign, although no measure produced higher than moderate classification accuracy. The M-FAST and DCT produced high false positive rates in the honest groups, ranging from 33% to 63%. Surprisingly, demographic and cultural variables were not significantly associated with test scores. The results emphasize the need for future related research. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Weiss, Rebecca A; Rosenfeld, Barry",2017.0,http://dx.doi.org/10.1037/pas0000381,0,0,
1217,Predicting adherence to internet-delivered psychotherapy for symptoms of depression and anxiety after myocardial infarction: Machine learning insights from the U-CARE Heart Randomized Controlled Trial.,"Background: Low adherence to recommended treatments is a multifactorial problem for patients in rehabilitation after myocardial infarction (MI). In a nationwide trial of internet-delivered cognitive behavior therapy (iCBT) for the high-risk subgroup of patients with MI also reporting symptoms of anxiety, depression, or both (MI-ANXDEP), adherence was low. Since low adherence to psychotherapy leads to a waste of therapeutic resources and risky treatment abortion in MI-ANXDEP patients, identifying early predictors for adherence is potentially valuable for effective targeted care. Objectives: The goal of the research was to use supervised machine learning to investigate both established and novel predictors for iCBT adherence in MI-ANXDEP patients. Methods: Data were from 90 MI-ANXDEP patients recruited from 25 hospitals in Sweden and randomized to treatment in the iCBT trial Uppsala University Psychosocial Care Programme (U-CARE) Heart study. Time point of prediction was at completion of the first homework assignment. Adherence was defined as having completed more than 2 homework assignments within the 14-week treatment period. A supervised machine learning procedure was applied to identify the most potent predictors for adherence available at the first treatment session from a range of demographic, clinical, psychometric, and linguistic predictors. The internal binary classifier was a random forest model within a 3 x 10-fold cross-validated recursive feature elimination (RFE) resampling which selected the final predictor subset that best differentiated adherers versus nonadherers. Results: Patient mean age was 58.4 years (SD 9.4), 62% (56/90) were men, and 48% (43/90) were adherent. Out of the underlying constructs the linguistic predictors tap into. Whether these findings replicate for other interventions outside of Sweden, in larger samples, and for patients with other conditions who are offered iCBT should also be investigated. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Wallert, John; Gustafson, Emelie; Held, Claes; Madison, Guy; Norlund, Fredrika; von Essen, Louise; Olsson, Erik Martin Gustaf",2018.0,,0,0,
1218," The role of day-to-day emotions, sleep, and social interactions in pediatric anxiety treatment"," Do day‚Äêto‚Äêday emotions, social interactions, and sleep play a role in determining which anxious youth respond to supportive child‚Äêcentered therapy (CCT) versus cognitive behavioral therapy (CBT)? We explored whether measures of day‚Äêto‚Äêday functioning (captured through ecological momentary assessment, sleep diary, and actigraphy), along with clinical and demographic measures, were predictors or moderators of treatment outcome in 114 anxious youth randomized to CCT or CBT. We statistically combined individual moderators into a single, optimal composite moderator to characterize subgroups for which CCT or CBT may be preferable. The strongest predictors of better outcome included: (a) experiencing higher positive affect when with one's mother and (b) fewer self‚Äêreported problems with sleep duration. The composite moderator indicated that youth for whom CBT was indicated had: (a) more day‚Äêto‚Äêday sleep problems related to sleep quality, efficiency, and waking, (b) day‚Äêto‚Äêday negative events related to interpersonal concerns, (c) more DSM‚ÄêIV anxiety diagnoses, and (d) college‚Äêeducated parents. These findings illustrate the value of both day‚Äêto‚Äêday functioning characteristics and more traditional sociodemographic and clinical characteristics in identifying optimal anxiety treatment assignment. Future studies will need to enhance the practicality of real‚Äêtime measures for use in clinical decision making and evaluate additional anxiety treatments."," Wallace, ML;  McMakin, DL;  Tan, PZ;  Rosen, D;  Forbes, EE;  Ladouceur, CD;  Ryan, ND;  Siegle, GJ;  Dahl, RE;  Kendall, PC;  et al.",2017.0, 10.1016/j.brat.2016.12.012,0,0,
1219,Sleep assessment in a randomized trial of hyperbaric oxygen in U.S. service members with post concussive mild traumatic brain injury compared to normal controls.,"Study objective: In this exploratory, double-blind, longitudinal sham-controlled trial of hyperbaric oxygen (HBO2) for military personnel with post concussive mild traumatic brain injury (mTBI), self-reports and objective measures of sleep-wake disturbances were assessed and compared to normals. Methods: Self-reports consisting of Pittsburg Sleep Quality Index (PSQI), sleep diary, screening for obstructive sleep apnea (OSA) risk, restless legs syndrome (RLS), cataplexy, and objective actigraphic measures of sleep-wake were obtained on 71 military personnel with mTBI [baseline, 13 weeks and six months post-randomization (post-intervention)], of which 35 met post-traumatic stress disorder (PTSD) criteria, and 75 healthy volunteers (baseline). Baseline between-group and follow-up changes from baseline overall and within subgroups were evaluated. Mild TBI was defined as consisting of head injury associated loss of consciousness (< 24 h), post-traumatic amnesia, and neurological deficits. Results: Sleep quality by self-reports was markedly degraded in the mTBI group at baseline compared to a normative cohort; insomnia 87.3 versus 2.8%, OSA risk 70% versus 1.3%, RLS 32.4% versus and 2.7%. (all p-values < 0.001), but actigraphy measures did not differentiate between groups. HBO2 compared to sham treatment improved self-reports of PSQI sleep measures, reports (five out of eight at 13-weeks and two out of eight at six-months). However, other sleep-wake measures were not different. Conclusions: Perceived sleep quality was markedly disrupted in mTBI military personnel and sleep-wake disturbances were prevalent compared to a normative cohort. HBO2 relative to sham improved some measures of sleep quality on the PSQI, but other measures of sleep were not significantly different. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Walker, James M; Mulatya, Caroline; Hebert, Donald; Wilson, Steffanie H; Lindblad, Anne S; Weaver, Lindell K",2018.0,http://dx.doi.org/10.1016/j.sleep.2018.06.006,0,0,
1220, Acute delivery of attention bias modification training (ABMT) moderates the association between combat exposure and posttraumatic symptoms: a feasibility study," Combat deployment enhances risk for posttraumatic stress symptoms. We assessed whether attention bias modification training (ABMT), delivered immediately prior to combat, attenuates the association between combat exposure and stress‚Äêrelated symptoms. 99 male soldiers preparing for combat were randomized to receive either an ABMT condition designed to enhance vigilance toward threat or an attention control training (ACT) designed to balance attention deployment between neutral and threat words. Frequency of combat events, and symptoms of PTSD and depression were measured prior to deployment and at a two‚Äêmonth follow‚Äêup. Regression analysis revealed that combat exposure uniquely accounted for 4.6% of the variance in stress‚Äêrelated symptoms change from baseline to follow‚Äêup and that the interaction between ABMT and combat exposure accounted for additional 5.4% of the variance. Follow‚Äêup analyses demonstrate that ABMT moderated the association between combat exposure and symptoms. ABMT appear to have potential as a preventative intervention to reduce risk for stress‚Äêrelated symptoms associated with combat exposure."," Wald, I;  Bitton, S;  Levi, O;  Zusmanovich, S;  Fruchter, E;  Ginat, K;  Charney, DS;  Pine, DS;  Bar-Haim, Y",2017.0, 10.1016/j.biopsycho.2016.01.005,0,0,
1221,Pilot study using Neurolinguistic Programming (NLP) in post-combat PTSD.,"Purpose: The purpose of this paper is to determine if neurolinguistic programming (NLP) tools and techniques were effective in alleviating the symptoms of posttraumatic stress disorder (PTSD) in clients from the Military and Emergency Services. Design/methodology/approach: This project ran at the ""Healing the Wounds"" charity in Bridgend. All clients were opportunistic, having self-referred to a charity specifically set up to support Veterans from the Armed Forces. In total, 29 clients from an initial cohort of 106 clients provided pre and post data using Depression Anxiety Stress Scale (DASS) and the NLP Wheel of Life scale. Interventions included a range of NLP techniques, addressing self-reported symptoms. Findings: Differences between DASS scores before and after treatment are very highly significant. t-test analysis infers that these results are indicative of the overall response from the clients in this study. Research limitations/implications: Limitations of the study include: client group; significant levels of incomplete data for the total study group; therapist effect and therapist training; treatment methodology. Originality/value: Data suggest that NLP has potential as a therapeutic tool in the treatment of symptoms of anxiety and depression associated with a self-report of PTSD. An observation is proposed that these candidates experience an improvement in their emotional state when NLP is used which is statistically significant (p < 0.001) both for overall DASS score averages and also for each of the three DASS categories (Depression, Anxiety and Stress). Stress was the highest scoring category prior to treatment for these clients; the reduction in their stress symptoms contributed most substantially to the overall reduction in average DASS score, indicating an improvement in their emotional state. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Wake, Lisa; Leighton, Margaret",2014.0,http://dx.doi.org/10.1108/MHRJ-08-2014-0026,0,0,
1222,A combined marker of early non-improvement and the occurrence of melancholic features improve the treatment prediction in patients with Major Depressive Disorders.,"Background: Early Improvement of depressive symptoms within two weeks of antidepressant treatment is a highly sensitive but less specific predictor of later treatment outcome. The aim of this study was to identify clinical features at treatment initiation which are associated with early improvement and non-improvement as well as to identify variables predicting non-remission in patients showing an early improvement. Methods: 889 patients with a major depressive episode according to DSM-IV who had participated in an antidepressant treatment trial served as study sample. Clinical predictors (demographic variables, psychopathology, comorbid disorders) were analysed in 698 (79%) early improver (Hamilton Depression Rating Scale reduction > 20% after 14 days of treatment) compared to 191 (21%) non-improver. Furthermore, clinical predictors for later remission and non-remission were analysed in the 698 patients showing an early improvement. Results: Patients with more severe depression and suicidality were more likely to become non-improver, and also non-remitter after 8 weeks of treatment in case of early improvement. Early improver with melancholic, anxious or atypical depression as well as with comorbid social phobia or avoidant personality disorder had an increased risk for non-remission at study end. The combined marker of early non-improvement and the occurrence of melancholic features increased the specificity of treatment prediction from 30% to 90%. Limitations: Comorbid disorders were only assessed at baseline. Conclusions: Patients with early non-improvement and melancholic features at treatment initiation have a particularly high risk of later non-remission. This group of patients should be considered more attention in treatment decisions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Wagner, Stefanie; Tadic, Andre; Roll, Sibylle C; Engel, Alice; Dreimuller, Nadine; Engelmann, Jan; Lieb, Klaus",2017.0,http://dx.doi.org/10.1016/j.jad.2017.06.042,0,0,
1223,Therapeutic effect of increased openness: Investigating mechanism of action in MDMA-assisted psychotherapy.,"A growing body of research suggests that traumatic events lead to persisting personality change characterized by increased neuroticism. Relevantly, enduring improvements in Post-Traumatic Stress Disorder (PTSD) symptoms have been found in response to 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. There is evidence that lasting changes in the personality feature of ""openness"" occur in response to hallucinogens, and that this may potentially act as a therapeutic mechanism of change. The present study investigated whether heightened Openness and decreased Neuroticism served as a mechanism of change within a randomized trial of MDMA-assisted psychotherapy for chronic, treatment-resistant PTSD. The Clinician-Administered PTSD Scale (CAPS) Global Scores and NEO PI-R Personality Inventory (NEO) Openness and Neuroticism Scales served as outcome measures. Results indicated that changes in Openness but not Neuroticism played a moderating role in the relationship between reduced PTSD symptoms and MDMA treatment. Following MDMA-assisted psychotherapy, increased Openness and decreased Neuroticism when comparing baseline personality traits with long-term follow-up traits also were found. These preliminary findings suggest that the effect of MDMA-assisted psychotherapy extends beyond specific PTSD symptomatology and fundamentally alters personality structure, resulting in long-term persisting personality change. Results are discussed in terms of possible mechanisms of psychotherapeutic change.",Wagner MT.; Mithoefer MC.; Mithoefer AT.; MacAulay RK.; Jerome L.; Yazar-Klosinski B.; Doblin R.,2017.0,10.1177/0269881117711712,0,0,
1224,The impact of childhood sexual abuse on the outcome of intensive trauma-focused treatment for PTSD.,"Background: It is assumed that PTSD patients with a history of childhood sexual abuse benefit less from trauma-focused treatment than those without such a history. Objective: To test whether the presence of a history of childhood sexual abuse has a negative effect on the outcome of intensive trauma-focused PTSD treatment. Method: PTSD patients, 83% of whom suffered from severe PTSD, took part in a therapy programme consisting of 2 x 4 consecutive days of Prolonged Exposure (PE) and EMDR therapy (eight of each). In between sessions, patients participated in sport activities and psycho-education sessions. No prior stabilization phase was implemented. PTSD symptom scores of clinician-administered and self-administered measures were analysed using the data of 165 consecutive patients. Pre-post differences were compared between four trauma groups; patients with a history of childhood sexual abuse before age 12 (CSA), adolescent sexual abuse (ASA; i.e. sexual abuse between 12 and 18 years of age), sexual abuse (SA) at age 18 and over, or no history of sexual abuse (NSA). Results: Large effect sizes were achieved for PTSD symptom reduction for all trauma groups (Cohen's d = 1.52-2.09). For the Clinical Administered PTSD Scale (CAPS) and the Impact of Event Scale (IES), no differences in treatment outcome were found between the trauma (age) groups. For the PTSD Symptom Scale Self Report (PSS-SR), there were no differences except for one small effect between CSA and NSA. Conclusions: The results do not support the hypothesis that the presence of a history of childhood sexual abuse has a detrimental impact on the outcome of first-line (intensive) trauma-focused treatments for PTSD. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Abstract (Chinese) :PTSD :PTSD:PTSD ,80%PTSD-2X4(PE)EMDR ,165PTSD,:12(CSA);(ASA,1218);18;(NSA): PTSD (Cohen's d = 1.52-2.09)<>(CAPS ) <<>>(IES) ()<>(PSS-SR), CSA NSA:,-() PTSD  (PsycINFO Database Record (c) 2018 APA, all rights reserved) Abstract (Spanish) Planteamiento: Se asume que los pacientes con TEPT con una historia de abuso sexual infantil se benefician menos del tratamiento centrado en el trauma que aquellos sin dicha historia. Objetivo: Probar si la presencia de una historia de abuso sexual en la infancia tiene un efecto negativo en el resultado del tratamiento intensivo centrado en el trauma para el TEPT. Metodos: Pacientes con TEPT, 83% de los cuales sufrian de TEPT grave, participaron en un programa de terapia que consta de 2 x 4 dias consecutivos de exposicion prolongada (EP) y terapia EMDR (ocho de cada). Entre sesiones, los pacientes participaron en actividades deportivas y sesiones de psicoeducacion. No se implemento una fase de estabilizacion previa. Las puntuaciones de sintomas de TEPT de las medidas administradas por el clinico y autoadministradas se analizaron usando los datos de 165 pacientes consecutivos. Las diferencias previas se compararon entre cuatro grupos de trauma: pacientes con antecedentes de abuso sexual infantil antes de los 12 anos (ASI), abuso sexual adolescente (ASA, es decir, abuso sexual entre 12 y 18 anos), abuso sexual (AS) a los 18 anos o mas, o sin antecedentes de abuso sexual abuso (NAS). Resultados: Se lograron grandes tamanos de efecto en la reduccion de sintomas de TEPT para todos los grupos de trauma (ds de Cohen = 1,52-2,09). Para la Escala de TEPT Clinica Administrada por el Clinico (CAPS, por sus siglas en ingles) y la Escala de Impacto del Evento (IES, por sus siglas en ingles), no se encontraron diferencias en el resultado del tratamiento entre los grupos de trauma (edad). Para la Escala de autoinforme de sintomas de TEPT (PSS-SR, por sus siglas en ingles), no hubo diferencias, excepto por un pequeno efecto entre ASI y NAS. Conclusion: Los resultados no respaldan la hipotesis de que la presencia de un historial de abuso sexual infantil tenga un impacto perjudicial en el resultado de los tratamientos de primera linea (intensivos) centrados en el trauma para el TEPT. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Wagenmans, Anouk; Van Minnen, Agnes; Sleijpen, Marieke; De Jongh, Ad",2018.0,http://dx.doi.org/10.1080/20008198.2018.1430962,0,0,
1225,"Targeting fear of spiders with control-, acceptance-, and information-based approaches.","The relative impact of control-, acceptance-, and information-based approaches in targeting a midlevel fear of spiders among college students was evaluated. Participants listened to a brief protocol presenting one of the three approaches before completing the Perceived-Threat Behavioral Approach Test (PT-BAT; Cochrane, Barnes-Holmes, & Barnes-Holmes, 2008). During the PT-BAT, participants placed their hands in a series of opaque jars that they were led to believe were increasingly likely to contain a spider. Participants in the acceptance-based condition progressed the farthest and were more willing to repeat the procedure a week later, despite not differing from their counterparts in levels of subjective distress. Implications for the relative efficacy of acceptance- versus control-based approaches in treatment of specific phobia, their possible differential mechanisms of action, and the use of the PT-BAT as a dependent measure in further research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wagener, Alexandra L; Zettle, Robert D",2011.0,,0,0,
1226, Randomized Clinical Trial of Online Parent Training for Behavior Problems After Early Brain Injury," OBJECTIVE: To evaluate the effectiveness of Internet‚Äêbased Interacting Together Everyday: Recovery After Childhood TBI (I‚ÄêInTERACT) versus abbreviated parent training (Express) or access to online resources (internet resources comparison [IRC]) in improving parenting skills and decreasing behavior problems after early traumatic brain injury (TBI). METHOD: In this randomized, controlled, clinical trial, 113 children 3 to 9 years old previously hospitalized for moderate to severe TBI were randomly assigned to receive Express (n = 36), I‚ÄêInTERACT (n = 39), or IRC (n = 38). Express included 7 online parent skills sessions, and I‚ÄêInTERACT delivered 10 to 14 sessions addressing parenting skills, TBI education, stress, and anger management. The 2 interventions coupled online modules with therapist coaching through a Health Insurance Portability and Accountability Act‚Äêcompliant Skype link. The IRC group received access to online TBI and parent skills resources. Co‚Äêprimary outcomes were blinded ratings of parenting skills and parent report of behavior problems and problem intensity on the Eyberg Child Behavior Inventory (ECBI). Outcomes were assessed before treatment and 3 and 6 months after treatment, with the latter constituting the primary endpoint. RESULTS: The Express and I‚ÄêInTERACT groups displayed higher levels of positive parenting at follow‚Äêup. Only the I‚ÄêInTERACT group had lower levels of negative parenting at 6 months. The Express group had lower ECBI intensity scores than the IRC group. Baseline symptom levels moderated improvements; children in the Express and I‚ÄêInTERACT groups with higher baseline symptoms demonstrated greater improvements than those in the IRC group. Changes in parenting skills mediated improvements in behavior in those with higher baseline symptoms. CONCLUSION: Brief online parent skills training can effectively decrease behavior problems after early TBI in children with existing behavioral symptoms. Clinical trial registration information‚ÄêInternet‚Äêbased Interacting Together Everyday, Recovery After Childhood TBI (I‚ÄêInTERACT)‚ÄêRRTC; http://clinicaltrials.gov/; NCT01214694."," Wade, SL;  Cassedy, AE;  Shultz, EL;  Zang, H;  Zhang, N;  Kirkwood, MW;  Stancin, T;  Yeates, KO;  Taylor, HG",2017.0, 10.1016/j.jaac.2017.09.413,0,0,
1227, Nature based solution for improving mental health and well-being in urban areas," The general disproportion of urban development and the socio‚Äêeconomical crisis in Serbia, followed by a number of acute and chronic stressors, as well as years of accumulated trauma, prevented the parallel physical, mental and social adaptation of society as a whole. These trends certainly affected the quality of mental health and well‚Äêbeing, particularly on the vulnerable urban population, increasing the absolute number of people with depression, stress and psychosomatic disorders. This study was pioneering in Serbia and was conducted in collaboration with the Faculty of Forestry, the Institute of Mental Health and the Botanical Garden in Belgrade, in order to understand how spending time and performing horticulture therapy in specially designed urban green environments can improve mental health. The participants were psychiatric patients (n=30), users of the day hospital of the Institute who were randomly selected for the study, and the control group, assessed for depression, anxiety and stress before and after the intervention, using a DASS21 scale. During the intervention period the study group stayed in the Botanical garden and participated in a special programme of horticulture therapy. In order to exclude any possible ""special treatment'' or ''placebo effect"", the control group was included in occupational art therapy while it continued to receive conventional therapy. The test results indicated that nature based therapy had a positive influence on the mental health and well‚Äêbeing of the participants. Furthermore, the difference in the test results of the subscale stress before and after the intervention for the study group was F1.28 = 5.442 and p<;.05. According to socio demographic and clinical variables, the interesting trend was recorded on the subscale of anxiety showing that the male participants in the study group were more anxious, with the most pronounced inflection noted on this scale after treatment. The results of this study have shown that recuperation from stress, depression and anxiety was possible and much more complete when participants were involved in horticulture therapy as a nature‚Äêbased solution for improving mental health."," Vujcic, M;  Tomicevic-Dubljevic, J;  Grbic, M;  Lecic-Tosevski, D;  Vukovic, O;  Toskovic, O",2017.0, 10.1016/j.envres.2017.06.030,0,0,
1228,Conceptualization and validation of questionnaires that could be used as surrogate endpoints in clinical trials in cocaine dependence (craving and psychotic symptoms),"Cocaine dependence is a growing public health concern in France. There is no pharmacological treatment validated for cocaine dependence treatment. Clinical trials require that validated methods are used to ascertain the efficacy of new drugs that are tested. There was no validated tool available to conduct pharmacological trials for cocaine dependence in French. We conceptualized and validated questionnaires that could be used as surrogate endpoints in pharmacological trials for cocaine dependence. We choose to work on two types of surrogate variables: craving and psychotic symptoms.Craving is the overwhelming desire to use a drug. It is a psychological construct that can be used as a biomarker of dependence. We designed a craving questionnaire in French named OCCS (Obsessive Compulsive Cocaïne Scale) after the work of several research teams working in the field of alcohol dependence. We validated this questionnaire in a sample of 119 cocaine addicts in a clinical setting (Vorspan et al 2012). We could demonstrate that the scores obtained on this questionnaire were correlated to those obtain on a visual analogue scale of craving. We could also demonstrate that the scores were higher in cocaine dependent that in cocaine abusing subjects. Lastly, we could demonstrate that the scores were time-sensitive. We used this questionnaire OCCS in an open-label trial of aripiprazole in 10 non-schizophrenic crack dependent patients (Vorspan et al 2008). We propose that this questionnaire could be used in clinical trials assessing the efficacy of various therapeutic interventions in cocaine dependent subjects, pharmacological treatments, but also deep brain stimulation (Vorspan et al 2011) and psychological interventions. Psychotic symptoms are composed of various phenomenons (hallucinations, delusions and behavioural modifications). We choose to adapt in French a validated questionnaire that assesses psychotic symptoms occurring between a few minutes to a few hours after cocaine intake: the SAPS-CIP (Scale for Assessment of Positive Symptoms for Cocaine-Induced Psychosis). We could demonstrate that those symptoms are frequent but of variable intensity in a sample of French cocaine addicts in a clinical setting (Vorspan et al, soumis). We could also demonstrate that those symptoms are change sensitive (Vorspan et al 2011). We hypothesized that there is a genetic vulnerability to cocaine-induced psychotic symptoms, and that being sensitive to the occurrence of psychotic symptoms could be a protective factor toward the development of cocaine dependence (Brousse et al 2010). The variability of cocaine-induced psychotic symptoms helps to conceptualize a pharmacogenetic model of drug dependence. We propose that those two questionnaires (OCCS for craving and SAPS-CIP for psychotic symptoms) could be used in clinical trial in cocaine dependent subjects. It seems very helpful indeed, knowing the clinical pattern of cocaine dependence, to design trails aimed at reducing or suppressing craving and psychotic symptoms. Reducing or suppressing craving could be a surrogate endpoint for cocaine abstinence. Reducing or suppressing cocaine-induced psychotic symptoms could reduce the morbidity and mortality associated with cocaine use.",Vorspan,2012.0,,0,0,
1229, Health Care Use Outcomes of an Integrated Hospital-to-Home Mother-Preterm Infant Intervention," OBJECTIVE: To compare health care use from initial hospital discharge through 6 weeks corrected age in two groups of mother‚Äêpreterm infant dyads: those who received an intervention, Hospital to Home: Optimizing Premature Infant's Environment (H‚ÄêHOPE), and an attention control group. DESIGN: Prospective randomized controlled trial. SETTING: Two community hospital NICUs. PARTICIPANTS: Mothers (n = 147) with social‚Äêenvironmental risk factors and their stable preterm infants. METHODS: Mother‚Äêinfant dyads were randomly assigned to the H‚ÄêHOPE or control group. When infants reached 6 weeks corrected age, information about health care visits since their hospital discharges was collected through an interview. RESULTS: Only half of all infants received all recommended well‚Äêchild visits. Infants in H‚ÄêHOPE were half as likely to have acute care episodes (illness visit to the clinic or emergency department or hospital readmission) as control infants (odds ratio [OR] = 0.46, 95% confidence interval [CI] [0.22, 0.95]). Infants of mothers with high trait anxiety were nearly 3 times more likely to have an acute care episode (OR = 2.78, 95% CI [1.05, 7.26]), and mothers who had low education levels (OR = .22, 95% CI [0.08, 0.60]) were less likely to have acute care episodes. There was a trend toward fewer acute care visits for infants whose mothers preferred an English interview (OR = .47, 95% CI [0.21, 1.06]). CONCLUSION: Findings emphasize the importance of reinforcing well‚Äêchild visits for vulnerable preterm infants. H‚ÄêHOPE, an integrated mother‚Äêinfant intervention, reduces acute care episodes (visits to the clinic or emergency department or hospital readmissions) for preterm infants."," Vonderheid, SC;  Rankin, K;  Norr, K;  Vasa, R;  Hill, S;  White-Traut, R",2016.0, 10.1016/j.jogn.2016.05.007,0,0,
1230," Randomized, open trial comparing a modified double-lumen needle follicular flushing system with a single-lumen aspiration needle in IVF patients with poor ovarian response"," Study question: Is a modified double‐lumen aspiration needle system with follicular flushing able to increase the mean oocyte yield by at least one in poor response IVF patients as compared to single‐lumen needle aspiration without flushing? Summary answer: Follicular flushing with the modified flushing system did not increase the number of oocytes, but increased the procedure duration. What is known already: Most studies on follicular flushing were performed with conventional double‐lumen needles in patients who were normal responders. Overall, these studies indicated no benefit of follicular flushing. Study design size, duration: Prospective, single‐centre, randomized, controlled, open, superiority trial comparing the 17 G Steiner‐Tan Needle® flushing system with a standard 17 G single‐lumen aspiration needle (Gynetics®); time frame February 2015‐March 2016. Participants/materials setting methods: Eighty IVF patients, 18‐45 years, BMI >18 kg/m2 to <35 kg/m2, presenting with ≤ five follicles >10 mm in both ovaries at the end of the follicular phase were randomized to either aspirating and flushing each follicle 3× with the Steiner‐Tan‐Needle® automated flushing system (n = 40) or a conventional single‐lumen needle aspiration (n = 40). Primary outcome was the number of cumulus‐oocyte‐complexes (COCs). Procedure duration, burden (Depression Anxiety and Stress Scale; DASS‐21) and post‐procedure pain were also assessed. Main results and the role of chance: Flushing was not superior with a mean (SD) number of COCs of 2.4 (2.0) and 3.1 (2.3) in the Steiner‐Tan Needle® and in the Gynectics® group, respectively (mean difference ‐0.7, 95% CI: 0.3 to ‐1.6; P = 0.27). Likewise no differences were observed in metaphase II  oocytes, two pronuclear oocytes, number of patients having an embryo transfer and DASS 21 scores. The procedure duration was significantly 2‐fold increased. Limitations reasons for caution: Testing for differences in the number of patients achieving an embryo transfer or differences in pregnancy rate would require a much larger sample size. Wider implications of the findings: The use of follicular flushing is unlikely to benefit the prognosis of patients with poor ovarian response. Study funding/competing interest(s): The Steiner‐Tan Needles® and the flushing system were provided for free by the manufacturer. K.v.H. has received personal fees from Finox and non‐financial support from Merck‐Serono; M.D. has received personal fees from Finox and non‐financial support from Merck‐Serono. A.S.‐M. has received personal fees and non‐financial support from M.D., Ferring, Merck‐Serono, Finox, TEVA. G.G. has received personal fees and non‐financial support from M.D., Ferring, Merck‐Serono, Finox, TEVA, IBSA, Glycotope, as well as personal fees from VitroLife, NMC Healthcare LLC, ReprodWissen LLC and ZIVA LLC. Trial registration number: NCT 02365350 (clinicaltrials.gov). Trial registration date: Sixth of February 2015. Date of first patient's enrolment: Ninth of February 2015."," von Horn, K;  Depenbusch, M;  Schultze-Mosgau, A;  Griesinger, G",2017.0, 10.1093/humrep/dex019,0,0,
1231,Liebowitz Social Anxiety Scale (LSAS): Optimal cut points for remission and response in a German sample.,"The Liebowitz Social Anxiety Scale (LSAS) is the most frequently used instrument to assess social anxiety disorder (SAD) in clinical research and practice. Both a self-reported (LSAS-SR) and a clinician-administered (LSAS-CA) version are available. The aim of the present study was to define optimal cut-off (OC) scores for remission and response to treatment for the LSAS in a German sample. Data of N = 311 patients with SAD were used who had completed psychotherapeutic treatment within a multicentre randomized controlled trial. Diagnosis of SAD and reduction in symptom severity according to the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, served as gold standard. OCs yielding the best balance between sensitivity and specificity were determined using receiver operating characteristics. The variability of the resulting OCs was estimated by nonparametric bootstrapping. Using diagnosis of SAD (present vs. absent) as a criterion, results for remission indicated cut-off values of 35 for the LSAS-SR and 30 for the LSAS-CA, with acceptable sensitivity (LSAS-SR: .83, LSAS-CA: .88) and specificity (LSAS-SR: .82, LSAS-CA: .87). For detection of response to treatment, assessed by a 1-point reduction in the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, rating, a reduction of 28% for the LSAS-SR and 29% for the LSAS-CA yielded the best balance between sensitivity (LSAS-SR: .75, LSAS-CA: .83) and specificity (LSAS-SR: .76, LSAS-CA: .80). To our knowledge, we are the first to define cut points for the LSAS in a German sample. Overall, the cut points for remission and response corroborate previously reported cut points, now building on a broader data basis.",von Glischinski M.; Willutzki U.; Stangier U.; Hiller W.; Hoyer J.; Leibing E.; Leichsenring F.; Hirschfeld G.,2018.0,10.1002/cpp.2179,0,0,
1232,Chronic Pain Among Homeless Persons with Mental Illness.,"Chronic pain is an important public health issue. However, characteristics and needs of marginalized populations have received limited attention. Studies on prevalence and correlates of chronic pain among homeless persons are lacking. We assessed chronic pain among homeless persons with mental illness in the At Home/Chez Soi study. Cross-sectional data from a randomized controlled trial on homelessness and mental health. Data collected between 2009 and 2013 in three Canadian cities. One thousand two hundred eighty-seven homeless persons with mental illness. Data on chronic pain and utilization of prescribed and nonprescribed interventions was assessed using a chronic pain screening instrument. Mental illness was diagnosed with the Mini-International Neuropsychiatric Interview. Forty-three percent reported moderate to severe chronic pain, interfering with general daily activities (80%), sleep (78%), and social interactions (61%). Multivariate analysis indicated that increasing age and diagnoses of major depressive disorder, mood disorder with psychotic features, panic disorder, and post-traumatic stress disorder (PTSD) were independent predictors of chronic pain. Chronic pain was further associated with increased suicidality. Among participants reporting chronic pain, 64% had sought medical treatment and 56% treated pain with prescribed drugs, while 38% used illicit drugs for pain relief. Chronic pain is very common among homeless persons with mental illness and affects activities of daily living. Clinicians treating this population should be aware of the common connections between chronic pain, depression, panic disorder, PTSD, and substance use. While the data indicate the contribution of chronic pain to complex treatment needs, they also indicate a clear treatment gap.",Vogel M.; Frank A.; Choi F.; Strehlau V.; Nikoo N.; Nikoo M.; Hwang SW.; Somers J.; Krausz MR.; Schütz CG.,2017.0,10.1093/pm/pnw324,0,0,
1233,Continuous passive motion and physical therapy (CPM) versus physical therapy (PT) versus delayed physical therapy (DPT) after surgical release for elbow contractures; a study protocol for a prospective randomized controlled trial.,"The elbow is prone to stiffness after trauma. To regain functional elbow motion several conservative- and surgical treatment options are available. Conservative treatment includes physical therapy, intra-articular injections with corticosteroids and a static progressive or dynamic splinting program. If conservative treatment fails, an operative release of the posttraumatic stiff elbow is often performed. The best Evidence-Based rehabilitation protocol for patients after an operative release is unknown to date and differs per surgeon, hospital and country. Options include early- or delayed motion supervised by a physical therapist, immediate continuous passive motion (CPM), (night) splinting and a static progressive or dynamic splinting program. The SET-Study (Stiff Elbow Trial) is a single-centre, prospective, randomized controlled trial. The primary objective of this study is to compare the active Range of Motion (ROM) (flexion arc and rotational arc) twelve months after surgery between three groups. The first group will receive in-hospital CPM in combination with early motion Physical Therapy (PT) supervised by a physical therapist, the second group will receive only in-hospital early motion PT supervised by a physical therapist and the third group will receive outpatient supervised PT from postoperative day seven till ten. Secondary outcome measures will be Patient Reported Outcome Measures (PROMs) including the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES), the quick Disabilities of Arm, Shoulder and Hand (qDASH) score, Visual Analogue pain Scale in rest and activity (VAS), Pain Catastrophizing Scale (PCS), the Short Form (SF)-36, the Centre for Epidemiological Studies Depression Scale Revised (CESD-R) and the Work Rehabilitation Questionnaire (WORQ) for the upper limb. A successful completion of this trial will provide evidence on the best rehabilitation protocol in order to (re)gain optimal motion after surgical release of the stiff elbow. The trial is registered at the Dutch Trial Register: NTR6067 , 31-8-2016.",Viveen J.; Doornberg JN.; Kodde IF.; Goossens P.; Koenraadt KLM.; The B.; Eygendaal D.,2017.0,10.1186/s12891-017-1854-0,0,0,
1234,Longitudinal methylation changes in the glucocorticoid receptor 1F region and psychopathology after deployment,"Background: The glucocorticoid receptor (GR) 1F region is involved in transcription and expression of the GR protein and influences hypothalamic-pituitary-adrenal (HPA)-axis activity. Several studies have investigated GR-1F DNA methylation in the context of traumatic stress and psychiatric disorders, such as major depressive disorder and posttraumatic stress disorder (PTSD). However, longitudinal studies examining GR-1F DNA methylation before and after exposure to traumatic stress are lacking. We therefore aimed to investigate prospective DNA methylation changes in the GR-1F region after military deployment and its relation to the emergence of psychopathology. Methods: Whole blood DNA methylation in the entire GR-1F region (52 CpGs) before and six months after deployment was quantified using pyrosequencing (N = 92). Methylation levels were linked to postdeployment mental health problems (Revised Symptom Checklist, SCL-90) and trauma exposure during deployment. Moreover, methylation was related to GR-1F expression, GR binding and genetic variation in the GR. Mean methylation, the number of methylated sites (methylation burden) and CpGs significantly associated with GR-1F expression (functional methylation) were examined. Results: Trauma exposure during deployment and the emergence of mental health problems were significantly related to an increased methylation burden (p < 0.05), which was associated with both decreased GR-1F expression (p < 0.01) and GR binding (p < 0.05). Moreover, development of mental health problems was significantly associated with increased methylation at functionally relevant CpGs (p < 0.001). Change in mean methylation was associated with a change in GR-1F expression (p < 0.05). Conclusions: This longitudinal study in a military cohort shows that GR-1F DNA methylation levels are related to trauma exposure during deployment and postdeployment mental health problems, particularly at functionally relevant sites. Our results provide further insight in transcriptional regulation of the glucocorticoid receptor gene, by demonstrating that GR-1F DNA methylation levels can vary over time and are related to stress vulnerability and the emergence of mental health problems.",Vinkers C.; Schur R.; Joels M.; Rutten B.; Geuze E.; De Nijs L.; Vermetten E.; Boks M.,2016.0,10.1016/j.psyneuen.2016.07.088,0,0,
1235,"Feasibility, acceptability and preliminary psychological benefits of mindfulness meditation training in a sample of men diagnosed with prostate cancer on active surveillance: results from a randomized controlled pilot trial.","In a pilot randomized controlled trial, examine the feasibility and preliminary efficacy of an 8-week, mindfulness training program (Mindfulness Based Stress Reduction) in a sample of men on active surveillance on important psychological outcomes including prostate cancer anxiety, uncertainty intolerance and posttraumatic growth. Men were randomized to either mindfulness (n = 24) or an attention control arm (n = 19) and completed self-reported measures of prostate cancer anxiety, uncertainty intolerance, global quality of life, mindfulness and posttraumatic growth at baseline, 8 weeks, 6 months and 12 months. Participants in the mindfulness arm demonstrated significant decreases in prostate cancer anxiety and uncertainty intolerance, and significant increases in mindfulness, global mental health and posttraumatic growth. Participants in the control condition also demonstrated significant increases in mindfulness over time. Longitudinal increases in posttraumatic growth were significantly larger in the mindfulness arm than they were in the control arm. While mindfulness training was found to be generally feasible and acceptable among participants who enrolled in the 8-week intervention as determined by completion rates and open-ended survey responses, the response rate between initial enrollment and the total number of men approached was lower than desired (47%). While larger sample sizes are necessary to examine the efficacy of mindfulness training on important psychological outcomes, in this pilot study posttraumatic growth was shown to significantly increase over time for men in the treatment group. Mindfulness training has the potential to help men cope more effectively with some of the stressors and uncertainties associated with active surveillance. Copyright © 2016 John Wiley & Sons, Ltd.",Victorson D.; Hankin V.; Burns J.; Weiland R.; Maletich C.; Sufrin N.; Schuette S.; Gutierrez B.; Brendler C.,2017.0,10.1002/pon.4135,0,0,
1236, The effects of Cognitive Bias Modification training and oxytocin administration on trust in maternal support: study protocol for a randomized controlled trial," BACKGROUND: Lack of trust in parental support is a transdiagnostic risk factor for the development of psychological problems throughout the lifespan. Research suggests that children's cognitive attachment representations and related information processing biases could be an important target for interventions aiming to build trust in the parent‚Äêchild relationship. A paradigm that can alter these biases and increase trust is that of Cognitive Bias Modification (CBM), during which a target processing bias is systematically trained. Trust‚Äêrelated CBM training effects could possibly be enhanced by oxytocin, a neuropeptide that has been proposed to play an important role in social information processing and social relationships. The present article describes the study protocol for a double‚Äêblind randomized controlled trial (RCT) aimed at testing the individual and combined effects of CBM training and oxytocin administration on trust in maternal support. METHODS/DESIGN: One hundred children (aged 8‚Äê12 years) are randomly assigned to one of four intervention conditions. Participants inhale a nasal spray that either contains oxytocin (OT) or a placebo. Additionally, they receive either a CBM training aimed at positively modifying trust‚Äêrelated information processing bias or a neutral placebo training aimed to have no trust‚Äêrelated effects. Main and interaction effects of the interventions are assessed on three levels of trust‚Äêrelated outcome measures: trust‚Äêrelated interpretation bias; self‚Äêreported trust; and mother‚Äêchild interactional behavior. Importantly, side‚Äêeffects of a single administration of OT in middle childhood are monitored closely to provide further information on the safety of OT administration in this age group. DISCUSSION: The present RCT is the first study to combine CBM training with oxytocin to test for individual and combined effects on trust in mother. If effective, CBM training and oxytocin could be easily applicable and nonintrusive additions to interventions that target trust in the context of the parent‚Äêchild relationship. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02737254 . Registered on 23 March 2016."," Verhees, MWFT;  Ceulemans, E;  Bakermans-Kranenburg, MJ;  van IJzendoorn, MH;  de Winter, S;  Bosmans, G",2017.0, 10.1186/s13063-017-2077-2,0,0,
1237,The Psychophysiological Determinants of Pacing Behaviour and Performance During Prolonged Endurance Exercise: A Performance Level and Competition Outcome Comparison,"INTRODUCTION: A three-dimensional framework of centrally regulated and goal-directed exercise behaviour emphasised the integration of distinct sensory-discriminatory, affective-motivational and cognitive-evaluative dimensions that underpin perceived fatigability. This study aimed to capture the complex interdependencies and temporal dynamics in these processes, their interrelations with observed pacing behaviour, performance and biochemical variables as well as their performance level- and competition outcome-dependent variances. METHODS: Twenty-three cyclists of distinct performance level categories engaged in individual and head-to-head competition time trials against a performance-matched opponent. Sensory, affective and cognitive processes were respectively assessed with the constructs perceived physical strain and perceived mental strain, valence and felt arousal underpinning core affect and action crisis characterised by a shift from an implemental to a deliberative mindset. CONCLUSION: The proposed constructs are interdependent in a nonlinear dynamic fashion, context dependent, constraint based, distinguishable by well-trained cyclists and interrelated with observed pacing behaviour, performance and physiological disturbance. The proposed framework provides a more comprehensive alternative to the Gestalt concept of perceived exertion and more completely accounts for centrally regulated and goal-directed exercise behaviour. RESULTS: Performance level- and competition outcome-dependent variances and differential temporal dynamics in constructs were associated with alterations in pacing behaviour, performance and physiological disturbance. Perceived physical and mental strain were primarily associated with observed pacing behaviour as necessary to align planned behaviour with current physiological state. Valence and arousal were primarily associated with differential responses in performance regulation. The mindset shift associated with an action crisis was primarily associated with non-adaptive, psycho-neuro-endocrinological distress response.",Venhorst A.; Micklewright D.P.; Noakes T.D.,2018.0,10.1007/s40279-018-0893-5,0,0,
1238, MOTIVATional intErviewing to improve self-care in Heart Failure patients (MOTIVATE-HF): study protocol of a three-arm multicenter randomized controlled trial," METHODS: A three‚Äêarm randomized controlled trial will be conducted in a sample of 240 HF patients and caregivers. Patients and caregivers will be randomized to the following arms: 1) MI intervention to patients only; 2) MI intervention to patients and caregivers; 3) standard of care to patients and caregivers. The primary outcome will be measured in patients 3months after enrollment. Primary and secondary outcomes also will be evaluated 6, 9 and 12months after enrollment. CONCLUSION: This study will contribute to understand if MI provided to patients and caregivers can improve self‚Äêcare. Because HF is rising in prevalence, findings can be useful to reduce the burden of the disease. AIMS: Heart Failure (HF) self‚Äêcare improves patient outcomes but trials designed to improve HF self‚Äêcare have shown inconsistent results. Interventions may be more effective in improving self‚Äêcare if they mobilize support from providers, promote self‚Äêefficacy, increase understanding of HF, increase the family involvement, and are individualized. All of these elements are emphasized in motivational interviewing (MI); few trials have been conducted using MI in HF patients and rarely have caregivers been involved in MI interventions. The aim of this study will be to evaluate if MI improves self‚Äêcare maintenance in HF patients, and to determine if MI improves the following secondary outcomes: a) in HF patients: self‚Äêcare management, self‚Äêcare confidence, symptom perception, quality of life, anxiety/depression, cognition, sleep quality, mutuality with caregiver, hospitalizations, use of emergency services, and mortality; b) in caregivers: caregiver contribution to self‚Äêcare, quality of life, anxiety/depression, sleep, mutuality with patient, preparedness, and social support."," Vellone, E;  Paturzo, M;  D'Agostino, F;  Petruzzo, A;  Masci, S;  Ausili, D;  Rebora, P;  Alvaro, R;  Riegel, B",2017.0, 10.1016/j.cct.2017.02.003,0,0,
1239,Safety Behavior After Extinction Triggers a Return of Threat Expectancy.,"Safety behavior is involved in the maintenance of anxiety disorders, presumably because it prevents the violation of negative expectancies. Recent research showed that safety behavior is resistant to fear extinction. This fear conditioning study investigated whether safety behavior after fear extinction triggers a return of fear in healthy participants. Participants learned that two stimuli (A and C) were followed by an aversive loud noise (""threat""), and one stimulus (B) was not. Participants then learned to use safety behavior that prevented the loud noise. Next, A and C were no longer followed by the loud noise, which typically led to extinction of threat expectancy. Safety behavior then became available again for C, but not for A and B. All participants used safety behavior on these C trials. In a final test phase, A, B, and C were presented once without the availability to use safety behavior. At each stimulus presentation, participants rated threat expectancy by indicating to what extent they expected that the loud noise would follow. Compared with the last extinction trial, threat expectancy increased for C in the test phase, whereas it did not increase for A and B. Hence, safety behavior after the extinction of classically conditioned fear caused a partial return of fear. The findings suggest that safety behavior may be involved in relapse after exposure-based therapy for anxiety disorders.",van Uijen SL.; Leer A.; Engelhard IM.,2018.0,10.1016/j.beth.2017.08.005,0,0,
1240,Cognitive Therapy for Obsessive-Compulsive Disorder.,"This case report is about a 31-year-old married female with a variety of obsessions, primarily focusing on harming obsessions. Because of anxiety, numerous washing rituals have taken place as well as the avoidance of situations. This client was diagnosed with Obsessive-Compulsive Disorder (OCD) and was seen for 25 sessions of individual cognitive therapy. The aim of this study therefore was to illustrate the assessment, case conceptualization, and course of treatment in a severe obsessive-compulsive client, using cognitive therapy. Several specific cognitive interventions, which address the estimations of catastrophes and the perceptions of personal responsibility, are presented and illustrated. At posttreatment and at follow-up, a clinically significant change for improvement was demonstrated for the obsessive-compulsive symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Van Oppen, Patricia",2004.0,http://dx.doi.org/10.1177/1534650103259647,0,0,
1241, Effectiveness of trauma-focused treatment for patients with psychosis with and without the dissociative subtype of post-traumatic stress disorder," This study presents secondary analyses of a recently published trial in which post‚Äêtraumatic stress disorder (PTSD) patients with psychosis (n = 108) underwent 8 sessions of trauma‚Äêfocused treatment, either prolonged exposure (PE) or eye movement desensitisation and reprocessing (EMDR) therapy. 24.1% fulfilled the criteria for the dissociative subtype, a newly introduced PTSD subtype in DSM‚Äê5. Treatment outcome was compared for patients with and without the dissociative subtype of PTSD. Patients with the dissociative subtype of PTSD showed large reductions in clinician‚Äêadministered PTSD scale (CAPS) score, comparable with patients without the dissociative subtype of PTSD. It is concluded that even in a population with severe mental illness, patients with the dissociative subtype of PTSD do benefit from trauma‚Äêfocused treatments without a pre‚Äêphase of emotion regulation skill training and should not be excluded from these treatments."," van Minnen, A;  van der Vleugel, BM;  van den Berg, DP;  de Bont, PA;  de Roos, C;  van der Gaag, M;  de Jongh, A",2016.0, 10.1192/bjp.bp.116.185579,0,0,
1242,Efficacy of meaning-centered group psychotherapy for cancer survivors: a randomized controlled trial.,"The aim of this study was to assess the efficacy of meaning-centered group psychotherapy for cancer survivors (MCGP-CS) to improve personal meaning, compared with supportive group psychotherapy (SGP) and care as usual (CAU). A total of 170 cancer survivors were randomly assigned to one of the three study arms: MCGP-CS (n = 57); SGP (n = 56); CAU (n = 57). The primary outcome measure was the Personal Meaning Profile (PMP; total score). Secondary outcome measures were subscales of the PMP, psychological well-being (Scales of Psychological Well-being; SPWB), post-traumatic growth (Posttraumatic Growth Inventory), Mental Adjustment to Cancer (MAC), optimism (Life Orientation Test-Revised), hopelessness (Beck's Hopelessness Scale), psychological distress (anxiety and depression, Hospital Anxiety and Depression Scale; HADS) and quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; EORTC QLQ-C30). Outcome measures were assessed before randomization, post-intervention, and after 3 and 6 months of follow-up (FU). Linear mixed model analyses (intention-to-treat) showed significant differences between MCGP-CS, SGP and CAU on the total PMP score, and on (sub)scales of the PMP, SPWB, MAC and HADS. Post-hoc analyses showed significantly stronger treatment effects of MCGP-CS compared with CAU on personal meaning (d = 0.81), goal-orientedness (d = 1.07), positive relations (d = 0.59), purpose in life (d = 0.69); fighting spirit (d = 0.61) (post-intervention) and helpless/hopeless (d = -0.87) (3 months FU); and distress (d = -0.6) and depression (d = -0.38) (6 months FU). Significantly stronger effects of MCGP-CS compared with SGP were found on personal growth (d = 0.57) (3 months FU) and environmental mastery (d = 0.66) (6 months FU). MCGP-CS is an effective intervention for cancer survivors to improve personal meaning, psychological well-being and mental adjustment to cancer in the short term, and to reduce psychological distress in the long run.",van der Spek N.; Vos J.; van Uden-Kraan CF.; Breitbart W.; Cuijpers P.; Holtmaat K.; Witte BI.; Tollenaar RAEM.; Verdonck-de Leeuw IM.,2017.0,10.1017/S0033291717000447,0,0,
1243,Will they like me? Neural and behavioral responses to social-evaluative peer feedback in socially and non-socially anxious females,"The current study examined neural and behavioral responses to social-evaluative feedback processing in social anxiety. Twenty-two non-socially and 17 socially anxious females (mean age = 19.57 years) participated in a Social Judgment Paradigm in which they received peer acceptance/rejection feedback that was either congruent or incongruent with their prior predictions. Results indicated that socially anxious participants believed they would receive less social acceptance feedback than non-socially anxious participants. EEG results demonstrated that unexpected social rejection feedback elicited a significant increase in theta (4–8 Hz) power relative to other feedback conditions. This theta response was only observed in non-socially anxious individuals. Together, results corroborate cognitive-behavioral studies demonstrating a negative expectancy bias in socially anxiety with respect to social evaluation. Furthermore, the present findings highlight a functional role for theta oscillatory dynamics in processing cues that convey social-evaluative threat, and this social threat-monitoring mechanism seems less sensitive in socially anxious females.",van der Molen M.J.W.; Harrewijn A.; Westenberg P.M.,2018.0,10.1016/j.biopsycho.2018.02.016,0,0,
1244, A Randomized Controlled Study of Neurofeedback for Chronic PTSD," INTRODUCTION: Brain/Computer Interaction (BCI) devices are designed to alter neural signals and, thereby, mental activity. This study was a randomized, waitlist (TAU) controlled trial of a BCI, EEG neurofeedback training (NF), in patients with chronic PTSD to explore the capacity of NF to reduce PTSD symptoms and increase affect regulation capacities. STUDY DESIGN: 52 individuals with chronic PTSD were randomized to either NF (n = 28) or waitlist (WL) (n = 24). They completed four evaluations, at baseline (T1), after week 6 (T2), at post‐treatment (T3), and at one month follow up (T4). Assessment measures were:1. Traumatic Events Screening Inventory (T1); 2. the Clinician Administered PTSD Scale (CAPS; T1, T3, T4); 3. the Davidson Trauma Scale (DTS; T1‐T4) and 4. the Inventory of Altered Self‐Capacities (IASC; T1‐T4). NF training occurred two times per week for 12 weeks and involved a sequential placement with T4 as the active site, P4 as the reference site. RESULTS: Participants had experienced an average of 9.29 (SD = 2.90) different traumatic events. Post‐treatment a significantly smaller proportion of NF (6/22, 27.3%) met criteria for PTSD than the WL condition (15/22, 68.2%), χ2 (n = 44, df = 1) = 7.38, p = .007. There was a significant treatment condition x time interaction (b = ‐10.45, t = ‐5.10, p< .001). Measures of tension reduction activities, affect dysregulation, and affect instability exhibited a significant Time x Condition interaction. The effect sizes of NF (d = ‐2.33 within, d = ‐ 1.71 between groups) are comparable to those reported for the most effective evidence based treatments for PTSD. DISCUSSION: Compared with the control group NF produced significant PTSD symptom improvement in individuals with chronic PTSD, as well as in affect regulation capacities. NF deserves further investigation for its potential to ameliorate PTSD and to improve affect regulation, and to clarify its mechanisms of action."," van der Kolk, BA;  Hodgdon, H;  Gapen, M;  Musicaro, R;  Suvak, MK;  Hamlin, E;  Spinazzola, J",2016.0, 10.1371/journal.pone.0166752,0,0,
1245, Economic evaluation of an e-mental health intervention for patients with retinal exudative diseases who receive intraocular anti-VEGF injections (E-PsEYE): protocol for a randomised controlled trial," INTRODUCTION: Because of the great potential of vascular endothelial growth factor inhibitors (anti‚ÄêVEGF) for retinal exudative diseases, an increased number of patients receives this treatment. However, during this treatment, patients are subjected to frequent invasive intravitreal injections, and the effects on reversing the process of vision loss are uncertain, which may have negative consequences for patients' mental health. One in three patients experience at least mild symptoms of depression/anxiety. To support patients in dealing with these symptoms, an e‚Äêmental health intervention (called E‚ÄêPsEYE) has been developed. E‚ÄêPsEYE is based on cognitive‚Äêbehavioural therapy (CBT) and contains nine modules. A stepped‚Äêcare model with three steps will be used to deliver the intervention: (1) providing information and psychoeducation, (2) when symptoms of depression/anxiety persist, guided CBT is offered and supported by social workers from low vision rehabilitation services and (3) when symptoms still persist, patients are referred to their general practitioner. METHODS AND ANALYSIS: An economic evaluation from a healthcare and societal perspective will be conducted alongside a multicentre randomised controlled trial in two parallel groups to evaluate whether E‚ÄêPsEYE is cost‚Äêeffective in comparison with usual care. Participants (n=174) will be 50 years or older, have retinal exudative diseases, receive anti‚ÄêVEGF treatment and have mild symptoms of depression/anxiety (assessed prior to randomisation). Main outcome measures are: depression (Patient Health Questionnaire‚Äê9), anxiety (Hospital Anxiety and Depression Scale‚ÄêAnxiety) and quality‚Äêadjusted life‚Äêyears (determined with the Health Utility Index‚Äê3 and the EuroQol‚Äê5 dimensions). Five measurements take place: at baseline and after 3, 6, 9 and 12 months. ETHICS AND DISSEMINATION: The study has been approved by the Medical Ethics Committee of the VU University Medical Centre Amsterdam. It will provide new and essential information on the cost‚Äêeffectiveness of an innovative intervention for a vulnerable population. Outcomes will be disseminated through peer‚Äêreviewed publications and conference presentations. TRIAL REGISTRATION: http://www.trialregister.nl, identifier: NTR6337."," van der Aa, HPA;  van Rens, GHMB;  Verbraak, FD;  Bosscha, M;  Koopmanschap, MA;  Comijs, HC;  Cuijpers, P;  van Nispen, RMA",2017.0, 10.1136/bmjopen-2017-018149,0,0,
1246, Economic evaluation of stepped-care versus usual care for depression and anxiety in older adults with vision impairment: randomized controlled trial," BACKGROUND: A stepped‐care program was found effective in preventing depressive and anxiety disorders in older adults with vision impairment. However, before a decision can be made about implementation, the cost‐effectiveness of this program should be investigated. Therefore, we aimed to compare the cost‐effectiveness of stepped‐care versus usual care within low vision rehabilitation. METHODS: An economic evaluation from a societal perspective was performed alongside a multicenter randomized controlled trial. Data were collected by masked assessors during 24 months. Included were 265 older adults with vision impairment and subthreshold depression and/or anxiety. They were randomly assigned to stepped‐care plus usual care (n = 131) or usual care alone (n = 134). Stepped‐care comprised 1) watchful waiting, 2) guided self‐help based on cognitive behavioral therapy, 3) problem solving treatment, and 4) referral to a general practitioner. Costs were based on direct healthcare costs and indirect non‐healthcare costs. Main outcome measures were quality‐adjusted life years (QALYs) and the cumulative incidence of major depressive, dysthymic and/or anxiety disorders. Secondary outcomes were symptoms of depression and anxiety. RESULTS: Based on intention‐to‐treat, significant differences were found in the incidence of depressive/anxiety disorders (mean difference 0.17; 95% CI 0.06 to 0.29) and symptoms of anxiety (mean difference 1.43, 95% CI 0.10 to 2.77) in favor of stepped‐care versus usual care; no significant difference was found for QALYs and symptoms of depression. Societal costs were non‐significantly lower in the stepped‐care group compared with the usual care group (mean difference: ‐€877; 95% confidence interval (CI): ‐8039 to 5489). Cost‐effectiveness acceptability curves showed that the probability of cost‐effectiveness was 95% or more at a willingness‐to‐pay of €33,000 per disorder prevented. The probability that stepped‐care was cost‐effective compared to usual care was 59% or more for a ceiling ratio of 0 €/QALY and increased to 65% at 20000 €/QALY. CONCLUSIONS: This economic evaluation shows that stepped‐care is dominant to usual care, with a probability of around 60%, due to its clinical superiority and its modest cost savings. However, it depends on the willingness‐to‐pay of decision makers whether or not stepped‐care is considered cost‐effective compared with usual care. TRIAL REGISTRATION: identifier: NTR3296 , date: 13‐02‐2012."," van der Aa, HPA;  van Rens, GHMB;  Bosmans, JE;  Comijs, HC;  van Nispen, RMA",2017.0, 10.1186/s12888-017-1437-5,0,0,
1247,Endogenous pain modulation: Association with resting heart rate variability and negative affectivity,"Objectives. Several chronic pain syndromes are characterized by deficient endogenous pain modulation as well as elevated negative affectivity and reduced resting heart rate variability. In order to elucidate the relationships between these characteristics, we investigated whether negative affectivity and heart rate variability are associated with endogenous pain modulation in a healthy population. Design, Subjects, and Methods. An offset analgesia paradigm with noxious thermal stimulation calibrated to the individual's pain threshold was used to measure endogenous pain modulation magnitude in 63 healthy individuals. Pain ratings during constant noxious heat stimulation to the arm (15 seconds) were compared with ratings during noxious stimulation comprising a 1 C rise and return of temperature to the initial level (offset trials, 15 seconds). Offset analgesia was defined as the reduction in pain following the 1 C decrease relative to pain at the same time point during continuous heat stimulation. Results. Evidence for an offset analgesia effect could only be found when noxious stimulation intensity (and, hence, the individual's pain threshold) was intermediate (46 C or 47 C). Offset analgesia magnitude was also moderated by resting heart rate variability: a small but significant offset effect was found in participants with high but not low heart rate variability. Negative affectivity was not related to offset analgesia magnitude. Conclusions. These results indicate that resting heart rate variability (HRV) is related to endogenous pain modulation (EPM) in a healthy population. Future research should focus on clarifying the causal relationship between HRV and EPM and chronic pain by using longitudinal study designs.",Van Den Houte M.; Van Oudenhove L.; Bogaerts K.; Van Diest I.; Van Den Bergh O.,2018.0,10.1093/pm/pnx165,0,0,
1248,Predicting trauma-focused treatment outcome in psychosis.,"Although TF treatments are effective in patients with psychosis, it is unknown whether specific psychosis-related obstacles limit the effects, and what determines good outcome. Baseline posttraumatic stress disorder (PTSD) symptom severity and seven psychosis-specific variables were tested as predictors in patients with a psychotic disorder and PTSD (n=108), who received eight sessions of TF treatment (Prolonged Exposure, or Eye Movement Desensitization and Reprocessing therapy) in a single-blind randomized controlled trial. Multiple regression analyses were performed. Baseline PTSD symptom severity was significantly associated with posttreatment PTSD symptom severity, explaining 11.4% of the variance. Additionally, more severe PTSD at baseline was also significantly associated with greater PTSD symptom improvement during treatment. After correction for baseline PTSD symptom severity, the model with the seven baseline variables did not significantly explain the variance in posttreatment PTSD outcome. Within this non-significant model, the presence of auditory verbal hallucinations contributed uniquely to posttreatment outcome but explained little variance (5.4%). Treatment completers and dropouts showed no significant difference on any of the psychosis-related variables. Given the low predictive utility of baseline psychosis-related factors, we conclude that there is no evidence-based reason to exclude patients with psychotic disorders from TF treatments. Also, we speculate that patients with psychosis and severe baseline PTSD might derive more benefit if given more than eight sessions. Trial registration current controlled-trials.com | Identifier: ISRCTN79584912 | http://www.isrctn.com/ISRCTN79584912.",van den Berg DPG.; van der Vleugel BM.; de Bont PAJM.; Staring ABP.; Kraan T.; Ising H.; de Roos C.; de Jongh A.; van Minnen A.; van der Gaag M.,2016.0,10.1016/j.schres.2016.07.016,0,0,
1249,Investigating interactions between reward and threat processing as mechanisms underlying costly fearful avoidance behaviour using startle reflex methodology,"Background: Fearful avoidance behaviour is a critical symptom across anxiety disorders and an important predictor of clinical outcome. However, little is known about how threat and reward appraisal interact to drive costly avoidance behaviour. Methods: Forty-eight subjects could choose to approach or avoid situations differing in potential threat (threat of shock, no shock) and potential reward (V0.01, V0.1 euro, V0.50 euro, V1 euro) to create varying levels of approach-avoid conflict. As physiological markers of threat appraisal and reward appraisal, we respectively measured the eye-blink startle and the post-auricular reflex (PAR) using electromyography during the build-up of decisions. Results: Avoidance behaviour was significantly higher during threat (p < .0001) and decreased with level of potential reward (p < .0001). A significant threat X reward interaction-effect (p = .002) indicated that there was little modulation by reward in the safe condition where avoidance was low overall, while the modulation was strongly present in the threat condition. Eyeblink startle and PAR startle both demonstrated a threat X reward interaction (p = .002; p < .0001). Interestingly, within subjects' variation in PAR magnitude (but not eye-blink) significantly predicted trial-by-trial avoidance rates (p < .0001). Conclusions: We successfully measured PAR and eye-blink magnitudes, as biological indicators of threat and reward appraisal respectively in a paradigm assessing approachavoidance conflict. Results suggest that fluctuations in PAR but not eye-blink predict the modulation of avoidance behaviour. This is the first indication that a psychophysiological measure of reward appraisal may predict costly avoidance behaviour.",Van De Pavert I.; Roelofs K.; Klumpers F.,2018.0,,0,0,
1250,The influence of comorbid anxiety on the effectiveness of Cognitive Therapy and Interpersonal Psychotherapy for Major Depressive Disorder.,"Anxious depression is an important subtype of Major Depressive Disorder (MDD) defined by both syndromal (anxiety disorders) and dimensional (anxiety symptoms) criteria. A debated question is how anxiety affects MDD treatment. This study examined the impact of comorbid anxiety disorders and symptoms on the effectiveness of and dropout during Cognitive Therapy (CT) and Interpersonal Psychotherapy (IPT) for MDD. Depressed individuals were randomized to CT (n‚ÄØ=‚ÄØ76) or IPT (n‚ÄØ=‚ÄØ75). Outcome was depression severity measured with the Beck Depression Inventory-II (BDI-II) at the start of each therapy session, post treatment, and monthly up to five months follow-up. Anxiety disorders were assessed with the Structured Clinical Interview for DSM-IV Axis I disorders, (phobic) anxiety symptoms were assessed with Brief Symptom Inventory subscales. Approximately one third of participants had a comorbid anxiety disorder. Comorbid anxiety disorders and anxiety symptoms were associated with less favorable depression change during IPT as compared to CT in the treatment phase, but not in the trial follow-up phase. Individuals with a comorbid anxiety disorder had significantly higher treatment dropout during both treatments. Not all therapists and participants were blind to the assessment of comorbid anxiety disorders and the assessments were performed by one rater. A preference for CT over IPT for MDD is justifiable when comorbid anxiety is present, although long-term differences are not established and replication of this finding is needed. Clinicians should be aware of the risk of dropout for depressed individuals with an anxiety disorder.",van Bronswijk SC.; Lemmens LHJM.; Huibers MJH.; Arntz A.; Peeters FPML.,2018.0,10.1016/j.jad.2018.02.003,0,0,
1251,The effect of peer support groups on family adaptation from the perspective of wives of war veterans with posttraumatic stress disorder.,"The aim of this study was to examine the effect of peer group support on family adaptation of wives of war veterans suffering from post-traumatic stress disorder (PTSD). In this randomized controlled trial, 80 wives of war veterans with PTSD were incorporated, and selected participants were randomly assigned into intervention and control groups (n = 40 per group). The intervention group was divided into four subgroups, with each participating in eight weekly based 1.5-hr peer support group sessions and the control group received no intervention. Demographics form and Family Adaptation Scale (FAS) developed by Antonovsky and Sourani (1988) were applied. The total mean scores of family adaptation increased significantly more in the intervention group than in the control group (p = .033). Furthermore, the time × group interaction effects were significant for internal family fit (p = .013) and a combination of both family fit and family community fit (p = .020) dimensions. Nonetheless family fit dimensions mean scores had no significant increase in the intervention group than the control group over time (p = .948). Peer support group can be a useful tool for health care professionals to enhance family adaptation in spouses of war veterans with PTSD.",Vagharseyyedin SA.; Gholami M.; Hajihoseini M.; Esmaeili A.,2017.0,10.1111/phn.12349,0,0,
1252, Tibial slope in total ankle arthroplasty: anterior or lateral approach," METHODS: The study included 217 ankles. Between May 2011 and April 2015, 77 patients underwent a TAA with a mobile‐bearing implant through an anterior approach and 45 with a fixed‐bearing implant through a lateral approach: in these patients the β angle was measured 2 and 12 months postoperatively. 95 subjects with unilateral post‐traumatic ankle arthritis composed the control group: in these patients we measured the anterior distal tibial angle (ADTA) of the controlateral, non arthritic tibiotalar joint. RESULTS: In the mobile‐bearing group, the mean β angle at 2 and 12 months postoperatively was 86.4±3.1 and 86.8±3.1 (p‐value=0.12). In the fixed‐bearing group, the mean β angle at 2 and 12 months postoperatively was 83.1±5.4 and 83.9±6.5 (p‐value=0.26). A statistically significant difference was found between the β angle of the two groups. In the control group the mean ADTA was 84.9±2.5. A non‐statistically significant difference was observed only between β angle of the fixed‐bearing group and the ADTA of the control group. CONCLUSIONS: Regarding the tibial slope, fixed‐bearing TAA through a lateral approach showed a more anatomic placement. In contrast, β angle in mobile‐bearing group appeared more reproducible than fixed‐bearing group. BACKGROUND: A new total ankle arthroplasty (TAA) system performed through a lateral approach provides direct visualization of the centre of rotation, allowing for accurate reconstruction of the joint alignment and less bone resection. Radiographic references are needed to describe deformities and plan the surgical procedures. The tibial slope is an important factor when treating malalignment. The aim of this study is to show if there is any difference regarding the post‐operative tibial slope (β angle) measurement comparing a fixed‐bearing TAA through a lateral approach and a mobile‐bearing TAA through an anterior approach."," Usuelli, FG;  Maccario, C;  Indino, C;  Manzi, L;  Gross, CE",2017.0, 10.1016/j.fas.2016.10.001,0,0,
1253,Cognitive-behavioural therapy (CBT) for renal fatigue (BReF): a feasibility randomised-controlled trial of CBT for the management of fatigue in haemodialysis (HD) patients.,"Fatigue is one of the most common and disabling symptoms in end-stage kidney disease, particularly among in-centre haemodialysis patients. This two-arm parallel group feasibility randomised controlled trial will determine whether a fully powered efficacy trial is achievable by examining the feasibility of recruitment, acceptability and potential benefits of a cognitive-behavioural therapy (CBT)-based intervention for fatigue among in-centre haemodialysis patients. We aim to recruit 40 adult patients undergoing in-centre haemodialysis at secondary care outpatient dialysis units, who meet clinical levels of fatigue. Patients will be randomised individually (using a 1:1 ratio) to either a 4-6 weeks' CBT-based intervention (intervention arm) or to a waiting-list control (control arm). The primary feasibility outcomes include descriptive data on numbers within each recruiting centre meeting eligibility criteria, rates of recruitment, numbers retained postrandomisation and treatment adherence. To assess the potential benefits of the cognitive-behavioural therapy for renal fatigue intervention, secondary self-report outcomes include measures of fatigue severity (Chalder Fatigue Questionnaire), fatigue-related functional impairment (Work and Social Adjustment Scale), sleep quality (Pittsburgh Sleep Quality Index), depression (Patient Health Questionnaire-9) and anxiety (Generalised Anxiety Disorder-7). Changes in fatigue perceptions (Brief Illness Perception Questionnaire), cognitive and behavioural responses to fatigue (Cognitive and Behavioural Responses to Symptoms Questionnaire), sleep hygiene behaviours (Sleep Hygiene Index) and physical activity (International Physical Activity Questionnaire-short form) will also be explored. These self-report measures will be collected at baseline and 3 months postrandomisation. Nested qualitative interviews will be conducted postintervention to explore the acceptability of the intervention and identify any areas in need of improvement. The statistician and assessor will be blinded to treatment allocation. A National Health Service (NHS) Research Ethics Committee approved the study. Any amendments to the protocol will be submitted to the NHS Committee and study sponsor. ISRCTN91238019;Pre-results.",Picariello F.; Moss-Morris R.; Macdougall IC.; Norton S.; Da Silva-Gane M.; Farrington K.; Clayton H.; Chilcot J.,2018.0,10.1136/bmjopen-2017-020842,0,0,
1254, 24- and 36-week outcomes for the Child/Adolescent Anxiety Multimodal Study (CAMS)," Objective We report active treatment group differences on response and remission rates and changes in anxiety severity at weeks 24 and 36 for the Child/Adolescent Anxiety Multimodal Study (CAMS). Method CAMS youth (N = 488; 74% <12 years of age) with DSM‚ÄêIV separation, generalized, or social anxiety disorder were randomized to 12 weeks of cognitive‚Äêbehavioral therapy (CBT), sertraline (SRT), CBT+SRT (COMB), or medication management/pill placebo (PBO). Responders attended 6 monthly booster sessions in their assigned treatment arm; youth in COMB and SRT continued on their medication throughout this period. Efficacy of COMB, SRT, and CBT (n = 412) was assessed at 24 and 36 weeks postrandomization. Youth randomized to PBO (n = 76) were offered active CAMS treatment if nonresponsive at week 12 or over follow‚Äêup and were not included here. Independent evaluators blind to study condition assessed anxiety severity, functioning, and treatment response. Concomitant treatments were allowed but monitored over follow‚Äêup. Results The majority (>80%) of acute responders maintained positive response at both weeks 24 and 36. Consistent with acute outcomes, COMB maintained advantage over CBT and SRT, which did not differ, on dimensional outcomes; the 3 treatments did not differ on most categorical outcomes over follow‚Äêup. Compared to COMB and CBT, youth in SRT obtained more concomitant psychosocial treatments, whereas those in SRT and CBT obtained more concomitant combined (medication plus psychosocial) treatment. Conclusions COMB maintained advantage over CBT and SRT on some measures over follow‚Äêup, whereas the 2 monotherapies remained indistinguishable. The observed convergence of COMB and monotherapy may be related to greater use of concomitant treatment during follow‚Äêup among youth receiving the monotherapies, although other explanations are possible. Although outcomes were variable, most CAMS‚Äêtreated youth experienced sustained treatment benefit. Clinical trial registration information ‚Äê Child and Adolescent Anxiety Disorders (CAMS); URL: http://clinicaltrials. gov. Unique identifier: NCT00052078."," Piacentini, J;  Bennett, S;  Compton, SN;  Kendall, PC;  Birmaher, B;  Albano, AM;  March, J;  Sherrill, J;  Sakolsky, D;  Ginsburg, G;  et al.",2014.0, 10.1016/j.jaac.2013.11.010,0,0,
1255,Sex Differences in the Association between Heavy Drinking and Behavioral Distress Tolerance and Emotional Reactivity among Non-Depressed College Students,"Background: Heavy episodic drinking (HED) is a common behavior among college students that is associated with severe negative consequences. Negative reinforcement processes have been applied to elucidate mechanisms underlying relationships between consumption of alcohol and the desire to alleviate negative feelings. Distress tolerance (DT) and emotional reactivity are two mechanisms that are consistent with the self-medication model that may contribute to HED. The current study investigated relationships between DT, emotional reactivity, defined as frustration reactivity and irritability reactivity, and HED in a non-depressed college population. Given differential patterns of consumption and motivation for drinking between males and females, sex differences were also examined. Short Summary: The study examined two constructs consistent with negative reinforcement processes, behavioral distress tolerance (DT) and emotional reactivity (frustration reactivity and irritability reactivity), to explain heavy episodic drinking (HED) among non-depressed college students. Behavioral DT and frustration reactivity independently predicted HED. Higher HED was associated with higher frustration reactivity and lower behavioral DT in women, but nor in men. Methods: One-hundred-ten college students without depressive symptoms completed alcohol use measures and the Paced Auditory Serial Attention Task (PASAT-C) to assess behavioral DT and emotional reactivity. Results: DT and frustration reactivity independently predicted HED. The association between DT and HED was moderated by sex such that higher levels of DT predicted higher HED among females, but not among males. Higher frustration reactivity scores were associated with a greater number of HED. Conclusions: Results provide supporting evidence that DT and emotional reactivity are distinct factors, and that they predict HED independently. Results underscore the importance of examining sex differences when evaluating the association between HED and negative reinforcement processes in this population.",Pedrelli P.; MacPherson L.; Khan A.J.; Shapero B.G.; Fisher L.B.; Nyer M.; Cassano P.; Parnarouskis L.; Farabaugh A.; Fava M.; Silveri M.M.,2018.0,10.1093/alcalc/agy045,0,0,
1256,Patients with chronic whiplash can be subgrouped on the basis of symptoms of sensory hypersensitivity and posttraumatic stress.,"The lack of efficacy of rehabilitative approaches to the management of chronic whiplash-associated disorders (WAD) may be in part due to heterogeneity of the clinical presentation of this patient population. The aim of this study was to identify homogeneous subgroups of patients with chronic WAD on the basis of symptoms of PTSD and sensory hypersensitivity and to compare the clinical presentation of these subgroups. Successive k-means cluster analyses using 2, 3 and 4 cluster solutions were performed by using data for 331 (221 female) patients with chronic (>3 months) WAD. The 4 cluster solution was identified as the most clinically relevant, yielding 4 distinct clusters: no to mild posttraumatic stress symptoms and no sensory hypersensitivity (nPnH), no to mild posttraumatic stress symptoms and sensory hypersensitivity (nPH), moderate to severe posttraumatic stress and no sensory hypersensitivity (PnH) and moderate to severe posttraumatic stress and sensory hypersensitivity (PH). The nPnH cluster was the largest cluster, comprising 43.5% of the sample. The PH cluster had significantly worse disability, pain intensity, self-reported mental health status and cervical range of motion in comparison to the nPnH and nPH clusters. These data provide further evidence of the heterogeneity of the chronic WAD population and the association of a more complex clinical presentation with higher disability and pain in this patient group. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Pedler, Ashley; Sterling, Michele",2013.0,http://dx.doi.org/10.1016/j.pain.2013.05.005,0,0,
1257," Effect of team sports and resistance training on physical function, quality of life, and motivation in older adults"," The aim of this study was to investigate the effect of team sports and resistance training on physical function, psychological health, quality of life, and motivation in older untrained adults. Twenty‚Äêfive untrained men and forty‚Äêseven untrained women aged 80 (range: 67‚Äê93) years were recruited. Fifty‚Äêone were assigned to a training group (TRG) of which twenty‚Äêfive performed team training (TG) and twenty‚Äêsix resistance training (RG). The remaining twenty‚Äêone were allocated to a control group (CG). TRG trained for 1 hour twice a week for 12 weeks. Compared with CG, TRG improved the number of arm curls within 30 seconds (P<.05) and 30‚Äêseconds chair stand (P<.05) during the intervention. In TRG, participation in training led to higher (P<.05) scores in the subscales psychological well‚Äêbeing, general quality of life, and health‚Äêrelated quality of life, as well as decreased anxiety and depression levels. No differences between changes in TG and RG were found over the intervention period, neither in physical function tests nor psychological questionnaires. Both TG and RG were highly motivated for training, but TG expressed a higher degree of enjoyment and intrinsic motivation mainly due to social interaction during the activity, whereas RG was more motivated by extrinsic factors like health and fitness benefits. In conclusion, both team training and resistance training improved physical function, psychological well‚Äêbeing, and quality of life. However, team sport training motivated the participants more by intrinsic factors than resistance training."," Pedersen, MT;  Vorup, J;  Nistrup, A;  Wikman, JM;  Alstr√∏m, JM;  Melcher, PS;  Pfister, GU;  Bangsbo, J",2017.0, 10.1111/sms.12823,0,0,
1258, SECOND-STAGE TREATMENTS FOR RELATIVE NONRESPONDERS TO COGNITIVE BEHAVIORAL THERAPY (CBT) FOR PANIC DISORDER WITH OR WITHOUT AGORAPHOBIA-CONTINUED CBT VERSUS SSRI: a RANDOMIZED CONTROLLED TRIAL," Background Cognitive behavioral therapy (CBT) and pharmacotherapy are efficacious for the short‚Äêterm treatment of panic disorder. Less is known about the efficacy of these therapies for individuals who do not respond fully to short‚Äêterm CBT. Method The current trial is a second‚Äêstep stratified randomized design comparing two treatment conditions ‚Äê selective serotonin reuptake inhibitor (SSRI; paroxetine or citalopram; n = 34) and continued CBT (n = 24) ‚Äê in a sample of individuals classified as treatment nonresponders to an initial course of CBT for panic disorder. Participants were randomized to 3 months of treatment and then followed for an additional 9 months. Only treatment responders after 3 months were maintained on the treatment until 12‚Äêmonth follow‚Äêup. Data analysis focused on panic disorder symptoms and achievement of response status across the first 3 months of treatment. Final follow‚Äêup data are presented descriptively. Results Participants in the SSRI condition showed significantly lower panic disorder symptoms as compared to continued CBT at 3 months. Results were similar when excluding individuals with comorbid major depression or analyzing the entire intent‚Äêto‚Äêtreat sample. Group differences disappeared during 9‚Äêmonth naturalistic follow‚Äêup, although there was significant attrition and use of nonstudy therapies in both arms. Conclusions These data suggest greater improvement in panic disorder symptoms when switching to SSRI after failure to fully respond to an initial course of CBT. Future studies should further investigate relapse following treatment discontinuation for nonresponders who became responders. Clinicaltrials.gov Identifier: NCT00000368; https://clinicaltrials.gov/show/NCT00000368"," Payne, LA;  White, KS;  Gallagher, MW;  Woods, SW;  Shear, MK;  Gorman, JM;  Farchione, TJ;  Barlow, DH",2016.0, 10.1002/da.22457,0,0,
1259, Premature ejaculation: pharmacotherapy vs group psychotherapy alone or in combination," MATERIALS AND METHODS: Out of 1237 male outpatients, 353 received a diagnosis of Premature Ejaculation. Of them, 279 were enrolled in the study and randomized into 3 groups (A, B and C). Only 157 patients were evaluable. Before and after treatments all participants completed two questionnaires to evaluate PE status and anxiety and referred their IELT. RESULTS: GROUP A: The mean post‚Äêtreatment Premature Ejaculation Diagnostic Tool (PEDT) score decreased from 12.95 to 8.26, while the mean Intra‚Äêvaginal Ejaculation Latency Time (IELT) increased from 50.77 sec to 203 sec. (p < 0.05); GROUP B: Reduction in the mean PEDT from 13.44 to 5.11 and an increased IELT from 48.33 to 431.11 sec (p < 0.001); GROUP C: The mean post‚Äêtreatment PEDT score decreased from 12.29 to 5.57, while the mean IELT increased from 46.86 to 412.14 sec (p < 0.001). All groups recorded an improvement in anxiety. CONCLUSIONS: According to our results Group Psychotherapy is an alternative method of treatment for PE. Group Psychotherapy plays a significant role in the treatment of PE, determining a better improvement of symptoms than Dapoxetine alone even if not statistically significant. OBJECTIVES: Premature Ejaculation (PE), the commonest sexual dysfunction in males, is generally treated with local anesthetic and SSRI (Dapoxetine). The aim of our study was investigate Group Psychotherapy as an alternative treatment for PE and compare the efficacy of pharmacological treatment and psychotherapy, either alone or in combination, in terms of response and improved Quality of Life (QoL). From a male outpatient population screened for PE, those who received a diagnosis of PE were proposed for the study, enrolled and divided into 3 groups (A, B and C). Each group was treated with Dapoxetine, Group Psychotherapy alone and Dapoxetine and Group Psychotherapy, respectively."," Pavone, C;  Abbadessa, D;  Gambino, G;  Scaduto, G;  Vella, M",2017.0, 10.4081/aiua.2017.2.114,0,0,
1260," Cognitive-behavioural therapy-based intervention to reduce fear of falling in older people: therapy development and randomised controlled trial - the Strategies for Increasing Independence, Confidence and Energy (STRIDE) study"," BACKGROUND: Falls cause fear, anxiety and loss of confidence, resulting in activity avoidance, social isolation and increasing frailty. The umbrella term for these problems is 'fear of falling', seen in up to 85% of older adults who fall. Evidence of effectiveness of physical and psychological interventions is limited, with no previous studies examining the role of an individually delivered cognitive‚Äêbehavioural therapy (CBT) approach. OBJECTIVES: Primary objective‚ÄÇTo develop and then determine the effectiveness of a new CBT intervention (CBTi) delivered by health‚Äêcare assistants (HCAs) plus usual care compared with usual care alone in reducing fear of falling. Secondary objectives‚ÄÇTo measure the impact of the intervention on falls, injuries, functional abilities, anxiety/depression, quality of life, social participation and loneliness; investigate the acceptability of the intervention for patients, family members and professionals and factors that promote or inhibit its implementation; and measure the costs and benefits of the intervention. DESIGN: Phase I‚ÄÇCBTi development. Phase II‚ÄÇParallel‚Äêgroup patient randomised controlled trial (RCT) of the new CBTi plus usual care compared with usual care alone. SETTING: Multidisciplinary falls services. PARTICIPANTS: Consecutive community‚Äêdwelling older adults, both sexes, aged ‚â•‚Äâ60 years, with excessive or undue fear of falling per Falls Efficacy Scale‚ÄêInternational (FES‚ÄêI) score of >‚Äâ23. INTERVENTIONS: Phase I‚ÄÇDevelopment of the CBTi. The CBTi was developed following patient interviews and taught to HCAs to maximise the potential for uptake and generalisability to a UK NHS setting. Phase II‚ÄÇRCT. The CBTi was delivered by HCAs weekly for 8 weeks, with a 6‚Äêmonth booster session plus usual care. MAIN OUTCOME MEASURES: These were assessed at baseline, 8 weeks, 6 months and 12 months. Primary outcome measure‚ÄÇFear of falling measured by change in FES‚ÄêI scores at 12 months. Secondary outcome measures‚ÄÇThese comprised falls, injuries, anxiety/depression [Hospital Anxiety and Depression Scale (HADS)], quality of life, social participation, loneliness and measures of physical function. There were process and health‚Äêeconomic evaluations alongside the trial. RESULTS: Four hundred and fifteen patients were recruited, with 210 patients randomised to CBTi group and 205 to the control group. There were significant reductions in mean FES‚ÄêI [‚Äê4.02; 95% confidence interval (CI) ‚Äê5.95 to ‚Äê2.1], single‚Äêitem numerical fear of falling scale (‚Äê1.42; 95% CI ‚Äê1.87 to 1.07) and HADS (‚Äê1; 95% CI ‚Äê1.6 to ‚Äê0.3) scores at 12 months in the CBTi group compared with the usual care group. There were no differences in the other secondary outcome measures. Most patients found the CBTi acceptable. Factors affecting the delivery of the CBTi as part of routine practice were identified. There was no evidence that the intervention was cost‚Äêeffective. CONCLUSIONS: Our new CBTi delivered by HCAs significantly improved fear of falling and depression scores in older adults who were attending falls services. There was no impact on other measures. FURTHER WORK: Further work should focus on a joint CBTi and physical training approach to fear of falling, more rational targeting of CBTi, the possibility of mixed group and individual CBTi, and the cost‚Äêeffectiveness of provision of CBTi by non‚Äêspecialists. TRIAL REGISTRATION: Current Controlled Trials ISRCTN78396615. FUNDING: This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 56. See the NIHR Journals Library website for further project information."," Parry, SW;  Bamford, C;  Deary, V;  Finch, TL;  Gray, J;  MacDonald, C;  McMeekin, P;  Sabin, NJ;  Steen, IN;  Whitney, SL;  et al.",2016.0, 10.3310/hta20560,0,0,
1261,Psychophysiological responses to CO2 inhalation,"Inhalation of CO2-enriched air has been used as a laboratory model for a number of anxiety disorders, such as general anxiety disorder and panic disorder. Because studies describing psychophysiological responses to this challenge are scarce, the present studies investigated skin conductance level, eyeblink startle, self-reported anxiety and fractional end-tidal carbon dioxide during inhalation of CO2-enriched air. In study 1, thirty-five healthy volunteers inhaled 7.5% CO2 for 2min. In study 2, twenty healthy volunteers inhaled 20% CO2 for 30s. Control groups (N=20 in each study) inhaled room air during the same time periods. Compared to room air breathing, both CO2-mixtures were associated with increases in skin conductance levels, self-reported anxiety and fractional end-tidal CO2. Eyeblink startles were inhibited during CO2 compared to room air breathing in both experiments. Our findings suggest that inhalation of CO2-enriched air is associated with a circa-strike defensive response pattern, corroborating its application as an interoceptive, panic-relevant stimulus in fear research. © 2012 Elsevier B.V.",Pappens M.; De Peuter S.; Vansteenwegen D.; Van den Bergh O.; Van Diest I.,2012.0,10.1016/j.ijpsycho.2012.01.008,0,0,
1262, Predicting chronic low-back pain based on pain trajectories in patients in an occupational setting: an exploratory analysis," OBJECTIVE: This study aimed to (i) identify subpopulations of patients in an occupational setting who will still have or develop chronic low‚Äêback pain (LBP) and (ii) evaluate a previously developed prediction model based on the determined subpopulations. METHOD: In this prospective cohort, study data were analyzed from three merged randomized controlled trials, conducted in an occupational setting (N=622). Latent class growth analysis (LCGA) was used to distinguish patients with a different course of pain intensity measured over 12 months. The determined subpopulations were used to derive a definition for chronic LBP and evaluate an existing model to predict chronic LBP. RESULTS: The LCGA model identified three subpopulations of LBP patients. These were used to define recovering (353) and chronic (269) patients. None of the interventions showed a relevant treatment effect over another but the rate of decline in symptoms during the first months of the intervention seems to predict recovery. The prediction model, based on this dichotomous outcome, with the variables pain intensity, kinesiophobia and a clinically relevant change in pain intensity and functional status in the first three months, showed a bootstrap‚Äêcorrected performance with an area under the operating characteristic curve (AUC) of 0.75 and explained variance of 0.26. CONCLUSION: In an occupational setting, different subpopulations of chronic LBP patients could be identified using LCGA. The prediction model based on these subpopulations showed a promising predictive performance."," Panken, G;  Hoekstra, T;  Verhagen, A;  van Tulder, M;  Twisk, J;  Heymans, MW",2016.0, 10.5271/sjweh.3584,0,0,
1263, The role of oxytocin in empathy in PTSD," OBJECTIVE: Although impairments in social skills are common in posttraumatic stress disorder (PTSD), only a handful of studies have investigated the empathic abilities of patients with PTSD. The first aim of this study was to characterize emotional and cognitive empathy deficits among patients with PTSD. Furthermore, intranasal oxytocin (OT) has been reported as possibly improving emotional empathy, and it has recently been suggested that patients with PTSD may suffer from abnormal functioning of the oxytocinergic system. Therefore, the second aim of this study was to investigate whether intranasal OT may enhance empathic abilities in these patients. METHOD: Using a randomized, double‚Äêblind, placebo‚Äêcontrolled crossover design, we administered 24 International Units of oxytocin and placebo at a 1‚Äêweek interval to 32 patients with PTSD and to 30 matched healthy controls and then measured participants' emotional and cognitive empathy. RESULTS: Patients with PTSD exhibited deficits in both emotional and cognitive empathy, and these deficits were associated with the severity of their PTSD symptoms. The administration of OT did not improve empathic abilities in our sample, although it did tend to selectively enhance the ability of men with PTSD to recognize body motions of anger. CONCLUSIONS: These results indicate that patients with PTSD have deficits in both emotional and cognitive empathic abilities and that their empathic difficulties may underlie their impairments in social and interpersonal skills. (PsycINFO Database Record"," Palgi, S;  Klein, E;  Shamay-Tsoory, S",2017.0, 10.1037/tra0000142,0,0,
1264,Cost-Effectiveness of Telemedicine-Based Collaborative Care for Posttraumatic Stress Disorder.,"The study examined the cost-effectiveness of a telemedicine-based collaborative care model designed to increase rural veterans' engagement in evidence-based treatments for posttraumatic stress disorder (PTSD). The Telemedicine Outreach for PTSD (TOP) study used a pragmatic randomized effectiveness trial to examine effects of PTSD care teams located at Veterans Affairs medical centers and supporting primary care providers in satellite clinics. Teams included a nurse care manager, pharmacist, psychologist, and psychiatrist. Effectiveness was estimated with quality-adjusted life years (QALYs) derived from the Short Form Health Survey for Veterans and Quality of Well-Being (QWB) scale. Intervention and health care costs were collected to evaluate the cost-effectiveness of the intervention. The sample (N=265) included mostly rural, unemployed, middle-aged men with a military service-connected disability for PTSD randomly assigned to TOP or usual care. Only minor improvements in QWB QALYs were found. The TOP intervention was relatively expensive, with costs totaling $2,029 per patient per year. Intervention costs were not offset by reductions in health care utilization costs, resulting in an incremental cost-effectiveness ratio of $185,565 per QALY (interquartile range $57,675 to $395,743). Because of the upfront training costs and the resource-intensive nature of this intervention, associated expenses were high. Although PTSD-specific effectiveness measures were significantly improved, these changes did not translate to QALYs in the main analysis. However, analyses focusing on patient subgroups with comorbid mental disorders indicated greater QALY improvement for TOP at lower cost.",Painter JT.; Fortney JC.; Austen MA.; Pyne JM.,2017.0,10.1176/appi.ps.201600485,0,0,
1265,Mental Health Does Not Moderate Compensatory Cognitive Training Efficacy for Veterans With a History of Mild Traumatic Brain Injury.,"To examine the potential moderating effects of mental health symptoms on the efficacy of compensatory cognitive training (CCT) for Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans with a history of mild traumatic brain injury (mTBI). Secondary analysis of a randomized controlled trial of CCT. Posttraumatic stress disorder, depression, and substance dependence symptom severity were examined as potential moderators of CCT efficacy for subjective cognitive complaints, use of cognitive strategies, and objective neurocognitive performance. Three Veterans Affairs medical centers. Participants included veterans with history of mTBI (N=119): 50 participated in CCT and 69 received usual care (UC). CCT is a 10-week group-based (90 minutes per session) manualized cognitive rehabilitation intervention. Objective (neuropsychological functioning) and subjective (self-report) cognitive functioning and use of cognitive strategies. Baseline mental health symptoms did not moderate CCT efficacy: veterans who received CCT reported significantly greater improvement in cognitive difficulties and use of cognitive strategies compared with the UC group, regardless of baseline mental health symptom severity. The CCT group also demonstrated significant improvements on neuropsychological measures of attention, learning, and executive functioning compared with the UC group, regardless of baseline mental health symptom severity. CCT is efficacious for improving objective cognitive functioning and compensatory strategy use for veterans with a history of mTBI, regardless of the severity of comorbid psychiatric symptoms.",Pagulayan KF.; O'Neil M.; Williams RM.; Turner AP.; Golshan S.; Roost MS.; Laman-Maharg B.; Huckans M.; Storzbach D.; Twamley EW.,2017.0,10.1016/j.apmr.2017.04.009,0,0,
1266,Preventing post-traumatic intrusions using virtual reality,"Post-Traumatic Stress Disorder (PTSD) research is of upmost importance given the high lifetime risk of experiencing a traumatic event. While there is a successful treatment protocol for PTSD, there can be delays in access and early interventions are lacking. Recent research has suggested that loading working memory with a visuo-spatial task immediately following a traumatic experience can reduce the frequency and development of intrusive trauma-related images. It was hypothesised here that completing a visuo-spatial task in virtual reality could enhance such interventions given its distinct attention-capturing ability. 30 non-clinical participants watched a traumatic film, then engaged in Tetris® on a desktop display, in virtual reality, or sat in silence (control condition). Participants kept a diary of intrusions experienced for the next 7 days. Participants in the virtual reality condition recorded significantly less intrusions over the 7 days than those in the no-task control condition. Using virtual reality was also rated as significantly more engaging than the desktop condition and had the secondary gain of significant post-task mood improvement. Although only initial findings, using virtual reality clearly has the potential to be both a more effective and a more appealing intrusion prevention technique following a trauma.",Page S.; Coxon M.,2017.0,,0,0,
1267,Outcomes for Depressed and Anxious Inpatients Discharged Before or After Group Cognitive Behavior Therapy: A Naturalistic Comparison.,"Treatment outcomes for psychiatric inpatients with a primary diagnosis of a depressive or anxiety disorder who completed a cognitive behavior therapy (CBT) program while inpatients or when discharged were examined. Of 340 inpatients, 197 had been discharged to day patient status before the end of the CBT program, and 143 remained as inpatients. Data were collected before and after the CBT program and at 3-month follow-up. There was a significant improvement by posttreatment in self-esteem, locus of control, anxiety, depression, and stress, and these gains were maintained at 3-month follow-up. In addition, anxious, but not depressed, patients who completed CBT as day patients demonstrated greater improvements from after the CBT program to follow-up than those treated as inpatients. Possible reasons for the beneficial effects of completing the CBT as a day patient rather than an inpatient are discussed, and threats to the validity of this naturalistic study are considered. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Page, Andrew C; Hooke, Geoffrey R",2003.0,http://dx.doi.org/10.1097/01.nmd.0000092174.38770.e9,0,0,
1268,Temperament clusters associate with anxiety disorder comorbidity in depression.,"Background: Individual temperament is associated with psychiatric morbidity and could explain differences in psychiatric comorbidities. We investigated the association of temperament profile clusters with anxiety disorder comorbidity in patients with depression. Methods: We assessed the temperament of 204 specialized care-treated depressed patients with the Temperament and Character Inventory (TCI-R) and their diagnoses with the Mini International Neuropsychiatric Interview. Two-step cluster analysis was used for defining patients' temperament profiles and logistic regression analysis was used for predicting different anxiety disorders for various temperament profiles. Results: Four temperament clusters were found: 1) Novelty seekers with highest Novelty Seeking scores (n = 56),2) Persistent with highest Persistence scores (n = 36), 3) Reserved with lowest Novelty Seeking scores (n = 66) and 4) Wearied with highest Harm avoidance, lowest Reward Dependence and lowest Persistence scores (n = 58). After adjusting for clinical variables, panic disorder and/or agoraphobia were predicted by Novelty seekers' temperament profile with odds ratio [OR] = 3.5 (95% confidence interval [CI] = 1.8 - 6.9, p < 0.001), social anxiety disorder was predicted by Wearied temperament profile with OR = 3.4 (95% CI = 1.6 - 7.5, p = 0.002), and generalized anxiety disorder was predicted by Reserved temperament profile with OR = 2.6 (95% CI = 1.2 - 5.3, p = 0.01). Limitations: The patients' temperament profiles were assessed while displaying depressive symptoms, which may have affected results. Conclusions: Temperament clusters with unique dimensional profiles were specifically associated with different anxiety disorders in this study. These results suggest that TCI-R could offer a valuable dimensional method for predicting the risk of anxiety disorders in diverse depressed patients. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Paavonen, Vesa; Luoto, Kaisa; Lassila, Antero; Leinonen, Esa; Kampman, Olli",2018.0,http://dx.doi.org/10.1016/j.jad.2018.04.084,0,0,
1269," The effects of inpatient versus outpatient spa therapy on pain, anxiety, and quality of life in elderly patients with generalized osteoarthritis: a pilot study"," This study aimed to investigate the effect of inpatient vs outpatient spa therapy on pain, quality of life, and anxiety in elderly patients with generalized osteoarthritis. A total of 150 patients were randomized into three groups. Group I was given medical treatment, group II was treated as outpatients, and group III was treated as inpatient spa therapy. Assessments were made using the Pain (VAS), EQ‐5D‐3L Scale, and State and Trait Anxiety Inventory (STAI) at the beginning of treatment (W0), at the end of treatment (W2), and at the fourth week after treatment (W6). The comparison of outpatient spa group and etodolac treatment group showed that outpatient spa group was superior to etodolac treatment group in all evaluated parameters at W2 vs W0 and W6 vs W0. The comparison of inpatient spa group and etodolac treatment group showed that inpatient spa group was superior to etodolac treatment group in all evaluated parameters at W2 vs W0 and W6 vs W0. The comparison of inpatient spa group and outpatient spa group showed that inpatient spa group was superior to outpatient spa group in all evaluated parameters except STAI‐TXII at W2 vs W0 and in all evaluated parameters W6 vs W0. Spa therapy, either as an outpatient or inpatient basis, may have a positive effect on pain, anxiety, and quality of life in geriatric patients with generalized osteoarthritis. The inpatient spa therapy may be more beneficial than outpatient spa therapy. When the side effects of drug treatments are emphasized, spa therapy may be considered as an interesting option for elderly with osteoarthritis."," Özkuk, K;  Uysal, B;  Ateş, Z;  Ökmen, BM;  Sezer, R;  Dilek, G",2018.0, 10.1007/s00484-018-1584-5,0,0,
1270,"Investigation of physical activity, stress and depression levels in pregnant women","Purpose: The aim of the study is to compare physical activity, distress and depression in pregnant women. Methods: A total of 210 women who applied to the Obstetrics and Gynecology Clinic were included in the study. The mean age of participants was 27.33±4.74 years. Individuals were categorized in 3 period according to weeks of their pregnancy as the first 0-13 weeks, second 14-26 weeks, and third trimester 27-40 weeks of pregnancy. The sociodemographic characteristics were gathered with the demographic information form. Physical activity levels of women by Pregnancy Physical Activity Questionnaire, depression levels by the Beck Depression Inventory and level of stress by Tilburg Pregnancy Distress Scale were assessed. Results: 25.2% of the women were in the first 43.8% in the second and 31% in the third trimester. When the physical activity and depression levels of women were compared, there was a significant difference in physical activity (p<0.001) and depression (p<0.001). When distress levels were compared no significant difference was observed (p=0.75). Conclusion: We found that the lowest level of physical activity was in the first trimester; however, as the pregnancy progressed, it is observed that physical activity was increased. In addition, the depression was found higher in the third trimester. Limitations of our study include not investigating the effect of physical activity on birth weight and easy delivery. It is known that increasing physical activity positively affects maternal and child health. We think it is necessary to plan the research in a wider sample.",Özdemir O.C.; Yavuz I.E.; Özel A.; Altuntaş D.; Topçuoǧlu A.,2017.0,,0,0,
1271,A Survey of Rabbit Handling Methods Within the United Kingdom and the Republic of Ireland,"Rabbits are commonly kept in a variety of settings, including homes, laboratories, and veterinary clinics. Despite the popularity of keeping this prey species, little research has investigated current methods of handling. The aim of this study was to examine the experience of caregivers (owners and keepers) in using five handling methods commonly referred to in books written for companion animal (pet) owners and veterinary and/or laboratory personnel. An online survey was completed by 2644 respondents, representing all three of these groups, and breeders. Data were acquired to determine sources that participants used to gain knowledge of different handling methods, the methods they used and for what purposes they used them, and their perceptions of any associated difficulties or welfare concerns. Results indicated that participants most frequently used the method of supporting a rabbit’s body against a person’s chest, which was considered the easiest and most welfare-friendly method of the handling methods explored. “Scruffing with rear support” was the least used method and was considered to be distressing and painful for the rabbit. As rabbits are a terrestrial prey species, being picked up is likely an innately stressful experience. Additional research is encouraged to explore the experience of rabbits during handling to identify methods that can be easily used with the fewest welfare compromises.",Oxley J.A.; Ellis C.F.; McBride E.A.; McCormick W.D.,2018.0,10.1080/10888705.2018.1459192,0,0,
1272,A randomized controlled trial evaluating Mindfulness-Based Stress Reduction (MBSR) for the treatment of palpitations: A pilot study.,,Owens JE.; Schorling J.; Plews-Ogan M.; Goodman M.; Moorman R.; Zaklin R.; Dent J.,2016.0,10.1016/j.ijcard.2016.08.183,0,0,
1273, Randomized Trial of a Social Networking Intervention for Cancer-Related Distress," BACKGROUND: Web and mobile technologies appear to hold promise for delivering evidence‚Äêinformed and evidence‚Äêbased intervention to cancer survivors and others living with trauma and other psychological concerns. Health‚Äêspace.net was developed as a comprehensive online social networking and coping skills training program for cancer survivors living with distress. PURPOSE: The purpose of this study was to evaluate the effects of a 12‚Äêweek social networking intervention on distress, depression, anxiety, vigor, and fatigue in cancer survivors reporting high levels of cancer‚Äêrelated distress. METHODS: We recruited 347 participants from a local cancer registry and internet, and all were randomized to either a 12‚Äêweek waiting list control group or to immediate access to the intervention. Intervention participants received secure access to the study website, which provided extensive social networking capabilities and coping skills training exercises facilitated by a professional facilitator. RESULTS: Across time, the prevalence of clinically significant depression symptoms declined from 67 to 34 % in both conditions. The health‚Äêspace.net intervention had greater declines in fatigue than the waitlist control group, but the intervention did not improve outcomes for depression, trauma‚Äêrelated anxiety symptoms, or overall mood disturbance. For those with more severe levels of anxiety at baseline, greater engagement with the intervention was associated with higher levels of symptom reduction over time. CONCLUSIONS: The intervention resulted in small but significant effects on fatigue but not other primary or secondary outcomes. Results suggest that this social networking intervention may be most effective for those who have distress that is not associated with high levels of anxiety symptoms or very poor overall psychological functioning. TRIAL REGISTRATION NUMBER: The trial was registered with the ClinicalTrials.gov database ( ClinicalTrials.gov #NCT01976949)."," Owen, JE;  O'Carroll Bantum, E;  Pagano, IS;  Stanton, A",2017.0, 10.1007/s12160-017-9890-4,0,0,
1274, Mediators and Treatment Factors in Intervention for Children Exposed to Interparental Violence," Changes in children's emotion differentiation, coping skills, parenting stress, parental psychopathology, and parent‚Äêchild interaction were explored as mediators of treatment factors in two selective preventive group interventions for children exposed to interparental violence (IPV) and their parents. One hundred thirty‚Äêfour IPV‚Äêexposed children (ages 6‚Äê12 years, 52% boys) and their parents were randomized to an IPV‚Äêfocused or common factors community‚Äêbased group intervention and completed baseline, posttest, and follow‚Äêup assessments for posttraumatic stress (PTS). A multilevel model tested mediators that included children's ability to differentiate emotions and coping skills, parenting stress, parental psychopathology, and parent‚Äêchild interactions. In both conditions, exposure to nonspecific factors, specific factors unrelated to IPV and trauma‚Äêspecific intervention factors was coded from videotaped child and parent sessions. Improved parental mental health mediated the link between greater exposure to nonspecific treatment factors and decreases in PTS symptoms. In addition, an increase in emotion differentiation and a decrease in parenting stress were associated with a decrease in PTS symptoms. Greater exposure to trauma‚Äêspecific factors in child sessions was associated with a small decrease in emotion differentiation, an increase in coping skills, and a decrease in PTS symptoms over time. Greater exposure to nonspecific treatment factors in child and parent sessions was associated with more positive parent‚Äêchild interaction. Parental mental health appears to be an important mechanism of change that can be promoted through exposure to nonspecific factors in parent intervention. For children, the effect of greater exposure to trauma‚Äêspecific factors in intervention is less clear and may not have clear benefits."," Overbeek, MM;  De Schipper, JC;  Willemen, AM;  Lamers-Winkelman, F;  Schuengel, C",2017.0, 10.1080/15374416.2015.1012720,0,0,
1275,Network mechanisms of clinical response to transcranial magnetic stimulation in posttraumatic stress disorder and major depressive disorder.,"Background: Repetitive transcranial magnetic stimulation (TMS) therapy can modulate pathological neural network functional connectivity in major depressive disorder (MDD). Posttraumatic stress disorder is often comorbid with MDD, and symptoms of both disorders can be alleviated with TMS therapy. This is the first study to evaluate TMS-associated changes in connectivity in patients with comorbid posttraumatic stress disorder and MDD. Methods: Resting-state functional connectivity magnetic resonance imaging was acquired before and after TMS therapy in 33 adult outpatients in a prospective open trial. TMS at 5 Hz was delivered, in up to 40 daily sessions, to the left dorsolateral prefrontal cortex. Analyses used a priori seeds relevant to TMS, posttraumatic stress disorder, or MDD (subgenual anterior cingulate cortex [sgACC], left dorsolateral prefrontal cortex, hippocampus, and basolateral amygdala) to identify imaging predictors of response and to evaluate clinically relevant changes in connectivity after TMS, followed by leave-one-out cross-validation. Imaging results were explored using data-driven multivoxel pattern activation. Results: More negative pretreatment connectivity between the sgACC and the default mode network predicted clinical improvement, as did more positive amygdala-to-ventromedial prefrontal cortex connectivity. After TMS, symptom reduction was associated with reduced connectivity between the sgACC and the default mode network, left dorsolateral prefrontal cortex, and insula, and reduced connectivity between the hippocampus and the salience network. Multivoxel pattern activation confirmed seed-based predictors and correlates of treatment outcomes. Conclusions: These results highlight the central role of the sgACC, default mode network, and salience network as predictors of TMS response and suggest their involvement in mechanisms of action. Furthermore, this work indicates that there may be network-based biomarkers of clinical response relevant to these commonly comorbid disorders. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Philip, Noah S; Barredo, Jennifer; van 't Wout-Frank, Mascha; Tyrka, Audrey R; Price, Lawrence H; Carpenter, Linda L",2018.0,http://dx.doi.org/10.1016/j.biopsych.2017.07.021,0,0,
1276,"Feasibility and efficacy of an mHealth game for managing anxiety: ""Flowy"" randomized controlled pilot trial and design evaluation.","Objective: Meeting the complex needs of patients with chronic common mental health disorders (CMHDs) may be the greatest challenge facing organized medical practice. On the basis of a well-established and proven theoretical foundation for controlled respiration as a behavioral intervention for CMHDs, as well as preliminary evidence that gamification can improve health outcomes through increasing patient engagement, this randomized controlled pilot study evaluated the feasibility and clinical efficacy of a mobile health game called ""Flowy"" (www.flowygame.com) that digitally delivered breathing retraining exercises for anxiety, panic, and hyperventilation symptom management. Materials and Methods: We designed an unblinded, Web-based, parallel-group randomized controlled trial focusing on feasibility, clinical efficacy, and design proof of concept. In the intervention condition (n = 31), participants received free access to ""Flowy"" for 4 weeks. In the control condition (n = 32), participants were placed on a waitlist for 4 weeks before being offered free access to ""Flowy."" Online measurements using psychological self-report questionnaires were made at 2 and 4 weeks post-baseline. Results: At trial conclusion, participants found ""Flowy"" acceptable as an anxiety management intervention. ""Flowy"" engaged participants sufficiently to endorse proactive gameplay. Intent-to-treat analysis revealed a reduction in anxiety, panic, and self-report hyperventilation scores in both trial arms, with the intervention arm experiencing greater quality of life. Participants perceived ""Flowy"" as a fun and useful intervention, proactively used ""Flowy"" as part of their care, and would recommend ""Flowy"" to family and friends. Conclusions: Our results suggest that a digital delivery of breathing retraining exercises through a mobile health game can manage anxiety, panic, and hyperventilation symptoms associated with CMHDs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pham, Quynh; Khatib, Yasmin; Stansfeld, Stephen; Fox, Simon; Green, Tobias",2016.0,http://dx.doi.org/10.1089/g4h.2015.0033,0,0,
1277, Dysfunctional posttraumatic cognitions as a mediator of symptom reduction in Trauma-Focused Cognitive Behavioral Therapy with children and adolescents: results of a randomized controlled trial," OBJECTIVE: To investigate whether the change in dysfunctional posttraumatic cognitions (PTC) during Trauma‚ÄêFocused Cognitive Behavioral Therapy (TF‚ÄêCBT) is a mediator of posttraumatic stress symptom (PTSS) reduction in a sample of children and adolescents. METHOD: A bootstrap mediation analysis was performed to investigate the indirect effect of dysfunctional PTC on treatment outcome in a recently completed RCT study with children and adolescents (n = 123; 7‚Äê17 years old) that investigated the effectiveness of TF‚ÄêCBT. RESULTS: The mediation model revealed that changes in dysfunctional PTC mediated the relationship between the group (TF‚ÄêCBT vs. waitlist) and PTSS at the end of treatment. CONCLUSION: Change in dysfunctional PTC is an important mechanism mediating the reduction of PTSS in TF‚ÄêCBT. Monitoring dysfunctional PTC throughout treatment might, therefore, be an important factor in optimizing treatment outcome."," Pfeiffer, E;  Sachser, C;  de Haan, A;  Tutus, D;  Goldbeck, L",2017.0, 10.1016/j.brat.2017.08.001,0,0,
1278, Treating Trauma in Addiction with EMDR: a Pilot Study," Abstract Objective: This study investigated the effects of standard eye movement desensitization and reprocessing (EMDR) protocol in chronically dependent patients. We propose that reprocessing traumatic memories with EMDR would lead to measurable changes of addiction symptoms. METHOD: Twelve patients with alcohol and/or drug dependency were randomly assigned to one of two treatment conditions: treatment as usual (TAU) or TAU plus eight sessions of EMDR (TAU+EMDR). Measures of PTSD symptoms, addiction symptoms, depression, anxiety, self‚Äêesteem, and alexithymia were included in this study. RESULTS: The TAU+EMDR group showed a significant reduction in PTSD symptoms but not in addiction symptoms. EMDR treatment was also associated with a significant decrease in depressive symptoms, while patients receiving TAU showed no improvement in this area. The TAU+EMDR group also showed significant changes in self‚Äêesteem and alexithymia post‚Äêtreatment. CONCLUSIONS: This study suggests that PTSD symptoms can be successfully treated with standard EMDR protocol in substance abuse patients."," Perez-Dandieu, B;  Tapia, G",2014.0, 10.1080/02791072.2014.921744,0,0,
1279, Child Anxiety Prevention Study: impact on Functional Outcomes," This study examined the impact of a selective anxiety prevention program for offspring of clinically anxious parents on three domains of child functioning: (1) social, (2) familial, and (3) emotional/behavioral. Dyads were randomized into either the Coping and Promoting Strength program (CAPS; n = 70) or Information Monitoring (IM; n = 66) comparison group. Multi‚Äêinformant assessments were conducted at baseline, post intervention, and 6 and 12 months follow‚Äêups. Random effects mixed models under the linear growth modeling (LGM) framework was used to assess the impact of CAPS on growth trajectories. Over time, children in the CAPS group had significantly lower anxiety, anxious/depressed symptoms, and lower total behavior problems (parent report), compared to children in IM group. The intervention did not impact other domains assessed (e.g., social functioning), which may be due to ""floor effects"" on these measures. Longitudinal follow‚Äêup data is needed to provide valuable information about this high risk population."," Pella, JE;  Drake, KL;  Tein, JY;  Ginsburg, GS",2017.0, 10.1007/s10578-016-0667-y,0,0,
1280, Eye movement desensitization and reprocessing therapy versus supportive therapy in affective relapse prevention in bipolar patients with a history of trauma: study protocol for a randomized controlled trial," BACKGROUND: Up to 60% of patients with bipolar disorder (BD) have a history of traumatic events, which is associated with greater episode severity, higher risk of comorbidity and higher relapse rates. Trauma‐focused treatment strategies for BD are thus necessary but studies are currently scarce. The aim of this study is to examine whether Eye Movement Desensitization and Reprocessing (EMDR) therapy focusing on adherence, insight, de‐idealisation of manic symptoms, prodromal symptoms and mood stabilization can reduce episode severity and relapse rates and increase cognitive performance and functioning in patients with BD. METHODS/DESIGN: This is a single‐blind, randomized controlled, multicentre trial in which 82 patients with BD and a history of traumatic events will be recruited and randomly allocated to one of two treatment arms: EMDR therapy or supportive therapy. Patients in both groups will receive 20 psychotherapeutic sessions, 60 min each, during 6 months. The primary outcome is a reduction of affective episodes after 12 and 24 months in favour of the EMDR group. As secondary outcome we postulate a greater reduction in affective symptoms in the EMDR group (as measured by the Bipolar Depression Rating Scale, the Young Mania Rating Scale and the Clinical Global Impression Scale modified for BD), and a better performance in cognitive state, social cognition and functioning (as measured by the Screen for Cognitive Impairment in Psychiatry, The Mayer‐Salovey‐Caruso Emotional Intelligence Test and the Functioning Assessment Short Test, respectively). Traumatic events will be evaluated by The Holmes‐Rahe Life Stress Inventory, the Clinician‐administered PTSD Scale and the Impact of Event Scale. DISCUSSION: The results of this study will provide evidence whether a specific EMDR protocol for patients with BD is effective in reducing affective episodes, affective symptoms and functional, cognitive and trauma symptoms. TRIAL REGISTRATION: The trial is registered at ClinicalTrials.gov, identifier: NCT02634372 . Registered on 3 December 2015."," Moreno-Alcázar, A;  Radua, J;  Landín-Romero, R;  Blanco, L;  Madre, M;  Reinares, M;  Comes, M;  Jiménez, E;  Crespo, JM;  Vieta, E;  et al.",2017.0, 10.1186/s13063-017-1910-y,0,0,
1281, Comparative study of group treatments for posttraumatic stress disorder," Presented herein is a comparative study of group treatments for posttraumatic stress disorder (PTSD). In this study, an emerging intervention, memory specificity training (MeST), was compared with cognitive processing therapy (CPT) using standardized outcome measures of target symptoms (i.e., anxiety and depression from client perspective; memory specificity from independent rater perspective) and global functioning (independent rater perspective), as well as a process measure of expectancy (client perspective). Clients were assessed on 3 separate occasions: at baseline, posttreatment, and 3 months posttreatment. Adherence and treatment fidelity (independent rater perspective) were monitored throughout the course of both treatment conditions. Improvement in PTSD symptoms, depressive symptoms, and global functioning were similar between MeST and CPT; an increase in ability to specify memories upon retrieval was also similar between MeST and CPT. Positive reliable change was observed in both groups on all outcome measures. With respect to the primary target of PTSD symptoms, 88% of participants in both treatment groups moved into the functional distribution by posttreatment and maintained these gains at follow‚Äêup. Notably, compared with CPT, MeST required only half the dosage (i.e., number of sessions) to accomplish these gains. Illustrative vignettes from client‚Äêtherapist exchanges are provided, and results are discussed in terms of the potential mechanisms of action. Implications for both clinical practice and clinical research are also included. (PsycINFO Database Record"," Maxwell, K;  Callahan, JL;  Holtz, P;  Janis, BM;  Gerber, MM;  Connor, DR",2016.0, 10.1037/pst0000032,0,0,
1282,A randomized controlled trial comparing EMDR and CBT for obsessive-compulsive disorder.,"This study aimed to evaluate eye movement desensitization and reprocessing (EMDR) as a treatment for obsessive-compulsive disorder (OCD), by comparison to cognitive behavioural therapy (CBT) based on exposure and response prevention. This was a pragmatic, feasibility randomized controlled trial in which 55 participants with OCD were randomized to EMDR (n = 29) or CBT (n = 26). The Yale-Brown obsessive-compulsive scale was completed at baseline, after treatment and at 6 months follow-up. Treatment completion and response rates were compared using chi-square tests. Effect size was examined using Cohen's d and multilevel modelling. Overall, 61.8% completed treatment and 30.2% attained reliable and clinically significant improvement in OCD symptoms, with no significant differences between groups (p > .05). There were no significant differences between groups in Yale-Brown obsessive-compulsive scale severity post-treatment (d = -0.24, p = .38) or at 6 months follow-up (d = -0.03, p = .90). EMDR and CBT had comparable completion rates and clinical outcomes.",Marsden Z.; Lovell K.; Blore D.; Ali S.; Delgadillo J.,2018.0,10.1002/cpp.2120,0,0,
1283,Targeting memory reconsolidation to prevent the return of fear in patients with fear of flying.,"Background: When a memory is recalled, it may again exist in a labile state and stored information becomes amenable to change, a psychobiological process known as reconsolidation. Exposure therapy for anxiety disorders involves accessing a fear memory and modifying it with less fearful information. A preclinical study reported that providing a reminder of a fear memory 10 min prior to extinction training in humans decreased fear up to 1 year later (Schiller et al., 2010). Methods: For this pilot clinical study, we used virtual reality exposure therapy (VRE) for fear of flying (FoF) to determine if using a cue to reactivate the memory of the feared stimulus 10 min prior to exposure sessions leads to fewer anxiety-related behaviors and a more durable response compared to a neutral cue. FoF participants (N = 89) received four sessions of anxiety management training followed by four sessions of VRE. Participants were randomly assigned to receive an FoF cue (reactivation group) or a neutral cue (control group) prior to the VRE sessions. Heart rate (HR) and skin conductance levels (SCLs) were collected during posttreatment and 3-month follow-up assessments as objective markers of fear responding. Results: Treatment was effective and all clinical measures improved equally between groups at posttreatment with maintained gains through follow-ups. Significant differences were identified with regard to HR and SCL indices. Conclusions: These results suggest that memory reactivation prior to exposure therapy did not have an impact on clinical measures but may enhance the effect of exposure therapy at the physiological level. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Maples-Keller, Jessica L; Price, Matthew; Jovanovic, Tanja; Norrholm, Seth D; Odenat, Lydia; Post, Loren; Zwiebach, Liza; Breazeale, Kathryn; Gross, Robin; Kim, Sae-Jin; Rothbaum, Barbara Olasov",2017.0,http://dx.doi.org/10.1002/da.22626,0,0,
1284, Moving to Second-Stage Treatments Faster: identifying Midtreatment Tailoring Variables for Youth with Anxiety Disorders," The current study presents an approach for empirically identifying tailoring variables at midtreatment of cognitive behavioral therapy (CBT) protocols for youth with anxiety disorders that can be used to guide moves to second‚Äêstage treatments. Using 2 independent data sets (Study 1 N = 240, M age = 9.86 years; Study 2 N = 341; M age = 9.53 years), we examined treatment response patterns after 8 sessions of CBT (i.e., CBT midtreatment). We identified and replicated 3 classes of response patterns at CBT midtreatment: Early Responders, Partial Responders, and Nonresponders. Class membership at CBT midtreatment was predictive of outcome at CBT posttreatment. Receiver operating characteristics curves were used to derive guidelines to optimize accuracy of assignment to classes at CBT midtreatment. These findings support the promise of treatment response at CBT midtreatment to identify tailoring variables for use in abbreviating first‚Äêstage treatments and facilitating moves to second‚Äêstage treatments."," Pettit, JW;  Silverman, WK;  Rey, Y;  Marin, C;  Jaccard, J",2016.0, 10.1080/15374416.2015.1038824,0,0,
1285, Findings from the Families on Track Intervention Pilot Trial for Children with Fetal Alcohol Spectrum Disorders and Their Families," BACKGROUND: Individuals with fetal alcohol spectrum disorders (FASD) are at high risk for costly, debilitating mental health problems and secondary conditions, such as school disruption, trouble with the law, and substance use. The study objective was to pilot a multicomponent intervention designed to prevent secondary conditions in children with FASD and improve family adaptation. METHODS: Thirty children with FASD or prenatal alcohol exposure (PAE) (ages 4 to 8) and their primary caregivers were enrolled. Families were randomized to either the Families on Track Integrated Preventive Intervention or an active control of neuropsychological assessment and personalized community referrals. The 30‚Äêweek intervention integrates scientifically validated bimonthly, in‚Äêhome parent behavioral consultation, and weekly child skills groups. Outcomes measured at baseline and follow‚Äêup postintervention included intervention satisfaction, child emotional and behavioral functioning, child self‚Äêesteem, caregiver knowledge of FASD and advocacy, caregiver attitudes, use of targeted parenting practices, perceived family needs met, social support, and self‚Äêcare. Data analysis emphasized calculation of effect sizes and was supplemented with analysis of variance techniques. RESULTS: Analyses indicated that families participating in the intervention reported high program satisfaction. Relative to comparison group outcomes, the intervention was associated with medium‚Äêto‚Äêlarge effects for child emotion regulation, self‚Äêesteem, and anxiety. Medium‚Äêsized improvements in disruptive behavior were observed for both groups. Medium and large effects were seen for important caregiver outcomes: knowledge of FASD and advocacy, attributions of behavior, use of antecedent strategies, parenting efficacy, family needs met, social support, and self‚Äêcare. CONCLUSIONS: This pilot study yielded promising findings from the multicomponent Families on Track Integrated Preventive Intervention for child and caregiver outcomes. An important next step is to complete a randomized control trial of the Families on Track Program with a larger sample fully representative of this underserved clinical population with built‚Äêin study of implementation parameters."," Petrenko, CLM;  Pandolfino, ME;  Robinson, LK",2017.0, 10.1111/acer.13408,0,0,
1286, Effects of disease salience and xenophobia on support for humanitarian aid," This article examines how disease salience influences attitudes toward two types of humanitarian aid: sending foreign aid and housing refugees. Some have argued that disease salience increases levels of out‚Äêgroup prejudice through what is referred to as the behavioral immune system (BIS), and this increase in out‚Äêgroup prejudice works to shape policy attitudes. However, an alternative mechanism that may explain the effects of disease salience is contamination fear, which would suggest there is no group bias in the effects of disease threat. Existing work largely interprets opposition to policies that assist out‚Äêgroups as evidence of out‚Äêgroup prejudice. We suggest it is necessary to separate measures of out‚Äêgroup animosity from opinions toward specific policies to determine whether increased out‚Äêgroup prejudice rather than fear of contamination is the mechanism by which disease salience impacts policy attitudes. Across two experiments, disease salience is shown to significantly decrease support for humanitarian aid, but only in the form of refugee support. Furthermore, there is converging evidence to suggest that any influence of disease salience on aid attitudes is not caused by a corresponding increase in xenophobia. We suggest that the mechanism by which disease threat influences policy attitudes is a general fear of contamination rather than xenophobia. These findings go against an important hypothesized mechanism of the BIS and have critical implications for the relationship between disease salience and attitudes toward transnational policies involving humanitarian aid."," Peterson, JC;  Gonzalez, FJ;  Schneider, SP",2017.0, 10.1017/pls.2017.24,0,0,
1287, Perspectives on a Home Telehealth Care Management Program for Veterans With Posttraumatic Stress Disorder Who Smoke," BACKGROUND: Individuals with posttraumatic stress disorder (PTSD) have high rates of smoking and low quit rates. We conducted a qualitative evaluation of an integrated smoking cessation randomized controlled trial (RCT) that used home telehealth and motivational interviewing (MI) to change smoking behaviors among individuals with PTSD. METHOD: Using a convenience sample sourced from the original RCT, intervention and control group participants were invited to participate in a qualitative evaluation. Semistructured interview guides were used to assess the effectiveness of study components, make recommendations for future interventions, and identify facilitators/barriers to smoking cessation. We analyzed these data using an inductive and deductive, team‚Äêbased content analysis approach. RESULTS: We interviewed 32 study participants (intervention: n = 15, control: n = 17) who completed the original RCT within the previous 6 months. Respondents were highly satisfied with home telehealth and MI counseling. The intervention group respondents found MI counseling to be supportive, nonjudgmental, and informative. Control group respondents felt that they had received smoking cessation assistance. Respondents from both groups desired more information about PTSD and smoking, relied on smoking as a coping mechanism for PTSD, and believed that quitting was an individual choice. CONCLUSION: Respondents reported that home telehealth and MI were acceptable ways to provide smoking cessation assistance to individuals with PTSD. The support and increased awareness of smoking behaviors were perceived as helpful. Future investigations should focus on increasing support and information about stress management, smoking, PTSD, and the relationship between them for individuals with PTSD who smoke."," Peterson, J;  Battaglia, C;  Fehling, KB;  Williams, KM;  Lambert-Kerzner, A",2017.0, 10.1097/JAN.0000000000000174,0,0,
1288, Processing of fair and unfair offers in the ultimatum game under social observation," Social context influences social decisions and outcome processing, partially depending on inter‚Äêindividual differences. The present study investigated social context‚Äêdependent modulation of behavior and feedback processing in the ultimatum game (UG) in relation to inter‚Äêindividual differences in social anxiety. Thirty‚Äêtwo healthy adults completed the UG both under social observation and without observation. Offers were allegedly either randomly generated by the computer or drawn from a pool of offers from previous human players. Overall, fewer unfair than fair offers were accepted. Observation decreased acceptance rates for unfair offers. The feedback‚Äêlocked feedback‚Äêrelated negativity (FRN) but not the P3 was modulated by observation and fairness, with stronger differential coding of unfair/fair under observation. This effect was strongly correlated with individual levels of social anxiety, with higher levels associated with stronger differential fairness coding in the FRN under observation. Behavioral findings support negative reciprocity in the UG, suggesting that (implicit) social norms overwrite explicit task instructions even in the absence of (alleged) social interaction. Observation enhances this effect. Fairness coding in the FRN was modulated by observation as a function of social anxiety, supporting the notion that altered sensitivity to equality in a social context may contribute to social avoidance in socially anxious individuals."," Peterburs, J;  Voegler, R;  Liepelt, R;  Schulze, A;  Wilhelm, S;  Ocklenburg, S;  Straube, T",2017.0, 10.1038/srep44062,0,0,
1289,Selective attention to emotional prosody in social anxiety: a dichotic listening study,"The majority of evidence on social anxiety (SA)-linked attentional biases to threat comes from research using facial expressions. Emotions are, however, communicated through other channels, such as voice. Despite its importance in the interpretation of social cues, emotional prosody processing in SA has been barely explored. This study investigated whether SA is associated with enhanced processing of task-irrelevant angry prosody. Fifty-three participants with high and low SA performed a dichotic listening task in which pairs of male/female voices were presented, one to each ear, with either the same or different prosody (neutral or angry). Participants were instructed to focus on either the left or right ear and to identify the speaker’s gender in the attended side. Our main results show that, once attended, task-irrelevant angry prosody elicits greater interference than does neutral prosody. Surprisingly, high socially anxious participants were less prone to distraction from attended-angry (compared to attended-neutral) prosody than were low socially anxious individuals. These findings emphasise the importance of examining SA-related biases across modalities.",Peschard V.; Gilboa-Schechtman E.; Philippot P.,2017.0,10.1080/02699931.2016.1261012,0,0,
1290,"A study investigating the impact of peer mentoring on pupils transitioning into secondary school who may be at risk of behavioural, emotional and social difficulties","Transition to secondary school is almost always a significant period of worry and anxiety. Research has linked it to a number of negative outcomes for young people including lower self-esteem and self-concept and lower academic achievement. Previous literature suggests that peer mentoring can combat negative effects associated with transition. The study explored the use of peer mentoring to support pupils who may be at risk of developing social, emotional and behavioural difficulties following transition to secondary school. A pre-test post-test two-group randomised controlled trial investigated the impact on the Year 7 pupils. To examine the impact on Year 9 peer mentors, a pre-test post-test single group design was applied. The quantitative data from Strengths and Difficulties Questionnaires (SDQ), Resiliency Scales and school attendance was analysed using ANOVAs and t-tests. A questionnaire was used to explore pupil views of the scheme and analysed using thematic analysis. No significant impact was found from the quantitative measures for either mentees or peer mentors. Whilst pupils largely enjoyed the experience, this did not translate into a significant measurable impact. Both the control and intervention group significantly improved on a number of SDQ subscales suggesting pupils may naturally improve following transition. The main themes regarding the things most liked about peer mentoring included having someone to talk to and supporting others. Areas proposed which could improve future schemes included a better environment and more frequent sessions. The study had some methodological limitations including a relatively small sample size, limiting the generalisability of the results; however, results coincide with previous research and the researcher questions future use of peer mentoring without more thorough investigation. This thesis highlights the lack of and need for well-conducted research into interventions before they are widely implemented.",Perry,2011.0,,0,0,
1291, Harm beliefs and coping expectancies in youth with specific phobias," Catastrophic beliefs and lowered coping expectancies are often present in individuals with specific phobias (SPs). The current study examined these beliefs and expectancies in 251 youth who received One Session Treatment for one of the three most common types of SP in youth (animals, natural environment, and situational). We compared the children's subjective beliefs to objective ratings of the likelihood of occurrence and the dangerousness of the feared events. Results revealed pre‐treatment differences in the youths' beliefs across phobia types and age. Specifically, children with animal phobias rated their beliefs as more likely to occur than did children with environmental and situational phobias. In addition, older children rated their beliefs as more dangerous than younger children. However, regardless of phobia type or child age, the beliefs improved following treatment. Changes in catastrophic beliefs and coping expectancies were related to changes in clinical severity following treatment but not 6‐months following treatment. Moreover, at pre‐treatment, children viewed their beliefs as significantly more catastrophic and likely to occur than did independent coders of these beliefs; however, these differences were no longer evident following treatment. Clinical implications are discussed, highlighting how changes in beliefs and expectancies might be associated with treatment outcomes."," Ollendick, TH;  Öst, LG;  Ryan, SM;  Capriola, NN;  Reuterskiöld, L",2017.0, 10.1016/j.brat.2017.01.007,0,0,
1292,Limbic-thalamo-cortical projections and reward-related circuitry integrity affects eating behavior: A longitudinal DTI study in adolescents with restrictive eating disorders.,"Few studies have used diffusion tensor imaging (DTI) to investigate the micro-structural alterations of WM in patients with restrictive eating disorders (rED), and longitudinal data are lacking. Twelve patients with rED were scanned at diagnosis and after one year of family-based treatment, and compared to twenty-four healthy controls (HCs) through DTI analysis. A tract-based spatial statistics procedure was used to investigate diffusivity parameters: fractional anisotropy (FA) and mean, radial and axial diffusivities (MD, RD and AD, respectively). Reduced FA and increased RD were found in patients at baseline in the corpus callosum, corona radiata and posterior thalamic radiation compared with controls. However, no differences were found between follow-up patients and controls, suggesting a partial normalization of the diffusivity parameters. In patients, trends for a negative correlation were found between the baseline FA of the right anterior corona radiata and the Eating Disorder Examination Questionnaire total score, while a positive trend was found between the baseline FA in the splenium of corpus callosum and the weight loss occurred between maximal documented weight and time of admission. A positive trend for correlation was also found between baseline FA in the right anterior corona radiata and the decrease in the Obsessive-Compulsive Inventory Revised total score over time. Our results suggest that the integrity of the limbic-thalamo-cortical projections and the reward-related circuitry are important for cognitive control processes and reward responsiveness in regulating eating behavior.",Olivo G.; Wiemerslage L.; Swenne I.; Zhukowsky C.; Salonen-Ros H.; Larsson EM.; Gaudio S.; Brooks SJ.; Schiöth HB.,2017.0,10.1371/journal.pone.0172129,0,0,
1293,Hemodynamic responses of eye movement desensitization and reprocessing in posttraumatic stress disorder.,"[Correction Notice: An erratum for this article was reported in Vol 66(2) of Neuroscience Research (see record 2010-01438-002). The publisher regrets that the surname of Dr. Ohtani was incorrectly spelt in the original article. The corrected author listing is given in the erratum.] Eye movement desensitization and reprocessing (EMDR) is an effective psychological intervention for posttraumatic stress disorder (PTSD). Trauma-related recall (Recall) with eye movements (EMs) is thought to reduce distress. However, the neural mechanisms underlying this process remain unknown. Thirteen patients with PTSD received EMDR treatment over the course of 2-10 weeks. We assessed the change in hemoglobin concentration in the lateral prefrontal cortex (PFC) during Recall with and without EM using multi-channel near-infrared spectroscopy (NIRS). Clinical diagnosis and improvement were evaluated using the Clinician-Administered PTSD Scale. Recall with EM was associated with a significant decrease in oxygenated hemoglobin concentration ([oxy-Hb]) in the lateral PFC as compared with Recall without EM. Longitudinally, [oxy-Hb] during Recall significantly decreased and the amount of decrease was significantly correlated with clinical improvement when the post-treatment data was compared with that of the pre-treatment. Our results suggest that performing EM during Recall reduces the over-activity of the lateral PFC, which may be part of the biological basis for the efficacy of EMDR in PTSD. NIRS may be a useful tool for objective assessment of psychological intervention in PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Ohta ni, Toshiyuki; Matsuo, Koji; Kasai, Kiyoto; Kato, Tadafumi; Kato, Nobumasa",2009.0,http://dx.doi.org/10.1016/j.neures.2009.08.014,0,0,
1294,"Changes in Problematic Anger, Shame, and Disgust in Anxious and Depressed Adults Undergoing Treatment for Emotion Dysregulation.","Emotion dysregulation, the pervasive difficulty managing negative emotions, is a core problem across mood and anxiety disorders. Anger, shame, and disgust are particularly problematic emotions, impacting both disorder severity and treatment outcome. We previously found that a 16-week dialectical behavior therapy skills training group (DBT-ST) was superior to an activities-based support group (ASG) in decreasing emotion dysregulation in 44 adults with high emotion dysregulation who met diagnostic criteria for an anxiety or depressive disorder. We presently examine these participants' changes in anger, shame, disgust, and distress using self-reports collected over 6 months during and after treatment. Hierarchical linear modeling analyses show that DBT-ST was superior to ASG in decreasing anger suppression (d = 0.93) and distress (d = 1.04). Both conditions significantly reduced shame, disgust propensity, and disgust sensitivity, but neither was superior for these outcomes. The treatments did not significantly reduce anger expression. Mediation analyses suggest that condition indirectly influenced 4-month anger suppression, shame, and distress through its effect on 2-month emotion dysregulation. These findings suggest that DBT-ST is efficacious for certain problematic emotions and distress in depressed and anxious adults and that common factors may account for some, but not all, of its benefits.",Neacsiu AD.; Rompogren J.; Eberle JW.; McMahon K.,2018.0,10.1016/j.beth.2017.10.004,0,0,
1295,Does cognitive behavioral therapy alter mental defeat and cognitive flexibility in patients with panic disorder?,"Mental defeat and cognitive flexibility have been studied as explanatory factors for depression and posttraumatic stress disorder. This study examined mental defeat and cognitive flexibility scores in patients with panic disorder (PD) before and after cognitive behavioral therapy (CBT), and compared them to those of a gender- and age-matched healthy control group. Patients with PD (n = 15) received 16 weekly individual CBT sessions, and the control group (n = 35) received no treatment. Patients completed the Mental Defeat Scale and the Cognitive Flexibility Scale before the intervention, following eight CBT sessions, and following 16 CBT sessions, while the control group did so only prior to receiving CBT (baseline). The patients' pre-CBT Mental Defeat and Cognitive Flexibility Scale scores were significantly higher on the Mental Defeat Scale and lower on the Cognitive Flexibility Scale than those of the control group participants were. In addition, the average Mental Defeat Scale scores of the patients decreased significantly, from 22.2 to 12.4, while their average Cognitive Flexibility Scale scores increased significantly, from 42.8 to 49.5. These results suggest that CBT can reduce mental defeat and increase cognitive flexibility in patients with PD Trial registration The study was registered retrospectively in the national UMIN Clinical Trials Registry on June 10, 2016 (registration ID: UMIN000022693).",Nagata S.; Seki Y.; Shibuya T.; Yokoo M.; Murata T.; Hiramatsu Y.; Yamada F.; Ibuki H.; Minamitani N.; Yoshinaga N.; Kusunoki M.; Inada Y.; Kawasoe N.; Adachi S.; Oshiro K.; Matsuzawa D.; Hirano Y.; Yoshimura K.; Nakazato M.; Iyo M.; Nakagawa A.; Shimizu E.,2018.0,10.1186/s13104-018-3130-2,0,0,
1296, Randomised controlled trial using a theory-based m-health intervention to improve physical activity and sleep health in adults: the Synergy Study protocol," INTRODUCTION: There is a need to reduce physical inactivity and poor sleep health in the adult population to decrease chronic disease rates and the associated burden. Given the high prevalence of these risk behaviours, effective interventions with potential for wide reach are warranted. METHODS AND ANALYSIS: The aim of this two‚Äêarm RCT will be to test the effect of a three‚Äâmonth personalised mobile app intervention on two main outcomes: minutes of moderate‚Äêto‚Äêvigorous‚Äêintensity physical activity and overall sleep quality. In addition, between‚Äêgroup changes in health‚Äêrelated quality of life and mental health status will be assessed as secondary outcomes. The pre‚Äêspecified mediators and moderators include social cognitive factors, the neighbourhood environment, health (BMI, depression, anxiety, stress), sociodemographic factors (age, gender, education) and app usage. Assessments will be conducted after three months (primary endpoint) and six months (follow‚Äêup). The intervention will provide access to a specifically developed mobile app, through which participants can set goals for active minutes, daily step counts, resistance training, sleep times and sleep hygiene practice. The app also allows participants to log their behaviours daily and view progress bars as well as instant feedback in relation to goals. The personalised support system will consist of weekly summary reports, educational and instructional materials, prompts on disengagement and weekly facts. ETHICS AND DISSEMINATION: The Human Research Ethics Committee of The University of Newcastle, Australia granted full approval: H‚Äê2016‚Äê0181. This study will assess the efficacy of a combined behaviour intervention, mechanisms of behaviour change and gather high‚Äêquality process data, all of which will help refine future trials. Dissemination of findings will include publication in a peer‚Äêreviewed journal and presentation at national or international conferences. Participants will receive a plain English summary report of results. TRIAL REGISTRATION NUMBER: ACTRN12617000376347; Pre‚Äêresults."," Murawski, B;  Plotnikoff, RC;  Rayward, AT;  Vandelanotte, C;  Brown, WJ;  Duncan, MJ",2018.0, 10.1136/bmjopen-2017-018997,0,0,
1297,Using interpersonal process recall to compare patients' accounts of resistance in two psychotherapies for generalized anxiety disorder.,"In a trial examining whether cognitive-behavioral therapy (CBT) could be improved by integrating motivational interviewing (MI) to target resistance,MI-CBT outperformed CBT over 12-month followup (Westra, Constantino, & Antony, 2016). Given that effectively addressing resistance is both a theoretically and an empirically supported mechanism of MI's additive effect, we explored qualitatively patients' experience of resistance, possibly as a function of treatment. For 5 patients from each treatment who exhibited early insession change ambivalence, and thus were at risk for later resistance, we conducted interpersonal process recall interviews after a session. Transcripts were analyzed with grounded theory and consensual qualitative research. A salient contrast in patient narratives was a sense of compliance engendered in standard CBT versus connection in MI-CBT. Yet both narratives supported the superordinate category of resistance as an interpersonal process triggered by patient perceptions of therapist beliefs and behaviors. Findings contribute to the conceptualization of resistance from patients' firsthand accounts. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Morrison, Nicholas R; Constantino, Michael J; Westra, Henny A; Kertes, Angela; Goodwin, Brien J; Antony, Martin M",2017.0,http://dx.doi.org/10.1002/jclp.22527,0,0,
1298,Estimating statistical power for open-enrollment group treatment trials,"Modeling turnover in group membership has been identified as a key barrier contributing to a disconnect between the manner in which behavioral treatment is conducted (open-enrollment groups) and the designs of substance abuse treatment trials (closed-enrollment groups, individual therapy). Latent class pattern mixture models (LCPMMs) are emerging tools for modeling data from open-enrollment groups with membership turnover in recently proposed treatment trials. The current article illustrates an approach to conducting power analyses for open-enrollment designs based on the Monte Carlo simulation of LCPMM models using parameters derived from published data from a randomized controlled trial comparing Seeking Safety to a Community Care condition for women presenting with comorbid posttraumatic stress disorder and substance use disorders. The example addresses discrepancies between the analysis framework assumed in power analyses of many recently proposed open-enrollment trials and the proposed use of LCPMM for data analysis. © 2011 Elsevier Inc.",Morgan-Lopez A.A.; Saavedra L.M.; Hien D.A.; Fals-Stewart W.,2011.0,10.1016/j.jsat.2010.07.010,0,0,
1299,Cognitive psychophysiological treatment of bodily-focused repetitive behaviors in adults: An open trial.,"Background: Body-focused repetitive behaviors (BFRBs), such as hair pulling, skin picking, and nail biting, are repetitive, destructive, and nonfunctional habits that cause significant distress. Separate BFRBs form a cohesive group and could be assessed as part of the Tourette/tic spectrum or obsessive-compulsive spectrum of disorders. The treatment of choice is either antidepressant or behavioral treatment, both of which have shown effectiveness. The cognitive psychophysiological (CoPs) model focuses on the tension and emotional build up that triggers habits by addressing cognitive-behavioral, emotional and psychophysiological processes preceding onset rather than the habit itself. The CoPs approach has already shown efficacy in treatment of tic and Tourette disorder. Objective: The aim of the current open trial was to view whether BFRBs can be validly assessed on a standard tic scale (Tourette Symptom Global Scale; TSGS) and evaluate the efficacy of the CoPs intervention on 64 participants (54 completers) with 1 of 3 subtypes of BFRBs (hair pulling, nail biting, and skin picking) compared to a waitlist control. Method: Participants were assessed at baseline on an adapted TSGS and after receving 14 weeks of CoPs therapy with six months follow up. Results: The TSGS was reliably and validly adapted to measure BFRBs. The CoPs intervention was effective for all BRFB subtypes with a large effect size (intention-to-treat g = 1.54; completers g = 2.04), with 74% of patients showing clinically significant improvement. Mood and self-esteem also improved posttreatment. The decrease in symptoms was maintained at the 6-month follow-up, with a further decrease in perfectionism. Conclusion BFRBs can be reliably assessed as a tic spectrum disorder rather than as part of the obsessive-compulsive spectrum. The CoPs model may offer a complementary treatment for BFRBs. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","O'Connor, Kieron; Lavoie, Marc; Desaulniers, Benoit; Audet, Jean-Sebastien",2018.0,http://dx.doi.org/10.1002/jclp.22501,0,0,
1300, The Mental Health in Diabetes Service (MINDS) to enhance psychosocial health: study protocol for a randomized controlled trial," BACKGROUND: After a diagnosis of diabetes mellitus, people not only have to cope with the physical aspects and common complications that require daily self‚Äêmanagement, they are also faced with ongoing psychosocial challenges. Subsequently they find themselves having to navigate the health system to engage multidisciplinary supports; the combination of these factors often resulting in reduced health‚Äêrelated quality of life. To maintain optimal diabetes control, interventions need to incorporate psychosocial supports and a skill base for disease management. Therefore, our aim was to evaluate an 'Optimal Health Program' that adopts a person‚Äêcentred approach and engages collaborative therapy to educate and support the psychosocial health of people diagnosed with type I or II diabetes. METHODS: This prospective randomised controlled trial will include 166 people diagnosed with diabetes: 83 in the intervention (Optimal Health Program) and 83 in the control (usual care) group. Participants with type diabetes mellitus will be recruited through hospital outpatient clinics and diabetes community organisations. Participants in the intervention group will receive nine (8‚Äâ+‚Äâ1 booster session) sequential sessions, based on a structured treatment manual emphasising educational and psychosocial support self‚Äêefficacy and skills building. The primary outcome measures will be generalised self‚Äêefficacy (GSE) and health‚Äêrelated quality of life (AQoL‚Äê6D and EQ‚Äê5D). Secondary measures will be anxiety and depression (HADS), social and workplace functioning (WSAS), diabetes‚Äêrelated quality of life (DQoL), diabetes‚Äêrelated distress (PAID), and type of coping strategies (Brief COPE). In addition, a health economic cost analysis and process evaluations will be performed to assess the economic cost and efficacy of the program's operations, implementation and service delivery. DISCUSSION: We envisage that the Optimal Health Program's emphasis on self‚Äêefficacy and self‚Äêmanagement will provide participants with the skills and knowledge to achieve increased empowerment and independence in aspects of health, which in turn, will help participants deal more effectively with the physical and psychosocial complexities of diabetes. TRIAL REGISTRATION: ACTRN12614001085662 . Registered on 10 October 2014."," O'Brien, CL;  Ski, CF;  Thompson, DR;  Moore, G;  Mancuso, S;  Jenkins, A;  Ward, G;  MacIsaac, RJ;  Loh, M;  Knowles, SR;  et al.",2016.0, 10.1186/s13063-016-1561-4,0,0,
1301, Behavioral activation versus physical activity via the internet: a randomized controlled trial," METHOD/RESULTS: Two hundred eighty six participants were included. The treatment period lasted twelve weeks, consisting of the following treatments: 1) physical activity without treatment rational, 2) physical activity with treatment rational, 3) behavioral activation without treatment rational and 4) behavioral activation with treatment rational. All groups (including a control‐group) showed a significant decrease in depressive symptoms. When the treatment groups were pooled and compared to the control group, there were significant differences from pretest to posttest (Hedges g LIMITATIONS: The differences between how many modules the participants completed could indicate that there are other factors than the treatments that caused the symptom reduction, however, the dose‐response analysis did not detect any significant differences on account of modules completed. CONCLUSIONS: The results support the positive effects of internet administered treatments for depression, and highlights the importance of psychoeducation, which tends to affect both the treatment outcome and the probability of remaining in treatment. These aspects need to be considered when developing and conducting new treatments for depression, since they would increase the likelihood of positive treatment outcomes. BACKGROUND: A major problem today is that only about fifty percent of those affected by depression seeks help. One way to reach more sufferers would be by offering easily accessible internet based treatments. The purpose of this study was to compare/evaluate four therapist supported internet administered treatments."," Nyström, MBT;  Stenling, A;  Sjöström, E;  Neely, G;  Lindner, P;  Hassmén, P;  Andersson, G;  Martell, C;  Carlbring, P",2017.0, 10.1016/j.jad.2017.03.018,0,0,
1302, Does Mindfulness-Based Cognitive Therapy benefit all people with diabetes and comorbid emotional complaints equally? Moderators in the DiaMind trial," METHODS: Outpatients with diabetes (type 1 or type 2; N=139) and an elevated level of emotional distress participated in the Diabetes and Mindfulness (DiaMind) trial. They were randomized into MBCT (N=70) or a control group (N=69) that received treatment as usual and that was offered the intervention 6months later. Primary outcomes were anxiety, depressive symptoms, and perceived stress at post‐intervention and at 6‐month follow‐up. RESULTS: Mixed models analyses showed that sex, extraversion, and baseline acting with awareness were significant moderators of effectiveness. In the MBCT group, women showed larger decreases in anxiety and depression across time (large effects) compared to men (medium to small effects). For extraversion divided into quartiles, the three lowest quartiles generally exhibited large decreases in symptoms, whereas the high extraversion group showed medium (perceived stress) to small (depression) decreases. CONCLUSION: MBCT seems to be effective to decrease symptoms of anxiety, depression, and perceived stress for a broad range of person characteristics in patients with diabetes. However, men and those high in extraversion showed considerably lower effectiveness compared to the other groups. The small effect in high extraverts may be due to the large dropout in this subgroup. OBJECTIVES: Research has shown the effectiveness of mindfulness‐based interventions for a variety of emotional problems in different samples, but it is unknown which factors influence this effectiveness. Therefore, the aim of the current study was: which factors (demographic, personality, and baseline levels of mindfulness skills) moderate the effectiveness of Mindfulness‐Based Cognitive Therapy (MBCT)?"," Nyklíček, I;  van Son, J;  Pop, VJ;  Denollet, J;  Pouwer, F",2016.0, 10.1016/j.jpsychores.2016.10.009,0,0,
1303, Impact of Tailored Interventions to Reduce Drug Use and Sexual Risk Behaviors Among Homeless Gay and Bisexual Men," A randomized controlled trial was conducted with homeless gay and bisexual men to assess the impact of two culturally sensitive intervention programs on reduction of drug use and risky sexual behavior. In this study, gay and bisexual men between 18 and 46 years of age were randomly assigned to one of two culturally sensitive behavioral intervention programs: a Nurse Case Management Plus Contingency Management (NCM + CM; n = 204) or a Standard Education Plus Contingency Management (SE + CM; n = 210) program. Regardless of group assignment, significant and clinically relevant reductions were observed in stimulant use over time. Multivariable predictors of stimulant use at 4‚Äê and 8‚Äêmonth follow‚Äêup evaluations were recent injection drug use, tested positive for HIV, or for use of amphetamine. Data revealed a significant linear decline over time for those who had sex with multiple partners. Furthermore, being HIV positive was associated with reporting multiple partners, while higher homophobia scores and having children were inversely related to reports of having sex with multiple partners at follow‚Äêup. Culturally sensitive approaches are needed to successfully reduce drug use and risky sexual activities among gay and bisexual populations."," Nyamathi, A;  Reback, CJ;  Shoptaw, S;  Salem, BE;  Zhang, S;  Yadav, K",2017.0, 10.1177/1557988315590837,0,0,
1304,Diet and lifestyle intervention on chronic moderate to severe depression and anxiety and other chronic conditions.,"This group study explored how an intervention of diet, lifestyle and behavior modification, including a plant-based diet, daily exercise and mindfulness techniques, would affect 500 adult men and women participants diagnosed with chronic moderate to severe depression and anxiety and other conditions during a 12 week period. An analysis of the health outcomes detailed in self-reported diary entries was carried out at the conclusion of the 12 week period. These reports noted improvements in depression, anxiety and all other conditions addressed by the study, with the majority of participants reporting substantial benefits. A six month follow up indicated that these benefits persisted in most of the participants. These results demonstrate that an intervention of diet, exercise, lifestyle and behavior modification may provide considerable benefits for moderate to severe depression and anxiety as well as other conditions.",Null G.; Pennesi L.,2017.0,10.1016/j.ctcp.2017.09.007,0,0,
1305,Virtual reality exposure versus prolonged exposure for PTSD: Which treatment for whom?,"The majority of studies comparing active psychological treatments for posttraumatic stress disorder (PTSD) do not find significant differences at posttreatment. This was the case in a recent trial examining prolonged exposure (PE) and virtual reality exposure (VRE) among active-duty soldiers with combat-related PTSD. Matching individual patients to specific treatments provides a potential avenue to improve significantly the public health impact of effective treatments for PTSD. A composite moderator approach was used to identify profiles of patients who would see superior PTSD symptom reduction in VRE or PE to inform future treatment matching. Active duty U.S. army soldiers (N = 108) were enrolled in a randomized clinical trial comparing VRE and PE in the treatment of PTSD stemming from deployments to Iraq or Afghanistan. Eighteen baseline variables were examined to identify treatment response heterogeneity in two patient groups: those with a superior response to PE and those with a superior response to VRE. The final composite moderator comprised four of 18 baseline variables. Results revealed that patients who were predicted to see greater PTSD symptom reduction in VRE were likely to be younger, not taking antidepressant medication, had greater PTSD hyperarousal symptoms, and were more likely to have greater than minimal suicide risk. Results suggest that treatment matching based on patient profiles could meaningfully improve treatment efficacy for combat-related PTSD. Future research can build on these results to improve our understanding of how to improve treatment matching for PTSD.",Norr AM.; Smolenski DJ.; Katz AC.; Rizzo AA.; Rothbaum BO.; Difede J.; Koenen-Woods P.; Reger MA.; Reger GM.,2018.0,10.1002/da.22751,0,0,
1306, Is computerized psychoeducation sufficient to reduce anxiety sensitivity in an at-risk sample?: a randomized trial," METHOD: The current study sought to determine the efficacy of a brief single‐session psychoeducation intervention for AS, compared to a control intervention, in a sample of at‐risk individuals (N=54) with elevated AS cognitive concerns. RESULTS: Individuals in the active condition displayed greater reductions in self‐reported AS (β=.198, 95% CI [.065, .331]) and less fear reactivity (β=.278, 95% CI [.069, .487]) to the induction of AS cognitive‐relevant sensations through a behavioral challenge compared to those in the control condition. Further, fear reactivity to the challenge was mediated by reductions in self‐reported AS cognitive concerns. LIMITATIONS: Study limitations include use of an at‐risk nonclinical student sample, lack of a long‐term follow‐up assessment, and inability to discern whether AS reductions due to CAST psychoeducation prevent future, or improve current, psychological symptoms. CONCLUSIONS: These results suggest that psychoeducation alone can produce significant AS reduction. BACKGROUND: Anxiety sensitivity (AS), or a fear of anxiety‐related sensations, has become one of the most well researched risk factors for the development of psychopathology and comprises three subfactors: physical, cognitive, and social concerns. Fortunately, research has demonstrated brief protocols can successfully reduce AS, and in turn improve psychopathological symptoms. Computerized AS reduction protocols have combined psychoeducation with interoceptive exposure (IE), but they have not been dismantled to evaluate the effects of psychoeducation alone."," Norr, AM;  Gibby, BA;  Schmidt, NB",2017.0, 10.1016/j.jad.2017.01.032,0,0,
1307, The differential effects of a focus on symptoms versus recovery in reducing stigma of schizophrenia," PURPOSE: We extend investigations of the impact of the content of video contact with an individual with schizophrenia on stigma reduction. We examine whether differential impacts persist over a 2‚Äêweek period and the extent to which they are mediated by perceived similarity and feelings of empathy and/or sympathy. METHOD: We used a randomized control trial wherein participants were exposed to a video in which an individual described his recovery from schizophrenia, or the same person described acute symptoms of schizophrenia, or a no‚Äêvideo control condition. Outcomes included impressions of and preferred social distance to the person in the video and people in general with schizophrenia and well as perceptions of similarity and feelings of sympathy and empathy. We also measured an overt behaviour, seating distance, at 2‚Äêweek follow‚Äêup. RESULTS: The recovery‚Äêfocused material was generally more effective in improving impressions and reducing preferred level of social distance. Although the symptom‚Äêfocused video resulted in great sympathy for the person, this did not translate into positive impressions or reduced social distance. Mediational analyses yielded findings consistent with the benefits of the recovery video being mediated by increased perceptions of similarity and lower feelings of sympathy. Exposure to the recovery‚Äêfocused video resulted in less anxiety in anticipation of meeting the person in the video relative to the control condition. CONCLUSIONS: Video contact emphasizing potential for recovery from schizophrenia was more effective in reducing stigmatizing responses than contact highlighting acute symptoms. Increased sympathy does not necessarily translate into reductions in stigma."," Norman, RMG;  Li, Y;  Sorrentino, R;  Hampson, E;  Ye, Y",2017.0, 10.1007/s00127-017-1429-2,0,0,
1308, Psychological mediators related to clinical outcome in cognitive behavioural therapy for coronary heart disease: a sub-analysis from the SUPRIM trial," Background The Secondary Prevention in Uppsala Primary Healthcare Project (SUPRIM) was a randomized controlled trial of a group‐based cognitive behavioural therapy stress management programme for patients with coronary heart disease. The project was successful in reducing the risk of fatal or non‐fatal first recurrent cardiovascular events. The aim of this study was to analyse the effect of cognitive behavioural therapy on self‐rated stress, somatic anxiety, vital exhaustion and depression and to study the associations of these factors with the reduction in cardiovascular events. Methods A total of 362 patients were randomly assigned to intervention or usual care groups. The psychological outcomes were assessed five times during 24 months and analysed using linear mixed models. The mediating roles of the outcomes were analysed using joint modelling of the longitudinal and time to event data. Results The intervention had a positive effect on somatic anxiety ( p < 0.05), reflecting a beneficial development over time compared with the controls. Stress, vital exhaustion and depression did not differ between the groups over time. Mediator analysis suggested that somatic anxiety may have mediated the effect of treatment on cardiovascular events. Conclusions The intervention had a small positive effect on somatic anxiety, but did not affect stress, vital exhaustion or depression in patients with coronary heart disease. Somatic anxiety was associated with an increased risk of cardiovascular events and might act as a partial mediator in the treatment effect on cardiovascular events. However, the mechanisms between the intervention and the protective cardiovascular outcome remain to be identified."," Norlund, F;  Olsson, EM;  Pingel, R;  Held, C;  Svärdsudd, K;  Gulliksson, M;  Burell, G",2017.0, 10.1177/2047487317693131,0,0,
1309,Therapist-guided internet-delivered cognitive-behavioural therapy supplemented with group exposure sessions for adolescents with social anxiety disorder: a feasibility trial.,"Social anxiety disorder (SAD) is one of the most common psychiatric disorders in youth, with a prevalence of about 3%-4% and increased risk of adverse long-term outcomes, such as depression. Cognitive-behavioural therapy (CBT) is considered the first-line treatment for youth with SAD, but many adolescents remain untreated due to limited accessibility to CBT. The aim of this study was to develop and evaluate the feasibility and preliminary efficacy of a therapist-guided internet-delivered CBT treatment, supplemented with clinic-based group exposure sessions (BIP SOFT). A proof-of-concept, open clinical trial with 6-month follow-up. The trial was conducted at a child and adolescent psychiatric research clinic, and participants (n=30) were 13-17 years old (83% girls) with a principal diagnosis of SAD. 12 weeks of intervention, consisting of nine remote therapist-guided internet-delivered CBT sessions and three group exposure sessions at the clinic for the adolescents and five internet-delivered sessions for the parents. Adolescents were generally satisfied with the treatment, and the completion rate of internet modules, as well as attendance at group sessions, was high. Post-treatment assessment showed a significant decrease in clinician-rated, adolescent-rated and parent-rated social anxiety (d=1.17, 0.85 and 0.79, respectively), as well as in general self-rated and parent-rated anxiety and depression (d=0.76 and 0.51), compared with pretreatment levels. Furthermore, 47% of participants no longer met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for SAD at post-treatment. At a 6-month follow-up, symptom reductions were maintained, or further improved, and 57% of participants no longer met criteria for SAD. Therapist-guided and parent-guided internet-delivered CBT, supplemented with a limited number of group exposure sessions, is a feasible and promising intervention for adolescents with SAD. NCT02576171; Results.",Nordh M.; Vigerland S.; Öst LG.; Ljótsson B.; Mataix-Cols D.; Serlachius E.; Högström J.,2017.0,10.1136/bmjopen-2017-018345,0,0,
1310,The implementation of guided Internet-based cognitive behaviour therapy for panic disorder in a routine-care setting: Effectiveness and implementation efforts.,"Panic disorder is a common mental disorder. Guided Internet-based cognitive behavioural therapy (Guided Internet-based cognitive behaviour therapy (ICBT)) is a promising approach to reach more people in need of help. In the present effectiveness study, we investigated the outcome of guided ICBT for panic disorder after implementation in routine care. A total of 124 patients were included in the study, of which 114 started the treatment. Large within-group effect sizes were observed on the primary panic disorder symptoms (post-treatment: d = 1.24; 6-month follow-up: d = 1.39) and moderate and large effects on secondary panic disorder symptoms and depressive symptoms at post-treatment and follow-up (d = .55-1.13). More than half (56.1%) of the patients who started treatment recovered or improved at post-treatment. Among treatment takers (completed at least five of the nine modules), 69.9% recovered or improved. The effectiveness reported in the present trial is in line with previous effectiveness and efficacy trials of guided ICBT for panic disorder. This provides additional support for guided ICBT as a treatment alternative in routine care. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Nordgreen, Tine; Gjestad, Rolf; Andersson, Gerhard; Carlbring, Per; Havik, Odd E",2018.0,http://dx.doi.org/10.1080/16506073.2017.1348389,0,0,
1311,Cognitive and metacognitive predictors of symptom improvement following treatment for social anxiety disorder: A secondary analysis from a randomized controlled trial.,"Cognitive therapy for social anxiety disorder (SAD) based on the Clark and Wells model emphasizes negative beliefs about the social self and self-consciousness as central causal factors. However, Wells' metacognitive model proposes that metacognitive beliefs are central to pathology universally. The relative importance of cognitive and metacognitive beliefs in the treatment of SAD is therefore an important research question. This study examined change in negative cognitive and negative metacognitive beliefs as independent correlates of symptom improvement in 46 SAD patients undergoing evidence-based treatments. Both types of beliefs decreased during treatment. However, change in metacognitive belief was the only consistent independent predictor across all outcomes and change in cognitive beliefs did not significantly predict outcomes when change in self-consciousness was controlled. The implication of this finding is that metacognitive change might be more important than cognitive belief change in symptom outcome and recovery in SAD. Cognitive and metacognitive beliefs decreased during treatment of SAD. Change in self-consciousness predicted symptom improvement. Change in metacognition predicted symptom improvement over change in cognition. Change in metacognition was a more reliable predictor than change in cognition.",Nordahl H.; Nordahl HM.; Hjemdal O.; Wells A.,2017.0,10.1002/cpp.2083,0,0,
1312,Pragmatic RAndomised controlled trial of a trauma-focused guided self-help Programme versus InDividual traumafocused cognitive Behavioural therapy for post-traumatic stress disorder (RAPID): Trial protocol.,"Background: There is good evidence that trauma-focused therapies for Post-Traumatic Stress Disorder are effective. However, they are not always feasible to deliver due a shortage of trained therapists and demands on the patient. An online trauma-focused Guided Self-Help (GSH) programme which could overcome these barriers has shown promise in a pilot study. This study will be the first to evaluate GSH against standard face-to-face therapy to assess its suitability for use in the NHS. Methods: The study is a large-scale multi-centre pragmatic randomised controlled non-inferiority trial, with assessors masked to treatment allocation. One hundred and ninety-two participants will be randomly allocated to receive either face-to-face trauma-focused cognitive behaviour therapy (TFCBT) or trauma-focused online guided self-help (GSH). The primary outcome will be the severity of symptoms of PTSD over the previous week as measured by the Clinician Administered PTSD Scale for DSM5 (CAPS-5) at 16 weeks post-randomisation. Secondary outcome measures include PTSD symptoms over the previous month as measured by the CAPS-5 at 52 weeks plus the Impact of Event Scale-revised (IES-R), Work and Social Adjustment Scale (WSAS), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Alcohol Use Disorders Test (AUDIT-O), Multidimensional Scale for Perceived Social Support (MSPSS), short Post-Traumatic Cognitions Inventory (PTCI), Insomnia Severity Index (ISI) and General Self Efficacy Scale (GSES) measured at 16 and 52 weeks post-randomisation. Changes in health-related quality of life will be measured by the EQ-5D and the level of healthcare resource utilisation for health economic analysis will be determined by an amended version of the Client Socio-Demographic and Service Receipt Inventory European Version. The Client Satisfaction Questionnaire (CSQ) will be collected at 16 weeks post-randomisation to evaluate treatment satisfaction. Discussion: This study will be the first to compare online GSH with usual face-to-face therapy for PTSD. The strengths are that it will test a rigorously developed intervention in a real world setting to inform NHS commissioning. The potential challenges of delivering such a pragmatic study may include participant recruitment, retention and adherence, therapist retention, and fidelity of intervention delivery. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Nollett, Claire; Lewis, Catrin; Kitchiner, Neil; Roberts, Neil; Addison, Katy; Brookes-Howell, Lucy; Cosgrove, Sarah; Cullen, Katherine; Ehlers, Anke; Heke, Sarah; Kelson, Mark; Lovell, Karina; Madden, Kim; McEwan, Kirsten; McNamara, Rachel; Phillips, Ceri; Pickles, Timothy; Simon, Natalie; Bisson, Jonathan",2018.0,http://dx.doi.org/10.1186/s12888-018-1665-3,0,0,
1313, Effects of five-minute internet-based cognitive behavioral therapy and simplified emotion-focused mindfulness on depressive symptoms: a randomized controlled trial," BACKGROUND: Notwithstanding a high expectation for internet‚Äêbased cognitive behavioral therapy (iCBT) for reducing depressive symptoms, many of iCBT programs have limitations such as temporary effects and high drop‚Äêout rates, possibly due to their complexity. We examined the effects of a free, simplified, 5‚Äêminute iCBT program by comparing it with a simplified emotion‚Äêfocused mindfulness (sEFM) exercise and with a waiting list control group. METHODS: A total of 974 participants, who were recruited using the website of a market research company, were randomly assigned to the iCBT group, the sEFM group, and the control group. Those in the intervention arms performed each exercise for 5 weeks. The primary outcome measure was the Center for Epidemiological Studies Depression scale (CES‚ÄêD) at postintervention. Secondary outcome measures were the Patient Health Questionnaire‚Äê9 (PHQ‚Äê9) and the Generalized Anxiety Disorder‚Äê7 scale (GAD‚Äê7). Intention‚Äêto‚Äêtreat analyses were conducted. RESULTS: During postintervention assessment, there were no significant differences between the intervention arms and the control group in the CES‚ÄêD, although the difference between the iCBT arm and control group was close to significance (p‚Äâ=‚Äâ0.05) in favor of iCBT. There was a significant difference in the PHQ‚Äê9 in favor of the sEFM group compared with the control group. There were no significant differences in outcome measures between the three groups at the 6‚Äêweek follow‚Äêup. CONCLUSIONS: Although both iCBT and sEFM have the potential to temporarily reduce depressive symptoms, substantial improvements are required to enhance and maintain their effects. TRIAL REGISTRATION: This trial is registered with the UMIN Clinical Trial Registry (UMIN‚ÄêCTR) (ID: UMIN000015097 ) on 1 October 2014."," Noguchi, R;  Sekizawa, Y;  So, M;  Yamaguchi, S;  Shimizu, E",2017.0, 10.1186/s12888-017-1248-8,0,0,
1314,Using cognitive processing therapy for assault victims with acute stress disorder.,"Cognitive processing therapy (CPT) was designed as a cognitive-behavioural treatment for posttraumatic stress disorder following sexual assault, and has been well supported empirically. Given its strong cognitive restructuring component, CPT is also likely to be beneficial for a range of comorbid problems associated with trauma (e.g., depression, other anxiety disorders, chronic pain). This chapter presents a description of CPT and preliminary results from a randomised controlled trial of CPT for assault victims with ASD. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Nixon, Reginald D. V",2007.0,,0,0,
1315, A randomized trial of cognitive behavior therapy and cognitive therapy for children with posttraumatic stress disorder following single-incident trauma: predictors and outcome at 1-year follow-up," OBJECTIVE: The 1‚Äêyear outcome and moderators of adjustment for children and youth receiving treatment for posttraumatic stress disorder (PTSD) following single‚Äêincident trauma was examined. METHOD: Children and youth who had experienced single‚Äêincident trauma (N = 33; 7‚Äê17 years old) were randomly assigned to receive 9 weeks of either trauma‚Äêfocused cognitive behavior therapy (CBT) or trauma‚Äêfocused cognitive therapy (without exposure; CT) that was administered to them and their parents individually. RESULTS: Intent‚Äêto‚Äêtreat analyses demonstrated that both groups maintained posttreatment gains in PTSD, depression and general anxiety symptoms reductions at 1‚Äêyear follow‚Äêup, with no children meeting criteria for PTSD. A large proportion of children showed good end‚Äêstate functioning at follow‚Äêup (CBT: 65%; CT: 71%). Contrary to 6‚Äêmonth outcomes, maternal adjustment no longer moderated children's outcome, nor did any other tested variables. CONCLUSION: The findings confirm the positive longer‚Äêterm outcomes of using trauma‚Äêfocused cognitive‚Äêbehavioral methods for PTSD secondary to single‚Äêincident trauma and that these outcomes are not dependent on the use of exposure. (PsycINFO Database Record"," Nixon, RDV;  Sterk, J;  Pearce, A;  Weber, N",2017.0, 10.1037/tra0000190,0,0,
1316, Cognitive Load Undermines Thought Suppression in Acute Stress Disorder," Thought suppression studies demonstrate that attempts to suppress can be undermined by cognitive load. We report the first instance in which this has been tested experimentally in a sample of recently traumatized individuals. Individuals with and without acute stress disorder (ASD) were recruited following recent trauma and randomized to load or no load conditions (N=56). They monitored intrusive memories during baseline, suppression, and think anything phases. The impact of suppression and load on self‚Äêreported intrusions, attention bias (dot‚Äêprobe), and memory priming (word‚Äêstem task) was assessed. The ASD load group were less able to suppress memories (d=0.32, CI95 [‚Äê0.15, 0.83], p=.088) than the ASD no load group (d=0.63, CI95 [0.08, 1.24], p<.001). In the think anything phase, the ASD load group reported more intrusions than the ASD no load or non‚ÄêASD groups (with and without load). No consistent findings were observed in relation to attentional bias. ASD load individuals exhibited stronger priming responses for motor vehicle accident and assault words than all other groups (ds between 0.35‚Äê0.73). Working memory did not moderate any outcomes of interest. The findings indicate that cognitive load interferes with suppression and may enhance access to trauma memories and associated material. The study extends previous research by demonstrating these effects for the first time in a clinical sample of recent survivors of trauma."," Nixon, RD;  Rackebrandt, J",2016.0, 10.1016/j.beth.2016.02.010,0,0,
1317, Interaction of acupuncture treatment and manipulation laterality modulated by the default mode network," Appropriate selection of ipsilateral or contralateral electroacupuncture (corresponding to the pain site) plays an important role in reaching its better curative effect; however, the involving brain mechanism still remains unclear. Compared with the heat pain model generally established in previous study, capsaicin pain model induces reversible cutaneous allodynia and is proved to be better simulating aspects of clinical nociceptive and neuropathic pain. In the current study, 24 subjects were randomly divided into two groups with a 2‚Äâ√ó‚Äâ2 factorial design: laterality (ipsi‚Äê or contralateral side, inter‚Äêsubject)‚Äâ√ó‚Äâtreatment with counter‚Äêbalanced at an interval of one week (verum and placebo electroacupuncture, within‚Äêsubject). We observed subjective pain intensity and brain activations changes induced by capsaicin allodynia pain stimuli before and after electroacupuncture treatment at acupoint LI4 for 30‚Äâmin. Analysis of variance results indicated that ipsilateral electroacupuncture treatment produced significant pain relief and wide brain signal suppressions in pain‚Äêrelated brain areas compared with contralateral electroacupuncture. We also found that verum electroacupuncture at either ipsi‚Äê or contralateral side to the pain site exhibited comparable significant magnitudes of analgesic effect. By contrast, placebo electroacupuncture elicited significant pain reductions only on the ipsilateral rather than contralateral side. It was inferred that placebo analgesia maybe attenuated on the region of the body (opposite to pain site) where attention was less focused, suggesting that analgesic effect of placebo electroacupuncture mainly rely on the motivation of its spatial‚Äêspecific placebo responses via attention mechanism. This inference can be further supported by the evidence that the significant interaction effect of manipulation laterality and treatment was exclusively located within the default mode network, including the bilateral superior parietal lobule, inferior parietal lobule, precuneus, and left posterior cingulate cortex. It is also proved that disruptions of the default mode network may account for the cognitive and behavioral impairments in chronic pain patients. Our findings further suggested that default mode network participates in the modulation of spatial‚Äêoriented attention on placebo analgesia as a mechanism underlying the degree to which treatment side corresponding to the pain."," Niu, X;  Zhang, M;  Liu, Z;  Bai, L;  Sun, C;  Wang, S;  Wang, X;  Chen, Z;  Chen, H;  Tian, J",2017.0, 10.1177/1744806916683684,0,0,
1318, Factors associated with depression and anxiety symptoms in family caregivers of patients with incurable cancer," BACKGROUND: Family caregivers (FCs) are critically important for patients with cancer, yet they may experience psychological distress related to caregiving demands. We sought to describe rates of depression and anxiety in FCs of patients with incurable cancer and identify factors associated with these symptoms to determine those at greatest risk for psychological distress. PATIENTS AND METHODS: We performed a cross‚Äêsectional analysis of baseline data from a randomized trial of early palliative care. We assessed depression and anxiety using the Hospital Anxiety and Depression Scale in patients within 8 weeks of diagnosis of incurable lung or gastrointestinal cancer and their FCs. We also assessed patients' quality of life (Functional Assessment of Cancer Therapy‚ÄêGeneral), coping strategies (Brief COPE), and their report of the primary goal of their cancer treatment. We used linear regression with purposeful selection of covariates to identify factors associated with FC depression and anxiety symptoms. RESULTS: We enrolled 78.6% (n = 275) of potentially eligible FCs. The majority were female (69.1%) and married to the patient (66.2%). While the proportion of FCs and patients reporting depression did not differ (16.4% versus 21.5%, P = 0.13), FCs were more likely to report anxiety compared with patients (42.2% versus 28.4%, P < 0.001). Patients' use of acceptance coping was associated with lower FC depression (B = ‚Äê0.42, P < 0.001), while emotional support coping was associated with higher FC depression (B = 0.69, P = 0.001) and lower FC anxiety (B = ‚Äê0.70, P < 0.001). Patient report that their primary goal of their treatment was to 'cure my cancer' was associated with higher FC depression (B = 0.72, P = 0.03). CONCLUSIONS: Patients with incurable cancer and their FCs report high levels of depression and anxiety symptoms. We demonstrated that patients' coping strategies and prognostic understanding were associated with FC depression and anxiety symptoms, underscoring the importance of targeting these risk factors when seeking to address the psychological distress experienced by FCs."," Nipp, RD;  El-Jawahri, A;  Fishbein, JN;  Gallagher, ER;  Stagl, JM;  Park, ER;  Jackson, VA;  Pirl, WF;  Greer, JA;  Temel, JS",2016.0, 10.1093/annonc/mdw205,0,0,
1319,The Development of an Internet-Based Treatment for Problem Gamblers and Concerned Significant Others: A Pilot Randomized Controlled Trial.,"Problem gambling creates significant harm for the gambler and for concerned significant others (CSOs). While several studies have investigated the effects of individual cognitive behavioral therapy (CBT) for problem gambling, less is known about the effects of involving CSOs in treatment. Behavioral couples therapy (BCT) has shown promising results when working with substance use disorders by involving both the user and a CSO. This pilot study investigated BCT for problem gambling, as well as the feasibility of performing a larger scale randomized controlled trial. 36 participants, 18 gamblers and 18 CSOs, were randomized to either BCT or individual CBT for the gambler. Both interventions were Internet-delivered self-help interventions with therapist support. Both groups of gamblers improved on all outcome measures, but there were no differences between the groups. The CSOs in the BCT group lowered their scores on anxiety and depression more than the CSOs of those randomized to the individual CBT group did. The implications of the results and the feasibility of the trial are discussed.",Nilsson A.; Magnusson K.; Carlbring P.; Andersson G.; Gumpert CH.,2018.0,10.1007/s10899-017-9704-4,0,0,
1320, Applying a novel statistical method to advance the personalized treatment of anxiety disorders: a composite moderator of comparative drop-out from CBT and ACT," METHOD: We combined data from two randomized controlled trials (N = 208) comparing CBT and ACT for patients with DSM‚ÄêIV anxiety disorders. Adapting Kraemer's method for constructing and evaluating composite moderators (2013), 26 variables were examined for individual effect sizes. Forward‚Äêstepwise regression combined with k‚Äêfold cross validation was used to identify a model to predict treatment dropout. RESULTS: Four baseline variables comprised the final composite moderator: self‚Äêreported degree of control over internal anxiety, current psychiatric medication use, religiosity, and endurance in a voluntary hyperventilation stressor. This composite moderator predicted differential dropout from ACT vs. CBT with a medium effect size (r = 0.28), and had a significantly larger effect size than any individual moderator. CONCLUSIONS: Findings reveal that specific patient profiles predict differential dropout from ACT vs. CBT for anxiety disorders. In the first investigation of a composite moderator with a dichotomous outcome, findings also support the superiority of composite over individual moderators. BACKGROUND: No prior studies have examined moderators of dropout between distinct treatments for anxiety disorders. This study applied a novel statistical approach for examining moderators of dropout from traditional cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT)."," Niles, AN;  Wolitzky-Taylor, KB;  Arch, JJ;  Craske, MG",2017.0, 10.1016/j.brat.2017.01.001,0,0,
1321,Turning wounds into wisdom: Posttraumatic growth over the course of two types of trauma-focused psychotherapy in patients with PTSD.,"Treatment studies in PTSD patients have mostly focused on adverse psychopathological outcomes whereas positive outcomes have received less attention. Objectives of this study were to investigate posttraumatic growth in response to two different psychotherapies, to examine the relationship between symptom improvement and growth, and to determine if posttraumatic growth predicted treatment response. Outpatients diagnosed with PTSD after various types of trauma (n = 116) participated in a randomized controlled trial that compared Brief Eclectic Psychotherapy for PTSD (BEP) and Eye Movement Desensitization and Reprocessing therapy (EMDR). Posttraumatic growth was assessed pre- and post-treatment. PTSD severity was measured weekly. Posttraumatic growth scores significantly increased after trauma-focused psychotherapy, as well as scores in the subdomains personal strength, new possibilities, relating to others, and appreciation of life. Greater self-reported and clinician-rated PTSD decline was significantly related to greater increase in posttraumatic growth. No changes were found between treatment conditions, except for a stronger correlation between PTSD symptom decrease and increase in relating to others in BEP as compared to EMDR. No predictive effects were found. We were unable to control for time effects because for ethical reasons, no control group not receiving treatment was included, and the stability of the changes could not be determined. Findings indicate that increases in posttraumatic growth accompany symptom decline in EMDR and BEP, and that these changes occur independent of whether the treatment specifically addresses posttraumatic growth as therapeutic process. Further research is encouraged to disentangle the contribution of therapeutic elements to growth.",Nijdam MJ.; van der Meer CAI.; van Zuiden M.; Dashtgard P.; Medema D.; Qing Y.; Zhutovsky P.; Bakker A.; Olff M.,2018.0,10.1016/j.jad.2017.11.031,0,0,
1322,Neurocognitive functioning over the course of trauma-focused psychotherapy for PTSD: Changes in verbal memory and executive functioning.,"Individuals with post-traumatic stress disorder (PTSD) have neurocognitive deficits in verbal memory and executive functioning. In this study, we examined whether memory and executive functioning changed over the course of treatment and which clinical variables were associated with change. Neuropsychological assessments were administered at baseline and endpoint of a randomized controlled trial as secondary outcome. Trauma survivors (n = 88) diagnosed with PTSD received trauma-focused psychotherapy within a 17-week randomized controlled trial. Neuropsychological tests were the California Verbal Learning Test, Rivermead Behavioural Memory Test, Stroop Color Word Test, and Trail Making Test. Significant, small- to medium-sized improvements in verbal memory, information processing speed, and executive functioning were found after trauma-focused psychotherapy (Cohen's d 0.16-0.68). Greater PTSD symptom decrease was significantly related to better post-treatment neurocognitive performance (all p < .005). Patients with comorbid depression improved more than patients with PTSD alone on interference tasks (p < .01). No differences emerged between treatment conditions and between patients on serotonergic antidepressants and those who were not. This study suggests that neurocognitive deficits in PTSD can improve over the course of trauma-focused psychotherapy and are therefore at least partly reversible. Improvements over treatment are in line with previous neuropsychological and neuroimaging studies and effect sizes exceed those of practice effects. Future research should determine whether these changes translate into improved functioning in the daily lives of the patients. Patients with PTSD have difficulties performing verbal memory tasks (e.g., remembering a grocery list, recall of a story) and executive functioning tasks (e.g., shifting attention between two tasks, ignoring irrelevant information to complete a task). Verbal memory, information processing speed, and executive functioning significantly improved in patients with post-traumatic stress disorder over the course of trauma-focused psychotherapy. Improvements were equal in size for two different trauma-focused psychotherapies (Eye movement desensitization and reprocessing therapy and brief eclectic psychotherapy for PTSD). Medium-sized effects were found for recall of a story, whereas effects in other aspects of verbal memory, information processing speed, and executive functioning were small-sized. No causal attributions can be made because we could not include a control group without treatment for ethical reasons. Findings may be more reflective of patients who completed treatment than patients who prematurely dropped out as completers were overrepresented in our sample.",Nijdam MJ.; Martens IJM.; Reitsma JB.; Gersons BPR.; Olff M.,2018.0,10.1111/bjc.12183,0,0,
1323, Transcendental Meditation and Reduced Trauma Symptoms in Female Inmates: a Randomized Controlled Study," CONTEXT: Compared with the general population, trauma experiences are higher among incarcerated women. OBJECTIVE: To evaluate the effects of Transcendental Meditation (TM) on trauma symptoms in female offenders. DESIGN: Twenty‚Äêtwo inmates at the Coffee Creek Correctional Facility in Wilsonville, OR, with at least 4 months left of incarceration were enrolled in this randomized controlled pilot study. Subjects were randomly assigned to either the TM group (n = 11) or a wait‚Äêlist control group (n = 11). MAIN OUTCOME MEASURES: Subjects were measured at baseline and 4‚Äêmonth posttest using the Posttraumatic Stress Disorder Checklist‚ÄêCivilian version (PCL‚ÄêC; primary outcome) with intrusive thoughts, avoidance, and hyperarousal subscales (secondary outcomes). Twenty of the subjects (10 in each group) took part in their treatment assignment and completed posttesting. RESULTS: Significant reductions were found on total trauma (p < 0.036), intrusive thoughts (p < 0.026), and hyperarousal (p < 0.043) on the PCL‚ÄêC. Effect sizes ranged from 0.65 to 0.99 for all variables. Eighty‚Äêone percent of the TM subjects were compliant with their program. CONCLUSION: The results of this study indicate feasibility of the TM program in a female prison population and suggest that TM may be an effective tool for decreasing trauma symptoms. Future large‚Äêscale research is warranted."," Nidich, S;  Seng, A;  Compton, B;  O'connor, T;  Salerno, JW;  Nidich, R",2017.0, 10.7812/TPP/16-008,0,0,
1324, Reduced Trauma Symptoms and Perceived Stress in Male Prison Inmates through the Transcendental Meditation Program: a Randomized Controlled Trial," CONTEXT: Trauma events are four times more prevalent in inmates than in the general public and are associated with increased recidivism and other mental and physical health issues. OBJECTIVE: To evaluate the effects of Transcendental Meditation (TM) on trauma symptoms in male inmates. DESIGN: One hundred eighty‚Äêone inmates with a moderate‚Äê to high‚Äêrisk criminal profile were randomly assigned to either the TM program or to a usual care control group. MAIN OUTCOME MEASURES: The Trauma Symptom Checklist and the Perceived Stress Scale were administered at baseline and four‚Äêmonth posttest. RESULTS: Significant reductions in total trauma symptoms, anxiety, depression, dissociation, and sleep disturbance subscales, and perceived stress in the TM group were found compared with controls (all p values < 0.001). The high‚Äêtrauma subgroup analysis further showed a higher magnitude of effects in the TM group compared with controls on all outcomes, with Cohen effect sizes ranging from 0.67 to 0.89. CONCLUSION: Results are consistent with those of prior studies of the TM program in other populations and its effects on trauma symptoms and perceived stress."," Nidich, S;  O'connor, T;  Rutledge, T;  Duncan, J;  Compton, B;  Seng, A;  Nidich, R",2016.0, 10.7812/TPP/16-007,0,0,
1325,Using online interventions to deliver college student mental health resources: Evidence from randomized clinical trials.,"This study evaluated the efficacy of Internet-based stress management programs for college students. This approach is particularly fitting for students owing to a lack of mental health resources on campus and to high levels of Internet use among students. Because a history of interpersonal trauma (IPT) is associated with more distress and poorer academic performance, IPT history was assessed as a moderator of intervention efficacy. Students (N = 365) were randomly assigned to a mindfulness plus present control intervention, a mindfulness only intervention, or a stress management information condition that served as an active comparison. Prior research has supported the efficacy of the mindfulness plus present control intervention (Nguyen-Feng et al., 2015). Outcome measures were self-report measures of stress, anxiety, depression, and perceived stress completed online at preintervention, postintervention, and 2 follow-ups (2-3 weeks and 4-5 weeks postintervention). Linear mixed modeling was used to assess change over time. Participants in all 3 groups reported significant decreases on all primary outcomes. All time-by-intervention group interaction effects were nonsignificant, suggesting that the 3 conditions were equally effective. When examining IPT history as a moderator, the mindfulness plus present control and stress management conditions were both more effective for IPT survivors than the mindfulness only intervention. Results suggested that Internet-based interventions are effective for lowering distress among college students and that specific approaches may be differentially effective for certain subgroups of students. They also suggested that providing students with stress management information without providing training in 1 specific skill may also be helpful. (PsycINFO Database Record",Nguyen-Feng VN.; Greer CS.; Frazier P.,2017.0,10.1037/ser0000154,0,0,
1326, The effect of fluvoxamine and behavior therapy on children and adolescents with obsessive-compulsive disorder," METHODS: Ten children/adolescents who had not previously responded to behavior therapy were randomly assigned to two groups: fluvoxamine alone or fluvoxamine with behavior therapy. All 10 patients received fluvoxamine for 10 weeks‚Äêfive continued solely on fluvoxamine for one year and five engaged in behavior therapy for 20 sessions along with fluvoxamine and then continued solely on medication until the end of the year. RESULTS: Eight of 10 patients improved significantly on fluvoxamine at week 10 on the primary outcome variable, the Children's Yale‚ÄêBrown Obsessive Compulsive Scale (CY‚ÄêBOCS). According to the other measurements‚ÄêNational Institute of Mental Health‚ÄêGlobal Obses‚Äêsive‚ÄêCompulsive Scale, Clinical Global Impression‚ÄêImprovement (assessing level of im‚Äêprovement from week to week), and Clinical Global Impression‚ÄêSeverity of Illness Scale (as‚Äêsessing how ill the patient is from week to week)‚Äêimprovement was not as evident. According to the CY‚ÄêBOCS, those who received a combination of fluvoxamine and exposure with response prevention showed significantly more improvement than those who only took medication. At two‚Äêyear follow‚Äêup, all patients continued to improve, with those in the combined approach improving more than those in the medication‚Äêalone group. CONCLUSIONS: Future studies should determine the specific effect of each treatment group, combined and singularly. Reasons for discrepancy in improvement ratings as noted by the different instruments are discussed. The addition of behavior therapy to fluvoxamine seems to enhance treatment efficacy, according to the CY‚ÄêBOCS. OBJECTIVE: The efficacy of medications, consisting of serotonin partial and specific reuptake blockers, and behavior therapy, consisting of exposure and response prevention in addition to social skills training, cognitive therapy, and habit reversal, in the treatment of obsessive‚Äêcompulsive disorder are well documented. The purpose of the study was to explore if adding behavior therapy to medication would enhance treatment efficacy."," Neziroglu, F;  Yaryura-Tobias, JA;  Walz, J;  McKay, D",2000.0, 10.1089/cap.2000.10.295,0,0,
1327, Interpersonal Problems Predict Differential Response to Cognitive Versus Behavioral Treatment in a Randomized Controlled Trial," OBJECTIVE: We examined dimensional interpersonal problems as moderators of cognitive behavioral therapy (CBT) versus its components (cognitive therapy [CT] and behavioral therapy [BT]). We predicted that people with generalized anxiety disorder (GAD) whose interpersonal problems reflected more dominance and intrusiveness would respond best to a relaxation‚Äêbased BT compared to CT or CBT, based on studies showing that people with personality features associated with a need for autonomy respond best to treatments that are more experiential, concrete, and self‚Äêdirected compared to therapies involving abstract analysis of one's problems (e.g., containing CT). METHOD: This was a secondary analysis of Borkovec, Newman, Pincus, and Lytle (2002). Forty‚Äêseven participants with principal diagnoses of GAD were assigned randomly to combined CBT (n = 16), CT (n = 15), or BT (n = 16). RESULTS: As predicted, compared to participants with less intrusiveness, those with dimensionally more intrusiveness responded with greater GAD symptom reduction to BT than to CBT at posttreatment and greater change to BT than to CT or CBT across all follow‚Äêup points. Similarly, those with more dominance responded better to BT compared to CT and CBT at all follow‚Äêup points. Additionally, being overly nurturant at baseline was associated with GAD symptoms at baseline, post, and all follow‚Äêup time‚Äêpoints regardless of therapy condition. CONCLUSIONS: Generally anxious individuals with domineering and intrusive problems associated with higher need for control may respond better to experiential behavioral interventions than to cognitive interventions, which may be perceived as a direct challenge of their perceptions."," Newman, MG;  Jacobson, NC;  Erickson, TM;  Fisher, AJ",2017.0, 10.1016/j.beth.2016.05.005,0,0,
1328,Web-based cognitive behavior therapy for depression in people with diabetes mellitus:A randomized controlled trial.,"Background: Depression is twice as common in diabetes mellitus (DM) as the general population and is associated with adverse health outcomes, but access to evidence-based therapies such as cognitive behavioral therapy (CBT) is limited in routine diabetes care. Past research has shown that generic Internet-based cognitive behavioral therapy (iCBT) is an effective treatment for depression in the general population, but it has never been evaluated in people with comorbid depression and DM. Objective: The aim of our study was to examine the efficacy of a generic 6-lesson iCBT delivered over 10 weeks in people with major depressive disorder (MDD) and DM. Methods: Participants with comorbid MDD and DM (type 1 or 2) were recruited online and randomized to an iCBT program with therapist support provided by phone and email (n = 42) or a treatment as usual (TAU, n = 49) control group. Outcomes were assessed through Web-based self-report questionnaires and the trial was Web-based with no face-to-face components. Primary outcomes were self-reported depression (patient health questionnaire-9, PHQ-9), diabetes-related distress (problem areas in diabetes, PAID), and self-reported glycemic control (hemoglobin A1c, HbA1c). Secondary outcomes were general distress (Kessler 10-item psychological distress scale, K-10) and disability (short form 12-item, SF-12), generalized anxiety (generalized anxiety disorder 7-item, GAD-7), and somatization (PHQ-15). The iCBT group was assessed at 3 months. Results: A total of 27 participants (66%; 27/41) completed the iCBT program. Analyses indicated between-group superiority of iCBT over TAU at posttreatment on PHQ-9 (g = 0.78), PAID (g = 0.80), K-10 (g = 1.06), GAD-7 (g = 0.72), and SF-12 mental well-being scores (g = 0.66), but no significant differences in self-reported HbA1c levels (g = 0.14), SF-12 physical well-being, or PHQ-15 scores (g = 0.03-0.21). Gains were maintained at 3-month follow-up in the iCBT group, and the 87% (27/31) of iCBT participants who were interviewed no longer met criteria for MDD. Clinically significant change following iCBT on PHQ-9 scores was 51% (21/41) versus 18% (9/49) in TAU. Conclusions: iCBT for depression is an efficacious, accessible treatment option for people with diabetes. Future studies should explore whether tailoring of iCBT programs improves acceptability and adherence, and evaluate the long-term outcomes following iCBT. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Newby, Jill; Robins, Lisa; Wilhelm, Kay; Smith, Jessica; Fletcher, Therese; Gillis, Inika; Ma, Trevor; Finch, Adam; Campbell, Lesley; Andrews, Gavin",2017.0,,0,0,
1329,Internet-based cognitive behavioral therapy versus psychoeducation control for illness anxiety disorder and somatic symptom disorder: A randomized controlled trial.,"Objective: To examine the efficacy of an Internet-delivered cognitive-behavioral therapy (iCBT) program for health anxiety compared to an active psychoeducation control group. Method: Individuals (N = 86, mean age: 30 years, 87% female) with a Diagnostic and Statistical Manual of Mental Disorders (5th ed.) diagnosis of illness anxiety disorder or somatic symptom disorder with health anxiety were randomized to either a 6-lesson clinician-guided iCBT program for health anxiety (n = 45) or an active control group who received anxiety psychoeducation, clinical support, and monitoring (control, n = 41) over a 12-week period. Results: Both groups experienced significant improvements between baseline and posttreatment on self-report measures of health anxiety, depression, general anxiety, and functional impairment. Intention-to-treat analyses indicated that the iCBT group experienced greater improvements in health anxiety on the Short Health Anxiety Inventory (SHAI) compared to controls (between-groups effect size = 1.39, 95% confidence interval [0.87, 1.93]), and a greater proportion of the iCBT group showed clinically reliable change on the SHAI (84% vs. 34% in the control group). Similarly, the iCBT group outperformed the control group on secondary measures of depression, generalized anxiety, functional impairment, maladaptive cognitions, body hypervigilance, safety behaviors and avoidance, and intolerance of uncertainty. Gains were maintained at 3-month follow-up in the iCBT group. Conclusion: iCBT for health anxiety is more effective than psychoeducation, clinical support, and monitoring, and presents an efficacious and accessible treatment option for people with health anxiety. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement What is the public health significance of this article?-This study suggests that Internet cognitive-behavioral therapy is an effective and accessible treatment for individuals with health anxiety. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Newby, Jill M; Smith, Jessica; Uppal, Shivani; Mason, Elizabeth; Mahoney, Alison E. J; Andrews, Gavin",2018.0,http://dx.doi.org/10.1037/ccp0000248,0,0,
1330,Reductions in Alexithymia and Emotion Dysregulation After Training Emotional Self-Awareness Following Traumatic Brain Injury: A Phase I Trial.,"To examine the acceptability and initial efficacy of an emotional self-awareness treatment at reducing alexithymia and emotion dysregulation in participants with traumatic brain injury (TBI). An outpatient rehabilitation hospital. Seventeen adults with moderate to severe TBI and alexithymia. Time postinjury ranged 1 to 33 years. Within subject design, with 3 assessment times: baseline, posttest, and 2-month follow-up. Eight lessons incorporated psychoeducational information and skill-building exercises teaching emotional vocabulary, labeling, and differentiating self-emotions; interoceptive awareness; and distinguishing emotions from thoughts, actions, and sensations. Toronto Alexithymia Scale-20 (TAS-20); Levels of Emotional Awareness Scale (LEAS); Trait Anxiety Inventory (TAI); Patient Health Questionnaire-9 (PHQ-9); State-Trait Anger Expression Inventory (STAXI); Difficulty With Emotion Regulation Scale (DERS); and Positive and Negative Affect Scale (PANAS). Thirteen participants completed the treatment. Repeated-measures analysis of variance revealed changes on the TAS-20 (P = .003), LEAS (P < .001), TAI (P = .014), STAXI (P = .015), DERS (P = .020), and positive affect (P < .005). Paired t tests indicated significant baseline to posttest improvements on these measures. Gains were maintained at follow-up for the TAS, LEAS, and positive affect. Treatment satisfaction was high. This is the first study published on treating alexithymia post-TBI. Positive changes were identified for emotional self-awareness and emotion regulation; some changes were maintained several months posttreatment. Findings justify advancing to the next investigational phase for this novel intervention.",Neumann D.; Malec JF.; Hammond FM.,,10.1097/HTR.0000000000000277,0,0,
1331,Group vs individual cognitive behaviour therapy in panic disorder: An open clinical trial with a six month follow-up.,"Compared the efficacy of group (CBTgr) and individual cognitive behavior therapy (CBTi) in the treatment of panic disorder with and without agoraphobia, in a 6 mo followup. 20 patients (aged 18-65 yrs) with panic disorder with and without agoraphobia were assigned to CBTgr and CBTi with weekly sessions for 12 or 14 wks. The CBTgr Ss were given additional 2 individual 1 hr sessions with the protocol being identical for both treatment modalities. Ss were administered a battery of tests within 10 days prior to the beginning of the treatment, at midpoint, within 10 days following treatment and monthly thereafter for the follow-up. Results indicate that both CBTgr and CBTi significantly reduced panic frequency at treatment end. However, a differential effect favoring CBTi over CBTgr was observed at the end of the follow-up phase with regards to symptoms other than panic, like generalized anxiety and depressive symptoms. (French abstract) (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Neron, Sylvain; Lacroix, Denis; Chaput, Yves",1995.0,http://dx.doi.org/10.1037/0008-400X.27.4.379,0,0,
1332,An experimental investigation of the sense of agency in people with subclinical checking tendencies,"The sense of agency (SoA) refers to the subjective experience of controlling one's own actions and resultant effects. Recent research has indicated possible underlying SoA abnormalities in people with Obsessive Compulsive Disorder (OGD), although these findings are inconsistent. This study attempted to clarify the nature of SoA alterations for people with subclinical checking tendencies compared with non-checking individuals. This was achieved by measuring both explicit and implicit aspects of the SoA in two separate tasks. In a 'Judgement of Agency' task, participants first engaged in a learning phase in which associations between actions (button press) and effect (tone type) were established. In the subsequent testing phase, the degree by which the tone following the action matched participants' learned expectations was varied. Participants provided SoA ratings for each trial. The checking group (n = 20) recorded significantly higher agency judgements than the non-checking group (n = 22), indicating a greater explicit sense of agency. The second task required participants to make time estimates for their actions and resultant effects, which provided a measurement for the subjective temporal compression of the interval between an action and effect. This phenomenon is known as 'Intentional Binding', and is recognised as an implicit measure of SoA This intentional binding effect was greater for the checking group (n = 22) compared with the non-checking group (n = 23). Together, these findings indicate that subclinical checkers experience greater explicit and implicit SoA compared with non-checking individuals. The findings are discussed in relation to previously described cognitive features of OCD such as intolerance of uncertainty, inflated sense of responsibility, and feelings of incompleteness. Potential implications for clinical practice are explored.",Nemeth,2013.0,,0,0,
1333,The Moderating Roles of Gender and Socioeconomic Status in the Association Between Racial Discrimination and Psychological Adjustment,"Racism-related stress poses a significant risk to the mental health functioning of many African American youth during the transition to adulthood. In light of the suggestion that personal and social factors might influence the association between racism-related stress and mental health functioning, this study examined the moderating roles of gender and socioeconomic status (SES) in the association between racial discrimination experiences and depressive symptoms, anxiety, and interpersonal sensitivity. Participants were 171 African American young adults (69% female; mean age = 18.4) recruited from a predominately White southeastern university. Regression analyses revealed that young African American men from lower SES backgrounds and women from higher SES backgrounds were most vulnerable to racial discrimination. These findings suggest that racism-related stress interacts with gender and SES to influence mental health correlates of racism-related stress during the transition to adulthood. We discuss how this knowledge can be used to inform assessment and cognitive-behavioral interventions for African American and other racial and ethnic-minority young adults.",Neblett E.W.; Bernard D.L.; Banks K.H.,2016.0,10.1016/j.cbpra.2016.05.002,0,0,
1334, Immediate chest X-ray for patients at risk of lung cancer presenting in primary care: randomised controlled feasibility trial," BACKGROUND: Achieving earlier stage diagnosis is one option for improving lung cancer outcomes in the United Kingdom. Patients with lung cancer typically present with symptoms to general practitioners several times before referral or investigation. METHODS: We undertook a mixed methods feasibility individually randomised controlled trial (the ELCID trial) to assess the feasibility and inform the design of a definitive, fully powered, UK‚Äêwide, Phase III trial of lowering the threshold for urgent investigation of suspected lung cancer. Patients over 60, with a smoking history, presenting with new chest symptoms to primary care, were eligible to be randomised to intervention (urgent chest X‚Äêray) or usual care. RESULTS: The trial design and materials were acceptable to GPs and patients. We randomised 255 patients from 22 practices, although the proportion of eligible patients who participated was lower than expected. Survey responses (89%), and the fidelity of the intervention (82% patients X‚Äêrayed within 3 weeks) were good. There was slightly higher anxiety and depression in the control arm in participants aged >75. Three patients (1.2%) were diagnosed with lung cancer. CONCLUSIONS: We have demonstrated the feasibility of individually randomising patients at higher risk of lung cancer, to a trial offering urgent investigation or usual care."," Neal, RD;  Barham, A;  Bongard, E;  Edwards, RT;  Fitzgibbon, J;  Griffiths, G;  Hamilton, W;  Hood, K;  Nelson, A;  Parker, D;  et al.",2017.0, 10.1038/bjc.2016.414,0,0,
1335,Impact of Psychological Grief Counseling on the Severity of Post-Traumatic Stress Symptoms in Mothers after Stillbirths.,"Planned support and interventions are necessary in the care and support of women who have experienced stillbirth. The present study was conducted to determine the effect of psychological grief counseling on the symptom severity of post-traumatic stress disorder (PTSD) in mothers after stillbirths. This interventional study is semi-experimental. The study was conducted on 100 women who had recently had stillbirths. Eligible samples were selected and randomly divided into the two groups of intervention and control. The data collection tool was the PPQ,1 which was completed as a pre-test and post-test in both groups. The intervention group received four sessions of psychological grief counseling over two weeks, and the control group received only routine postnatal care. PTSD severity was evaluated in both groups at the end of the fourth week after the final session. The results showed that there was a statistically significant difference in the mean score of the severity of the PTSD symptoms in both groups after the intervention (P = 0.0001), which means that psychological grief counseling led to the reduction of PTSD severity in mothers. Given the positive impact of psychological grief counseling on reducing the severity of PTSD, integration of intensive psychological interventions in the maternity care system seems essential for faster transition of grief stages and for the prevention of severe cases of PTSD.",Navidian A.; Saravani Z.; Shakiba M.,2017.0,10.1080/01612840.2017.1315623,0,0,
1336,Autonomic Regulation in Response to Stress: The Influence of Anticipatory Emotion Regulation Strategies and Trait Rumination,"According to the neurocognitive framework for regulation expectation, adaptively regulating emotions in anticipation of a stressful event should help individuals deal with the stressor itself. The goal of this study was twofold: first, the authors compared the influence of adaptive versus maladaptive anticipatory emotion regulation (ER) on the autonomic system during anticipation of, confrontation with, and recovery from a stressor; second, they explored whether trait rumination moderated this relationship. The authors collected data from 56 healthy female undergraduates during a public speaking task. The task involved 4 phases: baseline, anticipatory ER, stressor, and recovery. Participants were assigned to 1 of 2 anticipatory ER instructions (reappraisal or catastrophizing). Heart rate variability (HRV) indexed autonomic regulation. Results confirmed that HRV was higher in the reappraisal than in the catastrophizing group (over all time points, except for baseline). Trait rumination levels moderated the effect of anticipatory ER strategy on HRV during the stressor phase. Specifically, whereas for low ruminators reappraisal (versus catastrophizing) in the anticipation phase led to higher HRV when confronted to the stressor, high ruminators demonstrated lower HRV in that same condition. To conclude, over all participants, using reappraisal during the anticipation phase allowed participants to better cope with stress. However, only low, but not high ruminators could profit from the beneficial effect of anticipatory reappraisal on autonomic regulation. Even though further research is needed, this study suggests that, in female undergraduates, the tendency to ruminate is associated with abnormal anticipatory ER that might hinder an adaptive response to a stressor.",Nasso S.; Vanderhasselt M.-A.; Demeyer I.; De Raedt R.,2018.0,10.1037/emo0000448,0,0,
1337,Bridging the Gap Towards Awareness Detection in Disorders of Consciousness: An Experimental Study on the Mirror Neuron System,"Advanced functional neuroimaging approaches dealing with motor imagery have disclosed covert cognitive processes in patients with disorders of consciousness (DoC). However, motor impairment and cognitive-motor dissociation can bias such approaches. Fourteen patients with post-traumatic DoC and ten healthy controls (HC) were provided with three motor tasks related to mirror neuron system (MNS) activation (movement observation, movement execution, and passive motor imagery of a movement) while recording electroencephalographic (EEG) metrics [EEG power and Granger Casualty Index (GCI)] to detect residual signs of conscious awareness. The most relevant finding was that all HCs, all patients with Minimally Conscious State and one with Unresponsive Wakefulness Syndrome demonstrated an event-related synchronization in the gamma range over left frontal regions, with high GCI values, in the passive motor imagery condition. These data significantly correlated with the level of behavioral responsiveness measured by the Coma Recovery Scale-Revised. Thus, our findings may indicate that motor tasks related to MNS can activate frontoparietal networks, although leading to different conscious processes. Hence, MNS assessment can be usefully employed to differentiate among patients with DoC.",Naro A.; Calabrò R.S.; Leo A.; Russo M.; Milardi D.; Cannavò A.; Manuli A.; Buda A.; Casella C.; Bramanti P.; Cacciola A.; Bramanti A.,2018.0,10.1007/s10548-018-0628-9,0,0,
1338,Investigating clinical benefits of a novel sleep-focused mind-body program on Gulf War illness symptoms: A randomized controlled trial.,"Objective: Mind-Body Bridging (MBB) has been shown to be effective for improving disturbed sleep. In this prospective randomized controlled trial, we evaluated the efficacy of sleep-focused MBB compared with sleep education control (SED) for improving sleep in previously deployed Gulf War veterans. Methods: US military service members with sleep and physical health complaints who were deployed in 1990-1991 were randomized to receive three weekly sessions of either MBB (n = 33) or SED (n = 27) between 2012 and 2015. The primary outcome of Medical Outcomes Study Sleep Scale was completed at baseline, weekly during treatment, postintervention, and 3-month follow-up. Secondary outcome measures for posttraumatic stress disorder, depression, fatigue, quality of life, symptom severity, and mindfulness were completed at baseline, postintervention and 3-month follow-up. Salivary samples were collected at five time points per day at each visit for cortisol and alpha-amylase assessment. Clinician-administered assessments of sleep and co-occurring conditions were conducted at baseline and postintervention. Results: MBB was significantly more efficacious than SED in reducing disturbed sleep at follow-up (F(1,180.54) = 4.04, p = .046). In addition, self-reported posttraumatic stress disorder (F(1,56.42) = 4.50, p = .038) for the treatment effect, depression (F(1,93.70) = 4.44, p = .038), and fatigue symptoms (F(1,68.58) = 3.90, p = .050) at follow-up improved in MBB compared with those in SED. Consistently higher percentages of veterans in MBB reported improvements of sleep, pain, and composite sleep/general co-occurring symptoms at the postclinical evaluation, as compared with veterans in SED. Finally, the mean waking level of salivary alpha-amylase in the MBB declined to a greater extent than that in the SED, at follow-up (F(1,88.99) = 3.78, p = .055), whereas no effects were found on cortisol. Conclusions: Sleep-focused MBB can improve sleep and possibly also co-occurring symptoms in Gulf War veterans. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Nakamura, Yoshio; Lipschitz, David L; Donaldson, Gary W; Kida, Yuri; Williams, Samuel L; Landward, Richard; Glover, Don W; West, Gavin; Tuteja, Ashok K",2017.0,http://dx.doi.org/10.1097/PSY.0000000000000469,0,0,
1339,In Vivo Contrast-Enhanced Cone Beam CT Provides Quantitative Information on Articular Cartilage and Subchondral Bone.,"In post-traumatic osteoarthritis, both articular cartilage and subchondral bone undergo characteristic pathological changes. This study investigates potential of delayed cone beam computed tomography arthrography (dCBCTa) to simultaneously detect variations in cartilage and subchondral bone. The knees of patients (n = 17) with suspected joint injuries were imaged using a clinical CBCT scanner at 5 and 45 min after the intra-articular injection of anionic contrast agent (Hexabrix™) with hydroxyapatite phantoms around the knee. Normalized attenuation (i.e., contrast agent partition, an indicator of tissue composition) in cartilage, bone mineral density (BMD) in subchondral bone plate (SBP), subchondral bone and trabecular bone, and thicknesses of SBP and cartilage were determined. Lesions of cartilage were scored using International Cartilage Repair Society (ICRS) grading. Normalized attenuation in the delayed image (t = 45 min) increased along the increase of ICRS grade (p = 0.046). Moreover, BMD was significantly higher in SBPs under damaged cartilage (ICRS = 1-2 or ICRS ≥ 3; p = 0.047 and p = 0.038, respectively) than in SBP under non-injured tissue (ICRS = 0). For the first time, dCBCTa enabled the detection of articular cartilage injuries and subchondral bone alterations simultaneously in vivo. Significant relations between ICRS grading and both cartilage and bone parameters suggest that dCBCTa has potential for quantitative imaging of the knee joint.",Myller KA.; Turunen MJ.; Honkanen JT.; Väänänen SP.; Iivarinen JT.; Salo J.; Jurvelin JS.; Töyräs J.,2017.0,10.1007/s10439-016-1730-3,0,0,
1340,Evidence-based psychotherapy completion and symptom improvement among returning combat veterans with PTSD.,"Objective: Despite the availability of evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD) in the Veterans Health Administration, treatment completion rates are low and not all veterans benefit from these treatments. Understanding factors associated with PTSD EBP completion and symptom improvement is critical to improving completion rates and effectiveness. Method: This chart review study used the Andersen Behavioral Model to examine whether predisposing characteristics (nonmodifiable characteristics such as demographics), enabling factors (modifiable logistic variables that can facilitate or impede treatment use), and need factors (clinical characteristics such as symptom severity or comorbidities) predicted treatment completion or symptom improvement following PTSD EBP treatment among 82 Iraq and Afghanistan combat veterans. Logistic regression was used to examine treatment completion, and repeated measures analysis of variance was used to examine changes in PTSD and depression symptoms following treatment. Results: EBP completers had greater improvement in PTSD symptoms than did EBP dropouts. Need factors (lack of comorbid substance use disorders and having problems with family members/significant others) were related to treatment completion, whereas enabling resources (receiving individual rather than group treatment) were related to symptom improvement. Conclusions: This is one the first studies to use a comprehensive model to examine factors relevant to treatment completion and symptom improvement. Results suggest that nonmodifiable predisposing characteristics do not drive treatment completion and symptom improvement, underscoring the potential importance of targeting enabling resources and needs factors for intervention. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement Clinical Impact Statement: This real-world study of returning veterans with PTSD looked at different factors that impact how veterans complete and benefit from evidence based psychotherapy for PTSD. We found that veterans who completed treatment were less likely to have substance use problems and more likely to report problems with family members and significant others. We also found that veterans who received treatment individually had more improvement in their PTSD symptoms than veterans who did group treatment. This suggests that focusing on factors that can be modified by providers could help more returning veterans complete and benefit from treatment. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Myers, Ursula S; Haller, Moira; Angkaw, Abigail C; Harik, Juliette M; Norman, Sonya B",2018.0,http://dx.doi.org/10.1037/tra0000360,0,0,
1341, Cognitive Behaviour Therapy Versus a Counselling Intervention for Anxiety in Young People with High-Functioning Autism Spectrum Disorders: a Pilot Randomised Controlled Trial," The use of cognitive‚Äêbehavioural therapy (CBT) as a treatment for children and adolescents with autism spectrum disorder (ASD) has been explored in a number of trials. Whilst CBT appears superior to no treatment or treatment as usual, few studies have assessed CBT against a control group receiving an alternative therapy. Our randomised controlled trial compared use of CBT against person‚Äêcentred counselling for anxiety in 36 young people with ASD, ages 12‚Äê18. Outcome measures included parent‚Äê teacher‚Äê and self‚Äêreports of anxiety and social disability. Whilst each therapy produced improvements in participants, neither therapy was superior to the other to a significant degree on any measure. This is consistent with findings for adults."," Murphy, SM;  Chowdhury, U;  White, SW;  Reynolds, L;  Donald, L;  Gahan, H;  Iqbal, Z;  Kulkarni, M;  Scrivener, L;  Shaker-Naeeni, H;  et al.",2017.0, 10.1007/s10803-017-3252-8,0,0,
1342, Cognitive restructuring and imagery modification for posttraumatic stress disorder (CRIM-PTSD): a pilot study," BACKGROUND AND OBJECTIVES: Cognitive restructuring and imagery modification for PTSD (CRIM‐PTSD) is a new short intervention. It consists of the cognitive restructuring of core trauma‐related dysfunctional beliefs about the self and the use of imagery to encourage more functional beliefs. A randomized controlled trial showed that CRIM was effective for reducing posttraumatic stress disorder (PTSD) in survivors of childhood sexual abuse (CSA) when it focused on the feeling of being contaminated. For this study, CRIM was adapted to treat PTSD symptoms more generally and after various types of trauma by addressing the patients' negative self‐concept. METHODS: Ten patients with PTSD received two assessment sessions, two treatment sessions, and a booster session. The Clinician‐Administered PTSD Scale (CAPS) was administered prior to and four weeks after treatment. Self‐ratings, e.g., the Posttraumatic Diagnostic Scale (PDS) and the Posttraumatic Cognitions Inventory (PTCI), were administered at baseline, immediately posttreatment, and four weeks after treatment. RESULTS: The participants showed significant improvements in both clinician‐rated (d = 2.55; p < 0.01) and self‐reported PTSD symptoms (d = 1.47; p < 0.01). One month after treatment, 9 patients no longer fully met the diagnostic criteria for PTSD. LIMITATIONS: The results are limited by the small sample size and the lack of a control group. CONCLUSIONS: This pilot study suggests that addressing the negative self‐concept of PTSD patients using a combination of cognitive techniques and imagery modification can effectively reduce PTSD symptoms. Further research is needed to assess the treatment's effects and stability in a randomized controlled trial."," Müller-Engelmann, M;  Steil, R",2017.0, 10.1016/j.jbtep.2016.06.004,0,0,
1343,Psychosocial self help for disfigurement,"This thesis examines the utility of self-help for individuals with disfigurements. While variations in adjustment exist, research has also identified high levels of psychosocial distress, particularly relating to social anxiety and fear of negative evaluations. Psychological interventions have the potential to improve psychosocial functioning. However, owing to the stigma of disfigurements and gaps in services, psychological interventions are scarce. There is scope for self-help to meet the gaps in services. The first section is a systematic review of self-help for disfigurements. The aims were to identify and appraise what is currently known about self-help and explore outcomes and user perspectives in its use. Nine studies with varied methodology met the inclusion criteria. Randomised controlled trials are scarce but demonstrate tentative support for self-help interventions to lower psychosocial distress, particularly in reducing anxiety. Self-help is also actively sought with satisfaction for the medium. Recommendations for future research and clinical implications are discussed. To meet the gaps identified by the review, a randomised controlled feasibility trial was conducted with a psoriasis sample utilising compassion-focused self-help. The study aimed to address questions about recruitment, attrition, acceptability and effectiveness. The primary outcome of interest was external shame. Both self-help interventions significantly lowered external shame with small effects observed (d = .20). The interventions had high acceptability but attrition was high at 30%.",Muftin,2012.0,,0,0,
1344,"""Is it neurological or psychiatric?"" (Ethnology of the deep brain stimulation applied to obsessive compulsive disorder)","This thesis describes the unfolding of a clinical trial on the application of an experimental therapeutic device, the deep brain stimulation, to a psychiatric disorder, the obsessive compulsive disorder (OCD). Drawing on ethnographic data gathered at the Pitie-Salpetriere hospital's Clinical Research Center (Paris) where the protocol is coordinated, we conceive it as an example of neuroscience as a clinical and therapeutic practice in which the collaboration's modalities between neurology and psychiatry in the research and the patient's care has to be described. First, this thesis reconstitutes the history of a protocol at the frontier between a multiplicity of medical and research's worlds, exposed to the tensions of several interests and scientific rationales, thus creating an innovative practice. Then, this research tries to define what an OCD is and what a patient who is suffering from it is when they are integrated in the network of this ward and when they are the object of this innovation. At least, the thesis describes the repercussions of this experimental research on the way patients experience the illness and the treatment. Finally, this technology confronts us, at a practical level, with the naturalization of mental processes and gives us the possibility of studying how neuroscience transforms the individual's anthropological definition as ""cerebral"" individuality.",Moutaud,2009.0,,0,0,
1345,"Relationships between obsessive-compulsive disorder, depression and functioning before and after exposure and response prevention therapy.","Obsessive-compulsive disorder (OCD) is associated with impaired functioning and depression. Our aim was to examine relationships between OCD symptoms, depression and functioning before and after exposure and response prevention (ERP), a type of cognitive-behavioural therapy for OCD, specifically examining whether functioning, depression and other cognitive factors like rumination and worry acted as mediators. Forty-four individuals with OCD were randomised to 4 weeks of intensive ERP treatment first (n‚Äâ=‚Äâ23) or waitlist then treatment (n‚Äâ=‚Äâ21). We used a bootstrapping method to examine mediation models. OCD symptoms, depression and functioning significantly improved from pre- to post-intervention. Functioning mediated the relationship between OCD symptoms and depression and the relationship between functioning and depression was stronger at post-treatment. Depression mediated the relationship between OCD symptoms and functioning, but only at post-intervention. Similarly, rumination mediated the relationship between OCD symptoms and depression at post-intervention. Our findings suggest that after ERP, relationships between depression and functioning become stronger. Following ERP, treatment that focuses on depression and functioning, including medication management for depression, cognitive approaches targeting rumination, and behavioural activation to boost functionality may be important clinical interventions for OCD patients.",Motivala SJ.; Arellano M.; Greco RL.; Aitken D.; Hutcheson N.; Tadayonnejad R.; O'Neill J.; Feusner JD.,2018.0,10.1080/13651501.2017.1351991,0,0,
1346,Examination of posttraumatic stress disorder symptom networks using clinician-rated and patient-rated data.,"Network theory, which conceptualizes psychiatric disorders as networks of interacting symptoms, may provide a useful framework for understanding psychopathology. However, questions have arisen regarding the stability and generalizability of network analytic methods, with some researchers arguing that symptom networks have limited replicability. The aim of this study was to evaluate assessment modality as one possible source of instability in the estimation of posttraumatic stress disorder (PTSD) symptom networks. We estimated two cross-sectional DSM-5 PTSD symptom networks in 378 U.S. veterans: one using data from a clinician-rated assessment instrument (Clinician-Administered PTSD Scale for DSM-5; CAPS-5) and one using data from a self-rated questionnaire (the PTSD Checklist for DSM-5; PCL-5). We calculated centrality indices, conducted community structure analyses, and compared the strength and structure of the networks. The CAPS-5 and PCL-5 symptom networks were highly similar, challenging the notion that network methods produce unreliable results due to estimations consisting primarily of measurement error. Furthermore, each network contained distinct symptom communities that only partially overlapped with the DSM-5 PTSD symptom clusters. These findings may provide guidance for future revisions of the DSM, suggest hypotheses about how PTSD symptoms interact, and inform recent debate about replicability of psychopathology symptom networks. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement General Scientific Summary-Network analysis, a set of statistical methods that evaluate associations among psychiatric symptoms, may improve understanding of disorders such as posttraumatic stress disorder (PTSD). Our study found that network methods yield similar results when using both comprehensive clinician-rated interviews and brief self-rated questionnaires to assess PTSD, informing recent debate over the replicability of symptom networks. Results also suggest that symptoms in the network cluster together in ways that are not captured by the current diagnostic criteria for PTSD. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Moshier, Samantha J; Bovin, Michelle J; Gay, Natalie G; Wisco, Blair E; Mitchell, Karen S; Lee, Daniel J; Sloan, Denise M; Weathers, Frank W; Schnurr, Paula P; Keane, Terence M; Marx, Brian P",2018.0,http://dx.doi.org/10.1037/abn0000368,0,0,
1347,Writing your Way to Health? The Effects of Disclosure of Past Stressful Events in German Students.,"In 1986 Pennebaker and Beall published their renowned study on the long-term beneficial health effects of disclosing traumatic events in 4 brief sequential writing sessions. Their results have been confirmed in various studies, but conflicting results have also been reported. The intent of our study was to replicate the experiments from Pennebaker and Beall (1986), Pennebaker et al. (1988), and Greenberg and Stone (1992) using a German student sample. Additionally, essay variables that point to the emotional processing of events (e.g., depth of self-exploration, number of negative/positive emotions, intensity of emotional expression) were examined as potential mechanisms of action. Trait measures of personality which could moderate the personal consequences of disclosure (alexithymia, self-concealment, worrying, social support) were also assessed. In a second study the experimental condition (disclosure) was varied by implementing ""coping"" vs. ""helping"" instructions as variations of the original condition. Under the coping condition participants were asked to elaborate on what they used to do, continue to do, or could do in the future to better cope with the event. Under the helping condition participants were asked to imagine themselves in the role of a adviser and elaborate on what they would recommend to persons also dealing with the trauma in order to better cope with the event. The expected beneficial effects of disclosure on long-term health (e.g., physician visits, physical symptoms, affectivity) could not be corroborated in either the first or the second study. None of the examined essay variables of emotional processing and only a single personality variable was able to explain significant variance in the health-related outcome variables influence. Nevertheless, substantial reductions in posttraumatic stress symptoms (e.g., intrusions, avoidance, arousal), were found in both experiments. These improvements were significantly related to essay variables of emotional expression and self-exploration and were particularly pronounced under the activation of a prosocial motivation (helping condition). Repeated, albeit brief, expressive writing about personally upsetting or traumatic events resulted in an immediate increase in negative mood but did not lead to long-term positive health consequences in a German student sample. It did, however, promote better processing of stressful or traumatic events, as evidenced by reductions in posttraumatic stress symptoms. The instruction to formulate recommendations for persons dealing with the same trauma seems more helpful than standard disclosure or focusing on one's own past, present, and future coping endeavours. Overall, expressive writing seems to be a successful method of improving trauma processing. Determining the appropriate setting (e.g., self-help vs. therapeutic context) for disclore can be seen as an objective of future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Morris, Lisette; Linkemann, Annedore; Kroner-Herwig, Birgit",2006.0,,0,0,
1348,Prospective cohort feasibility study of a transdiagnostic group intervention for common mental health problems: The Take Control Course.,"While transdiagnostic psychological treatments appear to be promising, they require greater empirical support. Further, a number of available transdiagnostic treatments are targeted at clients with a specific category of disorder, such as clients with anxiety disorders. This study is a preliminary examination of the effectiveness, feasibility, and acceptability of a new transdiagnostic six-session group-based intervention (Take Control Course; TCC) predominantly aimed at clients within primary care. The group is aimed at a broad range of clients; it is derived from an integrative transdiagnostic theory, which specifies mechanisms of psychopathology across disorders. Briefer interventions are gaining an increasing evidence base, and this study seeks to compare the TCC to an established brief intervention within primary care. Prospective cohort study comparing two active psychological treatments. Take Control Course group (n = 66) was compared to a non-randomized control group of clients accessing individual low-intensity interventions (n = 43) using random-effect regression models. Primary outcomes were depression and anxiety scores; additional outcomes included social and other functioning. For the TCC group, changes on all pre-post outcomes were significant with moderate effect sizes. The between-group differences were not significant. Results show potential for TCC to be an effective intervention, but further work is required to validate these findings in a more rigorous, randomized study. Transdiagnostic understandings of psychological distress may inform pragmatic and effective treatments that can be offered to a broad range of clients. This study describes a transdiagnostic intervention (TCC) that targets maintenance processes common across disorders, and presents initial outcome data. The TCC was found to reduce pre-post scores on measures of anxiety and depression.",Morris L.; Mansell W.; Emsley R.; Bates R.; Comiskey J.; Pistorius E.; McEvoy P.,2016.0,10.1111/papt.12070,0,0,
1349, Internet-delivered cognitive behavior therapy for anxiety and insomnia in a higher education context," BACKGROUND AND OBJECTIVES: Anxiety and insomnia can be treated with internet‚Äêdelivered Cognitive Behavioral Therapy (iCBT). iCBT may be well‚Äêsuited to students who are known to be poor help‚Äêseekers and suffer these symptoms. iCBT can offer easy access to treatment and increase service availability. The aim of this study was to evaluate the efficacy of anxiety and insomnia iCBT programs in students. DESIGN: A randomized, controlled study. METHODS: Students were randomly allocated to intervention (""Anxiety Relief"": n‚Äâ=‚Äâ43; ""Insomnia Relief"": n‚Äâ=‚Äâ48; control: n‚Äâ=‚Äâ47). Interventions lasted six weeks. Outcome measures were the State‚ÄêTrait Anxiety Inventory and the Pittsburgh Sleep Quality Index. RESULTS: Significant within‚Äêgroup reductions in anxiety (t(31)‚Äâ=‚Äâ2.00, p‚Äâ=‚Äâ.03) with moderate between‚Äêgroups (compared to control) effect size (d‚Äâ=‚Äâ.64) and increases in sleep quality (t(31)‚Äâ=‚Äâ3.46, p‚Äâ=‚Äâ.002) with a moderate between‚Äêgroups effect size (d‚Äâ=‚Äâ.55) were found for completers of the anxiety program from pre‚Äê to post‚Äêintervention. Significant within‚Äêgroup increases in sleep quality were found for completers of the insomnia program from pre‚Äê to post‚Äêintervention (t(35)‚Äâ=‚Äâ4.28, p‚Äâ>‚Äâ.001) with a moderate between‚Äêgroups effect size (d‚Äâ=‚Äâ.51). CONCLUSIONS: Findings support the use of iCBT for anxiety and insomnia in students, and indicate that further research is needed."," Morris, J;  Firkins, A;  Millings, A;  Mohr, C;  Redford, P;  Rowe, A",2016.0, 10.1080/10615806.2015.1058924,0,0,
1350,Association of persistent postconcussion symptoms with violence perpetration among substance-using veterans.,"Objective: Traumatic brain injury (TBI) and persistent postconcussion symptoms (PPCS) are associated with increased substance use among veterans. Each factor is independently associated with the perpetration of violence; however, little is known about the associations TBI and PPCS have with violence among substance users. This study examined the distinct associations probable TBI and PPCS have with partner aggression (PA) and nonpartner aggression (NPA) in substance-using veterans. Method: Present sample included 810 veterans (6.7% women; Mage = 48.2, SD = 13.3) who completed self-report measures assessing sociodemographic characteristics, past month binge drinking and cocaine use, probable TBI, PPCS, probable posttraumatic stress disorder (PTSD), and chronic pain. Aggression measures included psychological, physical, and injury-related PA and NPA. Results: Bivariate analyses revealed age, probable PTSD, and PPCS were associated with most forms of PA and NPA, whereas race, cocaine use, pain, and TBI severity were mostly associated with NPA. Multivariate negative binomial regression analyses adjusting for other identified risk factors (e.g., age, probable PTSD, and chronic pain) revealed PPCS, but not TBI, was associated with most forms of PA and NPA. Conclusions: Findings highlight the importance of PPCS as a risk factor for PA and NPA in substance-using veterans and have important implications concerning the screening of violence risk. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Morris, David H; Spencer, Robert J; Winters, Jamie J; Walton, Maureen A; Friday, Steve; Chermack, Stephen T",2018.0,http://dx.doi.org/10.1037/vio0000175,0,0,
1351,Moderators of symptomatic outcome in metacognitive training for psychosis (MCT). Who benefits and who does not?,"Metacognitive training (MCT) for psychosis is a group intervention targeted at reducing positive symptoms in schizophrenia through an improvement of cognitive biases in these patients. Despite evidence for its feasibility and efficacy, the recommendations for including or excluding patients from MCT have so far been largely based on anecdotal clinical wisdom rather than empirical evidence. Predictors and moderators of outcome are presently unknown. We reanalyzed data from a large randomized controlled trial, for which 150 patients were randomly assigned to either MCT or CogPack (neurocognitive training) and followed up for up to 3 years. We explored which demographic variables, baseline symptoms, and cognitive biases would predict overall outcome and specific treatment benefits in MCT. Low self-esteem and social anxiety at baseline as well as positive appraisal of the intervention were consistently associated with improved outcome in MCT relative to CogPack. Among other variables, improvement of cognitive biases and selective attention during the intervention period as well as number of sessions attended were general predictors of positive outcome, irrespective of the type of intervention. Patients with cognitive biases and psychological strain (e.g., low self-esteem and quality of life) paired with social problems may represent an ideal target group for MCT. The present findings await replication in independent samples and may not generalise to other forms of metacognitive training (e.g., MCT for depression) or individualized metacognitive intervention for psychosis (MCT+). (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Moritz, Steffen; Menon, Mahesh; Andersen, Devon; Woodward, Todd S; Gallinat, Jurgen",2018.0,http://dx.doi.org/10.1007/s10608-017-9868-3,0,0,
1352,Alexithymia and personality in patients with anxiety disorders and major depression: Effects on treatment outcome.,"Objectives: Alexithymia is frequently associated with major depression and anxiety disorders, and in the literature it is considered as a negative prognostic factor in the treatment of these disorders. Nevertheless, limited evidence is available about the effect of alexithymia on treatment outcome. In this study, we analyze the presence of alexithymia in patients with depressive or anxiety disorders. In addition, we investigate the effects of alexithymia considered as a single factor, and the interaction between alexithymia and socio-demographics and clinical variables (personality traits) as modulators of response to combined treatment. Materials and methods: Eighteen outpatients with major depression or anxiety disorders underwent pharmacotherapy and individual psychodynamic psychotherapy. Subjects were assessed using the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A) and the Toronto Alexithymia Scale 20-item (TAS-20) at baseline and after eight weeks of treatment. Personality traits were assessed with the SCID II at baseline. Outcome was the change in scores of HAM-D and HAM-A from baseline to the eight weeks of treatment. Predictor was the TAS score. The statistical relationship between outcome and predictor was analyzed by linear regression. In the regression model, we included stratification factors (socio-demographics and clinical variables) as covariates if they had a significant statistic relationship with the main outcome and their interaction with the main outcome is included. Results: After eight weeks of treatment, we observed an improvement of 78% on HAM-D and of 69% on HAM-A, while 55.5% of subjects were not alexithymic, 22.2% were borderline alexithymic and 5.5% were diagnosed as alexithymic. No significant effect resulted from the analysis of alexithymia as a modulator of response to anxiety or depressive symptoms. On the other hand, the combination of alexithymia with ""older age"" predicted worse outcome by the HAM-D (p = 0.02873). Moreover, we observed a negative correlation between ""obsessive-compulsive personality traits"" and improvement on HAM-D (p = 0.002314), and a positive correlation between alexithymia and obsessive-compulsive personality traits (p = 0.02629). Conclusions: Alexithymia may interfere with response to treatment in subjects with depressive or anxiety disorders when combined with other socio-demographic and clinical variables. Further research is mandatory to confirm these results. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Mori, E; Drago, A; De Ronchi, D; Serretti, A",2015.0,,0,0,
1353, Can the efficacy of behavioral and cognitive therapy for obsessive compulsive disorder be augmented by innovative computerized adjuvant?," METHOD: In a participative process involving patients through meetings of the French OCD association (AFTOC) and therapists through methodological workshops, we built a therapeutic tool from an experimental checking task. This task, which had been published in an earlier work, was adapted for its psychoeducative dimension. We here report on a randomized double‐blind trial which included 35 patients with a moderate to severe OCD (Yale‐Brown obsessive‐compulsive scale, YBOCS between 16 and 25) predominant checking symptoms, no comorbidities, and 2‐month stabilized or no treatment. Patients were randomly assigned to either ""standard"" versus ""experimental"" CBT. Both therapies were conducted by four CBT‐experienced therapists specialized in OCD through weekly individualized sessions over 3 months. Therapy sessions of the experimental CBT were conducted as the standard CBT except for a short exercise with the computerized psychoeducative tool performed by the patient and debriefed with the therapist at the end of the sessions. Patients were assessed before, during, after therapy and again 6 months later using standard clinical tools and a neurobehavioral assessment based on an original symptom‐provocation task with anxiety ratings including three types of photographs: neutral, generic inducing obsessions (e.g., doorknobs, electric wires…) and personalized (taken by the patients in their own environment). RESULTS: Clinically, ""standard"" and ""experimental"" CBT resulted in a significant but equivalent improvement (48% vs 45% reduction of the Y‐BOCS score; P=0.36; d=0.12). Therapists were satisfied with the psychoeducative dimension of the computerized psychoeducative tool but reported variable acceptance across patients. Patients appreciated its usability. The clinical improvement was associated with a reduction of the task‐induced anxiety (r=0.42, P<0.05), especially towards personalized items (‐28,2% vs ‐20.41% for generic and ‐6.24% for neutral photographs, P<0.001). Mid‐therapy response level was predictive of the final improvement (r=0.82, P<0.001). CONCLUSION: The computerized tool may provide a well‐accepted therapeutic adjuvant even though it doesn't improve the therapeutic effect. Using a personalized symptom‐provocation task reveals the parallel evolution of symptoms and neurobehavioral markers through CBT. Despite the difficulty of improving an evidence‐based therapy, mid‐therapy results call for investigating the possible adjustments of treatment strategies at an early stage. AIM: Cognitive behavioral therapy (CBT) is recognized as an effective treatment for obsessive‐compulsive disorder (OCD). To maximize its effectiveness, we designed an ""experimental"" CBT defined by the addition of a computerized psychoeducative tool."," Morgiève, M;  N'Diaye, K;  Clair, AH;  Pelissolo, A;  Mallet, L",2016.0, 10.1016/j.encep.2016.03.004,0,0,
1354,Use of leukotomy for intractable anorexia nervosa: A long-term follow-up study.,"Studied the long-term outcomes of intractable anorexia nervosa treated with leukotomy and specialized psychotherapy over 20 yrs ago. All traceable Ss were interviewed using the Eating Disorders Examination (EDE) and the Structured Clinical Interview for DSM-III-R (SCID). Ss also completed questionnaires. Detailed histories were taken. Four of 5 female Ss were traced. Their cases had been severe, with failure of previous intensive psychotherapy and now with high risk of death from terminal inanition. One patient had committed suicide, whereas the others enjoyed a reasonable quality of life. Persistent core psychopathology was evident, but patients had not succumbed to weight loss. All suffered depression and anxiety-related disorders, but endorsed their treatment, which had allowed sustained weight gain by release of appetitive behavior, provision of a license to change, and alleviation of phobic anxiety, allowing psychotherapeutic engagement. The authors argue that these outcomes are relatively favorable and would not have been possible without this latter engagement in specialist psychotherapy to address burgeoning panic at unavoidable weight gain. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Morgan, John F; Crisp, Arthur H",2000.0,http://dx.doi.org/10.1002/%28SICI%291098-108X%28200004%2927:3%3C249::AID-EAT1%3E3.0.CO;2-K,0,0,
1355, Internet-Delivered Parenting Program for Prevention and Early Intervention of Anxiety Problems in Young Children: randomized Controlled Trial," OBJECTIVE: The Cool Little Kids parenting group program is an effective intervention for preventing anxiety disorders in young children who are at risk because of inhibited temperament. The program has six group sessions delivered by trained psychologists to parents of 3‚Äê to 6‚Äêyear‚Äêold children. An online adaptation (Cool Little Kids Online) has been developed to overcome barriers to its wide dissemination in the community. This study tested the efficacy of Cool Little Kids Online in a randomized controlled trial. METHOD: A total of 433 parents of a child aged 3 to 6 years with an inhibited temperament were randomized to the online parenting program or to a 24‚Äêweek waitlist. The online program has 8 interactive modules providing strategies that parents can implement with their child to manage their child's avoidant coping, reduce parental overprotection, and encourage child independence. Parents were provided telephone consultation support with a psychologist when requested. Parents completed self‚Äêreport questionnaires at baseline and at 12 and 24 weeks after baseline. RESULTS: The intervention group showed significantly greater improvement over time in child anxiety symptoms compared to the control group (d = 0.38). The intervention group also showed greater reductions in anxiety life interference (ds = 0.33‚Äê0.35) and lower rates of anxiety disorders than the control group (40% versus 54%), but there were minimal effects on broader internalizing symptoms or overprotective parenting. CONCLUSION: Results provide empirical support for the efficacy of online delivery of the Cool Little Kids program. Online dissemination may improve access to an evidence‚Äêbased prevention program for child anxiety disorders. Clinical trial registration information‚ÄêRandomised Controlled Trial of Cool Little Kids Online: A Parenting Program to Prevent Anxiety Problems in Young Children; http://www.anzctr.org.au/; 12615000217505."," Morgan, AJ;  Rapee, RM;  Salim, A;  Goharpey, N;  Tamir, E;  McLellan, LF;  Bayer, JK",2017.0, 10.1016/j.jaac.2017.02.010,0,0,
1356,Fixation of Anteromedial Coronoid Facet Fractures: A Biomechanical Evaluation of Plated Versus Screw Constructs,"OBJECTIVE: To examine the stability of plate (locking and non-) versus screw constructs in the fixation of these fractures. METHODS: An anteromedial coronoid facet fracture (OTA/AO type 21-B1, O'Driscoll type 2, subtype 3) was simulated in 24 synthetic ulna bones that were then assigned to 3 fracture fixation groups: non-locking plate, locking plate (LP), or screw fixation. Each construct was first cycled in tension (through a simulated medial collateral ligament) and then in compression. They were then loaded to failure (displacement >2 mm). Fracture fragment displacement was recorded with an optical tracking system. RESULTS: During tension testing, a mean maximum fragment displacement of 12 ± 13 and 14 ± 9 μm was seen in the locking and non-locking constructs, respectively. There was no difference in fragment motion between the plated constructs. All screw-only fixed constructs failed during the tension protocol. During compression testing, the mean maximum fragment displacement for the screw-only construct (64 ± 79 μm) was significantly greater than locking (9 ± 5 μm) and non-locking constructs (10 ± 9 μm). During load to failure testing, the maximum load to failure in the screw-only group (316 ± 83 N) was significantly lower than locking (650.4 ± 107 N) and non-locking constructs (550 ± 76 N). There was no difference in load to failure between the plated groups. CONCLUSION: Fixation of anteromedial coronoid fractures (type 2, subtype 3) is best achieved with a plating technique. Although LPs had greater stiffness, they did not offer any advantage over conventional non-LPs with respect to fracture fragment displacement in this study. CLINICAL RELEVANCE: Isolated screw fixation showed inferior stability when compared with plate constructs for these fractures. This could result in loss of fracture reduction leading to instability and posttraumatic arthrosis.",Morellato J.; Louati H.; Desloges W.; Papp S.; Pollock J.W.,2018.0,10.1097/BOT.0000000000001266,0,0,
1357,Mechanisms of cognitive-behavioral therapy for obsessive-compulsive disorder involve robust and extensive increases in brain network connectivity.,"Cognitive-behavioral therapy (CBT) is effective for obsessive compulsive disorder (OCD); however, little is understood about its mechanisms related to brain network connectivity. We examined connectivity changes from resting-state functional magnetic resonance imaging data pre-to-post-CBT in 43 OCD participants, randomized to receive either 4 weeks of intensive CBT or 4 weeks waitlist followed by 4 weeks of CBT, and 24 healthy controls before and after 4 weeks of no treatment. Network-based-statistic analysis revealed large-magnitude increases in OCD connectivity in eight networks. Strongest increases involved connectivity between the cerebellum and caudate/putamen, and between the cerebellum and dorsolateral/ventrolateral prefrontal cortices. Connectivity increases were associated with increased resistance to compulsions. Mechanisms of CBT may involve enhanced cross-network integration, both within and outside of classical cortico-striatal-thalamo-cortical regions; those involving cerebellar to striatal and prefrontal regions may reflect acquisition of new non-compulsive goal-directed behaviors and thought patterns. Our findings have implications for identifying targets for enhancing treatment efficacy and monitoring treatment progress.",Moody TD.; Morfini F.; Cheng G.; Sheen C.; Tadayonnejad R.; Reggente N.; O'Neill J.; Feusner JD.,2017.0,10.1038/tp.2017.192,0,0,
1358," Group-based multimodal exercises integrated with cognitive-behavioural therapy improve disability, pain and quality of life of subjects with chronic neck pain: a randomized controlled trial with one-year follow-up"," OBJECTIVE: To evaluate the effect of a group‚Äêbased multidisciplinary rehabilitation programme on disability, pain and quality of life in subjects with chronic neck pain. DESIGN: Randomized controlled trial. SETTING: Specialized rehabilitation centre. SUBJECTS: A total of 170 patients (mean age of 53 years (13); 121 females). INTERVENTIONS: The multidisciplinary group underwent a multidisciplinary rehabilitation programme combining multimodal exercises with psychologist‚Äêlead cognitive‚Äêbehavioural therapy sessions. The general exercise group underwent general physiotherapy. Both groups followed group‚Äêbased programmes once a week for ten weeks. Additionally, the multidisciplinary group met with the psychologist once a week for a 60‚Äêminute session. MAIN MEASURES: The Neck Disability Index (primary outcome), the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, a pain numerical rating scale and the Short‚ÄêForm Health Survey. The participants were evaluated before, after training and after 12 months. RESULTS: A linear mixed model for repeated measures was used for each outcome measure. Significant effects ( p‚Äêvalue <0.001) were found over time and between groups for all outcome measures. After training, significant improvements were found for both groups for all outcome measures except kinesiophobia and catastrophizing, which did not change in the control group; however, the improvements were significantly greater for the multidisciplinary group. At 12‚Äêmonth follow‚Äêup a clinically meaningful between‚Äêgroup difference of 12.4 Neck Disability Index points was found for disability. CONCLUSIONS: A group‚Äêbased multidisciplinary rehabilitation programme including cognitive‚Äêbehavioural therapy was superior to group‚Äêbased general physiotherapy in improving disability, pain and quality of life of subjects with chronic neck pain. The effects lasted for at least one year."," Monticone, M;  Ambrosini, E;  Rocca, B;  Cazzaniga, D;  Liquori, V;  Pedrocchi, A;  Vernon, H",2017.0, 10.1177/0269215516651979,0,0,
1359, Adults with idiopathic scoliosis improve disability after motor and cognitive rehabilitation: results of a randomised controlled trial," PURPOSE: To evaluate the effects of motor and cognitive rehabilitation on disability in adults with idiopathic scoliosis at lower risk of progression. METHODS: 130 adults with idiopathic scoliosis (main curve <35°) were randomly assigned to a 20‐week rehabilitation programme consisting of active self‐correction, task‐oriented exercises and cognitive‐behavioural therapy (experimental group, 65 subjects, mean age of 51.6, females 48) or general physiotherapy consisting of active and passive mobilizations, stretching, and strengthening exercises of the spinal muscles (control group, 65 subjects, mean age of 51.7, females 46). Before, at the end, and 12 months after treatment, each participant completed the Oswestry disability index (ODI) (primary outcome), the Tampa scale for kinesiophobia, the pain catastrophizing scale, a pain numerical rating scale, and the Scoliosis Research Society‐22 Patient Questionnaire. Radiological (Cobb angle) and clinical deformity (angle of trunk rotation) changes were also investigated. A linear mixed model for repeated measures was used for each outcome. RESULTS: Significant effects of time, group, and time by group interaction were found for all outcome measures (P < 0.001). After training, the primary outcome showed a clinically significant between‐group change (12 % points), which was preserved at follow‐up. At follow‐up, the radiological deformities showed a significant, although not clinically meaningful, between‐group difference of 4° in favour of the experimental group. CONCLUSION: The experimental programme was superior to general physiotherapy in reducing disability of adults with idiopathic scoliosis. Motor and cognitive rehabilitation also led to improvements in dysfunctional thoughts, pain, and quality of life. Changes were maintained for at least 1 year."," Monticone, M;  Ambrosini, E;  Cazzaniga, D;  Rocca, B;  Motta, L;  Cerri, C;  Brayda-Bruno, M;  Lovi, A",2016.0, 10.1007/s00586-016-4528-y,0,0,
1360,Changes in cerebellar functional connectivity and autonomic regulation in cancer patients treated with the Neuro Emotional Technique for traumatic stress symptoms.,"Purpose: A growing number of research studies have implicated the cerebellum in emotional processing and regulation, especially with regard to negative emotional memories. However, there currently are no studies showing functional changes in the cerebellum as a result of treatment for traumatic stress symptoms. The Neuro Emotional Technique (NET) is an intervention designed to help improve symptoms related to traumatic stress using an integrative approach that combines emotional, cognitive, and motor processing, with a particular focus on autonomic nervous system regulation. In this study, we evaluated whether the NET intervention alters functional connectivity in the brain of patients with traumatic stress symptoms associated with a cancer-related event. We hypothesized that the NET intervention would reduce emotional and autonomic reactivity and that this would correlate with connectivity changes between the cerebellum and limbic structures as well as the brain stem. Methods: We enrolled patients with a prior cancer diagnosis who experienced distressing cancer-related memories associated with traumatic stress symptoms of at least 6 months in duration. Participants were randomized to either the NET intervention or a waitlist control. To evaluate the primary outcome of neurophysiological effects, all participants received resting-state functional blood oxygen level-dependent (BOLD) magnetic resonance imaging (rs-fMRI) before and after the NET intervention. In addition, autonomic reactivity was measured using heart rate response to the traumatic stimulus. Pre/post comparisons were performed between the NET and control groups. Results: The results demonstrated significant changes in the NET group, as compared to the control group, in the functional connectivity between the cerebellum (including the vermis) and the amygdala, parahippocampus, and brain stem. Likewise, participants receiving the NET intervention had significant reductions in autonomic reactivity based on heart rate response to the traumatic stimulus compared to the control group. Conclusions: This study is an initial step towards establishing a neurological signature of treatment effect for the NET intervention. Specifically, functional connectivity between the cerebellum and the amygdala and prefrontal cortex appear to be associated with a reduction in autonomic reactivity in response to distressing cancer-related memories. Implications for cancer survivors: This study contributes to the understanding of possible mechanisms by which interventions like NET may help reduce emotional distress in cancer patients who suffer from traumatic stress symptoms. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Monti, Daniel A; Tobia, Anna; Stoner, Marie; Wintering, Nancy; Matthews, Michael; Conklin, Chris J; Mohamed, Feroze B; Chervoneva, Inna; Newberg, Andrew B",2018.0,http://dx.doi.org/10.1007/s11764-017-0653-9,0,0,
1361," Docosahexaenoic acid for reading, working memory and behavior in UK children aged 7-9: a randomized controlled trial for replication (the DOLAB II study)"," BACKGROUND: Omega‚Äê3 fatty acids are central to brain‚Äêdevelopment of children. Evidence from clinical trials and systematic reviews demonstrates the potential of long‚Äêchain Omega‚Äê3 supplementation for learning and behavior. However, findings are inconclusive and in need of robust replication studies since such work is lacking. OBJECTIVES: Replication of the 2012 DOLAB 1 study findings that a dietary supplementation with the long‚Äêchain omega‚Äê3 docosahexaenoic acid (DHA) had beneficial effects on the reading, working memory, and behavior of healthy schoolchildren. DESIGN: Parallel group, fixed‚Äêdose, randomized (minimization, 30% random element), double‚Äêblind, placebo‚Äêcontrolled trial (RCT). SETTING: Mainstream primary schools (n = 84) from five counties in the UK in 2012‚Äê2015. PARTICIPANTS: Healthy children aged 7‚Äê9 underperforming in reading (<20th centile). 1230 invited, 376 met study criteria. INTERVENTION: 600 mg/day DHA (from algal oil), placebo: taste/color matched corn/soybean oil; for 16 weeks. MAIN OUTCOME MEASURES: Age‚Äêstandardized measures of reading, working memory, and behavior, parent‚Äêrated and as secondary outcome teacher‚Äêrated. RESULTS: 376 children were randomized. Reading, working memory, and behavior change scores showed no consistent differences between intervention and placebo group. Some behavioral subscales showed minor group differences. CONCLUSIONS: This RCT did not replicate results of the earlier DOLAB 1 study on the effectiveness of nutritional supplementation with DHA for learning and behavior. Possible reasons are discussed, particularly regarding the replication of complex interventions. TRIAL REGISTRATION AND PROTOCOL: www.controlled‚Äêtrials.com (ISRCTN48803273) and protocols.io (https://dx.doi.org/10.17504/protocols.io.k8kczuw)."," Montgomery, P;  Spreckelsen, TF;  Burton, A;  Burton, JR;  Richardson, AJ",2018.0, 10.1371/journal.pone.0192909,0,0,
1362," Importance of Virtual Reality to Virtual Reality Exposure Therapy, Study Design of a Randomized Trial"," Post Traumatic Stress Disorder (PTSD) can be a debilitating problem in service members who have served in Iraq or Afghanistan. Virtual Reality Exposure Therapy (VRET) is one of the few interventions demonstrated in randomized controlled trials to be effective for PTSD in this population. There are theoretical reasons to expect that Virtual Reality (VR) adds to the effectiveness of exposure therapy, but there is also added expense and difficulty in using VR. Described is a trial comparing outcomes from VRET and a control exposure therapy (CET) protocol in service members with PTSD."," McLay, RN;  Baird, A;  Murphy, J;  Deal, W;  Tran, L;  Anson, H;  Klam, W;  Johnston, S",2015.0,,0,0,
1363,Two-year follow-up of behavioral treatment and maintenance for body dysmorphic disorder.,"Recent research has suggested that body dysmorphic disorder (BDD) is part of the obsessive-compulsive spectrum of disorders. As such, it has been hypothesized that these disorders respond in a similar manner to obsessive-compulsive disorder when behavioral interventions are used. A continuation of follow-up was conducted with a group of patients with BDD following treatment. 10 patients (aged 21-45 yrs) completed an intensive behavioral therapy program and either participated in a 6-mo maintenance program or served as controls. At 12-, 18-, and 24-mo follow-up assessments, patients participating in the maintenance program were more effective at managing limited symptom return and had significantly lower anxiety and depression. Both groups remained improved for acute symptomatology and behavioral avoidance. The results suggest that maintenance programs following behavioral treatment are effective in preventing symptom relapse and assist in patient self-management of lapses typically associated with BDD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","McKay, Dean",1999.0,http://dx.doi.org/10.1177/0145445599234006,0,0,
1364, Cortisol response and psychological distress predict susceptibility to false memories for a trauma film," For eyewitness testimony to be considered reliable, it is important to ensure memory remains accurate following the event. As many testimonies involve traumatic, as opposed to neutral, events, it is important to consider the role of distress in susceptibility to false memories. The aim of this study was to investigate whether cortisol response following a stressor would be associated with susceptibility to false memories. Psychological distress responses were also investigated, specifically, dissociation, intrusions, and avoidance. Participants were allocated to one of three conditions: those who viewed a neutral film (N‚Äâ=‚Äâ35), those who viewed a real trauma film (N‚Äâ=‚Äâ35), and a trauma ""reappraisal"" group where participants were told the film was not real (N‚Äâ=‚Äâ35). All received misinformation about the film in the form of a narrative. Participants provided saliva samples (to assess cortisol) and completed distress and memory questionnaires. Cortisol response was a significant predictor of the misinformation effect. Dissociation and avoidance were related to confabulations. In conclusion, following a stressor an individual may differ with regard to their psychological response to the event, and also whether they experience a cortisol increase. This may affect whether they are more distressed later on, and also whether they remember the event accurately."," Monds, LA;  Paterson, HM;  Ali, S;  Kemp, RI;  Bryant, RA;  McGregor, IS",2016.0, 10.1080/09658211.2015.1102287,0,0,
1365, Effects of a randomized controlled intervention trial on return to work and health care utilization after long-term sickness absence," BACKGROUND: The aim of the RCT study was to investigate if the effect of a multidisciplinary intervention on return to work (RTW) and health care utilization differed by participants' self‚Äêreported health status at baseline, defined by a) level of somatic symptoms, b) health anxiety and c) self‚Äêreported general health. METHODS: A total of 443 individuals were randomized to the intervention (n‚Äâ=‚Äâ301) or the control group (n‚Äâ=‚Äâ142) and responded to a questionnaire measuring health status at baseline. Participants were followed in registries measuring RTW and health care utilization. Relative risk (RR) and odds ratio (OR) were used as measures of associations. Results were adjusted for gender, age, educational level, work ability and previous sick leave. RESULTS: Among all responders we found no effect of the intervention on RTW. Among participants with low health anxiety, the one‚Äêyear probability of RTW was lower in the intervention than in the control group (RR‚Äâ=‚Äâ0.79 95 % CI 0.68‚Äê0.93), but for those with high health anxiety there was no difference between the groups (RR‚Äâ=‚Äâ1.15 95 % CI 0.84‚Äê1.57). Neither general health nor somatic symptoms modified the effect of the intervention on RTW. The intervention had no effect on health care utilization. CONCLUSIONS: The multidisciplinary intervention did not facilitate RTW or decrease health care utilization compared to ordinary case management in subgroups with multiple somatic symptoms, health anxiety or low self‚Äêrated health. However, the intervention resulted in a reduced chance of RTW among participants with low health anxiety levels. TRIAL REGISTRATION: ISRCTN43004323 , and ISRCTN51445682."," Momsen, AH;  Stapelfeldt, CM;  Nielsen, CV;  Nielsen, MB;  Aust, B;  Rugulies, R;  Jensen, C",2016.0, 10.1186/s12889-016-3812-4,0,0,
1366,One session treatment of cognitive and behavioral therapy and virtual reality for social and specific phobias. Preliminary results from a randomized clinical trial.,"This randomized clinical trial aimed to investigate the efficacy of one session treatment of VRCBT (cognitive behavioral therapy combined with virtual reality) for patients with social phobia, flight phobia and acrophobia. Additionally we concentrated on investigating if and to what extent do working alliance, patients' expectations and therapists' performance contribute to this change. Our preliminary results include data from a sample of 32 participants diagnosed with social phobia (N = 15), flight phobia (N = 9) and acrophobia (N = 8) who were randomly assigned to either immediate treatment or WL control group. Results indicated no significant differences between the two groups. Significant differences were shown between pre- and post-treatment for the majority of the measures used. Patients' expectations, working alliance and therapists' performance proved to be predictors of change. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Moldovan, Ramona; David, Daniel",2014.0,,0,0,
1367,Internet-based acceptance and commitment therapy for psychological distress experienced by people with hearing problems: A pilot randomized controlled trial.,"Psychological distress is common among people with hearing problems, but treatments that specifically target this aspect have been almost non-existent. In this pilot randomized controlled trial, an eight-week long Internet-based treatment, informed by Acceptance and Commitment Therapy, was administered to explore the feasibility and efficacy of such a treatment. Included participants were randomized to either treatment (n = 31) or wait-list control (n = 30) condition. All participants were measured prior to randomization and immediately after treatment ended using standardized self-report instruments measuring hearing-related emotional and social adjustment (Hearing Handicap Inventory for the Elderly-S, HHIE-S), quality of life (Quality of Life Inventory, QOLI), and symptoms of depression and anxiety (Patient health Questionnaire, PHQ-9 and Generalized Anxiety Disorder scale, GAD-7). Linear mixed effects regression analysis using the full intention-to-treat sample demonstrated that the treatment had superior outcomes on the main outcome measure as compared with the control group, Cohen's d = 0.93, 95% CI [0.24, 1.63]. The benefits of treatment over control were also evident in scores of depression, Cohen's d = 0.61, 95% CI [0.04, 1.19], and quality of life, Cohen's d = 0.88, 95% CI [0.14, 1.61]. The results provide preliminary support for Internet-delivered acceptance and commitment therapy as a potentially effective treatment of psychological symptoms associated with hearing problems. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Molander, Peter; Hesser, Hugo; Weineland, Sandra; Bergwall, Kajsa; Buck, Sonia; Malmlof, Johan Jader; Lantz, Henning; Lunner, Thomas; Andersson, Gerhard",2018.0,http://dx.doi.org/10.1080/16506073.2017.1365929,0,0,
1368,Startle potentiation in rapidly alternating conditions of high and low predictability of threat,"Effects of predictability of threat on potentiation of the startle reflex were investigated by presenting participants with predictable and unpredictable electric shocks. Shocks were presented either paired with a visual cue (paired condition) or unrelated to the presentation of the visual cues (unpaired condition). In contrast to previous slower-paced studies, conditions alternated at a rapid rate: each context lasted 8.5 s and within these contexts the visual cues had a duration of 1.5 s. Results replicated previous findings: in the predictable condition, startle responses were augmented by a threat-signaling stimulus, and startle responses in the unpredictable condition were larger than in a neutral condition in which no shocks were presented. In all three conditions, visual stimuli that did not carry information about when a shock could be presented augmented startle reactivity. A control experiment showed that the effects of threat on the startle response could not be ascribed to attention and that the effects of the lead stimuli that did not signal threat are likely to be unrelated to the effects of threat. These results show that the fear system is modulated dynamically as a function of rapidly changing information about threat and emphasize the role of predictability of an aversive stimulus in the distinction between cue-specific and contextual fear. © 2007 Elsevier B.V. All rights reserved.",Mol N.; Baas J.M.P.; Grillon C.; van Ooijen L.; Kenemans J.L.,2007.0,10.1016/j.biopsycho.2007.05.005,0,0,
1369,The Impact of Protective Factors on Posttraumatic Growth for College Student Survivors of Childhood Maltreatment,"Many college students experience traumatic life events in childhood, yet demonstrate personal growth following these experiences. Deriving benefit in the face of adversity has been termed “posttraumatic growth.” The relationship between posttraumatic growth and childhood experiences of abuse and neglect was investigated in a sample of 501 college students. The primary focus was on what protective factors moderated the relationship between childhood experiences of abuse and neglect and later posttraumatic growth. It was found that although the protective factors of acceptance, positive reframing, and emotional support all significantly predicted scores on the Posttraumatic Growth Inventory, only the factor of prosocial adults and the overall number of social and emotional resources experienced moderated the relationship between childhood maltreatment and posttraumatic growth. These findings have implications for designing effective interventions that foster growth in college students who report a history of childhood maltreatment.",Mohr D.; Rosén L.A.,2017.0,10.1080/10926771.2017.1304478,0,0,
1370,Banning pre-event rumination in social anxiety: A preliminary randomized trial.,"Background and Objectives: Pre-event rumination has a clear role in maintaining social anxiety according to cognitive models. However, it is unclear what specific strategies can address pre-event rumination for individuals diagnosed with SAD. The current study aimed to determine the effectiveness of a brief intervention on multiple aspects of pre-event rumination, state anxiety and performance and threat appraisals. Additionally, the trajectory of pre-event rumination was investigated over four days. Methods: Participants with SAD were informed they would be required to complete a speech task in four days' time and were randomised to an intervention (n = 27) or a non-active control group (n = 25). The intervention group were instructed to ""ban"" pre-event rumination using a metacognitive therapy technique known as detached mindfulness. All participants completed daily measures of pre-evet rumination that assessed frequency, uncontrollability, engagement and distress associated with pre-event rumination. On the day of the speech task, participants also completed state and cognitive measures before delivering the speech task. Results: The intervention group reported reduced frequency, uncontrollability and distress associated with pre-event rumination, compared to the control group. There was no difference between groups for performance and threat appraisals as well as state anxiety. Rumination is a stable and robust process, with an increase in frequency and associated distress 24 hours before a feared social situation. Limitations: The lack of an active control group precludes comparisons to more traditional cognitive-behavioural therapy strategies for pre-event rumination. Conclusions: Pre-event rumination is a durable process but banning pre-event rumination using metacognitive therapy techniques shows promise for specifically addressing this maladaptive process. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Modini, Matthew; Abbott, Maree J",2018.0,http://dx.doi.org/10.1016/j.jbtep.2018.06.009,0,0,
1371,"Negative rumination in social anxiety: A randomised trial investigating the effects of a brief intervention on cognitive processes before, during and after a social situation.","Background and objectives: According to cognitive models of Social Anxiety Disorder (SAD), negative rumination is a key maintaining factor in the vicious cycle of social anxiety. However, there is a scarcity of research investigating treatment effects on rumination in social anxiety, as well as other key cognitive variables. The current study aimed to determine the effectiveness of a brief intervention on a range of cognitive processes, most notably negative rumination. Additionally, predictors of negative rumination and state anxiety are also investigated. Methods: Participants with a diagnosis of SAD were randomly allocated to an intervention (n = 24) or control group (n = 23). Participant's initially completed trait and state based measures with the intervention group also completing a brief cognitive intervention. One-week later participants completed state anxiety and cognitive measures before and after a speech task. Finally, one-week post-speech task participants completed further trait and state based measures. Results: While the brief cognitive intervention had positive effects on some of the cognitive processes measured at different time points of the study, levels of negative rumination remained stable. Predictors of negative rumination and state anxiety were consistent with cognitive models of SAD. Limitations: The brief nature of the intervention and temporal stance of the intervention (delivered one-week before the speech) may have impacted outcomes. Conclusions: Cognitive technique can potentially impact a range of key processes that maintain SAD, however, more powerful and tailored interventions are needed that address the different processes at play before, during and after a social situation for socially anxious individuals. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Modini, Matthew; Abbott, Maree J",2017.0,http://dx.doi.org/10.1016/j.jbtep.2016.12.002,0,0,
1372,"3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: A randomised, double-blind, dose-response, phase 2 clinical trial.","Background: Post-traumatic stress disorder (PTSD) is prevalent in military personnel and first responders, many of whom do not respond to currently available treatments. This study aimed to assess the efficacy and safety of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for treating chronic PTSD in this population. Methods: We did a randomised, double-blind, dose-response, phase 2 trial at an outpatient psychiatric clinic in the USA. We included service personnel who were 18 years or older, with chronic PTSD duration of 6 months or more, and who had a Clinician-Administered PTSD Scale (CAPS-IV) total score of 50 or greater. Using a web-based randomisation system, we randomly assigned participants (1:1:2) to three different dose groups of MDMA plus psychotherapy: 30 mg (active control), 75 mg, or 125 mg. We masked investigators, independent outcome raters, and participants until after the primary endpoint. MDMA was administered orally in two 8-h sessions with concomitant manualised psychotherapy. The primary outcome was mean change in CAPS-IV total score from baseline to 1 month after the second experimental session. Participants in the 30 mg and 75 mg groups subsequently underwent three 100-125 mg MDMA-assisted psychotherapy sessions in an open-label crossover, and all participants were assessed 12 months after the last MDMA session. Safety was monitored through adverse events, spontaneously reported expected reactions, vital signs, and suicidal ideation and behaviour. This study is registered with ClinicalTrials.gov, number NCT01211405. Findings: Between Nov 10, 2010, and Jan 29, 2015, 26 veterans and first responders met eligibility criteria and were randomly assigned to receive 30 mg (n = 7), 75 mg (n = 7), or 125 mg (n = 12) of MDMA plus psychotherapy. At the primary endpoint, the 75 mg and 125 mg groups had significantly greater decreases in PTSD symptom severity (mean change CAPS-IV total scores of -58.3 [SD 9.8] and -44.3 [28.7]; p = 0.001) than the 30 mg group (-11.4 [12.7]). Compared with the 30 mg group, Cohen's d effect sizes were large: 2.8 (95% CI 1.19-4.39) for the 75 mg group and 1.1 (0.04-2.08) for the 125 mg group. In the open-label crossover with full-dose MDMA (100-125 mg), PTSD symptom severity significantly decreased in the group that had previously received 30 mg (p = 0.01), whereas no further significant decreases were observed in the group that previously achieved a large response after 75 mg doses in the blinded segment (p = 0.81). PTSD symptoms were significantly reduced at the 12-month follow-up compared with baseline after all groups had full-dose MDMA (mean CAPS-IV total score of 38.8 [SD 28.1] vs 87.1 [16.1]; p < 0.0001). 85 adverse events were reported by 20 participants. Of these adverse events, four (5%) were serious: three were deemed unrelated and one possibly related to study drug treatment. Interpretation: Active doses (75 mg and 125 mg) of MDMA with adjunctive psychotherapy in a controlled setting were effective and well tolerated in reducing PTSD symptoms in veterans and first responders. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Mithoefer, Michael C; Mithoefer, Ann T; Feduccia, Allison A; Jerome, Lisa; Wagner, Mark; Wymer, Joy; Holland, Julie; Hamilton, Scott; Yazar-Klosinski, Berra; Emerson, Amy; Doblin, Rick",2018.0,http://dx.doi.org/10.1016/S2215-0366%2818%2930135-4,0,0,
1373, Integrated Treatment of PTSD and Substance Use Disorders: examination of Imaginal Exposure Length," Efforts to improve the efficiency of prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD) have demonstrated that reducing the length of imaginal exposures does not negatively affect treatment outcome. A recent adaptation of PE, called Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure [COPE], integrates substance use disorder treatment with PE in the same timeframe (twelve 90‐minute sessions, 8 of which include imaginal exposure). The current study, which represents a subanalysis of a larger randomized controlled trial, examined how the length of imaginal exposures (nonrandomized and measured continually) related to PTSD, substance use, and depression in a sample of military veterans (N = 31) who completed the COPE treatment. Participants completed an average of 11.5 of the 12 therapy sessions and 7.2 of the 8 imaginal exposures during treatment. Results of 3 linear mixed models indicate that PTSD, substance use, and depressive symptoms all improved over the course of treatment (ps < .001; η"," Mills, AC;  Badour, CL;  Korte, KJ;  Killeen, TK;  Henschel, AV;  Back, SE",2017.0, 10.1002/jts.22175,0,0,
1374,Sexual distress and vaginal symptom severity in women diagnosed with cancer: Impact of a vaginal health workshop,"Objectives: Sexual dysfunction and changes in vaginal health are common sequelae for women undergoing treatments for cancer (for review see Sears, Robinson, &Walker, 2017), and can have a significant impact on quality of life and intimate relationships. The purpose of this study was to evaluate a single-session information workshop implemented to address women's vaginal and sexual health following cancer treatment. Material and Methods: Women (N = 45) treated for a cancer diagnosis within the past five years completed self-report measures including the Female Sexual Distress Scale (DeRogatis et al., 2008) and a modified version of the Vaginal Assessment Scale (Carter et al., 2015) prior to, and 3-months following, the workshop. Results: Paired samples t-tests were conducted to examine pre-post differences in sexual distress and vaginal symptoms. There was a significant difference in the scores for sexual distress before (M =28.63, SD = 13.09) and 3 months following the workshop (M =20.60, SD = 13.37); t(41) = 4.97, p <.001. At baseline, 89% of women indicated clinically significant sexual distress, while at 3-month follow-up 76% of women met the threshold for clinically significant sexual distress. Further, sexual distress decreased for 76% of women, remained stable for 7% of women, and increased for 17% of women. A significant difference was also found in the scores for the severity of vaginal symptoms before (M =1.48, SD = 0.67) and after (M =1.18, SD = 0.82) the workshop; t(44) = 4.13, p <.001. Vaginal symptom severity decreased for 76% of women, remained stable for 7% of women, and increased for 18% of women. Conclusions: Providing information to women diagnosed with cancer regarding sexual and vaginal health is associated with decreases in sexual distress and the severity of vaginal symptoms. However, it is important to note that 3-months following this intervention, the majority of women continued to experience clinically significant sexual distress. Future research could examine longer follow-up periods to determine the trajectories of change in distress and vaginal symptom severity, and determine whether more extensive intervention would be beneficial.",Millman R.; Sears C.; Jacox N.; Booker R.; Beck A.; Santos-Iglesias P.; Robinson J.; Walker L.,2018.0,,0,0,
1375,Insomnia severity as a mediator of the association between mental health symptoms and alcohol use in young adult veterans.,"Prior research has documented associations between mental health and alcohol use, mental health and insomnia, and insomnia and alcohol use. This study examined insomnia severity as a mediator of the association between mental health and alcohol-related outcomes in young adult veterans. Veterans aged 18-34 years (N=622, 83% male) who reported drinking in the past year completed assessments at baseline and one-month follow-up as part of a larger intervention trial. Participants reported symptoms of depression and posttraumatic stress disorder (PTSD) at baseline, insomnia severity at one month, and alcohol use and related consequences at baseline and one month. Mediation analyses using bootstrapped confidence intervals were used to examine the indirect effects of baseline mental health symptoms on alcohol-related outcomes at one month via insomnia severity. Insomnia severity was associated with both drinking quantity and alcohol-related consequences. Greater depressive (but not PTSD) symptoms were associated directly with more alcohol-related consequences. Neither depressive nor PTSD symptoms had direct effects on drinking quantity when controlling for the other mental health symptoms (e.g., depressive symptoms did not predict drinking quantity when controlling for symptoms of PTSD). However, symptoms of depression and PTSD predicted drinks per week and alcohol-related consequences indirectly through insomnia severity. Symptoms of depression and PTSD increase risk for alcohol use and related consequences in part by increasing symptoms of insomnia. Findings suggest that insomnia may be an appropriate target for prevention and intervention efforts among heavy-drinking Veterans reporting symptoms of depression or PTSD.",Miller MB.; DiBello AM.; Carey KB.; Borsari B.; Pedersen ER.,2017.0,10.1016/j.drugalcdep.2017.03.031,0,0,
1376,Understanding the mental health consequences of family separation for refugees: Implications for policy and practice.,"Consistent evidence documents the negative impacts of family separation on refugee mental health and concerns for the welfare of distant family members and desire to reunite with family members as priorities for refugees postmigration. Less is known about refugees' emic perspectives on their experiences of family separation. Using mixed methods data from a community-based mental health intervention study, we found that family separation was a major source of distress for refugees and that it was experienced in a range of ways: as fear for family still in harm's way, as a feeling of helplessness, as cultural disruption, as the greatest source of distress since resettlement, and contributing to mixed emotions around resettlement. In addition to these qualitative findings, we used quantitative data to test the relative contribution of family separation to refugees' depression/anxiety symptoms, posttraumatic stress disorder (PTSD) symptoms, and psychological quality of life. Separation from a family member was significantly related to all 3 measures of mental health, and it explained significant additional variance in all 3 measures even after accounting for participants' overall level of trauma exposure. Relative to 26 other types of trauma exposure, family separation was 1 of only 2 traumatic experiences that explained additional variance in all 3 measures of mental health. Given the current global refugee crisis and the need for policies to address this large and growing issue, this research highlights the importance of considering the ways in which family separation impacts refugee mental health and policies and practices that could help ameliorate this ongoing stressor. (PsycINFO Database Record",Miller A.; Hess JM.; Bybee D.; Goodkind JR.,2018.0,10.1037/ort0000272,0,0,
1377, Perceptions on use of home telemonitoring in patients with long term conditions - concordance with the Health Information Technology Acceptance Model: a qualitative collective case study," BACKGROUND: Health information technology (HIT) may be used to improve care for increasing numbers of older people with long term conditions (LTCs) who make high demands on health and social care services. Despite its potential benefits for reducing disease exacerbations and hospitalisations, HIT home monitoring is not always accepted by patients. Using the Health Information Technology Acceptance Model (HITAM) this qualitative study examined the usefulness of the model for understanding acceptance of HIT in older people (‚â•60 years) participating in a RCT for older people with Chronic Obstructive Pulmonary Disease (COPD) and associated heart diseases (CHROMED). METHODS: An instrumental, collective case study design was used with qualitative interviews of patients in the intervention arm of CHROMED. These were conducted at two time points, one shortly after installation of equipment and again at the end of (or withdrawal from) the study. We used Framework Analysis to examine how well the HITAM accounted for the data. RESULTS: Participants included 21 patients aged between 60‚Äê99 years and their partners or relatives where applicable. Additional concepts for the HITAM for older people included: concerns regarding health professional access and attachment; heightened illness anxiety and desire to avoid continuation of the 'sick‚Äêrole'. In the technology zone, HIT self‚Äêefficacy was associated with good organisational processes and informal support; while ease of use was connected to equipment design being suitable for older people. HIT perceived usefulness was related to establishing trends in health status, detecting early signs of infection and potential to self‚Äêmanage. Due to limited feedback to users opportunities to self‚Äêmanage were reduced. CONCLUSIONS: HITAM helped understand the likelihood that older people with LTCs would use HIT, but did not explain how this might result in improved self‚Äêmanagement. In order to increase HIT acceptance among older people, equipment design and organisational factors need to be considered. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01960907 October 9 2013 (retrospectively registered) Clinical tRials fOr elderly patients with MultiplE Disease (CHROMED). Start date October 2012, end date March 2016. Date of enrolment of the first participant was February 2013."," Middlemass, JB;  Vos, J;  Siriwardena, AN",2017.0, 10.1186/s12911-017-0486-5,0,0,
1378,"Dexamethasone facilitates fear extinction and safety discrimination in PTSD: A placebo-controlled, double-blind study.","Psychophysiological hallmarks of posttraumatic stress disorder (PTSD) include exaggerated fear responses, impaired inhibition and extinction of conditioned fear, and decreased discrimination between safety and fear cues. This increased fear load associated with PTSD can be a barrier to effective therapy thus indicating the need for new treatments to reduce fear expression in people with PTSD. One potential biological target for reducing fear expression in PTSD is the hypothalamic-pituitary-adrenal (HPA) axis, which is dysregulated in PTSD. Recent translational rodent studies and cross-sectional clinical studies have shown that dexamethasone administration and the resulting suppression of cortisol in individuals with PTSD leads to a decrease in the fear responses characteristic of PTSD. These data, taken together, suggest that dexamethasone may serve as a novel pharmacologic intervention for heightened fear responses in PTSD. We conducted a double-blind, placebo-controlled trial to test our hypothesis that dexamethasone administration and the concomitant suppression of HPA axis hyperactivity would attenuate fear expression and enhance fear extinction in individuals with PTSD. Study participants (n = 62) were recruited from Grady Memorial Hospital in Atlanta, GA. Participants were randomized to receive dexamethasone or placebo prior to fear conditioning and extinction, in a counterbalanced design (treatments separated by a week). Both PTSD- (n = 37) and PTSD+ (n = 25) participants showed significant startle increases in the presence of the danger signal during placebo and dexamethasone treatments (all p < 0.05). However, only PTSD- control participants showed decreases in fear-potentiated startle across extinction blocks during both conditions (p's <= 0.001), with PTSD+ participants showing deficits in fear extinction and safety discrimination in the placebo condition. Notably, extinction and discrimination deficits in PTSD+ subjects were markedly reversed with dexamethasone (p < 0.001). These data suggest that dexamethasone may serve as a pharmacological agent with which to facilitate fear extinction and discrimination in individuals with PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Michopoulos, Vasiliki; Norrholm, Seth D; Stevens, Jennifer S; Glover, Ebony M; Rothbaum, Barbara O; Gillespie, Charles F; Schwartz, Ann C; Ressler, Kerry J; Jovanovic, Tanja",2017.0,http://dx.doi.org/10.1016/j.psyneuen.2017.05.023,0,0,
1379,Repetitive transcranial magnetic stimulation (rTMS) for treatment-resistant major depression (TRMD) Veteran patients: study protocol for a randomized controlled trial.,"Evaluation of repetitive transcranial magnetic stimulation (rTMS) for treatment-resistant major depression (TRMD) in Veterans offers unique clinical trial challenges. Here we describe a randomized, double-blinded, intent-to-treat, two-arm, superiority parallel design, a multicenter study funded by the Cooperative Studies Program (CSP No. 556) of the US Department of Veterans Affairs. We recruited medical providers with clinical expertise in treating TRMD at nine Veterans Affairs (VA) medical centers as the trial local investigators. We plan to enroll 360 Veterans diagnosed with TRMD at the nine VA medical centers over a 3-year period. We will randomize participants into a double-blinded clinical trial to left prefrontal rTMS treatment or to sham (control) rTMS treatment (180 participants each group) for up to 30 treatment sessions. All participants will meet Diagnostic and statistical manual of mental disorders, 4 th edition (DSM-IV) criteria for major depression and will have failed at least two prior pharmacological interventions. In contrast with other rTMS clinical trials, we will not exclude Veterans with posttraumatic stress disorder (PTSD) or history of substance abuse and we will obtain detailed history regarding these disorders. Furthermore, we will maintain participants on stable anti-depressant medication throughout the trial. We will evaluate all participants on a wide variety of potential predictors of treatment response including cognitive, psychological and functional parameters. The primary dependent measure will be remission rate (Hamilton Rating Scale for Depression (HRSD24) ≤ 10), and secondary analyses will be conducted on other indices. Comparisons between the rTMS and the sham groups will be made at the end of the acute treatment phase to test the primary hypothesis. The unique challenges to performing such a large technically challenging clinical trial with Veterans and potential avenues for improvement of the design in future trials will be described. ClinicalTrials.gov, NCT01191333 . Registered on 26 August 2010. This report is based on the protocol version 4.6 amended in February 2016. All items from the World Health Organization Trial Registration Data Set are listed in Appendix A.",Mi Z.; Biswas K.; Fairchild JK.; Davis-Karim A.; Phibbs CS.; Forman SD.; Thase M.; Georgette G.; Beale T.; Pittman D.; McNerney MW.; Rosen A.; Huang GD.; George M.; Noda A.; Yesavage JA.,2017.0,10.1186/s13063-017-2125-y,0,0,
1380, Patterns of depressive symptom remission during the treatment of seasonal affective disorder with cognitive-behavioral therapy or light therapy," BACKGROUND: To elucidate mechanisms related to remission in winter seasonal affective disorder (SAD), we explored the course of individual depressive symptom offset across two distinct treatment modalities that show comparable outcomes at treatment endpoint: cognitive‚Äêbehavioral therapy for SAD (CBT‚ÄêSAD) and light therapy (LT). METHOD: One hundred seventy‚Äêseven adults with SAD in a depressive episode were randomized to 6‚Äêweeks of CBT‚ÄêSAD (n = 88) or LT (n = 89). Symptoms were assessed via the 29‚Äêitem Structured Interview Guide for the Hamilton Rating Scale for Depression‚ÄêSAD Version (SIGH‚ÄêSAD) at pretreatment and weekly during treatment. Survival analyses were conducted for the 17 SIGH‚ÄêSAD items endorsed by more than 40 participants at pretreatment. Within each of the included symptoms, data from participants who endorsed the symptom at pretreatment and who had 3 or fewer weeks missing were included. RESULTS: For most (13/17; 76%) symptoms, CBT‚ÄêSAD and LT did not differ in time to remission. However, for four symptoms (early insomnia, psychic anxiety, hypersomnia, and social withdrawal), LT led to symptom remission more quickly than CBT‚ÄêSAD. CONCLUSIONS: Symptom remission progressed comparably across CBT‚ÄêSAD and LT for most symptoms. Despite the fact that the two treatments led to similar remission rates and improvements at treatment endpoint, for early insomnia, psychic anxiety, hypersomnia, and social withdrawal, LT led to symptom remission faster than CBT‚ÄêSAD. These results suggest different mechanisms and pathways to the same therapeutic end. Speedier remission of early insomnia and hypersomnia is consistent with the theory that SAD is related to a pathological circadian phase‚Äêshift that can be corrected with LT."," Meyerhoff, J;  Young, MA;  Rohan, KJ",2018.0, 10.1002/da.22739,0,0,
1381, Prospective relationship between obsessive-compulsive and depressive symptoms during multimodal treatment in pediatric obsessive-compulsive disorder," The present study examined the prospective relationship between obsessive‚Äêcompulsive and depressive symptoms during a multimodal treatment study involving youth with obsessive‚Äêcompulsive disorder (OCD). Participants included fifty‚Äêsix youth, aged 7‚Äê17 years (M = 12.16 years) who were enrolled in a two‚Äêsite randomized controlled pharmacological and cognitive behavioral therapy treatment trial. Obsessive‚Äêcompulsive severity was measured using the Children's Yale‚ÄêBrown Obsessive‚ÄêCompulsive Scale, and depressive symptoms were rated using the Children's Depression Rating Scale‚ÄêRevised. Multi‚Äêlevel modeling analyses indicated that, on average over the course of treatment, variable and less severe obsessive‚Äêcompulsive symptoms significantly predicted a decrease in depressive symptoms. Additionally, week‚Äêto‚Äêweek fluctuations in OCD severity did not significantly predict weekly changes in depressive symptom severity. Level of baseline depressive symptom severity did not moderate these relationships. Findings suggest that when treating youth with OCD with co‚Äêoccurring depression, therapists should begin by treating obsessive‚Äêcompulsive symptoms, as when these are targeted effectively, depressive symptoms diminish as well."," Meyer, JM;  McNamara, JP;  Reid, AM;  Storch, EA;  Geffken, GR;  Mason, DM;  Murphy, TK;  Bussing, R",2014.0, 10.1007/s10578-013-0388-4,0,0,
1382, Protocol for the ENCODE trial: evaluating a novel online depression intervention for persons with epilepsy," BACKGROUND: Depression is common among persons with epilepsy (PwE), affecting roughly one in three individuals, and its presence is associated with personal suffering, impaired quality of life, and worse prognosis. Despite the availability of effective treatments, depression is often overlooked and treated inadequately in PwE, in part because of assumed concerns over drug interactions or proconvulsant effects of antidepressants. Internet‐administered psychological interventions might complement antidepressant medication or psychotherapy, and preliminary evidence suggests that they can be effective. However, no trial has yet examined whether an Internet intervention designed to meet the needs of PwE can achieve sustained reductions in depression and related symptoms, such as anxiety, when offered as adjunct to treatment as usual. METHODS/DESIGN: This randomized controlled trial will include 200 participants with epilepsy and a current depressive disorder, along with currently at least moderately elevated depression (Patient Health Questionnaire (PHQ‐9) sum score of at least 10). Patients will be recruited via epilepsy treatment centers and other sources, including Internet forums, newspaper articles, flyers, posters, and media articles or advertisements, in German‐speaking countries. Main inclusion criteria are: self‐reported diagnosis of epilepsy and a depressive disorder, as assessed with a phone‐administered structured diagnostic interview, none or stable antidepressant medication, no current psychotherapy, no other major psychiatric disorder, no acute suicidality. Participants will be randomly assigned to either (1) a care‐as‐usual/waitlist (CAU/WL) control group, in which they receive CAU and are given access to the Internet intervention after 3 months (that is, a CAU/WL control group), or (2) a treatment group that may also use CAU and in addition immediately receives six‐month access to the novel, Internet‐administered intervention. The primary outcome measure is the PHQ‐9, collected at three months post‐baseline; secondary measures include self‐reported anxiety, work and social adjustment, epilepsy symptoms (including seizure frequency and severity), medication adherence, potential negative treatment effects and health‐related quality of life. Measurements are collected online at pre‐treatment (T0), three months (T1), six months (T2), and nine months (T3). DISCUSSION: Results of this trial are expected to extend the body of knowledge with regard to effective and efficient treatment options for PwE who experience elevated depression and anxiety. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02791724 . Registered 01 June 2016."," Meyer, B;  Weiss, M;  Holtkamp, M;  Arnold, S;  Brückner, K;  Schröder, J;  Scheibe, F;  Nestoriuc, Y",2017.0, 10.1186/s12888-017-1229-y,0,0,
1383,Reductions in the internalising construct following internet-delivered treatment for anxiety and depression in primary care.,"Depressive and anxiety disorders are different manifestations of a latent internalising construct. To date, efficacy studies have tended to focus on disorder-specific outcomes, rather than underlying dimensions. This study examined the effect of a transdiagnostic internet-delivered cognitive behavioural therapy (iCBT) on the internalising construct in a primary care sample. Participants included 635 patients aged 18 years or over who were prescribed a six lesson transdiagnostic iCBT program for anxiety and depression by their primary healthcare professional. All patients completed the Patient Health Questionnaire 9, the Generalised Anxiety Disorder 7-Item Scale, the Mini Social Phobia Inventory and the Panic Disorder Severity Self-Report Scale at baseline. 325 of these patients completed the program and provided data on each of these scales during the final lesson. Reductions in the latent internalising construct were assessed within a longitudinal factor analysis framework that compared internalising factor means before and after treatment. The within group mean reduction in the latent internalising construct was large (ES = 1.23, SE = 0.09; p < 0.001). Due to the lack of a control group, between group reductions in the latent internalising construct could not be investigated. This study demonstrated that there are clinically significant reductions in the latent internalising construct following transdiagnostic iCBT for anxiety and depression.",Mewton L.; Hobbs MJ.; Sunderland M.; Newby J.; Andrews G.,2014.0,10.1016/j.brat.2014.10.001,0,0,
1384,Ultra-brief behavioral skills trainings for blood injection injury phobia.,"Blood injection injury (BII) phobia is common, with debilitating consequences to the health and well being of many of its sufferers. BII phobia presents with a unique fear response that can involve drops in blood pressure and ultimately fainting. The aim of this study was to provide proof of concept for a line of brief, easy to implement, video-based interventions for reducing phobic avoidance and fears in BII sufferers. One of the interventions was a novel Hypoventilation Respiratory Training (HRT) aimed at reducing the exaggerated ventilation response (hyperventilation) seen in BII phobia. The response has been linked to cerebral vasoconstriction and fainting symptoms. Sixty BII patients were randomly assigned to one of three 12-min video-guided trainings: Symptom-Associated Tension (SAT) training, Relaxation Skills Training (RST), or HRT. Experiential and cardiorespiratory activity to phobic stimuli was assessed before and after training. Both SAT and HRT resulted in overall greater reductions of phobic fears and symptoms than RST. SAT significantly increased heart rate during exposure, and HRT led to significantly reduced ventilation, increases in PCO2 , and elevated blood pressure throughout exposure and recovery. Treatment expectancy was rated equally high across conditions, whereas credibility ratings were highest for HRT. Brief, video-based instructions in muscle tension and normocapnic breathing are effective in reducing BII symptom severity and require minimal time and expertise. HRT may be particularly helpful in reducing fainting caused by cerebral vasoconstriction.",Meuret AE.; Simon E.; Bhaskara L.; Ritz T.,2017.0,10.1002/da.22616,0,0,
1385, The desire to belong: social identification as a predictor of treatment outcome in social anxiety disorder," OBJECTIVE: Perception of personal identity cannot be separated from the perception of the social context and one's social identity. Full involvement in group psychotherapy may require not only the awareness of personal impairment, but also social identification. The aim of the current study was to examine the association between social identification and symptom improvement in group‚Äêbased psychotherapy. METHOD: 169 participants received 12 sessions of group‚Äêbased cognitive behavioral therapy for social anxiety disorder. Social identification, the extent to which a person identifies with those who suffer from the same psychological problem as themselves and/or with those lacking psychopathology (non‚Äêsufferers), and clinical outcome were assessed at baseline, mid‚Äêand posttreatment, and 1, 3, and 6‚Äêmonths follow‚Äêup. RESULTS: At baseline, patients aspired for closeness with non‚Äêsufferers, and viewed themselves as distant from fellow sufferers and non‚Äêsufferers. After treatment, participants viewed not only themselves, but also other individuals with social anxiety, as closer to both non‚Äêsufferers and fellow sufferers. These ratings were related to clinical outcomes. CONCLUSIONS: The increase in closeness to both sufferers and non‚Äêsufferers across treatment may reflect a movement towards a more tolerant, less dichotomous and rigid, separation of ill and healthy that occurs with successful social anxiety treatment."," Meuret, AE;  Chmielewski, M;  Steele, AM;  Rosenfield, D;  Petersen, S;  Smits, JA;  Simon, NM;  Otto, MW;  Marques, L;  Pollack, MH;  et al.",2016.0, 10.1016/j.brat.2016.03.008,0,0,
1386, Effect of a musical intervention on tolerance and efficacy of non-invasive ventilation in the ICU: study protocol for a randomized controlled trial (MUSique pour l'Insuffisance Respiratoire Aigue - Mus-IRA)," BACKGROUND: Non‚Äêinvasive ventilation (NIV) tolerance is a key factor of NIV success. Hence, numerous sedative pharmacological or non‚Äêpharmacological strategies have been assessed to improve NIV tolerance. Music therapy in various health care settings has shown beneficial effects. In invasively ventilated critical care patients, encouraging results of music therapy on physiological parameters, anxiety, and agitation have been reported. We hypothesize that a musical intervention improves NIV tolerance in comparison to conventional care. We therefore question the potential benefit of a receptive music session administered to patients by trained caregivers (""musical intervention"") to enhance acceptance and tolerance of NIV. METHODS/DESIGN: We conduct a prospective, three‚Äêcenter, open‚Äêlabel, three‚Äêarm randomized trial involving patients in the intensive care unit (ICU) who require NIV, as assessed by the treating physician. Participants are allocated to a ""musical intervention"" arm (""musical intervention"" applied during all NIV sessions), to a ""sensory deprivation"" arm (sight and hearing isolation during all NIV sessions), or to the control group. The primary endpoint is the change in respiratory comfort (measured with a digital visual scale) before the initiation and after 30 minutes of the first NIV session. The evaluation of the primary endpoint is performed blindly from the treatment group. Secondary endpoints include changes in respiratory and cardiovascular parameters during NIV sessions, the percentage of patients requiring endotracheal intubation, day‚Äê90 anxiety/depression and health‚Äêrelated quality of life, post‚Äêtrauma stress induced by NIV, and the overall assessment of NIV. The follow‚Äêup for each participant is 90 days. We expect to randomize a total of 99 participants. DISCUSSION: As music intervention is a simple and easy‚Äêto‚Äêimplement non‚Äêpharmacological technique, efficacious in reducing anxiety in critically ill patients, it appeared logical to assess its efficacy in NIV, one of the most stressful techniques used in the ICU. Patient centeredness was crucial in choosing the outcomes assessed. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02265458 . Registered on 25 August 2014."," Messika, J;  Hajage, D;  Panneckoucke, N;  Villard, S;  Martin, Y;  Renard, E;  Blivet, A;  Reignier, J;  Maquigneau, N;  Stoclin, A;  et al.",2016.0, 10.1186/s13063-016-1574-z,0,0,
1387,"Health, dietary habits, and achievement motivation in college students with self-reported ADHD diagnosis.","Objective: The present study aimed to investigate aspects of health and motivation in a subpopulation of college students with ADHD. Method: Seventy-seven college students with self-reported ADHD (49 women; M age = 25.82, SD = 4.62) and 120 college students without ADHD (65 women; M age = 25.17, SD = 5.41) participated in an online survey assessing their health, dietary habits, and achievement motivation. Results: College students with ADHD showed impairment in psychological functioning, impairment in their mental health, and reported more ambition and less self-control. Furthermore, we found gender differences: Women with ADHD reported worse psychological functioning, and the gender differences in obsessive-compulsive behavior and compensatory effort were mediated by the timing of diagnosis. Conclusion: College students, especially women, with ADHD struggle with health-related issues. Some of these gender differences might be due to under diagnosis of girls in childhood. Differences in achievement motivation might indicate compensatory mechanisms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Merkt, Julia; Gawrilow, Caterina",2016.0,http://dx.doi.org/10.1177/1087054714523127,0,0,
1388,International Phase II clinical trial of CBTPsych: A standalone Internet social anxiety treatment for adults who stutter.,"CBTPsych is an individualized, fully automated, standalone Internet treatment program that requires no clinical contact or support. It is designed specifically for those who stutter. Two preliminary trials demonstrated that it may be efficacious for treating the social anxiety commonly associated with stuttering. However, both trials involved pre- and post-treatment assessment at a speech clinic. This contact may have increased compliance, commitment and adherence with the program. The present study sought to establish the effectiveness of CBTPsych in a large international trial with no contact of any kind from researchers or clinicians. Participants were 267 adults with a reported history of stuttering who were given a maximum of 5 months access to CBTPsych. Pre- and post-treatment functioning was assessed within the online program with a range of psychometric measures. Forty-nine participants (18.4%) completed all seven modules of CBTPsych and completed the post-treatment online assessments. That compliance rate was far superior to similar community trials of self-directed Internet mental health programs. Completion of the program was associated with large, statistically and clinically significant reductions for all measures. The reductions were similar to those obtained in earlier trials of CBTPsych, and those obtained in trials of in-clinic CBT with an expert clinician. CBTPsych is a promising individualized treatment for social anxiety for a proportion of adults who stutter, which requires no health care costs in terms of clinician contact or support. The reader will be able to: (a) discuss the reasons for investigating CBTPsych without any clinical contact; (b) describe the main components of the CBTPsych treatment; (c) summarize the results of this clinical trial; (d) describe how the results might affect clinical practice, if at all.",Menzies R.; O'Brian S.; Lowe R.; Packman A.; Onslow M.,2016.0,10.1016/j.jfludis.2016.06.002,0,0,
1389,Efficacy of self-administered treatments for depression and anxiety.,"Self-administered treatments (SATs) are widely used by the general public and mental health professionals. Previous reviews of the efficacy of SATs have included under this category interventions for nonclinical problems, group interventions, and interventions involving significant amounts of therapist contact. The efficacy of SATs for clinical levels of depression and anxiety with minimal therapeutic contact was examined by meta-analyzing 24 studies. The results show large effects for SATs when compared with no-treatment control groups (d=1.00). However, unlike previous meta-analyses that found nonsignificant differences between SATs and therapist-administered treatments, in this sample SATs resulted in significantly poorer outcomes (d=-0.31). Some differences in effect size were observed between the clinical targets of depression and anxiety. However, there were high correlations between clinical target, methodological quality of the study, and amount of contact. This makes it impossible to determine whether the observed differences could be explained by the nature of the disorders, methodological quality, or the amount of contact with a member of the research team. The implications of the findings for the clinical use of SATs and for future research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Menchola, Marisa; Arkowitz, Hal S; Burke, Brian L",2007.0,http://dx.doi.org/10.1037/0735-7028.38.4.421,0,0,
1390, Augmenting Cognitive Behavior Therapy for School Refusal with Fluoxetine: a Randomized Controlled Trial," This study investigates whether the augmentation of cognitive behavior therapy (CBT) with fluoxetine improves outcomes in anxious school refusing adolescents (11‚Äê16.5 years). Sixty‚Äêtwo participants were randomly allocated to CBT alone, CBT + fluoxetine or CBT + placebo. All treatments were well tolerated; with one suicide‚Äêattempt in the CBT + placebo group. All groups improved significantly on primary (school attendance) and secondary outcome measures (anxiety, depression, self‚Äêefficacy and clinician‚Äêrated global functioning); with gains largely maintained at 6‚Äêmonths and 1‚Äêyear. Few participants were anxiety disorder free after acute treatment. During the follow‚Äêup period anxiety and depressive disorders continued to decline whilst school attendance remained stable, at around 54 %. The only significant between‚Äêgroup difference was greater adolescent‚Äêreported treatment satisfaction in the CBT + fluoxetine group than the CBT alone group. These results indicate the chronicity of school refusal, and the need for future research into how to best improve school attendance rates."," Melvin, GA;  Dudley, AL;  Gordon, MS;  Klimkeit, E;  Gullone, E;  Taffe, J;  Tonge, BJ",2017.0, 10.1007/s10578-016-0675-y,0,0,
1391, Comparison of Short-Therm Results of Conservative versus Operative Treatment of Distal Ulna Fractures Associated with Distal Radius Fracture Treated by Plate Osteosynthesis," PURPOSE OF THE STUDY The study aims to evaluate and compare the results of conservative and operative treatment of individual types of distal ulna fractures associated with distal radius fracture treated by plate osteosynthesis and to verify the conclusions of the other authors regarding the recommended therapeutic procedures in these fractures. MATERIAL AND METHODS In the period from 08/2013 to 09/2015, a total of 81 patients participated in the prospective randomised study, with the mean follow‐up period of 24 months (6‐36). All the fractures of distal two thirds of ulnar styloid process were treated conservatively. The patients with the other types of ulnar fractures (fractures of the proximal third of ulnar styloid process, ulnar head fractures, subcapital fractures) were systematically divided into two cohorts, based on which the subsequent (conservative vs. operative) treatment of distal ulna fractures was indicated. The operative treatment of all the types of distal ulna fractures was performed by plate osteosynthesis using LCP Distal Ulna Plate implant so that a uniform method is applied. RESULTS In the post‐operative follow‐up not a single patient with tip fracture of ulnar styloid process in the cohort showed a posttraumatic instability or disorder of distal radioulnar joint (DRUJ) biomechanics (ROM 96.6% (91‐100), MWS 61.3 points (75‐100), QDASH 2.9 points (0‐6.8)). The patients with a fracture of the proximal third of ulnar styloid process, a fracture of ulnar head and a subcapital fracture, treated operatively, achieved better early radiographic and functional outcome (ROM 95.7% (60‐100), MWS 91.2 points (75‐100), QDASH 3.5 points (0‐11.4)) than patients treated conservatively (ROM 89.6% (64‐100), MWS 70.4 points (35‐85), QDASH 18.4 points (0‐52.3)). DISCUSSION The study confirms the conclusions drawn by the other authors that tip fractures of ulna do not cause posttraumatic DRUJ instability and do not require operative treatment. Conservative treatment of ulnar base fractures led to non‐union in 60% of cases and to malunion in 25% of cases, altogether in 15 patients (75%) the clinical examination revealed a conclusive posttraumatic DRUJ instability of various severity and these patients showed healing in malunion ad latus greater than 2 mm and non‐union of the fracture. By performing anatomical reduction and osteosynthesis of ulnar ""base fractures"", the stability and DRUJ function were restored in all the patients, thus also a better functional outcome was attained. Conservative treatment of ulnar head fractures brought worse outcomes due to malunion of fractures resulting in a noncongruent articular surface of DRUJ or a change in axial position of the distal end of the bone. The change in DRUJ biomechanics resulted in a limited rotation of radius and a limited range of forearm mobility. The operative treatment of subcapital ulna fracture had a very good early outcome as compared to conservative treatment of the fracture which healed in malunion, the change of axial position of the distal end of the bone resulted in a limited range of forearm mobility. CONCLUSIONS Based on the early functional and radiographic outcomes of RCT study it can be stated, in agreement with the other authors, that the operative treatment of distal ulna fractures associated with the distal radius fracture treated by ORIF should be indicated for base fractures of ulnar styloid process associated with DRUJ instability following the osteosynthesis of distal radius fracture and peripheral fragment dislocation ad axim or ad latus in radial direction by 2 mm and more, and also in case of displaced ulnar head fractures and instable and displaced subcapital fractures of the ulna. Key words: distal ulna fracture, plate osteosynthesis, LCP distal ulna plate."," Meluzinová, P;  Kopp, L;  Dráč, P;  Edelmann, K;  Obruba, P",2017.0,,0,0,
1392,"Psychoeducation against depression, anxiety, alexithymia and fibromyalgia: a pilot study in primary care for patients on sick leave.","Feasibility testing of a psychoeducational method -The Affect School and Script Analyses (ASSA) - in a Swedish primary care setting. Exploring associations between psychological, and medically unexplained physical symptoms (MUPS). Pilot study. Three Swedish primary care centers serving 20,000 people. 8 weekly 2-hour sessions with a 5-7 participant group led by two instructors - followed by 10 individual hour-long sessions. Thirty-six patients, 29 women (81%), on sick-leave due to depression, anxiety, or fibromyalgia. Feasibility in terms of participation rates and expected improvements of psychological symptoms and MUPS, assessed by self-report instruments pre-, one-week post-, and 18 months post-intervention. Regression coefficients between psychological symptoms and MUPS. The entire 26-hour psychoeducational intervention was completed by 30 patients (83%), and 33 patients (92%) completed the 16-hour Affect School. One-week post-intervention median test score changes were significantly favorable for 27 respondents, with p < .05 after correction for multiple testing for 9 of 11 measures (depression, anxiety, alexithymia, MUPS, general health, self-affirmation, self-love, self-blame, and self-hate); 18 months post intervention the results remained significantly favorable for 15 respondents for 7 of 11 measures (depression, alexithymia, MUPS, general health, self-affirmation, self-love, and self-hate). A psychoeducational method previously untested in primary care for mostly women patients on sick-leave due to depression, anxiety, or fibromyalgia had >80% participation rates, and clear improvements of self-assessed psychological symptoms and MUPS. The ASSA intervention thus showed adequate feasibility in a Swedish primary care setting. Key Points  A pilot study of a psychoeducational intervention - The Affect School and Script Analyses (ASSA) - was performed in primary care   • The intervention showed feasibility for patients on sick-leave due to depression, anxiety, or fibromyalgia   • 92% completed the 8 weeks/16 hours Affect School and 83% completed the entire 26-hour ASSA intervention   • 9 of 11 self-reported measures improved significantly one-week post intervention   • 7 of 11 self-reported measures improved significantly 18 months post-intervention.",Melin EO.; Svensson R.; Thulesius HO.,2018.0,10.1080/02813432.2018.1459225,0,0,
1393, Cognitive therapy as an early treatment for post-traumatic stress disorder in children and adolescents: a randomized controlled trial addressing preliminary efficacy and mechanisms of action," BACKGROUND: Few efficacious early treatments for post‚Äêtraumatic stress disorder (PTSD) in children and adolescents exist. Previous trials have intervened within the first month post‚Äêtrauma and focused on secondary prevention of later post‚Äêtraumatic stress; however, considerable natural recovery may still occur up to 6‚Äêmonths post‚Äêtrauma. No trials have addressed the early treatment of established PTSD (i.e. 2‚Äê to 6‚Äêmonths post‚Äêtrauma). METHODS: Twenty‚Äênine youth (8‚Äê17 years) with PTSD (according to age‚Äêappropriate DSM‚ÄêIV or ICD‚Äê10 diagnostic criteria) after a single‚Äêevent trauma in the previous 2‚Äê6 months were randomly allocated to Cognitive Therapy for PTSD (CT‚ÄêPTSD; n = 14) or waiting list (WL; n = 15) for 10 weeks. RESULTS: Significantly more participants were free of PTSD after CT‚ÄêPTSD (71%) than WL (27%) at posttreatment (intent‚Äêto‚Äêtreat, 95% CI for difference .04‚Äê.71). CT‚ÄêPTSD yielded greater improvement on child‚Äêreport questionnaire measures of PTSD, depression and anxiety; clinician‚Äêrated functioning; and parent‚Äêreported outcomes. Recovery after CT‚ÄêPTSD was maintained at 6‚Äê and 12‚Äêmonth posttreatment. Beneficial effects of CT‚ÄêPTSD were mediated through changes in appraisals and safety‚Äêseeking behaviours, as predicted by cognitive models of PTSD. CT‚ÄêPTSD was considered acceptable on the basis of low dropout and high treatment credibility and therapist alliance ratings. CONCLUSIONS: This trial provides preliminary support for the efficacy and acceptability of CT‚ÄêPTSD as an early treatment for PTSD in youth. Moreover, the trial did not support the extension of 'watchful waiting' into the 2‚Äê to 6‚Äêmonth post‚Äêtrauma window, as significant improvements in the WL arm (particularly in terms of functioning and depression) were not observed. Replication in larger samples is needed, but attention to recruitment issues will be required."," Meiser-Stedman, R;  Smith, P;  McKinnon, A;  Dixon, C;  Trickey, D;  Ehlers, A;  Clark, DM;  Boyle, A;  Watson, P;  Goodyer, I;  et al.",2017.0, 10.1111/jcpp.12673,0,0,
1394," Quality of life in patients with leg ulcers: results from CHALLENGE, a double-blind randomised controlled trial"," METHOD: A superiority randomised double‐blind controlled trial was conducted on patients presenting with a non‐infected leg ulcer (VLUs or mixed leg ulcers) of predominantly venous origin (ABPI >0.8), with a surface area ranging from 5 to 50cm RESULTS: In total, 187 patients were randomised to either the TLC‐NOSF group (n=94) or the control dressing group (n=93). The two groups were well balanced at baseline with regard to wound and patient characteristics. In the HRQoL questionnaire (EQ‐5D), the pain/discomfort and anxiety/depression dimensions were significantly improved in the TLC‐NOSF group versus the control one (pain/discomfort: 1.53±0.53 versus 1.74±0.65; p=0.022, and anxiety/depression: 1.35±0.53 versus 1.54±0.60, p=0.037). The VAS score was better in the test group compared with the control group (72.1±17.5 versus 67.3±18.7, respectively), without reaching significance (p=0.072). Acceptability and tolerance of the two products were similar in both groups. CONCLUSION: The double‐blind clinical trial has demonstrated that the TLC‐NOSF matrix dressing promotes faster healing of VLUs and mixed leg ulcers and significantly reduces the pain/discomfort and anxiety/depression experienced by the patients. These results suggest that acceleration of VLU healing could improve the HRQoL of the patients and reduced the emotional and social burden of these chronic wounds. OBJECTIVE: We recently showed the superiority of a matrix metalloproteinase (MMP) modulating dressing (foam impregnated with NOSF, nano‐oligosaccharide factor) compared with a lipidocolloid matrix (TLC) control dressing in median wound area reduction (WAR). Here we report the results from the same study assessing the performance and safety of TLC‐NOSF in the local management of venous leg ulcers (VLUs) or mixed leg ulcers and determining its impact on the patient's health‐related quality of life (HRQoL)."," Meaume, S;  Dompmartin, A;  Lok, C;  Lazareth, I;  Sigal, M;  Truchetet, F;  Sauvadet, A;  Bohbot, S",2017.0, 10.12968/jowc.2017.26.7.368,0,0,
1395, A Replication and Extension of the PEERS® for Young Adults Social Skills Intervention: examining Effects on Social Skills and Social Anxiety in Young Adults with Autism Spectrum Disorder," Young adults with ASD experience difficulties with social skills, empathy, loneliness, and social anxiety. One intervention, PEERS® for Young Adults, shows promise in addressing these challenges. The present study replicated and extended the original study by recruiting a larger sample (N = 56), employing a gold standard ASD assessment tool, and examining changes in social anxiety utilizing a randomized controlled trial design. Results indicated improvements in social responsiveness (SSIS‐RS SS, p = .006 and CPB, p = .005; SRS, p = .004), PEERS® knowledge (TYASSK, p = .001), empathy (EQ, p = .044), direct interactions (QSQ‐YA, p = .059), and social anxiety (LSAS‐SR, p = .019). Findings demonstrate further empirical support for the intervention for individuals with ASD."," McVey, AJ;  Dolan, BK;  Willar, KS;  Pleiss, S;  Karst, JS;  Casnar, CL;  Caiozzo, C;  Vogt, EM;  Gordon, NS;  Van Hecke, AV",2016.0, 10.1007/s10803-016-2911-5,0,0,
1396, Psychoeducation with problem-solving (PEPS) therapy for adults with personality disorder: a pragmatic randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of a manualised intervention to improve social functioning," BACKGROUND: If effective, less intensive treatments for people with personality disorder have the potential to serve more people. OBJECTIVES: To compare the clinical effectiveness and cost‐effectiveness of psychoeducation with problem‐solving (PEPS) therapy plus usual treatment against usual treatment alone in improving social problem‐solving with adults with personality disorder. DESIGN: Multisite two‐arm, parallel‐group, pragmatic randomised controlled superiority trial. SETTING: Community mental health services in three NHS trusts in England and Wales. PARTICIPANTS: Community‐dwelling adults with any personality disorder recruited from community mental health services. INTERVENTIONS: Up to four individual sessions of psychoeducation, a collaborative dialogue about personality disorder, followed by 12 group sessions of problem‐solving therapy to help participants learn a process for solving interpersonal problems. MAIN OUTCOME MEASURES: The primary outcome was measured by the Social Functioning Questionnaire (SFQ). Secondary outcomes were service use (general practitioner records), mood (measured via the Hospital Anxiety and Depression Scale) and client‐specified three main problems rated by severity. We studied the mechanism of change using the Social Problem‐Solving Inventory. Costs were identified using the Client Service Receipt Inventory and quality of life was identified by the European Quality of Life‐5 Dimensions questionnaire. Research assistants blinded to treatment allocation collected follow‐up information. RESULTS: There were 739 people referred for the trial and 444 were eligible. More adverse events in the PEPS arm led to a halt to recruitment after 306 people were randomised (90% of planned sample size); 154 participants received PEPS and 152 received usual treatment. The mean age was 38 years and 67% were women. Follow‐up at 72 weeks after randomisation was completed for 62% of participants in the usual‐treatment arm and 73% in the PEPS arm. Intention‐to‐treat analyses compared individuals as randomised, regardless of treatment received or availability of 72‐week follow‐up SFQ data. Median attendance at psychoeducation sessions was approximately 90% and for problem‐solving sessions was approximately 50%. PEPS therapy plus usual treatment was no more effective than usual treatment alone for the primary outcome [adjusted difference in means for SFQ ‐0.73 points, 95% confidence interval (CI) ‐1.83 to 0.38 points; p = 0.19], any of the secondary outcomes or social problem‐solving. Over the follow‐up, PEPS costs were, on average, £182 less than for usual treatment. It also resulted in 0.0148 more quality‐adjusted life‐years. Neither difference was statistically significant. At the National Institute for Health and Care Excellence thresholds, the intervention had a 64% likelihood of being the more cost‐effective option. More adverse events, mainly incidents of self‐harm, occurred in the PEPS arm, but the difference was not significant (adjusted incidence rate ratio 1.24, 95% CI 0.93 to 1.64). LIMITATIONS: There was possible bias in adverse event recording because of dependence on self‐disclosure or reporting by the clinical team. Non‐completion of problem‐solving sessions and non‐standardisation of usual treatment were limitations. CONCLUSIONS: We found no evidence to support the use of PEPS therapy alongside standard care for improving social functioning of adults with personality disorder living in the community. FUTURE WORK: We aim to investigate adverse events by accessing centrally held NHS data on deaths and hospitalisation for all PEPS trial participants. TRIAL REGISTRATION: Current Controlled Trials ISRCTN70660936. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 52. See the NIHR Journals Library website for further project information."," McMurran, M;  Crawford, MJ;  Reilly, J;  Delport, J;  McCrone, P;  Whitham, D;  Tan, W;  Duggan, C;  Montgomery, AA;  Williams, HC;  et al.",2016.0, 10.3310/hta20520,0,0,
1397,"Quetiapine adjunct to selective serotonin reuptake inhibitors or venlafaxine in patients with major depression, comorbid anxiety, and residual depressive symptoms: A randomized, placebo-controlled pilot study.","This double-blind, placebo-controlled study examined the efficacy and tolerability of quetiapine in combination with selective serotonin reuptake inhibitors (SSRIs)/venlafaxine in 58 patients with major depressive disorder, comorbid anxiety symptoms (HAM-A-14 score >=14), and residual depressive symptoms (HAM-D-17 score >=18, CGI-S score >=4). Patients had received an SSRI/venlafaxine (at a predefined therapeutic dose) for >=6 weeks. Overall, 62% (18/29) of quetiapine- and 55% (16/29) of placebo-treated patients completed the study. The mean change in HAM-D and HAM-A total scores from baseline to Week 8 (primary endpoint) was significantly greater with quetiapine (mean dose 182 mg/day) than placebo: -11.2 vs. -5.5 (P = .008) and -12.5 vs. -5.9 (P = .002), respectively. The onset of quetiapine efficacy (HAM-D/HAM-A/CGI-I) was rapid (by Week 1) and continued through to Week 8. Significant differences (P < .05) from baseline to Week 8 were observed between groups in 7/17 HAM-D (including feelings of guilt, suicide) and 6/14 HAM-A items (including tension, cardiovascular symptoms). Response (>=50% decrease in total score) was higher for quetiapine than placebo: HAM-D, 48% vs. 28% (not significant, NS); HAM-A, 62% vs. 28% (P = .02). Remission (total score <=7) was higher for quetiapine than placebo: HAM-D, 31% vs. 17% (NS); HAM-A, 41% vs. 17% (NS). CGI-S, CGI-I, and the Global Assessment Scale showed that quetiapine was significantly more effective than placebo. For quetiapine, adverse events (AEs) were similar to those previously observed; sedation/somnolence/lethargy was the most commonly reported. Here quetiapine was shown to be effective as augmentation of SSRI/venlafaxine therapy in patients with major depression, comorbid anxiety, and residual depressive symptoms, with no unexpected tolerability issues. Further studies are warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","McIntyre, Alexander; Gendron, Alain; McIntyre, Amanda",2007.0,http://dx.doi.org/10.1002/da.20275,0,0,
1398,Development of an integrated cognitive behavioral therapy for anxiety and opioid use disorder: Study protocol and methods.,"Opioid use disorder is a highly disabling psychiatric disorder, and is associated with both significant functional disruption and risk for negative health outcomes such as infectious disease and fatal overdose. Even among those who receive evidence-based pharmacotherapy for opioid use disorder, many drop out of treatment or relapse, highlighting the importance of novel treatment strategies for this population. Over 60% of those with opioid use disorder also meet diagnostic criteria for an anxiety disorder; however, efficacious treatments for this common co-occurrence have not be established. This manuscript describes the rationale and methods for a behavioral treatment development study designed to develop and test an integrated cognitive-behavioral therapy for those with co-occurring opioid use disorder and anxiety disorders. The aims of the study are (1) to develop and pilot test a new manualized cognitive behavioral therapy for co-occurring opioid use disorder and anxiety disorders, (2) to test the efficacy of this treatment relative to an active comparison treatment that targets opioid use disorder alone, and (3) to investigate the role of stress reactivity in both prognosis and recovery from opioid use disorder and anxiety disorders. Our overarching aim is to investigate whether this new treatment improves both anxiety and opioid use disorder outcomes relative to standard treatment. Identifying optimal treatment strategies for this population are needed to improve outcomes among those with this highly disabling and life-threatening disorder.",McHugh RK.; Votaw VR.; Barlow DH.; Fitzmaurice GM.; Greenfield SF.; Weiss RD.,2017.0,10.1016/j.cct.2017.07.006,0,0,
1399, Sleep to Lower Elevated Blood Pressure: a Randomized Controlled Trial (SLEPT)," BACKGROUND: Impaired sleep quality is common and associated with an increased risk of cardiovascular disease (CVD), thought to be mediated through adverse effects on established vascular risk factors, particularly hypertension. We determined if a web‚Äêdelivered sleep intervention (sleep‚Äêhygiene education, stimulus control, and cognitive behavioral therapy) reduces blood pressure compared to vascular risk factor education (standard care) alone. METHODS: Phase II randomized, blinded, controlled trial of 134 participants without CVD with mild sleep impairment and blood pressure 130‚Äê160/<110 mm Hg. The primary outcome was the difference in the mean change in 24‚Äêhour ambulatory systolic blood pressure (SBP) over 8 weeks between intervention and control groups. Secondary outcomes included measures of sleep quality and psychosocial health, namely Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). RESULTS: Participants in the sleep intervention group showed significantly greater improvements in sleep quality, including ISI [difference in mean improvement 2.8; 95% confidence interval (CI), 1.3‚Äê4.4], PSQI (1.1; 95% CI, 0.1‚Äê2.2), sleep condition indicator (0.8; 95% CI, 0.2‚Äê1.4), and psychosocial health, including BDI (2.0; 95% CI, 0.3‚Äê3.7) and BAI (1.4; 95% CI, 0.02‚Äê2.8). The mean improvement in 24‚Äêhour ambulatory SBP did not differ between the sleep intervention (0.9 mm Hg) and control (0.8 mm Hg) arms, (difference in mean improvement 0.1; 95% CI, ‚Äê3.4 to 3.2). CONCLUSION: A simple, low‚Äêcost, web‚Äêdelivered sleep intervention is feasible and significantly improves sleep quality and measures of psychosocial health in individuals with mild sleep impairment but does not result in short‚Äêterm improvements in blood pressure."," McGrath, ER;  Espie, CA;  Power, A;  Murphy, AW;  Newell, J;  Kelly, C;  Duffy, N;  Gunning, P;  Gibson, I;  Bostock, S;  et al.",2017.0, 10.1093/ajh/hpw132,0,0,
1400,Assessing the efficacy of imagery-enhanced cognitive behavioral group therapy for social anxiety disorder: Study protocol for a randomized controlled trial.,"Cognitive behavior group therapy (CBGT) is effective for social anxiety disorder (SAD), but a substantial proportion of patients do not typically achieve normative functioning. Cognitive behavioral models of SAD emphasize negative self-imagery as an important maintaining factor, and evidence suggests that imagery is a powerful cognitive mode for facilitating affective change. This study will compare two group CBGT interventions, one that predominantly uses verbally-based strategies (VB-CBGT) and another that predominantly uses imagery-enhanced strategies (IE-CBGT), in terms of (a) efficacy, (b) mechanisms of change, and (c) cost-effectiveness. This study is a parallel groups (two-arm) single-blind randomized controlled trial. A minimum of 96 patients with SAD will be recruited within a public outpatient community mental health clinic in Perth, Australia. The primary outcomes will be self-reported symptom severity, caseness (SAD present: yes/no) based on a structured diagnostic interview, and clinician-rated severity and life impact. Secondary outcomes and mechanism measures include blind observer-rated use of safety behaviors, physiological activity (heart rate variability and skin conductance level) during a standardized speech task, negative self-beliefs, imagery suppression, fear of negative and positive evaluation, repetitive negative thinking, anxiety, depression, self-consciousness, use of safety behaviors, and the EQ-5D-5L and TiC-P for the health economic analysis. Homework completion, group cohesion, and working alliance will also be monitored. The outcomes of this trial will inform clinicians as to whether integrating imagery-based strategies in cognitive behavior therapy for SAD is likely to improve outcomes. Common and distinct mechanisms of change might be identified, along with relative cost-effectiveness of each intervention.",McEvoy PM.; Moulds ML.; Grisham JR.; Holmes EA.; Moscovitch DA.; Hendrie D.; Saulsman LM.; Lipp OV.; Kane RT.; Rapee RM.; Hyett MP.; Erceg-Hurn DM.,2017.0,10.1016/j.cct.2017.06.010,0,0,
1401, Attention training improves aberrant neural dynamics during working memory processing in veterans with PTSD," Posttraumatic stress disorder (PTSD) is associated with executive functioning deficits, including disruptions in working memory (WM). Recent studies suggest that attention training reduces PTSD symptomatology, but the underlying neural mechanisms are unknown. We used high‚Äêdensity magnetoencephalography (MEG) to evaluate whether attention training modulates brain regions serving WM processing in PTSD. Fourteen veterans with PTSD completed a WM task during a 306‚Äêsensor MEG recording before and after 8 sessions of attention training treatment. A matched comparison sample of 12 combat‚Äêexposed veterans without PTSD completed the same WM task during a single MEG session. To identify the spatiotemporal dynamics, each group's data were transformed into the time‚Äêfrequency domain, and significant oscillatory brain responses were imaged using a beamforming approach. All participants exhibited activity in left hemispheric language areas consistent with a verbal WM task. Additionally, veterans with PTSD and combat‚Äêexposed healthy controls each exhibited oscillatory responses in right hemispheric homologue regions (e.g., right Broca's area); however, these responses were in opposite directions. Group differences in oscillatory activity emerged in the theta band (4‚Äê8 Hz) during encoding and in the alpha band (9‚Äê12 Hz) during maintenance and were significant in right prefrontal and right supramarginal and inferior parietal regions. Importantly, following attention training, these significant group differences were reduced or eliminated. This study provides initial evidence that attention training improves aberrant neural activity in brain networks serving WM processing."," McDermott, TJ;  Badura-Brack, AS;  Becker, KM;  Ryan, TJ;  Bar-Haim, Y;  Pine, DS;  Khanna, MM;  Heinrichs-Graham, E;  Wilson, TW",2016.0, 10.3758/s13415-016-0459-7,0,0,
1402,Baseline Psychological Treatment Reduces the Effect of Coaching in a Randomised Trial of a Depression Self-Care Intervention.,"To explore the effects of baseline psychological and antidepressant medication treatment in a trial of lay telephone coaching in a low-intensity, supported depression self-care intervention. A single blind, individually randomised, pragmatic trial was conducted among primary care adults with chronic physical conditions and comorbid depressive symptoms. Eligible subjects were randomised to receive a depression self-care toolkit with (intervention group) or without (control group) telephone coaching provided by trained lay coaches. For this brief communication, a secondary analysis of the trial data focused on the effects of baseline psychological and antidepressant treatments on mental health outcomes (Patient Health Questionnaire 9 [PHQ-9], SF-12 Mental Component Summary [MCS], Generalized Anxiety Disorder 7 [GAD-7]) and satisfaction with the intervention. In total, 223 patients were randomised, and 165 (74.0%) completed both 3- and 6-month follow-ups. There were 2 significant interactions of baseline treatment and study group for 6-month mental health outcomes. A significant benefit of coaching on 6-month PHQ-9 was seen only among participants who were not receiving baseline psychological treatment. A smaller interaction was found for baseline antidepressant medications and 6-month mental health. There was a significant main effect for baseline psychological treatment and lower 6-month satisfaction. Depressed patients receiving baseline psychological treatment may not benefit from lay coaching offered as part of a low-intensity depression self-care intervention.",McCusker J.; Cole M.; Lambert S.; Yaffe M.; Ciampi A.; Belzile E.,2017.0,10.1177/0706743716648299,0,0,
1403, fMRI predictors of treatment outcome in pediatric anxiety disorders," OBJECTIVE: The present study was designed to examine relationships between pretreatment amygdala activity and treatment response in a sample of anxious children and adolescents. MATERIALS AND METHODS: Participants, who were diagnosed predominantly with generalized anxiety disorder (GAD), underwent functional magnetic resonance imaging (fMRI) scanning before treatment with fluoxetine or cognitive behavioral therapy (CBT). RESULTS: Results indicated significant negative associations between degree of left amygdala activation and measures of posttreatment symptom improvement in the group, as a whole. DISCUSSION: Taken together with research on associations between adult amygdala activation and treatment response, these findings suggest that patients whose pretreatment amygdala activity is the strongest may be particularly likely to respond well to such widely used treatments as selective serotonin reuptake inhibitor (SSRI) medications and CBT. INTRODUCTION: A growing number of studies have found evidence that anxiety and depressive disorders are associated with atypical amygdala hyperactivation, which decreases with effective treatment. Interest has emerged in this phenomenon as a possible biological marker for individuals who are likely to benefit from tailored treatment approaches."," McClure, EB;  Adler, A;  Monk, CS;  Cameron, J;  Smith, S;  Nelson, EE;  Leibenluft, E;  Ernst, M;  Pine, DS",2007.0, 10.1007/s00213-006-0542-9,0,0,
1404,Cognitive bias modification for social anxiety in adults who stutter: a feasibility study of a randomised controlled trial.,"To determine the feasibility and acceptability of a computerised treatment for social anxiety disorder for adults who stutter including identification of recruitment, retention and completion rates, large cost drivers and selection of most appropriate outcome measure(s) to inform the design of a future definitive trial. Two-group parallel design (treatment vs placebo), double-blinded feasibility study. 31 adults who stutter. Attention training via an online probe detection task in which the stimuli were images of faces displaying neutral and disgusted expressions. Psychological measures: Structured Clinical Interview Global Assessment of Functioning score; Liebowitz Social Anxiety Scale; Social Phobia and Anxiety Inventory; State-Trait Anxiety Inventory; Unhelpful Thoughts and Beliefs about Stuttering. Speech fluency: percent syllables stuttered. Economic evaluation: resource use questionnaire; EuroQol three-dimension questionnaire.Acceptability: Likert Scale questionnaire of experience of trial, acceptability of the intervention and randomisation procedure. Feasibility of recruitment strategy was demonstrated. Participant feedback indicated that the intervention and definitive trial, including randomisation, would be acceptable to adults who stutter. Of the 31 participants who were randomised, 25 provided data at all three data collection points. The feasibility study informed components of the intervention. Modifications to the design are needed before a definitive trial can be undertaken. I SRCTN55065978; Post-results.",McAllister J.; Gascoine S.; Carroll A.; Humby K.; Kingston M.; Shepstone L.; Risebro H.; Mackintosh B.; Thompson TD.; Hodgekins J.,2017.0,10.1136/bmjopen-2016-015601,0,0,
1405, Negative Aging Stereotypes Impair Performance on Brief Cognitive Tests Used to Screen for Predementia," Objectives: There is today ample evidence that negative aging stereotypes impair healthy older adults' performance on cognitive tasks. Here, we tested whether these stereotypes also decrease performance during the screening for predementia on short cognitive tests widely used in primary care. Method: An experiment was conducted on 80 healthy older adults taking the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) under Threat or Reduced‐threat condition. Results: Stereotype threat significantly impaired older adults' performance on both tests, resulting in 40% of older adults meeting the screening criteria for predementia, compared with 10% in Reduced‐threat condition (MMSE and MoCA averaged). Discussion: Our research highlights the influence of aging stereotypes on short cognitive tests used to screen for predementia. It is of critical importance that physicians provide a threat‐free testing environment. Further research should clarify whether this socially induced bias may also operate in secondary care by generating false positives."," Mazerolle, M;  Régner, I;  Barber, SJ;  Paccalin, M;  Miazola, AC;  Huguet, P;  Rigalleau, F",2017.0, 10.1093/geronb/gbw083,0,0,
1406,[Effectiveness of CBT on Unemployed Compared to Employed Individuals Suffering from Prevalent Mental Disorders - A Naturalistic Study].,"Background Unemployed individuals suffer more from mental strain than those who have jobs. Up until now, little information could be found regarding the effectiveness of cognitive behavioral therapy (CBT) for unemployed people with mental disorders. The aim of this study was to compare the impact of CBT on employed versus unemployed individuals in a naturalistic setting. Methods 92 outpatients with prevalent mental disorders (depression and anxiety) were matched post-hoc and assessed pre-treatment, post-treatment, and at follow-up. Results Unemployed individuals were more impaired at all assessment points. The multi-level analysis showed that both groups benefited equally. Moderate-to-large effect sizes were found in both groups. At follow-up-assessment, one third of the unemployed sample and one-fifth of those with jobs were classified as unimpaired. The job integration rate was 26%. Discussion The effect sizes indicate that CBT is beneficial for both groups. However, unemployed participants were as impaired at post-treatment as the employed were at pre-treatment. The job integration rate of 26% was comparable to the general integration rate in Germany (25%), although no work-focused interventions were carried out during the adjustment period. Conclusions CBT is effective for unemployed individuals, but because the unemployed participants were still more impaired at post-treatment, they might have a higher risk of relapse.",Maurer F.; Kliem S.; Bode K.; Del Pozo MA.; Kröger C.,2017.0,10.1055/s-0042-124504,0,0,
1407,Prevalence and treatment of health anxiety in genitourinary medicine,"The concepts of hypochondriasis and health anxiety are described in historical and modern contexts and justification given for the preferred usage of health anxiety, with the condition better classified with the anxiety disorders. The prevalence of hypochondriasis is reviewed and it is noted that most of the data are in primary care with only one paper from genitourinary medicine. The treatments for health anxiety and hypochondriasis are reviewed and noted, until recently, to be relatively limited in efficacy. A prevalence study of health anxiety in genitourinary medicine in two centres found that 8‐ 11% of attenders had significant health anxiety recorded by the Health Anxiety Inventory; that symptoms persisted over a 9 month period, and were associated with higher numbers of medical consultations. This was followed by a randomised controlled trial in a genitourinary medicine clinic in which an adapted form of cognitive behaviour therapy was given by me as a medical practitioner, and compared with a single explanatory interview in a control group. Assessments of clinical symptoms, social functioning and costs were made at baseline, 3, 6 and 12 months after randomisation. In 49 patients allocated, greater improvement was seen for the primary outcome of Health Anxiety Inventory (HAI) scores in patients treated with CBT (n=23) than in the control group (n=26) (P=0.001). Similar but less marked differences were found for the secondary outcomes of generalised anxiety, depression and social function, and there were fewer health service consultations. These differences were maintained in the six months after treatment was completed. The treatment costs were only partly offset by the savings in clinic appointments and for every unit reduction in HAI score there was an incremental cost of £33. It is concluded that the treatment, given in this manner, has the potential to be generalised.","Seivewright, Helen",2009.0,,0,0,
1408, Comparison of acute effects of superficial and deep dry needling into trigger points of suboccipital and upper trapezius muscles in patients with cervicogenic headache," OBJECTIVE: The purpose of this study was to compare the acute effects of superficial and deep dry needling into trigger points of suboccipital and upper trapezius muscles in patients with cervicogenic headache. METHODS: Thirty participants (8 men, 22 women) aged 19‐60 years (mean age ± SD, 39 ± 10 y) with a clinical diagnosis of cervicogenic headache were randomly divided into superficial and deep groups. Headache index, trigger points tenderness, cervical range of motion (CROM), functional rating index was assessed at baseline, immediate and 1 week after the treatment. RESULTS: Two approaches of dry needling showed reduction in headache index and trigger points tenderness. Deep dry needling showed greater improvement of cervical range of motion (p < 0.001) and functional rating index (p < 0.01). CONCLUSION: The application of dry needling into trigger points of suboccipital and upper trapezius muscles induces significant improvement of headache index, trigger points tenderness, functional rating index and range of motion in patients with cervicogenic headache. Deep dry needling had greater effects on CROM and function."," Sedighi, A;  Nakhostin Ansari, N;  Naghdi, S",2017.0, 10.1016/j.jbmt.2017.01.002,0,0,
1409,Post-traumatic growth enhances social identification in liver transplant patients: A longitudinal study.,"The main aim of this paper is to investigate the prediction that greater subjective identification with relevant groups and social categories (i.e. 'family' and 'transplantees') can be an outcome of post-traumatic growth (PTG). To date there are no studies that have explored these relationships. A longitudinal study was conducted with a group of 100 liver transplant patients from the outpatient populations of the participating centre. Data were collected by means of a self-report questionnaire, which was completed at two different time points (T1 and T2) that were 24months apart. PTG was assessed using the Post-Traumatic Growth Inventory, while both transplantee and family identification were assessed using group identification scales. A path model was tested, using a structural equation model (SEM) approach, to examine the reciprocal effects among family identification, transplantee identification, and PTG over time. As predicted, we found that greater PTG T1 predicted both greater family identification T2 and marginally greater transplantee identification T2. However, the two identification variables did not predict PTG over time. The results show that family identification and transplantee identification may be outcomes of the PTG process, confirming the importance of adopting a thriving multidimensional model of adjustment to medical illness, whereby people facing adverse life events, such as transplantation, may flourish rather than deteriorate psychologically.",Scrignaro M.; Sani F.; Wakefield JR.; Bianchi E.; Magrin ME.; Gangeri L.,2016.0,10.1016/j.jpsychores.2016.07.004,0,0,
1410, Verbal memory functioning moderates psychotherapy treatment response for PTSD-Related nightmares," Posttraumatic stress disorder (PTSD) is associated with cognitive deficits in attention, executive control, and memory, although few studies have investigated the relevance of cognitive difficulties for treatment outcomes. We examined whether cognitive functioning and history of traumatic brain injury (TBI) were associated with response to cognitive‚Äêbehavioral therapy (CBT) for PTSD‚Äêrelated sleep problems. In a randomized controlled trial of Imagery Rehearsal (IR) added to components of CBT for Insomnia (IR + cCBT‚ÄêI) compared to cCBT‚ÄêI alone for PTSD‚Äêrelated recurrent nightmares, 94 U.S. veterans completed a battery of cognitive tests. TBI was assessed via structured clinical interview. Mixed‚Äêeffects models examined main effects of cognitive functioning and interactions with time on primary sleep and nightmare outcomes. Significant verbal immediate memory by time interactions were found for nightmare distress, nightmare frequency, and sleep quality, even after controlling for overall cognitive performance and depression. TBI exhibited main effects on outcomes but no interactions with time. Findings indicated that individuals with lower verbal memory performance were less likely to respond to treatment across two sleep interventions. Veterans with TBI displayed greater symptoms but no altered trajectories of treatment response. Together with prior literature, findings suggest that verbal memory functioning may be important to consider in PTSD treatment implementation."," Scott, JC;  Harb, G;  Brownlow, JA;  Greene, J;  Gur, RC;  Ross, RJ",2017.0, 10.1016/j.brat.2017.01.004,0,0,
1411,Psychological and functional effect of different primary treatments for prostate cancer: A comparative prospective analysis.,"The aim of the study was to comparatively evaluate the psychological and functional effect of different primary treatments in patients with prostate cancer. We conducted a single-center prospective non randomized study in a real-life setting using functional and psychological questionnaires in prostate cancer cases submitted to radical prostatectomy, external radiotherapy, or active surveillance. Totally, 220 cases were evaluated at baseline and during the follow-up at 1-, 3-, 6-, and 12-month interval after therapy. Patients self-completed questionnaires on urinary symptoms and incontinence, erectile and bowel function, psychological distress (PD), anxiety, and depression. Several significant differences among the three groups of treatment were found regarding the total score of the functional questionnaires. Regarding PD, cases submitted to radical prostatectomy showed stable scores during all the 12 months of follow-up whereas cases submitted to radiotherapy showed a rapid significant worsening of scores at 1-month interval and persistent also at 6- and 12-month interval. Cases submitted to active surveillance showed a slight and slow worsening of scores only at 12-month interval. PD and depression resulted to be more associated with urinary symptoms than sexual function worsening whereas anxiety resulted to be associated either with urinary symptoms or sexual function worsening. The results of our comparative and prospective analysis could be used to better inform treatment decision-making. Patients and their teams might wish to know how functional and psychological aspects may differently be influenced by treatment choice.",Sciarra A.; Gentilucci A.; Salciccia S.; Von Heland M.; Ricciuti GP.; Marzio V.; Pierella F.; Musio D.; Tombolini V.; Frantellizzi V.; Pasquini M.; Maraone A.; Guandalini A.; Maggi M.,2018.0,10.1016/j.urolonc.2018.03.022,0,0,
1412, Improving cognitive control in adolescents with post-traumatic stress disorder (PTSD)," The adverse impact of posttraumatic stress disorder (PTSD) on the developing mind in adolescence can extend well into adulthood. The developmental malleability of cognitive control capacity in this age group, however, may hold particular promise for cognitive training interventions. The present study investigated the effects of affective working memory (aWMT) compared to placebo‚Äêtraining on cognitive and affective functioning in adolescents with PTSD. 30 treatment‚Äêseeking adolescents trained for 20 days on either an affective dual n‚Äêback task (aWMT; n = 15) or a feature match task (placebo; n = 15). The aWMT group showed greater pre‚Äêto post‚Äêtraining increases in cognitive control as measured by the GoNogo task as well as improvements in symptoms of PTSD and increased use of adaptive emotion regulation strategies. These preliminary findings are promising given the potential for free and easy dissemination of the aWMT in schools and online."," Schweizer, S;  Samimi, Z;  Hasani, J;  Moradi, A;  Mirdoraghi, F;  Khaleghi, M",2017.0, 10.1016/j.brat.2017.03.017,0,0,
1413,Reduction of depersonalization during social stress through cognitive therapy for social anxiety disorder: A randomized controlled trial.,"Symptoms of depersonalization during feared social situations are commonly experienced by individuals with social anxiety disorder (SAD). Despite its clinical relevance, it is not addressed in standard treatment manuals and it remains unclear if depersonalization is reduced by well-established treatments. This study investigated whether cognitive therapy (CT) for SAD effectively reduces depersonalization and whether pre-treatment severity of depersonalization predicts or mediates treatment outcome. In a randomized controlled trial, patients underwent the standardized Trier Social Stress Test before and after CT (n=20) or a waitlist period (n=20) and were compared to healthy controls (n=21). Self-reported depersonalization was measured immediately after each stress test. Depersonalization significantly decreased following CT, especially in treatment responders (ηp2=0.32). Pre-treatment depersonalization did neither predict nor mediate post-treatment severity of social anxiety. Further prospective studies are needed for a better scientific understanding of this effect. It should be scrutinized whether SAD-patients suffering from depersonalization would benefit from a more specific therapy.",Schweden TLK.; Pittig A.; Bräuer D.; Klumbies E.; Kirschbaum C.; Hoyer J.,2016.0,10.1016/j.janxdis.2016.09.005,0,0,
1414," Does trait anxiety influence effects of oxytocin on eye-blink startle reactivity? A randomized, double-blind, placebo-controlled crossover study"," BACKGROUND: Previous research has demonstrated that the neuropeptide oxytocin modulates social behaviors and reduces anxiety. However, effects of oxytocin on startle reactivity, a well‚Äêvalidated measure of defense system activation related to fear and anxiety, have been inconsistent. Here we investigated the influence of oxytocin on startle reactivity with particular focus on the role of trait anxiety. METHODS: Forty‚Äêfour healthy male participants attended two experimental sessions. They received intranasal oxytocin (24 IU) in one session and placebo in the other. Startle probes were presented in combination with pictures of social and non‚Äêsocial content. Eye‚Äêblink startle magnitude was measured by electromyography over the musculus orbicularis oculi in response to 95 dB noise bursts. Participants were assigned to groups of high vs. low trait anxiety based on their scores on the trait form of the Spielberger State‚ÄêTrait Anxiety Inventory (STAI). RESULTS: A significant interaction effect of oxytocin with STAI confirmed that trait anxiety moderated the effect of oxytocin on startle reactivity. Post‚Äêhoc tests indicated that for participants with elevated trait anxiety, oxytocin increased startle magnitude, particularly when watching non‚Äêsocial pictures, while this was not the case for participants with low trait anxiety. CONCLUSION: Results indicate that effects of oxytocin on defense system activation depend on individual differences in trait anxiety. Trait anxiety may be an important moderator variable that should be considered in human studies on oxytocin effects."," Schumacher, S;  Oe, M;  Wilhelm, FH;  Rufer, M;  Heinrichs, M;  Weidt, S;  Moergeli, H;  Martin-Soelch, C",2018.0, 10.1371/journal.pone.0190809,0,0,
1415,A randomized controlled trial of a transdiagnostic internet intervention for individuals with panic and phobias - one size fits all.,"Background and objectives: Many individuals with anxiety disorders do not receive professional treatment. Internet interventions have shown to be effective in the treatment of anxiety. The present randomized controlled trial was designed to examine the effectiveness of a short-term (4-week) Internet intervention in treating panic disorder, agoraphobia, social anxiety disorder, and specific phobias ('ConfID'). We addressed the questions of whether this transdiagnostic program would affect these disorders to varying degrees and whether there would be moderators of effectiveness. Methods: Adults who were recruited in online forums for anxiety underwent an online baseline assessment (N = 179) and were randomized either to the intervention group (ConfID) or the control group (care as usual). Online post-assessment took place 4 weeks later. The primary outcome was assessed with the Beck Anxiety Inventory (BAI); the secondary outcomes targeted the disorder-specific symptoms, depression, and somatization. Results: Participants in the intervention group showed a significantly stronger anxiety reduction compared to participants receiving care as usual (small-to-medium effect size between groups in intention-to-treat analysis). The treatment effect was similar for the different disorders and was moderated by participants' attitudes towards Internet interventions. Secondary outcomes yielded effect sizes in the medium range. Limitations: Moderate treatment adherence, lack of measures beyond online self-reports, and unavailability of long-term results. Conclusions: The study provides further evidence that transdiagnostic Internet interventions are promising in reducing the existing treatment gap in individuals with panic disorder and phobias. Results extend previous findings by showing that significant effects can also be reached by comprehensive shortterm programs and that the effects might be moderated by participants' attitudes towards Internet interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Schroder, Johanna; Jelinek, Lena; Moritz, Steffen",2017.0,http://dx.doi.org/10.1016/j.jbtep.2016.05.002,0,0,
1416,The prevalence of premonitory symptoms in migraine: A questionnaire study in 461 patients,"Migraine attacks are often preceded by premonitory symptoms. Prevalence rates of migraine patients reporting one or more premonitory symptoms show considerable variability and rates range between 12% and 79%. Sources of variability might be differences in study population or research design. Using a questionnaire, we retrospectively studied the prevalence of 12 predefined premonitory symptoms in a clinic-based population. Of 461 migraine patients, 374 (81%) responded. At least one premonitory symptom was reported by 86.9% and 71.1% reported two or more. The most frequently reported premonitory symptoms were fatigue (46.5%), phonophobia (36.4%) and yawning (35.8%). The mean number of premonitory symptoms per person was 3.2 (± 2.5). Women reported 3.3 premonitory symptoms compared with 2.5 symptoms in men (P = 0.01). Age, education, migraine subtype (with or without aura) and mean attack frequency had no effect on the mean number of symptoms per individual. In conclusion, premonitory symptoms are frequently reported by migraine patients. Sensitivity and specificity of premonitory symptoms for migraine need to be assessed using prospective methods. © Blackwell Publishing Ltd.",Schoonman G.G.; Evers D.J.; Terwindt G.M.; Van Dijk J.G.; Ferrari M.D.,2006.0,10.1111/j.1468-2982.2006.01195.x,0,0,
1417, Nurse-led group consultation intervention reduces depressive symptoms in men with localised prostate cancer: a cluster randomised controlled trial," BACKGROUND: Radiotherapy for localised prostate cancer has many known and distressing side effects. The efficacy of group interventions for reducing psychological morbidity is lacking. This study investigated the relative benefits of a group nurse‚Äêled intervention on psychological morbidity, unmet needs, treatment‚Äêrelated concerns and prostate cancer‚Äêspecific quality of life in men receiving curative intent radiotherapy for prostate cancer. METHODS: This phase III, two‚Äêarm cluster randomised controlled trial included 331 men (consent rate: 72 %; attrition: 5 %) randomised to the intervention (n‚Äâ=‚Äâ166) or usual care (n‚Äâ=‚Äâ165). The intervention comprised four group and one individual consultation all delivered by specialist uro‚Äêoncology nurses. Primary outcomes were anxious and depressive symptoms as assessed by the Hospital Anxiety and Depression Scale. Unmet needs were assessed with the Supportive Care Needs Survey‚ÄêSF34 Revised, treatment‚Äêrelated concerns with the Cancer Treatment Scale and quality of life with the Expanded Prostate Cancer Index ‚Äê26. Assessments occurred before, at the end of and 6 months post‚Äêradiotherapy. Primary outcome analysis was by intention‚Äêto‚Äêtreat and performed by fitting a linear mixed model to each outcome separately using all observed data. RESULTS: Mixed models analysis indicated that group consultations had a significant beneficial effect on one of two primary endpoints, depressive symptoms (p = 0.009), and one of twelve secondary endpoints, procedural concerns related to cancer treatment (p = 0.049). Group consultations did not have a significant beneficial effect on generalised anxiety, unmet needs and prostate cancer‚Äêspecific quality of life. CONCLUSIONS: Compared with individual consultations offered as part of usual care, the intervention provides a means of delivering patient education and is associated with modest reductions in depressive symptoms and procedural concerns. Future work should seek to confirm the clinical feasibility and cost‚Äêeffectiveness of group interventions. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ANZCTRN012606000184572 . 1 March 2006."," Schofield, P;  Gough, K;  Lotfi-Jam, K;  Bergin, R;  Ugalde, A;  Dudgeon, P;  Crellin, W;  Schubach, K;  Foroudi, F;  Tai, KH;  et al.",2016.0, 10.1186/s12885-016-2687-1,0,0,
1418,Work-related quality of life and posttraumatic stress disorder symptoms among female veterans.,"Background: Posttraumatic stress disorder (PTSD) can have pervasive, negative effects on multiple aspects of quality of life. We investigated the relationship between PTSD symptom clusters and work-related quality of life among female veterans. Although prior studies have shown that PTSD symptom clusters are differentially related to work-related quality of life, no study has assessed these relationships in women specifically. Methods: Participants were 253 female veterans with current PTSD. We assessed three components of work-related quality of life (employment status, clinician-rated occupational impairment, and self-rated occupational satisfaction) and performed analyses with and without adjusting for self-reported depression symptoms. Results: None of the PTSD symptom clusters were associated with employment status. All PTSD symptom clusters had significant independent associations with occupational impairment. All PTSD symptom clusters except avoidance were significantly associated with lower occupational satisfaction, but none had independent associations with occupational satisfaction. No single PTSD symptom cluster emerged as most strongly associated with occupational outcomes. Symptoms of depression had substantial associations across all occupational outcomes, independent of PTSD symptoms. Conclusion: Knowledge about how PTSD relates to occupational outcomes in women veterans is important for addressing the needs of this growing segment of the VA patient population, in which PTSD is a prevalent condition. Because PTSD had differential relationships with the three components of work-related quality of life, measuring only one component, or using an aggregate measure, may obscure important distinctions. Resolving depression symptoms also may be integral to achieving meaningful recovery. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schnurr, Paula P; Lunney, Carole A",2011.0,http://dx.doi.org/10.1016/j.whi.2011.04.013,0,0,
1419, Vascular Impulse Technology versus elevation in the treatment of posttraumatic swelling of extremity fractures: study protocol for a randomized controlled trial," BACKGROUND: Fractures of the extremities are often complicated by a variable degree of swelling secondary to hemorrhage and soft tissue injury. Patients typically require up to 7 days of inpatient bed rest and elevation to reduce swelling to an acceptable level for operative treatment with internal fixation. Alternatively, an intermittent pneumatic compression device, such as the Vascular Impulse Technology (VIT) system, can be used at the injured extremity to reduce the posttraumatic swelling. The VIT system consists of a pneumatic compressor that intermittently rapidly inflates a bladder positioned under the arch of the hand or the foot, which results in compression of the venous hand or foot plexus. That intermittent compression induces an increased venous velocity and aims to reduce the soft tissue swelling of the affected extremity. METHODS/DESIGN: The VIT study is a prospective, monocenter, randomized controlled trial to compare the VIT system with elevation in the treatment of posttraumatic swelling in the case of a fracture of the upper and lower extremity. This study will include 280 patients with fractures of the upper and the lower extremity with nine different injury types. For each of the nine injury types a separate randomization to the two intervention groups (VIT group or control group) will be performed. The primary outcome parameter is the time taken for the swelling to resolve sufficiently to permit surgery. A separate analysis for each of the nine injury types will be performed. DISCUSSION: In the proposed study, the effectiveness of the VIT system in the treatment of posttraumatic swelling of upper and lower extremity fractures will be evaluated. TRIAL REGISTRATION: German Clinical Trial Register, No. DRKS00010510 . Registered on 17 July 2016."," Schnetzke, M;  Swartman, B;  Bonnen, I;  Keil, H;  Schüler, S;  Grützner, PA;  Franke, J",2017.0, 10.1186/s13063-017-1824-8,0,0,
1420,Multimodal Residential Treatment for Adolescent Anxiety: Outcome and Associations with Pre-treatment Variables.,"This study aimed to determine the effect of a multimodal residential treatment program for severe adolescent anxiety, and examine whether treatment outcome was associated with pre-treatment anxiety, comorbid disorders, or participant age or gender. Participants were 70 adolescents (61.4% female, mean age = 15.4 years) with a primary anxiety disorder who received residential treatment involving cognitive behavioral therapy and medication management. Treatment outcome was assessed both as the change in adolescent-reported anxiety symptoms, and using treatment response criteria. Results indicated a strong effect of the intervention on symptoms of anxiety, depression, and anxiety-related life interference. Most pre-treatment variables were not associated with treatment outcome. However, higher adolescent-reported pre-treatment anxiety was associated with a greater reduction in anxiety at post-treatment, and the presence of a comorbid anxiety disorder was associated with poorer odds of treatment response. Findings indicate that residential treatment is a robust intervention for adolescent anxiety.",Schneider SC.; La Buissonnière-Ariza V.; Højgaard DRMA.; Kay BS.; Riemann BC.; Eken SC.; Lake P.; Nadeau JM.; Storch EA.,2018.0,10.1007/s10578-017-0762-8,0,0,
1421,Mental imagery in dentistry: Phenomenology and role in dental anxiety,"Dental anxiety is a prevalent problem with marked psychological, physical and public health implications. Based on cognitive theory and evidence, we hypothesized that vivid, sensory image-based cognitions play a role in dental anxiety. A quantitative online survey (N = 306) and qualitative semi-structured interviews (N = 18) found that vivid sensory images were common irrespective of dental anxiety levels, but that their content, associated distress and responses varied. Participants reporting higher anxiety experienced intense and intrusive fear-provoking dental imagery focusing on unpleasant sensations, which were associated with the intrusive recollection of negative past experiences and avoidance of dentistry. Participants with lower anxiety ratings, reported images that were less distressing and centered around reassuring aspects and positive appointment outcomes, potentially acting as protective factors against dental anxiety and facilitating appointment attendance. The inclusion of components aimed at reducing intrusive memories and dental imagery rescripting may help improve interventions for dental anxiety.",Schneider A.; Andrade J.; Tanja-Dijkstra K.; Moles D.R.,2018.0,10.1016/j.janxdis.2018.06.009,0,0,
1422, A Pharmacologic Algorithm for Youth Who Are at High Risk for Bipolar Disorder," OBJECTIVE: Depression and brief periods of manic symptoms are linked to a significant risk of progression to bipolar disorder (BD) in children who have a first‚Äêdegree relative with BD I or II. However, little evidence exists to guide the pharmacologic management of children with these high‚Äêrisk phenotypes. We propose a pharmacological treatment algorithm for high‚Äêrisk youth and present results on its use in a study of children with a first‚Äêdegree relative with BD. METHODS: Subjects were 40 youth (mean 12.7 years, range 9‚Äê17 years) who had (1) a first‚Äêdegree relative with lifetime history of BD I or II, (2) DSM‚ÄêIV‚ÄêTR diagnoses of BD not otherwise specified, major depressive disorder or cyclothymic disorder, and (3) active symptoms of depression, mania, or hypomania. Participants and their families were enrolled in a randomized trial examining the effects of two psychosocial interventions on the 1‚Äêyear course of mood disorder. At study intake, participants received a psychiatric evaluation and were offered medications or had existing medications optimized to decrease symptom severity. During the 1‚Äêyear study, psychiatrists treated participants using a medication algorithm to treat depressive or manic symptoms as well as comorbid anxiety and/or attention‚Äêdeficit/hyperactivity disorder. RESULTS: At study entry, 25 of 40 (62.5%) of the participants were taking at least one psychiatric medication. At 1 year, nearly an identical proportion were taking medications (22 of 35, 63%). Independent ratings indicated that in 84.7% of the study visits, physicians maintained adherence to the algorithm. No patients experienced antidepressant‚Äê or stimulant‚Äêinduced mania during the study. CONCLUSIONS: An algorithmic approach to pharmacologic interventions may aid in the management of youth (i.e., age <18) at high risk for BD. Future studies should compare outcomes in high‚Äêrisk patients receiving algorithm‚Äêprescribed treatment versus those receiving treatment as usual. CLINICAL TRIAL REGISTRATION INFORMATION: Early Family‚ÄêFocused Treatment for Youth at Risk for Bipolar Disorder; www.clinicaltrials.gov/ ; NCT00943085."," Schneck, CD;  Chang, KD;  Singh, MK;  DelBello, MP;  Miklowitz, DJ",2017.0, 10.1089/cap.2017.0035,0,0,
1423,PPAR-gamma agonist pioglitazone modifies craving intensity and brain white matter integrity in patients with primary cocaine use disorder: A double-blind randomized controlled pilot trial.,"Background and aims: Pioglitazone (PIO), a potent agonist of PPAR-gamma, is a promising candidate treatment for cocaine use disorder (CUD). We tested the effects of PIO on targeted mechanisms relevant to CUD: cocaine craving and brain white matter (WM) integrity. Feasibility, medication compliance and tolerability were evaluated. Design: Two-arm double-blind randomized controlled proof-of-concept pilot trial of PIO or placebo (PLC). Setting: Single-site out-patient treatment research clinic in Houston, TX, USA. Participants: Thirty treatment-seeking adults, 18 to 60 years old, with CUD. Eighteen participants (8 = PIO; 10 = PLC) completed diffusion tensor imaging (DTI) of WM integrity at pre-/post-treatment. Intervention: Study medication was dispensed at thrice weekly visits along with once-weekly cognitive behavioral therapy for 12 weeks. Measurements: Measures of target engagement mechanisms of interest included cocaine craving assessed by the Brief Substance Craving Scale (BSCS), the Obsessive Compulsive Drug Use Scale (OCDUS), a visual analog scale (VAS) and change in WM integrity. Feasibility measures included number completing treatment, medication compliance (riboflavin detection) and tolerability (side effects, serious adverse events). Findings: Target engagement change in mechanisms of interest, defined as a >= 0.75 Bayesian posterior probability of an interaction existing favoring PIO over PLC, was demonstrated on measures of craving (BSCS, VAS) and WM integrity indexed by fractional anisotropy (FA) values. Outcomes indicated greater decrease in craving and greater increase in FA values in the PIO group. Feasibility was demonstrated by high completion rates among those starting treatment (21/26 = 80%) and medication compliance (>= 80%). There were no reported serious adverse events for PIO. Conclusions: Compared with placebo, patients receiving pioglitazone show a higher likelihood of reduced cocaine craving and improved brain white matter integrity as a function of time in treatment. Pioglitazone shows good feasibility as a treatment for cocaine use disorder. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Schmitz, Joy M; Green, Charles E; Hasan, Khader M; Vincent, Jessica; Suchting, Robert; Weaver, Michael F; Moeller, F. Gerard; Narayana, Ponnada A; Cunningham, Kathryn A; Dineley, Kelly T; Lane, Scott D",2017.0,http://dx.doi.org/10.1111/add.13868,0,0,
1424, A randomized clinical trial targeting anxiety sensitivity for patients with suicidal ideation," OBJECTIVE: Anxiety sensitivity (AS) is a well‚Äêestablished transdiagnostic risk factor for anxiety and mood psychopathology including suicide. A variety of interventions using cognitive‚Äêbehavioral skills as well as cognitive bias modification (CBM) suggest that AS can be quickly and effectively reduced in nonclinical and nontreatment seeking samples. However, it is unclear whether AS reduction protocols will have efficacy for more severe clinical samples. Moreover, the combination of cognitive‚Äêbehavioral techniques with CBM focused on changing interpretation bias (CBM‚ÄêI) related to AS has not been evaluated. METHOD: A patient sample with co‚Äêoccurring anxiety psychopathology and active suicidal ideation (N = 74) was randomly assigned to a brief 1‚Äêsession computerized treatment including: (a) psychoeducation and interoceptive exposure (i.e., cognitive anxiety sensitivity treatment [CAST]) plus CBM‚ÄêI for AS; or (b) health information condition plus sham CBM for AS. Participants were assessed immediately after the 1‚Äêhr intervention as well as at 1‚Äê and 4‚Äêmonth follow‚Äêups. RESULTS: Consistent with hypotheses, participants in the active treatment showed significantly greater AS reduction that was maintained through follow‚Äêup (effect sizes ranged from medium to large for the overall AS and the AS subscales). Mediation analyses suggested that changes in AS mediated suicide outcomes. CONCLUSIONS: In sum, these are the first findings to suggest that brief AS reduction protocols have efficacy both in terms of risk and symptom outcomes in patient samples showing active suicidal ideation. (PsycINFO Database Record"," Schmidt, NB;  Norr, AM;  Allan, NP;  Raines, AM;  Capron, DW",2017.0, 10.1037/ccp0000195,0,0,
1425, Reducing risk for anxiety and depression in adolescents: effects of a single-session intervention teaching that personality can change," Efforts to reduce youth mental health problems have advanced greatly but have not lowered overall rates of youth mental illness. Thus, a need exists for disseminable, mechanism‚Äêtargeted approaches to reducing risk of youth psychopathology. Accordingly, we conducted a randomized‚Äêcontrolled trial testing whether a single‚Äêsession intervention teaching growth personality mindsets (the belief that personality is malleable) reduced known risk factors for anxiety and depression in adolescents experiencing or at risk for internalizing problems (N = 96, ages 12‚Äê15). Compared to a supportive‚Äêtherapy control, a 30‚Äêmin computer‚Äêguided mindset intervention strengthened adolescents' perceived control; this improvement was associated with increases in growth mindsets. Further, electrodermal activity recovery slopes showed that youths receiving the mindset intervention recovered from a lab‚Äêbased social stressor over three times as fast as control group youths. Improvements in growth mindsets and perceived control were linked with faster stress recovery. Results suggest a disseminable strategy for reducing internalizing problem risk among adolescents."," Schleider, JL;  Weisz, JR",2016.0, 10.1016/j.brat.2016.09.011,0,0,
1426,[Surface replacement of proximal interphalangeal joints using CapFlex-PIP].,"The cementless implantation of the surface replacement CapFlex-PIP enables pain relief, preservation of motion, improves lateral stability and corrects axis deviation in proximal interphalangeal (PIP) joints of patients with primary and secondary PIP osteoarthritis. Painful PIP joints as a result of degenerative or posttraumatic osteoarthritis with restriction of motion. Secondary inflammatory destruction of PIP joints in rheumatoid arthritis with low inflammatory activity and good bone conditions. Destruction of PIP joints with severe bone loss, osseous defects and chronic joint luxation. Joint destruction induced by florid or subacute bacterial arthritis. Skin infections. Dorsal or palmar incision over the affected PIP joint while sparing the peritendinous tissue. Exposure of the proximal phalangeal head and meticulous bone resection. Precontouring of the bone bed for proximal prosthesis. Insertion of the trial prosthesis. Exposure of the distal base and resection in the correct axis. Determination of distal prosthesis size and height of the polyethylene inlay. Insertion of the trial prosthesis without bone protrusion. After clinical and radiological control, implantation of the final prosthesis. Long finger splint, palmar flexor support splint for 2-3 weeks with active mobilization. Then active free mobilization with a twin bandage. After 6 weeks radiological check and free functional mobilization. The active range of motion of 50 patients increased from 43.4° before surgery to 55.9° after 1 year with concomitant pain relief (6.5 to 2.2). In one case revision surgery was required due to traumatic rupture of the radial collateral ligament and four secondary tenolyses were performed.",Schindele SF.; Altwegg A.; Hensler S.,2017.0,10.1007/s00064-016-0475-3,0,0,
1427,Hypertonic saline attenuates inflammation in pulmonary epithelia through a perk-mediated pathway,"Introduction: Hypertonic saline (HTS) has been explored as a resuscitative fluid in the setting of trauma, and its anti-inflammatory effects have been shown through in-vivo models of acute lung injury. However, the pathways of HTS action in inflammation are not well understood. High throughput analyses of the RNA transcriptome have been used to determine the role of upstream regulators and changes in transcriptional activity within the cell. We propose that analysis of messenger RNA (mRNA) will reveal potential controllers and pathways that underlie the anti-inflammatory effects of HTS in the lung. Methods: Small airway epithelial cells (SAECs) were grown to confluence in 12 well tissue culture plates in triplicate. HTS (400mOsm, 1.17%) was applied to cells for 4 hours. RNA was isolated from cells and a high throughput RNAseq analysis was done on the Illumina HiSeq Platform. mRNA expression levels were compared between the HTS-treated and control cells. Fragments of kilobase of transcript per million mapped reads (FPKM) are the units used to quantify levels of mRNA seen for each gene. To correct for false positives, only genes with Q < .05 underwent further analysis via Ingenuity Pathway Analysis to identify upstream regulators of the HTS response within cells. Pathways were selected based on p-value and z-score. The p-value indicates the significance level of a gene being modulated by HTS as compared to control, and the z-score shows the level of activation of that gene based on mRNA transcript levels of downstream targets. Results: Analysis yielded 3,368 mapped IDs (Q < .05). Pathway analysis showed that EIF2 signaling (p-value 8.16e-16, z-score 3.175) and NRF2 mediated oxidative stress response (4.26e-11, 1.808) were the top canonical pathways upregulated by HTS. Both pathways had a significant percentage of downstream targets modulated: 36.7% for EIF2 (81/221) and 33.7% for NRF2 (65/193). PERK is an upstream regulator that acts on both pathways, and we found that HTS modulates PERK (1.96e-10). Additionally, an increase in PERK mRNA expression was seen at 4 hours in HTS as compared to control (4.4e-2). Conclusions: Our analysis indicates PERK mediated EIF2 and NRF2 activation were the dominant regulators of the HTS response in SAECs. Studies have shown that PERK modulates the activity of NRF2 and EIF2, and these pathways can suppress inflammatory responses in cells. These findings provide insight into potential mechanisms of the anti-inflammatory properties of HTS, which may lead to novel therapeutic targets to reduce post-traumatic ALI. (Figure presented).",Schiller D.J.; Mitra S.; Nunns G.R.; Stettler G.R.; Gamboni F.; Moore E.E.; Silliman C.C.; Jones K.L.; Banerjee A.,2018.0,10.1097/SHK.0000000000001158,0,0,
1428,Trauma cognitions are related to symptoms up to 10 years after cognitive behavioral treatment for posttraumatic stress disorder.,"This study examined (a) relationships between trauma-related cognitions and posttraumatic stress disorder (PTSD) symptoms from pretreatment through a long-term period after cognitive-behavioral therapy (CBT) for PTSD and (b) whether these relationships were impacted by treatment type. Participants were 171 women randomized into treatment for PTSD after rape. Measures of self-reported trauma-related cognitions and interviewer-assessed PTSD symptoms (i.e., Posttraumatic Maladaptive Beliefs Scale, Trauma-Related Guilt Inventory, and Clinician-Administered PTSD Scale) were obtained at pretreatment, posttreatment, and 3-month, 9-month, and 5-10 year follow-ups. Multilevel regression analyses were used to examine relationships between trauma-related cognitions and PTSD symptoms throughout the study period and whether these relationships differed as a function of treatment type (i.e., Cognitive Processing Therapy or Prolonged Exposure). Initial multilevel regression analyses that examined mean within-participant associations suggested that beliefs regarding Reliability and Trustworthiness of Others, Self-Worth and Judgment, Threat of Harm, and Guilt were related to PTSD symptoms throughout follow-up. Growth curve modeling suggested that patterns of belief change throughout follow-up were similar to those previously observed in PTSD symptoms over the same time period. Finally, multilevel mediation analyses that incorporated time further suggested that change in beliefs was related to change in symptoms throughout follow-up. With 1 minor exception, relationships between beliefs and symptoms were not moderated by treatment type. These data suggest that trauma-related cognitions are a potential mechanism for long-term maintenance of treatment gains after CBT for PTSD. Moreover, these cognitions may be a common, rather than specific, treatment maintenance mechanism. (PsycINFO Database Record",Scher CD.; Suvak MK.; Resick PA.,2017.0,10.1037/tra0000258,0,0,
1429,Mindfulness-based stress reduction added to care as usual for lung cancer patients and/or their partners: A multicentre randomized controlled trial.,"Lung cancer patients report among the highest distress rates of all cancer patients. Partners report similar distress rates. The present study examined the effectiveness of additional mindfulness-based stress reduction (care as usual [CAU] + MBSR) versus solely CAU to reduce psychological distress in lung cancer patients and/or their partners. We performed a multicentre, parallel-group, randomized controlled trial. Mindfulness-based stress reduction is an 8-week group-based intervention, including mindfulness practice and teachings on stress. Care as usual included anticancer treatment, medical consultations, and supportive care. The primary outcome was psychological distress. Secondary outcomes included quality of life, caregiver burden, relationship satisfaction, mindfulness skills, self-compassion, rumination, and posttraumatic stress symptoms. Outcomes were assessed at baseline, post-intervention, and 3-month follow-up. Linear mixed modeling was conducted on an intention-to-treat sample. Moderation (gender, disease stage, baseline distress, participation with/without partner) and mediation analyses were performed. A total of 31 patients and 21 partners were randomized to CAU + MBSR and 32 patients and 23 partners to CAU. After CAU + MBSR patients reported significantly less psychological distress (p = .008, d = .69) than after CAU. Baseline distress moderated outcome: those with more distress benefitted most from MBSR. Additionally, after CAU + MBSR patients showed more improvements in quality of life, mindfulness skills, self-compassion, and rumination than after CAU. In partners, no differences were found between groups. Our findings suggest that psychological distress in lung cancer patients can be effectively treated with MBSR. No effect was found in partners, possibly because they were more focused on patients' well-being rather than their own.",Schellekens MPJ.; van den Hurk DGM.; Prins JB.; Donders ART.; Molema J.; Dekhuijzen R.; van der Drift MA.; Speckens AEM.,2017.0,10.1002/pon.4430,0,0,
1430,"Body image in patients with mental disorders: Characteristics, associations with diagnosis and treatment outcome.","Objective: Despite the increasing recognition in clinical practice of body image problems in other than appearance related mental disorders, the question remains how aspects of body image are affected in different disorders. The aim of this study was to measure body image in patients with a variety of mental disorders and to compare scores with those in the general population in order to obtain more insight in the relative disturbance of body image in the patients group compared to healthy controls. In a further exploration associations with self-reported mental health, quality of life and empowerment were established as well as the changes in body image in patients over time. Methods: 176 women and 91 men in regular psychiatric treatment completed the Dresden Body Image Questionnaire, the Outcome Questionnaire, the Manchester Short Assessment of Quality of Life and the Mental Health Confidence Scale. Measurements were repeated after four months. Results: Patients with mental disorders, especially those with post-traumatic stress disorder (PTSD), scored significantly lower on body image, with large effect sizes, in comparison with the healthy controls. Scores of patients from different diagnostic groups varied across domains of body image, with body acceptance lowest in the group with eating disorders, and sexual fulfillment extremely low in PTSD. Vitality did not differ significantly between the various disorders. Gender differences were large for body acceptance and sexual fulfillment and small for vitality. Associations of body image with self-reported mental health, quality of life and empowerment were moderate to strong. After four months of treatment positive changes in body image were observed. Conclusions: Negative body image is a common problem occurring in most patients with mental disorders. Diagnosis-specific profiles emerge, with PTSD being the most affected disorder. Body acceptance and sexual fulfillment were the most differentiating aspects of body image between diagnoses. Changes in body image occur over the course of treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Scheffers, Mia; van Busschbach, Jooske T; Bosscher, Ruud J; Aerts, Liza C; Wiersma, Durk; Schoevers, Robert A",2017.0,http://dx.doi.org/10.1016/j.comppsych.2017.01.004,0,0,
1431, Do Children and Adolescents Have Different Types of Trauma Narratives and Does It Matter? Reliability and Face Validation for a Narrative Taxonomy," The construction of trauma narratives is a major component of several psychotherapy approaches for trauma‚Äêrelated problems, but questions remain as to whether fully expressive narratives are necessary and whether it is detrimental to ask avoidant youths to tell their narratives repeatedly. Characteristics of trauma narratives during psychotherapy have not been examined in youths and this represents a salient gap in knowledge. This study aimed to begin filling this gap by identifying categories of trauma narratives and empirically validating them. Youths (N = 47) aged 7 to 18 years, who were involved in a randomized controlled trial, received cognitive behavioral therapy. Transcripts of all narrative exposure therapy sessions for each youth were rated. Four categories were identified and were named expressive, avoidant, fabricated, and undemonstrative. Interrater reliability for identifying these categories was good, and face validation of the categories was supported by statistically significant differences between categories on the number of data elements of the trauma events, negative emotion words, and positive emotion words. These promising findings indicate that different types of narrative styles can be reliably identified. There was strong evidence for reduction of posttraumatic stress symptoms in each of the categories (Cohen's d = 0.9 to 2.5). Favorable treatment outcomes for all categories suggest that more remembering is not always better and clients appeared to effectively deal with memories in different ways."," Scheeringa, MS;  Lilly, ME;  Staiger, AB;  Heller, ML;  Jones, EG;  Weems, CF",2017.0, 10.1002/jts.22190,0,0,
1432,Description of an early cognitive behavioral intervention (UPFRONT-intervention) following mild traumatic brain injury to prevent persistent complaints and facilitate return to work.,"Purpose: Many patients with mild traumatic brain injury do not fully return to work owing to persistent posttraumatic complaints. Research suggests that preventing chronic complaints might be prevented by giving cognitive behavioral therapy early after injury. Therefore, a new cognitive behavioral intervention (UPFRONT-intervention) was developed to not only prevent chronic complaints but to also establish a more successful return to work. The intervention is currently being evaluated in a multicenter randomized controlled trial design (trial number ISRCTN86191894) in mild traumatic brain injury patients who are at-risk of negative outcomes (patients with high numbers of early complaints). Two case examples are presented to demonstrate the application of the intervention. Rationale: Psychological factors, like cognitive appraisal and coping, play an important role in the persistence of posttraumatic complaints. Some patients are less able to adapt and thus to cope with the injury and its initial consequences than others. Dealing with the injury in a passive, avoidant way, focusing on negative feelings, will hamper recovery and is therefore a valuable target for an intervention. Theory into practice: The UPFRONT intervention is a short cognitive behavioral therapy intervention for patients that are at-risk of developing persistent posttraumatic complaints. Patients will undergo five sessions of cognitive behavioral therapy within 4-10 weeks after trauma. The intervention aims to enhance patients' feeling of competency of dealing with the consequences of mild traumatic brain injury by providing psycho-education, identifying and challenging unrealistic illness perceptions and improving coping style (decreasing maladaptive coping and enhancing adaptive coping). (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Scheenen, Myrthe E; Visser-Keizer, Annemarie C; van der Naalt, Joukje; Spikman, Jacoba M",2017.0,http://dx.doi.org/10.1177/0269215516687101,0,0,
1433,Cognitive Behavioral Intervention Compared to Telephone Counseling Early after Mild Traumatic Brain Injury: A Randomized Trial.,"Many patients do not return to work (RTW) after mild traumatic brain injury (mTBI) because of persistent complaints that are often resistant to therapy in the chronic phase. Recent studies suggest that psychological interventions should be implemented early post-injury to prevent patients from developing chronic complaints. This study is a randomized, controlled trial that examines the effectiveness of a newly developed cognitive behavioral therapy (CBT) intervention (CBTi) compared to telephonic counseling (TC) in at-risk mTBI patients (patients with high reports of early complaints). Patients underwent either five sessions of CBT treatment or five phone conversations starting 4-6 weeks post-trauma. The main outcome measure was RTW 6 and 12 months post-trauma. Secondary measures comprised functional outcome at 6 and 12 months, and depression, anxiety, and reported post-traumatic complaints at 3, 6, and 12 months post-injury. After excluding dropouts, CBTi consisted of 39 patients and TC of 45 patients. No significant differences were found with regard to RTW, with 65% of CBTi patients and 67% of TC patients reporting a RTW at previous level. However, TC patients reported fewer complaints at 3 (8 vs. 6; p‚Äâ=‚Äâ0.010) and 12 months post-injury (9 vs. 5; p‚Äâ=‚Äâ0.006), and more patients in the TC group showed a full recovery 12 months post-injury compared to the CBTi group (62% vs. 39%). The results of this study suggest that early follow-up of at-risk patients can have a positive influence on patients' well-being, and that a low-intensive, low-cost telephonic intervention might be more effective than a CBT intervention at improving outcome in at-risk patients.",Scheenen ME.; Visser-Keizer AC.; de Koning ME.; van der Horn HJ.; van de Sande P.; van Kessel M.; van der Naalt J.; Spikman JM.,2017.0,10.1089/neu.2016.4885,0,0,
1434, Do pharmacological and behavioral interventions differentially affect treatment outcome for children with social phobia?," In a randomized trial for children with social phobia (SP), Social Effectiveness Therapy for Children (SET‚ÄêC; a treatment consisting of exposure and social skills training) and fluoxetine were more effective than pill placebo in reducing social distress and behavioral avoidance, but only SET‚ÄêC demonstrated significantly improved overall social skill and social competence. In the current study, the authors examined the specific social skills enhanced by SET‚ÄêC using a recently developed coding schema. At posttreatment, children treated with SET‚ÄêC displayed a more effective ability to manage the conversational topic (pragmatic social behaviors) and more appropriate motor movement, facial orientation, and posture (paralinguistic social behaviors) than children treated with fluoxetine or placebo. In contrast, children treated with fluoxetine displayed no more pragmatic or paralinguistic skill than children given a pill placebo. There were no group differences on ratings of voice volume and vocal inflection (speech and prosodic social behaviors). Furthermore, only children treated with SET‚ÄêC improved from pre‚Äê to posttreatment on all three skill variables. Findings suggest that pharmacological interventions that only target reduction in anxious arousal may not have an impact on social skill deficits and may not be adequate to optimally treat SP. The relationship of social skill to social avoidance and the importance of social skills training to enhance social competence in the treatment of childhood SP are discussed."," Scharfstein, LA;  Beidel, DC;  Finnell, LR;  Distler, A;  Carter, NT",2011.0, 10.1177/0145445511408590,0,0,
1435, Incentivizing attendance to prolonged exposure for PTSD with opioid use disorder patients: a randomized controlled trial," OBJECTIVE: To determine whether contingent monetary incentives increase opioid use disorder patients' attendance to Prolonged Exposure (PE) therapy and whether attendance is associated with improvement in posttraumatic stress disorder (PTSD) and substance use disorder (SUD) outcomes. METHOD: Patients (N = 58) with PTSD were offered PE or PE with incentives (PE + I; max $480) to attend PE sessions. Participants were assessed at baseline and weeks 6, 12, and 24 postrandomization. RESULTS: Participants were mostly women (79%) and Caucasian (71%); mean age 37.43 years (SD = 11.33). PE + I participants attended a median of 9 (of 12) sessions compared to 1 session for PE participants (p < .001), which included more exposure sessions (PE + I mdn = 6; PE mdn = 0; p < .001). A Time √ó treatment condition interaction indicated that PE + I participants exhibited a greater decrease in PTSD severity over time than PE participants (OR = 3.1; 95% CI = 0.4‚Äê5.7; p = .024). PE + I participants remained in substance use treatment longer than PE participants (mdn days = 262 vs. 192; p = .039). There were no group differences in drug use. CONCLUSIONS: Monetary incentives increased SUD patients' attendance to an otherwise poorly attended treatment for PTSD. Better attendance in the incentivized group was associated with greater PTSD improvement, better SUD treatment retention, and no increased drug use. Incentives are well supported for improving adherence to substance use treatment goals and promising as a means to improve therapy attendance, which may improve the effectiveness of existing psychotherapies in difficult‚Äêto‚Äêtreat populations. (PsycINFO Database Record"," Schacht, RL;  Brooner, RK;  King, VL;  Kidorf, MS;  Peirce, JM",2017.0, 10.1037/ccp0000208,0,0,
1436,"Depression, anxiety, alexithymia and somatosensory sensitivity in patients with benign palpitation","Objective: The aim of this study is to compare the frequency of depression, anxiety, alexithymia and somatosensory sensitivity in patients with benign palpitation with healthy controls. Method: Sixty-one patients with palpitation and 59 age-and sex-matched control subjects were enrolled. All study subjects were undergone thorough cardiac evaluation, and patients with palpitation also had echocardiography and 24-hour ECG monitoring to rule out significant arrhythmias, coronary artery disease and structural heart disease. All subjects were assessed by Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Toronto Alexithymia scale, Whiteley Index (WI) and Somatosensory Amplification Scale (SAS). Results: Patients with benign palpitation had significantly increased BAI, BDI, WI and SAS scores. Anxiety is the only independent predictor of benign palpitation (odds ratio = 1.12, 95% confidence interval = 1.05–1.19, p < 0.001). Conclusion: This study shows that patients with benign palpitation had increased anxiety levels and somatization disorders. So an integrated psycho-cardiological approach is needed in this special population.",Sayar N.; Yanartaş Ö.; Tigen K.; Sadıç B.Ö.; Ergun S.; Kepez A.; Çinçin A.,2017.0,10.1080/24750573.2017.1328095,0,0,
1437,"Design and challenges for a randomized, multi-site clinical trial comparing the use of service dogs and emotional support dogs in Veterans with post-traumatic stress disorder (PTSD).","Posttraumatic stress disorder (PTSD) is a leading cause of impairments in quality of life and functioning among Veterans. Service dogs have been promoted as an effective adjunctive intervention for PTSD, however published research is limited and design and implementation flaws in published studies limit validated conclusions. This paper describes the rationale for the study design, a detailed methodological description, and implementation challenges of a multisite randomized clinical trial examining the impact of service dogs on the on the functioning and quality of life of Veterans with PTSD. Trial design considerations prioritized participant and intervention (dog) safety, selection of an intervention comparison group that would optimize enrollment in all treatment arms, pragmatic methods to ensure healthy well-trained dogs, and the selection of outcomes for achieving scientific and clinical validity in a Veteran PTSD population. Since there is no blueprint for conducting a randomized clinical trial examining the impact of dogs on PTSD of this size and scope, it is our primary intent that the successful completion of this trial will set a benchmark for future trial design and scientific rigor, as well as guiding researchers aiming to better understand the role that dogs can have in the management of Veterans experiencing mental health conditions such as PTSD.",Saunders GH.; Biswas K.; Serpi T.; McGovern S.; Groer S.; Stock EM.; Magruder KM.; Storzbach D.; Skelton K.; Abrams T.; McCranie M.; Richerson J.; Dorn PA.; Huang GD.; Fallon MT.,2017.0,10.1016/j.cct.2017.08.017,0,0,
1438, Isolating the Unique Effects of the Unified Protocol Treatment Modules Using Single Case Experimental Design," The Unified Protocol (UP) for the Transdiagnostic Treatment of Emotional Disorders is a cognitive‚Äêbehavioral intervention designed to treat the range of anxiety, depressive, and related disorders. Thus far, the UP treatment modules have only been studied when they are delivered in their entirety and presented in a standard sequence. To personalize the presentation of the UP modules for a given patient's presentation (e.g., providing the modules in a varied order, dropping irrelevant modules), it is first necessary to establish that each module leads to change in the skill it is designed to promote, and that these changes can occur in the absence of the other modules. Using a multiple baseline design in accordance with the single‚Äêcase reporting guidelines in behavioral interventions (SCRIBE), eight patients with heterogeneous emotional disorders were randomly assigned to a 1‚Äê or 3‚Äêweek baseline assessment phase followed by four sessions of one of four UP modules (psychoeducation, emotional awareness, cognitive flexibility, and countering emotional behaviors). Results provide preliminary support for the notion that each UP module under study leads to change in its associated skill in the absence of the other modules (five of eight patients demonstrated reliable change in the module‚Äêspecific skill). In addition, exploratory analyses suggest that the emotion awareness training and cognitive flexibility modules appeared to exhibit change specific to their associated skills, psychoeducation, and countering emotional behaviors demonstrated somewhat more broad‚Äêbased change across skills."," Sauer-Zavala, S;  Cassiello-Robbins, C;  Conklin, LR;  Bullis, JR;  Thompson-Hollands, J;  Kennedy, KA",2017.0, 10.1177/0145445516673827,0,0,
1439,A trauma-focused approach for patients with tinnitus: The effectiveness of eye movement desensitization and reprocessing-A multicentre pilot trial.,"Background: While normal tinnitus is a short-term sensation of limited duration, in 10-15% of the general population it develops into a chronic condition. For 3-6% it seriously interferes with many aspects of life. Objective: The aim of this trial was to assess effectiveness of a trauma-focused approach, eye movement desensitization and reprocessing (EMDR), in reducing tinnitus distress. Methods: The sample consisted of 35 adults with high levels of chronic tinnitus distress from five general hospitals in the Netherlands. Participants served as their own controls. After pre-assessment (T1), participants waited for a period of 3 months, after which they were assessed again (T2) before they received six 90 min manualized EMDR treatment sessions in which tinnitus-related traumatic or stressful events were the focus of treatment. Standardized self-report measures, the Tinnitus Functional Index (TFI), Mini-Tinnitus Questionnaire (Mini-TQ), Symptom Checklist-90 (SCL-90) and the Self-Rating Inventory List for Post-traumatic Stress Disorder (SRIP), were completed again halfway through treatment (T3), post-treatment (T4) and at 3 months' follow-up (T5). Results: Repeated measures analysis of variance revealed significant improvement after EMDR treatment on the primary outcome, TFI. Compared to the waiting-list condition, scores significantly decreased in EMDR treatment [t(34) = -4.25, p < .001, Cohen's dz = .72]. Secondary outcomes, Mini-TQ and SCL-90, also decreased significantly. The treatment effects remained stable at 3 months' follow-up. No adverse events or side effects were noted in this trial. Conclusions: This is the first study to suggest that EMDR is effective in reducing tinnitus distress. Randomized controlled trials are warranted. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Abstract (Chinese) :-,-10-15%,3-6%,: - (EMDR):35(T1),3(T2),690EMDR,(T3),(T4)3(T5),(TFI),(Mini-TQ),(SCL)-90PTSD(SRIP):(ANOVA)EMDRTFI,EMDR(t(34)= -4.25,p < 0.001,Cohen's dz = 0.72)Mini-TQSCL-903:EMDR, (PsycINFO Database Record (c) 2018 APA, all rights reserved) Abstract (Spanish) Antecedentes: mientras que el tinnitus normal es una sensacion a corto plazo de duracion limitada, en el 10-15% de los pacientes se transforma en una condicion cronica. Para el 3-6% de los pacientes interfiere seriamente con muchos aspectos de la vida. El objetivo de este estudio fue evaluar la efectividad de un enfoque centrado en el trauma, la Desensibilizacion y Reprocesamiento por Movimientos Oculares (EMDR), para reducir el estres por tinnitus. Metodos: La muestra consistio en 35 adultos con altos niveles de estres por tinnitus cronico de cinco hospitales generales en los Paises Bajos. Los participantes sirvieron como sus propios controles. Despues de la pre-evaluacion (T1), los participantes esperaron por un periodo de 3 meses, despues de lo cual fueron evaluados nuevamente (T2) antes de recibir seis sesiones de tratamiento EMDR manualizadas de 90 minutos en las que los eventos traumaticos o estresantes relacionados con el tinnitus fueron el foco del tratamiento. Las medidas de autorreporte estandarizadas, el Indice Funcional de Tinnitus (TFI, por su sigla en ingles), el Mini Cuestionario de Tinnitus (Mini-TQ), la Lista de Chequeo de Sintomas - 90 (SCL-90, por su sigla en ingles) y la Lista de Inventario de Autorreporte para el TEPT (SRIP, por su sigla en ingles) se completaron nuevamente durante el tratamiento (T3), postratamiento (T4) y a los 3 meses de seguimiento (T5). Resultados: el analisis de varianza de medidas repetidas (ANOVA) revelo una mejora significativa despues del tratamiento con EMDR en el resultado primario TFI. Comparado con la condicion de lista de espera, los puntajes disminuyeron significativamente en el tratamiento con EMDR, como mostraron las pruebas t de muestras relacionadas (t(34) = -4.25, p <0.001, Cohen's dz = 0.72). Los resultados secundarios Mini-TQ y SCL-90 tambien disminuyeron significativamente. Los efectos del tratamiento se mantuvieron estables a los 3 meses de seguimiento. No se observaron eventos adversos o efectos secundarios en este estudio. Conclusiones: Este es el primer estudio que sugiere que el EMDR es efectivo para reducir el estres por tinnitus. Se requieren ensayos aleatorios controlados. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Rikkert, Marian; van Rood, Yanda; de Roos, Carlijn; Ratter, Julia; van den Hout, Marcel",2018.0,http://dx.doi.org/10.1080/20008198.2018.1512248,0,0,
1440,The Effect of modality specific interference on working memory in recalling aversive auditory and visual memories*,"Both auditory and visual emotional memories can be made less emotional by loading working memory (WM) during memory recall. Taxing WM during recall can be modality specific (giving an auditory [visuospatial] load during recall of an auditory [visual] memory) or cross modal (an auditory load during visual recall or vice versa). We tested whether modality specific loading taxes WM to a larger extent than cross modal loading. Ninety-six participants undertook a visual and auditory baseline Random Interval Repetition task (i.e. responding as fast as possible to a visual or auditory stimulus by pressing a button). Then, participants recalled a distressing visual and auditory memory, while performing the same visual and auditory Random Interval Repetition task. Increased reaction times (compared to baseline) were indicative of WM loading. Using Bayesian statistics, we compared five models in terms of general and modality specific taxation. There was support for the model describing the effect on WM of dual tasking in general, irrespective of modality specificity, and for the model describing the effect of modality specific loading. Both models combined gained the most support. The results suggest a general effect of dual tasking on taxing WM and a superimposed effect of taxing in matched modality.",Matthijssen S.J.M.A.; van Schie K.; van den Hout M.A.,2018.0,10.1080/02699931.2018.1547271,0,0,
1441, Change in blood levels of eicosapentaenoic acid and posttraumatic stress symptom: a secondary analysis of data from a placebo-controlled trial of omega3 supplements," METHODS: The percentages of EPA, DHA, and arachidonic acid (AA) were measured in erythrocyte membranes at baseline and posttreatment in 110 participants with severe physical injury who were randomly assigned to receive either a daily dose of 1,470mg DHA and 147mg EPA or of placebo for 12 weeks. Associations between change in erythrocyte fatty acid levels during the trial controlling for each baseline level and PTSD severity at 12 weeks were analyzed by treatment arm. RESULTS: In the omega3 supplements arm, changes in EPA+DHA (p=.023) and EPA (p=.001) as well as the EPA:AA ratio (p=.000) and EPA: DHA ratio (p=.013) were inversely correlated with PTSD severity. Change in AA was positively correlated with PTSD severity (p=.001). LIMITATION: This trial was conducted at a single‚Äêcenter in Japan and PTSD symptoms in most participants were not serious. CONCLUSIONS: Increased erythrocyte level of EPA during the trial was associated with low severity of PTSD symptoms in patients receiving omega3 supplements. BACKGROUND: Eicosapentaenoic acid (EPA) is suggested to be protective against posttraumatic stress disorder (PTSD) from two observational studies. We previously conducted a randomized controlled trial and found no effect of docosahexaenoic acid (DHA) for prevention of PTSD. This secondary analysis aimed to determine whether change in blood levels of EPA is associated with PTSD symptoms."," Matsuoka, YJ;  Hamazaki, K;  Nishi, D;  Hamazaki, T",2016.0, 10.1016/j.jad.2016.08.005,0,0,
1442,"Effects of omega-3 polyunsaturated fatty acids on psychophysiological symptoms of post-traumatic stress disorder in accident survivors: A randomized, double-blind, placebo-controlled trial.","Background: Psychophysiological symptoms (e.g., pounding heart) are known to be a prominent feature of post-traumatic stress disorder (PTSD). Although omega-3 polyunsaturated fatty acids (PUFAs) have a beneficial potential pharmacological effect of preventing these psychophysiological symptoms, no clinical data is yet available. Therefore, we conducted a randomized, double-blind, placebo-controlled trial of Japanese accident survivors. Methods: A total of 83 participants received either omega-3 PUFAs (1470mg docosahexaenoic acid and 147mg eicosapentaenoic acid per day) or placebo within 10 days of the accidental injury. After 12-week supplementation, participants performed script-driven imagery of their traumatic event during monitoring of their heart rate and skin conductance. Results: Analysis revealed that heart rate during both rest and script-driven imagery was significantly lower in the omega-3 group than the placebo group, whereas baseline heart rate was comparable between the two groups. Limitations: The present trial was conducted at a single-center in Japan and psychophysiological symptoms of PTSD in most participants were not serious. Conclusion: These findings suggest that post-trauma supplementation of omega-3 PUFAs might be effective for the secondary prevention of psychophysiological symptoms of PTSD. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Matsumura, Kenta; Noguchi, Hiroko; Nishi, Daisuke; Hamazaki, Kei; Hamazaki, Tomohito; Matsuoka, Yutaka J",2017.0,http://dx.doi.org/10.1016/j.jad.2016.05.054,0,0,
1443, Can school counselors deliver cognitive-behavioral treatment for social anxiety effectively? A randomized controlled trial," BACKGROUND: Social anxiety disorder (SAD) typically onsets in adolescence and is associated with multiple impairments. Despite promising clinical interventions, most socially anxious adolescents remain untreated. To address this clinical neglect, we developed a school‚Äêbased, 12‚Äêweek group intervention for youth with SAD, Skills for Academic and Social Success (SASS). When implemented by psychologists, SASS has been found effective. To promote dissemination and optimize treatment access, we tested whether school counselors could be effective treatment providers. METHOD: We randomized 138, ninth through 11th graders with SAD to one of three conditions: (a) SASS delivered by school counselors (C‚ÄêSASS), (b) SASS delivered by psychologists (P‚ÄêSASS), or (c) a control condition, Skills for Life (SFL), a nonspecific counseling program. Blind, independent, evaluations were conducted with parents and adolescents at baseline, post‚Äêintervention, and 5 months beyond treatment completion. We hypothesized that C‚ÄêSASS and P‚ÄêSASS would be superior to the control, immediately after treatment and at follow‚Äêup. No prediction was made about the relative efficacy of C‚ÄêSASS and P‚ÄêSASS. RESULTS: Compared to controls, adolescents treated with C‚ÄêSASS or P‚ÄêSASS experienced significantly greater improvement and reductions of anxiety at the end of treatment and follow‚Äêup. There were no significant differences between SASS delivered by school counselors and psychologists. CONCLUSION: With training, school counselors are effective treatment providers to adolescents with social anxiety, yielding benefits comparable to those obtained by specialized psychologists. Questions remain regarding means to maintain counselors' practice standards without external support."," Masia Warner, C;  Colognori, D;  Brice, C;  Herzig, K;  Mufson, L;  Lynch, C;  Reiss, PT;  Petkova, E;  Fox, J;  Moceri, DC;  et al.",2016.0, 10.1111/jcpp.12550,0,0,
1444,Effectiveness of operationalized Gestalt therapy role-playing in the treatment of phobic behaviors.,"The Gestalt therapy role-playing technique applied to dreams is based on the assumption that unwarranted avoidance behaviors in a dream are maintained by failing to recognize that the aversive properties attributed to avoided stimuli are self-created. This study extrapolates that the recognition of these projections through the Gestalt role-playing technique also can reduce avoidance in phobic behavior. 24 Ss with phobias were assigned to 3 groups. The role-playing technique varied as follows: full treatment (FT), role-playing both phobic responses and aversive properties attributed to the phobic stimulus; stimulus role-playing (SRP), role-playing only aversive properties attributed to the phobic stimulus; and response role-playing (RRP), role-playing only phobic responses. The groups that role-played aversive properties attributed to the phobic stimulus (FT and SRP) were significantly more effective in reducing their phobias than the RRP group. Results are interpreted as support for the Gestalt therapy projections construct. The cognitive restructuring related to the reduction of a phobic response may be achieved more effectively through a role-playing technique focusing on reenacting the aversive properties attributed to the phobic stimulus rather than on the phobic response. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Martinez, Mario E",2002.0,http://dx.doi.org/10.5325/gestaltreview.6.2.0148,0,0,
1445,History of sexual trauma moderates psychotherapy outcome for posttraumatic stress disorder.,"Moderators of differential psychotherapy outcome for posttraumatic stress disorder (PTSD) are rare, yet have crucial clinical importance. We tested the moderating effects of trauma type for three psychotherapies in 110 unmedicated patients with chronic DSM-IV PTSD. Patients were randomized to 14 weeks of prolonged exposure (PE, N = 38), interpersonal psychotherapy (IPT, N = 40), or relaxation therapy (RT, N = 32). The Clinician-Administered PTSD Scale (CAPS) was the primary outcome measure. Moderator candidates were trauma type: interpersonal, sexual, physical. We fit a regression model for week 14 CAPS as a function of treatment (a three-level factor), an indicator of trauma type presence/absence, and their interactions, controlling for baseline CAPS, and evaluated potential confounds. Thirty-nine (35%) patients reported sexual, 68 (62%) physical, and 102 (93%) interpersonal trauma. Baseline CAPS scores did not differ by presence/absence of trauma types. Sexual trauma as PTSD criterion A significantly moderated treatment effect: whereas all therapies had similar efficacy among nonsexually-traumatized patients, IPT had greater efficacy among sexually traumatized patients (efficacy difference with and without sexual trauma: IPT vs. PE and IPT vs. RT P's < .05), specifically in PTSD symptom clusters B and D (P's < .05). Few studies have assessed effects of varying trauma types on effects of differing psychotherapies. In this exploratory study, sexual trauma moderated PTSD outcomes of three therapies: IPT showed greater benefit for sexually traumatized patients than PE or RT. The IPT focuses on affect to help patients determine trust in their current environments may particularly benefit patients who have suffered sexual assault.",Markowitz JC.; Neria Y.; Lovell K.; Van Meter PE.; Petkova E.,2017.0,10.1002/da.22619,0,0,
1446,"Impact of Killing in War: A Randomized, Controlled Pilot Trial.","The purpose of this pilot study was to test the effectiveness of Impact of Killing (IOK), a novel, cognitive-behavioral treatment (CBT) aimed at reducing mental health symptoms and functional impairment. Participants were 33 combat Veterans with a posttraumatic stress disorder (PTSD) diagnosis who had completed trauma-focused psychotherapy and reported distress regarding killing or feeling responsible for the deaths of others in war. Veterans were randomized to either IOK treatment or a 6-week waitlist condition, after which Veterans could receive IOK. IOK is a 6- to 8-session, weekly, individual, CBT, lasting 60-90 minutes, and focused on key themes, including physiology of killing responses, moral injury, self-forgiveness, spirituality, making amends, and improved functioning. We found that compared to controls (N = 16), the IOK group (N = 17) experienced a significant improvement in PTSD symptoms, general psychiatric symptoms, and quality of life functional measures. Veterans who received IOK reported that the treatment was acceptable and feasible. These results provide preliminary evidence that Veterans can benefit from a treatment focused on the impact of killing after initial trauma therapy.",Maguen S.; Burkman K.; Madden E.; Dinh J.; Bosch J.; Keyser J.; Schmitz M.; Neylan TC.,2017.0,10.1002/jclp.22471,0,0,
1447," Clinical effectiveness, cost-effectiveness and acceptability of low-intensity interventions in the management of obsessive-compulsive disorder: the Obsessive-Compulsive Treatment Efficacy randomised controlled Trial (OCTET)"," BACKGROUND: The Obsessive‚ÄêCompulsive Treatment Efficacy randomised controlled Trial emerged from a research recommendation in National Institute for Health and Care Excellence obsessive‚Äêcompulsive disorder (OCD) guidelines, which specified the need to evaluate cognitive‚Äêbehavioural therapy (CBT) treatment intensity formats. OBJECTIVES: To determine the clinical effectiveness and cost‚Äêeffectiveness of two low‚Äêintensity CBT interventions [supported computerised cognitive‚Äêbehavioural therapy (cCBT) and guided self‚Äêhelp]: (1) compared with waiting list for high‚Äêintensity CBT in adults with OCD at 3 months; and (2) plus high‚Äêintensity CBT compared with waiting list plus high‚Äêintensity CBT in adults with OCD at 12 months. To determine patient and professional acceptability of low‚Äêintensity CBT interventions. DESIGN: A three‚Äêarm, multicentre, randomised controlled trial. SETTING: Improving Access to Psychological Therapies services and primary/secondary care mental health services in 15 NHS trusts. PARTICIPANTS: Patients aged ‚â•‚Äâ18‚Äâyears meeting INTERVENTIONS: Participants were randomised to (1) supported cCBT, (2) guided self‚Äêhelp or (3) a waiting list for high‚Äêintensity CBT. MAIN OUTCOME MEASURES: The primary outcome was OCD symptoms using the Yale‚ÄêBrown Obsessive Compulsive Scale ‚Äê Observer Rated. RESULTS: Patients were recruited from 14 NHS trusts between February 2011 and May 2014. Follow‚Äêup data collection was complete by May 2015. There were 475 patients randomised: supported cCBT ( LIMITATIONS: A significant issue in the interpretation of the results concerns the high level of access to high‚Äêintensity CBT during the waiting list period. CONCLUSIONS: Although low‚Äêintensity interventions are not associated with clinically significant improvements in OCD symptoms, economic analysis over 12 months suggests that low‚Äêintensity interventions are cost‚Äêeffective and may have an important role in OCD care pathways. Further research to enhance the clinical effectiveness of these interventions may be warranted, alongside research on how best to incorporate them into care pathways. TRIAL REGISTRATION: Current Controlled Trials ISRCTN73535163. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in"," Lovell, K;  Bower, P;  Gellatly, J;  Byford, S;  Bee, P;  McMillan, D;  Arundel, C;  Gilbody, S;  Gega, L;  Hardy, G;  et al.",2017.0, 10.3310/hta21370,0,0,
1448,Telepsychotherapy for the treatment of trichotillomania: A randomized controlled trial.,"Trichotillomania is defined as recurrent pulling of one's hair that results in distress and negative effects on general functioning and quality of life. Estimates of trichotillomania lifetime prevalence generally range from approximately 1% to 3% and it is likely as common as disorders such as obsessive-compulsive disorder and agoraphobia. Yet, quality treatment for trichotillomania is often difficult to find as many mental health professionals are uninformed about the disorder and its treatment. Moreover, mental health services in general are inaccessible to many with estimates suggesting that 96.5 million people do not have access to adequate services. The use of telepsychology has been an effective method for disseminating treatment services for a variety of mental health conditions. However, no research has examined the effectiveness of telepsychology to treat trichotillomania. The current study reports the results of a randomized clinical trial of Acceptance and Commitment Therapy Enhanced Behavior Therapy for the treatment of trichotillomania delivered by way of telepsychology. The study compared an active treatment condition (n = 12) to a waitlist control condition ( n = 10). Results showed significant reductions in hair pulling severity from pre- to post-treatment compared to the waitlist condition. Participants in the waitlist condition received the same treatment as participants in the treatment condition following the waitlist period. All participants were then combined to examine overall treatment effects from pre-treatment to a 12-week follow-up. The effect of treatment on hair pulling severity was still significant at follow-up, however the effect was not as strong as at post-treatment. Conversely, the effect on quality of life was maintained and even increased following post-treatment. Additional measures of psychological flexibility, perceived shame, and valued action also saw significant changes from pre-treatment to follow-up. The findings demonstrate that telepsychology is a viable option to disseminate treatment for trichotillomania. Implications, limitations, and future research directions are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Lee, Eric B",2018.0,,0,0,
1449, A BRIEF ECOLOGICAL MOMENTARY INTERVENTION FOR GENERALIZED ANXIETY DISORDER: a RANDOMIZED CONTROLLED TRIAL OF THE WORRY OUTCOME JOURNAL," METHODS: To address this issue, 51 participants with clinical levels of generalized anxiety disorder were randomly assigned to a treatment or control condition for 10 days. The treatment condition consisted of a brief ecological momentary intervention termed the Worry Outcome Journal (WOJ). WOJ participants recorded worries and tracked their outcomes, rating worry distress, interference, and expected outcome probabilities. Thought log (TL) control participants completed a record of their everyday thoughts and rated associated distress. All participants made four entries on paper each day when randomly prompted by text message. They then entered their paper contents online each night. After 30 days they reviewed their contents electronically and completed follow‚Äêup measures. RESULTS: Primary results revealed significant reductions in worry for WOJ users compared to TL users at postintervention. A marginally significant difference was found at 20‚Äêday follow‚Äêup and treatment gains were maintained. Secondary analyses showed no harmful increases in worry beliefs for WOJ users, as well as preliminary evidence for decreases in beliefs about the uncontrollability of thoughts in both groups. CONCLUSION: The WOJ may be a viable therapist‚Äêindependent treatment for reducing worry, even after only 10 days of use. BACKGROUND: The efficacy of many cognitive behavioral component interventions has not been examined, with worry outcome monitoring among them."," LaFreniere, LS;  Newman, MG",2016.0, 10.1002/da.22507,0,0,
1450,Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders.,"This reprinted article originally appeared in American Journal of Psychiatry 149, 7, 1992, pp. 936-943. Objective: This study was designed to determine the effectiveness of a group stress reduction program based on mindfulness meditation for patients with anxiety disorders. Method: The 22 study participants were screened with a structured clinical interview and found to meet the DSM-III-R criteria for generalized anxiety disorder or panic disorder with or without agoraphobia. Assessments, including self-ratings and therapists' ratings, were obtained weekly before and during the meditation-based stress reduction and relaxation program and monthly during the 3-month follow-up period. Results: Repeated measures analyses of variance documented significant reductions in anxiety and depression scores after treatment for 20 of the subjects-changes that were maintained at follow-up. The number of subjects experiencing panic symptoms was also substantially reduced. A comparison of the study subjects with a group of nonstudy participants in the program who met the initial screening criteria for entry into the study showed that both groups achieved similar reductions in anxiety scores on the SCL-90-R and on the Medical Symptom Checklist, suggesting generalizability of the study findings. Conclusions: A group mindfulness meditation training program can effectively reduce symptoms of anxiety and panic and can help maintain these reductions in patients with generalized anxiety disorder, panic disorder, or panic disorder with agoraphobia. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Kabat-Zinn, Jon; Massion, Ann O; Kristeller, Jean; Peterson, Linda Gay; Fletcher, Kenneth E; Pbert, Lori; Lenderking, William R; Santorelli, Saki F",2017.0,,0,0,
1451,The Counting Method: Applying the Rule of Parsimony to the Treatment of Posttraumatic Stress Disorder.,"The authors contend that the primary therapeutic element in psychological treatments for posttraumatic stress disorder is imaginal exposure, and that differences among major approaches are determined more by secondary techniques designed to circumvent the client's avoidant defenses against exposure. A study is described comparing Prolonged Exposure, Eye Movement Desensitization and Reprocessing, and the Counting Method with 51 multiply-traumatized women. Measures of PTSD were significantly reduced by all three methods, but differences among the methods were negligible. Because the Counting Method utilizes only imaginal exposure as a therapeutic element, support is given to the more parsimonious conclusion that imaginal exposure may be both the necessary and sufficient factor in therapeutic effect, countering a trend in the field toward more complex, multi-faceted treatment packages. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Johnson, David Read; Lubin, Hadar",2006.0,http://dx.doi.org/10.1177/153476560601200106,0,0,
1452, Randomized controlled trial of a brief Internet-based intervention for families of Veterans with posttraumatic stress disorder," Veterans with posttraumatic stress disorder (PTSD) and their families require resources to cope with postdeployment readjustment. Responding to this need, the current study examined a brief Internet‚Äêbased intervention that provided Veterans' families with psychoeducation on postdeployment readjustment. Participants were 103 dyads of Veterans with probable PTSD and a designated family member/partner. Dyads were randomized to an intervention group, in which the family member completed the intervention, or to a control group with no intervention. Each member of the dyad completed surveys at baseline and 2 mo follow‚Äêup. Family member surveys focused on perceived empowerment, efficacy to provide support, and communication (perceived criticism and reactivity to criticism). Veteran surveys assessed perceived family support and communication. Results showed that Veterans in the intervention group reported decreases in reactivity to criticism but also decreased perceived family support. No significant differences were observed in outcomes reported by family members. This preliminary study provides an early understanding of this novel outreach program, as well as the challenges inherent with a very brief intervention. Future research can build on the current study by more closely evaluating the communication changes that occur with this form of intervention and whether greater intervention intensity is needed. CLINICAL TRIAL REGISTRATION: Clinical Trials Identifier: NCT01554839."," Interian, A;  Kline, A;  Perlick, D;  Dixon, L;  Feder, A;  Weiner, MD;  Goldstein, MF;  Hennessy, K;  St Hill, L;  Losonczy, M",2016.0, 10.1682/JRRD.2014.10.0257,0,0,
1453,Effect of stress inoculation training with relaxation breathing on perceived stress and posttraumatic stress disorder in the military: A longitudinal study.,"In a previous study, we developed and evaluated a pilot predeployment stress inoculation training (SIT) program designed to teach relaxation breathing skills to minimize negative mental health consequences of combat stress. This study extends the investigation of the effectiveness of a SIT program of relaxation breathing on perceived stress symptoms and other mental health outcomes in a longitudinal randomized controlled trial. Heart rate variability was used to test the effect of SIT in reducing autonomic arousal in response to simulated combat-related stressors. Soldiers were randomized into SIT versus control groups at baseline and followed for 1 to 2 years. SIT did not have an overall effect on perceived stress scores or posttraumatic stress disorder symptoms when controlling for covariates. Consistent with previous findings in which SIT mitigated the risk of posttraumatic stress disorder in those without baseline mental health problems, the current study showed that SIT may prevent hyperarousal symptoms, among mentally healthy military personnel who are not otherwise interested in learning stress-control techniques, but was not supported as a general predeployment mental health prevention strategy. A heart rate variability increase in response to relaxation breathing training suggests further research is warranted into mental health effects of self-regulation techniques. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Hourani, Laurel; Tueller, Stephen; Kizakevich, Paul; Strange, Laura; Lewis, Gregory; Weimer, Belinda; Morgan, Jessica; Cooney, Darryl; Nelson, Jessica",2018.0,http://dx.doi.org/10.1037/str0000082,0,0,
1454,Therapeutic response to Cognitive Processing Therapy in White and Black female veterans with military sexual trauma-related PTSD.,"Cognitive Processing Therapy (CPT) is an evidence-based treatment (EBT) for posttraumatic stress disorder (PTSD) which has been validated for female veterans with military-related PTSD. Existing trials have enrolled predominantly White veterans with some studies documenting higher rates of early termination from EBTs among Black females when compared to White females. Data from a previously published randomized clinical trial were used to evaluate the effectiveness of CPT for Black female veterans with military sexual trauma (MST)-related PTSD. Reductions in PTSD symptom severity, number of sessions attended, and early termination rates were compared between Black (n = 20) and White (n = 16) female veterans. A hierarchical linear modeling approach was used, with PTSD symptom severity over the course of treatment and follow-up entered as a level-1 variable and race (Black or White) entered as a level-2 predictor. Piecewise growth curves analyses revealed that both Black and White female veterans experienced significant reductions in PTSD symptom severity over the course of treatment and gains were maintained up to 6 months post-treatment. Race was not found to be a significant predictor of change in the slope of PTSD symptom severity over the course of CPT treatment. Additionally, number of sessions attended and rates of early termination did not significantly differ based on race. Results suggest that CPT was a well-tolerated and effective psychotherapeutic treatment for this sample regardless of racial self-identification. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Holliday, Ryan P; Holder, Nicholas D; Williamson, Meredith L. C; Suris, Alina",2017.0,http://dx.doi.org/10.1080/16506073.2017.1312511,0,0,
1455,Effect on return to work or education of Individual Placement and Support modified for people with mood and anxiety disorders: results of a randomised clinical trial.,"The effect of Individual Placement and Support (IPS) on return to work or education among people with mood or anxiety disorders is unclear, while IPS increases return to work for people with severe mental illness. We examined the effect of IPS modified for people with mood and anxiety disorders (IPS-MA) on return to work and education compared with services as usual (SAU). In a randomised clinical superiority trial, 326 participants with mood and anxiety disorders were centrally randomised to IPS-MA, consisting of individual mentor support and career counselling (n=162) or SAU (n=164). The primary outcome was competitive employment or education at 24 months, while weeks of competitive employment or education, illness symptoms and level of functioning, and well-being were secondary outcomes. After 24 months, 44.4% (72/162) of the participants receiving IPS-MA had returned to work or education compared with 37.8% (62/164) following SAU (OR=1.34, 95% CI: 0.86 to 2.10, p=0.20). We found no difference in mean number of weeks in employment or education (IPS-MA 32.4 weeks vs SAU 26.7 weeks, p=0.14), level of depression (Hamilton Depression 6-Item Scale score IPS-MA 5.7 points vs SAU 5.0 points, p=0.12), level of anxiety (Hamilton Anxiety 6-Item Scale score IPS-MA 5.8 points vs SAU 5.1 points, p=0.17), level of functioning (Global Assessment of Functioning IPS-MA 59.1 points vs SAU 59.5 points, p=0.81) or well-being measured by WHO-Five Well-being Index (IPS-MA 49.6 points vs SAU 48.5 points, p=0.83) at 24 months. The modified version of IPS, IPS-MA, was not superior to SAU in supporting people with mood or anxiety disorders in return to work at 24 months. NCT01721824.",Hellström L.; Bech P.; Hjorthøj C.; Nordentoft M.; Lindschou J.; Eplov LF.,2017.0,10.1136/oemed-2016-104248,0,0,
1456,"Spiritually integrated care for PTSD: A randomized controlled trial of ""Building Spiritual Strength"".","Previous literature documents important cross-sectional and longitudinal relationships between spiritual distress and posttraumatic stress disorder (PTSD) outcomes. This study tests the efficacy of a spiritually integrated intervention ""Building Spiritual Strength"" (BSS) that can be delivered by trained chaplains. The intervention addresses spiritual concerns expressed by trauma survivors, including concerns in relationship with a Higher Power, difficulty with forgiveness, and theodicy. In a randomized controlled trial with blinded assessment, veterans were randomized to engage in a BSS condition (n = 71) or Present Centered Group Therapy (PCGT; control) condition (n = 67) with assessments at baseline, posttreatment, and a two-month follow up. Both groups showed similar, statistically significant reductions in symptoms of PTSD as measured by the Clinician Administered PTSD Scale (CAPS). BSS was shown to be more effective than PCGT in treating distress in relationship with a Higher Power. This was the second clinical trial of BSS with promising results and highlights the need for further study in psychospiritual interventions. More research is warranted on BSS being offered by non-specialized chaplains and on the application of BSS in suicide prevention. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Harris, J. Irene; Usset, Timothy; Voecks, Cory; Thuras, Paul; Currier, Joseph; Erbes, Christopher",2018.0,http://dx.doi.org/10.1016/j.psychres.2018.06.045,0,0,
1457,Improving functional outcomes in women with borderline personality disorder and PTSD by changing PTSD severity and post-traumatic cognitions.,"Although functional impairment typically improves during evidence-based psychotherapies (EBPs) for borderline personality disorder (BPD), functional levels often remain suboptimal after treatment. The present pilot study evaluated whether and how integrating PTSD treatment into an EBP for BPD would improve functional outcomes. Participants were 26 women with BPD, PTSD, and recent suicidal and/or self-injurious behavior who were randomized to receive one year of Dialectical Behavior Therapy (DBT) or DBT with the DBT Prolonged Exposure (DBT PE) protocol for PTSD. Five domains of functioning were assessed at 4-month intervals during treatment and at 3-months post-treatment. DBT + DBT PE was superior to DBT in improving global social adjustment, health-related quality of life, and achieving good global functioning, but not interpersonal problems or quality of life. Results of time-lagged mixed effects models indicated that, across both treatments, reductions in PTSD severity significantly predicted subsequent improvement in global social adjustment, global functioning, and health-related quality of life, whereas reductions in post-traumatic cognitions significantly predicted later improvement in all functional outcomes except global social adjustment. These findings provide preliminary evidence supporting the role of change in PTSD severity and trauma-related cognitions as active mechanisms in improving functional outcomes among individuals with BPD and PTSD. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Harned, Melanie S; Wilks, Chelsey R; Schmidt, Sara C; Coyle, Trevor N",2018.0,http://dx.doi.org/10.1016/j.brat.2018.02.002,0,0,
1458,Randomized controlled trial of internet-delivered cognitive behaviour therapy comparing standard weekly versus optional weekly therapist support.,"Internet-delivered cognitive behaviour therapy (ICBT) is effective for treating anxiety and depression. The relative benefits of offering standard weekly compared to optional weekly therapist support in conjunction with ICBT within routine care has not been examined. Patients seeking ICBT for depression and or anxiety in routine care were randomized to standard (n=92) or optional (n=88) weekly support. The optional approach resulted in therapists receiving half as many messages from (1.70 vs. 3.96) and sending half as many messages to patients (3.62 vs. 7.29). Optional Support was associated with lower completion rates (56.6% versus 82.4%), but, similar to Standard Support, resulted in large reductions on the GAD-7 (within Cohen's d‚â•1.08; avg. reduction ‚â•47%) and PHQ-9 (within Cohen's d‚â•0.82; avg. reduction ‚â•43%) at post-treatment and 3-month follow-up. Optional weekly support appears clinically effective and acceptable for many patients and may reduce costs, but safety requires monitoring given lower completion rates.",Hadjistavropoulos HD.; Schneider LH.; Edmonds M.; Karin E.; Nugent MN.; Dirkse D.; Dear BF.; Titov N.,2017.0,10.1016/j.janxdis.2017.09.006,0,0,
1459, Internet-based cognitive-behavioural writing therapy for reducing post-traumatic stress after intensive care for sepsis in patients and their spouses (REPAIR): study protocol for a randomised-controlled trial," INTRODUCTION: As a consequence of sepsis and intensive care, considerable proportions of patients but also of their spouses develop a post‐traumatic stress disorder (PTSD). However, only a very small number receive psychotherapeutic treatment. Internet‐based cognitive‐behavioural writing therapy (IB‐CBWT) has proven to be an effective treatment option for PTSD. It seems to fit the specific needs of this cohort and to overcome treatment barriers. Aim of the REPAIR trial is to examine the efficacy, safety and applicability of IB‐CBWT for PTSD in patients and their spouses after intensive care for sepsis. METHODS AND ANALYSIS: Participants will be assigned randomly either to a treatment or a wait‐list (WL) control group. The treatment group receives IB‐CBWT for PTSD, actively involving the partners of the participants. IB‐CBWT will be guided by a therapist and comprises two written assignments per week over a 5 week period. After completing the assignments, the participants obtain individual responses from the therapist. Participants of the WL control group will receive treatment after a waiting period of 5 weeks. The primary outcome is PTSD symptom severity in self‐rated PTSD Checklist for Diagnostic and Statistical Manual Fifth Edition at the end of treatment and waiting time, respectively. Secondary outcomes are remission of PTSD, depression, anxiety, and somatisation measured by the Brief Symptom Inventory‐18, marital satisfaction measured by the Relationship Assessment Scale, health‐related quality of life measured by the EQ‐5D‐5L, and the feasibility of IB‐CBWT for this cohort (ie, dropout rate). Statistical analysis will be performed according to the intent‐to‐treat principle. ETHICS AND DISSEMINATION: The study is conducted according to the principles of Good Clinical Practice and has been approved by the ethics committee of the Friedrich‐Schiller University Jena, Germany. Results will be disseminated at scientific conferences, published in peer‐reviewed journals, and provided to consumers of healthcare. TRIAL REGISTRATION NUMBER: Pre‐results, DRKS00010676."," Gawlytta, R;  Niemeyer, H;  Böttche, M;  Scherag, A;  Knaevelsrud, C;  Rosendahl, J",2017.0, 10.1136/bmjopen-2016-014363,0,0,
1460,Psychological treatment of comorbid asthma and panic disorder in Latino adults: Results from a randomized controlled trial.,"Confusion between panic and asthma symptoms can result in serious self-management errors. A cognitive behavior psychophysiological therapy (CBPT) intervention was culturally adapted for Latinos consisting of CBT for panic disorder (PD), asthma education, differentiation between panic and asthma symptoms, and heart rate variability biofeedback. An RCT compared CBPT to music and relaxation therapy (MRT), which included listening to relaxing music and paced breathing at resting respiration rates. Fifty-three Latino (primarily Puerto Rican) adults with asthma and PD were randomly assigned to CBPT or MRT for 8 weekly sessions. Both groups showed improvements in PD severity, asthma control, and several other anxiety and asthma outcome measures from baseline to post-treatment and 3-month follow-up. CBPT showed an advantage over MRT for improvement in adherence to inhaled corticosteroids. Improvements in PD severity were mediated by anxiety sensitivity in CBPT and by depression in MRT, although earlier levels of these mediators did not predict subsequent improvements. Attrition was high (40%) in both groups, albeit comparable to CBT studies targeting anxiety in Latinos. Additional strategies are needed to improve retention in this high-risk population. Both CBPT and MRT may be efficacious interventions for comorbid asthma-PD, and CBPT may offer additional benefits for improving medication adherence.",Feldman JM.; Matte L.; Interian A.; Lehrer PM.; Lu SE.; Scheckner B.; Steinberg DM.; Oken T.; Kotay A.; Sinha S.; Shim C.,2016.0,10.1016/j.brat.2016.09.007,0,0,
1461,A Randomized Controlled Trial of Medication and Cognitive-Behavioral Therapy for Hypochondriasis.,"Prior studies of hypochondriasis demonstrated benefits for pharmacotherapy and for cognitive-behavioral therapy (CBT). This study examined whether joint treatment offers additional benefit. Patients with DSM-IV hypochondriasis (N=195) were randomly assigned to one of four treatments-placebo, CBT, fluoxetine, or joint treatment with both fluoxetine and CBT. Evaluations assessed hypochondriasis, other psychopathology, adverse events, functional status, and quality of life. The primary analysis assessed outcome at week 24 among the intent-to-treat sample, with responders defined as having a 25% or greater improvement over baseline on both the Whiteley Index and a modified version of the Yale-Brown Obsessive Compulsive Scale for hypochondriasis (H-YBOCS-M). The Cochran-Armitage trend test assessed the hypothesized pattern of response: joint treatment > CBT or fluoxetine treatment > placebo treatment. The predicted pattern of response was statistically significant, as shown by the following responder rates: joint treatment group, 47.2%; single active treatment group, 41.8%; and placebo group, 29.6%. Responder rates for each active treatment were not significantly different from the rate for placebo. Secondary analyses of the Whiteley Index as a continuous measure revealed that, compared with placebo, fluoxetine (but not CBT) was significantly more effective at week 24 in reducing hypochondriasis and had a significantly faster rate of improvement over 24 weeks. Fluoxetine also resulted in significantly less anxiety and better quality of life than placebo. Dropout rates did not differ between groups, and treatment-emergent adverse events were evenly distributed. This study supports the safety, tolerance, and efficacy of fluoxetine for hypochondriasis. Joint treatment provided a small incremental benefit. Because approximately 50% of patients did not respond to the study treatments, new or more intensive approaches are needed.",Fallon BA.; Ahern DK.; Pavlicova M.; Slavov I.; Skritskya N.; Barsky AJ.,2017.0,10.1176/appi.ajp.2017.16020189,0,0,
1462,Surviving and thriving during stress: A randomized clinical trial comparing a brief web-based therapist-assisted acceptance-based behavioral intervention versus waitlist control for college students.,"The high rates of anxiety in college students and the many barriers to accessing evidence-based care in communities and on campuses indicate a clear need to explore ways to increase access to evidence-based treatments. Web-based interventions and preventions are one way to bridge this gap; they hold the potential to decrease mental health disparities and enhance student functioning. The current RCT examined the acceptability and efficacy of a 3-session web-based therapist-assisted acceptance-based behavioral intervention targeting anxiety (Surviving and Thriving During Stress) for college students versus a waitlist (WL) control condition, in a sample of racially and ethnically diverse college students. Overall, participants rated the program as helpful and acceptable. Mixed-effects regression models (MRMs) were run in SPSS to examine the effects of time, condition, and Condition x Time on outcomes and hypothesized mechanisms. Significant Condition x Time interactions for general anxiety, depression, and quality of life (QOL) emerged, suggesting that SATDS participants reported significantly greater changes on these outcomes from pre- to posttreatment versus WL. However, interaction effects were nonsignificant for anxious arousal and social anxiety. MRMs examining hypothesized mechanisms revealed significant Condition x Time interactions for experiential avoidance, decentering, and values-based living. However, interaction effects were nonsignificant for mindfulness. All significant gains were maintained at 1-month follow-up, with the exception of QOL. Results contribute to the growing literature on the acceptability and efficacy of web-based approaches, and suggest these approaches can be effective for diverse college students, and may provide a unique platform to increase access to evidence-based care. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Eustis, Elizabeth H; Hayes-Skelton, Sarah A; Orsillo, Susan M; Roemer, Lizabeth",2018.0,http://dx.doi.org/10.1016/j.beth.2018.05.009,0,0,
1463, Dysregulation in Youth with Anxiety Disorders: relationship to Acute and 7- to 19- Year Follow-Up Outcomes of Cognitive-Behavioral Therapy," This study evaluated the impact of dysregulation across cognitive, affective, and behavioral domains on acute and 7‚Äê to 19‚Äêyear follow‚Äêup outcomes of cognitive‚Äêbehavioral therapy (CBT) for anxiety, and explored dysregulation as a predictor of psychopathology and impairment in young adulthood among individuals who received anxiety treatment as youth. Participants (N = 64; 50 % female, 83 % non‚ÄêHispanic White) from two randomized clinical trials completed a follow‚Äêup assessment 7‚Äê19 years later. Latent profile analysis identified dysregulation based on Anxious/Depressed, Attention Problems, and Aggressive Behavior scores on the Child Behavior Checklist. Although pretreatment dysregulation was not related to acute or follow‚Äêup outcomes for anxiety diagnoses that were the focus of treatment, dysregulation predicted an array of non‚Äêtargeted psychopathology at follow‚Äêup. Among youth with a principal anxiety disorder, the effects of CBT (Coping Cat) appear to be robust against broad impairments in self‚Äêregulation. However, youth with a pretreatment dysregulation profile likely need follow‚Äêup to monitor for the emergence of other disorders."," Caporino, NE;  Herres, J;  Kendall, PC;  Wolk, CB",2016.0, 10.1007/s10578-015-0587-2,0,0,
1464,"The acceptability of an Internet-based exposure treatment for flying phobia with and without therapist guidance: Patients' expectations, satisfaction, treatment preferences, and usability.","Purpose: Internet-based treatments have been tested for several psychological disorders. However, few studies have directly assessed the acceptability of these self-applied interventions in terms of expectations, satisfaction, treatment preferences, and usability. Moreover, no studies provide this type of data on Internet-based treatment for flying phobia (FP), with or without therapist guidance. The aim of this study was to analyze the acceptability of an Internet-based treatment for FP (NO-FEAR Airlines) that includes exposure scenarios composed of images and real sounds. A secondary aim was to compare patients' acceptance of two ways of delivering this treatment (with or without therapist guidance). Patients and methods: The sample included 46 participants from a randomized controlled trial who had received the self-applied intervention with (n = 23) or without (n = 23) therapist guidance. All participants completed an assessment protocol conducted online and by telephone at both pre- and posttreatment. Results: Results showed good expectations, satisfaction, opinion, and usability, regardless of the presence of therapist guidance, including low aversiveness levels from before to after the intervention. However, participants generally preferred the therapist-supported condition. Conclusion: NO-FEAR Airlines is a well-accepted Internet-based treatment that can help enhance the application of the exposure technique, improving patient acceptance and access to FP treatment. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Campos, Daniel; Mira, Adriana; Breton-Lopez, Juana; Castilla, Diana; Botella, Cristina; Banos, Rosa Maria; Quero, Soledad",2018.0,,0,0,
1465,Long-term treatment effect of trauma-affected refugees with flexible cognitive behavioural therapy and antidepressants.,"Few studies exist on the long-term effect of treatment of trauma-affected refugees. The purpose of this study was to estimate the long-term treatment effects of cognitive behavioural therapy and antidepressants (sertraline and mianserin) in trauma-affected refugees. Follow-ups were conducted 6 and 18 months after a randomised controlled clinical trial. The included patients were refugees with war-related traumatic experiences, PTSD and without psychotic disorders. We found a small improvement over time in PTSD, depression and anxiety symptoms and level of functioning, but the improvement was not associated with any specific treatment. Personality change after catastrophic experiences and life events influenced the symptom level at all follow-ups while depression at completion of treatment was associated with a steeper decline in symptom load at the follow-ups. In spite of the limited decline in symptom scores and treatment effects immediately after treatment, the condition of the treated trauma-affected refugees was significantly improved 6 and 18 months after treatment although the improvement was small.",Buhmann CB.; Nordentoft M.; Ekstroem M.; Carlsson J.; Mortensen EL.,2018.0,10.1016/j.psychres.2018.03.069,0,0,
1466,Somatic experiencing for posttraumatic stress disorder: A randomized controlled outcome study.,"This study presents the first known randomized controlled study evaluating the effectiveness of somatic experiencing (SE), an integrative body-focused therapy for treating people with posttraumatic stress disorder (PTSD). There were 63 participants meeting DSM-IV-TR full criteria for PTSD included. Baseline clinical interviews and self-report measures were completed by all participants, who were then randomly assigned to study (n = 33) or waitlist (n = 30) groups. Study participants began 15 weekly SE sessions, whereas waitlist participants waited the same period, after which the second evaluation was conducted. All participants were evaluated a third time after an additional 15 weeks, during which time the waitlist group received SE therapy. Pretreatment evaluation showed no significant differences between groups. Mixed model linear regression analysis showed significant intervention effects for posttraumatic symptoms severity (Cohen's d = 0.94 to 1.26) and depression (Cohen's d = 0.7 to 1.08) both pre-post and pre-follow-up. This randomized controlled study of SE shows positive results indicating SE may be an effective therapy method for PTSD. Further research is needed to understand who shall benefit most from this treatment modality. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Brom, Danny; Stokar, Yaffa; Lawi, Cathy; Nuriel-Porat, Vered; Ziv, Yuval; Lerner, Karen; Ross, Gina",2017.0,http://dx.doi.org/10.1002/jts.22189,0,0,
1467,Evaluation of Operation Restore: A brief intervention for first responders exposed to traumatic events.,"The article summarizes the findings from an evaluation of Operation Restore, a brief posttrauma intervention developed for first responders. Participants were 207 police officers, firefighters, emergency services personnel, 911 operators/dispatchers, and Federal Bureau of Investigation agents, exposed to job-related critical incidents. These first responders participated in 1 of 35 deliveries of Operation Restore between 2013 and 2018. A mixed-methods pre/post follow-up evaluation design was used to assess changes in first responders' scores on a posttraumatic outcome measure and to obtain their qualitative feedback. Significant growth (p < .001) was observed in all domains on the posttraumatic measure following participation in Operation Restore; effect sizes were large (Cohen's d = .80-1.5). In all, 92% of the first responders experienced positive growth post retreat. With the exception of the personal strength domain, changes in scores at the 90-day follow-up assessment did not significantly decline from postretreat levels, and the effect size associated with the loss in personal strength was small (d = .30). In addition, changes in posttraumatic growth were not associated with participant sex, race/ethnicity, occupation, or veteran status, providing evidence that the intervention was appropriate for a broad range of participants. Qualitative findings supported the quantitative results and revealed that first responders could better handle their emotions following the retreat. The initial evaluation results provide support regarding the effectiveness of Operation Restore. Continued evaluation of the program and building on opportunities to strengthen and expand the design will serve to increase our understanding of this program. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Boothroyd, Roger A; Green, Shawna; Dougherty, Anne",2018.0,http://dx.doi.org/10.1037/trm0000168,0,0,
1468,Running for extinction? Aerobic exercise as an augmentation of exposure therapy in panic disorder with agoraphobia.,"Exposure-based Cognitive Behavioral Therapy (eb-CBT) represents the most evidence-based psychotherapeutic approach in anxiety disorders. However, its efficacy may be limited by a delay in onset of action and a substantial number of patients does not respond sufficiently to treatment. In this context, aerobic exercise was found to be effective in reducing clinical anxiety as well as to improve (elements of) disorder-specific CBT in some mental disorders. We therefore investigated the effect of aerobic exercise supplementary to an eb-CBT in panic disorder and agoraphobia (PD/AG). 77 patients with PD/AG performed a 30 min treadmill task with moderate or low intensity (70% or 30% of the maximal oxygen uptake [VO2max]) prior to five exposure sessions within a standardized seven-week CBT. At baseline, after completing the treatment period (post) and six month after post (follow-up), several measures of (un)specific psychopathology (Hamilton Anxiety Rating Scale [Ham-A], Mobility Inventory [MI], Panic and Agoraphobia Scale [PAS], Agoraphobic Cognitions Questionnaire [ACQ], Body Sensations Questionnaire [BSQ]) were established to assess for clinical changes. All patients experienced a significant improvement of symptoms from baseline to post (for all measures p < .001) but repeated-measures analyses of variance found a trend towards a significant time x group interaction in the Ham-A in favor for the moderate intense exercise group (f[1, 74] = 4.15, p = .045, alpha = .025 ). This trend, however, disappeared at follow-up since the low-intense exercise group further improved significantly in Ham-A after post. Our findings therefore might point to an accelerating effect of moderate-intense exercise within an exposure-based CBT for AG/PD. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Bischoff, Sophie; Wieder, Gesine; Einsle, Franziska; Petzold, Moritz B; Jansen, Christiane; Mumm, Jennifer L.M; Wittchen, Hans-Ulrich; Fydrich, Thomas; Plag, Jens; Strohle, Andreas",2018.0,http://dx.doi.org/10.1016/j.jpsychires.2018.03.001,0,0,
1469,Treatment of depression and/or anxiety - outcomes of a randomised controlled trial of the tree theme method® versus regular occupational therapy.,"Depression and anxiety disorders are a major concern in western countries, and because these often have a negative affect on everyday life interventions based on activities in everyday life are needed. The Tree Theme Method® (TTM) is a client-centred occupational therapy intervention designed to increase the ability to cope with, and to enhance satisfaction with, everyday life, both at home and at work. The aim of this study was to compare the short term outcomes of the TTM intervention with regular occupational therapy treatment for people with depression and/or anxiety disorders. This randomised controlled trial included patients from three counties in Sweden. Men and women with depression and/or anxiety disorders, ages 18 to 65, were randomised to either TTM or regular occupational therapy. Assessment data were collected at baseline and the follow-up directly after completing the intervention. Non-parametric and parametric statistical methods were used. The questionnaires were answered by 118 patients at baseline and by 107 patients after completing the intervention. No significant differences in short term outcomes were found between the groups. Both groups showed positive significant outcomes regarding almost all aspects of activities in everyday life, psychological symptoms, and health-related and intervention-related aspects. Despite the lack of differences between the groups, the positive outcomes regarding activities in everyday life, psychological symptoms, and health-related aspects after completing the intervention indicates the need for further research on the long-term perspective of TTM compared to regular occupational therapy. Clinical Trials.gov: NCT01980381 ; registered November 2013.",Birgitta Gunnarsson A.; Wagman P.; Hedin K.; Håkansson C.,2018.0,10.1186/s40359-018-0237-0,0,0,
1470,Effects of a transdiagnostic unguided Internet intervention ('velibra') for anxiety disorders in primary care: results of a randomized controlled trial.,"Internet-based cognitive-behavioural treatment (ICBT) for anxiety disorders has shown some promise, but no study has yet examined unguided ICBT in primary care. This randomized controlled trial (RCT) investigated whether a transdiagnostic, unguided ICBT programme for anxiety disorders is effective in primary care settings, after a face-to-face consultation with a physician (MD). We hypothesized that care as usual (CAU) plus unguided ICBT would be superior to CAU in reducing anxiety and related symptoms among patients with social anxiety disorder (SAD), panic disorder with or without agoraphobia (PDA) and/or generalized anxiety disorder (GAD). Adults (n = 139) with at least one of these anxiety disorders, as reported by their MD and confirmed by a structured diagnostic interview, were randomized. Unguided ICBT was provided by a novel transdiagnostic ICBT programme ('velibra'). Primary outcomes were generic measures, such as anxiety and depression symptom severity, and diagnostic status at post-treatment (9 weeks). Secondary outcomes included anxiety disorder-specific measures, quality of life, treatment adherence, satisfaction, and general psychiatric symptomatology at follow-up (6 months after randomization). CAU plus unguided ICBT was more effective than CAU at post-treatment, with small to medium between-group effect sizes on primary (Cohen's d = 0.41-0.47) and secondary (Cohen's d = 0.16-0.61) outcomes. Treatment gains were maintained at follow-up. In the treatment group, 28.2% of those with a SAD diagnosis, 38.3% with a PDA diagnosis, and 44.8% with a GAD diagnosis at pretreatment no longer fulfilled diagnostic criteria at post-treatment. The unguided ICBT intervention examined is effective for anxiety disorders when delivered in primary care.",Berger T.; Urech A.; Krieger T.; Stolz T.; Schulz A.; Vincent A.; Moser CT.; Moritz S.; Meyer B.,2017.0,10.1017/S0033291716002270,0,0,
1471,Web-Delivered CBT Reduces Heavy Drinking in OEF-OIF Veterans in Primary Care With Symptomatic Substance Use and PTSD.,"Veterans from conflicts such as the wars in Iraq and Afghanistan commonly return with behavioral health problems, including posttraumatic stress disorder (PTSD) and hazardous or harmful substance use. Unfortunately, many veterans experience significant barriers to receiving evidence-based treatment, including poor treatment motivation, concerns about stigma, and lack of access to appropriate care. To address this need, the current study developed and evaluated a web-based self-management intervention based on cognitive behavioral therapy (CBT), targeting PTSD symptoms and hazardous substance use in a group of symptomatic combat veterans enrolled in VA primary care. Veterans with PTSD/subthreshold PTSD and hazardous substance use were randomized to primary care treatment as usual (TAU; n = 81) or to TAU plus a web-based CBT intervention called Thinking Forward (n = 81). Thinking Forward consisted of 24 sections (approximately 20 minutes each), accessible over 12 weeks. Participants completed baseline and 4-, 8-, 12-, 16-, and 24-week follow-up assessments. Three primary outcomes of PTSD, alcohol and other drug use, and quality of life were examined. Significant treatment effects were found for heavy drinking, but not for PTSD or quality of life. The effect of the intervention on heavy drinking was mediated by intervening increases in coping, social support, self-efficacy, and hope for the future. These results demonstrate the promise of a web-based, self-management intervention for difficult-to-engage OEF/OIF veterans with behavioral health and substance use concerns.",Acosta MC.; Possemato K.; Maisto SA.; Marsch LA.; Barrie K.; Lantinga L.; Fong C.; Xie H.; Grabinski M.; Rosenblum A.,2017.0,10.1016/j.beth.2016.09.001,0,0,
1472,Enhancing outcomes in the treatment of generalised anxiety disorder.,"Describes the rationale and content for each of the treatment modules in our cognitive-behavioural treatment (CBT) for generalised anxiety disorder (GAD). In addition, mindfulness training for GAD is discussed and some results from our randomised controlled trial comparing mindfulness training with CBT for GAD are described. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Abbott, Maree",2007.0,,0,0,
1473,"Depression, anxiety, and smartphone addiction in university students- A cross sectional study.","The study aims to assess prevalence of smartphone addiction symptoms, and to ascertain whether depression or anxiety, independently, contributes to smartphone addiction level among a sample of Lebanese university students, while adjusting simultaneously for important sociodemographic, academic, lifestyle, personality trait, and smartphone-related variables. A random sample of 688 undergraduate university students (mean age = 20.64 ±1.88 years; 53% men) completed a survey composed of a) questions about socio-demographics, academics, lifestyle behaviors, personality type, and smartphone use-related variables; b) 26-item Smartphone Addiction Inventory (SPAI) Scale; and c) brief screeners of depression and anxiety (PHQ-2 and GAD-2), which constitute the two core DSM-IV items for major depressive disorder and generalized anxiety disorder, respectively. Prevalence rates of smartphone-related compulsive behavior, functional impairment, tolerance and withdrawal symptoms were substantial. 35.9% felt tired during daytime due to late-night smartphone use, 38.1% acknowledged decreased sleep quality, and 35.8% slept less than four hours due to smartphone use more than once. Whereas gender, residence, work hours per week, faculty, academic performance (GPA), lifestyle habits (smoking and alcohol drinking), and religious practice did not associate with smartphone addiction score; personality type A, class (year 2 vs. year 3), younger age at first smartphone use, excessive use during a weekday, using it for entertainment and not using it to call family members, and having depression or anxiety, showed statistically significant associations with smartphone addiction. Depression and anxiety scores emerged as independent positive predictors of smartphone addiction, after adjustment for confounders. Several independent positive predictors of smartphone addiction emerged including depression and anxiety. It could be that young adults with personality type A experiencing high stress level and low mood may lack positive stress coping mechanisms and mood management techniques and are thus highly susceptible to smartphone addiction.",Matar Boumosleh J.; Jaalouk D.,2017.0,10.1371/journal.pone.0182239,0,0,
1474, The Role of Psychological Factors in the Perception of Postneedling Soreness and the Influence of Postneedling Intervention," OBJECTIVES: The objectives of the present study were to determine whether catastrophizing, kinesiophobia, pain anxiety, and fear of pain are significant predictors of postneedling soreness over time; and to analyze whether the relationships between psychological variables and postneedling soreness vary as a function of the postneedling soreness intervention, which included ischemic compression, placebo or control (without treatment). DESIGN: Repeated‐measures observational study nested within a randomized controlled trial. SETTING: University community. PARTICIPANTS: Healthy volunteers (N = 90; 40 men and 50 women) 18 to 39 years of age (mean ± standard deviation 22 ± 3 years). METHODS: Catastrophizing, kinesiophobia, pain anxiety, and fear of pain were evaluated as possible predictors of postneedling pain before dry needling in a latent myofascial trigger point in the upper trapezius muscle. Participants were then divided into a treatment group that received ischemic compression as a postneedling intervention, a placebo group that received sham ischemic compression, and a control group that did not receive any treatment. MAIN OUTCOME MEASUREMENTS: Pain during needling and postneedling soreness were quantified using a visual analogue scale during needling, after treatment, and at 6, 12, 24, and 48 hours. RESULTS: A multilevel analysis revealed that individuals who exhibited more catastrophic thinking showed less postneedling soreness intensity immediately after needling in all participants (β = ‐0.049). Pain‐related anxiety was linked to greater immediate postneedling soreness in the compression condition (β = 0.057). Finally, participants who exhibited more catastrophic thinking showed a slower rate of decline in postneedling soreness levels over time in the compression condition (β = 0.038). CONCLUSIONS: Catastrophizing was associated with lower levels of postneedling soreness immediately after needling in all subjects. Although ischemic compression seems to be a useful procedure to reduce postneedling soreness, its efficacy could be slightly reduced in patients presenting higher scores of pain‐related anxiety. Psychological procedures may help to correct the distorted pain expectancies associated with needling interventions and might also improve the effectiveness of ischemic compression. LEVEL OF EVIDENCE: II. BACKGROUND: Myofascial trigger point dry needling is frequently associated with postneedling soreness, which can generate patient dissatisfaction and reduced treatment adherence. Psychological factors may influence the perception of postneedling soreness and the effectiveness of postneedling soreness treatments."," Martín-Pintado-Zugasti, A;  López-López, A;  González Gutiérrez, JL;  Pecos-Martín, D;  Rodríguez-Fernández, ÁL;  Alguacil-Diego, IM;  Gallego-Izquierdo, T;  Fernández-Carnero, J",2017.0, 10.1016/j.pmrj.2016.07.529,0,0,
1475,Lost in time and space: states of high arousal disrupt implicit acquisition of spatial and sequential context information,"Biased cognition during high arousal states is a relevant phenomenon in a variety of topics: from the development of post-traumatic stress disorders or stress-triggered addictive behaviors to forensic considerations regarding crimes of passion. Recent evidence indicates that arousal modulates the engagement of a hippocampus-based “cognitive” system in favor of a striatum-based “habit” system in learning and memory, promoting a switch from flexible, contextualized to more rigid, reflexive responses. Existing findings appear inconsistent, therefore it is unclear whether and which type of context processing is disrupted by enhanced arousal. In this behavioral study, we investigated such arousal-triggered cognitive-state shifts in human subjects. We validated an arousal induction procedure (three experimental conditions: violent scene, erotic scene, neutral control scene) using pupillometry (Preliminary Experiment, n = 13) and randomly administered this method to healthy young adults to examine whether high arousal states affect performance in two core domains of contextual processing, the acquisition of spatial (spatial discrimination paradigm; Experiment 1, n = 66) and sequence information (learned irrelevance paradigm; Experiment 2, n = 84). In both paradigms, spatial location and sequences were encoded incidentally and both displacements when retrieving spatial position as well as the predictability of the target by a cue in sequence learning changed stepwise. Results showed that both implicit spatial and sequence learning were disrupted during high arousal states, regardless of valence. Compared to the control group, participants in the arousal conditions showed impaired discrimination of spatial positions and abolished learning of associative sequences. Furthermore, Bayesian analyses revealed evidence against the null models. In line with recent models of stress effects on cognition, both experiments provide evidence for decreased engagement of flexible, cognitive systems supporting encoding of context information in active cognition during acute arousal, promoting reduced sensitivity for contextual details. We argue that arousal fosters cognitive adaptation towards less demanding, more present-oriented information processing, which prioritizes a current behavioral response set at the cost of contextual cues. This transient state of behavioral perseverance might reduce reliance on context information in unpredictable environments and thus represent an adaptive response in certain situations.",Maran T.; Sachse P.; Martini M.; Weber B.; Pinggera J.; Zuggal S.; Furtner M.,2017.0,10.3389/fnbeh.2017.00206,0,0,
1476, Acceptability and pilot efficacy trial of a web-based breast reconstruction decision support aid for women considering mastectomy," OBJECTIVE: The study aim was to test the acceptability and preliminary efficacy of a novel interactive web‐based breast reconstruction decision support aid (BRAID) for newly diagnosed breast cancer patients considering mastectomy. METHODS: Fifty‐five women considering mastectomy were randomly assigned to receive the BRAID versus the Cancer Support Community's Frankly Speaking About Cancer: Breast Reconstruction pamphlet. Participants completed measures of breast reconstruction (BR) knowledge, preparation to make a decision, decisional conflict, anxiety, and BR intentions before randomization and 2 weeks later. RESULTS: In terms of acceptability, enrollment into the study was satisfactory, but the rate of return for follow‐up surveys was lower among BRAID participants than pamphlet participants. Both interventions were evaluated favorably in terms of their value in facilitating the BR decision, and the majority of participants completing the follow‐up reported viewing the materials. In terms of preliminary efficacy, both interventions resulted in significant increases in BR knowledge and completeness and satisfaction with preparation to make a BR decision, and both interventions resulted in a significant reduction in decision conflict. However, there were no differences between interventions. CONCLUSION: A widely available free pamphlet and a web‐based customized decision aid were highly utilized. The pamphlet was as effective in educating women about BR and prepared women equally as well to make the BR decision as compared with a more costly, customized web‐based decision support aid. Copyright © 2015 John Wiley & Sons, Ltd."," Manne, SL;  Topham, N;  D'Agostino, TA;  Myers Virtue, S;  Kirstein, L;  Brill, K;  Manning, C;  Grana, G;  Schwartz, MD;  Ohman-Strickland, P",2016.0, 10.1002/pon.3984,0,0,
1477,Does psychiatric comorbidity in alcohol-dependent patients affect treatment outcome?,"Comorbidity in alcohol research refers to the presence of alcohol dependency and another major psychiatric disorder. The existence of additional disorders may have consequences for treatment planning and success. The aims of this paper are therefore: 1) to give an overview on prevalence rates in studies with representative cohorts and hospital-based samples; 2) to report results on gender differences and 3) to determine the impact of comorbidity on treatment outcome. Comorbidity was examined with the Composite International Diagnostic Interview (CIDI) in N=118 (61 male and 57 female) alcohol-dependent patients who were socially well integrated. Results show that 65% of the female patients but only 28% of the male patients had a lifetime history of additional psychiatric disorders. Significantly more phobic/anxiety disorders, mood disorders occur in female patients. One year after inpatient treatment, overall 39% had suffered a relapse. More detailed analysis revealed that 55% of the non-comorbid but only 28% of the comorbid women suffered a relapse, thus contradicting our initial hypothesis that comorbid patients have a poorer prognosis with regard to their alcohol dependence. Male comorbid (40.9%) and non-comorbid (35.3%) patients showed no significant differences regarding relapse rates. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mann, Karl; Hintz, Thomas; Jung, Martin",2004.0,http://dx.doi.org/10.1007/s00406-004-0465-6,0,0,
1478,Behavioral therapy teams for adults with OCD in a community mental health center: An open trial.,"Objective: This study assessed the acceptability and feasibility of a team-based approach to deliver Exposure and Ritual Prevention (ERP) for Obsessive Compulsive Disorder (OCD) in a community mental health center (CMHC). Method: Group ERP was adapted to meet the needs of adults with OCD receiving treatment in a CMHC and to be delivered by behavioral therapy teams (BTT). A training program, treatment manual, and fidelity ratings were developed to train CMHC therapists and case managers. Participants received 12 group ERP sessions and 10 individual home-based coaching sessions over 12 weeks. Results: Eight participants entered group ERP. Feasibility and acceptability of the BTT intervention were good with six clients completing treatment, 89% of scheduled sessions attended, and high treatment satisfaction ratings. Fidelity ratings indicated staff adhered well to an ERP protocol. Half of treatment completers experienced clinically significant reductions in symptoms on the Yale-Brown Obsessive Compulsive Scale by post-treatment or at the 3-month follow-up. Conclusions: BTT appear to be a feasible and acceptable way to deliver ERP for OCD in CMHCs. Modifications to ERP for CMCH populations may be needed to increase the reach of the intervention. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Mancebo, Maria C; Steketee, Gail; Muroff, Jordana; Rasmussen, Steven; Zlotnick, Caron",2017.0,http://dx.doi.org/10.1016/j.jocrd.2017.03.002,0,0,
1479, Immediate Effects of Upper Cervical Translatoric Mobilization on Cervical Mobility and Pressure Pain Threshold in Patients With Cervicogenic Headache: a Randomized Controlled Trial," OBJECTIVE: The purpose of this study was to evaluate the immediate effects of upper cervical translatoric spinal mobilization (UC‐TSM) on cervical mobility and pressure pain threshold in subjects with cervicogenic headache (CEH). METHODS: Eighty‐two volunteers (41.54 ± 15.29 years, 20 male and 62 female) with CEH participated in the study and were randomly divided into the control and treatment groups. The treatment group received UC‐TSM and the control group remained in the same position for the same time as the UC‐TSM group, but received no treatment. Cervical mobility (active cervical mobility and flexion‐rotation test), pressure pain thresholds over upper trapezius muscles, C2‐3 zygapophyseal joints and suboccipital muscles, and current headache intensity (visual analog scale) were measured before and immediately after the intervention by 2 blinded investigators. RESULTS: After the intervention, UC‐TSM group exhibited significant increases in total cervical mobility (P = .002, d = 0.16) and the flexion‐rotation test (P < .001, d = 0.81‐0.85). No significant difference in cervical pressure pain thresholds were observed between groups (P > .05). Nevertheless, there was a significantly lower intensity of headache in the UC‐TSM group (P = .039, d = 0.57). CONCLUSIONS: Upper cervical translatoric spinal mobilization intervention increased upper, and exhibited a tendency to improve general, cervical range of motion and induce immediate headache relief in subjects with CEH."," Malo-Urriés, M;  Tricás-Moreno, JM;  Estébanez-de-Miguel, E;  Hidalgo-García, C;  Carrasco-Uribarren, A;  Cabanillas-Barea, S",2017.0, 10.1016/j.jmpt.2017.07.007,0,0,
1480, Evaluating the short-term and long-term effects of an internet-based aural rehabilitation programme for hearing aid users in general clinical practice: a randomised controlled trial," OBJECTIVE: Guided internet‐based intervention beyond hearing aid (HA) fitting has been shown to be efficacious in randomised controlled trials (RCTs). However, internet interventions have rarely been applied clinically as a part of regular aural rehabilitation (AR). Our aim was to evaluate the effectiveness of internet‐based AR for HA users from a clinical population. OUTCOME MEASURES: The Hearing Handicap Inventory for the Elderly (HHIE) was used as the primary outcome measure, and the Communication Strategies Scale (CSS) and the Hospital Anxiety and Depression Scale were used as secondary outcome measures. All questionnaires were administered before and directly after the intervention and at 6 months postintervention. METHODS: We used a parallel group design (RCT). The data were collected in 2013‐2014 at three different clinics. Seventy‐four HA users were randomly assigned to receive either full internet‐based AR (intervention group, n=37) or one element of the internet‐based AR (control group, n=37). RESULTS: Data were analysed following the intention‐to‐treat principle. Each group showed improved HHIE scores over time and did not differ significantly from each other. The intervention group showed significantly greater improvement compared with the control group for the CSS total and the CONCLUSIONS: This study indicates that participants in an internet‐based intervention applied in general clinical practice showed improved self‐reported communication skills compared with a control group. Receiving a full intervention was not more effective in improving self‐reported hearing problems than receiving just one element of the internet‐based intervention. TRIAL REGISTRATION NUMBER: This trial is registered at ClinicalTrals.gov, NCT01837550; results."," Malmberg, M;  Lunner, T;  Kähäri, K;  Andersson, G",2017.0, 10.1136/bmjopen-2016-013047,0,0,
1481,Lifetime Traumatic Experiences and Disordered Eating among University Students: The Role of Posttraumatic Stress Symptoms.,"The associations between lifetime traumatic events (TEs), posttraumatic stress (PTS) symptoms, and disordered eating (DE) were studied in a sample of 614 university students (mean age 20 years). An anonymous questionnaire included 32 lifetime TEs, IES-revised measured PTS symptoms, and EAT-26 evaluated DE symptoms. Statistical analyses included Pearson correlations and structural equation models (SEM) with bootstrapping method. Findings reveal the prevalence of DE in 8.1% of participants, while 73.9% of students experienced at least one lifetime TE. 52.0% of students with DE had PTS symptoms (p < 0.0001) and 30.8% of students with lifetime TEs had PTS symptoms (p < 0.001). In SEM, direct paths from lifetime TEs to PTS symptoms (0.38, p < 0.0001) and from PTS symptoms to DE (0.40, p < 0.0001) were observed. The final SEM confirmed the mediating role of PTS symptoms in the path between some TEs (traffic accident and seriously injured) and DE among the university students. If PTS symptoms are associated with DE, then addressing PTS symptoms in the context of DE treatment may improve treatment efficacy.",Malinauskiene V.; Malinauskas R.,2018.0,10.1155/2018/9814358,0,0,
1482,Kinesiophobia and maladaptive coping strategies prevent improvements in pain catastrophizing following pain neuroscience education in fibromyalgia/chronic fatigue syndrome: An explorative study.,"Many patients with chronic fatigue syndrome(CFS) and/or fibromyalgia(FM) have little understanding of their condition, leading to maladaptive pain cognitions and coping strategies. These should be tackled during therapy, for instance by pain neurophysiology education (PNE). Although positive effects of PNE are well-established, it remains unclear why some patients benefit more than others. This paper aims at exploring characteristics of patients responding poor to PNE to further improve its effectiveness. Data from two RCT's were pooled to search for baseline predictors. Subjects (n = 39) suffering from CFS/FM, as defined by the American College of Rheumatology, underwent PNE treatment. The Pain Catastrophizing Scale (PCS); Pain Coping Inventory (PCI); and Tampa Scale of Kinesiophobia (TSK) were defined as outcome measures. There was a significant negative relationship between baseline TSK and the change in both PCS total score (r = -0.584; p < 0.001) and PCS rumination (r = -0.346; p < 0.05). There was a significant negative relationship between the change in PCS total score and baseline PCI worrying (r = -0.795; p < 0.001) and retreating (r = -0.356; p < 0.05). FM/CFS patients who tend to worry allot about their pain and with high levels of kinesiophobia are likely to experience less reductions in catastrophizing following PNE. It seems that PNE alone is insufficient to reduce catastrophic thinking regarding pain, and supplementary treatment is needed.",Malfliet A.; Van Oosterwijck J.; Meeus M.; Cagnie B.; Danneels L.; Dolphens M.; Buyl R.; Nijs J.,2017.0,10.1080/09593985.2017.1331481,0,0,
1483,Effective Debriefing: Empowering Trainees in Processing Distressing Clinical Events,"Objectives: The goals of this session are as follows: 1) to review the importance of debriefing after a distressing event; 2) to describe the components and impact of a debriefing workshop; and 3) to develop and practice ways to implement similar debriefing-educational interventions at one’s own home institution. Methods: At our institution, we developed a 2-hour debriefing workshop where senior residents learn the components of an effective debriefing session and practice these skills in a small group setting. Participants completed surveys before and after intervention, with regard to their attitudes, knowledge, and confidence in leading debriefing sessions. We will share the importance of debriefing and the components of our debriefing-educational intervention. We will then have small group-breakout sessions and engage in case-based skills building. We will end with a review of the practical session and questions and answers. Results: Twenty senior residents participated in the pilot study of our debriefing interventions at our institution. Participants reported a mean of 2.2 distressing events in the preceding month (SD = 2.4). Only 10% of participants reported debriefing within 1 week of an event. No residents reported having formal training in debriefing, and only 10% had ever led a debriefing session. After the workshop, there were statistically significant improvements in multiple domains, including comfort in leading debriefing sessions and likelihood of recognizing personal distress. We will share these data during the workshop, as well as the resources developed at our institution as a foundation for interactive, skill-building activities and discussion. Conclusions: This pilot study demonstrates that a 2-hour debriefing workshop for senior residents can result in greater knowledge of debriefing, greater confidence in leading debriefing, and better recognition of personal distress. It may serve as one model to enhance training and education regarding debriefing in residency-training programs. After completion of this workshop, participants will have an understanding of the value of debriefing and components of effective debriefing, identify strategies to develop and implement debriefing-educational interventions, and have time to practically apply their knowledge and skills during interactive case-based activities and discussion. AC, REST, STRESS",Malas N.; Govindan M.; Keefer P.,2018.0,10.1016/j.jaac.2018.07.846,0,0,
1484,Dispositional mindfulness attenuates the emotional attentional blink,"Emotional stimuli have been shown to automatically hijack attention, hindering the detection of forthcoming targets. Mindfulness is defined as a present moment non-judgemental attentional stance that can be cultivated by meditation practices, but that may present interindividual variability in the general population. The mechanisms underlying modification in emotional reactivity linked to mindfulness are still a matter of debate. In particular, it is not clear whether mindfulness is associated with a diminished emotional response, or with faster recovery. We presented participants with target pictures embedded in a rapid visual presentation stream. The targets could be preceded by negative, neutral or scrambled critical distractors. We showed that dispositional mindfulness, in particular the Non-reacting facet, was related to faster disengagement of attention from emotional stimuli. These results could have implications for mood disorders characterised by an exaggerated attentional bias toward emotional stimuli, such as anxiety and post-traumatic stress disorders.",Makowski D.; Sperduti M.; Lavallée S.; Nicolas S.; Piolino P.,2019.0,10.1016/j.concog.2018.11.004,0,0,
1485, Art therapy and music reminiscence activity in the prevention of cognitive decline: study protocol for a randomized controlled trial," BACKGROUND: Attention has shifted to the use of non‚Äêpharmacological interventions to prevent cognitive decline as a preventive strategy, as well as for those at risk and those with mild cognitive impairment. Early introduction of psycho‚Äêsocial interventions can address cognitive decline and significantly impact quality of life and the wellbeing of elderly individuals. This pilot study explores the feasibility of using art therapy and music reminiscence activity to improve the cognition of community living elderly with mild cognitive impairment. METHODS/DESIGN: This open‚Äêlabel, interventional study involves a parallel randomized controlled trial design with three arms (two intervention arms and a control group) over a nine‚Äêmonth period. Participants will be community‚Äêliving elderly individuals aged 60‚Äê85 years, both genders, who meet predefined inclusion and exclusion criteria. In the initial three months, interventions will be provided weekly and for the remaining six months fortnightly. A sample size of 90 participants is targeted based on expected neuropsychological test performance, a primary outcome measure, and drop‚Äêout rates. The randomization procedure will be carried out via a web‚Äêbased randomization system. Interventions will be provided by trained staff with a control group not receiving any intervention but continuing life as usual. Assessments will be done at baseline, three months, and nine months, and include neuroimaging to measure cerebral changes and neuropsychological tests to measure for changes in cognition. Secondary outcome measures will include mood changes in anxiety and depression and telomere lengths. Statistical analysis will be undertaken by statisticians; all efficacy analysis will be carried out on an intention‚Äêto‚Äêtreat basis. Primary and secondary outcomes will be modeled using the linear mixed model for repeated measurements and further analysis may be undertaken to adjust for potential confounders. DISCUSSION: This will be the first study to compare the effectiveness of art therapy and music reminiscence activity in a randomized controlled trial. We expect that the trial will provide useful evidence for developing psychosocial interventions for the elderly with mild cognitive impairment. TRIAL REGISTRATION: The study was registered on 7 July 2016 at Clinical Trials.gov, a service of the US National Institute of Health ( NCT02854085 ), retrospectively."," Mahendran, R;  Rawtaer, I;  Fam, J;  Wong, J;  Kumar, AP;  Gandhi, M;  Jing, KX;  Feng, L;  Kua, EH",2017.0, 10.1186/s13063-017-2080-7,0,0,
1486, Trauma and traumatic loss in pregnant adolescents: the impact of Trauma-Focused Cognitive Behavior Therapy on maternal unresolved states of mind and Posttraumatic Stress Disorder," Pregnant adolescents are a group at high risk for exposure to traumatic experiences. The present study aimed to examine if Trauma‚ÄêFocused Cognitive Behavior Therapy (TF‚ÄêCBT) typically applied to Posttraumatic Stress Disorder (PTSD), could also be applied to unresolved states of mind in a sample of socially at‚Äêrisk pregnant adolescents. Forty‚Äêthree adolescents who were in their second trimester of pregnancy and who also had positive indices of unresolved states of mind or symptoms of PTSD were randomly assigned to either the treatment as usual (parenting classes) or intervention (parenting classes + TF‚ÄêCBT) group. Adolescent mother‚Äêinfant dyads were then re‚Äêassessed at infant ages 6 and 12 months on a broad range of measures, including those specific to attachment, as well as to PTSD, and adolescent behavioral adjustment. Twenty‚Äêsix of the 43 (60%) recruited subjects completed all components of the study protocol. Although there were no significant effects of the TF‚ÄêCBT intervention on maternal attachment, infant attachment, PTSD diagnosis and adolescent behavioral adjustment, several study limitations restrict our ability to draw firm conclusions about the efficacy of TF‚ÄêCBT for use in pregnant adolescents with complex trauma. The discussion offers insight and guidance for clinical work and future intervention research efforts with this vulnerable population."," Madigan, S;  Vaillancourt, K;  McKibbon, A;  Benoit, D",2015.0, 10.1080/14616734.2015.1006386,0,0,
1487,"A cluster randomised controlled trial protocol of an adapted intervention for alcohol use disorders in people living with HIV and AIDS: impact on alcohol use, general functional ability, quality of life and adherence to HAART.","Interventions for alcohol use disorders (AUDs) in HIV infected individuals have been primarily targeted at HIV risk reduction and improved antiretroviral treatment adherence. However, reduction in alcohol use is an important goal. Alcohol use affects other key factors that may influence treatment course and outcome. In this study the authors aim to administer an adapted intervention for AUDs to reduce alcohol use in people living with HIV/AIDS (PLWHA). This study is a cluster randomised controlled trial at 16 HIV care clinics. A motivational interviewing and cognitive behavioural therapy based intervention for AUDs, developed through adaptation and piloted in Zimbabwe, will be administered to PLWHA with AUDs recruited at HIV clinics. The intervention will be administered over 16 sessions at 8 HIV clinics. This intervention will be compared with an equal attention control in the form of the World Health Organization Mental Health Gap Action Programme (WHO mhGAP) guide, adapted for the Zimbabwean context. General function, quality of life, and adherence to highly active antiretroviral treatment (HAART) will be secondary outcomes. Booster sessions will be administered to both groups at 3 and 6 months respectively. The primary outcome measure will be the Alcohol Use Disorder Identification Test (AUDIT) score. The World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0), World Health Organisation Quality of Life (WHOQoL) HIV, viral load, and CD4 counts will be secondary outcome measures. Outcome assessments will be administered at baseline, 3, 6, and 12 months. Moderating factors such as perceived social support, how people cope with difficult situations and post-traumatic exposure and experience will be assessed at baseline. Trained research assistants will recruit participants. The outcome assessors who will be trained in administering the outcome and moderating tools will be blinded to the treatment arms allocated to the participants. However, the principal investigator, participants and intervention staff will be unblinded. Data will be analysed using STATA Version 14. Primary and secondary outcomes will be measured at four time points that is; at baseline, 3, 6, and 12 months respectively. All participants will be included in the analysis of primary and secondary outcome measures. The mean AUDIT scores will be compared between groups using student t-tests. Multilevel logistic regression analysis will be performed for binominal variables and multilevel linear regression for continuous variables. Descriptive statistics will be computed for baseline and follow-up assessments. The study will be the first to address problematic alcohol use in PLWHA in Zimbabwe. It seeks to use local resources in delivering a modified, brief, evidence-based, and culturally contextualised intervention. The study results will determine the effectiveness of adapting psychological interventions for AUDs in HIV infected adults using a task-sharing framework. Pan African Clinical Trial Registry, PACTR201509001211149 . Registered 22 July 2015.",Madhombiro M.; Dube-Marimbe B.; Dube M.; Chibanda D.; Zunza M.; Rusakaniko S.; Stewart D.; Seedat S.,2017.0,10.1186/s12888-017-1208-3,0,0,
1488, Long-Term Effects of CBT on Social Impairment in Adolescents with ASD," Anxiety interventions involving social skills training and CBT for youth with ASD have shown promise, but few studies have examined the effects on social functioning or the maintenance of treatment gains. This study evaluated change in social skills during a randomized controlled trial of CBT and during the 1‚Äêyear follow‚Äêup for 25 adolescents with ASD and anxiety. We examined the effect of pretreatment social anxiety and loneliness on treatment response. Social impairment improved during treatment and continued to improve through the 3‚Äêmonth follow‚Äêup. Although adolescents with higher social anxiety had greater pretreatment social impairment, they showed steeper improvement in social skills during treatment. Loneliness was not a significant predictor of change during treatment. CBT targeting social skills and anxiety can lead to long‚Äêterm improvements in social functioning."," Maddox, BB;  Miyazaki, Y;  White, SW",2017.0, 10.1007/s10803-016-2779-4,0,0,
1489,Using a Mobile Application in the Treatment of Dysregulated Anger Among Veterans.,"Anger is a symptom of post-traumatic stress disorder (PTSD) associated with a range of clinical and functional impairments, and may be especially prevalent among veterans with PTSD. Effective anger management therapies exist but may be undermined by poor engagement or lack of treatment availability. Finding ways to engage veterans in anger management therapy or to improve access can be helpful in improving clinical outcomes. This randomized controlled trial compared anger management treatment (AMT) with AMT augmented by a mobile application (app) system, Remote Exercises for Learning Anger and Excitation Management (RELAX). Participants were 58 veterans enrolled in 12 sessions of either AMT alone or AMT with the RELAX system (AMT + RELAX). The RELAX system includes the RELAX app, a wearable heart rate monitor, a remote server, and a web-based therapist interface. RELAX allows the user to practice skills, monitor symptoms, and record physiological data. The server collects data on app use. A web-based interface allows the therapist to access data on between-session practice, and skills use. Measures administered at baseline, post-treatment, and 3-and 6-month follow-up include state and trait anger, dimensions of anger, PTSD, depression, interpersonal functioning, and satisfaction. We used multilevel modeling to account for the nesting of time points within participants and participants within treatment groups. Predictors were Treatment Condition (AMT + RELAX and AMT), Linear Time (baseline, post-treatment, 3-and 6-month follow-up), and Quadratic Time and Treatment Condition √ó Linear Time interaction. All analyses were conducted using SPSS 21 (Armonk, New York). Approval was obtained from the institutional review board. Across groups, the treatment dropout rate was 13.8%; of those who remained in treatment, 90% received an adequate dose of treatment (10 or more sessions). There were no significant differences between groups on attendance or treatment completion. Participants in both treatments demonstrated statistically significant and clinically meaningful reductions in anger severity and significant post-treatment reductions in PTSD. Veterans did not report significant changes in depression or interpersonal functioning. Veterans in the AMT + RELAX group reported spending significantly less time on homework assignments, and they rated the AMT + RELAX app as helpful and easy to use, with these ratings improving over time. Findings suggest that AMT + RELAX was beneficial in reducing anger symptoms and promoting efficient use of the between-session practice; however, AMT + RELAX did not outperform AMT. This study is an important contribution as it is one of the first randomized controlled trials to study the efficacy of a technology-enhanced, evidence-based psychotherapy for anger management. Findings are limited because of small sample size and modifications to the technology during the trial. However, the results highlight the possible benefits of mobile app-supported treatment, including increasing the accessibility of treatment, lowering therapist workload, reducing costs of treatment, reducing practice time, and enabling new activities and types of treatments. This study presents preliminary evidence that mobile apps can be a valuable addition to treatment for patients with anger difficulties. Future research should evaluate how much therapist involvement is needed to support anger management.",Mackintosh MA.; Niehaus J.; Taft CT.; Marx BP.; Grubbs K.; Morland LA.,2017.0,10.7205/MILMED-D-17-00063,0,0,
1490,"Response to Individualized Homeopathic Treatment for Depression in Climacteric Women with History of Domestic Violence, Marital Dissatisfaction or Sexual Abuse: Results from the HOMDEP-MENOP Study.","Although individualized homeopathic treatment is effective for depression in climacteric women, there is a lack of well-designed studies of its efficacy for depression in battered women or in post-traumatic stress disorder. The aim of this study was to assess the association between individualized homeopathic treatment or fluoxetine and response to depression treatment in climacteric women with high levels of domestic violence, sexual abuse or marital dissatisfaction. One hundred and thirty-three Mexican climacteric women with moderate-to-severe depression enrolled in the HOMDEP-MENOP Study (a randomized, placebo-controlled, double-blind, double-dummy, three-arm trial, with a 6-week follow-up study) were evaluated. Domestic violence, marital dissatisfaction and sexual abuse were assessed at baseline. Response to depression treatment was defined by a decrease of 50% or more from baseline score of Hamilton scale. Association between domestic violence, sexual abuse, and marital dissatisfaction and response to depression treatment was analyzed with bivariate analysis in the three groups. Odds ratio (OR) and 95% confidence interval (CI) were calculated. Homeopathy versus placebo had a statistically significant association with response to depression treatment after adjusting for sexual abuse (OR [95% CI]: 11.07 [3.22 to 37.96]), domestic violence (OR [95% CI]: 10.30 [3.24 to 32.76]) and marital dissatisfaction (OR [95% CI]: 8.61 [2.85 to 25.99]). Individualized homeopathic treatment is associated with response to depression treatment in climacteric women with high levels of domestic violence, sexual abuse or marital dissatisfaction. Further studies should be conducted to evaluate its efficacy specifically for post-traumatic stress disorder in battered women. CLINICALTRIALS. NCT01635218,:  URL: http://clinicaltrials.gov/ct2/show/NCT01635218?term=depression+homeopathy&rank=1.",Macías-Cortés EDC.; Llanes-González L.; Aguilar-Faisal L.; Asbun-Bojalil J.,2018.0,10.1055/s-0038-1654709,0,0,
1491,Client Retrospective Accounts of Corrective Experiences in Motivational Interviewing Integrated With Cognitive Behavioral Therapy for Generalized Anxiety Disorder.,"A corrective experience (CE) is one ""in which a person comes to understand or experience affectively an event or relationship in a different and unexpected way"" (Castonguay & Hill, 2012, p. 5). CEs disconfirm clients' expectations based on past problematic experiences, and can be emotional, relational, behavioral, and/or cognitive. This qualitative study explored corrective shifts among recovered participants (N = 8) who had received motivational interviewing (MI) integrated with cognitive behavioral therapy (CBT) in a randomized controlled trial comparing CBT alone to MI-CBT for generalized anxiety disorder (Westra, Constantino, & Antony, 2016). We administered a posttherapy interview querying their experience of, and explanations for, any shifts in therapy. Grounded theory analysis yielded three core themes: in command of the worry train, experiencing myself in new ways in therapy, and oriented toward change. Findings are discussed in terms of MI theory, and clinical implications for therapists are provided.",Macaulay C.; Angus L.; Khattra J.; Westra H.; Ip J.,2017.0,10.1002/jclp.22430,0,0,
1492,Distress Intolerance Moderation of Neurophysiological Markers of Response Inhibition After Induced Stress: Relations With Cannabis Use Disorder,"Cannabis use is prevalent but only a minority of regular users develop cannabis use disorder (CUD); thus, CUD risk identification among current cannabis users is vital for targeted intervention development. Existing data suggest that high distress intolerance (DI), an individual difference reflective of the ability to withstand negative affect, is linked to CUD, possibly via stress-elicited impairment of response inhibition but this has never been explicitly tested. Frequent cannabis users with high and low DI completed a go/no-go task during EEG recording before and after a laboratory stressor. Relations between DI, cannabis use-related problems, and behavioral as well as neurophysiological markers of response inhibition functioning were assessed. DI significantly moderated the effect of the stressor on the conflict-monitoring but not evaluative phase of response inhibition as measured by N2 and P3a amplitude, respectively. Unexpectedly, cannabis users with high DI demonstrated stressor-elicited enhancement rather than impairment of conflict-monitoring neural activity, which was related to faster reaction time (RT) and decreased past-month cannabis problems. Enhanced inhibition-related modulation of P3a amplitude was generally associated with increased cannabis problems regardless of acute stress. Results did not provide support for stress-elicited impairment in cognitive control as a mechanism linking high DI and CUD, though some support was found for the relevance of inhibition-related neural activity to CUD. Stress-elicited enhancement of conflict-monitoring neural activity during response inhibition may reflect an adaptive neural response among cannabis users with high DI that protects against CUD in this at-risk group.",Macatee R.J.; Albanese B.J.; Crane N.A.; Okey S.A.; Cougle J.R.; Schmidt N.B.,2018.0,10.1037/adb0000418,0,0,
1493, Evaluating the Effectiveness of a School-Based Cognitive Behavioural Therapy Intervention for Anxiety in Adolescents Diagnosed with Autism Spectrum Disorder," This study evaluated the effectiveness of a school‚Äêbased Cognitive Behavioural Therapy (CBT) on symptoms of anxiety, social worry and social responsiveness, and indices of attentional control and attentional biases to threat in adolescents diagnosed with Autism Spectrum Disorder. Thirty‚Äêfive young people (11‚Äê14 years; IQ > 70) with ASD and elevated teacher or parent reported anxiety were randomly assigned to 6 sessions of the Exploring Feelings CBT intervention (Attwood in Exploring feelings (anxiety). Future Horizons, Arlington, 2004) (n = 18) or a wait‚Äêlist control group (n = 17). The intervention (compared to the wait‚Äêlist control) group showed positive change for parent, teacher and self‚Äêreported anxiety symptoms, and more marginal effects of increased teacher‚Äêreported social responsiveness. The discussion highlights the potential value and limitations of school‚Äêbased CBT for young people with ASD."," Luxford, S;  Hadwin, JA;  Kovshoff, H",2017.0, 10.1007/s10803-016-2857-7,0,0,
1494,Physiological effects of a spit sock,"Objectives: Healthcare providers and law enforcement utilize spit socks to prevent exposure to communicable diseases transmitted by bodily fluid projection from agitated individuals. There are cases in which death is reported due to breathing being limited by a spit sock. There are no formally published studies on their use and safety. The aim of this study was to evaluate whether wearing a spit sock causes a clinically significant impact on breathing. Methods: Subjects sat with the spit mask over their heads for 15 min and their vital signs and ventilatory parameters were recorded after 5 min, 10 min and 15 min. Data were compared to baseline using Student's t-test with 95% confidence intervals using SPSS. Results: The median age of the 15 subjects was 28 years and 53% were male. There was no significant difference between baseline and wearing the spit sock for 5, 10 or 15 min for heart rate (p = 0.250, p = 0.181, p = 0.546), oxygen saturation (p = 0.334, p = 1.00, p = 0.173), end-tidal pCO2 (p = 0.135, p = 0.384, p = 0.187), and diastolic blood pressure (p = 0.485, p = 0.508, p = 0.915). The respiratory rate was not significantly different after 5 and 10 min (p = 0.898, p = 0.583), but decreased at 15 min (p = 0.048). The systolic blood pressure was lower after 5 and 10 min (p = 0.028, p = 0.045), but not significantly different at 15 min (p = 0.146). No subject indicated distress nor did the study need to be terminated due to pre-determined concerning vital signs or ventilatory parameters. Conclusions: In healthy subjects there were no clinically significant changes in the physiologic parameters of breathing while wearing a spit sock.",Lutz M.; Sloane C.M.; Castillo E.M.; Brennen J.J.; Coyne C.J.; Swift S.L.; Vilke G.M.,2018.0,10.1016/j.ajem.2018.09.050,0,0,
1495, Behavioral Treatment for Veterans with Obesity: 24-Month Weight Outcomes from the ASPIRE-VA Small Changes Randomized Trial," BACKGROUND: Small Changes (SC) is a weight management approach that demonstrated superior 12‚Äêmonth outcomes compared to the existing MOVE! OBJECTIVE: The purpose of the present study was to examine the effectiveness of a second year of low‚Äêintensity SC support compared to support offered by the usual care MOVE! programs. DESIGN: Following participation in the year‚Äêlong Aspiring to Lifelong Health in VA (ASPIRE‚ÄêVA) randomized controlled trial, participants were invited to extend their participation in their assigned program for another year. Three programs were extended to include six SC sessions delivered via telephone (ASPIRE‚ÄêPhone) or an in‚Äêperson group (ASPIRE‚ÄêGroup), or 12 sessions offered by the MOVE! programs. PARTICIPANTS: Three hundred thirty‚Äêtwo overweight/obese veterans who consented to extend their participation in the ASPIRE‚ÄêVA trial by an additional year. MAIN MEASURES: Twenty‚Äêfour‚Äêmonth weight change (kg). KEY RESULTS: Twenty‚Äêfour months after baseline, participants in all three groups had modest weight loss (‚Äê1.40 kg [‚Äê2.61 to ‚Äê0.18] in the ASPIRE‚ÄêGroup, ‚Äê2.13 kg [‚Äê3.43 to ‚Äê0.83] in ASPIRE‚ÄêPhone, and ‚Äê1.78 kg [‚Äê3.07 to ‚Äê0.49] in MOVE!), with no significant differences among the three groups. Exploratory post hoc analyses revealed that participants diagnosed with diabetes initially benefited from the ASPIRE‚ÄêGroup program (‚Äê2.6 kg [‚Äê4.37 to 0.83]), but experienced significant weight regain during the second year (+2.8 kg [0.92‚Äê4.69]) compared to those without diabetes. CONCLUSIONS: Participants in all three programs lost weight and maintained a statistically significant, though clinically modest, amount of weight loss over a 24‚Äêmonth period. Although participants in the ASPIRE‚ÄêGroup initially had greater weight loss, treatment was not sufficient to sustain weight loss through the second year, particularly in veterans with diabetes. Consistent, continuous‚Äêcare treatment is needed to address obesity in the VA."," Lutes, LD;  Damschroder, LJ;  Masheb, R;  Kim, HM;  Gillon, L;  Holleman, RG;  Goodrich, DE;  Lowery, JC;  Janney, C;  Kirsh, S;  et al.",2017.0, 10.1007/s11606-017-3987-0,0,0,
1496,How acute stress may enhance subsequent memory for threat stimuli outside the focus of attention: DLPFC-amygdala decoupling,"Stress-related disorders, e.g., anxiety and depression, are characterized by decreased top-down control for distracting information, as well as a memory bias for threatening information. However, it is unclear how acute stress biases mnemonic encoding and leads to prioritized storage of threat-related information even if outside the focus of attention. In the current study, healthy adults (N = 53, all male) were randomly assigned to stress induction using the socially evaluated cold-pressor test (SECPT) or a control condition. Participants performed a task in which they were required to identify a target letter within a string of letters that were either identical to the target and thereby facilitating detection (low distractor load) or mixed with other letters to complicate the search (high load). Either a fearful or neutral face was presented on the background, outside the focus of attention. Twenty-four hours later, participants were asked to perform a surprise recognition memory test for those background faces. Stress induction resulted in increased cortisol and negative subjective mood ratings. Stress did not affect visual search performance, however, participants in the stress group showed stronger memory compared to the control group for fearful faces in the low attentional load condition. Critically, the stress induced memory bias was accompanied by decoupling between amygdala and DLFPC during encoding, which may represent a mechanism for decreased ability to filter task-irrelevant threatening background information. The current study provides a potential neural account for how stress can produce a negative memory bias for threatening information even if presented outside the focus of attention. Despite of an adaptive advantage for survival, such tendencies may ultimately also lead to generalized fear, a possibility requiring additional investigation.",Luo Y.; Fern√°ndez G.; Hermans E.; Vogel S.; Zhang Y.; Li H.; Klumpers F.,2018.0,10.1016/j.neuroimage.2018.01.010,0,0,
1497, Sex-dependent neural effect of oxytocin during subliminal processing of negative emotion faces," In line with animal models indicating sexually dimorphic effects of oxytocin (OXT) on social‚Äêemotional processing, a growing number of OXT‚Äêadministration studies in humans have also reported sex‚Äêdependent effects during social information processing. To explore whether sex‚Äêdependent effects already occur during early, subliminal, processing stages the present pharmacological fMRI‚Äêstudy combined the intranasal‚Äêapplication of either OXT or placebo (n = 86‚Äê43 males) with a backward‚Äêmasking emotional face paradigm. Results showed that while OXT suppressed inferior frontal gyrus, dorsal anterior cingulate and anterior insula responses to threatening face stimuli in men it increased them in women. In women increased anterior cingulate reactivity during subliminal threat processing was also positively associated with trait anxiety. On the network level, sex‚Äêdependent effects were observed on amygdala, anterior cingulate and inferior frontal gyrus functional connectivity that were mainly driven by reduced coupling in women following OXT. Our findings demonstrate that OXT produces sex‚Äêdependent effects even at the early stages of social‚Äêemotional processing, and suggest that while it attenuates neural responses to threatening social stimuli in men it increases them in women. Thus in a therapeutic context OXT may potentially produce different effects on anxiety disorders in men and women."," Luo, L;  Becker, B;  Geng, Y;  Zhao, Z;  Gao, S;  Zhao, W;  Yao, S;  Zheng, X;  Ma, X;  Gao, Z;  et al.",2017.0, 10.1016/j.neuroimage.2017.08.079,0,0,
1498,"Perceived parental bonding, early maladaptive schemas and outcome in schema therapy of cluster c personality problems.","Objective: The objective of this paper was to examine the relationships between perceived parental bonding, Early Maladaptive Schemas (Young et al., 2003), and outcome of schema therapy of Cluster C personality problems and whether the perceptions of parental bonding could be influenced by schema therapy. Method: The sample consisted of 45 patients with panic disorder and/or agoraphobia and Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Cluster C personality traits who participated in an 11-week inpatient programme consisting of two phases; the first was a 5-week panic/agoraphobia-focused cognitive therapy, whereas the second phase was a personality-focused schema therapy. The patients were assessed at pre-treatment, mid-treatment and post-treatment and at 1-year follow-up. Results: Opposite to our hypothesis, lower paternal care at pre-treatment was related to more reduction in Cluster C personality traits from pre-treatment to 1-year follow-up. Maternal protection was related to the schema domains of impaired autonomy and exaggerated standards. Overall schema severity and the schema emotional inhibition at pre-treatment were associated with less change in Cluster C traits. Perceived maternal care was reduced from pre-treatment to 1-year follow-up, and more reduction in maternal care was related to less reduction in Cluster C traits. Discussion: Parental bonding failed to predict treatment outcome in the expected direction, but maternal protection was related to two of the schema domains. Overall schema severity and the particular schema emotional inhibition predicted outcome. Furthermore, perceived maternal care was reduced from before to after treatment. Future studies should examine these questions in larger samples of Cluster C patients receiving schema therapy of a longer duration. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Lunding, Synve Hoffart; Hoffart, Asle",2016.0,http://dx.doi.org/10.1002/cpp.1938,0,0,
1499,"Attentional bias, self-consciousness and perfectionism in social phobia before and after cognitive-behaviour therapy.","Attentional bias for threat words (as measured by the emotional Stroop task), self-consciousness and perfectionism was studied in 24 patients with social phobia before and after cognitive-behaviour treatment. A total of 18 (75%) of the patients were classified as treatment responders on the basis of reduced scores for social anxiety. The treatment responders showed a significant reduction in attentional bias for social threat words, in public self-consciousness and in perfectionism. The nonresponders showed an equal reduction in perfectionism; as they had a much higher level of perfectionism before treatment, however, their change only amounted to a lowering of their level of perfectionism to the level that characterized the treatment responders before treatment. The treatment responders, on the other hand, reduced their level of perfectionism to that of nonclinical samples. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lundh, Lars-Gunnar; Ost, Lars-Goran",2001.0,http://dx.doi.org/10.1080/028457101300140428,0,0,
1500,Association between kinesiophobia and walking gait characteristics in physically active individuals with anterior cruciate ligament reconstruction.,"Individuals with anterior cruciate ligament reconstruction (ACLR) demonstrate persistent alterations in walking gait characteristics that contribute to poor long-term outcomes. Higher kinesiophobia, or fear of movement/re-injury, may result in the avoidance of movements that increase loading on the ACLR limb. Determine the association between kinesiophobia and walking gait characteristics in physically active individuals with ACLR. We enrolled thirty participants with a history of unilateral ACLR (49.35 ± 27.29 months following ACLR) into this cross-sectional study. We used the Tampa Scale for Kinesiophobia (TSK-11) to measure kinesiophobia. We collected walking gait characteristics during a 60-s walking trial, which included gait speed, peak vertical ground reaction force (vGRF), instantaneous vGRF loading rate, peak internal knee extension moment (KEM), and knee flexion excursion. We calculated lower extremity kinetic and kinematic measures on the ACLR limb, and limb symmetry indices between ACLR and contralateral limbs (LSI= [ACLR/contralateral]*100). We used linear regression models to determine the association between TSK-11 score and each walking gait characteristic. We determined the change in R2 (ΔR2) when adding TSK-11 scores into the linear regression model after accounting for demographic covariates (sex, Tegner activity score, graft type, time since reconstruction, history of concomitant meniscal procedure). We did not find a significant association between kinesiophobia and self-selected gait speed (ΔR2 0.038, P = 0.319). Kinesiophobia demonstrated weak, non-significant associations with kinetic and kinematic outcomes on the ACLR limb and all LSI outcomes (ΔR2 range = 0.001-0.098). These data do not support that kinesiophobia is a critical factor contributing to walking gait characteristics in physically active individuals with ACLR.",Luc-Harkey BA.; Franz JR.; Losina E.; Pietrosimone B.,2018.0,10.1016/j.gaitpost.2018.06.029,0,0,
1501,Lesser lower extremity mechanical loading associates with a greater increase in serum cartilage oligomeric matrix protein following walking in individuals with anterior cruciate ligament reconstruction,"BACKGROUND: Aberrant mechanical loading during gait is hypothesized to contribute to the development of posttraumatic osteoarthritis following anterior cruciate ligament reconstruction. Our purpose was to determine if peak vertical ground reaction force and instantaneous vertical ground reaction force loading rate associate with the acute change in serum cartilage oligomeric matrix protein following a 20-minute bout of walking. METHODS: We enrolled thirty individuals with a unilateral anterior cruciate ligament reconstruction. Peak vertical ground reaction force and instantaneous vertical ground reaction force loading rate were extracted from the first 50% of the stance phase of gait during a 60-second trial. Blood samples were collected immediately before and after 20 min of treadmill walking at self-selected speed. The change in serum cartilage oligomeric matrix protein from pre- to post-walking was calculated. Stepwise linear regression models were used to determine the association between each outcome of loading and the change in serum cartilage oligomeric matrix protein after accounting for sex, gait speed, time since anterior cruciate ligament reconstruction, graft type, and history of concomitant meniscal procedure (ΔR2). FINDINGS: Lesser peak vertical ground reaction force (ΔR2 = 0.208; β = -0.561; P = 0.019) and instantaneous vertical ground reaction force loading rate (ΔR2 = 0.168; β = -0.519; P = 0.037) on the anterior cruciate ligament reconstructed limb associated with a greater increase in serum cartilage oligomeric matrix protein following 20 min of walking. INTERPRETATION: Mechanical loading may be a future therapeutic target for altering the acute biochemical response to walking in individuals with an anterior cruciate ligament reconstruction.",Luc-Harkey B.A.; Franz J.R.; Hackney A.C.; Blackburn J.T.; Padua D.A.; Pietrosimone B.,2018.0,10.1016/j.clinbiomech.2018.09.024,0,0,
1502,Postpartum outcomes and formal mindfulness practice in mindfulness-based cognitive therapy for perinatal women.,"Anxiety is common during pregnancy and associated with poorer outcomes for mother and child. Our single-arm pilot study of an 8-week mindfulness-based cognitive therapy (MBCT) intervention for pregnant women with elevated anxiety showed significant pre- to post-intervention improvements in anxiety, depression, worry, mindfulness, and self-compassion. It remains unclear whether these improvements are maintained postpartum and whether amount of formal mindfulness practice is correlated with outcomes. The current study examined whether (1) improvements in psychosocial outcomes were maintained 3 months postpartum; (2) women were adherent to formal practice recommendations; and (3) amount of mindfulness practice was correlated with outcomes. Twenty-three pregnant women (Mage = 33.5, SD = 4.40; 75% White; 71% with generalized anxiety disorder) completed home practice logs throughout the intervention, and self-report measures before and after the intervention and 3 months postpartum. Results indicated that previously reported post-intervention improvements in anxiety, worry, mindfulness, and self-compassion were maintained postpartum (p's < .05), and reductions in depression further improved (p < .001). Participants were generally adherent to mindfulness practice recommendations during the intervention (54-80% weekly adherence; M = 17.31 total practice hours [SD = 7.45]), and many continued practicing 1 week post-intervention (91%) and postpartum (55%). Mindfulness practice during the intervention was not significantly correlated with any outcome at post-intervention or postpartum. Mindfulness practice postpartum was only marginally related to improved worry postpartum (p = .05). MBCT may be associated with maintained improvements in psychosocial outcomes for women during pregnancy and postpartum, but the role of mindfulness practice is unclear. Research using larger samples and randomized controlled designs is needed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Luberto, Christina M; Park, Elyse R; Goodman, Janice H",2018.0,http://dx.doi.org/10.1007/s12671-017-0825-8,0,0,
1503,Early life adversity diminishes the cortisol response to opioid blockade in women: Studies from the family health patterns project,"Early life adversity (ELA) contributes to behavioral impulsivity along with risk for substance use disorders, both accompanied by blunted stress-axis reactivity. However, the biological contributors to blunted stress reactivity are not known. We took advantage of the fact that women have significant opioid inhibition of cortisol output by using the opioid antagonist, naltrexone, to unmask opioid interactions due to ELA. We administered 50 mg of naltrexone or placebo to 72 healthy women (23 years of age) in a double-blind crossover study and observed deviations in cortisol secretion from placebo over the next 180 minutes. ELA was assessed by reported exposure to physical and sexual abuse or neglect and low socioeconomic status and scored as Low, Medium, or High (0, 1-2, and 3+). The ELA groups all had identical placebo-day cortisol secretion, indicating normal basal regulation of the hypothalamic-pituitary-adrenocortical axis. Cortisol rises to naltrexone were largest in the Low-ELA group and strongly blunted in the High-ELA group (F = 3.51, p = 0.035), indicating a lack of opioid function in women with high degrees of ELA. The Low-ELA women reported dys-phoric responses to naltrexone (F = 4.05, p = .022) indicating a mild opioid withdrawal, an effect that was absent in the High-ELA group. Women exposed to ELA have blunted cortisol responses to naltrexone, indicating reduced opioid regulation of the stress axis. Central opioid changes may be one pathway linking ELA to blunted stress reactivity in adulthood.",Lovallo W.R.; Acheson A.; Vincent A.S.; Sorocco K.H.; Cohoon A.J.,2018.0,10.1371/journal.pone.0205723,0,0,
1504,A randomized controlled trial of 'MUMentum Pregnancy': Internet-delivered cognitive behavioral therapy program for antenatal anxiety and depression.,"Background: Anxiety and depression are common during pregnancy and associated with adverse outcomes for the mother and infant if left untreated. Despite the need to improve treatment accessibility and uptake in this population, no studies have investigated internet-delivered cognitive behavioural therapy (iCBT) for antenatal anxiety and depression. In a randomised controlled trial, we examined the efficacy and acceptability of a brief, unguided iCBT intervention-the MUMentum Pregnancy program-in pregnant women with anxiety and/or depression. Methods: Participants meeting clinical threshold on validated self-report measures of generalised anxiety and/or depression were recruited online and randomised to iCBT (n = 43) or a treatment as usual (TAU) control (n = 44). Outcomes were assessed at baseline, post-treatment and four-week follow-up; and included anxiety, depression, psychological distress, antenatal bonding, quality of life, and treatment acceptability. Results: Of the 36 women who started iCBT, 26 completed all three lessons of treatment (76% adherence rate). iCBT produced moderate to large effect size reductions for anxiety on the GAD-7 (Hedges' g = 0.76) and psychological distress on the Kessler-10 (g = 0.88) that were superior to TAU. Only small nonsignificant differences were found for depression outcomes (g = < 0.35). Participants reported that iCBT was an acceptable treatment for antenatal anxiety and/or depression. Limitations: Lack of an active control condition and long-term postpartum follow-up. Conclusions: This is the first study to evaluate brief unguided iCBT for antenatal anxiety and depression. While our findings are promising, particularly for anxiety reduction, additional RCTs are required to establish treatment efficacy. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Loughnan, Siobhan A; Sie, Amanda; Hobbs, Megan J; Joubert, Amy E; Smith, Jessica; Haskelberg, Hila; Mahoney, Alison E. J; Kladnitski, Natalie; Holt, Christopher J; Milgrom, Jeannette; Austin, Marie-Paule; Andrews, Gavin; Newby, Jill M",2019.0,http://dx.doi.org/10.1016/j.jad.2018.09.057,0,0,
1505, Effects of Combined Foot Massage and Cognitive Behavioral Therapy on the Stress Response in Middle-Aged Women," OBJECTIVE: Several intervention studies have suggested that foot massage and cognitive behavioral therapy (CBT) are beneficial for reducing the stress response. However, no randomized control trials have been conducted to examine these effects in middle‚Äêaged women, who are more commonly exposed to stress relative to others. This study aimed to examine the effects of combined self‚Äêadministered foot massage and CBT on the psychophysiological stress response in Korean middle‚Äêaged women. DESIGN: Randomized controlled trial. SETTING: Subjects were recruited from the social welfare center in Sahmcheok, Kangwondo, Korea. The subjects performed some of the massage at the center and some at home, and CBT was performed at the center. SUBJECTS: Fifty‚Äêthree women aged 45‚Äê64 years were randomly assigned to Group A (intervention, n‚Äâ=‚Äâ31) or B (usual care, n‚Äâ=‚Äâ30). INTERVENTION: Combined self‚Äêadministered foot massage and CBT. OUTCOME MEASURES: Depression, anxiety, stress, blood pressure, heart rate, blood glucose (BG), and oxygen saturation were measured at baseline and 3‚Äêweek follow‚Äêup. RESULTS: Mean depression scores (p‚Äâ=‚Äâ0.021), stress scores (p‚Äâ=‚Äâ0.009), systolic blood pressure (SBP) (p‚Äâ=‚Äâ0.035), and BG levels (p‚Äâ=‚Äâ0.007) had decreased significantly subsequent to the intervention. CONCLUSION: Combined self‚Äêadministered foot massage and CBT led to reductions in depression, stress, SBP, and BG levels. Therefore, the intervention could be an effective means of reducing the stress response in middle‚Äêaged women."," Lee, YM;  Yeun, YR",2017.0, 10.1089/acm.2016.0421,0,0,
1506,"Prompt mental health care, the Norwegian version of IAPT: Clinical outcomes and predictors of change in a multicenter cohort study.","Background: Prompt mental health care (PMHC) is a Norwegian initiative, inspired by the English 'Improving Access to Psychological Therapy' (IAPT), aimed to provide low-threshold access to primary care treatment for persons with symptoms of anxiety and depression. The objectives of the present study are to describe the PMHC service, to examine changes in symptoms of anxiety and depression following treatment and to identify predictors of change, using data from the 12 first pilot sites. Methods: A prospective cohort design was used. All participants were asked to complete questionnaires at baseline, before each treatment session and at the end of treatment. Effect sizes (ES) for pre-post changes and recovery rates were calculated based on the Patient Health Questionnaire and the Generalized Anxiety Disorder scale. Multiple imputation (MI) was used in order to handle missing data. We examined predictors through latent difference score models and reported the contribution of each predictor level in terms of ES. Results: In total, N = 2512 clients received treatment at PMHC between October 2014 and December 2016, whereof 61% consented to participate. The changes from pre- to post-treatment were large for symptoms of both depression (ES = 1.1) and anxiety (ES = 1.0), with an MI-based reliable recovery rate of 58%. The reliable recovery rate comparable to IAPT based on last-observation-carried-forward was 48%. The strongest predictors for less improvement were having immigrant background (ES change depression -0.27, ES change anxiety -0.26), being out of work at baseline (ES change depression -0.18, ES change anxiety -0.35), taking antidepressants (ES change anxiety -0.36) and reporting bullying as cause of problems (ES change depression -0.29). Taking sleep medication did on the other hand predict more improvement (ES change depression 0.23, ES change anxiety 0.45). Conclusions: Results in terms of clinical outcomes were promising, compared to both the IAPT pilots and other benchmark samples. Though all groups of clients showed substantial improvements, having immigrant background, being out of work, taking antidepressant medication and reporting bullying as cause stood out as predictors of poorer treatment response. Altogether, PMHC was successfully implemented in Norway. Areas for improvement of the service are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Knapstad, Marit; Nordgreen, Tine; Smith, Otto R. F",2018.0,,0,0,
1507, Optimizing exposure-based CBT for anxiety disorders via enhanced extinction: design and methods of a multicentre randomized clinical trial," Exposure‐based psychological interventions currently represent the empirically best established first line form of cognitive‐behavioural therapy for all types of anxiety disorders. Although shown to be highly effective in both randomized clinical and other studies, there are important deficits: (1) the core mechanisms of action are still under debate, (2) it is not known whether such treatments work equally well in all forms of anxiety disorders, including comorbid diagnoses like depression, (3) it is not known whether an intensified treatment with more frequent sessions in a shorter period of time provides better outcome than distributed sessions over longer time intervals. This paper reports the methods and design of a large‐scale multicentre randomized clinical trial (RCT) involving up to 700 patients designed to answer these questions. Based on substantial advances in basic research we regard extinction as the putative core candidate model to explain the mechanism of action of exposure‐based treatments. The RCT is flanked by four add‐on projects that apply experimental neurophysiological and psychophysiological, (epi)genetic and ecological momentary assessment methods to examine extinction and its potential moderators. Beyond the focus on extinction we also involve stakeholders and routine psychotherapists in preparation for more effective dissemination into clinical practice."," Heinig, I;  Pittig, A;  Richter, J;  Hummel, K;  Alt, I;  Dickhöver, K;  Gamer, J;  Hollandt, M;  Koelkebeck, K;  Maenz, A;  et al.",2017.0, 10.1002/mpr.1560,0,0,
1508, Autonomic markers associated with generalized social phobia symptoms: heart rate variability and salivary alpha-amylase," The study of autonomic nervous system changes associated with generalized social phobia (GSP) disorder has increased in recent years, showing contradictory results. The present study aimed to evaluate how young people with GSP reacted before, during, and after exposure to the Trier Stress Social Test (TSST), focusing on their autonomic changes (heart rate variability (HRV) and salivary alpha‐amylase (sAA)) compared to a control group (non‐GSP). Some psychological variables were also considered. Sex was specifically studied as a possible modulator of autonomic fluctuations and psychological state. Eighty young people were randomly distributed into two counterbalanced situations: stress condition (N = 18 and 21 for GSP and non‐GSP, respectively) and control condition (N = 21 and 20 for GSP and non‐GSP, respectively), where cardiovascular variables were continuously recorded. Psychological questionnaires about mood and perceived stress were filled out, and five saliva samples were collected to analyze sAA. GSP participants showed higher values on low‐ and high‐frequency ratios (HR domains), compared to non‐GSP people, during exposure to the TSST, but no differences were observed after the stressor. Furthermore, the two groups did not differ in sAA. Importantly, positive affect in GSP participants was modulated by sex. The present study suggests that the balance between high‐ and low‐frequency domains of HRV is a key cardiovascular marker reflecting the stress response of GSP people, as well the importance of sex in positive affect when facing a stressful situation."," García-Rubio, MJ;  Espín, L;  Hidalgo, V;  Salvador, A;  Gómez-Amor, J",2017.0, 10.1080/10253890.2016.1265939,0,0,
1509," Use of the PREPARE (PREhabilitation, Physical Activity and exeRcisE) program to improve outcomes after lumbar fusion surgery for severe low back pain: a study protocol of a person-centred randomised controlled trial"," BACKGROUND: Following lumbar fusion surgery, a successful outcome is empirically linked to effective rehabilitation. While rehabilitation is typically postoperative, the phase before surgery ‐ termed prehabilitation ‐ is reportedly an ideal time to prepare the patient. There are presently no guidelines for prehabilitation before lumbar fusion surgery. Physical activity has well‐known health benefits, and staying physically active despite pain is a major principle in non‐pharmacological chronic low back pain treatment. Psychological factors such as fear of movement, pain catastrophizing and low self‐efficacy are known to be barriers to staying active. No studies have investigated prehabilitation protocols that promote physical activity and target psychological risk factors before lumbar fusion surgery. The aim of our proposed randomised controlled trial is to investigate whether patients who undergo lumbar fusion surgery for degenerative disc disease experience better functioning with a physiotherapeutic prehabilitation program (PREPARE) based on a cognitive behavioural approach compared to conventional care. METHODS/DESIGN: We will recruit 110 patients between 18‐70 years of age with degenerative disc disease who are waiting for lumbar fusion surgery. These patients will be randomly assigned to receive either PREPARE or conventional care. PREPARE uses a person‐centred perspective and focuses on promoting physical activity and targeting psychological risk factors before surgery. The primary outcome will be disability measured using the Oswestry Disability Index 2.0. Secondary outcomes will include functioning (patient‐reported and performance‐based), physical activity (accelerometer), health‐related quality of life, back and leg pain intensity, pain catastrophizing, kinesiophobia, self‐efficacy, depression, anxiety, satisfaction with treatment results and health economic factors. Data will be collected at baseline (preoperatively) after the intervention (preoperatively), 3 and 8 weeks, 3, 6, 12, 24 and 60 months postoperatively. DISCUSSION: We hypothesise that the focus on promoting physical activity and targeting psychological risk factors before surgery will decrease disability and help the patients to be more active despite pain both before and after surgery. We will use a combination of outcome measures both patient‐reported and performance‐based, as well as accelerometer data. This will provide a more comprehensive picture of the patient's functioning than just patient‐reported outcomes alone. TRIAL REGISTRATION: Current Controlled Trials ISCRTN17115599 , Retrospectively Registered 18 May 2015."," Lotzke, H;  Jakobsson, M;  Brisby, H;  Gutke, A;  Hägg, O;  Smeets, R;  den Hollander, M;  Olsson, LE;  Lundberg, M",2016.0, 10.1186/s12891-016-1203-8,0,0,
1510,"Dissemination, etiology, pathogenesis and treatment of cattle teat diseases in agricultural organizations of the Sverdlovsk region of Russian Federation","In the highly productive herds of the Sverdlovsk region of Russian Federation, the cattle teat diseases are widespread and are registered by 11.9-56.6% of all examined udder quarters. The spread of teat diseases increases, correspondingly to the growth of milk production. At the same time, a significant percentage is revealed even with the use of automatic milking directly on the udder quarter. The studies showed that there is milking systems influence on the udder condition - the thermographic inspection showed that the udder surface temperature during milking decreases, but the teat surface temperature increases. However, the temperature increase depends on condition and type of milking equipment and teat cup liner. The permanent udder injury by automatic milking is confirmed by the presence of occult blood in 26.2-68.6% of samples. The main etiological factor in the development of teat diseases is the automatic milking, as well as a violation of milking technology and inadequate milking equipment. The location and size of teats, the shape of the udder, and the internal anatomical features of the structure also influence the occurrence of teat pathology and their injury level. In the course of the research, it was noted that if the mucous membrane has many folds in the teat part of gland cistern, then the teat injury level increases. A study of the defected teat internal structure under hyperkeratosis has shown that 35-40% of the length of the teat canal is damaged and shorter by 11.5% compared to nipples having an adequate physiological response to automatic milking represented by a circular callus, as well as an increase in its lumen in the region of the external opening. When the defect is in the form of a circular callus, there is a change in the mucosa by 12% of the length of the canal. Histological examination revealed changes in the teat tissues that characterize post-traumatic state: the presence of ruptures in the mucous membrane, edema, vascular reaction, micronecrosis foci, thickening of the stratum corneum and its sloughing. The use of silicone glycerogyrogel «Silativit» and pharmacological compositions based on it for the treatment of lactating cows with various forms of hyperkeratosis and teat injuries is highly effective and does not affect milking technology; it is evidenced by ultrasound and histological examination of the udder teat tissues. In addition, this drug allows short course treatments, since they have a pronounced prolonged effect on the tissue, despite the persistent effect of the etiologic factor.",Loretts O.G.; Barkova A.S.; Elesin A.V.; Khonina T.G.; Shurmanova E.I.; Barashkin M.I.; Milstein I.M.,2018.0,,0,0,
1511, Complaint-Directed Mini-Interventions for Depressive Complaints: a Randomized Controlled Trial of Unguided Web-Based Self-Help Interventions," BACKGROUND: Prevention of depression is important due to the substantial burden of disease associated with it. To this end, we developed a novel, brief, and low‚Äêthreshold Web‚Äêbased self‚Äêhelp approach for depressive complaints called complaint‚Äêdirected mini‚Äêinterventions (CDMIs). These CDMIs focus on highly prevalent complaints that are demonstrably associated with depression and have a substantial economic impact: stress, sleep problems, and worry. OBJECTIVE: The aim was to evaluate the effectiveness of the Web‚Äêbased self‚Äêhelp CDMIs in a sample of adults with mild‚Äêto‚Äêmoderate depressive symptoms compared to a wait‚Äêlist control group. METHODS: A two‚Äêarmed randomized controlled trial was conducted. An open recruitment strategy was used. Participants were randomized to either the Web‚Äêbased CDMIs or the no‚Äêintervention wait‚Äêlist control group. The CDMIs are online, unguided, self‚Äêhelp interventions, largely based on cognitive behavioral techniques, which consist of 3 to 4 modules with up to 6 exercises per module. Participants are free to choose between the modules and exercises. Assessments, using self‚Äêreport questionnaires, took place at baseline and at 3 and 6 months after baseline. The control group was given access to the intervention following the 3‚Äêmonth assessment. The primary goal of the CDMIs is to reduce depressive complaints. The primary outcome of the study was a reduction in depressive complaints as measured by the Inventory of Depressive Symptomatology Self‚ÄêReport (IDS‚ÄêSR). Secondary outcomes included reductions in stress, worry, sleep problems, and anxiety complaints, and improvements in well‚Äêbeing. Data were analyzed using linear mixed models. RESULTS: In total, 329 participants enrolled in the trial, of which 165 were randomized to the intervention group and 164 to the control group. Approximately three‚Äêquarters of the intervention group actually created an account. Of these participants, 91.3% (116/127) logged into their chosen CDMI at least once during the 3‚Äêmonth intervention period (median 3, range 0‚Äê166). After 3 months, there was a significant reduction in depressive symptomatology for participants in the intervention group compared to participants in the wait‚Äêlist control group (reduction in depression: mean ‚Äê4.47, 95% CI ‚Äê6.54 to ‚Äê2.40; Cohen d=‚Äê0.70). Furthermore, significant effects were observed for sleep problems, worry, anxiety, and well‚Äêbeing, with effect sizes ranging from ‚Äê0.29 to ‚Äê0.40. The intervention did not significantly reduce stress. At 6‚Äêmonth follow‚Äêup, the improvements in the intervention group were generally sustained. CONCLUSIONS: This study shows that the online self‚Äêhelp CDMIs have a positive impact on various mental health outcomes. Future research should focus on which specific strategies may boost adherence, and increase the reach of the CDMIs among people with low socioeconomic status. CLINICALTRIAL: Netherlands Trial Register (NTR): NTR4612; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4612 (Archived by WebCite at http://www.webcitation.org/6n4PVYddM)."," Lokman, S;  Leone, SS;  Sommers-Spijkerman, M;  van der Poel, A;  Smit, F;  Boon, B",2017.0, 10.2196/jmir.6581,0,0,
1512,Feasibility Study Combining Art Therapy or Cognitive Remediation Therapy with Family-based Treatment for Adolescent Anorexia Nervosa.,"Adolescents with anorexia nervosa who have obsessive-compulsive (OC) features respond poorly to family-based treatment (FBT). This study evaluated the feasibility of combining FBT with either cognitive remediation therapy (CRT) or art therapy (AT) to improve treatment response in this at-risk group. Thirty adolescents with anorexia nervosa and OC features were randomized to 15 sessions of FBT + CRT or AT. Recruitment rate was 1 per month, and treatment attrition was 16.6% with no differences between groups. Suitability, expectancy and therapeutic relationships were acceptable for both combinations. Correlations between changes in OC traits and changes in cognitive inefficiencies were found for both combinations. Moderate changes in cognitive inefficiencies were found in both groups but were larger in the FBT + AT combination. This study suggests that an RCT for poor responders to FBT because of OC traits combining FBT with either CRT or AT is feasible to conduct. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.",Lock J.; Fitzpatrick KK.; Agras WS.; Weinbach N.; Jo B.,2018.0,10.1002/erv.2571,0,0,
1513,Preoperative Pain Neuroscience Education Combined With Knee Joint Mobilization for Knee Osteoarthritis: A Randomized Controlled Trial.,"This study aimed to first compare the effects of a preoperative treatment combining pain neuroscience education (PNE) with knee joint mobilization versus biomedical education with knee joint mobilization on central sensitization (CS) in patients with knee osteoarthritis, both before and after surgery. Second, we wanted to compare the effects of both interventions on knee pain, disability, and psychosocial variables. Forty-four patients with knee osteoarthritis were allocated to receive 4 sessions of either PNE combined with knee joint mobilization or biomedical education with knee joint mobilization before surgery. All participants completed self-administered questionnaires and quantitative sensory testing was performed at baseline, after treatment and at a 1 month follow-up (all before surgery), and at 3 months after surgery. Significant and clinically relevant differences before and after surgery were found after treatments for both knee pain and disability, and some measures of CS (ie, widespread hyperalgesia, CS inventory), with no significant between-group differences. Other indicators of CS (ie, conditioned pain modulation, temporal summation) did not change over time following either treatment, and in some occasions the observed changes were not in the expected direction. Patients receiving PNE with knee joint mobilization achieved greater improvements in psychosocial variables (pain catastrophizing, kinesiophobia) both before and after surgery. Preoperative PNE combined with knee joint mobilization did not produce any additional benefits over time for knee pain and disability, and CS measures compared with biomedical education with knee joint mobilization. Superior effects in the PNE with knee joint mobilization group were only observed for psychosocial variables related to pain catastrophizing and kinesiophobia.",Lluch E.; Dueñas L.; Falla D.; Baert I.; Meeus M.; Sánchez-Frutos J.; Nijs J.,2018.0,10.1097/AJP.0000000000000511,0,0,
1514, The Community Navigator Study: a feasibility randomised controlled trial of an intervention to increase community connections and reduce loneliness for people with complex anxiety or depression," BACKGROUND: Loneliness is associated with poor health outcomes at all ages, including shorter life expectancy and greater risk of developing depression. People with mental health problems are particularly vulnerable to loneliness and, for those with anxiety or depression, loneliness is associated with poorer outcomes. Interventions which support people to utilise existing networks and access new social contact are advocated in policy but there is little evidence regarding their effectiveness. People with mental health problems have potential to benefit from interventions to reduce loneliness, but evidence is needed regarding their feasibility, acceptability and outcomes. An intervention to reduce loneliness for people with anxiety or depression treated in secondary mental health services was developed for this study, which will test the feasibility and acceptability of delivering and evaluating it through a randomised controlled trial. METHODS: In this feasibility trial, 40 participants with anxiety or depression will be recruited through two secondary mental health services in London and randomised to an intervention (n‚Äâ=‚Äâ30) or control group (n‚Äâ=‚Äâ10). The control group will receive standard care and written information about local community resources. The coproduced intervention, developed in this study, includes up to ten sessions with a 'Community Navigator' over a 6‚Äêmonth period. Community Navigators will work with people individually to increase involvement in social activities, with the aim of reducing feelings of loneliness. Data will be collected at baseline and at 6‚Äêmonth follow‚Äêup ‚Äê the end of the intervention period. The acceptability of the intervention and feasibility of participant recruitment and retention will be assessed. Potential primary and secondary outcomes for a future definitive trial will be completed to assess response and completeness, including measures of loneliness, depression and anxiety. Qualitative interviews with participants, staff and other stakeholders will explore experiences of Community Navigator support, the mechanisms by which it may have its effects and suggestions for improving the programme. DISCUSSION: Our trial will provide preliminary evidence of the feasibility and acceptability of Community Navigator support and of trial procedures for testing this. The results will inform a future definitive randomised controlled trial of this intervention. TRIAL REGISTRATION: ISRCTN10771821 . Registered on 3 April 2017."," Lloyd-Evans, B;  Bone, JK;  Pinfold, V;  Lewis, G;  Billings, J;  Frerichs, J;  Fullarton, K;  Jones, R;  Johnson, S",2017.0, 10.1186/s13063-017-2226-7,0,0,
1515,A randomized interventional study to promote milk secretion during mother-baby separation based on the health belief model: A consort compliant.,"Breast milk is the most important nutrition for premature babies, but mothers of premature infants have difficulty in initiating and sustaining lactation. Breastfeeding infants who are separated with mothers have decreased morbidity. Nevertheless, such decrease is limited due to insufficient milk supply resulting from mother-baby separation during lac. To evaluate the effect of intervention methods based on the health belief model on promoting the secretion of milk among mothers who were separated with their babies. In this prospective, randomized controlled clinical trial, we enrolled 260 separation mothers between September 26, 2016 and March 7, 2017, in a 3rd-grade women and children hospital of Chengdu. The mothers all had cesarean delivery and were randomized into 2 groups: the intervention group (educated by investigators based on the health belief) and the control group (routinely educated by obstetric nurses). Data on the onset of lactation and the milk volume during 3 days postpartum were collected. The breast swelling rate within 3 days postpartum and the exclusive breastfeeding rate at 42 days postpartum were compared. The psychologic scores of separation maternal in both groups were assessed with State-Trait Anxiety Inventory at the 3rd day postpartum. Compared with the control group, the intervention group had significantly earlier lactation time (P‚Ää<‚Ää.01), significantly larger milk volume (P‚Ää<‚Ää.01) during 24, 24 to 48, and 48 to 72‚Äähours, and significantly lower psychologic scores (P‚Ää<‚Ää.01) at the 3rd-day postpartum.The onset of lactation among mothers who initiated milk expression within 1‚Äähour after childbirth were earlier than those who initiated milk expression between 1 and 6‚Äähours (P‚Ää<‚Ää.01); the milk volume within 24-hour postpartum did not differ significantly between the 2 groups (P‚Ää>‚Ää.05). However, the milk volume of the early-expression group (<1‚Äähour) was significantly higher than that of the late-expression group (1-6‚Äähours) during 24 to 48 and 48 to72‚Äähours (P‚Ää<‚Ää.05).The breast swelling rate of separation mothers within 3 days postpartum in the intervention group was lower than that in the control group (P‚Ää<‚Ää.05). The exclusive breastfeeding rate of mothers in the intervention group was significantly higher than that in the control group (59% vs 35%; P < .01) at 42 days postpartum. Nursing intervention based on the health belief model can stimulate milk secretion in mothers who were separated with their babies.",Liu Y.; Yao J.; Liu X.; Luo B.; Zhao X.,2018.0,10.1097/MD.0000000000012921,0,0,
1516,Employing loving-kindness meditation to promote self- and other-compassion among war veterans with posttraumatic stress disorder.,"In this paper, we described how we have recently incorporated compassion training in the form of Loving Kindness Meditation into an existing psychotherapy for war-related PTSD called Adaptive Disclosure. We provided background to support the assumption that targeting compassion deficits in war-related trauma may improve mental and behavioral health by helping patients engage in adaptive and potentially reparative behaviors, particularly improving social connections. We also described how compassion training may help veterans suffering from traumatic loss and moral injury, specifically. Throughout, we provide clinical heuristics that may help care providers who work with veterans who have experienced diverse war traumas. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Litz, Brett; Carney, Jessica R",2018.0,http://dx.doi.org/10.1037/scp0000174,0,0,
1517,Brain serotonin synthesis capacity in obsessive-compulsive disorder: effects of cognitive behavioral therapy and sertraline.,"Cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) are both effective treatments for some patients with obsessive-compulsive disorder (OCD), yet little is known about the neurochemical changes related to these treatment modalities. Here, we used positron emission tomography and the α-[11C]methyl-L-tryptophan tracer to examine the changes in brain regional serotonin synthesis capacity in OCD patients following treatment with CBT or SSRI treatment. Sixteen medication-free OCD patients were randomly assigned to 12 weeks of either CBT or sertraline treatment. Pre-to-post treatment changes in the α-[11C]methyl-L-tryptophan brain trapping constant, K* (ml/g/min), were assessed as a function of symptom response, and correlations with symptom improvement were examined. Responders/partial responders to treatment did not show significant changes in relative regional tracer uptake; rather, in responders/partial responders, 12 weeks of treatment led to serotonin synthesis capacity increases that were brain-wide. Irrespective of treatment modality, baseline serotonin synthesis capacity in the raphe nuclei correlated positively with clinical improvement. These observations suggest that, for some patients, successful remediation of OCD symptoms might be associated with greater serotonergic tone.",Lissemore JI.; Sookman D.; Gravel P.; Berney A.; Barsoum A.; Diksic M.; Nordahl TE.; Pinard G.; Sibon I.; Cottraux J.; Leyton M.; Benkelfat C.,2018.0,10.1038/s41398-018-0128-4,0,0,
1518, Self-concept and quality of object relations as predictors of outcome in short- and long-term psychotherapy," METHODS Altogether 326 patients, 20‚Äê46 years of age, with mood and/or anxiety disorder, were randomized to short‚Äêterm (solution‚Äêfocused or short‚Äêterm psychodynamic) psychotherapy and long‚Äêterm psychodynamic psychotherapy. The Quality of Object Relations Scale (QORS) and the Structural Analysis of Social Behavior (SASB) self‚Äêconcept questionnaire were measured at baseline, and their prediction on outcome during the 3‚Äêyear follow‚Äêup was assessed by the Symptom Check List Global Severity Index and the Anxiety Scale, the Beck Depression Inventory and by the Work Ability Index, Social Adjustment Scale work subscale and the Perceived Psychological Functioning scale. RESULTS Negative self‚Äêconcept strongly and self‚Äêcontrolling characteristics modestly predicted better 3‚Äêyear outcomes in long‚Äêterm therapy, after faster early gains in short‚Äêterm therapy. Patients with a more positive or self‚Äêemancipating self‚Äêconcept, or more mature object relations, experienced more extensive benefits after long‚Äêterm psychotherapy. LIMITATIONS The importance of length vs. long‚Äêterm therapy technique on the differences found is not known. CONCLUSIONS Patients with mild to moderate personality pathology, indicated by poor self‚Äêconcept, seem to benefit more from long‚Äêterm than short‚Äêterm psychotherapy, in reducing risk of depression. Long‚Äêterm therapy may also be indicated for patients with relatively good psychological functioning. More research is needed on the relative importance of these characteristics in comparison with other patient‚Äêrelated factors. BACKGROUND Quality of object relations and self‚Äêconcept reflect clinically relevant aspects of personality functioning, but their prediction as suitability factors for psychotherapies of different lengths has not been compared. This study compared their prediction on psychiatric symptoms and work ability in short‚Äê and long‚Äêterm psychotherapy."," Lindfors, O;  Knekt, P;  Heinonen, E;  Virtala, E",2014.0, 10.1016/j.jad.2013.09.011,0,0,
1519, Clinical and neurobiological effects of aerobic exercise in dental phobia: a randomized controlled trial," BACKGROUND: Physical activity has shown to be effective in anxiety disorders. For specific phobia, no studies are available that systematically examined the effects of an aerobic exercise intervention on phobic fear within a randomized‚Äêcontrolled design. Therefore, we investigated the acute effect of a standardized aerobic training on clinical symptoms of dental phobia as well as on stress‚Äêrelated neurobiological markers. METHODS: Within a crossover design, 30 patients with dental phobia (mean age: 34.1 years; mean score of the Dental Anxiety Scale: 18.8) underwent two minor dental interventions separated by 7 days. Dental treatment was performed after 30 min of physical activity at either 20% VO RESULTS: In comparison to baseline, aerobic exercise within 70% VO CONCLUSIONS: Our study provides evidence for an effect of moderate‚Äêintense exercise on clinical symptoms and sC in patients with dental phobia. Therefore, acute aerobic exercise might be a simple and low‚Äêcost intervention to reduce disorder‚Äêspecific phobic fear."," Lindenberger, BL;  Plag, J;  Schumacher, S;  Gaudlitz, K;  Bischoff, S;  Bobbert, T;  Dimeo, F;  Petzold, MB;  Kirschbaum, C;  Dud√°s, Z;  et al.",2017.0, 10.1002/da.22659,0,0,
1520, Evaluation of a nurse-led management program to complement the treatment of adolescent acute lymphoblastic leukemia patients," METHODS: Seventy‐three adolescent ALL patients participated in an open, controlled clinical trial and were randomized into a nurse‐led management model group (n=36) and a doctor‐led management model group (n=37). Two assessment questionnaires were administered to assess and compare the 2 models during a 1.5‐year follow‐up period: the hospital anxiety and depression scale (HADS) questionnaire was administered at 6 different time points, and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ‐C30) at 3 different time points. RESULTS: There were no differences in anxiety and depression between the groups according to the first‐administered questionnaire (the mean anxiety and depression scores of the nurse‐led group were 14.2±4.1 and 10.8±2.7, respectively; those of the doctor‐led group were 13.8±3.8 and 10.6±2.2, respectively). However, repeated measures analysis of variance detected differences in subsequent HADS‐based scores as a function of time between the 2 groups (p<0.05). Moreover, the Holm‐Sidak's multiple comparisons tests showed that patients of the nurse‐led group had significantly decreased mean anxiety scores compared to those in the doctor‐led group at the third and subsequent sessions, as well as in mean depression scores from the second session onwards (all p<0.05). According to the last‐administered EORTC QLQ‐C30 questionnaire, there were statistical differences in cognitive, emotional, social, and quality of life scales between the 2 groups (all p<0.05), but not in role and physical scales (all p>0.05). CONCLUSIONS: It is necessary to offer unique cognitive, psychological, and behavioral management models to adolescent ALL patients that are tailored toward their age group. Strengthening such management is more conducive to alleviating or even reversing psychological problems, and to improving patients' quality of life while ensuring complication‐free follow‐up periods. PURPOSE: To evaluate a nurse‐led management model of adolescent acute lymphoblastic leukemia (ALL) patients and improve their psychological care and quality of life."," Lin, H;  Zhou, S;  Zhang, D;  Huang, L",2016.0, 10.1016/j.apnr.2016.08.001,0,0,
1521,Intensive Short-Term Dynamic Psychotherapy for generalized anxiety disorder: A pilot effectiveness and process-outcome study.,"The objective of this study was to evaluate the clinical- and cost-effectiveness of Intensive Short-Term Dynamic Psychotherapy (ISTDP) for generalized anxiety disorder (GAD). We further aimed to examine if a key clinical process within the ISTDP framework, termed the level of mobilization of unprocessed complex emotions (MUCE), was related to outcome. The sample consisted of 215 adult patients (60.9% female) with GAD and comorbid conditions treated in a tertiary mental health outpatient setting. The patients were provided an average of 8.3 sessions of ISTDP delivered by 38 therapists. The level of MUCE in treatment was assessed from videotaped sessions by a rater blind to treatment outcome. Year-by-year healthcare costs were derived independently from government databases. Multilevel growth models indicated significant decreases in psychiatric symptoms and interpersonal problems during treatment. These gains were corroborated by reductions in healthcare costs that continued for 4 years post-treatment reaching normal population means. Further, we found that the in-treatment level of MUCE was associated with larger treatment effects, underlining the significance of emotional experiencing and processing in the treatment of GAD. We conclude that ISTDP appears to reduce symptoms and costs associated with GAD and that the ISTDP framework may be useful for understanding key therapeutic processes in this challenging clinical population. Controlled studies of ISTDP for GAD are warranted. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Lilliengren, Peter; Johansson, Robert; Town, Joel M; Kisely, Steve; Abbass, Allan",2017.0,http://dx.doi.org/10.1002/cpp.2101,0,0,
1522,The evaluation and application of facial expression characteristics of high level athletes in the athletic state,"With the development of science and technology and the progress of sports, the performance of athletes in the match not only depends on the usual performance, but also depends on the athletes’ psychology, facial expressions and many other factors during the match. How to achieve the best condition of the athletes' competition psychology is a complicated work, which must be exercised in daily practice, and must be monitored and analysed through advanced monitoring technology. And then the psychological level of the athletes can be summed up and guided, especially the anxiety and panic psychology of athletes before competition.",Liguang X.; Wei Z.,2018.0,,0,0,
1523,Detecting implicit cues of aggressiveness in male faces in revictimized female PTSD patients and healthy controls.,"Victimized women are thought to have impairments in identifying risk and to have dysfunctional reactions to threatening situations, which increase the risk for revictimization. To investigate possible deficits in revictimized women, we used a method examining women's perceptions of an implicit facial cue of aggressiveness-the facial Width-to-Height Ratio (fWHR). We tested whether revictimized women show impairments in detecting aggressiveness in male faces by neglecting cues of fWHR and choosing a smaller preferred distance to men. Fifty-two revictimized PTSD patients and 52 healthy controls provided ratings of aggressiveness and attractiveness for 65 photographed men and chose their preferred distance towards 11 pictured men. Multiple regression analyses indicated that revictimized women do not show impairments in perceiving and reacting to cues of aggression accurately. Hierarchical linear models, however, indicated that revictimized women rated all men as less aggressive. Revictimized women with histories of intimate partner violence (IPV) rated men with larger fWHRs and higher values of actual aggression to be more attractive than did revictimized women without IPV histories. A reduced appraisal of threat signals as threatening and an attraction to wider-faced and more aggressive men might increase the risk for revictimization. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Lieberz, Klara A; Muller-Engelmann, Meike; Bornefeld-Ettmann, Pia; Priebe, Kathlen; Weidmann, Anke; Fydrich, Thomas; Geniole, Shawn N; McCormick, Cheryl M; Rausch, Sophie; Thome, Janine; Steil, Regina",2018.0,http://dx.doi.org/10.1016/j.psychres.2018.05.061,0,0,
1524,Mining latent information in PTSD psychometrics with fuzziness for effective diagnoses,"The options of traditional self-report rating-scale, like the PTSD Checklist Civilian (PCL-C) scale, have no clear boundaries which might cause considerable biases and low effectiveness. This research aimed to explore the feasibility of using fuzzy set in the data processing to promote the screening effectiveness of PCL-C in real-life practical settings. The sensitivity, specificity, Youden's index etc., of PCL-C at different cutoff lines (38, 44 and 50 respectively) were analyzed and compared with those of fuzzy set approach processing. In practice, no matter the cutoff line of the PCL-C was set at 50, 44 or 38, the PCL-C showed good specificity, but failed to exhibit good sensitivity and screening effectiveness. The highest sensitivity was at 65.22%, with Youden's index being 0.64. After fuzzy processing, the fuzzy-PCL-C's sensitivity increased to 91.30%, Youden's index rose to 0.91, having seen marked augmentation. In conclusion, this study indicates that fuzzy set can be used in the data processing of psychiatric scales which have no clear definition standard of the options to improve the effectiveness of the scales.",Li Y.; Xiong X.; Qiu C.; Wang Q.; Xu J.,2018.0,10.1038/s41598-018-34573-7,0,0,
1525, Effect and safety of sertraline for treat posttraumatic stress disorder: a multicenter randomised controlled study," OBJECTIVE: Although several previous studies have examined the efficacy of sertraline in the treatment of posttraumatic stress disorder (PTSD), none involved Chinese PTSD patients. This study aimed to evaluate sertraline efficacy and adverse events in Chinese patients with PTSD over 12 weeks. METHODS: In total, 72 PTSD patients were randomly assigned to receive sertraline (135‚Äâmg daily) or a placebo for 12 weeks. Impact of Event Scale‚ÄêRevised subscores constituted the primary outcome, with Clinical Global Impression Scale‚ÄêSeverity scores and adverse events as secondary outcomes. RESULTS: Sixty‚Äêfive subjects completed the study, and their data were included in the final analysis. Sertraline showed greater efficacy in enhancing Impact of Event Scale‚ÄêRevised and Clinical Global Impression Scale‚ÄêSeverity scores at 6 and 12 weeks relative to that of the placebo. The most common adverse event was nausea, which occurred in 12 (33.3%) and 8 (22.2%) patients in the sertraline and placebo groups, respectively. No sertraline‚Äêrelated deaths were recorded. CONCLUSIONS: In summary, we demonstrated that 12 weeks of sertraline was efficacious and well‚Äêtolerated in Chinese patients with PTSD."," Li, W;  Ma, YB;  Yang, Q;  Li, BL;  Meng, QG;  Zhang, Y",2017.0, 10.1080/13651501.2017.1291838,0,0,
1526,Moderate partially reduplicated conditioned stimuli as retrieval cue can increase effect on preventing relapse of fear to compound stimuli,"The theory of memory reconsolidation argues that consolidated memory is not unchangeable. Once a memory is reactivated it may go back into an unstable state and need new protein synthesis to be consolidated again, which is called “memory reconsolidation”. Boundary studies have shown that interfering with reconsolidation through pharmacologic or behavioral intervention can lead to the updating of the initial memory, for example, erasing undesired memories. Behavioral procedures based on memory reconsolidation interference have been shown to be an effective way to inhibit fear memory relapse after extinction. However, the effectiveness of retrieval-extinction differs by subtle differences in the protocol of the reactivation session. This represents a challenge with regard to finding an optimal operational model to facilitate its clinical use for patients suffering from pathogenic memories such as those associated with post-traumatic stress disorder. Most of the laboratory models for fear learning have used a single conditioned stimulus (CS) paired with an unconditioned stimulus (US). This has simplified the real situation of traumatic events to an excessive degree, and thus, limits the clinical application of the findings based on these models. Here, we used a basic visual compound CS model as the CS to ascertain whether partial repetition of the compound CSs in conditioning can reactivate memory into reconsolidation. The results showed that the no retrieval group or the 1/3 ratio retrieval group failed to open the memory reconsolidation time window. The 2/3 repetition retrieval group and the whole repetition retrieval group were able to prevent fear reinstatement, whereas only a 2/3 ratio repetition of the initial compound CS as a reminder could inhibit spontaneous recovery. We inferred that a retrieval-extinction paradigm was also effective in a more complex model of fear if a sufficient prediction error (PE) could be generated in the reactivation period. In addition, in order to achieve an optimal effect, a CS of moderate discrepancy should be used as a reminder.",Li J.; Chen W.; Caoyang J.; Wu W.; Jie J.; Xu L.; Zheng X.,2017.0,10.3389/fnhum.2017.00575,0,0,
1527,Three perspectives on immersion in water for labour and birth,"Background: Research supports water immersion in labour and birth for healthy women with no risk factors. However, there is a gap in knowledge and understanding relating to women's experiences of waterbirth and midwives education, knowledge and practice around immersion in water for labour or birth. Aim: This project explored water immersion for labour and birth to: evaluate the obstetric and neonatal outcomes; describe the perceptions and experiences of women; and assess midwives education, knowledge and practice. Methods: This three armed project was conducted between July 2015 and December 2016, at the sole tertiary public maternity hospital in Western Australia. Project one was a retrospective audit of clinical outcomes. Project two utilised an exploratory design using critical incident techniques. Project three was a mixed methods study. Findings: Project one: a total of 502 women intended to labour or give birth in water; 199 (40%) did not and 303 (60%) did. Most women using water immersion (179 of 303;59%) gave birth in water. Simultaneous multivariable modelling found women who gave birth in water had increased odds of: a first stage labour ≤240 minutes; a third stage labour of 11-30 minutes; and an intact perineum. Project two: included 296 women, with 31% (93 of 296) achieving a waterbirth. The primary reason for planning a waterbirth was pain relief. Words women used to describe birth were coded as; affirming; distressing; enduring; natural; quick; empowering; and long. Project three: questionnaire results confirmed following training, 93% (27 of 29) of midwives felt equipped to facilitate waterbirth. Focus groups exploration of what midwives enjoyed about caring for women who used water immersion revealed three themes: instinctive birthing; woman-centred atmosphere; and undisturbed space. Implications: This research highlights what immersion in water for labour and birth offers women and midwives and also the value of exploring this option from three perspectives.",Lewis L.; Hauck Y.,2018.0,10.1016/j.wombi.2018.08.098,0,0,
1528, CollAborative care and active surveillance for Screen-Positive EldeRs with subthreshold depression (CASPER): a multicentred randomised controlled trial of clinical effectiveness and cost-effectiveness," BACKGROUND: Efforts to reduce the burden of illness and personal suffering associated with depression in older adults have focused on those with more severe depressive syndromes. Less attention has been paid to those with mild disorders/subthreshold depression, but these patients also suffer significant impairments in their quality of life and level of functioning. There is currently no clear evidence‚Äêbased guidance regarding treatment for this patient group. OBJECTIVES: To establish the clinical effectiveness and cost‚Äêeffectiveness of a low‚Äêintensity intervention of collaborative care for primary care older adults who screened positive for subthreshold depression. DESIGN: A pragmatic, multicentred, two‚Äêarm, parallel, individually randomised controlled trial with a qualitative study embedded within the pilot. Randomisation occurred after informed consent and baseline measures were collected. SETTING: Thirty‚Äêtwo general practitioner (GP) practices in the north of England. PARTICIPANTS: A total of 705 participants aged ‚â•‚Äâ75 years during the pilot phase and ‚â•‚Äâ65 years during the main trial with subthreshold depression. INTERVENTIONS: Participants in the intervention group received a low‚Äêintensity intervention of collaborative care, which included behavioural activation delivered by a case manager for an average of six sessions over 7‚Äê8 weeks, alongside usual GP care. Control‚Äêarm participants received only usual GP care. MAIN OUTCOME MEASURES: The primary outcome measure was a self‚Äêreported measure of depression severity, the Patient Health Questionnaire‚Äê9 items PHQ‚Äê9 score at 4 months post randomisation. Secondary outcome measures included the European Quality of Life‚Äê5 Dimensions, Short Form questionnaire‚Äê12 items, Patient Health Questionnaire‚Äê15 items, Generalised Anxiety Disorder seven‚Äêitem scale, Connor‚ÄêDavidson Resilience Scale two‚Äêitem version, a medication questionnaire and objective data. Participants were followed up for 12 months. RESULTS: In total, 705 participants were randomised (collaborative care CONCLUSIONS: Collaborative care has been shown to be clinically effective and cost‚Äêeffective for older adults with subthreshold depression and to reduce the proportion of people who go on to develop case‚Äêlevel depression at 12 months. This intervention could feasibly be delivered in the NHS at an acceptable cost‚Äêbenefit ratio. Important future work would include investigating the longer‚Äêterm effect of collaborative care on the CASPER population, which could be conducted by introducing an extension to follow‚Äêup, and investigating the impact of collaborative care on managing multimorbidities in people with subthreshold depression. TRIAL REGISTRATION: Current Controlled Trials ISRCTN02202951. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in"," Lewis, H;  Adamson, J;  Atherton, K;  Bailey, D;  Birtwistle, J;  Bosanquet, K;  Clare, E;  Delgadillo, J;  Ekers, D;  Foster, D;  et al.",2017.0, 10.3310/hta21080,0,0,
1529, Are all safety behaviours created equal? A comparison of novel and routinely used safety behaviours in obsessive-compulsive disorder," Contamination fear is one of the most common symptoms of obsessive‚Äêcompulsive disorder (OCD). Exposure and response prevention (ERP) is effective for OCD, but a significant minority of treatment‚Äêseeking individuals refuse ERP entirely or drop out prematurely. Research suggests that safety behaviour (SB) may enhance the acceptability of ERP; however, questions remain about how to incorporate SB into existing treatments. Clinical participants with OCD and contamination fear (N = 57) were randomized to receive an exposure session with no SB (ERP), a routinely used SB (RU), or a never‚Äêused SB (NU). Significant reductions in contamination fear severity were observed in all conditions. Although omnibus comparisons were only marginally significant, pairwise comparisons revealed some condition differences. NU demonstrated significantly lower self‚Äêreported contamination fear severity at post‚Äêexposure, as well as marginally higher treatment acceptability ratings. Findings suggest that exposure with SB may be effective and acceptable, and are discussed in terms of cognitive‚Äêbehavioural theory and treatment of anxiety and related disorders."," Levy, HC;  Radomsky, AS",2016.0, 10.1080/16506073.2016.1184712,0,0,
1530,Distress tolerance but not impulsivity predicts outcome in concurrent treatment for posttraumatic stress disorder and substance use disorder.,"Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) commonly co-occur. Emerging research suggests that both distress tolerance and impulsivity may underlie this comorbidity. However, to our knowledge no studies have examined whether these 2 constructs predict outcome in PTSD-SUD treatment. The current study investigated whether pretreatment distress tolerance and impulsivity predicted posttreatment PTSD and cravings severity in a sample of 70 Veterans receiving concurrent treatment for PTSD and SUD in a residential day treatment program. Veterans completed measures of symptom severity before and after treatment. Results demonstrated that pretreatment distress tolerance predicted posttreatment PTSD severity while controlling for pretreatment PTSD. By contrast, pretreatment impulsivity was not predictive of posttreatment PTSD while controlling for pretreatment values. Neither distress tolerance nor impulsivity predicted posttreatment cravings severity. The findings support the notion that distress tolerance may help to explain the co-occurrence of PTSD and SUD and suggest that targeting this construct in PTSD-SUD treatment may be important for successful outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Levy, Hannah C; Wanklyn, Sonya G; Voluse, Andrew C; Connolly, Kevin M",2018.0,http://dx.doi.org/10.1080/08995605.2018.1478548,0,0,
1531, Help me if you can: evaluating the effectiveness of interpersonal compared to intrapersonal emotion regulation in reducing distress," METHODS: Forty‚Äêseven couples in a long‚Äêterm relationship volunteered to participate in the study. In each couple the two partners were randomly assigned as either target or regulator. The target viewed pictures with negative valance. In response to each picture he/she was then instructed to choose and apply a regulatory strategy (i.e., intrapersonal emotion regulation) or to apply a regulatory strategy chosen by his/her partner, the regulator (i.e., interpersonal emotion regulation). RESULTS: We found that the outside perspective of the regulator helped reducing distress more effectively than intrapersonal emotion regulation. Moreover, the cognitive, but not the emotional, empathy of the regulator predicted the added value of interpersonal emotion regulation. Specifically, regulators with a better ability to understand their partners' point of view, selected regulatory strategies that reduced levels of distress more effectively. LIMITATIONS: While the present study examined possible effects of depression, anxiety and the ability to identify and describe feelings, a larger sample is needed in order to optimally address their potential moderating effect. CONCLUSIONS: The results illuminate the value of non‚Äêprofessional interventions and the importance of cognitive empathy in reducing distress. The study has significant clinical implications, providing a simple behavioral tool that can be used to decrease and prevent psychopathology. BACKGROUND AND OBJECTIVES: Although humans have developed abundant strategies to down regulate their own negative emotions, at times of distress they frequently turn to significant others to seek comfort. In the present study we use a novel performance‚Äêbased paradigm to evaluate the effectiveness of this interaction."," Levy-Gigi, E;  Shamay-Tsoory, SG",2017.0, 10.1016/j.jbtep.2016.11.008,0,0,
1532,Baseline levels of rapid eye movement sleep may protect against excessive activity in fear-related neural circuitry,"Sleep, and particularly rapid eye movement sleep (REM), has been implicated in the modulation of neural activity following fear conditioning and extinction in both human and animal studies. It has long been presumed that such effects play a role in the formation and persistence of posttraumatic stress disorder, of which sleep impairments are a core feature. However, to date, few studies have thoroughly examined the potential effects of sleep prior to conditioning on subsequent acquisition of fear learning in humans. Furthermore, these studies have been restricted to analyzing the effects of a single night of sleep—thus assuming a state-like relationship between the two. In the current study, we used long-term mobile sleep monitoring and functional neuroimaging (fMRI) to explore whether trait-like variations in sleep patterns, measured in advance in both male and female participants, predict subsequent patterns of neural activity during fear learning. Our results indicate that higher baseline levels of REM sleep predict reduced fear-related activity in, and connectivity between, the hippocampus, amygdala and ventromedial PFC during conditioning. Additionally, skin conductance responses (SCRs) were weakly correlated to the activity in the amygdala. Conversely, there was no direct correlation betweenREMsleep and SCRs, indicating that REMmayonly modulate fear acquisition indirectly. In a follow-up experiment,weshow that these results are replicable, though to a lesser extent, when measuring sleep over a single night just before conditioning. As such, baseline sleep parameters may be able to serve as biomarkers for resilience, or lack thereof, to trauma.Significance Statement Numerous studies over the past two decades have established a clear role of sleep in fear-learning processes. However, previous work has focused on the effects of sleep following fear acquisition, thus neglecting the potential effects of baseline sleep levels on the acquisition itself. The current study provides the first evidence in humans of such an effect. Specifically, the results of this study suggest that baseline rapid eye movement (REM) sleep may serve a protective function against enhanced fear encoding through the modulation of connectivity between the hippocampus, amygdala, and the ventromedial PFC. Building on this finding, baseline REMmeasurements may serve as a noninvasive biomarker for resilience to trauma or, conversely, to the potential development of posttraumatic stress disorder following trauma.",Lerner I.; Lupkin S.M.; Sinha N.; Tsai A.; Gluck M.A.,2017.0,10.1523/JNEUROSCI.0578-17.2017,0,0,
1533, Brief cognitive behavioural intervention for depression and anxiety symptoms improves quality of life in chronic haemodialysis patients," OBJECTIVES: Psychological treatment of depression in end‐stage renal disease (ESRD) has focused on severely depressed patients. We designed and tested a brief (5 weeks) cognitive behavioural intervention (CBI) to reduce mild and moderate depression and anxiety symptoms in patients with ESRD. DESIGN: For the purpose of this study, a single‐blind, randomized controlled design was used to compare patients with ESRD under haemodialysis treatment with and without the CBI. METHODS: Depression and anxiety symptoms were screened in 152 subjects (18‐60 years old, 84 male). Sixty participants (age 41.8 ± 14.7, 29 males) with mild or moderate scores of depression (Beck Depression Inventory) and anxiety (Beck Anxiety Inventory) were randomly assigned to CBI or the control group. CBI techniques consisted of positive self‐reinforcement, deep breathing, muscle relaxation, and cognitive restructuring. Depression, anxiety, quality of life (QoL), and cognitive distortion scores were evaluated at baseline, after 5 weeks (end of treatment) and after 4‐week follow‐up. All scores were compared by ANOVA for repeated measures with post‐hoc tests adjusted by Bonferroni's method (p < .05 was considered significant). RESULTS: At follow‐up, depression, anxiety, and cognitive distortions had decreased, and QoL had increased in the intervention group, and there were no changes in the control group. Clinical utility was 33% for depression and 43% for anxiety. CONCLUSIONS: A brief CBI of 5 weeks is effective for decreasing mild or moderate depression and anxiety symptoms and improving QoL in ESRD haemodialysis patients. PRACTITIONER POINTS: A brief, systematic and structured cognitive behavioural intervention (CBI) decreases anxiety and depression symptoms and improves quality of life in patients with end‐stage renal disease (ESRD) who are being treated with haemodialysis. These benefits are not achieved when anxiety and depression symptoms are identified but not treated psychologically. This CBI consisted of cognitive restructuring of the distorted thoughts (perfectionism, catastrophic thinking, negative self‐labelling, and dichotomous thinking) that are correlated with depression and anxiety symptoms and that can be assessed by a validated questionnaire designed for patients with ESRD. The handbooks that were developed for this study are structured and systematic. They could be valuable in supporting the efforts and participation of non‐specialized health professionals in CBI such as nurses, physicians, social workers, and psychologists, raising the possibility of further application in a variety of clinical populations. Both the therapy and the client workbooks are available in Spanish upon request."," Lerma, A;  Perez-Grovas, H;  Bermudez, L;  Peralta-Pedrero, ML;  Robles-García, R;  Lerma, C",2017.0, 10.1111/papt.12098,0,0,
1534, Longitudinal outcomes of children with pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS)," Little is known about the natural history of children with pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS). This study prospectively followed 33 children with PANDAS for up to 4.8 years (mean 3.3 ± 0.7 years) after enrollment in a 24‐week randomized, double‐blind, placebo‐controlled trial of intravenous immunoglobulin (IVIG) (N = 35). Fourteen of eighteen children randomized to placebo received open label IVIG 6 weeks after the blinded infusion, so follow‐up results reported below largely reflect outcomes in a population of children who received at least one dose of IVIG. Telephone interviews with the parents of participants found that at the time of phone follow‐up, 29 (88%) were not experiencing clinically significant obsessive‐compulsive symptoms. During the interim period (6‐57 months after entering the clinical trial), 24 (72%) had experienced at least one exacerbation of PANDAS symptoms, with a median of one exacerbation per child (range 1‐12; interquartile range 0‐3). A variety of treatment modalities, including antibiotics, IVIG, psychiatric medications, cognitive behavioral therapy, and others, were used to treat these exacerbations, and were often used in combination. The outcomes of this cohort are better than those previously reported for childhood‐onset OCD, which may support conceptualization of PANDAS as a subacute illness similar to Sydenham chorea. However, some children developed a chronic course of illness, highlighting the need for research that identifies specific symptoms or biomarkers that can be used to predict the longitudinal course of symptoms in PANDAS."," Leon, J;  Hommer, R;  Grant, P;  Farmer, C;  D'Souza, P;  Kessler, R;  Williams, K;  Leckman, JF;  Swedo, S",2018.0, 10.1007/s00787-017-1077-9,0,0,
1535,Effectiveness of cognitive processing therapy for treating posttraumatic stress disorder.,"Analyzing 11 studies, we evaluated the effectiveness of cognitive processing therapy (CPT) for treating posttraumatic stress disorder (PTSD) and co-occurring depression symptoms in individuals diagnosed with PTSD. Separate meta-analytic procedures for between-group studies using waitlist or alternative treatment comparisons yielded large to very large effect sizes for CPT versus waitlist, and medium to large effect sizes when CPT was compared to alternative treatments. Implications for evidence-supported practice and study limitations are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Lenz, Stephen; Bruijn, Brian; Serman, Nina S; Bailey, Laura",2014.0,http://dx.doi.org/10.17744/mehc.36.4.1360805271967kvq,0,0,
1536, Cost-effectiveness of therapist-guided internet-delivered cognitive behaviour therapy for paediatric obsessive-compulsive disorder: results from a randomised controlled trial," OBJECTIVES: To evaluate the cost‐effectiveness of a therapist‐guided internet‐delivered cognitive behaviour therapy (ICBT) intervention for adolescents with obsessive‐compulsive disorder (OCD) compared with untreated patients on a waitlist. DESIGN: Single‐blinded randomised controlled trial. SETTING: A research clinic within the regular child and adolescent mental health service in Stockholm, Sweden. PARTICIPANTS: Sixty‐seven adolescents (12‐17 years) with a Diagnostic and Statistical Manual of Mental Disorders Fifth Edition diagnosis of OCD. INTERVENTIONS: Either a 12‐week, therapist‐guided ICBT intervention or a wait list condition of equal duration. PRIMARY OUTCOME MEASURES: Cost data were collected at baseline and after treatment, including healthcare use, supportive resources, prescription drugs, prescription‐free drugs, school absence and productivity loss, as well as the cost of ICBT. Health outcomes were defined as treatment responder rate and quality‐adjusted life years gain. Bootstrapped mixed model analyses were conducted comparing incremental costs and health outcomes between the groups from the societal and healthcare perspectives. RESULTS: Compared with waitlist control, ICBT generated substantial societal cost savings averaging US$‐144.98 (95% CI ‐159.79 to ‐130.16) per patient. The cost reductions were mainly driven by reduced healthcare use in the ICBT group. From the societal perspective, the probability of ICBT being cost saving compared with waitlist control was approximately 60%. From the healthcare perspective, the cost per additional responder to ICBT compared with waitlist control was approximately US$78. CONCLUSIONS: The results suggest that therapist‐guided ICBT is a cost‐effective treatment and results in societal cost savings, compared with patients who do not receive evidence‐based treatment. Since, at present, most patients with OCD do not have access to evidence‐based treatments, the results have important implications for the increasingly strained national and healthcare budgets. Future studies should compare the cost‐effectiveness of ICBT with regular face‐to‐face CBT. TRIAL REGISTRATION NUMBER: NCT02191631."," Lenhard, F;  Ssegonja, R;  Andersson, E;  Feldman, I;  Rück, C;  Mataix-Cols, D;  Serlachius, E",2017.0, 10.1136/bmjopen-2016-015246,0,0,
1537," Therapist-Guided, Internet-Delivered Cognitive-Behavioral Therapy for Adolescents With Obsessive-Compulsive Disorder: a Randomized Controlled Trial"," OBJECTIVE: Cognitive‐behavioral therapy (CBT) is the first‐line treatment for young people with obsessive‐compulsive disorder (OCD), but most patients do not have access to this treatment. Thus, innovative ways to increase the accessibility of CBT are needed. The objective of this trial was to evaluate the efficacy of therapist‐guided internet‐based CBT (ICBT) for adolescents with OCD. METHOD: Sixty‐seven adolescents (12‐17 years old) with OCD were randomly assigned to a 12‐week clinician‐ and parent‐supported ICBT program (BiP OCD) or a waitlist condition. The primary outcome was the Children Yale‐Brown Obsessive Compulsive Scale (CY‐BOCS) administered by blinded assessors before and after the intervention. All patients were followed up 3 months after the intervention. RESULTS: In intention‐to‐treat analyses, BiP OCD was superior to waitlist on the CY‐BOCS (time‐by‐group interaction, B = ‐4.53, z = ‐3.74, p < .001; Cohen's d = 0.69; 95% CI 0.19‐1.18) and on most secondary outcome measurements. Patients randomized to BiP OCD also showed further improvement from post‐treatment to 3‐month follow‐up, with a within‐group pretreatment to follow‐up effect size (Cohen's d) equal to 1.68 (95% CI 1.00‐2.36). Patient satisfaction with BiP OCD was high. There were no relevant adverse events. Average clinician support time was 17.5 minutes per patient per week. CONCLUSION: Therapist‐guided ICBT is a promising low‐intensity intervention for adolescents with OCD and has the potential to increase access to CBT. It might be particularly useful in a stepped‐care approach, in which a large proportion of patients with moderately severe OCD could first be offered ICBT, thus freeing limited resources for more complex cases. Clinical trial registration information‐Internet‐Delivered CBT for Adolescents With OCD: A Randomized Controlled Study (BiPOCD); http://clinicaltrials.gov; NCT02191631."," Lenhard, F;  Andersson, E;  Mataix-Cols, D;  Rück, C;  Vigerland, S;  Högström, J;  Hillborg, M;  Brander, G;  Ljungström, M;  Ljótsson, B;  et al.",2017.0, 10.1016/j.jaac.2016.09.515,0,0,
1538, Examination of Broad Symptom Improvement Resulting From Mindfulness-Based Stress Reduction in Breast Cancer Survivors: a Randomized Controlled Trial," PURPOSE: The purpose of this randomized trial was to evaluate the efficacy of the Mindfulness‚ÄêBased Stress Reduction for Breast Cancer (MBSR[BC]) program in improving psychological and physical symptoms and quality of life among breast cancer survivors (BCSs) who completed treatment. Outcomes were assessed immediately after 6 weeks of MBSR(BC) training and 6 weeks later to test efficacy over an extended timeframe. PATIENTS AND METHODS: A total of 322 BCSs were randomly assigned to either a 6‚Äêweek MBSR(BC) program (n = 155) or a usual care group (n = 167). Psychological (depression, anxiety, stress, and fear of recurrence) and physical symptoms (fatigue and pain) and quality of life (as related to health) were assessed at baseline and at 6 and 12 weeks. Linear mixed models were used to assess MBSR(BC) effects over time, and participant characteristics at baseline were also tested as moderators of MBSR(BC) effects. RESULTS: Results demonstrated extended improvement for the MBSR(BC) group compared with usual care in both psychological symptoms of anxiety, fear of recurrence overall, and fear of recurrence problems and physical symptoms of fatigue severity and fatigue interference (P < .01). Overall effect sizes were largest for fear of recurrence problems (d = 0.35) and fatigue severity (d = 0.27). Moderation effects showed BCSs with the highest levels of stress at baseline experienced the greatest benefit from MBSR(BC). CONCLUSION: The MBSR(BC) program significantly improved a broad range of symptoms among BCSs up to 6 weeks after MBSR(BC) training, with generally small to moderate overall effect sizes."," Lengacher, CA;  Reich, RR;  Paterson, CL;  Ramesar, S;  Park, JY;  Alinat, C;  Johnson-Mallard, V;  Moscoso, M;  Budhrani-Shani, P;  Miladinovic, B;  et al.",2016.0, 10.1200/JCO.2015.65.7874,0,0,
1539,Cognitive therapy and eye movement desensitization and reprocessing for reducing psychopathology among disaster-bereaved individuals: Study protocol for a randomized controlled trial.,"Background: Confrontation with a traumatic (e.g. disaster-related) loss is a risk factor for the development of psychopathology, including symptoms of prolonged grief (PG), posttraumatic stress (PTS), and depression. Although interventions have been developed for reducing post-loss psychopathology, more research into the effectiveness of treatment is needed to improve care for bereaved persons. Cognitive therapy (CT) and eye movement desensitization and reprocessing (EMDR) have been shown to be effective in trauma-exposed populations. We hypothesize that CT and EMDR are also effective in reducing symptoms among people exposed to traumatic loss. Objective: In this article we describe the rationale of a randomized controlled trial (RCT) to examine (1) treatment effects of CT and EMDR for reducing PG, PTS, and depression among traumatically bereaved people, and (2) the associations between improvements in PG, PTS, and depression symptoms on the one hand and tentative mechanisms of change, including a sense of unrealness, negative cognitions, avoidance behaviour, and intrusive memories, on the other hand. Method: A two-armed (intervention versus waiting list controls) RCT will be conducted. Participants will be asked to fill in questionnaires prior to treatment, during treatment, and one, 12, and 24 weeks post-treatment. Potential participants are people who have lost one or multiple significant other(s) in the Ukrainian plane disaster in 2014 with clinically significant levels of self-rated PG, PTS, and/or depression. Multiple regression, including analysis of covariance, and multilevel regression analyses will be used. Discussion: There is a need for treatment for psychopathology following traumatic loss. Strengths of this study are the development of a treatment that targets grief and trauma-related complaints and the examination of potential mechanisms of change in CT and EMDR. Bereaved people, clinicians, and researchers could benefit from the results of this study. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Abstract (Spanish) Planteamiento: Confrontar una perdida traumatica (p.ej., una perdida relacionada con un desastre) es un factor de riesgo para el desarrollo de una psicopatologia, tal como sintomas de duelo prolongado (DP), estres postraumatico (EPT) y depresion. Aunque se han desarrollado intervenciones para reducir la psicopatologia post-perdida, se necesita mas investigacion sobre la eficacia del tratamiento para mejorar la atencion a las personas en duelo. Se ha demostrado que la terapia cognitiva (TC) y la desensibilizacion y reprocesamiento por movimientos oculares (EMDR) son efectivas en poblaciones expuestas a trauma. La hipotesis plantea que la TC y EMDR tambien son eficaces en la reduccion de sintomas en personas expuestas a una perdida traumatica. Objetivo: En este articulo se describe la justificacion de usar de un ensayo controlado aleatorio (ECA) para examinar: a) los efectos del tratamiento de la TC y EMDR para reducir el DP, el EPT y la depresion en personas con un duelo traumatico y b) las asociaciones entre las mejorias del DP y los sintomas de depresion, por un lado, y los mecanismos tentativos de cambio, que incluyen una sensacion de irrealidad, cogniciones negativas, comportamiento de evitacion y recuerdos intrusivos, por otro lado. Metodo: Se llevara a cabo un ECA de dos brazos (intervencion frente a lista de espera). Se les pedira a los participantes que rellenen cuestionarios antes del tratamiento, durante el tratamiento, y una, 12 y 24 semanas despues del tratamiento. Los participantes potenciales son personas que han perdido uno o varios seres queridos en el desastre aereo ucraniano en 2014 con niveles clinicamente significativos de auto-puntuaciones de DP, EPT y/o depresion. Se usara una regresion multiple, que incluye un analisis de covarianza, y un analisis de regresion multinivel. Discusion: Existe necesidad de tratamiento para la psicopatologia despues de una perdida traumatica. Los puntos fuertes de este estudio son el desarrollo de un tratamiento que se centra en el duelo y las quejas relacionadas con el trauma, y el examen de los posibles mecanismos de cambio en TC y EMDR. Las personas en duelo, los clinicos y los investigadores podrian beneficiarse de los resultados de este estudio. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Lenferink, Lonneke I. M; Piersma, Eline; de Keijser, Jos; Smid, Geert E; Boelen, Paul A",2017.0,http://dx.doi.org/10.1080/20008198.2017.1388710,0,0,
1540,Evaluating the EMDR Group Traumatic Episode Protocol with refugees: A field study.,"In 2015, more than 1.5 million refugees arrived in Germany, many severely traumatized. Eye movement desensitization and reprocessing (EMDR) therapy has been proven to be an effective treatment for acute and chronic traumatic stress symptoms. A modification for provision in group settings was developed by E. Shapiro: the EMDR Group Traumatic Episode Protocol (G-TEP). In this field study, we investigated the effectiveness of 2 sessions of EMDR G-TEP in treating traumatized refugees. After receiving a psychoeducation session, 18 Arabic-speaking refugees from Syria and Iraq who had come to Germany during the previous 5 months were assigned to treatment and/or waitlist. The Impact of Event Scale-Revised (IES-R) and Beck Depression Inventory (BDI) were administered at pre- and posttreatment. Analysis was conducted using the Mann-Whitney U test and planned Kolmogorov-Smirnov tests. Results showed significant differences between the treatment and the waitlist groups, indicating a significant decline in IES-R scores (p = .05). Although differences in BDI scores did not reach significance (p = .06), a large decline in BDI scores was seen in the treatment group. These results provide preliminary evidence that it might be effective to treat groups of traumatized refugees with EMDR G-TEP. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Lehnung, Maria; Shapiro, Elan; Schreiber, Melanie; Hofmann, Arne",2017.0,http://dx.doi.org/10.1891/1933-3196.11.3.129,0,0,
1541,"Functional Brain Network Changes Following Use of an Allostatic, Closed-Loop, Acoustic Stimulation Neurotechnology for Military-Related Traumatic Stress","BACKGROUND AND PURPOSE: Post-traumatic stress disorder is associated with connectivity changes in the default mode, central executive, and salience networks, and other brain regions. This study evaluated changes in network connectivity associated with usage of High-resolution, relational, resonance-based electroencephalic mirroring (HIRREM®; Brain State Technologies, Scottsdale, AZ), a closed-loop, allostatic, acoustic stimulation neurotechnology, for military-related traumatic stress. METHODS: Eighteen participants (17 males, mean age 41 years [SD = 7], 15 active duty) enrolled in an IRB approved pilot trial for symptoms of military-related traumatic stress. Participants received 19.5 (1.1) HIRREM sessions over 12 days. Symptoms, physiological and functional measures, and whole brain resting MRI were collected before and after HIRREM. Six whole brain functional networks were evaluated using summary variables and community structure of predefined networks. Pre to postintervention change was analyzed using paired-sample statistical tests. RESULTS: Postintervention, there was an overall increase in connectivity of the default mode network (P =.0094). There were decreases of community structure in both the anterior portion of the default mode (medial prefrontal cortex, P =.0097) and in the sensorimotor (P =.005) network. There were no statistically significant changes at the whole brain level, or in the central executive, salience, or other networks analyzed. Participants demonstrated significant improvements in clinical symptoms, as well as autonomic cardiovascular regulation, which have been reported previously. CONCLUSIONS: Use of closed-loop, allostatic, acoustic stimulation neurotechnology (HIRREM) was associated with connectivity changes in the default mode and sensorimotor networks, in directions that may have explained the subjects’ clinical improvements.",Lee S.W.; Laurienti P.J.; Burdette J.H.; Tegeler C.L.; Morgan A.R.; Simpson S.L.; Gerdes L.; Tegeler C.H.,2018.0,10.1111/jon.12571,0,0,
1542, Electrical stimulation of auricular acupressure for dry eye: a randomized controlled-clinical trial," OBJECTIVE: To evaluate the clinical efficacy of electrical stimulation (ES) of auricular acupressure on reducing the ocular symptoms and signs before and after treatment for dry eye. METHODS: The inclusion criteria were the tear film break‚Äêup time (TFBUT) below 5 s and a Schirmer test‚ÄêI below 5 mm in dry eyes with ocular symptoms for at least 6 months. Subjects were randomized into a treatment group (50 cases) with continuous low frequency ES under auricular acupressure at acupoints and a no ES under auricular acupressure (no‚ÄêES, control group, 50 cases) on the same acupoints. Auricular acupressure were stimulated with ES at 4 master points of both ears, which were performed twice a week for 4 weeks at each point for 30 s. The ocular symptoms, the TFBUT, and Schirmer test‚ÄêI were evaluated before and after this procedure. RESULTS: There were significantly better scores in TFBUT (P=0.032), the Schirmer test‚ÄêI (P=0.044) and ocular symptoms (P=0.029) at 3 months post‚Äêtreatment in the treatment group than in the control group. The total effective rate in the treatment group was accomplished in 41 (82%) of the 50 cases of dry eye. CONCLUSIONS: Auricular acupressure with ES at auricular acupoint improves ocular symptoms and signs of dry eye for a period of at least 3 months."," Lee, JS;  Hwang, SH;  Shin, BC;  Park, YM",2017.0, 10.1007/s11655-016-2449-6,0,0,
1543,Art therapy based on appreciation of famous paintings and its effect on distress among cancer patients.,"We aimed to evaluate the effectiveness of art therapy based on appreciation of famous paintings on the distress of cancer patients receiving radiotherapy. In particular, we focused on anxiety, depression, and cancer-related symptoms. Between October 2015 and February 2016, cancer patients receiving radiotherapy were recruited prospectively to participate in the art therapy based on famous painting appreciation. The art therapy took place in two parts comprising 4 sessions of famous painting appreciation and 4 sessions of creative artwork generation; these sessions were performed twice weekly over four weeks. Cancer-related distress was measured using the Hospital Anxiety and Depression Scale (HADS), Hamilton Depression Rating Scale (HDRS), and Edmonton Symptom Assessment Scale (ESAS) at three points: before the art therapy began, after the fourth session of art therapy, and after the eighth session. Of the 24 enrolled patients, 20 (83%) completed all eight sessions. We observed significant improvements in HADS anxiety and total scores over time according to linear mixed models with Bonferroni corrections (all p < 0.05). Furthermore, HDRS scores demonstrated significant decreases according to linear mixed models (p = 0.001). Fewer patients met the HADS or HDRS criteria for severe anxiety or depression after the intervention. We observed no changes in ESAS mean scores. Art therapy based on famous painting appreciation significantly improved cancer-related anxiety and depression and reduced the prevalence of severe anxiety and depression during cancer treatment.",Lee J.; Choi MY.; Kim YB.; Sun J.; Park EJ.; Kim JH.; Kang M.; Koom WS.,2017.0,10.1007/s11136-016-1473-5,0,0,
1544, Comparing effects between music intervention and aromatherapy on anxiety of patients undergoing mechanical ventilation in the intensive care unit: a randomized controlled trial," PURPOSE: Using patient‚Äêreported outcomes and physiological indicators to test the effects of music intervention and aromatherapy on reducing anxiety for intensive care unit (ICU) patients undergoing mechanical ventilation. METHODS: Patients with ICU admission duration >24 h were randomly assigned to a Music intervention group (n‚Äâ=‚Äâ41), Aromatherapy group (n‚Äâ=‚Äâ47), or Control group (rest only; n‚Äâ=‚Äâ44). Each patient in the Music group listened to music; each patient in the Aromatherapy group received lavender essential oil massage on his/her back for 5 min; each patient in the Control group wore noise‚Äêcanceling headphones. Anxiety was measured using the Chinese version of the Stage‚ÄêTrait Anxiety Inventory (C‚ÄêSTAI) and the Visual Analogue Scale for Anxiety (VAS‚ÄêA) at baseline, post‚Äêtest, and 30‚Äêmin follow‚Äêup. Heart rate, breathing rate, and blood pressure were measured every 10 min from baseline to the 30‚Äêmin follow‚Äêup. RESULTS: The Music group had significantly better post‚Äêtest VAS‚ÄêA and C‚ÄêSTAI scores, and had lower heart rate and blood pressure than the Control group. The Aromatherapy group had significantly better VAS‚ÄêA score and lower heart rate than the Control group. The 30‚Äêmin follow‚Äêup showed that both Music and Aromatherapy groups had lower heart rate and blood pressure than the Control group. CONCLUSIONS: Music and aromatherapy interventions were both effective for ICU patients. The effects of music intervention were greater than that of aromatherapy; both interventions maintained the effects for at least 30 min."," Lee, CH;  Lai, CL;  Sung, YH;  Lai, MY;  Lin, CY;  Lin, LY",2017.0, 10.1007/s11136-017-1525-5,0,0,
1545,"Trauma symptoms, recovery, and participation in the Wellness Management and Recovery (WMR) program.","Despite the disproportionate prevalence of posttraumatic stress disorder (PTSD) among individuals with severe mental illness (SMI), and the emergence of effective trauma-specific treatments for comorbid PTSD/SMI, PTSD remains undertreated in this population. Literature points to two reasons for such: underdiagnosing of PTSD among individuals with SMI, and lack of clinician confidence/training in trauma-specific issues. A meta-analysis found non-trauma-specific groups reduced trauma symptoms in non-SMI populations. Against this backdrop, the purpose of this study was to determine whether individuals with SMI and trauma symptoms reported reduced trauma symptoms following completion of a non-trauma-specific, recovery-focused group treatment, the Wellness Management and Recovery (WMR) program. Pre- and post-WMR data were obtained from 54 participants via the Mental Health Recovery Measure and Posttraumatic Stress Disorder Checklist. Participants reported significant improvements in mental health recovery, and significant decreases in trauma symptoms. Results suggested that WMR-a non-trauma-specific group program-may offer promise in reducing trauma symptoms among individuals with SMI who may not have access to evidence-based trauma-specific treatments and/or who may not wish to specifically address trauma issues. Further exploration of the potential of WMR participation to reduce trauma symptoms among individuals with SMI is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lee, Alisha; Bullock, Wesley A; Hoy, Janet",2016.0,http://dx.doi.org/10.1080/15487768.2016.1162755,0,0,
1546,The efficacy of aerobic exercise and resistance training as transdiagnostic interventions for anxiety-related disorders and constructs: A randomized controlled trial.,"Evidence supports exercise as an intervention for many mental health concerns; however, randomized controlled investigations of the efficacy of different exercise modalities and predictors of change are lacking. The purposes of the current trial were to: (1) quantify the effects of aerobic exercise and resistance training on anxiety-related disorder (including anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder) status, symptoms, and constructs, (2) evaluate whether both modalities of exercise were equivalent, and (3) to determine whether exercise enjoyment and physical fitness are associated with symptom reduction. A total of 48 individuals with anxiety-related disorders were randomized to aerobic exercise, resistance training, or a waitlist. Symptoms of anxiety-related disorders, related constructs, and exercise enjoyment were assessed at pre-intervention and weekly during the 4-week intervention. Participants were further assessed 1-week and 1-month post-intervention. Both exercise modalities were efficacious in improving disorder status. As well, aerobic exercise improved general psychological distress and anxiety, while resistance training improved disorder-specific symptoms, anxiety sensitivity, distress tolerance, and intolerance of uncertainty. Physical fitness predicted reductions in general psychological distress for both types of exercise and reductions in stress for aerobic exercise. Results highlight the efficacy of different exercise modalities in uniquely addressing anxiety-related disorder symptoms and constructs.",LeBouthillier DM.; Asmundson GJG.,2017.0,10.1016/j.janxdis.2017.09.005,0,0,
1547,"Working Memory and Motor Activity: A Comparison Across Attention-Deficit/Hyperactivity Disorder, Generalized Anxiety Disorder, and Healthy Control Groups.","Converging findings from recent research suggest a functional relationship between attention-deficit/hyperactivity disorder (ADHD)-related hyperactivity and demands on working memory (WM) in both children and adults. Excessive motor activity such as restlessness and fidgeting are not pathognomonic symptoms of ADHD, however, and are often associated with other diagnoses such as generalized anxiety disorder (GAD). Further, previous research indicates that anticipatory processing associated with anxiety can directly interfere with storage and rehearsal processes of WM. The topographical similarity of excessive motor activity seen in both ADHD and anxiety disorders, as well as similar WM deficits, may indicate a common relationship between WM deficits and increased motor activity. The relationship between objectively measured motor activity (actigraphy) and PH and visuospatial WM demands in adults with ADHD (n = 21), adults with GAD (n = 21), and healthy control adults (n = 20) was examined. Although all groups exhibited significant increases in activity from control to WM conditions, the ADHD group exhibited a disproportionate increase in activity, while activity exhibited by the GAD and healthy control groups was not different. Findings indicate that ADHD-related hyperactivity is uniquely related to WM demands, and appear to suggest that adults with GAD are no more active relative to healthy control adults during a cognitively demanding laboratory task.",Lea SE.; Matt Alderson R.; Patros CHG.; Tarle SJ.; Arrington EF.; Grant DM.,2018.0,10.1016/j.beth.2017.08.009,0,0,
1548,Gaze-contingent music reward therapy for social anxiety disorder: A randomized controlled trial.,"Objective: Patients with social anxiety disorder exhibit increased attentional dwelling on social threats, providing a viable target for therapeutics. This randomized controlled trial examined the efficacy of a novel gaze-contingent music reward therapy for social anxiety disorder designed to reduce attention dwelling on threats. Method: Forty patients with social anxiety disorder were randomly assigned to eight sessions of either gaze-contingent music reward therapy, designed to divert patients' gaze toward neutral stimuli rather than threat stimuli, or to a control condition. Clinician and self-report measures of social anxiety were acquired pretreatment, posttreatment, and at 3-month followup. Dwell time on socially threatening faces was assessed during the training sessions and at pre- and post-treatment. Results: Gaze-contingent music reward therapy yielded greater reductions of symptoms of social anxiety disorder than the control condition on both clinician-rated and self-reported measures. Therapeutic effects were maintained at follow-up. Gaze-contingent music reward therapy, but not the control condition, also reduced dwell time on threat, which partially mediated clinical effects. Finally, gaze-contingent music reward therapy, but not the control condition, also altered dwell time on socially threatening faces not used in training, reflecting near-transfer training generalization. Conclusions: This is the first randomized controlled trial to examine a gaze-contingent intervention in social anxiety disorder. The results demonstrate target engagement and clinical effects. This study sets the stage for larger randomized controlled trials and testing in other emotional disorders. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Lazarov, Amit; Pine, Daniel S; Bar-Haim, Yair",2017.0,http://dx.doi.org/10.1176/appi.ajp.2016.16080894,0,0,
1549, Predictors of treatment response in anxious-depressed adolescents with school refusal," METHOD: A hierarchical multiple regression analysis was used to evaluate the following variables as potential predictors of treatment response as measured by school attendance at the end of treatment: baseline severity (school attendance at baseline), drug group (imipramine versus placebo), presence of separation anxiety disorder (SAD), and presence of avoidant disorder (AD). RESULTS: Baseline attendance, CBT plus imipramine, SAD, and AD were significant predictors of treatment response and accounted for 51% of the variance in outcome. Specifically, a higher rate of attendance at baseline and receiving imipramine predicted a better response to treatment whereas the presence of SAD and AD predicted a poorer response to treatment. The relationship between sociodemographic variables and treatment outcome was also evaluated. Age and socioeconomic status were unrelated to school attendance after treatment. Males had significantly higher rates of attendance after treatment than females. CONCLUSIONS: Adolescents with school refusal are a heterogeneous population and require individualized treatment planning. Variables such as diagnosis and severity at the start of treatment should be taken into consideration when planning treatment. OBJECTIVE: To identify predictors of treatment response to 8 weeks of cognitive‚Äêbehavioral therapy (CBT) among anxious‚Äêdepressed adolescents with school refusal, half of whom received imipramine plus CBT and half of whom received placebo plus CBT."," Layne, AE;  Bernstein, GA;  Egan, EA;  Kushner, MG",2003.0, 10.1097/00004583-200303000-00012,0,0,
1550, Logistical challenges and design considerations for studies using acute anterior cruciate ligament injury as a potential model for early posttraumatic osteoarthritis," Anterior cruciate ligament (ACL) injuries are common and lead to posttraumatic osteoarthritis (PTOA) in a high percentage of patients. Research has been ineffective in identifying successful treatment options for people suffering from symptomatic PTOA resulting in a shift of focus toward the young, ACL injured patients at risk of developing PTOA. Randomized clinical trials examining the very early phase after ACL injury are ideal to study this population; however, these trials face significant challenges regarding recruitment as well as reproducibility of patient‐reported outcomes (PROs) and inflammatory and/or chondrodegenerative biomarkers associated with early PTOA. The aim of this work was to develop an approach to allow for early recruitment into an RCT for early treatment following ACL injury and to analyze the variability of commonly used measures and biomarkers at various time points after injury. This paper reports the study design and data related to the first month of treatment for the placebo group of an ongoing 2‐year clinical trial to evaluate the effect of an early intra‐articular intervention after ACL injury. The results of this study suggest that acute ACL injury results in early changes of both inflammatory and chondrodegenerative biomarkers. These results also provide vital information for researchers to consider when developing future protocols, both related to the logistics of early patient enrollment as well as the appropriate timing of biomarker and patient‐reported outcome collection. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:641‐650, 2017."," Lattermann, C;  Jacobs, CA;  Bunnell, MP;  Jochimsen, KN;  Abt, JP;  Reinke, EK;  Gammon, LG;  Huebner, JL;  Kraus, VB;  Spindler, KP",2017.0, 10.1002/jor.23329,0,0,
1551,Effects of aerobic exercise on anxiety symptoms and cortical activity in patients with Panic Disorder: A pilot study.,"Background: The effects of the aerobic exercise on anxiety symptoms in patients with Panic Disorder (PD) remain unclear. Thus, the investigation of possible changes in EEG frontal asymmetry could contribute to understand the relationship among exercise, brain and anxiety. Objective: To investigate the acute effects of aerobic exercise on the symptoms of anxiety and the chronic effects of aerobic exercise on severity and symptoms related to PD, besides the changes in EEG frontal asymmetry. Methods: Ten PD patients were divided into two groups, Exercise Group (EG; n = 5) and Control Group (CG; n = 5), in a randomized allocation. At baseline and post-intervention, they submitted the psychological evaluation through Panic Disorder Severity Scale (PDSS), Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), EEG frontal asymmetry, and maximal oxygen consumption (VO2max). On the second visit, the patients of EG being submitted to the aerobic exercise (treadmill, 25 minutes, and 50-55% of heart rate reserve) and the CG remained seated for the same period of time. Both groups submitted a psychological evaluation with Subjective Units of Distress Scale (SUDS) at baseline, immediately after (Post-0), and after 10 minutes of the rest pause (Post-10). The patients performed 12 sessions of aerobic exercise with 48-72 hours of interval between sessions. Results: In EG, SUDS increased immediately after exercise practice and showed chronic decrease in BAI and BDI-II as well as increased in VO2max (Post-intervention). (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Lattari, Eduardo; Budde, Henning; Paes, Flavia; Neto, Geraldo Albuquerque Maranhao; Appolinario, Jose Carlos; Nardi, Antonio Egidio; Murillo-Rodriguez, Eric; Machado, Sergio",2018.0,http://dx.doi.org/10.2174/1745017901814010011,0,0,
1552,Exposure and non-fear emotions: A randomized controlled study of exposure-based and rescripting-based imagery in PTSD treatment.,"Interventions involving rescripting-based imagery have been proposed as a better approach than exposure-based imagery when posttraumatic stress disorder (PTSD) is associated with emotions other than fear. Prior research led to the study's hypotheses that (a) higher pretreatment non-fear emotions would predict relatively better response to rescripting as compared to exposure, (b) rescripting would be associated with greater reduction in non-fear emotions, and (c) pretreatment non-fear emotions would predict poor response to exposure. A clinically representative sample of 65 patients presenting a wide range of traumas was recruited from patients seeking and being offered PTSD treatment in an inpatient setting. Subjects were randomly assigned to 10 weeks of treatment involving either rescripting-based imagery (Imagery Rescripting; IR) or exposure-based imagery (Prolonged Exposure; PE). Patients were assessed on outcome and emotion measures at pretreatment, posttreatment and 12 months follow-up. Comparison to control benchmarks indicated that both treatments were effective, but no outcome differences between them appeared. None of the initial hypotheses were supported. The results from this study challenge previous observations and hypotheses about exposure mainly being effective for fear-based PTSD and strengthen the notion that exposure-based treatment is a generally effective treatment for all types of PTSD.",Langkaas TF.; Hoffart A.; √òktedalen T.; Ulvenes PG.; Hembree EA.; Smucker M.,2017.0,10.1016/j.brat.2017.06.007,0,0,
1553, Effects of a mindfulness intervention in Chilean high schoolers," AIM: To determine the impact of a mindfulness‐based intervention on negative emotional states of anxiety, stress, and depression in Chilean high schoolers. MATERIAL AND METHODS: Eighty‐eight teenagers aged 13 ± 0.6 years (46 females) were randomly assigned to a mindfulness group or a control (41 and 47, respectively). The mindfulness intervention consisted in eight weekly 45‐minute sessions. A depression, anxiety, and stress scale (DASS‐21) was applied at baseline, after the intervention, and at three and six‐month follow‐up. RESULTS: There was a significant reduction in anxiety, depression, and general symptomatology in the experimental group compared to the control group. However, these changes were not sustained at follow‐up. CONCLUSIONS: These preliminary results suggest the feasibility and effectiveness of a mindfulness intervention in Chilean schools as a strategy to reduce negative emotional states and prevent risk factors in adolescent population groups. BACKGROUND: Mindfulness has been conceptualized as paying attention to present moment experience in a non‐judgmental manner, and the practice of developing that skill."," Langer, ÁI;  Schmidt, C;  Aguilar-Parra, JM;  Cid, C;  Magni, A",2017.0, 10.4067/S0034-98872017000400008,0,0,
1554," The position of a written document in preoperative information for pediatric surgery: a randomized controlled trial on parental anxiety, knowledge, and satisfaction"," INTRODUCTION: Preoperative information is a legal and ethical obligation. Very little studies have evaluated the preoperative information method in pediatrics. Having a child operated on is stressful for the parents. Improving information is a way to lower their anxiety. Our study aims to measure the impact of a leaflet, which supports spoken information on parental anxiety, the comprehension‐memorization of the information and their satisfaction. MATERIALS & METHODS: Prospective study including 178 patients of outpatient surgery, randomized in two groups: spoken information versus spoken information supported by a leaflet, which is then handed out to the parents. The messages were identical: physiopathology, risks without treatment, surgical technique and its possible complications, description of the hospitalization day, and postoperative care. Parental evaluation was made with self‐questionnaires after the preoperative consultation, then on the day of surgery. At each moment we evaluated the level of anxiety, satisfaction of information quality and the comprehension‐memorization of the data. RESULTS: Written information significantly improves the scores of comprehension‐memorization, parental satisfaction and significantly decreases the level of anxiety. CONCLUSION: Significant impact of the written document as communication support in pediatric surgery, validating the method and encouraging it to be generalized to other pediatric surgery acts. LEVEL OF EVIDENCE: Level I. TYPE OF STUDY: Prognosis study."," Landier, M;  Villemagne, T;  Le Touze, A;  Braïk, K;  Meignan, P;  Cook, AR;  Morel, B;  Lardy, H;  Binet, A",2018.0, 10.1016/j.jpedsurg.2017.04.009,0,0,
1555,Mood reactivity and affective dynamics in mood and anxiety disorders.,"The application of ecological momentary assessment (EMA) in community settings provides a powerful opportunity to obtain measures of emotional reactivity to daily life events, as well as emotional dynamics in real time. This investigation examines the association between emotional reactivity to daily events and emotional experience in mood and anxiety disorders in a large community-based sample. Two-hundred and 87 participants with a lifetime history of bipolar I disorder (BPI; n = 33), bipolar II disorder (BPII; n = 37), major depression (MDD; n = 116), anxiety disorders without a mood disorder (ANX; n = 36), and controls without a lifetime history of mood, anxiety, or substance use disorder (n = 65) completed a 2-week EMA evaluation period concerning mood states and daily events. Following positive events, individuals with BPI reported greater decreases in both sad and anxious mood than did controls, and individuals with MDD experienced greater decreases in anxious mood. Following negative events, the BPII, MDD, and ANX (but not BPI) groups experienced greater increases in anxious mood, with no group differences in sad mood. Greater variability and instability were observed for sad mood in the BPII and MDD groups, and greater variability and instability was observed for anxious mood in all of the mood/anxiety groups. However, no group differences were observed for the inertia of sad or anxious moods. The findings demonstrate differences in emotional reactivity to daily events as well as the general affective dynamics of emotional states among individuals with mood or anxiety disorders, with potential specificity for BPI disorder relative to other disorders. Emotional variability and instability may constitute a nonspecific characteristic of both mood and anxiety disorders. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement General Scientific Summary-This study suggests that responses to positive and negative daily events differ by subtypes of mood disorders. Both reactivity and stability of emotional states among people with BPI disorder differ from those with BPII, MDD, and anxiety disorders, confirming emerging evidence from studies of familial and clinical features for distinguishing BPI from these other subgroups. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Lamers, Femke; Swendsen, Joel; Cui, Lihong; Husky, Mathilde; Johns, Jordan; Zipunnikov, Vadim; Merikangas, Kathleen R",2018.0,http://dx.doi.org/10.1037/abn0000378,0,0,
1556,Prevalence of mental disorders among depressed coronary patients with and without Type D personality. Results of the multi-center SPIRR-CAD trial.,"Type D personality, as with formal mental disorders, is linked to increased mortality in coronary heart disease (CHD). Our aim was to determine the prevalence of mental disorders among depressed CHD patients with and without Type D personality. Depressive symptoms (HADS, HAM-D), Type D personality (DS-14) and mental disorders based on DSM-IV (SCID I and II) were assessed. Results were calculated by Kruskal-Wallis tests, Fisher's exact tests and logistic regression analyses. 570 CHD patients were included (age 59.2±9.5years; male 78.9%, HADS-D depression 10.4±2.5; HAM-D 11.3±6.6; Type D 60.1%). 84.8% of patients with Type D personality and 79.3% of non-Type D patients suffered from at least one mental disorder (p=0.092), while 41.8% of Type D positives and 27.8% of Type D negatives had at least two mental disorders (p=0.001). Patients with Type D personality significantly more often had social phobia [odds ratio (95% confidence interval): 3.79 (1.1 to 13.12); p=0.035], dysthymia [1.78 (1.12 to 2.84); p=0.015], compulsive [2.25 (1.04 to 4.86); p=0.038] or avoidant [8.95 (2.08 to 38.49); p=0.003] personality disorder. Type D personality among depressed CHD patients is associated with more complex and enduring mental disorders. This implies higher treatment demands. ISRCTN 76240576; NCT00705965.",Lambertus F.; Herrmann-Lingen C.; Fritzsche K.; Hamacher S.; Hellmich M.; Jünger J.; Ladwig KH.; Michal M.; Ronel J.; Schultz JH.; Vitinius F.; Weber C.; Albus C.,,10.1016/j.genhosppsych.2017.10.001,0,0,
1557,An uncontrolled clinical trial of guided respiration mindfulness therapy (GRMT) in the treatment of depression and anxiety.,"Guided respiration mindfulness therapy (GRMT) is a manualized intervention that synthesizes a sustained focus on self-regulation of respiration, mindfulness, and relaxation. In our previous publication (in Lalande et al. J Contemp Psychother 46(2):107-116, 2016) we reported an evaluation of a manual-based GRMT therapist training program for the treatment of depression and anxiety. Here we report the outcomes of the manualized treatment program for depression and anxiety with clients. Forty-two participants with a primary diagnosis of depression or anxiety disorder participated in an uncontrolled clinical trial evaluating treatment response using standardised outcome measures with data collected on a session-by-session basis. For the majority of participants, treatment led to statistically and clinically significant reduction in symptoms of depression, anxiety and stress, along with reduced anxiety sensitivity and increases in overall wellbeing. Results suggested GRMT shows promise as an effective brief treatment option that does not rely on cognitive or behavioural techniques. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Lalande, Lloyd; King, Robert; Bambling, Matthew; Schweitzer, Robert D",2017.0,http://dx.doi.org/10.1007/s10879-017-9360-0,0,0,
1558,The effectiveness of critical time intervention for abused women leaving women's shelters: a randomized controlled trial.,"To examine the effectiveness of critical time intervention (CTI)-an evidence-based intervention-for abused women transitioning from women's shelters to community living. A randomized controlled trial was conducted in nine women's shelters across the Netherlands. 136 women were assigned to CTI (n = 70) or care-as-usual (n = 66). Data were analyzed using intention-to-treat three-level mixed-effects models. Women in the CTI group had significant fewer symptoms of post-traumatic stress (secondary outcome) (adjusted mean difference - 7.27, 95% CI - 14.31 to - 0.22) and a significant fourfold reduction in unmet care needs (intermediate outcome) (95% CI 0.06-0.94) compared to women in the care-as-usual group. No differences were found for quality of life (primary outcome), re-abuse, symptoms of depression, psychological distress, self-esteem (secondary outcomes), family support, and social support (intermediate outcomes). This study shows that CTI is effective in a population of abused women in terms of a reduction of post-traumatic stress symptoms and unmet care needs. Because follow-up ended after the prescribed intervention period, further research is needed to determine the full long-term effects of CTI in this population.",Lako DAM.; Beijersbergen MD.; Jonker IE.; de Vet R.; Herman DB.; van Hemert AM.; Wolf JRLM.,2018.0,10.1007/s00038-017-1067-1,0,0,
1559,Pilot trial of post-admission cognitive therapy: Inpatient program for suicide prevention.,"Suicide remains a significant public health problem for the United States military. Trauma-related diagnoses such as acute stress disorder (ASD) or posttraumatic stress disorder (PTSD) may exacerbate suicide risk, particularly among service members psychiatrically hospitalized following suicide-related events. To date, treatments to address suicide risk and trauma symptomatology among service members within inpatient milieus have been nonexistent. To address this gap, a randomized controlled pilot trial of Post-Admission Cognitive Therapy (PACT) was conducted to evaluate a targeted cognitive-behavioral program among traumatized military personnel (N = 36) hospitalized following a recent suicide attempt. All participants met criteria for ASD or PTSD and were randomly assigned to receive either PACT and enhanced usual care (PACT + EUC) or EUC alone. PACT consisted of six 60- to 90-min individual psychotherapy sessions, adapted from Brown et al.'s (2005) cognitive therapy protocol for suicide prevention. Blinded follow-up assessments were conducted at 1-, 2-, and 3-months postpsychiatric discharge. The primary outcome was days until repeat suicide attempt. Secondary outcomes included depression, hopelessness, suicide ideation, and PTSD symptoms. Participants did not significantly differ in reattempt status. However, based on reliable change index analyses, a greater proportion of PACT + EUC versus EUC participants met criteria for clinically significant change on measures of depression (100% vs. 78%), hopelessness (83% vs. 57%), and PTSD symptom severity (100% vs. 38%), but not for suicide ideation (60% vs. 67%). PACT is an innovative inpatient protocol, currently under evaluation in a well-powered multisite RCT for its efficacy in reducing subsequent suicidal behaviors. (PsycINFO Database Record",LaCroix JM.; Perera KU.; Neely LL.; Grammer G.; Weaver J.; Ghahramanlou-Holloway M.,2018.0,10.1037/ser0000224,0,0,
1560, Young women's genital self-image and effects of exposure to pictures of natural vulvas," INTRODUCTION: Many women have doubts about the normality of the physical appearance of their vulvas. This study measured genital self‚Äêimage in a convenience sample of college‚Äêeducated women, and assessed whether exposure to pictures of natural vulvas influenced their genital self‚Äêimage. METHOD: Forty‚Äêthree women were either shown pictures of natural vulvas (N‚Äâ=‚Äâ29) or pictures of neutral objects (N‚Äâ=‚Äâ14). Genital self‚Äêimage was measured before and after exposure to the pictures and two weeks later. Sexual function, sexual distress, self‚Äêesteem and trait anxiety were measured to investigate whether these factors influenced genital self‚Äêimage scores after vulva picture exposure. RESULTS: A majority of the participants felt generally positively about their genitals. Having been exposed to pictures of natural vulvas resulted in an even more positive genital self‚Äêimage, irrespective of levels of sexual function, sexual distress, self‚Äêesteem and trait anxiety. In the women who had seen the vulva pictures, the positive effect on genital self‚Äêimage was still present after two weeks. DISCUSSION: The results of this study seem to indicate that even in young women with a relatively positive genital self‚Äêimage, exposure to pictures of a large variety of natural vulvas positively affects genital self‚Äêimage. This finding may suggest that exposure to pictures of natural vulvas may also lead to a more positive genital self‚Äêimage in women who consider labiaplasty."," Laan, E;  Martoredjo, DK;  Hesselink, S;  Snijders, N;  van Lunsen, RHW",2017.0, 10.1080/0167482X.2016.1233172,0,0,
1561, A randomized controlled pilot trial of a Web-based resource to improve cancer knowledge in adolescent and young adult survivors of childhood cancer," OBJECTIVE: This study examined cancer knowledge in adolescent and young adult (AYA) survivors and pilot tested a Web‐based resource to provide individually tailored information regarding cancer treatment history, late effects risk, and resources. METHODS: Fifty‐two survivors (15‐28 years old) who completed cancer treatment were recruited from the University of Minnesota oncology clinics. Participants were randomly assigned to receive access to personalized health history, late effects information, and resources via a password‐protected Web portal or to standard of care (physician counseling) only. Participants completed surveys measuring cancer knowledge, health locus of control, and psychosocial well‐being prior to randomization and approximately 1 year later. RESULTS: Overall, few participants accurately reported their chemotherapy history with detail (19% at baseline and 33% at follow‐up), and many did not recognize that previous cancer treatments could impact future health (60% at baseline and 54% at follow‐up). Among those randomized to the receive access to the website, utilization was very low, making it difficult to draw conclusions about efficacy. Nonetheless, these data suggest that offering tailored information through the Web was not more effective than standard of care at improving cancer knowledge. Anxiety and health beliefs were associated with cancer knowledge, including knowledge of steps survivors could take to mitigate late effects risks (p < 01). CONCLUSIONS: Knowledge gaps exist among AYA survivors regarding important aspects of their treatment histories and ongoing health risks. Offering purely educational information (either in person by providers or via the Web) does not appear to be enough to close this gap. Copyright © 2015 John Wiley & Sons, Ltd."," Kunin-Batson, A;  Steele, J;  Mertens, A;  Neglia, JP",2016.0, 10.1002/pon.3956,0,0,
1562, Comparison of contemporaneous responses for EQ-5D-3L and Minnesota Living with Heart Failure; a case for disease specific multiattribute utility instrument in cardiovascular conditions," BACKGROUND: The EQ‚Äê5D‚Äê3L, a generic multi‚Äêattribute utility instrument (MAUI), is widely employed to assist in economic evaluations in health care. The EQ‚Äê5D‚Äê3L lacks sensitivity when used in conditions such as cardiovascular disease (CVD). Although there are number of CVD specific quality of life instruments, currently, there are no CVD specific MAUIs. The aim of this study is to investigate the discriminative ability and responsiveness of the EQ‚Äê5D‚Äê3L and the Minnesota Living with Heart Failure Questionnaire (MLHF), a CVD specific quality of life instrument in a group of heart failure patients. METHODS: The psychometric performance of the EQ‚Äê5D‚Äê3L and the MLHF was assessed using data from a randomised trial for a heart failure management intervention. The two instruments were compared for discrimination, responsiveness and agreement. The severity groups were defined using New York Heart Association functional classes. RESULTS: The effect sizes for severe classes were generally similar showing good discrimination. The MLHF recorded better responsiveness between the time points than the EQ‚Äê5D‚Äê3L which was indicated by higher effect sizes and standardised response means. The change in MLHF summary scores between the time points was significant (p<0.005; paired t‚Äêtest). The overall agreement between the two measures was low. CONCLUSION: The low correlation indicates that the two classification systems cover different aspects of health space. Comparison of CVD specific instruments with other generic MAUIs such as EQ‚Äê5D‚Äê3L and AQOL‚Äê8D is recommended for further research."," Kularatna, S;  Byrnes, J;  Chan, YK;  Carrington, MJ;  Stewart, S;  Scuffham, PA",2017.0, 10.1016/j.ijcard.2016.11.030,0,0,
1563,Patient Health Questionnaire Anxiety and Depression Scale: Initial Validation in Three Clinical Trials.,"We examine the reliability and validity of the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS)-which combines the nine-item Patient Health Questionnaire depression scale and seven-item Generalized Anxiety Disorder scale-as a composite measure of depression and anxiety. Baseline data from 896 patients enrolled in two primary-care based trials of chronic pain and one oncology-practice-based trial of depression and pain were analyzed. The internal reliability, standard error of measurement, and convergent, construct, and factor structure validity, as well as sensitivity to change of the PHQ-ADS were examined. The PHQ-ADS demonstrated high internal reliability (Cronbach α values of .8 to .9) in all three trials. PHQ-ADS scores can range from 0 to 48 (with higher scores indicating more severe depression/anxiety), and the estimated standard error of measurement was approximately 3 to 4 points. The PHQ-ADS showed strong convergent (most correlations, 0.7-0.8 range) and construct (most correlations, 0.4-0.6 range) validity when examining its association with other mental health, quality of life, and disability measures. PHQ-ADS cutpoints of 10, 20, and 30 indicated mild, moderate, and severe levels of depression/anxiety, respectively. Bifactor analysis showed sufficient unidimensionality of the PHQ-ADS score. PHQ-ADS change scores at 3 months differentiated (p < .0001) between individuals classified as worse, stable, or improved by a reference measure, providing preliminary evidence for sensitivity to change. The PHQ-ADS may be a reliable and valid composite measure of depression and anxiety which, if validated in other populations, could be useful as a single measure for jointly assessing two of the most common psychological conditions in clinical practice and research. Clinicaltrials.gov Identifier: NCT00926588 (SCOPE); NCT00386243 (ESCAPE); NCT00313573 (INCPAD).",Kroenke K.; Wu J.; Yu Z.; Bair MJ.; Kean J.; Stump T.; Monahan PO.,,10.1097/PSY.0000000000000322,0,0,
1564,Effects of an inquiry-based short intervention on state test anxiety in comparison to alternative coping strategies.,"Background and Objectives: Test anxiety can have undesirable consequences for learning and academic achievement. The control-value theory of achievement emotions assumes that test anxiety is experienced if a student appraises an achievement situation as important (value appraisal), but feels that the situation and its outcome are not fully under his or her control (control appraisal). Accordingly, modification of cognitive appraisals is assumed to reduce test anxiety. One method aiming at the modification of appraisals is inquiry-based stress reduction. In the present study (N = 162), we assessed the effects of an inquiry-based short intervention on test anxiety. Design: Short-term longitudinal, randomized control trial. Methods: Focusing on an individual worry thought, 53 university students received an inquiry-based short intervention. Control participants reflected on their worry thought (n = 55) or were distracted (n = 52). Thought related test anxiety was assessed before, immediately after, and 2 days after the experimental treatment. Results: After the intervention as well as 2 days later, individuals who had received the inquiry-based intervention demonstrated significantly lower test anxiety than participants from the pooled control groups. Further analyses showed that the inquiry-based short intervention was more effective than reflecting on a worry thought but had no advantage over distraction. Conclusions: Our findings provide first experimental evidence for the effectiveness of an inquiry-based short intervention in reducing students' test anxiety. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Krispenz, Ann; Dickhauser, Oliver",2018.0,http://dx.doi.org/10.3389/fpsyg.2018.00201,0,0,
1565, Transference Focused Psychotherapy for Borderline-Adolescents in a Day Clinic Treatment Program," Transference Focused Psychotherapy for Borderline‚ÄêAdolescents in a Day Clinic Treatment Program This paper focuses on the concept of transference focused psychotherapy (TFP) modified for juvenile borderline patients. Adolescents with borderline developmental personality disorder (bpd) have an essential deficit in their personality structure that leads to oscillations in their self‚Äêesteem and in a ""split"" perception of the world. They suffer from a variety of symptoms and severe impairments on their own and their families' quality of life. Their fragmented perception of themselves and others make relationships almost unbearable for them. Relationships are mostly marked by severe anxiety of resentment and rejection. For these patients this causes intolerable trouble at school where every day conflicts take place. Self‚Äêmutilation and suicidal thoughts often seem the only way out. By now, there is an agreement that an early specialized assessment and treatment is necessary in order to stop the typical consequences of their self‚Äêmutilative and dysfunctional behavior. Still, in contrast to adult age, empirical evidence is missing which proves the effectiveness of treating adolescent borderline patients. In this paper we present a research project on the effectiveness of transference focused psychotherapy with adolescent borderline patients (TFP‚ÄêA) in a day clinic setting, combining TFP with group skills training as known from dialectic behavior therapy (DBT). Furthermore, we give first results on analyzing the effectiveness of our day clinic treatment program based on TFP‚ÄêA, focusing on improving core symptoms such as affective problems, aggressive behavior against self and others and interpersonal problems."," Krischer, M;  Ponton-Rodriguez, T;  Gooran, GR;  Bender, S",2017.0, 10.13109/prkk.2017.66.6.445,0,0,
1566, Readiness to change and therapy outcomes of an innovative psychotherapy program for surgical patients: results from a randomized controlled trial," BACKGROUND: Readiness to change is a pivotal construct for psychotherapy research and a major target of motivational interventions. Our primary objective was to examine whether pre‚Äêtreatment readiness to change moderated therapy effects of Bridging Intervention in Anesthesiology (BRIA), an innovative psychotherapy approach for surgical patients. This stepped care program aims at motivating and supporting surgical patients with mental disorders to engage in psychosocial mental health care. METHODS: The major steps of BRIA are two motivational interventions with different intensity. The first step of the program consists of preoperative computer‚Äêassisted psychosocial self‚Äêassessment including screening for psychological distress and automatically composed computerized brief written advice (BWA). In the second step, patients participate in postoperative psychotherapy sessions combining motivational interviewing with cognitive behavioural therapy (BRIA psychotherapy sessions). We performed regression‚Äêbased moderator analyses on data from a recent randomized controlled trial published by our research group. The sample comprised 220 surgical patients with diverse comorbid mental disorders according to ICD‚Äê10. The most frequent disorders were mood, anxiety, substance use and adjustment disorders. The patients had a mean age of 43.31 years, and 60.90% were women. In a regression model adjusted for pre‚Äêtreatment psychological distress, we investigated whether readiness to change moderated outcome differences between (1) the BRIA psychotherapy sessions and (2) no psychotherapy / BWA only. RESULTS: Multiple regression analyses showed that readiness to change moderated treatment effects regarding the primary outcomes ""Participation in psychosocial mental health care options at month 6"" (p‚Äâ=‚Äâ0.03) and ""Having approached psychosocial mental health care options at month 6"" (p‚Äâ=‚Äâ0.048) but not regarding the secondary outcome ""Change of general psychological distress between baseline assessment and month 6"" (p‚Äâ=‚Äâ0.329). Probing the moderation effect with the Johnson‚ÄêNeyman technique revealed that BRIA psychotherapy sessions were superior to BWA in patients with low to moderate readiness, but not in those with high readiness. CONCLUSIONS: Readiness to change may act as moderator of the efficacy of psychosocial therapy. Combinations of motivational interviewing and cognitive behavioural therapy may be effective particularly in patients with a variety of mental disorders and low readiness to change. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01357694."," Krampe, H;  Salz, AL;  Kerper, LF;  Krannich, A;  Schnell, T;  Wernecke, KD;  Spies, CD",2017.0, 10.1186/s12888-017-1579-5,0,0,
1567, Cognitive bias modification for interpretation with and without prior repetitive negative thinking to reduce worry and rumination in generalised anxiety disorder and depression: protocol for a multisession experimental study with an active control condition," INTRODUCTION: Worry and rumination are two forms of repetitive thinking characterised by their negative content and apparently uncontrollable nature. Although worry and rumination share common features and have been conceptualised as part of a transdiagnostic repetitive negative thinking (RNT) process, it remains unclear whether they share the same underlying cognitive mechanisms. This multisession experimental study investigates the tendency to make negative interpretations regarding ambiguous information as a cognitive mechanism underlying RNT. We compare multisession cognitive bias modification for interpretations (CBM‐I) with an active control condition to examine whether repeatedly training positive interpretations reduces worry and rumination in individuals with generalised anxiety disorder or depression, respectively. Further, we examine the potential modulatory effects of engaging in RNT immediately prior to CBM‐I. DESIGN, METHODS AND ANALYSIS: A community sample of individuals meeting diagnostic criteria for either generalised anxiety disorder (n=60) or current major depressive episode (n=60) will be randomly allocated to CBM‐I with prior RNT, CBM‐I without prior RNT (ie, standard CBM‐I), or an active control (no resolution of ambiguity) condition. All conditions receive a 3‐week internet‐based intervention consisting of one initial session at the first study visit and nine home‐based sessions of CBM‐I training (or active control). We will assess and compare the effects of CBM‐I with and without prior RNT on 'near‐transfer' measures of interpretation bias closely related to the training as well as 'far‐transfer' outcomes related to RNT and emotional distress. Impact on questionnaire measures will additionally be assessed at 1‐month follow‐up. Multigroup analyses will be conducted to assess the impact of CBM‐I on near‐transfer and far‐transfer outcome measures."," Krahé, C;  Mathews, A;  Whyte, J;  Hirsch, CR",2016.0, 10.1136/bmjopen-2016-013404,0,0,
1568,Cognitive bias modification for interpretation with and without prior repetitive negative thinking to reduce worry and rumination in generalised anxiety disorder and depression: protocol for a multisession experimental study with an active control conditi,"Worry and rumination are two forms of repetitive thinking characterised by their negative content and apparently uncontrollable nature. Although worry and rumination share common features and have been conceptualised as part of a transdiagnostic repetitive negative thinking (RNT) process, it remains unclear whether they share the same underlying cognitive mechanisms. This multisession experimental study investigates the tendency to make negative interpretations regarding ambiguous information as a cognitive mechanism underlying RNT. We compare multisession cognitive bias modification for interpretations (CBM-I) with an active control condition to examine whether repeatedly training positive interpretations reduces worry and rumination in individuals with generalised anxiety disorder or depression, respectively. Further, we examine the potential modulatory effects of engaging in RNT immediately prior to CBM-I. A community sample of individuals meeting diagnostic criteria for either generalised anxiety disorder (n=60) or current major depressive episode (n=60) will be randomly allocated to CBM-I with prior RNT, CBM-I without prior RNT (ie, standard CBM-I), or an active control (no resolution of ambiguity) condition. All conditions receive a 3-week internet-based intervention consisting of one initial session at the first study visit and nine home-based sessions of CBM-I training (or active control). We will assess and compare the effects of CBM-I with and without prior RNT on 'near-transfer' measures of interpretation bias closely related to the training as well as 'far-transfer' outcomes related to RNT and emotional distress. Impact on questionnaire measures will additionally be assessed at 1-month follow-up. Multigroup analyses will be conducted to assess the impact of CBM-I on near-transfer and far-transfer outcome measures.",Krahé C.; Mathews A.; Whyte J.; Hirsch CR.,2016.0,10.1136/bmjopen-2016-013404,0,0,
1569, The effect of childhood adversity on 4-year outcome in individuals at ultra high risk for psychosis in the Dutch Early Detection Intervention Evaluation (EDIE-NL) Trial," Childhood adversity is associated with a range of mental disorders, functional impairment and higher health care costs in adulthood. In this study we evaluated if childhood adversity was predictive of adverse clinical and functional outcomes and health care costs in a sample of patients at ultra‚Äêhigh risk (UHR) for developing a psychosis. Structural Equation Modeling was used to examine the effect of childhood adversity on depression, anxiety, transition to psychosis and overall functioning at 4‚Äêyear follow‚Äêup. In addition, we evaluated economic costs of childhood adversity in terms of health care use and productivity loss. Data pertain to 105 UHR participants of the Dutch Early Detection and Intervention Evaluation (EDIE‚ÄêNL). Physical abuse was associated with higher depression rates (b=0.381, p=0.012) and lower social functional outcome (b=‚Äê0.219, p=0.017) at 4‚Äêyear follow‚Äêup. In addition, emotional neglect was negatively associated with social functioning (b=‚Äê0.313, p=0.018). We did not find evidence that childhood adversity was associated with transition to psychosis, but the experience of childhood adversity was associated with excess health care costs at follow‚Äêup. The data indicate long‚Äêterm negative effects of childhood adversity on depression, social functioning and health care costs at follow‚Äêup in a sample of UHR patients."," Kraan, TC;  Ising, HK;  Fokkema, M;  Velthorst, E;  van den Berg, DPG;  Kerkhoven, M;  Veling, W;  Smit, F;  Linszen, DH;  Nieman, DH;  et al.",2017.0, 10.1016/j.psychres.2016.11.014,0,0,
1570,Repetitive TMS to augment cognitive processing therapy in combat veterans of recent conflicts with PTSD: A randomized clinical trial.,"The objective was to test whether repetitive Transcranial Magnetic Stimulation (rTMS) just prior to Cognitive Processing Therapy (CPT) would significantly improve the clinical outcome compared to sham rTMS prior to CPT in veterans with PTSD. Veterans 18-60 years of age with current combat-related PTSD symptoms were randomized, using a 1:1 ratio in a parallel design, to active (rTMS+CPT) versus sham (sham+CPT) rTMS just prior to weekly CPT for 12-15 sessions. Blinded raters evaluated veterans at baseline, after the 5th and 9th treatments, and at 1, 3, and 6 months post-treatment. Clinician Administered PTSD Scale (CAPS) was the primary outcome measure with the PTSD Checklist (PCL) as a secondary outcome measure. The TMS coil (active or sham) was positioned over the right dorsolateral prefrontal cortex (110% MT, 1Hz continuously for 30min, 1800 pulses/treatment). Of the 515 individuals screened for the study, 103 participants were randomized to either active (n = 54) or sham rTMS (n = 49). Sixty-two participants (60%) completed treatment and 59 (57%) completed the 6-month assessment. The rTMS+CPT group showed greater symptom reductions from baseline on both CAPS and PCL across CPT sessions and follow-up assessments, t(df ≥ 325) ≤ -2.01, p ≤ 0.023, one-tailed and t(df ≥ 303) ≤ -2.14, p ≤ 0.017, one-tailed, respectively. Participants were predominantly male and limited to one era of conflicts as well as those who could safely undergo rTMS. The addition of rTMS to CPT compared to sham with CPT produced significantly greater PTSD symptom reduction early in treatment and was sustained up to six months post-treatment.",Kozel FA.; Motes MA.; Didehbani N.; DeLaRosa B.; Bass C.; Schraufnagel CD.; Jones P.; Morgan CR.; Spence JS.; Kraut MA.; Hart J.,2018.0,10.1016/j.jad.2017.12.046,0,0,
1571, The INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) study: design and methods to address mental healthcare gaps in India," INTRODUCTION: Depression and diabetes are highly prevalent worldwide and often co‚Äêexist, worsening outcomes for each condition. Barriers to diagnosis and treatment are exacerbated in low and middle‚Äêincome countries with limited health infrastructure and access to mental health treatment. The INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) study tests the sustained effectiveness and cost‚Äêeffectiveness of a multi‚Äêcomponent care model for individuals with poorly‚Äêcontrolled diabetes and depression in diabetes clinics in India. MATERIALS AND METHODS: Adults with diabetes, depressive symptoms (Patient Health Questionnaire‚Äê9 score‚â•10), and ‚â•1 poorly‚Äêcontrolled cardiometabolic indicator (either HbA1c‚â•8.0%, SBP‚â•140mmHg, and/or LDL‚â•130mg/dl) were enrolled and randomized to the intervention or usual care. The intervention combined collaborative care, decision‚Äêsupport, and population health management. The primary outcome is the between‚Äêarm difference in the proportion of participants achieving combined depression response (‚â•50% reduction in Symptom Checklist score from baseline) AND one or more of: ‚â•0.5% reduction in HbA1c, ‚â•5mmHg reduction in SBP, or ‚â•10mg/dl reduction in LDL‚Äêc at 24months (12‚Äêmonth intervention; 12‚Äêmonth observational follow‚Äêup). Other outcomes include control of individual parameters, patient‚Äêcentered measures (i.e. treatment satisfaction), and cost‚Äêeffectiveness. RESULTS: The study trained seven care coordinators. Participant recruitment is complete ‚Äê 940 adults were screened, with 483 eligible, and 404 randomized (196 to intervention; 208 to usual care). Randomization was balanced across clinic sites. CONCLUSIONS: The INDEPENDENT model aims to increase access to mental health care and improve depression and cardiometabolic disease outcomes among complex patients with diabetes by leveraging the care provided in diabetes clinics in India (clinicaltrials.gov number: NCT02022111)."," Kowalski, AJ;  Poongothai, S;  Chwastiak, L;  Hutcheson, M;  Tandon, N;  Khadgawat, R;  Sridhar, GR;  Aravind, SR;  Sosale, B;  Anjana, RM;  et al.",2017.0, 10.1016/j.cct.2017.06.013,0,0,
1572," Neurostimulation for abdominal pain-related functional gastrointestinal disorders in adolescents: a randomised, double-blind, sham-controlled trial"," BACKGROUND: Development of safe and effective therapies for paediatric abdominal pain‐related functional gastrointestinal disorders is needed. A non‐invasive, US Food and Drug Administration‐cleared device (Neuro‐Stim, Innovative Health Solutions, IN, USA) delivers percutaneous electrical nerve field stimulation (PENFS) in the external ear to modulate central pain pathways. In this study, we evaluated the efficacy of PENFS in adolescents with abdominal pain‐related functional gastrointestinal disorders. METHODS: In this randomised, sham‐controlled trial, we enrolled adolescents (aged 11‐18 years) who met Rome III criteria for abdominal pain‐related functional gastrointestinal disorders from a single US outpatient gastroenterology clinic. Patients were randomly assigned (1:1) with a computer‐generated randomisation scheme to active treatment or sham (no electrical charge) for 4 weeks. Patients were stratified by sex and presence or absence of nausea. Allocation was concealed from participants, caregivers, and the research team. The primary efficacy endpoint was change in abdominal pain scores. We measured improvement in worst abdominal pain and composite pain score using the Pain Frequency‐Severity‐Duration (PFSD) scale. Participants with less than 1 week of data and those with organic disease identified after enrolment were excluded from the modified intention‐to‐treat population. This trial has been completed and is registered with ClinicalTrials.gov, number NCT02367729. FINDINGS: Between June 18, 2015, and Nov 17, 2016, 115 children with abdominal pain‐related functional gastrointestinal disorders were enrolled and assigned to either PENFS (n=60) with an active device or sham (n=55). After exclusion of patients who discontinued treatment (n=1 in the PENFS group; n=7 in the sham group) and those who were excluded after randomisation because they had organic disease (n=2 in the PENFS group; n=1 in the sham group), 57 patients in the PENFS group and 47 patients in the sham group were included in the primary analysis. Patients in the PENFS group had greater reduction in worst pain compared with sham after 3 weeks of treatment (PENFS: median score 5·0 [IQR 4·0‐7·0]; sham: 7·0 [5·0‐9·0]; least square means estimate of change in worse pain 2·15 [95% CI 1·37‐2·93], p<0·0001). Effects were sustained for an extended period (median follow‐up 9·2 weeks [IQR 6·4‐13·4]) in the PENFS group: median 8·0 (IQR 7·0‐9·0) at baseline to 6·0 (5·0‐8·0) at follow‐up versus sham: 7·5 (6·0‐9·0) at baseline to 7·0 (5·0‐8·0) at follow‐up (p<0·0001). Median PFSD composite scores also decreased significantly in the PENFS group (from 24·5 [IQR 16·8‐33.3] to 8·4 [3·2‐16·2]) compared with sham (from 22·8 [IQR 8·4‐38·2] to 15·2 [4·4‐36·8]) with a mean decrease of 11·48 (95% CI 6·63‐16·32; p<0·0001) after 3 weeks. These effects were sustained at extended follow‐up in the PENFS group: median 24·5 (IQR 16·8‐33·3) at baseline to 12 (3·6‐22·5) at follow‐up, compared with sham: 22·8 (8·4‐38·2) at baseline to 16·8 (4·8‐33·6) at follow‐up (p=0·018). Ten patients reported side‐effects (three of whom discontinued the study): ear discomfort (n=6; three in the PENFS group, three in the sham group), adhesive allergy (n=3; one in the PENFS group, two in the sham group), and syncope due to needle phobia (n=1; in the sham group). There were no serious adverse events. INTERPRETATION: Our results show that PENFS with Neuro‐Stim has sustained efficacy for abdominal pain‐related functional gastrointestinal disorders in adolescents. This safe and effective approach expands treatment options and should be considered as a non‐pharmacological alternative for these disorders. FUNDING: American Neurogastroenterology and Motility Society."," Kovacic, K;  Hainsworth, K;  Sood, M;  Chelimsky, G;  Unteutsch, R;  Nugent, M;  Simpson, P;  Miranda, A",2017.0, 10.1016/S2468-1253(17)30253-4,0,0,
1573," Clinical and metabolic response to probiotic supplementation in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled trial"," METHODS: This randomized double‐blind placebo‐controlled clinical trial was conducted among 60 MS patients. Participants were randomly allocated into two groups to receive either a probiotic capsule (n = 30) or placebo containing starch (n = 30) for 12 weeks. Expanded disability status scale (EDSS) scoring and parameters of mental health were recorded at the baseline and 12 weeks after the intervention. RESULTS: Compared with the placebo, probiotic intake improved EDSS (‐0.3 ± 0.6 vs. +0.1 ± 0.3, P = 0.001), beck depression inventory (‐5.6 ± 4.9 vs. ‐1.1 ± 3.4, P < 0.001), general health questionnaire (‐9.1 ± 6.2 vs. ‐2.6 ± 6.4, P < 0.001) and depression anxiety and stress scale (‐16.5 ± 12.9 vs. ‐6.2 ± 11.0, P = 0.001). In addition, changes in high‐sensitivity C‐reactive protein (‐1.3 ± 3.5 vs. +0.4 ± 1.4 μg/mL, P = 0.01), plasma nitric oxide metabolites (+1.0 ± 7.9 vs. ‐6.0 ± 8.3 μmol/L, P = 0.002) and malondialdehyde (MDA) (+0.009 ± 0.4 vs. +0.3 ± 0.5 μmol/L, P = 0.04) in the probiotic group were significantly different from the changes in these parameters in the placebo group. Additionally, the consumption of probiotic capsule significantly decreased serum insulin (‐2.9 ± 3.7 vs. +1.1 ± 4.8 μIU/mL, P < 0.001), homeostasis model of assessment‐estimated insulin resistance (‐0.6 ± 0.8 vs.+0.2 ± 1.0, P = 0.001), Beta cell function (‐12.1 ± 15.5 vs. +4.4 ± 17.5, P < 0.001) and total‐/HDL‐cholesterol (‐0.1 ± 0.3 vs.0.1 ± 0.3, P = 0.02), and significantly increased quantitative insulin sensitivity check index (+0.01 ± 0.02 vs. ‐0.005 ± 0.01, P < 0.001) and HDL‐cholesterol levels (2.7 ± 3.4 vs. 0.9 ± 2.9 mg/dL, P = 0.02) compared with the placebo. CONCLUSIONS: Our study demonstrated that the use of probiotic capsule for 12 weeks among subjects with MS had favorable effects on EDSS, parameters of mental health, inflammatory factors, markers of insulin resistance, HDL‐, total‐/HDL‐cholesterol and MDA levels. BACKGROUND & AIMS: This trial was performed to evaluate the effects of probiotic intake on disability, mental health and metabolic condition in subjects with multiple sclerosis (MS)."," Kouchaki, E;  Tamtaji, OR;  Salami, M;  Bahmani, F;  Daneshvar Kakhaki, R;  Akbari, E;  Tajabadi-Ebrahimi, M;  Jafari, P;  Asemi, Z",2017.0, 10.1016/j.clnu.2016.08.015,0,0,
1574, Randomized clinical trial of expressive writing on wound healing following bariatric surgery," OBJECTIVE: Writing emotionally about upsetting life events (expressive writing) has been shown to speed healing of punch‐biopsy wounds compared to writing objectively about daily activities. We aimed to investigate whether a presurgical expressive writing intervention could improve surgical wound healing. METHOD: Seventy‐six patients undergoing elective laparoscopic bariatric surgery were randomized either to write emotionally about traumatic life events (expressive writing) or to write objectively about how they spent their time (daily activities writing) for 20 min a day for 3 consecutive days beginning 2 weeks prior to surgery. A wound drain was inserted into a laparoscopic port site and wound fluid analyzed for proinflammatory cytokines collected over 24 hr postoperatively. Expanded polytetrafluoroethylene tubes were inserted into separate laparoscopic port sites during surgery and removed after 14 days. Tubes were analyzed for hydroxyproline deposition (the primary outcome), a major component of collagen and marker of healing. Fifty‐four patients completed the study. RESULTS: Patients who wrote about daily activities had significantly more hydroxyproline than did expressive writing patients, t(34) = ‐2.43, p = .020, 95% confidence interval [‐4.61, ‐0.41], and higher tumor necrosis factor‐alpha, t(29) = ‐2.42, p = .022, 95% confidence interval [‐0.42, ‐0.04]. Perceived stress significantly reduced in both groups after surgery. CONCLUSIONS: Expressive writing prior to bariatric surgery was not effective at increasing hydroxyproline at the wound site 14 days after surgery. However, writing about daily activities did predict such an increase. Future research needs to replicate these findings and investigate generalizability to other surgical groups. (PsycINFO Database Record"," Koschwanez, H;  Robinson, H;  Beban, G;  MacCormick, A;  Hill, A;  Windsor, J;  Booth, R;  Jüllig, M;  Broadbent, E",2017.0, 10.1037/hea0000494,0,0,
1575,"Electronic visual analogue scales for pain, fatigue, anxiety and quality of life in people with multiple sclerosis using smartphone and tablet: a reliability and feasibility study.","To explore the reliability and feasibility of electronic visual analogue scales in people with multiple sclerosis (MS) and healthy individuals. Cross-sectional observational study Setting: Clinical setting Subjects: Convenience sample of 52 people with MS and 52 matched healthy controls Interventions: NA Main measures: Participants scored 15 statements assessing fatigue, pain, anxiety and quality of life on an electronic visual analogue scale (eVAS), either using a smartphone or a tablet (randomly allocated). To check for test-retest reliability, statements were administered in two separate randomly ordered groups. Subjects completed a feasibility questionnaire. Mean (SD) eVAS scores ranged from 35 (28.1) to 80 (22.1) in MS group, and from 57 (28.0) to 86 (13.2) in controls. Intra Class Correlations ranged from 0.73 to 0.95 in MS sample; 0.61 to 0.92 in controls. For most statements, Bland-Altman plots indicated no systematic error, but relatively large random error of the eVAS scores (exceeding 20mm). Considerable ceiling effects (i.e. better health) were found in healthy controls. Similar reliability was found among smartphone or tablet, different demographic groups and the experience-groups. Electronic visual analogue scales are reliable and useful for people with MS to register fatigue, pain, anxiety and quality of life.",Kos D.; Raeymaekers J.; Van Remoortel A.; D'hooghe MB.; Nagels G.; D'Haeseleer M.; Peeters E.; Dams T.; Peeters T.,2017.0,10.1177/0269215517692641,0,0,
1576,Efficacy and tolerability of levadex in treating acute migraine,"Background: Triptans may have inconsistent response, high recurrence, slow onset of action and potential MOH. IV DHE provides rapid relief, low recurrence and low MOH. However is difficult to administer and poorly tolerated. Levadex is a novel inhaled formulation of DHE.Methods: Randomized, double-blind, placebo-controlled study. Co-primary endpoints: pain-relief, nausea-free, photophobia- free, and phonophobia-free at 2 hours. Secondary endpoints: SPR at 2-24, pain-Relief at 4 hours, time to onset of pain-relief and PR at 10 minutes. Safety evaluations: clinical, laboratory, pulmonary and cardiac evaluations. Results: 792 in primary analysis. PR at 2 hours 59% for active arm (AA) compared to 35% for placebo (PL) (p=0.0001). Nausea-free, photophobia-free and phonophobiafree at 2 hours 67%, 47%, 53% respectively for AA and 59%, 27%, and 34% for the PL (p= 0.02, 0.0001 and 0.0001, respectively). PR at 10 minutes 9% for AA and 6% for PL (p=0.15). Time to PR was 30 minutes. SPR 2-24 and 2-48 hours for AA 44% and 36% and 20% and 17% for the PL (p=0.0001 and 0.0001 respectively). Well tolerated. No drugrelated SAEs.\ Conclusions: Levadex demonstrated rapid onset, high efficacy, and sustained response in this study. It was well tolerated. Study supported by: Study was funded in full by MAP Pharmaceuticals The presenting author is a full time employee of MAP Pharmaceuticals. Other authors are full time employees or have served as consultants to MAP pharmaceuticals.",Kori S.H.; Silberstein S.; Aurora S.; Tepper S.J.; Borland S.; Wang M.; Dodick D.,2010.0,10.1002/ana.22175,0,0,
1577,Efficacy and tolerability of LEVADEX in treating acute migraine,"Background: Triptans may have inconsistent response, high recurrence, slow onset of action and potential MOH. IV DHE provides rapid relief, low recurrence and low MOH. However, it is difficult to administer and poorly tolerated. Levadex is a novel inhaled formulation of DHE, 0.5 mg per actuation, with similar Tmax andAUC (and lower Cmax) as that of IV infusion, but is self-administered. Methods: Randomized, double-blind, placebo-controlled study. Co-primary endpoints: pain-relief, nausea-free, photophobia-free, and phonophobia-free at 2 hours. Secondary endpoints: pain-free at 2 hours, SPR and SPF at 2-24 and 2-48 hours, PR at 10 minutes, and time to onset of pain-relief. Safety evaluations: clinical, laboratory, pulmonary and cardiac evaluations. Results: 908 subjects were randomized, 792 of them who treated at least one headache, the mITT population, were included in the analysis. At baseline, 55% of patients reported moderate pain and 45% severe in the active group, and 53% and 47% respectively in placebo group. PR at 2 hours 59% for active arm (AA) compared to 35% for placebo (PL) (p=0.0001). Nausea-free, photophobia-free and phonophobia-free at 2 hours 67%, 47%, 53% respectively forAA and 59%, 27%, and 34% for the PL (p= 0.02, 0.0001 and 0.0001, respectively). PR at 10 minutes 9% for AA and 6% for PL (p=0.15). SPR 2-24 and 2-48 hours for AA 44% and 36% and 20% and 17% for the PL (p=0.0001 and 0.0001 respectively). Well tolerated. No drug-related serious adverse events. Conclusions: Levadex demonstrated rapid onset, high efficacy, and sustained response in this study. It was well tolerated.",Kori S.H.; Silberstein S.; Aurora S.; Borland S.; Wang M.; Dodick D.,2010.0,10.1111/j.1468-1331.2010.03231.x,0,0,
1578,Short-term effectiveness of web-based guided self-help for phobic outpatients: Randomized controlled trial.,"Background: Internet-based guided self-help has been successfully used in the general population, but it is unknown whether this method can be effectively used in outpatient clinics for patients waiting for face-to-face psychotherapy for phobias. Objective: The aim was to assess the clinical effectiveness of Phobias Under Control, an Internet-based intervention based on exposure therapy with weekly guidance. Methods: We conducted a randomized controlled trial, recruiting 212 outpatients scheduled to receive face-to-face psychotherapy for any type of phobia at an outpatient clinic. Participants suffering from at least 1 DSM-IV or ICD-10 classified phobia (social phobia, agoraphobia with or without panic disorder, and/or specific phobia as ascertained by a telephone interview at baseline) were randomly allocated to either a 5-week Internet-based guided self-help program based on exposure therapy with weekly student support followed by face-to-face psychotherapy (n = 105) or a wait-list control group followed by face-to-face psychotherapy (n = 107). Primary outcome was the Fear Questionnaire (FQ). Secondary outcomes were the Beck Anxiety Inventory (BAI) and Center of Epidemiological Studies-Depression scale (CES-D). Assessments took place by telephone at baseline (T0) and on the Internet at posttest (T1, self-assessment at 5 weeks after baseline). Missing data at T1 were imputed. Results: At posttest, analysis of covariance on the intention-to-treat sample showed significant but small effect sizes between intervention and control groups on the FQ (d = 0.35, P = .02), CES-D (d = 0.34, P = .03), and a nonsignificant effect size on the BAI (d = 0.28. P = .05). Although initial acceptance was good, high nonresponse was observed, with 86 of 212 participants (40.5%) lost to follow-up at T1 and only 14 of 105 (13.3%) intervention participants finishing all 5 weeks. Conclusions: Phobias Under Control is modestly effective in lowering phobic and depressive symptoms in a relatively short period and may be clinically beneficial when implemented in routine outpatient practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kok, Robin N; van Straten, Annemieke; Beekman, Aartjan T. F; Cuijpers, Pim",2014.0,,0,0,
1579, Subtyping social anxiety in youth," Few empirical studies have examined subtypes of social anxiety disorder (SAD) in youth, and limited consensus resides on the nature of potential subtypes. Identifying subtypes, based on both fear and avoidance patterns, can help improve assessment and treatment of SAD. Subtypes of fear and avoidance were examined in a sample comprising 131 youth (age 8‚Äê15 years) diagnosed with SAD using the Anxiety Disorders Interview Schedule for children and parents (ADIS‚ÄêC/P). Exploratory factor analysis of fear responses revealed three factors, defining fear subtypes linked to: (1) performance, (2) observation, and (3) interaction situations, respectively. Exploratory factor analysis of avoidance responses showed these were best represented by one avoidance factor. Few youth qualified exclusively for either of the fear subtypes, thus calling into question the clinical utility of these subtypes. Nevertheless, the findings indicate distinct contributions of fear and avoidance in SAD presentation. This finding might help clinicians target and improve treatment of the disorder."," Kodal, A;  Bjelland, I;  Gjestad, R;  Wergeland, GJ;  Havik, OE;  Heiervang, ER;  Fjermestad, K",2017.0, 10.1016/j.janxdis.2017.03.009,0,0,
1580, Posttraumatic stress and quality of life with the totally subcutaneous compared to conventional cardioverter-defibrillator systems," OBJECTIVE: This study aimed at comparing QoL and posttraumatic stress with both systems. METHODS: 60 S‐ICD RESULTS: n = 42 (70%) pairs were analyzed (n = 30 male, mean age 44.6 ± 12.2 years). Prior appropriate (p = 0.06) or inappropriate episodes (p = 0.24), ejection fraction (p = 0.28), or underlying cardiac disease did not differ significantly between groups. PDS revealed a PTSD in n = 6 tv‐ICD and n = 6 S‐ICD CONCLUSIONS: Our case‐control study revealed equal or even better physical well‐being of patients with the S‐ICD BACKGROUND: For prevention of sudden cardiac death, the transvenously implantable cardioverter‐defibrillator therapy (tv‐ICD) is well accepted. The subcutaneous system (S‐ICD"," Köbe, J;  Hucklenbroich, K;  Geisendörfer, N;  Bettin, M;  Frommeyer, G;  Reinke, F;  Dechering, D;  Burgmer, M;  Eckardt, L",2017.0, 10.1007/s00392-016-1055-0,0,0,
1581, Association between Blood Glucose Levels the Day after Targeted Temperature Initiation and Outcome in Traumatic Brain Injury: a Post-Hoc Analysis of the B-HYPO Study," We investigated associations between blood glucose levels and clinical outcomes in participants of the multi‐center randomized controlled Brain‐Hypothermia (B‐HYPO) study. Patients with severe traumatic brain injury (TBI, Glasgow Coma Scale 4‐8) were assigned to therapeutic hypothermia (TH, 32‐34°C, n = 98) or fever control (35.5‐37.0°C, n = 50) groups. TH patients were cooled as soon as possible for ≥72 h and rewarmed at a rate of <1°C/d. We recorded blood glucose (BG) levels on days 0, 1, and 3 after treatment initiation, and day 1 after rewarming. The Glasgow Outcome Scale was assessed at 6 months. Median BG levels decreased from day 0 to day 1 (163 vs. 132 mg/dL, p = 0.0062) in the fever control group. In contrast, a decrease was observed from day 1 to day 3 (157.5 vs. 126 mg/dL, p < 0.001) in the TH group. Day 1 BG was higher in the TH group compared with the fever control group (p = 0.0252). At day 0, BG levels were higher in non‐survivors compared with survivors across all patients (p = 0.0035), the TH group (p = 0.0125), and the non‐surgical group (p = 0.0236). Higher day 1 BG levels were observed in non‐survivors compared with survivors across all patients (p = 0.0071), the fever control group (p = 0.0495), and the surgical group (p = 0.0364). In the TH group, the initial stress hyperglycemia was sustained the next day after TH induction. Day 1 BG predicted outcome in TBI patients with TH and fever control. Our findings indicate the significance of BG control particularly during TH treatment."," Kobata, H;  Sugie, A;  Suehiro, E;  Dohi, K;  Kaneko, T;  Fujita, M;  Oda, Y;  Kuroda, Y;  Yamashita, S;  Maekawa, T",2017.0, 10.1089/neu.2016.4662,0,0,
1582, Effect of music on level of anxiety in patients undergoing colonoscopy without sedation," METHODS: This study enrolled 138 patients who underwent colonoscopy without sedation during a general health examination from February 2009 to January 2015. The patients were randomly assigned to a group that did not listen to music, a group that listened to music by David Tolley, or a group that listened to music by Kevin Kern. The State‚ÄêTrait Anxiety Inventory was used to evaluate the status of anxiety. RESULTS: A trend test for mild anxiety was performed on the patients in the three groups, and a significant trend was noted (p=0.017 for all patients; p=0.014 for analysis by sex). Multivariate analysis for mild anxiety on the patients in each group was also performed in this study, and music by Kevin Kern was found to have the lowest odds ratio (Odds ratio=0.34, p=0.045). CONCLUSION: Listening to music, especially music by Kevin Kern, reduced the level of anxiety in patients undergoing colonoscopy examination without sedation. BACKGROUND: Listening to music can be a noninvasive method for reducing the anxiety level without any adverse effects. The aim of this study was to explore whether music can reduce anxiety and to compare two different styles of music, informal classical music and light music, to ascertain the more effective style of music in reducing anxiety in patients undergoing colonoscopy without sedation."," Ko, CH;  Chen, YY;  Wu, KT;  Wang, SC;  Yang, JF;  Lin, YY;  Lin, CI;  Kuo, HJ;  Dai, CY;  Hsieh, MH",2017.0, 10.1016/j.jcma.2016.08.010,0,0,
1583, Design and protocol for the Dialysis Optimal Health Program (DOHP) randomised controlled trial," BACKGROUND: Chronic kidney disease (CKD) and end‚Äêstage kidney disease (ESKD) are serious and growing health problems with enormous impact on psychological and social functioning. Despite high rates of comorbid depression and anxiety in these patient populations, and the adverse impact these have upon treatment adherence, quality of life, social connectedness and healthcare costs there has been little attention focused on the prevention or management of these problems. Thus, our aim was to evaluate the Dialysis Optimal Health Program (DOHP) that adopts a person‚Äêcentred approach and engages collaborative therapy to educate and support those diagnosed with ESKD who are commencing dialysis. METHODS: The study design is a randomised controlled trial. Ninety‚Äêsix adult patients initiating haemodialysis or peritoneal dialysis will be randomly allocated to either the intervention (DOHP) or usual care group. Participants receiving the intervention will receive nine (8‚Äâ+‚Äâ1 booster session) sequential sessions based on a structured information/workbook, psychosocial and educational supports and skills building. The primary outcome measures are depression and anxiety (assessed by the Hospital Anxiety and Depression Scale; HADS). Secondary outcomes include health‚Äêrelated quality of life (assessed by the Kidney Disease Quality of Life instrument; KDQOL), self‚Äêefficacy (assessed by General Self‚ÄêEfficacy Scale) and clinical indices (e.g. albumin and haemoglobin levels). Cost‚Äêeffectiveness analysis and process evaluation will also be performed to assess the economic value and efficacy of the DOHP. Primary and secondary measures will be collected at baseline and at 3‚Äê, 6‚Äê, and 12‚Äêmonth follow‚Äêup time points. DISCUSSION: We believe that this innovative trial will enhance knowledge of interventions aimed at supporting patients in the process of starting dialysis, and will broaden the focus from physical symptoms to include psychosocial factors such as depression, anxiety, self‚Äêefficacy, wellbeing and community support. The outcomes associated with this study are significant in terms of enhancing an at‚Äêrisk population's psychosocial health and reducing treatment‚Äêrelated costs and associated pressures on the healthcare system. TRIAL REGISTRATION: ANZCTR no. 12615000810516 . Registered on 5 August 2015."," Knowles, SR;  Ski, CF;  Langham, R;  O'Flaherty, E;  Thompson, DR;  Rossell, SL;  Moore, G;  Hsueh, YS;  Castle, DJ",2016.0, 10.1186/s13063-016-1558-z,0,0,
1584,Effects of exposure to erotica on disgust: A preliminary test among contamination-fearful individuals,"Disgust has been implicated in the fear of contamination that is commonly observed in obsessive-compulsive disorder (OCD). However, basic and treatment-oriented research has shown that disgust is resistant to extinction among those with a fear of contamination. Consequently, there is growing interest in discovering novel approaches to targeting heightened disgust responding among those with OCD. Recent experimental research suggests that sexual arousal may inhibit disgust responding. Accordingly, the present study examines the effects of exposure to erotica on verbal reports of disgust and behavioral avoidance in a contamination-fearful sample of adults. Participants viewed sexually arousing, positively arousing, or neutral films and participated in a series of sexually relevant and non-sexually relevant behavioral approach tasks. Participants also gave ratings of disgust before and after completing each behavioral task. Although no group differences were observed for the number of steps completed on the behavioral approach tasks, those who viewed sexually arousing films reported significantly less change in disgust throughout the behavioral approach task compared to those who viewed positively arousing and neutral films. The potential clinical implications of the effects of sexual arousal on disgust responding in contamination-based OCD are discussed.",Knowles K.A.; Tomarken A.J.; Olatunji B.O.,2018.0,10.1016/j.jocrd.2018.06.006,0,0,
1585, 'One man's medicine is another man's poison': a qualitative study of user perspectives on low intensity interventions for Obsessive-Compulsive Disorder (OCD)," BACKGROUND: Low intensity interventions based on cognitive‚Äêbehavioral therapy (CBT) such as computerized therapy or guided self‚Äêhelp can offer effective and accessible care for mild to moderate mental health problems. However, critics argue that by reducing therapist input and the level of experience of the professionals delivering therapy, low intensity interventions deprive users of critical 'active ingredients'. Thus, while demand management arguments support the use of low intensity interventions for OCD, their integration into existing mental health services remains incomplete. Studies of user views of low intensity interventions can offer valuable insights to define their role and optimize their implementation in practice. METHODS: Qualitative interviews (n‚Äâ=‚Äâ36) in adults with OCD explored user perspectives on the initiation, continuation and acceptability of two low intensity CBT interventions: guided self‚Äêhelp (6 h of professional support) and computerized CBT (1 h of professional support), delivered within the context of a large pragmatic effectiveness trial (ISRCTN73535163). RESULTS: While uptake was relatively high, continued engagement with the low intensity interventions was complex, with the perceived limitations of self‚Äêhelp materials impacting on users' willingness to continue therapy. The addition of professional support provided an acceptable compromise between the relative benefits of self‚Äêhelp and the need for professional input. However, individual differences were evident in the extent to which this compromise was considered necessary and acceptable. The need for some professional contact to manage expectations and personalize therapy materials was amplified in users with OCD, given the unique features of the disorder. However, individual differences were again evident regarding the perceived value of face‚Äêto‚Äêface support. CONCLUSIONS: Overall the findings demonstrate the need for flexibility in the provision of low intensity interventions for OCD, responsive to user preferences, as these preferences impact directly on engagement with therapy and perceptions of effectiveness."," Knopp-Hoffer, J;  Knowles, S;  Bower, P;  Lovell, K;  Bee, PE",2016.0, 10.1186/s12913-016-1433-3,0,0,
1586,Reproducibility of low-dose stereography measurements of femoral torsion after IM nailing of femoral shaft fractures and in intact femurs.,"Rotational malunion is a complication of intramedullary (IM) nailing for femur fractures. Symptoms can appear with 15° or more of axial deformity. None of the currently available measurement methods have a satisfactory reliability/irradiation ratio. The purpose of this study was to study the reproducibility of measuring femoral torsion with an EOS(®) low-dose stereography (LDX) system. LDX is a reproducible method for measuring post-traumatic femoral torsion. The intra- and inter-observer reproducibility was studied in 45 patients who had a femoral fracture treated by IM nailing. Both the injured and contralateral healthy femurs were modelled. Bland-Altman plots were used to analyze the measurements made by three different observers (two orthopedic surgeons and one radiologist). For a given comparison, the interval between the upper limit of agreement (ULA) and lower limit of agreement (LLA) had to be within [-5°; 5°] for the examination to qualify as reproducible. Measurements were made by three observers (A, B, C) on the injured and healthy femur. With the fractured femurs (n=39), the intra-observer [LLA; ULA] interval was [-16.295; 12.977]; it was [-18.475; 16.744] for the A-B pairing, [-13.316; 13.532] for the B-C pairing and [-17.839; 19.355] for the A-C pairing. With the healthy femurs (n=37), the intra-observer [LLA; ULA] interval was [-7.909; 7.88]; it was [-11.924; 11.639] for the A-B pairing, [-12.654; 11.93] for the B-C pairing and [-11; 12.009] for the A-C pairing. The [LLA; ULA] intervals were greater than the [-5; +5] interval in all cases. LDX reproducibility is not sufficient for measuring femoral torsion after fracture or in healthy femurs. Observer experience, cohort size and the perfectible image quality are likely sources of bias. Conversely, the use of Bland-Altman plots and the multidisciplinary training of observers are major strengths of this study. Reproducibility will likely improve as the software is developed further and the image acquisition improves.",Knafo J.; Thelen T.; Verdier D.; Creppy L.; Tournier C.; Fabre T.,2016.0,10.1016/j.otsr.2016.03.020,0,0,
1587,The effectiveness of a multimodal brief group experiential psychotherapy approach.,"Assessed the effectiveness of a multimodal brief group experiential psychotherapy approach in reducing psychological symptoms, enhancing well-being, and in maintaining treatment outcomes at a 6-mo follow-up. Treatment outcomes were assessed in 41 Ss (aged 18-67 yrs) diagnosed with anxiety disorders, mood disorders, or adjustment disorders. Ss completed an 8-day, residential, group-therapy treatment program which involved 30 hr of intensive group experiential therapy, primarily using psychodrama. In addition, art therapy, music therapy, family sculpting, and Gestalt techniques were combined into an approach with philosophical and theoretical underpinnings in existential-humanistic psychology, developmental theory, and models of family therapy. Ss completed a battery of questionnaires at pretreatment, immediately following therapy, and between 4- and 6-mo posttreatment. Results show that the multimodal brief group experiential psychotherapy approach was effective in reducing negative psychological symptoms and in enhancing psychological well-being in the Ss. Future directions for research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Klontz, Bradley T; Wolf, Eve M; Bivens, Alex",2000.0,,0,0,
1588,Examining the effects of a novel training program and use of psychiatric service dogs for military-related PTSD and associated symptoms.,"This study explored an intensive 3-week training program and use of psychiatric service dogs for military-related posttraumatic stress disorder (PTSD) and associated symptoms. The sample included 2 separate cohorts of military veterans (n = 7 and n = 5) with prior diagnoses of PTSD. Participants completed self-report measures assessing PTSD, depression, perception of social support, anger, and overall quality of life 1 month prior to the training (baseline), at arrival to the training site, and 6-month follow-up. Results indicated that, for this sample, there was a statistically significant decrease in PTSD and depression symptoms from pre- to posttreatment, as well as 6-month follow-up. For most participants decreases were both clinically significant and reliable changes. Further, participants reported significant reductions in anger and improvement in perceived social support and quality of life. Limitations of the study include a lack of control group, a limitation of most naturalistic studies, as well as small sample size. Despite this, the findings indicate that utilizing psychiatric service dogs, coupled with an intensive trauma resilience training program for veterans with ongoing symptoms, is feasible as a complementary treatment for PTSD that could yield beneficial results in terms of symptom amelioration and improvement to overall quality of life. (PsycINFO Database Record",Kloep ML.; Hunter RH.; Kertz SJ.,2017.0,10.1037/ort0000254,0,0,
1589,Virtual reality and its contribution to the assessment and treatment of cognitive and behavioral disorders,"Virtual Reality technology offers new means to evaluate and rehabilitate cognitive functions. The contribution of this research concerns the appropriacy of the virtual reality approach to diagnosis, therapy and assessment in psychiatry and neuropsychology. Two little-researched subjects held our attention: the treatment of social phobia, and the assessment of action planning. Our first objective was to design an application based on virtual reality for each of these subjects and to evaluate their feasibility. The second objective was to identify the contribution of virtual reality to the assessment and treatment of human dysfunctions. The design and the implementation of a therapeutic treatment of social phobia, based on virtual reality, brought different challenges: the design of social interaction situations arousing emotional reactions among social phobic patients; the investigation of the various types of social phobia. The results of the clinical trial showed the efficacy of the virtual reality therapy. The design of a virtual reality system dedicated to human cognitive dysfunctions led us to tackle the assessment of action planning. It is based on the design of a planning task and a virtual environment, both of them called ecological. The study, carried out among old people and patients suffering from Parkinson s disease, helped us see the relevance and the potential of virtual reality approach. According to the experiments we carried out, we are now able to identify resulting benefits of virtual reality that open the way to new topics of reflection related to the role of virtual reality in the clinical process as well as in the patient-therapist relationship.",Klinger,2006.0,,0,0,
1590, Imipramine treatment of children with separation anxiety disorder," The efficacy of imipramine was investigated in 20 children (ages 6 to 15) with separation anxiety disorder. Children were treated for a month with vigorous behavioral treatment. If they did not respond, they entered a double‚Äêblind, randomized, 6‚Äêweek trial of imipramine or placebo. Of 45 children accepted, 21 (47%) entered the trial. About half the children improved with either treatment, and no superiority for imipramine was obtained. There was no instance of clinically significant EKG changes. This small study failed to replicate previous findings of imipramine efficacy in a similar, but larger, clinical population."," Klein, RG;  Koplewicz, HS;  Kanner, A",1992.0, 10.1097/00004583-199201000-00005,0,0,
1591,Quality of Life and Compassion Satisfaction in Clinicians: A Pilot Intervention Study for Reducing Compassion Fatigue.,"Compassion fatigue (CF) is prevalent in healthcare professionals, particularly in those caring for chronic, acutely ill, and/or those patients who might be moving toward comfort care. Over time, CF can lead to burnout (BO) and secondary traumatic stress and an overall decrease in professional quality of life. In this pilot study, participants completed a resiliency program focused on education about CF and self-awareness of its individualized impact and were expected to develop ongoing self-care practices to prevent/address the untoward effects. Healthcare professionals ( N = 15) participated in a formalized educational program consisting of three 90-minute educational sessions held 2 weeks apart. Preassessment and postintervention data were collected electronically in survey format. A postprogram evaluation was also offered. Upon completion of the program, participants noted an increase in compassion satisfaction (CS) and a small reduction in BO. Secondary traumatic stress remained unchanged. Feedback about the program was positive, and participants reported the impact on their clinical practice and life to be moderately high. At 6 months, over half of the participants continued to report positive impact on their personal/professional lives. While the small sample size of this pilot study limits the generalizability of the findings, there were positive effects for CS and BO in participants over time, indicating possible benefits of providing self-care education to healthcare providers. Additional research with a larger sample size is needed to address how healthcare providers might further benefit from resiliency education and interventions to improve professional quality of life.",Klein CJ.; Riggenbach-Hays JJ.; Sollenberger LM.; Harney DM.; McGarvey JS.,2018.0,10.1177/1049909117740848,0,0,
1592, Effects of Sleep after Experimental Trauma on Intrusive Emotional Memories," Study Objectives: To investigate sleep's effect in the immediate aftermath of experiencing an analog trauma in the laboratory on reducing intrusive emotional memory formation. Methods: Sixty‚Äêfive healthy women were exposed to an experimental laboratory trauma. They viewed a neutral and a trauma film in the laboratory and were randomly allocated to either a group that slept following film viewing or a group that remained awake. Sleep was recorded with electroencephalogram in a subgroup of participants in the sleep group. All participants recorded intrusive memories in the week following the film. Results: The sleep group experienced fewer and less distressing intrusive trauma memories compared to the wake group. These effects were particularly evident toward the end of the week. Duration spent in stage N2 as opposed to light N1 sleep, a higher number of fast parietal sleep spindles and a lower rapid eye movement sleep density predicted intrusion frequency. Conclusions: Our results have clinical implications and set the ground for early‚Äêintervention sleep studies following trauma and prevention of chronic posttrauma disorders."," Kleim, B;  Wysokowsky, J;  Schmid, N;  Seifritz, E;  Rasch, B",2016.0, 10.5665/sleep.6310,0,0,
1593,Auricular acupuncture for exam anxiety in medical students-A randomized crossover investigation.,"Auricular acupuncture (AA) is effective in the treatment of preoperative anxiety. The aim was to investigate whether AA can reduce exam anxiety as compared to placebo and no intervention. Forty-four medical students were randomized to receive AA, placebo, or no intervention in a crossover manner and subsequently completed three comparable oral anatomy exams with an interval of 1 month between the exams/interventions. AA was applied using indwelling fixed needles bilaterally at points MA-IC1, MA-TF1, MA-SC, MAAT1 and MA-TG one day prior to each exam. Placebo needles were used as control. Levels of anxiety were measured using a visual analogue scale before and after each intervention as well as before each exam. Additional measures included the State-Trait-Anxiety Inventory, duration of sleep at night, blood pressure, heart rate and the extent of participant blinding. All included participants finished the study. Anxiety levels were reduced after AA and placebo intervention compared to baseline and the no intervention condition (p < 0.003). AA was better at reducing anxiety than placebo in the evening before the exam (p = 0.018). Participants were able to distinguish between AA and placebo intervention. Both AA and placebo interventions reduced exam anxiety in medical students. The superiority of AA over placebo may be due to insufficient blinding of participants. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Klausenitz, Catharina; Hacker, Henriette; Hesse, Thomas; Kohlmann, Thomas; Endlich, Karlhans; Hahnenkamp, Klaus; Usichenko, Taras",2016.0,,0,0,
1594, Targeted Family Intervention for Complex Cases of Pediatric Obsessive-Compulsive Disorder: a Randomized Controlled Trial," OBJECTIVE: Although evidence‐based treatments for pediatric obsessive‐compulsive disorder (OCD) exist, many youth fail to respond, and interventions tailored to the needs of specific subsets of patients are lacking. This study examines the efficacy of a family intervention module designed for cases of OCD complicated by poor family functioning. METHOD: Participants were 62 youngsters aged 8 to 17 years (mean age = 12.71 years; 57% male; 65% white) with a primary diagnosis of OCD and at least 2 indicators of poor family functioning. They were randomized to receive 12 sessions of individual child cognitive‐behavioral therapy (CBT) plus weekly parent psychoeducation and session review (standard treatment [ST]) or the same 12 child sessions plus 6 sessions of family therapy aimed at improving OCD‐related emotion regulation and problem solving (positive family interaction therapy [PFIT]). Blinded raters evaluated outcomes and tracked responders to 3‐month follow‐up. RESULTS: Compared to ST, PFIT demonstrated better overall response rates on the Clinician Global Impression‐Improvement scale (CGI‐I; 68% versus 40%, p = .03, φ = 0.28) and rates of remission (58% PFIT versus 27% ST, p = .01, φ = 0.32). PFIT also produced significantly greater reductions in functional impairment, symptom accommodation, and family conflict, and improvements in family cohesion. As expected, these shifts in family functioning constitute an important treatment mechanism, with changes in accommodation mediating treatment response. CONCLUSION: PFIT is efficacious for reducing OCD symptom severity and impairment and for improving family functioning. Findings are discussed in terms of personalized medicine and mechanisms of change in pediatric OCD treatment. Clinical trial registration information‐Family Focused Treatment of Pediatric Obsessive Compulsive Disorder; http://clinicaltrials.gov/; NCT01409642."," Peris, TS;  Rozenman, MS;  Sugar, CA;  McCracken, JT;  Piacentini, J",2017.0, 10.1016/j.jaac.2017.10.008,0,0,
1595, Trajectories of change in youth anxiety during cognitive-behavior therapy," OBJECTIVE: To evaluate changes in the trajectory of youth anxiety following the introduction of specific cognitive‐behavior therapy (CBT) components: relaxation training, cognitive restructuring, and exposure tasks. METHOD: Four hundred eighty‐eight youths ages 7‐17 years (50% female; 74% ≤ 12 years) were randomly assigned to receive either CBT, sertraline (SRT), their combination (COMB), or pill placebo (PBO) as part of their participation in the Child/Adolescent Anxiety Multimodal Study (CAMS). Youths in the CBT conditions were evaluated weekly by therapists using the Clinical Global Impression Scale‐Severity (CGI‐S; Guy, 1976) and the Children's Global Assessment Scale (CGAS; Shaffer et al., 1983) and every 4 weeks by blind independent evaluators (IEs) using the Pediatric Anxiety Ratings Scale (PARS; RUPP Anxiety Study Group, 2002). Youths in SRT and PBO were included as controls. RESULTS: Longitudinal discontinuity analyses indicated that the introduction of both cognitive restructuring (e.g., changing self‐talk) and exposure tasks significantly accelerated the rate of progress on measures of symptom severity and global functioning moving forward in treatment; the introduction of relaxation training had limited impact. Counter to expectations, no strategy altered the rate of progress in the specific domain of anxiety that it was intended to target (i.e., somatic symptoms, anxious self‐talk, avoidance behavior). CONCLUSIONS: Findings support CBT theory and suggest that cognitive restructuring and exposure tasks each make substantial contributions to improvement in youth anxiety. Implications for future research are discussed. (PsycINFO Database Record"," Peris, TS;  Compton, SN;  Kendall, PC;  Birmaher, B;  Sherrill, J;  March, J;  Gosch, E;  Ginsburg, G;  Rynn, M;  McCracken, JT;  et al.",2015.0, 10.1037/a0038402,0,0,
1596, Therapist-Reported Features of Exposure Tasks That Predict Differential Treatment Outcomes for Youth With Anxiety," METHOD: This study draws on a sample of 279 children and adolescents (48.4% male; 79.6% white) with a principal anxiety disorder who received 14 sessions of CBT, either alone or in combination with medication, through the Child/adolescent Anxiety Multimodal treatment Study (CAMS). The present study examines therapist‚Äêreported quantity, difficulty level, compliance, and mastery of exposure tasks as they related to CBT response (i.e., Clinical Global Impressions‚ÄêImprovement ratings). Secondary treatment outcomes included reduction in anxiety symptom severity on the Pediatric Anxiety Rating Scale, global impairment measured via the Children's Global Assessment Scale, and parent‚Äêreport of anxiety‚Äêspecific functional impairment on the Child Anxiety Impairment Scale. RESULTS: Regression analyses indicated a dose‚Äêresponse relationship between therapist‚Äêreported quantity of exposure and independent evaluations of treatment outcome, with more time devoted to exposure linked to better outcomes. Similarly, greater time spent on more difficult (rather than mild or moderate) exposure tasks predicted better outcomes, as did therapist ratings of child compliance and mastery. CONCLUSION: The present findings highlight the importance of challenging children and adolescents with difficult exposure tasks and of collaborating to ensure compliance and mastery. OBJECTIVE: Exposure tasks are recognized widely as a key component of cognitive‚Äêbehavioral therapy (CBT) for child and adolescent anxiety. However, little research has examined specific exposure characteristics that predict outcomes for youth with anxiety and that may guide its application in therapy."," Peris, TS;  Caporino, NE;  O'Rourke, S;  Kendall, PC;  Walkup, JT;  Albano, AM;  Bergman, RL;  McCracken, JT;  Birmaher, B;  Ginsburg, GS;  et al.",2017.0, 10.1016/j.jaac.2017.10.001,0,0,
1597, Effect of chemotherapy counseling by pharmacists on quality of life and psychological outcomes of oncology patients in Malaysia: a randomized control trial," BACKGROUND: Cancer is now becoming a leading cause of death. Chemotherapy is an important treatment for cancer patients. These patients also need consultation during their treatment to improve quality of life and decrease psychological disorders. The objectives of the study were to develop, implement and evaluate the effectiveness of a chemotherapy counseling module by pharmacists among oncology patients on their quality of life and psychological outcomes in Malaysia. METHOD: A single‐blind randomized controlled trial was carried out among 162 oncology patients undergoing chemotherapy from July 2013 to February 2014 in a government hospital with oncology facilities in Malaysia. Participants were randomized to either the intervention group or the control group. Chemotherapy counseling using the module on 'Managing Patients on Chemotherapy' by Pharmacists was delivered to the intervention group. The outcome measures were assessed at baseline, first follow‐up and second follow‐up and third follow‐up post‐intervention. Chi‐square, independent samples t‐test and two‐way repeated measures ANOVA were conducted in the course of the data analyses. RESULTS: In assessing the impact of the chemotherapy counseling module, the study revealed that the module along with repetitive counseling showed significant improvement of quality of life in the intervention group as compared to the control group with a large effect size in physical health (p = 0.001, partial Ƞ CONCLUSION: The module on 'Managing Patients on Chemotherapy' along with repetitive counseling by pharmacists has been shown to be effective in improving quality of life and decreasing anxiety and depression among oncology patients undergoing chemotherapy. TRIAL REGISTRATION NUMBER: National Medical Research Register (NMRR) of Malaysia and given a registration number NMRR‐12‐1057‐12,363 on 21 December 2012."," Periasamy, U;  Mohd Sidik, S;  Rampal, L;  Fadhilah, SI;  Akhtari-Zavare, M;  Mahmud, R",2017.0, 10.1186/s12955-017-0680-2,0,0,
1598, Attention bias modification for youth with social anxiety disorder," BACKGROUND: Attention bias modification treatment (ABMT) targets threat‚Äêrelated attention biases in anxiety disorders. Most clinical trials of ABMT have focused on adults or small samples of youth. The current randomized controlled trial (RCT) examines ABMT efficacy in youth with social anxiety disorder (SAD) and tests possible moderators of treatment outcomes. METHOD: Sixty‚Äêseven youth with SAD were randomly assigned to ABMT or attention control training (ACT) conditions. Anxiety severity was measured at baseline, posttreatment, and 3‚Äêmonth follow‚Äêup. ClinicalTrials.gov name and identifier: Attention bias modification treatment for children with social anxiety, NCT01397032; http://www.clinicaltrials.gov. RESULTS: Both ABMT and ACT induced significant reductions in clinician and self‚Äêrated social anxiety (ps < .001). An additional reduction was observed at the 3‚Äêmonth follow‚Äêup in clinician‚Äêrated anxiety symptoms (p = .03). Moderation effects were nonsignificant for the clinician‚Äêrated anxiety outcome, but age moderated self‚Äêreported anxiety. Older but not younger children, showed significant reduction in anxiety following ABMT relative to ACT (p < .001). Individual differences in attention control also moderated ABMT's effect on self‚Äêreported anxiety (p = .05). Children rated by their parents as lower on attention control benefited more from ABMT than those rated higher on attention control. Baseline attention bias did not moderate anxiety (p = .17). CONCLUSIONS: Despite significant reductions in social anxiety, no specific evidence for ABMT was found relative to a control condition. Age and attention control moderated ABMT effects on self‚Äêreported SAD symptoms, with clinical effects for older relative to younger children and for those with lower attention control. These results highlight the need to consider developmental influences in the implementation of ABMT protocols."," Pergamin-Hight, L;  Pine, DS;  Fox, NA;  Bar-Haim, Y",2016.0, 10.1111/jcpp.12599,0,0,
1599, RANDOMIZED TRIAL OF D-CYCLOSERINE ENHANCEMENT OF COGNITIVE-BEHAVIORAL THERAPY FOR PANIC DISORDER," Background: Initial studies have provided a mixed perspective of the efficacy of d‚Äêcycloserine (DCS) for augmenting the efficacy of exposure‚Äêbased cognitive behavioral therapy (CBT) for panic disorder. In this multicenter trial, we examine the magnitude of DCS augmentation effects for an ultra‚Äêbrief program of CBT. Methods: We conducted a double‚Äêblind, controlled trial at three treatment sites, randomizing 180 adults with a primary diagnosis of panic disorder to five sessions of treatment, with study pill (50 mg DCS or matching placebo) administered 1 hr prior to the final three sessions. Two booster sessions were subsequently provided, and outcome was assessed at posttreatment and 1‚Äêmonth, 2‚Äêmonth, and 6‚Äêmonth follow‚Äêup assessments. The primary outcome was the degree of reduction in the Panic Disorder Severity Scale. Additional analyses examined the role of severity and current antidepressant or benzodiazepine use as moderators of DCS augmentation effects. Results: DCS augmentation resulted in significant benefit only early in the trial, with no beneficial effects of DCS augmentation evident at follow‚Äêup evaluations. We did not find that baseline severity or antidepressant or benzodiazepine use moderated DCS efficacy, but benzodiazepine use was associated with lower efficacy of CBT regardless of augmentation condition. Conclusions: Consistent with other recent multicenter trials, the benefit of DCS was less than indicated by pilot study and reflected an acceleration of treatment response evident at treatment endpoint, but no advantage in response over follow‚Äêup evaluation. Our results did not support severity or concomitant medication moderators observed in previous trials of DCS augmentation."," Otto, MW;  Pollack, MH;  Dowd, SM;  Hofmann, SG;  Pearlson, G;  Szuhany, KL;  Gueorguieva, R;  Krystal, JH;  Simon, NM;  Tolin, DF",2016.0, 10.1002/da.22531,0,0,
1600," Probiotic administration among free-living older adults: a double blinded, randomized, placebo-controlled clinical trial"," BACKGROUND: Diseases of the digestive system have been found to contribute to a higher symptom burden in older adults. Thus, therapeutic strategies able to treat gastrointestinal discomfort might impact the overall health status and help older adults to increase their overall health status and optimal functionality. OBJECTIVE: The aim of this double‐blinded, randomized, placebo‐controlled clinical trial was to evaluate the effect of the probiotic strain Lactobacillus reuteri on digestive health and wellbeing in older adults. METHODS: The study enrolled general older adults (>65 years). After eligibility screening qualified subjects (n = 290) participated in a 2‐arm study design, with each arm consisting of 12 weeks of intervention of either active or placebo product. Primary outcome measure was set to changes in gastrointestinal symptoms and secondary outcome measures were changes in level of wellbeing, anxiety and stress. Follow up was performed at 8 and 12 weeks. RESULTS: No persistent significant effects were observed on the primary or secondary outcome parameters of the study. A modest effect was observed in the probiotic arm, were levels of stress decreased at week 8 and 12. Similarly, we found that subjects suffering from indigestion and abdominal pain, respectively, showed a significant decrease of anxiety at week 8 after probiotic treatment, but not at week 12. CONCLUSION: The RCT failed to show any improvement in digestive health after daily intake of a probiotic supplement containing L. reuteri. Neither was any significant improvement in wellbeing, stress or anxiety observed. Even though the RCT had a negative outcome, the study highlights issues important to take into consideration when designing trials among older adults. TRIAL REGISTRATION: Clinicaltrials.gov/ NCT01837940 ."," Östlund-Lagerström, L;  Kihlgren, A;  Repsilber, D;  Björkstén, B;  Brummer, RJ;  Schoultz, I",2016.0, 10.1186/s12937-016-0198-1,0,0,
1601,Comparison of eye movement desensitization reprocessing and cognitive behavioral therapy as adjunctive treatments for recurrent depression: The European Depression EMDR Network (EDEN) randomized controlled trial.,"Background: Treatment of recurrent depressive disorders is currently only moderately successful. Increasing evidence suggests a significant relationship between adverse childhood experiences and recurrent depressive disorders, suggesting that trauma-based interventions could be useful for these patients. Objectives: To investigate the efficacy of Eye Movement Desensitization and Reprocessing therapy (EMDR) in addition to antidepressant medication (ADM) in treating recurrent depression. Design: A non-inferiority, single-blind, randomized clinical controlled trial comparing EMDR or CBT as adjunctive treatments to ADM. Randomization was carried out by a central computer system. Allocation was carried out by a study coordinator in each center. Setting: Two psychiatric services, one in Italy and one in Spain. Participants: Eighty-two patients were randomized with a 1:1 ratio to the EMDR group (n = 40) or CBT group (n = 42). Sixty-six patients, 31 in the EMDR group and 35 in the CBT group, were included in the completers analysis. Intervention: 15 +/- 3 individual sessions of EMDR or CBT, both in addition to ADM. Participants were followed up at 6-months. Main outcome measure: Rate of depressive symptoms remission in both groups, as measured by a BDI-II score < 13. Results: Sixty-six patients were analyzed as completers (31 EMDR vs. 35 CBT). No significant difference between the two groups was found either at the end of the interventions (71% EMDR vs. 48.7% CBT) or at the 6-month follow-up (54.8% EMDR vs. 42.9% CBT). A RM-ANOVA on BDI-II scores showed similar reductions over time in both groups [F(6,59) = 22.501, p < 0.001] and a significant interaction effect between time and group [F(6,59) = 3.357, p = 0.006], with lower BDI-II scores in the EMDR group at T1 [mean difference = -7.309 (95% CI [-12.811, -1.806]), p = 0.010]. The RM-ANOVA on secondary outcome measures showed similar improvement over time in both groups [F(14,51) = 8.202, p < 0.001], with no significant differences between groups [F(614,51) = 0.642, p = 0.817]. Conclusion: Although these results can be considered preliminary only, this study suggests that EMDR could be a viable and effective treatment for reducing depressive symptoms and improving the quality of life of patients with recurrent depression. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Ostacoli, Luca; Carletto, Sara; Cavallo, Marco; Baldomir-Gago, Paula; Di Lorenzo, Giorgio; Fernandez, Isabel; Hase, Michael; Justo-Alonso, Ania; Lehnung, Maria; Migliaretti, Giuseppe; Oliva, Francesco; Pagani, Marco; Recarey-Eiris, Susana; Torta, Riccardo; Tumani, Visal; Gonzalez-Vazquez, Ana I; Hofmann, Arne",2018.0,http://dx.doi.org/10.3389/fpsyg.2018.00074,0,0,
1602,Self Statements during Public Speaking Scale (SSPS): Cross-cultural adaptation for Brazilian Portuguese and internal consistency,"Background: The fear of public speaking is on of the most prevalent fears in the general population, and it is important to assess its underlying cognitive aspects. Objective: To perform the cross-cultural adaptation for Brazilian Portuguese of the Self Statements during Public Speaking Scale (SSPS), a self-assessment instrument designed for the public speaking situation. Methods: The process of translation and adaptation involved four bilingual professionals, the appreciation and approval of the back-translation by the authors of the original scale, a pilot study on 30 Brazilian undergraduate students, and appreciation by raters who attested to the face validity of the Portuguese version, which was called Escala para Auto-avaliação ao Falar em Público. As part of the psychometric study of the SSPS, the items of the scale were analyzed and its internal consistency was assessed in a sample of 2,314 undergraduate students. Results: The items of the positive self-evaluation subscale received the highest scores. The correlation of the items with the total score was quite adequate, ranging from 0.44 to 0.71, and internal consistency was also good, ranging from 0.78 to 0.90. Discussion: The Brazilian Portuguese version of the SSPS proved to be adequate regarding its psychometric properties. Studies evaluating the remaining indicators of validity and reliability of the SSPS on clinical and non-clinical samples would be opportune and necessary.",Osório F.D.L.; Crippa J.A.S.; Loureiro S.R.,2008.0,10.1590/S0101-60832008000600001,0,0,
1603, Dispositional Anxiety and Frontal-Midline Theta: on the Modulatory Influence of Sex and Situational Threat," In their adaptive control hypothesis, Cavanagh and Shackman (2015) recently claimed that dispositional anxiety is correlated with frontal‐midline theta (FMθ) as a generic ""need for control"" signal of the anterior midcingulate cortex. Here, we tested this assumption, also considering potential modulatory influences of anticipatory threat and individuals' sex. In a nonclinical sample of 168 participants (84 women), electroencephalogram was recorded while individuals performed a simple two‐choice task. Half of the participants were assigned to a threat anticipation condition (anticipation of public speaking), whereas the other half was assigned to a control condition. State anxiety was monitored across the experiment. Dispositional anxiety was assessed by self‐report scales, which were completed before individuals came to the laboratory. Target stimuli in the two‐choice task induced a transient increase in FMθ power that was subject to an interaction of dispositional anxiety, sex, and experimental group. Only in women who anticipated public speaking did we observe a substantial positive relation between dispositional anxiety and general FMθ power. Our results indicate that the link between dispositional anxiety and FMθ is not universal but rather depends on complex interactions of individuals' sex and situational threat."," Osinsky, R;  Karl, C;  Hewig, J",2017.0, 10.1111/jopy.12241,0,0,
1604, Efficacy of a Web-based Intervention for Concerned Spouses of Service Members and Veterans with Alcohol Misuse," Concerned partners (CPs) of service members and veterans who misuse alcohol face help‚Äêseeking barriers and mental health problems. We used multiple regression to evaluate the efficacy of Partners Connect, a four‚Äêsession web‚Äêbased intervention (WBI) to address military CPs' mental health and communication. We randomized 312 CPs to the WBI or a control group. Five months later, WBI CPs reported significant reductions in their anxiety and increases in their social support compared to control CPs. Intervention dose was also associated with improved WBI CP outcomes. Partners Connect appears to fill a need for families who face help‚Äêseeking barriers and provides an alternative to traditional care for those who may not otherwise seek help."," Osilla, KC;  Trail, TE;  Pedersen, ER;  Gore, KL;  Tolpadi, A;  Rodriguez, LM",2018.0, 10.1111/jmft.12279,0,0,
1605,A randomised placebo-controlled trial of a self-help Internet-based intervention for test anxiety.,"Test anxiety is widespread and associated with poor performance in academic examinations. The Internet, not well-proven for the treatment of anxiety, should be able to deliver highly accessible Cognitive Behavior Therapy (CBT). This study sought to test the hypothesis that CBT, available on the Internet, could reduce test anxiety. Ninety university students were randomly allocated to CBT or a control program, both on the Internet. Before and after treatment, the participants completed the Test Anxiety Inventory (TAI), an Anxiety Hierarchy Questionnaire (AHQ), the Exam Problem-Solving Inventory (EPSI), the General Self-Efficacy Scale (GSES) and the Heim reasoning tests (AH) as a measure of test performance. Of the CBT and control groups 28% and 35%, respectively, withdrew. According to the TAI, 53% of the CBT group showed a reliable and clinically significant improvement with treatment but only 29% of the control group exhibited such a change. On the AHQ, 67% of the CBT group and 36% of the control group showed a clinically significant improvement, more than two standard deviations above the mean of the baseline, a change in favour of CBT. Both groups improved on the GSES, in state anxiety during exams retrospectively assessed, and on the AH tests. The improvement on the AH tests was probably a practice effect and not a reflection of a change in capacity for academic testing. This study thus supports use of CBT on the Internet for the treatment of test anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Orbach, Gili; Lindsay, Stan; Grey, Susan",2007.0,http://dx.doi.org/10.1016/j.brat.2006.04.002,0,0,
1606," Reduction of body iron in HFE-related haemochromatosis and moderate iron overload (Mi-Iron): a multicentre, participant-blinded, randomised controlled trial"," BACKGROUND: The iron overload disorder hereditary haemochromatosis is most commonly caused by HFE p.Cys282Tyr homozygosity. In the absence of results from any randomised trials, current evidence is insufficient to determine whether individuals with hereditary haemochromatosis and moderately elevated serum ferritin, should undergo iron reduction treatment. This trial aimed to establish whether serum ferritin normalisation in this population improved symptoms and surrogate biomarkers. METHODS: This study was a multicentre, participant‐blinded, randomised controlled trial done at three centres in Australia. We enrolled people who were homozygous for HFE p.Cys282Tyr, aged between 18 and 70 years, with moderately elevated serum ferritin, defined as 300‐1000 μg/L, and raised transferrin saturation. Participants were randomly assigned, via a computer‐generated random number, to undergo either iron reduction by erythrocytapheresis (treatment group) or sham treatment by plasmapheresis (control group). Randomisation was stratified by baseline serum ferritin (<600 μg/L or ≥600 μg/L), sex, and study site. Erythrocytapheresis and plasmapheresis were done every 3 weeks, the number of procedures and volume of red cells or plasma removed determined on the basis of each patient's haemoglobin, haematocrit, and serum ferritin concentration, as well their height and weight. In the erythrocytapheresis group, the target was to reduce serum ferritin to less than 300 μg/L. The number of procedures for the control group was based on the initial serum ferritin and prediction of decrease in serum ferritin of approximately 120 μg/L per treatment. The primary outcome was patient‐reported Modified Fatigue Impact Scale (MFIS) score, measured at baseline and before unblinding. Analyses were by intention to treat, including the safety analysis. The trial is registered with ClinicalTrials.gov, number NCT01631708, and has been completed. FINDINGS: Between Aug 15, 2012, and June 9, 2016, 104 participants were randomly assigned to the treatment (n=54) and control (n=50) groups, of whom 94 completed the study (50 in the treatment group and 44 in the control group). Improvement in MFIS score was greater in the treatment group than in the control group (mean difference ‐6·3, 95% CI ‐11·1 to ‐1·4, p=0·013). There was a significant difference in the cognitive subcomponent (‐3·6, ‐5·9 to ‐1·3, p=0·0030), but not in the physical (‐1·90 ‐4·5 to 0·63, p=0·14) and psychosocial (‐0·54, ‐1·2 to 0·11, p=0·10) subcomponents. No serious adverse events occurred in either group. One participant in the control group had a vasovagal event and 17 participants (14 in the treatment group and three in the control group) had transient symptoms assessed as related to hypovolaemia. Mild citrate reactions were more common in the treatment group (32 events [25%] in 129 procedures) compared with the control group (one event [1%] in 93 procedures). INTERPRETATION: To our knowledge, this study is the first to objectively assess the consequences of iron removal in individuals with hereditary haemochromatosis and moderately elevated serum ferritin. Our results suggest that serum ferritin normalisation by iron depletion could be of benefit for all individuals with hereditary haemochromatosis and elevated serum ferritin levels. FUNDING: National Health and Medical Research Council (Australia)."," Ong, SY;  Gurrin, LC;  Dolling, L;  Dixon, J;  Nicoll, AJ;  Wolthuizen, M;  Wood, EM;  Anderson, GJ;  Ramm, GA;  Allen, KJ;  et al.",2017.0, 10.1016/S2352-3026(17)30214-4,0,0,
1607, The mediating role of changes in harm beliefs and coping efficacy in youth with specific phobias," Individuals with specific phobias (SPs) often experience catastrophic cognitions and compromised efficacy regarding their ability to cope when in the presence of the phobic object/situation. In the current study, 165 children (7‐16 years; 62% male) received either One Session Treatment or Educational Support Therapy for their SP. The children identified their feared belief and rated ""how bad"" it was, ""how likely"" it was to occur, and their ability to cope if it did occur. All of these ratings were reduced from pre‐treatment to 6‐month follow‐up, across both treatment conditions. However, ratings of ""how bad"" and ""how likely"" reduced to a significantly greater degree for children who received OST. Greater change in each of the three beliefs predicted lower clinician severity ratings (CSRs) at post‐treatment and 6‐month follow‐up. Additionally, changes in ""how bad"" and ""how likely"" the children rated their beliefs, and their reported ability to cope, partially mediated the relationship between treatment and post‐treatment and follow‐up CSRs. Overall, these findings suggest that although both treatment conditions produced changes in harm beliefs and coping efficacy, OST elicited greater changes and these changes may be important mechanisms in reduction of SP clinical severity."," Ollendick, TH;  Ryan, SM;  Capriola-Hall, NN;  Reuterskiöld, L;  Öst, LG",2017.0, 10.1016/j.brat.2017.10.007,0,0,
1608, A person-centered intervention targeting the psychosocial needs of gynecological cancer survivors: a randomized clinical trial," PURPOSE: We investigated the effect of a person‚Äêcentered intervention consisting of two to four nurse‚Äêled conversations using guided self‚Äêdetermination tailored to gynecologic cancer (GSD‚ÄêGYN‚ÄêC) on gynecological cancer survivors' quality of life (QOL), impact of cancer, distress, anxiety, depression, self‚Äêesteem, and self‚Äêreported ability to monitor and respond to symptoms of recurrence. METHODS: We randomly assigned 165 gynecological cancer survivors to usual care (UC) plus GSD‚ÄêGYN‚ÄêC or UC alone. Self‚Äêreported QOL‚Äêcancer survivor (QOL‚ÄêCS) total score and subscale scores on physical, psychological, social, and spiritual well‚Äêbeing were assessed before randomization and at 3 and 9 months after randomization using t tests. Bonferroni and Pipper corrections were applied for multiple testing adjustments. RESULTS: At 9 months, the GSD‚ÄêGYN‚ÄêC plus UC group scored significantly higher on the QOL‚ÄêCS total scale (P‚Äâ=‚Äâ0.02) and on the QOL‚ÄêCS physical well‚Äêbeing subscale (P‚Äâ=‚Äâ0.01), compared to women receiving UC alone. After adjusting for baseline scores, only the difference in the physical well‚Äêbeing subscale was statistically significant. No other measured outcomes differed between the intervention and control groups after baseline adjustment. CONCLUSION: We observed higher physical well‚Äêbeing 9 months after randomization in the GSD‚ÄêGYN‚ÄêC group, as compared to women receiving usual care. IMPLICATIONS FOR CANCER SURVIVORS: The results suggest that the person‚Äêcentered intervention GSD‚ÄêGYN‚ÄêC may improve physical well‚Äêbeing in gynecological cancer survivors. However, further testing is needed."," Olesen, ML;  Duun-Henriksen, AK;  Hansson, H;  Ottesen, B;  Andersen, KK;  Zoffmann, V",2016.0, 10.1007/s11764-016-0528-5,0,0,
1609, EFFECTS OF HOMEWORK COMPLIANCE ON COGNITIVE-BEHAVIORAL THERAPY WITH D-CYCLOSERINE AUGMENTATION FOR CHILDREN WITH OBSESSIVE COMPULSIVE DISORDER," Background The present study examined the effects of homework compliance on outcome from cognitive behavioral therapy (CBT) for children with obsessive‚Äêcompulsive disorder (OCD) and the extent to which these effects differ as a function of augmentation of CBT with D‚Äêcycloserine (DCS). Methods Twenty‚Äêseven youth with OCD were randomized to either 50 mg DCS or placebo (PBO) administered immediately after each of 10 CBT sessions, primarily consisting of exposure and ritual prevention (ERP). Independent evaluators assessed OCD severity using the Children's Yale‚ÄêBrown Obsessive‚ÄêCompulsive Scale (CY‚ÄêBOCS) at the start of each session. Compliance with between‚Äêsession ERP assignments was also assessed at the start of each session using the Patient ERP Adherence Scale (PEAS). Results Greater homework compliance between the previous session and the current session was related to lower CY‚ÄêBOCS at the current session. However, the relation between homework compliance and CY‚ÄêBOCS varied by treatment condition. Higher homework compliance was related to lower CY‚ÄêBOCS for participants in the DCS condition, but not for participants in the PBO condition. Furthermore, participants receiving DCS were estimated to have significantly lower CY‚ÄêBOCS than those given PBO among those with the highest levels of homework compliance. Conclusions DCS may more effectively facilitate the effects of CBT for youth with OCD when patients are compliant with prescribed homework. Theoretical and clinical implications are discussed."," Olatunji, BO;  Rosenfield, D;  Monzani, B;  Krebs, G;  Heyman, I;  Turner, C;  Isomura, K;  Mataix-Cols, D",2015.0, 10.1002/da.22423,0,0,
1610, The effect of the clinical pilates exercises on kinesiophobia and other symptoms related to osteoporosis: randomised controlled trial," METHODS: This study involved 40 females with osteoporosis. The subjects were randomly separated into two groups. Group 1 received specific Clinical Pilates exercises provided by a qualified Physiotherapies √ó3 per week for a period of 6 weeks. Group 2 acted as a control group, receiving no intervention and continuing their usual daily activities of life over the same period. All patients' kinesiophobia, pain and quality of life level and functional status were re‚Äêassessed at the end of 6 weeks. RESULTS: According to the measurements exercise group patients' kinesiophobia, pain decreased, functional status and quality of life statistically improved (p < 0,05). CONCLUSION: As clinical pilates training positively effects kinesiophobia, pain, functional status and quality of life, it can be recommended to osteoporosis patients, as a safe exercise model. OBJECTIVES: To investigate the effects of clinical pilates exercise on kinesiophobia, pain, functional status and quality of life of the osteoporosis patients."," Oksuz, S;  Unal, E",2017.0, 10.1016/j.ctcp.2016.12.001,0,0,
1611,Contribution of job satisfaction and overtime work to mental health: 1-year follow-up study,"Introduction Overtime work has been suspected as a risk factor for workers' mental distress. A recent cross-sectional study showed that job satisfaction and overtime work could modify the association with mental health in a direct and combined manner (Nakata, 2017). Thus, we have examined the association between job satisfaction and overtime work with mental health using a longitudinal study to explore of causal relationships. Methods Participants were 1,558 Japanese IT (information technology) workers. Each completed the General Health Questionnaire (GHQ, 28-item version) and Brief Job Stress Questionnaire (BJSQ, index for job strain and job supports) and indicated job satisfaction in 2011 and 2012. Actual amount of overtime work during 3 months in 2011 was recorded by the company. A total of 1408 respondents completed questionnaires and 758 participants were excluded from this analysis because of high GHQ scores (GHQ >5, indicating mental distress) in 2011. Finally, 650 participants were used for the evaluation. Risk of mental distress in 2012 by overtime work, job satisfaction, and both combined was estimated by univariable and multivariable logistic regression analysis. Result Compared to participants with high job satisfaction, those with low satisfaction had increased risk of mental distress in the following year (crude odds ratio (cOR): 1.75), but this difference became insignificant after adjusting for potential confounding factors such as job strain and job supports. Furthermore, there was no significant difference in the risk of mental distress for participants with or without overtime work. However, in the combined analysis, compared to participants with overtime work and high job satisfaction, those with overtime work and low job satisfaction had an increased risk of high GHQ scores (adjusted OR: 2.04). Conclusion Present longitudinal data suggests that the combination of low job satisfaction and overtime work induces an increased risk of mental distress.",Ohta M.; Higuchi Y.; Sugimura H.; Kumashiro M.,2018.0,10.1136/oemed-2018-ICOHabstracts.1745,0,0,
1612,Aging of holocaust survivors: Discrepancies between subjective and general health in the greater Tel Aviv area,"Aging has been associated with perceived lowering of health, especially in post-traumatic individuals. The effects may be more complex or even different for Holocaust survivors as they age due to their inherited resilience and life perspective. A cross-sectional study was conducted of Holocaust survivors and a matched comparison group recruited from the general Israeli population. All participants underwent a personal interview and completed the Cumulative Illness Rating Scale and a survey of subjective Likert-scale questions about perceived health. The study comprised 214 older adults: 107 Holocaust survivors and 107 comparison participants; 101 women and 113 men. The mean age for the participants was 80.7 ± 4.7 years (range 68–93). Holocaust survivors did not differ from comparison subjects in general health measures (mean 51.50 ± 3.06 vs. 52.27 ± 3.24, respectively). However, the Holocaust survivors’ subjective health was significantly lower, F (2,211) = 4.18, P < 0.05, and associated with decreased quality of life. The present study demonstrates the complex interplay between general and subjective health and suggests that future interventions need to focus on improving the psychological and social well-being of Holocaust survivors to achieve successful aging.",Ohana I.; Golander H.; Barak Y.,2018.0,,0,0,
1613, The Role of Threat Level and Intolerance of Uncertainty (IU) in Anxiety: an Experimental Test of IU Theory," Intolerance of uncertainty (IU) has been proposed as an important transdiagnostic variable within mood‚Äê and anxiety‚Äêrelated disorders. The extant literature has suggested that individuals high in IU interpret uncertainty more negatively. Furthermore, theoretical models of IU posit that those elevated in IU may experience an uncertain threat as more anxiety provoking than a certain threat. However, no research to date has experimentally manipulated the certainty of an impending threat while utilizing an in vivo stressor. In the current study, undergraduate participants (N = 79) were randomized to one of two conditions: certain threat (participants were told that later on in the study they would give a 3‚Äêminute speech) or uncertain threat (participants were told that later on in the study they would flip a coin to determine whether or not they would give a 3‚Äêminute speech). Participants also completed self‚Äêreport questionnaires measuring their baseline state anxiety, baseline trait IU, and prespeech state anxiety. Results indicated that trait IU was associated with greater state anticipatory anxiety when the prospect of giving a speech was made uncertain (i.e., uncertain condition). Further, findings indicated no significant difference in anticipatory state anxiety among individuals high in IU when comparing an uncertain versus certain threat (i.e., uncertain and certain threat conditions, respectively). Furthermore, results found no significant interaction between condition and trait IU when predicting state anticipatory anxiety. This investigation is the first to test a crucial component of IU theory while utilizing an ecologically valid paradigm. Results of the present study are discussed in terms of theoretical models of IU and directions for future work."," Oglesby, ME;  Schmidt, NB",2017.0, 10.1016/j.beth.2017.01.005,0,0,
1614,Effectiveness of a Self Help Cognitive Behavioural Treatment Program for Problem Gamblers: A Randomised Controlled Trial.,"The study aimed to strengthen the scarce literature on self-help treatments for Problem Gambling (PG) by comparing the effectiveness of a Self-Help Cognitive Behavioral Treatment (SHCBT) program (n = 23) with a 6-week Waitlist condition (n = 32) in problem gamblers. Participants were community volunteers with gambling problems and were randomly allocated to the Waitlist and treatment conditions. Results showed significant improvements at post-treatment in gambling behaviors including frequency of gambling, average amount gambled per day and PG symptoms as well as a number of gambling correlates including psychological states (e.g., depression, anxiety and stress), gambling cognitions, gambling urges, gambling related self-efficacy, satisfaction with life, and quality of life among those who completed the SHCBT program, when compared with the waitlist condition. The effect size (partial η 2) ranged from .25 to .57 for all assessed outcomes that showed significant improvement from pre- to post-treatment. It was concluded that a self-help CBT program can be beneficial for treating community problem gamblers.",Oei TPS.; Raylu N.; Lai WW.,2018.0,10.1007/s10899-017-9723-1,0,0,
1615,Changes in quality of life following group CBT for anxiety and depression in a psychiatric outpatient clinic.,"The present study examined the relationship between quality of life and symptom change following group CBT treatment for anxiety or depression in a psychiatric hospital outpatient setting. One hundred seventy seven outpatients undergoing eight sessions of group CBT for anxiety (n = 124) or mood disorders (n = 53) participated. The Beck Anxiety Inventory (BAI), Zung Self-Rating Depression Scale (Zung-SRDS), Quality of Life Inventory (QOLI), and Satisfaction with Life Scale (SWLS) were administered at baseline and post-treatment. Additionally, the QOLI and SWLS scores of those who achieved reliable improvement or clinically significant symptom change were compared to those who experienced no reliable symptom improvement. There were significant changes across the QOLI, SWLS, BAI and Zung-SRDS outcome measures between baseline and post-treatment, with moderate to very large effect sizes observed. Patients with reliable or clinically significant change in their symptoms experienced significant increases in QOLI and SWLS scores when compared to those whose symptoms did not change reliably. Overall, in a psychiatric hospital outpatient setting, group CBT appeared to be successful in increasing quality of life and satisfaction with life in addition to reducing anxiety and depression symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Oei, Tian Po; McAlinden, Niamh May",2014.0,http://dx.doi.org/10.1016/j.psychres.2014.08.036,0,0,
1616,Self-stigma and treatment effectiveness in patients with anxiety disorders-A mediation analysis.,"Goal: The goal of this study was to explore the impact of self-stigma on the treatment outcomes in patients with anxiety disorders and to find possible mediators of this relationship. Method: Two hundred and nine patients with anxiety disorders, who were hospitalized in a psychotherapeutic department, attended the study. The average age was 39.2 +/- 12.4 years; two-thirds were women. Most of the patients used a long-term medication. The participants underwent either cognitive behavioral therapy (CBT) or short psychodynamic therapy. The selection to the psychotherapy was not randomized. All individuals completed several scales - Beck Depression Inventory, the second edition (BDI-II), Beck Anxiety Inventory (BAI), Dissociative Experience Scale (DES), Sheehan Disability Scale (SDS), subjective Clinical Global Impression (subjCGI), and The Internalized Stigma of Mental Illness Scale (ISMI). A senior psychiatrist filled out the objective CGI (objCGI). Results: The patients significantly improved in the severity of anxiety (BAI), depression (BDI-II), and overall severity of the mental disorder (objCGI). The self-stigma predicted a lower change of the objCGI, but not a change of the anxiety and depressive symptoms severity. Anxiety, depressive symptoms, dissociation, and disability were assessed as possible mediators of the relationship between the self-stigma and the treatment change. None of them were significant. Conclusion: Self-stigma lowers the effectiveness of the combined treatment of anxiety disorders. Future research should explore other possible mediators influencing this relationship. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Ociskova, Marie; Prasko, Jan; Vrbova, Kristyna; Kasalova, Petra; Holubova, Michaela; Grambal, Ales; Machu, Klara",2018.0,,0,0,
1617, One session treatment for pediatric blood-injection-injury phobia: a controlled multiple baseline trial," The present study evaluated the effectiveness of a modified One Session Treatment (OST), which included an e‚Äêtherapy homework maintenance program over 4 weeks for Blood‚ÄêInjection‚ÄêInjury (BII) phobia in children and adolescents. Using a single case, non‚Äêconcurrent multiple‚Äêbaseline design, 24 children and adolescents (8‚Äê18 years; 7 males, 17 females) with a primary diagnosis of BII phobia were randomly assigned to a one, two or three week baseline prior to receiving OST. Primary outcome measures included diagnostic severity, diagnostic status, and child and parent fear ratings. Secondary outcome measures included avoidance during behavioural avoidance tasks (BAT), global functioning and self and parent reported anxiety, fear and depression. Efficacy was assessed at post‚Äêtreatment, 1‚Äêmonth, and 3‚Äêmonth follow‚Äêup. BII symptoms and diagnostic severity remained relatively stable during the baseline periods and then significantly improved following implementation of the intervention. Treatment response was supported by changes across multiple measures, including child, parent and independent clinician ratings. At post‚Äêtreatment 8 of the 24 (33.33%) children were BII diagnosis free. Treatment gains improved at follow‚Äêups with 14 (58.33%) children diagnosis free at 1‚Äêmonth follow‚Äêup and 15 (62.5%) diagnosis free at 3‚Äêmonth follow‚Äêup. Preliminary findings support the effectiveness of a modified OST approach for BII phobic youth with treatment outcomes improving over follow‚Äêup intervals."," Oar, EL;  Farrell, LJ;  Waters, AM;  Conlon, EG;  Ollendick, TH",2015.0, 10.1016/j.brat.2015.08.002,0,0,
1618, Glutamate in Pediatric Obsessive-Compulsive Disorder and Response to Cognitive-Behavioral Therapy: randomized Clinical Trial," Cognitive‐behavioral therapy (CBT) is effective for pediatric obsessive‐compulsive disorder (OCD), but non‐response is common. Brain glutamate (Glu) signaling may contribute to OCD pathophysiology and moderate CBT outcomes. We assessed whether Glu measured with magnetic resonance spectroscopy (MRS) was associated with OCD and/or CBT response. Youths aged 7‐17 years with DSM‐IV OCD and typically developing controls underwent 3 T proton echo‐planar spectroscopic imaging (PEPSI) MRS scans of pregenual anterior cingulate cortex (pACC) and ventral posterior cingulate cortex (vPCC)‐regions possibly affected by OCD‐at baseline. Controls returned for re‐scan after 8 weeks. OCD youth‐in a randomized rater‐blinded trial‐were re‐scanned after 12‐14 weeks of CBT or after 8 weeks of minimal‐contact waitlist; waitlist participants underwent a third scan after crossover to 12‐14 weeks of CBT. Forty‐nine children with OCD (mean age 12.2±2.9 years) and 29 controls (13.2±2.2 years) provided at least one MRS scan. At baseline, Glu did not differ significantly between OCD and controls in pACC or vPCC. Within controls, Glu was stable from scan‐to‐scan. Within OCD subjects, a treatment‐by‐scan interaction (p=0.034) was observed, driven by pACC Glu dropping 19.5% from scan‐to‐scan for patients randomized to CBT, with minor increases (3.8%) for waitlist participants. The combined OCD participants (CBT‐only plus waitlist‐CBT) also showed a 16.2% (p=0.004) post‐CBT decrease in pACC Glu. In the combined OCD group, within vPCC, lower pre‐CBT Glu predicted greater post‐CBT improvement in symptoms (CY‐BOCS; r=0.81, p=0.00025). Glu may be involved in the pathophysiology of OCD and may moderate response to CBT."," O'Neill, J;  Piacentini, J;  Chang, S;  Ly, R;  Lai, TM;  Armstrong, CC;  Bergman, L;  Rozenman, M;  Peris, T;  Vreeland, A;  et al.",2017.0, 10.1038/npp.2017.77,0,0,
1619,The effects of mindfulness-based cognitive therapy on depressive symptoms in elderly bereaved people with loss-related distress: A controlled pilot study.,"We examined the effects of mindfulness-based cognitive therapy (MBCT) on symptom severity of depression, complicated grief, posttraumatic stress, and working memory in elderly bereaved people with long-term bereavement-related distress. A non-randomized, controlled pilot design was used in a sample of elderly bereaved people (mean age = 77 years) with long-term bereavement-related distress. Results were compared between MBCT intervention group completers (n = 12), intervention group intention to treat (n = 18), and wait list controls (n = 18) at pre- and post-intervention and at a 5-month follow-up. Compared to wait list controls, MBCT reduced depressive symptoms significantly in intervention completers at follow-up (Hedges' g = 0.84, p = 0.04) with significant interaction between group and time (Hedges' g = 0.88, p = 0.02). No other significant outcome differences between groups were observed, although the interaction effect on working memory at post-intervention approached a significant level (Hedges' g = 0.35, p = 0.09). In the wait list group, 29 % had elevated depressive symptoms both before intervention and at follow-up. In the intervention group, 50 % of the completers had elevated depressive symptoms before intervention, but 0 % had elevated symptoms at follow-up. MBCT appears to reduce depressive symptoms in this sample of elderly bereaved people, but further studies of the effects of MBCT in this population are needed for firm conclusions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","O'Connor, Maja; Piet, Jacob; Hougaard, Esben",2014.0,http://dx.doi.org/10.1007/s12671-013-0194-x,0,0,
1620, Lifestyle intervention to improve quality of life and prevent weight gain after renal transplantation: design of the Active Care after Transplantation (ACT) randomized controlled trial," BACKGROUND: Low physical activity and reduced physical functioning are common after renal transplantation, resulting in a reduced quality of life. Another common post‚Äêtransplantation complication is poor cardio‚Äêmetabolic health, which plays a main role in long‚Äêterm outcomes in renal transplant recipients (RTR). It is increasingly recognized that weight gain in the first year after transplantation, especially an increase in fat mass, is a highly common contributor to cardio‚Äêmetabolic risk. The aim of this study is to compare the outcomes of usual care to the effects of exercise alone, and exercise combined with dietary counseling, on physical functioning, quality of life and post‚Äêtransplantation weight gain in RTR. METHODS: The Active Care after Transplantation study is a multicenter randomized controlled trial with three arms in which RTR from 3 Dutch hospitals are randomized within the first year after transplantation to usual care, to exercise intervention (3 months supervised exercise 2 times per week followed by 12 months active follow‚Äêup), or to an exercise + diet intervention, consisting of the exercise training with additional dietary counseling (12 sessions over 15 months by a renal dietician). In total, 219 participants (73 per group) will be recruited. The primary outcome is the subdomain physical functioning of quality of life, (SF‚Äê36 PF). Secondary outcomes include other evaluations of quality of life (SF‚Äê36, KDQOL‚ÄêSF, EQ‚Äê5D), objective measures of physical functioning (aerobic capacity and muscle strength), level of physical activity, gain in adiposity (body fat percentage by bio‚Äêelectrical impedance assessment, BMI, waist circumference), and cardiometabolic risk factors (blood pressure, lipids, glucose metabolism). Furthermore, data on renal function, medical history, medication, psychological factors (motivation, kinesiophobia, coping style), nutrition knowledge, nutrition intake, nutrition status, fatigue, work participation, process evaluation and cost‚Äêeffectiveness are collected. DISCUSSION: Evidence on the effectiveness of an exercise intervention, or an exercise + diet intervention on physical functioning, weight gain and cardiometabolic health in RTR is currently lacking. The outcomes of the present study may help to guide future evidence‚Äêbased lifestyle care after renal transplantation. TRIAL REGISTRATION: Number: NCT01047410 ."," Klaassen, G;  Zelle, DM;  Navis, GJ;  Dijkema, D;  Bemelman, FJ;  Bakker, SJL;  Corpeleijn, E",2017.0, 10.1186/s12882-017-0709-0,0,0,
1621,Distress and resilience associated with workload of medical students,"Background: University students face numerous stressors during their study curricula, which require adequate resilience to ensure healthy adaptation. Aims: To examine how relationships between study workload and mental health problems are moderated by resilience. Secondly, to compare our findings with other studies and assess differences in resilience and distress between medical and non-medical students. Methods: A prospective quantitative design was used. Participants completed a questionnaire package assessing resilience resources (Resilience Scale for Adults) and mental health (Core-OM: Clinical outcomes in routine evaluation–outcome measure) under three different conditions: heavy, low or regular workload. Results: During heavy workload, significantly higher distress score was found among medical students compared to other students (1.46 vs. 1.25; p < 0.05). Medical students had slightly higher overall resilience scores (5.21 vs. 4.94; p > 0.05). During heavy workload up to 20% of the participants had higher distress score than clinical samples’ average from other studies. RSA score and Core-OM scores were inversely dependent (p < 0.0001; r= −0.434). Conclusion: Findings suggest that distress mediated by heavy workload does not significantly affect resilience. Many students, especially medical, are experiencing high levels of distress. Resilience is associated with the decrease in distress.",Kiziela A.; Viliūnienė R.; Friborg O.; Navickas A.,2018.0,10.1080/09638237.2018.1521922,0,0,
1622,"PHIT for Duty, a Mobile Application for Stress Reduction, Sleep Improvement, and Alcohol Moderation","Post-traumatic stress and other problems often occur after combat, deployment, and other military operations. Because techniques such as mindfulness meditation show efficacy in improving mental health, our team developed a mobile application (app) for individuals in the armed forces with subclinical psychological problems as secondary prevention of more significant disease. Based on the Personal Health Intervention Toolkit (PHIT), a mobile app framework for personalized health intervention studies, PHIT for Duty integrates mindfulness-based relaxation, behavioral education in sleep quality and alcohol use, and psychometric and psychophysiological data capture. We evaluated PHIT for Duty in usability and health assessment studies to establish app quality for use in health research. Participants (N = 31) rated usability on a 1 (very hard) to 5 (very easy) scale and also completed the System Usability Scale (SUS) questionnaire (N = 9). Results were (mean ± SD) overall (4.5 ± 0.6), self-report instruments (4.5 ± 0.7), pulse sensor (3.7 ± 1.2), sleep monitor (4.4 ± 0.7), sleep monitor comfort (3.7 ± 1.1), and wrist actigraphy comfort (2.7 ± 0.9). The average SUS score was 85 ± 12, indicating a rank of 95%. A comparison of PHIT-based assessments to traditional paper forms demonstrated a high overall correlation (r = 0.87). These evaluations of usability, health assessment accuracy, physiological sensing, system acceptability, and overall functionality have shown positive results and affirmation for using the PHIT framework and PHIT for Duty application in mobile health research.",Kizakevich P.N.; Eckhoff R.; Brown J.; Tueller S.J.; Weimer B.; Bell S.; Weeks A.; Hourani L.L.; Spira J.L.; King L.A.,2018.0,10.1093/milmed/usx157,0,0,
1623," Promoting psychosocial well-being following stroke: study protocol for a randomized, controlled trial"," BACKGROUND: Stroke is a major public health threat globally. Psychosocial well‐being may be affected following stroke. Depressive symptoms, anxiety, general psychological distress and social isolation are prevalent. Approximately one third report depressive symptoms and 20% report anxiety during the first months or years after the stroke. Psychosocial difficulties may impact significantly on long‐term functioning and quality of life, reduce the effects of rehabilitation services and lead to higher mortality rates. The aim of the study is to evaluate the effect of a previously developed and feasibility tested dialogue‐based psychosocial intervention aimed at promoting psychosocial well‐being and coping following stroke among stroke survivors with and without aphasia. METHODS: The study will be conducted as a multicenter, randomized, single blind controlled trial with one intervention and one control arm. It will include a total of 330 stroke survivors randomly allocated into either an intervention group (dialogue‐based intervention to promote psychosocial well‐being) or a control group (usual care). Participants in the intervention group will receive eight individual sessions of supported dialogues in their homes during the first six months following an acute stroke. The primary outcome measure will be psychosocial well‐being measured by the General Health Questionnaire (GHQ). Secondary outcome measures will be quality of life (SAQoL), sense of coherence (SOC), and depression (Yale). Process evaluation will be conducted in a longitudinal mixed methods study by individual qualitative interviews with 15‐20 participants in the intervention and control groups, focus group interviews with the intervention personnel and data collectors, and a comprehensive analysis of implementation fidelity. DISCUSSION: The intervention described in this study protocol is based on thorough development and feasibility work, guided by the UK medical research council framework for developing and testing complex interventions. It combines classical effectiveness evaluation with a thorough process evaluation. The results from this study may inform the development of further trials aimed at promoting psychosocial well‐being following stroke as well as inform the psychosocial follow up of stroke patients living at home. TRIAL REGISTRATION: NCT02338869 ; registered 10/04/2014 (On‐going trial)."," Kirkevold, M;  Kildal Bragstad, L;  Bronken, BA;  Kvigne, K;  Martinsen, R;  Gabrielsen Hjelle, E;  Kitzmüller, G;  Mangset, M;  Angel, S;  Aadal, L;  et al.",2018.0, 10.1186/s40359-018-0223-6,0,0,
1624,Gender difference in attentional bias toward negative and positive stimuli in generalized anxiety disorder.,"Females are two times as likely as males to develop generalized anxiety disorder (GAD; Steiner et al., 2005; Vesga-Lopez et al., 2008). Moreover, the clinical presentation of GAD is different across genders. One explanation for these differences may be the role of cognitive biases involved in GAD between genders. In the present study, we used an exogenous spatial cueing task to examine gender differences in attentional bias for negative and positive information in 118 individuals with a primary diagnosis of GAD. Males and females did not differ in their attentional bias for idiographically selected negative or neutral words. However, women showed a significantly larger attentional bias for positive words than did men. Results suggest that developing gender-specific treatments for GAD could improve treatment response rates. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kinney, Kerry L; Boffa, Joseph W; Amir, Nader",2017.0,http://dx.doi.org/10.1016/j.beth.2016.06.002,0,0,
1625,A study of novel bilateral thermal capsulotomy with focused ultrasound for treatment-refractory obsessive-compulsive disorder: 2-year follow-up.,"Background: Recently, a new thermal lesioning approach using magnetic resonance-guided focused ultrasound (MRgFUS) was introduced for the treatment of neurologic disorders. However, only 2 studies have used this approach for treatment-refractory obsessive- compulsive disorder (OCD), and follow-up was short-term. We investigated the efficacy and safety of bilateral thermal lesioning of the anterior limb of the internal capsule using MRgFUS in patients with treatment-refractory OCD and followed them for 2 years. Methods: Eleven patients with treatment-refractory OCD were included in the study. Clinical outcomes were evaluated using the Yale-Brown Obsessive Compulsive Scale, the Clinical Global Impression scale (including improvement and severity), the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Rating Scale for Anxiety (HAM-A) at 1 week and 1, 3, 6, 12 and 24 months following MRgFUS. Neuropsychological functioning, Global Assessment of Functioning and adverse events were also assessed. Results: After MRgFUS, Yale-Brown Obsessive Compulsive Scale scores decreased significantly across the 24-month follow-up period (mean +/- standard deviation, 34.4 +/- 2.3 at baseline v. 21.3 +/- 6.2 at 24 months, p < 0.001). Scores on the Hamilton rating scales for depression and anxiety also significantly decreased from baseline to 24 months (HAM-D, 19.0 +/- 5.3 v. 7.6 +/- 5.3, p < 0.001; HAM-A, 22.4 +/- 5.9 v. 7.9 +/- 3.9, p < 0.001). Global Assessment of Functioning scores improved significantly (35.8 +/- 4.9 at baseline v. 56.0 +/- 10.3 at 24 months, p < 0.001) and Memory Quotient significantly improved, but other neuropsychological functions were unchanged. The side effects of MRgFUS included headache and vestibular symptoms, but these were mild and transient. Limitations: The main limitations of this study were the small sample size and the open-label design. Conclusion: Bilateral thermal lesioning of the anterior limb of the internal capsule using MRgFUS may improve obsessive-compulsive, depressive and anxiety symptoms in patients with treatment-refractory OCD, without serious adverse effects. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Kim, Se Joo; Roh, Daeyoung; Jung, Hyun Ho; Chang, Won Seok; Kim, Chan-Hyung; Chang, Jin Woo",2018.0,http://dx.doi.org/10.1503/jpn.170188,0,0,
1626,Reducing intrusive memories of trauma using a visuospatial interference intervention with inpatients with posttraumatic stress disorder (PTSD).,"Objective: The core clinical feature of posttraumatic stress disorder (PTSD) is recurrent intrusive memories of trauma. This study aimed to test a novel and simple intervention, inspired by the concepts of concurrent task interference and memory reconsolidation, to reduce the occurrence of intrusive memories among inpatients with complex PTSD. Method: In this open-label single case series 20 patients with longstanding complex PTSD in inpatient treatment monitored the occurrence of intrusive trauma memories (intrusions) over the course of their admission (5 to 10 weeks). Patients received study-specific intervention sessions (including a memory reminder for a specific intrusion then 25 min Tetris gameplay) on a weekly basis. A within-subjects multiple baseline AB design was used, in that the length of baseline (""A,"" preintervention, monitoring only) and postintervention (""B"") phases varied within-subjects across individual intrusions. Further, some intrusions were never targeted by the intervention. The study was registered prior to analysis, ISRCTN34320836. Results: Frequency of targeted intrusions reduced by on average 64% from baseline to the postintervention phase. Conversely, never-targeted intrusions reduced in frequency by on average 11% over a comparable time-period. Of the 20 patients, 16 met our criteria for showing ""response"" to the intervention. Conclusions: Results provide initial evidence that this brief behavioral procedure might reduce the occurrence of intrusive traumatic memories in longstanding and complex PTSD, here delivered in an inpatient setting. The potential of this simple, focused intervention opens up new possibilities for tackling a core clinical symptom of PTSD, warranting further research. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement What is the public health significance of this article?-This study provides first evidence that the frequency of intrusive memories of trauma for patients with longstanding and complex posttraumatic stress disorder might be reduced by a simple behavioral intervention. The intervention consists of a memory reminder procedure followed by playing the computer game Tetris. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Kessler, Henrik; Holmes, Emily A; Blackwell, Simon E; Schmidt, Anna-Christine; Schweer, Johanna M; Bucker, Anna; Herpertz, Stephan; Axmacher, Nikolai; Kehyayan, Aram",2018.0,http://dx.doi.org/10.1037/ccp0000340,0,0,
1627,Intolerance of uncertainty predicts increased striatal volume,"Oversensitivity to uncertain future threat is usefully conceptualized as intolerance of uncertainty (IU). Neuroimaging studies of IU to date have largely focused on its relationship with brain function, but few studies have documented the association between IU and the quantitative properties of brain structure. Here, we examined potential gray and white-matter brain structural correlates of IU from 61 healthy participants. Voxel-based morphometric analysis highlighted a robust positive correlation between IU and striatal volume, particularly the putamen. Conversely, tract-based spatial statistical analysis showed no evidence for a relationship between IU and the structural integrity of white-matter fiber tracts. Current results converge upon findings from individuals with anxiety disorders such as obsessive- compulsive disorder (OCD) or generalized anxiety disorder (GAD), where abnormally increased IU and striatal volume are consistently reported. They also converge with neurobehavioral data implicating the putamen in predictive coding. Most notably, the relationship between IU and striatal volume is observed at a preclinical level, suggesting that the volumetric properties of the striatum reflect the processing of uncertainty per se as it relates to this dimensional personality characteristic. Such a relationship could then potentially contribute to the onset of OCD or GAD, rather than being unique to their pathophysiology.",Justin Kim M.; Shin J.; Taylor J.M.; Mattek A.M.; Chavez S.J.; Whalen P.J.,2017.0,10.1037/emo0000331,0,0,
1628, What are People's Experiences of a Novel Cognitive Behavioural Therapy for Bipolar Disorders? A Qualitative Investigation with Participants on the TEAMS Trial," Background Psychological interventions for bipolar disorders typically produce mixed outcomes and modest effects. The need for a more effective intervention prompted the development of a new cognitive behavioural therapy, based on an integrative cognitive model ('Think Effectively About Mood Swings' [TEAMS] therapy). Unlike previous interventions, TEAMS addresses current symptoms and comorbidities, and helps clients achieve long‐term goals. A pilot randomized controlled trial (the TEAMS trial) of the therapy has recently concluded. This study explored participants' experiences of TEAMS, recommendations for improvement and experiences of useful changes post‐therapy. Methods Fourteen TEAMS therapy participants took part in semi‐structured interviews. Their accounts were analysed using interpretative thematic analysis. Two researchers coded the dataset independently. Member checks were conducted of the preliminary themes. Results Two overarching themes; 'useful elements of therapy' and 'changes from therapy' encompassed 12 emerging subthemes. Participants appreciated having opportunities to talk and described the therapy as person‐centred and delivered by caring, approachable and skilled therapists. Some recommended more sessions than the 16 provided. Helpful therapeutic techniques were reported to be, normalization about moods, methods to increase understanding of moods, relapse‐prevention, reappraisal techniques and metaphors. However, some did not find therapeutic techniques helpful. Post‐therapy, many reported changes in managing mood swings more effectively and in their thinking (although some participants reported changes in neither). Many described increased acceptance of themselves and of having bipolar disorder, increased productivity and reduced anxiety in social situations. Conclusions The present study evaluates participants' therapy experiences in detail, including aspects of therapy viewed as helpful, and meaningful post‐therapy outcomes. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: This is the first paper to qualitatively explore people's experiences of individual psychotherapy for bipolar disorders. It highlights elements of psychotherapy described as particularly helpful or unhelpful and the clinical changes viewed as most impactful. Participants reported benefitting in a number of ways from TEAMS therapy. They valued learning to reappraise and problem‐solve situations and manage moods. Participants identified TEAMS techniques as helpful, such as exploring advantages and disadvantages of moods, and building healthy self‐states."," Joyce, E;  Tai, S;  Gebbia, P;  Mansell, W",2017.0, 10.1002/cpp.2040,0,0,
1629, A Randomized Study of Yoga for Fatigue and Quality of Life in Women with Breast Cancer Undergoing (Neo) Adjuvant Chemotherapy," OBJECTIVES: To compare the effectiveness of yoga added to standard care (SC) versus SC only, in women with breast cancer during chemotherapy. DESIGN: A multicenter pragmatic, randomized controlled study. SETTINGS/LOCATION: Three hospitals in the Netherlands. SUBJECTS: Women with stage I‐III breast cancer undergoing chemotherapy. INTERVENTIONS: Women were randomized either to a program based on Dru Yoga, once a week yoga sessions for 12 weeks (N = 47), or SC only (N = 36). OUTCOME MEASURES: Primary outcome fatigue (Multidimensional Fatigue Inventory [MFI]; general fatigue) and secondary outcomes fatigue (MFI, Fatigue Quality List [FQL]), quality of life (30‐item Quality of Life Questionnaire‐C of the European Organization for Research and Treatment of Cancer [EORTC‐QLQ‐C‐30]) and psychological distress (Hospital Anxiety Depression Scale [HADS], Impact of Events Scale [IES]) were measured at baseline (T0), 3 months (T1), and 6 months (T2) and analyzed on observed cases. Other outcomes were adequate relief, reintegration to work, and adverse events. RESULTS: No significant differences were found in general fatigue at T1 (MFI: yoga; 14.6 ± 4.5 vs. SC; 14.2 ± 4.2, p = 0.987). Similar findings were observed for other fatigue (sub)scales of MFI and FQL and functional domains of EORTC. With respect to EORTCs symptom scales, women in the yoga group reported significantly less nausea and vomiting compared with SC at T2 (p = 0.004), but not at T1 (p = 0.807). Depressive symptoms were significantly lower with yoga at T1 (HADS: yoga; 4.7 ± 4.1 vs. SC; 5.1 ± 4.2, p = 0.031). More women in the yoga group experienced adequate relief compared with SC at T1 (yoga; 51% vs. SC; 19%) and had returned to work at T2 (yoga; 53% vs. SC; 23%). No adverse events were reported with yoga. CONCLUSIONS: A Dru‐based yoga program failed to demonstrate a significant beneficial effect on fatigue. Possible favorable effects of the yoga program on nausea and vomiting and early return to work in breast cancer survivors warrant further research."," Jong, MC;  Boers, I;  Schouten van der Velden, AP;  Meij, SV;  Göker, E;  Timmer-Bonte, ANJH;  van Wietmarschen, HA",2018.0, 10.1089/acm.2018.0191,0,0,
1630,"Magnetic versus electrical phrenic nerve stimulation: Comparison of reliability, subject discomfort and nerve/muscle latency","Introduction: In patients with diaphragm weakness, unilateral phrenic nerve stimulation can be used to determine the integrity and conduction properties of each phrenic nerve. Phrenic nerve latency is typically 6-8 milliseconds in adults and may be delayed in demyelinating polyneuropathies e.g. Guillain-Barre syndrome and chronic inflammatory demyelinating polyneuropathy. The phrenic nerve can be stimulated either electrically or magnetically. Aim & Hypothesis: To compare the reliability, subject discomfort and phrenic nerve/diaphragm latency of the magnetic versus electrical phrenic nerve stimulation. We hypothesised that compared to electrical stimulation, magnetic stimulation was more reliable, less distressing to the subject, and produced identical nerve/diaphragm latencies. Method: In 8 healthy male subjects, each phrenic nerve was stimulated at the neck electrically (150 V, duration 0.1 ms., delay 0.01 ms., rate 0.5 Hz) and magnetically (MagStim) at 30, 50, 70 and 90% maximum output. Compound muscle action potentials (CMAP) were detected using surface electrodes placed in the mid-axillary line at the 8th and 9th rib interspaces, and displayed on a digital chart recorder (PowerLab). We measured the number of stimulations required to elicit an analysable CMAP, the degree of discomfort (using a Borg CR-10 questionnaire), and nerve/muscle latencies. Data are expressed as mean ± SD and were compared using paired t-tests. Significance was defined as p<0.05. Results: Subjects were aged 36.1±15.3 years and had BMI 25.2±2.8 kg/m2. (Table presented) Conclusions: Compared to electrical phrenic nerve stimulation, magnetic stimulation was more reliable and, except at high output, caused less discomfort and obtained similar latencies.",Isaac A.; Harrison L.; Noffsinger W.; Singh B.,2018.0,10.1111/resp.13266,0,0,
1631,"The resilience, attachment, coping, and psychopathology of battered women: Comparison of sheltered versus in-home women.","Objective: To compare the resilience, attachment, coping, and psychopathology of the women exposed to domestic violence who were sheltered to those staying in their home. Methods: One hundred and fifty battered women -100 women staying in two sheltered houses in Istanbul (sheltered group) and 50 women staying in their home (in-home group)- were included in the study and completed the sociodemographic data form, the violence data form, the Scale for Adult Resilience (SAR) the Structured Clinical Interview Form for DSM-IV Axis I Disorders, the Patient Health Questionnaire--Somatic, Anxiety and Depressive Symptoms (PHQ-SADS), the Adult Attachment Scale, and the Coping Strategies Scale. Results: The prevalence of any psychiatric diagnosis was 76% in sheltered group and 90% in in-home group. The most common diagnosis was post-traumatic stress disorder (35%) in in-home group and major depression (66%) in sheltered group. The major depression, somatization disorder and generalized anxiety disorder were significantly more common in in-home group. The total score of the PHQ-SADS scale and subscores of somatization, generalized anxiety, panic, depression, impairment of functioning were significantly higher in-home group. The total score SAR and subscores of self-perception, future perception, structural style, and family resilience were significantly higher in the sheltered group. Among the subscales of the Coping Strategies Scale, score of active coping was significantly higher in sheltered group, as scores of nonfunctional coping and behavioral dismissal were higher in in-home group. There was no difference between the attachment styles of both groups. Discussion: Domestic violence negatively affects the mental health of women necessitating medical treatment. Compared to the women staying at home and living under ongoing violence, the sheltered battered women are advantageous in terms of active coping attitudes and resilience to combat violence, and prevalence of psychopathology. (PsycINFO Database Record (c) 2017 APA, all rights reserved) Abstract (Turkish) Amac: Bu calismada aile ici siddete ugrayan ve konukevlerinde kalan kadinlarla, evinde yasayan kadinlarin ruhsal dayaniklilik, baglanma bicimleri, basa cikma tutumlari ve psikopatoloji acisindan karsilastirilmasi amaclanmistir. Yontem: Istanbul'daki iki kadin konukevinde kalan aile ici siddet magduru 100 kadin ve evinde kalan ve halen siddet goren 50 kadin olmak uzere toplam 150 kadin, Sosyodemografik Veri Formu, Siddet Veri Formu, Yetiskinler icin Psikolojik Dayaniklilik Olcegi (YIPDO), DSM-IV Eksen I Bozukluklari icin Yapilandirilmis Klinik Gorusme Formu, Hasta Saglik Olcegi-Somatik, Anksiyete ve Depresif Belirtiler (PHQ-SADS) Olcegi, Eriskin Baglanma Bicimleri Olcegi ve Basa Cikma Tutumlari Degerlendirme Olcegi kullanilarak degerlendirilmistir. Bulgular: Konukevinde kalan kadinlarin %76'si, evinde kalan kadinlarin %90'i en az bir psikiyatrik taniya sahipti. Konukevinde travma sonrasi stres bozuklugu (%35), evinde kalan kadinlarda major depresyon (%66) en sik gorulen tani idi. Evinde kalan grupta major depresyon, somatizasyon bozuklugu ve yaygin anksiyete bozuklugu diger gruba gore anlamli derecede yuksek saptandi. PHQ-SADS Olcegine gore evinde kalan grupta, somatizasyon, yaygin anksiyete, panik, depresyon, islevsellik bozulmasi alt olcekleri ve olcek toplam puani diger gruba gore anlamli derecede yuksek bulundu. YIPDO toplam puani ve kendilik algisi, gelecek algisi, yapisal stil ve aile uyumu alt olcekleri ise konukevinde kalan grupta anlamli derecede yuksekti. Aktif basa cikma alt olcegi konukevinde kalan kadinlarda, islevsel olmayan basa cikma ve davranissal bos verme alt olcekleri ise evinde kalanlarda anlamli olarak yuksek bulundu. Iki grubun baglanma bicimleri arasinda fark saptanmadi. Sonuc: Aile ici siddet, kadinlarin ruh sagligini tedavi gerektirecek duzeyde olumsuz etkilemektedir. Evinde kalan ve siddet goren kadinlara gore konukevlerinde kalan kadinlar, siddete karsi koymakta koruyucu olan aktif basa cikma tutumlari ve ruhsal dayaniklilik acisindan avantajlidir ve daha az psikopatolojiye sahiptir. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Irmak, Cetin; Altintas, Merih",2017.0,,0,0,
1632,The association of scrupulosity with disgust propensity and contamination based obsessive compulsive symptoms: An experimental investigation using highly scrupulous muslims,"Background and objectives The present study investigated the role of scrupulosity, a rigid religious understanding characterized by fear of God and sinning, in the relationship between disgust and contamination-related OCD in a Muslim sample. Method The sample was composed of 209 university students. After an initial screening study, the high (N = 33) and low scrupulous (N = 29) groups were formed. After filling out a self-report questionnaire battery consisting of measures of disgust propensity, obsessive beliefs, and contamination-related cognitions and symptoms, participants were randomly assigned to view either 10 highly disgusting or neutral pictures while imagining themselves in the situation depicted in the picture. After the manipulation, they rated the unpleasantness of the image, emotions, urge to wash and avoid, and also their mood. In the last phase, participants performed a fear provocation task. Results The results indicated that the intensity of disgusting stimuli was positively associated with contamination-related ratings. As expected, high scrupulous participants showed higher disgust propensity and contamination-related symptoms after exposure to the disgust inducing pictures and the fear provocation task. Conclusions High disgust propensity may be a vulnerability factor for contamination based OCD symptoms in highly scrupulous Muslims.",Inozu M.; Eremsoy E.; Cicek N.M.; Ozcanli F.,2017.0,10.1016/j.jocrd.2017.08.004,0,0,
1633,Are Inflammatory Cytokines Associated with Pain during Acute Myocardial Infarction?,"Pain and inflammation during acute myocardial infarction (AMI) have been associated with the development of posttraumatic stress disorder and may also impact negatively on somatic outcome. We investigated the relationship between pain during AMI and levels of circulating proinflammatory (tumor necrosis factor [TNF]-α, interleukin [IL]-6) and anti-inflammatory (IL-33 and tissue growth factor [TGF]-β1) cytokines. Data were collected as part of the Myocardial Infarction - Stress Prevention Intervention (MI-SPRINT) study. We included 140 patients (mean age 59.6 years, 82.1% male) with high acute psychological distress within 48 h after MI. Fasting blood samples were drawn thereafter to measure cytokine levels. Sociodemographic factors, psychological and medical data, as well as cardiometabolic markers were assessed with questionnaires and patient interviews. Linear regression models showed a significant positive correlation of pain with TGF-β1 (b = 770.91, p = 0.031) and a significant inverse correlation of pain with IL-33 (b = -0.11, p = 0.015) after controlling for age, gender, body mass index, lifetime depression, acute stress disorder symptoms, and the prognostic Global Registry of Acute Coronary Events (GRACE) score. Pain was not associated with IL-6 but with the GRACE score (b = 0.01, p = 0.003). Pain showed no significant association with TNF-α. Pain during MI was associated with anti- but not proinflammatory cytokines. As IL-33 has been shown to be cardioprotective, lower IL-33 levels with more intense pain may suggest a pathway through which increased pain during MI may have an impact on the medical prognosis.",Imholz L.; Meister-Langraf RE.; Princip M.; Fux M.; Schnyder U.; Barth J.; Znoj H.; Schmid JP.; von Känel R.,2017.0,10.1159/000481455,0,0,
1634, Influence of illusory kinesthesia by vibratory tendon stimulation on acute pain after surgery for distal radius fractures: a quasi-randomized controlled study," DESIGN: A quasi‚Äêrandomized controlled trial. SETTING: Kawachi General Hospital, Japan. SUBJECTS: A total of 26 patients with fractures of the distal radius were distributed quasi‚Äêrandomly to either the illusory kinesthesia group (n‚Äâ=‚Äâ13) or control group (n‚Äâ=‚Äâ13). INTERVENTION: The intervention was performed on seven consecutive days from postoperative Day 1. Evaluation was performed at seven days, one month, and two months after the surgery. MAIN MEASURES: Data were collected for pain at rest, movement pain, the pain catastrophizing scale, the Hospital Anxiety and Depression Scale, and range of motion. RESULTS: The illusory kinesthesia group reported improved pain at rest (p‚Äâ<‚Äâ0.001), movement pain (p‚Äâ<‚Äâ0.001), pain catastrophizing scale (p‚Äâ<‚Äâ0.001), Hospital Anxiety and Depression Scale (p‚Äâ<‚Äâ0.01), and range of motion (p‚Äâ<‚Äâ0.05) compared with the control group at seven days, one month, and two months after the surgery. The mean (SD) score of the visual analogue scale of pain at rest was 51.3 (16.8) at one day and 4.2 (4.7) at seven days in the illusory kinesthesia group, and 56.8 (22.1) at one day and 35.5 (16.2) at seven days in the control group. CONCLUSION: Illusory kinesthesia group improves the sensory and emotion aspects of pain in patients with fractures of the distal radius. OBJECTIVES: We investigated the effects of inducing an illusion of motion by tendon vibration on sensory and emotional aspects of pain and range of motion in patients with fractures of the distal radius."," Imai, R;  Osumi, M;  Morioka, S",2016.0, 10.1177/0269215515593610,0,0,
1635,The relationships between growth and meaning in life following adversities: Considering multidimensional aspects of meaning in life,"The purpose of this study was to explore the relationships between posttraumatic growth(PTG) and meaning in life considering multidimensional aspects of meaning in life, which are importance, consistency, and specific sources of meaning in life. Data were collected from the 283 undergraduate students, who answered at 15 minutes-required questionnaires. Descriptive statistics for all the measurements were obtained and correlational analyses were conducted to explore the relationships between PTG and meaning in life by SPSS ver.18.0. And t-test was conducted to compare the characteristics of meaning in life according to the degree of PTG. The results showed that there was a significant difference between two groups (high PTG vs. low PTG) in the scores of importance and consistency of meaning in life. Second, the high PTG group considered ‘physical and psychological health’, ‘self-acceptance and growth’, and ‘relationships with family and friends’ more important than low PTG group, while there was no group-difference in importance for ‘satisfaction at work’, ‘social achievement’, ‘spirituality and religiosity’ and ‘contribution to society’. Third, the high PTG group tend to make their lives more meaningful in the aspects of self-related and interpersonal relational values than the lower. These findings suggest that the relationship between PTG and meaning in life could become different according to which aspects of meaning in life identified and measured.",Im S.-Y.,2018.0,10.5958/0976-5506.2018.01060.4,0,0,
1636, Effectiveness of postoperative home-exercise compared with usual care on kinesiophobia and physical activity in spondylolisthesis: a randomized controlled trial," OBJECTIVE: To study the effectiveness of a 12‐month exercise therapy on kinesiophobia and physical activity in patients with spondylolisthesis after lumbar spine fusion. // DESIGN: Randomized controlled trial. // SUBJECTS: Patients (n=98) with spondylolisthesis who had undergone lumbar spine fusion. // METHODS: All patients (mean age 59 years) had received lumbar spine fusion surgery and identical postoperative instructions. Three months postoperatively, they were randomized into an exercise group (n=48) or usual care group (n=50). The exercise group received 12‐month progressive home‐based training with regular booster sessions, and the usual care group a single session of physiotherapy instruction. Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK) and physical activity by the International Physical Activity Questionnaire (IPAQ) preoperatively, 3 months after lumbar spine fusion, and at the end of the 12‐month intervention. // RESULTS: Before the intervention, the median (first quartile; third quartile) of TSK was 32.5 (29.0; 37.0) in the exercise group and 30.0 (25.8; 36.0) in the usual care group, changing to 30.0 (25; 36) in the exercise group and to 30.5 (24; 36.3) in the usual care group (between‐group p=0.17). IPAQ metabolic equivalent minutes per week increased from 1,863 (1,040; 3,042) to 3,190 (1,634; 6,485) in the exercise group and from 2,569 (1,501; 4,075) to 3,590 (1,634; 6,484) in the usual care group (between‐group p=0.92). // CONCLUSION: Progressive 12‐month home‐exercise starting 3 months postoperatively was not superior to usual care in decreasing kinesiophobia or increasing physical activity in spondylolisthesis."," Ilves, O;  Häkkinen, A;  Dekker, J;  Wahlman, M;  Tarnanen, S;  Pekkanen, L;  Ylinen, J;  Kautiainen, H;  Neva, M",2017.0, 10.2340/16501977-2268,0,0,
1637,Attenuated Psychophysiological Reactivity following Single-Session Group Imagery Rescripting versus Verbal Restructuring in Social Anxiety Disorder: Results from a Randomized Controlled Trial.,"The effectiveness of psychotherapies for social anxiety disorder (SAD) is typically evaluated using self- and clinician-reported symptom change, while biomarkers of treatment response are rarely measured. The current study aimed to compare biomarkers of response following two brief group interventions for SAD. This randomized controlled trial evaluated the effectiveness of single-session group interventions for SAD (n = 58) - imagery rescripting (IR) and verbal restructuring (VR) versus waitlist control (WC). The IR intervention guided participants to rescript autobiographical memories through visualization whilst the VR intervention focused on thought challenging. Trial outcomes included change in psychophysiological reactivity (heart rate variability (HRV) and electrodermal responding) to social stress, and symptom-based measures (social interaction anxiety, negative self-portrayal, cognitive avoidance, repetitive negative thinking, memory modification, anxious behaviors). Psychophysiological reactivity was selectively attenuated following IR treatment, compared to VR and WC groups. The specific influence of the imagery-based intervention in modulating autonomic reactivity was evident across HRV parameters, including the standard deviation of intervals between heartbeats (IR vs. WC, d = 0.67, p = 0.021; IR vs. VR, d = 0.58, p = 0.041), and high frequency power - an indicator of parasympathetically mediated emotion regulation (IR vs. WC, d = 0.75, p = 0.034; IR vs. VR, d = 0.95, p = 0.006). Few group differences were observed across self-report measures. The current study highlights the specificity of brief imagery-based interventions in influencing psychophysiological reactivity in SAD and establishes the sensitivity of objective markers of treatment response in quantifying change over symptom-based measurements.",Hyett MP.; Bank SR.; Lipp OV.; Erceg-Hurn DM.; Alvares GA.; Maclaine E.; Puckridge E.; Hayes S.; McEvoy PM.,2018.0,10.1159/000493897,0,0,
1638,Distraction/Suppression and Distress Endurance diminish the extent to which generalized conditioned fear is associated with maladaptive behavioral avoidance,"A central conditioning correlate of clinical anxiety is the over-generalization of Pavlovian fear to safe stimuli resembling conditioned danger cues (CS+). Though much of the pathogenic influence of such generalization may lie in the unnecessary behavioral avoidance it evokes, few studies have examined maladaptive avoidance associated with Pavlovian generalization. Lab-based assessments of this process, here referred to as instrumental avoidance from Pavlovian generalization (IAP-G), have recently begun. The current study represents a next step in this line of work by examining personality factors that may reduce maladaptive IAP-G. This is a clinically relevant effort, as such traits may reflect resilience factors, with high levels reducing the likelihood of maladaptive generalized avoidance following Pavlovian generalization. Here we focus on the effects of Distraction/Suppression (DS) and Distress Endurance (DE) on IAP-G. Results indicate that both DS and DE moderate IAP-G by weakening relations between Pavlovian generalization of fear-potentiated startle and maladaptive generalized avoidance. Further, moderating effects of DS were most pronounced for more ambiguous cues of threat (i.e., stimuli moderately resembling CS+), while moderating effects of DE were most pronounced for more certain cues of threat (i.e., stimuli highly resembling CS+, as well as the CS + itself). Results implicate DS and DE as protective factors against the maladaptive behavioral consequences of Pavlovian generalization, and further indicate that the protective influence of these traits may depend on the ambiguity of the threat at hand.",Hunt C.; Cooper S.E.; Hartnell M.P.; Lissek S.,2017.0,10.1016/j.brat.2017.04.013,0,0,
1639,Tailored online cognitive behavioural therapy with or without therapist support calls to target psychological distress in adults receiving haemodialysis: A feasibility randomised controlled trial.,"Psychological distress is prevalent in haemodialysis (HD) patients yet access to psychotherapy remains limited. This study assessed the feasibility and acceptability of online cognitive-behavioural therapy (CBT) tailored for HD patients, with or without therapist support, for managing psychological distress. This feasibility randomised controlled trial recruited patients from a UK HD centre. Following psychological distress screens, patients with mild-moderate psychological distress (Patient Health Questionnaire PHQ-9; score: 5-19 and/or Generalised Anxiety Disorder; GAD-7 score: 5-14) who met remaining inclusion criteria were approached for consent. Consenters were individually randomised (1:1) to online-CBT or online-CBT plus three therapist support calls. Outcomes included recruitment, retention, and adherence rates. Exploratory change analyses were performed for: psychological distress, quality of life (QoL), illness perceptions, and costs. The statistician was blinded to allocation. 182 (44%) out of 410 patients approached completed psychological distress screens. 26% found screening unacceptable; a further 30% found it unfeasible. Psychological distress was detected in 101 (55%) patients, 60 of these met remaining inclusion criteria. The primary reason for ineligibility was poor computer literacy (N=17, 53%). Twenty-five patients were randomised to the supported (N=18) or unsupported arm (N=7); 92% were retained at follow-up. No differences in psychological distress or cost-effectiveness were observed. No trial adverse events occurred. Online CBT appears feasible but only for computer literate patients who identify with the label psychological distress. A definitive trial using the current methods for psychological distress screening and online care delivery is unfeasible. ClinicalTrials.gov Identifier: NCT02352870.",Hudson JL.; Moss-Morris R.; Norton S.; Picariello F.; Game D.; Carroll A.; Spencer J.; McCrone P.; Hotopf M.; Yardley L.; Chilcot J.,2017.0,10.1016/j.jpsychores.2017.09.009,0,0,
1640,"Repetitive transcranial magnetic stimulation of the right parietal cortex for comorbid generalized anxiety disorder and insomnia: A randomized, double-blind, sham-controlled pilot study.","Background: Repetitive transcranial magnetic stimulation (rTMS) has been considered to be a promising technique for the treatment of neuropsychiatric disorders. However, little is known about the effectiveness of rTMS in the treatment of generalized anxiety disorder (GAD). Moreover, treatment data on comorbid GAD and insomnia remain lacking. The aim of this study was to examine the therapeutic effects of 1 Hz rTMS applied over the right parietal lobe on both anxiety and insomnia symptoms in patients with comorbid GAD and insomnia. Methods: 36 patients were randomized to either sham or active rTMS group (n = 18 each group). The rTMS was administered over the right posterior parietal cortex (P4 electrode site) at a frequency of 1 Hz and an intensity of 90% of the resting motor threshold. Results: Ten days of 1 Hz rTMS to the right parietal lobe significantly improved both anxiety and insomnia symptoms in the active group. Although the anxiety severity was not significantly correlated with insomnia severity at baseline, the improvement in the Hamilton Rating Scale for Anxiety (HRSA) scores were positively correlated with improvement in the Pittsburgh Sleep Quality Index (PSQI) scores. Conclusions: The present study is the first randomized sham-controlled study to assess the effectiveness of low frequency rTMS on the right parietal lobe in patients with comorbid GAD and insomnia. Our results suggested that 1 Hz low frequency rTMS administered over the parietal cortex is effective for both anxiety and insomnia symptoms in patients with comorbid GAD and insomnia. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Huang, Zhaoyang; Li, Yue; Bianchi, Matt T; Zhan, Shuqin; Jiang, Fengying; Li, Ning; Ding, Yan; Hou, Yue; Wang, Li; Ouyang, Quping; Wang, Yuping",2018.0,http://dx.doi.org/10.1016/j.brs.2018.05.016,0,0,
1641, Patient Response to an Integrated Orthotic and Rehabilitation Initiative for Traumatic Injuries: the PRIORITI-MTF Study," Although limb salvage is now possible for many high‚Äêenergy open fractures and crush injuries to the distal tibia, ankle, hindfoot, and midfoot, orthotic options are limited. The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is a custom, energy‚Äêstoring carbon fiber orthosis developed for trauma patients undergoing limb salvage. The IDEO differs from other orthoses in that it allows patients with ankle weakness to have more normal ankle biomechanics and increased ankle power. This article describes the design of a study to evaluate the effectiveness of the IDEO when delivered together with a high‚Äêintensity, sports medicine‚Äêbased approach to rehabilitation. It builds on earlier studies by testing the program at military treatment facilities beyond the Brooke Army Medical Center and the Center for the Intrepid where the device was developed. The PRIORITI‚ÄêMTF study is a multicenter before‚Äêafter program evaluation where participants at least 1 year out from a traumatic lower extremity injury serve as their own controls. Participants are evaluated before receiving the IDEO, immediately after 4 weeks of physical therapy with the IDEO and at 6 and 12 months after the completion of physical therapy. Primary outcomes include functional performance, measured using well‚Äêvalidated assessments of speed, agility, power, and postural stability and self‚Äêreported functioning using the Short Musculoskeletal Function Assessment (SMFA) and the Veterans Health Survey (VR‚Äê12). Secondary outcomes include pain, depression, posttraumatic stress, and satisfaction with the IDEO."," Hsu, JR;  Owens, JG;  DeSanto, J;  Fergason, JR;  Kuhn, KM;  Potter, BK;  Stinner, DJ;  Sheu, RG;  Waggoner, SL;  Wilken, JM;  et al.",2017.0, 10.1097/BOT.0000000000000795,0,0,
1642,A pilot randomized controlled trial evaluating a web-based training program on pediatric medical traumatic stress and trauma-informed care for emergency department staff.,"This pilot parallel group superiority randomized controlled trial investigated the efficacy and acceptability of a web-based training program on pediatric medical traumatic stress and trauma-informed care (Australian and New Zealand Clinical Trials Registry number: ACTRN12617001148369). Eligibility criteria for this study included being a nurse or physician working in an ED in Australia or New Zealand, being fluent in English and having Internet access. Emergency department (ED) staff (N = 71) were randomly assigned into the training (n = 32) or control group n = 39). We hypothesized that compared to the control group, ED staff in the training group would show a greater improvement in knowledge of pediatric medical traumatic stress 1-week post training and that improvement would be maintained at 1-month post training. At baseline participants completed a brief questionnaire assessing knowledge of pediatric medical traumatic stress. The training group then completed the 15-min online training program. The knowledge questionnaire was readministered to all participants' 1 week and 1 month posttraining, after which the control group gained access to the training. Acceptability was based on a program evaluation measure utilizing quantitative and qualitative items. The training group had significantly greater knowledge following training and at follow-up than the control group (p > .001, f = .42) and reported high rates of satisfaction. The results demonstrated an improvement in ED staff knowledge as a result of the training and provide preliminary support for the efficacy and acceptability of brief online training to improve the knowledge of ED staff interested in pediatric medical traumatic stress and trauma-informed care. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Hoysted, Claire; Jobson, Laura; Alisic, Eva",2018.0,http://dx.doi.org/10.1037/ser0000247,0,0,
1643,"Poor mental health, peer drinking norms, and alcohol risk in a social network of first-year college students.","Objective: College students with anxiety and depressive symptomatology face escalated risk for alcohol-related negative consequences. While it is well-established that normative perceptions of proximal peers' drinking behaviors influence students' own drinking behaviors, it is not clear how mental health status impacts this association. In the current study, we examined cross-sectional relationships between anxiety and depressed mood, perceived drinking behaviors and attitudes of important peers, and past month alcohol consumption and related problems in a first-semester college student social network. Method: Participants (N = 1254, 55% female, 47% non-Hispanic White) were first-year students residing on campus at a single university who completed a web-based survey assessing alcohol use, mental health, and social connections among first-year student peers. Network autocorrelation models were used to examine the independent and interactive associations between mental health and perceptions of close peers' drinking on drinking outcomes, controlling for important variables. Results: Mental health interacted with perceptions to predict past-month drinking outcomes, such that higher anxiety and higher perceptions that peers drink heavily was associated with more drinks consumed and consequences, and higher depression and perceptions was associated with more drinks consumed, heavy drinking frequency, and consequences. Attitudes that peers approve of heavy drinking were associated with more drinks consumed and heavy drinking frequency among students with lower (vs. higher) depressed mood. Conclusions: This study provides strong evidence that perceiving that close peers drink heavily is particularly risk-enhancing for anxious and depressed college students, and offers implications about alcohol intervention targeted at these subgroups. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Kenney, Shannon R; DiGuiseppi, Graham T; Meisel, Matthew K; Balestrieri, Sara G; Barnett, Nancy P",2018.0,http://dx.doi.org/10.1016/j.addbeh.2018.04.012,0,0,
1644, Mindfulness and its efficacy for psychological and biological responses in women with breast cancer," Many breast cancer survivors have to deal with a variety of psychological and physiological sequelae including impaired immune responses. The primary purpose of this randomized controlled trial was to determine the efficacy of a mindfulness‐based stress reduction (MBSR) intervention for mood disorders in women with breast cancer. Secondary outcomes were symptom experience, health status, coping capacity, mindfulness, posttraumatic growth, and immune status. This RTC assigned 166 women with breast cancer to one of three groups: MBSR (8 weekly group sessions of MBSR), active controls (self‐instructing MBSR) and non‐MBSR. The primary outcome measure was the Hospital Anxiety and Depression Scale. Secondary outcome measures were: Memorial Symptom Assessment Scale, SF‐36, Sense of Coherence, Five Facets of Mindfulness Questionnaire, and Posttraumatic Growth Index. Blood samples were analyzed using flow cytometry for NK‐cell activity (FANKIA) and lymphocyte phenotyping; concentrations of cytokines were determined in sera using commercial high sensitivity IL‐6 and IL‐8 ELISA (enzyme‐linked immunosorbent assay) kits. Results provide evidence for beneficial effects of MBSR on psychological and biological responses. Women in the MBSR group experienced significant improvements in depression scores, with a mean pre‐MBSR HAD‐score of 4.3 and post‐MBSR score of 3.3 (P = 0.001), and compared to non‐MBSR (P = 0.015). Significant improvements on scores for distress, symptom burden, and mental health were also observed. Furthermore, MBSR facilitated coping capacity as well as mindfulness and posttraumatic growth. Significant benefits in immune response within the MBSR group and between groups were observed. MBSR have potential for alleviating depression, symptom experience, and for enhancing coping capacity, mindfulness and posttraumatic growth, which may improve breast cancer survivorship. MBSR also led to beneficial effect on immune function; the clinical implications of this finding merit further research."," Kenne Sarenmalm, E;  Mårtensson, LB;  Andersson, BA;  Karlsson, P;  Bergh, I",2017.0, 10.1002/cam4.1052,0,0,
1645, Lost in translation? The potential psychobiotic Lactobacillus rhamnosus (JB-1) fails to modulate stress or cognitive performance in healthy male subjects," BACKGROUND: Preclinical studies have identified certain probiotics as psychobiotics ‐ live microorganisms with a potential mental health benefit. Lactobacillus rhamnosus (JB‐1) has been shown to reduce stress‐related behaviour, corticosterone release and alter central expression of GABA receptors in an anxious mouse strain. However, it is unclear if this single putative psychobiotic strain has psychotropic activity in humans. Consequently, we aimed to examine if these promising preclinical findings could be translated to healthy human volunteers. OBJECTIVES: To determine the impact of L. rhamnosus on stress‐related behaviours, physiology, inflammatory response, cognitive performance and brain activity patterns in healthy male participants. METHODS: An 8week, randomized, placebo‐controlled, cross‐over design was employed. Twenty‐nine healthy male volunteers participated. Participants completed self‐report stress measures, cognitive assessments and resting electroencephalography (EEG). Plasma IL10, IL1β, IL6, IL8 and TNFα levels and whole blood Toll‐like 4 (TLR‐4) agonist‐induced cytokine release were determined by multiplex ELISA. Salivary cortisol was determined by ELISA and subjective stress measures were assessed before, during and after a socially evaluated cold pressor test (SECPT). RESULTS: There was no overall effect of probiotic treatment on measures of mood, anxiety, stress or sleep quality and no significant effect of probiotic over placebo on subjective stress measures, or the HPA response to the SECPT. Visuospatial memory performance, attention switching, rapid visual information processing, emotion recognition and associated EEG measures did not show improvement over placebo. No significant anti‐inflammatory effects were seen as assessed by basal and stimulated cytokine levels. CONCLUSIONS: L. rhamnosus was not superior to placebo in modifying stress‐related measures, HPA response, inflammation or cognitive performance in healthy male participants. These findings highlight the challenges associated with moving promising preclinical studies, conducted in an anxious mouse strain, to healthy human participants. Future interventional studies investigating the effect of this psychobiotic in populations with stress‐related disorders are required."," Kelly, JR;  Allen, AP;  Temko, A;  Hutch, W;  Kennedy, PJ;  Farid, N;  Murphy, E;  Boylan, G;  Bienenstock, J;  Cryan, JF;  et al.",2017.0, 10.1016/j.bbi.2016.11.018,0,0,
1646,"Technology Use, Preferences, and Capacity in Injured Patients at Risk for Posttraumatic Stress Disorder.","This investigation comprehensively assessed the technology use, preferences, and capacity of diverse injured trauma survivors with posttraumatic stress disorder (PTSD) symptoms. A total of 121 patients participating in a randomized clinical trial (RCT) of stepped collaborative care targeting PTSD symptoms were administered baseline one-, three-, and six-month interviews that assessed technology use. Longitudinal data about the instability of patient cell phone ownership and phone numbers were collected from follow-up interviews. PTSD symptoms were also assessed over the course of the six months after injury. Regression analyses explored the associations between cell phone instability and PTSD symptoms. At baseline, 71.9% (n = 87) of patients reported current cell phone ownership, and over half (58.2%, n = 46) of these patients possessed basic cell phones. Only 19.0% (n = 23) of patients had no change in cell phone number or physical phone over the course of the six months postinjury. In regression models that adjusted for relevant clinical and demographic characteristics, cell phone instability was associated with higher six-month postinjury PTSD symptom levels (p < 0.001). Diverse injured patients at risk for the development of PTSD have unique technology use patterns, including high rates of cell phone instability. These observations should be strongly considered when developing technology-supported interventions for injured patients with PTSD.",Kelly CM.; Van Eaton EG.; Russo JE.; Kelly VC.; Jurkovich GJ.; Darnell DA.; Whiteside LK.; Wang J.; Parker LE.; Payne TH.; Mooney SD.; Bush N.; Zatzick DF.,2017.0,10.1080/00332747.2016.1271162,0,0,
1647,"Effects of 35% carbon dioxide (CO2) inhalation in patients with post-traumatic stress disorder (PTSD): A double-blind, randomized, placebo-controlled, cross-over trial.","Background: In patients with post-traumatic stress disorder (PTSD) two open pilot studies about the effects of 35% carbon dioxide (CO2) exist. One shows an augmented panicogenic and anxiogenic response (Muhtz et al., 2011), the other does not (Talesnik et al. 2007). We further characterized the CO2 reactivity in PTSD using for the first time placebo-controlled and double-blind conditions. Methods: In 20 patients with PTSD we assessed panic, anxiety, dissociative and PTSD symptoms after a single vital capacity inhalation of 35% CO2 compared to a placebo gas condition in a within-participant cross-over, placebo-controlled, double-blind and randomized design. Results: Inhalation of 35% CO2 versus placebo provoked significantly increased panic, anxiety, dissociative and PTSD symptoms. The reaction to placebo gas was minimal. Order of inhalation, patients' sex or age did not influence the results. The panic and anxiety response under CO2 was considerably higher in the PTSD patients than in healthy controls from our previous open study. Conclusions: The results corroborate that our preceding findings of an increased CO2 reactivity in patients with PTSD are not false positive due to the open design or the lack of placebo control. Replication in a larger number of PTSD patients and matched control subjects is needed. The potential role of childhood traumatisation, psychiatric comorbidity, psychotropic medication and trait dissociation in prior contradictory reports should be clarified. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kellner, Michael; Muhtz, Christoph; Nowack, Sven; Leichsenring, Irina; Wiedemann, Klaus; Yassouridis, Alexander",2018.0,http://dx.doi.org/10.1016/j.jpsychires.2017.10.019,0,0,
1648," Study design, interventions, and baseline characteristics for the Substance use and TRauma Intervention for VEterans (STRIVE) trial"," While comorbidity between posttraumatic stress disorder (PTSD) and substance use disorders (SUD) is common among veterans, there is debate regarding how to best treat individuals suffering from both conditions. Despite data supporting the effectiveness of integrated treatments that simultaneously address both disorders, due to concerns that an early focus on trauma may increase dropout and reduce the likelihood of achieving SUD‚Äêrelated goals, providers continue to prefer a sequential approach, where the addiction is treated first and PTSD treatment is instituted following sustained abstinence or reduced use. This project is designed to directly examine these provider concerns by evaluating the benefits and harms of an integrated versus a sequential approach to treating comorbid PTSD and SUD. This paper reviews the study's methodology, treatment approaches, and baseline participant characteristics. In this randomized clinical trial, one hundred eighty‚Äêthree veterans with co‚Äêoccurring PTSD and SUD have been randomized to one of two psychotherapies that include the same treatment components for SUD and PTSD (Motivational Enhancement Therapy and Prolonged Exposure respectively), but differ by whether the components are delivered sequentially or are integrated such that PTSD and SUD symptoms are addressed concurrently. We hypothesize that veterans assigned to integrated treatment will show greater improvement in PTSD and SUD symptoms than veterans assigned to sequential treatment. If this hypothesis is supported, the findings have the potential to change clinicians' beliefs and challenge long‚Äêstanding practice patterns that require participation in SUD treatment prior to initiating trauma‚Äêfocused therapies for PTSD."," Kehle-Forbes, SM;  Drapkin, ML;  Foa, EB;  Koffel, E;  Lynch, KG;  Polusny, MA;  Van Horn, DH;  Yusko, DA;  Charlesworth, M;  Blasco, M;  et al.",2016.0, 10.1016/j.cct.2016.07.017,0,0,
1649,Parsing the roles of the frontal lobes and basal ganglia in task control using multivoxel pattern analysis,"Cognitive control has traditionally been associated with pFC based on observations of deficits in patients with frontal lesions. However, evidence from patients with Parkinson disease indicates that subcortical regions also contribute to control under certain conditions. We scanned 17 healthy volunteers while they performed a task-switching paradigm that previously dissociated performance deficits arising from frontal lesions in comparison with Parkinson disease, as a function of the abstraction of the rules that are switched. From a multivoxel pattern analysis by Gaussian Process Classification, we then estimated the forward (generative) model to infer regional patterns of activity that predict Switch/Repeat behavior between rule conditions. At 1000 permutations, Switch/Repeat classification accuracy for concrete rules was significant in the BG, but at chance in the frontal lobe. The inverse pattern was obtained for abstract rules, whereby the conditions were successfully discriminated in the frontal lobe but not in the BG. This double dissociation highlights the difference between cortical and subcortical contributions to cognitive control and demonstrates the utility of multivariate approaches in investigations of functions that rely on distributed and overlapping neural substrates.",Kehagia A.A.; Ye R.; Joyce D.W.; Doyle O.M.; Rowe J.B.; Robbins T.W.,2017.0,10.1162/jocn_a_01130,0,0,
1650,"In rape trauma PTSD, patient characteristics indicate which trauma-focused treatment they are most likely to complete.","Dropout rates for effective therapies for posttraumatic stress disorder (PTSD) can be high, especially in practice settings. Although clinicians have intuitions regarding what treatment patients may complete, there are few systematic data to drive those judgments. A multivariable model of dropout risk was constructed with randomized clinical trial data (n = 160) comparing prolonged exposure (PE) and cognitive processing therapy (CPT) for rape-induced PTSD. A two-step bootstrapped variable selection algorithm was applied to identify moderators of dropout as a function of treatment condition. Employing identified moderators in a model, fivefold cross-validation yielded estimates of dropout probability for each patient in each condition. Dropout rates between patients who did and did not receive their model-indicated treatment were compared. Despite equivalent dropout rates across treatments, patients assigned to their model-indicated treatment were significantly less likely to drop out relative to patients who did not (relative risk = 0.49 [95% CI: 0.29-0.82]). Moderators included in the model were: childhood physical abuse, current relationship conflict, anger, and being a racial minority, all of which were associated with higher likelihood of dropout in PE than CPT. Individual differences among patients affect the likelihood they will complete a particular treatment, and clinicians can consider these moderators in treatment planning. In the future, treatment selection models could be used to increase the percentage of patients who will receive a full course of treatment, but replication and extension of such models, and consideration of how best to integrate them into routine practice, are needed.",Keefe JR.; Wiltsey Stirman S.; Cohen ZD.; DeRubeis RJ.; Smith BN.; Resick PA.,2018.0,10.1002/da.22731,0,0,
1651,An exploratory study of salivary cortisol changes during chamomile extract therapy of moderate to severe generalized anxiety disorder.,"Objectives: Dysfunctions in stress biology are hypothesized to contribute to anxiety disorders, and to be ameliorated during successful treatment, but limited clinical data exist to support this hypothesis. We evaluated whether increases in morning cortisol and the diurnal cortisol slope, markers of stress biology, are associated with clinical response to chamomile therapy among subjects with generalized anxiety disorder (GAD). Methods: Among 45 subjects with DSM-IV diagnosed GAD in an open-label clinical trial of chamomile, salivary cortisol was assessed for three days each pre- and post-treatment, at 8am, 12pm, 4pm, and 8pm. Mixed model analyses assessed whether GAD symptom change predicted the degree to which cortisol levels changed during treatment. Results: Symptom improvement during treatment was significantly associated with pre-to-post treatment changes in cortisol. Subjects who experienced more symptomatic improvement experienced significant increases in their morning salivary cortisol (beta = 0.48, p < 0.001), and a greater decrease in cortisol from morning to the rest of the day (beta = 0.55, p < 0.001). In addition, at baseline a lower cortisol level (beta = -0.24, p = 0.023) and a lesser decrease in cortisol after morning (beta = 0.30, p = 0.003) were associated with greater symptomatic improvement. Conclusion: Increases in morning salivary cortisol and the diurnal cortisol slope are associated with symptom improvement in chamomile treatment of GAD. Response to treatment for GAD could partially stem from normalization of stress biology dysfunction, but further work involving establishing abnormalities within-sample, ruling out of confounds (e.g., sleep), and a placebo control is necessary to conclude an amelioration effect. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Keefe, John R; Guo, Wensheng; Li, Qing S; Amsterdam, Jay D; Mao, Jun J",2018.0,http://dx.doi.org/10.1016/j.jpsychires.2017.10.011,0,0,
1652, Comparing AquaStretch with supervised land based stretching for Chronic Lower Back Pain," METHOD: 29 subjects were randomly allocated into three groups, LBS (N = 10), AquaStretch (N = 10) and Control (N = 9). Modified Oswestry Low Back Pain Questionnaire (MOLBPQ) and Tampa Scale of Kinesiophobia (TSK) questionnaires were completed in weeks 1, 6, and 12. Visual Analogue Scale (VAS) pain scores were collected weekly till week 12. Treatment groups received two 30 min sessions per week for 12 weeks, control group continued their normal physical activity. RESULTS & CONCLUSION: Statistical significance (p < 0.05) was observed in the AquaStretch group for pain reduction (P = 0.006), kinesiophobia (P = 0.029), and perceived disability (P = 0.001). Both techniques are suggested to be beneficial for CLBP patients however AquaStretch has key additional benefits including time efficiency, cost effectiveness and the ability to be performed by qualified individuals other than physiotherapists. A reduction in pain post eight weeks of treatment using AquaStretch versus twelve weeks of land based stretching could result in potentially less treatment time needed and a possibility of less medication. Future research is recommended to determine the duration of AquaStretch benefits, and to compare AquaStretch with land based physical therapy programmes for CLBP and to research the potential reduction of Medication required for chronic pain conditions for both its relative clinical effectiveness together with potential health cost savings. OBJECTIVE: Chronic Lower Back Pain (CLBP) is a major health problem affecting 70‚Äê85% of the population in the UK. AquaStretch, a new form of assisted stretching in water, is compared with supervised land based stretching (LBS) for subjects with CLBP looking at pain reduction, kinesiophobia and disability."," Keane, LG",2017.0, 10.1016/j.jbmt.2016.07.004,0,0,
1653,Does patient reluctance towards exposure and psychologists' attitudes about evidence based practice influence treatment recommendations for panic disorder? An experimental investigation.,"This study examined the effects of patient reluctance towards exposure on practitioners' subsequent treatment recommendations. Participants (N=236) were doctoral level psychologists who received a vignette of a patient with panic disorder, which either did (experimental group) or did not (control group) mention patient reluctance towards exposure. Evidence Based Practice (EBP) attitudes were also assessed and taken into account. A significant main effect of reluctance, averaged across all levels of EBP attitudes, and theoretical orientations was obtained (OR=2.85, 95% CI=[1.51, 5.39], p=0.001, RR=1.46), with controls 1.46 times more likely to recommend exposure. A significant main effect of EBP attitudes was also obtained (p<0.001). The odds of recommending exposure increased by 11% with each increase of positive EBP attitudes, across both levels of patient reluctance and theoretical orientation.",Kazantzis N.; Ford C.; Paganini C.; Dattilio FM.; Farchione D.,2017.0,10.1016/j.janxdis.2017.03.001,0,0,
1654,Aripiprazole: A clinical review of its use for the treatment of anxiety disorders and anxiety as a comorbidity in mental illness.,"Background: Although anxiety disorders are common, optimal treatment is elusive. More than half of anxiety patients treated with an adequate course of antidepressants fail to fully improve: treatment resistance, residual symptoms, and recurrence/relapse remain a challenge. Recently, atypical antipsychotics have been considered for treatment-resistant anxiety disorders. This review will explore the available data for the role of aripiprazole in the treatment of anxiety. Methods: PubMed and conference abstracts were searched for randomized, double-blind studies that investigated the efficacy of aripiprazole in anxiety; its efficacy in bipolar disorder and depression was also explored for comparison. Results: A number of studies have shown atypical antipsychotics to be effective in anxiety, and currently available data suggest that aripiprazole augmentation in patients with anxiety disorders is likely as effective as other atypical antipsychotic drugs. Although there have been no randomized, controlled trials, aripiprazole has been found to be effective in treating anxiety disorders in two open-label trials. This combined with the larger data base demonstrating its utility in bipolar disorder and depression, its safety profile and its unique mechanism of action, make aripiprazole for anxiety an intriguing avenue of exploration. Limitations: Data from large randomized, controlled trials on the use of atypical antipsychotics for anxiety in general, and aripiprazole in particular, are currently lacking. Conclusion: The results of open-label trials of aripiprazole in anxiety provide enough support to warrant its further study. This, combined with a larger data base demonstrating its utility in bipolar disorder and depression, its safety profile and its unique mechanism of action, make aripiprazole for anxiety an intriguing avenue of exploration. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Katzman, Martin A",2011.0,http://dx.doi.org/10.1016/S0165-0327%2811%2970004-0,0,0,
1655, The Sternal Management Accelerated Recovery Trial (S.M.A.R.T) - standard restrictive versus an intervention of modified sternal precautions following cardiac surgery via median sternotomy: study protocol for a randomised controlled trial," BACKGROUND: The routine implementation of sternal precautions to prevent sternal complications that restrict the use of the upper limbs is currently worldwide practice following a median sternotomy. However, evidence is limited and drawn primarily from cadaver studies and orthopaedic research. Sternal precautions may delay recovery, prolong hospital discharge and be overly restrictive. Recent research has shown that upper limb exercise reduces post‚Äêoperative sternal pain and results in minimal micromotion between the sternal edges as measured by ultrasound. The aims of this study are to evaluate the effects of modified sternal precautions on physical function, pain, recovery and health‚Äêrelated quality of life after cardiac surgery. METHODS/DESIGN: This study is a phase II, double‚Äêblind, randomised controlled trial with concealed allocation, blinding of patients and assessors, and intention‚Äêto‚Äêtreat analysis. Patients (n‚Äâ=‚Äâ72) will be recruited following cardiac surgery via a median sternotomy. Sample size calculations were based on the minimal important difference (two points) for the primary outcome: Short Physical Performance Battery. Thirty‚Äêsix participants are required per group to counter dropout (20%). All participants will be randomised to receive either standard or modified sternal precautions. The intervention group will receive guidelines encouraging the safe use of the upper limbs. Secondary outcomes are upper limb function, pain, kinesiophobia and health‚Äêrelated quality of life. Descriptive statistics will be used to summarise data. The primary hypothesis will be examined by repeated‚Äêmeasures analysis of variance to evaluate the changes from baseline to 4 weeks post‚Äêoperatively in the intervention arm compared with the usual‚Äêcare arm. In all tests to be conducted, a p value <0.05 (two‚Äêtailed) will be considered statistically significant, and confidence intervals will be reported. DISCUSSION: The Sternal Management Accelerated Recovery Trial (S.M.A.R.T.) is a two‚Äêcentre randomised controlled trial powered and designed to investigate whether the effects of modifying sternal precautions to include the safe use of the upper limbs and trunk impact patients' physical function and recovery following cardiac surgery via median sternotomy. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry identifier: ACTRN12615000968572 . Registered on 16 September 2015 (prospectively registered)."," Katijjahbe, MA;  Denehy, L;  Granger, CL;  Royse, A;  Royse, C;  Bates, R;  Logie, S;  Clarke, S;  El-Ansary, D",2017.0, 10.1186/s13063-017-1974-8,0,0,
1656,Challenges and Solutions for Depression Prevention Research: Methodology for a Depression Prevention Trial for Older Adults with Knee Arthritis and Emotional Distress.,"To describe the methodology, challenges, and baseline characteristics of a prevention development trial entitled ""Reducing Pain, Preventing Depression."" A sequential multiple assignment randomized trial (SMART) compared sequences of cognitive behavioral therapy (CBT) and physical therapy for knee pain and prevention of depression and anxiety. Participants were randomized to CBT, physical therapy, or enhanced usual care and followed for 12 months for new-episode depression or anxiety. Participants were age‚Äâ‚â•‚Äâ60 with knee osteoarthritis and subsyndromal depression, defined as 9-item Patient Health Questionnaire (PHQ-9) score‚Äâ‚â•1 (which included the endorsement of one of the cardinal symptoms of depression [low mood or anhedonia]) and no diagnosis of major depressive disorder per the Structured Clinical Interview for DSM-IV. Depression and anxiety severity and characterization of new episodes were assessed with the PHQ-9, Generalized Anxiety Disorder-7, and the PRIME-MD. Knee pain was characterized with the Western Ontario McMaster Arthritis Index. Response was defined as at least ""Very Much Better"" on a Patient Global Impression of Change. At baseline there were 99 patients with an average age of 71; 61.62% were women and 81.8% white. The average PHQ-9 was 5.6 and average Generalized Anxiety Disorder-7, was 3.2. Most were satisfied with the interventions and study procedures. The challenges and solutions described here will also be used in a confirmatory clinical trial of efficacy. A SMART design for depression and anxiety prevention, using both CBT and physical therapy, appears to be feasible and acceptable to participants. The methodologic innovations of this project may advance the field of late-life depression and anxiety prevention.",Karp JF.; Dew MA.; Wahed AS.; Fitzgerald K.; Bolon CA.; Weiner DK.; Morse JQ.; Albert S.; Butters M.; Gildengers A.; Reynolds CF.,2016.0,10.1016/j.jagp.2015.10.012,0,0,
1657,Evidence of distinct profiles of Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) based on the new ICD-11 Trauma Questionnaire (ICD-TQ).,"The WHO International Classification of Diseases, 11th version (ICD-11), has proposed two related diagnoses following exposure to traumatic events; Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). We set out to explore whether the newly developed ICD-11 Trauma Questionnaire (ICD-TQ) can distinguish between classes of individuals according to the PTSD and CPTSD symptom profiles as per ICD-11 proposals based on latent class analysis. We also hypothesized that the CPTSD class would report more frequent and a greater number of different types of childhood trauma as well as higher levels of functional impairment. Methods Participants in this study were a sample of individuals who were referred for psychological therapy to a National Health Service (NHS) trauma centre in Scotland (N=193). Participants completed the ICD-TQ as well as measures of life events and functioning. Overall, results indicate that using the newly developed ICD-TQ, two subgroups of treatment-seeking individuals could be empirically distinguished based on different patterns of symptom endorsement; a small group high in PTSD symptoms only and a larger group high in CPTSD symptoms. In addition, CPTSD was more strongly associated with more frequent and a greater accumulation of different types of childhood traumatic experiences and poorer functional impairment. Sample predominantly consisted of people who had experienced childhood psychological trauma or been multiply traumatised in childhood and adulthood. CPTSD is highly prevalent in treatment seeking populations who have been multiply traumatised in childhood and adulthood and appropriate interventions should now be developed to aid recovery from this debilitating condition.",Karatzias T.; Shevlin M.; Fyvie C.; Hyland P.; Efthymiadou E.; Wilson D.; Roberts N.; Bisson JI.; Brewin CR.; Cloitre M.,2017.0,10.1016/j.jad.2016.09.032,0,0,
1658,Modeling the effect of blunt impact on mitochondrial function in cartilage: Implications for development of osteoarthritis,"Objective. Osteoarthritis (OA) is a disease characterized by degeneration of joint cartilage. It is associated with pain and disability and is the result of either age and activity related joint wear or an injury. Non-invasive treatment options are scarce and prevention and early intervention methods are practically non-existent. The modeling effort presented in this article is constructed based on an emerging biological hypothesis-post-impact oxidative stress leads to cartilage cell apoptosis and hence the degeneration observed with the disease. The objective is to quantitatively describe the loss of cell viability and function in cartilage after an injurious impact and identify the key parameters and variables that contribute to this phenomenon. Methods. We constructed a system of differential equations that tracks cell viability, mitochondrial function, and concentrations of reactive oxygen species (ROS), adenosine triphosphate (ATP), and glycosaminoglycans (GAG). The system was solved using MATLAB and the equations' parameters were fit to existing data using a particle swarm algorithm. Results. The model fits well the available data for cell viability, ATP production, and GAG content. Local sensitivity analysis shows that the initial amount of ROS is the most important parameter. Discussion. The model we constructed is a viable method for producing in silico studies and with a few modifications, and data calibration and validation, may be a powerful predictive tool in the search for a non-invasive treatment for post-traumatic osteoarthritis.",Kapitanov G.I.; Ayati B.P.; Martin J.A.,2017.0,10.7717/peerj.3468,0,0,
1659, Psychosocial Group Intervention Among War-Affected Children: an Analysis of Changes in Posttraumatic Cognitions," Cognitive theories point to reduction in dysfunctional posttraumatic cognitions (PTCs) as one mechanism involved in recovery from posttraumatic stress symptoms (PTSS), yet research findings have shown individual differences in the recovery process. We tested the cognitive mediation hypothesis above in a previously published psychosocial group intervention among war‐affected children. We also examined heterogeneity in children's PTCs during the intervention. We used a cluster randomized trial of Smith et al.'s (2002) teaching recovery techniques (TRT) intervention among 482 Palestinians 10‐13 years of age (n = 242 for intervention group, n = 240 for control group). Children reported PTSS, PTCs, and depressive symptoms at baseline, midpoint, postintervention, and at 6‐month follow‐up. Path analysis results showed that TRT was not effective in reducing dysfunctional PTCs, and the reductions did not mediate intervention effects on PTSS. Using latent class growth analysis, we chose the model with 3 differing trajectories in the intervention group: high, decreasing, moderate, downward trending, and severe, stable levels of PTCs. Higher PTSS and depressive symptoms at baseline were associated with membership in the severe, stable trajectory. The intervention did not produce the kind of beneficial cognitive change needed in the cognitive mediation conceptualization. Nevertheless, cognitive changes differed substantially across children during the intervention, and were associated with their preintervention mental health status. These findings call for more detailed examination of the process of cognitive mediation."," Kangaslampi, S;  Punamäki, RL;  Qouta, S;  Diab, M;  Peltonen, K",2016.0, 10.1002/jts.22149,0,0,
1660, Use and Appreciation of a Tailored Self-Management eHealth Intervention for Early Cancer Survivors: process Evaluation of a Randomized Controlled Trial," BACKGROUND: A fully automated computer‐tailored Web‐based self‐management intervention, Kanker Nazorg Wijzer (KNW [Cancer Aftercare Guide]), was developed to support early cancer survivors to adequately cope with psychosocial complaints and to promote a healthy lifestyle. The KNW self‐management training modules target the following topics: return to work, fatigue, anxiety and depression, relationships, physical activity, diet, and smoking cessation. Participants were guided to relevant modules by personalized module referral advice that was based on participants’ current complaints and identified needs. OBJECTIVE: The aim of this study was to evaluate the adherence to the module referral advice, examine the KNW module use and its predictors, and describe the appreciation of the KNW and its predictors. Additionally, we explored predictors of personal relevance. METHODS: This process evaluation was conducted as part of a randomized controlled trial. Early cancer survivors with various types of cancer were recruited from 21 Dutch hospitals. Data from online self‐report questionnaires and logging data were analyzed from participants allocated to the intervention condition. Chi‐square tests were applied to assess the adherence to the module referral advice, negative binominal regression analysis was used to identify predictors of module use, multiple linear regression analysis was applied to identify predictors of the appreciation, and ordered logistic regression analysis was conducted to explore possible predictors of perceived personal relevance. RESULTS: From the respondents (N=231; mean age 55.6, SD 11.5; 79.2% female [183/231]), 98.3% (227/231) were referred to one or more KNW modules (mean 2.9, SD 1.5), and 85.7% (198/231) of participants visited at least one module (mean 2.1, SD 1.6). Significant positive associations were found between the referral to specific modules (range 1‐7) and the use of corresponding modules. The likelihoods of visiting modules were higher when respondents were referred to those modules by the module referral advice. Predictors of visiting a higher number of modules were a higher number of referrals by the module referral advice (β=.136, P=.009), and having a partner was significantly related with a lower number of modules used (β=‐.256, P=.044). Overall appreciation was high (mean 7.5, SD 1.2; scale 1‐10) and was significantly predicted by a higher perceived personal relevance (β=.623, P=.000). None of the demographic and cancer‐related characteristics significantly predicted the perceived personal relevance. CONCLUSIONS: The KNW in general and more specifically the KNW modules were well used and highly appreciated by early cancer survivors. Indications were found that the module referral advice might be a meaningful intervention component to guide the users in following a preferred selection of modules. These results indicate that the fully automated Web‐based KNW provides personal relevant and valuable information and support for early cancer survivors. Therefore, this intervention can complement usual cancer aftercare and may serve as a first step in a stepped‐care approach. TRIAL REGISTRATION: Nederlands Trial Register: NTR3375; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3375 (Archived by WebCite at http://www.webcitation.org/6jo4jO7kb)."," Kanera, IM;  Willems, RA;  Bolman, CA;  Mesters, I;  Zambon, V;  Gijsen, BC;  Lechner, L",2016.0, 10.2196/jmir.5975,0,0,
1661, Moderators of treatment response to trauma-focused cognitive behavioral therapy among youth in Zambia," BACKGROUND: The effectiveness of mental health interventions such as trauma‚Äêfocused cognitive behavioral therapy (TF‚ÄêCBT) may vary by client, caregiver, and intervention‚Äêlevel variables, but few randomized trials in low‚Äê and middle‚Äêincome countries (LMIC) have conducted moderation analyses to investigate these characteristics. This study explores moderating factors to TF‚ÄêCBT treatment response among a sample of orphans and vulnerable children (OVC) in Zambia. METHODS: Data were obtained from a completed randomized trial of TF‚ÄêCBT among 257 OVC in Zambia. Trauma symptoms and functioning were measured at baseline and following the end of treatment. Mixed effects regression models were estimated for each moderator of interest: gender, age, number of trauma types experienced, history of sexual abuse, orphan status, primary caretaker, school status, and parental involvement in treatment. RESULTS: Treatment effectiveness was moderated by history of sexual abuse with greater reductions in both outcomes (trauma, p < .05; functioning, p < .01) for those that experienced sexual abuse. Primary caretaker was also a moderator with greater trauma reductions in those who identified their mother as the primary caretaker (p < .01), and better functioning in those that identified their father as the primary caretaker (p < .05). Nonorphans and single orphans (mother alive) showed greater reduction in functional impairment (p < .01) compared with double orphans. There was no significant moderator effect found by gender, age, number of trauma types, school status, or caregiver participation in treatment. CONCLUSIONS: This study suggests that TF‚ÄêCBT was effective in reducing trauma symptoms and functional impairment among trauma‚Äêaffected youth overall and that it may be particularly effective for survivors of child sexual abuse and children whose primary caretaker is a biological parent. Scale‚Äêup of TF‚ÄêCBT is warranted given the wide range of effectiveness and prevalence of child sexual abuse. Future randomized trials of interventions in LMIC should power for moderation analyses in the study design phase when feasible."," Kane, JC;  Murray, LK;  Cohen, J;  Dorsey, S;  Skavenski van Wyk, S;  Galloway Henderson, J;  Imasiku, M;  Mayeya, J;  Bolton, P",2016.0, 10.1111/jcpp.12623,0,0,
1662,Feasibility of a 6-Month Yoga Program to Improve the Physical and Psychosocial Status of Persons with Multiple Sclerosis and their Family Members.,"To the best of our knowledge, there has been no study on yoga that includes both persons with multiple sclerosis (MS) and their family members. Because yoga has therapeutic effects in both persons with MS and healthy persons, we hypothesized that it would be an effective method to improve not only the physical and psychosocial status but also the time persons with MS and their family members spend together. To examine the feasibility of a 6-month (long-term) yoga program to improve the physical and psychosocial status of persons with MS and their family members. Uncontrolled clinical trial. The protocol was developed at the Department of Neurology, Faculty of Medicine, and School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey. Persons with MS and healthy family members. Walking, balance, fatigue, health-related quality of life, depression, pain, and kinesiophobia. Yoga training was given once a week (at least 1h) for 6 months. The same assessors who assessed at baseline also performed the same assessments immediately after the end of the training (i.e., after 6 months). In total, 44 participants (27 persons with MS and 17 healthy family members) participated in the study. Twelve persons with MS and three healthy family members completed the 6-month yoga intervention. The completion rate for persons with MS and healthy subjects was 44.4% and 17.6%, respectively. In persons with MS, the mental dimension of health-related quality of life, walking speed, fatigue, and depression levels significantly improved after the yoga program (p < .05). However, there was no significant change in the self-reported walking impact, balance, pain, physical dimension of health-related quality of life, and kinesiophobia levels in the persons with MS (p > .05). This study suggests that a 6-month yoga program can improve the mental dimension of health-related quality of life, walking speed, fatigue, and depression in the persons with MS. However, the 6-month yoga program does not appear to be a feasible method to increase the time that persons with MS spend together with their family members.",Kahraman T.; Ozdogar AT.; Yigit P.; Hosgel I.; Mehdiyev Z.; Ertekin O.; Ozakbas S.,,10.1016/j.explore.2017.07.006,0,0,
1663,Post-9/11 veterans and their partners improve mental health outcomes with a self-directed mobile and Web-based wellness training program: A randomized controlled trial.,"Background: Veterans with history of deployment in the Global War on Terror face significant and ongoing challenges with high prevalences of adverse psychological, physical, spiritual, and family impacts. Together, these challenges contribute to an emerging public health crisis likely to extend well into the future. Innovative approaches are needed that reach veterans and their family members with strategies they can employ over time in their daily lives to promote improved adjustment and well-being. Objective: The objective of this study was to evaluate effects of use of a Web-based, self-directed program of instruction in mind- and body-based wellness skills to be employed by Global War on Terror veterans and their significant relationship partners on mental health and wellness outcomes associated with postdeployment readjustment. Methods: We recruited 160 veteran-partner dyads in 4 regions of the United States (San Diego, CA; Dallas, TX; Fayetteville, NC; and New York, NY) through publicity by the Iraq and Afghanistan Veterans of America to its membership. Dyads were randomly allocated to 1 of 4 study arms: Mission Reconnect (MR) program alone, MR plus the Prevention and Relationship Enhancement Program (PREP) for Strong Bonds weekend program for military couples, PREP alone, and waitlist control. We administered a battery of standardized and investigator-generated instruments assessing mental health outcomes at baseline, 8 weeks, and 16 weeks. Dyads in the MR arms were provided Web-based and mobile app video and audio instruction in a set of mindfulness-related stress reduction and contemplative practices, as well as partner massage for reciprocal use. All participants provided weekly reports on frequency and duration of self-care practices for the first 8 weeks, and at 16 weeks. Results: During the first 8-week reporting period, veterans and partners assigned to MR arms used some aspect of the program a mean of 20 times per week, totaling nearly 2.5 hours per week, with only modest declines in use at 16 weeks. Significant improvements were seen at 8 and 16 weeks in measures of posttraumatic stress disorder, depression, sleep quality, perceived stress, resilience, self-compassion, and pain for participants assigned to MR arms. In addition, significant reductions in self-reported levels of pain, tension, irritability, anxiety, and depression were associated with use of partner massage. Conclusions: Both veterans and partners were able to learn and make sustained use of a range of wellness practices taught in the MR program. Home-based, self-directed interventions may be of particular service to veterans who are distant from, averse to, or prohibited by schedule from using professional services. Leveraging the partner relationship may enhance sustained use of self-directed interventions for this population. Use of the MR program appears to be an accessible, low-cost approach that supports well-being and reduces multiple symptoms among post-9/11 veterans and their partners. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kahn, Janet R; Collinge, William; Soltysik, Robert",2016.0,http://dx.doi.org/10.2196/jmir.5800,0,0,
1664,Treatment of anxiety disorders: Does specialty training help?,"Does specialized training in the treatment of anxiety disorders have an impact on clinical outcome and efficiency? The authors compared specialists in the cognitive-behavioral treatment of anxiety disorders with nonspecialists. The specialist group saw patients for a shorter average period of time (6.37 vs. 8.44) and reported less anxiety in their patients at termination. Patients were followed for 2 years to determine relapse rates. Only 19% of the patients treated by specialists returned for treatment, whereas 40% of those treated by nonspecialists did. Therapists who used cognitive-behavioral techniques were more effective than other clinicians in the treatment of anxiety disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Howard, Rodney C",1999.0,http://dx.doi.org/10.1037/0735-7028.30.5.470,0,0,
1665, Investigating Habituation to Premonitory Urges in Behavior Therapy for Tic Disorders," Behavior therapy is effective for Persistent Tic Disorders (PTDs), but behavioral processes facilitating tic reduction are not well understood. One process, habituation, is thought to create tic reduction through decreases in premonitory urge severity. The current study tested whether premonitory urges decreased in youth with PTDs (N = 126) and adults with PTDs (N = 122) who participated in parallel randomized clinical trials comparing behavior therapy to psychoeducation and supportive therapy (PST). Trends in premonitory urges, tic severity, and treatment outcome were analyzed according to the predictions of a habituation model, whereby urge severity would be expected to decrease in those who responded to behavior therapy. Although adults who responded to behavior therapy showed a significant trend of declining premonitory urge severity across treatment, results failed to demonstrate that behavior therapy specifically caused changes in premonitory urge severity. In addition, reductions in premonitory urge severity in those who responded to behavior therapy were significant greater than those who did not respond to behavior therapy but no different than those who responded or did not respond to PST. Children with PTDs failed to show any significant changes in premonitory urges. Reductions in premonitory urge severity did not mediate the relationship between treatment and outcome in either adults or children. These results cast doubt on the notion that habituation is the therapeutic process underlying the effectiveness of behavior therapy, which has immediate implications for the psychoeducation and therapeutic rationale presented in clinical practice. Moreover, there may be important developmental changes in premonitory urges in PTDs, and alternative models of therapeutic change warrant investigation."," Houghton, DC;  Capriotti, MR;  Scahill, LD;  Wilhelm, S;  Peterson, AL;  Walkup, JT;  Piacentini, J;  Woods, DW",2017.0, 10.1016/j.beth.2017.08.004,0,0,
1666,Cognitive behavioral therapy vs. Eye movement desensitization and reprocessing for treating panic disorder: A randomized controlled trial.,"Objective: Cognitive Behavioral Therapy (CBT) is an effective intervention for patients with panic disorder (PD). From a theoretical perspective, Eye Movement Desensitization and Reprocessing (EMDR) therapy could also be useful in the treatment of PD because: (1) panic attacks can be experienced as life threatening; (2) panic memories specific to PD resemble traumatic memories as seen in posttraumatic stress disorder (PTSD); and (3) PD often develops following a distressing life event. The primary objective of this Randomized Controlled Trial (RCT), was to compare EMDR therapy with CBT for PD and determine whether EMDR is not worse than CBT in reducing panic symptoms and improving Quality Of Life (QOL). Methods: Two-arm (CBT and EMDR) parallel RCT in patients with PD (N = 84). Patients were measured at baseline (T1), directly after the last therapy session (T2), and 3 months after ending therapy (T3). Non-inferiority testing (linear mixed model with intention-to-treat analysis) was applied. Patients were randomly assigned to 13 weekly 60-min sessions of CBT (N = 42) or EMDR therapy (N = 42). Standard protocols were used. The primary outcome measure was severity of PD at T3, as measured with the Agoraphobic Cognitions Questionnaire (ACQ), the Body Sensations Questionnaire (BSQ), and the Mobility Inventory (MI). The secondary outcome measure was QOL, as measured with the World Health Organization Quality of Life short version (WHOQOL-Bref), at T3. Results: The severity of PD variables ACQ and BSQ showed non-inferiority of EMDR to CBT, while MI was inconclusive (adjusted analyses). Overall QOL and general health, Psychological health, Social relationships, and Environment showed non-inferiority of EMDR to CBT, while Physical health was inconclusive. Conclusion: EMDR therapy proved to be as effective as CBT for treating PD patients. Trial Registration: (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Horst, Ferdinand; Den Oudsten, Brenda; Zijlstra, Wobbe; de Jongh, Ad; Lobbestael, Jill; De Vries, Jolanda",2017.0,http://dx.doi.org/10.3389/fpsyg.2017.01409,0,0,
1667, Mobile Phone-Delivered Cognitive Behavioral Therapy for Insomnia: a Randomized Waitlist Controlled Trial," BACKGROUND: This study is one of the first randomized controlled trials investigating cognitive behavioral therapy for insomnia (CBT‚ÄêI) delivered by a fully automated mobile phone app. Such an app can potentially increase the accessibility of insomnia treatment for the 10% of people who have insomnia. OBJECTIVE: The objective of our study was to investigate the efficacy of CBT‚ÄêI delivered via the Sleepcare mobile phone app, compared with a waitlist control group, in a randomized controlled trial. METHODS: We recruited participants in the Netherlands with relatively mild insomnia disorder. After answering an online pretest questionnaire, they were randomly assigned to the app (n=74) or the waitlist condition (n=77). The app packaged a sleep diary, a relaxation exercise, sleep restriction exercise, and sleep hygiene and education. The app was fully automated and adjusted itself to a participant's progress. Program duration was 6 to 7 weeks, after which participants received posttest measurements and a 3‚Äêmonth follow‚Äêup. The participants in the waitlist condition received the app after they completed the posttest questionnaire. The measurements consisted of questionnaires and 7‚Äêday online diaries. The questionnaires measured insomnia severity, dysfunctional beliefs about sleep, and anxiety and depression symptoms. The diary measured sleep variables such as sleep efficiency. We performed multilevel analyses to study the interaction effects between time and condition. RESULTS: The results showed significant interaction effects (P<.01) favoring the app condition on the primary outcome measures of insomnia severity (d=‚Äê0.66) and sleep efficiency (d=0.71). Overall, these improvements were also retained in a 3‚Äêmonth follow‚Äêup. CONCLUSIONS: This study demonstrated the efficacy of a fully automated mobile phone app in the treatment of relatively mild insomnia. The effects were in the range of what is found for Web‚Äêbased treatment in general. This supports the applicability of such technical tools in the treatment of insomnia. Future work should examine the generalizability to a more diverse population. Furthermore, the separate components of such an app should be investigated. It remains to be seen how this app can best be integrated into the current health regimens. TRIAL REGISTRATION: Netherlands Trial Register: NTR5560; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5560 (Archived by WebCite at http://www.webcitation.org/6noLaUdJ4)."," Horsch, CH;  Lancee, J;  Griffioen-Both, F;  Spruit, S;  Fitrianie, S;  Neerincx, MA;  Beun, RJ;  Brinkman, WP",2017.0, 10.2196/jmir.6524,0,0,
1668,Evaluation of aggression control therapy for violent forensic psychiatric patients.,"Aggression Control Therapy is meant for Dutch forensic psychiatric patients and consists of 15 weekly sessions and three follow-up sessions at 5-week intervals after completion. It includes the components: Anger Management, Social Skills, Moral Reasoning and Self-regulation Skills. It has been shown in various forensic psychiatric hospitals that Aggression Control Therapy can be given to both inpatients and outpatients. Inpatients had a 12% dropout rate and outpatients a 34% dropout rate. The self-report questionnaires showed a significant decrease in hostile and aggressive behaviour in both inpatients and outpatients. This decrease was maintained at the follow-up assessment. Follow-up research with a control condition and with more objective outcome measures is needed to confirm this improvement. No changes in socially competent behaviour were observed, probably because patients reported at the beginning of the therapy less social anxiety and more social skills than a norm group. The therapy turned out to be beneficial for patients who had a comparatively high level of anger as a personality characteristic. It is recommended that the Social Skills component of the therapy focuses on a decrease in ""limit-setting"" skills like giving criticism and more on an increase of ""approaching"" skills like giving a compliment. A design for a future controlled study is described briefly. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hornsveld, Ruud H. J",2005.0,http://dx.doi.org/10.1080/10683160500255596,0,0,
1669, Differential effect of exposure-based therapy and cognitive therapy on post-traumatic stress disorder symptom clusters: a randomized controlled trial," A question remains regarding differential effects of exposure‚Äêbased versus non‚Äêexposure‚Äêbased therapies on specific post‚Äêtraumatic stress disorder (PTSD) symptom clusters. Traumatized emergency room patients were randomized to receive prolonged exposure (PE) or cognitive therapy (CT) without exposure. PE/CT had no differential effect on individual symptom clusters, and change in total PTSD score remained significant even after controlling for the reductions in all three symptom clusters. In addition, baseline levels of PTSD avoidance/intrusion/hyperarousal did not moderate the effects of PE and CT on total PTSD symptom scores. Taken together, these findings challenge the notion that PE and CT are specifically, and differentially, useful in treating one particular PTSD symptom cluster. PRACTITIONER POINTS: Despite their different theoretical backgrounds and techniques, the notion that PE and CT (without exposure) target different PTSD symptoms was not confirmed in this study. Thus, both interventions may in fact be equally effective for treating intrusion, avoidance and hyperarousal symptoms. Baseline levels of avoidance, intrusion and hyperarousal may not be good a priori indicators for PTSD treatment selection. The effect of PE and CT on PTSD as a whole does not seem to depend on a reduction in any specific symptom cluster. These findings indicate that exposure and non‚Äêexposure interventions may lead to similar results in terms of reductions in specific PTSD symptoms. It is quite possible that individual PTSD clusters may respond to therapy in an inter‚Äêrelated fashion, with one cluster affecting the other."," Horesh, D;  Qian, M;  Freedman, S;  Shalev, A",2017.0, 10.1111/papt.12103,0,0,
1670, Long-term Posterior Capsule Opacification Reduction with Square-Edge Polymethylmethacrylate Intraocular Lens: randomized Controlled Study," PURPOSE: To objectively assess the long‚Äêterm posterior capsule opacification (PCO) and neodymium‚Äêdoped yttrium aluminium garnet (Nd:YAG) capsulotomy rate of a square‚Äêedge (SE) polymethylmethacrylate (PMMA) intraocular lens (IOL) modification in comparison with a round‚Äêedge (RE) PMMA IOL or an SE hydrophobic acrylic IOL (SE‚ÄêAcrylic). DESIGN: Prospective, randomized, controlled fellow eye clinical study. PARTICIPANTS: Ninety‚Äêfour patients scheduled for bilateral phacoemulsification had an SE‚ÄêPMMA IOL implanted in 1 eye. An RE‚ÄêPMMA IOL was implanted in the fellow eye in 46 patients (group A), and an SE‚ÄêAcrylic IOL was implanted in the fellow eye in 48 patients (group B). Randomization was used to determine group assignment and which IOL was implanted in the first eye to undergo surgery. METHODS: Evaluation of Posterior Capsule Opacification (EPCO) image analysis software was used to objectively grade PCO density from standardized, high‚Äêresolution retroillumination photographs obtained annually for the first 5 postoperative years and at year 9. MAIN OUTCOME MEASURES: The PCO scores and Nd:YAG capsulotomy rate. RESULTS: Nine‚Äêyear follow‚Äêup was achieved by 72% from group A and 63% from group B. In group A, the mean PCO score was significantly lower in the SE‚ÄêPMMA IOL eyes compared with the contralateral RE‚ÄêPMMA eyes at all follow‚Äêup visits (P < 0.05). In group B, the mean PCO score was statistically lower in the SE‚ÄêPMMA IOL eyes compared with the contralateral SE‚ÄêAcrylic IOL eyes at all but the 1‚Äê and 3‚Äêyear follow‚Äêup visits. Nine‚Äêyear Nd:YAG capsulotomy rates were 2% for SE‚ÄêPMMA IOLs versus 37% for RE‚ÄêPMMA IOLs in group A (P < 0.001), and 4% for SE‚ÄêPMMA IOLs versus 10% for SE‚ÄêAcrylic IOLs in group B (P = 0.435). The RE‚ÄêPMMA PCO rate did not plateau and continued to increase throughout the 9‚Äêyear study period. CONCLUSIONS: This prospective, 9‚Äêyear fellow eye comparison study suggests that an inexpensive PMMA IOL design modification‚Äêa squared optic edge‚Äêcould significantly reduce the burden of vision‚Äêimpairing secondary membrane in developing countries."," Haripriya, A;  Chang, DF;  Vijayakumar, B;  Niraj, A;  Shekhar, M;  Tanpreet, S;  Aravind, S",2017.0, 10.1016/j.ophtha.2016.11.010,0,0,
1671,Towards a pragmatic human migraine model for drug testing: 2. Isosorbide-5-mononitrate in healthy individuals,"Background A model for the testing of novel anti-migraine drugs should preferably use healthy volunteers for ease of recruiting. Isosorbide-5-mononitrate (5-ISMN) provokes headache in healthy volunteers with some migraine features such as pulsating pain quality and aggravation by physical activity. Therefore, this headache might respond to sumatriptan, a requirement for validation of any model. The hypothesis of the present study was that sumatriptan is effective in 5-ISMN-induced headache in healthy individuals. Methods In a double-blind, randomised, crossover design, 30 healthy volunteers of both sexes received 5-ISMN 60 mg on two separate days, each day followed by oral self-administered placebo or sumatriptan 50 mg. Headache response and accompanying symptoms were registered in a questionnaire by the participants themselves. Results 5-ISMN induced a reproducible headache in all 30 participants. The headache had several migraine-like features in all participants and 20 individuals developed a migraine-like attack. Median peak headache score was 5 on both experimental days (p = 1.00). There was no reduction, but instead an increase in headache intensity 2 hours after sumatriptan (p = 0.003). Difference in area under the headache score curve (AUC) 0-4 hours between sumatriptan and placebo was not significant (p = 0.30). Conclusion 5-ISMN is a very powerful inducer of migraine-like headache in healthy individuals but the headache does not respond to sumatriptan. The model is not useful for future drug testing.",Hansen E.K.; Olesen J.,2017.0,10.1177/0333102416636095,0,0,
1672," The Effect of Listening to Music During Percutaneous Nephrostomy Tube Placement on Pain, Anxiety, and Success Rate of Procedure: a Randomized Prospective Study"," MATERIALS AND METHODS: One hundred consecutive patients (age >18 years) with hydronephrosis were prospectively enrolled in this study. All patients were prospectively randomized to undergo office‚Äêbased PNTP with (Group I, n‚Äâ=‚Äâ50) or without music (Group II, n‚Äâ=‚Äâ50). Anxiety levels were evaluated with State Trait Anxiety Inventory. A visual analog scale was used to evaluate pain levels, patient's satisfaction, and willingness to undergo the procedure. We also compared success rates of procedures. RESULTS: The mean age, duration of procedure, and gender distribution were statistically similar between the two groups. The mean postprocedural heart rates and systolic blood pressures in Group I patients were significantly lower than Group II patients (p‚Äâ=‚Äâ0.01 and p‚Äâ=‚Äâ0.028, respectively), whereas preprocedural pulse rate and systolic blood pressure were similar. The mean anxiety level and mean pain score of Group I were significantly lower than those of Group II (p‚Äâ=‚Äâ0.008 and p‚Äâ<‚Äâ0.001, respectively). Group I also carried a significant greater mean satisfaction score and willingness to undergo repeat procedure compared with Group II (p‚Äâ<‚Äâ0.001 for both). Success rate of nephrostomy tube placement in Group I was significantly higher compared with Group II (92% vs 66%, p‚Äâ=‚Äâ0.04). CONCLUSIONS: The present randomized prospective study demonstrates that listening to music during office‚Äêbased PNTP decreases anxiety or pain and increases success rate of procedure. As an alternative to sedation or general anesthesia, music is easily accessible without side effect and cost. PURPOSE: To evaluate the effect of listening to music on pain, anxiety, and success of procedure during office‚Äêbased percutaneous nephrostomy tube placement (PNTP)."," Hamidi, N;  Ozturk, E",2017.0, 10.1089/end.2016.0843,0,0,
1673, Web-Based Assessment of Mental Well-Being in Early Adolescence: a Reliability Study," BACKGROUND: The ever‚Äêincreasing use of the Internet among adolescents represents an emerging opportunity for researchers to gain access to larger samples, which can be queried over several years longitudinally. Among adolescents, young adolescents (ages 11 to 13 years) are of particular interest to clinicians as this is a transitional stage, during which depressive and anxiety symptoms often emerge. However, it remains unclear whether these youngest adolescents can accurately answer questions about their mental well‚Äêbeing using a Web‚Äêbased platform. OBJECTIVE: The aim of the study was to examine the accuracy of responses obtained from Web‚Äêbased questionnaires by comparing Web‚Äêbased with paper‚Äêand‚Äêpencil versions of depression and anxiety questionnaires. METHODS: The primary outcome was the score on the depression and anxiety questionnaires under two conditions: (1) paper‚Äêand‚Äêpencil and (2) Web‚Äêbased versions. Twenty‚Äêeight adolescents (aged 11‚Äê13 years, mean age 12.78 years and SD 0.78; 18 females, 64%) were randomly assigned to complete either the paper‚Äêand‚Äêpencil or the Web‚Äêbased questionnaire first. Intraclass correlation coefficients (ICCs) were calculated to measure intrarater reliability. Intraclass correlation coefficients were calculated separately for depression (Children's Depression Inventory, CDI) and anxiety (Spence Children's Anxiety Scale, SCAS) questionnaires. RESULTS: On average, it took participants 17 minutes (SD 6) to answer 116 questions online. Intraclass correlation coefficient analysis revealed high intrarater reliability when comparing Web‚Äêbased with paper‚Äêand‚Äêpencil responses for both CDI (ICC=.88; P<.001) and the SCAS (ICC=.95; P<.001). According to published criteria, both of these values are in the ""almost perfect"" category indicating the highest degree of reliability. CONCLUSIONS: The results of the study show an excellent reliability of Web‚Äêbased assessment in 11‚Äê to 13‚Äêyear‚Äêold children as compared with the standard paper‚Äêpencil assessment. Furthermore, we found that Web‚Äêbased assessments with young adolescents are highly feasible, with all enrolled participants completing the Web‚Äêbased form. As early adolescence is a time of remarkable social and behavioral changes, these findings open up new avenues for researchers from diverse fields who are interested in studying large samples of young adolescents over time."," Hamann, C;  Schultze-Lutter, F;  Tarokh, L",2016.0, 10.2196/jmir.5482,0,0,
1674, Treatment Outcomes in Anxious Youth with and without Comorbid ADHD in the CAMS," The purpose of this study is to examine the influence of Attention‚ÄêDeficit/Hyperactivity Disorder (ADHD), independent of Oppositional Defiant Disorder (ODD), on acute treatment response, remission rates and maintenance of gains at 6‚Äêmonth follow‚Äêup in anxious youth (ages 7‚Äê17, 76% Caucasian, 52% female) who received cognitive‚Äêbehavioral therapy (CBT) alone, pharmacotherapy alone, the combination of CBT and pharmacotherapy or placebo pill in the Child/Adolescent Multimodal Study. Treatment response was defined as independent evaluator rated meaningful improvement in anxiety. Remission was operationalized as the absence of targeted anxiety disorders. ADHD and ODD were examined as moderators of outcomes at a diagnostic level. In the CBT group only, an ADHD diagnosis predicted poorer immediate treatment response and remission rates. However, these associations were not obtained for the pharmacotherapy groups. Participants with comorbid ODD were not less likely to achieve acute treatment response and remission rates than their counterparts across treatment conditions. Due to small sample size of the comorbid subgroups, our analyses must be considered preliminary. Nevertheless, our initial findings suggest further exploration of the separate roles of ADHD and ODD are worth pursuing, as they may be differentially associated with treatment outcomes in anxious youth treated with CBT but not youth treated with pharmacotherapy. If confirmed, findings may indicate that anxious youth with comorbid ADHD are less likely to benefit from CBT strategies alone and raise the possibility that these youth need adjunctive pharmacotherapy or psychosocial interventions."," Halldorsdottir, T;  Ollendick, TH;  Ginsburg, G;  Sherrill, J;  Kendall, PC;  Walkup, J;  Sakolsky, DJ;  Piacentini, J",2015.0, 10.1080/15374416.2014.952008,0,0,
1675,Ethnoracial differences in PTSD symptoms and trauma-related cognitions in treatment-seeking active duty military personnel for PTSD.,"It is uncertain whether ethnoracial factors should be considered by clinicians assessing and treating posttraumatic stress disorder (PTSD) among service members. The purpose of this study was to shed light on ethnoracial variation in the presentation of PTSD symptoms, trauma-related cognitions, and emotions among treatment-seeking active duty military personnel. Participants were 303 male active duty military members with PTSD participating in a clinical trial (60% were self-identified as White, 19% as African American, and 21% as Hispanic/Latino). In the parent study, participants completed a baseline assessment that included clinician-administered and self-report measures of PTSD, trauma-related cognitions, and emotions. Multivariate hierarchical regression models were used to examine ethnoracial differences in these variables, covarying age, education, military grade, combat exposure, and exposure to other potentially traumatic events. Hispanic/Latino and African American participants reported more reexperiencing symptoms, more fear, and more guilt and numbing than White participants. All effect sizes were in the small to medium range. These findings suggest ethnoracial variation in PTSD symptom burden and posttraumatic cognitions among treatment-seeking service members with PTSD. Attending to cultural factors related to differences in PTSD presentation and cognitive coping strategies during the assessment and treatment process could increase rapport and lead to more comprehensive trauma processing. (PsycINFO Database Record",Hall-Clark BN.; Kaczkurkin AN.; Asnaani A.; Zhong J.; Peterson AL.; Yarvis JS.; Borah EV.; Dondanville KA.; Hembree EA.; Litz BT.; Mintz J.; Young-McCaughan S.; Foa EB.,2017.0,10.1037/tra0000242,0,0,
1676, Effects of yoga versus hydrotherapy training on health-related quality of life and exercise capacity in patients with heart failure: a randomized controlled study," METHODS: The design was a randomized controlled non‐inferiority study. A total of 40 patients, 30% women (mean±SD age 64.9±8.9 years) with heart failure were randomized to an intervention of 12 weeks, either performing yoga or training with hydrotherapy for 45‐60 minutes twice a week. Evaluation at baseline and after 12 weeks included self‐reported health‐related quality of life, a six‐minute walk test, a sit‐to‐stand test, clinical variables, and symptoms of anxiety and depression. RESULTS: Yoga and hydrotherapy had an equal impact on quality of life, exercise capacity, clinical outcomes, and symptoms of anxiety and depression. Within both groups, exercise capacity significantly improved (hydrotherapy p=0.02; yoga p=0.008) and symptoms of anxiety decreased (hydrotherapy p=0.03; yoga p=0.01). Patients in the yoga group significantly improved their health as rated by EQ‐VAS ( p=0.004) and disease‐specific quality of life in the domains symptom frequency ( p=0.03), self‐efficacy ( p=0.01), clinical summary as a combined measure of symptoms and social factors ( p=0.05), and overall summary score ( p=0.04). Symptoms of depression were decreased in this group ( p=0.005). In the hydrotherapy group, lower limb muscle strength improved significantly ( p=0.01). CONCLUSIONS: Yoga may be an alternative or complementary option to established forms of exercise training such as hydrotherapy for improvement in health‐related quality of life and may decrease depressive symptoms in patients with heart failure. AIMS: The aims of this study were to determine whether yoga and hydrotherapy training had an equal effect on the health‐related quality of life in patients with heart failure and to compare the effects on exercise capacity, clinical outcomes, and symptoms of anxiety and depression between and within the two groups."," Hägglund, E;  Hagerman, I;  Dencker, K;  Strömberg, A",2017.0, 10.1177/1474515117690297,0,0,
1677, Coping in Patients With Incurable Lung and Gastrointestinal Cancers: a Validation Study of the Brief COPE," CONTEXT: Patients with incurable cancer engage in several coping styles to manage the impact of cancer and its treatment. The Brief COPE is a widely used measure intended to capture multiple and distinct types of coping. The Brief COPE has not been validated among patients with incurable cancer. OBJECTIVES: We sought to validate seven subscales of the Brief COPE in a large sample of patients newly diagnosed with incurable lung and noncolorectal gastrointestinal cancers (N = 350). METHODS: Participants completed the Brief COPE and measures assessing quality of life (QOL) (Functional Assessment of Cancer Therapy‚ÄêGeneral) and psychological distress (Hospital Anxiety and Depression Scale) within eight weeks of diagnosis of incurable cancer. We evaluated the psychometric properties of the Brief COPE using a confirmatory factor analysis and tests of correlation with the QOL and distress scales. RESULTS: The Brief COPE factors were consistent with the original subscales, although the Behavioral Disengagement Scale had low internal consistency. Factors showed anticipated relationships with QOL and distress measures, except emotional support coping, which was correlated with increased depression and anxiety. We also conducted an exploratory high‚Äêorder factor analysis to determine if subscales' score variances grouped together. The high‚Äêorder factor analysis resulted in two factors, with active, emotional support, positive reframing, and acceptance loading onto one factor and denial and self‚Äêblame loading onto the second. CONCLUSION: The selected subscales of the Brief COPE are appropriate measures of coping among individuals newly diagnosed with incurable lung and gastrointestinal cancers."," Hagan, TL;  Fishbein, JN;  Nipp, RD;  Jacobs, JM;  Traeger, L;  Irwin, KE;  Pirl, WF;  Greer, JA;  Park, ER;  Jackson, VA;  et al.",2017.0, 10.1016/j.jpainsymman.2016.06.005,0,0,
1678, Posttraumatic stress and anxiety in patients with an implantable cardioverter defibrillator: trajectories and vulnerability factors," BACKGROUND: Implantable cardioverter defibrillator (ICD) therapy is the first‐line treatment for the primary and secondary prevention of sudden cardiac death. Despite the unequivocal medical benefits, living with an ICD may affect patients' psychological functioning and general well‐being. We examined the trajectories of symptoms of posttraumatic stress disorder (PTSD) and anxiety in patients with an ICD and the vulnerability factors associated with an increased risk of symptoms of PTSD and anxiety. METHODS: A total of 249 patients were included as part of the WEB‐based distress program for implantable CARdioverter dEfibrillator patients (WEBCARE) study. Data were analyzed using Latent class analyses, with trajectories of PTSD symptomatology and anxiety examined between baseline and 12 months follow‐up. RESULTS: The mean age of the sample was 58.9 ± 9.8, with the majority being male (82%). Latent Class analyses (LatentGOLD) revealed four classes with respect to PTSD symptomatology, and three classes of patients with respect to anxiety. Younger age, increased depression score at baseline, and Type D personality were all associated with increased vulnerability for posttraumatic stress and anxiety symptoms. CONCLUSION: Comparable trajectories were found for symptoms of PTSD and anxiety over time. Patients with a younger age, increased depression score at baseline, and Type D personality were especially prone to experience PTSD and anxiety symptomatology at 12 months follow‐up. Due to the negative association between PTSD, anxiety, and health outcomes, it is paramount to timely identify the subset of patients who are vulnerable to experience these symptoms and provide them with personalized support."," Habibović, M;  Denollet, J;  Pedersen, SS",2017.0, 10.1111/pace.13090,0,0,
1679,We prefer what we fear: A response preference bias mimics attentional capture in spider fear,"The extent to which emotionally significant stimuli capture visual attention remains elusive because a preference for reporting or choosing emotionally significant stimuli could mimic attentional capture by these stimuli. We conducted two prior-entry experiments to disentangle whether phobic and fear-relevant stimuli capture attention or merely produce a response bias in spider-fearful participants. Prior entry denotes the effect that attended stimuli are perceived earlier than unattended stimuli as indicated by temporal order judgments. We presented phobic (spiders), fear-relevant (snakes) and neutral stimuli in pairs with varying temporal onset. The participants’ task was to indicate which stimulus was presented first (Experiment 1) or second (Experiment 2). In the first experiment, spider-fearful but not control participants indicated that they had perceived spiders as occurring earlier in time, suggesting a prior-entry effect for spiders in this group. But surprisingly, in the second experiment, spider-fearful participants indicated more frequently that they had seen spiders as being presented second. This finding rules out a genuine prior-entry effect and instead suggests a strong preference for the response option associated with the feared animal. This response bias may result from a hypervigilance toward the feared stimulus and contribute to maintaining avoidance behavior in individuals with specific phobias.",Haberkamp A.; Biafora M.; Schmidt T.; Weiß K.,2018.0,10.1016/j.janxdis.2017.10.008,0,0,
1680,The dissociative post-traumatic stress disorder (PTSD) subtype: A treatment outcome cohort study in veterans with PTSD.,"Objectives: Dissociation is a prevalent phenomenon among veterans with post-traumatic stress disorder (PTSD) that may interfere with the effectiveness of treatment. This study aimed to replicate findings of a dissociative PTSD subtype, to identify corresponding patterns in coping style, symptom type, and symptom severity, and to investigate its impact on post-traumatic symptom improvement. Methods: Latent profile analysis (LPA) was applied to baseline data from 330 predominantly (97%) male treatment-seeking veterans (mean age 39.5 years) with a probable PTSD. Multinomial logistic models were used to identify predictors of dissociative PTSD. Eighty veterans with PTSD that commenced with psychotherapy were invited for a follow-up measure after 6 months. The majority (n = 64, 80% response rate) completed the follow-up measure. Changes in post-traumatic stress between baseline and follow-up were explored as a continuous distal outcome. Results: Latent profile analysis revealed four distinct patient profiles: 'low' (12.9%), 'moderate' (33.2%), 'severe' (45.1%), and 'dissociative' (8.8%) PTSD. The dissociative PTSD profile was characterized by more severe pathology levels, though not post-traumatic reactions symptom severity. Veterans with dissociative PTSD benefitted equally from PTSD treatment as veterans with non-dissociative PTSD with similar symptom severity. Conclusions: Within a sample of veterans with PTSD, a subsample of severely dissociative veterans was identified, characterized by elevated severity levels on pathology dimensions. The dissociative PTSD subtype did not negatively impact PTSD treatment. Practitioner points: 1. The present findings confirmed the existence of a distinct subgroup veterans that fit the description of dissociative PTSD. 2. Patients with dissociative PTSD subtype symptoms uniquely differed from patients with non-dissociative PTSD in the severity of several psychopathology dimensions. 3. Dissociative and non-dissociative PTSD patients with similar post-traumatic severity levels showed similar levels of improvement after PTSD treatment. 4. The observational design and small sample size caution interpretation of the treatment outcome data. 5. The IES-R questionnaire does not assess all PTSD DSM-IV diagnostic criteria (14 of 17), although it is considered a valid measure for an indication of PTSD. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Haagen, Joris F. G; van Rijn, Allison; Knipscheer, Jeroen W; van der Aa, Niels; Kleber, Rolf J",2018.0,http://dx.doi.org/10.1111/bjc.12169,0,0,
1681, Does timing matter? Examining the impact of session timing on outcome," OBJECTIVE: First‚Äêline treatments for posttraumatic stress disorder (PTSD) are often implemented twice per week in efficacy trials. However, there is considerable variability in the frequency of treatment sessions (e.g., once per week or twice per week) in clinical practice. Moreover, clients often cancel or reschedule treatment sessions, leading to even greater variability in treatment session timing. The goal of the current study is to investigate the impact of PTSD treatment session frequency on treatment outcome. METHOD: One hundred thirty‚Äêsix women (Mage = 32.16 [SD = 9.90]) with PTSD were randomized to receive cognitive processing therapy or prolonged exposure. PTSD symptom outcome was measured using the Clinician‚ÄêAdministered PTSD Scale, and session frequency and consistency were measured using dates of treatment session attendance. Session frequency was operationalized using average days between session, and consistency was defined by the standard deviation of the number of days between treatment sessions. RESULTS: Piecewise growth curve modeling revealed that higher average days between sessions was associated with significantly smaller PTSD symptom reduction, with more frequent sessions yielding greater PTSD symptom reduction (p < .001, d = .82). Higher consistency was also associated with significantly greater PTSD symptom reduction (p < .01, d = .48). The substantially larger effect size for frequency suggests that average days between treatment sessions impacts treatment outcome more than consistency. Follow‚Äêup analyses revealed a longer time interval between Sessions 4 and 5 was associated with smaller reductions in PTSD treatment outcome. CONCLUSIONS: More frequent scheduling of sessions may maximize PTSD treatment outcomes. (PsycINFO Database Record"," Gutner, CA;  Suvak, MK;  Sloan, DM;  Resick, PA",2016.0, 10.1037/ccp0000120,0,0,
1682,Blister Packaging Medication Increases Treatment Adherence in Psychiatric Patients.,"To evaluate whether blister packing medications would improve prescription medication adherence in psychiatric patients. It was hypothesized that patients in the blister pack (BP) condition would be more adherent to their daily medications than those in the dispense as usual condition. This was a randomized trial involving up to 1 year of monthly follow-up assessments. Participants were recruited from an urban Veterans Affairs (VA) Medical Center in the Western United States. Inclusion criteria for participants included being diagnosed with a major affective disorder, posttraumatic stress disorder, schizophrenia, or a combination of these disorders; being 18 to 89 years of age; receiving prescription medications from the VA pharmacy; and being considered competent to manage their own medications. Of the 303 patients who consented to participate, 277 were randomized to 1 of the 2 study conditions, and 243 were retained in the study. The sample was 87% male, 47% white, with a mean age of 54.4 years. All medications prescribed and dispensed by the VA were either repackaged in monthly BPs or dispensed in standard pill vials. The primary hypothesis was supported. Patients in the BPs condition showed evidence of better adherence at 12-month follow-up, as well as larger increases in adherence from 1 month to 12 months. Psychiatric patients adhere better to prescription medication regimens when receiving their medications in BP.",Gutierrez PM.; Wortzel HS.; Forster JE.; Leitner RA.; Hostetter TA.; Brenner LA.,2017.0,10.1097/PRA.0000000000000252,0,0,
1683, The NMDA receptor partial agonist d-cycloserine does not enhance motor learning," RATIONALE: There has recently been increasing interest in pharmacological manipulations that could potentially enhance exposure‐based cognitive behaviour therapy for anxiety disorders. One such medication is the partial NMDA agonist d‐cycloserine. It has been suggested that d‐cycloserine enhances cognitive behaviour therapy by making learning faster. While animal studies have supported this view of the drug accelerating learning, evidence in human studies has been mixed. We therefore designed an experiment to measure the effects of d‐cycloserine on human motor learning. METHODS: Fifty‐four healthy human volunteers were randomly assigned to a single dose of 250mg d‐cycloserine versus placebo in a double‐blind design. They then performed a motor sequence learning task. RESULTS: D‐cycloserine did not increase the speed of motor learning or the overall amount learnt. However, we noted that participants on d‐cycloserine tended to respond more carefully (shifting towards slower, but more correct responses). CONCLUSION: The results suggest that d‐cycloserine does not exert beneficial effects on psychological treatments via mechanisms involved in motor learning. Further studies are needed to clarify the influence on other cognitive mechanisms."," Günthner, J;  Scholl, J;  Favaron, E;  Harmer, CJ;  Johansen-Berg, H;  Reinecke, A",2016.0, 10.1177/0269881116658988,0,0,
1684, Target-D: a stratified individually randomized controlled trial of the diamond clinical prediction tool to triage and target treatment for depressive symptoms in general practice: study protocol for a randomized controlled trial," BACKGROUND: Depression is a highly prevalent and costly disorder. Effective treatments are available but are not always delivered to the right person at the right time, with both under‚Äê and over‚Äêtreatment a problem. Up to half the patients presenting to general practice report symptoms of depression, but general practitioners have no systematic way of efficiently identifying level of need and allocating treatment accordingly. Therefore, our team developed a new clinical prediction tool (CPT) to assist with this task. The CPT predicts depressive symptom severity in three months' time and based on these scores classifies individuals into three groups (minimal/mild, moderate, severe), then provides a matched treatment recommendation. This study aims to test whether using the CPT reduces depressive symptoms at three months compared with usual care. METHODS: The Target‚ÄêD study is an individually randomized controlled trial. Participants will be 1320 general practice patients with depressive symptoms who will be approached in the practice waiting room by a research assistant and invited to complete eligibility screening on an iPad. Eligible patients will provide informed consent and complete the CPT on a purpose‚Äêbuilt website. A computer‚Äêgenerated allocation sequence stratified by practice and depressive symptom severity group, will randomly assign participants to intervention (treatment recommendation matched to predicted depressive symptom severity group) or comparison (usual care plus Target‚ÄêD attention control) arms. Follow‚Äêup assessments will be completed online at three and 12 months. The primary outcome is depressive symptom severity at three months. Secondary outcomes include anxiety, mental health self‚Äêefficacy, quality of life, and cost‚Äêeffectiveness. Intention‚Äêto‚Äêtreat analyses will test for differences in outcome means between study arms overall and by depressive symptom severity group. DISCUSSION: To our knowledge, this is the first depressive symptom stratification tool designed for primary care which takes a prognosis‚Äêbased approach to provide a tailored treatment recommendation. If shown to be effective, this tool could be used to assist general practitioners to implement stepped mental‚Äêhealthcare models and contribute to a more efficient and effective mental health system. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR 12616000537459 ). Retrospectively registered on 27 April 2016. See Additional file 1 for trial registration data."," Gunn, J;  Wachtler, C;  Fletcher, S;  Davidson, S;  Mihalopoulos, C;  Palmer, V;  Hegarty, K;  Coe, A;  Murray, E;  Dowrick, C;  et al.",2017.0, 10.1186/s13063-017-2089-y,0,0,
1685,Virtual reality exposure therapy for the treatment of dental phobia: A controlled feasibility study.,"Background: Virtual reality exposure therapy (VRET) has been used to treat a variety of fears and phobias. Aim: To determine the feasibility (i.e. safety and efficacy) of using VRET to treat dental phobia. Method: Safety was evaluated by determining any adverse events or symptom exacerbation. Efficacy of VRET was evaluated by comparing the reduction in dental anxiety scores (measured 16 times within a 14-week study period, and at 6-month follow-up), and its behavioural effects with that of an informational pamphlet (IP) on ten randomized patients with dental phobia using a controlled multiple baseline design. Participants' heart rate response during VRET, and their experience post-VRET, were indexed. Results: No personal adverse events or symptom exacerbation occurred. Visual analysis and post-hoc intention-to-treat analysis showed a significantly greater decrease in dental anxiety scores [higher PND (percentage of non-overlap data) scores of 100% and lower POD (percentage of overlap data) of 0%, Modified Dental Anxiety Scale, F (1,8) = 8.61, p = 0.019, and Dental Fear Scale, F (1,8) = 10.53, p = 0.012], and behavioural avoidance in the VRET compared with the IP group [d = 4.2 and -1.4, respectively). There was no increase in average heart rate during VRET. Of the nine treatment completers, six (four from the VRET group and two from the IP group) no longer had dental phobia at 6-month follow-up. Four of the five VRET participants, but none of the IP participants, scheduled a dental treatment appointment following the intervention. Conclusion: VRET is a feasible alternative for patients with dental phobia. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Gujjar, Kumar Raghav; van Wijk, Arjen; Sharma, Ratika; de Jongh, Ad",2018.0,http://dx.doi.org/10.1017/S1352465817000534,0,0,
1686,Prevalence and psychometric screening for the detection of major depressive disorder and post-traumatic stress disorder in adults injured in a motor vehicle crash who are engaged in compensation.,"Background: Physical injury and psychological disorder following a motor vehicle crash (MVC) is a public health concern. The objective of this research was to determine rates of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) in adults with MVC-related injury engaged in compensation, and to determine the capacity (e.g. sensitivity and specificity) of two psychometric scales for estimating the presence of MDD and PTSD. Methods: Participants included 109 adults with MVC-related injury engaged in compensation during 2015 to 2017, in Sydney, Australia. The mean time from MVC to baseline assessment was 11 weeks. Comprehensive assessment was conducted at baseline, and the Depression Anxiety Stress Scales (DASS-21) and the Impact of Event Scale-Revised (IES-R) were administered to determine probable MDD and PTSD. An online psychiatric interview, based on Diagnostic and Statistical Manual for Mental Disorders (DSM-5), was used to diagnose actual MDD and PTSD, acknowledged as gold standard diagnostic criteria. One-way multivariate analyses of variance established criterion validity of the DASS-21 and IES-R, and sensitivity and specificity analyses were conducted to determine the most sensitive cut-off points for detecting probable MDD and PTSD. Results: Substantial rates of MDD (53.2%) and PTSD (19.3%) were found. The DASS-21 and IES-R were shown to have excellent criterion validity for detecting MDD and PTSD in injured participants. A range of cut-off points were investigated and shown to have acceptable sensitivity and specificity for detecting MDD and PTSD in an injured population engaged in compensation. The preferred cut-off points based on this study are: to detect MDD, a DASS-21 total score of 30 and/or a DASS-21 depression score of 10; to detect PTSD, IES-R scores of 33-40 and/or a DASS-21 anxiety score of 7-8. Conclusions: Major psychological disorder is prevalent following a MVC. Results suggest the DASS-21 and IES-R are suitable for use in clinical/compensation settings to detect probable MDD and PTSD soon after a MVC in physically injured people engaged in compensation. These results provide positive direction in the public health arena for improving mental health outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Guest, Rebecca; Tran, Yvonne; Gopinath, Bamini; Cameron, Ian D; Craig, Ashley",2018.0,,0,0,
1687, Prevention of the development of psychological distress following a motor vehicle crash: study protocol for a randomized controlled trial," BACKGROUND: It is estimated that up to 50 % of motor vehicle crash survivors develop significant psychological distress, such as depressive mood and anxiety, within 6 months of the crash. Associated impacts include loss of employment, delayed return to work, financial and familial stress, and increased medical and compensation costs. The major aim of this research is to investigate the efficacy of interventions for preventing the development of psychological distress following a motor vehicle crash. The efficacy of two brief interventions will be examined: a cognitive behaviour therapy (CBT) programme, targeting mood and anxiety, and a lifestyle programme, targeting sleep, diet and physical activity. METHODS/DESIGN: This is a randomized, controlled multisite study. Participants include at least 180 adults injured in a motor vehicle crash who have entered a compensation process. Research will compare outcomes in three groups randomly assigned to: one group of 60 adults, who receive a brief email‐delivered CBT programme, with one session every 2 weeks for 10 weeks and telephone contact every 2 weeks; a second group of 60 adults, who receive a brief email‐delivered lifestyle intervention involving one session every 2 weeks for 10 weeks with telephone contact; and an active waiting‐list control group of 60 adults who are provided claims processing‐related reading material along with telephone contact every 2 weeks for 10 weeks. Participants will be recruited within 12 weeks of the motor vehicle crash, and will be comprehensively assessed before and after treatment, and 6 and 12 months post‐injury. Assuming an α probability level of 0.05 and a power of 80 %, at least 180 participants will be recruited. The primary outcome measure is the presence and severity of psychological distress or disorder. Secondary outcome measures include assessment of self‐efficacy, resilience employment status, social activity and support, lifestyle and physical health factors, along with process outcome measures of treatment acceptability, feasibility and generalizability. DISCUSSION: This study will determine whether brief email‐delivered interventions distributed soon after the injury and entry into the claims process can be effective in preventing the development of psychological distress. TRIAL REGISTRATION: ANZCTR, ACTRN12615000326594 . Registered on 9 April 2015."," Guest, R;  Tran, Y;  Gopinath, B;  Cameron, ID;  Craig, A",2016.0, 10.1186/s13063-016-1455-5,0,0,
1688, Chinese version of the severe respiratory insufficiency questionnaire for patients with COPD receiving long-term oxygen therapy," Purpose: Patients with advanced‐stage COPD often experience severe hypoxemia. Treatment with long‐term oxygen therapy (LTOT) may relieve patients' symptoms and increase survival. As COPD is incurable, improving patients' health‐related quality of life is important. The Chinese version of the Severe Respiratory Insufficiency Questionnaire (SRI) is valid for patients with hypercapnic COPD undergoing noninvasive positive airway pressure ventilation at home. However, the reliability and validity of the Chinese SRI for patients with COPD undergoing LTOT have not been investigated. Patients and methods: We analyzed reliability using Cronbach's α coefficient. Construct validity was assessed with principal, exploratory, and confirmatory factor analysis. Concurrent validity was evaluated through the correlation between SRI domains and Chronic Respiratory Disease Questionnaire (CRQ) domains. Content validity was assessed by calculating the correlation between each SRI item score and the total score for the relevant domain. Results: In total, 161 patients participated in this study. The Cronbach's α coefficient for all SRI domains was >0.7, except for the attendant symptoms and sleep domain. Exploratory and confirmatory factor analysis showed a good model fit for each domain, but the factors extracted from each domain were correlated. SRI and CRQ domains correlated well with respect to similar aspects of health‐related quality of life, indicating good concurrent validity. Content validity was indirectly shown by a good correlation between each item score and the total score of the relevant domain. Conclusion: The Chinese version of the SRI has a good reliability and validity for patients with COPD undergoing LTOT in China."," Guan, L;  Xu, J;  Wu, W;  Chen, J;  Li, X;  Guo, B;  Yang, Y;  Huo, Y;  Zhou, L;  Chen, R",2018.0, 10.2147/COPD.S156135,0,0,
1689, Modulation of motor inhibition by subthalamic stimulation in obsessive-compulsive disorder," High‐frequency deep brain stimulation of the subthalamic nucleus can be used to treat severe obsessive‐compulsive disorders that are refractory to conventional treatments. The mechanisms of action of this approach possibly rely on the modulation of associative‐limbic subcortical‐cortical loops, but remain to be fully elucidated. Here in 12 patients, we report the effects of high‐frequency stimulation of the subthalamic nucleus on behavior, and on electroencephalographic responses and inferred effective connectivity during motor inhibition processes involved in the stop signal task. First, we found that patients were faster to respond and had slower motor inhibition processes when stimulated. Second, the subthalamic stimulation modulated the amplitude and delayed inhibition‐related electroencephalographic responses. The power of reconstructed cortical current densities decreased in the stimulation condition in a parietal‐frontal network including cortical regions of the inhibition network such as the superior parts of the inferior frontal gyri and the dorsolateral prefrontal cortex. Finally, dynamic causal modeling revealed that the subthalamic stimulation was more likely to modulate efferent connections from the basal ganglia, modeled as a hidden source, to the cortex. The connection from the basal ganglia to the right inferior frontal gyrus was significantly decreased by subthalamic stimulation. Beyond motor inhibition, our study thus strongly suggests that the mechanisms of action of high‐frequency subthalamic stimulation are not restricted to the subthalamic nucleus, but also involve the modulation of distributed subcortical‐cortical networks."," Kibleur, A;  Gras-Combe, G;  Benis, D;  Bastin, J;  Bougerol, T;  Chabardès, S;  Polosan, M;  David, O",2016.0, 10.1038/tp.2016.192,0,0,
1690, The effect of video information on anxiety levels in women attending colposcopy: a randomized controlled trial," OBJECTIVE: The aim was to investigate whether additional information, in video form, reduces anxiety, depression and pain levels in women referred for colposcopy. MATERIAL AND METHODS: Between September 2012 and March 2015, 136 patients referred for colposcopy were randomized into two study arms. Group A received video information in addition to the regular information leaflet, and group B (control group) received only the regular information leaflet. The patients were requested to complete standardized online questionnaires. The first online questionnaire (T1) was pre‚Äêrandomization, and was completed at home, 5 days prior to the appointment. The second online questionnaire (T2) was completed directly before the colposcopy appointment, and the last online questionnaire (T3) was completed directly following colposcopy at the out‚Äêpatient clinic. The questionnaires included the Spielberger State‚ÄêTrait Anxiety Inventory (STAI), the Hospital Anxiety and Depression Scale (HADS), and the Numeric Rating Scale (NRS) to assess pain. RESULTS: The STAI state anxiety score was high (44.6), but there was no significant difference in STAI, HADS and NRS between the two groups at the three measuring points. A post hoc analysis showed that women with a generally higher baseline anxiety trait had significantly lower HADS anxiety levels following video information. CONCLUSIONS: Additional information (video) before colposcopy did not significantly reduce anxiety, depression, and expected or experienced pain, as measured by the STAI, HADS and NRS in patients attending their first colposcopy appointment. However, most patients positively appreciated the video information, which may reduce the anxiety of extremely anxious patients."," Ketelaars, PJW;  Buskes, MHM;  Bosgraaf, RP;  van Hamont, D;  Prins, JB;  Massuger, LFAG;  Melchers, WJG;  Bekkers, RLM",2017.0, 10.1080/0284186X.2017.1355108,0,0,
1691,Voluntary Arousing Negative Experiences (VANE): Why We Like to Be Scared,"This study examined survey data and neural reactivity associated with voluntarily engaging in high arousal negative experiences (VANE). Here we suggest how otherwise negative stimuli might be experienced as positive in the context of voluntary engagement. Participants were recruited from customers who had already purchased tickets to attend an ""extreme"" haunted attraction. Survey data measuring self-report affect, expectations, and experience was collected from 262 adults (139 women and 123 men; age M = 27.5 years, SD = 9.3 years) before and after their experience. Changes in electroencephalographic (EEG) indices of reactivity to cognitive and emotional tasks were further assessed from a subsample of 100 participants. Results suggested that participants' reported affect improved, particularly for those that reported feeling tired, bored, or stressed prior to the experience. Among those whose moods improved, neural reactivity decreased in response to multiple tasks. Together, these data suggest that VANE reduces neural reactivity following stress. This result could explain post-VANE euphoria and may be adaptive in that it could help individuals to cope with subsequent stressors. To the extent that this phenomenon replicates in clinical situations, it could inform clinical interventions by using VANE principles to reduce neural reactivity to subsequent stressors.",Kerr M.; Siegle G.J.; Orsini J.,2018.0,10.1037/emo0000470,0,0,
1692, Effects of early motivational interviewing on post-stroke depressive symptoms: a pilot randomized study of the Good Mood Intervention program," AIMS: The aim of this pilot randomized study was to investigate the feasibility of early motivational interviewing, for reducing mood after acute stroke. BACKGROUND: Depression is a frequent consequence of stroke that can adversely affect recovery. METHODS: DESIGN: Pilot randomized study. Intervention group patients received 3, individual motivational interviewing sessions by nurses or social workers prior to hospital discharge. PARTICIPANTS: Adult patients with acute stroke during 2013 to 2014. BLINDING: Research assistant who collected data was blind to group assignment. OUTCOMES: Data were collected at 3 time points: baseline, 1‚Äêmonth, and 3‚Äêmonth follow‚Äêup. Outcome measures (anxiety, depression, quality of life) were analysed by descriptive statistics. RESULTS: Forty‚Äêeight patients were enrolled, and 79% retention was achieved at 3 months. Eight participants withdrew (16.7%), and 2 were unable to participate (death: 2.1% and new onset aphasia: 2.1%), leaving 38 participants in the final cohort (Intervention: N = 18, Control: N = 20). Anxiety, depression, and quality of life measures did not alter significantly in the study period. CONCLUSIONS: Carefully designed studies are required to investigate the effectiveness of early motivational interviewing for improving mood after stroke. The therapy can be administered by nurses, but significant resources are required in terms of training and fidelity."," Kerr, D;  McCann, T;  Mackey, E;  Wijeratne, T",2018.0, 10.1111/ijn.12657,0,0,
1693,Do symptoms of irritable bowel syndrome improve when patients receive cognitive behavioural therapy for co-morbid anxiety disorders in a primary care psychological therapy (IAPT) service?,"Background: Irritable bowel syndrome (IBS) is a common co-morbid condition with anxiety disorders, and patients often report a fear of incontinence in public places. This type of bowel control anxiety (BCA) can be conceptualized as a phobic syndrome. Yet little evidence exists on the prevalence or outcomes of these co-morbidities in routine primary care psychological therapy (Improving Access to Psychological Therapies, IAPT) services. Aims: To examine the prevalence and outcomes of IBS and BCA patients treated with cognitive behavioural therapy (CBT) for anxiety disorders within a routine IAPT service. Method: An observational cohort study screened 2322 referrals to an IAPT service over 12 months for the presence of IBS. Patients with co-morbid anxiety disorders and IBS were grouped into those with, and without BCA. Patients completed the IBS symptom severity scale and the IAPT minimum data set. Diagnoses and outcomes were examined for all groups up to 6 months follow-up. Results: A greater proportion of BCA patients had a primary diagnosis of phobic disorder. After receiving CBT, patients made clinically significant improvement in both anxiety and IBS symptoms at 6 months follow-up. Patients with BCA made greater improvement in phobia scales and IBS symptoms than non-BCA patients. Conclusions: Anxiety disorders with co-morbid IBS improved significantly in a routine IAPT service. A significant proportion of co-morbid IBS sufferers had a fear of incontinence in public places (BCA). Directly addressing and modifying these fears with CBT appeared to enhance improvement in both phobic anxiety and IBS symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kenwright, Mark; McDonald, Jason; Talbot, Jo; Janjua, Kinza",2017.0,http://dx.doi.org/10.1017/S1352465817000200,0,0,
1694,Interpersonal psychotherapy (IPT) for major depression following perinatal loss: a pilot randomized controlled trial.,"This randomized controlled pilot trial examined the feasibility, acceptability, and preliminary efficacy of an adapted interpersonal psychotherapy (IPT) for major depressive disorder (MDD) following perinatal loss (miscarriage, stillbirth, or early neonatal death). Fifty women who experienced a perinatal loss within the past 18 months, whose current depressive episode onset occurred during or after the loss, were randomized to the group IPT adapted for perinatal loss (the Group IPT for Major Depression Following Perinatal Loss manual developed for this study is available at no cost by contacting either of the first two authors) or to the group Coping with Depression (CWD), a cognitive behavioral treatment which did not focus on perinatal loss nor social support. Assessments occurred at baseline, treatment weeks 4 and 8, post-treatment, and 3 and 6 months after the end of treatment. IPT was feasible and acceptable in this population. Although some participants were initially hesitant to discuss their losses in a group (as occurred in IPT but not CWD), end of treatment satisfaction scores were significantly (p = 0.001) higher in IPT than in CWD. Confidence intervals around between-groups effect sizes favored IPT for reductions in depressive symptoms during treatment as well as for improvement in mode-specific targets (social support, grief symptoms) and recovery from a post-traumatic stress disorder over follow-up. This group IPT treatment adapted for MDD after perinatal loss is feasible, acceptable, and possibly efficacious.",Johnson JE.; Price AB.; Kao JC.; Fernandes K.; Stout R.; Gobin RL.; Zlotnick C.,2016.0,10.1007/s00737-016-0625-5,0,0,
1695, Protocol for the atWork trial: a randomised controlled trial of a workplace intervention targeting subjective health complaints," BACKGROUND: Subjective health complaints, such as musculoskeletal and mental health complaints, have a high prevalence in the general population, and account for a large proportion of sick leave in Norway. It may be difficult to prevent the occurrence of subjective health complaints, but it may be possible to influence employees' perception and management of these complaints, which in turn may have impact on sick leave and return to work after sick leave. Long term sick leave has many negative health and social consequences, and it is important to gain knowledge about effective interventions to prevent and reduce long term sick leave. METHODS/DESIGN: This study is a cluster randomised controlled trial to evaluate the effect of the modified atWork intervention, targeting non‚Äêspecific musculoskeletal complaints and mental health complaints. This intervention will be compared to the original atWork intervention targeting only non‚Äêspecific musculoskeletal complaints. Kindergartens in Norway are invited to participate in the study and will be randomly assigned to one of the two interventions. Estimated sample size is 100 kindergartens, with a total of approximately 1100 employees. Primary outcome is sick leave at unit level, measured using register data from the Norwegian Labour and Welfare Administration. One kindergarten equals one unit, regardless of number of employees. Secondary outcomes will be measured at the individual level and include coping, health, job satisfaction, social support, and workplace inclusion, collected through questionnaires distributed at baseline and at 12 months follow up. All employees in the included kindergartens are eligible for participating in the survey. DISCUSSION: The effect evaluation of the modified atWork intervention is a large and comprehensive project, providing evidence‚Äêbased information on prevention of long‚Äêterm sick leave, which may be of considerable benefit both from a societal, organisational, and individual perspective. TRIAL REGISTRATION: Clinicaltrials.gov: NCT02396797 . Registered March 23th, 2015."," Johnsen, TL;  Indahl, A;  Baste, V;  Eriksen, HR;  Tveito, TH",2016.0, 10.1186/s12889-016-3515-x,0,0,
1696," A Follow-Up Study from a Multisite, Randomized Controlled Trial for Traumatized Children Receiving TF-CBT"," Trauma‚Äêfocused cognitive behavioral therapy (TF‚ÄêCBT) is the treatment of choice for traumatized youth, however, follow‚Äêup studies are scarce, and treatment effects for co‚Äêoccurring depression show mixed findings. The aims of this study were to examine whether treatment effects of TF‚ÄêCBT are maintained at 18 month follow‚Äêup and whether degree of co‚Äêoccurring depression influences treatment effects. As rapid improvement in psychological functioning is warranted for youth, we also investigated whether the symptom trajectory was different for TF‚ÄêCBT compared to therapy as usual (TAU). The sample consisted of 156 youth (M age = 15.05, 79.50% girls) randomly assigned to TF‚ÄêCBT or TAU. The youth were assessed for posttraumatic stress symptoms (PTSS), depression, anxiety and general mental health symptoms. Mixed effects analyses followed the symptom courses over 5 time points. Youth receiving TF‚ÄêCBT maintained their symptom improvement at 18 months follow‚Äêup with scores below clinical cut‚Äêof on all symptom measures. The most depressed youth had also a significant decline in symptoms that were maintained at follow‚Äêup. Symptom trajectories differed as the TF‚ÄêCBT group reported a more rapid symptom reduction compared to the TAU condition. In the TAU condition, participants received 1.5 times the number of treatment sessions compared to the TF‚ÄêCBT participants. After 18 months the groups were significantly different on general mental health symptoms only. In conclusion, youth receiving TF‚ÄêCBT experienced more efficient improvement in trauma related symptoms than youth receiving TAU and these improvements were maintained after 18 months. Also youth experiencing serious co‚Äêoccurring depression benefitted from TF‚ÄêCBT."," Jensen, TK;  Holt, T;  Ormhaug, SM",2017.0, 10.1007/s10802-017-0270-0,0,0,
1697,"A recovery program to improve quality of life, sense of coherence and psychological health in ICU survivors: a multicenter randomized controlled trial, the RAPIT study.","The aim of this randomized controlled trial (RCT) was to test the effectiveness of a post-ICU recovery program compared to standard care during the first year after ICU discharge. A pragmatic, non-blinded, multicenter, parallel-group RCT was conducted between December 2012 and December 2015, at ten intensive care units (ICUs) in Denmark. We randomly assigned 386 adult patients (≥18 years) after receiving mechanical ventilation (≥48 h) to standard care (SC) plus a nurse-led intensive care recovery program or standard care alone after ICU discharge (190 intervention, 196 SC). Primary outcome was health-related quality of life (HRQOL) at 12 months. Secondary outcomes were sense of coherence (SOC), anxiety, depression, and post-traumatic stress disorder (PTSD) assessed at 3 and 12 months after ICU discharge including utilization of healthcare services at 12 months. At 12 months, we found no differences in HRQOL between groups (mean difference in the Physical Component Summary score, 1.41 [95 % CI, -1.53 to 4.35; p = 0.35] (n = 235); and in the Mental Component Summary score, 1.92 [95 % CI, -1.06 to 4.90; p = 0.11] (n = 235). No differences were found on self-reported SOC (p = 0.63), anxiety (p = 0.68), depression (p = 0.67), PTSD (p = 0.27), or the utilization of healthcare services including rehabilitation. We found a difference on anxiety, when a cut-off point ≥11 was applied, in per protocol analysis of complete cases at 3 months favoring the intervention (8.8 % vs. 16.2 %, p = 0.04). The tested recovery program was not superior to standard care during the first 12 months post-ICU. The trial is registered at Clinicaltrials.gov, identification no. NCT01721239.",Jensen JF.; Egerod I.; Bestle MH.; Christensen DF.; Elklit A.; Hansen RL.; Knudsen H.; Grode LB.; Overgaard D.,2016.0,10.1007/s00134-016-4522-1,0,0,
1698, Pre-treatment social anxiety severity moderates the impact of mindfulness-based stress reduction and aerobic exercise, We examined whether social anxiety severity at pre‚Äêtreatment would moderate the impact of mindfulness‚Äêbased stress reduction (MBSR) or aerobic exercise (AE) for generalized social anxiety disorder. MBSR and AE produced equivalent reductions in weekly social anxiety symptoms. Improvements were moderated by pre‚Äêtreatment social anxiety severity. PRACTITIONER POINTS: Mindfulness‚Äêbased stress reduction (MBSR) and aerobic exercise (AE) are effective in reducing symptoms of social anxiety. Pre‚Äêtreatment social anxiety severity can be used to inform treatment recommendations. Both MBSR and AE produced equivalent reductions in weekly levels of social anxiety symptoms. MBSR appears to be most effective for patients with lower pre‚Äêtreatment social anxiety symptom severity. AE appears to be most effective for patients with higher pre‚Äêtreatment social anxiety symptom severity.," Jazaieri, H;  Lee, IA;  Goldin, PR;  Gross, JJ",2016.0, 10.1111/papt.12060,0,0,
1699,EMDR protocol for recent critical incidents: A randomized controlled trial in a technological disaster context.,"This research evaluated the effectiveness of the Eye Movement Desensitization and Reprocessing (EMDR) Protocol for Recent Critical Incidents (EMDR-PRECI) in reducing posttraumatic stress symptoms related to the explosion in an explosives manufacturing factory north of Mexico City that killed 7 employees. The EMDR-PRECI was administered on 2 consecutive days to 25 survivors who had posttraumatic stress symptoms related to the critical incident. Participants' mean score on the Short PTSD Rating Interview (SPRINT) was 22, well above the clinical cutoff of 14. They were randomly assigned to immediate and waitlist/delayed treatment conditions and therapy was provided within 34 days of the explosion. Results showed significant main effects for the condition factor, F(1, 80) = 67.04, p < .000. SPRINT scores were significantly different across time showing the effects of the EMDR therapy through time, F(3, 80) = 150.69, p < .000. There was also a significant interaction effect, condition by time, F(2, 80) 5 55.45, p < .001. There were significant differences between the two treatment conditions at Time 2 (post-immediate treatment vs. post-waitlist/delayed), t(11) = 210.08, p < .000. Treatment effects were maintained at 90-day follow-up. Results also showed an overall subjective improvement in the participants. This randomized controlled trial provides evidence for the efficacy of EMDR-PRECI in reducing posttraumatic stress symptoms after a technological disaster. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Jarero, Ignacio; Uribe, Susana; Artigas, Lucina; Givaudan, Martha",2015.0,http://dx.doi.org/10.1891/1933-3196.9.4.166,0,0,
1700,Numerical Distraction Therapy: Initial Assessment of a Treatment for Posttraumatic Stress Disorder.,"The efficacy of a new therapy, numerical distraction therapy (NDT), in treating symptoms of posttraumatic stress disorder (PTSD) was investigated. It was hypothesized that the therapy would change the traumatic visual memories of PTSD patients and reduce the intensity of negative feelings associated with them. Both hypotheses were supported: 92% of patients reported post-treatment (positive) changes in their visual memories, and these same patients reported diminished levels of fear, shame, anxiety and other negative feelings. A subsample of patients reported stable treatment effects in follow-up surveys conducted two to four months later. The author also discusses possible mechanisms of NDT and suggests that NDT, eye movement desensitization and reprocessing (EMDR), and some forms of thought field therapy (TFT) might have ""dual attention"" as a common underlying mechanism. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Isaacs, John S",2004.0,http://dx.doi.org/10.1177/153476560401000104,0,0,
1701,Metacognition and cognition in inpatient MCT and CBT for comorbid anxiety disorders: A study of within-person effects.,"Psychotherapists have long questioned what mediating processes are linked to outcome of psychotherapy. Few studies examining this question have assessed within-person changes in the process outcome relationship over time. The present study examined changes in cognition and metacognition over the course of therapy using a dataset from a randomized controlled trial comparing Metacognitive therapy (MCT) and Cognitive-behavioral therapy (CBT). The sample included 74 patients measured on process and symptom instruments weekly throughout therapy. Multilevel longitudinal models (sessions nested within patients) were used to examine the relationship between metacognition, cognition, and anxiety. Main effects of metacognition and cognition on anxiety and the interaction with treatment, as well as the reciprocal relationships, were investigated. The results indicate a main effect of both cognitions and metacognitions on predicting anxiety. However, there was no interaction with treatment condition. The reciprocal relationship of anxiety on metacognitions was larger in MCT compared with CBT. This is the first study documenting within-person effects of both cognitions and metacognitions on anxiety over the course of therapy. Implications for therapy are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement Public Significance Statement-Decrease of metacognitions and cognitions in metacognitive therapy or cognitive behavioral therapy is likely to be followed by reduction of anxiety symptoms over the course of therapy. Thus, both metacognitions and cognitions are important processes in the treatment of comorbid anxiety disorder. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Johnson, Sverre Urnes; Hoffart, Asle; Nordahl, Hans M; Ulvenes, Pal G; Vrabel, KariAnne; Wampold, Bruce E",2018.0,http://dx.doi.org/10.1037/cou0000226,0,0,
1702,Metacognitive therapy versus disorder-specific CBT for comorbid anxiety disorders: A randomized controlled trial.,"Few studies have compared the effects of Metacognitive therapy (MCT) and Cognitive behavioral therapy (CBT) for comorbid anxiety disorders. In the current study we compared CBT and MCT for heterogeneous anxiety disorders in a residential setting. Ninety patients with a primary diagnosis of Post Traumatic Stress Disorder, Social Phobia or Panic disorder, with and without Agoraphobia, were randomized to either CBT or MCT. Patients were assessed at pre-treatment, post-treatment and one-year follow-up. Primary outcome measures were Beck Anxiety Inventory and ADIS IV and secondary outcome measures were SCID II, Beck Depression Inventory, Penn State Worry Questionnaire, The Symptom Checklist-90 and the Inventory of Interpersonal Problems-64. Treatment fidelity was satisfactory and therapist credibility was equal in both treatments. There was a significant difference in the level of anxiety favouring MCT at post-treatment (d=0.7), but there were no differences at one-year follow-up, mainly due to a further improvement in the CBT group during the follow-up period. Both treatments were efficacious. No differences in effect on comorbid diagnoses and symptoms were found, but MCT produced larger change in personality problems. MCT seems to have a more rapid effect on anxiety symptoms, but there were no significant differences in the long term for patients with comorbid anxiety disorders.",Johnson SU.; Hoffart A.; Nordahl HM.; Wampold BE.,2017.0,10.1016/j.janxdis.2017.06.004,0,0,
1703,Effects of therapeutic horseback riding on post-traumatic stress disorder in military veterans.,"Large numbers of post-deployment U.S. veterans are diagnosed with post-traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI), leading to an urgent need for effective interventions to reduce symptoms and increase veterans' coping. PTSD includes anxiety, flashbacks, and emotional numbing. The symptoms increase health care costs for stress-related illnesses and can make veterans' civilian life difficult. We used a randomized wait-list controlled design with repeated measures of U.S. military veterans to address our specific aim to test the efficacy of a 6-week therapeutic horseback riding (THR) program for decreasing PTSD symptoms and increasing coping self-efficacy, emotion regulation, social and emotional loneliness. Fifty-seven participants were recruited and 29 enrolled in the randomized trial. They were randomly assigned to either the horse riding group (n = 15) or a wait-list control group (n = 14). The wait-list control group experienced a 6-week waiting period, while the horse riding group began THR. The wait-list control group began riding after 6 weeks of participating in the control group. Demographic and health history information was obtained from all the participants. PTSD symptoms were measured using the standardized PTSD Checklist-Military Version (PCL-M). The PCL-M as well as other instruments including, The Coping Self Efficacy Scale (CSES), The Difficulties in Emotion Regulation Scale (DERS) and The Social and Emotional Loneliness Scale for Adults-short version (SELSA) were used to access different aspects of individual well-being and the PTSD symptoms. Participants had a statistically significant decrease in PTSD scores after 3 weeks of THR (P ≤ 0.01) as well as a statistically and clinically significant decrease after 6 weeks of THR (P ≤ 0.01). Logistic regression showed that participants had a 66.7% likelihood of having lower PTSD scores at 3 weeks and 87.5% likelihood at 6 weeks. Under the generalized linear model(GLM), our ANOVA findings for the coping self-efficacy, emotion regulation, and social and emotional loneliness did not reach statistical significance. The results for coping self-efficacy and emotion regulation trended in the predicted direction. Results for emotional loneliness were opposite the predicted direction. Logistic regression provided validation that outcome effects were caused by riding longer. The findings suggest that THR may be a clinically effective intervention for alleviating PTSD symptoms in military veterans.",Johnson RA.; Albright DL.; Marzolf JR.; Bibbo JL.; Yaglom HD.; Crowder SM.; Carlisle GK.; Willard A.; Russell CL.; Grindler K.; Osterlind S.; Wassman M.; Harms N.,2018.0,10.1186/s40779-018-0149-6,0,0,
1704," Glistenings, anterior/posterior capsular opacification and incidence of Nd: YAG laser treatments with two aspheric hydrophobic acrylic intraocular lenses - a long-term intra-individual study"," PURPOSE: To compare two hydrophobic acrylic intraocular lenses (IOLs) regarding long‚Äêterm anterior/posterior capsular opacification (ACO/PCO) development and need for neodymium:Yttrium‚ÄêAluminum‚ÄêGarnet (Nd:YAG) laser treatment due to visually disturbing PCO, and to study development of glistenings in the IOL materials. METHODS: In a prospective, randomized, intra‚Äêindividual, comparative trial, 50 cataract patients received either an AcrySof IQ RESULTS: Visual outcomes were similar for the two IOLs. Anterior capsular fibrosis and/or opacification developed more often in SN60WF eyes. Mean PCO area percentage was larger in ZCB00 eyes 3 years after surgery, but severity score did not differ with statistical significance between the two IOLs. Six ZCB00 eyes and 2 SN60WF eyes underwent Nd:YAG laser treatment during a mean of 4 years 8 months after surgery. This difference was not statistically significant. A high amount of glistenings developed in most SN60WF IOLs, while only few ZCB00 IOLs displayed a low degree of glistenings. CONCLUSION: Visual outcomes, PCO development over time and need for Nd:YAG laser treatment were similar for the two IOLs. Anterior capsule fibrosis/contraction and glistenings were more pronounced with the SN60WF IOL."," Johansson, B",2017.0, 10.1111/aos.13444,0,0,
1705,Cardiovascular activation during socially evaluated cold-pressor test is associated with changes in immune function but not with activation of steroid stress hormones,"Cold and other environmental stressors are known to affect blood pressure and heart rate. The cold pressor test is a cardiovascular test used clinically to evaluate autonomic and left ventricular function. Longitudinal studies have shown that an exaggerated vascular response and pulse excitability during cold pressor test can be considered a predictor of hypertension (Wood et al. 1984). The test is associated with clear increases in blood pressure and heart rate, but not with activation of hormones important in the stress response. To obtain a more complex view on neuroendocrine activation, a psychosocial component of the stressor (e.g. social evaluation) needs to be added (Schwabe et al. 2008). The aim of the present study was to test the hypotheses that 1) the neuroendocrine response of healthy subjects during socially evaluated cold pressor test depend on the level of stress perception and 2) neuroendocrine response during the test includes the activation of the immune system. The test was performed in healthy volunteers by 2 min immersion of one hand in ice water while watched by an experimenter. The volunteer was simultaneously videorecorded. As expected, there was a significant rise in systolic and diastolic blood pressure and in the heart rate. In contrast, there were no changes in salivary alpha-amylase activity (a marker of sympathetic activation), cortisol and aldosterone concentrations. When the subjects were stratified according to scores in a self-assessment scale on stress perception into a low and high distress group, no differences in cardiovascular and endocrine parameters were observed. However, subjects in the high distress group showed significantly higher salivary interleukin-1beta concentrations in the pre-stress time period. The mechanisms and significance of this new phenomenon remain to be elucidated. Supported by grant APVV-14-0840.",Jezova D.; Buzgoova K.; Balagova L.; Kapsdorfer D.; Marko M.; Riecansky I.,2018.0,10.1159/000491714,0,0,
1706,Patients' perspectives on treatment with metacognitive training for OCD: Feasibility and acceptability.,"There is much room for improvement in the treatment of obsessive-compulsive disorder (OCD). The current study introduces a newly developed version of Metacognitive Training for OCD (MCT-OCD), inspired by the self-help intervention myMCT as well as by MCT group programs for other disorders. The current study examines the acceptability of the training. Forty-four patients with OCD received four sessions of MCT-OCD in addition to inpatient treatment. At post assessment, patients provided a subjective appraisal of the training. Analyses revealed high acceptability and added value of the MCT-OCD. The current, preliminary version of the MCT-OCD is promising in terms of patient acceptance. Results will be used to improve current shortcomings of the training and to develop a more comprehensive MCT-OCD. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Abstract (German) Die Behandlungserfolge bei Zwangsstorungen sind nicht zufriedenstellend, und die Therapiemoglichkeiten sollten verbessert werden. Die vorliegende Pilotstudie stellt eine Version des Metakognitiven Gruppentrainings fur Zwangsstorungen (Z-MKT) vor, welches in Anlehnung an das Selbsthilfemanual myMCT"" sowie andere storungsspezifi sche Metakognitive Gruppentrainings entwickelt wurde. Ziel dieser Studie war es, die Akzeptanz des Trainings zu uberprufen. Vierundvierzig Patienten mit einer Zwangsstorung nahmen neben einer (teil-)stationaren Standardbehandlung an vier Sitzungen Z-MKT teil. Anschliesend wurden die subjektiven Bewertungen des Trainings erfasst. In den Analysen zeigte sich eine hohe Akzeptanz des Z-MKT. Die Akzeptanz der Pilotversion ist entsprechend als positiv zu beurteilen. Die Ergebnisse der Studie werden dazu verwendet, das Z-MKT zu verbessern und ein umfassenderes metakognitives Gruppentraining fur Zwangsstorungen zu entwickeln. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Jelinek, Lena; Zielke, Lotta; Hottenrott, Birgit; Miegel, Franziska; Cludius, Barbara; Sure, Anna; Demiralay, Cuneyt",2018.0,http://dx.doi.org/10.1024/1016-264X/a000211,0,0,
1707,Seasonal variation of organic matter characteristics and fluoride concentration in the Maji ya Chai River (Tanzania): Impact on treatability by nanofiltration/reverse osmosis,"The Maji ya Chai River in Northern Tanzania, a fluoride-rich tropical area, shows a seasonal variation of natural organic matter (NOM) and fluoride concentration. Water samples collected monthly during one year from two locations of the River were characterized. High levels of precipitation in the rainy seasons increased the total organic carbon (TOC) concentration to as high as 36 mgC L−1 and diluted the fluoride concentration from a dry season high of 24 mg L−1 to <4 mg L−1. A black water swamp in the Maji ya Chai River catchment was confirmed as the main source of NOM, fluoride, salinity, and inorganic carbon entering the River in the rainy season. The water samples were filtered by a number of nanofiltration/reverse osmosis (NF/RO) membranes to identify the retention mechanisms and the impact of varying water quality on treatability. While the denser membranes removed fluoride due to size exclusion, for the membranes with bigger pore radius charge repulsion was the dominant mechanism of fluoride retention. Regardless of the seasonal conditions a TOC concentration <2 mgC L−1 was achieved by all membranes at 50% recovery, as NF/RO membranes remove TOC mainly by size exclusion. Two swamp water samples, containing high TOC (79 and 183 mgC L−1), were filtered to determine the characteristics of NOM which permeate the NF/RO membranes. Liquid chromatography organic carbon detection (LC-OCD) was used to characterize the fractions in the permeates, consisting of about 1% of the original NOM. The average molecular weight of the permeate humic substances (HS) was more than four times larger than the membrane molecular weight cut-off. This suggests that large HS can permeate the NF/RO membranes through diffusion. Moreover, the relatively high aromaticity of the permeate HS (1.7–5.2 L mg−1 m−1) indicated the high content of hydrophobic-aromatic fractions.",Jeihanipour A.; Shen J.; Abbt-Braun G.; Huber S.A.; Mkongo G.; Schäfer A.I.,2018.0,10.1016/j.scitotenv.2018.05.113,0,0,
1708, Effects of Karate Training Versus Mindfulness Training on Emotional Well-Being and Cognitive Performance in Later Life," In a randomized controlled trial, we investigated the effects of karate versus a mindfulness‚Äêbased stress reduction (MBSR) intervention on well‚Äêbeing and cognitive functioning in older adults. Fifty‚Äêfive adults (52‚Äê81 years old) participated in twice‚Äêweekly karate versus MBSR sessions or no training for 8 weeks. In pre‚Äê and postassessments, subjective well‚Äêbeing, health, cognitive functioning, and chronic stress were measured. Preassessment hair cortisol served as physiological stress marker. The results showed an improvement for the karate group, but not the MBSR and control group, in subjective mental health and anxiety as well as cognitive processing speed. The MBSR group showed by trend as a decrease in stress. No significant correlation between preassessment hair cortisol and postassessment outcomes could be established. But the higher the level of baseline self‚Äêreported perceived stress, the higher the increase in depression, anxiety, and chronic stress. Generally, it can be assumed that karate and MBSR showed only small training effects concerning the assessed emotional and cognitive parameters."," Jansen, P;  Dahmen-Zimmer, K;  Kudielka, BM;  Schulz, A",2017.0, 10.1177/0164027516669987,0,0,
1709, Factors affecting the acceptability and consumption of Corn Soya Blend Plus as a prenatal dietary supplement among pregnant women in rural Cambodia," OBJECTIVE: Undernutrition is prevalent among pregnant women in Cambodia. The provision of fortified dietary supplements is one strategy to help pregnant women meet their nutritional needs. Corn Soya Blend Plus (CSBP) is a widely used prenatal dietary supplement in areas with high rates of undernutrition and food insecurity. However, little is known about its acceptability during pregnancy. The present study aimed to identify factors that affected the acceptability and consumption of CSBP supplements among pregnant women. DESIGN: Women completed a structured interview designed to provide information on facilitators of and barriers to utilization. In addition, six focus groups were conducted with a subset of women (n 70) to further explore attitudes, perceptions and experiences related to CSBP use. SETTING: Two districts in Kampong Chhnang Province, Cambodia. SUBJECTS: Pregnant women (n 288) participating in a cluster‚Äêrandomized trial of CSBP. RESULTS: The acceptability of CSBP was influenced by sensory attributes, family support, peer influences, and attitudes related to diet, nutritional status and weight gain in pregnancy. Attaining adequate nutrition was considered less important than other concerns during pregnancy, particularly anxiety related to the costs of delivery and postpartum care. Acceptance was lower among new mothers due to fears of weight gain. Health benefits were common reasons for continued use and minor side‚Äêeffects, such as nausea, were not major barriers to consumption. CONCLUSIONS: CSBP was generally well accepted in this population. However, organoleptic factors and perceptions regarding nutrition and weight gain in pregnancy, particularly for first‚Äêtime mothers, were barriers to increasing acceptance among Cambodian women."," Janmohamed, A;  Karakochuk, CD;  Boungnasiri, S;  Whitfield, KC;  Chapman, GE;  Janssen, P;  McLean, J;  Green, TJ",2016.0, 10.1017/S1368980015003018,0,0,
1710," Oral carnitine supplementation influences mental health parameters and biomarkers of oxidative stress in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial"," METHODS: In the current randomized, double‐blind, placebo‐controlled trial, 60 patients diagnosed with PCOS were randomized to take either 250 mg carnitine supplements (n = 30) or placebo (n = 30) for 12 weeks. RESULTS: After 12 weeks' intervention, compared with the placebo, carnitine supplementation resulted in a significant improvement in Beck Depression Inventory total score (‐2.7 ± 2.3 versus ‐0.2 ± 0.7, p < 0.001), General Health Questionnaire scores (‐6.9 ± 4.9 versus ‐0.9 ± 1.5, p < 0.001) and Depression Anxiety and Stress Scale scores (‐8.7 ± 5.9 versus ‐1.2 ± 2.9, p = 0.001). In addition, changes in plasma total antioxidant capacity (TAC) (+84.1 ± 151.8 versus +4.6 ± 64.5 mmol/L, p = 0.01), malondialdehyde (MDA) (‐0.4 ± 1.0 versus  +0.5 ± 1.5 μmol/L, p = 0.01) and MDA/TAC ratio (‐0.0005 ± 0.0010 versus +0.0006 ± 0.0019, p = 0.003) in the supplemented group were significantly different from the changes in these indicators in the placebo group. CONCLUSIONS: Overall, our study demonstrated that carnitine supplementation for 12 weeks among patients with PCOS had favorable effects on parameters of mental health and biomarkers of oxidative stress. INTRODUCTION: Limited data are available assessing the effects of oral carnitine supplementation on mental health parameters and biomarkers of oxidative stress of women with polycystic ovary syndrome (PCOS).This study was designed to determine the effects of oral carnitine supplementation on mental health parameters and biomarkers of oxidative stress in women with PCOS."," Jamilian, H;  Jamilian, M;  Samimi, M;  Afshar Ebrahimi, F;  Rahimi, M;  Bahmani, F;  Aghababayan, S;  Kouhi, M;  Shahabbaspour, S;  Asemi, Z",2017.0, 10.1080/09513590.2017.1290071,0,0,
1711,Anxiety disorder-specific predictors of treatment outcome in the Coordinated Anxiety Learning and Management (CALM) trial.,"Identifying baseline characteristics associated with treatment outcome in generalized anxiety disorder, panic disorder, social anxiety disorder (SAD) or post-traumatic stress disorder. We performed two secondary analyses of the Coordinated Anxiety Learning and Management trial. Baseline characteristics and their interactions with treatment assignment were analyzed via stepwise logistic regression models and receiver-operating criterion analyses by disorder predicting remission and response for each disorder. Predictors for poor outcome across diagnoses were comorbid depression and low socioeconomic status. Good outcome was associated with positive treatment expectancy and high self-efficacy expectancy. SAD had the lowest rate of remission and response compared to the other anxiety disorders, and differed in respect to its predictors of treatment outcome. Perceived social support predicted treatment outcome in SAD. The special role of SAD among the other anxiety disorders requires further study both because of its worse prognosis and its more specific treatment needs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Jakubovski, Ewgeni; Bloch, Michael H",2016.0,http://dx.doi.org/10.1007/s11126-015-9399-6,0,0,
1712, Effect of ischemic compression for cervicogenic headache and elastic behavior of active trigger point in the sternocleidomastoid muscle using ultrasound imaging," OBJECTIVES: To investigate the effect of ischemic compression on clinical outcomes of a cervicogenic headache and elastic behavior of myofascial trigger points. DESIGN: Randomized, controlled trial. SETTING: Outpatient headache clinic. SUBJECTS: 19 subjects with a cervicogenic headache originating from myofascial trigger point within the sternocleidomastoid muscle. INTERVENTIONS: Subjects were randomized in treatment group (n = 9) and control group (n = 10). Subjects in the treatment group received 4 sessions of ischemic compression in the myofascial trigger point region. MAIN MEASURES: Headache intensity, frequency, and duration, trigger point elastic modulus, trigger point area, pressure tolerance, and pressure pain threshold were assessed before and after treatment. RESULTS: Subjects in the treatment group compared with those in control group showed significant improvements in headache intensity (P = 0.002), headache frequency (P = 0.005), headache duration (P = 0.015), pressure tolerance (P < 0.001), pressure pain threshold (P = 0.039), and myofascial trigger point area (P = 0.017). Changes in myofascial trigger point elastic modulus did not reach a significant level (P > 0.05). CONCLUSION: The improvements in outcome measures suggest that ischemic compression may be effective in subjects with a cervicogenic headache associated with a myofascial trigger point in the sternocleidomastoid muscle. Data suggests that biomechanical properties of MTrP and severity of headache symptoms are not directly linked, and other mechanisms could be more influential in contributing to symptoms."," Jafari, M;  Bahrpeyma, F;  Togha, M",2017.0, 10.1016/j.jbmt.2017.01.001,0,0,
1713,Transdiagnostic and Transcultural: Pilot Study of Unified Protocol for Depressive and Anxiety Disorders in Japan.,"Unified protocol (UP) is a transdiagnostic cognitive behavior therapy for emotional disorders. It remains unknown whether UP is applicable for use in non-Western countries and for depressive disorders. We therefore examined its feasibility for a Japanese clinical population using this clinical trial design, which is multicentered, open-labeled, and single-armed (Clinical registry: UMIN000008322). The primary outcome was severity of anxiety symptoms, as assessed using Structured Interview Guide for the Hamilton Anxiety Rating Scale. Secondary outcomes were depressive symptoms, clinical global impression, functioning, quality of life, affectivity, emotion regulation, and adverse events. Of the 28 prospective participants, 17 were eligible and enrolled (depressive disorders=9, anxiety disorders=8). Severity of anxiety symptoms, which decreased significantly after the intervention, remained low for 3months (Hedges' g=1.29, 95% CI=0.56-2.06). Similar tendencies were observed for secondary outcome measures. No severe adverse event occurred. Two participants dropped out of the intervention. High treatment adherence and interrater reliability were confirmed. Results suggest the feasibility of UP in the Japanese context sufficient to warrant a larger clinical trial.",Ito M.; Horikoshi M.; Kato N.; Oe Y.; Fujisato H.; Nakajima S.; Kanie A.; Miyamae M.; Takebayashi Y.; Horita R.; Usuki M.; Nakagawa A.; Ono Y.,2016.0,10.1016/j.beth.2016.02.005,0,0,
1714, A Brief School-Based Cognitive-Behavioral Intervention for Japanese Adolescents With Severe Posttraumatic Stress," This pilot study investigated the efficacy of a brief school‚Äêbased cognitive‚Äêbehavioral intervention program for Japanese adolescents exposed to the Great East Japan Earthquake in 2011. The participants were 22 adolescents with severe posttraumatic stress symptoms at the time of the study in March 2014. They completed a single‚Äêsession 4‚Äêstep intervention program based on Ehlers and Clark's (2000) model at their school. Symptom status was assessed at 3 time points (preintervention, postintervention, and 4‚Äêmonth follow‚Äêup) using the Impact of Event Scale‚ÄêRevised (Weiss, 2004) and Center for Epidemiologic Studies Depression Scale (Radloff, 1977). The results showed significant improvements in all posttraumatic stress symptoms at postintervention (d = 0.81), and the effects were maintained throughout the 4‚Äêmonth follow‚Äêup period (d = 1.10). However, no improvement in depressive symptoms was shown. Results from this pilot study suggest that school‚Äêbased cognitive‚Äêbehavioral intervention programs are feasible and show promise for Japanese adolescents with posttraumatic stress symptoms regardless of cross‚Äêcultural differences, but that additional research examining effectiveness is needed. Despite the preliminary nature of the findings of this pilot study, the strengths of our intervention were that it was driven by a well‚Äêtested theoretical model and required only a single session to administer."," Ito, D;  Koseki, S;  Ohtani, T",2016.0, 10.1002/jts.22145,0,0,
1715,Death Anxiety Resilience; a Mixed Methods Investigation,"Research was conducted examining how death anxiety influenced PTSD and mental health among people who have experienced a life-threatening event. This study was conducted using undergraduate university students in Lithuania. The study used a mixed-method design and in phase 1, participants (N = 97) completed self-report questionnaires that gathered information on demographics, death anxiety, trauma and well-being. Data indicated a significant correlation between death anxiety and PTSD, but not psychiatric co-morbidity. Phase 2 attempted to further explore the phenomenological experience of participants with full PTSD, and 6 semi-structured interviews were conducted. IPA analysis found three major themes in response to the life-threatening event; self-efficacy, religious coping and existential attitude. Overall these coping mechanisms allowed participants to develop resilience against the effects of death anxiety and minimize its negative impact on mental health.",Hoelterhoff M.; Chung M.C.,2017.0,10.1007/s11126-016-9483-6,0,0,
1716,A wait-list controlled study of a trauma-focused cognitive behavioral treatment for intermittent explosive disorder in Timor-Leste.,"We tested a trauma-focused, cognitive-behavior therapy treatment (TF-CBT-anger) for intermittent explosive disorder (IED) and related dimensions of anger adapted to the local culture in postconflict Timor-Leste. The intention-to-treat sample (n = 78) comprised Timorese nationals (women = 49; men = 29), ages 18 years and older, meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for IED, with equal numbers (n = 39 each) being randomized to the treatment group (TG) and wait-list (WL). Assessments were made at 1 week prior to therapy, immediately at posttreatment, and at 1 month follow-up. Primary measures included an IED diagnosis made according to the East Timor explosive anger measure and the directionality of expression and control of anger assessed by 4 dimensions of the State-Trait Anger Expression Inventory (STAXI-2). Secondary measures included psychological distress assessed using the Kessler scale and an index of posttraumatic stress disorder (PTSD) assessed using the Harvard Trauma Questionnaire. In the TG, there was a decline in IED from 100% to zero at follow-up. In the WL, more than 70% (of the 100% at baseline) showed persisting IED at second and third assessments. The TG alone showed significant (p < .05) improvements on all STAXI-2 scales, the effect sizes for the intervention being uniformly large (>0.80). Psychological distress and PTSD showed substantial reductions in the TG but not the WL group. Although based on a modest-sized sample, our findings provide the first evidence in support of the efficacy of TF-CBT-anger for IED in a culturally diverse, postconflict setting. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement Public Policy Relevance Statement-We report the first evidence for a brief trauma-focused psychological therapy that can effectively reduce explosive anger attacks and related emotional problems among survivors in postconflict Timor-Leste. After further testing, the treatment protocol has the potential to be adapted and implemented by lay counselors in similar settings worldwide, the aim being to reduce anger and aggression in postconflict societies across different cultures. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Hewage, Kalhari; Steel, Zachary; Mohsin, Mohammed; Tay, Alvin Kuowei; De Oliveira, Jose Carlos; Da Piedade, Marcio; Tam, Natalino; Silove, Derrick",2018.0,http://dx.doi.org/10.1037/ort0000280,0,0,
1717,Radiological changes do not influence clinical mid-term outcome in stemless humeral head replacements with hollow screw fixation: a prospective radiological and clinical evaluation.,"Stemless shoulder arthroplasty is a fairly new concept. Clinical and radiological follow-up is essential to prove implant safety and concept. This prospective single-centre study was performed to evaluate the influence of radiological changes on clinical mid-term outcome following stemless humeral head replacement with hollow screw fixation. Short- and mid-term radiological and clinical evaluations were performed in 73 consecutive shoulders treated mainly for idiopathic and posttraumatic osteoarthritis with stemless humeral head arthroplasty including 40 hemi- (HSA) and 33 total shoulder arthroplasties (TSA). Operating times of stemless implantations were compared to 110 stemmed anatomical shoulder prostheses. Appearances of humeral radiolucencies or radiological signs of osteolysis or stress shielding were assessed on standardized radiographs. Patients' clinical outcome was evaluated using the Constant score and patients' satisfaction was documented. Radiological changes, detected in 37.0%, did not affect clinical outcome. Constant scores significantly improved from baseline to short and mid-term follow-up (p < 0.001). The majority of patients (96.2%) were satisfied with the procedure. No loosening of the humeral head component was detected during a mean follow-up of 58 months. Operating times were significantly shorter with stemless compared to stemmed implants (p < 0.001). Clinical mid-term outcome after stemless humeral head replacement was not affected by radiological changes. The institutional review board (St. Vincent Hospital Vienna; 201212_EK01; date of issue: 11.12.2012) approved the study. The trial was registered at ClinicalTrials.gov ( NCT02754024 ). Retrospective registration.",Heuberer PR.; Brandl G.; Pauzenberger L.; Laky B.; Kriegleder B.; Anderl W.,2018.0,10.1186/s12891-018-1945-6,0,0,
1718, Internet-based cognitive behavioural therapy for young people with suicide-related behaviour (Reframe-IT): a randomised controlled trial," BACKGROUND: Suicide‚Äêrelated behaviours are common in young people and associated with a range of negative outcomes. There are few evidence‚Äêbased interventions; however, cognitive behavioural therapy (CBT) shows promise. Internet delivery of CBT is popular, with potential to increase reach and accessibility. OBJECTIVE: To test the effectiveness of an internet‚Äêbased CBT program (Reframe‚ÄêIT) in reducing suicide‚Äêrelated behaviours, depression, anxiety, hopelessness and improving problem solving and cognitive and behavioural skills in school students with suicide‚Äêrelated behaviours. METHODS: A parallel randomised controlled trial testing the effectiveness of Reframe‚ÄêIT plus treatment as usual (TAU) compared with TAU alone in reducing suicidal ideation, suicide attempts, depression, hopelessness, symptoms of anxiety, negative problem orientation and cognitive and behavioural skill acquisition was undertaken. We recruited students experiencing suicidal ideation from 18 schools in Melbourne, Australia, between August 2013 and December 2016. The intervention comprised eight modules of CBT delivered online over 10 weeks with assessments conducted at baseline, 10 weeks and 22 weeks. FINDINGS: Only 50 of the planned 169 participants were recruited. There were larger improvements in the Reframe‚ÄêIT group compared with the TAU group for the primary outcome of suicidal ideation (intervention ‚Äê61.6, SD 41.6; control ‚Äê47.1, SD 42.3, from baseline to 22‚Äêweek follow‚Äêup intervention); however, differences were non‚Äêsignificant (p=0.593). There were no increases in distress in the majority of participants (91.1%) after completion of each module. Changes in depression and hopelessness partly mediated the effect of acquisition of CBT skills on suicidal ideation. CONCLUSIONS: The trial was underpowered due to difficulties recruiting participants as a result of the complex recruitment procedures that were used to ensure safety of participants. Although there were no significant differences between groups, young people were safely and generally well engaged in Reframe‚ÄêIT and experienced decreases in suicidal ideation and other symptoms as well as improvements in CBT skills. The study is the first online intervention trial internationally to include young people demonstrating all levels of suicide risk. CLINICAL IMPLICATIONS: Integration of internet‚Äêdelivered interventions for young people with suicide‚Äêrelated behaviour may result in reductions in these behaviours. Further research is needed, but researchers should feel more confident about being able to safely undertake research with young people who experience these behaviours. TRIAL REGISTRATION NUMBER: ACTRN12613000864729."," Hetrick, SE;  Yuen, HP;  Bailey, E;  Cox, GR;  Templer, K;  Rice, SM;  Bendall, S;  Robinson, J",2017.0, 10.1136/eb-2017-102719,0,0,
1719,Preventing intimate partner violence via the Internet: A randomized controlled trial of emotion-regulation and conflict-management training for individuals with aggression problems.,"The aim of this randomized controlled trial was to investigate the effect of an Internet-delivered cognitive behaviour therapy (iCBT), which incorporated emotion-regulation and conflict-resolution techniques, on intimate partner violence (IPV). Another aim was to test the theoretical underpinnings of the treatment model using mediation analysis. Sixty-five participants with aggression problems in intimate adult relationships were recruited from the community and were randomly assigned to iCBT or to a monitored waitlist control. Participants were assessed with standardized self-report measures of IPV or aggression (Multidimensional Measure of Emotional Abuse, Revised Conflict Tactics Scale, and Aggression Questionnaire), relationship quality (Dyadic Adjustment Scale), anxiety or depression symptomatology (Patient Health Questionnaire; Generalized Anxiety Disorder Screener), at pretreatment, posttreatment (8 weeks), and 1-year follow-up. Process variables (subscales of Dysfunctional and Emotional Regulation Scale and Anger Rumination Scale) were assessed weekly over the active treatment phase. Robust linear regression analysis of all randomized participants showed significant treatment effects on emotional abuse relative to control at postassessment. Mediation analysis using growth curve modeling revealed that the treatment effect was partially mediated by changes in emotion-regulation ability. Controlled effects on secondary outcomes were also observed. Analyses of uncontrolled effects indicted that gains on IPV were maintained at 1-year follow-up. iCBT focusing on enhancing conflict-resolution skills and emotion-regulation ability has the potential to reduce IPV among self-recruited individuals with mild forms of abusive behaviour in intimate relationships. Emotion-regulation ability is potentially a key therapeutic process of change. Internet-delivered clinician-guided cognitive behaviour therapy is a viable treatment option for reducing intimate partner violence among self-recruited individuals with mild forms of abusive behaviour. For persons who display patterns of frequent and severe violence, other treatments are most likely needed. Emotion-regulation training is potentially a key therapeutic component that ought to be incorporated in interventions targeting IPV.",Hesser H.; Axelsson S.; Bäcke V.; Engstrand J.; Gustafsson T.; Holmgren E.; Jeppsson U.; Pollack M.; Nordén K.; Rosenqvist D.; Andersson G.,2017.0,10.1002/cpp.2082,0,0,
1720, Medial prefrontal cortex stimulation accelerates therapy response of exposure therapy in acrophobia," OBJECTIVE: In this study, we aimed to proof our concept of accelerating extinction learning using rTMS of the mPFC in a group of anxiety disorder patients. METHODS: To specifically evaluate the impact of rTMS on exposure‚Äêbased therapy, we applied a sham‚Äêcontrolled protocol over the vmPFC (FPz) succeeded by a virtual reality exposure therapy (VRET) in n = 20 participants with acrophobia and n = 19 controls. RESULTS: We found a significantly higher reduction in active compared to sham stimulated group for anxiety (t[37] = 2.33, p < 0.05) as well as avoidance ratings t[37] = 2.34, p < 0.05) from pre to post therapy. CONCLUSION: This study provides first clinical evidence that high‚Äêfrequency rTMS over the vmPFC improves exposure therapy response of acrophobia symptoms. BACKGROUND: Animal as well as human research indicated that the ventral medial prefrontal cortex (vmPFC) is highly relevant for fear extinction learning. Recently, we showed that targeting the vmPFC with high‚Äêfrequency repetitive transcranial magnetic stimulation (rTMS) in a placebo‚Äêcontrolled study with 45 healthy controls induced higher prefrontal activity during extinction of conditioned stimuli (CS+) in the active compared to the sham stimulated group and better extinction learning as indicated by ratings, fear potentiated startles and skin conductance responses."," Herrmann, MJ;  Katzorke, A;  Busch, Y;  Gromer, D;  Polak, T;  Pauli, P;  Deckert, J",2017.0, 10.1016/j.brs.2016.11.007,0,0,
1721,Thrombin action on NST astrocytes disrupts glycemic and respiratory control,"Burns and severe trauma can produce a post-injury “metabolic self-destruction” characterized by catabolic metabolism and hyperglycemia. The severity of the hyperglycemia is highly correlated with post-trauma morbidity and mortality. No mechanism has been posited to connect severe trauma with a loss of autonomic control over metabolism. However, traumatic injury causes other failures of autonomic function; one of those, gastric stasis and ulceration (“Cushing's Ulcer”) has recently been connected with the generation of thrombin. As a protease, thrombin (produced as a consequence of tissue injury) acts on G-protein-coupled protease-activated receptors (PAR). Our previous work established that PAR1 receptors located on astrocytes in the autonomically critical nucleus of the solitary tract (NST) are responsible for modulating gastric control circuit neurons. The NST is at the center of a homeostatic control nexus that receives vast quantities of visceral afferent data from cranial nerve afferents including the vagus. This region of the hindbrain is also outside the “blood-brain barrier” and is accessible to large molecules from the circulation. The NST uses this neural and chemical information to regulate gastrointestinal, metabolic, cardiorespiratory, endocrine, and behavioral functions. Astrocytes in the hindbrain have been also been implicated as important detectors of low glucose or glucose utilization and when activated, these astrocytes trigger CRR. There may be a convergence between the effects of thrombin to derange hindbrain gastrointestinal control and the hindbrain circuitry that initiates counter-regulatory responses (CRR) to increase glycemia in reaction to critical hypoglycemia. We tested the hypothesis that administration of thrombin to the floor of the fourth ventricle (4V) or directly into the NST could trigger increases in glycemia through the mediation of astrocytes. Pre-exposure of the 4V to fluorocitrate (FC; a selective blocker of astrocyte metabotropic signaling) was used to evaluate astrocyte involvement in thrombin-triggered changes in glycemia. Our results suggest that thrombin acts within the NST to increase glycemia through an astrocyte dependent mechanism. Blockade of purinergic, but not glutamatergic, gliotransmission pathways interrupted the effect of thrombin to increase glycemia. Our studies also revealed that thrombin, acting in the NST, produces a rapid, dramatic and potentially lethal suppression of respiratory rhythm that was also a function of purinergic gliotransmission. These results suggest that the critical connection between traumatic injury and a general collapse of autonomic regulation involves thrombin action on astrocytes.",Hermann G.E.; Rogers R.C.,2018.0,,0,0,
1722, Telehealth Versus In-Person Acceptance and Commitment Therapy for Chronic Pain: a Randomized Noninferiority Trial," The purpose of this randomized noninferiority trial was to compare video teleconferencing (VTC) versus in‚Äêperson (IP) delivery of an 8‚Äêweek acceptance and commitment therapy (ACT) intervention among veterans with chronic pain (N = 128) at post‚Äêtreatment and at 6‚Äêmonth follow‚Äêup. The primary outcome was the pain interference subscale of the Brief Pain Inventory. Secondary outcomes included measures of pain severity, mental and physical health‚Äêrelated quality of life, pain acceptance, activity level, depression, pain‚Äêrelated anxiety, and sleep quality. In intent to treat analyses using mixed linear effects modeling, both groups exhibited significant improvements on primary and secondary outcomes, with the exception of sleep quality. Further, improvements in activity level at 6‚Äêmonth follow‚Äêup were significantly greater in the IP group. The noninferiority hypothesis was supported for the primary outcome and several secondary outcomes. Treatment satisfaction was similar between groups; however, significantly more participants withdrew during treatment in the VTC group compared with the IP group, which was moderated by activity level at baseline. These findings generally suggest that ACT delivered via VTC can be as effective and acceptable as IP delivery for chronic pain. Future studies should examine the optimal delivery of ACT for patients with chronic pain who report low levels of activity. This trial was registered at ClinicalTrials.gov (NCT01055639). PERSPECTIVE: This study suggests that ACT for chronic pain can be implemented via VTC with reductions in pain interference comparable with IP delivery. This article contains potentially important information for clinicians using telehealth technology to deliver psychosocial interventions to individuals with chronic pain."," Herbert, MS;  Afari, N;  Liu, L;  Heppner, P;  Rutledge, T;  Williams, K;  Eraly, S;  VanBuskirk, K;  Nguyen, C;  Bondi, M;  et al.",2017.0, 10.1016/j.jpain.2016.10.014,0,0,
1723,Effects of structured patient education in adults with atopic dermatitis: Multicenter randomized controlled trial.,"Atopic dermatitis (AD) is a chronic relapsing skin disease prevalent in 1% to 3% of adults in Western industrialized countries. We sought to investigate the effectiveness of educational training in an outpatient setting on coping with the disease, quality of life, symptoms, and severity in adults with AD. In this German prospective, randomized controlled multicenter study, adult patients with moderate-to-severe AD were educated by referring to a comprehensive 12-hour training manual consented by a multiprofessional study group from different centers (Arbeitsgemeinschaft Neurodermitisschulung für Erwachsene [ARNE]). Patients were randomly allocated to the intervention or waiting control groups. Study visits were performed at baseline and after 1 year (1 year of follow-up). Primary outcomes were defined as a decrease in (1) ""catastrophizing cognitions"" with respect to itching (Juckreiz-Kognitions-Fragebogen questionnaire), (2) ""social anxiety"" (Marburger Hautfragebogen questionnaire), (3) subjective burden by symptoms of the disease (Skindex-29 questionnaire), and (4) improvement of disease signs and symptoms assessed by using the SCORAD index at 1 year of follow-up. Data were analyzed on an intention-to-treat basis. At 1 year of follow-up, patients from the intervention group (n = 168) showed a significantly better improvement compared with the waiting group (n = 147) in the following defined primary study outcomes: coping behavior with respect to itching (P < .001), quality of life assessed by using the Skindex-29 questionnaire (P < .001), and the SCORAD index (P < .001). This is the first randomized, controlled multicenter study on patient education in adult AD. The ARNE training program shows significant beneficial effects on a variety of psychosocial parameters, as well as AD severity.",Heratizadeh A.; Werfel T.; Wollenberg A.; Abraham S.; Plank-Habibi S.; Schnopp C.; Sticherling M.; Apfelbacher C.; Biedermann T.; Breuer K.; Fell I.; Fölster-Holst R.; Heine G.; Grimm J.; Hennighausen L.; Kugler C.; Reese I.; Ring J.; Schäkel K.; Schmitt J.; Seikowski K.; von Stebut E.; Wagner N.; Waßmann-Otto A.; Wienke-Graul U.; Weisshaar E.; Worm M.; Gieler U.; Kupfer J.;  .,2017.0,10.1016/j.jaci.2017.01.029,0,0,
1724,Intensive prolonged exposure therapy for chronic PTSD patients following multiple trauma and multiple treatment attempts.,"Background: Suboptimal response and high dropout rates leave room for improvement of trauma-focused treatment (TFT) effectiveness in ameliorating posttraumatic stress disorder (PTSD) symptoms. Objective: To explore the effectiveness and safety of intensive prolonged exposure (iPE) targeting chronic PTSD patients with a likely diagnosis of ICD-11 Complex PTSD following multiple interpersonal trauma and a history of multiple treatment attempts. Method: Participants (N = 73) received iPE in 12 x 90-minute sessions over four days (intensive phase) followed by four weekly 90-minute booster prolonged exposure (PE) sessions (booster phase). The primary outcomes, clinician-rated severity of PTSD symptoms, and diagnostic status (Clinician-Administered PTSD Scale; CAPS-IV) were assessed at baseline, post-treatment, and at three and six months. Treatment response trajectories were identified and predictors of these trajectories explored. Results: Mixed model repeated measures analysis of CAPS-IV scores showed a baseline-to-posttreatment decrease in PTSD symptom severity (p < .001) that persisted during the three- and six-month follow-ups with large effect sizes (Cohen's d > 1.2); 71% of the participants responded. None of the participants dropped out during the intensive phase and only 5% during the booster phase. Adverse events were extremely low and only a minority showed symptom exacerbation. Cluster analysis demonstrated four treatment response trajectories: Fast responders (13%), Slow responders (26%), Partial responders (32%), and Non-responders (29%). Living condition and between-session fear habituation were found to predict outcome. Participants living alone were more likely to belong to the Partial responders than to the Non-responders cluster, and participants showing more between-session fear habituation were more likely to belong to the Fast responders than to the Non-responders cluster. Conclusions: The results of this open study suggest that iPE can be effective in PTSD patients with multiple interpersonal trauma and after multiple previous treatment attempts. In addition, in this chronic PTSD population iPE was safe. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Abstract (Spanish) Planteamiento: La respuesta suboptima y las altas tasas de abandono dejan margen para la mejora de la eficacia del tratamiento centrado en el trauma (TCT) en la mejora de los sintomas del trastorno por estres postraumatico (TEPT). Objetivo: explorar la efectividad y la seguridad de la exposicion prolongada intensiva (EPI) dirigida a pacientes con TEPT cronico con un probable diagnostico de TEPT complejo de la CIE-11 despues de multiples traumas interpersonales y un historial de multiples intentos de tratamiento. Metodo: Los participantes (N = 73) recibieron EPI en 12 sesiones de 90 minutos durante cuatro dias (fase intensiva) seguidas de cuatro sesiones semanales de exposicion prolongada (EP) de refuerzo de 90 minutos (fase de refuerzo). Los resultados principales, la gravedad de los sintomas del TEPT evaluados por el clinico y el estado diagnostico evaluados por el clinico (Escala de TEPT administrada por el clinico, CAPS-IV, por sus siglas en ingles) se evaluaron al inicio, despues del tratamiento, y a los tres y seis meses. Se identificaron las trayectorias de respuesta al tratamiento y se exploraron los predictores de estas trayectorias. Resultados: Los analisis de medidas repetidas de las puntuaciones de CAPS-IV desde un modelo mixto mostraron una disminucion de la linea de base hasta el postratamiento en cuanto a la gravedad de los sintomas de TEPT (p <.001) que persistio durante los seguimientos a los 3 y 6 meses con tamanos de efecto grandes (d de Cohen > 1,2); el 71% de los participantes respondieron. Ninguno de los participantes abandono durante la fase intensiva y solo el 5% lo hizo durante la fase de refuerzo. Los eventos adversos fueron extremadamente bajos y solo una minoria mostro exacerbacion de los sintomas. El analisis de clusters demostro cuatro trayectorias de respuesta al tratamiento: los que responden rapidamente (13%), los que responden lentamente (26%), los que responden parcialmente (32%) y los que no responden (29%). Se descubrio que las condiciones de vida y la habituacion al miedo entre sesiones predecian el resultado. Los participantes que vivian solos eran mas propensos a pertenecer a los que responden parcialmente que al grupo de los que no responden, y los participantes que demostraron mas habituacion al miedo entre sesiones tenian mas probabilidades de pertenecer a los que responden rapidamente que al grupo de los que no responden. Conclusiones: los resultados de este estudio abierto sugieren que la EPI puede ser efectiva en pacientes con TEPT con traumas interpersonales multiples y despues de multiples intentos previos de tratamiento. Ademas, en esta poblacion de TEPT cronico, la EPI era segura. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Hendriks, Lotte; Kleine, Rianne A. de; Broekman, Theo G; Hendriks, Gert-Jan; Minnen, Agnes van",2018.0,http://dx.doi.org/10.1080/20008198.2018.1425574,0,0,
1725,Facing others’ misfortune: Personal distress mediates the association between maladaptive emotion regulation and social avoidance,"Previous research has linked the use of certain emotion regulation strategies to the vicarious experience of personal distress (PD) and empathic concern (EC). However, it has not yet been tested whether (1) vicarious PD is positively associated with maladaptive emotion regulation strategies, (2) vicarious EC is positively associated with adaptive emotion regulation strategies or whether (3) PD and EC mediate the link between emotion regulation and reports of approach/avoidance in response to a person in distress. To that end, we assessed people’s reports of PD (i.e., anxious, troubled and upset) and EC (i.e., concerned, sympathetic and soft-hearted) in response to a video depicting a person in a threatening situation (n = 78). Afterwards, we assessed participants’ reports of avoidance and approach with regard to the character and their disposition to use maladaptive and adaptive emotion regulation strategies. Results showed that both PD and EC were positively related to maladaptive strategies and negatively related to adaptive strategies, and that the association between maladaptive regulation strategies (i.e., rumination) and the willingness to avoid the person in distress was mediated by reports of greater PD. This study thus expands previous evidence on the relationship between maladaptive regulation strategies and affective empathy and provides novel insights into the main role that PD plays in the association between maladaptive strategies and social avoidance.",Grynberg D.; López-Pérez B.,2018.0,10.1371/journal.pone.0194248,0,0,
1726, Can Early Rehabilitation on the General Ward After an Intensive Care Unit Stay Reduce Hospital Length of Stay in Survivors of Critical Illness?: a Randomized Controlled Trial," OBJECTIVE: The aim of this study was to evaluate if an early rehabilitation program for survivors of critical illness improves functional recovery, reduces length of stay, and reduces hospital costs. DESIGN: This was a prospective randomized controlled trial. Fifty‚Äêthree consecutive survivors of critical illness were included in the study. After discharge from the intensive care unit, the intervention group received an early rehabilitation program, and the standard‚Äêcare group received physical therapy as ordered by the primary care team. Length of stay at the general ward after transfer from the intensive care unit was recorded. In addition, Early Rehabilitation Barthel Index, visual analog scale for pain, 3‚Äêminute walk test, Beck Depression Inventory, State‚ÄêTrait Anxiety Inventory, and Medical Research Council scale were used. RESULTS: In the per‚Äêprotocol analysis, length of stay at the general ward was a median 14 days (interquartile range [IQR], 12‚Äê20 days) in the early rehabilitation and 21 days [IQR, 13‚Äê34 days) in the standard‚Äêcare group. This significant result could not be confirmed by the intention‚Äêto‚Äêtreat analysis (16 days [IQR, 13‚Äê23 days] vs. 21 days [IQR, 13‚Äê34 days]). Secondary outcomes were similar between the groups. Hospital costs were lower in the intervention group. No adverse effects were detected. CONCLUSIONS: An early rehabilitation program in survivors of critical illness led to an earlier discharge from the hospital, improved functional recovery, and was also cost‚Äêeffective and safe. TO CLAIM CME CREDITS: Complete the self‚Äêassessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to (1) delineate the benefits of early rehabilitation on a general medicine ward after an intensive care unit stay, (2) recognize the safety of appropriately implemented early rehabilitation, and (3) incorporate early rehabilitation on the general medical ward as applicable. LEVEL: Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal‚Äêbased CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)‚Ñ¢. Physicians should only claim credit commensurate with the extent of their participation in the activity."," Gruther, W;  Pieber, K;  Steiner, I;  Hein, C;  Hiesmayr, JM;  Paternostro-Sluga, T",2017.0, 10.1097/PHM.0000000000000718,0,0,
1727, Secondary distress in violence researchers: a randomised trial of the effectiveness of group debriefings," BACKGROUND: Secondary distress including emotional distress, vicarious trauma (VT) and secondary traumatic stress (STS) due to exposure to primary trauma victims have been described in helping professionals and in violence researchers. To our knowledge, there are few prevalence studies, and no tailored interventions have been tested to reduce secondary distress in violence researchers. The study aims to (1) describe the epidemiology of secondary distress experienced by violence researchers; to (2) assess the effectiveness of group debriefings in mitigating secondary distress; to (3) assess risk and protective factors. METHODS: We conducted an un‚Äêblinded, individually randomised trial with parallel assignment. Eligible participants were 59 Ugandan researchers employed by the Good Schools Study to interview children who experienced violence in a district of Uganda. Fifty‚Äêthree researchers agreed to participate and were randomly allocated. The intervention group (n = 26) participated in three group debriefings and the control group (n = 27) in three leisure sessions (film viewings). The primary outcome was change in levels of emotional distress (SRQ‚Äê20); secondary outcomes were levels of VT and STS at end‚Äêline. A paired t‚Äêtest assessed the difference in mean baseline and end‚Äêline emotional distress. Un‚Äêpaired t‚Äêtests compared the change in mean emotional distress (baseline vs. end‚Äêline), and compared levels of VT and STS at end‚Äêline. Separate logistic regression models tested the association between end‚Äêline emotional distress and a‚Äêpriori risk or protective factors. RESULTS: Baseline and end‚Äêline levels of emotional distress were similar in control (p = 0.47) and intervention (p = 0.59) groups. The superiority of group debriefing over leisure activities in lowering levels of emotional distress in the intervention group (n = 26; difference in SRQ‚Äê20 = 0.23 [SD = 2.18]) compared to the control group (n = 26; difference in SRQ‚Äê20 = 0.23 [SD = 1.63]) could not be detected (p = 1). In regression analysis (n = 48), baseline distress increased the odds of end‚Äêline distress (OR = 16.1, 95%CI 2.82 to 92.7, p = 0.002). Perceived organisational support (OR = 0.09, 95%CI 0.01 to 0.69, p = 0.02) and belief in God (OR = 0.21, 95%CI 0.03 to 1.26, p = 09) was protective against end‚Äêline distress. CONCLUSION: We found no evidence that violence researchers experienced elevated emotional distress after doing violence research. There was no difference between group debriefings and leisure activities in reducing distress in our sample. However, the hypotheses presented should not be ruled out in other violence research settings. Our findings suggest that organisational support is a significant protective factor and belief in God may be an important coping mechanism. TRIAL REGISTRATION: Clinical Trials NCT02390778 . Retrospectively registered 19 March 2015. The Good Schools Trial was registered at ( NCT01678846 ), on August 24, 2012."," Grundlingh, H;  Knight, L;  Naker, D;  Devries, K",2017.0, 10.1186/s12888-017-1327-x,0,0,
1728,Mapping concentrations of posttraumatic stress and depression trajectories following Hurricane Ike.,"We investigated geographic concentration in elevated risk for a range of postdisaster trajectories of chronic posttraumatic stress symptom (PTSS) and depression symptoms in a longitudinal study (N‚Äâ=‚Äâ561) of a Hurricane Ike affected population in Galveston and Chambers counties, TX. Using an unadjusted spatial scan statistic, we detected clusters of elevated risk of PTSS trajectories, but not depression trajectories, on Galveston Island. We then tested for predictors of membership in each trajectory of PTSS and depression (e.g., demographic variables, trauma exposure, social support), not taking the geographic nature of the data into account. After adjusting for significant predictors in the spatial scan statistic, we noted that spatial clusters of PTSS persisted and additional clusters of depression trajectories emerged. This is the first study to show that longitudinal trajectories of postdisaster mental health problems may vary depending on the geographic location and the individual- and community-level factors present at these locations. Such knowledge is crucial to identifying vulnerable regions and populations within them, to provide guidance for early responders, and to mitigate mental health consequences through early detection of mental health needs in the population. As human-made disasters increase, our approach may be useful also in other regions in comparable settings worldwide.",Gruebner O.; Lowe SR.; Tracy M.; Joshi S.; Cerd√° M.; Norris FH.; Subramanian SV.; Galea S.,2016.0,10.1038/srep32242,0,0,
1729, Usual Care for Rural Veterans With Posttraumatic Stress Disorder," METHOD: Veterans (N = 132) with PTSD recruited from 5 large‚Äê (5,000‚Äê10,000 patients) and 6 medium‚Äêsized (1,500‚Äê4,999) CBOCs were enrolled in the usual care arm of a randomized control trial for a PTSD collaborative care study. Chart review procedures classified all mental health encounters during the 1‚Äêyear study period into 10 mutually exclusive categories (7 psychotherapy and 3 medication management). FINDINGS: Seventy‚Äêtwo percent of participants received at least 1 medication management encounter with 30% of encounters being delivered via interactive video. More than half of veterans (58.3%) received at least 1 session of psychotherapy. Only 12.1% received a session of therapy classified as an evidence‚Äêbased psychotherapy for PTSD. The vast majority of psychotherapy encounters were delivered in group format and only a small proportion were delivered via interactive video. CONCLUSIONS: Findings suggest that veterans diagnosed with PTSD who receive their mental health treatment in large and medium CBOCs are likely to receive medication management, and very few veterans received evidence‚Äêbased psychotherapy. There may be ways to increase access to evidence‚Äêbased psychotherapy by expanding the use of interactive video to connect specialty mental health providers with patients, hosted either in CBOCs or in home‚Äêbased care, and to offer more group‚Äêbased therapies. PURPOSE: Community‚ÄêBased Outpatient Clinics (CBOCs) provide primary‚Äêcare‚Äêbased mental health services to rural veterans who live long distances from Veterans Affairs (VA) hospitals. Characterizing the composition of usual care will highlight the need and potential strategies to improve access to and engagement in evidence‚Äêbased psychotherapy for posttraumatic stress disorder (PTSD)."," Grubbs, KM;  Fortney, JC;  Kimbrell, T;  Pyne, JM;  Hudson, T;  Robinson, D;  Moore, WM;  Custer, P;  Schneider, R;  Schnurr, PP",2017.0, 10.1111/jrh.12230,0,0,
1730, A randomized controlled trial of an educational programme with telephone reinforcement to improve perceived health status of Brazilian burn victims at 6-month post discharge," BACKGROUND: Self‐care post discharge is an important factor on quality of life of burn victims. Reinforcement of self‐care programme via telephone follow‐up might improve self‐efficacy and general health perception in burn victims. DESIGN: Randomized, controlled clinical trial. METHOD: From 2011‐2012, we randomized 108 burn victims either to an educational programme on self‐care tailored for burn victims according to the cognitive social theory and reinforcement by telephone every 4‐6 weeks for 6 months post discharge, or to the routine instructions given at discharge from the hospital. During hospitalization, at discharge, at 6 and 12 months post discharge, we collected data on socio‐demographic characteristics, Burns Specific Health Scale Revised (BSHS‐R), Perceived Self‐Efficacy Scale (PSE), Hospital Anxiety and Depression Scales (HADS) and Impact of the Event Scale (IES). We analysed data using t‐test, Chi‐square test and linear regression models. RESULTS: Groups were similar regarding clinical and demographic characteristics, except for age. At 6‐month follow‐up, there were no differences between the groups on BSHS‐R, PSE and HADS Depression, while the intervention group showed fewer symptoms of anxiety (HADS Anxiety) and lower IES scores than the control group. CONCLUSION: The educational programme, when compared with usual care, reduced anxiety symptoms and post‐traumatic stress. Educational programmes with telephone follow‐up might be a viable intervention to improve self‐care for burn victims. AIM: The aim of this study was to compare health status, self‐efficacy, symptoms of depression and anxiety and post‐traumatic stress between two groups of burn victims receiving information on self‐care through routine care or an educational programme with telephone reinforcement."," Gonçalves, N;  Ciol, MA;  Dantas, RA;  Farina Junior, JA;  Rossi, LA",2016.0, 10.1111/jan.13003,0,0,
1731,Markers for context-responsiveness: Client baseline interpersonal problems moderate the efficacy of two psychotherapies for generalized anxiety disorder.,"To follow-up a randomized clinical trial that compared the acute and long-term efficacy of 15 sessions of cognitive-behavioral therapy (CBT) versus CBT integrated with motivational interviewing (MI) for severe generalized anxiety disorder (GAD; Westra, Constantino, & Antony, 2016), we (a) characterized the sample's baseline interpersonal problems, and (b) analyzed the role of several theory-relevant problems as moderators of the comparative treatment effects on outcome. We first compared clients' (N = 85) baseline interpersonal problems profile to a general clinical sample. We next conducted piecewise, 2-level growth models to analyze the interactive effects of treatment condition and the hypothesized interpersonal problem indices of nonassertiveness (ranging from low to high), exploitability (ranging from low to high on this specific combination of nonassertiveness and friendliness), and overall agency (ranging from more problems of being too submissive to more problems of being too domineering, including friendly or hostile variants) on acute and follow-up worry reduction. Finally, we conducted hierarchical generalized linear models to examine these interactive effects on the likelihood of achieving clinically meaningful worry reduction across follow-up. As expected, the GAD clients evidenced more nonassertive and exploitable interpersonal problems than the general clinical sample. Also as predicted, clients with more problematic nonassertiveness and low overall agency in their relationships had greater follow-up worry reduction in MI-CBT versus CBT, including to a clinically significant degree for the agency by treatment interaction. GAD-specific interpersonal problems can serve as contextual markers for integrative treatment selection and planning. (PsycINFO Database Record",Gomez Penedo JM.; Constantino MJ.; Coyne AE.; Westra HA.; Antony MM.,2017.0,10.1037/ccp0000233,0,0,
1732,Genetic expression of arc and c-fos in the insular cortex is related with taste familiarity,"The taste neophobic response reflects the reluctance to ingest novel tastes in order to avoid negative consequences. Several studies have demonstrated the involvement of the insular cortex (IC) in the taste neophobic response (Lin et al., 2015; Lin and Reilly, 2012; Moraga- Amaro et al., 2014; Adaikkan and Rosenblum, 2015). Discriminating novel and familiar taste stimuli is very important for survival. Therefore, taste familiarity is memory-dependent. Consolidation of long-term memories requires De novo protein synthesis induced by the activation of immediate early genes that act asmessengers. Thus, the level of gene transcription is coupled with changes in the protein synthesis and neuronal activity. The main aim of the present research is to explore both the behavioral performance and the expression profile of different immediate-early transcription factors (arc, jun, c-fos, narp and zif-268) in the insular cortex after exposure to a saccharin solution (0.4%) during the first (novel), the second (familiar I) and the sixth presentation (familiar II). The period of six days was chosen in order to obtain a complete attenuation of taste neophobia. We have found increased expression of arc and c-fos gene 30 min in the familiar I after drinking a saccharin solution which was becoming familiar during the second presentation in comparison with the group Novel that received the first exposure. No changes in the expression of zif-268, jun and Narp genes were found. The results support a role of the insular cortex in the consolidation of taste memory which is mediated by the increased expression of Arc, jun and cfos during the swift from novelty to familiarity.",Gómez-Chacón B.; Gallo M.,2018.0,10.1007/s13105-018-0656-7,0,0,
1733,Veterans Group Exercise: A randomized pilot trial of an Integrative Exercise program for veterans with posttraumatic stress.,"Posttraumatic stress disorder (PTSD) is prevalent among military veterans and is associated with significant negative health outcomes. However, stigma and other barriers to care prevent many veterans from pursuing traditional mental health treatment. We developed a group-based Integrative Exercise (IE) program combining aerobic and resistance exercise, which is familiar to veterans, with mindfulness-based practices suited to veterans with PTSD. This study aimed to evaluate the effects of IE on PTSD symptom severity and quality of life, as well as assess the feasibility and acceptability of IE. Veterans (N = 47) were randomized to either IE or waitlist control (WL). Veterans in IE were asked to attend three 1-h group exercise sessions for 12 weeks. Compared with WL, veterans randomized to IE demonstrated a greater reduction in PTSD symptom severity (d = -.90), a greater improvement in psychological quality of life (d = .53) and a smaller relative improvement in physical quality of life (d = .30) Veterans' ratings of IE indicated high feasibility and acceptability. The sample was relatively small and recruited from one site. The comparison condition was an inactive control. This initial study suggests that IE is an innovative approach to treating veterans with symptoms of PTSD that reduces symptoms of posttraumatic stress and improves psychological quality of life. This approach to recovery may expand the reach of PTSD treatment into non-traditional settings and to veterans who may prefer a familiar activity, such as exercise, over medication or psychotherapy.",Goldstein LA.; Mehling WE.; Metzler TJ.; Cohen BE.; Barnes DE.; Choucroun GJ.; Silver A.; Talbot LS.; Maguen S.; Hlavin JA.; Chesney MA.; Neylan TC.,2018.0,10.1016/j.jad.2017.11.002,0,0,
1734,Twelve month follow-up on a randomised controlled trial of relaxation training for post-stroke anxiety.,"To follow up participants in a randomised controlled trial of relaxation training for anxiety after stroke at 12 months. Twelve month follow-up to a randomised controlled trial, in which the control group also received treatment. Community. Fifteen of twenty one original participants with post-stroke anxiety participated in a one year follow-up study. A self-help autogenic relaxation CD listened to five times a week for one month, immediately in the intervention group and after three months in the control group. Hospital Anxiety and Depression Scale-Anxiety subscale and the Telephone Interview of Cognitive Status for inclusion. Hospital Anxiety and Depression Scale-Anxiety subscale for outcome. All measures were administered by phone. Anxiety ratings reduced significantly between pre and post-intervention, and between pre-intervention and one year follow-up ( χ2(2) = 22.29, p < 0.001). Reductions in anxiety in stroke survivors who received a self-help autogenic relaxation CD appear to be maintained after one year.",Golding K.; Fife-Schaw C.; Kneebone I.,2017.0,10.1177/0269215516682820,0,0,
1735,"Trajectories of social anxiety, cognitive reappraisal, and mindfulness during an RCT of CBGT versus MBSR for social anxiety disorder.","Cognitive-Behavioral Group Therapy (CBGT) and Mindfulness-Based Stress Reduction (MBSR) are efficacious in treating social anxiety disorder (SAD). It is not yet clear, however, whether they share similar trajectories of change and underlying mechanisms in the context of SAD. This randomized controlled study of 108 unmedicated adults with generalized SAD investigated the impact of CBGT vs. MBSR on trajectories of social anxiety, cognitive reappraisal, and mindfulness during 12 weeks of treatment. CBGT and MBSR produced similar trajectories showing decreases in social anxiety and increases in reappraisal (changing the way of thinking) and mindfulness (mindful attitude). Compared to MBSR, CBGT produced greater increases in disputing anxious thoughts/feelings and reappraisal success. Compared to CBGT, MBSR produced greater acceptance of anxiety and acceptance success. Granger Causality analyses revealed that increases in weekly reappraisal and reappraisal success predicted subsequent decreases in weekly social anxiety during CBGT (but not MBSR), and that increases in weekly mindful attitude and disputing anxious thoughts/feelings predicted subsequent decreases in weekly social anxiety during MBSR (but not CBGT). This examination of temporal dynamics identified shared and distinct changes during CBGT and MBSR that both support and challenge current conceptualizations of these clinical interventions. CLINICALTRIALS. NCT02036658.",Goldin PR.; Morrison AS.; Jazaieri H.; Heimberg RG.; Gross JJ.,2017.0,10.1016/j.brat.2017.06.001,0,0,
1736,Predictors of differential PTSD treatment outcomes between veteran and civilian women after cognitive processing therapy.,"This study used data from a recent randomized clinical trial (RCT) that found differences between women veterans and civilians in posttraumatic stress disorder (PTSD) treatment response, with civilians demonstrating greater improvement than did veterans. Despite having similar PTSD severity scores at baseline, veterans scored roughly 18 points higher than civilians did on the Clinician-Administered PTSD Scale (CAPS) at posttreatment (p < .01). This study sought to identify the clinical and treatment variables that were associated with the differential response to treatment demonstrated by the women in the RCT. Veteran (n = 21) and civilian (n = 105) women with PTSD received cognitive processing therapy (CPT) for PTSD. These secondary data analyses used structural equation modeling to investigate the role of 7 clinical and treatment variables to explain the reduced treatment response to CPT in veterans compared to civilians. Using structural equation modeling, we found that differences in CAPS scores at posttreatment were largely mediated by negative posttraumatic cognitions, as measured by the Posttraumatic Cognition Inventory (PTCI). Although veterans and civilians had similar PTCI scores at baseline, civilians had significantly lower PTCI scores at posttreatment, which predicted lower CAPS scores at posttreatment. This mediation appeared to be at least in part explained by lower treatment expectancies by veterans compared to civilians. Future research should be focused on further understanding and addressing these 2 treatment outcome predictors in an effort to reduce the gap in PTSD treatment outcomes between veterans and civilians. (PsycINFO Database Record",Gobin RL.; Mackintosh MA.; Willis E.; Allard CB.; Kloezeman K.; Morland LA.,2018.0,10.1037/tra0000266,0,0,
1737,Enhanced discrimination between threatening and safe contexts in high-anxious individuals,"Trait anxiety, a stable personality trait associated with increased fear responses to threat, is regarded as a risk factor for the development and maintenance of anxiety disorders. Although the effect of trait anxiety has been examined with regard to explicit threat cues, little is known about the effect of trait anxiety on contextual threat learning. To assess this issue, extreme groups of low and high trait anxiety underwent a contextual fear conditioning protocol using virtual reality. Two virtual office rooms served as the conditioned contexts. One virtual office room (CXT+) was paired with unpredictable electrical stimuli. In the other virtual office room, no electrical stimuli were delivered (CXT-). High-anxious participants tended to show faster acquisition of startle potentiation in the CXT+ versus the CXT- than low-anxious participants. This enhanced contextual fear learning might function as a risk factor for anxiety disorders that are characterized by sustained anxiety. © 2013 Elsevier B.V.",Glotzbach-Schoon E.; Tadda R.; Andreatta M.; Tröger C.; Ewald H.; Grillon C.; Pauli P.; Mühlberger A.,2013.0,10.1016/j.biopsycho.2013.01.011,0,0,
1738, Mediators of Outcome in Complicated Grief Treatment," OBJECTIVE: In this study, we examined the mechanisms of action of complicated grief treatment (CGT), an efficacious psychotherapy for complicated grief. METHOD: We explored 3 putative mediators (guilt/self‚Äêblame related to the deceased, negative thoughts about the future, and avoidance) among treatment completers assigned to either CGT (n = 35) or interpersonal psychotherapy (n = 34) in a previously reported randomized controlled trial. Antidepressant use was examined as a moderator of mediation effects. RESULTS: A reduction in guilt/self‚Äêblame, negative thoughts about the future, and avoidance behavior each mediated the relationship between treatment group and complicated grief outcomes. Reduction in avoidance emerged as an independent mediator after controlling for all mediators. CONCLUSION: Reducing avoidance of situations and emotions connected to the loss seems to be a key mechanism of change in CGT. Revising counterfactual thinking around troubling aspects of the death may also play a role in facilitating effective adaptation to loss."," Glickman, K;  Shear, MK;  Wall, MM",2017.0, 10.1002/jclp.22384,0,0,
1739," Social Anxiety and Biased Recall of Positive Information: it's Not the Content, It's the Valence"," Cognitive theorists hypothesize that individuals with social anxiety are prone to memory biases such that event recall becomes more negative over time. With few exceptions, studies have focused primarily on changes in negative self‚Äêjudgments. The current study examined whether memory for positive social events is also subject to recall bias. Undergraduate participants (N = 138) engaged in an unexpected public speaking task and received standardized positive or neutral feedback on their performance. They rated their memory of the received feedback following a 5‚Äêminute delay and again 1 week later. Results revealed that higher scores on social anxiety symptoms predicted significant reductions in the recalled valence of positive feedback over time, whereas no changes were observed for neutral feedback. The results suggest that social anxiety may lead to erosion in memory of positive events."," Glazier, BL;  Alden, LE",2017.0, 10.1016/j.beth.2016.08.001,0,0,
1740,The Effects of a Brief Acceptance-Based Behavioral Treatment Versus Traditional Cognitive-Behavioral Treatment for Public Speaking Anxiety: An Exploratory Trial Examining Differential Effects on Performance and Neurophysiology.,"Individuals with public speaking anxiety (PSA) experience fear and avoidance that can cause extreme distress, impaired speaking performance, and associated problems in psychosocial functioning. Most extant interventions for PSA emphasize anxiety reduction rather than enhancing behavioral performance. We compared the efficacy of two brief cognitive-behavioral interventions, a traditional cognitive-behavior treatment (tCBT) and an acceptance-based behavior treatment (ABBT), on public speaking performance and anxiety in a clinical sample of persons with PSA. The effects of treatment on prefrontal brain activation were also examined. Participants (n = 21) were randomized to 90 min of an ABBT or a tCBT intervention. Assessments took place at pre- and post-treatment and included self-rated anxiety and observer-rated performance measures, a behavioral assessment, and prefrontal cortical activity measurements using functional near-infrared spectroscopy (fNIRS). Exploratory results indicated that participants in the ABBT condition experienced greater improvements in observer-rated performance relative to those in the tCBT condition, while those in the tCBT condition experienced greater reductions in subjective anxiety levels. Individuals in the ABBT condition also exhibited a trend toward greater treatment-related reductions in blood volume in the left dorsolateral prefrontal cortex relative to those who received tCBT. Overall, these findings preliminarily suggest that acceptance-based treatments may free more cognitive resources in comparison with tCBT, possibly resulting in greater improvements in objectively rated behavioral performances for ABBT interventions.",Glassman LH.; Forman EM.; Herbert JD.; Bradley LE.; Foster EE.; Izzetoglu M.; Ruocco AC.,2016.0,10.1177/0145445516629939,0,0,
1741,The longitudinal impact of an internet safety decision aid for abused women.,"Introduction: Women experiencing intimate partner violence (IPV) navigate complex, dangerous decisions. Tailored safety information and safety planning, typically provided by domestic violence service providers, can prevent repeat IPV exposure and associated adverse health outcomes; however, few abused women access these services. The Internet represents a potentially innovative way to connect abused women with tailored safety planning resources and information. The purpose of this study was to compare safety and mental health outcomes at baseline, 6 months, and 12 months among abused women randomized to: (1) a tailored, Internet-based safety decision aid; or (2) control website (typical safety information available online). Design: Multistate, community-based longitudinal RCT with one-to-one allocation ratio and blocked randomization. Data were collected March 2011-May 2013 and analyzed June-July 2015. Setting/participants: Currently abused Spanish- or English-speaking women (N = 720). Intervention: A tailored Internet-based safety decision aid included priority-setting activities, risk assessment, and tailored feedback and safety plans. A control website offered typical safety information available online. Main outcome measures: Primary outcomes were decisional conflict, safety behaviors, and repeat IPV; secondary outcomes included depression and post-traumatic stress disorder. Results: At 12 months, there were no significant group differences in IPV, depression, or post-traumatic stress disorder. Intervention women experienced significantly less decisional conflict after one use (beta = -2.68, p = 0.042) and greater increase in safety behaviors they rated as helpful from baseline to 12 months (12% vs 9%, p = 0.033) and were more likely to have left the abuser (63% vs 53%, p = 0.008). Women who left had higher baseline risk (14.9 vs 13.1, p = 0.003) found more of the safety behaviors they tried helpful (61.1% vs 47.5%, p < 0.001), and had greater reductions in psychological IPV ((11.69 vs 7.5, p = 0.001) and sexual IPV (2.41 vs 1.25, p = 0.001) than women who stayed. Conclusions: Internet-based safety planning represents a promising tool to reduce the public health impact of IPV. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Glass, Nancy E; Perrin, Nancy A; Hanson, Ginger C; Bloom, Tina L; Messing, Jill T; Clough, Amber S; Campbell, Jacquelyn C; Gielen, Andrea C; Case, James; Eden, Karen B",2017.0,,0,0,
1742,The epigenetic regulation of GATA4-dependent brain natriuretic peptide expression during alcohol withdrawal.,"Objective: Natriuretic peptides participate in the collection of metabolic effects during alcohol withdrawal. Having witnessed modulation of other natriuretic peptides in alcohol-dependent patients during alcohol withdrawal, we were interested in the relation of brain natriuretic peptide (BNP) methylation with protein expression and craving in this longitudinal study. Methods: Ninety-nine male patients were compared to 101 healthy controls concerning epigenetic regulation and protein expression during detoxification treatment. Results: With BNP expression being GATA4 dependent, we observed a correlation of GATA4 binding site methylation and protein expression. BNP serum levels and Obsessive Compulsive Drinking Scale scores are significantly decreased during withdrawal. Focusing on the two CpGs that are between GATA transcription factor binding sites, statistical analysis revealed a reversely proportional methylation pattern, significantly increasing with ongoing detoxification and thereby supporting the observed serum levelc changes. Conclusion: Without the functional knowledge about regulation of BNP expression via the GATA transcription factor, it would have been easy to take the mean results of the global CpG data and propose a direct relationship between methylation and expression. Thus, these findings are a voice for functionally and mechanistically approved results. There was no causal relationship between protein expression levels and epigenetic changes. Further research is needed which includes protein expression and other approaches. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Glahn, Alexander; Rhein, Mathias; Heberlein, Annemarie; Muschler, Marc; Kornhuber, Johannes; Frieling, Helge; Bleich, Stefan; Hillemacher, Thomas",2017.0,http://dx.doi.org/10.1159/000456011,0,0,
1743,How to deal with negative thoughts? A preliminary comparison of detached mindfulness and thought evaluation in socially anxious individuals.,"This study compared two techniques, detached mindfulness (DM) and thought evaluation (TE), for dealing with negative thoughts that are drawn from different treatment modalities. Twelve participants with high social anxiety practised each technique in a cross-over repeated measures design before giving a speech. It was predicted that each technique would be advantageous, but that DM would be superior to TE overall. Results showed that both techniques improved anxiety scores. DM led to reductions in the observer-perspective, negative beliefs, and anticipatory processing as well. The overall change attributed to DM was greater than that attributed to TE. The results also suggested that combining these techniques in certain ways might prove disadvantageous. Results are discussed in terms of the potential clinical implications. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gkika, Styliani; Wells, Adrian",2015.0,http://dx.doi.org/10.1007/s10608-014-9637-5,0,0,
1744, Cognitive training in Alzheimer's disease: a controlled randomized study," This controlled randomized single‚Äêblind study evaluated the effects of cognitive training (CT), compared to active music therapy (AMT) and neuroeducation (NE), on initiative in patients with mild to moderate Alzheimer's disease (AD). Secondarily, we explored the effects of CT on episodic memory, mood, and social relationships. Thirty‚Äênine AD patients were randomly assigned to CT, AMT, or NE. Each treatment lasted 3 months. Before, at the end, and 3 months after treatment, neuropsychological tests and self‚Äêrated scales assessed initiative, episodic memory, depression, anxiety, and social relationships. At the end of the CT, initiative significantly improved, whereas, at the end of AMT and NE, it was unchanged. Episodic memory showed no changes at the end of CT or AMT and a worsening after NE. The rates of the patients with clinically significant improvement of initiative were greater after CT (about 62%) than after AMT (about 8%) or NE (none). At the 3‚Äêmonth follow‚Äêup, initiative and episodic memory declined in all patients. Mood and social relationships improved in the three groups, with greater changes after AMT or NE. In patients with mild to moderate AD, CT can improve initiative and stabilize memory, while the non‚Äêcognitive treatments can ameliorate the psychosocial aspects. The combining of CT and non‚Äêcognitive treatments may have useful clinical implications."," Giovagnoli, AR;  Manfredi, V;  Parente, A;  Schifano, L;  Oliveri, S;  Avanzini, G",2017.0, 10.1007/s10072-017-3003-9,0,0,
1745, Remission after acute treatment in children and adolescents with anxiety disorders: findings from the CAMS," OBJECTIVE: To report on remission rates in anxious youth who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS). The CAMS, a multisite clinical trial, randomized 488 children and adolescents (ages 7‚Äê17 years; 79% Caucasian; 50% female) with separation, social, and/or generalized anxiety disorder to a 12‚Äêweek treatment of sertraline (SRT), cognitive behavioral therapy (CBT), their combination (COMB), or clinical management with pill placebo (PBO). METHOD: The primary definition of remission was loss of all study‚Äêentry anxiety disorder diagnoses; additional definitions of remission were used. All outcomes were rated by independent evaluators blind to treatment assignment. Predictors of remission were also examined. RESULTS: Remission rates after 12 weeks of treatment ranged from 46% to 68% for COMB, 34% to 46% for SRT, 20% to 46% for CBT, and 15% to 27% for PBO. Rates of remission (i.e., achieving a nearly symptom‚Äêfree state) were significantly lower than rates of response (i.e., achieving a clinically meaningful improvement relative to baseline) for the entire sample. Youth who received COMB had significantly higher rates of remission compared to all other treatment groups. Both monotherapies had higher remission rates compared to PBO, but rates were not different from each other. Predictors of remission were younger age, nonminority status, lower baseline anxiety severity, absence of other internalizing disorders (e.g., anxiety, depression), and absence of social phobia. CONCLUSIONS: For the majority of children, some symptoms of anxiety persisted, even among those showing improvement after 12 weeks of treatment, suggesting a need to augment or extend current treatments for some children."," Ginsburg, GS;  Kendall, PC;  Sakolsky, D;  Compton, SN;  Piacentini, J;  Albano, AM;  Walkup, JT;  Sherrill, J;  Coffey, KA;  Rynn, MA;  et al.",2011.0, 10.1037/a0025933,0,0,
1746, Combining escitalopram and cognitive-behavioural therapy for social anxiety disorder: randomised controlled fMRI trial," AIMS: To evaluate whether adding escitalopram to internet‐delivered CBT (ICBT) improves clinical outcome and alters brain reactivity and connectivity in SAD. METHOD: Double‐blind, randomised, placebo‐controlled neuroimaging trial of ICBT combined either with escitalopram (n = 24) or placebo (n = 24), including a 15‐month clinical follow‐up (trial registration: ISRCTN24929928). RESULTS: Escitalopram+ICBT, relative to placebo+ICBT, resulted in significantly more clinical responders, larger reductions in anticipatory speech state anxiety at post‐treatment and larger reductions in social anxiety symptom severity at 15‐month follow‐up and at a trend‐level (P = 0.09) at post‐treatment. Right amygdala reactivity to emotional faces also decreased more in the escitalopram+ICBT combination relative to placebo+ICBT, and in treatment responders relative to non‐responders. CONCLUSIONS: Adding escitalopram improves the outcome of ICBT for SAD and decreased amygdala reactivity is important for anxiolytic treatment response. BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) and cognitive‐behavioural therapy (CBT) are often used concomitantly to treat social anxiety disorder (SAD), but few studies have examined the effect of this combination."," Gingnell, M;  Frick, A;  Engman, J;  Alaie, I;  Björkstrand, J;  Faria, V;  Carlbring, P;  Andersson, G;  Reis, M;  Larsson, EM;  et al.",2016.0, 10.1192/bjp.bp.115.175794,0,0,
1747, The SITLESS project: exercise referral schemes enhanced by self-management strategies to battle sedentary behaviour in older adults: study protocol for a randomised controlled trial," BACKGROUND: Older adults are the fastest growing segment of the world's population. Recent evidence indicates that excessive sitting time is harmful to health, independent of meeting the recommended moderate to vigorous physical activity (PA) guidelines. The SITLESS project aims to determine whether exercise referral schemes (ERS) can be enhanced by self‐management strategies (SMSs) to reduce sedentary behaviour (SB), increase PA and improve health, quality of life and function in the long term, as well as psychosocial outcomes in community‐dwelling older European citizens from four countries, within a three‐armed pragmatic randomised controlled trial, compared with ERS alone and also with general recommendations about PA. METHODS: A total of 1338 older adults will be included in this study, recruited from four European countries through different existing primary prevention pathways. Participants will be randomly allocated into an ERS of 16 weeks (32 sessions, 45‐60 min per session), ERS enhanced by seven sessions of SMSs and four telephone prompts, or a control group. Outcomes will be assessed at baseline, month 4 (end of ERS intervention), month 16 (12 months post intervention) and month 22 (18 months post intervention). Primary outcomes will include measures of SB (time spent sedentary) and PA (counts per minute). Secondary outcomes will include muscle and physical function, health economics' related outcomes, anthropometry, quality of life, social networks, anxiety and depressive symptoms, disability, fear of falling, executive function and fatigue. A process evaluation will be conducted throughout the trial. The full analysis set will follow an intention‐to‐treat principle and will include all randomised participants for whom a baseline assessment is conducted. The study hypothesis will be tested with mixed linear models with repeated measures, to assess changes in the main outcomes (SB and PA) over time (baseline to month 22) and between study arms. DISCUSSION: The findings of this study may help inform the design and implementation of more effective interventions to reduce SB and increase PA levels, and hence improve long‐term health outcomes in the older adult population. SITLESS aims to support policy‐makers in deciding how or whether ERS should be further implemented or restructured in order to increase its adherence, impact and cost‐effectiveness. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02629666 . Registered 19 November 2015."," Giné-Garriga, M;  Coll-Planas, L;  Guerra, M;  Domingo, À;  Roqué, M;  Caserotti, P;  Denkinger, M;  Rothenbacher, D;  Tully, MA;  Kee, F;  et al.",2017.0, 10.1186/s13063-017-1956-x,0,0,
1748,Effects of tryptophan depletion on selective serotonin reuptake inhibitor-remitted patients with obsessive compulsive disorder.,"Background: Serotonergic antidepressants are first-line medication therapies for obsessive-compulsive disorder, however it is not known if synaptic serotonin availability is important for selective serotonin reuptake inhibitor efficacy. The present study tested the hypothesis that temporary reduction in central serotonin transmission, through acute tryptophan depletion, would result in an increase in anxiety in selective serotonin reuptake inhibitor-remitted obsessive-compulsive disorder patients. Methods: Eight patients (four males) with obsessive-compulsive disorder who showed sustained clinical improvement with selective serotonin reuptake inhibitor treatment underwent acute tryptophan depletion in a randomized, double-blind, placebo-controlled, within-subjects design, over two days one week apart. Five hours after consumption of the depleting/sham drink the participants performed a personalized obsessive-compulsive disorder symptom exposure task. Psychological responses were measured using the Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and Visual Analogue Scales. Results: Free plasma tryptophan to large neutral amino acid ratio decreased by 93% on the depletion day and decreased by 1% on the sham day, as anticipated. Psychological rating scores as measured by Visual Analogue Scale showed a significant decrease in perceived control and increase in interfering thoughts at the time of provocation on the depletion day but not on the sham day. A measure of convergent validity, namely Visual Analogue Scale Similar to past, was significantly higher at the time of provocation on both the depletion and sham days. Both the depletion and time of provocation scores for Visual Analogue Scale Anxiety, Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and blood pressure were not significant. Conclusions: Acute tryptophan depletion caused a significant decrease in perceived control and increase in interfering thoughts at the time of provocation. Acute tryptophan depletion had no effect on the Spielberger State Anxiety Inventory or Visual Analogue Scale Anxiety measures, which suggests that the mechanism of action of selective serotonin reuptake inhibitors may be different to that seen in panic, social anxiety and post-traumatic stress disorder. Successful selective serotonin reuptake inhibitor treatment of obsessive-compulsive disorder may involve the ability of serotonin to switch habitual responding to goal-directed behaviour. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Hood, Sean D; Broyd, Annabel; Robinson, Hayley; Lee, Jessica; Hudaib, Abdul-Rahman; Hince, Dana A",2017.0,http://dx.doi.org/10.1177/0269881117736916,0,0,
1749,Eye movement attenuation of intrusive social anxiety imagery: A pilot study,,Homer S.R.; Deeprose C.,2018.0,10.1016/j.jbtep.2017.11.003,0,0,
1750,Prazosin during threat discrimination boosts memory of the safe stimulus,"The α-1 adrenoreceptor antagonist prazosin has shown promise in the treatment of post-traumatic stress disorder (PTSD) symptoms, but its mechanisms are not well understood. Here we administered prazosin or placebo prior to threat conditioning (day 1) and tested subsequent extinction (day 2) and reextinction (day 3) in healthy human participants. Prazosin did not affect threat conditioning but augmented stimulus discrimination during extinction and reextinction, via lower responding to the safe stimulus. These results suggest that prazosin during threat acquisition may have influenced encoding or consolidation of safety processing in particular, subsequently leading to enhanced discrimination between the safe and threatening stimuli.",Homan P.; Lin Q.; Murrough J.W.; Soleimani L.; Bach D.R.; Clem R.L.; Schiller D.,2017.0,10.1101/lm.045898.117,0,0,
1751,Depressive symptoms mediate the relationship between changes in emotion regulation during treatment and abstinence among women with alcohol use disorders.,"Women with alcohol use disorders (AUD) experience high rates of co-occurring conditions, such as depression and posttraumatic stress disorder (PTSD), which can complicate treatment engagement and response. Therefore, identifying factors that underlie alcohol use, depression, and PTSD symptoms in women with AUD has important treatment implications. The current study investigated emotion regulation as one such underlying factor. We tested a model that examined the extent to which changes in emotion regulation during treatment predicted women's depression and PTSD symptom severity at treatment completion and subsequent alcohol use following treatment. The study included 48 participants enrolled in a randomized controlled trial of interpersonal psychotherapy versus usual care for women with co-occurring alcohol dependence and major depression. Assessments were conducted at baseline, posttreatment (16 weeks), and follow-up (24 weeks). Descriptive statistics of baseline data revealed heightened levels of emotion dysregulation in this sample, which were related to fewer days abstinent from alcohol, more negative consequences from alcohol, and greater PTSD symptom severity. Women's lower depressive symptoms at the end of treatment were found to mediate the relationship between improved emotion regulation during the treatment period and greater abstinence following treatment. Posttreatment PTSD symptoms, however, were not found to mediate that relationship. These results suggest that improvements in depressive symptoms during treatment are associated with emotion regulation at the end of treatment, which may contribute to greater abstinence from alcohol following treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Holzhauer, Cathryn Glanton; Gamble, Stephanie A",2017.0,http://dx.doi.org/10.1037/adb0000274,0,0,
1752,Moderators of sudden gains after sessions addressing emotion regulation among women in treatment for alcohol use.,"Sudden gains (SGs) are defined as abrupt and significant improvements in mental health symptoms that occur between two psychotherapy sessions. Preliminary evidence suggests that SGs may be an important pattern of symptom reduction in the treatment of alcohol use disorder (AUD) (i.e., a steep between-session reduction in drinking or alcohol craving frequency or intensity) (Drapkin, Epstein, McCrady, & Eddie, 2015). The current study examined SGs within two randomized clinical trials (RCTs) testing female-specific cognitive behavior therapy (CBT) protocol for AUD (n = 146). We tested a priori hypotheses about whether women's baseline depression, anxiety, and confidence to be abstinent while in a negative emotional state would predict attainment of SGs after attending sessions that addressed depression, anxiety, and emotion regulation (i.e., sessions five and six of the 12-session protocol). Data were collected at baseline, within treatment, and 15 months after baseline. Results showed that women with high levels of depression and/or anxiety and low confidence to be abstinent in a negative emotional state at baseline were more likely to experience a SG (steep decrease in drinking) after sessions five and six (p = 0.02). Further, among women with high levels of depression and/or anxiety at baseline, those who experienced both a SG in drinking after session five/six and had higher confidence to remain abstinent in a negative emotional state at the end of treatment reported lower drinking frequency at 9- but not 15-month follow-up [95% CI = (-2.65, -0.86)]. Findings support the value of providing interventions targeting mood and emotion regulation in AUD treatment for women. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Holzhauer, Cathryn Glanton; Epstein, Elizabeth E; Hayaki, Jumi; Marinchak, James S; McCrady, Barbara S; Cook, Sharon M",2017.0,http://dx.doi.org/10.1016/j.jsat.2017.09.014,0,0,
1753, Development and Validation of the Behavioral Avoidance Test-Back Pain (BAT-Back) for Patients With Chronic Low Back Pain," MATERIALS AND METHODS: The BAT‐Back was administered to a group of CLBP patients (N=97) and pain‐free controls (N=31). Furthermore, pain, pain‐related fear, disability, catastrophizing, and avoidance behavior were measured using self‐report instruments. Reliability was assessed with intraclass correlation coefficient and Cronbach α. Validity was assessed by examining correlation and regression analysis. RESULTS: The intraclass correlation coefficient for the BAT‐Back avoidance score was r=0.76. Internal consistency was α=0.95. CLBP patients and controls differed significantly on BAT‐Back avoidance scores as well as self‐report measures. BAT‐Back avoidance scores were significantly correlated with scores on each of the self‐report measures (rs=0.27 to 0.54). They were not significantly correlated with general anxiety and depression, age, body mass index, and pain duration. The BAT‐Back avoidance score was able to capture unique variance in disability after controlling for other variables (eg, pain intensity and pain‐related fear). DISCUSSION: Results indicate that the BAT‐Back is a reliable and valid measure of pain‐related avoidance behavior. It may be useful for clinicians in tailoring treatments for chronic pain as well as an outcome measure for exposure treatments. OBJECTIVES: Pain‐related fear and avoidance of physical activities are central elements of the fear‐avoidance model of musculoskeletal pain. Pain‐related fear has typically been measured by self‐report instruments. In this study, we developed and validated a Behavioral Avoidance Test (BAT) for chronic low back pain (CLBP) patients with the aim of assessing pain‐related avoidance behavior by direct observation."," Holzapfel, S;  Riecke, J;  Rief, W;  Schneider, J;  Glombiewski, JA",2016.0, 10.1097/AJP.0000000000000349,0,0,
1754,Posttraumatic growth among head and neck cancer survivors with psychological distress.,"Background: Information on posttraumatic growth (PTG) among head and neck cancer (HNC) survivors with a high level of distress is limited. The aim of this cross-sectional study was to investigate the occurrence of PTG among distressed HNC survivors and its association with anxiety, depressive, nicotine, and alcohol use disorders and health-related quality of life. Methods: Seventy-four HNC survivors with psychological distress (Hospital Anxiety and Depression Scale (HADS) anxiety > 7 and/or HADS depression > 7) completed the Posttraumatic Growth Inventory, which comprises five subscales: relating to others, new possibilities, personal strength, spiritual change, and appreciation of life, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Anxiety, depressive, nicotine, and alcohol use disorders were measured using the Composite International Diagnostic Interview. Results: Moderate to high Posttraumatic Growth Inventory (PTGI) scores occurred in 10% of the HNC survivors with distress. The mean total PTGI score was 30.8 (SD = 19.7), with the highest mean score on the subscale relating to others. A multivariate regression model consisting of tumor stage, anxiety disorder, alcohol use disorder, and social functioning predicted total PTGI score best (F(4, 64) = 7.565, p < .000, R2 = .321). Conclusions: The presence of PTG in this population of distressed HNC survivors was low. PTG occurred most in the domain of relating to others. Among distressed HNC survivors, higher PTG was associated with lower tumor stage, absence of an anxiety disorder, absence of an alcohol use disorder, and better social functioning. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Holtmaat, K; Spek, N; Cuijpers, P; Leemans, C. R; Verdonck-de Leeuw, I. M",2017.0,http://dx.doi.org/10.1002/pon.4106,0,0,
1755,Decreases in suicide cognitions after cognitive processing therapy among veterans with posttraumatic stress disorder due to military sexual trauma: A preliminary examination.,"Posttraumatic stress disorder (PTSD) is associated with suicidal ideation (SI) and suicidal self-directed violence (SDV). Military sexual trauma (MST) is a common precursor to PTSD among veterans. Survivors of MST are more likely to be diagnosed with PTSD and are at greater risk for SI than survivors of other forms of trauma. Suicide-specific beliefs (e.g., unlovability, unbearability, unsolvability) have been shown to be strong predictors of SI and future suicidal SDV. Suicide-specific beliefs were examined over the course of treatment and follow-up in 32 veterans (23 women, 9 men) who received cognitive processing therapy (CPT) for MST-related PTSD. Hierarchical linear models revealed that veterans who received CPT had significant reductions in suicide-specific cognitions regarding unbearability, unlovability, and unsolvability. These preliminary findings warrant replication in a randomized controlled trial with a larger sample that includes participants with more acute suicidal intent. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Holliday, Ryan; Holder, Nicholas; Monteith, Lindsey L; Suris, Alina",2018.0,,0,0,
1756,Reductions in self-blame cognitions predict PTSD improvements with cognitive processing therapy for military sexual trauma-related PTSD.,"Reductions in trauma-related negative cognitions during Cognitive Processing Therapy (CPT) are theorized to precede posttraumatic stress disorder (PTSD) symptom reduction. This mechanism of change has not been validated for veterans with military sexual trauma-related PTSD. Using data from a previously published randomized clinical trial (n = 32), changes in trauma-related negative cognitions about self, self-blame, and the world were entered as predictors of change in PTSD symptoms for cross-lagged panel analyses. From baseline to 6-months posttreatment, only changes in self-blame predicted and temporally preceded changes in PTSD symptoms, highlighting a potential mechanism of change in CPT for military sexual trauma-related PTSD.",Holliday R.; Holder N.; Surís A.,2018.0,10.1016/j.psychres.2018.03.007,0,0,
1757,A preliminary examination of the role of psychotherapist fidelity on outcomes of cognitive processing therapy during an RCT for military sexual trauma-related PTSD.,"While cognitive processing therapy (CPT) is an effective evidence-based treatment for many veterans with military-related post-traumatic stress disorder (PTSD), not all veterans experience therapeutic benefit. To account for the discrepancy in outcomes, researchers have investigated patient- and research design-related factors; however, therapist factors (e.g. fidelity) have received less attention. The present study is a preliminary examination of the effect of psychotherapists' fidelity during CPT on clinical outcomes during a randomized clinical trial (RCT) for military sexual trauma-related PTSD. PTSD symptoms, trauma-related negative cognitions (NCs), and depression symptoms were assessed for 72 participants at baseline, and 1-week, 2-month, 4-month, and 6-month posttreatment. Of the four CPT therapists, two were found to have significantly poorer (i.e. ""below average"") treatment fidelity scores compared to the other two therapists who had ""good"" treatment fidelity scores. To examine possible therapist effects on outcomes, hierarchical linear modeling was utilized with therapist fidelity entered as a Level 2 predictor. Participants treated by a therapist with ""good"" treatment fidelity experienced significantly greater reductions in PTSD symptoms, NCs, and depression symptoms than patients treated by a therapist with ""below average"" treatment fidelity. Our preliminary findings highlight the importance of monitoring, maintaining, and reporting fidelity in psychotherapy treatment RCTs.",Holder N.; Holliday R.; Williams R.; Mullen K.; Surís A.,2018.0,10.1080/16506073.2017.1357750,0,0,
1758,The effect of mindfulness meditation training on biological acute stress responses in generalized anxiety disorder.,"Mindfulness-Based interventions have increased in popularity in psychiatry, but the impact of these treatments on disorder-relevant biomarkers would greatly enhance efficacy and mechanistic evidence. If Generalized Anxiety Disorder (GAD) is successfully treated, relevant biomarkers should change, supporting the impact of treatment and suggesting improved resilience to stress. Seventy adults with GAD were randomized to receive either Mindfulness-Based Stress Reduction (MBSR) or an attention control class; before and after, they underwent the Trier Social Stress Test (TSST). Area-Under-the-Curve (AUC) concentrations were calculated for adrenocorticotropic hormone (ACTH) and pro-inflammatory cytokines. MBSR participants had a significantly greater reduction in ACTH AUC compared to control participants. Similarly, the MBSR group had a greater reduction in inflammatory cytokines' AUC concentrations. We found larger reductions in stress markers for patients with GAD in the MBSR class compared to control; this provides the first combined hormonal and immunological evidence that MBSR may enhance resilience to stress.",Hoge EA.; Bui E.; Palitz SA.; Schwarz NR.; Owens ME.; Johnston JM.; Pollack MH.; Simon NM.,2018.0,10.1016/j.psychres.2017.01.006,0,0,
1759,"No Effects of D-Cycloserine Enhancement in Exposure With Response Prevention Therapy in Panic Disorder With Agoraphobia: A Double-Blind, Randomized Controlled Trial.","D-cycloserine (DCS) is a partial N-methyl-D-aspartate receptor agonist that potentially augments response to exposure therapy in anxiety disorders by enhancing extinction learning. This randomized, double-blinded, placebo-controlled augmentation trial examined (1) the effectiveness of adding 125 mg of DCS to exposure therapy (before or directly after the first 6 treatment sessions) in patients with panic disorder with agoraphobia and (2) the effectiveness of DCS augmentation preceding exposure relative to DCS augmentation directly postexposure. Fifty-seven patients were allocated to 1 of 3 medication conditions (placebo and pre-exposure and postexposure DCS) as an addition to 6 exposure sessions within a 12-session exposure and response prevention protocol. The primary outcome measure was the mean score on the ""alone"" subscale of the Mobility Inventory (MI). No differences were found in treatment outcome between DCS and placebo, administered either pre-exposure or postexposure therapy, although at 3-month follow-up, the DCS postexposure group compared with DCS pre-exposure, exhibited greater symptom reduction on the MI-alone subscale. Ancillary analyses in specific subgroups (responders vs nonresponders, early vs late responders, severely vs mildly affected patients) did not reveal any between-group DCS versus placebo differences. Finally, the study did not find an effect of DCS relative to placebo to be specific for successful exposure sessions. This study does not find an effect of augmentation with DCS in patients with severe panic disorder and agoraphobia administered either pretreatment or directly posttreatment sessions. Moreover, no preferential effects are revealed in specific subgroups nor in successful exposure sessions. Yet, a small effect of DCS administration postexposure therapy cannot be ruled out, given the relatively small sample size of this study.",Hofmeijer-Sevink MK.; Duits P.; Rijkeboer MM.; Hoogendoorn AW.; van Megen HJ.; Vulink NC.; Denys DA.; van den Hout MA.; van Balkom AJ.; Cath DC.,2017.0,10.1097/JCP.0000000000000757,0,0,
1760,Social self-reappraisal therapy for social phobia: Preliminary findings.,"The recent psychopathology literature suggests that individuals with social phobia overestimate social standards and are deficient in setting and attaining social goals, have a negative perception of themselves as social objects, and show heightened self-focused attention when confronted with social threat. They further overestimate the potential cost of a social encounter, experience their anxiety as uncontrollable and visible to others, view their social skills as inadequate, rely on safety behaviors and avoidance strategies to control their anxiety, and engage in post-event rumination. Traditional cognitive-behavioral therapy does not adequately address all of these features of social phobia during treatment. We discuss here an enhanced version of cognitive-behavioral treatment for social phobia, which is expressly designed to address these factors. The results of an uncontrolled pilot study suggest that this new treatment may be more effective than traditional cognitive-behavioral therapy for social phobia. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Hofmann, Stefan G; Scepkowski, Lisa A",2006.0,http://dx.doi.org/10.1891/jcop.20.1.45,0,0,
1761,Assessing bodily preoccupations is sufficient: Clinically effective screening for hypochondriasis.,"Objective: Hypochondriasis is a persistent psychiatric disorder and is associated with increased utilisation of health care services. However, effective psychiatric consultation interventions and CBT treatments are available. In the present study, we provide evidence of clinically effective screening for hypochondriasis. We describe the clinically effective identification of patients with a high probability of suffering from hypochondriasis. This identification is achieved by means of two brief standardised screening instruments, namely the Bodily Preoccupation (BP) Scale with 3 items and the Whiteley-7 (WI-7) with 7 items. Methods: Both the BP scale and the WI-7 were examined in a sample of 228 participants (72 with hypochondriasis, 80 with anxiety disorders and 76 healthy controls) in a large psychotherapy outpatients' unit, applying the DSM-IV criteria. Cut-off values for the BP scale and the WI-7 were computed to identify patients with a high probability of suffering from hypochondriasis. Additionally, other self-report symptom severity scales were completed in order to examine discriminant and convergent validity. Data was collected from June 2010 to March 2013. Results: The BP scale and the WI-7 discriminated significantly between patients with hypochondriasis and those with an anxiety disorder (d = 2.42 and d = 2.34). Cut-off values for these two screening scales could be provided, thus identifying patients with a high probability of suffering from hypochondriasis. Conclusions: In order to reduce costs, the BP scale or the WI-7 should be applied in medical or primary care settings, to screen for patients with a high probability of hypochondriasis and to transfer them to further assessment and effective treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hofling, Volkmar; Weck, Florian",2013.0,http://dx.doi.org/10.1016/j.jpsychores.2013.10.011,0,0,
1762,Internet-based grief therapy for bereaved individuals after loss due to Haematological cancer: study protocol of a randomized controlled trial.,"Approximately 10% of the individuals experiencing the death of a loved one develop prolonged grief disorder (PGD) after bereavement. Family members of haematological cancer patients might be particularly burdened since their loss experience is preceded by a very strenuous time of disease and aggressive treatment. However, support needs of relatives of cancer patients often remain unmet, also after the death of the patient. Therapeutic possibilities are enhanced by providing easily available and accessible Internet-based therapies. This study will adapt and evaluate an Internet-based grief therapy for bereaved individuals after the loss of a significant other due to haematological cancer. The efficacy of the Internet-based grief therapy is evaluated in a randomized controlled trial with a wait-list control group. Inclusion criteria are bereavement due to hematological cancer and meeting the diagnostic criteria for PGD. Exclusion criteria are severe depression, suicidality, dissociative tendency, psychosis, posttraumatic stress disorder, substance use disorder, and current psychotherapeutic or psychopharmacological treatment. The main outcome is PGD severity. Secondary outcomes are depression, anxiety, somatization, posttraumatic stress, quality of life, sleep quality, and posttraumatic growth. Data is collected pre- and posttreatment. Follow-up assessments will be conducted 3, 6, and 12 months after completion of the intervention. The Internet-based grief therapy is assumed to have at least moderate effects regarding PGD and other bereavement-related mental health outcomes. Predictors and moderators of the treatment outcome and PGD will be determined. Individuals bereaved due to haematological cancer are at high risk for psychological distress. Tailored treatment for this particularly burdened target group is missing. Our study results will contribute to a closing of this healthcare gap. German Clinical Trial Register UTN: U1111-1186-6255 . Registered 1 December 2016.",Hoffmann R.; Große J.; Nagl M.; Niederwieser D.; Mehnert A.; Kersting A.,2018.0,10.1186/s12888-018-1633-y,0,0,
1763,"A randomised controlled trial evaluating the effect of Mindfulness-Based Stress Reduction (MBSR) on mood, quality of life and wellbeing in women with stages 0 to III breast cancer","The aim of the study was to determine whether and to what extent mindfulness-based stress reduction (MBSR) has any effect on mood, disease related quality of life, wellbeing and endocrine symptoms in women with stages 0 to III breast cancer. The study chiefly used a randomised controlled trial design. Eligible participants had previously attended a day centre, Breast Cancer Haven in London, which offers support, information and complementary therapies for women. Eligibility was based on ending hospital treatment for breast cancer no less than two months and no more than two years previously (N=229). Consenting participants were randomly assigned to either an immediate intervention or wait-list control group. Participants completed the Profile of Mood States (POMS) (primary outcome measure), Functional Assessment of Cancer Therapy –Breast (FACT-B) and –Endocrine (FACT-ES), including their trial outcome indices (TOI) and World Health Organisation Five-Item Wellbeing Questionnaire (WHO-5) as well as a short proforma to obtain qualitative data. Two hundred and fourteen women, (mean age 49 years) completed the study, (a 93% response rate). Intention-to-treat between-group analysis showed that after the intervention, participants in the MBSR group, compared to controls, had statistically significantly improved scores on POMS Total Mood Disturbance at both eight weeks with MBSR group mean (SD) of 30.02 (31.60) compared to controls 47.81(39.81) (95% CI for difference -27.44 to -18.14, p<0.001) and 12 weeks mean (SD) of 29.83 (34.19) compared to controls 45.43 (35.51) (95% CI -25.01 to -6.20, p<0.001). Significant improvements were also found on all POMS subscales – anxiety, depression, anger, vigour, fatigue and confusion. Significant improvements were also found on a range of FACT dimensions: FACT-B, -ES, -B TOI, -ES TOI, and physical, emotional and functional wellbeing subscales, as well as on the WHO-5 Wellbeing Questionnaire. Qualitative findings revealed that participants found themselves to be more mindful and key themes included being calmer, centred, at peace, connected and more confident; being more aware; coping with stress, anxiety and panic; and accepting things as they are, being less judgemental of myself and others. The generalisability of these findings will be limited to those women attending Breast Cancer Haven with stages 0 to III breast cancer. MBSR was effective in improving mood state, quality of life including endocrine symptom and wellbeing in female breast cancer survivors (diagnosed with stages 0 to III breast cancer).",Hoffman,2009.0,,0,0,
1764,Interpersonal Therapy for Social Phobia: Theoretical Model and Review of the Evidence.,"A general interpersonal theory based on Mead's (1934) theory of the self-image and Benjamin's (1993) Structural Analysis of Social Behavior is developed. Central concepts in this theory are relational schema, introjective schema, and self-perpetuating interactional cycles. Within this general theory, a specific interpersonal model of social phobia is formulated. In this model, it is assumed that social phobia is maintained by a critical-defective relational schema, which--when activated--tend to lead to negative self-perpetuating interactive cycles. In addition, an introjective self-critique is elicited concurrently, strengthening these cycles. A review of the evidence indicates that most relationships in the model are empirically supported. An inpatient interpersonal therapy program for social phobia is presented. This therapy appears to be as efficacious as cognitive therapy. With respect to the potential contributions of interpersonal therapy for social phobia, the SASB principles provides a systematic thinking about treatment goals and steps towards these goals. The SASB also includes guidelines for therapists' interventions and patients' constructive social behavior. It is further argued that interpersonal therapy may make better use of a group format than cognitive therapy, and that the notion of relational schemas may lead to techniques that may enhance the benefits of social exposure. If it is correct that the generalized and specific subtypes of social phobia are qualitatively distinct, and if the generalized subtype is more of an interpersonal nature, interpersonal therapy may be more beneficial for generalized social phobia than cognitive therapy. It is concluded that interpersonal therapy may be a promising option for social phobia, both as an alternative to and integrated with cognitive therapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hoffart, Asle",2005.0,,0,0,
1765, Cognitive models for panic disorder with agoraphobia: a study of disaggregated within-person effects," METHOD: Participants were 46 PDA patients with agoraphobic avoidance of moderate to severe degree who were randomly allocated to 6 weeks of either cognitive therapy, based on the catastrophic cognitions model of PDA, or guided mastery (guided exposure) therapy, based on the self‚Äêefficacy model of PDA. Cognitions and anxiety were measured weekly over the course of treatment. The data were analyzed with mixed models, using person‚Äêmean centering to disaggregate within‚Äê and between‚Äêperson effects. RESULTS: All of the studied variables changed in the expected way over the course of therapy. There was a within‚Äêperson effect of physical fears, loss of control fears, social fears, and self‚Äêefficacy when alone on subsequent state anxiety. On the other hand, within‚Äêperson changes in anxiety did not predict subsequent cognitions. Loss of control and social fears both predicted subsequent self‚Äêefficacy, whereas self‚Äêefficacy did not predict catastrophic cognitions. In a multipredictor analysis, within‚Äêperson catastrophic cognitions still predicted subsequent anxiety, but self‚Äêefficacy when alone did not. CONCLUSIONS: Overall, the findings indicate that anxiety in PDA, at least in severe and long‚Äêstanding cases, is driven by catastrophic cognitions. Thus, these cognitions seem to be useful therapeutic targets. (PsycINFO Database Record OBJECTIVE: The purpose of this study was to test 2 cognitive models of panic disorder with agoraphobia (PDA)‚Äêa catastrophic cognitions model and a low self‚Äêefficacy model‚Äêby examining the within‚Äêperson effects of model‚Äêderived cognitive variables on subsequent anxiety symptoms."," Hoffart, A",2016.0, 10.1037/ccp0000114,0,0,
1766,Intensive prolonged exposure treatment for adolescent complex posttraumatic stress disorder: a single-trial design.,"The current study evaluated the effectiveness and safety of intensive prolonged exposure (PE) targeting adolescent patients with complex posttraumatic stress disorder (PTSD) and comorbid disorders following multiple interpersonal trauma. Ten adolescents meeting full diagnostic criteria for PTSD were recruited from a specialized outpatient mental health clinic and offered a standardized intensive PE. The intensive PE consisted of three daily 90-min exposure sessions delivered on five consecutive weekdays, followed by 3 weekly 90-min booster sessions. In a single-trial design, the participants were randomly allocated to one of five baseline lengths (4-8 weeks) before starting the intensive PE. Before, during, and after intensive PE completion, self-reported PTSD symptom severity was assessed weekly as a primary outcome (a total of 21 measurements). Furthermore, clinician-administered PTSD diagnostic status and symptom severity (primary outcome), as well as self-reported comorbid symptoms (secondary outcomes), were assessed at four single time points (baseline-to-6-month follow-up). Time-series analyses showed that self-reported PTSD symptom severity significantly declined following treatment (p = .002). Pre-postgroup analyses demonstrated significant reductions of clinician-administered PTSD symptom severity and self-reported comorbidity that persisted during the 3- and 6-month follow-ups (all ps < .05), where 80% of adolescents had reached diagnostic remission of PTSD. There was neither treatment dropout nor any adverse events. The results of this first proof of concept trial suggest that intensive PE can be effective and safe in an adolescent population with complex PTSD, although the gains achieved need to be confirmed in a randomized controlled trial.",Hendriks L.; de Kleine RA.; Heyvaert M.; Becker ES.; Hendriks GJ.; van Minnen A.,2017.0,10.1111/jcpp.12756,0,0,
1767, The Effectiveness of a Psychoeducation Intervention delivered via WhatsApp for mothers of children with Autism Spectrum Disorder (ASD) in the Kingdom of Saudi Arabia: a randomized controlled trial," BACKGROUND: Mothers of children with autism spectrum disorder (ASD) report high levels of stress and lower levels of well‚Äêbeing than parents of typically developing children. Current interventions for ASD typically focus on working with the child rather than delivering strategies to help support parents. OBJECTIVE: To evaluate the effectiveness of a psychoeducation intervention developed to support mothers of children with ASD in Saudi Arabia. METHOD: Sixty‚Äêtwo mothers (23‚Äê52 years) of children (26‚Äê78 months) were recruited to a multisite randomized controlled trials of the intervention. The intervention consisted of one face‚Äêto‚Äêface session (60 min) and four virtual sessions (30 min each) delivered using WhatsApp. Parenting stress was the primary outcome, with secondary outcomes focusing on maternal depression, anxiety, and happiness, and child behaviour problems and ASD symptoms. Data were collected at baseline T1, immediately postintervention T2 and 8‚Äêweek follow‚Äêup T3. RESULTS: One‚Äêway analysis of covariance was used at T2 and T3 with T1 scores entered as a covariate. Improvements were found at T2 for stress (F = 234.34, p = .00, and d = ‚Äê1.52) and depression (F = 195.70, p = .00, and d = ‚Äê2.14) but not anxiety, and these results were maintained at T3. Changes in child behaviour problems were limited to improvements in hyperactivity at T2 (F = 133.66, p = .00, and d = ‚Äê1.54). Although changes in stress and depression were statistically significant, change to clinically normal levels was limited to depression. None of the participants had recovered after the intervention (Parent Stress Index Short Form stress scores), whereas 23 mothers (71.87%) in the intervention group had recovered at T2 and 22 (68.75%) at T3 (Hospital Anxiety and Depression Scale depression scores). CONCLUSION: This intervention with WhatsApp support is beneficial but may need to be augmented with other forms of support for mothers of children with ASD including more condensed sessions on stress and interventions targeting anxiety."," Hemdi, A;  Daley, D",2017.0, 10.1111/cch.12520,0,0,
1768,Prediction of outcome in the treatment of specific phobia: A cross validation study.,"Investigated possible predictors (PRDs) of behavior therapy outcome in specific phobia at 1 wk after treatment, and at 1 yr followup. 138 Ss (aged 18-60 yrs) came from 4 studies (2 on spider phobia, 1 on blood phobia and 1 on injection phobia), and all had been diagnosed with simple phobia according to Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R). The dependent variables were clinically significant improvement in avoidance behavior in a behavior test, self-rated anxiety during the test, and assessor rating of phobic severity or fainting. 14 self-report, demographic, and physiological variables and data from the behavior test were used as prognostic variables. Multiple regression analyses were used in a cross validation procedure. Pretest diastolic BP was a PRD at post-treatment for one sample and credibility was found as a PRD for the other sample both at post-treatment and at 1-yr follow-up. Despite the large sample size and cross validation no stable PRDs were found. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hellstrom, Kerstin; Ost, Lars-Goran",1996.0,http://dx.doi.org/10.1016/0005-7967%2896%2900004-6,0,0,
1769,Acute social and physical stress interact to influence social behavior: The role of social anxiety,"Stress is proven to have detrimental effects on physical and mental health. Due to different tasks and study designs, the direct consequences of acute stress have been found to be wide-reaching: while some studies report prosocial effects, others report increases in antisocial behavior, still others report no effect. To control for specific effects of different stressors and to consider the role of social anxiety in stress-related social behavior, we investigated the effects of social versus physical stress on behavior in male participants possessing different levels of social anxiety. In a randomized, controlled two by two design we investigated the impact of social and physical stress on behavior in healthy young men. We found significant influences on various subjective increases in stress by physical and social stress, but no interaction effect. Cortisol was significantly increased by physical stress, and the heart rate was modulated by physical and social stress as well as their combination. Social anxiety modulated the subjective stress response but not the cortisol or heart rate response. With respect to behavior, our results show that social and physical stress interacted to modulate trust, trustworthiness, and sharing. While social stress and physical stress alone reduced prosocial behavior, a combination of the two stressor modalities could restore prosociality. Social stress alone reduced nonsocial risk behavior regardless of physical stress. Social anxiety was associated with higher subjective stress responses and higher levels of trust. As a consequence, future studies will need to investigate further various stressors and clarify their effects on social behavior in health and social anxiety disorders.",Heinrichs M.; Von Dawans B.; Trueg A.; Kirschbaum C.; Fischbacher U.,2018.0,10.1371/journal.pone.0204665,0,0,
1770, The incidence and predictors of depressive and anxiety symptoms in older adults with vision impairment: a longitudinal prospective cohort study," METHODS: A longitudinal prospective cohort study with a follow‚Äêup of 24 months in 540 older adults with vision impairment (mean age 75 years, 56% female, 48% macular degeneration, 15% glaucoma) from outpatient low‚Äêvision rehabilitation organisations was performed. The cumulative incidences of subthreshold depression and anxiety were calculated and linear mixed models with maximum likelihood estimation were used to determine two prediction models. Main outcome measures were: fluctuations in (i) depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES‚ÄêD) and (ii) anxiety symptoms (Hospital Anxiety and Depression Scale‚ÄêAnxiety subscale, HADS‚ÄêA). RESULTS: The annual cumulative incidences of subthreshold depression and anxiety were 21.3% (95% Confidence Interval (CI) 18.7‚Äê23.9%) and 9.5% (95% CI 7.4‚Äê11.6%), respectively. Risk factors for developing depressive symptoms were: living alone, having just enough money to cover expenses, having macular degeneration, having problems with adaptation to vision loss, reduced health related quality of life, and experiencing symptoms of anxiety. For developing anxiety symptoms, a relatively younger age, experiencing symptoms of depression, not living alone and experiencing hindrance at work proved to be risk factors. CONCLUSIONS: This study shows that the incidence of subthreshold depression and anxiety in older adults with vision impairment is twice as high compared with older adults in general and confirms that depression and anxiety symptoms fluctuate over time. It is of great importance that low vision rehabilitation staff monitor older adults with vision impairment who are most vulnerable for developing these symptoms, based on the risk factors that were found in this study, to be able to offer early interventions to prevent and treat mental health problems in this population. PURPOSE: Depression and anxiety are highly prevalent in older adults with vision impairment. Because symptoms of depression and anxiety appear to fluctuate, it is important to identify patients who are at risk of developing these symptoms for early diagnosis and treatment. Therefore, the aim of this study was to determine the incidence of subthreshold depression and anxiety, and to investigate predictors of developing symptoms of depression and anxiety in older adults with vision impairment who had no subthreshold depression or anxiety at baseline."," Heesterbeek, TJ;  van der Aa, HPA;  van Rens, GHMB;  Twisk, JWR;  van Nispen, RMA",2017.0, 10.1111/opo.12388,0,0,
1771, Impact of transcranial direct current stimulation on attentional bias for threat: a proof-of-concept study among individuals with social anxiety disorder," Cognitive models posit that social anxiety disorder (SAD) is associated with and maintained by attentional bias (AB) for social threat. However, over the last years, it has been suggested that AB in SAD may result from a decreased activation of the left prefrontal cortex, and particularly of its dorsolateral part (dlPFC). Accordingly, a transient increase of neural activity within the left dlPFC via non‚Äêinvasive brain stimulation decreases AB in non‚Äêanxious control participants. Yet, none of these studies focused on SAD. This is especially unfortunate as SAD constitutes the main target for which a genuine reduction of AB may be most appropriate. In this experiment, we sought to investigate the causal influence of left dlPFC neuromodulation on AB among 19 female individuals with a DSM‚Äê5 diagnosis of SAD. We adopted a double‚Äêblind within‚Äêsubject protocol in which we delivered a single‚Äêsession of anodal versus sham transcranial Direct Current Stimulation (tDCS) over the left dlPFC during the completion of a probe discrimination task assessing AB. Consistent with our hypothesis, participants demonstrated a significant decrease in AB during the anodal tDCS over the left DLPFC relative to the sham stimulation. These findings value tDCS as an innovative procedure to gain new insight into the underlying mechanisms of SAD."," Heeren, A;  Billieux, J;  Philippot, P;  De Raedt, R;  Baeken, C;  de Timary, P;  Maurage, P;  Vanderhasselt, MA",2017.0, 10.1093/scan/nsw119,0,0,
1772,The impact of exposure-based cognitive behavior therapy for severe health anxiety on self-rated health: Results from a randomized trial.,"Self-rated health (SRH) has been shown to be a stable predictor of illness and mortality. Improvement in SRH, even in the absence of change in objective health, predicts better health and reduced mortality. Severe health anxiety (SHA) is characterized by fear of illness and distorted health perception. The objective of the present study was to investigate if exposure-based cognitive behavior therapy (CBT) for SHA can lead to improvement in SRH and whether this improvement is mediated by reduced health anxiety. Data were collected from a randomized controlled trial where participants with SHA were allocated to 12weeks of exposure-based CBT (n=99) for SHA or to a no treatment control condition (n=33). The mediation analysis was based on SRH- and health anxiety data collected weekly during the treatment phase. Linear mixed effects models analysis showed a significant interaction effect of group and time indicating superior improvements in SRH in exposure-based CBT compared to the control condition (Z=2.69, p=0.007). The controlled effect size was moderately large (d=0.64) and improvements were stable at 1-year follow-up. Reduced health anxiety was a significant mediator of improvement in SRH. 12weeks of exposure-based CBT for SHA can lead to significant improvements in SRH. Considering the previously established importance of SRH as a predictor for disease and mortality, exposure-based CBT for severe health anxiety may lead to improvements on several important health parameters, possibly even increasing the likelihood of longevity.",Hedman-Lagerlöf E.; Axelsson E.; Andersson E.; Ljótsson B.; Andreasson A.; Lekander M.,2017.0,10.1016/j.jpsychores.2017.09.013,0,0,
1773,Exposure-based cognitive-behavioural therapy via the internet and as bibliotherapy for somatic symptom disorder and illness anxiety disorder: Randomised controlled trial.,"Background: In DSM-5 two new diagnoses, somatic symptom disorder (SSD) and illness anxiety disorder (IAD), have replaced DSM-IV hypochondriasis. There are no previous treatment studies for these disorders. Cognitive-behavioural therapy (CBT) delivered as therapist-guided or unguided internet treatment or as unguided bibliotherapy could be used to increase treatment accessibility. Aims: To investigate the effect of CBT delivered as guided internet treatment (ICBT), unguided internet treatment (U-ICBT) and as unguided bibliotherapy. Method: A randomised controlled trial (RCT) where participants (n = 132) with a diagnosis of SSD or IAD were randomised to ICBT, U-ICBT, bibliotherapy or to a control condition on a waiting list (trial registration: Clinicaltrials.gov identifier NCT01966705). Results: Compared with the control condition, all three treatment groups made large and significant improvements on the primary outcome Health Anxiety Inventory (between-group d at post-treatment was 0.80-1.27). Conclusions: ICBT, U-ICBT and bibliotherapy can be highly effective in the treatment of SSD and IAD. This is the first study showing that these new DSM-5 disorders can be effectively treated. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Hedman, Erik; Axelsson, Erland; Andersson, Erik; Lekander, Mats; Ljotsson, Brjann",2016.0,http://dx.doi.org/10.1192/bjp.bp.116.181396,0,0,
1774,Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders.,"This reprinted article originally appeared in Journal of Consulting and Clinical Psychology 80, 5, 2012, pp. 750-765. Objective: Randomized comparisons of acceptance-based treatments with traditional cognitive behavioral therapy (CBT) for anxiety disorders are lacking. To address this gap, we compared acceptance and commitment therapy (ACT) to CBT for heterogeneous anxiety disorders. Method: One hundred twenty-eight individuals (52% female, mean age = 38,33% minority) with 1 or more DSM-IV anxiety disorders began treatment following randomization to CBT or ACT; both treatments included behavioral exposure. Assessments at pre-treatment, post-treatment, and 6- and 12-month follow-up measured anxiety-specific (principal disorder Clinical Severity Ratings [CSRs], Anxiety Sensitivity Index, Penn State Worry Questionnaire, Fear Questionnaire avoidance) and nonanxiety-specific (Quality of Life Index [QOLI], Acceptance and Action Questionnaire-16 [AAQ]) outcomes. Treatment adherence, therapist competency ratings, treatment credibility, and co-occurring mood and anxiety disorders were investigated. Results: CBT and ACT improved similarly across all outcomes from pre- to post-treatment. During follow-up, ACT showed steeper linear CSR improvements than CBT (p < .05, d = 1.26), and at 12-month follow-up, ACT showed lower CSRs than CBT among completers (p < .05, d = 1.10). At 12-month follow-up, ACT reported higher AAQ than CBT (p = .08, d = 0.42; completers: p < .05, d = 0.56), whereas CBT reported higher QOLI than ACT (p < .05, d= 0.42). Attrition and comorbidity improvements were similar; ACT used more non-story psychotherpy at 6-month follow-up. Therapist adherence and competency were good; treatment credibility was higher in CBT. Conclusions: Overall improvement was similar between ACT and CBT, indicating that ACT is a highly viable treatment for anxiety disorders. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Arch, Joanna J; Eifert, Georg H; Davies, Carolyn; Vilardaga, Jennifer C. Plumb; Rose, Raphael D; Craske, Michelle G",2017.0,,0,0,
1775,Community program improves quality of life and self-management in older adults with diabetes mellitus and comorbidity.,"Objectives: To compare the effect of a 6-month community-based intervention with that of usual care on quality of life, depressive symptoms, anxiety, self-efficacy, self-management, and healthcare costs in older adults with type 2 diabetes mellitus (T2DM) and 2 or more comorbidities. Design: Multisite, single-blind, parallel, pragmatic, randomized controlled trial. Setting: Four communities in Ontario, Canada. Participants: Community-dwelling older adults (>= 65) with T2DM and 2 or more comorbidities randomized into intervention (n = 80) and control (n = 79) groups (N = 159). Intervention: Client-driven, customized self-management program with up to 3 in-home visits from a registered nurse or registered dietitian, a monthly group wellness program, monthly provider team case conferences, and care coordination and system navigation. Measurements: Quality-of-life measures included the Physical Component Summary (PCS, primary outcome) and Mental Component Summary (MCS, secondary outcome) scores of the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12). Other secondary outcome measures were the Generalized Anxiety Disorder Scale, Center for Epidemiologic Studies Depression Scale (CES-D-10), Summary of Diabetes Self-Care Activities (SDSCA), Self-Efficacy for Managing Chronic Disease, and healthcare costs. Results: Morbidity burden was high (average of eight comorbidities). Intention-to-treat analyses using analysis of covariance showed a group difference favoring the intervention for the MCS (mean difference = 2.68, 95% confidence interval (CI) = 0.28-5.09, P = .03), SDSCA (mean difference = 3.79, 95% CI = 1.02-6.56, P = .01), and CES-D-10 (mean difference = -1.45, 95% CI = -0.13 to -2.76, P = .03). No group differences were seen in PCS score, anxiety, self-efficacy, or total healthcare costs. Conclusion: Participation in a 6-month community-based intervention improved quality of life and self-management and reduced depressive symptoms in older adults with T2DM and comorbidity without increasing total healthcare costs. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Markle-Reid, Maureen; Ploeg, Jenny; Fraser, Kimberly D; Fisher, Kathryn A; Bartholomew, Amy; Griffith, Lauren E; Miklavcic, John; Gafni, Amiram; Thabane, Lehana; Upshur, Ross",2018.0,http://dx.doi.org/10.1111/jgs.15173,0,0,
1776, The ACHRU-CPP versus usual care for older adults with type-2 diabetes and multiple chronic conditions and their family caregivers: study protocol for a randomized controlled trial," BACKGROUND: Many community‚Äêbased self‚Äêmanagement programs have been developed for older adults with type‚Äê2 diabetes mellitus (T2DM), bolstered by evidence from randomized controlled trials (RCTs) that T2DM can be prevented and managed through lifestyle modifications. However, the evidence for their effectiveness is contradictory and weakened by reliance on single‚Äêgroup designs and/or small samples. Additionally, older adults with multiple chronic conditions (MCC) are often excluded because of recruiting and retention challenges. This paper presents a protocol for a two‚Äêarmed, multisite, pragmatic, mixed‚Äêmethods RCT examining the effectiveness and implementation of the Aging, Community and Health Research Unit‚ÄêCommunity Partnership Program (ACHRU‚ÄêCPP), a new 6‚Äêmonth interprofessional, nurse‚Äêled program to promote self‚Äêmanagement in older adults (aged 65 years or older) with T2DM and MCC and support their caregivers (including family and friends). METHODS/DESIGN: The study will enroll 160 participants in two Canadian provinces, Ontario and Alberta. Participants will be randomly assigned to the control (usual care) or program study arm. The program will be delivered by registered nurses (RNs) and registered dietitians (RDs) from participating diabetes education centers (Ontario) or primary care networks (Alberta) and program coordinators from partnering community‚Äêbased organizations. The 6‚Äêmonth program includes three in‚Äêhome visits, monthly group sessions, monthly team meetings for providers, and nurse‚Äêled care coordination. The primary outcome is the change in physical functioning as measured by the Physical Component Summary (PCS‚Äê12) score from the short form‚Äê12v2 health survey (SF‚Äê12). Secondary client outcomes include changes in mental functioning, depressive symptoms, anxiety, and self‚Äêefficacy. Caregiver outcomes include health‚Äêrelated quality of life and depressive symptoms. The study includes a comparison of health care service costs for the intervention and control groups, and a subgroup analysis to determine which clients benefit the most from the program. Descriptive and qualitative data will be collected to examine implementation of the program and effects on interprofessional/team collaboration. DISCUSSION: This study will provide evidence of the effectiveness of a community‚Äêbased self‚Äêmanagement program for a complex target population. By studying both implementation and effectiveness, we hope to improve the uptake of the program within the existing community‚Äêbased structures, and reduce the research‚Äêto‚Äêpractice gap. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier: NCT02158741 . Registered on 3 June 2014."," Markle-Reid, M;  Ploeg, J;  Fraser, KD;  Fisher, KA;  Akhtar-Danesh, N;  Bartholomew, A;  Gafni, A;  Gruneir, A;  Hirst, SP;  Kaasalainen, S;  et al.",2017.0, 10.1186/s13063-017-1795-9,0,0,
1777,Total migraine freedom: A potential primary endpoint to assess acute treatment of migraine in the avitriptan program,"Objectives: To investigate total migraine freedom (TMF) using an avitriptan clinical trial data base. To compare TMF as a single primary composite efficacy endpoint in establishing efficacy vs. four co-primary endpoints. Background: FDA currently requires four co-primary endpoints, at 2 hours post-dose, to establish efficacy in migraine patients: 1) pain (freedom or relief); 2) absence of photophobia; 3) absence of phonophobia; 4) absence of nausea. Total migraine freedom (pain free and no associated symptoms) has been proposed as an alternative primary endpoint. Total migraine freedom (TMF) represents a single composite endpoint that is easier to translate into clinical practice and was demonstrated to have significant advantages versus establishing efficacy using the standard four co-primary endpoints in an analysis conducted by Rogers et al (2010) of the complete rizatriptan study database. The development of avitriptan, a compound evaluated for the treatment of acute migraine, was discontinued in 1997. Methods: Retrospective data analysis of 5 double-blind placebo-controlled phase II-III studies of avitriptan in the treatment of acute migraine. TMF at 2 hours was evaluated using the Cochran-Mantel-Haenszel (CMH) test statistic in pairwise comparisons to placebo within each study, and similar approach was followed for the four co-primary endpoints. TMF was also evaluated by combining all avitriptan dose groups and, similarly, all placebo groups across studies. Simulation studies utilizing bootstrap sampling from the pooled data of the five studies were used to compare the empirical power (proportion of trials demonstrating superiority over placebo) of the TMF approach versus the four co-primary endpoints, and to explore implications on sample size. Results: Odds ratio (avitriptan vs. placebo) for TMF were 6.19 [95% CI: (3.99, 9.61) , p<0.001]. The proportion of patients achieving TMF at 2 hours for avitriptan and placebo were 30% and 6%, respectively. Only 39% of the patient population had all four migraine symptoms at baseline. Simulation results showed a substantial loss in power in the four co-primary endpoints approach versus the composite TMF endpoint. Conclusions: Avitiptan was superior to placebo in achieving TMF at 2 hours post-dose. Given that the majority of patients with migraine did not present with all three associated symptoms at baseline, the TMF endpoint has significant advantages as a primary endpoint compared to establishing efficacy with four co-primary endpoint.",Marcus R.N.; Manos G.; Tong G.,2011.0,10.1111/j.1526-4610.2011.01935.x,0,0,
1778,The mediating effect of mindful non-reactivity in exposure-based cognitive behavior therapy for severe health anxiety.,"Exposure-based cognitive behavior therapy (CBT) has been shown to be effective in the treatment of severe health anxiety, but little is known about mediators of treatment effect. The aim of the present study was to investigate mindful non-reactivity as a putative mediator of health anxiety outcome using data from a large scale randomized controlled trial. We assessed mindful non-reactivity using the Five Facets Mindfulness Questionnaire-Non-Reactivity scale (FFMQ-NR) and health anxiety with the Short Health Anxiety Inventory (SHAI). Participants with severe health anxiety (N=158) were randomized to internet-delivered exposure-based CBT or behavioral stress management (BSM) and throughout the treatment, both the mediator and outcome were measured weekly. As previously reported, exposure-based CBT was more effective than BSM in reducing health anxiety. In the present study, latent process growth modeling showed that treatment condition had a significant effect on the FFMQ-NR growth trajectory (α-path), estimate=0.18, 95% CI [0.04, 0.32], p=.015, indicating a larger increase in mindful non-reactivity among participants receiving exposure-based CBT compared to the BSM group. The FFMQ-NR growth trajectory was significantly correlated with the SHAI trajectory (β-path estimate=-1.82, 95% CI [-2.15, -1.48], p<.001. Test of the indirect effect, i.e. the estimated mediation effect (αβ) revealed a significant cross product of -0.32, which was statistically significant different from zero based on the asymmetric confidence interval method, 95% CI [-0.59, -0.06]. We conclude that increasing mindful non-reactivity may be of importance for achieving successful treatment outcomes in exposure-based CBT for severe health anxiety.",Hedman E.; Hesser H.; Andersson E.; Axelsson E.; Ljótsson B.,2017.0,10.1016/j.janxdis.2017.04.007,0,0,
1779,An experimental test of the role of control in spider fear.,"It is well established that uncontrollable adverse experiences lead to increased distress, but the role of client control during psychological interventions such as exposure is less clear. Earlier studies reported inconsistent findings, most likely owing to variations in the way client control was manipulated, degree of exposure, the outcome variables chosen and the follow-up periods used. Importantly, studies to date had suggested to participants that approaching their fears was beneficial thereby biasing their choices and these studies had not measured change beyond the laboratory. We recruited 96 spider-fearful student participants (mean age=22; SD=5.9; Range=18-45; 86 female). The experimental design allowed full choice over their degree of exposure, and manipulated the degree of control as the extent to which their movement of a joystick influenced their virtual distance from a moving spider image. Those with high control were yoked with a low control counterpart to ensure equal amounts of exposure. Measures were elicited at baseline, post-exposure, and at follow-up. As predicted, compared to low control participants, those with high control over exposure approached closer toward a spider post-exposure and reported less spider avoidance after an average of 17days. No group differences were found in physiological or subjective distress during the task, nor in distress and dysfunction.",Healey A.; Mansell W.; Tai S.,2017.0,10.1016/j.janxdis.2017.03.005,0,0,
1780, Effectiveness of Mindfulness-Based Stress Reduction Bibliotherapy: a Preliminary Randomized Controlled Trial," OBJECTIVE: This randomized controlled investigation examined the effectiveness of a self‚Äêhelp bibliotherapy format of the evidence‚Äêbased mindfulness‚Äêbased stress reduction (MBSR) intervention. METHOD: College students seeking stress reduction were randomly assigned to a 10‚Äêweek MBSR bibliotherapy intervention group (n = 47) or a no‚Äêtreatment control group (n = 45). Self‚Äêreport measures were collected at baseline and postintervention. RESULTS: A total of 25 bibliotherapy and 43 control group participants provided final data following the intervention period. Compared to the control group, bibliotherapy participants reported increased mindfulness following the intervention. Significant decreases on measures of depression, anxiety, stress, perceived stress, and anxiety sensitivity also were reported postintervention as well as increased quality of life in physical health, psychological, and environmental domains. No statistically significant group effects were found for social relationships quality of life domain, worry, and experiential avoidance measures. CONCLUSION: This MBSR workbook may provide an acceptable and effective alternative for motivated individuals seeking to reduce stress, at least for a select group of individuals who are willing and able to sustain participation in the intervention."," Hazlett-Stevens, H;  Oren, Y",2017.0, 10.1002/jclp.22370,0,0,
1781,Pattern destabilization and emotional processing in cognitive therapy for personality disorders.,"Clinical trials of treatments for personality disorders can provide a medium for studying the process of therapeutic change with particularly entrenched and self-perpetuating systems and might reveal important principles of system transition. We examined the extent to which maladaptive personality patterns were destabilized in a trial of cognitive therapy personality disorders (CT-PD) and how destabilization was associated with emotional processing and treatment outcomes. Dynamic systems theory was used as a theoretical framework for studying change. Method: Participants were 27 patients diagnosed with Avoidant or Obsessive Compulsive Personality Disorder (AVPD or OCPD), who completed an open trial of CT-PD. Raters coded treatment sessions using a coding system that operationalizes emotional processing, as well as cognitive, affective, behavioral, and somatic components of pathological (negative) and more adaptive (positive) patterns of functioning. Pattern destabilization (dispersion) scores during the early phase of treatment (phase 1: session 1-10) and the schema-focused phase (phase 2: session 11-34) were calculated using a program called GridWare. Results: More pattern destabilization and emotional processing in the schema-focused phase of CT-PD predicted more improvement in personality disorder symptoms and positive pattern strength at the end of treatment, whereas these variables in phase 1 did not predict outcome. Conclusion: In addition to illustrating a quantitative method for studying destabilization and change of patterns of psychopathology, we present findings that are consistent with recent updates of emotional processing theory and with principles from dynamic systems theory. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hayes, Adele M; Yasinski, Carly",2015.0,,0,0,
1782," The structure, correlates, and treatment related changes of mindfulness facets across the anxiety disorders and obsessive compulsive disorder"," Research with non‚Äêclinical and clinical samples has examined how mindfulness concepts relate to psychological symptom presentations. However, there is less clarity when examining treatment‚Äêseeking patients who experience DSM‚Äêdiagnosed anxiety and obsessional disorders ‚Äê both cross‚Äêsectionally, and following empirically‚Äêsupported treatments. The Five Facet Mindfulness Questionnaire (FFMQ; Baer, Smith, Hopkins, Krietemeyer, & Toney, 2006) conceptualizes mindfulness as consisting of five facets: Observing, Describing, Acting with Awareness, Nonreactivity, and Nonjudging. The current study examines the factor structure and predictive validity of the FFMQ in a large sample of treatment‚Äêseeking individuals with obsessive compulsive disorder (OCD), panic disorder with or without agoraphobia (PD/A), social anxiety disorder (SAD), and generalized anxiety disorder (GAD). Confirmatory factor analyses (CFA) established that both four and five‚Äêfactor models (i.e., with and without inclusion of the Observing factor) provided an acceptable representation of the underlying FFMQ structure, but did not support a one‚Äêfactor solution. For each of these diagnostic groups, hierarchical regression analyses clarified the association between specific FFMQ facets and diagnosis specific symptom change during CBT treatment. These findings are discussed in the context of the possible transdiagnostic relevance of specific mindfulness facets, and how these facets are differentially associated with diagnosis specific symptom alleviation during CBT."," Hawley, LL;  Rogojanski, J;  Vorstenbosch, V;  Quilty, LC;  Laposa, JM;  Rector, NA",2017.0, 10.1016/j.janxdis.2017.03.003,0,0,
1783,Concentrated ERP Delivered in a Group Setting: A Replication Study.,"In a previous effectiveness study (Havnen et al., 2014), 35 obsessive compulsive disorder (OCD) patients underwent Concentrated Exposure Treatment (cET), which is a newly developed group treatment format delivered over four consecutive days. The primary aims of the present study were to evaluate the treatment results for a new sample of OCD patients receiving the cET treatment approach and to replicate the effectiveness study described in Havnen et al. (2014). Forty-two OCD patients underwent cET treatment. Treatment was delivered by different therapists than in Havnen et al. (2014), except for two groups led by the developers of the treatment. Assessments of OCD symptom severity, treatment satisfaction, and occupational impairment were included. The results showed a significant reduction in Yale-Brown Obsessive Compulsive Scale scores from pre-treatment to post-treatment, which was maintained at 6-month follow-up. At post-treatment, 74% of the sample was remitted; at 6-month follow-up, 60% were recovered. The sample showed a very high degree of overall treatment satisfaction. The results from the present study were statistically compared with those obtained in the previous study. The analyses showed that the study samples had comparable demographic data and equal application of treatment. The outcome of the present and original study did not differ significantly on primary and secondary outcome measures. This study shows that cET was successfully replicated in a new patient sample treated by different therapists than the original study. The results indicate that cET is well accepted by the patients, and the potential for dissemination is discussed.",Havnen A.; Hansen B.; Öst LG.; Kvale G.,2017.0,10.1017/S1352465817000091,0,0,
1784,Beta-blocker propranolol modulates decision urgency during sequential information gathering,"Arbitrating between timely choice and extended information gathering is critical for effective decision making. Aberrant information gathering behavior is thought to be a feature of psychiatric disorders such as schizophrenia and obsessive-compulsive disorder, but we know little about the underlying neurocognitive control mechanisms. In a double-blind, placebo-controlled drug study involving 60 healthy human subjects (30 female), we examined the effects of noradrenaline and dopamine antagonism on information gathering during performance of an information sampling task. We show that modulating noradrenaline function with 40 mg of the β-blocker propranolol leads to decreased information gathering behavior. Modulating dopamine function via a single dose of 400 mg of amisulpride revealed some effects that were intermediate between those of propranolol and placebo. Using a Bayesian computational model, we show that sampling behavior is best explained by inclusion of a nonlinear urgency signal that promotes commitment to an early decision. Noradrenaline blockade promotes the expression of this decision-related urgency signal during information gathering. We discuss the findings with respect to psychopathological conditions that are linked to aberrant information gathering.",Hauser T.U.; Moutoussis M.; Purg N.; Dayan P.; Dolan R.J.,2018.0,10.1523/JNEUROSCI.0192-18.2018,0,0,
1785,The safety and efficacy of baclofen to reduce alcohol use in veterans with chronic hepatitis C: A randomized controlled trial.,"Background and Aims: Alcohol use disorders (AUDs) are common among people with chronic hepatitis C (HCV) and accelerate the development of fibrosis and cirrhosis caused by HCV. Baclofen, a gamma-aminobutyric acid (GABA) beta-receptor agonist, differs from medications for AUDs currently approved by the United States Food and Drug Administration (FDA), as it is metabolized primarily through the kidneys. The primary outcome of this study was to compare baclofen with a placebo in the percentage of days abstinent from alcohol. Design: A double-blind, placebo-controlled randomized trial. Setting: Hepatology clinics in four separate US Veteran Affairs Medical Centers in the United States. Participants: One hundred and eighty Veteran men and women older than 18 years with chronic HCV, a comorbid AUD and current alcohol use. Intervention and Comparator: Oral baclofen was given at dosages of 0 (placebo) or 30 mg/day over 12 weeks with concomitant manual-guided counseling. Measurements: The primary measurement was percentage of days abstinent during the 12-week study period between the baclofen and placebo groups [measured by time-line follow-back (TLFB)]. Secondary measurements were the percentage of Veterans who achieved complete abstinence, the percentage of Veterans who achieved no heavy drinking between weeks 4 and 12 of the study, alcohol craving, anxiety, depression and post-traumatic stress disorder (PTSD). Findings: Primary outcome: compared with placebo, baclofen did not improve the percentage of days abstinent. For all subjects there were significant reductions from baseline to 12 weeks in percentage of days abstinent from 37.0% [standard error (SE) = 2.7] to 68.6% (SE = 2.8, F(1151.1) = 66.1, P < 0.001). However, there was no statistically significant difference between groups for change in percentage of days abstinent over the 12-week study period [absolute difference 1.3% (-9.1 to 1.7%), F(1152.6) = 0.005, P = 0.95]. Secondary outcomes: Of subjects who completed the first 4 weeks of the study, 8.9% (15 of 168) achieved complete abstinence; 10.1% (nine of 89) in the placebo group and 7.6% (six of 79) in the baclofen group [chi2(1) = 0.33, odds ratio (OR) = 0.73 (0.24-2.15)]. The percentage of no heavy drinking for all subjects between weeks 4 and 12 was 20.2% (34 of 168), but no statistically significant differences were found between placebo 15.7% (14 of 89) and baclofen 25.3% (20 of 79) [chi2(1) = 2.38, OR = 1.82 (0.85-3.90)]. There were significant reductions for all subjects in all other secondary variables over the course of the study, but no differences between groups. Measures of various biomarkers of alcohol use did not change significantly throughout the course of the study for either the baclofen or placebo groups. Conclusions: Baclofen administered at 30 mg/day does not appear to be superior to placebo in increasing abstinence or in reducing alcohol use, cravings for alcohol or anxiety among people with alcohol use disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Hauser, Peter; Fuller, Bret; Ho, Samuel B; Thuras, Paul; Kern, Shira; Dieperink, Eric",2017.0,http://dx.doi.org/10.1111/add.13787,0,0,
1786, School-based cognitive behavioral interventions for anxious youth: study protocol for a randomized controlled trial," BACKGROUND: Anxiety disorders are prevalent among adolescents and may have long‚Äêlasting negative consequences for the individual, the family and society. Cognitive behavioral therapy (CBT) is an effective treatment. However, many anxious youth do not seek treatment. Low‚Äêintensity CBT in schools may improve access to evidence‚Äêbased services. We aim to investigate the efficacy of two CBT youth anxiety programs with different intensities (i.e., number and length of sessions), both group‚Äêbased and administered as early interventions in a school setting. The objectives of the study are to examine the effects of school‚Äêbased interventions for youth anxiety and to determine whether a less intensive intervention is non‚Äêinferior to a more intensive intervention. METHODS/DESIGN: The present study is a randomized controlled trial comparing two CBT interventions to a waitlist control group. A total of 18 schools participate and we aim to recruit 323 adolescents (12‚Äê16 years). Youth who score above a cutoff on an anxiety symptom scale will be included in the study. School nurses recruit participants and deliver the interventions, with mental health workers as co‚Äêtherapists and/or supervisors. Primary outcomes are level of anxiety symptoms and anxiety‚Äêrelated functional impairments. Secondary outcomes are level of depressive symptoms, quality of life and general psychosocial functioning. Non‚Äêinferiority between the two active interventions will be declared if a difference of 1.4 or less is found on the anxiety symptom measure post‚Äêintervention and a difference of 0.8 on the interference scale. Effects will be analyzed by mixed effect models, applying an intention to treat procedure. DISCUSSION: The present study extends previous research by comparing two programs with different intensity. A brief intervention, if effective, could more easily be subject to large‚Äêscale implementation in school health services. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02279251 . Registered on 15 October 2014. Retrospectively registered."," Haugland, BS;  Raknes, S;  Haaland, AT;  Wergeland, GJ;  Bjaastad, JF;  Baste, V;  Himle, J;  Rapee, R;  Hoffart, A",2017.0, 10.1186/s13063-017-1831-9,0,0,
1787, The effect of postal questionnaire burden on response rate and answer patterns following admission to intensive care: a randomised controlled trial," BACKGROUND: The effects of postal questionnaire burden on return rates and answers given are unclear following treatment on an intensive care unit (ICU). We aimed to establish the effects of different postal questionnaire burdens on return rates and answers given. METHODS: Design: A parallel group randomised controlled trial. We assigned patients by computer‚Äêbased randomisation to one of two questionnaire packs (Group A and Group B). SETTING: Patients from 26 ICUs in the United Kingdom. INCLUSION CRITERIA: Patients who had received at least 24 h of level 3 care and were 16 years of age or older. Patients did not know that there were different questionnaire burdens. The study included 18,490 patients. 12,170 were eligible to be sent a questionnaire pack at 3 months. We sent 12,105 questionnaires (6112 to group A and 5993 to group B). INTERVENTIONS: The Group A pack contained demographic and EuroQol group 5 Dimensions 3 level (EQ‚Äê5D‚Äê3 L) questionnaires, making four questionnaire pages. The Group B pack also contained the Hospital Anxiety and Depression Score (HADS) and the Post‚ÄêTraumatic Stress Disorder Check List‚ÄêCivilian (PCL‚ÄêC) questionnaires, making eight questionnaire pages in total. MAIN OUTCOME MEASURE: Questionnaire return rate 3 months after ICU discharge by group. RESULTS: In group A, 2466/6112 (40.3%) participants responded at 3 months. In group B 2315/ 5993 (38.6%) participants responded (difference 1.7% CI for difference 0‚Äê3.5% p‚Äâ=‚Äâ0.053). Group A reported better functionality than group B in the EQ‚Äê5D‚Äê3 L mobility (41% versus 37% reporting no problems p‚Äâ=‚Äâ0.003) and anxiety/depression (59% versus 55% reporting no problems p‚Äâ=‚Äâ0.017) domains. CONCLUSIONS: In survivors of intensive care, questionnaire burden had no effect on return rates. However, questionnaire burden affected answers to the same questionnaire (EQ‚Äê5D‚Äê3 L). TRIAL REGISTRATION: ISRCTN69112866 (assigned 02/05/2006)."," Hatch, R;  Young, D;  Barber, V;  Harrison, DA;  Watkinson, P",2017.0, 10.1186/s12874-017-0319-3,0,0,
1788, Goal intention reminding in traumatic brain injury: a feasibility study using implementation intentions and text messaging," OBJECTIVE: To examine feasibility of participant‚Äêcreated implementation intentions, delivered as text message reminders, to enhance goal‚Äêrelated activity in persons with chronic, moderate/severe traumatic brain injury (TBI). DESIGN: Pilot randomized controlled trial on effects of 8 weeks receiving goal‚Äêrelated implementation intentions (GI) compared to control condition, educational review regarding goals (GR). PARTICIPANTS: Eight persons with moderate/severe TBI nearing discharge from intensive outpatient brain injury treatment. MEASURES: Neuropsychological tests to characterize cognitive status; Participation with Recombined Tools‚ÄêObjective (PART‚ÄêO) assessing community activity, social relations and productivity; Brief Symptom Inventory‚Äê18 (BSI‚Äê18) assessing depression, anxiety and overall distress; Goal Attainment Scales (GAS). PART‚ÄêO, BSI‚Äê18 and GAS were completed at baseline and 8 weeks; significant others provided ratings on PART‚ÄêO and GAS. RESULTS: Participants replied to SMS messages at high rates. Statistically significant group √ó time interactions with medium‚Äêto‚Äêlarge effect sizes favouring the GI group were observed on PART‚ÄêO community activity and social relations. Neither BSI‚Äê18 nor GAS revealed differences or trends by group. Qualitative results suggested overall acceptance and success of SMS reminders. CONCLUSIONS: Given positive preliminary findings, implementation intentions delivered by text holds promise as a simple, low‚Äêcost intervention to help people with moderate/severe TBI to implement goal‚Äêrelevant behaviours."," Hart, T;  Vaccaro, MJ",2017.0, 10.1080/02699052.2016.1251612,0,0,
1789,On the neural basis of EMDR therapy: Insights from qEEG studies.,"Eye movement desensitization and reprocessing (EMDR) therapy has been shown by empirical studies to be effective in relief from psychological traumas including posttraumatic stress disorder (PTSD). Several logical concepts regarding the origin of the EMDR effect have been presented, but no detailed neural explanation is available. This lack of a widely accepted scientific explanation for the EMDR effect has led to skepticism about the therapy by many therapists and potential clients. The authors present evidence based primarily on quantitative electroencephalogram studies that the neural basis for the EMDR effect is depotentiation of fear memory synapses in the amygdala during an evoked brain state similar to that of slow wave sleep. These studies suggest that brain stimulation during EMDR significantly increases the power of a naturally occurring low-frequency rhythm in memory areas of the brain, binding these areas together and causing receptors on the synapses of fear memory traces to be disabled. This mechanical change in the memory trace enables it to be incorporated into the normal memory system without the extreme emotions previously associated with it. EMDR is a medical procedure because it changes the physical structure of the brain to modify problematically stored memories. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Harper, Melvin L; Rasolkhani-Kalhorn, Tasha; Drozd, John F",2009.0,http://dx.doi.org/10.1177/1534765609338498,0,0,
1790,Incremental Benefit-Cost of MOMCare: Collaborative Care for Perinatal Depression Among Economically Disadvantaged Women.,"Effectiveness of collaborative care for perinatal depression has been demonstrated for MOMCare, from early pregnancy up to 15 months postpartum, for Medicaid enrollees in a public health system. MOMCare had a greater impact on reducing depression and improving functioning for women with comorbid posttraumatic stress disorder (PTSD) than for those without PTSD. This study estimated the incremental benefit and cost and the net benefit of MOMCare for women with major depression and PTSD. A randomized trial (September 2009 to December 2014) compared the MOMCare collaborative care depression intervention (choice of brief interpersonal psychotherapy or pharmacotherapy or both) with enhanced maternity support services (MSS-Plus) in the public health system of Seattle-King County. Among pregnant women with a probable diagnosis of major depression or dysthymia (N=164), two-thirds (N=106) met criteria for probable PTSD. Blinded assessments at three, six, 12, and 18 months postbaseline included the Symptom Checklist-20 depression scale and the Cornell Services Index. Analyses of covariance estimated gain in depression free days (DFDs) by intervention and PTSD status. When the analysis controlled for baseline depression severity, women with probable depression and PTSD in MOMCare had 68 more depression-free days over 18 months than those in MSS-Plus (p<.05). The additional depression care cost per MOMCare participant with comorbid PTSD was $1,312. The incremental net benefit of MOMCare was positive if a DFD was valued at ‚â•$20. For women with probable major depression and PTSD, MOMCare had significant clinical benefit over MSS-Plus, with only a moderate increase in health services cost.",Grote NK.; Simon GE.; Russo J.; Lohr MJ.; Carson K.; Katon W.,2017.0,10.1176/appi.ps.201600411,0,0,
1791,Predictors of Treatment Discontinuation During Prolonged Exposure for PTSD.,"Post-traumatic stress disorder (PTSD) is a highly prevalent and impairing condition for which there are several evidence-based psychotherapies. However, a significant proportion of patients fail to complete a 'sufficient dose' of psychotherapy, potentially limiting treatment gains. The present study investigated predictors of premature treatment discontinuation during a trial of prolonged exposure (PE) therapy for PTSD. Combat veterans with PTSD were recruited to participate in a randomized clinical trial of PE delivered in person or via telehealth technologies. Of the 150 initial participants, 61 participants discontinued the trial before the completion of eight sessions (of an 8‚Äí12 session protocol). Treatment condition (telehealth or in person) and factors identified by prior research (age, combat theatre, social support, PTSD symptoms) were tested as predictors of treatment discontinuation. A Cox proportional hazards model (a subtype of survival analysis) was used to evaluate predictors of treatment discontinuation. Disability status and treatment condition were identified as significant predictors of discontinuation, with a noted disability and use of telehealth demonstrating higher risk. The present findings highlight the influence of telehealth and disability status on treatment discontinuation, while minimizing the role of the previously identified variables from studies with less sensitive analyses.",Gros DF.; Allan NP.; Lancaster CL.; Szafranski DD.; Acierno R.,2018.0,10.1017/S135246581700039X,0,0,
1792," Short-Term Effects of Binaural Beats on EEG Power, Functional Connectivity, Cognition, Gait and Anxiety in Parkinson's Disease"," We applied rhythmic binaural sound to Parkinson's Disease (PD) patients to investigate its influence on several symptoms of this disease and on Electrophysiology (Electrocardiography and Electroencephalography (EEG)). We conducted a double‚Äêblind, randomized controlled study in which rhythmic binaural beats and control were administered over two randomized and counterbalanced sessions (within‚Äêsubjects repeated‚Äêmeasures design). Patients ([Formula: see text], age [Formula: see text], stage I‚ÄêIII Hoehn & Yahr scale) participated in two sessions of sound stimulation for 10[Formula: see text]min separated by a minimum of 7 days. Data were collected immediately before and after both stimulations with the following results: (1) a decrease in theta activity, (2) a general decrease in Functional Connectivity (FC), and (3) an improvement in working memory performance. However, no significant changes were identified in the gait performance, heart rate or anxiety level of the patients. With regard to the control stimulation, we did not identify significant changes in the variables analyzed. The use of binaural‚Äêrhythm stimulation for PD, as designed in this study, seems to be an effective, portable, inexpensive and noninvasive method to modulate brain activity. This influence on brain activity did not induce changes in anxiety or gait parameters; however, it resulted in a normalization of EEG power (altered in PD), normalization of brain FC (also altered in PD) and working memory improvement (a normalizing effect). In summary, we consider that sound, particularly binaural‚Äêrhythmic sound, may be a co‚Äêassistant tool in the treatment of PD, however more research is needed to consider the use of this type of stimulation as an effective therapy."," G√°lvez, G;  Recuero, M;  Canuet, L;  Del-Pozo, F",2018.0, 10.1142/S0129065717500551,0,0,
1793,Anxiety symptoms predicted decline in episodic memory in cognitively healthy older adults: A 3‐year prospective study,"Objective: Prospective studies on late‐life anxiety disorders suggested that history of anxiety symptoms may be predictive of cognitive decline in old age. However, the relationship between anxiety and cognitive decline is still inconclusive due to heterogeneity in sample and methodology. This study was to explore how baseline anxiety symptoms associated with the change of memory in older people without cognitive impairment over a 3‐year period. Methods: This was a 3‐year prospective study on 91 cognitively normal older adults with anxiety symptoms. They were matched with 91 controls based on age, gender, and education. Anxiety symptoms were assessed with Revised Clinical Interview Schedule (CIS‐R). Physical health was assessed with Chronic Illness Rating Scale (CIRS). Cognitive performance was measured using Cantonese version of the mini‐mental state examination (CMMSE); 10‐minute delay recall; Category verbal fluency test (CVFT); Trail making tests (TMT); and digit and visual span tests. Outcomes were determined as the change of cognitive performance over a 3‐year period. Results: As expected, anxiety group had higher score in CIRS score (t = 4.45, P < .001) and CIS‐R score (t = 9.24, P < .001) than control group. Linear regression showed that baseline anxiety symptoms were associated with change in delayed recall (B = 0.77, P = 0.027, 95% CI = 0.09–1.46), after adjusting for cognitive performance, physical, and mental health statuses. Conclusions: Anxious healthy older adults showed specific decline in episodic memory over a 3-year interval. Our result suggested that anxiety symptoms are predictive of episodic memory decline in cognitively healthy older adults and may be an early sign of neurodegenerative disorders.",Fung A.W.T.; Lee J.S.W.; Lee A.T.C.; Lam L.C.W.,2018.0,10.1002/gps.4850,0,0,
1794,Behavioral and emotional consequences of thought listing versus cognitive restructuring during discarding decisions in hoarding disorder.,"An essential criterion for hoarding disorder (HD) is difficulty discarding or parting with possessions, yet few studies have examined reactions to actual discarding behaviors. The present study examined whether individuals with HD differed from non-hoarding community controls (CC) in discarding behavior and emotional reactions to discarding. A second purpose was to examine the course of experienced distress following discarding. A third purpose was to determine whether HD participants responded differently to a simple thought listing (TL) instruction or to a cognitive restructuring (CR) protocol. Participants were asked to decide whether to keep or discard (a) a personal possession and (b) a newly acquired object (magazine). HD participants anticipated more and longer distress and reported stronger attachment motives than community controls, but they did not differ significantly from community controls in actual discarding behavior. TL was somewhat more effective than CR in improving discarding behavior and reducing negative emotions and attachments to discarded objects among HD participants. Reductions in distress were observed for both HD-TL and HD-CR groups. Thought listing may have reduced avoidance of decision-making about discarding or perhaps CR, but not TL, provoked therapeutic reactance. Discarding was not related to reductions in distress or hoarding-related beliefs.",Frost RO.; Ong C.; Steketee G.; Tolin DF.,2016.0,10.1016/j.brat.2016.08.003,0,0,
1795,An original method for staging sleep based on dynamical analysis of a single EEG signal,"BACKGROUND: The dynamical complexity of brain electrical activity manifested in the EEG is quantifiable using recurrence analysis (RA). Employing RA, we described and validated an originative method for automatically classifying epochs of sleep that is conceptually and instrumentally distinct from the existing method. NEW METHOD: Complexity in single overnight EEGs was characterized second-by-second using four RA variables that were each averaged over consecutive 30-sec epochs to form four-component vectors. The vectors were staged using four-component cluster analysis. Method validity and utility were established by showing: (1) inter- and intra-subject consistency of staging results (method insusceptible to nonstationarity of the EEG); (2) use of method to eliminate costly and arduous visual staging in a binary classifications task for detecting a neurogenic disorder; (3) ability of method to provide new physiological insights into brain activity during sleep. RESULTS: RA of sleep-acquired EEGs yielded four continuous measures of complexity and its change-rate that allowed automatic classification of epochs into four statistically distinct clusters (""stages""). Matched subjects with and without mental distress were accurately classified using biomarkers based on stage designations. COMPARISON WITH EXISTING METHODS: For binary-classification purposes, the method was cheaper, faster, and at least as accurate as the existing staging method. Epoch-by-epoch comparison of new versus existing methods revealed that the latter assigned epochs having widely different dynamical complexities into the same stage (dynamical incoherence). CONCLUSIONS: Sleep can be automatically staged using an originative method that is fundamentally different from the existing method.",Frilot C.; McCarty D.E.; Marino A.A.,2018.0,10.1016/j.jneumeth.2018.07.017,0,0,
1796,The effectiveness of sandplay therapy in reducing anxiety in midlife women with Generalized Anxiety Disorder.,"Presents a study which aims to investigates 1) the effectiveness of sandplay therapy in decreasing anxiety symptoms in Indonesian women age 35-50 diagnosed with GAD, (2) the magnitude of the effect of sandplay therapy in the decrease of GAD scores in the group that received treatment, and (3) and the characteristics of the group that did not receive treatment. The effectiveness of sandplay therapy can be seen from the statistics of the group which received therapy compared to the group that did not. The group that did not receive sandplay therapy experienced an increase in anxiety scores. this study demonstrates that sandplay therapy does not just work to reduce anxiety scores in Indonesian women age 35-50 years, but it also indicates that it is an effective treatment for individuals with the personality trait of neuroticism. Limitations of this study include the small number of participants, their lack of diversity, and the use of one therapist for the experimental intervention. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Foo, Mariana; Ancok, Djamaludin; Milfayetty, Sri",2017.0,,0,0,
1797,Selective Effects of Psychotherapy on Frontopolar Cortical Function in PTSD.,"Exposure therapy is an effective treatment for posttraumatic stress disorder (PTSD), but a comprehensive, emotion-focused perspective on how psychotherapy affects brain function is lacking. The authors assessed changes in brain function after prolonged exposure therapy across three emotional reactivity and regulation paradigms. Individuals with PTSD underwent functional MRI (fMRI) at rest and while completing three tasks assessing emotional reactivity and regulation. Individuals were then randomly assigned to immediate prolonged exposure treatment (N=36) or a waiting list condition (N=30) and underwent a second scan approximately 4 weeks after the last treatment session or a comparable waiting period, respectively. Treatment-specific changes were observed only during cognitive reappraisal of negative images. Psychotherapy increased lateral frontopolar cortex activity and connectivity with the ventromedial prefrontal cortex/ventral striatum. Greater increases in frontopolar activation were associated with improvement in hyperarousal symptoms and psychological well-being. The frontopolar cortex also displayed a greater variety of temporal resting-state signal pattern changes after treatment. Concurrent transcranial magnetic stimulation and fMRI in healthy participants demonstrated that the lateral frontopolar cortex exerts downstream influence on the ventromedial prefrontal cortex/ventral striatum. Changes in frontopolar function during deliberate regulation of negative affect is one key mechanism of adaptive psychotherapeutic change in PTSD. Given that frontopolar connectivity with ventromedial regions during emotion regulation is enhanced by psychotherapy and that the frontopolar cortex exerts downstream influence on ventromedial regions in healthy individuals, these findings inform a novel conceptualization of how psychotherapy works, and they identify a promising target for stimulation-based therapeutics.",Fonzo GA.; Goodkind MS.; Oathes DJ.; Zaiko YV.; Harvey M.; Peng KK.; Weiss ME.; Thompson AL.; Zack SE.; Mills-Finnerty CE.; Rosenberg BM.; Edelstein R.; Wright RN.; Kole CA.; Lindley SE.; Arnow BA.; Jo B.; Gross JJ.; Rothbaum BO.; Etkin A.,2017.0,10.1176/appi.ajp.2017.16091073,0,0,
1798,PTSD Psychotherapy Outcome Predicted by Brain Activation During Emotional Reactivity and Regulation.,"Exposure therapy is an effective treatment for posttraumatic stress disorder (PTSD), but many patients do not respond. Brain functions governing treatment outcome are not well characterized. The authors examined brain systems relevant to emotional reactivity and regulation, constructs that are thought to be central to PTSD and exposure therapy effects, to identify the functional traits of individuals most likely to benefit from treatment. Individuals with PTSD underwent functional MRI (fMRI) while completing three tasks assessing emotional reactivity and regulation. Participants were then randomly assigned to immediate prolonged exposure treatment (N=36) or a waiting list condition (N=30). A random subset of the prolonged exposure group (N=17) underwent single-pulse transcranial magnetic stimulation (TMS) concurrent with fMRI to examine whether predictive activation patterns reflect causal influence within circuits. Linear mixed-effects modeling in line with the intent-to-treat principle was used to examine how baseline brain function moderated the effect of treatment on PTSD symptoms. At baseline, individuals with larger treatment-related symptom reductions (compared with the waiting list condition) demonstrated 1) greater dorsal prefrontal activation and 2) less left amygdala activation, both during emotion reactivity; 3) better inhibition of the left amygdala induced by single TMS pulses to the right dorsolateral prefrontal cortex; and 4) greater ventromedial prefrontal/ventral striatal activation during emotional conflict regulation. Reappraisal-related activation was not a significant moderator of the treatment effect. Capacity to benefit from prolonged exposure in PTSD is gated by the degree to which prefrontal resources are spontaneously engaged when superficially processing threat and adaptively mitigating emotional interference, but not when deliberately reducing negative emotionality.",Fonzo GA.; Goodkind MS.; Oathes DJ.; Zaiko YV.; Harvey M.; Peng KK.; Weiss ME.; Thompson AL.; Zack SE.; Lindley SE.; Arnow BA.; Jo B.; Gross JJ.; Rothbaum BO.; Etkin A.,2017.0,10.1176/appi.ajp.2017.16091072,0,0,
1799,Regional variation in quality of life in patients with a Fontan circulation: A multinational perspective.,"Impaired quality of life (QOL) is associated with congenital heart disease (CHD) and country of residence; however, few studies have compared QOL in patients with differing complexities of CHD across regional populations. The current study examined regional variation in QOL outcomes in a large multinational sample of patients with a Fontan relative to patients with atrial septal defects (ASDs) and ventricular septal defects (VSDs). From the Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease-International Study (APPROACH-IS), 405 patients (163 Fontan and 242 ASD/VSD) across Asia, Europe, and North America provided consent for access to their medical records and completed a survey evaluating QOL (0 to 100 linear analog scale). Primary CHD diagnosis, disease complexity, surgical history, and documented history of mood and anxiety disorders were recorded. Differences in QOL, medical complications, and mood and anxiety disorders between Fontan and ASD/VSD patients, and across geographic regions, were examined using analysis of covariance. Hierarchical regression analyses were conducted to identify variables associated with the QOL ratings. Patients with a Fontan reported significantly lower QOL, and greater medical complications and mood and anxiety disorders relative to patients with ASD/VSD. Inpatient cardiac admissions, mood disorders, and anxiety disorders were associated with lower QOL among patients with a Fontan, and mood disorders were associated with lower QOL among patients with ASD/VSD. Regional differences for QOL were not observed in patients with a Fontan; however, significant differences were identified in patients with ASD/VSD. Regional variation of QOL is commonplace in adults with CHD; however, it appears affected by greater disease burden. Among patients with a Fontan, regional variation of QOL is lost. Specific attempts to screen for QOL and mood and anxiety disorders among CHD patients may improve the care of patients with the greatest disease burden.",Fogleman ND.; Apers S.; Moons P.; Morrison S.; Wittekind SG.; Tomlin M.; Gosney K.; Sluman MA.; Johansson B.; Enomoto J.; Dellborg M.; Lu CW.; Subramanyan R.; Luyckx K.; Budts W.; Jackson J.; Kovacs A.; Soufi A.; Eriksen K.; Thomet C.; Berghammer M.; Callus E.; Fernandes SM.; Caruana M.; Cook SC.; Mackie AS.; White KS.; Khairy P.; Kutty S.; Veldtman G.;  .,2017.0,10.1016/j.ahj.2017.07.019,0,0,
1800, Transcutaneous electrical acupoint stimulation as an adjunct therapy for obsessive-compulsive disorder: a randomized controlled study," Background: Transcutaneous electrical acupoint stimulation (TEAS) is thought to have potential to treat obsessive‚Äêcompulsive disorder (OCD). Objective: The purpose of this study was to determine whether adding TEAS to cognitive behavioral therapy (CBT) and clomipramine would improve the efficacy of these conventional treatments in OCD. Methods: In this randomized controlled trial, 360 OCD patients were assigned to receive TEAS combined with CBT plus clomipramine (Group A, n = 120), TEAS combined with CBT plus placebo (Group B, n = 120), and simulated (placebo) TEAS combined with CBT plus clomipramine (Group C, n = 120) for 12 weeks. The primary outcome was measured using the Yale‚ÄêBrown Obsessive‚ÄêCompulsive Scale (Y‚ÄêBOCS). Results: OCD symptoms in all patients reduced over time, however Groups A and B had a significantly greater reduction in Y‚ÄêBOCS total score and the subscale for obsession and compulsion between week 2 and week 12 compared to Group C. Groups A and B had similar scores on these measures. Both groups had significantly higher rates of clinical response than Group C (88.3% and 81.7% vs. 67.5%, respectively, p < 0.001); and higher rates of remission (30.0% and 22.5% vs. 9.2%, respectively, p < 0.001). Group B experienced fewer adverse events than the other two groups. Conclusions: TEAS enhances the efficacy of conventional OCD interventions and avoids the adverse effects associated with conventional pharmacological treatment. It can be considered as an effective adjunct intervention for OCD."," Feng, B;  Zhang, ZJ;  Zhu, RM;  Yuan, GZ;  Luo, LY;  McAlonan, GM;  Xu, FZ;  Chen, J;  Liu, LY;  Lv, YY;  et al.",2016.0, 10.1016/j.jpsychires.2016.05.015,0,0,
1801,Do You Believe It? Verbal Suggestions Influence the Clinical and Neural Effects of Escitalopram in Social Anxiety Disorder: A Randomized Trial.,"Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for depression and anxiety, but their efficacy relative to placebo has been questioned. We aimed to test how manipulation of verbally induced expectancies, central for placebo, influences SSRI treatment outcome and brain activity in patients with social anxiety disorder (SAD). We did a randomized clinical trial, within an academic medical center (Uppsala, Sweden), of individuals fulfilling the DSM-IV criteria for SAD, recruited through media advertising. Participants were 18years or older and randomized in blocks, through a computer-generated sequence by an independent party, to nine weeks of overt or covert treatment with escitalopram (20mg daily). The overt group received correct treatment information whereas the covert group was treated deceptively with the SSRI described, by the psychiatrist, as active placebo. The treating psychiatrist was necessarily unmasked while the research staff was masked from intervention assignment. Treatment efficacy was assessed primarily with the self-rated Liebowitz Social Anxiety Scale (LSAS-SR), administered at week 0, 1, 3, 6 and 9, also yielding a dichotomous estimate of responder status (clinically significant improvement). Before and at the last week of treatment, brain activity during an emotional face-matching task was assessed with functional magnetic resonance imaging (fMRI) and during fMRI sessions, anticipatory speech anxiety was also assessed with the Spielberger State-Trait Anxiety Inventory - State version (STAI-S). Analyses included all randomized patients with outcome data at posttreatment. This study is registered at ISRCTN, number 98890605. Between March 17th 2014 and May 22nd 2015, 47 patients were recruited. One patient in the covert group dropped out after a few days of treatment and did not provide fMRI data, leaving 46 patients with complete outcome data. After nine weeks of treatment, overt (n=24) as compared to covert (n=22) SSRI administration yielded significantly better outcome on the LSAS-SR (adjusted difference 21.17, 95% CI 10.69-31.65, p<0.0001) with more than three times higher response rate (50% vs. 14%; χ2(1)=6.91, p=0.009) and twice the effect size (d=2.24 vs. d=1.13) from pre-to posttreatment. There was no significant between-group difference on anticipatory speech anxiety (STAI-S), both groups improving with treatment. No serious adverse reactions were recorded. On fMRI outcomes, there was suggestive evidence for a differential neural response to treatment between groups in the posterior cingulate, superior temporal and inferior frontal gyri (all z thresholds exceeding 3.68, p≤0.001). Reduced social anxiety with treatment correlated significantly with enhanced posterior cingulate (z threshold 3.24, p=0.0006) and attenuated amygdala (z threshold 2.70, p=0.003) activity. The clinical and neural effects of escitalopram were markedly influenced by verbal suggestions. This points to a pronounced placebo component in SSRI-treatment of SAD and favors a biopsychosocial over a biomedical explanatory model for SSRI efficacy. The Swedish Research Council for Working Life and Social Research (grant 2011-1368), the Swedish Research Council (grant 421-2013-1366), Riksbankens Jubileumsfond - the Swedish Foundation for Humanities and Social Sciences (grant P13-1270:1).",Faria V.; Gingnell M.; Hoppe JM.; Hjorth O.; Alaie I.; Frick A.; Hultberg S.; Wahlstedt K.; Engman J.; Månsson KNT.; Carlbring P.; Andersson G.; Reis M.; Larsson EM.; Fredrikson M.; Furmark T.,2017.0,10.1016/j.ebiom.2017.09.031,0,0,
1802,Working hard for oneself or others: Effects of oxytocin on reward motivation in social anxiety disorder.,"There is some evidence to suggest that oxytocin promotes social behavior, especially for disorders characterized by social dysfunction, such as social anxiety disorder (SAD). The goal of this study was to examine the effect of oxytocin on reward motivation in SAD. We tested whether oxytocin promotes prosocial, or antisocial, self-directed decisions, and whether its effects depended on social anxiety severity and attachment. Fifty-two males with SAD received 24 international units of oxytocin or placebo, and completed a reward motivation task that measured willingness to work for self vs. other monetary rewards. Although there was no main drug effect, social anxiety severity moderated the effect of oxytocin. Less socially anxious individuals who received oxytocin worked harder for other vs. own rewards, compared to high socially anxious individuals. Attachment did not moderate this effect. Among people with SAD, oxytocin enhances prosocial behaviors in individuals with relatively lower levels of social anxiety. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Fang, Angela; Treadway, Michael T; Hofmann, Stefan G",2017.0,http://dx.doi.org/10.1016/j.biopsycho.2017.05.015,0,0,
1803,Acute Optic Neuropathy and Development of Posttraumatic Stress Disorder.,"This study aimed to determine the prevalence and risk factors of posttraumatic stress disorder (PTSD) in 171 acute optic neuropathy (AON) patients, and to compare the findings to those previously reported on 366 rhegmatogenous retinal detachment (RRD) patients. PTSD positively screened AON patients underwent a structured psychiatric interview and a Visual Function Questionnaire (VFQ). Clinical measures were retrieved from medical records and compared between cohorts. None of the AON patients was diagnosed with PTSD, as opposed to 2.5% of RRD patients (P = 0.063). Of the AON cohort, 34% of patients were administered steroids, compared to none of the RRD patients, whereas all of the RRD patients underwent surgery, compared to none of the AON patients (P < 0.001). Clinical measures and VFQ scores were not found as risk factors for PTSD prediction. Results imply the potential role of surgery and of steroid treatment in developing PTSD in cases of ocular insults.",Fabian ID.; Abudi A.; Kinori M.; Moisseiev J.; Liashets-Peer A.; Zohar J.; Huna-Baron R.,2017.0,10.3109/08820538.2015.1115086,0,0,
1804, Reductions in experiential avoidance as a mediator of change in symptom outcome and quality of life in acceptance-based behavior therapy and applied relaxation for generalized anxiety disorder," As a field, we lack information about specific mechanisms that are responsible for changes that occur over the course of treatments for anxiety disorders (Kazdin, 2007). Identifying these mechanisms would help streamline evidence‚Äêbased approaches, increase treatment response rates, and aid in the dissemination and implementation of evidence‚Äêbased approaches in diverse contexts. The current study examined reductions in experiential avoidance (EA; Hayes, Wilson, Gifford, Follette, & Strosahl, 1996), attempts to control or eliminate distressing internal experiences, regardless of behavioral consequences, as a potential mechanism of change in participants with a principal diagnosis of generalized anxiety disorder (GAD) receiving either acceptance‚Äêbased behavior therapy (ABBT) or applied relaxation (AR). Participants' EA scores across treatment on the Acceptance and Action Questionnaire (AAQ) were used to calculate slopes, which were used as predictors in a series of linear regressions. Greater change in EA across treatment significantly predicted change in worry (PSWQ) and quality of life (QOLI) across both treatments. These results contribute to the body of literature on common mechanisms of change across traditional CBTs and mindfulness and acceptance‚Äêbased approaches."," Eustis, EH;  Hayes-Skelton, SA;  Roemer, L;  Orsillo, SM",2016.0, 10.1016/j.brat.2016.09.012,0,0,
1805, Pediatric selective mutism therapy: a randomized controlled trial," BACKGROUND: Selective mutism (SM) is a rare disease in children coded by DSM‐5 as an anxiety disorder. Despite the disabling nature of the disease, there is still no specific treatment. AIM: The aims of this study were to verify the efficacy of six‐month standard psychomotor treatment and the positive changes in lifestyle, in a population of children affected by SM. DESIGN: Randomized controlled trial registered in the European Clinical Trials Registry (EuDract 2015‐001161‐36). SETTING: University third level Centre (Child and Adolescent Neuropsychiatry Clinic). POPULATION: Study population was composed by 67 children in group A (psychomotricity treatment) (35 M, mean age 7.84±1.15) and 71 children in group B (behavioral and educational counseling) (37 M, mean age 7.75±1.36). METHODS: Psychomotor treatment was administered by trained child therapists in residential settings three times per week. Each child was treated for the whole period by the same therapist and all the therapists shared the same protocol. The standard psychomotor session length is of 45 minutes. At T0 and after 6 months (T1) of treatments, patients underwent a behavioral and SM severity assessment. To verify the effects of the psychomotor management, the Child Behavior Checklist questionnaire (CBCL) and Selective Mutism Questionnaire (SMQ) were administered to the parents. RESULTS: After 6 months of psychomotor treatment SM children showed a significant reduction among CBCL scores such as in social relations, anxious/depressed, social problems and total problems (P<0.001), Withdrawn (P=0.007) and Internalizing problems (P=0.020). Regarding SM severity according to SMQ assessment, children of group A showed a reduction of SM symptoms in all situations (school, P=0.003; family, P=0.018; and social, P=0.030 situations) and in SMQ total score (P<0.001). CONCLUSIONS: Our preliminary results suggest the positive effect of the psychomotor treatment in rehabilitative program for children affected by selective mutism, even if further studies are needed. CLINICAL REHABILITATION IMPACT: The present study identifies in psychomotricity a safe and efficacy therapy for pediatric selective mutism."," Esposito, M;  Gimigliano, F;  Barillari, MR;  Precenzano, F;  Ruberto, M;  Sepe, J;  Barillari, U;  Gimigliano, R;  Militerni, R;  Messina, G;  et al.",2017.0, 10.23736/S1973-9087.16.04037-5,0,0,
1806, Correlates of posttraumatic stress disorder in adults with congenital heart disease," DESIGN: Cross‐sectional. SETTING: Two university‐affiliated heart hospitals in Tehran, Iran. PATIENTS: A sample of 347 adults with congenital heart disease aged 18‐64 years (52% women), and 353 adults without congenital heart disease matched by sex and age (±2 years) was recruited. OUTCOME MEASURES: The PTSD Scale: Self‐report version was used to assess the diagnosis and severity of posttraumatic stress disorder. Hierarchical multivariate logistic regression analyses were performed to explore correlates of likely posttraumatic stress disorder diagnosis among each group of participants. RESULTS: The posttraumatic stress disorder in the patients was comparable to those of the control group, except for increased arousal (P = .027) which was scored higher among the patients. Over 52% of adults with congenital heart disease met the criteria for a likely posttraumatic stress disorder diagnosis compared with 48% of adults without congenital heart disease. The regression analyses among patients revealed that elevated depressive symptoms (OR = 1.27) and a positive history of cardiac surgery (OR = 2.02) were significantly associated with posttraumatic stress disorder. The model could explain 29% of the variance in posttraumatic stress disorder. CONCLUSIONS: The high and comparable prevalence of posttraumatic stress disorder among patients and nonpatients highlight the significance of the context in which adults with congenital heart disease may face other/additional stressors than disease‐related ones, an issue that clinicians need also take into account. Furthermore, the association of posttraumatic stress disorder with elevated depressive symptoms warrant a comprehensive psychological assessment and management of adults with congenital heart disease, in particular among those with a history of invasive procedures. OBJECTIVE: The aims of this study were to compare the level of posttraumatic stress disorder between adults with and without congenital heart disease, and to examine the correlates of posttraumatic stress disorder (e.g., sociodemographics)."," Eslami, B",2017.0, 10.1111/chd.12452,0,0,
1807, A neuromuscular exercise programme versus standard care for patients with traumatic anterior shoulder instability: study protocol for a randomised controlled trial (the SINEX study)," BACKGROUND: Anterior shoulder dislocation is a common injury and may have considerable impact on shoulder‚Äêrelated quality of life (QoL). If not warranted for initial stabilising surgery, patients are mostly left with little to no post‚Äêtraumatic rehabilitation. This may be due to lack of evidence‚Äêbased exercise programmes. In similar, high‚Äêimpact injuries (e.g. anterior cruciate ligament tears in the knee) neuromuscular exercise has shown large success in improving physical function and QoL. Thus, the objective of this trial is to compare a nonoperative neuromuscular exercise shoulder programme with standard care in patients with traumatic anterior shoulder dislocations (TASD). METHODS/DESIGN: Randomised, assessor‚Äêblinded, controlled, multicentre trial. Eighty patients with a TASD will be recruited from three orthopaedic departments in Denmark. Patients with primary or recurrent anterior shoulder dislocations due to at least one traumatic event will be randomised to 12 weeks of either a standardised, individualised or physiotherapist‚Äêsupervised neuromuscular shoulder exercise programme or standard care (self‚Äêmanaged shoulder exercise programme). Patients will be stratified according to injury status (primary or recurrent). Primary outcome will be change from baseline to 12 weeks in the patient‚Äêreported QoL outcome questionnaire, the Western Ontario Shoulder Instability Index (WOSI). DISCUSSION: This trial will be the first study to compare the efficacy and safety of two different nonoperative exercise treatment strategies for patients with TASD. Moreover, this is also the first study to investigate nonoperative treatment effects in patients with recurrent shoulder dislocations. Lastly, this study will add knowledge to the shared decision‚Äêmaking process of treatment strategies for clinical practice. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02371928 . Registered on 9 February 2015 at the National Institutes of Health Clinical Trials Protocol Registration System."," Eshoj, H;  Rasmussen, S;  Frich, LH;  Hvass, I;  Christensen, R;  Jensen, SL;  S√∏ndergaard, J;  S√∏gaard, K;  Juul-Kristensen, B",2017.0, 10.1186/s13063-017-1830-x,0,0,
1808,Risk Factors as Major Determinants of Resilience: A Replication Study,"The present study was conducted in the context of current concerns about replication in psychological research. It claims that risk factors should be regarded as an integral part of the definition of individual resilience, which should be defined in terms of the balance between individual strength or protective factors, and individual vulnerability or risk factors (IND-SVR). Five independent samples, including 3457 Israeli participants, were employed to determine the effects of resilience promoting and resilience suppressing variables on the IND-SVR index of resilience, and on its two components: recovery from adversity, and distress symptoms. Five path analyses were employed for determining the role of distress symptoms as a measure of psychological resilience, as compared to other indices of this resilience. Results indicated the major role of risk factors (distress symptoms) as an integral component of resilience. This role was generally replicated in the five investigated samples. Risk factors are legitimate, valid, and useful parts of the definition of psychological resilience. Resilience research has shifted away from studying individual risk factors to investigating the process through which individuals overcome the hardships they experience. The present data seem to suggest that this shift should be reexamined.",Eshel Y.; Kimhi S.; Lahad M.; Leykin D.; Goroshit M.,2018.0,10.1007/s10597-018-0263-7,0,0,
1809, Exploring the effect of case formulation driven CBT for children with anxiety disorders: a feasibility study," BACKGROUND: Little is known about the effect of case‚Äêformulation based cognitive behaviour therapy (CBT) for anxious children. AIM: The present study explores the feasibility of case‚Äêformulation driven CBT for anxious children. Parents were involved in treatment as either co‚Äêfacilitators (involved only as the child's assistants, treatment being primarily directed at the child), or as co‚Äêclients (parents received therapy targeting theoretically established maintaining mechanisms; children received half of the sessions, parents the other half). METHOD: Feasibility of the case‚Äêformulation driven CBT was established by comparing the completion rate and the percentage of children free of anxiety after treatment, with manualized treatments reported in existing meta‚Äêanalyses. Children aged 7‚Äê12 years and their parents participated (n = 54). Families were assessed at pre‚Äê and posttreatment and at 6‚Äêmonth follow‚Äêup. RESULTS: All families completed treatment and the percentage of recovery in the case‚Äêformulation driven approach was comparable to results obtained in manualized treatments. CONCLUSION: The findings from this stage I study supports the notion that a case‚Äêformulation driven approach to CBT may be a feasible option when selecting treatment for anxious children; however, further studies must be conducted before firm conclusions can be drawn."," Esbj√∏rn, BH;  Reinholdt-Dunne, ML;  Nielsen, SK;  Smith, AC;  Breinholst, S;  Leth, I",2015.0, 10.1017/S1352465813000702,0,0,
1810," Effects of Home-Delivered Cognitive Behavioral Therapy (CBT) for Depression on Anxiety Symptoms among Rural, Ethnically Diverse Older Adults"," BACKGROUND: We examined the effects of home‚Äêdelivered cognitive‚Äêbehavioral therapy (CBT) for depression on anxiety symptoms in an ethnically diverse, low resource, and medically frail sample of rural, older adults. METHOD: This was a secondary analysis of a randomized clincial trial with 134 rural‚Äêdwelling adults 65 years and older with decreased quality of life and elevated psychological symptomatology. Anxiety symptoms were assessed with the anxiety and phobic anxiety subscales of the Symptom Checklist‚Äê90‚ÄêRevised (SCL‚Äê90‚ÄêR). RESULTS: Compared to a minimal support control condition, CBT for depression resulted in significantly greater improvements in symptoms of anxiety and phobic anxiety from pre‚Äêtreatment to post‚Äêtreatment. CONCLUSION: Home‚Äêdelivered CBT for depression can be an effective treatment for anxiety in a hard‚Äêto‚Äêreach older populations. CLINICAL IMPLICATIONS: Additional research should explore integrated anxiety and depression protocols and other treatment modalities, including bibliotherapy or telehealth models of CBT, to reduce costs associated with its in home delivery. Flexibility in administration and adaptations to the CBT protocol may be necessary for use with vulnerable, rural older adults."," DiNapoli, EA;  Pierpaoli, CM;  Shah, A;  Yang, X;  Scogin, F",2017.0, 10.1080/07317115.2017.1288670,0,0,
1811,"Repetitive transcranial magnetic stimulation of the right dorsal lateral prefrontal cortex in the treatment of generalized anxiety disorder: A randomized, double-blind sham controlled clinical trial.","Up to 50% of people with GAD fail to respond to first-line pharmacotherapies for generalized anxiety disorder (GAD), partly due to poor treatment compliance rates and partly due to the complex physiology underlying GAD. Thus, new non-invasive techniques, like repetitive transcranial magnetic stimulation (rTMS) are being investigated. Participants were recruited from two different mood disorder sites: Kingston, Ontario, Canada and Sofia, Bulgaria. Hamilton Anxiety Rating Scale (HARS) scores were reported from patients diagnosed with GAD following treatment with high-frequency (20Hz) rTMS applied to the right dorsal lateral prefrontal cortex (DLPFC). By the end of 25 rTMS treatments, the ACTIVE (n=15) treatment group showed a clinically significant reduction in the HARS scores compared to the SHAM (n=25) group. Hedge's g at visit 4 (following 25 rTMS treatments) was 2.1 between ACTIVE and SHAM treatments. Furthermore, at 2 and 4weeks follow-up (after the end of treatment) HARS scores of the ACTIVE group remained stable and even slightly improved, demonstrating a sustained effect of the response. Relatively small sample size of the ACTIVE group as well as the SHAM procedure may limit the generalizability of the results. Thus, participants receiving rTMS treatment showed a clinically significant decrease in reported anxiety symptoms as measured by the HARS. rTMS may be a treatment options for patients treatment refractory to pharmacotherapies. www.clinicaltrials.gov: NCT00616447.",Dilkov D.; Hawken ER.; Kaludiev E.; Milev R.,2017.0,10.1016/j.pnpbp.2017.05.018,0,0,
1812," Repetitive transcranial magnetic stimulation for generalised anxiety disorder: a pilot randomised, double-blind, sham-controlled trial"," BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) holds promise for treating generalised anxiety disorder (GAD) but has only been studied in uncontrolled research. AIMS: This is the first randomised controlled trial (clinicaltrials.gov: NCT01659736) to investigate the efficacy and neural correlates of rTMS in GAD. METHOD: Twenty five participants (active n = 13; sham, n = 12) enrolled. rTMS was targeted at the right dorsolateral prefrontal cortex (DLPFC, 1 Hz, 90% resting motor threshold). RESULTS: Response and remission rates were higher in the active v. sham groups and there were significant group √ó time interactions for anxiety, worry and depressive symptoms, favouring active v. sham. In addition, right DLPFC activation during a decision‚Äêmaking gambling task increased at post‚Äêtreatment for active rTMS only, and changes in neuroactivation correlated significantly with changes in worry symptoms. CONCLUSIONS: Findings provide preliminary evidence that rTMS may improve GAD symptoms in association with modifying neural activity in the stimulation site."," Diefenbach, GJ;  Bragdon, LB;  Zertuche, L;  Hyatt, CJ;  Hallion, LS;  Tolin, DF;  Goethe, JW;  Assaf, M",2016.0, 10.1192/bjp.bp.115.168203,0,0,
1813, Improvements in emotion regulation following repetitive transcranial magnetic stimulation for generalized anxiety disorder," Generalized anxiety disorder (GAD) is characterized by emotion regulation difficulties, which are associated with abnormalities in neural circuits encompassing fronto‚Äêlimbic regions including the dorsolateral prefrontal cortex (DLPFC). The aim of this study was to determine whether DLPFC neuromodulation improves emotion regulation in patients with GAD. This is a secondary analysis from a randomized‚Äêcontrolled trial comparing 30 sessions of low‚Äêfrequency right‚Äêsided active (n=13) versus sham (n=12, sham coil) repetitive transcranial magnetic stimulation (rTMS) at the right DLPFC in patients with GAD. Results indicated statistically significant improvements in self‚Äêreported emotion regulation difficulties at posttreatment and 3‚Äêmonth follow‚Äêup in the active group only. Improvements were found primarily in the domains of goal‚Äêdirected behaviors and impulse control and were significantly associated with a global clinician rating of improvement. These preliminary results support rTMS as a treatment for GAD and suggest improved emotion regulation as a possible mechanism of change."," Diefenbach, GJ;  Assaf, M;  Goethe, JW;  Gueorguieva, R;  Tolin, DF",2016.0, 10.1016/j.janxdis.2016.07.002,0,0,
1814, Evaluation and Socio-occupational Intervention in Bipolar and Schizophrenic Patients within a Multimodal Intervention Program- PRISMA," BACKGROUND: Functional improvement in bipolar and schizophrenic patients is one of the main aims of treatment. Nevertheless, there is no evidence about the effect of socio‐occupational intervention within a multimodal intervention (MI) programme. OBJECTIVE: To describe the socio‐occupational profile and to evaluate the functional effect of a MI in bipolar I and schizophrenic patients. METHODS: A prospective, longitudinal, therapeutic‐comparative study was performed including 302 subjects (104 schizophrenic and 198 Bipolar Disorder I [BDI] patients), who were randomised into two groups, multimodal (psychiatry, psychology, medicine, occupational therapy, neuropsychology, and family therapy), or traditional intervention (psychiatry and medicine only). Several scales were applied to assess assertiveness, free time management, social abilities, general anxiety, self‐care and performance in home, work and community tasks. RESULTS: After performing the longitudinal analysis, it was shown that the multimodal intervention was more effective than traditional intervention in general anxiety scores (P=.026) and development in home tasks (P=.03) in schizophrenic patients. No statistical differences were found in bipolar patients. The other variables showed improvement, however, their effect was similar in both intervention groups. CONCLUSIONS: Our study identified functional improvement in home tasks in schizophrenic patients after receiving multimodal intervention. Other variables also showed improvement for both interventions groups. Future studies, applying longer rehabilitation programs and other ecological strategies should be performed to identify the most effective interventions."," Díaz Zuluaga, AM;  Duica, K;  Ruiz Galeano, C;  Vargas, C;  Agudelo Berruecos, Y;  Ospina, S;  López-Jaramillo, C",2018.0, 10.1016/j.rcp.2017.01.006,0,0,
1815,Mindfulness-based stress reduction in adolescents with mental disorders: A randomised clinical trial.,"Currently, there is a strong movement to implement mindfulness interventions with young people. The objective of this randomised clinical trial was to assess the potential effects of a mindfulness-based stress reduction (MBSR) programme for adolescent outpatients in mental health facilities in Cordoba, Spain. A total of 101 adolescents aged 13-16 years old, receiving psychological or psychiatric treatment for various disorders, were eligible for the study. The participants&rsquo; scores on mindfulness, self-esteem, perceived stress, state-trait anxiety and other psychological symptoms were examined at two time-points. Eighty adolescents completed the study (MBSR+TAU group = 41; TAU group = 39). The MBSR+TAU group showed a statistically significant decrease in anxiety state compared to the treatment-as-usual (TAU) group. No statistically significant differences were found between groups on the other scores, but the intervention was observed to have a greater impact on the MBSR+TAU group than in the TAU group, especially in reducing symptoms of depression, anxiety, paranoia and perceived stress. These results suggest that MBSR may be a useful adjunct treatment for adolescents in mental health facilities.",Díaz-González MC.; Pérez Dueñas C.; Sánchez-Raya A.; Moriana Elvira JA.; Sánchez Vázquez V.,2018.0,10.7334/psicothema2017.259,0,0,
1816,Feel the time. Time perception as a function of interoceptive processing,"The nature of time is rooted in our body. Constellations of impulses arising from the flesh constantly create our interoceptive perception and, in turn, the unfolding of these perceptions defines human awareness of time. This study explored the connection between time perception and interoception and proposes the Interoceptive Buffer saturation (IBs) index. IBs evaluates subjects’ ability to process salient stimuli from the body by measuring subjective distortions of interoceptive time perception, i.e., the estimated duration of tactile interoceptive stimulations. Thirty female healthy subjects were recruited through consecutive sampling and assessed for common variables related to interoceptive alterations: depressive symptoms (Beck Depression Inventory, BDI-II), eating disorders (EDI-3) risk, and anxiety levels (State Trait Anxiety Inventory, STAI). Interoceptive cardiac accuracy (IAc) was assessed as well. Subjects performed verbal time estimation of interoceptive stimuli (IBs) delivered using a specifically designed interoceptive tactile stimulator, as well as verbal time estimation of visual and auditory stimuli. Results showed that IBs index positively correlated with IAc, and negatively with EDI-3 Drive for Thinness (DT) risk subscale. Moreover, IBs index was positively predicted by IAc, and negatively predicted by DT and somatic factors of depression. Our results suggest that underestimations in interoceptive time perception are connected to different psychological conditions characterized by a diminished processing of high salience stimuli from the body. Conversely, overestimations of the duration of interoceptive stimuli appear to be function of subjects’ ability to correctly perceive their own bodily information. Evidence supported IBs index, fostering the concept of interoceptive treatments for clinical purposes.",Di Lernia D.; Serino S.; Pezzulo G.; Pedroli E.; Cipresso P.; Riva G.,2018.0,10.3389/fnhum.2018.00074,0,0,
1817,A randomized clinical trial of a postdeployment parenting intervention for service members and their families with very young children.,"Parenting through the deployment cycle presents unique stressors for military families. To date, few evidence-based and military-specific parenting programs are available to support parenting through cycles of deployment separation and reintegration, especially for National Guard/Reserve members. The purpose of this research was to test the efficacy of a parenting program developed specifically to support military families during reintegration. Within 1 year of returning from deployment to Afghanistan or Iraq, 115 service members with very young children were randomly assigned to receive either the Strong Families Strong Forces Parenting Program at baseline or after a 12-week waiting period. Using a home-based modality, service members, at-home parents, and their young child were assessed at baseline, 3 months posttreatment/wait period, and 6 months from baseline. Service member parents in Strong Families evidenced greater reductions in parenting stress and mental health distress relative to those in the waitlist comparison group. Service members with more posttraumatic stress symptoms reported higher levels of perceived parental efficacy in the intervention group than service members in the comparison group. Intervention also resulted in enhanced parental reflective capacity, including increased curiosity and interest in the young child among those in the intervention group relative to comparison. Service member parents and their spouses demonstrated high interest in participating in a postdeployment parenting program targeting families with very young children. Findings point to the feasibility, appeal, and efficacy of Strong Families in this initial trial and suggest promise for implementation in broader military and community service systems. (PsycINFO Database Record",DeVoe ER.; Paris R.; Emmert-Aronson B.; Ross A.; Acker M.,2017.0,10.1037/tra0000196,0,0,
1818," Study protocol and rationale for a prospective, randomized, double-blind, placebo-controlled study to evaluate the effects of Ashwagandha (Withania somnifera) extract on nonrestorative sleep"," Nonrestorative sleep (NRS) is one of the cardinal symptoms of insomnia and can occur independent of other components of insomnia. Among the sleep disturbances, NRS has been little studied in the general population, even though this symptom plays an important role in several medical conditions associated with chronic inflammation such as heart disease, fibromyalgia, and chronic fatigue syndrome, as well as various sleep disorders. There is paucity in the literature about effective treatments for NRS. Ashwagandha (Withania somnifera) has been demonstrated to reduce anxiety and stress, allowing the body to settle down and prepare for sleep. This study will be a double‚Äêblind, randomized, placebo‚Äêcontrolled interventional study in NRS population.The NRS participants are identified using Restorative Sleep Questionnaire‚Äêweekly version (RSQ‚ÄêW) questionnaire. Actigraphy and polysomnography are used for the objective assessment of sleep. The other assessments used are Hamilton Anxiety Depression Scale (HADS), World Health Organization Quality of Life (WHOQOL) scales, and C‚Äêreactive protein. Routine blood and urine analyses will be conducted to assess the safety of treatment. Duration of study for each participant will be 50 days with ""day one"" for screening followed by randomization for the treatment. The duration for medicine/placebo intake shall be 42 days.Primary outcome will be to evaluate effect of daily supplement of ashwagandha extract compared with placebo in subjects with NRS at 6 weeks from baseline, as assessed by the total score of RSQ‚ÄêW. CTRI REGISTRATION NUMBER: CTRI/2017/02/007801."," Deshpande, A;  Irani, N;  Balakrishnan, R",2018.0, 10.1097/MD.0000000000011299,0,0,
1819,Neurobiological and clinical effects of fNIRS-controlled rTMS in patients with panic disorder/agoraphobia during cognitive-behavioural therapy.,"A relevant proportion of patients with panic disorder (PD) does not improve even though they receive state of the art treatment for anxiety disorders such as cognitive-behavioural therapy (CBT). At the same time, it is known, that from a neurobiological point of view, PD patients are often characterised by prefrontal hypoactivation. Intermittent Theta Burst Stimulation (iTBS) is a non-invasive type of neurostimulation which can modulate cortical activity and thus has the potential to normalise prefrontal hypoactivity found in PD. We therefore aimed at investigating the effects of iTBS as an innovative add-on to CBT in the treatment for PD. In this double-blind, bicentric study, 44 PD patients, randomised to sham or verum stimulation, received 15 sessions of iTBS over the left prefrontal cortex (PFC) in addition to 9 weeks of group CBT. Cortical activity during a cognitive as well as an emotional (Emotional Stroop) paradigm was assessed both at baseline and post-iTBS treatment using functional near-infrared spectroscopy (fNIRS) and compared to healthy controls. In this manuscript we only report the results of the emotional paradigm; for the results of the cognitive paradigm please refer to Deppermann et al. (2014). During the Emotional Stroop test, PD patients showed significantly reduced activation to panic-related compared to neutral stimuli for the left PFC at baseline. Bilateral prefrontal activation for panic-related stimuli significantly increased after verum iTBS only. Clinical ratings significantly improved during CBT and remained stable at follow-up. However, no clinical differences between the verum- and sham-stimulated group were identified, except for a more stable reduction of agoraphobic avoidance during follow-up in the verum iTBS group. Limitations include insufficient blinding, the missing control for possible state-dependent iTBS effects, and the timing of iTBS application during CBT. Prefrontal hypoactivity in PD patients was normalised by add-on iTBS. Clinical improvement of anxiety symptoms was not affected by iTBS.",Deppermann S.; Vennewald N.; Diemer J.; Sickinger S.; Haeussinger FB.; Dresler T.; Notzon S.; Laeger I.; Arolt V.; Ehlis AC.; Fallgatter AJ.; Zwanzger P.,2017.0,10.1016/j.nicl.2017.09.013,0,0,
1820,Functional co-activation within the prefrontal cortex supports the maintenance of behavioural performance in fear-relevant situations before an iTBS modulated virtual reality challenge in participants with spider phobia.,"A number of studies/meta-analyses reported moderate antidepressant effects of activating repetitive transcranial magnetic stimulation (rTMS) over the prefrontal cortex (PFC). Regarding the treatment of anxiety, study outcomes are inconsistent, probably because of the heterogenity of anxiety disorders/study designs. To specifically evaluate the impact of rTMS on emotion regulation in fear-relevant situations we applied a sham-controlled activating protocol (intermittent Theta Burst Stimulation/iTBS) over the left PFC (F3) succeeded by a virtual reality (VR) challenge in n=41 participants with spider phobia and n=42 controls. Prior to/after iTBS and following VR prefrontal activation was assessed by functional near-infrared spectroscopy during an emotional Stroop paradigm. Performance (reaction times/error rates) was evaluated. Stimuli were rated regarding valence/arousal at both measurements. We found diminished activation in the left inferior frontal gyrus (IFG) of participants with spider phobia compared to controls, particularly elicited by emotionally-irrelevant words. Simultaneously, a functional connectivity analysis showed increased co-activation between the left IFG and the contra-lateral hemisphere. Behavioural performance was unimpaired. After iTBS/VR no significant differences in cortical activation between the phobic and control group remained. However, verum-iTBS did not cause an additional augmentation. We interpreted our results in terms of a prefrontal network which gets activated by emotionally-relevant stimuli and supports the maintenance of adequate behavioural reactions. The missing add-on effects of iTBS might be due to a ceiling effect of VR, thereby supporting its potential during exposure therapy. Concurrently, it implies that the efficient application of iTBS in the context of emotion regulation still needs to be studied further.",Deppermann S.; Notzon S.; Kroczek A.; Rosenbaum D.; Haeussinger FB.; Diemer J.; Domschke K.; Fallgatter AJ.; Ehlis AC.; Zwanzger P.,2016.0,10.1016/j.bbr.2016.03.028,0,0,
1821, The Role of Distinctiveness of Stimulus in Memory Distrust as a Function of Repeated Checking," METHOD: The Padua Inventory‐Washington State University Revision (PI‐WSUR) was applied in a cohort of university students. Among the students who completed the PI‐WSUR, 84 participants were selected and assigned to low Obsessive‐Compulsive Symptomatology (OCS) group or high OCS group according to their PI‐WSUR scores. An interactive computer animation was developed to test repeated checking behavior. Participants were randomly assigned to two experimental conditions: ""Feedback condition"" and ""no feedback condition"". The participants were all asked to carry out checking rituals on a virtual gas ring. However, half of the participants were given feedback indicating that checking activity was successful and complete and half of the participants were not. RESULTS: While there was no significant difference in terms of memory accuracy, memory detail and memory vividness between feedback condition and no feedback condition, there was a significant difference in terms of memory confidence between two experimental groups. DISCUSSION: Results are discussed in the light of a different explanation offering that the level of distinctiveness of recollections plays crucial role in memory distrust rather than the explanation of low confidence hypothesis. OBJECTIVE: Recent literature proposes that repeated checking increases familiarity with the material, making recollections less vivid and detailed and promoting distrust in memory. The aim of the current study is to investigate the possible underlying mechanisms of low confidence in memory."," Demirsöz, T;  Ayvaşık, HB",2017.0,,0,0,
1822,E-mail support as an adjunct to cognitive-behavioral group therapy for social anxiety disorder: Impact on dropout and outcome.,"The present study evaluates the impact of semi-individualized e-mail support as an adjunct to cognitive behavioral group therapy (CBGT) for social anxiety disorder (SAD) on dropout and outcome. The effectiveness of additional semi-individualized e-mail support was evaluated for the whole sample and for a subsample of patients at risk of dropping out of therapy. A total of 91 patients with SAD were allocated either to the intervention condition (CBGT with e-mail support), or to the control condition (CBGT without e-mail support). Anxiety symptoms, depression, global symptomatology and life satisfaction were assessed at pretreatment, post-treatment and follow-up (3, 6 and 12 months). From pre-treatment to post-treatment, both groups improved significantly on all symptom measures. Therapy gains were maintained at the 1-year follow-up. Subsample analyses showed that CBGT+e-mail was more effective than CGBT alone in reducing symptom severity among patients missing at least two therapy sessions. Additionally, in this subgroup, those receiving additional e-mail support showed a tendency towards lower dropout rates. Based on the results of this study, semi-individualized e-mail support between sessions seems to enhance the effectiveness of CBGT for SAD patients at risk of dropping out of treatment and should be considered as an additional tool in clinical practice.",Delsignore A.; Rufer M.; Emmerich J.; Weidt S.; Brühl AB.; Moergeli H.,2016.0,10.1016/j.psychres.2016.07.038,0,0,
1823,"Feedback-informed treatment versus usual psychological treatment for depression and anxiety: A multisite, open-label, cluster randomised controlled trial.","[Correction Notice: An Erratum for this article was reported in Vol 5(8) of The Lancet Psychiatry (see record 2018-38160-022). In the original article, in figure 2, the p values should not have been reported and have been replaced with d values and associated 95% CIs.] Background: Previous research suggests that the use of outcome feedback technology can enable psychological therapists to identify and resolve obstacles to clinical improvement. We aimed to assess the effectiveness of an outcome feedback quality assurance system applied in stepped care psychological services. Methods: This multisite, open-label, cluster randomised controlled trial was done at eight National Health Service (NHS) Trusts in England, involving therapists who were qualified to deliver evidence-based low-intensity or high-intensity psychological interventions. Adult patients (18 years or older) who accessed individual therapy with participating therapists were eligible for inclusion, except patients who accessed group therapies and those who attended less than two individual therapy sessions. Therapists were randomly assigned (1:1) to an outcome feedback intervention group or a treatment-as-usual control group by use of a computer-generated randomisation algorithm. The allocation of patients to therapists was quasi-random, whereby patients on waiting lists were allocated sequentially on the basis of therapist availability. All patients received low-intensity (less than eight sessions) or high-intensity (up to 20 sessions) psychological therapies for the duration of the 1-year study period. An automated computer algorithm alerted therapists in the outcome feedback group to patients who were not on track, and primed them to review these patients in clinical supervision. The primary outcome was symptom severity on validated depression (Patient Health Questionnaire-9 [PHQ-9]) and anxiety (Generalised Anxiety Disorder-7 [GAD-7]) measures after treatment of varying durations, which were compared between groups with multilevel modelling, controlling for cluster (therapist) effects. We used an intention-to-treat approach. This trial was prospectively registered with ISRCTN, number ISRCTN12459454. Findings: In total, 79 therapists were recruited to the study between Jan 8, 2016, and July 15, 2016, but two did not participate. Of these participants, 39 (51%) were randomly assigned to the outcome feedback group and 38 (49%) to the control group. Overall, 2233 patients were included in the trial (1176 [53%] were treated by therapists in the outcome feedback group, and 1057 [47%] by therapists in the control group). Patients classified as not on track had less severe symptoms after treatment if they were allocated to the outcome feedback group than those in the control group (PHQ-9 d = 0.23, B = -1.03 [95% CI -1.84 to -0.23], p = 0.012; GAD-7 d = 0.19, B = -0.85 [-1.56 to -0.14], p = 0.019). Interpretation: Supplementing psychological therapy with low-cost feedback technology can reduce symptom severity in patients at risk of poor response to treatment. This evidence supports the implementation of outcome feedback in stepped care psychological services. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Delgadillo, Jaime; de Jong, Kim; Lucock, Mike; Lutz, Wolfgang; Rubel, Julian; Gilbody, Simon; Ali, Shehzad; Aguirre, Elisa; Appleton, Mark; Nevin, Jacqueline; O'Hayon, Harry; Patel, Ushma; Sainty, Andrew; Spencer, Peter; McMillan, Dean",2018.0,http://dx.doi.org/10.1016/S2215-0366%2818%2930162-7,0,0,
1824, Improving the efficiency of psychological treatment using outcome feedback technology," AIMS: This study evaluated the impact of applying computerized outcome feedback (OF) technology in a stepped care psychological service offering low and high intensity therapies for depression and anxiety. METHODS: A group of therapists were trained to use OF based on routine outcome monitoring using depression (PHQ‚Äê9) and anxiety (GAD‚Äê7) measures. Therapists regularly reviewed expected treatment response graphs with patients and discussed cases that were ""not on track"" in clinical supervision. Clinical outcomes data were collected for all patients treated by this group (N = 594), six months before (controls = 349) and six months after the OF training (OF cases = 245). Symptom reductions in PHQ‚Äê9 and GAD‚Äê7 were compared between controls and OF cases using longitudinal multilevel modelling. Treatment duration and costs were compared using MANOVA. Qualitative interviews with therapists (N = 15) and patients (N = 6) were interpreted using thematic analysis. RESULTS: OF technology was generally acceptable and feasible to integrate in routine practice. No significant between‚Äêgroup differences were found in post‚Äêtreatment PHQ‚Äê9 or GAD‚Äê7 measures. However, OF cases had significantly lower average duration and cost of treatment compared to controls. CONCLUSIONS: After adopting OF into their practice, this group of therapists attained similar clinical outcomes but within a shorter space of time and at a reduced average cost per treatment episode. We conclude that OF can improve the efficiency of stepped care."," Delgadillo, J;  Overend, K;  Lucock, M;  Groom, M;  Kirby, N;  McMillan, D;  Gilbody, S;  Lutz, W;  Rubel, JA;  de Jong, K",2017.0, 10.1016/j.brat.2017.09.011,0,0,
1825,Mitoprotective therapy preserves chondrocyte viability and prevents cartilage degeneration in an ex vivo model of posttraumatic osteoarthritis,"No disease-modifying osteoarthritis (OA) drugs are available to prevent posttraumatic osteoarthritis (PTOA). Mitochondria (MT) mediate the pathogenesis of many degenerative diseases, and recent evidence indicates that MT dysfunction is a peracute (within minutes to hours) response of cartilage to mechanical injury. The goal of this study was to investigate cardiolipin-targeted mitoprotection as a new strategy to prevent chondrocyte death and cartilage degeneration after injury. Cartilage was harvested from bovine knee joints and subjected to a single, rapid impact injury (24.0 ±1.4 MPa, 53.8 ± 5.3 GPa/s). Explants were then treated with a mitoprotective peptide, SS-31 (1µM), immediately post-impact, or at 1, 6, or 12 h after injury, and then cultured for up to 7 days. Chondrocyte viability and apoptosis were quantified in situ using confocal microscopy. Cell membrane damage (lactate dehydrogenase activity) and cartilage matrix degradation (glycosaminoglycan loss) were quantified in cartilage-conditioned media. SS-31 treatment at all time points after impact resulted in chondrocyte viability similar to that of un-injured controls. This effect was sustained for up to a week in culture. Further, SS-31 prevented impact-induced chondrocyte apoptosis, cell membrane damage, and cartilage matrix degeneration. Clinical Significance: This study is the first investigation of cardiolipin-targeted mitoprotective therapy in cartilage. These results suggest that even when treatment is delayed by up to 12 h after injury, mitoprotection may be a useful strategy in the prevention of PTOA. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2147–2156, 2018.",Delco M.L.; Bonnevie E.D.; Szeto H.S.; Bonassar L.J.; Fortier L.A.,2018.0,10.1002/jor.23882,0,0,
1826,The role of obsessive beliefs and inferential confusion in predicting treatment outcomes for different subtypes of obsessive-compulsive disorder.,"The current study sought to investigate the cognitive dimensions associated with subtypes of obsessive-compulsive disorder (OCD) and determine whether changes in symptoms following inference-based therapy (IBT) coincided with the modification of cognitive domains. Fifty-nine participants were classified into various OCD subtypes using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and completed the Y-BOCS, Obsessional Beliefs Questionnaire (OBQ-44), Inferential Confusion Questionnaire: The Expanded Version (ICQ-EV), Beck Depression Inventory, the Second Edition (BDI-II), and Beck Anxiety Inventory (BAI) before and after therapy. It was found that the OBQ-44 belief domain Importance/Control of Thoughts was associated with the impulse phobia subtype. Inferential confusion levels were found to be similar across subtypes. Change in OCD symptoms was correlated with change in the level of inferential confusion and of the OBQ belief domain Responsibility/Threat Estimation. Percentage of change in levels of inferential confusion was found to be the most important predictor of OCD symptoms explaining 32% of the variance. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Del Borrello, Loide; O'Connor, Kieron",2014.0,http://dx.doi.org/10.1521/ijct.2014.7.1.43,0,0,
1827, Results of a prospective randomized control trial comparing hydrophilic to uncoated catheters in children with neurogenic bladder," INTRODUCTION: Children with neurogenic bladder (NGB) often require a lifetime of clean intermittent catheterization (CIC), typically using uncoated catheters (UCs). Hydrophilic catheters (HCs) have lower friction than UCs with reported less damage to the urethra. The purpose of this study is to compare outcomes between these catheters. METHODS: An investigator‚Äêinitiated, prospective, randomized clinical trial was conducted to compare HCs versus UCs. Children aged 2‚Äê17 years with NGB on CIC were enrolled for 1 year. Block randomization was used. Dexterity scores were obtained in those who perform self‚Äêcatheterization. Outcomes were UTI, difficulty passing the catheter, urethral injury, and patient satisfaction. RESULTS: Demographic data is presented in the Table. Seventy‚Äêeight patients were enrolled. Age and gender were similar between the groups. Fifteen patients in each group performed CIC via an abdominal wall stoma. Eight and 15 patients withdrew from the UC and HC groups, respectively. The HC group overall had more problems with the catheter, mainly difficulty with handling. There were no differences for passing the catheter, pain, hematuria, or urethral injuries. There were two urinary tract infections (UTIs) in two HC patients and 17 UTIs in seven UC patients (p = 0.003). Patients with UTIs in the HC group went from 16% in the previous year to 5% during the study. Three children in the HC group had three or more UTIs in the year before enrollment and none during the study. The patients that completed the study with HC were overall satisfied and many requested to continue with the HC. CONCLUSIONS: HCs may decrease the risk of UTI in children with NGB. Urethral complications were low in both groups. Most HC patients were pleased but some found the slippery coating difficult to handle."," DeFoor, W;  Reddy, P;  Reed, M;  VanderBrink, B;  Jackson, E;  Zhang, B;  Denlinger, J;  Noh, P;  Minevich, E;  Sheldon, C",2017.0, 10.1016/j.jpurol.2017.06.003,0,0,
1828, The pain course: a randomised controlled trial comparing a remote-delivered chronic pain management program when provided in online and workbook formats," This study compared a remote‚Äêdelivered pain management program, the Pain Course, when delivered in online and workbook formats. Participants (n = 178) were randomised into 2 groups: (1) an Internet Group (n = 84) who were provided with secure accounts to the program in an online format; or (2) a Workbook Group (n = 94) who were mailed workbook versions of the program. The content of both programs was identical and comprised 5 core lessons, which participants were encouraged to work through over an 8‚Äêweek period, according to a prescribed timetable. All participants were provided with weekly contact with a clinical psychologist through email and telephone throughout the program. The overall findings suggest that the workbook format was no less effective or acceptable than the validated online format. Significant improvements (avg. improvement; Internet Group vs Workbook Group) in levels of disability (PDI: 16% vs 24%; RMDQ: 12% vs 15%), anxiety (GAD‚Äê7: 36% vs 26%), and depression (PHQ‚Äê9: 36% vs 36%) were observed in both groups immediately posttreatment. Further improvements were observed in disability levels to 3‚Äêmonth follow‚Äêup, and improvements across the other primary outcomes were maintained until 12‚Äêmonth follow‚Äêup. High treatment completion rates and levels of satisfaction were reported in both groups, and both groups required a similarly small amount of clinician contact per participant (M = 74.85 minutes; SD = 41.03). These results highlight the public health potential of remote‚Äêdelivered pain management programs, delivered in either workbook or online formats, as methods of increasing access to pain management."," Dear, BF;  Gandy, M;  Karin, E;  Ricciardi, T;  Fogliati, VJ;  McDonald, S;  Staples, LG;  Perry, KN;  Sharpe, L;  Nicholas, MK;  et al.",2017.0, 10.1097/j.pain.0000000000000916,0,0,
1829, Motivational interviewing to enhance adolescent mental health treatment engagement: a randomized clinical trial," METHOD: Ninety‚Äêsix adolescents (13‚Äê18 years) with a principal diagnosis of an anxiety or mood disorder participated in a trial conducted at two publicly funded outpatient services. Participants were randomly assigned to individual MI for treatment engagement prior to gCBT (MI + gCBT), or to an individually administered active control (befriending) prior to gCBT (befriending + gCBT). Eight pairs of gCBT were run in parallel. Outcome measures were the mean number of gCBT sessions attended, treatment initiation, and ratings of readiness for treatment. RESULTS: Participants randomized to MI as a pretreatment intervention attended significantly more group therapy sessions compared to those in the active control condition. The MI group also demonstrated greater treatment initiation, and ratings of treatment readiness were significantly higher for those randomized to MI. CONCLUSIONS: MI, used as a pre‚Äêtreatment intervention, enhanced group treatment engagement in adolescents diagnosed with anxiety and mood disorders compared to the active control condition. MI is a promising intervention to facilitate engagement in adolescent mental health settings. BACKGROUND: The prevalence of anxiety and mood disorders in adolescents is a growing public health concern worldwide. Given the high rates of drop‚Äêout and limited resources available in psychiatric settings, the importance of engaging adolescents in evidence‚Äêbased treatments cannot be understated. The aim of the study was to determine the efficacy of motivational interviewing (MI), as a brief pre‚Äêtreatment intervention, to enhance treatment engagement in a standard therapy setting (group cognitive behavioral therapy; gCBT) for adolescents with anxiety and mood disorders."," Dean, S;  Britt, E;  Bell, E;  Stanley, J;  Collings, S",2016.0, 10.1017/S0033291716000568,0,0,
1830, Coping with Accident Reactions (CARE) early intervention programme for preventing traumatic stress reactions in young injured children: study protocol for two randomised controlled trials," BACKGROUND: Accidental injury represents the most common type of traumatic event experienced by children under the age of 6 years. Around 10‚Äê30 % of young injured children will go on to develop post‚Äêtraumatic stress disorder (PTSD) and other co‚Äêmorbid conditions. Parents of injured children are also at risk of PTSD, and this is associated with short‚Äê and long‚Äêterm consequences for their children's physical and psychological recovery. Despite the significance of this problem, to date, the mental health needs of injured young children have been neglected. One reason for this is due to the uncertainty and considerable debate around how to best provide early psychological intervention to traumatised children and adults. To address these gaps, researchers and psychologists in Australia and Switzerland have developed the Coping with Accident Reactions (CARE) programme, which is a two‚Äêsession early intervention designed to prevent persistent PTSD reactions in young injured children screened as 'at risk'. Two separate international studies are being conducted to evaluate the effectiveness and feasibility of this programme. METHODS/DESIGN: The study design for the two proposed studies will employ a randomised controlled trial design and children (aged 1‚Äê6 years) who are screened as at risk for PTSD 1 week after an unintentional injury, and their parents will be randomised to either (1) CARE intervention or (2) treatment as usual. Assessment will be completed at baseline (2 weeks) and 3 and 6 months post‚Äêinjury. DISCUSSION: This international collaboration provides an excellent opportunity to test the benefit of screening and providing early intervention to young children in two different countries and settings. It is expected that outcomes from this research will lead to significant original contributions to the scientific evidence base and clinical treatment and recovery of very young injured children. TRIAL REGISTRATION: The Australian study was registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12614000325606 ) on 26 March 2014. The Swiss study was registered with ClinicalTrials.gov ( NCT02088814 ) on 12 March 2014."," De Young, AC;  Haag, AC;  Kenardy, JA;  Kimble, RM;  Landolt, MA",2016.0, 10.1186/s13063-016-1490-2,0,0,
1831," Randomized, blinded, controlled trial on effectiveness of photobiomodulation therapy and exercise training in the fibromyalgia treatment"," This study evaluated the role of the phototherapy and exercise training (EXT) as well as the combined treatment in general symptoms, pain, and quality of life in women suffering from fibromyalgia (FM). A total of 160 women were enrolled and measures were carried out in two sets: it was sought to identify the acute effect for a single phototherapy and EXT session (Set 1); long‚Äêterm effect (10 weeks) of the interventions (Set 2). Phototherapy irradiation was performed at 11 locations in their bodies, employing a cluster with nine diodes (one super‚Äêpulsed infrared 905 nm, four light‚Äêemitting diodes [LEDs] of 640 nm, and four LEDs of 875 nm, 39.3 J per location). Algometry and VAS instrument were applied to evaluate pain. The FM symptoms were evaluated with Fibromyalgia Impact Questionnaire (FIQ) and Research Diagnostic Criteria (RDC) instruments. Quality of life was assessed through SF‚Äê36 survey. Set 1: pain threshold was improved with the phototherapy, and EXT improved the pain threshold for temporomandibular joint (right and left body side) and occipital site (right body side). Set 2: there was improved pain threshold in several tender points with the phototherapy and EXT. There was an overlap of therapies to reduce the tender point numbers, anxiety, depression, fatigue, sleep, and difficulty sleeping on FIQ/RDC scores. Moreover, quality of life was improved with both therapies. The phototherapy and EXT improved the pain threshold in FM women. A more substantial effect was noticed for the combined therapy, in which pain relief was accomplished by improving VAS and FIQ scores as well as quality of life."," da Silva, MM;  Albertini, R;  de Tarso Camillo de Carvalho, P;  Leal-Junior, ECP;  Bussadori, SK;  Vieira, SS;  Bocalini, DS;  de Oliveira, LVF;  Grandinetti, V;  Silva, JA;  et al.",2018.0, 10.1007/s10103-017-2388-2,0,0,
1832,Exploratory study of the effect of binaural beat stimulation on the EEG activity pattern in resting state using artificial neural networks,"Anxiety disorders afflict almost 7.3 percent of the world's population. One in 14 people will experience anxiety disorder at the given year. When associated with mood disorders, anxiety can also trigger or increase other diseases’ symptoms and effects, like depression and suicidal behavior. Binaural beats are a low-frequency type of acoustic stimulation perceived when the individual is subjected to two slightly different wave frequencies, from 200 to 900 Hz. Binaural beats can contribute to anxiety reduction and modification of other psychological conditions and states, modifying cognitive processes and mood states. In this work, we applied a 5 Hz binaural beat to 6 different subjects, to detect a relevant change in their brainwaves before and after the stimuli. We applied 20 min stimuli in 10 separated sessions. We assessed the differences using a Multi-Layer Perceptron classifier in comparison with non-parametric tests and Low-Resolution Brain Electromagnetic Tomography (eLORETA). eLORETA showed remarkable changes in High Alpha. Both eLORETA and MLP approaches revealed outstanding modifications in high Beta. MLP evinced significant changes in Theta brainwaves. Our study evidenced high Alpha modulation at the limbic lobe, implicating in a possible reduction of sympathetic system activation in the studied sample. Our main results on eLORETA suggest a strong increase in the current distribution, mostly in Alpha 2, at the Anterior Cingulate, which is related to the monitoring of mistakes regarding social conduct, recognition and expression of emotions. We also found that MLPs are able of evincing the main differences with high separability in Delta and Theta.",da Silva Junior M.; de Freitas R.C.; dos Santos W.P.; da Silva W.W.A.; Rodrigues M.C.A.; Conde E.F.Q.,2019.0,10.1016/j.cogsys.2018.11.002,0,0,
1833,EMDR treatment of distressful experiences that fail to meet the criteria for PTSD.,"Eye movement desensitization and reprocessing (EMDR) is thought to successfully treat not only posttraumatic stress disorder (PTSD) but also other psychiatric disorders and mental health problems inasmuch as these have experiential contributions. This randomized clinical trial investigated the effects of treatment of distressful experiences (or small ""t"" trauma) that fail to meet the criteria for PTSD. Three hours of a slightly adapted form of EMDR were compared to active listening (attentional placebo, also 3 hours) and wait list. Results with 90 participants showed that EMDR produced significantly lower scores on the Impact of Event Scale than active listening or wait list. EMDR also resulted in a significantly smaller increase on the State-Trait Anxiety Inventory (State subscale) after memory recall. Some limitations and implications of findings are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cvetek, Robert",2008.0,http://dx.doi.org/10.1891/1933-3196.2.1.2,0,0,
1834,"Can you snooze your way to an ‘A’? Exploring the complex relationship between sleep, autonomic activity, wellbeing and performance in medical students","Objective: Medical training brings with it multiple stressors, including demanding workloads in highly competitive environments, with well-documented impact on psychiatric morbidity. This study evaluated the impact of sleep-related factors on psychological wellbeing, cognitive task performance and academic standing in medical students. Methods: A total of 59 undergraduate medical students took part in this cross-sectional study over two consecutive days. Participants responded to questionnaires about their physical and psychological health, sleep, functioning and academic performance at the initial visit. Participants then wore an ambulatory bioharness overnight (to derive heart rate variability measures), before returning to complete a computerised battery of cognitive tasks. A sleep diary was completed for the next 7 days. Results: Poor sleep quality in the month preceding assessment correlated with psychological distress (p < 0.001) and reduced nocturnal heart rate variability (p = 0.007). Psychological distress also correlated with reduced nocturnal heart rate variability (p = 0.031) and less refreshing sleep during the monitoring week (p < 0.001), but not with sleep timing parameters. A greater increase in heart rate variability during the transition from awake to sleep significantly predicted better spontaneous cognitive performance (p = 0.021). Better academic standing was predicted by consistently short, less refreshing sleep (all p < 0.001), along with earlier bedtimes (p = 0.004) and greater psychological wellbeing (p = 0.009). Conclusion: Unrefreshing, short-duration sleep and psychological distress are prevalent in medical students during university training and were associated with reduced nocturnal parasympathetic autonomic activity. Achieving higher academic grades was associated with high psychological wellbeing despite consistently short, unrefreshing sleep. The long-term repercussions of such sleep behaviours on later professional functioning remain unclear, warranting further research.",Cvejic E.; Huang S.; Vollmer-Conna U.,2018.0,10.1177/0004867417716543,0,0,
1835,About a clinical case of a tortured and exile patient (from the recognition of his status to the care management of the trauma),"Torture, accepted in many countries of the world, is responsible for major trauma. The subjects who manage to survive torture generally choose to flee their country and live in exile. This imposed migration is added to the first trauma of violence. The concept of traumatic neurosis has gradually shifted to the state of post-traumatic stress disorder. For a diagnostic purpose, American doctors, at the origin of this concept, wanted to bring together different events responsible of these symptoms in a single entity. However, since the seventies, changes in society led to government policies requiring evidence of testimonies from subjects, creating the risk of transforming physicians into attestant doctors. Through a clinical situation, we follow the administrative and therapeutic fellow/ path of a man from the Democratic Republic of Congo who has suffered violence and forced migration. This patient has benefited both individual therapy and a group consultation. In both areas, his words were taken into account, without trial, without searching for evidence .",Cuvelier,2009.0,,0,0,
1836, A Double-Blind Placebo Randomized Controlled Trial of Minocycline to Reduce Pain After Carpal Tunnel and Trigger Finger Release," METHODS: This double‚Äêblinded randomized controlled trial included patients undergoing CTR or TFR under local anesthesia. Before surgery, participants recorded psychological and pain measures. Participants received oral minocycline, 200 mg, or placebo 2 hours prior to procedure, and then 100 mg of minocycline or placebo 2 times a day for 5 days. After surgery, participants were called daily assessing their pain. The primary end point of TPR was when participants had 3 consecutive days of 0 postsurgical pain. Futility analysis and Kaplan‚ÄêMeier analyses were performed. RESULTS: A total of 131 participants were randomized and 56 placebo and 58 controls were analyzed. Median TPR for CTR was 3 weeks, with 15% having pain more than 6 weeks. Median TPR for TFR was 2 weeks with 18% having pain more than 6 weeks. The overall median TPR for the placebo group was 2 weeks (10% pain > 6 weeks) versus 2.5 weeks (17% pain > 6 weeks) for the minocycline group. Futility analysis found that the likelihood of a true underlying clinically meaningful reduction in TPR owing to minocycline was only 3.5%. Survival analysis found minocycline did not reduce TPR. However, subgroup analysis of those with elevated posttraumatic distress scores found the minocycline group had longer TPR. CONCLUSIONS: Oral administration of minocycline did not reduce TPR after minor hand surgery. There was evidence that minocycline might increase length of pain in those with increased posttraumatic stress disorder symptoms. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic I. PURPOSE: Minocycline is a microglial cell inhibitor and decreases pain behaviors in animal models. Minocycline might represent an intervention for reducing postoperative pain. This trial tested whether perioperative administration of minocycline reduced time to pain resolution (TPR) after standardized hand surgeries with known prolonged pain profiles: carpal tunnel release (CTR) and trigger finger release (TFR)."," Curtin, CM;  Kenney, D;  Suarez, P;  Hentz, VR;  Hernandez-Boussard, T;  Mackey, S;  Carroll, IR",2017.0, 10.1016/j.jhsa.2016.12.011,0,0,
1837," Motor cortex tRNS improves pain, affective and cognitive impairment in patients with fibromyalgia: preliminary results of a randomised sham-controlled trial"," OBJECTIVES: Fibromyalgia (FM) is a clinical syndrome characterised by widespread musculoskeletal pain, chronic fatigue, cognitive deficits, and sleep and mood disorders. The effectiveness of most pharmacological treatments is limited, and there is a need for new, effective and well‚Äêtolerated therapies. It has recently been shown that transcranial direct‚Äêcurrent stimulation (tDCS) of the motor cortex reduces pain, and that tDCS of the dorso‚Äêlateral prefrontal cortex (DLPFC) improves anxiety, depression and cognitive impairment in FM patients. The new technique of transcranial random noise stimulation (tRNS) using randomly changing alternating currents has very recently been shown to improve working memory and pain in limited series of patients with FM or neuropathic pain. The aim of this study was to investigate the clinical effects of primary motor cortex (M1) tRNS in FM patients. METHODS: Twenty female FM patients aged 26‚Äê67 years were randomised to undergo active (real) or placebo (sham) tRNS sessions on five days a week (Monday‚ÄêFriday) for two weeks. Each patient was evaluated before and after treatment using a visual analogue scale (VAS), the Fibromyalgia Impact Questionnaire (FIQ), the Hospital Anxiety and Depression Scale (HADS), the Trail Making Test (TMT), the Rey Auditory Verbal Learning Test (RAVLT), the Forward and Backward Digit Span test, and the FAS verbal fluency test. RESULTS: In comparison with sham treatment, active tRNS of M1 induced a general improvement in the clinical picture of FM, with a significant reduction in pain, depression, anxiety and FIQ scores and a significant improvement in TMT (A), RAVLT and FAS scores. CONCLUSIONS: These findings suggest that tRNS of M1 can be very effective in relieving FM symptoms. Unlike motor cortex tDCS, it seems to counteract both pain and cognitive disturbances, possibly because the invoked mechanism of stochastic resonance synchronises neural firing and thus leads to more widespread and lasting effects."," Curatolo, M;  La Bianca, G;  Cosentino, G;  Baschi, R;  Salemi, G;  Talotta, R;  Romano, M;  Triolo, G;  De Tommaso, M;  Fierro, B;  et al.",2017.0,,0,0,
1838, The therapeutic relationship in cognitive-behavioral therapy and pharmacotherapy for anxious youth," OBJECTIVE: We examined the therapeutic relationship with cognitive‚Äêbehavioral therapists and with pharmacotherapists for youth from the Child/Adolescent Anxiety Multimodal Study (Walkup et al., 2008). The therapeutic relationship was examined in relation to treatment outcomes. METHOD: Participants were 488 youth (ages 7‚Äê17 years; 50% male) randomized to cognitive‚Äêbehavioral therapy (CBT; Coping Cat), pharmacotherapy (sertraline), their combination, or placebo pill. Participants met criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). The therapeutic relationship was assessed by youth report at Weeks 6 and 12 of treatment using the Child's Perception of Therapeutic Relationship scale (Kendall et al., 1997). Outcome measures (Pediatric Anxiety Rating Scale; Research Units on Pediatric Psychopharmacology Anxiety Study Group, 2002; and Clinical Global Impressions Scales; Guy, 1976) were completed by independent evaluators blind to condition. RESULTS: For youth who received CBT only, a stronger therapeutic relationship predicted positive treatment outcome. In contrast, the therapeutic relationship did not predict outcome for youth receiving sertraline, combined treatment, or placebo. CONCLUSION: A therapeutic relationship may be important for anxious youth who receive CBT alone."," Cummings, CM;  Caporino, NE;  Settipani, CA;  Read, KL;  Compton, SN;  March, J;  Sherrill, J;  Piacentini, J;  McCracken, J;  Walkup, JT;  et al.",2013.0, 10.1037/a0033294,0,0,
1839, Smartphone-based behavioural intervention alleviates children's anxiety during anaesthesia induction: a randomised controlled trial," BACKGROUND: Preoperative anxiety negatively influences children's anaesthetic and surgical experience, and results in postoperative complications, such as emergence delirium and behavioural changes. Nonpharmacological management using alternative therapies that alleviate psychological stress can be as important as pharmacological ones in reducing children's anxiety. Nevertheless, their validity as an effective anxiety‚Äêreducing strategy in children remains controversial. OBJECTIVE(S): To verify whether nonpharmacological strategies, that is, leaflet and distraction with smartphone application presented to parents/guardians and children, respectively, were effective in preventing children's anxiety during anaesthesia induction. DESIGN: Randomised clinical trial. SETTING: A tertiary care teaching hospital. PATIENTS: In total, 84 children (aged 4 to 8 years; American Society of Anesthesiologists I and II) undergoing minor‚Äêto‚Äêmoderate elective surgical procedures and their parents/guardians. INTERVENTIONS: Children were randomised into four groups: control group, in which the parent/guardian was verbally informed about the anaesthetic procedure; the informed group, in which the parent/guardian was also provided with an information leaflet about the anaesthetic procedure; the smartphone group, in which the parent/guardian was verbally informed and the child received a smartphone application to play with while in the holding area before entering the operating room and the smartphone and informed group, in which the parent/guardian also received an information leaflet and the child, a smartphone application to play with while in the holding area before entering the operating room. MAIN OUTCOME MEASURES: Children's anxiety at two time points: in the holding area of the surgical centre and in the operating room during induction of anaesthesia by facemask. RESULTS: Median (IQR) anxiety levels were greater at time point operating room for children in the control group (55.0; range: 30.0 to 68.4) than in the other groups: informed group, 28.4 (23.4 to 45.0); smartphone group, 23.4 (23.4 to 30.0); smartphone and informed group, 23.4 (23.4 to 25.9). CONCLUSION: The behavioural distraction strategies using smartphones were effective in preventing an increase in children's anxiety during anaesthesia induction. TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT02246062."," Cumino, DO;  Vieira, JE;  Lima, LC;  Stievano, LP;  Silva, RA;  Mathias, LA",2017.0, 10.1097/EJA.0000000000000589,0,0,
1840," Comparative effects of 12 weeks of equipment based and mat Pilates in patients with Chronic Low Back Pain on pain, function and transversus abdominis activation. A randomized controlled trial"," OBJECTIVE: To assess the effectiveness of 12 weeks of Pilates practice in disability, pain, kinesiophobia and transversus abdominis activation in patients with chronic nonspecific Low Back Pain. DESIGN: A randomized controlled trial was carried out. METHODS: A single‐blind randomized controlled trial with repeated measures at 6 and 12 weeks was carried out. A total of ninety eight patients with low back pain were included and randomly allocated to a Pilates Mat group (PMG) equipment based with apparatus Pilates (PAG) or control group (CG). Roland Morris Disability Questionnaire (RMDQ), visual analog scale (VAS) Tampa Scale of Kinesiophobia (TSK), and transversus abdominis (TrA) activation assessed by real time ultrasound measurement (US) were assessed as outcome measures. RESULTS: Improvement were observed in both intervention groups in all the included variables at 6 and 12 weeks (p<0.001). Faster enhancement was observed in the equipment based Pilates group (p=0.007). CONCLUSIONS: Equipment based and mat Pilates modalities are both effective in the improvement of TaA activation in patients with CLBP with associate improvement on pain, function and kinesiophobia. Significant differences were observed after 12 weeks of intervention in PMG and PAG with faster improvement in PAG suggesting that, feedback provided by equipment could help in the interiorization of Pilates principles. BACKGROUND: Pilates method has been recommended for patients with chronic low back pain (CLBP) and the activation of transversus abdominis has been deemed to play an important role in the improvement of these patients. Nevertheless, the evidence of the activation of TrA in Pilates practitioners remains unclear."," Cruz-Díaz, D;  Bergamin, M;  Gobbo, S;  Martínez-Amat, A;  Hita-Contreras, F",2017.0, 10.1016/j.ctim.2017.06.004,0,0,
1841,Scared and surrounded by clutter: The influence of emotional reactivity.,"Background: Home visits can improve treatment outcomes for hoarding disorder, but factors influencing the success of home visits remain unknown. As home visits expose individuals to clutter and fear, the present study examined the effect that fear and emotional reactivity have on the relationship between clutter and discarding behaviour. Methods: Participants with at least subclinical discarding problems (n = 143) were asked to save or discard personal possessions of varying value following an emotional induction that took place in either a tidy or cluttered context. Participants also completed questionnaires assessing hoarding severity, emotional state, and emotional reactivity, as defined by one's sensitivity, persistence, and intensity of reactions to emotional stimuli. Results: As expected, participants discarded more items in the presence of clutter and when feeling fearful. However, emotional reactivity moderated the relations between environmental context, acute emotional state, and discarding. Low sensitivity, low persistence, and high emotional intensity negatively influenced discarding in the cluttered context. When feeling fearful, low dispositional emotional intensity negatively influenced discarding in the tidy context. Limitations: Individuals in the tidy environment reported higher levels of fear and anxiety than individuals in the cluttered environment after the fear induction. These differences could have contributed to the difference noted between the two contexts when examining the effect of emotional intensity tendencies. Conclusions: Providing treatment in an environment more representative of the cluttered home can improve discarding or at the very least give therapists a more accurate picture of what clients do in the context that matters most. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Crone, Cassandra; Norberg, Melissa M",2018.0,http://dx.doi.org/10.1016/j.jad.2018.04.066,0,0,
1842, Somatic complaints in anxious youth," This study examined (a) demographic and clinical characteristics associated with physical symptoms in anxiety‚Äêdisordered youth and (b) the impact of cognitive‚Äêbehavioral therapy (Coping Cat), medication (sertraline), their combination, and pill placebo on physical symptoms. Youth (N = 488, ages 7‚Äê17 years) with a principal diagnosis of generalized anxiety disorder, separation anxiety disorder, or social phobia participated as part of a multi‚Äêsite, randomized controlled trial and received treatment delivered over 12 weeks. Diagnostic status, symptom severity, and impairment were assessed at baseline and week 12. The total number and severity of physical symptoms was associated with age, principal diagnosis, anxiety severity, impairment, and the presence of comorbid internalizing disorders. Common somatic complaints were headaches, stomachaches, head cold or sniffles, sleeplessness, and feeling drowsy or too sleepy. Physical symptoms decreased over the course of treatment, and were unrelated to treatment condition. Clinical implications and directions for future research are discussed (ClinicalTrials.gov number, NCT00052078)."," Crawley, SA;  Caporino, NE;  Birmaher, B;  Ginsburg, G;  Piacentini, J;  Albano, AM;  Sherrill, J;  Sakolsky, D;  Compton, SN;  Rynn, M;  et al.",2014.0, 10.1007/s10578-013-0410-x,0,0,
1843,Competing indirect effects in a comparative psychotherapy trial for generalized anxiety disorder.,"In a randomized trial for generalized anxiety disorder, cognitive-behavioral therapy (CBT) and CBT integrated with motivational interviewing (MI) promoted comparable worry reduction at posttreatment, whereas MI-CBT outperformed CBT over 12-month follow-up (Westra, Constantino, & Antony, 2016). Secondary analyses revealed competing mediators of the long-term treatment effect: MI-CBT related to lower patient resistance to the treatment, which promoted lower follow-up worry, whereas CBT related to greater increases in patient friendly submissiveness (FS), or compliance, which also promoted lower follow-up worry (that suppressed an even greater long-term advantage of MI-CBT). In this study, we tested these competing, though theoretically consistent, variables as mediators of the nonsignificant treatment effect on posttreatment worry, as there could also be treatment-specific means to arriving to these comparable ends. Eighty-five patients received 15 sessions of MI-CBT or CBT. Therapists rated patient FS through treatment, observers rated resistance at midtreatment, and patients rated worry at posttreatment. Bootstrap analyses indicated that MI-CBT patients exhibited less resistance, which promoted lower posttreatment worry, whereas CBT patients had greater increases in FS, which also promoted lower worry. CBT and MI-CBT achieved comparable posttreatment outcomes through separate indirect paths that each conferred an advantage for one treatment over the other (and had canceled out a direct treatment effect immediately after therapy). The composite trial findings have significance for understanding different pathways to personal change in both the short- and long terms, and for the importance of testing indirect effects both when direct treatment effects do and do not emerge. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement Clinical Impact Statement-Question: We investigated whether patients with generalized anxiety disorder who received either cognitive behavioral therapy (CBT) alone or CBT integrated with motivational interviewing (MI) achieved comparable posttreatment worry levels as a function of two opposing mediational pathways; that is, would CBT (relative to MI-CBT) promote lower posttreatment worry through eliciting greater increases in patients' trusting compliance and would MI-CBT (relative to CBT) promote lower posttreatment worry through eliciting less patient resistance? Findings: On average, both having patients who are more trustingly compliant, as better facilitated by CBT than MI-CBT, and less resistant, as better fostered by MI-CBT than CBT, comparably influenced patient worry levels immediately posttreatment (rendering the treatment conditions equally efficacious on average). Meaning: The composite trial findings have significance for understanding different pathways to personal change in both the short- and long-term, and for the importance of testing indirect effects even when direct treatment effects do not emerge. Next Steps: Future work should replicate the present findings and continue to explore treatment-specific pathways to personal improvement, even when treatments do not differ in their overall (average) efficacy. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Coyne, Alice E; Constantino, Michael J; Westra, Henny A; Antony, Martin M",2018.0,http://dx.doi.org/10.1037/pst0000163,0,0,
1844,Interactive effects of insomnia symptoms and total sleep time on symptoms of psychopathology,"Introduction: Sleep disturbance is implicated in psychopathology (Baglioni et al., 2017), particularly insomnia and decreased total sleep time (TST). However, recent evidence suggests comorbid insomnia and hypersomnia may provide new insight into the link between sleep and psychopathology (Soehner et al., 2014). Indeed, comorbid insomnia and hypersomnia are present in 30% of depression cases (Geoffroy et al., 2018) and is linked to increased odds of OCD (Breslau et al., 1996). Further, long TST is associated with depression symptoms (Michaels et al., 2017). However, no study has examined the interactive effects of insomnia symptoms and TST. Thus, the present study tested whether insomnia symptoms and TST interact to predict depression and OCD symptoms, controlling for time in bed (TIB). Methods: An adult sample (N = 150) completed an insomnia measure at baseline (Insomnia Severity Index; Bastien et al., 2001), one week of sleep monitoring with actigraphy and a sleep diary (Consensus Sleep Diary; Carney et al., 2012), and depression (Depression, Anxiety, and Stress Scale; Lovibond & Lovibond, 1995) and OCD measures (Obsessive-Compulsive Inventory-Revised; Foa et al., 2002) at follow-up. Results: Insomnia symptoms significantly interacted with subjective TST (β =.003, t=2.20, p<.05) to predict depression symptoms, such that increased TST predicted increased depression symptoms at high levels of insomnia symptoms. The effect for objective TST was trend level (β=.003, t=2.78, p=.08). Insomnia symptoms significantly interacted with both subjective (β=.009, t=2.38, p<.05) and objective TST (β =.012, t=2.53, p<.05) to predict OCD symptoms, such that increased TST predicted increased OCD symptoms at high levels of insomnia symptoms. Conclusion: Comorbid insomnia symptoms and long TST are associated with increased symptoms of depression and OCD, independent of TIB. Comorbid insomnia and long TST may reflect a unique disturbance in underlying regulatory systems that contributes to psychopathology. These findings also suggest that current theories on decreased sleep and psychopathology may not fully capture the complexity of this relationship. Future research is necessary to replicate these findings in a prospective design.",Cox R.C.; Olatunji B.O.,2018.0,,0,0,
1845, The effects of adaptive working memory training and mindfulness meditation training on processing efficiency and worry in high worriers," Worry is the principle characteristic of generalised anxiety disorder, and has been linked to deficient attentional control, a main function of working memory (WM). Adaptive WM training and mindfulness meditation practice (MMP) have both shown potential to increase attentional control. The present study hence investigates the individual and combined effects of MMP and a dual adaptive n‚Äêback task on a non‚Äêclinical, randomised sample of high worriers. 60 participants were tested before and after seven days of training. Assessment included self‚Äêreport questionnaires, as well as performance tasks measuring attentional control and working memory capacity. Combined training resulted in continued reduction in worry in the week after training, highlighting the potential of utilising n‚Äêback training as an adjunct to established clinical treatment. Engagement with WM training correlated with immediate improvements in attentional control and resilience, with worry decreasing over time. Implications of these findings and suggestions for future research are discussed."," Course-Choi, J;  Saville, H;  Derakshan, N",2017.0, 10.1016/j.brat.2016.11.002,0,0,
1846, Dose-Response Effects of Aerobic Exercise on Quality of Life in Postmenopausal Women: results from the Breast Cancer and Exercise Trial in Alberta (BETA)," BACKGROUND: Exercise generally improves quality of life (QoL) and psychosocial functioning in adult populations but few randomized trials have examined dose‚Äêresponse effects. PURPOSE: The purpose of the present study was to report the QoL and psychosocial outcomes from the Breast Cancer and Exercise Trial in Alberta (BETA). METHODS: Healthy but inactive postmenopausal women at risk for breast cancer were randomized to a year‚Äêlong aerobic exercise intervention consisting of either 150 min/week (moderate volume group, n = 200) or 300 min/week (high volume group, n = 200). QoL was assessed at baseline and 1 year using the short form‚Äê36 health survey. Sleep quality, depression, anxiety, stress, self‚Äêesteem, and happiness were also assessed. Participant preference for group assignment (i.e., exercise volume) was assessed at baseline and tested as a moderator. RESULTS: There were no statistically significant dose‚Äêresponse effects of aerobic exercise on any QoL, sleep quality, or psychosocial outcome. Participant preference for group assignment did not moderate any QoL, sleep quality, or psychosocial responses. Marital status was a significant moderator (p for interaction = 0.01) and obesity showed a trend towards being a moderator (p for interaction = 0.08) of the dose‚Äêresponse effects of aerobic exercise on global sleep quality such that unmarried and obese women improved sleep quality with the higher volume of aerobic exercise. CONCLUSIONS: A higher volume of aerobic exercise, approximately double the minimum public health guideline, did not provide additional QoL or psychosocial benefits compared to the minimum public health guideline in inactive postmenopausal women, even for women who preferred the higher volume of exercise at baseline. TRIAL REGISTRATION: Trial Registration clinicaltrials.gov identifier: NCT1435005."," Courneya, KS;  McNeil, J;  O'Reilly, R;  Morielli, AR;  Friedenreich, CM",2017.0, 10.1007/s12160-016-9859-8,0,0,
1847, Evaluation of a pilot sensory play intervention to increase fruit acceptance in preschool children," Recent research has found an association between dislike of messy play and higher levels of food neophobia in children. The aim of the present study was to pilot and assess a five week intervention with preschool children, to examine whether engagement in tactile sensory tasks leads to increased fruit acceptance. Interventions were carried out to examine whether weekly sessions of sensory play combined with fruit exposure, would increase acceptance and enjoyment of fruits to a greater extent than two non‚Äêsensory play conditions featuring fruit exposure or normal play activities alone. One hundred children aged 18 months to four years were recruited from ten playgroups in the Midlands area of the United Kingdom (UK) of which 83 completed the interventions. Participants were randomly assigned to one of four conditions: combined sensory play (fruit and non‚Äêfood), non‚Äêfood sensory play, fruit taste exposure, and control play. There were baseline differences in child fruit acceptance, so this was entered as a covariate into subsequent analyses. It was found that children in both the combined sensory play and non‚Äêfood sensory play conditions enjoyed significantly more fruits at follow up than children in the control play condition, whilst children in the non‚Äêfood sensory play group also enjoyed significantly more fruits than the fruit exposure group. These findings suggest that sensory play, with fruit and/or non‚Äêfood substances, combined with exposure may be an effective strategy to increase tasting and fruit acceptance in children."," Coulthard, H;  Williamson, I;  Palfreyman, Z;  Lyttle, S",2018.0, 10.1016/j.appet.2017.10.011,0,0,
1848,Sex & relationship peer support groups: A mixed method study on the impact on female sexual health,"Objective: Many women face challenges around sexuality, but few seek help. Research on non-sex related peer support groups show that participants feel normalized in their experience, supported by the group, and gain useful knowledge on how to manage various mind-body-heart aspects of their experience. This study aimed to explore whether peer support groups could positively impact female sexual health, specifically with respect to desire, arousal and satisfaction. Material and Methods: This was a mixed method study with pre/post qualitative data collection using the Female Sexual Function Index, Female Sexual Distress Scale and the EQ-5D-5L Quality of Life survey, and a qualitative interview with a set of women attending a 4-week peer-led series exploring their social, physical, mental and emotional relationships to sexuality. Results: Following 4 weeks of peer group interaction, statistically significant results were noted in the following domains of the FSFI: desire, arousal and orgasm. Overall FSFI score increased from 22.9 to 27.4, and overall FSDS-R score decreased from 18.6 to 13.4. Common themes reported include normalization, community/connection, justice/empowerment, self-discovery/growth, improved communication and improved sex. Conclusions: Given the promising results found in this study, further research is warranted to systematically look at the impact of peer support groups on sexual health and relationship satisfaction. We are connecting with medical and mental health professionals to advise on potential next steps which may include exploring the impact of changing the content and duration of the groups and addressing some limitations of this study through a larger and more diverse sample.",Costa P.; Bellin Z.; Canning T.; Blair B.; Millheiser L.,2018.0,,0,0,
1849,Human amygdala activation during rapid eye movements of rapid eye movement sleep: an intracranial study.,"The amygdaloid complex plays a crucial role in processing emotional signals and in the formation of emotional memories. Neuroimaging studies have shown human amygdala activation during rapid eye movement sleep (REM). Stereotactically implanted electrodes for presurgical evaluation in epileptic patients provide a unique opportunity to directly record amygdala activity. The present study analysed amygdala activity associated with REM sleep eye movements on the millisecond scale. We propose that phasic activation associated with rapid eye movements may provide the amygdala with endogenous excitation during REM sleep. Standard polysomnography and stereo-electroencephalograph (SEEG) were recorded simultaneously during spontaneous sleep in the left amygdala of four patients. Time-frequency analysis and absolute power of gamma activity were obtained for 250 ms time windows preceding and following eye movement onset in REM sleep, and in spontaneous waking eye movements in the dark. Absolute power of the 44-48 Hz band increased significantly during the 250 ms time window after REM sleep rapid eye movements onset, but not during waking eye movements. Transient activation of the amygdala provides physiological support for the proposed participation of the amygdala in emotional expression, in the emotional content of dreams and for the reactivation and consolidation of emotional memories during REM sleep, as well as for next-day emotional regulation, and its possible role in the bidirectional interaction between REM sleep and such sleep disorders as nightmares, anxiety and post-traumatic sleep disorder. These results provide unique, direct evidence of increased activation of the human amygdala time-locked to REM sleep rapid eye movements.",Corsi-Cabrera M.; Velasco F.; Del Río-Portilla Y.; Armony JL.; Trejo-Martínez D.; Guevara MA.; Velasco AL.,2016.0,10.1111/jsr.12415,0,0,
1850, Using Peer Navigators to Address the Integrated Health Care Needs of Homeless African Americans With Serious Mental Illness," OBJECTIVE: The study examined the impact of a peer navigator program (PNP) developed by a community‐based participatory research team and used with a group of African Americans with serious mental illness who were homeless. METHODS: Sixty‐seven research participants were randomly assigned to receive PNP or treatment as usual (control) for one year. Data on general health and mental health, recovery, and quality of life were collected at baseline and at four, eight, and 12 months. RESULTS: Findings from group × trial analyses of variance of omnibus measures of the four constructs showed significant impact over the year for participants in PNP compared with those in the control group, with analyses showing small to moderate effect sizes: general health status (η CONCLUSIONS: Implications for improving in‐the‐field health care for this population are discussed. Whether these results occurred because navigators were peers per se needs to be examined in future research."," Corrigan, PW;  Kraus, DJ;  Pickett, SA;  Schmidt, A;  Stellon, E;  Hantke, E;  Lara, JL",2017.0, 10.1176/appi.ps.201600134,0,0,
1851,The unpredictive brain under threat: A neurocomputational account of anxious hypervigilance.,"Background: Anxious hypervigilance is marked by sensitized sensory-perceptual processes and attentional biases to potential danger cues in the environment. How this is realized at the neurocomputational level is unknown but could clarify the brain mechanisms disrupted in psychiatric conditions such as posttraumatic stress disorder. Predictive coding, instantiated by dynamic causal models, provides a promising framework to ground these state-related changes in the dynamic interactions of reciprocally connected brain areas. Methods: Anxiety states were elicited in healthy participants (n = 19) by exposure to the threat of unpredictable, aversive shocks while undergoing magnetoencephalography. An auditory oddball sequence was presented to measure cortical responses related to deviance detection, and dynamic causal models quantified deviance-related changes in effective connectivity. Participants were also administered alprazolam (double-blinded, placebo-controlled crossover) to determine whether the cortical effects of threat-induced anxiety are reversed by acute anxiolytic treatment. Results: Deviant tones elicited increased auditory cortical responses under threat. Bayesian analyses revealed that hypervigilant responding was best explained by increased postsynaptic gain in primary auditory cortex activity as well as modulation of feedforward, but not feedback, coupling within a temporofrontal cortical network. Increasing inhibitory gamma-aminobutyric acidergic action with alprazolam reduced anxiety and restored feedback modulation within the network. Conclusions: Threat-induced anxiety produced unbalanced feedforward signaling in response to deviations in predicable sensory input. Amplifying ascending sensory prediction error signals may optimize stimulus detection in the face of impending threats. At the same time, diminished descending sensory prediction signals impede perceptual learning and may, therefore, underpin some of the deleterious effects of anxiety on higher-order cognition. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Cornwell, Brian R; Garrido, Marta I; Overstreet, Cassie; Pine, Daniel S; Grillon, Christian",2017.0,http://dx.doi.org/10.1016/j.biopsych.2017.06.031,0,0,
1852, Effect of exercising at minimum recommendations of the multiple sclerosis exercise guideline combined with structured education or attention control education - secondary results of the step it up randomised controlled trial," BACKGROUND: Recent exercise guidelines for people with multiple sclerosis (MS) recommend a minimum of 30 min moderate intensity aerobic exercise and resistance exercise twice per week. This trial compared the secondary outcomes of a combined 10‐week guideline based intervention and a Social Cognitive Theory (SCT) education programme with the same exercise intervention involving an attention control education. METHODS: Physically inactive people with MS, scoring 0‐3 on Patient Determined Disease Steps Scale, with no MS relapse or change in MS medication, were randomised to 10‐week exercise plus SCT education or exercise plus attention control education conditions. Outcomes included fatigue, depression, anxiety, strength, physical activity, SCT constructs and impact of MS and were measured by a blinded assessor pre and post‐intervention and 3 and 6 month follow up. RESULTS: One hundred and seventy‐four expressed interest, 92 were eligible and 65 enrolled. Using linear mixed effects models, the differences between groups on all secondary measures post‐intervention and at follow‐up were not significant. Post‐hoc, exploratory, within group analysis identified improvements in both groups post intervention in fatigue (mean ∆(95% CI) SCT ‐4.99(‐9.87, ‐0.21), p = 0.04, Control ‐7.68(‐12.13, ‐3.23), p = 0.00), strength (SCT ‐1.51(‐2.41, ‐0.60), p < 0.01, Control ‐1.55(‐2.30, ‐0.79), p < 0.01), physical activity (SCT 9.85(5.45, 14.23), p < 0.01, Control 12.92(4.69, 20.89), goal setting (SCT 7.30(4.19, 10.4), p < 0.01, Control 5.96(2.92, 9.01), p < 0.01) and exercise planning (SCT 5.88(3.37, 8.39), p < 0.01, Control 3.76(1.27, 6.25), p < 0.01) that were maintained above baseline at 3 and 6 month follow up (all p < 0.05). Only the SCT group improved at 3 and 6 month follow up in physical impact of MS(‐4.45(‐8.68, ‐0.22), ‐4.12(‐8.25, 0.01), anxiety(‐1.76(‐3.20, ‐0.31), ‐1.99(‐3.28, ‐0.71), depression(‐1.51(‐2.89, ‐0.13), ‐1.02(‐2.05, 0.01)) and cognition(5.04(2.51, 7.57), 3.05(0.81, 5.28), with a medium effect for cognition and fitness (Hedges' g 0.75(0.24, 1.25), 0.51(0.01, 1.00) at 3 month follow up. CONCLUSIONS: There were no statistically significant differences between groups for the secondary outcomes once age, gender, time since diagnosis and type of MS were accounted for. However, within the SCT group only there were improvements in anxiety, depression, cognition and physical impact of MS. Exercising at the minimum guideline amount has a positive effect on fatigue, strength and PA that is sustained at 3 and 6 months following the cessation of the program. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02301442 , retrospectively registered on November 13th 2014."," Coote, S;  Uszynski, M;  Herring, MP;  Hayes, S;  Scarrott, C;  Newell, J;  Gallagher, S;  Larkin, A;  Motl, RW",2017.0, 10.1186/s12883-017-0898-y,0,0,
1853,Art therapy as an adjuvant treatment for depression in elderly women: a randomized controlled trial.,"There are few quantitative studies on art therapy for the treatment of depression. The objective of this study was to evaluate if art therapy is beneficial as an adjuvant treatment for depression in the elderly. A randomized, controlled, single-blind study was carried out in a sample of elderly women with major depressive disorder (MDD) stable on pharmacotherapy. The experimental group (EG) was assigned to 20 weekly art therapy sessions (90 min/session). The control group (CG) was not subjected to any adjuvant intervention. Patients were evaluated at baseline and after 20 weeks, using the Geriatric Depression Scale (GDS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and cognitive measures. Logistic regression analysis adjusted for age revealed that women in EG (n=31) had significant improvement in GDS (p = 0.007), BDI (p = 0.025), and BAI (p = 0.032) scores as compared with controls (n=25). No difference was found in the cognitive measures. Art therapy as an adjunctive treatment for MDD in the elderly can improve depressive and anxiety symptoms. RBR-2YXY7Z.",Ciasca EC.; Ferreira RC.; Santana CLA.; Forlenza OV.; Dos Santos GD.; Brum PS.; Nunes PV.,,10.1590/1516-4446-2017-2250,0,0,
1854,An adapted mindfulness intervention for people with dementia in care homes: feasibility pilot study.,"Depression and anxiety are common in dementia. There is a need to develop effective psychosocial interventions. This study sought to develop a group-based adapted mindfulness programme for people with mild to moderate dementia in care homes and to determine its feasibility and potential benefits. A manual for a 10-session intervention was developed. Participants were randomly allocated to the intervention plus treatment as usual (n = 20) or treatment as usual (n = 11). Measures of mood, anxiety, quality of life, cognitive function, stress and mindfulness were administered at baseline and 1 week post-intervention. There was a significant improvement in quality of life in the intervention group compared to controls (p = 0.05). There were no significant changes in other outcomes. The intervention was feasible in terms of recruitment, retention, attrition and acceptability and was associated with significant positive changes in quality of life. A fully powered randomised controlled trial is required. Copyright © 2017 John Wiley & Sons, Ltd.",Churcher Clarke A.; Chan JMY.; Stott J.; Royan L.; Spector A.,2017.0,10.1002/gps.4669,0,0,
1855,TBI symptoms improve after PTSD remediation with emotional freedom techniques.,"A group of 59 veterans with clinical levels of posttraumatic stress disorder (PTSD) symptoms received emotional freedom techniques (EFT) coaching in a randomized controlled trial. A significant percentage dropped below the clinical threshold after 6 sessions of EFT (86%, p < .0001) and remained subclinical at 3-month and 6-month follow-ups. Traumatic brain injury (TBI) and somatoform symptoms isolated from the data set for detailed analysis are presented in the current paper. Compared with pretest, significant reductions in TBI symptoms were found after 3 sessions, with a further reduction after 6 months (-41%, p < .0021). Participant gains were maintained on 3-month and 6-month follow-ups (p < .0006). These results point to the poorly defined distinction between TBI and PTSD symptoms, the potential for partial TBI rehabilitation as a sequel to successful PTSD treatment, and the possibility of long-term maintenance of clinical gains. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Church, Dawson; Palmer-Hoffman, Julie",2014.0,http://dx.doi.org/10.1037/h0099831,0,0,
1856,"Pain, range of motion, and psychological symptoms in a population with frozen shoulder: A randomized controlled dismantling study of clinical EFT (emotional freedom techniques).","SCIENTIFIC ABSTRACT Clinical EFT (emotional freedom techniques) combines acupoint stimulation with elements of cognitive and exposure therapy. Numerous studies have demonstrated the efficacy of EFT for depression, anxiety, phobias, PTSD, and other psychological conditions. The current study assesses whether acupoint stimulation is an active ingredient or whether treatment effects are due to nonspecific factors. Thirty-seven participants with ""frozen shoulder"" consisting of limited range of motion (ROM) and pain were randomized into a wait list, or 1 of 2 treatment groups. ROM, pain, and the breadth and depth of psychological conditions such as anxiety and depression were assessed before and after a 30-min treatment session, and 30 days later. One treatment group received clinical EFT, while the other received an identical cognitive/exposure protocol but with diaphragmatic breathing (DB) substituted for acupoint stimulation. No significant improvement in any psychological symptom was found in the wait list. Participants in both the EFT and DB groups demonstrated significant posttest improvement in psychological symptoms and pain. Follow-up showed that both groups maintained their gains for pain, with EFT superior to DB, but only the EFT group maintained gains for psychological symptoms (p < .001). Large EFT treatment effects were found, with a Cohen's d = .9 for anxiety and pain, and d = 1.1 for depression. Though EFT showed a greater trend for improved ROM in most dimensions of movement, changes were nonsignificant for most measures in all groups. Reductions in psychological distress were associated with reduced pain as well as with improved ROM. The results are consistent with 5 earlier dismantling studies showing that acupoint stimulation is an active ingredient in EFT treatment. The study adds further support to other clinical trials indicating that clinical EFT is an efficacious evidence-based treatment for pain and psychological conditions. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Impact Statement Clinical EFT (emotional freedom techniques) combines fingertip stimulation of acupuncture points (acupressure) with elements drawn from cognitive and exposure therapies. Numerous studies have demonstrated the efficacy of EFT for depression, anxiety, phobias, posttraumatic stress disorder (PTSD), and other psychological conditions. The current study was designed to measure whether acupressure is an active ingredient in EFT, or whether its effects are due to its cognitive and exposure elements, or factors common to all therapies like sympathetic attention and belief in a positive outcome. In this study, 37 participants with ""frozen shoulder"" consisting of limited range of motion (ROM) and pain were randomized into a wait list, or 1 of 2 treatment groups. ROM, pain, and psychological conditions such as anxiety and depression were assessed before and after a 30-min treatment session, and 30 days later. One treatment group received clinical EFT, while the other received all the elements of EFT but with diaphragmatic breathing (DB) substituted for acupressure. No statistically significant improvement (1 possibility in 20) in any psychological symptom was found in the wait list group. After treatment, participants in the both the EFT and DB groups demonstrated statistically significant improvements in psychological symptoms and pain. Follow-up showed that both groups maintained their gains for pain, with EFT superior to DB, but only the EFT group maintained their gains for psychological symptoms. Statistically large EFT treatment effects were found for anxiety, pain, and depression. ROM changes were not statistically significant for most measures in any of the groups. The EFT group showed a significant association between reductions in psychological distress and pain. The results are consistent with 5 earlier studies showing that acupressure is an active ingredient in EFT treatment and not an inert ingredient or a placebo. The study adds further support to other clinical trials indicating that clinical EFT is an evidence-based and effective treatment for pain and psychological conditions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Church, Dawson; Nelms, Jerrod",2016.0,http://dx.doi.org/10.1037/arc0000028,0,0,
1857, EFT (Emotional Freedom Techniques) and Resiliency in Veterans at Risk for PTSD: a Randomized Controlled Trial," Prior research indicates elevated but subclinical posttraumatic stress disorder (PTSD) symptoms as a risk factor for a later diagnosis of PTSD. This study examined the progression of symptoms in 21 subclinical veterans. Participants were randomized into a treatment as usual (TAU) wait‐list group and an experimental group, which received TAU plus six sessions of clinical emotional freedom techniques (EFT). Symptoms were assessed using the PCL‐M (Posttraumatic Checklist‐Military) on which a score of 35 or higher indicates increased risk for PTSD. The mean pretreatment score of participants was 39 ± 8.7, with no significant difference between groups. No change was found in the TAU group during the wait period. Afterward, the TAU group received an identical clinical EFT protocol. Posttreatment groups were combined for analysis. Scores declined to a mean of 25 (‐64%, P < .0001). Participants maintained their gains, with mean three‐month and six‐month follow‐up PCL‐M scores of 27 (P < .0001). Similar reductions were noted in the depth and breadth of psychological conditions such as anxiety. A Cohen's d = 1.99 indicates a large treatment effect. Reductions in traumatic brain injury symptoms (P = .045) and insomnia (P = .004) were also noted. Symptom improvements were similar to those assessed in studies of PTSD‐positive veterans. EFT may thus be protective against an increase in symptoms and a later PTSD diagnosis. As a simple and quickly learned self‐help method, EFT may be a clinically useful element of a resiliency program for veterans and active‐duty warriors."," Church, D;  Sparks, T;  Clond, M",2016.0, 10.1016/j.explore.2016.06.012,0,0,
1858," The influence of androstadienone during psychosocial stress is modulated by gender, trait anxiety and subjective stress: an fMRI study"," Androstadienone (ANDR), a bodily secreted steroid compound, is a socially relevant chemosignal that modulates subjective and (neuro)physiological responses, predominantly in females. The impact of ANDR on stress responses in males and females has not been explored. Therefore, this fMRI study aimed to examine psychosocial stress reactions induced by mental arithmetic and social evaluation on behavioral and hormonal levels (46 participants: 15 naturally cycling females in their early follicular phase (EF), 15 females on hormonal contraceptives (HC) and 16 males); and on a neural level (40 participants: 13 EF‚Äêfemales, 13 HC‚Äêfemales and 14 males) in an ANDR and placebo treatment repeated‚Äêmeasures design. While no gender differences emerged in subjective ratings and performance during stress, neural activation patterns differed significantly. Besides, ANDR attenuated the post‚Äêstress increase of negative mood in all participants. Region of interest analyses showed that irrespective of treatment, males showed stronger activation of the dorsolateral prefrontal cortex (DLPFC) than females. At the whole brain level, gender differences emerged indicating stronger fronto‚Äêparietal activation in males compared to HC‚Äêfemales on both treatments. Males showed stronger visual and fusiform activation than EF‚Äêfemales under ANDR. Both female groups did not show stronger activation than males. Further, error ratio in the ANDR‚Äêstress condition was positively associated with their post‚Äêstress cortisol level and increase in subjective stress in males; and male DLPFC activity in the ANDR‚Äêstress condition was negatively associated with trait anxiety. Surprisingly, compared to HC‚Äêfemales, EF‚Äêfemale only showed stronger activation of arousal‚Äêrelated areas under placebo treatment. Taken together, these findings suggest that the male stress reaction under social evaluative threat was stronger than female stress reactions as a function of ANDR. More specifically, this effect on behavioral and neural stress reactions seems to depend on trait anxiety in males only. The study highlights the significance of a chemosignal in enhancing social threat that may facilitate adaptive stress responses."," Chung, KC;  Springer, I;  Kogler, L;  Turetsky, B;  Freiherr, J;  Derntl, B",2016.0, 10.1016/j.psyneuen.2016.02.026,0,0,
1859,Anxiety After Stroke: The Importance of Subtyping.,"Anxiety after stroke is common and disabling. Stroke trialists have treated anxiety as a homogenous condition, and intervention studies have followed suit, neglecting the different treatment approaches for phobic and generalized anxiety. Using diagnostic psychiatric interviews, we aimed to report the frequency of phobic and generalized anxiety, phobic avoidance, predictors of anxiety, and patient outcomes at 3 months poststroke/transient ischemic attack. We followed prospectively a cohort of new diagnosis of stroke/transient ischemic attack at 3 months with a telephone semistructured psychiatric interview, Fear Questionnaire, modified Rankin Scale, EuroQol-5D5L, and Work and Social Adjustment Scale. Anxiety disorder was common (any anxiety disorder, 38 of 175 [22%]). Phobic disorder was the predominant anxiety subtype: phobic disorder only, 18 of 175 (10%); phobic and generalized anxiety disorder, 13 of 175 (7%); and generalized anxiety disorder only, 7 of 175 (4%). Participants with anxiety disorder reported higher level of phobic avoidance across all situations on the Fear Questionnaire. Younger age (per decade increase in odds ratio, 0.64; 95% confidence interval, 0.45-0.91) and having previous anxiety/depression (odds ratio, 4.38; 95% confidence interval, 1.94-9.89) were predictors for anxiety poststroke/transient ischemic attack. Participants with anxiety disorder were more dependent (modified Rankin Scale score 3-5, [anxiety] 55% versus [no anxiety] 29%; P<0.0005), had poorer quality of life on EQ-5D5L, and restricted participation (Work and Social Adjustment Scale: median, interquartile range, [anxiety] 19.5, 10-27 versus [no anxiety] 0, 0-5; P<0.001). Anxiety after stroke/transient ischemic attack is predominantly phobic and is associated with poorer patient outcomes. Trials of anxiety intervention in stroke should consider the different treatment approaches needed for phobic and generalized anxiety.",Chun HY.; Whiteley WN.; Dennis MS.; Mead GE.; Carson AJ.,2018.0,10.1161/STROKEAHA.117.020078,0,0,
1860, Effect of Supportive Information on Anxiety Levels in Pregnant Women Awaiting Amniocentesis Results: a Randomized Controlled Trial," Objective: To evaluate the effect of supportive information on anxiety levels in women awaiting amniocentesis results. Material and Method: Women underwent amniocentesis were randomized into two groups according to whether they did (group A) or did not (group B) receive supportive information. Anxiety levels were measured using the Spielberger State‚ÄêTrait Anxiety Inventory at four time points, (1) after amniocentesis, (2) before phoning for test result appointment confirmation, (3) after phoning, during which supportive information was given to group A, and (4) before receiving the test results. Semistructured interviews were conducted after the last anxiety measurement. Results: There were no significant differences in the state anxiety scores between the two groups after amniocentesis and before phoning to confirm that the amniocentesis results were available. The state anxiety scores after telephoning and before receiving the test results in group A were significantly lower than those in group B (36.69 vs. 42.50, p<0.001, and 39.16 vs. 42.82, p<0.05, respectively). We identified three stages of psychological distress, uncertainty of fetal safety, uncertainty of the test results, and hopefulness concerning the test results. Women in group B experienced only the two early stages of distress, whereas after receiving supportive information, the psychological state of women in group A further progressed to the hopefulness concerning the test result Conclusion: Supportive information could alleviate the anxiety level of women awaiting amniocentesis results. Providing appropriate supportive information for each psychological stage should be considered for women underwent amniocentesis."," Chuenwattana, P;  Phaophan, A;  Mongkolchat, N",2017.0,,0,0,
1861,Two Novel Cognitive Behavioral Therapy-Based Mobile Apps for Agoraphobia: Randomized Controlled Trial.,"Despite the large body of literature demonstrating the effectiveness of cognitive behavioral treatments for agoraphobia, many patients remain untreated because of various barriers to treatment. Web-based and mobile-based interventions targeting agoraphobia may provide a solution to this problem, but there is a lack of research investigating the efficacy of such interventions. The objective of our study was to evaluate for the first time the effectiveness of a self-guided mobile-based intervention primarily targeting agoraphobic symptoms, with respect to a generic mobile app targeting anxiety. A Web-based randomized controlled trial (RCT) compared a novel mobile app designed to target agoraphobia (called Agoraphobia Free) with a mobile app designed to help with symptoms of anxiety in general (called Stress Free). Both interventions were based on established cognitive behavioral principles. We recruited participants (N=170) who self-identified as having agoraphobia and assessed them online at baseline, midpoint, and end point (posttreatment) over a period of 12 weeks. The primary outcome was symptom severity measured by the Panic and Agoraphobia Scale. Both groups had statistically significant improvements in symptom severity over time (difference -5.97, 95% CI -8.49 to -3.44, P<.001 for Agoraphobia Free and -6.35, 95% CI -8.82 to -3.87, P<.001 for Stress Free), but there were no significant between-group differences on the primary outcome (difference 0.38, 95% CI -1.96 to 3.20, P=.64). This is, to our knowledge, the first RCT to provide evidence that people who identify as having agoraphobia may equally benefit from a diagnosis-specific and a transdiagnostic mobile-based intervention. We also discuss clinical and research implications for the development and dissemination of mobile mental health apps. International Standard Randomized Controlled Trial Number (ISRCTN): 98453199; http://www.isrctn.com /ISRCTN98453199 (Archived by WebCite at http://www.webcitation.org/6uR5vsdZw).",Christoforou M.; S√°ez Fonseca JA.; Tsakanikos E.,2017.0,10.2196/jmir.7747,0,0,
1862, A randomized controlled trial of disclosing genetic risk information for Alzheimer disease via telephone," PurposeTelephone disclosure of genetic test results can improve access to services. To date, studies of its impact have focused on return of Mendelian risk information, principally hereditary cancer syndromes.MethodsIn a multisite trial of Alzheimer disease genetic risk disclosure, asymptomatic adults were randomized to receive test results in person or via telephone. Primary analyses examined patient outcomes 12 months after disclosure.ResultsData from 257 participants showed that telephone disclosure occurred 7.4 days sooner and was 30% shorter, on average, than in‚Äêperson disclosure (both P‚Äâ<‚Äâ0.001). Anxiety and depression scores were well below cutoffs for clinical concern across protocols. Comparing telephone and in‚Äêperson disclosure protocols, 99% confidence intervals of mean differences were within noninferiority margins on scales assessing anxiety, depression, and test‚Äêrelated distress, but inconclusive about positive impact. No differences were observed on measures of recall and subjective impact. Subanalyses supported noninferiority on all outcomes among apolipoprotein E (APOE) …õ4‚Äênegative participants. Subanalyses were inconclusive for APOE …õ4‚Äêpositive participants, although mean anxiety and depression scores were still well below cutoffs for clinical concern.ConclusionTelephone disclosure of APOE results and risk for Alzheimer disease is generally safe and helps providers meet demands for services, even when results identify an increased risk for disease."," Christensen, KD;  Uhlmann, WR;  Roberts, JS;  Linnenbringer, E;  Whitehouse, PJ;  Royal, CDM;  Obisesan, TO;  Cupples, LA;  Butson, MB;  Fasaye, GA;  et al.",2018.0, 10.1038/gim.2017.103,0,0,
1863, Qualitative exploration of the benefits of group-based memory rehabilitation for people with neurological disabilities: implications for rehabilitation delivery and evaluation," OBJECTIVE: To identify patient‚Äêperceived benefits of memory rehabilitation and draw transferrable lessons for the delivery and evaluation of similar interventions for people with neurological disabilities. METHODS: A qualitative study was conducted as part of a pragmatic randomised controlled trial comparing 2 memory rehabilitation approaches with a self‚Äêhelp control group. Postintervention interviews were conducted with 20 participants with a diagnosis of traumatic brain injury, multiple sclerosis or stroke. Data were analysed using a qualitative content analysis approach. RESULTS: Participants receiving memory rehabilitation reported that the sessions responded to previously unmet needs for information on brain injury and memory function and developed their insight along with a sense of self‚Äêefficacy and control over the management of their memory problems. Although they did not experience major improvements in their memory function per se, they reported that rehabilitation gave them the skills to effectively cope with the residual deficits. Respondents in the control groups did not report similar benefits. The opportunities for interaction offered by the group setting were greatly valued by all respondents. Mixed aetiology groups were received positively; however, marked differences in cognitive performance were frustrating for some participants. CONCLUSIONS: The study highlighted important patient‚Äêperceived outcomes that should be considered by researchers and rehabilitation professionals when evaluating the effects of memory rehabilitation. The use of domain‚Äêspecific outcome measures which reflect these areas is recommended. Qualitative changes in the use of memory aids may be achieved which cannot be captured by frequency indices alone. The benefits of the group‚Äêbased rehabilitation approach were stressed by participants, suggesting that a combination of group and individual sessions might be a good practice. TRIAL REGISTRATION NUMBER: ISRCTN92582254; Results."," Chouliara, N;  Lincoln, NB",2016.0, 10.1136/bmjopen-2016-011225,0,0,
1864," Child STEPs in California: a cluster randomized effectiveness trial comparing modular treatment with community implemented treatment for youth with anxiety, depression, conduct problems, or traumatic stress"," OBJECTIVE: This study reports outcomes from a randomized effectiveness trial testing modular treatment versus multiple community‚Äêimplemented evidence‚Äêbased treatments for youth. METHOD: An ethnoracially diverse sample of 138 youth ages 5 to 15 (62 girls, 76 boys) whose primary clinical concerns involved diagnoses or clinical elevations related to anxiety, depression, disruptive behavior, and/or traumatic stress were treated by community therapists randomly assigned to 1 of 2 conditions: (a) modular treatment, which involved a single modular protocol (i.e., modular approach to therapy for children; MATCH) that allowed flexible selection and sequencing of procedures to fit the chosen treatment focus in the context of measurement feedback, and (b) community‚Äêimplemented treatment (CIT), which was a county‚Äêsupported implementation of multiple evidence‚Äêbased practices for youth. RESULTS: Youth treated with MATCH showed significantly faster rates of improvement over time on clinical and functional outcomes relative to youth in the CIT condition and required significantly fewer sessions delivered over significantly fewer days. Caregiver‚Äêreported clinical improvement rates were significantly greater for MATCH (60%) versus CIT (36.7%). Further, youth in the CIT condition were significantly more likely to receive additional psychosocial treatment services and were significantly more likely to use a variety of psychotropic medications during the active treatment phase. CONCLUSIONS: These results extend prior findings, supporting the effectiveness and efficiency of a modular, multifocus approach that incorporates monitoring and feedback relative to community implementation of evidence‚Äêbased treatments. (PsycINFO Database Record"," Chorpita, BF;  Daleiden, EL;  Park, AL;  Ward, AM;  Levy, MC;  Cromley, T;  Chiu, AW;  Letamendi, AM;  Tsai, KH;  Krull, JL",2017.0, 10.1037/ccp0000133,0,0,
1865,"[The Effects of Neurofeedback Training on Physical, Psychoemotional Stress Response and Self-Regulation for Late Adolescence: A Non-Randomized Trial].","The aim of this study was to analyze the effects of neurofeedback training for reducing stress and enhancing self-regulation in late adolescence to identify the possibility of use for nursing intervention. A nonequivalent control group pre-post quasi-experimental design was used. Participants were 78 late adolescents assigned to the experimental group (n=39) that received the neurofeedback training and the control group (n=39). Data were collected on heart rate variability (HRV) and skin conductance level (SCL) to assess stress-biomarker response. The questionnaire contained 164 items from: Positive and Negative Affect Schedule (PANAS), Symptom Checklist-90-Revised (SCL-90-R) and Self-regulatory Ability scale. The neurofeedback training was based on the general adaptation syndrome and body-mind medicine. The intervention was conducted in a total of 10 sessions for 30 minutes per session with high-beta, theta and sensory motor rhythm training on scalp at central zero. There were significant difference in standard deviation of normal to normal interval (p=.036) in HRV and SCL (p=.029) of stress-biomarker response between the two groups. Negative affect (p=.036) in PANAS and obsessive compulsive (p=.023) and depression (p<.001) in SCL-90-R were statistically significant. Self-regulation mode (p=.004) in self-regulation ability scale showed a significant difference between the two groups. The results indicated that the neurofeedback training is effective in stress-biomarkers, psychoemotional stress response and self-regulation. Therefore, neurofeedback training using neuroscientific approach based on brain-mind-body model can be used as an effective nursing intervention for late adolescents in clinics and communities for effective stress responses.",Choi MJ.; Park WJ.,2018.0,10.4040/jkan.2018.48.2.208,0,0,
1866,"Applying network analysis to psychological comorbidity and health behavior: Depression, PTSD, and sexual risk in sexual minority men with trauma histories.","High rates of depression and posttraumatic stress disorder (PTSD) contribute to sexual risk, particularly in men who have sex with men (MSM) who have experienced childhood sexual abuse. The comorbidity between depression and PTSD and mechanisms by which they contribute to sexual risk in MSM remain unclear. This study sought to demonstrate the feasibility and utility of a network approach to (a) characterize symptom interconnections between depression and PTSD in MSM, (b) identify specific symptoms related to sexual risk behavior, and (c) compare symptom networks across groups at different levels of risk. Cross-sectional baseline data were collected from 296 HIV-negative urban MSM as part of a multisite randomized intervention trial. Symptoms of depression and PTSD were self-reported along with sexual risk behavior. Analyses were performed in R using regularized partial correlation network modeling. Network analyses revealed complex associations between depression and PTSD symptoms and in relation to sexual risk behavior. While symptoms clustered within their respective disorders, depression and PTSD were connected at key symptom nodes (e.g., sleep, concentration). Specific symptoms (e.g., avoiding thoughts and feelings) were linked to sexual risk behavior. Network comparisons across risk groups suggested avoidant processes could be more readily activated in higher-risk individuals, whereas hyperarousal symptoms may be more salient and protective for lower-risk individuals. This study is one of the earliest network analyses of depression and PTSD, and first to extend this inquiry to health behavior. Symptom-level investigations may clarify mechanisms underlying psychological comorbidity and behavioral risk in MSM and refine targets for intervention/prevention. (PsycINFO Database Record",Choi KW.; Batchelder AW.; Ehlinger PP.; Safren SA.; O'Cleirigh C.,2017.0,10.1037/ccp0000241,0,0,
1867,Population-based validation of a German version of the Brief Resilience Scale,"Smith and colleagues developed the Brief Resilience Scale (BRS) to assess the individual ability to recover from stress despite significant adversity. This study aimed to validate the German version of the BRS. We used data from a population-based (sample 1: n = 1.481) and a representative (sample 2: n = 1.128) sample of participants from the German general population (age 18) to assess reliability and validity. Confirmatory factor analyses (CFA) were conducted to compare one- and two-factorial models from previous studies with a method-factor model which especially accounts for the wording of the items. Reliability was analyzed. Convergent validity was measured by correlating BRS scores with mental health measures, coping, social support, and optimism. Reliability was good (α = .85, ω = .85 for both samples). The method-factor model showed excellent model fit (sample 1: χ2/df = 7.544; RMSEA = .07; CFI = .99; SRMR = .02; sample 2: χ2/df = 1.166; RMSEA = .01; CFI = 1.00; SRMR = .01) which was significantly better than the one-factor model (Δχ2(4) = 172.71, p < .001) or the two-factor model (Δχ2(3) = 31.16, p < .001). The BRS was positively correlated with well-being, social support, optimism, and the coping strategies active coping, positive reframing, acceptance, and humor. It was negatively correlated with somatic symptoms, anxiety and insomnia, social dysfunction, depression, and the coping strategies religion, denial, venting, substance use, and self-blame. To conclude, our results provide evidence for the reliability and validity of the German adaptation of the BRS as well as the unidimensional structure of the scale once method effects are accounted for.",Chmitorz A.; Wenzel M.; Stieglitz R.-D.; Kunzler A.; Bagusat C.; Helmreich I.; Gerlicher A.; Kampa M.; Kubiak T.; Kalisch R.; Lieb K.; Tüscher O.,2018.0,10.1371/journal.pone.0192761,0,0,
1868, A Randomized controlled trial to evaluate the impact of a Nurse Navigator Programme on outcomes of people with breast cancer: study protocol," AIM: To evaluate the effectiveness of a Nurse Navigator Programme on anxiety, psychological distress and quality of life in people with breast cancer. BACKGROUND: Breast cancer is the most frequently detected malignancy and a major cause of cancer death among women around the world. The lengthy course of illness from initial diagnosis to treatment and subsequent follow‚Äêup causes deterioration in physical, psychological and social status among patients. Nurses have a major role in cancer care. As women with breast cancer have to undergo various treatment modalities, continued care by a pivot nurse is thought to enhance treatment adherence. Limited studies have been reported from developing countries on Nurse Navigation Programmes. DESIGN: A Stratified Randomized controlled trial with repeated measures. METHODS: One hundred and twenty newly diagnosed women with breast cancer admitted to surgery wards of a tertiary care hospital in South India will be recruited. (Project funded in Octo""ber 2014). Women are randomly allocated to a control and intervention group. The outcome variables are anxiety, psychological distress and quality of life. Data on outcome measures will be collected at five different time points: before surgery, at discharge, beginning of adjuvant therapy, middle of adjuvant therapy and at the end of adjuvant therapy. DISCUSSION: This study may give evidence on the effectiveness of a Nurse Navigator Programme for women with breast cancer. If significant effects were detected, the programme could be integrated into hospital services to improve the patient care."," Chillakunnel Hussain Rawther, S;  Pai, MS;  Fernandes, DJ;  Mathew, S;  Binu, VS;  Chakrabarty, J;  Devi, ES;  George, A;  Nayak, BS",2017.0, 10.1111/jan.13203,0,0,
1869,Screening for psychological distress using the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial validation of structural validity in dialysis patients.,"Objective: To validate the factor structure of the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS)- which is a composite measure of depression and anxiety using the Patient Health Questionnaire-9 and Generalised Anxiety Disorder Scale (GAD-7), in a sample of haemodialysis patients. Method: Screening data (n = 182) used to select entry into a feasibility study of an online cognitive-behavioural therapy intervention for distress in dialysis patients were analysed here. Structural validity of the PHQ-ADS was evaluated using confirmatory factor analysis (CFA), assessing alternative models including a bi-factor model. In the bi-factor model all items from the PHQ-9 and GAD-7 (16-items in total) were loaded onto a general distress factor. Respective items of the PHQ-9 and GAD-7 were specified as subgroup factors. Omega-hierarchical was calculated to indicate the level of saturation of a multidimensional scale by a general factor. Construct validity was determined against the Brief Illness Perception Questionnaire. Results: A bi-factor PHQ-ADS model had good fit to the data (chi-square = 96.1, p = 0.26, CFI = 0.99; TLI = 0.99; RMSEA = 0.02). The general distress factor accounted for approximately 84% of the explained variance (omega-h = 0.90). Distress scores were significantly higher in females compare with males. There was a significant association between distress and negative illness perceptions (r = 0.58, p < 0.01). Conclusions: The PHQ-ADS appears to have good structural validity in haemodialysis patients and is sufficiently unidimensional to warrant the use of a total distress score. A full psychometric analysis of the PHQ-ADS in a larger sample of dialysis patients is warranted. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Chilcot, Joseph; Hudson, Joanna L; Moss-Morris, Rona; Carroll, Amy; Game, David; Simpson, Anna; Hotopf, Matthew",2018.0,http://dx.doi.org/10.1016/j.genhosppsych.2017.09.007,0,0,
1870, The impact of music therapy on pain and stress reduction during oocyte retrieval - a randomized controlled trial," RESEARCH QUESTION: Does music therapy help in reducing pain and anxiety in women undergoing transvaginal ultrasound‚Äêguided oocyte retrieval (TUGOR)? DESIGN: In this randomized controlled open label study, 209 participants were recruited and randomized into three groups (music group, n = 70; headphone group, n = 70; control group, n = 69). Patients' psychological status was assessed using the visual analogue scale of pain (VAS‚ÄêP), satisfaction of pain control, state‚Äêtrait anxiety inventory (STAI), Beck depression inventory (BDI), and general health questionnaire (GHQ). Stress biomarkers, including salivary alpha amylase (sAA) and salivary cortisol (sCort), were measured before and after TUGOR. RESULTS: No significant differences were found in psychological scoring of STAI, BDI, GHQ and the stress biomarkers. Although neither the anxiety scores nor the analgesic requirements differed among the three groups, the visual measure of vaginal pain (median, range) showed music group (20,0‚Äê70) was significantly (P = 0.005) lower than headphone group (30,0‚Äê90) and control group (30,0‚Äê100). The degree of satisfaction with pain control (median, range) in the music group (80,30‚Äê100), was significantly (P = 0.001) higher than the headphone group (80,10‚Äê100) and control group (70,0‚Äê100). CONCLUSION: Music is a simple, inexpensive and effective way to reduce pain score and increase satisfaction with pain control during TUGOR procedure, which may justify its routine use."," Cheung, CWC;  Yee, AWW;  Chan, PS;  Saravelos, SH;  Chung, JPW;  Cheung, LP;  Kong, GWS;  Li, TC",2018.0, 10.1016/j.rbmo.2018.04.049,0,0,
1871, Cognitive bias modification and CBT as early interventions for adolescent social and test anxiety: two-year follow-up of a randomized controlled trial," BACKGROUND AND OBJECTIVES: This two‚Äêyear follow‚Äêup study evaluated the long‚Äêterm outcomes of two early interventions that aimed at reducing social and test anxiety in young adolescents at risk for developing social anxiety disorder. METHODS: In this RCT, moderately socially anxious adolescents (N=240, mean age 13.6 years) were randomly assigned to a 10‚Äêweek internet‚Äêbased multifaceted cognitive bias modification training (CBM), a 10‚Äêweek school‚Äêbased cognitive behavioral group training (CBT), or a no‚Äêintervention control condition. Using multiple imputation, this study examined the changes in primary and secondary outcome measures from pretest to follow‚Äêup in a repeated measures design. RESULTS: Primary outcome: Self‚Äêreported social and test anxiety generally decreased from pre‚Äêtest to two‚Äêyear follow‚Äêup, regardless of treatment condition. The percentage of adolescents who developed a social anxiety disorder was very low (6%) and similar across conditions. Secondary outcome: There were beneficial changes in self‚Äêesteem, self‚Äêreported prosocial behaviors, and fear of negative evaluation, but none of these were related to treatment condition. Automatic social‚Äêthreat associations did not significantly change. The CBM intervention was effective in changing interpretative bias as indexed by the Recognition Task but this long‚Äêterm effect did not transfer to the Adolescent Interpretation and Belief Questionnaire. LIMITATIONS: There was a substantial (50%) though seemingly non‚Äêselective attrition at follow‚Äêup. CONCLUSIONS: This RCT does not support the longer‚Äêterm efficacy of school‚Äêbased CBT or CBM as an early intervention for social and test anxiety. Rather, it emphasizes the positive 'natural' course of highly socially anxious adolescents over two years."," de Hullu, E;  Sportel, BE;  Nauta, MH;  de Jong, PJ",2017.0, 10.1016/j.jbtep.2016.11.011,0,0,
1872, Behavior therapy versus clomipramine for the treatment of obsessive-compulsive disorder in children and adolescents," METHOD: Twenty‚Äêtwo children aged between 8 and 18 years were randomly assigned to behavior therapy (n = 12) or open clomipramine (n = 10) in a parallel design lasting 12 weeks. Behavior therapy included exposure and response prevention administered in weekly sessions. The mean dosage of clomipramine was 2.5 mg/kg (range = 1.4‚Äê3.3 mg/kg). The main outcome variables were the Children's Yale‚ÄêBrown Obsessive Compulsive Scale (CY‚ÄêBOCS) and the Leyton Obsessional Inventory‚ÄêChild Version (LOI‚ÄêCV). RESULTS: Significant improvement was obtained in both treatment conditions. Behavior therapy produced stronger therapeutic changes than clomipramine on the CY‚ÄêBOCS (p < .05), whereas on the LOI‚ÄêCV no significant differences between the results of the two treatments were found. Five of the nine initial nonresponders showed significant changes after extension of treatment for another 12 weeks. CONCLUSION: Behavior therapy is shown to be a good alternative for drug treatment and deserves further study in larger samples of children with obsessive‚Äêcompulsive disorder. OBJECTIVE: To compare, via a pilot study, the effectiveness of behavior therapy and of drug treatment in children and adolescents with obsessive‚Äêcompulsive disorder."," de Haan, E;  Hoogduin, KA;  Buitelaar, JK;  Keijsers, GP",1998.0,,0,0,
1873, Electrophysiological correlates of oxytocin-induced enhancement of social performance monitoring," Altered performance monitoring has been demonstrated after administration of different pharmacological compounds and in various clinical populations, such as excessive neurophysiological responses to mistakes in anxiety disorders. Here, a novel social pharmacological approach was applied to investigate whether oxytocin administration (24‚ÄâIU) enhances performance monitoring for errors that have negative consequences for another individual, so‚Äêcalled social mistakes. Healthy male volunteers (N‚Äâ=‚Äâ24) participated in a placebo‚Äêcontrolled crossover design. EEG measures were obtained while pairs of participants performed a speeded choice reaction‚Äêtime task in an individual and social context. Following oxytocin administration, error‚Äêrelated negativity amplitudes were increased for social compared with individual mistakes. This increase was not found in the placebo condition. No effects of oxytocin were present in the individual context. The current study shows that oxytocin enhances performance monitoring specifically for social mistakes. This outcome is in line with a presumed role for oxytocin in salience attribution to social cues and underlines its context‚Äêdependency. Combining these processes may thus open up new research avenues and advance our understanding of individual differences in performance monitoring and oxytocin responses from a social neurocognitive, pharmacological and clinical perspective."," de Bruijn, ERA;  Ruissen, MI;  Radke, S",2017.0, 10.1093/scan/nsx094,0,0,
1874,A randomized controlled study of power posing before public speaking exposure for social anxiety disorder: No evidence for augmentative effects.,"This manuscript details a randomized controlled study designed to test the efficacy of power posing (i.e., briefly holding postures associated with dominance and power) as an augmentative strategy for exposure therapy for social anxiety disorder (SAD). Seventy-three individuals diagnosed with SAD were assigned to one of three conditions: power posing, submissive posing, or rest (no posing) prior to participating in an exposure therapy session. Participants were assessed for between-group differences in pre- and post-manipulation salivary hormone levels, within-session subjective experiences of fear, and pre- and 1-week post-treatment SAD severity outcome measures. Though the intervention resulted in decreased SAD symptom severity one week later, analyses revealed no significant between-group differences on any tested variables. Accordingly, this study provides no evidence to suggest that power posing impacts hormone levels or exposure therapy outcomes.",Davis ML.; Papini S.; Rosenfield D.; Roelofs K.; Kolb S.; Powers MB.; Smits JAJ.,2017.0,10.1016/j.janxdis.2017.09.004,0,0,
1875,Comorbidity and the treatment of principal anxiety disorders in a naturalistic sample.,"This study examined the impact of comorbidity on treatment outcome and the effects of cognitive behavioral therapy (CBT) for anxiety and depressive disorders on comorbid disorders in a naturalistic sample of 150 patients presenting to an anxiety disorders clinic. The following results were observed across principal (i.e., most severe) diagnoses. Patients with comorbid anxiety and depressive disorders presented for treatment with higher severity of their principal disorder than patients without comorbidity. However, the presence of comorbidity did not predict dropout or poor treatment response, and patients demonstrated significant improvement in their principal disorders regardless of comorbidity. The frequency of clinically severe and subclinical (i.e., not severe enough to meet diagnostic criteria) comorbid conditions decreased significantly over the course of treatment. The implication of these findings for the classification and treatment of emotional disorders is discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Davis, Lissa; Barlow, David H; Smith, Lisa",2010.0,http://dx.doi.org/10.1016/j.beth.2009.09.002,0,0,
1876,Low baseline pCO2 predicts poorer outcome from behavioral treatment: Evidence from a mixed anxiety disorders sample.,"Low levels of end-tidal partial pressure of carbon dioxide (pCO2)-the amount of carbon dioxide measured from expired air-are commonly found in individuals with anxiety disorders but have not been examined as predictors of outcome from anxiety treatment. The current study examined pre-treatment baseline pCO2 as a predictor of outcome from cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for anxiety disorders. Sixty-one individuals with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) defined principal anxiety disorder diagnosis completed 12 sessions of either CBT or ACT. Baseline pCO2 was measured prior to entering treatment. Self-reported anxiety symptoms and quality of life were assessed at pre-treatment, post-treatment, and 6- and 12-month follow-up from baseline. Low baseline pCO2 was associated with higher anxiety symptoms and lower quality of life across follow-up timepoints, above and beyond baseline symptom severity. These results suggest that low baseline pCO2 predicts poorer outcome from CBT and ACT for anxiety and may warrant treatment that directly addresses respiratory dysregulation. ©2014 Elsevier Ireland Ltd. All rights reserved. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Davies, Carolyn D; Craske, Michelle G",2014.0,http://dx.doi.org/10.1016/j.psychres.2014.06.003,0,0,
1877,"Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: A randomized, double-blind, placebo-controlled pilot study.","Rationale: Standard therapeutic approaches to reduce social anxiety in autistic adults have limited effectiveness. Since 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy shows promise as a treatment for other anxiety disorders, a blinded, placebo-controlled pilot study was conducted. Objectives: To explore feasibility and safety of MDMA-assisted psychotherapy for reduction of social fear and avoidance that are common in the autistic population. Methods: Autistic adults with marked to very severe social anxiety were randomized to receive MDMA (75 to 125 mg, n = 8) or inactive placebo (0 mg, n = 4) during two 8-h psychotherapy sessions (experimental sessions) in a controlled clinical setting. Double-blinded experimental sessions were spaced approximately 1 month apart with 3 non-drug psychotherapy sessions following each. The primary outcome was change in Leibowitz Social Anxiety Scale (LSAS) Total scores from Baseline to one month after the second experimental session. Outcomes were measured again six months after the last experimental session. Results: Improvement in LSAS scores from baseline to the primary endpoint was significantly greater for MDMA group compared to the placebo group (P = 0.037), and placebo-subtracted Cohen's d effect size was very large (d = 1.4, CI -0.074, 2.874). Change in LSAS scores from baseline to 6-month follow-up showed similar positive results (P = 0.036), with a Cohen's d effect size of 1.1 (CI -0.307, 2.527). Social anxiety remained the same or continued to improve slightly for most participants in the MDMA group after completing the active treatment phase. Conclusions: This pilot trial demonstrated rapid and durable improvement in social anxiety symptoms in autistic adults following MDMA-assisted psychotherapy. Initial safety and efficacy outcomes support expansion of research into larger samples to further investigate this novel treatment for social anxiety. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Danforth, Alicia L; Grob, Charles S; Struble, Christopher; Feduccia, Allison A; Walker, Nick; Jerome, Lisa; Yazar-Klosinski, Berra; Emerson, Amy",2018.0,http://dx.doi.org/10.1007/s00213-018-5010-9,0,0,
1878,Bioequivalence of alprazolam sublingual tablet formulation and alprazolam immediate release tablet in healthy volunteers,"Alprazolam immediate release (IR) tablets are currently approved for the management of anxiety disorder or the short-term relief of symptoms of anxiety. A sublingual (SL) formulation of alprazolam, which disintegrates in the mouth without the need for additional fluids, has been developed. The aim of this study was to determine if the alprazolam SL 1 mg tablet was bioequivalent to the alprazolam IR 1 mg tablet in healthy volunteers. In this randomized, open label, two-way crossover, single dose study, subjects were randomized to receive a single alprazolam 1 mg IR tablet during one dosing period and a single 1 mg SL tablet during the other dosing period. The primary pharmacokinetic endpoints were area under the plasma concentration-time profile from time zero to the time of the last quantifiable concentration AUC(0-t) and maximum plasma concentration (Cmax). Adverse events (AEs) were monitored throughout the study. Bioequivalence was concluded if the 90% confidence intervals (CI) for the ratio of adjusted geometric means for both AUC(0-t) and Cmax were wholly within 80%-125%. Participants were mostly male (27/28 [96.4%]) and had a mean (standard deviation) age of 35.9 (8.2) years. For the alprazolam 1 mg SL tablet relative to the alprazolam 1 mg IR tablet, the ratio of adjusted geometric means (90% CI) for AUC(0-t) and Cmax were 95.43% (91.74%, 99.27%) and 88.27% (83.68%, 93.11%), respectively. The incidence of AEs was similar during both treatment periods: 24 participants reported 39 AEs during the alprazolam 1 mg IR treatment period, and 23 participants reported 38 AEs during the alprazolam 1 mg SL treatment period. Bioequivalence was demonstrated between the alprazolam IR and SL 1 mg tablets, suggesting that the clinical performance of the SL tablet will be similar to that of the IR tablet. © 2013 Damle B, et al.",Damle B.; Tarabar S.; Kuruganti U.; Crownover P.; Labadie R.R.,2013.0,10.4172/jbb.1000150,0,0,
1879," Intraoperative Patient Experience and Postoperative Visual Quality After SMILE and LASIK in a Randomized, Paired-Eye, Controlled Study"," PURPOSE: To compare intraoperative and postoperative subjective patient experience after small incision lenticule extraction (SMILE) and femtosecond laser‐assisted LASIK. METHODS: In a prospective, randomized, paired‐eye, single‐masked clinical trial at Singapore National Eye Centre, 70 patients were randomly treated with SMILE and LASIK in each eye. The intraoperative questionnaire was completed immediately after surgery and included light perception and levels of anxiety, fear, and discomfort. The postoperative 1‐ and 3‐month questionnaires evaluated severity of light sensitivity, eye discomfort, eye dryness, excessive tearing, gritty sensation, glare, halos, blurring, and fluctuations in vision. RESULTS: Average discomfort scores were higher during tissue manipulation in SMILE (1.9 ± 0.9) than flap lifting in LASIK (1.59 ± 0.8) (P = .020) but comparable during docking and laser application (P > .249). Fear scores were lower in SMILE than LASIK during docking (2.6 ± 1.6 vs 3.4 ± 1.9, P = .024) but similar during occasional blackout, laser application, and lenticule/flap manipulation (P > .364). Fear scores were generally higher in patients with intraoperative suction loss (n = 3). For SMILE, light sensitivity, eye discomfort, blurring, and fluctuations in vision improved from 1 to 3 months (P < .039). For LASIK, improvements were reported for light sensitivity, eye discomfort, eye dryness, gritty sensation, and fluctuations in vision from 1 to 3 months (P < .046). At 1 month, patients experienced more blurring after SMILE than LASIK (2.1 ± 0.8 vs 1.8 ± 0.7, P = .025), but with no differences in any of the visual symptoms at 3 months. CONCLUSIONS: Tissue manipulation may be more uncomfortable during SMILE than LASIK, but not more frightening. Subjective visual symptoms were comparable after 3 months. [J Refract Surg. 2018;34(2):92‐99.]."," Damgaard, IB;  Ang, M;  Farook, M;  Htoon, HM;  Mehta, JS",2018.0, 10.3928/1081597X-20171218-01,0,0,
1880,Acceptance and commitment therapy for generalized social anxiety disorder: A pilot study.,"Despite the demonstrated efficacy of cognitive-behavior therapy (CBT) for social anxiety disorder (SAD), many individuals do not respond to treatment or demonstrate residual symptoms and impairment posttreatment. Preliminary evidence indicates that acceptance-based approaches (e.g., acceptance and commitment therapy; ACT) can be helpful for a variety of disorders and emphasize exposure-based strategies and processes. Nineteen individuals diagnosed with SAD participated in a 12-week program integrating exposure therapy and ACT. Results revealed no changes across a 4-week baseline control period. From pretreatment to follow-up, significant improvements occurred in social anxiety symptoms and quality of life, yielding large effect size gains. Significant changes also were found in ACT-consistent process measures, and earlier changes in experiential avoidance predicted later changes in symptom severity. Results suggest the acceptability and potential efficacy of ACT for SAD and highlight the need for future research examining both the efficacy and mechanisms of change of acceptance-based programs for SAD. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Dalrymple, Kristy L; Herbert, James D",2007.0,http://dx.doi.org/10.1177/0145445507302037,0,0,
1881, The Role of Faith-Based Organizations in the Depression Care of African Americans and Hispanics in Los Angeles," OBJECTIVE: This study examined use of depression care provided by faith‚Äêbased organizations (FBOs) by African Americans and Hispanics and factors associated with the receipt of such care, including mental illness severity and use of traditional mental health services. METHODS: The study used baseline data from the Community Partners in Care study, a group‚Äêrandomized trial comparing a community‚Äêpartnered approach with a technical‚Äêassistance approach to improving depression care in underresourced communities in Los Angeles. A sample of 947 individuals (48% African American, 27% non‚ÄêU.S.‚Äêborn Hispanic, 15% U.S.‚Äêborn Hispanic, and 10% non‚ÄêHispanic white) were surveyed about recent visits to a religious or spiritual place and receipt of FBO depression care. Descriptive analyses compared racial‚Äêethnic, sociodemographic, and health service use variables for three groups: those who did not attend a religious place, those who attended a religious place and did not receive FBO depression services, and those who received FBO depression services. Multinomial logistic regression was used to identify predictors of receipt of FBO depression care. RESULTS: A larger proportion of African Americans and non‚ÄêU.S.‚Äêborn Hispanics received FBO faith‚Äêbased depression services compared with non‚ÄêHispanic whites and with U.S.‚Äêborn Hispanics. Receipt of FBO depression services was associated with younger age, lifetime diagnosis of mania, use of primary care depression services, and receipt of a mental health service from a substance abuse agency. CONCLUSIONS: FBO depression services were used in the community, especially by persons from racial‚Äêethnic minority groups. Collaborative efforts between FBOs and traditional health services may increase access to depression services for African Americans and Latinos."," Dalencour, M;  Wong, EC;  Tang, L;  Dixon, E;  Lucas-Wright, A;  Wells, K;  Miranda, J",2017.0, 10.1176/appi.ps.201500318,0,0,
1882, Distraction intervention for preschoolers undergoing intramuscular injections and subcutaneous port access," This study evaluated a distraction intervention designed to reduce the distress of preschool children undergoing repeated chemotherapy injections. Twenty‚Äênine children aged 2‚Äê5 years were randomly assigned either to distraction by a developmentally appropriate electronic toy or to a wait‚Äêlist control. Children who received the distraction intervention demonstrated lower overt behavioral distress and were rated by parents and nurses as less anxious than children in the control condition. The improvements were maintained over the 8‚Äêweek intervention. The results suggest that a developmentally appropriate, multisensory, variable‚Äêdistracting activity that requires active cognitive processing and active motor responses may be a viable cost‚Äêeffective alternative to more time‚Äêintensive parent‚Äêtraining programs for preschool‚Äêage children."," Dahlquist, LM;  Pendley, JS;  Landthrip, DS;  Jones, CL;  Steuber, CP",2002.0,,0,0,
1883,Cognitive rehabilitation for military service members with mild traumatic brain injury: A randomized clinical trial.,"Objective: To compare cognitive rehabilitation (CR) interventions for mild traumatic brain injury (mTBI) with standard of care management, including psychoeducation and medical care for noncognitive symptoms. Setting: Military medical center. Participants: A total of 126 service members who received mTBI from 3 to 24 months before baseline evaluation and reported ongoing cognitive difficulties. Interventions: Randomized clinical trial with treatment outcomes assessed at baseline, 3-week, 6-week, 12-week, and 18-week follow-ups. Participants were randomly assigned to one of four 6-week treatment arms: (1) psychoeducation, (2) computer-based CR, (3) therapist-directed manualized CR, and (4) integrated therapist-directed CR combined with cognitive-behavioral psychotherapy (CBT). Treatment dosage was constant (10 h/wk) for intervention arms 2 to 4. Measures: Paced Auditory Serial Addition Test (PASAT); Symptom Checklist-90 Revised (SCL-90-R); Key Behaviors Change Inventory (KBCI). Results: No differences were noted between treatment arms on demographics, injury-related characteristics, or psychiatric comorbidity apart from education, with participants assigned to the computer arm having less education. Using mixed-model analysis of variance, all 4 treatment groups showed a significant improvement over time on the 3 primary outcome measures. Treatment groups showed equivalent improvement on the PASAT. The therapist-directed CR and integrated CR treatment groups had better KBCI outcomes compared with the psychoeducation group. Improvements on primary outcome measures during treatment were maintained at follow-up with no differences among arms. Conclusions: Both therapist-directed CR and integrated CR with CBT reduced functional cognitive symptoms in service members after mTBI beyond psychoeducation and medical management alone. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Cooper, Douglas B; Bowles, Amy O; Kennedy, Jan E; Curtiss, Glenn; French, Louis M; Tate, David F; Vanderploeg, Rodney D",2017.0,http://dx.doi.org/10.1097/HTR.0000000000000254,0,0,
1884,Do changes in trauma-related beliefs predict PTSD symptom improvement in prolonged exposure and sertraline?,"Negative trauma-related belief change has been found to predict subsequent improvement in symptoms of posttraumatic stress disorder (PTSD) in prolonged exposure (PE) and other therapies, consistent with several psychological theories of treatment change (e.g., Foa & Kozak, 1986). However, belief change has not been examined in selective serotonin reuptake inhibitors such as sertraline. We examined processes associated with symptom improvement in 2 treatments for PTSD, hypothesizing that belief change would robustly predict PTSD improvement in patients treated with PE but not those treated with sertraline, reflecting moderation by treatment. Patients with chronic PTSD (N = 134; 78% women, 71.6% Caucasian, M = 38.1 years, SD = 11.8) received 10 weeks of PE or sertraline in a randomized, controlled trial. Patients reported PTSD and depression symptoms, and trauma-related beliefs (Post-Traumatic Cognitions Inventory; Foa, Ehlers, Clark, D Tolin, & Orsillo, 1999) at pretreatment, every treatment session, and posttreatment. Using time-lagged mixed regression models, change in trauma-related beliefs predicted subsequent PTSD symptom improvement, an effect moderated by treatment and particularly strong in PE (d = 0.93) compared with sertraline (d = 0.35). Belief change also predicted depressive symptom improvement but more modestly and bidirectionally, with no difference by treatment modality. Trauma-related belief change precedes PTSD improvement more robustly in PE than in sertraline and with greater specificity compared with depressive symptoms. These findings highlight potentially divergent processes contributing to symptom change in these PTSD treatments, with belief change as a key mechanism of PE. (PsycINFO Database Record",Cooper AA.; Zoellner LA.; Roy-Byrne P.; Mavissakalian MR.; Feeny NC.,2017.0,10.1037/ccp0000220,0,0,
1885," Homework ""Dose,"" Type, and Helpfulness as Predictors of Clinical Outcomes in Prolonged Exposure for PTSD"," Homework is often viewed as central to prolonged exposure (PE) for posttraumatic stress disorder (PTSD), but its relationship with treatment outcome is not well understood. We evaluated homework type, dose, and patients' perceptions of helpfulness as predictors of symptom change and posttreatment outcomes in PE. Patients with chronic PTSD received PE in a randomized clinical trial. Independent evaluators assessed PTSD severity at pre‚Äê and posttreatment. Patients reported homework adherence and perceived helpfulness at the beginning of each session, separately for in vivo and imaginal exposure assignments. These variables were examined as predictors of change in PTSD symptoms, PTSD remission, and good end‚Äêstate functioning (GESF; low PTSD, depression, and anxiety) at posttreatment. Higher imaginal homework adherence predicted greater symptom improvement between sessions and across treatment, as well as twice the odds of achieving remission and GESF. Patients who were at least moderately adherent to imaginal homework assignments (two or more times a week) reported more symptom gains than those who were least adherent but did not differ from those who were most adherent. In vivo adherence was not consistently associated with better outcome, perhaps due to heterogeneity in form and function of weekly assignments. Higher ratings of helpfulness of both types of homework predicted greater symptom improvement from pre‚Äê to posttreatment and between sessions. Overall, imaginal exposure homework may complement in‚Äêsession exposures by enhancing key change processes, though perfect adherence is not necessary. Patients' perceptions of helpfulness may reflect buy‚Äêin or perceived match between homework completion and functional impairment. Clinically, in addition to targeting adherence to homework assignments, querying about perceived helpfulness and adjusting assignments appropriately may help augment clinical gains."," Cooper, AA;  Kline, AC;  Graham, B;  Bedard-Gilligan, M;  Mello, PG;  Feeny, NC;  Zoellner, LA",2017.0, 10.1016/j.beth.2016.02.013,0,0,
1886, Effectiveness of skin-to-skin contact versus care-as-usual in mothers and their full-term infants: study protocol for a parallel-group randomized controlled trial," BACKGROUND: Twenty‚Äêto‚Äêforty percent of women experience postpartum depressive symptoms, which can affect both the mother and infant. In preterm infants, daily skin‚Äêto‚Äêskin contact (SSC) between the mother and her infant has been shown to decrease maternal postpartum depressive symptoms. In full‚Äêterm infants, only two studies investigated SSC effects on maternal depressive symptoms and found similar results. Research in preterm infants also showed that SSC improves other mental and physical health outcomes of the mother and the infant, and improves the quality of mother‚Äêinfant relationship. This randomized controlled trial will investigate the effects of a SSC intervention on maternal postpartum depressive symptoms and additional outcomes in mothers and their full‚Äêterm infants. Moreover, two potential underlying mechanisms for the relation between SSC and the maternal and infant outcomes will be examined, namely maternal oxytocin concentrations and infant intestinal microbiota. METHODS/DESIGN: Design: A parallel‚Äêgroup randomized controlled trial. PARTICIPANTS: 116 mothers and their full‚Äêterm infants. INTERVENTION: Mothers in the SSC condition will be requested to provide daily at least one continuous hour of SSC to their infant. The intervention starts immediately after birth and lasts for 5 weeks. Mothers in the control condition will not be requested to provide SSC. Maternal and infant outcomes will be measured at 2 weeks, 5 weeks, 12 weeks and 1 year after birth. PRIMARY OUTCOME: maternal postpartum depressive symptoms. Secondary maternal outcomes: mental health (anxiety, stress, traumatic stress following child birth, sleep quality), physical health (physical recovery from the delivery, health, breastfeeding, physiological stress), mother‚Äêinfant relationship (mother‚Äêinfant bond, quality of maternal caregiving behavior). Secondary infant outcomes: behavior (fussing and crying, sleep quality), physical health (growth and health, physiological stress), general development (regulation capacities, social‚Äêemotional capacities, language, cognitive and motor capacities). Secondary underlying mechanisms: maternal oxytocin concentrations, infant intestinal microbiota. DISCUSSION: As a simple and cost‚Äêeffective intervention, SSC may benefit both the mother and her full‚Äêterm infant in the short‚Äêand long‚Äêterm. Additionally, if SSC is shown to be effective in low‚Äêrisk mother‚Äêinfant dyads, then thought could be given to developing programs in high‚Äêrisk samples and using SSC in a preventive manner. TRIAL REGISTRATION: NTR5697 ; Registered on March 13, 2016."," Cooijmans, KHM;  Beijers, R;  Rovers, AC;  de Weerth, C",2017.0, 10.1186/s12887-017-0906-9,0,0,
1887,Validation of telephone-based behavioral assessments in aging services clients.,"The Behavioral Health Laboratory (BHL), a telephone-based mental health assessment, is a cost-effective approach that can improve mental illness identification and management. The individual BHL instruments, which were originally designed to be administered in-person, have not yet been validated with an in-person BHL assessment. This study therefore aims to characterize the concordance between the BHL data gathered by telephone and in-person interviews. A cross-sectional study was conducted with English-speaking aging services network (ASN) clients aged 60 years and older in Monroe County, NY who were randomized to a BHL interview either in-person (n = 55) or by telephone (n = 53). There was strong evidence of equivalence between telephone and in-person interviews for depressive disorders, generalized anxiety, panic disorder, drug misuse, psychosis, PTSD, mental illness symptom severity, and five of the six questions assessing suicidality. There was marginal equivalence in PHQ-9 total scores and one of the six questions assessing suicidal ideation, and no evidence of equivalence between interview modalities for assessing cognitive impairment. With a few exceptions, the BHL gathered nearly equivalent information via telephone as compared to in-person interviews. This suggests that the BHL may be a cost-effective approach appropriate for dissemination in a wide variety of settings including the ASN. Dissemination of the BHL has the potential to strengthen the linkages between primary care, mental healthcare, and social service providers and improve identification and management of those with late-life mental illness.",Conwell Y.; Simning A.; Driffill N.; Xia Y.; Tu X.; Messing SP.; Oslin D.,2018.0,10.1017/S1041610217001752,0,0,
1888, Tic-related obsessive-compulsive disorder (OCD): phenomenology and treatment outcome in the Pediatric OCD Treatment Study II," Objective Prior research has shown that youth with co‚Äêoccurring tic disorders and obsessive‚Äêcompulsive disorder (OCD) may differ from those with non‚Äêtic‚Äêrelated OCD in terms of clinical characteristics and treatment responsiveness. A broad definition of ""tic‚Äêrelated"" was used to examine whether children with tics in the Pediatric OCD Treatment Study II differed from those without tics in terms of demographic and phenomenological characteristics and acute treatment outcomes. Method Participants were 124 youth aged 7 to 17 years, inclusive, with a primary diagnosis of OCD who were partial responders to an adequate serotonin reuptake inhibitor (SRI) trial. Participants were randomized to medication management, medication management plus instructions in cognitive‚Äêbehavioral therapy (CBT), or medication management plus full CBT. Tic status was based on the presence of motor and/or vocal tics on the Yale Global Tic Severity Scale. Results Tics were identified in 53% of the sample. Those with tic‚Äêrelated OCD did not differ from those with non‚Äêtic‚Äêrelated OCD in terms of age, family history of tics, OCD severity, OCD‚Äêrelated impairment, or comorbidity. Those with tics responded equally in all treatment conditions. Conclusion Tic‚Äêrelated OCD was very prevalent using a broad definition of tic status. Results suggest that youth with this broad definition of tic‚Äêrelated OCD do not have increased OCD severity or inference, higher comorbidity rates or severity, or worsened functioning, and support the use of CBT in this population. This highlights the importance of not making broad assumptions about OCD symptoms most likely to occur in an individual with comorbid tics. Clinical trial registration information ‚Äê Treatment of Pediatric OCD for SRI Partial Responders; http://clinicaltrials.gov; NCT00074815."," Conelea, CA;  Walther, MR;  Freeman, JB;  Garcia, AM;  Sapyta, J;  Khanna, M;  Franklin, M",2014.0, 10.1016/j.jaac.2014.09.014,0,0,
1889, Secondary outcomes from the pediatric obsessive compulsive disorder treatment study II," The Pediatric Obsessive‚ÄêCompulsive Disorder Treatment Study II (POTS II) investigated the benefit of serotonin reuptake inhibitor (SRI) augmentation with cognitive behavioral therapy (CBT). Primary outcomes focused on OCD symptom change and indicated benefit associated with a full course of CBT. Given that the majority of youth with OCD suffer from significant comorbid symptoms and impaired quality of life, the current study examined POTS II data for effects on secondary outcomes. Participants were 124 youth ages 7‚Äê17 years with a primary diagnosis of OCD who were partial responders to an adequate SRI trial. Participants were randomized to medication management, medication management plus instructions in cognitive behavioral therapy (CBT), or medication management plus full CBT. Acute effects on non‚ÄêOCD anxiety, depression, inattention, hyperactivity, and quality of life were examined across treatment conditions. Improvement across treatment was observed for non‚ÄêOCD anxiety, inattention, hyperactivity, and quality of life. Changes were generally significantly greater in the group receiving full CBT. Child‚Äêrated depression was not found to change. OCD‚Äêfocused treatment lead to improvement in other areas of psychopathology and functioning. For youth who are partial responders to SRI monotherapy, augmentation with full CBT may yield the greatest benefit on these secondary outcomes. CLINICAL TRIALS REGISTRATION: Treatment of Pediatric OCD for SRI Partial Responders, Clinicaltrials.gov Identifier: NCT00074815, http://clinicaltrials.gov/show/NCT00074815."," Conelea, CA;  Selles, RR;  Benito, KG;  Walther, MM;  Machan, JT;  Garcia, AM;  Sapyta, J;  Morris, S;  Franklin, M;  Freeman, JB",2017.0, 10.1016/j.jpsychires.2017.04.001,0,0,
1890, Efficacy of an internet-based CBT program for children with comorbid High Functioning Autism Spectrum Disorder and anxiety: a randomised controlled trial," METHODS: Forty‚Äêtwo HFASD children, aged 8‚Äê12 years, with an anxiety disorder, and their parents, were randomly assigned to either the BRAVE‚ÄêONLINE condition (NET) or a waitlist control (WLC). Diagnostic interviews and parent/child questionnaires were completed at pre‚Äêtreatment, post‚Äêtreatment and 3‚Äêmonth follow‚Äêup. RESULTS: At post‚Äê assessment, compared to children in the WLC condition, children in the NET condition demonstrated a significantly greater reduction in number of anxiety diagnoses, clinical severity of diagnosis, and self and parent reported anxiety symptoms, as well as significantly greater increases in overall functioning. However, loss of primary diagnosis in this sample was lower than in previous studies. LIMITATIONS: The small sample size, coupled with attrition rates, makes it difficult to generalise the findings of the study to HFASD population and to conduct analyses regarding mediators, moderators and predictors of outcomes. CONCLUSIONS: The BRAVE‚ÄêONLINE program may be useful in reducing anxiety symptoms in HFASD children, although the effects are less strong than those found in neurotypical children for a variety of reasons. BACKGROUND: All trials conducted to date on BRAVE‚ÄêONLINE for youth anxiety disorders have excluded children with High Functioning Autism Spectrum Disorder (HFASD) and therefore it is unknown whether these programs might be beneficial to HFASD children. The aim of this study was to evaluate the efficacy of BRAVE‚ÄêONLINE in HFASD children with an anxiety disorder."," Conaughton, RJ;  Donovan, CL;  March, S",2017.0, 10.1016/j.jad.2017.04.032,0,0,
1891, Predictors and moderators of treatment response in childhood anxiety disorders: results from the CAMS trial," OBJECTIVE: We sought to examine predictors and moderators of treatment outcomes among 488 youths ages 7‐17 years (50% female; 74% ≤ 12 years) meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) criteria for diagnoses of separation anxiety disorder, social phobia, or generalized anxiety disorder who were randomly assigned to receive either cognitive behavioral therapy (CBT), sertraline (SRT), their combination (COMB), or medication management with pill placebo (PBO) in the Child/Adolescent Anxiety Multimodal Study (CAMS). METHOD: Six classes of predictor and moderator variables (22 variables) were identified from the literature and examined using continuous (Pediatric Anxiety Ratings Scale; PARS) and categorical (Clinical Global Impression Scale‐Improvement; CGI‐I) outcome measures. RESULTS: Three baseline variables predicted better outcomes (independent of treatment condition) on the PARS, including low anxiety severity (as measured by parents and independent evaluators) and caregiver strain. No baseline variables were found to predict Week 12 responder status (CGI‐I). Participants' principal diagnosis moderated treatment outcomes but only on the PARS. No baseline variables were found to moderate treatment outcomes on Week 12 responder status (CGI‐I). DISCUSSION: Overall, anxious children responded favorably to CAMS treatments. However, having more severe and impairing anxiety, greater caregiver strain, and a principal diagnosis of social phobia were associated with less favorable outcomes. Clinical implications of these findings are discussed."," Compton, SN;  Peris, TS;  Almirall, D;  Birmaher, B;  Sherrill, J;  Kendall, PC;  March, JS;  Gosch, EA;  Ginsburg, GS;  Rynn, MA;  et al.",2014.0, 10.1037/a0035458,0,0,
1892," Internet-delivered, family-based treatment for early-onset OCD: a pilot randomized trial"," OBJECTIVE: Despite advances in supported treatments for early onset obsessive‚Äêcompulsive disorder (OCD), progress has been constrained by regionally limited expertise in pediatric OCD. Videoteleconferencing (VTC) methods have proved useful for extending the reach of services for older individuals, but no randomized clinical trials (RCTs) have evaluated VTC for treating early onset OCD. METHOD: RCT comparing VTC‚Äêdelivered family based cognitive‚Äêbehavioral therapy (FB‚ÄêCBT) versus clinic‚Äêbased FB‚ÄêCBT in the treatment of children ages 4‚Äê8 with OCD (N = 22). Pretreatment, posttreatment, and 6‚Äêmonth follow‚Äêup assessments included mother‚Äê/therapist‚Äêreports and independent evaluations masked to treatment condition. Primary analyses focused on treatment retention, engagement and satisfaction. Hierarchical linear modeling preliminarily evaluated the effects of time, treatment condition, and their interactions. ""Excellent response"" was defined as a 1 or 2 on the Clinical Global Impressions‚ÄêImprovement Scale. RESULTS: Treatment retention, engagement, alliance and satisfaction were high across conditions. Symptom trajectories and family accommodation across both conditions showed outcomes improving from baseline to posttreatment, and continuing through follow‚Äêup. At posttreatment, 72.7% of Internet cases and 60% of Clinic cases showed ""excellent response,"" and at follow‚Äêup 80% of Internet cases and 66.7% of Clinic cases showed ""excellent response."" Significant condition differences were not found across outcomes. CONCLUSIONS: VTC methods may offer solutions to overcoming traditional barriers to care for early onset OCD by extending the reach of real‚Äêtime expert services regardless of children's geographic proximity to quality care. (PsycINFO Database Record"," Comer, JS;  Furr, JM;  Kerns, CE;  Miguel, E;  Coxe, S;  Elkins, RM;  Carpenter, AL;  Cornacchio, D;  Cooper-Vince, CE;  DeSerisy, M;  et al.",2017.0, 10.1037/ccp0000155,0,0,
1893,The Relative Effectiveness of EMDR Versus Relaxation Training with Battered Women Prisoners.,"Five women prisoners with a history of being battered and who met the DSM-IV criteria for post-traumatic stress disorder were assessed (A phase) and provided with structured relaxation training (RT) (B phase, or placebo treatment), followed by eye movement desensitization and reprocessing (EMDR) therapy (C phase). Using the Beck Anxiety Inventory and the Impact of Events Scale's avoidance behavior and intrusive thoughts subscales as outcome measures, RT alone did not result in any clinical improvements. The subsequent provision of EMDR did not improve upon this lack of success with 4 of the 5 participants; 1 did improve on anxiety and intrusive thoughts. The apparent ineffectiveness of EMDR with these participants may be attributed to several explanations. Foremost perhaps is the hypothesis that EMDR is not sufficient to ameliorate the effects of chronic abuse. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Colosetti, Sharman D; Thyer, Bruce A",2000.0,http://dx.doi.org/10.1177/0145445500245006,0,0,
1894, Putting a Hold on the Downward Spiral of Paranoia in the Social World: a Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy in Individuals with a History of Depression," CONTEXT: Paranoia embodies altered representation of the social environment, fuelling altered feelings of social acceptance leading to further mistrust. Mindfulness‚Äêbased cognitive therapy (MBCT) may relieve paranoia and reduce its impact on social acceptance. OBJECTIVE: To determine whether MBCT alters momentary feeling of paranoia and social acceptance in daily life. DESIGN: Randomized controlled trial of daily‚Äêlife repeated measures (up to 120 per participant) before and after allocation to MBCT or waiting list control. PARTICIPANTS: Volunteer sample of 130 eligible men and women with residual affective dysregulation after at least one episode of major depressive disorder. INTERVENTIONS: Eight weeks of MBCT in groups of 10‚Äê15 participants in addition to participants' usual treatment. OUTCOME MEASURES: Daily‚Äêlife ratings of paranoia and social acceptance. This manuscript concerns additional analyses of the original trial; hypotheses were developed after data collection (focus initially on depressive symptoms) but before data analysis. RESULTS: Sixty‚Äêsix participants were assigned to the waiting list control group and 64 to the MBCT intervention group, of whom 66 and 61 respectively were included in the per‚Äêprotocol analyses. Intention‚Äêto‚Äêtreat analyses revealed a significant group by time interaction in the model of momentary paranoia (b‚Ää=‚Ää‚Äê.18, p<0.001, d‚Ää=‚Ää‚Äê0.35) and social acceptance (b‚Ää=‚Ää.26, p<0.001, d‚Ää=‚Ää0.41). Paranoia levels in the intervention group were significantly reduced (b‚Ää=‚Ää‚Äê.11, p<0.001) and feelings of social acceptance significantly increased (b‚Ää=‚Ää.18, p<0.001), whereas in the Control condition a significant increase in paranoia (b‚Ää=‚Ää.07, p‚Ää=‚Ää0.008) and a decrease in social acceptance was apparent (b‚Ää=‚Ää‚Äê.09, p‚Ää=‚Ää0.013). The detrimental effect of paranoia on social acceptance was significantly reduced in the MBCT, but not the control group (group by time interaction: b‚Ää=‚Ää.12, p‚Ää=‚Ää0.022). CONCLUSIONS: MBCT confers a substantial benefit on subclinical paranoia and may interrupt the social processes that maintain and foster paranoia in individuals with residual affective dysregulation. TRIAL REGISTRATION: Netherlands Trial Register NTR1084."," Collip, D;  Geschwind, N;  Peeters, F;  Myin-Germeys, I;  van Os, J;  Wichers, M",2013.0, 10.1371/journal.pone.0066747,0,0,
1895,Neural correlates of prosocial behavior towards persons in pain in healthcare providers,"Pain perceived in others can be a stressful signal that elicits personal distress and discomfort that can interfere with prosocial behaviors. Healthcare providers (HCPs) have to be able to regulate these self-oriented feelings to offer optimal help to patients in pain. However, previous studies have documented a tendency in HCPs to underestimate the pain of patients that could interfere with optimal help to these patients. The aim of this study was to compare HCP and control (CTL) participants’ prosocial behavior towards persons in pain and their associated brain responses. HCPs and CTL participants took part in a newly developed prosocial task during which they were asked to choose how much time they wanted to offer to help patients in pain. It was shown that compared to CTL participants, HCPs offered more help to persons in pain and reported less trait personal distress when facing suffering in others. Additional evidence was provided by the fMRI results, which indicated that compared to CTL participants, HCP participants showed different pattern of activity in the dorsolateral prefrontal cortex, bilateral precuneus and the posterior cingulate cortex during the prosocial task, suggesting that the underlying mechanisms of the difference in prosocial behaviors could vary according to the degree to which processes such as mentalizing and cognitive control are solicited.",Coll M.-P.; Grégoire M.; Eugène F.; Jackson P.L.,2017.0,10.1016/j.biopsycho.2017.06.005,0,0,
1896,Clinical presentation of not-just right experiences (NJREs) in individuals with OCD: Characteristics and response to treatment.,"There is increasing recognition that instead of being motivated by a desire to prevent harm and reduce anxiety, some obsessive-compulsive symptoms may be driven by a desire to get things 'just right' or 'complete' and to reduce a sense of discomfort. However, existing data is largely from non-clinical samples. Therefore, in the current paper we examine the clinical presentation of not just right experiences (NJREs) in patients diagnosed with OCD and compare their experiences to both anxious and unselected controls. Then, we provide preliminary data on NJREs before and after cognitive behavioral therapy (exposure and response prevention). First, individuals with OCD were found to report experiencing significantly more NJREs and being more distressed by them compared to anxious controls and unselected controls. Next, there was some support for the specificity of NJREs to feelings of incompleteness. Finally, we found that after completing treatment, patients reported experiencing significantly less NJREs and experienced less distress associated with the NJREs. In conclusion we believe that more work on the role of NJREs is warranted and that characterizing OCD symptoms as either based on harm avoidance or incompleteness/NJREs may be a useful framework for classifying OCD symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Coles, Meredith E; Ravid, Ariel",2016.0,http://dx.doi.org/10.1016/j.brat.2016.09.013,0,0,
1897, Separate and combined effects of genetic variants and pre-treatment whole blood gene expression on response to exposure-based cognitive behavioural therapy for anxiety disorders," METHODS: Adult participants (n ≤ 181) diagnosed with panic disorder or a specific phobia underwent eCBT as part of standard care. Percentage decrease in the Clinical Global Impression severity rating was assessed across treatment, and between baseline and a 6‐month follow‐up. Associations with treatment response were assessed using expression data from 3,233 probes, and expression profiles clustered in a data‐ and literature‐driven manner. A total of 3,343,497 genetic variants were used to predict treatment response alone and combined in polygenic risk scores. Genotype and expression data were combined in expression quantitative trait loci (eQTL) analyses. RESULTS: Expression levels were not associated with either treatment phenotype in any analysis. A total of 1,492 eQTLs were identified with q < 0.05, but interactions between genetic variants and treatment response did not affect expression levels significantly. Genetic variants did not significantly predict treatment response alone or in polygenic risk scores. CONCLUSIONS: We assessed gene expression alone and alongside genetic variants. No associations with treatment outcome were identified. Future studies require larger sample sizes to discover associations. OBJECTIVES: Exposure‐based cognitive behavioural therapy (eCBT) is an effective treatment for anxiety disorders. Response varies between individuals. Gene expression integrates genetic and environmental influences. We analysed the effect of gene expression and genetic markers separately and together on treatment response."," Coleman, JR;  Lester, KJ;  Roberts, S;  Keers, R;  Lee, SH;  De Jong, S;  Gaspar, H;  Teismann, T;  Wannemüller, A;  Schneider, S;  et al.",2017.0, 10.1080/15622975.2016.1208841,0,0,
1898,Examination of racial differences in a posttraumatic stress disorder group therapy program for veterans.,"Posttraumatic stress disorder (PTSD) is 1 of the more prevalent mental health diagnoses for veterans. Group therapy can be an effective and efficient means of treating PTSD, yet the literature exploring treatment outcomes for racial minorities has been mixed and limited. The present study was an evaluation across racial groups of the PTSD Recovery Program, a manualized group therapy implemented at a Veterans Affairs hospital. Data were collected from male veterans (N = 450) who identified as non-Hispanic White or non-Hispanic African American and participated in a 10-week, combat-related, group therapy program between 2010 and 2014. Participants completed the Posttraumatic Stress Disorder Checklist-Military Version (PCL-M) measure at pretreatment and posttreatment. The program led to a statistically significant reduction in PCL-M scores (Cohen's d = .64). Symptom reduction occurred regardless of race, with no racial differences in improvement. Racial and ethnic composition of groups was not related to outcomes. The program was effective regardless of veteran group or provider. Results imply that the PTSD Recovery Program is an effective 1st-line option to treating non-Hispanic White and non-Hispanic African American veterans with PTSD. Future research should continue to explore the associations between group characteristics and treatment outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Coleman, Jennifer A; Lynch, John R; Ingram, Kathleen M; Sheerin, Christina M; Rappaport, Lance M; Trapp, Stephen K",2018.0,http://dx.doi.org/10.1037/gdn0000086,0,0,
1899, A Randomized Implementation Study of Trauma-Focused Cognitive Behavioral Therapy for Adjudicated Teens in Residential Treatment Facilities," Adjudicated youth in residential treatment facilities (RTFs) have high rates of trauma exposure and post‚Äêtraumatic stress disorder (PTSD). This study evaluated strategies for implementing trauma‚Äêfocused cognitive behavioral therapy (TF‚ÄêCBT) in RTF. Therapists (N = 129) treating adjudicated youth were randomized by RTF program (N = 18) to receive one of the two TF‚ÄêCBT implementation strategies: (1) web‚Äêbased TF‚ÄêCBT training + consultation (W) or (2) W + 2 day live TF‚ÄêCBT workshop + twice monthly phone consultation (W + L). Youth trauma screening and PTSD symptoms were assessed via online dashboard data entry using the University of California at Los Angeles PTSD Reaction Index. Youth depressive symptoms were assessed with the Mood and Feelings Questionnaire‚ÄêShort Version. Outcomes were therapist screening; TF‚ÄêCBT engagement, completion, and fidelity; and youth improvement in PTSD and depressive symptoms. The W + L condition resulted in significantly more therapists conducting trauma screening (p = .0005), completing treatment (p = .03), and completing TF‚ÄêCBT with fidelity (p = .001) than the W condition. Therapist licensure significantly impacted several outcomes. Adjudicated RTF youth receiving TF‚ÄêCBT across conditions experienced statistically and clinically significant improvement in PTSD (p = .001) and depressive (p = .018) symptoms. W + L is generally superior to W for implementing TF‚ÄêCBT in RTF. TF‚ÄêCBT is effective for improving trauma‚Äêrelated symptoms in adjudicated RTF youth. Implementation barriers are discussed."," Cohen, JA;  Mannarino, AP;  Jankowski, K;  Rosenberg, S;  Kodya, S;  Wolford, GL",2016.0, 10.1177/1077559515624775,0,0,
1900, Promoting a Positive Middle School Transition: a Randomized-Controlled Treatment Study Examining Self-Concept and Self-Esteem," The middle school transition is a salient developmental experience impacting adolescents around the world. This study employed a randomized‚Äêcontrolled treatment design, with randomization at the school level, to investigate the impact of a school adjustment program for middle school transition and potential gender differences. Participants included 1147 students (M"," Coelho, VA;  Marchante, M;  Jimerson, SR",2017.0, 10.1007/s10964-016-0510-6,0,0,
1901, Working with parents to treat anxiety-disordered children: a proof of concept RCT evaluating Fear-less Triple P," Little is known about the efficacy of parent‚Äêonly interventions and the maintenance of gains over time with anxiety‚Äêdisordered children and adolescents. The current study aimed to evaluate the efficacy of a 6‚Äêsession parent‚Äêfocused intervention (Fear‚Äêless Triple P) in reducing children's anxiety symptomatology. The parents of 61 anxiety‚Äêdisordered children (7‚Äê14 years) were randomly assigned to either the 6‚Äêsession parent‚Äêonly group CBT intervention or a wait‚Äêlist control (WL) group. Diagnostic and questionnaire measures were administered at post‚Äêtreatment; as well as 3‚Äê, 6‚Äê and 12 months following the completion of treatment. Families in the WL group were re‚Äêassessed after 6 weeks (the duration of the active intervention) and were then offered the intervention. The parent‚Äêonly intervention produced superior outcomes for children on diagnostic and questionnaire measures. The percentages of children free of any anxiety diagnosis following the intervention were 38.7% (post‚Äêtreatment); 58.6% (3‚Äêmth); 69.2% (6‚Äêmth); and 84% (12‚Äêmth). At the post‚Äêtreatment assessment point, 3.4% of children in the WL group were free of any anxiety diagnosis. Mother and child questionnaire measures demonstrated gains from pre to post‚Äêtreatment that were maintained over time. This proof of concept study suggests that the brief, parent‚Äêonly intervention evaluated is an efficacious treatment approach for child anxiety disorders. A parent‚Äêonly, group CBT intervention such as the one described here offers a cost‚Äêeffective, low intensity alternative to traditional child‚Äêfocused interventions."," Cobham, VE;  Filus, A;  Sanders, MR",2017.0, 10.1016/j.brat.2017.06.004,0,0,
1902,Therapy on the move: The development of a therapeutic smartphone application.,"The present research investigated the use of a Smartphone App as an adjunct in the treatment of a range of anxiety disorders. The primary aim of the App was to increase client adherence to between session therapy tasks, involving homework practice of a range of skills and tasks known to be associated with successful treatment of anxiety disorders. Homework is an important component of many therapeutic approaches, allowing clients to practise therapeutic skills between sessions, as well as providing continuity between sessions (Freeman & Rosenfield, 2002). Greater client adherence to homework tasks has been associated with improved treatment outcomes, and may be particularly important for reducing the risk of relapse (Scheel, Hanson, & Razzhavaikina, 2004). However, despite the benefits of engagement with homework tasks, client adherence to these activities can often be a significant barrier to treatment (Addis & Jacobson, 2000; Burns & Nolenhoeksema, 1991; Detweiler & Whisman, 1999; Detweiler-Bedell & Whisman, 2005). It is also one area in which the use of adjunctive technologies may have the greatest impact. The aim of this paper was to describe the development and pilot testing of a therapeutic Smartphone application, namely, PsychAssist. This application was designed as an adjunct to face-to-face therapy in the treatment of anxiety disorders among adults. The App was developed with the purpose of enhancing client engagement and adherence to between session (homework) tasks to improve maintenance and generalization of therapeutic behaviours. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Clough, Bonnie A; Casey, Leanne M",2015.0,http://dx.doi.org/10.4018/ijcbpl.2015010103,0,0,
1903,The impact of borderline personality disorder on process group outcome among women with posttraumatic stress disorder related to childhood abuse.,"The outcome of a 12-wk interpersonal process group therapy for women (aged 18+ yrs) with posttraumatic stress disorder (PTSD) related to childhood sexual abuse with and without borderline personality disorder (BPD) was assessed by comparing 3 naturally occurring treatment conditions: groups that did not have any members with borderline personality disorder (BPD-) (n = 18), groups in which at least 1 member carried the diagnosis (BPD+) (n = 16), and a 12-wk waitlist (WL) (n = 15). PTSD, anger, depression, and other symptoms were significantly reduced in the BPD- groups. However, the BPD+ and WL conditions did not show any pre- to posttreatment improvements. Furthermore, the BPD+ condition showed a significant worsening on measures of anger. Analyses within the BPD+ condition indicate that women with and without the diagnosis experience equal posttreatment increases in anger problems. These latter results suggest the presence of an anger ""contagion"" effect. That is, women without BPD do well in the BPD- groups but show increased anger similar to the BPD+ women when treated in groups with them. Implications for client-treatment matching considerations in PTSD group therapy are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cloitre, Marylene; Koenen, Karestan C",2001.0,http://dx.doi.org/10.1521/ijgp.51.3.379.49886,0,0,
1904,Depression as a moderator of STAIR Narrative Therapy for women with post-traumatic stress disorder related to childhood abuse.,"Background: Depression among those who have experienced childhood abuse is associated with earlier onset, more persistent and severe symptoms, more frequent relapse, and poorer treatment outcomes across a variety of psychiatric disorders. In addition, individuals with a history of childhood abuse are more likely to develop post-traumatic stress disorder (PTSD) co-occurring with depression. Objective: This study evaluated whether severity of depression moderated the outcome in a PTSD treatment for childhood abuse survivors. Specifically, we assessed whether individuals with significant depression obtained better outcomes when provided with a two-module treatment which included a skills training component with behavioral activation interventions, Skills Training in Affective and Interpersonal Regulation (STAIR) followed by a trauma-focused component, Narrative Therapy, as compared to two control conditions where one component (STAIR or Narrative Therapy) was replaced with Supportive Counseling. Method: Participants were 104 women with PTSD related to childhood abuse. Participants were randomized into three conditions: (1) STAIR plus Narrative Therapy (SNT), (2) STAIR plus Supportive Counseling (SSC), and (3) Supportive Counseling plus Narrative Therapy (SCNT). Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV) PTSD symptom severity was assessed at pre-treatment, post-treatment, and 3 and 6 month follow-up. Results: Participants with severe depression showed superior PTSD symptom reduction following SNT, while those in the other two conditions experienced a loss of improvement after treatment ended. A similar finding was obtained among those with moderate depression, while among those with low levels of depression, outcomes did not differ across the three treatment conditions. Conclusions: Childhood abuse survivors with severe depression obtained superior outcomes in a treatment that combined skills training with trauma-focused work. Skills packages which contain behavioral activation interventions in combination with trauma-focused work may be particularly beneficial for patients with childhood abuse and severe depression. (PsycINFO Database Record (c) 2017 APA, all rights reserved) Abstract (Spanish) Planteamiento: La depresion entre los que han sufrido malos tratos en la infancia se asocia con un inicio mas temprano, sintomas mas persistentes y graves, recaidas mas frecuentes y peores resultados de tratamiento en una variedad de trastornos psiquiatricos. Ademas, las personas con abuso infantil son mas propensas a desarrollar un TEPT concurrente con la depresion. Objetivo: Este estudio evaluo si la gravedad de la depresion moderaba el resultado en un tratamiento de TEPT para sobrevivientes de maltrato infantil. Especificamente, evaluamos si los individuos con depresion significativa obtenian mejores resultados cuando se les proporcionaba un tratamiento de dos modulos que incluia un componente de entrenamiento en habilidades con intervenciones de activacion conductual, Entrenamiento de habilidades en regulacion afectiva e Interpersonal (STAIR, siglas en ingles de Skills Training in Affective and Interpersonal Regulation), seguido de un componente centrado en el trauma, Terapia Narrativa (TN), en comparacion con dos condiciones de control en las que un componente (el STAIR o la TN) se sustituia por terapia de apoyo (TA). Metodos: Los participantes fueron 104 mujeres con TEPT relacionado con maltrato infantil. Los participantes fueron asignados al azar a tres condiciones: (1) STAIR mas Terapia Narrativa (STN) (2) STAIR mas terapia de apoyo (STA) y (3) terapia de apoyo mas Terapia Narrativa (TATN). Se evaluo la gravedad de los sintomas de TEPT con el CAPS-IV al inicio del tratamiento, despues del tratamiento y en el seguimiento a los 3 y 6 meses. Resultados: Los participantes con depresion grave mostraron una mayor reduccion de los sintomas de TEPT despues de la Terapia Narrativa de STAIR, mientras que los de las otras dos condiciones experimentaron una perdida de mejoria una vez finalizado el tratamiento. Se encontro un resultado similar entre los que tenian depresion moderada, mientras que entre los que tenian un nivel bajo de depresion, los resultados no difirieron entre las tres condiciones de tratamiento. Conclusion: Los supervivientes de maltrato infantil con depresion grave obtuvieron resultados superiores en un tratamiento que combina entrenamiento de habilidades con el trabajo centrado en el trauma. Los paquetes de habilidades que contienen intervenciones de activacion conductual en combinacion con el trabajo centrado en el trauma pueden ser particularmente beneficiosos para pacientes con abuso infantil y depresion grave. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Cloitre, Marylene; Garvert, Donn W; Weiss, Brandon J",2017.0,http://dx.doi.org/10.1080/20008198.2017.1377028,0,0,
1905," Randomized controlled trial of attention bias modification in a racially diverse, socially anxious, alcohol dependent sample"," OBJECTIVE: Attention biases may be an important treatment target for both alcohol dependence and social anxiety. This is the first ABM trial to investigate two (vs. one) targets of attention bias within a sample with co‚Äêoccurring symptoms of social anxiety and alcohol dependence. Additionally, we used trial‚Äêlevel bias scores (TL‚ÄêBS) to capture the phenomena of attention bias in a more ecologically valid, dynamic way compared to traditional attention bias scores. METHOD: Adult participants (N = 86; 41% Female; 52% African American; 40% White) with elevated social anxiety symptoms and alcohol dependence were randomly assigned to an 8‚Äêsession training condition in this 2 (Social Anxiety ABM vs. Social Anxiety Control) by 2 (Alcohol ABM vs. Alcohol Control) design. Symptoms of social anxiety, alcohol dependence, and attention bias were assessed across time. RESULTS: Multilevel models estimated the trajectories for each measure within individuals, and tested whether these trajectories differed according to the randomized training conditions. Across time, there were significant or trending decreases in all attention TL‚ÄêBS parameters (but not traditional attention bias scores) and most symptom measures. However, there were not significant differences in the trajectories of change between any ABM and control conditions for any symptom measures. CONCLUSIONS: These findings add to previous evidence questioning the robustness of ABM and point to the need to extend the effects of ABM to samples that are racially diverse and/or have co‚Äêoccurring psychopathology. The results also illustrate the potential importance of calculating trial‚Äêlevel attention bias scores rather than only including traditional bias scores."," Clerkin, EM;  Magee, JC;  Wells, TT;  Beard, C;  Barnett, NP",2016.0, 10.1016/j.brat.2016.08.010,0,0,
1906, Is early mobilisation better than immobilisation in the treatment of wrist sprains?," METHOD: Forty‐three patients, aged 18‐64 years, were randomised to either a dorsal wrist cast for 2 weeks (n = 21), or immediate mobilisation (n = 22). Follow‐up at 2, 4, and 6 weeks included clinical examination, self‐assessment questionnaires (DASH, VAS), and recording of days on sick‐leave. RESULTS: At 2 weeks patients treated in a cast had reduced wrist range of motion, ROM (77% vs 96%, p = 0.011), and higher DASH score (median 37 vs 18, p = 0.009) compared to patients treated with immediate mobilisation. At 4 weeks, DASH score was still higher in the group treated in a cast (median 14 vs 4, p = 0.01), but there was no difference in ROM. At 6 weeks there were no differences in any outcome measure between the groups. Furthermore, there was no significant difference in sick‐leave between the groups (median 27 days vs 14 days, p = 0.077). CONCLUSION: Patients with radial sided wrist pain where MRI does not demonstrate fracture or SL ligament injury do not benefit from cast immobilisation and can be treated with early mobilisation. OBJECTIVE: Posttraumatic radial sided wrist pain is common and can represent a fracture or a ligament injury. However, in some patients radiographs and MRI are normal, indicating no specific diagnosis other than a wrist sprain. There is no consensus on the ideal treatment for this patient group. The aim was to investigate if patients with posttraumatic radial sided wrist pain and MRI not showing signs of fracture or SL‐ligament injury should be treated with immediate mobilisation or 2 weeks cast immobilisation."," Clementson, M;  Thomsen, N;  Jørgsholm, P;  Besjakov, J;  Björkman, A",2016.0, 10.3109/2000656X.2015.1137925,0,0,
1907, Driving Intervention for Returning Combat Veterans," Increased crash incidence following deployment and veterans' reports of driving difficulty spurred traffic safety research for this population. We conducted an interim analysis on the efficacy of a simulator‚Äêbased occupational therapy driving intervention (OT‚ÄêDI) compared with traffic safety education (TSE) in a randomized controlled trial. During baseline and post‚Äêtesting, OT‚ÄêDriver Rehabilitation Specialists and one OT‚ÄêCertified Driver Rehabilitation Specialist measured driving performance errors on a DriveSafety CDS‚Äê250 high‚Äêfidelity simulator. The intervention group ( n = 13) received three OT‚ÄêDI sessions addressing driving errors and visual‚Äêsearch retraining. The control group ( n = 13) received three TSE sessions addressing personal factors and defensive driving. Based on Wilcoxon rank‚Äêsum analysis, the OT‚ÄêDI group's errors were significantly reduced when comparing baseline with Post‚ÄêTest 1 ( p < .0001) and comparing the OT‚ÄêDI group with the TSE group at Post‚ÄêTest 1 ( p = .01). These findings provide support for the efficacy of the OT‚ÄêDI and set the stage for a future effectiveness study."," Classen, S;  Winter, S;  Monahan, M;  Yarney, A;  Link Lutz, A;  Platek, K;  Levy, C",2017.0, 10.1177/1539449216675582,0,0,
1908," Randomized Trial of Group Music Therapy With Chinese Prisoners: impact on Anxiety, Depression, and Self-Esteem"," This study investigated the effects of group music therapy on improving anxiety, depression, and self‚Äêesteem in Chinese prisoners. Two‚Äêhundred male prisoners were randomly assigned to music therapy (n = 100) or standard care (n = 100). The music therapy had 20 sessions of group therapy compared with standard care. Anxiety (State and Trait Anxiety Inventory [STAI]), depression (Beck Depression Inventory [BDI]), and self‚Äêesteem (Texas Social Behavior Inventory [TSBI], Rosenberg Self‚ÄêEsteem Inventory [RSI]) were measured by standardized scales at baseline, mid‚Äêprogram, and post‚Äêprogram. Data were analyzed based on the intention to treat principle. Compared with standard care, anxiety and depression in the music therapy condition decreased significantly at mid‚Äêtest and post‚Äêtest; self‚Äêesteem improved significantly at mid‚Äêtest (TSBI) and at post‚Äêtest (TSBI, RSI). Improvements were greater in younger participants (STAI‚ÄêTrait, RSI) and/or in those with a lower level of education (STAI‚ÄêState, STAI‚ÄêTrait). Group music therapy seems to be effective in improving anxiety, depression, and self‚Äêesteem and was shown to be most beneficial for prisoners of younger age or with lower education level."," Chen, XJ;  Hannibal, N;  Gold, C",2016.0, 10.1177/0306624X15572795,0,0,
1909, The Effect of Life Style Based Education on the Fathers' Anxiety and Depression During Pregnancy and Postpartum Periods: a Randomized Controlled Trial," Due to the harmful effects of prenatal and postnatal anxiety and depression on fathers, the aim of this study was to determine the impact of lifestyle‚Äêbased training on paternal depression and anxiety (primary outcomes) during the prenatal and postnatal periods. This single‚Äêblind randomized controlled clinical trial was conducted on 126 spouses of pregnant women with gestational ages of 24‚Äê28 weeks. They were followed up until 6 weeks after childbirth. Using the block randomization method and stratified based on the number of children, the eligible samples were divided into two groups (one receiving two weekly group lifestyle‚Äêbased training session (lasting 60‚Äê90 min) and a control group). Edinburgh Postnatal Depression Scale and Spielberger's State‚ÄêTrait Anxiety Inventory were filled out by the participants before the intervention, 8 weeks after it, and 6 weeks after childbirth. The general linear model was used to analyze data. Out of 126 fathers, one individual from the intervention group left the study because he was not willing to cooperate. Compared with the control group, there was a significant decrease in depression (adjusted difference: ‚Äê1.6; 95% CI ‚Äê2.8 to ‚Äê0.5), state anxiety (‚Äê5.7; ‚Äê8.6 to ‚Äê2.9) and trait anxiety (‚Äê5.0; ‚Äê7.8 to ‚Äê2.2) scores at 8 weeks after intervention as well as postnatal depression (‚Äê3.3; ‚Äê5.0 to ‚Äê1.5); postnatal state anxiety (‚Äê7.5; ‚Äê11.6 to ‚Äê3.4), and postnatal trait anxiety (‚Äê8.3; ‚Äê12.2 to ‚Äê4.4) in the intervention group. The research results indicated the positive impact of training on prenatal and postnatal depression and anxiety in fathers. Given the easy implementation of training interventions during pregnancy, it is suggested that such interventions be paid more attention."," Charandabi, SM;  Mirghafourvand, M;  Sanaati, F",2017.0, 10.1007/s10597-017-0103-1,0,0,
1910,Economic evaluation of a bio-psycho-social intervention for comorbid disorders in a traumatized population in post-war Kosovo.,"Post-hoc economic evaluation of a bio-psycho-social intervention in post-war Kosovo from a societal perspective. Cost-effectiveness analysis, cost-utility analysis, and partial cost-benefit analysis using data from a randomized controlled trial. Thirty-four torture/war victims with comorbid conditions enrolled in 2012-2013. Participants were randomly assigned to an ""intervention"" and a ""waiting-list"" group. Changes in mental, emotional and physical health and functional impairment were assessed before and after treatment, along with increase in labour income as a proxy for productivity gain. The cost of an extra unit of effectiveness and an additional quality-adjusted life year were calculated. The total cost per participant was €1,322 including, or €1,019 excluding, research costs. Wide variations in costs of changes in mental, emotional and physical effectiveness were demonstrated. Multidisciplinary intervention resulted in functional improvement at a cost of €10,508 per quality-adjusted life year gained. With a mean monthly income increase to €133 (18%) after intervention, the intervention cost per participant would be equal to the total increase in monthly income after 4-5 years, assuming the increased level is maintained. Socio-economic benefit associated with quality-adjusted life year gain is shown, although the cost of an additional quality-adjusted life year is above the World Health Organization cost-effectiveness threshold.",Chang WL.; Andersen CJ.; Berisha BS.; Estrup O.; Wang SJ.,2018.0,10.2340/16501977-2322,0,0,
1911, The Experience of Learning Meditation and Mind/Body Practices in the COPD Population," OBJECTIVE: Understanding how persons with COPD experience learning meditation and mind/body skills would aid future meditation‚Äêfocused mind/body intervention design. DESIGN/SETTING/PATIENTS: A mixed‚Äêmethod study of a community based meditation‚Äêfocused mind/body intervention for persons with COPD. MEASURES: Reflective journaling, phone exit interviews and survey measures: chronic disease respiratory questionnaire, and Anxiety Sensitivity 3 questionnaire. INTERVENTION: Eight weekly one hour meditation‚Äêfocused mind/body classes that taught concentration and insight meditation skills along with mind/body exercises that facilitated increased body and emotional awareness. RESULTS: Out of 41 participants, 32 (73%) contributed detailed experience about learning and practicing meditation and mind/body practices that distilled into four themes, barriers to practice, learning style, emotional processing, and benefits of practice. Of those 32 participants 21 (73%) identified improvement in physical or emotional symptoms. Overall, 13 (40%) participants provided details regarding how they adapted specific meditation skills into daily life to improve emotional function and lessen dyspnea. Anxiety sensitivity to social situations was associated with a lack of participation. Lessons learned for larger scale application to future meditation and mind/body intervention design for chronic illness populations such as COPD are identified. CONTEXT: Persons with Chronic Obstructive Pulmonary Disease (COPD) exhibit high levels of comorbid anxiety that severely worsens their sensation of dyspnea and is associated with high levels of avoidance of essential activities resulting in an increase morbidity and mortality. Increasing meditation and mind/body practices have been shown to decrease anxiety, and improve intrapersonal and interpersonal relationships in general populations, however, results of studies in the COPD population have been mixed."," Chan, RR;  Lehto, RH",2016.0, 10.1016/j.explore.2016.02.004,0,0,
1912, Effects of horticultural therapy on elderly' health: protocol of a randomized controlled trial," BACKGROUND: Due to a rapidly ageing population in the world, it is increasingly pertinent to promote successful ageing strategies which are cost‚Äêeffective, easily accessible, and more likely to be acceptable to the elderly. Past research associates exposure to natural environments and horticultural therapy (HT) with positive psychological, social and physical health benefits. This Randomized Controlled Trial (RCT) is designed to evaluate the efficacy of HT in promoting Asian elderly' mental health, cognitive functioning and physical health. METHODS/DESIGN: 70 elderly participants aged 60 to 85 years old will be randomized to participate in either the active horticultural therapy group or be in the waitlist control. Sessions will be weekly for 12 weeks, and monthly for 3 months. Mental health will be assessed through self‚Äêreports of depressive and anxiety symptomatology, life satisfaction, social connectedness and psychological well‚Äêbeing, collaborated with immunological markers. Outcome measures of cognitive functioning and physical health include neuropsychological tests of cognitive function and basic health screening. Outcomes will be assessed at baseline, 3 months and 6 months post‚Äêintervention. DISCUSSION: This RCT comprehensively investigates the efficacy of a non‚Äêinvasive intervention, HT, in enhancing mental health, cognitive functioning and physical health. The results have tremendous potential for supporting future successful ageing programs and applicability to larger populations. TRIAL REGISTRATION: ClinicalTrials.gov NCT02495194 . Trial registration date: July 13, 2015. Retrospectively registered."," Chan, HY;  Ho, RC;  Mahendran, R;  Ng, KS;  Tam, WW;  Rawtaer, I;  Tan, CH;  Larbi, A;  Feng, L;  Sia, A;  et al.",2017.0, 10.1186/s12877-017-0588-z,0,0,
1913,Prediction and moderation of improvement in cognitive-behavioral and psychodynamic psychotherapy for panic disorder.,"To identify variables predicting psychotherapy outcome for panic disorder or indicating which of 2 very different forms of psychotherapy-panic-focused psychodynamic psychotherapy (PFPP) or cognitive-behavioral therapy (CBT)-would be more effective for particular patients. Data were from 161 adults participating in a randomized controlled trial (RCT) including these psychotherapies. Patients included 104 women; 118 patients were White, 33 were Black, and 10 were of other races; 24 were Latino(a). Predictors/moderators measured at baseline or by Session 2 of treatment were used to predict change on the Panic Disorder Severity Scale (PDSS). Higher expectancy for treatment gains (Credibility/Expectancy Questionnaire d = -1.05, CI95% [-1.50, -0.60]), and later age of onset (d = -0.65, CI95% [-0.98, -0.32]) were predictive of greater change. Both variables were also significant moderators: patients with low expectancy of improvement improved significantly less in PFPP than their counterparts in CBT, whereas this was not the case for patients with average or high levels of expectancy. When patients had an onset of panic disorder later in life (‚â•27.5 years old), they fared as well in PFPP as CBT. In contrast, at low and mean levels of onset age, CBT was the more effective treatment. Predictive variables suggest possibly fruitful foci for improvement of treatment outcome. In terms of moderation, CBT was the more consistently effective treatment, but moderators identified some patients who would do as well in PFPP as in CBT, thereby widening empirically supported options for treatment of this disorder. (PsycINFO Database Record",Chambless DL.; Milrod B.; Porter E.; Gallop R.; McCarthy KS.; Graf E.; Rudden M.; Sharpless BA.; Barber JP.,2017.0,10.1037/ccp0000224,0,0,
1914,Intensive cognitive-behavioural treatment for women with postnatal obsessive-compulsive disorder: A consecutive case series.,"The postnatal period has been identified as a time of increased risk for the development of OCD. Obsessions and compulsions at this time frequently focus on accidental or deliberate harm coming to the infant and may impact on the sufferer's capacities as a parent. Given the similarities in presentation between OCD at this and other times, cognitive-behaviour therapy is likely to be effective, but there is little information on whether or how adaptations of CBT can be made to maximise effectiveness and acceptability for mothers. There are no data on the impact of successful treatment on parenting. Six consecutively referred cases of postnatal OCD were treated using cognitive-behavioural therapy (CBT) intensively delivered over a two week period. All mothers improved on self-report and clinician-rated measures which were sustained at 3-5 month follow-up. Mothers reported significant benefits in terms of their own symptoms and in parenting in general. The intensive mode of delivery appears to be effective and acceptable for this group. Future work should explore whether particular difficulties in terms of parenting are experienced by this group and whether these persist beyond the remission of the maternal disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Challacombe, Fiona L; Salkovskis, Paul M",2011.0,http://dx.doi.org/10.1016/j.brat.2011.03.006,0,0,
1915,Cognitive impairment as measured by the THINC-integrated tool (THINC-it): The association with self-reported anxiety in Major Depressive Disorder.,"Background and objectives: This study evaluated the association between self-reported anxiety and objective/subjective measures of cognitive performance in adults with Major Depressive Disorder (MDD). Methods: Acutely depressed subjects with recurrent MDD (n = 100) and age-, sex-, and education-matched healthy controls (HC; n = 100) between the ages of 18 and 65 completed the cross-sectional validation study of the THINC-integrated tool (THINC-it; ClinicalTrials.gov: NCT02508493). Objective cognitive performance was assessed using the THINC-it, and subjective cognitive impairment with the Perceived Deficits Questionnaire for Depression-5-item. Subjects also completed the Generalized Anxiety Disorder-7-item (GAD-7) questionnaire. Results: Subjects with MDD reported significantly more anxiety symptoms, as assessed by the GAD-7, compared to HC (p < 0.001). Linear regression analysis determined that anxiety symptoms significantly accounted for 70.4% of the variability in subjective cognitive impairment, adjusting for depression severity. Moreover, subjects' ratings of the difficulties caused by their anxiety were reported as significantly more severe among subjects with MDD when compared to HC (p < 0.001). Likewise, greater self-reported difficulties with anxiety significantly predicted 57.8% of the variability in subjective cognitive impairment, adjusting for depression severity. Neither anxiety symptoms nor impairment due to anxiety symptoms predicted objective cognitive performance. Limitations: Subjects were not prospectively verified to have a clinical diagnosis of GAD. Rather, this study examined the relationships between symptoms of generalized anxiety, assessed using a brief screening tool, and subjective and objective cognitive function. Conclusions: Results from the current study indicate that adults with MDD and high levels of self-reported anxiety are significantly more likely to report experiencing subjective cognitive dysfunction. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Cha, Danielle S; Carmona, Nicole E; Rodrigues, Nelson B; Mansur, Rodrigo B; Lee, Yena; Subramaniapillai, Mehala; Phan, Lee; Cha, Rebekah H; Pan, Zihang; Lee, Jae Hon; Lee, JungGoo; Almatham, Fahad; Alageel, Asem; Rosenblat, Joshua D; Shekotikhina, Margarita; Rong, Carola; Harrison, John; McIntyre, Roger S",2018.0,http://dx.doi.org/10.1016/j.jad.2018.05.006,0,0,
1916,Bus operators' responses to job strain: An experimental test of the job demand-control model,"The research aim was to test the Job Demand-Control (JDC) Model demands × Control interaction (or buffering) hypothesis in a simulated bus driving experiment. The buffering hypothesis was tested using a 2 (low and high demands) × 2 (low and high decision latitude) design with repeated measures on the second factor. A sample of 80 bus operators were randomly assigned to the low (n = 40) and high demands (n = 40) conditions. Demands were manipulated by increasing or reducing the number of stops to pick up passengers, and decision latitude by imposing or removing restrictions on the Rapid Transit Bus (BRT) operators' pace of work. Outcome variables include physiological markers (heart rate [HR], heart rate variability [HRV], breathing rate [BR], electromyography [EMG], and skin conductance [SC]), objective driving performance and self-report measurements of psychological wellbeing (psychological distress, interest/enjoyment [I/E], perceived competence, effort/importance [E/I], and pressure/tension [P/T]). It was found that job decision latitude moderates the effect of job demands on both physiological arousal (BR: F(1, 74) = 4.680, p = .034, SC: F(1, 75) = 6.769, p = .011, and EMG: F(1, 75) = 6.550, p = .013) and psychological well-being (P/T: F(1, 75) = 4.289, p = .042 and I/E: F(1, 74) = 4.548, p = .036). Consistently with the JDC model buffering hypothesis, the experimental findings suggest that increasing job decision latitude can moderate the negative effect of job demands on different psychophysiological outcomes. This finding is useful for designing organizational and clinical interventions in an occupational group at high risk of work stress-related disease.",Cendales-Ayala B.; Useche S.A.; Gómez-Ortiz V.; Bocarejo J.P.,2017.0,10.1037/ocp0000040,0,0,
1917," Placebo Effects Across Self-Report, Clinician Rating, and Objective Performance Tasks Among Women With Post-Traumatic Stress Disorder: investigation of Placebo Response in a Pharmacological Treatment Study of Post-Traumatic Stress Disorder"," PURPOSE/BACKGROUND: For a drug to acquire Food and Drug Administration approval, it must significantly outperform placebo treatment. In recent years, the placebo effect seems to be increasing in neuropsychiatric conditions. Here, we examine placebo effects across self‚Äêreported, clinically rated, and performance‚Äêbased data from a trial using a corticotropin‚Äêreleasing hormone receptor type 1 (CRHR1) antagonist for treatment of post‚Äêtraumatic stress disorder (PTSD). METHODS/PROCEDURES: Women with chronic PTSD were randomized to treatment with either GSK561679, a CRHR1 antagonist, or placebo. Before randomization, participants completed self‚Äêreport scales, clinician‚Äêrated measures of PTSD and depression symptoms, and objective tests of cognition and functioning. Differences in change scores on measures were compared between GSK561679 and placebo‚Äêtreated participants. FINDINGS/RESULTS: GSK561679 failed to produce any significant improvement in the participants. A substantial placebo effect was observed in both self‚Äêreport and clinical rating scales, with effect sizes up to 1.5 SD. No single variable predicted placebo‚Äêrelated changes. Notably, there was an improvement on objective performance measures of cognition that exceeded previous standards for practice effects. IMPLICATIONS/CONCLUSIONS: Participants in this trial manifested retest effects on performance‚Äêbased measures of cognition. Notably, they had minimal prior experience with performance‚Äêbased assessments. Experiencing the structure and support of a clinical trial may have contributed to significant reductions in subject‚Äêreported and clinician‚Äêrated PTSD symptom levels. The improvement seen across all assessment domains was consistent with that seen in previous studies where the active treatments separated from placebo. Investigators conducting clinical trials treating PTSD patients should expect placebo effects and design studies accordingly."," Hodgins, GE;  Blommel, JG;  Dunlop, BW;  Iosifescu, D;  Mathew, SJ;  Neylan, TC;  Mayberg, HS;  Harvey, PD",2018.0, 10.1097/JCP.0000000000000858,0,0,
1918,Total migraine freedom: A potential primary endpoint to assess acute treatment in migraine,"Objectives: The FDA has set a higher regulatory hurdle for registration of new migraine agents requiring both pain freedom (or relief) and absence of each associated symptom (phonophobia, photophobia, and nausea). Methods: Twelve studies representing all phase III+efficacy/safety studies on rizatriptan 10 mg in adults treating migraine and completed by March 2009 were included in the meta-analysis. The percentage of patients achieving TMF at 2 hours by study and combined by treatment group was summarized by treatment paradigm (early/mild pain, moderate/severe, menstrual migraine). To demonstrate the impact of the strict migraine regulatory hurdle on clinical trial design and to further compare it to TMF, simulation via bootstrap sampling was used comparing the operating characteristics. Results: Odds ratios (rizatriptan vs. placebo, all p<0.001) for TMF were 6.2 [95% CI: (4.9, 7.7), p<0.001] for moderate/severe migraine, 2.7 [95% CI: (1.8, 4.0), p<0.001] for moderate/severe menstrual migraine, and 3.1 [95% CI: (2.4, 4.0), p<0.001] for early/mild pain. Analysis of presence of associated symptoms at baseline showed that the most participants with moderate/severe migraine had photophobia and/or phonophobia, but only approximately half had nausea. Simulation results showed a substantial loss of power analyzing absence of pain and of each symptom compared with the composite TMF endpoint across all treatment paradigms. Conclusions: Rizatriptan 10-mg was superior to placebo in achieving TMF at 2 hours postdose across all treatment paradigms. Given that the majority of patients with migraine do not exhibit all three associated symptoms, the TMF endpoint has significant advantages versus establishing efficacy on pain and on each symptom individually.",Ho T.W.; Rodgers A.; Hustad C.M.; Cady R.K.; Martin V.T.; Winner P.; Ramsey K.E.,2010.0,10.1111/j.1526-4610.2010.01740.x,0,0,
1919,Clinical profile of the novel oral CGRP receptor antagonist telcagepant for the acute treatment of migraine in phase 3 studies,"Purpose: To assess the clinical profile of the oral CGRP receptor antagonist telcagepant in the acute treatment of migraine. Methods: Two randomized, double-blind, placebo-controlled clinical trials in adults treating a single moderate or severe migraine attack were performed. Study 1 treatments were telcagepant 150- mg (N = 333), 300-mg (N = 354), zolmitriptan 5-mg (N = 345), or placebo (N = 348). Study 2 treatments were telcagepant 50-mg (N = 177), 150-mg (N = 381), 300-mg (N = 371), or placebo (N = 365). The 5 co-primary endpoints were pain-relief (mild or none), and freedom from pain, photophobia, phonophobia, and nausea, at 2h postdose. The key secondary endpoint was sustained pain-freedom from 2-24h postdose. Studies were analyzed separately and a pooled analysis was also performed. Results: In Study 1, telcagepant 300-mg was more effective than placebo for all co-primary, and the key secondary, endpoints (p ≤ 0.01). Significant differences were also seen for telcagepant 150-mg versus placebo (p ≤ 0.01) and zolmitriptan 5-mg versus placebo (p ≤ 0.001). The efficacy of telcagepant 300-mg was comparable to zolmitriptan 5-mg, telcagepant 150-mg was slightly less effective than zolmitriptan 5-mg. In Study 2, telcagepant 300- mg was significantly more effective than placebo (p ≤ 0.001), as was telcagepant 150-mg (p ≤ 0.05). All doses of telcagepant and zolmitriptan were generally well-tolerated. In Study 1, overall adverse event rates for telcagepant 150-mg, 300-mg, zolmitriptan 5-mg, and placebo were 31.4%, 37.2%, 50.7% and 32.1%, respectively. In Study 2, overall adverse event rates for telcagepant 50-mg, 150- mg, 300-mg, and placebo were 32.2%, 32.0%, 36.2% and 32.2%, respectively. Pooled data will be presented. Conclusions: The acute antimigraine efficacy of telcagepant 300- mg and 150-mg was demonstrated in two phase 3 studies. The efficacy of telcagepant 300-mg was similar to zolmitriptan 5-mg. Telcagepant was generally well-tolerated, with overall adverse event rates comparable to placebo.",Ho T.W.,2009.0,,0,0,
1920, Randomized controlled trial of supportive-expressive group therapy and body-mind-spirit intervention for Chinese non-metastatic breast cancer patients," PURPOSE: This study aimed to evaluate the efficacy of supportive‐expressive group (SEG) therapy and body‐mind‐spirit (BMS) intervention on emotional suppression and psychological distress in Chinese breast cancer patients. METHODS: This three‐arm randomized controlled trial assigned 157 non‐metastatic breast cancer patients to BMS, SEG, or social support control group. SEG focused on emotional expression and group support, whereas BMS emphasized relaxation and self‐care. All groups received 2‐h weekly sessions for 8 weeks. The participants completed measurements on emotional suppression, perceived stress, anxiety, and depression at baseline and three follow‐up assessments in 1 year. RESULTS: Using latent growth modeling, overall group difference was found for emotional suppression (χ CONCLUSIONS: The present results did not demonstrate overall effectiveness for either BMS or SEG therapy in the present sample of Chinese non‐metastatic breast cancer patients. The participants appear to derive only modest benefits in terms of their psychological well‐being from either intervention."," Ho, RT;  Fong, TC;  Lo, PH;  Ho, SM;  Lee, PW;  Leung, PP;  Spiegel, D;  Chan, CL",2016.0, 10.1007/s00520-016-3350-8,0,0,
1921,Accessibility of the Talar Dome-Anatomic Comparison of Plantarflexion Versus Noninvasive Distraction in Arthroscopy,"PURPOSE: The purpose of this study was to evaluate the difference in accessibility of the talar dome during ankle arthroscopy between noninvasive distraction and maximum plantar flexion without distraction. METHODS: For this study, 20 matched pairs (n = 40) of anatomic ankle specimens were used. Two groups (distraction or maximum plantar flexion) were defined. Through the use of chondral picks, the accessibility of each technique was tested arthroscopically. Afterward, the ankle joint was dissected and the reach achieved was measured and compared between the 2 groups. RESULTS: Through noninvasive distraction, 13.1 ± 4.4 mm of the talar dome was reached laterally and 16.7 ± 3.7 mm medially. Through plantar flexion, 18.1 ± 3.4 mm of the talar dome was reached laterally and 18.1 ± 3.4 mm medially. Statistical comparison revealed a significantly better reach in plantar flexion on the lateral side of the talar dome (P = .007). There was no significant difference medially. CONCLUSIONS: Plantar flexion significantly improves reachability of the dome on the lateral side and it is equal to noninvasive distraction medially. Results of this study may allow for better access to the lesion of the talus. CLINICAL RELEVANCE: Results of this study allow for a better planning of interventions in OCD of the talus.",Hirtler L.; Schuh R.,2018.0,10.1016/j.arthro.2017.07.036,0,0,
1922, Telephone-Delivered Exercise Advice and Behavior Change Support by Physical Therapists for People with Knee Osteoarthritis: protocol for the Telecare Randomized Controlled Trial," Background: Exercise and physical activity are a core component of knee osteoarthritis (OA) care, yet access to physical therapists is limited for many people. Telephone service delivery models may increase access. Objective: Determine the effectiveness of incorporating exercise advice and behavior change support by physical therapists into an existing Australian nurse‚Äêled musculoskeletal telephone service for adults with knee OA. Design: Randomized controlled trial with nested qualitative studies. Setting: Community, Australia‚Äêwide. Participants: One hundred seventy‚Äêfive people ‚â•45 years of age with knee symptoms consistent with a clinical diagnosis of knee OA. Eight musculoskeletal physical therapists will provide exercise advice and support. Intervention: Random allocation to receive existing care or exercise advice in addition to existing care. Existing care is a minimum of one phone call from a nurse for advice on OA self‚Äêmanagement. Exercise advice involves 5‚Äê10 calls over 6 months from a physical therapist trained in behavior change support to prescribe, monitor, and progress a strengthening exercise program and physical activity plan. Measurements: Outcomes will be measured at baseline and at 6 and 12 months. Primary outcomes are knee pain and physical function. Secondary outcomes include other measures of knee pain, self‚Äêefficacy, physical activity and its mediators, kinesiophobia, health service usage, work productivity, participant‚Äêperceived change, and satisfaction. Additional measures include adherence, adverse events, therapeutic alliance, satisfaction with telephone‚Äêdelivered therapy, and expectation of outcome. Semi‚Äêstructured interviews with participants with knee OA and therapists will be conducted. Limitations: Physical therapists cannot be blinded. Conclusions: This study will determine if incorporating exercise advice and behavior change support by physical therapists into a nurse‚Äêled musculoskeletal telephone service improves outcomes for people with knee OA. Findings will inform development and implementation of telerehabilitation services."," Hinman, RS;  Lawford, BJ;  Campbell, PK;  Briggs, AM;  Gale, J;  Bills, C;  French, SD;  Kasza, J;  Forbes, A;  Harris, A;  et al.",2017.0, 10.1093/ptj/pzx021,0,0,
1923, Design and development of a stepped-care behavioral intervention to support parents of young children newly diagnosed with type 1 diabetes," One of the most common chronic conditions of childhood, the prevalence of type 1 diabetes (T1D) in young children is increasing. Early childhood development complicates optimal T1D management and glycemic outcomes. Parents are at risk for elevated psychological distress, especially immediately following diagnosis. Few empirically supported interventions are available to support parents and promote optimal T1D management during this vulnerable period. This paper reports on the development and study design of First STEPS: Study of Type 1 in Early childhood and Parenting Support. The aim of this trial is to evaluate the efficacy of a stepped care behavioral intervention for parents of young children over the first year following a new T1D diagnosis. The stepped care design provides participants with up to three intensity levels, or steps, of clinical behavioral intervention support based on need, compared to usual care. Intervention steps include peer parent coaching, telephone‚Äêbased behavioral support, personalized psychological assessment and recommendations, and intensive assessment of T1D glycemic management with recommendations. Primary outcomes include children's glycemic control and parents' psychosocial functioning. Secondary outcomes include children's behavioral and psychosocial functioning. Exploratory analyses will evaluate demographic, disease‚Äêspecific, and psychosocial factors related to progression in and response to each step of the intervention."," Hilliard, ME;  Tully, C;  Monaghan, M;  Wang, J;  Streisand, R",2017.0, 10.1016/j.cct.2017.08.009,0,0,
1924, The effect of targeting tolerance of children's negative emotions among anxious parents of children with anxiety disorders: a pilot randomised controlled trial," Following cognitive behavioural therapy for child anxiety a significant minority of children fail to lose their diagnosis status. One potential barrier is high parental anxiety. We designed a pilot RCT to test claims that parental intolerance of the child's negative emotions may impact treatment outcomes. Parents of 60 children with an anxiety disorder, who were themselves highly anxious, received either brief parent‚Äêdelivered treatment for child anxiety or the same treatment with strategies specifically targeting parental tolerance of their child's negative emotions. Consistent with predictions, parental tolerance of the child's negative emotions significantly improved from pre‚Äê to post‚Äêtreatment. However, there was no evidence to inform the direction of this association as improvements were substantial in both groups. Moreover, while there were significant improvements in child anxiety in both conditions, there was little evidence that this was associated with the improvement in parental tolerance. Nevertheless, findings provide important clinical insight, including that parent‚Äêled treatments are appropriate even when the parent is highly anxious and that it may not be necessary to adjust interventions for many families."," Hiller, RM;  Apetroaia, A;  Clarke, K;  Hughes, Z;  Orchard, F;  Parkinson, M;  Creswell, C",2016.0, 10.1016/j.janxdis.2016.05.009,0,0,
1925," Nabilone pharmacotherapy for cannabis dependence: a randomized, controlled pilot study"," BACKGROUND AND OBJECTIVES: We assessed the safety, tolerability, and preliminary efficacy of nabilone, a cannabinoid agonist, to treat cannabis dependence. METHODS: Eighteen adults with DSM‚ÄêIV cannabis dependence were randomized to receive either 2‚Äâmg/day of nabilone (n‚Äâ=‚Äâ10) or placebo (n‚Äâ=‚Äâ8) for 10 weeks in addition to medication management. Twelve participants, six in each group, completed treatment. The safety and tolerability of nabilone was assessed at each visit. Any side effects from nabilone or the placebo were documented. Cannabis use outcomes were assessed via self‚Äêreport of days of use and twice‚Äêweekly urine cannabinoid tests; secondary outcomes included cannabis craving and anxiety. RESULTS: We assessed safety and tolerability at each study visit. A total of eight adverse events, all mild or moderate, were reported in two participants in the nabilone group, and six events were reported in four participants in the placebo group during study treatment. A total of eight adverse events were reported in two participants in the nabilone group and six events were reported in four participants in the placebo group during study treatment. All reported adverse events were rated mild‚Äêto‚Äêmoderate. There were no side effects deemed serious enough to be classified as an FDA‚Äêdefined serious adverse event. In general, participants in both groups reported reduced cannabis use according to self‚Äêreport over the course of the study, although these reductions were not statistically discernible. Moreover, there was no difference in cannabis use between the nabilone group and the placebo group as measured by self‚Äêreport. DISCUSSION AND CONCLUSIONS: Nabilone pharmacotherapy was safe and well‚Äêtolerated in participants with cannabis dependence. Future studies might evaluate a higher dose of nabilone to determine its effects on cannabis use outcomes in participants with cannabis dependence. SCIENTIFIC SIGNIFICANCE: There remains a clear need for additional pharmacotherapy trials for cannabis dependence, and nabilone remains a candidate for such trials. (Am J Addict 2017;26:795‚Äê801)."," Hill, KP;  Palastro, MD;  Gruber, SA;  Fitzmaurice, GM;  Greenfield, SF;  Lukas, SE;  Weiss, RD",2017.0, 10.1111/ajad.12622,0,0,
1926,Intimate violence as it relates to risky sexual behavior among at-risk females.,"Rates of sexually transmitted infections (STIs) among adolescents are on the rise. The majority of adolescents who contract STIs do so through risky sexual behavior. Previous literature has identified multiple correlates of risky sexual behaviors among adolescents, including physical and sexual victimization, mental health concerns, and substance use. Few studies, however, have examined these relationships together in a comprehensive model. The primary purpose of this study was to examine whether relationship violence was related to risky sexual behavior, and whether mental health symptoms and substance use mediated this relationship. A cross-sectional design was used, and adolescent females (N = 179), recruited from social service agencies, were 18.9 years old on average and were 37.2% White, 19.3% Black, 37.9% multiracial, and 5.6% other. Regression results revealed that females who were physically assaulted and sexually victimized by their intimate partners did engage in more sex without condoms. Mediational analyses indicated that PTSD symptoms significantly influenced the relationship between (1) physical assault and risky sexual behavior and (2) sexual victimization and risky sexual behavior. Contrary to expectations, PTSD may act to reduce risk perhaps by reducing interest in sex. It is important to address victimization, PTSD, and sexual risk in young women. More work is needed to understand these complex relationships using longitudinal designs. (PsycINFO Database Record (c) 2018 APA, all rights reserved).",Hill DC.; Stein LAR.; Rossi JS.; Magill M.; Clarke JG.,2018.0,10.1037/tra0000316,0,0,
1927, Video Colposcopy for Reducing Patient Anxiety During Colposcopy: a Randomized Controlled Trial," OBJECTIVE: To test whether video colposcopy reduces anxiety among patients undergoing colposcopy. METHODS: In a prospective, randomized multicenter trial, we compared video colposcopy and no video colposcopy in a one‐to‐one ratio. Situation‐specific anxiety was measured before (S1) and after (S2) colposcopy using the State‐Trait Anxiety Inventory. The primary endpoint was the reduction of the situation‐specific anxiety scores (ΔS=S2‐S1). Secondary endpoints were pain during and 10 minutes after colposcopy, general unpleasantness, anxiety during colposcopy, satisfaction with the information about the procedure, and overall satisfaction (11‐item visual analog scales). Analysis was by intention to treat. A sample size of 104 per group (n=208) was planned to achieve 80% power to detect a difference of 4.8 with a SD of 12.3 in the primary outcome. RESULTS: Between August 2016 and March 2017, 225 women were randomized. The mean ΔS was ‐10.3±11.3 SD in 111 women in the video colposcopy group and ‐10.3±11.0 SD in 105 women without video colposcopy (P=.50). The secondary endpoints pain during examination (median 2 [interquartile range 1‐3] compared with 2 [1‐4]; P=.91), pain 10 minutes after examination (1 [0‐3] compared with 1 [0‐2.5]; P=.24), general unpleasantness (3 [1‐5] compared with 3 [1‐5]; P=.90), anxiety during examination (3 [1‐5] compared with 3 [1‐5]; P=.61), satisfaction with the information about the procedure (10 [9‐10] compared with 10 [9‐10]; P=.88), and overall satisfaction (10 [9‐10] compared with 10 [9‐10]; P=.54) were also not different between the two study groups. In a multivariate linear regression analysis, study center (P=.028), body mass index (P=.033), and smoking status (P=.025) independently affected the reduction of anxiety. CONCLUSION: Video colposcopy does not reduce anxiety in women undergoing colposcopy. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02697175."," Hilal, Z;  Alici, F;  Tempfer, CB;  Seebacher, V;  Rezniczek, GA",2017.0, 10.1097/AOG.0000000000002127,0,0,
1928,Lagged effects of substance use on PTSD severity in a randomized controlled trial with modified prolonged exposure and relapse prevention.,"To advance understanding of the effectiveness of evidence-based treatments for comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD), research must provide a more nuanced picture of how substance use affects change in PTSD symptoms over the course of treatments and whether prolonged exposure techniques can be efficacious during active substance use. A data set that included patients with PTSD/subthreshold-PTSD and SUD treated with an exposure-based intervention provided an opportunity to conduct a secondary analysis to test how patients' substance use impacted PTSD change over treatment. We applied growth models to week-to-week PTSD symptom and substance use changes during treatment and follow-up of a randomized controlled trial of two cognitive-behavioral treatments for PTSD and SUD: Concurrent Treatment of PTSD and SUD Using Prolonged Exposure (COPE) and Relapse Prevention Therapy (RPT). Cross-lagged analyses were used to determine whether prior week substance use impacted subsequent PTSD symptom severity. Both treatments evidenced significant reductions in PTSD symptom severity. In the context of continued substance use, results suggest that individuals still benefit from exposure-based treatment. Results provide evidence that RPT and COPE both led to significant reductions in PTSD, providing further support that exposure-based techniques tailored for SUD can be conducted without jeopardizing PTSD or SUD outcomes. Implications for clinical decision making around treatment selection are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).",Hien DA.; Smith KZ.; Owens M.; López-Castro T.; Ruglass LM.; Papini S.,2018.0,10.1037/ccp0000345,0,0,
1929,Emotion dysregulation moderates the effect of cognitive behavior therapy with prolonged exposure for co-occurring PTSD and substance use disorders.,"A goal of clinical trials is to identify unique baseline characteristics that can inform treatment planning. One such target is emotion dysregulation (ED), which contributes to the maintenance of co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) and may be a potential moderator of treatment response. We examined the moderating impact of ED severity on treatment outcomes in an urban, socioeconomically disadvantaged, and racially/ethnically diverse sample with complex trauma and severe SUDs. Participants with co-occurring PTSD and SUD (PTSD+SUD) were randomized to Concurrent Treatment with Prolonged Exposure (COPE, n=39), Relapse Prevention Therapy (RPT, n=43), or an active monitoring control group (AMCG, n=28). Baseline ED severity moderated treatment outcomes such that high ED was associated with greater reduction in PTSD severity among those who received COPE relative to RPT and AMCG. In contrast, low ED was associated with greater reduction in substance use among those in RPT relative to COPE and AMCG. Implications for individualizing and optimizing treatment selection for PTSD+SUD are discussed.",Hien DA.; Lopez-Castro T.; Papini S.; Gorman B.; Ruglass LM.,2017.0,10.1016/j.janxdis.2017.10.003,0,0,
1930,Preliminary investigation of intolerance of uncertainty treatment for anxiety disorders.,"Intolerance of uncertainty (IU) is the tendency to react negatively to uncertain situations or events, and it has been found to be an important maintaining factor in a number of different anxiety disorders. It is often included as a part of cognitive behavioural interventions for anxiety disorders but its specific contribution to treatment outcome has not been examined. The aim of the present study was to examine the effectiveness of a brief treatment specifically targeting IU in a 25-year-old man with comorbid diagnoses of social phobia, panic disorder, generalised anxiety disorder, major depressive disorder and dysthymia. A single case design series was utilised. Six sessions of individual therapy were provided with symptom measures administered weekly throughout the 3-week baseline, treatment and 1-month post-treatment phase. Clinically significant improvement occurred on measures of IU and social anxiety but not on a general measure of anxiety. The clinical implications of this finding and directions for future research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hewitt, Sarah N; Egan, Sarah; Rees, Clare",2009.0,http://dx.doi.org/10.1080/13284200802702056,0,0,
1931,Double blind design and the use of psychological placebos in outcomes research in psychotherapy: Is it possible? A pilot feasibility study.,"Double blind design and placebos have been of crucial importance in medical clinical research. Their use in outcomes research in the field of psychotherapy has been controversial, though. Their feasibility in such case has been denied by many authors based on the assumption that the psychotherapist would need to know the nature of the applied procedure. In view of this, the author has conducted a pilot feasibility study on three subjects within the context of his doctoral dissertation. Said dissertation aims at establishing the role of alternating bilateral auditory stimulation in the processing of traumatic memories as used in the EMDR (Eye Movement Desensitization and Reprocessing) technique. To such end, the EMDR basic principles and procedures are introduced -with particular attention to alternating bilateral auditory stimulation- and a pilot study using placebos during EMDR administration is presented in detail. The goals of this study are testing the feasibility of: (a) using a psychological placebo in EMDR therapy,and (b) applying a double blind design study in EMDR outcomes research. A single case experimental design was performed on three different patients suffering from PTSD (Posttraumatic Stress Disorder). A symptomatology baseline was established through out three weekly sessions using the DTS (Davidson Trauma Scale) and the OQ-45.2 (Outcomes Questionnaire 45.2). First, three CDs were recorded -one with no sound at all (CD-1, silence condition); another one with auditory stimulation consisting of a tic-tac sound recorded in monaural condition, and reproduced simultaneously over both earphones at a rate of one beat per second (CD-2, monaural condition) and a third one with alternating bilateral auditory stimulation consisting of the exact same sound recorded in stereophonic condition, and reproduced alternatively over the left and right earphones (CD-3,stereo condition)-. At a second stage, these three experimental conditions were assigned randomly to the three subjects, who were administered: (a) EMDR protocol without any type of stimulation, with no sound coming out of the earphones using CD-1 (placebo 1), (b) EMDR protocol with simultaneous bilateral auditory stimulation using CD-2 (placebo 2), and (c) EMDR protocol with alternating bilateral auditory stimulation using CD-3 (active treatment). In all cases, the experimental conditions were implemented during three full sessions in which the CDs were reproduced for the subjects through earphones, instead of speakers, to ensure that the psychotherapist was unaware of the actual conditions. Subsequently, the standard EMDR protocol was administered to each subject until the end of the treatment, determined either by the symptoms being resolved or the maximum of ten sessions being completed. As a result of this pilot study, the author concludes that the feasibility of using double blind studies and placebos in EMDR psychotherapy has indeed been established. Since no apparent difficulties in the administration of the placebos were detected during the study, the use of psychological placebos seems viable. Such procedure is equally credible for the patient as well as for the psychotherapist, which renders possible the development of a double blind design in EMDR outcomes research. It should be noted, though, that the credibility of the placebo was not formally assessed, but rather was perceived through the author's informal observation. Developing assessment criteria and formal tools to evaluate the credibility of placebo procedures is advisable if future investigations on the subject are to be carried. Even though this study was conducted under a Single Case Experimental Design, the placebo procedure employed could be easily adapted for its use in between group's designs. Finally, some of the possible applications and consequences regarding the introduction of placebos and double blind design in psychotherapy research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cazabat, Eduardo H",2014.0,http://dx.doi.org/10.16888/interd.2014.31.1.5,0,0,
1932,Oxytocin receptors (OXTR) and early parental care: An interaction that modulates psychiatric disorders,"Oxytocin plays an important role in the modulation of social behavior in both typical and atypical contexts. Also, the quality of early parental care sets the foundation for long-term psychosocial development. Here, we review studies that investigated how oxytocin receptor (OXTR) interacts with early parental care experiences to influence the development of psychiatric disorders. Using Pubmed, Scopus and PsycInfo databases, we utilized the keyword ""OXTR"" before subsequently searching for specific OXTR single nucleotide polymorphisms (SNPs), generating a list of 598 studies in total. The papers were catalogued in a database and filtered for gene-environment interaction, psychiatric disorders and involvement of parental care. In particular, rs53576 and rs2254298 were found to be significantly involved in gene-environment interactions that modulated risk for psychopathology and the following psychiatric disorders: disruptive behavior, depression, anxiety, eating disorder and borderline personality disorder. These results illustrate the importance of OXTR in mediating the impact of parental care on the emergence of psychopathology.",Cataldo I.; Azhari A.; Lepri B.; Esposito G.,2018.0,10.1016/j.ridd.2017.10.007,0,0,
1933,Myocardial scar location as detected by cardiac magnetic resonance is associated with the outcome in heart failure patients undergoing surgical ventricular reconstruction.,"Post-infarction myocardial scar causes adverse left ventricular remodelling and negatively affects the prognosis. We sought to investigate whether scar extent and location obtained by cardiac magnetic resonance may affect the reverse remodelling and survival of heart failure patients undergoing surgical ventricular reconstruction. From January 2011 to December 2015, 151 consecutive patients with previous myocardial infarction and left ventricular remodelling underwent surgical ventricular reconstruction at our Institution, of which 88 (58%) patients had a preoperative protocol-standardized late gadolinium enhancement (LGE)-cardiac magnetic resonance examination during the week before surgery. We excluded 40 patients with devices (26%), 15 patients with irregular heart rhythm (permanent atrial fibrillation, 10% not included in the device group) or mixed contraindications (severe claustrophobia or presence of material magnetic resonance not compatible). Among the 145 survivors, 11 patients received an implantable cardioverter defibrillator after surgery (mostly for persistent low ejection fraction) and were excluded as well, yielding a total of 59 patients (48 men, aged 65 ± 9 years) who repeated a protocol-standardized LGE-cardiac magnetic resonance examination even 6 months postoperatively and therefore represent the study population. Patients were grouped according to the presence of LGE in the antero-basal left ventricular segments (Group A) or the absence of LGE in the same segments (Group B). The postoperative left ventricular end-systolic volume index was considered the primary end-point. After surgery, left ventricular end-systolic volume index and end-diastolic volume index significantly decreased (P < 0.001, for both), while diastolic sphericity index and ejection fraction significantly increased (P = 0.015 and P < 0.001, respectively). The presence of LGE in the antero-basal left ventricular segments (10 patients, Group A) was the only independent predictor of outcome (P = 0.02) at multivariate analysis, being the postoperative left ventricular end-systolic volume index significantly higher compared to that of patients of Group B (49 patients) (78 ± 26 ml/m2 vs 55 ± 20 ml/m2, P = 0.003). Furthermore, patients with a postoperative left ventricular end-systolic volume index >60 ml/m2 showed a higher risk of cardiac events (hazard ratio = 3.67, P = 0.02). In patients undergoing surgical ventricular reconstruction, LGE scar location affects the left ventricular reverse remodelling, which in turn might limit the survival benefit.",Castelvecchio S.; Careri G.; Ambrogi F.; Camporeale A.; Menicanti L.; Secchi F.; Lombardi M.,2018.0,10.1093/ejcts/ezx197,0,0,
1934,"A meta-analysis of imagery rehearsal for post-trauma nightmares: Effects on nightmare frequency, sleep quality, and posttraumatic stress.","This meta-analysis evaluates the efficacy of imagery rehearsal as a treatment for nightmares, general sleep disturbance, and symptoms of post-traumatic stress. Bibliographic databases and cited references were searched to identify clinical trials of imagery rehearsal in individuals with post-trauma nightmares. Thirteen studies met inclusion criteria and reported sleep and post-traumatic stress outcomes in sufficient detail to calculate effect sizes. Results indicate that imagery rehearsal had large effects on nightmare frequency, sleep quality, and PTSD symptoms from the initial to post-treatment assessments. These effects were sustained through 6 to 12 months follow-up. Furthermore, interventions that included both imagery rehearsal and cognitive behavioral therapy for insomnia resulted in greater treatment-related improvement in sleep quality than imagery rehearsal alone. Combined treatment did not improve outcomes for PTSD or nightmares. Notably, effect sizes were small in the single study that included an active-treatment control condition. Future research should identify necessary and sufficient components of interventions for trauma-related sleep disturbance and post-traumatic stress (e.g., exposure, cognitive reappraisal, sleep and circadian regulation). (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Casement, Melynda D; Swanson, Leslie M",2012.0,http://dx.doi.org/10.1016/j.cpr.2012.06.002,0,0,
1935,5 Hz Repetitive transcranial magnetic stimulation for posttraumatic stress disorder comorbid with major depressive disorder.,"Background: Standard clinical protocols for repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder (MDD) apply 10 Hz pulses over left prefrontal cortex, yet little is known about the effects of rTMS in more diagnostically complex depressed patients. Objective/hypothesis: Posttraumatic stress disorder (PTSD) is commonly comorbid with MDD, and while rTMS has been shown to alleviate PTSD symptoms in preliminary studies, ideal parameters remain unclear. We conducted a prospective, open-label study of 5 Hz rTMS for patients with comorbid PTSD + MDD and hypothesized stimulation would reduce symptoms of both disorders. Methods: Outpatients (N = 40) with PTSD + MDD and at least moderate global severity were enrolled. 5 Hz rTMS included up to 40 daily sessions followed by a 5-session taper. Symptoms were measured using the PTSD Checklist (PCL-5) and Inventory of Depressive Symptomatology, Self-Report (IDS-SR). Baseline-to-endpoint changes were analyzed. Results: The intent-to-treat population included 35 participants. Stimulation significantly reduced PTSD symptoms (PCL-5 baseline mean +/- SD score 52.2 +/- 13.1 versus endpoint 34.0 +/- 21.6; p < .001); 23 patients (48.6%) met a pre-defined categorical PTSD response criteria. MDD symptoms also improved significantly (IDS-SR, baseline 47.8 +/- 11.9 to endpoint 30.9 +/- 18.9; p < .001); 15 patients (42.9%) demonstrated categorical response and 12 (34.3%) remitted. PTSD and MDD symptom change was highly correlated (r = 0.91, p < .001). Limitations: Unblinded single-arm study, with modest sample size. Conclusion: Significant and clinically meaningful reductions in both MDD and PTSD symptoms were observed following stimulation. The preliminary efficacy of 5 Hz rTMS for both symptom domains in patients with comorbid disorders supports future controlled studies. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Carpenter, Linda L; Conelea, Christine; Tyrka, Audrey R; Welch, Emma S; Greenberg, Benjamin D; Price, Lawrence H; Niedzwiecki, Matthew; Yip, Agustin G; Barnes, Jennifer; Philip, Noah S",2018.0,http://dx.doi.org/10.1016/j.jad.2018.04.009,0,0,
1936, Do unto others: how cognitive fusion shapes the transmission of moral behavior," Moral transmission is the concept that moral behaviors can be contagious, spreading from person to person like a pathogen of social influence. We investigated how cognitive fusion‚Äêa transdiagnostic vulnerability to diverse mental health problems‚Äêinfluences moral transmission across 3 studies (N = 891) using real behavioral outcomes, including economic game decisions and donations to charity. The findings suggest that cognitively fused individuals are more susceptible to moral transmission because (a) they are more likely to pay forward or pay back moral behavior, and (b) they are more likely to engage in compensatory moral behavior. In fact, (c) our analyses revealed a more direct association between these 2 psychological processes, supporting our argument that moral transmission can integrate a variety of seemingly discrete social phenomena. As predicted, participants with more depression and anxiety symptoms revealed patterns of behavior similar to those high in cognitive fusion. Implications for research in both social and clinical psychology are discussed. (PsycINFO Database Record"," Carnes, NC;  Winer, JP",2017.0, 10.1037/xge0000294,0,0,
1937,Clinical and electrophysiological outcomes of deep TMS over the medial prefrontal and anterior cingulate cortices in OCD patients.,"Obsessive Compulsive Disorder (OCD) is a chronic and disabling disorder with poor response to pharmacological treatments. Converging evidences suggest that OCD patients suffer from dysfunction of the cortico-striato-thalamo-cortical (CSTC) circuit, including in the medial prefrontal cortex (mPFC) and the anterior cingulate cortex (ACC). To examine whether modulation of mPFC-ACC activity by deep transcranial magnetic stimulation (DTMS) affects OCD symptoms. Treatment resistant OCD participants were treated with either high-frequency (HF; 20 Hz), low-frequency (LF; 1 Hz), or sham DTMS of the mPFC and ACC for five weeks, in a double-blinded manner. All treatments were administered following symptoms provocation, and EEG measurements during a Stroop task were acquired to examine changes in error-related activity. Clinical response to treatment was determined using the Yale-Brown-Obsessive-Compulsive Scale (YBOCS). Interim analysis revealed that YBOCS scores were significantly improved following HF (n = 7), but not LF stimulation (n = 8), compared to sham (n = 8), and thus recruitment for the LF group was terminated. Following completion of the study, the response rate in the HF group (n = 18) was significantly higher than that of the sham group (n = 15) for at least one month following the end of the treatment. Notably, the clinical response in the HF group correlated with increased Error Related Negativity (ERN) in the Stroop task, an electrophysiological component that is attributed to ACC activity. HF DTMS over the mPFC-ACC alleviates OCD symptoms and may be used as a novel therapeutic intervention. Notwithstanding alternative explanations, this may stem from DTMS ability to directly modify ACC activity.",Carmi L.; Alyagon U.; Barnea-Ygael N.; Zohar J.; Dar R.; Zangen A.,,10.1016/j.brs.2017.09.004,0,0,
1938, Brief supportive-expressive group therapy for partners of men with early stage prostate cancer: lessons learned from a negative randomized controlled trial," PURPOSE: The purpose of this paper is to report the results of a negative randomized controlled trial, which piloted brief supportive‚Äêexpressive therapy (SET) for partners of men with prostate cancer, and to discuss lessons learned for future clinical trials. METHODS: Partners of men with newly diagnosed, non‚Äêmetastatic prostate cancer were randomized to SET (n = 45) or usual care (n = 32). SET involved six weekly group sessions emphasizing emotional expression, social support, and finding meaning in the cancer experience. Measures of mood disturbance, marital satisfaction, and social support were administered to both partners and patients at baseline, post‚Äêprogram, and at 3‚Äê and 6‚Äêmonth follow‚Äêup. RESULTS: There were no significant differences between SET and the control group for either patients or their wives on any outcome. Regardless of group membership, partners reported improvements in total mood disturbance (p = .011), tension (p < .001), anger (p = .041), confusion (p < .001), state anxiety (p = .001), and emotional support (p = .037), and patients reported improvements in tension (p = .003), emotional support (p = .047), positive interaction support (p = .004), and overall social support (p = .026). CONCLUSIONS: Compared to the natural course of recovery, SET did not improve psychosocial outcomes for either men with prostate cancer or their wives. Methodological challenges experienced in implementing this trial yield valuable lessons for future research, including designing interventions relevant to unique problems faced by specific groups, being closely guided by previous research, and the potential utility of screening for distress as an inclusion criteria in intervention trials."," Carlson, LE;  Rouleau, CR;  Speca, M;  Robinson, J;  Bultz, BD",2017.0, 10.1007/s00520-016-3551-1,0,0,
1939, Online attention modification for social anxiety disorder: replication of a randomized controlled trial," Social anxiety disorder (SAD) models posit vigilance for external social threat cues and exacerbated self‚Äêfocused attention as key in disorder development and maintenance. Evidence indicates a modified dot‚Äêprobe protocol may reduce symptoms of SAD; however, the efficacy when compared to a standard protocol and long‚Äêterm maintenance of treatment gains remains unclear. Furthermore, the efficacy of such protocols on SAD‚Äêrelated constructs remains relatively unknown. The current investigation clarified these associations using a randomized control trial replicating and extending previous research. Participants with SAD (n = 113; 71% women) were randomized to complete a standard (i.e. control) or modified (i.e. active) dot‚Äêprobe protocol consisting of 15‚Äêmin sessions twice weekly for four weeks. Self‚Äêreported symptoms were measured at baseline, post‚Äêtreatment, and 4‚Äêmonth and 8‚Äêmonth follow‚Äêups. Hierarchical linear modeling indicated significant self‚Äêreported reductions in symptoms of social anxiety, fear of negative evaluation, trait anxiety, and depression, but no such reductions in fear of positive evaluation. Symptom changes did not differ based on condition and were maintained at 8‚Äêmonth follow‚Äêup. Attentional biases during the dot‚Äêprobe task were not related to symptom change. Overall, our results replicate support for the efficacy of both protocols in reducing symptoms of SAD and specific related constructs, and suggest a role of exposure, expectancy, or practice effects, rather than attention modification, in effecting such reductions. The current results also support distinct relationships between fears of negative and positive evaluation and social anxiety. Further research focused on identifying the mechanisms of change in attention modification protocols appears warranted."," Carleton, RN;  Teale Sapach, MJ;  Oriet, C;  LeBouthillier, DM",2017.0, 10.1080/16506073.2016.1214173,0,0,
1940,Development and preliminary evaluation of a positive emotion regulation augmentation module for anxiety and depression.,"Research has shown that positive emotions are important to optimal health, functioning, and well-being, and contribute to resilience against psychological dysfunction. Many clinical disorders, particularly anxiety and mood disorders, are associated with deficits in positive emotion that may contribute to disorder severity and prevent full recovery, and these deficits have received insufficient attention in treatment. The present study represents a preliminary evaluation of the feasibility and utility of adding a novel brief intervention module for enhancing positive emotion in anxiety and depressive disorders to existing evidence-based treatment. This intervention was evaluated in nine patients with a range of principal anxiety disorders who had previously completed an initial course of cognitive-behavioral treatment, utilizing a multiple baseline experimental-across-participants design. Results indicated that the intervention was effective in improving positive emotion regulation skills for five of nine participants. The intervention was also associated with further improvements in anxiety and depressive symptoms, positive and negative emotion, functioning, quality of life, and well-being. Participants reported high acceptability and satisfaction with the study intervention. Future research is needed to confirm the validity of these findings and evaluate the generalizability of these effects across patients and settings. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Carl, Jenna R; Gallagher, Matthew W; Barlow, David H",2018.0,http://dx.doi.org/10.1016/j.beth.2017.11.008,0,0,
1941, Development and randomized trial evaluation of a novel computer-delivered anxiety sensitivity intervention," Objective: Anxiety disorders contribute substantially to the overall public health burden of psychopathology. Anxiety sensitivity (AS), a fear of anxiety related sensations, is one of the few known malleable risk factors for anxiety pathology. Previous AS reduction treatments have utilized highly trained clinicians. A completely‚Äêcomputerized AS treatment would reduce costs and increase dissemination possibilities. Cognitive bias modification for interpretation biases (CBM‚ÄêI) interventions have shown clinically significant reductions in anxiety symptoms. Another emerging literature focused on learning has shown context‚Äêshifting tasks can greatly increase learning without adding logistical burden to an intervention. The current study evaluated a CBM‚ÄêI for AS that utilized a context‚Äêshifting task to deliver twice the treatment dose of extant interventions. Design: Single‚Äêsite randomized controlled trial. Participants completed an intervention appointment, as well as one‚Äêweek and one‚Äêmonth follow‚Äêup assessments. Participants: Individuals with elevated levels of AS. Intervention: Single‚Äêsession computer‚Äêdelivered CBM‚ÄêI for AS. Results: Results indicate that the CBM‚ÄêI for AS was successful in reducing overall AS (62% post‚Äêintervention) and these reductions were maintained through one‚Äêmonth post‚Äêintervention (64%). Results also revealed that individuals in the active condition reported significantly less incidents of panic responding to a physiological straw‚Äêbreathing challenge and that change in interpretation bias significantly mediated the relationship between treatment condition and post‚Äêtreatment AS reductions. Conclusions: Taken together, the results show that the current CBM‚ÄêI intervention was strong in terms of immediate and one‚Äêmonth AS reductions. Given its brevity, low cost, low stigma and portability, this intervention could have substantial impact on reducing the burden of anxiety disorders."," Capron, DW;  Schmidt, NB",2016.0, 10.1016/j.brat.2016.04.001,0,0,
1942,"Combined ""top-down"" and ""bottom-up"" intervention for anxiety sensitivity: Pilot randomized trial testing the additive effect of interpretation bias modification.","Anxiety disorders contribute substantially to the overall public health burden. Anxiety sensitivity (AS), a fear of anxiety-related sensations, is one of the few known malleable risk factors for anxiety pathology. Previous AS reduction treatments have primarily utilized ""top-down"" (e.g., psychoeducation) interventions. The goal of the current study was to evaluate the effect of adding a ""bottom-up"" (interpretation bias modification; CBM-I) intervention to an AS psychoeducation intervention. Single-site randomized controlled trial. Participants completed either a 1) Psychoeducation + active CBM-I or 2) Psychoeducation + control CBM-I intervention. Change in AS was assessed post-intervention and at a one-month follow-up. Individuals with elevated levels of AS. Single-session computer-delivered intervention for AS. Accounting for baseline ASI-3 scores, post-intervention ASI-3 scores were significantly lower in the combined condition than in the psychoeducation + control CBM-I condition (β = 0.24, p < 0.05; d = 0.99). The active CBM-I plus psychoeducation AS intervention was successful in reducing overall AS (59% post-intervention; p < 0.05, Cohen's d = 0.99) and these reductions were maintained through one-month post-intervention (52%; p < 0.05, Cohen's d = 1.18). Participants in the active condition reported significantly lower rates of panic responding to a vital-capacity CO2 challenge (OR = 6.34, 95% CI = 1.07-37.66). Lastly, change in interpretation bias significantly mediated the relationship between treatment condition and post-treatment AS reductions. The current intervention was efficacious in terms of immediate and one-month AS reductions. Given its brevity, low-cost, low-stigma and portability, this intervention could lead to reducing the burden of anxiety disorders.",Capron DW.; Norr AM.; Allan NP.; Schmidt NB.,2017.0,10.1016/j.jpsychires.2016.11.003,0,0,
1943, Profiles of Temperament among Youth with Specific Phobias: implications for CBT Outcomes," Specific phobias (SPs) are characterized by excessive fear or anxiety regarding an object or situation. SPs often result in a host of negative outcomes in childhood and beyond. Children with SPs are broadly assumed to show dispositional over‚Äêregulation and fearfulness relative to children without SPs, but there are few attempts to distinguish dispositional patterns among children with SPs. In the present study, we examined trajectories of differing temperamental profiles for youth receiving a CBT‚Äêbased treatment for their SP. Participants were 117 treatment seeking youth (M Age = 8.77 years, Age Range = 6‚Äê15 years; 54.7% girls) who met criteria for a SP and their mothers. Three temperament profiles emerged and were conceptually similar to previously supported profiles: well‚Äêadjusted; inhibited; and under‚Äêcontrolled. While all groups showed similarly robust reductions in SP severity following treatment, differences among the three groups emerged in terms of broader internalizing symptoms, externalizing symptoms, and global outlook. The well‚Äêadjusted group was higher in functioning initially than the other two groups. The inhibited group had initial disadvantages in initial internalizing symptoms. The under‚Äêcontrolled group showed greatest comorbidity risks and had initial disadvantages in both internalizing and externalizing symptoms. These distinct clusters represent considerable heterogeneity within a clinical sample of youth with SP who are often assumed to have homogenous behavior tendencies of inhibition and fearfulness. Findings suggest that considering patterns of temperament among children with phobias could assist treatment planning and inform ongoing refinements to improve treatment response."," Capriola, NN;  Booker, JA;  Ollendick, TH",2017.0, 10.1007/s10802-016-0255-4,0,0,
1944, Establishing Clinical Cutoffs for Response and Remission on the Screen for Child Anxiety Related Emotional Disorders (SCARED)," OBJECTIVE: To determine optimal percent reduction and raw score cutoffs on the parent‚Äê and child‚Äêreport Screen for Child Anxiety Related Emotional Disorders (SCARED) for predicting treatment response and remission among youth with anxiety disorders. METHOD: Data were obtained from youth (N = 438; 7‚Äê17 years old) who completed treatment in the Child/Adolescent Anxiety Multimodal treatment Study, a multisite, randomized clinical trial that examined the relative efficacy of medication (sertraline), cognitive‚Äêbehavioral therapy (Coping Cat), their combination, and pill placebo for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. The parent‚Äê and youth‚Äêreport SCARED were administered at pre‚Äê and posttreatment. Quality receiver operating characteristic methods evaluated the performance of various SCARED percent reduction and absolute cutoff scores in predicting treatment response and remission, as defined by posttreatment ratings on the Clinical Global Impression scales and the Anxiety Disorders Interview Schedule. RESULTS: Reductions of 55% on the SCARED‚ÄêParent and 50% on the SCARED‚ÄêYouth optimally predicted treatment response. Posttreatment absolute raw scores of 10 (SCARED‚ÄêParent) and 12 (SCARED‚ÄêYouth) optimally predicted remission in the total sample, although separate SCARED‚ÄêParent cutoffs for children (12‚Äê13) and adolescents (9) showed greatest quality of efficiency. Each cutoff significantly predicted response and remission at 6‚Äêmonth follow‚Äêup. CONCLUSION: Results serve as guidelines for operationalizing treatment response and remission on the SCARED, which could help clinicians systematically monitor treatment outcomes of youth with anxiety disorders in a cost‚Äê and time‚Äêefficient manner. Clinical trial registration information‚ÄêChild and Adolescent Anxiety Disorders (CAMS); http://clinicaltrials.gov/; NCT00052078."," Caporino, NE;  Sakolsky, D;  Brodman, DM;  McGuire, JF;  Piacentini, J;  Peris, TS;  Ginsburg, GS;  Walkup, JT;  Iyengar, S;  Kendall, PC;  et al.",2017.0, 10.1016/j.jaac.2017.05.018,0,0,
1945,Report of the Primary Outcomes for Gait Mechanics in Men of the ACL-SPORTS Trial: Secondary Prevention With and Without Perturbation Training Does Not Restore Gait Symmetry in Men 1 or 2 Years After ACL Reconstruction.,"Movement asymmetries during walking are common after anterior cruciate ligament (ACL) injury and reconstruction and may influence the early development of posttraumatic osteoarthritis. Preoperative neuromuscular training (like perturbation training, which is neuromuscular training requiring selective muscle activation in response to surface perturbations) improves gait asymmetries and functional outcomes among people who are ACL-deficient, but the effect of postoperative perturbation training on gait mechanics after ACL reconstruction is unknown. Among men undergoing ACL reconstruction, we sought to compare strength, agility, and secondary prevention (SAP) treatment with SAP plus perturbation training (SAP+PERT) with respect to (1) gait mechanics; and (2) elimination of gait asymmetries 1 and 2 years after ACL reconstruction. Forty men were randomized into a SAP group or a SAP+PERT group after ACL reconstruction and before returning to preinjury activities. Participants were required to achieve ≥ 80% quadriceps muscle strength symmetry, minimal knee effusion, full ROM, no reports of pain, and completion of a running progression (all between 3 and 9 months postoperatively) before enrollment. Of 94 potentially eligible athletic male patients evaluated < 9 months after ACL reconstruction, 54 were excluded for prespecified reasons. Participants underwent motion analysis during overground walking at 1 and 2 years postoperatively. Variables of interest included (1) sagittal and frontal plane hip and knee angles and moments at peak knee flexion angle; (2) sagittal plane hip and knee angles and moments at peak knee extension angle; (3) sagittal plane hip and knee excursion during weight acceptance; and (4) sagittal plane hip and knee excursion during midstance. We also calculated the proportion of athletes in each group who walked with clinically meaningful interlimb asymmetry in sagittal plane hip and knee variables and compared these proportions using odds ratios. There was no differential loss to followup between groups. There were no differences between the SAP or SAP+PERT groups for the biomechanical gait variables. The involved limb's knee excursion during midstance for the SAP (mean ± SD: 1 year: 15° ± 5°; 2 years: 16° ± 5°) and SAP+PERT (1 year: 16° ± 5°; 2 years: 15° ± 4°) athletes was not different between groups at 1 year (mean difference: -1°; 95% confidence interval [CI], -5° to 2°; p = 0.49) or 2 years (mean difference: 1°; 95% CI, -2° to 4°; p = 0.54). There were no differences between SAP and SAP+PERT athletes regarding the elimination of gait asymmetries, and gait asymmetries persisted to a large degree in both groups 1 and 2 years postoperatively. At 1 year, 11 of 18 SAP and 11 of 20 SAP+PERT athletes walked with truncated knee excursions during weight acceptance (odds ratio: 0.8, p = 0.70) and midstance (SAP 12 of 18, SAP+PERT 12 of 20; odds ratio: 0.8, p = 0.67), whereas at 2 years postoperatively, truncated knee excursions during weight acceptance (SAP seven of 17, SAP+PERT eight of 19; odds ratio: 1.0, p = 0.96) and midstance (SAP five of 17, SAP+PERT 11 of 19; odds ratio: 3.3, p = 0.09) remained prevalent. We found that a comprehensive, progressive return-to-sport training program with or without perturbation was not effective at restoring interlimb symmetry among men 1 or 2 years after ACL reconstruction. Although gait asymmetries improved from 1 to 2 years postoperatively, meaningful asymmetries persisted in both groups. To restore gait symmetry after ACL reconstruction, additional interventions likely are necessary. Level II, therapeutic study.",Capin JJ.; Zarzycki R.; Arundale A.; Cummer K.; Snyder-Mackler L.,2017.0,10.1007/s11999-017-5279-8,0,0,
1946, Therapeutic Alliance during Prolonged Exposure Versus Client-Centered Therapy for Adolescent Posttraumatic Stress Disorder," OBJECTIVES: To examine the relationship between improvements in adolescent ratings of therapeutic alliance and reductions in posttraumatic stress disorder (PTSD) severity over time among adolescent girls during prolonged exposure therapy for adolescents (PE‚ÄêA) versus client‚Äêcentered therapy (CCT), as well as to examine differences in changes in alliance between treatment groups. METHOD: A total of 61 adolescent girls (aged 13‚Äê18 years) with sexual assault‚Äêrelated PTSD received PE‚ÄêA or CCT in a randomized controlled trial. Participants rated alliance at session 3, midtreatment, and posttreatment. RESULTS: The rate of improvement in adolescent‚Äêrated alliance was greater in PE‚ÄêA than CCT over the course of treatment. In addition, improvement in adolescent‚Äêrated alliance significantly contributed to improvements in PTSD (regardless of treatment condition), but not vice versa. CONCLUSIONS: Contrary to beliefs that trauma‚Äêfocused treatments fail to establish strong therapeutic alliance in sexually abused adolescents, improvement in adolescent ratings of alliance were greater in PE‚ÄêA compared to CCT, and improvements in adolescent‚Äêrated alliance were significantly associated with better treatment outcome across both types of treatments."," Capaldi, S;  Asnaani, A;  Zandberg, LJ;  Carpenter, JK;  Foa, EB",2016.0, 10.1002/jclp.22303,0,0,
1947,Cognitive behavioural therapy attenuates the enhanced early facial stimuli processing in social anxiety disorders: An ERP investigation.,"Background: Previous studies of patients with social anxiety have demonstrated abnormal early processing of facial stimuli in social contexts. In other words, patients with social anxiety disorder (SAD) tend to exhibit enhanced early facial processing when compared to healthy controls. Few studies have examined the temporal electrophysiological event-related potential (ERP)-indexed profiles when an individual with SAD compares faces to objects in SAD. Systematic comparisons of ERPs to facial/object stimuli before and after therapy are also lacking. We used a passive visual detection paradigm with upright and inverted faces/objects, which are known to elicit early P1 and N170 components, to study abnormal early face processing and subsequent improvements in this measure in patients with SAD. Methods: Seventeen patients with SAD and 17 matched control participants performed a passive visual detection paradigm task while undergoing EEG. The healthy controls were compared to patients with SAD pre-therapy to test the hypothesis that patients with SAD have early hypervigilance to facial cues. We compared patients with SAD before and after therapy to test the hypothesis that the early hypervigilance to facial cues in patients with SAD can be alleviated. Results: Compared to healthy control (HC) participants, patients with SAD had more robust P1-N170 slope but no amplitude effects in response to both upright and inverted faces and objects. Interestingly, we found that patients with SAD had reduced P1 responses to all objects and faces after therapy, but had selectively reduced N170 responses to faces, and especially inverted faces. Interestingly, the slope from P1 to N170 in patients with SAD was flatter post-therapy than pre-therapy. Furthermore, the amplitude of N170 evoked by the facial stimuli was correlated with scores on the interaction anxiousness scale (IAS) after therapy. Conclusions: Our results did not provide electrophysiological support for the early hypervigilance hypothesis in SAD to faces, but confirm that cognitive-behavioural therapy can reduce the early visual processing of faces. These findings have potentially important therapeutic implications in the assessment and treatment of social anxiety. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Cao, Jianqin; Liu, Quanying; Li, Yang; Yang, Jun; Gu, Ruolei; Liang, Jin; Qi, Yanyan; Wu, Haiyan; Liu, Xun",2017.0,http://dx.doi.org/10.1186/s12993-017-0130-7,0,0,
1948, An Internet-based treatment for flying phobia (NO-FEAR Airlines): study protocol for a randomized controlled trial," BACKGROUND: Flying phobia (FP) is a common and disabling mental disorder. Although in vivo exposure is the treatment of choice, it is linked to a number of limitations in its implementation. Particularly important, is the limited access to the feared stimulus (i.e., plane). Moreover, the economic cost of in vivo exposure should be specially considered as well as the difficulty of applying the exposure technique in an appropriate way; controlling important variables such as the duration of the exposure or the number of sessions. ICTs could help to reduce these limitations. Computer‐assisted treatments have remarkable advantages in treating FP. Furthermore, they can be delivered through the Internet, increasing their advantages and reaching more people in need. The Internet has been established as an effective way to treat a wide range of mental disorders. However, as far as we know, no controlled studies exist on FP treatment via the Internet. This study aims to evaluate the efficacy of an Internet‐based treatment for FP (NO‐FEAR Airlines) versus a waiting list control group. Secondary objectives will be to explore two ways of delivering NO‐FEAR Airlines, with or without therapist guidance, and study the patients' acceptance of the program. This paper presents the study protocol. METHODS/DESIGN: The study is a randomized controlled trial. A minimum of 57 participants will be randomly assigned to three conditions: a) NO‐FEAR Airlines totally self‐applied, b) NO‐FEAR Airlines with therapist guidance, or c) a waiting list control group (6 weeks). Primary outcomes measures will be the Fear of Flying Questionnaire‐II and the Fear of Flying Scale. Secondary outcomes will be included to assess other relevant clinical measures, such as the Fear and Avoidance Scales, Clinician Severity Scale, and Patient's Improvement scale. Analyses of post‐treatment flights will be conducted. Treatment acceptance and preference measures will also be included. Intention‐to‐treat and per protocol analyses will be conducted. DISCUSSION: An Internet‐based treatment for FP could have considerable advantages in managing in vivo exposure limitations, specifically in terms of access to treatment, acceptance, adherence, and the cost‐effectiveness of the intervention. This is the first randomized controlled trial to study this issue. TRIAL REGISTRATION: Clinicaltrials.gov: NCT02298478 . Trial registration date 3 November 2014."," Campos, D;  Bretón-López, J;  Botella, C;  Mira, A;  Castilla, D;  Baños, R;  Tortella-Feliu, M;  Quero, S",2016.0, 10.1186/s12888-016-0996-1,0,0,
1949,Personal resilience resources predict post-stem cell transplant cancer survivors' psychological outcomes through reductions in depressive symptoms and meaning-making.,"This longitudinal study examined whether post-transplant cancer survivors (N = 254, 9 months to 3 years after stem cell transplant treatment) with greater personal resilience resources demonstrated better psychological outcomes and whether this could be attributed to reductions in depressive symptoms and/or four meaning-making processes (searching for and finding reasons for one's illness; searching for and finding benefit from illness). Hierarchical linear regression analyses examined associations of survivors' baseline personal resilience resources (composite variable of self-esteem, mastery, and optimism), which occurred an average of 1.7 years after transplant, and 4-month changes in psychological outcomes highly relevant to recovering from this difficult and potentially traumatic treatment: post-traumatic stress disorder (PTSD) symptoms and purpose in life. Boot-strapped analyses tested mediation. Greater personal resilience resources predicted decreases in PTSD stress symptoms (b = -0.07, p = 0.005), mediated by reductions in depressive symptoms (b = -0.01, 95% CI: -0.027, -0.003) and in searching for a reason for one's illness (b = -0.01, 95% CI: -0.034, -0.0003). In addition, greater resilience resources predicted increases in purpose in life (b = 0.10, p < 0.001), mediated by reductions in depressive symptoms (b = 0.02, 95% CI: 0.003, 0.033). Having greater personal resilience resources may promote better psychological adjustment after a difficult cancer treatment, largely because of improvements in depressive symptoms, although decreased use of a potentially maladaptive form of meaning-making (searching for a reason for one's illness) was also important for reducing PTSD symptoms.",Campo RA.; Wu LM.; Austin J.; Valdimarsdottir H.; Rini C.,,10.1080/07347332.2017.1342306,0,0,
1950,Attentional bias modification in reducing test anxiety vulnerability: A randomized controlled trial.,"Background: A tendency to selectively process a threat to positive information may be involved in the etiology of anxiety disorders. The aim of this study is to examine whether attentional bias modification (ABM) can be used to modify high test-anxiety individuals' attention to emotional information and whether this change is related to anxiety vulnerability. Methods: Seventy-seven undergraduates were included: 28 individuals received a 5-day modified dot probe task as ABM training, 29 individuals received a 5-day classic dot probe task as placebo, and 20 individuals did not receive an intervention between the two test sections. In addition to the measure of biased attention, salivary alpha-amylase (sAA) and the visual analogue scale of anxiety were assessed as emotional reactivity to stress. Results: A repeated measurement of variance analysis and paired sample t-test indicated that the ABM group showed a significant change in attentional bias scores after the 5-day training, whereas there were no changes in the attentional bias scores in the placebo or waiting list groups. Importantly, anxiety vulnerability with attention to threats was significantly decreased in the training group. Conclusions: These results suggest that attentional bias toward threat stimuli may play an important role in anxiety vulnerability. The attentional bias modification away from the threat is effective for the individuals preparing for an exam. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Cai, Wenpeng; Pan, Yu; Chai, Huangyangzi; Cui, Yi; Yan, Jin; Dong, Wei; Deng, Guanghui",2018.0,,0,0,
1951,Prevention of post intensive care syndrome-family with sensation awareness focused training intervention: A randomized controlled trial pilot study.,"Post Intensive Care Syndrome-Family (PICS-F) refers to acute and chronic psychological effects of critical illness on family members of patients in intensive care units (ICU). Evidence about the increase and persistence of PICS-F warrants the need for prevention interventions. This study evaluated the feasibility of providing Sensation Awareness Focused Training (SAF-T) during the ICU stay for spouses of mechanically ventilated patients. Methods: A randomized controlled trial of SAF-T versus a control group was conducted (n=10) to assess safety, acceptability, feasibility, and effect size of the intervention on PICS-F symptoms. Symptoms assessed as outcome measures included stress, anxiety, depression, posttraumatic stress disorder, and sleep efficiency. Those randomly assigned to SAF-T received one session daily over 3-days in the ICU. Repeated measures (day 1, day 3, day 30, and day 90) of PICS-F symptoms in both groups were analyzed. Results: Mean age was 58 +/- 12 years; 70% were female. Feasibility success criteria were met in weekly recruitment (8 +/- 3.5), enrollment rate (67%), SAF-T acceptability (100% of doses received, no adverse events) with significantly lower post SAF-T stress levels (p<.05) compared to pre SAF-T stress levels, ActiWatch acceptability rate (90% agreed to wear, no adverse events) with no significant difference in sleep efficiency between groups (p>.05), and repeated measures completion rate (>90%). Conclusions: This study provided guidance for modifications to protocol outcome measures and evidence of a large effect size, which will inform a larger clinical trial to assess the effectiveness of the SAF-T intervention in reducing PICS-F. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Cairns, Paula L",2018.0,,0,0,
1952, Is higher formula intake and limited dietary diversity in Australian children at 14 months of age associated with dietary quality at 24 months?," A varied and diverse diet in childhood supports optimum long‐term preferences and growth. Previous analysis from 14‐month‐old Australian children in the NOURISH and South Australian Infants Dietary Intake (SAIDI) studies found higher formula intake was associated with lower dietary diversity. This analysis investigated whether formula intake and dietary diversity at 14 months of age is associated with dietary quality at 24 months. This is a secondary analysis of intake data from NOURISH and SAIDI cohorts. Scores for dietary diversity, fruit variety, vegetable variety and meat/alternative variety were combined using structural equation modelling to form the latent variable 'Dietary quality' (DQ) at age 24 months. A longitudinal model examined influence of formula (grams), cow's milk (grams) and dietary diversity at 14 months and covariates, on DQ. At age 24 months (n = 337) 27% of children obtained a maximum dietary diversity score (5/5). Variety scores were relatively low ‐ with mean variety scores (and possible range) being four for fruit (0‐30); five for vegetables (0‐36); and three for meat/alternatives (0‐8). Dietary diversity at 14 months (β = 0.19, p = 0.001), maternal age (β = 0.24, p < 0.001) and education (β = 0.22, p < 0.001) predicted DQ at 24 months while Child Food Neophobia Score was negatively associated with DQ (β = ‐0.30, p < 0.001). Formula intake was negatively associated with diversity at 14 months, but not DQ at 24. Diversity and variety were limited despite sociodemographic advantage of the sample. Diversity at 14 months, degree of neophobia and sociodemographic factors predicted DQ at 24 months. There is an ongoing need to emphasise the importance of repeated early exposure to healthy foods, such that children have the opportunity to learn to like a range of tastes and texture, thereby maximising dietary diversity and quality in infancy and early toddlerhood."," Byrne, R;  Yeo, MEJ;  Mallan, K;  Magarey, A;  Daniels, L",2018.0, 10.1016/j.appet.2017.09.002,0,0,
1953,"The Effect of Mulligan Mobilization Technique in Older Adults with Neck Pain: A Randomized Controlled, Double-Blind Study.","The purpose of this study was to examine the effect of Mulligan mobilization technique (MMT) on pain, range of motion (ROM), functional level, kinesiophobia, depression, and quality of life (QoL) in older adults with neck pain (NP). Forty-two older adults with NP were included in the study, and they were randomly divided into two groups: traditional physiotherapy (TP) group and traditional physiotherapy-Mulligan mobilization (TPMM) group. Treatment program was scheduled for 10 sessions. Participants were assessed in terms of pain, ROM, functional level, kinesiophobia, depression, and QoL both pre- and posttreatment. Pain, ROM, functional level, kinesiophobia, depression, and QoL improved in both groups following treatment (p < 0.05). When comparing effects of these two treatment programs, it was observed that the TPMM group had a better outcome (p < 0.05) in terms of ROM, kinesiophobia, depression, and QoL. In older adults with NP, MMT has been found to have significant effects on pain, ROM, functional level, kinesiophobia, depression, and QoL as long as it is performed by a specialist. ""This trial is registered with NCT03507907"".",Buyukturan O.; Buyukturan B.; Sas S.; Karartı C.; Ceylan İ.,2018.0,10.1155/2018/2856375,0,0,
1954," Cervical stability training with and without core stability training for patients with cervical disc herniation: a randomized, single-blind study"," BACKGROUND: This study aims at evaluating and comparing the effects of cervical stability training to combined cervical and core stability training in patients with neck pain and cervical disc herniation. // METHODS: Fifty patients with neck pain and cervical disc herniation were included in the study, randomly divided into two groups as cervical stability and cervical‚Äêcore stability. Training was applied three times a week in three phases, and lasted for a total duration of 8 weeks. Pain, activation and static endurance of deep cervical flexor muscles, static endurance of neck muscles, cross‚Äêsectional diameter of M. Longus Colli, static endurance of trunk muscles, disability and kinesiophobia were assessed. // RESULTS: Pain, activation and static endurance of deep cervical flexors, static endurance of neck muscles, cross‚Äêsectional diameter of M. Longus Colli, static endurance of trunk muscles, disability and kinesiophobia improved in both groups following the training sessions (p < 0.05). Comparison of the effectiveness of these two training methods revealed that the cervical stability group produced a greater increase in the right transverse diameter of M. Longus Colli (p < 0.05). However, static endurance of trunk muscles and kinesiophobia displayed better improvement in the cervical‚Äêcore stability group (p < 0.05). // CONCLUSIONS: Cervical stability training provided benefit to patients with cervical disc herniation. The addition of core stability training did not provide any additional significant benefit. Further research is required to investigate the efficacy of combining other techniques with cervical stability training in patients with cervical disc herniation. // SIGNIFICANCE: Both cervical stability training and its combination with core stability training were significantly and similarly effective on neck pain and neck muscle endurance in patients with cervical disc herniation."," Buyukturan, B;  Guclu-Gunduz, A;  Buyukturan, O;  Dadali, Y;  Bilgin, S;  Kurt, EE",2017.0, 10.1002/ejp.1073,0,0,
1955," Randomized Trial of ConquerFear: a Novel, Theoretically Based Psychosocial Intervention for Fear of Cancer Recurrence"," Purpose Fear of cancer recurrence (FCR) is prevalent, distressing, and long lasting. This study evaluated the impact of a theoretically/empirically based intervention (ConquerFear) on FCR. Methods Eligible survivors had curable breast or colorectal cancer or melanoma, had completed treatment (not including endocrine therapy) 2 months to 5 years previously, were age > 18 years, and had scores above the clinical cutoff on the FCR Inventory (FCRI) severity subscale at screening. Participants were randomly assigned at a one‚Äêto‚Äêone ratio to either five face‚Äêto‚Äêface sessions of ConquerFear (attention training, metacognitions, acceptance/mindfulness, screening behavior, and values‚Äêbased goal setting) or an attention control (Taking‚Äêit‚ÄêEasy relaxation therapy). Participants completed questionnaires at baseline (T0), immediately post‚Äêtherapy (T1), and 3 (T2) and 6 months (T3) later. The primary outcome was FCRI total score. Results Of 704 potentially eligible survivors from 17 sites and two online databases, 533 were contactable, of whom 222 (42%) consented; 121 were randomly assigned to intervention and 101 to control. Study arms were equivalent at baseline on all measured characteristics. ConquerFear participants had clinically and statistically greater improvements than control participants from T0 to T1 on FCRI total ( P < .001) and severity subscale scores ( P = .001), which were maintained at T2 ( P = .017 and P = .023, respectively) and, for FCRI total only, at T3 ( P = .018), and from T0 to T1 on three FCRI subscales (coping, psychological distress, and triggers) as well as in general anxiety, cancer‚Äêspecific distress (total), and mental quality of life and metacognitions (total). Differences in FCRI psychological distress and cancer‚Äêspecific distress (total) remained significantly different at T3. Conclusion This randomized trial demonstrated efficacy of ConquerFear compared with attention control (Taking‚Äêit‚ÄêEasy) in reduction of FCRI total scores immediately post‚Äêtherapy and 3 and 6 months later and in many secondary outcomes immediately post‚Äêtherapy. Cancer‚Äêspecific distress (total) remained more improved at 3‚Äê and 6‚Äêmonth follow‚Äêup."," Butow, PN;  Turner, J;  Gilchrist, J;  Sharpe, L;  Smith, AB;  Fardell, JE;  Tesson, S;  O'Connell, R;  Girgis, A;  Gebski, VJ;  et al.",2017.0, 10.1200/JCO.2017.73.1257,0,0,
1956,"Distinct common factor use among cognitive, behavioral, and psychodynamic psychotherapies.","A significant body of literature suggests the plausibility that non-specific factors or common factors of psychotherapy, regardless of the specific methods used, may play an important role in the outcome of psychotherapy. Research on common factors, however, has not accounted for the potential that common factors may be used differently by therapists depending on their theoretical orientation. Non-uniform common factor definitions and differing prescriptions for common factor use between psychotherapy modalities may account for some of the obfuscation of such research aims. Previous literature acknowledges the ubiquitous nature of common factors but has not yet explored the possibility that theoretical orientation or other variables may play a role in how common factors are used. The objective of the current study was to investigate the degree to which therapists of different theoretical orientations use each of the common factors and when they are used while conducting psychotherapy with patients who are diagnosed with panic disorder. The present study used archival data for 101 patients and 13 psychotherapists, collected from a randomized clinical trial (RCT) comparing the efficacy of three treatments for panic disorder (Milrod, Chambless, Gallop, Busch, Schwalberg, McCarthy, Gross, Sharpless, Leon, & Barber, 2015). Evidence was found that therapists of different theoretical orientations might use common factors of psychotherapy differently. Different therapy models tended to use certain factors more than others, however, all factors were used to at least some degree by each orientation. Some common factors may be more active in nature than others, which may have implications for how they are executed and how they are perceived by the patient. The current study also found evidence that use of certain common factors may influence different aspects of the therapeutic relationship. Discussion of the implications for training, practice, and future research follows. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Butman, David A",2017.0,,0,0,
1957,Pilot of a randomised controlled trial of the selective serotonin reuptake inhibitor sertraline versus cognitive behavioural therapy for anxiety symptoms in people with generalised anxiety disorder who have failed to respond to low-intensity psychological,"Generalised anxiety disorder (GAD) is common, causing unpleasant symptoms and impaired functioning. The National Institute for Health and Care Excellence (NICE) guidelines have established good evidence for low-intensity psychological interventions, but a significant number of patients will not respond and require more intensive step 3 interventions, recommended as either high-intensity cognitive behavioural therapy (CBT) or a pharmacological treatment such as sertraline. However, there are no head-to-head comparisons evaluating which is more clinically effective and cost-effective, and current guidelines suggest that treatment choice at step 3 is based mainly on patient preference. To assess clinical effectiveness and cost-effectiveness at 12 months of treatment with the selective serotonin reuptake inhibitor (SSRI) sertraline compared with CBT for patients with persistent GAD not improved with NICE-defined low-intensity psychological interventions. Participant randomised trial comparing treatment with sertraline with high-intensity CBT for patients with GAD who had not responded to low-intensity psychological interventions. Community-based recruitment from local Improving Access to Psychological Therapies (IAPT) services. Four pilot services located in urban, suburban and semirural settings. People considered likely to have GAD and not responding to low-intensity psychological interventions identified at review by IAPT psychological well-being practitioners (PWPs). Those scoring ≥ 10 on the Generalised Anxiety Disorder-7 (GAD-7) anxiety measure were asked to consider involvement in the trial. Aged ≥ 18 years, a score of ≥ 10 on the GAD-7, a primary diagnosis of GAD diagnosed on the Mini International Neuropsychiatric Interview questionnaire and failure to respond to NICE-defined low-intensity interventions. Inability to participate because of insufficient English or cognitive impairment, current major depression, comorbid anxiety disorder(s) causing greater distress than GAD, significant dependence on alcohol or illicit drugs, comorbid psychotic disorder, received antidepressants in past 8 weeks or high-intensity psychological therapy in previous 6 months and any contraindications to treatment with sertraline. Consenting eligible participants randomised via an independent, web-based, computerised system. (1) The SSRI sertraline prescribed in therapeutic doses by the patient's general practitioner for 12 months and (2) 14 (± 2) CBT sessions delivered by high-intensity IAPT psychological therapists in accordance with a standardised manual designed for GAD. The primary outcome was the Hospital Anxiety and Depression Scale - Anxiety component at 12 months. Secondary outcomes included measures of depression, social functioning, comorbid anxiety disorders, patient satisfaction and economic evaluation, collected by postal self-completion questionnaires. Only seven internal pilot participants were recruited against a target of 40 participants at 7 months. Far fewer potential participants were identified than anticipated from IAPT services, probably because PWPs rarely considered GAD the main treatment priority. Of those identified, three-quarters declined participation; the majority (30/45) were reluctant to consider the possibility of randomisation to medication. Poor recruitment was the main limiting factor, and the trial closed prematurely. It is unclear how much of the recruitment difficulty was a result of conducting the trial within a psychological therapy service and how much was possibly a result of difficulty identifying participants with primary GAD. It may be easier to answer this important question by recruiting people from primary care rather than from those already engaged in a psychological treatment service. Current Controlled Trials ISCRTN14845583. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 45. See the NIHR Journals Library website for further project information.",Buszewicz M.; Cape J.; Serfaty M.; Shafran R.; Kabir T.; Tyrer P.; Clarke CS.; Nazareth I.,2017.0,10.3310/hta21450,0,0,
1958,"Psychological, cognitive factors and contextual influences in pain and pain-related suffering as revealed by a combined qualitative and quantitative assessment approach","Previous psychophysiological research suggests that pain measurement needs to go beyond the assessment of Pain Intensity and Unpleasantness by adding the evaluation of Pain-Related Suffering. Based on this three-dimensional approach, we attempted to elucidate who is more likely to suffer by identifying reasons that may lead individuals to report Pain and Pain-Related Suffering more than others. A sample of 24 healthy participants (age range 18–33) underwent four different sessions involving the evaluation of experimentally induced phasic and tonic pain. We applied two decision tree models to identify variables (selected from psychological questionnaires regarding pain and descriptors from post-session interviews) that provided a qualitative characterization of the degrees of Pain Intensity, Unpleasantness and Suffering and assessed the respective impact of contextual influences. The overall classification accuracy of the decision trees was 75% for Intensity, 77% for Unpleasantness and 78% for Pain-Related Suffering. The reporting of suffering was predominantly associated with fear of pain and active cognitive coping strategies, pain intensity with bodily competence conveying strength and resistance and unpleasantness with the degree of fear of pain and catastrophizing. These results indicate that the appraisal of the three pain dimensions was largely determined by stable psychological constructs. They also suggest that individuals manifesting higher active coping strategies may suffer less despite enhanced pain and those who fear pain may suffer even under low pain. The second decision tree model revealed that suffering did not depend on pain alone, but that the complex rating-related decision making can be shifted by situational factors (context, emotional and cognitive). The impact of coping and fear of pain on individual Pain-Related Suffering may highlight the importance of improving cognitive coping strategies in clinical settings.",Bustan S.; Gonzalez-Roldan A.M.; Schommer C.; Kamping S.; Löffler M.; Brunner M.; Flor H.; Anton F.,2018.0,10.1371/journal.pone.0199814,0,0,
1959,Use of a two-phase process to identify possible cases of mental ill health in the UK military.,"Two-phase mental health screening methods, in which an abridged mental health measure is used to establish who should receive a more comprehensive assessment, may be more efficient and acceptable to respondents than a stand-alone complete questionnaire. Such two-phase methods are in use in US armed forces post-deployment mental health screening. This study assesses the sensitivity and specificity of abridged instruments (used in the first phase) compared to the full instruments (the second phase), and whether false negative cases resulting from the use of abridged tests were detected by another test, among a UK military screening sample. Data from a group of UK Armed Forces personnel (n = 1464) who had completed full questionnaires assessing symptoms of post-traumatic stress disorder (PTSD) (PTSD Checklist - Civilian Version, PCL-C) and alcohol misuse (Alcohol Use Disorder Identification Test, AUDIT) were used. An abridged version of the PCL-C performed well in discriminating potential PTSD cases (as measured by the full instrument); AUDIT showed less discriminatory power, particularly due to poor specificity. Many cases missed by one abridged test would have been detected by an alternative test. Thus two-phase screening designs reduce the resource burden of a project without substantial loss of sensitivity for PTSD, but are less effective in discriminating potential cases of alcohol misuse. Copyright © 2016 John Wiley & Sons, Ltd.",Burdett H.; Fear NT.; Jones N.; Greenberg N.; Wessely S.; Rona RJ.,2016.0,10.1002/mpr.1501,0,0,
1960, Transgenerational trauma in a post-conflict setting: effects on offspring PTSS/PTSD and offspring vulnerability in Cambodian families," We assessed transgenerational effects of maternal traumatic exposure, posttraumatic stress symptoms and posttraumatic stress disorder on trauma‚Äêrelated symptoms in Cambodian offspring born after the genocidal Khmer Rouge Regime. We conducted a randomized cross‚Äêsectional study. N=378 mothers from 4 provinces of the country and one of each of their grown‚Äêup children were interviewed. Lifetime traumatic exposure was determined using a context‚Äêadapted event list. Present posttraumatic stress symptoms and a potential posttraumatic stress disorder were assessed using the civilian version of the Posttraumatic Stress Disorder Checklist. We found no indication of transgenerational effects that were directly related to maternal traumatic exposure, posttraumatic stress symptoms or posttraumatic stress disorder. Instead, a gender‚Äêspecific moderating effect was found. Individual traumatic exposure had a stronger effect on posttraumatic stress symptoms in daughters, the higher the mother's lifetime traumatic exposure. There is evidence of an interaction between lifetime traumatic exposure of mothers and their offspring that can be interpreted as an increased vulnerability to symptoms of posttraumatic stress in daughters. The mechanisms of transgenerational trauma in the Cambodian context require further research, as learning from previous conflicts will be instructive when addressing the pressing humanitarian needs of today's world."," Burchert, S;  Stammel, N;  Knaevelsrud, C",2017.0, 10.1016/j.psychres.2017.04.033,0,0,
1961,Associations between PTSD and intimate partner and non-partner aggression among substance using veterans in specialty mental health.,"Risk factors of violence perpetration in veterans include substance use and posttraumatic stress disorder (PTSD); however, it is unknown whether these factors are associated with greater risk for partner or non-partner violence. This study investigated the associations between probable PTSD, heavy drinking, marijuana use, cocaine use, and partner and non-partner violence perpetration. Self-report questionnaires assessing past-year partner and non-partner aggression (CTS2) as well as past-month substance use (SAOM), probable PTSD (PCL-C), and probable depression (PHQ-9) were administered to 810 substance using veterans entering VA mental health treatment. In bivariate analyses, probable PTSD in substance using veterans was associated with violence perpetration (partner physical, χ2=11.46, p=0.001, φ=0.12; non-partner physical, χ2=50.64, p<0.001, φ=0.25; partner injury, χ2=6.41, p=0.011, φ=0.09; non-partner injury, χ2=42.71, p<0.001, φ=0.23). In multiple logistic regression analyses that adjusted for sociodemographic characteristics, probable PTSD was independently associated with non-partner physical (odds ratio [OR], 2.82; 95% confidence interval [CI], 1.97-4.05) and injury aggression (OR, 3.96; CI, 2.56-6.13). Cocaine and heavy drinking were independently associated with non-partner physical and injury aggression and non-partner injury aggression respectively. The results provide evidence that probable PTSD, heavy drinking, and cocaine use are associated with increased risk of non-partner violence perpetration in substance using veterans. These results underscore the importance of screening for PTSD symptoms and violence perpetration towards non-partners in substance using veterans presenting for treatment.",Buchholz KR.; Bohnert KM.; Sripada RK.; Rauch SA.; Epstein-Ngo QM.; Chermack ST.,2017.0,10.1016/j.addbeh.2016.08.039,0,0,
1962,Effectiveness of a brief behavioural intervention on psychological distress among women with a history of gender-based violence in urban Kenya: A randomised clinical trial.,"Gender-based violence (GBV) represents a major cause of psychological morbidity worldwide, and particularly in low- and middle-income countries (LMICs). Although there are effective treatments for common mental disorders associated with GBV, they typically require lengthy treatment programs that may limit scaling up in LMICs. The aim of this study was to test the effectiveness of a new 5-session behavioural treatment called Problem Management Plus (PM+) that lay community workers can be taught to deliver. In this single-blind, parallel, randomised controlled trial, adult women who had experienced GBV were identified through community screening for psychological distress and impaired functioning in Nairobi, Kenya. Participants were randomly allocated in a 1:1 ratio either to PM+ delivered in the community by lay community health workers provided with 8 days of training or to facility-based enhanced usual care (EUC) provided by community nurses. Participants were aware of treatment allocation, but research assessors were blinded. The primary outcome was psychological distress as measured by the total score on the 12-item General Health Questionnaire (GHQ-12) assessed at 3 months after treatment. Secondary outcomes were impaired functioning (measured by the WHO Disability Adjustment Schedule [WHODAS]), symptoms of posttraumatic stress (measured by the Posttraumatic Stress Disorder Checklist [PCL]), personally identified problems (measured by Psychological Outcome Profiles [PSYCHLOPS]), stressful life events (measured by the Life Events Checklist [LEC]), and health service utilisation. Between 15 April 2015 and 20 August 2015, 1,393 women were screened for eligibility on the basis of psychological distress and impaired functioning. Of these, 518 women (37%) screened positive, of whom 421 (81%) were women who had experienced GBV. Of these 421 women, 209 were assigned to PM+ and 212 to EUC. Follow-up assessments were completed on 16 January 2016. The primary analysis was intention to treat and included 53 women in PM+ (25%) and 49 women in EUC (23%) lost to follow-up. The difference between PM+ and EUC in the change from baseline to 3 months on the GHQ-12 was 3.33 (95% CI 1.86-4.79, P = 0.001) in favour of PM+. In terms of secondary outcomes, for WHODAS the difference between PM+ and EUC in the change from baseline to 3-month follow-up was 1.96 (95% CI 0.21-3.71, P = 0.03), for PCL it was 3.95 (95% CI 0.06-7.83, P = 0.05), and for PSYCHLOPS it was 2.15 (95% CI 0.98-3.32, P = 0.001), all in favour of PM+. These estimated differences correspond to moderate effect sizes in favour of PM+ for GHQ-12 score (0.57, 95% CI 0.32-0.83) and PSYCHLOPS (0.67, 95% CI 0.31-1.03), and small effect sizes for WHODAS (0.26, 95% CI 0.02-0.50) and PCL (0.21, 95% CI 0.00-0.41). Twelve adverse events were reported, all of which were suicidal risks detected during screening. No adverse events were attributable to the interventions or the trial. Limitations of the study include no long-term follow-up, reliance on self-report rather than structured interview data, and lack of an attention control condition. Among a community sample of women in urban Kenya with a history of GBV, a brief, lay-administered behavioural intervention, compared with EUC, resulted in moderate reductions in psychological distress at 3-month follow-up. Australian New Zealand Clinical Trials Registry ACTRN12614001291673.",Bryant RA.; Schafer A.; Dawson KS.; Anjuri D.; Mulili C.; Ndogoni L.; Koyiet P.; Sijbrandij M.; Ulate J.; Harper Shehadeh M.; Hadzi-Pavlovic D.; van Ommeren M.,2017.0,10.1371/journal.pmed.1002371,0,0,
1963,Activating attachment representations impact how we retrieve autobiographical memories,"Although much research indicates that proximity to attachment figures confers many psychological benefits, there is little evidence pertaining to how attachment activation may impact autobiographical memory retrieval. Following a negative mood induction to elicit overgeneral autobiographical retrieval, participants (N‚Äâ=‚Äâ70) were administered an induction in which they imagined a person who is a strong attachment figure or an acquaintance. Participants then completed an autobiographical memory task to retrieve memories in response to neutral and negative cue words. Attachment priming resulted in less distress, increased retrieval of specific memories, and reduced retrieval of categoric memories. These findings indicate that activation of mental representations of attachment figures can impact on the specificity of autobiographical memory retrieval, and extends prevailing models of autobiographical memory by integrating them with attachment theory.",Bryant R.A.; Bali A.,2018.0,10.1080/09658211.2017.1367404,0,0,
1964,The range and impact of postmigration stressors during treatment of trauma-affected refugees.,"Trauma-affected refugees commonly experience postmigration stressors, which can compound conflict-related emotional distress. Our study aimed to assess clinician-rated frequency and types of postmigration stressors deemed to be interfering with the treatment of refugees attending a service for trauma-related mental distress. A total of 116 patients completed 6 months of multidisciplinary treatment. Clinician-rated postmigration stressors were registered at each session. Outcome measures were Harvard Trauma Questionnaire and Global Assessment of Functioning, function (GAF-F) and symptom. Postmigration stressors were deemed to impact on 39.1% of treatment sessions with medical personnel. Issues related to work, finances, and family were the most frequently identified stressors. Postmigration stressors interfering with treatment were more common among male refugees, those living alone, those from Middle Eastern origin, and persons with low baseline GAF-F. Explicitly identifying and, where possible, dealing with postmigration stressors may assist in averting their interference with the treatment of distress in refugees. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Bruhn, Maja; Rees, Susan; Mohsin, Mohammed; Silove, Derrick; Carlsson, Jessica",2018.0,,0,0,
1965, Influence of Sleep Disturbance on Global Functioning After Posttraumatic Stress Disorder Treatment," Chronic insomnia and recurrent nightmares are prominent features of posttraumatic stress disorder (PTSD). Evidence from adult research indicates that these sleep disturbances do not respond as well to cognitive‚Äêbehavioral therapies for PTSD and are associated with poorer functional outcomes. This study examined the effect of prolonged exposure therapy for adolescents versus client‚Äêcentered therapy on posttraumatic sleep disturbance, and the extent to which sleep symptoms impacted global functioning among adolescents with sexual abuse‚Äêrelated PTSD. Participants included 61 adolescent girls seeking treatment at a rape crisis center. The Child PTSD Symptom Scale‚ÄêInterview (Foa, Johnson, Feeny, & Treadwell, 2001) was used to assess PTSD diagnosis and severity of symptoms, including insomnia and nightmares. The Children's Global Assessment Scale (Shaffer et al., 1983) was used to assess global functioning. There were significant main effects of time and treatment on insomnia symptoms. Additionally, there was a main effect of time on nightmares. Results also showed that insomnia and nightmares significantly predicted poorer global functioning posttreatment (R"," Brownlow, JA;  McLean, CP;  Gehrman, PR;  Harb, GC;  Ross, RJ;  Foa, EB",2016.0, 10.1002/jts.22139,0,0,
1966, The Stroke and Carer Optimal Health Program (SCOHP) to enhance psychosocial health: study protocol for a randomized controlled trial," BACKGROUND: Stroke is a leading cause of disability and distress, and often profoundly affects the quality of life of stroke survivors and their carers. With the support of carers, many stroke survivors are returning to live in the community despite the presence of disability and ongoing challenges. The sudden and catastrophic changes caused by stroke affects the mental, emotional and social health of both stroke survivors and carers. The aim of this study is to evaluate a Stroke and Carer Optimal Health Program (SCOHP) that adopts a person‚Äêcentred approach and engages collaborative therapy to educate, support and improve the psychosocial health of stroke survivors and their carers. METHODS: This study is a prospective randomised controlled trial. It will include a total of 168 stroke survivors and carers randomly allocated into an intervention group (SCOHP) or a control group (usual care). Participants randomised to the intervention group will receive nine (8‚Äâ+‚Äâ1 booster) sessions guided by a structured workbook. The primary outcome measures for stroke survivors and carers will be health‚Äêrelated quality of life (AQoL‚Äê6D and EQ‚Äê5D) and self‚Äêefficacy (GSE). Secondary outcome measures will include: anxiety and depression (HADS); coping (Brief COPE); work and social adjustment (WSAS); carer strain (MCSI); carer satisfaction (CASI); and treatment evaluation (TEI‚ÄêSF and CEQ). Process evaluation and a health economic cost analysis will also be conducted. DISCUSSION: We believe that this is an innovative intervention that engages the stroke survivor and carer and will be significant in improving the psychosocial health, increasing independence and reducing treatment‚Äêrelated costs in this vulnerable patient‚Äêcarer dyad. In addition, we expect that the intervention will assist carers and stroke survivors to negotiate the complexity of health services across the trajectory of care and provide practical skills to improve self‚Äêmanagement. TRIAL REGISTRATION: ACTRN12615001046594 . Registered on 7 October 2015."," Brasier, C;  Ski, CF;  Thompson, DR;  Cameron, J;  O'Brien, CL;  Lautenschlager, NT;  Gonzales, G;  Hsueh, YS;  Moore, G;  Knowles, SR;  et al.",2016.0, 10.1186/s13063-016-1559-y,0,0,
1967,Investigating the relationship between competence and patient outcome with CBT.,"Little is understood about the relationship between therapist competence and the outcome of patients treated for common mental health disorders. Understanding the relationship between competence and patient outcome is of fundamental importance to the dissemination and implementation of Cognitive Behavioural Therapy (CBT). The current study extends existing literature by exploring the relationship between CBT competence and patient outcome in routine clinical practice within the framework of the British Government's Improving Access to Psychological Therapies (IAPT) programme. Participants comprised 43 therapists treating 1247 patients over a training period of one year. Results found little support of a general association between CBT competence and patient outcome; however significantly more patients of the most competent therapists demonstrated a reliable improvement in their symptoms of anxiety than would be expected by chance alone, and fewer experienced no reliable change. Conversely, significantly more patients treated by the least competent therapists experienced a reliable deterioration in their symptoms than would be expected. The implications of these results for the dissemination and implementation of CBT are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Branson, Amanda; Shafran, Roz; Myles, Pamela",2015.0,http://dx.doi.org/10.1016/j.brat.2015.03.002,0,0,
1968," The second Randomised Evaluation of the Effectiveness, cost-effectiveness and Acceptability of Computerised Therapy (REEACT-2) trial: does the provision of telephone support enhance the effectiveness of computer-delivered cognitive behaviour therapy? A randomised controlled trial"," BACKGROUND: Computerised cognitive behaviour therapy (cCBT) is an efficient form of therapy potentially improving access to psychological care. Indirect evidence suggests that the uptake and effectiveness of cCBT can be increased if facilitated by telephone, but this is not routinely offered in the NHS. OBJECTIVES: To compare the clinical effectiveness and cost‚Äêeffectiveness of telephone‚Äêfacilitated free‚Äêto‚Äêuse cCBT [e.g. MoodGYM (National Institute for Mental Health Research, Australian National University, Canberra, ACT, Australia)] with minimally supported cCBT. DESIGN: This study was a multisite, pragmatic, open, two‚Äêarm, parallel‚Äêgroup randomised controlled trial with a concurrent economic evaluation. SETTING: Participants were recruited from GP practices in Bristol, Manchester, Sheffield, Hull and the north‚Äêeast of England. PARTICIPANTS: Potential participants were eligible to participate in the trial if they were adults with depression scoring ‚â•‚Äâ10 on the Patient Health Questionnaire‚Äê9 (PHQ‚Äê9). INTERVENTIONS: Participants were randomised using a computer‚Äêgenerated random number sequence to receive minimally supported cCBT or telephone‚Äêfacilitated cCBT. Participants continued with usual general practitioner care. MAIN OUTCOME MEASURES: The primary outcome was self‚Äêreported symptoms of depression, as assessed by the PHQ‚Äê9 at 4 months post randomisation. SECONDARY OUTCOMES: Secondary outcomes were depression at 12 months and anxiety, somatoform complaints, health utility (as assessed by the European Quality of Life‚Äê5 Dimensions questionnaire) and resource use at 4 and 12 months. RESULTS: Clinical effectiveness: 182 participants were randomised to minimally supported cCBT and 187 participants to telephone‚Äêfacilitated cCBT. There was a difference in the severity of depression at 4 and 12 months, with lower levels in the telephone‚Äêfacilitated group. The odds of no longer being depressed (defined as a PHQ‚Äê9 score of <‚Äâ10) at 4 months were twice as high in the telephone‚Äêfacilitated cCBT group [odds ratio (OR) 2.05, 95% confidence interval (CI) 1.23 to 3.42]. The benefit of telephone‚Äêfacilitated cCBT was no longer significant at 12 months (OR 1.63, 95% CI 0.98 to 2.71). At 4 months the between‚Äêgroup difference in PHQ‚Äê9 scores was 1.9 (95% CI 0.5 to 3.3). At 12 months the results still favoured telephone‚Äêfacilitated cCBT but were no longer statistically significant, with a difference in PHQ‚Äê9 score of 0.9 (95% CI ‚Äê0.5 to 2.3). When considering the whole follow‚Äêup period, telephone‚Äêfacilitated cCBT was asssociated with significantly lower PHQ‚Äê9 scores than minimally supported cCBT (mean difference ‚Äê1.41, 95% CI ‚Äê2.63 to ‚Äê0.17; CONCLUSIONS: The results showed short‚Äêterm benefits from the addition of telephone facilitation to cCBT. The effect was small to moderate and comparable with that of other primary care psychological interventions. Telephone facilitation should be considered when offering cCBT for depression. LIMITATIONS: Participants' depression was assessed with the PHQ‚Äê9, cCBT use was quite low and there was a slightly greater than anticipated loss to follow‚Äêup. FUTURE RESEARCH RECOMMENDATIONS: Improve the acceptability of cCBT and its capacity to address coexisting disorders. Large‚Äêscale pragmatic trials of cCBT with bibliotherapy and telephone‚Äêbased interventions are required. TRIAL REGISTRATION: Current Controlled Trials ISRCTN55310481. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in"," Brabyn, S;  Araya, R;  Barkham, M;  Bower, P;  Cooper, C;  Duarte, A;  Kessler, D;  Knowles, S;  Lovell, K;  Littlewood, E;  et al.",2016.0, 10.3310/hta20890,0,0,
1969, Comparison of Two Types of Meditation on Patients' Psychosocial Responses During Radiation Therapy for Head and Neck Cancer," OBJECTIVES: Radiation treatment for head and neck cancer introduces adaptive demands and subjects patients to significant and unique psychosocial challenges. There is growing evidence that meditation is useful in lessening anxiety and depression in cancer patients. This study compared the effects of two types of meditation training on the psychological responses of patients with head and neck cancer during radiation therapy. DESIGN: Randomized clinical trial. SETTING: Smilow Cancer Hospital at Yale New Haven. PATIENTS: A total of 29 patients with head and neck cancers were recruited and 28 patients were followed during their radiation therapy over 12 weeks. INTERVENTIONS: Depending on their group assignment, patients were taught one of two standardized meditations: meditation with a coach or self‚Äêmeditation with a CD. OUTCOME MEASURES: Patient psychosocial responses were defined as anxiety, depression, and emotional distress and were measured by the Hospital and Anxiety Depression Scale (HADS) and the Emotional Distress Thermometer. Measures were self‚Äêreported and collected by the nurse manager at baseline and 6 and 12 weeks during the patient's scheduled weekly visit. RESULTS: No significant mean differences were found between the two meditation groups on all three outcomes: anxiety, depression, and emotional distress. Patients in both the meditation with a coach and self‚Äêmeditation with a CD groups reported less distress from baseline and at 6 and 12 weeks, as evidenced by the HADS anxiety scale. CONCLUSIONS: This study demonstrated two equally effective meditation techniques that can be implemented with patients experiencing high stress during radiation treatments in any health care setting to decrease patient anxiety, depression, and emotional distress. The data established self‚Äêmeditation with a CD as a more cost‚Äêeffective alternative to meditation with a coach, which requires intensive training and time commitment for patients."," Boxleitner, G;  Jolie, S;  Shaffer, D;  Pasacreta, N;  Bai, M;  McCorkle, R",2017.0, 10.1089/acm.2016.0214,0,0,
1970,Negative religious coping as a mediator of trauma symptoms in older survivors.,"Forty-three spiritually distressed older women (aged 55-83) who had survived multiple types of interpersonal trauma participated in a spiritually focused group intervention designed to address spiritual struggles related to earlier abuse and to enhance spiritual coping. It was hypothesized that the intervention would increase spiritual well-being and that religious/spiritual coping would mediate the relationship between the intervention and the outcomes of depression, posttraumatic stress, anxiety, somatic symptoms, and spiritual well-being. The results provide strong initial support for the importance of understanding the effect of negative religious/spiritual coping on depression and anxiety symptoms in older religious survivors of interpersonal trauma. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bowland, Sharon; Edmond, Tonya; Fallot, Roger D",2013.0,http://dx.doi.org/10.1080/15528030.2012.739989,0,0,
1971,Treatment of co-occurring posttraumatic stress disorder and substance use: Does order of onset influence outcomes?,"Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) represent major public health concerns, particularly among veterans. They are associated with significant distress and impairment, and are highly comorbid. Little is known, however, about what role the temporal order of diagnostic onset may play in severity of presenting symptomatology and treatment outcomes. The aim of this study, therefore, was to examine treatment outcomes by order of onset. Participants were 46 U.S. military veterans (91.3% male) enrolled in a larger randomized controlled trial examining the efficacy of an integrated, exposure-based treatment (Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure; COPE). Participants were grouped into 2 categories: (a) primary PTSD (i.e., PTSD developed before the onset of SUD) or (b) primary SUD (i.e., SUD developed before the onset of PTSD). No significant associations between order of onset and baseline symptomatology were observed. The findings revealed that participants with primary PTSD were significantly more likely than participants with primary SUD to report higher levels of PTSD symptoms at the end of treatment. However, there was no effect of order of onset on SUD outcomes. The findings suggest that individuals with earlier PTSD onset are a particularly high-risk group in terms of their trauma-related symptoms. Implications for treatment of comorbid PTSD/SUD are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).",Bountress KE.; Badour C.; Flanagan J.; Gilmore AK.; Back SE.,2018.0,10.1037/tra0000309,0,0,
1972, Virtual reality compared with, null," Bouchard, S;  Dumoulin, S;  Robillard, G;  Guitard, T;  Klinger, É;  Forget, H;  Loranger, C;  Roucaut, FX",2017.0, 10.1192/bjp.bp.116.184234,0,0,
1973,Mindfulness On-The-Go: Effects of a Mindfulness Meditation App on Work Stress and Well-Being,"We investigated whether a mindfulness meditation program delivered via a smartphone application could improve psychological well-being, reduce job strain, and reduce ambulatory blood pressure during the workday. Participants were 238 healthy employees from two large United Kingdom companies that were randomized to a mindfulness meditation practice app or a wait-list control condition. The app offered 45 prerecorded 10- to 20-min guided audio meditations. Participants were asked to complete one meditation per day. Psychosocial measures and blood pressure throughout one working day were measured at baseline and eight weeks later; a follow-up survey was also emailed to participants 16 weeks after the intervention start. Usage data showed that during the 8-week intervention period, participants randomized to the intervention completed an average of 17 meditation sessions (range 0-45 sessions). The intervention group reported significant improvement in well-being, distress, job strain, and perceptions of workplace social support compared to the control group. In addition, the intervention group had a marginally significant decrease in self-measured workday systolic blood pressure from pre- to postintervention. Sustained positive effects in the intervention group were found for well-being and job strain at the 16-week follow-up assessment. This trial suggests that short guided mindfulness meditations delivered via smartphone and practiced multiple times per week can improve outcomes related to work stress and well-being, with potentially lasting effects.",Bostock S.; Crosswell A.D.; Prather A.A.; Steptoe A.,2018.0,10.1037/ocp0000118,0,0,
1974,CollAborative care for Screen-Positive EldeRs with major depression (CASPER plus): a multicentred randomised controlled trial of clinical effectiveness and cost-effectiveness.,"Depression in older adults is common and is associated with poor quality of life, increased morbidity and early mortality, and increased health and social care use. Collaborative care, a low-intensity intervention for depression that is shown to be effective in working-age adults, has not yet been evaluated in older people with depression who are managed in UK primary care. The CollAborative care for Screen-Positive EldeRs (CASPER) plus trial fills the evidence gap identified by the most recent guidelines on depression management. To establish the clinical effectiveness and cost-effectiveness of collaborative care for older adults with major depressive disorder in primary care. A pragmatic, multicentred, two-arm, parallel, individually randomised controlled trial with embedded qualitative study. Participants were automatically randomised by computer, by the York Trials Unit Randomisation Service, on a 1 : 1 basis using simple unstratified randomisation after informed consent and baseline measures were collected. Blinding was not possible. Sixty-nine general practices in the north of England. A total of 485 participants aged ≥ 65 years with major depressive disorder. A low-intensity intervention of collaborative care, including behavioural activation, delivered by a case manager for an average of six sessions over 7-8 weeks, alongside usual general practitioner (GP) care. The control arm received only usual GP care. The primary outcome measure was Patient Health Questionnaire-9 items score at 4 months post randomisation. Secondary outcome measures included depression severity and caseness at 12 and 18 months, the EuroQol-5 Dimensions, Short Form questionnaire-12 items, Patient Health Questionnaire-15 items, Generalised Anxiety Disorder-7 items, Connor-Davidson Resilience Scale-2 items, a medication questionnaire, objective data and adverse events. Participants were followed up at 12 and 18 months. In total, 485 participants were randomised (collaborative care, n = 249; usual care, n = 236), with 390 participants (80%: collaborative care, 75%; usual care, 86%) followed up at 4 months, 358 participants (74%: collaborative care, 70%; usual care, 78%) followed up at 12 months and 344 participants (71%: collaborative care, 67%; usual care, 75%) followed up at 18 months. A total of 415 participants were included in primary analysis (collaborative care, n = 198; usual care, n = 217), which revealed a statistically significant effect in favour of collaborative care at the primary end point at 4 months [8.98 vs. 10.90 score points, mean difference 1.92 score points, 95% confidence interval (CI) 0.85 to 2.99 score points; p  < 0.001], equivalent to a standard effect size of 0.34. However, treatment differences were not maintained in the longer term (at 12 months: 0.19 score points, 95% CI -0.92 to 1.29 score points; p = 0.741; at 18 months: < 0.01 score points, 95% CI -1.12 to 1.12 score points; p = 0.997). The study recorded details of all serious adverse events (SAEs), which consisted of 'unscheduled hospitalisation', 'other medically important condition' and 'death'. No SAEs were related to the intervention. Collaborative care showed a small but non-significant increase in quality-adjusted life-years (QALYs) over the 18-month period, with a higher cost. Overall, the mean cost per incremental QALY for collaborative care compared with usual care was £26,016; however, for participants attending six or more sessions, collaborative care appears to represent better value for money (£9876/QALY). Study limitations are identified at different stages: design (blinding unfeasible, potential contamination), process (relatively low overall consent rate, differential attrition/retention rates) and analysis (no baseline health-care resource cost or secondary/social care data). Collaborative care was effective for older people with case-level depression across a range of outcomes in the short term though the reduction in depression severity was not maintained over the longer term of 12 or 18 months. Participants who received six or more sessions of collaborative care did benefit substantially more than those who received fewer treatment sessions but this difference was not statistically significant. Recommendations for future research include investigating the longer-term effect of the intervention. Depression is a recurrent disorder and it would be useful to assess its impact on relapse and the prevention of future case-level depression. Current Controlled Trials ISRCTN45842879. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 67. See the NIHR Journals Library website for further project information.",Bosanquet K.; Adamson J.; Atherton K.; Bailey D.; Baxter C.; Beresford-Dent J.; Birtwistle J.; Chew-Graham C.; Clare E.; Delgadillo J.; Ekers D.; Foster D.; Gabe R.; Gascoyne S.; Haley L.; Hamilton J.; Hargate R.; Hewitt C.; Holmes J.; Keding A.; Lewis H.; McMillan D.; Meer S.; Mitchell N.; Nutbrown S.; Overend K.; Parrott S.; Pervin J.; Richards DA.; Spilsbury K.; Torgerson D.; Traviss-Turner G.; Trépel D.; Woodhouse R.; Gilbody S.,2017.0,10.3310/hta21670,0,0,
1975,Identity challenges and 'burden of normality' after DBS for severe OCD: A narrative case study.,"Background: Deep Brain Stimulation (DBS) is an emerging and potentially powerful biological treatment for severe Obsessive-Compulsive Disorder (OCD), but the wider impact of the intervention and the sometimes dramatic reduction in symptoms need greater attention in research and practice. The aim of this case study is to explore the subjective experience of preparing for and undergoing DBS as a treatment for severe and treatment-refractory OCD and the experience of the impact of the treatment. Methods: This study of subjective experience before and after DBS is based on narrative analysis of two in-depth interviews conducted in November 2014 (1 year after DBS surgery) with a 30-year-old man and his father, utilizing Consolidated Criteria for Reporting Qualitative Studies (COREQ) criteria. Results: The parallel stories show how OCD posed severe challenges to identity and social milestones, with profound positive and negative impact on the person and family. Yet symptom remission was accompanied by expanded horizons, but also by uncertainty and intense distress associated with the changed identity. Discussion: The concept of 'burden of normality' is discussed, in light of a treatment experience with DBS for OCD that gives rise to a new array of life challenges and opportunities, with implications for clinical care. Conclusions: The concept of burden of normality has, thus far, not extended to evaluations of people who have had DBS for severe OCD and that of their lived experience and recovery trajectory thereafter. This concept highlights that there is work to be done on expectations of normal living and on the transitioning self-concept, in the post-surgical period. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Bosanac, Peter; Hamilton, Bridget Elizabeth; Lucak, James; Castle, David",2018.0,,0,0,
1976,Therapist-Client Language Matching: Initial Promise as a Measure of Therapist-Client Relationship Quality,"While research suggests that the therapeutic alliance is important in predicting outcomes of psychotherapy, relatively little is known about the development of the alliance or the moment-to-moment components of the relationship and how they combine to create an alliance, which may represent a serious limitation in existing methods of measurement. Language style matching (LSM), or the degree to which unconscious aspects of an interactional partner's language mimic that of the other partner, is a promising, unobtrusive measure of interaction quality that could provide novel insight into the therapist- client alliance. In this article, we present a theoretical argument regarding the trajectory of therapist- client LSM across therapy sessions, as well as potential precursors and consequences of LSM. We then report on a pilot test of our hypotheses that examined how LSM, clients' relational histories, and clients' symptoms were associated within a therapeutic context. Using a small sample of substance dependent mothers (N = 7, 100% Caucasian women) enrolled in a randomized controlled trial of psychodynamic psychotherapy lasting 12 sessions, we examined client and therapist LSM across 4 of the 12 sessions. We found that, on average, LSM decreases over the course of treatment. Furthermore, greater client interpersonal problems prospectively predict lower early LSM in therapist- client dyads, which in turn predicts greater posttreatment psychiatric distress. Results generate questions for future research and support further investigations of LSM as one index of the quality of interactions between therapist and client.",Borelli J.L.; Sohn L.; Wang B.A.; Hong K.; DeCoste C.; Suchman N.E.,2018.0,10.1037/pap0000177,0,0,
1977, Language and hope in schizophrenia-spectrum disorders," Hope is integral to recovery for those with schizophrenia. Considering recent advancements in the examination of clients' lexical qualities, we were interested in how clients' words reflect hope. Using computerized lexical analysis, we examined social, emotion, and future words' relations to hope and its pathways and agency components. Forty‚Äêfive clients provided detailed narratives about their life and mental illness. Transcripts were analyzed using the Linguistic Inquiry and Word Count program (LIWC), which assigns words to categories (e.g., ""anxiety"") based on a pre‚Äêexisting dictionary. Correlations and linear multiple regression were used to examine relationships between lexical qualities and hope. Hope and its subcomponents had significant or trending bivariate correlations in expected directions with several emotion‚Äêrelated word categories (anger and sadness) but were not associated with expected categories such as social words, positive emotions, optimism, achievement, and future words. In linear multiple regressions, no LIWC variable significantly predicted hope agency, but anger words significantly predicted both total hope and hope pathways. Our findings indicate lexical analysis tools can be used to investigate recovery‚Äêoriented concepts such as hope, and results may inform clinical practice. Future research should aim to replicate our findings in larger samples."," Bonfils, KA;  Luther, L;  Firmin, RL;  Lysaker, PH;  Minor, KS;  Salyers, MP",2016.0, 10.1016/j.psychres.2016.08.013,0,0,
1978,"Metacognition, Personal Distress, and Performance-Based Empathy in Schizophrenia","Background: People with schizophrenia experience significant deficits in the kinds of empathic skills that are the foundation for interpersonal relationships. Researchers have speculated that deficits in empathic skills in schizophrenia may be related to disturbances in metacognition and heightened levels of personal distress. To explore this issue, this study examined whether better metacognition and reduced personal distress would be associated with improved performance on cognitive and affective empathy tasks. Further, we tested whether metacognition moderated the relationship between personal distress and empathy. Method: Fifty-eight participants with schizophrenia-spectrum disorders receiving community-based treatment completed a self-report questionnaire of personal distress, a performance-based measure of empathy, and an observer-rated interview to assess metacognitive capacity. Results: Correlation analyses revealed that metacognitive capacity, but not personal distress, was significantly associated with cognitive and affective empathy performance. Moderation results suggest the relationship between personal distress and affective empathy performance was significant for those with low metacognition, but that the relationship was the opposite of hypotheses-increased personal distress predicted better performance. This relationship changed at higher levels of metacognition, when increased personal distress became associated with reduced performance. Conclusions: This study is the first of its kind to examine performance-based empathy with metacognition and personal distress. Results suggest interventions targeted to improve metacognition may be useful in enhancing empathic skills.",Bonfils K.A.; Lysaker P.H.; Minor K.S.; Salyers M.P.,2019.0,10.1093/schbul/sby137,0,0,
1979,Recovery programme for ICU survivors has no effect on relatives' quality of life: Secondary analysis of the RAPIT-study.,"Relatives of intensive care patients are at risk of developing symptoms of anxiety, depression and posttraumatic stress resulting in reduced health-related quality of life. Recovery programmes for patients have been implemented, but their effect on relatives is uncertain. To determine whether relatives benefit from a recovery programme intended for intensive care survivors. A randomised controlled trial of 181 adult relatives: intervention group (n‚ÄØ=‚ÄØ87), control group (n‚ÄØ=‚ÄØ94). Ten intensive care units in Denmark. Primary outcome: health-related quality of life (HRQOL). Sense of coherence (SOC), and symptoms of anxiety, depression and posttraumatic stress, compared to standard care at 12‚ÄØmonths after intensive care discharge. No difference in HRQOL between groups was observed at 12‚ÄØmonths (mean difference in mental component summary score, 1.35 [CI 95%: -3.13; 5.82], p‚ÄØ=‚ÄØ0.55; and physical component summery score, 1.86 [CI 95%: -1.88; 5.59], p‚ÄØ=‚ÄØ0.33). No differences were found in secondary outcomes. The recovery programme intended for intensive care survivors did not have an effect on the relatives. Future recovery programmes should be targeted to help both patient and family, and future research should be conducted on a larger scale to make conclusions with higher probability.",Bohart S.; Egerod I.; Bestle MH.; Overgaard D.; Christensen DF.; Jensen JF.,2018.0,10.1016/j.iccn.2018.03.002,0,0,
1980,Investigating the role of hopelessness in the relationship between PTSD symptom change and suicidality.,"This study served as an initial investigation of the role hopelessness may play in the relationship between PTSD symptom change and suicide intent, among a trauma-exposed, treatment-seeking sample. We explored whether the effect of PTSD symptom change on self-reported likelihood of a future suicide attempt (FSA) varies as a function of pre-treatment hopelessness, and whether reductions in hopelessness serve as a mechanism through which PTSD symptom change influences FSA likelihood. Data was collected from participants (N = 159) in a larger randomized clinical trial of a suicide risk-factor intervention. Self-report questionnaires assessed hopelessness, PTSD symptoms, depression symptoms, and FSA likelihood at pre-treatment and one-month follow-up. Pre-treatment hopelessness emerged as a significant moderator, such that overall PTSD symptom reductions were related to overall decreases in FSA likelihood among those at or above (but not those below) the sample mean of pre-treatment hopelessness. In a subsample of individuals who reported FSA likelihood > 0 and elevated hopelessness at pre-treatment, overall pre-treatment-to-month-one reductions in hopelessness significantly mediated the relationship between overall PTSD symptom reductions and decreased FSA likelihood during this same time period, even after accounting for depression symptom changes. Data were limited to self-report measures (i.e., hopelessness, FSA likelihood). The intervention was not PTSD-specific. Mediation analyses were strictly statistical due to overlapping time-points. This preliminary investigation suggests pre-treatment hopelessness may serve to identify trauma-exposed individuals for whom PTSD treatment would significantly reduce FSA likelihood. Moreover, reductions in FSA likelihood during treatment may be due in part to reduced hopelessness.",Boffa JW.; King SL.; Turecki G.; Schmidt NB.,2018.0,10.1016/j.jad.2017.08.004,0,0,
1981,A role focused self-help course reduces stress and subsequent work functioning problems in workers who have informal care responsibilities,"Introduction Many paid workers who fulfil informal care responsibilities in their private situation report stress complaints and impaired functioning at work. It was examined whether a newly developed role-focused self-help intervention decreases caregiver stress and distress, and work functioning problems, in these workers. Methods A study that had a randomised controlled design (intervention vs wait-list control) was conducted. Workers suffering stress due to involvement in informal care activities were participants (n=128). The workers allocated to the intervention group received the role-focused self-help course. The workers allocated to the control group received the intervention after all measurements. Caregiver stress (primary outcome), distress, work functioning, care-to-work interference, and care-to-social and personal life interference, were measured prior to the random allocation (pre-test) and one (posttest 1) and two (post-test 2) months after allocation. Mixed Model ANOVAs and mediation analyses were used in dataanalysis. Results The mixed model ANOVAs showed that two months after allocation the workers allocated to the intervention group had decreased levels of caregiver stress and distress as compared to the workers allocated to the no treatment control group. Further, the mediation analysis suggested that involvement in the intervention decreases functioning problems in workers who have informal care responsibilities because it reduces caregiver stress. Discussion The role-focused self-help course intervention decreases levels of caregiver stress and distress in workers who suffer stress due to involvement in informal care activities. Because of this effect, the intervention also plays a role in the work functioning of these types of workers. The intervention represents a contribution to the literature and a means for occupational health professionals and organisations to contribute to the health and functioning of workers who combine paid work with informal care activities.",Boezeman E.J.; Nieuwenhuijsen K.; Sluiter J.K.,2018.0,10.1136/oemed-2018-ICOHabstracts.1628,0,0,
1982,An intervention that reduces stress in people who combine work with informal care: randomized controlled trial results,"Background: The aim of the research was to examine whether a role-focused self-help course intervention would decrease caregiver stress and distress, and functioning problems, among people who suffer stress because they combine paid work with informal care. Methods: A pre-registered (NTR 5528) randomized controlled design was applied (intervention vs. wait list control). Participants (n = 128) were people who had paid work and were suffering stress due to their involvement in informal care activities. Participants allocated to the intervention group (n = 65) received the role-focused self-help course. Control group members (n = 63) received this intervention after all measurements. Prior to the random allocation (pre-test), and 1 month (post-test 1) and 2 months (post-test 2) after allocation, all participants completed a questionnaire that measured their caregiver stress (primary outcome), distress, work functioning, negative care-to-work interference and negative care-to-social and personal life interference. Mixed model ANOVAs were used to test the effectiveness of the intervention. Results: Two months after allocation, the intervention group participants had lower levels of caregiver stress and distress compared with the control group participants. The intervention did not directly resolve impaired work functioning or interference of care with work and social/personal life. Conclusion: The intervention decreases caregiver stress and distress in people who suffer stress because they combine paid work with informal caring. The intervention (Dutch version) can be downloaded at no cost from www.amc.nl/mantelzorgstress.",Boezeman E.J.; Nieuwenhuijsen K.; Sluiter J.K.,2018.0,10.1093/eurpub/cky052,0,0,
1983,Patient expectations in internet-based self-help for social anxiety.,"A number of controlled trials have demonstrated the efficacy of Internet-based cognitive-behaviour therapy for treating social anxiety disorder (SAD). However, little is known about what makes those interventions work. The current trial focuses on patient expectations as one common mechanism of change. The study examines whether patients' expectancy predicts outcome, adherence, and dropout in an unguided Internet-based self-help programme for SAD. Data of 109 participants in a 10-week self-help programme for SAD were analysed. Social anxiety measures were administered prior to the intervention, at week 2, and after the intervention. Expectancy was assessed at week 2. Patient expectations were a significant predictor of change in social anxiety (beta=2.35 to 2.40, all p<.003). Patient expectations also predicted treatment adherence (beta=.27, p=.02). Patients with higher expectations showed more adherence and better outcome. Dropout was not predicted by expectations. The effect of positive expectations on outcome was mediated by early symptom change (from week 0 to week 2). Results suggest that positive outcome expectations have a beneficial effect on outcome in Internet-based self-help for SAD. Furthermore, patient expectations as early process predictors could be used to inform therapeutic decisions such as stepping up patients to guided or face-to-face treatment options. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Boettcher, Johanna; Renneberg, Babette; Berger, Thomas",2013.0,http://dx.doi.org/10.1080/16506073.2012.759615,0,0,
1984,Internet-based attention training for social anxiety: A randomized controlled trial.,"Several studies suggest that computer-based attention modification programmes can be a promising new approach for the treatment of various anxiety disorders, including social anxiety disorder (SAD). The current study investigates the efficacy of a four-week Internet-delivered version of an attentional training for SAD in a randomized controlled double-blind study. Sixty-eight individuals seeking treatment for SAD were randomly assigned to either an attention training group (ATG, N = 33) or a control group (CG, N = 35). Participants of the ATG completed modified dot-probe tasks designed to facilitate attentional disengagement from threat. Participants in the CG completed control dot-probe tasks. At post-assessment, participants in both groups showed significant symptom reductions with medium to large within-group effect sizes on social anxiety measures (ATG: Cohen's d = .47-.80; CG: d = .56-.63). However, no significant differences between groups were found at post-treatment for any outcome measure. These findings will be discussed along with the results of a 4-months follow-up assessment. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Boettcher, Johanna; Berger, Thomas; Renneberg, Babette",2012.0,http://dx.doi.org/10.1007/s10608-011-9374-y,0,0,
1985, Pain Neurophysiology Education and Therapeutic Exercise for Patients With Chronic Low Back Pain: a Single-Blind Randomized Controlled Trial," OBJECTIVE: To assess the effect of a pain neurophysiology education (PNE) program plus therapeutic exercise (TE) for patients with chronic low back pain (CLBP). DESIGN: Single‐blind randomized controlled trial. SETTING: Private clinic and university. PARTICIPANTS: Patients with CLBP for ≥6 months (N=56). INTERVENTIONS: Participants were randomized to receive either a TE program consisting of motor control, stretching, and aerobic exercises (n=28) or the same TE program in addition to a PNE program (n=28), conducted in two 30‐ to 50‐minute sessions in groups of 4 to 6 participants. MAIN OUTCOMES MEASURES: The primary outcome was pain intensity rated on the numerical pain rating scale which was completed immediately after treatment and at 1‐ and 3‐month follow‐up. Secondary outcome measures were pressure pain threshold, finger‐to‐floor distance, Roland‐Morris Disability Questionnaire, Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Patient Global Impression of Change. RESULTS: At 3‐month follow‐up, a large change in pain intensity (numerical pain rating scale: ‐2.2; ‐2.93 to ‐1.28; P<.001; d=1.37) was observed for the PNE plus TE group, and a moderate effect size was observed for the secondary outcome measures. CONCLUSIONS: Combining PNE with TE resulted in significantly better results for participants with CLBP, with a large effect size, compared with TE alone."," Bodes Pardo, G;  Lluch Girbés, E;  Roussel, NA;  Gallego Izquierdo, T;  Jiménez Penick, V;  Pecos Martín, D",2018.0, 10.1016/j.apmr.2017.10.016,0,0,
1986, Case Management may Reduce Emergency Department Frequent use in a Universal Health Coverage System: a Randomized Controlled Trial," BACKGROUND: Frequent emergency department (ED) users account for a disproportionately high number of ED visits. Studies on case management (CM) interventions to reduce frequent ED use have shown mixed results, and few studies have been conducted within a universal health coverage system. OBJECTIVE: To determine whether a CM intervention‐compared to standard emergency care‐reduces ED attendance. DESIGN: Randomized controlled trial. PARTICIPANTS: Two hundred fifty frequent ED users (5 or more visits in the prior 12 months) who visited a public urban ED at the Lausanne University Hospital between May 2012 and July 2013 were allocated to either an intervention (n = 125) or control (n = 125) group, and monitored for 12 months. INTERVENTIONS: An individualized CM intervention consisting of concrete assistance in obtaining income entitlements, referral to primary or specialty medical care, access to mental health care or substance abuse treatment, and counseling on at‐risk behaviors and health care utilization (in addition to standard care) at baseline and 1, 3, and 5 months. MAIN MEASURES: We used a generalized linear model for count data (negative binomial distribution) to compare the number of ED visits during the 12‐month follow‐up between CM and usual care, from an intention‐to‐treat perspective. KEY RESULTS: At 12 months, there were 2.71 (±0.23) ED visits in the intervention group versus 3.35 (±0.32) visits among controls (ratio = 0.81, 95 % CI = 0.63; 1.02). In the multivariate model, the effect of the CM intervention on the number of ED visits approached statistical significance (b = ‐0.219, p = 0.075). The presence of poor social determinants of health was a significant predictor of ED use in the multivariate model (b = 0.280, p = 0.048). CONCLUSIONS: CM may reduce ED use by frequent users through an improved orientation to the health care system. Poor social determinants of health significantly increase use of the ED by frequent users."," Bodenmann, P;  Velonaki, VS;  Griffin, JL;  Baggio, S;  Iglesias, K;  Moschetti, K;  Ruggeri, O;  Burnand, B;  Wasserfallen, JB;  Vu, F;  et al.",2017.0, 10.1007/s11606-016-3789-9,0,0,
1987,"Experiential, autonomic, and respiratory correlates of CO2 reactivity in individuals with high and low anxiety sensitivity","Psychometric studies indicate that anxiety sensitivity (AS) is a risk factor for anxiety disorders such as panic disorder (PD). To better understand the psychophysiological basis of AS and its relation to clinical anxiety, we examined whether high-AS individuals show similarly elevated reactivity to inhalations of carbon dioxide (CO2) as previously reported for PD and social phobia in this task. Healthy individuals with high and low AS were exposed to eight standardized inhalations of 20% CO2-enriched air, preceded and followed by inhalations of room air. Anxiety and dyspnea, in addition to autonomic and respiratory responses were measured every 15s. Throughout the task, high AS participants showed a respiratory pattern of faster, shallower breathing and reduced inhalation of CO2 indicative of anticipatory or contextual anxiety. In addition, they showed elevated dyspnea responses to the second set of air inhalations accompanied by elevated heart rate, which could be due to sensitization or conditioning. Respiratory abnormalities seem to be common to high AS individuals and PD patients when considering previous findings with this task. Similarly, sensitization or conditioning of anxious and dyspneic symptoms might be common to high AS and clinical anxiety. Respiratory conditionability deserves greater attention in anxiety disorder research. © 2013 Elsevier Ireland Ltd.",Blechert J.; Wilhelm F.H.; Meuret A.E.; Wilhelm E.M.; Roth W.T.,2013.0,10.1016/j.psychres.2013.02.010,0,0,
1988, Movement cognition and narration of the emotions treatment versus standard speech therapy in the treatment of children with borderline intellectual functioning: a randomized controlled trial," BACKGROUND: Borderline intellectual functioning (BIF) is defined as a ""health meta‐condition… characterized by various cognitive dysfunctions associated with an intellectual quotient (IQ) between 71 and 85 which determines a deficit in the individual's functioning both in the restriction of activities and in the limitation of social participation"". It can be caused by many factors, including a disadvantaged background and prematurity. BIF affects 7‐12% of primary school children that show academic difficulties due to poor executive functioning. In many children with BIF, language, movement and social abilities are also affected, making it difficult to take part in daily activities. Dropping out of school and psychological afflictions such as anxiety and depression are common in children with BIF. This study investigates whether an intensive rehabilitation program that involves all of the areas affected in children with BIF (Movement, Cognition and Narration of emotions, MCNT) is more effective than Standard Speech Therapy (SST). METHODS: This is a multicenter interventional single blind randomized controlled study. Children aged between 6 to 11 years who attend a mainstream primary school and have multiple learning difficulties, behavioral problems and an IQ ranging between 85 to 70 have been enrolled. Participants are randomly allocated to one of three groups. The first group receives individual treatment with SST for 45 min, twice a week for 9 months. The second group receives the experimental treatment MCNT for 3 h per day, 5 days/ week for 9 months and children work in small groups. The third group consists of children on a waiting list for the SST for nine months. DISCUSSION: BIF is a very frequent condition with no ad hoc treatment. Over the long term, there is a high risk to develop psychiatric disorders in adulthood. Due to its high social impact, we consider it very important to intervene during childhood so as to intercept the remarkable plasticity of the developing brain. TRIAL REGISTRATION: ""Study Let them grow: A new intensive and multimodal Treatment for children with borderline intellectual functioning based on Movement, Cognition and Narration of emotions"", retrospectively registered in ISRCTN Register with ISRCTN81710297 at 2017‐01‐09."," Blasi, V;  Baglio, G;  Baglio, F;  Canevini, MP;  Zanette, M",2017.0, 10.1186/s12888-017-1309-z,0,0,
1989, A cognitive-behavioral and mindfulness-based group sleep intervention improves behavior problems in at-risk adolescents by improving perceived sleep quality," OBJECTIVE: The aim of this study was to test whether a cognitive‚Äêbehavioral and mindfulness‚Äêbased group sleep intervention would improve behavior problems in at‚Äêrisk adolescents, and whether these improvements were specifically related to improvements in sleep. METHOD: Secondary analysis of a randomized controlled trial conducted with 123 adolescent participants (female = 60%; mean age = 14.48, range 12.04‚Äê16.31 years) who had high levels of sleep problems and anxiety symptoms. Participants were randomized into either a sleep improvement intervention (n = 63) or an active control ""study skills"" intervention (n = 60). Participants completed sleep and behavior problems questionnaires, wore an actiwatch and completed a sleep diary for five school nights, both before and after the intervention. RESULTS: Parallel multiple mediation models showed that postintervention improvements in social problems, attention problems, and aggressive behaviors were specifically mediated by moderate improvements in self‚Äêreported sleep quality on school nights, but were not mediated by moderate improvements in actigraphy‚Äêassessed sleep onset latency or sleep diary‚Äêmeasured sleep efficiency on school nights. CONCLUSION: This study provides evidence, using a methodologically rigorous design, that a cognitive‚Äêbehavioral and mindfulness‚Äêbased group sleep intervention improved behavior problems in at‚Äêrisk adolescent by improving perceived sleep quality on school nights. These findings suggest that sleep interventions could be directed towards adolescents with behavior problems. CLINICAL TRIAL REGISTRATION: This study was part of The SENSE Study (Sleep and Education: learning New Skills Early). URL: ACTRN12612001177842; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12612001177842&isBasic=True."," Blake, MJ;  Snoep, L;  Raniti, M;  Schwartz, O;  Waloszek, JM;  Simmons, JG;  Murray, G;  Blake, L;  Landau, ER;  Dahl, RE;  et al.",2017.0, 10.1016/j.brat.2017.10.006,0,0,
1990, Imagery versus verbal interpretive cognitive bias modification for compulsive checking," Pathological doubting and checking is a common symptom presentation in obsessive‚Äêcompulsive disorder (OCD). Previous research has established that compulsive checkers do not display an actual memory deficit, but lack confidence in their memories and experience intolerance of uncertainty regarding the completion of tasks. We investigated whether interpretive cognitive bias modification (CBM‚ÄêI) reduced memory distrust and intolerance of uncertainty in a nonclinical sample. We also examined the possible enhancement of CBM‚ÄêI for OCD through imagery training. The results provide evidence that participants who received positive imagery CBM‚ÄêI training may have interpreted novel ambiguous checking scenarios more adaptively and endorsed negative checking beliefs less relative to participants in the control imagery CBM‚ÄêI condition. Findings on behavioural checking tasks did not indicate any specific response to CBM‚ÄêI training. Future research may translate these suggestive findings into a useful adjunct to traditional strategies targeting maladaptive OCD beliefs."," Black, MJ;  Grisham, JR",2016.0, 10.1016/j.brat.2016.05.009,0,0,
1991,Posttraumatic stress disorder and social support in female victims of sexual assault: The impact of spousal involvement on the efficacy of cognitive-behavioral therapy.,"The goal of this study is to enhance the efficacy of CBT with victims of sexual assault suffering from PTSD by getting the spouse involved. Thus, in addition to attempting to reduce PTSD symptoms, the therapy focuses on improving the support offered by the spouse and favors management of the impact of the traumatic event within the couple. A single-case, multiple-baseline across-subjects design is used. Three victims of sexual assault with a diagnosis of PTSD participated in the study. Results at posttreatment and at 3-month follow-up are promising. None of the participants presents a diagnosis of PTSD, and all report a significant improvement in their satisfaction with the support received from their spouses. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Billette, Valerie; Guay, Stephane; Marchand, Andre",2008.0,http://dx.doi.org/10.1177/0145445508319280,0,0,
1992, Rationale and study protocol for a multi-component Health Information Technology (HIT) screening tool for depression and post-traumatic stress disorder in the primary care setting," The prevalence rate of depression in primary care is high. Primary care providers serve as the initial point of contact for the majority of patients with depression, yet, approximately 50% of cases remain unrecognized. The under‚Äêdiagnosis of depression may be further exacerbated in limited English‚Äêlanguage proficient (LEP) populations. Language barriers may result in less discussion of patients' mental health needs and fewer referrals to mental health services, particularly given competing priorities of other medical conditions and providers' time pressures. Recent advances in Health Information Technology (HIT) may facilitate novel ways to screen for depression and other mental health disorders in LEP populations. The purpose of this paper is to describe the rationale and protocol of a clustered randomized controlled trial that will test the effectiveness of an HIT intervention that provides a multi‚Äêcomponent approach to delivering culturally competent, mental health care in the primary care setting. The HIT intervention has four components: 1) web‚Äêbased provider training, 2) multimedia electronic screening of depression and PTSD in the patients' primary language, 3) Computer generated risk assessment scores delivered directly to the provider, and 4) clinical decision support. The outcomes of the study include assessing the potential of the HIT intervention to improve screening rates, clinical detection, provider initiation of treatment, and patient outcomes for depression and post‚Äêtraumatic stress disorder (PTSD) among LEP Cambodian refugees who experienced war atrocities and trauma during the Khmer Rouge. This technology has the potential to be adapted to any LEP population in order to facilitate mental health screening and treatment in the primary care setting."," Biegler, K;  Mollica, R;  Sim, SE;  Nicholas, E;  Chandler, M;  Ngo-Metzger, Q;  Paigne, K;  Paigne, S;  Nguyen, DV;  Sorkin, DH",2016.0, 10.1016/j.cct.2016.07.001,0,0,
1993, Comparison of two approaches to prevention of mental health problems in college students: enhancing coping and executive function skills," OBJECTIVE: College students face a significant number of stressors, increasing risk for internalizing and externalizing psychopathology. The current study examines two promising avenues of intervention aimed to reduce stress and prevent psychopathology in this population: a coping skills group and a cognitive training program. PARTICIPANTS: 62 undergraduate students from two universities were recruited from 2013 to 2015. METHODS: Students were randomized to a 6‚Äêweek coping skills group or cognitive training program and completed measures of stress, coping, executive function, and symptoms of anxiety, depression and Attention‚ÄêDeficit Hyperactivity Disorder (ADHD) at pre‚Äê and post‚Äêintervention. RESULTS: Participants in both conditions reported significant decreases in social stress, executive function difficulties, and anxiety symptoms post‚Äêintervention. Students in the cognitive program improved significantly more on measures of behavior regulation and ADHD symptoms compared to the coping group at post‚Äêintervention. CONCLUSIONS: Brief stress management interventions targeting coping and executive function may benefit college students at risk for psychopathology."," Bettis, AH;  Coiro, MJ;  England, J;  Murphy, LK;  Zelkowitz, RL;  Dejardins, L;  Eskridge, R;  Adery, LH;  Yarboi, J;  Pardo, D;  et al.",2017.0, 10.1080/07448481.2017.1312411,0,0,
1994,Social emotional leaning and behavioral tendencies in high and low socially anxious men and women,"Background: A biased processing of socially threatening information, security behaviors, and an enhanced physiological arousal are the most important characteristics of social anxiety. While enhanced fear conditioning is central for the development of social anxiety, avoidance and security behaviors are critical for its maintenance and generalization. The neuropeptide oxytocin influences key mechanisms for the etiology and maintenance of social anxiety. Intranasally administered oxytocin, for instance, reduces the amygdalar reactivity for socially aversive stimuli in healthy men and enhances the attentional focus for positive facial expressions. Methods: In randomized double-blind placebo-controlled functional magnetic resonance imaging,weinvestigated behavioral and neurofunctional effects of oxytocin on processes of social learning and on approach and avoidance behavior in 180 socially high and little anxious men and women. The study allowed systematically investigating sex-specific effects of intranasally administered oxytocin on social-emotional functions. Results: In the placebo condition, socially high anxious individuals showed increased arousal for negatively conditioned social stimuli as well as deficits in fast approach-avoidance behaviors. Similar to low anxious individuals, socially high anxious individuals of the oxytocin condition showed strongest arousal for positively conditioned social stimuli and were faster in avoiding than approaching angry faces which was related to alterations in lateral prefrontal and amygdalar activations. Conclusions: The results indicate a normalization of social learning and approach-avoidance tendencies in socially high anxious individuals by intransasally administered oxytocin possibly driven by alterations in prefrontal and amygdalar activation patterns. Oxytocin may hence help improving social-emotional behaviors in socially anxious individuals.",Bertsch K.; Volman I.; Roelofs K.; Herpertz S.C.; Muller L.E.,2017.0,10.16/j.psyneuen.2017.07.371,0,0,
1995,Genomic investigation of porcine periweaning failure to thrive syndrome (PFTS),"Porcine periweaning failure to thrive syndrome (PFTS) can be defined by anorexia, lethargy, progressive debilitation and compulsive behaviours that occur in seemingly healthy pigs within two to threeweeks of weaning in the absence of any known infectious, nutritional, management or environmental factors. A genetic component has been hypothesised for this syndrome. In the present study, 119 commercial pigs (80 cases and 39 controls) were genotyped with the porcine 80K single nucleotide polymorphism-chip and were analysed with logistic regression and two Fixation Index-based approaches. The analyses revealed several regions on chromosomes 1, 3, 6 and 11 with moderate divergence between cases and controls, particularly three haplotypes on SSC3 and 11. The gene-based analyses of the candidate regions revealed the presence of genes that have been reported to be associated with phenotypes like PFST including depression (PDE10A) and intestinal villous atrophy (CUL4A). It is important to increase the effort of collecting more samples to improve the power of these analyses.",Bertolini F.; Yang T.; Huang Y.; Harding J.C.S.; Plastow G.S.; Rothschild M.F.,2018.0,10.1136/vr.104825,0,0,
1996,The development of intrusive thoughts to obsessions,"The aim of this thesis was to consider the role of appraisals of intrusive thoughts in the development of Obsessive-Compulsive Disorder. A narrative literature review explored the hypothesis that 'normal' intrusive thoughts lie on a continuum with clinical obsessions. The review discussed previous research on intrusive thoughts in nonclinical samples and drew comparisons with characteristics of clinical obsessions. An internet-based empirical investigation employed a randomised controlled trial design in order to test the effectiveness of an intervention based on normalising information in reducing problematic meta-cognitive beliefs. A large sample (N = 148) of young adults (aged 18-20 years) was screened in to the study based on high levels of problematic meta-cognitive beliefs. Participants completed questionnaire measures of meta-cognitive beliefs, obsessive-compulsive symptoms, reactions to intrusive thoughts and experiential avoidance. Participants completed an interactive quiz based on normalising information (experimental condition) or pet information (control condition). Significant reductions in problematic meta-cognitive beliefs and experiential avoidance were observed in both conditions, thus no additional benefit of normalising information was indicated. The implications of these findings are discussed in the context of the potential normalising effects of symptom monitoring. Overall this thesis supports the comparison of 'normal' intrusive thoughts and obsessions and suggests that negative appraisals, such as problematic metacognitive beliefs, may not be the only defining factor in the development of Obsessive-Compulsive Disorder.",Berry,2011.0,,0,0,
1997, Imipramine plus cognitive-behavioral therapy in the treatment of school refusal," METHOD: This was a randomized, double‚Äêblind trial with 63 subjects entering the study and 47 completing. Outcome measures were weekly school attendance rates based on percentage of hours attended and anxiety and depression rating scales. RESULTS: Over the course of treatment, school attendance improved significantly for the imipramine group (z = 4.36, p < .001) but not for the placebo group (z = 1.26, not significant). School attendance of the imipramine group improved at a significantly faster rate than did that of the placebo group (z = 2.39, p = .017). Over the 8 weeks of treatment, there was a significant difference between groups on attendance after controlling for baseline attendance; mean attendance rate in the final week was 70.1% +/‚Äê 30.6% for the imipramine group and 27.6% +/‚Äê 36.1% for the placebo group (p < .001). Defining remission as 75% school attendance, 54.2% of the imipramine group met this criterion after treatment compared with only 16.7% from the placebo group (p = .007). Anxiety and depression rating scales decreased significantly across treatment for both groups, with depression on the Children's Depression Rating Scale‚ÄêRevised decreasing at a significantly faster rate in the imipramine group compared with the placebo group (z = 2.08, p = .037). CONCLUSIONS: Imipramine plus CBT is significantly more efficacious than placebo plus CBT in improving school attendance and decreasing symptoms of depression in school‚Äêrefusing adolescents with comorbid anxiety and depression. OBJECTIVE: To investigate the efficacy of 8 weeks of imipramine versus placebo in combination with cognitive‚Äêbehavioral therapy (CBT) for the treatment of school‚Äêrefusing adolescents with comorbid anxiety and major depressive disorders."," Bernstein, GA;  Borchardt, CM;  Perwien, AR;  Crosby, RD;  Kushner, MG;  Thuras, PD;  Last, CG",2000.0, 10.1097/00004583-200003000-00008,0,0,
1998, Imipramine compliance in adolescents," METHOD: Sixty‚Äêthree anxious‚Äêdepressed adolescents in an 8‚Äêweek double‚Äêblind study of imipramine versus placebo, each in combination with cognitive‚Äêbehavioral therapy for school refusal, were evaluated. Measures of side effects, global improvement, family functioning, medication compliance based on pill counts, and guesses of drug assignment (imipramine versus placebo) were analyzed. RESULTS: Mean side effects ratings were significantly higher for the imipramine group compared with the placebo group (p = .001). Side effects were not associated with noncompliance or with dropping out. Oppositional defiant disorder (ODD) in the adolescents was significantly associated with medication noncompliance (p = .036). On the Family Adaptability and Cohesion Evaluation Scale II (FACES II), low family adaptability (i.e., rigidity), low family cohesion (i.e., disengagement), and extreme family type were significantly associated with greater noncompliance with medications. Accuracy rates for guessing medication assignment (imipramine versus placebo) were 66% for subjects, 62.5% for mothers, and 79.5% for the psychiatrist. Logistic regression demonstrated that side effects (p = .005) and global improvement scores (p = .06) predicted the psychiatrist's guesses of drug assignment. CONCLUSIONS: Side effects were not associated with noncompliance. Nonadherence with taking medications was associated with ODD in the adolescents and problematic family functioning on FACES II. The psychiatrist, who was blind to treatment condition, guessed the subjects' medication assignments with high accuracy. Thus, because of expectancy bias, the data support the use of blind independent evaluators for rating changes in medication trials. OBJECTIVE: To investigate side effects, medication compliance, and assumption of medication assignment in adolescents taking imipramine versus placebo in a clinical trial."," Bernstein, GA;  Anderson, LK;  Hektner, JM;  Realmuto, GM",2000.0, 10.1097/00004583-200003000-00009,0,0,
1999,Personal wellbeing in posttraumatic stress disorder (PTSD): association with PTSD symptoms during and following treatment.,"It remains unclear to what extent treatment-related gains in posttraumatic stress disorder (PTSD) symptoms translate to improvements in broader domains of personal wellbeing, such as community connectedness, life achievement and security. We sought to determine whether: 1. personal wellbeing improves during the course of a treatment program and 2. changes in core symptom domains (PTSD, anxiety and depression) were associated with improvements in overall personal wellbeing. Participants (N‚Äâ=‚Äâ124) completed the PTSD Checklist, the Depression and Anxiety Stress Scales and the Personal Wellbeing Index at the start and end of a 4-week Trauma Focused CBT residential program, as well as 3- and 9-months post-treatment. Personal wellbeing improved significantly across the 9-months of the study. Generalised estimating equations analyses indicated that (older) age and improvements in PTSD and depressive symptoms were independent predictors of personal wellbeing across time. Although personal wellbeing improved in tandem with PTSD symptoms, the magnitude of improvement was small. These findings highlight a need to better understand how improvements in personal wellbeing can be optimised following PTSD treatment.",Berle D.; Hilbrink D.; Russell-Williams C.; Kiely R.; Hardaker L.; Garwood N.; Gilchrist A.; Steel Z.,2018.0,10.1186/s40359-018-0219-2,0,0,
2000,Topiramate in posttraumatic stress disorder: Preliminary clinical observations.,"This article reviews the effects of the novel antiepileptic drug topiramate on 3 patients, a 40 yr old male, and two 33 and 45 year old females, meeting Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for chronic posttraumatic stress disorder (PTSD). In these previously treatment-refractory patients, topiramate had a marked effect: reducing and even eliminating trauma-related intrusive memories and nightmares and normalizing depressed mood. Adverse events were effectively controlled with careful drug titration and discontinuation of concomitant therapies. These findings, together with observations in more than 30 additional patients (reported elsewhere), suggest that further study of topiramate as a treatment for PTSD is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Berlant, Jeffrey L",2001.0,,0,0,
2001, Treatment of intra-oral injection phobia: a randomized delayed intervention controlled trial among Norwegian 10- to 16-year-olds," MATERIAL AND METHODS: This was a randomized delayed intervention controlled trial in 67 patients, fulfilling the DSM‚Äê5 criteria for specific phobia. All patients received the same CBT performed by dentists specially trained in CBT. The patients were randomly assigned to either an immediate treatment group (ITG) (34 patients) or a waitlist‚Äêcontrol group (WCG) (33 patients). The WCG was put on a waitlist for 5 weeks. After treatment, all patients were combined for post‚Äêtreatment analyses. Assessments including the psychometric self‚Äêreport scales Intra‚Äêoral injection fear scale (IOIF‚Äês), Children's Fear Survey Schedule‚ÄêDental Subscale (CFSS‚ÄêDS), Injection Phobia Scale for children (IS‚Äêc) and Mutilation Questionnaire for children (MQ‚Äêc) and a behavioural avoidance test (BAT) followed by a questionnaire on cognitions during the BAT, occurred pre‚Äê, post‚Äêtreatment/waitlist and at a 1‚Äêyear follow‚Äêup. RESULTS: CBT had a significant effect compared to no treatment (WCG). After treatment, the scores on the psychometric self‚Äêreport scales were significantly reduced and higher levels in the BAT were achieved. The results were maintained at 1‚Äêyear follow‚Äêup. Of the 67 patients, 70.1% received intra‚Äêoral injections during CBT treatment, whereas 69.4% of those completing the CBT, in need for further dental treatment, managed to receive the necessary intra‚Äêoral injections at their regular dentist. CONCLUSIONS: The 10‚Äê to 16‚Äêyear‚Äêolds diagnosed with intra‚Äêoral injection phobia benefitted positively on CBT performed by specially trained dentists. OBJECTIVE: To evaluate the effect of five sessions of cognitive behavioural therapy (CBT) for 10‚Äê to 16‚Äêyear‚Äêolds with intra‚Äêoral injection phobia."," Berge, KG;  Agdal, ML;  Vika, M;  Skeie, MS",2017.0, 10.1080/00016357.2017.1297849,0,0,
2002, The Screen-ICD trial. Screening for anxiety and cognitive therapy intervention for patients with implanted cardioverter defibrillator (ICD): a randomised controlled trial protocol," INTRODUCTION: Previous research shows that patients with an implanted cardioverter defibrillator (ICD) have a fourfold increased mortality risk when suffering from anxiety compared with ICD patients without anxiety. This research supports the screening of ICD patients for anxiety with the purpose of starting relevant intervention. METHODS AND ANALYSIS: Screen‚ÄêICD consists of 3 parts: (1) screening of all hospitalised and outpatient patients at two university hospitals using the Hospital Anxiety and Depression Scale (HADS), scores ‚â•8 are invited to participate. (2) Assessment of type of anxiety by Structured Clinical Interview for DSM Disorders (SCID). (3) Investigator‚Äêinitiated randomised clinical superiority trial with blinded outcome assessment, with 1:1 randomisation to cognitive‚Äêbehavioural therapy (CBT) performed by a cardiac nurse with CBT training, plus usual care or usual care alone. The primary outcome is HADS‚ÄêA measured at 16‚ÄÖweeks. Secondary outcomes include Becks Anxiety Inventory, HeartQoL, Hamilton Anxiety Scale, heart rate variability, ICD shock, time to first shock and antitachycardia pacing. A total of 88 participants will be included. The primary analyses are based on the intention‚Äêto‚Äêtreat principle and we use a mixed model with repeated measurements for continuous outcomes. For binary outcomes (HADS‚ÄêA score <8), we use a generalised mixed model with repeated measurements. ETHICS AND DISSEMINATION: The trial is performed in accordance with the Declaration of Helsinki. All patients must give informed consent prior to participation and the trial is initiated after approval by the Danish Data Protection Agency (RH‚Äê2015‚Äê282) and the regional ethics committee (H‚Äê16018868). Positive, neutral and negative results of the trial will be published. TRIAL REGISTRATION NUMBER: NCT02713360."," Berg, SK;  Herning, M;  Svendsen, JH;  Christensen, AV;  Thygesen, LC",2016.0, 10.1136/bmjopen-2016-013186,0,0,
2003,Drumming through trauma: Music therapy with post-traumatic soldiers.,"Combat stress reaction is common among soldiers and can develop to a post-traumatic stress disorder (PTSD). This distressing condition embraces symptoms such as feelings of loneliness and isolation from society, intrusive memories, outbursts of anger and generalized feelings of helplessness. Drumming has been receiving considerable attention in music therapy. Only few references relate to such activity among those who suffer from PTSD, and even fewer relate to combat induced post-traumatic syndrome, none of them empirical. The current study presents music therapy group work with six soldiers diagnosed as suffering from combat or terror related PTSD. Data were collected from digital cameras which filmed the sessions, open-ended in-depth interviews, and a self-report of the therapist. Some reduction in PTSD symptoms was observed following drumming, especially increased sense of openness, togetherness, belonging, sharing, closeness, connectedness and intimacy, as well as achieving a non-intimidating access to traumatic memories, facilitating an outlet for rage and regaining a sense of self-control. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bensimon, Moshe; Amir, Dorit; Wolf, Yuval",2008.0,http://dx.doi.org/10.1016/j.aip.2007.09.002,0,0,
2004, Guided self-help interventions for mental health disorders in children with neurological conditions: study protocol for a pilot randomised controlled trial," BACKGROUND: Rates of mental health disorders are significantly greater in children with physical illnesses than in physically well children. Children with neurological conditions, such as epilepsy, are known to have particularly high rates of mental health disorders. Despite this, mental health problems in children with neurological conditions have remained under‚Äêrecognised and under‚Äêtreated in clinical settings. Evidence‚Äêbased guided self‚Äêhelp interventions are efficacious in reducing symptoms of mental health disorders in children, but their efficacy in reducing symptoms of common mental health disorders in children with neurological conditions has not been investigated. We aim to pilot a guided self‚Äêhelp intervention for the treatment of mental health disorders in children with neurological conditions. METHODS/DESIGN: A pilot randomised controlled trial with 18 patients with neurological conditions and mental health disorders will be conducted. Participants attending specialist neurology clinics at a National UK Children's Hospital will be randomised to receive guided self‚Äêhelp for common mental health disorders or to a 12‚Äêweek waiting list control. Participants in the treatment group will receive 10 sessions of guided self‚Äêhelp delivered over the telephone. The waiting list control group will receive the intervention after a waiting period of 12 weeks. The primary outcome measure is reduction in symptoms of mental health disorders. Exclusion criteria are limited to those at significant risk of harm to self or others, the presence of primary mental health disorder other than anxiety, depression or disruptive behaviour (e.g. psychosis, eating disorder, obsessive‚Äêcompulsive disorder) or intellectual disability at a level meaning potential participants would be unable to access the intervention. The study has ethical approval from the Camden and Islington NHS Research Ethics Committee, registration number 14.LO.1353. Results will be disseminated to patients, the wider public, clinicians and researchers through publication in journals and presentation at conferences. DISCUSSION: This is the first study to investigate guided self‚Äêhelp interventions for mental health problems in children with neurological conditions, a group which is currently under‚Äêrepresented in mental health research. The intervention is modular and adapted from an empirically supported cognitive behavioural treatment. The generalisability and broad inclusion criteria are strengths but may also lead to some weaknesses. TRIAL REGISTRATION: Current Controlled Trials: ISRCTN21184717 . Registered on 25 September 2015."," Bennett, S;  Heyman, I;  Coughtrey, A;  Simmonds, J;  Varadkar, S;  Stephenson, T;  DeJong, M;  Shafran, R",2016.0, 10.1186/s13063-016-1663-z,0,0,
2005,Outcomes of a Therapeutic Fly-Fishing Program for Veterans with Combat-Related Disabilities: A Community-Based Rehabilitation Initiative.,"The purpose of this study was to examine the outcomes of a therapeutic fly-fishing program for veterans with combat-related disabilities. A total of 40 veterans participated in the 4-day therapeutic fly-fishing program and this study. The outcomes examined included reducing symptoms of posttraumatic stress (PTS), depression, perceived stress, functional impairment (i.e., work, relationships, physical, and everyday life), increasing self-determination, and leisure satisfaction. Each research participant completed pretest, posttest, and 3-month follow-up questionnaires. Repeated measures MANOVA and ANOVA were conducted to examine the differences between the three time points on each outcomes. The results indicated significant decreases from the pretest to posttest for symptoms of PTS, depression, perceived stress, and functional impairment, and an increase in leisure satisfaction from pretest to 3-month follow-up. These results highlight the use of therapeutic recreation programming for veterans with disabilities as a holistic approach to treatment and recovery.",Bennett JL.; Piatt JA.; Van Puymbroeck M.,2017.0,10.1007/s10597-017-0124-9,0,0,
2006,Associations between posttraumatic stress and legal charges among substance using veterans.,"Substance misuse is prevalent among veterans entering the criminal justice system, and is related to recidivism. Research demonstrates that trauma exposure and posttraumatic stress (PTS) symptoms, which commonly co-occur with substance misuse, also increase the risk of legal involvement and recidivism. However, it is unclear whether the associations between trauma, PTS symptoms and violent and nonviolent crime may be conflated by substance use. The aim of the present study was to understand the association between PTS symptoms and criminal justice involvement (both violent and nonviolent crime) among substance-using veterans seeking Veterans Affairs (VA) specialty mental health care after accounting for substance use frequency and demographics including age, gender, and ethnicity. Further, this study examined whether specific clusters of PTS were associated with violent and nonviolent veteran offending. Participants included 697 veterans (52 women) aged 21 to 75 (M = 47.49, SD = 13.51) with a history of trauma exposure. Veterans self-reported past-month PTS symptoms, substance use, and lifetime legal charges. Logistic regression results indicated total PTS symptoms were associated with violent, but not nonviolent charges, above and beyond age, sex, race, cocaine use, and heavy alcohol use. Intrusion symptoms, in particular, were associated with violent charges. Results highlight the utility of examining PTS as a multifaceted construct and have implications for the assessment and treatment needs of justice-involved veterans. For example, the findings suggest that treatment needs appear to differ for those reporting violent or nonviolent offending, with a greater need for assessing and treating PTS for those involved with violent crime. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement Public Significance Statement-Among veterans enrolled in VA mental health care with a history of recent substance use problems, violent and nonviolent legal charges were differentially associated with substance use, demographic variables, and posttraumatic stress symptoms. Most notably, PTS symptoms, specifically intrusion symptoms, were uniquely related to violent charges. Screening justice-involved veterans for posttraumatic stress symptoms in addition to substance use, and offering evidence-based substance use and trauma-focused treatment where applicable, may aid in diversion efforts from legal involvement. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Bennett, Diana C; Morris, David H; Sexton, Minden B; Bonar, Erin E; Chermack, Stephen T",2018.0,http://dx.doi.org/10.1037/lhb0000268,0,0,
2007,Dynamics of defensive response mobilization during repeated terminations of exposure to increasing interoceptive threat,"Resistant avoidance behaviors play a crucial role in the maintenance of anxiety disorders and are therefore central targets of therapeutic interventions. In the present study, the development of avoidance behavior was investigated in 24 healthy participants who repeatedly prematurely terminated the exposure to increasing interoceptive threat, i.e., the feeling of dyspnea induced by increasing inspiratory resistive loads that were followed by the ultimate threat, a short breathing occlusion. Physiological responses and subjective anxiety preceding terminations were compared to matched intervals of a matched control group (N = 24) who completed the exposure. Initially, participants terminated during the ultimate threat, i.e., during occlusion. This first termination was preceded by a strong surge in autonomic arousal and reported anxiety. Startle reflex and the P3 component of event-related brain potentials to startle probes were strongly inhibited, indicating preparation for defensive action. With repetitive terminations, individuals successively terminated earlier, avoiding exposure to the occlusion. This avoidant behavior was accompanied by alleviated autonomic arousal as compared to the first termination. In addition, no indication of physiological response preparation was found implying that the avoidance behavior was performed in a rather habitual way. Matched controls did not show any indication of a defensive response surge in the matched intervals. In matched controls, no changes in physiological response patterns were detected while anxiety levels increased with repetitions. The present results shed new light on our understanding of the motivational basis of avoidance behavior and may help to refine etiological models, behavioral analysis and therapeutic strategies in treating anxiety disorders.",Benke C.; Krause E.; Hamm A.O.; Pané-Farré C.A.,2018.0,10.1016/j.ijpsycho.2017.09.013,0,0,
2008,Predictors of behavioral avoidance during respiratory symptom provocation,"Excessive anxiety and avoidance during provocation of body symptoms are core features of anxiety-related disorders and might contribute to the development and maintenance of these disorders. Previous studies examined psychological (anxiety sensitivity, fear of suffocation and trait anxiety) and biobehavioral (breath-holding time) predictors of reported anxiety during symptom provocation. However, the role of these predictors on avoidance of feared body symptoms remains unclear. Therefore, the present work aimed at investigating the main and interactive effects of psychological and biobehavioral variables in predicting avoidance during provocation of dyspnea that successively increased in severity. 28 of 69 participants prematurely terminated the provocation sequence, thus preventing further progression of symptom provocation. Logistic regressions revealed that higher anxiety sensitivity and lower breath-holding time were significantly associated with avoidance during exposure. Suffocation fear and trait anxiety were not related to avoidance. Moreover, there was a significant interaction between breath-holding time and anxiety sensitivity in predicting avoidance. Participants with a lower breath-holding time showed more avoidance behavior when reporting high as compared to low anxiety sensitivity. The data suggest that anxiety sensitivity and breath-holding time increase the risk to show avoidance and thus might contribute to the development and maintenance of anxiety-related disorders.",Benke C.; Krause E.; Hamm A.O.; Pané-Farré C.A.,2019.0,10.1016/j.brat.2018.11.012,0,0,
2009, Sequential Treatment of Comorbid Insomnia and Generalized Anxiety Disorder," OBJECTIVE: To explore the efficacy of cognitive‐behavior therapy (CBT) for patients with comorbid generalized anxiety disorder (GAD) and insomnia using 2 sequential treatments. METHOD: Using a single‐case methodology, 10 women (mean age = 45) with chronic insomnia and GAD were randomly assigned to CBT for GAD followed by CBT for insomnia, or to CBT for insomnia followed by CBT for GAD. Sleep and anxiety were measured via diagnostic interviews, daily diaries, and self‐report questionnaires. RESULTS: Time series analyses, group effect sizes, and indications of clinically significant change revealed improvements on anxiety, worry, and sleep after CBT for GAD. Following CBT for insomnia, positive changes were observed on sleep and, to a lesser extent, anxiety and worry. CONCLUSIONS: In the presence of comorbid GAD and insomnia, initiating treatment for GAD first produced superior clinical benefits in anxiety and sleep. The addition of insomnia‐specific treatment led to additional improvements in worry and sleep quality."," Belleville, G;  Ivers, H;  Bélanger, L;  Blais, FC;  Morin, CM",2016.0, 10.1002/jclp.22300,0,0,
2010, Pre-treatment predictors of dropout from prolonged exposure therapy in patients with chronic posttraumatic stress disorder and comorbid substance use disorders," Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) are commonly co‚Äêoccurring disorders associated with more adverse consequences than PTSD alone. Prolonged exposure therapy (PE) is one of the most efficacious treatments for PTSD. However, among individuals with PTSD‚ÄêSUD, 35‚Äê62% of individuals drop out of trauma‚Äêfocused exposure treatments. Thus, it is important to identify predictors of PTSD treatment dropout among substance abusers with PTSD in order to gain information about adapting treatment strategies to enhance retention and outcomes. The current study explored pre‚Äêtreatment predictors of early termination from PE treatment in a sample of 85 individuals receiving concurrent treatment for PTSD and a SUD in a residential treatment facility as part of a randomized controlled trial. The results indicated that less education and more anxiety sensitivity uniquely predicted PE treatment dropout. Demographic variables, PTSD severity, SUD severity, mental health comorbidities, and emotion regulation difficulties did not predict treatment dropout. These results suggest that adding pre‚Äêtreatment interventions that address anxiety sensitivity, and promote social adjustment and cognitive flexibility, could possibly improve PE retention rates in clients with high anxiety or low education."," Belleau, EL;  Chin, EG;  Wanklyn, SG;  Zambrano-Vazquez, L;  Schumacher, JA;  Coffey, SF",2017.0, 10.1016/j.brat.2017.01.011,0,0,
2011,Supplementation with Robuvit® in post-traumatic stress disorders associated to high oxidative stress.,"Post-traumatic stress disorder (PTSD) is associated to recurrent, obsessive recollection of severe traumatic events. This condition is still not completely understood. Elective treatment of PTSD is psychotherapy. Standardized supplements, used for improving chronic fatigue syndrome (i.e. Robuvit®, Horphag Research Ltd) can also be used to control some of the symptoms associated to PTSD, as well as to control the associated increased oxidative stress, present in many of these patients. The aim of this open registry was to evaluate the effects of supplementary Robuvit® 300 mg/day, added to standard management (SM), in subjects with PTSD over a period of 4 weeks, both on the psychological and the inflammatory level. Otherwise healthy individuals with a diagnosis of PTSD were included in this registry. A clear main traumatic event occurred with different modalities in all subjects during or just after major earthquakes in Central Italy. SM included exposure therapy and psychotherapy. Supportive psychotherapy was used in all affected subjects. Subjects autonomously decided which group to enter (either SM or SM + Robuvit®), without any pre-defined group allocation or randomization. No placebo was used. The two groups were comparable: 18 subjects (11 females; age range 25-49) were included in the SM group, and 16 subjects (8 females; age range 26-52) using SM in combination with Robuvit® supplementation. BMI of all subjects was below 25 kg/m2. After 4 weeks, the percentages of subjects with recurrent memories and dreams, transient walking-dissociative states and reactive flashbacks/hallucinations, alarm reactions and intense emotional distress, emotional numbness, social disinterest and detachment were significantly lower in the subjects treated with Robuvit® (P<0.05%). Sleeping problems, irritability, and fatigue were also significantly reduced with supplementation. The results of our preliminary, pilot registry show that symptoms of PTSD as well as the high oxidative stress-related to the condition can be controlled and improved using Robuvit® as a supplementary management. The improvement with Robuvit® is faster and larger than that seen with standard management only. Supplementation is safe and well tolerated and may represent an important option in PTSD treatment.",Belcaro G.; Luzzi R.; Hosoi M.; Dugall M.; Cesarone MR.,2018.0,10.23736/S0026-4806.18.05573-8,0,0,
2012, Photophobia and Seasonal Variation of Migraine in a Subarctic Population," METHODS: In this cross‐sectional study, migraineurs consecutively recruited were referred to a specialist center located above the Arctic Circle at 68‐71 degrees North during a 2.5‐year period. Data were obtained through a structured interview. RESULTS: In total, 302 migraineurs with a mean (±SD) age of 35.5 (±12.6) years were included. Patients who reported seasonal variation of migraine (n = 90; 29.8%) also reported more often interictal photophobia than the others (61/90, 67.8% vs 92/212, 43.4%, P < .0001). Patients reported sunlight or other bright light to trigger migraine attacks in 74.4% with seasonal migraine (SM) compared with 40.6% in patients with non‐seasonal migraine (NSM) (P < .0001), but there were similar frequencies of attacks reported to be triggered by sleep, menstruation, and other precipitating factors. After adjusting for migraine with aura, migraine disability, chronic migraine, interictal photophobia, and insomnia, sunlight or other bright light, photophobia was still associated with SM (OR; 3.47, CI [95%]; 1.83‐6.59, P < .0001). CONCLUSIONS: Migraineurs in a subarctic area reporting seasonal variation of attack frequency also report increased interictal photophobia independent of other clinical factors. Chronobiological mechanisms and/or increased activity in the visual system may be responsible for this phenomenon. OBJECTIVE: To investigate associations between photophobia and seasonal variation of migraine."," Bekkelund, SI;  Müller, KI;  Wilhelmsen, A;  Alstadhaug, KB",2017.0, 10.1111/head.13131,0,0,
2013, Effect of an Immersive Preoperative Virtual Reality Experience on Patient Reported Outcomes: a Randomized Controlled Trial," OBJECTIVE: To investigate the effect of exposure to a virtual reality (VR) environment preoperatively on patient‚Äêreported outcomes for surgical operations. BACKGROUND: There is a scarcity of well‚Äêdeveloped quality improvement initiatives targeting patient satisfaction. METHODS: We performed a randomized controlled trial of patients undergoing cranial and spinal operations in a tertiary referral center. Patients underwent a 1:1 randomization to an immersive preoperative VR experience or standard preoperative experience stratified on type of operation. The primary outcome measures were the Evaluation du Vecu de l'Anesthesie Generale (EVAN‚ÄêG) score and the Amsterdam Preoperative Anxiety and Information (APAIS) score, as markers of the patient's experience during the surgical encounter. RESULTS: During the study period, a total of 127 patients (mean age 55.3 years, 41.9% females) underwent randomization. The average EVAN‚ÄêG score was 84.3 (standard deviation, SD, 6.4) after VR, and 64.3 (SD, 11.7) after standard preoperative experience (difference, 20.0; 95% confidence interval, CI, 16.6‚Äê23.3). Exposure to an immersive VR experience also led to higher APAIS score (difference, 29.9; 95% CI, 24.5‚Äê35.2). In addition, VR led to lower preoperative VAS stress score (difference, ‚Äê41.7; 95% CI, ‚Äê33.1 to ‚Äê50.2), and higher preoperative VAS preparedness (difference, 32.4; 95% CI, 24.9‚Äê39.8), and VAS satisfaction (difference, 33.2; 95% CI, 25.4‚Äê41.0) scores. No association was identified with VAS stress score (difference, ‚Äê1.6; 95% CI, ‚Äê13.4 to 10.2). CONCLUSIONS: In a randomized controlled trial, we demonstrated that patients exposed to preoperative VR had increased satisfaction during the surgical encounter. Harnessing the power of this technology, hospitals can create an immersive environment that minimizes stress, and enhances the perioperative experience."," Bekelis, K;  Calnan, D;  Simmons, N;  MacKenzie, TA;  Kakoulides, G",2017.0, 10.1097/SLA.0000000000002094,0,0,
2014, SET-C versus fluoxetine in the treatment of childhood social phobia," OBJECTIVE: To determine the efficacy of fluoxetine, pill placebo, and Social Effectiveness Therapy for Children (SET‚ÄêC) for children and adolescents with social phobia. METHOD: Youths ages 7 to 17 were randomly assigned to one of the treatment conditions. Outcome was evaluated using self‚Äêreports, parent ratings, independent evaluator ratings, and behavioral assessment. RESULTS: Both fluoxetine and SET‚ÄêC were more efficacious than placebo in reducing social distress and behavioral avoidance and increasing general functioning. SET‚ÄêC was superior to fluoxetine on each of these measures and was the only treatment superior to placebo in terms of improving social skills, decreasing anxiety in specific social interactions, and enhancing ratings of social competence. Furthermore, whereas fluoxetine appears to exert maximum effect by 8 weeks, SET‚ÄêC provides continued improvement through week 12. CONCLUSIONS: Both fluoxetine and SET‚ÄêC are efficacious for social phobia, although SET‚ÄêC appears to provide added benefit by enhancing social skills."," Beidel, DC;  Turner, SM;  Sallee, FR;  Ammerman, RT;  Crosby, LA;  Pathak, S",2007.0, 10.1097/chi.0b013e318154bb57,0,0,
2015,Patient Rating of Therapeutic Factors and Response to Cognitive-Behavioral Group Therapy in Patients with Obsessive-Compulsive Disorder.,"Group therapy involves complex mechanisms that rely on certain therapeutic factors to promote improvement. The objective of this study was to assess patient rating of therapeutic factors during cognitive-behavioral group therapy (CBGT) and to investigate the correlation between patient rating and outcome of CBGT for the treatment of obsessive-compulsive disorder (OCD). In the present clinical trial, 15 patients participated in a 12-session CBGT protocol. Severity of symptoms was assessed before and after CBGT with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Clinical Global Impression (CGI), Hamilton Anxiety Scale (HAM-A), and Beck Depression Inventory (BDI). Yalom's Curative Factors Questionnaire was administered at the end of each session for patient rating of the usefulness of 12 therapeutic factors to treat OCD. There was a significant interaction between improvement in obsessive-compulsive symptoms and patient rating of altruism, universality, interpersonal learning input and output, family re-enactment, self-understanding, and existential factors over time. The results show that group therapeutic factors positively influence the response to CBGT in OCD patients.",Behenck AS.; Gomes JB.; Heldt E.,2016.0,10.3109/01612840.2016.1158335,0,0,
2016,Contribution of group therapeutic factors to the outcome of cognitive-behavioral therapy for patients with panic disorder.,"Background: Investigating the contribution of therapeutic factors arising from the collective nature or group therapy to treat mental disorders may help therapists maximize the outcome of therapy. Studies about the role of therapeutic factors in cognitive-behavioral group therapy (CBGT) for panic disorder (PD) patients are still scarce. Objectives: To identify the therapeutic factors rated as the most useful by patients during CBGT. Also, we aimed to investigate the relationship between patient rating of therapeutic factors and specific stages of CBGT. Design: Non-controlled clinical trial. Methods: A 12-session CBGT protocol was set up, covering psychoeducation, techniques for anxiety coping, cognitive restructuring, interoceptive and naturalistic exposure, and live exposure to avoidant behavior. PD symptom severity was assessed before and after the CBGT protocol. Yalom's Curative Factors Questionnaire was self-administered at the end of each session to evaluate the 12 therapeutic factors. Results: The sample consisted of 16 patients, who produced 192 assessments of therapeutic factors. Severity of symptoms improved at the end of CBGT, with a large effect size (> 1.0). Different ratings were attributed to therapeutic factors at different phases of CBGT. Seven factors were rated as significantly helpful: altruism, interpersonal learning/input, guidance, identification, family reenactment, self-understanding, and existential factors. Conclusions: Therapeutic factors are dynamic and interdependent. Therefore, recognizing the impact of these factors during CBGT may potentially contribute to a better understanding of the therapeutic process. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Behenck, Andressa; Wesner, Ana Cristina; Finkler, Debora; Heldt, Elizeth",2017.0,http://dx.doi.org/10.1016/j.apnu.2016.09.001,0,0,
2017,Effectiveness of an internet intervention (Deprexis) for depression in a united states adult sample: A parallel-group pragmatic randomized controlled trial.,"To examine the effectiveness of an Internet intervention for depression with a randomized, controlled trial in a large sample of adults recruited from the United States. The current study examines the effectiveness of Deprexis, an Internet treatment for depression that was provided with relatively minimal support. There were 376 treatment-seeking adults (mean age = 32 years; 74% female; 77% Caucasian, 7% Asian, 7% multiple races, 4% African American, and 11% Hispanic/Latino) with elevated depression (Quick Inventory of Depressive Symptoms-Self-Report [QIDS-SR] > = 10) who were randomized to receive an 8-week course of treatment immediately (n = 285) or after an 8-week delay (n = 91; i.e., waitlist control). Intention-to-treat analyses indicated that treatment was associated with greater reduction in self-reported symptoms of depression (effect size d = .80) and 12 times greater likelihood of experiencing at least 50% symptom improvement compared with waitlist control. Similar effects were observed for several secondary outcomes, such as interviewer-rated depression symptoms, well-being, and depression-related disability. Treatment effects for symptoms of social anxiety, panic, and traumatic intrusions were relatively small. Results suggest that Deprexis can produce symptomatic improvement among depressed adults recruited from the United States. Additional research is needed that examines whether improvements are maintained over time and who is particularly likely to respond to this form of treatment. (PsycINFO Database Record",Beevers CG.; Pearson R.; Hoffman JS.; Foulser AA.; Shumake J.; Meyer B.,2017.0,10.1037/ccp0000171,0,0,
2018,"Computer-guided problem-solving treatment for depression, PTSD, and insomnia symptoms in student veterans: A pilot randomized controlled trial.","Depression is a highly prevalent psychological disorder experienced disproportionately by college student military veterans with many deleterious effects including risk for suicide. Treatment can help, but the debilitating nature of depression often makes seeking in-person treatment difficult and many are deterred by stigma, inconvenience, concerns about privacy, or a preference to manage problems themselves. The current study examines the efficacy of a computer-guided Problem-Solving Treatment (ePST) for reducing symptoms of depression, posttraumatic stress disorder (PTSD), and insomnia in student military veterans. Twenty-four student veterans (Meanage = 32.7) with symptoms of depression were randomly assigned either to a treatment group receiving six weekly sessions of ePST or to a minimal contact control group (MCC). Participants completed the Patient Health Questionnaire-9 (PHQ-9) depression scale at baseline and then weekly through post-ePST or post-MCC. PTSD and insomnia questionnaires were also completed at baseline and posttreatment. A linear mixed model regression showed a statistically significant Group (ePST vs. MCC) x Time (pretreatment through posttreatment) interaction for depression, with the ePST showing substantial improvements in depressive symptoms over the 6-week period. Significant improvements were also seen in PTSD and insomnia symptoms. Results suggest that ePST can effectively treat depression, PTSD, and insomnia symptoms in student military veterans and may be a viable alternative for those who are not able to access live therapy. Future work should examine the durability of treatment effects and utility for more severe depression and suicide prevention. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Bedford, Lee A; Dietch, Jessica R; Taylor, Daniel J; Boals, Adriel; Zayfert, Claudia",2018.0,http://dx.doi.org/10.1016/j.beth.2017.11.010,0,0,
2019," Impact of Skill-Based Approaches in Reducing Stigma in Primary Care Physicians: results from a Double-Blind, Parallel-Cluster, Randomized Controlled Trial"," OBJECTIVE: Most interventions to reduce stigma in health professionals emphasize education and social contact‚Äêbased strategies. We sought to evaluate a novel skill‚Äêbased approach: the British Columbia Adult Mental Health Practice Support Program. We sought to determine the program's impact on primary care providers' stigma and their perceived confidence and comfort in providing care for mentally ill patients. We hypothesized that enhanced skills and increased comfort and confidence on the part of practitioners would lead to diminished social distance and stigmatization. Subsequently, we explored the program's impact on clinical outcomes and health care costs. These outcomes are reported separately, with reference to this article. METHODS: In a double‚Äêblind, cluster randomized controlled trial, 111 primary care physicians were assigned to intervention or control groups. A validated stigma assessment tool, the Opening Minds Scale for Health Care Providers (OMS‚ÄêHC), was administered to both groups before and after training. Confidence and comfort were assessed using scales constructed from ad hoc items. RESULTS: In the primary analysis, no significant differences in stigma were found. However, a subscale assessing social distance showed significant improvement in the intervention group after adjustment for a variable (practice size) that was unequally distributed in the randomization. Significant increases in confidence and comfort in managing mental illness were observed among intervention group physicians. A positive correlation was found between increased levels of confidence/comfort and improvements in overall stigma, especially in men. CONCLUSIONS: This study provides some preliminary evidence of a positive impact on health care professionals' stigma through a skill‚Äêbuilding approach to management of mild to moderate depression and anxiety in primary care. The intervention can be used as a primary vehicle for enhancing comfort and skills in health care providers and, ultimately, reducing an important dimension of stigma: preference for social distance."," Beaulieu, T;  Patten, S;  Knaak, S;  Weinerman, R;  Campbell, H;  Lauria-Horner, B",2017.0, 10.1177/0706743716686919,0,0,
2020,'Cancer coping online': A pilot trial of a self-guided CBT internet intervention for cancer-related distress.,"While internet-based cognitive behaviour therapy (iCBT) programs for mental health conditions has a demonstrated evidence base, the application of iCBT to those experiencing cancer-related distress has not been reported. This study therefore developed and pilot tested a self-guided iCBT program for patients with early stage cancer. Cancer Coping Online is a 6-week intervention which provides information, worksheets, and activities to address commonly experienced physical, emotional, social and communication difficulties. Participants were 12 patients (11 female) recruited over a 3-month period from one public hospital. The primary outcome measures were negative affect and posttraumatic stress. The secondary outcome measures were coping styles (helplessness/hopelessness, anxious preoccupation, cognitive avoidance, fatalism and fighting spirit). Changes over time were measured using within group effect sizes (Cohen's d), with reliable change indices (RCIs) used to assess the clinical significance of changes over time. The intervention led to reductions in negative affect (d = 0.53), helplessness/hopelessness (d = 0.64), anxious preoccupation (d = 0.43), and fatalism (d = 0.42). These reductions were clinically significant for 33% of the sample for negative affect, and for 25% of the sample for helplessness/hopelessness and anxious preoccupation. These results indicate that an iCBT program for cancer patients can reduce distress, and warrant further investigation through a randomised controlled trial. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Beatty, Lisa; Koczwara, Bogda; Wade, Tracey",2011.0,http://dx.doi.org/10.7790/ejap.v7i2.256,0,0,
2021, Effectiveness of Taste Lessons with and without additional experiential learning activities on children's willingness to taste vegetables," This study assessed the effectiveness of the Dutch school programme Taste Lessons with and without additional experiential learning activities on children's willingness to taste unfamiliar vegetables. Thirty‚Äêthree primary schools (877 children in grades 6‚Äê7 with a mean age of 10.3 years) participated in Taste Lessons Vegetable Menu (TLVM, lessons and extra activities), Taste Lessons (TL, lessons), or a control group. A baseline and follow‚Äêup measurement was used to assess for each child: number of four familiar and four unfamiliar vegetables tasted, quantity tasted, choice of vegetable of which to eat more, and number of vegetables willing to taste again later. Furthermore, children filled out a questionnaire on daily vegetable intake and food neophobia. Multilevel and Cox regression analyses were conducted to compare changes in the outcome measures between the three study groups. No significant intervention effects were found on willingness to taste unfamiliar vegetables. Neither were effects found on familiar vegetables, except for number of familiar vegetables tasted (p < 0.05). Furthermore, no significant intervention effects were found on daily vegetable consumption and food neophobia. These results indicate that more intensive school‚Äêbased nutrition education activities are needed to increase children's willingness to taste unfamiliar vegetables and increase their vegetable intake."," Battjes-Fries, MCE;  Haveman-Nies, A;  Zeinstra, GG;  van Dongen, EJI;  Meester, HJ;  van den Top-Pullen, R;  Van't Veer, P;  de Graaf, K",2017.0, 10.1016/j.appet.2016.05.020,0,0,
2022,The panic disorder screener (PADIS): Development of an accurate and brief population screening tool,"The Panic Disorder Screener (PADIS) was developed as a new screener to identify panic disorder in the community and to assess severity of symptoms. The PADIS was developed to fill a gap in existing screening measures, as there are no brief panic screeners available that assess severity. The current study aimed to test the performance of the screener relative to the Patient Health Questionnaire-panic scale (PHQ-panic). The 4-item PADIS was administered to 12,336 young Australian adults, together with the PHQ-panic. A subsample of 1674 participants also completed a phone-based clinical interview to determine whether they met DSM-IV criteria for panic disorder. The PADIS (77% sensitivity, 84% specificity) had higher sensitivity for identifying panic disorder based on clinical criteria than the PHQ-panic (57% sensitivity, 91% specificity), although with reduced specificity. Administration of the PADIS required a mean of 1.9 items, compared to 4.7 items for the PHQ-panic. Each one-point increase in PADIS score was associated with 69% increased odds of meeting clinical criteria for panic disorder. The PADIS was found to be a valid, reliable and brief panic screener that is freely available for use in research and clinical settings.",Batterham P.J.; Mackinnon A.J.; Christensen H.,2015.0,10.1016/j.psychres.2015.04.016,0,0,
2023,Direction of stimulus movement alters fear-linked individual differences in attentional vigilance to spider stimuli.,"Researchers have proposed that high spider-fearful individuals are characterised by heightened attentional vigilance to spider stimuli, as compared to low spider-fearful individuals. However, these findings have arisen from methodologies that have uniformly employed only static stimuli. Such findings do not inform upon the patterns of fear-linked attentional selectivity that occur in the face of moving feared stimuli. Hence, the present study developed a novel methodology designed to examine the influence of stimulus movement on attentional vigilance to spider and non-spider stimuli. Eighty participants who varied in level of spider-fear completed an attentional-probe task that presented stimuli under two conditions. One condition presented stimuli that displayed an approaching movement, while the other condition presented stimuli that displayed a receding movement. Fear-linked heightened attentional vigilance was observed exclusively under the latter condition. These findings suggest that fear-linked attentional vigilance to spider stimuli does not represent a uniform characteristic of heightened spider-fear, but rather is influenced by stimulus context. The means by which these findings inform understanding of attentional mechanisms that characterise heightened spider-fear, and avenues for future research, are discussed.",Basanovic J.; Dean L.; Riskind JH.; MacLeod C.,2017.0,10.1016/j.brat.2017.10.004,0,0,
2024,Does prolonged grief treatment foster posttraumatic growth? Secondary results from a treatment study with long-term follow-up and mediation analysis.,"Objectives: Prolonged grief disorder (PGD) is a persistent and disabling kind of grief reaction that can be treated effectively with psychotherapeutic interventions. There has been limited investigation of whether these interventions can also enhance positive outcomes of bereavement, such as posttraumatic growth or benefit finding. Design: As part of secondary analyses in a randomized controlled trial evaluating integrative cognitive-behavioural therapy for PGD (PG-CBT), the posttraumatic growth trajectories in 51 outpatients with clinically relevant prolonged grief symptoms were followed up from baseline up to 1.5 years. Methods: Immediate treatment effects on posttraumatic growth in comparison with a waiting list control group were evaluated with univariate ANCOVA. Using mediation analysis, we examined the relation between symptom reduction and the short-term treatment effect on posttraumatic growth. For evaluating long-term outcome stability, the immediately treated group and the delayed treatment group were pooled. Results: PG-CBT significantly fostered growth in patients suffering from PGD, with a controlled medium effect size of Cohen's d = 0.60 (completer analysis). This effect remained stable up to the 1.5-year follow-up. Grief symptom reduction mediated short-term treatment effects on posttraumatic growth. However, growth also partially mediated treatment effects on prolonged grief symptoms. Conclusions: Taken together, PG-CBT was effective in enhancing the participants' perception of posttraumatic growth, but the definite interaction between symptom reduction and posttraumatic growth remains unclear, as both seemed to influence each other's trajectory in the course of treatment. Practitioner points: 1. Integrative CBT for prolonged grief disorder also fostered posttraumatic growth. 2. Post-treatment and 1.5-year follow-up effect sizes for posttraumatic growth were moderate. 3. Whether growth-enhancing techniques are useful in grief treatment needs further research. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Bartl, Helga; Hagl, Maria; Kotoucova, Michaela; Pfoh, Gabriele; Rosner, Rita",2018.0,http://dx.doi.org/10.1111/papt.12140,0,0,
2025, Collaboration enhances later individual memory for emotional material," Research on collaborative remembering suggests that collaboration hampers group memory (i.e., collaborative inhibition), yet enhances later individual memory. Studies examining collaborative effects on memory for emotional stimuli are scarce, especially concerning later individual memory. In the present study, female undergraduates watched an emotional movie and recalled it either collaboratively (n = 60) or individually (n = 60), followed by an individual free recall test and a recognition test. We replicated the standard collaborative inhibition effect. Further, in line with the literature, the collaborative condition displayed better post‐collaborative individual memory. More importantly, in post‐collaborative free recall, the centrality of the information to the movie plot did not play an important role. Recognition rendered slightly different results. Although collaboration rendered more correct recognition for more central details, it did not enhance recognition of background details. Secondly, the collaborative and individual conditions did not differ with respect to overlap of unique correct items in free recall. Yet, during recognition former collaborators more unanimously endorsed correct answers, as well as errors. Finally, extraversion, neuroticism, social anxiety, and depressive symptoms did not moderate the influence of collaboration on memory. Implications for the fields of forensic and clinical psychology are discussed."," Bärthel, GA;  Wessel, I;  Huntjens, RJ;  Verwoerd, J",2017.0, 10.1080/09658211.2016.1208248,0,0,
2026,Pilot RCT of the use of video interactive guidance with preterm babies.,"Objective: To assess the potential of video interaction guidance (VIG) to increase sensitivity in parents of preterm infants. Background: Parental sensitivity has been identified as explaining some but not all of the capacity of full-term infants for later affect-regulation via its impact on the infant's attachment system. Video interaction guidance (VIG) appears to be a promising intervention to improve parental sensitivity. Methods: A pilot randomised control trial was undertaken of the effectiveness of VIG in improving parental sensitivity using the CARE-Index as a primary outcome measure. Secondary outcomes included parenting stress, depression and anxiety, and post-traumatic stress. Data were collected at baseline and post-intervention, and analysed on an intent-to-treat basis, using analyses of covariance. Results: Thirty-one parents of an infant born at 32 weeks or less gestation were recruited from a city neonatal intensive care unit (NICU). The results show large but non-significant differences favouring the intervention group for both parental sensitivity (d = 0.86; p = 0.069) and infant cooperativeness (d = 0.78; p = 0.10). There were also medium to large non-significant differences favouring the intervention group for depression (d = 0.33; p = 0.41), anxiety (d = 0.38; p = 0.30), and parenting stress (d = 0.87; p = 0.14). There was no difference between groups in the proportion of parents with post-traumatic stress disorder (RR: 1.05; 95% CI: 0.85-1.37). Conclusion: VIG appears to be a promising intervention with which to increase parental sensitivity in parents of preterm infants, but additional components explicitly targeting parental trauma may also be needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Barlow, Jane; Sembi, Sukhdev; Underdown, Angela",2016.0,http://dx.doi.org/10.1080/02646838.2016.1217404,0,0,
2027,Inactivation of ventral hippocampus projections promotes sensitivity to changes in contingency,"The loss of behavioral flexibility is common across a number of neuropsychiatric illnesses. This may be in part due to the loss of the ability to detect or use changes in action-outcome contingencies to guide behavior. There is growing evidence that the ventral hippocampus plays a critical role in the regulation of flexible behavior and reward-related decision making. Here, we investigated the role of glutamatergic projections from the ventral hippocampus in the expression of contingency-mediated reward seeking. We demonstrate that selectively silencing ventral hippocampus projections can restore the use of action-outcome contingencies to guide behavior, while sparing cue-guided behavior and extinction learning. Our findings further indicated that the ability of the ventral hippocampus to promote habitual response strategies may be in part mediated by selective projections from the ventral hippocampus to the nucleus accumbens shell. Together these results implicate glutamatergic projections from the ventral hippocampus in the regulation of behavioral flexibility and suggest that alterations in ventral hippocampus function may contribute to overreliance on habitual response strategy observed in neuropsychiatric illnesses including addiction and obsessive-compulsive disorder.",Barker J.M.; Bryant K.G.; Chandler L.J.,2019.0,10.1101/lm.048025.118,0,0,
2028,A longitudinal examination of the role of attentional control in the relationship between posttraumatic stress and threat-related attentional bias: An eye-tracking study.,"The purpose of the present study was to use eye-tracking technology to (a) show that attentional control can be used to reduce attentional bias to threat (ABT) among those with higher levels of posttraumatic stress (PTS) symptoms, (b) identify the specific attentional control (AC) processes (i.e., inhibition, shifting, working memory updating) that account for this effect, and (c) determine the short- (sympathetic nervous system reactivity) and long-term effects (PTS symptoms) of using attentional control in this manner. At Time 1 (T1), participants (N = 116 trauma exposed) completed self-report measures, an eye-tracking task assessing ABT, and behavioral measures assessing cognitive processes. A subsample (n = 49) completed an online follow-up assessment (T2). AC at T1 moderated the PTS-ABT relationship. Inhibitory ability appears to be driving this effect. Those with higher PTS symptoms and higher AC at T1, who spent less time attending to threat stimuli and had the lowest sympathetic response, had the highest levels of PTS symptoms at T2. Findings suggest that the habitual use of AC (especially inhibition) to shift attention from threat to neutral stimuli may alleviate distress in the short-term for those with higher PTS symptoms, but maintain, and perhaps exacerbate, PTS symptoms over longer periods. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Bardeen, Joseph R; Daniel, Thomas A",2017.0,http://dx.doi.org/10.1016/j.brat.2017.09.003,0,0,
2029,Dual focus schema therapy for personality disorders and substance dependence: Case study results.,"This chapter reviews the theory, techniques, and development of a manual-guided individual psychotherapy for substance-dependent individuals diagnosed with personality disorders. Dual Focus Schema Therapy is a 24-wk therapy that integrates relapse prevention for substance dependence with targeted work on early maladaptive schemas (enduring negative beliefs about oneself, others, and events) and coping styles. The first 3 patients--one each from Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) Axis-II Cluster A, B, and C--treated during the pilot testing phase of the manual are summarized to illustrate differences in psychopathology, personality and interpersonal functioning, early maladaptive schemas, and coping styles, as well as treatment response. The 3 patients examined are a 41-yr-old female with schizotypal personality disorder, a 34-yr-old female with borderline personality disorder, and a 36-yr-old male with obsessive-compulsive personality disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ball, Samuel A; Young, Jeffrey E",2000.0,http://dx.doi.org/10.1016/S1077-7229%2800%2980083-8,0,0,
2030, Group schema therapy versus group cognitive behavioral therapy for social anxiety disorder with comorbid avoidant personality disorder: study protocol for a randomized controlled trial," BACKGROUND: Social anxiety disorder (SAD) with comorbid avoidant personality disorder (APD) has a high prevalence and is associated with serious psychosocial problems and high societal costs. When patients suffer from both SAD and APD, the Dutch multidisciplinary guidelines for personality disorders advise offering prolonged cognitive behavioral therapy (CBT). Recently there is increasing evidence for the effectiveness of schema therapy (ST) for personality disorders such as borderline personality disorder and cluster C personality disorders. Since ST addresses underlying personality characteristics and maladaptive coping strategies developed in childhood, this treatment might be particularly effective for patients with SAD and comorbid APD. To our knowledge, there are no studies comparing CBT with ST in this particular group of patients. This superiority trial aims at comparing the effectiveness of these treatments. As an additional goal, predictors and underlying mechanisms of change will be explored. METHODS/DESIGN: The design of the study is a multicentre two‐group randomized controlled trial (RCT) in which the treatment effect of group cognitive behavioral therapy (GCBT) will be compared to that of group schema therapy (GST) in a semi‐open group format. A total of 128 patients aged 18‐65 years old will be enrolled. Patients will receive 30 sessions of GCBT or GST during a period of approximately 9 months. Primary outcome measures are the Liebowitz Social Anxiety Scale Self‐Report (LSAS‐SR) for social anxiety disorder and the newly developed Avoidant Personality Disorder Severity Index (AVPDSI) for avoidant personality disorder. Secondary outcome measures are the MINI section SAD, the SCID‐II section APD, the Schema Mode Inventory (SMI‐2), the Inventory of Depressive Symptomatology Self‐Report (IDS‐SR), the World Health Organization Quality of Life‐BREF (WHOQOL‐BREF), the Difficulties in Emotion Regulation Scale (DERS), the Rosenberg Self‐Esteem Scale (RSES) and the Acceptance and Action Questionnaire (AAQ‐II). Data will be collected at the start, halfway and at the end of the treatment, followed by measurements at 3, 6 and 12 months post‐treatment. DISCUSSION: The trial will increase our knowledge on the effectiveness and applicability of both treatment modalities for patients suffering from both diagnoses. TRIAL REGISTRATION: Dutch Trial Register: NTR3921 . Registered on 25 March 2013."," Baljé, A;  Greeven, A;  van Giezen, A;  Korrelboom, K;  Arntz, A;  Spinhoven, P",2016.0, 10.1186/s13063-016-1605-9,0,0,
2031, Randomized trial of an uncertainty self-management telephone intervention for patients awaiting liver transplant," OBJECTIVE: We tested an uncertainty self‚Äêmanagement telephone intervention (SMI) with patients awaiting liver transplant and their caregivers. METHODS: Participants were recruited from four transplant centers and completed questionnaires at baseline, 10, and 12 weeks from baseline (generally two and four weeks after intervention delivery, respectively). Dyads were randomized to either SMI (n=56) or liver disease education (LDE; n=59), both of which involved six weekly telephone sessions. SMI participants were taught coping skills and uncertainty management strategies while LDE participants learned about liver function and how to stay healthy. Outcomes included illness uncertainty, uncertainty management, depression, anxiety, self‚Äêefficacy, and quality of life. General linear models were used to test for group differences. RESULTS: No differences were found between the SMI and LDE groups for study outcomes. CONCLUSION: This trial offers insight regarding design for future interventions that may allow greater flexibility in length of delivery beyond our study's 12‚Äêweek timeframe. PRACTICE IMPLICATIONS: Our study was designed for the time constraints of today's clinical practice setting. This trial is a beginning point to address the unmet needs of these patients and their caregivers as they wait for transplants that could save their lives."," Bailey, DE;  Hendrix, CC;  Steinhauser, KE;  Stechuchak, KM;  Porter, LS;  Hudson, J;  Olsen, MK;  Muir, A;  Lowman, S;  DiMartini, A;  et al.",2017.0, 10.1016/j.pec.2016.10.017,0,0,
2032,"Effect of aromatherapy massage on anxiety, depression, and physiologic parameters in older patients with the acute coronary syndrome: A randomized clinical trial.","This study aimed to investigate the effect of aromatherapy massage on anxiety, depression, and physiologic parameters in older patients with acute coronary syndrome. This randomized controlled trial was conducted on 90 older women with acute coronary syndrome. The participants were randomly assigned into the intervention and control groups (n = 45). The intervention group received reflexology with lavender essential oil, but the control group only received routine care. Physiologic parameters, the levels of anxiety and depression in the hospital were evaluated using a checklist and the Hospital's Anxiety and Depression Scale, respectively, before and immediately after the intervention. Significant differences in the levels of anxiety and depression were reported between the groups after the intervention. The analysis of physiological parameters revealed a statistically significant reduction (P < .05) in systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate. However, no significant difference was observed in the respiratory rate. Aromatherapy massage can be considered by clinical nurses an efficient therapy for alleviating psychological and physiological responses among older women suffering from acute coronary syndrome.",Bahrami T.; Rejeh N.; Heravi-Karimooi M.; Vaismoradi M.; Tadrisi SD.; Sieloff C.,2017.0,10.1111/ijn.12601,0,0,
2033,Trauma-related altered states of consciousness in post-traumatic stress disorder patients with or without comorbid dissociative disorders.,"Background: The four-dimensional ('4-D') model has been proposed as a theoretical framework to understand and delineate trauma-related dissociative experiences, categorizing symptoms into trauma-related altered states of consciousness (TRASC) and normal waking consciousness (NWC), which occur along four dimensions: time, thought, body and emotion. Objective: The main aim of the present study was to evaluate the validity of this model in patients with post-traumatic stress disorder (PTSD), with and without comorbid dissociative disorders. Method: The predictions of the 4-D model were tested in 142 patients with PTSD, with (N = 46) and without (N = 96) comorbid dissociative disorders. Results: As predicted by the 4-D model, experiences of TRASC were less frequent and more specifically related to other measures of dissociation, dissociative disorder comorbidity and a history of childhood sexual abuse compared to experiences of NWC. The predicted lower intercorrelation of TRASC was not supported. Conclusion: The 4-D model represents a promising framework for understanding dissociation across trauma-related disorders. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Abstract (Chinese) :'4-D',(TRASC)(NWC),:(1); (2); (3); (4)(PTSD): 142PTSD4-D,N = 46,N = 96: 4-D,NWC,TRASC,TRASC: 4-D- (PsycINFO Database Record (c) 2018 APA, all rights reserved) Abstract (Spanish) Antecedentes: El 'modelo 4-D' ha sido propuesto como un marco teorico para entender y delinear las experiencias disociativas relacionadas al trauma, categorizando los sintomas en estados alterados de conciencia relacionados al trauma (TRASC en su sigla en ingles) y la conciencia en vigilia normal (NWC en sus siglas en ingles), que ocurren a lo largo de cuatro dimensiones: (1) tiempo; (2) pensamiento; (3) cuerpo; y (4) emocion. El principal objetivo del presente estudio fue evaluar la validez de este modelo en pacientes con Trastorno de Estres Postraumatico (TEPT), con y sin trastornos disociativos comorbidos. Metodos: Los predictores del modelo 4-D fueron probados en 142 pacientes con TEPT, con (N = 46) y sin (N = 96) trastornos disociativos comorbidos. Resultados: Como predice el modelo 4-D, las experiencias de los TRASC fueron menos frecuentes y mas especificamente relacionados a otras medidas de disociacion, comorbilidad del trastorno disociativo y una historia de abuso sexual infantil en comparacion a las experiencias de NWC. La prediccion de la intercorrelacion mas baja de los TRASC no fue confirmada. Conclusion: El modelo 4-D representa un prometedor marco para el entendimiento de la disociacion de forma transversal en los trastornos relacionados al trauma. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Baekkelund, Harald; Frewen, Paul; Lanius, Ruth; Berg, Akiah Ottesen; Arnevik, Espen Ajo",2018.0,http://dx.doi.org/10.1080/20008198.2018.1544025,0,0,
2034,"Binge eating, trauma, and suicide attempt in community adults with major depressive disorder.","Eating disorders comorbid with depression are an established risk factor for suicide. In this study, we aimed to determine the effects of binge eating (BE) symptoms on suicidality and related clinical characteristics in major depressive disorder (MDD). A total of 817 community participants with MDD were included. We compared two groups (with and without lifetime BE symptoms). The MDD with BE group was subdivided into a frequent BE (FBE) subgroup (BE symptoms greater than twice weekly) and any BE (ABE) subgroup (BE symptoms greater than twice weekly). The MDD with BE group comprised 142 (17.38%) patients. The FBE and ABE subgroups comprised 75 (9.18%) and 67 (8.20%) patients, respectively. Comorbid alcohol use disorder, anxiety disorder, post-traumatic stress disorder (PTSD) and history of suicide attempt were significantly more frequent in the MDD with BE group than MDD without BE group. Sexual trauma was also reported more frequently in MDD with BE group. No significant differences were observed between the ABE and FBE subgroups. Multivariate logistic regression revealed an association of suicide attempt with BE symptoms and sexual trauma. Structural equation modeling showed that sexual trauma increased BE (β = 0.337, P <0.001) together with alcohol use (β = 0.185, P <0.001) and anxiety (β = 0.299, p<0.001), which in turn increased suicide attempt (β = 0.087, p = 0.011). BE symptoms were associated with suicide attempt in MDD after adjusting for other factors associated with suicidality. BE symptoms also moderated an association between suicide attempt and sexual trauma.",Baek JH.; Kim K.; Hong JP.; Cho MJ.; Fava M.; Mischoulon D.; Chang SM.; Kim JY.; Cho H.; Jeon HJ.,2018.0,10.1371/journal.pone.0198192,0,0,
2035,Effect of attention training on attention bias variability and PTSD symptoms: Randomized controlled trials in Israeli and U.S. combat veterans.,"Objective: Attention allocation to threat is perturbed in patients with posttraumatic stress disorder (PTSD), with some studies indicating excess attention to threat and others indicating fluctuations between threat vigilance and threat avoidance. The authors tested the efficacy of two alternative computerized protocols, attention bias modification and attention control training, for rectifying threat attendance patterns and reducing PTSD symptoms. Method: Two randomized controlled trials compared the efficacy of attention bias modification and attention control training for PTSD:one in Israel Defense Forces veterans and one in U.S.military veterans. Both utilized variants of the dot-probe task, with attention bias modification designed to shift attention away from threat and attention control training balancing attention allocation between threat and neutral stimuli. PTSD symptoms, attention bias, and attention bias variability were measured before and after treatment. Results: Both studies indicated significant symptom improvement after treatment, favoring attention control training. Additionally, both studies found that attention control training, but not attention bias modification, significantly reduced attention bias variability. Finally, a combined analysis of the two samples suggested that reductions in attention bias variability partially mediated improvement in PTSD symptoms. Conclusions: Attention control training may address aberrant fluctuations in attention allocation in PTSD, thereby reducing PTSD symptoms. Further study of treatment efficacy and its underlying neurocognitive mechanisms is warranted. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Badura-Brack, Amy S; Naim, Reut; Ryan, Tara J; Levy, Ofir; Abend, Rany; Khanna, Maya M; McDermott, Timothy J; Pine, Daniel S; Bar-Haim, Yair",2015.0,,0,0,
2036,Attention training modulates resting-state neurophysiological abnormalities in posttraumatic stress disorder.,"Recent research indicates the relative benefits of computerized attention control treatment (ACT) and attention bias modification treatment (ABMT) for posttraumatic stress disorder (PTSD); however, neural changes underlying these therapeutic effects remain unknown. This study examines how these two types of attention training modulate neurological dysfunction in veterans with PTSD. A community sample of 46 combat veterans with PTSD participated in a randomized double-blinded clinical trial of ACT versus ABMT and 32 of those veterans also agreed to undergo resting-state magnetoencephalography (MEG) recordings. Twenty-four veterans completed psychological and MEG assessments at pre- and post-training to evaluate treatment effects. MEG data were imaged using an advanced Bayesian reconstruction method and examined using statistical parametric mapping. In this report, we focus on the neural correlates and the differential treatment effects observed using MEG; the results of the full clinical trial have been described elsewhere. Our results indicated that ACT modulated occipital and ABMT modulated medial temporal activity more strongly than the comparative treatment. PTSD symptoms decreased significantly from pre- to post-test. These initial neurophysiological outcome data suggest that ACT modulates visual pathways, while ABMT modulates threat-processing regions, but that both are associated with normalizing aberrant neural activity in veterans with PTSD. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Badura-Brack, Amy; McDermott, Timothy J; Becker, Katherine M; Ryan, Tara J; Khanna, Maya M; Pine, Daniel S; Bar-Haim, Yair; Heinrichs-Graham, Elizabeth; Wilson, Tony W",2018.0,http://dx.doi.org/10.1016/j.pscychresns.2017.11.008,0,0,
2037, Self-help interventions for adjustment disorder problems: a randomized waiting-list controlled study in a sample of burglary victims," Adjustment disorders (AjD) are among the most frequent mental disorders yet often remain untreated. The high prevalence, comparatively mild symptom impairment, and transient nature make AjD a promising target for low‚Äêthreshold self‚Äêhelp interventions. Bibliotherapy represents a potential treatment for AjD problems. This study investigates the effectiveness of a cognitive behavioral self‚Äêhelp manual specifically directed at alleviating AjD symptoms in a homogenous sample of burglary victims. Participants with clinical or subclinical AjD symptoms following experience of burglary were randomized to an intervention group (n = 30) or waiting‚Äêlist control group (n = 24). The new explicit stress response syndrome model for diagnosing AjD was applied. Participants received no therapist support and assessments took place at baseline, after the one‚Äêmonth intervention, and at three‚Äêmonth follow‚Äêup. Based on completer analyses, group by time interactions indicated that the intervention group showed more improvement in AjD symptoms of preoccupation and in post‚Äêtraumatic stress symptoms. Post‚Äêintervention between‚Äêgroup effect sizes ranged from Cohen's d = .17 to .67 and the proportion of participants showing reliable change was consistently higher in the intervention group than in the control group. Engagement with the self‚Äêhelp manual was high: 87% of participants had worked through at least half the manual. This is the first published RCT of a bibliotherapeutic self‚Äêhelp intervention for AjD problems. The findings provide evidence that a low‚Äêthreshold self‚Äêhelp intervention without therapist contact is a feasible and effective treatment for symptoms of AjD."," Bachem, R;  Maercker, A",2016.0, 10.1080/16506073.2016.1191083,0,0,
2038,Anxiety-Like Behavioural Inhibition Is Normative under Environmental Threat-Reward Correlations,"Behavioural inhibition is a key anxiety-like behaviour in rodents and humans, distinct from avoidance of danger, and reduced by anxiolytic drugs. In some situations, it is not clear how behavioural inhibition minimises harm or maximises benefit for the agent, and can even appear counterproductive. Extant explanations of this phenomenon make use of descriptive models but do not provide a formal assessment of its adaptive value. This hampers a better understanding of the neural computations underlying anxiety behaviour. Here, we analyse a standard rodent anxiety model, the operant conflict test. We harvest Bayesian Decision Theory to show that behavioural inhibition normatively arises as cost-minimising strategy in temporally correlated environments. Importantly, only if behavioural inhibition is aimed at minimising cost, it depends on probability and magnitude of threat. Harnessing a virtual computer game, we test model predictions in four experiments with human participants. Humans exhibit behavioural inhibition with a strong linear dependence on threat probability and magnitude. Strikingly, inhibition occurs before motor execution and depends on the virtual environment, thus likely resulting from a neural optimisation process rather than a pre-programmed mechanism. Individual trait anxiety scores predict behavioural inhibition, underlining the validity of this anxiety model. These findings put anxiety behaviour into the context of cost-minimisation and optimal inference, and may ultimately pave the way towards a mechanistic understanding of the neural computations gone awry in human anxiety disorder.",Bach D.R.,2015.0,10.1371/journal.pcbi.1004646,0,0,
2039,Pupillometry reveals the physiological underpinnings of the aversion to holes,"An unusual, but common, aversion to images with clusters of holes is known as trypophobia. Recent research suggests that trypophobic reactions are caused by visual spectral properties also present in aversive images of evolutionary threatening animals (e.g., snakes and spiders). However, despite similar spectral properties, it remains unknown whether there is a shared emotional response to holes and threatening animals. Whereas snakes and spiders are known to elicit a fear reaction, associated with the sympathetic nervous system, anecdotal reports from self-described trypophobes suggest reactions more consistent with disgust, which is associated with activation of the parasympathetic nervous system. Here we used pupillometry in a novel attempt to uncover the distinct emotional response associated with a trypophobic response to holes. Across two experiments, images of holes elicited greater constriction compared to images of threatening animals and neutral images. Moreover, this effect held when controlling for level of arousal and accounting for the pupil grating response. This pattern of pupillary response is consistent with involvement of the parasympathetic nervous system and suggests a disgust, not a fear, response to images of holes. Although general aversion may be rooted in shared visual-spectral properties, we propose that the specific emotion is determined by cognitive appraisal of the distinct image content.",Ayzenberg V.; Hickey M.R.; Lourenco S.F.,2018.0,10.7717/peerj.4185,0,0,
2040, Adaptation and implementation of a trauma-focused cognitive behavioral intervention for girls in child welfare," This study describes the process of adapting and implementing Girls Aspiring toward Independence (GAIN), a trauma‚Äêfocused, group‚Äêbased therapy adapted from Cognitive Behavioral Intervention for Trauma in Schools (CBITS) for girls in child welfare. Descriptive data were examined on 3 outcomes: posttraumatic stress disorder (PTSD), depression, and social problem‚Äêsolving skills among adolescent girls in the child welfare system. Qualitative and quantitative methods were utilized to inform the adaptation of the CBITS intervention, evaluate feasibility, treatment fidelity, and acceptability, and to test the effects of the intervention. Girls ages 12 to 18 (N = 27) were randomly assigned to the experimental and usual care conditions. Participants' symptoms of PTSD and depression and social problem‚Äêsolving skills were evaluated at pre, post‚Äê (3 months), and follow‚Äêup (6 months) assessments. Adaptations for GAIN were primarily related to program structure. Data indicated that the program was receptive to girls in child welfare and that it was feasible to recruit, randomize, assess outcomes, and implement with adequate fidelity. Retention was more successful among younger girls. Descriptive initial data showed greater reductions in the percentage of girls with PTSD and depression, and modest increases in social problem‚Äêsolving skills in the experimental versus usual care condition. Despite the growth of knowledge in dissemination and implementation research, the application of trauma‚Äêfocused empirically supported treatment to child welfare populations lags behind. A large‚Äêscale RCT is needed to determine if GAIN is effective in reducing mental health problems and social problem‚Äêsolving in the child welfare population. (PsycINFO Database Record"," Auslander, W;  McGinnis, H;  Tlapek, S;  Smith, P;  Foster, A;  Edmond, T;  Dunn, J",2017.0, 10.1037/ort0000233,0,0,
2041,Evaluating an activity intervention with hemodialysis patients in Israel.,"As a life-threatening and potentially disabling disease, End Stage Renal Disease and its treatment cause stress as well as other psychosocial problems for patients and their families. This paper examines the results of an innovative activity-based intervention aimed at reducing some of the psychosocial repercussions of hemodialysis. A modified withdrawal/reversal design was employed to compare patients (mean age 54 yrs) participating in the intervention and those who did not, at 2 points in time. The findings confirmed that dialysis patients in general have relatively high levels of psychological distress, difficulty adhering to the treatment regimen and poor self-rated health. Patients participating in the group activity were more anxious and had lower levels of interdialytic weight gain than the non-participants. After the intervention was terminated, levels of psychological distress, hostility and phobic anxiety among patients in the treatment group dropped, while their weight gain continued to be less than that of non-participating patients. The implications of these findings as well as the methodological difficulties entailed in this type of study are examined. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Auslander, Gail K; Buchs, Adina",2002.0,http://dx.doi.org/10.1300/J010v35n01_05,0,0,
2042, Materialism moderates the impact of mortality salience on impulsive tendencies toward luxury brands," Luxury goods have been shown to help individuals coping with death‚Äêrelated anxiety. However, the extent to which the symbolic value allocated to possessions (i.e., materialism) moderates this effect is still unclear. Here, we investigated the impact of materialism on impulsive approach tendencies toward luxury clothing brands in a context of mortality salience. Results showed that the impact of mortality salience was moderated by materialism with lower impulsive approach tendencies toward luxury clothing brands observed in non‚Äêmaterialistic participants. These findings highlight how materialism values may impact luxury consumption through impulsive pathways in a situation of death‚Äêrelated anxiety."," Audrin, C;  Cheval, B;  Chanal, J",2018.0, 10.1080/07481187.2017.1334008,0,0,
2043,Pituitary gland volumes in patients with obsessive-compulsive disorder before and after cognitive-behavioral therapy.,"The beneficial effects of psychopharmacological and cognitive behavioral therapy (CBT) on the brain are not well understood. In a previous study, we found smaller pituitary volumes in patients with obsessive-compulsive disorder (OCD). The purpose of this study was to examine the effect of CBT on pituitary gland volume. A total of 81 patients with various anxiety disorders and the same number of healthy controls underwent magnetic resonance imaging, and their pituitary gland volumes were compared at baseline. Pituitary gland volumes were also measured before and after CBT in the patient group. OCD patients had smaller pituitary gland volumes at baseline than healthy controls (0.54±0.29 cm3 for OCD patients vs. 0.82±0.30 cm3 for healthy controls; p < 0.001). We found no significant changes in OCD patient pituitary gland volume after the 16-week treatment period, with mean pre- and post-treatment values of 0.54±0.29 cm3 and 0.56±0.32 cm3, respectively (p > 0.05). Our results indicate an absence of post-CBT volumetric changes in the pituitary gland of OCD patients.",Atmaca M.; Yildirim H.; Yilmaz S.; Caglar N.; Baykara S.; Kekilli Y.; Koseoglu F.; Turkcapar H.,,10.1590/1516-4446-2017-2449,0,0,
2044," Effectiveness of a 'Workshop on Decluttering and Organising' programme for teens and middle-aged adults with difficulty decluttering: a study protocol of an open-label, randomised, parallel-group, superiority trial in Japan"," INTRODUCTION: Hoarding disorder can cause problems with work performance, personal hygiene, health and well‚Äêbeing. The disorder is a growing social problem in Japan. Having difficulty discarding rubbish, decluttering and organising can signal a future hoarding disorder, and early intervention is important. We developed an educational workshop on decluttering and organising for teens and adults with difficulty organising. The objective of this study is to evaluate the effectiveness of a workshop for reducing clutter and improving quality of life among younger people with difficulty decluttering and organising. METHODS AND ANALYSIS: An open‚Äêlabel, parallel‚Äêgroup, randomised controlled trial will be conducted among volunteers aged 12‚Äê55 years with mild difficulty decluttering and organising. Those in the intervention group will attend the workshop and receive a visit from a professional cleaning company to declutter their living space. The control group will have only the latter. The primary outcome will be the score on the Japanese version of the Saving Inventory‚ÄêRevised. Secondary outcomes will be scores on the Clutter Image Rating Scale, the Japanese version of the Rosenberg Self‚ÄêEsteem Scale and the Roles of Private Space Scale. The results will be examined for differences between the two groups in changes from baseline to 7 months. We will examine crude effects and adjust for gender and age using a general linear model for continuous variables and a logistic regression model for dichotomous variables. Sample size was calculated assuming a significance level of 5% (two tailed), a power of 80% and an effect size of 0.75. In total, 60 subjects (30 in each group) will be required. ETHICS AND DISSEMINATION: The study protocol has been approved by the Medical Ethical Committee of Teikyo University (No. 15‚Äê065). The findings will be disseminated widely through peer‚Äêreviewed publication and conference presentations. TRIAL REGISTRATION NUMBER: UMIN000020568. Issue date: 16 January 2016."," Aso, Y;  Yamaoka, K;  Nemoto, A;  Naganuma, Y;  Saito, M",2017.0, 10.1136/bmjopen-2016-014687,0,0,
2045,The effect of treatment on quality of life and functioning in OCD.,"Given that obsessive compulsive disorder (OCD) is associated with impaired quality of life (QoL) and functioning, it is important examine whether therapeutic recovery from OCD leads to improvements on these important secondary outcomes. Only a few studies have examined how measures of OCD symptom severity relate to QoL and functioning among patients receiving treatment for OCD. OCD severity was measured with the Obsessive-Compulsive Inventory-Revised (OCI-R), a self-report scale of OCD, and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), an interview measure of OCD. Participants were 100 adults with a primary diagnosis of OCD on serotonin reuptake inhibitors (SRIs) enrolled in a randomized clinical trial comparing SRI augmentation with either exposure and response prevention (EX/RP) therapy, risperidone, or pill placebo. At baseline, mid-treatment, and post-treatment, patients completed assessments for OCD symptoms and QoL/functioning measures. Multilevel modeling was used to assess changes in QoL/functioning over the course of treatment and to compare such changes across treatment conditions. Improvements in QoL/functioning were significantly greater among those receiving EX/RP compared to those receiving risperidone. Compared to pill placebo, EX/RP performed better on measures of functioning but not QoL. Greater improvement in individual OCI-R scores was associated with greater improvements in QoL/functioning, regardless of condition. In addition, Y-BOCS scores appeared to moderate improvements in QoL over the course of all treatment conditions, such that those with higher Y-BOCS scores showed the greatest improvements in QoL over time. Improvements in QoL/functioning were associated with reduction in OCD symptom severity. The implications on OCD treatment and clinical research are discussed.",Asnaani A.; Kaczkurkin AN.; Alpert E.; McLean CP.; Simpson HB.; Foa EB.,2017.0,10.1016/j.comppsych.2016.10.004,0,0,
2046,Neurofeedback as an adjunct therapy for treatment of chronic posttraumatic stress disorder related to refugee trauma and torture experiences: Two case studies.,"Objective: The objective of this study was to describe the use of neurofeedback for refugee-related chronic posttraumatic stress disorder (PTSD) in two case studies. Methods: We describe the assessment and application of neurofeedback integrated into the treatment of two clients with chronic PTSD. We include details of our treatment schedule, symptoms and quantitative electrophysiological data for each case. Results All clients achieved significant reduction in symptoms of PTSD and improvement in daily functioning post-neurofeedback therapy. Quantitative electroencephalogric (EEG) measures indicate a normalisation of EEG markers relating to trauma, including overarousal at rest and working memory function. Conclusions Neurofeedback as an adjunct to trauma-informed therapy may help to remediate chronic PTSD relating to refugee experiences. If replicated then improvements demonstrated in this population would be generalisable to all chronic PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Askovic, Mirjana; Watters, Anna J; Aroche, Jorge; Harris, Anthony W. F",2017.0,http://dx.doi.org/10.1177/1039856217715988,0,0,
2047,"Key Ingredients-Target Groups, Methods and Messages, and Evaluation-of Local-Level, Public Interventions to Counter Stigma and Discrimination: A Lived Experience Informed Selective Narrative Literature Review","A proliferation of recent literature provides substantial direction as to the key ingredients-target groups, messages and methods, and evaluation-of local-level, public interventions to counter stigma and discrimination. This paper provides a selective narrative review of that literature from the perspective or standpoint of anti-stigma experts with lived experience of mental distress, the key findings of which have been synthesised and presented in diagrammatic overviews (infographics). These are intended to guide providers in planning, delivering and evaluating lived experience-directed local-level, public interventions to counter stigma and discrimination in accord with current best practice.",Ashton L.J.; Gordon S.E.; Reeves R.A.,2018.0,10.1007/s10597-017-0189-5,0,0,
2048,Psychooncology in middle income countries: A focus on Latin American and the Caribbean,"As global cancer incidence is increasing with well documented poorer outcomes, cancer is receiving increasing attention in Latin America and the Caribbean. Due to the urgency of the cancer burden in developing countries (LMIC) where mortality ranges from 50-90% compared to the 20-40% range for developed countries (except for lung cancer), we are compelled to ask provocative questions and cultivate innovative best approaches in research and practice for more rapid translation of new knowledge and implementation of interventions to bring whole person cancer care and reduce the undue burden of cancer in this region. Further, mounting evidence directs our attention to the social determinants of cancer outcomes. Yet, there are several challenges in examining broad social contexts requiring the inclusion and guidance of survivor-advocates. This symposium will discuss survivorship outcomes and survivorship care development within the Caribbean region focusing on two specific nations Brazil and Trinidad and Tobago. Our findings indicate high cancer related societal and survivor burden. The health care systems in LMIC countries are overwhelmed with the increasing cancer incidence. Multilevel factors including socioeconomic status, quality of care, distress screening and management seem to be associated with patient outcomes. Developing psychosocial and supportive care in developing countries involve the engagement of multisectorial stakeholders including civil society, government, healthcare system, clinicians, advocates and patients. The need to develop these cancer care components is urgent and compelling.",Ashing K.T.; George M.; Carrington A.; Bergerot C.D.,2017.0,10.1002/pon.4476,0,0,
2049, Association between continuous hyperosmolar therapy and survival in patients with traumatic brain injury - a multicentre prospective cohort study and systematic review," BACKGROUND: Intracranial hypertension (ICH) is a major cause of death after traumatic brain injury (TBI). Continuous hyperosmolar therapy (CHT) has been proposed for the treatment of ICH, but its effectiveness is controversial. We compared the mortality and outcomes in patients with TBI with ICH treated or not with CHT. METHODS: We included patients with TBI (Glasgow Coma Scale ≤ 12 and trauma‐associated lesion on brain computed tomography (CT) scan) from the databases of the prospective multicentre trials Corti‐TC, BI‐VILI and ATLANREA. CHT consisted of an intravenous infusion of NaCl 20% for 24 hours or more. The primary outcome was the risk of survival at day 90, adjusted for predefined covariates and baseline differences, allowing us to reduce the bias resulting from confounding factors in observational studies. A systematic review was conducted including studies published from 1966 to December 2016. RESULTS: Among the 1086 included patients, 545 (51.7%) developed ICH (143 treated and 402 not treated with CHT). In patients with ICH, the relative risk of survival at day 90 with CHT was 1.43 (95% CI, 0.99‐2.06, p = 0.05). The adjusted hazard ratio for survival was 1.74 (95% CI, 1.36‐2.23, p < 0.001) in propensity‐score‐adjusted analysis. At day 90, favourable outcomes (Glasgow Outcome Scale 4‐5) occurred in 45.2% of treated patients with ICH and in 35.8% of patients with ICH not treated with CHT (p = 0.06). A review of the literature including 1304 patients from eight studies suggests that CHT is associated with a reduction of in‐ICU mortality (intervention, 112/474 deaths (23.6%) vs. control, 244/781 deaths (31.2%); OR 1.42 (95% CI, 1.04‐1.95), p = 0.03, I CONCLUSIONS: CHT for the treatment of posttraumatic ICH was associated with improved adjusted 90‐day survival. This result was strengthened by a review of the literature."," Asehnoune, K;  Lasocki, S;  Seguin, P;  Geeraerts, T;  Perrigault, PF;  Dahyot-Fizelier, C;  Paugam Burtz, C;  Cook, F;  Demeure Dit Latte, D;  Cinotti, R;  et al.",2017.0, 10.1186/s13054-017-1918-4,0,0,
2050, Environmental Enrichment Therapy for Autism: outcomes with Increased Access," We have previously shown in two randomized clinical trials that environmental enrichment is capable of ameliorating symptoms of autism spectrum disorder (ASD), and in the present study, we determined whether this therapy could be effective under real‚Äêworld circumstances. 1,002 children were given daily Sensory Enrichment Therapy, by their parents, using personalized therapy instructions given over the Internet. Parents were asked to assess the symptoms of their child every 2 weeks for up to 7 months. An intention‚Äêto‚Äêtreat analysis showed significant overall gains for a wide range of symptoms in these children, including learning, memory, anxiety, attention span, motor skills, eating, sleeping, sensory processing, self‚Äêawareness, communication, social skills, and mood/autism behaviors. The children of compliant caregivers were more likely to experience a significant improvement in their symptoms. The treatment was effective across a wide age range and there was equal progress reported for males and females, for USA and international subjects, for those who paid and those who did not pay for the therapy, and for individuals at all levels of initial symptom severity. Environmental enrichment, delivered via an online system, therefore appears to be an effective, low‚Äêcost means of treating the symptoms of ASD."," Aronoff, E;  Hillyer, R;  Leon, M",2016.0, 10.1155/2016/2734915,0,0,
2051, Mindfulness-Based Cognitive Therapy for Neuroticism (Stress Vulnerability): a Pilot Randomized Study," Objective: Neuroticism, a characteristic associated with increased stress vulnerability and the tendency to experience distress, is strongly linked to risk of different forms of psychopathology. However, there are few evidence‚Äêbased interventions to target neuroticism. This pilot study investigated the efficacy and acceptability of mindfulness‚Äêbased cognitive therapy (MBCT) compared with an online self‚Äêhelp intervention for individuals with high levels of neuroticism. The MBCT was modified to address psychological processes that are characteristic of neuroticism. Method: Participants with high levels of neuroticism were randomized to MBCT (n = 17) or an online self‚Äêhelp intervention (n = 17). Self‚Äêreport questionnaires were administered preintervention and again at 4 weeks postintervention. Results: Intention‚Äêto‚Äêtreat analyses found that MBCT participants had significantly lower levels of neuroticism postintervention than the control group. Compared with the control group, the MBCT group also experienced significant reductions in rumination and increases in self‚Äêcompassion and decentering, of which the latter two were correlated with reductions in neuroticism within the MBCT group. Low drop‚Äêout rates, high levels of adherence to home practice, and positive feedback from MBCT participants provide indications that this intervention may be an acceptable form of treatment for individuals who are vulnerable to becoming easily stressed. Conclusions: MBCT specifically modified to target neuroticism‚Äêrelated processes is a promising intervention for reducing neuroticism. Results support evidence suggesting neuroticism is malleable and amenable to psychological intervention. MBCT for neuroticism warrants further investigation in a larger study."," Armstrong, L;  Rimes, KA",2016.0, 10.1016/j.beth.2015.12.005,0,0,
2052, Preliminary support for a brief psychological intervention to improve first-time hearing aid use among adults," OBJECTIVES: Suboptimal hearing aid use extorts significant social, health, and economic costs. The aims of this study were to (1) test the novel hypothesis that the threat associated with being diagnosed with hearing loss could be ameliorated with a self‚Äêaffirmation manipulation and (2) gauge the feasibility of deploying the manipulation in routine clinical practice. DESIGN: Parallel groups randomized controlled trial with 10‚Äêweek follow‚Äêup. METHOD: Fifty people, newly prescribed with a hearing aid, completed either a questionnaire that included a brief self‚Äêaffirming exercise or an identical questionnaire with no self‚Äêaffirming exercise. The main outcome measure was derived from data logging automatically stored by the hearing aid. Perceived threat ('anxiety about ageing'), behavioural intention, and self‚Äêefficacy were measured as potential mediators. RESULTS: Objectively measured hours of daily hearing aid use were marginally higher in the intervention group compared with the control group (between‚Äêgroup difference = 1.94 hr, 95%CI = ‚Äê1.24, 5.12, d = 0.43). At follow‚Äêup, participants in the intervention group were significantly less anxious about ageing and more accepting of older people than were participants in the control group (between‚Äêgroup difference = 0.75, 95%CI = 0.26, 1.22, d = 0.87). There was no statistically significant effect of the intervention on behavioural intention or self‚Äêefficacy. CONCLUSIONS: Although not statistically significant, the magnitude of the effect of the intervention on hearing aid use (d = 0.43) suggests that it would be worthwhile working towards a fully powered randomized controlled trial. The ability to reduce anxieties about ageing with this brief intervention could have far‚Äêreaching benefits for multiple patient and general population groups. Statement of contribution What is already known on this subject? Hearing impairment is more disabling than diabetes, yet hearing aid use is suboptimal. Anxieties about ageing may undermine hearing aid use. What does this study add? The study tests a brief theory‚Äêbased psychological intervention to reduce anxiety about ageing and promote hearing aid use. Results show that the brief psychological intervention reduced anxiety and marginally increased objective hearing aid use. Further work is required to identify other situations in which anxieties about ageing undermine behaviour change efforts. The very brief, flexible nature of the intervention means it could be adapted and deployed in numerous other health care settings."," Armitage, CJ;  Lees, D;  Lewis, K;  Munro, KJ",2017.0, 10.1111/bjhp.12244,0,0,
2053,Transcranial Alternating Current Stimulation at Alpha Frequency Reduces Pain When the Intensity of Pain is Uncertain,"Alpha activity directly before pain onset has been implicated in pain experience with higher prestimulus alpha associated with lower reported pain. However, expectations about pain intensity also seem to affect prestimulus alpha activity. To date, evidence for a relationship between alpha activity and pain experience has been largely correlational. Transcranial alternating current stimulation at alpha frequency (alpha tACS) permits direct manipulation of alpha activity and therefore an examination of the potential causal relationship between alpha activity and pain. We investigated whether somatosensory alpha tACS could reduce pain experience and whether this was influenced by uncertainty about pain intensity. In a within-subjects design, perceived pain intensity and unpleasantness were assessed in 23 participants during alpha tACS and sham stimulation. Visual cues preceding the pain stimulus were used to manipulate uncertainty. A significant tACS × Uncertainty × Stimulus intensity interaction was found for reported pain intensity (F2,44 = 4.50, P =.017, partial η2 =.17) and unpleasantness (F1,22 = 4.78, P =.040, partial η2 =.18). Pain experience during the application of somatosensory alpha tACS was significantly lowered compared with sham stimulation, but only when the intensity of an upcoming stimulus was uncertain. Perspective: To our knowledge, this is the first study to suggest that somatosensory alpha tACS might lead to a reduction in pain. Interventions targeting alpha activity may have the potential to alleviate chronic pain. However, a patient's expectation about the intensity of upcoming pain must also be taken into account.",Arendsen L.J.; Hugh-Jones S.; Lloyd D.M.,2018.0,10.1016/j.jpain.2018.02.014,0,0,
2054, Effect of Housing First on Suicidal Behaviour: a Randomised Controlled Trial of Homeless Adults with Mental Disorders," OBJECTIVE: This study attempted to determine if Housing First (HF) decreased suicidal ideation and attempts compared to treatment as usual (TAU) amongst homeless persons with mental disorders, a population with a demonstrably high risk of suicidal behaviour. METHOD: The At Home/Chez Soi project is an unblinded, randomised control trial conducted across 5 Canadian cities (Vancouver, Winnipeg, Toronto, Montreal, Moncton) from 2009 to 2013. Homeless adults with a diagnosed major mental health disorder were recruited through community agencies and randomised to HF ( n = 1265) and TAU ( n = 990). HF participants were provided with private housing units and received case management support services. TAU participants retained access to existing community supports. Past‚Äêmonth suicidal ideation was measured at baseline and 6, 12, 18, and 21/24 months. A history of suicide attempts was measured at baseline and the 21/24‚Äêmonth follow‚Äêup. RESULTS: Compared to baseline, there was an overall trend of decreased past‚Äêmonth suicidal ideation (estimate = ‚Äê.57, SE = .05, P < 0.001), with no effect of treatment group (i.e., HF vs. TAU; estimate = ‚Äê.04, SE = .06, P = 0.51). Furthermore, there was no effect of treatment status (estimate = ‚Äê.10, SE = .16, P = 0.52) on prevalence of suicide attempts (HF = 11.9%, TAU = 10.5%) during the 2‚Äêyear follow‚Äêup period. CONCLUSION: This study failed to find evidence that HF is superior to TAU in reducing suicidal ideation and attempts. We suggest that HF interventions consider supplemental psychological treatments that have proven efficacy in reducing suicidal behaviour. It remains to be determined what kind of suicide prevention interventions (if any) are specifically effective in further reducing suicidal risk in a housing‚Äêfirst intervention."," Aquin, JP;  Roos, LE;  Distasio, J;  Katz, LY;  Bourque, J;  Bolton, JM;  Bolton, SL;  Wong, JY;  Chateau, D;  Somers, JM;  et al.",2017.0, 10.1177/0706743717694836,0,0,
2055,Women with high estradiol status are protected against declarative memory impairment by pre-learning stress,"Stress is a potent modulator of learning and memory. Factors contributing to whether stress aids or impairs memory are timing of the stressor, memory stage, form of memory studied, and sex of the subjects. The female sex hormone 17-beta-estradiol (E2) has widespread effects in the brain and affects hippocampus-dependent memory in animals. In humans, the interaction between stress effects and E2 has not been widely studied. We report data from a healthy sample divided into 3 hormone-status groups: free-cycling women in the early follicular phase (EF: low E2, low progesterone [P4]), or during midcycle (MC: high E2, low P4), and men. Participants within each hormone-status group were randomly assigned to a psychosocial stressor or a control treatment 37 min before encoding a short story of neutral content. We found a Hormone status √ó Stress √ó Time (immediate, 35-min, 24-h delayed recall) interaction. Irrespective of time, hormone status mattered only after stress treatment: stressed early follicular women had poorer recall compared to stressed men and midcycle women. Only in the early follicular group, recall was negatively correlated with increases in salivary cortisol, but not with blood levels of E2 and P4. To uncover changes beyond immediate recall, we computed the individual percent change relative to immediate recall and repeated the analysis for these adjusted 35-min and 24-h data. Despite the lack of a stress effect in raw data, memory in stressed men was more stable over time (35-min and 24-h delay) than in unstressed men. In contrast, stressed EF-women (vs. control) recalled less at the 35-min and (as a trend) at the 24-h delay. Stressed MC-women (vs. control) showed less recall only at the 35-min delay while compensating this stress effect after a 24-h consolidation interval. Overall, results suggest that women in high-E2 midcycle phase could be less vulnerable to effects of pre-learning stress on declarative memory encoding and consolidation.",Antov M.I.; Stockhorst U.,2018.0,10.1016/j.nlm.2018.08.018,0,0,
2056,A latent profile analysis of aggression and victimization across relationship types among veterans who use substances.,"Objective: This study examined patterns of violence victimization and aggression in both intimate partner and nonpartner relationships among U.S. military veterans using latent profile analysis to identify subtypes of violence involvement. Method: Participants were 839 substance use seeking veterans (93% male) from a large Veterans Affairs Medical Center who completed screening measures for a randomized controlled trial. Results: Past-year violence involvement, including both intimate partner violence (IPV) and nonpartner violence (NPV), was common in the sample, although NPV occurred at somewhat higher rates. When we included either IPV or NPV aggression or victimization, more than 40% reported involvement with physical violence, 30% with violence involving injury, and 86% with psychological aggression. Latent profile analysis including both aggression and victimization in partner and non partner relationships indicated a four-profile solution: no/low violence (NLV; n = 377), predominantly IPV (n = 219), predominantly NPV (n = 134), and high general violence (HGV; n = 109). Multinomial logistic regression analyses revealed that,compared with the NLV group, the remaining three groups differed in age, cocaine use, posttraumatic stress disorder (PTSD) symptoms, and legal involvement. Legal issues appeared to differentiate the profiles most, with the predominantly NPV and HGV profiles reporting more instances of driving under the influence and the HGV profile reporting legal problems related to aggression. Conclusions: IPV and NPV are fairly common among veterans seeking substance use treatment. The clinical characteristics of violence profiles indicate that cocaine use,PTSD symptoms, and legal involvement are treatment needs that vary with violence profile and may be useful for clinical decision making. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Anderson, RaeAnn E; Bonar, Erin E; Walton, Maureen A; Goldstick, Jason E; Rauch, Sheila A. M; Epstein-Ngo, Quyen M; Chermack, Stephen T",2017.0,http://dx.doi.org/10.15288/jsad.2017.78.597,0,0,
2057,A randomized controlled trial of brief Somatic Experiencing for chronic low back pain and comorbid post-traumatic stress disorder symptoms.,"Background: It is well documented that comorbid post-traumatic stress disorder (PTSD) in chronic pain is associated with a more severe symptom profile with respect to pain, disability and psychological distress. However, very few intervention studies exist targeting both PTSD and pain. The current study is the first randomized controlled trial evaluating the effect of the body-oriented trauma approach of Somatic Experiencing (SE) for comorbid PTSD and low back pain. Although the method is well recognized by clinicians and widely used, SE still needs to be tested in a randomized clinical trial in comparison with an active control group. Objective: The aim of the current study was to compare the effect of an SE intervention in addition to treatment-as-usual (TAU) for patients with chronic low back pain and comorbid PTSD compared to TAU alone. Method: The study was a two-group randomized controlled clinical trial. A cohort of patients (n = 1045) referred to a large Danish spine centre between February 2013 and October 2014 were screened for PTSD and randomized to either TAU (4-12 sessions of supervised exercises for low back pain) or TAU plus SE (6-12 sessions). In total, 91 patients fulfilled the inclusion criteria and volunteered to participate in the study. Treatment effects were evaluated by self-report questionnaires comparing baseline measures with 12-month follow-up measures. Results: The additional SE intervention significantly reduced the number of PTSD symptoms compared with TAU alone, corresponding to a large effect size. Also, fear of movement was significantly reduced (moderate effect size). Both groups achieved a large reduction in pain-catastrophizing, disability and pain. Conclusions: A brief additional SE intervention was found to have a significant effect on PTSD and fear of movement compared to TAU alone. However, the overall effect of SE was less than expected and the clinical importance of the effects can be questioned. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Andersen, Tonny Elmose; Lahav, Yael; Ellegaard, Hanne; Manniche, Claus",2017.0,http://dx.doi.org/10.1080/20008198.2017.1331108,0,0,
2058, Enhanced self-efficacy after a self-management programme in pituitary disease: a randomized controlled trial," OBJECTIVE: To examine the effects of a SMI i.e. Patient and Partner Education Programme for Pituitary disease (PPEP‚ÄêPituitary). DESIGN AND SUBJECTS: A multicentre randomized controlled trial included 174 patients with pituitary disease, and 63 partners were allocated to either PPEP‚ÄêPituitary or a control group. PPEP‚ÄêPituitary included eight weekly sessions (90‚Äâmin). Self‚Äêefficacy, bother and needs for support, illness perceptions, coping and QoL were assessed before the intervention (T0), directly after (T1) and after six months (T2). Mood was assessed before and after each session. RESULTS: Patients in PPEP‚ÄêPituitary reported improved mood after each session (except for session 1). In partners, mood only improved after the last three sessions. Patients reported higher self‚Äêefficacy at T1 ( CONCLUSION: This first study evaluating the effects of a SMI targeting psychosocial issues in patients with pituitary disease and their partners demonstrated promising positive results. Future research should focus on the refinement and implementation of this SMI into clinical practice. CONTEXT: Patients with pituitary disease report impairments in Quality of Life (QoL) despite optimal biomedical care. Until now, the effects of a self‚Äêmanagement intervention (SMI) addressing psychological and social issues for these patients and their partners have not been studied."," Andela, CD;  Repping-Wuts, H;  Stikkelbroeck, NMML;  Pronk, MC;  Tiemensma, J;  Hermus, AR;  Kaptein, AA;  Pereira, AM;  Kamminga, NGA;  Biermasz, NR",2017.0, 10.1530/EJE-16-1015,0,0,
2059, Aerobic exercise training and general health status in ambulatory heart failure patients with a reduced ejection fraction-Findings from the Heart Failure and A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION)trial," BACKGROUND: Although aerobic exercise improves quality of life as assessed by a disease‐specific instrument in ambulatory HF patients with a reduced ejection fraction (EF), the impact of an exercise intervention on general health status has not been previously reported. METHODS: A secondary analysis was performed of the HF‐ACTION trial (ClinicalTrials.gov Number: NCT00047437), which enrolled 2331 medically stable outpatients with HF and an EF ≤35% and randomized them to aerobic exercise training, consisting of 36 supervised sessions followed by home‐based training versus usual care for a median follow‐up of 30 months. The EuroQOL 5‐dimension questionnaire (EQ‐5D) was administered to study participants at baseline, 3 months, and 12 months. EQ‐5D includes functional dimensions (ie, mobility, self‐care, usual activities, pain/discomfort, and anxiety/depression), which were mapped to corresponding utility scores (ie, 0=death and 1=perfect health), and a visual analogue scale (VAS) ranging from 0 (ie, ""worst imaginable health state"") to 100 (ie, ""best imaginable health state""). RESULTS: Study participants had a median (25th, 75th) age of 59 (51, 68) years and 71% were male. A history of ischemic heart disease was reported in 51% of participants and the EF was 25% (20%, 30%). Baseline VAS and mapped utility scores were 65±19 and 0.81±0.14. Exercise training led to an improvement in VAS score compared with usual care from baseline to 3 months (exercise training: 6±17 vs usual care: 3±20; P <.01) although there were no further significant changes at 12 months. Aerobic exercise training did not favorably change mapped utility scores over either timeframe. After multivariable adjustment, lower mapped utility (hazard ratio [HR] 1.19 per 0.1 decrease, 95% CI 1.09‐1.29; P < .0001) and VAS scores (HR 1.05 per 10 point decrease, 95% CI 1.02‐1.08; P < .01) at baseline were associated with increased risk of death or hospitalization. CONCLUSION: Ambulatory HF patients with a reduced EF had impaired health status at baseline which was associated with increased morbidity and mortality, in part mitigated by a structured aerobic exercise regimen."," Ambrosy, AP;  Cerbin, LP;  DeVore, AD;  Greene, SJ;  Kraus, WE;  O'Connor, CM;  Piña, IL;  Whellan, DJ;  Wojdyla, D;  Wu, A;  et al.",2017.0, 10.1016/j.ahj.2016.12.017,0,0,
2060,[Not Available].,,Altmann U.; Worrack S.; Kaczmarek MC.; Mühleck J.; Volk GF.; Guntinas-Lichius O.; Strauß BM.,2017.0,10.1055/s-0043-100764,0,0,
2061,Hypoalgesic effects of three different manual therapy techniques on cervical spine and psychological interaction: A randomized clinical trial,"Objective The purpose of this study was to evaluate the extent to which psychological factors interact with a particular manual therapy (MT) technique to induce hypoalgesia in healthy subjects. Methods Seventy-five healthy volunteers (36 female, 39 males), were recruited in this double-blind, controlled and parallel study. Subjects were randomly assigned to receive: High velocity low amplitude technique (HVLA), joint mobilization, or Cervical Lateral glide mobilization (CLGM). Pressure pain threshold (PPT) over C7 unilaterally, trapezius muscle and lateral epicondyle bilaterally, were measured prior to single technique MT was applied and immediately after to applied MT. Pain catastrophizing, depression, anxiety and kinesiophobia were evaluated before treatment. Results The results indicate that hypoalgesia was observed in all groups after treatment in the neck and elbow region (P < 0.05), but mobilization induces more hypoalgesic effects. Catastrophizing interacted with change over time in PPT, for changes in C7 and in manipulation group. Conclusions All the MT techniques studied produced local and segmental hypoalgesic effects, supporting the results of previous studies studying the individual interventions. Interaction between catastrophizing and HVLA technique suggest that whether catastrophizing level is low or medium, the chance of success is high, but high levels of catastrophizing may result in poor outcome after HVLA intervention. Trial registration ClinicalTrials.gov Registration Number: NCT02782585.",Alonso-Perez J.L.; Lopez-Lopez A.; La Touche R.; Lerma-Lara S.; Suarez E.; Rojas J.; Bishop M.D.; Villafañe J.H.; Fernández-Carnero J.,2017.0,10.1016/j.jbmt.2016.12.005,0,0,
2062,Moral injury in German Armed Forces soldiers with war-related trauma. Effectiveness of value-based cognitive behavioral group therapy.,"Background: The violation of inner value orientations, moral convictions and expectations can lead to a profound moral shock, so-called moral injury (MI). The war-related MI in chronically traumatized soldiers induces high levels of psychological stress including strong feelings of shame. Up to now the treatment of morally injured German soldiers with posttraumatic shock syndrome (PTSD) has not been evaluated. Objective: This pilot study investigated the effect of a value-based cognitive behavioral group therapy on coping styles related to feelings of shame and war related MI. Material and methods: A total of 21 soldiers suffering from war-related MI as well as chronic PTSD participated in a 3-week inpatient, semi-standardized group therapy, focusing on values and compassionate imagery. Coping strategies for the experience of maladaptive shame were assessed via the Compass of Shame Scale (COSS) before starting the intervention (t1), at the end of treatment (t2) and 3 months after treatment (t3). Results: A significant reduction of the maladaptive coping strategies ""attack others"", ""attack self"" and ""withdrawal"" in the COSS was observed, leading towards an implementation of more functional coping styles when it comes to feelings of shame in morally injured soldiers. The overall mental stress decreased immediately after therapy. The depressive coexisting symptoms showed positive changes of tendencies under therapy. Conclusion: This form of value-based cognitive behavioral therapy may be an important extension for the provision of health care in chronically traumatized German soldiers with war-related MI. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Abstract (German) Hintergrund. Die Verletzung innerer Werteorientierungen, moralischer Uberzeugungen und Erwartungen kann zu einer tiefgreifenden moralischen Erschutterung, der moral injury"" (MI), fuhren. Diese MI verursachen im Rahmen der kriegsbedingten Traumatisierungen bei Soldaten einen hohen Leidensdruck, der oft mit starken Schamgefuhlen einhergeht. Die Therapie der MI wurde bisher bei traumatisierten deutschen Soldaten nicht untersucht. Fragestellung: Die vorliegende Pilotstudie untersucht die Wirksamkeit einer wertebasierten kognitiv-behavioralen Gruppentherapie auf das Coping-Verhalten von Scham im Zusammenhang mit kriegsbedingter MI. Material und MethodeEs wurden 21 Soldaten mit MI und chronischer posttraumatischer Belastungsstorung (PTBS) im Rahmen einer 3-wochigen, stationaren, halbstandardisierten Gruppentherapie behandelt. Die Soldaten wurden vor (t1) und nach (t2) der Intervention sowie nach 3 Monaten (t3) hinsichtlich ihrer Coping-Strategien fur maladaptives Schamerleben mit der Compass of Shame Scale (COSS) untersucht. Der Fokus der Therapie lag auf einem wertebasierten Ansatz in Verbindung mit gezielter Entwicklung von compassionate imagery"". Ergebnisse: Die maladaptiven Coping-Strategien attack other"", attack self"" sowie withdrawal"" im COSS zeigen nach der wertebasierten kognitiv-behavioralen Gruppentherapie eine Veranderung in Richtung eines funktionaleren Umgangs mit Schamerleben bei kriegsbedingter MI. Die psychische Gesamtbelastung sinkt unmittelbar nach der Therapie signifikant. Die depressive Begleitsymptomatik zeigt unter der Therapie positive Veranderungstendenzen. Schlussfolgerung: Die wertebasierte kognitiv-behaviorale Gruppentherapie konnte in Zukunft eine wertvolle Erweiterung des Versorgungsangebotes fur chronisch kriegstraumatisierte Soldaten mit speziellen moralischen Verletzungen darstellen. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Alliger-Horn, Christina; Hessenbruch, Isabel; Fischer, Christian; Thiel, Thomas; Varn, Alexander; Willmund, Gerd; Zimmermann, Peter",2018.0,http://dx.doi.org/10.1007/s00278-018-0287-z,0,0,
2063,"The distressed (Type D) personality factor of social inhibition, but not negative affectivity, enhances eyeblink conditioning","Recent work has focused on a learning diathesis model in which specific personality factors such as behavioral inhibition (BI) may influence associative learning and in turn increase risk for the development of anxiety disorders. We have found in a series of studies that individuals self-reporting high levels of BI exhibit enhanced acquisition of conditioned eyeblinks. In the study reported here, hypotheses were extended to include distressed (Type D) personality which has been found to be related to BI. Type D personality is measured with the DS-14 scale which includes two subscales measuring negative affectivity (NA) and social inhibition (SI). We hypothesized that SI, which is similar to BI, would result in enhanced acquisition while the effect of NA is unclear. Eighty nine participants completed personality inventories including the Adult Measure of Behavioral Inhibition (AMBI) and DS-14. All participants received 60 acquisition trials with a 500 ms, 1000 Hz, tone CS and a co-terminating 50 ms, 5 psi corneal airpuff US. Participants received either 100% CS-US paired trials or a schedule of partial reinforcement where 50% US alone trials were intermixed into CS-US training. Acquisition of CRs did not differ between the two training protocols. Whereas BI was significantly related to Type D, SI, and NA, only BI and SI individuals exhibited enhanced acquisition of conditioned eyeblinks as compared to non-inhibited individuals. Personality factors now including social inhibition can be used to identify individuals who express enhanced associative learning which lends further support to a learning diathesis model of anxiety disorders.",Allen M.T.; Handy J.D.; Blankenship M.R.; Servatius R.J.,2018.0,10.1016/j.bbr.2018.02.035,0,0,
2064,Lower-order anxiety sensitivity and intolerance of uncertainty dimensions operate as specific vulnerabilities for social anxiety and depression within a hierarchical model.,"Within a hierarchical framework for depressive and anxiety disorders, negative affect (NA) is posited to be indirectly related to social anxiety and depression through cognitive vulnerabilities, including intolerance of uncertainty (IU) and anxiety sensitivity (AS). However, few prior studies have considered whether the lower-order dimensions of IU (i.e., prospective and inhibitory IU) and AS (i.e., physical, cognitive, and social concerns) better explain the indirect relation between NA and social anxiety and depression. The indirect relations between NA and social anxiety and depression through these cognitive vulnerabilities were examined using structural equation modeling in a clinical sample (N = 298). NA and social anxiety symptoms were indirectly related through AS social concerns and inhibitory IU, although a direct effect of NA was also found. Only AS social concerns explained the relation between NA and a social anxiety disorder diagnosis. AS cognitive concerns was the only cognitive vulnerability factor to indirectly explain the relation between NA and depressive symptoms, although a direct effect of NA was also found. These findings suggest that the lower-order dimensions of AS and IU demonstrate more specific and less transdiagnostic associations with social anxiety and depression. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Allan, Nicholas P; Cooper, Danielle; Oglesby, Mary E; Short, Nicole A; Saulnier, Kevin G; Schmidt, Norman B",2018.0,http://dx.doi.org/10.1016/j.janxdis.2017.08.002,0,0,
2065,Effect of hand and foot surface stroke massage on anxiety and vital signs in patients with acute coronary syndrome: A randomized clinical trial.,"Anxiety affects various body systems, which leads to an increase in respiratory rate, heart rate, blood pressure, and myocardial oxygen demand. The aim of this study was to investigate the effect of hand and foot surface stroke massage on the level of anxiety and vital signs in patients with acute coronary syndrome (ACS). The single-blind clinical trial was performed on 70 patients with ACS. The patients were randomly assigned to the case and control groups. Anxiety levels were controlled 30 min before and 15 min after the intervention. The vital signs were checked in the two groups before, immediately after, 60 min, and 90 min after the intervention. The data were analyzed using SPSS software, descriptive statistics (mean ± standard deviation), independent t-test, paired t-test, and chi-square test. No significant difference was observed in the patients' levels of anxiety, systolic blood pressure, diastolic blood pressure, respiratory rate, and pulse rate before the intervention. However, after the intervention, the mean changes in the levels of anxiety, blood pressure, heart rate, and respiratory rate were significant. Hand and foot massage can be a useful nursing intervention in attenuating anxiety levels and improving the vital signs in patients.",Alimohammad HS.; Ghasemi Z.; Shahriar S.; Morteza S.; Arsalan K.,2018.0,10.1016/j.ctcp.2018.01.012,0,0,
2066,Interactive effects of traumatic brain injury and anxiety sensitivity on PTSD symptoms: A replication and extension in two clinical samples.,"Traumatic brain injury is prevalent and linked with heightened risk for post-traumatic stress symptoms, yet little research has investigated the role of well-established cognitive-affective risk factors in explaining this association. The present study addressed this gap by evaluating if elevations in anxiety sensitivity global score and subscales (cognitive concerns, physical concerns, social concerns) potentiated the effects of traumatic brain injury history on post-traumatic stress symptoms in two clinical samples: trauma-exposed smokers (n = 256; study 1) and trauma-exposed treatment-seeking adults (n = 117; study 2). Both samples revealed a significant interaction such that traumatic brain injury was more strongly linked with post-traumatic stress symptoms among those with high anxiety sensitivity cognitive concerns. In addition, anxiety sensitivity cognitive concerns demonstrated a stronger relationship with post-traumatic stress symptoms among those with a traumatic brain injury history. Taken together, these results of both studies underscore the importance of anxiety sensitivity cognitive concerns in the association of traumatic brain injury and posttraumatic stress symptoms. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Albanese, Brian J; Macatee, Richard J; Boffa, Joseph W; Bryan, Craig J; Zvolensky, Michael J; Schmidt, Norman B",2018.0,http://dx.doi.org/10.1007/s10608-017-9883-4,0,0,
2067,Multiple comorbidities of 21 psychological disorders and relationships with psychosocial variables: A study of the online assessment and diagnostic system within a Web-based population.,"Background: While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables. Objective: We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life. Methods: An online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age. Results: A 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same two disorders. Conclusions: Comorbidities of several psychological disorders using an online assessment tool within a Web-based population were similar to those found in face-to-face clinics using traditional assessment tools. Results provided support for the transdiagnostic approaches and confirmed the positive relationship between comorbidity and suicidal ideation, the negative relationship between comorbidity and social support, and the negative relationship comorbidity and quality of life. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","AL-Asadi, Ali M; Klein, Britt; Meyer, Denny",2015.0,,0,0,
2068, The effects of upper extremity aerobic exercise in patients with spinal cord injury: a randomized controlled study," BACKGROUND: Immobility and secondary complications, including cardiopulmonary disease, pressure ulcers, and pain, occur in patients with spinal cord injury (SCI). These patients also have difficulty coping with the strain of daily activities. Thus, it is important for SCI patients to engage in aerobic exercise in order to be able to cope adequately with the strain of activities and SCI‚Äêrelated complications. AIM: The aim of this study was to investigate the effects of arm aerobic exercise on the parameters of cardiopulmonary function, quality of life, degree of disability, psychological state, and metabolic syndrome. DESIGN: This study was a single blind, randomized, controlled trial. SETTING: This study was conducted in a university hospital. POPULATION: SCI patients were randomly assigned to an intervention group (N.=17) or a control group (N.=16). Arm ergometer exercises (three days/week; 1.5 hours/week 50‚Äê70% pVO2) and general exercises (two sessions/day; 5 days/week), were assigned to the intervention group for 12 weeks. The control group was assigned general exercises only during this trial. METHODS: Before the rehabilitation (Week 0), after six weeks, and after the rehabilitation (Week 12), all patients were evaluated for functional status (maximal oxygen uptake [pVO2], power output [PO], and Functional Independence Measurement), pulmonary function (FEV1%, FVC%, FEV1/FVC%), quality of life (World Health Organization Measure of Quality of Life, short form, Turkish version), metabolic syndrome parameters (triglycerides, total cholesterol, high‚Äêdensity lipoprotein cholesterol, low‚Äêdensity lipoprotein cholesterol, fasting blood sugar, waist circumference, and systolic and diastolic blood pressure), degree of disability (Craig Handicap Assessment and Reporting Technique, short form), and psychological status (Center for Epidemiologic Studies Depression Scale and Hospital Anxiety and Depression Scale). RESULTS: At the end of the study, increases of 39.6% and 45.4% in the pVO2 and PO levels, respectively, were found. Additionally, no statistically significant difference was found in the intervention group after the rehabilitation compared to the levels before rehabilitation (P<0.05). However, no statistically significant differences in functional status, quality of life, psychological state, level of disability, or metabolic syndrome parameters were found in the intervention group (P>0.05). The control group, on the other hand, showed no clinically significant differences in any of the parameters (P>0.05). CONCLUSIONS: Short‚Äêterm arm aerobic exercise performed by patients with SCI improves their exercise capacities. These patients require longer rehabilitation programs to receive more benefits from aerobic exercise training. CLINICAL REHABILITATION IMPACT: Adding arm cranking exercise training to the rehabilitation program of patients with spinal cord injury demonstrated improved exercise capacity; however, further studies are needed to assess the effects of exercise training on other health issues."," Akkurt, H;  Karapolat, HU;  Kirazli, Y;  Kose, T",2017.0, 10.23736/S1973-9087.16.03804-1,0,0,
2069, Effect of Matching or Overconstraining Knee Laxity During Anterior Cruciate Ligament Reconstruction on Knee Osteoarthritis and Clinical Outcomes: a Randomized Controlled Trial With 84-Month Follow-up," BACKGROUND: The ""initial graft tension"" applied at the time of graft fixation during anterior cruciate ligament (ACL) reconstruction surgery modulates joint contact mechanics, which in turn may promote posttraumatic osteoarthritis (OA). PURPOSE/HYPOTHESES: The study objectives were to compare clinical, functional, patient‐reported, and OA imaging outcomes between 2 different initial laxity‐based graft tension cohorts and a matched uninjured control group as well as to evaluate the effects of laxity‐based graft tension on OA development at 84‐month follow‐up. The 2 laxity‐based tension protocols were (1) to restore normal anteroposterior (AP) laxity at the time of surgery relative to the contralateral uninjured knee (low‐tension group) or (2) to overconstrain AP laxity by 2 mm relative to the contralateral uninjured knee (high‐tension group). The hypotheses were that (1) the high‐tension group would have improved outcomes and decreased OA compared with the low‐tension group after 84 months, and (2) the outcomes for the high‐tension group would be equivalent to those for an age‐, sex‐, race‐, and activity‐matched group of control participants with uninjured knees. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: Patients had their ACLs reconstructed with either a bone‐patellar tendon‐bone or 4‐stranded hamstring autograft, and outcomes were compared with a matched control group. Outcomes were evaluated preoperatively and at 60 and 84 months postoperatively and included clinical (KT‐1000 arthrometer AP laxity measurement and International Knee Documentation Committee [IKDC] examination score), functional (1‐legged hop for distance and knee extensor torque), patient‐reported (Knee injury and Osteoarthritis Outcome Score [KOOS], Short Form‐36 [SF‐36], and patient satisfaction survey), and OA imaging (measurement of joint space width [JSW], Osteoarthritis Research Society International [OARSI] radiographic score, and Whole‐Organ Magnetic Resonance Imaging Score [WORMS]) components. Repeated‐measures analyses of variance were used to evaluate differences in outcomes between the treatment groups and the control group. RESULTS: There were significant differences between the 2 tension groups in 1 of 5 KOOS subscales (sports and recreation; P = .04) and 2 of 8 SF‐36 subscales (vitality, mental health; P < .04) at 84 and 60 months, respectively. Both tension groups scored significantly worse than the control group in the IKDC examination (P < .001), 1‐legged hop (P ≤ .017), KOOS quality of life and symptoms subscales (P < .03), and OARSI radiographic score (P ≤ .02) at 84 months. The low‐tension group performed significantly worse than the control group on the KOOS pain subscale (P = .03), SF‐36 general health and social functioning (P < .04), OARSI radiographic score (P < .001), and WORMS (P = .001), while the high‐tension group had statistically different results than the control group in AP knee laxity (P < .001), radiographic JSW (P = .003), and OARSI radiographic score (P = .02) as well as significantly more subsequent knee injuries (P = .02) at 84 months. CONCLUSION: The results do not support the hypotheses that the high‐tension group would have improved outcomes when compared with the low‐tension group after 84 months of healing or that the outcomes for the high‐tension group would be equivalent to those for the matched control group. While there were minor differences in patient‐reported outcomes between the 2 laxity‐based tension groups, all other outcomes were similar. REGISTRATION: NCT00434837."," Akelman, MR;  Fadale, PD;  Hulstyn, MJ;  Shalvoy, RM;  Garcia, A;  Chin, KE;  Duryea, J;  Badger, GJ;  Tung, GA;  Fleming, BC",2016.0, 10.1177/0363546516638387,0,0,
2070, The application of the biological feedback technique for the treatment of the patients presenting with chronic somatic diseases," The objective of the present work was to study the influence of the application of the biological feedback (BFB) technique on the dynamics of the psychological and clinical status of the patients presenting with various chronic somatic diseases (CSD) and to identify the predictors of the effectiveness of the treatment by this method. PATIENTS AND METHODS: The study included 337 patients suffering from CSD who were interviewed with the use of the concise standardized multifactorial personality inventory (SMPI), the Spielberger State‚ÄêTrait Anxiety Inventory (STAI), and the Beck depression inventory (BDI) scales. The patients were randomly distributed into two groups. Group 1 (main) was comprised of 168 patients who underwent psychotherapeutic treatment based on the BFB method, group 2 (control) consisted of 169 patients who did not receive the psychotherapeutic treatment. In order to identify the predictors of the effectiveness of the treatment by the biological feedback technique, the patients of the main group were subdivided into two subgroups at the end of the study period. Subgroup A contained 112 (67%) patients whose health status was normalized under the influence of psychotherapy, subgroup B included 56 (33%) patients who experienced the improvement of the somatic conditions. We undertook the comparative analysis of the background characteristics of the patients belonging to each group. RESULTS AND DISCUSSION: The study has demonstrated that by the end of the observation period the patients of the main group showed a significantly more pronounced (compared with controls) decrease of the parameters estimated based on the scales 1, 2, and 7 and an increase of those evaluated based on the (SMPI) scale 9. Simultaneously, the levels of state and trait anxiety estimated based on the Spielberger –∏ Beck inventory scales decreased. These findings give evidence of the improvement of psychological adaptation of the patients, decrease of the anxiety level and emotional stress under the influence of the treatment with the use of the biological feedback technique; these changes were concomitant with the enhancement of the general activity of the patients, the improvement of their working capacity, mood, and feelings of optimism. The study of the predictors of the effectiveness of the BFB method revealed the significantly higher background values estimated based on the SMPI scales 1, 4, and 6 in the patients with the improvement of the health status compared with those exhibiting normalized conditions (p<0,01). In 12% of the patients in the former subgroup (but in none of the patients of the latter subgroup), the values obtained based on the Beck scale were higher than 20 scores which suggested either the moderate or high level of depression. These data give reason to conclude that the patients that exhibited a relatively weak response to the treatment with the application of the biological feedback technique were initially predisposed to the un‚Äênecessary excessive fixation of attention on their sensations in the combination with enhanced impulsivity, rigidity of attitudes, and the presence of depressive disorders."," Aivazyan, TA;  Zaitsev, VP",2016.0, 10.17116/kurort201654-7,0,0,
2071,Comparative buccal delivery of cyclobenzaprine HCl and cyclobenzaprine (base) using mucoadhesive buccal film,"Since delivery of drug through buccal mucosa offer many advantages, buccal route has attracted great attention in recent years. Avoiding first pass metabolism, rapid absorption and ease of access of buccal mucosa are the major advantage of this route of delivery. Cyclobenzaprine HCl (CBZ HCl) is most commonly used muscle relaxant in case of muscle pain. New indication of CBZ HCl for improving sleep quality in patient with fibromyalgia and post-traumatic stress syndrome (PTSS) recently was approved by the FDA. CBZ HCl has low oral bioavailability (35-55%) due to extensive pre-systemic metabolism in the gut wall and liver. The aim of this research work was to compare the permeability of cyclobenzaprine (base) and cyclobenzaprine HCl (salt) via buccal mucosa and evaluate the effect of lecithin soya on their permeability. In addition, feasibility of formulating them as mucoadhesive buccal film was assessed. The film formulation made from POLYOX WSR N750 and HPMC was evaluated in term of film thickness, content uniformity, swelling index and adhesion time and drug release rate. Result obtained from ex-vivo permeability studies showed that the transferred mass during 2 hours was 0.36 ± 0.03 (mg/cm2) and 0.27 ± 0.04 (mg/cm2) for MF1 (contain CBZ HCl) and MF3 (contain CBZ base) respectively which shows buccal mucosa was more permeable to CBZ HCl than CBZ base. Soya lecithin was found to increase permeability of CBZ HCl (0.61 ± 0.07 (mg/cm2)) but it did not enhance that of CBZ base (0.24 ± 0.04 (mg/cm2)). The result demonstrated that CBZ in salt form is more suitable form, for delivery via buccal mucosa than basic form.",Ahmady A.,2018.0,,0,0,
2072,"Buprenorphine augmentation improved symptoms of OCD, compared to placebo-Results from a randomized, double-blind and placebo-controlled clinical trial.","Background: In the search for new psychopharmacologic options in the treatment of obsessive-compulsive disorders (OCD), some findings suggested that augmentation with buprenorphine, a partial-opioid agonist used to treat opioid addiction, moderate acute pain and moderate chronic pain, is worthy of consideration. Accordingly, to explore this possibility further, a double-blinded, placebo-controlled clinical trial was performed. Method: A total of 43 patients (mean age: 34.41 years; SD = 6.58; 53.5% males) with refractory OCD and treated with SSRIs or clomipramine at therapeutic dosages were randomly assigned either to an adjuvant buprenorphine or to an adjuvant placebo condition. Patients completed the Yale-Brown-Obsessive-Compulsive Scale (Y-BOCS) at baseline, weeks 3, 9 and 12 (study completion). Buprenorphine (2-4 mg; sublingual) and placebo (tablets with identical shape, color, consistency, and scent) were given daily. Results: Symptoms of obsessive-compulsive disorders decreased over time, but more so in the buprenorphine than in the placebo condition. Substantial improvements were observed up to week 3 and then 9. Response and partial response were observed in the buprenorphine at week 9 more than in the placebo condition. The advantage had disappeared by week 12. Conclusions: The pattern of results suggests that adjuvant buprenorphine augmentation can reduce symptoms of obsessive-compulsive disorders after only three weeks, compared to a placebo. Adjuvant buprenorphine seems to accelerate symptom improvement. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Ahmadpanah, Mohammad; Reihani, Amin; Ghaleiha, Ali; Soltanian, Alireza; Haghighi, Mohammad; Jahangard, Leila; Sadeghi Bahmani, Dena; Holsboer-Trachsler, Edith; Brand, Serge",2017.0,http://dx.doi.org/10.1016/j.jpsychires.2017.06.004,0,0,
2073, Metabotropic glutamate2/3 receptor agonism facilitates autonomic recovery after pharmacological panic challenge in healthy humans," Group II metabotropic glutamate receptors (mGluR2/3) are suggested to modulate anxiety, arousal, and stress including autonomic control. However, no study has investigated mGluR2/3‚Äêrelated effects on baseline autonomic activity and reactivity to emotional challenge in humans as yet. Using a double‚Äêblind, randomized placebo‚Äêcontrolled, cross‚Äêover study design, we investigated the influence of a 1‚Äêweek treatment with the mGluR2/3 agonist LY544344, prodrug of LY354740, on autonomic reactivity to a cholecystokinin tetrapeptide (CCK‚Äê4) panic challenge in eight healthy young men. The main outcome measures were time and frequency domain heart rate variability parameters during baseline, CCK‚Äê4 challenge, and recovery. There was no evidence for LY544344‚Äêmediated effects on baseline and CCK‚Äê4 challenge vagal activity, but a significantly lower recovery low frequency (%) and low frequency/high frequency ratio in the LY544344 group, suggesting enhanced autonomic recovery. This pilot study provides first human data indicating that mGluR2/3 agonism is involved in autonomic responsiveness, suggesting an important role of mGluR2/3 in central autonomic regulation."," Agorastos, A;  Demiralay, C;  Stiedl, O;  Muhtz, C;  Wiedemann, K;  Kellner, M",2016.0, 10.1097/YIC.0000000000000117,0,0,
2074,Executive function training in veterans with PTSD and mild TBI,"Objective: Difficulties in executive control functions, including selection, maintenance and execution of goal-relevant information and activities are common sequelae of both TBI and PTSD. Goal-Oriented Attentional Self-Regulation (GOALS) training was designed to target these deficits with attention regulation training applied to participant-defined goals. In previous studies, both Veteran and civilian participants with chronic TBI significantly improved post GOALS, but not control training, on measures of attention/executive function, functional task performance, and self-report measures of emotional regulation (Novakovic-Agopian et al., 2011; Novakovic-Agopian et al., 2015), and on goal-directed control over neural processing on fMRI (Chen et al., 2011). The objective of this ongoing study is to assess effectiveness of GOALS training in Veterans with comorbid PTSD and mTBI. Participants and Methods: 30 Veterans diagnosis of PTSD, history of chronic mTBI and mild-moderate executive dysfunction on daily living tasks, were randomized to start with either 5 weeks of GOALS or matched control psychoeducation (EDU) training. Assessments at baseline and post training included neuropsychological, functional task performance and self-report measures. Results: At week 5, post GOALS, but not EDU training, participants significantly improved from baseline on:1) overall neuropsychological attention/executive function domain score, and following subdomain scores: sustained attention and inhibition; 2) overall complex functional task performance score, and following subdomains: maintenance of attention, task execution, switching and memory; and 3) on emotional regulation self-report measures including: significant symptom decrease on Profile of Mood States (POMS), Beck Depression Inventory-II (BDI-II) and Post-traumatic Checklist Military (PCL-M). Majority of participants reported incorporating some of trained strategies into their daily life. Conclusions: GOALS training may be promising in Veterans with concurrent PTSD and chronic mTBI. Training self-regulatory cognitive and emotional control strategies applied to actual situations in participant lives and personally relevant goals may provide meaningful improvements in cognitive, emotional and occupational functioning. The challenges and importance of: a) assessing change in functioning at different levels and b) using participant-defined goals applied to relevant training will be discussed.",Agopian T.N.; Abrams G.; Kornblith E.,2017.0,10.1080/02699052.2017.1312145,0,0,
2075,Internet-based trials and the creation of health consumers.,"In this paper we document the experience of participating in novel randomised controlled trials for panic disorder-where face-to-face and Internet delivery of cognitive behavioural therapy are compared. Our analysis is based on 18 months of observation and in-depth interviews with 10 trial participants and 8 trialists in Victoria, Australia. We argue that the participants are positioned as active health consumers and approach the trial as they would other self-help practices. High levels of individual responsibility are assumed of participants in these trials, which they accept by approaching the trials reflexively and searching for information and strategies they can employ while building their health literacy on panic disorder. Although the researchers set the parameters of the treatment and interaction, increasingly the participants choose the extent to which they will comply with their defined role. For the participants the trial is one of the 'pick and mix' options of available treatment and we suggest it is a compelling example of contemporary health consumption. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Advocat, Jenny; Lindsay, Jo",2010.0,http://dx.doi.org/10.1016/j.socscimed.2009.10.051,0,0,
2076,Efficacy of intravenous magnesium sulfate in acute attacks of migraine,"Attacks of migraine are one of the common causes for emergency ward admissions.despite effective abortive treatments a completely safe,cheap and effective drugs seems to be lacking.some of these drugs have distressing side effects or contraindicated in some medical conditions.during recent years some investigators has attached a great importance to the role of magnesium in migraine. Materials and methods: In this double blind randomized placebo controlled study among patients admitted in emergency ward with attack of headache, 30 migraine patient (IHS criteria) was selected and randomized to two groups, receiving either iv 10 cc normal saline or magnesium sulfate 2gr iv slowly over 5 min. if after 30 minutes no headache relief was' noted in both groups, in the second phase magnesium sulfate and normal saline was administered in a cross over manner eg:placebo group received mg (2gr) and active arm received normal saline. both groups were visited immediately after injection and at 30 min, 2 hr and 24 hr intervals to monitor probable side effects and relief of headache and associated symptoms. Statistical analysis was performed between two groups with t-test and p-value. Finding and results In 14 out of 15 (93.3%)patients in active group there was significant relief of headache (13 complete relief and 1 partial relief and 1 got no relief but in all of them there was complete relief of nausea,vomiting, photophobia and phonophobia. none of 15 pts(0%) in placebo arm report headache relief but associated symptoms was relieved in 2 pts. interestingly in second phase after magnesium administration to placebo group in 14 pts out of 15 (93.3%) there was significant relief of both headache and associated symptoms. no significant side effect of mg except flushing was noted.our study showed a clear cut efficacy of 2gr mgso4 in acute migraine but large scale study is recommended.",Abrishami Zadeh A.A.,2010.0,10.1007/s10194-010-0259-3,0,0,
2077,A pilot randomized controlled trial of aerobic exercise as an adjunct to OCD treatment.,"The purpose of the current study was to conduct a randomized controlled trial testing the efficacy of aerobic exercise for decreasing OCD symptom severity, other mental health outcomes, and increasing exercise behaviors and cardiorespiratory fitness among individuals with OCD. Fifty-six patients (64% female; mean age=38.8years) with OCD and a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score of 16 or greater despite engaging in OCD treatment were randomized to 12-weeks of supervised plus home-based moderate-intensity aerobic exercise (AE; n=28) or to 12-weeks of health education sessions (HE; n=28). Random intercepts mixed models examined differences between conditions at post-treatment. Though no difference between conditions on outcomes was observed, both AE and HE showed significant reduction in OCD symptom severity, depression and anxiety at post-treatment. Relative to HE, significant increases were noted in amount of exercise and cardiorespiratory fitness for those in the AE condition. At post-treatment, 30.4% of the AE condition (7 of 23) were treatment-responders (using the commonly accepted measure of 35% symptom reduction from baseline). In the HE condition, 7.7% of the sample (2 of 26) met this criterion at post-treatment. The results of this preliminary study suggest that exercise and health-focused interventions may be beneficial adjuncts to existing OCD treatment. Future studies with larger samples are needed to more definitively answer questions the efficacy of AE for reducing OCD symptoms and improving related clinical outcomes.",Abrantes AM.; Brown RA.; Strong DR.; McLaughlin N.; Garnaat SL.; Mancebo M.; Riebe D.; Desaulniers J.; Yip AG.; Rasmussen S.; Greenberg BD.,2017.0,10.1016/j.genhosppsych.2017.06.010,0,0,
2078,The effects of alcohol on heartbeat perception: Implications for anxiety,"Introduction It is well established that some individuals self-medicate their anxiety with alcohol. Though much evidence exists that alcohol consumption can be negatively reinforcing, there remains uncertainty regarding what mediates the relationship between alcohol and anxiety. An unexplored possibility is that, for some, alcohol impairs interoceptive sensitivity (the ability to accurately perceive one's physiological state), thereby decreasing state anxiety. Consistent with this, highly accurate heartbeat perception is a risk factor both for elevated trait anxiety and anxiety disorders. However, the direct impact of alcohol on cardioceptive accuracy has not to our knowledge been previously examined. Methods Sixty-one social drinkers came to the lab in groups of 4–6 on two days spaced a week apart. Each participant was randomly assigned to receive alcoholic drinks targeting a BAC of 0.05% on one testing day and placebo drinks on the other, with the order counter-balanced. On both testing days, participants engaged in a Schandry heartbeat perception task on three occasions: at baseline, after an alcohol absorption period, and after physiological arousal was raised via exercise. Results For men only, alcohol significantly impaired cardioceptive accuracy relative to a placebo at both low and high levels of arousal, with medium to large effect sizes. Conclusions Though preliminary, this finding is consistent with the proposed hypothesis linking alcohol consumption and anxiety, at least for men. Future studies should directly examine whether, among individuals with anxiety disorders, cardioceptive sensitivity mediates the relationship between alcohol consumption and state anxiety.",Abrams K.; Cieslowski K.; Johnson S.; Krimmel S.; La Rosa G.B.-D.; Barton K.; Silverman P.,2018.0,10.1016/j.addbeh.2017.12.023,0,0,
2079,Treatment of obsessive thoughts and cognitive rituals using exposure and response prevention: A case study.,"This case study describes the application of cognitive-behavioral therapy by exposure and response prevention (EX/RP) to a young man with obsessive-compulsive disorder (OCD) involving primarily obsessional thoughts and mental rituals. Although patients with primarily cognitive OCD symptoms have been previously considered treatment-resistant, novel approaches to EX/RP have been developed and validated. Successful treatment of such symptoms requires a thorough and informed assessment. The theoretical and empirical basis for these procedures is described, along with a cognitive-behavioral analysis of the problem. The course of treatment, use of assessment data, and recommendations to clinicians are also discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Abramowitz, Jonathan S",2002.0,http://dx.doi.org/10.1177/1534650102001001002,0,0,
2080, Modulation of fear extinction processes using transcranial electrical stimulation," Research associates processes of fear conditioning and extinction with treatment of anxiety and stress‚Äêrelated disorders. Manipulation of these processes may therefore be beneficial for such treatment. The current study examines the effects of electrical brain stimulation on fear extinction processes in healthy humans in order to assess its potential relevance for treatment enhancement. Forty‚Äêfive participants underwent a 3‚Äêday fear conditioning and extinction paradigm. Electrical stimulation targeting the medial prefrontal cortex was applied during the extinction‚Äêlearning phase (Day 2). Participants were randomly assigned to three stimulation conditions: direct‚Äêcurrent (DC) stimulation, aimed at enhancing extinction‚Äêlearning; low‚Äêfrequency alternating‚Äêcurrent (AC) stimulation, aimed at interfering with reconsolidation of the activated fear memory; and sham stimulation. The effect of stimulation on these processes was assessed in the subsequent extinction recall phase (Day 3), using skin conductance response and self‚Äêreports. Results indicate that AC stimulation potentiated the expression of fear response, whereas DC stimulation led to overgeneralization of fear response to non‚Äêreinforced stimuli. The current study demonstrates the capability of electrical stimulation targeting the medial prefrontal cortex to modulate fear extinction processes. However, the stimulation parameters tested here yielded effects opposite to those anticipated and could be clinically detrimental. These results highlight the potential capacity of stimulation to manipulate processes relevant for treatment of anxiety and stress‚Äêrelated disorders, but also emphasize the need for additional research to identify delivery parameters to enable its translation into clinical practice. Clinical trial identifiers: Modulation of Fear Extinction Processes Using Transcranial Electrical Stimulation; https://clinicaltrials.gov/show/NCT02723188; NCT02723188 NCT02723188."," Abend, R;  Jalon, I;  Gurevitch, G;  Sar-El, R;  Shechner, T;  Pine, DS;  Hendler, T;  Bar-Haim, Y",2016.0, 10.1038/tp.2016.197,0,0,
2081,Efficacy of cognitive-behavioral hypnotherapy on body dysmorphic disorder: Case study.,"Objectives: This study examined the effect of cognitive behavioral hypnotherapy on Body Dysmorphic Disorder (BDD), depression, and disability of patients. Methods: In this article, we present a single subject experimental design with multiple baselines. The subjects of the study were patients with BDD in Sanandaj city. Purposive sampling was used, and after obtaining diagnostic interview and qualifications of the study, subjects underwent the treatment process. The Yale-Brown Obsessive Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS), Beck Depression Inventory (DBI-II), Sheehan Disability Scale (SDS), Millon Clinical Multiaxial Inventory-III (MCMI-III) and clinical interview were used as diagnostic tools. Cognitive-behavioral hypnotherapy was employed for 15 sessions of one and a half hours and for two sessions per week. For data analysis, we used a single-case analysis using graphs and comparison of mean and median positions. Results: The results showed that participants' scores in BDD, depression, and disability decreased noticeably. Treatment outcomes were continued up to four months of follow-up period as well. Conclusion: Cognitive-behavioral hypnotherapy is effective in improving BDD, depression, and disability of these patients. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Abbarin, Morteza; Zemestani, Mehdi; Rabiei, Mehdi; Bagheri, Amirhooshang",2018.0,http://dx.doi.org/10.29252/nirp.ijpcp.23.4.394,0,0,
2082, Effects of Inpatient Multicomponent Occupational Rehabilitation versus Less Comprehensive Outpatient Rehabilitation on Somatic and Mental Health: secondary Outcomes of a Randomized Clinical Trial," Purpose To evaluate effects on somatic and mental health of a multicomponent inpatient occupational rehabilitation program compared to a less comprehensive outpatient program in individuals on sick leave for musculoskeletal complaints or mental health disorders. Methods A randomized clinical trial with parallel groups. Participants were individuals on sick‚Äêleave for 2‚Äê12 months with a sick‚Äêleave diagnosis within the musculoskeletal, psychological or general and unspecified chapters of ICPC‚Äê2. Potential participants were identified in the Social Security System Registry. The multicomponent inpatient program (4 + 4 days) consisted of Acceptance and Commitment Therapy, physical training and work‚Äêrelated problem‚Äêsolving including creating a return to work plan and a workplace visit if considered relevant. The comparative outpatient program consisted primarily of ACT (6 sessions during 6 weeks). Self‚Äêreported health‚Äêrelated quality of life, subjective health complaints, pain and anxiety and depression symptoms were assessed up to 12 months after the program. Results 168 individuals were randomized to the multicomponent inpatient program (n = 92) or the outpatient program (n = 76). Linear mixed models showed no statistically significant differences between the programs, except for slightly more reduced pain after the outpatient program. Conclusions This study presents no support that a 4 + 4 days multicomponent inpatient rehabilitation program is superior to a less comprehensive outpatient program, in improving health outcomes."," Aasdahl, L;  Pape, K;  Vasseljen, O;  Johnsen, R;  Gismervik, S;  Jensen, C;  Fimland, MS",2017.0, 10.1007/s10926-016-9679-5,0,0,
2083,"Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: a randomized, placebo-controlled trial on psychological distress.","The aim of this randomized placebo-controlled trail was to compare the effects of an objectively titrated mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) and an intraoral placebo device on symptoms of psychological distress in OSA patients. In a parallel design, 64 mild/moderate OSA patients (52.0 ± 9.6 years) were randomly assigned to an objectively titrated MAD, nCPAP, or an intraoral placebo appliance. All patients filled out the Symptom Checklist-90-Revised twice: one before treatment and one after 6 months of treatment. The Symptom Checklist-90-Revised is a multidimensional symptom inventory designed to measure symptomatic psychological distress over the past week. Linear mixed model analyses were performed to study differences between the therapy groups for the different dimensions of the Symptom Checklist-90-Revised over time. The MAD group showed significant improvements over time in the dimensions ""somatization,"" ""insufficiency of thinking and acting,"" ""agoraphobia,"" ""anxiety,"" ""sleeping problems,"" and ""global severity index"" (F = 4.14-16.73, P = 0.048-0.000). These improvements in symptoms of psychological distress were, however, not significantly different from those observed in the nCPAP and placebo groups (P = 0.374-0.953). There is no significant difference between MAD, nCPAP, and an intraoral placebo appliance in their beneficial effects on symptoms of psychological distress. The improvement in psychological distress symptoms in mild/moderate OSA patients under MAD or nCPAP treatment may be explained by a placebo effect.",Aarab G.; Nikolopoulou M.; Ahlberg J.; Heymans MW.; Hamburger HL.; de Lange J.; Lobbezoo F.,2017.0,10.1007/s00784-016-2045-3,0,0,
2084,Description and Diagnosis of Panic Disorder Diagnosis,,"Zebb, Barbara J",1994.0,,0,0,
2085,Development and initial evaluation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders.,"Considerable attention has focused on the growing need for evidence-based psychotherapy for veterans with affective disorders within the Department of Veteran Affairs. Despite, and possibly due to, the large number of evidence-based protocols available, several obstacles remain in their widespread delivery within Veterans Affairs Medical Centers. In part as an effort to address these concerns, newer transdiagnostic approaches to psychotherapy have been developed to provide a single treatment that is capable of addressing several, related disorders. The goal of the present investigation was to develop and evaluate a transdiagnostic psychotherapy, Transdiagnostic Behavior Therapy (TBT), in veterans with affective disorders. Study 1 provided initial support for transdiagnostic presentation of evidence-based psychotherapy components in veterans with principal diagnoses of affective disorders (n = 15). These findings were used to inform the development of the TBT protocol. In Study 2, an initial evaluation of TBT was completed in a second sample of veterans with principal diagnoses of affective disorders (n = 29). The findings of Study 2 demonstrated significant improvements in symptoms of depression, anxiety, stress, posttraumatic stress, and related impairment across participants with various principal diagnoses. Together, the investigation provided preliminary support for effectiveness of TBT in veterans with affective disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gros, Daniel F",2014.0,http://dx.doi.org/10.1016/j.psychres.2014.08.018,0,0,
2086,Intensive referral to mutual-help groups: A field trial of adaptations for rural veterans.,"A multisite field trial testing whether improved outcomes associated with intensive referral to mutual help groups (MHGs) could be maintained after the intervention was adapted for the circumstances and needs of rural veterans in treatment for substance use disorder (SUD). In three Veterans Affairs treatment programs in the Midwest, patients (N=195) received standard referral (SR) or rural-adapted intensive referral (RAIR) and were measured at baseline and 6-month follow-up. Both groups reported significant improvement at 6-months, but no significant differences between SR and RAIR groups in MHG participation, substance use, addiction severity, and posttraumatic stress symptoms. Inconsistent delivery of the intervention resulted in only one-third of the RAIR group receiving the full three sessions, but this group reported significantly greater 6-month abstinence from alcohol than those receiving no sessions. Further research should explore implementation problems and determine whether consistent delivery of the intervention enhances 12-step facilitation. The addition of rural-specific elements to the original intensive referral intervention has not been shown to increase its effectiveness among rural veterans.",Grant KM.; Young LB.; Tyler KA.; Simpson JL.; Pulido RD.; Timko C.,2018.0,10.1016/j.pec.2017.07.012,0,0,
2087," Examining the utility of using genotype and functional biology in a clinical pharmacology trial: pilot testing dopamine β-hydroxylase, norepinephrine, and post-traumatic stress disorder",," Graham, DP;  Nielsen, DA;  Kosten, TR;  Davis, LL;  Hamner, MB;  Makotkine, I;  Yehuda, R",2014.0, 10.1097/YPG.0000000000000039,0,0,
2088,Low Endogenous Fibroblast Growth Factor 2 Levels Are Associated With Heightened Conditioned Fear Expression in Rats and Humans,"Background Hippocampal concentrations of the neurotrophic factor fibroblast growth factor 2 (FGF2) are negatively associated with the expression of fear following conditioning in rats. Heightened conditioned fear expression may be a prospective risk factor for the development of human anxiety and trauma disorders. However, the relationship between conditioned fear expression and FGF2 is yet to be established in humans. Methods Using a cross-species approach, we first investigated the relationship between serum concentrations of FGF2 and individual differences in conditioned fear expression in rats (n = 19). We then subjected 88 human participants, who were recruited from university and community advertisements, to a differential fear conditioning procedure and assessed the relationship between salivary concentrations of FGF2 and fear expression to a conditioned stimulus (CS) (a stimulus paired with a shock) and a CS that was never paired with shock. Results Rats with low serum levels of FGF2 exhibited significantly more freezing than rats with high serum levels of FGF2. Similarly, relative to those with high salivary FGF2, human participants with low salivary FGF2 exhibited significantly heightened skin conductance responses to the CS without shock during fear conditioning and to both the CS with shock and CS without shock during fear recall. Conclusions These studies establish that peripheral markers of FGF2 concentrations are negatively associated with fear expression in both rats and humans. To the extent that conditioned fear expression predicts anxiety and trauma disorder vulnerability, FGF2 may be a clinically useful biomarker in the prediction and eventual prevention of these disorders.",Graham B.M.; Zagic D.; Richardson R.,2017.0,10.1016/j.biopsych.2017.03.020,0,0,
2089,Repeated cortisol administration does not reduce intrusive memories - a double blind placebo controlled experimental study.,"PTSD is a severe mental disorder, which may develop after exposure to traumatic events and is characterized by intrusive memories. Intrusions are sudden brief sensory memories of the traumatic event, that cause immense distress and impairment in every day functioning. Thus, the reduction of intrusive memories is one of the main aims of PTSD therapy. Recently, the glucocorticoid cortisol has been proposed as a pharmacological option to reduce intrusive memories, because cortisol is known to have memory retrieval inhibiting effects. However, the research on the effects of cortisol administration on intrusive memories is not conclusive. The aim of the present study was to examine if repeated cortisol administration inhibits intrusions and recognition memory in an experimental study using the trauma film paradigm. In a randomized double-blind placebo controlled design participants were exposed to a traumatic film (known to induce intrusions in healthy participants) and received either a low dose of cortisol (20mg) or placebo on the three days following ""trauma exposure"". Intrusive memories were assessed with an Electronic Diary and an Intrusion Triggering Task. Furthermore, we assessed explicit memory for the traumatic film clip with a recognition test. Contrary to our predictions, the cortisol group did not report fewer intrusions than the placebo group nor did it show diminished performance on the recognition test. Our results show that sole cortisol administration after a traumatic experience cannot reduce intrusive re-experiencing. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Graebener, Alexandra Heike; Michael, Tanja; Holz, Elena; Lass-Hennemann, Johanna",2017.0,http://dx.doi.org/10.1016/j.euroneuro.2017.09.001,0,0,
2090, Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial," There is increasing evidence that mindfulness can reduce stress, and thereby affect other psychological and physiological outcomes as well. Earlier, we reported the direct 3‚Äêmonth results of an online modified mindfulness‚Äêbased stress reduction training in patients with heart disease, and now we evaluate the effect at 12‚Äêmonth follow‚Äêup. 324 patients (mean age 43.2 years, 53.7% male) were randomized in a 2:1 ratio to additional 3‚Äêmonth online mindfulness training or to usual care alone. The primary outcome was exercise capacity measured with the 6 minute walk test (6MWT). Secondary outcomes were blood pressure, heart rate, respiratory rate, NT‚ÄêproBNP, cortisol levels (scalp hair sample), mental and physical functioning (SF‚Äê36), anxiety and depression (HADS), perceived stress (PSS), and social support (PSSS12). Differences between groups on the repeated outcome measures were analyzed with linear mixed models. At 12‚Äêmonths follow‚Äêup, participants showed a trend significant improvement exercise capacity (6MWT: 17.9 meters, p = 0.055) compared to UC. Cohen's D showed significant but small improvement on exercise capacity (d = 0.22; 95%CI 0.05 to 0.39), systolic blood pressure (d = 0.19; 95%CI 0.03 to 0.36), mental functioning (d = 0.22; 95%CI 0.05 to 0.38) and depressive symptomatology (d = 0.18; 95%CI 0.02 to 0.35). All other outcome measures did not change statistically significantly. In the as‚Äêtreated analysis, systolic blood pressure decreased significantly with 5.5 mmHg (p = 0.045; d = 0.23 (95%CI 0.05‚Äê0.41)). Online mindfulness training shows favorable albeit small long‚Äêterm effects on exercise capacity, systolic blood pressure, mental functioning, and depressive symptomatology in patients with heart disease and might therefore be a beneficial addition to current clinical care. TRIAL REGISTRATION: www.trialregister.nl NTR3453."," Gotink, RA;  Younge, JO;  Wery, MF;  Utens, EMWJ;  Michels, M;  Rizopoulos, D;  van Rossum, LFC;  Roos-Hesselink, JW;  Hunink, MMG",2017.0, 10.1371/journal.pone.0175923,0,0,
2091, A randomized waitlist control community study of Social Cognition and Interaction Training for people with schizophrenia," OBJECTIVE: Social Cognition and Interaction Training (SCIT) has demonstrated effectiveness in improving social cognition and functioning of people with schizophrenia. This pilot study examines the acceptability, feasibility, and effectiveness of SCIT with individuals who have schizophrenia‚Äêspectrum disorders and are receiving care through a public mental health service. METHOD: In a pragmatic randomized waitlist controlled trial, 36 participants (aged 19‚Äê55 years) with a schizophrenia spectrum disorder were randomly allocated to SCIT or treatment as usual (TAU). Measures of theory of mind, emotion perception, attributional bias, social skills, quality of life, life skills, depression, anxiety, and stress were administered pre‚Äê and post‚Äêintervention with follow‚Äêup conducted 4 months later. All wait‚Äêlist controls subsequently received the intervention and a secondary within‚Äêgroup analysis was conducted including these participants. RESULTS: While no significant differences were found between groups on any outcomes, there was strong engagement with the SCIT intervention. Of the 21 participants in the intervention group, the completion rate was 85.71% with a median attendance rate of 17 sessions. Within subject analyses of SCIT participants over time showed significant improvements in quality of life, emotion recognition, social skills, and a trend towards better life skills from pre‚Äê to post‚Äêintervention. These gains were sustained at the 4‚Äêmonth follow‚Äêup time. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Although this study showed limited benefits in outcomes associated with SCIT compared with TAU, it demonstrated the acceptability of SCIT to participants in a real world public health setting shown by high retention, attendance, and positive feedback. This pilot shows SCIT can be implemented in routine clinical practice and lays the foundation for a larger pragmatic study. PRACTITIONER POINTS: SCIT can be implemented successfully in a real‚Äêworld community mental health setting. SCIT had high levels of acceptability to these participants. Limitations The small sample size meant there was insufficient power to detect differences between groups on outcome measures. The study did not include measures of psychiatric symptoms or neuropsychological functioning which may have influenced participants' capacity to benefit from SCIT."," Gordon, A;  Davis, PJ;  Patterson, S;  Pepping, CA;  Scott, JG;  Salter, K;  Connell, M",2018.0, 10.1111/bjc.12161,0,0,
2092,Automaticity of Attentional Bias to Threat in High and Low Worriers,"Individuals with high levels of worry are more likely than others to attend to possible threats, although the extent of top-down attentional control processes on this bias is unknown. We compared the performance of high (n = 26) and low worriers (n = 26) on a probe discrimination task designed to assess attention to threat cues, under cognitive load or no-load conditions. The expected difference between groups was confirmed, with high worriers being more likely to attend to threat cues than low worriers. Importantly however, there were no significant effects involving condition (cognitive load vs. no-load), nor any significant association with self-perceived attentional control ability. These results suggest that pathological worriers are more likely to attend to threat than are individuals with low levels of worry, regardless of task demands on limited cognitive control resources. This finding is consistent with the dominance of habitual bottom-up influences over top-down control processes in biased attention to threat.",Goodwin H.; Eagleson C.; Mathews A.; Yiend J.; Hirsch C.,2017.0,10.1007/s10608-016-9818-5,0,0,
2093,The impact of service-connected disability and therapist experience on outcomes from prolonged exposure therapy with veterans.,"Objective: Although prolonged exposure therapy (PE) has been shown to be effective in treating posttraumatic stress disorder (PTSD), a sizable minority do not benefit. Examining patient and therapist characteristics that impact treatment outcome may improve treatment delivery and identify individuals who are less likely to respond to treatment or are at risk to prematurely discontinue treatment. The current study uses a sample from a large urban Veterans' Affairs (VA) hospital to build on a previous report that identified correlates of treatment outcome for Veterans who received PE. Method: Two hundred eighty-seven veterans completed measures of PTSD, depression, and quality of life at the beginning and end of treatment. Veterans' service-connected disability rating, therapist experience, benzodiazepine prescription, and traumatic brain injury diagnosis were investigated as predictors of treatment outcome in linear regression analyses. Results: Results showed that Veterans with a service-connected disability for a mental health condition had smaller treatment gains than those without service connection (p < .01). Additionally, results showed that patients treated by certified PE therapists had larger treatment gains than those treated by noncertified PE therapists (p < .01). Finally, younger age and therapist certification were associated with dropout from treatment (p < .05). Conclusion: Veterans treated by PE-certified therapists and Veterans who were not service-connected for a mental health condition fared better in treatment. Results suggest that additional study of both the national effort to train VA clinicians in PE and the impact of service connection on PTSD treatment outcome may be helpful for future research. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Goodson, Jason T; Helstrom, Amy W; Marino, Emily J; Smith, Rachel V",2017.0,http://dx.doi.org/10.1037/tra0000260,0,0,
2094,Treating anxiety and depression of cancer survivors: Behavioral activation versus acceptance and commitment therapy.,"Behavioral activation (BA) and acceptance and commitment therapy (ACT) are considered particularly useful treatments when dealing with emotional problems of cancer survivors. The efficacy of these two treatments, applied on a group basis, were evaluated and compared. An analysis was carried out of pre-post treatment changes in the emotional state and patterns of activation/avoidance of 52 cancer patients, with anxiety and/or depression, randomly assigned to three groups (BA/ACT/waiting list control). Both therapies were superior to no treatment in all the variables evaluated. Significant differences were found between the two treatments in favor of ACT in social impairment and avoidance/rumination. BA and ACT, applied on a group basis, are efficacious in the treatment of those emotional difficulties most prevalent in cancer survivors. Results suggest that activation and avoidance are the mechanisms responsible for the changes.",González-Fernández S.; Fernández-Rodríguez C.; Paz-Caballero MD.; Pérez-Álvarez M.,2018.0,10.7334/psicothema2017.396,0,0,
2095,Trauma-Focused Smoking Cessation for Smokers Exposed to the World Trade Center Disaster: A Randomized Clinical Trial.,"The main objective was to evaluate the efficacy of an 8-session, group-based comprehensive smoking cessation and trauma management (CSC-T) treatment among daily smokers (≥5 cigarettes/day) exposed to the World Trade Center (WTC) disaster with elevated WTC-related post-traumatic stress disorder (PTSD) symptoms. Participants (N = 90) were randomly assigned to CSC-T (N = 44; 63.6% white; 27.3% female; mean age = 51.32 ± 7.87) or comprehensive smoking cessation (CSC) alone (N = 46; 71.7% white; 28.3% female; mean age = 48.74 ± 10.66), which was comparable in length and time. Assessments included a diagnostic clinical interview and self-report measures of PTSD and respiratory symptoms, and smoking behavior, and biologically confirmed smoking abstinence. Evaluations occurred at a baseline visit, each treatment session, and at 1-, 2-, 4-, 12-, and 26-weeks post-treatment. The two treatments did not differ in regard to PTSD symptom improvement. After quit day (week 6), the two groups had similar 7-day (~15%) and 6-month (~20%) abstinence rates as well as average number of cigarettes smoked, and PTSD and respiratory symptoms. It is possible that the Cognitive Behavioral Therapy skills specific to quitting smoking, group-based support, and degree of therapist contact, that were available in both treatments may have played a role in equalizing the abstinence rates between the two conditions. Although the current study found no evidence that the CSC-T was superior to the CSC alone treatment, the abstinence rates observed were high relative to previous trials of smokers with diagnosed PTSD. Further development of smoking cessation programs tailored to the needs of smokers with PTSD symptoms continues to be needed. This study suggests that a CSC program aids in smoking abstinence for smokers with PTSD symptoms and that incorporating trauma management skills, may not add additional benefits for abstinence and PTSD and respiratory symptom relief. Further work is needed to improve smoking cessation efforts for smokers with PTSD symptoms.",Gonzalez A.; Friedberg F.; Li X.; Zvolensky MJ.; Bromet EJ.; Mahaffey BL.; Vujanovic AA.; Luft BJ.; Kotov R.,2017.0,10.1093/ntr/ntw384,0,0,
2096,Inpatient cognitive behavior therapy for obsessive-compulsive disorder: Effectiveness and predictors of response in routine clinical practice.,"Background: Studies examining the effectiveness of inpatient or outpatient cognitive behavior therapy (CBT) for obsessive-compulsive disorder (OCD) in routine clinical practice are rare. Multi-morbid, psychotherapeutically pre-treated patients are mostly excluded in randomized controlled trails (RCTs). In the present study, effectiveness and outcome predictors of inpatient CBT in a routine clinical setting were examined in a largely unselected sample, and the results were compared with those of RCTs. Methods: 108 patients with OCD were treated with inpatient CBT (mean treatment duration = 52.0 days; SD = 11.9) and examined in a naturalistic design. 91% were psychotherapeutically pre-treated, 76% had co-morbid disorders and 63% received antidepressive medication at admission. The outcome measures (Yale-Brown Obsessive-Compulsive Scale-Self-Rating (Y-BOCS-SR); Beck's Depression Inventory (BDI)) were administered at the beginning and at the end of treatment. Predictor variables were assessed via routine clinical documentation. Results: Obsessive-compulsive and depressive symptoms significantly declined. Effect sizes were large (Y-BOCS-SR: d = 1.7; BDI: d = 0.9), even when prematurely discharged patients were included in the analysis. At the end of treatment, half of the patients were improved and one-third recovered. None of the examined features (symptom severity, co-morbid disorder, depressive disorder, personality disorder, psychotherapeutic pre-treatment, sexual trauma, couple problems, unemployment) had an effect on treatment outcome. Conclusions: Cognitive behavior therapy in a routine clinical inpatient setting can achieve very good results for multi-morbid, pre-treated OCD patients. Compared with inpatient RCTs, the effects were somewhat smaller but, on the other hand, treatment duration was shorter. Adequate evaluation of the effects of different studies requires careful documentation and comparison of relevant study features, e.g. therapy dose, sample characteristics, exclusion criteria/rate and applied measures. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gonner, Sascha; Limbacher, Klaus; Ecker, Willi",2012.0,http://dx.doi.org/10.1159/000335776,0,0,
2097," ""Do you expect me to receive PTSD care in a setting where most of the other patients remind me of the perpetrator?"": home-based telemedicine to address barriers to care unique to military sexual trauma and veterans affairs hospitals"," Home‚Äêbased telemedicine (HBT) is a validated method of evidence‚Äêbased treatment delivery for posttraumatic stress disorder (PTSD), and justification for its use has centered on closing gaps related to provider availability and distance to treatment centers. However, another potential use of HBT may be to overcome barriers to care that are inherent to the treatment environment, such as with female veterans who have experienced military sexual trauma (MST) and who must present to VA Medical Centers where the majority of patients share features with perpetrator (e.g. gender, clothing) and may function as reminders of the trauma. Delivering evidence‚Äêbased therapies to female veterans with MST‚Äêrelated PTSD via HBT can provide needed treatment to this population. This manuscript describes an ongoing federally funded randomized controlled trial comparing Prolonged Exposure (PE) delivered in‚Äêperson to PE delivered via HBT. Outcomes include session attendance, satisfaction with services, and clinical and quality of life indices. It is hypothesized that based on intent‚Äêto‚Äêtreat analyses, HBT delivery of PE will be more effective than SD at improving both clinical and quality of life outcomes at post, 3‚Äê, and 6‚Äêmonth follow‚Äêup. This is because 'dose received', that is fewer sessions missed, and lower attrition, will be observed in the HBT group. Although the current manuscript focuses on female veterans with MST‚Äêrelated PTSD, implications for other populations facing systemic barriers are discussed."," Gilmore, AK;  Davis, MT;  Grubaugh, A;  Resnick, H;  Birks, A;  Denier, C;  Muzzy, W;  Tuerk, P;  Acierno, R",2016.0, 10.1016/j.cct.2016.03.004,0,0,
2098, Psychometric properties of the Child Anxiety Life Interference Scale - Preschool Version," Despite growing recognition of childhood anxiety as a common and often debilitating clinical concern, we have limited knowledge of the particular ways in which anxiety interferes with daily life for young children who have not yet entered formal schooling. The present study evaluated the psychometric properties of the Child Anxiety Life Interference Scale ‚Äê Preschool Version (CALIS‚ÄêPV). The CALIS‚ÄêPV is a brief (18 item) parent‚Äêreport measure of the impacts of a young child's anxiety on their own life and that of her or his parent. Participants were 784 parents of a child aged 3‚Äê7 years, who completed the CALIS‚ÄêPV as a part of the follow‚Äêup assessment battery for two anxiety prevention trials targeted at preschool children with temperamental inhibition. Confirmatory factor analysis supported three CALIS‚ÄêPV factors reflecting anxiety‚Äêrelated life interference at home, outside home and on parent life. The three factors showed good internal consistency and good convergent and divergent validity, and successfully differentiated children with and without an anxiety diagnosis. Findings provide initial support for the CALIS‚ÄêPV as a reliable and valid measure of the daily life impacts of childhood anxiety for preschool‚Äêaged children and their parents."," Gilbertson, TJ;  Morgan, AJ;  Rapee, RM;  Lyneham, HJ;  Bayer, JK",2017.0, 10.1016/j.janxdis.2017.10.002,0,0,
2099,Internet-Delivered Acceptance-Based Cognitive-Behavioral Intervention for Social Anxiety Disorder With and Without Therapist Support: A Randomized Trial.,"Social anxiety disorder (SAD) is one of the most prevalent psychiatric disorders in the United States. Although evidenced-based behavioral treatments are available, less than 20% of those with SAD receive treatment. Internet-based interventions can address barriers to treatment access, and guided Internet-based treatments have been demonstrated to be effective for SAD. However, the optimal role (if any) of the therapist in such programs remains unclear. We examined the acceptability and efficacy of a novel Internet-based cognitive-behavior therapy for SAD that utilizes traditional behavioral interventions (e.g., exposure) within the context of a model emphasizing mindfulness and psychological acceptance. Forty-two participants were randomized to an eight-module self-help intervention with ( n = 20) or without ( n = 22) adjunctive therapist support; the therapist support was delivered through 10 to 15 min of weekly videoconferencing and daily text messages. Both groups experienced a significant reduction in SAD symptoms and improvements in functioning and quality of life, with no significant differences between groups in both completer-only and intent-to-treat analyses. However, the therapist support group evidenced lower attrition than the minimal support group (20% vs. 50%). Implications for dissemination and future directions are discussed.",Gershkovich M.; Herbert JD.; Forman EM.; Schumacher LM.; Fischer LE.,2017.0,10.1177/0145445517694457,0,0,
2100, Fear conditioning and extinction in pediatric obsessive-compulsive disorder," BACKGROUND: Fear acquisition and extinction are central constructs in the cognitive‚Äêbehavioral model of obsessive‚Äêcompulsive disorder (OCD), which underlies exposure‚Äêbased cognitive‚Äêbehavioral therapy. Youths with OCD may have impairments in fear acquisition and extinction that carry treatment implications. METHODS: Eighty youths (39 OCD, 41 healthy controls [HC]) completed clinical interviews, rating scales, and a differential conditioning task that included habituation, acquisition, and extinction phases. Skin conductance response (SCR) served as the primary dependent measure. RESULTS: During habituation, participants with OCD exhibited a stronger orienting SCR to initial stimuli relative to HC participants. During acquisition, differential fear conditioning was observed for both groups as evidenced by larger SCRs to the visual conditioned stimulus paired with an aversive unconditioned stimulus (CS+) compared with a CS‚Äê; OCD participants exhibited a larger SCR to the CS+ relative to HC participants. The absolute magnitude of the unconditioned fear response was significantly larger in participants with OCD, compared with HC participants. During extinction, OCD participants continued to exhibit a differential SCR to the CS+ and CS‚Äê, whereas HC participants exhibited diminished SCR to both stimuli. CONCLUSIONS: Participants with OCD exhibit a different pattern of fear extinction relative to HC participants, suggestive of greater fear acquisition and impaired inhibitory learning."," Geller, DA;  McGuire, JF;  Orr, SP;  Pine, DS;  Britton, JC;  Small, BJ;  Murphy, TK;  Wilhelm, S;  Storch, EA",2017.0,,0,0,
2101,@Home eTherapy Service for People with Common Mental Health Problems: an Evaluation.,"Ensuring rapid access to psychological interventions is a priority of mental health services. The involvement of peer workers to support the delivery of more accessible treatment options such as computerized cognitive behaviour therapy (CCBT) is recognized. To evaluate the implementation of a third sector remote CCBT @Home eTherapy service for people experiencing common mental health problems supported by individuals with lived experience. Supported CCBT packages with telephone support were delivered over a 30-month period. Self-complete measures identifying levels of depression, anxiety and functioning were administered at each treatment appointment. Over 2000 people were referred to the @Home eTherapy service; two-thirds attended an initial assessment and 53.4% of referrals assigned to CCBT completed treatment. Statistically significant improvements in anxiety, depression and functioning were found, with 61.6% of treated clients meeting recovery criteria. The service meets Improving Access to Psychological Therapies (IAPT) key performance targets, and is comparable to other IAPT services using CCBT. Evidence for the successful implementation of such a service by a third sector organization is provided.",Gellatly J.; Chisnall L.; Seccombe N.; Ragan K.; Lidbetter N.; Cavanagh K.,2018.0,10.1017/S1352465817000297,0,0,
2102,A single session of repetitive transcranial magnetic stimulation of the prefrontal cortex reduces cue-induced craving in patients with gambling disorder.,"Background: Gambling disorder (GD) is common and disabling addictive disorder. In patients with substance use disorders, the application of repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) offers promise to alleviate craving. We hypothesized that applying real compared to sham rTMS over the left DLPFC would reduce gambling craving in patients with GD. Methods: In a randomized sham-controlled crossover design, 22 treatment-seeking patients with GD received real or sham treatment with high frequency rTMS over the left DLPFC followed a week later by the other type of treatment. Before and after each rTMS session, participants rated their gambling craving (from 0 to 100) before and after viewing a gambling video used as a cue. We used the Yale-Brown Obsessive Compulsive Scale adapted for Pathological Gambling to assess gambling behavior before and 7 days after each rTMS session. Results: As compared to sham (mean +0.74; standard deviation +/- 3.03), real rTMS significantly decreased cue-induced craving (-2.12+/-3.39; F(1,19) = 4.87; P = 0.04; partial eta2 = 0.05; 95% CI: 0.00-0.21). No significant effect of rTMS was observed on gambling behavior. Conclusions: Patients with GD reported decreased cue-induced craving following a single session of high frequency rTMS applied over the left DLPFC. Further large randomized controlled studies are needed to determine the usefulness of rTMS in GD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Gay, A; Boutet, C; Sigaud, T; Kamgoue, A; Sevos, J; Brunelin, J; Massoubre, C",2017.0,http://dx.doi.org/10.1016/j.eurpsy.2016.11.001,0,0,
2103,Preliminary evidence for the efficacy of EMDR in treating generalized anxiety disorder.,"This preliminary study sought to evaluate the potential effectiveness of eye movement desensitization and reprocessing (EMDR) as a treatment modality for generalized anxiety disorder (GAD). Using a single-case design with multiple baselines across four subjects, the effectiveness of 15 EMDR sessions was evaluated. Results indicate that subsequent to targeting the experiential contributors to GAD and the current and anticipated situations that caused excessive worry, the scores of anxiety and of excessive worry dropped to levels below diagnostic threshold and in two cases to full remission of GAD symptoms. At both posttreatment and at 2 months follow-up, all four participants no longer presented with GAD diagnosis. In addition, time-series analyses (ARMA) indicate statistically significant improvement on both daily measures of worry and anxiety over the course of the EMDR treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gauvreau, Philippe; Bouchard, Stephane",2008.0,http://dx.doi.org/10.1891/1933-3196.2.1.26,0,0,
2104,"Activity interruptions by pain impair activity resumption, but not more than activity interruptions by other stimuli: An experimental investigation","Interrupting ongoing activities whilst intending to resume them later is a natural response to pain. Whereas this response facilitates pain management, at the same time it may also disrupt task performance. Previous research has shown that activity interruptions by pain impair subsequent resumption of the activity, but not more than pain-irrelevant interruptions. Ongoing task complexity and pain threat value might influence interruption effects. In this experiment, we adjusted a paradigm from outside the field of pain to investigate how activity interruptions by pain affect task performance. Healthy participants (n = 69) were required to answer a series of questions, in a specific sequence, about presented letter-digit combinations. This ongoing task was occasionally interrupted by painful electrocutaneous or nonpainful vibrotactile stimulation (between-subjects), followed by a typing task. On interruption completion, participants were required to resume the ongoing task at the next step of the question sequence. Results indicate impaired sequence accuracy (less frequent resumption at the correct step of the sequence) but preserved nonsequence accuracy (similarly frequent correct responses to question content) immediately after an interruption. Effects were not larger for interruptions by pain compared with nonpain. Furthermore, participants in the 2 conditions reported similar task experience, namely task motivation, perceived difficulty, and confidence to resume the interrupted task. Pain catastrophizing did not influence the results. As in previous studies, activity interruptions by pain were shown to impair the resumption of a task that requires keeping to a step sequence, but not more than interruptions by nonpainful stimuli. Potential explanations are discussed.",Gatzounis R.; Schrooten M.G.S.; Crombez G.; Vlaeyen J.W.S.,2018.0,10.1097/j.pain.0000000000001079,0,0,
2105,Silexan does not cause withdrawal symptoms even when abruptly discontinued.,"Objective: Subsequent to a randomised, double-blind, double dummy clinical trial assessing the efficacy of silexan compared to placebo and paroxetine in patients suffering from generalised anxiety disorder (GAD), a 1week follow-up phase was added in order to assess possible withdrawal symptoms of silexan after abrupt discontinuation. Methods: Participants received silexan 80 mg/d, silexan 160 mg/d, paroxetine 20 mg/d, or placebo at a ratio of 1:1:1:1. Study medication was discontinued after the 10 week active treatment phase of the original trial. Whereas paroxetine was tapered as indicated, silexan administration was discontinued abruptly. Assessment of possible withdrawal effects was done using the Physician Withdrawal Checklist questionnaire (PWC-20). Results: During the 1 week down-titration phase, mean total PWC-20 scores had reduced by 0.19 in placebo, 0.23 in silexan 80, 0.65 in silexan 160, and 0.51 in paroxetine. The median change in all four groups was 0.00. In none of the treatment groups withdrawal effects occurred after discontinuation. Conclusions: Values assessed for the silexan groups indicate the absence of a dependency potential of this preparation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Gastpar, M; Muller, W. E; Volz, H. P; Moller, H. J; Schlafke, S; Dienel, A; Kasper, S",2017.0,http://dx.doi.org/10.1080/13651501.2017.1301488,0,0,
2106,"The ICU-Diary study: prospective, multicenter comparative study of the impact of an ICU diary on the wellbeing of patients and families in French ICUs.","Post-intensive care syndrome includes the multiple consequences of an intensive care unit (ICU) stay for patients and families. It has become a new challenge for intensivists. Prevention programs have been disappointing, except for ICU diaries, which report the patient's story in the ICU. However, the effectiveness of ICU diaries for patients and families is still controversial, as the interpretation of the results of previous studies was open to criticism hampering an expanded use of the diary. The primary objective of the study is to evaluate the post-traumatic stress syndrome in patients. The secondary objectives are to evaluate the post-traumatic stress syndrome in families, anxiety and depression symptoms in patients and families, and the recollected memories of patients. Endpoints will be evaluated 3 months after ICU discharge or death. A prospective, multicenter, randomized, assessor-blind comparative study of the effect of an ICU diary on patients and families. We will compare two groups: one group with an ICU diary written by staff and family and given to the patient at ICU discharge or to the family in case of death, and a control group without any ICU diary. Each of the 35 participating centers will include 20 patients having at least one family member who will likely visit the patient during their ICU stay. Patients must be ventilated within 48 h after ICU admission and not have any previous chronic neurologic or acute condition responsible for cognitive impairments that would hamper their participation in a phone interview. Three months after ICU discharge or death of the patient, a psychologist will contact the patient and family by phone. Post-traumatic stress syndrome will be evaluated using the Impact of Events Scale-Revised questionnaire, anxiety and depression symptoms using the Hospital Anxiety and Depression Scale questionnaire, both in patients and families, and memory recollection using the ICU Memory Tool Questionnaire in patients. The content of a randomized sample of diaries of each center will be analyzed using a grid. An interview of the patients in the intervention arm will be conducted 6 months after ICU discharge to analyze in depth how they use the diary. This study will provide new insights on the impact of ICU diaries on post-traumatic stress disorders in patients and families after an ICU stay. ClinicalTrial.gov, ID: NCT02519725 . Registered on 13 July 2015.",Garrouste-Orgeas M.; Flahault C.; Fasse L.; Ruckly S.; Amdjar-Badidi N.; Argaud L.; Badie J.; Bazire A.; Bige N.; Boulet E.; Bouadma L.; Bretonnière C.; Floccard B.; Gaffinel A.; de Forceville X.; Grand H.; Halidfar R.; Hamzaoui O.; Jourdain M.; Jost PH.; Kipnis E.; Large A.; Lautrette A.; Lesieur O.; Maxime V.; Mercier E.; Mira JP.; Monseau Y.; Parmentier-Decrucq E.; Rigaud JP.; Rouget A.; Santoli F.; Simon G.; Tamion F.; Thieulot-Rolin N.; Thirion M.; Valade S.; Vinatier I.; Vioulac C.; Bailly S.; Timsit JF.,2017.0,10.1186/s13063-017-2283-y,0,0,
2107," Effects of a Physical Therapy Protocol in Patients with Chronic Migraine and Temporomandibular Disorders: a Randomized, Single-Blinded, Clinical Trial"," AIMS: To investigate the effects of adding orofacial treatment to cervical physical therapy in patients with chronic migraine and temporomandibular disorders (TMD). METHODS: A total of 45 participants with chronic migraine and TMD aged 18 to 65 years were randomized into two groups: a cervical group (CG) and a cervical and orofacial group (COG). Both groups continued their medication regimens for migraine treatment and received physical therapy. The CG received physical therapy only in the cervical region, and the COG received physical therapy in both the cervical and orofacial regions. Both groups received six sessions of treatment that consisted of manual therapy and therapeutic exercise in the cervical region or the cervical and orofacial regions. Scores on the Craniofacial Pain and Disability Inventory (CF‐PDI) and the Headache Impact Test (HIT‐6) were primary outcome variables, and the secondary outcome variables were scores on the Tampa Scale for Kinesiophobia (TSK‐11), pain intensity measured on a visual analog scale (VAS), pressure pain thresholds (PPTs) in the temporal, masseter (2 points, M1 and M2) and extratrigeminal (wrist) regions, and maximal mouth opening (MMO). Data were recorded at baseline, posttreatment, and after 12 weeks of follow‐up. The α level was set at .05 for all tests and two‐way repeated‐measures analysis of variance (ANOVA) for within‐ and between‐group interactions. RESULTS: There were 22 CG participants (13.6% men and 86.4% women) and 23 COG participants (13% men and 87% women). The ANOVA analysis revealed statistically significant differences for group × time interaction in CF‐PDI, HIT‐6 in the last follow‐up, pain intensity, PPTs in the trigeminal region, and MMO (P < .05), with a medium‐large magnitude of effect. No statistically significant differences were found in the PPTs of the extratrigeminal region or in the TSK‐11 (P > .05). CONCLUSION: Both groups reported a significant improvement in CF‐PDI, HIT‐6, and pain intensity. Cervical and orofacial treatment was more effective than cervical treatment alone for increasing PPTs in the trigeminal region and producing pain‐free MMO. Physical therapy alone was not effective for increasing the PPTs in the extratrigeminal region (wrist) or decreasing the level of TSK‐11."," Garrigós-Pedrón, M;  La Touche, R;  Navarro-Desentre, P;  Gracia-Naya, M;  Segura-Ortí, E",2018.0, 10.11607/ofph.1912,0,0,
2108, Randomized Controlled Trial of Brief Mindfulness Training and Hypnotic Suggestion for Acute Pain Relief in the Hospital Setting," BACKGROUND: Medical management of acute pain among hospital inpatients may be enhanced by mind‚Äêbody interventions. OBJECTIVE: We hypothesized that a single, scripted session of mindfulness training focused on acceptance of pain or hypnotic suggestion focused on changing pain sensations through imagery would significantly reduce acute pain intensity and unpleasantness compared to a psychoeducation pain coping control. We also hypothesized that mindfulness and suggestion would produce significant improvements in secondary outcomes including relaxation, pleasant body sensations, anxiety, and desire for opioids, compared to the control condition. METHODS: This three‚Äêarm, parallel‚Äêgroup randomized controlled trial conducted at a university‚Äêbased hospital examined the acute effects of 15‚Äêmin psychosocial interventions (mindfulness, hypnotic suggestion, psychoeducation) on adult inpatients reporting ""intolerable pain"" or ""inadequate pain control."" Participants (N = 244) were assigned to one of three intervention conditions: mindfulness (n = 86), suggestion (n = 73), or psychoeducation (n = 85). KEY RESULTS: Participants in the mind‚Äêbody interventions reported significantly lower baseline‚Äêadjusted pain intensity post‚Äêintervention than those assigned to psychoeducation (p < 0.001, percentage pain reduction: mindfulness = 23%, suggestion = 29%, education = 9%), and lower baseline‚Äêadjusted pain unpleasantness (p < 0.001). Intervention conditions differed significantly with regard to relaxation (p < 0.001), pleasurable body sensations (p = 0.001), and desire for opioids (p = 0.015), but all three interventions were associated with a significant reduction in anxiety (p < 0.001). CONCLUSIONS: Brief, single‚Äêsession mind‚Äêbody interventions delivered by hospital social workers led to clinically significant improvements in pain and related outcomes, suggesting that such interventions may be useful adjuncts to medical pain management. TRIAL REGISTRATION: Trial Registry: ClinicalTrials.gov ; registration ID number: NCT02590029 URL: https://clinicaltrials.gov/ct2/show/NCT02590029."," Garland, EL;  Baker, AK;  Larsen, P;  Riquino, MR;  Priddy, SE;  Thomas, E;  Hanley, AW;  Galbraith, P;  Wanner, N;  Nakamura, Y",2017.0, 10.1007/s11606-017-4116-9,0,0,
2109, Age-appropriate preparations for children with cancer undergoing radiotherapy: a feasibility study," The aim of this study was to test age‐appropriate information and preparation procedures for children with cancer undergoing radiotherapy (RT) for feasibility and effectiveness in terms of the need for general anesthesia (GA) and anxiety. In a quasi‐experimental controlled clinical trial, 17 children aged 3‐18 years receiving age‐appropriate preparation were compared with 16 children in a control group. Feasibility in terms of recruitment, compliance, and acceptability was assessed. Effectiveness was assessed by the number of children who underwent treatment without GA and their respective fractions and validated instruments measured the children's anxiety and emotional behavior. The preparation parts were delivered as intended without any additional personnel and without dropouts in the intervention group (IG) and therefore found feasible and acceptable. No statistic significances were found concerning the number of children receiving GA or anxiety. However, three children planned for GA in the IG completed their treatments, including 73 fractions awake. Children receiving GA, regardless of group, showed significantly higher negative emotional behavior. Giving children individualized preparation may decrease the need for GA during RT, which gives benefits in terms of fewer risks and restrictions in life for the child and lower costs for health care."," Gårdling, J;  Törnqvist, E;  Månsson, ME;  Hallström, IK",2017.0, 10.1177/1367493517727070,0,0,
2110, State-trait anxiety levels during pregnancy and foetal parameters following intervention with music therapy," BACKGROUND: Research indicates that anxiety during pregnancy may be a risk factor for the development of alterations in the mental health of the pregnant woman and of obstetric complications. OBJECTIVE: to investigate the effect of music therapy on maternal anxiety, before and after a non‐stress test (NST), and the effect of maternal anxiety on the birthing process and birth size. METHODS: 409 nulliparous women coming for routine prenatal care were randomized in the third trimester to receive either music therapy (n = 204) or no music therapy (n = 205) during an NST. Maternal anxiety was assessed using the Spielberger State‐Trait Anxiety Inventory before and after the NST. RESULTS: After the NST, the women from the music group showed significantly lower scores in state anxiety (OR = 0.87; p < 0.001) as well as trait anxiety (p < 0.001) than the control group. Furthermore, the pregnant women from the music group presented lower levels of state‐trait anxiety than the control group in relation to the variables of birth process, and higher birth weight and chest circumference in the newborn (OR = 3.5 and OR = 0.81, respectively; p < 0.05). LIMITATIONS: This study was limited by the fact that it was a single‐centre study; the observers conducting the NST were not blinded to the allocation, although neither midwife had any knowledge of the maternal anxiety scores, and we could not apply the double‐blind method due to the nature of the observation. CONCLUSIONS: Our findings confirm that music therapy intervention during pregnancy could reduce elevated state‐trait anxiety levels during the third trimester. Further research into the influence of music therapy as intervention on maternal anxiety and on the birthing process and birth size is required during pregnancy."," Garcia-Gonzalez, J;  Ventura-Miranda, MI;  Requena-Mullor, M;  Parron-Carreño, T;  Alarcon-Rodriguez, R",2018.0, 10.1016/j.jad.2018.02.008,0,0,
2111, The Effect of Binaural Beat Technology on the Cardiovascular Stress Response in Military Service Members With Postdeployment Stress," PURPOSE: To assess the efficacy of embedded theta brainwave frequency in music using binaural beat technology (BBT) compared to music alone on the cardiovascular stress response in military service members with postdeployment stress. DESIGN: A double‚Äêblinded, randomized, pre‚Äê and postintervention trial. METHODS: Seventy‚Äêfour military services members with complaint of postdeployment stress were randomized to either music with BBT or music alone. Each group listened to their respective intervention for a minimum of 30 min at bedtime for three consecutive nights a week for a total of 4 weeks. A 20‚Äêmin pre‚Äê and postintervention heart rate variability (HRV) stress test and daily perceived stress via diaries assessed intervention efficacy. FINDINGS: There was a statistical difference (p = .01) in low‚Äêfrequency HRV between the music with BBT group compared to the music only group. The average low‚Äêfrequency HRV decreased in the music with BBT group 2.5 ms CONCLUSIONS: When placed under an acute stressor, participants who used music with embedded BBT showed a decrease in sympathetic responses and an increase in parasympathetic responses, while participants who used music alone had the opposite effect. CLINICAL RELEVANCE: The use of BBT in the theta brainwave frequency embedded into music decreases physical and psychological indications of stress. BBT embedded with beta and delta frequencies may improve cognitive functioning and sleep quality, respectively."," Gantt, MA;  Dadds, S;  Burns, DS;  Glaser, D;  Moore, AD",2017.0, 10.1111/jnu.12304,0,0,
2112, Indicated school-based intervention to improve depressive symptoms among at risk Chilean adolescents: a randomized controlled trial," BACKGROUND: Depression is a disabling condition affecting people of all ages, but generally starting during adolescence. Schools seem to be an excellent setting where preventive interventions may be delivered. This study aimed to test the effectiveness of an indicated school‐based intervention to reduce depressive symptoms among at‐risk adolescents from low‐income families. METHODS: A two‐arm, parallel, randomized controlled trial was conducted in 11 secondary schools in vulnerable socioeconomic areas in Santiago, Chile. High‐risk students in year 10 (2° Medio) were invited to a baseline assessment (n = 1048). Those who scored ≥10 (boys) and ≥15 (girls) in the BDI‐II were invited to the trial (n = 376). A total of 342 students consented and were randomly allocated into an intervention or a control arm in a ratio of 2:1. The intervention consisted of 8 group sessions of 45 min each, based on cognitive‐behavioural models and delivered by two trained psychologists in the schools. Primary (BDI‐II) and secondary outcomes (measures of anxiety, automatic thoughts and problem‐solving skills) were administered before and at 3 months post intervention. The primary outcome was the recovery rate, defined as the proportion of participants who scored in the BDI‐II <10 (among boys) and <15 (among girls) at 3 months after completing the intervention. RESULTS: There were 229 participants in the intervention group and 113 in the control group. At 3‐month follow‐up 81.4 % in the intervention and 81.7 % in the control group provided outcome data. The recovery rate was 10 % higher in the intervention (50.3 %) than in the control (40.2 %) group; with an adjusted OR = 1.62 (95 % CI: 0.95 to 2.77) (p = 0.08). No difference between groups was found in any of the secondary outcomes. Secondary analyses revealed an interaction between group and baseline BDI‐II score. CONCLUSIONS: We found no clear evidence of the effectiveness of a brief, indicated school‐based intervention based on cognitive‐behavioural models on reducing depressive symptoms among Chilean adolescents from low‐income families. More research is needed in order to find better solutions to prevent depression among adolescents. TRIAL REGISTRATION: Current Controlled Trials ISRCTN33871591 . Retrospectively registered 29 June 2011."," Gaete, J;  Martinez, V;  Fritsch, R;  Rojas, G;  Montgomery, AA;  Araya, R",2016.0, 10.1186/s12888-016-0985-4,0,0,
2113, A Randomized Controlled Comparison of Emotional Freedom Technique and Cognitive-Behavioral Therapy to Reduce Adolescent Anxiety: a Pilot Study," DESIGN: Randomized controlled study. SETTINGS: This study took place in 10 schools (8 public/2 private; 4 high schools/6 middle schools) in 2 northeastern states in the United States. PARTICIPANTS: Sixty‚Äêthree high‚Äêability students in grades 6‚Äê12, ages 10‚Äê18 years, who scored in the moderate to high ranges for anxiety on the Revised Children's Manifest Anxiety Scale‚Äê2 (RCMAS‚Äê2) were randomly assigned to CBT (n‚Äâ=‚Äâ21), EFT (n‚Äâ=‚Äâ21), or waitlist control (n‚Äâ=‚Äâ21) intervention groups. INTERVENTIONS: CBT is the gold standard of anxiety treatment for adolescent anxiety. EFT is an evidence‚Äêbased treatment for anxiety that incorporates acupoint stimulation. Students assigned to the CBT or EFT treatment groups received three individual sessions of the identified protocols from trained graduate counseling, psychology, or social work students enrolled at a large northeastern research university. OUTCOME MEASURES: The RCMAS‚Äê2 was used to assess preintervention and postintervention anxiety levels in participants. RESULTS: EFT participants (n‚Äâ=‚Äâ20; M‚Äâ=‚Äâ52.16, SD‚Äâ=‚Äâ9.23) showed significant reduction in anxiety levels compared with the waitlist control group (n‚Äâ=‚Äâ21; M‚Äâ=‚Äâ57.93, SD‚Äâ=‚Äâ6.02) (p‚Äâ=‚Äâ0.005, d‚Äâ=‚Äâ0.74, 95% CI [‚Äê9.76, ‚Äê1.77]) with a moderate to large effect size. CBT participants (n‚Äâ=‚Äâ21; M‚Äâ=‚Äâ54.82, SD‚Äâ=‚Äâ5.81) showed reduction in anxiety but did not differ significantly from the EFT (p‚Äâ=‚Äâ0.18, d‚Äâ=‚Äâ0.34; 95% CI [‚Äê6.61, 1.30]) or control (p‚Äâ=‚Äâ0.12, d‚Äâ=‚Äâ0.53, 95% CI [‚Äê7.06, .84]). CONCLUSIONS: EFT is an efficacious intervention to significantly reduce anxiety for high‚Äêability adolescents. OBJECTIVE: The objective of this pilot study was to compare the efficacy of Emotional Freedom Techniques (EFT) with that of Cognitive‚ÄêBehavioral Therapy (CBT) in reducing adolescent anxiety."," Gaesser, AH;  Karan, OC",2017.0, 10.1089/acm.2015.0316,0,0,
2114,Examination of an internet-delivered cognitive behavioural pain management course for adults with fibromyalgia: A randomized controlled trial.,"Fibromyalgia (FM) is a common and often debilitating chronic pain condition. Research shows that symptoms of depression and anxiety are present in up to 3 quarters of individuals with FM. Of concern, most adults with FM cannot access traditional face-to-face cognitive behavioural pain management programs, which are known to be beneficial. Given known difficulties with treatment access, the present study sought to explore the efficacy and acceptability of a previously developed Internet-delivered cognitive behavioural pain management course, the Pain Course, for adults with FM. The five-lesson course was delivered over 8 weeks and was provided with brief weekly contact, via telephone and secure email, with a guide throughout the course. Participants were randomized either to the Pain Course (n = 30) or to a waiting-list control group (n = 30). Symptoms were assessed at pre-treatment, post-treatment and 4-week follow-up. Completion rates (87%) and satisfaction ratings (86%) were high. Improvements were significantly greater in treatment group participants compared to waiting-list group participants on measures of FM (Cohen's d = 0.70; 18% reduction), depression (Cohen's d = 0.63-0.72; 20%-28% reduction), pain (Cohen's d = 0.87; 11% improvement) and fear of pain (Cohen's d = 1.61; 12% improvement). Smaller effects were also observed on measures of generalized anxiety and physical health. The changes were maintained at 4-week follow-up. The current findings add to existing literature and highlight the specific potential of Internet-delivered cognitive behavioural pain management programs for adults with FM, especially as a part of stepped-care models of care. Future research directions are described. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Friesen, Lindsay N; Hadjistavropoulos, Heather D; Schneider, Luke H; Alberts, Nicole M; Titov, Nikolai; Dear, Blake F",2017.0,http://dx.doi.org/10.1097/j.pain.0000000000000802,0,0,
2115, Still Struggling: characteristics of youth with OCD who are partial responders to medication treatment," The primary aim of this paper is to examine the characteristics of a large sample of youth with OCD who are partial responders (i.e., still have clinically significant symptoms) to serotonin reuptake inhibitor (SRI) medication. The sample will be described with regard to: demographics, treatment history, OCD symptoms/severity, family history and parental psychopathology, comorbidity, and global and family functioning. The sample includes 124 youth with OCD ranging in age from 7 to 17 with a primary diagnosis of OCD and a partial response to an SRI medication. The youth are a predominantly older (age 12 and over), Caucasian, middle to upper income group who had received significant past treatment. Key findings include moderate to severe OCD symptoms, high ratings of global impairment, and significant comorbidity, despite partial response to an adequate medication trial. Considerations regarding generalizability of the sample and limitations of the study are discussed."," Freeman, J;  Sapyta, J;  Garcia, A;  Fitzgerald, D;  Khanna, M;  Choate-Summers, M;  Moore, P;  Chrisman, A;  Haff, N;  Naeem, A;  et al.",2011.0, 10.1007/s10578-011-0227-4,0,0,
2116, Mindfulness-Based Stress Reduction and Group Support Decrease Stress in Adolescents with Cardiac Diagnoses: a Randomized Two-Group Study," Adolescents with cardiac diagnoses face unique challenges that can cause psychosocial distress. This study compares a Mindfulness‚ÄêBased Stress Reduction (MBSR) program to a video online support group for adolescents with cardiac diagnoses. MBSR is a structured psycho‚Äêeducational program which includes yoga, meditation, cognitive restructuring, and group support. A published feasibility study by our group showed significant reduction in anxiety following this intervention. Participants were randomized to MBSR or video online support group, and completed measures of anxiety, depression, illness‚Äêrelated stress, and coping pre‚Äê and post‚Äê6‚Äêsession interventions. Qualitative data were obtained from post‚Äêintervention interviews. A total of 46 teens participated (mean 14.8 years; 63% female). Participants had congenital heart disease and/or cardiac device (52%), or postural orthostatic tachycardia syndrome (48%). Illness‚Äêrelated stress significantly decreased in both groups. Greater use of coping skills predicted lower levels of depression in both groups post‚Äêstudy completion. Higher baseline anxiety/depression scores predicted improved anxiety/depression scores in both groups. Each group reported the benefits of social support. The MBSR group further expressed benefits of learning specific techniques, strategies, and skills that they applied in real‚Äêlife situations to relieve distress. Both the MBSR intervention and video support group were effective in reducing distress in this sample. Qualitative data elucidated the added benefits of using MBSR techniques to manage stress and symptoms. The video group format is useful for teens that cannot meet in person but can benefit from group support. Psychosocial interventions with stress management techniques and/or group support can reduce distress in adolescents with cardiac diagnoses."," Freedenberg, VA;  Hinds, PS;  Friedmann, E",2017.0, 10.1007/s00246-017-1679-5,0,0,
2117, The effect of expressive writing intervention for infertile couples: a randomized controlled trial," STUDY QUESTION: Is expressive writing intervention (EWI) efficacious in reducing distress and improving pregnancy rates for couples going through ART treatment? SUMMARY ANSWER: Compared to controls, EWI statistically significantly reduced depressive symptoms but not anxiety and infertility‚Äêrelated distress. WHAT IS KNOWN ALREADY: ART treatment is considered stressful. So far, various psychological interventions have been tested for their potential in reducing infertility‚Äêrelated distress and the results are generally positive. It remains unclear whether EWI, a brief and potentially cost‚Äêeffective intervention, could be advantageous. STUDY DESIGN SIZE, DURATION: Between November 2010 and July 2012, a total of 295 participants (163 women, 132 men) were randomly allocated to EWI or a neutral writing control group. PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants were couples undergoing IVF/ICSI treatment. Single women and couples with Preimplantation Genetic Diagnosis or acute change of procedure from insemination to IVF, were excluded. EWI participants participated in three 20‚Äêmin home‚Äêbased writing exercises focusing on emotional disclosure in relation to infertility/fertility treatment (two sessions) and benefit finding (one session). Controls wrote non‚Äêemotionally in three 20‚Äêmin sessions about their daily activities. The participants completed questionnaires at the beginning of treatment (t1), prior to the pregnancy test (t2), and 3 months later (t3). In total, 26.8% (79/295) were lost to follow‚Äêup. Mixed linear models were chosen to compare the two groups over time for psychological outcomes (depression, anxiety and infertility‚Äêrelated distress), and a Chi LIMITATIONS, REASONS FOR CAUTION: The results for depressive symptoms corresponded to a small effect size and the remaining results failed to reach statistical significance. This could be due to sample characteristics leading to a possible floor‚Äêeffect, as we did not exclude participants with low levels of emotional distress at baseline. Furthermore, men showed increased infertility‚Äêrelated distress over time. WIDER IMPLICATIONS OF THE FINDINGS: EWI is a potentially cost‚Äêeffective and easy to implement home‚Äêbased intervention, and even small effects may be relevant. When faced with infertility, EWI could thus be a relevant tool for alleviating depressive symptoms by allowing the expression of feelings about infertility that may be perceived as socially unacceptable. However, the implications do not seem to be applicable for men, who presented with increased infertility‚Äêrelated distress over time. STUDY FUNDING/COMPETING INTERESTS: The present study was supported by research grants from Merck Sharpe and Dohme and The Danish Agency for Science Technology and Innovation as part of a publicly funded PhD. The funding bodies had no influence on the data collection, analysis or conclusions of the study. None of the authors have any conflicts of interest to declare. TRIAL REGISTRATION NUMBER: Clinicaltrials.gov, trial no. NCT01187095. TRIAL REGISTRATION DATE: 7th September 2010 DATE OF FIRST PATIENT'S ENROLMENT: 23rd November 2010."," Frederiksen, Y;  O'Toole, MS;  Mehlsen, MY;  Hauge, B;  Elbaek, HO;  Zachariae, R;  Ingerslev, HJ",2017.0, 10.1093/humrep/dew320,0,0,
2118, Caregiver-Reported Health Outcomes: effects of Providing Reflexology for Symptom Management to Women With Advanced Breast Cancer," PURPOSE/OBJECTIVES: To determine the effects of delivering a reflexology intervention on health outcomes of informal caregivers, and to explore whether intervention effects are moderated by caregiver characteristics. ‚Ä©. DESIGN: Two‚Äêgroup, randomized clinical trial.‚Ä©. SETTING: Eight oncology clinics in urban and rural regions of Michigan and Illinois.‚Ä©. SAMPLE: 180 informal caregivers of patients with advanced breast cancer.‚Ä©. METHODS: Caregivers were randomized to provide reflexology to individuals with cancer during a four‚Äêweek period or to attention control. Data collection occurred at baseline and at weeks 5 and 11. Linear mixed‚Äêeffects modeling was used to test intervention effects among all participants and the effects of the number of sessions delivered in the reflexology group.‚Ä©. MAIN RESEARCH VARIABLES: Caregiver characteristics; psychological, physical, and social outcomes.‚Ä©. FINDINGS: Caregiver fatigue in the reflexology group was reduced compared to controls at weeks 5 (p = 0.02) and 11 (p = 0.05). No differences were found for anxiety, depression, pain, physical function, sleep disturbance, satisfaction with participation in social roles, and pain interference between caregivers who delivered reflexology and those who did not.‚Ä©. CONCLUSIONS: Informal caregivers who provided reflexology to individuals with cancer did not have negative psychological, physical, or social outcomes. Fatigue levels were lower among caregivers who provided reflexology. ‚Ä©. IMPLICATIONS FOR NURSING: Clinicians need to be aware that providing supportive care interventions, such as reflexology, to reduce symptom burden does not increase negative outcomes on informal caregivers who provide this care, and it may even lead to reduced fatigue."," Frambes, D;  Sikorskii, A;  Tesnjak, I;  Wyatt, G;  Lehto, R;  Given, B",2017.0, 10.1188/17.ONF.596-605,0,0,
2119, Prevention and treatment of long-term social disability amongst young people with emerging severe mental illness with social recovery therapy (The PRODIGY Trial): study protocol for a randomised controlled trial," BACKGROUND: Young people who have social disability associated with severe and complex mental health problems are an important group in need of early intervention. Their problems often date back to childhood and become chronic at an early age. Without intervention, the long‚Äêterm prognosis is often poor and the economic costs very large. There is a major gap in the provision of evidence‚Äêbased interventions for this group, and therefore new approaches to detection and intervention are needed. This trial provides a definitive evaluation of a new approach to early intervention with young people with social disability and severe and complex mental health problems using social recovery therapy (SRT) over a period of 9 months to improve mental health and social recovery outcomes. METHODS: This is a pragmatic, multi‚Äêcentre, single blind, superiority randomised controlled trial. It is conducted in three sites in the UK: Sussex, Manchester and East Anglia. Participants are aged 16 to 25 and have both persistent and severe social disability (defined as engaged in less than 30 hours per week of structured activity) and severe and complex mental health problems. The target sample size is 270 participants, providing 135 participants in each trial arm. Participants are randomised 1:1 using a web‚Äêbased randomisation system and allocated to either SRT plus optimised treatment as usual (enhanced standard care) or enhanced standard care alone. The primary outcome is time use, namely hours spent in structured activity per week at 15 months post‚Äêrandomisation. Secondary outcomes assess typical mental health problems of the group, including subthreshold psychotic symptoms, negative symptoms, depression and anxiety. Time use, secondary outcomes and health economic measures are assessed at 9, 15 and 24 months post‚Äêrandomisation. DISCUSSION: This definitive trial will be the first to evaluate a novel psychological treatment for social disability and mental health problems in young people presenting with social disability and severe and complex non‚Äêpsychotic mental health problems. The results will have important implications for policy and practice in the detection and early intervention for this group in mental health services. TRIAL REGISTRATION: Trial Registry: International Standard Randomised Controlled Trial Number (ISRCTN) Registry. TRIAL REGISTRATION NUMBER: ISRCTN47998710 (registered 29/11/2012)."," Fowler, D;  French, P;  Banerjee, R;  Barton, G;  Berry, C;  Byrne, R;  Clarke, T;  Fraser, R;  Gee, B;  Greenwood, K;  et al.",2017.0, 10.1186/s13063-017-2062-9,0,0,
2120, Does parental mental health moderate the effect of a telephone and internet-assisted remote parent training for disruptive 4-year-old children?," This study explores the moderators affecting the success of an Internet‐based and telephone assisted remote parent training intervention and compares them to an educational control group. We prospectively identified 464 parents who reported at a health check that their 4‐year‐old children showed elevated levels of externalizing behavior. The moderators explored included parental attention deficit and hyperactivity disorder (ADHD) and parental distress. The dependent variables were child externalization scores and self‐reported parenting skills. The measures were completed at baseline, six and 12‐months follow‐up. The 232 families randomized to active treatment received 11 Internet‐based training sessions with weekly phone calls from a coach. The other 232 families had access to a website that provided general positive parenting advice and one 45‐minute phone‐call from a coach. Using hierarchical linear models, we explored if the parental ADHD or parental distress modified the treatment effects on child externalizing behavior or parenting skills. The results showed that none of the independent variables moderated intervention effects on child externalizing behavior or parenting skills. The lack of significant moderator effects could have been due to the treatment's personalization, the format's flexibility and adaptability to when and how the parents wanted to complete the sessions or the relatively low levels of ADHD and parental distress among the participants."," Fossum, S;  Cunningham, C;  Ristkari, T;  McGrath, PJ;  Hinkka-Yli-Salomäki, S;  Sourander, A",2018.0, 10.1111/sjop.12430,0,0,
2121,Fouling development in direct contact membrane distillation: Non-invasive monitoring and destructive analysis,"Fouling development in direct contact membrane distillation (DCMD) for seawater desalination was evaluated combining in-situ monitoring performed using optical coherence tomography (OCT) together with destructive techniques. The non-invasive monitoring with OCT provided a better understanding of the fouling mechanism by giving an appropriate sampling timing for the membrane autopsy. The on-line monitoring system allowed linking the flux trend with the structure of fouling deposited on the membrane surface. The water vapor flux trend was divided in three phases based on the deposition and formation of different foulants over time. The initial flux decline was due to the deposition of a 50–70 nm porous fouling layer consisting of a mixture of organic compounds and salts. Liquid chromatography with organic carbon detection (LC-OCD) analysis revealed the abundance of biopolymer in the fouling layer formed at the initial phase. In the second phase, formation of carbonate crystals on the membrane surface was observed but did not affect the flux significantly. In the last phase, the water vapor flux dropped to almost zero due to the deposition of a dense thick layer of sulfate crystals on the membrane surface.",Fortunato L.; Jang Y.; Lee J.-G.; Jeong S.; Lee S.; Leiknes T.; Ghaffour N.,2018.0,10.1016/j.watres.2017.12.059,0,0,
2122,Emotion regulation enhancement of cognitive behavior therapy for college student problem drinkers: A pilot randomized controlled trial.,"This pilot randomized clinical trial tested an emotion regulation enhancement to cognitive behavior therapy (CBT) with 29 college student problem drinkers with histories of complex trauma and current clinically significant traumatic stress symptoms. Participants received eight face-to-face sessions of manualized Internet-supported CBT for problem drinking with or without trauma-focused emotion regulation skills (Trauma Affect Regulation: Guide for Education and Therapy [TARGET]). Both interventions were associated with sustained (at one-month follow-up) reductions in self-reported drinking frequency, drinking-related impairment, and heavy drinking in the past week, as well as Post-Traumatic Stress Disorder (PTSD) and complex PTSD symptoms, and improvement in self-reported emotion regulation. The enhanced intervention was associated with significantly greater sustained reductions in complex PTSD symptoms and resulted in medium/large effect size reductions in days of alcohol use (versus small effects by CBT). Emotion regulation enhancement of CBT for college student problem drinkers with interpersonal trauma histories warrants further investigation. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Ford, Julian D; Grasso, Damion J; Levine, Joan; Tennen, Howard",2018.0,http://dx.doi.org/10.1080/1067828X.2017.1400484,0,0,
2123,Using NIATx strategies to implement integrated services in routine care: a study protocol.,"Access to integrated services for individuals with co-occurring substance use and mental health disorders is a long-standing public health issue. Receiving integrated treatment services are both more effective and preferred by patients and families versus parallel or fragmented care. National policy statements and expert consensus guidelines underscore the benefits of integrated treatment. Despite decades of awareness, adequate treatment for individuals with co-occurring substance use and mental health disorders occurs infrequently. The underlying disease burden associated with alcohol, illicit and prescription drug problems, as well as mental health disorders, such as depression, posttraumatic stress disorder and schizophrenia, is substantial. This cluster randomized controlled trial (RCT) is designed to determine if the multi-component Network for the Improvement of Addiction Treatment (NIATx) strategies are effective in implementing integrated services for persons with co-occurring substance use and mental health disorders. In this study, 50 behavioral health programs in Washington State will be recruited and then randomized into one of two intervention arms: 1) NIATx implementation strategies, including coaching and learning sessions over a 12-month intervention period to implement changes targeting integrated treatment services; or 2) wait-list control. Primary outcome measures include: 1) fidelity - a standardized organizational assessment of integrated services (Dual Diagnosis in Addiction Treatment [DDCAT] Index); and 2) penetration - proportion of patients screened and diagnosed with co-occurring disorders, proportion of eligible patients receiving substance use and mental health services, and psychotropic or substance use disorder medications. Barriers and facilitators, as determinants of implementation outcomes, will be assessed using the Consolidated Framework for Implementation Research (CFIR) Index. Fidelity to and participation in NIATx strategies will be assessed utilizing the NIATx Fidelity Scale and Stages of Implementation Completion (SIC). This study addresses an issue of substantial public health significance: the gap in access to an evidence-based practice for integrated treatment for individuals with co-occurring mental health and substance use disorders. The study utilizes rigorous and reproducible quantitative approaches to measuring implementation determinants and strategies, and may address a longstanding gap in the quality of care for persons with co-occurring disorders. ClinicalTrials.gov NCT03007940 . Registered 02 January 2017 - Retrospectively Registered.",Ford JH.; Osborne EL.; Assefa MT.; McIlvaine AM.; King AM.; Campbell K.; McGovern MP.,2018.0,10.1186/s12913-018-3241-4,0,0,
2124,Examining the short-term anxiolytic and antidepressant effect of Floatation-REST.,"Floatation-REST (Reduced Environmental Stimulation Therapy) reduces sensory input to the nervous system through the act of floating supine in a pool of water saturated with Epsom salt. The float experience is calibrated so that sensory signals from visual, auditory, olfactory, gustatory, thermal, tactile, vestibular, gravitational and proprioceptive channels are minimized, as is most movement and speech. This open-label study aimed to examine whether Floatation-REST would attenuate symptoms of anxiety, stress, and depression in a clinical sample. Fifty participants were recruited across a spectrum of anxiety and stress-related disorders (posttraumatic stress, generalized anxiety, panic, agoraphobia, and social anxiety), most (n = 46) with comorbid unipolar depression. Measures of self-reported affect were collected immediately before and after a 1-hour float session, with the primary outcome measure being the pre- to post-float change score on the Spielberger State Anxiety Inventory. Irrespective of diagnosis, Floatation-REST substantially reduced state anxiety (estimated Cohen's d > 2). Moreover, participants reported significant reductions in stress, muscle tension, pain, depression and negative affect, accompanied by a significant improvement in mood characterized by increases in serenity, relaxation, happiness and overall well-being (p < .0001 for all variables). In reference to a group of 30 non-anxious participants, the effects were found to be more robust in the anxious sample and approaching non-anxious levels during the post-float period. Further analysis revealed that the most severely anxious participants reported the largest effects. Overall, the procedure was well-tolerated, with no major safety concerns stemming from this single session. The findings from this initial study need to be replicated in larger controlled trials, but suggest that Floatation- REST may be a promising technique for transiently reducing the suffering in those with anxiety and depression. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Feinstein, Justin S; Khalsa, Sahib S; Yeh, Hung-wen; Wohlrab, Colleen; Simmons, W. Kyle; Stein, Murray B; Paulus, Martin P",2018.0,,0,0,
2125,Prazosin addition to fluvoxamine: A preclinical study and open clinical trial in OCD.,"The efficacy of selective serotonin reuptake inhibitors (SRIs) in psychiatric disorders may be ""augmented"" through the addition of atypical antipsychotic drugs. A synergistic increase in dopamine (DA) release in the prefrontal cortex has been suggested to underlie this augmentation effect, though the mechanism of action is not clear yet. We used in vivo microdialysis in rats to study DA release following the administration of combinations of fluvoxamine (10 mg/kg) and quetiapine (10 mg/kg) with various monoamine-related drugs. The results confirmed that the selective 5-HT1A antagonist WAY-100635 (0.05 mg/kg) partially blocked the fluvoxamine-quetiapine synergistic effect (maximum DA increase dropped from 325% to 214%). A novel finding is that the alpha1-adrenergic blocker prazosin (1 mg/kg), combined with fluvoxamine, partially mimicked the effect of augmentation (maximum DA increase 205%; area-under-the-curve 163%). As this suggested that prazosin augmentation might be tested in a clinical study, we performed an open clinical trial of prazosin 20mg addition to SRI in therapy-resistant patients with obsessive-compulsive disorder applying for neurosurgery. A small, non-significant reduction in Yale Brown Obsessive Compulsive Scale (Y-BOCS) scores was observed in 10 patients and one patient was classified as a responder with a reduction in Y-BOCS scores of more than 25%. We suggest that future clinical studies augmenting SRIs with an alpha1-adrenergic blocker in less treatment resistant cases should be considered. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Feenstra, Matthijs G. P; Klompmakers, Andre; Figee, Martijn; Fluitman, Sjoerd; Vulink, Nienke; Westenberg, Herman G. M; Denys, Damiaan",2016.0,http://dx.doi.org/10.1016/j.euroneuro.2015.12.008,0,0,
2126,Treatment of depression and anxiety in Parkinson's Disease: A pilot study using group cognitive behavioural therapy.,"Depression and anxiety affect up to 50% of people with Parkinson's Disease (PD) (Marsh, 2000; Murray, 1996), however, few studies have examined the effectiveness of psychological treatment. This study examined the effectiveness of group cognitive behaviour therapy (GET) in treating depression and anxiety in PD. Four participants, aged between 56 and 81 years, who had been diagnosed with PD and suffering from depression and/or anxiety were included in the study. The results suggested that CBT was effective in treating depression and anxiety in PD. Furthermore, the results supported that the gains were maintained at 1-month follow-up. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Feeney, Farah; Egan, Sarah; Gasson, Natalie",2005.0,http://dx.doi.org/10.1080/13284200500048240,0,0,
2127, An experimental test of the effect of acute anxious arousal and anxiety sensitivity on negative reinforcement smoking," METHOD: Participants were adult daily smokers (n=90; Mage=43.6 SD =9.7); average 15.8 cigarettes per day). A between‚Äêsubjects design was used; participants were randomly assigned to complete a biological challenge procedure consisting of either a single vital capacity inhalation of 35% carbon dioxide (CO2)‚Äêenriched air mixture or compressed room air. Smoking urges and smoking topography (puff behavior) were assessed before and after the challenge. RESULTS: Results revealed a significant interaction between anxiety sensitivity and experimental condition (b=‚Äê9.96, p=0.014), such that high anxiety sensitive smokers exposed to 35% CO2‚Äêenriched air reported significantly lower levels of smoking urges, relative to low anxiety sensitive smokers; the conditional effect of anxiety sensitivity was not observed for the room air condition. There were no significant interaction effects of experimental manipulation by anxiety sensitivity for any of the smoking topography outcomes. DISCUSSION: The present results suggest for smokers with higher levels of anxiety sensitivity, the acute experience of anxious arousal is related to decreased subjective smoking urges. These data invite future research to explore the reasons for dampened smoking urges, including cardiorespiratory symptom severity. INTRODUCTION: Although anxiety sensitivity has been reliably associated with smoking‚Äêanxiety comorbidity, there has not been a test of whether this construct moderates the effect of acute anxious arousal on actual smoking behavior. The present study utilized an experimental design to test the moderating role of anxiety sensitivity on laboratory‚Äêinduced anxious arousal in terms of smoking urges and topography (puff style)."," Farris, SG;  Zvolensky, MJ",2016.0, 10.1177/0269881116642880,0,0,
2128,Association of comorbid personality disorders with clinical characteristics and outcome in a randomized controlled trial comparing two psychotherapies for early-onset persistent depressive disorder.,"Persistent depressive disorder (PDD) is associated with high rates of comorbid personality disorders (PD). The association of comorbid PD and clinical characteristics has not been systematically studied in PDD. Results regarding effects on treatment outcome are heterogeneous. We analyzed the association of comorbid personality disorders with clinical characteristics and outcome in a randomized controlled trial comparing the disorder-specific Cognitive Behavioral Analysis System of Psychotherapy (CBASP) with nonspecific supportive psychotherapy (SP) in patients with early-onset PDD. The main outcome measure was the Hamilton Rating Scale for Depression (HRSD-24). Further baseline measures were comorbid axis-I diagnoses (SCID-I), quality of life (QLDS), global functioning (GAF), interpersonal problems (IIP-64) and childhood maltreatment (CTQ). Out of the 268 patients, 103 (38.4%) met criteria for at least one PD. PD was associated with higher rates of axis I comorbidities (mainly anxiety disorders) and interpersonal problems (patients with PD were more vindictive, more self-sacrificing, less assertive and more inhibited socially than patients without PD). There was no significant main effect of PD on treatment outcome and no significant interaction between PD and treatment group. The main limitation was the exclusion of patients with certain personality disorders (antisocial, schizotypal, and borderline personality disorders). Furthermore, the study was underpowered to find interaction effects of small size. Persistently depressed patients with and without comorbid PD primarily seemed to differ in the rate of axis I comorbidity and the severity of interpersonal problems. Treatment outcomes appear to be not significantly affected by the presence of PD.",Erkens N.; Schramm E.; Kriston L.; Hautzinger M.; Härter M.; Schweiger U.; Klein JP.,2018.0,10.1016/j.jad.2017.12.091,0,0,
2129, Effects of Aqua-Lymphatic Therapy on Lower Extremity Lymphedema: a Randomized Controlled Study," BACKGROUND: The purpose of this study is to investigate the effects of the aqua‐lymphatic therapy (ALT) on unilateral lower extremity lymphedema in the maintenance phase. MATERIALS AND METHODS: This is a randomized controlled trial with a blinded assessor. The study was completed with 30 ALT and 27 control group participants. Foot volume was assessed by a water displacement device, limb volume by circumference measurements, functional capacity by a 6‐minute walk test, quality of life by Short Form‐36, and social appearance by Social Appearance Anxiety Scale and hopeless by Beck Hopeless Scale. The ALT and the control group had group sessions twice in a week for 6 weeks directed by a physiotherapist. RESULTS: The mean age of ALT patients was 44.50 ± 13.69 years, whereas that of the control patients was 47.66 ± 16.82 years. After the intervention, both groups' measurement of edema, functional level, quality of life, as well as social and future concerns improved significantly but this improvement was higher in the ALT group (p < 0.05, p ≤ 0.001). CONCLUSIONS: ALT was found to be a safe effective method for unilateral lower extremity lymphedema patients during the maintenance phase of Complex Decongestive Physiotherapy."," Ergin, G;  Karadibak, D;  Sener, HO;  Gurpinar, B",2017.0, 10.1089/lrb.2017.0017,0,0,
2130,Bigger is better: Full-length versions of the Social Interaction Anxiety Scale and Social Phobia Scale outperform short forms at assessing treatment outcome.,"The Social Interaction Anxiety Scale (SIAS) and Social Phobia Scale (SPS) are 20-item companion measures of social anxiety symptoms frequently used to evaluate outcome in treatment trials. The SIAS-6, SPS-6, and Social Interaction Phobia Scale (SIPS) are promising short forms of the SIAS and SPS. The current study evaluated whether it is sound to use these short scales instead of the full-length instruments to measure outcome in social anxiety disorder (SAD) treatment studies, using data from a trial in which 255 adults with SAD were treated with traditional or imagery-enhanced group cognitive-behavioral therapy. Several deficiencies with the short forms were identified including ceiling effects, inflated variances, imprecise effect size estimates, and a loss of statistical power when testing for between-treatment differences. Using the short forms can alter the substantive findings of a treatment trial, as genuine differences in efficacy between treatments can be missed. We recommend treatment outcome be measured using the full SIAS and SPS rather than the SIPS, SIAS-6, and SPS-6. The full-length instruments provide precise estimates of treatment effects and maximize the chance of detecting between-treatment differences when they exist. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement Public Significance Statement: This study shows that it is important for researchers to carefully select instruments for measuring social anxiety symptoms in clinical trials of treatments for social anxiety disorder. Differences in the effectiveness of treatments can be overlooked if less sensitive instruments are used. This could lead to people with social anxiety being offered ineffective treatments. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Erceg-Hurn, David M; McEvoy, Peter M",2018.0,http://dx.doi.org/10.1037/pas0000601,0,0,
2131,Attention in action and perception: Unitary or separate mechanisms of selectivity?,"What is the relation between the two visual stream hypothesis and selective visual attention? In this chapter, we first consider this question at a theoretical level before presenting an example of work from our lab that examines the question: Under what conditions does the emotional content of a visual object influence visually guided action? Previous research has demonstrated that fear can influence perception, both consciously and unconsciously, but it is unclear when fear influences visually guided action. The study tested participants with varying degrees of spiderphobia on two visually guided pointing tasks, while manipulating the emotional valence of the target (positive and negative) and the cognitive load of the participant (single vs dual task). Participants rapidly moved their finger from a home position to a suddenly appearing target image on a touch screen. The images were emotionally negative (e.g., spiders and scorpions) or positive (e.g., flowers and food). In order to test the effect of emotional valence on the online control of the reach, the target either remained static or jumped to a new location. In both the single and dual tasks, a stream of digits were presented on the screen near the finger's starting location, but only in the dual task were participants asked to identify a letter somewhere in the stream. In the single task, increased fear of spiders reduced the speed and accuracy of the movement. In the dual task, increased fear impaired letter identification, but pointing actions were now equally efficient for low- and high-fear participants. These results imply that the finger's autopilot is influenced by emotional content only when attention can be fully devoted to the identification of the emotion-evoking images. As such, the results support the view that the mechanisms of selection are not the same in the two visual streams.",Enns J.T.; Brennan A.A.; Whitwell R.L.,2017.0,10.1016/bs.pbr.2017.08.004,0,0,
2132,BRIGHTEN heart intervention for depression in minority older adults: Randomized controlled trial.,"Objective: Assess the effectiveness of an interdisciplinary geriatric team intervention in decreasing symptoms of depression among urban minority older adults in primary care. Secondary outcomes included cardiometabolic syndrome and trauma. Method: 250 African American and Hispanic older adults with PHQ-9 scores >= 8 and BMI >= 25 were recruited from 6 underserved urban primary care clinics. Intervention arm participants received the BRIGHTEN Heart team intervention plus membership in Generations, an older adult educational activity program; comparison participants received only Generations. Results: Both arms demonstrated clinically significant improvements in PHQ-9 scores at 6 months (-5 points, intervention and comparison) and 12 months (-7 points intervention, -6.5 points comparison); there was no significant difference in change scores between groups on depression or cardiometabolic syndrome at 6 months; there was a small difference in depression trajectory at 12 months (p < .001). More participants in the treatment group (70.7%) had greater than 50% reduction in PHQ-9 scores than the comparison group (56.3%; p = .036). For those with higher PTSD symptoms (PCL-C6), improvement in depression was significantly better in the intervention arm than the comparison arm, regardless of baseline PHQ-9 (p = .001). In mixed models, those with higher PTSD symptoms (beta = -0.012, p = < 0.001) in the intervention arm showed greater depression improvement than those with lower PTSD symptoms (beta = -0.004, p = .001). Conclusions: The BRIGHTEN Heart intervention may be effective in reducing depression for urban minority older adults. Further research on team care interventions and screening for PTSD symptoms in primary care is warranted. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Emery-Tiburcio, Erin E; Rothschild, Steven K; Avery, Elizabeth F; Wang, Yamin; Mack, Laurin; Golden, Robyn L; Holmgreen, Lucie; Hobfoll, Stevan; Richardson, DeJuran; Powell, Lynda H",2018.0,http://dx.doi.org/10.1037/hea0000684,0,0,
2133,BRIGHTEN Heart intervention for depression in minority older adults: Randomized controlled trial.,"Objective: Assess the effectiveness of an interdisciplinary geriatric team intervention in decreasing symptoms of depression among urban minority older adults in primary care. Secondary outcomes included cardiometabolic syndrome and trauma. Method: 250 African American and Hispanic older adults with PHQ-9 scores >= 8 and BMI >= 25 were recruited from 6 underserved urban primary care clinics. Intervention arm participants received the BRIGHTEN Heart team intervention plus membership in Generations, an older adult educational activity program; comparison participants received only Generations. Results: Both arms demonstrated clinically significant improvements in PHQ-9 scores at 6 months (-5 points, intervention and comparison) and 12 months (-7 points intervention, -6.5 points comparison); there was no significant difference in change scores between groups on depression or cardiometabolic syndrome at 6 months; there was a small difference in depression trajectory at 12 months (p < .001). More participants in the treatment group (70.7%) had greater than 50% reduction in PHQ-9 scores than the comparison group (56.3%; p = .036). For those with higher PTSD symptoms (PCL-C6), improvement in depression was significantly better in the intervention arm than the comparison arm, regardless of baseline PHQ-9 (p = .001). In mixed models, those with higher PTSD symptoms (beta = -0.012, p = < 0.001) in the intervention arm showed greater depression improvement than those with lower PTSD symptoms (beta = -0.004, p = .001). Conclusions: The BRIGHTEN Heart intervention may be effective in reducing depression for urban minority older adults. Further research on team care interventions and screening for PTSD symptoms in primary care is warranted. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Emery-Tiburcio, Erin E; Rothschild, Steven K; Avery, Elizabeth F; Wang, Yamin; Mack, Laurin; Golden, Robyn L; Holmgreen, Lucie; Hobfoll, Stevan; Richardson, DeJuran; Powell, Lynda H",2019.0,http://dx.doi.org/10.1037/hea0000684,0,0,2132
2134,The Female Genital Self-Image Scale (FGSIS): cross-cultural adaptation and validation of psychometric properties within a Turkish population,"Introduction and hypothesis: Women’s perceived satisfaction from their own genital appearance is linked to genital image and sexual esteem. A comprehensive and easy to use scale to measure self-image was scarce in the literature. It was aimed in the present study to complement cross-culturally adapted and validated into Turkish version of the Female Genital Self-Image Scale (FGSIS) and to assess its psychometric properties. Methods: After cross-cultural adaptation, the Turkish version of the FGSI, Female Sexual Distress Scale-Revised (FSDS-R), and Female Sexual Function Index (FSFI) were administered to 461 female participants. Content/face validity, exploratory, and confirmatory factor analysis, internal consistency, and reliability were appropriately assessed. Predefined and specific hypotheses were formulated for construct validity. Results: Our findings indicated excellent content/face validity, sufficient internal consistency (Cronbach’s alpha 0.818), and test–retest reliability [intraclass correlation coefficient (ICC) 0.951]. Construct validity was demonstrated by proving the hypothesis that participants who have performed at least one vaginal/clitoral masturbation for the last month reported significantly higher FGSIS scores compared with those who abstained (Z −6.37, p < 0.001). Factor analyses formed one factor structure. In the proposed two-factor construct, all seven items demonstrated good to high correlations with their subdomains and lower correlations with the other domain, indicating sufficient convergent validity. Conclusions: The FGSIS was successfully validated for use in the Turkish population. The scale exhibited strong psychometric properties to assess perceived female genital image. It might be reliably used in genital cosmetic surgeries and in a variety of gynecologic conditions.",Ellibes Kaya A.; Yassa M.; Dogan O.; Basbug A.; Pulatoglu C.; Caliskan E.,2018.0,10.1007/s00192-018-3688-1,0,0,
2135,Augmentation of fear extinction by transcranial direct current stimulation (tDCS),"Although posttraumatic stress disorder (PTSD; DSM-V 309.82) and anxiety disorders (DSM-V 300.xx) are widely spread mental disorders, the effectiveness of their therapy is still unsatisfying. Non-invasive brain-stimulation techniques like transcranial direct current stimulation (tDCS) might be an option to improve extinction learning, which is a main functional factor of exposure-based therapy for anxiety disorders. To examine this hypothesis, we used a fear conditioning paradigm with female faces as conditioned stimuli (CS) and a 95-dB female scream as unconditioned stimulus (UCS). We aimed to perform a tDCS of the ventromedial prefrontal cortex (vmPFC), which is mainly involved in the control of extinction-processes. Therefore, we applied two 4 × 4cm electrodes approximately at the EEG-positions F7 and F8 and used a direct current of 1.5mA. The 20-min stimulation was started during a 10-min break between acquisition and extinction and went on overall extinction-trials. The healthy participants were randomly assigned in two double-blinded process into two sham stimulation and two verum stimulation groups with opposite current flow directions. To measure the fear reactions, we used skin conductance responses (SCR) and subjective ratings. We performed a generalized estimating equations model for the SCR to assess the impact of tDCS and current flow direction on extinction processes for all subjects that showed a successful conditioning (N = 84). The results indicate that tDCS accelerates early extinction processes with a significantly faster loss of CS+/CS- discrimination. The discrimination loss was driven by a significant decrease in reaction toward the CS+ as well as an increase in reaction toward the CS- in the tDCS verum groups, whereas the sham groups showed no significant reaction changes during this period. Therefore, we assume that tDCS of the vmPFC can be used to enhance early extinction processes successfully. But before it should be tested in a clinical context further investigation is needed to assess the reason for the reaction increase on CS-. If this negative side effect can be avoided, tDCS may be a tool to improve exposure-based anxiety therapies.",Dittert N.; Hüttner S.; Polak T.; Herrmann M.J.,2018.0,10.3389/fnbeh.2018.00076,0,0,
2136,Prevalence and impact of co-occurring psychiatric disorders on outcomes from a private hospital drug and alcohol treatment program.,"Aim: This naturalistic study was designed to assess the prevalence and impact of co-occurring mental disorders in 104 adults (52% male) admitted to a private hospital drug and alcohol treatment program in Brisbane, Australia. Method: Psychiatric diagnoses made by the participants' admitting psychiatrists were collected by chart audit. Measures of substance use, dependence and mood were obtained by a program psychologist on participants' admission to the hospital, and during a follow-up interview conducted by the second researcher an average of 8.5 months after participants' discharge. Results: Ninety-two per cent of the sample was diagnosed with at least one mental disorder; most commonly Major Depressive Disorder (57%), Generalised Anxiety Disorder (20%) and Borderline Personality Disorder (16%). Having a concurrent mood, anxiety or personality disorder was not significantly related to either program attendance or outcomes on substance related self-report measures. Only depression symptoms at follow-up were associated with significantly fewer per cent days abstinent in the past 30 days. Conclusion: While co-occurring mental disorders are highly prevalent in this sample, the disorders conferred no significant disadvantage for patients undergoing treatment for substance abuse. However, depression symptoms should be addressed in the period after discharge in order to ensure positive longer-term outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dingle, Genevieve A; King, Pauline",2009.0,http://dx.doi.org/10.1080/17523280802593319,0,0,
2137,[Efficacy and safety of tertiary hospital guided and community-driven family self-help cardiac rehabilitation model].,"Objective: To explore the efficacy and safety of tertiary hospital guided and community-driven family self-help cardiac rehabilitation model. Methods: This study was a prospective randomized controlled study, 80 patients from Beijing Electrical Power Hospital and Beijing Jingmei Group General Hospital with acute coronary syndrome were included from June to December 2015 and divided into 2 groups. Patients in rehabilitation group (n=52) received tertiary hospital(Peiking University Peoples' Hospital) guided and community-driven family self-help cardiac rehabilitation for 3 months, and patients in control group (n=28) received routine secondary treatment for 3 months. Following parameters including 6 minutes walk distance, score of life quality (evaluated by Short Form-12), score of anxiety (evaluated by Generalized Anxiety Disorder-7), score of depression (evaluated by Perceived Health Questionnaire-9), self-management competency (evaluated by questionnaire) were collected at baseline and after treatment for 3 months. Results: Compared with control group, 6 minutes walk distance was longer in rehabilitation group((60.2±6.8) meters vs. (24.9±10.5)meters, P<0.01). The difference values between after and before intervention of life quality scores((0.14±3.90)scores vs.(-7.44±5.85)scores, P>0.05), anxiety scores((-0.16±2.12 ) scores vs.(0.70±1.13)scores, P>0.05) and depression scores((-1.17±2.79) scores vs.(0.60±0.36)scores, P>0.05) were similar between the 2 groups. The amplification of patients with regular exercise (50.26% vs. 0, P<0.05), limit sugary foods usually and always (53.22% vs. 3.98%, P<0.05), eat 200-400 g fruits usually and always (78.61 % vs. 0, P<0.05), eat 300-500 g vegetables usually and always (9.74% vs. 0, P<0.05), and answering very confident to questions such as let the physicians know about your diseases (40.17% vs. 5.00%, P<0.05), know how to take medicines (44.52% vs. 5.00%, P<0.05), know how much exercise was right for yourself (26.43% vs.0, P<0.05) were significantly higher in rehabilitation group than in control group. There were no cardiac rehabilitation training related cardiovascular events. Conclusion: Tertiary hospital guided and community-driven family self-help cardiac rehabilitation model is an effective and safe management model of cardiovascular disease in chronic phase, and it is necessary to further expand the study population to verify the efficacy of this model.",Ding RJ.; Gao LM.; Chu L.; Xie WL.; Wang XR.; Tang Q.; Wang HL.; Hu DY.,2017.0,10.3760/cma.j.issn.0253-3758.2017.03.008,0,0,
2138,The efficacy of 90-minute versus 60-minute sessions of prolonged exposure for posttraumatic stress disorder: Design of a randomized controlled trial in active duty military personnel.,"Objective: Posttraumatic stress disorder (PTSD) can have devastating effects on multiple aspects of functioning. Thus, it is imperative to increase access to evidence-based treatment for PTSD. Prolonged Exposure therapy (PE) has extensive empirical support and is one of the first-line PTSD treatments included in civilian, veteran, and military clinical practice guidelines. However, the standard 90-min PE session format can constitute a significant barrier to its adoption in routine clinical care settings, which typically schedule 60-min appointment sessions. If the length of PE sessions could be reduced from 90 to 60 min without compromising treatment efficacy and efficiency, this would remove a major barrier to PE adoption. Method: This paper describes the rationale and methods of a randomized controlled noninferiority trial comparing 90-min versus 60-min PE sessions (including 40- vs. 20-min imaginal exposures, respectively) among 160 active duty military personnel with PTSD. The aims of this study are to: (1) examine the efficacy and efficiency (i.e., rate of symptom improvement) of 90- versus 60-min PE; (2) assess change in psychophysiological markers of treatment response across conditions; and (3) test mechanisms of change underlying the efficacy of PE. Results/Conclusions: The results of this study will inform dissemination efforts in military, veteran, and civilian sectors. Further, identifying mechanisms of therapeutic change will answer important theoretical questions about how PE works, in order to refine and increase the efficacy and efficiency of PE to better meet the needs of individuals with PTSD. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement Clinical Impact Statement-Prolonged exposure (PE) therapy is an evidence-based treatment for posttraumatic stress disorder (PTSD) with established efficacy. However, psychotherapy providers often do not use PE with their PTSD patients because PE sessions are 90 min, and most psychotherapy appointments are 60 min. We describe a study that will test whether PE is as effective when delivered in 60-min as compared with the usual 90-min sessions. We also test whether PTSD patients need more 60-min sessions to recover compared with 90-min sessions. Psychotherapy providers who treat PTSD may be more likely to use PE if it can be delivered in 60-min sessions. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Foa, Edna B; Zandberg, Laurie J; McLean, Carmen P; Rosenfield, David; Fitzgerald, Hayley; Tuerk, Peter W; Wangelin, Bethany C; Young-McCaughan, Stacey; Peterson, Alan L",2018.0,http://dx.doi.org/10.1037/tra0000351,0,0,
2139,The implementation of prolonged exposure: Design of a multisite study evaluating the usefulness of workshop with and without consultation.,"This randomized trial examines the dissemination and implementation of prolonged exposure (PE) therapy for posttraumatic stress symptoms in U.S. Army medical treatment facilities. The study compares two PE training models: Standard PE training, comprised of a 4-day workshop only, and Extended PE training, comprised of a 4-day workshop plus expert case consultation. Behavioral health providers (N=180) across three medium-to-large Army installations will be randomly assigned to either Standard PE training or Extended PE training. Changes in provider attitudes will be examined across groups. After completing PE training, the use of PE components with patients reporting posttraumatic stress symptoms and clinical outcomes of these participating patients (N=500) will be examined. This article describes the rationale and methods of the study. In addition, a number of methodological issues in conducting a multisite naturalistic study in the U.S. Army are discussed.",Foa EB.; McLean CP.; Zandberg LJ.; Zang Y.; Asnaani A.; Benhamou K.; Rosenfield D.; Campbell H.; Francis J.; Hanson BS.; Lillard IJ.; Patterson TJ.; Scott V.; Weber C.; Wise JE.; Zamora C.; Mintz J.; Young-McCaughan S.; Peterson AL.;  .,2017.0,10.1016/j.cct.2017.07.018,0,0,
2140,"How to customize a bona fide psychotherapy for generalized anxiety disorder? A two-arms, patient blinded, ABAB crossed-therapist randomized clinical implementation trial design [IMPLEMENT 2.0].","Background: Bona fide psychotherapy approaches are effective treatments for generalized anxiety disorder (GAD) compared to no-treatment conditions. Treatment manuals and protocols allow a relatively high degree of freedom for the way therapists implement these overall treatment packages and there is a systematic lack of knowledge on how therapists should customize these treatments. The present study experimentally examines two implementation strategies of customizing a bona fide psychotherapy approach based on a 16 session time-limited cognitive-behavioral therapy (CBT) protocol and their relation to the post-session and ultimate treatment outcomes. Methods: This trial contrasts two different implementation strategies of how to customize the in-session structure of a manual-based CBT-protocol for GAD. The patients will be randomly assigned to two implementation conditions: (1) a systematic focus on subtle changes lasting from 7 to 20 min at the check-in phase of every psychotherapy session and (2) a state-of-the-art (SOTA) check-in phase lasting several minutes mainly focused on the session goals. Potential therapist effects will be examined based on an ABAB crossed-therapist design. Treatment outcomes will be assessed at the following times: post-session outcomes, treatment outcome at post assessment and 6- as well as 12-month follow-up. Discussion: The proposed randomized clinical implementation trial addresses the clinically relevant question of how to customize a bona fide psychotherapy protocol experimentally contrasting two implementation strategies. Through the development and testing of the proposed implementation design, this trial has the potential to inform therapists about efficacious implementation strategies of how to customize a manual-based treatment protocol in respect to the timing of the in-session structure. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Fluckiger, Christoph; Wolfer, Christine; Held, Judith; Hilpert, Peter; Rubel, Julian; Allemand, Mathias; Zinbarg, Richard E; Visla, Andreea",2018.0,,0,0,
2141," A Single-blinded, Randomized Clinical Trial of How to Implement an Evidence-based Treatment for Generalized Anxiety Disorder --Effects of Three Different Strategies of Implementation"," Background: Despite long‐standing calls to disseminate evidence‐based treatments for generalized anxiety (GAD), modest progress has been made in the study of how such treatments should be implemented. The primary objective of this study was to test three competing strategies on how to implement a cognitive behavioral treatment (CBT) for out‐patients with GAD (i.e., comparison of one compensation vs. two capitalization models). Methods: For our three‐arm, single‐blinded, randomized controlled trial (implementation of CBT for GAD [IMPLEMENT]), we recruited adults with GAD using advertisements in high‐circulation newspapers to participate in a 14‐session cognitive behavioral treatment (Mastery of your Anxiety and Worry, MAW‐packet). We randomly assigned eligible patients using a full randomization procedure (1:1:1) to three different conditions of implementation: adherence priming (compensation model), which had a systematized focus on patients' individual GAD symptoms and how to compensate for these symptoms within the MAW‐packet, and resource priming and supportive resource priming (capitalization model), which had systematized focuses on patients' strengths and abilities and how these strengths can be capitalized within the same packet. In the intention‐to‐treat population an outcome composite of primary and secondary symptoms‐related self‐report questionnaires was analyzed based on a hierarchical linear growth model from intake to 6‐month follow‐up assessment. This trial is registered at ClinicalTrials.gov (identifier: NCT02039193) and is closed to new participants. Findings: From June 2012 to Nov. 2014, from 411 participants that were screened, 57 eligible participants were recruited and randomly assigned to three conditions. Forty‐nine patients (86%) provided outcome data at post‐assessment (14% dropout rate). All three conditions showed a highly significant reduction of symptoms over time. However, compared with the adherence priming condition, both resource priming conditions indicated faster symptom reduction. The observer ratings of a sub‐sample of recorded videos (n = 100) showed that the therapists in the resource priming conditions conducted more strength‐oriented interventions in comparison with the adherence priming condition. No patients died or attempted suicide. Interpretation: To our knowledge, this is the first trial that focuses on capitalization and compensation models during the implementation of one prescriptive treatment packet for GAD. We have shown that GAD related symptoms were significantly faster reduced by the resource priming conditions, although the limitations of our study included a well‐educated population. If replicated, our results suggest that therapists who implement a mental health treatment for GAD might profit from a systematized focus on capitalization models. Funding: Swiss Science National Foundation (SNSF‐Nr. PZ00P1_136937/1) awarded to CF."," Flückiger, C;  Forrer, L;  Schnider, B;  Bättig, I;  Bodenmann, G;  Zinbarg, RE",2016.0, 10.1016/j.ebiom.2015.11.049,0,0,
2142, Tackling psychosocial maladjustment in Parkinson's disease patients following subthalamic deep-brain stimulation: a randomised clinical trial," BACKGROUND: Subthalamic nucleus deep brain stimulation (STN‚ÄêDBS) is an effective treatment for the motor and non‚Äêmotor signs of Parkinson's disease (PD), however, psychological disorders and social maladjustment have been reported in about one third of patients after STN‚ÄêDBS. We propose here a perioperative psychoeducation programme to limit such social and familial disruption. METHODS: Nineteen PD patients and carers were included in a randomised single blind study. Social adjustment scale (SAS) scores from patients and carers that received the psychoeducation programme (n = 9) were compared, both 1 and 2 years after surgery, with patients and carers with usual care (n = 10). Depression, anxiety, cognitive status, apathy, coping, parkinsonian disability, quality‚Äêof‚Äêlife, carers' anxiety and burden were also analysed. RESULTS: Seventeen patients completed the study, 2 were excluded from the final analysis because of adverse events. At 1 year, 2/7 patients with psychoeducation and 8/10 with usual care had an aggravation in at least one domain of the SAS (p = .058). At 2 years, only 1 patient with psychoeducation suffered persistent aggravated social adjustment as compared to 8 patients with usual care (p = .015). At 1 year, anxiety, depression and instrumental coping ratings improved more in the psychoeducation than in the usual care group (p = .038, p = .050 and p = .050, respectively). No significant differences were found between groups for quality of life, cognitive status, apathy or motor disability. CONCLUSIONS: Our results suggest that a perioperative psychoeducation programme prevents social maladjustment in PD patients following STN‚ÄêDBS and improves anxiety and depression compared to usual care. These preliminary data need to be confirmed in larger studies."," Flores Alves Dos Santos, J;  Tezenas du Montcel, S;  Gargiulo, M;  Behar, C;  Montel, S;  Hergueta, T;  Navarro, S;  Belaid, H;  Cloitre, P;  Karachi, C;  et al.",2017.0, 10.1371/journal.pone.0174512,0,0,
2143, Online Evaluative Conditioning Did Not Alter Internalized Homonegativity or Self-Esteem in Gay Men," OBJECTIVE: Internalized homonegativity is linked to psychological distress in sexual minorities and is thus a potential treatment target in this population. Previous studies have shown that evaluative conditioning (EC) can modify self‚Äêesteem, another self‚Äêdirected attitude. The present study aimed to determine if EC deployed over the Internet could modify self‚Äêesteem and internalized homonegativity. METHOD: Gay men recruited online (N = 184) were randomly assigned to a control group or an experimental condition. Participants completed self‚Äêreports and measures of implicit attitudes before and after being exposed to control or experimental tasks. The study was administered online. RESULTS: There were no significant between‚Äêgroup differences on implicit or explicit self‚Äêesteem (ps > .49) or internalized homonegativity (ps > .28). CONCLUSION: Despite past laboratory success, Internet‚Äêbased EC did not produce significant effects in implicit or explicit self‚Äêdirected attitudes. Post hoc analyses did not support any of several potential explanations for these results. Alternative explanations are discussed."," Fleming, JB;  Burns, MN",2017.0, 10.1002/jclp.22388,0,0,
2144,The REACH protocol: an innovative strategy for home management of infants with complex CHD.,"Approximately 32,000 infants are born with CHDs each year in the United States of America. Of every 1000 live births, 2.3 require surgical or transcatheter intervention in the first year of life. There are few more stressful times for parents than when their neonate receives a diagnosis of complex CHD requiring surgery. The stress of caring for these infants is often unrelenting and may last for weeks, months, and often years, placing parents at risk for developing post-traumatic stress disorder, as well as a drastic decrease in quality of life. Anxiety often peaks in the days and weeks after discharge from the hospital as families no longer have immediate access to nursing and medical staff. The purpose of this paper is to describe the methods of a randomised controlled trial that was designed to determine whether REACH would favourably affect parental and infant outcomes by decreasing parental stress, improve parental quality of life, increase infant stability, and decrease resource utilisation in infants with complex CHD.",Fleck DA.; Marino BS.; Costello JM.; Ravishankar C.; Torowicz D.; Alden C.; Van't Hof K.; Medoff-Cooper B.,2018.0,10.1017/S1047951118000604,0,0,
2145,Effects of oxytocin on working memory and executive control system connectivity in posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) is a chronic, debilitating condition for which effective medications are scant and little is known about neural correlates of risk versus resilience. Oxytocin is a hypothalamic neuropeptide that has demonstrated promise in modulating neurobiological and behavioral correlates of PTSD. Cognitive deficits in areas such as working memory and executive control are highly prevalent among individuals with PTSD and oxytocin might modulate these impairments in individuals with PTSD. Using a double-blind, placebo-controlled design, this study employed functional MRI (fMRI) and the n-back working memory task to examine the effects of oxytocin (24 IU) versus placebo on working memory and dorsolateral prefrontal cortex (DLPFC) connectivity among individuals with PTSD (n = 16) as compared with a trauma-exposed control group (n = 18). Results indicate that individuals with PTSD on oxytocin performed better in the 2-back condition of the n-back task compared with individuals with PTSD on placebo. Results also indicate that connectivity between DLPFC and anterior cingulate increased in the 2-back condition among individuals with PTSD on oxytocin as compared with placebo. These findings provide preliminary evidence of an effect of oxytocin on working memory among individuals with PTSD and insights into the neurobiological mechanisms underlying this association. Future studies are necessary to understand the mechanisms responsible for working memory deficits in PTSD and to examine the potential of oxytocin for use as a treatment for PTSD. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement Public Health Significance-This preliminary study found that oxytocin, as compared with placebo, was associated with (a) improved working memory performance among individuals with PTSD, and (b) greater functional connectivity between the dorsolateral prefrontal cortex and anterior cingulate during a working memory task. Results from this study support emerging literature suggesting that oxytocin has promise as a potential pharmacologic in the treatment of PTSD, for which effective medications are scant. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Flanagan, Julianne C; Hand, Anne; Jarnecke, Amber M; Moran-Santa Maria, Megan M; Brady, Kathleen T; Joseph, Jane E",2018.0,http://dx.doi.org/10.1037/pha0000197,0,0,
2146, The Role of Relationship Adjustment in an Integrated Individual Treatment for PTSD and Substance Use Disorders Among Veterans: an Exploratory Study," OBJECTIVE: Identifying factors that influence treatment outcomes of emerging integrated interventions for co‚Äêoccurring posttraumatic stress disorder (PTSD) and substance use disorder is crucial to maximize veterans' health. Dyadic adjustment suffers among individuals with PTSD and substance use disorder and may be an important mechanism of change in treatment. This exploratory study examined the association between dyadic adjustment and treatment outcomes in individual integrated treatment for co‚Äêoccurring PTSD and substance use disorder. METHODS: Participants were treatment‚Äêseeking veterans (N = 15) participating in a larger randomized controlled trial examining the efficacy of a novel integrated treatment for co‚Äêoccurring PTSD and substance use disorder. Multiple regression analyses controlling for baseline symptom severity and independent sample t‚Äêtests were used to examine the relation between dyadic adjustment and treatment outcome variables including PTSD, substance use disorder, and depression symptom severity. RESULTS: Baseline dyadic adjustment was associated with session 12 PTSD symptom severity as measured by both the Clinician‚ÄêAdministered PTSD Scale (CAPS) and PTSD Checklist (PCL), such that participants with high dyadic adjustment had significantly lower session 12 CAPS and PCL scores compared to participants with low dyadic adjustment. Baseline dyadic adjustment was not associated with session 12 depression symptoms or frequency of substance use. CONCLUSIONS: These findings suggest that while the primary determinant of treatment outcome in this sample is the application of an evidence‚Äêbased intervention, dyadic adjustment may play a role in individual treatment outcome for some treatment‚Äêseeking veterans. Data from this study were derived from clinical trial NCT01365247."," Flanagan, JC;  Fischer, MS;  Badour, CL;  Ornan, G;  Killeen, TK;  Back, SE",2017.0, 10.1080/15504263.2017.1312039,0,0,
2147, A randomized controlled trial of attention bias modification training for socially anxious adolescents," The current study aimed to examine the efficacy of attention bias modification (ABM) training to reduce social anxiety in a community‚Äêbased sample of adolescents 15‚Äê18 years. The study used a single‚Äêblind, parallel group, randomized controlled trial design (Clinical Trials ID: NCT02270671). Participants were screened in second‚Äêlevel schools using a social anxiety questionnaire. 130 participants scoring >24 on the Social Phobia and Anxiety Inventory for Children (SPAI‚ÄêC) were randomized to the ABM training (n = 66)/placebo (n = 64) group, 120 of which completed pre‚Äê, post‚Äê, and 12‚Äêweek follow‚Äêup data collection including threat bias, anxiety, and depression measures. The ABM intervention included 4 weekly training sessions using a dot‚Äêprobe task designed to reduce attention bias to threatening stimuli. ABM training did not alter the primary outcomes of attention bias to threat or social anxiety symptoms raising questions about the efficacy of ABM as an intervention for adolescents."," Fitzgerald, A;  Rawdon, C;  Dooley, B",2016.0, 10.1016/j.brat.2016.06.003,0,0,
2148,Metacognitive therapy for obsessive compulsive disorder by videoconference: A preliminary study.,"Evidence-supported therapy for obsessive-compulsive disorder (OCD) is often difficult to access, especially in rural and remote areas. Videoconferencing is gaining momentum as a means of improving access. Metacognitive therapy (MCT) has already been found to be effective for OCD when delivered face-to-face. This preliminary study explored whether videoconference-based MCT can be effective for OCD. Three participants completed a brief course of MCT using videoconferencing. Participants experienced clinically significant reductions in OCD symptoms, depression, anxiety, and stress, some of which were maintained after a 6- to 8-week follow-up period. Results suggest that videoconferencing MCT can be effective for OCD. Implications for clinicians are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Fitt, Samantha; Rees, Clare",2012.0,http://dx.doi.org/10.1017/bec.2012.21,0,0,
2149,Lack of group-to-individual generalizability is a threat to human subjects research.,"Only for ergodic processes will inferences based on group-level data generalize to individual experience or behavior. Because human social and psychological processes typically have an individually variable and time-varying nature, they are unlikely to be ergodic. In this paper, six studies with a repeated-measure design were used for symmetric comparisons of interindividual and intraindividual variation. Our results delineate the potential scope and impact of nonergodic data in human subjects research. Analyses across six samples (with 87-94 participants and an equal number of assessments per participant) showed some degree of agreement in central tendency estimates (mean) between groups and individuals across constructs and data collection paradigms. However, the variance around the expected value was two to four times larger within individuals than within groups. This suggests that literatures in social and medical sciences may overestimate the accuracy of aggregated statistical estimates. This observation could have serious consequences for how we understand the consistency between group and individual correlations, and the generalizability of conclusions between domains. Researchers should explicitly test for equivalence of processes at the individual and group level across the social and medical sciences.",Fisher AJ.; Medaglia JD.; Jeronimus BF.,2018.0,10.1073/pnas.1711978115,0,0,
2150,Item ordering and computerized classification tests with cluster-based scoring: An investigation of the countdown method,"The countdown method is a well-known approach to reducing the average length of screening instruments that are presented by computer. In the countdown method, testing is terminated once the result of the screener (""positive"" or ""negative"") has been unambiguously determined from prior answers. Previous research has examined whether presenting dichotomously scored items in order from ""least to most frequently endorsed"" or ""most to least frequently endorsed"" is more efficient when the countdown method is used. The current study describes the Mean Score procedure, an extension of the above item ordering procedures to polytomously scored items, and evaluates its efficiency relative to the distribution of other possible item orderings in 2 real-data simulations. Both simulations involve item responses to the Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5). In the first simulation, items were scored polytomously, and a single cutoff point was used to determine the screening result. In the second simulation, items were converted to dichotomous scores, as well as categorized into 4 clusters; a positive result for the entire assessment was obtained if and only if a positive result was obtained for each cluster. The latter simulation also investigated the effect of reordering the clusters themselves on the efficiency of the countdown method. Results indicated that the Mean Score procedure does not necessarily produce the optimal ordering, but tends to assemble an efficient item ordering relative to the distribution of possible orderings. In the second simulation, reordering the clusters themselves affected efficiency. Future research directions are suggested.",Finkelman M.D.; Lowe S.R.; Kim W.; Gruebner O.; Smits N.; Galea S.,2018.0,10.1037/pas0000470,0,0,
2151,Staying in service with posttraumatic headache: A retrospective cohort study of patient outcome.,"Objective: To predict the probability of a military outcome (medical discharge/retirement) in patients with mild traumatic brain injury from a clinical analysis of predetermined patient and headache characteristics. Methods: This retrospective cohort study sampled all new patients referred for headache evaluation at the Brain Injury Clinic of the Womack Army Medical Center, Ft. Bragg, NC (August 2008-January 2010). Headache characteristics were extracted and analyzed. Multivariable binary logistic regressions were conducted to predict probability of medical discharge/retirement. Results: Ninety-five soldiers (age 31.3 +/- 7.4 years, male 93.7%) reported 166 headaches. The most common injury cited was a blast (53.7%). Patients with a continuous headache have almost 4 times the odds of a medically related discharge/retirement compared to patients without such a headache (continuous headache regression coefficient estimate: p < 0.042, odds ratio 3.98, 95% Wald confidence interval 1.05-15.07). Results suggest that, compared to service members who did not have a continuous headache, patients with headache histories with severe holocephalic pain who medicate to keep functioning had the highest probability of medical discharge/retirement. Conclusions: Certain headache characteristics may be predictive of military outcomes after mild traumatic brain injury, and we propose a profile that may be useful in that prediction. These data could be useful in future attempts to assess and treat patients with posttraumatic headache and to advise longer-term planning for return to duty or discharge. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Finkel, Alan G; Klaric, John S; Yerry, Juanita A; Choi, Young S",2017.0,http://dx.doi.org/10.1212/WNL.0000000000004358,0,0,
2152," Efficacy, Safety and Tolerability of Augmentative rTMS in Treatment of Major Depressive Disorder (MDD): a Prospective Cohort Study in Croatia"," SUBJECTS AND METHODS: Total of 93 MDD patients were enrolled; 41 of them were treated by augmentative rTMS and 52 were treated by standard (psychopharmacotherapy and psychotherapy) therapy only. We delivered rTMS to the left dorsolateral prefrontal cortex at 120% motor threshold (10 Hz, 4‐second train duration), 3000 pulses per session using a figure‐eight coil, minimum of 20 sessions during four weeks. Our key outcome was the change in Hamilton Depression Scale (HAM‐D17) result from baseline to 4 RESULTS: After four weeks the changes of HAM‐D17 and HAM‐A results were significantly different between the group of patients treated by augmentative rTMS (48% and 53% decrease, respectively) and the group of patients treated by the standard therapy alone (24% and 30% decrease) (P=0.004, P=0.007). Absolute benefit increase defined as the difference between rates of remission (HAM‐D17 ≤7) in rTMS and control group was 33% (P=0.001). Number of patients needed to treat with rTMS in order to achieve remission in one patient was NNT=3. In a group of patients treated with augmentative rTMS 21/41 (51%), and in control group 17/52 (33%) were responders (P=0.071). CONCLUSIONS: It seems that augmentative treatment with rTMS is more effective on depression and anxiety symptoms than standard therapy in MDD with equal safety and tolerability. Randomized, controlled studies are required to verify this finding. BACKGROUND: An increasing body of research suggest that repetitive Transcranial Magnetic Stimulation (rTMS) is effective and safe treatment option for patients with major depressive disorder (MDD). The Psychiatric Hospital ""Sveti Ivan"" has the first TMS laboratory with rTMS and deep TMS (dTMS) in Croatia. The objective of this study was to assess the efficacy, safety and tolerability of augmentative rTMS treatment vs standard treatment in Croatian patients with major depressive disorder (MDD)."," Filipcic, I;  Milovac, Z;  Sucic, S;  Gajsak, T;  Filipcic, IS;  Ivezic, E;  Aljinovic, V;  Orgulan, I;  Penic, SZ;  Bajic, Z",2017.0,,0,0,
2153, The dynamic nature of the reconsolidation process and its boundary conditions: evidence based on human tests," The reconsolidation process is the mechanism by which the strength and/or content of consolidated memories are updated. This process is triggered by the presentation of a reminder (training cues). It is not always possible to trigger the reconsolidation process. For example, memory age and strength are boundary conditions for the reconsolidation process. Here, we investigated the dynamic changes in these conditions. We propose that the boundary conditions of the reconsolidation process are not fixed and vary as a consequence of the interaction between memory features and reminder characteristics. To modify memory properties, participants received a threatening social protocol that improves memory acquisition or a control condition (fake, without social interaction) prior to learning pairs of meaningless syllables. To determine whether a strong young or old declarative memory undergoes the reconsolidation process, we used an interference task (a second list of pairs of meaningless syllables) to disrupt memory re‚Äêstabilization. To assess whether the older memory could be strengthened, we repeated the triggering of reconsolidation. Strong young or old memories modulated by a threatening experience could be interfered during reconsolidation and updated (strengthened) by reconsolidation. Rather than being fixed, boundary conditions vary according to the memory features (strong memory), which indicates the dynamic nature of the reconsolidation process. Our findings demonstrate that it is possible to modify these limits by recruiting the reconsolidation process and making it functionally operative again. This novel scenario opens the possibility to new therapeutically approaches that take into account the reconsolidation process."," Fern√°ndez, RS;  Bavassi, L;  Forcato, C;  Pedreira, ME",2016.0, 10.1016/j.nlm.2016.03.001,0,0,
2154,Impact of mycophenolic acid on t-cell metabolic reprogramming,"Naïve and memory T cells rely on oxidative phosphorylation but activated T cells use anaerobic glycolysis to support rapid cell growth and proliferation. This metabolic shift is critical for T cell fate and polarization, and is regulated by metabolic checkpoints, including Myc, HIF-1γ, AMPK and mTOR. Our objective was to determine the impact of mycophenolic acid (MPA), compared with rapamycin (Rapa), a classic inhibitor of the metabolic checkpoint mTORC1, used as a control, on proliferating T cell metabolism. In vitro experiments were performed on the Jurkat T cell line incubated with MPA and Rapa from 24 to 72 h. We used RT-PCR, Western Blot, glucose uptake, glycolytic and glutaminolytic flux experiments and lactate and ATP dosage. We identified a drug-specific transcriptomic signature of key enzymes and transporters involved in glycolysis, glutaminolysis or nucleotide synthesis, resulting from significantly different effects on metabolic reprogramming. MPA produced an early and transient drop in intracellular ATP content related to the inhibition of the de novo synthesis of purines, leading to the activation of the energetic sensor AMPK. The analysis of glycolytic or glutaminolytic fluxes indicates that both MPA and Rapa produce a significant decrease of glucolytic flux, in agreement with a reduction in glucose uptake, both also in glutamine oxidation. In addition, both drugs reduce aerobic glycolysis. Consistent with this, the expression HIF-1γ and Myc, promoting the activation of glycolysis and glutaminolysis, was inhibited by MPA and Rapa. In conclusion, we report for the first time that MPA profoundly impacts the cellular metabolism of proliferating T cells by generating an energetic distress, decreasing the glycolytic and glutaminolytic fluxes and by targeting the metabolic checkpoints HIF-1γ and Myc. These findings open interesting perspectives for new therapeutic targets blocking metabolic checkpoints to inhibit T-cell proliferation.",Fernandez Ramos A.A.; Marchetti-Laurent C.; Poindessous V.; Antonio S.; Bortoli S.; Loriot M.-A.; Pallet N.,2017.0,10.1111/tri.13050,0,0,
2155, Motivational engagement in first-time hearing aid users: a feasibility study," OBJECTIVE: To assess (1) the feasibility of incorporating the Ida Institute's Motivation Tools into a UK audiology service, (2) the potential benefits of motivational engagement in first‚Äêtime hearing aid users, and (3) predictors of hearing aid and general health outcome measures. DESIGN: A feasibility study using a single‚Äêcentre, prospective, quasi‚Äêrandomized controlled design with two arms. The Ida Institute's Motivation Tools formed the basis for motivational engagement. STUDY SAMPLE: First‚Äêtime hearing aid users were recruited at the initial hearing assessment appointment. The intervention arm underwent motivational engagement (M+, n‚Äâ=‚Äâ32), and a control arm (M‚Äê, n‚Äâ=‚Äâ36) received standard care only. RESULTS: The M+ group showed greater self‚Äêefficacy, reduced anxiety, and greater engagement with the audiologist at assessment and fitting appointments. However, there were no significant between‚Äêgroup differences 10‚Äêweeks post‚Äêfitting. Hearing‚Äêrelated communication scores predicted anxiety, and social isolation scores predicted depression for the M+ group. Readiness to address hearing difficulties predicted hearing aid outcomes for the M‚Äê group. Hearing sensitivity was not a predictor of outcomes. CONCLUSIONS: There were some positive results from motivational engagement early in the patient journey. Future research should consider using qualitative methods to explore whether there are longer‚Äêterm benefits of motivational engagement in hearing aid users."," Ferguson, M;  Maidment, D;  Russell, N;  Gregory, M;  Nicholson, R",2016.0, 10.3109/14992027.2015.1133935,0,0,
2156,Reconstruction of large diaphyseal bone defect by simplified bone transport over nail technique: A 7-case series.,"Reconstruction of large diaphyseal bone defect is complex and the complications rate is high. This study aimed to assess a simplified technique of segmental bone transport by monorail external fixator over an intramedullary nail.A prospective study included 7 patients: 2 femoral and 5 tibial defects. Mean age was 31years (range: 16-61years). Mean follow-up was 62 months (range: 46-84months). Defects were post-traumatic, with a mean length of 7.2cm (range: 4 to 9.5cm). For 3 patients, reconstruction followed primary failure. In 4 cases, a covering flap was necessary. Transport used an external fixator guided by an intramedullary nail, at a rate of 1mm per day. One pin was implanted on either side of the distraction zone. The external fixator was removed 1 month after bone contact at the docking site. Mean bone transport time was 11 weeks (range: 7-15 weeks). Mean external fixation time was 5.1months (range: 3.5 to 8months). Full weight-bearing was allowed 5.7months (range: 3.5-13months) after initiation of transport. In one patient, a pin had to be repositioned. In 3 patients, the transported segment re-ascended after external fixatorablation, requiring repeat external fixation and resumption of transport. There was just 1 case of superficial pin infection. Reconstruction quality was considered ""excellent"" on the Paley-Marr criteria in 6 cases. The present technique provided excellent reconstruction quality in 6 of the 7 cases. External fixation time was shorter and resumption of weight-bearing earlier than with other reconstruction techniques, notably including bone autograft, vascularized bone graft or the induced membrane technique. Nailing facilitated control of limb axis and length. The complications rate was 50%, comparable to other techniques. This study raises the question of systematic internal fixation of the docking site, to avoid any mobilization of the transported segment. The bone quality, axial control and rapidity shown by the present technique make it well-adapted to reconstruction of diaphyseal bone defect. Four-case series.",Ferchaud F.; Rony L.; Ducellier F.; Cronier P.; Steiger V.; Hubert L.;  .,2017.0,10.1016/j.otsr.2017.05.016,0,0,
2157, Impact of providing patients with copies of their medical correspondence: a randomised controlled study," AIMS: To determine whether providing clinic correspondence and endoscopy reports to patients leads to improved understanding, satisfaction or anxiety. METHODS: This is a prospective, randomised controlled study conducted at an Australian tertiary hospital from October 2013 to February 2015. New adult referrals to the general gastroenterology clinic requiring an urgent endoscopic procedure were eligible for the study. The intervention group received a copy of their clinic correspondence and endoscopy report, while the control group received neither. Participants completed questionnaires, including visual analogue scales and the Hospital Anxiety and Depression Scale, at three time points. Primary outcomes were patient understanding, anxiety and satisfaction. RESULTS: A total of 70 participants was included in the study. There was no reduction in anxiety levels (P‚Äâ=‚Äâ0.52), no increase in understanding (P‚Äâ=‚Äâ0.73) or any increase in satisfaction (P‚Äâ=‚Äâ0.33) in participants receiving correspondence. However, 97% of participants indicated that they wished to receive correspondence in the future, and 94% of participants in the correspondence group reported that receiving correspondence had helped them to understand their medical condition. CONCLUSION: Patients wish to receive copies of their correspondence and feel it improves their understanding of their medical condition. Although we were unable to demonstrate a measurable reduction in anxiety, increase in understanding or satisfaction, we recommend that patients be offered the choice of receiving copies of their clinic correspondence and endoscopy reports. BACKGROUND: In Australia, correspondence is routinely sent to general practitioners following a specialist consultation. Written communication is an important way to enhance patient experiences and understanding, yet most patients do not receive copies of their medical correspondence."," Fenton, C;  Al-Ani, A;  Trinh, A;  Srinivasan, A;  Marion, K;  Hebbard, G",2017.0, 10.1111/imj.13252,0,0,
2158, Efficacy of the small step program in a randomised controlled trial for infants below age 12 months with clinical signs of CP; a study protocol," BACKGROUND: Children with cerebral palsy (CP) have life‐long motor disorders, and they are typically subjected to extensive treatment throughout their childhood. Despite this, there is a lack of evidence supporting the effectiveness of early interventions aiming at improving motor function, activity, and participation in daily life. The study will evaluate the effectiveness of the newly developed Small Step Program, which is introduced to children at risk of developing CP during their first year of life. The intervention is based upon theories of early learning‐induced brain plasticity and comprises important components of evidence‐based intervention approaches used with older children with CP. METHOD AND DESIGN: A two‐group randomised control trial will be conducted. Invited infants at risk of developing CP due to a neonatal event affecting the brain will be randomised to either the Small Step Program or to usual care. They will be recruited from Astrid Lindgren Children's Hospital at regular check‐up and included at age 3‐8 months. The Small Step Program was designed to provide individualized, goal directed, and intensive intervention focusing on hand use, mobility, and communication in the child's own home environment and carried out by their parents who have been trained and coached by therapists. The primary endpoint will be approximately 35 weeks after the start of the intervention, and the secondary endpoint will be at 2 years of age. The primary outcome measure will be the Peabody Developmental Motor Scale (second edition). Secondary assessments will measure and describe the children's general and specific development and brain pathology. In addition, the parents' perspective of the program will be evaluated. General linear models will be used to compare outcomes between groups. DISCUSSION: This paper presents the background and rationale for developing the Small‐Step Program and the design and protocol of a randomized controlled trial. The aim of the Small Step Program is to influence development by enabling children to function on a higher level than if not treated by the program and to evaluate whether the program will affect parent's ability to cope with stress and anxiety related to having a child at risk of developing CP. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT02166801 . Registered June 12, 2014."," Eliasson, AC;  Holmström, L;  Aarne, P;  Nakeva von Mentzer, C;  Weiland, AL;  Sjöstrand, L;  Forssberg, H;  Tedroff, K;  Löwing, K",2016.0, 10.1186/s12887-016-0711-x,0,0,
2159,Tibial plateau fracture management: arthroscopically-assisted versus ORIF procedure - clinical and radiological comparison.,"Tibial plateau fractures are articular injuries that may influence final functional outcome of the knee. Although these fractures comprise only 1% of all fractures, the fracture pattern is usually complex and requires anatomical reduction and absolutely stable fixation to achieve satisfactory results. The development of knee osteoarthritis is a common late complication and it can be strongly influenced by additional, underestimated cartilage defects, and meniscal and ligament tears. Between January 2012 and February 2015, a total of 78 patients with tibial plateau fractures (Schatzker type I-III) were enrolled in the study. Patients were divided into two groups: one group was treated with arthroscopically-assisted reduction and internal fixation (ARIF) and the other with open reduction and internal fixation (ORIF). The final number of patients was 75; 40 in the ARIF group and 35 in the ORIF group. Radiography and computed tomography were used to assess fracture pattern. An immediate postoperative radiograph was performed, and then repeated at 6 weeks, and 3,6 and 12 months after surgery. Demographic data (age and sex), additional intraarticular injuries, hospital stay and complications were noted, and clinical and radiological Rasmunssen score at 3, 6 and 12 months after surgery were evaluated. Additional intraarticular lesions were found in 27 patients; 20 in the ARIF group and 7 in the ORIF group (p = 0.06). There was a statistically significant difference in average duration of hospital stay: 3.10 ± 0.63 days for the ARIF group and 5.51 ± 1.66 days for the ORIF group (p = 0.0001). All fractures healed within 3 months following surgery. The overall complication rate was 12%. There was no statistically significant difference in complication rate between the two groups (p = 0.63). Clinical and radiological scores were excellent in most patients in both groups. There was no statistically significant difference in average clinical and radiological Rasmunssen scores between the two groups. Both ARIF and ORIF can provide equally good results; however, ARIF seems to offer a more precise evaluation and treatment of associated intraarticular lesions and to reduce the duration of hospital stay.",Elabjer E.; Benčić I.; Ćuti T.; Cerovečki T.; Ćurić S.; Vidović D.,2017.0,10.1016/S0020-1383(17)30742-8,0,0,
2160,A Randomized Crossover Trial Evaluating Continuous Positive Airway Pressure Versus Mandibular Advancement Device on Health Outcomes in Veterans With Posttraumatic Stress Disorder.,"Despite the overall improvement in posttraumatic stress disorder (PTSD) symptomatology with continuous positive airway pressure (CPAP) therapy, adherence to CPAP is far worse in veterans with PTSD compared to the general population with obstructive sleep apnea (OSA). The aim of this study was to compare the efficacy, adherence, and preference of CPAP versus mandibular advancement device (MAD) and the effect of these treatments on health outcomes in veterans with PTSD. Forty-two subjects with PTSD and newly diagnosed OSA by polysomnography were treated in a randomized, crossover trial of 12 weeks with CPAP alternating with MAD separated by a 2-week washout period. The primary outcome was the difference in titration residual apnea-hypopnea index (AHI) between CPAP and MAD. Secondary outcome measures included PTSD Checklist and health-related quality of life (Medical Outcomes Study 36-Item Short Form and Pittsburgh Sleep Quality Index). Analyses were limited to the 35 subjects (mean age 52.7 ± 11.6 years) who completed the trial, regardless of compliance with their assigned treatment. CPAP was more efficacious in reducing AHI and improving nocturnal oxygenation than MAD (P < .001 and P = .04, respectively). Both treatments reduced PTSD severity and ameliorated scores of the Medical Outcomes Study Short Form 36 and Pittsburgh Sleep Quality Index, although no differences were detected between the CPAP and MAD arms. The reported adherence to MAD was significantly higher than CPAP (P < .001), with 58% preferring MAD to CPAP. Although CPAP is more efficacious than MAD at improving sleep apnea, both treatment modalities imparted comparable benefits for veterans with PTSD in relation to PTSD severity and health-related quality of life. MAD offers a viable alternative for veterans with OSA and PTSD who are nonadherent to CPAP. Title: A Randomized Cross Over Trial of Two Treatments for Sleep Apnea in Veterans With Post-Traumatic Stress Disorder; URL: https://www.clinicaltrials.gov/ct/show/NCT01569022; Identifier: NCT01569022.",El-Solh AA.; Homish GG.; Ditursi G.; Lazarus J.; Rao N.; Adamo D.; Kufel T.,2017.0,10.5664/jcsm.6808,0,0,
2161,Effect of Inpatient Palliative Care During Hematopoietic Stem-Cell Transplant on Psychological Distress 6 Months After Transplant: Results of a Randomized Clinical Trial.,"Purpose Inpatient palliative care integrated with transplant care improves patients' quality of life (QOL) and symptom burden during hematopoietic stem-cell transplant (HCT). We assessed patients' mood, post-traumatic stress disorder (PTSD) symptoms, and QOL 6 months post-transplant. Methods We randomly assigned 160 patients with hematologic malignancies who underwent autologous or allogeneic HCT to inpatient palliative care integrated with transplant care (n = 81) or transplant care alone (n = 79). At baseline and 6 months post-transplant, we assessed mood, PTSD symptoms, and QOL with the Hospital Anxiety and Depression Scale and Patient Health Questionnaire, PTSD checklist, and Functional Assessment of Cancer Therapy-Bone Marrow Transplant. To assess symptom burden during HCT, we used the Edmonton Symptom Assessment Scale. We used analysis of covariance while controlling for baseline values to examine intervention effects and conducted causal mediation analyses to examine whether symptom burden or mood during HCT mediated the effect of the intervention on 6-month outcomes. Results We enrolled 160 (86%) of 186 potentially eligible patients between August 2014 and January 2016. At 6 months post-transplant, intervention participants reported lower depression symptoms on the Hospital Anxiety and Depression Scale and Patient Health Questionnaire (adjusted mean difference, -1.21 [95% CI, -2.26 to -0.16; P = .024] and -1.63 [95% CI, -3.08 to -0.19; P = .027], respectively) and lower PTSD symptoms (adjusted mean difference, -4.02; 95% CI, -7.18 to -0.86; P = .013), but no difference in QOL or anxiety. Symptom burden and anxiety during HCT hospitalization partially mediated the effect of the intervention on depression and PTSD at 6 months post-transplant. Conclusion Inpatient palliative care integrated with transplant care leads to improvements in depression and PTSD symptoms at 6 months post-transplant. Reduction in symptom burden and anxiety during HCT partially accounts for the effect of the intervention on these outcomes.",El-Jawahri A.; Traeger L.; Greer JA.; VanDusen H.; Fishman SR.; LeBlanc TW.; Pirl WF.; Jackson VA.; Telles J.; Rhodes A.; Li Z.; Spitzer TR.; McAfee S.; Chen YA.; Temel JS.,2017.0,10.1200/JCO.2017.73.2800,0,0,
2162, Effects of Early Integrated Palliative Care on Caregivers of Patients with Lung and Gastrointestinal Cancer: a Randomized Clinical Trial," BACKGROUND: The family and friends (caregivers) of patients with advanced cancer often experience tremendous distress. Although early integrated palliative care (PC) has been shown to improve patient‚Äêreported quality of life (QOL) and mood, its effects on caregivers' outcomes is currently unknown. MATERIALS AND METHODS: We conducted a randomized trial of early PC integrated with oncology care versus oncology care alone for patients who were newly diagnosed with incurable lung and noncolorectal gastrointestinal cancers and their caregivers. The early PC intervention focused on addressing the needs of both patients and their caregivers. Eligible caregivers were family or friends who would likely accompany patients to clinic visits. The intervention entailed at least monthly patient visits with PC from the time of diagnosis. Caregivers were encouraged, but not required, to attend the palliative care visits. We used the Hospital Anxiety and Depression Scale (HADS) and Medical Health Outcomes Survey Short‚ÄêForm to assess caregiver mood and QOL. RESULTS: Two hundred seventy‚Äêfive caregivers (intervention CONCLUSION: Early involvement of PC for patients with newly diagnosed lung and gastrointestinal cancers leads to improvement in caregivers' psychological symptoms. This work demonstrates that the benefits of early, integrated PC models in oncology care extend beyond patient outcomes and positively impact the experience of caregivers. IMPLICATIONS FOR PRACTICE: Early involvement of palliative care for patients with newly diagnosed lung and gastrointestinal cancers leads to improvement in caregivers' psychological symptoms. The findings of this trial demonstrate that the benefits of the early, integrated palliative care model in oncology care extend beyond patient outcomes and positively impact the experience of caregivers. These findings contribute novel data to the growing evidence base supporting the benefits of integrating palliative care earlier in the course of disease for patients with advanced cancer and their caregivers."," El-Jawahri, A;  Greer, JA;  Pirl, WF;  Park, ER;  Jackson, VA;  Back, AL;  Kamdar, M;  Jacobsen, J;  Chittenden, EH;  Rinaldi, SP;  et al.",2017.0, 10.1634/theoncologist.2017-0227,0,0,
2163,Does internet-based cognitive behaviour therapy reduce healthcare costs and resource use in treatment of social anxiety disorder? A cost-minimisation analysis conducted alongside a randomised controlled trial.,"Social anxiety disorder (SAD) can be effectively treated with internet-delivered cognitive behavioural therapy (ICBT), but studies on long-term cost minimisation from a healthcare provider perspective in comparison to an evidence-based control treatment of therapeutic equivalence are lacking. The objective of the study was to determine whether ICBT reduces healthcare costs and use of healthcare resources compared with cognitive behavioural group therapy (CBGT). A cost-minimisation study alongside a randomised controlled trial where participants (n=126) with SAD were randomised to ICBT or to CBGT. Costs measured from a healthcare provider perspective were estimated using time-driven activity-based costing alongside health status over 4 years from baseline measured with EQ-5D. A psychiatric outpatient clinic in Stockholm, Sweden. Participants were 126 individuals with SAD. Changes in EQ-5D and costs. Participants received either CBGT or ICBT for a duration of 15 weeks. ICBT minimised healthcare costs and demonstrated health improvements within the non-inferiority margin. Assuming a practical work capacity for personnel varying between 100%, 80% and 50% of theoretical full capacity, the cost for ICBT varied in the range between 400€, 463€ and 654 €, while the cost for CBGT varied between 699€, 806€ and 1134€. Within-group effect size was -0.36 (95% CI -0.70 to -0.01) for ICBT and -0.25 (95% CI -0.60 to 0.10) for CBGT. Mean use of effective psychologist time in ICBT was 189.60 (SD=53.77) minutes compared with 499.78 (SD=30.91) in the CBGT group. In treatment of SAD, ICBT is equally effective but is associated with more efficient staff utilisation and less costs compared with CBGT. From a healthcare provider perspective, ICBT is an advantageous treatment option. ",El Alaoui S.; Hedman-Lagerlöf E.; Ljótsson B.; Lindefors N.,2017.0,10.1136/bmjopen-2017-017053,0,0,
2164, An initial waitlist-controlled trial of the unified protocol for the treatment of emotional disorders in adolescents," A substantial proportion of adolescents are non‚Äêresponders to well‚Äêestablished treatments for anxiety and depression, and many existent approaches do not adequately address comorbidity. There is a need to develop and evaluate unified treatments for adolescents that flexibly address higher order factors shared among internalizing or emotional disorders. The Unified Protocol for the Treatment of Emotional Disorders in Adolescents (UP‚ÄêA) is a transdiagnostic treatment that targets shared vulnerability and maintenance factors in a flexible format. This study examined initial outcomes of a randomized, waitlist‚Äêcontrolled trial of the UP‚ÄêA. The UP‚ÄêA outperformed waitlist at mid‚Äêtreatment with respect to disorder severity and functional impairment, and there was a significant treatment effect in favor of the UP‚ÄêA on all outcome measures at post‚Äêtreatment. Within‚Äêsubjects analyses collapsing across participants revealed significant improvements on outcome measures over time. Results support further study of the UP‚ÄêA and its potential efficacy in treating adolescent anxiety and depression."," Ehrenreich-May, J;  Rosenfield, D;  Queen, AH;  Kennedy, SM;  Remmes, CS;  Barlow, DH",2017.0, 10.1016/j.janxdis.2016.10.006,0,0,
2165,Effect of psychotherapy for depression via home telehealth on glycemic control in adults with type 2 diabetes: Subgroup analysis of a randomized clinical trial.,"Objective We evaluated the impact of telemedicine-delivered behaviour activation treatment (BAT) on glycemic control in a subgroup of older adults with diabetes who participated in a randomized controlled trial for depression. Research design and methods We randomized older adults with major depression to same-room or telemedicine BAT. Each group received eight weekly sessions. For the subgroup analysis, we identified individuals with type 2 diabetes and obtained hemoglobin A1c at baseline and 12 months' follow-up. We used mixed-effects models (MEM) for repeated measures analysis to compare the longitudinal mean A1c. We estimated model-derived mean A1c values and considered an adjusted model to account for baseline health status. Results We included 90 individuals with type 2 diabetes of the original 241 in the subgroup analysis (43 in telemedicine and 47 in same room). Treatment groups were not significantly different at baseline for demographics, depression, anxiety or A1c levels (telemedicine 6.9 vs. same room 7.3, p‚Äâ=‚Äâ0.19). Baseline mean A1c for the telemedicine group remained at 6.9 (55‚Äâmmol/mol) at 12 months, whereas baseline mean A1c for the same-room group increased to 7.7 (61‚Äâmmol/mol). Longitudinal trajectories of model-derived mean A1c indicated a significant main effect of treatment group on mean A1c value at study end (difference‚Äâ=‚Äâ-0.82, 95% CI -1.41, -0.24). Adjusted analyses gave comparable results. Conclusions Telemedicine-delivered BAT was superior to same room in achieving lower mean A1c values in participants with type 2 diabetes, suggesting BAT-delivered via telemedicine is a viable treatment option for adults with diabetes.",Egede LE.; Walker RJ.; Payne EH.; Knapp RG.; Acierno R.; Frueh BC.,2018.0,10.1177/1357633X17730419,0,0,
2166,Cognitive behavioural treatment of perfectionism: A single case experimental design series.,"Perfectionism can maintain depression, anxiety and eating disorders, yet few studies have evaluated treatments for perfectionism. This study examined the effectiveness of individual cognitive behaviour therapy (CBT) in treating perfectionism in four adults with a diagnosis of either an anxiety disorder or depression. The study used an A-B single case experimental design series with follow-up, and a 3-week pre-and postbaseline phase. Treatment involved 8 sessions and a 2-week follow-up session. Visual inspection of data revealed downward trends in overall perfectionism and clinically significant decreases in perfectionism for two participants. No clinically significant reductions were observed in depressive or anxious symptomatology. CBT for perfectionism warrants further investigation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Egan, Sarah J; Hine, Paula",2008.0,http://dx.doi.org/10.1375/bech.25.4.245,0,0,
2167, Use of sleep medication in children with ADHD," METHOD Sleep medication use was ascertained using a prospective parent‚Äêcompleted seven‚Äênight sleep and medication log. Exposure variables included socio‚Äêdemographic characteristics, total sleep problem severity (Children's Sleep Habits Questionnaire), ADHD severity and subtype (ADHD Rating Scale IV), ADHD medication use, internalising and externalising co‚Äêmorbidities (Anxiety Disorders Interview Schedule for Children/Parent version IV) and parent mental health (Depression Anxiety Stress Scale). RESULTS Two hundred and fifty‚Äêseven children with ADHD participated and of these 57 (22%) were taking sleep medication (melatonin 14% and clonidine 9%). Sleep medication use was associated with combined‚Äêtype ADHD and ADHD medication use. The presence of co‚Äêoccurring internalising and externalising co‚Äêmorbidities was also associated with sleep medication use in ad hoc analyses. CONCLUSION Sleep medication use is common in children with ADHD and is associated with combined‚Äêtype ADHD and use of ADHD medication. Further research is needed on the broad functional benefits and long‚Äêterm safety of sleep medication in this population. OBJECTIVE Sleep problems are common in children with attention‚Äêdeficit/hyperactivity disorder (ADHD), yet little is known about sleep medication use in this population. The aim of this study was to describe sleep medication use, as well as associated child and family characteristics in school‚Äêaged children with ADHD."," Efron, D;  Lycett, K;  Sciberras, E",2014.0, 10.1016/j.sleep.2013.10.018,0,0,
2168, A three arm cluster randomised controlled trial to test the effectiveness and cost-effectiveness of the SMART Work & Life intervention for reducing daily sitting time in office workers: study protocol," BACKGROUND: Office‚Äêbased workers typically spend 70‚Äê85% of working hours, and a large proportion of leisure time, sitting. High levels of sitting have been linked to poor health. There is a need for fully powered randomised controlled trials (RCTs) with long‚Äêterm follow‚Äêup to test the effectiveness of interventions to reduce sitting. This paper describes the methodology of a three‚Äêarm cluster RCT designed to determine the effectiveness and cost‚Äêeffectiveness of the SMART Work & Life intervention, delivered with and without a height‚Äêadjustable desk, for reducing daily sitting. METHODS/DESIGN: A three‚Äêarm cluster RCT of 33 clusters (660 council workers) will be conducted in three areas in England (Leicester; Manchester; Liverpool). Office groups (clusters) will be randomised to the SMART Work & Life intervention delivered with (group 1) or without (group 2) a height‚Äêadjustable desk or a control group (group 3). SMART Work & Life includes organisational (e.g., management buy‚Äêin, provision/support for standing meetings), environmental (e.g., relocating waste bins, printers), and group/individual (education, action planning, goal setting, addressing barriers, coaching, self‚Äêmonitoring, social support) level behaviour change strategies, with strategies driven by workplace champions. Baseline, 3, 12 and 24 month measures will be taken. PRIMARY OUTCOME: Objectively measured daily sitting time (activPAL3). SECONDARY OUTCOMES: objectively measured sitting, standing, stepping, prolonged sitting and moderate‚Äêto‚Äêvigorous physical activity time and number of steps at work and daily; objectively measured sleep (wrist accelerometry). Adiposity, blood pressure, fasting glucose, glycated haemoglobin, cholesterol (total, HDL, LDL) and triglycerides will be assessed from capillary blood samples. Questionnaires will examine dietary intake, fatigue, musculoskeletal issues, job performance and satisfaction, work engagement, occupational and general fatigue, stress, presenteeism, anxiety and depression and sickness absence (organisational records). Quality of life and resources used (e.g. GP visits, outpatient attendances) will also be assessed. We will conduct a full process evaluation and cost‚Äêeffectiveness analysis. DISCUSSION: The results of this RCT will 1) help to understand how effective an important simple, yet relatively expensive environmental change is for reducing sitting, 2) provide evidence on changing behaviour across all waking hours, and 3) provide evidence for policy guidelines around population and workplace health and well‚Äêbeing. TRIAL REGISTRATION: ISRCTN11618007 . Registered on 21 January 2018."," Edwardson, CL;  Biddle, SJH;  Clarke-Cornwell, A;  Clemes, S;  Davies, MJ;  Dunstan, DW;  Eborall, H;  Granat, MH;  Gray, LJ;  Healy, GN;  et al.",2018.0, 10.1186/s12889-018-6017-1,0,0,
2169," ""Active Team"" a social and gamified app-based physical activity intervention: randomised controlled trial study protocol"," BACKGROUND: Physical inactivity is a leading preventable cause of chronic disease and premature death globally, yet over half of the adult Australian population is inactive. To address this, web‚Äêbased physical activity interventions, which have the potential to reach large numbers of users at low costs, have received considerable attention. To fully realise the potential of such interventions, there is a need to further increase their appeal to boost engagement and retention, and sustain intervention effects over longer periods of time. This randomised controlled trial aims to evaluate the efficacy of a gamified physical activity intervention that connects users to each other via Facebook and is delivered via a mobile app. METHODS: The study is a three‚Äêgroup, cluster‚ÄêRCT. Four hundred and forty (440) inactive Australian adults who use Facebook at least weekly will be recruited in clusters of three to eight existing Facebook friends. Participant clusters will be randomly allocated to one of three conditions: (1) waitlist control condition, (2) basic experimental condition (pedometer plus basic app with no social and gamification features), or (3) socially‚Äêenhanced experimental condition (pedometer plus app with social and gamification features). Participants will undertake assessments at baseline, three and nine months. The primary outcome is change in total daily minutes of moderate‚Äêto‚Äêvigorous physical activity at three months measured objectively using GENEActive accelerometers [Activeinsights Ltd., UK]. Secondary outcomes include self‚Äêreported physical activity, depression and anxiety, wellbeing, quality of life, social‚Äêcognitive theory constructs and app usage and engagement. DISCUSSION: The current study will incorporate novel social and gamification elements in order to examine whether the inclusion of these components increases the efficacy of app‚Äêbased physical activity interventions. The findings will be used to guide the development and increase the effectiveness of future health behaviour interventions. TRIAL REGISTRATION: This trial was registered with the Australian and New Zealand Clinical Trial Registry ( ACTRN12617000113358 , date of registration 23 January, 2017)."," Edney, S;  Plotnikoff, R;  Vandelanotte, C;  Olds, T;  De Bourdeaudhuij, I;  Ryan, J;  Maher, C",2017.0, 10.1186/s12889-017-4882-7,0,0,
2170,Use of a smartphone camera to estimate systolic blood pressure compared to standard oscillometric blood pressure measurement-a prospective trial,"Background: Along with the rapid developing market of novel apps and wearable devices several attempts to introduce alternative methods to measure blood pressure have evolved. Critical evaluation of these novel tools is needed. We tested a novel algorithm regarding its reliability and suitability to estimate systolic blood pressure using the photoplethysmographic (PPG) signal of a smartphone camera. Methods: Subjects at our University Hospital received a standard oscillometric cuff device (OCD) on their upper arm and a smartphone with its camera facing their index finger of the same arm after they signed informed consent. Seven sequential measurements starting with the OCD followed by the smartphone were performed. PPG files were analysed blinded for the oscillometric results and correlated with the mean between the preceding and the succeeding oscillometric result. In addition, 200 predefined subjects had repetitive measurement blocks within 3 days. Results: In total 1000 subjects were recruited and 4671 datasets were analysed. Mean absolute deviation was 14mmHg, standard deviation 11mmHg. Data is best displayed in fig. 1 as Bland-Altman plot. Subgroup analysis was performed for normotensive, grade 1 hypertensive and >grade 1 hypertensive individuals (table 1). Conclusion: In this prospective blinded trial, the algorithm provided a fair estimation of the systolic blood pressure in normotensive and grade 1 hypertensive individuals but is not suitable yet for hypertensive values. It is evident that at present this tool is not at a clinical level, but close to a screening tool. Further improvement is needed.",Eckstein J.; Burkardt T.; Winterhalder C.; Leonardi L.; Thommen E.; Weber S.; Birkemeyer R.; Seeck A.; Koenig N.; Doerr M.,2017.0,10.1093/eurheartj/ehx502.P441,0,0,
2171, Psychometric properties of the Behavioural Outcomes of Anxiety questionnaire in stroke patients with aphasia," OBJECTIVE: To evaluate the psychometric properties of an observational, carer‚Äêcompleted anxiety screen for aphasic stroke patients. DESIGN: Phase 1: A cross‚Äêsectional questionnaire design to establish psychometric properties. Phase 2: A randomized longitudinal design with treatment and control to evaluate sensitivity to change and repeatability/reliability. SUBJECTS: Phase 1: 111 patient‚Äêcarer dyads were recruited through stroke charities: patient mean age 69.7(10. 7), 6.2(5. 2) years since stroke, 76 male; carer mean age 64.7(12. 2), 27 male. Phase 2. A subsample of 50 dyads (29 completed). MEASURES: All patients completed the Tension Rating Circles and the Frenchay Aphasia Screening Test. Carers completed the Behavioural Outcomes of Anxiety questionnaire, observational versions of the Hospital Anxiety and Depression Scale (HADS‚ÄêA) and the Generalised Anxiety Disorder‚Äê7, and a feedback questionnaire. INTERVENTION: Phase 2: 25 dyads were offered relaxation training and 25 acted as controls. RESULTS: The Behavioural Outcomes of Anxiety questionnaire correlated .77 with the HADS‚ÄêA and Cronbach's Alpha was .82 demonstrating validity and internal consistency. Using HADS‚ÄêA cut‚Äêoff > 7 as criterion the area under the curve was 0.90 and at cut‚Äêoff of > 16 sensitivity (0.85) and specificity (0.85) were both good. Scores declined significantly more in a group given anxiety training ( n = 12) than in a control group ( n = 17), demonstrating sensitivity to change and construct validity. Two‚Äêweek repeatability/reliability was .92. Feedback suggested the scale was acceptable. CONCLUSIONS: The Behavioural Outcomes of Anxiety questionnaire shows promise as an anxiety screen for stroke patients with aphasia and is sensitive to change. Further analysis of dimensionality and discriminant validity is needed."," Eccles, A;  Morris, R;  Kneebone, I",2017.0, 10.1177/0269215516644311,0,0,
2172,Corticotropin-releasing factor receptor 1 antagonism is ineffective for women with posttraumatic stress disorder.,"Background: Medication and psychotherapy treatments for posttraumatic stress disorder (PTSD) provide insufficient benefit for many patients. Substantial preclinical and clinical data indicate abnormalities in the hypothalamic-pituitary-adrenal axis, including signaling by corticotropin-releasing factor, in the pathophysiology of PTSD. Methods: We conducted a double-blind, placebo-controlled, randomized, fixed-dose clinical trial evaluating the efficacy of GSK561679, a corticotropin-releasing factor receptor 1 (CRF1 receptor) antagonist in adult women with PTSD. The trial randomized 128 participants, of whom 96 completed the 6-week treatment period. Results: In both the intent-to-treat and completer samples, GSK561679 failed to show superiority over placebo on the primary outcome of change in Clinician-Administered PTSD Scale total score. Adverse event frequencies did not significantly differ between GSK561679- and placebo-treated subjects. Exploration of the CRF1 receptor single nucleotide polymorphism rs110402 found that response to GSK561679 and placebo did not significantly differ by genotype alone. However, subjects who had experienced a moderate or severe history of childhood abuse and who were also GG homozygotes for rs110402 showed significant improvement after treatment with GSK561679 (n = 6) but not with placebo (n = 7) on the PTSD Symptom Scale-Self-Report. Conclusions: The results of this trial, the first evaluating a CRF1 receptor antagonist for the treatment of PTSD, combined with other negative trials of CRF1 receptor antagonists for major depressive disorder, generalized anxiety disorder, and social anxiety disorder, suggest that CRF1 receptor antagonists lack efficacy as monotherapy agents for these conditions. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Dunlop, Boadie W; Binder, Elisabeth B; Iosifescu, Dan; Mathew, Sanjay J; Neylan, Thomas C; Pape, Julius C; Carrillo-Roa, Tania; Green, Charles; Kinkead, Becky; Grigoriadis, Dimitri; Rothbaum, Barbara O; Nemeroff, Charles B; Mayberg, Helen S",2017.0,http://dx.doi.org/10.1016/j.biopsych.2017.06.024,0,0,
2173, A Randomized Controlled Trial Testing the Efficacy of the Creating Opportunities for Parent Empowerment Program for Parents of Children With Epilepsy and Other Chronic Neurological Conditions," BACKGROUND: Parents of children with epilepsy and other neurological conditions live with a feeling of constant uncertainty. The uncertainty associated with caring for a child with a neurological condition produces stress, which leads to decreased parental belief in caregiving skills, anxiety, and depression, ultimately altering parental functioning resulting in an increase in child behavioral problems. The stress associated with caring for children with neurological conditions is unlike caring for children with other chronic conditions. Neurological conditions are unpredictable, and there are often no warning signs before an acute event. This unpredictability accompanied with stigma results in social isolation and impacts family functioning. In addition, children with neurological conditions have a higher rate of psychological comorbidities and behavior problems when compared with children with other chronic conditions. This produces an additional burden on the parents and family. STUDY DESIGN: This randomized controlled trial tested the efficacy of the Creating Opportunities for Parent Empowerment intervention for parents of children with epilepsy and other neurological conditions. This intervention was administered at three intervals: (a) during hospital admission, (b) 3 days after hospital discharge by telephone, and (c) 4‚Äê6 weeks after hospital discharge. RESULTS: Forty‚Äêsix parents of children admitted to the inpatient neuroscience unit at Boston Children's Hospital participated in the study. Several study limitations resulted in an inadequate sample size to obtain the power necessary to reach statistically significant results for most of the research questions. A one‚Äêbetween, one‚Äêwithin multivariate analysis of variance revealed that the main effect of time was significant for differences in state anxiety for both the usual care group and the intervention group, F(1, 20) = 9.86, p = .005, indicating that state anxiety for both groups combined was more pronounced during the hospitalization. A one‚Äêbetween, one‚Äêwithin multivariate analysis of variance showed that the effect of the interaction between time and group was significant for internalized behavior assessment system score only (p = .037) because the usual care group reported a significant decrease in internalizing behavior scores in their children over time. CONCLUSIONS: Findings from this study have significant implications for clinical practice and future research. Parents of children with neurological conditions often struggle to manage a constant feeling of uncertainty in their daily lives. Nurses possess the knowledge and expertise necessary to identify the psychosocial needs of these parents and provide education and support as needed. Future research should focus on designing interventions to meet the needs of these families and develop strategies to help improve the quality of life for both the parent and child living with a neurological condition."," Duffy, LV;  Vessey, JA",2016.0, 10.1097/JNN.0000000000000199,0,0,
2174, Posttraumatic Bone Marrow Lesion Volume and Knee Pain Within 4 Weeks After Anterior Cruciate Ligament Injury," CONTEXT:   After an anterior cruciate ligament (ACL) injury, a majority of patients have a traumatic bone marrow lesion (BML, or bone bruise). The clinical relevance of posttraumatic lesions remains unclear. OBJECTIVE:   To explore the cross‐sectional associations between traumatic BML volume and self‐reported knee pain and symptoms among individuals within 4 weeks of ACL injury. DESIGN:   Cross‐sectional exploratory analysis of a randomized clinical trial. SETTING:   Orthopaedic departments at 2 hospitals in Sweden. PATIENTS OR OTHER PARTICIPANTS:   As part of a randomized trial (knee anterior cruciate ligament nonoperative versus operative treatment [KANON] study), 121 young active adults (74% men, age = 26 ± 5 years, height = 1.8 ± 0.1 m, weight = 76 ± 13 kg) with an ACL tear were studied. MAIN OUTCOME MEASURE(S):   The BML volume in the proximal tibia and distal femur was segmented using magnetic resonance images obtained within 4 weeks of injury. A radiologist evaluated the presence of depression fractures on the images. Pain and symptoms of the injured knee (Knee Injury and Osteoarthritis Outcome Score [KOOS] pain and symptoms subscales) were obtained the same day as imaging. We used linear regression models to assess the associations. RESULTS:   Most knees had at least 1 BML (96%), and the majority (57%) had a depression fracture. Whole‐knee BML volume was not related to knee pain for the entire cohort (β = ‐0.09, P = .25). Among those without a depression fracture, larger whole‐knee BML volume was associated with increased knee pain (β = ‐0.46, P = .02), whereas no association was found for those with a depression fracture (β = 0.0, P = .96). Larger medial (β = ‐0.48, P = .02) but not lateral (β = ‐0.03, P = .77) tibiofemoral BML volume was associated with greater pain. We found no association between BML volume and knee symptoms. CONCLUSIONS:   We confirmed the absence of relationships between whole‐knee BML volume and pain and symptoms within 4 weeks of ACL injury. Our findings extend previous reports in identifying weak associations between larger BML volume in the medial compartment and greater pain and between BML volume and greater pain among those without a depression fracture."," Driban, JB;  Lohmander, S;  Frobell, RB",2017.0, 10.4085/1062-6050-52.1.09,0,0,
2175,Preextinction Stress Prevents Context-Related Renewal of Fear,"Extinction learning, which creates new safety associations, is thought to be the mechanism underlying exposure therapy, commonly used for the treatment of anxiety disorders and posttraumatic stress disorder. The relative strength and availability for retrieval of both the fear and safety memories determine the response in a given situation. While the fear memory is often context-independent and may easily generalize, extinction memory is highly context-specific. “Renewal” of the extinguished fear memory might thus occur following a shift in context. The aim of the current work was to create an enhanced and generalized extinction memory to a discrete stimulus using stress exposure before extinction learning, thereby preventing renewal. In our contextual fear conditioning paradigm, 40 healthy men acquired (Day 1), retrieved and extinguished (Day 2) the fear memories, with no differences between the stress and the control group. A significant difference between the groups emerged in the renewal test (Day 3). A renewal effect was seen in the control group (N = 20), confirming the context-dependency of the extinction memory. In contrast, the stress group (N = 20) showed no renewal effect. Fear reduction was generalized to the acquisition context as well, suggesting that stress rendered the extinction memory more context-independent. These results are in line with previous studies that showed contextualization disruption as a result of pre-learning stress, mediated by the rapid effects of glucocorticoids on the hippocampus. Our findings support research investigating the use of glucocorticoids or stress induction in exposure therapy and suggest the right timing of administration in order to optimize their effects.",Drexler S.M.; Merz C.J.; Wolf O.T.,2018.0,10.1016/j.beth.2018.03.001,0,0,
2176,Internet-based self-management of generalised anxiety disorder: A preliminary study.,"Despite the continuing development of effective cognitive and behavioural interventions for Generalised Anxiety Disorder (GAD) less attention has been paid to the important issue of improving treatment accessibility and affordability. Self-management approaches that utilise the convenience of the Internet may provide a means by which more people can avail themselves of effective treatments. To date, studies examining the effectiveness of such approaches for GAD lag behind the work conducted with other clinical problems. This study describes the response of three individuals with a primary diagnosis of GAD to an Internet-based treatment completed at their own pace. The intervention ('What? Me Worry!?!; Saulsman, Nathan, Lim, and Correia, 2005) combines several cognitive and behavioural components with the inclusion of a significant metacognitive component. All participants achieved clinically significant improvement on measures of worry, GAD symptomatology, and metacognitions. Moreover, none of the participants met the diagnostic criteria for GAD at the completion of the study. A larger randomised controlled trial of this intervention is indicated. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Draper, Mark; Rees, Clare S; Nathan, Paula R",2008.0,http://dx.doi.org/10.1375/bech.25.4.229,0,0,
2177, Impact of an educational DVD on anxiety and glycaemic control in women diagnosed with gestational diabetes mellitus (GDM): a randomised controlled trial," METHODS: 150 multi‐ethnic women, aged 19‐44years, from three UK hospitals were randomised to either usual care plus DVD (DVD group, n=77) or usual care alone (control group, n=73) at GDM diagnosis. Primary outcomes were anxiety (State‐Trait Anxiety Inventory) and mean 1‐h postprandial capillary self‐monitored blood glucose for all meals, on day prior to follow‐up. RESULTS: No significant difference between the DVD and control group were reported, for anxiety (37.7±11.7 vs 36.2±10.9; mean difference after adjustment for covariates (95% CI) 2.5 (‐0.8, 5.9) or for mean 1‐h postprandial glucose for all meals (6.9±0.9 vs 7.0±1.2mmol/L; ‐0.2 (‐0.5, 0.2). However, the DVD group had significantly lower postprandial breakfast glucose compared to the control group (6.8±1.2 vs 7.4±1.9mmol/L; ‐0.5 (‐1.1, ‐<0.1; p=0.04). CONCLUSIONS: The results in this trial did not highlight any differences between those who received the intervention and those who received usual care. It is possible that women already felt supported by their frequent attendance at specialist clinics for monitoring and advice. Healthcare professional and family support are key elements to empowering women with GDM and require further consideration in future interventions. Nonetheless, educational resources such as this will be beneficial to help support women given the current resource and time implications of the year on year rises in the incidence of gestational diabetes. AIMS: The diagnosis of gestational diabetes mellitus (GDM) during pregnancy can lead to anxiety. This study evaluated the impact of an innovative patient‐centred educational DVD on anxiety and glycaemic control in women newly diagnosed with GDM."," Draffin, CR;  Alderdice, FA;  McCance, DR;  Maresh, M;  Harper, R;  Patterson, CC;  Bernatavicius, G;  Brennan, SF;  Gough, A;  McSorley, O;  et al.",2017.0, 10.1016/j.diabres.2017.02.016,0,0,
2178, The impact of telephone-delivered cognitive behaviour therapy and befriending on mood disorders in people with chronic obstructive pulmonary disease: a randomized controlled trial," OBJECTIVES: The main objectives of this pragmatic randomized controlled trial were to investigate the impact of cognitive behaviour therapy (CBT) and an active social control (befriending) on depression and anxiety symptoms in people with chronic obstructive pulmonary disease (COPD). METHODS: Eligible participants were randomly allocated to receive eight weekly telephone interventions of CBT (n = 54) or befriending (n = 56). Repeated‚Äêmeasures ANOVA was used to assess changes in scores and Cohen's d was used to assess effect sizes. RESULTS: Significant improvement was observed in anxiety symptoms for the befriending group from baseline (T1) to post‚Äêintervention assessment (T2) and to 8‚Äêweek follow‚Äêup assessment (T3), with a small to medium effect size (Cohen's d = 0.3). Significant improvement was noted in depression symptoms from T1 to T2 for both groups, but only the CBT group had a significant difference at T3, with a small to medium effect size (Cohen's d = 0.4). For secondary outcomes, there was a significant change in COPD symptoms from T1 to T2 for the befriending group; however, at T3 this change was no longer significant. Finally, there was a significant change in general self‚Äêefficacy for both groups between T1 and T2, and T1 and T3. CONCLUSION: Cognitive behaviour therapy reduced depression symptoms but not anxiety. Befriending reduced depression symptoms in the short term and anxiety symptoms in both the short term and long term. Further research is needed to demonstrate non‚Äêinferiority of telephone delivery compared with other formats, and to understand the impact of befriending which has the potential to be a cost‚Äêeffective support for people with COPD. Statement of contribution What is already known on this subject? Depression and anxiety are common comorbidities in people with chronic obstructive pulmonary disease. Mood disorders are not commonly routinely treated in people with chronic obstructive pulmonary disease. Telephone‚Äêadministered CBT has been shown to be as effective as face‚Äêto‚Äêface CBT in reducing depression and anxiety. What does this study add? Telephone‚Äêadministered CBT can reduce depression symptoms in people with COPD. Telephone‚Äêadministered befriending can reduce anxiety and depression symptoms in people with COPD. People with COPD who have mood disorders would prefer to have CBT than befriending."," Doyle, C;  Bhar, S;  Fearn, M;  Ames, D;  Osborne, D;  You, E;  Gorelik, A;  Dunt, D",2017.0, 10.1111/bjhp.12245,0,0,
2179,"""Transcend"": Initial outcomes from a posttraumatic stress disorder/substance abuse treatment program.","This paper describes the development of a comprehensive treatment program for combat veterans diagnosed with posttraumatic stress disorder (PTSD) and substance abuse (SA). Outcome data are presented on 46 male patients (aged 44-55 yrs) who completed the 12-week partial hospitalization treatment program between 1996 and 1998. The treatment approach, defined by a detailed manual, integrates elements of cognitive-behavioral skills training, constructivist theory approaches, SA relapse prevention strategies, and peer social support into a group-focused program. The Clinician-Administered PTSD Scale (CAPS) and the Addiction Severity Index (ASI) were used to assess treatment effectiveness at discharge and 6- and 12-month follow-up. Significant symptom changes revealed on CAPS and ASI scores at discharge and follow-up are analyzed. Discussion focuses on hypotheses regarding treatment effectiveness, study limitations, and suggestions for further research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Donovan, Beverly; Padin-Rivera, Edgardo; Kowaliw, Sean",2001.0,http://dx.doi.org/10.1023/A:1013094206154,0,0,
2180," The role of immediate provisional restorations on implants with a hydrophilic surface: a randomised, single-blind controlled clinical trial"," OBJECTIVES: To compare the radiographic bone changes, clinical parameters and aesthetic outcomes of immediately provisionalised and conventionally restored implants at 12‚Äê and 24‚Äêmonths post‚Äêimplant placement. MATERIAL AND METHODS: In 24 patients, 24 bone level implants with a hydrophilic (SLActive) surface were placed in healed sites and they were either immediately provisionalised with a non‚Äêoccluding temporary crown (test group) or left without a crown (control group). In both groups, the definitive restoration was placed 16 weeks after implant placement. Clinical and radiographic parameters were calculated at 12‚Äê and 24‚Äêmonths post‚Äêimplant placement, together with implant success/survival rates according to three different sets of criteria. The aesthetic outcome was evaluated through the Papilla Fill Index and the Pink Aesthetic Score. RESULTS: The mean marginal bone loss at 1 year was ‚Äê0.73 mm (SD 0.83 mm) in the test group and ‚Äê0.22 mm (SD 0.46 mm) in the control group (p > .05). Whilst 100% survival rate and positive aesthetic outcomes were recorded in both groups, three patients of the test group did not fulfil all success criteria. CONCLUSIONS: Immediate provisionalisation may represent a viable option for the replacement of single missing teeth, with radiographic, clinical and aesthetic results comparable to those of conventionally loaded implants at 2 years of follow‚Äêup."," Donos, N;  Horvath, A;  Mezzomo, LA;  Dedi, D;  Calciolari, E;  Mardas, N",2018.0, 10.1111/clr.13038,0,0,
2181,Disorder- and Treatment-Specific Therapeutic Competence Scales for Posttraumatic Stress Disorder Intervention: Development and Psychometric Properties.,"Although the assessment of therapeutic competence in psychotherapy research is essential for examining its possible associations with treatment outcomes, it is often neglected due to high costs and a lack of valid instruments. This study aimed to develop two therapeutic competence scales that assess disorder-specific and treatment-specific therapeutic competence, and to examine these scales' psychometric properties along with those of the already established Cognitive Therapy Scale (CTS) in a posttraumatic stress disorder (PTSD) sample. Using an inductive procedure, two rating scales for assessing disorder-specific and treatment-specific competence were constructed. The psychometric properties of these scales and those of the CTS were assessed in a sample of 30 videotaped sessions of eight patients from a multicenter study in which PTSD related to child abuse was treated using cognitive processing therapy. Two raters assessed therapeutic competence in 30 videotaped psychotherapy sessions. Interrater reliability, internal consistency, and content validity were determined. The scales (all items and total scores) demonstrated good to excellent interrater reliability, intraclass correlation coefficients (ICCs) = .67 to .97, and internal consistency, Cronbach's α = .73 to .92. The PTSD experts' ratings confirmed good internal validity. We found statistically significant associations with therapeutic adherence, r = .62 to .85; p < .001; and therapeutic alliance, r = .47, p < .001. These preliminary data imply that the two newly developed competence scales and the CTS can be reliably used to assess different types of therapeutic competence in PTSD samples and may be useful as possible predictors of treatment outcomes.",Dittmann C.; Müller-Engelmann M.; Stangier U.; Priebe K.; Fydrich T.; Görg N.; Rausch S.; Resick PA.; Steil R.,2017.0,10.1002/jts.22236,0,0,
2182,Adherence Rating Scale for Cognitive Processing Therapy - Cognitive Only: Analysis of Psychometric Properties.,"The assessment of therapeutic adherence is essential for accurately interpreting treatment outcomes in psychotherapy research. However, such assessments are often neglected. To fill this gap, we aimed to develop and test a scale that assessed therapeutic adherence to Cognitive Processing Therapy - Cognitive Only (CPT), which was adapted for a treatment study targeting patients with post-traumatic stress disorder and co-occurring borderline personality symptoms. Two independent, trained raters assessed 30 randomly selected treatment sessions involving seven therapists and eight patients who were treated in a multicentre randomized controlled trial. The inter-rater reliability for all items and the total score yielded good to excellent results (intraclass correlation coefficient [ICC] = 0.70 to 1.00). Cronbach's α was .56 for the adherence scale. Regarding content validity, three experts confirmed the relevance and appropriateness of each item. The adherence rating scale for the adapted version of CPT is a reliable instrument that can be helpful for interpreting treatment effects, analysing possible relationships between therapeutic adherence and treatment outcomes and teaching therapeutic skills.",Dittmann C.; Müller-Engelmann M.; Resick PA.; Gutermann J.; Stangier U.; Priebe K.; Fydrich T.; Ludäscher P.; Herzog J.; Steil R.,2017.0,10.1017/S1352465816000679,0,0,
2183, Use of Different Vegetable Products to Increase Preschool-Aged Children's Preference for and Intake of a Target Vegetable: a Randomized Controlled Trial," BACKGROUND: Children's low vegetable consumption requires effective strategies to enhance preference for and intake of vegetables. OBJECTIVE: The study compared three preparation practices for a target vegetable (spinach) on their effectiveness in increasing preschool‚Äêaged children's preference for and intake of the target vegetable in comparison to a control vegetable (green beans). DESIGN: We conducted a randomized controlled trial with four parallel groups: plain spinach, creamed spinach, spinach ravioli, and green beans. During the intervention, children were served the vegetable at their main meal six times over 6 weeks at home. PARTICIPANTS/SETTING: Children aged 2 to 4 years were recruited from six child‚Äêcare centers located in Wageningen, the Netherlands, and randomly assigned to one of the four groups, with vegetable products provided by the researchers. The study was performed between September 2014 and January 2015. In total, 103 children participated, with 26, 25, 26, and 26 in the plain spinach, creamed spinach, spinach ravioli, and green beans groups, respectively. MAIN OUTCOME MEASURES: Preference for and ad libitum intake of cooked spinach were assessed during a test meal at the day‚Äêcare center pre‚Äê and postintervention. Food neophobia was assessed via the Child Food Neophobia Scale. STATISTICAL ANALYSES PERFORMED: General linear model repeated measures analysis, including food neophobia, spinach liking, exposure, and consumption scores as covariates, was performed to test for effects of group on intake. Logistic regression was used to assess changes in preference between pre‚Äê and postintervention. RESULTS: All four groups significantly increased their spinach intake from pre‚Äê (53 g) to postintervention (91 g) by an average of 70%. For preference, no significant shift toward the target vegetable was found from pre‚Äê to postintervention. The effect on intake depended on the child's neophobia status and preintervention spinach consumption, with children with neophobia being less responsive to the intervention and with children who ate more spinach before the intervention being more responsive to the intervention. CONCLUSIONS: These findings suggest that repeated exposure to differently prepared spinach products, or even another green vegetable, improved children's spinach intake. However, children with neophobia may need a different approach."," de Wild, VWT;  de Graaf, C;  Jager, G",2017.0, 10.1016/j.jand.2016.11.006,0,0,
2184, Family Presence during Resuscitation: a Qualitative Analysis from a National Multicenter Randomized Clinical Trial," BACKGROUND: The themes of qualitative assessments that characterize the experience of family members offered the choice of observing cardiopulmonary resuscitation (CPR) of a loved one have not been formally identified. METHODS AND FINDINGS: In the context of a multicenter randomized clinical trial offering family members the choice of observing CPR of a patient with sudden cardiac arrest, a qualitative analysis, with a sequential explanatory design, was conducted. The aim of the study was to understand family members' experience during CPR. All participants were interviewed by phone at home three months after cardiac arrest. Saturation was reached after analysis of 30 interviews of a randomly selected sample of 75 family members included in the trial. Four themes were identified: 1‚Äê choosing to be actively involved in the resuscitation; 2‚Äê communication between the relative and the emergency care team; 3‚Äê perception of the reality of the death, promoting acceptance of the loss; 4‚Äê experience and reactions of the relatives who did or did not witness the CPR, describing their feelings. Twelve sub‚Äêthemes further defining these four themes were identified. Transferability of our findings should take into account the country‚Äêspecific medical system. CONCLUSIONS: Family presence can help to ameliorate the pain of the death, through the feeling of having helped to support the patient during the passage from life to death and of having participated in this important moment. Our results showed the central role of communication between the family and the emergency care team in facilitating the acceptance of the reality of death."," De Stefano, C;  Normand, D;  Jabre, P;  Azoulay, E;  Kentish-Barnes, N;  Lapostolle, F;  Baubet, T;  Reuter, PG;  Javaud, N;  Borron, SW;  et al.",2016.0, 10.1371/journal.pone.0156100,0,0,
2185," Comparison of eye movement desensitization and reprocessing therapy, cognitive behavioral writing therapy, and wait-list in pediatric posttraumatic stress disorder following single-incident trauma: a multicenter randomized clinical trial"," BACKGROUND: Practice guidelines for childhood posttraumatic stress disorder (PTSD) recommend trauma‚Äêfocused psychotherapies, mainly cognitive behavioral therapy (CBT). Eye movement desensitization and reprocessing (EMDR) therapy is a brief trauma‚Äêfocused, evidence‚Äêbased treatment for PTSD in adults, but with few well‚Äêdesigned trials involving children and adolescents. METHODS: We conducted a single‚Äêblind, randomized trial with three arms (n = 103): EMDR (n = 43), Cognitive Behavior Writing Therapy (CBWT; n = 42), and wait‚Äêlist (WL; n = 18). WL participants were randomly reallocated to CBWT or EMDR after 6 weeks; follow‚Äêups were conducted at 3 and 12 months posttreatment. Participants were treatment‚Äêseeking youth (aged 8‚Äê18 years) with a DSM‚ÄêIV diagnosis of PTSD (or subthreshold PTSD) tied to a single trauma, who received up to six sessions of EMDR or CBWT lasting maximally 45 min each. RESULTS: Both treatments were well‚Äêtolerated and relative to WL yielded large, intent‚Äêto‚Äêtreat effect sizes for the primary outcomes at posttreatment: PTSD symptoms (EMDR: d = 1.27; CBWT: d = 1.24). At posttreatment 92.5% of EMDR, and 90.2% of CBWT no longer met the diagnostic criteria for PTSD. All gains were maintained at follow‚Äêup. Compared to WL, small to large (range d = 0.39‚Äê1.03) intent‚Äêto‚Äêtreat effect sizes were obtained at posttreatment for negative trauma‚Äêrelated appraisals, anxiety, depression, and behavior problems with these gains being maintained at follow‚Äêup. Gains were attained with significantly less therapist contact time for EMDR than CBWT (mean = 4.1 sessions/140 min vs. 5.4 sessions/227 min). CONCLUSIONS: EMDR and CBWT are brief, trauma‚Äêfocused treatments that yielded equally large remission rates for PTSD and reductions in the severity of PTSD and comorbid difficulties in children and adolescents seeking treatment for PTSD tied to a single event. Further trials of both treatments with PTSD tied to multiple traumas are warranted."," de Roos, C;  van der Oord, S;  Zijlstra, B;  Lucassen, S;  Perrin, S;  Emmelkamp, P;  de Jongh, A",2017.0, 10.1111/jcpp.12768,0,0,
2186, PKCα is genetically linked to memory capacity in healthy subjects and to risk for posttraumatic stress disorder in genocide survivors," Strong memory of a traumatic event is thought to contribute to the development and symptoms of posttraumatic stress disorder (PTSD). Therefore, a genetic predisposition to build strong memories could lead to increased risk for PTSD after a traumatic event. Here we show that genetic variability of the gene encoding PKCα (PRKCA) was associated with memory capacity‐‐including aversive memory‐‐in nontraumatized subjects of European descent. This finding was replicated in an independent sample of nontraumatized subjects, who additionally underwent functional magnetic resonance imaging (fMRI). fMRI analysis revealed PRKCA genotype‐dependent brain activation differences during successful encoding of aversive information. Further, the identified genetic variant was also related to traumatic memory and to the risk for PTSD in heavily traumatized survivors of the Rwandan genocide. Our results indicate a role for PKCα in memory and suggest a genetic link between memory and the risk for PTSD."," de Quervain, DJ;  Kolassa, IT;  Ackermann, S;  Aerni, A;  Boesiger, P;  Demougin, P;  Elbert, T;  Ertl, V;  Gschwind, L;  Hadziselimovic, N;  et al.",2012.0, 10.1073/pnas.1200857109,0,0,
2187,"The influence of reward sensitivity, heart rate dynamics and EEG-delta activity on placebo analgesia","Personality traits have been shown to interact with environmental cues to modulate biological responses including treatment responses, and potentially having a role in the formation of placebo effects. Here we used the Reinforcement Sensitivity Theory Personality Questionnaire (RST-PQ) to identify personality traits that predict placebo analgesic responding. Cardiac inter-beat (R–R) time series and electroencephalographic (EEG) band oscillations were recorded from healthy women in a cold-pain (Pain) and placebo analgesia (PA) condition. The measures of Hypnotizability, and self-reported ratings of Hypnotic Depth, Motivation, Pain Expectation, Involuntariness in PA responding, Pain and Distress intensity were obtained. Separate principal components factor analyses with varimax rotation were performed on summarized heart rate variability (HRV) measures of time, frequency, nonlinear Complexity, and EEG-band activity. Both analyses yielded a similar three-factor solution including Frequency HRV (factor-1), Complexity HRV dynamics (factor-2), and time HRV & EEG-delta activity (factor-3). Reward Interest sub-trait of the Behavioral Approach System (BAS-RI), Pain Expectation, Involuntariness in PA responding, and Hypnotic Depth were positively associated, whereas negative changes in time-HRV & EEG-delta scores were associated with Pain Reduction. Multiple mediation analyses disclosed that BAS-RI, potentially served by the dopaminergic system, through Involuntariness in PA responding can alter placebo responding to laboratory pain. Our results also show that a linear compound of HR slowing and higher EEG delta activity during PA explains a substantial proportion of the variance in placebo analgesic responses. Future studies should examine the potential role that these individual difference measures may play in patient responsiveness to treatments for clinical pain.",De Pascalis V.; Scacchia P.,2019.0,10.1016/j.bbr.2018.11.014,0,0,
2188," INDIVIDUALIZED YOGA FOR REDUCING DEPRESSION AND ANXIETY, AND IMPROVING WELL-BEING: a RANDOMIZED CONTROLLED TRIAL"," METHODS: A sample of 101 people with symptoms of depression and/or anxiety participated in a randomized controlled trial comparing a 6‚Äêweek yoga intervention with waitlist control. Yoga was additional to usual treatment. The control group was offered the yoga following the waitlist period. Measures included Depression Anxiety Stress Scale (DASS‚Äê21), Kessler Psychological Distress Scale (K10), Short‚ÄêForm Health Survey (SF12), Scale of Positive and Negative Experience (SPANE), Flourishing Scale (FS), and Connor‚ÄêDavidson Resilience Scale (CD‚ÄêRISC2). RESULTS: There were statistically significant differences between yoga and control groups on reduction of depression scores (‚Äê4.30; 95% CI: ‚Äê7.70, ‚Äê0.01; P = .01; ES ‚Äê.44). Differences in reduced anxiety scores were not statistically significant (‚Äê1.91; 95% CI: ‚Äê4.58, 0.76; P = .16). Statistically significant differences in favor of yoga were also found on total DASS (P = .03), K10, SF12 mental health, SPANE, FS, and resilience scores (P < .01 for each). Differences in stress and SF12 physical health scores were not statistically significant. Benefits were maintained at 6‚Äêweek follow‚Äêup. CONCLUSION: Yoga plus regular care was effective in reducing symptoms of depression compared with regular care alone. Further investigation is warranted regarding potential benefits in anxiety. Individualized yoga may be particularly beneficial in mental health care in the broader community. BACKGROUND: Depression and anxiety are leading causes of disability worldwide. Current treatments are primarily pharmaceutical and psychological. Questions remain about effectiveness and suitability for different people. Previous research suggests potential benefits of yoga for reducing depression and anxiety. The aim of this study is to investigate the effects of an individualized yoga intervention."," de Manincor, M;  Bensoussan, A;  Smith, CA;  Barr, K;  Schweickle, M;  Donoghoe, LL;  Bourchier, S;  Fahey, P",2016.0, 10.1002/da.22502,0,0,
2189,D-cycloserine addition to exposure sessions in the treatment of patients with obsessive-compulsive disorder.,"Background: Preliminary studies have shown that the addition of the partial NMDA-agonist D-cycloserine (DCS) might be promising in enhancing the results of exposure therapy in obsessive-compulsive disorder (OCD). We examined the effect of DCS addition to exposure therapy in a somewhat larger sample of OCD patients with special attention to subgroups, because of the heterogeneity of OCD. Methods: A randomized, double-blind, placebo controlled trial was conducted in 39 patients with OCD. Patients received 6 guided exposure sessions, once a week. One hour before each session 125mg DCS or placebo was administered. Results: Scores on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) declined more in the DCS group than in the placebo group, but the difference did not reach statistical significance (P = 0.076, partial eta2 = 0.13). Response percentages also did not differ between the DCS and the placebo group (37% and 15% respectively). In the 'cleaning/contamination' subgroup a significant effect was found in favour of DCS (P = 0.033, partial eta2 = 0.297). Conclusions: The results of this study did not support the application of DCS to exposure therapy in OCD. Some specific aspects need further investigation: efficacy of DCS in a larger 'cleaning/contamination' (sub-)group, DCS addition only after successful sessions, interaction with antidepressants. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","de Leeuw, A. S; van Megen, H. J. G. M; Kahn, R. S; Westenberg, H. G. M",2017.0,http://dx.doi.org/10.1016/j.eurpsy.2016.06.011,0,0,
2190, Clinical features of serous retinopathy observed with cobimetinib in patients with BRAF-mutated melanoma treated in the randomized coBRIM study," BACKGROUND: Serous chorioretinopathy has been associated with MEK inhibitors, including cobimetinib. We describe the clinical features of serous retinopathy observed with cobimetinib in patients with BRAF METHODS: In the coBRIM study, 493 patients were treated in two randomly assigned treatment groups: cobimetinib and vemurafenib (n = 247) or vemurafenib (n = 246). All patients underwent prospective ophthalmic examinations at screening, at regular intervals during the study, and whenever ocular symptoms developed. Patients with serous retinopathy were identified in the study database using a group of relevant and synonymous adverse event terms. RESULTS: Eighty‚Äêsix serous retinopathy events were reported in 70 patients (79 events in 63 cobimetinib and vemurafenib‚Äêtreated patients vs seven events in seven vemurafenib‚Äêtreated patients). Most patients with serous retinopathy identified by ophthalmic examination had no symptoms or had mild symptoms, among them reduced visual acuity, blurred vision, dyschromatopsia, and photophobia. Serous retinopathy usually occurred early during cobimetinib and vemurafenib treatment; median time to onset was 1.0 month. Most events were managed by observation and continuation of cobimetinib without dose modification and resolved or were resolving by the data cutoff date (19 Sept 2014). CONCLUSIONS: Cobimetinib treatment was associated with serous retinopathy in patients with BRAF"," de la Cruz-Merino, L;  Di Guardo, L;  Grob, JJ;  Venosa, A;  Larkin, J;  McArthur, GA;  Ribas, A;  Ascierto, PA;  Evans, JTR;  Gomez-Escobar, A;  et al.",2017.0, 10.1186/s12967-017-1246-0,0,0,
2191,Harm expectancy violation during exposure therapy for posttraumatic stress disorder.,"Exposure therapy has proven efficacy in the treatment of posttraumatic stress disorder (PTSD). Emotional processing theory proposes that fear habituation is a central mechanism in symptom reduction, but the empirical evidence supporting this is mixed. Recently it has been proposed that violation of harm expectancies is a crucial mechanism of action in exposure therapy. But to date, changes in harm expectancies have not been examined during exposure therapy in PTSD. The goal of the current study was to examine harm expectancy violation as mechanism of change in exposure therapy for posttraumatic stress disorder (PTSD). Patients (N=50, 44 female) with a primary diagnosis of chronic PTSD received intensive exposure therapy. Harm expectancies, harm experiences and subjective units of distress (SUDs) were assessed at each imaginal exposure session, and PTSD symptoms were assessed pre- and posttreatment with the Clinician Administered PTSD Scale (CAPS). Results showed that harm expectancies were violated within and strongly declined in-between exposure therapy sessions. However, expectancy violation was not related to PTSD symptom change. Fear habituation measures were moderately related to PTSD symptom reductions. In line with theory, exposure therapy promotes expectancy violation in PTSD patients, but this is not related to exposure therapy outcome. More work is warranted to investigate mechanisms of change during exposure therapy in PTSD.",de Kleine RA.; Hendriks L.; Becker ES.; Broekman TG.; van Minnen A.,2017.0,10.1016/j.janxdis.2017.03.008,0,0,
2192,Tobacco use and lower accuracy in a novel facial detection task,"The aim of the present study was to investigate the ways in which tobacco addiction affects a person's ability to recognize facial patterns. Facial detection was assessed in 16 individuals with tobacco use disorder and 16 healthy nonsmokers. Facial stimuli were taken from the Ignatian Educational Foundation (FEI) database, from which 12 male and 12 female faces were randomly selected. In the facial detection task, the subjects' task was to detect the location of a face when it was presented with a face/nonface pair on the screen. The order of stimulus presentation was randomized within sessions. Bayesian adaptive estimation was used for stimulus presentation. Presentation times varied between 16.7 and 3,006 ms. Lower response accuracy was associated with worse discrimination. No predictive effects of the cognitive tests on facial detection were found. A person's ability of facial detection can be applied to provide initial descriptions of impairments in the visual processing system. Early stage visual processing is impaired by chronic smoking, and subjects are able to recognize this. Therefore, there is a possibility of reversing this effect and promoting a better prognosis. The present task has biopsychosocial applications and may improve smokers' health by detecting subtle initial changes in visual processing.",De Almeida N.L.; Fernandes T.M.P.; Comfort W.E.M.; Dos Santos N.A.,2018.0,10.1037/pne0000144,0,0,
2193, Attention bias dynamics and symptom severity during and following CBT for social anxiety disorder," METHOD: Adults with social anxiety disorder (N = 39) assigned to either yohimbine‚Äê or placebo‚Äêaugmented CBT completed measures of attention bias and social anxiety symptom severity weekly throughout CBT (5 sessions) and at 1‚Äêweek and 1‚Äêmonth posttreatment. RESULTS: TLBSs of attention bias temporal dynamics showed stronger psychometric properties than mean aggregated scores and were highly interrelated, in line with within‚Äêsubject temporal variability fluctuating in time between attentional overengagement and strategic avoidance from threat. Attention bias toward threat and temporal variability in attention bias (i.e., attentional dysregulation), but not attention bias away from threat, significantly reduced over the course of CBT. Cross‚Äêlag analyses revealed no evidence of a causal relation between reductions in attentional dysregulation leading to symptom severity reduction, or vice versa. Observed relations did not vary as a function of time. CONCLUSIONS: We found no evidence for attentional dysregulation as a causal mechanism for symptom reduction in CBT for social anxiety disorders. Implications for future research are discussed. (PsycINFO Database Record OBJECTIVE: Threat‚Äêrelated attention bias figures prominently in contemporary accounts of the maintenance of anxiety disorders, yet longitudinal intervention research relating attention bias to anxiety symptom severity is limited. Capitalizing on recent advances in the conceptualization and measurement of attention bias, we aimed to examine the relation between attention bias, indexed using trial‚Äêlevel bias scores (TLBSs) to quantify temporal dynamics reflecting dysregulation of attentional processing of threat (as opposed to aggregated mean bias scores) and social anxiety symptom severity over the course of cognitive‚Äêbehavioral therapy (CBT) and 1‚Äêmonth follow‚Äêup."," Davis, ML;  Rosenfield, D;  Bernstein, A;  Zvielli, A;  Reinecke, A;  Beevers, CG;  Koster, EH;  Smits, JA",2016.0, 10.1037/ccp0000125,0,0,
2194,A behavioral intervention for death anxiety in nurses,,"White PD, Gilner FH, Handal PJ, Napoli JG",1984.0,,0,0,
2195,Does cognitive-behavioral therapy response among adults with obsessive-compulsive disorder differ as a function of certain comorbidities?,"This study examines the impact of several of the most common comorbid psychiatric disorders (i.e., generalized anxiety disorder (GAD); major depressive disorder (MDD); social phobia, and panic disorder) on cognitive-behavioral therapy (CBT) response in adults with obsessive-compulsive disorder (OCD). One hundred and forty-three adults with OCD (range=18-79 years) received 14 sessions of weekly or intensive CBT. Assessments were conducted before and after treatment. Primary outcomes included scores on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), response rates, and remission status. Sixty-nine percent of participants met criteria for at least one comorbid diagnosis. Although baseline OCD severity was slightly higher among individuals with OCD+MDD and OCD+GAD (in comparison to those with OCD-only), neither the presence nor the number of pre-treatment comorbid disorders predicated symptom severity, treatment response, remission, or clinically significant change rates at post-treatment. These data suggest that CBT for OCD is robust to the presence of certain common Axis-I comorbidities.",Storch EA.; Lewin AB.; Farrell L.; Aldea MA.; Reid J.; Geffken GR.; Murphy TK.,2010.0,10.1016/j.janxdis.2010.03.013,0,0,
2196,Neurosubstrates of remission following prolonged exposure therapy in veterans with posttraumatic stress disorder.,"Prolonged exposure (PE) therapy is the first-line treatment for posttraumatic stress disorder (PTSD) in combat veterans. The underlying brain changes of treatment effect in PTSD are currently unknown. A total of 31 veterans with PTSD completed an fMRI scan performing an affective anticipation task at baseline and were enrolled in PE therapy. Of these, 7 prematurely terminated therapy, while 24 individuals completed PE therapy and an identical follow-up fMRI scan. At follow-up, 15 of the 24 completers still had diagnosable PTSD (NR-PTSD) and 9 of the 24 completers showed complete remission from PTSD (R-PTSD), i.e. they did not meet diagnostic criteria for PTSD. The left anterior insula showed a significant group by scan session interaction. Specifically, the R-PTSD group showed decreased activation during anticipation of negative images from pre- to posttreatment scans, while the NR-PTSD group showed increased activation during anticipation of positive images in this region. Furthermore, the change in functional activation in the insula co-occurred with increased connectivity between this insular region and the right cingulate and right mid-posterior insular region in R-PTSD. These findings suggest that the capacity to effectively remit from PTSD symptoms after PE treatment requires the ability to connect with physiological signals and moderate the discomfort of anticipatory anxiety of exposure therapy. These processes appear to be controlled by a network where the anterior insula is connected with the cingulate and the mid-posterior insula.",Simmons AN.; Norman SB.; Spadoni AD.; Strigo IA.,2013.0,10.1159/000348867,0,0,
2197,Acceptability of virtual reality interoceptive exposure for the treatment of panic disorder with agoraphobia,"Interoceptive exposure (IE) is a standard component of cognitive-behavioural therapy (CBT) for panic disorder and agoraphobia. The virtual reality (VR) program ‘Panic-Agoraphobia’ has several virtual scenarios designed for applying exposure to agoraphobic situations; it can also simulate physical sensations. This work examines patients’ acceptability of the IE component as applied in two different ways: using VR versus traditional IE. Additionally, it explores the relationship between users’ treatment expectations and satisfaction and clinically significant change. Results showed that VR and traditional IE were well accepted by all participants. Furthermore, treatment expectations predicted efficacy.","Quero, Soledad; Pérez-Ara, M. Ángeles; Bretón-López, Juana; García-Palacios, Azucena; Baños, Rosa M.; Botella, Cristina",2014.0,10.1080/03069885.2013.852159,0,0,
2198,Treatment outcome of female agoraphobics 3-9 years after exposure in vivo: a comparison with healthy controls.,"It is well documented that most agoraphobics, with or without panic disorder, respond to exposure in vivo. But only little data compared their anxiety levels at follow-up (FU) with those of healthy controls. Forty-two female agoraphobics with or without panic disorder participated in FUs 3-9 years after exposure in vivo. Agoraphobic symptoms were compared to data of 42 healthy controls, who were matched according to gender, age, marital and occupational status. Remission criteria were defined from agoraphobia scores of the controls. A total of 17 (40%) of the patients had no further agoraphobic symptoms at all. A total of 15 (36%) patients still had mild-to-moderate agoraphobic symptoms at FU. A total of 10 (24%) were non-responders and suffered from severe agoraphobia at FU. The percentage of treated patients with complete remission is much higher than previously reported. However, the majority still suffer from mild or severe agoraphobic symptoms and could possibly benefit from additional interventions.",Peter H.; Brückner E.; Hand I.; Rohr W.; Rufer M.,2008.0,10.1016/j.jbtep.2006.05.004,0,0,
2199,Cognitive-Behavioural Therapy and Psychodynamic Psychotherapy in the Treatment of Combat-Related Post-Traumatic Stress Disorder: A Comparative Effectiveness Study.,"This study compared the effectiveness of two psychotherapy approaches for treating combat veterans with chronic post-traumatic stress disorder (PTSD): cognitive-behavioural therapy (CBT) and psychodynamic psychotherapy (PDT). These treatments are routinely used by the Unit for Treatment of Combat-Related PTSD of the Israel Defense Forces (IDF). IDF veterans with chronic PTSD were assigned to either CBT (n = 148) or PDT (n = 95) based on the nature of their complaint and symptoms. Psychiatric status was assessed at baseline, post-treatment and 8-12 months follow-up using the Clinician-Administered PTSD Scale, the PTSD Questionnaire, the Montgomery and Asberg Depression Rating Scale and the Psychotherapy Outcome Assessment and Monitoring System-Trauma Version assessment questionnaire. Both treatment types resulted in significant reduction in symptoms and with improved functioning from pre-treatment to post-treatment, which were maintained at follow-up. No differences between the two treatments were found in any the effectiveness measures. At post-treatment, 35% of the CBT patients and 45% of the PDT patients remitted, with no difference between the groups. At follow-up, remission rates were 33% and 36% for the CBT and PDT groups, respectively. The study recommends further randomized controlled trials to determine treatment efficacy. Copyright © 2015 John Wiley & Sons, Ltd. Both cognitive-behavioural therapy and psychodynamic psychotherapy have to be treatments offered in clinics for treating PTSD. Therapists who treat PTSD should be familiar with cognitive-behavioural and dynamic methods. The type of treatment chosen should be based on thorough psychosocial assessment.",Levi O.; Bar-Haim Y.; Kreiss Y.; Fruchter E.,2016.0,10.1002/cpp.1969,0,0,
2200,Randomized controlled trial of acceptance and commitment therapy versus traditional cognitive behavior therapy for social anxiety disorder: Symptomatic and behavioral outcomes,"Only two trials have compared acceptance and commitment therapy (ACT) and traditional cognitive behavior therapy (tCBT) in the treatment of social anxiety disorder (SAD), with both finding no significant differences. These trials did not examine effects on observer-rated behavioral outcomes and did not explicitly quantify the dose of exposure therapy within each treatment. In a replication trial, one hundred and two individuals with SAD (per DSM-IV criteria) were randomized to 12 sessions of ACT (n = 49) or tCBT (n = 53) controlling for exposure dose and assessing behavioral outcomes. Assessments were completed at pre- and post-treatment using clinician-rated and self-report measures of social anxiety, quality of life, and overall functioning. Observer-rated behavioral measures of social performance were completed for a subsample of participants. Results indicated that participants across conditions received equivalent doses of exposure. Those who received tCBT evidenced greater improvements in self-reported social anxiety symptoms and overall functioning, which contrasts with prior studies finding no differences between tCBT and ACT in the treatment of social anxiety. Medium effect sizes, while not statistically significant, indicate that ACT participants may have had greater improvements in observer-rated social behavior than tCBT participants. The discrepancy between these symptom and behavioral outcomes, building upon prior literature, calls for more research to assess the differences between tCBT and ACT treatments in behavioral domains.","Herbert, James D.; Forman, Evan M.; Kaye, Joanna L.; Gershkovich, Marina; Goetter, Elizabeth; Yuen, Erica K.; Glassman, Lisa; Goldstein, Stephanie; Hitchcock, Peter; Tronieri, Jena Shaw; Berkowitz, Staci; Marando-Blanck, Stephanie",2018.0,10.1016/j.jcbs.2018.07.008,0,0,
2201,A Naturalistic Comparison of Group Transdiagnostic Behaviour Therapy (TBT) and Disorder-Specific Cognitive Behavioural Therapy Groups for the Affective Disorders,"<p> <bold>Background:</bold> Transdiagnostic psychotherapies are designed to apply the same underlying treatment principles across a set of psychiatric disorders, without significant tailoring to specific diagnoses. Several transdiagnostic psychotherapy protocols have been developed recently, each of which has its own strengths and weaknesses. One promising treatment is Transdiagnostic Behaviour Therapy (TBT), in that it is one of the few transdiagnostic treatments to date shown to be effective in patients with depressive and anxiety disorders. However, TBT has only been investigated via individual psychotherapy. <bold>Aims:</bold> The present study investigated the effectiveness of a group protocol for TBT, compared with disorder-specific group psychotherapies, in a naturalistic setting. <bold>Method:</bold> 109 participants with various diagnoses of affective disorders completed either group TBT ( <italic>n</italic> = 37) or a disorder-specific group psychotherapy ( <italic>n</italic> = 72). Measures included assessments of psychiatric symptomatology and transdiagnostic impairment at baseline and post-treatment. <bold>Results:</bold> Overall, participants in the TBT group demonstrated significant improvements across all measures. When compared with disorder-specific groups, no statistical differences were observed between groups across symptoms; however, participants in the TBT group demonstrated roughly twice the treatment effect sizes in transdiagnostic impairment compared with participants in the disorder-specific groups. In addition, when participants from the most well-represented diagnosis and disorder-specific treatment (social anxiety disorder) were investigated separately, participants in the TBT group demonstrated significantly larger improvements in comorbid depressive symptoms than participants in the disorder-specific treatment. <bold>Conclusions:</bold> Pending replication and additional comparison studies, group TBT may provide an effective group treatment option for patients with affective disorders. </p>","Gros, Daniel F.; Merrifield, Colleen; Rowa, Karen; Szafranski, Derek D.; Young, Lisa; McCabe, Randi E.",2018.0,10.1017/S1352465818000309,0,0,
2202,Cognitive-behavioral group treatment for panic disorder with agoraphobia.,"Cognitive-behavioral therapy (CBT) is well documented in the treatment of panic disorder with or without agoraphobia; however, little is known about the efficacy of group treatment. The purpose of this open study is to investigate the benefits of a combination of the major cognitive and behavioral techniques used in the several specific versions of CBT thus far developed, in a psychotherapeutic group approach for panic and agoraphobia. Seventy-six outpatients meeting the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised (DSM-III-R; American Psychiatric Association, 1987) criteria for panic disorder with or without agoraphobia were included in the study. The treatment consisted of 14 weekly 2-hr group sessions and included: (a) an educational component, (b) interoceptive exposure, (c) cognitive restructuring, (d) problem solving, and (e) in vivo exposure. Patients achieved significant treatment gains on all dimensions assessed with a high rate of panic remission and significant improvement in the associated symptoms. Furthermore, these gains were maintained at 6-months' follow-up. Our results suggest the feasibility of this combination of cognitive and behavioral techniques. The findings raise questions about the specificity and the impact of each technique.",Galassi F.; Quercioli S.; Charismas D.; Niccolai V.; Barciulli E.,2007.0,10.1002/jclp.20358,0,0,
2203,Cognitive behaviour therapy for good and poor prognosis generalized anxiety disorder: A clinical effectiveness StudyF,"Cognitive behaviour therapy (CBT) for generalized anxiety disorder\nproduces variable results. It would be valuable to identify which\npatients respond well to brief CBT and whether increased intensity of\ntherapy improves outcome for those with a poor prognosis. This clinical\neffectiveness study was designed to address these issues using a\nprognostic index developed from earlier research. Suitable patients were\ngiven five sessions of CBT if they had a good prognosis and either 9 or\n15 sessions of CBT if they had a poor prognosis. There was no evidence\nthat increasing the intensity of therapy for poor prognosis patients\nimproved outcome and 60% remained cases at 6 month follow-up. In\ncontrast, only 12% of good prognosis patients remained cases at\nfollow-up despite receiving only brief therapy. Patient characteristics\nare a more powerful influence on outcome than the length of therapy.\nPrognostic indices may have an important place in routine clinical\npractice. Copyright (C) 2004 John Wiley Sons, Ltd.","Durham, R C; Fisher, P L; Dow, M G T; Sharp, D; Power, K G; Swan, J S; Morton, R V",2004.0,10.1002/cpp.405,0,0,
2204,Changes in quality of life following cognitive-behavioral therapy for obsessive-compulsive disorder.,"Cognitive-behavioral therapy (CBT) incorporating exposure and response prevention is a first line treatment for obsessive-compulsive disorder (OCD). Although, the efficacy of CBT in reducing OCD symptoms is well documented, less is known about its effects on quality of life (QOL). In the current study, functional impairment aspects of QOL (as measured by the Sheehan Disability Scale) were assessed among 70 adult outpatients with OCD before and after CBT. Statistically significant improvements in QOL and large pre- to post-treatment effect sizes were observed for work, social, and family functioning. Improvements in social and family functioning were predicted by improvements in OCD symptom severity even after controlling for improvements in depressive symptoms. In addition, clinically significant change in OCD symptoms and QOL were highly related, although there was a subset of participants whose symptoms improved without corresponding improvements in QOL. These results suggest that the effects of CBT may extend beyond OCD symptom reduction to QOL.",Diefenbach GJ.; Abramowitz JS.; Norberg MM.; Tolin DF.,2007.0,10.1016/j.brat.2007.04.014,0,0,
2205,Group cognitive behavior therapy for Japanese patients with social anxiety disorder: preliminary outcomes and their predictors.,"A number of studies have provided strong evidence for the use of cognitive behavior therapy (CBT) in the treatment of social anxiety disorder (SAD). However, all of the previous reports were from Europe and North America and it is unknown whether Western psychological therapies are effective for SAD in non-Western cultures. The present pilot study aimed to evaluate CBT program for SAD which was originally developed for Western patients, among Japanese patients. Fifty-seven outpatients who participated in group CBT for SAD were evaluated using eight self-reported and one clinician-administered questionnaires to measure various aspects of SAD symptomatology at the beginning and at the end of the program. Pre- and post-treatment scores were compared and the magnitude of treatment effect was quantified as well based once on the intention-to-treat (ITT) and once among the completers only. We also examined baseline predictors of the CBT outcomes. Seven patients (12%) did not complete the program. For the ITT sample, the percentage of reduction was 20% to 30% and the pre to post treatment effect sizes ranged from 0.37 to 1.01. Among the completers, the respective figures were 20% to 33% and 0.41 to 1.19. We found no significant pretreatment predictor of the outcomes. Group CBT for SAD is acceptable and can bring about a similar degree of symptom reduction among Japanese patients with SAD as among Western patients.",Chen J.; Nakano Y.; Ietzugu T.; Ogawa S.; Funayama T.; Watanabe N.; Noda Y.; Furukawa TA.,2007.0,10.1186/1471-244X-7-69,0,0,
2206,Group versus individual cognitive treatment for obsessive-compulsive disorder: Changes in severity at post-treatment and one-year follow-up.,"Very few studies have compared the efficacy of individual and group cognitive behaviour therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) by taking into consideration the change in OCD severity in both the short and long term. To conduct an open trial of individual versus group CBT for OCD, comparing the clinical and statistically significant changes in severity both at post-treatment and one year later. Forty-two OCD subjects were assigned to individual (n = 18) or group CBT (n = 24, in four groups). Sixteen and 22 subjects completed the treatment in the individual and group conditions, respectively. The Yale-Brown Obsessive Compulsive Scale was recorded at pre-treatment, post-treatment and at the one-year follow-up. At the end of treatment, the clinically significant change was comparable for the two treatment conditions and remained stable at the one-year follow-up. Of the 16 participants who completed the individual CBT treatment, 68.75% were classified as recovered at post-treatment, compared to 40.9% of those receiving group CBT. At follow-up the rate of recovery decreased to 62.5% in individual CBT and to 31.8% in group CBT. Group CBT is effective in decreasing OCD severity. The post-treatment changes were maintained one year later. Nevertheless, these changes were higher in the individual delivery of CBT.",Cabedo E.; Belloch A.; Carrió C.; Larsson C.; Fernández-Alvarez H.; García F.,2010.0,10.1017/S135246580999066X,0,0,
2207,Full remission and relapse of obsessive-compulsive symptoms after cognitive-behavioral group therapy: a two-year follow-up.,"The aim of this study was to assess whether the results obtained with 12 sessions of cognitive-behavioral group therapy with obsessive-compulsive patients were maintained after two years, and whether the degree of symptom remission was associated with relapse. Forty-two patients were followed. The severity of symptoms was measured at the end of cognitive-behavioral group therapy and at 18 and 24 months of follow-up. The assessment scales used were the Yale-Brown Obsessive-Compulsive Scale, Clinical Global Impression, Beck Depression Inventory, and Beck Anxiety Inventory. The reduction in symptom severity observed at the end of treatment was maintained during the two-year follow-up period (F = 57.881; p < 0.001). At the end of the treatment, 9 (21.4%) patients presented full remission, 22 (52.4%) presented partial remission, and 11 (26.2%) had unchanged scores in the Yale-Brown Obsessive-Compulsive Scale. After two years, 13 patients (31.0%) presented full remission, 20 (47.6%) had partial remission, and 9 (21.4%) had unchanged Yale-Brown Obsessive-Compulsive Scale scores. The full remission of symptoms at the end of the treatment was a protective factor against relapse (chi2 = 4,962; df = 1; p = 0.026). Our findings underscore the importance of attaining full remission of obsessive-compulsive symptoms during treatment and the need for new therapeutic strategies to achieve this.",Braga DT.; Manfro GG.; Niederauer K.; Cordioli AV.,2010.0,,0,0,
2208,Empirically grounded clinical interventions: Cognitive versus behaviour therapy in the individual treatment of obsessive-compulsive disorder: Changes in cognitions and clinically significant outcomes at post-treatment and one-year follow-up,"Clinical significance analyses of controlled studies comparing Exposure and Response Prevention (ERP) and Cognitive Therapy (CT) in the treatment of Obsessive-Compulsive Disorder (OCD) are scarce. The objective of this study is to compare the clinical efficacy of ERP and CT for OCD patients, and the usefulness of each in changing dysfunctional beliefs and thought control strategies at post-treatment and at a one-year follow-up. The two treatments were delivered on the basis of a routine clinical practice in a public-mental health service. Thirty-three OCD patients were randomly assigned to ERP or CT, and 29 completed the treatments (13 in ERP and 16 in CT). The ERP applied was in vivo, gradual and therapist-guided. The CT was designed to challenge all the cognitive domains considered relevant for OCD, using cognitive techniques. The improvement and recovery rates (YBOCS) were slightly superior for CT than for ERP (ERP: 69.23% and 61.53%, respectively; CT: 81.25% and 68.75%, respectively). These therapeutic outcomes were maintained after the two treatments: at the one-year follow-up, 53.85% of the treated patients remained free of symptoms in ERP, and 65.5% in CT. Finally, the two treatments were equally effective in modifying dysfunctional beliefs, and the outcomes at the end of the treatments were maintained, or even increased, one year later. (copyright) 2008 British Association for Behavioural and Cognitive Psychotherapies.","Belloch, Amparo; Cabedo, Elena; Carrió, Carmen",2008.0,10.1017/S1352465808004451,0,0,
2209,1 Bakhshani 2007.pdf,,,,,0,0,
2210,Community based cognitive therapy in the treatment of posttraumatic stress disorder following the Omagh bomb.,"Studies in academic research centres with selected patients have shown that several cognitive behaviour therapies are effective in the treatment of PTSD following traumas affecting individuals or small groups. Little information is available on the extent to which these positive findings will generalize to more routine clinical settings with less selected patients or to a trauma that affects a whole community. The present study addresses these generalization issues. A consecutive series of 91 patients with PTSD resulting from a car bomb which exploded in the centre of Omagh, Northern Ireland in August 1998 were treated with cognitive therapy, along lines advocated by Ehlers and Clark (2000). There were no major exclusion criteria and 53% of patients had an additional axis I disorder (comorbidity). Therapists were NHS staff with heavy caseloads and modest prior training in CBT for PTSD. A brief training in specialist procedures for PTSD was provided. Patients received an average of eight treatment sessions. Significant and substantial improvements in PTSD were observed. Degree of improvement was comparable to that in previously reported research trials. Comorbidity was not associated with poorer outcome, perhaps because comorbid patients were given more sessions of treatment (average 10 vs 5 sessions). Patients who were physically injured improved less than those who were not physically injured. Overall, the results indicate that the positive findings obtained in research settings generalize well to a frontline, non-selective service.",Gillespie K.; Duffy M.; Hackmann A.; Clark DM.,2002.0,,0,0,
2211,Cognitive-behavioral therapy with and without medication in the treatment of obsessive-compulsive disorder.,"Cognitive-behavioral therapy (CBT) and pharmacotherapy with serotonin reuptake inhibitors (SRIs) are established monotherapies for obsessive-compulsive disorder (OCD), yet research on their combined efficacy is lacking. Practicing psychologists who treat OCD are thus unable to say definitively whether exposure and ritual prevention would be more successful with concomitant SRI pharmacotherapy. The authors explored this issue in a clinical sample of 56 outpatients who received fee-for-service CBT; 31 (55%) received CBT alone, and 25 (45%) received CBT plus SRI. Both groups made clinically significant and comparable posttreatment gains, suggesting that CBT is effective with or without concomitant pharmacotherapy. Clinical implications are discussed. (PsycINFO Database Record (c) 2013 APA, all rights reserved). (journal abstract)","Franklin, Martin E.; Abramowitz, Jonathan S.; Bux, Donald A., Jr.; Zoellner, Lori A.; Feeny, Norah C.",2002.0,10.1037//0735-7028.33.2.162,0,0,
2212,Implementation of cognitive therapy for PTSD in routine clinical care: effectiveness and moderators of outcome in a consecutive sample.,"Trauma-focused psychological treatments are recommended as first-line treatments for Posttraumatic Stress Disorder (PTSD), but clinicians may be concerned that the good outcomes observed in randomized controlled trials (RCTs) may not generalize to the wide range of traumas and presentations seen in clinical practice. This study investigated whether Cognitive Therapy for PTSD (CT-PTSD) can be effectively implemented into a UK National Health Service Outpatient Clinic serving a defined ethnically mixed urban catchment area. A consecutive sample of 330 patients with PTSD (age 17-83) following a wide range of traumas were treated by 34 therapists, who received training and supervision in CT-PTSD. Pre and post treatment data (PTSD symptoms, anxiety, depression) were collected for all patients, including dropouts. Hierarchical linear modeling investigated candidate moderators of outcome and therapist effects. CT-PTSD was well tolerated and led to very large improvement in PTSD symptoms, depression and anxiety. The majority of patients showed reliable improvement/clinically significant change: intent-to-treat: 78.8%/57.3%; completer: 84.5%/65.1%. Dropouts and unreliable attenders had worse outcome. Statistically reliable symptom exacerbation with treatment was observed in only 1.2% of patients. Treatment gains were maintained during follow-up (M=280 days, n=220). Few of the selection criteria used in some RCTs, demographic, diagnostic and trauma characteristics moderated treatment outcome, and only social problems and needing treatment for multiple traumas showed unique moderation effects. There were no random effects of therapist on symptom improvement, but therapists who were inexperienced in CT-PTSD had more dropouts than those with greater experience. The results support the effectiveness of CT-PTSD and suggest that trauma-focused cognitive behavior therapy can be successfully implemented in routine clinical services treating patients with a wide range of traumas.",Ehlers A.; Grey N.; Wild J.; Stott R.; Liness S.; Deale A.; Handley R.; Albert I.; Cullen D.; Hackmann A.; Manley J.; McManus F.; Brady F.; Salkovskis P.; Clark DM.,2013.0,10.1016/j.brat.2013.08.006,0,0,
2213,Intensive cognitive therapy for PTSD: a feasibility study.,"Cognitive Behaviour Therapy (CBT) of anxiety disorders is usually delivered in weekly or biweekly sessions. There is evidence that intensive CBT can be effective in phobias and obsessive compulsive disorder. Studies of intensive CBT for posttraumatic stress disorder (PTSD) are lacking. A feasibility study tested the acceptability and efficacy of an intensive version of Cognitive Therapy for PTSD (CT-PTSD) in 14 patients drawn from consecutive referrals. Patients received up to 18 hours of therapy over a period of 5 to 7 working days, followed by 1 session a week later and up to 3 follow-up sessions. Intensive CT-PTSD was well tolerated and 85.7 % of patients no longer had PTSD at the end of treatment. Patients treated with intensive CT-PTSD achieved similar overall outcomes as a comparable group of patients treated with weekly CT-PTSD in an earlier study, but the intensive treatment improved PTSD symptoms over a shorter period of time and led to greater reductions in depression. The results suggest that intensive CT-PTSD is a feasible and promising alternative to weekly treatment that warrants further evaluation in randomized trials.",Ehlers A.; Clark DM.; Hackmann A.; Grey N.; Liness S.; Wild J.; Manley J.; Waddington L.; McManus F.,2010.0,10.1017/S1352465810000214,0,0,
2214,Assessment and treatment of nocturnal panic attacks.,"Nocturnal panic (NP), waking from sleep in a state of panic, is a common occurrence among patients with panic disorder, with 44-71% reporting at least one such attack. NP is a non-REM event that is distinct from sleep terrors, sleep apnea, nightmares or dream-induced arousals. This review outlines recent advances in the characterization of NP, as well as current approaches to the assessment and treatment of NP. In contrast to earlier work, more recent studies suggest that patients with NP do not differ from patients without NP on sleep architecture, sleep physiology, self-reported sleep quality and severity of panic disorder. However, more precise measurement of physiological precipitants and features is warranted. Assessment of NP focuses on ruling out other explanations for NP, with differential diagnosis based on interviews, sleep polysomnography and ambulatory recording of sleep. Psychological treatment (cognitive-behavioral therapy) targets misappraisals of anxiety sensations, hyperventilatory response, and conditioned reactions to internal, physical cues. Recent evidence supports the efficacy of this approach, however, controlled studies on pharmacological agents in the treatment of NP are lacking. Research is needed to examine the effects of combined cognitive-behavioral therapy and medications, compared to medication alone in the treatment of NP.",Craske MG.; Tsao JC.,2005.0,10.1016/j.smrv.2004.11.003,0,0,
2215,Treatment of agoraphobia with group exposure in vivo and imipramine.,"Seventy-six white agoraphobic women, 21 to 45 years old, were treated with combined group exposure in vivo and imipramine or placebo in a randomized double-blind study. A majority of the patients in both the placebo and imipramine groups showed moderate to marked improvement. However, imipramine therapy was significantly superior to placebo therapy on three of the four reported measures of improvement: primary phobia, spontaneous panic, and global improvement. There was a negative correlation between depression and outcome; ie, the more depressed patients fared worse on several outcome measures than those who were less depressed. A comparison of these patients with agoraphobic women previously treated with imipramine and imaginal desensitization showed a superiority of exposure in vivo midway in treatment, but no significant difference between the two groups at the completion of therapy.",Zitrin CM.; Klein DF.; Woerner MG.,1980.0,,0,0,
2216,"Dyadic predictors of outcome in a cognitive-behavioral program for patients with generalized anxiety disorder in committed relationships: a ""spoonful of sugar"" and a dose of non-hostile criticism may help.","The present study tested whether pre-treatment levels of partner hostility and non-hostile criticism predicted outcome in an individual cognitive-behavioral therapy package for generalized anxiety disorder (GAD). Eighteen patients with a principal or co-principal diagnosis of GAD were randomly allocated to a treatment condition (n=8) or a delayed treatment condition (n=10). In addition, the patients and their partners were videotaped discussing the patients' worries. These videotapes were later coded for levels of partner hostility and non-hostile criticism directed at the patients. Treatment resulted in statistically and clinically significant change at post-test. Finally, partner hostility predicted worse end-state functioning whereas partner non-hostile criticism predicted better end-state functioning.",Zinbarg RE.; Lee JE.; Yoon KL.,2007.0,10.1016/j.brat.2006.06.005,0,0,
2217,Collaborative interventions for physically injured trauma survivors: A pilot randomized effectiveness trial.,"Posttraumatic behavioral and emotional disturbances occur frequently among physically injured hospitalized trauma survivors. This investigation was a pilot randomized effectiveness trial of a 4-mo collaborative care intervention for injured motor vehicle crash and assault victims. As surgical inpatients, intervention subjects (Ss; N=16; mean age 35.3 yrs) were assigned to a trauma support specialist who provided counseling, consulted with surgical and primary care providers, and attempted postdischarge care coordination. Control Ss (N=18; mean age 32.5 yrs) received usual posttraumatic care. For all Ss, posttraumatic stress disorder (PTSD) and depressive symptoms, episodic alcohol intoxication, and functional limitations were evaluated during the hospitalization and 1 and 4 mo postinjury. Study logs and field notes revealed that over 75% of intervention activity occurred in the first month after the trauma. One-month post-trauma intervention Ss when compared to controls demonstrated statistically significant decreases in PTSD symptoms as well as a reduction in depressive symptoms. However, at the 4-mo assessment, intervention Ss evidenced no significant improvements in PTSD and depressive symptoms, episodic alcohol intoxication, or functional limitations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zatzick, Douglas F; Roy-Byrne, Peter; Russo, Joan E; Rivara, Frederick P; Koike, Alan; Jurkovich, Gregory J; Katon, Wayne; Andrykowski, Armstrong, Blanchard, Bonnie, Bordow, Brady, Breslau, Bryant, Chesnut, Danielsson, Dunn, Emanuel, Foa, Foa, Foa, Follette, Gentilello, Gentilello, Gentilello, Gerteis, Harvey, Hidalgo, Hingson, Hohmann, Holbrook, Holbrook, Katon, Katon, Katon, Kessler, Kleinman, Lane, Li, Marmar, Marmar, Mayou, McCaig, McDowell, McLellan, Michaels, Norris, Radloff, Rice, Rivara, Rivara, Rose, Rothman, Roy-Byrne, Shalev, Shalev, Sherbourne, Shinar, Silver, Soderstrom, Solomon, Von Korff, Ware, Weathers, Wessely, Zatzick, Zatzick, Zatzick, Zatzick",2001.0,,0,0,
2218,"Cognitive Behavioral Therapy for Patients with Social Anxiety Disorder Who Remain Symptomatic following Antidepressant Treatment: A Randomized, Assessor-Blinded, Controlled Trial.","Although antidepressants are still a commonly used treatment for social anxiety disorder (SAD), a significant proportion of patients fail to remit following antidepressants. However, no standard approach has been established for managing such patients. This study aimed to examine the effectiveness of cognitive behavioral therapy (CBT) as an adjunct to usual care (UC) compared with UC alone in SAD patients who remain symptomatic following antidepressant treatment. This was a prospective randomized open-blinded end-point study with two parallel groups (CBT + UC, and UC alone, both for 16 weeks) conducted from June 2012 to March 2014. SAD patients who remain symptomatic following antidepressant treatment were recruited, and a total sample size of 42 was set based on pilot results. Patients were randomly allocated to CBT + UC (n = 21) or UC alone (n = 21). After 16 weeks, adjusted mean reduction in the Liebowitz Social Anxiety Scale from baseline for CBT + UC and UC alone was -40.87 and 0.68, respectively; the between-group difference was -41.55 (-53.68 to -29.42, p < 0.0001). Response rates were 85.7 and 10.0% for CBT + UC and UC alone, respectively (p < 0.0001). The corresponding remission rates were 47.6 and 0.0%, respectively (p = 0.0005). Significant differences were also found in favor of CBT + UC for social anxiety symptoms, depressive symptoms, and functional impairment. Our results suggest that in SAD patients who have been ineffectively treated with antidepressants, CBT is an effective treatment adjunct to UC over 16 weeks in reducing social anxiety and related symptoms.",Yoshinaga N.; Matsuki S.; Niitsu T.; Sato Y.; Tanaka M.; Ibuki H.; Takanashi R.; Ohshiro K.; Ohshima F.; Asano K.; Kobori O.; Yoshimura K.; Hirano Y.; Sawaguchi K.; Koshizaka M.; Hanaoka H.; Nakagawa A.; Nakazato M.; Iyo M.; Shimizu E.,,10.1159/000444221,0,0,373
2219,The effectiveness of integrated treatment in patients with substance use disorders co-occurring with anxiety and/or depression-A group randomized trial.,"Background: Integrated Treatment (IT) has proved effective in treating patients with Substance Use Disorders (SUD) co-occurring with severe Mental Disorders (MD), less is known about the effectiveness of IT for patients with SUD co-occurring with less severe MD. The aim of this study was to investigate the effectiveness of IT for patients with SUD co-occurring with anxiety and/or depression on the following parameters: 1. The use of substances, as measured by the Alcohol Use Identification Test (AUDIT), the Drug Use Identification Test (DUDIT), and the Addiction Severity Index (EuropASI). 2. The severity of psychiatric symptoms, as measured by the Symptom Check List 90 r (SCL 90R). 3. The client's motivation for changing his/her substance use behaviour, as measured by the Substance Abuse Treatment Scale (SATSr). Methods: This is a group randomized clinical trial comparing the effectiveness of IT to treatment as usual in Community Mental Health Centres (CMHCs). Five CMHCs were drawn to the Intervention Group (IG) and four CMHCs to the Control Group (CG). The allocation to treatment conditions was not blinded. New referrals were screened with the AUDIT and the DUDIT. Those who scored above the cut-off level of these instruments were assessed with the Structured Clinical Interview for DSM-IV 1 and 2. We included patients with anxiety and/or depression together with one or more SUDs. Results: We included 55 patients in the IG and 21 in the CG. A linear multilevel model was used. Both groups reduced their alcohol and substance use during the trial, while there was no change in psychiatric symptoms in either group. However, the IG had a greater increase in motivation for substance use treatment after 12 months than had the CG with an estimate of 1.76, p = 0.043, CI95% (0.08; 3.44) (adjusted analyses). There were no adverse events. Conclusions: Integrated treatment is effective in increasing the motivation for treatment amongst patients with anxiety and/or depression together with SUD in outpatient clinics. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wusthoff, Linda E; Waal, Helge; Grawe, Rolf W; Altman, Baker, Baker, Baker, Bartels, Berman, Boutron, Burnam, Campbell, Cleary, Compton, Connors, Crome, Derogatis, Derogatis, Derogatis, Drake, Drake, Drake, English, First, First, Goldman, Grawe, Green, Grol, Hannes, Hasin, Hesse, Hopewell, Hopewell, Hotopf, Kendall, Kessler, Kessler, Kessler, Kirkhei, Kokkevi, Kypri, Lehman, Mangrum, McHugo, McLellan, Menezes, Merikangas, Miller, Miller, Miller, Miller, Minkoff, Minkoff, Moher, Moher, Mueser, Mueser, Osher, Polcin, Prochaska, Regier, Reinert, Rendell, Rush, Sacks, Saunders, Saunders, Schulz, Watkins, Weisner, Wing, Wing, Wusthoff, Wusthoff",2014.0,,0,0,
2220,The effectiveness of integrated treatment in patients with substance use disorders co-occurring with anxiety and/or depression--a group randomized trial.,"Integrated Treatment (IT) has proved effective in treating patients with Substance Use Disorders (SUD) co-occurring with severe Mental Disorders (MD), less is known about the effectiveness of IT for patients with SUD co-occurring with less severe MD.The aim of this study was to investigate the effectiveness of IT for patients with SUD co-occurring with anxiety and/or depression on the following parameters:1. The use of substances, as measured by the Alcohol Use Identification Test (AUDIT), the Drug Use Identification Test (DUDIT), and the Addiction Severity Index (EuropASI).2. The severity of psychiatric symptoms, as measured by the Symptom Check List 90 r (SCL 90R).3. The client's motivation for changing his/her substance use behaviour, as measured by the Substance Abuse Treatment Scale (SATSr). This is a group randomized clinical trial comparing the effectiveness of IT to treatment as usual in Community Mental Health Centres (CMHCs). Five CMHCs were drawn to the Intervention Group (IG) and four CMHCs to the Control Group (CG). The allocation to treatment conditions was not blinded. New referrals were screened with the AUDIT and the DUDIT. Those who scored above the cut-off level of these instruments were assessed with the Structured Clinical Interview for DSM-IV 1 and 2. We included patients with anxiety and/or depression together with one or more SUDs. We included 55 patients in the IG and 21 in the CG. A linear multilevel model was used. Both groups reduced their alcohol and substance use during the trial, while there was no change in psychiatric symptoms in either group. However, the IG had a greater increase in motivation for substance use treatment after 12 months than had the CG with an estimate of 1.76, p = 0.043, CI95% (0.08; 3.44) (adjusted analyses). There were no adverse events. Integrated treatment is effective in increasing the motivation for treatment amongst patients with anxiety and/or depression together with SUD in outpatient clinics. ClinicalTrials.gov: NCT00447733.",Wüsthoff LE.; Waal H.; Gråwe RW.,2014.0,10.1186/1471-244X-14-67,0,0,
2221,"A new psychological intervention: ""512 psychological intervention model"" used for military rescuers in Wenchuan Earthquake in China.","Objective: We sought to compare the efficacy of the ""512 Psychological Intervention Model"" (that is, ""512 PIM"", a new psychological intervention) with debriefing on symptoms of post-traumatic stress disorder (PTSD), anxiety and depression of Chinese military rescuers in relation to a control group that had no intervention. Method: We conducted a randomized controlled trial with 2,368 military rescuers 1 month after this event and then at follow-up 1, 2 and 4 months later to evaluate changes in symptoms of PTSD, anxiety and depression based on DSM-IV criteria, respectively. Results: Baseline analysis suggested no significant differences between the study groups. Severity of PTSD,anxiety and depression decreased over time in all three groups, with significant differences between the groups in symptoms of PTSD (P < 0.01). Compared with the debriefing and control group, significant lower scores of PTSD and positive efficacy in improving symptoms of reexperiencing, avoidance and hyperarousal were found in the ""512 PIM"" group. Conclusion: ""512 PIM"" was an effective psychological intervention for military rescuers in reducing symptoms of PTSD, anxiety and depression after a crisis. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wu, Shengjun; Zhu, Xia; Zhang, Yinling; Liang, Jie; Liu, Xufeng; Yang, Yebing; Yang, Hai; Miao, Danmin; Adler, Amer, Arendt, Armfield, Becker, Benight, Bisson, Bland, Bledsoe, Boscarino, Brailey, Brewin, Britton, Browne, Bodvarsdottir, Carlier, Carlier, Chemtob, Curtis, Davidson, De Gaglia, Deahl, Devilly, Devilly, Everly, Farhood, Gist, Greenberg, Horesh, Jacobs, Johansen, Kaplan, Kessler, Kozaric-Kovacic, Kroll, Lamb, Lincoln, Loo, Marmar, Mayou, McCaroll, McKenzie, McNally, Missinne, Mitchell, Mitchell, Neuner, Noy, Ozer, Priebe, Priebe, Raphael, Raphael, Rielly, Rose, Shalev, Sharpley, Sijbrandij, Smith, Ursano, Ursano, van Emmerik, Vogt, Waltz, Weiss, Whealin, Williams, Woodhead, Leilei, Zigmond",2012.0,,0,0,
2222,Psychotherapy for social anxiety disorder: long-term effectiveness of resource-oriented cognitive-behavioral therapy and cognitive therapy in social anxiety disorder.,"Resource-oriented cognitive-behavioral therapy (ROCBT) and cognitive therapy (CT) have been shown to be effective treatments for social anxiety disorder. However, so far few studies have examined the long-term effectiveness of these treatments. Thus, there is little information available about the durability of change in treated patients with social anxiety disorder. This study examined the effectiveness of both treatments at 2-year and 10-year follow-up assessments. Patients who received ROCBT or CT were re-contacted after 2 (n = 51), and 10 years (n = 27), respectively, and completed a battery of self-report questionnaires. Treatment gains were maintained over the 2-year follow-up on all measures. Furthermore, there was a significant improvement on 2 social anxiety measures between posttreatment and the 10-year follow-up. ROCBT and CT did not differ in overall effectiveness. The results suggest that both treatments are effective and durable approaches in the treatment of social anxiety disorder.",Willutzki U.; Teismann T.; Schulte D.,2012.0,10.1002/jclp.21842,0,0,
2223,Internet-based cognitive bias modification for obsessive compulsive disorder: study protocol for a randomized controlled trial.,"Cognitive bias modification (CBM) interventions have demonstrated efficacy in augmenting core biases implicated in psychopathology. The current randomized controlled trial (RCT) will evaluate the efficacy of an internet-delivered positive imagery cognitive bias modification intervention for obsessive compulsive disorder (OCD) when compared to a control condition. Patients meeting diagnostic criteria for a current or lifetime diagnosis of OCD will be recruited via the research arm of a not-for-profit clinical and research unit in Australia. The minimum sample size for each group (alpha set at 0.05, power at .80) was identified as 29, but increased to 35 to allow for 20% attrition. We will measure the impact of CBM on interpretations bias using the OC Bias Measure (The Ambiguous Scenarios Test for OCD ;AST-OCD) and OC-beliefs (The Obsessive Beliefs Questionnaire-TRIP; OBQ-TRIP). Secondary outcome measures include the Dimensional Obsessive-Compulsive Scale (DOCS), the Patient Health Questionnaire (PHQ-9), The Kessler Psychological Distress Scale (K10), and the Word Sentence Association Test for OCD (WSAO). Change in diagnostic status will be indexed using the OCD Mini International Neuropsychiatric Interview (M.I.N.I) Module at baseline and follow-up. Intent-to-treat (ITT) marginal and mixed-effect models using restricted maximum likelihood (REML) estimation will be used to evaluate the primary hypotheses. Stability of bias change will be assessed at 1-month follow-up. A limitation of the online nature of the study is the inability to include a behavioral outcome measure. The trial was registered on 10 October 2013 with the Australian New Zealand Clinical Trials Registry (ACTRN12613001130752).",Williams AD.; Pajak R.; O'Moore K.; Andrews G.; Grisham JR.,2014.0,10.1186/1745-6215-15-193,0,0,
2224,Group and individual treatment of obsessive-compulsive disorder using cognitive therapy and exposure plus response prevention: a 2-year follow-up of two randomized trials.,"Relatively little is known about the long-term durability of group treatments for obsessive-compulsive disorder (OCD) and contemporary cognitive treatments. The current study investigated the 2-year follow-up results for participants who completed randomized trials of group or individual treatment and received either cognitive therapy (CT) or exposure plus response prevention (ERP). Yale-Brown Obsessive Compulsive Scale (YBOCS) scores for individual ERP and CT were not significantly different over 2 years. However, YBOCS scores were consistently lower over time for group ERP participants than for group CT participants. With a single exception in the group treatment study, secondary cognitive and depression scores were stable, indicating that gains achieved during acute treatment were maintained over 2 years. Less than 10% of treatment completers relapsed in each of the treatment trials. Approximately 50% of the completer sample was rated as recovered at 2 years. Additionally, a tentative cross-study comparison suggests that CT was better tolerated and resulted in less dropout than did ERP. Despite the overall positive results, efficacy of OCD treatments has reached a plateau and may require a fresh perspective to move forward.",Whittal ML.; Robichaud M.; Thordarson DS.; McLean PD.,2008.0,10.1037/a0013076,0,0,
2225,Evaluating a multiple-family group access intervention for refugees with PTSD.,The purpose of this study was to analyze the effects of a multiple-family group in increasing access to mental health services for refugees with posttraumatic stress disorder (PTSD). This study investigated a nine-session multiple-family group called Coffee and Families Education and Support with refugee families from Bosnia-Herzegovina in Chicago. Adults with PTSD (n = 197) and their families were randomly assigned to receive either the intervention or a control condition. The results indicated that a multiple-family group was effective in increasing access to mental health services and that depression and family comfort with discussing trauma mediated the intervention effect. Further well-designed studies of family interventions are needed for developing evidence-based interventions for refugee families.,Weine S.; Kulauzovic Y.; Klebic A.; Besic S.; Mujagic A.; Muzurovic J.; Spahovic D.; Sclove S.; Pavkovic I.; Feetham S.; Rolland J.,2008.0,10.1111/j.1752-0606.2008.00061.x,0,0,
2226,The role of posttraumatic growth in a randomized controlled trial of cognitive-behavioral conjoint therapy for PTSD.,"Posttraumatic growth (PTG) is defined as a positive psychological change that can emerge following a traumatic life event. Although documented in noninterventional studies of traumatized individuals, there are scant data on the potential for therapy to induce or improve PTG. Thus, the primary goal of this study was to examine changes in PTG in a controlled trial of cognitive-behavioral conjoint therapy for posttraumatic stress disorder versus waitlist (CBCT for PTSD; Monson & Fredman, 2012). We also examined whether pretreatment relationship satisfaction and PTSD symptomatology moderated change in PTG. There were 40 couples (75% with a female partner with PTSD) who were randomized to either immediate CBCT for PTSD or a 3-month waitlist (WL). Compared to WL, individuals who received treatment immediately demonstrated a significant increase in PTG. There was a moderate effect size between-group difference (Hedge's g = 0.45). There was a nonsignificant relationship with a moderate effect size (Hedge's g = 0.65) for the positive effect of pretreatment relationship satisfaction on the trajectory of PTG, but no effect of pretreatment PTSD symptoms. Results suggested that CBCT for PTSD facilitated PTG, even with a limited focus on PTG in this conjoint intervention. Future research should target PTG as a treatment goal and further examine the role of close others in facilitating development of PTG. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Wagner, Anne C; Torbit, Lindsey; Jenzer, Tiffany; Landy, Meredith S. H; Pukay-Martin, Nicole D; Macdonald, Alexandra; Fredman, Steffany J; Monson, Candice M; Barskova, Blake, Calhoun, Cohen, Dekel, First, Hedges, Linley, Monson, Monson, Prati, Raudenbush, Spanier, Tedeschi, Tedeschi, Tedeschi, Zoellner",2016.0,,0,0,
2227,Psychotherapy with traumatised refugees--the design of a randomised clinical trial.,"There is little evidence as to which kind of psychotherapy is the most effective in the treatment of traumatised refugees. At the Competence Center for Transcultural Psychiatry, a series of clinical trials have been conducted since 2008. The first results are pending publication. The aim of this paper is to discuss some of the challenges in adapting Cognitive Behavioural Therapy (CBT) to the treatment of traumatised refugees, as well as describe a randomised clinical trial designed to test two such adaptations. In the described trial one group receives CBT with a focus on cognitive restructuring while the other group receives CBT focusing on Stress Management. A main goal of this setup is to test whether some, perhaps even most, of the traumatised refugees referred to treatment, may benefit from a more direct focus on current stress, and its alleviation through simple, repetitive exercises, compared to a focus on analysing and changing thought patterns.",Vindbjerg E.; Klimpke C.; Carlsson J.,2014.0,,0,0,
2228,One- vs. five-session treatment of intra-oral injection phobia: a randomized clinical study.,"The present study aimed to evaluate the effect of one and five sessions of treatment for intra-oral injection phobia in 55 subjects fulfilling the DSM-IV criteria for specific phobia. The subjects were randomly assigned to one or five sessions of cognitive behavioural therapy (CBT) performed by dentists. Assessments included behavioural tests and self-report instruments used pretreatment, post-treatment, and at 1 yr of follow-up. The dental anxiety scale (DAS), the injection phobia scale-anxiety, and the mutilation questionnaires were applied. Mean avoidance duration of intra-oral injections before treatment was 7.0 yr. The results showed that 89% of the subjects had received intra-oral injections from a regular dentist during the 1-yr follow-up. The only significant difference between the one- and the five-session groups was that the five-session group reported less anxiety (as measured using the DAS) at 1 yr of follow-up. It was concluded that both treatments performed by dentists specially trained in CBT have a significant treatment effect on the intra-oral injection phobia.",Vika M.; Skaret E.; Raadal M.; Ost LG.; Kvale G.,2009.0,10.1111/j.1600-0722.2009.00628.x,0,0,
2229,Cost-utility of brief psychological treatment for depression and anxiety.,"The cost-utility of brief therapy compared with cognitive-behavioural therapy (CBT) and care as usual in the treatment of depression and anxiety has not yet been determined. To assess the cost-utility of brief therapy compared with CBT and care as usual. A pragmatic randomised controlled trial involving 702 patients was conducted at 7 Dutch mental healthcare centres (MHCs). Patients were interviewed at baseline and then every 3 months over a period of 1.5 years, during which time data were collected on direct costs, indirect costs and quality of life. The mean direct costs of treatment at the MHCs were significantly lower for brief therapy than for CBT and care as usual. However, after factoring in other healthcare costs and indirect costs, no significant differences between the treatment groups could be detected. We found no significant differences in quality-adjusted life-years between the groups. Cost-utility did not differ significantly between the three treatment groups.",van Roijen LH.; van Straten A.; Al M.; Rutten F.; Donker M.,2006.0,10.1192/bjp.188.4.323,0,0,
2230,"Trauma-Focused Treatment in PTSD Patients With Psychosis: Symptom Exacerbation, Adverse Events, and Revictimization.","Most clinicians refrain from trauma treatment for patients with psychosis because they fear symptom exacerbation and relapse. This study examined the negative side effects of trauma-focused (TF) treatment in patients with psychosis and posttraumatic stress disorder (PTSD). Analyses were conducted on data from a single-blind randomized controlled trial comparing TF treatment (N = 108; 8 sessions prolonged exposure or eye movement desensitization) and waiting list (WL; N = 47) among patients with a lifetime psychotic disorder and current chronic PTSD. Symptom exacerbation, adverse events, and revictimization were assessed posttreatment and at 6-month follow-up. Also investigated were symptom exacerbation after initiation of TF treatment and the relationship between symptom exacerbation and dropout. Any symptom exacerbation (PTSD, paranoia, or depression) tended to occur more frequently in the WL condition. After the first TF treatment session, PTSD symptom exacerbation was uncommon. There was no increase of hallucinations, dissociation, or suicidality during the first 2 sessions. Paranoia decreased significantly during this period. Dropout was not associated with symptom exacerbation. Compared with the WL condition, fewer persons in the TF treatment condition reported an adverse event (OR = 0.48, P = .032). Surprisingly, participants receiving TF treatment were significantly less likely to be revictimized (OR = 0.40, P = .035). In these participants, TF treatment did not result in symptom exacerbation or adverse events. Moreover, TF treatment was associated with significantly less exacerbation, less adverse events, and reduced revictimization compared with the WL condition. This suggests that conventional TF treatment protocols can be safely used in patients with psychosis without negative side effects.",van den Berg DP.; de Bont PA.; van der Vleugel BM.; de Roos C.; de Jongh A.; van Minnen A.; van der Gaag M.,2016.0,10.1093/schbul/sbv172,0,0,
2231,Trauma-focused treatment for posttraumatic stress disorder combined with CBT for severe substance use disorder: a randomized controlled trial.,"This randomized controlled trial (RCT) investigated the effectiveness of a combined treatment for co-morbid Posttraumatic Stress Disorder (PTSD) and severe Substance Use Disorder (SUD). Structured Writing Therapy for PTSD (SWT), an evidence-based traumafocused intervention, was added on to Treatment As Usual (TAU), consisting of an intensive cognitive behavioral inpatient or day group treatment for SUD. The outcomes of the combined treatment (TAU + SWT) were compared to TAU alone in a sample of 34 patients. Results showed a general reduction of SUD symptoms for both TAU + SWT and TAU. Treatment superiority of TAU + SWT was neither confirmed by interaction effects (time x condition) for SUD or PTSD symptoms, nor by a group difference for SUD diagnostic status at post-treatment. However, planned contrasts revealed that improvements for PTSD severity over time were only significant within the TAU + SWT group. In addition, within the TAU + SWT group the remission of PTSD diagnoses after treatment was significant, which was not the case for TAU. Finally, at post-treatment a trend was noticed for between group differences for the number of PTSD diagnoses favoring TAU + SWT above TAU. In sum, the current study provides preliminary evidence that adding a trauma-focused treatment on to standard SUD treatment may be beneficial.",van Dam D.; Ehring T.; Vedel E.; Emmelkamp PM.,2013.0,10.1186/1471-244X-13-172,0,0,
2232,An Internet-based guided self-help intervention for panic symptoms: randomized controlled trial.,"Internet-based guided self-help is efficacious for panic disorder, but it is not known whether such treatment is effective for milder panic symptoms as well. To evaluate the effectiveness of Don't Panic Online, an Internet-based self-help course for mild panic symptoms, which is based on cognitive behavioral principles and includes guidance by email. A pragmatic randomized controlled trial was conducted. Participants (N=126) were recruited from the general population and randomized to either the intervention group or to a waiting-list control group. Inclusion criteria were a Panic Disorder Severity Scale-Self Report (PDSS-SR) score between 5-15 and no suicide risk. Panic symptom severity was the primary outcome measure; secondary outcome measures were anxiety and depressive symptom severity. Measurements were conducted online and took place at baseline and 12 weeks after baseline (T1). At baseline, diagnoses were obtained by telephone interviews. Analyses of covariance (intention-to-treat) showed no significant differences in panic symptom reduction between groups. Completers-only analyses revealed a moderate effect size in favor of the intervention group (Cohen's d=0.73, P=.01). Only 27% of the intervention group finished lesson 4 or more (out of 6). Nonresponse at T1 was high for the total sample (42.1%). Diagnostic interviews showed that many participants suffered from comorbid depression and anxiety disorders. The Internet-based guided self-help course appears to be ineffective for individuals with panic symptoms. However, intervention completers did derive clinical benefits from the intervention. Nederlands Trial Register: NTR1639; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1639 (Archived by WebCite at http://www.webcitation.org/6ITZPozs9).",van Ballegooijen W.; Riper H.; Klein B.; Ebert DD.; Kramer J.; Meulenbeek P.; Cuijpers P.,2013.0,10.2196/jmir.2362,0,0,
2233,Traumatic incident reduction: Brief treatment of trauma-related symptoms in incarcerated females.,"An experimental outcome study of female inmates with trauma-related symptoms was conducted in a federal prison to examine the effectiveness of Traumatic Incident Reduction (TIR), a brief, memory-based, therapeutic intervention, on symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, and low expectancy of success. An experimental control group design was used to evaluate the efficacy of TIR in a prison setting. The Posttraumatic Symptom Scale, The Beck Depression Inventory, the Clinical Anxiety Scale, and the Generalized Expectancy of Success Scale were administered in pretest, posttest, and a three-month follow-up format. Results revealed an amelioration of PTSD, depression, and anxiety symptoms in the experimental condition only across the posttest and follow-up periods. Concomitantly, the experimental condition showed significant increases in generalized expectancy of success, while the control condition did not. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Valentine, Pamela Vest",1997.0,,0,0,
2234,A multi-component cognitive-behavioral intervention for sleep disturbance in veterans with PTSD: a pilot study.,"A significant portion of US military personnel are returning from deployment with trauma-related sleep disturbance, and disrupted sleep has been proposed as a mechanism for the development of medical conditions in those with posttraumatic stress disorder (PTSD). Although individuals with PTSD may realize improved sleep with either PTSD treatment or CBT for insomnia, many continue to experience residual sleep difficulties. Newly developed interventions designed to address nightmares are effective to this end, but often do not fully remove all aspects of PTSD-related sleep difficulties when used in isolation. A combined intervention involving both a nightmare-specific intervention and CBT for insomnia may lead to more marked reductions in PTSD-related sleep disturbances. Twenty-two veterans meeting criteria for PTSD were enrolled in the study. A combined intervention comprised of CBT for insomnia and imagery rehearsal therapy was evaluated against a usual care comparison group. Intent-to-treat analyses revealed medium to large treatment effect sizes for all sleep diary outcomes, and very large treatment effects for insomnia severity, sleep quality, and PTSD symptoms. Findings demonstrate that an intervention targeting trauma-specific sleep disturbance produces large short-term effects, including substantial reductions in PTSD symptoms and insomnia severity. Future research should focus on the optimal approach to the treatment of comorbid PTSD and sleep disturbance in terms of sequencing, and should assure that sleep-focused interventions are available and acceptable to our younger veterans, who were more likely to drop out of treatment.",Ulmer CS.; Edinger JD.; Calhoun PS.,2011.0,,0,0,
2235,Evaluating the efficacy of habit reversal: comparison with a placebo control.,"The purpose of this study was to compare the effectiveness of habit reversal with a placebo control as a treatment for chronic nail biting in adults. Thirty adults with a chronic nail-biting problem (occurring > or = 5 times/day nearly every day for > or = 4 weeks and causing physical damage or social impairment) were randomly assigned to a placebo control or habit reversal group. Five participants withdrew from the study prior to the completion of treatment. The remaining individuals in both groups received a total of 2 hours of treatment over 3 sessions. Individuals in the habit reversal group (N = 13) received the components of awareness training, competing response training, and social support. Individuals in the placebo control group (N = 12) simply discussed their nail biting. At pretreatment, posttreatment, and a 5-month follow-up, nail length was measured, photographs were taken of the damaged nails and later rated by independent observers, and data on participant depression, anxiety, and self-esteem were obtained. Treatment compliance and acceptability data were collected at posttreatment only. Results showed that habit reversal produced a greater increase in nail length at posttreatment and follow-up when compared with the placebo. Data from the independent raters confirmed these findings. Habit reversal was also viewed as a more acceptable intervention by the participants. At posttreatment, the habit reversal group had increased their nail length by 22% from pretreatment compared with a 3% increase for the placebo group. At follow-up, the habit reversal group maintained a 19% increase in nail length from pretreatment compared with a 0% increase for the placebo group. Findings from this study suggest habit reversal is more effective than a placebo control and should be considered a well-established intervention for body-focused repetitive behaviors.",Twohig MP.; Woods DW.; Marcks BA.; Teng EJ.,2003.0,,0,0,
2236,Group treatment for trichotillomania: cognitive-behavioral therapy versus supportive therapy,"ER OBJECTIVE: Trichotillomania is a psychiatric condition characterized by the chronic pulling and plucking of one's own hair. Cognitive-behavioral therapy shows promise as a treatment for trichotillomania and might be preferable to pharmacotherapy. However, there have been no randomized, controlled studies of the efficacy of group cognitive-behavioral therapy.METHOD: We evaluated 44 subjects, recruited from April 2009 to May 2010, all of whom met DSM-IV criteria for a diagnosis of trichotillomania. Subjects were randomized to receive 22 sessions of either group cognitive-behavioral therapy or group supportive therapy (control). Treatment evaluation was non-blind and used self-report scales. The primary outcome measure was the improvement of hair-plucking behavior as assessed by the Massachusetts General Hospital Hairpulling Scale. Secondary measures included scores on the Beck Depression Inventory, the Beck Anxiety Inventory, and the Social Adjustment Scale-Self-Report.RESULTS: Both groups showed significant posttreatment improvement in the scores from the Massachusetts General Hospital Hairpulling Scale (F = 23.762, P < .001) and the Beck Depression Inventory (F = 6.579, P = .003). The decrease in hair-plucking behavior over time was significantly greater in the study group than in the control group (F = 3.545, P < .038). There were no significant differences between the pretreatment and posttreatment time points or between the groups in the scores from the Beck Anxiety Inventory and the Social Adjustment Scale-Self-Report.CONCLUSIONS: We conclude that group cognitive-behavioral therapy is a valid treatment for trichotillomania. This treatment model should be further revised and expanded to address comorbidities such as anxiety and social maladjustment.TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01968343.","Toledo, E L; Togni, Muniz E; Brito, A M; Abreu, C N; Tavares, H",2015.0,10.4088/JCP.13m08964,0,0,
2237,An RCT comparing effect of two types of support on severity of symptoms for people completing internet-based cognitive behaviour therapy for social phobia.,"Objective: The present study (Shyness 6) compares the benefits and acceptability of two types of guidance on severity of symptoms during Internet treatment for social phobia. Methods: Non-inferiority randomized controlled trial of Internet treatment, supplemented with weekly telephone calls from a technician (computerized cognitive-behavioural treatment (CCBT + Tel), or regular access to a clinician-moderated online discussion forum (CCBT + Forum), was carried out. An intention-to-treat model was used for data analyses. The participants consisted of 82 volunteers with social phobia. The intervention consisted of six lessons of CCBT for social phobia (the Shyness programme) with complex automated reminders. The main outcome measures were the Social Interaction Anxiety Scale and Social Phobia Scale. Results: A total of 79% of CCBT + Tel and 79% of CCBT + Forum group participants completed all six lessons. Large mean within-groups effect sizes (Cohen's d) for the two social phobia measures were found for the CCBT Tel and CCBT + Forum groups (1.31 and 1.54, respectively). Each participant in the CCBT + Tel group received a mean total of 38 min of technician time over the 8 week programme, while participants in the CCBT + Forum group received a mean total of 37 min of clinician time. Quantitative and qualitative data indicate that both the CCBT + Tel and CCBT + Forum procedures were equally and highly acceptable to participants. Conclusions: The Shyness programme with either telephone support or access to a clinician-moderated online forum resulted in good clinical outcomes with equivalent patient acceptability. These results confirm that people with social phobia may significantly benefit from a highly structured education programme administered by clinical or non-clinical staff. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Titov, Nickolai; Andrews, Gavin; Schwencke, Genevieve; Solley, Karen; Johnston, Luke; Robinson, Emma; Andersson, Andersson, Aydos, Carlbring, Carlbring, Carlbring, Devilly, Gaston, Julious, Kessler, Kiropoulos, Klein, Kroenke, Marks, Marks, Mattick, McEvoy, Perini, Shandley, Sheehan, Sheehan, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Vickers, Vickers, Zwarenstein",2009.0,,0,0,
2238,Cognitive therapy or imaginal exposure in the treatment of post-traumatic stress disorder. Twelve-month follow-up.,"Previously reported results have demonstrated the efficacy of exposure and cognitive therapy in the treatment of chronic post-traumatic stress disorder (PTSD), but have not shown one to be superior to the other. To investigate whether treatment benefits and equivalence are maintained at 12-month follow-up in patients with chronic PTSD treated with either imaginal exposure or cognitive therapy. Twelve-month follow-up of a randomised clinical trial. Fifty-four subjects (87% of the sample) were available to follow-up. They did not significantly differ clinically from drop-outs. There was significant clinical improvement at 12 months compared with pre-treatment. However, 39% of those followed-up still met criteria for PTSD. There were no significant differences between the two treatments. Victims of crime displayed higher levels of symptoms at follow-up than victims of accidents. Clinical benefits for exposure or cognitive therapy were maintained.",Tarrier N.; Sommerfield C.; Pilgrim H.; Humphreys L.,1999.0,,0,0,
2239,"Mindfulness group therapy in primary care patients with depression, anxiety and stress and adjustment disorders: randomised controlled trial.","Individual-based cognitive-behavioural therapy (CBT) is in short supply and expensive. The aim of this randomised controlled trial (RCT) was to compare mindfulness-based group therapy with treatment as usual (primarily individual-based CBT) in primary care patients with depressive, anxiety or stress and adjustment disorders. This 8-week RCT (ClinicalTrials.gov ID: NCT01476371) was conducted during spring 2012 at 16 general practices in Southern Sweden. Eligible patients (aged 20-64 years) scored ≥10 on the Patient Health Questionnaire-9, ≥7 on the Hospital Anxiety and Depression Scale or 13-34 on the Montgomery-Åsberg Depression Rating Scale (self-rated version). The power calculations were based on non-inferiority. In total, 215 patients were randomised. Ordinal mixed models were used for the analysis. For all scales and in both groups, the scores decreased significantly. There were no significant differences between the mindfulness and control groups. Mindfulness-based group therapy was non-inferior to treatment as usual for patients with depressive, anxiety or stress and adjustment disorders.",Sundquist J.; Lilja Å.; Palmér K.; Memon AA.; Wang X.; Johansson LM.; Sundquist K.,2015.0,10.1192/bjp.bp.114.150243,0,0,
2240,Effectiveness of an empirically based treatment for panic disorder delivered in a service clinic setting: 1-year follow-up.,"The transportability of cognitive-behavioral therapy (CBT) for panic disorder to a community mental health center (CMHC) setting at 1-year follow-up was examined by comparing CMHC treatment outcome data with results obtained in controlled efficacy studies. Participants were 81 CMHC clients with a primary diagnosis of panic disorder with or without agoraphobia who completed CBT for panic disorder. Despite differences in settings, clients, and treatment providers, both the magnitude of change from pretreatment to follow-up and the maintenance of change from posttreatment to follow-up in the CMHC sample were comparable with the parallel findings in the efficacy studies. At follow-up, 89% of the CMHC clients were panic free and a substantial proportion of the sample successfully discontinued benzodiazepine use. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stuart, Gregory L; Treat, Teresa A; Wade, Wendy A; Addis, Barlow, Barlow, Beck, Beck, Borkovec, Brown, Bruce, Chambless, Craske, Craske, DiNardo, Fyer, Goldfried, Hoagwood, Hollon, Jacobson, Kendall, Kendall, Kendall, Kendall, Marks, McFall, Otto, Pecknold, Persons, Reiss, Seligman, Spiegel, Telch, Wade, Watson",2000.0,,0,0,
2241,Mindfulness-based exposure and response prevention for obsessive compulsive disorder: study protocol for a pilot randomised controlled trial.,"Obsessive Compulsive Disorder (OCD) is a distressing and debilitating condition affecting 1-2% of the population. Exposure and response prevention (ERP) is a behaviour therapy for OCD with the strongest evidence for effectiveness of any psychological therapy for the condition. Even so, only about half of people offered ERP show recovery after the therapy. An important reason for ERP failure is that about 25% of people drop out early, and even for those who continue with the therapy, many do not regularly engage in ERP tasks, an essential element of ERP. A mindfulness-based approach has the potential to reduce drop-out from ERP and to improve ERP task engagement with an emphasis on accepting difficult thoughts, feelings and bodily sessions and on becoming more aware of urges, rather than automatically acting on them. This is a pilot randomised controlled trial of mindfulness-based ERP (MB-ERP) with the aim of establishing parameters for a definitive trial. Forty participants diagnosed with OCD will be allocated at random to a 10-session ERP group or to a 10-session MB-ERP group. Primary outcomes are OCD symptom severity and therapy engagement. Secondary outcomes are depressive symptom severity, wellbeing and obsessive-compulsive beliefs. A semi-structured interview with participants will guide understanding of change processes. Findings from this pilot study will inform future research in this area, and if effect sizes on primary outcomes are in favour of MB-ERP in comparison to ERP, funding for a definitive trial will be sought. Current Controlled Trials registration number ISRCTN52684820. Registered on 30 January 2014.",Strauss C.; Rosten C.; Hayward M.; Lea L.; Forrester E.; Jones AM.,2015.0,10.1186/s13063-015-0664-7,0,0,
2242,Calmer life: A culturally tailored intervention for anxiety in underserved older adults.,"Objectives: To evaluate the feasibility of the Calmer Life and Enhanced Community Care interventions delivered by community and expert providers and test their preliminary effectiveness on worry, generalized anxiety disorder (GAD) severity, anxiety, depression, sleep, health-related quality of life, and satisfaction. Design: Small randomized trial, with measurements at baseline and 3 months. Setting: Underserved, low-income, mostly minority communities in Houston, TX. Participants: Forty underserved adults 50 years and older, with significant worry and principal or coprincipal GAD or anxiety disorder not otherwise specified. Intervention: Combination of person-centered, flexible skills training to reduce worry; resource counseling to target unmet basic needs; and facilitation of communication with primary care providers developed through a community-academic partnership with social service and faith-based organizations. Religion/spirituality may be incorporated. Measurements: Primary outcomes: worry (Penn State Worry Questionnaire-Abbreviated), GAD severity (GAD-7), anxiety (Geriatric Anxiety Inventory-Short Form). Secondary outcomes: depression (Patient Health Questionnaire-8 and Geriatric Depression Scale-Short Form), sleep (Insomnia Severity Index), health-related quality of life (12-item Medical Outcomes Study Short Form), satisfaction (Client Satisfaction Questionnaire and exit interviews). Results: Provider training was valid; mean ratings for community providers were well above average, with none less than adequate. Reach was excellent. Participants receiving the Calmer Life intervention had greater improvement in GAD severity and depression than those receiving Enhanced Community Care. Satisfaction with both treatments was equivalent. Conclusions: A larger comparative-effectiveness trial needs to examine outcomes following the Calmer Life intervention relative to standard community-based care and to evaluate more fully issues of implementation potential. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stanley, Melinda A; Wilson, Nancy; Shrestha, Srijana; Amspoker, Amber B; Armento, Maria; Cummings, Jeremy P; Evans-Hudnall, Gina; Wagener, Paula; Kunik, Mark E; Arean, Attkisson, Blank, Brenes, Byrne, Callahan, Ciechanowski, Crittendon, Cruz, Dobransky-Fasiska, First, Friedman, Goncalves, Gould, Gum, Jameson, Jette, Kim, Kraus-Schuman, Kroenke, Kroenke, Levin, Morin, Pachana, Razykov, Rubin, Sheikh, Shrestha, Spitzer, Stanley, Stanley, Stanley, Ware, Weissman, Wetherell, Wolitzky-Taylor, Wuthrich, Zhang, Zou",2016.0,,0,0,
2243,Patterns of change during cognitive behavioral treatment for panic disorder.,"The present investigation examined patterns of change in basic features of panic and anxiety during cognitive behavioral treatment for panic disorder. Data were collected in the context of a study comparing the efficacy of cognitive therapy (CT) and relaxation training, both administered without exposure-based treatments of any kind. Thirty-six panic disorder patients completed 10 weeks of either CT or relaxation training. Weekly measures of panic frequency, state and trait anxiety, and associated fears were obtained. Data were examined using both multivariate techniques (which conceptualize change as incremental) and analysis of response slopes (wherein change is conceptualized as continuous). Results indicated that during the first half of treatment, relaxation training led to greater reductions in state and trait anxiety and agoraphobic fear, whereas CT demonstrated a slight advantage on change in panic frequency. During the second half of treatment, CT produced faster reductions in state anxiety and agoraphobic fears. Over the entire treatment course, CT conferred an advantage in rate of change in social fears. The data provide support for the utility of a more process-oriented approach to the examination of treatment effects.",Stanley MA.; Beck JG.; Averill PM.; Baldwin LE.; Deagle EA.; Stadler JG.,1996.0,,0,0,
2244,Internet-based trauma-focused cognitive behavioural therapy for PTSD with and without exposure components: A randomised controlled trial.,"Background: Internet-delivered trauma-focused cognitive behavioural therapy is efficacious for PTSD; however, no studies have investigated the roles of individual treatment components or the safety of online treatments. Aims: To compare the efficacy and safety of an online treatment for PTSD comprised of psychoeducation, stress management, cognitive restructuring and exposure components with the equivalent protocol without the exposure components, using a randomised controlled trial design. Methods: Sixty-six individuals were randomised to a non-exposure condition and 59 to the full protocol with exposure components. Treatment duration was 8 weeks and pre-, post-treatment and three-month follow-up outcomes were analysed using a mixed linear modelling approach. Results: Both groups achieved improvements in symptoms with no differences between groups on any primary or secondary outcome measures, diagnostic remission rates or adverse events. Limitations: The study included several secondary measures that have not been previously validated and treatments were not time matched in terms of number of lessons. Conclusions: These findings indicate that trauma-focused cognitive behavioural therapy for PTSD with or without exposure components can be safe and efficacious. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Spence, Jay; Titov, Nickolai; Johnston, Luke; Jones, Michael P; Dear, Blake F; Solley, Karen; Amstadter, Bisson, Bryant, Cohen, Creamer, Dalenberg, Feeny, Foa, Foa, Foa, Foa, Forbes, Grey, Hembree, Hirai, Kersting, Kessler, Klein, Klein, Knaevelsrud, Knaevelsrud, Kroenke, Lange, Litz, Marks, Mcnally, Neuner, Paunovic, Possemato, Resick, Resick, Riggs, Schulz, Sheehan, Sloan, Spence, Spitzer, Tarrier, Taylor, Taylor, Wagner, Weiss",2014.0,,0,0,
2245,Internet-based trauma-focused cognitive behavioural therapy for PTSD with and without exposure components: a randomised controlled trial.,"Internet-delivered trauma-focused cognitive behavioural therapy is efficacious for PTSD; however, no studies have investigated the roles of individual treatment components or the safety of online treatments. To compare the efficacy and safety of an online treatment for PTSD comprised of psychoeducation, stress management, cognitive restructuring and exposure components with the equivalent protocol without the exposure components, using a randomised controlled trial design. Sixty-six individuals were randomised to a non-exposure condition and 59 to the full protocol with exposure components. Treatment duration was 8 weeks and pre-, post-treatment and three-month follow-up outcomes were analysed using a mixed linear modelling approach. Both groups achieved improvements in symptoms with no differences between groups on any primary or secondary outcome measures, diagnostic remission rates or adverse events. The study included several secondary measures that have not been previously validated and treatments were not time matched in terms of number of lessons. These findings indicate that trauma-focused cognitive behavioural therapy for PTSD with or without exposure components can be safe and efficacious.",Spence J.; Titov N.; Johnston L.; Jones MP.; Dear BF.; Solley K.,2014.0,10.1016/j.jad.2014.03.009,0,0,
2246,Cognitive-behavioural therapy for anxiety in dementia: pilot randomised controlled trial.,"Anxiety is common and problematic in dementia, yet there is a lack of effective treatments. To develop a cognitive-behavioural therapy (CBT) manual for anxiety in dementia and determine its feasibility through a randomised controlled trial. A ten-session CBT manual was developed. Participants with dementia and anxiety (and their carers) were randomly allocated to CBT plus treatment as usual (TAU) (n = 25) or TAU (n = 25). Outcome and cost measures were administered at baseline, 15 weeks and 6 months. At 15 weeks, there was an adjusted difference in anxiety (using the Rating Anxiety in Dementia scale) of (-3.10, 95% CI -6.55 to 0.34) for CBT compared with TAU, which just fell short of statistical significance. There were significant improvements in depression at 15 weeks after adjustment (-5.37, 95% CI -9.50 to -1.25). Improvements remained significant at 6 months. CBT was cost neutral. CBT was feasible (in terms of recruitment, acceptability and attrition) and effective. A fully powered RCT is now required.",Spector A.; Charlesworth G.; King M.; Lattimer M.; Sadek S.; Marston L.; Rehill A.; Hoe J.; Qazi A.; Knapp M.; Orrell M.,2015.0,10.1192/bjp.bp.113.140087,0,0,
2247,Phenelzine and exposure in the treatment of phobias.,"A double-blind study was carried out on 40 agoraphobic and socially phobic patients, matched, then randomly assigned to one of four treatment groups; phenelzine-exposure, phenelzine-no exposure, placebo-exposure, and placebo-no exposure. Exposure consisted of encouraging the patient to face the phobic situation a predetermined number of times. Assessments, made at the beginning and end of 8 weeks of therapy and 8 weeks thereafter, showed that the phobia ratings of groups decreased significantly. The combined exposure group improved significantly more than the combined no exposure group during treatment. At 8 weeks follow-up there was some deterioration in the phenelzine-exposure and placebo-no exposure groups. Exposure, with or without phenelzine, was the superior treatment modality. The antiphobic effect of phenelzine was not supported, although it seemed to reduce subjective anxiety during exposure experiences. The possibility that effect of phenelzine is dose-related is discussed.",Solyom C.; Solyom L.; LaPierre Y.; Pecknold J.; Morton L.,1981.0,,0,0,
2248,"A randomized, controlled trial of cognitive-behavioral therapy for augmenting pharmacotherapy in obsessive-compulsive disorder.","Although serotonin reuptake inhibitors (SRIs) are approved for the treatment of obsessive-compulsive disorder (OCD), most OCD patients who have received an adequate SRI trial continue to have clinically significant OCD symptoms. The purpose of this study was to examine the effects of augmenting SRIs with exposure and ritual prevention, an established cognitive-behavioral therapy (CBT) for OCD. A randomized, controlled trial was conducted at two academic outpatient clinics to compare the effects of augmenting SRIs with exposure and ritual prevention versus stress management training, another form of CBT. Participants were adult outpatients (N=108) with primary OCD and a Yale-Brown Obsessive Compulsive Scale total score > or = 16 despite a therapeutic SRI dose for at least 12 weeks prior to entry. Participants received 17 sessions of CBT (either exposure and ritual prevention or stress management training) twice a week while continuing SRI pharmacotherapy. Exposure and ritual prevention was superior to stress management training in reducing OCD symptoms. At week 8, significantly more patients receiving exposure and ritual prevention than patients receiving stress management training had a decrease in symptom severity of at least 25% (based on Yale-Brown Obsessive Compulsive Scale scores) and achieved minimal symptoms (defined as a Yale-Brown Obsessive Compulsive Scale score < or = 12). Augmentation of SRI pharmacotherapy with exposure and ritual prevention is an effective strategy for reducing OCD symptoms. However, 17 sessions were not sufficient to help most of these patients achieve minimal symptoms.",Simpson HB.; Foa EB.; Liebowitz MR.; Ledley DR.; Huppert JD.; Cahill S.; Vermes D.; Schmidt AB.; Hembree E.; Franklin M.; Campeas R.; Hahn CG.; Petkova E.,2008.0,10.1176/appi.ajp.2007.07091440,0,0,
2249,"Treatment of Vietnam War veterans with PTSD: a comparison of eye movement desensitization and reprocessing, biofeedback, and relaxation training.","Analyses of scaled self-report data from Vietnam War veterans receiving inpatient treatment for Post-Traumatic Stress Disorder drawn during a program evaluation study suggested inpatient treatment as provided by the program resulted in significant improvement in the areas of Anxiety, Anger, Depression, Isolation, Intrusive Thoughts (of combat experiences), Flashbacks, Nightmares (of combat experiences), and Relationship Problems. Comparing the relative effects of the incremental addition of Eye Movement Desensitization and Reprocessing (EMDR), Relaxation Training, and Biofeedback found that EMDR was for most problems the most effective extra treatment, greatly increasing the positive impact of the treatment program.",Silver SM.; Brooks A.; Obenchain J.,1995.0,,0,0,
2250,Emotional or educational debriefing after psychological trauma. Randomised controlled trial.,"Recent studies show that individual single-session psychological debriefing does not prevent and can even aggravate symptoms of post-traumatic stress disorder (PTSD). We studied the effect of emotional ventilation debriefing and educational debriefing v. no debriefing on symptoms of PTSD, anxiety and depression. We randomised 236 adult survivors of a recent traumatic event to either emotional ventilation debriefing, educational debriefing or no debriefing (control) and followed up at 2 weeks, 6 weeks and 6 months. Psychiatric symptoms decreased in all three groups over time, without significant differences between the groups in symptoms of PTSD (P=0.33). Participants in the emotional debriefing group with high baseline hyperarousal score had significantly more PTSD symptoms at 6 weeks than control participants (P=0.005). Our study did not provide evidence for the usefulness of individual psychological debriefing in reducing symptoms of PTSD, anxiety and depression after psychological trauma.",Sijbrandij M.; Olff M.; Reitsma JB.; Carlier IV.; Gersons BP.,2006.0,10.1192/bjp.bp.105.021121,0,0,
2251,Stress hormones during flooding therapy and their relationship to therapy outcome in patients with panic disorder and agoraphobia.,"In spite of excessive fear during a panic attack, studies have found no or little evidence for an activation of cortisol during natural panic attacks. Whether this phenomenon is related to psychopathology or outcome of psychotherapy is unknown. In this study, 10 patients with panic disorder and agoraphobia were treated with cognitive behavioural therapy including 3 in-vivo exposures (flooding) to individual phobic situations. Before, during and after exposure, the level of subjective fear was assessed and blood was collected simultaneously. Cortisol and ACTH were analysed from plasma. Ten matched healthy control subjects went through the same procedure. Fear and stress hormones during exposure were compared in patients and controls as well as related to therapy outcome at the end of therapy and 2 follow-ups in patients. Results showed that the concentrations of cortisol and ACTH did not significantly increase during exposure. Patients' cortisol concentrations were higher than those of controls at baseline and during exposure, while ACTH concentrations were comparable before and during exposure, and even lower than those of controls at recovery. Cortisol concentrations were moderately but consistently correlated to therapy outcome, i.e. patients with least cortisol release during exposure profited least from therapy. The study showed that a lack of stimulation of the HPA system at repeated confrontation with the phobic situation was related to therapeutic outcome. Mechanisms of action via the influence of cortisol on extinction learning or the inhibition of central excitatory neurotransmission are conceivable.",Siegmund A.; Köster L.; Meves AM.; Plag J.; Stoy M.; Ströhle A.,2011.0,10.1016/j.jpsychires.2010.07.002,0,0,
2252,Effects of cognitive-behavioral conjoint therapy for PTSD on partners' psychological functioning.,"A number of studies have documented that posttraumatic stress disorder (PTSD) symptoms in ""one"" partner are negatively associated with their intimate partner's psychological functioning. The present study investigated intimate partners' mental health outcomes (i.e., depression, anxiety, and anger) in a sample of 40 partners of individuals with PTSD within a randomized waitlist controlled trial of cognitive-behavioral conjoint therapy for PTSD (Monson & Fredman, 2012). There were no significant differences between active treatment and waitlist in intimate partners' psychological functioning at posttreatment. Subgroup analyses, however, of partners exhibiting clinical levels of distress at pretreatment on several measures showed reliable and clinically significant improvements in their psychological functioning at posttreatment and no evidence of worsening. Results suggest that cognitive-behavioral conjoint therapy for PTSD may have additional benefits for partners presenting with psychological distress.",Shnaider P.; Pukay-Martin ND.; Fredman SJ.; Macdonald A.; Monson CM.,2014.0,10.1002/jts.21893,0,0,
2253,A randomized pilot study of anger treatment for Iraq and Afghanistan veterans.,"Anger and aggression are serious problems for a significant proportion of veterans who have served in combat. While prior research has suggested that cognitive behavioral treatments may be effective for anger problems, there are few controlled studies of anger treatment in veterans and no studies of anger treatment focusing exclusively on veterans from the Iraq and Afghanistan wars. This randomized pilot study compared an adapted cognitive behavioral intervention (CBI) to a supportive intervention (SI) control condition for the treatment of anger problems in veterans returning from deployment in Iraq or Afghanistan. 25 veterans with warzone trauma, problems with anger, and one or more additional hyperarousal symptoms were randomized and 23 started treatment (CBI, n = 12; SI, n = 11). Outcome measures were administered at pre- and post- treatment and at 3 months post-treatment. CBI was associated with significantly more improvement than SI on measures of anger and interpersonal functioning. Gains were maintained at follow-up. Findings suggest that CBI may be more effective than an active control providing psychoeducation, relaxation, and supportive therapy for treating anger problems in returning veterans. The findings need to be replicated in an adequately powered and more diverse sample.",Shea MT.; Lambert J.; Reddy MK.,2013.0,10.1016/j.brat.2013.05.013,0,0,
2254,Can motivational interviewing enhance mental health treatment engagement in Iraq and Afghanistan veterans: Preliminary results from a randomized controlled trial,"BACKGROUND: Motivational interviewing (MI) is a client-centered, nonconfrontational method for enhancing intrinsic motivation for behavioral change and may be delivered by a wide range of health and service providers.MI has a strong evidence base for enhancement of mental health treatment engagement and improved clinical outcomes in patients with variousmental health problems. Combat veterans of Iraq and Afghanistan have high rates of mental health disorders, yet stigma and other barriers prevent veterans from entering mental health treatment. The aim of this study is to develop and test the efficacy of telephone-administered MI to enhance mental health treatment engagement and secondarily to improve mental health symptoms and function in Iraq and Afghanistan veterans. METHODS: This ongoing pilot randomized controlled trial (RCT) has been conducted in 3 phases to refine a telephone-based MI intervention for Iraq and Afghanistan veterans. Veterans undergo rapid telephone assessment using standard brief instruments to assess for PTSD, depression, high-risk drinking, substance misuse, and functional status. Veterans who screen positive for ‚â• 1 mental health problems and are not in mental health treatment are randomized to receive either brief 4 telephone MI sessions or 4 neutral telephone sessions (Attention Control) delivered by clinicians and non-clinicians at baseline, 2, 4 and 8 weeks. Audiotaped sessions are monitored for fidelity. Blinded assessments occur at 2, 4, 8 and 16 weeks to determine readiness for and engagement in mental health treatment, symptoms, and function. Intention to treat analyses compared proportions in each arm that initiated mental health treatment and effect sizes were calculated using Cohen's h. Mixed model ANCOVAs compared mental health symptoms, functioning, and readiness for treatment. RESULTS: To date, 70 OEF/OIF veterans have enrolled in the 3-phase pilot RCT and 55 participants have completed the study; 29 MI and 26 Control. The mean age was 33 (SD +/- 9), 16% were women, and 37% were ethnic minorities. Of the 55 completers, 36% screened positive for PTSD, 64% for depression, 69% for high-risk drinking and 29% for substance misuse. Table 1 demonstrates large effect sizes, showing greater improvements in mental health symptoms, functioning and treatment readiness in the MI versus Control condition, with several outcomes achieving statistical significance despite small sample size. In the third phase of MI treatment development (n=18 completers), 63% of veterans in the MI arm versus 30% in the Attention Control arm initiated mental health treatment (Cohen's h= 0.67), representing a medium to large effect size. CONCLUSIONS: Despite a small sample size, preliminary findings from this ongoing RCT indicate that a refined telephone-based MI intervention demonstrates greater efficacy than Attention Control. Further, MI may be used by various providers, including non-clinicians, to enhancemental health treatment engagement, various aspects of functioning and possible symptom reduction in Iraq and Afghanistan veterans with mental health concerns.(Table presented).",Seal K.; McCaslin S.; McCamish N.; Ren L.; Abadjian L.; Burt M.; Daley A.,2010.0,10.1007/s11606-010-1338-5,0,0,
2255,[Surgical management of talipes equinovarus as sequelae of a compartment and/or postischemic syndrome of the deep flexor compartment of the lower leg].,"Cases of posttraumatic pes equinovarus after compartment syndrome have become more frequent in the last 3 decades because limb-saving procedures like compartment splitting, vascular repair, and microvascular free flaps have become well established in trauma surgery, thus reducing early below knee amputations. But if the deep flexor compartment is not split completely or if the muscles are crushed by direct trauma severe necrosis and subsequent muscle contractures result in a very severe clubfoot deformity. Metatarsalgia of fifth, fourth, and third metatarsal head even in well-fitted orthopaedic shoes occurs as well as painful bunions and fatigue fractures of the fifth metatarsal. Infected ulcers below the fifth/fourth metatarsal bone in a numb plantar sole often require head resection because of osteomyelitis.From 1994 to 2007 a total of 24 patients with severe pes equinovarus after compartment and/or postischemic syndrome were treated operatively. Only in 5 cases was a triple, Chopart, or Lisfranc arthrodesis necessary; 19 cases however could be treated only by soft tissue procedures like tenolysis, tendon lengthening, medial release of the scarred flexor retinacula and contracted capsules of the posterior ankle, subtalar and talonavicular joint to reorientate all axes of the foot. By temporary K-wire transfixation (6 weeks), initial external tibiotarsal transfixation of the foot (10 days), and additional tendon transfer for active foot elevation excellent and good long-term (5 years) results are achievable.The results according to the McKay Score are not significantly different regarding the triple arthrodesis group versus the pure soft tissue release group. Nevertheless, saving joints in the latter group seems to be very important.",Zwipp H.; Sabauri G.; Amlang M.,2008.0,10.1007/s00113-008-1494-9,0,0,
2256,[Operative treatment of displaced intra-articular calcaneal fractures].,"Anatomic reduction of displaced intra-articular calcaneal fractures with restoration of height, length, and axial alignment and reconstruction of the subtalar and calcaneocuboid joints. Displaced intra-articular calcaneal fractures with incongruity of the posterior facet of the subtalar joint, loss of height, and axial malalignment. High perioperative risk, soft tissue infection, advanced peripheral arterial disease (stage III), neurogenic osteoarthropathy, poor patient compliance (e. g., substance abuse). Extended lateral approach with the patient placed on the uninjured side. Reduction of the anatomic shape and joint surfaces according to the preoperative CT-based planning. Reduction of the medial wall and step-wise reconstruction of the posterior facet from medial to lateral. Reduction of the tuberosity and anterior process fragments to the posterior joint block and temporary fixation with Kirschner wires. Internal fixation with an anatomic lateral plate in a locking or nonlocking mode. Alternatively less invasive internal fixation with a calcaneus nail over a sinus tarsi approach for less severe fracture types. The lower leg is immobilized in a brace until the wound is healed. Range of motion exercises of the ankle and subtalar joints are initiated on the second postoperative day. Patients are mobilized in their own shoe with partial weight bearing of 20 kg for 6-12 weeks depending on fracture severity and bone quality. Over a 4-year period, 163 patients with 184 displaced, intra-articular calcaneal fractures were treated with a lateral plate via an extended approach. In all, 102 patients with 116 fractures were followed for a mean of 8 years. A surgical revision was necessary in 4 cases (3.4%) of postoperative hematoma, 2 (1.7%) superficial and 5 (4.3%) deep infections. Of the latter, 2 patients needed a free flap for definite wound coverage, no calcanectomy or amputation was needed. Secondary subtalar fusion for symptomatic posttraumatic arthritis was performed in 9 cases (7.8%). At follow-up, the AOFAS Ankle/Hindfoot Score averaged 70.2, the Zwipp Score averaged 76.0, the German versions of the Foot Function Index and SF-36 physical component averaged 32.8 and 42.2, respectively. Scores were significantly lower with increasing fracture severity according to the Sanders and Zwipp classifications, bilateral fractures, open fractures, and with work-related injuries. With less invasive fixation using a calcaneal nail, superficial wound edge necrosis was seen in 2 of 75 cases (2.7%).",Zwipp H.; Rammelt S.; Amlang M.; Pompach M.; Dürr C.,2013.0,10.1007/s00064-013-0246-3,0,0,
2257,Cognitive processes in the maintenance of insomnia and co-morbid anxiety,"Harvey (2002) developed a model of insomnia that has advanced the understanding of cognitive processes involved in the maintenance of this problem. Despite the high co-morbidity of insomnia with mental health problems, such as anxiety, the relevance of the cognitive processes specified in the model to people with insomnia as well as other mental health problems is yet to be established. This was the subject of investigation in the present study. A between-subjects design was used to compare people with insomnia and co-morbid anxiety (insomnia plus anxiety) with people with insomnia only (insomnia only), and with good sleepers on measures of mental arousal prior to sleep, thought control strategies employed, and unhelpful beliefs about sleep. Results showed that participants with insomnia plus anxiety were comparable to participants with insomnia only, and significantly different from good sleepers on all measures. The research suggests that the cognitive processes thought to maintain insomnia in people without other co-morbid mental health problems may also maintain insomnia in people with co-morbid anxiety disorders. © 2005 British Association for Behavioural and Cognitive Psychotherapies.",Zwi R.; Shawe-Taylor M.; Murray J.,2005.0,10.1017/S1352465805002109,0,0,
2258,[Motivation for psychosomatic-psychotherapeutic treatment of vocational stresses -- development and validation of a questionnaire].,"There is a lack of questionnaires assessing the motivation of inpatients to scrutinize occupational stresses and deal with them as part of their psychotherapeutic treatment. Work-related stress contributes significantly to the development of mental disorders. Vocational reintegration is an outcome criterion for the success of vocational rehabilitation. Patients are often not motivated for dealing with occupational stresses during inpatient medical rehabilitation. Therefore it is necessary to assess patient motivation at the beginning of treatment, in order to assign them to specific interventions, e. g. promoting motivation. A questionnaire (Fragebogen zur berufsbezogenen Therapiemotivation -- FBTM) consisting of 84 items was developed, based on published questionnaires for psychotherapy motivation. 283 psychosomatic rehabilitation inpatients were administered the FBTM, subsequently analyzed by item and factor analyses. Based on a second sample (n = 282) confirmatory factor analyses and validation of the questionnaire were executed. Item and factor analyses revealed a four factor structure. 24 items constituted the subscales that could be described as ""intention to change"", ""wish for pension"", ""negative treatment expectations"" and ""active coping"". Reliability (Cronbach's Alpha) was satisfactory with coefficients between 0.69 and 0.87, and only low correlations could be found between the four subscales. Correlations with other measures were most pronounced for the subscale ""intention to change"". Some significant but low correlations could be reported between the FBTM and a standardized questionnaire of psychotherapy motivation (FMP). Confirmatory factor analyses of a second sample (n = 282) confirmed the original four factors. First evidence of sensitivity could be observed in a sample of patients who took part in an intervention promoting work-related therapy motivation during psychosomatic inpatient rehabilitation. The FBTM is a reliable and valid instrument assessing work-related therapy motivation of inpatients, as a relevant therapeutic measure in psychosomatic rehabilitation. Further validation, especially the analysis of predictive validity is desirable.",Zwerenz R.; Knickenberg RJ.; Schattenburg L.; Beutel ME.,2005.0,10.1055/s-2004-834599,0,0,
2259,"Cost-effectiveness of i-Sleep, a guided online CBT intervention, for patients with insomnia in general practice: protocol of a pragmatic randomized controlled trial","ER BACKGROUND: Insomnia is a highly prevalent disorder causing clinically significant distress and impairment. Furthermore, insomnia is associated with high societal and individual costs. Although cognitive behavioural treatment for insomnia (CBT-I) is the preferred treatment, it is not used often. Offering CBT-I in an online format may increase access. Many studies have shown that online CBT for insomnia is effective. However, these studies have all been performed in general population samples recruited through media. This protocol article presents the design of a study aimed at establishing feasibility, effectiveness and cost-effectiveness of a guided online intervention (i-Sleep) for patients suffering from insomnia that seek help from their general practitioner as compared to care-as-usual.METHODS/DESIGN: In a pragmatic randomized controlled trial, adult patients with insomnia disorder recruited through general practices are randomized to a 5-session guided online treatment, which is called ""i-Sleep"", or to care-as-usual. Patients in the care-as-usual condition will be offered i-Sleep 6 months after inclusion. An ancillary clinician, known as the psychological well-being practitioner who works in the GP practice (PWP; in Dutch: POH-GGZ), will offer online support after every session. Our aim is to recruit one hundred and sixty patients. Questionnaires, a sleep diary and wrist actigraphy will be administered at baseline, post intervention (at 8 weeks), and at 6 months and 12 months follow-up. Effectiveness will be established using insomnia severity as the main outcome. Cost-effectiveness and cost-utility (using costs per quality adjusted life year (QALY) as outcome) will be conducted from a societal perspective. Secondary measures are: sleep diary, daytime consequences, fatigue, work and social adjustment, anxiety, alcohol use, depression and quality of life.DISCUSSION: The results of this trial will help establish whether online CBT-I is (cost-) effective and feasible in general practice as compared to care-as-usual. If it is, then quality of care might be increased because implementation of i-Sleep makes it easier to adhere to insomnia guidelines. Strengths and limitations are discussed.TRIAL REGISTRATION: Netherlands Trial register NTR 5202 (registered April 17(st) 2015).","Zweerde, T; Lancee, J; Slottje, P; Bosmans, J; Someren, E; Reynolds, C; Cuijpers, P; Straten, A",2016.0,10.1186/s12888-016-0783-z,0,0,
2260,Transcranial magnetic stimulation for panic.,"Reported on a 52-year-old woman treated with right prefrontal repetitive transcranial magnetic stimulation (rTMS) who showed a reduction in panic disorder symptoms and improvement in cholecystokinin tetrapeptide (CCK-4)-induced panic attacks associated with blunting of the CCK-4 elevation of ACTH and cortisol. This report adds to previous evidence (e.g., M. S. George et al, 1999) that slow rTMS of the right prefrontal cortex ameliorates the symptoms of major depression and anxiety disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zwanzger, Peter; Minov, Christo; Ella, Robin; Schule, Cornelius; Baghai, Thomas; Moller, Hans-Jurgen; Rupprecht, Rainer; Padberg, Frank; Bandelow, Bradwejn, Bradwejn, Dillon, George, Greenberg, McCann, Speer",2002.0,,0,0,
2261,Effects of repetitive transcranial magnetic stimulation (rTMS) on panic attacks induced by cholecystokinin-tetrapeptide (CCK-4),"Low-frequency (LF) rTMS shows beneficial effects in patients with depression and anxiety disorders. To explore its anxiolytic properties we investigated the effects of rTMS on experimentally induced panic attacks. Eleven healthy subjects underwent 1 Hz rTMS or sham rTMS over the right dorsolateral prefrontal cortex in a randomized cross-over protocol. Panic induction with 50 μg CCK-4 was carried out immediately after rTMS. Response to CCK-4 was assessed using the Acute Panic Inventory and the Panic Symptom Scale and measurements of heart rate, plasma ACTH and cortisol. All subjects reported a marked panic response following CCK-4 administration after both real and sham rTMS. Moreover, injection of CCK-4 induced a marked increase in heart rate, cortisol and ACTH concentrations. However, ANOVA showed no significant differences in any of the measures between both conditions. In contrast to the effects of pretreatment with alprazolam on CCK-4-induced panic in healthy subjects LF rTMS does not affect CCK-4-induced panic and cortisol or ACTH release. © 2006 Collegium Internationale Neuropsychopharmacologicum.",Zwanzger P.; Eser D.; Völkel N.; Baghai T.C.; Möller H.-J.; Rupprecht R.; Padberg F.,2007.0,10.1017/S146114570600695X,0,0,
2262,Neuroactive steroids are not affected by panic induction with 50 μg cholecystokinin-tetrapeptide (CCK-4) in healthy volunteers [1],,Zwanzger P.; Eser D.; Padberg F.; Baghai T.C.; Schüle C.; Rupprecht R.; Di Michele F.; Romeo E.; Pasini A.; Ströhle A.,2004.0,10.1016/S0022-3956(03)00109-2,0,0,
2263,Effects of the GABA-reuptake inhibitor tiagabine on panic and anxiety in patients with panic disorder.,"Introduction: There is evidence that a decreased GABAergic tone plays a role in the pathophysiology of panic disorder (PD). Selective GABAergic treatment has been suggested as a new therapeutic strategy in PD. In this pilot-study anxiolytic effects of the GABA reuptake inhibitor tiagabine (TGB) were investigated in PD. Methods: A total of 19 patients were treated with TGB (n=10) or placebo (n=9) for 4 weeks. PAS, HAM-A, and CGI ratings were administered every week. To further assess specific antipanic activity, panic challenges with CCK-4 were carried out in single subjects. Results: Although there was a significant reduction of clinical rating scores over time, no differences were detected between the groups. However, during challenge experiments TGB treated subjects showed decreased sensitivity to CCK-4. Discussion: Whereas tiagabine did not show beneficial effects on clinical symptoms in PD compared to placebo, results of challenge experiments suggest effects of TGB on sensitivity to experimentally induced panic. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zwanzger, P; Eser, D; Nothdurfter, C; Baghai, T. C; Moller, H.-J; Padberg, F; Rupprecht, R; Ballenger, Bandelow, Bandelow, Bradwejn, Cameron, Dillon, Goddard, Hamilton, Hasler, Meldrum, Pistovcakova, Pollack, Savin, Sayin, Schmi'fr, Schmitt, Sheehan, Sherif, Sherif, Shlik, van Megen, Zwanzger, Zwanzger, Zwanzger, Zwanzger, Zwanzger, Zwanzger",2009.0,,0,0,
2264,Effects of alprazolam on cholecystokinin-tetrapeptide-induced panic and hypothalamic-pituitary-adrenal-axis activity: a placebo-controlled study,"ER Cholecystokinin-tetrapeptide (CCK-4) induces panic attacks both in patients with panic disorder (PD) and healthy volunteers. It has been shown that panic elicited by CCK-4 is improved after treatment with antidepressants. Moreover, a reduction of CCK-4-induced panic has also been demonstrated after treatment with lorazepam in single subjects and after selective GABAergic treatment with vigabatrin. Although benzodiazepines are widely used as anxiolytics, no controlled study on the effects of benzodiazepines on CCK-4-induced panic symptoms is available so far. Therefore, we investigated the effects of alprazolam and placebo on CCK-4-induced panic symptoms in a double-blind, placebo-controlled study. A total of 30 healthy subjects were challenged with 50 microg CCK-4. Out of these 30 subjects, 26 showed a marked panic response to CCK-4. Subjects were rechallenged after a 7-day interval and treated with 1 mg alprazolam or placebo 1 h prior to the second CCK-4 challenge. Panic was assessed using the acute panic inventory (API) and a DSM-IV-derived panic symptom scale (PSS). Moreover, the number of reported symptoms and self-rated anxiety and arousal were recorded. We found a significant reduction of the API and PSS scores and of the number of reported symptoms compared to placebo. Moreover, compared to placebo the CCK-4-induced ACTH and cortisol release were significantly attenuated during the CCK-4 challenge after alprazolam treatment. However, also placebo treatment reduced CCK-4-induced anxiety and HPA-axis activation to a certain extent. In conclusion, our data show that alprazolam reduces CCK-4-induced panic, which supports the hypothesis of a possible interaction between the GABA and the CCK system.","Zwanzger, P; Eser, D; Aicher, S; Schüle, C; Baghai, T C; Padberg, F; Ella, R; Möller, H J; Rupprecht, R",2003.0,10.1038/sj.npp.1300131,0,0,
2265,Vigabatrin decreases cholecystokinin-tetrapeptide (CCK-4) induced panic in healthy volunteers,"Vigabatrin increases gamma aminobutyric acid (GABA) levels by irreversible inhibition of the GABA-catabolizing enzyme GABA-transaminase (GABA-T). Preclinical studies suggest anxiolytic effects in vigabatrin treated rats. Anxiolytic effects in patients with panic disorder (PD) could therefore be expected. To evaluate putative anxiolytic properties of vigabatrin in humans, CCK-4-induced panic symptoms were studied in healthy volunteers before and after vigabatrin treatment. After placebo-controlled administration of 50 μg CCK-4, ten healthy volunteers received vigabatrin for seven days with a daily dosage of 2 g. The treatment period was followed by a second CCK-4 challenge. Panic and anxiety were assessed using the Acute Panic Inventory (API) score and a DSM-IV derived panic-symptom-scale (PSS). ACTH and cortisol plasma levels were determined during the CCK-4 challenge. All subjects reported a marked reduction of CCK-4-induced panic symptoms and anxiety after seven days of vigabatrin treatment both in the API- and PSS-scores. Moreover, there was a significant attenuation of CCK-induced elevation of ACTH and cortisol levels following vigabatrin treatment. In conclusion, our data show that GABA-transaminase inhibitors exert anxiolytic effects in CCK-4-induced panic in healthy volunteers and suggest that GABA transaminase inhibitors might be useful in ameliorating panic symptoms also in patients with PD. © 2001 American College of Neuropsychopharmacology. Published by Elsevier Science Inc.",Zwanzger P.; Baghai T.C.; Schuele C.; Ströhle A.; Padberg F.; Kathmann N.; Schwarz M.; Möller H.-J.; Rupprecht R.,2001.0,10.1016/S0893-133X(01)00266-4,0,0,
2266,Emotional responding to biological challenge as a function of panic disorder and smoking.,"The present investigation evaluated anxious and fearful responding to bodily sensations as a function of panic disorder (PD) and smoking status. Participants completed a voluntary hyperventilation procedure that elicits panic-relevant bodily sensations. Psychophysiological data were collected throughout the study procedures. Assessments of anxiety and bodily distress were conducted pre-challenge baseline, post-hyperventilation, and during a recovery period following the challenge. Results indicated that smokers with PD reported greater levels of anxiety and bodily distress than smokers without PD and than nonsmokers with PD at the post-challenge assessment and recovery period. No differences in autonomic responding were evident during the challenge or in the recovery phase. In terms of rate of recovery, the linear decrease in anxiety, but not bodily distress, was significantly more steep for nonsmokers with PD than for smokers with PD. These findings are discussed in relation to better understanding the potential role that smoking may play in terms of anxious and fearful responding to bodily sensations.",Zvolensky MJ.; Leen-Feldner EW.; Feldner MT.; Bonn-Miller MO.; Lejuez CW.; Kahler CW.; Stuart G.,2004.0,,0,0,
2267,Assessment of anxiety sensitivity in young American Indians and Alaska Natives,"In the present study, the Anxiety Sensitivity Index [ASI; Behav. Res. Ther. 24 (1986) 1] was administered to 282 American Indian and Alaska Native college students in a preliminary effort to: (a) evaluate the factor structure and internal consistency of the ASI in a sample of Native Americans; (b) examine whether this group would report greater levels of anxiety sensitivity and gender and age-matched college students from the majority (Caucasian) culture lesser such levels; and (c) explore whether gender differences in anxiety sensitivity dimensions varied by cultural group (Native American vs. Caucasian). Consistent with existing research, results of this investigation indicated that, among Native peoples, the ASI and its subscales had high levels of internal consistency, and a factor structure consisting of three lower-order factors (i.e. Physical, Psychological, and Social Concerns) that all loaded on a single higher-order (global Anxiety Sensitivity) factor. We also found that these Native American college students reported significantly greater overall ASI scores as well as greater levels of Psychological and Social Concerns relative to counterparts from the majority (Caucasian) culture. There were no significant differences detected for ASI physical threat concerns. In regard to gender, we found significant differences between males and females in terms of total and Physical Threat ASI scores, with females reporting greater levels, and males lesser levels, of overall anxiety sensitivity and greater fear of physical sensations; no significant differences emerged between genders for the ASI Psychological and Social Concerns dimensions. These gender differences did not vary by cultural group, indicating they were evident among Caucasian and Native Americans alike. We discuss the results of this investigation in relation to the assessment of anxiety sensitivity in American Indians and Alaska Natives, and offer directions for future research with the ASI in Native peoples. Copyright © 2001 Elsevier Science Ltd.",Zvolensky M.J.; McNeil D.W.; Porter C.A.; Stewart S.H.,2001.0,10.1016/S0005-7967(00)00010-3,0,0,
2268,"Affective style among smokers: Understanding anxiety sensitivity, emotional reactivity, and distress tolerance using biological challenge","The present investigation evaluated affective style in terms of anxiety sensitivity, emotional reactivity, and distress tolerance in heavy smokers. Specifically, heavy smokers (≥ 20 cigarettes per day) were partitioned into those who were able to quit for at least 7 days (n = 10) and those who were able to quit for less than 7 days (n = 12). All participants completed measures of anxiety sensitivity and maximum breath-holding duration and then were exposed to a 20% carbon dioxide-enriched air challenge. Results indicated that heavy smokers who had not been able to remain abstinent from smoking for at least 1 week during a quit attempt demonstrated significantly greater cognitive-affective reactivity to the challenge relative to their counterparts but did not differ at a physiological level of analysis. Contrary to our hypotheses, neither anxiety sensitivity scores nor maximum breath-holding duration significantly differed between the groups. These findings are discussed in relation to better understanding affective style among heavy smokers. © 2001 Elsevier Science Ltd. All rights reserved.",Zvolensky M.J.; Feldner M.T.; Eifert G.H.; Brown R.A.,2001.0,10.1016/S0306-4603(01)00242-8,0,0,
2269,The effects of offset control over 20% carbon-dioxide-enriched air on anxious responding,"ER Control over the offset of repeated administrations of 20% carbon-dioxide-enriched air was assessed in nonclinical participants (n = 30) reporting elevated levels of anxiety sensitivity--a population at an increased risk for experiencing panic attacks and possibly developing panic disorder. In Phase I, participants were randomly assigned to 1 of 2 conditions: one that permitted offset control over gas inhalation and one that did not. These conditions were reversed in Phase II. Across phases, a lack of offset control resulted in greater self-reported anxiety compared with having control, although no significant differences were observed for heart rate. Whereas all participants demonstrated a Stroop interference effect for general (e.g., coffin) compared with specific (e.g., dizzy) physical threat word types prior to the first experimental phase, this effect persisted only for participants who had offset control in Phase I. We discuss these results in relation to the differential effects of offset control, with implications for better understanding anxious responding during elevated bodily arousal.","Zvolensky, M J; Eifert, G H; Lejuez, C W; McNeil, D W",1999.0,,0,0,
2270,Transcendental meditation verus muscle relaxation: two-year follow-up of a controlled experiment,"ER In this questionnaire survey the authors measured the outcome among 20 students randomly assigned to muscle relaxation training and 19 assigned to transcendental mediatation at one year (the number of respondents in each group was 13 and 16, respectively) and two and one-half years (the number of respondents was 18 and 17, respectively). At both follow-ups there were no differences between the groups in frequency of practice or satisfaction. In both groups, less than 25% reported more than moderate satisfaction, and less than 20% practices as mush as once per week. Subjects' expectancies at nine weeks predicted their satisfaction and frequency of practice at two and on-half years. The authors conclude that although some subjects (15%-20%) to enjoy and continue to practice transcendental meditation, it is not universally beneficial.","Zuroff, D C; Schwarz, J C",1980.0,10.1176/ajp.137.10.1229,0,0,
2271,Venlafaxine versus applied relaxation for generalized anxiety disorder: a randomized controlled study on clinical and electrophysiological outcomes.,"Some components of generalized anxiety disorder, such as physical symptoms, are thought to reflect autonomic nervous system arousal. This study primarily assessed the relationships between psychophysiological and clinical measures using venlafaxine extended release or applied relaxation, and secondarily, the impact of combination treatment in patients not remitting after 8 weeks. Fifty-eight patients were randomly assigned to 8 weeks of treatment with either venlafaxine or applied relaxation (Phase I). Non-remitted patients received combination treatment for an additional 8 weeks (Phase II). Assessments included the Hamilton Anxiety Scale (HAM-A), Beck Depression Inventory, Penn State Worry Questionnaire and the Stroop Color-Word Task coupled with electrophysiological measures (skin conductance and frontalis electromyography (EMG)). In Phase 1, a time effect was found for the clinical and skin conductance measures. Thirteen patients from each group were in remission. In Phase 2, seven additional patients remitted. Baseline psychophysiological measures were not associated with baseline clinical variables or with clinical outcomes. Independently of treatment allocation, a reduction in frontal EMG values at week 4 was significantly associated with a decrease in HAM-A scores at week 8. At week 4, responders from the applied relaxation group had lower electrophysiological activity than the venlafaxine group. Baseline psychophysiological measures were not linked with clinical measures at study inclusion or with treatment response. Frontal EMG response at week 4 is a possible predictor of treatment response. Treatment combination enhances treatment response after initial failure.",Zullino D.; Chatton A.; Fresard E.; Stankovic M.; Bondolfi G.; Borgeat F.; Khazaal Y.,2015.0,10.1007/s11126-014-9334-2,0,0,
2272,A comparison of the effect of three therapies on generalized anxiety disordered adults' self-reported internal working models of attachment.,"Attachment theorists have argued that internal working models of attachment in adults (IWMs) can only be changed through intensive, psychodynamic therapy, based on Bowlby's (1988) theories. However, research shows that cognitive therapy also contains the essential components of what Bowlby argues are necessary for IWM change. This study examined the hypothesis that clients' IWMs would change after a course of cognitive and cognitive-behavioral therapy. Pre and post-therapy IWMs were compared in clients who underwent 14 weeks of cognitive therapy, self-controlled desensitization, or a combination of cognitive therapy and self-controlled desensitization for treatment of Generalized Anxiety Disorder. Analyses did not support the hypothesis that cognitive and cognitive-behavioral therapy would lead to more IWM change than behavioral therapy. Results showed no significant differences among the three therapy conditions on scales measuring IWMs, and little clinically significant change on those scales. Change was found across therapies on two scales, suggesting that cognitive, cognitive-behavioral, and behavioral therapy aided in reducing client's angry/oscillating feelings toward their mothers, as well as their memories of having enmeshed/role-reversed relationships with their mothers during childhood. Finally, clinically significant change on the angry/oscillating, no memory, and rejected scales was associated with clinically significant change on outcome measures for anxiety. Implications and future recommendations are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zuellig, Andrea Renee",2003.0,,0,0,
2273,The effects of respiratory sinus arrhythmia biofeedback on heart rate variability and posttraumatic stress disorder symptoms: a pilot study.,"Recent studies have found a significant association between PTSD and low heart rate variability (HRV), a biomarker of autonomic dysregulation. Research indicates that respiratory sinus arrhythmia (RSA) biofeedback increases HRV while reducing related pathological symptoms. This controlled pilot study compared RSA biofeedback to progressive muscle relaxation (PMR) as adjunctive interventions for 38 persons with PTSD symptoms in a residential treatment facility for a substance use disorder. Both groups were assessed at pre-intervention and 4-week post-intervention. Group x time interactions revealed significantly greater reductions in depressive symptoms and increases in HRV indices for the RSA group. Both groups significantly reduced PTSD and insomnia symptoms and a statistical trend was observed for reduced substance craving for the RSA group. Increases in HRV were significantly associated with PTSD symptom reduction. Overall, these results provide preliminary support for the efficacy of RSA biofeedback in improving physiological and psychological health for individuals with PTSD.",Zucker TL.; Samuelson KW.; Muench F.; Greenberg MA.; Gevirtz RN.,2009.0,10.1007/s10484-009-9085-2,0,0,
2274,Dissociative symptomatology in posttraumatic stress disorder and disorders of extreme stress.,"The present study was designed to assess differences in dissociative symptoms in adults with Posttraumatic Stress Disorder (PTSD) vs. PTSD plus Disorders of Extreme Stress Not Otherwise Specified (DESNOS). This study was done for two reasons: (1) to better understand the clinical profile of DESNOS clients in order to inform more effective treatment, and (2) to further empirical research on the validity of the DESNOS construct. To assess severity of dissociative symptoms, the authors administered the Dissociative Experiences Scale (DES) to 155 participants with PTSD. Using the Structured Interview for Disorders of Extreme Stress (SIDES), participants were divided into two groups: those who also met criteria for DESNOS and those who did not. DES means are provided for the two groups. Participants with PTSD plus DESNOS scored higher than participants with only PTSD on the measure of dissociative symptomatology, particularly on the DES scales that tap absorption/fantasy and depersonalization/derealization. The two groups did not differ on the amnesia subscale of the DES. Findings support the construct validity of the DESNOS concept and further delineate the clinical profiles of community-based PTSD with and without DESNOS, thus contributing to the knowledge base on the assessment of complex adaptations to trauma. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zucker, Marla; Spinazzola, Joseph; Blaustein, Margaret; van der Kolk, Bessel A; Bernstein, Blake, Branscomb, Bremner, Carlson, Cloitre, Cloitre, Coons, Ford, Ford, Frischholz, Jaycox, Korn, Luxenberg, Luxenberg, Newman, Pelcovitz, Ross, van der Kolk, van der Kolk, van der Kolk, van der Kolk, Weathers, Zlotnick",2006.0,,0,0,
2275,A cognitive behavioral workshop for subclinical obsessions and compulsions.,"The present study investigates the effectiveness of a 3-h cognitive behavioral workshop for individuals, ages 18-22, with subclinical obsessions and compulsions. It was hypothesized that, compared to individuals in an assessment-only waitlist group (n = 42), individuals assigned to the workshop group (n = 43) would experience a significant decrease in obsessive-compulsive (OC) symptomatology, comorbidity, and thought action fusion endorsement at 1-month and 5-month follow-up assessments. An additional outcome of interest was the number of incident cases of obsessive-compulsive disorder (OCD) over the course of the study. The results indicated that the workshop group reported a significantly fewer number of OC symptoms at 5-month follow-up and endorsed significantly less thought action fusion at both follow-up points. However, there were no differences between groups in severity of OC symptoms and number of comorbid diagnoses endorsed. Only one incident case of OCD was observed during the study, from a participant in the waitlist group. These results are discussed in reference to treatment of subclinical anxiety symptoms.",Zucker BG.; Craske MG.; Blackmore MA.; Nitz A.,2006.0,10.1016/j.brat.2005.03.015,0,0,
2276,Thought action fusion: can it be corrected?,"The goal of this study was to investigate whether or not a brief educational intervention delivered prior to engaging in an anxiety-provoking task (writing a sentence about hoping that a friend/relative was in a car accident) would be effective in offsetting anxiety in college students with a strong propensity to endorse statements of thought action fusion (TAF). As hypothesized, individuals receiving the educational intervention were less anxious than a placebo intervention control group at post task; they were also less likely to endorse statements of TAF after receiving the educational intervention. Also, those who chose to neutralize after writing the sentence (regardless of experimental group) were more likely to report feeling guiltier, more immoral and a greater sense of responsibility about writing the sentence prior to neutralizing than those who did not subsequently neutralize. These results are discussed in relation to the cognitive theory of obsessive-compulsive disorder and implications for prevention programs.",Zucker BG.; Craske MG.; Barrios V.; Holguin M.,2002.0,,0,0,
2277,5-HT-related drugs and human experimental anxiety,"Clinical observations and double-blind studies demonstrated an anxiolytic effect of drugs that facilitate serotonergic transmission on several anxiety disorders. There is a latency of several weeks for their anxiolytic effect to take place. There may be, in addition, a biphasic effect, i.e., an acute anxiogenic effect followed by an anxiolytic effect after chronic use. In addition, acute administration of m-chlorophenylpiperazine (MCPP), an agonist of 5-HT-1 receptors, increased anxiety in normal volunteers as well as in patients with panic or obsessive-compulsive disorders. Studies in healthy volunteers have been performed in our laboratory to explore the acute effect on human anxiety of drugs that selectively influence 5-HT neurotransmission. We observed that acute administration of chlorimipramine enhanced the rise in anxiety induced in healthy volunteers by speaking in front of a video camera. With a similar experimental design, we also demonstrated an anxiogenic effect of metergoline, a nonselective 5-HT receptor blocker. It is suggested that the proanxiogenic effect of acute administration of 5-HT uptake inhibitors may be due to impaired 5-HT neurotransmission.",Zuardi A.W.,1990.0,10.1016/S0149-7634(05)80075-2,0,0,
2278,The effect of attentional focus on social anxiety.,"The aim of the present study was to examine the effect of attentional focus on social anxiety in a group of high and low blushing-anxious subjects. One hundred and fourteen psychology undergraduate students were screened using the Fear of Blushing subscale of the Blushing Questionnaire [Bögels, S. M., & Reith, W. (1999). Validity of two questionnaires to assess social fears: The Dutch social phobia and anxiety questionnaire and the blushing, trembling and sweating questionnaire. Journal of Psychopathology and Behavioral Assessment, 21, 51-66]. Those with the most extreme scores in the top and bottom 20% of the distribution were selected to form a high (n=22) and a low (n=22) blushing-anxious group. Subjects were randomly allocated to either a self-focused attention (SFA) condition or a task-focused attention (TFA) condition. They were asked to engage in a 5 min conversation with the first author, and were instructed to either self-focus (SFA condition) or task-focus (TFA condition). Levels of social anxiety and self-awareness were measured using visual analogue scales. Results suggest that the there was a significant condition by group interaction, with high blushing individuals showing considerably higher levels of social anxiety in the SFA condition compared to the TFA condition while low blushing individuals showed no significant difference across the two conditions.",Zou JB.; Hudson JL.; Rapee RM.,2007.0,10.1016/j.brat.2007.03.014,0,0,
2279,Prefrontal control of the amygdala during real-time fMRI neurofeedback training of emotion regulation.,"We observed in a previous study (PLoS ONE 6:e24522) that the self-regulation of amygdala activity via real-time fMRI neurofeedback (rtfMRI-nf) with positive emotion induction was associated, in healthy participants, with an enhancement in the functional connectivity between the left amygdala (LA) and six regions of the prefrontal cortex. These regions included the left rostral anterior cingulate cortex (rACC), bilateral dorsomedial prefrontal cortex (DMPFC), bilateral superior frontal gyrus (SFG), and right medial frontopolar cortex (MFPC). Together with the LA, these six prefrontal regions thus formed the functional neuroanatomical network engaged during the rtfMRI-nf procedure. Here we perform a structural vector autoregression (SVAR) analysis of the effective connectivity for this network. The SVAR analysis demonstrates that the left rACC plays an important role during the rtfMRI-nf training, modulating the LA and the other network regions. According to the analysis, the rtfMRI-nf training leads to a significant enhancement in the time-lagged effect of the left rACC on the LA, potentially consistent with the ipsilateral distribution of the monosynaptic projections between these regions. The training is also accompanied by significant increases in the instantaneous (contemporaneous) effects of the left rACC on four other regions - the bilateral DMPFC, the right MFPC, and the left SFG. The instantaneous effects of the LA on the bilateral DMPFC are also significantly enhanced. Our results are consistent with a broad literature supporting the role of the rACC in emotion processing and regulation. Our exploratory analysis provides, for the first time, insights into the causal relationships within the network of regions engaged during the rtfMRI-nf procedure targeting the amygdala. It suggests that the rACC may constitute a promising target for rtfMRI-nf training along with the amygdala in patients with affective disorders, particularly posttraumatic stress disorder (PTSD).",Zotev V.; Phillips R.; Young KD.; Drevets WC.; Bodurka J.,2013.0,10.1371/journal.pone.0079184,0,0,
2280,The relationships between therapeutic alliance and internalizing and externalizing symptoms in Trauma-Focused Cognitive Behavioral Therapy,"ER Therapeutic alliance has been considered an important factor in child psychotherapy and is consistently associated with positive outcomes. Nevertheless, research on alliance in the context of child trauma therapy is very scarce. This study examined the relationships between child therapeutic alliance and psychopathology in an empirically supported child trauma therapy model designed to address issues related to trauma with children and their caregivers. Specifically, we examined the extent to which the child's psychopathology would predict the establishment of a positive alliance early in treatment, as well as the association between alliance and outcome. Participants were 95 children between the ages of 7 and 12 and their caregivers, who went through a community-based Trauma-Focused Cognitive Behavioral Therapy program in Canada. Caregivers filled out the CBCL prior to assessment and following treatment. Children and therapists completed an alliance measure (TASC) at three time points throughout treatment. Symptomatology and child gender emerged as important factors predicting alliance at the beginning of treatment. Girls and internalizing children developed stronger alliances early in treatment. In addition, a strong early alliance emerged as a significant predictor of improvement in internalizing symptoms at the end of treatment. Our findings indicate that symptomatology and gender influence the development of a strong alliance in trauma therapy. We suggest that clinicians should adjust therapeutic style to better engage boys and highly externalizing children in the early stages of therapy.","Zorzella, K P; Muller, R T; Cribbie, R A",2015.0,10.1016/j.chiabu.2015.08.002,0,0,
2281,Reduction of depersonalization during social stress through cognitive therapy for social anxiety disorder: A randomized controlled trial.,"Symptoms of depersonalization during feared social situations are commonly experienced by individuals with social anxiety disorder (SAD). Despite its clinical relevance, it is not addressed in standard treatment manuals and it remains unclear if depersonalization is reduced by well-established treatments. This study investigated whether cognitive therapy (CT) for SAD effectively reduces depersonalization and whether pre-treatment severity of depersonalization predicts or mediates treatment outcome. In a randomized controlled trial, patients underwent the standardized Trier Social Stress Test before and after CT (n = 20) or a waitlist period (n = 20) and were compared to healthy controls (n = 21). Self-reported depersonalization was measured immediately after each stress test. Depersonalization significantly decreased following CT, especially in treatment responders (etap2 = 0.32). Pre-treatment depersonalization did neither predict nor mediate post-treatment severity of social anxiety. Further prospective studies are needed for a better scientific understanding of this effect. It should be scrutinized whether SAD-patients suffering from depersonalization would benefit from a more specific therapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schweden, Tabea L. K; Pittig, Andre; Brauer, David; Klumbies, Elisabeth; Kirschbaum, Clemens; Hoyer, Juergen; Bernstein, Clark, Clark, Clark, Cohen, Davidson, Ebner-Priemer, Freyberger, Gul, Halvorsen, Hartling, Hofmann, Hofmann, Hoyer, Hunter, Hunter, Kamaradova, Kirschbaum, Kleindienst, Klumbies, Kraemer, Leichsenring, Leising, Liebowitz, Mathew, McManus, Mendoza, Michal, Michal, Michal, Michelson, Mortberg, Potter, Price, Sadler, Segui, Sierra, Sierra, Stangier, Stangier, Stangier, Wittchen, Wong, Zanarini",2016.0,,0,0,
2282,A randomized controlled trial of a transdiagnostic internet intervention for individuals with panic and phobias - one size fits all.,"Background and objectives: Many individuals with anxiety disorders do not receive professional treatment. Internet interventions have shown to be effective in the treatment of anxiety. The present randomized controlled trial was designed to examine the effectiveness of a short-term (4-week) Internet intervention in treating panic disorder, agoraphobia, social anxiety disorder, and specific phobias ('ConfID'). We addressed the questions of whether this transdiagnostic program would affect these disorders to varying degrees and whether there would be moderators of effectiveness. Methods: Adults who were recruited in online forums for anxiety underwent an online baseline assessment (N = 179) and were randomized either to the intervention group (ConfID) or the control group (care as usual). Online post-assessment took place 4 weeks later. The primary outcome was assessed with the Beck Anxiety Inventory (BAI); the secondary outcomes targeted the disorder-specific symptoms, depression, and somatization. Results: Participants in the intervention group showed a significantly stronger anxiety reduction compared to participants receiving care as usual (small-to-medium effect size between groups in intention-to-treat analysis). The treatment effect was similar for the different disorders and was moderated by participants' attitudes towards Internet interventions. Secondary outcomes yielded effect sizes in the medium range. Limitations: Moderate treatment adherence, lack of measures beyond online self-reports, and unavailability of long-term results. Conclusions: The study provides further evidence that transdiagnostic Internet interventions are promising in reducing the existing treatment gap in individuals with panic disorder and phobias. Results extend previous findings by showing that significant effects can also be reached by comprehensive shortterm programs and that the effects might be moderated by participants' attitudes towards Internet interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schroder, Johanna; Jelinek, Lena; Moritz, Steffen; Alfonsson, Andersson, Andersson, Andersson, Association, Attkisson, Attkisson, Bandelow, Barnett, Beck, Berger, Carlbring, Christensen, Davidson, Dear, Derogatis, Ebert, First, Fogliati, Griffiths, Hedman, Hedman, Hilvert-Bruce, Hofmann, Hollon, Johnston, Kessler, Kessler, Kohn, Kroenke, Meyer, Newby, Nordgren, Rausch, Rutherford, Saddichha, Scheffer, Schroder, Sheehan, Spitzer, Titov, Titov, Titov, Titov, Titov, Tural",2017.0,,0,0,
2283,Structured writing and processing major stressful events: a controlled trial.,"Traumatic events may result in a variety of physical and psychological health problems. Self-confrontation with traumatic memories, by putting painful emotions and thoughts into (verbal) words, is associated with psychophysiological benefits. Self-confrontation may be invoked during sessions and enhanced by structural assignments, which the client carries out between the sessions. In this context, writing assignments could be a useful tool in reprocessing traumatic events. The effects of writing assignments have been demonstrated in several case studies and in a number of experimental studies. However, the experimental studies have several limitations, for example the effects of writing on the impact of trauma are not examined. Furthermore, the psychological mechanisms that mediate the effects of trauma on health are less clear. These two issues are the main issues of the current study. A group of 26 participants were instructed to write about their negative events during five 45-min sessions over a period of 2 weeks. They were compared at pre-treatment, post-treatment and at 6-week follow-up to a waiting-list control group (n = 22). The trauma-writing groups experienced fewer intrusions and showed less avoidance behavior from pre-treatment to follow-up, whereas the waiting-list control group did not change significantly. Similar results were found on depressive symptoms. No effects on mood measures were found. Implications for future research and clinical practice are discussed.",Schoutrop MJ.; Lange A.; Hanewald G.; Davidovich U.; Salomon H.,,56282,0,0,
2284,Association Splitting: A randomized controlled trial of a new method to reduce craving among inpatients with alcohol dependence.,"Association Splitting, a novel cognitive intervention, was tested in patients with alcohol dependence as an add-on intervention in an initial randomized controlled trial. Preliminary support for Association Splitting has been found in patients with obsessive-compulsive disorder, as well as in an online pilot study of patients with alcohol use disorders. The present variant sought to reduce craving by strengthening neutral associations with alcohol-related stimuli, thus, altering cognitive networks. Eighty-four inpatients with verified diagnoses of alcohol dependence, who were currently undergoing inpatient treatment, were randomly assigned to Association Splitting or Exercise Therapy. Craving was measured at baseline, 4-week follow-up, and six months later with the Obsessive-Compulsive Drinking Scale (primary outcome) and the Alcohol Craving Questionnaire. There was no advantage for Association Splitting after three treatment sessions relative to Exercise Therapy. Among Association Splitting participants, 51.9% endorsed a subjective decline in craving and 88.9% indicated that they would use Association Splitting in the future. Despite high acceptance, an additional benefit of Association Splitting beyond standard inpatient treatment was not found. Given that participants were concurrently undergoing inpatient treatment and Association Splitting has previously shown moderate effects, modification of the study design may improve the potential to detect significant effects in future trials.",Schneider BC.; Moritz S.; Hottenrott B.; Reimer J.; Andreou C.; Jelinek L.,2016.0,10.1016/j.psychres.2016.02.051,0,0,
2285,Internet-guided self-help with or without exposure therapy for phobic and panic disorders.,"As many sufferers from phobic and panic (phobia/panic) disorders cannot get to suitable therapists, routine aspects of therapy were delegated to internet-accessed computer-aided self-help with or without exposure instructions. Phobia/panic referrals were randomised to computer-aided self-help via the internet at home in a 2:1 ratio either by self-exposure cognitive behaviour therapy (CBT) [FearFighter (FF), n = 45] or by minimal CBT without exposure [Managing Anxiety (MA), n = 23]. All had brief backup phone advice from a clinician concerning their computer guidance. On self-ratings and blinded assessor ratings, patients improved equally with each form of self-help over 10 treatment weeks but significantly more on 5 out of 10 measures by week 14 (1-month follow-up) when the self-help included self-exposure instructions than when it did not. In accord with this, standardised effect sizes (Cohen's d) indicated superiority of FF over MA on 5 measures by week 14. Satisfaction with treatment in all patients pooled correlated positively with improvement after treatment and at 1-month follow-up. At the end of treatment, computer-aided CBT self-help at home via the internet plus brief live helpline support was effective with or without exposure instructions, and at 1-month follow-up it was more effective on some measures if exposure instructions had been included. Analysis is needed of how non-exposure CBT produced its shorter-term effect.",Schneider AJ.; Mataix-Cols D.; Marks IM.; Bachofen M.,2005.0,10.1159/000084000,0,0,
2286,Dismantling cognitive-behavioral treatment for panic disorder: questioning the utility of breathing retraining.,"Cognitive-behavioral treatment (CBT) protocols for panic disorder (PD) consist of a set of interventions that often includes some form of breathing retraining (BR). A controlled outcome study was designed to assess the necessity of BR in the context of a multicomponent CBT protocol. To accomplish this, patients with PD (N = 77) were randomly assigned to receive CBT with or without BR or to a delayed-treatment control. The main study hypothesis was that patients receiving BR would display a less complete recovery relative to the other active-treatment condition given that BR appears to be a more attractive (but less adaptive) option for some patients. Some data suggested that the addition of BR yielded a poorer outcome. However, findings were generally more consistent with treatment equivalence, questioning whether BR produces any incremental benefits in the context of other CBT interventions for PD.",Schmidt NB.; Woolaway-Bickel K.; Trakowski J.; Santiago H.; Storey J.; Koselka M.; Cook J.,2000.0,,0,0,
2287,Extinction of panicogenic effects of a 35% CO2 challenge in patients with panic disorder.,"Inhalations of high concentrations of carbon dioxide (CO2) reliably produce panic attacks in patients with panic disorder. The present study evaluated whether cognitive-behavioral treatment (CBT) for panic disorder would extinguish CO2-induced panic and whether changes in panic and arousal-related cognitions were associated with the induction of panic. Patients with panic disorder (N = 54) were assigned to 1 of 3 experimental conditions: CBT with respiratory training (CBT-R), CBT without respiratory training (CBT), or delayed treatment. Participants received 5 repeated vital-capacity inhalations of 35% CO2/65% O2 prior to and following either 12 treatment sessions or a 12-week waiting period. During pretreatment assessments, 74% of patients experienced a panic attack during at least 1 inhalation. At posttreatment, only 20% of treated participants (CBT-R = 19%, CBT = 22%), compared with 64% of untreated participants, panicked. Forty-four percent of treated participants, compared with 0% of untreated participants, reported no anxiety during all posttreatment inhalations. Anxiety sensitivity as well as panic appraisals regarding the likelihood of panic and self-efficacy with coping with panic were significantly related to fearful responding to the CO2 challenge.",Schmidt NB.; Trakowski JH.; Staab JP.,1997.0,,0,0,
2288,Attention training for generalized social anxiety disorder.,"Attentional bias toward negative social cues is thought to serve an etiological and/or maintaining role in social anxiety disorder (SAD). The current study tested whether training patients to disengage from negative social cues may ameliorate social anxiety in patients (N = 36) with a primary diagnosis of generalized SAD. Patients were randomly assigned to either an attention training condition (n = 18), in which patients completed a modified dot-probe task designed to facilitate attentional disengagement from disgusted faces, or a control dot-probe task condition (n = 18). As predicted, patients in the attention training condition exhibited significantly greater reductions in social anxiety and trait anxiety, compared with patients in the control condition. At termination, 72% of patients in the active treatment condition, relative to 11% of patients in the control condition, no longer met Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for SAD. At 4-month follow-up, patients in the attention training condition continued to maintain their clinical improvement, and diagnostic differences across conditions were also maintained. Results support attention-based models of anxiety and suggest that attention training is a promising alternative or complementary intervention.",Schmidt NB.; Richey JA.; Buckner JD.; Timpano KR.,2009.0,10.1037/a0013643,0,0,
2289,Anxiety Sensitivity Amelioration Training (ASAT): a longitudinal primary prevention program targeting cognitive vulnerability.,"Fear of arousal symptoms, often referred to as anxiety sensitivity (AS) appears to be associated with risk for anxiety pathology and other Axis I conditions. Findings from a longitudinal prevention program targeting AS are reported. Participants (n=404) scoring high on the Anxiety Sensitivity Index (ASI) were randomly assigned to receive a brief intervention designed to reduce AS (Anxiety Sensitivity Amelioration Training (ASAT)) or a control condition. Participants were followed for up to 24 months. Findings indicate that ASAT produced greater reductions in ASI levels compared with the control condition. Moreover, reductions were specific to anxiety sensitivity relative to related cognitive risk factors for anxiety. ASAT also produced decreased subjective fear responding to a 20% CO(2) challenge delivered postintervention. Data from the follow-up period show a lower incidence of Axis I diagnoses in the treated condition though the overall group difference was not statistically different at all follow-up intervals. Overall, findings are promising for the preventative efficacy of a brief, computer-based intervention designed to decrease anxiety sensitivity.",Schmidt NB.; Eggleston AM.; Woolaway-Bickel K.; Fitzpatrick KK.; Vasey MW.; Richey JA.,2007.0,10.1016/j.janxdis.2006.06.002,0,0,
2290,Attention focusing versus distraction during exposure in dental phobia.,"A survey of the discrepant findings regarding the effects of attention focusing and distraction on exposure suggested that subjective measures of anxiety and avoidance respond better to the latter condition, and heart rate (HR) reaction responds to the former. To test this hypothesis, 63 dental phobics were recruited who had not visited a dentist for a mean of 6.6 (1.5-25) years. Participants received a 1-h exposure session with either attention focusing or distraction. Subjective anxiety and HR to phobia-related pictures were assessed before and after the treatment session and again after 1 week. Avoidance was recorded in terms of adherence to the dental treatment schedule in the following 6 months. Contrary to expectation, state anxiety showed a greater decrease in the attention focusing than the distraction condition after 1 week. Both treatment conditions were similarly effective with regard to HR and avoidance. HR habituated in both groups after exposure and 73% of followed-up patients adhered to the dental treatment schedule. Comparison of the present with previous results suggests that the differences between attentional conditions tend to be more pronounced during shorter exposure sessions than were employed in the present study.",Schmid-Leuz B.; Elsesser K.; Lohrmann T.; Jöhren P.; Sartory G.,2007.0,10.1016/j.brat.2007.07.004,0,0,
2291,Narrative exposure therapy versus interpersonal psychotherapy. A pilot randomized controlled trial with Rwandan genocide orphans.,"The aim of the present study was to evaluate the efficacy of treatment modules for trauma spectrum disorders in a sample of Rwandan genocide orphans. Twenty-six orphans (originally 27) who presented with posttraumatic stress disorder (PTSD) at first assessment continued to meet a PTSD DSM-IV diagnosis 6 months after their initial assessment. They were offered participation in a controlled treatment trial. A group adaptation of interpersonal psychotherapy (IPT, n = 14) was compared to individual narrative exposure therapy (NET, n = 12). The last NET session involved guided mourning. Each treatment program consisted of 4 weekly sessions. Main outcome measures were diagnostic status and symptoms of PTSD and depression assessed before treatment, at 3 months post-test and at 6 months follow-up using the Clinician-Administered PTSD Scale, Mini-International Neuropsychiatric Interview, and Hamilton Rating Scale. At post-test, there were no significant group differences between NET and IPT on any of the examined outcome measures. At 6-month follow-up, only 25% of NET, but 71% of IPT participants still fulfilled PTSD criteria. There was a significant time x treatment interaction in the severity of PTSD [Wilks' Lambda = 0.75, F(2,23) = 3.93; p < 0.05] and depression symptoms [Wilks' Lambda = 0.23, F(2,23) = 3.40; p = 0.05]. At follow-up, NET participants were significantly more improved than IPT participants with respect to both the severity of symptoms of PTSD and depression. Individual NET in combination with group-based mourning comprises an effective treatment for traumatized survivors who have to bear the loss of loved ones and have been suffering from symptoms of PTSD and depression.",Schaal S.; Elbert T.; Neuner F.,2009.0,10.1159/000229768,0,0,
2292,Virtual reality cognitive-behavior therapy for public speaking anxiety: one-year follow-up.,"Public speaking anxiety (PSA) is a common social phobia. Although cognitive-behavior therapy (CBT) is the treatment of choice, difficulties arise with both in vivo and in vitro exposure (lack of therapist control, patient's inability to imagine, self-flooding, and a lack of confidentiality resulting from public exposure). Virtual reality CBT (VRCBT) enables a high degree of therapist control, thus overcoming these difficulties. In a previous publication, the authors reported on their findings that VRCBT (n = 28) and CBT (n = 30) groups were significantly more effective than a wait-list control (WLC; n = 30) group in anxiety reduction on four of five anxiety measures as well as on participant's self-rating of anxiety during a behavioral task. No significant differences were found between VRCBT and CBT. However, twice as many clients dropped out of CBT (15) than from VRCBT (6). Results demonstrated that VRCBT is an effective and brief treatment regimen, equal to CBT. This brief report examined durability of these changes. They found that both VRCBT (25) and CBT (24) groups maintained their improvement from post treatment to follow-up, on all five measures. In addition, they found that the CBT group continued to improve from post treatment to follow-up on Liebowitz Social Anxiety Scale (LSAS) fear. Thus, treatment gains were maintained at a 1-year follow-up.",Safir MP.; Wallach HS.; Bar-Zvi M.,2012.0,10.1177/0145445511429999,0,0,
2293,Web-based therapist-assisted cognitive behavioral treatment of panic symptoms: a randomized controlled trial with a three-year follow-up.,"Internet-delivered treatment may reduce barriers to care in those unwilling or unable to access traditional forms of treatment. To assesses the efficacy of web-based therapist-assisted cognitive behavioral treatment (web-CBT) of panic symptoms. A randomized waiting-list controlled trial with an uncontrolled three-year follow-up. A community sample of 58 participants with chronic panic symptoms of varying severity (immediate treatment: n=27, waiting-list control: n=31). The primary outcome measures were a one-week Panic Diary and the Panic Disorder Severity Scale - Self-Report (PDSS-SR); secondary measures were the Agoraphobic Cognitions Questionnaire (ACQ), the Body Sensations Questionnaire (BSQ), the Mobility Inventory - Alone subscale (MI-AAL), and the Depression Anxiety Stress Scales (DASS-42). In the RCT, 54 participants (93%) completed posttest measurements. With regard to the primary outcome measures, intention-to-treat ANCOVAs revealed that participants in the treatment condition improved more than the participants in the waiting-list control condition (p<.03), with a pooled between-group effect size of d=.7. After three years (n=47; 81% study compliance), effects were more pronounced. The results demonstrate the efficacy of therapist-assisted web-CBT in the treatment of panic symptoms.",Ruwaard J.; Broeksteeg J.; Schrieken B.; Emmelkamp P.; Lange A.,2010.0,10.1016/j.janxdis.2010.01.010,0,0,
2294,A randomized effectiveness trial of collaborative care for patients with panic disorder in primary care.,"Effectiveness studies have tested interventions to improve quality of care for depression in primary care, but none, to our knowledge, have been completed for panic disorder (PD) in this setting. This study sought to test the clinical effectiveness of PD pharmacotherapy embedded in a disease management framework of ""collaborative care"" (CC). One hundred fifteen patients with PD from 3 primary care clinics were randomized to CC or ""usual care"" (UC). Patients in CC (n = 57) received educational videotapes and pamphlets; pharmacotherapy with the selective serotonin reuptake inhibitor paroxetine; 2 psychiatrist visits and 2 telephone calls in the first 8 weeks; and up to 5 telephone calls between 3 and 12 months' follow-up. Usual care patients (n = 58) were treated by their primary care physician. Telephone assessments of panic, anxiety sensitivity, depression, and disability variables were performed at 3, 6, 9, and 12 months' follow-up. Adequacy of pharmacotherapy was assessed with an algorithm based on a review of efficacy studies. Patients in CC were more likely to receive adequate (type, dose, duration) medication and more likely to adhere to this medication at 3 and 6 months. Random regression analyses showed that CC patients improved significantly more over time compared with UC patients on anxiety, depression, and disability measures, with the greatest effects at 3 and 6 months. Compared with UC, CC interventions significantly improved both quality of care and clinical and functional outcomes in primary care PD patients. Clinical differences were greatest in the first 6 months, corresponding to the greater quality of care and the greater intensity of intervention.",Roy-Byrne PP.; Katon W.; Cowley DS.; Russo J.,2001.0,,0,0,
2295,"Cognitive-behavioral treatment for panic disorder with agoraphobia: a randomized, controlled trial and cost-effectiveness analysis.","A randomized, controlled trial was conducted to examine the cost-effectiveness of cognitive-behavioral treatment (CBT) for panic disorder with agoraphobia. A total of 100 participants were randomly assigned to standard (n = 33), group (n = 35), and brief (n = 32) treatment conditions. Results show significant clinical and statistical improvement on standard symptom measures and quality of life from baseline to posttreatment and 3-month follow-up, with no significant differences between treatment conditions. Compared with standard CBT, brief and group CBT incurred lower treatment costs and had a superior cost-effectiveness ratio, suggesting the potential of these alternative treatment conditions in increasing access to effective treatment.",Roberge P.; Marchand A.; Reinharz D.; Savard P.,2008.0,10.1177/0145445507309025,0,0,
2296,A follow-up study on short-term treatment of agoraphobia.,"The differential effectiveness of three treatment packages for agoraphobia was tested. Patients received one of three short-term treatments: Breathing Retraining and Cognitive Restructuring, graded Self-Exposure in vivo, or a combination of both. No differential effects were found between the treatment conditions at posttest and at an 18 months follow-up. Improvement at follow-up assessment was associated with whether patients had further treatment during the follow-up period. No relationship was found between further improvement and demographic variables, pre- and posttest scores on psychological questionnaires or the use of medication at follow-up. Implications of these findings are examined.",Rijken H.; Kraaimaat F.; de Ruiter C.; Garssen B.,1992.0,,0,0,
2297,"PHASE: a randomised, controlled trial of supervised self-help cognitive behavioural therapy in primary care.","Common mental health problems account for up to 40% of all general practitioner (GP) consultations. Patients have limited access to evidence-based psychological therapies. Cognitive behavioural therapy self-help strategies offer one potential solution. To determine differences in clinical outcome, patient satisfaction and costs, between a cognitive behavioural-based self-help package facilitated by practice nurses compared to ordinary care by GPs for mild to moderate anxiety and depression. Randomised controlled trial. Seventeen primary healthcare teams. Patients presenting to their GP with mild to moderate anxiety and/or depression were recruited to the study and randomised to receive either a self-help intervention facilitated by practice nurses or ordinary care. The self-help intervention consisted of up to three appointments: two 1 week apart and a third 3 months later. There were no restrictions on ordinary care. Intention-to-treat analysis showed that patients treated with practice nurse-supported cognitive behavioural therapy self-help attained similar clinical outcomes for similar costs and were more satisfied than patients treated by GPs with ordinary care. On-treatment analysis showed patients receiving the facilitated cognitive behavioural therapy self-help were more likely to be below clinical threshold at 1 month compared to the ordinary care group (odds ratio [OR] = 3.65, 95% confidence interval [CI] = 1.87 to 4.37). This difference was less well marked at 3 months (OR = 1.36, 95% CI = 0.52 to 3.56). Facilitated cognitive behavioural self-help may provide a short-term cost-effective clinical benefit for patients with mild to moderate anxiety and depression. This has the potential to help primary care provide a choice of effective psychological as well as pharmacological treatments for mental health problems.",Richards A.; Barkham M.; Cahill J.; Richards D.; Williams C.; Heywood P.,2003.0,,0,0,
2298,Cognitive-behavioral treatment for chronic nightmares in trauma-exposed persons: assessing physiological reactions to nightmare-related fear.,"Cognitive-behavioral treatments (CBTs) that target nightmares are efficacious for ameliorating self-reported sleep problems and psychological distress. However, it is important to determine whether these treatments influence objective markers of nightmare-related fear, because fear and concomitant physiological responses could promote nightmare chronicity and sleep disturbance. This randomized, controlled study (N=40) assessed physiological (skin conductance, heart rate, facial electromyogram) and subjective (displeasure, fear, anger, sadness, arousal) reactions to personally relevant nightmare imagery intended to evoke nightmare-related fear. Physiological assessments were conducted at pretreatment as well as 1-week, 3-months, and 6-months posttreatment. Results of mixed effects analysis of variance models suggested treatment reduced physiological and subjective reactions to nightmare imagery, gains that were generally maintained at the 6-month follow-up. Potential implications are discussed.",Rhudy JL.; Davis JL.; Williams AE.; McCabe KM.; Bartley EJ.; Byrd PM.; Pruiksma KE.,2010.0,10.1002/jclp.20656,0,0,
2299,"Effect of relaxation with guided imagery on anxiety, depression, and self-esteem in primiparas.","A pretest-posttest experimental design with a convenience sample of 60 subjects was used to examine the effects of a relaxation with guided imagery protocol on anxiety, depression, and self-esteem in primiparas during the first 4 weeks of the postpartum period. The results showed that the experimental group had less anxiety and depression and greater self-esteem than did the control group at the end of the period. Positive correlations were obtained between anxiety and depression; negative correlations between self-esteem and anxiety and depression. All findings were significant at the .05 level.",Rees BL.,1995.0,10.1177/089801019501300307,0,0,
2300,Reduction in posttraumatic stress symptoms in Congolese refugees practicing transcendental meditation.,"This matched single-blind pilot study tested the effect of Transcendental Meditation® (TM) practice on symptoms of posttraumatic stress (PTS) in Congolese refugees. Urban refugees (N = 102) staying around Kampala, Uganda attended introductory meetings. After initial random assignment to the TM group, 30 refugees who revealed that they were unable to attend all meetings and were eliminated from the study. The remaining 21 TM group participants were then instructed in TM and matched with refugees in the control group on age, sex, and baseline scores on the Post-traumatic Stress Disorder Checklist-Civilian (PCL-C). All participants completed the PCL-C measure of PTS symptoms at baseline, and 30-day and 135-day posttests. The PCL-C scores in the control group trended upward. In contrast, the PCL-C scores in the TM group went from 65 on average at baseline indicating severe PTS symptoms to below 30 on average after 30 days of TM practice, and remained low at 135 days. Effect size was high (d > 1.0). Compliance with TM practice was good; most reported regular practice throughout the study. There were no adverse events. All refugees who learned TM completed the study and were able to practice TM successfully, with subsequent substantial reduction in PTS symptoms.",Rees B.; Travis F.; Shapiro D.; Chant R.,2013.0,10.1002/jts.21790,0,0,
2301,"The effects of forgiveness therapy on depression, anxiety, and posttraumatic stress for women after spousal emotional abuse.","Emotionally abused women experience negative psychological outcomes long after the abusive spousal relationship has ended. This study compares forgiveness therapy (FT) with an alternative treatment (AT; anger validation, assertiveness, interpersonal skill building) for emotionally abused women who had been permanently separated for 2 or more years (M = 5.00 years, SD = 2.61; n = 10 per group). Participants, who were matched, yoked, and randomized to treatment group, met individually with the intervener. Mean intervention time was 7.95 months (SD = 2.61). The relative efficacy of FT and AT was assessed at p < .05. Participants in FT experienced significantly greater improvement than AT participants in depression, trait anxiety, posttraumatic stress symptoms, self-esteem, forgiveness, environmental mastery, and finding meaning in suffering, with gains maintained at follow-up (M = 8.35 months, SD = 1.53). FT has implications for the long-term recovery of postrelationship emotionally abused women.",Reed GL.; Enright RD.,2006.0,10.1037/0022-006X.74.5.920,0,0,
2302,Biological and symptom changes in posttraumatic stress disorder treatment: a randomized clinical trial.,"Understanding cognitive and biological mechanisms of PTSD treatment can help refine treatments and increase rates of response. Thirty-six veterans with PTSD were randomly assigned to receive Prolonged exposure therapy (PE) or Present-Centered therapy (PCT). We examined symptoms, trauma-related cognitions, and two indices of HPA axis function (cortisol awakening response and cortisol response to a script-driven imagery task). Thirty veterans started treatment and 26 completed. PE resulted in significantly more symptom reduction than PCT (P = .008). High treatment responders collapsed across treatments showed nominally higher cortisol levels measured at pretreatment 30 min after trauma script exposure compared to low responders (P = .08). At midtreatment, high treatment responders showed higher cortisol levels throughout the imagery task (Ps = .03-.04). There were no differences between high and low treatment responders at posttreatment. Thoughts of incompetence (F (1.6, 35.8) = 16.8, P = .000) and a dangerous world (F (1.3, 29.9) = 8.2, P = .004) significantly improved over time in high treatment responders but showed no change in low responders. Script-associated cortisol response prior to treatment and reductions in thoughts of incompetence accounted for 83% of the variance in reductions in PTSD severity with PE. Both increased cortisol response to personal trauma script prior to PTSD therapy and reductions in cognitive symptoms of PTSD were significantly and uniquely related to reductions in the core symptoms of PTSD in PE. However, contrary to our hypotheses, cortisol measures were not related to cognitive changes.",Rauch SA.; King AP.; Abelson J.; Tuerk PW.; Smith E.; Rothbaum BO.; Clifton E.; Defever A.; Liberzon I.,2015.0,10.1002/da.22331,0,0,
2303,Changes in brain electrical activity after cognitive behavioral therapy for posttraumatic stress disorder in patients injured in motor vehicle accidents.,"To explore changes for the first time in neural processing due to effective cognitive behavioral therapy (CBT) in posttraumatic stress disorder (PTSD) after severe motor vehicle accidents. Recent studies have highlighted the role of right hemisphere activation during withdrawal-related emotions (e.g., anxiety). There has been little research on changes in brain function due to cognitive-behavioral interventions in anxiety disorders. We conducted a randomized, controlled trial comparing cognitive-behavioral therapy with an assessment-only Wait-list condition. Spontaneous electroencephalographic activity was recorded from left and right anterior and posterior regions in participants with PTSD/subsyndromal PTSD receiving CBT (n = 17) before and after a CBT program. Wait-list controls (n = 18) were investigated before and after 3 months. At the pretreatment assessment, a pattern of increased right-sided activation during exposure to a trauma-related picture (relative to a neutral picture) was observed in both CBT and Wait-list participants. At posttreatment, there was a greater reduction of right anterior activation in the CBT group as compared with Wait-list controls. Across both groups, PTSD symptom reduction was significantly positively correlated with a decrease in right anterior activation to the trauma stimulus. These findings suggest that effective CBT treatment of PTSD may be accompanied by adaptive changes in asymmetrical brain function. Future studies are needed to confirm our findings.",Rabe S.; Zoellner T.; Beauducel A.; Maercker A.; Karl A.,2008.0,10.1097/PSY.0b013e31815aa325,0,0,
2304,The effect of a combined versus a conventional cognitive-behavioral therapy on quality of life for comorbid panic disorder with agoraphobia and generalized anxiety disorder: preliminary results.,"Concurrent panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) are the most common diagnostic occurrences among anxiety disorders. This particular comorbidity is associated with significant impairments in quality of life (QOL). The current study sought to investigate the efficacy of a combined cognitive-behavioral psychotherapy that addressed both conditions compared with a conventional psychotherapy, which attends solely to the primary disorder. The hypotheses postulated firstly, that both treatment conditions would lead to improvements in participants' QOL and secondly, that the combined therapy would lead to greater QOL ameliorations. Twenty-five participants with comorbid PDA/GAD diagnoses were evaluated with a number of clinical interviews and self-report questionnaires, and were provided with either conventional or combined cognitive-behavioral psychotherapy, which consisted of 14 one-hour weekly sessions. Participants were once again evaluated in the same fashion 2-weeks after the completion of the psychotherapy. The results revealed that both conditions led to significant improvements in participants' QOL, but that the two groups did not significantly differ in terms of the effect on QOL. The results also reveal that the two conditions did not significantly differ in terms of their effect on PDA and GAD symptomatology or psychiatric comorbidity. The results demonstrate that the combined psychotherapy, which addresses both conditions simultaneously, is similar to the conventional psychotherapy employed for the primary disorder in terms of QOL enhancement, symptom severity, and comorbidity reduction.",Primiano S.; Marchand A.; Gosselin P.; Langlois F.; Bouchard S.; Bélanger C.; Labrecque J.; Dugas M.; Dupuis G.,2014.0,10.1177/0145445513504430,0,0,
2305,Outcome after 10 years of Panic Disorder: A longitudinal naturalistic study.,"Aim: There are few studies that examine long-term outcome (more than 2 years) of patients with Panic Disorder (PD). The aim of this study was to evaluate the long term course of patients affected by PD with agoraphobia treated with pharmacotherapy and psychotherapy in a naturalistic setting. Method: 20 consecutive patients (7 males and 13 females, age range 21-38) with DSM III-R PD with agoraphobia have been followed for 10 years. Drugs, psychotherapy and combined therapy were the treatment used; the psychometric assessment included Marks-Sheehan Phobia Scale (MSPS), Hamilton Anxiety Scale (F1AM-A), Hamilton Depression Rating Scale (HAM-D), Global Assessment Scale (VGF), Clinical Global Impression (CGI). The instruments were administered respectively on 3 occasions: at the beginning of the study, before the prescription of any kind of therapy (TO); after 5 years, with 2 years of variability (T1) and at the end of the 10 years of the study (T2). Results and Discussion: After 5 (T1) and 10 years (T2) a significant improvement (p < .01) was observed in MSPS, HAM-A, HAM-D, VGF, CGI scores, as well as a reduction of number and intensity of panic attacks. Only 4 patients (20%) had no relapse, while in the remaining 16 (80%) the number of relapses varied from 1 to 10, but they were of lower intensity than the first attack. At the end of the study 95% of the sample was free from panic attacks and had CGI scores in the range of 1-3, with marginal and residual symptoms in 40% of cases. These results suggest a long-term course of PD more favourable than commonly reported. A limitation of our naturalistic study is the small sample of patients examined, strict selection criteria and the only 2 points of observation during the 10 years of the study. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Preziosa, Paolo; Roma, Stefania; Biondi, Massimo; Beck, Biondi, Biondi, Biondi, Biondi, Biondi, Brown, Brugnoli, Clark, Conti, Coplan, Cottraux, Craske, Davidson, Fava, Fava, Katschnig, Liebowitz, Marks, Mavissakalian, Palazzo, Pollack, Roy-Byrne, Sanavio, Schweizer, Shear, Simon, Swoboda, Toni, Wolfe",2006.0,,0,0,
2306,Disentangling the effects of safety-behavior utilization and safety-behavior availability during exposure-based treatment: a placebo-controlled trial.,"The primary aim of the current study was to further investigate the deleterious effects of safety-seeking behaviors on fear reduction by disentangling the effects of perceived availability of threat-relevant safety behaviors during treatment versus their actual use. Participants (N=72) displaying marked claustrophobic fear were randomly assigned to 1 of 5 conditions: (a) exposure only (EO), (b) exposure with phobic safety-behavior availability (SBA), (c) exposure with safety-behavior utilization (SBU), (d) credible placebo treatment (PL), or (e) wait list (WL). High end-state functioning rates at posttreatment were as follows: EO = 94%, SBA = 45%, SBU = 44%, PL = 25%, and WL = 0%. Findings suggest that it is the perception of the availability of safety aids as opposed to their actual use that exerts a disruptive effect on fear reduction. Clinical implications are discussed.",Powers MB.; Smits JA.; Telch MJ.,2004.0,10.1037/0022-006X.72.3.448,0,0,
2307,Quality of life after multiple trauma: the effect of early onset psychotherapy on quality of life in trauma patients,"ER MATERIALS AND METHODSThe study was a randomised, controlled study. Of 298 primary screened patients 171 were eligible and randomised. Ninety-two patients adhered to follow-up investigations at 6 and 12 months. Main outcome measure was a sum score according to O'Brien calculated of five different questionnaires (BDI, SF-36, STAI, SCL 90R, F-SOZU-22).RESULTSThe sum score for overall HRQOL did not show significant group differences at follow-up. Effects on HRQOL sub-dimensions within groups have been found. In the dimension of depression therapy group showed significant improvement from the first measurement to discharge from hospital (p < 0.001), 6 MFU (p = 0.004) and to 12 MFU (p = 0.013). Measures of anxiety showed significant improvement for the therapy group at discharge from hospital (p = 0.001). In the control group there was only a significant reduction in depression and anxiety from surgical ward to discharge (p = 0.013/p = 0.031).CONCLUSIONSEarly onset cognitive therapy is not effective in improving overall HRQOL of severely injured patients but shows promising effects on depression and anxiety up to 12 months after trauma.BACKGROUND AND AIMSThe aim of this study was to improve health-related quality of life (HRQOL) related to depression, anxiety, pain, physical functioning and social aspects for severely injured trauma survivors by early onset cognitive behavioural therapy applied on the surgical ward.","Pirente, N; Blum, C; Wortberg, S; Bostanci, S; Berger, E; Lefering, R; Bouillon, B; Rehm, K E; Neugebauer, E A",2007.0,10.1007/s00423-007-0171-8,0,0,
2308,Responding to the need for sleep among survivors of interpersonal violence: A randomized controlled trial of a cognitive-behavioral insomnia intervention followed by PTSD treatment.,"Sleep disturbance is a common feature of posttraumatic stress disorder (PTSD), but is not a focus of standard PTSD treatments. Psychological trauma exposure is associated with considerable physical and mental health morbidity, possibly due to the alterations in neuroendocrine function and inflammation observed in trauma exposed individuals. Although PTSD treatments are efficacious, they are associated with high drop-out rates in clinical trials and clinical practice. Finally, individuals with PTSD stemming from exposure to interpersonal violence represent an especially under-treated population with significant sleep disturbance. Community-based participatory research was utilized to design and prepare a clinical trial that randomizes recent survivors of interpersonal violence who have PTSD, depression, and insomnia to receive either: (1) Cognitive Behavioral Therapy for Insomnia (CBTi) followed by Cognitive Processing Therapy (CPT) for trauma, or (2) attention control followed by CPT. Outcome measures include subjective and objective measures of sleep, clinician-administered PTSD and depression scales, inflammatory cytokines, and salivary cortisol. Assessments are conducted at baseline, following the sleep or control intervention, and again following CPT. The design allows for: (1) the first test of a sleep intervention in this population; (2) the comparison of sequenced CBTi and CPT to attention control followed by CPT, and (3) assessing the roles of neuroendocrine function, inflammatory processes, and objective sleep markers in mediating treatment outcomes. The study's overarching hypothesis is that treating insomnia will produce reduction in insomnia, PTSD, and depression severity, allowing patients to more fully engage in, and derive optimal benefits from, cognitive processing therapy.",Pigeon WR.; Heffner KL.; Crean H.; Gallegos AM.; Walsh P.; Seehuus M.; Cerulli C.,2015.0,10.1016/j.cct.2015.08.019,0,0,
2309,Efficacy of CBT for benzodiazepine discontinuation in patients with panic disorder: Further evaluation.,"Despite its acute efficacy for the treatment of panic disorder, benzodiazepines (BZs) are associated with a withdrawal syndrome that closely mimics anxiety sensations, leading to difficulty with treatment discontinuation and often disorder relapse. An exposure-based cognitive-behavioral treatment for BZ discontinuation, Panic Control Treatment for BZ Discontinuation (CBT) targets the fear of these sensations and has demonstrated efficacy in preventing disorder relapse and facilitating successful BZ discontinuation among patients with panic disorder. In this randomized controlled trial, CBT was compared to taper alone and a taper plus a relaxation condition to control for the effect of therapist contact and support among 47 patients with panic disorder seeking taper from BZs. Based on the primary outcome of successful discontinuation of BZ use, results indicate that adjunctive CBT provided additive benefits above both taper alone and taper plus relaxation, with consistently medium and large effect sizes over time that reached significance at the six month follow-up evaluation. The efficacy of CBT relative to either of the other taper conditions reflected very large and significant effect sizes at that time. These findings suggest that CBT provides specific efficacy for the successful discontinuation from BZs, even when controlling for therapist contact and relaxation training.",Otto MW.; McHugh RK.; Simon NM.; Farach FJ.; Worthington JJ.; Pollack MH.,2010.0,10.1016/j.brat.2010.04.002,0,0,
2310,Efficacy of CBT for benzodiazepine discontinuation in patients with panic disorder: Further evaluation.,"Despite its acute efficacy for the treatment of panic disorder, benzodiazepines (BZs) are associated with a withdrawal syndrome that closely mimics anxiety sensations, leading to difficulty with treatment discontinuation and often disorder relapse. An exposure-based cognitive-behavioral treatment for BZ discontinuation, Panic Control Treatment for BZ Discontinuation (CBT) targets the fear of these sensations and has demonstrated efficacy in preventing disorder relapse and facilitating successful BZ discontinuation among patients with panic disorder. In this randomized controlled trial, CBT was compared to taper alone and a taper plus a relaxation condition to control for the effect of therapist contact and support among 47 patients with panic disorder seeking taper from BZs. Based on the primary outcome of successful discontinuation of BZ use, results indicate that adjunctive CBT provided additive benefits above both taper alone and taper plus relaxation, with consistently medium and large effect sizes over time that reached significance at the six month follow-up evaluation. The efficacy of CBT relative to either of the other taper conditions reflected very large and significant effect sizes at that time. These findings suggest that CBT provides specific efficacy for the successful discontinuation from BZs, even when controlling for therapist contact and relaxation training. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Otto, Michael W; McHugh, R. Kathryn; Simon, Naomi M; Farach, Frank J; Worthington, John J; Pollack, Mark H; Barlow, Barlow, Barlow, Beck, Beck, Bernstein, Borkovec, Bruce, Cohen, Colvin, Craske, DiNardo, Dupont, Fontaine, Fyer, Glass, Gosselin, Gould, Gould, Gould, Hamilton, Hegel, Lader, McHugh, Mellman, Michelini, Morin, Noyes, Otto, Otto, Otto, Otto, Otto, Otto, Oude Voshaar, Oude-Voshaar, Parr, Pecknold, Peterson, Reiss, Rickels, Roy-Byrne, Salkovskis, Salzman, Schmidt, Schweizer, Spiegel, Stewart, Tyrer, Whittal",2010.0,,0,0,
2311,One-session group therapy of spider phobia: direct versus indirect treatments.,"Forty-six patients with spider phobia, fulfilling the DSM-IV criteria for specific phobia, were assessed with behavioral, physiological and self-report measures. They were randomly assigned to three group treatment conditions: (1) direct treatment; (2) direct observation; and (3) indirect observation. All treatments were carried out in large groups of eight patients, and consisted of one 3 hr session of massed exposure and modelling. The results showed that on the behavioral test, measures and the specific self-report measures of spider phobia the direct treatment was significantly better than direct observation and indirect observation, which did not differ. On the physiological measures and the psychopathology self-report measures there were significant pre-post improvements, but no differences between the groups. The effects were maintained or furthered at the one year follow-up assessment. The proportion of clinically significantly improved patients were, at post-treatment, 75% in the direct treatment, 7% in the direct observation, and 31% in the indirect observation group. At follow-up, the corresponding figures were 75, 14, and 44%, respectively. The conclusion that can be drawn is that direct treatment is the treatment of choice.",Ost LG.; Ferebee I.; Furmark T.,1997.0,,0,0,
2312,Applied relaxation vs progressive relaxation in the treatment of panic disorder.,,Ost LG.,1988.0,,0,0,
2313,"Stepped early psychological intervention for posttraumatic stress disorder, other anxiety disorders, and depression following serious injury.","The best approach for implementing early psychological intervention for anxiety and depressive disorders after a traumatic event has not been established. This study aimed to test the effectiveness of a stepped model of early psychological intervention following traumatic injury. A sample of 683 consecutively admitted injury patients were screened during hospitalization. High-risk patients were followed up at 4-weeks postinjury and assessed for anxiety and depression symptom levels. Patients with elevated symptoms were randomly assigned to receive 4-10 sessions of cognitive-behavioral therapy (n = 24) or usual care (n = 22). Screening in the hospital identified 89% of those who went on to develop any anxiety or affective disorder at 12 months. Relative to usual care, patients receiving early intervention had significantly improved mental health at 12 months. A stepped model can effectively identify and treat injury patients with high psychiatric symptoms within 3 months of the initial trauma.",O'Donnell ML.; Lau W.; Tipping S.; Holmes AC.; Ellen S.; Judson R.; Varker T.; Elliot P.; Bryant RA.; Creamer MC.; Forbes D.,2012.0,10.1002/jts.21677,0,0,
2314,Cognitive behaviour therapy and medication in the treatment of obsessive-compulsive disorder.,"To compare cognitive behaviour therapy (CBT) with CBT plus medication; medication alone; and placebo in the treatment of adult obsessive-compulsive disorder (OCD). Forty-eight participants (43 completers) were recruited into two protocols. In the first protocol, 21 people with OCD were randomly allocated to either a standard medication (fluvoxamine) or standard placebo condition for a 5-month period. Both these groups subsequently received CBT for a further 5 months. In the second protocol, 22 people with OCD received CBT, one group was already stabilized on an antidepressant of choice; the second group was drug naïve. All active treatments, but not the placebo, showed clinical improvement. There was no difference in treatment response to CBT regardless of whether participants had previously received medication or placebo. CBT has a more specific antiobsessional effect than medication but CBT plus medication shows greatest overall clinical improvement in mood.",O'Connor KP.; Aardema F.; Robillard S.; Guay S.; Pélissier MC.; Todorov C.; Borgeat F.; Leblanc V.; Grenier S.; Doucet P.,2006.0,10.1111/j.1600-0447.2006.00767.x,0,0,
2315,Cognitive-behaviour therapy and medication in the treatment of obsessive-compulsive disorder: a controlled study.,"To evaluate the effect of combining cognitive-behaviour therapy (CBT) and medication in the treatment of obsessive-compulsive disorder (OCD). Twenty-nine subjects diagnosed with OCD according to Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria were recruited through the Anxiety Clinic of Louis-H Lafontaine Hospital. They were evaluated at baseline and after treatment on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) by a psychiatrist who was blind to treatment modality. Subjects rated their degree of resistance to their rituals and the strength of their obsessional beliefs. Subjects then received 1 of 4 treatments: medication and CBT simultaneously (n = 9), CBT only (n = 6), medication while on a wait-list for CBT (n = 6), or no treatment while on a wait-list for CBT (n = 5). Multivariate analysis revealed that Y-BOCS scores and clinical ratings significantly improved posttreatment in all groups except the nontreatment wait-list control group. Subjects in the 2 active treatment groups receiving CBT showed reduced strength in their obsessional beliefs. The subsequent administration of CBT to those groups on the wait-list also decreased the strength of their primary obsessional beliefs and beliefs about the consequences of not performing the rituals. Our results suggest that either CBT or medication alone is more effective than no treatment. The combination of CBT and medication seems to potentiate treatment efficacy, and we found it more clinically beneficial to introduce CBT after a period of medication rather than to start both therapies simultaneously.",O'Connor K.; Todorov C.; Robillard S.; Borgeat F.; Brault M.,1999.0,10.1177/070674379904400108,0,0,
2316,"Eye movement desensitization and reprocessing therapy in subsyndromal bipolar patients with a history of traumatic events: a randomized, controlled pilot-study.","Traumatic events are frequent in bipolar patients and can worsen the course of the disease. Psychotherapeutic interventions for these events have not been studied so far. Twenty DSM-IV bipolar I and II patients with subsyndromal mood symptoms and a history of traumatic events were randomly assigned to Eye Movement Desensitization and Reprocessing therapy (n=10) or treatment as usual (n=10). The treatment group received between 14 and 18 Eye Movement Desensitization and Reprocessing sessions during 12 weeks. Evaluations of affective symptoms, symptoms of trauma and trauma impact were carried out by a blind rater at baseline, 2 weeks, 5 weeks, 8 weeks, 12 weeks and at 24 weeks follow-up. Patients in the treatment group showed a statistically significant improvement in depressive and hypomanic symptoms, symptoms of trauma and trauma impact compared to the treatment as usual group after intervention. This effect was only partly maintained in trauma impact at the 24 weeks follow-up visit. One patient dropped from Eye Movement Desensitization and Reprocessing group whereas four from the treatment as usual group. This pilot study suggests that Eye Movement Desensitization and Reprocessing therapy may be an effective and safe intervention to treat subsyndromal mood and trauma symptoms in traumatized bipolar patients.",Novo P.; Landin-Romero R.; Radua J.; Vicens V.; Fernandez I.; Garcia F.; Pomarol-Clotet E.; McKenna PJ.; Shapiro F.; Amann BL.,2014.0,10.1016/j.psychres.2014.05.012,0,0,
2317,The effects of direct versus Socratic cognitive therapies on battered women with posttraumatic stress disorder.,"The magnitude of domestic violence in America has often been overlooked. It is a much larger problem than can be realized. A growing number of researchers have suggested that the most accurate diagnosis for many survivors of interpersonal and family violence is that of posttraumatic stress disorder. Yet, the majority of the literature on battered women does not explicitly highlight posttraumatic stress disorder as a construct; it is merely referred to as symptomatology. Research has repeatedly failed to use standardized measures to assess for the presence of posttraumatic stress disorder among battered women. Therefore it was evident that the utilization of standardized measures was needed in order to obtain significant data for the application of the diagnosis of posttraumatic stress disorder to battered women. Also, the cognitive processing of traumatic events has been emphasized in theoretical discussions of violence impact. This highlights the trend of the growing use of cognitive therapies with battered women. These obvious research needs were the major premises behind this study. The purposes of this study were (1) To explore the diagnosis of posttraumatic stress disorder as it pertains to battered women by using standardized measures, and (2) To apply cognitive group counseling techniques (i.e.: direct vs. indirect/Socratic) as therapeutic methods to treat the battered women's posttraumatic stress disorder. The instruments used to assess the amount and type of abuse (physical vs. psychological) received by the women participants from their partners were: (1) The Abusive Behavior Inventory (ABI), and (2) The Conflict Tactics Scales (CTS). The instruments used to assess the levels of posttraumatic stress disorder of the participants were: (1) The Impact of Event Scale (IES), and (2) The MMPI Subscale for the Assessment of Posttraumatic Stress Disorder (MMPI/PTSD). The 85 women who participated in the study were divided into four types of treatment groups: (1) (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Norton, Marcia Ann",1997.0,,0,0,
2318,Internet-provided cognitive behaviour therapy of posttraumatic stress symptoms following childbirth-A randomized controlled trial.,"The aim of this study was to analyse the effects of trauma-focused guided Internet-based cognitive behaviour therapy for relieving posttraumatic stress disorder (PTSD) symptoms following childbirth, a problem that about 3% women encounter postpartum. Following inclusion, 56 traumatized women were randomized to either treatment or to a waiting list control group. Primary outcome measures were the Traumatic Event Scale (TES) and Impact of Event Scale-Reversed (IES-R). Secondary measures were Beck depression inventory II, Patient Health Questionnaire (PHQ-9), Beck Anxiety Inventory, Quality Of Life Inventory and the EuroQol 5 Dimensions. The treatment was guided by a clinician and lasted eight weeks and comprised eight modules of written text. The between-group effect size (ES) was d = .82 (p < .0001) for the IES-R. The ES for the TES was small (d = .36) and not statistically significant (p = .09). A small between-group ES (d = .20; p = .02) was found for the PHQ-9. The results from pre- to post-treatment showed large within-group ESs for PTSD symptoms in the treatment group both on the TES (d = 1.42) and the IES-R (d = 1.30), but smaller ESs in the control group from inclusion to after deferred treatment (TES, d = .80; IES-R d = .45). In both groups, the treatment had positive effects on comorbid depression and anxiety, and in the treatment group also on quality of life. The results need to be verified in larger trials. Further studies are also needed to examine long-term effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Nieminen, Katri; Berg, Ida; Frankenstein, Katri; Viita, Lina; Larsson, Kamilla; Persson, Ulrika; Spanberger, Loviisa; Wretman, Anna; Silfvernagel, Kristin; Andersson, Gerhard; Wijma, Klaas; Andersson, Andersson, Areskog, Ayers, Ayers, Ayers, Ayers, Ayers, Ayers, Ayers, Beck, Beck, Beck, Bisson, Bradley, Cannon, Clark-Carter, Creedy, Czarnocka, Ehring, Fenech, Foa, Forbes, Ford, Frisch, Furlanetto, Gottvall, Grekin, Hembree, Ivarsson, Kessler, Kroenke, McKenzie-McHarg, Nice, Nieminen, Olde, Parfitt, Roberts, Robjant, Rozental, Ryding, Raisanen, Schulz, Sheehan, Soet, Spence, Spanghagen, Sterne, Stramrood, Soderquist, Soderquist, Soderquist, Vickers, Waldenstrom, Weiss, Wijma, Wijma, Wijma, Zar",2016.0,,0,0,
2319,Is the whole less than the sum of its parts? Full versus individually adapted metacognitive self-help for obsessive-compulsive disorder: A randomized controlled trial.,"Self-help resources are frequently sought out by individuals with obsessive-compulsive disorder (OCD); however their efficacy has rarely been evaluated in randomized controlled trials, despite frequently bold claims for their efficacy. In the present study, we examined if a metacognitive self-help manual called myMCT (for ""my Metacognitive Training""), which encompasses exercises from cognitive-behavioral therapy (CBT) and its ""third wave"", is superior to a wait-list control group in reducing OCD symptoms. Further, we examined whether an individually adapted version of the manual suited to personal problems would yield larger effects than the full manual. Methods: A total of 89 individuals with OCD symptoms participated in the online study. Participants were randomly assigned to three conditions; patients either received the full myMCT manual (sent via email attachment), an individually adapted myMCT version, or were allocated to a wait-list control group. Before randomization (pre-assessment) and six weeks later (post-assessment), individuals were asked to fill out several questionnaires tapping obsessive-compulsive and depressive symptoms. Results: Individuals in the two myMCT conditions improved significantly more on the Yale-Brown Obsessive Compulsive Scale and Obsessive-Compulsive Inventory-Revised total scores than the wait-list control group (between-group comparison), with a medium to large effect size. Subsidiary analyses showed that improvements were particularly pronounced for obsessions, while effects on compulsions were mainly small and insignificant. Contrary to our expectation, the adapted version did not lead to better outcomes than the full version. Discussion: The present study supports the feasibility of a bibliotherapeutic metacognitive approach for the treatment of obsessive thoughts. While results confirm prior reports that metacognitive training is effective in OCD, results are limited by a rather high non-completion rate. Further studies should investigate the long-term effectiveness of the approach and its utility in the framework of guided self-help or face-to-face treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Moritz, Steffen; Stepulovs, Olena; Schroder, Johanna; Hottenrott, Birgit; Meyer, Bjorn; Hauschildt, Marit; Abramowitz, Angermeyer, Baer, Barkham, Baumeister, Beck, Beck, Berger, Besiroglu, Carlbring, Carlbring, Cludius, Coles, Demet, Dettore, Donker, Eysenbach, Federici, Fischer, Fisher, Foa, Garamova, Goodman, Goodman, Gosling, Harwood, Hauschildt, Hauschildt, Hayes, Herbst, Herbst, Huppert, Iljin, Jelinek, Jenkins, Johansson, Kholmogorova, Kim, Kohn, Krasnov, Marques, Mataix-Cols, McDaid, Meyer, Mironova, Moritz, Moritz, Moritz, Moritz, Moritz, Moritz, Moritz, Moritz, Moritz, Moritz, Moritz, Moritz, Moritz, Pinto, Poyraz, Schaible, Schneider, Schroder, Schulenberg, Steketee, Steketee, Tolin, Wells, Wootton",2016.0,,0,0,
2320,The effectiveness of VR exposure therapy for PTSD in returning warfighters.,"In the decade following the attack on the World Trade Center, over 2.3 million American military personnel were deployed to Iraq and Afghanistan. Lengthy tours of duty and multiple re-deployments were characteristic of these operations. Research findings demonstrate that prolonged exposure to combat increases the risk of developing posttraumatic stress disorder (PTSD). The current study was a randomized controlled clinical trial designed to assess the effectiveness of a novel intervention to treat combat-related PTSD in returning Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) warfighters. A cognitive behavior treatment approach augmented with virtual reality exposure therapy (VRE) was developed, and administered for 10 treatment sessions over 5 weeks. Comparisons with a control group receiving minimal attention (MA) for 5 weeks revealed that the VRE group had significant reductions in the avoidance/numbing symptoms on the Clinician Administered PTSD Scale (CAPS). The VRE group also had significant reductions in guilt at post-treatment compared to the control group.",Miyahira SD.; Folen RA.; Hoffman HG.; Garcia-Palacios A.; Spira JL.; Kawasaki M.,2012.0,,0,0,
2321,The effectiveness of VR exposure therapy for PTSD in returning warfighters.,"In the decade following the attack on the World Trade Center, over 2.3 million American military personnel were deployed to Iraq and Afghanistan. Lengthy tours of duty and multiple re-deployments were characteristic of these operations. Research findings demonstrate that prolonged exposure to combat increases the risk of developing posttraumatic stress disorder (PTSD). The current study was a randomized controlled clinical trial designed to assess the effectiveness of a novel intervention to treat combat-related PTSD in returning Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) warfighters. A cognitive behavior treatment approach augmented with virtual reality exposure therapy (VRE) was developed, and administered for 10 treatment sessions over 5 weeks. Comparisons with a control group receiving minimal attention (MA) for 5 weeks revealed that the VRE group had significant reductions in the avoidance/numbing symptoms on the Clinician Administered PTSD Scale (CAPS). The VRE group also had significant reductions in guilt at post-treatment compared to the control group. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Miyahira, Sarah D; Folen, Raymond A; Hoffman, Hunter G; Garcia-Palacios, Azucena; Spira, James L; Kawasaki, Michelle; Litz, Hoge, Reger, McLay",2012.0,,0,0,
2322,Obsessive-compulsive symptoms in at-risk mental states for psychosis: associations with clinical impairment and cognitive function.,"Obsessive-compulsive symptoms (OCS) constitute a major comorbidity in schizophrenia. Prevalence estimations of OCS for patients with at-risk mental states (ARMS) for psychosis vary largely. It is unclear how ARMS patients with or without comorbid OCS differ regarding general psychosocial functioning, psychotic and affective symptoms and neurocognitive abilities. At-risk mental states patients (n = 233) from the interventional trial PREVENT (Secondary Prevention of Schizophrenia) were stratified according to the presence or absence of comorbid OCS and compared on several clinical variables. Patients, who fulfilled the criteria for obsessive-compulsive disorder (OCD) or presented with subclinical OCS (ARMSposOCS sample), did not significantly differ from patients without OCS (ARMSnegOCS) with regard to gender, age, premorbid verbal intelligence and levels of education. Furthermore, similar severity of depressive syndromes, basic cognitive, attenuated psychotic and brief limited intermittent psychotic symptoms were found. However, ARMSposOCS patients showed more impairment of psychosocial functioning and higher general psychopathology. In contrast, they scored higher in cognitive tasks measuring working memory and immediate verbal memory. Findings extend upon previous results due to the multidimensional assessment. Subsequent longitudinal studies might elucidate how comorbid OCS influence differential treatment response, especially to cognitive behavioural interventions and the transition rates to psychosis.",Zink M.; Schirmbeck F.; Rausch F.; Eifler S.; Elkin H.; Solojenkina X.; Englisch S.; Wagner M.; Maier W.; Lautenschlager M.; Heinz A.; Gudlowski Y.; Janssen B.; Gaebel W.; Michel TM.; Schneider F.; Lambert M.; Naber D.; Juckel G.; Krueger-Oezguerdal S.; Wobrock T.; Hasan A.; Riedel M.; Müller H.; Klosterkötter J.; Bechdolf A.,2014.0,10.1111/acps.12258,0,0,
2323,Vasopressin modulates medial prefrontal cortex-amygdala circuitry during emotion processing in humans,"ER The neuropeptide vasopressin is a modulator of mammalian social behavior and emotion, particularly fear, aggression, and anxiety. In humans, the neural circuitry underlying behavioral effects of vasopressin is unknown. Using a double-blind crossover administration of 40 IU of vasopressin or placebo and functional MRI during processing of facial emotions in healthy male volunteers, we show that vasopressin specifically reduces differential activation in the subgenual cingulate cortex. Structural equation modeling of a previously evaluated circuit between amygdala, subgenual cingulate, and supragenual cingulate revealed altered effective connectivity between subgenual and supragenual cingulate under vasopressin. Our data demonstrate an impact of vasopressin on activity and connectivity in the cortical component of a medial prefrontal cortex-amygdala circuit implicated in emotional regulation, providing the first data on the neural basis for the effects of vasopressin on social behavior in humans with potential therapeutic significance for mood and anxiety disorders.","Zink, C F; Stein, J L; Kempf, L; Hakimi, S; Meyer-Lindenberg, A",2010.0,10.1523/JNEUROSCI.4899-09.2010,0,0,
2324,Vasopressin modulates social recognition-related activity in the left temporoparietal junction in humans,"ER The neuropeptide vasopressin is a key molecular mediator of social behavior in animals and humans, implicated in anxiety and autism. Social recognition, the ability to assess the familiarity of others, is essential for appropriate social interactions and enhanced by vasopressin; however, the neural mechanisms mediating this effect in humans are unknown. Using functional magnetic resonance imaging (fMRI) and an implicit social recognition matching task, we employed a double-blinded procedure in which 20 healthy male volunteers self-administered 40 UI of vasopressin or placebo intranasally, 45 min before performing the matching task in the scanner. In a random-effects fMRI analysis, we show that vasopressin induces a regionally specific alteration in a key node of the theory of mind network, the left temporoparietal junction, identifying a neurobiological mechanism for prosocial neuropeptide effects in humans that suggests novel treatment strategies.","Zink, C F; Kempf, L; Hakimi, S; Rainey, C A; Stein, J L; Meyer-Lindenberg, A",2011.0,10.1038/tp.2011.2,0,0,
2325,"Evaluation of alexithymia, somatosensory sensitivity, and health anxiety levels in patients with noncardiac chest pain","ER METHODS: Fifty-one patients with noncardiac chest pain and 51 healthy controls were included in the study. All participants performed self-report based health anxiety inventory (HAI), somatosensory amplification scale (SAS), and Toronto alexithymia scale (TAS).RESULTS: The patient group had significantly higher scores on the SAS, HAI-1, and HAI-T scales compared to controls (P < 0.001, P = 0.006, and P = 0.038, resp.). SAS, HAI-1, and HAI-T scores were significantly higher in female patients than male (P = 0.002, 0.036, and 0.039, resp.). There were significant differences in all TAS subscale scores between two groups. Patients, who had total TAS score more than 50, also presented higher levels of health anxiety (P = 0.045).CONCLUSIONS: Anxiety, somatic symptoms, and the exaggerated sense of bodily sensations are common in patients with NCCP. These patients unnecessarily occupy the cardiology outpatient clinics. These negative results can be eliminated when consultation-liaison psychiatry evaluates these patients in collaboration with cardiology departments.OBJECTIVE: Noncardiac chest pain (NCCP) is seen more frequently in young population and in these patients loss of function is evolving in social and professional areas. The aim of the study is to evaluate the levels of anxiety and somatic perception in patients with chest pain presenting to cardiology clinic.","Zincir, S B; Sunbul, M; Sunbul, E A; Dalkilic, B; Cengiz, F; Kivrak, T; Durmus, E",2014.0,10.1155/2014/896183,0,0,
2326,Psychological performance in anxious patients treated with diazepam.,"1. After each week of a flexible dosage treatment with either diazepam, amylobarbitone or placebo anxious patients were assessed by a comprehensive battery of psychiatrist's ratings, subjective tests and psychological performance tasks to detect the clinical and psychological effects of the drugs. 2. Self rated anxiety and insomnia were improved significantly by diazepam, while amylobarbitone improved only the self rated insomnia. 3. An impairment of performance relative to placebo was detected on two performance tasks after the barbiturate and on six performance tasks after the benzodiazepine. 4. The patient's reported level of anxiety under each treatment condition was related to the performance on the five tasks showing drug effects, thus confirming the postulated inverted U-shape relationship between drive and performance.",Zimmermann-Tansella C.; Tansella M.; Lader M.,1979.0,,0,0,
2327,"[Promoting Self-Management in Primary Care - the Association of Motivation for Change, Self-Efficacy and Psychological Distress Prior to the Onset of Intervention].","Anxiety, depressive and somatoform disorders are highly prevalent in primary care. Managing these disorders is time-consuming and requires strong commitment on behalf of the general practitioners (GPs). Furthermore, the resources for the management of these patients are limited by the increasing workload in primary care practices, especially in the German health care system. In order to address the SMADS-study within psychenet - the Hamburg Network for Mental Health (NCT01726387) implements and evaluates a complex, low-threshold, nurse-led intervention using a goal-oriented set of case management and counseling techniques to promote self-management in these patients. This paper investigates the association of the patients' motivation for change and their perceived self-efficacy, the primary outcome - to get to know whether the intervention will target the appropriate population.",Zimmermann T.; Puschmann E.; Porzelt S.; Ebersbach M.; Ernst A.; Thomsen P.; Scherer M.,2015.0,10.1055/s-0034-1387686,0,0,
2328,Effects of massed versus distributed practice of test taking on achievement and test anxiety,"ER The effects of massed versus distributed practice on achievement and test anxiety were investigated using a quasi-experimental design employing 56 college students under two conditions. Test anxiety was assessed using Sarason's four-dimensional Reactions to Tests, while classroom achievement was measured on tests using multiple-choice applications. Experimental subjects were given four Reactions to Tests items and 10-item examinations on a weekly basis for 10 weeks, while control subjects had only a 100-item final examination. Analysis indicated (1) significantly higher final examination performance for the distributed testing condition; (2) a significant reduction in test anxiety between initial sessions and the remainder of the term in the distributed testing condition; (3) no difference in test anxiety between the distributed testing and control conditions when test anxiety was assessed at the end of the term; and (4) nonsignificant correlations between test anxiety dimensions of the Reactions to Tests and achievement in both the control and distributed testing conditions. Results support the contention that relationships between achievement and test anxiety may be more complex than previously thought.","Zimmer, J W; Hocevar, D J",1994.0,10.2466/pr0.1994.74.3.915,0,0,
2329,Low birthweight in a public prenatal care program: behavioral and psychosocial risk factors and psychosocial intervention,"ER A retrospective, observational study of 3073 low income African American, Latina, and White women receiving comprehensive prenatal care at 26 provider sites was completed. The purpose of the study was to test three hypotheses. First, after adjustment for biomedical complications, the presence of maternal behavioral and psychosocial factors would be associated with an increased rate of low birthweight infants. Second, increased time spent in psychosocial services would negate the relationship between maternal psychosocial factors and low birthweight. Third, after adjusting for biomedical, behavioral, and psychosocial factors, rates of low birthweight would no longer differ by race. Maternal smoking (over five cigarettes per week), maternal low weight for height and/or weight gain, negative mood (depression, anxiety, and/or hostility) and rejection of the pregnancy were found to be related to an increased rate of low birthweight birth (< 2500 g). Receiving more than 45 min of psychosocial services was related to a reduced rate of low birthweight birth for all women regardless of risk profile. The rate of low birthweight remained higher in African American women after adjusting for all significant maternal biomedical, behavioral, and psychosocial risk and intervention factors. Further analyses revealed that the strength and direction of the relationship between time spent in psychosocial services and low birthweight remained after controlling for the number of prenatal care visits, the time spent in nutrition or health educational services, and gestational age. Also, the time spent in psychosocial services was related to a reduced rate of low birthweight even after excluding time spent in psychosocial services in the third trimester of pregnancy or excluding women who received their first psychosocial assessment in the third trimester from the analysis. Although definitive evidence from randomized trials of psychosocial services is lacking, receiving over 45 min of psychosocial services was related to a reduced risk of low birthweight for all women in this study. Therefore, general psychosocial services appears to be an important component of prenatal care for all low income women.","Zimmer-Gembeck, M J; Helfand, M",1996.0,,0,0,
2330,Does marital therapy enhance the effectiveness of treatment for sexual dysfunction?,"A controlled treatment trial was conducted with couples in which the woman suffered from secondary forms of sexual dysfunction. To test whether marital therapy is helpful in enhancing the effectiveness of symptom-specific therapy for sexual dysfunction, two treatment conditions were compared to a waiting list control group. All couples received 12 sessions of therapy directed to the sexual symptom. One half of the couples received nine sessions of relaxation and information before sex therapy, and the other half, nine sessions of marital therapy before sex therapy. Whereas both treatment conditions showed clinical and statistical improvement at termination and follow-up, treatment gains were more pronounced and more comprehensive for the couples who received the combination of marital and sex therapy. Generalization from marital therapy to sexual functioning was greater than generalization from sex therapy to marital adaptation.",Zimmer D.,1987.0,10.1080/00926238708403892,0,0,
2331,Are there subtypes of panic disorder? An interpersonal perspective.,"Panic disorder (PD) is associated with significant personal, social, and economic costs. However, little is known about specific interpersonal dysfunctions that characterize the PD population. The current study systematically examined these interpersonal dysfunctions. The present analyses included 194 patients with PD out of a sample of 201 who were randomized to cognitive-behavioral therapy, panic-focused psychodynamic psychotherapy, or applied relaxation training. Interpersonal dysfunction was measured with the Inventory of Interpersonal Problems-Circumplex (Horowitz, Alden, Wiggins, & Pincus, 2000). Individuals with PD reported greater levels of interpersonal distress than that of a normative cohort (especially when PD was accompanied by agoraphobia), but lower than that of a cohort of patients with major depression. There was no single interpersonal profile that characterized PD patients. Symptom-based clusters (with vs. without agoraphobia) could not be discriminated on core or central interpersonal problems. Rather, as revealed by cluster analysis based on the pathoplasticity framework, there were 2 empirically derived interpersonal clusters among PD patients that were not accounted for by symptom severity and were opposite in nature: domineering-intrusive and nonassertive. The empirically derived interpersonal clusters appear to be of clinical utility in predicting alliance development throughout treatment: Although the domineering-intrusive cluster did not show any changes in the alliance throughout treatment, the nonassertive cluster showed a process of significant strengthening of the alliance. Empirically derived interpersonal clusters in PD provide clinically useful and nonredundant information about individuals with PD.",Zilcha-Mano S.; McCarthy KS.; Dinger U.; Chambless DL.; Milrod BL.; Kunik L.; Barber JP.,2015.0,10.1037/a0039373,0,0,
2332,Reducing Dropout in Treatment for Depression: Translating Dropout Predictors Into Individualized Treatment Recommendations.,"Premature discontinuation of therapy is a widespread problem that hampers the delivery of mental health treatment. A high degree of variability has been found among rates of premature treatment discontinuation, suggesting that rates may differ depending on potential moderators. In the current study, our aim was to identify demographic and interpersonal variables that moderate the association between treatment assignment and dropout. Data from a randomized controlled trial conducted from November 2001 through June 2007 (N = 156) comparing supportive-expressive therapy, antidepressant medication, and placebo for the treatment of depression (based on DSM-IV criteria) were used. Twenty prerandomization variables were chosen based on previous literature. These variables were subjected to exploratory bootstrapped variable selection and included in the logistic regression models if they passed variable selection. Three variables were found to moderate the association between treatment assignment and dropout: age, pretreatment therapeutic alliance expectations, and the presence of vindictive tendencies in interpersonal relationships. When patients were divided into those randomly assigned to their optimal treatment and those assigned to their least optimal treatment, dropout rates in the optimal treatment group (24.4%) were significantly lower than those in the least optimal treatment group (47.4%; P = .03). Present findings suggest that a patient's age and pretreatment interpersonal characteristics predict the association between common depression treatments and dropout rate. If validated by further studies, these characteristics can assist in reducing dropout through targeted treatment assignment. Secondary analysis of data from ClinicalTrials.gov identifier: NCT00043550.",Zilcha-Mano S.; Keefe JR.; Chui H.; Rubin A.; Barrett MS.; Barber JP.,2016.0,10.4088/JCP.15m10081,0,0,
2333,Changes in well-being and quality of life in a randomized trial comparing dynamic psychotherapy and pharmacotherapy for major depressive disorder,"ER METHODS: Data from a randomized controlled trial (trial registration: NCT00043550) comparing SET, MED and PBO for the treatment of depression (N=156) were analyzed. Outcome measures addressed patients' QOL and physical and mental well-being. Changes in outcomes were assessed across and between treatments using linear mixed models.RESULTS: Across treatments, patients showed significant improvement in QOL and mental and physical health measures, as well as a reduction in interpersonal distress and depressive and anxiety symptoms (p?.002 for all measures). Those changes were not only the products of a decrease in depressive symptoms, but also predicted subsequent reduction in symptoms. No significant differences were found between the three treatment conditions.LIMITATIONS: The limitation is the study's moderate sample size.CONCLUSIONS: Current treatments for depression significantly improve patients' QOL and well-being. No significant differences were found between the three conditions examined in this study. The current study highlights the role of well-being in predicting subsequent symptomatic change.BACKGROUND: Major depressive disorder (MDD) is associated with a decrease in quality of life (QOL) and well-being. Therefore, researchers are increasingly complementing traditional symptom measurements with QOL and well-being assessments in order to broaden the evaluation of treatment outcomes. The current prospective study investigated the effectiveness of supportive-expressive therapy (SET), antidepressant medication (MED) and placebo (PBO) in improving QOL and well-being in patients with MDD.","Zilcha-Mano, S; Dinger, U; McCarthy, K S; Barrett, M S; Barber, J P",2014.0,10.1016/j.jad.2013.10.015,0,0,
2334,Evaluating an intervention to reduce fear of falling and associated activity restriction in elderly persons: design of a randomised controlled trial,"ER METHODS/DESIGNA two-group randomised controlled trial was developed to evaluate the intervention. Persons 70 years of age or over and still living in the community were eligible for study if they experienced at least some fear of falling and associated activity restriction. A random community sample of elderly people was screened for eligibility; those eligible for study were measured at baseline and were subsequently allocated to the intervention or control group. Follow-up measurements were carried out directly after the intervention period, and then at six months and 12 months after the intervention. People allocated to the intervention group were invited to participate in eight weekly sessions of two hours each and a booster session. This booster session was conducted before the follow-up measurement at six months after the intervention. People allocated to the control group received no intervention as a result of this trial. Both an effect evaluation and a process evaluation were performed. The primary outcome measures of the effect evaluation are fear of falling, avoidance of activity due to fear of falling, and daily activity. The secondary outcome measures are perceived general health, self-rated life satisfaction, activities of daily life, feelings of anxiety, symptoms of depression, social support interactions, feelings of loneliness, falls, perceived consequences of falling, and perceived risk of falling. The outcomes of the process evaluation comprise the performance of the intervention according to protocol, the attendance and adherence of participants, and the participants' and facilitators' opinion about the intervention. Data of the effect evaluation will be analysed according the intention-to-treat and on-treatment principle. Data of the process evaluation will be analysed using descriptive techniques.BACKGROUNDFear of falling and associated activity restriction is common in older persons living in the community. Adverse consequences of fear of falling and associated activity restriction, like functional decline and falls, may have a major impact on physical, mental and social functioning of these persons. This paper presents the design of a trial evaluating a cognitive behavioural group intervention to reduce fear of falling and associated activity restriction in older persons living in the community.","Zijlstra, G; Haastregt, J C; Eijk, J T; Kempen, G I",2005.0,10.1186/1471-2458-5-26,0,0,
2335,Epinephrine-induced panic attacks and hyperventilation,"ER To assess the effects of epinephrine on ventilation in patients with panic disorder and in social phobics, analyses were performed on pooled data from two previous infusion studies. Throughout the infusion, changes in transcutaneous PCO2 (tcPCO2), subjective anxiety, heart rate and blood pressure were recorded continuously. Twenty-nine patients received epinephrine, ten patients received placebo. Thirteen patients (45%) had a panic attack during epinephrine. The fall in tcPCO2 and the cardiovascular response was greater in panicking patients than patients who did not panic. Although the fall in tcPCO2 associated with panic was not substantial and did not indicate clinically significant acute hyperventilation, it appears to be a sensitive index for epinephrine-induced panic. The fall in tcPCO2 was predicted rather by the frequency of occurrence of anxiety-related somatic symptoms than by the fear of these symptoms. These findings further reduce a role for fear of bodily sensations in epinephrine-induced panic attacks and favor a biological sensitivity to sympathetic stimulation.","Zijderveld, G A; Veltman, D J; Dyck, R; Doornen, L J",1999.0,,0,0,
2336,Posttraumatic stress disorder treatment for Operation Enduring Freedom/Operation Iraqi Freedom combat veterans through a civilian community-based telemedicine network.,"Telemedicine holds great potential to improve access to care and to reduce barriers to treatment for military populations with posttraumatic stress disorder (PTSD). This study sought to integrate the use of telemedicine mental health treatment services by a community healthcare provider to military populations residing in a rural location and to compare the equivalency of cognitive behavioral therapy (CBT) administered via telemedicine and traditional face-to-face therapy. Study subjects were men or women 18 years of age or older who had served in Operation Enduring Freedom (OEF) and/or Operation Iraqi Freedom (OIF) and were diagnosed with PTSD. The 18 study subjects were randomized and provided 10 weekly therapy sessions of CBT. Pre- and post-intervention assessments were conducted using the Clinician Administered PTSD Scale (CAPS), Hamilton Anxiety Rating Scale (HAM-A), Montgomery-Asberg Depression Rating Scale (MADRS), Life Events Checklist, and SF-36v2® (QualityMetric, Lincoln, RI) Health Survey. The CAPS, HAM-A, and MADRS each demonstrated lower scores, signifying improvement, and 69% of subjects experienced a clinically significant change in the CAPS. Patient satisfaction results indicated greater satisfaction for telemedicine as opposed to traditional face-to-face treatment. Findings reveal a trend expressing the equivalence of telemedicine and face-to-face therapy when treating OEF/OIF veterans with PTSD among rural populations by a community provider. It further demonstrates the successful collaboration between a community healthcare provider and the military healthcare system.",Ziemba SJ.; Bradley NS.; Landry LA.; Roth CH.; Porter LS.; Cuyler RN.,2014.0,10.1089/tmj.2013.0312,0,0,
2337,Assessment of the performance of nasal pillows at high CPAP pressures.,"Compliance with CPAP therapy remains an issue despite its effectiveness. Mask selection is likely to affect a patients experience with CPAP, and multiple mask options are currently available. Nasal pillows have less contact with the face compared to nasal masks and may benefit patients by minimizing side effects; however, they are infrequently used at high CPAP pressures. The aim of this study was to examine the performance of nasal pillows at pressures ≥ 12 cm H2O compared with nasal masks. Twenty-one subjects were recruited. Participants were randomized to Swift FX nasal pillows and their current nasal mask for 7 consecutive nights each in a prospective crossover trial. Objective device data and subjective feedback were collected. There were no differences in objective device data of nasal pillows vs. nasal masks: Daily Usage 7.4 ± 1.4 vs. 7.2 ± 1.4 (h/night); 95(th)%ile Leak 28.6 ± 13.5 vs. 27.9 ± 17.9 (L/min); AHI 1.9 ± 1.3 vs. 1.7 ± 1.1, respectively (all p-values > 0.05). There were no differences between the nasal pillows and nasal masks for subjective ratings of comfort, seal, red marks, side effects such as jetting and dry nose/mouth, and overall performance (all p-values > 0.05). The nasal pillows were rated to be less obtrusive and claustrophobic (both p-values < 0.01), but less stable (p = 0.04). Overall preference was 50% nasal pillows, 45% nasal masks; 5% found no difference. Nasal pillows are as efficacious as nasal masks at CPAP pressures ≥ 12 cm H2O and are a suitable option for patients requiring high CPAP pressures. NIH Clinical Trials Registry. http://clinicaltrials.gov. Nasal Pillows at High CPAP Pressure. Identifier: NCT01690923.",Zhu X.; Wimms AJ.; Benjafield AV.,2013.0,10.5664/jcsm.2984,0,0,
2338,Traditional and online consumers in China: A preliminary study of their personality traits and decision-making styles,"Background: Population of online consumers increases rapidly, but the decision-making styles of online consumers and psychiatric denominators such as the personality correlates remain unclear. Subjects and methods: In 196 traditional, and 196 age-, education- and gender-matched online consumers, we have tested the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ) and the Consumer Style Inventory (CSI). Results: After exploratory and confirmatory factor analyses, we have defined a five-factor model CSI with 24 items. Online consumers scored lower on ZKPQ Neuroticism-Anxiety and higher on Aggression-Hostility than traditional ones did, and scored higher on CSI Novelty-fashion consciousness and Brand consciousness, and lower on Time consciousness than the traditional consumers did. ZKPQ Neuroticism-Anxiety was positively correlated with CSI Confused by overchoice in both groups, Sociability was positively correlated with Novelty-fashion consciousness and negatively with Time consciousness in traditional group, and Impulsive Sensation Seeking was positively correlated with Novelty-fashion consciousness and Time consciousness in online group. Conclusions: Our study suggests that, regarding the decision-making styles, online consumers display curiosity that lacks security and need other ways to improve their social lives. It also calls further designs to address the contributions of other psychiatric features to the particular decision-making styles in online consumers. © Medicinska naklada - Zagreb, Croatia.",Zhu J.; Xu Y.; Huang J.; Yeow C.; Wang W.,2012.0,,0,0,
2339,The effects of rumination on mood and intrusive memories after exposure to traumatic material: An experimental study,"Correlational studies have shown that trauma-related rumination predicts chronic post-traumatic stress disorder (PTSD). This study aimed to experimentally test the hypothesis that rumination is causally involved in the development and maintenance of PTSD symptoms. A video depicting the aftermath of serious road traffic accidents was used as an analogue stressor. After having watched the video, N = 101 healthy participants were randomly assigned to a guided thinking task designed to induce (a) rumination, (b) memory integration and (c) distraction. In line with the hypotheses, rumination led to less recovery from sad mood triggered by the video than the other two conditions. In addition, self-reported state levels of rumination during the guided thinking task predicted subsequent intrusive memories in the session. However, no significant main effect of the experimental manipulation on intrusive memories of the video was found. Results of exploratory analyses suggested possible sex differences in the way the processing manipulations were effective. Taken together, the results partially support the hypothesis that rumination is involved in the maintenance of negative mood and post-traumatic stress symptoms. © 2009 Elsevier Ltd. All rights reserved.",Zetsche U.; Ehring T.; Ehlers A.,2009.0,10.1016/j.jbtep.2009.07.001,0,0,
2340,"Using target population specification, effect size, and reach to estimate and compare the population impact of two PTSD preventive interventions.","The population impact of a preventive intervention depends on two factors: what proportion of the full population at risk receives the intervention and how large a reduction in risk occurs among those who receive it. We sought to illustrate how information from a cognitive behavioral psychotherapy (CBT) trial and stepped collaborative care (CC) trial could be used to estimate the population impact of two contrasting approaches to PTSD prevention. We first specified trauma center target populations represented by participants in each trial. Patient characteristics were compared, as were effect size and reach indices and population-level reductions in PTSD incidence. The CBT trial demonstrated a larger effect size (50% PTSD prevention), but minimal reach (27/10,000), while the CC trial demonstrated a smaller effect size (7% PTSD prevention) but greater reach (1762/10,000). Modeling of the population impact suggested that a 9.5-fold greater cumulative reduction in the incidence of PTSD would result from the dissemination of the CC broad reach prevention strategy. A reciprocal relationship between effect size and reach was evident in these two trials. By specifying a target population, effect size and reach could be combined to project the overall population impact of each PTSD prevention approach. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zatzick, Douglas F; Koepsell, Thomas; Rivara, Frederick P; Ahern, Bateson, Blake, Blanchard, Cronbach, First, Flay, Galea, Glasgow, Glasgow, Glasgow, Glasgow, Green, Helzer, Hoge, Hoge, Katon, Kerner, Koepsell, Kravitz, Longford, Perrin, Rose, Rothwell, Sabin, Schmoor, Street, Tunis, Ursano, Wagner, Weathers, Zatzick, Zatzick, Zatzick, Zatzick, Zatzick, Zatzick, Zatzick",2009.0,,0,0,
2341,Acupuncture treatment of generalized anxiety disorder.,,Zhiling W.; Yuhong L.; Hong L.,2006.0,,0,0,
2342,[Effects of electroacupuncture on resting-state encephalic functional connectivity network in patients with PTSD].,"To explore the central regulatory mechanism of electroacupuncture (EA) on patients with post-traumatic stress disorder (PTSD). Fourteen patients of PTSD were selected as study objects and treated with ""regulating mind and restoring consciousness"" acupuncture method, in which Baihui (GV 20) and Shenting (GV 24) were used as main acupoints and Sishencong (EX-HN 1) and Fengchi (GB 20) were used as supporting acupoints for acupuncture. After the arrival of qi, Han's acupoint nerve stimulator was connected for 30 min per treatment, three times a week for consecutive 12 weeks. Before treatment and 12 weeks into treatment, the clinician administered PTSD scale (CAPS), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were evaluated; a Siemens 3.0 T magnetic resonance imaging system was used to perform resting-state scan, and bilateral hippocampus were taken as region of interested to perform encephalic function connectivity analysis. After the treatment, the scores of CAPS, SAS and SDS were all reduced compared with those before treatment (all P<0.05) ; function connectivity was enhanced in bilateral hippocampus, right posterior central gyrus and left superior parietal lobule (2.3<Z<4.0, P<0.05), but the connectivity in left parahippocampal gyrus and right amygdaloid nucleus was suppressed. Electroacupuncture has certain improving effects on PTSD symptoms, which is likely to be related with enhancing the connectivity between parietal lobe and hippocampus, suppressing the connectivity between hippocampus and parahippocampal gyrus, amygdaloid, leading to an indirect influence on limbic system.",Zheng C.; Tan L.; Zhou T.; Zhang H.,2015.0,,0,0,
2343,Short-term psychotherapy in complex treatment of non-psychotic depressive spectrum disorders,"The aim of this investigation was to study the effectiveness of a combination of differentiated short-term psychotherapy and pharmacotherapy with antidepressants. Methods: The study was implemented in a clinical randomized clinical trial. Experimental group consisted of 44 patients whose treatment is differentiated short-term psychotherapy, developed on the basis of the received data, in combination with standard pharmacotherapy. Comparison group comprised 35 patients whose treatment consisted of cognitive therapy in combination with standard pharmacotherapy. In short-term depressive reactions set a techniques include: a) psychological relaxation sessions, b) exposition techniques, c) cognitive therapy for correction of vulnerable personality traits. With prolonged depressive reaction applied psychotherapy aimed at correcting avoid personality traits in various modalities. Results: As compared to the group of comparison for certain the subscales of depressed mood (p< 0,01) became better anymore, middle insomnia (p< 0,001), retardation (p< 0,05), anxiety psychic (p< 0,001) and anxiety somatic (p< 0,001), general somatic symptoms (p< 0,05), paranoid symptoms (p< 0,01) and depersonalization (p< 0,05). According to the questionnaire of",Zhebentyaev V.A.; Igumnov S.A.,2011.0,10.1016/S0924-9338(11)73019-X,0,0,
2344,Correlation between the evaluation of life style and level of psychological health in vocational college students,"Aim: To investigate and evaluate the life style of vocational college students, and test as well as analyze its relationship with psychological health. Methods: Randomized stratified clustering was adopted to select 466 students from 10 classes and 3 departments of medical sciences, pharmaceutical sciences and nursing in Hunan Vocational College of Environment and Biology in May 2006. Healthy Living Style Scale edited by Liang Jing and SCL-90 were adopted to conduct group testing and comparing analysis. The Healthy Living Style Scale included 16 questions and there were 3 answers for each question. Each answer was scored as 1, 10, 20 and 30 points respectively. This scale was designed by referring to the characteristics of learning and living based on the principle and basis of it, and the expressions of individual question as well as answer were reformed and adjusted properly without influencing the reliability and validity. The total score of Healthy Living Style Scale was obtained by summing up the scores of 16 items. SCL-90 was composed of 90 items in 10 factors, including somatization, compulsion, interpersonal relationship, depression, anxiety, hostility, horror, bigoted and psychosis etc. Results: A total of 466 questionnaires were sent out, and 450 qualified questionnaires were recollected with the effective rate of 96.57%. 1 The scores of 70.67% of students were in a higher range of 280- < 400 points, which was considered as a healthy and civilized living-style, whereas 24.22% of students got a score ranged 160- < 280, which should be noticed. 2 Comparison in score of life style among different students: it was greatly different between male students and female students, and the differences were significant (333.4±51.9,305.5±56.7, P < 0.05), and it was higher in urban students than that in countryside students, and the differences were remarkable (314.4±56.2,297.4±56.5, P < 0.05). However, there was no significant difference among students of different age and majors. 3 The score of Healthy Living Style Scale was in negative correlation with all factors in SCL-90 (r=-0.246,-0.174,-0.190,-0.269,-0.282, -0.279,-0.201,-0.229,-0.236,P <0.01). 4 Compared with domestic norm, students with the score of Healthy Living Style Scale < 400 points got increased scores in factors of somatization, compulsion, depression, anxiety, hostility, horror, bigoted and psychosis, and the differences was significant (P < 0.05 or 0.01). Conclusion: The living style of about a quarter students should be noticed and improved. The health condition of living style is highly correlated with the level of psychological health.",Zhao H.-S.; Deng J.-G.; Li J.-Z.,2007.0,,0,0,
2345,Music reduces panic: an initial study of listening to preferred music improves male patient discomfort and anxiety during flexible cystoscopy.,"To assess the impact of listening to preferred music on relieving male patients' pain and anxiety during flexible cystoscopy. A total of 124 male patients were admitted to our hospital for flexile cystoscopy by a single urologist between January 2013 and September 2013 and randomized to two equal groups. Group 2 included 62 patients who could select and listen to their preferred music during flexible cystoscopy. Group 1 included 62 patients who were unable to listen to the music. All patients were administered the same amount of lidocaine (10 mL) for 3 minutes for local anesthesia before flexible cystoscopy. A visual analog scale (VAS) ranging from 0 to 10 was used to assess patients' pain feeling after the cystoscopy procedure. Anxiety levels were calculated according to the State Instrument of State-Trait Anxiety Inventory (STAI-S), and the pulse rate were recorded 5 minutes before and immediately after the procedure. The duration of the procedure of each group were also analyzed. Statistically significant differences were detected between group 1 and group 2 in the mean pain score on VAS (2.53 ± 1.34 vs 1.63 ± 1.09, P=0.002, Mann-Whitney U test), mean postprocedural State Anxiety Inventory pain score (39.4 ± 6.5 vs 34.5 ± 5.8), and postprocedural pulse rate (79.8 ± 5.5 vs 76.0 ± 7.3) (P<0.001 for both, t test). Patients who listened to their preferred music experienced less discomfort and lower anxiety at cystoscopy. Patient age, duration of the procedure, preprocedural STAI-S, and preprocedural pulse rate of each group were comparable. Listening to preferred music during flexible cystoscopy is an easy way to improves male patients' comfort and reduce their anxiety. It could be recommended for male patients.",Zhang ZS.; Wang XL.; Xu CL.; Zhang C.; Cao Z.; Xu WD.; Wei RC.; Sun YH.,2014.0,10.1089/end.2013.0705,0,0,
2346,A novel design of the multilobed latissimus dorsi myocutaneous flap to achieve primary donor-site closure in the reconstruction of large defects.,"The main drawback of the latissimus dorsi myocutaneous flap for large defect repairs is the relatively small skin paddle size that can be raised to allow primary closure of the donor site. In this article, the authors describe a novel design of the flap using multiple separate skin paddles, with each paddle nourished by independent perforators, to repair very large defects while maintaining primary donor-site closure. After the size of the defect was calculated, its total area was split into two or three skin paddles and marked on the back skin so that the largest width of each paddle did not exceed 8 cm. A multilobed skin paddle was designed with a total area that was much larger than traditional latissimus dorsi flaps. After harvesting the flap, several smaller skin paddles were transferred and rejoined at the recipient site. From June of 2009 to March of 2012, this method was used to restore posttraumatic and postoncologic defects of the head in seven cases and lower limb defects in two cases. Seven flaps were raised as bilobed flaps, and two flaps were raised as trilobed flaps. The donor site was closed primarily in all cases. One case was complicated by partial necrosis of one paddle and required further local flap coverage. Donor-site breakdown was not observed in any of the cases. The multilobed myocutaneous latissimus dorsi flap enables a customized reconstruction of large defects for all types of patients and direct closure of the donor site. Therapeutic, IV.",Zhang YX.; Messmer C.; Pang FK.; Ong YS.; Feng SQ.; Qian Y.; Spinelli G.; Agostini T.; Levin LS.; Lazzeri D.,2013.0,10.1097/PRS.0b013e3182865bcc,0,0,
2347,"Cost-utility of collaborative nurse-led self-management support for primary care patients with anxiety, depressive or somatic symptoms: A cluster-randomized controlled trial (the SMADS trial).","Background: Anxiety, depressive and somatoform disorders are highly prevalent and cause a huge economic burden. A nurse-led collaborative care intervention has been set up in order to improve self-management of patients with these mental disorders in primary care in Hamburg, Germany. The aim of this study was to determine the cost-utility of this nurse-led intervention from the health care payer perspective. Methods: This analysis was part of a 12-month cluster-randomized controlled trial aiming to increase perceived self-efficacy of primary care patients with anxiety, depressive or somatic symptoms by collaborative nurse-led self-management support compared with routine care. A cost-effectiveness analysis using quality-adjusted life years was performed. Net-monetary benefit regressions adjusted for baseline differences for different willingness-to-pay thresholds were conducted and cost-effectiveness acceptability curves were constructed. Results: In total, n = 325 patients (intervention group: n = 134; control group: n = 191) with a mean age of 40 from 20 primary care practices were included in the analysis. The adjusted differences in quality-adjusted life years and mean total costs between intervention group and control group were +0.02 and +1145, respectively. Neither of the two differences was statistically significant. The probability for cost-effectiveness of the complex nurse-led intervention was 49% for a willingness-to-pay of 50,000 per additional quality-adjusted life year. The probability for cost-effectiveness did not exceed 65%, independent of the willingness-to-pay. Conclusion: The complex nurse-led intervention promoting self-management for primary care patients with anxiety, depressive or somatic symptoms did not prove to be cost-effective relative to routine care from a health care payer perspective. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Grochtdreis, Thomas; Zimmermann, Thomas; Puschmann, Egina; Porzelt, Sarah; Dams, Judith; Scherer, Martin; Konig, Hans-Helmut",2018.0,http://dx.doi.org/10.1016/j.ijnurstu.2017.12.010,0,0,
2348,Preliminary evidence of attenuated blood pressure reactivity to acute stress in adults following a recent marital separation,"OBJECTIVE: This study explores cardiovascular reactivity during an acute-stress task in a sample of recently separated adults. DESIGN: In a cross-sectional design, we examined the association between adults' subjective separation-related distress and changes in heart rate and blood pressure across the acute-stress laboratory paradigm in a sample of 133 (n = 49 men) recently separated adults. MAIN OUTCOME MEASURES: Heart rate (HR) and Blood pressure (BP) were recorded across a resting baseline period, a math stressor task, and a recovery period. RESULTS: Multilevel analyses revealed that adults who reported greater separation-related distress exhibited higher initial BP and a slower linear increase in BP across the study period. In addition, adults reporting greater separation-related distress evidenced significantly slower declines in diastolic blood pressure (DBP) following the acute-stress task. HR reactivity was not moderated by separation-related distress. CONCLUSIONS: In recently separated adults, preliminary evidence suggests that the context of the stressors may reveal differential patterns of problematic reactivity (exaggerated or blunted responding). Greater emotional intrusion and hyperactivity symptoms may index increased risk for blunted cardiovascular reactivity to general stressors. This pattern of reactivity is consistent with models of allostatic load that emphasise the deleterious effect of hyporesponsivity to environmental demands.",Grinberg A.M.; O'Hara K.L.; Sbarra D.A.,2018.0,10.1080/08870446.2017.1373111,0,0,
2349,Clinical anxiety promotes excessive response inhibition.,"Background: Laboratory tasks to delineate anxiety disorder features are used to refine classification and inform our understanding of etiological mechanisms. The present study examines laboratory measures of response inhibition, specifically the inhibition of a pre-potent motor response, in clinical anxiety. Data on associations between anxiety and response inhibition remain inconsistent, perhaps because of dissociable effects of clinical anxiety and experimentally manipulated state anxiety. Few studies directly assess the independent and interacting effects of these two anxiety types (state v. disorder) on response inhibition. The current study accomplished this goal, by manipulating state anxiety in healthy and clinically anxious individuals while they complete a response inhibition task. Method: The study employs the threat-of-shock paradigm, one of the best-established manipulations for robustly increasing state anxiety. Participants included 82 adults (41 healthy; 41 patients with an anxiety disorder). A go/nogo task with highly frequent go trials was administered during alternating periods of safety and shock threat. Signal detection theory was used to quantify response bias and signal-detection sensitivity. Results: There were independent effects of anxiety and clinical anxiety on response inhibition. In both groups, heightened anxiety facilitated response inhibition, leading to reduced nogo commission errors. Compared with the healthy group, clinical anxiety was associated with excessive response inhibition and increased go omission errors in both the safe and threat conditions. Conclusions: Response inhibition and its impact on go omission errors appear to be a promising behavioral marker of clinical anxiety. These results have implications for a dimensional view of clinical anxiety. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Grillon, C; Robinson, O. J; O'Connell, K; Davis, A; Alvarez, G; Pine, D. S; Ernst, M",2017.0,http://dx.doi.org/10.1017/S0033291716002555,0,0,
2350,Emotional arousal does not affect delay eyeblink conditioning,"Arousal can modulate information processing, including associative learning. However, there are conflicting results as to whether arousal affects eyeblink conditioning in humans. One potential problem with previous studies is that they have not taken into account factors that are known to affect conditioning. One such factor is the strength of the unconditioned response (UR). Despite evidence that greater UR leads to greater conditioned responses (CR), prior studies have not examined the role of the UR in CR performance. Prior studies have also usually classified subjects into low and high arousal groups based on a priori categorization without reliance on objective measures of arousal. The present study was designed to examine the impact of arousal on delay eyeblink conditioning. Changes in arousal levels were obtained by having participants view pictures selected for their a priori emotional and arousal values as being pleasant/arousing, unpleasant/arousing, or neutral/not arousing. Each subject viewed pictures of only one category. The spontaneous fluctuation of the skin conductance was taken as an index of physiological arousal. Subjects were divided into low and high arousal groups according to a median-split. Results showed that the rate of CR was positively related to the amplitude of the UR, but was not affected by emotional pictures or by physiological arousal. It is argued that changes in CR during arousal could be due to differences in unconditioned eyeblink strength rather than to changes in associative processes. © 2003 Elsevier B.V. All rights reserved.",Grillon C.; Hill J.,2003.0,10.1016/S0926-6410(03)00141-1,0,0,
2351,Effects of the beta-blocker propranolol on cued and contextual fear conditioning in humans,"Rationale: Beta-adrenergic receptors are involved in the consolidation of emotional memories. Yet, a number of studies using Pavlovian cued fear conditioning have been unable to demonstrate an effect of beta-adrenergic blockade on acquisition or retention of fear conditioning. Evidence for the involvement of beta-adrenergic receptors in emotional memories comes mostly from studies using fear inhibitory avoidance in rodents. It is possible that fear inhibitory avoidance is more akin to contextual conditioning than to cued fear conditioning, suggesting that context conditioning may be disrupted by beta-adrenergic blockade. Objective: This study investigated the effects of the beta-adrenergic blocker propranolol on cued and contextual fear conditioning in humans. Methods: Subjects were given either placebo (n=15) or 40 mg propranolol (n=15) prior to differential cued conditioning. A week later, they were tested for retention of context and cued fear conditioning using physiological (startle reflex and electrodermal activity) and subjective measures of emotional arousal. Results: The results were consistent with the hypothesis. The skin conductance level (SCL) and the subjective measure of arousal suggested reduced emotional arousal upon returning to the conditioning context in the propranolol group, compared to the placebo group. The acquisition and retention of cued fear conditioning were not affected by propranolol. Conclusions: These results suggest that beta-adrenergic receptors are involved in contextual fear conditioning.",Grillon C.; Cordova J.; Morgan C.A.; Charney D.S.; Davis M.,2004.0,10.1007/s00213-004-1819-5,0,0,
2352,Anxiolytic effects of a novel group II metabotropic glutamate receptor agonist (LY354740) in the fear-potentiated startle paradigm in humans,"Rationale: LY354740, a structural analogue of glutamate that shows specificity at the mGluR2/3 receptor, has anxiolytic effects in animal models. Objective: This study investigated the anxiolytic effects of LY354740 in humans using the fear-potentiated startle reflex methodology. Methods: Subjects were given either placebo (n=16), 20 mg LY354740 (n=15), or 200 mg LY354740 (n=13). The fear-potentiated startle tests examined startle potentiation to shock anticipation and to darkness. Results: Consistent with previous results, startle was increased by threat of shock and by darkness. LY354740 did not affect baseline startle. Correspondingly, subjects did not report LY354740 to be sedative. LY354740 significantly reduced the increase in startle magnitude during shock anticipation, but not during darkness. Subjective reports of state anxiety and negative affectivity during the fear-potentiated startle tests were also reduced in a dose-dependent manner by LY354740. Conclusions: These results suggest that LY354740 has an anxiolytic profile in humans without being sedative.",Grillon C.; Cordova J.; Levine L.R.; Morgan III C.A.,2003.0,10.1007/s00213-003-1444-8,0,0,
2353,Conditioned inhibition of fear-potentiated startle and skin conductance in humans,"Conditioned inhibition of classical conditioning was investigated with the startle reflex and the skin conductance response (SCR) in humans using a serial presentation of the conditioned inhibitor (X) and of the conditioned stimulus (CS). The unconditioned stimulus (US) was a shock. During conditioning, participants were presented with two different reinforced CS (A, B) and with X preceding A (noted X ‚Üí A). During X ‚Üí A, A was not reinforced with the US. During the summation test, B, X ‚Üí B, and Y ‚Üí B were presented (Y was a new stimulus that tested the specificity of the inhibitory properties of X). B was not reinforced during the summation test. A, B, X, and Y were lights of different colors. Participants were divided into a low and a high anxious group based on the TPQ (C.R. Cloninger, 1987). In the low anxious group, conditioned startle potentiation and SCR responses to A were inhibited when X preceded A (noted AXA). This differential responding to A and AXA emerged earlier with the SCR than with startle. During the summation test, the inhibitory properties of X did not transfer to B. In the high anxious group, there was only a differential SCR to A and AXA. X did not inhibit startle potentiation to A.",Grillon C.; Ameli R.,2001.0,10.1017/S0048577201000294,0,0,
2354,Greater Sustained Anxiety but Not Phasic Fear in Women Compared to Men,"Startle reflex studies in rodents indicate that female are more reactive than rats in experimental models of sustained anxiety but not in models of phasic fear (Toufexis, 2007). This study examined evidence for a similar effect in humans. Participants were exposed to three conditions, (1) predictable aversive shocks signaled by a cue, (2) unpredictable shocks, and (3) no shocks. Acoustic startle stimuli were delivered regularly across conditions. Phasic startle potential to the threat cue in the predictable condition was not affected by sex. In contrast, and consistent with basic research, the sustained increase in startle in the predictable and unpredictable conditions was greater in women compared to men. Animal studies suggest that such an effect may be mediated by the effects of sexual dimorphism in limbic structures, including the bed nucleus of the stria terminalis. However, psychosocial factors may also contribute to this effect. © 2008 American Psychological Association.",Grillon C.,2008.0,10.1037/1528-3542.8.3.410,0,0,
2355,The effect of EMDR and CBT on low self-esteem in a general psychiatric population: A randomized controlled trial.,"Although low self-esteem has been found to be an important factor in the development and maintenance of psychopathology, surprisingly little is known about its treatment. This study investigated the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy and Cognitive Behavioural Therapy (CBT), regarding their capacities in enhancing self-esteem in a general psychiatric secondary health care population. A randomized controlled trial with two parallel groups was used. Participants were randomly allocated to either 10 weekly sessions of EMDR (n = 15) or CBT (n = 15). They were assessed pre-treatment, after each session, post treatment and at 3 months follow-up on self-esteem (Rosenberg Self-esteem Scale and Credibility of Core Beliefs), psychological symptoms (Brief Symptom Inventory), social anxiety, and social interaction (Inventory of Interpersonal Situations) (IIS). The data were analyzed using repeated measures ANOVA for the complete cases (n = 19) and intention-to-treat (n = 30) to examine differences over time and between conditions. Both groups, EMDR as well as CBT, showed significant improvements on self-esteem, increasing two standard deviations on the main parameter (RSES). Furthermore, the results showed significant reductions in general psychiatric symptoms. The effects were maintained at 3 months follow-up. No between-group differences could be detected. Although the small sample requires to exercise caution in the interpretation of the findings, the results suggest that, when offering an adequate number of sessions, both EMDR and CBT have the potential to be effective treatments for patients with low self-esteem and a wide range of comorbid psychiatric conditions. This study was registered at www.trialregister.nl with identifier NTR4611. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Griffioen, Brecht T; van der Vegt, Anna A; de Groot, Izaak W; de Jongh, Ad",2017.0,http://dx.doi.org/10.3389/fpsyg.2017.01910,0,0,
2356,Cognitive-Behavioral Therapy for Body Dysmorphic Disorder by Proxy.,"Body dysmorphic disorder (BDD) is a distressing or impairing preoccupation with a perceived defect in physical appearance. BDD by proxy (BDDBP) is a significant but understudied variant of BDD in which the primary preoccupation involves perceived imperfections of another person. Like BDD, individuals with BDDBP engage in time-consuming rituals to ""fix"" the other person's appearance or alleviate distress. Avoidance is common and the impact of BDDBP on social functioning is profound. Cognitive-behavioral therapy (CBT) is the best-studied and most promising psychological treatment for BDD, but no studies have examined its generalizability to the BDDBP variant. We tested feasibility, acceptability, and treatment outcome of CBT modified for BDDBP in a sample of 6 adults with primary BDDBP. Treatment was delivered in weekly individual sessions over 12-20weeks. Mean symptom severity (BDDBP-YBOCS) dropped from the moderately severe range at pretreatment to the subclinical range at posttreatment, t(6)=10.7, p<.001, d=3.3. One hundred percent of treatment completers were responders (‚â•30% reduction in BDDBP-YBOCS). Insight also improved. Treatment gains were maintained at 3-month follow-up. To our knowledge, this represents the first treatment study for BDDBP.",Greenberg JL.; Mothi SS.; Wilhelm S.,2016.0,10.1016/j.beth.2016.01.002,0,0,
2357, A Controlled Randomized Preliminary Trial of a Modified Dissonance-Based Eating Disorder Intervention Program," OBJECTIVE: We conducted a controlled randomized preliminary trial of a modified dissonance‚Äêbased eating disorder program (n = 24) compared to an assessment‚Äêonly control condition (n = 23) via a longitudinal design (baseline, postintervention, 2‚Äêmonth follow‚Äêup) in a community sample of women (N = 47) with clinical (n = 22) and subclinical (n = 25) eating disorder symptoms. METHOD: The traditional content of the Body Project, a dissonance‚Äêbased eating disorder prevention program, was modified to include verbal, written, and behavioral exercises designed to dissuade self‚Äêobjectification and maladaptive social comparison. Women with clinical and subclinical symptoms were included in the target audience to investigate both the treatment and the indicated prevention utility of the modified dissonance program. Body dissatisfaction, self‚Äêesteem, self‚Äêobjectification, thin‚Äêideal internalization, maladaptive social comparison, trait anxiety, and eating disorder symptoms were evaluated in the control and the modified dissonance condition at baseline, postintervention, and 2‚Äêmonth follow‚Äêup. RESULTS: We predicted a statistically significant 2 (condition: control, modified dissonance) x 3 (time: baseline, postintervention, 2‚Äêmonth follow‚Äêup) interaction in the mixed factorial multivariate analyses of variance results. Results confirmed this hypothesis. Eating disorder risk factors and symptoms decreased significantly among participants in the modified dissonance condition at postintervention and 2‚Äêmonth follow‚Äêup compared to baseline; symptom improvement was greater among participants in the modified compared to the control condition. A secondary analysis indicated symptom improvement did not vary as a function of symptom status (clinical, subclinical), suggesting the program is efficacious in both indicated prevention and treatment applications. CONCLUSION: Results provide preliminary support for the modified dissonance program."," Green, MA;  Willis, M;  Fernandez-Kong, K;  Reyes, S;  Linkhart, R;  Johnson, M;  Thorne, T;  Lindberg, J;  Kroska, E;  Woodward, H",2017.0, 10.1002/jclp.22468,0,0,
2358,Affect and neural activity in women with PTSD during a task of emotional interference.,"The current study sought to determine the relationship between self-reported dimensions of affect and activation in brain regions associated with emotion regulation in PTSD during a task of non-conscious emotional processing in interpersonal trauma survivors with PTSD and healthy controls. Participants included 52 women diagnosed with PTSD and 18 female healthy controls. All participants completed a clinical assessment including the SCID, CAPS, and PANAS followed by a functional MRI assessment including a task of implicit emotional conflict. When PTSD participants were oriented to fearful faces, negative affect (NA) was inversely related to activation in the left amygdala and positive affect (PA) was inversely related to activation in the right amygdala. When ignoring fearful faces, NA was positively associated with activation in the right parahippocampal gyrus and PA was inversely related to activation in the left hippocampus. Similar results were observed in healthy controls regarding PA. However, NA was not significantly related to any region of interest in healthy controls. Limitations include the homogeneity of the healthy controls with regard to racial diversity, results may only be specific to female interpersonal trauma survivors with PTSD, and neutral faces within the conflict task may be perceived as negative by clinical samples. Persistent, increased NA may represent a proxy for disruptions in emotional processing in interpersonal trauma survivors with PTSD. As such, clinicians may prioritize increasing emotional awareness through emotion regulation and/or distress tolerance strategies in this population.",Brown WJ.; Wojtalik JA.; Dewey D.; Bruce SE.; Yang Z.; Sheline YI.,2016.0,10.1016/j.jad.2016.05.065,0,0,
2359,Changes in posttraumatic stress disorder (PTSD) and depressive symptoms over the course of prolonged exposure.,"Objective: Prior studies of prolonged exposure therapy (PE) suggested that reduction of posttraumatic stress disorder (PTSD) precedes reduction in depression, yet no research has collapsed data across multiple studies to examine whether the directionality of reduction remains consistent in larger and diagnostically diverse samples. Thus, the objective of this study is to conduct an evaluation of bidirectional associations between PTSD and depression in PE. Method: Participants (n = 216) from three randomized controlled trials of PE alone, PE + alcohol use disorder treatment, and PE + nicotine use disorder treatment completed weekly PTSD and depression severity measures. First, we analyzed the directional relationship between PTSD and depression over time in 2 single models to separately examine the effects of PTSD on depression and vice versa. Second, we analyzed a combined model to examine the simultaneous effects of reduction in PTSD on reduction in depression over and above the effects of reduction in depression on reduction in PTSD, and vice versa. Results: Two single models suggested that reductions in PTSD lead to reductions in depression and vice versa. The combined models suggested that both directions of change are important and reciprocal. The strength of predictive power from PTSD to depression, and vice versa, is approximately equal. Most significant prediction of PTSD from depression and vice versa occurred early in treatment. Conclusion: The relationship between reductions in PTSD and depression during PE is transactional. Regardless of whether PTSD or depression decreases first, reduction in the other symptom cluster is likely to follow. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement What is the public health significance of this article?-This study suggests that posttraumatic stress disorder (PTSD) and depression have a reciprocal relationship during prolonged exposure (PE) therapy for PTSD. As PTSD symptoms improve, depression symptoms subsequently improve. Similarly, as depression symptoms improve, PTSD symptoms subsequently improve. (PsycINFO Database Record (c) 2018 APA, all rights reserved)","Brown, Lily A; Jerud, Alissa; Asnaani, Anu; Petersen, Julie; Zang, Yinyin; Foa, Edna B",2018.0,http://dx.doi.org/10.1037/ccp0000292,0,0,
2360, Guided parent-delivered cognitive behaviour therapy for children with anxiety disorders: outcomes at 3- to 5-year follow-up," OBJECTIVES: Brief guided parent‚Äêdelivered cognitive behaviour therapy (CBT) has been developed to meet the demand for non‚Äêintensive interventions for children with anxiety disorders, and initial trials have shown it to be effective for children with a range of anxiety disorders. This study examined outcomes 3‚Äê5 years post‚Äêtreatment. DESIGN: A long‚Äêterm follow‚Äêup (LTFU) cohort study. METHODS: Families who (1) completed at least 50% of allocated treatment sessions of guided parent‚Äêdelivered CBT for childhood anxiety as part of a randomized control trial (RCT), (2) provided consent to be recontacted, (3) had not received further mental health interventions, and (4) were contactable were invited to take part. Fifty‚Äêseven families (29% of the original sample) completed structured diagnostic interviews on average 50 months after treatment (39‚Äê61 months). RESULTS: At LTFU, 79% of the assessed children who had received the treatment no longer met criteria for their primary diagnosis, 63% did not meet criteria for any anxiety disorder, and 61% did not meet criteria for any DSM‚ÄêIV disorder. Treatment gains were mostly maintained (60%), and some children went on to recover during the follow‚Äêup period without additional input from mental health services (19%). Few young people had relapsed since their last assessment (12%). Mean scores on standardized symptom questionnaires were within the normal range. CONCLUSIONS: Children who recovered from anxiety disorders following brief guided parent‚Äêdelivered CBT typically maintained good outcomes and few relapsed. These findings suggest that this is a viable first‚Äêline, low‚Äêintensity treatment approach. This study only included a small subsample of those in the original RCT (29%), and more information is required about those who dropped out of treatment and those who required further intervention immediately after treatment. PRACTITIONER POINTS: Treatment gains from brief guided parent‚Äêdelivered cognitive behaviour therapy for children with anxiety are maintained for most children 3‚Äê5 years later. The majority of children who completed at least 50% of the intervention required no further mental health intervention in that time. Some children make continued improvement after completing the intervention. Data are based on a sample of families from southern England where the primary caregiving parent was free of mental health difficulties. Further research is needed to explore the mental health needs of those who do not benefit from this intervention."," Brown, A;  Creswell, C;  Barker, C;  Butler, S;  Cooper, P;  Hobbs, C;  Thirlwall, K",2017.0, 10.1111/bjc.12127,0,0,
2361, Telephone-delivered problem-solving training after mild traumatic brain injury: qualitative analysis of service members' perceptions," METHOD: Standard qualitative methods were employed, using a ""process"" coding strategy to explore the conceptual perceptions of the intervention experience as suggested by the data recorded from final telephone interviews of 80 service members who participated in a randomized controlled trial evaluating the efficacy of telephone‚Äêdelivered PST after having sustained concussions or mild traumatic brain injuries during recent (PsycINFO Database Record OBJECTIVE: The purpose of this study was to identify the specific reasons for service members' satisfaction or dissatisfaction with problem‚Äêsolving training (PST), telephone delivery, and other aspects of a telephone‚Äêdelivered PST intervention in order to determine what might enhance this approach for future clinical use."," Brockway, JA;  St De Lore, J;  Fann, JR;  Hart, T;  Hurst, S;  Fey-Hinckley, S;  Savage, J;  Warren, M;  Bell, KR",2016.0, 10.1037/rep0000077,0,0,
2362, Effect of supervised exercise in groups on psychological well-being among pregnant women at risk of depression (the EWE Study): study protocol for a randomized controlled trial," BACKGROUND: Pregnant women with depression and/or anxiety prior to pregnancy are at higher risk of preterm birth, breastfeeding problems, postpartum depression, and disruption of the mother‚Äêinfant attachment. It is well documented that exercise improves psychological well‚Äêbeing in nonpregnant subjects with symptoms of depression. However, in only a few small studies have researchers examined the effect of exercise on symptoms of depression among pregnant women. We hypothesize that physiotherapist‚Äêsupervised group exercise for pregnant women at risk of antenatal depression increases their psychological well‚Äêbeing. This paper describes the study protocol of a randomized controlled trial (RCT) on a supervised group exercise intervention for pregnant women with a current or previous history of depression and/or anxiety. METHODS/DESIGN: The RCT is being carried out at the Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, in the period 2016‚Äê2019. The inclusion criteria are pregnant women ‚â•18 years of age with depression and/or anxiety requiring treatment by a psychiatrist or a psychologist within the last 10 years and/or intake of antidepressants in the 3 months prior to conception and/or during pregnancy. The women must have appropriate Danish language skills, be pregnant with a single fetus, give written informed consent, and be at 17‚Äê22 gestational weeks when the intervention begins. The primary outcome is psychological well‚Äêbeing (the five‚Äêitem World Health Organization Well‚Äêbeing Index). Secondary outcomes are symptoms of depression (Edinburgh Postnatal Depression Scale), functional ability (General Health Questionnaire), clinical symptoms of anxiety (State‚ÄêTrait Anxiety Inventory), sleep quality and sleep disturbances (Pittsburgh Sleep Quality Index), and pregnancy and delivery outcomes. The intervention is supervised group exercise twice weekly for 12 weeks. The control group will receive standard antenatal care. On the basis of sample size calculation, a total of 300 women will be randomly assigned to either the intervention or the control group in a ratio of 1:1. DISCUSSION: The trial is expected to contribute to the body of knowledge used in planning antenatal care for pregnant women at risk of depression. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02833519 . Registered on 19 May 2016."," Broberg, L;  Backhausen, M;  Damm, P;  Bech, P;  Tabor, A;  Hegaard, HK",2017.0, 10.1186/s13063-017-1938-z,0,0,
2363, Collaborative care for depression in general practice: study protocol for a randomised controlled trial," BACKGROUND: Depression is a common illness with great human costs and a significant burden on the public economy. Previous studies have indicated that collaborative care (CC) has a positive effect on symptoms when provided to people with depression, but CC has not yet been applied in a Danish context. We therefore developed a model for CC (the Collabri model) to treat people with depression in general practice in Denmark. Since systematic identification of patients is an ""active ingredient"" in CC and some literature suggests case finding as the best alternative to standard detection, the two detection methods are examined as part of the study. The aim is to investigate if treatment according to the Collabri model has an effect on depression symptoms when provided to people with depression in general practice in Denmark, and to examine if case finding is a better method to detect depression in general practice than standard detection. METHODS/DESIGN: The trial is a cluster‚Äêrandomised, clinical superiority trial investigating the effect of treatment according to the Collabri model for CC, compared to treatment as usual for 480 participants diagnosed with depression in general practice in the Capital Region of Denmark. The primary outcome is depression symptoms (Beck's Depression Inventory (BDI‚ÄêII)) after 6 months. Secondary outcomes include depression symptoms (BDI‚ÄêII) after 15 months, anxiety symptoms (Beck's Anxiety Inventory (BAI)), level of functioning (Global Assessment of Function (GAF)) and psychological stress (Symptom Checklist‚Äê90‚ÄêRevised (SCL‚Äê90‚ÄêR)). In addition, case finding (with the recommended screening tool Major Depression Inventory (MDI)) and standard detection of depression is examined in a cluster‚Äêrandomized controlled design. Here, the primary outcome is the positive predictive value of referral diagnosis. DISCUSSION: If the Collabri model is shown to be superior to treatment as usual, the study will contribute with important knowledge on how to improve treatment of depression in general practice, with major benefit to patients and society. If case finding is shown to be superior to standard detection, it will be recommended as the detection method in future treatment according to the Collabri model. TRIAL REGISTRATION: ClinicalTrials.gov. NCT02678845 . Retrospectively registered on 7 February 2016."," Brinck-Claussen, U√ò;  Curth, NK;  Davidsen, AS;  Mikkelsen, JH;  Lau, ME;  Lundsteen, M;  Csillag, C;  Christensen, KS;  Hjorth√∏j, C;  Nordentoft, M;  et al.",2017.0, 10.1186/s13063-017-2064-7,0,0,
2364,"Web-based alcohol intervention for veterans: PTSD, combat exposure, and alcohol outcomes.","The purpose of the current study was to evaluate the relationship between baseline levels of posttraumatic stress disorder (PTSD), combat exposure, and alcohol outcomes in a sample of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans using a web-based self-management intervention (VetChange) for problem drinking. The current study focuses on 523 veterans who participated in a larger randomized clinical trial. Analyses in the current study include (a) multivariable linear regression models to assess the relationship between PTSD, combat exposure, and alcohol variables at baseline, and (b) general linear models accounting for correlated data within subjects to analyze change over time for alcohol outcomes as a function of baseline PTSD symptoms, combat exposure, and covariates. There was a positive association between PTSD symptom severity and alcohol use and alcohol problem severity at baseline. However, participants with higher baseline PTSD symptoms demonstrated a significantly greater reduction in alcohol use during the intervention and a greater reduction in alcohol problems from baseline to 3-month follow-up. Combat exposure severity was positively associated with alcohol problems at baseline. However, veterans with higher exposure demonstrated a greater reduction in average weekly drinking between end of intervention and follow-up, and otherwise showed changes similar to participants with lower exposure. Higher levels of baseline PTSD symptoms and combat exposure severity did not prevent OEF/OIF veterans from achieving positive alcohol outcomes through participation in a self-management web intervention for problem drinking. (PsycINFO Database Record",Brief DJ.; Solhan M.; Rybin D.; Enggasser JL.; Rubin A.; Roy M.; Helmuth E.; Schreiner A.; Heilman M.; Vittorio L.; Rosenbloom D.; Keane TM.,2018.0,10.1037/tra0000281,0,0,
2365, Posttraumatic Stress Disorder in U.S. Military Primary Care: trajectories and Predictors of One-Year Prognosis," We examined the longitudinal course of primary care patients in the active duty Army with posttraumatic stress disorder (PTSD) and identified prognostic indicators of PTSD severity. Data were drawn from a 6‐site randomized trial of collaborative primary care for PTSD and dpression in the military. Subjects were 474 soldiers with PTSD (scores ≥ 50 on the PTSD Checklist ‐Civilian Version). Four assessments were completed at U.S. Army installations: baseline, and follow‐ups at 3 months (92.8% response rate [RR]), 6 months (90.1% RR), and 12 months (87.1% RR). Combat exposure and 7 validated indicators of baseline clinical status (alcohol misuse, depression, pain, somatic symptoms, low mental health functioning, low physical health functioning, mild traumatic brain injury) were used to predict PTSD symptom severity on the Posttraumatic Diagnostic Scale (Cronbach's α = .87, .92, .95, .95, at assessments 1‐4, respectively). Growth mixture modeling identified 2 PTSD symptom trajectories: subjects reporting persistent symptoms (Persisters, 81.9%, n = 388), and subjects reporting improved symptoms (Improvers 18.1%, n = 86). Logistic regression modeling examined baseline predictors of symptom trajectories, adjusting for demographics, installation, and treatment condition. Subjects who reported moderate combat exposure, adjusted odds ratio (OR) = 0.44, 95% CI [0.20, 0.98], or who reported high exposure, OR = 0.39, 95% CI [0.17, 0.87], were less likely to be Improvers. Other baseline clinical problems were not related to symptom trajectories. Findings suggested that most military primary care patients with PTSD experience persistent symptoms, highlighting the importance of improving the effectiveness of their care. Most indicators of clinical status offered little prognostic information beyond the brief assessment of combat exposure."," Bray, RM;  Engel, CC;  Williams, J;  Jaycox, LH;  Lane, ME;  Morgan, JK;  Unützer, J",2016.0, 10.1002/jts.22119,0,0,
2366,Effects of an Integrated 'Fast Track' Rehabilitation Service for Multi-Trauma Patients: A Non-Randomized Clinical Trial in the Netherlands.,"The effects on health related outcomes of a newly-developed rehabilitation program, called 'supported Fast Track multi-trauma rehabilitation service' (Fast Track), were evaluated in comparison with conventional trauma rehabilitation service (Care as Usual). Prospective, multi-center, non-randomized controlled study. Between 2009 and 2012, 132 adult multi-trauma patients were included: 65 Fast Track and 67 Care as Usual patients with an Injury Severity Score ‚â•16, complex multiple injuries in several extremities or complex pelvic and/or acetabulum fractures. The Fast Track program involved: integrated coordination between trauma surgeon and rehabilitation physician, shorter stay in hospital with faster transfer to a specialized trauma rehabilitation unit, earlier start of multidisciplinary treatment and 'non-weight bearing' mobilization. Primary outcomes were functional status (FIM) and quality of life (SF-36) measured through questionnaires at baseline, 3, 6, 9 and 12 months post-trauma. Outcomes were analyzed using a linear mixed-effects regression model. The FIM scores significantly increased between 0 and 3 months (p<0.001) for both groups showing that they had improved overall, and continued to improve between 3 and 6 months for Fast Track (p = 0.04) and between 3 and 9 months for Care as Usual (p = 0.03). SF-36 scores significantly improved in both groups between 3 and 6 months (Fast Track, p<0.001; Care as Usual, p = 0.01). At 12 months, SF-36 scores were still below (self-reported) baseline measurements of patient health prior to the accident. However, the FIM and SF-36 scores differed little between the groups at any of the measured time points. Both Fast Track and Care as Usual rehabilitation programs were effective in that multi-trauma patients improved their functional status and quality of life. A faster (maximum) recovery in functional status was observed for Fast Track at 6 months compared to 9 months for Care as Usual. At twelve months follow-up no differential effects between treatment conditions were found. ISRCTN68246661.",Bouman AI.; Hemmen B.; Evers SM.; van de Meent H.; Ambergen T.; Vos PE.; Brink PR.; Seelen HA.,2017.0,10.1371/journal.pone.0170047,0,0,
2367,Cognitive-behavioral therapy and the treatment of panic disorder: efficacy and strategies.,"In this article, we review the efficacy and applications of cognitive-behavioral therapy (CBT) for panic disorder. Research supports CBT as an effective first-line treatment of panic disorder that offers relatively quick onset of action and long-term maintenance of treatment benefits. These characteristics, plus the acceptability, tolerability, and cost-efficacy of CBT, make it an especially attractive treatment option for panic disorder. We review these findings as well as some newer developments in the field including research on emotional acceptance, the importance of context in extinction learning, and the use of CBT in combination with pharmacotherapy.",Otto MW.; Deveney C.,2005.0,,0,0,
2368,The effectiveness of internet cognitive behavioural therapy for generalized anxiety disorder in clinical practice.,"Clinical trials have demonstrated the efficacy of internet cognitive behavioral therapy (iCBT) in the treatment of generalized anxiety disorder (GAD). The current study aims to determine whether these efficacy findings, established under controlled research conditions, translate into effectiveness in practice. The sample comprised 588 patients who completed at least one iCBT lesson for GAD through CRUfAD clinic (www.crufadclinic.org). This six-lesson course became available to primary care physicians to prescribe in 2009. Routine data collection included demographics, GAD symptomatology (GAD-7), psychological distress (K-10), and disability (WHODAS). All six lessons were completed by 324/588 (55.1%) patients. When compared with completers, noncompleters tended to be younger and based in rural locations. Prior to discontinuing the course, noncompleters demonstrated statistically significant reductions in psychological distress. For those who completed the course, effect sizes on all outcome measures were medium to large and over 60% of moderate-to-severe GAD cases met criteria for remission upon treatment completion. The current study indicates that computerized CBT for GAD is effective in generating positive, clinically significant outcomes among typical patients treated under the usual conditions in primary care. Future research should focus on reducing treatment discontinuation among younger people and those based in rural locations.",Mewton L.; Wong N.; Andrews G.,2012.0,10.1002/da.21995,0,0,
2369,Predictors of response to cognitive behaviour therapy for obsessive-compulsive disorder,"Response to psychological treatment for Obsessive-Compulsive Disorder (OCD) varies, and dropout and relapse rates remain troubling. However, while studies examining symptom reductions are favourable, outcomes are less encouraging when outcome is defined in terms of clinically significant change. Moreover, there is little understanding of what predicts treatment outcome. This study examined demographic, symptomatic and cognitive predictors of outcome in 79 participants undertaking individualised cognitive-behavioural therapy for OCD. After investigating differences between treatment completers and non-completers, we examined treatment response as defined by post-treatment symptom severity and clinically reliable change, as well as predictors of treatment response. Completers were less likely to present with co-morbidity. The treatment was highly efficacious irrespective of whether completer or intention-to-treat analysis was undertaken, with 58% of treatment completers considered ""recovered"" at post-treatment. Lower pre-treatment levels of OCD symptoms and greater perfectionism/intolerance of uncertainty were the best unique predictors of OCD severity outcomes at post-treatment. Changes in obsessional beliefs were associated with symptomatic change, although only perfectionism/intolerance of uncertainty was a significant unique predictor of post-treatment change. Recovery status was predicted only by pre-treatment OCD severity. In helping to identify those at risk for poorer outcomes, such research can lead to the development of more effective interventions.","Kyrios, Michael; Hordern, Celia; Fassnacht, Daniel B.",2015.0,10.1016/j.ijchp.2015.07.003,0,0,
2370,A comparison of CBT and EMDR for sexually-abused Iranian girls,"Fourteen randomly assigned Iranian girls ages 12–13 years who had been sexually abused received up to 12 sessions of CBT or EMDR treatment. Assessment of post-traumatic stress symptoms and problem behaviours was completed at pre-treatment and 2 weeks post-treatment. Both treatments showed large effect sizes on the post-traumatic symptom outcomes, and a medium effect size on the behaviour outcome, all statistically significant. A non-significant trend on self-reported post-traumatic stress symptoms favoured EMDR over CBT. Treatment efficiency was calculated by dividing change scores by number of sessions; EMDR was significantly more efficient, with large effect sizes on each outcome. Limitations include small N, single therapist for each treatment condition, no independent verification of treatment fidelity, and no long-term follow-up. These findings suggest that both CBT and EMDR can help girls to recover from the effects of sexual abuse, and that structured trauma treatments can be applied to children in Iran. Copyright © 2004 John Wiley & Sons, Ltd","Jaberghaderi, Nasrin; Greenwald, Ricky; Rubin, Allen; Zand, Shahin Oliaee; Dolatabadi, Shiva",2004.0,10.1002/cpp.395,0,0,
2371,Preliminary evidence for cognitive mediation during cognitive-behavioral therapy of panic disorder.,"Cognitive-behavioral therapy (CBT) and pharmacotherapy are similarly effective for treating panic disorder with mild or no agoraphobia, but little is known about the mechanism through which these treatments work. The present study examined some of the criteria for cognitive mediation of treatment change in CBT alone, imipramine alone, CBT plus imipramine, and CBT plus placebo. Ninety-one individuals who received 1 of these interventions were assessed before and after acute treatment, and after a 6-month maintenance period. Multilevel moderated mediation analyses provided preliminary support for the notion that changes in panic-related cognitions mediate changes in panic severity only in treatments that include CBT.",Hofmann SG.; Meuret AE.; Rosenfield D.; Suvak MK.; Barlow DH.; Gorman JM.; Shear MK.; Woods SW.,2007.0,10.1037/0022-006X.75.3.374,0,0,
2372,Manualised Individual Cognitive Behavioural Therapy for mood disorders in people with mild to moderate intellectual disability: A feasibility randomised controlled trial,"Background: Evaluation of complex interventions, including standardisation of the intervention, types O[ outcomes selected and measures of change, is a fairly novel concept in the field of intellectual disabilities. Our aim was to explore these issues in a feasibility study of Manualised Individual Cognitive Behaviour Treatment (M-iCBT) compared to the treatment as usual alone (TALJ). Methods: Service users with mild to moderate intellectual disability experiencing a mood disorder or symptoms of depression and!or anxiety (mini PAS-ADD total score > 10 or 7 respectively) were randomly assigned to either. Results: In total, 32 participants were randomly assigned to 16 sessions of M-iCBT (n = 16) in addition to TAU or TAU alone (n = 16). We explored recruitment and accrual rates, willingness to participate, acceptability of the intervention and suitability of assessment tools. Mean change (95% CI) in the Beck Depression Inventory-Youth (BDI-Y) score from baseline to the 16 week endpoint (primary variable) was 010 (95% CI: -856, 876) and in the Beck Anxiety Inventory-Youth (BAI-Y) 242 (95% CI: -527, 1012) in favour of TAIl However, there was a clear trend in favour of CBT in depressed participants with or without anxiety. Limitations: The intervention targeted both depression and anxiety following a transdiagnostic model. This may have impacted the anticipated size of change in the primary outcome. The precise impact of cognitive limitations on ability to use therapy effectively is not fully understood. Conclusions: This study demonstrates that it is feasible to carry out a pragmatic randomised controlled trial of M-iCBT for people with mild to moderate intellectual disability. However, uncertainties about its clinical and cost effectiveness can only be fully answered by further examination of its superiority against other treatments. © 2013 Elsevier BV. All rights reserved. © 2013 Elsevier B.V. All rights reserved.","Hassiotis, Angela; Serfaty, Marc; Azam, Kiran; Strydom, Andre; Blizard, Robert; Romeo, Renee; Martin, Sue; King, Michael",2013.0,10.1016/j.jad.2013.05.076,0,0,
2373,Impact of personality disorder comorbidity on cognitive-behavioral therapy outcome for mood and anxiety disorders: results from a university training clinic,"<p>This study examined the impact of co-occurring personality disorder (PD) pathology on mood and anxiety symptom improvement in response to non-manualized, short-term, cognitive-behavioral therapy (CBT) delivered by trainees. The sample comprised 305 adult outpatients treated individually for mood (unipolar depression) and anxiety disorders [generalized anxiety disorder (GAD), panic disorder, social anxiety disorder (SAD), specific phobia, obsessive-compulsive disorder (OCD)] by doctoral students within a university training clinic. After comprehensive assessment of psychopathology, symptom-specific measures were administered at pre- and end-treatment. Both magnitude of disorder-specific mood and anxiety symptom change, as well as treatment outcome classification (via reliable change and clinical significance indices) were utilized to assess treatment response. Results indicated that patients treated for depression, GAD, panic disorder, SAD, and specific phobias evidenced significant reductions in symptoms, irrespective of PD presence, and there was no interaction between PD comorbidity and level of symptom improvement. Among patients treated for OCD, PD pathology negatively impacted OCD symptom improvement. When treatment outcome was determined categorically, PD presence had a deleterious effect on clinical recovery only among patients treated for GAD. Neither the number of PD diagnoses nor PD cluster type moderated results. In conclusion, in most instances (with the exception of GAD and OCD patients), individuals with PDs treated by graduate student trainees within a university training clinic experienced significant mood and anxiety symptom improvement in response to short-term CBT, and these improvements were comparable to those without co-occurring PDs.</p>","Harte, Christopher B.; Hawkins II, Raymond C.",2016.0,10.4081/ripppo.2016.210,0,0,
2374,Quantitative evaluation of three-phase bone scintigraphy before and after the treatment of post-traumatic reflex sympathetic dystrophy.,"Three-phase bone scans performed in 65 patients with post-traumatic reflex sympathetic dystrophy (RSD) were reviewed to evaluate which changes in uptake of the tracer appear before and after treatment, whether the form of treatment affects the intensity of uptake, and to investigate the correlation between the results of treatment and the intensity of the uptake both at initial and final scintigraphic examination. Forty-nine patients were treated using three different methods; 16 patients were observed without treatment. Bone scintigraphy was performed twice in each patient: first before treatment or observation and then at the final assessment, from 6 to 18 months after the end of treatment. Clinical results were rated as follows: good, moderate and poor. Scintigrams were evaluated quantitatively after processing the data obtained from the selected regions of interest. A significant reduction in the initially increased uptake of the tracer was noted in each phase/region of interest 6-18 months after initial imaging. At final assessment, mean uptake ratios in treated and non-treated patients were similar. This suggests that treatment does not affect the rate of reduction of uptake. In patients with good and moderate response to treatment, mean uptake ratios at initial scanning were significantly higher than in patients with poor outcome. This indicates that three-phase bone scintigraphy has prognostic value in RSD: marked hyperfixation of the tracer indicates better final outcome. At final imaging, the mean uptake ratios of patients with good, moderate and poor response to treatment did not differ significantly. This suggests that three-phase bone scintigraphy has no value in monitoring the course of treatment of RSD.",Zyluk A.; Birkenfeld B.,1999.0,,0,0,
2375,The embryologist as counsellor during assisted reproduction procedures,"ER This study aimed to establish whether patients who receive support counselling by the embryologist as counsellor during assisted reproduction procedures would be better equipped with efficient coping mechanisms than patients who were not counselled. Sixty patients were randomly assigned to either the support counselling or the control groups. Questionnaires, measuring pre- and post-treatment levels of anxiety, depression and ways of coping, were presented to both groups. The support counselling group received emotional support and counselling from the embryologist. The control group were treated routinely, received no counselling or emotional support and were asked to phone the gynaecologist daily concerning embryo development. Despite reliable internal consistency, the hypothesis was not accepted due to non-significant differences between the groups. However, t-tests indicated a changed pattern of behaviour within the support counselling group, who experienced a statistically significant (P < 0.017) reduction in anxiety levels after the counselling intervention, as well as increased use of problem-focused coping strategies, such as instrumental action, in dealing with the demands of the treatment programme.","Zyl, C; Dyk, A C; Niemandt, C",2005.0,,0,0,
2376,"Acute psycho-social stress does not disrupt item-method directed forgetting, emotional stimulus content does","It has been shown that stress affects episodic memory in general, but knowledge about stress effects on memory control processes such as directed forgetting is sparse. Whereas in previous studies item-method directed forgetting was found to be altered in post-traumatic stress disorder patients and abolished for highly arousing negative pictorial stimuli in students, no study so far has investigated the effects of experimentally induced psycho-social stress on this task or examined the role of positive picture stimuli. In the present study, 41 participants performed an item-method directed forgetting experiment while being exposed either to a psychosocial laboratory stressor, the Trier Social Stress Test (TSST), or a cognitively challenging but non-stressful control condition. Neutral and positive pictures were presented as stimuli. As predicted, salivary cortisol level as a biological marker of the human stress response increased only in the TSST group. Still, both groups showed directed forgetting. However, emotional content of the employed stimuli affected memory control: Directed forgetting was intact for neutral pictures whereas it was attenuated for positive ones. This attenuation was primarily due to selective rehearsal improving discrimination accuracy for neutral, but not positive, to-be-remembered items. Results suggest that acute experimentally induced stress does not alter item-method directed forgetting while emotional stimulus content does. © 2011 Elsevier Inc.",Zwissler B.; Koessler S.; Engler H.; Schedlowski M.; Kissler J.,2011.0,10.1016/j.nlm.2011.01.007,0,0,
2377,Attention bias in earthquake-exposed survivors: an event-related potential study.,"The Chinese Wenchuan earthquake, which happened on the 28th of May in 2008, may leave deep invisible scars in individuals. China has a large number of children and adolescents, who tend to be most vulnerable because they are in an early stage of human development and possible post-traumatic psychological distress may have a life-long consequence. Trauma survivors without post-traumatic stress disorder (PTSD) have received little attention in previous studies, especially in event-related potential (ERP) studies. We compared the attention bias to threat stimuli between the earthquake-exposed group and the control group in a masked version of the dot probe task. The target probe presented at the same space location consistent with earthquake-related words was the congruent trial, while in the space location of neutral words was the incongruent trial. Thirteen earthquake-exposed middle school students without PTSD and 13 matched controls were included in this investigation. The earthquake-exposed group showed significantly faster RTs to congruent trials than to incongruent trials. The earthquake-exposed group produced significantly shorter C1 and P1 latencies and larger C1, P1 and P2 amplitudes than the control group. In particular, enhanced P1 amplitude to threat stimuli was observed in the earthquake-exposed group. These findings are in agreement with the prediction that earthquake-exposed survivors have an attention bias to threat stimuli. The traumatic event had a much greater effect on earthquake-exposed survivors even if they showed no PTSD symptoms than individuals in the controls. These results will provide neurobiological evidences for effective intervention and prevention to post-traumatic mental problems.",Zhang Y.; Kong F.; Han L.; Najam Ul Hasan A.; Chen H.,2014.0,10.1016/j.ijpsycho.2014.09.004,0,0,
2378,Clinical study on treatment of the earthquake-caused post-traumatic stress disorder by cognitive-behavior therapy and acupoint stimulation,"ER METHODSThe 91 PTSD patients in Wenchuan hit by a strong earthquake were randomly divided into a control group of 24 cases treated by the cognitive-behavior therapy, and a treatment group of 67 cases treated by both cognitive-behavior therapy and acupoint stimulation. The scores were evaluated according to Chinese version of the incident effect scale revised (IES-R) and the self-compiled questionnaire for the major post-traumatic psychological condition, and the curative effect was compared between the two groups.RESULTSThe total scores of IES-R, the scores of all factors and the total scores of the questionnaire in the two groups after treatment were much lower than those before treatment (P < 0.01). The comparison of reduction in the factor scores between the two groups showed that the curative effect in the treatment group was better that of in the control group.CONCLUSIONThe acupoint stimulation is effective for the PTSD patients, with better results than that of cognitive-behavior therapy used alone.OBJECTIVETo study the curative effect of acupoint stimulation on the earthquake-caused post-traumatic stress disorder (PTSD).","Zhang, Y; Feng, B; Xie, J P; Xu, F Z; Chen, J",2011.0,,0,0,
2379,Perioperative comprehensive supportive care interventions for chinese patients with esophageal carcinoma: a prospective study.,"To assess the effects of perioperative comprehensive supportive care interventions on outcome of Chinese esophageal cancer patients in a prospective study. 60 patients with primary esophageal carcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chinese version of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions, including health education, psychological support, stress management, coping strategies and behavior training, were carried out in 3 phases (preoperative, postoperative I and postoperative II), and psychological effects were thereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costs were estimated at discharge. Survival of patients was estimated each year post-surgery. General health status and satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. All the subjects demonstrated higher scores in the preoperative phase than the normal range of Chinese population concerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groups at admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CG at weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less than those of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-year survival or health status between two groups. Appropriate perioperative comprehensive supportive care interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, to reduce health care costs and to promote satisfaction of patients and their families with hospital.",Zhang XD.; Zhao QY.; Fang Y.; Chen GX.; Zhang HF.; Zhang WX.; Yang XP.,2013.0,,0,0,
2380,Diagnostic Prediction for Social Anxiety Disorder via Multivariate Pattern Analysis of the Regional Homogeneity.,"Although decades of efforts have been spent studying the pathogenesis of social anxiety disorder (SAD), there are still no objective biological markers that could be reliably used to identify individuals with SAD. Studies using multivariate pattern analysis have shown the potential value in clinically diagnosing psychiatric disorders with neuroimaging data. We therefore examined the diagnostic potential of regional homogeneity (ReHo) underlying neural correlates of SAD using support vector machine (SVM), which has never been studied. Forty SAD patients and pairwise matched healthy controls were recruited and scanned by resting-state fMRI. The ReHo was calculated as synchronization of fMRI signals of nearest neighboring 27 voxels. A linear SVM was then adopted and allowed the classification of the two groups with diagnostic accuracy of ReHo that was 76.25% (sensitivity = 70%, and specificity = 82.5%, P ≤ 0.001). Regions showing different discriminating values between diagnostic groups were mainly located in default mode network, dorsal attention network, self-referential network, and sensory networks, while the left medial prefrontal cortex was identified with the highest weight. These results implicate that ReHo has good diagnostic potential in SAD, and thus may provide an initial step towards the possible use of whole brain local connectivity to inform the clinical evaluation.",Zhang W.; Yang X.; Lui S.; Meng Y.; Yao L.; Xiao Y.; Deng W.; Zhang W.; Gong Q.,2015.0,10.1155/2015/763965,0,0,
2381,Effcacy of Williams LifeSkills Training in improving psychological health of Chinese male juvenile violent offenders: a randomized controlled study,"ER This randomized controlled study was conducted to evaluate the efficacy of Williams LifeSkills Training (WLST) as a means of improving the psychological health of Chinese male juvenile violent offenders. Sixty-six participants were assigned randomly to receive the usual intervention plus 8 weeks of WLST (study group, n = 33) or only the usual intervention (control group, n = 33). We found that the study group exhibited significantly decreased State-Trait Anxiety Inventory (STAI X-1, X-2) STAX2 scores and Trait Coping Style Questionnaire (TCSQ) negative scores, and increased Interpersonal Support Evaluation List (ISEL) tangible scores from baseline to 9 weeks later (P <0.01). In addition, a between-group difference in changes of TCSQ negative score was observed at the end of week 9 (P <0.05). These fndings suggest that WLST can improve trait anxiety, coping style, and interpersonal support in male Chinese juvenile violent offenders.","Zhang, S; Wang, H; Chen, C; Zhou, J; Wang, X",2015.0,10.1007/s12264-014-1492-6,0,0,
2382,Early use of Chinese drug rhodiola compound for patients with post-trauma and inflammation in prevention of ALI/ARDS,"ER METHODS104 patients who coincide with their diagnosis and standard scale were divided randomly in to single number groups A(1), B(1), C(1) and D(1) (early preventive treatment group EG) and double number groups A(2), B(2), C(2) and D(2) (control group CG). The treatment of primary disease both in EG and CG was similar, but in EG four grams of rhodiola compound (RCO) were used every day for a period of 3-15 days since admission and 5-7 days after operation. The indicators related to ALI in each groups were measured.RESULTSPaO(2), AaDO(2) and hemorheology were significant in EG than in CG (P < 0.05) or (P < 0.01). The complication rate of ARDS was decreased about of 50.0% in EG than in CG.CONCLUSIONSEarly use of RCO may protect against major risk factors of ALI/ARDS caused by massive trauma/infection and thoracic-cardio-operations.OBJECTIVETo evaluate the effects of the Chinese drug rhodiola on the preventive treatment of acute lung injury (ALI) caused by post-traumatic/inflammatory and thoracic-cardiovascular operations.","Zhang, S; Gao, W; Xu, K; Guo, Y; Lin, S; Xue, X; Lu, G; Li, N; Liu, H; Liu, W",1999.0,,0,0,
2383,A randomized single-blind controlled trial of combination of Naikan and Morita therapy (NMT) in patients with generalized anxiety.,"Objective:To investigate the clinical efficacy of Naikan and Morita therapy (NMT) in patients with generalized anxiety disorder (GAD). Methods: Seventy participants with a principle diagnosis of GAD were assigned randomly to the NMT group (n = 35) and the Morita therapy group (n = 35). Both groups were administrated with the same medication. The NMT group were applied with Naikan and Morita therapy (they received Naikan therapy in the 1st week, the 2th to 4th stages of Morita therapy in the 2nd to 5th weeks). The Morita therapy group were applied with the 1 st to 4th stages of Morita therapy. The treatment period was 5 weeks. AU participants completed baseline measures and post-intervention measures with the Minnesota Multiphasic Personality Inventory (MMPI), Hamilton Anxiety Scale (HAMA), Toronto Alexithymia Scale (TAS) and Tolerance Scale (To). Results: Thirty-four cases in the NMT group and 33 cases in the Morita therapy group were analyzed. After intervention, the differences between post-test and pre-test scores of MMPI dimension scores of hypochondriasis, hysteria, paranoia, mental weakness, introverted social subscale, and HAMA total scores, TAS total scores and scores of ability in describing the emotions, identifying and distinguishing emotion and body experience, the To total scores were higher in the NMT group than in the Morita therapy group[e. g. , hypochondriasis (-13.1 +/- 2.3) vs. ( -11.1 +/- 2.4), Ps < 0.05]. Conclusion: This study shows that combination of Naikan therapy and Morita therapy (NMT) have the effect of promoting personality growth, enhancing trust level and tolerance, improving the capability of alexithymia, and relieving symptoms of anxiety, and its'efficacy is superior to Morita therapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zhang, Qin-Feng; Yuan, Yan-Ting; Ren, Qing-Tao; Lu, Ying-Zhi; Nukina",2014.0,,0,0,
2384,Biased Perception of Mean Emotion in Abstinent Heroin Abusers,"ER Although evidence suggests that drug abusers exhibit biases when coding individual emotional facial expressions, little is known about how they process multiple expressions simultaneously. The present study evaluated the mean emotions perceived by abstinent heroin abusers. Male abstinent heroin abusers (AHs) and healthy controls (HCs) were randomly assigned into three emotional conditions (happy, sad, or angry), viewed sets of four faces (Experiment 1) or individual faces (Experiment 2) that varied in emotionality (neutral to happy/sad/angry), and judged whether a test face presented later was more/less emotional than the preceding stimuli. Average points of subjective equality were calculated to reflect participants' biases in perceiving emotions of sets or single faces. Relative to HCs, AHs overestimated mean emotions for sad and angry faces in Experiment 1; however, no such biases were found in Experiment 2. This suggests biased ensemble coding towards negative emotional facial expressions in AHs. Furthermore, when controlling for depression and anxiety, AHs' enhanced perception of mean emotion for angry or sad faces in Experiment 1 decreased, indicating a possible mediating effect of these psychopathological variables in the relationship between drug addiction history and abnormal ensemble processing for sets of emotional expressions.","Zhang, M; Wang, X; Hu, C; Liao, H; Yang, T; Shen, M",2015.0,10.1080/02791072.2015.1101181,0,0,
2385,Comparison of distraction arthroplasty alone versus combined with arthroscopic microfracture in treatment of post-traumatic ankle arthritis.,"This study aims to compare clinical outcomes of distraction arthroplasty alone versus combined with arthroscopic microfracture in treating post-traumatic ankle arthritis. The study cohort consisted of 96 patients (96 ankles) who underwent distraction arthroplasty alone or combined with arthroscopic microfracture between May 2005 and April 2012. Patients were divided into the distraction group (n = 46) and the combined group (n = 50). The American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analog scale (VAS), and ankle activity score (AAS) were used to compare the clinical outcomes between groups. Arthritis severity was assessed on the radiograph. At the mean follow-up period of 30.8 ± 3.1 and 31.4 ± 3.6 months, respectively, no severe complications occurred and no further surgical interventions for symptomatic arthritis were required in both groups. The AOFAS scores improved significantly in the combined group than in the distraction group (59.0 ± 4.7 and 58.0 ± 4.9 preoperatively versus 85.0 ± 4.9 and 88.9 ± 5.4 at final visit, P < 0.001). The AAS scores were also significantly higher in the combined group (3.6 ± 1.1 and 3.3 ± 1.0 preoperatively versus 6.5 ± 1.1 and 7.1 ± 1.3 at final visit, P = 0.009). Pain was significantly alleviated in the combined group by the VAS scores (6.4 ± 0.9 and 6.7 ± 0.9 preoperatively versus 2.3 ± 0.8 and 2.0 ± 0.7 at final visit, P = 0.040). The combined group achieved better radiographic arthritis severity decrease than the distraction group (P = 0.012). Compared to distraction arthroplasty alone, distraction arthroplasty combined with arthroscopic microfracture can offer better functional recovery, pain relief, and ankle arthritis resolution for treating post-traumatic ankle arthritis.",Zhang K.; Jiang Y.; Du J.; Tao T.; Li W.; Li Y.; Gui J.,2017.0,10.1186/s13018-017-0546-7,0,0,
2386,Investigation and analysis of self-esteem and mental health in college students at high altitude region,"Aim: To study the level of self-respect and condition of mental health in college students at high altitude region, so as to advance the effectiveness and pertinence of education of mental health. Methods: College students, randomly selected from 7 universities of Qinghai Province, were investigated with questionnaire taking a class as a unit. Results: 1 The level of self-esteem in college students at high altitude region was 3.00 ± 0.38. 2 Each term score of SCL-90 in college students at high altitude region was prominently higher than that in national norm and nationwide youth group norm. Conclusion: 1 The level of self-esteem in college students at high altitude region is better. 2 Mental health of college students at high altitude region is good, furthermore the level of mental health of college students gradually advances along with educated degrees. 3 Common psychological problems among college students are interpersonal sensitivity, obsessive-compulsion, paranoid ideation, hostility, depression and anxiety.",Zhang J.,2004.0,,0,0,
2387,Prevention of anxiety and depression in Chinese: a randomized clinical trial testing the effectiveness of a stepped care program in primary care.,"Despite empirical evidence demonstrating the effectiveness of collaborative stepped care program (SCP) in Western countries, such programs have not been evaluated in the east, which has a different services system structure and cultural nuances in seeking help for mental illness. Furthermore, only a few studies have used SCP for depression and anxiety prevention. We conducted a trial to test its effectiveness in preventing major depressive disorder and generalized anxiety disorder among primary care patients with subthreshold depression and/or anxiety in Hong Kong. Subthreshold depression and/or anxiety patients were randomized into the SCP group (n=121) or care as usual (CAU) group (n=119). The SCP included watchful waiting, telephone counseling, problem solving therapy, and family doctor treatment within one year. The primary outcome was the onset of major depressive disorder or generalized anxiety disorder in 15 months. The secondary outcomes were depressive and anxiety symptoms, quality of life and time absent from work due to any illness. Survival analysis showed no differences between the SCP and CAU groups (the cumulative probability of onset at 15 month was 23.1% in the SCP group and 20.5% in the CAU group; Hazard Ratio=1.62; 95% Confidence Interval: 0.82-3.18; p=0.16). No significant differences were found in secondary outcomes. Sample size might not have been large enough. SCP did not show beneficial effect on depression/anxiety prevention compared with CAU in Hong Kong primary care. As a large majority of patients improved overtime without any intervention, we are not able to exclude the possibility that the intervention might be effective. Future studies would need to have a larger sample size and conduct on patients with more severe symptoms or perform a second screening.",Zhang DX.; Lewis G.; Araya R.; Tang WK.; Mak WW.; Cheung FM.; Mercer SW.; Griffiths SM.; Woo J.; Lee DT.; Kung K.; Lam AT.; Yip BH.; Wong SY.,2014.0,10.1016/j.jad.2014.08.015,0,0,
2388,"[Posttraumatic vegetative status: clinical picture, diagnosis, and potentialities of treatment].","Based on the results of treatment in 167 patients with severe brain injury, the authors estimated the immediate outcomes of the injury within 4 months. In particular, the regularities and frequency of formation of the traumatic vegetative status were established. The specific MRI signs are described in this condition. Its new treatment by transliquor electrostimulation of the brain stem is proposed.",Zhanaĭdarov ZhS.; Klimash AV.,,,0,0,
2389,Evaluating the angina plan in patients admitted to hospital with angina: a randomized controlled trial,"ER The aim of this trial was to evaluate the Angina Plan (AP), a cognitive-behavioral nurse-facilitated self-help intervention against standard care (SC). A randomized controlled trial of 218 patients hospitalized with angina assessed participants predischarge and 6 months later. Data were collected during a structured interview using validated questionnaires, self-report, and physiological measurement to assess between group changes in mood, knowledge and misconceptions, cardiovascular risk, symptoms, quality of life, and health service utilization. The intention-to-treat (ITT) analysis found no reliable effects on anxiety and depression at 6 months. AP participants reported increased knowledge, less misconceptions, reduced body mass index (BMI), an increase in self-reported exercise, less functional limitation, and improvements in general health perceptions and social and leisure activities compared to those receiving SC. Sensitivity analysis excluding participants with high baseline depression revealed a statistical significant reduction in depression levels in AP compared to the SC participants. Analysis excluding participants receiving cardiac surgery or angioplasty removed the ITT effects on physical limitation, self-reported exercise and general health perceptions and the improvements seen in social and leisure activities, while adaptive effects on knowledge, misconceptions and BMI remained and between-group changes in depression approached significance. Initiating the AP in a secondary care setting for patients with new and existing angina produces similar benefits to those reported in newly diagnosed primary care patients. Further evaluation is required to examine the extent of observed effects in the longer term.","Zetta, S; Smith, K; Jones, M; Allcoat, P; Sullivan, F",2011.0,10.1111/j.1755-5922.2009.00109.x,0,0,
2390,"The eCALM trial: eTherapy for cancer applying mindfulness. Exploratory analyses of the associations between online mindfulness-based cancer recovery participation and changes in mood, stress symptoms, mindfulness, posttraumatic growth, and spirituality.","Avenues to increase accessibility of evidence-based psychosocial programs that mitigate cancer-related distress and symptoms are needed, and the internet represents one modality garnering research attention. Mindfulness-Based Cancer Recovery (MBCR) is an evidence-based group psychosocial program adapted to an online ""real-time"" synchronous format. The objective of this study was to assess the effects of participation in online MBCR on patient-reported outcomes in cancer patients. Participants completed questionnaires before and after the online MBCR program. The intervention consisted of eight weekly 2-hour online classes plus a 6-hour retreat. Mixed model analyses for repeated measures were conducted and subgroup analyses investigated associations of age, sex, and cancer stage on patient-reported outcomes. Standardized subscale change score analyses for mood and stress symptom measures were conducted to evaluate relative improvements over time. Sixty-two distressed participants enrolled. Analyses revealed improvements over time on measures of mood, stress, spirituality, posttraumatic growth, and four of five measured mindfulness facets. Relative to older participants, younger participants showed greater improvements in stress symptoms (p = 0.031), spirituality (p = 0.019), and non-reactivity to experience (p = 0.023). Posttraumatic growth increased more over time in men compared to women (p = 0.005). Within mood and stress symptoms subscales, Vigor, Fatigue, and Sympathetic Arousal had the greatest relative improvements, suggesting improved energy while also inducing relaxation. Results are promising in terms of offering an accessible online MBCR approach to help cope with symptoms associated with cancer and its treatment. Further research into differential effects may allow for greater tailoring to further improve access and ease of use. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Zernicke, Kristin A; Campbell, Tavis S; Speca, Michael; Ruff, Kelley McCabe; Flowers, Steven; Tamagawa, Rie; Carlson, Linda E; Baer, Baer, Barak, Birnie, Brady, Carlson, Carlson, Carlson, Carlson, Carlson, Carlson, Carver, Cotton, Deng, Faller, Gardner-Nix, Garland, Gonzalez-Angulo, Henderson, Henoch, Holland, Howell, Jacobsen, Krupski, Labelle, Labelle, Lechner, Lechner, Ledesma, Linley, Matchim, McNair, Mitchell, Morrill, Musial, Peterman, Piet, Rouleau, Shapiro, Shennan, Speca, Stephen, Stephen, Tallman, Tamagawa, Tedeschi, Tedeschi, Thompson, Visser, Whitford, Witek-Janusek, Zabora, Zernicke, Zernicke, Zwahlen",2016.0,,0,0,
2391,A randomized wait-list controlled trial of feasibility and efficacy of an online mindfulness-based cancer recovery program: the eTherapy for cancer applying mindfulness trial.,"A treatment-as-usual randomized wait-list controlled trial was conducted to investigate the feasibility and impact of an online synchronous Mindfulness-Based Cancer Recovery (MBCR) group program for underserved distressed cancer survivors. Sixty-two men and women exhibiting moderate to high distress within 3 years of completing primary cancer treatment without access to in-person MBCR were randomized to either immediate online MBCR (n = 30) or to wait for the next available program (n = 32). Participants completed questionnaires preintervention and postintervention or wait period online. Program evaluations were completed after MBCR. Feasibility was tracked through monitoring eligibility and participation through the protocol. Intent-to-treat mixed-model analyses for repeated measures were conducted. Feasibility targets for recruitment and retention were achieved, and participants were satisfied and would recommend online MBCR. There were significant improvements and moderate Cohen d effect sizes in the online MBCR group relative to controls after MBCR for total scores of mood disturbance (d = 0.44, p = .049), stress symptoms (d = 0.49, p = .021), spirituality (d = 0.37, p = .040), and mindfully acting with awareness (d = 0.50, p = .026). Main effects of time were observed for posttraumatic growth and remaining mindfulness facets. Results provide evidence for the feasibility and efficacy of an online adaptation of MBCR for the reduction of mood disturbance and stress symptoms, as well as an increase in spirituality and mindfully acting with awareness compared with a treatment-as-usual wait-list. Future study using larger active control RCT designs is warranted. ClinicalTrials.gov: NCT01476891.",Zernicke KA.; Campbell TS.; Speca M.; McCabe-Ruff K.; Flowers S.; Carlson LE.,2014.0,10.1097/PSY.0000000000000053,0,0,
2392,Reality monitoring and motor memory in checking-prone individuals,"Studies concerning reality monitoring and motor memory abilities in checkers have provided mixed results. The aim of this study was to re-examine this question by asking 75 undergraduate students to perform, watch the experimenter perform, imagine themselves performing, imagine the experimenter performing, or verbally repeat different daily actions. Two groups were created (checking-prone and nonchecking-prone subjects) based on participants' checking subscores on the revised version of the Obsessive-Compulsive Inventory. First, results suggested that checking-prone subjects have a poorer motor memory than nonchecking-prone participants. Second, our data indicated that checking-prone participants confused actions they had performed with actions the experimenter had performed more often than nonchecking-prone participants. In other words, checking-prone participants remembered events from an observer's viewpoint. Finally, our findings suggest that dissociation could be a mediating variable between some of the reality monitoring abilities and checking. © 2005 Elsevier Inc. All rights reserved.",Zermatten A.; Van der Linden M.; Larøi F.; Ceschi G.,2006.0,10.1016/j.janxdis.2005.08.001,0,0,
2393,Suicidal Ideation Among Wives of Former Prisoners of War: A Longitudinal Dyadic Study,"Objectives: The associations between posttraumatic stress disorder (PTSD) and suicidal ideation (SI) among ex-prisoners of war (ex-POWs) has recently been exemplified. Several studies have revealed the toll of war captivity in the secondary traumatization (ST) of ex-POWs’ wives. This study aimed to assess SI among ex-POWs’ wives and the longitudinal associations between their husbands’ PTSD and their own ST. Method: A sample of 233 Israeli couples (142 ex-POW couples and a comparison group of 91 veteran couples) completed self-report measures of PTSD symptoms, SI, and depression at two time points: T1 (2003) and T2 (2008), 30 and 37 years after the 1973 Yom Kippur War. Results: Among control wives, although not among ex-POWs’ wives, the more ST symptoms they reported, the higher their level of SI. Furthermore, for both research groups, husbands’ PTSD and wives’ ST were positively associated with their own levels of SI, respectively. Autoregressive cross-legged (ARCL) analysis demonstrated that SI at T1 predicted ST at T2 among control wives but not among ex-POWs’ wives. Surprisingly, an actor-partner interdependence modeling (APIM) analysis revealed, only among ex-POWs’ couples, that the more the husbands suffered from PTSD and SI, the more moderate the increase of the wives’ SI was between T1 and T2, thus, leading to better outcomes in terms of the wives’ SI. Conclusions: Ex-POWs’ posttraumatic distress is longitudinally related to their spouses’ ST and SI. Clinical implications of these findings of the relations between captivity trauma and suicidality for veteran couples are discussed.",Zerach G.; Levi-Belz Y.; Michelson M.; Solomon Z.,2016.0,10.1080/00332747.2015.1124643,0,0,
2394,Thought suppression: an experimental investigation of spider phobics.,"Researchers have observed that attempts to suppress a thought cause either an immediate increase in the occurrence of the thought (i.e. immediate enhancement effect) or a delayed increase in the occurrence of the thought (i.e. rebound effect). In this study, we examined whether suppression of a personally-relevant, emotional thought item (i.e. a spider to spider phobics) results in an immediate enhancement or a rebound effect. Forty-eight spider phobics were randomly assigned to either a suppression group or a control group. Subjects spent three 5-min periods alone monitoring their thoughts. During the first period, subjects in both groups were instructed to 'think about anything'. During the second period, subjects in the suppression group were instructed 'not to think of a spider', whereas subjects in the control group were instructed to 'think about anything'. During the third period, subjects in both groups were instructed to 'think about anything'. The number of spider-related thoughts was recorded for each period. Results from the second period failed to support an immediate enhancement effect. Evidence for a rebound effect, however, was obtained in the third period. The theoretical and clinical implications of these findings are discussed.",Zeitlin SB.; Netten KA.; Hodder SL.,1995.0,,0,0,
2395,Prevention of bone loss in paraplegics over 2 years with alendronate,"ER INTRODUCTIONBone loss after spinal cord injury (SCI) leads to increased fracture risk in the lower limbs of paraplegics. The aim of this study was to document long-term treatment of bone loss with alendronate in a group of paraplegic men with complete motor lesion after SCI.MATERIALS AND METHODSSixty-five men with complete motor post-traumatic medullary lesion between T1 and L2 with total motor and sensory loss (Frankel classification, stage A) or with total motor and partial sensory loss (Frankel classification, stage B) after SCI were included in this prospective randomized controlled open label study that was 2 years in duration. The patients were randomized to either the treatment group with alendronate 10 mg daily and elemental calcium 500 mg daily or to the control group with elemental calcium 500 mg daily alone. The primary endpoint was defined as the effect over 24 months of alendronate and calcium compared with calcium alone on the BMD values at the distal tibial epiphysis (as a surrogate for trabecular bone in the paralyzed zone). The secondary endpoints were changes in BMD at supra- and infralesional sites of measurement. Biochemical markers of bone turnover were assessed.RESULTSFifty-five subjects, 0.1-29.5 years post-SCI, completed the study over 24 months. BMD at the distal tibial epiphysis significantly decreased from baseline in the calcium group (-10.8 +/- 2.7% at 24 months, p < 0.001), whereas it remained stable in the alendronate plus calcium group (-2.0 +/- 2.9% at 24 months, p = not significant versus baseline), leading to a significant intergroup difference over time (p = 0.017). At the tibial diaphysis, similar significant results were observed. At the ultradistal radius and the radial shaft, BMD did not change significantly from baseline in either treatment group. At the total hip, BMD decreased significantly in the calcium group (-4.1 +/- 1.6%, p = 0.038) but remained stable in the alendronate plus calcium group (+0.43 +/- 1.2%), with a significant intergroup difference (p = 0.037). At the lumbar spine, BMD increased significantly (p < 0.0001) from baseline in both groups. Biochemical markers of bone resorption were significantly decreased with alendronate versus baseline and control. Alendronate and calcium were generally safe and well tolerated.CONCLUSIONSIn paraplegic men, SCI bone loss was stopped at all measured cortical and trabecular infralesional sites over 24 months with alendronate 10 mg daily.UNLABELLEDTo assess the effects of long-term treatment of bone loss with alendronate in a group of paraplegic men, 55 patients were evaluated in a prospective randomized controlled open label study that was 2 years in duration comparing alendronate and calcium with calcium alone. Bone loss was stopped at all cortical and trabecular infralesional sites (distal tibial epiphysis, tibial diaphysis, total hip) with alendronate 10 mg daily.","Zehnder, Y; Risi, S; Michel, D; Knecht, H; Perrelet, R; Kraenzlin, M; Zäch, G A; Lippuner, K",2004.0,10.1359/JBMR.040313,0,0,
2396,Possible deleterious effects of adjunctive omega-3 fatty acids in post-traumatic stress disorder patients.,"This study describes possible deleterious effects of adjunctive omega-3 fatty acids in post-traumatic stress disorder patients. Omega-3 (polyunsarurated) fatty acids are essential long-chain polyunsaturated fatty acids that are concentrated in the central nervous system, retina, and testes in humans. The subject group consisted of three men and three women, with a mean age of 44.25 (+/-SD 17.6) years, range 23-66. Psychiatric symptoms, such as hostility, interpersonal sensitivity, somatization, depression, anxiety, phobia, obsession, paranoia, and psychoticism were evaluated. At completion, all the mean symptoms were unchanged as compared with the baseline symptoms. Assessed in terms of individual scores, three patients showed mild to moderate tendencies towards worsening in almost all items, and the remaining patient showed no change. The results of this abruptly curtailed study suggest that adjunctive EPA may well be ineffective in relieving either the anger and hostility or the depressive symptoms in PTSD patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zeev, Kaplan; Michael, Matar; Ram, Kamin; Hagit, Cohen; Davidson, Davidson, Derogatis, Freeman, Fux, Geleijnse, Horowitz, Marangell, Nemets, Plutchik, Solomon, Speilberger, Stoll",2005.0,,0,0,
2397,Internalization of the therapeutic process: differences between borderline and neurotic patients.,"Intersession process in psychotherapy refers to the thoughts, memories, and feelings about each other and about their therapy sessions that participants experience during the intervals between sessions. This study compared the intersession process experienced by patients who had been diagnosed with severe borderline personality disorders (BPD) with others who had not. A total of 76 patients with neurotic disturbances and 20 patients with BPD were treated in a therapeutic day clinic and completed the Intersession Experience Questionnaire (IEQ) before sessions of individual psychotherapy and the Session Questionnaire (Stundenbogen) after those sessions. Comparison of the two groups on these measures of intersession process and postsession outcome showed markedly different patterns in patients' evaluations and internalizations of in-session therapeutic experiences: most prominently, that BPD patients internalize therapy sessions with much more negative and contradictory emotions.",Zeeck A.; Hartmann A.; Orlinsky DE.,2006.0,10.1521/pedi.2006.20.1.22,0,0,
2398,"Panic-related responses to pentagastrin, flumazenil, and thyrotropin-releasing hormone in healthy volunteers","Thyrotropin-releasing hormone (TRH) induces some somatic symptoms that resemble those of a panic attack, without being considered to be a laboratory panicogen in panic disorder (PD) patients. This study aimed to identify doses of TRH and the laboratory panicogens, pentagastrin and flumazenil, that would produce a similar intensity of panic-related somatic symptoms in healthy volunteers because comparison of the effects of these doses in PD patients could be used to test the hypothesis that these agents have specific panicogenic effects that are not explained solely by cognitively mediated reactions to somatic symptoms. Nine subjects were administered pentagastrin (0.2 μg/kg) and TRH (600 or 1,200 μg) in a double-blind, randomized order, within-subjects design. Fifteen subjects received pentagastrin (0.1 μg/kg), TRH (600 or 1200 μg) and flumazenil (2 mg) in a double-blind, randomized order within-subjects design. Although low dose pentagastrin (0.1 μg/kg) induced comparable cardiorespiratory responses to those of TRH, it induced greater anxiety, suggesting that TRH would not be a credible comparator for pentagastrin in challenge studies in PD. However, TRH produced equal or greater symptom and physiological responses compared with flumazenil, suggesting that flumazenil may act as a panicogen in PD via a GABAergic mechanism rather than via a cognitively mediated response to somatic symptoms. This now requires confirmation in PD patients. © 2003 Wiley-Liss, Inc.",Zedkova L.; Coupland N.J.; Man G.C.W.; Dinsa G.; Sanghera G.,2003.0,10.1002/da.10085,0,0,
2399,Diagnostic overlap of generalized anxiety disorder and major depressive disorder in a primary care sample.,"Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are highly comorbid. A possible explanation is that they share four symptoms according to the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision (DSM-IV-TR). The present study addressed the symptom overlap of people meeting DSM-IV-TR diagnostic criteria for GAD, MDD, or both to investigate whether comorbidity might be explained by overlapping diagnostic criteria. Participants (N = 1,218) were enrolled in the Coordinated Anxiety Learning and Management study (a randomized effectiveness clinical trial in primary care). Hypotheses were (1) the comorbid GAD/MDD group endorses the overlapping symptoms more than the nonoverlapping symptoms, and (2) the comorbid GAD/MDD group endorses the overlapping symptoms more than GAD only or MDD only groups, whereas differences would not occur for nonoverlapping symptoms. The overlapping GAD/MDD symptoms were endorsed more by the comorbid group than the MDD group but not the GAD group when covarying for total symptom endorsement. Similarly, the comorbid group endorsed the overlapping symptoms more than the nonoverlapping symptoms and did not endorse the nonoverlapping symptoms more than the GAD or MDD groups when covarying for total symptom endorsement. The results suggest that comorbidity of GAD and MDD is strongly influenced by diagnostic overlap. Results are discussed in terms of errors of diagnostic criteria, as well as models of shared psychopathology that account for diagnostic criteria overlap.",Zbozinek TD.; Rose RD.; Wolitzky-Taylor KB.; Sherbourne C.; Sullivan G.; Stein MB.; Roy-Byrne PP.; Craske MG.,2012.0,10.1002/da.22026,0,0,
2400,"[Sense of coherence, personality and style of coping by patients suffering from depressive disorders].","At present increasing medical attention is paid to the salutogenesis approach suggested by Aaron Antonovsky. The main focus of interest in the approach is the sense of coherence. The aim of the study was to define the sense of coherence and the mutual condition linked between this sense and some personality traits within an individual, including the styles of coping by men and women suffering from depression. The research included the use of a SOC-29 questionnaire, NEO-FFI test and Moos' test. The research was conducted on 69 patients recognized to have suffered from depression. The patients were in treatment at The Psychiatric and Neurosis Disorder Clinic with Critical Intervention Ward, Medical University of Lódź. 1) A sense of coherence within an individual is considerably stronger in male patients. 2) Males and females differ in the realm of particular personality traits and the ways of dealing with every day problems. 3) Character traits and the ways to handle stressful situations differ among individuals in respects to the sense of coherence level within an individual.",Zboralski K.; Florkowski A.; Gałecki P.,,,0,0,
2401,Strengthening the patient-provider relationship in the aftermath of physical trauma through an understanding of the nature and severity of posttraumatic concerns.,"Few investigations have focused on patients' concerns in the immediate aftermath of physical trauma. A population-based sample of 120 hospitalized injury survivors was recruited and followed over the course of the year after injury. Open-ended, semi-structured items were developed to elicit up to three concerns related to the injury from each hospitalized inpatient. Concern narratives were coded into content domains, and concern severity was assessed. Patients most frequently expressed physical health concerns (68%), followed by work and finance (59%), social (44%), psychological (25%), medical (8%), and legal (5%) concerns. The expression of three severe concerns immediately after the trauma was associated with higher PTSD symptoms levels over the course of the year. Greater initial concern severity independently predicted persistent PTSD symptoms 12 months after the injury (Adjusted Relative Risk = 1.71, 95% Confidence Interval = 1.05, 2.78). Early posttraumatic concerns can be readily elicited and reliably interpreted. Psychological concerns constitute a minority of total concerns after physical trauma, and the presence of greater numbers of severe concerns predicts worsening symptomatic course. Incorporation of posttraumatic concern assessments has the potential to simultaneously strengthen the posttraumatic patient-provider relationship and to link patient-centered evaluation with individual and community-level PTSD and functional outcome evaluations.",Zatzick DF.; Russo J.; Rajotte E.; Uehara E.; Roy-Byrne P.; Ghesquiere A.; Jurkovich G.; Rivara F.,2007.0,10.1521/psyc.2007.70.3.260,0,0,
2402,An effectiveness-implementation hybrid trial study protocol targeting posttraumatic stress disorder and comorbidity.,"Each year in the USA, 1.5-2.5 million Americans are so severely injured that they require inpatient hospitalization. Multiple conditions including posttraumatic stress disorder (PTSD), alcohol and drug use problems, depression, and chronic medical conditions are endemic among physical trauma survivors with and without traumatic brain injuries. The trauma survivors outcomes and support (TSOS) effectiveness-implementation hybrid trial is designed to test the delivery of high-quality screening and intervention for PTSD and comorbidities across 24 US level I trauma center sites. The pragmatic trial aims to recruit 960 patients. The TSOS investigation employs a stepped wedge cluster randomized design in which sites are randomized sequentially to initiate the intervention. Patients identified by a 10-domain electronic health record screen as high risk for PTSD are formally assessed with the PTSD Checklist for study entry. Patients randomized to the intervention condition will receive stepped collaborative care, while patients randomized to the control condition will receive enhanced usual care. The intervention training begins with a 1-day on-site workshop in the collaborative care intervention core elements that include care management, medication, cognitive behavioral therapy, and motivational-interviewing elements targeting PTSD and comorbidity. The training is followed by site supervision from the study team. The investigation aims to determine if intervention patients demonstrate significant reductions in PTSD and depressive symptoms, suicidal ideation, alcohol consumption, and improvements in physical function when compared to control patients. The study uses implementation science conceptual frameworks to evaluate the uptake of the intervention model. At the completion of the pragmatic trial, results will be presented at an American College of Surgeons' policy summit. Twenty-four representative US level I trauma centers have been selected for the study, and the protocol is being rolled out nationally. The TSOS pragmatic trial simultaneously aims to establish the effectiveness of the collaborative care intervention targeting PTSD and comorbidity while also addressing sustainable implementation through American College of Surgeons' regulatory policy. The TSOS effectiveness-implementation hybrid design highlights the importance of partnerships with professional societies that can provide regulatory mandates targeting enhanced health care system sustainability of pragmatic trial results. ClinicalTrials.gov NCT02655354 . Registered 27 July 2015.",Zatzick DF.; Russo J.; Darnell D.; Chambers DA.; Palinkas L.; Van Eaton E.; Wang J.; Ingraham LM.; Guiney R.; Heagerty P.; Comstock B.; Whiteside LK.; Jurkovich G.,2016.0,10.1186/s13012-016-0424-4,0,0,
2403,Collaborative interventions for physically injured trauma survivors: a pilot randomized effectiveness trial.,"Posttraumatic behavioral and emotional disturbances occur frequently among physically injured hospitalized trauma survivors. This investigation was a pilot randomized effectiveness trial of a 4-month collaborative care intervention for injured motor vehicle crash and assault victims. As surgical inpatients, intervention subjects (N=16) were assigned to a trauma support specialist who provided counseling, consulted with surgical and primary care providers, and attempted postdischarge care coordination. Control subjects (N=18) received usual posttraumatic care. For all participants, posttraumatic stress disorder (PTSD) and depressive symptoms, episodic alcohol intoxication, and functional limitations were evaluated during the hospitalization and 1 and 4 months postinjury. Study logs and field notes revealed that over 75% of intervention activity occurred in the first month after the trauma. One-month post-trauma intervention subjects when compared to controls demonstrated statistically significant decreases in PTSD symptoms as well as a reduction in depressive symptoms. However, at the 4-month assessment, intervention subjects evidenced no significant improvements in PTSD and depressive symptoms, episodic alcohol intoxication, or functional limitations. Future larger scale trials of stepped collaborative care interventions for physically injured trauma survivors are recommended.",Zatzick DF.; Roy-Byrne P.; Russo JE.; Rivara FP.; Koike A.; Jurkovich GJ.; Katon W.,,,0,0,
2404,"Using target population specification, effect size, and reach to estimate and compare the population impact of two PTSD preventive interventions.","The population impact of a preventive intervention depends on two factors: what proportion of the full population at risk receives the intervention and how large a reduction in risk occurs among those who receive it. We sought to illustrate how information from a cognitive behavioral psychotherapy (CBT) trial and stepped collaborative care (CC) trial could be used to estimate the population impact of two contrasting approaches to PTSD prevention. We first specified trauma center target populations represented by participants in each trial. Patient characteristics were compared, as were effect size and reach indices and population-level reductions in PTSD incidence. The CBT trial demonstrated a larger effect size (50% PTSD prevention), but minimal reach (27/10,000), while the CC trial demonstrated a smaller effect size (7% PTSD prevention) but greater reach (1762/10,000). Modeling of the population impact suggested that a 9.5-fold greater cumulative reduction in the incidence of PTSD would result from the dissemination of the CC broad reach prevention strategy. A reciprocal relationship between effect size and reach was evident in these two trials. By specifying a target population, effect size and reach could be combined to project the overall population impact of each PTSD prevention approach.",Zatzick DF.; Koepsell T.; Rivara FP.,2009.0,10.1521/psyc.2009.72.4.346,0,0,
2405,"Collaborative care intervention targeting violence risk behaviors, substance use, and posttraumatic stress and depressive symptoms in injured adolescents: a randomized clinical trial","ER IMPORTANCE: Violence and injury risk behaviors, alcohol and drug use problems, and posttraumatic stress disorder (PTSD) and depressive symptoms occur frequently among adolescents presenting to acute care medical settings after traumatic physical injury.OBJECTIVE: To test the effectiveness of a stepped collaborative care intervention targeting this constellation of risk behaviors and symptoms in randomly sampled hospitalized adolescents with and without traumatic brain injury.DESIGN, SETTING, AND PARTICIPANTS: A pragmatic randomized clinical trial was conducted at a single US level I trauma center. Participants included 120 adolescents aged 12 to 18 years randomized to intervention (n?=?59) and control (n?=?61) conditions.INTERVENTIONS: Stepped collaborative care intervention included motivational interviewing elements targeting risk behaviors and substance use as well as medication and cognitive behavioral therapy elements targeting PTSD and depressive symptoms.MAIN OUTCOMES AND MEASURES: Adolescents were assessed at baseline before randomization and 2, 5, and 12 months after injury hospitalization. Standardized instruments were used to assess violence risk behaviors, alcohol and drug use, and PTSD and depressive symptoms.RESULTS: The investigation attained more than 95% adolescent follow-up at each assessment point. At baseline, approximately one-third of the participants endorsed the violence risk behavior of carrying a weapon. Regression analyses demonstrated that intervention patients experienced significant reductions in weapon carrying compared with controls during the year after injury (group?√ó?time effect, F3,344?=?3.0; P?=?.03). At 12 months after the injury, 4 (7.3%) intervention patients vs 13 (21.3%) control patients reported currently carrying a weapon (relative risk,?0.31; 95% CI, 0.11-0.90). The intervention was equally effective in reducing the risk of weapon carrying among injured adolescents with and without traumatic brain injury. Other treatment targets, including alcohol and drug use problems and high levels of PTSD and depressive symptoms, occurred less frequently in the cohort relative to weapon carrying and were not significantly affected by the intervention.CONCLUSIONS AND RELEVANCE: Collaborative care intervention reduced the risk of adolescent weapon carrying during the year after the injury hospitalization. Future investigation should replicate this preliminary observation. If the finding is replicated, orchestrated investigative and policy efforts could systematically implement and evaluate screening and intervention procedures targeting youth violence prevention at US trauma centers.TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT00619255.","Zatzick, D; Russo, J; Lord, S P; Varley, C; Wang, J; Berliner, L; Jurkovich, G; Whiteside, L K; O'Connor, S; Rivara, F P",2014.0,10.1001/jamapediatrics.2013.4784,0,0,
2406,Enhancing the population impact of collaborative care interventions: mixed method development and implementation of stepped care targeting posttraumatic stress disorder and related comorbidities after acute trauma,"ER METHODWe describe the design and implementation of the Trauma Survivors Outcomes and Support study. An interdisciplinary treatment development team was composed of trauma surgical, clinical psychiatric and mental health services ""change agents"" who spanned the boundaries between frontline trauma center clinical care and acute care policy. Mixed method clinical epidemiologic and clinical ethnographic studies informed the development of PTSD screening and intervention procedures.RESULTSTwo hundred seven acutely injured trauma survivors with high early PTSD symptom levels were randomized into the study. The stepped collaborative care model integrated care management (i.e., posttraumatic concern elicitation and amelioration, motivational interviewing and behavioral activation) with cognitive behavioral therapy and pharmacotherapy targeting PTSD. The model was feasibly implemented by frontline acute care masters in social work and nurse practioner providers.CONCLUSIONSStepped care protocols targeting PTSD may enhance the population impact of early interventions developed for survivors of individual and mass trauma by extending the reach of collaborative care interventions to acute care medical settings and other nonspecialty posttraumatic contexts.OBJECTIVEThe objective of the study was to develop and implement a stepped collaborative care intervention targeting posttraumatic stress disorder (PTSD) and related comorbidities to enhance the population impact of early trauma-focused interventions.","Zatzick, D; Rivara, F; Jurkovich, G; Russo, J; Trusz, S G; Wang, J; Wagner, A; Stephens, K; Dunn, C; Uehara, E; Petrie, M; Engel, C; Davydow, D; Katon, W",2011.0,10.1016/j.genhosppsych.2011.01.001,0,0,307
2407,Group psychoeducation as treatment for psychological nonepileptic seizures.,"There is no consensus for the type(s) of treatment(s) that may be effective or ineffective for psychological nonepileptic seizures (PNES). We provided an open-ended group psychotherapy program to 10 patients with PNES, including a disorder-specific psychoeducation treatment component in the first 10 weeks. Seizure frequency and questionnaire responses were examined pre- and posttreatment in all 7 of 10 individuals who completed the majority of the psychoeducational sessions. Four individuals experienced no change in seizure frequency; in three of these this was due to a cessation of events at treatment initiation. Two individuals experienced a decline; and one, an increase, in seizure frequency. Significant decreases were reported in posttraumatic (P=0.003) and dissociative (P=0.04) symptoms and emotionally based coping mechanisms (P=0.03). There was also a trend toward improved quality of life (P=0.07). Experience/expression of anger remained stable. Psychoeducation may be an effective method of treating PNES and may improve coping strategies and reduce PNES-associated psychopathology in some patients. Additional controlled studies on larger samples are needed.",Zaroff CM.; Myers L.; Barr WB.; Luciano D.; Devinsky O.,2004.0,10.1016/j.yebeh.2004.03.005,0,0,
2408,Eye movement desensitization and reprocessing: A multiple baseline study.,"Eye Movement Desensitization and Reprocessing (EMDR) was developed in 1987 by Francine Shapiro, as a modality for relieving anxiety, traumatic memories, intrusive thoughts, and reprocessing negative self-beliefs to positive self-beliefs. One of the most common uses of EMDR in recent years has been the treatment of Post Traumatic Stress Disorder (PTSD). This current study investigated the effects of EMDR across a sample of 3 sexually abused women diagnosed with PTSD using a multiple baseline design across subjects. The study specifically focused on whether or not intervention with EMDR effects traumatic memory and negative/irrational cognitions, decreases stress or changes levels of anxiety, depression and heart rate. The study intended to assess the efficacy of EMDR while simultaneously reduce human suffering and answer some of the more serious criticisms which have blurred confidence in EMDR outcome research. Specifically, the study controlled for a number of the criticisms in the literature predominantly through a confirmation of an accurate PTSD diagnosis and through the use of a multiple baseline design. The multiple baseline design was applied sequentially to the same problem across different but matched subjects sharing the same environmental conditions. Heart rate level and well-known psychometrics were used to obtain baseline, intervention and post-intervention measures. Psychometric scores reflecting levels of depression, anxiety, and subjective levels of the impact of distress regarding the trauma were assessed along with the levels of anxiety currently experienced about the trauma and subjective ratings regarding the acceptance of the preferred, self-generated positive cognition. The measures used in this study were an initial clinical interview, an Anxiety Disorders Interview Schedule for the DSM IV (Brown, DiNardo & Barlow, 1994), Beck Depression Inventory (Beck, Rush, Shaw & Emery, 1979), Beck Anxiety Inventory (Beck, 1993), Wolpe's Subjective Unit of (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zeper, Robbi Schlaffman",1997.0,,0,0,
2409,Posterior surgical correction of posttraumatic kyphosis of the thoracolumbar segment.,"To analyze the clinical characteristics and surgical results of posttraumatic kyphosis of the thoracolumbar segment. Thirty-four patients with posttraumatic kyphosis of the thoracolumbar segment underwent posterior osteotomy, kyphosis correction, and fixation at our hospital. The kyphosis apex was from T10 to L2. There were 15 male and 19 female patients. The mean age was 48.9 years. Full-spine standing radiographs were obtained before surgery, after surgery, and at follow-up. The sagittal spine balance status was evaluated, and the kyphotic angle, the lumbar lordotic angle, and the thoracic kyphotic angle were measured. The Frankel grading system for neurological functions and the Visual Analogue Scale for back pain were evaluated before surgery and at follow-up. The Oswestry Disability Index was applied for assessment of life quality and surgical results of patients. The Patient Satisfied Index (PSI) was also used for determination of surgical results. Patients were grouped according to the extent of kyphotic angle and the surgical technique. The difference in kyphosis correction and back pain between groups was observed before and after surgery. Relief from neurological symptoms was also observed. The average kyphotic angle was 48.5 degrees, the average lumbar lordotic angle was 57.9 degrees, and the average thoracic kyphotic angle was 11.4 degrees before surgery. The sagittal spine balance was well maintained in 14 cases, and negative imbalance and positive imbalance were seen in 13 cases and 7 cases, respectively. There was significant difference in back pain between patients in the abnormal and normal groups of the lumbar lordotic angle. The average follow-up time after surgery was 32.1 months. The average kyphotic angle correction rate was 90.4% after surgery and 87.2% at follow-up. The average Oswestry Disability Index was 50.4% before surgery, which improved to 29.4% at follow-up, with an improvement rate of 41.5%. The Patient Satisfied Index result showed a total satisfactory rate of 94.1%. There were 16 cases of neurological deficit before surgery; 8 of them achieved various degrees of improvement after surgery. Surgical correction of posttraumatic kyphosis of the thoracolumbar segment can show good radiologic and clinical results with the appropriate procedure according to the extent of the kyphosis angle. Some patients with neurological deficit are still worthy of surgical treatment.",Zeng Y.; Chen Z.; Sun C.; Li W.; Qi Q.; Guo Z.; Zhao Y.; Yang Y.,2013.0,10.1097/BSD.0b013e318231d6a3,0,0,
2410,A community-based controlled trial of a comprehensive psychological intervention for community residents with diabetes or hypertension.,"Background: Depression and anxiety often occur in persons with chronic physical illnesses and typically magnify the impairment caused by these physical conditions, but little attention has been paid to this issue in low- and middle-income countries. Aim: Evaluate the effectiveness of a community-based psychological intervention administered by non-specialized clinicians and volunteers for alleviating depressive and anxiety symptoms in individuals with chronic physical illnesses. Methods: A total of 10,164 community residents receiving treatment for diabetes or hypertension in Shanghai were arbitrarily assigned to a treatment-as-usual condition (n=2042) or an intervention condition (n=8122) that included community-wide psychological health promotion, peer support groups, and individual counseling sessions. The self-report Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder scale (GAD-7), and 12-item Short-Form Health Survey (SF-12) assessed depressive symptoms, anxiety symptoms, and quality of life at baseline and after the 6-month intervention. Results: Among the 8813 individuals who completed the baseline assessment, 16% had mild or more severe depressive or anxiety symptoms (PHQ-9 or GAD-7 >=5) and 4% had moderate or severe depressive or anxiety symptoms (PHQ-9 or GAD-7 >=10). The education component of the intervention was effectively implemented, but only 31% of those eligible for peer-support groups and only 9% of those eligible for individual counseling accepted these interventions. The dropout rate was high (51%), and there were significant differences between those who did and did not complete the follow-up assessment. After adjusting for these confounding factors, the results in individuals who completed both assessments indicated that the intervention was associated with significant improvements in depressive symptoms (F=9.98, p<0.001), anxiety symptoms (F=12.85, p<0.001), and in the Mental Component Summary score of the SF-12 (F=16.13, p<0.001). There was, however, no significant change in the self-reported rates of uncontrolled diabetes or hypertension. Conclusions: These results support the feasibility of implementing community-based interventions to reduce the severity of depressive and anxiety symptoms in persons with chronic medical conditions in low and middle-income countries where psychiatric manpower is very limited. However, there are substantial methodological challenges to mounting such interventions that need to be resolved in future studies before the widespread up-scaling of this approach will be justified. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Zeng, Qingzhi; He, Yanling; Shi, Zhenyu; Liu, Weiqing; Tao, Hua; Bu, Shiming; Miao, Donglei; Liu, Ping; Zhang, Xuanzhao; Li, Xiaoping; Qi, Xuejun; Zhou, Qin; Archer, Atlantis, Baumeister, Baumeister, Bian, Coventry, Dai, Dale, DeJean, Duan, Fu, Gee, He, Hegel, Huang, Katon, Katon, Khuwaja, Kroenke, Lam, Li, Li, Long, Ontario, Quan, Simon, Spitzer, Von Korff, Ware, Whalley, Wu, Xu",2016.0,,0,0,
2411,"Influence of three-piece and single-piece designs of two sharp-edge optic hydrophobic acrylic intraocular lenses on the prevention of posterior capsule opacification: a prospective, randomised, long-term clinical trial","ER SETTINGEye clinic of Kaunas University of Medicine, Lithuania. Prospective randomised clinical study.METHODSSeventy-four eyes of 74 patients scheduled for cataract surgery were included in a prospective randomised clinical study. Thirty-seven eyes of 37 patients received a three-piece acrylic hydrophobic (AcrySof, MA3OBA, Alcon) IOL; and thirty-seven eyes of 37 patients received a one-piece acrylic hydrophobic (AcrySof, SA3OAL, Alcon) IOL. Visual acuity, anterior capsule opacification (ACO), capsular folds, capsulorrhexis/optic overlapping and posterior capsule opacification (PCO) were evaluated. ACO was assessed subjectively. PCO values in the entire IOL optic area and in the central 3 mm optic zone were assessed using a photographic image-analysis system (EPCO2000). Follow-ups were performed postoperatively at 1 day, 6 months, 1 year and 2 years.RESULTSThere were no significant differences in best corrected visual acuity, grade of ACO and capsulorrhexis/optic overlapping between IOL types during the follow-up period. Patients in the one-piece acrylic hydrophobic IOL group more frequently presented with capsular folds behind the IOL optic area than those in the three-piece IOL group. In the three-piece acrylic hydrophobic IOL group, PCO values (mean (SD)) of the entire IOL optic area were significantly lower six months postoperative (three-piece: 0.002 (0.009); one-piece: 0.007 (0.017); p=0.04), one year postoperative (three-piece: 0.004 (0.016); one-piece: 0.026 (0.041); p=0.001) as well as one year postoperative in the central 3 mm optic zone (three-piece: 0.000 (0.0002); one-piece: 0.019 (0.049); p=0.001). However, two years postoperative, the PCO values of the groups did not show significant differences (entire IOL optic area: three-piece, 0.136 (0.223); one-piece, 0.154 (0.190); p=0.18; central zone: three-piece, 0.023 (0.065); one-piece: 0.020 (0.039); p=0.44).CONCLUSIONThe 2 year follow-up after cataract surgery showed no significant difference in ACO and PCO development between three-piece and one-piece acrylic hydrophobic intraocular lenses.BACKGROUNDPosterior capsule opacification (PCO) is still a major long-term complication of modern cataract surgery. We evaluated the impact of sharp-edged intraocular lenses (IOLs) with different haptic designs made from the same hydrophobic acrylic material on posterior and anterior lens capsule opacification.","Zemaitiene, R; Jasinskas, V; Auffarth, G U",2007.0,10.1136/bjo.2006.103648,0,0,
2412,"Prevention of posterior capsule opacification with 3 intraocular lens models: a prospective, randomized, long-term clinical trial","ER UNLABELLED: The aim of this prospective randomized study was to evaluate the impact of different sharp-edged intraocular lenses (IOLs) (hydrophobic acrylic or silicone) on posterior and anterior lens capsule opacification (PCO and ACO) at 3-year postoperative follow-up.MATERIAL AND METHODS: A total of 96 eyes (89 patients) having a standard uncomplicated phacoemulsification procedure for age-related cataract were included in a prospective clinical study: 34 eyes with a 3-piece acrylic hydrophobic (AcrySof, MA3OBA), 32 eyes with a 1-piece acrylic hydrophobic (AcrySof, SA3OAL), and 30 eyes with a 3-piece silicone (CeeOn 911A) IOL. Visual acuity, capsulorrhexis/optic overlapping, ACO and PCO (using EPCO2000 system) were evaluated at 3-year follow-up. Capsulotomies performed by means of neodymium-yttrium-aluminum-garnet (Nd:YAG) laser were recorded.RESULTS: Three years after surgery, the grade of ACO of the capsulorrhexis rim area and the capsule/optic area was significantly greater in the silicone IOL group than in the acrylic IOL groups (P0.05).CONCLUSION: The 3-year follow-up after cataract surgery showed no difference in PCO development (EPCO2000) between acrylic hydrophobic and silicone sharp-edged IOLs. However, the need for Nd:YAG laser capsulotomy was higher in the acrylic IOL groups than the silicone IOL group, though the difference was not significant. ACO was greatest in the eyes with 3-piece silicone IOLs.","Zemaitien?, R; Ja?inskas, V",2011.0,,0,0,
2413,The cues and care randomized controlled trial of a neonatal intensive care unit intervention: effects on maternal psychological distress and mother-infant interaction.,"This study tested the efficacy of a brief intervention (Cues program) with mothers of very low birth weight (VLBW <1500 g) infants. The primary hypothesis was that mothers in the Cues program would report lower levels of anxiety compared with mothers in the control group. Secondary hypotheses examined whether Cues mothers would report less stress, depression, and role restriction, and exhibit more sensitive interactive behavior, than control group mothers. A total of 121 mothers of VLBW infants were randomly assigned to either the experimental (Cues) intervention or an attention control (Care) condition. The Cues program combined training to reduce anxiety and enhance sensitivity. The control group received general information about infant care. Both programs were initiated during the neonatal intensive care unit stay. Maternal anxiety, stress, depression, and demographic variables were evaluated at baseline, prior to randomization. Postintervention outcomes were assessed during a home visit when the infant was ∼6 to 8 weeks of corrected age. Although mothers in the Cues group demonstrated greater knowledge of the content of the experimental intervention than mothers in the Care group, the groups did not differ in levels of anxiety, depression, and symptoms of posttraumatic stress. They were similar in their reports of parental role restrictions and stress related to the infant's appearance and behavior. Cues and Care group mothers were equally sensitive in interaction with their infants. Nonspecific attention was as effective as an early skill-based intervention in reducing maternal anxiety and enhancing sensitive behavior in mothers of VLBW infants.",Zelkowitz P.; Feeley N.; Shrier I.; Stremler R.; Westreich R.; Dunkley D.; Steele R.; Rosberger Z.; Lefebvre F.; Papageorgiou A.,2011.0,10.1097/DBP.0b013e318227b3dc,0,0,
2414,The Cues and Care Trial: a randomized controlled trial of an intervention to reduce maternal anxiety and improve developmental outcomes in very low birthweight infants.,"Very low birthweight infants are at risk for deficits in cognitive and language development, as well as attention and behaviour problems. Maternal sensitive behaviour (i.e. awareness of infant cues and appropriate responsiveness to those cues) in interaction with her very low birthweight infant is associated with better outcomes in these domains; however, maternal anxiety interferes with the mother's ability to interact sensitively with her very low birthweight infant. There is a need for brief, cost-effective and timely interventions that address both maternal psychological distress and interactive behaviour. The Cues and Care trial is a randomized controlled trial of an intervention designed to reduce maternal anxiety and promote sensitive interaction in mothers of very low birthweight infants. Mothers of singleton infants born at weights below 1500 g are recruited in the neonatal intensive care units of 2 tertiary care hospitals, and are randomly assigned to the experimental (Cues) intervention or to an attention control (Care) condition. The Cues intervention teaches mothers to attend to their own physiological, cognitive, and emotional cues that signal anxiety and worry, and to use cognitive-behavioural strategies to reduce distress. Mothers are also taught to understand infant cues and to respond sensitively to those cues. Mothers in the Care group receive general information about infant care. Both groups have 6 contacts with a trained intervener; 5 of the 6 sessions take place during the infant's hospitalization, and the sixth contact occurs after discharge, in the participant mother's home. The primary outcome is maternal symptoms of anxiety, assessed via self-report questionnaire immediately post-intervention. Secondary outcomes include maternal sensitive behaviour, maternal symptoms of posttraumatic stress, and infant development at 6 months corrected age. The Cues and Care trial will provide important information on the efficacy of a brief, skills-based intervention to reduce anxiety and increase sensitivity in mothers of very low birthweight infants. A brief intervention of this nature may be more readily implemented as part of standard neonatal intensive care than broad-based, multi-component interventions. By intervening early, we aim to optimize developmental outcomes in these high risk infants. Current Controlled Trials ISRCTN00918472. The Cues and Care Trial: A randomized controlled trial of an intervention to reduce maternal anxiety and improve developmental outcomes in very low birthweight infants.",Zelkowitz P.; Feeley N.; Shrier I.; Stremler R.; Westreich R.; Dunkley D.; Steele R.; Rosberger Z.; Lefebvre F.; Papageorgiou A.,2008.0,10.1186/1471-2431-8-38,0,0,
2415,Superior temporal sulcus and social cognition in dangerous drivers,"Understanding the neural systems underpinning social cognition is a primary focus of contemporary social neuroscience. Using functional magnetic resonance imaging (fMRI), the present study asked if brain activity reflecting socio-cognitive processes differs between individuals according to their social behavior; namely, between a group of drivers with frequent traffic offenses and a group with none. Socio-cognitive processing was elicited by employing videos from a traffic awareness campaign, consisting of reckless and anti-social driving behavior ending in tragic consequences, and control videos with analogous driving themes but without such catastrophic endings. We investigated whether relative increases in brain function during the observation of these campaign stimuli compared with control videos differed between these two groups. To develop the results of our previous study we focused our analyses on superior temporal sulcus/gyrus (STS/STG). This revealed a bigger increase in brain activity within this region during the campaign stimuli in safe compared with dangerous drivers. Furthermore, by thematically coding drivers' verbal descriptions of the stimuli, we also demonstrate differences in STS reactivity according to drivers' scores on two indices of socio-cognitive processing: subjects' perceived consequences of actors' actions, and their affective evaluation of the clips. Our results demonstrate the influence of social behavior and socio-cognitive processing on STS reactivity to social stimuli, developing considerably our understanding of the role of this region in social cognition. © 2013 Elsevier Inc.",Zelinková J.; Shaw D.J.; Mareček R.; Mikl M.; Urbánek T.; Peterková L.; Zámečník P.; Brázdil M.,2013.0,10.1016/j.neuroimage.2013.07.063,0,0,
2416,"[Neuroses--myths, models, facts. A contribution to the genesis of neurotic disturbances].",,Zapotoczky HG.,1976.0,,0,0,
2417,Extracorporeal membrane oxygenation in severe acute respiratory failure. A randomized prospective study.,"Nine medical centers collaborated in a prospective randomized study to evaluate prolonged extracorporeal membrane oxygenation (ECMO) as a therapy for severe acute respiratory failure (ARF). Ninety adult patients were selected by common criteria of arterial hypoxemia and treated with either conventional mechanical ventilation (48 patients) or mechanical ventilation supplemented with partial venoarterial bypass (42 patients). Four patients in each group survived. The majority of patients suffered acute bacterial or viral pneumonia (57%). All nine patients with pulmonary embolism and six patients with posttraumatic acute respiratory failure died. The majority of patients died of progressive reduction of transpulmonary gas exchange and decreased compliance due to diffuse pulmonary inflammation, necrosis, and fibrosis. We conclude that ECMO can support respiratory gas exchange but did not increase the probability of long-term survival in patients with severe ARF.",Zapol WM.; Snider MT.; Hill JD.; Fallat RJ.; Bartlett RH.; Edmunds LH.; Morris AH.; Peirce EC.; Thomas AN.; Proctor HJ.; Drinker PA.; Pratt PC.; Bagniewski A.; Miller RG.,1979.0,,0,0,
2418,Longitudinal course of substance treatment benefits in older male veteran at-risk drinkers.,"This investigation aims to determine the 12-month drinking trajectory of older at-risk drinkers in treatment. Furthermore, the drinking trajectory between at-risk drinkers who had met the threshold suggestive of alcohol dependence (problem at-risk drinkers) and those who did not meet this threshold (nonproblematic at-risk drinkers) were compared. This investigation is a component of the PRISM-E (Primary Care Research in Substance Abuse and Mental Health for the Elderly) Study, a multisite randomized trial comparing service use, outcomes, and cost between Integrated (IC) versus Enhanced Specialty Referral (ESR) care models for older (65+ years) adults with depression, anxiety, and/or at-risk alcohol consumption. This investigation focuses only on at-risk drinkers, generally defined as exceeding recommended drinking limits, which in the case of older adults has been classified as consuming more than one drink per day. Two hundred fifty-eight randomized older at-risk drinkers were examined, of whom 56% were problem drinkers identified through the Short Michigan Alcohol Screening Test-Geriatric version. Over time, all at-risk drinkers showed a significant reduction in drinking. Problem drinkers showed reductions in average weekly consumption and number of occurrences of binge drinking at 3, 6, and 12 months, whereas nonproblematic drinkers showed significant reductions in average weekly consumption at 3, 6, and 12 months and number of occurrences of binge drinking at only 6 months. IC treatment assignment led to higher engagement in treatment, which led to better binge drinking outcomes for problem drinkers. Despite significant reductions in drinking, approximately 29% of participants displayed at-risk drinking at the end of the study. Results suggest that older at-risk drinkers, both problem and nonproblematic, show a considerable decrease in drinking, with slightly greater improvement evidenced in problem drinkers and higher engagement in treatment seen in those assigned to IC.",Zanjani F.; Mavandadi S.; TenHave T.; Katz I.; Durai NB.; Krahn D.; Llorente M.; Kirchner J.; Olsen E.; Van Stone W.; Cooley S.; Oslin DW.,2008.0,,0,0,
2419,Outcome of total hip replacement for avascular necrosis in systemic lupus erythematosus.,"To describe the short and medium term results of total hip arthroplasty (THA) for avascular necrosis in patients with systemic lupus erythematosus (SLE). Nineteen patients with SLE and avascular necrosis of the femoral head (AVNFH), who underwent 26 THA were retrospectively reviewed with a minimum followup of 2 years. To determine whether these patients had results similar to those of patients with other conditions, we formed a control group of 19 patients who had 29 THA. They were matched for age, sex, and followup to the patients with SLE. Controls had THA for juvenile rheumatoid arthritis (n = 7), osteoarthritis (5), adult onset rheumatoid arthritis (8), developmental dysplasia of the hip (4), and other diagnoses (5). Outcome measures included a 10 point visual analog scale (VAS) for pain, the Harris hip score, and the SF-36 self-administered health outcome questionnaire. We used the methods of Delee, Harris, and Engh for radiological assessment. Mean age at surgery was 46 years (range 21-71 years) and average followup was 4 years, 7 months (range 1 yr 9 mo to 9 yrs 6 mo), similar in both groups. Technical problems, mostly consisting of small, nonpropagating cracks of the calcar in uncemented stems, were encountered in 4 SLE hips and 1 control hip. Six complications were noted in the SLE group, including 2 early, nonrecurrent dislocations, 1 patient with thigh pain for 1 year, 1 pericarditis, 1 sick-sinus syndrome, and 1 urinary tract infection. There was one case of urinary tract infection in the control group. One SLE patient developed a low grade prosthetic infection and underwent successful revision 2 years after primary surgery. Clinical outcome measures had similar scores in the 2 groups: average VAS pain score = 2.00 in SLE hips (maximum 10) and 1.97 in control hips; mean Harris hip score = 86.7 in SLE patients (maximum 100) and 81.9 in controls; average SF-36 score = 63.4 in SLE patients (maximum 100) and 60.5 in controls. There was no radiological evidence of implant loosening in controls; there was 1 asymptomatic cup migration in the SLE group. In the short and medium term, patients with SLE and AVN had good results after THA. Results were similar in patients who had hip replacement for other diagnoses. Less favorable clinical outcomes of hip replacement have been reported in young patients who have AVN of other etiology (e.g., alcoholic, post-traumatic), but this was not the case in our young patients who had AVN and SLE. Thus, AVNFH and SLE should not constitute a contraindication to hip replacement.",Zangger P.; Gladman DD.; Urowitz MB.; Bogoch ER.,2000.0,,0,0,
2420,Change in negative cognitions associated with PTSD predicts symptom reduction in prolonged exposure.,"The goal of the current study was to examine mechanisms of change in prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD). Emotional processing theory of PTSD proposes that disconfirmation of erroneous cognitions associated with PTSD is a central mechanism in PTSD symptom reduction; but to date, the causal relationship between change in pathological cognitions and change in PTSD severity has not been established. Female sexual or nonsexual assault survivors (N = 64) with a primary diagnosis of PTSD received 10 weekly sessions of PE. Self-reported PTSD symptoms, depression symptoms, and PTSD-related cognitions were assessed at pretreatment, each of the 10 PE treatment sessions, and posttreatment. Lagged mixed-effect regression models indicated that session-to-session reductions in PTSD-related cognitions drove successive reductions in PTSD symptoms. By contrast, the reverse effect of PTSD symptom change on change in cognitions was smaller and did not reach statistical significance. Similarly, reductions in PTSD-related cognitions drove successive reductions in depression symptoms, whereas the reverse effect of depression symptoms on subsequent cognition change was smaller and not significant. Notably, the relationships between changes in cognitions and PTSD symptoms were stronger than the relationships between changes in cognitions and depression symptoms. To our knowledge, this is the 1st study to establish change in PTSD-related cognitions as a central mechanism of PE treatment. These findings are consistent with emotional processing theory and have important clinical implications for the effective implementation of PE.",Zalta AK.; Gillihan SJ.; Fisher AJ.; Mintz J.; McLean CP.; Yehuda R.; Foa EB.,2014.0,10.1037/a0034735,0,0,
2421,Sleep quality predicts treatment outcome in CBT for social anxiety disorder.,"Sleep quality may be an important, yet relatively neglected, predictor of treatment outcome in cognitive-behavioral therapy (CBT) for anxiety disorders. Specifically, poor sleep quality may impair memory consolidation of in-session extinction learning. We therefore examined sleep quality as a predictor of treatment outcome in CBT for social anxiety disorder and the impact of d-cycloserine (DCS) on this relationship. One hundred sixty-nine participants with a primary diagnosis of DSM-IV generalized social anxiety disorder were recruited across three sites. Participants were enrolled in 12 weeks of group CBT. Participants randomly received 50 mg of DCS (n = 87) or pill placebo (n = 82) 1 hr prior to sessions 3-7. Participants completed a baseline measure of self-reported sleep quality and daily diaries recording subjective feelings of being rested upon wakening. Outcome measures including social anxiety symptoms and global severity scores were assessed at each session. Poorer baseline sleep quality was associated with slower improvement and higher posttreatment social anxiety symptom and severity scores. Moreover, patients who felt more ""rested"" after sleeping the night following a treatment session had lower levels of symptoms and global severity at the next session, controlling for their symptoms and severity scores the previous session. Neither of these effects were moderated by DCS condition. Our findings suggest that poor sleep quality diminishes the effects of CBT for social anxiety disorder and this relation is not attenuated by DCS administration. Therapeutic attention to sleep quality prior to initiation of CBT and during the acute treatment phase may be clinically indicated.",Zalta AK.; Dowd S.; Rosenfield D.; Smits JA.; Otto MW.; Simon NM.; Meuret AE.; Marques L.; Hofmann SG.; Pollack MH.,2013.0,10.1002/da.22170,0,0,
2422,"The effectiveness of bivalving, cast spreading, and webril cutting to reduce cast pressure in a fiberglass short arm cast.","A fiberglass short arm cast can be used to treat a distal radial fracture, but posttraumatic edema may lead to excessive cast tightness and resultant soft-tissue injury. We sought to quantify a simulated edema-induced pressure within a fiberglass short arm cast and to determine the effectiveness of different cast-cutting methods for pressure reduction. We hypothesized that cast cutting could eliminate all clinically relevant pressure and Ace wrap would insignificantly increase pressure. Skin surface pressure under fiberglass short arm casts was measured on ninety wrists from forty-five volunteers randomly assigned to one cast-cutting method: single-cut (cast bivalve and Ace wrap), double-cut (cast bivalve, spread, and Ace wrap), or triple-cut (cast bivalve, spread, Webril cut, and Ace wrap). Each wrist was immobilized in a cast in the neutral position with one roll of 2-inch (5.1-cm) cotton Webril and one roll of 2-inch (5.1-cm) fiberglass. Each fiberglass short arm cast contained an empty intravenous fluid bag in which we infused air. This simulated edema, which generated a skin surface pressure, which was measured by a pressure transducer. Each cast-cutting method significantly reduced (p < 0.0001) the skin surface pressure from the average maximum of 92.5 mm Hg in a non-fracture setting. Prior to Ace wrapping, there was a reduction in skin surface pressure of 70.8% for the single-cut method, 85.1% for the double-cut method, and 99.9% for the triple-cut method. Ace wrap significantly increased skin surface pressure (p < 0.0001), lessening the effectiveness of cast cutting. There was an overall reduction in skin surface pressure of 55.9% for the single-cut method, 64.3% for the double-cut method, and 77.2% for the triple-cut method. Throughout our study, women had significantly higher skin surface pressure than men (p < 0.0001); the average maximum was 104.4 mm Hg for women and 81.1 mm Hg for men. The single-cut method provides the greatest pressure reduction, but only the triple-cut method eliminated all relevant skin surface pressure. Ace wrapping a cut cast noticeably increased skin surface pressure. In volunteers without a fracture, only the triple-cut method is effective enough to eliminate clinically relevant skin surface pressure. Ace wrap should be applied with caution after the cast is cut. The specific effect on pressure reduction in a patient who requires some soft-tissue pressure to maintain fracture reduction was not studied.",Zaino CJ.; Patel MR.; Arief MS.; Pivec R.,2015.0,10.2106/JBJS.N.00579,0,0,
2423,Psychological response and cortisol reactivity to in vitro fertilization treatment in women with a lifetime anxiety of unipolar mood disorder diagnosis.,"Objective: Knowledge regarding the emotional and physiologic response of women with psychiatric disorders undergoing in vitro fertilization (IVF) treatments is rather limited. We evaluated psychological adjustment and cortisol reactivity to IVF treatment in women with a lifetime diagnosis of a unipolar mood or anxiety disorder compared to those without such a diagnosis. Method: Women undergoing IVF treatments (N = 121) were interviewed from January 2006 to December 2007 to assess for the presence of a history of a lifetime DSM-IV-TR unipolar mood or anxiety disorder. They were evaluated prospectively at baseline, at ovulation, and before the pregnancy test. Primary outcome measures included assessments of depressive and anxiety symptoms (Center for Epidemiologic Studies Depression Scale and State-Trait Anxiety Inventory, respectively) and plasma cortisol levels. Results: Of 108 participants included in the study, 19.4% (n = 21) were determined to have a lifetime Axis I unipolar mood or anxiety diagnosis. Women with lifetime Axis I psychopathology showed significantly greater symptom elevation for depression (F2,194 = 10.97, P < .001) and for anxiety (F2,194 = 3.4813, P = .033) compared to the group without psychopathology. A different physiologic pattern was observed for cortisol response: whereas the group without psychopathology responded physiologically to the stressful treatment with continuously elevated cortisol levels, a blunted cortisol response was observed for the group with lifetime psychopathology (F2,200 = 2.9, P = .05). Conclusions: Women diagnosed with a lifetime unipolar mood or anxiety disorder developed robust symptom exacerbation during IVF treatment compared to women without an Axis I diagnosis. Conversely, the women with a lifetime diagnosis are characterized by a blunted cortisol response, indicating a pattern of dissociation between the robust increase in anxiety and depression and cortisol response to the acute psychological stress. This study emphasizes the need for a psychiatric screening prior to IVF treatment and for the utilization of preventive psychiatric and psychological interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zaig, Inbar; Azem, Foad; Schreiber, Shaul; Amit, Ami; Litvin, Yael Gottlieb; Bloch, Miki; Ahrens, Bagley, Bloch, Bloch, Boivin, Boivin, Brummelte, Burke, Burns, Bystritsky, Carver, Chen, Cousineau, Csemiczicy, de Liz, Derogatis, Domar, First, Freeman, Fries, Gao, Gilboa, Hammerli, Jurado, Kudielka, Lopez-Duran, Marcus, Nemeroff, Nierenberg, Olivius, Petrowski, Post, Radloff, Rudolph, Soares, Spielberger, Stroud, Tica, Verhaak, Volgsten, Warnock, Williams, Williams, Yli-Kuha, Young",2013.0,,0,0,
2424,Evaluation of the clinical global impression scale among individuals with social anxiety disorder.,"The clinical Global Impression Scale (CGI) is commonly used as a primary outcome measure in studies evaluating the efficacy of treatments for anxiety disorders. The current study evaluated the psychometric properties and predictors of clinicians' ratings on an adapted version of the CGI among individuals with social anxiety disorders. An independent assessor administered the CGI Severity of Illness and Improvement ratings to 123 patients at baseline and the subset of treated patients again mid- and post-treatment. Improvement ratings were strongly related to both concurrent Severity of Illness and changes in Severity of Illness ratings from baseline. Additionally, both CGI ratings were positively correlated with both self-report and clinician-administered measures of social anxiety, depression, impairment and quality of life. Measures of social anxiety symptoms accounted for a large portion of the variance in Severity of Illness ratings, with significant additional variance accounted for by measures of impairment and depression. Changes in social anxiety symptoms from baseline accounted for significant variance in Improvement ratings, but no significant additional variance was accounted for by changes in impairment and depressive symptoms. Our findings support the utility of the CGI as an index of global severity and symptom-specific improvement among individuals with social anxiety disorder.",Zaider TI.; Heimberg RG.; Fresco DM.; Schneier FR.; Liebowitz MR.,2003.0,,0,0,
2425,The Videoinsight® method: improving rehabilitation following anterior cruciate ligament reconstruction--a preliminary study,"ER PURPOSE: The purpose of this randomized double blind controlled study was to investigate if the vision of contemporary art video according to the Videoinsight(®) method could produce better short-term clinical and subjective outcomes after anterior cruciate ligament (ACL) reconstruction.METHODS: One-hundred and six patients treated with single-bundle ACL reconstruction plus extra-articular tenodesis were enrolled in this study and randomly assigned to Group A (53 patients) and Group B (53 patients). Group A received one art video that was established to produce positive and therapeutic ""insight"", while Group B received one art video with an ""insight"" unfavourable to the psychological recovery. All patients were instructed to watch the video 3 times a week for the first 2 months during the execution of the same rehabilitative protocol. Patients were evaluated pre-operatively and 3 months after surgery with Tegner, subjective International Knee Documentation Committee (IKDC), physical and mental SF-36 scores and Tampa Scale of Kinesiophobia (TSK). Time to crutches discharge was collected at final follow-up as well.RESULTS: Five patients were lost to follow-up and 101 patients (Group A: 51 patients; Group B: 50 patients) were available at mean 3.0 ± 0.2 months follow-up. Age at surgery was 33.0 ± 17.0 years. The two groups were homogeneous regarding pre-operative demographic data, meniscal lesions and clinical outcomes. Significant improvements were observed in Group A compared to Group B at final follow-up for subjective IKDC (82.0 ± 13.8 vs. 71.0 ± 19.7, p = 0.0470), TKS (28.1 ± 6.0 vs. 32.0 ± 5.8, p = 0.0141) and time to crutches discharge (20.9 ± 5.0 vs. 26.5 ± 8.2 days, p = 0.0012). A positive significant correlation between TSK and time to crutches discharge (r = 0.35, p = 0.0121) was observed.CONCLUSIONS: The Videoinsight(®) method combined to adequate rehabilitation could be an effective tool in order to improve short-term clinical and functional outcomes in patients who underwent ACL reconstruction.","Zaffagnini, S; Russo, R L; Marcheggiani, Muccioli G M; Marcacci, M",2013.0,10.1007/s00167-013-2392-4,0,0,
2426,A cross-sectional examination of the mental health of homeless mothers: does the relationship between mothering and mental health vary by duration of homelessness?,"This study draws on baseline data from the At Home/Chez Soi demonstration project to examine the association between parenting status and mental health among homeless women and whether the association varies by duration of homelessness. Structured interviews were conducted with participants in five cities across Canada including Moncton, Montreal, Toronto, Vancouver and Winnipeg. Eligibility criteria included those with legal adult status, with a mental illness, and who lacked a regular, fixed shelter. All 713 women who participated in the larger project were selected for inclusion in this analysis. The mental health conditions of interest include depression, post-traumatic stress disorder (PTSD), alcohol dependence and substance dependence. The relationship between parenting status and depression, as well as PTSD, varied by duration of homelessness. Among women who had been homeless for less than 2 years, no relationship was found between parenting status and depression, or PTSD. However, among women who had been homeless for 2 or more years, the odds of depression was twice as high among parenting women compared with others (aOR=2.05, p≤0.05). A similar relationship was found between parenting status and PTSD (aOR=2.03, p≤0.05). The odds of substance dependence was found to be 2.62 times greater among parenting women compared with others and this relationship did not vary by duration of homelessness (aOR=2.62; 95% CI 1.86 to 3.69). No relationship was found between parenting and alcohol dependence. Overall, the findings from this study suggest that there is a relationship between long-term homelessness and mothers' risk of poor mental health. Given the multiple demands mothers face, a failure to recognise their unique needs is likely to contribute to intergenerational legacies of homelessness and mental health problems. World Health Organization's International Clinical Trials Registry Platform (ISRCTN66721740 and ISRCTN57595077).",Zabkiewicz DM.; Patterson M.; Wright A.,2014.0,10.1136/bmjopen-2014-006174,0,0,
2427,Efficacy of a training program for long-term disease- free cancer survivors as health partners: a randomized controlled trial in Korea.,"To determine whether the Health Partner Program is effective in training long-term cancer survivors to be health coaches. We randomly assigned cancer survivors who were selected through a rigorous screening process to either the Health Partner Program or the waiting-list control group. The program consisted of 8 weeks of training in health management, leadership, and coaching. At baseline, 8, and 16 weeks, we measured primary outcomes using the Seven Habit Profile (SHP), the Korean Leadership Coaching Competency Inventory (KCCI), Ed Diner's Satisfaction with Life Scale (SWLS), and the Posttraumatic Growth inventory (PTGI) and secondary outcomes using the Hospital Anxiety and Depression Scale (HADS), the Impact of Event Scale-Revised (IES-R), and the Medical Outcomes Study (MOS) short form 36-item questionnaire (SF- 36). We recruited 70 subjects and randomly assigned 34 to the intervention group. The Sharpen the Saw habit of the SHP increased significantly more in intervention group than in the control group (p = 0.049), as did most PTGI factors. The intervention group also showed a significantly greater enhancement of vitality (p = 0.015) and mental health (p = 0.049) SF-36 scores but no improvement in KCCI, SWLS, HADS, or IES-R scores. The intervention group also showed a greater clinically meaningful improvement in the ""Think Win-Win"" of SHP (p = 0.043) and in the personal strength score (p = 0.025) and total score (p = 0.015) of the PTGI. Long-term cancer survivors can benefit from the Health Partner Program to become health coaches.",Yun YH.; Lee MK.; Bae Y.; Shon EJ.; Shin BR.; Ko H.; Lee ES.; Noh DY.; Lim JY.; Kim S.; Kim SY.; Cho CH.; Jung KH.; Chun M.; Lee SN.; Park KH.; Chang YJ.,2013.0,,0,0,
2428,The extinction of phobic behavior as a function of attention shifts.,,Yulis S.; Brahm G.; Charnes G.; Jacard LM.; Picota E.; Rutman F.,1975.0,,0,0,
2429,Treatment of social anxiety disorder using online virtual environments in Second Life.,"Over 80% of people with social anxiety disorder (SAD) do not receive any type of treatment, despite the existence of effective evidence-based treatments. Barriers to treatment include lack of trained therapists (particularly in nonmetropolitan areas), logistical difficulties (e.g., cost, time, transportation), concerns regarding social stigma, and fear of negative evaluation from health care providers. Interventions conducted through electronic communication media, such as the Internet, have the potential to reach individuals who otherwise would not have access to evidence-based treatments. Second Life is an online virtual world that holds great promise in the widespread delivery of evidence-based treatments. We assessed the feasibility, acceptability, and initial efficacy of an acceptance-based behavior therapy in Second Life to treat adults with generalized SAD. Participants (n=14) received 12 sessions of weekly therapy and were assessed at pretreatment, midtreatment, posttreatment, and follow-up. Participants and therapists rated the treatment program as acceptable and feasible, despite frequently encountered technical difficulties. Analyses showed significant pretreatment to follow-up improvements in social anxiety symptoms, depression, disability, and quality of life, with effect sizes comparable to previously published results of studies delivering in-person cognitive behavior therapy for SAD. Implications and future directions are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Yuen, Erica K; Herbert, James D; Forman, Evan M; Goetter, Elizabeth M; Comer, Ronald; Bradley, Jean-Claude; Andersson, Baker, Beck, Beidel, Berger, Bond, Carlbring, Carlbring, Clark, Clark, Collins, Dalrymple, Davidson, DiNardo, Eifert, Fedoroff, Feske, First, Forman, Frisch, Goisman, Gould, Grant, Hayes, Hayes, Hayes, Hayes, Hayes, Hedman, Heimberg, Heimberg, Herbert, Herbert, Herbert, Herbert, Herbert, Holt, Horrigan, Horrigan, Jacobson, Kessler, Klinger, Lappalainen, Leary, Leon, Leon, Liebowitz, Liebowitz, Mortberg, Olfson, Osman, Osman, Otto, Parsons, Powers, Rodebaugh, Rubin, Steer, Thomas, Titov, Titov, Titov, Turner, Ventura, Wang, Yuen",2013.0,,0,0,
2430,Acceptance based behavior therapy for social anxiety disorder through videoconferencing.,"Most individuals with social anxiety disorder (SAD) do not receive any type of treatment. Reasons include logistical barriers (e.g., geographic location, travel time), fear of stigmatization, and fear of the social interactions associated with seeking treatment. Videoconferencing technology holds great promise in the widespread delivery of evidence-based treatments to those who would otherwise not receive treatment. This pilot study assessed the feasibility, acceptability, and initial efficacy of an acceptance-based behavioral intervention using Skype videoconferencing to treat adults with generalized SAD. Twenty-four participants received 12 sessions of weekly therapy and were assessed at pre-treatment, mid-treatment, post-treatment, and 3-month follow-up. Participants and therapists rated the intervention as acceptable and feasible. Analyses revealed significant pre-treatment to follow-up improvements in social anxiety, depression, disability, quality of life, and experiential avoidance, with effect sizes comparable to or larger than previously published results of studies delivering in-person CBT for SAD. Implications and future directions are discussed.",Yuen EK.; Herbert JD.; Forman EM.; Goetter EM.; Juarascio AS.; Rabin S.; Goodwin C.; Bouchard S.,2013.0,10.1016/j.janxdis.2013.03.002,0,0,
2431,Randomized Controlled Trial of Home-Based Telehealth Versus In-Person Prolonged Exposure for Combat-Related PTSD in Veterans: Preliminary Results.,"Telehealth technology may reduce the effect of treatment barriers and improve participation in treatment for veterans with posttraumatic stress disorder (PTSD). The present study is an ongoing randomized controlled trial comparing the effectiveness of prolonged exposure (PE) delivered via in person or home-based video telehealth modalities. A total of 52 veterans with combat-related PTSD were randomized to receive 8-12 weeks of PE through either home-based telehealth or standard in-person office-based care. Participants evinced significant reductions in symptoms of PTSD, depression, and anxiety from pre- to posttreatment across both conditions. Analyses conducted within a noninferiority framework suggested nonsignificant treatment outcome differences in clinician-reported PTSD and self-reported anxiety between the conditions. Results were inconclusive for self-reported PTSD and depression symptoms. Patient satisfaction ratings did not significantly differ between the two groups. Results suggest that PE can be delivered via home-based telehealth with outcomes and satisfaction ratings comparable to in-person practices for certain symptoms, however additional research is needed. This modality has the potential to address stigma- and geographic-related barriers to treatment, such as travel time and cost.",Yuen EK.; Gros DF.; Price M.; Zeigler S.; Tuerk PW.; Foa EB.; Acierno R.,2015.0,10.1002/jclp.22168,0,0,
2432,Contrast sensitivity and color vision with a yellow intraocular len,"ER DESIGNRandomized clinical trial.METHODSExtracapsular cataract extraction was performed in 60 senile cataract patients. The patients were randomly assigned to receive 30 yellow UV IOLs and 30 ordinary UV IOLs. Visual acuity, contrast sensitivity, and color vision were examined up to 6 months postoperatively.RESULTSThe yellow UV IOLs showed statistically significantly higher spatial contrast sensitivity than ordinary UV IOLs in the low and middle frequencies. There was no significant difference between yellow and ordinary UV IOL in color vision. Incidences of photophobia and cyanopsia were less in patients who received the yellow UV IOLs.CONCLUSIONSYellow UV IOLs are preferable to ordinary UV IOLs in preserving spatial contrast sensitivity and cause less photophobia and cyanopsia in the early postoperative period.OBJECTIVETo evaluate contrast sensitivity and color vision of yellow ultraviolet (UV) intraocular len (IOL) in cataract patients.","Yuan, Z; Reinach, P; Yuan, J",2004.0,10.1016/j.ajo.2004.02.024,0,0,
2433,Difference of mental health level and coping styles in different sex freshmen from normal colleges,"Aim: To explore the mental health status, coping styles and their relationship of freshman in teachers college. Methods: 304 junior college freshmen of 2004 grade were selected randomly from Cangzhou Teachers College during September 2004. The mental health level of freshmen was tested by symptom evaluation scale, and compared with Chinese youth norms. The scale included somatizaion, compulsion, in-terpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, para-noid ideation, and psychoticism etc. Compared with Chinese adult norm standard: factorial scores were lower 1.8 for normal; between 1.8 and 2.0 for light abnormality; between 2.1 and3.0 for middle abnormality; factorial score higher 3.0 for severe abnormality. The coping style facing stress of Coping Style Questionnaire, which had five coping strategies, tested college freshmen: problem solving, self-blame, help-seeking, fancy and avoidance. The community test was done taking the class as a unit, during the test us-ing unification instruction language without recording the name, and the questionnaires were took back at the scene. Results: There were 310 questionnaires issued totally. The questionnaire counts and retrieves 304 finally; the effective rate of recovery of questionnaire was 97.7%. 1 The score of every factor of symptom checklist (SCL) of the freshmen and compared with the national youth norm: Except somatization and hostility, all the factorial scores of college freshmen were higher than that of the national norm, showing a big difference. 2 The multi-element analysis of variance of the SCL and coping styles of the freshmen: Each factor of the SCL and coping styles was considered as the dependent variable, and sex and source of students as the independent variable, the multi-element analysis of variance was done. There were no sex differences on each factor of mental health, but a significant principle effect of sex was showed on problem solving and fancy. The scores of problem solving of male freshman were higher than that of female, and the scores of fancy of male freshman were lower than that of female; There was a principle effect among anxiety, psychoticism, help-seeking etc.; College freshmen who came from countryside was higher than others who came from city in anxiety and psychoticism. When facing problems, college freshmen that came from city more intend to select help-seeking that was a positive coping style than college freshmen who came from countryside; There was no in-teractions between factors of SCL and coping style. 3 Relationship analy-sis of SCL and coping style: There was a certain negative correlation be-tween factors of SCL and problem solving, and the positive correlations ex-isted among each factor of self-blame, fancy and rationalization etc. Conclusion: The mental health level of college freshman is lower than that of Chinese young norm level, and there are closely related of mental problems with appropriate coping styles. Male college freshman intend to select more positive coping styles when they faced pressure, setback, difficult position, compared with the females. On the contrary, female freshmen use more negative, passive fantasy to seek the method of solving problem.",Yuan J.-F.; Qi J.-M.,2005.0,,0,0,
2434,Counseling model of medical students.,"Studied the effect of a 3-in-1 counseling model on the mental health of medical students. The counseling model combined with mental health education, group counseling, and individual counseling was applied to 150 medical college students (freshmen) as a study group in 1-yr intervention. Data from 150 medical college students (freshmen) were collected as a control group. Both groups were assessed with the Eysenck Personal Questionnaire (EPQ), the Symptom Checklist (SCL-90), Gross Well-Being (GWB), Self-Consistency and Congruence Scale (SCCS), Social Avoidance and Distress Scale (SAD), and Life Events Scale for Undergraduates (LESU) at the beginning, in the middle, and at the end of the study. After intervention, the study group presented lower scores of psychoticism in the EPQ than the control group, but increased extraversion scores and had higher score in flexibility than the control group. In the study group, the total scores of the SCL-90 decreased, while in the control group, the scores of social avoidance, distress, and social anxiety increased. The study concludes that the 3-in-1 counseling model can improve personality, reduce psychosomatic symptoms, facilitate self-consistency, and enhance social interaction of medical college students. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Yu, Shaohua; Zhang, Yalin; Luo, Ailan; Hu, Kai; Rogers",2003.0,,0,0,
2435,Mobilization versus massage therapy in the treatment of cervicogenic headache: a clinical study,"ER BACKGROUND AND OBJECTIVE: Cervicogenic headache (CGH) is a common problem associated with neck pain. In this study the effect of cervical mobilizations was compared with that of massage therapy in the management of CGH.DESIGN: Thirty-six subjects with CGH, randomly assigned into two groups, participated in the study. The first group was treated with spinal mobilization techniques of the upper cervical spine, while the second group was treated with massage therapy of the neck region. All subjects underwent active neck range of motion, isometric and dynamic strengthening and endurance exercises in two sessions/week for 6 weeks. Pre- and post-treatment outcomes were assessed with means and standard error of the means of measured headache pain intensity, frequency and duration of headache attacks as well as via the functional Neck Disability Index (NDI) and active neck range of motion.RESULTS: The results of the study showed significant improvement in all measured variables in each treatment group. Comparison between the two groups showed significant differences in all measured variables after intervention in favor of mobilization techniques with the exception of the functional NDI.CONCLUSION: Upper cervical spine mobilization demonstrated more clinical benefits than massage therapy with regard to headache pain parameters and neck mobility for CGH subjects.","Youssef, E F; Shanb, A S",2013.0,10.3233/BMR-2012-0344,0,0,
2436,Bright light treatment for high-anxious young adults: A randomized controlled pilot study.,"Background: Available treatments for anxiety have limitations and/or side effects. The aim of this study was to examine the influence of bright light exposure as a treatment in high-anxious young adults. Methods: In an acute exposure study, participants (n = 33) were randomly assigned to 4Smin of (I) bright light or (2) placebo. Participants then performed a 5-week study (n = 29). Following a 1-week baseline, participants were randomly assigned to 4 weeks of daily exposure to either (1) bright light (45min/day) or (2) placebo treatment, initiated <= l hr after awakening. Before and after the experiment, clinical ratings were conducted with the Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale, and Clinical Global Impressions scale. Following each week, blood pressure, anxiety (Spielberger State-Trait Anxiety Inventory Yl), depression, mood, sleep, and side effects were assessed. Results: No significant treatment effect was found in the acute exposure study. Likewise, in the 5-week study, no significant treatment effect was found. However, bright light elicited marginally greater reductions in psychic symptoms of the HAM-A (P = .06) and other measures. Conclusions: This pilot study provides little compelling evidence for an anxiolytic effect of bright light in high-anxious young adults. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Youngstedt, Shawn D; Kline, Christopher E; Ginsberg, Jay P; Zielinski, Mark R; Hardin, James W; Anderson, Ashkenazy, Avery, Beck, Brainard, Buffett-Jerrott, Buysse, de la Cruz, Deltito, Eastman, First, Goel, Goel, Gooley, Guy, Hamilton, Horne, Hoschl, Kessler, Kohsaka, Kripke, Lewy, Loving, Loving, MacKenzie, McNair, Moscovici, Moscovici, Neumeister, Partonen, Rosenthal, Ruger, Rybak, Scott, Segraves, Silverstone, Snyderman, Spielberger, Tam, Terman, Terman, Terman, Williams, Wirz-Justice, Youngstedt, Youngstedt, Zivin",2011.0,,0,0,
2437,Bright light treatment for high-anxious young adults: a randomized controlled pilot study.,"Available treatments for anxiety have limitations and/or side effects. The aim of this study was to examine the influence of bright light exposure as a treatment in high-anxious young adults. In an acute exposure study, participants (n = 33) were randomly assigned to 45  min of (1) bright light or (2) placebo. Participants then performed a 5-week study (n = 29). Following a 1-week baseline, participants were randomly assigned to 4 weeks of daily exposure to either (1) bright light (45  min/day) or (2) placebo treatment, initiated ≤1 hr after awakening. Before and after the experiment, clinical ratings were conducted with the Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale, and Clinical Global Impressions scale. Following each week, blood pressure, anxiety (Spielberger State-Trait Anxiety Inventory Y1), depression, mood, sleep, and side effects were assessed. No significant treatment effect was found in the acute exposure study. Likewise, in the 5-week study, no significant treatment effect was found. However, bright light elicited marginally greater reductions in psychic symptoms of the HAM-A (P = .06) and other measures. This pilot study provides little compelling evidence for an anxiolytic effect of bright light in high-anxious young adults.",Youngstedt SD.; Kline CE.; Ginsberg JP.; Zielinski MR.; Hardin JW.,2011.0,10.1002/da.20784,0,0,
2438,Therapist A--B score and treatment outcome with psychiatric in patients: a table of random numbers.,"The study evaluated the relationship between therapist personality and treatment success for 141 schizophrenics and 94 non-schizophrenics randomly assigned to short or long hospitalization. The 47 therapists were self-rated on the Whitehorn--Betz A--B scale in both the original and the Campbell versions. Outcome was assessed on the Health--Sickness Rating Scale and the Psychiatric Evaluation Form at discharge and at 1 and 2 year follow-up. The hypothesis of greater success for A--type therapists with schizophrenics was not confirmed, nor were alternative relationships evident in the data.",Young RC.; Glick ID.; Hargreaves WA.; Braff D.; Drues J.,1979.0,,0,0,
2439,Impact of comorbid anxiety in an effectiveness study of interpersonal psychotherapy for depressed adolescents,"ER METHODA randomized clinical trial was conducted from April 1, 1999, through July 31, 2002. Sixty-three depressed adolescents, ages 12 to 18, received either IPT-A or treatment as usual delivered by school-based mental health clinicians. Adolescents with and without probable comorbid anxiety disorders were compared on depression and overall functioning. All analyses used an intent-to-treat design.RESULTSComorbid anxiety was associated with higher depression scores at baseline (p <.01) and poorer depression outcome posttreatment (p <.05). IPT-A was nonsignificantly more effective in treating the depression of adolescents with comorbid anxiety (p =.07). Adolescents whose depression and functioning improved during the course of treatment also showed an improvement in anxiety (p <.01), largely irrespective of treatment condition.CONCLUSIONSAdolescents with comorbid depression and anxiety present with more severe depression and may be more difficult to treat. Structured treatments like IPT-A may be particularly helpful for comorbidly depressed adolescents as compared to supportive therapy.OBJECTIVETo assess the impact of comorbid anxiety on treatment for adolescent depression in an effectiveness study of interpersonal psychotherapy for depressed adolescents (IPT-A).","Young, J F; Mufson, L; Davies, M",2006.0,10.1097/01.chi.0000222791.23927.5f,0,0,
2440,Web-based depression treatment: associations of clients' word use with adherence and outcome,"ER BACKGROUND: The growing number of web-based psychological treatments, based on textual communication, generates a wealth of data that can contribute to knowledge of online and face-to-face treatments. We investigated whether clients' language use predicted treatment outcomes and adherence in Master Your Mood (MYM), an online group course for young adults with depressive symptoms.METHODS: Among 234 participants from a randomised controlled trial of MYM, we tested whether their word use on course application forms predicted baseline levels of depression, anxiety and mastery, or subsequent treatment adherence. We then analysed chat session transcripts of course completers (n=67) to investigate whether word use changes predicted changes in treatment outcomes.RESULTS: Depression improvement was predicted by increasing use of 'discrepancy words' during treatment (e.g. should). At baseline, more discrepancy words predicted higher mastery level. Adherence was predicted by more words used at application, more social words and fewer discrepancy words.LIMITATIONS: Many variables were included, increasing the chance of coincidental results. This risk was constrained by examining only those word categories that have been investigated in relation to depression or adherence.CONCLUSIONS: This is the first study to link word use during treatment to outcomes of treatment that has proven to be effective in an RCT. The results suggest that paying attention to the length of problem articulation at application and to 'discrepancy words' may be wise, as these seem to be psychological markers. To expand knowledge of word use as psychological marker, research on web-based treatment should include text analysis.","Zanden, R; Curie, K; Londen, M; Kramer, J; Steen, G; Cuijpers, P",2014.0,10.1016/j.jad.2014.01.005,0,0,
2441,Hypercarbia versus hypocarbia in panic disorder,"ER In order to compare the panicogenic effects of hypercarbia and hypocarbia in panic disorder (PD), 12 PD patients and 11 healthy controls underwent a 35% CO2 challenge as well as a hyperventilation provocation test in a random cross-over design. Both anxiety and anxiety symptoms proved to be significantly higher during the 35% CO2 challenge in PD patients as compared to the response during 35% CO2 in normals and during hyperventilation in both patients and normals. The results suggest that PD patients are specifically hypersensitive to an increase in pCO2.","Zandbergen, J; Lousberg, H H; Pols, H; Loof, C; Griez, E J",1990.0,,0,0,
2442,Change in obsessive-compulsive symptoms mediates subsequent change in depressive symptoms during exposure and response prevention.,"The current study examines the temporal relationship between changes in obsessive-compulsive symptoms and changes in depressive symptoms during exposure and response prevention (EX/RP) therapy for obsessive-compulsive disorder (OCD). Participants were 40 adults (53% female) who received EX/RP in a randomized controlled trial comparing serotonin reuptake inhibitor (SRI) augmentation strategies. Participants completed clinician-administered assessments of OCD (Yale-Brown Obsessive Compulsive Scale) and depressive symptoms (Hamilton Depression Rating Scale) every four weeks from baseline to 32-week follow-up. Lagged multilevel mediational analyses indicated that change in OCD symptoms accounted for 65% of subsequent change in depressive symptoms. In contrast, change in depressive symptoms only partially mediated subsequent change in OCD symptoms, accounting for 20% of the variance in outcome. These data indicate that reductions in co-morbid depressive symptoms during EX/RP for OCD are largely driven by reductions in obsessive-compulsive symptoms.",Zandberg LJ.; Zang Y.; McLean CP.; Yeh R.; Simpson HB.; Foa EB.,2015.0,10.1016/j.brat.2015.03.005,0,0,
2443,Concurrent treatment of posttraumatic stress disorder and alcohol dependence: Predictors and moderators of outcome.,"The present study examined predictors and moderators of treatment response among 165 adults meeting Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria for comorbid posttraumatic stress disorder (PTSD) and alcohol dependence (AD), who were randomized to 24 weeks of Naltrexone (NAL), NAL and prolonged exposure (PE), pill placebo, or pill placebo and PE. All participants received supportive counseling for alcohol use. Six domains of predictors or moderators (23 variables) were evaluated using measures of PTSD (Posttraumatic Stress Symptom Scale Interview) and AD (days drinking from the timeline follow-back interview) collected every 4 weeks throughout treatment. Multilevel modeling with the Fournier approach was used to evaluate predictors and moderators of rates of symptom improvement and posttreatment outcomes. Combat trauma, sexual assault trauma, and higher baseline anxiety sensitivity predicted slower improvement and poorer PTSD outcome. Combat trauma, White race, and higher baseline drinking severity predicted poorer drinking outcome. PTSD severity moderated the efficacy of PE on PTSD outcomes, such that the benefit of PE over no-PE was greater for participants with higher baseline PTSD severity. Baseline depressive severity moderated the efficacy of PE on drinking outcomes, whereby the benefit of PE over no-PE was greater for participants with higher depressive symptoms. NAL effects were most beneficial for those with the longest duration of AD. These results suggest that concurrent, trauma-focused treatment should be recommended for PTSD-AD patients who present with moderate or severe baseline PTSD and depressive symptoms. Future research should examine the mechanisms underlying poorer outcome among identified subgroups of PTSD-AD patients.",Zandberg LJ.; Rosenfield D.; McLean CP.; Powers MB.; Asnaani A.; Foa EB.,2016.0,10.1037/ccp0000052,0,0,
2444,Predictors of dropout in concurrent treatment of posttraumatic stress disorder and alcohol dependence: Rate of improvement matters.,"The present study examined predictors and moderators of dropout among 165 adults meeting DSM-IV criteria for posttraumatic stress disorder (PTSD) and alcohol dependence (AD). Participants were randomized to 24 weeks of naltrexone (NAL), NAL and prolonged exposure (PE), pill placebo, or pill placebo and PE. All participants received supportive AD counseling (the BRENDA manualized model). Logistic regression using the Fournier approach was conducted to investigate baseline predictors of dropout across the entire study sample. Rates of PTSD and AD symptom improvement were included to evaluate the impact of symptom change on dropout. Trauma type and rates of PTSD and AD improvement significantly predicted dropout, accounting for 76% of the variance in dropout. Accidents and ""other"" trauma were associated with the highest dropout, and physical assault was associated with the lowest dropout. For participants with low baseline PTSD severity, faster PTSD improvement predicted higher dropout. For those with high baseline severity, both very fast and very slow rates of PTSD improvement were associated with higher dropout. Faster rates of drinking improvement predicted higher dropout among participants who received PE. The current study highlights the influence of symptom trajectory on dropout risk. Clinicians may improve retention in PTSD-AD treatments by monitoring symptom change at regular intervals, and eliciting patient feedback on these changes.",Zandberg LJ.; Rosenfield D.; Alpert E.; McLean CP.; Foa EB.,2016.0,10.1016/j.brat.2016.02.005,0,0,
2445,Prevention of delirium (POD) for older people in hospital: study protocol for a randomised controlled feasibility trial,"ER METHODS/DESIGN: The Prevention of Delirium Study is a multicentre, cluster randomised feasibility study designed to explore the potential effectiveness and cost-effectiveness of the Prevention of Delirium Programme. Sixteen elderly care medicine and orthopaedic/trauma wards in eight National Health Service acute hospitals will be randomised to receive the Prevention of Delirium Programme or usual care. Patients will be eligible for the trial if they have been admitted to a participating ward and are aged 65 years or over. The primary objectives of the study are to provide a preliminary estimate of the effectiveness of the Prevention of Delirium Programme as measured by the incidence of new onset delirium, assess the variability of the incidence of new-onset delirium, estimate the intracluster correlation coefficient and likely cluster size, assess barriers to the delivery of the Prevention of Delirium Programme system of care, assess compliance with the Prevention of Delirium Programme system of care, estimate recruitment and follow-up rates, assess the degree of contamination due to between-ward staff movements, and investigate differences in financial costs and benefits between the Prevention of Delirium Programme system of care and standard practice. Secondary objectives are to investigate differences in the number, severity and length of delirium episodes (including persistent delirium); length of stay in hospital; in-hospital mortality; destination at discharge; health-related quality of life and health resource use; physical and social independence; anxiety and depression; and patient experience.DISCUSSION: This feasibility study will be used to gather data to inform the design of a future definitive randomised controlled trial.TRIAL REGISTRATION: ISRCTN01187372 . Registered 13 March 2014.BACKGROUND: Delirium is the most frequent complication among older people following hospitalisation. Delirium may be prevented in about one-third of patients using a multicomponent intervention. However, in the United Kingdom, the National Health Service has no routine delirium prevention care systems. We have developed the Prevention of Delirium Programme, a multicomponent delirium prevention intervention and implementation process. We have successfully carried out a pilot study to test the feasibility and acceptability of implementation of the programme. We are now undertaking preliminary testing of the programme.","Young, J; Cheater, F; Collinson, M; Fletcher, M; Forster, A; Godfrey, M; Green, J; Anwar, S; Hartley, S; Hulme, C; Inouye, S K; Meads, D; Santorelli, G; Siddiqi, N; Smith, J; Teale, E; Farrin, A J",2015.0,10.1186/s13063-015-0847-2,0,0,
2446,Soft contact lens-related dryness with and without clinical signs,"ER PURPOSE: To report demographics, wearing patterns, and symptoms from soft contact lens (SCL) wearers with significant SCL-related dryness symptoms with and without significant ocular signs of dryness.METHODS: In a multicenter, prospective observational clinical trial, symptomatic SCL wearers reported significant SCL-related dryness via self-administered questionnaire of frequency and intensity of dryness after a dry eye (DE) examination. DE etiology was assigned post hoc by an expert panel, and those with and without significant DE-related signs were analyzed by univariate logistic regression. Possible DE etiologies were aqueous tear deficiency, SCL-induced tear instability, meibomian gland dysfunction, or ""other."" Wearers without signs that qualified for any DE etiology were designated as No DE Signs (NDES).RESULTS: Of the 226 SCL symptomatic wearers examined, 23% were without signs, 30% had aqueous tear deficiency, 25% had SCL-induced tear instability, 14% had meibomian gland dysfunction, and 8% had ""other"" diagnoses. The NDES wearers had significantly longer pre-lens break-up time (9.8 vs. 6.6 s, p < 0.0001), better lens wetting (3.4 vs. 2.4 0 to 4 scale, p < 0.0001), lower levels of film deposits on lenses (0.45 vs. 0.92, 0 to 4 scale, p < 0.0001), and of most slit lamp signs. The NDES wearers were significantly more likely to be male (36% vs.19%, p = 0.013), were less likely to have deteriorating comfort during the day (81% vs. 97%, p = 0.001), reported longer average hours of comfortable wear (11 ± 3 vs. 9 ± 4 h, p = 0.014), had older contact lenses (18 ± 14 vs. 13 ± 12 days, p = 0.029), and greater intensity of photophobia early and late in the day (p = 0.043 and 0.021).CONCLUSIONS: Symptoms of dryness in SCL wearers stem from a variety of underlying causes. However, nearly one-quarter of these symptomatic SCL wearers appear to be free of signs of dryness. The effective management of CL-related dryness requires a comprehensive range of clinical assessments and the use of a diverse range of management strategies.","Young, G; Chalmers, R; Napier, L; Kern, J; Hunt, C; Dumbleton, K",2012.0,10.1097/OPX.0b013e3182640af8,0,0,
2447,An experimental investigation of modeling and verbal reinforcement in the modification of assertive behavior,,"Young, E R; Rimm, D C; Kennedy, T D",1973.0,,0,0,
2448,A single blind randomized control trial on support groups for Chinese persons with mild dementia,"ER RESEARCH METHODS: Participants were randomly assigned to either a ten-session support group or a control group. Standardized assessment tools were used for data collection at pretreatment and post-treatment periods by a research assistant who was kept blind to the group assignment of the participants. Upon completion of the study, 20 treatment group participants and 16 control group participants completed all assessments.RESULTS: At baseline, the treatment and control groups did not show any significant difference on all demographic variables, as well as on all baseline measures; over one-half (59%) of all the participants reported having depression, as assessed by a Chinese Geriatric Depression Scale score ?8. After completing the support group, the depressive mood of the treatment group participants reduced from 8.83 (standard deviation =2.48) to 7.35 (standard deviation =2.18), which was significant (Wilcoxon signed-rank test; P=0.017, P<0.05), while the control group's participants did not show any significant change.CONCLUSION: This present study supports the efficacy and effectiveness of the support group for persons with mild dementia in Chinese society. In particular, this present study shows that a support group can reduce depressive symptoms for participants.PURPOSE: Persons with mild dementia experience multiple losses and manifest depressive symptoms. This research study aimed to evaluate the effectiveness of a support group led by a social worker for Chinese persons with mild dementia.","Young, D K; Kwok, T C; Ng, P Y",2014.0,10.2147/CIA.S68687,0,0,
2449,Seven-year outcome following Colles' type distal radial fracture. A comparison of two treatment methods.,"Eighty-five patients were reviewed 7 years after prospective randomization to bridging external fixation or plaster immobilization for treatment of a Colles' type distal radial fracture. The Gartland and Werley score showed that most patients in each group had an excellent or good outcome and patient satisfaction was comparable and high in both groups. The fixator group had significantly less radial shortening (P<0.05). Despite a high level of radiographic malunion (50%) overall function, range of movement and activities of daily living were not limited. Twenty-five per cent of patients had minor radiological signs of post-traumatic arthritis although only one patient was symptomatic. We conclude that, in the long term, external fixation of distal radius fractures does not confer an improved outcome when compared to plaster immobilization.",Young CF.; Nanu AM.; Checketts RG.,2003.0,,0,0,
2450,Failure of prophylactically administered phenytoin to prevent post-traumatic seizures in children,"ER We report the results of a randomized, double-blind, placebo-controlled study to determine whether phenytoin administered soon after a head injury lessens the incidence of late post-traumatic epilepsy in children. 41 patients were randomized into either a phenytoin or placebo group and followed for 18 months. The patients were administered phenytoin or placebo intravenously or intramuscularly within 24 h of hospital admission. The patients were parenterally administered phenytoin or placebo until oral doses could be tolerated. There was no significant difference in the percentage of children having seizures in the treated and placebo groups (p = 0.25).","Young, B; Rapp, R P; Norton, J A; Haack, D; Walsh, J W",1983.0,,0,0,
2451,Failure of prophylactically administered phenytoin to prevent early posttraumatic seizures,"ER A randomized double-blind placebo-controlled study was carried out to determine whether phenytoin administered soon after injury lessens the incidence of epilepsy in the 1st week after severe head trauma. In this study, 244 patients were randomized into either a phenytoin or placebo group. The patients in the phenytoin group were administered phenytoin intravenously or intramuscularly within 24 hours of hospital admission. Patients in the placebo group received intravenous or intramuscular diluent. The patients were switched from parenterally administered phenytoin or placebo as soon as oral doses could be tolerated. Over 78% of the phenytoin patients had plasma concentrations of at least 10 micrograms/ml at 1, 3, and 7 days after injury. There was no significant difference in the percentage of patients having early seizures in the treated and placebo groups (p = 0.99). There was no significant difference in the interval from injury to first seizure between the treated and placebo groups (p = 0.41). The early administration of phenytoin did not lessen the occurrence of seizures in the 1st week after head injury. Since the effectiveness of seizure prophylaxis has not been established, the authors suggest that anticonvulsant drugs be administered only after an early seizure has occurred.","Young, B; Rapp, R P; Norton, J A; Haack, D; Tibbs, P A; Bean, J R",1983.0,10.3171/jns.1983.58.2.0231,0,0,
2452,Failure of prophylactically administered phenytoin to prevent late posttraumatic seizures,"ER This randomized double-blind placebo-controlled study was undertaken in a series of 179 patients to determine whether phenytoin administered soon after head injury lessens the incidence of late posttraumatic epilepsy. When delayed hypersensitivity to phenytoin developed, the patient was switched to phenobarbital. The patients were followed for 18 months to detect the occurrence of seizures and to serially measure plasma phenytoin concentrations. There was no significant difference in the percentage of patients having late seizures in the treated and placebo groups (p = 0.75). The time between injury and seizures did not significantly differ between the two groups. The results provide no support for the continued use of phenytoin in the low therapeutic range for prophylaxis against late posttraumatic seizures. It cannot be concluded that higher phenytoin plasma concentrations and higher compliance rates than obtained in this study would not have significantly decreased the occurrence of late posttraumatic epilepsy. The finding that no patient with a phenytoin plasma concentration of 12 microgram/ml or higher had a seizure raises the question of whether phenytoin in blood concentrations in higher therapeutic ranges might lessen the occurrence of posttraumatic epilepsy, and should be studied further. Posttraumatic epilepsy is a major public health problem deserving a large cooperative trial to determine if phenytoin at higher blood levels than obtained in this study, or other currently available or newly developed drugs, can prevent the occurrence of posttraumatic epilepsy.","Young, B; Rapp, R P; Norton, J A; Haack, D; Tibbs, P A; Bean, J R",1983.0,10.3171/jns.1983.58.2.0236,0,0,
2453,Impact of shared mental health care in the general population on subjects' perceptions of mental health care and on mental health status.,"A community survey evaluated whether the development of a shared mental health care intervention had an impact on health care perceptions and mental health status of subjects with common mental health problems (MHP). Adults <70 years old with common MHP (DSM-IV/CIDI-SF major depressive disorder, generalized anxiety or MHI-SF 36 psychic distress diagnoses), were randomly drawn from the general population in the intervention area (IA, n = 349) and in a control area (CA, n = 360), and evaluated twice at an interval of 18 months (percentage of follow-up: IA = 69.3%, CA = 71.9%, P = .44). CA and IA groups did not differ for the criteria of interest at baseline. At 18 months, compared to CA, IA reported significantly different help-seeking attitudes or behaviours (P = .02 for all subjects and .006 for subjects with current MHP) and greater general satisfaction with care (P = .03 for both). Remission rates and daily life functioning did not differ. After 4 years of development of a mental health network based on a consultation-liaison model, Shared Mental Health Care was associated with greater satisfaction and access with care among subjects with common MHP. The association was not found with mental health status, but the study lacked power to adequately address the issues.",Younès N.; Hardy-Bayle MC.; Falissard B.; Kovess V.; Gasquet I.,2008.0,10.1007/s00127-007-0285-x,0,0,
2454,Effective and less effective therapists for generalized anxiety disorder: Are they conducting therapy the same way?,"The current study uses data from a randomized controlled trial (RCT) aimed at determining whether cognitive-behavioral therapy (CBT) for generalized anxiety disorder (GAD) could be improved by the addition of techniques targeting GAD difficulties not systematically addressed in traditional CBT. Briefly, research suggests that individuals with GAD worry, in part, to avoid emotional processing (Borkovec, Alcaine, & Behar, 2004; Newman & Llera, 2011). Interestingly, research and conceptual critiques of CBT (e.g., Mahoney, 1980; Wiser & Goldfried, 1993) point out that interventions in this approach are used to control or reduce affect, thereby reinforcing the maladaptive function of worry-the primary symptom of GAD. In addition, research has demonstrated that GAD is associated with a wide range of past and current interpersonal problems, and that a high level of interpersonal difficulties post CBT-treatment is linked with higher relapse (Newman, Castonguay, Borkovec, & Molnar, 2004). Process research shows that CBT tends to focus more on intrapersonal (e.g., thoughts) than on interpersonal issues (e.g., Castonguay, Hayes, Goldfried, & DeRubeis, 1995), thereby reducing its ability to address variables involved in the etiology or maintenance of GAD. Aggregating these psychopathology and psychotherapy factors together, one way to improve the efficacy of CBT for GAD would be to add humanistic, psychodynamic, and interpersonal interventions to its protocols, developed to foster the deepening of emotions and to facilitate the fulfillment of interpersonal needs. On the basis of this reasoning, a theoretically driven combination of CBT and non-CBT interventions was built in an integrative therapy manual (which is described in the Method section of this chapter and more fully in Newman et al., 2004). (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Youn, Soo Jeong; Xiao, Henry; Kim, Hanjoo; Castonguay, Louis G; McAleavey, Andrew A; Newman, Michelle G; Safran, Jeremy D; Baldwin, Borkovec, Brown, Castonguay, Goldfried, Hamilton, Heide, Hill, Jackson, Mahoney, Meyer, Newman, Newman, Newman, Newman, Orlinsky, Spielberger, Strupp, Strupp, Strupp, Strupp, Wiser; Castonguay, Louis G [Ed], Hill, Clara E [Ed]",2017.0,,0,0,
2455,Cognitive behaviour therapy using the Clark & Wells model: A case study of a Japanese social anxiety disorder patient.,"Cognitive behaviour therapy (CBT) is widely regarded as an effective treatment for social anxiety disorder (SAD) in Europe and North America. The theoretical orientations underlying CBT models and treatment interventions developed in Western cultures were typically constrained by Western conceptualizations of SAD. This case study reports on the use of CBT for Japanese SAD, demonstrating the successful implementation of cognitive techniques grounded in the Clark & Wells model. The patient was a Japanese female with excessively high standards for workplace social performance. Therapy mainly comprised case formulation, behavioural experiments, and opinion surveying based on the Clark & Wells model. These techniques allowed the patient to reduce the strength of maladaptive cognitions and lower her excessively high standards for social performance. CBT treatment using the Clark & Wells model was effective and suitable for Japanese SAD, at least in the present case. We also discuss the cross-cultural differences of SAD and adaptation of CBT. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Yoshinaga, Naoki; Kobori, Osamu; Iyo, Masaomi; Shimizu, Eiji; Clark, Draguns, Higuchi, Hofmann, Hofmann, Jenkins, Kleinknecht, Klopf, Liebowitz, Munekata, Ono, Roland, Shear, Stein, Watanabe, Yoshinaga",2013.0,,0,0,
2456,"A preliminary study of individual cognitive behavior therapy for social anxiety disorder in Japanese clinical settings: a single-arm, uncontrolled trial.","Cognitive behavior therapy (CBT) is regarded as an effective treatment for social anxiety disorder (SAD) in Europe and North America. Individual CBT might be acceptable and effective for patients with SAD even in non-Western cultures; therefore, we conducted a feasibility study of individual CBT for SAD in Japanese clinical settings. We also examined the baseline predictors of outcomes associated with receiving CBT. This single-arm trial employed a 14-week individual CBT intervention. The primary outcome was the self-rated Liebowitz Social Anxiety Scale, with secondary measurements of other social anxiety and depressive severity. Assessments were conducted at baseline, after a waiting period before CBT, during CBT, and after CBT. Of the 19 subjects screened, 15 were eligible for the study and completed the outcome measures at all assessment points. Receiving CBT led to significant improvements in primary and secondary SAD severity (ps < .001). The mean total score on the Liebowitz Social Anxiety Scale improved from 91.8 to 51.7 (before CBT to after CBT), and the within-group effect size at the end-point assessment was large (Cohen's d = 1.71). After CBT, 73% of participants were judged to be treatment responders, and 40% met the criteria for remission. We found no significant baseline predictors of those outcomes. Despite several limitations, our treatment-which comprises a 14-week, individual CBT program-seems feasible and may achieve favorable treatment outcomes for SAD in Japanese clinical settings. Further controlled trials are required in order to address the limitations of this study. UMIN-CTR UMIN000005897.",Yoshinaga N.; Ohshima F.; Matsuki S.; Tanaka M.; Kobayashi T.; Ibuki H.; Asano K.; Kobori O.; Shiraishi T.; Ito E.; Nakazato M.; Nakagawa A.; Iyo M.; Shimizu E.,2013.0,10.1186/1756-0500-6-74,0,0,
2457,What are the roles of perfectionism and responsibility in checking and cleaning compulsions?,"Empirical findings revealed that an inflated sense of responsibility has a major impact on obsessive-compulsive symptomatology (OCS). Another cognitive variable, perfectionism, is also theoretically linked to OCS. The assumption about the insufficient but necessary role of perfectionism for OCS and the view of perfectionism as a manifestation of avoidance of serious consequences led us to explore the role of an important cognitive mediator (responsibility) in this relationship. The present study aimed to explore the mediational role of responsibility for the effects of perfectionism on checking and cleaning symptom profiles of OCS in a nonclinical population in Turkey. Findings of the present study suggested that responsibility appraisals mediate effects of self-oriented and socially prescribed perfectionism on checking and the effect of socially prescribed perfectionism on cleaning. There was a partial mediation for self-oriented perfectionism on cleaning. The findings are discussed within the scope of current literature and implications for clinical applications are suggested. © 2005 Elsevier Inc. All rights reserved.",Yorulmaz O.; Karanci A.N.; Tekok-Kiliç A.,2006.0,10.1016/j.janxdis.2005.02.009,0,0,
2458,The role of magical thinking in Obsessive-Compulsive Disorder symptoms and cognitions in an analogue sample,"Background and objectives: In addition to clinical observations exemplifying biased reasoning styles (e.g., overemphasis of thoughts) and particular ritualistic behaviors, it is also empirically supported that magical beliefs are also associated with Obsessive-Compulsive Disorder (OCD) symptoms and some cognitions. It should be noted, however, that most empirical studies have been carried out on the samples from Western cultures, even though these beliefs were culturally determined. Thus, more research is needed in order to understand their roles in the OCD symptoms in different cultural contexts. The present study aimed to examine the impact of magical beliefs in OCD symptoms, cognitions and thought control in a non-Western analogue sample from Turkey. Method: The measures of paranormal beliefs, fusion of thoughts-actions, obsessive beliefs, strategies of thought control and OCD symptoms were administered to an undergraduate sample. Result: Consistent with findings in the literature, the analyses of group comparisons, correlation and regression showed that even after controlling general negative affect, magical beliefs were still associated with OCD symptoms, some beliefs and control strategies, namely the symptoms of obsessional thoughts and checking, fusions of thoughts and actions in likelihood, faulty beliefs in perfectionism-certainty and punishment. Limitations: Some methodological concerns such as cross-sectional nature, inclusion of only non-clinical sample were major restrictions of the present study. Conclusion: Evidence that magical thinking is a critical factor in the OCD is supported once more in a different cultural context. © 2010 Elsevier Ltd. All rights reserved.",Yorulmaz O.; Inozu M.; Gültepe B.,2011.0,10.1016/j.jbtep.2010.11.007,0,0,
2459,Verbal desensitisation in bronchial asthma,,"Yorkston, N J; McHugh, R B; Brady, R; Serber, M; Sergeant, H G",1974.0,,0,0,
2460,Modified magnetic resonance image based parcellation method for cerebral cortex using successive fuzzy clustering and boundary detection.,"Development of the accurate and reproducible parcellation of the human brain can be used to resolve the complex structure-functional relationships in the brain. We propose a modified parcellation method that provides the reliable and reproducible regions of interest using successive fuzzy c-means (sFCM) and boundary-detection algorithm. This method displays simultaneously both original brain image for identifying the sulcal landmarks and its tissue-classified image for referring to patterns of sulci. The whole cerebral region is extracted by the semiautomated region growing method and then classified to gray matter, white matter, and cerebrospinal fluid by sFCM. Referred to the other previous researches, the volume ratio of gray matter to white matter was shown to find that the efficiency of classification was improved (conventional FCM: 0.80 +/- 0.12 vs. sFCM: 1.57 +/- 0.18). Inter-rater reliability, estimated by the regression analysis, demonstrated that the proposed method was more reliable and reproducible than conventional methods [ANALYZE: correlation coefficient (CC)=0.341, Sig.=0.335 vs. proposed method: CC=0.816, Sig.=0.004]. The volume ratio of the whole cerebrum to the parceled object can be used to investigate structural abnormalities for the pathological detection of the various mental diseases such as schizophrenia, obsessive-compulsive disorder.",Yoon U.; Lee JM.; Kim JJ.; Lee SM.; Kim IY.; Kwon JS.; Kim SI.,2003.0,,0,0,
2461,Working memory capacity and spontaneous emotion regulation in generalised anxiety disorder,"Researchers have postulated that deficits in cognitive control are associated with, and thus may underlie, the perseverative thinking that characterises generalised anxiety disorder (GAD). We examined associations between cognitive control and levels of spontaneous state rumination following a stressor in a sample of healthy control participants (CTL; n‚Äâ=‚Äâ27) and participants with GAD (n‚Äâ=‚Äâ21). We assessed cognitive control by measuring working memory capacity (WMC), defined as the ability to maintain task-relevant information by ignoring task-irrelevant information. To this end, we used an affective version of the reading span task with valenced (negative or neutral) distractors. Lower WMC in the presence of negative distractors was associated with greater state rumination in the GAD group, but not in the CTL group. These findings suggest that difficulty maintaining task-relevant information due to interference from negative distractors contributes to perseverative thinking in GAD.",Yoon K.L.; LeMoult J.; Hamedani A.; McCabe R.,2017.0,10.1080/02699931.2017.1282854,0,0,
2462,Usefulness of mindfulness-based cognitive therapy for treating insomnia in patients with anxiety disorders: a pilot study.,"The objective of this study was to examine the usefulness of a mindfulness-based cognitive therapy (MBCT) for treating insomnia symptoms in patients with anxiety disorder. Nineteen patients with anxiety disorder were assigned to an 8-week MBCT clinical trial. Participants showed significant improvement in Pittsburgh Sleep Quality Index (Z = -3.46, p = 0.00), Penn State Worry Questionnaire (Z = -3.83, p = 0.00), Ruminative Response Scale (Z = -3.83, p = 0.00), Hamilton Anxiety Rating Scale (Z = -3.73, p = 0.00), and Hamilton Depression Rating Scale scores (Z = -3.06, p = 0.00) at the end of the 8-week program as compared with baseline. Multiple regression analysis showed that baseline Penn State Worry Questionnaire scores were associated with baseline Pittsburgh Sleep Quality Index scores. These findings suggest that MBCT can be effective at relieving insomnia symptoms by reducing worry associated sleep disturbances in patients with anxiety disorder. However, well-designed, randomized, controlled trials are needed to confirm our findings.",Yook K.; Lee SH.; Ryu M.; Kim KH.; Choi TK.; Suh SY.; Kim YW.; Kim B.; Kim MY.; Kim MJ.,2008.0,10.1097/NMD.0b013e31817762ac,0,0,
2463,A randomized controlled trial of the Korean version of the PEERS(®) parent-assisted social skills training program for teens with ASD,"ER Impaired social functioning is a hallmark feature of autism spectrum disorder (ASD), often requiring treatment throughout the life span. PEERS(®) (Program for the Education and Enrichment of Relational Skills) is a parent-assisted social skills training for teens with ASD. Although PEERS(®) has an established evidence base in improving the social skills of adolescents and young adults with ASD in North America, the efficacy of this treatment has yet to be established in cross-cultural validation trials. The objective of this study is to examine the feasibility and treatment efficacy of a Korean version of PEERS(®) for enhancing social skills through a randomized controlled trial (RCT).The English version of the PEERS(®) Treatment Manual (Laugeson & Frankel, 2010) was translated into Korean and reviewed by 21 child mental health professionals. Items identified as culturally sensitive were surveyed by 447 middle school students, and material was modified accordingly. Participants included 47 teens between 12 and 18 years of age with a diagnosis of ASD and a verbal intelligence quotient (IQ) ? 65. Eligible teens were randomly assigned to a treatment group (TG) or delayed treatment control group (CG). Primary outcome measures included questionnaires and direct observations quantifying social ability and problems directly related to ASD. Secondary outcome measures included scales for depressive symptoms, anxiety, and other behavioral problems. Rating scales for parental depressive symptoms and anxiety were examined to detect changes in parental psychosocial functioning throughout the PEERS(®) treatment. Independent samples t-tests revealed no significant differences at baseline across the TG and CG conditions with regard to age (14.04 ± 1.64 and 13.54 ± 1.50 years), IQ (99.39 ± 18.09 & 100.67 ± 16.97), parental education, socioeconomic status, or ASD symptoms (p < 0.05), respectively. Results for treatment outcome suggest that the TG showed significant improvement in communication and social interaction domain scores on the Autism Diagnostic Observation Schedule, interpersonal relationship and play/leisure time on the subdomain scores of the Korean version of the Vineland Adaptive Behavior Scale (p's < 0.01), social skills knowledge total scores on the Test of Adolescent Social Skills Knowledge-Revised (p < 0.01), and decreased depressive symptoms on the Child Depression Inventory following treatment (p < 0.05). Analyses of parental outcome reveal a significant decrease in maternal state anxiety in the TG after controlling for potential confounding variables (p < 0.05). Despite cultural and linguistic differences, the PEERS(®) social skills intervention appears to be efficacious for teens with ASD in Korea with modest cultural adjustment. In an RCT, participants receiving the PEERS(®) treatment showed significant improvement in social skills knowledge, interpersonal skills, and play/leisure skills, as well as a decrease in depressive symptoms and ASD symptoms. This study represents one of only a few cross-cultural validation trials of an established evidence-based treatment for adolescents with ASD.","Yoo, H J; Bahn, G; Cho, I H; Kim, E K; Kim, J H; Min, J W; Lee, W H; Seo, J S; Jun, S S; Bong, G; Cho, S; Shin, M S; Kim, B N; Kim, J W; Park, S; Laugeson, E A",2014.0,10.1002/aur.1354,0,0,
2464,Prolonged exposure therapy for combat-related posttraumatic stress disorder: Comparing outcomes for veterans of different wars.,"There is significant support for exposure therapy as an effective treatment for posttraumatic stress disorder (PTSD) across a variety of populations, including veterans; however, there is little empirical information regarding how veterans of different war theaters respond to exposure therapy. Accordingly, questions remain regarding therapy effectiveness for treatment of PTSD for veterans of different eras. Such questions have important implications for the dissemination of evidence based treatments, treatment development, and policy. The current study compared treatment outcomes across 112 veterans of the Vietnam War, the first Persian Gulf War, and the wars in Afghanistan and Iraq. All subjects were diagnosed with PTSD and enrolled in Prolonged Exposure (PE) treatment. Veterans from all three groups showed significant improvement in PTSD symptoms, with veterans from Vietnam and Afghanistan/Iraq responding similarly to treatment. Persian Gulf veterans did not respond to treatment at the same rate or to the same degree as veterans from the other two eras. Questions and issues regarding the effectiveness of evidence based treatment for veterans from different eras are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Yoder, Matthew; Tuerk, Peter W; Price, Matthew; Grubaugh, Anouk L; Strachan, Martha; Myrick, Hugh; Acierno, Ron; Allison, Beck, Blake, Blanchard, Bradley, Cason, Chard, Cigrang, Cloitre, Cooper, First, Foa, Fontana, Glynn, Keane, Orsillo, Rauch, Rubin, Seal, Steer, Tuerk, Tuerk",2012.0,,0,0,
2465,Effect of neck exercises on cervicogenic headache: a randomized controlled trial,"ER METHODSA total of 180 female office workers, with chronic, non-specific neck pain were randomly assigned to 3 groups. The strength group performed isometric, dynamic and stretching exercises. The endurance group performed dynamic muscle and stretching exercises. The control group performed stretching exercises. Pain was assessed with a visual analogue scale. Each group was divided into 3 subgroups according to headache intensity.RESULTSAt the 12-month follow-up headache had decreased by 69% in the strength group, 58% in the endurance group and 37% in the control group compared with baseline. Neck pain diminished most in the strength group with the most severe headache (p < 0.001). In the dose analysis, one metabolic equivalent per hour of training per week accounted for a 0.6-mm decrease in headache on the visual analogue scale. Upper extremity pain decreased by 58% in the strength group, 70% in the endurance group and 21% in the control group.CONCLUSIONAll of the training methods decreased headache. However, stretching, which is often recommended for patients, was less effective alone than when combined with muscle endurance and strength training. Care must be taken in recommending the type of training to be undertaken by patients with severe cervicogenic headache.OBJECTIVETo compare the efficacy of three 12-month training programmes on headache and upper extremity pain in patients with chronic neck pain.","Ylinen, J; Nikander, R; Nykänen, M; Kautiainen, H; Häkkinen, A",2010.0,10.2340/16501977-0527,0,0,
2466,"Illness, cytokines, and depression","ER Various medical conditions that involve activation of the immune system are associated with psychological and neuroendocrine changes that resemble the characteristics of depression. In this review we present our recent studies, designed to investigate the relationship between the behavioral effects of immune activation and depressive symptomatology. In the first set of experiments, we used a double-blind prospective design to investigate the psychological consequences of illness in two models: (1) vaccination of teenage girls with live attenuated rubella virus, and (2) lipopolysaccharide (LPS) administration in healthy male volunteers. In the rubella study, we demonstrated that, compared to control group subjects and to their own baseline, a subgroup of vulnerable individuals (girls from low socioeconomic status) showed a significant virus-induced increase in depressed mood up to 10 weeks after vaccination. In an ongoing study on the effects of LPS, we demonstrated significant LPS-induced elevation in the levels of depression and anxiety as well as memory deficits. These psychological effects were highly correlated with the levels of LPS-induced cytokine secretion. In parallel experiments, we demonstrated in rodents that immune activation with various acute and chronic immune challenges induces a depressive-like syndrome, characterized by anhedonia, anorexia, body weight loss, and reduced locomotor, exploratory, and social behavior. Chronic treatment with antidepressants (imipramine or fluoxetine) attenuated many of the behavioral effects of LPS, as well as LPS-induced changes in body temperature, adrenocortical activation, hypothalamic serotonin release, and the expression of splenic TNF-alpha mRNA. Taken together, these findings suggest that cytokines are involved in the etiology and symptomatology of illness-associated depression.","Yirmiya, R; Pollak, Y; Morag, M; Reichenberg, A; Barak, O; Avitsur, R; Shavit, Y; Ovadia, H; Weidenfeld, J; Morag, A; Newman, M E; Pollmächer, T",2000.0,,0,0,
2467,Effect of exercise combined with encouragement on quality of life of patients with chronic obstructive pulmonary disease,"ER OBJECTIVE: To explore the effect of rehabilitation exercise combined with encouragement on the quality of life of patients with chronic obstructive pulmonary disease (COPD).METHODS: A total of 120 inpatients with moderate or severe COPD in stable conditions were randomized equally into experimental and control groups. The patients in both groups received routine treatment for 1 year, and those in the experimental group had additional respiratory muscle and limb exercises with encouragement. The quality of life, 6-min walking distance, lung function, anxiety and depression levels were compared between the two groups before and after the treatments.RESULTS: The quality of life was improved significantly in the experimental group after the treatments (P<0.01) with obviously increased 6-min walking distance and lowered levels of anxiety and depression in comparison with those in the control group (P<0.05). Compared with the control group, the patients in the experimental group showed also significantly improved lung functions.CONCLUSION: Comprehensive pulmonary rehabilitation training program with exercise combined with encouragement can improve the physical and emotional state, social adapt ability and the quality of life of patients with COPD.","Ying, S; Zhou, X; Zhou, L; Hu, X; Liu, Y",2013.0,,0,0,
2468,Experimental manipulation of the Trier Social Stress Test-Modified (TSST-M) to vary arousal across development,"ER Reliable laboratory protocols manipulating the intensity of biobehavioral arousal for children are uncommon, and those available have minimal converging evidence of their efficacy in manipulating arousal across multiple biological systems. This report presents two studies of the efficacy of the modified Trier Social Stress Test (TSST-M). In Study 1, sixty-three 7-15-year olds, and 19 young adults (18-25 yrs) completed the TSST-M. Comparable reactivity across age groups was observed for salivary cortisol, salivary alpha-amylase (sAA), pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA), whereas self-reported stress was higher in adults compared to children. In Study 2, eighty-four 7-8-year olds and eighty-six 12-15-year olds were randomly assigned to a standard or low-stress TSST-M condition. Cortisol and self-reported stress responses were higher in the standard compared to the low-stress condition. In contrast, sAA and PEP were higher in the low-stress condition and RSA responses were comparable between the two TSST-M conditions. In addition, age group differences emerged in Study 2, though never in conjunction with the TSST-M manipulation. To test, refine, and advance theory about the implications of stress for child development, laboratory tasks that manipulate and enable assessment of biobehavioral arousal in children are needed.","Yim, I S; Quas, J A; Rush, E B; Granger, D A; Skoluda, N",2015.0,10.1016/j.psyneuen.2015.03.021,0,0,
2469,The effect of personality disorders on asthma severity and quality of life.,"Assesment of health related quality of life (HRQL) is increasingly recognized as an important part of the patient care in asthma. We aimed to evaluate the effect of personality disorders (PDs) on HRQL and the severity of disease in asthmatic patients. Ninety seven consecutive patients with asthma and ninety healthy controls were included. All patients completed a Short Form-36 health survey (SF-36) and Structured Clinical Interview Form for DSM-III-R Axis-II Disorders (SCID-II). All SF-36 questionnaire scores of asthmatic patients were significantly lower than the controls. There were statistical differences between the asthma severity and the mean scores of vitality and emotional role difficulties of HRQL's subdomains (p=0.03, p=0.014, respectively). There was a weak but statistically significant correlation between the scores of pain and emotional role difficulties, and forced expiratory volume in 1 second (FEV1) (r=0.27, p=0.007; r=0.24, p=0.01, respectively). When compared to healthy controls, patients with asthma had higher prevalence of PDs (p=0.0001). The most common PDs found in asthmatic patients were obsessive-compulsive and avoidant PDs. HRQL values of asthma patients with PDs were significantly lower than patients without PDs except for the physical functioning subscores on HRQL. We conclude that patients with asthma have higher prevalence of PDs, which is associated with their poor quality of life. A psychiatric evaluation may be beneficial in patients with asthma if a concomitant PD is suspected.",Yılmaz A.; Cumurcu BE.; Etikan I.; Hasbek E.; Doruk S.,2014.0,,0,0,
2470,Biased interpretation in perfectionism and its modification,"Perfectionism is a transdiagnostic construct associated with a range of diagnoses, including depression, eating disorders and obsessive compulsive disorder. Treatments that directly target perfectionist cognitions have been shown to successfully reduce associated pathologies. However, the way in which they do this is not clear. We set out to assess the role of one candidate mechanism of action, namely the cognitive process of interpretation of ambiguity. In one experiment we looked for associations between biased interpretation and perfectionism. In a second, we manipulated interpretations, thereby providing a strong test of their aetiological significance. Results from the first experiment confirmed the presence of biased interpretation in perfectionism and demonstrated that these are highly specific to perfection relevant information, rather than reflecting general negativity. The second experiment succeeded in manipulating these perfection relevant interpretations and demonstrated that one consequence of doing so is a change in perfectionist behaviour. Together, these data experimentally demonstrate that biased interpretation of perfection relevant ambiguity contributes to the maintenance of perfectionism, but that it is also possible to reverse this. Clinical implications include the identification of one likely mechanism of therapeutic change within existing treatments, as well as identification of an appropriate evidence-based focus for future treatment development. Targeting underlying functional mechanisms, such as biased interpretation, has the potential to offer transdiagnostic benefits. © 2011 Elsevier Ltd.",Yiend J.; Savulich G.; Coughtrey A.; Shafran R.,2011.0,10.1016/j.brat.2011.10.004,0,0,
2471,Enduring consequences of experimentally induced biases in interpretation,"ER Previous research has demonstrated that it is possible to induce biases in the interpretation of ambiguous text passages by training. Participants consistently trained to interpret emotionally ambiguous passages in either a negative or positive direction show training-congruent effects when presented with new ambiguous material. These training effects are demonstrated by participants' subsequent recognition ratings for disambiguating sentences, which represent both possible meanings of the novel ambiguous test passages. In this series of experiments, we investigated the durability of these training effects over time spans of up to 1 day and found them to be robust. The findings encourage us to believe that induced biases may serve as a useful analogue to those observed clinically.","Yiend, J; Mackintosh, B; Mathews, A",2005.0,10.1016/j.brat.2004.06.007,0,0,
2472,"The relationship between sexual trauma, peritraumatic dissociation, posttraumatic stress disorder, and HIV-related health in HIV-positive men.","This study tested a novel extension of P. P. Schnurr and B. L. Green's (2004) model of the relationships between trauma symptoms and health outcomes with specific application to HIV-positive men. A diverse sample of 167 HIV-positive men recruited from San Francisco Bay Area HIV clinics completed demographic, medical, trauma history, and symptom questionnaires. Mediation analyses were conducted using the method proposed by R. Baron and D. Kenny (1986). Regression analyses found that sexual revictimization (SR) significantly mediated the relationship between child sexual abuse and peritraumatic dissociation (PD), and PD mediated the relationship between SR and current posttraumatic stress (PTS) symptom severity. PTS symptoms partially mediated the relationship between SR and current HIV symptom severity. The findings indicate that among HIV-positive men, sexually revictimized men constitute a vulnerable group that is prone to PD, which places them at risk for posttraumatic stress disorder (PTSD) and worsened HIV-related health. Furthermore, traumatic stress symptoms were associated with worse HIV-related symptoms, suggesting that PTS symptoms mediate the link between trauma and health outcomes. This study highlights the need for future research to identify the biobehavioral mediators of the PTSD-health relationship in HIV-positive individuals.",Yiaslas TA.; Kamen C.; Arteaga A.; Lee S.; Briscoe-Smith A.; Koopman C.; Gore-Felton C.,2014.0,10.1080/15299732.2013.873376,0,0,
2473,Depression and heart rate variability.,,Yeragani VK.; Balon R.; Pohl R.; Ramesh C.,1995.0,10.1016/0006-3223(95)00365-7,0,0,
2474,Heart rate time series: Decreased chaos after intravenous lactate and increased non-linearity after isoproterenol in normal subjects,"In this study, we reanalyzed our previous heart rate time series data on the effects of intravenous sodium lactate (n = 9) and intravenous isoproterenol (n = 11) using non-linear techniques. Our prior findings of significantly higher baseline non-linear scores (NL: SnetGS) and significantly lower largest Lyapunov exponents in supine posture in patients with panic disorder compared to control subjects prompted this study. We obtained the largest Lyapunov exponent (LLE), and a measure of non-linearity (NL: SnetGS) of heart rate time series. LLE quantifies predictability and NL quantifies the deviation from linear processes. There was a significant increase in NL score, (SnetGS) after isoproterenol infusions and a significant decrease in LLE (an increase in predictability indicating decreased chaos), after intravenous lactate in supine posture in normal control subjects. Increased NL scores in supine posture after intravenous isoproterenol may be due to a relative increase in cardiac sympathetic activity or a decrease in vagal activity at least in certain circumstances, and an overall decrease in LLE may indicate an impaired cardiac autonomic flexibility after intravenous sodium lactate, as LLE is diminished by autonomic blockade by atropine. Band analysis of LLE (LF/HF) (LF: 0.04-0.15 Hz and HF: 0.15-0.5 Hz) showed an increase of these ratios during either condition with a higher sympathovagal interaction after the drug administration. These findings may throw new light on the association of anxiety and significant cardiovascular events. © 2002 Elsevier Science Ireland Ltd. All rights reserved.",Yeragani V.K.; Rao R.; Jayaraman A.; Pohl R.; Balon R.; Glitz D.,2002.0,,0,0,
2475,Increased QT variability in patients with panic disorder and depression,"This study investigated beat-to-beat QT variability in patients with panic disorder and depression, and normal control subjects using an automated algorithm to compute QT intervals. An increase in QT variability appears to be associated with symptomatic patients with dilated cardiomyopathy and also with an increased risk for sudden death. QT(vm) (QT variability normalized for mean QT interval) and QT(vi) (a log ratio of QT variance normalized for mean QT over heart rate variability normalized for mean heart rate) were significantly higher in patients with panic disorder and depression in supine as well as standing postures (P=0.002 and 0.0001 for QT(vm) and QT(vi), respectively). In another analysis, QT(vi) was significantly higher in patients with panic disorder compared to control subjects in supine as well as standing postures during spontaneous breathing as well as 12, 15 and 20 per minute breathing (P=0.005). These findings are important especially in view of the recent reports of increased risk for cardiovascular mortality and sudden death in patients with anxiety and depression and the utility of QT(vi) as a noninvasive measure of temporal repolarization lability. Copyright (C) 2000 Elsevier Science Ireland Ltd.",Yeragani V.K.; Pohl R.; Jampala V.C.; Balon R.; Ramesh C.; Srinivasan K.,2000.0,10.1016/S0165-1781(00)00119-0,0,0,
2476,Effects of laboratory-induced panic-anxiety on subsequent provocative infusions,"ER The effects of infusion-induced panic-anxiety on subsequent pre-infusion anxiety ratings and infusion-induced panic attacks were studied in 64 panic disorder patients, in a double-blind randomized study using sodium lactate, isoproterenol, and placebo infusions. While there was a decrease of preinfusion anxiety from one infusion to the next infusion both for panickers and nonpanickers, there was no evidence of either a significant decrease or an increase in the frequency of subsequent panic attacks. These results suggest that there is neither a desensitizing nor a sensitizing effect of pharmacologically induced panic attacks on subsequent infusions in a serial three-infusion design.","Yeragani, V K; Balon, R; Rainey, J M; Ortiz, A; Berchou, R; Lycaki, H; Pohl, R",1988.0,,0,0,
2477,"Sodium lactate increases sympathovagal ratios in normal control subjects: Spectral analysis of heart rate, blood pressure, and respiration","We used spectral analysis of heart rate (HR), blood pressure (BP), and respiration to examine the effects of lactate on cholinergic and adrenergic influences on HR and BP variability, a technique found to be very useful in cardiovascular research. We specifically used high frequency (0.2-0.5 Hz) and midfrequency (0.07-0.15 Hz) powers to study cholinergic and adrenergic activity in nine normal control subjects before and after lactate and placebo infusions. Our results demonstrate a marked decrease in cholinergic activity and a significant increase in sympathovagal ratios of HR modulation after lactate infusions. This altered sympathovagal balance may contribute to the panicogenic effects of lactate in panic disorder patients.",Yeragani V.K.,1994.0,10.1016/0165-1781(94)90068-X,0,0,
2478,A randomized trial of a reconciliation workshop with and without PTSD psychoeducation in Burundian sample.,"Posttraumatic stress disorder (PTSD) psychoeducation is increasingly offered in diverse cultural settings. As the literature offers theoretical arguments for why such information might be normalizing and distress-reducing, or might risk morbid suggestion of greater vulnerability, a two-sided hypothesis was proposed to examine the specific effect of PTSD psychoeducation. Participants of a trauma healing and reconciliation intervention in Burundi were randomized to conditions with and without PTSD psychoeducation, or to a waitlist control. Both interventions reduced symptoms more than the waitlist. Participants in the condition without psychoeducation experienced a greater reduction in PTSD symptoms relative to other conditions. Findings are discussed in relationship to intervention development for traumatic stress in nonindustrialized and culturally diverse settings.",Yeomans PD.; Forman EM.; Herbert JD.; Yuen E.,2010.0,10.1002/jts.20531,0,0,
2479,The relation between family adversity and social anxiety among adolescents in Taiwan: effects of family function and self-esteem,"ER This study aimed to examine the relationship between three indicators of family adversity (domestic violence, family substance use, and broken parental marriage) and the severity of social anxiety among adolescents in Taiwan, as well as the mediating effects of perceived family function and self-esteem on that relationship, using structural equation modeling (SEM). A total of 5607 adolescents completed the social anxiety subscale of the Multidimensional Anxiety Scale for Children; the Family APGAR Index; the Rosenberg Self-Esteem Scale; and a questionnaire for domestic violence, family substance use, and broken parental marriage. The relation between family adversity and social anxiety, as well as the mediating effects of family function and self-esteem, was examined using SEM. SEM analysis revealed that all three indicators of family adversity reduced the level of family function, that decreased family function compromised the level of self-esteem, and that a low level of self-esteem further increased the severity of social anxiety. The results indicated that, along with intervening to change family adversity, evaluating and improving adolescents' self-esteem and family function are also important clinical issues when helping adolescents reduce their social anxiety.","Yen, C F; Yang, P; Wu, Y Y; Cheng, C P",2013.0,10.1097/NMD.0000000000000032,0,0,
2480,The impact on unemployment of an intervention to increase recognition of previously untreated anxiety among primary care physicians.,"Anxiety is a common, though often unrecognized, problem in primary care settings. This study examines the effect on employment of an intervention designed to attune primary care physicians to previously unrecognized and untreated anxiety. Primary care physicians in a mixed-model health maintenance organization (HMO) were randomized by practice site to groups with (intervention) and without (usual care) intensive one-on-one education about anxiety and periodic feedback about their patients with anxiety. All persons 21-65 years of age presenting to the offices of these primary care providers were screened for anxiety with the SCL-90-R on two occasions. Those meeting the SCL-90-R cutpoints for anxiety and whose medical records provided no evidence of recognition or treatment for a mental health condition within the last 6 months were eligible for the study (n = 637). Of these, 573 (90%) completed two follow-up assessments. The present study evaluates the impact of the intervention aimed at the primary care physicians on the labor force participation rate of the persons with anxiety after 5 months of follow-up. The study also evaluates the impact of the intervention on hours of work and the presence of days spent in bed among the persons with anxiety working at the baseline interview and after 5 months. At baseline, the patients of intervention and usual care physicians with previously unrecognized and untreated anxiety did not differ in labor force participation rates. At the conclusion of the study, the patients of the intervention group physicians had significantly lower rates of labor force participation than those of the usual care group physicians. Among those working both at the beginning and conclusion of the study, the intervention had no impact on hours of work or the presence of days spent in bed. We conclude that attuning physicians may reduce labor force participation rates.",Yelin E.; Mathias SD.; Buesching DP.; Rowland C.; Calucin RQ.; Fifer S.,1996.0,,0,0,
2481,"Cortisol metabolic predictors of response to psychotherapy for symptoms of PTSD in survivors of the World Trade Center attacks on September 11, 2001.","Background: A proportion of subjects with symptoms of posttraumatic stress disorder (PTSD) are unresponsive to specialized psychotherapy, but a biological basis for this has not been described. To observe whether differences in cortisol or its metabolites predict or correlate with response to therapy for PTSD symptoms, cortisol and its metabolites were measured from urine samples at pre-treatment, at the conclusion of psychotherapy, and at 3-month follow-up. Methods: 28 survivors of the World Trade Center attacks on September 11, 2001 seeking psychological treatment for PTSD symptoms received four sessions of either exposure therapy or supportive counseling, followed by up to 10 sessions of prolonged exposure in a specialized PTSD treatment program at a private hospital serving the New York City metropolitan area. 24-h mean integrated cortisol excretion was assessed by radioimmunoassay (RIA); urinary free cortisol and metabolites cortisone, 5alpha-tetrahydrocortisol (5alpha-THF), 5beta-tetrahydrocortisol, and tetrahydrocortisone were assessed by gas chromatography-mass spectrometry (GC-MS); and indices of enzyme activity for 5alpha- and 5beta-reductase and for the 11beta-hydroxysteroid dehydrogenases were derived from the metabolite and glucocorticoid measures. Results: 5alpha-Reductase activity was significantly lower at pre-treatment among non-responders, whereas there were no significant pre-treatment differences between responders and non-responders in any other hormone or metabolite level. In repeated measures analyses across the three time points, 5alpha-reductase activity, as well as 5alpha-THF and total glucocorticoids, significantly differed between responders and non-responders. For urinary cortisol measured by RIA, there was a significant group x time interaction indicating that, although not different at pre-treatment, urinary cortisol levels declined over time in the non-responder group, such that by follow-up, lowered cortisol significantly distinguished non-responders from responders. Indices of 5alpha-reductase activity, including 5alpha-THF and total glucocorticoids, were significantly negatively correlated with avoidance symptom severity at pre-treatment. At follow-up, indices of 5alpha-reductase activity were significantly negatively correlated with severity of all three PTSD symptom clusters and with total PTSD severity scores. Conclusion: Lower 5alpha-reductase activity is associated with avoidance severity and predicts non-responsiveness to psychological treatment for PTSD symptomatology. Relatively diminished 5alpha-reductase activity may mark a state of primary vulnerability, perhaps via attenuated peripheral catabolism of cortisol resulting in the suppression of hypothalamic-pituitary-adrenal axis responsiveness. Lower cortisol levels appear later in the progression to chronic, treatment-resistant PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Yehuda, Rachel; Bierer, Linda M; Sarapas, Casey; Makotkine, Iouri; Andrew, Ruth; Seckl, Jonathan R; Aerni, Agis-Balboa, Andrew, Baker, Best, Bierer, Bonne, Boscarino, Boscarino, Bremner, Bryant, Delahanty, Edwards, Ehlers, Foa, Foa, Forbes, Forbes, Forbes, Frye, Goenjian, Griffin, Hamilton, Hawk, Hebbar, Kellner, Kessler, King, Kita, Livingstone, Mann, Mason, Mason, Meewisse, Melcangi, Oberlander, Olff, Olff, Olff, Palermo, Paterson, Schelling, Schnurr, Seckl, Seckl, Seckl, Shalev, Sijbrandij, Spitzer, Steptoe, Symonds, Sanchez, Tucker, Tucker, Westerbacka, Yehuda, Yehuda, Yehuda, Yehuda, Yehuda, Yehuda, Yehuda, Yehuda",2009.0,,0,0,
2482,Changes in relative glucose metabolic rate following cortisol administration in aging veterans with posttraumatic stress disorder: an FDG-PET neuroimaging study,"ER The authors aimed to examine central glucocorticoids effects by measuring relative glucose metabolic rate (rGMR) in the hippocampus, amygdala, and anterior cingulate cortex (ACC) and the relationship between amygdala and ACC activity. The participants were male combat veterans with and without PTSD, 52 to 81 years old. The authors utilized randomized, double-blind, placebo-controlled examinations of the rGMR response to 17.5 mg hydrocortisone (HCORT) using 2-Deoxy-2-[(18)F]fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) neuroimaging. Group differences in hemispheric laterality of rGMR were observed following placebo administration, reflecting lower rGMR in the right hippocampus and ventral amygdala, and higher rGMR in the left ventral amygdala in the PTSD+ group compared to the PTSD- group. HCORT reduced these group differences in laterality. The net effect of HCORT was to restore a normal inverse association between the ACC and amygdala in the PTSD+ group, but disrupt this neural network in the PTSD- group. The magnitude of improvement in working memory correlated with greater hemispheric laterality in the dorsal amygdala following HCORT in both groups. The restorative effects of HCORT on metabolism and working memory provide a rationale for examining the therapeutic benefits of glucocorticoid manipulation in aging PTSD patients.","Yehuda, R; Harvey, P D; Golier, J A; Newmark, R E; Bowie, C R; Wohltmann, J J; Grossman, R A; Schmeidler, J; Hazlett, E A; Buchsbaum, M S",2009.0,10.1176/jnp.2009.21.2.132,0,0,
2483,"Hydrocortisone responsiveness in Gulf War veterans with PTSD: effects on ACTH, declarative memory hippocampal FDG uptake on PET","ER Neuroendocrine, cognitive and hippocampal alterations have been described in Gulf War (GW) veterans, but their inter-relationships and significance for posttraumatic stress disorder (PTSD) have not been described. Hydrocortisone (Hcort) was administered to GW veterans with (PTSD+ n=12) and without (PTSD- n=8) chronic PTSD in a randomized, placebo-controlled, double-blind challenge. Changes in plasma ACTH, memory, and hippocampal [(18)F]FDG uptake on positron emission tomography were assessed. The low-dose dexamethasone suppression test was also administered. The PTSD+ group showed greater cortisol and ACTH suppression, reflecting greater peripheral glucocorticoid receptor (GR) responsiveness, and did not show an Hcort-induced decrement in delayed recall or retention. The groups had comparable relative regional hippocampal [(18)F]FDG uptake at baseline, but only the PTSD- group had an Hcort-associated decrease in hippocampal [(18)F]FDG uptake. Asymmetry in hippocampal hemispheric volumes differed between PTSD+ and PTSD- groups. This asymmetry was associated with cortisol, ACTH, retention and functional hippocampal asymmetry before, but not after, Hcort administration. Differences in brain metabolic responses between GW veterans with and without PTSD may reflect differences in peripheral and central GR responsiveness.","Yehuda, R; Golier, J A; Bierer, L M; Mikhno, A; Pratchett, L C; Burton, C L; Makotkine, I; Devanand, D P; Pradhaban, G; Harvey, P D; Mann, J J",2010.0,10.1016/j.pscychresns.2010.06.010,0,0,
2484,"Cortisol metabolic predictors of response to psychotherapy for symptoms of PTSD in survivors of the World Trade Center attacks on September 11, 2001.","A proportion of subjects with symptoms of posttraumatic stress disorder (PTSD) are unresponsive to specialized psychotherapy, but a biological basis for this has not been described. To observe whether differences in cortisol or its metabolites predict or correlate with response to therapy for PTSD symptoms, cortisol and its metabolites were measured from urine samples at pre-treatment, at the conclusion of psychotherapy, and at 3-month follow-up. 28 survivors of the World Trade Center attacks on September 11, 2001 seeking psychological treatment for PTSD symptoms received four sessions of either exposure therapy or supportive counseling, followed by up to 10 sessions of prolonged exposure in a specialized PTSD treatment program at a private hospital serving the New York City metropolitan area. 24-h mean integrated cortisol excretion was assessed by radioimmunoassay (RIA); urinary free cortisol and metabolites cortisone, 5alpha-tetrahydrocortisol (5alpha-THF), 5beta-tetrahydrocortisol, and tetrahydrocortisone were assessed by gas chromatography-mass spectrometry (GC-MS); and indices of enzyme activity for 5alpha- and 5beta-reductase and for the 11beta-hydroxysteroid dehydrogenases were derived from the metabolite and glucocorticoid measures. 5alpha-Reductase activity was significantly lower at pre-treatment among non-responders, whereas there were no significant pre-treatment differences between responders and non-responders in any other hormone or metabolite level. In repeated measures analyses across the three time points, 5alpha-reductase activity, as well as 5alpha-THF and total glucocorticoids, significantly differed between responders and non-responders. For urinary cortisol measured by RIA, there was a significant groupxtime interaction indicating that, although not different at pre-treatment, urinary cortisol levels declined over time in the non-responder group, such that by follow-up, lowered cortisol significantly distinguished non-responders from responders. Indices of 5alpha-reductase activity, including 5alpha-THF and total glucocorticoids, were significantly negatively correlated with avoidance symptom severity at pre-treatment. At follow-up, indices of 5alpha-reductase activity were significantly negatively correlated with severity of all three PTSD symptom clusters and with total PTSD severity scores. Lower 5alpha-reductase activity is associated with avoidance severity and predicts non-responsiveness to psychological treatment for PTSD symptomatology. Relatively diminished 5alpha-reductase activity may mark a state of primary vulnerability, perhaps via attenuated peripheral catabolism of cortisol resulting in the suppression of hypothalamic-pituitary-adrenal axis responsiveness. Lower cortisol levels appear later in the progression to chronic, treatment-resistant PTSD.",Yehuda R.; Bierer LM.; Sarapas C.; Makotkine I.; Andrew R.; Seckl JR.,2009.0,10.1016/j.psyneuen.2009.03.018,0,0,
2485,Cortisol augmentation of a psychological treatment for warfighters with posttraumatic stress disorder: Randomized trial showing improved treatment retention and outcome.,"Prolonged exposure (PE) therapy for post-traumatic stress disorder (PTSD) in military veterans has established efficacy, but is ineffective for a substantial number of patients. PE is also associated with high dropout rates. We hypothesized that hydrocortisone augmentation would enhance symptom improvement and reduce drop-out rates by diminishing the distressing effects of traumatic memories retrieved during imaginal exposure. We also hypothesized that in responders, hydrocortisone augmentation would be more effective in reversing glucocorticoid indices associated with PTSD than placebo augmentation. Twenty-four veterans were randomized to receive either 30 mg oral hydrocortisone or placebo prior to PE sessions 3-10 in a double-blind protocol. Glucocorticoid receptor sensitivity was assessed in cultured peripheral blood mononuclear cells (PBMC) using the in vitro lysozyme inhibition test and was determined before and after treatment. Intent-to-treat analysis was performed using latent growth curve modeling of treatment effects on change in PTSD severity over time. Veterans who no longer met diagnostic criteria for PTSD at post-treatment were designated as responders. Veterans randomized to hydrocortisone or placebo augmentation did not differ significantly in clinical severity or glucocorticoid sensitivity at pre-treatment. Hydrocortisone augmentation was associated with greater reduction in total PTSD symptoms compared to placebo, a finding that was explained by significantly greater patient retention in the hydrocortisone augmentation condition. A significant treatment condition by responder status interaction for glucocorticoid sensitivity indicated that responders to hydrocortisone augmentation had the highest pre-treatment glucocorticoid sensitivity (lowest lysozyme IC50-DEX) that diminished over the course of treatment. There was a significant association between decline in glucocorticoid responsiveness and improvement in PTSD symptoms among hydrocortisone recipients. The results of this pilot study suggest that hydrocortisone augmentation of PE may result in greater retention in treatment and thereby promote PTSD symptom improvement. Further, the results suggest that particularly elevated glucocorticoid responsiveness at pre-treatment may identify veterans likely to respond to PE combined with an intervention that targets glucocorticoid sensitivity. Confirmation of these findings will suggest that pharmacologic interventions that target PTSD-associated glucocorticoid dysregulation may be particularly helpful in promoting a positive clinical response to PTSD psychotherapy.",Yehuda R.; Bierer LM.; Pratchett LC.; Lehrner A.; Koch EC.; Van Manen JA.; Flory JD.; Makotkine I.; Hildebrandt T.,2015.0,10.1016/j.psyneuen.2014.08.004,0,0,
2486,Oxytocin modulates semantic integration in speech comprehension,"Listeners interpret utterances by integrating information from multiple sources including word level semantics and world knowledge. When the semantics of an expression is inconsistent with their knowledge about the world, the listener may have to search through the conceptual space for alternative possible world scenarios that can make the expression more acceptable. Such cognitive exploration requires considerable computational resources and might depend on motivational factors. This study explores whether and how oxytocin, a neuropeptide known to influence social motivation by reducing social anxiety and enhancing affiliative tendencies, canmodulate the integration of world knowledge and sentence meanings. The study used a between-participant double-blind randomized placebo-controlled design. Semantic integration, indexed with magnetoencephalography through the N400m marker, was quantified while 45 healthy male participants listened to sentences that were either congruent or incongruent with facts of the world, after receiving intranasally delivered oxytocin or placebo. Compared with congruent sentences, world knowledge incongruent sentences elicited a stronger N400m signal from the left inferior frontal and anterior temporal regions and medial pFC (the N400m effect) in the placebo group. Oxytocin administration significantly attenuated the N400m effect at both sensor and cortical source levels throughout the experiment, in a state-like manner. Additional electrophysiological markers suggest that the absence of the N400m effect in the oxytocin group is unlikely due to the lack of early sensory or semantic processing or a general downregulation of attention. These findings suggest that oxytocin drives listeners to resolve challenges of semantic integration, possibly by promoting the cognitive exploration of alternative possible world scenarios.",Ye Z.; Stolk A.; Toni I.; Hagoort P.,2017.0,10.1162/jocn_a_01044,0,0,
2487,Effects of repeated ingestion of grapefruit juice on the single and multiple oral-dose pharmacokinetics and pharmacodynamics of alprazolam,"The effects of repeated ingestion of grapefruit juice, an inhibitor of cytochrome P450 3A4 (CYP3A4), on the pharmacokinetics and pharmacodynamics of both single and multiple oral doses of alprazolam, a substrate of CYP3A4, were examined. In study 1, eight healthy volunteers ingesting 600 ml/day water or grapefruit juice for 10 days took a single oral 0.8-mg dose of alprazolam on the eighth day. Plasma drug concentrations were monitored up to 48 h after alprazolam dosing together with evaluation of psychomotor function. Grapefruit juice altered neither the plasma concentrations of alprazolam at any time points, any pharmacokinetic parameters, nor the majority of psychomotor function parameters in subjects. In study 2, 11 patients with anxiety disorders receiving alprazolam (0.8-2.4 mg/day) ingested grapefruit juice (600 ml/day) for 7 days. Blood samples were collected before and during grapefruit juice ingestion and 1 week after its discontinuation together with an assessment of clinical status. Grapefruit juice altered neither the steady-state plasma concentration of alprazolam nor the clinical status in patients. The present study shows that grapefruit juice is unlikely to affect pharmacokinetics or pharmacodynamics of alprazolam due to its high bioavailability.",Yasui N.; Kondo T.; Furukori H.; Kaneko S.; Ohkubo T.; Uno T.; Osanai T.; Sugawara K.; Otani K.,2000.0,10.1007/s002130000438,0,0,
2488,"Relationships between reward sensitivity, risk-taking and family history of alcoholism during an interactive competitive fMRI task","Background: Individuals with a positive family history for alcoholism (FHP) have shown differences from family-history-negative (FHN) individuals in the neural correlates of reward processing. FHP, compared to FHN individuals, demonstrate relatively diminished ventral striatal activation during anticipation of monetary rewards, and the degree of ventral striatal activation shows an inverse correlation with specific impulsivity measures in alcohol-dependent individuals. Rewards in socially interactive contexts relate importantly to addictive propensities, yet have not been examined with respect to how their neural underpinnings relate to impulsivity-related measures. Here we describe impulsivity measures in FHN and FHP individuals as they relate to a socially interactive functional magnetic resonance imaging (fMRI) task. Methods: Forty FHP and 29 FHN subjects without histories of Axis-I disorders completed a socially interactive Domino task during functional magnetic resonance imaging and completed self-report and behavioral impulsivity-related assessments. Results: FHP compared to FHN individuals showed higher scores (p = .004) on one impulsivity-related factor relating to both compulsivity (Padua Inventory) and reward/punishment sensitivity (Sensitivity to Punishment/Sensitivity to Reward Questionnaire). Multiple regression analysis within a reward-related network revealed a correlation between risk-taking (involving another impulsivity-related factor, the Balloon Analog Risk Task (BART)) and right ventral striatum activation under reward >punishment contrast (p<0.05 FWE corrected) in the social task. Conclusions: Behavioral risk-taking scores may be more closely associated with neural correlates of reward responsiveness in socially interactive contexts than are FH status or impulsivity-related self-report measures. These findings suggest that risk-taking assessments be examined further in socially interactive settings relevant to addictive behaviors.",Yarosh H.L.; Hyatt C.J.; Meda S.A.; Jiantonio-Kelly R.; Potenza M.N.; Assaf M.; Pearlson G.D.,2014.0,10.1371/journal.pone.0088188,0,0,
2489,"A prospective randomized single-blind, multicenter trial comparing the efficacy and safety of paroxetine with and without quetiapine therapy in depression associated with anxiety.","Objective: To evaluate quetiapine as an adjunct to paroxetine in patients with comorbid depression and anxiety. Method: Prospective, multicenter, single-blind trial of patients with DSM-IV major depression and associated anxiety, who were randomised to an 8-week treatment with paroxetine alone (n = 54) or paroxetine + quetiapine (n = 58). Quetiapine was dosed to 200 mg/day and paroxetine to 60 mg/day, as required. Results: Decrease in HAM-A scores was significantly greater in the combined therapy group than with paroxetine alone at weeks 2, 4, 6 and LOCF (P < 0.008). Decrease in HAM-D scores was significantly greater in the combined therapy group than with paroxetine alone throughout the study period (P < 0.008). Regarding adverse events, it was found that increases in anxiety and insomnia were more prevalent in the paroxetine only group, while increased appetite was more prevalent when quetiapine was added (P < 0.05). Conclusion: Quetiapine added to paroxetine is well tolerated and may speed up and improve response in patients with comorbid depression and anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Yargic, L. Ilhan; Corapcioglu, Aytul; Kocabasoglu, Nese; Erdogan, Ayten; Koroglu, Gulsah; Yilmaz, Dilek; Arean, Devane, Fresquet, Glick, Gorman, Gorman, Hamilton, Hirose, Kaplan, Keck, Krakowski, Kuzel, Lader, Marangell, Mauri, Mullen, Muller-Siecheneder, Nasrallah, Nemeroff, Nutt, Ostroff, Rouillon, Sramek, Tollefson, Weizman",2004.0,,0,0,
2490,Partial radiocarpal arthrodesis.,"Eight patients underwent partial radiocarpal arthrodesis for various wrist disorders. There were 5 men and 3 women, whose age at operation ranged from 33 to 59 years with an average of 44 years. The indications for operation included post-traumatic changes secondary to distal radius fracture in 5 cases, Kienböck's disease in 1, Madelung's deformity in 1, and rheumatoid arthritis in 1. Arthrodesis was performed at the radiolunate joint in 5 cases, and at the radioscapholunate joint in 3 cases. In all cases, bone union was obtained within 3 months postoperatively. Postoperative wrist pain disappeared in 6 cases, and decreased in 2 cases. The average postoperative flexion-extension arc of motion was 35 degrees in the radioscapholunate arthrodesis group, and 85 degrees in the radiolunate arthrodesis group. The postoperative grip strength compared with the unaffected hand averaged 51% in the radioscapholunate arthrodesis group, and 68% in the radiolunate arthrodesis group. One patient showed a deterioration in the osteoarthritic change in the midcarpal joint.",Yajima H.; Tamai S.; Ono H.,1994.0,,0,0,
2491,Effects of intervening measures on postpartum depression,"ER METHODS1 597 pregnant women selected from our antenatal care clinic were investigated by using the hospital anxiety and depression questionnaire (HAD) during pregnancy and the Edinburgh postpartum depression scale (EPDS) after childbirth. All the enrolled women were randomly divided into control group and intervening group by the proportion of 1 to 2. Six intervening measures were used in the latter group.RESULTS(1) There were 49 women whose HAD >or= 11 score (anxiety-depression mood) with 28 cases (57.1%) had got postpartum depression in the control group. In the intervening group, however, there were 94 women whose HAD >or= 11 score with 24 cases (25.5%) had got postpartum depression. There is a significant difference between the two groups (P or= 13 score (postpartum depression) in the control group. In the intervening group, however, there were 63 (6.0%) women whose EPDS >or= 13 score. There had a significant difference between the two groups (P < 0.01). (3) PPD women had higher N and P scores than those of non-PPD women (P < 0.01).CONCLUSION(1) Prenatal anxiety, depression, negative personality and postpartum psychological and physiological changes were high risk factors to PPD. (2) Psychological personality play an important role in PPD. (3) Incidence of PPD was significantly reduced by social support.OBJECTIVETo study the related factors of postpartum depression (PPD) and the effects of intervening measures to PPD incidence.","Xu, F S; Liu, J X; Zhang, S P; Li, J; Su, Q",2003.0,,0,0,
2492,Effectiveness of Bufei Yishen Granule combined with acupoint sticking therapy on quality of life in patients with stable chronic obstructive pulmonary disease,"ER OBJECTIVE: To evaluate the efficacy of Bufei Yishen Granule BFYSG) combined with Shufei Tie acupoint sticking therapy on quality of life of patients with stable chronic obstructive pulmonary disease (COPD).METHODS: A multi-center, double-blinded, double-dummy and randomized controlled method was adopted in this trial. A total of 244 patients were randomly assigned to a trial group and a control group according to the random number, each with 122 patients; treatment allocation occurred when the participants met the inclusion criteria and signed the informed consent form. In the trial group, patients were treated with BFYSG combined with ""Shufei Tie"" acupoint sticking therapy and sustained-release theophylline dummy, and in the control group patients were treated with oral sustained-release theophylline and BFYSG dummy combined with ""Shufei Tie"" acupoint sticking therapy dummy. The therapeutic course for two groups was 4 months and the follow-up was 6 months. The frequency and duration of acute exacerbation calculated by adding up each frequency and duration of acute exacerbation in treatment and follow-up time respectively, the quality of life measured by the World Health Organization Quality of Life (WHOQOL)-BREF scale and adult COPD quality of life (COPD-QOL) scale were observed.RESULTS: Among the 244 enrolled patients, 234 were screened for full analysis set (FAS); 221 were screened for per-protocol analysis set (PPS). After 4-month treatment and 6-month follow-up there were differences between the trial group and the control group in frequency of acute exacerbation (FAS: P=0.013; PPS: P=0.046); duration of acute exacerbation (FAS: P=0.005; PPS: P=0.006); scores of physiological, psychological and environment aspects of the WHOQOL-BREF questionnaire (FAS: P=0.002, P=0.006, P=0.000; PPS: P=0.00, P=0.001, P=0.000); scores of daily living ability, social activity, depression symptoms aspects of the COPD-QOL questionnaire (FAS: P=0.000, P=0.000, P=0.006; PPS: P=0.002, P=0.001, P=0.001).CONCLUSION: BFYSG combined with acupoint sticking therapy could improve the quality of life of patients with stable COPD.","Xie, Y; Li, J S; Yu, X Q; Li, S Y; Zhang, N Z; Li, Z G; Shao, S J; Guo, L X; Zhu, L; Zhang, Y J",2013.0,10.1007/s11655-013-1438-2,0,0,
2493,Taoistic cognitive psychotherapy for neurotic patients: a preliminary clinical trial.,"Taoistic cognitive psychotherapy is a cognitive therapy based on Taostic philosophy of life and health. The present preliminary study aims to test clinical significance of the Taoistic cognitive psychotherapy, indicates that type A behavior patterns distorted values and psychopathologies can be improved after a short period (4 weeks) of Taoistic cognitive psychotherapy. The theoretical basis of this psychotherapy is also briefly introduced.",Xiao S.; Young D.; Zhang H.,1998.0,,0,0,
2494,Randomized controlled trial of modified banxia houpo decoction in treating functional dyspepsia patients with psychological factors,"ER OBJECTIVE: To observe the therapeutic effect of Modified Banxia Houpo Decoction (MBHD) in treating patients with functional dyspepsia (FD) accompanied with psychological factors, and to compare it with Domperidone, Neurostan, and Domperidone + Neurostan.METHODS: Recruited were 89 FD patients accompanied with anxiety and/or depression, who were randomly assigned to four groups, i.e., the MBHD group (23 cases), the Domperidone group (22 cases), the Neurostan group (22 cases), and the Domperidone + Neurostan group (22 cases). Corresponding medication lasted for4 weeks. The psychological scoring was performed using Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA). The improvement rate of FD symptoms, the ratios of FD symptoms scoring 50% were calculated by the scoring of FD symptoms. The gastric emptying rates of patients in each group were compared using the examinations of gastric emptying.RESULTS: There was no statistical difference in pre-treatment HAMD, HAMA, FD symptoms scoring, and the gastric emptying rate among the 4 groups (P >0.05). The psychological scoring and FD symptoms scoring significantly decreased in the 4 groups except the Domperidone group after 4-week treatment (P50% were calculated by the scoring of FD symptoms. The gastric emptying rates of patients in each group were compared using the examinations of gastric emptying.RESULTS: There was no statistical difference in pre-treatment HAMD, HAMA, FD symptoms scoring, and the gastric emptying rate among the 4 groups (P >0.05). The psychological scoring and FD symptoms scoring significantly decreased in the 4 groups except the Domperidone group after 4-week treatment (P50% were calculated by the scoring of FD symptoms. The gastric emptying rates of patients in each group were compared using the examinations of gastric emptying.RESULTS: There was no statistical difference in pre-treatment HAMD, HAMA, FD symptoms scoring, and the gastric emptying rate among the 4 groups (P >0.05). The psychological scoring and FD symptoms scoring significantly decreased in the 4 groups except the Domperidone group after 4-week treatment (P50% were calculated by the scoring of FD symptoms. The gastric emptying rates of patients in each group were compared using the examinations of gastric emptying.RESULTS: There was no statistical difference in pre-treatment HAMD, HAMA, FD symptoms scoring, and the gastric emptying rate among the 4 groups (P >0.05). The psychological scoring and FD symptoms scoring significantly decreased in the 4 groups except the Domperidone group after 4-week treatment (P50% were the highest in the Domperidone + Neurostan group, followed by the MBHD group, and then the Domperidone group. After treatment the gastric emptying rate obviously increased in each treatment group when compared with before treatment in the same group (P <0. 01), and there was no statistical difference among these groups after treatment.CONCLUSIONS: MBHD had certain therapeutic effects on FD patients accompanied with psychological factors. Its effect was associated with gastric emptying. Besides, its improvement of the psychological state and symptoms was superior to that of Domperidone.","Xiao, L; Li, Y",2013.0,,0,0,
2495,Assessing health-related quality of life in generalized anxiety disorder using the Quality of Life Enjoyment and Satisfaction Questionnaire.,"Generalized anxiety disorder (GAD) is a chronic illness that leads to substantial impairments in quality of life. This post-hoc analysis used combined data from three 8-week quetiapine extended-release trials to investigate the reliability, validity, and responsiveness of the Short Form of the Quality of Life Enjoyment and Satisfaction Questionnaire [Q-LES-Q (SF)] in 2588 patients with GAD. The baseline Q-LES-Q (SF) score showed a Cronbach's alpha value of 0.86, indicative of reliability. Validity analyses for Q-LES-Q (SF) identified significant correlations with clinical efficacy measures (r>0.34 at week 8; P<0.001) and significant discrimination between patient groups categorized by symptom severity (P<0.001). Responsiveness was shown by significant differences in mean changes in Q-LES-Q (SF) scores at week 8 between patients defined according to the Hamilton Rating Scale for Anxiety response or remission criteria (P<0.001). The minimum clinically important Q-LES-Q (SF) score change was identified to be 6.80 points. Using this definition, response rates were significantly greater with quetiapine extended-release 150 mg versus placebo in individual trials and the combined population (P<=0.02). This analysis shows the overall reliability, validity, and responsiveness of the Q-LES-Q (SF) as a measure of overall quality of life and satisfaction in patients with GAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wyrwich, Kathleen; Harnam, Neesha; Revicki, Dennis A; Locklear, Julie C; Svedsater, Henrik; Endicott, Jean; Barger, Bruce, Buysse, Chouinard, Cohen, Cronbach, Demyttenaere, Dott, Endicott, Endicott, Endicott, Endicott, Eton, Faravelli, Grant, Hays, Hays, Henning, Hoyer, Joyce, Kroenke, Merideth, Mick, Newnham, Norman, Olfson, Pollack, Rapaport, Revicki, Revicki, Ritsner, Rossi, Schechter, Schonfeld, Stein, Wetherell",2009.0,,0,0,
2496,[Testing the significance of psychic factors in the etiology of alopecia areata. II. Examination of personality by means of Eysenck's Personality Inventory (MPI) adapted by Choynowski].,We evaluated the role of psychic factors in the etiopathogenesis of alopecia areata on the basis of Eysenck's Personality Inventory adapted by Choynowski. 55 patients were tested (28 women and 27 men). The control group consisted of 50 volunteers. The analysis of the results showed that the neurotic type of personality was predominant in the group of patients (43.64%). Neurotic personality found in such a high percentage of the patients with alopecia areata may be an additional element in the group of psychic factors that possibly have some influence on the development of the disease.,Wygledowska-Kania M.; Bogdanowski T.,1995.0,,0,0,
2497,Efficacy of an in-home nursing intervention following short-stay breast cancer surgery,"ER This randomized controlled trial (n = 240) was designed to test the efficacy of a sub-acute home nursing intervention following short-stay surgery for breast cancer. Intervention participants received the in-home nursing protocol, whereas non-intervention participants received agency nursing care or no nursing care. Data, collected via questionnaire, telephone interview, and chart audit, included surgical recovery/self-care knowledge, functional status, anxiety, quality of life (QOL), and health service utilization. There were no significant group differences on postoperative functional status, anxiety, QOL, further surgeries, or complications. Intervention participants were more likely to receive instruction on surgical self-care (p <or=.001) and report improved social/family QOL (p <or=.05), with fewer home visits (p <or=.001). These findings suggest that a targeted nursing protocol may, at reasonable cost, improve QOL and enhance health-related knowledge.","Wyatt, G K; Donze, L F; Beckrow, K C",2004.0,10.1002/nur.20032,0,0,
2498,A randomized controlled trial of the Cool Teens CD-ROM computerized program for adolescent anxiety.,"Computerized cognitive behavioral interventions for anxiety disorders in adults have been shown to be efficacious, but limited data are available on the use of computerized interventions with young persons. Adolescents in particular are difficult to engage in treatment and may be especially suited to computerized technologies. This paper describes the results of a small randomized controlled trial of the Cool Teens program for adolescent anxiety, and examines potential barriers to treatment and user preferences of computerized technology in this population. Forty-three adolescents with a primary diagnosis of anxiety were randomly allocated to the Cool Teens program, a 12-week computerized cognitive-behavioral therapy program for anxiety management, or a 12-week wait list. Effects on symptoms, negative thoughts, and life interference were assessed at post-treatment and 3-month follow-up, based on diagnosis as well as self and maternal report. Using mixed-model analyses, at post-treatment and follow-up assessments, adolescents in the Cool Teens condition, compared with those on the wait list, were found to have significant reductions in the total number of anxiety disorders, the severity of the primary anxiety disorder, and the average severity for all disorders. These results were matched by significant reductions in mother and child questionnaire reports of anxiety, internalizing symptoms, automatic thoughts, and life interference. Further few barriers to treatment were found, and user preferences indicated that the computerized treatment was well suited to adolescents with anxiety. The Cool Teens program is efficacious for treatment of adolescent anxiety. Clinical trial registration information-A randomized controlled trial of the Cool Teens computerized program for anxious adolescents compared with waist list; http://www.anzctr.org.au; ACTRN12611000508976.",Wuthrich VM.; Rapee RM.; Cunningham MJ.; Lyneham HJ.; Hudson JL.; Schniering CA.,2012.0,10.1016/j.jaac.2011.12.002,0,0,
2499,Differences in anxiety and depression symptoms: Comparison between older and younger clinical samples.,"Background: Anxiety and depression symptoms change over the lifespan and older adults use different terms to describe their mental health, contributing to under identification of anxiety and depression in older adults. To date, research has not examined these differences in younger and older samples with comorbid anxiety and depression. Methods: One hundred and seven treatment-seeking participants (47 older, 60% female, and 60 younger, 50% female) with anxiety and mood disorders completed the Anxiety Disorders Interview Schedule and a symptom checklist to examine differences in symptom severity, symptom profiles and terms used to describe anxiety and mood. Results: The findings indicated several key differences between the presentation and description of anxiety and depression in younger and older adults. Older adults with Social Phobia reported fearing a narrower range of social situations and less distress and interference. Older adults with Generalized Anxiety Disorder (GAD) reported less worry about interpersonal relationships and work/school than younger adults, however, there were no differences between age groups for behavioral symptoms endorsed. Further older adults reported phobia of lifts/small spaces more frequently than younger adults. Depressed older depressed adults also reported more anhedonia compared to younger adults, but no differences in terms of reported sadness were found. Finally, older and younger adults differed in their descriptions of symptoms with older adults describing anxiety as feeling stressed and tense, while younger adults described anxiety as feeling anxious, worried or nervous. Conclusions: Clinicians need to assess symptoms broadly to avoid missing the presence of anxiety and mood disorders especially in older adults. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wuthrich, Viviana M; Johnco, Carly J; Wetherell, Julie L; Adams, Beekman, Beekman, Bryant, Byers, Carstensen, Christensen, Ciliberti, DeNardo, Fiske, Flint, Gallo, Goncalves, Grenier, Gretarsdottir, Gross, Gum, Hybels, Karlsson, Kessler, Letamendi, Mezuk, Mioshi, Mohlman, Montario, O'Conner, Shah, Trollor, Wetherell, Wolitzky-Taylor",2015.0,,0,0,
2500,Mindfulness significantly reduces self-reported levels of anxiety and depression: results of a randomised controlled trial among 336 Danish women treated for stage I-III breast cancer.,"As the incidence of and survival from breast cancer continue to raise, interventions to reduce anxiety and depression before, during and after treatment are needed. Previous studies have reported positive effects of a structured 8-week group mindfulness-based stress reduction program (MBSR) among patients with cancer and other conditions. To test the effect of such a programme on anxiety and depression among women with breast cancer in a population-based randomised controlled study. A total of 336 women who had been operated on for breast cancer (stage I-III) were randomised to usual care or MBSR+usual care. Questionnaires including the Symptom Checklist-90r anxiety and depression subscales and the Center for Epidemiological Studies-Depression scale were administered before randomisation and immediately, 6 and 12 months after the intervention. Intention-to-treat analyses showed differences between groups in levels of anxiety (p=0.0002) and depression (SCL-90r, p<0.0001; CES-D, p=0.0367) after 12 months. Graphical comparisons of participants with higher levels of anxiety and depression at baseline showed a significantly greater decrease in the intervention group throughout follow-up and no differences among least affected participants. Medium-to-large effects were found for all outcomes in the intervention group in analyses of change scores after 12 months' follow-up. The 8-week group based MBSR intervention had clinically meaningful, statistically significant effects on depression and anxiety after 12 months' follow-up, and medium-to-large effect sizes. Our findings support the dissemination of MBSR among women with breast cancer. (Clintrials.gov No.: NCT00990977).",Würtzen H.; Dalton SO.; Elsass P.; Sumbundu AD.; Steding-Jensen M.; Karlsen RV.; Andersen KK.; Flyger HL.; Pedersen AE.; Johansen C.,2013.0,10.1016/j.ejca.2012.10.030,0,0,
2501,[Quantitative assessment of brain morphology with CT in agoraphobia].,"This CT study was designed to assess brain morphology in agoraphobia. 21 patients and 21 normal control subjects matched in age and sex were investigated. Frontal and parietooccipital cortex, temporal cortex, lateral ventricles and third ventricle were evaluated by qualitative assessment on a 3-point scale (normal, questionable, abnormal). Patients showed significant bilateral enlargement of prefrontal cortical cerebrospinal fluid (CSF) spaces (p < .05). The rating ""abnormal"" was given to none (0%) of the normal controls, but to 6 (28.6%) of the patients in the left hemisphere, and to 4 patients (19%) in the right hemisphere, respectively. No qualitative differences were seen in the temporal cortex, lateral ventricles and third ventricle. These findings support the hypothesis that alterations in brain morphology are involved in the etiology of agoraphobia. The lack of a correlation between CSF enlargement and duration of illness suggests that prefrontal CSF enlargement is a neurobiological vulnerability marker in agoraphobia.",Wurthmann C.; Gregor J.; Schwarz A.; Baumann B.; Effenberger O.; Döhring W.; Bogerts B.,1998.0,10.1055/s-2007-995281,0,0,
2502,Prefrontal enlargement of CSF spaces in agoraphobia: a qualitative CT-scan study.,"1. This CT study was designed to assess brain morphology in 21 patients with agoraphobia and 21 normal control subjects matched for age and sex. 2. Internal and external CSF spaces were evaluated by qualitative assessment on a 3-point scale (normal, questionable, abnormal). 3. Patients showed bilateral enlargement of prefrontal CSF spaces (p < .05). The rating abnormal"" was given in the left hemisphere to 6 (28.6%) of the patients, to 4 (19%) of the patients in the right hemisphere, but to none (0%) of the normal controls. 4. These findings suggest that alterations in brain morphology are involved in the etiology of agoraphobia.",Wurthmann C.; Gregor J.; Baumann B.; Schwarz A.; Effenberger O.; Doehring W.; Bogerts B.,1999.0,,0,0,
2503,Treating irritable bowel syndrome by wuling capsule combined pinaverium bromide: a clinical research,"ER METHODS: Sixty-four IBS patients were randomized into two groups, the treatment group and the control group, 32 in each group. Patients in the treatment group took wuling Capsule (0. 33 g/capsule, 3 times per day) and Pinaverium Bromide (50 mg/tablet, one tablet each time, 3 times per day) , while those in the control group only took Pinaverium Bromide (50 mg/tablet, one tablet each time, 3 times per day). The therapeutic course for all was 6 weeks. IBS symptom score questionnaire, IBS-Quality of Life (IBS-QOL) , Self-Rating Depression Scale (SDS) , and Self-Rating Anxiety Scale (SAS) were assessed before and after treatment. Adverse reactions were also observed.RESULTS: The improvement of abdominal pain, stool frequency, and stool properties, as well as changing rates of integrals were significantly higher in the treatment group than in the control group (P <0. 05). The improvement of dysphoria, body image, concerns for health, and dietary restriction of IBS-QOL, as well as changing rates of integrals were significantly higher in the treatment group than in the control group (P <0. 05). The improvement of SDS and SAS, as well as changing rates of integrals were significantly higher in the treatment group than in the control group (P <0. 05). No severe adverse reaction occurred in either group.CONCLUSION: Combination therapy of wuling Capsule and Pinaverium Bromide could improve abdominal pain and defecation, attenuate depression and anxiety of IBS patients with higher safety.OBJECTIVE: To evaluate the efficacy and safety of wuling Capsule combined with Pinaverium Bromide in treatment of irritable bowel syndrome (IBS).","Wu, X W; Hou, Y; Ji, H Z; Liang, M M; Xu, L E; Wang, F Y",2015.0,,0,0,
2504,[Nineteen cases of panic disorder treated with muscular needling tech nique at Neiguan (PC 6)].,,Wu X.; Hu H.,2014.0,,0,0,
2505,[A controlled study of irrational interpretations of intrusive thoughts in obsessive-compulsive disorder].,"Recent research suggested that the irrational interpretations of intrusive thoughts might be cognitive structures underlying obsessive compulsive disorder (OCD). We present a study on intrusive thoughts and their interpretations in 36 patients suffering from OCD (DSM IV criteria), compared with 36 sex and age matched non clinical subjects, with the Intrusive Thoughts and their Interpretations Questionnaire-revised version (ITIQ-r). This questionnaire measures intrusive thoughts intensity and three types of interpretation: responsibility, guilt and inferiority. The measures of OCD, of depression, of social phobia and of anxiety have been used. OCD patients reported more frequent intrusive thoughts and higher irrational interpretations than controls. The higher the intrusive thoughts, the higher the irrational interpretations. The multiple regression showed that both intrusive thoughts and irrational interpretations were respectively predicted by obsessional compulsive pathology (the Obsessive Thoughts Checklist or the Y-BOCS). The Y-BOCS was the only predictor for inferiority interpretation, but there was no significant predictor for responsibility or for guilt interpretations. Responsibility correlated only with aggressive intrusive thoughts. Guilt was related to intrusions about fear of loss. Inferiority was highly correlated with intrusive thoughts about perfectionism and sexuality.",Yao SN.; Cottraux J.; Martin R.,,,0,0,
2506,Does attention redirection contribute to the effectiveness of attention bias modification on social anxiety?,"Attention bias modification (ABM) is designed to modify threat-related attention bias and thus alleviate anxiety. The current research examined whether consistently directing attention towards targeted goals per se contributes to ABM efficacy. We randomly assigned 68 non-clinical college students with elevated social anxiety to non-valence-specific attend-to-geometrics (AGC), attention modification (AMC), or attention control (ACC) conditions. We assessed subjective, behavioral, and physiological reactivity to a speech task and self-reported social anxiety symptoms. After training, participants in the AMC exhibited an attention avoidance from threat, and those in the AGC responded more rapidly toward targeted geometrics. There was a significant pre- to post-reduction in subjective speech distress across groups, but behavioral and physiological reactivity to speech, as well as self-report social anxiety symptoms, remained unchanged. These results lead to questions concerning effectiveness of ABM training for reducing social anxiety. Further examination of the current ABM protocol is required.",Yao N.; Yu H.; Qian M.; Li S.,2015.0,10.1016/j.janxdis.2015.09.006,0,0,
2507,Multi-tensor investigation of orbitofrontal cortex tracts affected in subcaudate tractotomy,"Subcaudate tractotomy (SCT) is a neurosurgical lesioning procedure that can reduce symptoms in medically intractable obsessive compulsive disorder (OCD). Due to the putative importance of the orbitofrontal cortex (OFC) in symptomatology, fibers that connect the OFC, SCT lesion, and either the thalamus or brainstem were investigated with two-tensor tractography using an unscented Kalman filter approach. From this dataset, fibers were warped to Montreal Neurological Institute space, and probability maps with center-of-mass analysis were subsequently generated. In comparing fibers from the same OFC region, including medial OFC (mOFC), central OFC (cOFC), and lateral OFC (lOFC), the area of divergence for fibers connected with the thalamus versus the brainstem is posterior to the anterior commissure. At the anterior commissure, fibers connected with the thalamus run dorsal to those connected with the brainstem. As OFC fibers travel through the ventral aspect of the internal capsule, lOFC fibers are dorsal to cOFC and mOFC fibers. Using neuroanatomical comparison, tracts coursing between the OFC and thalamus are likely part of the anterior thalamic radiations, while those between the OFC and brainstem likely belong to the medial forebrain bundle. These data support the involvement of the OFC in OCD and may be relevant to creating differential lesional procedures of specific tracts or to developing deep brain stimulation programming paradigms.",Yang J.C.; Papadimitriou G.; Eckbo R.; Yeterian E.H.; Liang L.; Dougherty D.D.; Bouix S.; Rathi Y.; Shenton M.; Kubicki M.; Eskandar E.N.; Makris N.,2015.0,10.1007/s11682-014-9314-z,0,0,
2508,Effect of dipeptide of glutamine and alanine on severe traumatic brain injury,"ER METHODSA total of 46 patients (31 males and 15 females, aged 7-68 years, (47+/-9.6) years on average) with severe traumatic brain injury were randomized into two groups: Group G (n=23) and Group C (n=23). The patients in Group G received nutritional remedy with the dipeptide of glutamine and alanine, whereas the patients in Group C received routine nutritional therapy only. GCS changes, the length of stay in the neurosurgical intensive care unit (NICU), the mortality,the count of lymphocytes, related complications including lung infection and hemorrhage of alimentary tracts, etc, were examined and recorded.RESULTSThe fatality rate and the length of stay in NICU in Group G was lower than these in Group C (P larger than 0.05), but no obvious difference was found in GCS changes of the patients between the two groups (P larger than 0.05). The patients with lung infection and alimentary tract hemorrhage in Group G were less than those in Group C (P larger than 0.05). The count of lymphocytes in Group G was more than that in Group C (P larger than 0.05), but no difference was found in other nutritional data.CONCLUSIONSDipeptide of glutamine and alanine can increase the resisting stress and anti-infection ability of patients with severe traumatic brain injury, which can also lower the mortality and shorten the NICU stay.OBJECTIVETo determine the effect of dipeptide of glutamine and alanine on patients with severe traumatic brain injury.","Yang, D L; Xu, J F",2007.0,,0,0,
2509,The effect of a researcher designated music intervention on hospitalised psychiatric patients with different levels of anxiety.,"The purpose of this study was to investigate the effects of a music intervention on hospitalised psychiatric patients with different levels of anxiety. In clinical practice, psychiatric inpatients and nurses routinely suffer from anxiety. A music intervention may possibly be useful, but knowledge as to how useful and how effective it is in patients with different levels of anxiety is limited. The study design was a three-group, repeated-measures experimental study. Subjects were 22 psychiatric patients who were divided into three groups based on their level of anxiety. They listened to 20 minutes of music each day for 10 days and were assessed using the Beck Anxiety Inventory before and after the music intervention and at a one-week follow-up; an electroencephalogram and finger temperature were monitored before and during the music intervention. Anxiety levels of all three groups showed a significant difference (p = 0·0339) after the intervention. The difference alpha and beta electroencephalogram percentages for all three groups showed a significant difference (p = 0·04; p = 0·01). The finger temperature showed a non-significant difference (p = 0·41). A music intervention can effectively alleviate the anxiety of hospitalised psychiatric patients who suffer from all levels of anxiety. The study recommends a practice in alleviating anxiety. Effective lower-cost interventions to reduce anxiety in psychiatric inpatient settings would be of interest to nurses and benefit patients.",Yang CY.; Miao NF.; Lee TY.; Tsai JC.; Yang HL.; Chen WC.; Chung MH.; Liao YM.; Chou KR.,2016.0,10.1111/jocn.13098,0,0,
2510,Does overgeneral autobiographical memory result from poor memory for task instructions?,"Considerable previous research has shown that retrieval of overgeneral autobiographical memories (OGM) is elevated among individuals suffering from various emotional disorders and those with a history of trauma. Although previous theories suggest that OGM serves the function of regulating acute negative affect, it is also possible that OGM results from difficulties in keeping the instruction set for the Autobiographical Memory Test (AMT) in working memory, or what has been coined ""secondary goal neglect"" (Dalgleish, 2004). The present study tested whether OGM is associated with poor memory for the task's instruction set, and whether an instruction set reminder would improve memory specificity over repeated trials. Multilevel modelling data-analytic techniques demonstrated a significant relationship between poor recall of instruction set and probability of retrieving OGMs. Providing an instruction set reminder for the AMT relative to a control task's instruction set improved memory specificity immediately afterward.",Yanes PK.; Roberts JE.; Carlos EL.,2008.0,10.1080/09658210802135351,0,0,
2511,The regulation from guaiacyl to syringyl lignin in the differentiating xylem of Robinia pseudoacacia,"13C- and deuterium (D)-labeled ferulic acid and sinapic acid ([8-13C, 3-OCD3]-ferulic acid and [8-13C, 3,5-OCD3]-sinapic acid) were administered to robinia (Robinia pseudoacacia L.) shoots. To estimate the distribution of the label from administrated ferulic or sinapic acid, continuous 50-μm-thick tangential sections cut from the cambium of robinia were subjected to lignin chemical analysis by the DFRC method. Labeled ferulic acid was incorporated into guaiacyl and syringyl lignin. The incorporation of labeled ferulic acid into syringyl units was observed only in the later stage of lignification. Labeled sinapic acid was incorporated into syringyl lignin in the early stage and the later stage of lignification. In general, syringyl lignin was deposited in the later stage of cell wall lignification. Thus, the incorporation of sinapic acid to syringyl lignin in the early stage of lignification was abnormal. Taken together, the aromatic ring-modifying reactions (the conversion from guaiacyl to syringyl moiety, including the hydroxylation and methylation) were more important for the regulation of the sinapyl alcohol biosynthesis than the reducing reactions (the reduction of acids to alcohols) in the differentiating xylem. © 2004 Académie des Sciences. Published by Elsevier SAS. All rights reserved.",Yamauchi K.; Fukushima K.,2004.0,10.1016/j.crvi.2004.07.012,0,0,
2512,Direct effects of short-term psychoeducational intervention for relatives of patients with schizophrenia in Japan,"This study examined the direct effects of short-term psychoeducation on relatives of inpatients with schizophrenia, with the goal of introducing this type of support program into standard care. The subjects were 46 relatives of inpatients with schizophrenia who attended three or four sessions of psychoeducation. Levels of anxiety and subjective burden and distress were measured before and after sessions using self-administered rating scales. In addition, levels of expressed emotion were also measured. Results showed that both state and trait anxiety on the State-Trait Anxiety Inventory were significantly lower after psychoeducational intervention than before intervention. In addition, subjective burden and distress reported by the family significantly decreased on the subscales for family confusion resulting from a lack of knowledge of the illness and anxiety about the future, subjective burden and depression resulting from the patient's illness, and difficulties in the relatives' relationships with the patient. Comparison of high and low expressed emotion families showed that the intervention was almost equally effective for the two groups. However, its effectiveness with regard to the subjective burden and depression experienced by the families was significantly greater among high expressed emotion families. The present study confirmed that family psychoeducation during hospitalization, even for a short period, is effective for all families, whether high or low expressed emotion. Moreover, the results suggested that the intervention may have a greater effect on emotional factors in high expressed emotion families than in low expressed emotion families. © 2006 The Authors.",Yamaguchi H.; Takahashi A.; Takano A.; Kojima T.,2006.0,10.1111/j.1440-1819.2006.01563.x,0,0,
2513,[Relationship between intensity of annoyance due to throat discomfort and psychological test results].,"For 87 male and 100 female patients (average age of 58.5 years) with throat discomfort, we investigated the relationship between the intensity of annoyance caused by throat discomfort and psychological distress. We asked patients to assess their throat discomfort using a 100-mm horizontal visual analogue scale (VAS) which defined the left end (0) as no annoyance and the right end (100) as overwhelming annoyance attributed to throat discomfort. The extent of their psychological distress was evaluated by 3 tests: Cornell Medical Index-Health Questionnaire (CMI), Self-rating Depression Scale (SDS) and Self-rating Questionnaire for Depression (SRQ-D). Our results indicate that the increase in intensity of annoyance caused by throat discomfort was significantly related to the increase in somatic symptoms (Spearman's rho = 0.164, p = 0.025), symptoms connected to autonomic nerve dysfunction (rho = 0.203, p = 0.006) as measured by CMI and neurotic condition as classified by Fukamachi's diagnostic method for CMI (p = 0.049 by Kruskal-Wallis test). The increase in intensity of annoyance caused by throat discomfort was significantly related to the increase in depressive condition as measured using SRQ-D (rho = 0.263, p < 0.001), but not to that measured using SDS (rho = 0.097, p = 0.185). The results obtained from the present study indicate that VAS is a useful tool for measuring annoyance caused by throat discomfort, yielding valuable information about the intensity of patients' somatic and psychological complaints.",Yamagiwa M.; Hattori R.,2000.0,,0,0,
2514,Coping behavior in patients with panic disorder,"The purpose of the present paper was to investigate the role of coping behavior in patients with panic disorder (PD). This was done by evaluating three items of coping behavior (seeking of social support, wishful thinking and avoidance) in the Ways of Coping Checklist. The subjects consisted of 30 patients with PD (26 with agoraphobia). Coping behavior and the severity of PD was investigated at baseline and at 24 months (the final outcome). At baseline there were no gender differences in coping behavior. The severity of panic attacks significantly correlated with that of agoraphobia. The baseline severity of PD (panic attacks and agoraphobia) did not correlate with coping behavior. At the outcome assessment there was no significant correlation between the severity of panic attack and coping behavior. The severity of agoraphobia at final outcome and the coping behavior (seeking of social support) at baseline were significantly correlated. In the group that had remission in agoraphobia (the good outcome group), the severity of agoraphobia at baseline was significantly lower and the seeking of social support coping behavior was significantly higher than that of the poor outcome group. No significant difference in panic attack severity was noted between the good and poor outcome groups. Discriminant analysis revealed that seeking of social support coping behavior was a significant discriminant factor of agoraphobia. Although these are preliminary data, special coping behavior might be related to improvement of agoraphobia in patients with PD.",Yamada K.; Fujii I.; Akiyoshi J.; Nagayama H.,2004.0,10.1111/j.1440-1819.2003.01213.x,0,0,
2515,The impact of a weekend group experience on individual therapy.,"Thirty-three patients in long-term individual therapy were referred to one of three weekend groups: two experimental (affect-arousing, gestalt therapy) groups and one control (meditation-Tai Chi) group. The impact of the weekend group experience (WGE) on individual therapy was examined six and 12 weeks later. At six weeks the patients in the experimental groups showed, on some measures, a significantly greater improvement in their individual therapy than did controls. By 12 weeks, there were no demonstrable differences. The WGE was not without risk: even though the group leaders were highly trained, responsible clinicians, two patients suffered considerable psychological damage. The control (meditation-Tai Chi) group offered a relatively innocuous experience; there was no risk, but few members found the specific procedures useful in their lives. Intense affect arousal in the WGE was not related to positive change in subsequent individual therapy. Those expressing the greatest affect in either experimental group were no more likely to have had a measurable positive impact on their subsequent individual therapy than patients expressing little or no measurable affect.",Yalom ID.; Bond G.; Bloch S.; Zimmerman E.; Friedman L.,1977.0,,0,0,
2516,Functional MRI-navigated repetitive transcranial magnetic stimulation over supplementary motor area in chronic tic disorders,"ER BACKGROUND: Open label studies have shown repetitive transcranial magnetic stimulation to be effective in reducing tics.OBJECTIVES: To determine whether 8 sessions of continuous theta burst stimulation (cTBS) over supplementary motor area (SMA) given over 2 days may reduce tics and motor cortical network activity in Tourette syndrome/chronic tic disorders.METHODS: This was a randomized (1:1), double-blind, sham-controlled trial of functional MRI (fMRI)-navigated, 30 Hz cTBS at 90% of resting motor threshold (RMT) over SMA in 12 patients ages 10-22 years. Comorbid ADHD (n = 8), OCD (n = 8), and stable concurrent medications (n = 9) were permitted. Neuro-navigation utilized each individual's event-related fMRI signal. Primary clinical and cortical outcomes were: 1) Yale Global Tic Severity Scale (YGTSS) at one week; 2) fMRI event-related signal in SMA and primary motor cortex (M1) during a finger-tapping motor task.RESULT: Baseline characteristics were not statistically different between groups (age, current tic/OCD/ADHD severities, tic-years, number of prior medication trials, RMT). Mean YGTSS scores decreased in both active (27.5 ± 7.4 to 23.2 ± 9.8) and sham (26.8 ± 4.8 to 21.7 ± 7.7) groups. However, no significant difference in video-based tic severity rating was detected between the two groups. Two-day post-treatment fMRI activation during finger tapping decreased significantly in active vs. sham groups for SMA (P = 0.02), left M1 (P = 0.0004), and right M1 (P < 0.0001). No serious adverse events occurred.CONCLUSION: Active, fMRI-navigated cTBS administered in 8 sessions over 2 days to the SMA induced significant inhibition in the motor network (SMA, bilateral M1). However, both groups on average experienced tic reduction at 7 days. Larger sample size and protocol modifications may be needed to produce clinically significant tic reduction beyond placebo effect.","Wu, S W; Maloney, T; Gilbert, D L; Dixon, S G; Horn, P S; Huddleston, D A; Eaton, K; Vannest, J",2014.0,10.1016/j.brs.2013.10.005,0,0,
2517,Effect of transcutaneous acupoint electrical stimulation on stress in brain surgery with propofol target controlled infusion general anesthesia,"ER OBJECTIVE: To study the effect of transcutaneous acupoint electrical stimulation (TAES) on stress who received propofol target controlled infusion (TCI) general anesthesia in brain surgery.METHODS: Totally 40 neurosurgical patients of I-II grade (ASA grading) in our hospital were randomly divided into the TAES group (T group) and the control group (C group), 20 in each group. All patients received intravenous anesthesia by propofol TCI. The TAES intervention was adopted in those of C group. Electrodes were only applied to corresponding acupoints without electric stimulation. The arterial blood was withdrawn before TAES (T0), before anesthesia (T1), before cutting (T2), at 60 min after encephalic incision (T3), immediately after incisions suture (T4), at about 10 min after removing tracheal catheters (T5) to detect beta-endorphin (beta-EP), cortisol (COR), adrenalin (E), blood sugar (Glu). The heart rate (HR) and mean arterial pressure (MAP) were recorded. The total time of surgery, anesthesia, total infusion amount, blood lost amount, and urine amount were recorded.RESULTS: In both groups, HR, MAP, COR, and E at T2 were lower than at T0 significantly (P < 0.05). beta-EP in group C at T2 was lower than at T0 significantly (P < 0.05). HR, MAP, COR in group C at T3 were higher than at T0 significantly (P < 0.05). HR, MAP, E, and Glu in group C at T4 and T5 were higher than at T0 significantly (P < 0.05). beta-EP in group T at T1 and T3 were higher than at T0 significantly (P < 0.05). HR, COR, E, Glu, and beta-EP in group T at T4 and T5 were higher than at T0 significantly (P < 0.05). Between groups, comparing with the time point T0, the amplitude of variation of MAP, COR, and E at T2 in group C were significantly less (P < 0.05); the amplitude of variation of HR, MAP, and COR at T3 in group C were less significantly, when compared with the time point T0 (P < 0.05); the amplitude of variation of HR, MAP, COR, E, and Glu at T4 and T5 in group C were less significantly, when compared with the time point T0 (P < 0.05). When comparing the two groups, the amplitude of variation of beta-EP at time points of T1, T3, T4, and T5 in group T were larger than at T0 in group C (P < 0.05).CONCLUSION: TAES could reduce stress and stabilize the internal environment when used in brain surgery with propofol TCI general anesthesia.","Wu, Q; Mo, Y C; Huang, L P; Luo, L; Wang, J L",2013.0,,0,0,
2518,Clinical observation on post-stroke anxiety neurosis treated by acupuncture.,"To observe the therapeutic effect of acupuncture on post-stroke anxiety neurosis (PSAN). 34 patients in the treatment group received acupuncture treatment. Points such as Baihui (GV 20), Shenting (GV 24), Yintang (EX-HN 3), Shuigou (GV 26), Hegu (LI 4), Taichong (LR 3), Shenmen (HT 7) and Neiguan (PC 6) were punctured and supplemented by electroacupuncture. 33 patients in the control group orally took Alprazolam. Hamilton Anxiety Scale (HAMA) was used to evaluate the severity and relief of anxiety. Anxiety symptoms of the patients in the treatment group were obviously relieved with a total effective rate of 82.35%, and no remarkable difference was found as compared with that of the control group (P > 0.05). Acupuncture is a safe, effective and important method for treating PSAN.",Wu P.; Liu S.,2008.0,,0,0,
2519,Effects of menstrual cycle and neuroticism on females' emotion regulation.,"Fifteen highly neurotic women and 21 women who were low in neuroticism participated in this study. The women were surveyed three times over a single menstrual cycle during the mid-late luteal, menstrual, and late follicular phases. Each time, the participants were asked to use reappraisal to regulate their emotions, which were evoked by a sad film clip, and their subjective emotional experiences and physiological responses were recorded. The results showed that neuroticism had no impact on emotion regulation, and the females experienced fluctuations in their emotion regulation success over their menstrual cycle. During the menstrual phase, women reported significantly higher levels of reappraisal, but subjective sadness did not differ throughout the three phases. Additionally, the regulation effects on galvanic skin response (GSR) were smaller during the menstrual phase than in the mid-late luteal phase. These results suggested that women in the menstrual phase expended more effort but gained less success at regulating their emotions.",Wu M.; Zhou R.; Huang Y.,2014.0,10.1016/j.ijpsycho.2014.10.003,0,0,
2520,Brain correlates of negative and positive visuospatial priming in adults,"A balance of inhibitory and facilitatory mechanisms is essential for efficient and goal-directed behaviors. These mechanisms may go awry in several neuropsychiatric disorders characterized by uncontrolled, repetitive behaviors. The visuospatial priming paradigm is a well-established probe of inhibition and facilitation that has been used to demonstrate behavioral deficits in patients with Tourette syndrome and obsessive-compulsive disorder. However, the brain correlates of this visuospatial priming paradigm are not yet well established. In the present study, we used a visuospatial priming paradigm and event-related functional MRI, to probe inhibitory and facilitatory brain mechanisms in healthy adult women. When subjects performed the negative priming (i.e., inhibitory) task, several regions of the prefrontal cortex were selectively activated relative to the neutral condition. Non-overlapping regions of the prefrontal cortex were deactivated in the positive priming condition. These results support the notion that the prefrontal cortex is involved in both inhibitory and facilitatory processing and demonstrate that this visuospatial priming task shares brain correlates with other positive and negative priming tasks. In conjunction with functional MRI, this visuospatial priming task may be useful for studying the pathophysiology of neuropsychiatric disorders in which deficient inhibitory processing or excessive facilitation is a feature. © 2005 Elsevier Inc. All rights reserved.",Wright C.I.; Keuthen N.J.; Savage C.R.; Martis B.; Williams D.; Wedig M.; McMullin K.; Rauch S.L.,2006.0,10.1016/j.neuroimage.2005.10.015,0,0,
2521,A controlled family study of children with DSM-IV bipolar-I disorder and psychiatric co-morbidity,"ER METHODWe conducted a blinded, controlled family study using structured diagnostic interviews of 157 children with BP-I probands (n=487 first-degree relatives), 162 attention deficit hyperactivity disorder (ADHD) (without BP-I) probands (n=511 first-degree relatives), and 136 healthy control (without ADHD or BP-I) probands (n=411 first-degree relatives).RESULTSThe morbid risk (MR) of BP-I disorder in relatives of BP-I probands (MR=0.18) was increased 4-fold [95% confidence interval (CI) 2.3-6.9, p<0.001] over the risk to relatives of control probands (MR=0.05) and 3.5-fold (95% CI 2.1-5.8, p<0.001) over the risk to relatives of ADHD probands (MR=0.06). In addition, relatives of children with BP-I disorder had high rates of psychosis, major depression, multiple anxiety disorders, substance use disorders, ADHD and antisocial disorders compared with relatives of control probands. Only the effect for antisocial disorders lost significance after accounted for by the corresponding diagnosis in the proband. Familial rates of ADHD did not differ between ADHD and BP-I probands.CONCLUSIONSOur results document an increased familial risk for BP-I disorder in relatives of pediatric probands with DSM-IV BP-I. Relatives of probands with BP-I were also at increased risk for other psychiatric disorders frequently associated with pediatric BP-I. These results support the validity of the diagnosis of BP-I in children as defined by DSM-IV. More work is needed to better understand the nature of the association between these disorders in probands and relatives.BACKGROUNDTo estimate the spectrum of familial risk for psychopathology in first-degree relatives of children with unabridged DSM-IV bipolar-I disorder (BP-I).","Wozniak, J; Faraone, S V; Mick, E; Monuteaux, M; Coville, A; Biederman, J",2010.0,10.1017/S0033291709991437,0,0,
2522,Systematic desensitization and expectancy in the treatment of speaking anxiety,,"Woy, J R; Efran, J S",1972.0,,0,0,
2523,Reducing analogue trauma symptoms by computerized reappraisal training - considering a cognitive prophylaxis?,"Distressing intrusions are a hallmark of posttraumatic stress disorder (PTSD). Dysfunctional appraisal of these symptoms may exacerbate the disorder, and conversely may lead to further intrusive memories. This raises the intriguing possibility that learning to 'reappraise' potential symptoms more functionally may protect against such symptoms. Woud, Holmes, Postma, Dalgleish, and Mackintosh (2012) found that 'reappraisal training' when delivered after an analogue stressful event reduced later intrusive memories and other posttraumatic symptoms. The present study aimed to investigate whether reappraisal training administered before a stressful event is also beneficial. Participants first received positive or negative reappraisal training (CBM-App training) using a series of scripted vignettes. Subsequently, participants were exposed to a film with traumatic content. Effects of the CBM-App training procedure were assessed via three distinct outcome measures, namely: (a) post-training appraisals of novel ambiguous vignettes, (b) change scores on the Post Traumatic Cognitions Inventory (PTCI), and (c) intrusive symptom diary. CBM-App training successfully induced training-congruent appraisal styles. Moreover, those trained positively reported less distress arising from their intrusive memories of the trauma film during the subsequent week than those trained negatively. However, the induced appraisal bias only partly affected PTCI scores. Participants used their own negative event as a reference for the PTCI assessments. The events may have differed regarding their emotional impact. There was no control group. CBM-App training has also some beneficial effects when applied before a stressful event and may serve as a cognitive prophylaxis against trauma-related symptomatology.",Woud ML.; Postma P.; Holmes EA.; Mackintosh B.,2013.0,10.1016/j.jbtep.2013.01.003,0,0,
2524,Alcohol-related interpretation bias in alcohol-dependent patients.,"Models of addictive behaviors postulate that implicit alcohol-related memory associations and biased interpretation processes contribute to the development and maintenance of alcohol misuse and abuse. The present study examined whether alcohol-dependent patients (AP) show an alcohol-related interpretation bias. Second, the relationship between the interpretation bias and levels of harmful drinking was investigated. The sample included 125 clinically diagnosed AP and 69 clinically diagnosed control patients (CP) who had either a mood or an anxiety disorder. Participants completed a booklet containing 12 open-ended ambiguous scenarios. Seven scenarios were alcohol-relevant, and 5 were emotionally relevant, that is, panic- or depression-relevant. Participants were asked to read each scenario and to generate a continuation. In addition, the Alcohol Use Disorder Identification Test (AUDIT) and Beck Depression Inventory were administered. Logistic multivariate multilevel analyses revealed that AP' probability of generating an alcohol-related continuation on all 3 scenario types was higher than that of CP. Moreover, alcohol-related interpretation biases were positively associated with levels of harmful drinking (i.e., AUDIT scores). These findings are the first to show that AP show an alcohol-related interpretation bias, which generalizes to other ambiguous emotionally relevant contexts, and therefore advance our understanding of the role of implicit biased alcohol-related memory associations and interpretation processes.",Woud ML.; Pawelczak S.; Rinck M.; Lindenmeyer J.; Souren P.; Wiers RW.; Becker ES.,2014.0,10.1111/acer.12334,0,0,
2525,Ameliorating intrusive memories of distressing experiences using computerized reappraisal training.,"The types of appraisals that follow traumatic experiences have been linked to the emergence of posttraumatic stress disorder (PTSD). Could changing reappraisals following a stressful event reduce the emergence of PTSD symptoms? The present proof-of-principle study examined whether a nonexplicit, systematic computerized training in reappraisal style following a stressful event (a highly distressing film) could reduce intrusive memories of the film, and symptoms associated with posttraumatic distress over the subsequent week. Participants were trained to adopt a generally positive or negative poststressor appraisal style using a series of scripted vignettes after having been exposed to highly distressing film clips. The training targeted self-efficacy beliefs and reappraisals of secondary emotions (emotions in response to the emotional reactions elicited by the film). Successful appraisal induction was verified using novel vignettes and via change scores on the post traumatic cognitions inventory. Compared with those trained negatively, those trained positively reported in a diary fewer intrusive memories of the film during the subsequent week, and lower scores on the Impact of Event Scale (a widely used measure of posttraumatic stress symptoms). Results support the use of computerized, nonexplicit, reappraisal training after a stressful event has occurred and provide a platform for future translational studies with clinical populations that have experienced significant real-world stress or trauma.",Woud ML.; Holmes EA.; Postma P.; Dalgleish T.; Mackintosh B.,2012.0,10.1037/a0024992,0,0,
2526,An integrated framework for information-centred human-machine systems analysis,"In emergency management operators and commanders must rely on dynamic, distributed systems and organisations for safe and effective mission accomplishment. Commanders and operators often experience extreme risk exposure, and coping with environmental hazards, fear, exhaustion and compulsion is part of their profession. They routinely handle highly ambiguous decision situations, where critical demands are inflicted upon their cognitive abilities and response times. In the future they will make decisions in situations where operational and system characteristics are highly dynamic and nonlinear, i.e. small actions or decisions may have serious and irreversible consequences for the entire mission. Commanders and operators are required to manage true real-time system properties at all levels, individual operators, stand-alone technical systems, higher-order integrated sociotechnical systems and joint operations forces alike. Coping with these conditions in performance assessment, system development and operational testing is a challenge for practitioners, instructors and researchers. Using a monotheory approach such as classic decision theory and multiattribute utility theory is nearly impossible. New results, new measurement techniques and new methodological breakthroughs facilitate a more accurate and deeper understanding, generating new and updated models and paradigms. This in turn generates theoretical advances. Some good examples of successful polytheory approaches are found in the research areas of cognitive systems engineering, systems theory, and psychophysiology, and in the fields of dynamic, distributed decision making and naturalistic decision making. A successful attempt to integrate these areas into a coherent framework, Action Control Theory (ACT) is described. Copyright © 2002 Inderscience Enterprises Ltd.",Worm A.,2003.0,10.1504/IJEM.2002.000515,0,0,
2527,Early programmes of high and low intensity exercise and quality of life after acute myocardial infarction,"ER SETTINGAustralian teaching hospital.PATIENTS224 men from a consecutive series of 339 men under 70 admitted to a coronary care unit with transmural acute myocardial infarction.INTERVENTIONPatients were randomly allocated in hospital to a group programme lasting eight weeks of either high intensity exercise training or light exercise.MAIN OUTCOME MEASURESPhysical working capacity based on metabolic equivalents achieved from treadmill exercise tests at entry, after 11 weeks, and after one year. Quality of life based on self report scores of anxiety, depression, denial, and wellbeing and interview assessments of activities and psychosocial adjustment at entry, after four months, and after one year.RESULTSThe two groups were well matched at entry. At 11 weeks the mean results of treadmill testing were 10.7 (95% confidence interval 10.20 to 11.20) metabolic equivalents for exercise training and 9.7 (9.26 to 10.14) for light exercise (t = 2.85, df = 181, p = 0.005). Apart from this small temporary benefit in mean physical working capacity, there were no significant differences between groups. Improvement in occupational adjustment score from baseline to four months was greater after exercise training than after light exercise, but at one year repeated measures analysis of variance showed no significant effects of treatment or interaction between treatment and time point.CONCLUSIONThe effects on quality of life of a low cost programme of light exercise are similar to those obtained from a high intensity exercise training programme.OBJECTIVETo determine whether a group programme of light exercise could improve quality of life in patients after acute myocardial infarction to the same extent as a high intensity exercise training programme.","Worcester, M C; Hare, D L; Oliver, R G; Reid, M A; Goble, A J",1993.0,,0,0,
2528,Valence-dependent influence of serotonin depletion on model-based choice strategy,"ER Human decision-making arises from both reflective and reflexive mechanisms, which underpin goal-directed and habitual behavioural control. Computationally, these two systems of behavioural control have been described by different learning algorithms, model-based and model-free learning, respectively. Here, we investigated the effect of diminished serotonin (5-hydroxytryptamine) neurotransmission using dietary tryptophan depletion (TD) in healthy volunteers on the performance of a two-stage decision-making task, which allows discrimination between model-free and model-based behavioural strategies. A novel version of the task was used, which not only examined choice balance for monetary reward but also for punishment (monetary loss). TD impaired goal-directed (model-based) behaviour in the reward condition, but promoted it under punishment. This effect on appetitive and aversive goal-directed behaviour is likely mediated by alteration of the average reward representation produced by TD, which is consistent with previous studies. Overall, the major implication of this study is that serotonin differentially affects goal-directed learning as a function of affective valence. These findings are relevant for a further understanding of psychiatric disorders associated with breakdown of goal-directed behavioural control such as obsessive-compulsive disorders or addictions.","Worbe, Y; Palminteri, S; Savulich, G; Daw, N D; Fernandez-Egea, E; Robbins, T W; Voon, V",2016.0,10.1038/mp.2015.46,0,0,
2529,"Repetitive behaviours in patients with Gilles de la Tourette syndrome: tics, compulsions, or both?","Repetitive behaviours (RB) in patients with Gilles de la Tourette syndrome (GTS) are frequent. However, a controversy persists whether they are manifestations of obsessive-compulsive disorder (OCD) or correspond to complex tics. 166 consecutive patients with GTS aged 15-68 years were recruited and submitted to extensive neurological, psychiatric and psychological evaluations. RB were evaluated by the YBOCS symptom checklist and Mini International Neuropsychiatric Interview (M.I.N.I), and classified on the basis of a semi-directive psychiatric interview as compulsions or tics. RB were present in 64.4% of patients with GTS (107/166) and categorised into 3 major groups: a 'tic-like' group (24.3%-40/166) characterised by RB such as touching, counting, 'just right' and symmetry searching; an 'OCD-like' group (20.5%-34/166) with washing and checking rituals; and a 'mixed' group (13.2%-22/166) with both 'tics-like' and 'OCD-like' types of RB present in the same patient. In 6.3% of patients, RB could not be classified into any of these groups and were thus considered 'undetermined'. The results confirm the phenomenological heterogeneity of RB in GTS patients and allows to distinguish two types: tic-like behaviours which are very likely an integral part of GTS; and OCD-like behaviours, which can be considered as a comorbid condition of GTS and were correlated with higher score of complex tics, neuroleptic and SSRIs treatment frequency and less successful socio-professional adaptation. We suggest that a meticulous semiological analysis of RB in GTS patients will help to tailor treatment and allow to better classify patients for future pathophysiologic studies. ClinicalTrials.gov NCT00169351.",Worbe Y.; Mallet L.; Golmard JL.; Béhar C.; Durif F.; Jalenques I.; Damier P.; Derkinderen P.; Pollak P.; Anheim M.; Broussolle E.; Xie J.; Mesnage V.; Mondon K.; Viallet F.; Jedynak P.; Ben Djebara M.; Schüpbach M.; Pelissolo A.; Vidailhet M.; Agid Y.; Houeto JL.; Hartmann A.,2010.0,10.1371/journal.pone.0012959,0,0,
2530,Disgust as a motivator of avoidance of spiders.,"Individuals with small animal phobias show elevated general disgust sensitivity, and spider phobics often endorse both fear and disgust in response to a spider. Some researchers have argued that the link between disgust and fear of small animals is spurious. On the other hand, disgust may play a functional role, as might any negative emotion that is strongly stimulus-bound, in which escape or avoidance is negatively reinforced. It is therefore important to clarify whether disgust has a functional or epiphenomenal role in avoidance of feared stimuli. The present study examined the degree to which disgust motivates avoidance of spider-related stimuli using a series of behavioral avoidance tests comparing a harmless tarantula, a pen that had come in contact with the spider, and a clean pen. Peak disgust was a stronger predictor than anxiety of avoidance of both the spider and the ""contaminated"" pen.",Woody SR.; McLean C.; Klassen T.,2005.0,10.1016/j.janxdis.2004.04.002,0,0,
2531,Reduced cytokine levels and T-cell function in healthy males: Relation to individual differences in subclinical anxiety,"Previous studies of psychopathological populations and populations challenged by significant life events have shown that high levels of anxiety and depression are associated with impaired cellular immunity. However, less is known about the sources and psychoimmunological relevance of subclinical variations in distress in healthy populations faced with typical levels of life stress. In the present study, we examined the relations of state distress to T-cell function and in vivo cytokine levels in 40 male college freshmen on two occasions. In addition, we assessed the possible contribution of dispositional determinants of distress to immune-related differences in mood. Relative to characteristically less anxious subjects, subjects who were characteristically more anxious (but subclinically anxious) had more anxious mood and had significantly lower lymphocyte proliferative responses to the mitogen concanavalin A (Con A) as well as lower levels of circulating interleukin-1β. In addition, subjects with more negative attributional styles for bad events exhibited reduced Con A-stimulated T-cell responses and lower levels of circulating interleukin-2. Finally, subjects who were more depressed (but subclinically depressed) also had reduced blastogenic responses. Individual differences in cortisol and P-endorphin were not shown to mediate these relationships. The present study provides evidence that dispositionally related variations in distress in psychiatrically healthy, relatively unstressed college males have immunological correlates that suggest altered T-cell and macrophage activity.",Zorrilla E.P.; Redei E.; DeRubeis R.J.,1994.0,10.1006/brbi.1994.1028,0,0,
2532,ADRA2B deletion variant selectively predicts stress-induced enhancement of long-term memory in females,"Clarifying the mechanisms that underlie stress-induced alterations of learning and memory may lend important insight into susceptibility factors governing the development of stress-related psychological disorders, such as post-traumatic stress disorder (PTSD). Previous work has shown that carriers of the ADRA2B Glu301-Glu303 deletion variant exhibit enhanced emotional memory, greater amygdala responses to emotional stimuli and greater intrusiveness of traumatic memories. We speculated that carriers of this deletion variant might also be more vulnerable to stress-induced enhancements of long-term memory, which would implicate the variant as a possible susceptibility factor for traumatic memory formation. One hundred and twenty participants (72 males, 48 females) submerged their hand in ice cold (stress) or warm (no stress) water for 3min. Immediately afterwards, they studied a list of 42 words varying in emotional valence and arousal and then completed an immediate free recall test. Twenty-four hours later, participants' memory for the word list was examined via free recall and recognition assessments. Stressed participants exhibiting greater heart rate responses to the stressor had enhanced recall on the 24-h assessment. Importantly, this enhancement was independent of the emotional nature of the learned information. In contrast to previous work, we did not observe a general enhancement of memory for emotional information in ADRA2B deletion carriers. However, stressed female ADRA2B deletion carriers, particularly those exhibiting greater heart rate responses to the stressor, did demonstrate greater recognition memory than all other groups. Collectively, these findings implicate autonomic mechanisms in the pre-learning stress-induced enhancement of long-term memory and suggest that the ADRA2B deletion variant may selectively predict stress effects on memory in females. Such findings lend important insight into the physiological mechanisms underlying stress effects on learning and their sex-dependent nature. © 2014 Elsevier Ltd.",Zoladz P.R.; Kalchik A.E.; Hoffman M.M.; Aufdenkampe R.L.; Lyle S.M.; Peters D.M.; Brown C.M.; Cadle C.E.; Scharf A.R.; Dailey A.M.; Wolters N.E.; Talbot J.N.; Rorabaugh B.R.,2014.0,10.1016/j.psyneuen.2014.06.012,0,0,
2533,ADRA2B deletion variant influences time-dependent effects of pre-learning stress on long-term memory,"Extensive work over the past few decades has shown that certain genetic variations interact with life events to confer increased susceptibility for the development of psychological disorders. The deletion variant of the ADRA2B gene, which has been associated with enhanced emotional memory and heightened amygdala responses to emotional stimuli, might confer increased susceptibility for the development of post-traumatic stress disorder (PTSD) or related phenotypes by increasing the likelihood of traumatic memory formation. Thus, we examined whether this genetic variant would predict stress effects on learning and memory in a non-clinical sample. Two hundred and thirty-five individuals were exposed to the socially evaluated cold pressor test or a control condition immediately or 30 min prior to learning a list of words that varied in emotional valence and arousal level. Participants’ memory for the words was tested immediately (recall) and 24 h after learning (recall and recognition), and saliva samples were collected to genotype participants for the ADRA2B deletion variant. Results showed that stress administered immediately before learning selectively enhanced long-term recall in deletion carriers. Stress administered 30 min before learning impaired recognition memory in male deletion carriers, while enhancing recognition memory in female deletion carriers. These findings provide additional evidence to support the idea that ADRA2B deletion variant carriers retain a sensitized stress response system, which results in amplified effects of stress on learning and memory. The accumulating evidence regarding this genetic variant implicates it as a susceptibility factor for traumatic memory formation and PTSD-related phenotypes.",Zoladz P.R.; Dailey A.M.; Nagle H.E.; Fiely M.K.; Mosley B.E.; Brown C.M.; Duffy T.J.; Scharf A.R.; Earley M.B.; Rorabaugh B.R.,2017.0,10.1016/j.nlm.2017.02.014,0,0,
2534,Mortality rates between treated post-traumatic stress disorder Israeli male veterans compared to non-diagnosed veterans.,"The literature suggests that post-traumatic stress disorder (PTSD) is associated with increased mortality. However, to date, mortality rates amongst veterans diagnosed with post-traumatic stress disorder have not been reported for Israeli veterans, who bear a different profile than veterans from other countries. This study aims to evaluate age-adjusted mortality rates amongst Israeli Defense Forces veterans with and without PTSD diagnosis. The study was carried out in a paired sample design with 2457 male veterans with treated PTSD and 2457 matched male veterans without a PTSD diagnosis. Data on PTSD and non-PTSD veterans was collected from the Rehabilitation Division of the Israeli Ministry of Defense (MOD) and the Israeli Defense Forces' (IDF) special unit for treatment of combat stress reaction. Mortality data were collected from the Ministry of the Interior (MOI) computerized database. Comparison of mortality rates between PTSD and non-PTSD veterans was done using paired observations survival analysis by applying a proportional hazards regression model. Overall no statistically significant difference in mortality rates was found between veterans with treated PTSD and veterans without PTSD. These findings hold even when excluding veterans who died in battle and including non-PTSD veterans who died before their matched PTSD veteran was diagnosed. However, among pairs with similar military jobs PTSD group had significantly less mortality. The results of this large national cohort suggest that treated PTSD is not associated with increased mortality. We submit that the lack of this association represents the ""net"" pathophysiology of PTSD due to the unique characteristics of the sample.",Zohar J.; Fostick L.;  .,2014.0,10.1016/j.euroneuro.2013.10.009,0,0,
2535,Processing of phobic stimuli and its relationship to outcome.,"Explored factors related to successful treatment outcome in 48 university students (aged 18-40 yrs) with a fear of spiders. Specifically, the authors examined the relationship of general memory, memory for the phobic stimulus, memory for anxious responses, and perceived self-efficacy to treatment outcome. Treatment consisted of 2 sessions of in vivo exposure therapy (with sessions 1 wk apart). During therapy, Ss were asked to engage in a series of graded steps (10 steps for day 1, 17 steps for day 2). During both sessions, Ss completed measures of general memory, memory for the phobic stimulus, recall of anxiety level during exposure tasks, and self-efficacy during exposure tasks. The results indicate that better memory for anxious responses, but not memory for the phobic stimulus, is related to lower anticipatory and actual anxiety at posttreatment assessment. Also, greater self-efficacy is related to better behavioral performance. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Zoellner, Lori A; Echiverri, Aileen; Craske, Michelle G",2000.0,,0,0,
2536,Changes in negative beliefs following three brief programs for facilitating recovery after assault.,"This study examines whether changes in negative beliefs about oneself, others, and the world occur as a result of early intervention aimed at preventing the development of chronic PTSD and further explores whether changes in negative beliefs during early intervention mediate long-term changes in psychopathology and functioning. Ninety recent female assault survivors were randomized to 4-week early intervention programs: brief cognitive behavioral intervention, weekly assessment, or supportive counseling (SC). Changes in negative beliefs were examined from preintervention to postintervention. Negative beliefs improved across interventions, with somewhat less benefit reported by participants receiving SC. As expected, before intervention more severe negative beliefs were associated with higher initial trauma reactions and these negative beliefs generally improved from preintervention to postintervention. Moreover, for the brief cognitive-behavioral intervention, changes in perceptions of self and one's safety mediated longer-term changes in trauma-related symptoms. The present results highlight the potential importance of changes in negative beliefs in long-term adjustment of recent assault survivors.",Zoellner LA.; Feeny NC.; Eftekhari A.; Foa EB.,2011.0,10.1002/da.20847,0,0,
2537,What you believe is what you want: modeling PTSD-related treatment preferences for sertraline or prolonged exposure.,"Despite the known efficacy of various psychotherapies and pharmacotherapies for posttraumatic stress disorder (PTSD), we know little about what factors predict treatment preference. In the present study, we first developed exploratory path models of treatment preference for a psychotherapy or pharmacotherapy (n=273) and then conducted confirmatory analyses of these models in a second sample (n=324) and in a third generalization sample of trauma-exposed women (n=105). We examined demographic and psychopathology factors and treatment-related beliefs (i.e., credibility and personal reactions). Across all samples, treatment-related beliefs were the strongest predictors of treatment preference. Further, severity of depression directly reduced the likelihood of choosing psychotherapy, and severity of PTSD directly increased the likelihood of choosing pharmacotherapy. These results underscore the importance of better understanding individual's beliefs regarding treatments. With a clearer understanding of these factors, we may be able to reduce barriers to treatment and increase access to effective treatments for those with trauma-related symptoms.",Zoellner LA.; Feeny NC.; Bittinger JN.,2009.0,10.1016/j.jbtep.2009.06.001,0,0,
2538,Interoceptive accuracy and panic,"Psychophysiological models of panic hypothesize that panickers focus attention on and become anxious about the physical sensations associated with panic. Attention on internal somatic cues has been labeled interoception. The present study examined the role of physiological arousal and subjective anxiety on interoceptive accuracy. Infrequent panickers and nonanxious participants participated in an initial baseline to examine overall interoceptive accuracy. Next, participants ingested caffeine, about which they received either safety or no safety information. Using a mental heartbeat tracking paradigm, participants' count of their heartbeats during specific time intervals were coded based on polygraph measures. Infrequent panickers were more accurate in the perception of their heartbeats than nonanxious participants. Changes in physiological arousal were not associated with increased accuracy on the heartbeat perception task. However, higher levels of self-reported anxiety were associated with superior performance. Copyright (C) 1999 Elsevier Science Ltd.",Zoellner L.A.; Craske M.G.,1999.0,10.1016/S0005-7967(98)00202-2,0,0,
2539,A cognitive-behavioral treatment for incarcerated women with substance abuse disorder and posttraumatic stress disorder: findings from a pilot study.,"Treatment for comorbid substance use disorder (SUD) and posttraumatic stress disorder (PTSD) is of particular relevance for incarcerated women, whose rates of PTSD and SUD are considerably higher than women in the general population. Yet virtually no treatments have been developed or systematically evaluated that target concurrently the symptoms of PTSD and SUD in this underserved population. This preliminary study evaluates the initial efficacy of a cognitive-behavioral treatment, Seeking Safety, as an adjunct to treatment-as-usual in an uncontrolled pilot study of incarcerated women with current SUD and comorbid PTSD. Of the 17 incarcerated women with PTSD and SUD who received Seeking Safety treatment and had outcome data, results show that nine (53%) no longer met criteria for PTSD at the end of treatment; at a followup 3 months later, seven (46%) still no longer met criteria for PTSD. Additionally, there was a significant decrease in PTSD symptoms from intake to posttreatment, which was maintained at the 3-month followup assessment. Based on results from a diagnostic interview and results of urinalyses, six (35%) of the women reported the use of illegal substances within 3 months from release from prison. Measures of client satisfaction with treatment were high. Recidivism rate (return to prison) was 33% at a 3-month followup. Overall, our data suggest that Seeking Safety treatment appears to be appealing to incarcerated women with SUD and PTSD and that the treatment has the potential to be beneficial, especially for improving PTSD symptoms. However, these findings are tentative given that there was no control group.",Zlotnick C.; Najavits LM.; Rohsenow DJ.; Johnson DM.,2003.0,,0,0,
2540,An interpersonally based intervention for low-income pregnant women with intimate partner violence: a pilot study.,"This study assessed the initial feasibility, acceptability, and efficacy of an intervention aimed at reducing depression and posttraumatic stress disorder (PTSD) in a sample of low-income pregnant women with recent intimate partner violence (IPV). Fifty-four women were randomly assigned to the intervention or control group. The intervention consisted of four sessions during pregnancy and one ""booster"" session within 2 weeks of delivery. Based on principles of Interpersonal Psychotherapy, the intervention was designed to help participants improve their interpersonal relationships, including their social support networks, and master their role transition to motherhood. Assessments were administered at four time points (intake, 5-6 weeks post-intake, 2 weeks postpartum, 3 months postpartum) to assess for depression, PTSD, and IPV. The intervention did not significantly reduce the likelihood of a major depressive episode, PTSD, or IPV during pregnancy or up to 3-month postpartum. However, we found moderate effects for the intervention in reducing symptoms of PTSD and depression during pregnancy and a large effect for PTSD symptoms from pregnancy up to 3 months postpartum. This study suggests some initial support for our intervention. Larger randomized trials are needed to further examine the intervention both during and after pregnancy.",Zlotnick C.; Capezza NM.; Parker D.,2011.0,10.1007/s00737-010-0195-x,0,0,
2541,Treatment of phobias. I. Comparison of imipramine hydrochloride and placebo.,"In a controlled-outcome study of phobias, 218 adult phobic patients (147 women and 71 men) received a course of 26 weekly treatment sessions that consisted of behavior therapy (BT) and imipramine hydrochloride, BT and placebo, or supportive psychotherapy and imipramine. The BT consisted of systematic desentization using fantasy and assertiveness training. Patients were classified as agoraphobic, mixed phobic, or simple phobic. Although the conditions of most patients in each group showed moderate to marked improvement, the effects of imipramine were significantly superior to those of placebo in patients with spontaneous panic attacks, ie, patients with agoraphobia or mixed phobia. In patients with simple phobia, who do not experience spontaneous panic, there was not a significant difference between imipramine and placebo. This study clearly distinguished those phobic patients who experienced spontaneous panic from those who did not in terms of pharmacologic benefits.",Zitrin CM.; Klein DF.; Woerner MG.; Ross DC.,1983.0,,0,0,
2542,"Behavior therapy, supportive psychotherapy, imipramine, and phobias.","In a controlled outcome study of phobias, 111 adult patients (69% women, 31% men) received a course of 26 weekly treatment sessions consisting of (1) behavior therapy and imipramine hydrochloride (2) behavior therapy and placebo, or (3) supportive psychotherapy and imipramine. Patients were classified as agoraphobic, mixed phobic, or simple phobic. The great majority of patients in all groups showed moderate to marked global improvement (70% to 86%, depending on rater). In agoraphobics and mixed phobics (both groups experiencing spontaneous panic attacks), imipramine was significantly superior to placebo. There was no difference between behavior therapy and supportive therapy, both resulting in high improvement rates (76% to 100%, depending on rater). In simple phobic patients, there was a high rate of improvement with all treatment regimens (72% to 93%, depending on rater), with no significant difference between imipramine and placebo or between behavior therapy and supportive therapy. Of 88 moderately to markedly improved patients followed up for one year after completing treatment, 83% maintained their gains and 17% relapsed. No patients showed symptom substitution. Eighteen percent of the patients receiving imipramine hydrochloride showed marked stimulant side effects on from 5 to 75 mg/day.",Zitrin CM.; Klein DF.; Woerner MG.,1978.0,,0,0,
2543,Comparison of short-term treatment regimens in phobic patients: a preliminary report.,,Zitrin CM.; Klein DF.; Lindemann C.; Tobak P.; Rock M.; Kaplan JE.; Ganz VH.,1976.0,,0,0,
2544,"Imipramine, behavior therapy, and phobia.",,Zitrin CM.; Klein DF.,1975.0,,0,0,
2545,[Impacts of acupuncture at twelve meridians acupoints on brain waves of patients with general anxiety disorder].,"To observe the clinical efficacy of acupuncture at twelve meridians acupoints on general anxiety disorder and explore its mechanism. Eighty patients were randomized into an acupuncture group and a clonazepam group, 40 cases in each one. In the acupuncture group, acupuncture at twelve meridians acupoints was applied, meaning quick needling at the specific acupoints of each meridian, such as Lieque (LU 7) of the Lung Meridian, Hegu (LI 4) of the Large Intestine Meridian and Shenmen (HT 7) of the Heart Meridian. After arrival of qi, the reinforcing or reducing technique was applied accordingly and the needles were not retained. In the clonazepam group, clonazepam was prescribed for oral administration. The course of treatment was 6 weeks. Before treatment and in 2, 4 and 6 weeks of treatment, respectively, Hamilton Anxiety Scale (HAMA) was evaluated in two groups and the changes in the basic electrical activity of brain waves before and after treatment were observed. HAMA score was reduced apparently after treatment as compared with that before treatment in two groups (all P < 0.01). The improvements of the total HAMA scores in 2, 4 and 6 weeks of treatment in the acupuncture group were superior obviously to those in the clonazepam group (all P < 0.05). After treatment, the activity of brain waves was improved remarkably, manifested as reducing of wave a frequency, increasing of wave alpha rhythm and reducing of wave theta (all P < 0.05). The efficacy was similar in comparison between the two groups (all P > 0.05). Acupuncture at the twelve meridians acupoints achieves the superior and quick effect on general anxiety disorder as compared with clonazepam and the efficacy mechanism is related to the improvements of brain waves in the patients.",Zhou XF.; Li Y.; Zhu H.; Chen LL.,2013.0,,0,0,
2546,Impacts of acupuncture at twelve meridians acupoints on brain waves of patients with general anxiety disorder,"ER OBJECTIVE: To observe the clinical efficacy of acupuncture at twelve meridians acupoints on general anxiety disorder and explore its mechanism.METHODS: Eighty patients were randomized into an acupuncture group and a clonazepam group, 40 cases in each one. In the acupuncture group, acupuncture at twelve meridians acupoints was applied, meaning quick needling at the specific acupoints of each meridian, such as Lieque (LU 7) of the Lung Meridian, Hegu (LI 4) of the Large Intestine Meridian and Shenmen (HT 7) of the Heart Meridian. After arrival of qi, the reinforcing or reducing technique was applied accordingly and the needles were not retained. In the clonazepam group, clonazepam was prescribed for oral administration. The course of treatment was 6 weeks. Before treatment and in 2, 4 and 6 weeks of treatment, respectively, Hamilton Anxiety Scale (HAMA) was evaluated in two groups and the changes in the basic electrical activity of brain waves before and after treatment were observed.RESULTS: HAMA score was reduced apparently after treatment as compared with that before treatment in two groups (all P  0.05).CONCLUSION: Acupuncture at the twelve meridians acupoints achieves the superior and quick effect on general anxiety disorder as compared with clonazepam and the efficacy mechanism is related to the improvements of brain waves in the patients.","Zhou, X F; Li, Y; Zhu, H; Chen, L L",2013.0,,0,0,2545
2547,Reduced recruitment of orbitofrontal cortex to human social chemosensory cues in social anxiety,"Social anxiety refers to the prevalent and debilitating experience of fear and anxiety of being scrutinized in social situations. It originates from both learned (e.g. adverse social conditioning) and innate (e.g. shyness) factors. Research on social anxiety has traditionally focused on negative emotions induced by visual and auditory social cues in socially anxious clinical populations, and posits a dysfunctional orbitofrontal-amygdala circuit as a primary etiological mechanism. Yet as a trait, social anxiety is independent of one's specific emotional state. Here we probe the neural substrate of intrinsic social anxiety by employing a unique type of social stimuli, airborne human social chemosensory cues that are inherently social, ubiquitously present, and yet operating below verbal awareness. We show that the adopted social chemosensory cues were not perceived to be human-related, did not differentially bias self-report of anxiety or autonomic nervous system responses, yet individuals with elevated social anxiety demonstrated a reduced recruitment of the orbitofrontal cortex to social chemosensory cues. No reciprocal activity in the amygdala was observed. Our findings point to an intrinsic neural substrate underlying social anxiety that is not associated with prior adverse social conditioning, thereby providing the first neural evidence for the inherent social aspect of this enigmatic phenomenon. © 2010 Elsevier Inc.",Zhou W.; Hou P.; Zhou Y.; Chen D.,2011.0,10.1016/j.neuroimage.2010.12.064,0,0,
2548,"A clinical randomized controlled trial of music therapy and progressive muscle relaxation training in female breast cancer patients after radical mastectomy: results on depression, anxiety and length of hospital stay.","To examine effects of music therapy and progressive muscle relaxation training on depression, anxiety and length of hospital stay in Chinese female breast cancer patients after radical mastectomy. A total of 170 patients were randomly allocated to the intervention group (n = 85) receiving music therapy and progressive muscle relaxation training plus routine nursing care and the control group (n = 85) receiving routine nursing care. Music therapy and progressive muscle relaxation training were performed twice a day within 48 h after radical mastectomy, once in the early morning (6a.m.-8a.m.) and once in the evening (9p.m.-11p.m.), for 30 min per session until discharged from the hospital. A general linear model with univariate analysis showed that the intervention group patients had significant improvement in depression and anxiety in the effects of group (F = 20.31, P < 0.001; F = 5.41, P = 0.017), time (F = 56.64, P < 0.001; F = 155.17, P < 0.001) and group*time interaction (F = 6.91, P = 0.009; F = 5.56, P = 0.019). The intervention group patients had shorter length of hospital stay (12.56 ± 1.03) than that of the control group (17.01 ± 2.46) with statistical significance (F = 13.36, P < 0.001). Music therapy and progressive muscle relaxation training can reduce depression, anxiety and length of hospital stay in female breast cancer patients after radical mastectomy.",Zhou K.; Li X.; Li J.; Liu M.; Dang S.; Wang D.; Xin X.,2015.0,10.1016/j.ejon.2014.07.010,0,0,
2549,"Effects of a Randomized Comprehensive Psychosocial Intervention Based on Cognitive Behavioral Therapy Theory and Motivational Interviewing Techniques for Community Rehabilitation of Patients With Opioid Use Disorders in Shanghai, China.","China is faced with the challenge of community rehabilitation of persons with opioid use disorders. A 1-year comprehensive psychosocial intervention (CPI) was developed, and its effectiveness was assessed in terms of its ability to improve community rehabilitation of persons with opioid use disorders after their release from detention in compulsory treatment centers in Shanghai, China. Participants were randomized to the CPI (n = 90) condition or the usual community care (UCC, n = 90) as a control condition. The Addiction Severity Index, Symptom Checklist-90, and Medical Outcomes Study 36-Item Short Form Health Survey were administered at baseline and at the end of the intervention. Urine screens were used to increase the validity of self-reported drug use. Compared with the UCC group at follow-up, the CPI group showed lower scores in 6 dimensions of the Symptom Checklist-90: somatization, obsessive-compulsive, anxiety, phobia-anxiety, paranoia, and psychoticism. Members of the CPI group had higher scores in 2 dimensions of the 36-Item Short Form Health Survey—physical role limitation and emotional role limitation—compared with the UCC group (P < 0.05). A logistic regression analysis revealed that phobia-anxiety, lifetime heroin or amphetamine use, and injection drug use were risk factors of relapse, but differences were not found in drug urine test or self-report drug use between the 2 groups (P > 0.05). The CPI condition improved participants' mental health and quality of life, and it could be a promising community rehabilitation approach for patients with opioid use disorders in recovery.",Zhong N.; Yuan Y.; Chen H.; Jiang H.; Du J.; Sun H.; Hao W.; Zhao M.,,10.1097/ADM.0000000000000139,0,0,
2550,Mechanisms of symptom reduction in treatment for obsessions.,"Objective: We explored the dynamic relationship between cognition and obsession severity during 2 different treatments for primary obsessions, examining evidence for the hypothesis that symptom reduction would be mediated by appraisals about the meaning of unwanted intrusive thoughts. Method: Data from a recent randomized controlled trial were analyzed with traditional mediation analyses and latent difference scores. The trial had compared cognitive behavioral therapy and stress management training among 73 patients with primary obsessions. Mediation analyses were conducted with pre-, post-, and follow-up scores on the Obsessions subscale of the Yale-Brown Obsessive Compulsive Scale and 2 self-report measures of cognitions related to obsessive-compulsive disorder. Bivariate dual change score (BDCS) analyses were conducted with weekly assessments of obsession severity and appraisals of personal significance. Results: Change in most cognitions related to obsessive-compulsive disorder accounted for reduction in obsession severity during the course of treatment and follow-up. BDCS analyses of the longitudinal data, however, indicated prior obsession severity is a leading indicator of subsequent change in appraisals, rather than the reverse. Analyses also suggested cognitive behavioral therapy is more effective than stress management training when symptoms are severe and that stress management training is more advantageous in the context of mild-to-moderate obsessions. Conclusions: The traditional mediation analysis indicated that appraisal change is a tenable mediator of obsession reduction, but the BDCS results raise doubts about the causal direction. The results highlight the importance of examining the dynamic relationship between putative mediators and outcome variables, and they suggest interesting hypotheses about mechanisms in treatment of obsessions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Woody, Sheila R; Whittal, Maureen L; McLean, Peter D; Baron, Butler, Calamari, Calamari, Ferrer, First, Freeston, Goodman, Goodman, Hawley, Hawley, Hoffart, Hoffart, Hofmann, Kazdin, Kim, Kraemer, Lindsay, MacKinnon, MacKinnon, McArdle, McArdle, McArdle, O'Connor, Preacher, Preacher, Preacher, Rachman, Rachman, Rachman, Rachman, Salkovskis, Sbarra, Schafer, Shrout, Simpson, Teachman, Whittal",2011.0,,0,0,
2551,Treatment of major depression in the context of panic disorder.,"Individuals with major depression frequently have panic attacks, and often panic disorder, but rarely have researchers studied the impact of comorbidity of panic on the outcome of psychological treatment of depression. In this study, patients with comorbid panic and depression were first treated with cognitive-behavioral therapy (CBT) for panic. Depression symptoms in this treated group were compared to a group of patients with major depression who were on a minimal therapist contact waitlist. In the second phase of the study, patients in both groups (comorbid and depression-only) were treated with CBT for depression. CBT for panic had little effect on co-existing depression, suggesting a specificity of action for CBT directed at different disorders. In addition, the presence of current or recently remitted panic attacks or agoraphobic avoidance did not interfere with the outcome of CBT for depression. These findings stand in contrast to previous studies showing greater linkage between depression and panic in treatment outcome. While there are implications for treatment planning, these conclusions may be limited by the exclusion criteria and the highly structured treatment approach of separating treatment for panic from treatment for depression.",Woody S.; McLean PD.; Taylor S.; Koch WJ.,1999.0,,0,0,
2552,PTSD-related hyperarousal assessed during sleep.,"Posttraumatic stress disorder is widely understood to include ""persistent symptoms of increased arousal."" This presumption has rarely been tested under conditions in which effects of anticipatory anxiety could be ruled out. In this study, heart rate and electroencephalogram spectral power were assessed during sleep, a state free of most sources of artifact contaminating indices of tonic arousal. Fifty-six unmedicated nonapneic Vietnam combat-related inpatients with posttraumatic stress disorder (PTSD) and 14 controls spent 3 or more nights in the sleep laboratory during which their electrocardiograms and electroencephalograms were continuously recorded. Heart rate and electroencephalogram spectral power were quantified continuously off-line and averaged by sleep stage over all postadaptational nights. Sleep heart rate exhibited no group differences and no covariation with the severity of subjective hyperarousal reported by PTSD patients. PTSD patients exhibited a trend toward reduced low-frequency electroencephalogram spectral power during nonrapid-eye-movement (NREM) sleep. This reduction was significant during slow-wave sleep in those subjects producing scoreable slow-wave sleep. The relationship of rapid-eye-movement (REM) beta-band power to NREM beta-band power was different in PTSD patients and controls, with the patients exhibiting more beta in REM versus NREM sleep than controls. In patients, NREM sleep sigma-band electroencephalogram spectral power exhibited a positive correlation with subjective hyperarousal. Finally, a novel and surprisingly strong inverse correlation between REM-NREM sleep heart rate difference and REM percent of sleep was observed in PTSD patients only. In summary, peripheral and central measures of tonic arousal during sleep demonstrated contrastive relations to PTSD diagnostic and symptom status. The data suggest that more consideration should be directed to mechanisms of central arousal in PTSD.",Woodward SH.; Murburg MM.; Bliwise DL.,,,0,0,
2553,Heart rate during group flooding therapy for PTSD.,"The objective of this study was to assess, via heart rate, the arousal levels of participants in group trauma reexposure therapy for posttraumatic stress disorder, and so to better understand this common mode of treatment, particularly in regards to its presumed curative factor, extinction. Six Vietnam combat-related PTSD inpatients participated twice weekly in group trauma reexposure therapy during which their electrocardiograms were recorded. Heart rate was quantified continuously off-line. Heart rates of participants not directly engaged in imaginal reexposure to their personal combat traumas consistently exhibited mild linear declines from the beginnings to the ends of the approximately 2.5 hour sessions. Participants actively engaged in personal combat trauma reexposure exhibited higher whole-session heart rates. Most also exhibited more specific elevation extending over the later portions of therapy sessions during which intensive reexposure usually occurred. Surprisingly, no patients exhibited focal increases in heart rate concurrent with periods of most intensive traumatic incident review as judged from videotape. Administering imaginal reexposure in a group context does not preclude substantial physiological (sympathetic) arousal, as is preconditional for extinction. Under conditions in which the actively engaged reexposure patient is reliably identified, group trauma reexposure therapy may not provide an opportunity for ""vicarious"" flooding in nonengaged participants.",Woodward SH.; Drescher KD.; Murphy RT.; Ruzek JI.; Foy DW.; Arsenault NJ.; Gusman FD.,,,0,0,
2554,REMCARE: Pragmatic Multi-Centre Randomised Trial of Reminiscence Groups for People with Dementia and their Family Carers: Effectiveness and Economic Analysis.,"Joint reminiscence groups, involving people with dementia and family carers together, are popular, but the evidence-base is limited. This study aimed to assess the effectiveness and cost-effectiveness of joint reminiscence groups as compared to usual care. This multi-centre, pragmatic randomised controlled trial had two parallel arms: intervention group and usual-care control group. A restricted dynamic method of randomisation was used, with an overall allocation ratio of 1:1, restricted to ensure viable sized intervention groups. Assessments, blind to treatment allocation, were carried out at baseline, three months and ten months (primary end-point), usually in the person's home. Participants were recruited in eight centres, mainly through NHS Memory Clinics and NHS community mental health teams. Included participants were community resident people with mild to moderate dementia (DSM-IV), who had a relative or other care-giver in regular contact, to act as informant and willing and able to participate in intervention. 71% carers were spouses. 488 people with dementia (mean age 77.5)were randomised: 268 intervention, 220 control; 350 dyads completed the study (206 intervention, 144 control). The intervention evaluated was joint reminiscence groups (with up to 12 dyads) weekly for twelve weeks; monthly maintenance sessions for further seven months. Sessions followed a published treatment manual and were held in a variety of community settings. Two trained facilitators in each centre were supported by volunteers. Primary outcome measures were self-reported quality of life for the person with dementia (QoL-AD), psychological distress for the carer (General Health Questionnaire, GHQ-28). Secondary outcome measures included: autobiographical memory and activities of daily living for the person with dementia; carer stress for the carer; mood, relationship quality and service use and costs for both. The intention to treat analysis (ANCOVA) identified no differences in outcome between the intervention and control conditions on primary or secondary outcomes (self-reported QoL-AD mean difference 0.07 (-1.21 to 1.35), F = 0.48, p = 0.53). Carers of people with dementia allocated to the reminiscence intervention reported a significant increase in anxiety on a General Health Questionnaire-28 sub-scale at the ten month end-point (mean difference 1.25 (0.25 to 2.26), F = 8.28, p = 0.04). Compliance analyses suggested improved autobiographical memory, quality of life and relationship quality for people with dementia attending more reminiscence sessions, however carers attending more groups showed increased care-giving stress. Economic analyses from a public sector perspective indicated that joint reminiscence groups are unlikely to be cost-effective. There were no significant adverse effects attributed to the intervention. Potential limitations of the study include less than optimal attendance at the group sessions--only 57% of participants attended at least half of the intervention sessions over the 10 month period, and a higher rate of study withdrawal in the control group. This trial does not support the clinical effectiveness or cost-effectiveness of joint reminiscence groups. Possible beneficial effects for people with dementia who attend sessions as planned are offset by raised anxiety and stress in their carers. The reasons for these discrepant outcomes need to be explored further, and may necessitate reappraisal of the movement towards joint interventions. ISRCTN Registry ISRCTN42430123.",Woods RT.; Orrell M.; Bruce E.; Edwards RT.; Hoare Z.; Hounsome B.; Keady J.; Moniz-Cook E.; Orgeta V.; Rees J.; Russell I.,2016.0,10.1371/journal.pone.0152843,0,0,
2555,REMCARE: reminiscence groups for people with dementia and their family caregivers - effectiveness and cost-effectiveness pragmatic multicentre randomised trial,"ER OBJECTIVES: The aim of the REMiniscence groups for people with dementia and their family CAREgivers (REMCARE) study was to assess the effectiveness and cost-effectiveness of joint reminiscence groups for people with dementia and their family caregivers as compared with usual care.DESIGN: A multicentre, pragmatic randomised controlled trial with two parallel arms - an intervention group and a usual-care control group - was carried out. A restricted dynamic method of randomisation was used with an overall allocation ratio of 1 : 1, restricted to ensure intervention groups of a viable size. Assessments, blind to treatment allocation, were carried out at baseline, 3 months and 10 months (primary end point).SETTING: Most participants were recruited through NHS Memory Clinics and Community Mental Health Teams for older people. Assessments were usually carried out in the person's home, and treatment groups were held in a variety of community settings.PARTICIPANTS: A total of 488 individuals (mean age 77.5 years) with mild to moderate dementia (meeting Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition criteria), who were initially living in the community, and who had a relative or other caregiver maintaining regular contact, who could act as an informant and was willing and able to participate in the intervention, were recruited to the study. Most carers were spouses (71%). A total of 350 dyads completed the study.INTERVENTIONS: The intervention consisted of joint reminiscence groups held weekly for 12 consecutive weeks, followed by monthly maintenance sessions for a further 7 months. The sessions followed a treatment manual, and were led by two trained facilitators in each centre, supported by a number of volunteers. Up to 12 dyads were invited to attend each group.MAIN OUTCOME MEASURES: The primary outcome measures were self-reported quality of life for the person with dementia and psychological distress for the carer [General Health Questionnaire-28 item version (GHQ-28)]. Secondary outcome measures included autobiographical memory and activities of daily living for the person with dementia, carer stress for the carer and mood, relationship quality and service use and costs for both parties.RESULTS: The intention-to-treat analysis identified no differences in outcome between the intervention and control conditions on primary or secondary outcomes [self-reported quality of life in Alzheimer's disease: mean difference 0.07, standard error (SE) 0.65; F = 0.48; p = 0.53]. Carers of people with dementia allocated to the reminiscence intervention reported a significant increase in anxiety on a subscale of the GHQ-28 at the 10-month end point (mean difference 1.25, SE 0.5; F = 8.28; p = 0.04). Compliance analyses suggested some benefits for people with dementia who attended more reminiscence sessions; however, carers attending more groups showed increased caregiving stress. Use of health- and social-care services was modest, with no significant difference in service use between conditions. Owing to negligible difference in quality-adjusted life-year gains (derived from European Quality of Life-5 Dimensions) between the conditions the planned full economic analysis was curtailed.CONCLUSIONS: This trial does not provide support for the effectiveness or cost-effectiveness of joint reminiscence groups for people with dementia and their carers. Although there may be some beneficial effects for people with dementia who attend sessions as planned, this must be viewed in the context of raised anxiety and stress in their carers. The reasons for these discrepant outcomes need to be explored further, and may necessitate reappraisal of the movement towards joint interventions.TRIAL REGISTRATION: Current Controlled Trials ISRCTN42430123.FUNDING: This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 16, No. 48. See the HTA programme website for further project information.","Woods, R T; Bruce, E; Edwards, R T; Elvish, R; Hoare, Z; Hounsome, B; Keady, J; Moniz-Cook, E D; Orgeta, V; Orrell, M; Rees, J; Russell, I T",2012.0,10.3310/hta16480,0,0,
2556,Behavior therapy for tics in children: acute and long-term effects on psychiatric and psychosocial functioning,"ER Children (n = 126) ages 9 to 17 years with chronic tic or Tourette disorder were randomly assigned to receive either behavior therapy or a control treatment over 10 weeks. This study examined acute effects of behavior therapy on secondary psychiatric symptoms and psychosocial functioning and long-term effects on these measures for behavior therapy responders only. Baseline and end point assessments conducted by a masked independent evaluator assessed several secondary psychiatric symptoms and measures of psychosocial functioning. Responders to behavior therapy at the end of the acute phase were reassessed at 3-month and 6-month follow-up. Children in the behavior therapy and control conditions did not differentially improve on secondary psychiatric or psychosocial outcome measures at the end of the acute phase. At 6-month posttreatment, positive response to behavior therapy was associated with decreased anxiety, disruptive behavior, and family strain and improved social functioning. Behavior therapy is a tic-specific treatment for children with tic disorders.","Woods, D W; Piacentini, J C; Scahill, L; Peterson, A L; Wilhelm, S; Chang, S; Deckersbach, T; McGuire, J; Specht, M; Conelea, C A; Rozenman, M; Dzuria, J; Liu, H; Levi-Pearl, S; Walkup, J T",2011.0,10.1177/0883073810397046,0,0,
2557,300 cases of menopausal syndrome treated by acupuncture.,,Wu L.; Zhou X.,1998.0,,0,0,
2558,A randomized controlled trial of the effectiveness of brief-CBT for patients with symptoms of posttraumatic stress following a motor vehicle crash.,"Motor vehicle crashes (MVCs) are leading contributors to the global burden of disease. Patients attending accident and emergency (A&E) after an MVC may develop symptoms of posttraumatic stress disorder (PTSD). There is evidence that brief cognitive behavioural therapy (B-CBT) can be effective in treating PTSD; however, there are few studies of the use of B-CBT to treat PTSD in MVC survivors. This study examined the effects of B-CBT and a self-help program on the severity of psychological symptoms in MVC survivors at risk of developing PTSD. Sixty participants who attended A&E after a MVC were screened for PTSD symptoms and randomized to a 4-weekly session B-CBT or a 4-week self-help program (SHP) booklet treatment conditions. Psychological assessments were completed at baseline (1-month post-MVC) and posttreatment (3- and 6-month follow-ups) by utilizing Impact of Event Scale-Revised (IES-R) and Hospital Anxiety and Depression Scale (HADS). There were significant improvements in the measures of anxiety, depression, and PTSD symptoms over time. Participants treated with B-CBT showed greater reductions in anxiety at 3-month and 6-month follow-ups, and in depression at 6-month follow-up. A comparison of effect size favoured B-CBT for the reduction of anxiety and depression symptoms measured by HADS. A high level of pretreatment anxiety and depression were predictive of negative outcome at 6-month follow-up in the SHP condition. There was no differential effect on PTSD symptoms measured by IES-R. This trial supports the efficacy of providing B-CBT as a preventive strategy to improve psychological symptoms after an MVC.",Wu KK.; Li FW.; Cho VW.,2014.0,10.1017/S1352465812000859,0,0,
2559,A randomized controlled trial of the effectiveness of brief-CBT for Patients with symptoms of posttraumatic stress following a motor vehicle crash.,"Background: Motor vehicle crashes (MVCs) are leading contributors to the global burden of disease. Patients attending accident and emergency (A&E) after an MVC may develop symptoms of posttraumatic stress disorder (PTSD). There is evidence that brief cognitive behavioural therapy (B-CBT) can be effective in treating PTSD; however, there are few studies of the use of B-CBT to treat PTSD in MVC survivors. Aims: This study examined the effects of B-CBT and a self-help program on the severity of psychological symptoms in MVC survivors at risk of developing PTSD. Method: Sixty participants who attended A&E after a MVC were screened for PTSD symptoms and randomized to a 4-weekly session B-CBT or a 4-week self-help program (SHP) booklet treatment conditions. Psychological assessments were completed at baseline (1-month post-MVC) and posttreatment (3- and 6- month follow-ups) by utilizing Impact of Event Scale-Revised (IES-R) and Hospital Anxiety and Depression Scale (HADS). Results: There were significant improvements in the measures of anxiety, depression, and PTSD symptoms over time. Participants treated with B-CBT showed greater reductions in anxiety at 3-month and 6-month follow-ups, and in depression at 6-month follow-up. A comparison of effect size favoured B-CBT for the reduction of anxiety and depression symptoms measured by HADS. A high level of pretreatment anxiety and depression were predictive of negative outcome at 6-month follow-up in the SHP condition. There was no differential effect on PTSD symptoms measured by IES-R. Conclusions: This trial supports the efficacy of providing B-CBT as a preventive strategy to improve psychological symptoms after an MVC. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wu, Kitty K; Li, Frendi W; Cho, Valda W; Adler, Bisson, Blanchard, Bryant, Bryant, Bugg, Cohen, Devilly, Ehlers, Foa, Foa, Friendly, Hedges, Leung, Mayou, Resick, Roberts, Roberts, Rose, Scholes, Scott, Turpin, Weiss, Williams, Wu, Wu",2014.0,,0,0,
2560,The effectiveness of an accessibility-enhanced multimedia informational educational programme in reducing anxiety and increasing satisfaction of patients undergoing cardiac catheterisation,"ER AIMS AND OBJECTIVES: To evaluate the effectiveness of an accessibility-enhanced multimedia informational educational programme in reducing anxiety and increasing satisfaction with the information and materials received by patients undergoing cardiac catheterisation. BACKGROUND: Cardiac catheterisation is one of the most anxiety-provoking invasive procedures for patients. However, informational education using multimedia to inform patients undergoing cardiac catheterisation has not been extensively explored. DESIGN: A randomised experimental design with three-cohort prospective comparisons. METHODS: In total, 123 consecutive patients were randomly assigned to one of three groups: regular education; (group 1), accessibility-enhanced multimedia informational education (group 2) and instructional digital videodisc education (group 3). Anxiety was measured with Spielberger's State Anxiety Inventory, which was administered at four time intervals: before education (T0), immediately after education (T1), before cardiac catheterisation (T2) and one day after cardiac catheterisation (T3). A satisfaction questionnaire was administrated one day after cardiac catheterisation. Data were collected from May 2009-September 2010 and analysed using descriptive statistics, chi-squared tests, one-way analysis of variance, Scheffe's post hoc test and generalised estimating equations. RESULTS: All patients experienced moderate anxiety at T0 to low anxiety at T3. Accessibility-enhanced multimedia informational education patients had significantly lower anxiety levels and felt the most satisfied with the information and materials received compared with patients in groups 1 and 3. A statistically significant difference in anxiety levels was only found at T2 among the three groups (p = 0004). CONCLUSIONS: The findings demonstrate that the accessibility-enhanced multimedia informational education was the most effective informational educational module for informing patients about their upcoming cardiac catheterisation, to reduce anxiety and improve satisfaction with the information and materials received compared with the regular education and instructional digital videodisc education. RELEVANCE TO CLINICAL PRACTICE: As the accessibility-enhanced multimedia informational education reduced patient anxiety and improved satisfaction with the information and materials received, it can be adapted to complement patient education in future regular cardiac care.","Wu, K L; Chen, S R; Ko, W C; Kuo, S Y; Chen, P L; Su, H F; Chang, W Y",2014.0,10.1111/jocn.12469,0,0,
2561,Further investigation of the obsessive-compulsive inventory: Psychometric analysis in two non-clinical samples,"The obsessive-compulsive inventory [OCI; Psychol. Assessment 10 (1998) 206-214] is a self-report measure of obsessive-compulsive disorder (OCD) intended for use with both clinical and non-clinical samples (American Psychiatric Association, 2000). Two reports support its convergence with established measures of OCD and its assessment of specific symptom subtypes (e.g., checking and washing). The current studies investigate the OCI factor structure in two non-clinical samples. Based on correlational analyses and complementary factor analyses, Study 1 results indicate that five subscales, rather than the seven rationally derived ones, best capture the structure of symptoms measured by the OCI. These findings were replicated in Study 2. Based on these analyses, we offer suggestions for revising the original subscales into these five empirically derived subscales that closely resemble structures proposed in the current OCD literature. © 2002 Elsevier Science Inc. All rights reserved.",Wu K.D.; Watson D.,2003.0,10.1016/S0887-6185(02)00234-7,0,0,
2562,"Modulatory effects of aromatherapy massage intervention on electroencephalogram, psychological assessments, salivary cortisol and plasma brain-derived neurotrophic factor","Objectives: Aromatherapy massage is commonly used for the stress management of healthy individuals, and also has been often employed as a therapeutic use for pain control and alleviating psychological distress, such as anxiety and depression, in oncological palliative care patients. However, the exact biological basis of aromatherapy massage is poorly understood. Therefore, we evaluated here the effects of aromatherapy massage interventions on multiple neurobiological indices such as quantitative psychological assessments, electroencephalogram (EEG) power spectrum pattern, salivary cortisol and plasma brain-derived neurotrophic factor (BDNF) levels. Design: A control group without treatment (n= 12) and aromatherapy massage group (n= 13) were randomly recruited. They were all females whose children were diagnosed as attention deficit hyperactivity disorder and followed up in the Department of Psychiatry, Jeju National University Hospital. Participants were treated with aromatherapy massage for 40. min twice per week for 4 weeks (8 interventions). Results: A 4-week-aromatherapy massage program significantly improved all psychological assessment scores in the Stat-Trait Anxiety Index, Beck Depression Inventory and Short Form of Psychosocial Well-being Index. Interestingly, plasma BDNF levels were significantly increased after a 4 week-aromatherapy massage program. Alpha-brain wave activities were significantly enhanced and delta wave activities were markedly reduced following the one-time aromatherapy massage treatment, as shown in the meditation and neurofeedback training. In addition, salivary cortisol levels were significantly reduced following the one-time aromatherapy massage treatment. Conclusions: These results suggest that aromatherapy massage could exert significant influences on multiple neurobiological indices such as EEG pattern, salivary cortisol and plasma BDNF levels as well as psychological assessments. © 2014 The Authors.",Wu J.-J.; Cui Y.; Yang Y.-S.; Kang M.-S.; Jung S.-C.; Park H.K.; Yeun H.-Y.; Jang W.J.; Lee S.; Kwak Y.S.; Eun S.-Y.,2014.0,10.1016/j.ctim.2014.04.001,0,0,
2563,Causing harm and allowing harm: A study of beliefs in obsessional problems,"This study investigates two factors hypothesised as relevant to obsessional problems because of the way in which they influence decisions whether or not to act to prevent harm. These are (i) the way in which intrusive thoughts increase the internal awareness of harm, and confront the person with the possibility of taking action to prevent such harm and (ii) the extent to which there is some obvious external factor which increases awareness of the possibility of preventing harm. Obsessional patients, anxious and non-clinical controls completed a scale which systematically measured these factors across a wide range of situations. Results across all situations evaluated confirmed previous findings that both obsessionals and nonobsessionals were more likely to report acting to prevent harm when awareness of it is prompted by an intrusion than when it is not. It was also found that participants in all groups acted more 'obsessionally' when a scenario is described in ways which suggest that harm may be by 'commission' than when it is described in terms of an 'omission'. When scenarios about which each individual is most disturbed were analysed, anxious and non-clinical controls continued to differentially rate omission and commission situations; as predicted, this differential was not present for obsessional patients.It is concluded that obsessionals are more sensitive to omission than are nonobsessionals when considering scenarios about which they are concerned, and that this sensitivity is one factor influencing the decision whether to act to prevent harm. Copyright (C) 2000 Elsevier Science Ltd.",Wroe A.L.; Salkovskis P.M.,2000.0,10.1016/S0005-7967(99)00145-X,0,0,
2564,"Psychosocial difficulties, deprivation and cancer: three questionnaire studies involving 609 cancer patients","ER The aim of the study is to investigate associations between deprivation and self-reported social difficulties and psychological distress in cancer patients. A total of 304 men and 305 women (age range 18-88 years) with a range of cancer diagnoses and living in a socially diverse region (Carstairs and Morris index) completed the Hospital Anxiety and Depression Scale and the Social Difficulties Inventory. Univariate analyses of variance revealed statistically significant differences in reported social difficulties between groups (F (67, 576)=2.4, P<0.0001) with stage of disease (F (5, 576)=7.6, P<0.0001), age (F (2, 576)=4.8, P=0.009) and to a lesser extent deprivation (F (1, 576)=4.0, P=0.048) making significant contributions. Significantly more social difficulties were reported by less affluent patients with locally recurrent disease or 'survivors'. No other interactions were found. Significant differences in levels of reported psychological distress were found between groups (F (67, 575)=1.723, P=0.001) for stage of disease, sex and deprivation but no interactions observed. In conclusion, deprivation is associated with reported psychological distress and, to a lesser extent, social difficulties. Patients at particular risk cannot be identified with confidence by socio-demographic and clinical means supporting the recommendation from National Institute for Clinical Excellence for provision of psychosocial assessment for individual cancer patients.","Wright, P; Smith, A; Booth, L; Winterbottom, A; Kiely, M; Velikova, G; Selby, P",2005.0,10.1038/sj.bjc.6602777,0,0,
2565,Development and validation of the Homophobia Scale,"This study describes the development and validation of the Homophobia Scale. The scale was developed to assess the cognitive, affective, and behavioral components of homophobia. The participants (n = 321 for the field trials and n = 122 for test-retest reliability) were college students from a large Midwestern university. Results yielded a 25-item questionnaire consisting of three factors: a factor that assesses mainly negative cognitions regarding homosexuality, a factor that assess primarily negative affect and avoidance of homosexual individuals, and a factor that assesses negative affect and aggression toward homosexual individuals. Concurrent validity was established using The Index of Homophobia (Hudson and Ricketts, 1980). The phases of scale development and implications of the results are discussed.",Wright Jr. L.W.; Adams H.E.; Bernat J.,1999.0,,0,0,
2566,Development and initial testing of a multimedia program for computer-assisted cognitive therapy.,"A multimedia program for computer-assisted psychotherapy has been developed to help patients learn cognitive therapy skills. The program is designed to provide psychoeducation, teach self-help methods, and give information to clinicians on the patient's progress in using the software. Multimedia technology is utilized to engage users in the learning process and to make the program accessible for persons who do not have computer or keyboard skills. A preliminary study with 96 subjects who used the software along with treatment as usual found that 75 (78.1%) completed the entire program. Users indicated a high rate of acceptance of this form of computer-assisted therapy, and mean scores on a measure of cognitive therapy knowledge were significantly improved.",Wright JH.; Wright AS.; Salmon P.; Beck AT.; Kuykendall J.; Goldsmith LJ.; Zickel MB.,2002.0,,0,0,
2567,The effect on hospital admissions of psychiatric case management involving general practitioners: preliminary results.,"A two year follow-up of two matched groups of subjects with chronic severe mental illness was performed in order to evaluate a new psychiatric case management system. One group (n = 59) received care through psychiatric case management, using an assertive community treatment model that directly involved general practitioners. The other group, matched for age, sex, diagnostic group and number of hospital admissions, received standard outpatient care. Comparing the two years before and after case management, the experimental group showed a dramatic fall in inpatient admission days while the control group admission days remained the same (median difference in admission days across matched subject pairs = 64.5, 95% C.I. from 134.5 to 16). The experimental group remained out of hospital longer before first readmission (Kaplan-Meier survival analysis, P = 0.002). This type of case management programme can shorten or prevent admissions to psychiatric hospitals of patients with chronic mental illness, and increase their time before readmission.",Wood K.; Anderson J.,1995.0,10.1080/00048679509075914,0,0,
2568,Family cognitive behavioral therapy for child anxiety disorders,"ER METHODForty clinically anxious youth (6-13 years old) were randomly assigned to a family- or child-focused cognitive-behavioral therapy (CBT). Conditions were matched for therapist contact time. Both interventions included coping skills training and in vivo exposure, but the family CBT intervention also included parent communication training. Independent evaluator, parent, and child report measures with demonstrated validity and reliability were used to assess child anxiety symptom outcomes at pre- and posttreatment. The data analytic strategy involved an evaluable patient analysis.RESULTSCompared with child-focused CBT, family CBT was associated with greater improvement on independent evaluators' ratings and parent reports of child anxiety--but not children's self-reports--at posttreatment.CONCLUSIONSBoth treatment groups showed improvement on all outcome measures, but family CBT may provide additional benefit over and above child-focused CBT. These findings provide preliminary support for the efficacy of the ""Building Confidence"" program and encourage further research in parental participation in treatment for childhood anxiety.OBJECTIVEThis study compared family-focused cognitive behavioral therapy (CBT; the Building Confidence Program) with traditional child-focused CBT with minimal family involvement for children with anxiety disorders.","Wood, J J; Piacentini, J C; Southam-Gerow, M; Chu, B C; Sigman, M",2006.0,10.1097/01.chi.0000196425.88341.b0,0,0,
2569,One-year follow-up of family versus child CBT for anxiety disorders: exploring the roles of child age and parental intrusiveness,"ER METHODThirty-five children (6-13 years old) randomly assigned to 12-16 sessions of family-focused CBT (FCBT) or child-focused CBT (CCBT) participated in a 1-year follow-up assessment. Independent evaluators, parents, and children rated anxiety and parental intrusiveness. All were blind to treatment condition and study hypotheses.RESULTSChildren assigned to FCBT had lower anxiety scores than children assigned to CCBT on follow-up diagnostician- and parent-report scores, but not child-report scores. Exploratory analyses suggested the advantage of FCBT over CCBT may have been evident more for early adolescents than for younger children and that reductions in parental intrusiveness may have mediated the treatment effect.CONCLUSIONFCBT may yield a stronger treatment effect than CCBT that lasts for at least 1 year, although the lack of consistency across informants necessitates a circumspect view of the findings. The potential moderating and mediating effects considered in this study offer interesting avenues for further study.OBJECTIVETo compare the relative long-term benefit of family-focused cognitive behavioral therapy (FCBT) and child-focused cognitive behavioral therapy (CCBT) for child anxiety disorders at a 1-year follow-up.","Wood, J J; McLeod, B D; Piacentini, J C; Sigman, M",2009.0,10.1007/s10578-009-0127-z,0,0,
2570,"Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety: a randomized, controlled trial","ER Clinically elevated anxiety is a common, impairing feature of autism spectrum disorders (ASD). A modular CBT program designed for preteens with ASD, Behavioral Interventions for Anxiety in Children with Autism (BIACA; Wood et al., 2009) was enhanced and modified to address the developmental needs of early adolescents with ASD and clinical anxiety. Thirty-three adolescents (11-15. years old) were randomly assigned to 16 sessions of CBT or an equivalent waitlist period. The CBT model emphasized exposure, challenging irrational beliefs, and behavioral supports provided by caregivers, as well as numerous ASD-specific treatment elements. Independent evaluators, parents, and adolescents rated symptom severity at baseline and posttreatment/postwaitlist. In intent-to-treat analyses, the CBT group outperformed the waitlist group on independent evaluators' ratings of anxiety severity on the Pediatric Anxiety Rating Scale (PARS) and 79% of the CBT group met Clinical Global Impressions-Improvement scale criteria for positive treatment response at posttreatment, as compared to only 28.6% of the waitlist group. Group differences were not found for diagnostic remission or questionnaire measures of anxiety. However, parent-report data indicated that there was a positive treatment effect of CBT on autism symptom severity. The CBT manual under investigation, enhanced for early adolescents with ASD, yielded meaningful treatment effects on the primary outcome measure (PARS), although additional developmental modifications to the manual are likely warranted. Future studies examining this protocol relative to an active control are needed.","Wood, J J; Ehrenreich-May, J; Alessandri, M; Fujii, C; Renno, P; Laugeson, E; Piacentini, J C; Nadai, A S; Arnold, E; Lewin, A B; Murphy, T K; Storch, E A",2015.0,10.1016/j.beth.2014.01.002,0,0,
2571,"Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial","ER METHOD: Forty children (7-11 years old) were randomly assigned to 16 sessions of CBT or a 3-month waitlist (36 completed treatment or waitlist). Therapists worked with individual families. The CBT model emphasized behavioral experimentation, parent-training, and school consultation. Independent evaluators blind to treatment condition conducted structured diagnostic interviews and parents and children completed anxiety symptom checklists at baseline and posttreatment/postwaitlist.RESULTS: In intent-to-treat analyses, 78.5% of the CBT group met Clinical Global Impressions-Improvement scale criteria for positive treatment response at posttreatment, as compared to only 8.7% of the waitlist group. CBT also outperformed the waitlist on diagnostic outcomes and parent reports of child anxiety, but not children's self-reports. Treatment gains were maintained at 3-month follow-up.CONCLUSIONS: The CBT manual employed in this study is one of the first adaptations of an evidence-based treatment for children with autism spectrum disorders. Remission of anxiety disorders appears to be an achievable goal among high-functioning children with autism.BACKGROUND: Children with autism spectrum disorders often present with comorbid anxiety disorders that cause significant functional impairment. This study tested a modular cognitive behavioral therapy (CBT) program for children with this profile. A standard CBT program was augmented with multiple treatment components designed to accommodate or remediate the social and adaptive skill deficits of children with ASD that could pose barriers to anxiety reduction.","Wood, J J; Drahota, A; Sze, K; Har, K; Chiu, A; Langer, D A",2009.0,10.1111/j.1469-7610.2008.01948.x,0,0,
2572,Brief report: effects of cognitive behavioral therapy on parent-reported autism symptoms in school-age children with high-functioning autism,ER This pilot study tested the effect of cognitive behavioral therapy (CBT) on parent-reported autism symptoms. Nineteen children with autism spectrum disorders and an anxiety disorder (7-11 years old) were randomly assigned to 16 sessions of CBT or a waitlist condition. The CBT program emphasized in vivo exposure supported by parent training and school consultation to promote social communication and emotion regulation skills. Parents completed a standardized autism symptom checklist at baseline and posttreatment/postwaitlist and 3-month follow-up assessments. CBT outperformed the waitlist condition at posttreatment/postwaitlist on total parent-reported autism symptoms (Cohen's d effect size = .77). Treatment gains were maintained at 3-month follow-up. Further investigation of this intervention modality with larger samples and broader outcome measures appears to be indicated.,"Wood, J J; Drahota, A; Sze, K; Dyke, M; Decker, K; Fujii, C; Bahng, C; Renno, P; Hwang, W C; Spiker, M",2009.0,10.1007/s10803-009-0791-7,0,0,
2573,Virtual reality graded exposure therapy with arousal control for the treatment of combat related posttraumatic stress disorder: A follow up case series.,"Important challenges confronting DOD/military medical care are that of maintaining or increasing quality of care and increasing the effectiveness of treatments for warriors diagnosed with Posttraumatic Stress Disorder (PTSD) secondary to their combat deployments to Iraq and/or Afghanistan. Virtual Reality Graded Exposure Therapy with Arousal Control (VR-GET) has demonstrated a positive treatment effectiveness resulting in significant reductions of PTSD symptom severity. This positive treatment effectiveness has been maintained for up to 22 weeks after VR-GET therapy was completed. A robust methodology for the assessment of Virtual Reality efficacy suggests that the ideal time for followup begins at twelve months. Others have suggested that follow-up should occur between two and four years post treatment. In this report we describe the outcome of VR-GET for the treatment of combat-related PTSD with three warriors between five and seven years following their having completed treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wood, Dennis Patrick; Mclay, Robert L; Webb-Murphy, Jennifer; Wiederhold, Mark D; Spira, James L; Pyne, Jeff M; Wiederhold, Brenda K; Kok, Hoge, Arthur, Wood, Wood, Wood, Ritchie, Bisson, Howard, Kar, Forsten, Goncalves, McLay, McLay, Tanielian",2014.0,,0,0,
2574,The effect of telephone-based intervention (TBI) in alcohol abusers: a pilot study,"ER MATERIAL AND METHODSixty individuals suffering from alcohol abuse were randomly assigned to either the intervention group (n=30) (in which the TBI was modified based on the combination of motivational interviewing and supportive techniques), or the control group (n=30) (in which the participants received mail concerning health promotion). Each participant in the intervention group received individual weekly therapy sessions of 20 to 30 minutes via telephone for six weeks. Simultaneously, the participants in the control group received weekly mails for six weeks. Assessment was done at weeks 0, 6, and 18. The primary outcome was defined as a change in the amount of alcohol consumed and the number ofdays spent drinking. Anxiety, depression, and self-esteem were also compared between the two groups. All were analyzed by intention-to-treat.RESULTSAfter 18 weeks, 54 out of the original 60 participants had complete data sets. The mean amount and frequency of alcohol consumption was significantly lower in the intervention group than in the control group (4.1 days +/- 2.0 vs. 2.8 days +/- 2.0, p < 0.01). At the end of week six, 37.3% of participants in the experiment group (compared with 11.8% of the control) had successfully decreased their alcohol consumption (f = 16.49, df = I, p < 0.001, with an NNT = 1.69). The frequency of drinking, as determined by the number of drinking days per week, was significantly lower in the experiment group from baseline than in the control group at week 6 (2 = 18.20, df= 1, p < 0.001, with an NNT = 1.8). There was no difference between week 6 and the end of week 18 regarding amount and frequency of drinking in both groups. There was no difference in depressive, anxiety and self-esteem scores between the two groups over time and these factors were found to have no effect on alcohol consumption in either group. A common problem reported in the telephone group was connection failures.CONCLUSIONTelephone motivational interviews showed promise in being effective in reducing the frequency and amount of drinking for non-treatment-seeking primary care patients who abuse alcohol. Moreover, the effect of the intervention lasted for at least three months. Limitations of the present study are discussed.OBJECTIVEThe present study was to examine the efficacy of Telephone-based intervention (TBI) with alcohol abusers.","Wongpakaran, T; Petcharaj, K; Wongpakaran, N; Sombatmai, S; Boripuntakul, T; Intarakamhaeng, D; Wannarit, K",2011.0,,0,0,
2575,"Prevalence, clinical spectrum and health care utilization of gastro-oesophageal reflux disease in a Chinese population: a population-based study","ER METHODSEthnic Chinese (3605) were invited to participate in a telephone survey using a validated gastro-oesophageal reflux disease questionnaire and the Hospital Anxiety and Depression Scale.RESULTSA total of 2209 subjects (58% female; mean age, 40.3 years) completed the interview. The annual, monthly and weekly prevalence rates of gastro-oesophageal reflux disease were 29.8%, 8.9% and 2.5%, respectively. Gastro-oesophageal reflux disease symptoms were associated with non-cardiac chest pain [odds ratio (OR), 2.3; 95% confidence interval (95% CI), 1.7-3.1], dyspepsia (OR, 1.9; 95% CI, 1.4-2.5), globus (OR, 1.8; 95% CI, 1.2-2.7), acid feeling in the stomach (OR, 5.8; 95% CI, 4.5-7.5) and the use of non-steroidal anti-inflammatory drugs (OR, 2.3; 95% CI, 1.5-3.6), but not with dysphagia, bronchitis, asthma, hoarseness and pneumonia. Patients with gastro-oesophageal reflux disease had a significantly higher anxiety and depression score and required more days off work when compared with subjects without. The frequency of heartburn (P = 0.032), female gender (P < 0.001), degree of depression (P = 0.004) and social morbidity (P < 0.001) were independent factors associated with health care-seeking behaviour.CONCLUSIONThe prevalence of gastro-oesophageal reflux disease was lower than that in Western populations, but carried a significant socio-economic burden in the studied Chinese population. The frequency of heartburn, female gender and psychosocial factors were associated with health care utilization in gastro-oesophageal reflux disease.BACKGROUNDPopulation-based data on gastro-oesophageal reflux disease in Chinese are lacking. The prevalence, clinical spectrum and health care-seeking behaviour of subjects with gastro-oesophageal reflux disease were studied.","Wong, W M; Lai, K C; Lam, K F; Hui, W M; Hu, W H; Lam, C L; Xia, H H; Huang, J Q; Chan, C K; Lam, S K; Wong, B C",2003.0,,0,0,
2576,"A randomized, controlled clinical trial: the effect of mindfulness-based cognitive therapy on generalized anxiety disorder among Chinese community patients: protocol for a randomized trial.","Research suggests that an eight-week Mindfulness-Based Cognitive Therapy (MBCT) program may be effective in the treatment of generalized anxiety disorders. Our objective is to compare the clinical effectiveness of the MBCT program with a psycho-education programme and usual care in reducing anxiety symptoms in people suffering from generalized anxiety disorder. A three armed randomized, controlled clinical trial including 9-month post-treatment follow-up is proposed. Participants screened positive using the Structure Clinical Interview for DSM-IV (SCID) for general anxiety disorder will be recruited from community-based clinics. 228 participants will be randomly allocated to the MBCT program plus usual care, psycho-education program plus usual care or the usual care group. Validated Chinese version of instruments measuring anxiety and worry symptoms, depression, quality of life and health service utilization will be used. Our primary end point is the change of anxiety and worry score (Beck Anxiety Inventory and Penn State Worry Scale) from baseline to the end of intervention. For primary analyses, treatment outcomes will be assessed by ANCOVA, with change in anxiety score as the baseline variable, while the baseline anxiety score and other baseline characteristics that significantly differ between groups will serve as covariates. This is a first randomized controlled trial that compare the effectiveness of MBCT with an active control, findings will advance current knowledge in the management of GAD and the way that group intervention can be delivered and inform future research. Unique Trail Number (assigned by Centre for Clinical Trails, Clinical Trials registry, The Chinese University of Hong Kong): CUHK_CCT00267.",Wong SY.; Mak WW.; Cheung EY.; Ling CY.; Lui WW.; Tang WK.; Wong RL.; Lo HH.; Mercer S.; Ma HS.,2011.0,10.1186/1471-244X-11-187,0,0,
2577,Improving general practitioners' interviewing skills in managing patients with depression and anxiety: a randomized controlled clinical trial.,"Studies regarding the effectiveness of CME programmes on physicians' behaviour and communication skills showed inconsistent results. Few randomized controlled trials have been conducted in Asia. To evaluate the effectiveness of a 4 2-hour education programme to improve GP interviewing behaviours, 16 general practitioners were randomized to the intervention and control groups, respectively. Physicians assigned to the intervention group received 8 hours of training emphasizing interviewing behaviours in the diagnosis and treatment of depression and generalized anxiety disorders (GDS). Those assigned to the control group did not receive any training until the completion of study. Standardized patients were used to evaluate the performance of physicians. Two consultations before and after enrolling in the education programme were videotaped. Independent evaluations of consultations were made by a trained clinical psychologist and a social worker blinded to the study status of physicians. The rating schedule for the videotapes was based on the tasks listed on the Calgary Cambridge Observation Guide. The change of score between the intervention and control physicians was significantly different in 'active listening and facilitating patients' response' (p = 0.011) with the intervention physicians having improvement of score. For 'non-verbals', 'understanding patient's perspective' and 'negotiating mutual plan of action', positive change of score in the intervention physicians were seen when compared to that of the control, although the difference did not reach statistical significance (p = 0.06, p = 0.05, p = 0.06, respectively). However, for 'opening', 'structuring the consultation', 'explanation and planning' and 'closure', there were no statistical significant differences between control and intervention group. Our results showed that only certain communication skills, such as active listening and facilitating patient's response, can be taught in the management of depression and generalized anxiety disorder (GAD) in Chinese primary care physicians.",Wong SY.; Cheung AK.; Lee A.; Cheung N.; Leung A.; Wong W.; Chan K.,2007.0,10.1080/01421590601050585,0,0,
2578,Distrust of the senses and its association with obsessive-compulsive symptoms,"Background and objectives Leading cognitive theories of OCD suggests that despite prevalent and persistent doubt, individuals with OCD do not have perceptual deficits. An alternate cognitive theory, the Seeking Proxies for Internal States hypothesis (SPIS), proposes that sensory distrust in OCD stems from actual deficits in accessing internal states. Consistent with the SPIS, previous research has found that high-OC individuals were less accurate than low-OC individuals in producing target levels of muscle tension in a biofeedback task and that OC symptoms were positively associated with reliance on an external proxy. Methods The current study aimed to replicate and extend the SPIS hypothesis in two experiments using a modified version of the biofeedback-aided muscle tensing task using grip strength as the sensory input and a distance perception task. We contrasted the performance of undergraduate students self-reporting high- and low-OC symptoms. Results Overall, our findings failed to substantially support the SPIS hypothesis such that OC symptoms were not associated with deficient access to internal states of grip strength and distance perception or increased reliance on feedback. Limitations As this study was conducted in a non-clinical sample, we were unable to generalise our findings to a clinical population. Conclusions Findings are commensurate with the wider OCD literature suggesting the absence of cognitive and perceptual deficits in OCD individuals.",Wong S.F.; Williams A.D.; Grisham J.R.,2017.0,10.1016/j.jbtep.2017.06.002,0,0,
2579,Processing mode during repetitive thinking in socially anxious individuals: evidence for a maladaptive experiential mode.,"Evidence from the depression literature suggests that an analytical processing mode adopted during repetitive thinking leads to maladaptive outcomes relative to an experiential processing mode. To date, in socially anxious individuals, the impact of processing mode during repetitive thinking related to an actual social-evaluative situation has not been investigated. We thus tested whether an analytical processing mode would be maladaptive relative to an experiential processing mode during anticipatory processing and post-event rumination. High and low socially anxious participants were induced to engage in either an analytical or experiential processing mode during: (a) anticipatory processing before performing a speech (Experiment 1; N = 94), or (b) post-event rumination after performing a speech (Experiment 2; N = 74). Mood, cognition, and behavioural measures were employed to examine the effects of processing mode. For high socially anxious participants, the modes had a similar effect on self-reported anxiety during both anticipatory processing and post-event rumination. Unexpectedly, relative to the analytical mode, the experiential mode led to stronger high standard and conditional beliefs during anticipatory processing, and stronger unconditional beliefs during post-event rumination. These experiments are the first to investigate processing mode during anticipatory processing and post-event rumination. Hence, these results are novel and will need to be replicated. These findings suggest that an experiential processing mode is maladaptive relative to an analytical processing mode during repetitive thinking characteristic of socially anxious individuals.",Wong QJ.; Moulds ML.,2012.0,10.1016/j.jbtep.2012.05.002,0,0,
2580,A randomized controlled comparison of integrative cognitive-affective therapy (ICAT) and enhanced cognitive-behavioral therapy (CBT-E) for bulimia nervosa,"ER BACKGROUND: The purpose of this investigation was to compare a new psychotherapy for bulimia nervosa (BN), integrative cognitive-affective therapy (ICAT), with an established treatment, 'enhanced' cognitive-behavioral therapy (CBT-E).METHOD: Eighty adults with symptoms of BN were randomized to ICAT or CBT-E for 21 sessions over 19 weeks. Bulimic symptoms, measured by the Eating Disorder Examination (EDE), were assessed at baseline, at the end of treatment (EOT) and at the 4-month follow-up. Treatment outcome, measured by binge eating frequency, purging frequency, global eating disorder severity, emotion regulation, self-oriented cognition, depression, anxiety and self-esteem, was determined using generalized estimating equations (GEEs), logistic regression and a general linear model (intent-to-treat).RESULTS: Both treatments were associated with significant improvement in bulimic symptoms and in all measures of outcome, and no statistically significant differences were observed between the two conditions at EOT or follow-up. Intent-to-treat abstinence rates for ICAT (37.5% at EOT, 32.5% at follow-up) and CBT-E (22.5% at both EOT and follow-up) were not significantly different.CONCLUSIONS: ICAT was associated with significant improvements in bulimic and associated symptoms that did not differ from those obtained with CBT-E. This initial randomized controlled trial of a new individual psychotherapy for BN suggests that targeting emotion and self-oriented cognition in the context of nutritional rehabilitation may be efficacious and worthy of further study.","Wonderlich, S A; Peterson, C B; Crosby, R D; Smith, T L; Klein, M H; Mitchell, J E; Crow, S J",2014.0,10.1017/S0033291713001098,0,0,
2581,Double-blind placebo-controlled trial of static magnets for the treatment of osteoarthritis of the knee: results of a pilot study.,"Outpatient clinical studies of magnet therapy, a complementary therapy commonly used to treat osteoarthritis (OA), have been limited by the absence of a credible placebo control. Our objective was to assess the feasibility and promise of studying static magnetic therapy for knee OA and determine the ability of a new placebo-magnet device to provide concealment of group assignment. Randomized, double-blind, placebo-controlled clinical trial. Academic teaching hospital in Boston. We enrolled 29 subjects with idiopathic or post-traumatic OA of the knee. Subjects received either high-strength magnetic (active) or placebo-magnetic (placebo) knee sleeve treatment for 4 hours in a monitored setting and self-treatment 6 hours daily for 6 weeks. Primary outcomes were change in knee pain as measured by the WOMAC Osteoarthritis Index Pain Subscale at 6 weeks and extent of group concealment at study end. At 4 hours, VAS pain scores (+/- SE) on a 5-item scale (0-500, 500 worst) decreased 79 +/- 18 mm in the active group and 10 +/- 21 mm in the placebo group (P < 0.05). There were no significant differences in any primary or secondary measure of efficacy between the treatment groups at 6 weeks. Despite widespread testing for magnetic properties, at study end, 69% of the active group and 77% of the placebo group (P > 0.2) believed that they had been assigned to the active treatment group. Despite our small sample size, magnets showed statistically significant efficacy compared to placebo after 4 hours under rigorously controlled conditions. The sustained efficacy of magnetic therapy for knee osteoarthritis could be assessed in an adequately powered trial utilizing an appropriate control such our new placebo-magnet device.",Wolsko PM.; Eisenberg DM.; Simon LS.; Davis RB.; Walleczek J.; Mayo-Smith M.; Kaptchuk TJ.; Phillips RS.,,,0,0,
2582,Double-blind placebo-controlled trial of static magnets for the treatment of osteoarthritis of the knee: results of a pilot study,"ER OBJECTIVEOur objective was to assess the feasibility and promise of studying static magnetic therapy for knee OA and determine the ability of a new placebo-magnet device to provide concealment of group assignment.DESIGNRandomized, double-blind, placebo-controlled clinical trial.SETTINGAcademic teaching hospital in Boston.PARTICIPANTSWe enrolled 29 subjects with idiopathic or post-traumatic OA of the knee.INTERVENTIONSSubjects received either high-strength magnetic (active) or placebo-magnetic (placebo) knee sleeve treatment for 4 hours in a monitored setting and self-treatment 6 hours daily for 6 weeks.MAIN OUTCOME MEASURESPrimary outcomes were change in knee pain as measured by the WOMAC Osteoarthritis Index Pain Subscale at 6 weeks and extent of group concealment at study end.RESULTSAt 4 hours, VAS pain scores (+/- SE) on a 5-item scale (0-500, 500 worst) decreased 79 +/- 18 mm in the active group and 10 +/- 21 mm in the placebo group (P  0.2) believed that they had been assigned to the active treatment group.CONCLUSIONDespite our small sample size, magnets showed statistically significant efficacy compared to placebo after 4 hours under rigorously controlled conditions. The sustained efficacy of magnetic therapy for knee osteoarthritis could be assessed in an adequately powered trial utilizing an appropriate control such our new placebo-magnet device.CONTEXTOutpatient clinical studies of magnet therapy, a complementary therapy commonly used to treat osteoarthritis (OA), have been limited by the absence of a credible placebo control.","Wolsko, P M; Eisenberg, D M; Simon, L S; Davis, R B; Walleczek, J; Mayo-Smith, M; Kaptchuk, T J; Phillips, R S",2004.0,,0,0,2581
2583,"Visual imagery, expected roles and extinction as possible factors in reducing fear and avoidance behavior.",,Wolpin M.; Raines J.,1966.0,,0,0,
2584,"Postpartum depression and companionship in the clinical birth environment: a randomized, controlled study","ER STUDY DESIGNOf 189 nulliparous women laboring in a familiar community hospital, 92 were allocated by randomized, sealed envelopes to receive additional companionship from one of three volunteer labor companions recruited from the community.RESULTSThe group receiving support attained higher self-esteem scores and lower postpartum depression and anxiety ratings 6 weeks after delivery.CONCLUSIONIn the clinical labor environment companionship modifies factors that contribute to the development of postnatal depression. We emphasize the importance of paying attention to the psychosocial environment in which labor takes place, to facilitate adaptation to parenthood.OBJECTIVEPostpartum depression is a common feature of childbearing and is the cause of considerable morbidity. We have explored the possibility that clinically oriented care during labor may contribute to its occurrence.","Wolman, W L; Chalmers, B; Hofmeyr, G J; Nikodem, V C",1993.0,,0,0,
2585,Effects of breathing training on voluntary hypo- and hyperventilation in patients with panic disorder and episodic anxiety.,"Anxiety disorders are associated with respiratory abnormalities. Breathing training (BT) aimed at reversing these abnormalities may also alter the anxiogenic effects of biological challenges. Forty-five Panic Disorder (PD) patients, 39 Episodic Anxiety patients, and 20 non-anxious controls underwent voluntary hypoventilation and hyperventilation tests twice while psychophysiological measures were recorded. Patients were randomized to one of two BT therapies (Lowering vs. Raising pCO(2)) or to a waitlist. Before treatment panic patients had higher respiration rates and more tidal volume instability and sighing at rest than did non-anxious controls. After the Lowering therapy, patients had lower pCO(2) during testing. However, neither reactivity nor recovery to either test differed between patients and controls, or were affected by treatment. Although the two treatments had their intended opposite effects on baseline pCO(2), other physiological measures were not affected. We conclude that baseline respiratory abnormalities are somewhat specific to PD, but that previously reported greater reactivity and slower recovery to respiratory challenges may be absent.",Wollburg E.; Roth WT.; Kim S.,2011.0,10.1007/s10484-011-9150-5,0,0,
2586,End-tidal versus transcutaneous measurement of PCO2 during voluntary hypo- and hyperventilation,"ER Recent studies have shown that end-tidal PCO(2) is lower during anxiety and stress, and that changing PCO(2) by altering breathing is therapeutic in panic disorder. However, end-tidal estimation of arterial PCO(2) has drawbacks that might be avoided by the transcutaneous measurement method. Here we compare transcutaneous and end-tidal PCO(2) under different breathing conditions in order to evaluate these methods in terms of their comparability and usability. Healthy volunteers performed two hypoventilation (slow vs. paused breathing) and two hyperventilation tests (25 mm Hg at 18 vs. 30 breaths per minute). Three measurements of PCO(2) (two end-tidal and one transcutaneous device), tidal volume, and respiration rate were recorded. Before and after each test, subjects filled out a symptom questionnaire. The results show that PCO(2) estimated by the two methods was comparable except that for transcutaneous measurement registration of changes in PCO(2) was delayed and absolute levels were much higher. Both methods documented that paused breathing was effective for raising PCO(2), a presumed antidote for anxious hyperventilation. We conclude that since the two methods give comparable results choosing between them for specific applications is principally a matter of whether the time lag of the transcutaneous method is acceptable.","Wollburg, E; Roth, W T; Kim, S",2009.0,10.1016/j.ijpsycho.2008.07.011,0,0,
2587,Moderators and non-specific predictors of treatment outcome for anxiety disorders: a comparison of cognitive behavioral therapy to acceptance and commitment therapy.,"Understanding for whom, and under what conditions, treatments exert their greatest effects is essential for developing personalized medicine. Research investigating moderators of outcome among evidence-based treatments for anxiety disorders is lacking. The current study examined several theory-driven and atheoretical putative moderators of outcome in cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT). Eighty-seven patients with a Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) anxiety disorder completed 12 sessions of ACT or CBT and were assessed with a self-report measure of anxiety at baseline, post-treatment, and 6- and 12-month follow-up assessments. CBT outperformed ACT among those at moderate levels of baseline anxiety sensitivity, and among those with no comorbid mood disorder. ACT outperformed CBT among those with comorbid mood disorders. Higher baseline neuroticism was associated with poorer outcome across treatment conditions. Neither moderation nor general prediction was observed for baseline anxiety disorder comorbidity, race/ethnicity, gender, age, or baseline severity of the principal anxiety disorder. When including all randomized participants who completed the pre-treatment assessment (N = 121), a similar pattern was observed. Prescriptive recommendations for clinical practice and directions for future research are discussed.",Wolitzky-Taylor KB.; Arch JJ.; Rosenfield D.; Craske MG.,2012.0,10.1037/a0029418,0,0,
2588,Randomized clinical trial investigating the efficacy of self-administered interventions for reducing pathological academic worry.,"Despite the ostensible prevalence of academic worry at the college and university level, there is a paucity of research in this area. In addition, there is an even greater dearth of research investigating treatments for excessive and uncontrollable academic worry. Further, the research on non-pharmacological treatment strategies for reducing pathological worry (as seen in its most severe form in generalized anxiety disorder; GAD) is limited. The primary goal of this study was to investigate the potential benefits of two self-administered interventions for reducing pathological academic worry. Participants experiencing pathological academic worry (N = 113) were randomized to one of four conditions: (a) worry exposure (WE), (b) expressive writing (EW), (c) a credible placebo control, consisting of pulsed audio-photic stimulation (APS), and (d) wait-list control (WLC). Participants were instructed to practice their interventions three times per week for one month. Participants in all three of the intervention conditions showed significant improvement on self-report measures, while no such changes were observed for the control group. Findings were mixed on the objective measures. In general, neither the WE nor EW conditions consistently outperformed placebo, and in some cases, EW failed to outperform the waitlist control group at post-treatment. Overall, those assigned to WE showed greater improvement than those assigned to EW at post-treatment, but few significant differences between the three intervention groups emerged at follow-up. These mixed findings suggest that either the efficacy of each of the treatments does not go beyond the that which would be expected of non-specific treatment effects, or that the pulsed audio-photic stimulation did in fact exert more of an effect than a typical placebo, suggesting there may have been an unanticipated active treatment component. Despite this, several participants in WE and EW showed marked improvement, and even continued improvement by follow-up, suggesting that, while perhaps not highly potent treatments when delivered in isolation, these may be easy, cost-effective interventions for pathological worry. Further research is needed with clinical GAD samples, and research is also needed on the placebo response rate in GAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wolitzky-Taylor, Kate Basia",2010.0,,0,0,
2589,The impact of alcohol use severity on anxiety treatment outcomes in a large effectiveness trial in primary care.,"The presence of anxiety disorders is associated with poorer alcohol use disorder treatment outcomes, but little is known about the impact of alcohol use problems on anxiety disorder treatment outcomes despite their high comorbidity. The current study examined the impact of alcohol use symptom severity on anxiety disorder treatment outcomes in a multi-site primary care effectiveness study of anxiety disorder treatment. Data came from the Coordinated Anxiety Learning and Management (CALM) effectiveness trial. Participants (N=1004) were randomized to an evidence-based anxiety intervention (including cognitive behavioral therapy and medications) or usual care in primary care. Participants completed measures of alcohol use, anxiety, and depression at baseline, 6-, 12-, and 18-month follow-up periods. Patients with alcohol dependence were excluded. There were no significant moderating (Treatment Group √ó Alcohol Use Severity) interactions. The majority of analyses revealed no predictive effects of alcohol use severity on outcome; however, alcohol problems at baseline were associated with somewhat higher anxiety and depression symptoms at the 18-month follow-up. These data indicate that patients with alcohol problems in primary care can be effectively treated for anxiety disorders. Baseline alcohol problems were associated with some poorer long-term outcomes, but this was evident across CALM and usual care. These findings provide preliminary evidence that there may be no need to postpone treatment of anxiety disorders until alcohol problems are addressed, at least among those who have mild to moderate alcohol problems. Replication with more severe alcohol use disorders is needed.",Wolitzky-Taylor K.; Brown LA.; Roy-Byrne P.; Sherbourne C.; Stein MB.; Sullivan G.; Bystritsky A.; Craske MG.,2015.0,10.1016/j.janxdis.2014.12.011,0,0,
2590,Augmenting in vivo exposure with fear antagonistic actions: a preliminary test.,"The current study investigated the efficacy of an exposure augmentation strategy in which the phobic individual is encouraged to enact actions that are in direct opposition to the fear action tendencies associated with acrophobia. Participants (N=88) meeting DSM-IV criteria for specific phobia (acrophobia) were randomized to (a) exposure with oppositional actions (E+OA), (b) exposure only (EO), (c) a credible placebo consisting of pulsed audio-photic stimulation (APS), or (d) a waitlist control (WLC). Treatment consisted of six, 6-min exposure trials. Participants were assessed with questionnaire, behavioral, and physiologic measures at pre- and posttreatment, and at a 1-month follow-up session. Participants receiving E+OA showed significantly greater improvement on behavioral and questionnaire measures than those in the other 3 conditions at both posttreatment and follow-up. Further, whereas treatment improvement generalized to an untrained context for those receiving E+OA, such was not the case for EO- and APS-treated participants. Findings suggest augmenting exposure with oppositional actions may enhance treatment outcome and thus warrant additional investigation with clinical samples.",Wolitzky KB.; Telch MJ.,2009.0,10.1016/j.beth.2007.12.006,0,0,
2591,A clinical trial comparing interviewer and computer-assisted assessment among clients with severe mental illness.,"Demographic, behavioral, and diagnostic information should routinely be collected from clients with severe mental illness, and data gathering should employ the most efficient techniques available. Surveys are increasingly conducted via Web-based computer-assisted interviewing (CAI), but this technique is not well validated for patients with severe mental illness. A randomized clinical trial of 245 clients was carried out to compare face-to face and computer-assisted interviewing (233 clients completed two surveys). Self-report data were collected on demographic characteristics, substance abuse, risk behaviors for blood-borne diseases, trauma history, and posttraumatic stress disorder. Each client was assessed twice and randomly assigned to one of the four possible combinations of interviewer and computer (computer and computer, N=53; computer and interviewer, N=56; interviewer and computer, N=59; and interviewer and interviewer, N=65). The two formats were compared on feasibility, client preference, cost, reliability, convergent validity, and criterion validity. This study demonstrated the feasibility of CAI across a variety of inpatient and outpatient settings. All participants who began the CAI process completed the interview and responded to over 95% of the survey items. Participants liked using the computers as well as they liked face-to-face interviews, and they completed the CAI as quickly. CAI produced data as reliable and valid as face-to-face interviews produced and was less expensive, and results were available more quickly. The two formats were similar in criterion validity. CAI appears to be a viable technology for gathering clinical data from the population with severe mental illness and for transforming such information into a useful, quickly accessible form to aid in clinical decision making.",Wolford G.; Rosenberg SD.; Rosenberg HJ.; Swartz MS.; Butterfield MI.; Swanson JW.; Jankowski MK.,2008.0,10.1176/ps.2008.59.7.769,0,0,
2592,Implementation and effectiveness of integrated trauma and addiction treatment for incarcerated men.,"A controlled trial of Seeking Safety (SS) and Male-Trauma Recovery Empowerment Model (M-TREM) examined implementation and effectiveness of integrated group therapy for comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) on PTSD and mental health symptoms plus self-esteem and efficacy for incarcerated men. The study sample (n=230) was male inmates 18 years or older who were primarily non-white, high school graduates or equivalents, had childhood trauma histories, committed violent crimes, had serious mental illnesses, and resided in a maximum security prison. Incarcerated men, who screened positive for PTSD and SUD, were assigned randomly (n=142) or by preference (n=88) to receive SS or M-TREM, with a waitlist group of (n=93). Manualized interventions were group-administered for 14 weeks. Primary outcomes were PTSD and other mental health symptoms. Secondary outcomes were self-esteem, coping, and self-efficacy. SUD outcomes cannot be measured in a correctional setting. Implementation feasibility was exhibited by the ability to recruit, screen, assign, and retain participants. Effectiveness findings depended on sample, design, and method for analysis. Using a waitlist control group and no follow-up period, we found no aggregate effect of treatment on PTSD symptoms, although, when disaggregated, M-TREM was found to improve PTSD severity and SS improved general mental health symptoms and psychological functioning. Using intent-to-treat and completer analyses, no significant differences were found in the relative performance between SS and M-TREM on primary or secondary outcomes. When longitudinal data were maximized and modeled in ways that reflect the hierarchical nature of the data, we found that SS and M-TREM performed better than no treatment on PTSD severity and secondary outcomes, and that treatment benefits endured. Findings cautiously support implementing either Seeking Safety or M-TREM to treat incarcerated men with co-morbid PTSD and addiction problems.",Wolff N.; Huening J.; Shi J.; Frueh BC.; Hoover DR.; McHugo G.,2015.0,10.1016/j.janxdis.2014.10.009,0,0,
2593,Effectiveness of cognitive-behavioral trauma treatment for incarcerated women with mental illnesses and substance abuse disorders.,"An open trial design was used to examine the implementation and effectiveness of a cognitive-behavioral intervention (Seeking Safety) for comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) for incarcerated women with Axis I mental disorders who self-referred for specialty trauma treatment. The study sample was female inmates aged 18 and old who were primarily minority, had experienced childhood-based trauma, committed violent crimes, had a serious mental illness, and resided in maximum, medium, and minimum compounds of a women's prison. A total of 74 women completed the group intervention, with the average attending 23 of the 28 sessions (82%). Implementation feasibility was demonstrated by the ability to recruit, screen, assign, and retain participation. Effectiveness was supported by changes pre-post intervention on the PTSD Checklist (ES=0.56) and Global Severity Index (ES=0.47). Of the 19 completers with PCL scores of 50 or higher pre-intervention, 16 (84%) had scores below 50, the ""cut score"" consistent with or supportive of a PTSD diagnosis. Three-quarters or more of participants reported that Seeking Safety was helpful in each of the following areas: overall, for traumatic stress symptoms, for substance use, to focus on safety, and to learn safe coping skills. Future directions include the need for larger scale randomized controlled trials in medium or maximum security prisons and fidelity evaluations of non-research dissemination efforts.",Wolff N.; Frueh BC.; Shi J.; Schumann BE.,2012.0,10.1016/j.janxdis.2012.06.001,0,0,
2594,The effect of hyperbaric oxygen on symptoms after mild traumatic brain injury.,"In this single-center, double-blind, randomized, sham-controlled, prospective trial at the U.S. Air Force School of Aerospace Medicine, the effects of 2.4 atmospheres absolute (ATA) hyperbaric oxygen (HBO₂) on post-concussion symptoms in 50 military service members with at least one combat-related, mild traumatic brain injury were examined. Each subject received 30 sessions of either a sham compression (room air at 1.3 ATA) or HBO₂ treatments at 2.4 ATA over an 8-week period. Individual and total symptoms scores on Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT®) and composite scores on Post-traumatic Disorder Check List-Military Version (PCL-M) were measured just prior to intervention and 6 weeks after completion of intervention. Difference testing of post-intervention means between the sham-control and HBO₂ group revealed no significant differences on the PCL-M composite score (t=-0.205, p=0.84) or on the ImPACT total score (t=-0.943, p=0.35), demonstrating no significant effect for HBO₂ at 2.4 ATA. PCL-M composite scores and ImPACT total scores for sham-control and HBO(2) groups revealed significant improvement over the course of the study for both the sham-control group (t=3.76, p=0.001) and the HBO₂ group (t=3.90, p=0.001), demonstrating no significant HBO₂ effect. Paired t-test results revealed 10 ImPACT scale scores in the sham-control group improved from pre- to post-testing, whereas two scale scores significantly improved in the HBO₂ group. One PCL-M measure improved from pre- to post-testing in both groups. This study showed that HBO₂ at 2.4 ATA pressure had no effect on post-concussive symptoms after mild TBI.",Wolf G.; Cifu D.; Baugh L.; Carne W.; Profenna L.,2012.0,10.1089/neu.2012.2549,0,0,
2595,Emotional processing in PTSD: heightened negative emotionality to unpleasant photographic stimuli.,"This study evaluated evidence for 2 forms of emotional abnormality in posttraumatic stress disorder (PTSD): numbing and heightened negative emotionality. Forty-nine male veterans with PTSD and 75 without the disorder rated their emotional responses to photographs that depicted scenes of Vietnam combat or were drawn from the International Affective Picture System (Lang et al., 2005). Images varied in their trauma-relatedness and affective qualities. A series of repeated measures ANOVAs revealed that Vietnam combat veterans with PTSD responded to unpleasant images with greater negative emotionality (i.e., enhanced arousal and lower valence ratings) than those without the disorder and this effect was modified by the trauma-relatedness of the image with stronger effects for trauma-related images. In contrast, the 2 groups showed equivalent patterns of responses to pleasant images. Findings raise questions about the sensitivity of the International Affective Picture System rating protocol for the assessment of PTSD-related emotional numbing.",Wolf EJ.; Miller MW.; McKinney AE.,2009.0,10.1097/NMD.0b013e3181a61c68,0,0,
2596,The influence of the dissociative subtype of posttraumatic stress disorder on treatment efficacy in female veterans and active duty service members.,"A dissociative subtype of posttraumatic stress disorder (PTSD) was recently added to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013) and is thought to be associated with poor PTSD treatment response. We used latent growth curve modeling to examine data from a randomized controlled trial of prolonged exposure and present-centered therapy for PTSD in a sample of 284 female veterans and active duty service members with PTSD to test the association between the dissociative subtype and treatment response. Individuals with the dissociative subtype (defined using latent profile analysis) had a flatter slope (p = .008) compared with those with high PTSD symptoms and no dissociation, such that the former group showed, on average, a 9.75 (95% confidence interval [-16.94, -2.57]) lesser decrease in PTSD severity scores on the Clinician Administered PTSD Scale (Blake et al., 1995) over the course of the trial. However, this effect was small in magnitude. Dissociative symptoms decreased markedly among those with the subtype, though neither treatment explicitly addressed such symptoms. There were no differences as a function of treatment type. Results raise doubt about the common clinical perception that exposure therapy is not effective or appropriate for individuals who have PTSD and dissociation, and provide empirical support for the use of exposure treatment for individuals with the dissociative subtype of PTSD.",Wolf EJ.; Lunney CA.; Schnurr PP.,2016.0,10.1037/ccp0000036,0,0,
2597,Hyperbaric side effects in a traumatic brain injury randomized clinical trial.,"To catalog the side effects of 2.4 atmospheres absolute (atm abs) hyperbaric oxygen (HBO2) vs. sham on post-concussion symptoms in military service members with combat-related, mild traumatic brain injury (TBI). Fifty subjects diagnosed with TBI were randomized to either a sham (1.3 atm abs breathing air) or treatment (2.4 atm abs breathing 100% oxygen) hyperbaric profile. Forty-eight subjects completed 30 exposures. Medical events during hyperbaric exposures were separately annotated by medical staff and chamber operators. After the blind was broken, events were segregated into the exposure groups. These side effects were observed as rate (sham/treatment): ear block (ear barotrauma) 5.51% (1.09%/5.91%), sinus squeeze 0.14% (0.0%/0.27%), and confinement anxiety 0.27% (0.27%/0.27%). Other conditions that occurred included: headache 0.61% (0.68%/0.54%); nausea 0.2% (0.14%/0.27%); numbness 0.07% (0%/0.13%); heartburn 0.07% (0.14%/0%); musculoskeletal chest pain 0.07% (0%/0.13%); latex allergy 0.07% (0.14%/0%); and hypertension 0.07% (0.14%/0%). This study demonstrated no major adverse events, such as pulmonary barotraumas, pulmonary edema or seizure. Given the infrequent, mild side effect profile, the authors feel the study demonstrated that hyperbaric oxygen therapy (HBO2T) was safe at a relatively high treatment pressure in TBI subjects, and these data can be used to evaluate the risk/ benefit calculation when deciding to utilize HBO2T for treatment of various diseases in the TBI population.",Wolf EG.; Prye J.; Michaelson R.; Brower G.; Profenna L.; Boneta O.,,,0,0,
2598,Cognitive function in a traumatic brain injury hyperbaric oxygen randomized trial.,"Determine changes in cognition and post-traumatic stress disorder (PTSD) symptoms in subjects with traumatic brain injury (TBI) exposed to 2.4 atmospheres absolute (atm abs) breathing 100% oxygen vs. sham (1.3 atm-abs air). Fifty randomized subjects completed a total of 30 exposures. A concussion history was taken, then baseline, post-series, and six-week follow-up immediate post-concussion assessment and cognitive testing, Brain-checkers and PTSD Checklist for Military (PCL-M) tests were administered. No statistically significant differences between groups were noted, but both groups improved. Subgroups analyses, based on concussion history and individual test components, showed improvement in the treatment group vs. the sham. These subgroups included the number of concussive events, time from event to consent, loss of consciousness, visual memory, processing, go--no go, and simple reaction time. There was no statistically significant difference between a sham and 2.4 atm abs hyperbaric oxygen (HBO2) in cognitive scores from ImPACT and Brain-checkers or composite scores in the PCL-M; however both groups showed improvement. Subgroups with favorable response to treatment are identified. Future studies evaluating HBO2 should consider concussion histories or focus on validating subgroup response to determine HBO2 as a potential adjunctive treatment for persistent symptoms following TBI.",Wolf EG.; Baugh LM.; Kabban CM.; Richards MF.; Prye J.,,,0,0,
2599,Hyperbaric side effects in a traumatic brain injury randomized clinical trial,"ER OBJECTIVE: To catalog the side effects of 2.4 atmospheres absolute (atm abs) hyperbaric oxygen (HBO2) vs. sham on post-concussion symptoms in military service members with combat-related, mild traumatic brain injury (TBI).METHODS: Fifty subjects diagnosed with TBI were randomized to either a sham (1.3 atm abs breathing air) or treatment (2.4 atm abs breathing 100% oxygen) hyperbaric profile. Forty-eight subjects completed 30 exposures. Medical events during hyperbaric exposures were separately annotated by medical staff and chamber operators. After the blind was broken, events were segregated into the exposure groups.RESULTS: These side effects were observed as rate (sham/treatment): ear block (ear barotrauma) 5.51% (1.09%/5.91%), sinus squeeze 0.14% (0.0%/0.27%), and confinement anxiety 0.27% (0.27%/0.27%). Other conditions that occurred included: headache 0.61% (0.68%/0.54%); nausea 0.2% (0.14%/0.27%); numbness 0.07% (0%/0.13%); heartburn 0.07% (0.14%/0%); musculoskeletal chest pain 0.07% (0%/0.13%); latex allergy 0.07% (0.14%/0%); and hypertension 0.07% (0.14%/0%).CONCLUSION: This study demonstrated no major adverse events, such as pulmonary barotraumas, pulmonary edema or seizure. Given the infrequent, mild side effect profile, the authors feel the study demonstrated that hyperbaric oxygen therapy (HBO2T) was safe at a relatively high treatment pressure in TBI subjects, and these data can be used to evaluate the risk/ benefit calculation when deciding to utilize HBO2T for treatment of various diseases in the TBI population.","Wolf, E G; Prye, J; Michaelson, R; Brower, G; Profenna, L; Boneta, O",2012.0,,0,0,2597
2600,Cognitive function in a traumatic brain injury hyperbaric oxygen randomized trial,"ER METHODS: Fifty randomized subjects completed a total of 30 exposures. A concussion history was taken, then baseline, post-series, and six-week follow-up immediate post-concussion assessment and cognitive testing, Brain-checkers and PTSD Checklist for Military (PCL-M) tests were administered.RESULTS: No statistically significant differences between groups were noted, but both groups improved. Subgroups analyses, based on concussion history and individual test components, showed improvement in the treatment group vs. the sham. These subgroups included the number of concussive events, time from event to consent, loss of consciousness, visual memory, processing, go--no go, and simple reaction time.CONCLUSION: There was no statistically significant difference between a sham and 2.4 atm abs hyperbaric oxygen (HBO2) in cognitive scores from ImPACT and Brain-checkers or composite scores in the PCL-M; however both groups showed improvement. Subgroups with favorable response to treatment are identified. Future studies evaluating HBO2 should consider concussion histories or focus on validating subgroup response to determine HBO2 as a potential adjunctive treatment for persistent symptoms following TBI.OBJECTIVE: Determine changes in cognition and post-traumatic stress disorder (PTSD) symptoms in subjects with traumatic brain injury (TBI) exposed to 2.4 atmospheres absolute (atm abs) breathing 100% oxygen vs. sham (1.3 atm-abs air).","Wolf, E G; Baugh, L M; Kabban, C M; Richards, M F; Prye, J",2015.0,,0,0,2598
2601,Exposure in vivo vs social skills training for social phobia: long-term outcome and differential effects.,"This study examined the long-term effectiveness of specific exposure in vivo (individual IE or group GE) and of office-based social skills training (group SST) in two groups of patients with social inhibition (primary social skills deficits or primary social phobia). Seventy-eight outpatients were divided into these two subgroups according to clinical assessment. Twenty-seven patients received SST which consisted of 25 twice a week 90-min group sessions: 32 patients received GE and 17 IE. Exposure in vivo consisted of 4 weekly (8-hr in the group condition included 2 hr discussion; 3 hr in the individual condition included 1 hr discussion) sessions. Self-rating-assessments were carried out at pre- and post-treatment, at 3 months- and 2.5 yr follow-up. The general results indicate that all three treatment modes led to clinically and statistically-significant improvements in the main problem area (social anxiety, skills deficits), in other neurotic complaints (depression, obsessions, psychosomatic complaints) and in attribution-style. Patients with the diagnosis of primary phobia seemed to get the same profit from either treatment and showed slightly better gains (in all treatment modalities) than patients with skills deficits at long-term follow-up. Within the subgroup with skills deficits there was a tendency for superior outcome of group exposure. These results and recommendations for future research are discussed.",Wlazlo Z.; Schroeder-Hartwig K.; Hand I.; Kaiser G.; Münchau N.,1990.0,,0,0,
2602,Intramedullary osteosynthesis in fractures of the mid-third of the clavicle in sports traumatology,"ER METHODSThis prospective randomised trial compares the results of 68 athletes with an isolated fracture of the middle third of the clavicle. One group (n=35) received intramedullary splints, the other group (n=33) had a figure of eight dressing instead.RESULTSPost-traumatic pain was significantly (p=0.05) lower in the group that had intramedullary splints. Furthermore, the postoperative mobility of the injured area was significantly better (p=0.05). Measurements of the strength of the injured side 120 days after the trauma show a significant (p=0.01) advantage of the pin osteosynthesis.CONCLUSIONThe intramedullary titanium pin osteosynthesis is a promising alternative with better results. Up to date literature and our own results prove the advantages of this minimally invasive osteosynthesis. This procedure allows sports activities to be resumed soon after the operation. As intramedullary pin osteosynthesis is an ideal operation of fractures of the middle third of the clavicle, this comparatively easy procedure with few complications should be more widespread.AIMIn Germany, non-operative treatment using a figure of eight dressing is the most common method for managing fractures of the mid-third of the clavicle. This treatment is chosen preferably even in cases of dislocated fractures. The described procedures of open osteosynthesis are characterised by a huge access trauma. Up to date literature shows the advantages of intramedullary pin osteosynthesis, which can be considered as a minimally invasive procedure. In this study we compare the results of pin-osteosynthesis with the non-operative treatment in athletes.","Witzel, K",2007.0,10.1055/s-2007-965616,0,0,
2603,Exploring the collective hospice caregiving experience,"ER OBJECTIVE: The goal of this study was to determine whether being in a caregiver pair affected caregiver anxiety and depression and how outcomes changed over time.DESIGN: A mixed model analysis was used.SETTING/SUBJECTS: Hospice caregivers (260 solo caregivers and 44 caregivers in 22 pairs) who participated in a larger, randomized controlled trial completed caregiver measures upon hospice admission and periodically until the death of the patient or hospice decertification.MEASUREMENTS: Measured were caregiver quality of life, social support, anxiety, and depression.RESULTS: Caregiver pairs had higher anxiety and depression scores than solo caregivers. Emotional, financial, and physical quality of life were associated with decreased depression, whereas only emotional and financial quality of life were correlated with lower levels of anxiety. Social support was associated with lower levels of depression and anxiety.CONCLUSIONS: Despite assumptions that social support is positively facilitated vis-a-vis collective caregiving, caregiving pairs may be at higher risk for anxiety and depression. Future research is needed to address why individuals become anxious and/or depressed when working as part of a caregiving pair.BACKGROUND: Collective caregiving, performed by caregivers working in pairs (informal primary and secondary caregivers working together), is common in the hospice setting. Research suggests that caregiving pairs may experience different caregiver outcomes. However, little is known about how caregiving pairs differ from solo caregivers (informal primary caregivers) on outcome measures.","Wittenberg-Lyles, E; Kruse, R L; Oliver, D P; Demiris, G; Petroski, G",2014.0,10.1089/jpm.2013.0289,0,0,
2604,Exploring oral literacy in communication with hospice caregivers,"ER CONTEXT: Low oral literacy has been identified as a barrier to pain management for informal caregivers who receive verbal instructions on pain medication and pain protocols.OBJECTIVES: To examine recorded communication between hospice staff and informal caregivers and explore caregiver experiences.METHODS: Using transcripts of interactions (n = 47), oral literacy features were analyzed by examining the generalized language complexity using the Flesch-Kincaid grading scale and the dialogue interactivity defined by talking turns and interaction time. Means for longitudinal follow-up measures on caregiver anxiety, quality of life, perception of pain management, knowledge and comfort providing pain medication, and satisfaction were examined to explore their relationship to oral literacy.RESULTS: Communication between team members and caregivers averaged a fourth-grade level on the Flesch-Kincaid scale, indicating that communication was easy to understand. Reading ease was associated (r = 0.67, P < 0.05) with caregiver understanding of and comfort with pain management. Perceived barriers to caregiver pain management were lower when sessions had increased use of passive sentences (r = 0.61, P < 0.01), suggesting that passive voice was not an accurate indicator of language complexity. Caregiver understanding and comfort with administering pain medications (r = -0.82, P < 0.01) and caregiver quality of life (r = -0.49, P < 0.05) were negatively correlated with dialogue pace.CONCLUSION: As the grade level of talk with caregivers and hospice teams increased, associated caregiver anxiety increased. Caregivers with higher anxiety also experienced greater difficulty in understanding pain medication and its management. Specific adjustments that hospice teams can make to improve caregiver experiences are identified.","Wittenberg-Lyles, E; Goldsmith, J; Oliver, D P; Demiris, G; Kruse, R L; Stee, S",2013.0,10.1016/j.jpainsymman.2012.11.006,0,0,
2605,Practitioner perfectionism: Relationship to ambiguity tolerance and work satisfaction,"Perfectionism among psychological practitioners is a common phenomenon, but a neglected topic in the research literature. This article presents data indicating that perfectionism is negatively related to both tolerance of ambiguity and satisfaction of conducting psychotherapy in a sample of 197 doctoral-level, private-practice psychologists. Results demonstrated that high, socially prescribed perfectionism and low tolerance of ambiguity are associated with reduced enjoyment of conducting psychotherapy. Several methods to self-evaluate and moderate perfectionism in clinicians are offered. © 2001 John Wiley & Sons, Inc.",Wittenberg K.J.; Norcross J.C.,2001.0,10.1002/jclp.1116,0,0,
2606,Test-retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI).,"The structure and content of the Munich-Composite International Diagnostic Interview (M-CIDI) for the assessment of DSM-IV symptoms, syndromes, and diagnoses is described along with findings from a test-retest reliability study. A sample of 60 community respondents were interviewed twice independently by trained interviewers with an average time interval of 38 days between investigations. Test-retest reliability was good for almost all specific DSM-IV core symptom questions and disorders examined, with kappa values ranging from fair for two diagnoses--bulimia (kappa 0.55) and generalized anxiety disorder (kappa 0.45)--to excellent (kappa above 0.72) for all other anxiety disorders and alcohol use disorders. Test-retest reliability for age of onset and time-related questions was fairly consistently high (intra-class correlation values of 0.79 or above), with one notable exception: the assessment of disorders with onset before puberty. We concluded that the M-CIDI is acceptable for respondents, efficient in terms of time needed for and ease of administration, and reliable in terms of consistency of findings over time periods of at least 1 month.",Wittchen HU.; Lachner G.; Wunderlich U.; Pfister H.,1998.0,,0,0,
2607,Effects of acute social stress on alcohol consumption in healthy subjects,"ER METHODSThirty-seven men and women, ages 21-35, were randomly assigned to a placebo (n = 15) or ethanol group (n = 22). Subjects participated in two sessions, one with stress (Trier Social Stress Test) the other without stress. In each session, immediately after the stress or no-stress period, subjects consumed the first dose (placebo or 0.3 g/kg of ethanol for men or 0.2 g/kg for women). Then, subjects were allowed to choose up to six more beverages (0.1 g/kg each for the ethanol group or placebo beverages for the placebo group). Measures included percentage of beverage consumed, salivary cortisol level, heart rate, blood pressure, and subjective ratings of mood and drug effect.RESULTSSubjects in both the placebo and ethanol groups consumed significantly more of their beverages after stress, compared to no stress. Stress increased anxiety, uneasiness, and produced some stimulant-like effects and, in the ethanol group, it dampened some of the acute subjective effects of ethanol. The direct physiologic and mood effects of the stress were fairly short-lived.CONCLUSIONSIt is concluded that acute stress may produce a modest increase in alcohol consumption in healthy, nonproblem social drinkers but that this increase is not directly related to the pharmacological effects of the drug. Nonpharmacological factors may include expectancies, thirst, or nonspecific facilitation of ongoing behaviors.BACKGROUNDThere has been renewed interest in interactions between stress and use of drugs and alcohol. Although there is evidence that stress increases drug use in human drug users and in laboratory animals, the processes by which stress affects drug-motivated behavior are not understood. Here we examined the effects of an acute social stressor (performing a mental arithmetic task in front of an audience) on consumption of ethanol or placebo beverages in healthy social drinkers.","Wit, H; Söderpalm, A H; Nikolayev, L; Young, E",2003.0,10.1097/01.ALC.0000081617.37539.D6,0,0,
2608,Evaluating the impact of treatment for sleep/wake disorders on recovery of cognition and communication in adults with chronic TBI.,"To longitudinally examine objective and self-reported outcomes for recovery of cognition, communication, mood and participation in adults with traumatic brain injury (TBI) and co-morbid post-traumatic sleep/wake disorders. Prospective, longitudinal, single blind outcome study. Community-based. Ten adults with moderate-severe TBI and two adults with mild TBI and persistent symptoms aged 18-58 years. Six males and six females, who were 1-22 years post-injury and presented with self-reported sleep/wake disturbances with onset post-injury. Individualized treatments for sleep/wake disorders that included sleep hygiene recommendations, pharmacological interventions and/or treatments for sleep apnea with follow-up. Insomnia Severity Index, Beck Depression and Anxiety Inventories, Latrobe Communication Questionnaire, Speed and Capacity of Language Processing, Test of Everyday Attention, Repeatable Battery for the Assessment of Neuropsychological Status, Daily Cognitive-Communication and Sleep Profile. Group analysis revealed positive trends in change for each measure and across sub-tests of all measures. Statistically significant changes were noted in insomnia severity, p‚Äâ=‚Äâ0.0003; depression severity, p‚Äâ=‚Äâ0.03; language, p‚Äâ=‚Äâ0.01; speed of language processing, p‚Äâ=‚Äâ0.007. These results add to a small but growing body of evidence that sleep/wake disorders associated with TBI exacerbate trauma-related cognitive, communication and mood impairments. Treatment for sleep/wake disorders may optimize recovery and outcomes.",Wiseman-Hakes C.; Murray B.; Moineddin R.; Rochon E.; Cullen N.; Gargaro J.; Colantonio A.,2013.0,10.3109/02699052.2013.823663,0,0,
2609,"Short course of cognitive behavioural therapy may reduce health anxiety, say researchers.",,Wise J.,2013.0,,0,0,
2610,Mechanisms of change in written exposure treatment of posttraumatic stress disorder.,"Although the effectiveness of exposure therapy for PTSD is recognized, treatment mechanisms are not well understood. Emotional processing theory (EPT) posits that fear reduction within and between sessions creates new learning, but evidence is limited by self-report assessments and inclusion of treatment components other than exposure. We examined trajectories of physiological arousal and their relation to PTSD treatment outcome in a randomized controlled trial of written exposure treatment, a protocol focused on exposure to trauma memories. Hierarchical linear modeling was used to model reduction in Clinician Administered PTSD Scale score as a predictor of initial activation and within- and between-session change in physiological arousal. Treatment gains were significantly associated with initial physiological activation, but not with within- or between-session changes in physiological arousal. Treatment gains were associated with larger between-session reductions in self-reported arousal. These findings highlight the importance of multimethod arousal assessment and add to a growing literature suggesting refinements of EPT. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wisco, Blair E; Baker, Aaron S; Sloan, Denise M; Berntson, Berntson, Bluett, Borkovec, Borkovec, Boucsein, Bouton, Bradley, Cohen, Craske, Foa, Foa, Foa, Goodie, Graham, Greenwald, Hauschildt, Hodgson, Jaycox, Lang, Lang, Lang, Marx, Minnen, Nacasch, Pitman, Pitman, Pole, Rauch, Raudenbush, Rowe, Sloan, Sloan, Sripada, Tsao, van Minnen, Vrana, Weathers",2016.0,,0,0,
2611,Mechanisms of Change in Written Exposure Treatment of Posttraumatic Stress Disorder.,"Although the effectiveness of exposure therapy for PTSD is recognized, treatment mechanisms are not well understood. Emotional processing theory (EPT) posits that fear reduction within and between sessions creates new learning, but evidence is limited by self-report assessments and inclusion of treatment components other than exposure. We examined trajectories of physiological arousal and their relation to PTSD treatment outcome in a randomized controlled trial of written exposure treatment, a protocol focused on exposure to trauma memories. Hierarchical linear modeling was used to model reduction in Clinician Administered PTSD Scale score as a predictor of initial activation and within- and between-session change in physiological arousal. Treatment gains were significantly associated with initial physiological activation, but not with within- or between-session changes in physiological arousal. Treatment gains were associated with larger between-session reductions in self-reported arousal. These findings highlight the importance of multimethod arousal assessment and add to a growing literature suggesting refinements of EPT.",Wisco BE.; Baker AS.; Sloan DM.,2016.0,10.1016/j.beth.2015.09.005,0,0,
2612,A deletion variant of the α2b-adrenoceptor modulates the stress-induced shift from “cognitive” to “habit” memory,"Stress induces a shift from hippocampus-based “cognitive” toward dorsal striatum-based “habitual” learning and memory. This shift is thought to have important implications for stress-related psychopathologies, including post-traumatic stress disorder (PTSD). However, there is large individual variability in the stress-induced bias toward habit memory, and the factors underlying this variability are completely unknown. Here we hypothesized that a functional deletion variant of the gene encoding the α2b-adrenoceptor (ADRA2B), which has been linked to emotional memory processes and increased PTSD risk, modulates the stress-induced shift from cognitive toward habit memory. In two independent experimental studies, healthy humans were genotyped for the ADRA2B deletion variant. After a stress or control manipulation, participants completed a dual-solution learning task while electroencephalographic (Study I) or fMRI measurements (Study II) were taken. Carriers compared with noncarriers of the ADRA2B deletion variant exhibited a significantly reduced bias toward habit memory after stress. fMRI results indicated that, whereas noncarriers of the ADRA2B deletion variant showed increased functional connectivity between amygdala and putamen after stress, this increase in connectivity was absent in carriers of the deletion variant, who instead showed overall enhanced connectivity between amygdala and entorhinal cortex. Our results indicate that a common genetic variation of the noradrenergic system modulates the impact of stress on the balance between cognitive and habitual memory systems, most likely via altered amygdala orchestration of these systems.",Wirz L.; Wacker J.; Felten A.; Reuter M.; Schwabe L.,2017.0,10.1523/JNEUROSCI.3507-16.2017,0,0,
2613,Feasibility and safety of neural tissue transplantation in patients with syringomyelia.,"Transplantation of fetal spinal cord (FSC) tissue has demonstrated significant potential in animal models for achieving partial anatomical and functional restoration following spinal cord injury (SCI). To determine whether this strategy can eventually be translated to humans with SCI, a pilot safety and feasibility study was initiated in patients with progressive posttraumatic syringomyelia (PPTS). A total of eight patients with PPTS have been enrolled to date, and this report presents findings for the first two patients through 18 months postoperative. The study design included detailed assessments of each subject at multiple pre- and postoperative time points. Outcome data were then compared with each subject's own baseline. The surgical protocol included detethering, cyst drainage, and implantation of 6-9-week postconception human FSC tissue. Immunosuppression with cyclosporine was initiated a few days prior to surgery and continued for 6 months postoperatively. Key outcome measures included: serial magnetic resonance imaging (MRI) exams, standardized measures of neurological impairment and functional disability, detailed pain assessment, and extensive neurophysiological testing. Through 18 months, the first two patients have been stable neurologically and the MRIs have shown evidence of solid tissue at the graft sites, without evidence of donor tissue overgrowth. Although it is still too soon to draw any firm conclusions, the findings from the initial two patients in this study suggest that intraspinal grafting of human FSC tissue is both feasible and safe.",Wirth ED.; Reier PJ.; Fessler RG.; Thompson FJ.; Uthman B.; Behrman A.; Beard J.; Vierck CJ.; Anderson DK.,2001.0,10.1089/089771501750451839,0,0,
2614,Evaluation of an internet support group for women with primary breast cancer.,"Women with breast carcinoma commonly experience psychologic distress following their diagnosis. Women who participate in breast cancer support groups have reported significant reduction in their psychologic distress and pain and improvement in the quality of their lives. Web-based breast cancer social support groups are widely used, but little is known of their effectiveness. Preliminary evidence suggests that women benefit from their participation in web-based support groups. Seventy-two women with primary breast carcinoma were assigned randomly to a 12-week, web-based, social support group (Bosom Buddies). The group was semistructured, moderated by a health care professional, and delivered in an asynchronous newsgroup format. The results indicate that a web-based support group can be useful in reducing depression and cancer-related trauma, as well as perceived stress, among women with primary breast carcinoma. The effect sizes ranged from 0.38 to 0.54. Participants perceived a variety of benefits and high satisfaction from their participation in the intervention This study demonstrated that the web-based program, Bosom Buddies, was effective in reducing participants' scores on depression, perceived stress, and cancer-related trauma measures. The effect size of the intervention was in the moderate range. Although web-based social support groups offer many advantages, this delivery mechanism presents a number of ethical issues that need to be addressed.",Winzelberg AJ.; Classen C.; Alpers GW.; Roberts H.; Koopman C.; Adams RE.; Ernst H.; Dev P.; Taylor CB.,2003.0,10.1002/cncr.11174,0,0,
2615,The potential impact of recruitment method on sample characteristics and treatment outcomes in a psychosocial trial for women with co-occurring substance use disorder and PTSD.,"Background: Recruitment method can impact the sample composition of a clinical trial and, thus, the generalizability of the results, but the importance of recruitment method in substance use disorder trials has received little attention. The present paper sought to address this research gap by evaluating the association between recruitment method and sample characteristics and treatment outcomes in a substance use disorder trial. Methods: In a multi-site trial evaluating Seeking Safety (SS), relative to Women's Health Education (WHE), for women with co-occurring PTSD (either sub-threshold or full PTSD) and substance use disorders, one site assessed the method by which each participant was recruited. Data from this site (n =106), which recruited participants from newspaper advertising and clinic intakes, were analyzed. Results: Participants recruited through advertising, relative to those from the clinic, had significantly higher levels of baseline drug use and higher rates of meeting DSM-IV-TR criteria for full PTSD. Results suggest that the effectiveness of SS in decreasing PTSD symptoms was greater for participants recruited through advertising relative to those recruited from the clinic. Conversely, the results revealed a significant treatment effect in the clinic-recruited participants, not seen in the advertising-recruited participants, with SS, relative to WHE, participants being more likely to report past week drug use during the follow-up phase. Conclusion: Recruitment method may impact sample composition and treatment effects. Replication of this finding would have important implications for substance use disorder efficacy trials which often utilize advertising to recruit participants. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Winhusen, Theresa; Winstanley, Erin L; Somoza, Eugene; Brigham, Gregory; Andersen, Blake, Brigham, Fals-Stewart, Fitzmaurice, Foa, Glasgow, Harris, Hien, Hoving, Schlernitzauer, Sobell, Stack",2012.0,,0,0,
2616,The Severe Respiratory Insufficiency (SRI) Questionnaire: a specific measure of health-related quality of life in patients receiving home mechanical ventilation,"ER METHODSThe Severe Respiratory Insufficiency (SRI) Questionnaire was developed and tested for its psychometric properties following a multicentric clinical trial including 226 patients receiving HMV (mean age 57.3+/-14.0 years).RESULTSForty-nine items passed the selection process and were allocated to seven subscales: Respiratory Complaints, Physical Functioning, Attendant Symptoms and Sleep, Social Relationships, Anxiety, Psychologic Well-Being, and Social Functioning. Cronbach's alpha was >0.7 in all subscales and >0.8 in four subscales indicating high internal consistency reliability. Construct validity was confirmed by factor analysis, indicating one summary scale that accounts for 59.8% of the variance. Concurrent validity was confirmed by correlating subscales of the SRI and the SF-36 (0.21<r<0.79). Item-scale correlations revealed a high item discriminant validity. In addition, different diagnostic groups could be discriminated by the SRI. Here, the overall best HRQL was measured in the following order: patients with kyphoscoliosis, miscellaneous disorders, neuromuscular diseases, post-tuberculosis, and chronic obstructive pulmonary disease (P<.05).CONCLUSIONThe SRI is a new multidimensional instrument with high psychometric properties designed to measure specific HRQL in patients with SRI receiving HMV.BACKGROUND AND OBJECTIVEThe objective of this study was to develop a specific instrument for measuring health-related quality of life (HRQL) in patients receiving home mechanical ventilation (HMV).","Windisch, W; Freidel, K; Schucher, B; Baumann, H; Wiebel, M; Matthys, H; Petermann, F",2003.0,,0,0,
2617,A randomized controlled dismantling trial of post-workshop consultation strategies to increase effectiveness and fidelity to an evidence-based psychotherapy for Posttraumatic Stress Disorder.,"Posttraumatic Stress Disorder (PTSD) is a serious mental health condition with substantial costs to individuals and society. Among military veterans, the lifetime prevalence of PTSD has been estimated to be as high as 20%. Numerous research studies have demonstrated that short-term cognitive-behavioral psychotherapies, such as Cognitive Processing Therapy (CPT), lead to substantial and sustained improvements in PTSD symptoms. Despite known benefits, only a minority of clinicians provide these therapies. Transferring this research knowledge into clinical settings remains one of the largest hurdles to improving the health of veterans with PTSD. Attending a workshop alone is insufficient to promote adequate knowledge transfer and sustained skill; however, relatively little research has been conducted to identify effective post-training support strategies. The current study investigates whether clinicians receiving post-workshop support (six-month duration) will deliver CPT with greater fidelity (i.e., psychotherapy adherence and competence) and have improved patient outcomes compared with clinicians receiving no formal post-workshop support. The study conditions are: technology-enhanced group tele-consultation; standard group tele-consultation; and fidelity assessment with no consultation. The primary outcome is independent assessment (via audio-recordings) of the clinicians' adherence and competence in delivering CPT. The secondary outcome is observed changes in patient symptoms during and following treatment as a function of clinician fidelity. Post-consultation interviews with clinicians will help identify facilitators and barriers to psychotherapy skill acquisition. The study results will inform how best to implement and transfer evidence-based psychotherapy (e.g., CPT) to clinical settings to attain comparable outcomes to those observed in research settings. Findings will deepen our understanding of how much and what type of support is needed following a workshop to help clinicians become proficient in delivering a new protocol. Several influences on clinician learning and patient outcomes will be discussed. An evidence-based model of clinical consultation will be developed, with the ultimate goal of informing policy and influencing best practice in clinical consultation. ClinicalTrials.gov: NCT01861769.",Wiltsey Stirman S.; Shields N.; Deloriea J.; Landy MS.; Belus JM.; Maslej MM.; Monson CM.,2013.0,10.1186/1748-5908-8-82,0,0,
2618,Eye movement desensitization and reprocessing (EMDR) treatment for psychologically traumatized individuals.,"The effects of 3 90-min eye movement desensitization and reprocessing (EMDR) treatment sessions on traumatic memories of 80 participants were studied. Participants were randomly assigned to treatment or delayed-treatment conditions and to 1 of 5 licensed therapists trained in EMDR. Participants receiving EMDR showed decreases in presenting complaints and in anxiety and increases in positive cognition. Participants in the delayed-treatment condition showed no improvement on any of these measures across the 30 days before treatment, but after treatment participants in the delayed-treatment condition showed similar effects on all measures. The effects were maintained at 90-day follow-up.",Wilson SA.; Becker LA.; Tinker RH.,1995.0,,0,0,
2619,Transfer of manualized Short Term Psychodynamic Psychotherapy (STPP) for social anxiety disorder into clinical practice: Results from a cluster-randomised controlled trial.,"Background: Despite growing evidence for manualized psychodynamic treatments, there is a lack of studies on their transfer to routine practice. This is the first study to examine the effects of an additional training in manualized Short Term Psychodynamic Psychotherapy (STPP) on the outcome in routine psychotherapy for social anxiety disorder (SAD). The study is an extension to a large RCT comparing STPP to Cognitive-Behavioral Therapy of SAD. Methods: The manualized treatment was designed for a time limited approach with 25 individual sessions of STPP over 6 months. Private practitioners were randomized to training in manualized STPP (mSTPP) vs. treatment as usual without a specific training (tauSTPP). A total of 109 patients were enrolled (105 started treatment; 75 completed at least 20 treatment sessions). Assessments were conducted pre-treatment, after 8 and 15 weeks, after 25 treatment sessions, at the end of treatment, 6 and 12 months after termination of treatment. Remission as primary outcome was defined by the Liebowitz-Social-Anxiety-Scale (LSAS) score <= 30. Secondary outcomes were response (at least 31% reduction in LSAS), treatment duration and number of sessions, changes in social anxiety (LSAS, SPAI), depression (BDI), clinical global impression (CGI), and quality of life (EQ-5D). Results: Remission rates of mSTPP (9%) resp. tauSTPP (16%) and also response rates of 33% resp. 28% were comparable between the two treatment approaches as well as treatment duration and number of sessions. Most of the within-group differences (baseline to 25 sessions) indicated moderate to large improvements in both treatments; within-group differences from baseline to 12 months follow-up (LSAS, SPAI, BDI, CGI) were large ranging from d = -0.605 to d = -2.937. Benefits of mSTPP were limited to single outcomes. Conclusions: Findings are discussed with regard to implementation and dissemination of empirically validated treatments in psychodynamic training and practice. SAD patients with a high comorbidity of personality disorders and a long treatment history may need longer treatments. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Wiltink, Jorg; Ruckes, Christian; Hoyer, Jurgen; Leichsenring, Falk; Joraschky, Peter; Leweke, Frank; Pohlmann, Karin; Beutel, Manfred E; Abbass, Albani, Bandelow, Bandelow, Bandelow, Barber, Beck, Beesdo-Baum, Beutel, Fehm, Fydrich, Graf von der Schulenburg, Guy, Hautzinger, Holt, Hoyer, Keller, Kessler, Leichsenring, Leichsenring, Leichsenring, Leichsenring, Leichsenring, Leichsenring, Liebowitz, Liebowitz, McHugh, Mennin, Stangier, Turner, Wiltink, Wiltink, Wittchen, Wittchen, Wittchen",2017.0,,0,0,
2620,Dilemmas families face in talking with returning U.S. military service members about seeking professional help for mental health issues.,"Drawing on Goldsmith's (2004) normative theory, this article maps dilemmas family members experience when talking with returning service members (SMs) about seeking mental health care. Eighty family members of United States SMs who served in Iraq or Afghanistan read a scenario where their SM was displaying posttraumatic stress disorder (PTSD) or depression symptoms. Participants described goals they would pursue, barriers they might encounter, and advice they would give others in the situation. Four dilemmas of talking about mental health emerged: (a) getting you to recognize the problem without implying you're not normal, (b) convincing you to seek help without implying you're weak, (c) being persistent but patient, and (d) wanting you to open up without implying I can understand. Family members reported using four groups of strategies to manage these dilemmas. Directions for expanding the concept of dilemmas as ""paradoxes"" and for supporting military families as well as rethinking policy assumptions are discussed.",Wilson SR.; Gettings PE.; Hall ED.; Pastor RG.,2015.0,10.1080/10410236.2014.899659,0,0,
2621,Distress proneness and cognitive decline in a population of older persons.,"The association between distress proneness and cognitive decline was examined in older residents of a biracial community in Chicago. At baseline, participants completed four cognitive tests that yielded a global measure (baseline mean=101.2; standard deviation (SD)=7.8), and a brief measure of the tendency to experience negative emotions (mean=16.5; SD=6.7) based on the Neuroticism scale of the NEO Five-Factor Inventory. Cognitive testing was repeated twice at three-year intervals. In mixed models that controlled age, sex, race, and education, for each point on the distress proneness scale, global cognitive score was 0.12 unit lower at baseline (p<0.001) and annual rate of decline increased by 0.01 unit (p=0.002), or about 2%. Thus, cognitive decline was about 30% faster in a person highly prone to distress (score=24, 90th percentile) compared to the one low in distress proneness (score=9, 10th percentile). This effect was unchanged after controlling for level of cognitive activity or excluding people with cognitive impairment at baseline, but it was reduced to a trend (p=0.059) after controlling for depressive symptoms. The results suggest that the tendency to experience psychological distress is associated with increased cognitive decline in old age.",Wilson RS.; Bennett DA.; Mendes de Leon CF.; Bienias JL.; Morris MC.; Evans DA.,2005.0,10.1016/j.psyneuen.2004.04.005,0,0,
2622,Differentiation between the intensity of breathlessness and the distress it evokes in normal subjects during exercise,"1. This study was designed to examine whether normal subjects could differentiate between the 'intensity' of their breathlessness and the amount of 'distress' it evoked, by specific wording of the instructions. 2. A preliminary study showed no significant difference between 'distress' score during exercise measured on two separate occasions (P = 0.3). 3. Ten subjects each performed two identical incremental cycle-ergometer exercise tests on separate occasions during which they were asked to quantify either 'intensity' or 'distress' by using modified Borg scales. 4. In all subjects there was a significant correlation (P < 0.001) between 'intensity' and minute ventilation. In eight subjects there was a significant correlation (P < 0.05) between 'distress' and minute ventilation. One subject displayed no significant correlation and one registered no distress. 5. Mean 'intensity' was greater than the mean 'distress' (P = 0.0001). The slope of 'intensity'/minute ventilation was greater than the slope of 'distress'/minute ventilation (P = 0.0001). 6. Within individuals there was a significant correlation between 'intensity' and 'distress' (P < 0.05). There was a wide scatter in the slope of this relationship between subjects and maximum 'intensity' and 'distress' did not correlate. 7. Different elements of the breathlessness sensation could be identified and selectively measured depending on the wording of the instructions given to the subject. 8. There was a wide intersubject variation in the magnitude of both breathlessness 'intensity' and 'distress' estimates, but the differences between subjects in these two components of the sensation did not appear to follow a common pattern.",Wilson R.C.; Jones P.W.,1991.0,,0,0,
2623,Emotional and cognitive consequences of head injury in relation to the glasgow outcome scale.,"There is current debate over the issue of the best way of assessing outcome after head injury. One criticism of scales of disability and handicap such as the Glasgow outcome scale (GOS) is that they fail to capture the subjective perspective of the person with head injury. The aims of the study were to investigate aspects of the validity of structured interviews for the GOS, and address the issue of the relation between the GOS and subjective reports of health outcome. A total of 135 patients with head injury were assessed using the GOS and an extended GOS (GOSE) and other measures of outcome and clinical status at 6 months after injury. There were robust correlations between the GOS and measures of initial injury severity (particularly post-traumatic amnesia) and outcome assessed by disability scales (particularly the disbility rating scale (DRS)); however, associations with cognitive tests were generally modest. There were also strong correlations with self report measures of health outcome: both the GOS and GOSE were related to depression measured by the Beck depression inventory, mental wellbeing assessed by the general health questionnaire, and to all subscales of the short form-36. The GOS scales were also strongly associated with frequency of reported symptoms and problems on the neurobehavioural functioning inventory. The GOS and GOSE show consistent relations with other outcome measures including subjective reports of health outcome; they thus remain useful overall summary assessments of outcome of head injury.",Wilson JT.; Pettigrew LE.; Teasdale GM.,2000.0,,0,0,
2624,Self-versus drug-produced relaxation and the effects of instructional set in standardized systematic desensitization.,,Wilson GT.; Thomas MG.,1973.0,,0,0,
2625,The clinical utility of randomized controlled trials,"Objective: Efficacy studies using randomized controlled trials (RCTs), on which empirically supported treatments are based, are often rejected as having little if any relevance to clinical practice. RCTs are faulted for allegedly excluding poor prognosis patients and therapists and treatments that are unrepresentative of clinical practice. Methods: Evidence on the generalizability of findings from RCTs to diverse patient populations, different therapists, and varied clinical settings is critically evaluated. Results: Existing research indicates that RCTs commonly include patients with multiple problems and levels of disturbance as severe as patients in clinical settings. Discussion: The applicability of the findings of RCTs to clinical practice will be a changing function of the nature of the particular study and clinical setting to which the results are to be generalized. Future research should address the clinical utility of the findings of efficacy studies across different patient populations, therapists, and treatment methods.",Wilson G.T.,1998.0,10.1002/(SICI)1098-108X(199807)24:1<13::AID-EAT2>3.0.CO;2-3,0,0,
2626,The causal role of interpretive bias in anxiety reactivity.,"Elevated anxiety vulnerability is associated with a tendency to interpret ambiguous stimuli as threatening, but the causal basis of this relationship has not been established. Recently, procedures have been developed to systematically manipulate interpretive bias, but the impact of such manipulation on anxiety reactivity to a subsequent stressor has not yet been examined. In the present study, training procedures were used to induce interpretive biases favoring the threatening or nonthreatening meanings of ambiguous information in a sample of 48 undergraduate students. Following this interpretive training, participants' emotional reactions to a stressful video were assessed. The finding that the manipulation of interpretive bias modified emotional reactivity supports the hypothesis that interpretive bias can indeed play a causal role in anxiety vulnerability.",Wilson EJ.; MacLeod C.; Mathews A.; Rutherford EM.,2006.0,10.1037/0021-843X.115.1.103,0,0,
2627,Eye movement desensitization and reprocessing: effectiveness and autonomic correlates.,"Eighteen subjects distressed by memories of a specific traumatic event were randomly assigned to a single session of one of three conditions: Eye Movement Desensitization and Reprocessing (EMDR), a Time Interval Condition (TIC), or Tapping Alternate Phalanges (TAP). All subjects treated in the EMDR group showed desensitization as monitored by SUDs, which correlated with the physiological data and cessation of pronounced symptomatology. Only one subject in a control group showed desensitization. Compared to TIC and TAP, autonomic measures showed distinct changes during EMDR: (1) respiration synchronized with the rhythm of the eye movements in a shallow, regular pattern; (2) heart rate slowed significantly overall; (3) systolic blood pressure increased during early sets, invariably declined during abreactions, and decreased overall; (4) finger tip skin temperature consistently increased; and (5) the galvanic skin response consistently decreased in a clear ""relaxation response"". This relaxing effect of the eye movements suggests that at least one of the mechanisms operating during EMDR is desensitization by reciprocal inhibition, by pairing emotional distress with an unlearned or ""compelled"" relaxation response.",Wilson DL.; Silver SM.; Covi WG.; Foster S.,1996.0,,0,0,
2628,A study of the comparative effectiveness of systematic desensitization and implosive therapy.,,Willis RW.; Edwards JA.,1969.0,,0,0,
2629,"Effects of the KiVa anti-bullying program on adolescents' depression, anxiety, and perception of peers","ER The present study investigated the effects of the KiVa antibullying program on students' anxiety, depression, and perception of peers in Grades 4-6. Furthermore, it was investigated whether reductions in peer-reported victimization predicted changes in these outcome variables. The study participants included 7,741 students from 78 schools who were randomly assigned to either intervention or control condition, and the program effects were tested with structural equation modeling. A cross-lagged panel model suggested that the KiVa program is effective for reducing students' internalizing problems and improving their peer-group perceptions. Finally, changes in anxiety, depression, and positive peer perceptions were found to be predicted by reductions in victimization. Implications of the findings and future directions for research are discussed.","Williford, A; Boulton, A; Noland, B; Little, T D; Kärnä, A; Salmivalli, C",2012.0,10.1007/s10802-011-9551-1,0,0,
2630,Anxiety and depressive symptoms among people living with HIV and childhood sexual abuse: The role of shame and posttraumatic growth.,"There is a critical need to examine protective and risk factors of anxiety and depressive symptoms among people living with HIV in order to improve quality of life. Structural equation modeling was used to examine the associations between HIV-related shame, sexual abuse-related shame, posttraumatic growth, and anxiety and depressive symptoms among a cohort of 225 heterosexual women and men who have sex with men (MSM) living with HIV who have experienced childhood sexual abuse (CSA). Higher sexual abuse-related shame was related to more anxiety and depressive symptoms for heterosexual women. Higher posttraumatic growth predicted less anxiety symptoms for only heterosexual women. Higher posttraumatic growth predicted less depressive symptoms for heterosexual women and MSM, but the magnitude of this effect was stronger for heterosexual women than MSM. Psychosocial interventions may need to be tailored to meet the specific needs of heterosexual women and MSM living with HIV and CSA. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Willie, Tiara C; Overstreet, Nicole M; Peasant, Courtney; Kershaw, Trace; Sikkema, Kathleen J; Hansen, Nathan B; Anderson, Bartholow, Basu, Beck, Beck, Bollen, Boudreaux, Bowlby, Briere, Budden, Calhoun, Calhoun, Carballo-Dieguez, Chandwani, Courtenay-Quirk, Draucker, Feiring, Feiring, Feiring, Feiring, Feiring, Fethers, Fields, Finkelhor, Finkelhor, Folkman, Gaisa, Gilbert, Gilbert, Golin, Gonzalez, Gorcey, Henny, Hoyle, Hu, Jennings, Kalichman, Kaplan, Kemppainen, Kline, Lee, Lisak, MacMillan, Markowitz, Matos, Mayer, McMillen, Milam, Milam, Mo, Mosack, Mugavero, Muthen, Muthen, Neufeld, O'Brien, Park, Parker, Paul, Persons, Prati, Przybyla, Radloff, Relf, Rosa-Cunha, Rosario, Scheier, Schroevers, Sears, Semb, Sikkema, Sikkema, Sikkema, Sikkema, Tangney, Tarakeshwar, Tedeschi, Thornton, Vishnevsky, Whetten, Widman, Williams, Willie, Wright",2016.0,,0,0,
2631,Video-Based Coping Skills to Reduce Health Risk and Improve Psychological and Physical Well-Being in Alzheimer's Disease Family Caregivers,"Objective: To determine whether video-based coping skills (VCS) training with telephone coaching reduces psychosocial and biological markers of distress in primary caregivers of a relative with Alzheimer's disease or related dementia (ADRD). Methods: A controlled clinical trial was conducted with 116 ADRD caregivers who were assigned, alternately as they qualified for the study, to a Wait List control condition or the VCS training arm in which they viewed two modules/week of a version of the Williams LifeSkills Video adapted for ADRD family care contexts, did the exercises and homework for each module presented in an accompanying Workbook, and received one telephone coaching call per week for 5 weeks on each week's two modules. Questionnaire-assessed depressive symptoms, state and trait anger and anxiety, perceived stress, hostility, caregiver self-efficacy, salivary cortisol across the day and before and after a stress protocol, and blood pressure and heart rate during a stress protocol were assessed before VCS training, 7 weeks after training was completed, and at 3 months' and 6 months' follow-up. Results: Compared with controls, participants who received VCS training plus telephone coaching showed significantly greater improvements in depressive symptoms, trait anxiety, perceived stress, and average systolic and diastolic blood pressures that were maintained over the 6-month follow-up period. Conclusions: VCS training augmented by telephone coaching reduced psychosocial and biological indicators of distress in ADRD caregivers. Future studies should determine the long-term benefits to mental and physical health from this intervention. © 2010 by the American Psychosomatic Society.",Williams V.P.; Bishop-Fitzpatrick L.; Lane J.D.; Gwyther L.P.; Ballard E.L.; Vendittelli A.P.; Hutchins T.C.; Williams R.B.,2010.0,10.1097/PSY.0b013e3181fc2d09,0,0,
2632,A randomised controlled trial of cognitive behavioural treatment for obsessive compulsive disorder in children and adolescents,"ER Cognitive behaviour therapy (CBT) for young people with obsessive compulsive disorder (OCD) has become the treatment of first choice. However, the literature is largely based on studies emphasising exposure and response prevention. In this study, we report on a randomised controlled trial of CBT for young people carried out in typical outpatient clinic conditions which focused on cognitions. A randomised controlled trial compares 10 sessions of manualised cognitive behavioural treatment with a 12-week waiting list for adolescents and children with OCD. Assessors were blind to treatment allocation. 21 consecutive patients with OCD aged between 9 and 18 years were recruited. The group who received treatment improved more than a comparison group who waited for 3 months. The second group was treated subsequently using the same protocol and made similar gains. In conclusion, CBT can be delivered effectively to young people with OCD in typical outpatient settings.","Williams, T I; Salkovskis, P M; Forrester, L; Turner, S; White, H; Allsopp, M A",2010.0,10.1007/s00787-009-0077-9,0,0,
2633,Manipulating recall vantage perspective of intrusive memories in dysphoria,"The current study attempted to experimentally manipulate mode of recall (field, observer perspective) in a sample of mildly dysphoric participants (N = 134) who reported a distressing intrusive memory of negative autobiographical event. Specifically, the current study sought to ascertain whether shifting participants into a converse perspective would have differential effects on the reported experience of their memory. Results indicated that shifting participants from a field to an observer perspective resulted in decreased experiential ratings: specifically, reduced distress and vividness. Also, as anticipated, the converse shift in perspective (from observer to field) did not lead to a corresponding increase in experiential ratings, but did result in reduced ratings of observation and a trend was observed for decreased levels of detachment. The findings support the notion that recall perspective has a functional role in the regulation of intrusion-related distress and represents a cognitive avoidance mechanism.",Williams A.D.; Moulds M.L.,2008.0,10.1080/09658210802290453,0,0,
2634,Mental health care needs of female veterans.,"Gender differences in diagnosis, demographic and family characteristics, and trauma histories among psychiatric outpatients at a Veterans Affairs clinic were examined. Among the 51 women and 46 men, significantly more women had affective disorders and schizoaffective disorder; significantly more men had anxiety disorders, schizophrenia, and substance use disorders. Although women had sharply higher rates than men of every type of trauma except combat trauma, more male veterans received a diagnosis of posttraumatic stress disorder. Men were four times more likely to be married. Women were more likely than men to be the sole caretakers of minor children. These differences have important treatment and policy implications. The findings confirm that recently initiated VA programs recognize important treatment needs of female veterans.",Willer JK.; Grossman LS.,1995.0,10.1176/ps.46.9.938,0,0,
2635,Accurate heartbeat perception in panic disorder: Fact and artefact,"The hypothesis was investigated that more accurate perception of heartbeats by patients with panic disorder is an artefact of arousal. Twenty-three patients with panic disorder, 16 patients with a mood disorder and 21 normal controls were tested. There were more panic patients who accurately perceived their heart rates (N = 7) than depressed patients (N = 0) or normals (N = 2). The nine accurate perceivers had higher scores on questionnaires measuring the cognitions associated with panic. For non-accurate perceivers, perceived heart rates were unrelated to actual heart rates, unrelated to cognitive factors, but significantly related to arousal. It is concluded that the accurate perception of heartbeats by patients with panic disorder is both fact and artefact: some patients are accurate perceivers, but the majority are not.",Willem Van Der Does A.J.; Van Dyck R.; Spinhoven P.,1997.0,10.1016/S0165-0327(96)01414-0,0,0,
2636,Treated depression in adolescents: predictors of outcome at 28 weeks,"ER AIMSTo identify which clinical and environmental risk factors at baseline and during treatment predicted major depression at 28-week follow-up in a sample of adolescents with depression.METHODOne hundred and ninety-two British adolescents with unipolar major depression were enrolled in a randomised controlled trial (the Adolescent Depression Antidepressants and Psychotherapy Trial, ADAPT). Participants were treated for 28 weeks with routine psychosocial care and selective serotonin reuptake inhibitors (SSRIs), with half also receiving cognitive-behavioural therapy (CBT). Full clinical and demographic assessment was carried out at baseline and 28 weeks.RESULTSDepression at 28 weeks was predicted by the additive effects of severity, obsessive-compulsive disorder and suicidal ideation at entry together with presence of at least one disappointing life event over the follow-up period.CONCLUSIONSClinicians should assess for severity, suicidality and comorbid obsessive-compulsive disorder at presentation and should monitor closely for subsequent life events during treatment.BACKGROUNDThere is great heterogeneity of clinical presentation and outcome in paediatric depression.","Wilkinson, P; Dubicka, B; Kelvin, R; Roberts, C; Goodyer, I",2009.0,10.1192/bjp.bp.108.052381,0,0,
2637,Developing mental health indicators in England,"Objectives: This paper reports on the construction of a set of indicators for mental health and the publication of a report for England's Chief Medical Officer. The report was the seventh in a series of reports aimed at initiating public health action to improve health at a regional level in England. Study design: Observational study using routine data. Methods: A set of over 80 indicators was constructed by an expert group. These indicators were then populated from routine datasets. Commentary was provided on each indicator in the report. Results: A small team compiled this large set of indicators from routine data working in a public health observatory in one region of England. Conclusions: It is possible to produce a large array of indicators about mental health. The conclusion from examining these indicators is that there are many unexplained differences in mental health across the regions of England. Many of these indicators are closely linked to deprivation. Some indicators show a lack of difference across the country, and in many instances, service provision is inconsistent and does not always relate to need. In some cases, there was a worrying absence of data, e.g. data on ethnicity and the mental health of offenders. © 2007 The Royal Institute of Public Health.",Wilkinson J.; Bywaters J.; Simms S.; Chappel D.; Glover G.,2008.0,10.1016/j.puhe.2007.10.012,0,0,
2638,Reduced relapse rate in duodenal ulcer disease leads to normalization of psychological distress: twelve-year follow-up.,"The aim of this study was to elucidate the relationship between duodenal ulcer (DU) disease and psychological symptoms. Sixty-four Helicobacter pylori-positive patients with frequently relapsing DUs (patient group 1) were compared with 78 control subjects without dyspepsia, starting 2 years before and ending 10 years after eradication of H. pylori. Seven non-relapsing and untreated patients (patient group 2) were also followed-up. The relapse rate was reduced from 100% per year in the two years before anti-H. pylori treatment to 0.3% per year after treatment in patient group 1. The reinfection rate was 0.7% per year. Anxiety and neuroticism were high at inclusion, but had normalized at the 10-year follow-up in relapse-free patients. There was no increase of gastro-oesophageal reflux symptoms during the 10 years after H. pylori eradication. Normalization of anxiety and neuroticism following cure of DU disease supports the view that the increased anxiety and neuroticism are consequences, and not causes, of the disease.",Wilhelmsen I.; Berstad A.,2004.0,10.1080/00365520410006044,0,0,
2639,Do not use epinephrine in digital blocks: myth or truth?,"ER The purpose of this study was to examine the role for epinephrine augmentation of digital block anesthesia by safely prolonging its duration of action and providing a temporary hemostatic effect. After obtaining approval from the review board of the authors' institution, 60 digital block procedures were performed in a prospective randomized double-blinded study. The digital blocks were performed using the dorsal approach. All anesthetics were delivered to treat either posttraumatic injuries or elective conditions. Of the 60 digital block procedures, 31 were randomized to lidocaine with epinephrine and 29 to plain lidocaine. Of the procedures performed using lidocaine with epinephrine, one patient required an additional injection versus five of the patients who were given plain lidocaine (p = 0.098). The need for control of bleeding required digital tourniquet use in 20 of 29 block procedures with plain lidocaine and in 9 of 31 procedures using lidocaine with epinephrine (p < 0.002). Two patients experienced complications after plain lidocaine blocks, while no complications occurred after lidocaine with epinephrine blocks (p = 0.23). By prolonging lidocaine's duration of action, epinephrine may prevent the need for an additional injection and prolong post-procedure pain relief. This study demonstrated that the temporary hemostatic effect of epinephrine decreased the need for, and thus the potential risk of, using a digital tourniquet (p < 0.002). As the temporary vasoconstrictor effect is reversible, the threat of complication from vasoconstrictor-induced ischemia is theoretical.","Wilhelmi, B J; Blackwell, S J; Miller, J H; Mancoll, J S; Dardano, T; Tran, A; Phillips, L G",2001.0,,0,0,
2640,Cognitive behavior group therapy for body dysmorphic disorder: A case series.,"This open case series provides data on a new cognitive-behavioral treatment for body dysmorphic disorder (BDD). Thirteen 18-48 yr old females diagnosed with BDD were treated in small groups that met for 12 weekly 90-minute sessions. Assessments of BDD and depression symptoms were conducted on a weekly basis and included patient self-report on the Yale-Brown Obsessive Compulsive Scale modified for assessing BDD and the Beck Depression Inventory. Patients improved significantly over the course of treatment, with reductions in both BDD and depression symptoms. This finding adds to a nascent literature documenting the potential efficacy of short-term cognitive-behavior therapy for patients suffering from BDD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Wilhelm, Sabine; Otto, Michael W; Lohr, Bethany; Deckersbach, Thilo",1999.0,,0,0,
2641,Modular cognitive-behavioral therapy for body dysmorphic disorder: a randomized controlled trial.,"There are few effective treatments for body dysmorphic disorder (BDD) and a pressing need to develop such treatments. We examined the feasibility, acceptability, and efficacy of a manualized modular cognitive-behavioral therapy for BDD (CBT-BDD). CBT-BDD utilizes core elements relevant to all BDD patients (e.g., exposure, response prevention, perceptual retraining) and optional modules to address specific symptoms (e.g., surgery seeking). Thirty-six adults with BDD were randomized to 22 sessions of immediate individual CBT-BDD over 24 weeks (n=17) or to a 12-week waitlist (n=19). The Yale-Brown Obsessive-Compulsive Scale Modified for BDD (BDD-YBOCS), Brown Assessment of Beliefs Scale, and Beck Depression Inventory-II were completed pretreatment, monthly, posttreatment, and at 3- and 6-month follow-up. The Sheehan Disability Scale and Client Satisfaction Inventory (CSI) were also administered. Response to treatment was defined as ‚â•30% reduction in BDD-YBOCS total from baseline. By week 12, 50% of participants receiving immediate CBT-BDD achieved response versus 12% of waitlisted participants (p=0.026). By posttreatment, 81% of all participants (immediate CBT-BDD plus waitlisted patients subsequently treated with CBT-BDD) met responder criteria. While no significant group differences in BDD symptom reduction emerged by Week 12, by posttreatment CBT-BDD resulted in significant decreases in BDD-YBOCS total over time (d=2.1, p<0.0001), with gains maintained during follow-up. Depression, insight, and disability also significantly improved. Patient satisfaction was high, with a mean CSI score of 87.3% (SD=12.8%) at posttreatment. CBT-BDD appears to be a feasible, acceptable, and efficacious treatment that warrants more rigorous investigation.",Wilhelm S.; Phillips KA.; Didie E.; Buhlmann U.; Greenberg JL.; Fama JM.; Keshaviah A.; Steketee G.,2014.0,10.1016/j.beth.2013.12.007,0,0,
2642,Augmentation of behavior therapy with D-cycloserine for obsessive-compulsive disorder.,"This study examined whether d-cycloserine, a partial agonist at the N-methyl-D-aspartate (NMDA) glutamatergic receptor, enhances the efficacy of behavior therapy for obsessive-compulsive disorder (OCD). A randomized, double-blind, placebo-controlled trial investigating D-cycloserine versus placebo augmentation of behavior therapy was conducted in 23 OCD patients. Patients first underwent a diagnostic interview and pretreatment evaluation, followed by a psychoeducational/treatment planning session. Then they received 10 behavior therapy sessions. Treatment sessions were conducted twice per week. One hour before each of the behavior therapy sessions, the participants received either D-cycloserine, 100 mg, or a placebo. Relative to the placebo group, the D-cycloserine group's OCD symptoms were significantly more improved at mid-treatment, and the D-cycloserine group's depressive symptoms were significantly more improved at posttreatment. These data provide support for the use of D-cycloserine as an augmentation of behavior therapy for OCD and extend findings in animals and other human disorders suggesting that behavior therapy acts by way of long-term potentiation of glutamatergic pathways and that the effects of behavior therapy are potentiated by an NMDA agonist.",Wilhelm S.; Buhlmann U.; Tolin DF.; Meunier SA.; Pearlson GD.; Reese HE.; Cannistraro P.; Jenike MA.; Rauch SL.,2008.0,10.1176/appi.ajp.2007.07050776,0,0,
2643,Mechanisms of change in cognitive therapy for obsessive compulsive disorder: role of maladaptive beliefs and schemas.,"The present study aimed to identify mechanisms of change in individuals with moderately severe obsessive-compulsive disorder (OCD) receiving cognitive therapy (CT). Thirty-six adults with OCD received CT over 24 weeks. At weeks 0, 4/6, 12, 16/18, and 24, independent evaluators assessed OCD severity, along with obsessive beliefs and maladaptive schemas. To examine mechanisms of change, we utilized a time-varying lagged regression model with a random intercept and slope. Results indicated that perfectionism and certainty obsessive beliefs and maladaptive schemas related to dependency and incompetence significantly mediated (improved) treatment response. In conclusion, cognitive changes in perfectionism/certainty beliefs and maladaptive schemas related to dependency/incompetence precede behavioral symptom reduction for OCD patients. Targeting these mechanisms in future OCD treatment trials will emphasize the most relevant processes and facilitate maximum improvement.",Wilhelm S.; Berman NC.; Keshaviah A.; Schwartz RA.; Steketee G.,2015.0,10.1016/j.brat.2014.12.006,0,0,
2644,The treatment of fear of flying: a controlled study of imaginal and virtual reality graded exposure therapy.,"The goal of this study was to determine if virtual reality graded exposure therapy (VRGET) was equally efficacious, more efficacious, or less efficacious, than imaginal exposure therapy in the treatment of fear of flying. Thirty participants (Age = 39.8 +/- 9.7) with confirmed DSM-IV diagnosis of specific phobia fear of flying were randomly assigned to one of three groups: VRGET with no physiological feedback (VRGETno), VRGET with physiological feedback (VRGETpm), or systematic desensitization with imaginal exposure therapy (IET). Eight sessions were conducted once a week. During each session, physiology was measured to give an objective measurement of improvement over the course of exposure therapy. In addition, self-report questionnaires, subjective ratings of anxiety (SUDs), and behavioral observations (included here as flying behavior before beginning treatment and at a three-month posttreatment followup) were included. In the analysis of results, the Chi-square test of behavioral observations based on a three-month posttreatment followup revealed a statistically significant difference in flying behavior between the groups [chi(2) (4) = 19.41, p < 0.001]. Only one participant (10%) who received IET, eight of the ten participants (80%) who received VRGETno, and ten out of the ten participants (100%) who received VRGETpm reported an ability to fly without medication or alcohol at three-month followup. Although this study included small sample sizes for the three groups, the results showed VRGET was more effective than IET in the treatment of flying. It also suggests that physiological feedback may add to the efficacy of VR treatment.",Wiederhold BK.; Jang DP.; Gevirtz RG.; Kim SI.; Kim IY.; Wiederhold MD.,2002.0,,0,0,
2645,The effects of immersiveness on physiology.,"The effects of varying levels of immersion in virtual reality environments on participant's heart rate, respiration rate, peripheral skin temperature, and skin resistance levels were examined. Subjective reports of presence were also noted. Participants were presented with a virtual environment of an airplane flight both as seen from a two-dimensional computer screen and as seen from within a head-mounted display. Subjects were randomly assigned to different order of conditions presented, but all subjects received both conditions. Differences between the non-phobics' physiological responses and the phobic's response when placed in a virtual environment related to the phobia were noted. Also noted were changes in physiology based on degree of immersion.",Wiederhold BK.; Davis R.; Wiederhold MD.,1998.0,,0,0,
2646,Psychological flexibility as a mediator of improvement in Acceptance and Commitment Therapy for patients with chronic pain following whiplash,"ER Cognitive behavior therapy (CBT) has made important contributions to chronic pain management, but the process by which it is effective is not clear. Recently, strong arguments have been raised concerning the need for theory driven research to e.g. identify mechanisms of change in CBT and enhance the effectiveness of this type of treatment. However, the number of studies addressing these issues is still relatively scarce. Furthermore, the arrival of varieties of CBT with seemingly different process targets increases the need for such information. The present study explored the processes of change in a previously reported successful randomized controlled trial evaluating the effectiveness of an exposure-based form of behavioral and cognitive therapy, Acceptance and Commitment Therapy (ACT), on improvement in pain-related disability and life satisfaction for patients suffering from whiplash-associated disorder (WAD). Several process variables relevant to theories underlying traditional CBT were included: pain, distress, kinesiophobia, self-efficacy, and the process primarily targeted by ACT: psychological inflexibility. Mediation analyses were performed using a non-parametric cross-product of the coefficients approach. Results illustrated that pain intensity, anxiety, depression, kinesiophobia, and self-efficacy did not have significant mediating effects on the dependent variables. In contrast, significant indirect effects were seen for psychological inflexibility on pain-related disability (pre- to post-change scores) and life satisfaction (pre- to post; pre- to 4-month follow-up change scores). Although tentative, these results support the mediating role of psychological inflexibility in ACT-oriented interventions aimed at improving functioning and life satisfaction in people with chronic pain.","Wicksell, R K; Olsson, G L; Hayes, S C",2010.0,10.1016/j.ejpain.2010.05.001,0,0,
2647,Evaluating the effectiveness of exposure and acceptance strategies to improve functioning and quality of life in longstanding pediatric pain--a randomized controlled trial,"ER Although several studies have illustrated the effectiveness of cognitive behavior therapy (CBT) on adult pain patients, there are few randomized controlled trials on children and adolescents. There is particularly a need for studies on pediatric patients who are severely disabled by longstanding pain syndromes. Acceptance and Commitment Therapy, as an extension of traditional CBT, focuses on improving functioning and quality of life by increasing the patient's ability to act effectively in concordance with personal values also in the presence of pain and distress. Following a pilot study, we sought to evaluate the effectiveness of an ACT-oriented intervention based on exposure and acceptance strategies and to compare this with a multidisciplinary treatment approach including amitriptyline (n=32). The ACT condition underwent a relatively brief treatment protocol of approximately 10 weekly sessions. Assessments were made before and immediately after treatment, as well as at 3.5 and 6.5 months follow-up. Prolonged treatment in the MDT group complicated comparisons between groups at follow-up assessments. Results showed substantial and sustained improvements for the ACT group. When follow-up assessments were included, ACT performed significantly better than MDT on perceived functional ability in relation to pain, pain intensity and to pain-related discomfort (intent-to-treat analyses). At post-treatment, significant differences in favor of the ACT condition were also seen in fear of re/injury or kinesiophobia, pain interference and in quality of life. Thus, results from the present study support previous findings and suggest the effectiveness of this ACT-oriented intervention for pediatric longstanding pain syndromes.","Wicksell, R K; Melin, L; Lekander, M; Olsson, G L",2009.0,10.1016/j.pain.2008.11.006,0,0,
2648,MMPI-2 patterns in electrical injury: a controlled investigation.,"The psychological consequences of electrical injury (EI) are many. Depression, posttraumatic stress disorder, anxiety, and somatic preoccupation are often concomitant with this type of injury (Kelley, Pliskin, Meyer, & Lee, 1994). The present study utilized the MMPI-2 as a tool for characterizing profiles of psychological distress in EI. We examined MMPI-2 profiles in 79 EI patients and their relationship to both injury parameters (i.e., time since injury, LOC, voltage), and extra-diagnostic factors, such as litigation status. EI patient profiles were also compared to individuals with mild traumatic brain injury (TBI), and chronic pain sufferers (CP). Results indicated that in EI, clinical elevations (T > or = 65) were found on the Hs and Hy scales, and approached clinical levels on the D scale. The injury parameter of time since injury was predictive of a distinctive profile, with individuals in the post acute phase experiencing more distress. Compared to other clinical groups, MMPI-2 scores on the Hs and Hy scales were significantly higher within the EI cohort as compared with their CP peers, with higher scores on the Pd scale for CP than EI. No statistically significant differences emerged between the EI and TBI groups. However, TBI patients showed significant elevations on Hy and D compared to CP, and EI patients endorsed more somatic symptoms than CP patients. Implications of these findings and future directions will be discussed.",Wicklund AH.; Ammar A.; Weitlauf JC.; Heilbronner RL.; Fink J.; Lee RC.; Kelley K.; Pliskin NH.,2008.0,10.1080/13825580601025924,0,0,
2649,[Manifestation of Dupuytren nodules following fracture of the distal radius].,"The aim of this study is to evaluate the incidence of post-traumatic development of Dupuytren nodules in distal radius fractures treated operatively. In 2 prospective randomised studies for operative treatment of distal radius fractures, the formation of Dupuytren nodules was registered. One of the exclusion criteria was a pre-existing Dupuytren's disease at the date of trauma. In addition to the notification of the development of Dupuytren nodules, signs of a complex regional pain syndrome were registered as well as the wrist function, level of pain and grip strength. The Castaing and the Gartland and Werley scores were assessed. The clinical outcomes of patients with and without Dupuytren nodules were compared. 239 of 275 (87%) of the patients could be examined 1 year after the operation, consisting of 32 men and 207 women with a median age of 64.2 years. The patients with Dupuytren nodules were re-evaluated after 16-60 months (median 41.8) for progression of the disease. 21 patients (8.7%) developed changes of the palmar aponeurosis. In 20 patients nodules were stated, one patient showed a cord at the fourth ray of the injured hand. 19 out of 21 patients were female (90.5%). At re-evaluation after 41.8 months (16-60) progression could not be noted nor could similar changes be seen on the contralateral side. Patients with Dupuytren nodules were not handicapped in their hand function. 3 patients (14.3%) revealed a positive family history for Dupuytren's disease. Abuse of alcohol or diabetes was not present in any of the patients with Dupuytren nodules, 7 (33%) were smokers. The occurrence of Dupyutren nodules can be triggered by a trauma or operation. It may be speculated that these nodules are an entity of their own as no progression of the contracture could be seen during the follow-up period.",Wichelhaus A.; Wendt M.; Mielsch N.; Gradl G.; Mittlmeier T.,2015.0,10.1055/s-0034-1398660,0,0,
2650,Manifestation of Dupuytren nodules following fracture of the distal radius,"ER PURPOSE: The aim of this study is to evaluate the incidence of post-traumatic development of Dupuytren nodules in distal radius fractures treated operatively.PATIENTS AND METHODS: In 2 prospective randomised studies for operative treatment of distal radius fractures, the formation of Dupuytren nodules was registered. One of the exclusion criteria was a pre-existing Dupuytren's disease at the date of trauma. In addition to the notification of the development of Dupuytren nodules, signs of a complex regional pain syndrome were registered as well as the wrist function, level of pain and grip strength. The Castaing and the Gartland and Werley scores were assessed. The clinical outcomes of patients with and without Dupuytren nodules were compared. 239 of 275 (87%) of the patients could be examined 1 year after the operation, consisting of 32 men and 207 women with a median age of 64.2 years. The patients with Dupuytren nodules were re-evaluated after 16-60 months (median 41.8) for progression of the disease.RESULTS: 21 patients (8.7%) developed changes of the palmar aponeurosis. In 20 patients nodules were stated, one patient showed a cord at the fourth ray of the injured hand. 19 out of 21 patients were female (90.5%). At re-evaluation after 41.8 months (16-60) progression could not be noted nor could similar changes be seen on the contralateral side. Patients with Dupuytren nodules were not handicapped in their hand function. 3 patients (14.3%) revealed a positive family history for Dupuytren's disease. Abuse of alcohol or diabetes was not present in any of the patients with Dupuytren nodules, 7 (33%) were smokers.CONCLUSION: The occurrence of Dupyutren nodules can be triggered by a trauma or operation. It may be speculated that these nodules are an entity of their own as no progression of the contracture could be seen during the follow-up period.","Wichelhaus, A; Wendt, M; Mielsch, N; Gradl, G; Mittlmeier, T",2015.0,10.1055/s-0034-1398660,0,0,2649
2651,Does brief dynamic psychotherapy reduce the relapse rate of panic disorder?,"Although panic disorder can be effectively alleviated by drug treatment, the relapse rate is high. By adding brief dynamic psychotherapy focused on the psychosocial vulnerability of patients with panic disorder to an established drug treatment regimen, we hypothesized that this would result in a lower relapse rate after pharmacotherapy. Patients with panic disorder (defined by DSM-III-R) were randomized to treatment with either clomipramine for 9 months (n = 20), or clomipramine for 9 months combined with 15 weekly sessions of brief dynamic psychotherapy (n = 20). Measures of anxiety and depression were collected at intake and at regular intervals. The patients had blind follow-up interviews at 6, 12, and 18 months after beginning treatment. All patients in both groups became free of panic attacks within 26 weeks of the start of treatment. On termination of pharmacotherapy, the relapse rate was significantly higher in the clomipramine-only group during the follow-up period. There were significantly lower scores for most anxiety measures in the clomipramine plus psychotherapy group at the 9-month follow-up. The addition of brief dynamic psychotherapy to treatment with clomipramine significantly reduces the relapse rate of panic disorder compared with clomipramine treatment alone.",Wiborg IM.; Dahl AA.,1996.0,,0,0,
2652,Mean term follow-up of a series of post-traumatic syringomyelia patients after syringo-peritoneal shunting.,"We report the follow-up of a series of post-traumatic syringomyelia patients treated by syringo-peritoneal shunting (SPS). The neurological status was determined following the international ASIA/IMSOP standards for neurological classification of spinal cord injury; this was completed by a modified Silberstein classification that identifies the ascending neurological symptoms as well as the increasing myelopathic symptoms in patients with post-traumatic syringomyelia. Magnetic resonance imaging (MRI) was systematically performed to assess the presence of a postoperative residual syrinx or of meningeal fibrosis. Eight patients were studied (five men, three women) with an age ranging from 17 to 54 years (mean of 30.7 years) at the time of the spinal cord injury. Three had a complete or nearly complete paraplegia, five were incomplete. The post-traumatic syringomyelia was diagnosed from 2 to 8 years after the spinal cord injury and was treated by syringo-peritoneal shunting. Early complications occurred in three patients: (1) displacement of the catheter, (2) obstruction of the catheter, and (3) haematomyelia, which disappeared after a new surgical procedure was performed. The postoperative follow-up ranged from 3 to 9 years (mean of 4.5 years). The neurological level decreased in every case and the ascending neurological symptoms decreased or were stabilised in seven patients. The postoperative ASIA/IMSOP scores and the increasing myelopathic symptoms improved in four patients but worsened in the four others, incomplete. The MRI showed an important decrease of the syrinxes in every patient associated with a serious meningeal fibrosis in five cases. Syringo-peritoneal shunting seems to be efficient in the treatment of the syrinx but may have a poor effect regarding the prevention of meningeal fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)",Wiart L.; Dautheribes M.; Pointillart V.; Gaujard E.; Petit H.; Barat M.,1995.0,10.1038/sc.1995.55,0,0,
2653,A prospective evaluation of open face masks for head and neck radiation therapy.,"Head and neck (HN) radiation therapy patients are typically immobilized with closed thermoplastic masks that cover the face and may cause discomfort. In this work, we examine the use of open masks for HN radiation therapy. Fifty HN patients were prospectively randomized into 2 groups (25 closed masks, 25 open masks). The open-mask group was monitored with surface imaging to evaluate intrafraction motion. Both groups underwent daily volumetric imaging. All daily images were rigidly registered to their respective planning images to evaluate spinal canal and mandible position as a check for interfraction posture change. Posture changes were determined by the amount the spinal canal and mandible contours from the planning images had to be expanded to cover the structures on each daily image set. The vector length (VL) of the intrafraction linear translations, spine, and mandible positions for each open-mask patient were checked for correlation with fraction number using the Pearson r value. All patients were given a weekly survey ranking anxiety and claustrophobia from 0 to 10 (0 = no issue, 10 = extreme issue). The mean VL for all open-mask patients was 0.9 ± 0.5 mm (1 standard deviation). Only 1 patient showed significant correlation between VL and fraction number. The mean contour expansions to cover the spine and mandible were 1.5 ± 0.9 mm and 1.8 ± 1.3 mm for the closed-mask group, and 1.6 ± 0.8 mm and 1.8 ± 1.1 mm for the open-mask group. Both groups showed similar behavior relative to fraction number. The mean anxiety and claustrophobia scores were 1.63 and 1.44 for the closed-mask group, and 0.81 and 0.63 for the open-mask group. The groups were not significantly different. Open masks provide comparable immobilization and posture preservation to closed masks for HN radiation therapy.",Wiant D.; Squire S.; Liu H.; Maurer J.; Lane Hayes T.; Sintay B.,,10.1016/j.prro.2016.02.003,0,0,
2654,A prospective evaluation of open face masks for head and neck radiation therapy,"ER METHODS AND MATERIALS: Fifty HN patients were prospectively randomized into 2 groups (25 closed masks, 25 open masks). The open-mask group was monitored with surface imaging to evaluate intrafraction motion. Both groups underwent daily volumetric imaging. All daily images were rigidly registered to their respective planning images to evaluate spinal canal and mandible position as a check for interfraction posture change. Posture changes were determined by the amount the spinal canal and mandible contours from the planning images had to be expanded to cover the structures on each daily image set. The vector length (VL) of the intrafraction linear translations, spine, and mandible positions for each open-mask patient were checked for correlation with fraction number using the Pearson r value. All patients were given a weekly survey ranking anxiety and claustrophobia from 0 to 10 (0 = no issue, 10 = extreme issue).RESULTS: The mean VL for all open-mask patients was 0.9 ± 0.5 mm (1 standard deviation). Only 1 patient showed significant correlation between VL and fraction number. The mean contour expansions to cover the spine and mandible were 1.5 ± 0.9 mm and 1.8 ± 1.3 mm for the closed-mask group, and 1.6 ± 0.8 mm and 1.8 ± 1.1 mm for the open-mask group. Both groups showed similar behavior relative to fraction number. The mean anxiety and claustrophobia scores were 1.63 and 1.44 for the closed-mask group, and 0.81 and 0.63 for the open-mask group. The groups were not significantly different.CONCLUSIONS: Open masks provide comparable immobilization and posture preservation to closed masks for HN radiation therapy.PURPOSE: Head and neck (HN) radiation therapy patients are typically immobilized with closed thermoplastic masks that cover the face and may cause discomfort. In this work, we examine the use of open masks for HN radiation therapy.","Wiant, D; Squire, S; Liu, H; Maurer, J; Lane, Hayes T; Sintay, B",2016.0,10.1016/j.prro.2016.02.003,0,0,2653
2655,Lifetime depression and anxiety increase prevalent psychological symptoms and worsen glycemic control in type 2 diabetes: the Fremantle Diabetes Study Phase II,"ER METHODS: 1285 community-dwelling people with type 2 diabetes (Fremantle Diabetes Study Phase-II; FDS2) completed the PHQ-9 and Brief Life-Time Depression Scale (BLDS) to assess current and past MDD. The Generalized Anxiety Disorder Scale (GADS) and the Generalized Anxiety Disorder Scale-Lifetime (GAD-LT), designed for FDS2, assessed current and past anxiety. Data were analysed using analysis of covariance and multiple mediation models, controlling for age, gender, marital status, and diabetes duration.RESULTS: L-MDD and L-GAD were independently associated with more severe current depression (both P<0.001) and anxiety (both P<0.001) symptoms. Mediation models revealed that, through increasing the severity of current depressive symptoms, L-MDD was associated with higher HbA1c and body mass index (BMI), greater likelihood of current smoking, and reduced self-monitoring of blood glucose (SMBG) (indirect regression path ab, all P<0.001). In combination, L-MDD+L-GAD additionally elevated the risk of higher HbA1c and worse diabetes management, by increasing the severity of current depressive symptoms (indirect regression path ab, all P<0.001).CONCLUSIONS: Lifetime depression and anxiety increase risk of more severe psychological symptoms, hyperglycaemia, and difficulties with health behaviour in type 2 diabetes. Early screening for these disorders at diabetes diagnosis may be warranted to maximize long-term health outcomes.AIMS: To determine the contribution of lifetime major depressive disorder (L-MDD) and lifetime generalized anxiety disorder (L-GAD) to current psychological symptom severity, health behaviour and glycaemic control in type 2 diabetes.","Whitworth, S R; Bruce, D G; Starkstein, S E; Davis, W A; Davis, T M; Bucks, R S",2016.0,10.1016/j.diabres.2016.10.023,0,0,
2656,Treatment of obsessive-compulsive disorder: cognitive behavior therapy vs. exposure and response prevention.,"The efficacy of contemporary cognitive therapy for obsessive-compulsive disorder (OCD) has only recently been investigated. The current study compares exposure and response prevention (ERP) and cognitive behavior therapy (CBT) delivered in an individual format. Participants were randomly assigned to the 12 consecutive-week CBT or ERP treatment. Based on 59 treatment completers, there was no significant difference in YBOCS scores between CBT and ERP at post-treatment or at 3-month follow-up. A higher percentage of CBT participants obtained recovered status at post-treatment (67%) and at follow-up (76%), compared to ERP participants (59% and 58%, respectively), but the difference was not significant. Effect sizes (ESs) were used to compare the results of the current study with a previous study conducted at our center that utilized group CBT and ERP treatments, as well as other controlled trials that have compared CBT and ERP. The significance of these results is discussed and a comparison is made with the existing literature.",Whittal ML.; Thordarson DS.; McLean PD.,2005.0,10.1016/j.brat.2004.11.012,0,0,
2657,Sensorimotor alpha activity is modulated in response to the observation of pain in others,"The perception-action account of empathy states that observation of another person's state automatically activates a similar state in the observer. It is still unclear in what way ongoing sensorimotor alpha oscillations are involved in this process. Although they have been repeatedly implicated in (biological) action observation and understanding communicative gestures, less is known about their role in vicarious pain observation. Their role is understood as providing a graded inhibition through functional inhibition, thereby streamlining information flow through the cortex. Although alpha oscillations have been shown to have at least visual and sensorimotor origins, only the latter are expected to be involved in the empathetic response. Here, we used magnetoencephalography, allowing us to spatially distinguish and localize oscillatory components using beamformer source reconstruction. Subjects observed realistic pictures of limbs in painful and no-pain (control) conditions. As predicted, time-frequency analysis indeed showed increased alpha suppression in the pain condition compared to the no-pain condition. Although both pain and no-pain conditions suppressed alpha- and beta-band activity at both posterior and central sensors, the pain condition suppressed alpha more only at central sensors. Source reconstruction localized these differences along the central sulcus. Our results could not be accounted for by differences in the evoked fields, suggesting a unique role of oscillatory activity in empathetic responses. We argue that alpha oscillations provide a unique measure of the underlying functional architecture of the brain, suggesting an automatic disinhibition of the sensorimotor cortices in response to the observation of pain in others. © 2011 Whitmarsh, Nieuwenhuis, Barendregt and Jensen.",Whitmarsh S.; Nieuwenhuis L.C.I.; Barendregt H.P.; Jensen O.,2011.0,10.3389/fnhum.2011.00091,0,0,
2658,Psychological sequelae of surgery in a prospective cohort of patients from three intraoperative awareness prevention trials.,"Elective surgery can have long-term psychological sequelae, especially for patients who experience intraoperative awareness. However, risk factors, other than awareness, for symptoms of posttraumatic stress disorder (PTSD) after surgery are poorly defined, and practical screening methods have not been applied to a broad population of surgical patients. The Psychological Sequelae of Surgery study was a prospective cohort study of patients previously enrolled in the United States and Canada in 3 trials for the prevention of intraoperative awareness. The 68 patients who experienced definite or possible awareness were matched with 418 patients who denied awareness based on age, sex, surgery type, and awareness risk. Participants completed the PTSD Checklist-Specific (PCL-S) and/or a modified Mini-International Neuropsychiatric Interview telephone assessment to identify symptoms of PTSD and symptom complexes consistent with a PTSD diagnosis. We then used structural equation modeling to produce a composite PTSD score and examined potential risk factors. One hundred forty patients were unreachable; of those contacted, 303 (88%) participated a median of 2 years postoperatively. Forty-four of the 219 patients (20.1%) who completed the PCL-S exceeded the civilian screening cutoff score for PTSD symptoms resulting from their surgery (15 of 35 [43%] with awareness and 29 of 184 [16%] without). Nineteen patients (8.7%; 5 of 35 [14%] with awareness and 14 of 184 [7.6%] without) both exceeded the cutoff and endorsed a breadth of symptoms consistent with the Diagnostic and Statistical Manual Fourth Edition diagnosis of PTSD attributable to their surgery. Factors independently associated with PTSD symptoms were poor social support, previous PTSD symptoms, previous mental health treatment, dissociation related to surgery, perceiving that one's life was threatened during surgery, and intraoperative awareness (all P ≤ 0.017). Perioperative dissociation was identified as a potential mediator for perioperative PTSD symptoms. Events in the perioperative period can precipitate psychological symptoms consistent with subsyndromal and syndromal PTSD. We not only confirmed the high rate of postoperative PTSD in awareness patients but also identified a significant rate in matched nonawareness controls. Screening surgical patients, especially those with potentially mediating risk factors such as intraoperative awareness or perioperative dissociation, for postoperative PTSD symptoms with the PCL-S is practical and could promote early referral, evaluation, and treatment.",Whitlock EL.; Rodebaugh TL.; Hassett AL.; Shanks AM.; Kolarik E.; Houghtby J.; West HM.; Burnside BA.; Shumaker E.; Villafranca A.; Edwards WA.; Levinson CA.; Langer JK.; Fernandez KC.; El-Gabalawy R.; Zhou EY.; Sareen J.; Jacobsohn E.; Mashour GA.; Avidan MS.,2015.0,10.1213/ANE.0000000000000498,0,0,
2659,A randomised controlled trial of a lengthened and multi-disciplinary consultation model in a socially deprived community: a study protocol,"ER METHODS/DESIGNIn a randomised controlled trial, families with a history of social problems, substance misuse or depression are randomly allocated to an intervention or control group. The study is based in three general practices in a highly deprived area of North Dublin. Primary health care teams will be trained in conducting a multidisciplinary lengthened consultation. Families in the intervention group will participate in the new style multidisciplinary consultation. Outcomes of families receiving the intervention will be compared to the control group who will receive only usual general practitioner care. The primary outcome is the psychological health of mothers of the families and secondary outcomes include general health status, quality of life measures and health service usage.DISCUSSIONThe main aim of this study is to evaluate the effectiveness of a lengthened multidisciplinary team consultation in primary care. The embedded nature of this study in general practices in a highly deprived area ensures generalisability to other deprived communities, but more particularly it promises relevance to primary care.TRIAL REGISTRATIONCurrent Controlled Trials ISRCTN70578736.BACKGROUNDThere has been little development of the general practice consultation over the years, and many aspects of the present consultation do not serve communities with multiple health and social problems well. Many of the problems presenting to general practitioners in socio-economically disadvantaged areas are not amenable to a purely medical solution, and would particularly benefit from a multidisciplinary approach. Socio-economic deprivation is also associated with those very factors (more psychosocial problems, greater need for health promotion, more chronic diseases, more need for patient enablement) that longer consultations have been shown to address. This paper describes our study protocol, which aims to evaluate whether a lengthened multidisciplinary primary care team consultation with families in a socially deprived area can improve the psychological health of mothers in the families.","Whitford, D L; Chan, W S",2007.0,10.1186/1471-2296-8-38,0,0,
2660,Effects of diazepam on phobic avoidance behavior and phobic anxiety.,The efficacy of diazepam for controlling phobic avoidance behavior and phobic anxiety and the potential usefulness of the behavioral approach measure for screening new antianxiety drugs was investigated in a double-blind study. The distance from the phobic object beyond which the subject would not approach and a rating of subjective anxiety at closest approach were made in 14 phobic patients immediately before and again 2 hr after 10-mg oral diazepam or placebo. Behavioral approach to the object was increased and subjective anxiety was decreased by diazepam as compared to placebo. The method appeared useful for early clinical screening of new drugs because it discriminated drug from placebo in a single short session using small groups and because it employed a more objective dependent measure than self-report of subjective feeling states.,Whitehead WE.; Blackwell B.; Robinson A.,1978.0,,0,0,
2661,Using skinfold calipers while teaching body fatness-related concepts: cognitive and affective outcomes,"ER Body composition testing has been advocated as part of fitness test batteries in an educational effort to promote health-related fitness, and to prevent public health problems like obesity. However, the measurement of the body composition of children and youth, especially involving the use of skinfold calipers, has raised concerns. In two experiments the cognitive and affective consequences of skinfold caliper use in a 7th grade (155 boys, 177 girls, total N = 332) health/physical education context were examined. Experiment 1 demonstrated that the students could be taught to accurately measure a partner and/or significantly learn body fatness-related concepts compared to controls. It was also shown that inexpensive plastic Fat Control calipers produced accurate measurements. Experiment 2 was designed to replicate the significant cognitive outcome effects, and also to test the hypothesis that psychological damage is a likely consequence of skinfold caliper use-and that hypothesis was refuted. Specifically, knowledge scores, and outcome scores on adapted affect scales (e.g., PANAS, MAACL), physical self-esteem scales (CY-PSPP) and on the Social Physique Anxiety Scale supported the premise that skinfold calipers can be used in an educational context to facilitate cognitive learning without causing adverse affective consequences.","Whitehead, J R; Eklund, R C; Williams, A C",2003.0,,0,0,
2662,Acute and delayed effects of alprazolam on flight phobics during exposure.,"In order to test if a benzodiazepine would enhance or hinder the therapeutic effects of exposure, immediate and delayed effects of alprazolam on flight phobics were assessed by questionnaires and ambulatory physiological recording. Physiological measures included heart rate, skin conductance level and fluctuations, finger temperature, respiratory sinus arrhythmia, and various respiratory measures derived from two bands calibrated for each subject. Twenty-eight women with flying phobia flew twice at a 1-week interval. One and a half hours before flight 1, 14 randomly assigned phobics received double-blind 1 mg of alprazolam and 14 received placebo. On flight 1, alprazolam reduced self-reported anxiety (5.0 vs 7.4) and symptoms (5.3 vs 3.6) more than placebo, but induced an increase in heart rate (114 vs 105 bpm) and respiratory rate (22.7 vs 18.3 breaths/min). Before flight 2, the alprazolam group did not expect to be more anxious than the placebo group (6.7 vs 6.5), but in fact indicated more anxiety during flight (8.5 vs 5.6), and a substantial increase in panic attacks from flight 1 to flight 2 (7% vs 71%). Heart rates in the alprazolam group increased further (123 bpm). Results indicate that alprazolam increases physiological activation under acute stress conditions and hinders therapeutic effects of exposure in flying phobia.",Wilhelm FH.; Roth WT.,1997.0,,0,0,
2663,"Taking the laboratory to the skies: ambulatory assessment of self-report, autonomic, and respiratory responses in flying phobia.","We evaluated the feasibility of recording multiple physiological anxiety measures during a flight and how well they could distinguish flight phobics from controls. Benefits of baseline adjustment and transformation for all variables and adjustment of heart rate by ventilation to give additional heart rate were calculated. Effect size, one measure of the power to discriminate groups, was between 1.1 and 1.7 for heart rate measures. Although respiratory rate and minute ventilation, indicators of hyperventilation, did not differ between groups, phobics paused more during inspiration than did controls. Phobics also showed more skin conductance fluctuations and less respiratory sinus arrhythmia. Self-reported anxiety was a more powerful discriminator than physiological measures, a result that may be partially explained by how phobics were selected. These results indicate that monitoring of multiple physiological systems outside the laboratory is practical and informative. Physiological measures of psychological importance can be quantified accurately in a noisy, changing, unsupervised ambulatory setting.",Wilhelm FH.; Roth WT.,1998.0,,0,0,
2664,Mindfulness-based stress reduction for family caregivers: a randomized controlled trial,"ER DESIGN AND METHODS: We randomly assigned 78 family caregivers to an MBSR or a CCES intervention, matched for time and attention. Study participants attended 8 weekly intervention sessions and participated in home-based practice. Surveys were completed at baseline, postintervention, and at 6 months. Participants were 32- to 82-year-old predominately non-Hispanic White women caring for a parent with dementia.RESULTS: MBSR was more effective at improving overall mental health, reducing stress, and decreasing depression than CCES. Both interventions improved caregiver mental health and were similarly effective at improving anxiety, social support, and burden.IMPLICATIONS: MBSR could reduce stress and improve mental health in caregivers of family members with dementia residing in the community.PURPOSE: Caring for a family member with dementia is associated with chronic stress, which can have significant deleterious effects on caregivers. The purpose of the Balance Study was to compare a mindfulness-based stress reduction (MBSR) intervention to a community caregiver education and support (CCES) intervention for family caregivers of people with dementia.","Whitebird, R R; Kreitzer, M; Crain, A L; Lewis, B A; Hanson, L R; Enstad, C J",2013.0,10.1093/geront/gns126,0,0,
2665,"Can a tailored telephone intervention delivered by volunteers reduce the supportive care needs, anxiety and depression of people with colorectal cancer? A randomised controlled trial","ER OBJECTIVE: The objective was to assess the effectiveness of a volunteer-delivered tailored telephone-based intervention in reducing prevalence of unmet supportive care needs, elevated levels of anxiety and depression among people with colorectal cancer over a 9-month period.METHODS: There were 653 participants who completed the baseline questionnaire and were randomised to usual care (n?=?341) or intervention (n?=?306). Three follow-up questionnaires were completed at 3-monthly intervals (response rates: 93%, 87%, 82%, respectively). All four questionnaires contained the Supportive Care Needs Survey (SCNS), Hospital Anxiety and Depression Scale (HADS) and checklists for colorectal cancer symptoms and use of support services. The intervention consisted of trained volunteers providing emotional support, service referral and information and was delivered after completion of each of the first three questionnaires. Primary outcomes were prevalence of moderate to high SCNS needs and elevated levels (scores of 8+) of HADS anxiety and depression.RESULTS: Over the study period, SCNS needs decreased similarly for both groups, and prevalence of elevated depression did not change for either group. There was a greater reduction in the prevalence of elevated anxiety in the intervention than usual care group (p?<?0.01), with the intervention group decrease mainly occurring between baseline and the first follow-up survey (p?<?0.01). However, the prevalence of elevated anxiety was similar between the two groups at each follow-up point.CONCLUSIONS: The intervention had no effect on supportive care needs or depression, although it may be associated with a greater reduction in anxiety. Future research should test the intervention with patients closer to diagnosis.","White, V M; Macvean, M L; Grogan, S; D'Este, C; Akkerman, D; Ieropoli, S; Hill, D J; Sanson-Fisher, R",2012.0,10.1002/pon.2019,0,0,
2666,Prediction error representation in individuals with generalized anxiety disorder during passive avoidance.,"Objective: Deficits in reinforcement-based decision making have been reported in generalized anxiety disorder. However, the pathophysiology of these deficits is largely unknown; published studies have mainly examined adolescents, and the integrity of core functional processes underpinning decision making remains undetermined. In particular, it is unclear whether the representation of reinforcement prediction error (PE) (the difference between received and expected reinforcement) is disrupted in generalized anxiety disorder. This study addresses these issues in adults with the disorder. Method: Forty-six unmedicated individuals with generalized anxiety disorder and 32 healthy comparison subjects group-matched on IQ, gender, and age performed a passive avoidance task while undergoing functional MRI. Data analyses were performed using a computational modeling approach. Results: Behaviorally, individuals with generalized anxiety disorder showed impaired reinforcement-based decision making. Imaging results revealed that during feedback, individuals with generalized anxiety disorder relative to healthy subjects showed a reduced correlation between PE and activity within the ventromedial prefrontal cortex, ventral striatum, and other structures implicated in decision making. In addition, individuals with generalized anxiety disorder relative to healthy participants showed a reduced correlation between punishment PEs, but not reward PEs, and activity within the left and right lentiform nucleus/putamen. Conclusions: This is the first study to identify computational impairments during decision making in generalized anxiety disorder. PE signaling is significantly disrupted in individuals with the disorder and may lead to their decision-making deficits and excessive worry about everyday problems by disrupting the online updating (""reality check"") of the current relationship between the expected values of current response options and the actual received rewards and punishments. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","White, Stuart F; Geraci, Marilla; Lewis, Elizabeth; Leshin, Joseph; Teng, Cindy; Averbeck, Bruno; Meffert, Harma; Ernst, Monique; Blair, James R; Grillon, Christian; Blair, Karina S; Alexander, Benson, Blair, Blair, Blair, Blair, Clithero, Cox, DeVido, Engelmann, First, Galvan, Guyer, Kuhnen, Lissek, Liu, Luhmann, Maner, O'Doherty, O'Doherty, Raghunathan, Rescorla, Schultz, Talairach, Teng, White, Yassa",2017.0,,0,0,
2667,Assessment of global functioning in adolescents with autism spectrum disorders: utility of the Developmental Disability-Child Global Assessment Scale,"ER Assessment of global functioning is an important consideration in treatment outcome research; yet, there is little guidance on its evidence-based assessment for children with autism spectrum disorders. This study investigated the utility and validity of clinician-rated global functioning using the Developmental Disability-Child Global Assessment Scale in a sample of higher functioning adolescents with autism spectrum disorders and comorbid anxiety disorders enrolled in a randomized controlled trial (n = 30). Pretreatment Developmental Disability-Child Global Assessment Scale scores correlated with severity of autism spectrum disorders core symptoms (r = -.388, p = .034), pragmatic communication (r = .407, p = .032), and verbal ability (r = .449, p = .013) and did not correlate with severity of anxiety symptoms or with parent-reported adaptive behavior. Change in Developmental Disability-Child Global Assessment Scale scores during treatment was associated with autism spectrum disorders symptomatic improvement (r = .414, p = .040) and with improved general communication (r = .499, p = .013). Results support the importance of assessing global functioning in addition to symptom change and treatment response in clinical trials.","White, S W; Smith, L A; Schry, A R",2014.0,10.1177/1362361313481287,0,0,
2668,Randomized controlled trial: multimodal Anxiety and Social Skill Intervention for adolescents with autism spectrum disorder,"ER Anxiety is common among adolescents with autism spectrum disorders (ASD) and may amplify the core social disability, thus necessitating combined treatment approaches. This pilot, randomized controlled trial evaluated the feasibility and preliminary outcomes of the Multimodal Anxiety and Social Skills Intervention (MASSI) program in a sample of 30 adolescents with ASD and anxiety symptoms of moderate or greater severity. The treatment was acceptable to families, subject adherence was high, and therapist fidelity was high. A 16 % improvement in ASD social impairment (within-group effect size = 1.18) was observed on a parent-reported scale. Although anxiety symptoms declined by 26 %, the change was not statistically significant. These findings suggest MASSI is a feasible treatment program and further evaluation is warranted.","White, S W; Ollendick, T; Albano, A M; Oswald, D; Johnson, C; Southam-Gerow, M A; Kim, I; Scahill, L",2013.0,10.1007/s10803-012-1577-x,0,0,
2669,Adding a motivational interviewing pretreatment to cognitive behavioral therapy for generalized anxiety disorder: a preliminary randomized controlled trial.,"Seventy-six individuals with a principal diagnosis of generalized anxiety disorder (GAD) were randomly assigned to receive either an MI pretreatment or no pretreatment (NPT), prior to receiving CBT. Significant group differences favoring the MI-CBT group were observed on the hallmark GAD symptom of worry and on therapist-rated homework compliance, which mediated the impact of treatment group on worry reduction. Adding MI pretreatment to CBT was specifically and substantively beneficial for individuals with high worry severity at baseline. There was evidence of relapse at 6-month follow-up for high severity individuals who received MI-CBT, but significant moderator effects favoring the high severity MI-CBT group were again apparent at 12-months post-treatment. Pending replication in a more controlled test, these findings suggest that MI may be a promising adjunct to CBT for GAD for those of high severity, a group which has been less responsive to CBT in past research.",Westra HA.; Arkowitz H.; Dozois DJ.,2009.0,10.1016/j.janxdis.2009.07.014,0,0,
2670,Effects of interoceptive exposure in cognitive-behavioral therapy of panic disorder with agoraphobia.,"Background: Although interoceptive exposure is a frequent component of cognitive-behavioral therapies (CBT) in panic disorder with agoraphobia, there is a lack of evidence investigating the effect of this treatment component and its underlying mechanisms of change. The present study aimed at characterizing individual responses to interoceptive exposure and response changes after repeated exposure. Patients and Methods: Under the national research initiative 'Panic Net', self-report data were analyzed including bodily symptoms, symptom intensity and experienced anxiety during interoceptive exposure of 301 PD/AG patients who participated in a manualized CBT trial. Results: Interoceptive exposure induced bodily symptoms and anxiety. Respiratory, vestibular and cardiovascular symptoms were most frequently reported. Spinning, breathing through a straw and hyperventilation produced most intense symptom reports and anxiety ratings. Repeating the interoceptive exposure reliably reduced reported symptom intensity and anxiety ratings particularly after spinning, breathing through a straw and hyperventilation. Discussion and Conclusions: In PD/AG patients, interoceptive exposure induces bodily symptoms and reduces reported symptom intensity and anxiety, particularly through spinning, hyperventilation and breathing through a straw. Repeated rehearsal is encouraged given that larger reduction of anxiety and symptom reports were associated with more training. Further research is needed to assess the relevance of respiratory, vestibular and cardiovascular symptoms for CBT treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Westphal, Dorte; Gerlach, Alexander L; Lang, Thomas; Wittchen, Hans-Ulrich; Hamm, Alfons O; Strohle, Andreas; Fydrich, Thomas; Kircher, Tilo; Alpers, Georg W; Deckert, Jurgen; Arolt, Volker; Einsle, Franziska; Andor, Antony, Barlow, Barlow, Beck, Bouton, Chambless, Chambless, Cohen, Edelman, Foa, Gerlach, Gloster, Gloster, Goldstein, Guy, Hand, Ito, Jennrich, Klan, Lang, Lang, Lee, Rosenthal, Schmidt, Shear, Tryon, van den Hout, Wirtz, Wittchen",2015.0,,0,0,
2671,The role of attachment in responses to victims of life crises,"ER Attachment effects on affect, cognitions, and behavior during an interaction with a confederate who purportedly had cancer and whose attachment orientation had been manipulated in a prior context were examined among 241 participants. Results supported theoretically derived predictions: Participant anxious attachment predicted anxiety, participant avoidant attachment predicted supportiveness, and participant avoidant attachment interacted with confederate avoidant attachment to predict rejection. Results suggest (a) the importance of attachment in predicting interpersonal responses in a nonromantic stressful context, (b) that anxious attachment is an important predictor of anxiety in a situation with implicit support demands, (c) that avoidant attachment is a potentially important predictor of the likelihood of supportive responses to victims, and (d) that attachment orientation can be successfully manipulated in experimental studies of attachment.","Westmaas, J L; Silver, R C",2001.0,,0,0,
2672,Implicit associations and social anxiety,"The aim of this study was to test whether an Implicit Association Test (IAT) with self- and social anxiety-words is sensitive to differences in trait social anxiety, and to an experimental induction of social anxiety. This was performed in the context of a partial replication of a previous study, in which Mauss et al. (2004) compared high and low trait socially anxious individuals before and after a social anxiety induction (an impromptu speech). Mauss et al.'s findings were replicated; that is, (i) the social anxiety induction produced increases in self-rated anxiety, self-rated physiological responses, and actual physiological arousal; and (ii) higher trait social anxiety was associated with stronger self-rated anxiety and stronger self-rated physiological responses, but not with stronger actual physiological responses. In addition, the results showed higher IAT social anxiety scores, both (i) as a result of the social anxiety induction, and (ii) as a function of self-reported trait social anxiety. It is suggested that the IAT may be a useful method for the experimental study of automatic evaluational thought patterns.",Westberg P.; Lundh L.-G.; Jönsson P.,2007.0,10.1080/08037060601020401,0,0,
2673,"Booster Sessions after Cognitive-Behavioural Group Therapy for Panic Disorder: Impact on Resilience, Coping, and Quality of Life.","Panic disorder (PD) has a chronic nature, especially as a result of maladaptive coping strategies to deal with stressful events. To evaluate the impact of booster sessions with cognitive techniques on coping strategies, resilience, and quality of life (QoL) in patients previously submitted to standard cognitive-behavioural group therapy (CBGT) for PD. A controlled clinical trial with 44 patients with PD (intervention = 20; control = 24) who had previously completed a 12-week CBGT protocol. PD, anxiety, and depression severity symptoms were assessed at baseline and 1, 6, and 12 months after the booster sessions. Coping strategies, resilience, and QoL were assessed by Coping Strategies Inventory (CSI), Resilience Scale, and WHOQOL-BREF respectively. Over time, a significant improvement in PD and depression symptoms was observed in both groups. A significant increase in the QoL social relations domain was found in the booster group, considering a time/group interaction. Coping and other QoL domains did not change after the booster sessions. Changes in resilience were dependent on the intensity of symptoms, with negative but non-significant correlations. The improvement in PD and depression symptoms for both groups may be a result of the group format of the intervention. Group booster sessions after CBGT are useful to maintain the benefits obtained with CBGT.",Wesner AC.; Gomes JB.; Detzel T.; Guimar√£es LS.; Heldt E.,2015.0,10.1017/S1352465814000289,0,0,
2674,Hippocampal function during associative learning in patients with posttraumatic stress disorder.,"In the last decade several studies have shown memory deficits in patients with posttraumatic stress disorder (PTSD) which have been associated with a reduced hippocampus volume. However, until now we do not know how or whether these structural abnormalities turn into functional abnormalities. Thus, the primary purpose of the present study was the investigation of the hippocampal function using functional magnet resonance imaging (fMRI). We compared PTSD patients and healthy control participants using an associative learning paradigm consisting of two encoding and one retrieval condition. During fMRI scanning participants had to learn face-profession pairs. Afterwards only faces were presented as cue stimuli for associating the category of the prior learned target profession and the participants had to decide whether this face belonged to a scientific or an artistic profession. Additionally, cognitive functioning, i.e. memory and attention, was examined using neuropsychological standard tests. During encoding PTSD patients showed stronger hippocampal and weaker prefrontal activation compared to healthy control participants. During retrieval the two groups did not differ neither in hippocampus activation nor in accuracy of retrieval. PTSD patients however showed a reduced activation in the left parahippocampal gyrus and other memory-related brain regions. We did not find any significant memory differences between PTSD patients and healthy control participants. The results suggest that PTSD has an effect on memory-related brain function despite intact memory functioning. In particular the hippocampal/parahippocampal regions and the prefrontal cortex show functional alterations during associative learning and memory.",Werner NS.; Meindl T.; Engel RR.; Rosner R.; Riedel M.; Reiser M.; Fast K.,2009.0,10.1016/j.jpsychires.2008.03.011,0,0,
2675,Levels of anxiety sensitivity in relation to repressive and self-deceptive coping styles,"Levels of anxiety sensitivity (AS) were investigated in relation to self-deception and repression in 296 university students. It was hypothesized that a low level of AS, rather than constituting 'normal' functioning, would be associated with more general response biases. Scores on the Anxiety Sensitivity Index (ASI; Peterson and Reiss, 1987, 1992) were negatively and significantly correlated with measures of self-deception and denial. Individuals with low AS were significantly more likely to meet an operational definition of repression (i.e., low anxiety and high defensiveness), compared to mid AS and high AS groups. When confronted with a hypothetical health problem, individuals with low AS were less likely to choose a task-oriented response and more likely to choose denial and self-deceptive responses, compared to the other groups. These findings support the observations of Shostak and Peterson (1990) that low AS represents an extreme group that may not be indicative of normal functioning. Copyright (C) 2000 Elsevier Science Ltd.",Werhun C.D.; Cox B.J.,1999.0,10.1016/S0887-6185(99)00026-2,0,0,
2676,Predictors of dropout from community clinic child CBT for anxiety disorders,"ER The aim was to investigate predictors of treatment dropout among 182 children (aged 8-15 years) participating in an effectiveness trial of manual-based 10-session individual and group cognitive behavior therapy (CBT) for anxiety disorders in community clinics. The dropout rate was 14.4%, with no significant difference between the two treatment conditions. We examined predictors for overall dropout (n=26), early (?session 4, n=15), and late dropout (?session 5, n=11). Overall dropout was predicted by low child and parent rated treatment credibility, and high parent self-rated internalizing symptoms. Low child rated treatment credibility predicted both early and late dropout. High parent self-rated internalizing symptoms predicted early dropout, whereas low parent rated treatment credibility predicted late dropout. These results highlight the importance of addressing treatment credibility, and to offer support for parents with internalizing symptoms, to help children and families remain in treatment.","Wergeland, G J; Fjermestad, K W; Marin, C E; Haugland, B S; Silverman, W K; Öst, L G; Havik, O E; Heiervang, E R",2015.0,10.1016/j.janxdis.2015.01.004,0,0,
2677,An effectiveness study of individual vs. group cognitive behavioral therapy for anxiety disorders in youth,"ER OBJECTIVE: Conducted a randomized controlled trial to investigate the effectiveness of cognitive behavioral therapy (CBT), and compared the relative effectiveness of individual (ICBT) and group (GCBT) treatment approaches for anxiety disorders in children and adolescents.METHODS: Referred youth (N = 182, M age = 11.5 years, range 8-15 years, 53% girls) with separation anxiety, social phobia, or generalized anxiety disorder were randomly assigned to ICBT, GCBT or a waitlist control (WLC) in community clinics. Pre-, post-, and one year follow-up assessments included youth and parent completed diagnostic interview and symptom measures. After comparing CBT (ICBT and GCBT combined) to WLC, ICBT and GCBT were compared along diagnostic recovery rates, clinically significant improvement, and symptom measures scores using traditional hypothesis tests, as well as statistical equivalence tests.RESULTS: Significantly more youth lost all anxiety disorders after CBT compared to WLC. Full diagnostic recovery rate was 25.3% for ICBT and 20.5% in GCBT, which was not significantly different. There was continued lack of significant differences between ICBT and GCBT at one year follow-up. However, equivalence between GCBT and ICBT could only be demonstrated for clinical severity rating of the principal anxiety disorder and child reported anxiety symptoms post-treatment.CONCLUSION: Findings support the effectiveness of CBT compared to no intervention for youth with anxiety disorders, with no significant differences between ICBT and GCBT. However, the relatively low recovery rates highlight the need for further improvement of CBT programs and their transportability from university to community settings.","Wergeland, G J; Fjermestad, K W; Marin, C E; Haugland, B S; Bjaastad, J F; Oeding, K; Bjelland, I; Silverman, W K; Ost, L G; Havik, O E; Heiervang, E R",2014.0,10.1016/j.brat.2014.03.007,0,0,
2678,Predictors of treatment outcome in an effectiveness trial of cognitive behavioral therapy for children with anxiety disorders,"ER A substantial number of children with anxiety disorders do not improve following cognitive behavioral therapy (CBT). Recent effectiveness studies have found poorer outcome for CBT programs than what is typically found in efficacy studies. The present study examined predictors of treatment outcome among 181 children (aged 8-15 years), with separation anxiety, social phobia, or generalized anxiety disorder, who participated in a randomized, controlled effectiveness trial of a 10-session CBT program in community clinics. Potential predictors included baseline demographic, child, and parent factors. Outcomes were as follows: a) remission from all inclusion anxiety disorders; b) remission from the primary anxiety disorder; and c) child- and parent-rated reduction of anxiety symptoms at post-treatment and at 1-year follow-up. The most consistent findings across outcome measures and informants were that child-rated anxiety symptoms, functional impairment, a primary diagnosis of social phobia or separation anxiety disorder, and parent internalizing symptoms predicted poorer outcome at post-treatment. Child-rated anxiety symptoms, lower family social class, lower pretreatment child motivation, and parent internalizing symptoms predicted poorer outcome at 1-year follow-up. These results suggest that anxious children with more severe problems, and children of parents with elevated internalizing symptom levels, may be in need of modified, additional, or alternative interventions to achieve a positive treatment outcome.","Wergeland, G J; Fjermestad, K W; Marin, C E; Bjelland, I; Haugland, B S; Silverman, W K; Öst, L G; Bjaastad, J F; Oeding, K; Havik, O E; Heiervang, E R",2016.0,10.1016/j.brat.2015.11.001,0,0,
2679,Psychosocial telephone counseling for survivors of cervical cancer: results of a randomized biobehavioral trial,"ER Purpose Survivors of cervical cancer experience quality-of-life (QOL) disruptions that persist years after treatment. This study examines the effect of a psychosocial telephone counseling (PTC) intervention on QOL domains and associations with biomarkers. Patients and Methods We conducted a randomized clinical trial in survivors of cervical cancer, who were > 9 and less than 30 months from diagnosis (n = 204), to compare PTC to usual care (UC). PTC included five weekly sessions and a 1-month booster. Patient-reported outcomes (PROs) and biospecimens were collected at baseline and 4 and 9 months after enrollment. Changes in PROs over time and associations with longitudinal change in cytokines as categorical variables were analyzed using multivariable analysis of variance for repeated measures. Results Participant mean age was 43 years; 40% of women were Hispanic, and 51% were non-Hispanic white. Adjusting for age and baseline scores, participants receiving PTC had significantly improved depression and improved gynecologic and cancer-specific concerns at 4 months compared with UC participants (all P < .05); significant differences in gynecologic and cancer-specific concerns (P < .05) were sustained at 9 months. Longitudinal change in overall QOL and anxiety did not reach statistical significance. Participants with decreasing interleukin (IL) -4, IL-5, IL-10, and IL-13 had significantly greater improvement in QOL than those with increasing cytokine levels.Conclusion This trial confirms that PTC benefits mood and QOL cancer-specific and gynecologic concerns for a multiethnic underserved population of survivors of cancer. The improvement in PROs with decreases in T-helper type 2 and counter-regulatory cytokines supports a potential biobehavioral pathway relevant to cancer survivorship.","Wenzel, L; Osann, K; Hsieh, S; Tucker, J A; Monk, B J; Nelson, E L",2015.0,10.1200/JCO.2014.57.4079,0,0,
2680,Memory bias against threat in social phobia.,"The present study examined whether social phobia is an anxiety disorder associated with a memory bias toward threat. Social phobic (N = 16) and non-anxious (N = 17) individuals were compared on their recall of evaluative threat and neutral prose passage content. Participants were presented with two evaluative threat and two neutral prose passages and completed an immediate free recall task after each trial. Contrary to expectation, individuals with social phobia recalled a smaller percentage of units from the evaluative threat passages than non-anxious individuals. Consistent with the vigilance-avoidance theory, it is suggested that social phobia is an anxiety disorder characterized by the avoidance of elaborate processing of threatening material.",Wenzel A.; Holt CS.,2002.0,,0,0,
2681,Autobiographical memories prompted by automatic thoughts in panic disorder and social phobia.,"This study examined the retrieval of autobiographical memories when prompted by automatic thoughts that were representative of maladaptive schema content specific to 2 anxiety disorders. Participants with panic disorder (n = 20), those with social phobia (n = 22) and non-anxious participants (n = 20) indicated the first specific memory that came to mind when cued with panic-related, social phobia-related and control automatic thoughts. Panic participants retrieved memories cued with panic disorder-related automatic thoughts more quickly than social phobic and non-anxious participants, and social phobic participants retrieved memories cued with social phobia-related automatic thoughts more quickly than non-anxious participants. Relative to non-anxious participants, participants in both patient groups retrieved more anxious/worried memories when cued with automatic thoughts related to their diagnosis and more fearful memories when cued with either type of diagnosis-related automatic thought. Results indicate that panic and social phobic participants were characterized by general threat-relevant autobiographical memory biases.",Wenzel A.; Cochran CK.,2006.0,10.1080/16506070600583130,0,0,
2682,Schema content for a threatening situation: Responses to expected and unexpected events,"Although previous research has identified the components of event-based schemas, or scripts, for threatening situations in anxious individuals, no studies have examined how scripts change when anxious individuals are faced with a deviation in the expected sequence of events. In the present study, blood fearful (n = 49) and nonfearful (n = 48) participants assigned subjective units of discomfort (SUD) ratings to the events comprising the script for getting a bleeding cut on the arm. Subsequently, they listed a series of 10 events that would occur following 1 of 2 unexpected events that interrupted the script. Results indicated that blood fearful participants assigned higher SUD ratings to scripted events than nonfearful participants. Participants in the two groups generated largely similar sequences of events that would occur after the unexpected events. However, relative to nonfearful participants, blood fearful participants listed more events characterized by negative affect. These results suggest that blood fearful individuals are able to recover from deviations from the standard script for a common but threatening situation, although their associated emotional experiences are more distressing than those of nonfearful individuals. © 2009 Springer Publishing Company.",Wenzel A.,2009.0,10.1891/0889-8391.23.2.136,0,0,
2683,Signal changes of the alar ligament in a healthy population: A dispositional or degenerative consequence?,"OBJECT: The alar ligaments (ALs) are vital for stabilizing the craniocervical junction. In terms of morphology, their appearance varies and is visible on MRI. Dark signal of the AL on proton-density (PD)-weighted images is generally considered the norm, but the etiology of frequently observed signal hyperintensities is poorly understood. Using spectral fat suppression, signal hyperintensities can be differentiated into fat- and nonfat-related hyperintensities (NFH). Although signal hyperintensities have no evident association with whiplash-associated disorder, age-related degeneration has often been theorized. Therefore, this study investigates the signal intensities of the ALs on 3.0-T MRI with special reference to age. Expanding thereon, the authors investigated the relationship between signal hyperintensities and patient characteristics, such as height, weight, and sex. METHODS: Sixty-six healthy volunteers were scanned using 3.0-T PD-weighted MRI, including spectral fat suppression of the craniocervical junction. The study population was separated into 2 groups (old vs young) using 2 approaches: dichotomization at the median age (40.0 years) and the calculated threshold (28.5 years) using receiver operating characteristics (ROC). The AL was independently characterized with respect to continuity, course, shape, signal intensity, and graduation of homogeneity by 2 experienced neuroradiologists. Signal intensity was differentiated into fat-related hyperintensity and NFH. Univariate and multivariate logistic regression models were employed to investigate the relationship between patient characteristics and signal intensities. RESULTS: Two different AL patterns were observed: inhomogeneous (33.3%) and homogeneous (66.7%). The latter pattern was mostly surrounded by a small dark rim (56.8%). Fat could be identified in 15.9% of all ALs (21 of 132 patients), and NFH was identified in 17.4% of all ALs (23 of 132 patients). Here, 28.5 years was the preferred threshold, demonstrating a relatively high sensitivity for dichotomizing the population based on the ROC of NFH. The most relevant factor for having NFH was being older than the calculated threshold (odds ratio [OR] 3.420, p = 0.051). Fat-related hyperintensities occurred significantly more frequently in men than women (OR 0.110 and p = 0.007 for women; OR 9.075 and p = 0.007 for men). Height was the second most significant factor: for every 1-cm increase, the odds of having fat lesions increased by approximately 10% (OR 1.102; p = 0.017). CONCLUSIONS: This study shows that AL signal hyperintensities are substantially influenced by age, sex, and height in healthy individuals. Regarding fat-related hyperintensities, the most relevant factors proved to be sex and height. The odds of detecting NFH increased almost significantly after a relatively young age (> 28.5 years) and were remarkably more frequent in individuals older than 28.5 years. The authors caution presumptions equating signal alterations with age-related deterioration. Instead, they suggest that dispositional factors such as sex and height are more relevant in the AL constitution. Signal alterations in ALs naturally occur in healthy symptom-free individuals, underscoring the importance of cautiously interpreting such lesions on posttraumatic MRI scans.",Wenz H.; Kerl H.U.; Maros M.E.; Wenz R.; Kalvin K.; Groden C.; Nölte I.,2015.0,10.3171/2015.1.SPINE141214,0,0,
2684,Manipulating Skill of Accumulative Scoring Paradoxical Intervention in Psychotherapy.,"Objective: To introduce the Accumulative Scoring Skill of paradoxical intervention in China. Methods: For removing the symptoms of mental disorders, we applied the method of actively eliciting and aggravating the underlying unpleasant experience. The therapist and the patient construct a symptom hierarchy in which the points of symptom were rated from the most to the least upsetting. The more the clients gain the points, the more severe symptoms were actively evoked. Through accumulating the scores, the attention of the clients were distracted from self to the objective world, so that the patients ultimately would be free of suffering from the symptoms. Results: The skill was very effective for the 42 cases reported in this article. Conclusion: The Accumulative Scoring Skill of paradoxical intervention has the advantage that the changes it produces in a short time and the cost of psychotherapy is greatly reduced. The skill is applied to a variety of problems in adolescents, especially for obsessive thinking, obsessive image and school phobia. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wenqing, Fu; Shuqiao, Yao; Alan, Frankl, Shapiro",2004.0,,0,0,
2685,Efficacy of metacognitive therapy for prolonged grief disorder: protocol for a randomised controlled trial,"ER METHODS AND ANALYSIS: The proposed trial comprises three phases. Phase 1 consists of a review of the literature and semistructured interviews with key members of the target population to inform the development of a metacognitive therapy programme for Prolonged Grief. Phase 2 involves a randomised controlled trial to implement and evaluate the programme. Male and female adults (N=34) will be randomly assigned to either a wait list or an intervention group. Measures of PGD, anxiety, depression, rumination, metacognitions and quality of life will be taken pretreatment and posttreatment and at the 3-month and 6-month follow-up. The generalised linear mixed model will be used to assess treatment efficacy. Phase 3 will test the social validity of the programme.DISCUSSION: This study is the first empirical investigation of the efficacy of a targeted metacognitive treatment programme for PGD. A focus on identifying and changing the metacognitive mechanisms underpinning the development and maintenance of prolonged grief is likely to be beneficial to theory and practice.ETHICS: Ethics approval was obtained from Curtin University Human Research Ethics Committee (Approval number HR 41/2013.)TRIAL REGISTRATION NUMBER: ACTRN12613001270707.INTRODUCTION: Studies of effective psychotherapy for individuals suffering from the effects of prolonged grief disorder (PGD) are scarce. This paper describes the protocol for an evaluation of a metacognitive therapy programme designed specifically for PGD, to reduce the psychological distress and loss of functioning resulting from bereavement.","Wenn, J; O'Connor, M; Breen, L J; Kane, R T; Rees, C S",2015.0,10.1136/bmjopen-2014-007221,0,0,
2686,Disentangling sequential effects of stimulus- and response-related conflict and stimulus-response repetition using brain potentials,"Conflict monitoring theory holds that detection of conflicts in information processing by the anterior cingulate cortex (ACC) results in processing adaptation that minimizes subsequent conflict. Applying an Eriksen f lanker task with four stimuli mapped onto two responses, we investigated whether such modulation occurs only after response-related or also after stimulus-related conflict, focusing on the N2 component of the event-related potential. Contrasting with previous findings, both stimulus- and response-related conflict elicited enhancement of the N2, suggesting that the ACC is sensitive to conflict at both the stimulus and the response level. However, neither type of conflict resulted in reduced conflict effects on the following trial when stimulus-response (S-R) sequence effects were controlled by excluding identical S-R repetition trials. Identical S-R repetitions were associated with facilitated processing, thus demonstrating that inclusion of these trials in the analysis may mimic results predicted by the conflict adaptation hypothesis. © 2007 Massachusetts Institute of Technology.",Wendt M.; Heldmann M.; Münte T.F.; Kluwe R.H.,2007.0,10.1162/jocn.2007.19.7.1104,0,0,
2687,"""Stress control"" large group therapy for generalized anxiety disorder: Two year follow-up.","While treatments for Generalized Anxiety Disorder have considerably improved recently, they remain less effective than similar treatments for other anxiety disorders. This paper reports on a comparative outcome study of a large group didactic therapy specifically designed to teach patients to ""become their own therapists"" in an attempt to counter the relapse problems commonly associated with this condition. Data from 56 patients suggest that improvements noted at 6 mo follow-up are maintained at 2 yrs. Suggestions are forwarded to explain the lack of differential responding found among different therapy approaches. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","White, Jim",1998.0,,0,0,
2688,Acute and delayed effects of alprazolam on flight phobics during exposure.,"Conducted a test to determine if a benzodiazepine would enhance or hinder the therapeutic effects of exposure. The test consisted in assessing the therapeutic effects of alprazolam on flight phobics by means of questionnaires and ambulatory recordings. Physiological measures included heart rate, skin conductance levels and fluctuations, finger temperature and respiratory arrhythmia. The test was conducted by means of 2 flights 1 week apart, using 28 female Ss with flying phobia, who were administered alprazolam and placebos in different sequences and combinations. A control group of 14 non-phobic Ss was used for comparison purposes. Study results indicate that alprazolam increases physiological activation under acute stress conditions and hinders therapeutic effects of exposure in flight phobics. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wilhelm, F.H; Roth, W.T",1998.0,,0,0,2662
2689,Clinical effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: the CoBalT randomised controlled trial,"ER BACKGROUND: Only one-third of patients with depression respond fully to treatment with antidepressant medication. However, there is little robust evidence to guide the management of those whose symptoms are 'treatment resistant'.OBJECTIVE: The CoBalT trial examined the clinical effectiveness and cost-effectiveness of cognitive behavioural therapy (CBT) as an adjunct to usual care (including pharmacotherapy) for primary care patients with treatment-resistant depression (TRD) compared with usual care alone.DESIGN: Pragmatic, multicentre individually randomised controlled trial with follow-up at 3, 6, 9 and 12 months. A subset took part in a qualitative study investigating views and experiences of CBT, reasons for completing/not completing therapy, and usual care for TRD.SETTING: General practices in Bristol, Exeter and Glasgow, and surrounding areas.PARTICIPANTS: Patients aged 18-75 years who had TRD [on antidepressants for ? 6 weeks, had adhered to medication, Beck Depression Inventory, 2nd version (BDI-II) score of ? 14 and fulfilled the International Classification of Diseases and Related Health Problems, Tenth edition criteria for depression]. Individuals were excluded who (1) had bipolar disorder/psychosis or major alcohol/substance abuse problems; (2) were unable to complete the questionnaires; or (3) were pregnant, as were those currently receiving CBT/other psychotherapy/secondary care for depression, or who had received CBT in the past 3 years.INTERVENTIONS: Participants were randomised, using a computer-generated code, to usual care or CBT (12-18 sessions) in addition to usual care.MAIN OUTCOME MEASURES: The primary outcome was 'response', defined as ? 50% reduction in depressive symptoms (BDI-II score) at 6 months compared with baseline. Secondary outcomes included BDI-II score as a continuous variable, remission of symptoms (BDI-II score of < 10), quality of life, anxiety and antidepressant use at 6 and 12 months. Data on health and social care use, personal costs, and time off work were collected at 6 and 12 months. Costs from these three perspectives were reported using a cost-consequence analysis. A cost-utility analysis compared health and social care costs with quality adjusted life-years.RESULTS: A total of 469 patients were randomised (intervention: n = 234; usual care: n = 235), with 422 participants (90%) and 396 (84%) followed up at 6 and 12 months. Ninety-five participants (46.1%) in the intervention group met criteria for 'response' at 6 months compared with 46 (21.6%) in the usual-care group {odds ratio [OR] 3.26 [95% confidence interval (CI) 2.10 to 5.06], p < 0.001}. In repeated measures analyses using data from 6 and 12 months, the OR for 'response' was 2.89 (95% CI 2.03 to 4.10, p < 0.001) and for a secondary 'remission' outcome (BDI-II score of < 10) 2.74 (95% CI 1.82 to 4.13, p < 0.001). The mean cost of CBT per participant was £ 910, the incremental health and social care cost £ 850, the incremental QALY gain 0.057 and incremental cost-effectiveness ratio £ 14,911. Forty participants were interviewed. Patients described CBT as challenging but helping them to manage their depression; listed social, emotional and practical reasons for not completing treatment; and described usual care as mainly taking medication.CONCLUSIONS: Among patients who have not responded to antidepressants, augmenting usual care with CBT is effective in reducing depressive symptoms, and these effects, including outcomes reflecting remission, are maintained over 12 months. The intervention was cost-effective based on the National Institute for Health and Care Excellence threshold. Patients may experience CBT as difficult but effective. Further research should evaluate long-term effectiveness, as this would have major implications for the recommended treatment of depression.TRIAL REGISTRATION: Current Controlled Trials ISRCTN38231611.","Wiles, N; Thomas, L; Abel, A; Barnes, M; Carroll, F; Ridgway, N; Sherlock, S; Turner, N; Button, K; Odondi, L; Metcalfe, C; Owen-Smith, A; Campbell, J; Garland, A; Hollinghurst, S; Jerrom, B; Kessler, D; Kuyken, W; Morrison, J; Turner, K; Williams, C; Peters, T; Lewis, G",2014.0,10.3310/hta18310,0,0,
2690,"Postamputation pain and sensory changes in treatment-naive patients: characteristics and responses to treatment with tramadol, amitriptyline, and placebo","ER METHODSIn the current study, 94 treatment-naive posttraumatic limb amputees with phantom pain (intensity: mean visual analog scale score [0-100], 40 [95% confidence interval, 38-41]) were randomly assigned to receive individually titrated doses of tramadol, placebo (double-blind comparison), or amitriptyline (open comparison) for 1 month. Nonresponders were crossed over to the alternative active treatment.RESULTSAfter 1 month, phantom pain intensity was 1 (0-2) in the 48 tramadol responders (mean dose, 448 mg [95% confidence interval, 391-505 mg]), 0 (0-0) in the 40 amitriptyline responders (55 [50-59] mg), and 0 (0-0) in the 2 placebo responders, with similar effects on stump pain. Cytochrome P-450 2D6 slow metabolizers derived greater analgesia from tramadol and less from amitriptyline compared with fast metabolizers in the first treatment week (P < 0.01). Electrical pain thresholds increased and pain during suprathreshold stimulation decreased markedly on the stump and, to a lesser extent, on the contralateral limb after 1 month of treatment with amitriptyline or tramadol. Adverse effects were minor in all groups, but more common with tramadol.CONCLUSIONSIn treatment-naive patients, both amitriptyline and tramadol provided excellent and stable phantom limb and stump pain control with no major adverse events. Both drugs demonstrated consistent and large antinociceptive effects on both the stump and the intact limbs.BACKGROUNDPain after amputation is common but difficult to treat, and few controlled treatment studies exist.","Wilder-Smith, C H; Hill, L T; Laurent, S",2005.0,,0,0,
2691,Posttraumatic stress disorder and suicide attempts in a community sample of urban american young adults.,"Previous research has shown that exposure to traumatic events, especially sexual trauma during childhood, is associated with an increased risk of attempted suicide. However, no information is available as to whether the increased risk of attempted suicide is related primarily to posttraumatic stress disorder (PTSD) following traumatic experiences or applies also to persons who experienced trauma but did not develop PTSD. We examine the association between exposure to traumatic events with and without resulting PTSD and the risk of a subsequent suicide attempt in a community sample of urban young adults. A cohort study followed young adults who had participated in a randomized trial of all first-grade students entering 19 public schools. Baltimore, Maryland, an urban setting. A total of 1698 young adults (mean age, 21; 47% male; 71% African American) who represented 75% of the original cohort of 2311 persons. Relative risk of a subsequent suicide attempt associated with PTSD and with exposure to assaultive and non-assaultive traumas (no PTSD), as estimated using discrete time survival analysis. Posttraumatic stress disorder was associated with increased risk of a subsequent suicide attempt. The PTSD-suicide attempt association was robust, even after adjustment for a prior major depressive episode, alcohol abuse or dependence, and drug abuse or dependence (adjusted relative risk, 2.7; 95% confidence interval, 1.3-5.5; P < .01). In contrast, exposure to traumatic events without PTSD was not associated with an increased risk of attempted suicide. Posttraumatic stress disorder is an independent predictor of attempted suicide. Exposure to traumatic events without PTSD is not associated with a later suicide attempt.",Wilcox HC.; Storr CL.; Breslau N.,2009.0,10.1001/archgenpsychiatry.2008.557,0,0,
2692,[Auditiv distraction and music-hallucination in dental practice].,,Wikström PO.,1977.0,,0,0,
2693,Preattentive bias for snake words in snake phobia?,"Stroop interference and skin conductance responses (SCRs) for words related to snakes, spiders, flowers, and mushrooms were studied in a group of women (n=40) with snake phobia who were randomised to a stress or no-stress condition. The 21 low-stress snake phobics showed Stroop interference for unmasked (but not for masked) snake words, compared with 21 age- and sex-matched controls. Stroop interference was not significantly different between high-stress and low-stress snake phobics. No support for stronger SCRs for masked snake words was found in snake phobics in a lexical decision task with masked presentations of the same words. The lack of a masked Stroop interference in snake phobics suggests a possible difference in cognitive-emotional mechanisms underlying specific phobia vs. other anxiety disorders that deserves further investigation.",Wikström J.; Lundh LG.; Westerlund J.; Högman L.,2004.0,10.1016/j.brat.2003.07.002,0,0,
2694,The effect of the video game Mindlight on anxiety symptoms in children with an Autism Spectrum Disorder,"ER METHODS/DESIGN: The present study involves a randomized controlled trial (RCT) with two conditions (experimental versus control), in which it is investigated whether Mindlight is effective in decreasing (sub) clinical anxiety symptoms in children with an ASD. For this study, children of 8-16 years old with a diagnosis of an ASD and (sub) clinical anxiety symptoms will be randomly assigned to the experimental (N = 60) or the control (N = 60) condition. Children in the experimental condition will play Mindlight for one hour per week, for six consecutive weeks. Children in the control condition will play the puzzle game Triple Town, also for one hour per week and for six consecutive weeks. All children will complete assessments at baseline, post-intervention and 3-months follow-up. Furthermore, parents and teachers will also complete assessments at the same time points. The primary outcome will be child report of anxiety symptoms. Secondary outcomes will be parent report of child anxiety, child/parent report of depressive symptoms, and parent/teacher report of social functioning and behavior problems.DISCUSSION: This paper aims to describe a study that will examine the effect of the serious game Mindlight on (sub) clinical anxiety symptoms of children with an ASD in the age of 8-16 years old. It is expected that children in the experimental condition will show lower levels of anxiety symptoms at 3-months follow-up, compared to children in the control condition. If Mindlight turns out to be effective, it could be an important contribution to the already existing interventions for anxiety in children with an ASD. Mindlight could then be implemented as an evidence-based treatment for anxiety symptoms in children with an ASD in mental health institutes and special education schools.TRIAL REGISTRATION: Dutch Trial Register NTR5069 . Registered 20 April 2015.BACKGROUND: In the clinical setting, a large proportion of children with an autism spectrum disorder (ASD) experience anxiety symptoms. Because anxiety is an important cause of impairment for children with an ASD, it is necessary that effective anxiety interventions are implemented for these children. Recently, a serious game called Mindlight has been developed that is focused on decreasing anxiety in children. This approach is based on recent research suggesting that video games might be suitable as an intervention vehicle to enhance mental health in children. In the present study it will be investigated whether Mindlight is effective in decreasing (sub) clinical anxiety symptoms in children who are diagnosed with an ASD.","Wijnhoven, L A; Creemers, D H; Engels, R C; Granic, I",2015.0,10.1186/s12888-015-0522-x,0,0,
2695,Reductions in neural activity underlie behavioral components of repetition priming,"Repetition priming is a nonconscious form of memory that is accompanied by reductions in neural activity when an experience is repeated. To date, however, there is no direct evidence that these neural reductions underlie the behavioral advantage afforded to repeated material. Here we demonstrate a causal linkage between neural and behavioral priming in humans. fMRI (functional magnetic resonance imaging) was used in combination with transcranial magnetic stimulation (TMS) to target and disrupt activity in the left frontal cortex during repeated classification of objects. Left-frontal TMS disrupted both the neural and behavioral markers of priming. Neural priming in early sensory regions was unaffected by left-frontal",Wig G.S.; Grafton S.T.; Demos K.E.; Kelley W.M.,2005.0,10.1038/nn1515,0,0,
2696,"Insight among people with severe mental illness, co-occurring PTSD and elevated psychotic symptoms: Correlates and relationship to treatment participation.","There is a dearth of research on what factors are predictive of insight among people with severe mental illness and co-occurring PTSD. Data were drawn from 146 participants with severe mental illness, co-occurring PTSD and elevated psychotic symptoms participating in a randomized controlled trial comparing two interventions for PTSD among people with severe mental illness. We examined the clinical and demographic correlates of insight at baseline, the relationship between baseline insight and treatment participation, the relationship between treatment participation and post-treatment insight, and the relationship between change in insight and change in other clinical variables. Impaired insight was relatively common, with roughly half the sample demonstrating mild or moderate impairment at baseline. Baseline insight was associated with fewer psychotic and disorganized symptoms, and greater emotional discomfort and PTSD knowledge, but was not associated with negative symptoms, PTSD symptoms, depression/anxiety, or treatment participation. Participation in PTSD treatment was associated with increased insight at post-treatment. Improved insight was associated with improvements in disorganization and negative symptoms, but not with knowledge of PTSD or positive symptoms. The findings suggest that engagement in treatment that includes educating people about PTSD may lead to improvements in insight and related improvements in other psychiatric symptoms.",Yanos PT.; Vayshenker B.; Pleskach P.; Mueser KT.,2016.0,10.1016/j.comppsych.2016.04.016,0,0,
2697,Clinical observation on the treatment of cervicogenic headache by muscular acupuncture stimulation therapy,,"Yang, X C; Zhou, Y M; Lv, M; Wang, X C; Qiu, Z L",2009.0,,0,0,
2698,[The impact of early restrictive positive fluid balance strategy on the prognosis of patients with severe trauma].,"To observe the impact of early restrictive positive fluid balance strategy on the prognosis of patients with trauma. A prospective controlled study was conducted. The patients with severe post-trauma capillary leak syndrome (PTCLS) admitted to department of critical care medicine of the Fifth Center Hospital in Tianjin were considered as study object. Fluid treatment was adjusted according to intra-thoracic blood volume index (ITBVI), mean arterial pressure (MAP), cardiac index (CI) and oxygen saturation of central vein (ScvO2) at leakage stage of PTCLS. Patients were divided into two groups according to different fluid therapy volume, restrictive positive fluid balance group (restrictive group) and non-restrictive positive fluid balance group (non-restrictive group), 30 patients were enrolled into each group. The fluid balance volume and index of prognosis between two groups were analyzed within 7 days of treatment. During the leakage stage of PTCLS, compared with non-restrictive group, fluid positive volume of the restrictive group were decreased at 1-6 days of the treatment (1 day: 5968.8±1818.0 ml/d vs. 7109.7±2186.41 ml/d, 2 days: 3653.7±1525.1 ml/d vs. 6080.3±1538.8 ml/d, 3 days: 1953.6±621.3 ml/d vs. 3223.3±875.1 ml/d, 4 days: -2808.7±888.0 ml/d vs. -4169.9±1302.5 ml/d, 5 days: -5969.1±1470.8 ml/d vs. -6896.5±1619.4 ml/d, 6 days: -1938.1±746.0 ml/d vs. -4964.0±1389.6 ml/d, P<0.05 or P<0.01), ITBVI and extravascular lung water index (EVLWI) were decreased at 2 days and 3 days of the treatment (ITBVI 2 days: 689.2±60.6 ml/m(2) vs. 807.7±67.8 ml/m(2), 3 days: 729.6±43.3 ml/m(2) vs. 825.5±71.5 ml/m(2); EVLWI 2 days: 6.9±2.0 ml/kg vs. 8.3±2.1 ml/kg, 3 days: 7.6±2.0 ml/kg vs. 8.9±1.9 ml/kg, P<0.05 or P<0.01). Compared with non-restrictive group, the occurrence of respiratory dysfunction (46.7% vs. 76.7%), gastrointestinal dysfunction (33.3% vs. 60.0%) and the occurrence of intracranial hypertension (26.7% vs. 56.7%) at 7 days of treatment in restrictive group were decreased (all P<0.05), the time of mechanical ventilation (3.6±1.1 days vs. 5.1±1.5 days) and intensive care unit (ICU) stay time (5.5±1.5 days vs. 7.0±1.9 days) were shortened (both P<0.01). There were no differences in the occurrence of dysfunction of cardiovascular, blood coagulation, hepatic and renal function, the percentage of patients receiving renal-replacement therapy and the number of days with dialysis, as well as the mortality during the first 28 days between two groups (all P>0.05). Using restrictive positive fluid balance strategy in the leakage stage of PTCLS, fluid positive balance volume, occurrence of dysfunction of some organs, mechanical ventilation and ICU stay time can be decreased.",Yang WJ.; Feng QG.; Wei K.; Wang W.; Zhao XF.; Li C.; Cheng XL.,2013.0,10.3760/cma.j.issn.2095-4352.2013.01.010,0,0,
2699,Elevated audiovisual temporal interaction in patients with migraine without aura,"ER BACKGROUND: Photophobia and phonophobia are the most prominent symptoms in patients with migraine without aura. Hypersensitivity to visual stimuli can lead to greater hypersensitivity to auditory stimuli, which suggests that the interaction between visual and auditory stimuli may play an important role in the pathogenesis of migraine. However, audiovisual temporal interactions in migraine have not been well studied. Therefore, our aim was to examine auditory and visual interactions in migraine.METHODS: In this study, visual, auditory, and audiovisual stimuli with different temporal intervals between the visual and auditory stimuli were randomly presented to the left or right hemispace. During this time, the participants were asked to respond promptly to target stimuli. We used cumulative distribution functions to analyze the response times as a measure of audiovisual integration.RESULTS: Our results showed that audiovisual integration was significantly elevated in the migraineurs compared with the normal controls (p?<?0.05); however, audiovisual suppression was weaker in the migraineurs compared with the normal controls (p?<?0.05).CONCLUSIONS: Our findings further objectively support the notion that migraineurs without aura are hypersensitive to external visual and auditory stimuli. Our study offers a new quantitative and objective method to evaluate hypersensitivity to audio-visual stimuli in patients with migraine.","Yang, W; Chu, B; Yang, J; Yu, Y; Wu, J; Yu, S",2014.0,10.1186/1129-2377-15-44,0,0,
2700,Effect of Tongfu Jinghua Decoction on hemodynamics and tissue oxygen metabolism in patients with post-traumatic sepsis shock,"ER OBJECTIVE: To explore the effect of Tongfu Jinghua Decoction (TJD) onhemodynamics and tissue oxygen metabolism in patients with post-traumatic sepsisshock. METHODS: Totally 60 patients were randomly assigned to the treatment groupand the control group, 30 in each group. Patients in the treatment group took TJDor were administered with TJD by nasal feeding in combined with conventionalWestern medical treatment, while patients in the control group only receivedconventional Western medical treatment. Changes of each index in hemodynamics andtissue oxygen metabolism were observed before treatment, and at 6, 12, 24, and 48h after treatment. RESULTS: Compared with before treatment in the same group,hemodynamic changes were significantly improved at each time point in the twogroups. All indices of tissue oxygen metabolism at each time point of the twogroups were significantly improved, except changes of O2 extraction ratio (ER)after treatment in the control group (P < 0.05, P < 0.01). Compared with thecontrol group in the same period, heart rate (HR), systemic vascular resist- ance(SVR), and cardiac output (CO) were significantly improved with statisticaldifference (P < 0.05, P < 0.01). Mean arterial pressure (MAP), central venouspressure (CVP), and cardiac index (CI) were significantly improved at 6, 12, and24 h after treatment with statistical difference (P < 0.05, P < 0.01). Each indexof tissue oxygen metabolism in the treatment group were all improved at each timepoint with statistical difference (P < 0.05, P < 0.01). CONCLUSION: TJD combinedwith conventional Western medical treatment could quickly improve hemodynamicsand tissue oxygen metabolism disorder in patients with septic shock, and itscurative effect was superior to that of conventional Western medical treatmentalone.","Yang, T Z; Li, L Y; Han, L L; Wang, F Y",2014.0,,0,0,
2701,Fear of negative evaluation and the hypervigilance-avoidance hypothesis: An eye-tracking study,"The hypervigilance-avoidance hypothesis assumes that anxious individuals initially attend to and subsequently avoid threatening stimuli. In this study pairs of emotional (angry or happy) and neutral facial expressions were presented to students of high or low fear of negative evaluation (FNE) while their eye movements were recorded. High FNE participants initially looked more often at emotional compared to neutral faces, indicating an attentional bias for emotional facial expressions. This effect was further modulated by the sex of the face, as high FNE clearly showed a preference for happy female faces. Analysis of the time course of attention revealed that high FNE looked at the emotional faces longer during the first second of stimulus exposure, whereas they avoided these faces in the consecutive time interval from 1 to 1.5 s. These results partially support the hypervigilance-avoidance hypothesis and additionally indicate the relevance of happy faces for high FNE. Further research should clarify the meaning of happy facial expressions as well as the influence of the sex of the observed face in social anxiety. © 2008 Springer-Verlag.",Wieser M.J.; Pauli P.; Weyers P.; Alpers G.W.; Mühlberger A.,2009.0,10.1007/s00702-008-0101-0,0,0,
2702,Probing the attentional control theory in social anxiety: An emotional saccade task,"Volitional attentional control has been found to rely on prefrontal neuronal circuits. According to the attentional control theory of anxiety, impairment in the volitional control of attention is a prominent feature in anxiety disorders. The present study investigated this assumption in socially anxious individuals using an emotional saccade task with facial expressions (happy, angry, fearful, sad, neutral). The gaze behavior of participants was recorded during the emotional saccade task, in which participants performed either pro- or antisaccades in response to peripherally presented facial expressions. The results show that socially anxious persons have difficulties in inhibiting themselves to reflexively attend to facial expressions: They made more erratic prosaccades to all facial expressions when an antisaccade was required. Thus, these findings indicate impaired attentional control in social anxiety. Overall, the present study shows a deficit of socially anxious individuals in attentional control - for example, in inhibiting the reflexive orienting to neutral as well as to emotional facial expressions. This result may be due to a dysfunction in the prefrontal areas being involved in attentional control. © 2009 The Psychonomic Society, Inc.",Wieser M.J.; Pauli P.; Mühlberger A.,2009.0,10.3758/CABN.9.3.314,0,0,
2703,Treatment of chronically depressed patients: a multisite randomized controlled trial testing the effectiveness of 'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP) for chronic depressions versus usual secondary care,"ER METHODS/DESIGNThe purpose of the present paper is to report the study protocol of a multisite randomized controlled trial testing the effectiveness of 'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP) for chronic depression in the Netherlands. In this study, CBASP in combination with medication, will be tested versus usual secondary care in combination with medication. The aim is to recruit 160 patients from three mental health care organizations. Depressive symptoms will be assessed at baseline, after 8 weeks, 16 weeks, 32 weeks and 52 weeks, using the 28-item Inventory for Depressive Symptomatology (IDS). Effect modification by co morbid anxiety, alcohol consumption, general and social functioning and working alliance will be tested. GEE analyses of covariance, controlling for baseline value and center will be used to estimate the overall treatment effectiveness (difference in IDS score) at post-treatment and follow up. The primary analysis will be by 'intention to treat' using double sided tests. An economic analysis will compare the two groups in terms of mean costs and cost-effectiveness from a societal perspective.DISCUSSIONThe study will provide an answer to the question whether the favorable effects of CBASP can be replicated outside the US.TRIAL REGISTRATIONThe Dutch Cochrane Center, NTR1090.BACKGROUND'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP) is a form of psychotherapy specifically developed for patients with chronic depression. In a study in the U.S., remarkable favorable effects of CBASP have been demonstrated. However, no other studies have as yet replicated these findings and CBASP has not been tested outside the United States. This protocol describes a randomized controlled trial on the effectiveness of CBASP in the Netherlands.","Wiersma, J E; Schaik, D J; Oppen, P; McCullough, J P; Schoevers, R A; Dekker, J J; Blom, M B; Maas, K; Smit, J H; Penninx, B W; Beekman, A T",2008.0,10.1186/1471-244X-8-18,0,0,
2704,Costs and benefits of hospital and day treatment with community care of affective and schizophrenic disorders.,"A randomised controlled trial of day treatment with community care for patients with schizophrenic and affective disorders, referred for in-patient psychiatric treatment, was conducted to evaluate patterns of treatment and the course of illness with its psychosocial consequences over a period of two years. Seventy patients, of whom 34 had affective and 36 had schizophrenic disorder, were assigned to the experimental condition (day treatment with ambulatory and domiciliary care), and 33 patients, of whom 16 had affective and 17 had schizophrenic disorder, were assigned to the control condition of standard clinical care. Day treatment with community care was feasible for 40.6% of the affective patients and 33.3% of the schizophrenic patients. The direct treatment costs of both disorders, based on numbers of in- and day-patient days and out-patient contacts over two years, appeared more or less the same. Patients benefited equally from day treatment as from in-patient treatment, although there were some gains in self-care and in functioning in the household among experimentals. Although schizophrenics were socioeconomically worse off, and also suffered from more (severe) symptoms and social disabilities than the affective patients at entry into the study, they were similar at two years. This finding is unexpected, compared with other follow-up studies. Extra cost for patients and families were not observed. Patients and their families in the experimental condition were significantly more satisfied with the treatment. Experimental patients spent much more time at home during admission, remained much less time in secluded wards, and were more compliant with treatment. Day treatment could be considered a cost-effective alternative to in-patient treatment.",Wiersma D.; Kluiter H.; Nienhuis FJ.; Rüphan M.; Giel R.,1995.0,,0,0,
2705,Costs and benefits of hospital and day treatment with community care of affective and schizophrenic disorders,"ER METHODSeventy patients, of whom 34 had affective and 36 had schizophrenic disorder, were assigned to the experimental condition (day treatment with ambulatory and domiciliary care), and 33 patients, of whom 16 had affective and 17 had schizophrenic disorder, were assigned to the control condition of standard clinical care.RESULTSDay treatment with community care was feasible for 40.6% of the affective patients and 33.3% of the schizophrenic patients. The direct treatment costs of both disorders, based on numbers of in- and day-patient days and out-patient contacts over two years, appeared more or less the same. Patients benefited equally from day treatment as from in-patient treatment, although there were some gains in self-care and in functioning in the household among experimentals. Although schizophrenics were socioeconomically worse off, and also suffered from more (severe) symptoms and social disabilities than the affective patients at entry into the study, they were similar at two years. This finding is unexpected, compared with other follow-up studies. Extra cost for patients and families were not observed. Patients and their families in the experimental condition were significantly more satisfied with the treatment. Experimental patients spent much more time at home during admission, remained much less time in secluded wards, and were more compliant with treatment.CONCLUSIONSDay treatment could be considered a cost-effective alternative to in-patient treatment.BACKGROUNDA randomised controlled trial of day treatment with community care for patients with schizophrenic and affective disorders, referred for in-patient psychiatric treatment, was conducted to evaluate patterns of treatment and the course of illness with its psychosocial consequences over a period of two years.","Wiersma, D; Kluiter, H; Nienhuis, F J; Rüphan, M; Giel, R",1995.0,,0,0,2704
2706,[Long-term results after mediocarpal and total arthrodesis of the wrist--a matched paired study].,"Indications for total wrist arthrodesis are still a matter of discussion. The aim of this study was to investigate the long-term results (mean 118 +/- 49.5 months) of total wrist arthrodesis (TA) in comparison to mediocarpal arthrodesis (MA). A paired study of the TA group and the MA group was performed including 22 patients after posttraumatic wrist arthrosis in each group. Subjective, objective and radiological parameters were assessed. In addition, the modified Mayo wrist score, the DASH score and the SF-36 were utilized. Mean pain did not differ significantly in both groups. Mean wrist function (DASH) was assessed better by MA patients (25.3 +/- 25.8) compared to TA patients (35.5 +/- 25.9; p > 0.1). Mean total wrist motion in the MA group was 66.1 % of the opposite side. The average grip strength of the TA group was 85.5 % +/- 58.4 % and of the MA group 79.9 % +/- 25.4 % of the uninvolved wrist. The Mayo score of the MA group (56.4 +/- 12.4) was significantly higher than in the TA group (65.9 +/- 16.3; p = 0.04). The SF-36 showed no significant difference between both groups. In self-assessment, pain was of higher importance then wrist motion. According to our findings the type of arthrodesis did not influence patient satisfaction. Total wrist arthrodesis should not be excluded categorically as a possible alternative to mediocarpal arthrodesis.",Wieloch PT.; Martini AK.; Jung M.; Daecke W.,,10.1055/s-2005-872527,0,0,
2707,"Efficacy of a comprehensive program for reducing stress in women: a prospective, randomized trial","ER OBJECTIVE: This study evaluated the efficacy of a comprehensive stress management program in reducing perceived stress among women who reported moderate-to-high stress levels. METHODS: A total of 562 highly motivated females, aged 25-45, with moderate to high stress levels, were enrolled in a 14-week study. Participants were randomized into one of three groups: Group 1 included Internet-based coaching focusing on behavior modification, daily use of proprietary olfactive-based personal care products, and periodic feedback reports; Group 2 consisted of only online coaching; and Group 3 had no active stress management program. Participants in the three groups filled out validated psychometric assessments at baseline and throughout the study period. Several outcomes including Perceived Stress Scale (PSS), Profile of Mood States (POMS), St Mary's Hospital Sleep Questionnaire (SMS), the Trier Inventory of Chronic Stress (TICS), Spielberger State-Trait Anxiety Inventory (STAI), Short-Form-36 (SF-36) and the Work Productivity and Activity Impairment (WPAI), were measured periodically to assess changes in subject-perceived stress, stress-related comorbidities, and sleep quality and to evaluate overall program efficacy. Ethical approval of protocols was conducted by the Allendale Investigational Review Board (AIRB). Voluntary informed consent was obtained from each subject. RESULTS: At the end of the 14-week study period, subjects in Group 1 had statistically significant improvement in the PSS score vs. Group 3 (p < 0.01). There were statistically significant improvements in other efficacy outcomes such as POMS total mood disturbance, TICS work overload and social responsibility subscales, STAI and in the number of night awakenings, assessed by the SMS questionnaire (p < 0.05). Self-reported program efficacy was also significantly higher for Group 1 (p < 0.001). CONCLUSION: Despite study limitations, including reduction of stress in Group 3, this study demonstrates that this comprehensive stress management program is effective in reducing stress among women with moderate to high stress levels.","Wiegand, B; Luedtke, K; Friscia, D; Nair, M; Aleles, M; McCloskey, R",2010.0,10.1185/03007991003688193,0,0,
2708,Virtual reality exposure therapy vs. imagery desensitization therapy in the treatment of flying phobia.,"This study examined the value of virtual reality graded exposure therapy (VRGET) compared to standard graded exposure therapy using imagery alone for patients with flying phobia. Thirty subjects (mean age 39.8 yrs) were randomized into either VRGET with physiological feedback of skin resistance, peripheral skin temperature, heart rate, and respiration; VRGET with no physiological feedback, or imagery conditions. Patients in all conditions were first taught to relax (for two sessions) and then exposed in six subsequent sessions to flying stimuli (either through a virtual airplane with visual and somatic stimuli, or through producing mental images). Results showed that subjects in all three conditions were equally physiologically and subjectively aroused throughout the exposure series. However while only 20% of imagery patients flew after 8 weeks of therapy, 80% of VR patients receiving no physiological feedback and 100% of VR patients receiving physiological feedback were able to fly without using medications (p<.001). This is the first study to compare the benefit of virtual reality graded exposure therapy to graded exposure using imagery alone. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wiederhold, Brenda K; Gevirtz, Richard N; Spira, James L; Agras, Beckham, Borkovec, Borkovec, Botella, Botella, Botella, Botella, Bullinger, Carlin, Denholtz, Denholtz, Doctor, Emmelkamp, Foa, Foa, Forgione, Girodo, Glantz, Greco, Greist, Haug, Hodges, Hodges, Howard, Huang, Jang, Kalawsky, Keppel, Kosslyn, North, North, North, Regan, Roberts, Rothbaum, Rothbaum, Rothbaum, Rothbaum, Schwartz, Scott, Solyom, Spielberger, Stevens, Walder, Wiederhold, Wiederhold, Wiederhold, Wiederhold, Wolpe, Wolpe; Riva, Giuseppe [Ed], Galimberti, Carlo [Ed]",2001.0,,0,0,
2709,Three-year follow-up for virtual reality exposure for fear of flying.,"Thirty participants who had been treated for aviophobia with virtual reality graded exposure therapy with physiological monitoring and visual feedback (VRGETpm), virtual reality graded exposure therapy with physiological monitoring only (VRGETno), or imaginal exposure therapy (visualization) with physiological monitoring only (IET) between January 1998 and January 1999 were contacted in January 2002 for a 3-year posttreatment follow-up assessment. Of the participants in the VRGETpm group who had flown successfully by the end of treatment, all had maintained their ability to fly at follow-up. Of the participants in the VRGETno group who had flown successfully by the end of treatment, two were no longer able to fly. Of the participants in the IET group who had flown successfully, all were still able to fly. It appears that the addition of teaching self-control via visual feedback of physiological signals may serve to maintain treatment gains in long-term follow-up.",Wiederhold BK.; Wiederhold MD.,2003.0,10.1089/109493103322278844,0,0,
2710,Depression and anxiety following psychosis: associations with mindfulness and psychological flexibility.,"Individuals experiencing psychosis can present with elevated levels of depression and anxiety. Research suggests that aspects of depression and anxiety may serve an avoidant function by limiting the processing of more distressing material. Acceptance and Commitment Therapy suggests that avoidance of aversive mental experiences contributes to psychological inflexibility. Depression and anxiety occurring in the context of psychosis have a limiting effect on quality of life. No research to date has investigated how levels of psychological flexibility and mindfulness are associated with depression and anxiety occurring following psychosis. This study investigated associations psychological flexibility and mindfulness had with depression and anxiety following psychosis. Thirty participants with psychosis were recruited by consecutive referral on the basis that they were experiencing emotional dysfunction following psychosis. The Hospital Anxiety and Depression Scale (HADS), Positive and Negative Syndrome Scale (PANSS), Acceptance and Action Questionnaire (AAQ-II) and the Kentucky Inventory of Mindfulness Skills (KIMS) were used. A cross-sectional correlational design was used. The depression and anxiety subscales of the HADS both had significant correlations with psychological flexibility (as assessed by the AAQ-II) and aspects of mindfulness (as assessed by the KIMS). Hierarchical regression analyses indicated that psychological flexibility, but not mindfulness, contributed significantly to models predicting 46% of variance in both depression and anxiety scores. Although aspects of mindfulness are associated with depression and anxiety following an episode of psychosis, psychological flexibility appears to account for a larger proportion of variance in depression and anxiety scores in this population.",White RG.; Gumley AI.; McTaggart J.; Rattrie L.; McConville D.; Cleare S.; Mitchell G.,2013.0,10.1017/S1352465812000239,0,0,
2711,Cascading effects: The influence of attention bias to threat on the interpretation of ambiguous information,"Both attention bias to threat and negative interpretive bias have been implicated in the emergence and maintenance of anxiety disorders. However, relations between attention and interpretive biases remain poorly understood. The current study experimentally manipulated attention bias to threat and examined the effects of attention training on the way ambiguous information was interpreted. Results suggest that the preferential allocation of attention towards threat affects the manner in which ambiguous information is interpreted. Individuals trained to attend to threat were more likely than individuals in a placebo training group to interpret ambiguous information in a threat-related manner. These data suggest that perturbations in the initial stages of information processing associated with anxiety may lead to a cascade of subsequent processing biases. © 2011 Elsevier Ltd.",White L.K.; Suway J.G.; Pine D.S.; Bar-Haim Y.; Fox N.A.,2011.0,10.1016/j.brat.2011.01.004,0,0,
2712,Attrition in a multicenter clinical trial for panic disorder.,"This study examined attrition in a multisite clinical trial for panic disorder. Of 379 eligible patients, 19 refused treatment (5% Refusal Rate), 104 discontinued treatment prematurely (19% Dropout Rate) or were withdrawn by the investigators (8% Withdrawal Rate), and 256 completed the treatment (68% Completion Rate). Logistic regression was used to examine 5 domains theorized to be related to attrition (e.g., diagnostic severity, treatment factors). Few variables were associated with increased odds of attrition at padj < 0.004. Younger age was the only independent predictor of attrition in the demographic factor model. Diagnostic severity and comorbidity, panic disorder symptom severity, treatment factors, and therapist factors were unrelated to study attrition. Patient dropout was highest after treatment sessions that targeted interoceptive and situational exposure exercises. Findings suggest that attrition may not strongly threaten the validity of results from treatment outcome studies.",White KS.; Allen LB.; Barlow DH.; Gorman JM.; Shear MK.; Woods SW.,2010.0,10.1097/NMD.0b013e3181ef3627,0,0,
2713,"""Stresspac"": Three-year follow-up of a controlled trial of self-help package for the anxiety disorders.","In order to test the efficacy of a self-help anxiety management package, 62 anxiety disorder patients were randomly allocated to one of three conditions. ""Stresspac"" patients were given a self-help package, ""Advice Only"" patients were offered verbal advice on ways of coping. Patients in both conditions were seen on one occasion shortly after referral for assessment and management advice. They were then placed back on the waiting list for a three-month period. Patients in the ""No Intervention"" condition also completed measures during this time. They were formally assessed at the end of this period. All patients were then followed through therapy. Results from a previous paper clearly indicated the superiority of the Stresspac condition at all data points up to one year follow-up. This paper looks at three-year follow-up and, while finding generally good outcome across conditions, finds further evidence of the superiority of the Stresspac condition on a range of measures. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","White, Jim",1998.0,,0,0,
2714,EMDR and hypnosis: A theoretical and clinical investigation.,"Eye Movement Desensitization and Reprocessing (EMDR) is a controversial new treatment for anxiety disorders that is proported to evince rapid and lasting treatment gains. EMDR theorists argue that humans have an innate biological drive to process events and their memories into adaptive and useful forms. Traumatic memories become ""stuck"" and unprocessed, resulting in a host of psychopathological symptoms. EMDR's curative power rests primarily in the eye movements. Shapiro argues that the eye movements directly access and alter traumatic memories at a neurophysiological level. Memories are then processed down into adaptive forms, with a concomitant abatement of symptoms. Research supports the clinical efficacy of EMDR. However, there is much debate as to the actual mutative element in the EMDR protocol. Support for eye movements playing a curative role is meager and equivocal. This study examines the proposition that the primary mutative component of EMDR is response to suggestion. Specifically, this study proposes that the EMDR treatment protocol is laced with suggestion for improvement. Highly hypnotizable individuals will respond to these suggestions even though EMDR is an explicitly nonhypnotic treatment. That is, subjects will improve to the extent they respond to suggestion. Further, this study tests the viability of Shapiro's eye movement theory. An eye movement condition is compared to an eye fixation condition in terms of treatment outcome. Results indicate a positive correlation between subjects' hypnotizability and treatment outcome. In addition, eye movement conditions were as efficacious as eye fixation conditions where treatment outcome is concerned. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Whalen, Jonathan Earle",1999.0,,0,0,
2715,Evaluation of Healing by Gentle Touch for the Treatment of Musculoskeletal Disorders.,"All new patients with various musculoskeletal ailments attending The Centre for Complementary Care between 1995 and 2001 were invited to participate in a questionnaire-based study to evaluate a first course of 4 treatment sessions using gentle touch. The questionnaires included specific characteristics of the patients, expectations of treatment outcomes (entry questionnaire), and subjective scores for physical (pain, disability, immobility, sleep disturbances, ability to carry out usual activities) and psychological (stress, panic, fear, anger, relaxation, coping ability, depression/anxiety) functioning and quality of life. Symptom scoring was based on a 10-item visual analog scale questionnaire and the EuroQoL (EQ-5D), an extensively used and validated generic health status measure. Diagnostic labels provided by the patient were back pain/injury (30 patients), joint pain/injury (15), osteoarthritis (26), and rheumatoid arthritis (5). Patients with the most severe symptoms on entry recorded the greatest improvements in visual analog scale scores for stress, pain, sleep patterns, and coping ability. These findings are highly generalizable and justify evaluation of healing by prospective, randomized controlled trials and study of long-term effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Weze, Clare; Leathard, Helen L; Stevens, Gretchen; Birchfield, Brazier, Dorman, Doucette, Hurst, Jones, Luff, MacManaway, Marks, Stevens, Tiplady, Van Agt",2004.0,,0,0,
2716,Evaluation of healing by gentle touch.,"To evaluate the effectiveness and safety of healing by gentle touch in clients attending The Centre for Complementary Care (CCC) in Eskdale, Cumbria. An evaluation of data collected by questionnaire over 6 years. All clients attending the CCC between 1995 and 2001 were invited to participate in this study, and data were collected from 300 subjects with a wide range of ailments who received four treatment sessions within 6 weeks. Exclusion criteria were: recent treatment at the CCC; failure to complete four treatment sessions; and age under 16 years. Outcome measures included comparison of pre- and post-treatment levels of physical (pain, disability, immobility, sleep disturbances, reliance upon medication, daily activities) and psychological (stress, panic, fear, anger, relaxation, coping, depression/anxiety) functioning; these were assessed using a questionnaire with visual analogue scales for subjective rating of symptoms and the EuroQoL (EQ-5D), a generic state-of-health measure. Wilcoxon signed ranks tests showed statistically significant improvements in both psychological and physical functioning, particularly in stress reduction (median stress levels fell by four points), pain relief (median pain ratings fell by two points), increased ability to cope (median improvement of three points) and increased general health ratings (median improvement of 20 points) between study entry and end of treatment (P < 0.0004 for all these symptoms). The most substantial improvements were seen in those with the most severe symptoms at study entry. No adverse effects of treatment were documented. This audit of treatment outcomes provides evidence consistent with the hypothesis that healing, as provided at the CCC, was associated with improved psychological and physical functioning in the majority of subjects, and is worthy of further evaluation.",Weze C.; Leathard HL.; Grange J.; Tiplady P.; Stevens G.,2005.0,10.1016/j.puhe.2004.03.003,0,0,
2717,Connecting Emergency Department Patients to Primary Care,"ER Background: Inappropriate emergency department (ED) use among Medicaid enrollees is considered a problem because of cost. We developed and evaluated a system change innovation designed to remove system barriers to primary care access for Medicaid patients. Methods: Patients who presented to the ED without an identified primary care provider were randomized to the intervention (n = 72) or comparison group (n = 68) for a 12-month study designed to connect these patients to primary care offices. Evaluation was mixed quantitative/qualitative. Results: Significantly more intervention participants attended at least 1 primary care visit 3 months after the intervention (odds ratio [OR], 2.52; 95% confidence interval [CI], 1.06-6.02), though this difference was not significant by 12 months (OR, 1.74; 95% CI, 0.79-3.84). The intervention participants also did not have lower odds of returning to the ED for nonurgent reasons by the 12-month follow-up (OR, 1.27; 95% CI, 0.65-2.48). Patient-reported barriers to attending a primary care appointment were primarily social and health system-related factors. Conclusion: The intervention did not decrease ED visits nor increase primary care use over the 12 months of the study period. The qualitative results provide insight into nonurgent ED utilization by patients with Medicaid, suggesting potential future interventions.","Wexler, R; Hefner, J L; Sieck, C; Taylor, C A; Lehman, J; Panchal, A R; Aldrich, A; McAlearney, A S",2015.0,10.3122/jabfm.2015.06.150044,0,0,
2718,Does rapid genetic counseling and testing in newly diagnosed breast cancer patients cause additional psychosocial distress? results from a randomized clinical trial,"ER Purpose:Female breast cancer patients carrying a BRCA1/2 mutation have an increased risk of second primary breast cancer. Rapid genetic counseling and testing (RGCT) before surgery may influence choice of primary surgical treatment. In this article, we report on the psychosocial impact of RGCT.Methods:Newly diagnosed breast cancer patients at risk for carrying a BRCA1/2 mutation were randomized to an intervention group (offer of RGCT) or a usual care control group (ratio 2:1). Psychosocial impact and quality of life were assessed with the Impact of Events Scale, Hospital Anxiety and Depression Scale, Cancer Worry Scale, and the EORTC QLQ-C30 and QLQ-BR23. Assessments took place at study entry and at 6- and 12-month follow-up visits.Results:Between 2008 and 2010, 265 patients were recruited into the study. Completeness of follow-up data was more than 90%. Of the 178 women in the intervention group, 177 had genetic counseling, of whom 71 (40%) had rapid DNA testing and 59 (33%) received test results before surgery. Intention-to-treat and per-protocol analyses showed no statistically significant differences between groups over time in any of the psychosocial outcomes.Conclusions:In this study, RGCT in newly diagnosed breast cancer patients did not have any measurable adverse psychosocial effects.","Wevers, M R; Ausems, M G; Verhoef, S; Bleiker, E M; Hahn, D E; Brouwer, T; Hogervorst, F B; Luijt, R B; Dalen, T; Theunissen, E B; Ooijen, B; Roos, M A; Borgstein, P J; Vrouenraets, B C; Vriens, E; Bouma, W H; Rijna, H; Vente, J P; Kieffer, J M; Valdimarsdottir, H B; Rutgers, E J; Witkamp, A J; Aaronson, N K",2016.0,10.1038/gim.2015.50,0,0,
2719,Serotonin receptor sensitivity and aggression.,"Investigated the relationship between increased serotonin 5-hydroxytryptamine (5-HT) receptor sensitivity and human aggression. A low oral dose of meta-chlorophenylpiperazine (MCPP), a postsynaptic 5-HT receptor agonist, was administered in a placebo-controlled design to 22 depressed and 20 panic disorder patients classified with or without signs of outwardly directed aggression (ODA), 11 patients with a history of suicide attempts (inwardly directed aggression), and 19 normal controls. MCPP did not induce or reduce anger. Patients with ODA did not have significantly greater MCPP-induced cortisol or prolactin release than did patients without signs of ODA. Patients with a history of suicide attempts did not have significantly greater MCPP-induced cortisol or prolactin release than controls. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wetzler, Scott; Kahn, Rene S; Asnis, Gregory M; Korn, Martin; Van Praag, Herman M",1991.0,,0,0,
2720,Post-traumatic stress symptoms in patients undergoing autologous stem cell transplantation.,"The aim of this explorative study was prospectively to evaluate the presence of post-traumatic stress symptoms (PTSS) in patients with hematological malignant disorders undergoing autologous stem cell transplantation (ASCT). The findings were related to sense of coherence and quality of life aspects. Twenty patients were evaluated with four standardized instruments before undergoing ASCT and then at two follow-ups. The patients participating in the study reported PTSS levels high enough to merit attention. Although PTSS declined over time, the levels were still high compared with other studied populations of cancer patients. Intrusive and avoidant symptoms correlated significantly to anxiety and depression but not to sense of coherence and physical dimensions. The high levels of PTSS and their relation to emotional distress emphasize the importance of psychosocial care for this group of patients.",Wettergren L.; Langius A.; Björkholm M.; Björvell H.,1999.0,,0,0,
2721,Effects of emotional disclosure on psychological and physiological outcomes in patients with rheumatoid arthritis: an exploratory home-based study,"ER The effects of an exploratory, home-based emotional disclosure intervention on psychological and physiological outcomes were assessed in patients with rheumatoid arthritis. Patients were randomly assigned to a disclosure group (n = 19) in which they wrote/talked about traumatic personal experiences, or to a control group (n = 15) in which they wrote/talked about the events of a particular day. Participants undertook these tasks for periods of 20 minutes on 4 consecutive days. The disclosure group demonstrated increases in negative mood and objective markers of disease activity at 1 week post-intervention. However, there were significant trends for the disclosure group to demonstrate minor improvements in mood and stability in disease activity, compared with the control group. These group differences appeared to be due to deteriorations in the control group more than improvements in the disclosure group.","Wetherell, M A; Byrne-Davis, L; Dieppe, P; Donovan, J; Brookes, S; Byron, M; Vedhara, K; Horne, R; Weinman, J; Miles, J",2005.0,10.1177/1359105305049778,0,0,
2722,Antidepressant medication augmented with cognitive-behavioral therapy for generalized anxiety disorder in older adults.,"OBJECTIVE Generalized anxiety disorder is common among older adults and leads to diminished health and cognitive functioning. Although antidepressant medications are efficacious, many elderly individuals require augmentation treatment. Furthermore, little is known about maintenance strategies for older people. The authors examined whether sequenced treatment combining pharmacotherapy and cognitive-behavioral therapy (CBT) boosts response and prevents relapse in older adults with generalized anxiety disorder. METHOD Participants were individuals at least 60 years of age with generalized anxiety disorder (N=73) who were recruited from outpatient clinics at three sites. Participants received 12 weeks of open-label escitalopram and were then randomly assigned to one of four conditions: 16 weeks of escitalopram (10-20 mg/day) plus modular CBT, followed by 28 weeks of maintenance escitalopram; escitalopram alone, followed by maintenance escitalopram; escitalopram plus CBT, followed by pill placebo; and escitalopram alone, followed by placebo. RESULTS Escitalopram augmented with CBT increased response rates on the Penn State Worry Questionnaire but not on the Hamilton Anxiety Rating Scale compared with escitalopram alone. Both escitalopram and CBT prevented relapse compared with placebo. CONCLUSIONS This study demonstrates effective strategies for treatment of generalized anxiety disorder in older adults. The sequence of antidepressant medication augmented with CBT leads to worry reduction in the short-term. Continued medication prevents relapse, but for many individuals, CBT would allow sustained remission without requiring long-term pharmacotherapy.",Wetherell JL.; Petkus AJ.; White KS.; Nguyen H.; Kornblith S.; Andreescu C.; Zisook S.; Lenze EJ.,2013.0,10.1176/appi.ajp.2013.12081104,0,0,
2723,Age differences in treatment response to a collaborative care intervention for anxiety disorders.,"Some data suggest that older adults with anxiety disorders do not respond as well to treatment as do younger adults. We examined age differences in outcomes from the Coordinated Anxiety Learning and Management (CALM) study, an effectiveness trial comparing usual care to a computer-assisted collaborative care intervention for primary care patients with panic disorder, generalised anxiety disorder, post-traumatic stress disorder (PTSD), and/or social anxiety disorder. This is the first study to examine the efficacy of a collaborative care intervention in a sample that included both younger and older adults with anxiety disorders. We hypothesised that older adults would show a poorer response to the intervention than younger adults. We examined findings for the overall sample, as well as within each diagnostic category (clinicaltrials.gov identifier: NCT00347269). The CALM intervention was more effective than usual care among younger adults overall and for those with generalised anxiety disorder, panic disorder and social anxiety disorder. Among older adults, the intervention was effective overall and for those with social anxiety disorder and PTSD but not for those with panic disorder or generalised anxiety disorder. The effects of the intervention also appeared to erode by the 18-month follow-up, and there were no significant effects on remission among the older adults. These results are consistent with the findings of other investigators suggesting that medications and psychotherapy for anxiety disorders may not be as effective for older individuals as they are for younger people.",Wetherell JL.; Petkus AJ.; Thorp SR.; Stein MB.; Chavira DA.; Campbell-Sills L.; Craske MG.; Sherbourne C.; Bystritsky A.; Sullivan G.; Roy-Byrne P.,2013.0,10.1192/bjp.bp.112.118547,0,0,
2724,Modular psychotherapy for anxiety in older primary care patients.,"To develop and test a modular psychotherapy protocol in older primary care patients with anxiety disorders. Randomized, controlled pilot study. University-based geriatric medicine clinics. Thirty-one elderly primary care patients with generalized anxiety disorder or anxiety disorder not otherwise specified. Modular form of psychotherapy compared with enhanced community treatment. Self-reported, interviewer-rated, and qualitative assessments of anxiety, worry, depression, and mental health-related quality of life. Both groups showed substantial improvements in anxiety symptoms, worry, depressive symptoms, and mental health-related quality of life. Most individuals in the enhanced community treatment condition reported receiving medications or some other form of professional treatment for anxiety. Across both conditions, individuals who reported major life events or stressors and those who used involvement in activities as a coping strategy made smaller gains than those who did not. Results suggest that modular psychotherapy and other treatments can be effective for anxiety in older primary care patients. Results further suggest that life events and coping through increased activity may play a role in the maintenance of anxiety in older adults.",Wetherell JL.; Ayers CR.; Sorrell JT.; Thorp SR.; Nuevo R.; Belding W.; Gray E.; Stanley MA.; Areán PA.; Donohue M.; Unützer J.; Ramsdell J.; Xu R.; Patterson TL.,2009.0,10.1097/JGP.0b013e3181a31fb5,0,0,
2725,Acceptance and Commitment Therapy for generalized anxiety disorder in older adults: a preliminary report.,"Some evidence suggests that acceptance-based approaches such as Acceptance and Commitment Therapy (ACT) may be well-suited to geriatric generalized anxiety disorder (GAD). The primary goal of this project was to determine whether ACT was feasible for this population. Seven older primary-care patients with GAD received 12 individual sessions of ACT; another 9 were treated with cognitive-behavioral therapy. No patients dropped out of ACT, and worry and depression improved. Findings suggest that ACT may warrant a large-scale investigation with anxious older adults.",Wetherell JL.; Afari N.; Ayers CR.; Stoddard JA.; Ruberg J.; Sorrell JT.; Liu L.; Petkus AJ.; Thorp SR.; Kraft A.; Patterson TL.,2011.0,10.1016/j.beth.2010.07.002,0,0,
2726,Preparing Clients for Cognitive Behavioral Therapy: A Randomized Pilot Study of Motivational Interviewing for Anxiety.,"Although CBT is a well-supported treatment for anxiety, recovery rates and compliance with treatment procedures are less than optimal. Using adjunctive brief preparatory interventions may help bolster response rates and engagement with therapy procedures. Motivational Interviewing (MI: Miller, W. R., & Rollnick, S. (1991, 2002). Motivational interviewing: preparing people to change addictive behavior. New York: Guilford) is a client-centered, directive method for enhancing motivation for change and has been demonstrated to be a valuable treatment prelude in the addictions domain. Prior to group cognitive behavioral therapy, 55 individuals with a principal anxiety diagnosis (45% panic disorder, 31% social phobia, and 24% generalized anxiety disorder) were randomly assigned to receive either three sessions of MI adapted for anxiety or no pretreatment (NPT). The MI pretreatment group, compared to NPT, showed significantly higher expectancy for anxiety control and greater homework compliance in CBT. Although both groups demonstrated clinically significant anxiety symptom improvements, the MI pretreatment group had a significantly higher number of CBT responders compared to NPT. At 6-month follow-up, both groups evidenced maintenance of gains. These results provide suggestive evidence that brief pretreatments, such as MI, may enhance engagement with and outcome from CBT. The promising results also justify the future investigation of these effects using more powerful designs which may discern whether the effects are specific to MI or to some type of pretreatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Westra, Henny A; Dozois, David J. A; Arkowitz, Arkowitz, Arkowitz, Beck, Borkovec, Borkovec, Brown, Burke, Burns, Burns, Chambless, Chambless, Chambless, Colesa, Collins, Collins, Connors, Craske, Craske, Detweiler, Dozois, Dozois, Dozois, Dugas, Engle, Frank, Franklin, Garfield, Hoehn-Saric, Humfress, Huppert, Huppert, Jacobson, Kazantzis, Kemp, Kemp, Leahy, Leary, Leger, Maller, Maltby, Martino, Meyer, Miller, Miller, Murphy, Murphy, O'Hare, Orne, Peterson, Safren, Schmidt, Spitzer, Swanson, Tolin, Walitzer, Watson, Westen, Westra, Westra, Westra, Westra, Westra, Westra, Westra, Westra",2006.0,,0,0,
2727,Integrating motivational interviewing with cognitive-behavioral therapy for severe generalized anxiety disorder: An allegiance-controlled randomized clinical trial.,"Objective: Although integrating motivational interviewing (MI) and cognitive-behavioral therapy (CBT) has been recommended for treating anxiety, few well-controlled tests of such integration exist. Method: In the present randomized trial for severe generalized anxiety disorder (GAD), we compared the efficacy of 15 sessions of CBT alone (N = 43) versus 4 MI sessions followed by 11 CBT sessions integrated with MI to address client resistance/ambivalence (N = 42). Clients were adults, predominantly female and Caucasian, with a high rate of diagnostic comorbidity. To control for allegiance, therapists were nested within treatment group and supervised separately by experts in the respective treatments. Results: Piecewise multilevel models revealed no between-groups differences in outcomes from pre- to posttreatment; however, there were treatment effects over the follow-up period with MI-CBT clients demonstrating a steeper rate of worry decline (gamma = -0.13, p = .03) and general distress reduction (gamma = -0.12, p = .01) than CBT alone clients. Also, the odds of no longer meeting GAD diagnostic criteria were ~5 times higher at 12-months for clients receiving MI-CBT compared with CBT alone. There were also twice as many dropouts in CBT alone compared with MI-CBT (23% vs. 10%); a difference that approached significance (p = .09). The treatments were competently delivered, and intraclass correlations revealed negligible between-therapist effects on the outcomes. Conclusions: The findings support the integration of MI with CBT for severe GAD and point to the importance of training therapists in appropriate responsivity to in-session markers of resistance and ambivalence. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Impact Statement What is the public health significance of this article?-This study highlights that assimilating MI strategies into CBT for GAD results in better longer-term outcomes than CBT alone. Thus, standard CBT for this debilitating condition can be improved by training therapists to notice markers of client resistance and ambivalence, and to shift in these moments to interventions marked by empathy, collaboration, and client-centeredness. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Westra, Henny A; Constantino, Michael J; Antony, Martin M; Altman, Angus, Antony, Aspland, Aviram, Aviram, Bagoien, Bandura, Beck, Beutler, Bohart, Bohart, Borkovec, Borkovec, Brown, Buffett-Jerrott, Burns, Campbell-Sills, Carney, Constantino, Cote, Covin, Craske, Cuijpers, Dugas, Durham, Faris, First, Gillis, Greenberg, Haby, Hara, Hayes-Skelton, Henry, Hunot, Jacobson, Kazantzis, Lombardi, Lovibond, Lundahl, Meyer, Miller, Miller, Miller, Molina, Moyers, Munder, Murphy, Newman, Powers, Raudenbush, Raudenbush, Riper, Rogers, Shaw, Stiles, Wampold, Waters, Wells, Westen, Westra, Westra, Westra, Westra, Young, Zickgraf, Zinbarg",2016.0,,0,0,
2728,Adding a motivational interviewing pretreatment to cognitive behavioral therapy for generalized anxiety disorder: A preliminary randomized controlled trial.,"Seventy-six individuals with a principal diagnosis of generalized anxiety disorder (GAD) were randomly assigned to receive either an MI pretreatment or no pretreatment (NPT), prior to receiving CBT. Significant group differences favoring the MI-CBT group were observed on the hallmark GAD symptom of worry and on therapist-rated homework compliance, which mediated the impact of treatment group on worry reduction. Adding MI pretreatment to CBT was specifically and substantively beneficial for individuals with high worry severity at baseline. There was evidence of relapse at 6-month follow-up for high severity individuals who received MI-CBT, but significant moderator effects favoring the high severity MI-CBT group were again apparent at 12-months post-treatment. Pending replication in a more controlled test, these findings suggest that MI may be a promising adjunct to CBT for GAD for those of high severity, a group which has been less responsive to CBT in past research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Westra, Henny A; Arkowitz, Hal; Dozois, David J. A; Altman, Antony, Arkowitz, Barlow, Baron, Behar, Bieling, Borkovec, Borkovec, Borkovec, Borkovec, Borkovec, Brown, Brown, Brown, Brown, Bryant, Buckner, Burke, Butler, Campbell, Cartwright-Hatton, Cohen, Covin, Deci, Dugas, Durham, Freeston, Gillis, Gosselin, Guy, Handmaker, Heimberg, Hettema, Hirschfeld, Hodgins, Jacobson, Katon, Kertes, Ladouceur, Lovibond, Mendlowicz, Meyer, Miller, Molina, Moyers, Newman, Pelletier, Primakoff, Robichaud, Rogers, Ruscio, Shaw, Sheehan, Sheehan, Simpson, Sobel, Taft, Wells, Wells, Westra, Westra, Westra, Westra, Westra, Young, Zaider",2009.0,,0,0,
2729,Comparing the predictive capacity of observed in-session resistance to self-reported motivation in cognitive behavioral therapy.,"Self-report measures of motivation for changing anxiety have been weakly and inconsistently related to outcome in cognitive behavioral therapy (CBT). While clients may not be able to accurately report their motivation, ambivalence about change may nonetheless be expressed in actual therapy sessions as opposition to the direction set by the therapist (i.e., resistance). In the context of CBT for generalized anxiety disorder, the present study compared the ability of observed in-session resistance in CBT session 1 and two self-report measures of motivation for changing anxiety (the Change Questionnaire & the Client Motivational for Therapy Scale) to (1) predict client and therapist rated homework compliance (2) predict post-CBT and one-year post-treatment worry reduction, and (3) differentiate those who received motivational interviewing prior to CBT from those who received no pre-treatment. Observed in-session resistance performed very well on each index, compared to the performance of self-reported motivation which was inconsistent and weaker relative to observed resistance. These findings strongly support both clinician sensitivity to moments of client resistance in actual therapy sessions as early as session 1, and the inclusion of observational process measures in CBT research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Westra, Henny A; Aharonovich, Ahmed, Amrhein, Antony, Arkowitz, Aviram, Beutler, Beutler, Binder, Bischoff, Borkovec, Borkovec, Borkovec, Brogan, Brown, Brown, Bryant, Burns, Chamberlain, Chamberlain, De Haan, Deci, Dozois, Engle, Geller, Jungbluth, Kampman, Keijsers, Keijsers, Keijsers, Keijsers, Keithly, McConnaughy, McHugh, Meyer, Miller, Miller, Miller, Moyers, Moyers, Newman, Patterson, Pelletier, Primakoff, Safran, Shirk, Taft, Vogel, Watson, Westra, Westra, Westra, Westra, Westra, Westra, Zuroff",2011.0,,0,0,
2730,Metacognitive therapy for PTSD: A preliminary investigation of a new brief treatment.,"The effectiveness of a new treatment for post traumatic stress disorder (PTSD) is addressed. Treatment was based on a metacognitive theory of mechanisms by which natural traumatic processing is enabled or hindered by coping strategies. It suggests that elimination of worry/rumination, of maladaptive attention strategies, and enhancing metacognitive flexibility, will permit natural processing and a return to normal cognition. An A-B direct replication series (n=6) with follow-up assessments at 3, 6, and 18-41 months was implemented. Treatment commenced 3-10 months post-trauma. All patients showed large and statistically significant improvements in general emotion and specific PTSD measures. Gains were maintained at follow-up. Two further consecutively referred patients were treated at 8 and 12 months posttrauma to add to sample size (n=8). Overall post treatment effect sizes were large, ranging from 3.0 to 5.0. Further evaluations are clearly warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wells, Adrian; Sembi, Sundeep; Barlow, Beck, Beck, Bisson, Butler, Cohen, Cooper, Davidson, First, Foa, Foa, Hammarberg, Hayes, Holeva, Horowitz, Kilic, Marks, Mcfarlane, Nolen-Hoeksema, Nolen-Hoeksema, Richards, Sherman, Sidman, Tarrier, van Etten, Warda, Wells, Wells, Wells, Wells",2004.0,,0,0,
2731,Brief cognitive therapy for social phobia: A case series.,"Social phobia is a common and disabling anxiety disorder. The most effective psychological treatments for social phobia are cognitive therapy and exposure. However, the degree of improvement across these treatments is variable, and their implementation is costly and time-consuming. This study aimed to conduct a preliminary clinical evaluation of the effectiveness of a brief, new form of cognitive therapy based on a recent cognitive model of social phobia. Six consecutively referred male patients (age 18-44 yrs) with social phobia were treated using established single case series methodology. Brief cognitive therapy was effective with all patients demonstrating clinically significant improvements in all measures. Treatment gains were maintained at follow-up. The mean number of treatment sessions delivered was 5.5 and improvements compare favourably with previous treatment studies. Brief cognitive therapy for social phobia appears promising and it is potentially cost-effective. Future randomised and controlled evaluations of this brief treatment are warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wells, Adrian; Papageourgiou, Costas; Barlow, Beck, Beck, Clark, Clark, Clark, First, Hackmann, Harvey, Heimberg, Heimberg, Rachman, Taylor, Watson, Wells, Wells, Wells, Wells, Wells, Wells, Wells",2001.0,,0,0,
2732,"The observer perspective: biased imagery in social phobia, agoraphobia, and blood/injury phobia.","Clark and Wells' (1995): 'A cognitive model of social phobia'. In Social phobia: Diagnosis, assessment, and treatment (pp. 69-93), R. G. Heimberg, M. R. Liebowitz, D. A. & F. R. Hope (eds.); cognitive model of social phobia proposes that social phobics generate a negative impression of how they appear to others. This impression often occurs in the form of an image from an ""observer"" perspective in which social phobics can see themselves as if from another person's vantage point. This study investigated the specificity of the observer perspective among patients with social phobia, agoraphobia, and blood/injury phobia. All participants were asked to recall and imagine a recent anxiety-provoking social situation and a non-social/non-anxiety-provoking situation, and rate their perspective for each. Consistent with predictions only patients with social-evaluative concerns (social phobics and agoraphobics) reported observer perspectives for anxiety-provoking social situations. Only social phobics showed a significant shift from an observer to a field perspective across the two conditions. The clinical implications of these findings are briefly discussed.",Wells A.; Papageorgiou C.,1999.0,,0,0,
2733,Preliminary tests of a cognitive model of generalized anxiety disorder.,"Although worry is the central feature of Generalised Anxiety Disorder (GAD), little is known about the factors that contribute to pathological or problematic worry. In a recent cognitive model of GAD, Wells, A. (1995) proposed that negative appraisal of worrying itself (meta-worry or type 2 worry) should be distinguished from other types of worrying (type 1 worry). A central feature of this model is the idea that individuals with GAD hold rigid positive beliefs about the usefulness of worrying as a coping strategy. However, these individuals also hold negative beliefs and appraise worrying as uncontrollable and dangerous. This combination of cognitions and associated responses leads to an increased frequency and generality of worrying, and thus to the pathological worry characteristic of GAD. This paper reports a preliminary test of the hypothesis that meta-worry contributes to problematic and pathological worrying, and this relationship is independent of the frequency of other types of worry. In testing for associations between worry dimensions we controlled for overlaps with Trait anxiety, and the controllability of worrying. Results of a series of regression analyses support the hypothesis that pathological worry is associated with meta-worry and this association is independent of Trait-anxiety and type 1 worry. The clinical implications of these data are briefly discussed.",Wells A.; Carter K.,1999.0,,0,0,
2734,Enhanced wound healing after emotional disclosure intervention,"ER DESIGNThe study used a prospective, longitudinal design with random assignment to the control (writing about time management) and experimental group (writing about a traumatic event).METHODSParticipants (N=36) completed questionnaires measuring perceived and emotional distress, loneliness, self-esteem, social support, dispositional optimism, and health-related behaviours. Accurate indication of the healing of a small punch biopsy wound was determined by using a high-resolution ultrasound scanner.RESULTSRepeated measures ANOVA indicated that the disclosure intervention impacted wound healing. Participants who wrote about traumatic events had significantly smaller wounds 14 and 21 days after the biopsy compared with those who wrote about time management.CONCLUSIONSIt is concluded that a relatively brief and easy to administer intervention can have beneficial effects on wound healing. The potential for use in patient samples is indicated.OBJECTIVESPsychological stress is believed to impair wound healing via a down-regulation of the immune system. Since previous research suggests that disclosure of tra-umatic experiences can result in an up-regulation of immune function, the present study aimed to investigate the impact of a disclosure intervention on the progress of wound healing.","Weinman, J; Ebrecht, M; Scott, S; Walburn, J; Dyson, M",2008.0,10.1348/135910707X251207,0,0,
2735,"Posttraumatic stress disorder among hospital surgical physicians exposed to victims of terror: A prospective, controlled questionnaire survey","Background and Objective: Surgical physicians often treat victims of terror-related multiple-casualty incidents. This may cause secondary posttraumatic stress disorder (PTSD), impairing their ability to care for patients. The objective of this study was to determine whether professional exposure to victims of terror caused PTSD in Israeli physicians from surgical disciplines. Method: This was a validated questionnaire survey of physicians (November 2002 through March 2003) from 2 Jerusalem hospitals (a tertiary trauma center and a secondary regional hospital) divided into study (physicians from surgical disciplines regularly exposed to victims of terror) and control (physicians not regularly exposed) groups. Questionnaires included the PTSD Symptom Scale-Self-Report to diagnose PTSD (DSM-IV criteria) and allowed exclusion of other causes of similar symptoms. The main outcome measure was the difference in the prevalence of PTSD between groups. Results: Included were 212 (102 study, 110 control) participants. The study group experienced a significantly higher level of exposure to terror victims at work, validating prospective group definitions. The prevalence of PTSD was similar in both groups (study group = 16%, control group = 15%; p = 1.00). The study and control groups were similar in all predicting variables except for number of years in medical practice, occupational status, and workplace. The groups had similar levels of exposure to terror outside work (p = .24). The probability that a physician would have PTSD was related to use of non-adaptive coping strategies (OR = 5.1; p = .009) and a higher level of exposure to terror out of work (OR = 3.5; p = .013). Conclusion: Hospital physicians from surgical disciplines who were professionally exposed to victims of terror did not demonstrate a higher incidence of PTSD than their less exposed counterparts.",Weiniger C.F.; Shalev A.Y.; Ofek H.; Freedman S.; Weissman C.; Einav S.,2006.0,,0,0,
2736,Sleep recordings in individuals with borderline personality disorder before and after trauma therapy.,"Most individuals diagnosed with borderline personality disorder (BPD) have been exposed to severe and traumatic stressors and thus frequently present with symptoms of a posttraumatic stress disorder (PTSD). Severe sleep disturbances often accompany these complex cases, but changes of sleep parameters during therapy and the impact of sleep on treatment response have barely been studied. Narrative Exposure Therapy (NET) is an evidence-based approach for the treatment of trauma-related psychological disorders. To investigate the effect of NET on sleep in patients with BPD and comorbid PTSD, we screened 45 inpatients and outpatients who met the inclusion criteria of both diagnoses according to DSM-IV and who had a minimum of 2 weeks' stable medication. Patients were allocated to NET (N = 13) or treatment as usual (TAU; N = 8) in blocks. Polysomnographies and psychological questionares were performed before, directly and 6 months after the last therapy session. The aim of this pilot study was to investigate the effectiveness of trauma therapy by NET on sleep quantity (total sleep time) and sleep continuity (sleep efficiency and awakenings) in patients with comorbid BPD and PTSD. Participants of the NET group compared with those who received TAU showed an increased reduction in sleep latency from baseline to the end of therapy and a reduction in arousals over time. Patients with longer pre-treatment total sleep time and pre-treatment REM sleep duration showed a better outcome of NET with respect to PTSD symptoms. NET seems not lead to a change in sleep for the worse during therapy and seems to improve sleep as good as treatment as usual. Furthermore, our results provide evidence of an influence of sleep structure at baseline on treatment success later on. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Weinhold, Sara Lena; Goder, Robert; Pabst, Astrid; Scharff, Anna-Lena; Schauer, Maggie; Baier, Paul Christian; Aldenhoff, Josef; Elbert, Thomas; Seeck-Hirschner, Mareen; Asaad, Bastien, Battaglia, Benish, Benson, Bisson, Buysse, Clarke, De la Fuente, De la Fuente, Driessen, Ehlers, Foa, Golier, Gunderson, Hamilton, Harty, Herman, Hornung, Leichsenring, Linehan, McDonagh, Ogata, Pabst, Pabst, Philipsen, Plante, Plante, Plante, Reynolds, Schauer, Schauer, Schredl, Semiz, Silk, Terr, Yen, Zanarini, Zimmerman, Zweig-Frank",2017.0,,0,0,
2737,[Impact of surgical strategy on quality of life and radiological outcome in traumatic fractures of the thoracolumbar spine].,"There are a variety of surgical strategies for the treatment of traumatic thoracolumbar vertebral fractures. There is still no proof for the superiority of any strategy concerning clinical or radiological outcomes. The aim of this study was the evaluation of residual complaints and correlation with radiological findings. 87 patients, who underwent different types of surgery for vertebral fractures of the thoracolumbar region were included. Patients were treated by posterior stabilisation with internal fixation alone, by a combined approach using posterior internal fixation and anterior fusion by bone graft from the iliac crest with or without additional anterior plating or with a combined approach using posterior stabilisation and anterior implantation of an expandable titanium cage. Data were collected using results of physical examination, standardised testing of several established quality of life scores (SF-36, VAS, LBOS and Oswestry score) as well as radiological findings (post-traumatic kyphosis, loss of correction). There was no difference in the overall results of quality of life in the different subgroups. Analysis of the subgroups revealed differences in the complaints according to the surgical strategy used (a high rate of non-fusion where bone grafts, especially without additional anterior plating were used, combined with a high rate of bone graft morbidity, intercostal neuralgia in cage implantation). Loss of correction as documented in the radiological course showed a maximum in patients who underwent posterior stabilisation without an additional anterior approach. There was no correlation of loss of correction and quality of life. Overall outcomes of the four surgical strategies were comparable in our study concerning loss of correction and quality of life, respectively. The use of bone grafts, however, results in a high rate of non-fusion with a remarkable number of patients complaining about bone graft morbidity. Therefore we prefer the use of expandable titanium cages for anterior stabilisation if additional anterior stabilisation is necessary due to type of fracture or damage of adjacent discs. In any other cases, a limited approach by posterior instrumentation alone should be considered.",Weiner X.; El Saman A.; Rüger F.; Laurer H.; Marzi I.,2013.0,10.1055/s-0032-1328655,0,0,
2738,A preliminary evaluation of repeated exposure for depersonalization and derealization.,"Dissociative symptoms including depersonalization and derealization are commonly experienced by individuals suffering from panic disorder or posttraumatic stress disorder (PTSD). Few studies have been published investigating the specific treatment of these symptoms in individuals diagnosed with panic disorder or PTSD, despite evidence that the subset of individuals with panic disorder who experience depersonalization and derealization report more panic attacks as well as greater panic severity and functional impairment. Furthermore, it has been shown that these symptoms can impede treatment and recovery in PTSD. Finally, recent research has shown that interoceptive exposure generally enhances the efficacy of treatment outcome for PTSD and PTSD with comorbid panic. This study investigated the use of a novel interoceptive exposure technique for treatment of depersonalization and derealization in individuals with high anxiety sensitivity and/or symptoms of PTSD. Results indicated significant reductions on six of seven items as well as total score on an outcome measure of depersonalization and derealization. Thus, this technique appears to hold promise for utilization as a form of interoceptive exposure in the treatment of these symptoms.",Weiner E.; McKay D.,2013.0,10.1177/0145445512461651,0,0,
2739,WARRIOR-trial - is routine radiography following the 2-week initial follow-up in trauma patients with wrist and ankle fractures necessary: study protocol for a randomized controlled trial.,"Extremity fractures such as wrist and ankle fractures are a common and costly healthcare problem. The management of these fractures depends on fracture type and loss of congruity of the joint, resulting in cast immobilization or operative treatment. Loss of congruity or displacement leading to uneven joint loading, osteoarthritis and an increased probability of a poor functional outcome should be identified within the first 2 weeks post-trauma, based upon radiographs to determine optimal treatment. After this period, routine radiographs are scheduled for monitoring the bone-healing process. Current protocols describe imaging at 1, 2, 6 and 12 weeks post-trauma. However, it is questionable whether routine radiography following the initial follow-up ( 2-weeks post-trauma) is cost effective. The aim of this study is to determine whether a modification of the radiographic follow-up protocol can be conducted with no worse outcome and less cost than the current standard of care for patients with a wrist or ankle fracture. In a multicenter randomized controlled trial, 697 patients aged 18 years or older will be included: 385 wrist fracture- and 312 ankle fracture patients. Patients will be randomized into two groups: Group 1 receives usual care, consisting of radiographs 1, 2, 6 and 12 weeks post-trauma; Group 2 receives radiographs beyond the initial follow-up only when clinically indicated. The primary outcome is the overall extremity-specific function. For wrist fractures, this includes the Disabilities of the Arm, Shoulder and Hand Score; for the ankle fractures, this includes the Olerud and Molander ankle score. Secondary outcomes include: healthcare cost, the specific function measured with the Patient Rated Wrist and Hand Evaluation for wrist fractures and American Academy of Orthopaedic Surgeons foot and ankle questionnaire for ankle fractures, pain-intensity, health-related quality of life, self-perceived recovery, and complications. Both groups will be monitored at 1, 2, and 6 weeks and 3, 6, and 12 months. This study will provide data on (cost) effectiveness of routine radiography in the follow-up of wrist and ankle fractures, and could pave the way for a change in (inter)national protocols. Netherlands Trial Register NTR4610 , registration date 22 June 2014.",Weil NL.; Termaat MF.; Rubinstein SM.; El Moumni M.; Zuidema WP.; Derksen RJ.; Krijnen P.; van Bodegom-Vos L.; Wendt KW.; van Kuijk C.; Rosendaal FR.; Breederveld RS.; Goslings JC.; Schipper IB.; van Tulder MW.,2015.0,10.1186/s13063-015-0600-x,0,0,
2740,Group therapy for communication fear in normal school preschool education students.,"Studied the efficacy of group therapy for communication fear in normal school preschool education students. 38 preschool education majors of a normal school in China were screened for communication fear by using the Self-Reported Communication Fear Scale (X. Wang). Ss with communication fear were randomly assigned to an experimental group (21 Ss) and a control group (19 Ss). Ss in the control group did not get any intervention while Ss in the experimental group received cognitive-behavioral group therapy for 10 wks (1 hr/wk). The therapy consisted of the following: understanding the therapy, group counseling of common problems, image control training, raising questions and lecturing, individual counseling, and exchanging experiences of communication problem solving. The therapeutic efficacy was evaluated with before and after comparisons, group comparisons, self-report, and parents' responses. Recovery of 12 Ss in the experimental group and 3 Ss in the control group are reported. Advantages of group therapy in changing Ss' attitudes are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wei, Xing",2000.0,,0,0,
2741,"Perceived social support, hopefulness, and emotional regulations as mediators of the relationship between enacted stigma and post-traumatic growth among children affected by parental HIV/AIDS in rural China","ER Some previous studies have revealed a negative impact of enacted stigma on post-traumatic growth (PTG) of children affected by HIV/AIDS, but little is known about protective psychological factors that can mitigate the effect of enacted stigma on children's PTG. This study aims to examine the mediating effects of perceived social support, hopefulness, and emotional regulation on the relationship between enacted stigma and PTG among HIV-affected children. Cross-sectional data were collected from 790 children affected by parental HIV (382 girls, 408 boys) aged 6-17 years in 2012 in rural central China. Multiple regression was conducted to test the mediation model. The study found that the experience of enacted stigma had a negative effect on PTG among children affected by HIV/AIDS. Emotional regulation together with hopefulness and perceived social support mediated the impact of enacted stigma on PTG. Perceived social support, hopefulness, and emotional regulation offer multiple levels of protection that can mitigate the impact of enacted stigma on PTG. Results suggest that future psychological intervention programs should seek strategies to reduce the stigmatizing experience of these children and promote children's level of PTG, and health professionals should also emphasize the development of these protective psychological factors.","Wei, W; Li, X; Tu, X; Zhao, J; Zhao, G",2016.0,10.1080/09540121.2016.1146217,0,0,
2742,Psychometric properties of the Chinese version of the fear of negative evaluation scale-brief (BFNE) and the BFNE-straightforward for middle school students,"Background: The 12-item brief version of the Fear of Negative Evaluation Scale (BFNE) is one of the most widely used instruments to assess fear of negative evaluation. Recent evidence strongly supports the version composed of 8 straightforward items (BFNE-S), which pos-sessesstronger psychometric properties. The purpose of the current study is to examine the psychometric prop-erties of the Chinese versions of the BFNE and BFNE-S for middle school students. Methodology: A total of 1009 middle school students were recruited in this study. The BFNE, the BFNE-S, the Friedman-Bendas Text Anxiety Scale (FBTAS), and the Social Anxiety Scale (SAS) were administered to 497 participants, and 52 participants were re-tested after four weeks. The BFNE, the BFNE-S, the Rosenberg Self-Esteem Scale (RSES), and the Balanced Inventory of Desirable Responding (BIDR) wereadministered to 492 participants. The BFNE and BFNE-S significantly cor-related with all the scales, supporting their convergent, divergent and concurrent validity. Principal Findings: The Cronbach's alpha of the BFNE (BFNE-S) was 0.864 (0.867) with 497 par-ticipants and 0.886 (0.844) with 492 participants, and the test-retest reliability coefficient was 0.791 (0.855) (ICC). Although the EFA identified a two-factor solution in which the 8 straightforward items loaded on one factor and the 4 reversed items loaded on the other, the CFA, using a random intercept model to control the wording effect, supported a unidimensional factor struc-ture of the BFNE. Both EFA and CFA supported the unidimensional assumption of the BFNE-S. The correlations of the BFNE and BFNE-S were 0.929 and 0.952 in two samples. Conclusions: The Chinese versions of the BFNE and BFNE-S demonstrate adequate psychometric properties for assessing fear of negative evaluation. The results support their use among the Chinese middle school students. Considering its greater parsimony and excellent reliability and validity, the BFNE-S is a better tool.",Wei J.; Zhang C.; Li Y.; Xue S.; Zhang J.,2015.0,10.1371/journal.pone.0115948,0,0,
2743,Cervical cage without plating in management of type II / II A Hangman's fracture combined with intervertebral disc injury.,"Surgical intervention is increasingly performed as the primary treatment of unstable Hangman's fracture. Some authors have advocated using anterior C2/3 discectomy with interbody fusion and plating to treat unstable Hangman's fracture combined with intervertebral disc injury; however, there are few reports on unstable Hangman's fracture treated by anterior interbody fusion with the cervical cage (PEEK material) solely. This study was to assess the efficacy of the cervical cage in management of unstable Hangman's fracture combined with intervertebral disc injury. A cohort of 15 patients with unstable Hangman's fractures fulfilling the inclusion criteria were prospectively submitted to surgical treatment of anterior C2/3 discectomy and interbody fusion using the cervical cage without plating. According to the Levine and Edwards classification, there were 5 type II, and 10 type IIA cases. The clinical outcome (the visual analog scale and the clinical post-traumatic neck score), radiological findings (angulation, translation, and disc height), and bone healing were assessed at 3, 6, 12, and 24 months. All the patients were followed up successfully. There were no intra- or postoperative complications observed. Solid fusion was achieved in all cases by 6 months after surgery. The local kyphotic angle was corrected significantly with the mean preoperative 12.31 ± 2.96 degrees, initial postoperative -1.98 ± 1.62 degrees and the latest follow-up -1.72 ± 1.60 degrees respectively (P < 0.05).The translation was also corrected significantly with the mean preoperative 3.20 ± 1.16 mm, initial postoperative 0.97 ± 0.36 mm, and the latest follow-up 1.05 ± 0.34 mm respectively (P < 0.05). The mean visual analog scale and the clinical post-traumatic neck score improved significantly following surgery (P < 0.05). This case series demonstrates that anterior C2/3 discectomy and interbody fusion with the cervical cage solely is effective and reliable in management of type II / IIA Hangman's fracture with C2/3 disc injury when properly indicated.",Wei F.; Wang L.; Zhou Z.; Zhong R.; Liu S.; Cui S.; Pan X.; Gao M.,2015.0,10.1186/s12891-015-0734-8,0,0,
2744,Psychosocial stress but not exercise increases cortisol and reduces state anxiety levels in school classes - results from a stressor applicable in large group settings,"ER Both, psychosocial stress and exercise in the past have been used as stressors to elevate saliva cortisol and change state anxiety levels. In the present study, high-school students at the age of 14 were randomly assigned to three experimental groups: (1) an exercise group (n = 18), that was running 15 minutes at a medium intensity level of 65-75% HRmax, (2) a psychosocial stress group (n = 19), and (3) a control group (n = 18). The psychosocial stress was induced to the students by completing a standardized intelligence test under the assumption that their IQ scores would be made public in class. Results display that only psychosocial stress but not exercise was able to significantly increase cortisol levels but decreased cognitive state anxiety in adolescents. The psychosocial stress protocol applied here is proposed for use in future stress studies with children or adolescents in group settings, e.g., in school.","Wegner, M; Müller-Alcazar, A; Jäger, A; Machado, S; Arias-Carrión, O; Budde, H",2014.0,,0,0,
2745,Low levels of estradiol are associated with elevated conditioned responding during fear extinction and with intrusive memories in daily life,"Posttraumatic stress disorder (PTSD) can be conceptualized as a disorder of emotional memory showing strong (conditioned) responses to trauma reminders and intrusive memories among other symptoms. Women are at greater risk of developing PTSD than men. Recent studies have demonstrated an influence of ovarian steroid hormones in both fear conditioning and intrusive memory paradigms. However, although intrusive memories are considered non-extinguished emotional reactions to trauma reminders, none of the previous studies has investigated effects of ovarian hormones on fear conditioning mechanisms and intrusive memories in conjunction. This may have contributed to an overall inconsistent picture of the role of these hormones in emotional learning and memory. To remedy this, we exposed 37 healthy women with a natural menstrual cycle (during early follicular or luteal cycle phase) to a novel conditioned-intrusion paradigm designed to model real-life traumatic experiences. The paradigm included a differential fear conditioning procedure with short violent film clips as unconditioned stimuli. Intrusive memories about the film clips were assessed ambulatorily on subsequent days. Women with lower levels of estradiol displayed elevated differential conditioned skin conductance responding during fear extinction and showed stronger intrusive memories. The inverse relationship between estradiol and intrusive memories was at least partially accounted for by the conditioned responding observed during fear extinction. Progesterone levels were not associated with either fear acquisition/extinction or with intrusive memories. This suggests that lower levels of estradiol might promote stronger symptoms of PTSD through associative processes.",Wegerer M.; Kerschbaum H.; Blechert J.; Wilhelm F.H.,2014.0,10.1016/j.nlm.2014.10.001,0,0,
2746,Maternal depression and treatment gains following a cognitive behavioral intervention for posttraumatic stress in preschool children,"ER The evidence base for cognitive behavioral therapy (CBT) to treat child emotional and behavioral symptoms following exposure to trauma in youth is compelling, but relatively few studies are available on preschool children and on moderators of treatment outcomes. This paper examines maternal and child characteristics as moderators of posttraumatic stress (PTS) treatment outcomes in preschool children. Outcome data from a previously published randomized trial in three to six year old preschool children with diagnostic interview data from participating mothers were used. Hypotheses were tested via hierarchical linear modeling. Maternal depression was associated with higher initial child posttraumatic stress disorder (PTSD) symptoms, and was associated with increasing PTSD symptom trends at follow up suggesting potential child PTSD symptom relapse. Maternal PTSD symptoms similarly predicted differential child separation anxiety symptom change but not child PTSD symptom change. Targeting dyads with child PTSD symptoms and maternal depression or PTSD symptoms with enhanced interventions may be a useful strategy to improve treatment maintenance.","Weems, C F; Scheeringa, M S",2013.0,10.1016/j.janxdis.2012.11.003,0,0,
2747,Study protocol: a randomised controlled trial testing the effectiveness of 'Op Volle Kracht' in Dutch residential care,"ER METHODS/DESIGN: The CBT-based resiliency program, Op Volle Kracht (OVK), which is based on the US Penn Resiliency Program (PRP), was adapted to suit the needs of adolescents with both externalizing and internalizing problems, either with or without MID, in Dutch residential treatment centres. The effectiveness of this group intervention program of eight sessions will be tested in a randomised controlled trial (RCT) with N?=?182 adolescents aged 12-16, allocated to either the target intervention plus treatment as usual (OVK?+?TAU) or treatment as usual only (TAU). The main outcome variables include depressive symptoms (primary), anxiety, behavioural problems, and group therapeutic climate. Cognitive styles and coping styles will be included as possible mediators. Assessments take place at baseline (T1), one week before the start of the program (T2), immediately after the program (T3), and at three months follow-up (T4).DISCUSSION: The program assets include its wide implementation possibilities due to low costs, the short duration of the program and the delivery by group care workers, and its suitability for adolescents with MID. Further strengths of the present study design include its robust method (RCT), the ecological validity, and the inclusion of possible mediators of treatment effect. The program emphasizes individual risk factors for depression rather than social and family factors. Implications for practice and future research are discussed.TRIAL REGISTRATION: Dutch Trial Register NTR4836.BACKGROUND: Although adolescents are often referred to residential treatment centres because of severe externalizing behaviours, a vast majority demonstrated comorbid symptoms of depression and anxiety. Covert internalizing symptoms in these adolescents might be easily unrecognized and therefore untreated. Adolescents with mild intellectual disability (MID) are overrepresented among youth with both externalizing and internalizing problems. There are yet few treatment programs available for adolescents with both externalizing and internalizing problems.","Weeland, M M; Nijhof, K S; Vermaes, I; Engels, R C; Buitelaar, J K",2015.0,10.1186/s12888-015-0498-6,0,0,
2748,Nocturnal urinary cortisol excretion over a randomized controlled trial with paroxetine vs. placebo combined with relaxation training or aerobic exercise in panic disorder.,"Data on basal hypothalamo-pituitary-adrenomedullary (HPA) function over controlled treatment trials with serotonergic drugs in anxiety disorders are still rare. 29 patients with panic disorder participating in a 10 week randomized, controlled trial (paroxetine vs. placebo with exercise or relaxation; N=60) collected urine for cortisol excretion over 3 consecutive nights before start and before termination of the treatment episode. Urinary cortisol was measured by radioimmunoassay. Efficacy measures were the Clinical Global Impression Scale (CGI) and the Panic and Agoraphobia Scale (P&A). 83% were female (p<.05 vs. males). 55% received additional aerobic exercise, and 45% relaxation. 55% received paroxetine treatment, and 45% placebo. Significantly fewer males received placebo treatment (p<.05). All subjects improved significantly. Cortisol excretion did not differ between treatment groups or at pre-/post measurements. Females showed a significantly higher variability of cortisol excretion compared to males, at pre-(p<.005) and post (p=.015) assessments. Males displayed a trend to lower basal HPA function at end of treatment (p=.08). HPA variability after treatment showed a trend to be higher in the paroxetine (p=.052) -who clinically improved significantly better- compared to the placebo group. No relationship between HPA activity and treatment response or with exercise was detected. HPA function shows significant gender differences, with females having a higher HPA function variability. Future studies on HPA function in treatment trials should address gender and medication effects.",Wedekind D.; Sprute A.; Broocks A.; Hüther G.; Engel K.; Falkai P.; Bandelow B.,2008.0,,0,0,
2749,"A randomized, controlled trial of aerobic exercise in combination with paroxetine in the treatment of panic disorder.","Regular aerobic exercise (running) has been shown to be superior to a pill placebo in the treatment of panic disorder. Combined drug and exercise treatment has not been investigated in randomized controlled studies to date. This is a randomized, 10-week, controlled, parallel group, pilot study. A total of 75 outpatients with panic disorder with or without agoraphobia (DSM-IV and ICD-10) received either (1) exercise plus paroxetine 40 mg/day (n=21), (2) relaxation plus paroxetine (n=17), (3) exercise plus pill placebo (n=20), or (4) relaxation plus pill placebo (n=17). Changes in the Panic and Agoraphobia Scale (P&A), and the Clinical Global Impression Scale (CGI) underwent repeated measure analysis. Effects sizes were large for all groups (d=1.53-3.87), however not significantly different. Paroxetine-treated patients were significantly more improved than placebo-treated patients. On the CGI, patients in the exercise groups (plus paroxetine or placebo) had a trend toward better improvement compared to relaxation (P=0.06). Response and remission rates were higher in the paroxetine compared to pill placebo groups. While paroxetine was superior to placebo, aerobic exercise did not differ from relaxation training in most efficacy measures.",Wedekind D.; Broocks A.; Weiss N.; Engel K.; Neubert K.; Bandelow B.,2010.0,10.3109/15622975.2010.489620,0,0,
2750,"Changes in mood, craving and sleep during acute abstinence reported by male cocaine addicts",,Weddington W.W.; Brown B.S.; Cone E.J.; Haertzen C.A.; Dax E.M.; Herning R.I.; Michaelson B.S.,1990.0,,0,0,
2751,Treatment failure in cognitive-behavioural therapy: Therapeutic alliance as a precondition for an adherent and competent implementation of techniques.,"Objectives: Treatment failure is a common phenomenon, but little is known about the reasons. Therapeutic alliance, therapist adherence, and therapist competence are considered important aspects of treatment success and formed the focus of the current investigation. Design: Three randomized controlled trials for the treatment of depression, social phobia, and hypochondriasis were the basis of the current study. Methods The role of therapeutic alliance, as well as therapist adherence and competence, were investigated in 61 patients, which were classified either as treatment failure or as treatment success. Process variables were evaluated by independent raters on the basis of videotapes of the first three treatment sessions. Results: Therapists' adherence and therapeutic alliance differed significantly between successful treatments and those classified as failures, whereas therapists' competence did not. In cross-sectional analysis, we found a moderating effect of adherence with alliance on treatment outcome, indicating that the better the therapeutic alliance, the stronger the effect of adherence on treatment outcome. Moreover, higher therapists' competence was found to affect treatment outcome positively, only mediated by therapeutic alliance. Higher therapists' adherence affected treatment outcome positively, only mediated by the competence-alliance relationship. In additional longitudinal analyses, we found evidence that the therapeutic alliance within one session influences therapists' adherence and competence in the subsequent session, but not the other way around. Conclusions: Therapeutic alliance proved to be an important variable for the prediction of treatment failure. Furthermore, in our longitudinal analyses, we found evidence that the therapeutic alliance is a precondition for the adherent and competent implementation of therapeutic techniques, which questions the results of our cross-sectional analysis and of previous research. Practitioner points: Clinical implications Treatment failure is associated with a lower therapeutic alliance in cognitive-behavioural treatment. Therapeutic alliance seems to be an important precondition for the adherent and competent implementation of therapeutic techniques. Therapeutic alliance should be monitored during psychotherapeutic treatment. Cautions or limitations: Results are limited to cognitive-behavioural therapy and may not be representative for other treatment approaches. Process analyses are based on highly standardized randomized controlled trials and may not be generalizable to routine care. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Weck, Florian; Grikscheit, Florian; Jakob, Marion; Hofling, Volkmar; Stangier, Ulrich; Barber, Barber, Barber, Barber, Bassler, Beck, Beck, Crits-Christoph, Dennhag, DeRubeis, Despland, Dimidjian, Dunn, Dunn, First, Fydrich, Ginzburg, Hamilton, Hautzinger, Hedges, Hiller, Horvath, Jacobson, Kellner, Kuyken, Lambert, Lambert, Liebowitz, Luborsky, MacKinnon, McLeod, Muthen, Richtberg, Risch, Samstag, Samstag, Schermelleh-Engel, Shrout, Simons, Stangier, Stangier, Stangier, Stangier, Strunk, Strunk, Turner, Ulvenes, Waltz, Webb, Weck, Weck, Weck, Weck, Weck, Weck, Weck, Weck, Young",2015.0,,0,0,
2752,Depression and anxiety symptoms in women at high risk for breast cancer: pilot study of a group intervention.,"The psycho-oncology literature to date contains only one outcome study based on a group model for high-risk relatives of breast cancer patients. The authors set out to study the effects of group intervention in high-risk relatives of breast cancer patients. Thirty-three high-risk relatives of breast cancer patients participated in a six-session, 12-hour group intervention model that consisted of educational and psychosocial components. There was a significant reduction of depression symptoms as reported on the Center for Epidemiologic Studies Depression Scale. Similarly, there was a significant reduction of anxiety symptoms as reported on the State-Trait Anxiety Inventory state scale. In this pilot study, the investigators found the group intervention model effective at reducing symptoms of depression and reactive (not chronic) anxiety.",Wellisch DK.; Hoffman A.; Goldman S.; Hammerstein J.; Klein K.; Bell M.,1999.0,10.1176/ajp.156.10.1644,0,0,
2753,Family nurture intervention (FNI): methods and treatment protocol of a randomized controlled trial in the NICU,"ER BACKGROUND: The stress that results from preterm birth, requisite acute care and prolonged physical separation in the Neonatal Intensive Care Unit (NICU) can have adverse physiological/psychological effects on both the infant and the mother. In particular, the experience compromises the establishment and maintenance of optimal mother-infant relationship, the subsequent development of the infant, and the mother's emotional well-being. These findings highlight the importance of investigating early interventions that are designed to overcome or reduce the effects of these environmental insults and challenges.METHODS: This study is a randomized controlled trial (RCT) with blinded assessment comparing Standard Care (SC) with a novel Family Nurture Intervention (FNI). FNI targets preterm infants born 26-34 weeks postmenstrual age (PMA) and their mothers in the NICU. The intervention incorporates elements of mother-infant interventions with known efficacy and organizes them under a new theoretical context referred to collectively as calming activities. This intervention is facilitated by specially trained Nurture Specialists in three ways: 1) In the isolette through calming interactions between mother and infant via odor exchange, firm sustained touch and vocal soothing, and eye contact; 2) Outside the isolette during holding and feeding via the Calming Cycle; and 3) through family sessions designed to engage help and support the mother. In concert with infant neurobehavioral and physiological assessments from birth through 24 months corrected age (CA), maternal assessments are made using standard tools including anxiety, depression, attachment, support systems, temperament as well as physiological stress parameters. Quality of mother-infant interaction is also assessed. Our projected enrolment is 260 families (130 per group).DISCUSSION: The FNI is designed to increase biologically important activities and behaviors that enhance maternally-mediated sensory experiences of preterm infants, as well as infant-mediated sensory experiences of the mother. Consequently, we are enlarging the testing of preterm infant neurodevelopment beyond that of previous research to include outcomes related to mother-infant interactions and mother-infant co-regulation. Our primary objective is to determine whether repeated engagement of the mother and her infant in the intervention's calming activities will improve the infant's developmental trajectory with respect to multiple outcomes. Our secondary objective is to assess the effectiveness of FNI in the physiological and psychological co-regulation of the mother and infant. We include aspects of neurodevelopment that have not been comprehensively measured in previous NICU interventions.TRIAL REGISTRATION: ClinicalTrials.gov: NCT01439269.","Welch, M G; Hofer, M A; Brunelli, S A; Stark, R I; Andrews, H F; Austin, J; Myers, M M",2012.0,10.1186/1471-2431-12-14,0,0,
2754,Eye movement desensitization and reprocessing: Treatment of sexual trauma post-traumatic stress disorder and a treatment efficacy hypothesis.,"The purpose of this investigation was to study the treatment effects of eye movement desensitization and reprocessing (EMDR) on a civilian population of individuals diagnosed with post-traumatic stress disorder (PTSD) from sexual trauma. A series of single case designs was utilized with 6 subjects to examine EMDR treatment efficacy. The results suggested that EMDR was effective in reducing distress and related PTSD symptomatology in 1 or 2 sessions of treatment. These treatment gains were maintained at 1 year follow-up. It is suggested that affective arousal may have a critical role in maintaining a number of disorders including PTSD and that EMDR appears to be able to activate as well as desensitize affective mood states so that more adaptive cognitive processing can take place. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Welch, Kenneth L",1996.0,,0,0,
2755,Position of anterior capsulorhexis and posterior capsule opacification,"ER METHODSA total of 119 patients, aged 61-86 years, underwent cataract surgery with phacoemulsification performed by a single surgeon. The patients were randomized to implantation with either a silicone intraocular lens (IOL) (SI40NB, Allergan) or an AcrySof IOL (MA60BM, Alcon). Three years after surgery, the rate of PCO was analysed using the evaluation of posterior capsule opacification computer software (EPCO). The results were related to the capsulorhexis position, which was assessed with a retroillumination photograph.RESULTSIf the capsulorhexis was located partially or completely off the optics of the IOL, compared to totally on the IOL, significantly more PCO was found (p = 0.0014). When comparing within each IOL type, patients with AcrySof IOLs were found to have significantly less PCO when the capsulorhexis was totally on the optic (p = 0.0048). This difference was also significant in the silicone group (p = 0.041).CONCLUSIONA relatively small and central capsulorhexis allowing for the complete covering of the IOL optics by the rhexis edges seems to protect against PCO in cataract surgery, with both round-edged silicone IOLs and sharp-edged hydrophobic acrylic IOLs.PURPOSETo evaluate whether the position of the anterior continuous curvilinear capsulorhexis influences the rate of posterior capsule opacification (PCO).","Wejde, G; Kugelberg, M; Zetterström, C",2004.0,10.1111/j.1600-0420.2004.00322.x,0,0,
2756,Neuromagnetic indicators of auditory cortical reorganization of tinnitus,"Animal studies show that following damage to inner-ear receptors, central representations of intact lesion-edge (LE) frequencies become enlarged (map reorganization). One theory of tinnitus holds that this process could be related to the tinnitus sensation. To test this hypothesis, neuromagnetic evoked fields of tinnitus participants with high-frequency hearing loss and normal hearing controls were measured, while subjects listened to monaurally presented LE or control (CO; an octave below LE) tones. The predictions made based on the map reorganization hypothesis of tinnitus were that neuronal responses to LE frequencies would be enhanced, and that source localizations for LE would be distorted. N1m equivalent dipole moments for LE were not supranormal in the tinnitus group, whereas responses to CO of tinnitus patients compared to controls were enlarged in the right hemisphere. This effect was positively associated with tinnitus-related distress. Abnormal source locations were found for generators activated by LE tones in the right hemisphere of the tinnitus group. This right-hemispheric map distortion was not associated with subjective variables of tinnitus. A positive correlation with tinnitus distress was found for the left hemisphere with more anterior sources being associated with enhanced distress. However, this result was independent of the frequency of the stimulus. Overall, the present study suggests that mechanisms of map reorganization, although present in the data, cannot satisfactorily explain the emergence of tinnitus and that differential hemispheric involvement must be considered. © The Author (2005). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved.",Weisz N.; Wienbruch C.; Dohrmann K.; Elbert T.,2005.0,10.1093/brain/awh588,0,0,
2757,Treatment effects on the social adjustment of depressed patients,,"Weissman, M M; Klerman, G L; Paykel, E S; Prusoff, B; Hanson, B",1974.0,,0,0,
2758,Community-based mental health treatments for survivors of torture and militant attacks in Southern Iraq: a randomized control trial.,"Systematic violence is a long-standing problem in Iraq. Research indicates that survivors often experience multiple mental health problems, and that there is a need for more rigorous research that targets symptoms beyond post-traumatic stress (PTS). Our objective was to test the effectiveness of two counseling therapies in Southern Iraq in addressing multiple mental health problems among survivors of systematic violence: (1) a transdiagnostic intervention (Common Elements Treatment Approach or CETA); and (2) cognitive processing therapy (CPT). The therapies were provided by non-specialized health workers since few MH professionals are available to provide therapy in Iraq. This was a randomized, parallel, two site, two-arm (1:1 allocation), single-blinded, wait-list controlled (WLC) trial of CETA in one site (99 CETA, 50 WLC), and CPT in a second site (129 CPT, 64 WLC). Eligibility criteria were elevated trauma symptoms and experience of systematic violence. The primary and secondary outcomes were trauma symptoms and dysfunction, respectively, with additional assessment of depression and anxiety symptoms. Non-specialized health workers (community mental health worker, CMHW) provided the interventions in government-run primary health centers. Treatment effects were determined using longitudinal, multilevel models with CMHW and client as random effects, and a time by group interaction with robust variance estimation, to test for the net difference in mean score for each outcome between the baseline and follow up interview. Multiple imputation techniques were used to account for missingness at the item level and the participant level. All analyses were conducted using Stata 12. The CETA intervention showed large effect sizes for all outcomes. The CPT intervention showed moderate effects sizes for trauma and depression, with small to no effect for anxiety or dysfunction, respectively. Both CETA and CPT appear to benefit survivors of systematic violence in Southern Iraq by reducing multiple mental health symptoms, with CETA providing a very large benefit across a range of symptoms. Non-specialized health workers were able to treat comorbid symptoms of trauma, depression and anxiety, and dysfunction among survivors of systematic violence who have limited access to mental health professionals. The trial further supports the use of evidence-based therapies in lower-resource settings. This trial was registered at ClinicalTrials.gov on 16 July 2010 with an identifier of NCT01177072 as the Study of Effectiveness of Mental Health Interventions among Torture Survivors in Southern Iraq. The study protocol can be downloaded from the following website: http://tinyurl.com/CETA-Iraq-Protocol . In the protocol, the CETA intervention is given a different name: components-based intervention or CBI.",Weiss WM.; Murray LK.; Zangana GA.; Mahmooth Z.; Kaysen D.; Dorsey S.; Lindgren K.; Gross A.; Murray SM.; Bass JK.; Bolton P.,2015.0,10.1186/s12888-015-0622-7,0,0,
2759,[Repositioning options with percutaneous dorsal stabilization. For burst fractures of the thoracolumbar junction].,"The purpose of this investigation was to evaluate the options of percutaneous systems for reducing relevant posttraumatic kyphosis in spinal burst fractures. Clinical advantages of percutaneous techniques are evident from the literature and a disadvantage can be a lack of repositioning options in reducing the fracture kyphosis. Better results seem to be possible with new techniques and especially monoaxial percutaneous screws. A total of 70 patients with burst fractures (AO type Magerl A3.1-A3.3) of the thoracolumbar spine were treated with a special percutaneous reduction technique in the Trauma Clinic in Murnau (BGU) Germany between July 2009 and March 2011. Posttraumatic, intraoperative and postoperative kyphosis was measured in computed tomography (CT) scans in monosegmental and bisegmental angles. Two different percutaneous fixation systems were compared for reduction. Statistical analyses were carried out with Student's t-test. We found a highly significant difference between preoperative and postoperative kyphosis angles but no differences in reduction between the two percutaneous systems. In 39 cases additional reconstruction of the anterior column was necessary because of a ventral defect. In comparison to the MCS 2 study of the German Society of Trauma Surgery (DGU) we found no differences in postoperative kyphosis angles (3°). A significant reduction of posttraumatic kyphosis of thoracolumbar burst fractures is possible with percutaneous techniques. Prerequisites are percutaneous monoaxial screws and tools and a special percutaneous technique as described.",Weiß T.; Hauck S.; Bühren V.; Gonschorek O.,2014.0,10.1007/s00113-013-2364-7,0,0,
2760,Identifying feigning in trauma-exposed African immigrants.,"As the populations of Western countries become more diverse, the risk of inaccurately generalizing knowledge from majority ethnic groups to minority groups is increasing. However, few of the measures used in forensic assessment are based on normative samples that represent the considerable diversity present in forensic settings. This study examined 4 commonly used measures of feigning: the Dot Counting Test (DCT; Boone, Lu, & Herzberg, 2002); the Miller Forensic Assessment of Symptoms (M-FAST; Miller, 2001); the Test of Memory Malingering (TOMM; Tombaugh, 1996); and a validity scale (atypical responding; ATR) on the Trauma Symptom Inventory-2 (Briere, 2011). The study compared performance on these measures of feigning among 3 groups of African immigrants: honest participants with and without posttraumatic stress disorder, and participants asked to feign distress-related symptoms. The data were used to assess the classification accuracy of each measure and the effect of demographic and cultural variables. Three of the 4 measures (M-FAST, TOMM, and ATR) significantly differentiated between participants asked to respond honestly and those asked to feign, although no measure produced higher than moderate classification accuracy. The M-FAST and DCT produced high false positive rates in the honest groups, ranging from 33% to 63%. Surprisingly, demographic and cultural variables were not significantly associated with test scores. The results emphasize the need for future related research. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Weiss, Rebecca A; Rosenfeld, Barry; Ahmadi, Ashendorf, Boone, Breslau, Briere, Briere, de Fouchier, Farkas, Fazel, Fleiss, Frederick, Gambetti, Guriel, Gutierrez Wang, Kirmayer, Kleinbaum, Krammer, Light, Lindert, Liu, Lopez, Lustig, Marin, Martin, Martin, Mason, McCall, Miller, Mollica, Montes, Norcross, Okawa, Rasmussen, Rees, Robles, Rogers, Rogers, Rosenfeld, Strutt, Tabacknick, Tombaugh, Vasterling, Vilar-Lopez, Weiss, Wooley",2017.0,,0,0,
2761,"How does the therapeutic alliance develop throughout cognitive behavioral therapy for panic disorder? Sawtooth patterns, sudden gains, and stabilization.","Abstract: Objective: There has been little research on the development of the therapeutic alliance in cognitive behavioral therapy (CBT). This study aims to examine the development of therapeutic alliance in CBT for panic disorder. Method: Nineteen patients were treated with CBT for panic disorder. Pre- and post-session data of the therapeutic alliance and panic symptoms and cognitions were collected. Results: Several patterns were observed, including a sawtooth pattern (within-session improvements followed by decline between sessions; 63% of the patients), sudden gains in the alliance (58%), and late stabilization (89%). The sawtooth pattern was related to less symptom reduction between sessions (explained variance = 20-48%). Though not statistically significant, there were moderate effect sizes for the relationships between outcomes and early alliance and sudden gains (explained variance = 13-17%). Conclusions: Overall, results suggest that intensive data collection is likely to yield understanding of the relationship between therapy processes and outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Weiss, Michal; Kivity, Yogev; Huppert, Jonathan D; Baldwin, Barber, Barber, Barber, Barlow, Barlow, Borckardt, Castonguay, Castonguay, Connolly Gibbons, Constantino, Crits-Christoph, Crits-Christoph, Eaton, Emmerling, Fishman, Fluckiger, Foa, Gaston, Hartmann, Hayes, Hersoug, Horvath, Houck, Huppert, Huppert, Jacobson, Kazdin, Kivlighan, Klein, Lipsitz, Lutz, Marker, Martin, Mitte, Monkul, Muran, Orlinsky, Raudenbush, Safran, Shear, Shear, Sheehan, Stiles, Stiles, Tang, Taylor, Tracey, Webb, Westra",2014.0,,0,0,
2762,A Randomized Double-Blind Trial of Paroxetine and/or Dextroamphetamine and Problem-Focused Therapy for Attention-Deficit/Hyperactivity Disorder in Adults.,"Objective: To determine the effect of psychotherapy, dextroamphetamine, and/or paroxetine on attention-deficit/hyperactivity-disorder (ADHD) in adults. Method: Ninety-eight adults with DSM-IV ADHD were randomly assigned to receive psychotherapy and dextroamphetamine, paroxetine, both, or placebo for 20 weeks. A 2 x 2 factorial design compared patients who received dextroamphetamine versus no dextroamphetamine with patients who received paroxetine versus no paroxetine. Data were collected from August 2000 until May 2002. Results: One half of the 98 enrolled subjects were found to have at least 1 lifetime mood or anxiety disorder on the Structured Clinical Interview for DSM-IV. Sixty percent of patients who received medication and 80% of those who received placebo completed the 5-month trial. ADHD symptoms were significantly (p = .012) lower in patients in the completer group who received dextroamphetamine. Paroxetine had no effect on ADHD. Hamilton Rating Scales for Anxiety (HAM-A) and Depression (HAM-D) scores were low to start, and no treatment differences were evident at endpoint. Significantly (p < .001) more patients in the completer group were rated by clinicians as ADHD responders if they received dextroamphetamine (85.7%) or combined treatment (66.7%) versus paroxetine (20.0%) or placebo (21.1%). Significantly (p = .003) more patients in the completer group were rated by clinicians as mood/anxiety responders if they received paroxetine (100%) or combined treatment (73.3%) versus those receiving dextroamphetamine (57.15%) or placebo (47.4%). Clinicians rated any patient who received medication and psychological therapy as significantly more improved overall than those who received placebo and psychological therapy (intent to treat: p = .033; completers: p = .001). Conclusion: ADHD symptoms improved with dextroamphetamine. Mood and internalizing symptoms were seen as improved with paroxetine by clinicians, despite absence of response on the HAM-A and HAMD. The presence of a lifetime internalizing disorder attenuated the response to dextroamphetamine. Patients who received both dextroamphetamine and paroxetine had more severe adverse events but did not show greater improvement overall than patients treated with 1 medication. Clinical Trials Registry #GSK707. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Weiss, Margaret; Hechtman, Lily; The Adult ADHD Research Group; Agranat-Meged, Altfas, Bagby, Biederman, Bussing, Carlson, Cohen-Zion, Conners, Faries, First, Fones, Gammon, Giedd, Go, Greenhill, Hamilton, Hamilton, Hawi, Hoehn-Saric, Hoehn-Saric, Holtkamp, Kessler, Kessler, Levitan, Marks, Miller, Murphy, Nakamura, Pliszka, Pliszka, Quist, Rauch, Reimherr, Safren, Shekim, Spencer, Spencer, Weiss, Weiss, Wilens, Zimmerman, Zoroglu",2006.0,,0,0,
2763,Mindfulness-based stress reduction as an adjunct to outpatient psychotherapy.,"Research on Mindfulness-Based Stress Reduction (MBSR) has supported the utility of the technique in a number of clinical settings. This study explored whether MBSR, used as an adjunct to individual psychotherapy, would result in more rapid alleviation of symptoms, increased achievement of therapeutic goals, and a decrease in number of therapy sessions sought by clients. A group undergoing psychotherapy coupled with training in MBSR was compared with a group undergoing psychotherapy alone. At the conclusion of MBSR training, the groups showed a comparable significant decrease in psychological distress. However, the MBSR group's gains on a novel measure of goal achievement were significantly greater than those of the comparison group. In addition, the MBSR group terminated therapy at a significantly greater rate than the comparison group. The effects of introducing MBSR early in psychotherapy, as well as its effect on self-directed goal attainment in non-psychotherapy contexts, deserve further attention.",Weiss M.; Nordlie JW.; Siegel EP.,2005.0,10.1159/000083169,0,0,
2764,Filgrastim (rhG-CSF) related modulation of the inflammatory response in patients at risk of sepsis or with sepsis,"Over a period of 14 days a longitudinal analysis was performed on the effects of filgrastim (recombinant human granulocyte colony stimulating factor, rhG-CSF) administered to 20 postoperative/posttraumatic patients at risk of or with sepsis. The following parameters were determined: leukocyte counts, serum cytokine levels and the surface expression of functional antigens and adhesion molecules. Filgrastim (1 μg/kg day) was infused continuously on the first 3 days and tapered to 0.5 μg/kg day on the following 4 days or until discharge from the surgical intensive care unit. During infusion of filgrastim, G-CSF levels increased in 16 out of the 20 patients within 48 h. In these 16 patients, leukocyte counts increased in 15 out of 16 patients. Expression of CD64 was upregulated within 24 h. The expression of CD32 was upregulated in 8 out of 9 patients with an initial expression < 55%. LAM-1 expression was downregulated in all patients revealing an initial expression of LAM-1 > 40%. Soluble ICAM increased in 9 out of 11 patients. IL-8 decreased in all 6 patients presenting initial values of IL-8 > 90 pg/ml. IL-1RA increased in 10 patients. Filgrastim had no effect on the expression of CD14, CD16 and CD34 and on the levels of TNF-α and sTNF-R type I (p55). In conclusion, infusion of filgrastim in postoperative/post traumatic patients at risk of and with sepsis resulted in improved generation and function of neutrophils and appeared to counterregulate hyperactivation of proinflammatory processes.",Weiss M.; Gross-Weege W.; Harms B.; Schneider E.M.,1996.0,10.1006/cyto.1996.0035,0,0,
2765,The utility of the Generalized Anxiety Disorder Severity Scale (GADSS) with older adults in primary care.,"The Generalized Anxiety Disorder Severity Scale (GADSS) is an interview rating scale designed specifically for assessing symptom severity of generalized anxiety disorder (GAD), which has demonstrated positive psychometric data in a sample of adult primary care patients with GAD and panic disorder. However, the psychometric properties of the GADSS have not been evaluated for older adults. This study evaluated the psychometric properties of the GADSS, administered via telephone, with a sample of older primary care patients (n=223) referred for treatment of worry and/or anxiety. The GADSS demonstrated adequate internal consistency, strong inter-rater reliability, adequate convergent validity, poor diagnostic accuracy, and mixed discriminant validity. Results provide mixed preliminary support for use of the GADSS with older adults.",Weiss BJ.; Calleo J.; Rhoades HM.; Novy DM.; Kunik ME.; Lenze EJ.; Stanley MA.,2009.0,10.1002/da.20520,0,0,
2766,Is anyone really M.A.D.?: the occurrence and course of mixed anxiety-depressive disorder in a sample of primary care patients.,"We examined the occurrence and 1-year course of mixed anxiety-depressive disorder (MAD) in a sample of primary care patients. Participants are part of the Primary Care Anxiety Project, a naturalistic, longitudinal study of anxiety disorders in primary care. Participants completed a questionnaire screening for anxiety symptoms. Those screening positive were invited for an interview to diagnose MAD and DSM-IV Axis I disorders. Participants were then interviewed at 6 and 12 months postintake. Of 1634 participants completing an intake interview, four participants (0.2%) met complete DSM-IV MAD criteria. The adjusted probability of remitting from MAD in 1 year was 80%. Although this was not a prevalence study, results indicate a very low occurrence of MAD across 15 primary care settings. Further, they indicate that this diagnosis may not be stable across time and raise doubts about its utility.",Weisberg RB.; Maki KM.; Culpepper L.; Keller MB.,2005.0,,0,0,
2767,Stress doses of hydrocortisone reduce chronic stress symptoms and improve health-related quality of life in high-risk patients after cardiac surgery: a randomized study,"ER METHODSThirty-six high-risk patients undergoing cardiac surgery were prospectively randomized to receive either stress doses of hydrocortisone or placebo. Of 28 available patients at 6 months after cardiac surgery, 14 had received hydrocortisone, and 14 had received placebo. Traumatic memories, chronic stress symptoms (posttraumatic stress disorder scores), and health-related quality of life were measured by using validated questionnaires.RESULTSCompared with patients from the placebo group, patients from the hydrocortisone group had a significantly shorter duration of intensive care unit treatment, required lower doses of the stress hormone norepinephrine during cardiac surgery, and had significantly fewer stress symptoms and a better health-related quality of life regarding physical function, chronic pain, general health, vitality, and mental health during follow-up. The groups did not differ with regard to the number or type of intensive care unit-related traumatic memories.CONCLUSIONSThe use of stress doses of hydrocortisone in high-risk cardiac surgical patients reduces perioperative stress exposure, decreases chronic stress symptoms, and improves health-related quality of life at 6 months after cardiac surgery.OBJECTIVESImprovement in health-related quality of life is a major object of cardiac surgery. However, high stress exposure during the perioperative period of cardiac surgery can result in the formation of traumatic memories and symptoms of chronic stress or even posttraumatic stress disorder, which can have negative effects on health-related quality-of-life outcome. In this controlled study we examined whether exogenously administered stress doses of hydrocortisone during cardiac surgery reduce perioperative stress exposure and the long-term incidence of chronic stress symptoms and improve health-related quality of life after cardiac surgery.","Weis, F; Kilger, E; Roozendaal, B; Quervain, D J; Lamm, P; Schmidt, M; Schmölz, M; Briegel, J; Schelling, G",2006.0,10.1016/j.jtcvs.2005.07.063,0,0,
2768,Treating obsessive-compulsive and tic disorders,,"Weir, E",2000.0,,0,0,
2769,Dynamics of exercise induced affect,"This study investigated: (a) whether moderate intensity aerobic exercise exerted a significant affective influence during, and postexercise, (b) the nature of the affective response to exercise in relation to positive and negative affects, and affects associated with physiological distress, and (c) whether exercise induced affect was significantly influenced by exercise behaviour. Habitual exercisers (n = 15) and sedentary participants (n = 13) undertook three randomly allocated interventions; (a) exercise (EX; i.e., 20 min of cycling at 60% estimated VO2max), (b) normal workstation duties for 60 min (WRK), and (c) a 60 min sedentary lunch break (SED). Affect was measured pre, post, and 90 min postintervention, as well as every 5 min during exercise, using the Subjective Exercise Experiences Scale (SEES; McAuley and Courneya, 1994). Exercise behaviour had no significant effect on affective responses to exercise in this study (p >.05). Significant (p <.05) postintervention increases in positive affect were found for EX compared to WRK and SED indicating that exercise did produce a positive affective influence. Despite enduring postexercise (i.e., 90 min) improvements in both positive and negative affects, and affects related to fatigue, the affective response during exercise was characterised by significant (p <.05) decreases in levels of positive affect and increased levels of affects related to fatigue.",Watt B.J.; Spinks W.L.,1997.0,,0,0,
2770,Emotional dysfunction in schizophrenia spectrum psychosis: the role of illness perceptions.,"Assessing illness perceptions has been useful in a range of medical disorders. This study of people with a recent relapse of their psychosis examines the relationship between illness perception, their emotional responses and their attitudes to medication. One hundred patients diagnosed with a non-affective psychotic disorder were assessed within 3 months of relapse. Measures included insight, self-reported illness perceptions, medication adherence, depression, self-esteem and anxiety. Illness perceptions about psychosis explained 46, 36 and 34% of the variance in depression, anxiety and self-esteem respectively. However, self-reported medication adherence was more strongly associated with a measure of insight. Negative illness perceptions in psychosis are clearly related to depression, anxiety and self-esteem. These in turn have been linked to symptom maintenance and recurrence. Clinical interventions that foster appraisals of recovery rather than of chronicity and severity may therefore improve emotional well-being in people with psychosis. It might be better to address adherence to medication through direct attempts at helping them understand their need for treatment.",Watson PW.; Garety PA.; Weinman J.; Dunn G.; Bebbington PE.; Fowler D.; Freeman D.; Kuipers E.,2006.0,10.1017/S0033291706007458,0,0,
2771,The effects of prolonged exposure to phobic situations upon agoraphobic patients treated in groups.,,Watson JP.; Mullett GE.; Pillay H.,1973.0,,0,0,
2772,Physiological habituation to continuous phobic stimulation.,,Watson JP.; Gaind R.; Marks IM.,1972.0,,0,0,
2773,Conspicuous psychotic behavior as a manipulative tool,,"Watson, C G",1973.0,,0,0,
2774,Verbal repetition in the reappraisal of contamination-related thoughts.,"Acceptance and Commitment Therapy advocates use of cognitive defusion techniques to reduce the distress evoked by negative thoughts, including verbal repetition (VR). In VR, a negative word is repeated until its semantic meaning is diluted (i.e. until semantic satiation is achieved). The present two studies examined whether VR is more effective than brief imaginal exposure (IE) and no intervention (CONT) in the reappraisal of contamination-related thoughts. Participants high in contamination fears identified their most distressing thoughts and were randomly assigned to VR, IE, or CONT. A category membership decision task was also conducted to determine if VR produced semantic satiation. In Study 1, there was no evidence of semantic satiation. Significant reductions in negative response to the thoughts was observed immediately following VR, but not IE or CONT; however, at one-week follow-up, both VR and IE groups reported similar reductions. In Study 2, the effects of VR and IE practice between post-intervention and follow-up were examined, as well as changes in behavioural avoidance. VR was found to produce semantic satiation of contamination thoughts, and VR was associated with less negative response at follow-up relative to IE and CONT, but the degree of satiation was not associated with the decreases in negative response. Only IE produced decreases in behavioural avoidance and vigilance monitoring. Taken together, these results suggest that VR may have potential as an additional strategy for managing obsessional thoughts, but more research is warranted.",Watson C.; Burley MC.; Purdon C.,2010.0,10.1017/S1352465810000196,0,0,
2775,Effects of leukoreduced blood on acute lung injury after trauma: a randomized controlled trial.,"The requirement for a blood transfusion after trauma is associated with an increased risk of acute lung injury. Residual leukocytes contaminating red cells are potential mediators of this syndrome. The goal of this trial was to test our hypothesis that prestorage leukoreduction of blood would reduce rates of posttraumatic lung injury. Double blind, randomized, controlled clinical trial. University-affiliated level I trauma center in King County, Seattle, WA. Two hundred sixty-eight injured patients requiring red blood cell transfusion within 24 hrs of injury. Prestorage leukoreduced vs. standard allogeneic blood transfusions. We compared the incidence of acute lung injury and acute respiratory distress syndrome at early (< or = 72 hrs) and late (> 72 hrs) time points after injury. In a subset, we compared plasma levels of surfactant protein-D and von Willebrand factor antigen between intervention arms. Rates of acute lung injury (relative risk [RR] 1.06, 95% confidence interval [CI] .69-1.640) and acute respiratory distress syndrome (RR .96, 95% CI 0.48-1.91) were not statistically different between intervention arms early after injury. Similarly, no statistically significant effect of leukoreduced transfusion on rates of acute lung injury (RR .88, 95% CI .54-1.44) or acute respiratory distress syndrome (RR .95, 95% CI .58-1.57) was observed to occur late after injury. There was no significant difference in the number of ventilator-free days or in other ventilator parameters between intervention arms. No statistically significant effect of leukoreduced blood on plasma levels of surfactant protein-D or von Willebrand factor antigen was identified. Prestorage leukoreduction had no effect on the incidence or timing of lung injury or on plasma measures of systemic alveolar and endothelial inflammation in a population of trauma patients requiring transfusion. The relationship between transfusion and lung injury is not obviously explained by mechanistic pathways involving the presence of transfused leukocytes.",Watkins TR.; Rubenfeld GD.; Martin TR.; Nester TA.; Caldwell E.; Billgren J.; Ruzinski J.; Nathens AB.,2008.0,10.1097/CCM.0b013e318170a9ce,0,0,
2776,Effect of kava extract on vagal cardiac control in generalized anxiety disorder: preliminary findings,"ER Anxiety disorders are associated with low vagal control of heart rate and increased risk of cardiac mortality and sudden cardiac death. This study examined whether the herbal anxiolytic, kava, produces improvement in vagal control in generalized anxiety disorder. Before and after treatment with placebo (n = 7) or kava (n = 6), two indices of vagal control were measured under supine conditions using power spectral analysis: baroreflex control of heart rate (BRC) and respiratory sinus arrhythmia (RSA). Significantly more patients treated with kava showed improved BRC compared to the placebo group (p < 0.05). Furthermore, the magnitude of improvement in BRC was significantly correlated with the degree of clinical improvement (p < 0.05). RSA did not respond to treatment. These preliminary findings suggest that kava might exert a favourable effect on reflex vagal control of heart rate in generalized anxiety disorder patients. The parallel clinical and BRC responses may reflect an underlying common effect of this herbal anxiolytic.","Watkins, L L; Connor, K M; Davidson, J R",2001.0,10.1177/026988110101500407,0,0,
2777,Rumination-focused cognitive-behavioural therapy for residual depression: phase II randomised controlled trial.,"About 20% of major depressive episodes become chronic and medication-refractory and also appear to be less responsive to standard cognitive-behavioural therapy (CBT). To test whether CBT developed from behavioural activation principles that explicitly and exclusively targets depressive rumination enhances treatment as usual (TAU) in reducing residual depression. Forty-two consecutively recruited participants meeting criteria for medication-refractory residual depression were randomly allocated to TAU v. TAU plus up to 12 sessions of individual rumination-focused CBT. The trial has been registered (ISRCTN22782150). Adding rumination-focused CBT to TAU significantly improved residual symptoms and remission rates. Treatment effects were mediated by change in rumination. This is the first randomised controlled trial providing evidence of benefits of rumination-focused CBT in persistent depression. Although suggesting the internal validity of rumination-focused CBT for residual depression, the trial lacked an attentional control group so cannot test whether the effects were as a result of the specific content of rumination-focused CBT v. non-specific therapy effects.",Watkins ER.; Mullan E.; Wingrove J.; Rimes K.; Steiner H.; Bathurst N.; Eastman R.; Scott J.,2011.0,10.1192/bjp.bp.110.090282,0,0,
2778,Decentring and distraction reduce overgeneral autobiographical memory in depression.,"Increased recall of categorical autobiographical memories is a phenomenon unique to depression and post-traumatic stress disorder, and is associated with a poor prognosis for depression. Although the elevated recall of categorical memories does not change on remission from depression, recent findings suggest that overgeneral memory may be reduced by cognitive interventions and maintained by rumination. This study tested whether cognitive manipulations could influence the recall of categorical memories in dysphoric participants. Forty-eight dysphoric and depressed participants were randomly allocated to rumination or distraction conditions. Before and after the manipulation, participants completed the Autobiographical Memory Test, a standard measure of overgeneral memory. Participants were then randomized to either a 'decentring' question (Socratic questions designed to facilitate viewing moods within a wider perspective) or a control question condition, before completing the Autobiographical Memory Test again. Distraction produced significantly greater decreases in the proportion of memories retrieved that were categorical than rumination. Decentring questions produced significantly greater decreases in the proportion of memories retrieved that were categorical than control questions, with this effect independent of the prior manipulation. Elevated categorical memory in depression is more modifiable than has been previously assumed; it may reflect the dynamic maintenance of a cognitive style that can be interrupted by brief cognitive interventions.",Watkins E.; Teasdale JD.; Williams RM.,2000.0,,0,0,
2779,Psychophysiological responses during analogue systematic desensitization and nonrelaxation control procedures.,"This investigation tested the hypotheses than an analogue systematic desensitization procedure (SD) would be both more effective and more efficient than a comparable non-relaxation control procedure (NRC) with respect to subjective report, behavioral and psychophysiological variables. Phobic subjects responded to slides depicting a feared aversive stimulus. The SD procedure resulted in significantly less reported fear, fewer trials to a criterion level of decrease in subjective fear, and significantly greater decreases in ANS baseline measures. However, measures of behavioral avoidance and measures of decrease in psychophysiological responsivity to the aversive stimuli revealed significant changes within both SD and NRC groups,and no significant differences between the groups,whether or not the groups were equated for number of stimulus presentations. The results, indicating equivalent efficacy and efficiency for the SD and NRC procedures, suggested a limited role for relaxation in systematic desensitization. An extinction or habituation hypothesis was supported at the expense of a counterconditioning hypothesis. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Waters, William F; McDonald, David G; Koresko, Richard L; Cooke, Crowder, Davison, Guthrie, Krapfl, Lader, Lang, Lang, London, Mathews, Melamed, Paul, Proctor, Rachman, Schubot, Thompson, Van Egeren, Wolpe",1972.0,,0,0,
2780,Psychophysiological responses during analogue systematic desensitization and non-relaxation control procedures.,,Waters WF.; McDonald DG.; Koresko RL.,1972.0,,0,0,
2781,"Autonomic response to auditory, visual and imagined stimuli in a systematic desensitization context.",,Waters WF.; McDonald DG.,1973.0,,0,0,
2782,Biomarkers affected by impact velocity and maximum strain of cartilage during injury,"Osteoarthritis is one of the most common, debilitating, musculoskeletal diseases; 12% associated with traumatic injury resulting in post-traumatic osteoarthritis (PTOA). Our objective was to develop a single impact model with cartilage ""injury level"" defined in terms of controlled combinations of strain rate to a maximum strain (both independent of cartilage load resistance) to study their sensitivity to articular cartilage cell viability and potential PTOA biomarkers. A servo-hydraulic test machine was used to measure canine humeral head cartilage explant thickness under repeatable pressure, then subject it (except sham and controls) to a single impact having controlled constant velocity V=1 or 100mm/s (strain rate 1.82 or 182/s) to maximum strain ε=10%, 30%, or 50%. Thereafter, explants were cultured in media for twelve days, with media changed at day 1, 2, 3, 6, 9, 12. Explant thickness was measured at day 0 (pre-injury), 6 and 12 (post-injury). Cell viability, and tissue collagen and glycosaminoglycan (GAG) were analyzed immediately post-injury and day 12. Culture media were tested for biomarkers: GAG, collagen II, chondroitin sulfate-846, nitric oxide, and prostaglandin E2 (PGE2). Detrimental effects on cell viability, and release of GAG and PGE2 to the media were primarily strain-dependent, (PGE2 being more prolonged and sensitive at lower strains). The cartilage injury model appears to be useful (possibly superior) for investigating the relationship between impact severity of injury and the onset of PTOA, specifically for discovery of biomarkers to evaluate the risk of developing clinical PTOA, and to compare effective treatments for arthritis prevention.",Waters N.P.; Stoker A.M.; Carson W.L.; Pfeiffer F.M.; Cook J.L.,2014.0,10.1016/j.jbiomech.2014.06.015,0,0,
2783,Attention training towards positive stimuli in clinically anxious children,"ER OBJECTIVE: Attention bias modification training (ABMT) is a promising treatment. Nevertheless, few studies examine its effectiveness in anxious children. This study examined the efficacy of such an ABMT protocol in pediatric anxiety.METHOD: 37 anxious children were randomly assigned to one of two ABMT conditions. In the attention-towards-positive (ATP) condition, children searched 3√ó3 matrices for a happy face amongst angry faces. In the attention-training-control (ATC) condition, they searched for a bird amongst flowers. Children completed 160 trials in each of four training sessions per week for three weeks at home (1920 total trials). Clinical and attention bias measures were assessed before and after ABMT.RESULTS: Children randomized to ATP showed greater post-training attention bias towards happy faces than children randomized to ATC. ATP also produced significantly greater reductions in clinician-rated diagnostic severity and number of diagnoses, compared to ATC. In the ATP group, 50% of children who completed training did not meet criteria for their principal diagnosis, compared to 8% in the ATC group.CONCLUSION: Training anxious children to focus attention on positive features of their environment may be a promising treatment.","Waters, A M; Pittaway, M; Mogg, K; Bradley, B P; Pine, D S",2013.0,10.1016/j.dcn.2012.09.004,0,0,
2784,Cognitive-behavioural therapy for young children with anxiety disorders: comparison of a Child + Parent condition versus a Parent Only condition,"ER The present study compared the efficacy of a group-based cognitive-behavioural treatment (GCBT) delivered exclusively to parents of young anxious children (between 4 and 8 years of age) with the same intervention delivered to both children and parents, relative to a Wait-list Control condition. Parents of children in the Parent Only condition (N = 25) received 10 weekly sessions of GCBT whereas children and parents in the Parent + Child condition (N = 24) each received 10 weekly sessions of GCBT. Intent-to-treat analyses indicated that both active treatment conditions were superior to the Wait-list condition (N = 11), with 55.3% of children in the Parent Only condition and 54.8% of children in the Parent + Child condition no longer meeting criteria for their principal diagnosis at post-treatment. These treatment gains were maintained in both treatment conditions at six-month and 12-month follow-up assessments. There were no significant differences between the two active conditions on other outcome measures including parental psychopathology and parenting style. However, an unexpected finding was that parenting satisfaction and to some extent parenting competence reduced significantly from pre- to post-treatment regardless of the active treatment condition. The present results suggest that GCBT delivered exclusively to parents of young anxious children may be a viable treatment alternative for improving accessibility to efficacious treatments for children with anxiety disorders and for reducing costs associated with mental health care delivery.","Waters, A M; Ford, L A; Wharton, T A; Cobham, V E",2009.0,10.1016/j.brat.2009.04.008,0,0,
2785,Augmenting one-session treatment of children's specific phobias with attention training to positive stimuli,"ER This study examined the efficacy of combining two promising approaches to treating children's specific phobias, namely attention training and one 3-h session of exposure therapy ('one-session treatment', OST). Attention training towards positive stimuli (ATP) and OST (ATP+OST) was expected to have more positive effects on implicit and explicit cognitive mechanisms and clinical outcome measures than an attention training control (ATC) condition plus OST (ATC+OST). Thirty-seven children (6-17 years) with a specific phobia were randomly assigned to ATP+OST or ATC+OST. In ATP+OST, children completed 160 trials of attention training responding to a probe that always followed the happy face in happy-angry face pairs. In ATC+OST, the probe appeared equally often after angry and happy faces. In the same session, children completed OST targeting their phobic situation/object. Clinical outcomes included clinician, parent and child report measures. Cognitive outcomes were assessed in terms of change in attention bias to happy and angry faces and in danger and coping expectancies. Assessments were completed before and after treatment and three-months later. Compared to ATC+OST, the ATP+OST condition produced (a) significantly greater reductions in children's danger expectancies about their feared situations/object during the OST and at three-month follow-up, and (b) significantly improved attention bias towards positive stimuli at post-treatment, which in turn, predicted a lower level of clinician-rated phobia diagnostic severity three-months after treatment. There were no significant differences between ATP+OST and ATC+OST conditions in clinician, parent, or child-rated clinical outcomes. Training children with phobias to focus on positive stimuli is effective in increasing attention towards positive stimuli and reducing danger expectancy biases. Studies with larger sample sizes and a stronger 'dose' of ATP prior to the OST may reveal promising outcomes on clinical measures for training attention towards positive stimuli.","Waters, A M; Farrell, L J; Zimmer-Gembeck, M J; Milliner, E; Tiralongo, E; Donovan, C L; McConnell, H; Bradley, B P; Mogg, K; Ollendick, T H",2014.0,10.1016/j.brat.2014.07.020,0,0,
2786,"Safety and immunogenicity of a rederived, live-attenuated dengue virus vaccine in healthy adults living in Thailand: a randomized trial","ER Safety and immunogenicity of two formulations of a live-attenuated tetravalent dengue virus (TDEN) vaccine produced using rederived master seeds from a precursor vaccine were tested against a placebo control in a phase II, randomized, double blind trial (NCT00370682). Two doses were administered 6 months apart to 120 healthy, predominantly flavivirus-primed adults (87.5% and 97.5% in the two vaccine groups and 92.5% in the placebo group). Symptoms and signs reported after vaccination were mild to moderate and transient. There were no vaccine-related serious adverse events or dengue cases reported. Asymptomatic, low-level viremia (dengue virus type 2 [DENV-2], DENV-3, or DENV-4) was detected in 5 of 80 vaccine recipients. One placebo recipient developed a subclinical natural DENV-1 infection. All flavivirus-unprimed subjects and at least 97.1% of flavivirus-primed subjects were seropositive to antibodies against all four DENV types 1 and 3 months post-TDEN dose 2. The TDEN vaccine was immunogenic with an acceptable safety profile in flavivirus-primed adults.","Watanaveeradej, V; Gibbons, R V; Simasathien, S; Nisalak, A; Jarman, R G; Kerdpanich, A; Tournay, E; Barrerra, R; Dessy, F; Toussaint, J F; Eckels, K H; Thomas, S J; Innis, B L",2014.0,10.4269/ajtmh.13-0452,0,0,
2787,Do calendars enhance posttraumatic temporal orientation?: a pilot study.,"The purpose of this study was to determine the effectiveness of an in-room calendar to correct temporal disorientation in a brain-injured population. Thirty consecutive brain injured patients (16 traumatic, 14 non-traumatic) admitted to a brain injury rehabilitation unit were randomly assigned to either a group with in-room calendars (n = 14) or a group without calendars (n = 16). A baseline Temporal Orientation Test (TOT) score was obtained. Daily TOT scores were obtained for patients throughout their rehabilitation stay or until two consecutive normal scores were obtained. When orientation errors were made, they were corrected and the attention of the patient was drawn to the calendar. There were no statistically significant associations between group and age, gender or mean GCS (for patients with traumatic etiology). Only baseline length of post-traumatic amnesia (PTA) had a significant association with eventual emergence from PTA (as defined by a normal score on the TOT). Age and presence of calendar were not significant. In-room calendars have been espoused as orientation aides. The data from this pilot study suggest that calendars do not hasten re-orientation. This finding suggests that other widely held but not rigorously tested beliefs regarding cognitive rehabilitation may need to be examined.",Watanabe TK.; Black KL.; Zafonte RD.; Millis SR.; Mann NR.,1998.0,,0,0,
2788,Change in quality of life and their predictors in the long-term follow-up after group cognitive behavioral therapy for social anxiety disorder: A prospective cohort study.,"Background: Social anxiety disorder (SAD) is one of the most common anxiety disorders. The efficacy of cognitive behaviour therapy (CBT) has been examined but to date its effects on Quality of Life (QoL) have not been appropriately evaluated especially in the long term. The study aimed to examine, in the long term, what aspects of Quality of Life (QoL) changed among social anxiety disorder (SAD) patients treated with group cognitive behaviour therapy (CBT) and what predictors at baseline were associated with QoL. Methods: Outpatients diagnosed with SAD were enrolled into group CBT, and assessed at follow-ups for up to 12 months in a typical clinical setting. QoL was evaluated using the Short Form 36. Various aspects of SAD symptomatology were also assessed. Each of the QoL domains and scores on symptomatology were quantified and compared with those at baseline. Baseline predictors of QoL outcomes at follow-up were investigated. Results: Fifty-seven outpatients were enrolled into group CBT for SAD, 48 completed the whole program, and 44 and 40 completed assessments at the 3-month and 12-month follow-ups, respectively. All aspects of SAD symptomatology and psychological subscales of the QoL showed statistically significant improvement throughout follow-ups for up to 12 months. In terms of social functioning, no statistically significant improvement was observed at either follow-up point except for post-treatment. No consistently significant pre-treatment predictors were observed. Conclusions: After group CBT, SAD symptomatology and some aspects of QoL improved and this improvement was maintained for up to 12 months, but the social functioning domain did not prove any significant change statistically. Considering the limited effects of CBT on QoL, especially for social functioning, more powerful treatments are needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Watanabe, Norio; Furukawa, Toshi A; Chen, Junwen; Kinoshita, Yoshihiro; Nakano, Yumi; Ogawa, Sei; Funayama, Tadashi; Ietsugu, Tetsuji; Noda, Yumiko; Aaronson, Acarturk, Andersson, Andrews, Asakura, Baker, Barrera, Beesdo, Carlbring, Chartier, Chen, Clark, Cohen, Cottraux, Derogatis, Dimenas, Eng, First, Fukuhara, Furukawa, Ghaedi, Hansen, Haug, Hollandsworth, Kanai, Kasper, Keller, Kessler, Kessler, Kessler, Liebowitz, Mattick, McHorney, Mortberg, Rapaport, Safren, Schneier, Simon, Stein, Stein, Stein, Stein, Wittchen",2010.0,,0,0,
2789,Pathway from PTSD to respiratory health: Longitudinal evidence from a psychosocial intervention.,"Objective: Respiratory illness and posttraumatic stress disorder (PTSD) are common debilitating conditions that frequently co-occur. Observational studies indicate that PTSD, independently of smoking, is a major risk and maintenance factor for lower respiratory symptoms (LRS). The current study experimentally tested this etiologic pathway by investigating whether LRS can be reduced by treating PTSD symptoms. Method: Ninety daily smokers exposed to the World Trade Center (WTC) disaster (mean age 50 years, 28% female; 68% White) completed 8-session group-based weekly comprehensive trauma management and smoking cessation treatment that focused on skills to alleviate PTSD symptoms. LRS, PTSD symptoms, and smoking were assessed weekly. Data was analyzed using multilevel models of within-person associations between LRS, PTSD symptoms, smoking, and treatment dose across 8 weekly sessions with concurrent and lagged outcomes. Results: LRS improved significantly with treatment (reduction of .50 standard deviations). Reduction in PTSD symptoms uniquely predicted improvement in LRS at consecutive sessions 1 week apart and fully accounted for the treatment effect on LRS. The effect of PTSD symptoms was stronger than that of smoking, and the only effect to remain significant when both entered the model. Notably, reduction in LRS did not predict future improvement in PTSD symptoms. Conclusions: The results are in line with the etiologic pathway suggesting that PTSD symptoms are a risk and maintenance factor for chronic LRS and that treatment of PTSD can help to alleviate LRS in trauma-exposed populations. PTSD is emerging as a novel and important treatment target for chronic respiratory problems. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Waszczuk, Monika A; Li, Xiaotong; Bromet, Evelyn J; Gonzalez, Adam; Zvolensky, Michael J; Ruggero, Camilo; Luft, Benjamin J; Kotov, Roman; Aldrich, Alvares, Bar-Haim, Blanchard, Blechert, Brackbill, Bromet, Brown, Burney, Cohen, Constans, Cwikel, Dales, Dasaro, Dobie, Druss, Druss, Engel, Feldner, Fu, Gavett, Gonzalez, Herbert, Himelhoch, Hoge, Ironson, Kahler, Koenen, Kotov, Landrigan, Lecrubier, Leucht, Lioy, Luft, McGee, Mercer, Muthen, Nair, Nandi, Naylor, Niles, Orth, Pace, Paunovi, Payne, Perrin, Pietrzak, Pitman, Pole, Prezant, Scott, Scott, Sobell, Spitzer, Spitzer, Stellman, Unutzer, Ustun, Von Korff, Weathers, Webber, Weisberg, Whiteman, Wilkins, Wisnivesky, Yehuda, Yellowlees, Zvolensky",2017.0,,0,0,
2790,Unique characteristics of informal hospice cancer caregiving,"ER Purpose: The purpose of this study was to describe the unique characteristics of informal hospice cancer caregiving. Methods: Researchers conducted a secondary analysis of data drawn from a randomized clinical trial of an informal hospice caregiving intervention (N = 348). Demographic characteristics and measures of the informal caregiving experience of hospice patients and their informal caregivers were compared based on the patient's diagnosis using chi-square tests for association of categorical variables and t tests for continuous variables. Results: Informal caregivers of cancer patients differed from their non-cancer counterparts in a number of respects including patient age, caregiver age, patient residence, relationship between patient and caregiver, amount and duration of care provided, likelihood to incur out-of-pocket expenses related to patient care, caregiver problem-solving style, and impact on caregiver daily schedule. There were no statistically significant differences between cancer and non-cancer caregivers in terms of gender, race, employment status, anxiety, and quality of life. Conclusions: While cancer and non-cancer caregivers are similar in many respects, a number of unique features characterize the informal hospice cancer caregiving experience. Attention to these unique features will allow hospice providers to tailor supportive care interventions to better address cancer caregivers' needs.","Washington, K T; Pike, K C; Demiris, G; Oliver, D P",2015.0,10.1007/s00520-014-2570-z,0,0,
2791,PTSD risk and mental health care engagement in a multi-war era community sample of women veterans.,"Post-traumatic stress disorder (PTSD) is common in women veterans (WVs), and associated with significant co-morbidity. Effective treatment is available; however, PTSD is often unrecognized. Identify PTSD prevalence and mental healthcare (MHC) use in a representative national WV sample. Cross-sectional, population-based 2008-2009 national survey of 3,611 WVs, weighted to the population. We screened for PTSD using a validated instrument, and also assessed demographic characteristics, health characteristics, and MHC use in the prior 12 months. Among those screening positive, we conducted multivariate logistic regression to identify independent predictors of MHC use. Overall, 13.0 % (95 % confidence interval [CI] 9.8-16.2) of WVs screened PTSD-positive. Veterans Health Administration (VA) healthcare was used by 31.1 % of PTSD-positives and 11.4 % of PTSD-negatives (p<0.001). Among those screening positive, 48.7 % (95 % CI 35.9-61.6) used MHC services (66.3 % of VA-users, 40.8 % of VA-nonusers; p<0.001). Having a diagnosis of depression (OR=8.6; 95 % CI 1.5-48.9) and VA healthcare use (OR=2.7; 95 % CI 1.1-7.0) predicted MHC use, whereas lacking a regular provider for health care (OR=0.2; 95 % CI 0.1-0.4) and household income below the federal poverty level (OR=0.2; 95 % CI 0.1-0.5) predicted nonuse. More than one in eight WVs screened positive for PTSD. Though a majority of VA-users received MHC, low income predicted nonuse. Only a minority of VA-nonusers received MHC. The majority of WVs use non-VA healthcare providers, who may be unaware of their veteran status and PTSD risk. VA outreach to educate VA-nonusers and their healthcare providers about WVs' PTSD risk and available evidence-based VA treatment options is one approach to extend the reach of VA MHC. Research to characterize barriers to VA MHC use for VA-nonusers and low income VA-users is warranted to better understand low service utilization, and to inform program development to engage more WVs in needed MHC.",Washington DL.; Davis TD.; Der-Martirosian C.; Yano EM.,2013.0,10.1007/s11606-012-2303-2,0,0,
2792,Research in private practice.,"The authors discuss designing an empirically oriented practice and choosing outcome measures for a private practice. In addition, the authors illustrate research in a private practice setting by examining a study they conducted on effectiveness of cognitive-behavioral therapy treatment for panic disorder. Participants were 36 female and 14 male clients (aged 18-59 yrs) of The Anxiety Disorders Clinic in Lake Oswego, Oregon. All clients received panic control treatment and manuals. Overall, the clients showed substantial improvement in their symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Warren, Ricks; Thomas, Jay C; Antony, Barlow, Barlow, Barlow, Barlow, Beck, Beck, Beck, Borkovec, Brown, Chambless, Chambless, Clement, Corcoran, Cronbach, Foxhall, Guy, Hayes, Kiresuk, Markowitz, Marks, McDonald, Meyer, Nezu, Persons, Persons, Reiss, Sookman, Spielberger, Strand, Trierweiler, Warren, Warren, Warren, Warren, Warren, Warren, Warren, Warren, Warren, Warren, Warren, Zaider, Zgourides; Thomas, Jay C [Ed], Hersen, Michel [Ed]",2003.0,,0,0,
2793,Cognitive-behavior therapy of obsessive-compulsive disorder in private practice: an effectiveness study.,"A controversy exists over whether or not the results of randomized controlled trials (RCTs) are generalizable to routine clinical practice. The present study examines the effectiveness of cognitive-behavior therapy (CBT) for obsessive-compulsive disorder (OCD) in a private practice setting. Twenty-six consecutive clients referred to a private anxiety disorders specialty clinic began treatment for OCD. Of the 19 (73%) clients who completed treatment, 84% were treatment responders. Clients, treatment, and outcome of the present study are compared with those of representative RCTs, and it is concluded that there are more similarities than differences. It is concluded that CBT can be effectively delivered in routine clinical practice.",Warren R.; Thomas JC.,,,0,0,
2794,"The neural bases of acquisitiveness: Decisions to acquire and discard everyday goods differ across frames, items, and individuals","The human tendency to acquire and keep large quantities of goods has become a serious concern, but has yet to be examined from a neuroscientific perspective. The mesolimbocortical system, particularly the orbitofrontal cortex (OFC) and nucleus accumbens (NAcc), is implicated when humans and animals acquire rewards. However, this may not extend to acquisitiveness per se, which involves fairly mundane items and is interconnected with a failure to discard. Moreover, the NAcc has not been implicated in neuroimaging studies of the extreme acquisitiveness of compulsive hoarders. In a study of the neural bases of normal acquisitiveness, subjects made decisions during functional neuroimaging to acquire or remove everyday items from a hypothetical collection, while maximizing personal preference or monetary profit. All decisions engaged the OFC, but the OFC and all regions of interest shifted in their relative involvement across the four decision contexts. The NAcc was only engaged during personal acquisition to the extent of problematic hoarding, suggesting that even common items can acquire an incentive salience that makes them hard to resist for acquisitive individuals. The types of items preferred also shifted with condition, with subjects only being biased toward expensive items when instructed to maximize profit. Item preferences even differed depending on whether participants were acquiring versus removing items, even though the task only differed superficially in the two conditions. Acquisitiveness reflects a complex mix of affective, cognitive, and personality factors that extend well beyond the drive to acquire valuable resources, with important implications for basic decision science, sustainability, and pathologies associated with compulsive acquisition. © 2012 Elsevier Ltd.",Wang J.M.; Seidler R.D.; Hall J.L.; Preston S.D.,2012.0,10.1016/j.neuropsychologia.2012.01.033,0,0,
2795,Distraction arthrolysis of posttraumatic elbow stiffness with a hinged external fixator.,"The treatment of elbow stiffness remains a challenge for orthopedic surgeons. A hinged external fixator with distraction ability has recently emerged as a new option in the surgical treatment of elbow stiffness. Between January 2007 and December 2009, twenty-five posttraumatic stiff elbows (mean patient age, 29.2 years) received distraction arthrolysis from 1 surgeon group (W.J.W., L.H., P.Z.J.) at the authors' institution. For patients with only periarticular soft tissue contracture (grade 1), close mechanical distraction was performed with the assistance of an external fixator under anesthesia; open arthrolysis was avoided as much as possible. For patients who also had heterotopic ossification (grade 2), it was removed through a limited approach before the external fixator was applied. For patients with osteoarticular surface damage or destruction (grade 3), osteoarticular integrity was restored before arthrolysis. Range of motion increased markedly, from 33.4° (range, 0°-75°) preoperatively to 105.6° (range, 80°-140°) immediately postoperatively (Student's t test, P<.05). Of the 25 patients, 23 were followed for a mean of 16 months. No serious complications occurred. Mean range of motion was 97.4° (range, 70°-130°) at final follow-up, a significant increase from preoperatively (Student's t test, P<.05). No significant loss of range of motion was found at final follow-up compared with intraoperative values (average 8.2° loss; Student's t test, P>.05). This study suggests that a hinged external distraction fixator is a less invasive option for treating posttraumatic elbow stiffness and prevents contracture recurrence after arthrolysis.",Wang J.; Li H.; Zheng Q.; Feng G.; Li J.; Pan Z.,2012.0,10.3928/01477447-20121023-20,0,0,
2796,Anticonvulsants to treat post-traumatic stress disorder.,"Objective: We reviewed the existing literature on the efficacy of anticonvulsants in treating post-traumatic stress disorder. Methods: We performed a literature search using PubMed, EMBASE and the Cochrane database on 30 September 2013. Randomized, controlled studies that investigated the efficacy of anticonvulsants for post-traumatic stress disorder were included in this review. Studies with retrospective designs, case reports and case series were excluded. Results: A total of seven studies met the inclusion criteria for this review. Three studies used topiramate with negative findings regarding its efficacy. Two studies used divalproex, both of which failed to show superiority over placebo. One study used lamotrigine, with favourable results, and one study used tiagabine, with negative results. Conclusions: Future long-term studies with larger sample sizes are needed to investigate the clinical utility of anticonvulsants for post-traumatic stress disorder treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wang, Hee Ryung; Woo, Young Sup; Bahk, Won-Myong; Ahearn, Alderman, Bailey, Berger, Berigan, Berlant, Blake, Clark, Cohen, Connor, Davidson, Davidson, Davidson, Davidson, Davidson, Davis, Fesler, Friedman, Guy, Guy, Hamilton, Hamner, Hertzberg, Hertzberg, Iancu, Ipser, Liebowitz, Lindley, Lipov, Lipper, Lipper, Mula, Nutt, Petty, Schwartz, Taylor, Tucker, Yeh, Zohar",2014.0,,0,0,
2797,The clinical therapic efficiency of anethol trithione on dry eye,"ER METHODSIt was a prospective random double-blind controlled study. Eighty cases diagnosed dry eye in Ocular Surface Out-patient Clinic of Xiamen University Affiliated Xiamen Eye Center from 2006 to 2008 were divided into two groups: anethol trithione group and control group, 40 cases in each group. Every group was then divided into two subgroups: weak dry eye subgroup,middle and severe dry eye subgroup. All groups had been added with 0.05% refresh drops. All patients had been detected and evaluated by subjective symptoms of dry eye, visual acuity, corneal fluorescent staining (F1), break-up time (BUT) and Schirmer I test (SIT) at pretherapy and 3, 7, 28 d of post-therapy. All groups had been compared and analyzed by F test and sample mean difference (SMD) or median difference (MD) comparison between pre-therapy and post-therapy.RESULTSExcept of tear and red eye,the other subjective symptoms of dry eye, Fl, BUT and SIT of weak dry eye subgroup of both groups had been improved at 7 d after therapy. Only those of middle and severe dry eye subgroup of anethol trithione group had been improved at 7 d after therapy compared with those of pretherapy: SMD = 0.96 (visual tiredness), 1.26 (dry and unsmooth sensation), 0.82 (foreign body sensation), 1.28 (burning sensation), 1.05 ( photophobia), 1.48 (pain); MD = 0.30 (visual acuity), 4.00 (Fl), 5.00 (BUT), 5.00 (SIT) [F = 15.30 (visual tiredness), 15.68 (dry and unsmooth sensation), 13.56 (foreign body sensation), 20.91 (burning sensation), 18.90 (photophobia), 27.22 (pain), 10.54 (visual acuity),188.21 (F1), 261.76 (BUT), 269.05 (SIT); P  0.05]. SIT of anethol trithione group had been improved more significantly after therapy (F = 13.77, P < 0.05).CONCLUSIONAnethol trithione could significantly improve middle and severe dry eye patients' symptoms and signs whose lacrimal gland function survival and it has clinical application value.OBJECTIVETo investigate anethol trithione therapic efficiency on dry eye.","Wang, H; Liu, Z G; Peng, J; Lin, H; Zhong, J X; Hu, J Y",2009.0,,0,0,
2798,Clinical observation on physiological and psychological effects of Eight-Section Brocade on type 2 diabetic patients.,"To observe the physiological and psychological changing of type 2 diabetic patients after practicing Eight-Section Brocade, to evaluate the clinical curative effect, and to provide a safe and effective self-regulating method for type 2 diabetic patients. This study is a random controlled trial, the 54 type 2 diabetic patients were randomly assigned into the intervention and the control group. The intervention group was given a 2-month period of Eight-Section Brocade practice, then a comparison between groups was made. The intervention group continued to do Eight-Section Brocade practice for 2 months, so it was 4 months' intervention all together for this group, and then a comparison within the intervention group was made. There was significant difference 4 months later on HbA1c in the intervention group (P < 0.05). There was significant difference between the intervention and control groups on obsessive-compulsive, depression, anxiety and hostility scores after 2 months' practice (P < 0.05). There was significant difference between 2 and 4 months' practice on hostilities scores within the intervention group (P < 0.05). As an important part of the traditional Chinese medicine, Eight-section Brocade has physiological and psychological effects on type 2 Diabetic Patients.",Wang F.; Wang W.; Zhang R.; Lin Y.; Hong L.; Zhao Y.; Ni Q.; Zhang L.; Isiiyasutomo .; Tutiutitakuya .; Kosikawafusako .; Kisitaiti .; Havukiyutaka .; Suzukiakio .,2008.0,,0,0,
2799,Comparison of the neurobiological effects of attribution retraining group therapy with those of selective serotonin reuptake inhibitors.,"The aim of this study was to compare the effectiveness of attribution retraining group therapy (ARGT) with selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD). Subjects were sequentially recruited and randomized into two groups, one receiving ARGT (n = 63) and the other SSRIs (n = 66) for 8 weeks. Fifty-four ARGT outpatients with MDD (n = 19), GAD (n = 19), and OCD (n = 16) and 55 SSRI outpatients with MDD (n = 19), GAD (n = 19), and OCD (n = 17) completed the study. All subjects were assessed using the Hamilton Depression Scale and Hamilton Anxiety Scale before and after treatment. The 10-item Yale-Brown Obsessive Compulsive Scale was employed only for OCD subjects. Plasma levels of serotonin, norepinephrine, cortisol, and adrenocorticotropic hormone were also measured at baseline and 8 weeks after completion of treatment. Symptom scores were significantly reduced (P < 0.001) in both the ARGT and SSRI groups at the end of treatment. However, MDD, GAD and OCD patients in the ARGT group had significantly lower plasma cortisol concentrations compared to baseline (P < 0.05), whereas MDD and OCD patients receiving SSRIs showed significantly increased plasma levels of serotonin (P < 0.05). These findings suggest that ARGT may modulate plasma cortisol levels and affect the hypothalamus-pituitary-adrenal axis as opposed to SSRIs, which may up-regulate plasma serotonin levels via a different pathway to produce an overall improvement in the clinical condition of the patients.",Wang C.; Zhang N.; Zhang YL.; Zhang J.; Yang H.; Timothy TC.,2013.0,,0,0,
2800,Tai Chi for treating knee osteoarthritis: designing a long-term follow up randomized controlled trial,"ER METHODS/DESIGNForty eligible patients, age > 55 yr, BMI < or = 40 kg/m2 with tibiofemoral osteoarthritis (American College of Rheumatology criteria) are identified and randomly allocated to either Tai Chi (10 modified forms from classical Yang style Tai Chi) or attention control (wellness education and stretching). The 60-minute intervention sessions take place twice weekly for 12 weeks. The study is conducted at an urban tertiary medical center in Boston, Massachusetts. The primary outcome measure is the Western Ontario and McMaster Universities (WOMAC) pain subscale at 12 weeks. Secondary outcomes include weekly WOMAC pain, function and stiffness scores, patient and physician global assessments, lower-extremity function, knee proprioception, depression, self-efficacy, social support, health-related quality of life, adherence and occurrence of adverse events after 12, 24 and 48 weeks.DISCUSSIONIn this article, we present the challenges of designing a randomized controlled trial with long-term follow up. The challenges encountered in this design are: strategies for recruitment, avoidance of selection bias, the actual practice of Tai Chi, and the maximization of adherence/follow-up while conducting the clinical trial for the evaluation of the effectiveness of Tai Chi on KOA.TRIAL REGISTRATIONClinicalTrials.gov identifier: NCT00362453.BACKGROUNDKnee Osteoarthritis (KOA) is a major cause of pain and functional impairment among elders. Currently, there are neither feasible preventive intervention strategies nor effective medical remedies for the management of KOA. Tai Chi, an ancient Chinese mind-body exercise that is reported to enhance muscle function, balance and flexibility, and to reduce pain, depression and anxiety, may safely and effectively be used to treat KOA. However, current evidence is inconclusive. Our study examines the effects of a 12-week Tai Chi program compared with an attention control (wellness education and stretching) on pain, functional capacity, psychosocial variables, joint proprioception and health status in elderly people with KOA. The study will be completed by July 2009.","Wang, C; Schmid, C H; Hibberd, P L; Kalish, R; Roubenoff, R; Rones, R; Okparavero, A; McAlindon, T",2008.0,10.1186/1471-2474-9-108,0,0,
2801,Ultrasound-Guided versus Fluoroscopy-Guided Deep Cervical Plexus Block for the Treatment of Cervicogenic Headache,"ER Objective. The aim of this study was to compare the efficacy of ultrasound-guided deep cervical plexus block with fluoroscopy-guided deep cervical plexus block for patients with cervicogenic headache (CeH). Methods. A total of 56 patients with CeH were recruited and randomly assigned to either the ultrasound-guided (US) or the fluoroscopy-guided (FL) injection group. A mixture of 2-4?mL 1% lidocaine and 7?mg betamethasone was injected along C2 and/or C3 transverse process. The measurement of pain was evaluated by patients' ratings of a 10-point numerical pain scale (NPS) before and 2?wks, 12?wks, and 24?wks after treatments. Results. The blocking procedures were well tolerated. The pain intensity, as measured by NPS, significantly decreased at 2?wks after injection treatment in both US and FL groups, respectively, compared with that of baseline (P < 0.05). The blocking procedures had continued, and comparable pain relieving effects appeared at 12?wks and 24?wks after treatment in both US and FL groups. There were no significant differences observed in the NPS before and 2?wks, 12?wks, and 24?wks after treatment between US and FL groups. Conclusions. The US-guided approach showed similar satisfactory effect as the FL-guided block. Ultrasonography can be an alternative method for its convenience and efficacy in deep cervical plexus block for CeH patients without radiation exposure.","Wan, Q; Yang, H; Li, X; Lin, C; Ke, S; Wu, S; Ma, C",2017.0,10.1155/2017/4654803,0,0,
2802,Breathlessness rating type influences respiratory behavior during hypercapnia in the rebreathing test,"Objective: The online rating of perceived breathlessness in a rebreathing test (RT) is a new and powerful technique to analyze the psychological and physiological process related to the mechanisms of breathlessness. The aim of the present study was to assess the influence of rating type on respiratory sensation and behavior during repeated hypercapnic exposures. Methods: Sixty-one healthy women performed three rebreathing trials. Half of them were auditorily cued to rate breathlessness intensity every 12 s (CR, n=30), the other half was instructed to rate breathlessness each time a change in breathlessness intensity was perceived (UCR, n=31). The ventilatory response was assessed simultaneously. Results: The CR group yielded an earlier threshold in tidal volume (VT) than the UCR group. Only in the UCR group did changes occur across rebreathing trials: the VT threshold decreased, the respiratory rate (RR) threshold increased, and the sensitivity of the RR increased. Conclusions: The type of breathlessness rating influences respiratory behavior in the RT. The short-interval cued rating seems to be the best option for a standardized application of this test in research on panic disorder. © 2008 Elsevier Inc. All rights reserved.",Wan L.; Van Diest I.; De Peuter S.; Bogaerts K.; Van de Woestijne K.; Gallego J.; Van den Bergh O.,2008.0,10.1016/j.jpsychores.2008.05.008,0,0,
2803,Early Treatment Response in Children and Adolescents Receiving CBT for Trauma,"ER METHODS: 56 youth who participated in a randomized controlled trial of CBT for PTSD and D-cycloserine were included. Youth with PTSD symptoms below clinical cutoff after Session 4 of a 12-session protocol were classified as early treatment responders (32% of parent reports, 44.6% of child reports). Pretreatment characteristics were examined in relation to responder status.RESULTS: Lower levels of pretreatment PTSD, depression, and anxiety symptoms and fewer trauma types were related to child- and parent-reported responder status (d = .57, d = .52, respectively). Early treatment response was maintained at follow-up.CONCLUSIONS: Pretreatment symptoms levels and number of traumas may play an important role in predicting early treatment response. Correlates of early treatment response may provide avenues for identifying youth who could benefit from abbreviated protocols.OBJECTIVES: To investigate the incidence and correlates of early treatment response among youth receiving cognitive behavioral therapy (CBT) for posttraumatic stress disorder (PTSD).","Wamser-Nanney, R; Scheeringa, M S; Weems, C F",2016.0,10.1093/jpepsy/jsu096,0,0,
2804,"Veterans with depression in primary care: provider preferences, matching, and care satisfaction.","Primary care is often the first point of care for individuals with depression. Depressed patients often have comorbid alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD). Understanding variations in treatment preferences and care satisfaction in this population can improve care planning and outcomes. The design involved a cross-sectional comparison of veterans screening positive for depression. Veterans receiving primary care during the previous year were contacted (n = 10, 929) and were screened for depression using the PHQ-2/PHQ-9. Those with probable depression (n = 761) underwent a comprehensive assessment including screens for AUD and PTSD, treatment provider preferences, treatments received, and satisfaction with care. Treatment provider preferences differed based on specific mental health comorbidities, and satisfaction with care was associated with receipt of preferred care. Depressed veterans with comorbid PTSD were more likely to prefer care from more than one provider type (e.g., a psychiatrist and a primary care provider) and were more likely to receive treatment that matched their preferences than veterans without comorbid PTSD. Veterans receiving full or partial treatment matches affirmed satisfaction with care at higher rates, and veterans with comorbid PTSD were least satisfied when care did not match their preferences. Patient satisfaction with care is an increasingly important focus for health care systems. This study found significant variations in depressed patients' satisfaction with care in terms of treatment matching, particularly among those with comorbid PTSD. Delivery of care that matches patient treatment preferences is likely to improve depressed patient's satisfaction with the care provided. (PsycINFO Database Record (c) 2014 APA, all rights reserved).",Waltz TJ.; Campbell DG.; Kirchner JE.; Lombardero A.; Bolkan C.; Zivin K.; Lanto AB.; Chaney EF.; Rubenstein LV.,2014.0,10.1037/fsh0000071,0,0,
2805,The mental health of elderly woman in the community,This community study of the mental health of women demonstrates twice as much psychiatric ill-health among those over the age of 65 compared to younger woman. The findings are best explained in terms of the loss of the work role for the elderly woman rather than the loss of the domestic role. An apparently high frequency of phobia in the urban women is seen as an understandable reaction to their increase vulnerability and decreased mobility consequent on their chronic physicall ill-health.,Walton V.A.; Romans-Clarkson S.E.; Mullen Herbison P.E.G.P.,1990.0,,0,0,
2806,Recent trends in the incidence of anxiety diagnoses and symptoms in primary care.,"Anxiety is common, with significant morbidity, but little is known about presentations and recording of anxiety diagnoses and symptoms in primary care. This study aimed to determine trends in incidence and socio-demographic variation in General Practitioner (GP) recorded diagnoses of anxiety, mixed anxiety/depression, panic and anxiety symptoms. Annual incidence rates of anxiety diagnoses and symptoms were calculated from 361 UK general practices contributing to The Health Improvement Network (THIN) database between 1998 and 2008, adjusted for year of diagnosis, gender, age, and deprivation. Incidence of GP recorded anxiety diagnosis fell from 7.9 to 4.9/1000PYAR from 1998 to 2008, while incidence of anxiety symptoms rose from 3.9 to 5.8/1000PYAR. Incidence of mixed anxiety/depression fell from 4.0 to 2.2/1000PYAR, and incidence of panic disorder fell from 0.9/1000PYAR in 1998 to 0.5/1000PYAR in 2008. All these entries were approximately twice as common in women and more common in deprived areas. GP-recorded anxiety diagnoses, symptoms and mixed anxiety/depression were commonest aged 45-64 years, whilst panic disorder/attacks were more common in those 16-44 years. GPs predominately use broad non-specific codes to record anxiety problems in the UK. GP recording of anxiety diagnoses has fallen whilst recording of anxiety symptoms has increased over time. The incidence of GP recorded diagnoses of anxiety diagnoses was lower than in screened populations in primary care. The reasons for this apparent under-recording and whether it represents under-detection in those being seen, a reluctance to report anxiety to their GP, or a reluctance amongst GPs to label people with anxiety requires investigation.",Walters K.; Rait G.; Griffin M.; Buszewicz M.; Nazareth I.,2012.0,10.1371/journal.pone.0041670,0,0,
2807,"Assessing needs from patient, carer and professional perspectives: The Camberwell assessment of need for elderly people in primary care","Background: despite evidence that needs assessment of older people can improve survival and function when linked to effective long-term management, there is no structured needs assessment tool in widespread use. The Camberwell Assessment of Need for the Elderly is a new tool not previously evaluated in primary care. It includes the views of patients, carers and health professionals, enabling a direct comparison of their perspectives. Aim: to conduct a feasibility study of Camberwell Assessment of Need for the Elderly in primary care and to compare the needs identified by patients, carers and health professionals. Methods: we selected a random sample of 1:20 of all people aged 75 and over from four general practices in inner-city and suburban north-west London. We interviewed the patients, their informal carers and lead health professionals using the Camberwell Assessment of Need for the Elderly schedule. Results: 55 (65.5%) of 84 patients, 15 (88.2%) of 17 carers and all of 55 health professionals completed interviews. The patients' three most frequently identified unmet needs were with 'eyesight/hearing', 'psychological distress' and 'incontinence'. The carers' three most frequently identified unmet needs were with 'mobility', 'eyesight/hearing' and 'accommodation' and the health professionals' were with 'daytime activities', 'accommodation' and 'mobility'. κ tests comparing patient and health professional assessments showed poor or fair agreement with 18 of the 24 variables and moderate or good agreement with six. None showed very good agreement. Conclusion: the Camberwell Assessment of Need for the Elderly schedule is feasible to use in primary care and can identify perceived needs not previously known about by health professionals. A shorter version of Camberwell Assessment of Need for the Elderly focusing on areas of poor agreement and high levels of need might be useful in the assessment of needs in older people in primary care.",Walters K.; Iliffe S.; Tai S.S.; Orrell M.,2000.0,10.1093/ageing/29.6.505,0,0,
2808,More than symptom reduction: changes in executive function over the course of PTSD treatment.,"Persons with posttraumatic stress disorder (PTSD) have neuropsychological impairments in multiple cognitive domains, though particularly in executive function. This exploratory study examined whether these cognitive impairments were alleviated following trauma-focused treatment. Fifteen women underwent neuropsychological testing within a week of treatment onset and approximately 3 months later. Results suggest medium-sized improvement in multiple aspects of executive function, including tests of cognitive flexibility/set-shifting and organization/planning. If replicated in larger samples, such findings raise the possibility that treatment may alleviate neuropsychological impairment in persons with PTSD and thus reduce risk for poor outcome.",Walter KH.; Palmieri PA.; Gunstad J.,2010.0,10.1002/jts.20506,0,0,
2809,Psychiatric comorbidity effects on compensatory cognitive training outcomes for veterans with traumatic brain injuries.,"To investigate the influence of posttraumatic stress disorder (PTSD) diagnosis, and PTSD and depression severity, on the postconcussive symptom trajectory over the course of a 1-year study period. Secondary analysis of a randomized controlled trial comparing veterans who received supported employment combined with compensatory cognitive training to those who received supported employment only. Assessments were conducted at baseline, 3- (postintervention), 6-, and 12-months. Participants were 50 Operation Enduring and Iraqi Freedom (OEF/OIF) veterans with a history of mild to moderate traumatic brain injury (TBI) who were unemployed, seeking work, and who had neuropsychological impairment. Of all participants, 74% met diagnostic criteria for PTSD. All participants received supported employment and half of the sample also received Cognitive Symptom Management and Rehabilitation Therapy (CogSMART), a 12-session, manualized compensatory cognitive training intervention. Veterans with PTSD and greater depression severity endorsed significantly more severe postconcussive symptomatology at all assessment time points. However, the rate of CogSMART-associated improvement in postconcussive symptoms did not differ as a result of psychiatric symptomatology. Study results suggest that for veterans with a history of mild to moderate TBI, presence of comorbid PTSD or depressive symptoms should not preclude participation in cognitive rehabilitation interventions.",Walter KH.; Jak AJ.; Twamley EW.,2015.0,10.1037/rep0000049,0,0,
2810,Increased Hospital-Based Physical Rehabilitation and Information Provision After Intensive Care Unit Discharge: The RECOVER Randomized Clinical Trial.,"Critical illness results in disability and reduced health-related quality of life (HRQOL), but the optimum timing and components of rehabilitation are uncertain. To evaluate the effect of increasing physical and nutritional rehabilitation plus information delivered during the post-intensive care unit (ICU) acute hospital stay by dedicated rehabilitation assistants on subsequent mobility, HRQOL, and prevalent disabilities. A parallel group, randomized clinical trial with blinded outcome assessment at 2 hospitals in Edinburgh, Scotland, of 240 patients discharged from the ICU between December 1, 2010, and January 31, 2013, who required at least 48 hours of mechanical ventilation. Analysis for the primary outcome and other 3-month outcomes was performed between June and August 2013; for the 6- and 12-month outcomes and the health economic evaluation, between March and April 2014. During the post-ICU hospital stay, both groups received physiotherapy and dietetic, occupational, and speech/language therapy, but patients in the intervention group received rehabilitation that typically increased the frequency of mobility and exercise therapies 2- to 3-fold, increased dietetic assessment and treatment, used individualized goal setting, and provided greater illness-specific information. Intervention group therapy was coordinated and delivered by a dedicated rehabilitation practitioner. The Rivermead Mobility Index (RMI) (range 0-15) at 3 months; higher scores indicate greater mobility. Secondary outcomes included HRQOL, psychological outcomes, self-reported symptoms, patient experience, and cost-effectiveness during a 12-month follow-up (completed in February 2014). Median RMI at randomization was 3 (interquartile range [IQR], 1-6) and at 3 months was 13 (IQR, 10-14) for the intervention and usual care groups (mean difference, -0.2 [95% CI, -1.3 to 0.9; P‚Äâ=‚Äâ.71]). The HRQOL scores were unchanged by the intervention (mean difference in the Physical Component Summary score, -0.1 [95% CI, -3.3 to 3.1; P‚Äâ=‚Äâ.96]; and in the Mental Component Summary score, 0.2 [95% CI, -3.4 to 3.8; P‚Äâ=‚Äâ.91]). No differences were found for self-reported symptoms of fatigue, pain, appetite, joint stiffness, or breathlessness. Levels of anxiety, depression, and posttraumatic stress were similar, as were hand grip strength and the timed Up & Go test. No differences were found at the 6- or 12-month follow-up for any outcome measures. However, patients in the intervention group reported greater satisfaction with physiotherapy, nutritional support, coordination of care, and information provision. Post-ICU hospital-based rehabilitation, including increased physical and nutritional therapy plus information provision, did not improve physical recovery or HRQOL, but improved patient satisfaction with many aspects of recovery. isrctn.com Identifier: ISRCTN09412438.",Walsh TS.; Salisbury LG.; Merriweather JL.; Boyd JA.; Griffith DM.; Huby G.; Kean S.; Mackenzie SJ.; Krishan A.; Lewis SC.; Murray GD.; Forbes JF.; Smith J.; Rattray JE.; Hull AM.; Ramsay P.;  .,2015.0,10.1001/jamainternmed.2015.0822,0,0,
2811,Relations between young children's responses to the depiction of separation and pain experiences,"ER This study examined relations between young children's representations of separation and pain experiences in 60, 4- and 5-year-old children. Separation representations were assessed with the Separation Anxiety Test (SAT) and pain representations were assessed by examining responses to pictures of children about to experience pain in the presence of parent figures. Results showed that representations of separation and pain experience were systematically related and the patterns were not accounted for by the child's ability to differentiate emotional states, language ability, or reports of emotional regulation. These findings are consistent with Bowlby's (1982) concept of secure base behaviour in response to a variety of distress, and support the hypothetical construct of an internal working model of attachment which organizes children's behaviours, thoughts, and feelings in response to both separation experience and painful events.","Walsh, T M; Symons, D K; McGrath, P J",2004.0,10.1080/14616730410001663489,0,0,
2812,"Repetitive transcranial magnetic stimulation in bulimia nervosa: preliminary results of a single-centre, randomised, double-blind, sham-controlled trial in female outpatients.","Bulimia nervosa (BN) is often associated with depressive symptoms and treatment with antidepressants has shown positive effects. A shared deficient serotonergic transmission was postulated for both syndromes. The left dorsolateral prefrontal cortex was argued to regulate eating behaviour and to be dysfunctional in eating disorders. Fourteen women meeting DSM-IV criteria for BN were included in a randomised placebo-controlled double-blind trial. In order to exclude patients highly responsive to placebo, all patients were first submitted to a one-week sham treatment. Randomisation was followed by 3 weeks of active treatment or sham stimulation. As the main outcome criterion we defined the change in binges and purges. Secondary outcome variables were the decrease of the Hamilton Depression Rating Scale (HDRS), the Beck Depression Inventory (BDI) and the Yale-Brown Obsessive Compulsive Scale (YBOCS) over time. The average number of binges per day declined significantly between baseline and the end of treatment in the two groups. There was no significant difference between sham and active stimulation in terms of purge behaviour, BDI, HDRS and YBOCS over time. These preliminary results indicate that repetitive transcranial magnetic stimulation (rTMS) in the treatment of BN does not exert additional benefit over placebo. A larger number of patients might clarify a further role of rTMS in the treatment of BN.",Walpoth M.; Hoertnagl C.; Mangweth-Matzek B.; Kemmler G.; Hinterhölzl J.; Conca A.; Hausmann A.,2008.0,10.1159/000110061,0,0,
2813,Neurophysiological and neuropsychiatric aspects of transcranial magnetic stimulation,"Introduction: The authors review the literature in the field of Transcranial Magnetic Stimulation (TMS). Materials and methods: For this purpose a PubMed search was performed. Additional information was gained by cross-referencing from papers found in the data base. Results: Data from controlled studies as well as supplementary information from relevant review articles pertinent to the topic were used. History and the basics of TMS and repetitive Transcranial Magnetic Stimulation (rTMS) are presented. The ability of rTMS to non-invasively modulate higher cognitive functions such as learning and memory developed to a new exciting field. TMS, in fact, allows to transiently disrupt ongoing cortical processing, thus helping to enlighten the causal role of a specific brain area in a certain observable behaviour. Finally, rTMS clinical effectiveness in mood disorders, anxiety disorders, schizophrenic psychoses and Parkinson's disease, as well as in pain syndrome, is discussed. Conclusions: RTMS in concert with functional neuroimaging methods allows to analyse neuronal networks. Long-Term Potentiation (LTP) and Long-Term Depression (LTD) are phenomena seen in preclinical studies after rTMS, thus reflecting plastic modulation of the brain. In fact, changes in brain plasticity are supposed to be putative mechanisms underlying the pathophysiology of psychiatric diseases like major depression. © 2009 Elsevier Srl. All rights reserved.",Walpoth M.; Giupponi G.; Pycha R.; Hörtnagl C.; Hausmann A.; Altamura A.C.; Dell'Osso B.; Pompili M.; Conca A.,2010.0,10.1016/j.quip.2009.04.005,0,0,
2814,The role of treatment delivery factors in exposure-based cognitive behavioral therapy for panic disorder with agoraphobia.,"Treatment delivery factors (i.e., therapist adherence, therapist competence, and therapeutic alliance) are considered to be important for cognitive behavioral therapy (CBT) for panic disorder and agoraphobia (PD/AG). In the current study, four independent raters conducted process evaluations based on 168 two-hour videotapes of 84 patients with PD/AG treated with exposure-based CBT. Two raters evaluated patients' interpersonal behavior in Session 1. Two raters evaluated treatment delivery factors in Session 6, in which therapists provided the rationale for conducting exposure exercises. At the 6-month follow-up, therapists' adherence (r = 0.54) and therapeutic alliance (r = 0.31) were significant predictors of changes in agoraphobic avoidance behavior; therapist competence was not associated with treatment outcomes. Patients' interpersonal behavior in Session 1 was a significant predictor of the therapeutic alliance in Session 6 (r = 0.17). The findings demonstrate that treatment delivery factors, particularly therapist adherence, are relevant to the long-term success of CBT for PD/AG. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Weck, Florian; Grikscheit, Florian; Hofling, Volkmar; Kordt, Anne; Hamm, Alfons O; Gerlach, Alexander L; Alpers, Georg W; Arolt, Volker; Kircher, Tilo; Pauli, Paul; Rief, Winfried; Lang, Thomas; Bandelow, Barber, Barlow, Boswell, Brown, Casey, Chambless, Dennhag, Derogatis, Dimidjian, Faul, Fava, Foley, Franke, Gloster, Grikscheit, Guy, Haug, Horvath, Huppert, Huppert, Huppert, Ito, Kazantzis, Lang, Lang, Lang, Muthen, Orlinsky, Orlinsky, Ost, Palmqvist, Perepletchikova, Perepletchikova, Ramnero, Richtberg, Richtberg, Ruhmland, Sanchez-Meca, Schermelleh-Engel, Shrout, Sloan, Telch, Waltz, Webb, Weck, Weck, Weck, Weck, Weiss, Young, Zarafonitis-Muller, Zickgraf",2016.0,,0,0,
2815,Exposure therapy changes dysfunctional evaluations of somatic symptoms in patients with hypochondriasis (health anxiety). A randomized controlled trial.,"Dysfunctional evaluations of somatic symptoms are considered a central factor in maintaining hypochondriasis. The aim of the current study was to investigate whether exposure therapy (ET) without cognitive restructuring is sufficient to change dysfunctional evaluations of somatic symptoms. The current study was based on a randomized controlled trial and compared patients with hypochondriasis (N=73) receiving ET or cognitive therapy (CT) to a wait list (WL) control group. In both the ET and CT groups, dysfunctional symptom evaluations changed significantly compared with the WL group. No differences between the ET and CT groups emerged. The relationship between the treatment condition (active treatment vs. WL) and reductions in health anxiety was mediated by changes in somatic symptom evaluations only in a specific card sorting procedure. We conclude that addressing dysfunctional symptom evaluations is a necessary precondition for the effective treatment of hypochondriasis. However, the results indicate that ET and CT appear to change those processes to a similar degree.",Weck F.; Neng JM.; Schwind J.; Höfling V.,2015.0,10.1016/j.janxdis.2015.05.008,0,0,
2816,Treatment failure in cognitive-behavioural therapy: therapeutic alliance as a precondition for an adherent and competent implementation of techniques.,"Treatment failure is a common phenomenon, but little is known about the reasons. Therapeutic alliance, therapist adherence, and therapist competence are considered important aspects of treatment success and formed the focus of the current investigation. Three randomized controlled trials for the treatment of depression, social phobia, and hypochondriasis were the basis of the current study. The role of therapeutic alliance, as well as therapist adherence and competence, were investigated in 61 patients, which were classified either as treatment failure or as treatment success. Process variables were evaluated by independent raters on the basis of videotapes of the first three treatment sessions. Therapists' adherence and therapeutic alliance differed significantly between successful treatments and those classified as failures, whereas therapists' competence did not. In cross-sectional analysis, we found a moderating effect of adherence with alliance on treatment outcome, indicating that the better the therapeutic alliance, the stronger the effect of adherence on treatment outcome. Moreover, higher therapists' competence was found to affect treatment outcome positively, only mediated by therapeutic alliance. Higher therapists' adherence affected treatment outcome positively, only mediated by the competence-alliance relationship. In additional longitudinal analyses, we found evidence that the therapeutic alliance within one session influences therapists' adherence and competence in the subsequent session, but not the other way around. Therapeutic alliance proved to be an important variable for the prediction of treatment failure. Furthermore, in our longitudinal analyses, we found evidence that the therapeutic alliance is a precondition for the adherent and competent implementation of therapeutic techniques, which questions the results of our cross-sectional analysis and of previous research. Clinical implications Treatment failure is associated with a lower therapeutic alliance in cognitive-behavioural treatment. Therapeutic alliance seems to be an important precondition for the adherent and competent implementation of therapeutic techniques. Therapeutic alliance should be monitored during psychotherapeutic treatment. Cautions or limitations Results are limited to cognitive-behavioural therapy and may not be representative for other treatment approaches. Process analyses are based on highly standardized randomized controlled trials and may not be generalizable to routine care.",Weck F.; Grikscheit F.; Jakob M.; Höfling V.; Stangier U.,2015.0,10.1111/bjc.12063,0,0,
2817,Assessing treatment integrity in cognitive-behavioral therapy: comparing session segments with entire sessions.,"The evaluation of treatment integrity (therapist adherence and competence) is a necessary condition to ensure the internal and external validity of psychotherapy research. However, the evaluation process is associated with high costs, because therapy sessions must be rated by experienced clinicians. It is debatable whether rating session segments is an adequate alternative to rating entire sessions. Four judges evaluated treatment integrity (i.e., therapist adherence and competence) in 84 randomly selected videotapes of cognitive-behavioral therapy for major depressive disorder, social anxiety disorder, and hypochondriasis (from three different treatment outcome studies). In each case, two judges provided ratings based on entire therapy sessions and two on session segments only (i.e., the middle third of the entire sessions). Interrater reliability of adherence and competence evaluations proved satisfactory for ratings based on segments and the level of reliability did not differ from ratings based on entire sessions. Ratings of treatment integrity that were based on entire sessions and session segments were strongly correlated (r=.62 for adherence and r=.73 for competence). The relationship between treatment integrity and outcome was comparable for ratings based on session segments and those based on entire sessions. However, significant relationships between therapist competence and therapy outcome were only found in the treatment of social anxiety disorder. Ratings based on segments proved to be adequate for the evaluation of treatment integrity. The findings demonstrate that session segments are an adequate and cost-effective alternative to entire sessions for the evaluation of therapist adherence and competence.",Weck F.; Grikscheit F.; Höfling V.; Stangier U.,2014.0,10.1016/j.beth.2014.03.003,0,0,
2818,[Mid-term results after post-traumatic knee joint replacement in elderly patients].,"Due to the increasing prevalence of elderly people in Germany, the number of geriatric fractures will continue to increase. Typical geriatric skeletal and physical changes are osteoporosis, arthrosis, and reduced ability of coordination. Altogether, these factors may lead to a failure of a performed osteosynthesis, or may make the classical fracture treatment of reduction and internal fixation appear to be impossible. The aim of this study was to examine the results of peri-knee fractures treated directly or within 3 months by implantation of a knee prosthesis. 15 geriatric patients could be identified who were treated in the described way in the last 4 years. The follow-up time was 39 months. The knee injury occurred in all cases after a banal trauma. 14 patients could be examined by applying the HSS scoring system. We furthermore checked the operative management and postoperative course. The patients reached a good score level and showed few complications. For elderly patients, the primary knee arthroplasty after periarticular fractures of the knee is a valid treatment option. Nevertheless, the surgeon has to identify those fractures which are impossible to treat by a classical osteosynthesis. Furthermore, the application of the appropriate knee prosthesis, regarding the degree of hinge constrainment or augmentation of the tibial or femoral bone stock, is important.",Weber O.; Goost H.; Mueller M.; Burger C.; Wirtz D.; Pagenstert G.; Gravius S.,2011.0,10.1055/s-0030-1249793,0,0,
2819,Neural Correlates of Three Promising Endophenotypes of Depression: Evidence from the EMBARC Study.,"Major depressive disorder (MDD) is clinically, and likely pathophysiologically, heterogeneous. A potentially fruitful approach to parsing this heterogeneity is to focus on promising endophenotypes. Guided by the NIMH Research Domain Criteria initiative, we used source localization of scalp-recorded EEG resting data to examine the neural correlates of three emerging endophenotypes of depression: neuroticism, blunted reward learning, and cognitive control deficits. Data were drawn from the ongoing multi-site EMBARC study. We estimated intracranial current density for standard EEG frequency bands in 82 unmedicated adults with MDD, using Low-Resolution Brain Electromagnetic Tomography. Region-of-interest and whole-brain analyses tested associations between resting state EEG current density and endophenotypes of interest. Neuroticism was associated with increased resting gamma (36.5-44 Hz) current density in the ventral (subgenual) anterior cingulate cortex (ACC) and orbitofrontal cortex (OFC). In contrast, reduced cognitive control correlated with decreased gamma activity in the left dorsolateral prefrontal cortex (dlPFC), decreased theta (6.5-8 Hz) and alpha2 (10.5-12 Hz) activity in the dorsal ACC, and increased alpha2 activity in the right dlPFC. Finally, blunted reward learning correlated with lower OFC and left dlPFC gamma activity. Computational modeling of trial-by-trial reinforcement learning further indicated that lower OFC gamma activity was linked to reduced reward sensitivity. Three putative endophenotypes of depression were found to have partially dissociable resting intracranial EEG correlates, reflecting different underlying neural dysfunctions. Overall, these findings highlight the need to parse the heterogeneity of MDD by focusing on promising endophenotypes linked to specific pathophysiological abnormalities.",Webb CA.; Dillon DG.; Pechtel P.; Goer FK.; Murray L.; Huys QJ.; Fava M.; McGrath PJ.; Weissman M.; Parsey R.; Kurian BT.; Adams P.; Weyandt S.; Trombello JM.; Grannemann B.; Cooper CM.; Deldin P.; Tenke C.; Trivedi M.; Bruder G.; Pizzagalli DA.,2016.0,10.1038/npp.2015.165,0,0,
2820,Health Coaching Reduces HbA1c in Type 2 Diabetic Patients From a Lower-Socioeconomic Status Community: a Randomized Controlled Trial,"ER OBJECTIVE: To evaluate a health coach intervention with and without the use of mobile phones to support health behavior change in patients with type 2 diabetes.METHODS: In this noninferiority, pragmatic randomized controlled trial (RCT), patients from two primary care health centers in Toronto, Canada, with type 2 diabetes and a glycated hemoglobin/hemoglobin A1c (HbA1c) level of ?7.3% (56.3 mmol/mol) were randomized to receive 6 months of health coaching with or without mobile phone monitoring support. We hypothesized that both approaches would result in significant HbA1c reductions, although health coaching with mobile phone monitoring would result in significantly larger effects. Participants were evaluated at baseline, 3 months, and 6 months. The primary outcome was the change in HbA1c from baseline to 6 months (difference between and within groups). Other outcomes included weight, waist circumference, body mass index (BMI), satisfaction with life, depression and anxiety (Hospital Anxiety and Depression Scale [HADS]), positive and negative affect (Positive and Negative Affect Schedule [PANAS]), and quality of life (Short Form Health Survey-12 [SF-12]).RESULTS: A total of 138 patients were randomized and 7 were excluded for a substudy; of the remaining 131, 67 were allocated to the intervention group and 64 to the control group. Primary outcome data were available for 97 participants (74.0%). While both groups reduced their HbA1c levels, there were no significant between-group differences in change of HbA1c at 6 months using intention-to-treat (last observation carried forward [LOCF]) (P=.48) or per-protocol (P=.83) principles. However, the intervention group did achieve an accelerated HbA1c reduction, leading to a significant between-group difference at 3 months (P=.03). This difference was reduced at the 6-month follow-up as the control group continued to improve, achieving a reduction of 0.81% (8.9 mmol/mol) (P=.001) compared with a reduction of 0.84% (9.2 mmol/mol)(P=.001) in the intervention group. Intervention group participants also had significant decreases in weight (P=.006) and waist circumference (P=.01) while controls did not. Both groups reported improvements in mood, satisfaction with life, and quality of life.CONCLUSIONS: Health coaching with and without access to mobile technology appeared to improve glucoregulation and mental health in a lower-SES, T2DM population. The accelerated improvement in the mobile phone group suggests the connectivity provided may more quickly improve adoption and adherence to health behaviors within a clinical diabetes management program. Overall, health coaching in primary care appears to lead to significant benefits for patients from lower-SES communities with poorly controlled type 2 diabetes.TRIAL REGISTRATION: ClinicalTrials.gov NCT02036892; http://clinicaltrials.gov/ct2/show/NCT02036892 (Archived by WebCite at http://www.webcitation.org/6b3cJYJOD).BACKGROUND: Adoptions of health behaviors are crucial for maintaining good health after type 2 diabetes mellitus (T2DM) diagnoses. However, adherence to glucoregulating behaviors like regular exercise and balanced diet can be challenging, especially for people living in lower-socioeconomic status (SES) communities. Providing cost-effective interventions that improve self-management is important for improving quality of life and the sustainability of health care systems.","Wayne, N; Perez, D F; Kaplan, D M; Ritvo, P",2015.0,10.2196/jmir.4871,0,0,
2821,Relationships between spider constructs in phobics.,"An index of tight construing was derived from a Kelly grid in which the elements were spiders. This index, the coefficient of concordance, corresponds to the average correlation between constructs. Concordance was significantly higher in spider phobics than controls, in line with the hypothesis that emotional disorders are associated with higher correlations between symptom-related constructs (i.e. 'tight' construing). Desensitization, though it reduced phobic anxiety, had no effect on concordance.",Watts FN.; Sharrock R.,1985.0,,0,0,
2822,Desensitization as an habituation phenomenon. I. Stimulus intensity as determinant of the effects of stimulus lengths.,,Watts F.,1971.0,,0,0,
2823,A sham controlled study of repetitive transcranial magnetic stimulation for posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) is a commonly occurring and often debilitating psychiatric condition. There currently is not definitive information regarding the efficacy of repetitive transcranial magnetic stimulation (rTMS) for PTSD. This study seeks to examine the efficacy of rTMS for PTSD. Twenty subjects with PTSD were randomly assigned to receive either 10 rTMS sessions delivered at 1 Hz to the right dorsolateral prefrontal cortex (DLPRC) or 10 sham rTMS sessions to the same area. A blinded rater assessed PTSD, depressive, anxiety, and neurocognitive symptoms before treatment, after the treatment series, and during a 2-month follow-up period. Trancranial magnetic stimulation delivered at 1 Hz to the right DLPRC resulted in statistically and clinically significant improvements in core PTSD symptoms and depressive symptoms compared with sham treatments. The effectiveness showed some degradation during the 2 months after treatments were stopped. This blinded sham controlled trial supports the efficacy of 10 sessions of right DLPRC rTMS delivered at 1 Hz for the treatment of PTSD symptoms.",Watts BV.; Landon B.; Groft A.; Young-Xu Y.,2012.0,10.1016/j.brs.2011.02.002,0,0,
2824,Understanding and meeting information needs for patients with posttraumatic stress disorder.,"Background: Posttraumatic Stress Disorder (PTSD) is a commonly occurring mental illness. There are multiple treatments for PTSD that have similar effectiveness, but these treatments differ substantially in other ways. It is desirable to have well-informed patients involved in treatment choices. A patient decision aid (PtDA) is one method to achieve this goal. This manuscript describes the rationale and development of a patient decision aid (PtDA) designed for patients with PTSD. Methods: We conducted an informational needs assessment of veterans (n = 19) to obtain their baseline information needs prior to the development of the PtDA. We also conducted a literature review of effective PTSD treatments, and we calculated respective effective sizes. A PtDA prototype was developed according to the guidelines from the International Patient Decision Aid Standards. These standards guided our development of both content and format for the PtDA. In accordance with the standards, we gathered feedback from patients (n = 20) and providers (n = 7) to further refine the PtDA. The information obtained from patients and the literature review was used to develop a decision aid for patients with PTSD. Results: Patients with PTSD reported a strong preference to receive information about treatment options. They expressed interest in also learning about PTSD symptoms. The patients preferred information presented in a booklet format. From our literature review several treatments emerged as effective for PTSD: Cognitive Therapy, Exposure Therapy, Eye Movement Desensitization Therapy, Selective Serotonin Reuptake Inhibitors, venlafaxine, and risperidone. Conclusion: It appears that the criteria set forth to develop decision aids can effectively be applied to PTSD. The resultant PTSD patient decision aid is a booklet that describes the causes, symptoms, and treatments for PTSD. Future work will examine the effects of use of the PTSD decision aid in clinical practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Watts, Bradley V; Zayed, Maha H; Llewellyn-Thomas, Hilary; Schnurr, Paula P; Benish, Bradley, Brady, Bryant, Cohen, Davidson, Davidson, Foa, Foa, Guest, Hamann, Hamann, Kessler, Kulka, Lee, Loh, Marshall, Resick, Schnurr, Schnurr, Shapiro, Stacey, Tucker, Vaughn, Watts, Watts",2016.0,,0,0,
2825,Consultants' perceptions of school counselors' ability to implement an empirically-based intervention for adolescent social anxiety disorder.,"Social anxiety is highly prevalent but goes untreated. Although school-based CBT programs are efficacious when delivered by specialized psychologists, it is unclear whether school counselors can implement these interventions effectively, which is essential to promote sustainable school programs. We present an initial consultation strategy to support school counselor implementation of group CBT for social anxiety and an evaluation of counselors' treatment fidelity. Counselors were highly adherent to the treatment, but competence varied based on measurement. Counselors and consultants demonstrated good agreement for adherence, but relatively modest correspondence in competence ratings. We discuss future directions for school-based implementation efforts informed by these initial findings. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Warner, Carrie Masia; Brice, Chad; Esseling, Petra G; Stewart, Catherine E; Mufson, Laura; Herzig, Kathleen; Anderson, Atkins, Atkins, Becker, Beidas, Beidas, Beidas, Beidel, Beidel, Beidel, Bittner, Bohart, Brosan, Burns, Carroll, Chagnon, Chiu, Chorpita, Cicchetti, Colognori, Costello, Damschroder, Dimeff, Dobson, Essau, Fixsen, Foster, Funderbunk, Garland, Gega, Grover, Han, Henggeler, Herschell, Herzig-Anderson, Hogue, Hogue, Husky, James, Kataoka, Katzelnick, Kazdin, Kazdin, Kelly, Khanna, Khanna, Langley, Lyon, Lyon, Lyon, Mannix, Manteuffel, Masia Warner, Masia Warner, Masia Warner, Masia, Masia, McLeod, McLeod, Merikangas, Merikangas, Meyers, Miller, Miller, Milne, Mitcheson, Mufson, Page, Perepletchikova, Ryan, Schoenwald, Shediac-Rizhallah, Sholomskas, Sholomskas, Silverman, Strout, Vismara, Waltz, Warren, Weisz, Wittchen",2013.0,,0,0,
2826,Cognitive-behavioral treatment of persistent functional somatic complaints and pediatric anxiety: an initial controlled trial,"ER METHODS: Children and adolescents (aged 8-16) experiencing somatic complaints, without an explanatory medical disorder (i.e., functional), were recruited from primary care and specialty (gastroenterologists and cardiologists) pediatricians. Forty children, primarily with gastrointestinal symptoms, who met criteria for a co-occurring anxiety disorder, were randomly assigned to a cognitive-behavioral treatment addressing pain and anxiety, Treatment of Anxiety and Physical Symptoms (TAPS), or to a waiting list control.RESULTS: TAPS was found to be an acceptable treatment for this population and was superior to the waiting list condition. Eighty percent of children in TAPS were rated as treatment responders by independent evaluators compared with none of the controls. Overall, self- and parent ratings indicated reductions in children's somatic discomfort and anxiety following intervention. TAPS participants maintained clinical gains 3 months following treatment.CONCLUSIONS: The study supports the feasibility and preliminary efficacy of a cognitive-behavioral intervention targeting co-occurring physical distress and anxiety in youth presenting for medical treatment. Such an approach has the potential to exert broad impact on children's dysfunction and to minimize exposure to invasive, ineffective, and costly medical procedures and treatments.BACKGROUND: Children and adolescents who seek medical treatment for persistent physical distress often suffer from co-occurring anxiety disorders. Treatment options for this impaired population are limited. This study tests the feasibility and potential efficacy of a cognitive-behavioral intervention targeting pain and anxiety for youth with impairing functional physical symptoms and anxiety disorders presenting to pediatricians for medical care.","Warner, C M; Colognori, D; Kim, R E; Reigada, L C; Klein, R G; Browner-Elhanan, K J; Saborsky, A; Petkova, E; Reiss, P; Chhabra, M; McFarlane-Ferreira, Y B; Phoon, C K; Pittman, N; Benkov, K",2011.0,10.1002/da.20821,0,0,
2827,"Ketamine, an NMDA receptor antagonist, suppresses spatial and temporal properties of burn-induced secondary hyperalgesia in man: A double-blind, cross-over comparison with morphine and placebo","Effects of morphine and ketamine (NMDA receptor antagonist) on temporally summated pain ('wind-up-like pain') and spatial aspects of secondary hyperalgesia were investigated in 12 healthy volunteers. Hyperalgesia was produced by a local 1°burn injury covering 12.5 cm2 on the medial surface of the calf. Primary hyperalgesia was determined by measuring heat pain detection threshold (HPDT) within the site of injury. Spatial aspects of secondary hyperalgesia present outside the site of injury were quantitated by determination of the areas in which a mechanical punctate (von Frey hair, 50.6 mN), or brush stimuli elicited pain sensation. Temporal aspects of secondary hyperalgesia were determined by repetitively pricking the skin with a standard yon Frey hair (834 mN) inducing a 'wind-up-like pain'. Morphine 0.15 mg/kg, ketamine 0.15 mg/kg or placebo (NaCl 0.9%) were administrated i.v. on 3 separate days 50 rain after the burn injury in a double-blind, placebo controlled, randomised and cross-over design. In all subjects HPDT was significantly reduced within the injured area compared to the pre-injury threshold (primary hyperalgesia). All subjects developed areas of allodynia and hyperalgesia to punctate stimuli and brush stimuli outside the injured area (secondary hyperalgesia). HPDT was not reduced in the area of secondary hyperalgesia. In 95% of the measurements we found a sudden appearance of pain to repeated pricking with a yon Frey hair (834 mN) in the area of secondary hyperalgesia ('wind-up-like pain'). Ketamine significantly reduced the area of secondary hyperalgesia both for puncture and brush stimuli in the first measurement 15 rain after injection and eight of the 11 subjects reported that the 'wind-up-like pain' disappeared. On the measurements 45 and 75 min after ketamine injection, secondary hyperalgesia and 'wind-up-like pain' reappeared. Morphine did not significantly change the size of the area of secondary hyperalgesia and did not affect 'wind-up-like pain'. Ketamine or morphine did not change thermal detection thresholds. We conclude that spatial and temporal mechanisms, underlying secondary hyperalgesia, are mediated by glutamatergic transmission via NMDA receptors.",Warncke T.; Stubhaug A.; Jorum E.,1997.0,10.1016/S0304-3959(97)00006-7,0,0,
2828,Internet-based treatment for adults with depressive symptoms: randomized controlled trial.,"Many depressed people do not receive help for their symptoms, and there are various barriers that impede help-seeking. The Internet may offer interesting alternatives for reaching and helping people with depression. Depression can be treated effectively with Internet-based cognitive behavioral therapy (CBT), but a short intervention based on problem solving therapy (PST) could constitute a worthwhile alternative to CBT. In this study we evaluated the effectiveness of Internet-based CBT and Internet-based PST in comparison to a waiting list control group (WL), and we determined the differences between the two treatments. We conducted a 3-arm randomized controlled trial to compare CBT, PST, and WL. The main inclusion criterion was presence of depressive symptoms (>or= 16 on the Center for Epidemiological Studies Depression scale). CBT and PST consisted of eight and five weekly lessons respectively. Participants were supported by email. Self-report measures of depression, anxiety, and quality of life were completed at pretest and after 5, 8, and 12 weeks. A total of 263 participants were randomized to the three conditions (CBT: n=88; PST: n=88; WL: n=87). Of the 263 participants, 184 (70%) completed questionnaires after 5 weeks, 173 (66%) after 8 weeks, and 151 (57%) after 12 weeks. Between-group effect sizes for depressive symptoms were 0.54 for CBT after 8 weeks (95% confidence interval (CI): 0.25 - 0.84) and 0.47 for PST after 5 weeks (95% CI: 0.17 - 0.77). These effects were further improved at 12 weeks (CBT: 0.69, 95% CI: 0.41 - 0.98; PST: 0.65, 95% CI: 0.36 - 0.95). For anxiety, effect sizes were also at a medium level. Effect sizes for quality of life were low. The number of participants showing clinically significant change at 12 weeks was significantly higher for CBT (n = 34, 38.6%) and PST (n = 30, 34.1%), compared to WL (n = 0). Both Internet-based treatments are effective in reducing depressive symptoms, although the effect of PST is realized more quickly. International Standard Randomized Controlled Trial Number (ISRCTN): 16823487; http://www.controlled-trials.com/ISRCTN16823487/16823487 (Archived by WebCite at http://www.webcitation.org/5cQsOj7xf).",Warmerdam L.; van Straten A.; Twisk J.; Riper H.; Cuijpers P.,2008.0,10.2196/jmir.1094,0,0,
2829,Online cognitive behavioral therapy and problem-solving therapy for depressive symptoms: exploring mechanisms of change,"ER The purpose of this study was to evaluate treatment specificity and potential mediators of two online therapies for depressive symptoms. We conducted a randomized controlled trial in which 263 participants were randomized to online cognitive behavioral therapy (CBT), online problem-solving therapy (PST) or a waiting list control group. Both treatments were more effective than the control group in reducing dysfunctional attitudes, worry, negative problem orientation and enhancing feelings of control. No differences between the treatments were found on each of the potential mediators. Furthermore, results suggest that dysfunctional attitudes, worrying, a negative problem orientation and perceived control all played a mediating role in CBT as well as in PST. Our findings suggest that regardless of the theoretical background to the therapy, the psychological processes necessary for symptom reduction seem to be comparable.","Warmerdam, L; Straten, A; Jongsma, J; Twisk, J; Cuijpers, P",2010.0,10.1016/j.jbtep.2009.10.003,0,0,
2830,Internet-based treatment for adults with depressive symptoms: the protocol of a randomized controlled trial,"ER METHODS: This study is a randomized controlled trial with three conditions: two treatment conditions and one waiting list control group. The two treatment conditions are Internet-based cognitive behavior therapy and Internet-based problem-solving therapy. They consist of 8 and 5 weekly lessons respectively. Both interventions are combined with support by e-mail. Participants in the waiting list control group receive the intervention three months later. The study population consists of adults from the general population. They are recruited through advertisements in local and national newspapers and through banners on the Internet. Subjects with symptoms of depression (> or = 16 on the Center for Epidemiological Studies Depression scale) are included. Other inclusion criteria are having sufficient knowledge of the Dutch language, access to the Internet and an e-mail address. Primary outcome is depressive symptoms. Secondary outcomes are anxiety, quality of life, dysfunctional cognitions, worrying, problem solving skills, mastery, absence at work and use of healthcare. We will examine the following variables as potential mediators: dysfunctional cognitions, problem solving skills, worrying, anxiety and mastery. Potential moderating variables are: socio-demographic characteristics and symptom severity. Data are collected at baseline and at 5 weeks, 8 weeks, 12 weeks and 9 months after baseline. Analyses will be conducted on the intention-to-treat sample.DISCUSSION: This study evaluates two Internet-based treatments for depression, namely cognitive behavioral therapy and problem-solving therapy. The effectiveness of Internet-based problem-solving therapy suggest that this may be a worthwhile alternative to other more intensive treatment options. Strengths and limitations of this study are discussed.TRIAL REGISTRATION: Current Controlled Trials ISRCTN16823487.BACKGROUND: Depression is a highly prevalent condition, affecting more than 15% of the adult population at least once in their lives. Guided self-help is effective in the treatment of depression. The purpose of this study is to investigate the effectiveness of two Internet-based guided self-help treatments with adults reporting elevated depressive symptoms. Other research questions concern the identification of potential mediators and the search for subgroups who respond differently to the interventions.","Warmerdam, L; Straten, A; Cuijpers, P",2007.0,10.1186/1471-244X-7-72,0,0,
2831,Smoked cannabis for chronic neuropathic pain: a randomized controlled trial,"ER METHODSAdults with post-traumatic or postsurgical neuropathic pain were randomly assigned to receive cannabis at four potencies (0%, 2.5%, 6% and 9.4% tetrahydrocannabinol) over four 14-day periods in a crossover trial. Participants inhaled a single 25-mg dose through a pipe three times daily for the first five days in each cycle, followed by a nine-day washout period. Daily average pain intensity was measured using an 11-point numeric rating scale. We recorded effects on mood, sleep and quality of life, as well as adverse events.RESULTSWe recruited 23 participants (mean age 45.4 [standard deviation 12.3] years, 12 women [52%]), of whom 21 completed the trial. The average daily pain intensity, measured on the 11-point numeric rating scale, was lower on the prespecified primary contrast of 9.4% v. 0% tetrahydrocannabinol (5.4 v. 6.1, respectively; difference = 0.7, 95% confidence interval [CI] 0.02-1.4). Preparations with intermediate potency yielded intermediate but nonsignificant degrees of relief. Participants receiving 9.4% tetrahydrocannabinol reported improved ability to fall asleep (easier, p = 0.001; faster, p < 0.001; more drowsy, p = 0.003) and improved quality of sleep (less wakefulness, p = 0.01) relative to 0% tetrahydrocannabinol. We found no differences in mood or quality of life. The most common drug-related adverse events during the period when participants received 9.4% tetrahydrocannabinol were headache, dry eyes, burning sensation in areas of neuropathic pain, dizziness, numbness and cough.CONCLUSIONA single inhalation of 25 mg of 9.4% tetrahydrocannabinol herbal cannabis three times daily for five days reduced the intensity of pain, improved sleep and was well tolerated. Further long-term safety and efficacy studies are indicated. (International Standard Randomised Controlled Trial Register no. ISRCTN68314063).BACKGROUNDChronic neuropathic pain affects 1%-2% of the adult population and is often refractory to standard pharmacologic treatment. Patients with chronic pain have reported using smoked cannabis to relieve pain, improve sleep and improve mood.","Ware, M A; Wang, T; Shapiro, S; Robinson, A; Ducruet, T; Huynh, T; Gamsa, A; Bennett, G J; Collet, J P",2010.0,10.1503/cmaj.091414,0,0,
2832,Effects of concurrent diazepam treatment on the outcome of exposure therapy in agoraphobia.,"In a study designed to evaluate the impact of benzodiazepine use on the outcome of behaviour therapy, 91, severe, chronic agoraphobics (46 BDZ users and 45 non-users) were randomly allocated on a double-blind basis to in vivo exposure with low-dose diazepam (ED) or placebo (EP). Drug doses were adjusted on the basis of weekly psychiatric assessments over weeks 1-4. Patients had 8 x 2 hr exposure sessions (weeks 5-12) and were then withdrawn from medication (weeks 13-16). Re-assessments were completed at weeks 4, 12 and 16, and follow-up assessments at approx 20, 46 and 72 weeks. In the analysis of the results, the clinical outcome was evaluated in relation to the therapeutic regime (ED vs EP) and prior BDZ use (users vs non-users). The results showed that the ED group had greater changes in anxiety than the EP group during the drug manipulation phases (anxiety increasing during BDZ withdrawal). There were no group differences in agoraphobic symptoms and no evidence that the outcome of the behavior therapy was significantly affected by concurrent BDZ treatment. There were significant improvements in agoraphobic symptoms over the treatment period, with no evidence for relapse of treatment gains on withdrawal from BDZ, nor for differential responses over the one year follow-up. Initial differences between users and non-users were less marked than expected, although there was a trend for more drop-outs among users across both ED and EP groups.",Wardle J.; Hayward P.; Higgitt A.; Stabl M.; Blizard R.; Gray J.,1994.0,,0,0,
2833,Increasing children's acceptance of vegetables; a randomized trial of parent-led exposure,"ER Despite considerable epidemiological evidence of the health benefits of a diet high in fruit and vegetables, consumption in pre-school children remains well below recommended levels. This study evaluated the effectiveness of an exposure-based intervention, carried out by parents in the home, in increasing children's liking for a previously disliked vegetable. 156 parents of 2-6 year old children were randomly assigned to Exposure, Information or Control groups after a pre-intervention taste test at which a 'target' vegetable was selected. Parents in the Exposure group gave their child a taste of this vegetable daily for 14 days, parents in the Information group were given nutritional advice and a leaflet, and parents in the Control group received no further intervention. All participants took part in a post-intervention taste test. Greater increases in liking, ranking and consumption of the 'target' vegetable from pre- to post-intervention occurred in the Exposure group than in either of the other two groups. Only the Exposure group showed significant increases across all three outcomes. It can be concluded that a parent-led, exposure-based intervention involving daily tasting of a vegetable holds promise for improving children's acceptance of vegetables. These findings suggest a parental advice strategy which could be disseminated directly to parents or by health professionals.","Wardle, J; Cooke, L J; Gibson, E L; Sapochnik, M; Sheiham, A; Lawson, M",2003.0,,0,0,
2834,Posttraumatic stress disorder in patients with traumatic brain injury and amnesia for the event?,"Frequency of DSM-III-R posttraumatic stress disorder (PTSD) was studied in 47 active-duty service members (46 male, 1 female; mean age 27 = 7) with moderate traumatic brain injury and neurogenic amnesia for the event. Patients had attained ""oriented and cooperative"" recovery level. When evaluated with a modified Present State Examination and other questions at various points from study entry to 24-month follow-up, no patients met full criteria for PTSD or met criterion B (reexperience); 6 (13%) met both C (avoidance) and D (arousal) criteria. Five of these 6 also had organic mood disorder, depressed type, and/or organic anxiety disorder. Posttraumatic amnesia following moderate head injury may protect against recurring memories and the development of PTSD. Some patients with neurogenic amnesia may develop a form of PTSD without the reexperiencing symptoms.",Warden DL.; Labbate LA.; Salazar AM.; Nelson R.; Sheley E.; Staudenmeier J.; Martin E.,1997.0,10.1176/jnp.9.1.18,0,0,
2835,Demographic and clinical characteristics of current comorbid psychiatric disorders in a randomized clinical trial for adults with stimulant use disorders.,"This study aimed to determine if current comorbid psychiatric disorders differ in adults with cocaine use disorder, other stimulant (primarily methamphetamine) use disorder, or both, and identify demographic and clinical characteristics in those with increasing numbers of comorbid disorders. Baseline data from a randomized controlled trial beginning in residential settings (N = 302) was used. Mood disorders were present in 33.6%, and anxiety disorders in 29.6%, with no differences among stimulant use disorder groups. Panic disorder was more frequently present with other stimulant use disorder. Those with two or more comorbid psychiatric disorders were more often female, White, had more symptoms of depression, greater propensity and risk for suicidal behavior, lower functioning in psychiatric and family domains, lower quality of life, more symptoms with stimulant abstinence and greater likelihood of marijuana dependence. Those with one or more comorbid disorders had more medical disorder burden, lower cognitive and physical functioning, greater pain, and higher rates of other drug dependence. With current comorbid psychiatric disorders, the morbidity of stimulant use disorders increases. Use of validated assessments near treatment entry, and a treatment plan targeting not only substance use and comorbid psychiatric disorders, but functional impairments, medical disorder burden and pain, may be useful. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Warden, Diane; Sanchez, Katherine; Greer, Tracy; Carmody, Thomas; Walker, Robrina; dela Cruz, Adriane; Toups, Marisa; Rethorst, Chad; Trivedi, Madhukar H; Conway, dela Cruz, Drake, Endicott, Fava, Glasner-Edwards, Glasner-Edwards, Gonzalez-Saiz, Grant, Hasin, Hasin, Helmus, Herrero, Kampman, Kelly, Levin, McDowell, McKay, McLellan, Nunes, Nunes, Nunes, Pettinati, Raby, Ries, Sacks, Salo, Sangha, Satel, Schuckit, Sheehan, Sobell, Sussner, Torrens, Trivedi, Trivedi, Trivedi, Vergara-Moragues, Ware, Weddington, Weiss, Zweben",2016.0,,0,0,
2836,"Randomised controlled trial of non-directive counselling, cognitive-behaviour therapy, and usual general practitioner care for patients with depression. I: clinical effectiveness.","To compare the clinical effectiveness of general practitioner care and two general practice based psychological therapies for depressed patients. Prospective, controlled trial with randomised and patient preference allocation arms. General practices in London and greater Manchester. 464 of 627 patients presenting with depression or mixed anxiety and depression were suitable for inclusion. Usual general practitioner care or up to 12 sessions of non-directive counselling or cognitive-behaviour therapy provided by therapists. Beck depression inventory scores, other psychiatric symptoms, social functioning, and satisfaction with treatment measured at baseline and at 4 and 12 months. 197 patients were randomly assigned to treatment, 137 chose their treatment, and 130 were randomised only between the two psychological therapies. All groups improved significantly over time. At four months, patients randomised to non-directive counselling or cognitive-behaviour therapy improved more in terms of the Beck depression inventory (mean (SD) scores 12.9 (9.3) and 14.3 (10.8) respectively) than those randomised to usual general practitioner care (18.3 (12.4)). However, there was no significant difference between the two therapies. There were no significant differences between the three treatment groups at 12 months (Beck depression scores 11.8 (9.6), 11.4 (10.8), and 12.1 (10.3) for non-directive counselling, cognitive-behaviour therapy, and general practitioner care). Psychological therapy was a more effective treatment for depression than usual general practitioner care in the short term, but after one year there was no difference in outcome.",Ward E.; King M.; Lloyd M.; Bower P.; Sibbald B.; Farrelly S.; Gabbay M.; Tarrier N.; Addington-Hall J.,2000.0,,0,0,
2837,Large group exposure treatment: A feasibility study of exposure combined with diaphragmatic breathing in highly dental fearful individuals.,"A large-group one session treatment (LG-OST) combining exposure and diaphragmatic breathing as a bodily coping element was carried out to investigate its feasibility and effectiveness in a sample of 43 highly dental fearful individuals treated simultaneously. We assessed subjective dental fear, dysfunctional dental-related beliefs, and perceived control pre- and post-intervention and at four-month follow-up. Participants additionally performed a behavioural approach test (BAT) pre- and post-intervention. During the applied exposure exercises, four participants (9.3%) discontinued the program all reporting too high levels of distress. Regarding subjective dental fear and dysfunctional dental related beliefs post treatment effects, LG-OST showed medium to large effect sizes, ranging from Cohen's d = 0.51 to d = 0.84 in the Intention-to-Treat analysis. Subjective dental fear improved clinically significantly in about one fourth (25.6%) of therapy completers. All post-treatment effects remained stable over time. Concerning the behavioral fear dimension, we observed a strong ceiling effect. Already at preassessment, participants accomplished more than six out of seven BAT-steps. Thus, behavioral approach did not increase significantly following treatment. Overall, the LGOST protocol proved feasible and efficient. Compared to other one-session individual and multi-session group treatments the observed LG-OST effects were smaller. However, if LG-OST could match the efficacy of highly intensive short treatments delivered in an individual setting in the future, for example, by applying a wider array of exposure exercises, it could be a very useful treatment option as an intermediate step within a stepped care approach. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Wannemueller, Andre; Johren, Hans-Peter; Borgstadt, Alina; Bosch, Jessica; Meyers, Milena; Volse, Miriam; Scholten, Saskia; Margraf, Jurgen; Bower, Brunsman, Busch, Choy, Cohen, Corah, Corah, Cronin, De Jongh, De Jongh, Enkling, Frederikson, Gordon, Gotestam, Haukebo, Hellstrom, Howard, Jacobson, Johren, Krahe, Laux, Liddell, Logan, Lovibond, Moore, Moore, Moore, Newman, Ning, Norcross, Oosterink, Pendleton, Ritter, Roy-Byrne, Sartory, Thom, Vika, Wannemuller, Wannemuller, Wannemuller, Wittchen, Wittchen, Wolitzky-Taylor, Zlomke, Ost, Ost, Ost, Ost, Ost, Ost",2017.0,,0,0,
2838,Taking the pulse of prolonged exposure therapy: Physiological reactivity to trauma imagery as an objective measure of treatment response.,"Background: Physiological reactivity to trauma-related cues is a primary symptom of PTSD and can be assessed objectively using script-driven imagery paradigms. However, subjective self-reported symptom measures are the most common outcome indices utilized in PTSD treatment trials and clinic settings. We examined physiological reactivity during a short trauma imagery task as an objective index of response to PTSD treatment, optimized for use in routine clinical care settings. Methods: Participants were 35 male combat veterans receiving prolonged exposure (PE) therapy in a Veterans Affairs outpatient clinic. In addition to traditional subjective self-reported and clinician-rated symptom measures, patients also completed a script-driven imagery task in which heart rate (HR) and skin conductance (SC) were recorded at three assessment points across treatment. We examined changes in subjective symptom measures and objective trauma-specific physiological reactivity over the course of PE, and investigated the association between pretreatment physiological reactivity and treatment response. Results: Patients who completed PE showed significantly diminished HR and SC reactivity to trauma imagery across therapy. Additionally, individuals showing greater trauma-specific HR reactivity at pretreatment showed greater reductions in subjectively reported PTSD symptoms at posttreatment. Conclusions: Findings support the utility of physiological reactivity during trauma imagery as an objective outcome measure that has the potential to be incorporated into evidence-based PTSD treatment in routine clinical settings, or prospective studies related to the individualization of care at pretreatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wangelin, Bethany C; Tuerk, Peter W; Bauer, Beck, Blake, Blanchard, Blanchard, Blanchard, Carson, Cloitre, Cook, Cuthbert, Cuthbert, Eftekhari, Foa, Foa, Foa, Foa, Foa, Foa, Goncalves, Insel, Keane, LaBar, Lang, Lindauer, McTeague, McTeague, Milad, Norte, Orr, Orr, Pineles, Pitman, Pitman, Pole, Quirk, Rauch, Rauch, Rauch, Sanislow, Shalev, Smits, Smits, Steenkamp, Technology, Technology, Technology, Telch, Tuerk, Tuerk, Tuerk, Wangelin, Weathers, Zoellner",2015.0,,0,0,
2839,"Enhancing exposure therapy for PTSD with yohimbine HCL: protocol for a double-blind, randomized controlled study implementing subjective and objective measures of treatment outcome.","Prolonged exposure (PE) therapy is considered a gold standard protocol for the treatment of PTSD, and it is associated with large treatment effect sizes in combat veteran samples. However, considering high rates of PTSD in the present veteran population, ongoing research work is important toward improving treatment efficiency by decreasing time to symptom amelioration and increasing the amount of symptom amelioration. The proposed research aims to enhance exposure therapy outcomes for veterans with PTSD via combination treatment with PE and yohimbine hydrochloride (HCL), an alpha-2 adrenergic receptor antagonist. The proposed investigation entails a randomized, placebo-controlled trial investigating the effect of a single administration of yohimbine HCL (paired with the first session of imaginal exposure) on outcome of PE in 40 veterans with PTSD. An additional goal is to establish a pragmatic method of tracking psychophysiological measures over the course of therapy for incorporation into future clinical psychotherapy trials. Thus, in addition to traditional self- and clinician-reported psychological outcomes, heart rate and skin conductance reactivity will be measured during a standard trauma-specific imagery task before, during, and after PE treatment. We will further investigate whether changes in psychophysiological measures predict changes in patient- and clinician-reported outcome measures.",Wangelin BC.; Powers MB.; Smits JA.; Tuerk PW.,2013.0,10.1016/j.cct.2013.08.003,0,0,
2840,An internet-based self-help intervention program application for traumatized persons.,"Objective: To examine the user dropouts at different stages of an internet-based intervention program application for traumatized persons and to investigate the influence of posttraumatic symptoms severity, perceived social acknowledgement and trauma disclosure attitudes on the usage of the program. Methods: A total of 428 traumatized persons were recruited via internet advertisements from 22 cities and provinces. Among them 103 gave consent to participation and were randomized into the treatment and waiting list groups. After completing pretreatment test, the treatment group used the intervention program for one month. The waiting list group received one-month delayed treatment after they filled out post-waiting test. To examine the usage of the program, two new groups were used in data analyses, consisting of participants using or not using the intervention website. Participants' adherence to the program was examined with pre-treatment dropout, visiting days and pages visited at the website, and follow-up dropout. Measures used included the Posttraumatic Diagnostic Scale (PDS), Disclosure of Trauma Questionnaire (DTQ), and Social Acknowledgement Questionnaire ( SAQ). Results: Among 103 participants, 61 (59.2%) used the website and 42 (40.8%) dropped out before the treatment. Compared to using the website group, the participants who dropped out before intervention scored higher on the DTQ ""urge to talk"" [(2.1 +/- 1.2) vs. (1.5 +/- 1.0), P < 0.05] and consisted of more females (86% vs. 69% , P = 0.050). The number of users visiting the website decreased sharply from 61 (10%) in the first week to 19 (31%) in the second week. During one-month treatment period, 51 (84%) users visited the website for five days or less, and four (7%) users visited it more than 10 days with a maximum of 12; the mean of pages visited number was (81.3 +/- 77.1), and 18 (30%) users visited (repeatedly) more than 100 pages, with a maximum of 295, at the website which contains 118 pages. Linear regression analyses showed that the users' visiting days at the website were positively correlated with the SAQ family disapproval scores (beta = 0.31, P < 0.05), and the number of pages visited was positively correlated with the SAQ general disapproval scores (beta = 0.31, P < 0.05). Conclusion: It suggests that individuals' urge to talk may influence their adoption of internet-based self-help interventions after trauma. Users might repeatedly read some contents of the self-help intervention programs. Perceived disapproval from family and social network may have influence on traumatized persons' adherence to the programs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wang, Zhi-Yun; Wang, Jian-Ping; Maercker, Andreas; Amstadter, Bandura, Benight, Berger, Breslau, Brewin, Christensen, Davis, Eysenbach, Foa, Klein, Lange, Lange, Maercker, Melville, Meyer, Mueller, Ruggiero, Schneider, Steinmetz, Su, Van't Riet, Wang",2013.0,,0,0,
2841,Application of the Willis covered stent for the management of posttraumatic carotid-cavernous fistulas: an initial clinical study.,"To evaluate the feasibility of using the Willis covered stent in the management of patients with traumatic carotid-cavernous fistulas (CCFs). Twelve consecutive patients with 14 post-traumatic CCFs referred for treatment with Willis covered stents were enrolled in this prospective study. Data on technical success, initial and final angiographic results, mortality, morbidity and final clinical outcome were collected. Follow- up was at one, three, six, and 12 months, and yearly thereafter. Deployment of covered stents was technically successful in all the patients without complications. One covered stent was placed in eight patients and two covered stents in four. Angiographic results following stent placement showed a complete occlusion in nine patients with 11 CCFs, and an incomplete occlusion in three patients. Angiographic follow-up (mean, 14.00 ± 6.93 months; range, 6-24 months) revealed complete occlusion and no obvious in-stent stenosis in all the patients. Clinical follow-up (mean, 17.75 ± 7.05 months; range, 7-28 months) demonstrated full recovery in 11 patients, and improvement in one. This initial experience indicates that the use of the Willis covered stent is a feasible procedure and may be an alternative treatment option for CCFs.",Wang YL.; Ma J.; Li YD.; Ding PX.; Han XW.; Wu G.,,10.4103/0028-3886.96397,0,0,
2842,Coping Card Usage can Further Reduce Suicide Reattempt in Suicide Attempter Case Management Within 3-Month Intervention,"ER This randomized controlled trial was designed to evaluate the effectiveness of using crisis coping cards (n = 32) in the case management of suicide prevention compared with case management without the use of coping cards (n = 32) over a 3-month intervention period. The generalized estimating equation was used to examine the interaction effect between treatments and time on suicide risk, depression, anxiety, and hopelessness. Results indicated that subsequent suicidal behaviors, severity of suicide risk, depression, anxiety, and hopelessness were reduced more in the coping card intervention group compared to the case management only group. Moreover, for the survival curves of time to suicide reattempt, the coping card group showed a significantly longer time to reattempt than the case management only group at 2-month and 3-month intervention periods.","Wang, Y C; Hsieh, L Y; Wang, M Y; Chou, C H; Huang, M W; Ko, H C",2016.0,10.1111/sltb.12177,0,0,
2843,Auditory evoked potentials and multiple personality measures in migraine and post-traumatic headaches.,"Migraine sufferers have abnormal cerebral information processing and personality disorders, post-traumatic headache sufferers also have some personality changes. We therefore, studied intensity dependence of auditory evoked potentials, Plutchik-van Praag's depression inventory, Zuckerman's sensation seeking scales and Zuckerman-Kuhlman's personality questionnaire in patients suffering from migraine without aura (n = 26) and chronic post-traumatic headaches (n = 26) as well as in healthy volunteers (n = 30). The migraine group showed significantly increased neuroticism-anxiety than controls, increased intensity dependence of N1-P2, and decreased thrill and adventure score compared with the controls and post-traumatic headaches. The post-traumatic headache had significantly increased depression compared with the controls, and increased disinhibition compared with the controls and migraines. This study demonstrates that the two headache types have different neurophysiological and personality traits. The pronounced intensity dependence of N1-P2 suggests a cortical potentiation response, together with a decreased thrill and adventure seeking, favor a lower serotonergic innervation in migraine. While the elevated disinhibition and depression, as consequences, may be linked with the wide cortical neuronal/axonal degeneration in post-traumatic headache.",Wang W.; Wang YH.; Fu XM.; Sun ZM.; Schoenen J.,1999.0,,0,0,
2844,Effects of electro-acupuncture on personality traits in depression: a randomized controlled study,"ER OBJECTIVE: To explore the personality-adjusting effect of electro-acupuncture treatment for depression and compared this treatment with paroxetine treatment.METHODS: A non-blinded, randomized controlled trial was adopted. Sixty depressed patients, who met trial criteria, were randomly assigned to the treatment and the control groups. In the treatment group, electro-acupuncture treatment was used, and paroxetine treatment was used in the control group. During the 24-week study period, 12 patients dropped out and 48 patients completed the study. The Minnesota Multiple Personality Inventory (MMPI) was adopted as the evaluation tool. At the same time, the Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS) and Montgomery-Asberg Depression Rating Scale (MADRS) were used to evaluate the psychological state. Evaluations were done before and after treatment.RESULTS: After treatment, patients' psychological state improved significantly in both groups (P<0.01). For the treatment group, within-group comparison between baseline and after 24 weeks of treatment showed that severity of depression had significantly decreased (P<0.01). MADRS and SDS scores decreased significantly (P<0.05) and MMPI subscale scores for hypochondriasis, depression, psychopathic deviate, psychasthenia, social introversion and fake decreased significantly (P<0.05). For the control group, severity of depression also decreased significantly. MADRS and SDS scores decreased significantly (P<0.05); and MMPI subscale scores for hypochondriasis, depression, hysteria, paranoia, and psychasthenia decreased significantly (P<0.05). Between-group comparison demonstrated that for the MMPI subscales paranoia and social introversion, the decrease of score was greater in the treatment group than in the control group (P<0.05). However, there were no other significant differences between the control group and the treatment group.CONCLUSION: Electro-acupuncture is effective for treating depression and affects personality traits.","Wang, W D; Lu, X Y; Ng, S M; Hong, L; Zhao, Y; Lin, Y N; Wang, F",2013.0,10.1007/s11655-013-1594-4,0,0,
2845,The effect of abdominal massage in reducing malignant ascites symptoms,"ER As many as 50% of end-stage cancer patients will develop ascites and associated symptoms, including pain, tiredness, nausea, depression, anxiety, drowsiness, loss of appetite, dyspnea, perceived abdominal bloating, and immobility. Abdominal massage may stimulate lymph return to the venous system and reduce ascites-related symptoms. The purpose of this study was to test the effect of abdominal massage in reducing these symptoms and reducing ascites itself as reflected in body weight. For a randomized controlled design using repeated measures, a sample of 80 patients with malignant ascites was recruited from gastroenterology and oncology units of a medical center in northern Taiwan and randomly assigned to the intervention or the control group. A 15-minute gentle abdominal massage, using straight rubbing, point rubbing, and kneading, was administered twice daily for 3 days. The control group received a twice-daily 15-minute social interaction contact with the same nurse. Symptoms and body weight were measured in the morning for 4 consecutive days from pre- to post-test. In generalized estimation equation modeling, a significant group-by-time interaction on depression, anxiety, poor wellbeing, and perceived abdominal bloating, indicated that abdominal massage improved these four symptoms, with the greatest effect on perceived bloating. The intervention had no effect on pain, tiredness, nausea, drowsiness, poor appetite, shortness of breath, mobility limitation, or body weight. Abdominal massage appears useful for managing selected symptoms of malignant ascites.","Wang, T J; Wang, H M; Yang, T S; Jane, S W; Huang, T H; Wang, C H; Lin, Y H",2015.0,10.1002/nur.21637,0,0,
2846,Efficacy of Yiqiyangxin Chinese medicine compound combined with cognitive therapy in the treatment of generalized anxiety disorders.,"To observe the clinical efficacy of Yiqiyangxin Chinese medicine compound combined with cognitive therapy on generalized anxiety disorders. A total of 202 generalized anxiety disorders patients were randomly allocated to a control condition (Paroxetine combined with cognitive therapy) or a treatment condition (Yiqiyangxin Chinese medicine compound combined with cognitive therapy). Subsequently, scores of Hamilton Anxiety Scale (HAMA), Zung Self-rating Anxiety Scale (SAS) and blood routine, urine routine, liver function, renal function, electrocardiogram were detected before treatment, 3 months, 6 months after treatment and 6 months after medicine withdrawal, respectively. HAMA and SAS scores were significantly reduced in two groups (P<0.001) after treatment, but the differences in HAMA and SAS scores, apparent effect and effectiveness were not significant (P>0.05). HAMA and SAS scores were significantly increased in two groups (P<0.05) after medicine withdrawal, and there were significant differences in HAMA and SAS scores, recurrent disease and adverse reaction (P<0.001). The incidence of recurrent disease and adverse reaction in treatment group was low. Both two groups showed no apparent abnormality in blood routine, urine routine, liver and renal function, and electrocardiogram. Yiqiyangxin Chinese medicine compound combined with cognitive therapy can significantly reduce the recurrence after medicine withdrawal and is effective on generalized anxiety disorders. Furthermore, the incidence of adverse reactions is low. The treatment program is worthy clinic application in the further.",Wang T.; Ding JY.; Xu GX.; Zeng Y.; Xiao SR.,2012.0,10.1016/S1995-7645(12)60150-3,0,0,
2847,Effect of post-liver transplantation administration of ursodeoxycholic acid on serum liver tests and biliary complications: a randomized clinical trial,"ER OBJECTIVE: Endogenous hydrophobic bile acids may be a pathogenetic factor of biliary complications after orthotopic liver transplantation (OLT).This study was designed to investigate the effects of hydrophilic ursodeoxycholic acid (UDCA), when administered early after OLT, on serum liver tests and on the incidence of biliary complications.METHODS: A total of 112 adult patients undergoing OLT were randomly assigned to one of two groups for receipt of UDCA (13 to 15 mg/kg/d for 4 weeks, n=56) or a placebo (n=56). All patients underwent serum liver testing and measurement of serum bile acids during the 4 weeks following OLT.Patients with T-tube underwent measurement of biliary bile acids during the 4 weeks following OLT.Biliary complications, as well as patient and graft survival rates, were analyzed during the follow-up period (mean of 65.6 months).RESULTS: At post-OLT days 7, 21 and 28, the UDCA-treated patients showed significantly lower levels of alanine aminotransferase, aspartate aminotransferase and gamma glutamyl transpeptidase (all P less than 0.05).In addition, the UDCA-treated patients showed significantly lower incidence of biliary sludge and casts within the first year post-OLT (3.6% vs.14.3%; x2=3.953, P=0.047). However, there were no significant differences for the incidence of other biliary complications at post-OLT years 1, 3 and 5.The graft and patient survival rates were also similar between the two groups.CONCLUSION: UDCA, when administered early after OLT, improves results from serum liver tests and decreases the incidence of biliary sludge and casts within the first postoperative year.","Wang, S; Tang, M; Chen, G; Xu, J; Zhong, L; Wang, Z; Deng, G; Xing, T; Lu, L; Peng, Z",2014.0,,0,0,
2848,"Effects of comprehensive therapy based on traditional Chinese medicine patterns on older patients with chronic obstructive pulmonary disease: a subgroup analysis from a four-center, randomized, controlled study","ER This study aimed to evaluate the efficacy of comprehensive therapy based on traditional Chinese medicine (TCM) patterns on older patients with chronic obstructive pulmonary disease (COPD) through a fourcenter, open-label, randomized controlled trial. Patients were divided into the trial group treated using conventional western medicine and Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules, and Yi-Qi Zi-Shen granules based on TCM patterns respectively; and the control group treated using conventional western medicine. A total of 136 patients ? 65 years completed the study, with 63 patients comprising the trial group and 73 comprising the control group. After the six-month treatment and the 12-month follow-up period, significant differences were observed between the trial and control groups in the following aspects: frequency of acute exacerbation (P ? 0.040), duration of acute exacerbation (P = 0.034), symptoms (P ? 0.034), 6-min walking distance (6MWD) (P ? 0.039), dyspnea scale (P ? 0.036); physical domain (P ? 0.019), psychological domain (P ? 0.033), social domain (P ? 0.020), and environmental domain (P ? 0.044) of the WHOQOL-BREF questionnaire; and daily living ability domain (P ? 0.007), social activity domain (P ? 0.018), depression symptoms domain (P ? 0.025), and anxiety symptoms domain (P ? 0.037) of the COPD-QOL. No differences were observed between the trial and control groups with regard to FVC, FEV1, and FEV1%.","Wang, M; Li, J; Li, S; Xie, Y",2014.0,10.1007/s11684-014-0360-0,0,0,
2849,The influence of gender and sex steroid hormones on the plasma binding of propranolol enantiomers,"1 Plasma binding of tritium-labelled racemic propranolol (P) was measured by equilibrium dialysis. The unbound enantiomers were separated by h.p.l.c. after chiral derivatization. The binding of (-)-P was higher than that of (+)-P. 2 Contrary to previous suggestions, a sex difference in the plasma binding of the P enantiomers (9 young women, 12 young men) was not observed. The unbound percentage of (-)-P was 9.2 ± 1.8 (mean ± s.d.) in women vs 9.1 ± 1.7 in men; for (+)-P it was 10.8 ± 1.8 vs 10.8 ± 2.1. 3 In the nine women, the binding did not change with fluctuating plasma oestradiol concentrations during the menstrual cycle. Testosterone cypionate doubled the circulating concentrations of testosterone in eight men but had no effect on P binding. 4 Ethinyl oestradiol (50 μg day-1 alone or together with norethindrone (OCD) in eight of the women produced an increase in the unbound percentage of both (-)-P (11.4 ± 2.6 vs 9.5 ± 1.6 for control; P < 0.001) and (+)-P (13.2 ± 2.5 vs 11.2 ± 1.5 for control; P < 0.001). This was due to a decrease in the plasma concentrations of α1-acid glycoprotein from 0.54 ± 0.11 mg ml-1 in control to 0.37 ± 0.08 mg ml-1 (P < 0.001) during ethinyl oestradiol treatment. 5 Enantioselectivity in the unbound fraction of P increased with increasing total binding from a (-)/(+)-ratio of 0.93 at 84% binding to a (-)/(+)-ratio of 0.78 at 94% binding (P < 0.001).",Walle U.K.; Fagan T.C.; Topmiller M.J.; Conradi E.C.; Walle T.,1994.0,,0,0,
2850,Emotion dysregulation: A predictor for CBT treatment outcomes in a comorbid PTSD and SUD population.,"Trauma has been shown to disrupt self-regulatory processes; emotion regulation deficits have also been implicated in the initiation and maintenance of substance use disorders (SUDs). Treatments for these complex comorbid problems utilize a variety of approaches. However, to date, few studies have examined the effect of various available treatments on emotion dysregulation in this population. This study extends the research on emotion regulation among the population with comorbid posttraumatic stress disorder (PTSD) and SUD. This study is a secondary analysis of part of the data from a randomized clinical trial assessing the relative efficacy of two active treatment conditions for substance dependent individuals who also meet criteria for current DSM-IV-TR PTSD. The current study examined features associated with emotion dysregulation, correlating dysregulation with PTSD and SUD symptoms; the study focused on baseline emotion dysregulation as a predictor of treatment outcomes. Additionally, the study examined emotion dysregulation over time to determine the mutability of this complex factor in response to treatment. Lastly, this study utilized a case illustration to examine in more depth change in emotion dysregulation over time, as measured by physiological arousal; this methodology provides for a more thorough depiction of the phenomenon. Correlation analyses identified that baseline emotion dysregulation was associated with baseline PTSD symptom severity, but not with baseline substance use frequency among those with comorbid PTSD and SUD. A repeated measures ANOVA determined that the high baseline dysregulation group that received relapse prevention treatment showed no change in substance use frequency from baseline to follow-up. Additionally, the high baseline dysregulation group that received Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) showed a trending decrease in dysregulation at follow-up. Altogether, this exploratory study provided evidence that exposure therapy can be tolerated by and beneficial to highly dysregulated persons with both PTSD and SUD and that psychotherapy focusing only on substance used may be contraindicated for highly dysregulated individuals with comorbid PTSD and SUD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wallach, Jennifer R",2016.0,,0,0,
2851,The effect of attention on conventional automated perimetry and luminance size threshold perimetry,"ER METHODSTen healthy subjects, ages 27 to 65, with two perimetry types (CAP and LSTP) were tested in random order. At a later session, these tests were given with a mental workload to simulate the effect of anxiety or distraction on subjects performing visual field testing, also in random order. The mental workload, the Paced Auditory Serial Addition Test (PASAT), was first administered to each subject, and the score was recorded. During the visual field testing, the PASAT was again administered continuously. Each subject was instructed to attend primarily to the PASAT while taking each visual field test.RESULTSCAP was affected by the addition of the PASAT, with a worsening of sensitivity from an average of 30.0 +/- 0.67 to 24.2 +/- 7.4 dB with a range of -0.04 to -23.2 dB (P = 0.04). LSTP showed a generalized reduction in threshold 1.71 +/- 0.22 to 2.35 +/- 0.72 dB with a range of 0.12 to -2.17 dB (P = 0.25). The percentage of correct responses on the PASAT was not significantly different between CAP (76.9%) and LSTP (74.8%). False-positive and -negative catch trial responses were increased during CAP with PASAT testing (P = 0.009). A substantial increase of fixation losses occurred during CAP with PASAT (3.7-16.2, P = 0.002). LSTP with PASAT showed increases in localization error (P < 0.001) and reaction time (P = 0.004).CONCLUSIONSDivided attention significantly affects performance on conventional automated perimetry with its fixed size stimuli and when the stimuli are scaled (LSTP). The deficits may simulate nerve-fiber-bundle-like defects.PURPOSETo investigate the effects of divided attention on conventional automated perimetry (CAP) and luminance size threshold perimetry (LSTP).","Wall, M; Woodward, K R; Brito, C F",2004.0,,0,0,
2852,Preliminary research on the efficacy of virtual reality exposure therapy to treat driving phobia.,"This article presents a review of preliminary research of two studies of the efficacy of virtual reality exposure therapy (VRET) to treat driving phobia. Study 1 describes a case study of a patient who completed a 7-day baseline followed by three sessions of VRET. Her peak anxiety decreased within and across sessions. At the post-treatment assessment, her phobic-related symptoms had diminished and she no longer met diagnostic criteria for driving phobia. Clinical improvement was maintained at 1-, 3-, and 7-month follow-up. In study 2, a multiple baseline across-subjects design was used to treat five patients over eight weekly VRET sessions. Visual and statistical analyses showed clear improvement in driving anxiety and avoidance in three patients between pre- and post-treatment assessments, and they no longer met criteria for driving phobia. There was marginal improvement in one patient, and the remaining individual showed no treatment gains. There was negligible change in actual driving frequency for any of the patients. Some gains were lost at the follow-up, particularly for the two individuals with poorer treatment responses. The results from these preliminary studies suggest that VRET may be a promising intervention for treating driving phobia. Avenues for improving treatment outcome are discussed.",Wald J.; Taylor S.,2003.0,10.1089/109493103769710488,0,0,
2853,Battlefield-like stress following simulated combat and suppression of attention bias to threat.,"Acute stress disorder involves prominent symptoms of threat avoidance. Preliminary cross-sectional data suggest that such threat-avoidance symptoms may also manifest cognitively, as attentional threat avoidance. Confirming these findings in a longitudinal study might provide insights on risk prediction and anxiety prevention in traumatic exposures. Attention-threat bias and post-traumatic symptoms were assessed in soldiers at two points in time: early in basic training and 23 weeks later, during advanced combat training. Based on random assignment, the timing of the repeat assessment occurred in one of two schedules: for a combat simulation group, the repeat assessment occurred immediately following a battlefield simulation exercise, and for a control group, the assessment occurred shortly before this exercise. Both groups showed no threat-related attention bias at initial assessments. Following acute stress, the combat simulation group exhibited a shift in attention away from threat whereas the control group showed no change in attention bias. Stronger threat avoidance in the combat simulation group correlated with severity of post-traumatic symptoms. Such an association was not found in the control group. Acute stress may lead some individuals to shift their attention away from threats, perhaps to minimize stress exposure. This acute attention response may come at a psychological cost, given that it correlates with post-traumatic stress disorder (PTSD) symptoms. Further research is needed to determine how these associations relate to full-blown PTSD in soldier and civilian populations.",Wald I.; Lubin G.; Holoshitz Y.; Muller D.; Fruchter E.; Pine DS.; Charney DS.; Bar-Haim Y.,2011.0,10.1017/S0033291710002308,0,0,
2854,Selective prevention of combat-related post-traumatic stress disorder using attention bias modification training: A randomized controlled trial.,"Background: Efficacy of pre-trauma prevention for post-traumatic stress disorder (PTSD) has not yet been established in a randomized controlled trial. Attention bias modification training (ABMT), a computerized intervention, is thought to mitigate stress-related symptoms by targeting disruptions in threat monitoring. We examined the efficacy of ABMT delivered before combat in mitigating risk for PTSD following combat. Method: We conducted a double-blind, four-arm randomized controlled trial of 719 infantry soldiers to compare the efficacy of eight sessions of ABMT (n = 179), four sessions of ABMT (n = 184), four sessions of attention control training (ACT; n = 180), or no-training control (n = 176). Outcome symptoms were measured at baseline, 6-month follow-up, 10 days following combat exposure, and 4 months following combat. Primary outcome was PTSD prevalence 4 months post-combat determined in a clinical interview using the Clinician-Administered PTSD Scale. Secondary outcomes were self-reported PTSD and depression symptoms, collected at all four assessments. Results: PTSD prevalence 4 months post-combat was 7.8% in the no-training control group, 6.7% with eight-session ABMT, 2.6% with four-session ABMT, and 5% with ACT. Four sessions of ABMT reduced risk for PTSD relative to the no-training condition (odds ratio 3.13, 95% confidence interval 1.01-9.22, p < 0.05, number needed to treat = 19.2). No other between-group differences were found. The results were consistent across a variety of analytic techniques and data imputation approaches. Conclusions: Four sessions of ABMT, delivered prior to combat deployment, mitigated PTSD risk following combat exposure. Given its low cost and high scalability potential, and observed number needed to treat, research into larger-scale applications is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wald, I; Fruchter, E; Ginat, K; Stolin, E; Dagan, D; Bliese, P. D; Quartana, P. J; Sipos, M. L; Pine, D. S; Bar-Haim, Y; Abend, Adler, Agorastos, Badura-Brack, Beevers, Blake, Blanchard, Bradley, Britton, Browning, Eldar, Feldner, Forneris, Hoge, Iacoviello, Kliem, Kroenke, Kuckertz, Ledoux, Linetzky, MacLeod, MacLeod, Monk, Naim, Pine, Sipos, Skeffington, Steenkamp, Thomas, Urbaniak, Wald, Wald, Wald, Weathers, Zeger",2016.0,,0,0,
2855,Generalization of therapeutic changes in agoraphobia: the role of perceived self-efficacy.,"Investigated the extent and mechanisms of therapeutic generalization across distinct areas of agoraphobic dysfunction. Twenty-seven severe agoraphobics were each given performance-based treatment for some phobic areas while leaving their other phobias untreated. Behavioral tests revealed that (a) the treated phobias improved significantly more than the untreated (transfer) phobias, (b) the transfer phobias improved significantly more than control phobias, and (c) the transfer benefits were highly variable within and between subjects. Analyses of possible cognitive mechanisms revealed that perceived self-efficacy accurately predicted treatment and transfer effects even when alternative factors such as previous behavior, anticipated anxiety, anticipated panic, perceived danger, and subjective anxiety were held constant. In contrast, these alternative factors lost most or all predictive value when self-efficacy was held constant. Agoraphobia thus appears to be neither a unitary entity nor a mere collection of independent phobias, but a complexly patterned problem governed largely by self-perceptions of coping efficacy.",Williams SL.; Kinney PJ.; Falbo J.,1989.0,,0,0,
2856,Psychological distress among british South Asians: The contribution of stressful situations and subcultural differences in the West of Scotland Twenty-07 Study,"Background. This paper seeks to explain an excess of psychological distress previously found among groups of British South Asians (with ancestry from the Indian subcontinent) living in Glasgow, compared with the general population. The excess was found on a psychosomatic measure and a measure of self-assessed distress but not on a clinically validated measure (the General Health Questionnaire or GHQ). The paper investigates whether South Asians are subject to stressful situations to which the GHQ is less sensitive than the other two measures. Methods. Random samples of 159 South Asians aged 30-40, mean age 35, and 319 from the general population, all aged 35, were interviewed in Glasgow, using the 12-item General Health Questionnaire (GHQ-12), a psychosomatic symptom scale (PSS) and a self-assessment of distress. Subcultural groupings were differentiated by South Asian origin, English fluency, religion, and gender. Stressful situations assessed were experience of assault, stress/dissatisfaction with work, overcrowding, low standard of living, absence of family and absence of confidants. Results. The GHQ-12 was less sensitive to certain stressful situations than the other two measures. The PSS and/or self-assessed distress were more sensitive to low standard of living, self-rated stress in work around the house and possibly experience of assault. In a combined analysis, the relation between distress on the PSS or self-assessed measure and subcultural groupings became nonsignificant, while the relation between distress and key stressful situations remained significant. Conclusions. The greater distress of women, Muslims and limited English speakers is largely explained by the stressful situations they experience. The GHQ-12 under-estimates distress related to situations experienced particularly by ethnic minorities and by women.",Williams R.; Hunt K.,1997.0,10.1017/S0033291797005473,0,0,
2857,Personality predictors of mood related to dieting.,"The clinical utility of a model of normal emotional functioning (vs. psychopathology) and the moderating effects of neuroticism (N) and extraversion (E) on mood were examined during a 6-week weight-loss trial. Participants were 40 obese women who completed measures of negative affect (NA) and positive affect (PA) weekly during the diet and measures of anxiety and depression (Beck Depression Inventory [BDI]) at pre-, mid-, and postdiet. Results indicated that (a) average NA and PA were each uniquely related to postdiet BDI scores, (b) N was significantly related to NA during the diet and postdiet BDI scores, and (c) N and E interacted to predict PA during the diet. The results suggest that assessment of personality and normal mood variation may be useful additions to weight-loss intervention and research.",Williams PG.; Surwit RS.; Babyak MA.; McCaskill CC.,1998.0,,0,0,
2858,Effects of a circuit weight training program on the body images of college students,"ER METHODThe weight trainers consisted of 39 college students (27 women and 12 men). The control group of 39 individuals did not weight-train currently or within the past year. All participants were pre- and posttested on the Multidimensional Body Self-Relations Questionnaire, the Social Physique Anxiety Scale, and the Physical Self-Efficacy Scale. Weight trainers were also pre- and posttested on muscular strength and assessed on their motives for exercise.RESULTSThe program successfully increased upper- and lower-body strength. In contrast to the comparison group, weight trainers had a significantly improved evaluation of their appearance, greater body satisfaction, reduced social physique anxiety, and enhanced physical self-efficacy. Outcomes were unrelated to the extent of concurrent aerobic exercise and largely unrelated to exercise motives.DISCUSSIONEven a relatively brief weight training program can produce improvements in multiple aspects of body image. Further research should investigate weight training as an adjunct to psychosocial treatments of body dissatisfaction.OBJECTIVEThe present investigation examined the extent to which participation in a 6-week circuit-weight training program produced changes in participants' body images relative to a matched control group.","Williams, P A; Cash, T F",2001.0,,0,0,
2859,Myth of the pure obsessional type in obsessive--compulsive disorder.,"Several studies have identified discrete symptom dimensions in obsessive-compulsive disorder (OCD), derived from factor analyses of the individual items or symptom categories of the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist (YBOCS-SC). This study aims to extend previous work on the relationship between obsessions and compulsions by specifically including mental compulsions and reassurance-seeking. Because these compulsions have traditionally been omitted from prior factor analytic studies, their association to what have been called ""pure obsessions"" may have been overlooked. Participants (N = 201) were recruited from two multi-site randomized clinical treatment trials for OCD. The YBOCS-SC was used to assess OCD symptoms, as it includes a comprehensive list of obsessions and compulsions, arranged by content category. Each category was given a score based on whether symptoms were present and if the symptom was a primary target of clinical concern, and a factor analysis was conducted. Mental compulsions and reassurance-seeking were considered separate categories for the analysis. Using an orthogonal geomin rotation of 16 YBOCS-SC categories/items, we found a five-factor solution that explained 67% of the total variance. Inspection of items that composed each factor suggests five familiar constructs, with mental compulsions and reassurance-seeking included with sexual, aggressive, and religious obsessions (unacceptable/taboo thoughts). This study suggests that the concept of the ""pure obsessional"" (e.g., patients with unacceptable/taboo thoughts yet no compulsions) may be a misnomer, as these obsessions were factorially associated with mental compulsions and reassurance-seeking in these samples. These findings may have implications for DSM-5 diagnostic criteria.",Williams MT.; Farris SG.; Turkheimer E.; Pinto A.; Ozanick K.; Franklin ME.; Liebowitz M.; Simpson HB.; Foa EB.,2011.0,10.1002/da.20820,0,0,
2860,Myth of the pure obsessional type in obsessive-compulsive Disorder.,"Background: Several studies have identified discrete symptom dimensions in obsessive-compulsive disorder (OCD), derived from factor analyses of the individual items or symptom categories of the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist (YBOCS-SC). This study aims to extend previous work on the relationship between obsessions and compulsions by specifically including mental compulsions and reassurance-seeking. Because these compulsions have traditionally been omitted from prior factor analytic studies, their association to what have been called ''pure obsessions'' may have been overlooked. Method: Participants (N = 201) were recruited from two multi-site randomized clinical treatment trials for OCD. The YBOCS-SC was used to assess OCD symptoms, as it includes a comprehensive list of obsessions and compulsions, arranged by content category. Each category was given a score based on whether symptoms were present and if the symptom was a primary target of clinical concern, and a factor analysis was conducted. Mental compulsions and reassurance-seeking were considered separate categories for the analysis. Results: Using an orthogonal geomin rotation of 16 YBOCS-SC categories/items, we found a five-factor solution that explained 67% of the total variance. Inspection of items that composed each factor suggests five familiar constructs, with mental compulsions and reassurance-seeking included with sexual, aggressive, and religious obsessions (unacceptable/taboo thoughts). Conclusions: This study suggests that the concept of the ''pure obsessional'' (e.g., patients with unacceptable/taboo thoughts yet no compulsions) may be a misnomer, as these obsessions were factorially associated with mental compulsions and reassurance-seeking in these samples. These findings may have implications for DSM-5 diagnostic criteria. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Williams, Monnica T; Farris, Samantha G; Turkheimer, Eric; Pinto, Anthony; Ozanick, Krystal; Franklin, Martin E; Liebowitz, Michael; Simpson, H. Blair; Foa, Edna B; Abramowitz, Alonso, Baer, Bloch, Calvocoressi, Feinstein, First, Foa, Foa, Goodman, Grabill, Greist, Jenike, Katerberg, Leckman, MacDonald, Mataix-Cols, Mataix-Cols, McLean, Muthen, Pinto, Pinto, Pinto, Rufer, Simpson, Sussman, Williams, Wu",2011.0,,0,0,
2861,The impact of symptom dimensions on outcome for exposure and ritual prevention therapy in obsessive-compulsive disorder.,"Objective: Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP). This study examined the impact of symptom dimensions on EX/RP outcomes in OCD patients. Method: The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to determine primary symptoms for each participant. An exploratory factor analysis (EFA) of 238 patients identified five dimensions: contamination/cleaning, doubts about harm/checking, hoarding, symmetry/ordering, and unacceptable/taboo thoughts (including religious/moral and somatic obsessions among others). A linear regression was conducted on those who had received EX/RP (n = 87) to examine whether scores on the five symptom dimensions predicted post-treatment Y-BOCS scores, accounting for pre-treatment Y-BOCS scores. Results: The average reduction in Y-BOCS score was 43.0%, however the regression indicated that unacceptable/taboo thoughts (beta = .27, p = .02) and hoarding dimensions (beta = .23, p = .04) were associated with significantly poorer EX/RP treatment outcomes. Specifically, patients endorsing religious/moral obsessions, somatic concerns, and hoarding obsessions showed significantly smaller reductions in Y-BOCS severity scores. Conclusions: EX/RP was effective for all symptom dimensions, however it was less effective for unacceptable/taboo thoughts and hoarding than for other dimensions. Clinical implications and directions for research are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Williams, Monnica T; Farris, Samantha G; Turkheimer, Eric N; Franklin, Martin E; Simpson, H. Blair; Liebowitz, Michael; Foa, Edna B; Abramowitz, Abramowitz, Abramowitz, Abramowitz, Alonso, Baer, De Araujo, Deacon, Feinstein, Foa, Foa, Foa, Foa, Foa, Frances, Frare, Freston, Goodman, Goodman, Grant, Greist, Himle, Huppert, Katerberg, Kessler, Koran, Kozak, Leckman, Leckman, Mataix-Cols, Mataix-Cols, McKay, McLean, Munthen, Nelson, Pertusa, Phillips, Pinto, Pinto, Rosario-Campos, Rosmarin, Rufer, Ruscio, Saxena, Siev, Simpson, Simpson, Storch, Whittal, Williams, Williams, Williams, Williams, Williams, Woody",2014.0,,0,0,
2862,Trauma modulates amygdala and medial prefrontal responses to consciously attended fear.,"Effective fear processing relies on the amygdala and medial prefrontal cortex (MPFC). Post-trauma reactions provide a compelling model for examining how the heightened experience of fear impacts these systems. Post-traumatic stress disorder (PTSD) has been associated with excessive amygdala and a lack of MPFC activity in response to nonconscious facial signals of fear, but responses to consciously processed facial fear stimuli have not been examined. We used functional MRI to elucidate the effect of trauma reactions on amygdala-MPFC function during an overt fear perception task. Subjects with PTSD (n = 13) and matched non-traumatized healthy subjects (n = 13) viewed 15 blocks of eight fearful face stimuli alternating pseudorandomly with 15 blocks of neutral faces (stimulus duration 500 ms; ISI 767 ms). We used random effects analyses in SPM2 to examine within- and between-group differences in the MPFC and amygdala search regions of interest. Time series data were used to examine amygdala-MPFC associations and changes across the first (Early) versus second (Late) phases of the experiment. Relative to non-traumatized subjects, PTSD subjects showed a marked bilateral reduction in MPFC activity (in particular, right anterior cingulate cortex, ACC), which showed a different Early-Late pattern to non-traumatized subjects and was more pronounced with greater trauma impact and symptomatology. PTSD subjects also showed a small but significant enhancement in left amygdala activity, most apparent during the Late phase, but reduction in Early right amygdala response. Over the time course, trauma was related to a distinct pattern of ACC and amygdala connections. The findings suggest that major life trauma may disrupt the normal pattern of medial prefrontal and amygdala regulation.",Williams LM.; Kemp AH.; Felmingham K.; Barton M.; Olivieri G.; Peduto A.; Gordon E.; Bryant RA.,2006.0,10.1016/j.neuroimage.2005.03.047,0,0,
2863,A sexual risk and stress reduction intervention designed for HIV-positive bisexual African American men with childhood sexual abuse histories.,"Objectives: HIV transmission risk is high among men who have sex with men and women (MSMW), and it is further heightened by a history of childhood sexual abuse (CSA) and current traumatic stress or depression. Yet, traumatic stress is rarely addressed in HIV interventions. We tested a stress-focused sexual risk reduction intervention for African American MSMW with CSA histories. Methods: This randomized controlled trial compared a stress-focused sexual risk reduction intervention with a general health promotion intervention. Sexual risk behaviors, psychological symptoms, stress biomarkers (urinary cortisol and catecholamines), and neopterin (an indicator of HIV progression) were assessed at baseline and at 3- and 6-month follow-ups. Results: Both interventions decreased and sustained reductions in sexual risk and psychological symptoms. The stress-focused intervention was more efficacious than the general health promotion intervention in decreasing unprotected anal insertive sex and reducing depression symptoms. Despite randomization, baseline group differences in CSA severity, psychological symptoms, and biomarkers were found and linked to subsequent intervention outcomes. Conclusions: Although interventions designed specifically for HIV-positive African American MSMW can lead to improvements in health outcomes, future research is needed to examine factors that influence intervention effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Williams, John K; Glover, Dorie A; Wyatt, Gail E; Kisler, Kimberly; Liu, Honghu; Zhang, Muyu; Alvy, Antoni, Antoni, Balsam, Bandura, Beck, Briere, Brondolo, Bronfenbrenner, Brown, Carrico, Chartier, Chin, Classen, Crepaz, Djoba Siawaya, Feiring, Fergus, Foa, Foa, Garmezy, Geronimus, Geronimus, Glei, Glover, Glover, Glover, Glover, Glover, Glover, Glover, Green, Greenfield, Gwadz, Holmes, Hornor, Joe, Johnson, Kalichman, Lanius, Lanius, Lenderking, Lovejoy, Luthar, Maniglio, Masten, Mays, Mays, Mays, McEwen, McEwen, McEwen, McEwen, McEwen, Miller, Millett, Millett, Myrick, Nelson, Operario, Peterson, Prochaska, Roche, Rumstein-McKean, Rutter, Sciolla, Scott-Sheldon, Seplaki, Sikkema, Sikkema, Weber, Whiffen, Whiffen, Williams, Williams, Williams, Wilton, Wirleitner, Wyatt, Wyatt, Yehuda, Yehuda",2013.0,,0,0,
2864,Mindfulness-based cognitive therapy reduces overgeneral autobiographical memory in formerly depressed patients.,"Previous research on depressed and suicidal patients and those with posttraumatic stress disorder has shown that patients' memory for the past is overgeneral (i.e., patients retrieve generic summaries of past events rather than specific events). This study investigated whether autobiographical memory could be affected by psychological treatment. Recovered depressed patients were randomly allocated to receive either treatment as usual or treatment designed to reduce risk of relapse. Whereas control patients showed no change in specificity of memories recalled in response to cue words, the treatment group showed a significantly reduced number of generic memories. Although such a memory deficit may arise from long-standing tendencies to encode and retrieve events generically, such a style is open to modification.",Williams JM.; Teasdale JD.; Segal ZV.; Soulsby J.,2000.0,,0,0,
2865,Mindfulness-based Cognitive Therapy (MBCT) in bipolar disorder: preliminary evaluation of immediate effects on between-episode functioning.,"Bipolar disorder is highly recurrent and rates of comorbidity are high. Studies have pointed to anxiety comorbidity as one factor associated with risk of suicide attempts and poor overall outcome. This study aimed to explore the feasibility and potential benefits of a new psychological treatment (Mindfulness-based Cognitive Therapy: MBCT) for people with bipolar disorder focusing on between-episode anxiety and depressive symptoms. The study used data from a pilot randomized trial of MBCT for people with bipolar disorder in remission, focusing on between-episode anxiety and depressive symptoms. Immediate effects of MBCT versus waitlist on levels of anxiety and depression were compared between unipolar and bipolar participants. The results suggest that MBCT led to improved immediate outcomes in terms of anxiety which were specific to the bipolar group. Both bipolar and unipolar participants allocated to MBCT showed reductions in residual depressive symptoms relative to those allocated to the waitlist condition. Analyses were based on a small sample, limiting power. Additionally the study recruited participants with suicidal ideation or behaviour so the findings cannot immediately be generalized to individuals without these symptoms. The study, although preliminary, suggests an immediate effect of MBCT on anxiety and depressive symptoms among bipolar participants with suicidal ideation or behaviour, and indicates that further research into the use of MBCT with bipolar patients may be warranted.",Williams JM.; Alatiq Y.; Crane C.; Barnhofer T.; Fennell MJ.; Duggan DS.; Hepburn S.; Goodwin GM.,2008.0,10.1016/j.jad.2007.08.022,0,0,
2866,International reliability of a diagnostic intake procedure for panic disorder.,"Test-retest diagnostic reliability interviews using the Upjohn version of the Structured Clinical Interview for DSM-III (SCID) were conducted with 72 patients at 13 international sites of the Cross-National Collaborative Panic Study. Agreement on the diagnosis of panic disorder was very good. For the subtypes (uncomplicated, with limited phobic avoidance, and agoraphobia), agreement was fair to good.",Williams JB.; Spitzer RL.; Gibbon M.,1992.0,10.1176/ajp.149.4.560,0,0,
2867,Comparison of site-based versus central ratings in a study of generalized anxiety disorder.,"Lack of standardization across sites and raters, poor interrater reliability, and possible scoring bias affecting the primary outcome measure contribute to a high failure rate in anxiety trials. Remote centralized raters who are blinded to protocol inclusion and exclusion criteria as well as visit number may standardize assessments across raters and eliminate scoring bias, decreasing placebo response and thereby increasing signal detection. The purpose of the primary study was to test the safety and efficacy of an anxiolytic in a double-blind, placebo-controlled (no active comparator), multicenter trial. However, there was an additional prospective objective to explore site ratings compared with remote centralized ratings in the cohort of subjects on placebo. Site raters assessed subjects 6 times over an 8-week period. The primary outcome measure was the week 8 site-rated Hamilton Anxiety Scale (HAM-A). Remote centralized raters by telephone independently rated these subjects on the HAM-A at baseline and week 6. Of the 122 subjects selected by site raters and therefore randomized, remote centralized raters would have admitted 59 (48%) and excluded 63 (52%), based on their HAM-A ratings. The mean change from baseline in HAM-A total score in the placebo group admitted to the study by site raters was 9.3, significantly higher than the 5.9 point mean change on placebo as measured by the remote centralized raters. The data are consistent with the potential for qualification bias at baseline when rated by sites. The results make a strong case for using strategies to ensure that baseline scoring is truly independent of the pressure to enroll. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Williams, Janet B. W; Kobak, Kenneth A; Giller, Earl; Reasner, David S; Curry, Lisa; Detke, Michael J; Aziz, Cohen, Coric, Cronbach, DeBrota, Khan, Khin, Kobak, Kobak, Kobak, Kobak, Leon, Oren, Paulsen, Rickels, Sheehan, Shen, Shen, Shrout, Stein, Williams, Winer",2015.0,,0,0,
2868,Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: a randomized dismantling trial,"ER METHOD: A randomized controlled trial in which 274 participants were allocated in the ratio 2:2:1 to MBCT plus TAU, CPE plus TAU, and TAU alone, and data were analyzed for the 255 (93%; MBCT = 99, CPE = 103, TAU = 53) retained to follow-up. MBCT was delivered in accordance with its published manual, modified to address suicidal cognitions; CPE was modeled on MBCT, but without training in meditation. Both treatments were delivered through 8 weekly classes.RESULTS: Allocated treatment had no significant effect on risk of relapse to MDD over 12 months follow-up, hazard ratio for MBCT vs. CPE = 0.88, 95% CI [0.58, 1.35]; for MBCT vs. TAU = 0.69, 95% CI [0.42, 1.12]. However, severity of childhood trauma affected relapse, hazard ratio for increase of 1 standard deviation = 1.26 (95% CI [1.05, 1.50]), and significantly interacted with allocated treatment. Among participants above median severity, the hazard ratio was 0.61, 95% CI [0.34, 1.09], for MBCT vs. CPE, and 0.43, 95% CI [0.22, 0.87], for MBCT vs. TAU. For those below median severity, there were no such differences between treatment groups.CONCLUSION: MBCT provided significant protection against relapse for participants with increased vulnerability due to history of childhood trauma, but showed no significant advantage in comparison to an active control treatment and usual care over the whole group of patients with recurrent depression.OBJECTIVE: We compared mindfulness-based cognitive therapy (MBCT) with both cognitive psychological education (CPE) and treatment as usual (TAU) in preventing relapse to major depressive disorder (MDD) in people currently in remission following at least 3 previous episodes.","Williams, J M; Crane, C; Barnhofer, T; Brennan, K; Duggan, D S; Fennell, M J; Hackmann, A; Krusche, A; Muse, K; Rohr, I R; Shah, D; Crane, R S; Eames, C; Jones, M; Radford, S; Silverton, S; Sun, Y; Weatherley-Jones, E; Whitaker, C J; Russell, D; Russell, I T",2014.0,10.1037/a0035036,0,0,
2869,A sexual risk and stress reduction intervention designed for HIV-positive bisexual African American men with childhood sexual abuse histories,"ER METHODS: This randomized controlled trial compared a stress-focused sexual risk reduction intervention with a general health promotion intervention. Sexual risk behaviors, psychological symptoms, stress biomarkers (urinary cortisol and catecholamines), and neopterin (an indicator of HIV progression) were assessed at baseline and at 3- and 6-month follow-ups.RESULTS: Both interventions decreased and sustained reductions in sexual risk and psychological symptoms. The stress-focused intervention was more efficacious than the general health promotion intervention in decreasing unprotected anal insertive sex and reducing depression symptoms. Despite randomization, baseline group differences in CSA severity, psychological symptoms, and biomarkers were found and linked to subsequent intervention outcomes.CONCLUSIONS: Although interventions designed specifically for HIV-positive African American MSMW can lead to improvements in health outcomes, future research is needed to examine factors that influence intervention effects.OBJECTIVES: HIV transmission risk is high among men who have sex with men and women (MSMW), and it is further heightened by a history of childhood sexual abuse (CSA) and current traumatic stress or depression. Yet, traumatic stress is rarely addressed in HIV interventions. We tested a stress-focused sexual risk reduction intervention for African American MSMW with CSA histories.","Williams, J K; Glover, D A; Wyatt, G E; Kisler, K; Liu, H; Zhang, M",2013.0,10.2105/AJPH.2012.301121,0,0,
2870,"Ballistic strength training compared with usual care for improving mobility following traumatic brain injury: protocol for a randomised, controlled trial.","Traumatic brain injury is the leading cause of disability in young adults aged 15 to 45 years. Mobility limitations are prevalent, and range in severity from interfering with basic day-to-day tasks to restricting participation in higher level social, leisure, employment and sporting activities. Despite the prevalence and severity of physical impairments, such as poor balance and spasticity, the main contributor to mobility limitations following traumatic brain injury is low muscle power generation. Strengthening exercises that are performed quickly are termed 'ballistic' as they are aimed at improving the rate of force production and, hence, muscle power. This is compared with conventional strength training, which is performed slowly and aims to improve maximum force production, yet has limited impact on mobility. In people recovering from traumatic brain injury: (1) is a 12-week ballistic strength-training program targeting the three muscle groups critical for walking more effective than usual care at improving mobility, strength and balance; and (2) does improved mobility translate to better health-related quality of life? A prospective, multi-centre, randomised, single-blind trial with concealed allocation will be conducted. Participants will be patients with a neurologically based movement disorder affecting mobility as a result of traumatic brain injury. Patients will be recruited during the acute phase of rehabilitation (n=166), from brain injury units in large metropolitan hospitals in Melbourne and Sydney, Australia. For 12 weeks, participants in the experimental group will have three 60-minute sessions of usual physiotherapy intervention replaced by three 60-minute sessions of strength training (ballistic strength, gait). The three key muscle groups responsible for forward propulsion will be targeted: ankle plantarflexors, hip flexors and the hip extensors. Initial loads will be low, to facilitate high contraction velocities. Progression to higher loads will occur only if participants can perform the exercises ballistically. The control group will have their three 60-minute sessions of usual physiotherapy intervention (balance, strength, stretch, cardiovascular fitness, gait) standardised so that all participants have equivalent therapy time. Both groups will continue to receive usual rehabilitation. The primary outcome will be mobility, measured using the High Level Mobility Assessment Tool. The secondary outcomes will be walking speed, muscle strength, balance and health-related quality of life. Walking speed will be measured using the 10-m walking test. Strength will be measured by a 6 repetition maximum, seated, single leg press test. Balance will be measured as the single limb support time. Health-related quality of life will be measured using the Assessment of Quality of Life. Outcomes will be measured at baseline (0 months), at completion of the intervention phase (3 months), and 3 months after cessation of intervention (6 months). Baseline measures will be completed prior to randomisation. Assessors blinded to group allocation will perform all measures. Baseline characteristics of participants will be determined according to group, using descriptive statistics. The proportion of patients compliant with the intervention will be calculated according to group and compared using Fisher's exact test. Compliance with the intervention will be defined as those who have satisfactorily completed at least 80% of the allocated sessions (29 of 36 sessions). The between-group difference for all outcomes will be estimated using analysis of covariance, adjusting for baseline High Level Mobility Assessment Tool score, age, gender and length of post-traumatic amnesia. Analyses will be conducted on an intention-to-treat basis. Strength training in neurological rehabilitation is highly topical because muscle weakness has been identified as the primary impairment leading to mobility limitations in many neurological populations. This project represents the first international study of ballistic strength training after traumatic brain injury. The novelty of ballistic strength training is that the exercises attempt to replicate how lower limb muscles work, by targeting the high angular velocities attained during walking and higher level activities.",Williams G.; Ada L.; Hassett L.; Morris ME.; Clark R.; Bryant AL.; Olver J.,2016.0,10.1016/j.jphys.2016.04.003,0,0,
2871,Online CBT life skills programme for low mood and anxiety: study protocol for a pilot randomized controlled trial,"ER METHODS: Individuals with elevated symptoms of depression will be recruited directly from the community via online and newspaper advertisements. Participants will be remotely randomized to receive either immediate access or delayed access to the Living Life to the Full guided online CBT-based life skills package, with telephone or email support provided whilst they use the online intervention. The primary end point will be at 3 months post-randomization, at which point the delayed-access group will be offered the intervention. Levels of depression, anxiety, social functioning and satisfaction will be assessed.DISCUSSION: This pilot study will test the trial design, and ability to recruit and deliver the intervention. Drop-out rates will be assessed and the completion and acceptability of the package will be investigated. The study will also inform a sample size power calculation for a subsequent substantive randomized controlled trial.TRIAL REGISTRATION: ISRCTN ISRCTN12890709.BACKGROUND: Low mood is a common mental health problem with significant health consequences. Studies have shown that cognitive behavioural therapy (CBT) is an effective treatment for low mood and anxiety when delivered one-to-one by an expert practitioner. However, access to this talking therapy is often limited and waiting lists can be long, although a range of low-intensity interventions that can increase access to services are available. These include guided self-help materials delivered via books, classes and online packages. This project aims to pilot a randomized controlled trial of an online CBT-based life skills course with community-based individuals experiencing low mood and anxiety.","Williams, C; McClay, C A; Martinez, R; Morrison, J; Haig, C; Jones, R; Farrand, P",2016.0,10.1186/s13063-016-1336-y,0,0,
2872,Cognitive Bias Modification (CBM) of obsessive compulsive beliefs.,"Cognitive bias modification (CBM) protocols have been developed to help establish the causal role of biased cognitive processing in maintaining psychopathology and have demonstrated therapeutic benefits in a range of disorders. The current study evaluated a cognitive bias modification training paradigm designed to target interpretation biases (CBM-I) associated with obsessive compulsive disorder (OCD). We evaluated the impact of CBM-I on measures of interpretation bias, distress, and on responses to three OC stressor tasks designed to tap the core belief domains of Importance of Thoughts/Control, Perfectionism/Intolerance of Uncertainty, and Contamination/Estimation of Threat in a selected sample of community members reporting obsessive compulsive (OC) symptoms (N = 89). Participants randomly assigned to the Positive condition evidenced a change in interpretation bias towards more positive and less negative OC-relevant interpretations following CBM-I compared to participants assigned to the Control condition. Importantly, a positivity bias was not observed for foil scenarios unrelated to the core OC belief domains. Further, participants in the Positive condition reported less distress and urge to neutralize following an OC stressor task designed to tap Importance of Thoughts/Control. No significant difference emerged on the indices of behavioural response to the OC stressor tasks. Severity of OC symptoms did not moderate the effects of positive CBM-I training. CBM-I appears effective in selectively targeting OC beliefs. Results need to be replicated in clinical samples in order for potential therapeutic benefit to be demonstrated.",Williams AD.; Grisham JR.,2013.0,10.1186/1471-244X-13-256,0,0,
2873,Thought-action fusion as a mediator of religiosity and obsessive-compulsive symptoms,"Background and Objectives: Thought-action fusion (TAF), or maladaptive cognitions regarding the relationship between mental events and behaviours, has been implicated in the development and maintenance of obsessive-compulsive disorder (OCD). As some religions promote TAF-like appraisals, it has been proposed that religiosity may play a role in the transformation of normally occurring intrusive thoughts into clinically distressing obsessions. No research, however, has experimentally investigated the mediating role of TAF on the relationship between religiosity and OC symptoms. Methods: 85 Christian, Jewish, and Atheist/Agnostic participants were exposed to an experimental thought-induction protocol and reported on their associated levels of distress, guilt, feelings of responsibility, and urge to suppress target intrusions experienced during a 5-min monitoring period. Participants also completed measures of obsessive-compulsive symptomatology, TAF beliefs, and general psychopathology. Results: Using PROCESS and bootstrapping analyses, a test of the conditional indirect effects of religiosity on obsessive-compulsive symptoms revealed that Christianity moderated the effects of religiosity on moral TAF beliefs, which in turn mediated the relationship between religiosity and obsessive-compulsive symptoms. Furthermore, in the Christian group, moral TAF beliefs mediated the relationship between religiosity and ratings of guilt and responsibility following the experimental protocol. Limitations: The use of university students with moderate levels of religiosity. Conclusions: Collectively the results suggest that obsessional thinking is not attributable to religion per se, but that teachings underlying certain religious doctrines may fuel TAF beliefs that are implicated in the maintenance of OCD. © 2012 Elsevier B.V. All rights reserved.",Williams A.D.; Lau G.; Grisham J.R.,2013.0,10.1016/j.jbtep.2012.09.004,0,0,
2874,"[ ""Weight phobia"". A discussion of the problem of ""atypical"" and ""not otherwise specified"" eating and weight disorders].","A number of authors have stated that the problem of classifying patients whose diagnosis does not meet all the criteria of anorexia and bulimia nervosa has not been satisfactorily solved. The question has been asked if it is justified to regard characteristics like ""weight phobia"" or body image disturbance as valid diagnostic criteria. In the present study the differences observed in three groups of patients with eating and weight disorders (anorexia: n = 42; bulimia: n = 29; atypical group without ""weight phobia"": n = 14) were compared using the Giessen-Test. The atypical group was shown to be significantly more ""tractable"" on scale 2 than the main groups, which achieved a higher score on ""dominance"". Significant differences between the atypical group and the ""uncontrolled"" group of patients with bulimia were noted for scale 3, with the atypical group showing comparable results to those recorded in the anorexic group on ""compulsiveness"". The authors discuss the significance of the results under an epistemological aspect. The description and classification of clinical phenomena which is based on the clinical manifestation of the disorder independently of theoretical concepts is therefore indispensible for realising a uniform basis for communication by researchers worldwide. Equally indispensible is the differentiation or ""extension"" of the classification to allow a more detailed systematic categorisation guided along specific theoretical concepts. This requires the operational definition of psychopathological and psychodynamic criteria as, e.g. ""the struggle for identy"" or the ""relentless pursuit of thinness"". The experiences with the OPD (Operationalized Psychodynamic Diagnosis; 1996) have shown this to be a difficult but viable approach.",Willenberg H.; Krauthauser H.,,10.1055/s-2000-13238,0,0,
2875,Using minute ventilation for ambulatory estimation of additional heart rate.,"Both physical activity and emotion produce physiological activation. The emotional component of heart rate (HR) can be estimated as the additional HR (aHR) above that predicted by O2 consumption. Our innovation was to substitute minute ventilation (V) for O2 consumption, calculating aHR from individual relations between V and HR during an exercise test. We physiologically monitored 28 flight phobics and 15 non-anxious controls while walking (leaving the hospital, entering a plane), and during a commercial flight. Raw HR did not differ between phobics and controls when leaving the hospital (118/114 bpm) or entering the plane (117/110 bpm). However, although aHR was not different when leaving the hospital (7.0/8.6 bpm), it was significantly greater when entering the plane (17.5/9.9 bpm), accurately reflecting the increased subjective anxiety of the phobics. V was not higher in phobics than controls during any condition, suggesting an absence of hyperventilation in the phobics. The results demonstrate the utility of our method for analyzing HR in people whose stress occurs when they are physically active.",Wilhelm FH.; Roth WT.,1998.0,,0,0,
2876,Mechanistic Pathways of Mindfulness Meditation in Combat Veterans With Posttraumatic Stress Disorder.,"This study's objective was to evaluate the effect of two common components of meditation (mindfulness and slow breathing) on potential mechanistic pathways. A total of 102 combat veterans with posttraumatic stress disorder (PTSD) were randomized to (a) the body scan mindfulness meditation (MM), (b) slow breathing (SB) with a biofeedback device, (c) mindful awareness of the breath with an intention to slow the breath (MM+SB), or (d) sitting quietly (SQ). Participants had 6 weekly one-on-one sessions with 20 minutes of daily home practice. The mechanistic pathways and measures were as follows: (a) autonomic nervous system (hyperarousal symptoms, heart rate [HR], and heart rate variability [HRV]); (b) frontal cortex activity (attentional network task [ANT] conflict effect and event-related negativity and intrusive thoughts); and (c) hypothalamic-pituitary-adrenal axis (awakening cortisol). PTSD measures were also evaluated. Meditation participants had significant but modest within-group improvement in PTSD and related symptoms, although there were no effects between groups. Perceived impression of PTSD symptom improvement was greater in the meditation arms compared with controls. Resting respiration decreased in the meditation arms compared with SQ. For the mechanistic pathways, (a) subjective hyperarousal symptoms improved within-group (but not between groups) for MM, MM+SB, and SQ, while HR and HRV did not; (b) intrusive thoughts decreased in MM compared with MM+SB and SB, while the ANT measures did not change; and (c) MM had lower awakening cortisol within-group (but not between groups). Treatment effects were mostly specific to self-report rather than physiological measures. Continued research is needed to further evaluate mindfulness meditation's mechanism in people with PTSD.",Wahbeh H.; Goodrich E.; Goy E.; Oken BS.,2016.0,10.1002/jclp.22255,0,0,
2877,Tianeptine: A review of its use in depressive disorders,"Tianeptine is an antidepressant agent with a novel neurochemical profile. It increases serotonin (5-hydroxytryptamine; 5-HT) uptake in the brain (in contrast with most antidepressant agents) and reduces stress-induced atrophy of neuronal dendrites. Like the selective serotonin reuptake inhibitors (SSRIs) and in contrast with most tricyclic antidepressant agents, tianeptine does not appear to be associated with adverse cognitive, psychomotor, sleep, cardiovascular or bodyweight effects and has a low propensity for abuse. Tianeptine has a comparatively favourable pharmacokinetic profile. It is not subject to first-pass hepatic metabolism, has high bioavailability and limited distribution, and is rapidly eliminated. While this offers advantages for tianeptine over the tricyclic antidepressant agents in terms of dose titration, treatment changes and potential drug interactions, its rapid elimination makes adherence to dosage schedules more important. Tianeptine differs from most antidepressants in that it is not primarily metabolised by the hepatic cytochrome P450 system, indicating less likelihood of drug-drug interactions; this is of particular interest for elderly patients. Tianeptine, in dosages of 25 to 50 mg/day, has been investigated in patients with major depression, depressed bipolar disorder, dysthymia or adjustment disorder. It has equivalent antidepressant efficacy to several classical antidepressant agents (amitriptyline, clomipramine, imipramine, mianserin) and the SSRIs fluoxetine (in most patients), paroxetine and sertraline. Comparison with maprotiline indicated superior efficacy for tianeptine but dothiepin appeared superior in another study. Extended treatment with tianeptine decreases the incidence of relapse/recurrence of depression. Tianeptine appears to be as effective as fluoxetine, sertraline, amitriptyline, clomipramine and mianserin and more effective than maprotiline in improving associated anxiety in patients with depressive disorders. Depression and anxiety symptoms in alcohol dependant patients also respond well to tianeptine. The adverse effects associated with tianeptine are similar in many respects to those of the SSRIs and minimal in comparison with the tricyclic antidepressants. The most common adverse effects are nausea, constipation, abdominal pain, headache, dizziness and changes in dreaming. Anticholinergic effects occur less often with tianeptine than with tricyclic agents. Hepatoxicity is rare. The dosage should be decreased in elderly patients and those with severe renal failure, but adjustment is not necessary in patients with alcoholism or hepatic impairment, or those undergoing haemodialysis. Conclusions: The antidepressant efficacy and favourable tolerability and pharmacokinetic profiles of tianeptine in patients with depression, including those with associated anxiety, have been proven; the data indicate that it may have additional potential in specific subgroups of depressed patients such as the elderly and those with chronic alcoholism.",Wagstaff A.J.; Ormrod D.; Spencer C.M.,2001.0,,0,0,
2878,Effects of cortisol suppression on sleep-associated consolidation of neutral and emotional memory,"Background: Previous research indicates that hippocampus-dependent declarative memory benefits from early nocturnal sleep, when slow-wave sleep (SWS) prevails and cortisol release is minimal, whereas amygdala-dependent emotional memory is enhanced through late sleep, when rapid eye movement (REM) sleep predominates. The role of the strong cortisol rise accompanying late sleep for emotional memory consolidation has not yet been investigated. Methods: Effects of the cortisol synthesis inhibitor metyrapone on sleep-associated consolidation of memory for neutral and emotional texts were investigated in a randomized, double-blind, placebo-controlled study in 14 healthy men. Learning took place immediately before treatment, which was followed by 8 hours of sleep. Retrieval was tested at 11 am the next morning. Results: Metyrapone suppressed cortisol during sleep and blocked particularly the late-night rise in cortisol. It reduced SWS and concomitantly impaired the consolidation of neutral texts. Emotional texts were spared from this impairing influence, however. Metyrapone even amplified emotional enhancement in text recall indicating amygdala-dependent memory. Conclusions: Cortisol blockade during sleep impairs hippocampus-dependent declarative memory formation but enhances amygdala-dependent emotional memory formation. The natural cortisol rise during late sleep may thus protect from overshooting emotional memory formation, a mechanism possibly pertinent to the development of posttraumatic stress disorder. © 2005 Society of Biological Psychiatry.",Wagner U.; Degirmenci M.; Drosopoulos S.; Perras B.; Born J.,2005.0,10.1016/j.biopsych.2005.05.008,0,0,
2879,A comparison of reciprocal inhibition and operant conditioning in the systematic desensitization of a fear of snakes.,,Wagner MK.; Cauther NR.,1968.0,,0,0,
2880,Cognitive adaptability as a moderator of expressive writing effects in an HIV sample,"ER This study explored the effects of expressive writing on positive and negative outcomes related to perceived psychosocial and health status among persons with HIV. This was the first study to examine the moderating effects of cognitive adaptability--consisting of dispositional optimism coupled with perceived competence--on outcomes of expressive writing. Thirty-seven participants wrote about either traumatic experiences or trivial topics in four 20-min sessions. Dependent measures obtained at baseline were repeated 1 month later. Although no main effects for group were found, baseline levels of cognitive adaptability were differentially associated with changes in a positive outcomes index, and a pain and physical functioning index in those assigned to the two groups. No moderating effects of cognitive adaptability were found for changes in a negative outcomes index. Findings underscore the importance of identification of moderating variables in understanding the impact of expressive writing interventions among individuals with HIV or other conditions.","Wagner, L J; Hilker, K A; Hepworth, J T; Wallston, K A",2010.0,10.1007/s10461-008-9427-8,0,0,
2881,A 1.5-year follow-up of an Internet-based intervention for complicated grief.,"Only recently have psychotherapeutic interventions for complicated grief been developed and evaluated in randomized controlled trials. These trials have reported significant reductions in complicated grief and related symptoms in response to treatment relative to control groups. However, little is known about the long-term outcomes of these treatments. The authors present an evaluation of a 1.5-year follow-up of an Internet-based cognitive-behavioral intervention for complicated grief. Treatment group patients (n = 22) were administered various assessments of complicated grief indicators, including the Impact of Event Scale, the anxiety and depression subscales of the Brief Symptom Inventory, and the SF-12. Results indicate that the reduction in symptoms of complicated grief observed at posttreatment was maintained at 1.5-year follow-up.",Wagner B.; Maercker A.,2007.0,10.1002/jts.20230,0,0,
2882,Post-traumatic growth and optimism as outcomes of an internet-based intervention for complicated grief.,"This explorative study examines the effects of an internet-based cognitive-behavioural therapy for complicated grief on post-traumatic growth and optimism. The study is part of a larger randomized controlled trial described in Wagner, Knaevelsrud, and Maercker (2006). The patients were randomly assigned to either a treatment group (n = 26) or a waiting list control condition (n = 25). The internet-based intervention consisted of exposure to bereavement cues, cognitive reappraisal exercises, and a module on integration and restoration. A short form of the Post-traumatic Growth Inventory (PTGI), the Life Orientation Test-Revised (LOT-R), and measures of complicated grief and psychopathological outcomes were administered. Results indicate that post-traumatic growth increased in the treatment group. No treatment effect was found for optimism. These findings contribute to the growing literature on personal growth in psychotherapy.",Wagner B.; Knaevelsrud C.; Maercker A.,2007.0,10.1080/16506070701339713,0,0,
2883,Online working alliance predicts treatment outcome for posttraumatic stress symptoms in Arab war-traumatized patients.,"Previous studies have shown that Internet-based interventions for posttraumatic stress disorder are feasible. However, little is known about how therapeutic process factors impact online interventions in war and conflict regions. This study aims to assess the quality of the working alliance at midtreatment and posttreatment and its relationship with therapy outcome in an Internet-based cognitive-behavioral intervention for Arabic-speaking traumatized patients. A trial was conducted from January 2009 to August 2011 with patients recruited specifically in Iraq. Fifty-five participants with posttraumatic stress symptoms completed the Working Alliance Inventory (WAI) after at least session 4. Participants' mean age was 27.7 years (SD = 6.9); 78% of participants were females. Participants received two weekly 45-min Internet-based cognitive-behavioral interventions over a 5-week period. The main outcome measures were the Posttraumatic Diagnostic Scale (PDS) and the WAI. High ratings of the therapeutic alliance were obtained early in treatment, and results remained stable from sessions 4 to 10, indicating that it was possible to establish a positive and stable online therapeutic relationship. The working alliance at both assessment points predicted treatment outcome for posttraumatic stress symptoms. Despite the instability of the settings and patients' ongoing exposure to human right violations through war and dictatorships, it was possible to establish a stable online therapeutic relationship.",Wagner B.; Brand J.; Schulz W.; Knaevelsrud C.,2012.0,10.1002/da.21962,0,0,
2884,Rebuilding self-confidence after cancer: a feasibility study of life-coaching,"ER BACKGROUND: Cancer survivors often experience decreased self-confidence which impacts negatively on their ability to self-manage the practical, social and emotional problems frequently faced as they emerge from end of treatment. This was a feasibility study of a life-coaching intervention, designed to rebuild confidence of survivors and support transition to life after cancer treatment.METHODS: A one group pre-test, post-test design was used, recruiting participants from community organisations. Eligibility criteria are as follows: 18, no metastases, and no mental health problems. Participants received one individualised face-to-face and five telephone coaching sessions over 3 months. Outcome measures are as follows: New General Self-Efficacy Scale, Hope Scale, Personal Well-being Index, Assessment of Survivorship Concerns, Quality of Life in Adult Cancer Survivors, Hospital Anxiety and Depression Scale, Social Difficulties Index, and a goal attainment score. Interviews explored feasibility, acceptability and impact of life-coaching and research design.RESULTS: Nine women and two men were recruited, representing varying cancer diagnoses. All outcome measures were sensitive to change and indicated positive trends post-intervention. Participant interviews indicated the intervention was well received and had a positive impact. Lessons were learnt about study design, recruitment and intervention delivery.CONCLUSIONS: Life-coaching has a potential to enable cancer survivors to manage the transition to life beyond cancer and effect change on a range of outcomes. The intervention was feasible to deliver and acceptable to survivors at a time when many struggle to make sense of life. It merits further evaluation through a randomised controlled trial.","Wagland, R; Fenlon, D; Tarrant, R; Howard-Jones, G; Richardson, A",2015.0,10.1007/s00520-014-2399-5,0,0,
2885,Formulation and evaluation of fast dispersible tablets of aceclofenac using different superdisintegrant,"Convenience of administration and patient compliance are gaining significant importance in design of dosage form. Fast dispersible tablets disintegrate either rapidly in water, to form a stabilized suspension, or disperse instantaneously in the mouth to be swallowed without the aid of water. Aceclofenac, a non-steroidal antiinflammatory drug, is used for posttraumatic pain and rheumatoid arthritis. Fast dissolving tablet of aceclofenac were prepared by direct compression method after incorporating superdisintegrants croscarmellose sodium, crospovidone and sodium starch glycolate. Nine formulation having superdisintegrant at different concentration (10, 15, 20 mg) level were prepared. Effect of superdisintegrant on wetting time, dispersion time, drug content and in vitro release has been studied. Tablet containing cross carmellose sodium showed excellent in vitro dispersion time and drug release as compared to other formulation. After study of nine formulations F3 shows short dispersion time with maximum drug release in 30 min. It is concluded that fast-dispersible aceclofenac tablets could be prepared by direct compression using superdisintegrants.",Wagh M.P.; Yewale C.P.; Zate S.U.; Kothawade P.I.; Mahale G.H.,2010.0,,0,0,
2886,Beyond reward learning: A network-based view of fronto-striatal interactions in pleasure and pain,"Background: Brain circuits involved in emotion and motivational drives are thought to be central in addiction and related mental health disorders. A consensus view is that a circuit connecting ventromedial prefrontal cortex (vmPFC) and nucleus accumbens-both targets of the mesolimbic dopamine pathway-plays a critical role in reward learning. Aberrant reward-related processes in this circuit are thought to play a central role in addiction. I present recent evidence suggesting that this view must be broadened in several ways. Methods: This work uses a combination of several emerging techniques. The first is multivariate pattern recognition or “machine learning” approaches to developing brain signatures. These signatures are designed to make accurate predictions about new, individual participants. Developing signatures allows us to validate them across multiple studies and research groups. Secondly, our work relies on two kinds of effective connectivity models. The first is multi-level mediation, which allows us to test path models of how experimental manipulations affect outcomes via mediating brain mechanisms. This technique allows us to search for brain mediators. The second technique is Dynamic Causal Modeling (DCM), an effective connectivity technique that models the bidirectional relationships in dynamic changes among a small set of regions. Results: Findings from our studies suggest that 'valuerelated' portions of vmPFC plays a prominent role in shaping pain avoidance and responses to distress as well. These circuits may play an important role in addiction by governing distress-avoidance. DCM findings outline a circuit connecting the vMPFC and midbrain PAG, which jointly govern pain avoidance learning. Secondly, this circuit is not merely a passive learner of value driven by reinforcement. It is responsive to conceptual thought, including expectations, beliefs, and self-regulation. Multi-level mediation results demonstrate that cognitive self-regulation of pain works by shaping functional responses in a vmPFC-nucleus accumbens circuit. This circuit also mediates placebo effects on pain. Conclusions: Together, these findings implicate processes beyond reward learning in substance use, and indicate a role for midline fronto-striatal circuits in avoiding anticipating negative outcomes.",Wager T.,2016.0,10.1038/npp.2016.239,0,0,
2887,Cholinergic REM sleep induction in atypical depression,"ER The arecoline REM induction test, a measurement of central cholinergic sensitivity, was performed in 10 patients with atypical depression. Arecoline induced REM sleep significantly more rapidly than placebo. Atypical depressives without evidence of anxiety, in particular those without panic attacks, had a more rapid REM induction response to arecoline than atypicals with anxiety symptoms. We compared our atypical depressives with normal controls and affectively ill patients studied in other laboratories. The rapid REM induction response observed in atypical depressives without anxiety was comparable to that seen in endogenous depressives and euthymic bipolars. Previous studies have demonstrated the presence of cholinergic supersensitivity in the latter two groups of patients. Our results suggest that atypical depressives may be distinguished in their response to arecoline based on their anxiety history, and that cholinergic supersensitivity is present in atypical depressives without anxiety. Additional studies with larger samples and simultaneously studied control groups are necessary to test these preliminary findings.","Wager, S; Robinson, D; Goetz, R; Nunes, E; Gully, R; Quitkin, F",1990.0,,0,0,
2888,"Targeting fear of spiders with control-, acceptance-, and information-based approaches.","The relative impact of control-, acceptance-, and information-based approaches in targeting a midlevel fear of spiders among college students was evaluated. Participants listened to a brief protocol presenting one of the three approaches before completing the Perceived-Threat Behavioral Approach Test (PT-BAT; Cochrane, Barnes-Holmes, & Barnes-Holmes, 2008). During the PT-BAT, participants placed their hands in a series of opaque jars that they were led to believe were increasingly likely to contain a spider. Participants in the acceptance-based condition progressed the farthest and were more willing to repeat the procedure a week later, despite not differing from their counterparts in levels of subjective distress. Implications for the relative efficacy of acceptance- versus control-based approaches in treatment of specific phobia, their possible differential mechanisms of action, and the use of the PT-BAT as a dependent measure in further research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wagener, Alexandra L; Zettle, Robert D; Blanchard, Chapman, Choy, Cochrane, Cohen, Davey, Eifert, Feldner, Gird, GutieRrez, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Keogh, Kessler, Koury, Laberge, Levitt, Linehan, Masedo, Moses, Muris, Olatunji, Osinsky, Paez-Blarrina, Roche, Segal, Smith-Janik, Szymanski, Wolitzky-Taylor, Zettle, Zettle",2011.0,,0,0,
2889,A pilot study of a yoga and meditation intervention for dementia caregiver stress,"Twelve older female dementia patient family caregivers (eight Latinas and four Caucasians) participated in a six-session manualized yoga-meditation program (called Inner Resources) designed to help caregivers cope with stress. Pre/post comparisons revealed statistically significant reductions in depression and anxiety and improvements in perceived self-efficacy. Average minutes of weekly yoga-meditation practice were significantly associated with improvements in depression. The majority of caregivers found the intervention useful and reported subjective improvements in physical and emotional functioning. These findings suggest that Inner Resources may be a feasible and effective intervention for family caregivers and may improve affect, coping, physical well-being, and stress management. © 2004 Wiley Periodicals, Inc.",Waelde L.C.; Thompson L.; Gallagher-Thompson D.,2004.0,10.1002/jclp.10259,0,0,
2890,Agreement between touch-screen and paper-based patient-reported outcomes for patients with fibromyalgia: a randomized cross-over reproducibility study.,"To compare data based on computerized and paper versions of health status questionnaires (HSQs) for sampling patient-reported outcomes (PROs) in patients with fibromyalgia (FM). In addition, to examine associations between patient characteristics (age, education, computer experience) and differences between versions. Finally, to evaluate the acceptability of computer-based questionnaires among patients with FM. The study population comprised female patients diagnosed with FM. All patients completed six HSQs: the Fibromyalgia Impact Questionnaire (FIQ), the Major Depression Inventory (MDI), the 36-item Short Form Health Survey (SF-36), the painDETECT questionnaire (PDQ), the Coping Strategies Questionnaire (CSQ), and the Generalized Anxiety Disorder Self-Assessment Questionnaire (GAD-10), both on paper and using a touch screen. One HSQ was tested at a time in a repeated randomized cross-over design. The two versions were completed with a 5-min interval and between each HSQ the participants had a 5-min break. Means, mean differences with 95% confidence intervals (CIs), medians, median differences, and intraclass correlation coefficients (ICCs) were calculated for all HSQs, including relevant subscales. Associations between patient characteristics and differences between versions were explored using Spearman's correlation coefficients. Twenty women, mean age 48.4 years, participated in the study. Except for one item, ICCs between touch-screen and paper versions of the HSQs examined indicated acceptable agreement (ICC = 0.71-0.99). Overall, mean and median differences revealed no differences between versions. No significant associations were observed for patient characteristics. None of the participants preferred paper questionnaires over computerized versions. The computerized HSQs using a touch screen gave comparable results to answers given on paper and were generally preferred by the participants.",Wæhrens EE.; Amris K.; Bartels EM.; Christensen R.; Danneskiold-Samsøe B.; Bliddal H.; Gudbergsen H.,2015.0,10.3109/03009742.2015.1029517,0,0,
2891,A randomized trial of teen online problem solving: efficacy in improving caregiver outcomes after brain injury,"ER OBJECTIVE: To examine the results of a randomized clinical trial (RCT) of Teen Online Problem Solving (TOPS), an online problem solving therapy model, in increasing problem-solving skills and decreasing depressive symptoms and global distress for caregivers of adolescents with traumatic brain injury (TBI).METHOD: Families of adolescents aged 11-18 who sustained a moderate to severe TBI between 3 and 19 months earlier were recruited from hospital trauma registries. Participants were assigned to receive a web-based, problem-solving intervention (TOPS, n = 20), or access to online resources pertaining to TBI (Internet Resource Comparison; IRC; n = 21). Parent report of problem solving skills, depressive symptoms, global distress, utilization, and satisfaction were assessed pre- and posttreatment. Groups were compared on follow-up scores after controlling for pretreatment levels. Family income was examined as a potential moderator of treatment efficacy. Improvement in problem solving was examined as a mediator of reductions in depression and distress.RESULTS: Forty-one participants provided consent and completed baseline assessments, with follow-up assessments completed on 35 participants (16 TOPS and 19 IRC). Parents in both groups reported a high level of satisfaction with both interventions. Improvements in problem solving skills and depression were moderated by family income, with caregivers of lower income in TOPS reporting greater improvements. Increases in problem solving partially mediated reductions in global distress.CONCLUSIONS: Findings suggest that TOPS may be effective in improving problem solving skills and reducing depressive symptoms for certain subsets of caregivers in families of adolescents with TBI.","Wade, S L; Walz, N C; Carey, J; McMullen, K M; Cass, J; Mark, E; Yeates, K O",2012.0,10.1037/a0028440,0,0,
2892,"Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety","ER METHODSIn this randomized, controlled trial, we assigned 488 children between the ages of 7 and 17 years who had a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia to receive 14 sessions of cognitive behavioral therapy, sertraline (at a dose of up to 200 mg per day), a combination of sertraline and cognitive behavioral therapy, or a placebo drug for 12 weeks in a 2:2:2:1 ratio. We administered categorical and dimensional ratings of anxiety severity and impairment at baseline and at weeks 4, 8, and 12.RESULTSThe percentages of children who were rated as very much or much improved on the Clinician Global Impression-Improvement scale were 80.7% for combination therapy (P<0.001), 59.7% for cognitive behavioral therapy (P<0.001), and 54.9% for sertraline (P<0.001); all therapies were superior to placebo (23.7%). Combination therapy was superior to both monotherapies (P<0.001). Results on the Pediatric Anxiety Rating Scale documented a similar magnitude and pattern of response; combination therapy had a greater response than cognitive behavioral therapy, which was equivalent to sertraline, and all therapies were superior to placebo. Adverse events, including suicidal and homicidal ideation, were no more frequent in the sertraline group than in the placebo group. No child attempted suicide. There was less insomnia, fatigue, sedation, and restlessness associated with cognitive behavioral therapy than with sertraline.CONCLUSIONSBoth cognitive behavioral therapy and sertraline reduced the severity of anxiety in children with anxiety disorders; a combination of the two therapies had a superior response rate. (ClinicalTrials.gov number, NCT00052078.)BACKGROUNDAnxiety disorders are common psychiatric conditions affecting children and adolescents. Although cognitive behavioral therapy and selective serotonin-reuptake inhibitors have shown efficacy in treating these disorders, little is known about their relative or combined efficacy.","Walkup, J T; Albano, A M; Piacentini, J; Birmaher, B; Compton, S N; Sherrill, J T; Ginsburg, G S; Rynn, M A; McCracken, J; Waslick, B; Iyengar, S; March, J S; Kendall, P C",2008.0,10.1056/NEJMoa0804633,0,0,
2893,Effects of psychosocial stimulation and dietary supplementation in early childhood on psychosocial functioning in late adolescence: follow-up of randomised controlled trial,"ER DESIGNSixteen year follow-up study of a randomised controlled trial.SETTINGPoor neighbourhoods in Kingston, Jamaica.PARTICIPANTSOf 129 stunted children identified at age 9-24 months, 103 adolescents aged 17-18 were followed up.INTERVENTIONSupplementation with 1 kg milk based formula each week or psychosocial stimulation (weekly play sessions with mother and child), or both, for two years.MAIN OUTCOME MEASURESAnxiety, depression, self esteem, and antisocial behaviour assessed by questionnaires administered by interviewers; attention deficit, hyperactivity, and oppositional behaviour assessed by interviews with parents.RESULTSPrimary analysis indicated that participants who received stimulation had significantly different overall scores from those who did not (F = 2.047, P = 0.049). Supplementation had no significant effect (F = 1.505, P = 0.17). Participants who received stimulation reported less anxiety (mean difference - 2.81, 95% confidence interval - 5.02 to - 0.61), less depression (- 0.43, - 0.78 to - 0.07), and higher self esteem (1.55, 0.08 to 3.02) and parents reported fewer attention problems (- 3.34, - 6.48 to - 0.19). These differences are equivalent to effect sizes of 0.40-0.49 standard deviations.CONCLUSIONSStimulation in early childhood has sustained benefits to stunted children's emotional outcomes and attention.OBJECTIVETo determine whether dietary supplementation or psychosocial stimulation given to growth retarded (stunted) children age 9-24 months has long term benefits for their psychosocial functioning in late adolescence.","Walker, S P; Chang, S M; Powell, C A; Simonoff, E; Grantham-McGregor, S M",2006.0,10.1136/bmj.38897.555208.2F,0,0,
2894,Impact of qEEG-guided coherence training for patients with a mild closed head injury.,"Investigated the effects of quantitative EEG (qEEG) guided coherence training on residual symptoms following mild closed head injury (MHI). 26 patients (aged 25-65 yrs) with persistent posttraumatic symptoms underwent neurofeedback therapy designed to normalize subjects' (Ss') abnormal qEEG coherence scores observed 3-70 mo following MHI. Five training sessions addressed each qEEG abnormality, until significant improvement was observed or until 40 total sessions occurred. Results show that significant improvement was noted in 88% of Ss. All previously employed Ss reported that they were able to return to work following treatment. On average, 19 sessions were required. It is concluded that most MHI patients experience substantial and rapid symptomatic improvement following qEEG guided coherence training, including a return to work. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Walker, Jonathan E; Norman, Charles A; Weber, Ronald K; Alexander, Alves, Arcia, Ayers, Byers, Coppens, Gass, Gronwall, Hoffman, John, Kibby, Kraus, Lubar, McAllister, Niemann, Oddy, Othmer, Packard, Posthuma, Rattok, Rimel, Shaw, Silver, Thatcher, Thatcher, Thatcher, Thornton, Triplett, Wade",2002.0,,0,0,
2895,"The impact of cataract surgery on visual functioning, vision-related disability and psychological distress: a randomized controlled trial.","Determine whether there are changes in visual functioning, vision-related disability, health status and mood after cataract surgery. 45 adults (mean age = 73.7 years) with bilateral cataract needing surgery for the first eye were recruited from public ophthalmology clinics. The Visual Functioning-14 survey assessed visual disability. Minimal angle of resolution tested visual acuity, and the Melbourne Edge Test examined contrast sensitivity. Demographic, psychological, health and medication use variables were examined. Participants were randomized to either an intervention or control arm. Controls were assessed on two occasions at a 3-month interval before having surgery. The intervention group was assessed 1-2 weeks before surgery and then reassessed 3 months after surgery. Visual functioning improved for those who had cataract surgery with better visual acuity in the better (P = 0.010) and worse (P = 0.028) eye compared with controls. The intervention group reported fewer difficulties with overall vision-related disability (P = 0.0001), reading (P = 0.004) and instrumental activities of daily living (P = 0.010) post-surgery compared with controls. People with improved depression scores (P = 0.048) after surgery had less difficulty with reading compared with those with unchanged or worsened depression scores. Cataract surgery did not improve health status. First eye cataract surgery is effective in improving outcomes in visual functioning and disability. Improved mood after surgery was related to less vision-related disability compared with unchanged or worse depression.",Walker JG.; Anstey KJ.; Hennessy MP.; Lord SR.; von Sanden C.,2006.0,10.1111/j.1442-9071.2006.01340.x,0,0,
2896,Integrated collaborative care for major depression comorbid with a poor prognosis cancer (SMaRT Oncology-3): a multicentre randomised controlled trial in patients with lung cancer,"ER BACKGROUND: The management of depression in patients with poor prognosis cancers, such as lung cancer, creates specific challenges. We aimed to assess the efficacy of an integrated treatment programme for major depression in patients with lung cancer compared with usual care.METHODS: Symptom Management Research Trials (SMaRT) Oncology-3 is a parallel-group, multicentre, randomised controlled trial. We enrolled patients with lung cancer and major depression from three cancer centres and their associated clinics in Scotland, UK. Participants were randomly assigned in a 1:1 ratio to the depression care for people with lung cancer treatment programme or usual care by a database software algorithm that used stratification (by trial centre) and minimisation (by age, sex, and cancer type) with allocation concealment. Depression care for people with lung cancer is a manualised, multicomponent collaborative care treatment that is systematically delivered by a team of cancer nurses and psychiatrists in collaboration with primary care physicians. Usual care is provided by primary care physicians. The primary outcome was depression severity (on the Symptom Checklist Depression Scale [SCL-20], range 0-4) averaged over the patient's time in the trial (up to a maximum of 32 weeks). Trial statisticians and data collection staff were masked to treatment allocation, but patients and clinicians could not be masked to the allocations. Analyses were by intention to treat. This trial is registered with Current Controlled Trials, number ISRCTN75905964.FINDINGS: 142 participants were recruited between Jan 5, 2009, and Sept 9, 2011; 68 were randomly allocated to depression care for people with lung cancer and 74 to usual care. 43 (30%) of 142 patients had died by 32 weeks, all of which were cancer-related deaths. No intervention-related serious adverse events occurred. 131 (92%) of 142 patients provided outcome data (59 in the depression care for people with lung cancer group and 72 in the usual care group) and were included in the intention-to-treat primary analysis. Average depression severity was significantly lower in patients allocated to depression care for people with lung cancer (mean score on the SCL-20 1·24 [SD 0·64]) than in those allocated to usual care (mean score 1·61 [SD 0·58]); difference -0·38 (95%","Walker, J; Hansen, C H; Martin, P; Symeonides, S; Gourley, C; Wall, L; Weller, D; Murray, G; Sharpe, M",2014.0,10.1016/S1470-2045(14)70343-2,0,0,
2897,Predicting suicidal ideation in community-dwelling older adults with elevated levels of distress,"Objectives/aims: Identifying predictors of suicidal ideation in community-dwelling older adults with elevated psychological distress over two years. Methods: 900 adults (60-74 years) with elevated psychological distress (Kessler Distress 10 Scale; scores>15) participated in a randomized controlled trial of psychological (mental health literacy) and lifestyle-based (physical activity promotion, folate supplementation) interventions for reducing depressive symptoms. Suicidal ideation across a two-year period (five time points) was assessed using an item from the Patient Health Questionnaire. Demographics, mental and physical functioning (SF-12), and cognitive functioning (Telephone Interview Cognitive Schedule-Modified) were measured. Results: Intervention type did not predict suicide ideation at any follow up. Those with single or multiple occurrences of suicidal ideation during the two-year period had elevated distress (Single OR=1.06, p=.044; Multiple OR=1.10, p=.001) and depression levels (Single OR=1.07, p=.042; Multiple OR=1.20, p=.001) at baseline, and more likely to be separated from their partner (Single OR=1.81, p=.024; Multiple OR=2.12, p=.016] than those with no ideation. Those with ideation were more likely to experience greater distress at every time point (e.g., 24 months OR=1.18, p=.006) compared to those with no ideation. At 24 months, individuals reporting ideation were significantly more likely to have lower education levels (OR=.81, p=.015), poorer cognitive functioning (OR=.88, p=.036), and greater mental (OR=.89, p=.004) and physical (OR=.92, p=.025) disability. Conclusion: Elevated distress is consistently related to suicidal ideation. Individuals experiencing suicidal ideation are more likely to be separated, have lower education levels, poorer mental and physical functioning, and poorer overall cognitive functioning than those with no suicidal ideation.",Walker J.G.; Batterham P.J.; Christensen H.,2011.0,10.1016/S0924-9338(11)73357-0,0,0,
2898,Predictors of outcome in a primary care depression trial,"ER DESIGNRandomized trial of a stepped collaborative care intervention versus usual care.SETTINGHMO in Seattle, Wash.PATIENTSPatients with major depression were stratified into severe (N = 149) and mild to moderate depression (N = 79) groups prior to randomization.INTERVENTIONSA multifaceted intervention targeting patient, physician, and process of care, using collaborative management by a psychiatrist and primary care physician.MEASUREMENTS AND MAIN RESULTSPatients with more severe depression had a higher risk for panic disorder (odds ratio [OR], 5.8), loneliness (OR, 2.6), and childhood emotional abuse (OR, 2.1). Among those with less severe depression, intervention patients showed significantly improved depression outcomes over time compared with those in usual care (z = -3.06, P<.002); however, this difference was not present in the more severely depressed groups (z = 0.61, NS). Although the group with severe depression showed differences between the intervention and control groups from baseline to 3 months that were similar to the group with less severe depression (during the acute phase of the intervention), these differences disappeared by 6 months.CONCLUSIONSInitial depression severity, comorbid panic disorder, and other psychosocial vulnerabilities were associated with a decreased response to the collaborative care intervention. Although the intervention was appropriate for patients with moderate depression, individuals with higher levels of depression may require a longer continuation phase of therapy in order to achieve optimal depression outcomes.OBJECTIVEPrevious treatment trials have found that approximately one third of depressed patients have persistent symptoms. We examined whether depression severity, comorbid psychiatric illness, and personality factors might play a role in this lack of response.","Walker, E A; Katon, W J; Russo, J; Korff, M; Lin, E; Simon, G; Bush, T; Ludman, E; Unützer, J",2000.0,,0,0,
2899,Effectiveness of a group anger management programme after severe traumatic brain injury.,"Primary objective: This study examined the effectiveness of a group approach to the treatment of anger management difficulties for people with severe traumatic brain injury (TBI). Research design: Repeated-measures design with convenience sampling. Method and procedure: Participants were community living clients of a tertiary brain injury service. The group programme consisted of 12 weekly sessions based on a cognitive behavioural therapy (CBT) model, with modifications to incorporate compensations for TBI-related cognitive impairment. Treatment effectiveness was measured using the State-Trait Anger Expression Inventory (STAXI), at pre-treatment, post-treatment and follow-up. Main outcomes and results: The programme was completed by 52 people across nine groups over the years 1998-2006 and 31 of these attended a follow-up session. Completion of the programme was associated with significant decreases in self-reported frequency with which anger was experienced (STAXI Trait Anger) and frequency of expression of anger (Anger Expression-Out), as well as a significant increase in reported attempts to control feelings of anger (Anger Control); changes were maintained at follow-up assessment. Conclusions: A group CBT approach shows promise as an effective community-based treatment for anger control issues after severe TBI. Future research directions should include a wait-list control group and objective rating of anger expression. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Walker, Alexandra J; Nott, Melissa T; Doyle, Margaret; Onus, Margaret; McCarthy, Kathleen; Baguley, Ian J; Alderman, Allen, Anson, Baguley, Dawson, Delmonico, Demark, Feld, Hagiliassis, Hart, Hoofien, Kelly, Kelly, Kim, Kim, Marsh, Medd, Mela, Novaco, Novaco, O'Leary, Orozco, Peat, Ponsford, Rosenbaum, Schmitz, Speilberger, Speilberger, Todd, Uomoto, Watson, Whitehouse, Winkler, Ylvisaker",2010.0,,0,0,
2900,"Characteristics of alcoholic smokers, nonsmokers, and former smokers: personality, negative affect, alcohol involvement, and treatment participation.","Previous research has indicated that smoking behavior in the general population is linked to personality traits such as behavioral undercontrol and negative emotionality, but it is unknown whether these traits pertain to alcoholic smokers. Further, prior research has not established whether alcoholic smokers differ from their nonsmoking counterparts in terms of alcohol involvement severity and treatment participation. Exploration of these associations is important, given the high prevalence of cigarette smoking among alcoholics. Treatment-seeking alcoholics were categorized into daily cigarette smokers (n = 76), nonsmokers (n = 34), and former smokers (n = 33). These groups were compared on personality traits, negative affect, alcohol involvement, and alcohol outpatient treatment participation. All three groups scored similarly on a variety of personality traits (e.g., extraversion and neuroticism), and on most aspects of negative affect, with the exception of anxiety (smokers scored higher than nonsmokers and former smokers). In terms of alcohol involvement, alcoholic smokers reported greater negative drinking consequences and alcohol physical dependence relative to former smokers, even considering that alcoholic smokers had relatively more abstinent days. Finally, alcoholic smokers attended considerably fewer alcohol outpatient treatment sessions relative to both nonsmokers and former smokers. Common risk factors for both alcoholism and smoking behavior, such as personality traits and negative affect, may obscure personality differences between smokers and nonsmokers in an alcohol treatment sample. Furthermore, findings suggest that current nicotine use among alcoholics is associated with greater anxiety and severity of alcoholism than among their former-smoking counterparts.",Walitzer KS.; Dearing RL.,2013.0,10.1093/ntr/nts112,0,0,
2901,Recorded music in the mental health waiting room: A music medicine investigation,"The impact of music on ameliorating anxiety, improving mood, and enhancing patient satisfaction has been previously established. Given the heightened importance of mental health services in recent years and the perceived stigma associated with seeking psychiatric treatment, music may play an important role in mitigating negative affective states that would otherwise prevent patients from accessing care. The purpose of the current investigation was to examine the effects of recorded music on patient satisfaction and anxiety among adult consumers awaiting a mental health evaluation. This study employed a two-group, cluster-randomized design to investigate the effects of recorded music on adults in an outpatient mental health clinic. Participants in the experimental condition were exposed to a recorded music program for up to 30 min while completing clinical background paperwork. Those in the control condition completed their paperwork without the recorded music program. Two instruments, a researcher-designed Satisfaction Questionnaire and the Generalized Anxiety Disorder 7-Item Scale, served as the dependent measures. There was a significant effect suggesting that participants in the music group were more satisfied than those in the control condition. There was no such finding for anxiety. This study may provide some empirical support for, and encourage wider spread adoption of, the cost efficient use of music in mental health settings.",Waldon E.G.; Thom J.C.,2015.0,10.1016/j.aip.2015.07.006,0,0,
2902,Posttraumatic stress disorder and chronic pain arising from motor vehicle accidents: efficacy of interoceptive exposure plus trauma-related exposure therapy.,"Preliminary data are presented on the pattern of treatment response of combining interoceptive exposure (IE) with trauma-related exposure therapy (TRE) in five female patients with posttraumatic stress disorder (PTSD) and comorbid chronic musculoskeletal pain originating from motor vehicle accidents. Treatment consisted of four sessions of IE followed by eight sessions of TRE. Four participants reported a reduction in PTSD symptoms after completing treatment, and three no longer met diagnostic criteria for PTSD. Although both interventions were associated with reductions in PTSD symptoms, TRE was associated with greater reductions in PTSD symptoms than IE and was particularly effective at reducing avoidance. IE was associated with larger reductions in anxiety sensitivity than TRE. Pain symptoms lessened slightly during IE and then worsened following TRE. Anxiety decreased after completing treatment, whereas panic and depressive symptoms responded less so. Three individuals completed a 3-month follow-up assessment. There was no change in their PTSD diagnostic status, and all experienced a slight loss of pre-post gains, particularly involving the return of pain. Clinical and research implications are discussed.",Wald J.; Taylor S.; Chiri LR.; Sica C.,2010.0,10.1080/16506070903183570,0,0,
2903,Putting the pieces together: preliminary efficacy of a family problem-solving intervention for children with traumatic brain injury,"ER PARTICIPANTSFamilies of 32 school-aged children with moderate to severe TBI randomly assigned to FPS or usual care (UC) group.MAIN OUTCOME MEASURESChild Behavior Checklist, Brief Symptom Inventory, Conflict Behavior Questionnaire.INTERVENTIONSeven-session problem-solving/skill-building intervention delivered over a 6-month period for the participating families.RESULTSParents in the FPS group reported significantly greater improvements in their children in internalizing symptoms, anxiety/depression, and withdrawal than did parents in the UC comparison group.CONCLUSIONSFPS holds promise for reducing child behavior problems, the most common and persistent sequelae of TBI.OBJECTIVETo describe a family-centered problem-solving intervention (FPS) for pediatric traumatic brain injury (TBI), and to assess the efficacy of the intervention in a randomized clinical trial.","Wade, S L; Michaud, L; Brown, T M",2006.0,,0,0,
2904,Counselor-assisted problem solving improves caregiver efficacy following adolescent brain injury,"ER RESEARCH METHOD/DESIGN: In a randomized clinical trial comparing CAPS (n = 65), an online problem-solving intervention with accompanying Web-based counseling sessions, with an information-based Internet Resource Comparison (IRC; n = 67) program, participants included families of 12- to 17-year-olds who had sustained a TBI in the past 6 months. Linear regression analyses were used to identify main effects and to examine whether caregiver education, race, or prior computer use moderated treatment efficacy.RESULTS: Computer experience moderated postintervention improvements in caregiving self-efficacy following CAPS, Specifically, parents in CAPS with low levels of prior use reporting the greatest improvements. CAPS participants who completed 5 or more sessions reported greater reductions in depression than did the IRC; however, the groups did not differ on global distress.CONCLUSIONS/IMPLICATIONS: Findings support the potential utility of counselor-supported Web-based interventions particularly for individuals with limited computer expertise following adolescent TBI.PURPOSE: The purpose of the current study is to examine the efficacy of Counselor-Assisted Problem Solving (CAPS) in improving caregiver adaptation following traumatic brain injury (TBI).","Wade, S L; Karver, C L; Taylor, H G; Cassedy, A; Stancin, T; Kirkwood, M W; Brown, T M",2014.0,10.1037/a0034911,0,0,
2905,An online family intervention to reduce parental distress following pediatric brain injury,"ER This study examined whether an online problem-solving intervention could improve parental adjustment following pediatric traumatic brain injury (TBI). Families of children with moderate-to-severe TBI were recruited from the trauma registry of a large children's hospital and randomly assigned to receive online family problem solving therapy (FPS; n = 20) or Internet resources (IRC; n = 20) in addition to usual care. The FPS group reported significantly less global distress, depressive symptoms, and anxiety at follow-up than did the IRC group after controlling for baseline symptoms. The FPS group also reported significant improvements in problem-solving skills, although the groups did not differ significantly at follow-up. Findings suggest that an online, skill-building approach can be effective in facilitating parental adaptation after TBI.","Wade, S L; Carey, J; Wolfe, C R",2006.0,10.1037/0022-006X.74.3.445,0,0,
2906,Routine follow up after head injury: a second randomised controlled trial.,"To confirm that patients admitted to hospital with a head injury benefit from a routinely offered early intervention service. A mixed rural and urban Health District of 560000 people with two accident and emergency departments provided the setting. Existing routine services for most patients with head injury are minimal. All patients aged 16-65 years admitted to hospital after a head injury of any severity, with or without other injuries entered the trial. Prospective randomisation, with a block randomisation procedure was used to allocate all eligible patients to either: a group offered an additional service by a specialist team; or a group receiving existing standard services. Patients were assessed at follow up six months after injury. The primary outcome measure was the Rivermead head injury follow up questionnaire, a validated and reliable measure of social disability. The Rivermead post-concussion symptoms questionnaire was used to estimate severity of post-concussion symptoms. Each patient in the trial group was contacted 7-10 days after injury, and offered assessment and interventions as needed. These initially focused on the provision of information, support, and advice. Forty six per cent of patients in the trial group also received further outpatient intervention or additional support by telephone. 314 patients were registered: 184 were randomised into the trial group, 130 into the control group. For prognostic data, the groups were comparable at randomisation, and remained comparable when assessed at six months. 132 trial and 86 control patients were followed up at six months after injury. Patients' posttraumatic amnesia ranged from mild (n=79, 40%), and moderate (n=62, 32%), to severe (n=38, 19%) and very severe (n=17, 9%). The trial group patients had significantly less social disability (p=0.01) and significantly less severe post-concussion symptoms (p=0.02) at follow up at six months after injury than the control group patients. The early interventions offered by a specialist service significantly reduced social morbidity and severity of post-concussion symptoms in trial group patients at six months after head injury. Recommendations about how specialist services should be targeted are made both in the light of these results and those from a previous randomised controlled trial.",Wade DT.; King NS.; Wenden FJ.; Crawford S.; Caldwell FE.,1998.0,,0,0,
2907,Does routine follow up after head injury help? A randomised controlled trial.,"To evaluate the Medical Disability Society's 1988 recommendation that ""every patient attending hospital after a head injury should be registered and offered an outpatient follow up appointment"" by determining whether offering a routine follow up service to patients presenting to hospital with a head injury of any severity affects outcome six months later. A randomised controlled trial design with masked assessment of outcome. A mixed rural and urban health district with a population of about 560000. 1156 consecutive patients resident in Oxfordshire aged between 16 and 65 years presenting over 13 months to accident and emergency departments or admitted to hospital and diagnosed as having a head injury of any severity, including those with other injuries. Patients were registered and randomised to one of two groups. Both groups continued to receive the standard service offered by the hospitals. The early follow up group were approached at 7-10 days after injury and offered additional information, advice, support, and further intervention as needed. All randomised patients were approached for follow up assessment six months after injury by independent clinicians blind to their group. Validated questionnaires were used to elicit ratings of post-concussion symptoms (the Rivermead postconcussion symptoms questionnaire), and changes in work, relationships, leisure, social, and domestic activities (the Rivermead head injury follow up questionnaire). The two groups were comparable at randomisation. Data was obtained at six months on 226 of 577 ""control"" patients and 252 of 579 ""trial"" patients (59% were lost to follow up). There were no significant differences overall between the trial and control groups at follow up, but subgroup analysis of the patients with moderate or severe head injuries (posttraumatic amnesia > or = one hour, or admitted to hospital), showed that those in the early intervention group had significantly fewer difficulties with everyday activities (P = 0.03). The results from the 41% of patients followed up do not support the recommendation of offering a routine follow up to all patients with head injury, but they do suggest that routine follow up is most likely to be beneficial to patients with moderate or severe head injuries. Some of those with less severe injuries do continue to experience difficulties and need access to services. A further trial is under way to test these conclusions.",Wade DT.; Crawford S.; Wenden FJ.; King NS.; Moss NE.,1997.0,,0,0,
2908,Availability bias in clinical formulation: the first idea that comes to mind.,"This study tested whether initial client formulations are based simply on the ideas that come most readily to mind, irrespective of the validity of these ideas. This phenomenon is known in decision theory literature as availability bias. The study tested the influence of two possible sources of availability bias in formulation: (a) theoretical orientation; and (b) a suggestion in a referral letter. Forty-four qualified and 20 trainee clinical psychologists participated in a procedure designed to reflect clinical practice. Clinical materials consisted of a fictional referral letter describing a client with adult attachment difficulties and post-traumatic stress disorder. Participants recalled information from the referral letter, described their areas of further interest and initial hypotheses. Results showed no evidence of an availability bias in clinical formulation as a result of theoretical orientation. Theoretical orientation towards attachment did appear to influence the availability of attachment ideas and predicted clinicians taking a stronger attachment focus when discussing the client. In particular, a self-report measure of theoretical orientation demonstrated high predictive validity. However, orientation towards attachment did not predict bias in the sense of selective recall of attachment information or neglect of alternative psychological frameworks. The study provided an inadequate test of availability bias as a result of a suggestion in the referral letter, possibly due to a ceiling effect, and no conclusions can be drawn as to clinical materials as a potential source of availability bias. The discussion addresses implications for further research and for a scientist-practitioner approach to individual case formulation.",Waddington L.; Morley S.,2000.0,,0,0,
2909,Preventing Empathic Distress and Social Stressors at Work Through Nonviolent Communication Training: A Field Study With Health Professionals,"One major source of mental health problems in health professionals are personally demanding encounters at work. Thus, a crucial prevention focus is the development of emotional and social skills necessary to effectively manage interactions with clients, colleagues, and supervisors. The aim of our pre-post intervention field study was to evaluate an employee training in nonviolent communication (NVC) within a public health organization. A training group participated in a 3-day NVC training and completed questionnaires before and 3 months after training. Changes in NVC skills, empathic distress, empathy, and social stressors at work were compared with data from a control group without training. Additionally, we observed NVC-trained participants' communication behavior immediately before and after the intervention. We found a promotion of communication skills in training participants as evidenced by increased emotion verbalization behavior and enhanced use of NVC at work. Empathic distress declined, and an increase of social stressors at work was prevented by enhanced emotion verbalization. The findings demonstrate that NVC training can be an effective means to foster emotional and interpersonal skills and to prevent empathic distress and social stressors at work in individuals working in socioemotionally challenging settings. Possible causal mechanisms explaining the training effects are discussed. (PsycINFO Database Record",Wacker R.; Dziobek I.,2016.0,10.1037/ocp0000058,0,0,
2910,The effects of long-term psychotherapy on patients' self-perception.,"A review of the literature regarding the effects of long-term psychotherapy indicates that it has rarely been examined purely from the standpoint of the patient. This study attempts to determine how the patients perceive attitudinal change in themselves and their therapists during the treatment process. Twenty patients who received dynamically oriented psychotherapy in excess of one year in a typical outpatient clinic participated. These patients were randomly assigned a therapist who was either a Clinic staff member or senior resident in psychiatry. Slightly more than half the patients included in the study had a diagnosis of psychoneurosis, while the remainder were viewed as possessing characterological or psychotic disturbances. Evaluation of patient attitudes was achieved through the use of a modified version of Osgood's Semantic Differential Scale. It was determined that patients perceived themselves as becoming significantly more like their therapists after one year of psychotherapy. They saw themselves as more active, independent, dominant, outgoing, realistic and happy. This ""psychic shift"" is discussed in terms of identification, transference and counter-transference phenomena.",Vora S.; Layman WA.; Mann ET.; Danesino A.,1977.0,,0,0,
2911,Rebound symptoms following battery depletion in the NIH OCD DBS cohort: Clinical and reimbursement issues.,"Objective: Deep brain stimulation (DBS) is a promising treatment for medication refractory obsessive compulsive disorder (OCD); however, there may be neuropsychiatric symptoms from unintended battery failure. Background: Previous studies indicated rebound symptoms from impulse generator (IPG) failure in Parkinson's disease, dystonia, and essential tremor. Unique to OCD is that battery failure may precipitate neuropsychiatric symptoms rather than motor symptoms. Methods: Six patients with medication refractory OCD received implants as part of the previously reported National Institutional Health (NIH) DBS cohort. All available clinical data and adverse event data was reviewed. Results: The average age of cohort was 42.2 years (30-59 years), and the average baseline Y-BOCS score was 33.8 (31-38). All six subjects were observed to have increased OCD symptomatology during IPG failure; however, Y-BOCS scores remained less than pretreatment range, in five subjects. One of the subjects had a Y-BOCS score greater than pretreatment during the period of IPG failure. In addition, Y-BOCS scores improved back to baseline after IPG replacement in five subjects. Other symptoms potentially related to battery failure included: suicidality (n = 1), mood disturbance (n = 2), panic attacks (n = 1), fatigue (n = 2), and a restless sensation in the arms and legs (n = 1). A small number of subjects reported no side effects associated with IPG failure because of preemptive replacement (n = 2). Conclusions: This is a preliminary case series detailing the side effects resulting from IPG failure during OCD DBS. Preemptive battery replacement was an effective strategy for avoiding these issues, and timeliness in insurance reimbursement may be considered in the future. Additionally the use of rechargeable batteries may also help this issue. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Vora, A. K; Ward, H; Foote, K. D; Goodman, W. K; Okun, M. S; Alesch, Bittar, Goodman, Greenberg, Hariz, Limousin, Maina",2012.0,,0,0,
2912,Antidepressant treatment outcomes of psychogenic movement disorder.,"Psychogenic movement disorder (PMD) is a subtype of conversion disorder. We describe the outcomes of a series of PMD patients following antidepressant treatment. Twenty-three outpatients with chronic PMD, diagnosed using Fahn and Williams' criteria, underwent psychiatric assessment. The patients were referred for assessment and management from January 2003 to July 2004. Fifteen agreed to be treated with antidepressants. Patients received citalopram or paroxetine; those who did not respond after 4 weeks of taking an optimal dose were switched to venlafaxine. Concurrently, 3 had supportive psychotherapy, and 1 had family intervention. Assessments included the DSM-IV-based Mini-International Neuropsychiatric Interview and scales measuring depression, anxiety, and motor and global severity. Eighteen patients (78%) had at least 1 Axis I diagnosis in addition to the somatoform diagnosis, and 3 (13%) had somatization disorder. Five (22%) had previous psychiatric contact. Nine (39%) had previously been treated with antidepressants, but only 4 (17%) had adequate trials. No significant differences existed in patient characteristics between treated and untreated groups. Among treated patients, Montgomery-Asberg Depression Rating Scale scores improved from baseline (p < .01). Two treated subgroups were identified: 10 patients (67%) had primary conversion disorder, of whom 8 had marked motor and global improvements with 7 complete remissions, and 5 (33%) had primary hypochondriasis, somatization disorder, or probable factitious disorder/malingering, of whom none improved. All of the patients with primary conversion disorder had a current or previous depressive or anxiety disorder compared with 40% (N = 2) of the patients with additional somatoform diagnoses. Our preliminary findings suggest that chronic PMD with primary conversion symptoms and with recent or current depression or anxiety may respond to antidepressants. Further well-designed studies, now under way, are required to confirm these findings.",Voon V.; Lang AE.,2005.0,,0,0,
2913,Decisional impulsivity and the associative-limbic subthalamic nucleus in obsessive-compulsive disorder: stimulation and connectivity.,"Why do we make hasty decisions for short-term gain? Rapid decision-making with limited accumulation of evidence and delay discounting are forms of decisional impulsivity. The subthalamic nucleus is implicated in inhibitory function but its role in decisional impulsivity is less well-understood. Here we assess decisional impulsivity in subjects with obsessive compulsive disorder who have undergone deep brain stimulation of the limbic and associative subthalamic nucleus. We show that stimulation of the subthalamic nucleus is causally implicated in increasing decisional impulsivity with less accumulation of evidence during probabilistic uncertainty and in enhancing delay discounting. Subthalamic stimulation shifts evidence accumulation in subjects with obsessive-compulsive disorder towards a functional less cautious style closer to that of healthy controls emphasizing its adaptive nature. Thus, subjects with obsessive compulsive disorder on subthalamic stimulation may be less likely to check for evidence (e.g. checking that the stove is on) with no difference in subjective confidence (or doubt). In a separate study, we replicate in humans (154 healthy controls) using resting state functional connectivity, tracing studies conducted in non-human primates dissociating limbic, associative and motor frontal hyper-direct connectivity with anterior and posterior subregions of the subthalamic nucleus. We show lateralization of functional connectivity of bilateral ventral striatum to right anterior ventromedial subthalamic nucleus consistent with previous observations of lateralization of emotionally evoked activity to right ventral subthalamic nucleus. We use a multi-echo sequence with independent components analysis, which has been shown to have enhanced signal-to-noise ratio, thus optimizing visualization of small subcortical structures. These findings in healthy controls converge with the effective contacts in obsessive compulsive disorder patients localized within the anterior and ventral subthalamic nucleus. We further show that evidence accumulation is associated with anterior associative-limbic subthalamic nucleus and right dorsolateral prefrontal functional connectivity in healthy controls, a region implicated in decision-making under uncertainty. Together, our findings highlight specificity of the anterior associative-limbic subthalamic nucleus in decisional impulsivity. Given increasing interest in the potential for subthalamic stimulation in psychiatric disorders and the neuropsychiatric symptoms of Parkinson's disease, these findings have clinical implications for behavioural symptoms and cognitive effects as a function of localization of subthalamic stimulation.",Voon V.; Droux F.; Morris L.; Chabardes S.; Bougerol T.; David O.; Krack P.; Polosan M.,2017.0,10.1093/brain/aww309,0,0,
2914,Xbox Kinect? based rehabilitation as a feasible adjunct for minor upper limb burns rehabilitation: a pilot RCT,"ER AIM: The objectives of this pilot study were to compare the efficacy of the Xbox Kinect? with conventional physiotherapy as an adjunctive tool to promote activity and, to explore their efficacy in influencing functionality and pain.METHOD: A randomised controlled clinical trial design was used. Intervention group participants were asked to complete two daily 30min exercise sessions consisting of 15min of self-directed physiotherapy exercise followed by 15min of Xbox Kinect? activities, based on location of burn. Control group participants were asked to complete two daily 30min exercise sessions of self-directed physiotherapy exercises involving two 15min sets of exercises, standardised for location of burn. Participants were recruited for a maximum of 7 days. Outcomes assessed included daily activity time, treatment satisfaction, upper limb disability, pain, and self-reported fear of movement (kinesiophobia).RESULTS: A sample of 30 burn patients admitted to Royal Perth Hospital was randomised into intervention and control groups. The intervention group demonstrated significantly greater total activity time compared to control group (median 49.4 and 26.7min respectively, p<0.0001), irrespective of total burns surface area (TBSA). Significantly greater satisfaction scores were also demonstrated in the intervention group compared to controls (median 8.53 vs 7.8 respectively, p<0.0001). There was no evidence to support differences between group measures for upper limb disability, pain and fear avoidance of movement.CONCLUSION: The Xbox Kinect? is a useful tool in increasing rehabilitation exercise time and patient satisfaction compared to conventional physiotherapy without indication of concurrent negative effects on patient recovery.INTRODUCTION: Rehabilitation following burns is integral to improving physical and psychological outcomes. Interactive video game consoles are emerging as therapeutic adjuncts due to their ease of use, affordability, and interactive gameplay. The Xbox Kinect? has advantage over similar consoles, with controller free interaction utilising three dimensional motion capture software. Player movements during gameplay have been shown to be comparable to completing daily tasks and therefore the Xbox Kinect? has potential for use as a rehabilitation tool.","Voon, K; Silberstein, I; Eranki, A; Phillips, M; Wood, F M; Edgar, D W",2016.0,10.1016/j.burns.2016.06.007,0,0,
2915,Exposure therapy in the treatment of vaginal penetration phobia: A single-case evaluation.,"A 25-yr-old female graduate student sought treatment due to her fear of vaginal penetration, which had prevented her from having intercourse for 2 yrs. At age 17 yrs she had had 3 mo of weekly therapy focusing mainly on her relationship with her stepfather; she sought further treatment at ages 20 and 21 yrs. Graduated exposure therapy involving self-conducted and partner-assisted homework exercises produced a complete resolution of the problem within 12 sessions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Vonk, M. Elizabeth; Thyer, Bruce A",1995.0,,0,0,
2916,Not self-focused attention but negative beliefs affect poor social performance in social anxiety: An investigation of pathways in the social anxiety-social rejection relationship,"Patients with social anxiety disorder (SAD) not only fear negative evaluation but are indeed less likeable than people without SAD. Previous research shows social performance to mediate this social anxiety-social rejection relationship. This study studied two pathways hypothesized to lead to poor social performance in social anxiety: increased self-focused attention and negative beliefs. State social anxiety was experimentally manipulated in high and low-blushing-fearful individuals by letting half of the participants believe that they blushed intensely during a 5 min getting-acquainted interaction with two confederates. Participants rated their state social anxiety, self-focused attention, and level of negative beliefs. Two confederates and two video-observers rated subsequently likeability (i.e., social rejection) and social performance of the participants. In both groups, the social anxiety-social rejection relationship was present. Although state social anxiety was related to heightened self-focused attention and negative beliefs, only negative beliefs were associated with relatively poor social performance. In contrast to current SAD models, self-focused attention did not play a key-role in poor social performance but seemed to function as a by-product of state social anxiety. Beliefs of being negatively evaluated seem to elicit changes in behavioral repertoire resulting in a poor social performance and subsequent rejection. © 2010 Elsevier Ltd.",Voncken M.J.; Dijk C.; de Jong P.J.; Roelofs J.,2010.0,10.1016/j.brat.2010.06.004,0,0,
2917,[The premorbid personality of patients with endogenous depression. A cross-validation of the results of an earlier investigation].,,von Zerssen D.; Koeller DM.; Rey ER.,1970.0,,0,0,
2918,[The Postero-Lateral Approach--An Alternative to Closed Anterior-Posterior Screw Fixation of a Dislocated Postero-Lateral Fragment of the Distal Tibia in Complex Ankle Fractures].,"The dislocated posterolateral fragment of the distal tibia is considered as a key fragment for the successful reduction of comminuted ankle fractures. The reduction of this fragment can either be achieved indirectly by joint reduction using the technique of closed anterior-posterior screw fixation, or directly using the open posterolateral approach followed by plate fixation. The aim of this study was to compare the outcome after stabilization of the dislocated posterolateral tibia fragment using either closed reduction and screw fixation, or open reduction and plate fixation via the posterolateral approach in complex ankle fractures. In a prospective study between 01/2010 and 12/2012, all mono-injured patients with closed ankle fractures and dislocated posterolateral tibia fragments were assessed 12 months after osteosynthesis. Parameters included: size of the posterolateral tibia fragment relative to the tibial joint surface (CT scan, in %) as an indicator of injury severity, unreduced area of tibial joint surface postoperatively, treatment outcome assessed by using the ""Ankle Fracture Scoring System"" (AFSS), as well as epidemiological data and duration of the initial hospital treatment. In 11 patients (10 female, 1 male; age 51.6 ± 2.6 years [mean ± SEM], size of tibia fragment 42.1 ± 2.5 %) the fragment fixation was performed using a posterolateral approach. Impaired postoperative wound healing occurred in 2 patients of this group. In the comparison group, 12 patients were treated using the technique of closed anterior-posterior screw fixation (10 female, 2 male; age 59.5 ± 6.7 years, size of tibia fragment 45.9 ± 1.5 %). One patient of this group suffered an incomplete lesion of the superficial peroneal nerve. Radiological evaluation of the joint surface using CT scan imaging demonstrated significantly less dislocation of the tibial joint surface following the open posterolateral approach (0.60 ± 0.20 mm) compared to the closed anterior-posterior screw fixation (1.03 ± 0.08 mm; p < 0.05). Assessment of the treatment outcome using the AFSS demonstrated a significantly higher score of 97.4 ± 6.4 in the group with a posterolateral approach compared to a score of 74.4 ± 12.1 (p < 0.05) in the group with an anterior-posterior screw fixation. In comparison to the anterior-posterior screw fixation, open reduction and fixation of the dislocated, posterolateral key fragment of the distal tibia using a posterolateral approach resulted in a more accurate fracture reduction and significantly better functional outcome 12 months after surgery. In addition, no increased rate of postoperative complications, or extended hospital stay was observed but there was less severe post-traumatic joint arthritis. The results of this study suggest that in complex ankle factures the open fixation of the dislocated posterolateral fragment is recommended as an alternative surgical procedure and may be beneficial for both clinical and radiological long-term outcomes.",von Rüden C.; Hackl S.; Woltmann A.; Friederichs J.; Bühren V.; Hierholzer C.,2015.0,10.1055/s-0035-1545706,0,0,
2919,Opposite effect of negative and positive affect on stress procoagulant reactivity,"Exaggerated procoagulant responses to acute mental stress may contribute to coronary thrombosis, and continuing low-grade systemic coagulation activation may link negative affect with the development of coronary artery disease. We investigated whether negative and positive affect and perceived social support would moderate stress procoagulant reactivity. Psychological functioning, exhaustion, negative affectivity, depression, anxiety, worrying, vigor, and social support were assessed in 27 apparently healthy men (mean age 47 ± 8 years) who underwent the 13-min Trier Social Stress Test combining preparation, speech, and mental arithmetic. Plasma levels of von Willebrand factor antigen (VWF:Ag), fibrinogen, factor VII clotting activity (FVII:C), FVIII:C, FXII:C, and D-dimer were measured immediately before and after stress. Acute stress elicited significant increases in hemodynamic, cortisol, and coagulant activity (p values < 0.05). VWF:Ag reactivity showed inverse relationships with exhaustion (r = - 0.63, p < 0.001), negative affectivity (r = - 0.53, p = 0.005), and worrying (r = - 0.53, p = 0.005). Exhaustion and negative affectivity emerged as independent predictors of VWF:Ag reactivity explaining 54% of its variance. Fibrinogen reactivity showed inverse relationships with negative affectivity (r = - 0.59, p = 0.002) and anxiety (r = - 0.54, p = 0.005); negative affectivity emerged as an independent predictor of fibrinogen reactivity explaining 35% of its variance. Psychological functioning and FVII:C reactivity were also correlated (r = - 0.52, p = 0.006). Whereas FVIII:C reactivity correlated positively with vigorous mood (r = 0.48, p = 0.012), positive associations between social support and procoagulant reactivity did not reach significance. Negative affect was associated with attenuated procoagulant reactivity to stress and the opposite was observed for positive affect. Negative affect is not likely to enhance the acute procoagulant stress response in healthy men. © 2005 Elsevier Inc. All rights reserved.",Von Känel R.; Kudielka B.M.; Preckel D.; Hanebuth D.; Herrmann-Lingen C.; Frey K.; Fischer J.E.,2005.0,10.1016/j.physbeh.2005.06.005,0,0,
2920,Assessing therapeutic competence in cognitive therapy for social phobia: psychometric properties of the cognitive therapy competence scale for social phobia (CTCS-SP).,"There has been considerable acknowledgement in treatment outcome research that, although the assessment of treatment integrity is essential in many respects, it requires great effort as well as resources and is therefore often neglected. In order to fill this gap, the Cognitive Therapy Competence Scale for Social Phobia (CTCS-SP) was developed, based on the Cognitive Therapy Scale, to measure therapist competence in delivering cognitive therapy for social phobia. The aim of the present study was to investigate interrater reliability, internal consistency and retest reliability of the scale. Raters evaluated therapist competence from 161 videotaped sessions (98 patients) selected from 234 cognitive treatments within a multi-centre study. Interrater-reliability was found to be high for the overall score (ICC = .81) and moderate for individual items (ICC = .62-.92). Internal consistency and retest reliability were also found to be high (Cronbach's alpha = .89; (ICCretest = .86). The results indicate that the CTCS-SP is highly reliable. As even individual items yield satisfactory reliability, the scale can be used in various fields of research, including the measurement of changes in skill acquisition and the impact of competence on outcome criteria.",von Consbruch K.; Clark DM.; Stangier U.,2012.0,10.1017/S1352465811000622,0,0,
2921,Naltrexone in the treatment of alcoholism: predicting response to naltrexone,"ER The pooled results of 99 subjects from our Veterans Affairs population show that naltrexone-treated subjects had a greater reduction in alcohol craving, number of drinking days, and alcoholic relapse rates when compared with placebo-treated subjects. Based on our findings and results from other double-blind trials of naltrexone, we conclude that naltrexone is a safe and useful adjunct in the rehabilitation of alcohol-dependent patients. Increased baseline levels of psychological distress and craving as well as higher levels of somatic distress, anxiety, phobic anxiety, and obsessive-compulsive symptoms predicted an increased number of drinking days during the study. Significant interactions between naltrexone treatment, initial craving, and somatic distress suggest that naltrexone may be useful for subjects who present with high levels of craving and somatic symptoms.","Volpicelli, J R; Clay, K L; Watson, N T; O'Brien, C P",1995.0,,0,0,
2922,[Role of various risk factors in the development and diagnosis of recurrent pain in adolescents--students of cadet corps].,"Randomized single-blind case--control study is performed. In total, the cadet corp students with recurrent functional abdominal pain and headaches are examined. The paper shows the role of various risk factors in the occurrence of these states. Diagnostic validity is evaluated. Multifactorial genesis of the studied pathology is proved. The essential role in the formation of the psychological characteristics of personality, neurotic states and autonomic dysfunction is shown. Several constitutional characteristics of the organism were not diagnostically significant.",Voloshina EA.; Grigor'ev SG.; Kuznetsova EA.; Miroliubov AV.; Sergeev IuS.; Shabalov NP.,2012.0,,0,0,
2923,Role of various risk factors in the development and diagnosis of recurrent pain in adolescents--students of cadet corps,"ER Randomized single-blind case--control study is performed. In total, the cadet corp students with recurrent functional abdominal pain and headaches are examined. The paper shows the role of various risk factors in the occurrence of these states. Diagnostic validity is evaluated. Multifactorial genesis of the studied pathology is proved. The essential role in the formation of the psychological characteristics of personality, neurotic states and autonomic dysfunction is shown. Several constitutional characteristics of the organism were not diagnostically significant.","Voloshina, E A; Grigor'ev, S G; Kuznetsova, E A; Miroliubov, A V; Sergeev, IuS; Shabalov, N P",2012.0,,0,0,2922
2924,Divide and Conquer: Functional Segregation of Synaptic Inputs by Astrocytic Microdomains Could Alleviate Paroxysmal Activity Following Brain Trauma,"Traumatic brain injury often leads to epileptic seizures. Among other factors, homeostatic synaptic plasticity (HSP) mediates posttraumatic epileptogenesis through unbalanced synaptic scaling, partially compensating for the trauma-incurred loss of neural excitability. HSP is mediated in part by tumor necrosis factor alpha (TNFα), which is released locally from reactive astrocytes early after trauma in response to chronic neuronal inactivity. During this early period, TNFα is likely to be constrained to its glial sources; however, the contribution of glia-mediated spatially localized HSP to post-traumatic epileptogenesis remains poorly understood. We used computational model to investigate the reorganization of collective neural activity early after trauma. Trauma and synaptic scaling transformed asynchronous spiking into paroxysmal discharges. The rate of paroxysms could be reduced by functional segregation of synaptic input into astrocytic microdomains. Thus, we propose that trauma-triggered reactive gliosis could exert both beneficial and deleterious effects on neural activity. © 2013 Volman et al.",Volman V.; Bazhenov M.; Sejnowski T.J.,2013.0,10.1371/journal.pcbi.1002856,0,0,
2925,"Psychological and cardiovascular effects and short-term sequelae of MDMA (""Ecstasy"") in MDMA-naive healthy volunteers.","3,4-Methylenedioxymethamphetamine (MDMA, ""Ecstasy"") is a recreational drug reported to produce a different psychological profile than that of classic hallucinogens and stimulants. It has, therefore, been tentatively classified into a novel pharmacological class termed entactogens. This double-blind placebo-controlled study examined the effects of a typical recreational dose of MDMA (1.7 mg/kg) in 13 MDMA-naive healthy volunteers (aged 23-47 yrs). MDMA produced an affective state of enhanced mood, well-being, and increased emotional sensitiveness, little anxiety, but no hallucinations or panic reactions. Mild depersonalization and derealization phenomena occurred together with moderate thought disorder, first signs of loss of body control, and alterations in the meaning of percepts. Ss also displayed changes in the sense of space and time, heightened sensory awareness, and increased psychomotor drive. Adverse sequelae during the following 24 hrs included lack of energy and appetite, feelings of restlessness, insomnia, jaw clenching, occasional difficulty concentrating, and brooding. The present findings are consistent with the hypothesis that MDMA produces a different psychological profile than classic hallucinogens or psychostimulants. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Vollenweider, Franz X; Gamma, Alex; Liechti, Matthias; Huber, Theo",1998.0,,0,0,
2926,Efficacy of massage therapy in chronic pain: a pragmatic randomized trial,"ER DESIGNPragmatic RCT of classic massage compared to standard medical care (SMC) in chronic pain conditions of back, neck, shoulders, head and limbs.OUTCOME MEASUREPain rating (nine-point Likert-scale; predefined main outcome criterion) at pretreatment, post-treatment, and 3 month follow-up, as well as pain adjective list, depression, anxiety, mood, and body concept.RESULTSBecause of political and organizational problems, only 29 patients were randomized, 19 to receive massage, 10 to SMC. Pain improved significantly in both groups, but only in the massage group was it still significantly improved at follow-up. Depression and anxiety were improved significantly by both treatments, yet only in the massage group maintained at follow-up.CONCLUSIONDespite its limitation resulting from problems with numbers and randomization this study shows that massage can be at least as effective as SMC in chronic pain syndromes. Relative changes are equal, but tend to last longer and to generalize more into psychologic domains. Because this is a pilot study, the results need replication, but our experiences might be useful for other researchers.BACKGROUNDAlthough classic massage is used widely in Germany and elsewhere for treating chronic pain conditions, there are no randomized controlled trials (RCT).","Walach, H; Güthlin, C; König, M",2003.0,10.1089/107555303771952181,0,0,
2927,Effects of a smoking cessation program for pregnant women and their partners attending a public hospital antenatal clinic,"This study aimed to assess the effect of a hospital-based smoking cessation intervention delivered by midwives during routine antenatal and postnatal care on the smoking habits of pregnant women and their partners. At the first antenatal visit, women in the intervention group (n = 110) were given a demonstration of the immediate effects of smoking on foetal heart rate, brief smoking cessation advice and smoking cessation booklets for themselves and their partners; at delivery, they were given brief advice and a booklet about postpartum cessation. Compared with an historical control group who received usual care (n = 110) and assuming those lost to follow-up continued to smoke, biochemically-verified maternal cessation sustained from at least 24 weeks gestation to late pregnancy was 6.4% in the intervention group and 1.8% in the comparison group. However, there was no difference between maternal quit rates at six months postpartum. Partners were more likely to try to quit in the intervention group, but quit rates did not differ. Exposure to the intervention was not associated with increased levels of psychological distress, as measured by the 12-item General Health Questionnaire. We conclude that this type of intervention, when implemented by staff during routine care, is probably associated with a small improvement in maternal cessation in pregnancy, similar to that produced by minimal advice to quit smoking.",Wakefield M.; Jones W.,1998.0,,0,0,
2928,Online parent-targeted cognitive-behavioural therapy intervention to improve quality of life in families of young cancer survivors: study protocol for a randomised controlled trial,"ER METHODS/DESIGNThe 'Cascade' (Cope, Adapt, Survive: Life after C AncEr) study is a three-arm randomised controlled trial to evaluate the feasibility and efficacy of a new intervention to improve the quality of life of parents of young cancer survivors. Cascade will be compared to a peer-support group control and a 6-month waitlist control. Parents (n?=?120) whose child (under 16 years of age) has completed cancer treatment in the past 1 to 12 months will be recruited from hospitals across Australia. Those randomised to receive Cascade will participate in four, weekly, 90-minute online group sessions led live by a psychologist. Cascade involves peer discussion on cognitive-behavioural coping skills, including behavioural activation, thought challenging, mindfulness and acceptance, communication and assertiveness skills training, problem-solving and goal-setting. Participants randomised to peer support will receive four, weekly, 90-minute, live, sessions of non-directive peer support. Participants will complete measures at baseline, directly post-intervention, one month post-intervention, and 6 months post-intervention. The primary outcome will be parents' quality of life. Secondary outcomes include parent depression, anxiety, parenting self-agency, and the quality of life of children in the family. The child cancer survivor and all siblings aged 7 to 15 years will be invited to complete self-report quality of life measures covering physical, emotional, social and school-related domains.DISCUSSIONThis article reviews the empirical rationale for group-based, online cognitive-behavioural therapy in parents of children who have recently finished cancer treatment. The potential challenges of delivering skills-based programs online are highlighted. Cascade's videoconferencing technology has the potential to address the geographic and psychological isolation of families after cancer treatment. Teaching parents coping skills as they resume their normal lives after their child's cancer may see long-term benefits for the quality of life of the family as a whole.TRIAL REGISTRATIONACTRN12613000270718 (registered 6 March 2013).BACKGROUNDDue to advances in multimodal therapies, most children survive cancer. In addition to the stresses of diagnosis and treatment, many families are now navigating the challenges of survivorship. Without sufficient support, the ongoing distress that parents experience after their child's cancer treatment can negatively impact the quality of life and psychological wellbeing of all family members.","Wakefield, C E; Sansom-Daly, U M; McGill, B C; McCarthy, M; Girgis, A; Grootenhuis, M; Barton, B; Patterson, P; Osborn, M; Lowe, C; Anazodo, A; Miles, G; Cohn, R J",2015.0,10.1186/s13063-015-0681-6,0,0,
2929,Pilot study using Neurolinguistic Programming (NLP) in post-combat PTSD.,"Purpose: The purpose of this paper is to determine if neurolinguistic programming (NLP) tools and techniques were effective in alleviating the symptoms of posttraumatic stress disorder (PTSD) in clients from the Military and Emergency Services. Design/methodology/approach: This project ran at the ""Healing the Wounds"" charity in Bridgend. All clients were opportunistic, having self-referred to a charity specifically set up to support Veterans from the Armed Forces. In total, 29 clients from an initial cohort of 106 clients provided pre and post data using Depression Anxiety Stress Scale (DASS) and the NLP Wheel of Life scale. Interventions included a range of NLP techniques, addressing self-reported symptoms. Findings: Differences between DASS scores before and after treatment are very highly significant. t-test analysis infers that these results are indicative of the overall response from the clients in this study. Research limitations/implications: Limitations of the study include: client group; significant levels of incomplete data for the total study group; therapist effect and therapist training; treatment methodology. Originality/value: Data suggest that NLP has potential as a therapeutic tool in the treatment of symptoms of anxiety and depression associated with a self-report of PTSD. An observation is proposed that these candidates experience an improvement in their emotional state when NLP is used which is statistically significant (p < 0.001) both for overall DASS score averages and also for each of the three DASS categories (Depression, Anxiety and Stress). Stress was the highest scoring category prior to treatment for these clients; the reduction in their stress symptoms contributed most substantially to the overall reduction in average DASS score, indicating an improvement in their emotional state. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Wake, Lisa; Leighton, Margaret; Bandler, Bandler, Bigley, Churches, Ehlers, Figley, Foa, Foa, Gray, Gray, Gray, Grinder, James, Juhnke, Kar, Linder-Pelz, Lovibond, McDermott, Muss, Satir, Simpson, Skinner, Stipancic, Sturt, Wake, Wake, Wake, Weaver, Witt, Witt",2014.0,,0,0,
2930,A double-blind study of citalopram versus placebo in the treatment of compulsive sexual behaviors in gay and bisexual men,"ER METHODTwenty-eight men who have sex with men who met the threshold for CSB on the basis of existing validated measures participated in a 12-week, double-blind trial of citalopram 20 to 60 mg/day to evaluate its effects on CSB symptoms. The primary efficacy measure was the Yale-Brown Obsessive Compulsive Scale-Compulsive Sexual Behavior. The study was conducted from June 2002 to April 2004.RESULTSSignificant treatment effects were obtained for sexual desire/drive (p < .05) and frequency of masturbation (p < .01) and pornography use (p < .05). Both groups reduced sexual risk, but did not differ significantly.CONCLUSIONSThis study provides partial support for the effectiveness of citalopram for reducing symptoms of CSB in this population. Larger-scale trials are recommended to determine the public health benefits of this treatment.OBJECTIVECompulsive sexual behavior (CSB) is a condition characterized by loss of control over sexual behavior and repeated negative consequences, including unsafe sex. Selective serotonin reuptake inhibitors have been found to reduce CSB symptomatology in open-label trials. The objective of this study was to conduct a preliminary double-blind, placebo-controlled evaluation of the efficacy, acceptability, and tolerability of citalopram in the treatment of CSB.","Wainberg, M L; Muench, F; Morgenstern, J; Hollander, E; Irwin, T W; Parsons, J T; Allen, A; O'Leary, A",2006.0,,0,0,
2931,One method for objective adherence measurement in mind-body medicine.,"Objectives: Home practice is frequently prescribed as part of mind-body medicine interventions, although rarely objectively measured. This brief methods report describes one method for objectively measuring home practice adherence using a custom monitoring software program. Design: Methods for objectively measuring adherence were developed as part of a randomized controlled trial on the mechanisms of mindfulness meditation. Settings/location: The study was conducted at Oregon Health & Science University, Portland, Oregon. Subjects: The subjects comprised 11 combat veterans with post-traumatic stress disorder. Interventions: The method used was mindfulness meditation. Outcome measures: There were subjective and objective adherence measurements of mindfulness meditation home practice. Results: The first iteration of objective adherence monitoring used an iPod device and had limitations in participant usage and correctly capturing data. In the second iteration, objective data were easily collected, uploaded, and viewed using the custom software application, iMINDr. Participants reported that iMINDr was straightforward to use, and they returned the monitoring units as directed. Conclusions: The iMINDr is an example of a simple objective adherence measurement system that may help mind-body researchers examine how home practice adherence may affect outcomes in future clinical trials. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Wahbeh, Helane; Zwickey, Heather; Oken, Barry; Carmody, Carmody, Flegal, Osterberg, Rosenzweig, Sannes, Wahbeh",2011.0,,0,0,
2932,[Controlled examination of an extremely short psychotherapy (15 hours) with guided affective imagery (author's transl)].,,Wächter HM.; Pudel V.,1980.0,,0,0,
2933,Cognitive behavioral therapy in pharmacoresistant obsessive-compulsive disorder.,"Background: The aim of the study was to determine whether patients with obsessive-compulsive disorder (OCD) resistant to drug therapy may improve their condition using intensive, systematic cognitive behavioral therapy (CBT) lasting for 6 weeks, and whether it is possible to predict the therapeutic effect using demographic, clinical, and selected psychological characteristics at baseline. Methods: Sixty-six OCD patients were included in the study, of which 57 completed the program. The diagnosis was confirmed using the structured Mini International Neuropsychiatric Interview. Patients were rated using the objective and subjective forms of the Yale-Brown Obsessive Compulsive Scale, objective and subjective forms of the Clinical Global Impression, Beck Anxiety Inventory, Beck Depression Inventory, Dissociative Experiences Scale, 20-item Somatoform Dissociation Questionnaire, and the Sheehan Disability Scale before their treatment, and with subjective Yale-Brown Obsessive Compulsive Scale, objective and subjective Clinical Global Impression, Beck Anxiety Inventory, and Beck Depression Inventory at the end of the treatment. Patients were treated with antidepressants and daily intensive group CBT for the 6-week period. Results: During the 6-week intensive CBT program in combination with pharmacotherapy, there was a significant improvement in patients suffering from OCD resistant to drug treatment. There were statistically significantly decrease in the scores assessing the severity of OCD symptoms, anxiety, and depressive feelings. A lower treatment effect was achieved specifically in patients who 1) showed fewer OCD themes in symptomatology, 2) showed a higher level of somatoform dissociation, 3) had poor insight, and 4) had a higher initial level of overall severity of the disorder. Remission of the disorder was more likely in patients who had 1) good insight, 2) a lower initial level of anxiety, and 3) no comorbid depressive disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Vyskocilova, Jana; Prasko, Jan; Sipek, Jiri; Abramowitz, Alonso, Amorim, Bartlett, Basoglu, Beck, Beck, Beck, Beck, Belli, Belloch, Bernstein, Bonham, Bystritsky, Camuri, Coles, Cottraux, Cottraux, De Ayala, de Beurs, Dell'Osso, Demet, Denys, Eisen, Eisen, Farina, Foa, Foa, Foa, Gava, Goff, Goodman, Goodman, Guy, Hantouche, Hollander, Hollander, Kampman, Kampman, Kaplan, Karno, Keeley, Knopp, Koprivova, Koran, Kozak, Lack, Lochner, Magan, Maina, March, Mataix-Cols, Mataix-Cols, Nakao, Nestadt, Nijenhuis, O'Neill, Olatunji, Pastucha, Pena-Garijo, Piane, Pigott, Pigott, Pinninti, Pizarro, Prasko, Prasko, Prasko, Preiss, Ptacek, Raszka, Raszka, Ravizza, Romanelli, Rufer, Salkovskis, Saxena, Saxena, Semiz, Shavitt, Sheehan, Sheehan, Shetti, Spitzer, Steketee, Steketee, Steketee, Steketee, Storch, Subramaniam, Thompson-Hollands, Torres, Vaingankar, van Balkom, Vigne, Visser, Wang, Weissman, Yaryura-Obias, Zaider",2016.0,,0,0,
2934,Are some Panic Attacks really Temporal Lobe Seizures?,"Anxiety Disorders are the most prevalent psychiatric disorders, Panic Disorder (PD) is characterized by recurrent unexpected Panic Attacks, about which there is persistent concern. Life time prevalence of PD is 1.5 to 3.5%. Panic Attacks often have the same clinical signs as Temporal Lobe Seizures (TLE) with psychic content. Reports of concomitant PD and epilepsy are highly suggestive of an intimate relationship between them. SSRI is currently first-line treatment for all Anxiety Disorders. However, they are ineffective in approximately 40 to 50% of patients, and cause unacceptable side effects. Benzodiazepines are both anxiolytic and anticonvulsants. However, long-term use can cause tolerance, dependence and withdrawal. Levetiracetam (Anti-Epileptic Drug, AED) is effective in PD. EEG abnormalities have been reported in patients with PD, although controlled studies are lacking. 20 to 40% of clinically proven Complex Partial Seizure patients have normal routine clinical EEG. At least 30% of routine EEG of PD patients is abnormal. Many reported normal in routine EEGs show abnormalities in long term EEGs including sleep. No studies were found which address the circumstances in which AEDs should be used in treatment of PD. Further investigation is warranted to determine the association between PD and TLE, and choice of treatment.",Vyas U.; Moore N.C.; Boutros N.N.,2009.0,,0,0,
2935,A randomized trial among women with heavy menstruation -- impact of a decision aid on treatment outcomes and costs,"ER DESIGN: Randomized trial and pre-trial prospective cohort study.SETTING AND PARTICIPANTS: Gynaecology outpatient clinics in 14 Finnish hospitals, 363 (randomized trial) plus 206 (cohort study) patients with menorrhagia.INTERVENTION: A decision aid booklet explaining menorrhagia and treatment options, mailed to patients before their first clinic appointment.MAIN OUTCOME MEASURES: Health related quality of life, psychological well-being, menstrual symptoms, satisfaction with treatment outcome, use and cost of health care services.RESULTS: All study groups experienced overall improvement in health-related quality of life, anxiety, and psychosomatic and menstrual symptoms, but not in sexual life. Treatment in the intervention group was more active than in the control group, with more frequent course of medication and less undecided treatments. However, there were no marked disparities in health outcomes, satisfaction with treatment outcome and costs. Total costs (including productivity loss) per woman because of menorrhagia over the 12-month follow-up were 2760 and 3094 in the intervention and control group, respectively (P = 0.1). The pre-trial group also had a significantly lower rate of uterus saving surgery compared with the control group, but no difference in costs because of menorrhagia treatment.CONCLUSION: Despite some differences in treatment courses, a decision aid for menorrhagia in booklet form did not increase the use of health services or treatment costs, nor had it impact on health outcomes or satisfaction with outcome of treatment.OBJECTIVE: To evaluate the effects of a decision aid for menorrhagia on treatment outcomes and costs over a 12-month follow-up.","Vuorma, S; Teperi, J; Aalto, A M; Hurskainen, R; Kujansuu, E; Rissanen, P",2004.0,10.1111/j.1369-7625.2004.00297.x,0,0,
2936,Catechol-O-methyltranferase gene expression is associated with response to citalopram in obsessive-compulsive disorder.,"Objective. To determine whether polymorphisms of the dopamine D2 receptor (DRD2) and catechol- O -methyl-transferase (COMT) receptor genes affect the efficacy of quetiapine addition to citalopram in patients with OCD. Methods. Sixty-four drug-free or drug-naive patients meeting DSM-IV criteria for OCD were randomized to 10 weeks double-blind treatment with citalopram (60 mg/day) with quetiapine (300-450 mg/day) or with placebo. The change from baseline to endpoint on the total Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the response to treatment were the primary outcome measures. Response was defined as a 25% decrease in Y-BOCS score. Responders and nonresponders were stratified according to DRD2 TaqI A and COMT Val(158)Met genotypes. Results. No significant differences in genotype distribution or allele frequencies of the COMT or DRD2 receptor were found between responders and nonresponders to citalopram with quetiapine. However, nearly half of responders to citalopram with placebo carried the Met/Met (48%) genotype of the COMT polymorphism compared to none of the nonresponders (chi2 = 10.06, df 2, P = 0.007). Conclusions. The Met allele load of the COMT receptor gene was associated with response to 10 weeks of treatment with citalopram in drug-free or drug-naive OCD patients. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Vulink, Nienke C. C; Westenberg, Herman G. M; van Nieuwerburgh, Filip; Deforce, Dieter; Fluitman, Sjoerd B. A. H. A; Meinardi, Jantien S. C; Denys, Damiaan; Ainsworth, Arias, Baune, Chertkow, Denys, Denys, Denys, Dewey, Durlach-Misteli, Dziedzicka-Wasylewska, First, First, Goodman, Goodman, Grandy, Hamilton, Hesse, Huang, Karayiorgou, Kim, Klimke, Koch, Komossa, Kugaya, Lachman, Maj, Matsunaga, Moresco, Penttila, Perani, Pogarell, Richelson, Rogoz, Sakumoto, Sasson, Schafer, Sekine, Suzuki, Szegedi, Tiihonen, Tunbridge, van der Wee, Vulink, Westenberg, Zhang",2012.0,,0,0,
2937,Telephone Problem-Solving Treatment Improves Sleep Quality in Service Members With Combat-Related Mild Traumatic Brain Injury: Results From a Randomized Clinical Trial.,"Evaluate sleep quality, its correlates, and the effect of telephone-based problem-solving treatment (PST) in active duty postdeployment service members with mild traumatic brain injury (mTBI) SETTING:: Randomized clinical trial. Active duty service members with combat-related mTBI. Education-only (EO) and PST groups (N = 178 each) received printed study materials and 12 educational brochures. The PST group additionally received up to 12 PST telephone calls addressing participant-selected issues. Outcomes were evaluated postintervention (6 months) and at 12 months. Pittsburgh Sleep Quality Index. Sleep quality was manifestly poor in both groups at baseline (Pittsburgh Sleep Quality Index = 12.5 ± 4). Overall sleep quality was significantly different between the PST and EO groups at 6 months (P = .003) but not at 12 months. Longitudinally, PST significantly improved sleep quality at 6 months (P = .001) but not over the follow-up. Low sleep quality was associated with concussion symptoms, pain, depression, and posttraumatic stress disorder at all time points (P < .0001). Sleep disorders, common in postdeployment service members with mTBI, are strongly associated with the presence of pain, posttraumatic stress disorder, and depression. Telephone-based PST may be an effective therapeutic approach for reducing sleep disorders in this population. Research should focus on maintenance of treatment gains.",Vuletic S.; Bell KR.; Jain S.; Bush N.; Temkin N.; Fann JR.; Stanfill KE.; Dikmen S.; Brockway JA.; He F.; Ernstrom K.; Raman R.; Grant G.; Stein MB.; Gahm GA.;  .,,10.1097/HTR.0000000000000221,0,0,
2938,Telephone problem-solving treatment improves sleep quality in service members with combat-related mild traumatic brain injury: Results from a randomized clinical trial.,"Objective: Evaluate sleep quality, its correlates, and the effect of telephone-based problem-solving treatment (PST) in active duty postdeployment service members with mild traumatic brain injury (mTBI) Setting: Randomized clinical trial. Participants: Active duty service members with combat-related mTBI. Study design: Education-only (EO) and PST groups (N = 178 each) received printed study materials and 12 educational brochures. The PST group additionally received up to 12 PST telephone calls addressing participant-selected issues. Outcomes were evaluated postintervention (6 months) and at 12 months. Main Measure: Pittsburgh Sleep Quality Index. Results: Sleep quality was manifestly poor in both groups at baseline (Pittsburgh Sleep Quality Index = 12.5 +/- 4). Overall sleep quality was significantly different between the PST and EO groups at 6 months (P = .003) but not at 12 months. Longitudinally, PST significantly improved sleep quality at 6 months (P = .001) but not over the follow-up. Low sleep quality was associated with concussion symptoms, pain, depression, and posttraumatic stress disorder at all time points (P < .0001). Conclusions: Sleep disorders, common in postdeployment service members with mTBI, are strongly associated with the presence of pain, posttraumatic stress disorder, and depression. Telephone-based PST may be an effective therapeutic approach for reducing sleep disorders in this population. Research should focus on maintenance of treatment gains. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Vuletic, S; Bell, K. R; Jain, S; Bush, N; Temkin, N; Fann, J. R; Stanfill, K. E; Dikmen, S; Brockway, J. A; He, F; Ernstrom, K; Raman, R; Grant, G; Stein, M. B; Gahm, G. A; CONTACT Investigators; Ayalon, Babson, Bell, Betar, Boyle, Bramoweth, Brenner, Brooks, Bryan, Bush, Buysse, Choe, da Costa, DePalma, Engdahl, Evans, Faraguna, Farrell-Carnahan, Faul, Fichtenberg, Ford, Frencham, Garthus-Niegel, Germain, Halbauer, Harvey, Hefez, Heltemes, Hoge, Kiernan, Kim, King, Kobeissy, Kroenke, Lamarche, Lavigne, Lew, Luxton, Macera, McKee, Meachen, Miro, Mollayeva, Mustafa, Mysliwiec, Nampiaparampil, O'Neil, Onen, Orff, Pigeon, Reinsel, Riemann, Ruff, Saper, Saunders, Schneiderman, Schreiber, Searle, Seelig, Sheehan, Sivertsen, Spitzer, Tanielian, Tello-Velasquez, Ware, Weathers, Wilk, Wojcik, Zeitzer, Zumstein",2016.0,,0,0,
2939,Epigenetic modification of the glucocorticoid receptor gene is linked to traumatic memory and post-traumatic stress disorder risk in genocide survivors,"Recent evidence suggests that altered expression and epigenetic modification of the glucocorticoid receptor gene (NR3C1) are related to the risk of post-traumatic stress disorder (PTSD). The underlying mechanisms, however, remain unknown. Because glucocorticoid receptor signaling is known to regulate emotional memory processes, particularly in men, epigenetic modifications of NR3C1mightaffect the strength oftraumatic memories. Here, we found thatincreased DNA methylation atthe NGFI-A (nerve growth factor-induced protein A) binding site of the NR3C1promoter was associated with less intrusive memory of the traumatic event and reduced PTSD risk in male, but not female survivors of the Rwandan genocide.NR3C1methylation was not significantly related to hyperarousal or avoidance symptoms. We further investigated the relationship between NR3C1methylation and memory functions in a neuroimaging study in healthy subjects. Increased NR3C1methylation-which was associated with lower NR3C1expression-was related to reduced picture recognition in male, but not female subjects. Furthermore, we found methylation-dependent differences in recognition memory-related brain activity in men. Together, these findings indicate that an epigenetic modification of the glucocorticoid receptor gene promoter is linked to interindividual and gender-specific differences in memory functions and PTSD risk. © 2014 the authors.",Vukojevic V.; Kolassa I.-T.; Fastenrath M.; Gschwind L.; Spalek K.; Milnik A.; Heck A.; Vogler C.; Wilker S.; Demougin P.; Peter F.; Atucha E.; Stetak A.; Roozendaal B.; Elbert T.; Papassotiropoulos A.; de Quervain J.-F.D.,2014.0,10.1523/JNEUROSCI.1526-14.2014,0,0,
2940,Single-session anxiety sensitivity reduction program for trauma-exposed adults: A case series documenting feasibility and initial efficacy.,"The present case series examined a single-session, cognitive-behavioral anxiety sensitivity (AS) reduction program among five trauma-exposed adults. Participants (age range = 19-37 years) reported significantly elevated levels of AS at baseline, a history of posttraumatic stress disorder Criterion A trauma exposure, and no current Axis I psychopathology. The outcomes of the preventive intervention were examined with regard to 3-month postintervention changes in AS, posttraumatic stress, panic attack frequency and severity, negative affect levels, and behavioral functioning and impairment. Results demonstrated decreases in each of the studied outcomes over the examined time period. This preliminary yet uncontrolled data provides empirical evidence of the feasibility and support for the utilization of a brief AS reduction intervention program to target anxiety-related vulnerability among trauma-exposed adults. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Vujanovic, Anka A; Bernstein, Amit; Berenz, Erin C; Zvolensky, Michael J; Bernstein, Bernstein, Bernstein, Blake, Breslau, Breslau, Castellanos, Davidson, Eifert, Elwood, Fedoroff, Feldner, Fierman, First, Foa, Foa, Foa, Gardenswartz, Grant, Kessler, King, Kulka, Leon, Leskin, Marshall, McNally, Miniati, Olatunji, Otto, Rhudy, Schmidt, Schmidt, Schmidt, Schmidt, Shear, Shear, Sheehan, Sheehan, Sheikh, Stein, Stephenson, Taylor, Taylor, Teng, Wald, Wald, Wald, Watson, Watson, Watt, Weathers, Wolpe, Zvolensky",2012.0,,0,0,
2941,Single-session anxiety sensitivity reduction program for trauma-exposed adults: a case series documenting feasibility and initial efficacy.,"The present case series examined a single-session, cognitive-behavioral anxiety sensitivity (AS) reduction program among five trauma-exposed adults. Participants (age range=19-37 years) reported significantly elevated levels of AS at baseline, a history of posttraumatic stress disorder Criterion A trauma exposure, and no current Axis I psychopathology. The outcomes of the preventive intervention were examined with regard to 3-month postintervention changes in AS, posttraumatic stress, panic attack frequency and severity, negative affect levels, and behavioral functioning and impairment. Results demonstrated decreases in each of the studied outcomes over the examined time period. This preliminary yet uncontrolled data provides empirical evidence of the feasibility and support for the utilization of a brief AS reduction intervention program to target anxiety-related vulnerability among trauma-exposed adults.",Vujanovic AA.; Bernstein A.; Berenz EC.; Zvolensky MJ.,2012.0,10.1016/j.beth.2012.03.005,0,0,
2942,Affect intensity: Association with anxious and fearful responding to bodily sensations,"The present investigation evaluated affect intensity in regard to anxious and fearful responding to a voluntary hyperventilation paradigm. Participants were 90 young adults without a history of Axis I psychopathology or nonclinical panic attacks. The incremental validity of affect intensity was examined relative to gender, negative affectivity, anxiety sensitivity, and anticipatory anxiety. As hypothesized, affect intensity significantly and incrementally predicted the perceived intensity of post-challenge panic-relevant physical and cognitive symptoms but not physiological arousal. Findings are discussed in relation to better understanding the role of affect intensity as a potential risk factor for panic-related problems. © 2005 Elsevier Inc. All rights reserved.",Vujanovic A.A.; Zvolensky M.J.; Gibson L.E.; Lynch T.R.; Leen-Feldner E.W.; Feldner M.T.; Bernstein A.,2006.0,10.1016/j.janxdis.2004.12.002,0,0,
2943,Posttraumatic stress symptoms and cigarette deprivation in the prediction of anxious responding among trauma-exposed smokers: a laboratory test,"ER METHODSParticipants were 63 daily smokers (46.0% women; M(age) = 30.79, SD = 13.12, range = 18-60) who reported experiencing one or more traumatic events. The study consisted of two laboratory sessions. At the first session, participants were administered a structured diagnostic interview and completed self-reported measures. Eligible participants were randomly assigned to one of two conditions for the second session: (a) 12-hr cigarette deprivation or (b) noncigarette deprivation (i.e., smoking as usual). At the second session, participants' smoking status was biochemically verified, and all eligible participants then were administered the 10% CO?-enriched air laboratory challenge protocol.RESULTSThe main and interactive effects of posttraumatic stress symptom severity and the smoking-as-usual condition--not the hypothesized 12-hr cigarette deprivation condition--were significantly predictive of peri-challenge anxiety. The interactive effect of posttraumatic stress by smoking as usual was significant at Minutes 3 and 4 of the challenge specifically.CONCLUSIONSThe present investigation provided novel findings related to the roles of cigarette deprivation and smoking with regard to self-reported anxious responding, among trauma-exposed smokers, during a challenge paradigm.INTRODUCTIONThe present investigation examined the main and interactive effects of posttraumatic stress symptom severity and 12-hr cigarette deprivation (cf. smoking as usual) in the prediction of anxious responding during a 4-min 10% carbon dioxide (CO?)-enriched air laboratory challenge. It was hypothesized that 12-hr cigarette deprivation would exacerbate the effects of posttraumatic stress symptom severity with regard to anxious responding during the challenge.","Vujanovic, A A; Marshall-Berenz, E C; Beckham, J C; Bernstein, A; Zvolensky, M J",2010.0,10.1093/ntr/ntq154,0,0,
2944,Posttraumatic stress and alcohol use coping motives among a trauma-exposed community sample: The mediating role of non-judgmental acceptance,"The current investigation evaluated (1) the incremental predictive validity of non-judgmental acceptance in terms of alcohol use coping motives and (2) the mediating role of non-judgmental acceptance in the association between posttraumatic stress symptom severity and alcohol use coping motives. Participants included 153 (79 women) adults who reported exposure to at least one DSM-IV PTSD Criterion A traumatic life event and alcohol use in the past month. Non-judgmental acceptance emerged as a significant incremental predictor of alcohol use coping motives. Furthermore, non-judgmental acceptance partially mediated the association between posttraumatic stress symptom severity and alcohol use coping motives. Theoretical and clinical implications of the findings are discussed with regard to better understanding the co-occurrence of posttraumatic stress and alcohol use disorders. © 2011.",Vujanovic A.A.; Bonn-Miller M.O.; Marlatt G.A.,2011.0,10.1016/j.addbeh.2011.01.033,0,0,
2945,Testing sex-specific pathways from peer victimization to anxiety and depression in early adolescents through a randomized intervention trial,"ER The aim of this study was to test for sex differences in the role of physical and relational victimization in anxiety and depression development through a randomized prevention trial. 448 seven-year-old boys and girls were randomly assigned to the Good Behavior Game intervention, a two-year universal classroom based intervention aimed at reducing disruptive behavior problems and creating a safe and predictable classroom environment, or to a control condition. Assessments of self-reported physical and relational victimization at age 10 years, and self-reported major depressive disorder, generalized anxiety, social anxiety, and panic/agoraphobia symptoms at age 13 years were available. Reductions in anxiety/depression were mediated by reduced rates of relational victimization in girls, whereas reductions in physical victimization accounted for the reduced anxiety/depression scores among boys. The results support sex-specific pathways of victimization leading to anxiety and depression.","Vuijk, P; Lier, P A; Crijnen, A A; Huizink, A C",2007.0,10.1016/j.jad.2006.11.003,0,0,
2946,Belief bias and the extinction of induced fear,"Some people show slower extinction of UCS expectancies than other people. Little is known about what predicts such delayed extinction. Extinction requires that people deduce the logical implication of corrective experiences challenging the previously learned CS-UCS contingency. ""A strong habitual tendency to confirm beliefs"" may therefore be a powerful mechanism immunising against refutation of UCS expectancies. This study investigated whether individual differences in such a belief confirming tendency (a process called ""belief bias"") may help in explaining individual differences in extinction. We tested whether relatively strong belief bias predicts delayed extinction of experimentally induced UCS expectancies. In a differential aversive conditioning paradigm, we used UCS-irrelevant (Experiment 1) and UCS-relevant (Experiment 2) pictorial stimuli as CS+ and CS-, and electrical stimulation as UCS. Belief bias indeed predicted delayed extinction of UCS expectancies when the CS+ was UCS-relevant (as is typically the case for phobic stimuli, Experiment 2). The study provides preliminary evidence that enhanced belief bias may indeed play a role in the persistence of UCS expectancies, and can thereby contribute to the development and persistence of anxiety disorders. The results also point to the relevance of reasoning tendencies in the search for predictors of delayed extinction of UCS expectancies. © 2013 Taylor & Francis.",Vroling M.S.; de Jong P.J.,2013.0,10.1080/02699931.2013.792245,0,0,
2947,"Will the truth come out? the effect of deception, age, status, coaching, and social skills on CBCA scores","ER The impact of Veracity, Age, Status (witness or suspect), Coaching (informed or uninformed regarding CBCA), and Social Skills (social anxiety, social adroitness, and self-monitoring) on Criteria-Based Content Analysis scores was examined. Participants (aged 5-6, 10-11, 14-15, and undergraduates) participated in a ""rubbing the blackboard"" event. In a subsequent interview they told the truth or lied about the event. They were accused of having rubbed the blackboard themselves (suspect condition) or were thought to have witnessed the event (witness condition), and were or were not taught some CBCA criteria prior to the interview. CBCA scores discriminated between liars and truth tellers in children, adults, witnesses, and suspects. However, truth tellers obtained higher CBCA scores than liars only when the liars were uninformed about CBCA. CBCA scores were correlated with social skills. It is argued that thesefindings should caution those who believe that the validity of CBCA has been conclusively demonstrated.","Vrij, A; Akehurst, L; Soukara, S; Bull, R",2002.0,,0,0,
2948,Regulating emotion during imaginal exposure to social anxiety: impact of the specificity of information processing.,"The present study investigates the emotional impact of a specific vs. generic mode of information processing during imaginal exposure. Forty-nine socially anxious students mentally relived a personally experienced stressful social situation. Half of the participants were instructed to activate generic elements of the target event (i.e., elements repetitively experienced in similar social situations); the other half had to recall the specific features of the target event. Results showed that participants who focused on specific elements reported less distress than those who focused on generic features. Clinical implications are discussed.",Vrielynck N.; Philippot P.,2009.0,10.1016/j.jbtep.2008.12.006,0,0,
2949,A preliminary RCT of a mind body skills based intervention addressing mood and coping strategies in patients with acute orthopaedic trauma.,"To test the acceptability and feasibility of a mind body skills-based intervention (RRCB) and estimate its preliminary effect in reducing disability and pain intensity as compared to standard care (SC) in patients with acute musculoskeletal trauma. Randomised controlled trial. Level I trauma centre. Adult patients with acute fractures at risk for chronic pain and disability based on scores on two coping with pain measures who presented to an orthopedic trauma center and met inclusion and exclusion criteria. Participants were randomied to either RRCB with SC or SC alone. Disability (short musculoskeletal functional assessment, SMFA) and pain (Numerical Analogue Scale). coping strategies (Pain Catastrophizing Scale, PCS and Pain Anxiety Scale, PAS) and mood (CESD Depression and PTSD checklist). Among the 50 patients consented, two did not complete the initial assessment. Of these, the first four received the intervention as part of an open pilot and the next 44 were randomised (24 RRCBT and 20 UC) and completed initial assessment. We combined the patients who received RRCB into one group, N=28. Of the entire sample, 34 completed time two assessments (24 RRCBT and 10 SC). The RRCB proved to be feasible and accepted (86% retention, 28 out of 24 completers). Analyses of covariance ANCOVA showed a significant (p<05) improvement and large effect sizes for all time two main study variables (.2-.5) except pain with activity where the effect size was medium (.08). Improvement for pain at rest was not significantly higher in the RRCB as compared to the control, for a small effect size (.03). The RRCB is feasible, acceptable and potentially efficacious. Level 1 prognostic.",Vranceanu AM.; Hageman M.; Strooker J.; ter Meulen D.; Vrahas M.; Ring D.,2015.0,10.1016/j.injury.2014.11.001,0,0,
2950,Mind-body therapy via videoconferencing in patients with neurofibromatosis: an RCT,"ER METHODS: Sixty-three patients completed baseline assessments and were randomized. Primary outcomes were physical health and psychological quality of life (QoL), measured by the WHOQOL-BREF (World Health Organization QoL abbreviated instrument). Secondary outcomes were social relations and environment QoL, depression, anxiety, pain intensity, and pain interference.RESULTS: Sixty-three participants completed the intervention (100%) and 52 the 6-month follow-up (82.5%). Acceptability was 4.1 (5-point scale). Patients in the 3RP-NF showed greater improvement in physical health QoL (7.69; 95% confidence interval [CI]: 0.29-15.10; p = 0.040), psychological QoL (5.57; 95% CI: 0.17-11.34; p = 0.056), social relations QoL (10.95; 95% CI: 1.57-20.31; p = 0.021), environment QoL (8.02; 95% CI: 2.57-13.48; p = 0.005), and anxiety (-2.32; 95% CI: -3.96 to 0.69; p = 0.006) compared to those in HEP-NF, and gains were maintained at follow-up. Patients in the 3RP-NF did not improve more than those in HEP-NF on depression, with both groups showing improvement. Patients in the 3RP-NF with baseline pain ?5 of 10 showed improvement in pain intensity from baseline to posttest (1.30; 95% CI: -2.26 to -0.34; p = 0.009) with effects maintained at follow-up; this improvement was not greater than that in HEP-NF. There were more treatment responders in the 3RP-NF group (p < 0.05).CONCLUSIONS: The 3RP-NF delivered via videoconferencing was highly feasible and accepted by patients, and resulted in sustained improvement in QoL.CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that for patients with NF, a mind-body program is superior to an attention placebo control in improving QoL.OBJECTIVE: To test, within a single-blind randomized controlled trial, the feasibility, acceptability, efficacy, and durability of a mind-body program (the Relaxation Response Resiliency Program for neurofibromatosis [3RP-NF]) vs an attention placebo control (Health Enhancement Program for NF [HEP-NF]), both delivered via group videoconferencing.","Vranceanu, A M; Riklin, E; Merker, V L; Macklin, E A; Park, E R; Plotkin, S R",2016.0,10.1212/WNL.0000000000003005,0,0,
2951,Early cerebral monitoring using the transcranial Doppler pulsatility index in patients with severe brain trauma.,"The early posttraumatic period is critical in patients with traumatic brain injury (TBI) because of the increased risk of secondary ischemic injuries to the injured brain. For these patients, cerebral perfusion pressure (CPP) monitoring is recommended. This, however, requires an invasive device to measure intracranial pressure (ICP). Transcranial Doppler (TCD) ultrasonography is an effective, noninvasive method for the detection of cerebral hemodynamic changes. Use of the dimensionless TCD-pulsatility index (PI) has the advantage of eliminating errors in measurements due to insonation angle variations. We investigated 37 patients with severe TBI (GCS < or = 8 on admission). The TCD parameters included the systolic, diastolic, and mean velocities of the middle cerebral artery (MCV) and the pulsatility index (PI). Mean arterial pressure (MAP), ICP, CPP, and simultaneous arterial and venous blood gases were also measured. We observed a strong correlation between ICP and PI (r = 0.82, p < 0.0001) for ICP values >20 mmHG. The correlation of CPP to PI were also statistically significant (P < 0.0001). The strongest inverse correlation between CPP and PI was obtained (r = 0.86, p < 0.0001) for CPP values below 70 mmHg. Pulsatility index measurements permit the early identification of patients with low CPP and high risk of cerebral ischemia. In emergency situations it can be used alone when ICP monitoring is contraindicated or not readily available.",Voulgaris SG.; Partheni M.; Kaliora H.; Haftouras N.; Pessach IS.; Polyzoidis KS.,2005.0,,0,0,
2952,Prevention of postoperative anxiety and depression.,,Voulgari A.; Papanikolaou MN.; Lykouras L.; Alevizos B.; Alexiou E.; Christodoulou GN.,1994.0,,0,0,
2953,Prevention of postoperative anxiety and depression,,"Voulgari, A; Papanikolaou, M N; Lykouras, L; Alevizos, B; Alexiou, E; Christodoulou, G N",1994.0,,0,0,2952
2954,A randomized clinical trial of cognitive behavioral therapy and interpersonal psychotherapy for panic disorder with agoraphobia.,"Interpersonal psychotherapy (IPT) seems to be as effective as cognitive behavioral therapy (CBT) in the treatment of major depression. Because the onset of panic attacks is often related to increased interpersonal life stress, IPT has the potential to also treat panic disorder. To date, a preliminary open trial yielded promising results but there have been no randomized controlled trials directly comparing CBT and IPT for panic disorder. This study aimed to directly compare the effects of CBT versus IPT for the treatment of panic disorder with agoraphobia. Ninety-one adult patients with a primary diagnosis of DSM-III or DSM-IV panic disorder with agoraphobia were randomized. Primary outcomes were panic attack frequency and an idiosyncratic behavioral test. Secondary outcomes were panic and agoraphobia severity, panic-related cognitions, interpersonal functioning and general psychopathology. Measures were taken at 0, 3 and 4 months (baseline, end of treatment and follow-up). Intention-to-treat (ITT) analyses on the primary outcomes indicated superior effects for CBT in treating panic disorder with agoraphobia. Per-protocol analyses emphasized the differences between treatments and yielded larger effect sizes. Reductions in the secondary outcomes were equal for both treatments, except for agoraphobic complaints and behavior and the credibility ratings of negative interpretations of bodily sensations, all of which decreased more in CBT. CBT is the preferred treatment for panic disorder with agoraphobia compared to IPT. Mechanisms of change should be investigated further, along with long-term outcomes.",Vos SP.; Huibers MJ.; Diels L.; Arntz A.,2012.0,10.1017/S0033291712000876,0,0,
2955,Experimental investigation of targeting responsibility versus danger in cognitive therapy of obsessive-compulsive disorder.,"Cognitive therapy (CT) for obsessive-compulsive disorder (OCD) has shown to be effective in diminishing OCD symptoms, but there is little known about the individual contributions of the specific treatment targets to CTtreatment outcome. Two of the treatment targets of CTare overestimations of danger and inflated beliefs of personal responsibility. No studies to date have investigated the relative efficacy of targeting inflated beliefs of personal responsibility compared to the overestimation of danger in the treatment of OCD. The aim of the present study was to experimentally investigate the relative efficacy of targeting inflated beliefs of responsibility (CT-R) versus targeting overestimations of danger (CT-D) in the cognitive treatment of DSM-III/DSM-IV OCDwith overt compulsions. We conducted a randomized trial of CT-D (N = 38) versus CT-R (N = 40). Outcomes were change in OCDsymptoms and behavior, cognitions, and general psychopathology. The results showed that patients in both conditions improved significantly on all measures. Overall improvement effect sizes were large, percentages of clinically improved patients moderate. No differences between conditions were found. These initial results suggest that both treatment targets are of value to the cognitive treatment of OCD.",Vos SP.; Huibers MJ.; Arntz A.,2012.0,10.1002/da.21915,0,0,
2956,A randomized clinical trial of cognitive behavioral therapy and interpersonal psychotherapy for panic disorder with agoraphobia.,"Background: Interpersonal psychotherapy (IPT) seems to be as effective as cognitive behavioral therapy (CBT) in the treatment of major depression. Because the onset of panic attacks is often related to increased interpersonal life stress, IPT has the potential to also treat panic disorder. To date, a preliminary open trial yielded promising results but there have been no randomized controlled trials directly comparing CBT and IPT for panic disorder. Method: This study aimed to directly compare the effects of CBT versus IPT for the treatment of panic disorder with agoraphobia. Ninety-one adult patients with a primary diagnosis of DSM-III or DSM-IV panic disorder with agoraphobia were randomized. Primary outcomes were panic attack frequency and an idiosyncratic behavioral test. Secondary outcomes were panic and agoraphobia severity, panic-related cognitions, interpersonal functioning and general psychopathology Measures were taken at 0, 3 and 4 months (baseline, end of treatment and follow-up) Results: Intention-to-treat (ITT) analyses on the primary outcomes indicated superior effects for CBT in treating panic disorder with agoraphobia. Per-protocol analyses emphasized the differences between treatments and yielded larger effect sizes Reductions in the secondary outcomes were equal for both treatments, except for agoraphobic complaints and behavior and the credibility ratings of negative interpretations of bodily sensations, all of which decreased more in CBT. Conclusions: CBT is the preferred treatment for panic disorder with agoraphobia compared to IPT Mechanisms of change should be investigated further, along with long-term outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Vos, S. P. F; Huibers, M. J. H; Diels, L; Arntz, A; Arntz, Arrindell, Barlow, Barlow, Beck, Beck, Borkovec, Bouman, Chambless, Clark, Clark, Clark, Cohen, Craske, Derogatis, Devilly, Elkin, Elkin, Evers, Fairbum, Faravelli, First, First, Goisman, Hill, Hollon, Hollon, Hollon, Horowitz, Jacobson, Klerman, Lipsitz, Luty, Marks, Metzger, Norman, Pollard, Reiss, Shear, Shear, Shear, Spielberger, Van den Hout, Weissman, Wilcox, Wilfley",2012.0,,0,0,
2957,The effect of regular walks on various health aspects in older people with dementia: protocol of a randomized-controlled trial,"ER METHODS/DESIGNThis study is a longitudinal randomized controlled, single blind study. Ambulatory older people with dementia, who are regular visitors of daily care or living in a home for the elderly or nursing home in the Netherlands, will be randomly allocated to the experimental or control condition. Participants of the experimental group make supervised walks of 30 minutes a day, 5 days a week, as part of their daily nursing care. Participants of the control group will come together three times a week for tea or other sedentary activities to control for possible positive effects of social interaction. All dependent variables will be assessed at baseline and after 6 weeks, and 3, 6, 9, 12 and 18 months of intervention. The dependent variables include neuropsychological tests to assess cognition, physical tests to determine physical functioning, questionnaires to assess ADL, QoL, level of depression and anxiety, actigraphy to assess rest-activity rhythm and pain scales to determine pain levels. Potential moderating variables at baseline are: socio-demographic characteristics, body mass index, subtype of dementia, apolipoprotein E (ApoE) genotype, medication use and comorbidities.DISCUSSIONThis study evaluates the effect of regular walking as a treatment for older people with dementia. The strength of this study is that 1) it has a longitudinal design with multiple repeated measurements, 2) we assess many different health aspects, 3) the intervention is not performed by research staff, but by nursing staff which enables it to become a routine in usual care. Possible limitations of the study are that 1) only active minded institutions are willing to participate creating a selection bias, 2) the drop-out rate will be high in this population, 3) not all participants will be able to perform/understand all tests.TRIAL REGISTRATIONNTR1482.BACKGROUNDPhysical activity has proven to be beneficial for physical functioning, cognition, depression, anxiety, rest-activity rhythm, quality of life (QoL), activities of daily living (ADL) and pain in older people. The aim of this study is to investigate the effect of walking regularly on physical functioning, the progressive cognitive decline, level of depression, anxiety, rest-activity rhythm, QoL, ADL and pain in older people with dementia.","Volkers, K M; Scherder, E J",2011.0,10.1186/1471-2318-11-38,0,0,
2958,Parity of publication for psychiatry,"Background There is an established disparity between physical and mental healthcare. Parity of research outputs has not been assessed internationally across influential medical journals. Aims To assess parity of publication between physical and mental health, and within psychiatry. Method Four major medical disciplines were identified and their relative burden estimated. All publications from the highestimpact general medical journals in 2001, 2006 and 2011 were categorised accordingly. The frequency of psychiatry, cardiology, oncology and respiratory medicine articles were compared with the expected proportion (given illness burdens). Six subspecialties within psychiatry were also compared. Results Psychiatry was consistently and substantially underrepresented; other specialties were overrepresented. Dementia and psychosis demonstrated overrepresentation, with addiction and anxiety disorders represented proportionately and other disorders underrepresented. The underrepresentation of mood disorders increased more recently. Conclusions There appears to be an important element of disparity of esteem; further action is required to achieve equivalence between mental and physical health research publications.",Vivekanantham S.; Strawbridge R.; Rampuri R.; Ragunathan T.; Young A.H.,2016.0,10.1192/bjp.bp.115.165118,0,0,
2959,Evaluation of an outpatient intervention for women with severe depression and a history of childhood trauma,"ER METHODS: Eighty-seven women who sought treatment from a public health service in Curicó, Chile, and who had severe depression and a history of childhood traumatic experiences were randomly assigned to receive either the intervention (N=44) or standard treatment (N=43). The participants were assessed at baseline and at three months (completion of the intervention) and six months with use of the Hamilton Depression Scale (Ham-D); Lambert's Outcome Questionnaire (OQ-45.2), which rates psychiatric symptoms, interpersonal relationships, and social role functioning; and the Post-traumatic Stress Treatment Outcome scale (PTO 8), which assesses symptoms of posttraumatic stress disorder. An intent-to-treat design was used with multiple analyses of variance.RESULTS: At three months significant differences were found in favor of the intervention group in Ham-D scores (p<.001) and OQ-45.2 scores (p<.05). At six months a significantly greater proportion of the intervention group had indicators of remission as measured by the OQ-45.2 (39% versus 14%, p<.05) and by the Ham-D (22% versus 5%, p<.05). Scores on the PTO 8 indicated significant improvements in posttraumatic stress disorder symptoms at six months, although there were no significant differences between the groups.CONCLUSIONS: An outpatient intervention that screened for and focused on childhood traumas and that helped patients understand current psychosocial difficulties as a repetition of past traumas was effective in reducing psychiatric symptoms and improving interpersonal relationships and social role functioning among women with severe depression and a history of childhood trauma.OBJECTIVE: The study examined the effectiveness of a three-month structured outpatient intervention developed for women with severe depression and childhood trauma that used brief psychodynamic psychotherapy by comparing it to standard treatment recommended in clinical guidelines issued by the Chilean Ministry of Health.","Vitriol, V G; Ballesteros, S T; Florenzano, R U; Weil, K P; Benadof, D F",2009.0,10.1176/ps.2009.60.7.936,0,0,
2960,Efficacy and associated costs of an outpatient intervention in women with severe depression and early trauma,"ER AIMTo compare the efficacy and costs associated with a treatment that enquires directly into childhood trauma and understands present interpersonal difficulties as a compulsion to repeat the traumatic past, versus the usual treatment, in women with severe depression and childhood trauma.MATERIAL AND METHODSEighty seven women with depression and prior history of early trauma that sought help at the Mental Health Unit of the Hospital de Curicó were studied. Forty four were randomly assigned to the experimental treatment, and 43 to the usual management. Patients were evaluated using the Hamilton Depression Scale, the Outcome Questionnaire (OQ 45.2) and an expenditures sheet at baseline, three and six months. An intention to treat analysis and a simple cost-analysis were performed.RESULTSHamilton and OQ 45.2 scores improved in both treatment groups, with significantly better results achieved in the experimental patients. The direct overall costs of experimental and control treatments were CLP 8,628,587 and 9,688,240, respectively. The main contributors to costs in both arms were medications (26.5%), followed by the number of psychiatric consultations (19.2%) in the experimental group and by hospitalizations (25.4%) in the control group. The costs per patient recovered in experimental and control groups were CLP 616,328 and 1,973,649, respectively.CONCLUSIONSThe proposed model resulted more effective for the treatment of this group of women.BACKGROUNDA high proportion of women consulting for depression have a history of childhood abuse and trauma.","Vitriol, G V; Cancino, A A; Florenzano, U R; Ballesteros, T S; Schwartz, P D",2010.0,,0,0,
2961,Cognitive endophenotypes in OCD: A study of unaffected siblings of probands with familial OCD,"Background: Impairments in executive functions and non-verbal memory are considered potential endophenotype markers of obsessive-compulsive disorder (OCD). For the neuropsychological deficits to be considered endophenotypes, they should be demonstrable in unaffected family members. Aim: To compare the neuropsychological performance in unaffected siblings of probands with familial OCD with that of individually matched healthy controls. Methods: Twenty-five unaffected siblings of OCD probands with familial OCD, and 25 individually matched healthy controls were assessed with tests of attention, executive function, memory and intelligence. Results: Unaffected siblings showed significant deficits in tests of decision making and behavioural reversal i.e., the Iowa Gambling Task (IGT) and the Delayed Alternation Test (DAT) respectively, but performed adequately in other tests. Conclusions: Our study suggests that the deficits in decision making and behavioural reversal could be potential endophenotypes in OCD. These deficits are consistent with the proposed neurobiological model of OCD involving the orbitofrontal cortex. Future studies could couple cognitive and imaging strategies to identify neurocognitive endophenotypes in homogenous samples of OCD. © 2009 Elsevier Inc. All rights reserved.",Viswanath B.; Janardhan Reddy Y.C.; Kumar K.J.; Kandavel T.; Chandrashekar C.R.,2009.0,10.1016/j.pnpbp.2009.02.018,0,0,
2962,Psychosocial functioning of adolescents with idiopathic short stature or persistent short stature born small for gestational age during three years of combined growth hormone and gonadotropin-releasing hormone agonist treatment,ER METHODSThirty-eight adolescents participated in a controlled trial with GH/GnRHa treatment or no intervention. Each year the adolescents and their parents completed questionnaires and structured interviews. Multilevel analysis was used to analyze data.RESULTSThe adolescents of the treatment group showed a worse outcome than the adolescents of the control group on 3 of 16 variables: perceived competence of scholastic (p < 0.01) and athletic ability (p < 0.05) and trait anxiety (p < 0.05). Adolescents in both the treatment and control groups perceived improved current height (p < 0.001) and self-appraisal of physical appearance (p < 0.05). The parents did not report changes in their children during treatment.CONCLUSIONThe observation of some adverse psychological consequences as experienced by the adolescents indicates that it is useful to monitor psychosocial functioning during a combined GH/GnRHa treatment in adolescents with ISS or SGA. It is uncertain whether the hypothesized positive effects of the expected gain in final height by adulthood can sufficiently counterbalance possible short-term negative effects.AIMTo examine psychosocial functioning of medically referred adolescents with idiopathic short stature (ISS) or persistent short stature born small for gestational age (SGA) during 3 years of combined growth hormone (GH) and gonadotropin-releasing hormone agonist (GnRHa) treatment.,"Visser-van, Balen H; Geenen, R; Moerbeek, M; Stroop, R; Kamp, G A; Huisman, J; Wit, J M; Sinnema, G",2005.0,10.1159/000087700,0,0,
2963,The effects of parental components in a trauma-focused cognitive behavioral based therapy for children exposed to interparental violence: study protocol for a randomized controlled trial,"ER BACKGROUND: Interparental violence is both common and harmful and impacts children's lives directly and indirectly. Direct effects refer to affective, behavioral, and cognitive responses to interparental violence and psychosocial adjustment. Indirect effects refer to deteriorated parental availability and parent-child interaction. Standard Trauma Focused Cognitive Behavioral Therapy may be insufficient for children traumatized by exposure to interparental violence, given the pervasive impact of interparental violence on the family system. HORIZON is a trauma focused cognitive behavioral therapy based group program with the added component of a preparatory parenting program aimed at improving parental availability; and the added component of parent-child sessions to improve parent-child interaction.METHODS/DESIGN: This is a multicenter, multi-informant and multi-method randomized clinical trial study with a 2 by 2 factorial experimental design. Participants (N?=?100) are children (4-12 years), and their parents, who have been exposed to interparental violence. The main aim of the study is to test the effects of two parental components as an addition to a trauma focused cognitive behavioral based group therapy for reducing children's symptoms. Primary outcome measures are posttraumatic stress symptoms, and internalizing and externalizing problems in children. The secondary aim of the study is to test the effect of the two added components on adjustment problems in children and to test whether enhanced effects can be explained by changes in children's responses towards experienced violence, in parental availability, and in quality of parent-child interaction. To address this secondary aim, the main parameters are observational and questionnaire measures of parental availability, parent-child relationship variables, children's adjustment problems and children's responses to interparental violence. Data are collected three times: before and after the program and six months later. Both intention-to-treat and completer analyses will be done.DISCUSSION: The current study will enhance our understanding of the efficacy interparental violence-related parental components added to trauma focused cognitive behavioral group program for children who have been exposed to IPV. It will illuminate mechanisms underlying change by considering multiple dimensions of child responses, parenting variables and identify selection criteria for participation in treatment.TRIAL REGISTRATION: Netherlands Trial Register NTR4015 . Registered 4th of June, 2013.","Visser, M M; Telman, M D; Schipper, J C; Lamers-Winkelman, F; Schuengel, C; Finkenauer, C",2015.0,10.1186/s12888-015-0533-7,0,0,
2964,To Fear Is to Gain? The Role of Fear Recognition in Risky Decision Making in TBI Patients and Healthy Controls.,"Fear is an important emotional reaction that guides decision making in situations of ambiguity or uncertainty. Both recognition of facial expressions of fear and decision making ability can be impaired after traumatic brain injury (TBI), in particular when the frontal lobe is damaged. So far, it has not been investigated how recognition of fear influences risk behavior in healthy subjects and TBI patients. The ability to recognize fear is thought to be related to the ability to experience fear and to use it as a warning signal to guide decision making. We hypothesized that a better ability to recognize fear would be related to a better regulation of risk behavior, with healthy controls outperforming TBI patients. To investigate this, 59 healthy subjects and 49 TBI patients were assessed with a test for emotion recognition (Facial Expression of Emotion: Stimuli and Tests) and a gambling task (Iowa Gambling Task (IGT)). The results showed that, regardless of post traumatic amnesia duration or the presence of frontal lesions, patients were more impaired than healthy controls on both fear recognition and decision making. In both groups, a significant relationship was found between better fear recognition, the development of an advantageous strategy across the IGT and less risk behavior in the last blocks of the IGT. Educational level moderated this relationship in the final block of the IGT. This study has important clinical implications, indicating that impaired decision making and risk behavior after TBI can be preceded by deficits in the processing of fear.",Visser-Keizer AC.; Westerhof-Evers HJ.; Gerritsen MJ.; van der Naalt J.; Spikman JM.,2016.0,10.1371/journal.pone.0166995,0,0,
2965,Inference-Based Approach versus Cognitive Behavioral Therapy in the Treatment of Obsessive-Compulsive Disorder with Poor Insight: A 24-Session Randomized Controlled Trial.,"Obsessive-compulsive disorder (OCD) with poor insight has severe consequences for patients; nonetheless, no randomized controlled trial has ever been performed to evaluate the effectiveness of any treatment specifically for poor-insight OCD. A new psychotherapy for OCD, the inference-based approach (IBA), targets insight in OCD by strengthening normal sensory-driven reality testing. The goal of the present study is to compare the effectiveness of this new treatment to the effectiveness of cognitive behavior therapy (CBT) for patients with OCD with poor insight. A randomized controlled trial was conducted, in which 90 patients with OCD with poor insight received either 24 CBT sessions or 24 IBA sessions. The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (YBOCS). Secondary outcome measures were level of insight, anxiety and depressive symptoms, and quality of life. Mixed-effects models were used to determine the treatment effect. In both conditions, a significant OCD symptom reduction was reached, but no condition effects were established. Post hoc, in a small subgroup of patients with the worst insight (n = 23), it was found that the patients treated with the IBA reached a significantly higher OCD symptom reduction than the patients treated with CBT [estimated marginal mean = -7.77, t(219.45) = -2.4, p = 0.017]. Patients with OCD with poor insight improve significantly after psychological treatment. The results of this study suggest that both CBT and the IBA are effective treatments for OCD with poor insight. The IBA might be more promising than CBT for patients with more extreme poor insight.",Visser HA.; van Megen H.; van Oppen P.; Eikelenboom M.; Hoogendorn AW.; Kaarsemaker M.; van Balkom AJ.,2015.0,10.1159/000382131,0,0,
2966,Low-vision rehabilitation by means of MP-1 biofeedback examination in patients with different macular diseases: a pilot study.,"Macular disease is one of the main causes of visual impairment. We studied the efficacy of low-vision rehabilitation by means of MP-1 biofeedback examination in patients with different macular disease. Five patients were enrolled (3 female and 2 male, mean age 53.8 years) and a total of 9 eyes was examined: 2 eyes with vitelliform dystrophy, 1 with a post-traumatic macular scar, 2 with Stargardt disease, 2 with myopic macular degeneration, 2 with cone dystrophy. All the patients underwent the following tests: visual acuity, reading speed, fixation test, MP-1 microperimetry. Low-vision rehabilitation, which lasted 10 weeks, consisted of 10 training sessions of 10 min for each eye, performed once a week using the MP-1 biofeedback examination. Statistical analysis was performed using Student's t-test. p values less than 0.05 were considered statistically significant. After training all patients displayed an improvement in visual acuity, fixation behaviour, retinal sensitivity and reading speed. Fixation behaviour within the 2 degrees diameter circle improved and was statistically significant for reading speed (p = 0.01). Reading speed improved from a mean value of 64.3 to 92 words/min. Our results show that audio feedback can, by increasing attentional modulation, help the brain to fix the final preferred retinal locus. Audio feedback facilitates stimuli transmission between intraretinal neurons as well as between the retina and brain, which is where the highest level of stimuli processing occurs, thereby probably supporting a ""remapping phenomenon"".",Vingolo EM.; Salvatore S.; Cavarretta S.,2009.0,10.1007/s10484-009-9083-4,0,0,
2967,Stereotypes in the judgement of personality from handwriting.,,Vine I.,1974.0,,0,0,
2968,"Resistance exercise, disability, and pain catastrophizing in obese adults with back pain","ER PURPOSE: The purpose of this study was to compare the effects of two different resistance exercise protocols on self-reported disability, fear avoidance beliefs, pain catastrophizing, and back pain symptoms in obese, older adults with low back pain (LBP).METHODS: Obese adults (n = 49, 60-85 yr) with chronic LBP were randomized into a total body resistance exercise intervention (TOTRX), lumbar extensor exercise intervention (LEXT), or a control group (CON). Main outcomes included perceived disability (Oswestry Disability Index, Roland Morris Disability Questionnaire). Psychosocial measures included the Fear Avoidance Beliefs survey, Tampa Scale of Kinesiophobia, and Pain Catastrophizing Scale. LBP severity was measured during three functional tasks: walking, stair climbing, and chair rise using an 11-point numerical pain rating scale.RESULTS: The TOTRX group had greater reductions in self-reported disability scores due to back pain (Oswestry Disability Index, Roland Morris Disability Questionnaire) compared with those in the LEXT (P < 0.05). The Pain Catastrophizing Scale scores decreased in the TOTRX group compared with that in the CON group by month 4 (64.3% vs 4.8%, P < 0.05). Pain severity during chair rise activity and walking was decreased in both the LEXT and TOTRX groups relative to the CON group.CONCLUSIONS: Greater reductions in perceived disability due to LBP can be achieved with TOTRX compared with those achieved with LEXT. Pain catastrophizing and pain severity decreased most with TOTRX. The positive change in psychological outlook may assist obese, older adults with chronic back pain in reconsidering the harmfulness of the pain and facilitate regular participation in other exercise programs.","Vincent, H K; George, S Z; Seay, A N; Vincent, K R; Hurley, R W",2014.0,10.1249/MSS.0000000000000294,0,0,
2969,Brain Derived Neurotrophic Factor (BDNF) levels as a possible predictor of psychopathology in healthy twins at high and low risk for affective disorder,"Brain Derived Neurotrophic Factor (BDNF) is a potential biomarker of affective disorder. However, longitudinal studies evaluating a potential predictive role of BDNF on subsequent psychopathology are lacking. The aim of this study was to investigate whether BDNF alone or in interaction with the BDNF Val66Met polymorphism predict onset of affective disorder in healthy individuals at heritable risk for affective disorder. In a high-risk study, we assessed whole blood levels of BDNF in 234 healthy monozygotic and dizygotic twins with or without a co-twin history of affective disorder (high and low risk twins, respectively). Participants were followed up longitudinally with questionnaires at 6-month intervals for mean seven years and then reassessed with a personal interview to obtain information about whether they had developed psychiatric illness. At follow-up 36 participants (15.4%) had developed psychiatric disorder. Cox regression analysis revealed that BDNF levels at baseline were not associated with onset of illness in this explorative study. Further, two-way interactions between BDNF levels and the Val66Met polymorphism or between familial risk and the Val66Met polymorphism did not predict illness onset.",Vinberg M.; Miskowiak K.; Kessing L.V.,2014.0,10.1016/j.psyneuen.2013.09.007,0,0,
2970,Acceptance and Commitment Therapy modules: differential impact on treatment processes and outcomes,"ER A modular, transdiagnostic approach to treatment design and implementation may increase the public health impact of evidence-based psychosocial interventions. Such an approach relies on algorithms for selecting and implementing treatment components intended to have a specific therapeutic effect, yet there is little evidence for how components function independent of their treatment packages when employed in clinical service settings. This study aimed to demonstrate the specificity of treatment effects for two components of Acceptance and Commitment Therapy (ACT), a promising candidate for modularization. A randomized, nonconcurrent, multiple-baseline across participants design was used to examine component effects on treatment processes and outcomes in 15 adults seeking mental health treatment. The ACT OPEN module targeted acceptance and cognitive defusion; the ACT ENGAGED module targeted values-based activation and persistence. According to Tau-U analyses, both modules produced significant improvements in psychiatric symptoms, quality of life, and targeted therapeutic processes. ACT ENGAGED demonstrated greater improvements in quality of life and values-based activation. ACT OPEN showed greater improvements in symptom severity, acceptance, and defusion. Both modules improved awareness and non-reactivity, which were mutually targeted, though using distinct intervention procedures. Both interventions demonstrated high treatment acceptability, completion, and patient satisfaction. Treatment effects were maintained at 3-month follow up. ACT components should be considered for inclusion in a modular approach to implementing evidence-based psychosocial interventions for adults.","Villatte, J L; Vilardaga, R; Villatte, M; Plumb, Vilardaga J C; Atkins, D C; Hayes, S C",2016.0,10.1016/j.brat.2015.12.001,0,0,
2971,A meta-analysis of efficacy and safety of pregabalin and clonazepam in the treatment of anxiety disorders,"OBJECTIVES: The purpose of this study was to evaluate the relative effi cacy and safety of pregabalin and clonazepam in the treatment of anxiety disorders. METHODS: A meta-analysis was performed with randomized clinical trials (RCTs) where pregabalin or clonazepam were used for any anxiety disorders. Effectiveness was assessed with the Hamilton Anxiety Rating Scale (HAM-A); safety with the frequency and type of adverse events (AEs). RCT were searched in July 2008 in Medline, EMBASE, PsycInfo, CINAHL and the Cochrane Collaboration. Two independent reviewers identifi ed the abstracts, full articles, and then extracted data; results were compared and settled through consensus. RCT included both drugs and its comparison with placebo. Odds ratios and weighted means differences (WMD) were calculated. Both, fi xed and random effects models were employed in the analysis. RESULTS: From 1893 abstracts, we obtained 40 RCT, 23 were excluded (unacceptable designs, insuffi cient outcome data, no placebo control) leaving 17. Seven pregabalin studies were used to evaluate its effectiveness and safety; four clonazepam studies for effectiveness and six for safety. Clonazepam studies included panic disorder and social phobia. Six of seven pregabalin studies were in generalized anxiety disorder and one for social anxiety disorder. We found that both drugs signifi cantly diminished anxiety levels after four to 32 weeks of treatment. Among clonazepam studies the frequency of AEs was higher than placebo by nearly 50%; with pregabalin, less than 30%. We didn't found any headto- head studies with pregabalin and clonazepam and no statistical difference in anxiety level reduction was distinguished between drugs, WMD in HAM-A: 1.2(CI95% ?1.13, 3.54). However, clonazepam showed higher AE rates than pregabalin in somnolence (OR 0.54; 95%CI 0.44-0.66), headache (OR 0.50; 0.34-0.74), blurred vision (OR 0.36; 0.13-0.98) and cognitive impairment (OR 0.25; 0.09-0.72). CONCLUSIONS: Clonazepam and pregabalin are effective in diminishing anxiety levels in several anxiety disorders, although clonazepam seems to cause a higher frequency of AEs.",Villasis-Keever M.A.; Rivas-Ruiz R.; Mould-Quevado J.,2009.0,10.1111/j.1524-4733.2009.00537-2.x,0,0,
2972,"Efficacy of quetiapine monotherapy in posttraumatic stress disorder: A randomized, placebo-controlled trial.","Objective: This was a 12-week randomized, placebo-controlled trial to assess the efficacy of quetiapine monotherapy in the treatment of posttraumatic stress disorder (PTSD). Method: Eighty patients were randomly assigned to treatment with either quetiapine or placebo. The primary outcome measure was the Clinician-Administered PTSD Scale (CAPS). Secondary efficacy measures included the CAPS subscales, the Davidson Trauma Scale, the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impressions (CGI) scales for severity of Illness and improvement, the Hamilton Depression Rating Scale (HAM-D), and the Hamilton Anxiety Rating Scale (HAM-A). Safety measurements included adverse events, vital signs, the Abnormal Involuntary Movement Scale, the Barnes Akathisia Scale, the Simpson-Angus Scale, and the Arizona Sexual Experiences Scale. Results:After a 1-week placebo run-in, quetiapine was started at a daily dosage of 25 mg and increased to a maximum of 800 mg; the average was 258 mg (range, 50-800 mg). Reductions in CAPS total, re-experiencing, and hyperarousal scores were significantly greater for the quetiapine group than for the placebo group. Greater improvements were also observed for quetiapine in scores on the Davidson Trauma Scale, CGI severity and improvement ratings, PANSS positive symptom and general psychopathology subscales, HAM-A, and HAM-D than for placebo. Adverse events were generally mild and expected based on prior studies of quetiapine in this and other patient population. There were no differences in safety measures between groups. Conclusion:Quetiapine monotherapy was efficacious in the treatment of PTSD. These findings suggest quetiapine as a single agent is effective in treating military PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Villarreal, Gerardo; Hamner, Mark B; Canive, Jose M; Robert, Sophie; Calais, Lawrence A; Durklaski, Valerie; Zhai, Yusheng; Qualls, Clifford; Ahearn, Bauer, Benedek, Blake, Byers, Carey, Canive, David, First, Foa, Hamner, Hamner, Hamner, Hamner, Hamner, Hamner, Hermes, Hertzberg, Hoge, Kessler, Krystal, Lopez-Munoz, Mohamed, Newcomer, Nikisch, Raskind, Richelson, Robert, Stein, Thase, van der Kolk, Villarreal, Zohar",2016.0,,0,0,
2973,"Fibrinogen degradation product-D, fibrinogen, and serum change polymorphonuclear granulocyte activity - possibly important post-trauma?","Severe trauma favors the susceptibility of patients to infection. It has been shown that proteins or protein fragments are responsible for an endogenous immunodepression. After trauma a coagulopathy accompanied by increased serum levels of fibrinogen degradation products (FDP) is often found. Therefore, we examined whether FDP-D can influence the activity of polymorphonuclear neutrophils (PMN). PMN-activation was measured by two different superoxide-specific methods (Cytochrome-C-test, INT-test). With both methods we found a decrease of PMN activity by FDP-D compared to fibrinogen. Albumin, which was used as a control protein, only influenced PMN activity in unphysiologically high concentrations. The third method used to quantify PMN activity was chemiluminescence, which is a more unspecific method since it is developed not only by oxygen radical species but also by activating the lipoxygenase pathway. In contrast to the superoxide specific tests we found an inhibitory effect of fibrinogen and also serum compared to FDP-D using chemiluminescence.",Vogel P.; Klosterhalfen B.; Kirkpatrick C.J.; Schone S.,1991.0,,0,0,
2974,The effects of exposure to fear stimuli on fear reduction.,,Vodde TW.; Gilner FH.,1971.0,,0,0,
2975,Effect of the hydrophilicity of acrylic intraocular lens material and haptic angulation on anterior capsule opacification,"ER METHODSProspective study on 53 patients with bilateral age-related cataract. Patients underwent standard cataract surgery by the same surgeon and randomly received a hydrophilic acrylic intraocular lens (IOL) in one eye and a hydrophobic acrylic IOL in the other eye. Forty five of these patients completed the one-year follow-up. The following parameters were assessed: decentration, buttonholing, anterolenticular gap (ALG), ACO, outgrowth and refractive outcome.RESULTSAt the one-year follow-up, ACO was seen in 80% of the hydrophilic and 100% of the hydrophobic IOLs. ACO was more intense in the hydrophobic IOLs (p<0.001). Outgrowth was seen in 42% of the hydrophilic and 2% of the hydrophobic IOLs (p = 0.0003). No case of persisting ALG was seen in the hydrophobic IOLs, but in 42% of the hydrophilic IOLs. The refractive outcome was -0.29 (SD 0.56) dioptres for the hydrophilic and 0.003 (SD 0.44) dioptres for the hydrophobic IOLs (p<0.001).CONCLUSIONThese results suggest that there is less ACO in hydrophilic acrylic than in hydrophobic acrylic IOLs. Although material properties might play a role, the angulated haptics of the hydrophilic IOLs exert an additional effect by the persisting ALG and a lack of contact between the IOL and the anterior capsule.AIMTo evaluate the influence of hydrophilic and hydrophobic acrylic material and haptic angulation on anterior capsule opacification (ACO).","Vock, L; Georgopoulos, M; Neumayer, T; Buehl, W; Findl, O",2007.0,10.1136/bjo.2006.103390,0,0,
2976,Posterior capsule opacification in silicone and hydrophobic acrylic intraocular lenses with sharp-edge optics six years after surgery,"ER DESIGNRandomized, controlled, patient- and examiner-masked trial with intra-patient comparison.METHODSOne hundred and six eyes in 53 patients were included initially. Forty-four eyes of 22 patients with age-related bilateral cataract were available for the 6 years follow-up. Each patient had standard cataract surgery and randomly received a silicone (CeeOn 911A; AMO, Santa Ana, California, USA) or hydrophobic acrylic (AcrySof MA60BM; Alcon, Fort Worth, Texas, USA) IOL in the first eye, the other type of IOL in the fellow eye. Follow-up examinations were at 1, 3, and 6 years after surgery. The intensity of posterior capsule opacification (PCO) was assessed using digital retro-illuminated photos and the ""automated quantification of after-cataract"" (AQUA) software. Neodymium-yttrium-aluminum-garnet-laser capsulotomies (YAG-LC) performed were noted.RESULTSSix years after surgery, the AQUA scores were 2.3 +/- 1.4 for the silicone and 3.8 +/- 2.0 for the acrylic IOLs (P = .0016). The acrylic IOL eyes also had a significant increase in AQUA score from the 3-year to the 6-year follow-up. YAG-LC were performed in 2 silicone and 6 acrylic IOLs (P = .01).CONCLUSIONSAn angulated three-piece hydrophobic acrylic IOL had more PCO 6 years after surgery than a silicone IOL of otherwise similar design. Apart from an optic material effect, differences in haptic design and the degree of optic edge sharpness may play a role.PURPOSETo compare posterior capsule opacification (PCO) between 2 three-piece intraocular lenses (IOLs) both with sharp-optic edges and open loop haptics, one made of silicone and the other made of hydrophobic acrylate, 6 years after surgery.","Vock, L; Crnej, A; Findl, O; Neumayer, T; Buehl, W; Sacu, S; Rainer, G; Menapace, R",2009.0,10.1016/j.ajo.2008.11.006,0,0,
2977,Preparing patients for gastrointestinal endoscopy: the influence of information in medical situations,"ER The effects of the provision of information were tested in a sample of patients who underwent a gastrointestinal endoscopy for the first time (N=260). On the basis of their Threatening Medical Situation Inventory (TMSI)-monitoring score these patients were divided in high monitors versus low monitors. On the basis of the existing literature each group received the type of information that was considered most beneficial with regard to their coping style, and each group was compared with a control group receiving standard care (the usual information plus coaching by a nurse). Dependent variables were anxiety at different points in time, heart rate and skin conductance, pain, experience of the procedure, course of the procedure, duration of gagging, and satisfaction with the information provided. Unexpectedly, it turned out that high monitors did not profit by extensive information when compared with high monitors receiving standard care. Also for low monitors their minimal informational intervention did not exceed the effects of standard care. In the discussion, four factors possibly responsible for these results were elaborated. It is concluded that reservedness is required in providing (too) extensive information to patients who ask for this. Furthermore, considering the rather unpredictable and uncontrollable course of a gastrointestinal endoscopy, coaching by a nurse remains a valuable type of support.","Vliet, M J; Grypdonck, M; Zuuren, F J; Winnubst, J; Kruitwagen, C",2004.0,,0,0,
2978,Anxiogenic effects of pentagastrin in patients with social phobia and healthy controls,,"Vliet, I M; Westenberg, H G; Slaap, B R; Boer, J A; Ho, Pian K L",1997.0,10.1016/S0006-3223(97)00185-6,0,0,
2979,Gradual reduction of endotracheal tube diameter during mechanical ventilation via different humidification devices,"ER METHODSTwenty-three such patients were randomly assigned to three types of airway humidifier based on three different working principles: a Fisher Paykell hot water system (n = 7), a Pall BB2215 heat and moisture exchanger (HME) hydrophobic filter (n = 8), and a Dar Hygrobac 35254111 HME hygroscopic filter (n = 8). The decrease in internal pressure along the ETT and the flow rate were measured in each patient every 2 days. An ""effective inner diameter"" was derived from these measurements and allowed the inner ETT configuration to be monitored.RESULTSOn the first day of intubation, the mean diameter was similar in the three groups, and was slightly smaller than the in vitro diameter (mean +/- SD: 7.6 +/- 0.6 mm for Fisher-Paykell, 7.7 +/- 0.4 for Pall, and 7.5 +/- 0.4 for Dar). The mean diameter tended to decrease from day to day. At the end of the study, the overall reduction in mean diameter was significantly greater with the hydrophobic HME (Pall) than with the two other systems (Pall: -6.5 +/- 4% vs. 2.5 +/- 2.5% for Dar and 1.5 +/- 3% for Fisher-Paykell; P < 0.01 with analysis of variance). The same was true of the mean reduction in effective inner ETT diameter expressed per day of ventilation (-1.6 +/- 1.5% per day for Pall vs. -0.5 +/- 0.4% for Dar and -0.2 +/- 0.4% for Fisher-Paykell; P < 0.01). In four patients, the ETT became obstructed and emergency repeated tracheal intubation was required. The Pall HME and the Fisher-Paykell system were being used in three and one patient, respectively. Before obstruction, the reduction in ETT diameter was significantly greater for these four patients than for the remaining 23 patients (7.8 +/- 1.4% vs. 3.1 +/- 4.1%; P < 0.01).CONCLUSIONSDuring prolonged mechanical ventilation, significant alterations in inner ETT configuration occur frequently and are influenced by the type of humidification device used. In vivo monitoring of ETT mechanical properties might be clinically useful.BACKGROUNDLimited data suggest that increased resistance to flow within endotracheal tubes (ETT) may occur in patients whose lungs are mechanically ventilated for more than 48 h, especially when airway humidification is inadequate. This could lead to sudden ETT obstruction or induce excessive loading during spontaneous breathing.","Villafane, M C; Cinnella, G; Lofaso, F; Isabey, D; Harf, A; Lemaire, F; Brochard, L",1996.0,,0,0,
2980,The fate of Transparent Exopolymer Particles (TEP) in integrated membrane systems: Removal through pre-treatment processes and deposition on reverse osmosis membranes,"The abundance of Transparent Exopolymer Particles (TEP) in surface waters has been unnoticed for many years until recently as a potential foulant in reverse osmosis systems. Recent studies indicate that TEP may cause organic and biological fouling and may enhance particulate/colloidal fouling in reverse osmosis membranes. The presence of TEP was measured in the raw water, the pre-treatment processes and reverse osmosis (RO) systems of 6 integrated membrane installations. A spectrophotometric method was used to measure TEP in the particulate size range (>0.40 μm) and was extended to measure TEP in the colloidal size range (0.05-0.40 μm). Ultrafiltration pre-treatment applied in 4 plants, totally removed particulate TEP while microfiltration systems (2 plants) and coagulation/sedimentation/rapid sand filtration systems (3 plants) partially removed this fraction. None of the pre-treatment systems investigated totally removed colloidal TEP. Biopolymer analysis using LC-OCD showed consistency between colloidal TEP and polysaccharide removal by UF pre-treatment and further verified the presence of TEP in the RO feedwater. TEP deposition in the RO system was determined after measuring total TEP concentrations in the RO feed and concentrate. The TEP deposition factors and specific deposition rates indicate that TEP accumulation had occurred in all plants investigated. This observation was verified by an autopsy of RO modules from two RO plants. Further improvement and verification of the (modified) TEP method, in particular the calibration, is necessary so that it can be employed to investigate the role of TEP in the fouling of RO systems. © 2009.",Villacorte L.O.; Kennedy M.D.; Amy G.L.; Schippers J.C.,2009.0,10.1016/j.watres.2009.08.030,0,0,
2981,"Subjective intoxication in response to alcohol challenge: Heritability and covariation with personality, breath alcohol level, and drinking history","Background: Numerous studies have identified differences in subjective response to alcohol in subjects differentiated by family history of alcoholism. Results suggest that genetic influences on individual variation in subjective response to alcohol may be a mechanism for genetic effects on alcohol problems. However, direct evidence for genetic effects on subjective response to alcohol is very limited. Methods: In a sample of 99 adult twin pairs, we studied genetic influences on subjective intoxication after alcohol challenge. The twins ingested a standard dose of ethanol (0.70 g/kg for men/0.65 g/kg for women), and two measures of subjective response to alcohol were assessed. Results: Genetic effects on variation in subjective intoxication reported 1 hr after drinking were significant and substantial: heritability was 0.60 for a 22-item scale and 0.48 for a brief 2-item measure. Self-report measures of neuroticism, psychasthenia, hostility, and family problems shared significant genetic covariation with subjective intoxication. Achieved breath alcohol level, rate of change in breath alcohol on the descending limb, and individual drinking history all shared familial variation with subjective intoxication. No significant genetic effects for subjective intoxication were found 2 hr after drinking, but familial influences remained present, and many of the same personality, drinking history, and breath alcohol variables were predictive of intoxication. Conclusions: Subjective response to alcohol is heritable, and genetic effects on subjective intoxication are partly shared with genetic effects on personality.",Viken R.J.; Rose R.J.; Morzorati S.L.; Christian J.C.; Li T.-K.,2003.0,10.1097/01.ALC.0000067974.41160.95,0,0,
2982,Trained volunteer-delivered mental health support to those bereaved by Asian tsunami--an evaluation.,"While mental health consequences following the Asian December 2004 tsunami have been studied, its impact on the survivors who lost close family members deserves attention. We investigated the usefulness of trained volunteer-delivered mental health support for the bereaved persons. Non-randomized control design involving all adults aged 18 years or above who lost at least one close family member during tsunami from two geographically different coastal areas in Chennai, India. From the intervention and control sites, 45 and 57 participants were recruited respectively for the study. One year after baseline assessment, all 102 participants in intervention and control sites were interviewed. Participants receiving interventions on a consistent basis from trained volunteers were less likely to report depressive symptoms and general psychological distress compared with participants who did not receive the above intervention. Regression analysis for predicting the effect of intervention on the difference between the baseline and follow-up in BDI as well as GHQ scores, found a significant association between intervention and the improvement in BDI (adjusted beta (SE): -0.53 (2.44); p = 0.000) and GHQ (adjusted beta (SE): -0.52 (1.81); p = 0.001) scores. Suicidal attempts were also significantly less in the intervention group (FET p = 0.02). In settings where mental health professionals are limited in number, trained lay volunteers can offer empathetic listening, support and referrals that can be potentially beneficial.",Vijayakumar L.; Kumar MS.,2008.0,10.1177/0020764008090283,0,0,
2983,Nurses' intentions to provide home care: the impact of AIDS and homosexuality,"ER The purpose of this experimental study was to identify key factors influencing the intention of nurses (n = 102) to provide care at home to AIDS or leukaemia patients, homosexual or heterosexual. Ajzen's theory of planned behaviour with the addition of personal normative belief borrowed from Triandis's theory defined the theoretical framework. Homophobia and social desirability were also assessed as control variables. All nurses completed a self-administered and anonymous questionnaire after reading one of the four randomly-assigned vignettes that described the context of care. Sexual orientation of the patient influenced the personal normative belief (p < 0.05), and type of disease affected significantly perceived subjective social norm (p < 0.05). The regression of intention on all variables yielded an adjusted R2 of 0.48 (p < 0.0001), with perceived behavioural control, personal normative belief, attitude and homophobia being the significant predictors. In conclusion, nurses need to be better informed, better prepared and have better skills in order to provide appropriate care to homosexual AIDS patients.","Vermette, L; Godin, G",1996.0,10.1080/09540129650125669,0,0,
2984,Capturing worry in daily life: Are trait questionnaires sufficient?,"Worry is crucial in the development and maintenance of anxiety disorders and has been associated with several other adverse health outcomes. Yet, little is known about the frequency and perseveration of worry in daily life, and its predictability by widely used trait questionnaires. In this study 432 students completed the Penn State Worry Questionnaire (PSWQ), the Worry Domains Questionnaire (WDQ) and the State-Trait Anxiety Inventory-Trait version (STAI-T) and kept a log of worry frequency and duration during six consecutive days and nights. The results showed that worry is a very common phenomenon that is predicted by the two trait worry questionnaires, independent of trait anxiety. The often clinically utilized PSWQ predicted worry duration better than the WDQ, and exclusively predicted night-time worry and several other indices of perseverative and potentially pathogenic worry. Although this study provides some support for the predictive validity of the PSWQ and the WDQ, these questionnaires did not account for the larger part of variance in daily worry. Future studies of worry and its associated perseverative processes should consider using momentary assessments. © 2007 Elsevier Ltd. All rights reserved.",Verkuil B.; Brosschot J.F.; Thayer J.F.,2007.0,10.1016/j.brat.2007.02.004,0,0,
2985,Modeling neuropathologies as disruption of normal sequence generation in working memory networks,"Recurrent networks of cortico-cortical connections have been implicated as the substrate of working memory persistent activity, and patterned sequenced representation as needed in cognitive function. We examine the pathological behavior which may result from specific changes in the normal parameters or architecture in a biologically plausible computational working memory model capable of learning and reproducing sequences which come from external stimuli. Specifically, we examine systematical reductions in network inhibition, excitatory potentiation, delays in excitatory connections, and heterosynaptic plasticity. We show that these changes result in a set of dynamics which may be associated with cognitive symptoms associated with different neuropathologies, particularly epilepsy, schizophrenia, and obsessive compulsive disorders. We demonstrate how cognitive symptoms in these disorders may arise from similar or the same general mechanisms acting in the recurrent working memory networks. We suggest that these pathological dynamics may form a set overlapping states within the normal network function, and relate this to observed associations between different pathologies. © 2011 Elsevier Ltd.",Verduzco-Flores S.; Ermentrout B.; Bodner M.,2012.0,10.1016/j.neunet.2011.09.007,0,0,
2986,Computer simulation games as an adjunct for treatment in male veterans with alcohol use disorder.,"This study examined the impact of a computer simulation designed to provide the opportunity for individuals with alcohol use disorders (AUDs) to practice relapse prevention skills. Participants were 41 male veterans enrolled in an intensive outpatient substance abuse treatment program. Participants were randomly assigned to either view educational slides about treatment for AUD or play a simulation videogame for eight sessions within 12 weeks. Participants were assessed at a 4-week follow-up visit. Outcome measures included relapse rates as well as ratings on the Obsessive Compulsive Drinking Scale (OCDS) and a custom-designed relapse prevention self efficacy scale. While rates of relapse did not differ between groups, those who played the game showed overall reductions in ratings on the OCDS, as well as higher ratings of self-efficacy at week 8, suggesting that the videogame simulation may be a useful adjunct to AUD treatment.",Verduin ML.; LaRowe SD.; Myrick H.; Cannon-Bowers J.; Bowers C.,2013.0,10.1016/j.jsat.2012.08.006,0,0,
2987,A 35% carbon dioxide challenge in simple phobias,"ER Twenty-eight subjects meeting the DSM-III-R criteria for simple phobia and 30 normal controls were subjected to a 35% carbon dioxide panic provocation challenge. Simple phobics were subdivided into two groups, animal phobics and situational or natural phenomena phobics. Animal phobics were not more vulnerable to carbon dioxide than normal controls. However, situational or natural phenomena phobics reacted significantly more strongly to the challenge than normal controls. The increase in anxiety in this group was comparable to the increase of anxiety of panic disorder patients from previous studies. Our results suggest the existence of a constitutional predisposition that may not only lead to panic disorder but also to the development of certain specific phobias.","Verburg, C; Griez, E; Meijer, J",1994.0,,0,0,
2988,Using humor in systematic desensitization to reduce fear,"ER Effectiveness of systematic desensitization for fear reduction, using humorous hierarchy scenes without relaxation, was tested. Participants were 40 students highly fearful of spiders. Using a 24-item behavioral approach test with an American tarantula, participants were matched on fear level and randomly assigned to 1 of 3 treatment groups: (a) systematic desensitization, (b) humor desensitization, and (c) untreated controls. Each participant was seen for 6 sessions, including pretest and posttest. Analyses of covariance of posttest scores revealed that the 2 treatment groups showed greater reduction in fear than the controls on 3 measures but did not differ from each other. Therefore, humor in systematic desensitization reduced fear as effectively as more traditional desensitization. This finding may have therapeutic applications; however, it may also be applicable in advertising to desensitize fear of a dangerous product, such as cigarettes.","Ventis, W L; Higbee, G; Murdock, S A",2001.0,10.1080/00221300109598911,0,0,
2989,A randomised study comparing resection of acetabular bone at resurfacing and total hip replacement,"ER We have undertaken a prospective, randomised study to compare conservation of acetabular bone after total hip replacement and resurfacing arthroplasty of the hip. We randomly assigned 210 hips to one of the two treatment groups. Uncemented, press-fit acetabular components were used for both. No significant difference was found in the mean diameter of acetabular implant inserted in the groups (54.74 mm for total hip replacement and 54.90 mm for resurfacing arthroplasty). In seven resurfacing procedures (6.8%), the surgeon used a larger size of component in order to match the corresponding diameter of the femoral component. With resurfacing arthroplasty, conservation of bone is clearly advantageous on the femoral side. Our study has shown that, with a specific design of acetabular implant and by following a careful surgical technique, removal of bone on the acetabular side is comparable with that of total hip replacement.","Vendittoli, P A; Lavigne, M; Girard, J; Roy, A G",2006.0,10.1302/0301-620X.88B8.17615,0,0,
2990,Epinephrine infusions in panic disorder: A double-blind placebo-controlled study.,"Twenty-four Ss with Panic Disorder were infused with epinephrine in physiological doses or placebo according to a double-blind design. The panic rate in the epinephrine group (67%) was higher than in the placebo group (25%). Placebo panic occurred early during the procedure and was apparently associated with anticipation anxiety and stress-provoking situational factors. Panickers were characterized by a greater increase in heart rate as well as a drop in pCO2. Fear of bodily sensations was only weakly associated with state anxiety levels at point of panic. It is concluded that cognitive factors may not be important in epinephrine-induced panic. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Veltman, Dirk J; van Zijderveld, Gudo A; van Dyck, Richard",1996.0,,0,0,
2991,Epinephrine and fear of bodily sensations in panic disorder and social phobia,"Fear of bodily symptoms of arousal has been implicated in the pathogenesis of both spontaneously occurring and experimentally provoked panic. Fear of bodily symptoms may be characteristic for panic disorder (PD) and is hypothesized to predict state anxiety and panic frequency during experimentally induced peripheral arousal. Twenty-eight subjects, 14 with PD and 14 with social phobia (SP) were infused with placebo and epinephrine (20, 40 and 80 ng/kg bodyweight/min) according to a fixed schedule in a single blind design. Fear of bodily symptoms was higher in subjects with PD, who also reported more bodily symptoms and higher state anxiety scores during the experiment. The panic rate (five out of 14), however, was the same in both groups. Panickers did not differ from non-panickers in trait- or baseline measures except for fear of bodily symptoms, which was marginally higher in panickers. Panickers showed greater reactivity in heart rate, diastolic blood pressure and capillary PCO2. Our data do not support the hypothesis of a major role for fear of bodily symptoms in epinephrine-induced panic. Also, our results do not demonstrate a different reaction to epinephrine in PD and SP with situational panic attacks.",Veltman D.J.; Van Zijderveld G.; Tilders F.J.H.; Van Dyck R.,1996.0,,0,0,
2992,Electrostimulation for the prevention of deep venous thrombosis in patients with major trauma: a prospective randomized study.,"Current methods of posttraumatic thromboprophylaxis (heparins and sequential compression devices) are inadequate. New methods should be tested. Muscle electrostimulation (MEST) has been used over the years with mixed-but predominantly encouraging-results for a variety of conditions, including prevention of deep venous thrombosis (DVT). It has not been tested in multiple trauma patients. Trauma patients with Injury Severity Score higher than 9 who were admitted to the intensive care unit and had a contraindication for prophylactic heparinization were randomized to groups MEST and control. MEST patients received 30-minute MEST sessions twice daily for 7 to 14 days. Venous flow velocity and venous diameter were measured by duplex venous scan. Venography-or, if not available, duplex-was used to evaluate the presence of proximal and peripheral DVT between days 7 and 15. After exclusions, 26 MEST and 21 control patients completed the study and received outcome evaluation by venography (25) or duplex (22). Three patients in each group developed proximal DVT (11.5% vs 14%, P = .79), and an additional 4 (15%) MEST group and 3 (14%) control group patients developed peripheral DVT ( P = .96). There was no difference in venous flow velocity or venous diameter between the groups. MEST was not effective in decreasing DVT rates in major trauma patients.",Velmahos GC.; Petrone P.; Chan LS.; Hanks SE.; Brown CV.; Demetriades D.,2005.0,10.1016/j.surg.2005.01.010,0,0,
2993,The GuidAge study: New results,"The GuidAge study is a 5-year double-blind randomized placebo-controlled trial assessing the efficacy of standardised Ginkgo biloba extract (EGb761) in the prevention of Alzheimer's disease. Subjects aged 70 years or older having spontaneously complained of memory problems to a general practitioner and who were free of dementia, major depression, generalised anxiety or objective memory impairment were included. 2854 subjects were randomised to receive either EGb 761 120 mg bid or matching placebo. Participants underwent an annual visit at a memory centre, where a series of neuropsychological tests were administered to assess cognitive function (Grober and Buschke, Trail-Making and controlled oral word association tests) and cognitive status (MMSE and CDR). Functional status is evaluated with the Instrumental Activities of Daily Living questionnaire. The primary outcome is the transition to a diagnosis of AD (DSM-IV and NINCDS-ADRDA criteria), determined at the annual memory centre visit. Secondary outcomes include cognitive and functional decline. The trial is due to finish in November 2009 and results are expected in 2010.",Vellas B.,2010.0,10.1016/j.neurobiolaging.2009.12.003,0,0,
2994,Detection of negative and positive audience behaviours by socially anxious subjects,"Nineteen subjects high in social anxiety and 20 subjects low in social anxiety were asked to give a 5-min speech in front of three audience members. Audience members were trained to provide indictators of positive evaluation (e.g. smiles) and negative evaluation (e.g. frowns) at irregular intervals during the speech. Subjects were instructed to indicate, by depressing one of two buttons, when they detected either positive or negative behaviours. Results indicated that subjects high in social anxiety were both more accurate at, and had a more liberal criterion for, detecting negative audience behaviours while subjects low in social anxiety were more accurate at detecting positive audience behaviours.",Veljaca K.-A.; Rapee R.M.,1998.0,10.1016/S0005-7967(98)00016-3,0,0,
2995,Cost effectiveness of interpersonal community psychiatric treatment for people with long-term severe non-psychotic mental disorders: protocol of a multi-centre randomized controlled trial,"ER BACKGROUND: This study aims for health gain and cost reduction in the care for people with long-term non-psychotic psychiatric disorders. Present care for this population has a limited evidence base, is often open ended, little effective, and expensive. Recent epidemiological data shows that 43.5% of the Dutch are affected by mental illness during their life. About 80% of all patients receiving mental health services (MHS) have one or more non-psychotic disorders. Particularly for this group, long-term treatment and care is poorly developed. Care As Usual (CAU) currently is a form of low-structured treatment/care. Interpersonal Community Psychiatric Treatment (ICPT) is a structured treatment for people with long-term, non-psychotic disorders, developed together with patients, professionals, and experts. ICPT uses a number of evidence-based techniques and was positively evaluated in a controlled pilot study.METHODS/DESIGN: Multi-centre cluster-randomized clinical trial: 36 professionals will be randomly allocated to either ICPT or CAU for an intervention period of 12 months, and a follow-up of 6 months. 180 Patients between 18-65 years of age will be included, who have been diagnosed with a non-psychotic psychiatric disorder (depressive, anxiety, personality or substance abuse disorder), have long-term (>2 years) or high care use (>1 outpatient contact per week or >2 crisis contacts per year or >1 inpatient admission per year), and who receive treatment in a specialized mental health care setting. The primary outcome variable is quality of life; secondary outcomes are costs, recovery, general mental health, therapeutic alliance, professional-perceived difficulty of patient, care needs and social contacts.DISCUSSION: No RCT, nor cost-effectiveness study, has been conducted on ICPT so far. The empirical base for current CAU is weak, if not absent. This study will fill this void, and generate data needed to improve daily mental health care.TRIAL REGISTRATION: Netherlands Trial Register (NTR): 3988 . Registered 13th of May 2013.","Veen, M; Koekkoek, B; Mulder, N; Postulart, D; Adang, E; Teerenstra, S; Schoonhoven, L; Achterberg, T",2015.0,10.1186/s12888-015-0476-z,0,0,
2996,Telephone-administered cognitive behavioral therapy: a case study of anxiety and depression in Parkinson's disease.,"Parkinson's disease (PD) is a chronic medical illness with a high incidence of psychiatric comorbidity, specifically depression and anxiety. Research on treatment of such psychiatric complications is scarce. Non-pharmaceutical treatment options are especially attractive. Cognitive behavioral therapy (CBT) is a psychotherapeutic treatment option that has been successful in other chronically medically ill populations with comorbid depression and anxiety. The current research had two aims. The first was to pilot the feasibility of screening and identifying PD patients with symptoms of anxiety and depression in a specialized outpatient clinic. The second aim was to pilot the feasibility of telephone-administered CBT for the treatment of depression and anxiety in persons with PD, which was done through a case series comparing telephone-administered CBT to a Support strategy. A fairly large portion (67.5%) of patients screened in the outpatient clinic were identified as having symptoms of anxiety and/or depression. Results also indicated that CBT delivered via the telephone is a useful approach for targeting psychiatric symptoms in this population. A case example is given to illustrate the clinical considerations associated with delivering therapy via telephone to persons with PD.",Veazey C.; Cook KF.; Stanley M.; Lai EC.; Kunik ME.,2009.0,10.1007/s10880-009-9167-6,0,0,
2997,Outcome of intensive cognitive behaviour therapy in a residential setting for people with severe obsessive compulsive disorder: A large open case series.,"Background: There is little data to inform the treatment of severe obsessive compulsive disorder (OCD) in an inpatient or residential setting. Aims: This paper aimed to: a) describe treatment outcomes at a residential unit over 11 years; b) investigate whether treatment was successful for a subset of severe treatment refractory residents; c) compare an intensive treatment programme to a ""standard"" treatment programme; and d) find predictors of self or early discharge from the unit. Method: We compared treatment outcomes for (i) a minimum 12-week treatment (hereafter ""standard"") programme versus a 2-week intensive programme and (ii) for severe treatment refractory cases on the standard programme. We identified 472 residents with OCD admitted to the Anxiety Disorders Residential Unit at the Bethlem Royal Hospital between 2001 and 2012. Outcomes were measured with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Obsessive Compulsive Inventory (OCI), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) obtained throughout treatment and up to one year after discharge. Results: Although residents had very severe OCD on admission, sequential assessment with the Y-BOCS, OCI, BAI and BDI demonstrated that scores on all outcome measures significantly decreased from pre to posttreatment and were generally maintained at follow-up. There was no significant difference between those on the standard or the 2-week intensive programme. Sixty-nine per cent of residents with OCD made significant improvements, with at least a 25% reduction on the Y-BOCS. There were predictors of self or early discharge but none for outcome on the Y-BOCS. Conclusions: The data support the principle of stepped care for severe OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Veale, David; Naismith, Iona; Miles, Sarah; Childs, Grace; Ball, Jack; Muccio, Francesca; Darnley, Simon; Adams, Beck, Beck, Bjorgvinsson, Boschen, Castle, Drummond, First, Fisher, Foa, Gilbert, Gonner, Goodman, Hollander, Knopp, Langner, McKenzie, Oldfield, Pallanti, Salkovskis, Salkovskis, Stewart, Stewart, Veale, White",2016.0,,0,0,
2998,Long-term outcome of cognitive behavior therapy for body dysmorphic disorder: A naturalistic case series of 1 to 4 years after a controlled trial.,"There is some evidence for the efficacy of cognitive behavior therapy (CBT) for body dysmorphic disorder (BDD) after 1 to 6 months but none in the long term. The aim of this study was to follow up the participants in a randomized controlled trial of CBT versus anxiety management to determine whether or not the treatment gains were maintained over time. Thirty of the original 39 participants who had CBT were followed up over 1 to 4 years and assessed using a number of clinician and self-report measures, which included the primary outcome measure of the Yale-Brown Obsessive Compulsive Scale modified for BDD. Outcome scores generally maintained over time from end of treatment to long-term follow-up. There was a slight deterioration from n =20 (51.3%) to n =18 (46.2%) who met improvement criteria at long-term follow-up. Eleven (28.2%) were in full remission and 22 (56.4%) were in partial remission. The gains made were generally maintained at long-term follow-up. However, there were a significant number of participants who maintained chronic symptoms after treatment and may need a longer-term or more complex intervention and active medication management. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Veale, David; Miles, Sarah; Anson, Martin; Bjornsson, Cash, Dimidjian, Eisen, Foa, Fontenelle, Green, Gyani, Jacobson, Johnson, Keller, Knopp, Kroenke, McKay, Montgomery, Phillips, Phillips, Phillips, Phillips, Phillips, Phillips, Phillips, Phillips, Phillips, Rabiei, Rosen, Spitzer, Veale, Veale, Veale, Veale, Veale, Wilhelm",2015.0,,0,0,
2999,Efficacy of cognitive behaviour therapy versus anxiety management for body dysmorphic disorder: A randomised controlled trial.,"Background: The evidence base for the efficacy of cognitive behaviour therapy (CBT) for treating body dysmorphic disorder (BDD) is weak. Aims: To determine whether CBT is more effective than anxiety management (AM) in an outpatient setting. Method: This was a single-blind stratified parallel-group randomised controlled trial. The primary endpoint was at 12 weeks, and the Yale-Brown Obsessive Compulsive Scale for BDD (BDD-YBOCS) was the primary outcome measure. Secondary measures for BDD included the Brown Assessment of Beliefs Scale (BABS), the Appearance Anxiety Inventory (AAI) and the Body Image Quality of Life Inventory (BIQLI). The outcome measures were collected at baseline and week 12. The CBT group, unlike the AM group, had 4 further weekly sessions that were analysed for their added value. Both groups then completed measures at their 1-month follow-up. Forty-six participants with a DSM-IV diagnosis of BDD, including those with delusional BDD, were randomly allocated to either CBT or AM. Results: At 12 weeks, CBT was found to be significantly superior to AM on the BDD-YBOCS [beta = -7.19; SE (beta) = 2.61; p < 0.01; 95% CI = -12.31 to -2.07; d = 0.99] as well as the secondary outcome measures of the BABS, AAI and BIQLI. Further benefits occurred by week 16 within the CBT group. There were no differences in outcome for those with delusional BDD or depression. Conclusions: CBT is an effective intervention for people with BDD even with delusional beliefs or depression and is more effective than AM over 12 weeks. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Veale, David; Anson, Martin; Miles, Sarah; Pieta, Maria; Costa, Ana; Ellison, Nell; Andrews, Baldock, Beck, Cash, Devilly, Eisen, First, Hollander, Hrabosky, Jain, Koran, Kroenke, Lindsay, Manzoni, Montgomery, Muller, Neziroglu, Osman, Phillips, Phillips, Phillips, Phillips, Phillips, Phillips, Phillips, Phillips, Phillips, Rabiei, Rief, Rosen, Russell, Sarwer, Schroder, Spitzer, Veale, Veale, Veale, Veale, Veale, Veale, Whittal, Wilhelm",2014.0,,0,0,
3000,Long-Term Outcome of Cognitive Behavior Therapy for Body Dysmorphic Disorder: A Naturalistic Case Series of 1 to 4 Years After a Controlled Trial.,"There is some evidence for the efficacy of cognitive behavior therapy (CBT) for body dysmorphic disorder (BDD) after 1 to 6months but none in the long term. The aim of this study was to follow up the participants in a randomized controlled trial of CBT versus anxiety management to determine whether or not the treatment gains were maintained over time. Thirty of the original 39 participants who had CBT were followed up over 1 to 4years and assessed using a number of clinician and self-report measures, which included the primary outcome measure of the Yale-Brown Obsessive Compulsive Scale modified for BDD. Outcome scores generally maintained over time from end of treatment to long-term follow-up. There was a slight deterioration from n=20 (51.3%) to n=18 (46.2%) who met improvement criteria at long-term follow-up. Eleven (28.2%) were in full remission and 22 (56.4%) were in partial remission. The gains made were generally maintained at long-term follow-up. However, there were a significant number of participants who maintained chronic symptoms after treatment and may need a longer-term or more complex intervention and active medication management.",Veale D.; Miles S.; Anson M.,2015.0,10.1016/j.beth.2015.06.003,0,0,
3001,Body dysmorphic disorder: a cognitive behavioural model and pilot randomised controlled trial.,"A cognitive behavioural model of body image is presented with specific reference to body dysmorphic disorder (BDD). We make specific hypotheses from the model for testing BDD patients in comparison with: (i) patients with ""real"" disfigurements who seek cosmetic surgery; (ii) subjects with ""real"" disfigurements who are emotionally well adjusted; and (iii) healthy controls without any defect. There have been no randomised controlled trials of treatment for BDD and therefore the model has clear implications for the development of cognitive behavioural therapy. This was evaluated in a pilot controlled trial. Nineteen patients were randomly allocated to either cognitive behaviour therapy or a waiting list control group over 12 weeks. There were no significant pre-post differences on any of the measures in the waiting list group. There were significant changes in the treated group on specific measures of BDD and depressed mood. Cognitive behaviour therapy should be further evaluated in a larger controlled trial in comparison with another psychological treatment such as interpersonal therapy and pharmacotherapy.",Veale D.; Gournay K.; Dryden W.; Boocock A.; Shah F.; Willson R.; Walburn J.,1996.0,,0,0,
3002,Efficacy of cognitive behaviour therapy versus anxiety management for body dysmorphic disorder: a randomised controlled trial.,"The evidence base for the efficacy of cognitive behaviour therapy (CBT) for treating body dysmorphic disorder (BDD) is weak. To determine whether CBT is more effective than anxiety management (AM) in an outpatient setting. This was a single-blind stratified parallel-group randomised controlled trial. The primary endpoint was at 12 weeks, and the Yale-Brown Obsessive Compulsive Scale for BDD (BDD-YBOCS) was the primary outcome measure. Secondary measures for BDD included the Brown Assessment of Beliefs Scale (BABS), the Appearance Anxiety Inventory (AAI) and the Body Image Quality of Life Inventory (BIQLI). The outcome measures were collected at baseline and week 12. The CBT group, unlike the AM group, had 4 further weekly sessions that were analysed for their added value. Both groups then completed measures at their 1-month follow-up. Forty-six participants with a DSM-IV diagnosis of BDD, including those with delusional BDD, were randomly allocated to either CBT or AM. At 12 weeks, CBT was found to be significantly superior to AM on the BDD-YBOCS [β = -7.19; SE (β) = 2.61; p < 0.01; 95% CI = -12.31 to -2.07; d = 0.99] as well as the secondary outcome measures of the BABS, AAI and BIQLI. Further benefits occurred by week 16 within the CBT group. There were no differences in outcome for those with delusional BDD or depression. CBT is an effective intervention for people with BDD even with delusional beliefs or depression and is more effective than AM over 12 weeks.",Veale D.; Anson M.; Miles S.; Pieta M.; Costa A.; Ellison N.,2014.0,10.1159/000360740,0,0,
3003,"Do not worry, be mindful: effects of induced worry and mindfulness on respiratory variability in a nonanxious population.","Generalized anxiety disorder (GAD) is characterized by chronic worry. Mindfulness-based stress reduction is thought to remediate excessive worry, because it counteracts a permanent defense state of enhanced vigilance to potential threats. The present study aimed to compare respiratory variability (RV) during worry and mindfulness. Following an 8-minute baseline, 37 healthy participants underwent 11-min worry and mindfulness inductions, in randomized order, using auditory scripts. Respiration was measured by chest and abdominal inductance belts. RV was quantified by (1) autocorrelation to assess linear breathing variability and (2) sample entropy to assess nonlinear breathing variability. Compared to baseline and mindfulness, worry showed decreased autocorrelation in all respiratory parameters and compared to mindfulness, worry showed decreased entropy in respiratory rate. These results suggest that, in contrast to mindfulness, worry is characterized by decreased respiratory stability and flexibility, and therefore worry and mindfulness seem to have countering effects on RV and respiratory regulation.",Vlemincx E.; Vigo D.; Vansteenwegen D.; Van den Bergh O.; Van Diest I.,2013.0,10.1016/j.ijpsycho.2012.12.002,0,0,
3004,Bacterial adhesion to unworn and worn silicone hydrogel lenses,"ER PURPOSE: The objective of this study was to determine the bacterial adhesion to various silicone hydrogel lens materials and to determine whether lens wear modulated adhesion.METHODS: Bacterial adhesion (total and viable cells) of Staphylococcus aureus (31, 38, and ATCC 6538) and Pseudomonas aeruginosa (6294, 6206, and GSU-3) to 10 commercially available different unworn and worn silicone hydrogel lenses was measured. Results of adhesion were correlated to polymer and surface properties of contact lenses.RESULTS: S. aureus adhesion to unworn lenses ranged from 2.8 √ó 10 to 4.4 √ó 10 colony forming units per lens. The highest adhesion was to lotrafilcon A lenses, and the lowest adhesion was to asmofilcon A lenses. P. aeruginosa adhesion to unworn lenses ranged from 8.9 √ó 10 to 3.2 √ó 10 colony forming units per lens. The highest adhesion was to comfilcon A lenses, and the lowest adhesion was to asmofilcon A and balafilcon A lenses. Lens wear altered bacterial adhesion, but the effect was specific to lens and strain type. Adhesion of bacteria, regardless of genera/species or lens wear, was generally correlated with the hydrophobicity of the lens; the less hydrophobic the lens surface, the greater the adhesion.CONCLUSIONS: P. aeruginosa adhered in higher numbers to lenses in comparison with S. aureus strains, regardless of the lens type or lens wear. The effect of lens wear was specific to strain and lens. Hydrophobicity of the silicone hydrogel lens surface influenced the adhesion of bacterial cells.","Vijay, A K; Zhu, H; Ozkan, J; Wu, D; Masoudi, S; Bandara, R; Borazjani, R N; Willcox, M D",2012.0,10.1097/OPX.0b013e318264f4dc,0,0,
3005,Biological sex and social setting affects pain intensity and observational coding of other people's pain behaviors,"This experiment examines the impact of biological sex and audience composition on laboratory-induced ischemic pain intensity and observational coding of other people's pain behaviors. Situational context was manipulated by varying the sex and number of audience stimuli in the laboratory setting during the pain task and during observational evaluations of other people's pain suffering. The analyses revealed sex differences in felt pain intensity and observable pain behaviors, with male subjects reporting lower pain intensity and evidencing fewer pain behaviors than female subjects on average. Follow-up analyses revealed that, after controlling for social anxiety, audience composition was linked to felt pain intensity, and this relation was moderated by participant sex and audience sex, such that only male subjects showed decreased pain intensity with increasing number of female audience members. Sex differences were also found in the rating of other people's pain behaviors, with male observers rating the pain of others lower than female observers. Composition of the audience influenced observers' pain ratings such that the presence of more male subjects in the audience correlated with lower observer ratings, whereas the presence of more female subjects correlated with higher observer ratings. This is the first study to show that the sex and the composition of the social context in which pain is experienced affects the intensity of felt pain and the evaluation of other people's pain suffering. Implications of the findings for measuring and interpreting pain suffering in male and female patients by male and female treatment providers in health care settings are discussed. © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.",Vigil J.M.; Coulombe P.,2011.0,10.1016/j.pain.2011.05.019,0,0,
3006,Internet-delivered cognitive behavioural therapy for children with anxiety disorders: a randomised controlled trial,"ER Background: Cognitive behaviour therapy (CBT) has been shown to be an effective treatment for anxiety disorders in children, but few affected seek or receive treatment. Internet-delivered CBT (ICBT) could be a way to increase the availability of empirically supported treatments. Aims: A randomised controlled trial was conducted to evaluate ICBT for children with anxiety disorders. Method: Families (N = 93) with a child aged 8-12 years with a principal diagnosis of generalised anxiety disorder, panic disorder, separation anxiety, social phobia or specific phobia were recruited through media advertisement. Participants were randomised to 10 weeks of ICBT with therapist support, or to a waitlist control condition. The primary outcome measure was the Clinician Severity Rating (CSR) and secondary measures included child- and parent-reported anxiety. Assessments were made at pre-treatment, post-treatment and at three-month follow-up. Results: At post-treatment, there were significant reductions on CSR in the treatment group, with a large between-group effect size (Cohen's d = 1.66). Twenty per cent of children in the treatment group no longer met criteria for their principal diagnosis at post-treatment and at follow-up this number had increased to 50%. Parent-reported child anxiety was significantly lower in the treatment group than in the waitlist group at post-treatment, with a small between-group effect size (Cohen's d = 0.45). There were no significant differences between the groups regarding child-ratings of anxiety at post-treatment. Improvements were maintained at three-month follow-up, although this should be interpreted cautiously due to missing data. Conclusions: Within the limitations of this study, results suggest that ICBT with therapist support for children with anxiety disorders can reduce clinician- and parent-rated anxiety symptoms. Trial registration: Clinicaltrials.gov: NCT01533402.","Vigerland, S; Ljótsson, B; Thulin, U; Öst, L G; Andersson, G; Serlachius, E",2016.0,10.1016/j.brat.2015.11.006,0,0,
3007,Trait anxiety and sleep-onset insomnia: evaluation of treatment using anxiety management training.,"This study was initially designed to test the notion that generalized anxiety is a predominant factor in the maintenance of psychologically determined sleep-onset insomnia and that a trait anxiety reducing technique can provide significant therapeutic gains. Twenty participants (age 19-63) with moderate to severe sleep-onset chronic insomnia were first asked to monitor their sleep-onset latency (SOL) for a 3-week baseline period at home using a SOL clock device. Then, 10 received anxiety management training (AMT) for 9 weeks, while the remaining 10 were trained in the use of progressive relaxation (PR). All participants were measured before and after therapy using sleep laboratory recordings (three nights each), the Spielberger Trait Anxiety Inventory and the Beck Depression Inventory. Daily home sleep-onset measures with the SOL clock device were also taken during therapy. There was no change in SOL over the 3-week baseline period. However, both groups experienced a significant improvement in SOL from pretreatment (end of baseline) to posttreatment periods. In the laboratory, both groups experienced a reduction in Stage 1 sleep as well as an increase in slow wave sleep (SWS) and sleep satisfaction. On the personality measures, both groups experienced a significant reduction in trait anxiety and a decrease in depression. Overall, there was no indication that one of the therapies was significantly better than the other in effecting changes. These results suggest that both PR and AMT are efficient therapies for sleep onset insomnia and overall sleep quality. Improvements in the application of the AMT technique are proposed to maximize its usefulness.",Viens M.; De Koninck J.; Mercier P.; St-Onge M.; Lorrain D.,2003.0,,0,0,
3008,A comparison of eye movement desensitization and reprocessing and biofeedback/stress inoculation training in treating test anxiety.,"Eye Movement Desensitization and Reprocessing (EMDR) treatment, Biofeedback/Stress Inoculation Training (B/SIT) treatment, and no treatment (NT) were compared in treating test anxiety. Subjects (30) reporting test anxiety were randomly assigned to EMDR, B/SIT or NT. Treatment consisted of three 90 minute sessions using B/SIT and one 45 minute session/three 75 minute sessions using EMDR. Treatment therapists were licensed psychologists, counselors or social workers with two to twenty years experience using EMDR or B/SIT. Subjects in the NT group were offered treatment following the study. Six dependent variables were measured pre/post: trait and state anxiety (State Trait Anxiety Inventory, STAI-T.S.), test anxiety (Test Anxiety Inventory, TAI-T.W.E.), rationality of personal beliefs (Rational Behavior Inventory, RBI), negative self statements (TAI-W) and self report of physiological response (Autonomic Perception Inventory, APQ) using.05 level. ANOVAs were performed followed by a Newman-Keuls Multiple Comparison. There was a significant interaction between pre-post tests and type of group on all dependent measures except the RBI. EMDR showed a tendency toward greater improvement from pre to post test than B/SIT and NT. There were no significant differences between groups on the pre test. Post group means indicated: (a) STAI-S, there was no difference between the groups; (b) STAI-T and APQ, EMDR and B/SIT had a greater reduction than NT; (c) TAI-E, EMDR showed more reduction than B/SIT and NT; (d) TAI-T and W, there were differences between all three groups with EMDR showing the most reduction. A meta-analysis was performed to determine clinical significance. Prior to treatment all three groups were above the normative effect size of 1 SD. The NT group showed no change on post tests. The EMDR group showed a larger reduction in effect size than B/SIT. Based on the data both EMDR and B/SIT reduced test anxiety with EMDR generally outperforming B/SIT. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Vienot, Rosemary Cook",1998.0,,0,0,
3009,Impact of experimentally induced serotonin deficiency by tryptophan depletion on saliva cortisol concentrations,"ER METHODSAfter TD at 18.00 h, salivary cortisol was sampled in the evening and on the following morning. The first study was a randomized, placebo-controlled, crossover study in healthy subjects. Two further open trials in patients with obsessive-compulsive disorder (OCD) and primary insomnia compared the effects of TD on cortisol with baseline conditions.RESULTSIn healthy subjects, TD significantly diminished cortisol the next morning compared with placebo. In OCD patients and primary insomniacs, cortisol the morning after TD was lowered compared with baseline. Evening cortisol was not affected by TD in any of the groups.CONCLUSIONSContrary to expectation, TD led to a comparable decrease of morning cortisol in all groups investigated. However, these findings are consistent with former studies analyzing the impact of antiserotonergic drugs on cortisol secretion. The results underline that the antiserotonergic effects caused by TD may influence cortisol secretion.BACKGROUNDTryptophan depletion (TD) has been shown to induce a transient mood-lowering effect in psychiatric patients and susceptible healthy subjects. We investigated the effects of TD on cortisol secretion in psychiatric patients and healthy subjects based on the hypothesis that the potential mood-lowering effects may be associated with increased activity of the hypothalamic-pituitary-adrenal axis, thus leading to a rise of cortisol secretion.","Vielhaber, K; Riemann, D; Feige, B; Kuelz, A; Kirschbaum, C; Voderholzer, U",2005.0,10.1055/s-2005-837808,0,0,
3010,Mediators of a smoking cessation intervention for persons living with HIV/AIDS,"ER Background: Cigarette smoking among persons living with HIV (PLWH) is a pressing public health concern, and efforts to evaluate cessation treatments are needed. The purpose of the present study was to assess potential mechanisms of a cell phone-delivered intervention for HIV-positive smokers. Methods: Data from 350 PLWH enrolled in a randomized smoking cessation treatment trial were utilized. Participants were randomized to either usual care (UC) or a cell phone intervention (CPI) group. The independent variable of interest was treatment group membership, while the dependent variable of interest was smoking abstinence at a 3-month follow-up. The hypothesized treatment mechanisms were depression, anxiety, social support, quit motivation and self-efficacy change scores. Results: Abstinence rates in the UC and CPI groups were 4.7% (8 of 172) and 15.7% (28 of 178), respectively. The CPI group (vs. UC) experienced a larger decline in depression between baseline and the 3-month follow-up, and a decline in anxiety. Self-efficacy increased for the CPI group and declined for the UC group. Quit motivation and social support change scores did not differ by treatment group. Only self-efficacy met the predefined criteria for mediation. The effect of the cell phone intervention on smoking abstinence through change in self-efficacy was statistically significant (p<. 0.001) and accounted for 17% of the total effect of the intervention on abstinence. Conclusions: The findings further emphasize the important mechanistic function of self-efficacy in promoting smoking cessation for PLWH. Additional efforts are required to disentangle the relationships between emotional, distress motivation, and efficacious smoking cessation treatment.","Vidrine, D J; Kypriotakis, G; Li, L; Arduino, R C; Fletcher, F E; Tamí-Maury, I; Gritz, E R",2015.0,10.1016/j.drugalcdep.2014.12.003,0,0,
3011,A randomized trial of a proactive cellular telephone intervention for smokers living with HIV/AIDS,"ER DESIGNA two-group randomized clinical trial compared a smoking cessation intervention delivered by cellular telephone with usual care approach.METHODSCurrent smokers from a large, inner city HIV/AIDS care center were recruited and randomized to receive either usual care or a cellular telephone intervention. The usual care group received brief physician advice to quit smoking, targeted self-help written materials and nicotine replacement therapy. The cellular telephone intervention received eight counseling sessions delivered via cellular telephone in addition to the usual care components. Smoking-related outcomes were assessed at a 3-month follow-up.RESULTSThe trial had 95 participants and 77 (81.0%) completed the 3-month follow-up assessment. Analyses indicated biochemically verified point prevalence smoking abstinence rates of 10.3% for the usual care group and 36.8% for the cellular telephone group; participants who received the cellular telephone intervention were 3.6 times (95% confidence interval, 1.3-9.9) more likely to quit smoking compared with participants who received usual care (P = 0.0059).CONCLUSIONSThese results suggest that individuals living with HIV/AIDS are receptive to, and can be helped by, smoking cessation treatment. In addition, smoking cessation treatment tailored to the special needs of individuals living with HIV/AIDS, such as counseling delivered by cellular telephone, can significantly increase smoking abstinence rates over that achieved by usual care.OBJECTIVETo assess the efficacy of an innovative smoking cessation intervention targeted to a multiethnic, economically disadvantaged HIV-positive population.","Vidrine, D J; Arduino, R C; Lazev, A B; Gritz, E R",2006.0,10.1097/01.aids.0000198094.23691.58,0,0,
3012,Impact of a cell phone intervention on mediating mechanisms of smoking cessation in individuals living with HIV/AIDS,"ER Mounting evidence suggests that smokers living with HIV/AIDS have a significantly increased risk of numerous adverse health outcomes (both AIDS- and non-AIDS-related) compared with HIV-positive nonsmokers. Therefore, efforts to design and implement effective cessation programs for this ever-growing special population are warranted. The present study assessed the effects of a cell phone intervention (CPI) on hypothesized mediators (i.e., changes in depression, anxiety, social support, and self-efficacy) demonstrated to influence cessation outcomes in other populations. Ninety-five participants from an inner-city AIDS clinic were randomized to receive either the CPI or recommended standard of care (RSOC) smoking cessation treatment. Participants randomized to the RSOC group (n=47) received brief advice to quit, a 10-week supply of nicotine patches, and self-help materials. Participants randomized to the CPI group (n=48) received RSOC components plus a series of eight proactive counseling sessions delivered via cell phones. A series of regression analyses (linear and logistic) was used to assess the relationships between treatment group, the hypothesized mediators, and biochemically confirmed smoking cessation outcomes. Results indicated that the CPI group experienced greater reductions in anxiety and depression, and increases in self-efficacy compared with the RSOC group. Further, changes in depression, anxiety, and self-efficacy weakened the association between treatment group and cessation outcome. The mediator hypothesis, however, for social support was rejected, as the difference score was not significantly associated with treatment group. These results suggest that the efficacy of the CPI is at least partially mediated by its ability to decrease symptoms of distress while increasing self-efficacy.","Vidrine, D J; Arduino, R C; Gritz, E R",2006.0,,0,0,
3013,Screening for depression in medical students and sports academy students,"Introduction: Depression is one of the biggest health challenges the world faces and it is the leading cause of disability worldwide. Globally, an estimated 350 million people of all ages suffer from depression and women are more affected than men. Statistics show that diagnoses are growing at an alarming rate. Many people suffer symptoms of depression without seeking care. Now a global health issue depression awareness, diagnosis and treatment are matters of crucial significance in building a healthier, happier world. Students begin medical school anticipating the challenges of a new environment, difficult coursework and increasing responsibilities [1]. During the first year, stressors are often more variable and of greater intensity, but stressful situations inherent in the medical curriculum can trigger anxiety or sadness at any time [2]. Subsequently, physicians who enter the profession with low selfesteem and depressive tendencies are more likely to suffer from mood and anxiety disorders. Aim: A growing body of literature documents high rates of depression and suicidal ideation among physicians and medical students. Barriers to seeking mental health treatment in this group include concerns about time, stigma, confidentiality, and potential career impact. The aim of this study was to assess and compare the level of depression among medical students and sports academy students. Methods: One hundred and thirty-seven first-year medical students (45 male and 92 female) and 71 first-year sports academy students (42 male and 29 female) at the Saints Cyril and Methodius University of Skopje, Macedonia, were asked to fill in Patient Health Questionnaire (PHQ-9). PHQ-9 is commonly used and validated screening tool for depression. It has 61 percent sensitivity and 94 percent specificity in adults. If this screening test is positive for depression, further evaluation is needed to confirm that the patient's symptoms meet the diagnostic criteria for diagnosis. All students were aged 18-20 years (mean age, 19 years). Comparative data analysis were applied. Results: Scores for medical students were as follows: score 0: 0% (both male and female); score 1-4 (minimal depression): 22% (male), 17% (female); score 5-9 (mild depression): 40% (male), 42% (female); score 10-14 (moderate depression): 24% (male), 27% (female); score 15-19 (moderately severe depression): 9% (male), 12% (female); score 20-27 (severe depression): 5% (male), 2% (female). Scores for sports academy students were as follows: score 0: 5% (male), 0% (female); score 1-4: 52% (male), 55% (female); score 5-9: 38% (male), 34% (female); score 10-14: 5% (male), 1% (female); score 15-19: 0% (both male and female); score 20-27: 0% (both male and female). Conclusion: Medical students had higher depression rates than sports academy students. Female medical students had higher rates than male. Inverse relationships exist among depression and healthy lifestyle beliefs/behaviors. The relatively high depression rates among medical students may be attributed to their special stressful learning environment. Medical students have higher degree of pressure from studies, along with low levels of exercise and inadequate sleep [3]. Identifying medical students who appear to be at higher risk (without stigmatizing them) and providing them with coping techniques to enhance their adjustment seems feasible [4]. It is a step towards production of capable and emotionally healthy physicians.",Videnova V.; Manuseva N.; Gjorgjevikj D.; Isjanovski V.,2016.0,,0,0,
3014,Effect of a capsular tension ring on axial intraocular lens position,"ER Purpose To assess the effect of a capsular tension ring (CTR) on the postoperative anterior chamber depth (ACD). Setting Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria. Design Prospective observer- and patient-masked randomized trial. Methods Bilateral small-incision cataract surgery with implantation of a hydrophobic acrylic single-piece intraocular lens (IOL) (Tecnis ZCB00) was performed using a standard technique. Each patient received a CTR in 1 eye (CTR group) and no CTR in the fellow eye (control group). The ACD was measured preoperatively with biometry (IOLMaster 500) and at 1 hour and 12 weeks postoperatively using partial coherence interferometry (ACMaster). The subjective refraction was assessed at 12 weeks. Results Sixty eyes (30 patients) were included. Preoperatively, the mean axial length was 23.36 mm +/- 1.55 (SD) (range 21.01 to 29.46 mm) in the CTR group and 23.37 +/- 1.70 mm (range 21.14 to 28.84 mm) in the control group and the mean ACD was 3.06 +/- 0.45 mm (range 2.25 to 4.16 mm) and 3.03 +/- 0.47 mm (range 2.18 to 4.10 mm), respectively. The differences were not statistically significant (P=.148 and P=.074, respectively). The mean postoperative ACD was 4.83 +/- 0.46 mm (range 3.84 to 5.76 mm) in the CTR group and 4.81 +/- 0.43 mm (range 3.67 to 5.65 mm) in the control group. The difference between the groups was not statistically significant (P=.329). Conclusion Implantation of a CTR had no significant influence on the postoperative axial IOL position. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.","Weber, M; Hirnschall, N; Rigal, K; Findl, O",2015.0,10.1016/j.jcrs.2014.04.035,0,0,
3015,Abnormal frontal and parietal activity during working memory updating in post-traumatic stress disorder,"This study used event-related potentials (ERPs) to investigate the timing and scalp topography of working memory in post-traumatic stress disorder (PTSD). This study was designed to investigate ERPs associated with a specific working memory updating process. ERPs were recorded from 10 patients and 10 controls during two visual tasks where (a) targets were a specific word or (b) targets were consecutive matching words. In the first task, nontarget words are not retained in working memory. In the second task, as in delay-match-to-sample tasks, a non-target word defines a new target identity, so these words are retained in working memory. This working memory updating process was related to large positive ERPs over frontal and parietal areas at 400-800 ms, which were smaller in PTSD. Estimation of cortical source activity indicated abnormal patterns of frontal and parietal activity in PTSD, which were also observed in regional cerebral blood flow [Clark, C.R., McFarlane, A.C., Morris, P., Weber, D.L., Sonkkilla, C., Shaw, M., Marcina, J., Tochon-Danguy, H., Egan, G., 2003. Cerebral function in posttraumatic stress disorder during verbal working memory updating: a positron emission tomography study. Biological Psychiatry 53, 474-481]. Frontal and parietal cortex are known to be involved in distributed networks for working memory processes, interacting with medial temporal areas during episodic memory processes. Abnormal function in these brain networks helps to explain everyday concentration and memory difficulties in PTSD. © 2005 Elsevier Ireland Ltd. All rights reserved.",Weber D.L.; Clark C.R.; McFarlane A.C.; Moores K.A.; Morris P.; Egan G.F.,2005.0,10.1016/j.pscychresns.2005.07.003,0,0,
3016,Using a bug-killing paradigm to understand how social validation and invalidation affect the distress of killing.,"Clinical evidence demonstrates that killing among soldiers at war predicts their experience of long-lasting trauma/distress. Killing leads to distress, in part, due to guilt experienced from violating moral standards. Because social consensus shapes what actions are perceived as moral and just, we hypothesized that social validation for killing would reduce guilt, whereas social invalidation would exacerbate it. To examine this possibility in a laboratory setting, participants were led to kill bugs in an ""extermination task."" Perceptions of social validation/invalidation were manipulated through the supposed actions of a confederate (Study 1) or numerous previous participants (Study 2) that agreed or refused to kill bugs. Distress measures focused on trauma-related guilt. Higher levels of distress were observed when individuals perceived their actions as invalidated as opposed to when they perceived their actions as socially validated. Implications for posttraumatic stress disorder (PTSD) experienced by soldiers and the paradoxical nature of publicly expressing antiwar sentiments are discussed.",Webber D.; Schimel J.; Martens A.; Hayes J.; Faucher EH.,2013.0,10.1177/0146167213477891,0,0,
3017,Circumferential fusion improves outcome in comparison with instrumented posterolateral fusion: long-term results of a randomized clinical trial,"ER OBJECTIVEThe aim of the present study was to analyze the long-term outcome with respect to functional disability, pain, and general health of patients treated by means of circumferential lumbar fusion in comparison with those treated by means of instrumented posterolateral lumbar fusion.SUMMARY OF BACKGROUND DATACircumferential fusion has become a common procedure in lumbar spinal fusion both as a primary and salvage procedure. However, the claimed advantages of circumferential fusion over conventional posterolateral fusion lack scientific documentation. (The primary report with a 2-year follow-up has been published in Spine in 2002.)METHODSFrom April 1996 to November 1999, a total of 148 patients (mean age, 45 years) with severe chronic low back pain were randomly selected for either posterolateral lumbar fusion (titanium Cotrel-Dubousset) or circumferential lumbar fusion (instrumented posterolateral fusion with anterior intervertebral support by a Brantigan cage). The primary outcome measure was the Dallas Pain Questionnaire (DPQ). The secondary outcome measures were the Oswestry Disability Index, the SF-36 instrument, and the Low Back Pain Rating Scale. All measures assessed the endpoint outcomes at 5 to 9 years after surgery.RESULTSThe available response rate was 93%. The circumferential group showed a significantly better improvement (P < 0.05) in comparison with the posterolateral group with respect to all four DPQ categories: daily activities, work/leisure, anxiety/depression, and social interest. The Oswestry Disability Index supported these results (P < 0.01). General health, as assessed by means of the SF-36, also showed significantly better physical health (P < 0.01) in the circumferential group, whereas no significant difference was found with respect to mental health compared with the posterolateral group. The circumferential group experienced significantly less back pain (P < 0.05) in comparison with the posterolateral group. In regard to leg pain, no significant difference was found.CONCLUSIONCircumferential lumbar fusion demands more extensive operative resources compared with posterolateral lumbar fusion. However, 5 to 9 years after surgery, the circumferentially fused patients had a significantly improved outcome compared with those treated by means of posterolateral fusion. These new results not only emphasize the superiority of circumferential fusion in the complex pathology of the lumbar spine but are also strongly supported in all of the validated questionnaires used in the study.STUDY DESIGNProspective randomized clinical study with a 5- to 9-year follow-up period.","Videbaek, T S; Christensen, F B; Soegaard, R; Hansen, E S; Høy, K; Helmig, P; Niedermann, B; Eiskjoer, S P; Bünger, C E",2006.0,10.1097/01.brs.0000247793.99827.b7,0,0,
3018,Adaptation as a sensorial profile in trait anxiety: a study with virtual reality.,"Twenty-four volunteers were recruited on the basis of their trait anxiety scores (low trait anxiety [LTA] and high trait anxiety [HTA]) as assessed by the State-Trait Anxiety Inventory. Adaptation to conflicting visual-vestibular stimulation (VVS) was used to study integration of space-related multi-sensory information in trait anxiety. First, vestibular perception was assessed by rotating the blindfolded subjects about the vertical axis (horizontal plane rotations) on a remote-controlled mobile robot. The subjects were asked to indicate the perceived rotation by use of an angular pointer. Subjects were then immersed into the center of a visual virtual square room by means of a head-mounted display. They were asked to control the robot with a joystick in order to perform 90 degrees rotations in the virtual room. However, a gain of 0.5 was introduced between visual scene and robot rotation so that the subjects were submitted to a conflict situation in which the 90 degrees rotational visual input was concurrent with a 180 degrees vestibular input. After 45 min of training with the virtual reality display, subjects were tested again in total darkness in order to determine whether their vestibular system had been reset by the conflicting visual signals. We found significant differences in adaptation to VVS between HTA and LTA groups as well as between males and females. Subjects of the HTA group demonstrated larger adaptation than that of the LTA group. Males also showed a greater level of adaptation compared to females. Our results suggest greater visual dependence in HTA subjects. This might be important for understanding the mechanisms underlying pathological anxiety and particularly agoraphobia.",Viaud-Delmon I.; Ivanenko YP.; Berthoz A.; Jouvent R.,,,0,0,
3019,Adaptation as a sensorial profile in trait anxiety: a study with virtual reality,"ER Twenty-four volunteers were recruited on the basis of their trait anxiety scores (low trait anxiety [LTA] and high trait anxiety [HTA]) as assessed by the State-Trait Anxiety Inventory. Adaptation to conflicting visual-vestibular stimulation (VVS) was used to study integration of space-related multi-sensory information in trait anxiety. First, vestibular perception was assessed by rotating the blindfolded subjects about the vertical axis (horizontal plane rotations) on a remote-controlled mobile robot. The subjects were asked to indicate the perceived rotation by use of an angular pointer. Subjects were then immersed into the center of a visual virtual square room by means of a head-mounted display. They were asked to control the robot with a joystick in order to perform 90 degrees rotations in the virtual room. However, a gain of 0.5 was introduced between visual scene and robot rotation so that the subjects were submitted to a conflict situation in which the 90 degrees rotational visual input was concurrent with a 180 degrees vestibular input. After 45 min of training with the virtual reality display, subjects were tested again in total darkness in order to determine whether their vestibular system had been reset by the conflicting visual signals. We found significant differences in adaptation to VVS between HTA and LTA groups as well as between males and females. Subjects of the HTA group demonstrated larger adaptation than that of the LTA group. Males also showed a greater level of adaptation compared to females. Our results suggest greater visual dependence in HTA subjects. This might be important for understanding the mechanisms underlying pathological anxiety and particularly agoraphobia.","Viaud-Delmon, I; Ivanenko, Y P; Berthoz, A; Jouvent, R",2000.0,,0,0,3018
3020,Low or high fractionation dose ?-radiotherapy for pterygium? A randomized clinical trial,"ER PURPOSE: Postoperative adjuvant treatment using ?-radiotherapy (RT) is a proven technique for reducing the recurrence of pterygium. A randomized trial was conducted to determine whether a low fractionation dose of 2 Gy within 10 fractions would provide local control similar to that after a high fractionation dose of 5 Gy within 7 fractions for surgically resected pterygium.METHODS: A randomized trial was conducted in 200 patients (216 pterygia) between February 2006 and July 2007. Only patients with fresh pterygium resected using a bare sclera method and given RT within 3 days were included. Postoperative RT was delivered using a strontium-90 eye applicator. The pterygia were randomly treated using either 5 Gy within 7 fractions (Group 1) or 2 Gy within 10 fractions (Group 2). The local control rate was calculated from the date of surgery.RESULTS: Of the 216 pterygia included, 112 were allocated to Group 1 and 104 to Group 2. The 3-year local control rate for Groups 1 and 2 was 93.8% and 92.3%, respectively (p = .616). A statistically significant difference for cosmetic effect (p = .034), photophobia (p = .02), irritation (p = .001), and scleromalacia (p = .017) was noted in favor of Group 2.CONCLUSIONS: No better local control rate for postoperative pterygium was obtained using high-dose fractionation vs. low-dose fractionation. However, a low-dose fractionation schedule produced better cosmetic effects and resulted in fewer symptoms than high-dose fractionation. Moreover, pterygia can be safely treated in terms of local recurrence using RT schedules with a biologic effective dose of 24-52.5 Gy(10.).","Viani, G A; Fendi, L I; Fonseca, E C; Stefano, E J",2012.0,10.1016/j.ijrobp.2010.11.017,0,0,
3021,Isovolume hypertonic solutes (sodium chloride or mannitol) in the treatment of refractory posttraumatic intracranial hypertension: 2 mL/kg 7.5% saline is more effective than 2 mL/kg 20% mannitol,"ER DESIGNProspective, randomized study.SETTINGSA trauma center in a university hospital.PATIENTSTwenty consecutive patients with head trauma and persistent coma who required infusions of an osmotic agent to treat episodes of intracranial hypertension resistant to well-conducted standard modes of therapy were studied. Intracranial hypertension was considered refractory when it persisted despite deep sedation, optimal hemodynamic status, and, in some patients, drainage of cerebral spinal fluid.INTERVENTIONSPatients were randomly assigned to receive isovolume infusions of either 7.5% hypertonic saline solution (2400 mOsm/kg/H(2)O) or 20% mannitol (1160 mOsm/kg/H(2)O). The patients were given 2 mL/kg (body weight) of either solution, i.e., 361 +/- 13 mOsm of saline or 175 +/- 12 mOsm of mannitol per injection.MEASUREMENTS AND MAIN RESULTSThe main variables studied were the number and the duration of episodes of intracranial hypertension per day during the study period, which was stopped after the last episode of intracranial hypertension was recorded from intracranial pressure monitoring or after the allocated treatment failure. Patients in the HHS group were monitored for 7 +/- 5 days and those in the mannitol group for 7 +/- 6 days (not significant). The rate of failure for each treatment was also evaluated. Failure was defined as the persistence of intracranial hypertension despite two successive infusions of the same osmotic agent. The mean number of osmotic solute infusions was 3.7 +/- 5.3 in the mannitol group and 3.3 +/- 4.1 in the hypertonic saline solution group (not significant). The mean number (6.9 +/- 5.6 vs. 13.3 +/- 14.6 episodes) of intracranial hypertension episodes per day and the daily duration (67 +/- 85 vs. 131 +/- 123 min) of intracranial hypertension episodes were significantly lower in the hypertonic saline solution group (p <.01). The rate of clinical failure was also significantly lower in the hypertonic saline solution group: 1 of 10 patients vs. 7 of 10 patients (p <.01).CONCLUSIONIn this study, when a hypertonic solute was required for the treatment of refractory intracranial hypertension episodes in patients with severe head trauma, increasing the osmotic load by giving 2 mL/kg (body weight) of 7.5% saline (361 +/- 13 mOsm) was more effective than giving 2 mL/kg (body weight) of 20% mannitol (175 +/- 12 mOsm). Within the limitations of the present study, these data suggest that giving 2 mL/kg hypertonic saline solution (approximately 480 mOsm/70 kg body weight) is an effective and safe initial treatment for intracranial hypertension episodes in head-trauma patients when osmotherapy is indicated.OBJECTIVETo evaluate the clinical benefit of increasing the osmotic load of the hypertonic solution administered for the treatment of refractory intracranial hypertension episodes in patients with severe head injury.","Vialet, R; Albanèse, J; Thomachot, L; Antonini, F; Bourgouin, A; Alliez, B; Martin, C",2003.0,10.1097/01.CCM.0000063268.91710.DF,0,0,
3022,Increased incidence and impact of nonconvulsive and convulsive seizures after traumatic brain injury as detected by continuous electroencephalographic monitoring.,"The early pathophysiological features of traumatic brain injury observed in the intensive care unit (ICU) have been described in terms of altered cerebral blood flow, altered brain metabolism, and neurochemical excitotoxicity. Seizures occur in animal models of brain injury and in human brain injury. Previous studies of posttraumatic seizures in humans have been based principally on clinical observations without a systematic approach to electroencephalographic (EEG) recording of seizures. The purpose of this study was to determine prospectively the incidence of convulsive and nonconvulsive seizures by using continuous EEG monitoring in patients in the ICU during the initial 14 days post-injury. Ninety-four patients with moderate-to-severe brain injuries underwent continuous EEG monitoring begin-ning at admission to the ICU (mean delay 9.6+/-5.4 hours) and extending up to 14 days postinjury. Convulsive and nonconvulsive seizures occurred in 21 (22%) of the 94 patients, with six of them displaying status epilepticus. In more than half of the patients (52%) the seizures were nonconvulsive and were diagnosed on the basis of EEG studies alone. All six patients with status epilepticus died, compared with a mortality rate of 24% (18 of 73) in the nonseizure group (p<0.001). The patients with status epilepticus had a shorter mean length of stay (9.14+/-5.9 days compared with 14+/-9 days [t-test, p<0.031). Seizures occurred despite initiation of prophylactic phenytoin on admission to the emergency room, with maintenance at mean levels of 16.6+/-2.8 mg/dl. No differences in key prognostic factors (such as the Glasgow Coma Scale score, early hypoxemia, early hypotension, or 1-month Glasgow Outcome Scale score) were found between the patients with seizures and those without. Seizures occur in more than one in five patients during the 1st week after moderate-to-severe brain injury and may play a role in the pathobiological conditions associated with brain injury.",Vespa PM.; Nuwer MR.; Nenov V.; Ronne-Engstrom E.; Hovda DA.; Bergsneider M.; Kelly DF.; Martin NA.; Becker DP.,1999.0,10.3171/jns.1999.91.5.0750,0,0,
3023,Preferential processing of visual trauma-film reminders predicts subsequent intrusive memories,"This study used an analogue design to test the hypothesis that preferential processing of visual trauma reminders in the aftermath of a stressful or traumatic event gives rise to subsequent intrusive memories. Shortly after the presentation of a stressful film fragment, participants (n = 36) were asked to detect neutral targets (rotated buildings or nature scenes) in a single target rapid serial visual presentation (RSVP) paradigm. During half of the streams, the target was preceded by a distracter. The distracters consisted of visual images extracted from an earlier presented stressful film (e.g., persons and objects that figured in the film). The degree of interference by these film reminders predicted subsequent intrusions recorded in a one-week diary. The results provide evidence that a deficient ability to obtain attentional control over perceptual ""trauma"" reminders during goal-directed behaviour may set people at risk for persistent intrusive memories. Implications for research investigating attentional bias and intrusive memories in context of posttraumatic stress disorder (PTSD) are discussed.",Verwoerd J.; Wessel I.; de Jong P.J.; Nieuwenhuis M.M.W.,2009.0,10.1080/02699930802457952,0,0,
3024,Individual differences in experiencing intrusive memories: The role of the ability to resist proactive interference,"This study explored whether a relatively poor ability to resist or inhibit interference from irrelevant information in working memory is associated with experiencing undesirable intrusive memories. Non-selected participants (N = 91) completed a self-report measure of intrusive memories, and carried out experimental tasks intended to measure two different types of inhibition: resistance to proactive interference and response inhibition (i.e., the ability to prevent automatically triggered responses). The results showed a significant relationship between inhibition at the cognitive level (i.e., resistance to proactive interference) and the frequency of intrusive memories (especially in the group of female participants) whereas no such relationship with measures of response inhibition emerged. These findings are consistent with the idea that deficient inhibitory control reflects a vulnerability factor for experiencing intrusive memories. Implications for research investigating risk factors for the development of posttraumatic stress disorder (PTSD) are discussed. © 2008 Elsevier Ltd. All rights reserved.",Verwoerd J.; Wessel I.; de Jong P.J.,2009.0,10.1016/j.jbtep.2008.08.002,0,0,
3025,Does Kinesiophobia Modify the Effects of Physical Therapy on Outcomes in Patients With Sciatica in Primary Care? Subgroup Analysis From a Randomized Controlled Trial.,"A higher level of kinesiophobia appears to be associated with poor recovery in patients with sciatica. The aim of this study was to investigate whether kinesiophobia modifies the effect of physical therapy on outcomes in patients with sciatica. This was a subgroup analysis from a randomized controlled trial. The study was conducted in a primary care setting. A total of 135 patients with acute sciatica participated. Patients were randomly assigned to groups that received (1) physical therapy plus general practitioners' care (intervention group) or (2) general practitioners' care alone (control group). Kinesiophobia at baseline was measured with the Tampa Scale for Kinesiophobia (TSK) and a single substitute question for kinesiophobia (SQK). Pain and recovery were assessed at 3- and 12-month follow-ups. Regression analysis was used to test for interaction between the level of kinesiophobia at baseline and treatment allocation. Subgroup results were calculated for patients classified with high fear of movement and for those classified with low fear of movement. Kinesiophobia at baseline interacted with physical therapy in the analysis with leg pain intensity at 12-month follow-up. Kinesiophobia at baseline did not interact with physical therapy regarding any outcome at 3-month follow-up or recovery at 12-month follow-up. When comparing both treatment groups in the subgroup of patients with high fear of movement (n=73), the only significant result was found for leg pain intensity difference from baseline at 12-month follow-up (intervention group: XÃÖ=-5.0, SD=2.6; control group: XÃÖ=-3.6, SD=2.7). The post hoc study design and relatively small sample size were limitations of the study. In 135 patients with sciatica, evidence shows that patients with a higher level of kinesiophobia at baseline may particularly benefit from physical therapy with regard to decreasing leg pain intensity at 12-month follow-up.",Verwoerd AJ.; Luijsterburg PA.; Koes BW.; el Barzouhi A.; Verhagen AP.,2015.0,10.2522/ptj.20140458,0,0,
3026,Fear generalization in humans: Impact of prior non-fearful experiences,"Fear generalization lies at the heart of many anxiety problems, and is therefore an important target for prevention and/or treatment. Here, we investigated whether fear generalization towards a specific stimulus can be weakened by prior non-fearful experiences with that stimulus. Using the standard human fear conditioning procedure, all participants received paired presentations of a geometric figure and an electric shock. This was followed by a test phase in which a similar but different figure was presented. Electrodermal responding and ratings of shock-expectancy measured the level of fear generalization towards this test stimulus. Crucially, half of the participants had been preexposed to that stimulus (without shock). The results show significantly less generalization in this group, suggesting that prior non-fearful experiences can protect against fear generalization. These results may inspire novel ways to prevent the development of clinical anxiety. © 2010.",Vervliet B.; Kindt M.; Vansteenwegen D.; Hermans D.,2010.0,10.1016/j.brat.2010.07.002,0,0,
3027,Physiological and affective reactivity to a 35% CO2 inhalation challenge in individuals differing in the 5-HTTLPR genotype and trait neuroticism,"The inhalation of 35% carbon dioxide (CO2) results in an acute stress response in healthy individuals and may accordingly provide a good paradigm to examine potential vulnerability factors for stress reactivity and stress-related psychopathology. It has been proposed that CO2 reactivity is moderated by genetic (5-HTTLPR) and personality (neuroticism) factors, yet no experimental study has investigated their effects on CO2 reactivity simultaneously. The current study examined the singular and interactive effects of the 5-HTTLPR genotype and neuroticism in predicting the affective and physiological response to a 35% CO2 challenge in a healthy sample of male and female students. From a large group of 771 students, 48 carriers of the low/low expressing allele (S/S, S/Lg, Lg/Lg) and 48 carriers of the high/high expressing allele (La/La) with the lowest and the highest neuroticism scores (77 females, 19 males; mean age±SD: 20.6±2years) were selected and underwent a 35% CO2 inhalation. Visual analogue scales for anxiety and discomfort and the Panic Symptom List were used to assess affective symptomatology, while salivary samples and heart rate were assessed to establish the physiological response. A typical pattern of responses to CO2 was observed, characterised by increases in anxiogenic symptoms and physical panic symptomatology and a reduction in heart rate; however, no effect on salivary cortisol concentration was observed. Additionally, the CO2 reactivity did not differ between groups divided by the 5-HTTLPR genotype or neuroticism. Findings of the current study do not support a role for singular or interactive effects of the 5-HTTLPR genotype and trait neuroticism on affective and physiological reactivity to a 35% CO2 inhalation procedure. © 2011 Elsevier B.V. and ECNP.",Verschoor E.; Markus C.R.,2012.0,10.1016/j.euroneuro.2011.12.003,0,0,
3028,Horticultural therapy for patients with chronic musculoskeletal pain: results of a pilot study,"ER CONTEXT: Therapists can use horticultural therapy as an adjuvant therapy in a non threatening context, with the intent of bringing about positive effects in physical health, mental health, and social interaction. Very few experimental studies exist that test its clinical effectiveness.OBJECTIVE: To determine whether the addition of horticultural therapy to a pain-management program improved physical function, mental health, and ability to cope with pain.DESIGN: The research team designed a prospective, nonrandomized, controlled cohort study, enrolling all patients consecutively referred to the Zurzach Interdisciplinary Pain Program (ZISP) who met the studys criteria. The team divided them into two cohorts based on when medical professionals referred them: before (control group) or after (intervention group) introduction of a horticultural therapy program.SETTING: The setting was the rehabilitation clinic (RehaClinic) in Bad Zurzach, Switzerland.PARTICIPANTS: Seventy-nine patients with chronic musculoskeletal pain (fibromyalgia or chronic, nonspecific back pain) participated in the study.INTERVENTIONS: The research team compared a 4-week, inpatient, interdisciplinary pain-management program with horticultural therapy (intervention, n = 37) with a pain-management program without horticultural therapy (control, n = 42). The horticultural therapy program consisted of seven sessions of group therapy, each of 1-hour duration.OUTCOME MEASURES: The research team assessed the outcome using the Medical Outcome Study Short Form-36 (SF-36), the West Haven-Yale Multidimensional Pain Inventory (MPI), the Hospital Anxiety and Depression Scale (HADS), the Coping Strategies Questionnaire (CSQ ), and two functional performance tests. The team tested participants on entry to and discharge from the 4-week pain-management program.RESULTS: Between-group differences in sociodemographic and outcome variables were not significant on participants entry to the pain-management program. On discharge, the research team measured small to moderate outcome effects (effect size [ES] up to 0.71) within both groups. The study found significantly larger improvements for the horticultural therapy group vs the control group in SF-36 role physical (ES = 0.71 vs 0.22; P = .018); SF-36 mental health (ES = 0.46 vs 0.16; P = .027); HADS anxiety (ES = 0.26 vs 0.03; P = .043); and CSQ pain behavior (ES = 0.30 vs -0.05; P = .032).CONCLUSION: The addition of horticultural therapy to a pain management program improved participants' physical and mental health and their coping ability with respect to chronic musculoskeletal pain.","Verra, M L; Angst, F; Beck, T; Lehmann, S; Brioschi, R; Schneiter, R; Aeschlimann, A",2012.0,,0,0,
3029,A Randomized Pragmatic Clinical Trial of Chiropractic Care for Headaches With and Without a Self-Acupressure Pillow,"ER Objective The purpose of this study was to determine if the addition of a self-acupressure pillow (SAP) to typical chiropractic treatment results in significantly greater improvement in tension-type and cervicogenic headache sufferers. Methods A pragmatic randomized clinical trial was conducted in a chiropractic college teaching clinic. Thirty-four subjects, including tension-type and cervicogenic headache sufferers, 21 to 60 years of age, male or female, completed the study. Group A (n = 15) received typical chiropractic care only (manual therapy and exercises), and group B (n = 19) received typical chiropractic care with daily home use of the SAP. The intervention period was 4 weeks. The main outcome measure was headache frequency. Satisfaction and relief scores were obtained from subjects in the SAP group. Analysis of variance was used to analyze the intergroup comparisons. Results Owing to failure of randomization to produce group equivalence on weekly headache frequency, analysis of covariance was performed showing a trend (P =.07) favoring the chiropractic-only group; however, this was not statistically significant. Group A obtained a 46% reduction of weekly headache frequency (t = 3.1, P =.002; d = 1.22). The number of subjects in group A achieving a reduction in headaches greater than 40% was 71%, while for group B, this was 28%. The mean benefit score (0-3) in group B of the use of the SAP was 1.2 (.86). The mean satisfaction rating of users of the SAP was 10.4 (2.7) out of 15 (63%). Conclusion This study suggests that chiropractic care may reduce frequency of headaches in patients with chronic tension-type and cervicogenic headache. The use of a self-acupressure pillow (Dr Zaxx device) may help those with headache and headache pain relief as well as producing moderately high satisfaction with use.","Vernon, H; Borody, C; Harris, G; Muir, B; Goldin, J; Dinulos, M",2015.0,10.1016/j.jmpt.2015.10.002,0,0,
3030,[What to do when confronted with syncope].,,Vernant P.,1974.0,,0,0,
3031,Brain imaging and PTSD,"Posttraumatic stress disorder (PTSD) is a disabling anxiety disorder. It is a relatively young disorder that is making headway in clinical neuroscience research. Rapid developments in the field of neuroimaging (fMRI, PET) have opened windows of opportunities to improve our understanding of brain correlates and responses in PTSD e.g. wider availability of scanning protocols, increases in magnetic field strength, closer mimic of induction of fear related memories through virtual reality, personalized use of cognitive and/or sensory cues, differentiation in dissociative vs hyperresponsive response types, receptor imaging protocols. The role of various brain structures in PTSD is becoming more clear, e.g. hippocampal volume, amygdala hyperresponsiveness, failure of medial prefrontal cortical activation. These structures are critically involved in memory processing, emotional responses and fear processing. New information on pain processing applied to PTSD has showed discrete alterations. Yet, the specificity of alterations in these brain regions for the disorder is not completely clear and needs to be better studied in relation to other psychiatric disorders and treatment outcome. In the last 5 years the number of imaging studies has tripled, and it is not unlikely that this will increase further. New fields are starting to emerge that are working on implementation of clinical progress in treatment approaches, using virtual reality and neurofeedback principles. Developments that are derived from this need to be carefully tested in clinical trials before implementation in current practices. Most importantly, they need to be integrated with current practices to further optimized the efficacy of treatment.",Vermetten E.; Geuze E.; Westenberg H.G.M.,2008.0,,0,0,
3032,Clomipramine test: Serum level determination in three groups of psychiatric patients,"Concentrations of clomipramine, a specific and potent serotonin uptake inhibitor, are measured in 67 psychiatric patients and 12 normal volunteers. The psychiatric patients are grouped according to the DSM III R criteria namely; pathological gamblers, obsessive compulsives and sufferers of panic disorders. Before and 30, 60, 90 and 120 min after an intravenous infusion of the drug (12.5 mg in 10 min), serum samples are collected to evaluate the concentrations of cortisol, prolactine and growth hormone. Simultaneously the clomipramine concentration of these samples is determined and these results only are reported in this communication. Very different drug concentrations are observed in individual patients receiving the same amount of drug, indicating a substantial inter-individual variability of drug metabolism. No statistical differences (Newman-Keules test) between the clomipramine concentrations from the patients of the three psychiatric groups and the normal group are observed. Neither are statistical correlations observed when clomipramine concentrations from all individuals (n = 79) are related with the age, sex or consumer behaviour (cigarette smoking, alcohol and coffee intakes) of the patients.",Vazquez Rodriguez A.M.; Arranz Pena M.I.; Lopez Ibor J.J.; Aguilera M.G.; Vinas R.; Moreno I.; Vecino Morales A.M.,1991.0,10.1016/0731-7085(91)80028-8,0,0,
3033,"Female-specific education, management, and lifestyle enhancement for implantable cardioverter defibrillator patients: the FEMALE-ICD study","ER METHODTwenty-nine women were recruited for the study. Fourteen women were randomized to the intervention group and participated in a psychosocial intervention focused on female-specific issues; 15 were randomized to the wait-list control group. All women completed individual psychological batteries at baseline and at 1-month follow-up measuring shock anxiety and device acceptance.RESULTSPre-post measures of shock anxiety demonstrated a significant time by group interaction effect with the intervention group having a significantly greater decrease (Pillai's trace = 5.58, P = 0.026). A significant interaction effect (Pillai's trace = 5.05, P = 0.046) was found, such that women under the age of 50 experienced greater reduction in shock anxiety than their middle-aged cohorts. Pre-post measures of device acceptance revealed a significant time by group interaction effect with the intervention group having significantly greater increases (Pillai's trace = 5.80, P = 0.023).CONCLUSIONSStructured interventions for female ICD patients involving ICD-specific education, cognitive behavioral therapy strategies, and group social support provide improvements in shock anxiety and device acceptance at 1-month re-assessment. Young women appear to be an at-risk subgroup of this population and may experience more benefit from psychosocial treatment targeting device-specific concerns.BACKGROUNDSignificant rates of psychological distress occur in implantable cardioverter defibrillator (ICD) patients. Research has demonstrated that women are particularly at risk for developing distress and warrant psychosocial attention. The major objectives were to implement and test the effectiveness of a female-specific psychosocial group intervention on disease-specific quality of life outcomes in outpatient female ICD recipients versus a wait-list control group.","Vazquez, L D; Conti, J B; Sears, S F",2010.0,10.1111/j.1540-8159.2010.02787.x,0,0,
3034,"Prevalence, comorbidity, and correlates of DSM-IV axis I mental disorders among female university students.","This cross-sectional study evaluated the prevalence of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), axis I mental disorders among Spanish female students and investigated their psychiatric comorbidity and correlates. 1054 female students with a mean age of 22.2 years were randomly selected, with stratification by academic seniority and the type of academic discipline. The cases of mental disorder were identified by clinically trained interviewers with the aid of the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinician Version. The lifetime prevalence of the targeted psychiatric disorders was 50.8%, and its point prevalence was 37.3%. The commonest disorders were nicotine dependence, depression, and generalized anxiety disorder. Nearly 37% of subjects with a psychiatric disorder had two or more diagnoses. Mental illness was associated with family income, financial independence, type of academic discipline, violence from men, social support, and self-esteem. Psychiatric disorders are common among female university students. Serious attention should be paid to preventive and therapeutic programs in this group.",Vázquez FL.; Torres Á.; Otero P.; Díaz O.,2011.0,10.1097/NMD.0b013e31821cd29c,0,0,
3035,Physical examination and self-reported pain outcomes from a randomized trial on chronic cervicogenic headache,"ER METHODS: This is an exploratory analysis of data generated by attention control PE from an open-label randomized clinical trial. Of 80 subjects, 40 were randomized to 8 treatments (spinal manipulative therapy or light massage control) and 8 PE over 8 weeks. The remaining subjects received no PE. Physical examination included motion palpation of the cervical and upper thoracic regions, active cervical range of motion (ROM) and associated pain, and algometric pain threshold evaluated over articular pillars. Self-reported outcomes included CGH and neck pain and disability, number of CGH headaches, and related disability days. Associations between PE and self-reported outcomes were evaluated using generalized linear models, adjusting for sociodemographic differences and study group.RESULTS: At baseline, number of CGH and disability days were strongly associated with cervical active ROM (P < .001 to .037). Neck pain and disability were strongly associated with ROM-elicited pain (P < .001 to .035) but not later in the study. After the final treatment, pain thresholds were strongly associated with week 12 neck pain and disability and CGH disability and disability days (P < or = .001 to .048).CONCLUSIONS: Cervical ROM was most associated with the baseline headache experience. However, 4 weeks after treatment, algometric pain thresholds were most associated. No one PE measure remained associated with the self-reported headache outcomes over time.OBJECTIVE: Objective clinical measures for use as surrogate markers of cervicogenic headache (CGH) pain have not been established. In this analysis, we investigate relationships between objective physical examination (PE) measures with self-reported CGH outcomes.","Vavrek, D; Haas, M; Peterson, D",2010.0,10.1016/j.jmpt.2010.05.004,0,0,
3036,"[Differentiated short- and long-term effects of a ""Training of Emotional Intelligence"" and of the ""Integrated Psychologic Therapy Program"" for schizophrenic patients?].","Social cognition was shown as a rate limiting factor for both psychosocial outcome and response to psychosocial intervention in schizophrenia. In a randomized controlled trial a new cognitive-behavioral group treatment for schizophrenic inpatients (the ""Training of Emotional Intelligence"", TEI) was tested against the well evaluated ""Integrated Psychological Therapy Program"" (IPT) of H. Brenner. Within the framework of P. Salovey's work the Training of Emotional Intelligence focussed on three domains of deficits in schizophrenia: emotional perception, emotional understanding and emotional management. In the randomized controlled trial with 41 DSM-IV schizophrenic inpatients no differences were found in problem-solving and negative symptoms, both post treatment and in the 12 months-follow up. Additionally there was a better outcome in affect decoding capacity post treatment, and a progess in regulation of negative affects in the follow up. Emotional role taking behavior and social anxiety returned to baseline level, perhaps by reasons of no ""booster sessions"" in the follow up. Unfortunately in contrast to our hypotheses we failed to show treatment-specific effects, which may be due to an underpowered statistical testing. There was only one exception of this: While the Integrated Psychological Therapy Program showed a greater reduction of global psychopathology after treatment, the Training of Emotional Intelligence reduced psychopathology in the follow up more strongly. Possible reasons for these results are discussed.",Vauth R.; Joe A.; Seitz M.; Dreher-Rudolph M.; Olbrich H.; Stieglitz RD.,2001.0,10.1055/s-2001-18383,0,0,
3037,"Differentiated short- and long-term effects of a ""Training of Emotional Intelligence"" and of the ""Integrated Psychologic Therapy Program"" for schizophrenic patients?","Evaluated a new cognitive-behavioral group treatment for schizophrenia inpatients, Training of Emotional Intelligence (TEI), and compared it with the well-evaluated Integrated Psychological Therapy program (IPT) of H. Brenner. Within the framework of P. Salovey's work, the TEI treatment focused on 3 domains of deficits in schizophrenia: emotional perception, emotional understanding and emotional management. In a randomized controlled trial with 41 inpatients, the results show no differences in problem-solving and negative symptoms, both post-treatment and in the 12-mo follow up. Additionally, there was a better outcome in affect decoding capacity post-treatment, and progress in regulation of negative affects in the followup. Emotional role taking behavior and social anxiety returned to baseline levels, perhaps because of no booster sessions in the followup. No treatment-specific effects were demonstrated, which may be due to underpowered statistical testing. There was only one exception to this: while the IPT program showed a greater reduction of global psychopathology after treatment, TEI reduced psychopathology in the followup more strongly. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Vauth, R; Joe, A; Seitz, M; Dreher-Rudolph, M; Olbrich, H; Stieglitz, R.-D; Andreasen, Andreasen, Bell, Bellack, Birchwood, Bonner, Braff, Brenner, Brenner, Catanzaro, Catanzaro, Charles, Ciochetti, Cutting, D'Zurilla, Dixon, Ekman, Falloon, Folkman, Frith, Gaebel, Grawe, Green, Green, Green, Heinssen, Heppner, Herz, Hodel, Hogarty, Hogarty, Ihnen, Izard, Kane, Kasermann, Kirsch, Kraemer, Laporte, Lewis, Mandal, Mass, Mayer, Mehrabian, Meichenbaum, Meichenbaum, Miklowitz, Mueser, Mussgay, Nuechterlein, Nuechterlein, Overall, Penn, Peralta, Roder, Roy, Salovey, Sayers, Shrout, Siris, Spaulding, Spaulding, Theilemann, Tollefson, Ullrich de Muynck, Ullrich, Vauth, Vauth, Vauth, Vauth, Vauth, Wiedemann, Wiedl, Wiedl, Zito",2001.0,,0,0,
3038,"Differentiated short- and long-term effects of a ""Training of Emotional Intelligence"" and of the ""Integrated Psychologic Therapy Program"" for schizophrenic patients?","ER Social cognition was shown as a rate limiting factor for both psychosocial outcome and response to psychosocial intervention in schizophrenia. In a randomized controlled trial a new cognitive-behavioral group treatment for schizophrenic inpatients (the ""Training of Emotional Intelligence"", TEI) was tested against the well evaluated ""Integrated Psychological Therapy Program"" (IPT) of H. Brenner. Within the framework of P. Salovey's work the Training of Emotional Intelligence focussed on three domains of deficits in schizophrenia: emotional perception, emotional understanding and emotional management. In the randomized controlled trial with 41 DSM-IV schizophrenic inpatients no differences were found in problem-solving and negative symptoms, both post treatment and in the 12 months-follow up. Additionally there was a better outcome in affect decoding capacity post treatment, and a progess in regulation of negative affects in the follow up. Emotional role taking behavior and social anxiety returned to baseline level, perhaps by reasons of no ""booster sessions"" in the follow up. Unfortunately in contrast to our hypotheses we failed to show treatment-specific effects, which may be due to an underpowered statistical testing. There was only one exception of this: While the Integrated Psychological Therapy Program showed a greater reduction of global psychopathology after treatment, the Training of Emotional Intelligence reduced psychopathology in the follow up more strongly. Possible reasons for these results are discussed.","Vauth, R; Joe, A; Seitz, M; Dreher-Rudolph, M; Olbrich, H; Stieglitz, R D",2001.0,10.1055/s-2001-18383,0,0,3036
3039,Attention and memory dysfunction in posttraumatic stress disorder.,"Attention and memory performances were studied in Persian Gulf War veterans with and without posttraumatic stress disorder (PTSD) diagnoses. Veterans diagnosed with PTSD showed relative performance deficiencies on tasks of sustained attention, mental manipulation, initial acquisition of information, and retroactive interference. Their performances were also characterized by errors of commission and intrusion. The tendency toward response disinhibition and intrusion on cognitive tasks was correlated positively with reexperiencing symptoms and negatively with avoidance-numbing symptoms. These cognitive deficit patterns are consistent with models of PTSD that emphasize the role of hyperarousal and implicate dysfunction of frontal-subcortical systems. Results suggest that intrusion of traumatic memories in PTSD may not be limited to trauma-related cognitions but instead reflects a more general pattern of disinhibition.",Vasterling JJ.; Brailey K.; Constans JI.; Sutker PB.,1998.0,,0,0,
3040,Adaptive and maladaptive self-focus: a pilot extension study with individuals high and low in fear of negative evaluation.,"Previous research in depressed participants has supported the differentiation of self-focus into distinct modes of self-attention with distinct functional effects. In particular, Rimes and Watkins (2005) investigated the effects of self-focused rumination on overgeneral thinking and found that analytical, evaluative self-focus increased global negative self-judgments, whereas self-focus low in analytical thinking decreased such judgments in depressed participants. Given that self-focused attention and rumination have been implicated in the maintenance of social anxiety, the present study investigated the effects of these two distinct forms of self-focused attention on global negative self-judgments in an analogue sample for social anxiety (high and low fear of negative evaluation, FNE). Individuals high and low in FNE (n=41 per group) were randomly allocated to analytic (abstract, evaluative) or experiential (concrete, process-focused) self-focused manipulations. As predicted, in high FNE individuals, the experiential self-focus condition decreased ratings of the self as worthless and incompetent pre- to post-manipulation, whereas the analytical self-focus condition maintained such negative self-judgments. Analytical and experiential self-focus did not differ in their effects on mood. The results suggest that an experiential mode of self-focused rumination may be adaptive in social anxiety.",Vassilopoulos SP.; Watkins ER.,2009.0,10.1016/j.beth.2008.05.003,0,0,
3041,Coping strategies and anticipatory processing in high and low socially anxious individuals.,"The purpose of this study was to investigate coping responses associated with anticipatory social anxiety. Participants were presented with vignettes that involved anticipating a stressful social situation and were instructed to record their thoughts and recalled memories to allow for the examination of the content of anticipatory processing. Anticipatory coping and distraction were assessed via self-report. Results indicated that participants high in social anxiety were more likely to engage in mental preparation for stressful events compared to those low in social anxiety. Further, high socially anxious participants reported more planning thoughts about concealing their state of anxiety or avoiding the stressful situation and less planning thoughts about improving their in-situation performance compared to those low in social anxiety. Finally, individuals high in social anxiety produced less positive autobiographical memories and more negative self-evaluative thoughts. No group differences on distraction coping emerged. The theoretical and clinical implications of the results are discussed.",Vassilopoulos SP.,2008.0,10.1016/j.janxdis.2007.01.010,0,0,
3042,Experimentally modifying interpretations for positive and negative social scenarios in children: a preliminary investigation,"ER BACKGROUND: Past research suggests that socially anxious individuals display a tendency to interpret ambiguous and clearly valenced information in a threatening way. Interpretation training programs, in which individuals are trained to endorse benign rather than negative interpretations of ambiguous social scenarios, have proven effective for reducing anxiety-related cognitive biases. However, it is not clear whether the same paradigms are effective in modifying interpretation biases for clearly valenced social information.METHOD: In this experiment, a group of unselected children (aged 10-13 years) was trained to endorse the more positive of two possible interpretations of mildly negative and positive social events.RESULTS: Data revealed that this group (n = 77) showed a decrease in catastrophic interpretations and an increase in neutral interpretations of mildly negative events compared to children in a no-training control group (n = 76). Furthermore, participants in the training condition showed an increase in positive interpretations and a trend for a decrease in discounting interpretations of positive events. However, training did not affect emotional ratings of mildly negative and positive events or trait social anxiety.CONCLUSIONS: Notwithstanding certain limitations of this pilot study, we believe that the results are promising with regard to modifying interpretative biases for clearly valenced vignettes, and that further study regarding the effects of training on mood is warranted.","Vassilopoulos, S P; Moberly, N J; Zisimatou, G",2013.0,10.1017/S1352465812000537,0,0,
3043,The differential effects of written and spoken presentation for the modification of interpretation and judgmental bias in children,"ER AIMS: The current study investigated whether the effects of the interpretation training procedure in children are differentiated according to the mode of presentation of the training.METHOD: Ninety-four primary school children (aged 10-12 years) scoring above the mean on a social anxiety scale were randomly allocated to four groups, in which they were trained using written or spoken presentation of training materials in either the negative or benign direction.RESULTS: For the negative training, children who heard the training material spoken aloud (spoken presentation) made more negative interpretations of ambiguous social events, compared to children who read the training material (written presentation). However, for the benign training, there was less clear evidence for a differentiation of the effects between the two modes of presentation, although children in the spoken presentation group performed better in a stressful task and showed a trend to rate their mood as more positive after the task than children in the written presentation group.CONCLUSIONS: These results not only forward our understanding of the mechanism of the genesis of cognitive bias in children, but also highlight the need for further investigation of how to optimize the effectiveness of interpretation training in children.BACKGROUND: Interpretation training programs, in which individuals are trained to interpret ambiguous scenarios in either a negative or benign way, have proven effective in altering anxiety-related cognitive biases in both children and adults.","Vassilopoulos, S P; Blackwell, S E; Misailidi, P; Kyritsi, A; Ayfanti, M",2014.0,10.1017/S1352465813000301,0,0,
3044,"It was as big as my head, I swear! Biased spider size estimation in spider phobia.","The current study tested the association between fear and perception in spider phobic individuals (n = 57) within the context of a treatment outcome study. Participants completed 5 post-treatment Behavioral Approach Tasks (BATs) in which they encountered a live spider and were asked to provide spider size estimates. Consistent with predictions, results indicated that high levels of fear were associated with magnified perception of phobic stimuli. Specifically, we found a significant positive correlation between size estimates and self-reported fear while encountering spiders. Together with previous findings, these results further support the notion that fear is involved in the encoding and processing of perceptual information. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Vasey, Michael W; Vilensky, Michael R; Heath, Jacqueline H; Harbaugh, Casaundra N; Buffington, Adam G; Fazio, Russell H; Ahs, Amaral, Arntz, Cahill, Cisler, Clerkin, Cody, Coles, Ehlers, Gilbert, Larson, Mogg, Nunes, Ohman, Phelps, Reinecke, Riskind, Rowe, Schnall, Stefanucci, Story, Szymanski, Teachman, Teachman, Vuilleumier, Witt, Witt",2012.0,,0,0,
3045,Predicting return of fear following exposure therapy with an implicit measure of attitudes.,"We sought to advance understanding of the processes underlying the efficacy of exposure therapy and particularly the phenomenon of return of fear (ROF) following treatment by drawing on a social psychological view of phobias as attitudes. Specifically, a dual process theory of attitude-related behavior predicts that a positive response to exposure therapy may reflect change in either the automatic (the attitude representation itself) or controlled (skills and confidence at coping with the fear) responses to the phobic stimulus, or both. However, if the attitude representation remains negative following treatment, ROF should be more likely. We tested this hypothesis in a clinical sample of individuals with public speaking phobia using a single-session exposure therapy protocol previously shown to be efficacious but also associated with some ROF. Consistent with predictions, a post-treatment implicit measure of attitudes toward public speaking (the Personalized Implicit Association Test [PIAT]) predicted ROF at 1-month follow-up. These results suggest that change in the automatically activated attitude toward the phobic stimulus is an important goal of exposure therapy and that an implicit measure like the PIAT can provide a useful measure of such change by which to gauge the adequacy of exposure treatment and predict its long-term efficacy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Vasey, Michael W; Harbaugh, Casaundra N; Buffington, Adam G; Jones, Christopher R; Fazio, Russell H; Ajzen, Asendorpf, Beck, Bouton, Choy, Collins, Craske, Craske, Craske, Ellwart, Fazio, Fazio, First, Gamer, Han, Han, Hermans, Hofmann, Huijding, Huijding, Jones, Karpinski, Leary, Mansell, McNally, Moscovitch, Olson, Olson, Ouimet, Paul, Phillips, Rachman, Roefs, Spielberger, Spielberger, Teachman, Tsao, Wells, Wigboldus, Wild, Wolpe",2012.0,,0,0,
3046,Reasoning training in veteran and civilian traumatic brain injury with persistent mild impairment,"ER Traumatic brain injury (TBI) is a chronic health condition. The prevalence of TBI, combined with limited advances in protocols to mitigate persistent TBI-related impairments in higher order cognition, present a significant challenge. In this randomised study (n?=?60), we compared the benefits of Strategic Memory Advanced Reasoning Training (SMART, n?=?31), a strategy-based programme shown to improve cognitive control, versus an active learning programme called Brain Health Workshop (BHW, n?=?29) in individuals with TBI with persistent mild functional deficits. Outcomes were measured on cognitive, psychological health, functional, and imaging measures. Repeated measures analyses of immediate post-training and 3-month post-training demonstrated gains on the cognitive control domain of gist reasoning (ability to abstract big ideas/goals from complex information/tasks) in the SMART group as compared to BHW. Gains following the SMART programme were also evident on improved executive function, memory, and daily function as well as reduced symptoms associated with depression and stress. The SMART group showed an increase in bilateral precuneus cerebral blood flow (CBF). Improvements in gist reasoning in the SMART group were also associated with an increase in CBF in the left inferior frontal region, the left insula and the bilateral anterior cingulate cortex. These results add to prior findings that the SMART programme provides an efficient set of strategies that have the potential to improve cognitive control performance and associated executive functions and daily function, to enhance psychological health, and facilitate positive neural plasticity in adults with persistent mild impairment after TBI.","Vas, A; Chapman, S; Aslan, S; Spence, J; Keebler, M; Rodriguez-Larrain, G; Rodgers, B; Jantz, T; Martinez, D; Rakic, J; Krawczyk, D",2016.0,10.1080/09602011.2015.1044013,0,0,
3047,NeuroSPECT findings in patients with posttraumatic anosmia: a quantitative analysis.,"To investigate quantitative neuroSPECT findings, particularly from orbital frontal cortex, in patients rendered totally anosmic from head injury. Veterans Administration (VA) Medical Center. Eighteen patients with head injury resulting in severe anosmia and five normal controls. All 18 patients had sustained their head injuries at least 5 years prior to involvement in the study. Quantitative neuroSPECT (count density) from sagittal regions of interest (ROIs) ranging circumferentially from orbital frontal cortex to occipital pole. Quantitative evaluation of neuroSPECT findings for anosmic patients as a group showed substantial orbital frontal hypoperfusion compared with controls, with 67% of individual anosmic patients showing orbital frontal hypoperfusion at a level two or more standard deviations below that of the worst control subject. By contrast, there were no between-group differences for five other ROIs (inferior frontal pole, superior frontal pole, posterior superior frontal lobe, the parasagittal region, and occipital pole), and individual abnormalities were infrequent in these areas. In addition, orbital frontal count was significantly correlated with ratings of outcome, the only ROI to have such a relationship. Findings strongly suggest that posttraumatic anosmia and the neuropsychological deficits typically associated with posttraumatic anosmia are closely and specifically associated with hypoperfusion in orbital frontal cortex. The results also underscore the importance of posttraumatic anosmia as a clinical sign of orbital frontal damage, which is particularly important in patients with mild head injury who have normal computed tomography and magnetic resonance imaging scans.",Varney NR.; Bushnell D.,1998.0,,0,0,
3048,Yoga-based intervention for caregivers of outpatients with psychosis: a randomized controlled pilot study.,"The use of yoga as an intervention for caregivers of patients with psychosis has been poorly studied. The current study aimed to test the efficacy of a brief yoga program as an intervention in caregivers of outpatients with functional psychotic disorders using a randomized controlled research design. Caregivers who agreed to participate in the study (n=29) were randomized into yoga (n=15) or wait-list group (n=14). They were assessed at baseline and at the end of 3 months. Patients who were randomized into the yoga group were offered supervised yoga training thrice a week for 4 weeks, after which they were instructed to practice at home for the next 2 months. Due to the small sample size and some variables not being normally distributed, non-parametric statistical analysis was used. Results showed significantly reduced burden scores and improved quality of life scores in the yoga group as compared to the wait-list group at the end of 3 months. There were no significant changes in anxiety and depression scores in caregivers, or psychopathology scores in patients. In caregivers of outpatients with functional psychosis, 4 weeks of training followed by 3 months of home practice of a yoga module offered significant advantage over waitlist. Yoga can be offered as an intervention for caregivers of patients with severe mental disorders. Methods of providing yoga intervention closer to the community or use of flexible modules at hospitals needs further study.",Varambally S.; Vidyendaran S.; Sajjanar M.; Thirthalli J.; Hamza A.; Nagendra HR.; Gangadhar BN.,2013.0,10.1016/j.ajp.2012.09.017,0,0,
3049,The repeated confrontation with videotapes of spiders in multiple contexts attenuates renewal of fear in spider-anxious students.,"In a treatment-analogue experiment, extinction of fear of spiders was investigated in a group of spider-anxious students. Two groups were created: in the single extinction group the extinction trials consisted of repeated presentations of a videotaped spider in one specific location of a house, whereas in the multiple extinction group the trials consisted of videotapes of the same spider in three different locations of a house. Also a control group was included that was exposed to videotapes of the location but without the spider. As reflected in skin conductance responses and self-report data, fear of spiders was significantly reduced in the two extinction groups compared to the control group. Moreover, when the extinction groups were confronted with the videotape of the spider in a new location, the single extinction group did not show generalisation of extinction, whereas the multiple extinction group did. These results corroborate the existing evidence for context dependence of extinction of fear and provide new evidence that the use of multiple contexts during extinction might improve the generalisability of extinction in humans. Implications for exposure therapy are discussed.",Vansteenwegen D.; Vervliet B.; Iberico C.; Baeyens F.; Van den Bergh O.; Hermans D.,2007.0,10.1016/j.brat.2006.08.023,0,0,
3050,Autogenic training and future oriented hypnotic imagery in the treatment of tension headache: outcome and process,"ER The aim of the present study was (a) to investigate the relative efficacy of autogenic training and future oriented hypnotic imagery in the treatment of tension headache and (b) to explore the extent to which therapy factors such as relaxation, imagery skills, and hypnotizability mediate therapy outcome. Patients were randomly assigned to the 2 therapy conditions and therapists. 55 patients (28 in the autogenic therapy condition and 27 in the future oriented hypnotic imagery condition) completed the 4 therapy sessions and 2 assessment sessions. No significant main effect or interaction effects for treatment condition or therapist was revealed. A significant effect for time in analyzing scores for headache pain, pain medication usage, depression, and state anxiety was found. In the self-hypnosis condition, pain reduction proved to be associated with depth of relaxation during home practice (as assessed with diaries) and capacity to involve in imagery (as assessed with the Dutch version [van der Velden & Spinhoven, 1984] of the Creative Imagination Scale [Barber & Wilson, 1978/79; Wilson & Barber, 1978]). After statistically controlling for relaxation and imagery, hypnotizability scores (as assessed with the Dutch version [Oyen & Spinhoven, 1983] of the Stanford Hypnotic Clinical Scale [Morgan & J.R. Hilgard, 1975, 1978/79]) were significantly correlated with ratings of pain reduction. Results are discussed in the context of the neo-dissociation and social-cognitive model of hypnoanalgesia. The clinical relevance and the methodological shortcomings of the present study are also critically assessed.","VanDyck, R; Zitman, F G; Linssen, A C; Spinhoven, P",1991.0,10.1080/00207149108409615,0,0,
3051,"Education, progressive muscle relaxation therapy, and exercise for the treatment of night eating syndrome. A pilot study.","Night eating syndrome (NES) is a circadian rhythm disorder in which food intake is shifted toward the end of the day, interfering with sleep. According to the biobehavioral model of NES, the disorder is the result of a genetic predisposition that, coupled with stress, leads to enhanced reuptake of serotonin, thereby dysregulating circadian rhythms and decreasing satiety. Using the biobehavioral model as a guide, we developed a brief behavioral intervention using education, relaxation strategies, and exercise to address the core symptoms of NES. In this pilot randomized controlled clinical trial, 44 participants with NES were randomly assigned to an educational group (E; n‚Äâ=‚Äâ14), E plus progressive muscle relaxation therapy (PMR; n‚Äâ=‚Äâ15); or PMR plus exercise (PMR Plus, n‚Äâ=‚Äâ15). Participants received a baseline intervention with 1- and 3-week follow-up sessions. Effectiveness analyses showed that participants in all three groups evidenced significant reductions on measures of NES symptoms (p‚Äâ<‚Äâ.001), depression (p‚Äâ<‚Äâ.05), anxiety (p‚Äâ<‚Äâ.01), and perceived stress (p‚Äâ<‚Äâ.05). However, the only significant between group change was for the percent of food eaten after the evening meal, with the PMR group showing the greatest reduction (-30.54%), followed by the PMR Plus group (-20.42%) and the E group (-9.5%); only the difference between the PMR and E groups was statistically significant (p‚Äâ=‚Äâ.012). Reductions in NES scores were significantly associated with reductions on measures of depression (r‚Äâ=‚Äâ.47; p‚Äâ<‚Äâ.01) and perceived stress (r‚Äâ=‚Äâ.37; p‚Äâ<‚Äâ.05), but not anxiety (r‚Äâ=‚Äâ.26, p‚Äâ=‚Äâns). Results support the role of education and relaxation in the behavioral treatment of NES.",Vander Wal JS.; Maraldo TM.; Vercellone AC.; Gagne DA.,2015.0,10.1016/j.appet.2015.01.024,0,0,
3052,The role of the right temporoparietal junction in the elicitation of vicarious experiences and detection accuracy while observing pain and touch,"This study investigated the effects of observing pain and touch in others upon vicarious somatosensory experiences and the detection of subtle somatosensory stimuli. Furthermore, transcranial direct current stimulation (tDCS) was used to assess the role of the right temporoparietal junction (rTPJ), as this brain region has been suggested to be involved in perspective taking and self–other distinction. Undergraduates (N = 22) viewed videos depicting hands being touched, hands being pricked, and control scenes (same approaching movement as in the other video categories but without the painful/touching object), while experiencing vibrotactile stimuli themselves on the left, right, or both hands. Participants reported the location at which they felt a somatosensory stimulus. Vibrotactile stimuli and visual scenes were applied in a congruent or incongruent way. During three separate testing sessions, excitability of the rTPJ was modulated with tDCS (cathodal, anodal, or sham). We calculated the proportion of correct responses and false alarms (i.e., number of trials in which a vicarious somatosensory experience was reported congruent to the site of the visual information). Pain-related scenes facilitated the correct detection of tactile stimuli and augmented the number of vicarious somatosensory experiences compared with observing touch or control videos. Stimulation of the rTPJ had no reliable influence upon detection accuracy or the number of vicarious errors. This study indicates that the observation of pain-related scenes compared to the observation of touch or control videos increases the likelihood that a somatosensory stimulus is detected. Contrary to our expectations, the rTPJ did not modulate detection accuracy.",Vandenbroucke S.; Bardi L.; Lamm C.; Goubert L.,2016.0,10.1007/s00221-015-4516-1,0,0,
3053,The moderational role of anxiety sensitivity in flight phobia,"Anxiety sensitivity (AS) is the tendency to interpret anxiety-related bodily sensations in a threatening way. Previous research in a subclinical population identified AS as a vulnerability factor in flight phobia: AS moderates the relationship between somatic sensations and flight anxiety. The present study aimed at gaining further evidence for the moderational role of AS in a large clinical population with flight phobia. The data were obtained from 103 participants: 54 flight phobic participants and 49 controls. Just before taking a flight participants were asked to complete the Anxiety Sensitivity Index and to report their level of anxiety and bodily sensations. Results showed that AS moderates the relationship between somatic sensations and flight phobia: somatic sensations significantly predicted flight anxiety in subjects with higher AS scores, while this was not the case for subjects scoring lower on AS. Present findings implicate that treatment protocols should be supplemented by interventions specifically aimed at reducing AS, especially for individuals high in AS. © 2010 Elsevier Ltd.",Vanden Bogaerde A.; De Raedt R.,2011.0,10.1016/j.janxdis.2010.11.005,0,0,
3054,TaylorActive--Examining the effectiveness of web-based personally-tailored videos to increase physical activity: a randomised controlled trial protocol,"ER METHODS/DESIGN: In total 510 Australians will be recruited through social media advertisements, e-mail and third party databases. Participants will be randomised to one of three groups: text-tailored, video-tailored, or control. All groups will gain access to the same web-based platform and a library containing brief physical activity articles. The text-tailored group will additionally have access to 8 sessions of personalised physical activity advice that is instantaneously generated based on responses to brief online surveys. The theory-based advice will be provided over a period of 3 months and address constructs such as self-efficacy, motivation, goal setting, intentions, social support, attitudes, barriers, outcome expectancies, relapse prevention and feedback on performance. Text-tailored participants will also be able to complete 7 action plans to help them plan what, when, where, who with, and how they will become more active. Participants in the video-tailored group will gain access to the same intervention content as those in the text-tailored group, however all sessions will be provided as personalised videos rather than text on a webpage. The control group will only gain access to the library with generic physical activity articles. The primary outcome is objectively measured physical activity. Secondary outcomes include website engagement and retention, quality of life, depression, anxiety, stress, sitting time, sleep and psychosocial correlates of physical activity. Outcomes will be measured at baseline, 3, and 9 months.DISCUSSION: This study presents an ideal opportunity to study the effectiveness of an isolated feature within a web-based physical activity intervention and the knowledge generated from this study will help to increase intervention effectiveness.TRIAL REGISTRATION: Australian New-Zealand Clinical Trial Registry: ACTRN12615000057583 . Registered 22 January 2015. CQUniversity Ethics Project Number: H14/07-163.BACKGROUND: Physical inactivity levels are unacceptably high and effective interventions that can increase physical activity in large populations at low cost are urgently needed. Web-based interventions that use computer-tailoring have shown to be effective, though people tend to 'skim' and 'scan' text on the Internet rather than thoroughly read it. The use of online videos is, however, popular and engaging. Therefore, the aim of this 3-group randomised controlled trial is to examine whether a web-based physical activity intervention that provides personally-tailored videos is more effective when compared with traditional personally-tailored text-based intervention and a control group.","Vandelanotte, C; Short, C; Plotnikoff, R C; Hooker, C; Canoy, D; Rebar, A; Alley, S; Schoeppe, S; Mummery, W K; Duncan, M J",2015.0,10.1186/s12889-015-2363-4,0,0,
3055,The efficacy of alpha and theta neurofeedback training in treatment of generalized anxiety disorder.,"Examined whether EEG theta neurofeedback training (NFT) would produce a beneficial effect in the same way as EEG alpha NFT neurofeedback training. Eighteen Ss with generalized anxiety disorder (GAD) were given 15 sessions of either alpha NFT (increasing alpha and decreasing beta) or theta NFT (increasing theta and decreasing beta) following a baseline evaluation. The post-treatment evaluation indicated that the alpha and theta NFT are associated with a significant decrease in self-reported and observer-rated anxiety measures, and a significant increase in the quality of life measure. The beneficial effects of the treatment appeared comparable between alpha and theta NFT groups. However, the effects of alpha and theta NFT were not seen on the EEG spectral analysis carried out at pre- and post-treatment phases in all Ss. The results suggest that theta NFT could be as effective as alpha NFT in the management of clinical symptoms of GAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Vanathy, S; Sharma, P. S. V. N; Kumar, K. B",1998.0,,0,0,
3056,Clinical effects of buspirone in social phobia: A double-blind placebo-controlled study.,"Investigated the efficacy of buspirone in 30 patients with social phobia using a 12-wk double-blind placebo controlled design. Ss were randomly assigned to receive either buspirone 30 mg daily or placebo. Efficacy of treatment was measured using the Social Phobia Scale (subscores anxiety and avoidance) and the Hamilton Rating Scale for Anxiety. Using a reduction of 50% or more on the Social Phobia Scale as a criterion for clinically relevant improvement, only 1 Ss on buspirone and 1 on placebo responded to treatment. A subjective and clinically relevant improvement was reported by 4 Ss on buspirone and 2 on placebo. There were no statistically significant differences between buspirone and placebo on any of the outcome measures. Generally speaking, buspirone was well tolerated. Results did not support the results of open studies where a reduction in social anxiety and social avoidance was reported in Ss with social phobia treated with buspirone. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","van Vliet, Irene M; den Boer, Johan A; Westenberg, Herman G. M; Pian, Kamini L. Ho",1997.0,,0,0,
3057,"Behavioral, neuroendocrine and biochemical effects of different doses of 5-HTP in panic disorder","To investigate the role of serotonin (5-HT) in the pathophysiology of panic disorder (PD) a challenge test with L-5-hydroxytryptophan (5-HTP) was conducted. Seven patients suffering from PD and seven healthy controls received an i.v. challenge with 10 mg, 20 mg and 40 mg 5-HTP and placebo in random order on four different occasions. Before, during and until 2 h after 5-HTP administration anxious and depressive symptomatology was assessed. In addition, plasma levels of 5-HTP, cortisol, and 5-HIAA were measured at several timepoints. During and after infusion of placebo or any of the different dosages of 5-HTP, none of the patients or controls experienced a panic attack or showed an increase in anxiety or depressive symptoms. There was a dose-related increase in side effects, like nausea, dizziness and fatigue. Only infusion with 40 mg 5-HTP led to an increase in plasma cortisol in both patients and controls. The observed increase in plasma cortisol level was higher for patients compared to controls only at 30 min after infusion. In conclusion, stimulation of the serotonergic neuronal system by three different dosages of 5-HTP did not induce panic or anxiety in PD patients and healthy controls. The 5-HT hypersensitivity hypothesis of PD could not be confirmed in the present study.",Van Vliet I.M.; Slaap B.R.; Westenberg H.G.M.; Den Boer J.A.,1996.0,10.1016/0924-977X(95)00070-6,0,0,
3058,The impact of personality disorders on behavioral treatment outcome for social phobia.,"Compared the effects of exposure in vivo treatment for social phobia in 3 groups of social phobics (aged 18-65 yrs): social phobia without any PD (N = 30), social phobia with a single diagnosis of avoidant PD (N = 18), and social phobia with multiple PDs (N = 13). Parallel change for social phobia with and without an avoidant PD with the latter group being more impaired before and after treatment was hypothesized. In the 1st treatment session, avoidance behavior was explored. Directly following the last session, Ss filled in post-treatment measures, and were invited for a follow-up 3 mo later. Social phobics in all 3 groups improved significantly during treatment. The analyses showed that an additional anxiety or mood disorder also did not predict outcome of exposure treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Van Velzen, Carol J. M; Emmelkamp, Paul M. G; Scholing, Agnes",1997.0,,0,0,
3059,Safety Behavior Increases Obsession-Related Cognitions About the Severity of Threat,"This study investigated whether checking behavior, the most common safety behavior in obsessive-compulsive disorder (OCD), contributes to the development of OCD symptoms. Ninety healthy undergraduates spent a week between a pre- and posttest either actively engaging in clinically representative checking behavior on a daily basis (experimental group, n=30), monitoring their normal checking behavior (monitor group, n=30), or received no instructions on checking behavior (control group, n=30). Cognitions about the severity of threat increased from pre- to posttest in the experimental group, but not in the monitor and control groups. Cognitions about the importance of checking decreased in the monitor group. The results indicate that checking behavior contributes directly to the exacerbation of OCD symptoms. Together with the findings of previous studies, this suggests that safety behavior may be involved in the development of anxiety disorders and OCD. Potential mechanisms of how engaging in safety behavior increases threat perception are discussed.",van Uijen S.L.; Toffolo M.B.J.,2015.0,10.1016/j.beth.2015.04.001,0,0,
3060,Stepped-care prevention of anxiety and depression in late life: a randomized controlled trial.,"Given the public health significance of late-life depression and anxiety, and the limited capacity of treatment, there is an urgent need to develop effective strategies to prevent these disorders. To determine the effectiveness of an indicated stepped-care prevention program for depression and anxiety disorders in the elderly. Randomized controlled trial with recruitment between October 1, 2004, and October 1, 2005. Thirty-three primary care practices in the northwestern part of the Netherlands. A total of 170 consenting individuals, 75 years and older, with subthreshold symptom levels of depression or anxiety who did not meet the full diagnostic criteria for the disorders. Participants were randomly assigned to a preventive stepped-care program (n = 86) or to usual care (n = 84). Stepped-care participants sequentially received a watchful waiting approach, cognitive behavior therapy-based bibliotherapy, cognitive behavior therapy-based problem-solving treatment, and referral to primary care for medication, if required. The cumulative incidence of DSM-IV major depressive disorder or anxiety disorder after 12 months as measured using the Mini International Neuropsychiatric Interview. The intervention halved the 12-month incidence of depressive and anxiety disorders, from 0.24 (20 of 84) in the usual care group to 0.12 (10 of 86) in the stepped-care group (relative risk, 0.49; 95% confidence interval, 0.24 to 0.98). Indicated stepped-care prevention of depression and anxiety in elderly individuals is effective in reducing the risk of onset of these disorders and is valuable as seen from the public health perspective.",van't Veer-Tazelaar PJ.; van Marwijk HW.; van Oppen P.; van Hout HP.; van der Horst HE.; Cuijpers P.; Smit F.; Beekman AT.,2009.0,10.1001/archgenpsychiatry.2008.555,0,0,
3061,Prevention of late-life anxiety and depression has sustained effects over 24 months: A pragmatic randomized trial.,"Objective: Depressive and anxiety disorders in later life have a high incidence and are associated with reduced quality of life. Elsewhere, we demonstrated that a stepped-care prevention approach was successful in halving the incidence of these disorders over a period of 12 months. As a decreasing effect over time is to be expected, our aim was to investigate the longer-term effects. Design: Randomized controlled trial. Setting: Thirty-three primary care practices in the Netherlands. Participants: One hundred seventy consenting individuals, age 75 years and older, presenting with subthreshold depression or anxiety, not meeting the diagnostic criteria. Intervention: Participants were randomized to a preventive intervention or usual care. In the first 12 months, the preventive intervention entailed watchful waiting, minimally supported CBT-based self-help intervention, problem-solving treatment, and referral to a primary care physician for medication, if required. In the last 12 months, 95% of the participants ceased to receive such support. Measurements: Mini International Neuropsychiatric Interview. Results: The cumulative incidence rate of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, major depression or anxiety disorder over a period of 24 months was halved by the intervention, from 33 of 84 (39.3%) in the usual care group to 17 of 86 (19.8%) in the intervention group (odds ratio = 0.38; 95% confidence interval = 0.19-0.76), which was significant (z = 2.75; p = 0.006). The corresponding number needed to treat was 5 (95% confidence interval = 3-16). Conclusions: A stepped-care approach to the prevention of depression and anxiety in late life was not only successful in halving the incidence of depressive and anxiety disorders after 1 year, but these favorable effects were also sustained over 24 months. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","van't Veer-Tazelaar, Petronella J; van Marwijk, Harm W. J; van Oppen, Patricia; van der Horst, Henriette E; Smit, Filip; Cuijpers, Pim; Beekman, Aartjan T. F; Andrews, Antonuccio, Bartels, Breslau, Cole, Cuijpers, Cuijpers, Cuijpers, Haringsma, Hosman, Jackson, Jansen, Kendrick, Mrazek, Munoz, Mynors-Wallis, Mynors-Wallis, Rost, Rubin, Schoevers, Sheehan, Smit, Smit, Stevens, Van't Veer-Tazelaar, Van't Veer-Tazelaar, van't Veer-Tazelaar",2011.0,,0,0,
3062,Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial.,"There is an urgent need for the development of cost-effective preventive strategies to reduce the onset of mental disorders. To establish the cost-effectiveness of a stepped care preventive intervention for depression and anxiety disorders in older people at high risk of these conditions, compared with routine primary care. An economic evaluation was conducted alongside a pragmatic randomised controlled trial (ISRCTN26474556). Consenting individuals presenting with subthreshold levels of depressive or anxiety symptoms were randomly assigned to a preventive stepped care programme (n = 86) or to routine primary care (n = 84). The intervention was successful in halving the incidence rate of depression and anxiety at euro563 ( pound412) per recipient and euro4367 ( pound3196) per disorder-free year gained, compared with routine primary care. The latter would represent good value for money if the willingness to pay for a disorder-free year is at least euro5000. The prevention programme generated depression- and anxiety-free survival years in the older population at affordable cost.",Van't Veer-Tazelaar P.; Smit F.; van Hout H.; van Oppen P.; van der Horst H.; Beekman A.; van Marwijk H.,2010.0,10.1192/bjp.bp.109.069617,0,0,
3063,Prevention of anxiety and depression in the age group of 75 years and over: a randomised controlled trial testing the feasibility and effectiveness of a generic stepped care programme among elderly community residents at high risk of developing anxiety an,"In frail elderly, the effects of depression and anxiety are deep encroaching. Indicated prevention studies, aimed at subjects with subthreshold disorder, have shown that well designed interventions are capable of reducing the incidence of depression and anxiety. In this randomised prevention trial for elderly, living in the community and suffering from subthreshold depression and anxiety, a stepped care programme was put together to be tested versus usual (GP) care.  randomised controlled trial. (See figure 1: organisation chart) together with two other projects, this project is part of a national consortium that investigates the prevention of anxiety and depressive disorders in later life using a stepped care programme. The three projects have their own particular focus. This project is aimed at elderly living in the community.Inclusion: subjects with a high risk for depression and anxiety without clinical evidence of these syndromes. The participants are 75 years of age and over and have subthreshold symptoms of depression and or anxiety: they score above the cut-off point on the self-report Centre for Epidemiologic Studies Depression (CES-D) scale, but the criteria for a major depressive disorder or anxiety disorder (panic disorder, agoraphobia, social phobia, generalized anxiety disorder) according to a validated interview, the Mini International Neuropsychiatric Interview (MINI) are not fulfilled. primary outcome: incidence of a depressive or anxiety disorder over a period of two years (MINI); secondary outcome: a positive influence of the intervention, a stepped care programme, on symptoms of depression and anxiety and on quality of life as assessed with the CES D, the HADS A and the SF36 respectively (i.e. stabilisation or improvement of symptoms) [see table 1]. Take place at baseline and at 3, 6, 9, 12, 18 and 24 months. Trained independent evaluators assess depression and anxiety status, the primary end point (6, 12, 18, 24 months) [see table 2]. Late-life depression and anxiety are characterised by high prevalence, unfavourable prognosis, reduced quality of life, excess mortality and substantial societal costs. No health service, however well equipped, will be able to effectively treat all elderly with depression and anxiety. Therefore, development of (cost) effective means to prevent these disorders is very important.",van 't Veer-Tazelaar N.; van Marwijk H.; van Oppen P.; Nijpels G.; van Hout H.; Cuijpers P.; Stalman W.; Beekman A.,2006.0,10.1186/1471-2458-6-186,0,0,
3064,Stepped care for depression in primary care: what should be offered and how?,"Stepped-care approaches may offer a solution to delivering accessible, effective and efficient services for individuals with depression. In stepped care, all patients commence with a low-intensity, low-cost treatment. Treatment results are monitored systematically, and patients move to a higher-intensity treatment only if necessary. We deliver a stepped-care model targeting patients with depression. The first step consists of ""watchful waiting"", as half of all patients with a depressive episode recover spontaneously within 3 months. The second step, guided self-help, is the key element of the stepped-care model. Guided self-help, especially when offered through the internet, is effective and cost-efficient. The third step consists of brief face-to-face psychotherapy. Finally, in the fourth step, longer-term face-to-face psychotherapy and antidepressant medication might be considered. Patients are monitored by one person, a care manager, who is responsible for the decision to step up to the next treatment and for continuity of care. The different treatments within the stepped-care model are evidence-based. Data on cost-effectiveness of the full model are still scarce, but we recently demonstrated that the incidence of new cases of depression and anxiety could be halved by introducing stepped care. Effects of web-based guided self-help could be enhanced by incorporating them in a stepped-care model.",van Straten A.; Seekles W.; van 't Veer-Tazelaar NJ.; Beekman AT.; Cuijpers P.,2010.0,,0,0,
3065,Comparison of posterior capsule opacification with hydrophobic acrylic and hydrophilic acrylic intraocular lenses,"ER SETTINGIladevi Cataract and IOL Research Institute, Ahmedabad, India.DESIGNProspective randomized clinical trial.METHODSA hydrophobic Acrysof (hydrophobic group) or a hydrophilic C-flex (hydrophilic group C) or Akreos Adapt IOL (hydrophilic group A) was randomized for implantation in the fellow eye or vice versa of each patient. The Evaluation of Posterior Capsule Opacification (EPCO) area, EPCO score, and neodymium:YAG (Nd:YAG) capsulotomy rates were compared using digital photographs.RESULTSThe study enrolled 68 patients. Although there was no significant difference at 1 month, the median EPCO score was statistically significantly lower in the hydrophobic group than in hydrophilic group C (P = .00) and hydrophilic group A (P = .000) at 3 years. There were no significant differences in the median EPCO area at 1 month; however, the area was statistically significantly less in the hydrophobic group than in hydrophilic group C and hydrophilic group A at 3 years (both P = .000). Four (12.9%) of 31 eyes in hydrophilic group C and 5 (16%) of 31 eyes in hydrophilic group A required an Nd:YAG capsulotomy; no eye in the hydrophobic group required a capsulotomy (P = .04 and P = .02, respectively).CONCLUSIONPosterior capsule opacification was significantly less with the Acrysof hydrophobic acrylic IOL at 3 years.FINANCIAL DISCLOSURENo author has a financial or proprietary interest in any material or method mentioned.PURPOSETo compare posterior capsule opacification (PCO) 3 years postoperatively in contralateral eyes with a single-piece hydrophobic acrylic and 1 of 2 single-piece hydrophilic acrylic intraocular lenses (IOLs) with different configurations.","Vasavada, A R; Raj, S M; Shah, A; Shah, G; Vasavada, V",2011.0,10.1016/j.jcrs.2010.12.060,0,0,
3066,[Dynamic gait analysis of blocked distal tibiofibular joint following syndesmotic complex lesions].,"Dynamic gait analysis of blocked distal tibiofibular joint (TFJ) has not performed yet. This prospective study investigated patients treated for ankle fractures with combined syndesmotic complex lesions after surgery including tibiofibular positioning screw using CT data detecting fibular maltorsion and dynamic gait analysis. Prepublished data of 61 patients after surgical block of TFJ were analysed for torsional deformity of the distal fibula with an especially developed novel CT method. 10 of these patients were selected for dynamic pedography (emed-SF4, Novel GmbH, Munich). The measurements were accomplished one and six weeks (with blocked TFJ) and four months (with deblocked TFJ) postoperatively. The gait pattern of 10 pedographically investigated patients showed increased loads of the hindfoot as well as a load shift to the lateral midfoot. Four months postoperative significant differences of the plantar pressure pattern concerning the parameters force, pressure, impulse and contact time were not observed. The analysis of the foot progression angle (fpa) of the non operated feet demonstrated external rotation of 9,5 degrees in average. In comparison to the healthy side with tibiofibular positioning screw the operated feet were significantly internal rotated during the first two measurements. Patients with fibular torsional differences > 15 degrees showed not only with tibiofibular positioning screw but also after its removal a persistent difference of fpa in average of 5,6 degrees without external rotating retraction. The temporary blockage of TFJ results into an altered pattern of dynamic plantar pressure distribution. A constant foot progression angle in relative internal rotation is registered. After removal of the positioning screw the recovered ligamentous structures allow retraction to the anatomic position. But, concerning fibular torsional differences > 15 degrees osseous fixation leads to alterated fpa presented as diminished external rotation of the foot of the formerly fractured ankle with consecutive dysfunction of the physiologic kinematic of movement and eventual provocation of posttraumatic arthritis. Dynamic gait analysis of a blocked distal tibiofibular joint (TFJ) has not been performed yet. This prospective study investigated patients treated for ankle fractures with combined syndesmotic complex lesions after surgery including a tibiofibular positioning screw using CT data for detecting fibular maltorsion and dynamic gait analysis. Prepublished data of 61 patients after surgical block of TFJ were analysed for torsional deformity of the distal fibula with an especially developed novel CT method. Ten of these patients were selected for dynamic pedography (emed-SF4, Novel GmbH, Munich). The measurements were accomplished one and six weeks (with blocked TFJ) and four months (with deblocked TFJ) postoperatively. The gait patterns of 10 pedographically investigated patients showed increased loads of the hindfoot as well as a load shift to the lateral midfoot. Four months postoperative significant differences of the plantar pressure pattern concerning the parameters force, pressure, impulse and contact time were not observed. The analysis of the foot progression angle (fpa) of the non-operated feet demonstrated external rotation of 9,5 degrees in average. In comparison to the healthy side the operated feet with tibiofibular positioning screw were significantly internally rotated during the first two measurements. Patients with fibular torsional differences > 15 degrees showed not only with the tibiofibular positioning screw but also after its removal a persistent difference of fpa in average of 5.6 degrees without external rotating retraction. The temporary blockage of the TFJ results into an altered pattern of dynamic plantar pressure distribution. A constant foot progression angle in relative internal rotation is registered. After removal of the positioning screw the recovered ligamentous structures allow retraction to the anatomic position. But, concerning fibular torsional differences > 15 degrees osseous fixation leads to alterated fpa presented as diminished external rotation of the foot of the formerly fractured ankle with consecutive dysfunction of the physiologic kinematic of movement and eventual provocation of posttraumatic arthritis.",Vasarhelyi A.; Lubitz J.; Zeh A.; Wohlrab D.; Hein W.; Mittlmeier T.,,10.1055/s-0029-1185695,0,0,
3067,Higher-order reasoning training years after traumatic brain injury in adults.,"To conduct a feasibility study to compare the effects of top-down Strategic Memory and Reasoning Training (SMART) versus information-based Brain Health Workshop (BHW, control) on gist-reasoning (ie, abstracting novel meaning from complex information), memory, executive functions, and daily function in adults with traumatic brain injury. Twenty-eight participants (of the 35 recruited), 16 men & 12 women, aged 20 to 65 years (M = 43, SD = 11.34) at chronic stages posttraumatic brain injury (2 years or longer) completed the training. Fourteen participants that received SMART and 14 participants that completed BHW were assessed both pre- and posttraining. Thirteen of the SMART trained and 11 from BHW participated in a 6-month testing. The study was a single blinded randomized control trial. Participants in both groups received a minimum of 15 hours of training over 8 weeks. The SMART group significantly improved gist-reasoning as compared to the BHW group. Benefits of the SMART extended to untrained measures of working memory and participation in functional activities. Exploratory analyses suggested potential transfer effects of SMART on memory and executive functions. The benefits of the SMART program as compared to BHW were evident at immediately posttraining and 6 months posttraining. This study provides preliminary evidence that short-term intensive training in top-down modulation of information benefits gist-reasoning and generalizes to measures of executive function and real life function at chronic stages of post-TBI.",Vas AK.; Chapman SB.; Cook LG.; Elliott AC.; Keebler M.,,10.1097/HTR.0b013e318218dd3d,0,0,
3068,Higher-order reasoning training years after traumatic brain injury in adults,"ER PARTICIPANTSTwenty-eight participants (of the 35 recruited), 16 men & 12 women, aged 20 to 65 years (M = 43, SD = 11.34) at chronic stages posttraumatic brain injury (2 years or longer) completed the training. Fourteen participants that received SMART and 14 participants that completed BHW were assessed both pre- and posttraining. Thirteen of the SMART trained and 11 from BHW participated in a 6-month testing.DESIGNThe study was a single blinded randomized control trial. Participants in both groups received a minimum of 15 hours of training over 8 weeks.RESULTSThe SMART group significantly improved gist-reasoning as compared to the BHW group. Benefits of the SMART extended to untrained measures of working memory and participation in functional activities. Exploratory analyses suggested potential transfer effects of SMART on memory and executive functions. The benefits of the SMART program as compared to BHW were evident at immediately posttraining and 6 months posttraining.CONCLUSIONThis study provides preliminary evidence that short-term intensive training in top-down modulation of information benefits gist-reasoning and generalizes to measures of executive function and real life function at chronic stages of post-TBI.OBJECTIVETo conduct a feasibility study to compare the effects of top-down Strategic Memory and Reasoning Training (SMART) versus information-based Brain Health Workshop (BHW, control) on gist-reasoning (ie, abstracting novel meaning from complex information), memory, executive functions, and daily function in adults with traumatic brain injury.","Vas, A K; Chapman, S B; Cook, L G; Elliott, A C; Keebler, M",2011.0,10.1097/HTR.0b013e318218dd3d,0,0,3067
3069,Reducing suicidal thoughts in the Australian general population through web-based self-help: study protocol for a randomized controlled trial.,"Suicidal thoughts are common in the general population, causing significant disability. However, a substantial number of people struggling with suicidality do not access appropriate services. Online self-help may help overcome barriers to help-seeking. This study aims to examine the effectiveness of an online self-help program targeted at reducing suicidal thoughts compared with an attention-matched control condition in the Australian adult population. This trial is based on a Dutch self-help program, which was found to be effective in reducing suicidal thoughts. A total of 570 community-dwelling adults (18 to 65 years old) with suicidal thoughts will be recruited via various media and randomly assigned to the 6-week online program aimed at reducing suicidal thoughts or a 6-week attention-matched control program. Primary outcome measure is the severity of suicidal thoughts. Secondary outcome measures include suicide plans, capacity to cope with suicidal thoughts, reasons for living, symptoms of depression, hopelessness, anxiety/worry, rumination, panic, perceived burdensomeness and thwarted belongingness, acquired capability, alcohol consumption, insomnia, and various cost-effectiveness measures. Although the original Dutch trial found web-based self-help to be effective in reducing suicidal thoughts, randomized controlled trials (RCT) of online programs for suicidal thoughts are rare. The present study extends previous research by running the first English language RCT of this sort. As a result of the original study, the current RCT includes refinements to the design, including greater levels of participant anonymity and longer follow-up periods. Limitations of this trial include the potential for high drop-out and the inability to ascertain whether any suicides occur during the study. Australian New Zealand Clinical Trials Registry (ANZCTR) Registration number: ACTRN12613000410752 (15 April 2013). Universal Trial Number (UTN): U1111-1141-6595 (15 April 2013).",van Spijker BA.; Calear AL.; Batterham PJ.; Mackinnon AJ.; Gosling JA.; Kerkhof AJ.; Solomon D.; Christensen H.,2015.0,10.1186/s13063-015-0589-1,0,0,
3070,Mindfulness-based cognitive therapy for people with diabetes and emotional problems: long-term follow-up findings from the DiaMind randomized controlled trial.,"The DiaMind trial showed beneficial immediate effects of mindfulness-based cognitive therapy (MBCT) on emotional distress, but not on diabetes distress and HbA1c. The aim of the present report was to examine if the effects would be sustained after six month follow-up. In the DiaMind trial, 139 outpatients with diabetes (type-I or type-II) and a lowered level of emotional well-being were randomized into MBCT (n=70) or a waiting list with treatment as usual (TAU: n=69). Primary outcomes were perceived stress, anxiety and depressive symptoms, and diabetes distress. Secondary outcomes were, among others, health status, and glycemic control (HbA1c). Compared to TAU, MBCT showed sustained reductions at follow-up in perceived stress (p<.001, d=.76), anxiety (p<.001, assessed by HADS d=.83; assessed by POMS d=.92), and HADS depressive symptoms (p=.004, d=.51), but not POMS depressive symptoms when using Bonferroni correction for multiple testing (p=.016, d=.48). No significant between-group effect was found on diabetes distress and HbA1c. This study showed sustained benefits of MBCT six months after the intervention on emotional distress in people with diabetes and a lowered level of emotional well-being. Dutch Trial Register NTR2145, http://www.trialregister.nl.",van Son J.; Nyklíček I.; Pop VJ.; Blonk MC.; Erdtsieck RJ.; Pouwer F.,2014.0,10.1016/j.jpsychores.2014.03.013,0,0,
3071,Long-term treatment effects of imagery rehearsal therapy for nightmares in a population with diverse psychiatric disorders.,"Nightmares are a common problem with debilitating consequences. Meta-analyses have revealed that imagery rehearsal therapy (IRT), in which the storyline of the recurring nightmare is changed, is the treatment of choice for nightmares. In a randomized clinical trial, we recently demonstrated that IRT was also effective in a population of patients with diverse mental disorders. In this trial, IRT showed moderate additional benefits over treatment as usual on nightmare distress, general psychopathology, and posttraumatic stress symptoms. In the current paper we report on the six- and nine month follow-up measurements of the IRT group of this trial. In the six- and nine-month follow-up the moderate improvements observed at post-treatment were sustained for all measures. This means that IRT has long-lasting effects, also in a sample with severe co-morbid psychopathology. IRT could be considered at an early stage in addition to the usual mental health treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","van Schagen, Annette M; Lancee, Jaap; Spoormaker, Victor I; van den Bout, Jan; Arrindell, Augedal, Belicki, Davis, Hovens, Hox, Krakow, Krakow, Lancee, Lancee, Lancee, Sandman, Sterne, Swart, Thunker, van Schagen",2016.0,,0,0,
3072,Personality and cognitive vulnerability in remitted recurrently depressed patients.,"Introduction: Personality disorders (PDs) have been associated with a poor prognosis of Major Depressive Disorder (MDD). The aim of the current study was to examine cognitive vulnerability (i.e., dysfunctional beliefs, extremity of beliefs, cognitive reactivity, and rumination) that might contribute to this poor prognosis of patients with PD comorbidity. Methods: 309 outpatients with remitted recurrent MDD (SCID-I; HAM-D17 <= 10) were included within two comparable RCTs and were assessed at baseline with the Personality Diagnostic Questionnaire-4+ (PDQ-4+), the Dysfunctional Attitude Scale Version-A (DAS-A), the Leiden Index of Depression Sensitivity (LEIDS), the Ruminative Response Scale (RRS), and the Inventory of Depressive Symptomatology-Self Report (IDS-SR). Results: We found an indication that the PD prevalence was 49.5% in this remitted recurrently depressed sample. Having a PD (and higher levels of personality pathology) was associated with dysfunctional beliefs, cognitive reactivity, and rumination. Extreme 'black and white thinking' on the DAS was not associated with personality pathology. Brooding was only associated with a Cluster C classification (t(308) = 4.03, p < .001) and with avoidant PD specifically (t(308) = 4.82, p < .001), while surprisingly not with obsessive-compulsive PD. Limitations: PDs were assessed by questionnaire and the analyses were cross-sectional in nature. Conclusion: Being the first study to examine cognitive reactivity and rumination in patients with PD and remitted MDD, we demonstrated that even after controlling for depressive symptomatology, dysfunctional beliefs, cognitive reactivity, and rumination were associated with personality pathology. Rumination might be a pathway to relapse for patients with avoidant PD. Replication of our findings concerning cognitive vulnerability and specific PDs is necessary. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","van Rijsbergen, Gerard D; Kok, Gemma D; Elgersma, Hermien J; Hollon, Steven D; Bockting, Claudi L. H; Abela, Arntz, Baer, Barnow, Beck, Beck, Beevers, Bockting, Bockting, Bockting, Boisseau, Carr, Charlton, Costa, Craighead, Cribb, De Bolle, Douma, Dozois, Durbin, Farabaugh, Fava, First, Fournier, Friborg, Geiger, Grilo, Grilo, Guidi, Hansen, Hirschfeld, Hollon, Hopwood, Hyler, Hyler, Ilardi, Jacobs, Jarrett, Lewinsohn, Lopez-Castroman, McHoskey, Melartin, Michalak, Morey, Moulds, Mulder, Newton-Howes, Nolen-Hoeksema, Nolen-Hoeksema, Otto, Parker, Petersen, Pilkonis, Pretzer, Raes, Rubin, Rush, Rush, Samuel, Sato, Schafer, Segal, Shea, Sieswerda, Skodol, Smith, Teasdale, Teasdale, Ten Doesschate, Treynor, Van den Heuvel, Van der Does, Van Rijsbergen, Van Velzen, Veen, Vittengl, Watkins, Weissman",2015.0,,0,0,
3073,The effect of imaginal exposure length on outcome of treatment for PTSD.,"The effects of prolonged imaginal exposure sessions (60 minutes; n=60) were compared with those of shorter exposure sessions (30 minutes, n=32) for patients with chronic posttraumatic stress disorder (PTSD). Consistent with the authors' hypothesis, patients who received 30-minute imaginal exposure sessions showed less within-session habituation than patients who received 60-minute exposure sessions. However, no differences between patients who received 60-minute and 30-minute exposure sessions emerged on improvement in PTSD-symptoms, state anxiety, depression, and end-state functioning, both at posttreatment and at 1-month follow-up. No group differences were found with regard to between-sessions habituation, number of sessions, and dropout rate. Results suggest that 30-minute imaginal exposure sessions are as effective as 60-minute exposure sessions and that within-session habituation may not be a necessary condition for successful treatment of PTSD. Future research is needed to replicate these findings and extend them to other clinical populations.",van Minnen A.; Foa EB.,2006.0,10.1002/jts.20146,0,0,
3074,"Maladaptive behavioral consequences of conditioned fear-generalization: A pronounced, yet sparsely studied, feature of anxiety pathology","Fear-conditioning experiments in the anxiety disorders focus almost exclusively on passive-emotional, Pavlovian conditioning, rather than active-behavioral, instrumental conditioning. Paradigms eliciting both types of conditioning are needed to study maladaptive, instrumental behaviors resulting from Pavlovian abnormalities found in clinical anxiety. One such Pavlovian abnormality is generalization of fear from a conditioned danger-cue (CS+) to resembling stimuli. Though lab-based findings repeatedly link overgeneralized Pavlovian-fear to clinical anxiety, no study assesses the degree to which Pavlovian overgeneralization corresponds with maladaptive, overgeneralized instrumental-avoidance. The current effort fills this gap by validating a novel fear-potentiated startle paradigm including Pavlovian and instrumental components. The paradigm is embedded in a computer game during which shapes appear on the screen. One shape paired with electric-shock serves as CS+, and other resembling shapes, presented in the absence of shock, serve as generalization stimuli (GSs). During the game, participants choose whether to behaviorally avoid shock at the cost of poorer performance. Avoidance during CS+ is considered adaptive because shock is a real possibility. By contrast, avoidance during GSs is considered maladaptive because shock is not a realistic prospect and thus unnecessarily compromises performance. Results indicate significant Pavlovian-instrumental relations, with greater generalization of Pavlovian fear associated with overgeneralization of maladaptive instrumental-avoidance. © 2014 Elsevier Ltd.",van Meurs B.; Wiggert N.; Wicker I.; Lissek S.,2014.0,10.1016/j.brat.2014.03.009,0,0,
3075,The cholecystokinin-B receptor antagonist CI-988 failed to affect CCK-4 induced symptoms in panic disorder patients.,"The effects of the cholecystokinin-B (CCKB) receptor antagonist CI-988 on symptoms elicited by the cholecystokinin tetrapeptide (CCK4) were studied in DSM-IIIR patients with panic disorder. The study employed a double-blind, two-period incomplete block design. Patients (n = I4) received two different dosages of CI-988 (50 mg or 100 mg) or placebo 2 h prior to an IV bolus injection of CCK4 (20 gg) on two separate occasions. The primary efficacy parameter was the total intensity score on the Panic Symptoms Scale (PSS). Secondary parameters were the number of panic symptoms, time to and occurrence of the first panic symptoms, duration of symptoms, intensity of apprehension and the percentage of patients who did not have a panic attack. The PSS failed to show a statistically significant treatment effect on any of these outcome measures. The average panic rate was 50%, 14.3 % and 37.5% after placebo, 50 and 100rag CI-988, respectively. The differences in panic rate were not statistically significant. The results of this study suggest that CI-988 in doses up to 100 mg is not effective in reducing symptoms of panic anxiety induced by CCK4. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","van Megen, Harold J. G. M; Westenberg, Herman G. M; den Boer, Johan A; Slaap, Bernard; van Es-Radhakishnn, Fenny; Pande, Atul C; Abelson, Bammert-Adams, Bradwejn, Bradwejn, Bradwejn, Bradwejn, Bradwejn, Costall, Hamilton, Harm, Hughes, Kramer, Lines, Montigny de, Powell, Singh, Singh, Thijssen, Van Megen, Van Megen, Van Megen, Van Megen, Van Megen, Woodruff",1997.0,,0,0,
3076,Effectiveness of an intercultural module added to the treatment guidelines for Moroccan and Turkish patients with depressive and anxiety disorders.,"Background: Since the sixties of the last century, many people from Morocco and Turkey have migrated into the Netherlands. In the last decade, Moroccan and Turkish patients have found their way to organizations for mental health care. However, they often drop out of treatment. Problems in the communication with therapists and different expectations regarding treatment seem to be causal factors for the early drop-out of therapy. In the Netherlands as in other countries courses have been developed for training cultural competence of therapists. Yet, up to now, the effectiveness of increased cultural competence of therapists in reducing drop-out of treatment has not been studied. Methods/Design: A randomized clinical trial was started in January 2010. Moroccan and Turkish adult patients who are referred to our outpatient clinics for mood and anxiety disorders are randomly assigned to mental health workers who are trained in a cultural module and to those who are not. The therapists have been trained in the Cultural Formulation and in techniques bridging the (cultural) gap between them and their Moroccan and Turkish patients. The target number of participants is 150 patients, 75 for each group. Drop-out of treatment is the primary outcome measure. Secondary outcome measures are no-show and patients' perspective of care. Discussion: The study will give an answer to the question whether increasing cultural competence of therapists reduces drop-out of treatment in Moroccan and Turkish outpatients with depressive and anxiety disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","van Loon, Annelies; van Schaik, Digna J. F; Dekker, Jack J; Beekman, Aartjan TF; Bausel, Beck, Bhugra, Bhui, Blom, Borra, Brocker, Chwastiak, de Jong, de Wit, de Wit, Dein, Griner, Fassaert, Fassaert, Friele, Hakkaart-Van Roijen, Hilderink, Hinton, Kamperman, Kleinman, Kleinman, Kortman, Kramer, Levecque, Lewis-Fernandez, Luborsky, Meadows, Mooren, Nelissen, Noordenbos, Pearlin, Rush, Schraufnagel, Schrier, Stansfeld, Struijs, Ulusoy, van Hint, Von Korff, Wacker, Wittchen, Wittchen",2011.0,,0,0,
3077,Catch me if you can: Do the five-factor model personality traits moderate dropout and acute treatment response in post-traumatic stress disorder patients?,"We therefore investigated the Five-Factor Model (FFM) personality traits as moderators of dropout and treatment response in PTSD patients. Specifically, we hypothesized that neuroticism was associated with dropout, and that lower scores on openness to experience, agreeableness, and conscientiousness, and higher scores on neuroticism, were associated with less favorable treatment outcome. Data were obtained from patients meeting DSM-IV criteria for PTSD in a previous randomized controlled trial. Our main findings can be summarized as follows. Baseline self-reported post-traumatic stress (PTS) symptoms were predictive of posttest levels of PTS symptoms. This is in line with previous studies, which in fact identified pretreatment PTS severity as the only consistent predictor of PTSD treatment outcome to date. In terms of clinical implications, our findings confirm that baseline PTS severity matters, and in fact matters more than individual personality differences, in predicting PTSD treatment outcome. Clinicians may be advised to be sensitive to extreme standings on openness to experience and conscientiousness, but by and large these effects are considerably less predictive of treatment response than initial symptom severity and do not appear to impact diagnostic status following treatment. Personality thus appears to be of more importance as a vulnerability factor than as a treatment response factor in the context of discrete anxiety disorders for which specific evidence-based protocols are available. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","van Emmerik, Arnold A.P; Kamphuis, Jan H; Noordhof, A; Emmelkamp, Paul M.G; Bisson, Bisson, Blanchard, Bryant, Cloitre, Costa, Costa, Ehlers, First,, Foa, Foa, Forbes, Forbes, Hembree, Hoekstra, Horowitz, Karatzias, Kraemer, Kubany, McCrae, Miller, Perconte, Resick, Rothbaum, Tarrier, Telch, Van Emmerik, Van Minnen, Wiggins",2011.0,,0,0,
3078,Depersonalization and derealization during panic and hypnosis in low and highly hypnotizable agoraphobics.,"The primary aim of the present study was to investigate the association between spontaneous experiences of depersonalization or derealization (D-D) during panic states and hypnosis in low and highly hypnotizable phobic individuals. Secondarily, the association among level of hypnotizability, capacity for imaginative involvement, and severity of phobic complaints was also assessed. Sixty-four patients with panic disorder with agoraphobia according to the DSM-III-R (American Psychiatric Association, 1987) criteria participated in the study. Proneness to experience D-D during hypnosis was positively related to hypnotizability, but only for agoraphobic patients who had already experienced these perceptual distortions during panic episodes. Correlations of level of hypnotizability and capacity for imaginative involvement with severity of agoraphobic complaints were not significant. These findings suggest that hypnotizability may be a mediating variable between two different, although phenotypically similar, perceptual distortions experienced during panic states and hypnosis. Implications for both theory and clinical practice are discussed.",Van Dyck R.; Spinhoven P.,1997.0,10.1080/00207149708416105,0,0,
3079,Does preference for type of treatment matter? A study of exposure in vivo with or without hypnosis in the treatment of panic disorder with agoraphobia.,"There is evidence that preference for a given therapy may influence results. Literature also suggests that hypnotizability may be elevated in agoraphobic patients, making hypnosis a potentially powerful method for treatment. Agoraphobic patients (N = 64) were treated with either exposure in vivo or exposure combined with hypnosis in a crossover design. Half of the patients started with the treatment they preferred and the other half received the other treatment first. Although patients' preference clearly shifted in favor of the combined therapy in the course of the study, no effect of preference on outcome was evident. Although hypnotizability clearly correlated to outcome in the combined therapy, no difference in effect between the two therapies was found on behavioral, self-report, and observer measures. No additional effect of hypnosis could be shown and preference was not found to be a powerful mediator of effect.",Van Dyck R.; Spinhoven P.,1997.0,10.1177/01454455970212003,0,0,
3080,Non-drug treatment for social phobia.,"A review of controlled studies on currently available nondrug treatments for social phobia reveals short-term effectiveness for social skills training, exposure therapy, and cognitive therapy. The combination of exposure and cognitive therapy may have some superiority over the separate treatments. Group therapy and individual therapy do not differ clearly in outcome, while attempts to match treatment and patient characteristics have so far failed to produce consistently better results. With follow-up periods of either less than or more than 1 yr, the therapies reviewed appear to lead to stable results, although the available data allow no firm conclusions because of attrition and additional treatments during follow-up. Except for the recent study by R. G. Heimberg and M. R. Liebowitz (1995), cognitive behavior therapy has not been adequately compared to medication. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","van Dyck, R",1996.0,,0,0,
3081,CO2 challenge results in hypothalamic-pituitary-adrenal activation in healthy volunteers,"The 35% CO2 challenge is known to induce symptoms of a panic attack both in panic disorder (PD) patients and healthy volunteers. Although the challenge applies more to PD patients, studies in healthy volunteers provide the opportunity to isolate the physical symptoms from the disorder and to focus on the direct effect from the challenge on stress responsive systems. One of the main stress responsive systems is the hypothalamic-pituitary-adrenal (HPA) axis. It remains unclear whether panic symptoms are accompanied by HPA axis activation. Differences in design have hampered any comparison between studies. For example, both serum and salivary cortisol have been used to provide an index of HPA axis activation. Furthermore, indications for central HPA axis disturbance have been suggested. The current study aimed to study the HPA axis response following the induction of panic symptoms in healthy volunteers, both at the pituitary level and at the adrenal level. Furthermore, both serum and salivary cortisol levels were determined. Subjective feelings of anxiety and, correspondingly, Cortisol and ACTH levels, were found to be significantly increased following the 35% CO2 challenge. Cortisol and ACTH responses to CO2 were also associated. A significant Cortisol increase was observed in both serum and saliva samples, although these were more pronounced when considering the free fraction serum values. We conclude that the induction of panic symptoms results in HPA axis activation, both at the pituitary and adrenal level. The question remains as to whether positive responders to the 35% CO2 inhalation (more specifically PD patients) show a more pronounced HPA axis response. © 2005 British Association for PsychopharmacoLogy.",Van Duinen M.A.; Schruers K.R.J.; Maes M.; Griez E.J.L.,2005.0,10.1177/0269881105051527,0,0,
3082,The role of ideational distress in the relation between persecutory ideations and reactive aggression,"Background People with schizophrenia are more likely to be violent than the people without it. Feeling driven to act on persecutory delusions may be one explanation for this, but it remains unclear why some should act on such delusions but some not. Acquisition of data from people who are very ill is problematic. Our study explores testing of hypotheses on similar ideational and behavioural associations among healthy recruits from the general population. Aims This study aims to test the effect of distress induced by persecutory ideas on any relationships between those ideas and aggressive behaviour, and the effect of gender. Methods Twenty-four men and 53 women from the general population participated in this study. The measures of aggressive behaviour were experimentally induced aggressive responding, self-reported aggressive behaviour in general, and self-reported reactive and proactive aggressive behaviours. Results Among men, persecutory ideation predicted reactive aggressive responding and aggressive style of behaviour only in those who experienced higher levels of persecutory ideational distress. Among women, with generally lower levels of aggression, the role of ideational distress was more complicated; Women in the low distress group responded with higher aggression on the task. Women in the higher distress group responded with higher aggressive style. For neither men nor women were there links between persecutory ideation and proactive aggression, regardless of distress. Conclusions Ideational distress moderates the relation between persecutory ideation and aggression in different measures of aggression in men and women. Implications for practice and/or research Recognition of a relation between persecutory ideations and aggression is also important in the general population. Insight in the theory of acting upon delusions may lead to more accurate violence risk assessment. Facilitation of early detection of experienced delusional distress may lead to development of more specific psychotherapeutic interventions to manage violence risk. © 2012 John Wiley & Sons, Ltd. Copyright © 2012 John Wiley & Sons, Ltd.",Van Dongen J.D.M.; Buck N.M.L.; Van Marle H.J.C.,2012.0,10.1002/cbm.1836,0,0,
3083,Effectiveness of the implementation of guidelines for anxiety disorders in specialized mental health care.,"Objective: To examine the effect of implementing anxiety disorders guidelines on guideline adherence and patient outcomes in specialized mental health care. Method: A treatment setting in which guidelines were implemented (intervention condition) was compared with one in which guidelines were only disseminated (control condition). Results: Of 61.7% of 81 intervention-condition patients received treatment according to the guidelines vs. 40.6% of 69 control-condition patients (P = 0.01). At 1-year follow-up, intervention-condition patients showed a greater decrease in anxiety symptoms (d = 0.48, P < 0.05); higher percentages of response (52.6% vs. 33.8%; P = 0.025) and remission (33.3% vs.16.9%; P = 0.026); and a greater decrease in the rate of phobic avoidance (d = 0.34, P < 0.05). At 2-year follow-up, control-condition patients had experienced a longer period of treatment, which had eroded most of these differences, except for phobic avoidance. Conclusion: Systematic guideline implementation results in earlier gains and shorter treatment times. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","van Dijk, M. K; Oosterbaan, D. B; Verbraak, M. J. P. M; Hoogendoorn, A. W; Penninx, B. W. J. H; van Balkom, A. J. L. M; Ajzen, Andrews, Baldwin, Bauer, Beck, Fernandez, Forsner, Grol, Grol, Malhi, Marks, Mendlowics, Morris, Penninx, Rush, Twisk, van Dijk, van Dijk, van Dijk, van Dijk, Verbeke, Wang, Weinmann, Yoshino, Young",2015.0,,0,0,
3084,Feasibility of mindfulness-based therapy in patients recovering from a first psychotic episode: a pilot study.,"Recently, a mindfulness therapy for people with psychotic disorders was developed. However, clinicians and researchers are cautious given case reports in which extensive meditation provoked psychotic symptoms in people with a psychotic disorder. The purpose of this study was to examine the feasibility, adverse effects and possible favourable effects of mindfulness-based therapy (MBT) in people recently recovering from a first episode of psychosis. A nonrandomized, non-controlled prospective follow-up study. Patients were offered an MBT that consisted of eight 1-hour sessions within a 4-week time span. Positive and Negative Syndrome Scale, Symptoms Checklist 90 and the Southampton Mindfulness Questionnaire were assessed before and after the therapy. Of the 16 persons who started MBT, 13 completed (81.5%) the therapy. No significant increase in psychotic symptoms was found. Between two meetings, one participant initially misunderstood the mindfulness instructions, which led to an increase in distress. No increased awareness of intrusive thoughts or visual or auditory hallucinations was reported by participants. We found a decrease in agoraphobic symptoms (p < 0.028) and in psychoneuroticism (P < 0.025). The MBT had no significant adverse effect on psychotic symptoms in patients in this small pilot study, neither did it raise the level of mindfulness in the participants. A decrease in psychological symptoms was found, although one patient experienced an increase in symptoms of distress. Our study demonstrates that therapists should be cautious that therapy and practice instructions are understood properly. Future studies are feasible and needed, in larger samples with an RCT design, in order to draw conclusions regarding the effects of the MBT.",van der Valk R.; van de Waerdt S.; Meijer CJ.; van den Hout I.; de Haan L.,2013.0,10.1111/j.1751-7893.2012.00356.x,0,0,
3085,The influence of alcohol on the mood of the alcoholic.,,van der Spuy HI.,1972.0,,0,0,
3086,Fear of negative evaluation modulates electrocortical and behavioral responses when anticipating social evaluative feedback,"Cognitive models posit that the fear of negative evaluation (FNE) is a hallmark feature of social anxiety. As such, individuals with high FNE may show biased information processing when faced with social evaluation. The aim of the current study was to examine the neural underpinnings of anticipating and processing social-evaluative feedback, and its correlates with FNE. We used a social judgment paradigm in which female participants (N = 31) were asked to indicate whether they believed to be socially accepted or rejected by their peers. Anticipatory attention was indexed by the stimulus preceding negativity (SPN), while the feedback-related negativity and P3 were used to index the processing of social-evaluative feedback. Results provided evidence of an optimism bias in social peer evaluation, as participants more often predicted to be socially accepted than rejected. Participants with high levels of FNE needed more time to provide their judgments about the social-evaluative outcome. While anticipating social-evaluative feedback, SPN amplitudes were larger for anticipated social acceptance than for social rejection feedback. Interestingly, the SPN during anticipated social acceptance was larger in participants with high levels of FNE. None of the feedback-related brain potentials correlated with the FNE. Together, the results provided evidence of biased information processing in individuals with high levels of FNE when anticipating (rather than processing) social-evaluative feedback. The delayed response times in high FNE individuals were interpreted to reflect augmented vigilance imposed by the upcoming social-evaluative threat. Possibly, the SPN constitutes a neural marker of this vigilance in females with higher FNE levels, particularly when anticipating social acceptance feedback. © 2014 Van derMolen, Poppelaars, Van Hartingsveldt, Harrewijn, Gunther Moor and Westenberg.",Van der Molen M.J.W.; Poppelaars E.S.; Van Hartingsveldt C.T.A.; Harrewijn A.; Moor B.G.; Westenberg P.M.,2014.0,10.3389/fnhum.2013.00936,0,0,
3087,Yoga as an adjunctive treatment for posttraumatic stress disorder: a randomized controlled trial.,"More than a third of the approximately 10 million women with histories of interpersonal violence in the United States develop posttraumatic stress disorder (PTSD). Currently available treatments for this population have a high rate of incomplete response, in part because problems in affect and impulse regulation are major obstacles to resolving PTSD. This study explored the efficacy of yoga to increase affect tolerance and to decrease PTSD symptomatology. Sixty-four women with chronic, treatment-resistant PTSD were randomly assigned to either trauma-informed yoga or supportive women's health education, each as a weekly 1-hour class for 10 weeks. Assessments were conducted at pretreatment, midtreatment, and posttreatment and included measures of DSM-IV PTSD, affect regulation, and depression. The study ran from 2008 through 2011. The primary outcome measure was the Clinician-Administered PTSD Scale (CAPS). At the end of the study, 16 of 31 participants (52%) in the yoga group no longer met criteria for PTSD compared to 6 of 29 (21%) in the control group (n = 60, χ²₁ = 6.17, P = .013). Both groups exhibited significant decreases on the CAPS, with the decrease falling in the large effect size range for the yoga group (d = 1.07) and the medium to large effect size decrease for the control group (d = 0.66). Both the yoga (b = -9.21, t = -2.34, P = .02, d = -0.37) and control (b = -22.12, t = -3.39, P = .001, d = -0.54) groups exhibited significant decreases from pretreatment to the midtreatment assessment. However, a significant group × quadratic trend interaction (d = -0.34) showed that the pattern of change in Davidson Trauma Scale significantly differed across groups. The yoga group exhibited a significant medium effect size linear (d = -0.52) trend. In contrast, the control group exhibited only a significant medium effect size quadratic trend (d = 0.46) but did not exhibit a significant linear trend (d = -0.29). Thus, both groups exhibited significant decreases in PTSD symptoms during the first half of treatment, but these improvements were maintained in the yoga group, while the control group relapsed after its initial improvement. Yoga significantly reduced PTSD symptomatology, with effect sizes comparable to well-researched psychotherapeutic and psychopharmacologic approaches. Yoga may improve the functioning of traumatized individuals by helping them to tolerate physical and sensory experiences associated with fear and helplessness and to increase emotional awareness and affect tolerance. ClinicalTrials.gov identifier: NCT00839813.",van der Kolk BA.; Stone L.; West J.; Rhodes A.; Emerson D.; Suvak M.; Spinazzola J.,2014.0,10.4088/JCP.13m08561,0,0,
3088,The efficacy of a brief internet-based self-help intervention for the bereaved.,"Research so far has shown little evidence that written disclosure facilitates recovery from bereavement. There are good reasons to assume that written disclosure may only benefit those bereaved who are at risk for developing problems or who are experiencing significant psychological problems as a result of their loss, and only when appropriate writing instructions are used. Drawing on previous work in the area of post-traumatic stress, a writing intervention was designed to test these assumptions. Bereaved individuals, who were still significantly distressed by their loss, were randomly assigned to the intervention condition (N = 460) or a waiting-list control condition (N = 297). Both groups filled in questionnaires online at baseline, and 3 and 6 months later. The intervention was administered via e-mail immediately after baseline measurement. Results showed that writing decreased feelings of emotional loneliness and increased positive mood, in part through its effect on rumination. However, writing did not affect grief or depressive symptoms. Contrary to expectations, effects did not depend on participants' risk profile or baseline distress level. Implications of these findings are discussed.",van der Houwen K.; Schut H.; van den Bout J.; Stroebe M.; Stroebe W.,2010.0,10.1016/j.brat.2009.12.009,0,0,
3089,Metacognitive therapy for obsessive-compulsive disorder: A pilot study.,"The first-line psychological treatment for OCD, exposure and response prevention (ERP), has been shown to lead to statistically significant improvements in 75% of patients. However, as only about 60% of treatment completers achieve recovery, and 25% of patients are asymptomatic following treatment, there is room for improvement. One promising approach is metacognitive therapy, which targets metacognition, a key cognitive process involved in the development and maintenance of OCD. This open trial examined the effectiveness of MCT among 25 consecutively referred outpatients with OCD. At posttreatment and follow-up, MCT produced significant and large reductions across all outcome variables, with high proportions of clinically significant change (patients recovered at posttreatment, 74%; at follow-up, 80%) on the Y-BOCS. In addition, the majority of patients (63% and 80% respectively) no longer fulfilled the diagnostic criteria for OCD. The encouraging results from this open trial justify a controlled trial in which the effectiveness of MCT is evaluated against ERP. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","van der Heiden, Colin; van Rossen, Kim; Dekker, Anika; Damstra, Marianne; Deen, Mathijs; Beck, Burns, Clark, Cohen, First, Fisher, Fisher, Fisher, Flavell, Foa, Frost, Goodman, Hurvich, Jacobson, Meyer, Olatunji, Ost, Purdon, Rees, Rosenthal, Singer, Verbeke, Wells, Wells, Wells, Wells",2016.0,,0,0,
3090,Trigeminal nerve stimulation (TNS) for panic disorder: An open label proof-of-concept trial.,"Presents a study which aims to examine both the safety and potential clinical efficacy of a trigeminal nerve stimulation (TNS) protocol for treating panic disorder (PD). Regarding the main outcome, at the end of intervention there was a reduction of PD symptoms from 18.1. All patients reported a mild paresthesia underneath the electrodes during stimulation. No severe adverse effects were reported. One patient reported tension headaches after the third and fourth sessions; that individual elected to discontinue participation despite clinical improvements. PD symptoms substantially improved during the 10-day treatment course and remained stable after one month follow-up. Significant global clinical gains were reported. The rationale behind cranial nerve stimulation is based on the so-called ""bottom up"" mechanism. According to this hypothesis, the propagation of electric stimuli follows an inverse path from trigeminal nerve toward the brain stem and central structures, such as the nucleus tractus solitarii (NTS). The findings in this proof-of-concept trial evaluating a TNS protocol for PD support the possibility of using TNS as a therapy for ameliorating PD symptoms. However, interpretations are limited by the unblinded study design and the small sample size. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Trevizol, Alisson Paulino; Sato, Isa Albuquerque; Cook, Ian A; Lowenthal, Rosane; Barros, Mirna Duarte; Cordeiro, Quirino; Shiozawa, Pedro; Cook, George, George, Keough, Kessler, Li, Shiozawa, Shiozawa, Trevizol, Trevizol",2016.0,,0,0,
3091,"Self-talk in youth with anxiety disorders: states of mind, content specificity, and treatment outcome","ER This study investigated the relationship between childhood anxiety disorders, the valence and content of self-statements, and the impact of treatment on the internal dialogue. Participants (151 8- to 13-year-olds) included 71 youth with anxiety disorders and 80 control participants. Positive and negative self-statements and a states-of-mind (SOM) ratio were examined. Results indicated that the negative self-statements and SOM ratio (but not positive self-statements) of children with anxiety disorders significantly predicted anxiety. Results also indicated that negative (but not positive cognition) and SOM ratio predicted improvement in anxiety after treatment and mediated treatment gains. Results of analyses to explore the content specificity hypothesis were mixed. The impact of negative self-talk on children's anxious symptomatology and favorable treatment outcome is discussed.","Treadwell, K R; Kendall, P C",1996.0,,0,0,
3092,Substance use and substance use disorders in recently deployed and never deployed soldiers.,"Military studies investigating the prevalence of substance use (SU) and substance use disorders (SUD) and the relation between SU and mental disorders often lack a comprehensive assessment of SU, SUD and mental disorders and comparable groups of deployed and non-deployed personnel. There is also limited data regarding SU and SUD in the German military to date. Cross-sectional examination of n=1483 soldiers recently deployed in Afghanistan and 889 never deployed soldiers using a fully-standardized diagnostic interview (MI-CIDI) including a comprehensive substance section. Across both groups, 12-months prevalence of DSM-IV alcohol use disorders was 3.1%, 36.9% reported binge drinking, 13.9% heavy drinking, 1.3% illegal drug use. 55.1% were regular smokers, 10.9% nicotine dependent. Although recently deployed soldiers revealed slightly higher rates in some measures, there were no significant differences to the never deployed regarding SU und SUD except that recently deployed soldiers smoked more cigarettes per day. The association of SU with mental mental disorders was substantially different though, revealing significant associations between SU and mental disorders only among recently deployed soldiers. We do not find remarkable differences in the prevalence of SU and SUD between recently deployed and never deployed soldiers. Especially binge drinking and regular smoking were prevalent across both samples indicating needs for improved interventions. The finding that SU and mental disorders are only associated in recently deployed soldiers might have implications for improved screening and prevention and suggests that deployment might promote different pathways and mechanisms involved in the evolution of SU and mental disorders.",Trautmann S.; Schönfeld S.; Behrendt S.; Höfler M.; Zimmermann P.; Wittchen HU.,2014.0,10.1016/j.drugalcdep.2013.09.024,0,0,
3093,Organ scarcity and the psychological pre-heart transplant evaluation: a simulation study using community residents,"ER OBJECTIVETo examine the influence of transplant knowledge pertaining to organ scarcity and wait list demand on simulated ratings of psychological distress provided by community residents participating in a simulated pre-heart transplant evaluation.DESIGNA randomized, controlled design. We used a vignette simulation to experimentally manipulate the effect of transplant knowledge pertaining to organ scarcity in a group of community residents with no previous knowledge or experience with the transplant selection process.PARTICIPANTSOne hundred forty-three community residents visiting a department of motor vehicles office in north central Florida were recruited. Community residents were randomly assigned to 1 of 2 experimental conditions, with either mention (n=66) or no mention (n=77) of organ scarcity and wait list demand statistics in their assigned vignette. Participants then served as actors and completed measures of psychological distress as part of a mock psychological pre-heart transplant evaluation.RESULTSParticipants with mention of organ scarcity reported significantly fewer symptoms of anxiety and depression compared to those with no mention of organ scarcity. This relationship remained significant even after controlling for relevant covariates, including age and simulated ratings of social desirability.CONCLUSIONTransplant knowledge pertaining to organ scarcity and wait list demand may influence transplant candidates to report fewer symptoms of psychological distress. Clinical suggestions for dealing with underreporting of psychological distress are discussed.CONTEXTAlthough research examining medical outcomes in heart transplantation has progressed, there are few studies examining the impact of organ scarcity and wait list demand on the transplant candidate evaluation process.","Todaro, J F; Sears, S F; Rodrigue, J R; Musto, K",2005.0,,0,0,
3094,No association between the Clara cell secretory protein (CC16) gene polymorphism and personality traits,"Clara cell secretory protein (CC16) is an anti-inflammatory protein expressed in the respiratory tract. Several studies have suggested the association between CC16 and mental disturbances, such as schizophrenia, depression, and post-traumatic stress disorder. In the present study, we investigated the association between the CC16 gene A38G polymorphism and personality traits in 214 healthy Japanese subjects. Personality traits were evaluated by using the Revised NEO Personality Inventory (NEO PI-R) and the State-Trait Anxiety Inventory (STAI). As a result, no significant association was observed between the genotypes and the scores of the NEO PI-R or the STAI. The present results suggest that CC16 may not have a major role in the development of personality traits. © 2006 Elsevier Inc. All rights reserved.",Tochigi M.; Otowa T.; Hibino H.; Kato C.; Marui T.; Ohtani T.; Umekage T.; Kato N.; Sasaki T.,2006.0,10.1016/j.pnpbp.2006.04.019,0,0,
3095,A quantitative analysis of cerebrospinal fluid flow in posttraumatic syringomyelia,,Tobimatsu Y.; Nihei R.; Kimura T.; Suyama T.; Tobimatsu H.,1991.0,,0,0,
3096,Randomized controlled trial of web-based treatment of social phobia without clinician guidance.,"Objective: The aim of the present study (Shyness 4) was to determine which level of reminder best facilitated a clinician-free Internet treatment for social phobia. Method: A pragmatic randomized controlled trial of an enhanced Internet treatment, with and without weekly telephone reminders, was done. Participants consisted of 163 volunteers with social phobia, who completed six lessons of computerized cognitive behaviour therapy for social phobia with complex automated reminders. Main outcome measures were the Social Interaction Anxiety Scale and Social Performance Scale. Results: Social phobia improved in both groups. Adherence (68% vs 81%) and improvement in social phobia (effect size = 0.86 vs 1.15) was better in the group with the added telephone reminders. Conclusions: Enhanced Internet-based cognitive behaviour therapy without clinician guidance is a strong treatment for social phobia. Telephone reminders further improve outcome. Because both interventions are effective, it is a pragmatic decision for a practice or a service as to whether the 33% increase in efficacy justifies 1 h of practice nurse or receptionist time. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Titov, Nickolai; Andrews, Gavin; Choi, Isabella; Schwencke, Genevieve; Johnston, Luke; Andersson, Andrews, Borkovec, Butler, Christensen, Clarke, Devilly, Farvolden, Faul, Gaston, Hotopf, Kessler, Martin, Mathers, Mattick, McEvoy, Perini, Perini, Sheehan, Sheehan, Spek, Titov, Titov, Titov, Titov, Vickers, Vickers, Wims",2009.0,,0,0,
3097,Clinical and cost-effectiveness of therapist-guided internet-delivered cognitive behavior therapy for older adults with symptoms of depression: a randomized controlled trial.,"Depression is a common and significant health problem among older adults. Unfortunately, while effective psychological treatments exist, few older adults access treatment. The aim of the present randomized controlled trial (RCT) was to examine the efficacy, long-term outcomes, and cost-effectiveness of a therapist-guided internet-delivered cognitive behavior therapy (iCBT) intervention for Australian adults over 60 years of age with symptoms of depression. Participants were randomly allocated to either a treatment group (n=29) or a delayed-treatment waitlist control group (n=25). Twenty-seven treatment group participants started the iCBT treatment and 70% completed the treatment within the 8-week course, with 85% of participants providing data at posttreatment. Treatment comprised an online 5-lesson iCBT course with brief weekly contact with a clinical psychologist, delivered over 8 weeks. The primary outcome measure was the Patient Health Questionnaire-9 Item (PHQ-9), a measure of symptoms and severity of depression. Significantly lower scores on the PHQ-9 (Cohen's d=2.08; 95% CI: 1.38 - 2.72) and on a measure of anxiety (Generalized Anxiety Disorder-7 Item) (Cohen's d=1.22; 95% CI: 0.61 - 1.79) were observed in the treatment group compared to the control group at posttreatment. The treatment group maintained these lower scores at the 3-month and 12-month follow-up time points and the iCBT treatment was rated as acceptable by participants. The treatment group had slightly higher Quality-Adjusted Life-Years (QALYs) than the control group at posttreatment (estimate: 0.012; 95% CI: 0.004 to 0.020) and, while being a higher cost (estimate $52.9l 95% CI: -23.8 to 128.2), the intervention was cost-effective according to commonly used willingness-to-pay thresholds in Australia. The results support the potential efficacy and cost-effectiveness of therapist-guided iCBT as a treatment for older adults with symptoms of depression. Australian and New Zealand Clinical Trials Registry: ACTRN12611000927921; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=343384.",Titov N.; Dear BF.; Ali S.; Zou JB.; Lorian CN.; Johnston L.; Terides MD.; Kayrouz R.; Klein B.; Gandy M.; Fogliati VJ.,2015.0,10.1016/j.beth.2014.09.008,0,0,
3098,Disorder-specific versus transdiagnostic and clinician-guided versus self-guided treatment for major depressive disorder and comorbid anxiety disorders: A randomized controlled trial.,"Disorder-specific cognitive behavior therapy (DS-CBT) is effective at treating major depressive disorder (MDD) while transdiagnostic CBT (TD-CBT) addresses both principal and comorbid disorders by targeting underlying and common symptoms. The relative benefits of these two models of therapy have not been determined. Participants with MDD (n=290) were randomly allocated to receive an internet delivered TD-CBT or DS-CBT intervention delivered in either clinician-guided (CG-CBT) or self-guided (SG-CBT) formats. Large reductions in symptoms of MDD (Cohen's d‚â•1.44; avg. reduction‚â•45%) and moderate-to-large reductions in symptoms of comorbid generalised anxiety disorder (Cohen's d‚â•1.08; avg. reduction‚â•43%), social anxiety disorder (Cohen's d‚â•0.65; avg. reduction‚â•29%) and panic disorder (Cohen's d‚â•0.45; avg. reduction‚â•31%) were found. No marked or consistent differences were observed across the four conditions, highlighting the efficacy of different forms of CBT at treating MDD and comorbid disorders.",Titov N.; Dear BF.; Staples LG.; Terides MD.; Karin E.; Sheehan J.; Johnston L.; Gandy M.; Fogliati VJ.; Wootton BM.; McEvoy PM.,2015.0,10.1016/j.janxdis.2015.08.002,0,0,
3099,Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: a 12-month follow-up of a randomised controlled trial.,"A recent paper reported the outcomes of a study examining a new self-guided internet-delivered treatment, the Wellbeing Course, for symptoms of anxiety or depression. This study found the intervention resulted in significant symptom reductions. It also found that automated emails increased treatment completion and clinical improvements in a subsample with elevated anxiety and depression. To examine the clinical outcomes and the effect of automated emails at 12 months post-treatment. Participants, who were randomly allocated to a Treatment Plus Automated Emails Group (TEG; n = 100), a standard Treatment Group (TG; n = 106) or delayed-treatment Waitlist Control Group (Control; n = 51), were followed up at 12 months post-treatment. Eighty-one percent, 78% and 87% of participants in the TEG, TG and treated Waitlist Control Group provided symptom data at 12-month follow-up, respectively. The primary outcome measures were the Patient Health Questionnaire-9 Item Scale (PHQ-9) and the Generalized Anxiety Disorder-7 Item Scale (GAD-7). Significant improvements in symptoms of anxiety and depression were observed over time in both the TEG and TG (Fs >69, ps <.001) these were sustained from post-treatment to 12-month follow-up (ps >.05), and were associated with large effect sizes. No statistically significant differences in symptoms were found between the TEG and TG at post-treatment, 3-month or 12-month follow-up. Previously reported symptom differences between TEG and TG participants with comorbid symptoms were no longer present at 12-month follow-up (ps >.70). The overall benefits of the Wellbeing Course were sustained at 12-month follow-up. Although automated emails facilitated Course completion and reductions in symptoms for participants with comorbid anxiety and depression from pre-post treatment, these differences were no longer observed at 12-month follow-up. The results indicate that automated emails promote more rapid treatment response for people with elevated and comorbid symptoms, but may not improve longer term outcomes. Australian and New Zealand Clinical Trials Registry ACTRN12610001058066.",Titov N.; Dear BF.; Johnston L.; McEvoy PM.; Wootton B.; Terides MD.; Gandy M.; Fogliati V.; Kayrouz R.; Rapee RM.,2014.0,10.1371/journal.pone.0089591,0,0,
3100,Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: randomised controlled trial.,"Depression and anxiety are common, disabling and chronic. Self-guided internet-delivered treatments are popular, but few people complete them. New strategies are required to realise their potential. To evaluate the effect of automated emails on the effectiveness, safety, and acceptability of a new automated transdiagnostic self-guided internet-delivered treatment, the Wellbeing Course, for people with depression and anxiety. A randomised controlled trial was conducted through the website: www.ecentreclinic.org. Two hundred and fifty seven people with elevated symptoms were randomly allocated to the 8 week course either with or without automated emails, or to a waitlist control group. Primary outcome measures were the Patient Health Questionnaire 9-Item (PHQ-9) and the Generalized Anxiety Disorder 7-Item (GAD-7). Participants in the treatment groups had lower PHQ-9 and GAD-7 scores at post-treatment than controls. Automated emails increased rates of course completion (58% vs. 35%), and improved outcomes in a subsample with elevated symptoms. The new self-guided course was beneficial, and automated emails facilitated outcomes. Further attention to strategies that facilitate adherence, learning, and safety will help realise the potential of self-guided interventions. Australian and New Zealand Clinical Trials Registry ACTRN12610001058066.",Titov N.; Dear BF.; Johnston L.; Lorian C.; Zou J.; Wootton B.; Spence J.; McEvoy PM.; Rapee RM.,2013.0,10.1371/journal.pone.0062873,0,0,
3101,Randomized controlled trial of Internet cognitive behavioural treatment for social phobia with and without motivational enhancement strategies.,"The present study (Shyness 7) has two aims: Firstly, to replicate an earlier trial showing that a self-guided Internet treatment for social phobia is efficacious, and secondly, to examine whether the addition of self-guided motivational enhancement strategies improves completion rates and clinical outcomes. Randomized controlled trial (RCT) of self-guided Internet-based cognitive behavioural treatment (iCBT), or iCBT plus self-guided motivational enhancement strategies (iCBT+MS), was conducted. An intention-to-treat and last observation carried forward model was used for data analyses. The participants consisted of 108 volunteers with social phobia. The iCBT intervention consisted of two online lessons about symptoms and treatment of anxiety disorders and six lessons about management of social phobia (the Shyness programme) with complex automated reminders. The motivational intervention was based on traditional techniques including understanding and exploring ambivalence about change using a cost–benefit analysis, developing and resolving discrepancy between values and symptoms, and enhancing self-efficacy for change. The main outcome measures were the Social Interaction Anxiety Scale and Social Phobia Scale. More iCBT+MS group participants completed the eight lessons than iCBT group participants (75% versus 56%, respectively), but there were no between-group differences in outcome measures at post-treatment or at 3 month follow up. Large mean within-groups effect sizes (Cohen's d) for the two social phobia measures were found for both the iCBT and iCBT+ MS groups (1.1 and 0.95, respectively), which were sustained at 3 month follow up (1.06 and 1.07, respectively). Both iCBT and iCBT+MS group participants reported that the procedures were highly acceptable. Both self-guided versions of the Shyness programme were reliably efficacious, confirming that people with social phobia may significantly benefit from a highly structured self-guided intervention. The addition of motivational techniques increased completion rates but did not improve clinical outcomes or acceptability.",Titov N.; Andrews G.; Schwencke G.; Robinson E.; Peters L.; Spence J.,2010.0,10.3109/00048674.2010.493859,0,0,
3102,A weighty issue: Explaining the association between body mass index and appearance-based social anxiety,"Research has indicated that individuals who are overweight or obese are more likely to experience mental health difficulties. One line of research has indicated that body mass index (BMI) is positively associated with appearance-based social anxiety, rather than social anxiety more generally. However, there is a lack of research that has attempted to explain this association. Thus, the current study recruited an undergraduate sample (N=90) and aimed (a) to replicate previous research by examining the associations between BMI, social anxiety, and appearance-based social anxiety and (b) to extend previous research by examining two potential mediators in the relationship between BMI and appearance-based social anxiety suggested in the literature (i.e., body image dissatisfaction and emotional eating). Analyses indicated that BMI was not associated with social anxiety but positively associated with appearance-based social anxiety. The association between BMI and appearance-based social anxiety was only mediated by body image dissatisfaction, and the model of these relationships emerged as the best fitting model relative to a plausible alternative model. The findings replicate and extend previous research on weight status and psychological factors and highlight the need for future longitudinal research on BMI, appearance-based social anxiety, and body image dissatisfaction so that interventions for obesity and weight loss maintenance programs can be ultimately enhanced.",Titchener K.; Wong Q.J.J.,2015.0,10.1016/j.eatbeh.2014.10.005,0,0,
3103,The effects of a stress-management training program in individuals at risk in the community at large.,"In this study we examine the effects of a stress-management training program on individuals without serious (mental) health complaints but with an increased chance of developing them as a consequence of stress. Potential subjects were randomly selected from the community at large and, then screened for participation in the training program if some of several (mental) health risk factors could be attributed to them: past life-events, neuroticism, inassertiveness, avoidant coping style and lack of social support. The control group, which did not take part in the training program, consisted of individuals with a similar risk profile as those in the training group. The training program consisted of several stress-management techniques: changing unhealthy life-style, relaxation training, problem-solving training and social skills-training. Multivariate analyses of variance showed that the training group, as compared to the control group, reported significantly less distress, less trait anxiety, less daily hassles, more assertiveness and more satisfaction with social support at follow-up. There were, however, no significant changes found in the coping skills of either group.",Timmerman IG.; Emmelkamp PM.; Sanderman R.,1998.0,,0,0,
3104,"Low degree of formal education and musical experience predict degree of music-induced stress reduction in relatives and friends of patients: a single-center, randomized controlled trial","ER OBJECTIVE: To determine the factors that may predict music-induced relaxation in friends and family of patients in the emergency department.BACKGROUND: It remains unclear to date which demographic and experiential factors predict the effectiveness of music-induced relaxation. Furthermore, in-hospital stressors for friends and family of patients rather than patients themselves are underresearched and deserve in-depth investigation to improve this group's experience in health care environments.METHODS: A total of 169 relatives and friends of patients in the emergency department-waiting area completed a series of questionnaires, including the Spielberger State-Trait Anxiety Inventory (STAI), the Music Experience Questionnaire (MEQ), and a demographic survey. They were then randomly assigned to either Case Group (1 hour in the waiting area with classical music in the background) or Control Group (1 hour with no music) before completing a second, identical copy of the STAI to measure change from baseline. Data were analyzed for associations between music intervention, change in STAI scores, MEQ scores, and demographic characteristics.RESULTS: Participants who underwent the music intervention experienced a 9.8% decrease in overall mean State Anxiety, whereas those in the Control Group experienced no change over time (P = 0.001). Higher education significantly inversely correlated with the effectiveness of music intervention: participants with no formal education beyond high school showed a greater overall mean decrease in State Anxiety than those with a college education or beyond in response to classical music (P = 0.006). Furthermore, MEQ scores indicated that the Social Uplift scale (a measure of one's tendency to be uplifted in a group-oriented manner by music) was highly predictive of the effectiveness of music intervention.CONCLUSIONS: Music is an effective and inexpensive means of reducing anxiety in friends and family of patients, who are underresearched in medicine. Moreover, low educational attainment and tendency to respond positively to music in a group setting can predict the effectiveness of music-induced relaxation.","Tilt, A C; Werner, P D; Brown, D F; Alam, H B; Warshaw, A L; Parry, B A; Jazbar, B; Booker, A; Stangenberg, L; Fricchione, G L; Benson, H; Lillemoe, K D; Conrad, C",2013.0,10.1097/SLA.0b013e31828ee1da,0,0,
3105,Treating university students with social phobia and public speaking fears: Internet delivered self-help with or without live group exposure sessions.,"This study investigated the efficacy of an Internet-based self-help program with minimal therapist contact via e-mail for Swedish university students with social phobia and public speaking fears. The main objective was to test if the Internet-based self-help program would be more effective if five live group exposure sessions were added. Thirty-eight students meeting the diagnostic and statistical manual of mental disorders, 4th edition criteria for social phobia were randomized into two different treatment groups: Internet delivered cognitive behavior therapy combined with five group exposure sessions (ICBT+ exp) or the Internet program alone (ICBT). Results were analyzed on an intention-to-treat basis. Both treatment groups showed significant improvement from pre- to post-test, and from pre-test to 1-year follow-up, on all measured dimensions (social anxiety, general anxiety, depression levels, and quality of life). For both the groups, the average within-group effect sizes for the primary social anxiety scales, expressed as Cohen's d, were comparable to those seen in traditionally administered cognitive behavioral therapy both at post-test and at 1- year follow-up. The results suggest that the Internet-based self-help program on its own is efficient in the treatment of university students with social phobia. Adding group exposure sessions did not improve the outcome significantly.",Tillfors M.; Carlbring P.; Furmark T.; Lewenhaupt S.; Spak M.; Eriksson A.; Westling BE.; Andersson G.,2008.0,10.1002/da.20416,0,0,
3106,A randomized trial of Internet-delivered treatment for social anxiety disorder in high school students.,"Internet-based cognitive behavior therapy (CBT) has been shown effective for university students with social anxiety disorder (SAD) and public speaking fears. The aim of this study was to investigate whether the promising results can be transferred to high school students suffering from this condition. A total of 19 speech-anxious high school students with SAD were randomized either into 9 weeks of Internet-delivered CBT or to a wait-list control group. Significant improvements were found on measures of social anxiety, general anxiety, and depression. Effects were maintained at 1-year follow-up. The average within- and between-group effect sizes (Cohen's d) for the primary social anxiety scales at posttest were 0.98 and 1.38, respectively. However, the average number of completed modules in the CBT program was low. Although compliance can be improved, the results suggest that Internet-based guided self-help is effective in the treatment of high school students with SAD.",Tillfors M.; Andersson G.; Ekselius L.; Furmark T.; Lewenhaupt S.; Karlsson A.; Carlbring P.,2011.0,10.1080/16506073.2011.555486,0,0,
3107,Environmental effects on compulsive tail chasing in dogs,"Obsessive Compulsive Disorder (OCD) is a neuropsychiatric disorder observed both in humans and animals. Examples of Canine Compulsive Disorder (CD) include excessive tail chasing (TC), light/shadow chasing and flank sucking. We performed a questionnaire survey to investigate the characteristics of compulsive (TC) and its possible associations with environmental correlates and personality in a pet population of 368 dogs from four dog breeds. We observed an early onset of TC at 3-6 months of age and a large variation in TC frequency in all breeds, with an overrepresentation of milder cases. Almost half of the TC dogs showed lowered responsiveness during bouts and displayed also other types of compulsions more often than the controls. Interestingly, dogs that received dietary supplements, especially vitamins and minerals, expressed less TC compared to dogs that did not receive any supplements. Neutered females had less TC, suggesting an influence of ovarian hormones on TC. Tail chasers were shyer and had separated earlier from their mothers than the controls. Finally, our genetic study did not find an association between TC and CDH2, a locus previously associated with the canine flank sucking compulsion. In conclusion, the early-onset and the variable nature of the repetitive behaviour, which is affected by environmental factors such as micronutrients, neutering and maternal care, share several similar components between canine and human compulsions and supports canine TC as a model for human OCD. © 2012 Tiira et al.",Tiira K.; Hakosalo O.; Kareinen L.; Thomas A.; Hielm-Björkman A.; Escriou C.; Arnold P.; Lohi H.,2012.0,10.1371/journal.pone.0041684,0,0,
3108,"Military sexual assault, gender, and PTSD treatment outcomes of U.S. Veterans.","This study examined whether gender and military sexual assault (MSA) were associated with psychiatric severity differences at initiation of treatment for posttraumatic stress disorder (PTSD) and whether MSA and gender predicted psychiatric treatment outcomes. Male (n = 726) and female (n = 111) patients were recruited from 7 U.S. Department of Veterans Affairs (VA) PTSD specialty intensive treatment programs and completed an intake survey; 69% (n = 574) of the participants completed a 4-month postdischarge follow-up survey. Measures included current PTSD and depressive symptoms, aggressive/violent behaviors, alcohol and drug use severity, and quality of life. Multilevel multivariate regression analyses were conducted to examine the main and interaction effects of gender and MSA on psychiatric treatment outcomes at 4-month follow-up, including demographics, baseline severity, hostile fire, and treatment length of stay. Baseline PTSD severity did not differ by gender or MSA status, but women had more severe depressive symptoms (d = 0.40) and less aggressive/violent symptoms (d = -0.46) than men. Gender, MSA status, and the interaction between gender and MSA did not predict treatment outcomes as hypothesized. Male and female veterans with and without MSA responded equally well to treatment in VA PTSD intensive treatment programs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Tiet, Quyen Q; Leyva, Yani E; Blau, Kathy; Turchik, Jessica A; Rosen, Craig S; Biddle, Breslau, Code, Foa, Fontana, Fontana, Galovski, Horowitz, Kang, Keane, Kessler, Kimerling, Kimerling, Koss, Kulka, Maguen, McDonald, McLellan, Mezey, O'Brien, Preacher, Radloff, Radloff, Rosen, Rosen, Rowe, Sable, Suris, Suris, Turchik, Turchik, Twisk, Walker, Weathers, Yaeger, Zlotnick",2015.0,,0,0,
3109,A trial of neuropsychologic rehabilitation in mild-spectrum traumatic brain injury,"ER DESIGNSingle-blind randomized, wait-listed controlled trial, with repeated measures and multiple baselines.SETTINGOutpatient clinic in northern New Jersey.PARTICIPANTSTwenty persons with persisting complaints after mild and moderate TBI (11 in treatment group, 9 controls).INTERVENTIONSThe experimental group received both 50 minutes of individual cognitive-behavioral psychotherapy and 50 minutes of individual cognitive remediation, 3 times a week for 11 weeks. The control group was wait-listed and received treatment after conclusion of follow-up.MAIN OUTCOME MEASURESSymptom Check List-90R General Symptom Index, plus scales of depression, anxiety, coping, attention, and neuropsychologic functioning.RESULTSCompared with the control group, the treatment group showed significantly improved emotional functioning, including lessened anxiety and depression. Most significant improvements in emotional distress were noted at 1 month and 3 months posttreatment. Performance on a measure of divided auditory attention also improved, but no changes were noted in community integration scores.CONCLUSIONSCognitive behavioral psychotherapy and cognitive remediation appear to diminish psychologic distress and improve cognitive functioning among community-living persons with mild and moderate TBI.OBJECTIVETo test the effectiveness of a neuropsychologic rehabilitation program consisting of psychotherapy and cognitive remediation in the treatment of the affective and neuropsychologic sequelae of mild-spectrum traumatic brain injury (TBI).","Tiersky, L A; Anselmi, V; Johnston, M V; Kurtyka, J; Roosen, E; Schwartz, T; Deluca, J",2005.0,10.1016/j.apmr.2005.03.013,0,0,
3110,"Expressions of cyclooxygenase 2, bone morphogenetic protein 2 and vascular endothelial growth factor in elbow heterotopic ossification","Background: Several studies have shown that cyclooxygenase 2 (COX-2) inhibitors can prevent heterotopic ossification around the elbow joint. Objective: To investigate the expression of COX-2, bone morphogenetic protein 2 (BMP-2) and vascular endothelial growth factor (VEGF) in post-traumatic elbow heterotopic ossification tissues, and to analyze their relationship. Methods: The expressions of COX-2, BMP-2 and VEGF were examined by S-P immunohistochemical staining in 18 cases of heterotopic ossification and 10 cases of normal bone tissue. The 10 cases were as controls. The average absorbance value and the percentage of positive area of COX-2, BMP-2 and VEGF in heterotopic ossification and normal bone tissue were measured by HPIAS-1000 image analysis system. The relationship among the percentage of the positive area in the three kinds of proteins was analyzed. Results and Conclusion: COX-2,BMP-2 and VEGF were strongly expressed in heterotopic ossification, but those in the normal bone tissue showed low express or no express. Image analysis demonstrated that the average absorbance value and the percentage of positive area of COX-2, BMP-2 and VEGF in heterotopic ossification were significantly higher than those in the normal bone tissue (P < 0.01). The percentage of positive area of COX-2 expression was closely correlated with that in the BMP-2 and VEGF in heterotopic ossification (P < 0.01). These findings suggest that COX-2, BMP-2 and VEGF may play important roles in the process of heterotopic ossification formation. COX-2 may induce the expression of BMP-2 and VEGF to promote osteogenesis and angiogenesis in the heterotopic ossification organization.",Tian J.; Fan C.-Y.; Rui Y.-J.; Mi J.-Y.; Ruan H.-J.; Liu K.; Zeng B.-F.,2012.0,10.3969/j.issn.2095-4344.2012.42.005,0,0,
3111,Individual brief art therapy can be helpful for women with breast cancer: a randomized controlled clinical study,"ER METHODSThe participants were between 37 and 69 years old; six participants in each group were below 50 years of age. Half of the participants (n = 20) received art therapy and the other half (n = 21) were assigned to a control group. At the first measurement, at least 17% (n = 7) of the participants medicated with antidepressants. Data were collected before and after art therapy and at a 4-month follow-up using self-rating scales that measure self-image (the Structural Analysis of Social Behaviour) and psychiatric symptoms (the Symptom Check List-90).RESULTSAt follow-up, significant lower ratings of depression, anxiety, and somatic symptoms and less general symptoms were reported for the art therapy group compared to the control group. The regression analysis showed that art therapy relates to lower ratings of depression, anxiety, and general symptoms; chemotherapeutic treatment predicts lower depressive symptoms; in contrast to axillary surgery and hormonal treatment as well as being a parent predicts higher ratings of anxiety and general symptoms.SIGNIFICANCE OF RESULTSThe conclusion suggests that art therapy has a long-term effect on the crisis following the breast cancer and its consequences.OBJECTIVERecent research shows that almost every second woman with breast cancer is depressed or has anxiety; the risk for younger women is even higher. Moreover, research shows that women are at risk for developing depression, also a threat for women with breast cancer. The aim of this randomized controlled clinical trial was to study the outcome of five sessions of art therapy given at a 5-week period of postoperative radiotherapy.","Thyme, K E; Sundin, E C; Wiberg, B; Oster, I; Aström, S; Lindh, J",2009.0,10.1017/S147895150900011X,0,0,
3112,The effects of ethanol intoxication on phobic anxiety,"Behavioral conceptions of alcohol abuse often include the hypothesis that drinking behavior is a negatively reinforced operant, with ethanol intoxication viewed as alleviating aversive environmental and internal states. This hypothesis has not been confirmed or refuted by previous studies which employed mild stressors and limited assessment methodology. In the present experiment, 22 patients with severe phobias approached their phobic animal under two consecutive conditions-first while sober and second after drinking either a placebo or an intoxicating dose of ethanol. The severe anxiety induced was assessed behaviorally, physiologically and by the patient's self-report of fear. The intoxication patients did not experience decreased anxiety, tachycardia or avoidance, compared to the placebo group. These results have clinical implications and suggest the need to reconsider tension-reduction theories of alcohol abuse.",Thyer B.A.; Curtis G.C.,1984.0,10.1016/0005-7967(84)90122-0,0,0,
3113,Social support moderates outcome in a randomized controlled trial of exposure therapy and (or) cognitive restructuring for chronic posttraumatic stress disorder.,"To understand what predicts good outcome in psychiatric treatments, thus creating a pathway to improving efficacy. Our study investigated relations between predictor variables and outcome (on the Clinician Administered Posttraumatic Stress Disorder [PTSD] Scale [CAPS]) at posttreatment for 77 treatment completers in a randomized controlled trial of exposure therapy and (or) cognitive restructuring, compared with relaxation, for chronic PTSD in adults. More social support on the Significant Others Scale significantly predicted better outcome on the CAPS, even after controlling for the effects of treatment group and of pretreatment severity. Importantly, social support was only a significant predictor of outcome for participants receiving cognitive restructuring and (or) exposure therapy and not for participants in the relaxation condition. Better social support is associated with significantly greater gain following cognitive restructuring and (or) exposure therapy for PTSD. Future interventions should consider augmenting social support as an adjunct to treatment.",Thrasher S.; Power M.; Morant N.; Marks I.; Dalgleish T.,2010.0,10.1177/070674371005500311,0,0,
3114,The effect of one-session treatment for spider phobia on attentional bias and beliefs.,"Spider phobics were tested before and after one-session treatment for spider phobia, or a comparable waiting period, using a spider-word Stroop test and questionnaires in which they rated spider-relevant threat beliefs. Compared with untreated spider phobic controls, the treated phobics changed significantly in their negative beliefs about spiders after treatment. Controls and treated phobics showed the same change in their reaction time latencies to spider stimuli in the Stroop test. These data are consistent with the hypothesis that the modification of threat beliefs is crucial in changing the response to phobic stimuli. It is concluded that the threat-specific Stroop test is an ambiguous measure of fear-related cognitive processes.",Thorpe SJ.; Salkovskis PM.,1997.0,,0,0,
3115,Studies on the role of disgust in the acquisition and maintenance of specific phobias,"Disgust has been proposed as a possible factor in phobic acquisition and maintenance, particularly in spider phobia. Cognitions and processes concerning disgust were examined in a series of studies with spider phobics, other specific phobics and nonphobic controls. Beliefs about the disgusting nature of their phobic objects were present in phobics but did not contribute to an attentional bias. Measures of global disgust sensitivity were not closely linked to the phobic fear response. The disgust associated with phobic objects appears to have different constituents to the disgust associated with objects that do not evoke the phobic response. In the light of evidence presented here, it seems unlikely that disgust plays a central role in the aetiology or maintenance of spider phobia in particular and specific phobias in general. It is proposed that when stimuli normally associated with disgust become the focus of phobic anxiety the disgust response may be amplified.",Thorpe S.J.; Salkovskis P.M.,1998.0,10.1016/S0005-7967(98)00066-7,0,0,
3116,A randomized controlled trial of a brief family intervention to reduce accommodation in obsessive-compulsive disorder.,"Obsessive-compulsive disorder (OCD) is associated with substantial impairment across a number of life domains. Recently increased interest has been focused on the bi-directional relationship between OCD and family processes, particularly a subset of family reactions to OCD symptoms that are termed ""accommodation"". Accommodation consists of any changes in family members' behavior aimed at preventing or reducing the patient's rituals or their distress related to OCD symptoms. For example, family members may provide patients with supplies they need to ritualize (e.g., extra soap), or may engage in rituals themselves (e.g., excessive washing). Previous research has indicated high levels of accommodation are associated with more severe OCD symptoms and functional impairment on the part of patients, and may interfere with the first line psychosocial treatment for OCD, a form of cognitive behavior therapy (CBT) consisting of exposure (to cues provoking obsessions) and ritual prevention (ERP). Thus, the aims of this research project were to develop and test a brief intervention focused on reducing accommodation in the family members of adult OCD patients with the aim of facilitating the implementation of ERP. Eighteen patient and family member dyads participated in the study. All patients received a course of standard individual ERP for OCD. Family members were randomized to either the intervention group or a control group that did not receive any intervention. The goals of the two-session intervention were to identify current accommodation behaviors and provide alternative ways of responding to OCD symptoms. Patients and family members were assessed at baseline and regularly throughout the 25-week study. Results revealed that the intervention successfully reduced accommodation with a large effect size. Patients whose family members received the intervention showed greater levels of symptom reduction than patients whose family members had not. Hierarchical regression analyses revealed that change in family accommodation from baseline accounted for a significant amount of variance in later OCD symptoms. These results suggest that this intervention successfully enhanced the outcomes of standard CBT including ERP for adults with OCD. The findings support further exploration of this intervention in larger samples and in other diagnostic groups where accommodation is likely to occur. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Thompson-Hollands, Johanna",2016.0,,0,0,
3117,A randomized clinical trial of a brief family intervention to reduce accommodation in obsessive-compulsive disorder: A preliminary study.,"Accommodation consists of changes in family members' behavior to prevent or reduce patients' obsessive-compulsive disorder (OCD) rituals or distress. High levels of family accommodation are associated with more severe symptoms and functional impairment in patients, and may also interfere with exposure-based treatment. The purpose of this study was to develop and test an intervention to reduce accommodation in the family members of adult OCD patients. Patients (N =18, mean age=35.44, 33% male, 94% Caucasian) received a course of standard individual exposure and ritual prevention (ERP) for OCD. Family members (N =18, mean age=41.72, 56% male, 94% Caucasian) were randomized to either receive or not receive the adjunctive intervention, consisting of two sessions of psychoeducation and skills training in reducing accommodation. Results revealed that the intervention successfully reduced scores on the clinician-rated Family Accommodation Scale (Week 8: d =1.05). Patients whose family members received the intervention showed greater reductions in Yale-Brown Obsessive-Compulsive Scale scores across treatment than patients whose family members had not (Week 8: d =1.27), and hierarchical regression analyses revealed that change in family accommodation from baseline accounted for a significant amount of variance in later OCD symptoms (beta=.45, p =.02). Results from this preliminary study suggest that adjunctive intervention produces more rapid treatment response compared with traditional ERP alone. Accommodation is a potentially important target for improving treatment in OCD and other diagnostic groups where accommodation is likely to occur. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Thompson-Hollands, Johanna; Abramovitch, Amitai; Tompson, Martha C; Barlow, David H; Abramowitz, Amir, Barlow, Barlow, Beck, Beck, Behar, Boeding, Brown, Brown, Brown, Calvocoressi, Caporino, Dattilio, de Abreu Ramos-Cerqueira, DiNardo, Ellard, Epstein, Erdfelder, Farchione, Field, Foa, Freeman, Grunes, Jacobson, Kobak, Koran, Lebowitz, Lebowitz, Lensi, Merlo, Olatunji, Peris, Piacentini, Renshaw, Riggs, Ruscio, Steer, Steketee, Steketee, Stewart, Storch, Storch, Storch, Storch, Thompson-Hollands, Thompson-Hollands, Van Noppen, Van Noppen",2015.0,,0,0,
3118,The effect of one-session treatment for spider phobia on attentional bias and beliefs,"Spider phobics were tested before and after one-session treatment for spider phobia, or a comparable waiting period, using a spider-word Stroop test and questionnaires in which they rated spider-relevant threat beliefs. Compared with untreated spider phobic controls, the treated phobics changed significantly in their negative beliefs about spiders after treatment. Controls and treated phobics showed the same change in their reaction time latencies to spider stimuli in the Stroop test. These data are consistent with the hypothesis that the modification of threat beliefs is crucial in changing the response to phobic stimuli. It is concluded that the threat-specific Stroop test is an ambiguous measure of fear-related cognitive processes.",Thorpe S.J.; Salkovskis P.M.,1997.0,,0,0,3114
3119,Prolonged exposure therapy for older veterans with posttraumatic stress disorder: a pilot study.,": The purpose of this pilot study was to assess the feasibility and preliminary efficacy of prolonged exposure psychotherapy in older Veterans with posttraumatic stress disorder (PTSD). Exposure therapy has broad empirical support for PTSD, but it has not been studied systematically in older adults, partly due to published concerns that older adults would not tolerate the treatment. : The trial followed a prospective pre-post design of 11 men recruited from a Veterans Affairs (VA) PTSD Clinical Team program. After baseline assessment, eight participants completed prolonged exposure therapy. Results were compared with a nonrandomized treatment-as-usual comparison group. The traumatic events identified by the Veterans in our samples had occurred, on average, 40 years prior to their study participation. : Results revealed that conducting 6 weeks of exposure therapy with older Veterans with PTSD was feasible and efficacious, with evidence of some superiority to treatment-as-usual therapy. : As hypothesized, Veterans showed a significant decrease in symptoms of PTSD (clinician-rated and self-reported) following exposure therapy.",Thorp SR.; Stein MB.; Jeste DV.; Patterson TL.; Wetherell JL.,2012.0,10.1097/JGP.0b013e3182435ee9,0,0,
3120,Effects of yoga practice on stress-related symptoms in the aftermath of an earthquake: A community-based controlled trial.,"To evaluate the effect of an integrated hatha yoga practice on perceived stress and stress-related symptoms in the aftermath of an earthquake. Inhabitants, aged 20-67 years, from highly exposed earthquake areas of two villages in South Iceland were offered to participate in a yoga program subsequent to an earthquake. Sixty-six individuals were self-selected into the study and divided by residential convenience into an experimental group (n=31) and a waiting list control group (n=35). The yoga program was conducted twice a week for six weeks, in normal situations among the inhabitants in the community. Several validated questionnaires assessing stress and stress-related symptoms, posttraumatic symptoms, depression, anxiety and health related quality of life were administered at pre- and post-intervention. Multivariate analysis of variance (MANOVA) revealed differences between the experimental group and waiting list control group on sleep quality (p=.03) and social relations (p=.04). These differences did not prevail at Bonferroni correction for multiple testing (at alpha level of .005). Participants in both groups showed significant improvements in stress and some stress-related symptoms such as sleep, concentration, well-being, quality of life, depression and anxiety from pre- to post-intervention. The data from this small study show no statistically significant improvement of an integrated hatha yoga program above and beyond waiting list control, following exposure to an earthquake. However, the observed trend toward improved sleep quality and social relations deserve further exploration in larger effectiveness studies on the impact of Hatha yoga on recovery after natural disaster.",Thordardottir K.; Gudmundsdottir R.; Zoëga H.; Valdimarsdottir UA.; Gudmundsdottir B.,2014.0,10.1016/j.ctim.2014.01.008,0,0,
3121,Long-term experience with citalopram in the treatment of adolescent OCD.,"The primary purpose of the study was to describe tolerability and effectiveness of citalopram in the treatment of adolescent obsessive-compulsive disorder (OCD). Thirty nondepressed patients (15 females, 15 males) with a mean age of 13.7 years (range 13-18 years) were treated for their OCD with citalopram in an open-label, flexible-dose study (range of dose 20-70 mg; mean dose 46.5 mg). All patients were referred to Aarhus University Hospital. The patients were monitored for 1 to 2 years. The mean total score on the Yale-Brown Obsessive Compulsive Scale (child or adult version) was 28.7 at base-line, 23.3 after 10 weeks of treatment, 20.0 after 6 months, 18.4 after 1 year, and 17.9 after 2 years (from baseline to 2 years of treatment: t = 11.65; p < .001). Seventy percent showed a decrease in total Yale-Brown Obsessive Compulsive Scale score in excess of 35% from baseline to 1 year of treatment. Twenty percent still had a score of greater than 20 after 1 year of treatment, indicating that clinically they still had OCD. Side effects were similar to those reported from the use of other selective serotonin reuptake inhibitors (SSRIs). No patient was excluded because of serious side effects during the 1 year of observation. The clinical effectiveness and tolerability of citalopram in the long-term treatment seem to be comparable with the observations of other SSRIs in childhood and adolescent OCD. A further, statistically significant reduction is provided by an extended treatment period of up to 1 year.",Thomsen PH.; Ebbesen C.; Persson C.,2001.0,10.1097/00004583-200108000-00010,0,0,
3122,"Causal uncertainty, claimed and behavioural self-handicapping","ER AIMSAccordingly, we sought to establish links between trait causal uncertainty, claimed and behavioural self-handicapping.SAMPLEParticipants were N=72 undergraduate students divided equally between high and low causally uncertain groups.METHODWe used a 2 (causal uncertainty status: high, low) x 3 (performance feedback condition: success, non-contingent success, non-contingent failure) between-subjects factorial design to examine the effects of causal uncertainty on achievement behaviour. Following performance feedback, participants completed 20 single-solution anagrams and 12 remote associate tasks serving as performance measures, and 16 unicursal tasks to assess practice effort. Participants also completed measures of claimed handicaps, state anxiety and attributions.RESULTSRelative to low causally uncertain participants, high causally uncertain participants claimed more handicaps prior to performance on the anagrams and remote associates, reported higher anxiety, attributed their failure to internal, stable factors, and reduced practice effort on the unicursal tasks, evident in fewer unicursal tasks solved.CONCLUSIONSThese findings confirm links between trait causal uncertainty and claimed and behavioural self-handicapping, highlighting the need for educators to facilitate means by which students can achieve surety in the manner in which they attribute the causes of their achievement outcomes.BACKGROUNDCausal uncertainty beliefs involve doubts about the causes of events, and arise as a consequence of non-contingent evaluative feedback: feedback that leaves the individual uncertain about the causes of his or her achievement outcomes. Individuals high in causal uncertainty are frequently unable to confidently attribute their achievement outcomes, experience anxiety in achievement situations and as a consequence are likely to engage in self-handicapping behaviour.","Thompson, T; Hepburn, J",2003.0,10.1348/00070990360626967,0,0,
3123,Clinical psychologist-administered cognitive behavioural therapy: Effectiveness for older adults in cognitive rehabilitation.,"Examined the effectiveness of clinical psychologist-administered cognitive behavioral therapy (CBT) for older adults in cognitive rehabilitation. 2 male and 5 female (aged 54-79 yrs) Ss who had been diagnosed with unipolar depression and generalized anxiety were selected. All Ss were offered a minimum of 2 hourly sessions of CBT. In practice, the mean duration of CBT was 6 hours according to clinical judgement of need. Ss were assessed at 2 points separated by a mean interval of 263 days. The Beck Depression Inventory II (BDI-II), and for 2 patients, the Hospital Anxiety and Depression Scale (HADS), was administered in addition to 9 orientation questions. All 7 patients showed improvements on their BD-II scores. In addition, 2 patients also showed improvement in their depression scores on the HADS. Using the Wilcoxon Signed Ranks test, all 7 Ss were found to have improved BD-II scores between assessments. BD-II scores and the number of hours of CBT were analyzed using the Spearman Rank Correlation but no significant correlation was found. Results of this small-scale study have shown that it is particularly worthwhile to consider CBT in cognitive rehabilitation for the treatment of depression and anxiety disorders in older adults in cognitive rehabilitation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Thompson, Simon B. N; Beck, Beck, Blackburn, Bradbury, Butler, Cheston, Dick, Dobson, Gatz, Grant, King, Koder, Scogin, Sims, Teri, Thompson, Thompson, Thompson, Thompson, Thompson, Thompson, Wilkinson",2001.0,,0,0,
3124,Thought-action fusion across anxiety disorder diagnoses: Specificity and treatment effects.,"Thought-action fusion (TAF) is a cognitive error that has been frequently investigated within the context of obsessive-compulsive disorder (OCD). However, evidence suggests that this error may also be present in disorders other than OCD, indicating that TAF is related to higher order factors rather than a specific diagnosis. We explored TAF in a sample of patients with mixed diagnoses undergoing treatment with a transdiagnostic CBT protocol. Elevated TAF levels at baseline were not specific to patients with OCD. However, the presence of any generalized anxiety disorder (GAD) diagnosis was unexpectedly the strongest predictor of likelihood TAF. Likelihood TAF, a particular component of TAF, was reduced after transdiagnostic treatment, and this reduction was not affected by the presence of a GAD diagnosis. Results indicate that TAF is responsive to treatment and should be assessed and, perhaps, treated in disorders beyond OCD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Thompson-Hollands, Johanna; Farchione, Todd J; Barlow, David H; Abramowitz, Amir, Barlow, Barlow, Barlow, Barrett, Beck, Beck, Berle, Berman, Bocci, Borkovec, Borkovec, Brown, Brown, Einstein, Einstein, Emmelkamp, Fairburn, Fairholme, Farchione, Foa, Freeston, Hamilton, Hamilton, Harvey, Hazlett-Stevens, Hope, Jonsson, Lee, Manos, Marcks, Marino-Carper, Marks, McLean, Mundt, Muris, Rachman, Rapee, Rassin, Rassin, Rassin, Salkovskis, Shafran, Shafran, Shafran, Shafran, Shear, Solem, Taylor, Watson, Whittal, Williams, Zinbarg",2013.0,,0,0,
3125,A randomized clinical trial of a brief family intervention to reduce accommodation in obsessive-compulsive disorder: a preliminary study.,"Accommodation consists of changes in family members' behavior to prevent or reduce patients' obsessive-compulsive disorder (OCD) rituals or distress. High levels of family accommodation are associated with more severe symptoms and functional impairment in patients, and may also interfere with exposure-based treatment. The purpose of this study was to develop and test an intervention to reduce accommodation in the family members of adult OCD patients. Patients (N=18, mean age=35.44, 33% male, 94% Caucasian) received a course of standard individual exposure and ritual prevention (ERP) for OCD. Family members (N=18, mean age=41.72, 56% male, 94% Caucasian) were randomized to either receive or not receive the adjunctive intervention, consisting of two sessions of psychoeducation and skills training in reducing accommodation. Results revealed that the intervention successfully reduced scores on the clinician-rated Family Accommodation Scale (Week 8: d=1.05). Patients whose family members received the intervention showed greater reductions in Yale-Brown Obsessive-Compulsive Scale scores across treatment than patients whose family members had not (Week 8: d=1.27), and hierarchical regression analyses revealed that change in family accommodation from baseline accounted for a significant amount of variance in later OCD symptoms (β=.45, p=.02). Results from this preliminary study suggest that adjunctive intervention produces more rapid treatment response compared with traditional ERP alone. Accommodation is a potentially important target for improving treatment in OCD and other diagnostic groups where accommodation is likely to occur.",Thompson-Hollands J.; Abramovitch A.; Tompson MC.; Barlow DH.,2015.0,10.1016/j.beth.2014.11.001,0,0,
3126,Evaluation of indicated suicide risk prevention approaches for potential high school dropouts,"ER METHODSDrawn from a pool of potential high school dropouts, 460 youths were identified as being at risk for suicide and participated in 1 of 3 conditions randomly assigned by school: (1) Counselors CARE (C-CARE) (n = 150), a brief one-to-one assessment and crisis intervention; (2) Coping and Support Training (CAST) (n = 155), a small-group skills-building and social support intervention delivered with C-CARE; and (3) usual-care control (n = 155). Survey instruments were administered pre-intervention, following C-CARE (4 weeks), following CAST (10 weeks), and at a 9-month follow-up.RESULTSGrowth curve analyses showed significant rates of decline in attitude toward suicide and suicidal ideation associated with the experimental interventions. C-CARE and CAST, compared with usual care, also were effective in reducing depression and hopelessness. Among females, reductions in anxiety and anger were greater in response to the experimental programs. CAST was most effective in enhancing and sustaining personal control and problem-solving coping for males and females.CONCLUSIONSSchool-based, indicated prevention approaches are feasible and effective for reducing suicidal behaviors and related emotional distress and for enhancing protective factors.OBJECTIVESThis study evaluated the efficacy of 2 indicated preventive interventions, postintervention and at 9-month follow-up.","Thompson, E A; Eggert, L L; Randell, B P; Pike, K C",2001.0,,0,0,
3127,Does adding cognitive-behavioural physiotherapy to exercise improve outcome in patients with chronic neck pain? A randomised controlled trial,"ER Objectives: To determine whether adding a physiotherapist-led cognitive-behavioural intervention to an exercise programme improved outcome in patients with chronic neck pain (CNP). Design: Multicentre randomised controlled trial. Setting: Four outpatient physiotherapy departments. Participants: Fifty-seven patients with CNP. Follow-up data were provided by 39 participants [57% of the progressive neck exercise programme (PNEP) group and 79% of the interactive behavioural modification therapy (IBMT) group]. Interventions: Twenty-eight subjects were randomised to the PNEP group and 29 subjects were randomised to the IBMT group. IBMT is underpinned by cognitive-behavioural principles, and aims to modify cognitive risk factors through interactive educational sessions, graded exercise and progressive goal setting. Main outcome measures: The main outcome measure was disability, measured by the Northwick Park Questionnaire (NPQ). Secondary outcomes were the Numeric Pain Rating Scale (NPRS), Pain Catastrophising Scale, Tampa Scale for Kinesiophobia (TSK), Chronic Pain Self-efficacy Scale (CPSS) and the Pain Vigilance and Awareness Questionnaire. Results: No significant between-group differences in disability were observed (mean NPQ change: PNEP = -7.2, IBMT = -10.2). However, larger increases in functional self-efficacy (mean CPSS change: PNEP = 1.0, IBMT = 3.2) and greater reductions in pain intensity (mean NPRS change: PNEP = -1.0, IBMT = -2.2; P < 0.05) and pain-related fear (mean TSK change: PNEP = 0.2, IBMT = -4.7, P < 0.05) were observed with IBMT. Additionally, a significantly greater proportion of participants made clinically meaningful reductions in pain (25% vs 55%, P < 0.05) and disability (25% vs 59%, P < 0.05) with IBMT. Conclusions: The primary outcome did not support the use of cognitive-behavioural physiotherapy in all patients with CNP. However, superior outcomes were observed for several secondary measures, and IBMT may offer additional benefit in some patients. Clinical Trial Registration Number: ISRCTN27611394.","Thompson, D P; Oldham, J A; Woby, S R",2016.0,10.1016/j.physio.2015.04.008,0,0,
3128,Psychological characteristics and the effectiveness of patient-controlled analgesia.,"We have evaluated the level of state and trait anxiety, neuroticism, extroversion and coping style as predictors of the effectiveness of patient-controlled analgesia (PCA) in 110 patients undergoing total abdominal hysterectomy. After operation patients were allocated to receive pain control with either PCA or i.m. injections (IMI). Pain was assessed using the short form McGill pain questionnaire at 6, 18 and 24 h after operation, and by recording the amount of analgesic consumed in the first 24 h after surgery. Both state anxiety and coping style were significant predictors of postoperative pain, irrespective of the method of analgesia used. Patients using PCA experienced significantly better pain control than those receiving IMI. However, it was those with high levels of state anxiety who experienced the greatest reduction in pain with PCA. In addition to achieving better pain control, patients who received PCA used significantly less analgesia and were discharged earlier than patients who received IMI.",Thomas V.; Heath M.; Rose D.; Flory P.,1995.0,,0,0,
3129,Alcoholics with and without social phobia: a comparison of substance use and psychiatric variables.,"While alcoholics with social phobia comprise a substantial portion of the alcoholic population, little is known about how they differ from alcoholics without social phobia in their substance use and psychiatric health. The present study was conducted to examine baseline differences between alcoholics with and without social phobia on substance use and psychiatric variables. Alcoholics without social phobia (n = 397) were chosen to match those with social phobia (n = 397) on several variables, including age and gender. All subjects were participants in Project MATCH, a large clinical client-treatment matching study. Exploratory/Confirmatory analyses revealed that alcoholics with social phobia had higher scores on the alcohol dependence scale and endorsed more dependence symptoms on the SCID, although they did not drink greater amounts or more often than alcoholics without social phobia. They also reported drinking in order to improve sociability and enhance functioning more than did the comparison group. Alcoholics with social phobia were more likely to conform to social norms than alcoholics without social phobia. They also had more symptoms of depression as indicated by higher scores on the Beck Depression Inventory and higher incidence of a major depressive episode from the C-DIS. Alcoholics with social phobia enter treatment with some problems that are more severe than those expressed by alcoholics without social phobia. Whether these problems affect treatment efficacy is an important area for future research.",Thomas SE.; Thevos AK.; Randall CL.,1999.0,,0,0,
3130,Drinking to cope in socially anxious individuals: a controlled study.,"Several hypotheses exist to account for the higher than normal rate of alcoholism in individuals with high trait anxiety (or anxiety disorders). Most of these suggest that the practice of drinking alcohol to reduce anxiety leads to an increased risk of alcoholism in vulnerable individuals. The first assumption of the hypothesis is that anxious individuals use alcohol to cope with their anxiety. Few studies have examined this issue systematically, and none have used a nonanxious matched control group. Twenty-three individuals with high social anxiety and 23 nonsocially anxious matched controls were included in the study. Groups were similar on demographic variables and alcohol use. All participants were queried regarding the use of alcohol to cope, the practice of avoiding social situations if alcohol was not available, and the degree of relief attained by alcohol. Participants also were asked about using alcohol in 11 specific situations. The socially anxious group was significantly more likely than controls to report using alcohol to feel more comfortable in social situations and to avoid social situations if alcohol was unavailable. They also reported a greater degree of relief of anxiety from alcohol. Exploratory analyses revealed that socially anxious individuals reported using alcohol more to cope with social interactions than with social performance situations. Individuals high in social anxiety deliberately drink alcohol to cope with their social fears. They report that alcohol is moderately effective at reducing their anxiety, which is seemingly sufficient to allow them to endure social situations. The data support the first assumption of the self-medication hypothesis-that alcohol is used to reduce social discomfort in socially anxious individuals; however, the study was not designed to address the veracity of the self-medication hypothesis as a whole. Results can help guide future studies that examine the relationship between social anxiety and alcohol.",Thomas SE.; Randall CL.; Carrigan MH.,2003.0,10.1097/01.ALC.0000100942.30743.8C,0,0,
3131,The PROblem Gambling RESearch Study (PROGRESS) research protocol: a pragmatic randomised controlled trial of psychological interventions for problem gambling.,"International prevalence rates for problem gambling are estimated at 2.3%. Problem gambling is a serious global public health concern due to adverse personal and social consequences. Previous research evaluating the effectiveness of psychological interventions for the treatment of problem gambling has been compromised by methodological limitations, including small sample sizes and the use of waitlist control groups. This article describes the study protocol for a pragmatic randomised controlled trial (RCT) evaluating the effectiveness of cognitive-behavioural therapy (CBT), behaviour therapy (BT), motivational interviewing (MI) against a non-directive supportive therapy (NDST) control, in treating problem gambling. This study was a mixed-methods design, with a parallel group, pragmatic RCT as the primary component, and embedded qualitative studies conducted alongside. A total of 297 participants were recruited from the community in Victoria, Australia. Individuals aged 18‚ÄÖyears and over, could communicate in English and wished to receive treatment for a gambling problem were eligible. Participants were randomly allocated in to 1 of the 4 psychological interventions: CBT, BT, MI and NDST. Repeated measures were conducted at pretreatment and post-treatment, and 6 and 12‚ÄÖmonths post-treatment. The statistical analysis will use an intention-to-treat approach. Multilevel mixed modelling will be used to examine changes in the primary outcome measures: gambling symptom severity, using the Gambling Symptom Assessment Scale, and gambling behaviours (frequency, time and expenditure). Secondary outcomes are depression, anxiety, stress and alcohol use. Individual semistructured qualitative interviews were conducted at pretreatment and post-treatment and 12‚ÄÖmonths post-treatment for a subset of participants (n=66). This study was approved by the Victorian Department of Justice, Monash University and the University of Melbourne Human Research Ethics Committees. Findings will be reported in a government report, peer-reviewed publications and conference presentations. Current Controlled Trials ISRCTN01629698.",Thomas SA.; Merkouris SS.; Browning CJ.; Radermacher H.; Feldman S.; Enticott J.; Jackson AC.,2015.0,10.1136/bmjopen-2015-009385,0,0,
3132,Psychological factors and survival in the cardiac arrhythmia suppression trial (CAST): a reexamination,"ER OBJECTIVESTo examine the independent contributions of psychosocial and physiological status to survival of patients who had had myocardial infarction.METHODSThe sample consisted of 348 patients in the Cardiac Arrhythmia Suppression Trial who had asymptomatic ventricular arrhythmias after myocardial infarction. Psychosocial status was assessed with the Social Support Questionnaire-6, Social Readjustment Rating Scale, State-Trait Anxiety Inventory, Self-Rating Depression Scale, Jenkins Activity Survey, and Expression of Anger Scale. Physiological data included measurement of left ventricular ejection fraction; history of previous myocardial infarction, congestive heart failure, and diabetes; and results of Holter monitoring.RESULTSAt the first follow-up, after the effect of the physiological predictors was controlled for, psychosocial factors were significant independent predictors of survival. Among men in the nonactive medication group (n = 263), higher state anxiety, lower anger outward, more past life events, and lower expectations of future life events were predictors of mortality. Data suggested that the relationship of anger to mortality might differ for men and women. Increases in past life events and depression from baseline to first follow-up were greater among those who died than among those who lived.CONCLUSIONAmong patients who had asymptomatic ventricular arrhythmias after myocardial infarction, psychological status during the period after infarction contributed to mortality beyond the effect of physiological status. The results reaffirm the critical interrelationship between mind and body for cardiovascular health.BACKGROUNDEvaluating the independent effects of psychosocial and physiological factors on survival of cardiac patients is difficult because it requires obtaining extensive physiological and psychosocial data and long-term follow-up of high-risk patients.","Thomas, S A; Friedmann, E; Wimbush, F; Schron, E",1997.0,,0,0,
3133,Changes in psychosocial distress in outpatients with heart failure with implantable cardioverter defibrillators,"ER Patients given implantable cardioverter defibrillators (ICDs) after arrhythmic events or sudden cardiac arrest (SCA) experience psychosocial distress. ICDs now are inserted for the primary prevention of SCA in patients with heart failure; the psychosocial impact of ICDs on patients with heart failure is unknown. Changes in psychosocial status in these ICD recipients were examined. ICD recipients (n = 57) completed depression, anxiety, and social support inventories every 6 months for up to 2 years. Initially, 35% of recipients were depressed and 45% of recipients were anxious. In linear mixed models, depression decreased over time overall but increased in those who experienced ICD shocks. Anxiety decreased in New York Heart Association class III ICD recipients but not in class II ICD recipients. Decreases in social support were related to age: the younger the patient the greater the decrease. A significant proportion of ICD recipients were depressed or anxious, or had diminished social support even after 2 years. Investigation of strategies to improve ICD recipients' psychosocial status is warranted.","Thomas, S A; Friedmann, E; Gottlieb, S S; Liu, F; Morton, P G; Chapa, D W; Lee, H J; Nahm, E S",2009.0,10.1016/j.hrtlng.2008.05.005,0,0,
3134,Computerised patient-specific guidelines for management of common mental disorders in primary care: a randomised controlled trial.,"A large proportion of people with depression and anxiety go unrecognised by their general practitioner (GP). Case-finding does not appear to be effective on its own. To compare the effectiveness of case-finding followed by computer-generated patient-specific guidelines with usual care for the management of common mental disorders in primary care. Individual patient randomised controlled trial. Five general practices in Bristol and Cardiff. 762 individuals aged >/= 16 years scoring >/= 12 on the Clinical Interview Schedule Revised were randomised. The experimental intervention required participants to complete a computerised psychosocial assessment that generated a report for the GP including patient-specific treatment recommendations. The control patients were treated as usual with access to locally agreed guidelines. Participants' 12-item General Health Questionnaire (GHQ) score dropped irrespective of treatment allocation. The experimental group had a significantly lower GHQ score at 6 weeks, but not at 6 months. Recovery at 6 months was 3% greater among those receiving the experimental intervention (95% confidence interval [CI] = -4 to 10). Treatment was not significantly associated with quality of life or patient satisfaction. Only small benefits are likely from using case-finding followed by patient-specific guidelines to improve clinical management of common mental disorders in primary care. However, depression and anxiety are important public health problems so the utility of such systems should be further investigated.",Thomas HV.; Lewis G.; Watson M.; Bell T.; Lyons I.; Lloyd K.; Weich S.; Sharp D.,2004.0,,0,0,
3135,Total knee arthroplasty in rheumatoid arthritis. A comparison of the polycentric and total condylar prostheses.,"From 1971 to 1985, 393 total knee arthroplasties (TKAs) were performed in patients for rheumatoid arthritis. Of these, 112 used polycentric prostheses and 131 used total condylar prostheses. One hundred seven of the patients with polycentric prostheses and 102 of the patients with total condylar prostheses were followed for a minimum of two years (average, 61 and 55 months, respectively). At the time of the latest examination, nine knees with polycentric prostheses required revision surgery: six for tibial component loosening and instability and three for patellofemoral pain. Five knees with total condylar prostheses required revision: one for chronic instability, one for a late posttraumatic patellar fracture, and three for late hematogenous infections. The total condylar prostheses with patellar resurfacing had better scores for pain (8.5 points) than the polycentric prosthesis without patellofemoral resurfacing (7.0 points). The total condylar prosthesis appeared more durable in terms of fixation, with no evidence of aseptic loosening of femoral or tibial components noted in this series thus far.",Thomas BJ.; Cracchiolo A.; Lee YF.; Chow GH.; Navarro R.; Dorey F.,1991.0,,0,0,
3136,Increased anterior cingulate cortex and hippocampus activation in Complex PTSD during encoding of negative words,"ER Post-traumatic stress disorder (PTSD) is associated with impaired memory performance coupled with functional changes in brain areas involved in declarative memory and emotion regulation. It is not yet clear how symptom severity and comorbidity affect neurocognitive functioning in PTSD. We performed a functional magnetic resonance imaging (fMRI) study with an emotional declarative memory task in 28 Complex PTSD patients with comorbid depressive and personality disorders, and 21 healthy non-trauma-exposed controls. In Complex PTSD patients--compared to controls--encoding of later remembered negative words vs baseline was associated with increased blood oxygenation level dependent (BOLD) response in the left ventral anterior cingulate cortex (ACC) and dorsal ACC extending to the dorsomedial prefrontal cortex (dmPFC) together with a trend for increased left hippocampus activation. Patients tended to commit more False Alarms to negative words compared to controls, which was associated with enhanced left ventrolateral prefrontal and orbitofrontal cortex (vlPFC/OFC) responses. Severity of child abuse was positively correlated with left ventral ACC activity and severity of depression with (para) hippocampal and ventral ACC activity. Presented results demonstrate functional abnormalities in Complex PTSD in the frontolimbic brain circuit also implicated in fear conditioning models, but generally in the opposite direction, which may be explained by severity of the trauma and severity of comorbid depression in Complex PTSD.","Thomaes, K; Dorrepaal, E; Draijer, N; Ruiter, M B; Elzinga, B M; Sjoerds, Z; Balkom, A J; Smit, J H; Veltman, D J",2013.0,10.1093/scan/nsr084,0,0,
3137,Treatment effects on insular and anterior cingulate cortex activation during classic and emotional Stroop interference in child abuse-related complex post-traumatic stress disorder,"ER BACKGROUND: Functional neuroimaging studies have shown increased Stroop interference coupled with altered anterior cingulate cortex (ACC) and insula activation in post-traumatic stress disorder (PTSD). These brain areas are associated with error detection and emotional arousal. There is some evidence that treatment can normalize these activation patterns.METHOD: At baseline, we compared classic and emotional Stroop performance and blood oxygenation level-dependent responses (functional magnetic resonance imaging) of 29 child abuse-related complex PTSD patients with 22 non-trauma-exposed healthy controls. In 16 of these patients, we studied treatment effects of psycho-educational and cognitive behavioural stabilizing group treatment (experimental treatment; EXP) added to treatment as usual (TAU) versus TAU only, and correlations with clinical improvement.RESULTS: At baseline, complex PTSD patients showed a trend for increased left anterior insula and dorsal ACC activation in the classic Stroop task. Only EXP patients showed decreased dorsal ACC and left anterior insula activation after treatment. In the emotional Stroop contrasts, clinical improvement was associated with decreased dorsal ACC activation and decreased left anterior insula activation.CONCLUSIONS: We found further evidence that successful treatment in child abuse-related complex PTSD is associated with functional changes in the ACC and insula, which may be due to improved selective attention and lower emotional arousal, indicating greater cognitive control over PTSD symptoms.","Thomaes, K; Dorrepaal, E; Draijer, N; Ruiter, M B; Elzinga, B M; Balkom, A J; Smit, J H; Veltman, D J",2012.0,10.1017/S0033291712000499,0,0,
3138,Lessons learned from studies of psychotherapy for posttraumatic stress disorder via video teleconferencing.,"This article summarizes two ongoing randomized controlled trials that compare individual in-person psychotherapy with psychotherapy provided using video teleconferencing for military veterans with posttraumatic stress disorder. We describe training methods, populations, technology, challenges, successes, and lessons learned so far during the trials.",Thorp SR.; Fidler J.; Moreno L.; Floto E.; Agha Z.,2012.0,10.1037/a0027057,0,0,
3139,Test of mindfulness and hope components in a psychological intervention for women with cancer recurrence.,"Objective: Psychological interventions can attenuate distress and enhance coping for those with an initial diagnosis of cancer, but there are few intervention options for individuals with cancer recurrence. To address this gap, we developed and tested a novel treatment combining Mindfulness, Hope Therapy, and biobehavioral components. Method: An uncontrolled, repeated measures design was used. Women (N = 32) with recurrent breast or gynecologic cancers were provided 20 treatment sessions in individual (n = 12) or group (n = 20) formats. On average, participants were middle aged (M = 58) and Caucasian (81%). Independent variables (i.e., hope and mindfulness) and psychological outcomes (i.e., depression, negative mood, worry, and symptoms of generalized anxiety disorder) were assessed pre-treatment and 2, 4, and 7 months later. Session-by-session therapy process (positive and negative affect, quality-of-life) and mechanism (use of intervention-specific skills) measures were also included. Results: Distress, anxiety, and negative affect decreased, whereas positive affect and mental-health-related quality-of-life increased over the course of treatment, as demonstrated in mixed-effects models with the intent-to-treat sample. Both hope and mindfulness increased, and use of mindfulness skills was related to decreased anxiety. Conclusions: This treatment was feasible to deliver and was acceptable to patients. The trial serves as preliminary evidence for a multi-component intervention tailored to treat difficulties specific to recurrent cancer. The blending of the components was novel as well as theoretically and practically consistent. A gap in the literature is addressed, providing directions for testing interventions designed for patients coping with the continuing stressors and challenges of cancer recurrence. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Thornton, Lisa M; Cheavens, Jennifer S; Heitzmann, Carolyn A; Dorfman, Caroline S; Wu, Salene M; Andersen, Barbara L; Akechi, Andersen, Andersen, Andersen, Andersen, Andersen, Andersen, Andersen, Andersen, Baer, Baker, Berendes, Berg, Brothers, Brothers, Bull, Campbell, Carlson, Carlson, Cheavens, Christopher, Comstock, Crittendon, Curran, de Moor, Devine, Edwards, Evans, Evans, Feldman, Galway, Garland, Goodwin, Gotay, Gum, Hann, Hersch, Hoffman, Hofmann, Hopko, Jacobson, Jacobson, Kabat-Zinn, Kabat-Zinn, Kissane, Lengacher, Low, Mackinnon, Meyer, Meyer, Naaman, Newman, Palesh, Piet, Pinquart, Radloff, Raftery, Raudenbush, Rodebaugh, Sarenmalm, Schumacher, Shacham, Sheard, Shennan, Snyder, Snyder, Snyder, Snyder, Spiegel, Spiegel, Stahl, Stanton, Stanton, Thornton, Ware, Ware, Ware, Watson, Weisman, Wrobleski, Yang, Yang",2014.0,,0,0,
3140,Relationships among emotion regulation and symptoms during trauma-focused CBT for school-aged children,"ER This study examined improvement in emotion regulation throughout Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) and the degree to which improvement in emotion regulation predicted improvement in symptoms. Traumatized children, 7-12 years (69.9% female), received TF-CBT. Data from 4 time periods were used: pre-assessment (n=107), pre-treatment (n=78), post-treatment (n=58), and 6-month follow-up (n=44). Questionnaires measured emotion regulation in the form of inhibition and dysregulation (Children's Emotion Management Scales) and lability/negativity and emotion regulation skill (Emotion Regulation Checklist), as well as child-reported (Trauma Symptom Checklist for Children) and parent-reported (Trauma Symptom Checklist for Young Children) posttraumatic stress, and internalizing and externalizing problems (Child Behaviuor Checklist). To the extent that children's dysregulation and lability/negativity improved, their parents reported fewer symptoms following therapy. Improvements in inhibition best predicted improvements in child-reported posttraumatic stress (PTS) during clinical services, but change in dysregulation and lability/negativity best predicted improvement in child-reported PTS symptoms at 6-month follow-up. Moreover, statistically significant improvements of small effect size were found following therapy, for inhibition, dysregulation, and lability/negativity, but not emotion regulation skill. These findings suggest that emotion regulation is a worthy target of intervention and that improvements in emotion regulation can be made. Suggestions for future research are discussed.","Thornback, K; Muller, R T",2015.0,10.1016/j.chiabu.2015.09.011,0,0,
3141,Complex PTSD following early-childhood trauma: emotion-regulation training as addition to the PTSD guideline,"ER BACKGROUND: Posttraumatic stress disorder (PTSD) symptoms in individuals who have experienced repeated trauma (sexual and/or physical) in early childhood can lead to problems associated with emotion regulation, interpersonal functioning and self-image. This so-called complex PTSD is often accompanied by a comorbid personality disorder. Although ptsd is associated with structural and functional abnormalities in emotion-regulation areas in the brain, it is not known whether complex PTSD shows similar abnormalities. Experts take the view that before individuals with complex PTSD are given appropriate therapy they should receive a course of emotion-regulation therapy such as the one tested by Zlotnick e.a. (1997) in a randomised controlled trial (RCT).  AIM: To replicate Zlotnick's RCT in the Netherlands and to find out whether complex PTSD patients show specific structural and functional brain abnormalities and whether psychological recovery is linked to the 'normalisation' of these abnormalities.METHOD: In a RCT with complex PTSD patients (n = 71) who had experienced trauma in early childhood, we compared normal individual treatment with treatment supported by 'Before and beyond', which consists of emotion-regulation therapy combined with cognitive group therapy. In a subsample (n= 33) we also performed an mri (repeated, n = 9) in which individuals were required to execute an emotional memory and attention task.RESULTS: In complex PTSD, structural abnormalities in the brain seemed to be more extensive than in PTSD and brain activity in complex PTSD seemed to be strikingly different from the brain activity seen in PTSD patients who had experienced only single trauma. The results of the RCT indicate that 'Before and beyond' is a clinically meaningful treatment (with minimal drop-out) for complex PTSD patients with a variety of personality disorders. The psychological recovery of patients who received the emotion regulation and cognitive group treatment was associated with normalisation of brain function.CONCLUSION: Treatment guidelines for ptsd patients cannot be applied directly and automatically to complex PTSD because there is no scientific evidence to justify such a step. The neurobiological profile of PTSD differs from that of complex PTSD. Patients with complex PTSD seem to react favourably to emotion regulation therapy. This treatment therefore could be a useful addition to the current PTSD guideline for this specific group. There is a need for further research that focuses on complex PTSD patients.","Thomaes, K; Dorrepaal, E; Balkom, A J; Veltman, D J; Smit, J H; Hoogendoorn, A W; Draijer, N",2015.0,,0,0,
3142,Measurement of tracheal temperature is not a reliable index of total respiratory heat loss in mechanically ventilated patients,"ER METHODTotal respiratory heat loss was measured, with three different methods of inspired gas conditioning, in 10 sedated patients. The study was randomized and of a crossover design. Each patient was ventilated for three consecutive 24-h periods with a heated humidifier (HH), a hydrophobic heat-moisture exchanger (HME) and a hygroscopic HME. Total respiratory heat loss and tracheal temperature were simultaneously obtained in each patient. Measurements were obtained during each 24-h study period after 45 min, and 6 and 24 h.RESULTSTotal respiratory heat loss varied from 51 to 52 cal/min with the HH, from 100 to 108 cal/min with the hydrophobic HME, and from 92 to 102 cal/min with the hygroscopic HME (P < 0.01). Simultaneous measurements of maximal tracheal temperatures revealed no significant differences between the HH (35.7-35.9 degrees C) and either HME (hydrophobic 35.3-35.4 degrees C, hygroscopic 36.2-36.3 degrees C).CONCLUSIONIn intensive care unit (ICU) mechanically ventilated patients, total respiratory heat loss was twice as much with either hydrophobic or hydroscopic HME than with the HH. This suggests that a much greater amount of heat was extracted from the respiratory tract by the HMEs than by the HH. Tracheal temperature, although simple to measure in ICU patients, does not appear to be a reliable estimate of total respiratory heat loss.BACKGROUNDMinimizing total respiratory heat loss is an important goal during mechanical ventilation. The aim of the present study was to evaluate whether changes in tracheal temperature (a clinical parameter that is easy to measure) are reliable indices of total respiratory heat loss in mechanically ventilated patients.","Thomachot, L; Viviand, X; Lagier, P; Dejode, J M; Albanèse, J; Martin, C",2001.0,10.1186/cc974,0,0,
3143,"Comparing two heat and moisture exchangers, one hydrophobic and one hygroscopic, on humidifying efficacy and the rate of nosocomial pneumonia","ER DESIGNProspective, randomized study.SETTINGICU of a university hospital.PATIENTSAll patients who required mechanical ventilation for > or = 24 h during the study period.INTERVENTIONSOn admission to the ICU, patients were randomly assigned to one of two groups. In one group, the patients were ventilated with a hygroscopic device (Humid-Vent Filter Light HMEF; Gibeck; Upplands Vaesby, Sweden). The condensation surface was made of paper (Microwell) impregnated with CaCl2. The filter membrane was made of polypropylene. In the other group, the patients were ventilated with a hydrophobic device (Pall BB100 HMEF). The condensation surface was made of a hydrophobic resin with a hydrophylic layer. The filter membrane was made of ceramic fibers. In both groups, HMEFs were changed daily.MEASUREMENTS AND RESULTSBoth groups of patients were similar for the tested characteristics, including parameters of mechanical ventilation. Sixty-six patients were ventilated for 11.7+/-11 days with the Humid-Vent Filter Light HMEF and 70 patients for 12.2+/-12 days with the Pall BB 100. Patients ventilated with the Humid-Vent Filter Light underwent 6.0+/-3.0 tracheal aspirations and 1.7+/-2.0 instillations per day, and those with the Pall BB 100, 6.0+/-3.0 and 1.6+/-2.0 per day, respectively (not significant [NS]). Abundance of tracheal secretions, presence of blood, and viscosity, evaluated by semiquantitative scales, were similar in both groups. No difference in the rate of atelectasis was observed between the two groups (7.5% and 7.1%, NS). One episode of tracheal tube occlusion was observed with the Humid-Vent Filter Light HMEF, and one with the other HMEF (NS). One patient in each group (NS) was switched to an active heated humidifier because of very tenacious bronchial secretions despite repeated instillations. Tracheal colonization was observed at a rate of 67% with the Humid-Vent Filter Light and 58% with the Pall BB 100 (NS). A small, but NS difference was observed in the rate of ventilator-associated pneumonia: Humid-Vent Filter Light, 32% (27.1 per 1000 ventilator days); and Pall BB 100, 37% (30.4 per 1000 ventilator days). Bacteria responsible for tracheal colonization and pneumonia were similar in both groups. Three patients in each group died from their nosocomial pneumonia.CONCLUSIONDespite differences in their components, the two HMEFs tested achieved similar performances in terms of humidification and heating of inspired gases. Only one episode of endotracheal tube occlusion was detected and very few patients (one in each group) had to be switched to an active heated humidifier. No difference was observed either in the rate of tracheal colonization or of ventilator-associated pneumonia. These data show that the hygroscopic HME (Humid-Vent Filter Light) and the hydrophobic HME (Pall BB 100) are suited for use in ICU patients.OBJECTIVEMany heat and moisture exchangers with filter (HMEF) have been developed. In-house data from companies provide some information about their performances; unfortunately, to our knowledge, no comparative evaluation in clinical conditions has been undertaken of these newer products. The aim of this study was to compare the efficiency of two HMEFs, one hydrophobic and one hygroscopic, on humidifying capacity and the rate of bronchial colonization and ventilator-associated pneumonia in ICU patients.","Thomachot, L; Viviand, X; Arnaud, S; Boisson, C; Martin, C D",1998.0,,0,0,
3144,Randomized clinical trial of extended use of a hydrophobic condenser humidifier: 1 vs. 7 days,"ER DESIGNProspective, controlled, randomized, not blinded, clinical study.SETTINGTwelve-bed intensive care unit of a university hospital.PATIENTSOne hundred and fifty-five consecutive patients undergoing mechanical ventilation for > or = 48 hrs.INTERVENTIONSAfter randomization, patients were allocated to one of the two following groups: a) heat and moisture exchangers (HMEs) changed every 24 hrs; b) HMEs changed only once a week. Devices in both groups could be changed at the discretion of the staff when signs of occlusion or increased resistance were identified.MEASUREMENTS AND MAIN RESULTEfficient airway humidification and heating were assessed by clinical variables (numbers of tracheal suctionings and instillations required, peak and mean airway pressures). The frequency rates of bronchial colonization and ventilation-acquired pneumonia were evaluated by using clinical and microbiological criteria. Endotracheal tube occlusion, ventilatory support variables, duration of mechanical ventilation, length of intensive care, acquired multiorgan dysfunction, and mortality rates also were recorded. The two groups were similar at the time of randomization. Endotracheal tube occlusion never occurred. In the targeted population (patients ventilated for > or = 7 days), the frequency rate of ventilation-acquired pneumonia was 24% in the HME 1-day group and 17% in the HME 7-day group (p > .05, not significant). Ventilation-acquired pneumonia rates per 1000 ventilatory support days were 16.4/1000 in the HME 1-day group and 12.4/1000 in the HME 7-day group (p > .05, not significant). No statistically significant differences were found between the two groups for duration of mechanical ventilation, intensive care unit length of stay, acquired organ system derangements, and mortality rate. There was indirect evidence of very little, if any, change in HME resistance.CONCLUSIONSChanging the studied hydrophobic HME after 7 days did not affect efficiency, increase resistance, or altered bacterial colonization. The frequency rate of ventilation-acquired pneumonia was also unchanged. Use of HMEs for > 24 hrs and up to 7 days is safe.OBJECTIVETo determine whether extended use (7 days) would affect the efficiency on heat and water preservation of a hydrophobic condenser humidifier as well as the rate of ventilation-acquired pneumonia, compared with 1 day of use.","Thomachot, L; Leone, M; Razzouk, K; Antonini, F; Vialet, R; Martin, C",2002.0,,0,0,
3145,Treatment of child anxiety disorders via guided parent-delivered cognitive-behavioural therapy: randomised controlled trial,"ER Background: Promising evidence has emerged of clinical gains using guided self-help cognitive-behavioural therapy (CBT) for child anxiety and by involving parents in treatment; however, the efficacy of guided parent-delivered CBT has not been systematically evaluated in UK primary and secondary settings. Aims: To evaluate the efficacy of low-intensity guided parent-delivered CBT treatments for children with anxiety disorders. Method: A total of 194 children presenting with a current anxiety disorder, whose primary carer did not meet criteria for a current anxiety disorder, were randomly allocated to full guided parent-delivered CBT (four face-to-face and four telephone sessions) or brief guided parent-delivered CBT (two face-to-face and two telephone sessions), or a wait-list control group (trial registration: ISRCTN92977593). Presence and severity of child primary anxiety disorder (Anxiety Disorders Interview Schedule for DSM-IV, child/parent versions), improvement in child presentation of anxiety (Clinical Global Impression-Improvement scale), and change in child anxiety symptoms (Spence Children's Anxiety Scale, child/parent version and Child Anxiety Impact scale, parent version) were assessed at post-treatment and for those in the two active treatment groups, 6 months posttreatment. Results: Full guided parent-delivered CBT produced superior diagnostic outcomes compared with wait-list at posttreatment, whereas brief guided parent-delivered CBT did not: at post-treatment, 25 (50%) of those in the full guided CBT group had recovered from their primary diagnosis, compared with 16 (25%) of those on the wait-list (relative risk (RR) 1.85, 95% CI 1.14-2.99); and in the brief guided CBT group, 18 participants (39%) had recovered from their primary diagnosis post-treatment (RR = 1.56, 95% CI 0.89-2.74). Level of therapist training and experience was unrelated to child outcome. Conclusions: Full guided parent-delivered CBT is an effective and inexpensive first-line treatment for child anxiety.","Thirlwall, K; Cooper, P J; Karalus, J; Voysey, M; Willetts, L; Creswell, C",2013.0,10.1192/bjp.bp.113.126698,0,0,
3146,The Coronary Health Improvement Project (CHIP) for lowering weight and improving psychosocial health.,"This study extends previous research evaluating the association between the CHIP intervention, change in body weight, and change in psychological health. A randomized controlled health intervention study lasting 4 wk. was used with 348 participants from metropolitan Rockford, Illinois; ages ranged from 24 to 81 yr. Participants were assessed at baseline, 6 wk., and 6 mo. The Beck Depression Inventory (BDI) and three selected psychosocial measures from the SF-36 Health Survey were used. Significantly greater decreases in Body Mass Index (BMI) occurred after 6 wk. and 6 mo. follow-up for the intervention group compared with the control group, with greater decreases for participants in the overweight and obese categories. Significantly greater improvements were observed in BDI scores, role-emotional and social functioning, and mental health throughout follow-up for the intervention group. The greater the decrease in BMI through 6 wk., the better the chance of improved BDI score, role-emotional score, social functioning score, and mental health score, with odds ratios of 1.3 to 1.9. Similar results occurred through 6 mo., except the mental health variable became nonsignificant. These results indicate that the CHIP intervention significantly improved psychological health for at least six months afterwards, in part through its influence on lowering BMI.",Thieszen CL.; Merrill RM.; Aldana SG.; Diehl HA.; Mahoney ML.; Greenlaw RL.; Vermeersch DA.; Englert H.,2011.0,10.2466/06.10.13.17.PR0.109.4.338-352,0,0,
3147,Heat and moisture exchangers in mechanically ventilated intensive care unit patients: a plea for an independent assessment of their performance,"ER DESIGNProspective, randomized, controlled clinical study comparing two combined HMEs.SETTINGMedical intensive care unit at a university teaching hospital.PATIENTSLong-term, mechanically ventilated, COPD patients compared with non-COPD patients.INTERVENTIONSIn the first part of the study, COPD patients were studied with the Hygroster HME changed once a week. For the second part, the Hygroster was assessed in non-COPD patients and compared with the Hygrobac HME used in COPD and non-COPD patients for 1 wk without change. Devices could be changed if hygrometric measurements indicated insufficient humidity delivery.MEASUREMENTS AND MAIN RESULTSDaily measurements were recorded for inspired gas temperature and relative and absolute humidity. Ventilatory variables, clinical indicators of efficient humidification, were also recorded. No tracheal tube occlusion occurred. However, contrary to the manufacturer advertisement, the Hygroster experienced surprisingly low values for absolute humidity in both COPD and non-COPD patients. Such events did not occur with the Hygrobac. Absolute humidity with the Hygroster was constantly and significantly lower during the 7-day study period than with the Hygrobac. Absolute humidity measured in COPD patients was identical to that measured in the rest of the study population with both HMEs.CONCLUSIONSManufacturer specifications and bedside measurements of absolute humidity differed considerably for the Hygroster, which in certain instances did not achieve efficient humidification in both COPD and non-COPD patients. This did not occur with the Hygrobac, which performed well throughout the 7-day period in both COPD and non-COPD patients. Our results speak for independent and evaluation of HMEs.OBJECTIVETo determine whether use of a hygroscopic and hydrophobic heat and moisture exchanger (HME) for 7 days without change affects its efficiency in long-term, mechanically ventilated, chronic obstructive pulmonary disease (COPD) patients.","Thiéry, G; Boyer, A; Pigné, E; Salah, A; Lassence, A; Dreyfuss, D; Ricard, J D",2003.0,10.1097/01.CCM.0000050443.45863.F5,0,0,
3148,Social support in alcohol dependence and social phobia: Treatment comparisons.,"This study investigated whether different alcoholism treatment approaches differentially impact social support scores in individuals with concurrent alcohol dependence and social phobia. 397 Individuals (aged 21-69 yrs old) were selected retrospectively from a larger pool of participants enrolled in a multisite randomized clinical trial on treatment matching. Three standard treatments were delivered over 12 wks: Cognitive-Behavioral Therapy (CBT), Twelve Step Facilitation Therapy (TSF), and Motivational Enhancement Therapy (MET). Social support measures were analyzed to test the effects of treatment group and gender. For men, there was significant improvement on 2 measures of social support regardless of treatment group. Women who received CBT or TSF had better support outcomes than women who received MET. These data suggest that social support can be improved through alcohol treatment in individuals with coexisting social phobia, particularly if social workers emphasize skills training and facilitating involvement in 12-step groups. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Thevos, Angelica K; Thomas, Suzanne E; Randall, Carrie L; Akerlind, Billings, Blouin, Booth, Booth, Brennan, Broadhead, Bromet, Chaney, Cohen, Donovan, Feragne, Finney, Germain, Gordon, House, Kadden, Kadden, Kushner, Lotufo-Neto, Miller, Miller, Monti, Nowinski, Procidano, Reifman, Rice, Robins, Ross, Schilit, Schneier, Smail, Strug, Thevos, Thomas, Turner",2001.0,,0,0,
3149,Cognitive behavioral therapy delays relapse in female socially phobic alcoholics,"ER The present study was conducted to test the hypothesis that socially phobic alcoholics treated with Cognitive Behavioral therapy (CBT) will have better drinking outcomes than those treated with Twelve-Step Facilitation therapy (TSF). Three hundred ninety-seven treatment-seeking alcoholics with concurrent social phobia were compared retrospectively to a matched sample of 397 alcoholics without social phobia. Treatment was delivered in an outpatient setting, and patients were randomized to either CBT, TSF, or Motivational Enhancement therapy (MET). The groups were compared on self-reported drinking measures (e.g., quantity and frequency of drinking, and time-to-event measures) during treatment period and monthly for 1 year following treatment. Survival analyses revealed that female outpatients with social phobia showed delayed relapse to drinking when treated with CBT rather than TSF; the reverse was true for female outpatients without social phobia. Survival analyses in male outpatients with and without social phobia revealed an opposite trend, though it was not statistically significant. These data suggest that Cognitive Behavioral therapy is superior to Twelve-Step Facilitation therapy for the treatment of alcohol problems in specific populations. namely socially phobic women seeking outpatient treatment.","Thevos, A K; Roberts, J S; Thomas, S E; Randall, C L",2000.0,,0,0,210
3150,'Person under train' incidents: Medical consequences for subway drivers,"From the subway driver's point of view, a 'person under train' (PUT) incident is a serious life event. This study focuses on the 1-year consequences of such events. Follow-up was made 3 weeks, 3 months, and 1 year after the event. Forty consecutive PUT subway drivers were followed. For each PUT driver, a control driver matched with regard to gender, age, and country of birth was followed at identical intervals. Main results: The PUT group had significantly more sick days during the interval from the event to 3 weeks later. During the period 3 weeks to 3 months after the event no difference between the groups was observed. From 3 months to 1 year after the PUT significantly more days were again reported by the PUT group. Thirty-eight percent in the PUT group versus 14% in the control group had at least 1 month of sickness absence during this period. A mild acute psychophysiological reaction was observed 3 weeks after the event, with elevated prolactin and increased sleep disturbance in the PUT group. Such acute reactions were transitory and not correlated with long-term sick leave, which was predicted independently, however, by a high plasma cortisol level (analyzed in men) and a high depression score. Drivers in the group with seriously injured victims were absent from work for longer periods than drivers in the groups with mildly injured or dead victims.",Theorell T.; Leymann H.; Jodko M.; Konarski K.; Norbeck H.E.; Eneroth P.,1992.0,,0,0,
3151,Urinary phenylethylamine excretion in phobic and obsessive patients,"Urinary excretion of phenylethylamine (PEA) was determined in 19 agoraphobic, 15 obsessive compulsive and 10 neurotic depressive outpatients, and 17 healthy volunteers. Variations in urinary PEA concentrations did not appear to correlate with any of the diagnostic groups.",Theofilopoulos N.; Flaskos J.; George A.J.,1991.0,,0,0,
3152,Oxytocin administration leads to a preference for masculinized male faces,"ER Preferences for sexually dimorphic traits in men's faces are consistent with a trade-off between cues to indirect (genetic) and direct (prosociality) benefits, associated perceptually with relative masculinity and femininity respectively. As the neuropeptide oxytocin (OT) has been shown to promote social perception, we hypothesized that temporary OT elevation would result in a preference for masculinity in men's faces, by reducing the apparent social costs of masculine traits. In a double-blind, placebo-controlled study, 96 participants received either 24 IU OT or placebo. They then completed a computer task in which they used the mouse to alter the shape of displayed men's and women's faces, making them look more or less masculine. Participants were instructed to make each face as attractive as possible. OT administration led to a trend for a relative preference for masculinity in men's faces but did not affect preferences for femininity in women's faces, and this effect occurred irrespective of the participant's sex. We tentatively speculate that OT may 'mask' negative personality attributions normally associated with masculine male faces. These results may be pointing to the role of personality attribution in attractiveness judgements, and the role of OT in social perception.","Theodoridou, A; Rowe, A C; Rogers, P J; Penton-Voak, I S",2011.0,10.1016/j.psyneuen.2011.02.004,0,0,
3153,Acceptance and commitment therapy in the treatment of alcohol use disorder and comorbid affective disorder: A pilot matched control trial.,"This study examined whether acceptance and commitment therapy (ACT) enhances treatment as usual (TAU) in improving treatment outcomes in patients with alcohol use disorder (AUD) and comorbid affective disorder. Fifty-two participants were included in the study, of whom 26 were patients with AUD and either depression or bipolar disorder treated with ACT group therapy in parallel with TAU (inpatient integrated treatment) and 26 were matched controls who had received TAU alone. Drinking and craving outcomes were total alcohol abstinence, cumulative abstinence duration (CAD) and Obsessive Compulsive Drinking Scale (OCDS) scores at 3 and 6months postintervention. Affective and anxiety outcomes were Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Young Mania Rating Scale (YMRS) scores at these follow-ups. Baseline demographic and clinical characteristics were similar in both groups. Retention rates were high: 100% of the ACT group were followed up at 3 and 6months; 92.3% and 84.6% of the TAU alone group were followed up at 3 and 6months, respectively. Patients in the ACT group reported significantly higher CAD at 3 and 6months, significantly lower BDI and BAI scores at 3 and 6months, and significantly lower OCDS scores at 3months, than those who received only TAU. No other significant differences in treatment outcomes were found between the groups. ACT provides added benefit to TAU in improving drinking, craving, depression and anxiety outcomes in patients with AUD and comorbid affective disorder. Most treatment improvements were sustained over a 6-month follow-up period. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Thekiso, Thekiso B; Murphy, Philip; Milnes, Jennie; Lambe, Kathryn; Curtin, Aisling; Farren, Conor K; Agyapong, Agyapong, Akiskal, Angst, Anton, Barkham, Beck, Beck, Beck, Bowen, Breese, Brown, Burns, Carey, Cornelius, Dalton, Farren, Farren, Farren, Feldner, First, Forman, Hasin, Hasin, Hayes, Hayes, Hayes, Hayes, Haynes, Heffner, Hoff, Judd, Keuhn, Kranzler, Luciano, Mason, McKowen, Murphy, Nunes, Petersen, Pettinati, Pettinati, Potash, Roelofs, Roemer, Ruiz, Sacks, Salloum, Shoal, Sinha, Sobell, Sobell, Stewart, Tiet, Unnebrink, van de Mortel, Weiss, Young, Zettle",2015.0,,0,0,
3154,Acceptance and Commitment Therapy in the Treatment of Alcohol Use Disorder and Comorbid Affective Disorder: A Pilot Matched Control Trial.,"This study examined whether acceptance and commitment therapy (ACT) enhances treatment as usual (TAU) in improving treatment outcomes in patients with alcohol use disorder (AUD) and comorbid affective disorder. Fifty-two participants were included in the study, of whom 26 were patients with AUD and either depression or bipolar disorder treated with ACT group therapy in parallel with TAU (inpatient integrated treatment) and 26 were matched controls who had received TAU alone. Drinking and craving outcomes were total alcohol abstinence, cumulative abstinence duration (CAD) and Obsessive Compulsive Drinking Scale (OCDS) scores at 3 and 6 months postintervention. Affective and anxiety outcomes were Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Young Mania Rating Scale (YMRS) scores at these follow-ups. Baseline demographic and clinical characteristics were similar in both groups. Retention rates were high: 100% of the ACT group were followed up at 3 and 6 months; 92.3% and 84.6% of the TAU alone group were followed up at 3 and 6 months, respectively. Patients in the ACT group reported significantly higher CAD at 3 and 6 months, significantly lower BDI and BAI scores at 3 and 6 months, and significantly lower OCDS scores at 3 months, than those who received only TAU. No other significant differences in treatment outcomes were found between the groups. ACT provides added benefit to TAU in improving drinking, craving, depression and anxiety outcomes in patients with AUD and comorbid affective disorder. Most treatment improvements were sustained over a 6-month follow-up period.",Thekiso TB.; Murphy P.; Milnes J.; Lambe K.; Curtin A.; Farren CK.,2015.0,10.1016/j.beth.2015.05.005,0,0,
3155,Phasic heart period reactions to cued threat and nonthreat stimuli in generalized anxiety disorder.,"The hallmark of generalized anxiety disorder (GAD) is chronic uncontrollable worry. A preattentive bias toward threat cues and hypervigilance may support this ongoing state of apprehension. A study was conducted to bridge the attentional and physiological underpinnings of GAD by examining phasic heart period (HP) responses to cued threat and nonthreat stimuli. Thirty-three GAD clients and 33 nonanxious control participants engaged in an S1-S2 procedure that employed cued threat and nonthreat word stimuli, during which phasic HP reactions were recorded. As compared with the control group, the GAD group showed (1) smaller cardiac orienting responses and impaired habituation of cardiac orienting to neutral words, (2) HR acceleration in response to threat words, and (3) a conditioned anticipatory HR deceleration to threat words over repeated trials. The cardiac-autonomic underpinnings of GAD appear to rigidly maintain precognitive defensive responses against threat. This portrayal is discussed in the context of an integrative model that depicts diminished global adaptive variability in GAD.",Thayer JF.; Friedman BH.; Borkovec TD.; Johnsen BH.; Molina S.,2000.0,,0,0,
3156,Exploratory factor analysis of two measures of posttraumatic stress disorder (PTSD) symptoms in a non-clinical sample of college students,"This study investigated the psychometric structure of two widely utilized measures of posttraumatic symptoms in a primarily Caucasian non-clinical sample. Given the prevalence of trauma exposure in non-referred samples, measurement of resulting symptoms is a critical issue. Exploratory factor analysis was utilized to assess and compare the factor structure of the Impact of Event Scale [IES; Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209-218] and the Mississippi Scale for Posttraumatic Stress Disorder, Civilian version [MIS-Civ; Vreven, D. L., Gudanowski, D. M., King, L. A., & King, D. W. (1995). The Civilian Version of the Mississippi PTSD Scale - a psychometric evaluation. Journal of Traumatic Stress, 8, 91-109] in a sample of college students reporting exposure to potentially traumatic events. The psychometric structure of the IES was largely consistent with the two-factor structure widely reported in the literature, while the structure of the MIS-Civ varied considerably in this sample. Notably, non-clinical samples tended to report fewer social and occupational dysfunction than clinical samples predominantly utilized in PTSD research. Implications for use of these instruments in screening samples are discussed. © 2004 Elsevier Inc. All rights reserved.",Thatcher D.L.; Krikorian R.,2005.0,10.1016/j.janxdis.2004.11.004,0,0,
3157,Hysterectomy improves quality of life and decreases psychiatric symptoms: a prospective and randomised comparison of total versus subtotal hysterectomy,"ER DESIGNProspective, randomised, double-blind study.SETTINGA large UK Teaching Hospital (St George's Hospital, London) and a large District General Hospital (Mayday University Hospital, Croydon). METHODS.SAMPLETwo hundred and seventy-nine women undergoing hysterectomy for benign disease were randomly allocated to total hysterectomy (n= 146) or subtotal hysterectomy (n= 133).MAIN OUTCOME MEASURESQuality of life assessment using the Short-Form-36 health survey (SF-36) and psychological outcome measures using the General Health Questionnaire-28 (GHQ-28) before the operation and 6 and 12 months after.RESULTSQuality of life and psychological symptoms were similar in the two groups at baseline. Following surgery, quality of life improved in six of the eight domains, with no significant difference between the groups, with the exception of emotions which showed a greater improvement in subtotal hysterectomy women between baseline and 12 months. When this difference was examined further by looking at change in the GHQ subscales, there were no significant differences between total and subtotal hysterectomy women in the amount of change in anxiety, depression, somatic symptoms or social dysfunction, between baseline and post-operative measurements. All women showed an improvement in psychological symptoms following both operations.CONCLUSIONHysterectomy, whether total or subtotal, may improve quality of life and psychological outcome.OBJECTIVETo conduct a prospective and concurrent evaluation of changes in health status and quality of life and psychological outcome measures over one year in women randomised to total or subtotal abdominal hysterectomy. The concurrent evaluation was the impact of total versus subtotal hysterectomy on bladder, bowel and sexual function.","Thakar, R; Ayers, S; Georgakapolou, A; Clarkson, P; Stanton, S; Manyonda, I",2004.0,10.1111/j.1471-0528.2004.00242.x,0,0,
3158,Effects of client-centered psychotherapy for personality disorders alone and in combination with psychopharmacological treatment: An empirical follow-up study,"Background: There is an increasing interest concerning the treatment of patients with personality disorders (PD) in data on the efficacy of psychotherapeutic strategies especially when combined with medication. Methods: The efficacy of an inpatient client-centered treatment program (CCT) was studied prospectively in 142 patients with PD and additional depressive, anxiety or eating disorders (ICD-10). Results: Significant improvements in depression, self-esteem and social adjustment were achieved up to discharge, which remained stable at the 1-year follow-up. The efficacy with regard to individual variables or the total result could not be further enhanced by a combination with psychopharmacological treatment (CCT + MED), consisting mainly of antidepressants. Within the subgroups of patients with socially deviant (F60.0-2), emotionally unstable/borderline (F60.3) and histrionic/narcissistic PD (F60.4, F60.8), CCT was significantly superior to CCT + MED in the reduction of depression (Bech-Rafaelsen Melancholia Scale ratings), whereas the response was enhanced by medication in the subgroup of patients with socially dependent 'cluster C′ PD (F60.5-7). Conclusions: The results are discussed with regard to client-centered therapeutic concepts and to the further development of differential combination strategies. Copyright © 2001 S. Karger AG, Basel.",Teusch L.; Böhme H.; Finke J.; Gastpar M.,2001.0,10.1159/000056273,0,0,
3159,"Exclusive, conflict-centered treatment or integration: Different mechanisms of change in panic and agoraphobia by client-centered therapy alone and in combination with behavioral exposure.","The mechanisms of change due to different psychotherapeutic treatments of anxiety disorders are the subject of the present study. Sixty-eight patients with agoraphobia and panic (DSM III R No. 300.21, ICD 10 No. F 40.01) were included, exclusively treated with client-centered treatment (n = 28) or with additional behavioral exposure treatment (n = 40) in an inpatient setting. The patients were examined on admission, at discharge, and at 6 and 12 months follow-ups with the Structured Clinical Interview for DSM III R (SKID), the Freiburg Personality Inventory (FPI R), and the Giessen Test (GIESS). Both treatment modalities significantly reduced panic and avoidance. Differences were found in personality scales. The support of autonomy was superior by client-centered treatment alone: client-centered treated (CCT) patients felt less dependent on the expectations of others, less under stress, and had fewer psychosomatic complaints. Patients with additional exposure treatment feel accepted by their social environment earlier. The results are discussed with regard to open questions of therapy integration and different mechanisms of change. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Teusch, L; Bohme, H; Finke, J; Beckmann, Bergin, Bohme, Fahrenberg, Fava, Fava, Finke, Finke, Grawe, Grawe, Grawe, Grawe, Hallam, Kachele, Krauthauser, Mathews, Meyer, Meyer, Plog, Roth, Sachse, Schumacher, Shear, Speierer, Stiles, Teusch, Teusch, Teusch, Teusch, Teusch, Victor, Wittchen",2001.0,,0,0,
3160,Fear activation and distraction during the emotional processing of claustrophobic fear.,"We tested several hypotheses derived from the emotional processing theory of fear reduction by manipulating claustrophobic participants' focus of attention during in vivo exposure. Sixty participants displaying marked claustrophobic fear were randomized to one of four exposure conditions. Each participant received a total of 30-min of self-guided exposure 2-weeks after pretreatment testing. One group attended to threatening words and images during exposure (TW) and was compared to a control group that attended to neutral words and images (NW). A third group performed a demanding cognitive load task--a modified Seashore Rhythm Test during exposure (SR) and was compared to an exposure only (EO) control group. Contrary to prediction, the threat word manipulation was not associated with lower levels of fear following treatment. Consistent with prediction, the distraction manipulation resulted in less fear reduction at post-treatment. Treatment process analyses revealed that the negative effects of distraction on treatment outcome manifested early as slower between-trial habituation. These results and their relevance to emotional processing theory are discussed.",Telch MJ.; Valentiner DP.; Ilai D.; Young PR.; Powers MB.; Smits JA.,2004.0,10.1016/j.jbtep.2004.03.004,0,0,
3161,[Conflict-centered individual therapy or integration of psychotherapy methods. Process of change in client-centered psychotherapy with and without behavioral exposure therapy in agoraphobia with panic disorder].,"The mechanisms of change due to different psychotherapeutic treatments of anxiety disorders are the subject of the present study. Sixty-eight patients with agoraphobia and panic (DSM III R No. 300.21, ICD 10 No. F 40.01) were included, exclusively treated with client-centered treatment (n = 28) or with additional behavioral exposure treatment (n = 40) in an inpatient setting. The patients were examined on admission, at discharge, and at 6 and 12 months follow-ups with the Structured Clinical Interview for DSM III R (SKID), the Freiburg Personality Inventory (FPI R), and the Giessen Test (GIESS). Both treatment modalities significantly reduced panic and avoidance. Differences were found in personality scales. The support of autonomy was superior by client-centered treatment alone: client-centered treated (CCT) patients felt less dependent on the expectations of others, less under stress, and had fewer psychosomatic complaints. Patients with additional exposure treatment feel accepted by their social environment earlier. The results are discussed with regard to open questions of therapy integration and different mechanisms of change.",Teusch L.; Böhme H.; Finke J.,2001.0,,0,0,
3162,Conflict-centered individual therapy or integration of psychotherapy methods. Process of change in client-centered psychotherapy with and without behavioral exposure therapy in agoraphobia with panic disorder,"ER The mechanisms of change due to different psychotherapeutic treatments of anxiety disorders are the subject of the present study. Sixty-eight patients with agoraphobia and panic (DSM III R No. 300.21, ICD 10 No. F 40.01) were included, exclusively treated with client-centered treatment (n = 28) or with additional behavioral exposure treatment (n = 40) in an inpatient setting. The patients were examined on admission, at discharge, and at 6 and 12 months follow-ups with the Structured Clinical Interview for DSM III R (SKID), the Freiburg Personality Inventory (FPI R), and the Giessen Test (GIESS). Both treatment modalities significantly reduced panic and avoidance. Differences were found in personality scales. The support of autonomy was superior by client-centered treatment alone: client-centered treated (CCT) patients felt less dependent on the expectations of others, less under stress, and had fewer psychosomatic complaints. Patients with additional exposure treatment feel accepted by their social environment earlier. The results are discussed with regard to open questions of therapy integration and different mechanisms of change.","Teusch, L; Böhme, H; Finke, J",2001.0,,0,0,3161
3163,Accuracy of freehand fluoroscopy-guided placement of C1 lateral mass and C2 isthmic screws in atlanto-axial instability.,"The C1 lateral mass and C2 isthmic stabilization, as introduced by Goel and Laheri and by Harms and Melcher, is a well-known fixation technique. We present the clinical and radiographic results with freehand fluoroscopy guided C1 lateral mass and C2 isthmic fixation in a consecutive series of 28 patients, evaluating the accuracy of screw placement. Twenty-eight consecutive patients suffering from post-traumatic and other C1-C2 instability were operated on between 2001 and 2010. Indications for surgery were: trauma (n‚Äâ=‚Äâ21 cases), os odontoideum (n‚Äâ=‚Äâ1), cranio-verterbal malformation (n‚Äâ=‚Äâ1), and arthritis (n‚Äâ=‚Äâ3) and idiopathic instability (n‚Äâ=‚Äâ2). C1 lateral mass and C2 isthmic screws were placed according to the usual anatomical landmarks with lateral fluoroscopy guidance. All patients underwent a postoperative CT scan. The extent of cortical lateral or medial breach was determined and classified as follows: no breach (grade A), 0-2 mm (grade B), 2-4 mm (grade C), 4-6 mm (grade D), more than 6 mm (grade E). Grade A and B screws were considered well positioned. A total of 56 C1 lateral mass and 55 C2 isthmic screws were placed. Accuracy of screw placement was as follows: 107 grade A (96.4%), four grade B (3.6%), and no grade C, D or E. Clinical and radiological follow-up showed improvement in symptoms (mainly pain) and stability of the implants at the end of the follow-up. Freehand fluoroscopy-guided insertion of C1 lateral mass and C2 isthmic screws can be safely and effectively performed.",Tessitore E.; Bartoli A.; Schaller K.; Payer M.,2011.0,10.1007/s00701-011-1039-9,0,0,
3164,Effects of eye movement desensitization and reprocessing (EMDR) on non-specific chronic back pain: a randomized controlled trial with additional exploration of the underlying mechanisms.,"Non-specific chronic back pain (CBP) is often accompanied by psychological trauma, but treatment for this associated condition is often insufficient.Nevertheless, despite the common co-occurrence of pain and psychological trauma, a specific trauma-focused approach for treating CBP has been neglected to date. Accordingly, eye movement desensitization and reprocessing (EMDR), originally developed as a treatment approach for posttraumatic stress disorders, is a promising approach for treating CBP in patients who have experienced psychological trauma.Thus, the aim of this study is to determine whether a standardized, short-term EMDR intervention added to treatment as usual (TAU) reduces pain intensity in CBP patients with psychological trauma vs. TAU alone. The study will recruit 40 non-specific CBP patients who have experienced psychological trauma. After a baseline assessment, the patients will be randomized to either an intervention group (n‚Äâ=‚Äâ20) or a control group (n‚Äâ=‚Äâ20). Individuals in the EMDR group will receive ten 90-minute sessions of EMDR fortnightly in addition to TAU. The control group will receive TAU alone. The post-treatment assessments will take place two weeks after the last EMDR session and six months later.The primary outcome will be the change in the intensity of CBP within the last four weeks (numeric rating scale 0-10) from the pre-treatment assessment to the post-treatment assessment two weeks after the completion of treatment.In addition, the patients will undergo a thorough assessment of the change in the experience of pain, disability, trauma-associated distress, mental co-morbidities, resilience, and quality of life to explore distinct treatment effects. To explore the mechanisms of action that are involved, changes in pain perception and pain processing (quantitative sensory testing, conditioned pain modulation) will also be assessed.The statistical analysis of the primary outcome will be performed on an intention-to-treat basis. The secondary outcomes will be analyzed in an explorative, descriptive manner. This study adapts the standard EMDR treatment for traumatized patients to patients with CBP who have experienced psychological trauma. This specific, mechanism-based approach might benefit patients. This trial has been registered with ClinicalTrials.gov (NCT01850875).",Tesarz J.; Gerhardt A.; Leisner S.; Janke S.; Hartmann M.; Seidler GH.; Eich W.,2013.0,10.1186/1471-2474-14-256,0,0,
3165,Does pain catastrophizing contribute to threat-evoked amplification of pain and spinal nociception?,"Unpredictable threat amplifies pain and spinal nociception (as measured by the nociceptive flexion reflex, NFR), but it is unknown whether pain catastrophizing mediates this threat-related amplification. To examine this, the present study experimentally reduced catastrophizing and examined the effect on threat-evoked pain/NFR facilitation. Healthy pain-free participants (N 113) were randomly assigned to a brief 30-minute intervention designed to reduce catastrophic thoughts or a control intervention that involved education about pain neurobiology. Before the interventions, participants underwent a block of 8 pseudorandomly ordered periods of safe (no abdominal shock) and threat (abdominal shock possible) during which pain and NFR were evoked by electric stimulations to the ankle. After the safe/threat periods, participants rated pain intensity, pain unpleasantness, and situation-specific pain catastrophizing. The same test block was delivered after the intervention to examine changes in catastrophizing and threat-evoked pain/NFR facilitation. As expected, pain catastrophizing was reduced by the catastrophizing reduction intervention, relative to the control group. Furthermore, pain intensity, unpleasantness, and NFR magnitudes were higher during threat periods than safe. However, this threat-related pain/NFR amplification was not attenuated by the catastrophizing reduction intervention at the group level, although the intervention generally led to lower pain ratings (but not reduced NFR), regardless of the context. Nonetheless, bootstrapped mediation analyses found that reductions in catastrophizing mediated reductions in threat-related amplification of pain, but not NFR. This suggests that catastrophizing is partly responsible for threat-evoked pain amplification and provides further evidence that catastrophizing does not amplify pain at the spinal level.",Terry E.L.; Thompson K.A.; Rhudy J.L.,2016.0,10.1097/j.pain.0000000000000392,0,0,
3166,The role of social anxiety in a brief alcohol intervention for heavy-drinking college students.,"The Brief Alcohol Screening and Intervention for College Students (BASICS) reduces alcohol use and alcohol-related problems among undergraduates, yet variability in outcomes exists. Identifying individual difference variables related to outcomes could inform efforts to improve treatment protocols. The current study evaluated the role of social anxiety during BASICS. High socially anxious (HSA; n = 26) and low socially anxious (LSA; n = 44) heavy-drinking undergraduates were randomly assigned to BASICS (n = 38) or an assessment-only control (n = 32). HSA patients reported higher baseline alcohol consumption (typical drinks, weekly quantity, and frequency). BASICS significantly decreased weekly alcohol consumption and alcohol-related problems relative to the control group. Social anxiety moderated outcomes such that in the BASICS condition; HSA patients reported heavier typical drinks at posttest, even after controlling for referral status, baseline typical drinks, and trait anxiety. This was not the case in the control group. HSA patients may benefit from social anxiety-specific interventions during BASICS. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Terlecki, Meredith A; Buckner, Julia D; Larimer, Mary E; Copeland, Amy L; Abelson, Babor, Baer, Baer, Barnett, Borsari, Borsari, Brown, Bruch, Buckner, Buckner, Buckner, Clements, Cohen, Cohen, Collins, Darkes, Dimeff, Eggleston, Fromme, Gilles, Ginzler, Goldman, Goldman, Grant, Gwaltney, Ham, Heimberg, Hingston, Holmbeck, Jackson, Johnston, Kessler, Kessler, Kessler, Kidorf, Knight, Kokotailo, Larimer, Larimer, Larimer, Lewis, Lewis, Marlatt, Marlatt, Mattick, Merline, Miller, Miller, Murphy, Murphy, Neal, Neighbors, O'Hare, Perkins, Saunders, Schneier, Spielberger, Terlecki, Thomas, Thomas, Tran, Tran, Wechsler, Weeks, White, White",2011.0,,0,0,
3167,Sleep characteristics of menopausal insomnia: A polysomnographic study,"Although menopausal insomnia is of clinical significance, the essential features of this form of disrupted sleep are poorly understood. The aim of the present study was to identify the sleep characteristics of menopausal insomnia by using overnight polysomnography (PSG). Twenty-one subjects with menopausal insomnia (MI) and 13 sex- and age-matched normal control (NC) subjects without sleep complaints took part in the present study. All MI and NC subjects underwent PSG on two consecutive nights. In comparison with NC, MI subjects had non-specific findings such as significantly shorter total sleep time, longer sleep latency, higher wake time after sleep onset, and lower sleep efficiency. As for rapid eye movement (REM) sleep variables, MI subjects had significantly shorter total REM sleep time, fewer numbers of REM sleep periods, longer REM latency, and higher REM density than did the NC subjects. As for the time course of REM density, REM density during the first 3 h period of nocturnal sleep was significantly higher for MI than for NC subjects. Unlike NC subjects, REM density for MI subjects did not tend to rise progressively during nocturnal sleep. The MI subjects had objective evidence of disrupted sleep and the most striking characteristics of this dysfunction were observed in REM sleep variables. The sleep characteristics of MI subjects were found to differ in REM sleep variables from those of patients with major depression (except for REM density). Menopausal insomnia patients appear to be similar to patients with generalized anxiety disorder accompanied by severe sleep disruption. These data lend support to the clinical distinction between menopausal insomnia and insomnia associated with major psychiatric disorders.",Terashima K.; Mikami A.; Tachibana N.; Kumano-Go T.; Teshima Y.; Sugita Y.; Takeda M.,2004.0,10.1111/j.1440-1819.2003.01214.x,0,0,
3168,Behavior therapy augments response of patients with obsessive-compulsive disorder responding to drug treatment.,"In many patients with obsessive-compulsive disorder (OCD), residual symptoms persist despite a clinically meaningful response. The objective of this study was to examine whether addition of behavior therapy would augment treatment outcome in these patients. Ninety-six patients with DSM-IV OCD who had responded to 3 months of drug treatment were randomly assigned to either receive addition of behavior therapy or continue on drug treatment alone for 6 months. Patients who continued on drug treatment alone eventually received addition of behavior therapy for 6 months. Data were gathered from October 1998 to June 2002. OCD patients who received addition of behavior therapy showed a greater improvement in obsessive-compulsive symptoms (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score change = -3.9 in the completers sample) than those who continued on drug treatment alone (Y-BOCS score change = +3.9 for completers). Significantly more patients who received addition of behavior therapy were in remission compared with those who continued on drug treatment alone (p < .0001 for completers). Patients who received behavior therapy after 6 months of drug treatment alone showed a nonsignificant decline in obsessive-compulsive symptoms (Y-BOCS score change = -2.7 for completers); however, the remission rate found in this group was comparable to the remission rate found in the group of patients receiving addition of behavior therapy directly after responding to drug treatment. The results indicate that addition of behavior therapy is beneficial for patients who have responded to drug treatment. The data also suggest that the effect is greater when behavior therapy is added immediately after attainment of the drug response.",Tenneij NH.; van Megen HJ.; Denys DA.; Westenberg HG.,2005.0,,0,0,
3169,Changes of the essential fatty acids in plasmalipid fractions of polytraumatized patients with different parenteral nutrition (author's transl),"ER In two groups of polytraumatized patients we investigated changes in the fatty acid pattern of plasma-lipids during the phase of total parenteral nutrition. For parenteral nutrition we gave L-amino acid solutions in a dose of 0.24 g N/kg body weight/day. In addition, we administered in the first group glucose and fructose and in the second group glucose, fructose and fat emulsions in a total dose of 30 kcal/kg body weight/day. In the latter group, the proportion of the fat emulsions was 30-40% of the administered calories. We compared the achieved results with the values of a group of control persons. The most essential findings of these studies were the striking decrease of the essential fatty acids with regard to the phospholipid fraction in the early post-traumatic phase. In the first group we observed a further reduction of essential fatty acids during the period of observation. This could be avoided by administering fat emulsions of the same type as we gave in the case of the second group of patients. The functions of essential fatty acids in membranes and in intermediary metabolism are discussed.","Tempel, G; Lohninger, A; Jelen, S; Riedl, W; Blümel, G",1978.0,,0,0,
3170,"A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures","ER METHODSTo study further the effectiveness of phenytoin (Dilantin) in preventing post-traumatic seizures, we randomly assigned 404 eligible patients with serious head trauma to treatment with phenytoin (n = 208) or placebo (n = 196) for one year in a double-blind fashion. An intravenous loading dose was given within 24 hours of injury. Serum levels of phenytoin were maintained in the high therapeutic range (3 to 6 mumol of free phenytoin per liter). Follow-up was continued for two years. The primary data analysis was performed according to the intention to treat.RESULTSBetween drug loading and day 7, 3.6 percent of the patients assigned to phenytoin had seizures, as compared with 14.2 percent of patients assigned to placebo (P less than 0.001; risk ratio, 0.27; 95 percent confidence interval, 0.12 to 0.62). Between day 8 and the end of year 1, 21.5 percent of the phenytoin group and 15.7 percent of the placebo group had seizures; at the end of year 2, the rates were 27.5 percent and 21.1 percent, respectively (P greater than 0.2 for each comparison; risk ratio, 1.20; 95 percent confidence interval, 0.71 to 2.02). This lack of a late effect could not be attributed to differential mortality, low phenytoin levels, or treatment of some early seizures in patients assigned to the placebo group.CONCLUSIONSPhenytoin exerts a beneficial effect by reducing seizures only during the first week after severe head injury.BACKGROUNDAntiepileptic drugs are commonly used to prevent seizures that may follow head trauma. However, previous controlled studies of this practice have been inconclusive.","Temkin, N R; Dikmen, S S; Wilensky, A J; Keihm, J; Chabal, S; Winn, H R",1990.0,10.1056/NEJM199008233230801,0,0,
3171,Effectiveness of a blended web-based intervention on return to work for sick-listed employees with common mental disorders: results of a cluster randomized controlled trial.,"Common mental disorders are strongly associated with long-term sickness absence, which has negative consequences for the individual employee's quality of life and leads to substantial costs for society. It is important to focus on return to work (RTW) during treatment of sick-listed employees with common mental disorders. Factors such as self-efficacy and the intention to resume work despite having symptoms are important in the RTW process. We developed ""E-health module embedded in Collaborative Occupational health care"" (ECO) as a blended Web-based intervention with 2 parts: an eHealth module (Return@Work) for the employee aimed at changing cognitions of the employee regarding RTW and a decision aid via email supporting the occupational physician with advice regarding treatment and referral options based on monitoring the employee's progress during treatment. This study evaluated the effect of a blended eHealth intervention (ECO) versus care as usual on time to RTW of sick-listed employees with common mental disorders. The study was a 2-armed cluster randomized controlled trial. Employees sick-listed between 4 and 26 weeks with common mental disorder symptoms were recruited by their occupational health service or employer. The employees were followed up to 12 months. The primary outcome measures were time to first RTW (partial or full) and time to full RTW. Secondary outcomes were response and remission of the common mental disorder symptoms (self-assessed). A total of 220 employees were included: 131 participants were randomized to the ECO intervention and 89 to care as usual (CAU). The duration until first RTW differed significantly between the groups. The median duration was 77.0 (IQR 29.0-152.3) days in the CAU group and 50.0 (IQR 20.8-99.0) days in the ECO group (hazard ratio [HR] 1.390, 95% CI 1.034-1.870, P=.03). No significant difference was found for duration until full RTW. Treatment response of common mental disorder symptoms did not differ significantly between the groups, but at 9 months after baseline significantly more participants in the ECO group achieved remission than in the CAU group (OR 2.228, 95% CI 1.115-4.453, P=.02). The results of this study showed that in a group of sick-listed employees with common mental disorders, applying the blended eHealth ECO intervention led to faster first RTW and more remission of common mental disorder symptoms than CAU. Netherlands Trial Register NTR2108; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2108. (Archived by WebCite at http://www.webcitation.org/6YBSnNx3P).",Volker D.; Zijlstra-Vlasveld MC.; Anema JR.; Beekman AT.; Brouwers EP.; Emons WH.; van Lomwel AG.; van der Feltz-Cornelis CM.,2015.0,10.2196/jmir.4097,0,0,
3172,Tenants with additional needs: when housing first does not solve homelessness.,"At Home/Chez-Soi was a 24 month randomized controlled trial of Housing First (HF) conducted in five Canadian cities. This article attempts to identify the characteristics of participants who experienced housing instability one year after entering HF. Those defined as experiencing housing instability were housed <50% of the last 9 months of the first year, excluding time in institutions, unless they were housed 100% of the past 3 months. Only 13.5% of HF participants (n‚Äâ=‚Äâ157/1162) met criteria for housing instability. Several variables were significant predictors of instability in between-group comparisons and multiple regression analyses: residence in Winnipeg, cumulative lifetime homelessness, percent of previous 3 months spent in jail, and community psychological integration; while residence in Moncton and a diagnosis of PTSD or panic disorder predicted stability. The predictive models were weak, identifying correctly only 3.8% of individuals that failed to achieve housing stability. It is not possible to predict confidently at baseline who will experience early housing instability in HF. There are certain individual characteristics that might be considered risk factors. Providing HF to all individuals who qualify for a HF program remains the most valid way to administer admission to housing.",Volk JS.; Aubry T.; Goering P.; Adair CE.; Distasio J.; Jette J.; Nolin D.; Stergiopoulos V.; Streiner DL.; Tsemberis S.,2016.0,10.3109/09638237.2015.1101416,0,0,
3173,"Clinically assessed posttraumatic stress in patients with breast cancer during the first year after diagnosis in the prospective, longitudinal, controlled COGNICARES study.","Objective: There is ongoing debate whether cancer qualifies as traumatic stressor. We investigated prevalence and course of posttraumatic stress in patients with early breast cancer (BC) during their first year after diagnosis and determined effects of mastectomy and chemotherapy. Methods: Patients with stage 0-III BC aged <= 65 years were evaluated with the Structured Clinical Interview for DSM-IV modules for acute and posttraumatic stress disorder (ASD and PTSD, respectively) before treatment, after chemotherapy, and 1 year after diagnosis. Matched controls were assessed at matched intervals. Effects of time, mastectomy, and chemotherapy on BC-related PTSD symptom severity were tested with linear mixed model analysis. Results: Stress disorder (ASD or PTSD) related to BC was diagnosed in 6 (3.6%) of 166 patients before treatment and in 3 patients (2.0%) 1 year later. The rate of patients who experienced PTSD symptoms related to BC decreased from 82.5 to 57.3% (p < 0.001), and the mean of BC-related PTSD symptoms diminished from 3.1 to 1.7 (p < 0.001). Only university education significantly predicted the course of BC-related PTSD symptom severity (p = 0.009). In 60 controls, no diagnosis of stress disorder, a rate of 18% women experiencing PTSD symptoms, and a mean of 0.4 PTSD symptoms (p vs. patients < 0.001) were found. Conclusions: Most newly diagnosed patients with BC experience PTSD symptoms, whereas full diagnoses of DSM-IV stress disorder are rare. Symptoms diminish somewhat within 1 year furthered by university education but independently from mastectomy and chemotherapy. Throughout the year after diagnosis, having BC entails markedly increased PTSD symptom burden. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Voigt, Varinka; Neufeld, Franziska; Kaste, Judith; Buhner, Markus; Sckopke, Philipp; Wuerstlein, Rachel; Hellerhoff, Karin; Sztrokay-Gaul, Aniko; Braun, Michael; von Koch, Franz Edler; Silva-Zurcher, Eliane; Hasmuller, Stephan; Bauerfeind, Ingo; Debus, Gerlinde; Herschbach, Peter; Mahner, Sven; Harbeck, Nadia; Hermelink, Kerstin; Abbey, Alonso, Alter, Amir, Andrykowski, Andrykowski, Cordova, Desaive, Green, Green, Greimel, Gurevich, Hahn, Hermelink, Koopman, Kornblith, Koutrouli, Kwakkenbos, Mehnert, Mundy, O'Connor, Palmer, Perez, Shelby, Smith, Vin-Raviv, Wittchen",2017.0,,0,0,
3174,"The quality of life enjoyment and satisfaction questionnaire (Q-LES-Q), Latvian language version: Study, validation, and quality of life measurement in posttraumatic stress disorder risk patients","There are various reasons to study quality of life (QoL) in medical practice: for an estimation of the efficiency of methods of modern clinical medicine and various rehabilitation technologies or for an estimation of a degree of severity of a disease, efficiency of treatment. Assessment of disease-specific QoL in clinical trials appears to be a widely accepted independent outcome measurement. Considering the interest of health economics, there is a demand for valid methods for measuring health-related quality of life (HRQoL) in Posttraumatic Stress Disorder (PTSD). Among the various instruments available, a short version of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) by Jean End- icott has been tested extensively. This instrument was chosen since it is mental illness-related. The purpose of the present study was to assess the evaluative and discriminative properties of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) by Jean Endicott when measuring disease-specific symptoms of patients with functional impairment associated with posttraumatic stress disorder (PTSD). Methods: In total, 143 participants (males, Europeans, of average age 27.4, PTSD risk patients - Contingent of international operations) were examined. Baseline QoL was estimated by Q-LES-Q, which measures QoL in key domains. The short form includes 14 general activities of the long form, as well as 2 global items. Five-point item scores are aggregated, with higher scores indicative of greater enjoymentor satisfaction in each domain. Scores are also presented as a percentage of the maximum probable score. Q-LES-Q Latvian language version's reliability, as well as correlation between clinical symptoms and Q-LES-Q scores (construct validity), test-pretest, Cronbach alpha criterion were assessed. Results: At baseline, QoL was significantly impaired as reflected by a mean Q-LES-Q score of 67% of the total possible score. The baseline Q-LES-Q score showed a Cronbach's a value of 0.83, indicative of reliability (the questions are of high consequence level). The reliability-consequence data is below the critical level (0.90-0.95), suggesting that Q-LES-Q items reflect and evaluate very narrow, specific manifestations of the disease. The most sensitive QoL domains are: physical health and mood, followed by: family relationships, ability to function in daily life, and psychological/spiritual (healthcare, personal faith, and life goals). Q-LES-Q has good reproducibility and also high interclass correlation coefficients for the total and domain- wise scores in PTSD-risk patients. Conclusions: The Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) is a self-report measure. The summary scores were found to be reliable and valid measures in a group of PTSD-risk patients. Q-LES-Q is sensitive to important differences among the patients that are not detected by the measures usually employed. It was concluded that the Q-LES-Q has strong measurement properties for measuring stress-specific quality of life. It is a valid instrument for QoL measurements both in clinical and research studies.",Voicehovskis V.V.; Ancane G.; Voicehovska J.; Skesters A.,2010.0,10.1016/j.ijpsycho.2010.06.128,0,0,
3175,[Treatment of sleep disorders].,,Vlasov NA.,1977.0,,0,0,
3176,Can pain-related fear be reduced? The application of cognitive-behavioural exposure in vivo.,"Although cognitive-behavioural treatments of patients with chronic pain generally are reported to be effective, customization might increase their effectiveness. One possible way to customize treatment is to focus the intervention on the supposed mechanism underlying the transition from acute to chronic pain disability. Evidence is accumulating in support of the conjecture that pain-related fear and associated avoidance behaviours are crucial in the development and maintenance of chronic pain disability. It seems timely to apply this knowledge to the cognitive-behavioural management of chronic pain. Two studies are presented here. Study 1 concerns a secondary analysis of data gathered in a clinical trial that was aimed at the examination of the supplementary value of coping skills training when added to an operant-behavioural treatment in patients with chronic back pain. The results show that, compared with a waiting list control, an operant-behavioural treatment with or without pain-coping skills training produced very modest and clinically negligible decreases in pain-related fear. Study 2 presents the effects of more systematic exposure in vivo treatment with behavioural experiments in two single patients reporting substantial pain-related fear. Randomization tests for AB designs revealed dramatic changes in pain-related fear and pain catastrophizing. In both cases, pain intensity also decreased significantly, but at a slower pace. Differences before and after treatment revealed clinically significant improvements in pain vigilance and pain disability.",Vlaeyen JW.; De Jong JR.; Onghena P.; Kerckhoffs-Hanssen M.; Kole-Snijders AM.,2002.0,,0,0,
3177,Graded exposure in vivo in the treatment of pain-related fear: a replicated single-case experimental design in four patients with chronic low back pain,"ER The aim of this investigation was to examine the effectiveness of a graded exposure in vivo treatment with behavioural experiments as compared to usual graded activity in reducing pain-related fears, catastrophising and pain disability in chronic low back pain patients reporting substantial fear of movement/(re)injury. Included in the study were four consecutive CLBP patients who were referred for outpatient behavioural rehabilitation, and who reported substantial fear of movement/(re)injury (Tampa Scale for Kinesiophobia score>40). A replicated single-case cross-over design was used. After a no-treatment baseline measurement period, the patients were randomly assigned to one of two interventions. In intervention A, patients received the exposure first, followed by graded activity. In intervention B, the sequence of treatment modules was reversed. Sixty-three daily measures of pain-related cognitions and fears were recorded with visual analogue scales. Before and after the treatment, the following measures were taken: pain-related fear, pain catastrophising, pain control and pain disability. Using time series analysis on the daily measures of pain-related cognitions and fears, we found that improvements only occurred during the graded exposure in vivo, and not during the graded activity, irrespective of the treatment order. Analysis of the pre-post treatment differences also revealed that decreases in pain-related fear concurred with decreases in pain catastrophising and pain disability, and in half of the cases an increase in pain control. This study shows that the external validity of exposure in vivo also extends to the subgroup of chronic low back pain patients who report substantial fear of movement/(re)injury.","Vlaeyen, J W; Jong, J; Geilen, M; Heuts, P H; Breukelen, G",2001.0,,0,0,
3178,Nocebo hyperalgesia induced by social observational learning,"ER Nocebo effects can be acquired by verbal suggestion, but it is unknown whether they can be induced through observational learning and whether they are influenced by factors known to influence pain perception, such as pain anxiety or pain catastrophizing. Eighty-five female students (aged 22.5 ± 4.4 years) were randomly assigned to one of three conditions. Participants in the control condition (CC) received information that an ointment had no effect on pain perception. Participants in the verbal suggestion condition (VSC) received information that it increased pain sensitivity. Participants in the social observational learning condition (OLC) watched a video in which a model displayed more pain when ointment was applied. Subsequently, all participants received three pressure pain stimuli (60 seconds) on each hand. On one hand, the ointment was applied prior to the stimulation. Numerical pain ratings were collected at 20-second intervals during pain stimulation. The participants filled in questionnaires regarding pain-related attitudes (Pain Anxiety Symptoms Scale, Pain Catastrophizing Scale, and Somatosensory Amplification Scale). Participants in the OLC showed higher pain ratings with than without ointment. Pain ratings within the CC and the VSC were at the same level with and without ointment. In the VSC, the pain ratings were higher than in the CC with and without ointment. The nocebo response correlated with pain catastrophizing but not with pain anxiety or somatosensory amplification. A nocebo response to pressure pain was induced by observational learning but not by verbal suggestion. This finding highlights the importance of investigating the influence of observational learning on nocebo hyperalgesia.","Vögtle, E; Barke, A; Kröner-Herwig, B",2013.0,10.1016/j.pain.2013.04.041,0,0,
3179,Prone positioning improves oxygenation in post-traumatic lung injury--a prospective randomized trial.,"In a prospective randomized trial the effect of prone positioning on the duration of mechanical ventilation was evaluated in multiple trauma patients and was compared with patients ventilated in supine position. Multiple trauma patients of the intensive care units of two university hospitals were considered eligible if they met the criteria for acute lung injury or the acute respiratory distress syndrome. Patients in the prone group (N = 21) were kept prone for at least eight hours and a maximum of 23 hours per day. Prone positioning was continued until a PaO2:FiO2 ratio of more than 300 was present in prone as well as supine position over a period of 48 hours. Patients in the supine group (N = 19) were positioned according to standard care guidelines. The duration of ventilatory support did not differ significantly (30 +/- 17 days in the prone group and 33 +/- 23 days in the supine group). Worst case analysis (death and deterioration of gas exchange) displayed ventilatory support for 41 +/- 29 days in the prone group and 61 +/- 35 days in the supine group (p = 0.06). The PaO2:FiO2 ratio increased significantly more in the prone group in the first four days (p = 0.03). The prevalence of Acute Respiratory Distress Syndrome (ARDS) following acute lung injury (p = 0.03) and the prevalence of pneumonia (p = 0.048) were reduced also. One patient in the prone and three patients in the supine group died due to multi organ failure (p = 0.27). Intermittent prone positioning was not able to reduce the duration of mechanical ventilation in this limited number of patients. However the oxygenation improved significantly over the first four days of treatment, and the prevalence of ARDS and pneumonia were reduced.",Voggenreiter G.; Aufmkolk M.; Stiletto RJ.; Baacke MG.; Waydhas C.; Ose C.; Bock E.; Gotzen L.; Obertacke U.; Nast-Kolb D.,2005.0,,0,0,
3180,Psychophysiologic effects of applied tension on the emotional fainting response to blood and injury.,"The present study was designed to investigate the psychophysiologic effects of ""Applied Tension"" (AT) on the emotional fainting response to blood and injury in a controlled experiment. Twenty-two persons reporting to generally feel faint or to have fainted at the sight of blood or injury and 22 participants classified as Non-Fainters were randomly allocated to a treatment or control condition. Psychophysiologic responses were continuously monitored while individuals watched a video depicting open-heart surgery and a control film. Prior to the surgery film, participants in the treatment condition were instructed in the use of AT. All participants classified as Fainters showed a diphasic response pattern while watching the surgery film. This response, however, was significantly attenuated in Fainters in the treatment condition. These results suggest that AT provides an effective treatment strategy for the prevention of fainting responses in persons with a fear of blood and injury.",Vögele C.; Coles J.; Wardle J.; Steptoe A.,2003.0,,0,0,
3181,"Treatment motivation, treatment expectancy, and helping alliance as predictors of outcome in cognitive behavioral treatment of OCD.","Predictors of improvement in obsessive-compulsive symptoms (Y-BOCS) in a randomized clinical trial with adult obsessive-compulsive disorder outpatients were examined. Results of multiple regression analyses revealed that a positive helping alliance was significantly predictive of posttreatment Y-BOCS. Treatment expectancy and high motivation to change were not significantly related to posttreatment outcome. None of the predictors were significantly related to Y-BOCS levels at 12-month follow-up, but positive alliance showed a trend to significance.",Vogel PA.; Hansen B.; Stiles TC.; Götestam KG.,2006.0,10.1016/j.jbtep.2005.12.001,0,0,
3182,[Group techniques and relaxation in the treatment of several subtypes of anxiety: a non-randomized controlled trial].,"To evaluate the impact of group relaxation on women suffering distress and general anxiety disorders. A non-randomised study with a control. A sample of 32 women between 25 and 55 in each group (intervention and control) was used. They belonged to the El Naranjo Health District and fitted the diagnostic criteria. The intervention group underwent a course of group techniques and relaxation. Anxiety was evaluated using the STAI state-characteristic test, before and after intervention, for both groups. A qualitative evaluation using discussion groups was also made. At the start of the study, the two groups were homogeneous regarding all the variables. The anxiety-state mean in the post-test for the study group was 22.96 +/- 13.3; and for the control group, 33.3 +/- 13.17, a statistically significant difference (p = 0.004). The post-test mean of the anxiety characteristic for the study group was 28.62 +/- 12.28; against 35.26 +/- 9.84 for the control group, which was also statistically significant (p = 0.02). This type of intervention is effective in reducing temporary anxiety and improves, to a small extent, an inbuilt tendency to react with anxiety. These groups provide a qualitative improvement in self-esteem and in the women's network of relationships.",Tello Bernabé ME.; Téllez Arévalo A.; Ruiz Serrano A.; de Frutos Martín MA.; Elcano Alfaro R.,1997.0,,0,0,
3183,Effectiveness of a clinical practice guideline implementation strategy for patients with anxiety disorders in primary care: cluster randomized trial.,"Anxiety is a common mental health problem seen in primary care. However, its management in clinical practice varies greatly. Clinical practice guidelines (CPGs) have the potential to reduce variations and improve the care received by patients by promoting interventions of proven benefit. However, uptake and adherence to their recommendations can be low. This study involves a community based on cluster randomized trial in primary healthcare centres in the Madrid Region (Spain). The project aims to determine whether the use of implementation strategy (including training session, information, opinion leader, reminders, audit, and feed-back) of CPG for patients with anxiety disorders in primary care is more effective than usual diffusion. The number of patients required is 296 (148 in each arm), all older than 18 years and diagnosed with generalized anxiety disorder, panic disorder, and panic attacks by the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). They are chosen by consecutive sampling. The main outcome variable is the change in two or more points into Goldberg anxiety scale at six and twelve months. Secondary outcome variables include quality of life (EuroQol 5D), and degree of compliance with the CPG recommendations on treatment, information, and referrals to mental health services. Main effectiveness will be analyzed by comparing the patients percentage improvement on the Goldberg scale between the intervention group and the control group. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. There is a need to identify effective implementation strategies for CPG for the management of anxiety disorders present in primary care. Ensuring the appropriate uptake of guideline recommendations can reduce clinical variation and improve the care patients receive. ISRCTN: ISRCTN83365316.",Tello-Bernabé E.; Sanz-Cuesta T.; del Cura-González I.; de Santiago-Hernando ML.; Jurado-Sueiro M.; Fernández-Girón M.; García-de Blas F.; Pensado-Freire H.; Góngora-Maldonado F.; de la Puente-Chamorro MJ.; Rodríguez-Pasamontes C.; Martín-Iglesias S.,2011.0,10.1186/1748-5908-6-123,0,0,
3184,Neuroscience education in addition to trigger point dry needling for the management of patients with mechanical chronic low back pain: A preliminary clinical trial.,"The objective of the current study was to determine the short-term effects of trigger point dry needling (TrP-DN) alone or combined with neuroscience education on pain, disability, kinesiophobia and widespread pressure sensitivity in patients with mechanical low back pain (LBP). Twelve patients with LBP were randomly assigned to receive either TrP-DN (TrP-DN) or TrP-DN plus neuroscience education (TrP-DN + EDU). Pain intensity (Numerical Pain Rating Scale, 0-10), disability (Roland-Morris Disability Questionnaire-RMQ-, Oswestry Low Back Pain Disability Index-ODI), kinesiophobia (Tampa Scale of Kinesiophobia-TSK), and pressure pain thresholds (PPT) over the C5-C6 zygapophyseal joint, transverse process of L3 vertebra, second metacarpal, and tibialis anterior muscle were collected at baseline and 1-week after the intervention. Patients treated with TrP-DN + EDU experienced a significantly greater reduction of kinesiophobia (P = 0.008) and greater increases in PPT over the transverse process of L3 (P = 0.049) than those patients treated only with TrP-DN. Both groups experienced similar decreases in pain, ODI and RMQ, and similar increases in PPT over the C5/C6 joint, second metacarpal, and tibialis anterior after the intervention (all, P > 0.05). The results suggest that TrP-DN was effective for improving pain, disability, kinesiophobia and widespread pressure sensitivity in patients with mechanical LBP at short-term. The inclusion of a neuroscience educational program resulted in a greater improvement in kinesiophobia.",Téllez-García M.; de-la-Llave-Rincón AI.; Salom-Moreno J.; Palacios-Ceña M.; Ortega-Santiago R.; Fernández-de-Las-Peñas C.,2015.0,10.1016/j.jbmt.2014.11.012,0,0,
3185,Post traumatic stress symptoms and heart rate variability in Bihar flood survivors following yoga: a randomized controlled study.,"An earlier study showed that a week of yoga practice was useful in stress management after a natural calamity. Due to heavy rain and a rift on the banks of the Kosi river, in the state of Bihar in north India, there were floods with loss of life and property. A week of yoga practice was given to the survivors a month after the event and the effect was assessed. Twenty-two volunteers (group average age +/- S.D, 31.5 +/- 7.5 years; all of them were males) were randomly assigned to two groups, yoga and a non-yoga wait-list control group. The yoga group practiced yoga for an hour daily while the control group continued with their routine activities. Both groups' heart rate variability, breath rate, and four symptoms of emotional distress using visual analog scales, were assessed on the first and eighth day of the program. There was a significant decrease in sadness in the yoga group (p < 0.05, paired t-test, post data compared to pre) and an increase in anxiety in the control group (p < 0.05, paired t-test, post data compared to pre). A week of yoga can reduce feelings of sadness and possibly prevent an increase in anxiety in flood survivors a month after the calamity. Clinical Trials Registry of India: CTRI/2009/091/000285.",Telles S.; Singh N.; Joshi M.; Balkrishna A.,2010.0,10.1186/1471-244X-10-18,0,0,
3186,Impact of cognitive-behavioral treatment on quality of life in panic disorder patients.,"Panic disorder (PD) is associated with significant social and health consequences. The present study examined the impact of treatment on PD patients' quality of life. Patients (N = 156) meeting DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders [3rd ed., rev.]; American Psychiatric Association, 1987) criteria for PD with agoraphobia were randomly assigned to group cognitive-behavioral treatment (CBT) or a delayed-treatment control. An assessment battery measuring the major clinical features of PD as well as quality of life was administered at baseline (Week 0), post-treatment (Week 9) and 6-month follow-up (Week 35). Consistent with previous studies, PD patients displayed significant impairment in quality of life at intake. Compared with delayed-treatment control participants, CBT-treated participants showed significant reductions in impairment that were maintained at follow-up. Consistent with prediction, anxiety and phobic avoidance were significantly associated with quality of life, whereas frequency of panic attacks was not.",Telch MJ.; Schmidt NB.; Jaimez TL.; Jacquin KM.; Harrington PJ.,1995.0,,0,0,
3187,Combined pharmacological and behavioral treatment for agoraphobia.,,Telch MJ.; Agras WS.; Taylor CB.; Roth WT.; Gallen CC.,1985.0,,0,0,
3188,"Unexpected arousal, anxiety sensitivity, and their interaction on CO?-induced panic: further evidence for the context-sensitivity vulnerability model","ER The present experiment tested several predictions derived from the context-sensitivity vulnerability model of panic. Participants (N=79) scoring either high or low in anxiety sensitivity (AS) and with no history of unexpected panic were randomly assigned to one of two instructional sets: expected arousal (EA) or expected relaxation (ER). All participants were administered inhalation of room air and 35% CO(2) in a counterbalanced order. Consistent with theoretical predictions, High-AS participants who received ER instructions showed greater emotional responding compared to High-AS participants who received EA instructions, while instructional set did not affect responding among Low-AS participants. Panic attacks were observed in 52% of the High-AS-ER group compared to 17%, 5%, and 5% in the High-AS-EA, Low-AS-ER, and Low-AS-EA groups respectively. These findings are consistent with the theory's assertion that dispositional tendencies, such as anxiety sensitivity potentiate the panicogenic effects of threat-relevant context variables.","Telch, M J; Harrington, P J; Smits, J A; Powers, M B",2011.0,10.1016/j.janxdis.2011.02.005,0,0,
3189,Suppression of experimental pain by auriculopressure,"In a controlled trial at a University Clinic of Physical Therapy and Rehabilitation, healthy student volunteers were given auriculopressure to investigate its analgesic effect. There were two study groups, each containing 30 volunteers. The first group was given auriculopressure to the toe somatic point on the ear, with pressure sensitivity being measured on the skin of the toe with an algometer device before and after ear stimulation. The control group had the same measurements with placebo stimulation to the ear. In the auriculopressure group the increase in pain threshold was statistically significant. In the placebo control group there was no significant change. These results suggest that auriculopressure could be a useful method for suppression of post-traumatic somatic pain.",Tekeoglu I.; Adak B.; Ercan M.,1996.0,,0,0,
3190,"Clinical, hemispheric, and autonomic changes associated with use of closed-loop, allostatic neurotechnology by a case series of individuals with self-reported symptoms of post-traumatic stress.","Background: The objective of this pilot study was to explore the use of a closed-loop, allostatic, acoustic stimulation neurotechnology for individuals with self-reported symptoms of post-traumatic stress, as a potential means to impact symptomatology, temporal lobe high frequency asymmetry, heart rate variability (HRV), and baroreflex sensitivity (BRS). Methods: From a cohort of individuals participating in a naturalistic study to evaluate use of allostatic neurotechnology for diverse clinical conditions, a subset was identified who reported high scores on the Posttraumatic Stress Disorder Checklist (PCL). The intervention entailed a series of sessions wherein brain electrical activity was monitored noninvasively at high spectral resolutions, with software algorithms translating selected brain frequencies into acoustic stimuli (audible tones) that were delivered back to the user in real time, to support auto-calibration of neural oscillations. Participants completed symptom inventories before and after the intervention, and a subset underwent short-term blood pressure recordings for HRV and BRS. Changes in temporal lobe high frequency asymmetry were analyzed from baseline assessment through the first four sessions, and for the last four sessions. Results: Nineteen individuals (mean age 47, 11 women) were enrolled, and the majority also reported symptom scores that exceeded inventory thresholds for depression. They undertook a median of 16 sessions over 16.5 days, and 18 completed the number of sessions recommended. After the intervention, 89% of the completers reported clinically significant decreases in post-traumatic stress symptoms, indicated by a change of at least 10 points on the PCL. At a group level, individuals with either rightward (n = 7) or leftward (n = 7) dominant baseline asymmetry in temporal lobe high frequency (23-36 Hz) activity demonstrated statistically significant reductions in their asymmetry scores over the course of their first four sessions. For 12 individuals who underwent short-term blood pressure recordings, there were statistically significant increases in HRV in the time domain and BRS (Sequence Up). There were no adverse events. Conclusion: Closed-loop, allostatic neurotechnology for auto-calibration of neural oscillations appears promising as an innovative therapeutic strategy for individuals with symptoms of post-traumatic stress. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Tegeler, Charles H; Cook, Jared F; Tegeler, Catherine L; Hirsch, Joshua R; Shaltout, Hossam A; Simpson, Sean L; Fidali, Brian C; Gerdes, Lee; Lee, Sung W; Beck, Belleville, Beristianos, Bernardy, Blanchard, Brownlow, Chang, Clark, Cohen, Cohen, Cuthbert, Farina, Farr, Fortunato, Gapen, Gerdes, Ginsberg, Hrobjartsson, Hughes, Jonas, Kearney, Kluetsch, Krook-Magnuson, Lee, Meyer, Monson, Najavits, Nishith, Norte, Oppenheimer, Parcella, Peniston, Pruiksma, Rabe, Radloff, Ramaswamy, Rees, Riemann, Saunders, Schottenbauer, Shah, Sinha, Smarr, Spoormaker, Steenkamp, Sterling, Sterling, Sterling, Sterling, Tegeler, Tegeler, Tegeler, Wahbeh, Weathers, Williamson, Zucker",2017.0,,0,0,
3191,"The CLIMATE schools combined study: a cluster randomised controlled trial of a universal Internet-based prevention program for youth substance misuse, depression and anxiety.","Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders and frequently co-occur. While programs for the prevention and reduction of symptoms associated with (i) substance use and (ii) mental health disorders exist, research is yet to determine if a combined approach is more effective. This paper describes the study protocol of a cluster randomised controlled trial to evaluate the effectiveness of the CLIMATE Schools Combined intervention, a universal approach to preventing substance use and mental health problems among adolescents. Participants will consist of approximately 8400 students aged 13 to 14-years-old from 84 secondary schools in New South Wales, Western Australia and Queensland, Australia. The schools will be cluster randomised to one of four groups; (i) CLIMATE Schools Combined intervention; (ii) CLIMATE Schools - Substance Use; (iii) CLIMATE Schools - Mental Health, or (iv) Control (Health and Physical Education as usual). The primary outcomes of the trial will be the uptake and harmful use of alcohol and other drugs, mental health symptomatology and anxiety, depression and substance use knowledge. Secondary outcomes include substance use related harms, self-efficacy to resist peer pressure, general disability, and truancy. The link between personality and substance use will also be examined. Compared to students who receive the universal CLIMATE Schools - Substance Use, or CLIMATE Schools - Mental Health or the Control condition (who received usual Health and Physical Education), we expect students who receive the CLIMATE Schools Combined intervention to show greater delays to the initiation of substance use, reductions in substance use and mental health symptoms, and increased substance use and mental health knowledge. This trial is registered with the Australian and New Zealand Clinical Trials registry, ACTRN12613000723785.",Teesson M.; Newton NC.; Slade T.; Chapman C.; Allsop S.; Hides L.; McBride N.; Mewton L.; Tonks Z.; Birrell L.; Brownhill L.; Andrews G.,2014.0,10.1186/1471-244X-14-32,0,0,
3192,Early short-term inpatient psychotherapeutic treatment versus continued outpatient psychotherapy on psychosocial outcome: a randomized controlled trial in trauma patients.,"Inpatient psychotherapeutic support has been shown to reduce mental health problems in severely injured patients. However, this effect mostly disappears after discharge. The aim of this study was to compare short-term inpatient versus continued long-term outpatient psychotherapeutic support. Patients with at least two injuries of a combined Abbreviated Injury Scale Severity Score Index‚â•5 were included in the study. Of 862 screened patients, 113 met all inclusion criteria. They were randomly assigned to a short-term group (n=59), where only inpatient support was given, and a long-term group (n=54), with additional outpatient sessions. The cognitive behavioral treatment was standardized by a manual. Psychological assessment for depression, anxiety, and posttraumatic stress disorder (PTSD) was performed in written form at the time of inclusion, discharge, and 6 months, 12 months, and 18 months after trauma. Forty-one percent (n=46) of all patients completed follow-up visits. The results show that symptoms of depression, anxiety, and PTSD disappeared more often in the long-term group than in the short-term group 1 year after trauma. Differences nearly reach significance for anxiety (p=0.051) and PTSD (p=0.059). Twenty-one percent of the short-term group patients showed at least one mental health disorder compared with no patients in the long-term group 1 year after trauma (p=0.035). Psychotherapeutic support of severely injured patients seems to be more effective in reducing depression, anxiety, and PTSD if extended further into outpatient care. This conclusion should be considered preliminary because of the small number of study patients.",Tecic T.; Schneider A.; Althaus A.; Schmidt Y.; Bierbaum C.; Lefering R.; Mueller D.; Bouillon B.; Janssen C.; Pfaff H.; Erli HJ.; Rangger C.; Neugebauer EA.,2011.0,10.1097/TA.0b013e3181f024fe,0,0,
3193,Automatic associations and panic disorder: trajectories of change over the course of treatment.,"Cognitive models of anxiety and panic suggest that symptom reduction during treatment should be preceded by changes in cognitive processing, including modifying the anxious schema. The current study tested these hypotheses by using a repeated measures design to evaluate whether the trajectory of change in automatic panic associations over a 12-week course of cognitive behavior therapy (CBT) is related to the trajectory of change in panic symptoms. Individuals with panic disorder (N = 43) completed a measure of automatic panic associations--the Implicit Association Test (A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz, 1998), which reflects elements of the schema construct--every 3 weeks over the course of therapy and measures of panic symptoms each week. Dynamic bivariate latent difference score modeling not only indicated that automatic panic associations changed over the course of CBT for panic disorder but showed these changes were correlated with symptom reduction. Moreover, change in automatic panic associations was a significant predictor of change in panic symptom severity. These findings permit inferences about the temporality of change, suggesting that cognitive change does in fact precede and contribute to symptom change.",Teachman BA.; Marker CD.; Smith-Janik SB.,2008.0,10.1037/a0013113,0,0,
3194,I am going to gag: Disgust cognitions in spider and blood-injury-injection fears,"There is mounting evidence that disgust plays an important role in certain anxiety disorders, yet little is known about disgust's cognitive component. The current study introduces a measure of cognitions associated with disgust and contamination to assess the role of disgust-specific primary and secondary appraisals in phobic responding. A multi-modal assessment of blood-injury-injection (BII) and spider phobia was conducted using BII (N=29) and spider (N=30) fearful groups, and a non-fearful control group (N=30). The Disgust Cognitions scale showed good reliability and validity, and distinguished among the groups. For example, relative to the other groups, the spider fear group reported higher disgust cognitions following presentation of a live spider, whereas the BII Fear group reported higher disgust cognitions following a surgery video. Moreover, the scale was associated with multiple phobic indicators (behavioural avoidance, subjective distress, symptom endorsement), suggesting cognitions may be critical to understanding how disgust contributes to anxiety disorders.",Teachman B.A.; Saporito J.,2009.0,10.1080/02699930801961731,0,0,
3195,Training non-threatening interpretations in spider fear,"To evaluate a causal relationship between biased information processing and fear responding, as posited by many cognitive models of anxiety disorders, spider-relevant interpretations were trained to be non-threatening in an analog phobic sample. Participants high in spider fear (N = 61) were randomly assigned to a 'Positive training' condition, or to a 'Neutral training' or 'No training' control condition. 'Positive training' involved learning to ascribe non-threatening meanings to emotionally ambiguous scenarios. Results suggested this training was successful at inducing interpretation biases to be non-threatening, as indicated by faster responses to positive (versus negative) word fragments, as well as more positive and less negative interpretations of novel scenarios (relative to control conditions). Notwithstanding, the impact of training on subsequent avoidance and fear when presented with a live spider was minimal. No differences across training conditions were found; however, faster responding to positive word fragments predicted less avoidance and fear for participants receiving 'Positive training'. © 2006 Springer Science+Business Media, LLC.",Teachman B.A.; Addison L.M.,2008.0,10.1007/s10608-006-9084-z,0,0,
3196,Behavioural treatment of post-traumatic stress disorder associated with recovered memories.,"Post-traumatic stress disorder (PTSD) is sometimes associated with recovered memories (RMs) of traumatic events. That is, the sufferer reports having forgotten traumatic events for a period of time, only to recall them later on. As the memories of traumatic events are recalled, PTSD may emerge. The cause of recovered memories is uncertain and is the subject of debate. Some RMs may be reasonably accurate, while others may be ""recollections"" of imagined rather than actual events. It is unclear whether conventional PTSD therapies, such as behavior therapy, are appropriate and effective in treating PTSD-RM. The present article considers these issues in the context of a case study, in which a patient (male in his late 30s) with PTSD-RM was treated with behavior therapy (in vivo and imaginal exposure). The patient sought treatment because he wanted relief from his PTSD symptoms, regardless of whether his RMs were accurate (he was completely convinced in the accuracy of the memories). Treatment outcome was compared with the outcome of 13 PTSD patients (mean age 38 yrs) who did not have RMs, who were also treated with behavior therapy. Results suggest that PTSD-RM can be effectively treated with behavior therapy, but not for all cases. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Taylor, Steven; Thordarson, Dana S; Asmundson, Beck, Beck, Bernstein, Blake, Chambless, Clifft, Courtois, Davidson, Elliott, First, Foa, Herman, Karon, King, Landis, Loftus, Marks, McHugh, McNally, Pitman, Shrout, Taylor, Taylor, van Etten",2002.0,,0,0,
3197,Robust Dimensions of Anxiety Sensitivity: Development and Initial Validation of the Anxiety Sensitivity Index-3,"Accumulating evidence suggests that anxiety sensitivity (fear of arousal-related sensations) plays an important role in many clinical conditions, particularly anxiety disorders. Research has increasingly focused on how the basic dimensions of anxiety sensitivity are related to various forms of psychopathology. Such work has been hampered because the original measure-the Anxiety Sensitivity Index (ASI)-was not designed to be multidimensional. Subsequently developed multidimensional measures have unstable factor structures or measure only a subset of the most widely replicated factors. Therefore, the authors developed, via factor analysis of responses from U.S. and Canadian nonclinical participants (n = 2,361), an 18-item measure, the ASI-3, which assesses the 3 factors best replicated in previous research: Physical, Cognitive, and Social Concerns. Factorial validity of the ASI-3 was supported by confirmatory factor analyses of 6 replication samples, including nonclinical samples from the United States and Canada, France, Mexico, the Netherlands, and Spain (n = 4,494) and a clinical sample from the United States and Canada (n = 390). The ASI-3 displayed generally good performance on other indices of reliability and validity, along with evidence of improved psychometric properties over the original ASI. © 2007 American Psychological Association.",Taylor S.; Zvolensky M.J.; Cox B.J.; Deacon B.; Heimberg R.G.; Ledley D.R.; Abramowitz J.S.; Holaway R.M.; Sandin B.; Stewart S.H.; Coles M.; Eng W.; Daly E.S.; Arrindell W.A.; Bouvard M.; Cardenas S.J.,2007.0,10.1037/1040-3590.19.2.176,0,0,
3198,Cognitive restructuring in the treatment of social phobia. Efficacy and mode of action.,"Cognitive restructuring (CR) is commonly used to treat social phobia, although its contribution to treatment efficacy has not been established. CR requires the person to think about and discuss feared social events with his or her therapist and thus entails some degree of exposure to social stimuli. CR also is thought to enhance the efficacy of therapeutic exposure exercises (EXP). Four predictions were tested based on this model: Relative to a control intervention matched for the exposure inherent in CR, CR is more effective in (1) reducing social phobia, (2) reducing negative social cognitions, (3) increasing positive cognitions, and (4) enhancing the effects of subsequent EXP. People with generalized social phobia (N = 60) were randomly assigned to CR followed by EXP or to a control intervention followed by EXP. Support was found for predictions 1 to 3, but not 4.",Taylor S.; Woody S.; Koch WJ.; McLean P.; Paterson RJ.; Anderson KW.,1997.0,10.1177/01454455970214006,0,0,
3199,Stimulus estimation and the overprediction of fear.,"Overprediction of fear is the tendency to overestimate the amount of fear that one will experience in a subjectively threatening situation. Little is known about this bias, despite the important role it appears to play in producing phobic avoidance. The present study proposed a stimulus estimation hypothesis of overprediction, which states that overprediction of fear arises from the overprediction of the danger features of the feared stimulus and the underprediction of safety features. This model was supported by the results of structural equation modelling based on the responses of 224 snake-fearful subjects exposed to a live harmless snake. The determinants of the stimulus estimation bias are considered and directions for further investigation are discussed.",Taylor S.; Rachman SJ.,1994.0,,0,0,
3200,"Novel Three-Day, Community-Based, Nonpharmacological Group Intervention for Chronic Musculoskeletal Pain (COPERS): a Randomised Clinical Trial","ER METHODS AND FINDINGS: We conducted a multi-centre, pragmatic, randomised, controlled effectiveness and cost-effectiveness (cost-utility) trial across 27 general practices and community musculoskeletal services in the UK. We recruited 703 adults with musculoskeletal pain of at least 3 mo duration between August 1, 2011, and July 31, 2012, and randomised participants 1.33:1 to intervention (403) or control (300). Intervention participants were offered a participative group intervention (COPERS) delivered over three alternate days with a follow-up session at 2 wk. The intervention introduced cognitive behavioural approaches and was designed to promote self-efficacy to manage chronic pain. Controls received usual care and a relaxation CD. The primary outcome was pain-related disability at 12 mo (Chronic Pain Grade [CPG] disability subscale); secondary outcomes included the CPG disability subscale at 6 mo and the following measured at 6 and 12 mo: anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), pain acceptance (Chronic Pain Acceptance Questionnaire), social integration (Health Education Impact Questionnaire social integration and support subscale), pain-related self-efficacy (Pain Self-Efficacy Questionnaire), pain intensity (CPG pain intensity subscale), the census global health question (2011 census for England and Wales), health utility (EQ-5D-3L), and health care resource use. Analyses followed the intention-to-treat principle, accounted for clustering by course in the intervention arm, and used multiple imputation for missing or incomplete primary outcome data. The mean age of participants was 59.9 y, with 81% white, 67% female, 23% employed, 85% with pain for at least 3 y, and 23% on strong opioids. Symptoms of depression and anxiety were common (baseline mean HADS scores 7.4 [standard deviation 4.1] and 9.2 [4.6], respectively). Overall, 282 (70%) intervention participants met the predefined intervention adherence criterion. Primary outcome data were obtained from 88% of participants. There was no significant difference between groups in pain-related disability at 6 or 12 mo (12 mo: difference -1.0, intervention versus control, 95%","Taylor, S J; Carnes, D; Homer, K; Kahan, B C; Hounsome, N; Eldridge, S; Spencer, A; Pincus, T; Rahman, A; Underwood, M",2016.0,10.1371/journal.pmed.1002040,0,0,
3201,An expanded anxiety sensitivity index: evidence for a hierarchic structure in a clinical sample.,"Anxiety sensitivity (AS) is the fear of anxiety-related sensations. According to Reiss's (e.g., Reiss, 1991) expectancy theory, AS amplifies fear and anxiety reactions, and plays an important role in the etiology and maintenance of anxiety disorders, particularly panic disorder. Recent evidence suggests that AS has a hierarchical structure, consisting of multiple lower order factors, loading on a single higher order factor. If each factor corresponds to a discrete mechanism (Cattell, 1978), then the results suggest that AS arises from a hierarchic arrangement of mechanisms. A problem with previous studies is that they were based on the 16-item Anxiety Sensitivity Index, which may not contain enough items to reveal the type and number of lower order factors. Also, some of the original ASI items are too general to assess specific, lower order factors. Accordingly, we developed an expanded measure of AS--the ASI-R--which consists of 36 items with subscales assessing each of the major domains of AS suggested by previous studies. The ASI-R was completed by 155 psychiatric outpatients. Factor analyses indicated a four-factor hierarchical solution, consisting of four lower order factors, loading on a single higher factor. The lower order factors were: (1) fear of respiratory symptoms, (2) fear of publicly observable anxiety reactions, (3) fear of cardiovascular symptoms, and (4) fear of cognitive dyscontrol. Each factor was correlated with measures of anxiety and depression, and fear of cognitive dyscontrol was most highly correlated with depression, which is broadly consistent with previous research. At pretreatment, patients with panic disorder tended to scored highest on each of the factors, compared to patients with other anxiety disorders and those with nonanxiety disorders. These findings offer further evidence that Reiss's expectancy theory would benefit from revision, to incorporate the notion of a hierarchic structure of AS.",Taylor S.; Cox BJ.,,,0,0,
3202,The effect of nursing interventions utilizing music therapy or sensory information on Chinese patients' anxiety prior to cardiac catheterization: a pilot study,"ER AIMS: To determine the effects of using nursing interventions of music therapy or sensory information, on reducing anxiety and uncertainty, and improving negative mood among Chinese subjects immediately prior to cardiac catheterization.METHODS: An experimental three-group repeated measures design for this pilot study was used. Forty-five hospitalized adults (15/group) undergoing cardiac catheterization were randomly assigned to either (1) a music therapy intervention, (2) a sensory information intervention or (3) treatment as usual (control). Anxiety, uncertainty and mood state were measured using self-reported questionnaires and physiological measures were made at baseline, post-intervention to determine their effect and post-cardiac catheterization to determine whether these interventions had any long-lasting effect.RESULTS: The control group was found to be significantly older (P=0.001) than the two experimental groups. Older age was associated with lower anxiety scores (r=-0.31, P=0.04 at baseline; r=-0.30, P=0.04 post-intervention; r=-0.22, P=0.15 post-cardiac catheterization). After controlling for age, the use of music therapy or sensory information did not significantly reduce anxiety, improve mood state, reduce uncertainty, decrease heart or respiratory rate among subjects undergoing cardiac catheterization.CONCLUSION: The non-significant result may have been affected by the small sample, and the social and cultural expectations regarding the public display of emotions among Chinese populations.BACKGROUND: Unrelieved anxiety can produce an increase in sympathetic nervous system activity leading to an increase in cardiac workload. Nursing interventions using music therapy or sensory information among patients with coronary artery disease has resulted in anxiety reduction, though results in Chinese subjects has not previously been published.","Taylor-Piliae, R E; Chair, S Y",2002.0,10.1016/S1474-5151(02)00037-3,0,0,
3203,"Effect of psychological skills training during military survival school: a randomized, controlled field study.","In this randomized, controlled field study, we examined the effects of a brief psychological skills training (PST) intervention on stress responses during military survival school. A second purpose was to build upon prior research in this unique environment by extending the follow-up window to 3 months. Baseline subjective distress (dissociative) symptoms were measured in 65 male military subjects, who were then randomized either to PST or a control group that received no training beyond the normal survival school curriculum. PST received training in arousal control, mental imagery, goal setting, and positive self-talk in two separate 40-minute sessions before stressful field exercises. Stress symptoms were then assessed during a mock-captivity phase of training, as well as 24 hours, 1 month, and 3 months after completion of training. Repeated-measures analyses of variance with follow-up paired t tests examined differences between groups and across time. Survival training precipitated remarkable increases in subjective distress, but few substantive group differences emerged. This study extends prior work quantifying the human stress response to intense military training.",Taylor MK.; Stanfill KE.; Padilla GA.; Markham AE.; Ward MD.; Koehler MM.; Anglero A.; Adams BD.,2011.0,,0,0,
3204,"Stressful military training: Endocrine reactivity, performance, and psychological impact","Introduction: We examined the responsiveness of both cortisol and dehydroepiandrosterone sulfate (DHEAS) to the stress of survival training in military men and evaluated relationships to performance, peritraumatic dissociation, and the subsequent impact of stressful events. Methods: Baseline salivary cortisol samples were self-collected by 19 men at 0900 and 1930 in a free-living (FL) environment. DHEAS samples were also collected in a subset of this sample (N = 12). Samples were subsequently taken at similar time points during a stressful captivity (SC) phase of training. Repeated-measures analyses of variance with follow-up paired t-tests examined differences across time and conditions. Results: Significant increases were observed at both time points (0900 and 1930) from FL to SC in both cortisol (0900: 9.2 ± 3.4 nmol·L-1 vs. 18.4 ± 10.5 nmol·L-1; 1930: 3.5 ± 3.0 nmol·L-1 vs. 27.7 ± 10.9 nmol·L-1) and DHEAS (0900: 1.7 ± 1.3 ng·ml -1 vs. 6.7 ± 3.5 ng·ml-1; 1930: 1.5 ± 0.84 ng·ml-1 vs. 4.5 ± 3.0 ng·ml-1). Also, overall performance during a high-intensity captivity-related challenge was inversely related to the DHEAS-cortisol ratio; conversely, overall performance during a low-intensity captivity-related challenge was positively related to DHEAS at the 0900 time point during SC. Dissociation was unrelated to endocrine indices measured during SC, while total impact of events was inversely related to percent change in DHEAS from FL to SC. Conclusions: Cortisol and DHEAS increase in response to allostatic load, and may relate to human performance during SC as well as PTSD symptoms. Reprint & Copyright © by Aerospace Medical Association.",Taylor M.K.; Sausen K.P.; Potterat E.G.; Mujica-Parodi L.R.; Reis J.P.; Markham A.E.; Padilla G.A.; Taylor D.L.,2007.0,10.3357/ASEM.2151.2007,0,0,
3205,Death and television: terror management theory and themes of law and justice on television,"ER Based on terror management theory, it was hypothesized that media choices may be affected by the salience of death-related thoughts. Three experiments with samples of undergraduate students were conducted to investigate whether such a process would affect preferences for law and justice television programming. In the first experiment (n = 132), individuals for whom mortality had been made salient through experimental induction preferred more programs with law and justice themes than individuals for whom mortality had not been made salient. In the second experiment (n = 761), this effect was observed regardless of trust in law enforcement and only for participants induced to think about death, not those induced to think about pain. In the third experiment (n = 163), participants for whom mortality was salient who watched a crime drama that showed justice being carried out showed a diminished self-enhancing bias compared to participants who watched a version of the same program in which justice was thwarted. Results indicate that entertainment choices are influenced by thought of death beyond simply seeking distraction and that entertainment programming emphasizing justice can effectively ameliorate existential anxiety that arises from thoughts of death.","Taylor, L D",2012.0,,0,0,
3206,A pilot study to investigate the induction and manipulation of learned helplessness in healthy adults.,"Eliminating the controllability of a noxious stimulus may induce a learned helplessness (LH) that resembles aspects of depression and post-traumatic stress disorder (PTSD). This study examined whether repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) promotes resilience in an aversive stimulus model of LH. All 55 participants were told that an undisclosed sequence of button presses would terminate an aversive stimulus on their forearm. In truth, only half had control (+C). The other half had no control (-C). All participants received real (R) or sham (S) left DLPFC rTMS during the paradigm (+C/R, -C/S,+C/S,-C/R). We evaluated the cognitive effects of LH using an anagram task. The LH paradigm successfully reduced perceived control in the -C groups. As predicted, the +C/R and +C/S groups tended to give up less quickly and take less time to solve each anagram than did the -C/S group. Superior anagram performance in the -C/R group approached statistical significance. Our preliminary results suggest that manipulating the controllability of an aversive stimulus may induce an LH effect that manifests as impaired anagram performance. Further research is needed to refine this model and determine if DLPFC rTMS mitigates any LH effects.",Taylor JJ.; Neitzke DJ.; Khouri G.; Borckardt JJ.; Acierno R.; Tuerk PW.; Schmidt M.; George MS.,2014.0,10.1016/j.psychres.2014.05.045,0,0,
3207,Predictors of anxiety recurrence in the Coordinated Anxiety Learning and Management (CALM) trial.,"Few studies have examined anxiety recurrence after symptom remission in the primary care setting. We examined anxiety recurrence in the Coordinated Anxiety Learning and Management (CALM) trial. From 2006 to 2009, CALM randomized adults with anxiety disorders (generalized anxiety disorder, panic disorder, social anxiety disorder, and post-traumatic stress disorder) in primary care clinics to usual care (UC) or a collaborative care (CC) intervention of pharmacotherapy and/or cognitive behavioral therapy. We examined 274 patients who met criteria for anxiety remission (Brief Symptom Inventory for anxiety and somatization (BSI-12) < 6) after 6 months of randomized treatment and completed a follow-up of 18 months. Logistic regression and receiver operating characteristics (ROC) were used to identify predictors of anxiety recurrence (BSI-12 ≥ 6 and 50% increase from 6-month ratings) during the year following remission. Recurrence was lower in CC (29%) compared to UC (41%) (p = 0.04). Patients with comorbid depression or lower self-perceived socioeconomic status particularly benefited (in terms of reduced recurrence) if assigned to CC instead of UC. In the multivariable logistic regression model, smoking, being single, Anxiety Sensitivity Index score, functional impairment at month 6 due to residual anxiety (measured with the Sheehan Disability Scale), and treatment with benzodiazepines were associated with subsequent anxiety recurrence. ROC identified prognostic subgroups based on the risk of recurrence. Our study was exploratory, and our findings require replication. Future studies should also examine the effectiveness of relapse prevention programs in patients at highest risk for recurrence.",Taylor JH.; Jakubovski E.; Bloch MH.,2015.0,10.1016/j.jpsychires.2015.03.020,0,0,
3208,Predictors of anxiety recurrence in the Coordinated Anxiety Learning and Management (CALM) trial.,"Few studies have examined anxiety recurrence after symptom remission in the primary care setting. We examined anxiety recurrence in the Coordinated Anxiety Learning and Management (CALM) trial. From 2006 to 2009, CALM randomized adults with anxiety disorders (generalized anxiety disorder, panic disorder, social anxiety disorder, and post-traumatic stress disorder) in primary care clinics to usual care (UC) or a collaborative care (CC) intervention of pharmacotherapy and/or cognitive behavioral therapy. We examined 274 patients who met criteria for anxiety remission (Brief Symptom Inventory for anxiety and somatization (BSI-12) < 6) after 6 months of randomized treatment and completed a follow-up of 18 months. Logistic regression and receiver operating characteristics (ROC) were used to identify predictors of anxiety recurrence (BSI-12 >= 6 and 50% increase from 6-month ratings) during the year following remission. Recurrence was lower in CC (29%) compared to UC (41%) (p = 0.04). Patients with comorbid depression or lower self-perceived socioeconomic status particularly benefited (in terms of reduced recurrence) if assigned to CC instead of UC. In the multivariable logistic regression model, smoking, being single, Anxiety Sensitivity Index score, functional impairment at month 6 due to residual anxiety (measured with the Sheehan Disability Scale), and treatment with benzodiazepines were associated with subsequent anxiety recurrence. ROC identified prognostic subgroups based on the risk of recurrence. Our study was exploratory, and our findings require replication. Future studies should also examine the effectiveness of relapse prevention programs in patients at highest risk for recurrence. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Taylor, Jerome H; Jakubovski, Ewgeni; Bloch, Michael H; Abravanel, Adler, Andreescu, Andreescu, Batelaan, Bruce, Calkins, Craske, Derogatis, Fava, Gilbody, Jakubovski, Joesch, Kelly, Kiernan, Kroenke, Kroenke, Kroenke, Lang, McLeod, Michelini, Mitchell, Morlan, Muntaner, Pennell, Peterson, Rodriguez, Rodriguez, Roy-Byrne, Schat, Schatzberg, Scholten, Schumm, Sheehan, Sheehan, Sherbourne, Singh-Manoux, Sturm, Sullivan, Wells, Young",2015.0,,0,0,
3209,What does the Driving and Riding Avoidance Scale (DRAS) measure?,"Driving anxiety can have a significant impact on everyday functioning and usually results in some kind of avoidance behaviour. The Driving and Riding Avoidance Scale (DRAS; Stewart, A. E., & St. Peter, C. C. (2004). Driving and riding avoidance following motor vehicle crashes in a non-clinical sample: psychometric properties of a new measure. Behaviour Research and Therapy, 42, 859-879) shows promise in the self-report assessment of the degree of such avoidance. The present study investigated the psychometric properties of the DRAS in a sample of 301 university students. Internal consistency for the DRAS was 0.89 and temporal stability over two months was 0.71. The factor structure of the DRAS supported the use of the general and traffic avoidance subscales but not the weather and riding avoidance subscales in the present non-clinical sample. However, a significant limitation of the DRAS is that it does not assess the reasons for driving avoidance, and is therefore not a measure of avoidance that is due to driving anxiety. Some items may be rated highly for practical reasons, such as avoidance because of increasing fuel and other costs associated with driving. Modified instructions for the DRAS should ensure that it measures anxiety-related avoidance behaviour. © 2008 Elsevier Ltd. All rights reserved.",Taylor J.E.; Sullman M.J.M.,2009.0,10.1016/j.janxdis.2008.10.006,0,0,
3210,Frequency-dependent effects of sine-wave cranial transcutaneous electrical nerve stimulation in human subjects,,Taylor D.N.; Lee C.-T.,1992.0,,0,0,
3211,"A multicentre, randomised trial examining the effect of test procedures measuring emergence from post-traumatic amnesia.","Post-traumatic amnesia (PTA) tests that record different PTA durations in the same patient, thereby raising measurement accuracy issues, have been reported previously. A major problem lies in determining the end point of PTA. To delineate areas of discrepancy in PTA tests and to provide independent verification for a criterion signalling emergence from PTA. In a randomised design, two related PTA procedures were compared, one purportedly more difficult (Westmead PTA Scale, WPTAS) than the other (Modified Oxford PTA Scale, MOPTAS). Eighty two patients in the early stages of PTA were examined daily until emergence, by using the Galveston Orientation and Amnesia Test (GOAT) and the WPTAS/MOPTAS. A short battery of cognitive and behavioural measurements was made on three occasions: at the early stage of PTA (time 1), towards the end of PTA when the maximum score (12/12) was first obtained (time 2) and at the traditional criterion for emergence (scoring 12/12 for 3 consecutive days; time 3). No significant difference was recorded in PTA duration between the MOPTAS and WPTAS. Both scales recorded longer PTA durations than the GOAT. By using Kaplan-Meier survival analyses, the WPTAS was found to show a more protracted pattern of emergence at the end stage of PTA than the MOPTAS. A time lag of > or = 1 week in the resolution of disorientation as compared with amnesia was observed in 59% cases. Significant improvements occurred on all independent measurements between time 1 and time 2, but on only 2 of 5 cognitive measurements between time 2 and time 3. Although no significant differences in the duration of PTA on the MOPTAS/WPTAS were recorded, emergence from the late stages of PTA occurred more promptly with the MOPTAS. The need for inclusion of both orientation and memory items in PTA tests is highlighted by the frequency of disorientation-amnesia dissociations. The patterns of results on the independent measures suggest that patients who are in PTA for > 4 weeks have probably emerged from PTA when they first score 12/12 on the MOPTAS/WPTAS, and this criterion can replace the traditional criterion.",Tate RL.; Pfaff A.; Baguley IJ.; Marosszeky JE.; Gurka JA.; Hodgkinson AE.; King C.; Lane-Brown AT.; Hanna J.,2006.0,10.1136/jnnp.2005.074989,0,0,
3212,Augmentation of exposure therapy with post-session administration of D-cycloserine.,"Pre-session administration of d-cycloserine (DCS) has been found to augment exposure therapy outcomes in a variety of anxiety disorders. To be able to enhance learning only for successful exposure sessions, it would be beneficial to have the option of administering DCS after rather than before the session, a strategy encouraged by pre-clinical work. We believe the present study is the first published report on the efficacy of post-session administration of DCS in humans. Adults (N = 29) with a DSM-IV diagnosis of acrophobia were randomized to receive two sessions of virtual reality exposure therapy (VRE) in combination with placebo or 50 mg of DCS. Instead of administering the pill prior to each of the sessions, as has been done in extant work, we administered the pill immediately following each session. Measures of acrophobia severity were collected at baseline, at each treatment session, 1-week post-treatment, and at 1-month follow-up. Mixed-effects repeated-measures ANOVAs and GLMMs revealed significant improvement in all outcome measures over time, but no between-group differences were observed. At post-treatment, 63.5% of patients in the placebo condition vs. 60.0% of those in the DCS condition were in remission. At 1-month follow up, 63.4% of those in the placebo condition vs. 66.6% of those in the DCS condition were in remission. These findings do not support the application of post-session DCS administration for augmenting the efficacy of exposure-based treatments. Possible reasons for these findings are discussed. The Trial is registered at ClinicalTrials.gov (NCT01102803).",Tart CD.; Handelsman PR.; Deboer LB.; Rosenfield D.; Pollack MH.; Hofmann SG.; Powers MB.; Otto MW.; Smits JA.,2013.0,10.1016/j.jpsychires.2012.09.024,0,0,
3213,Factors associated with outcome of cognitive-behavioural treatment of chronic post-traumatic stress disorder.,"Examined factors that were associated with outcome in the treatment of 57 patients with posttraumatic stress disorder (PTSD). A trial of cognitive therapy compared to imaginal exposure of chronic PTSD showed that although clinical improvements were obtained after treatment and at 6 mo follow-up 1 type of treatment was not significantly superior to the other. Characteristics of the patient, the trauma and treatment and of pretreatment clinical measures were investigated as predictors of PTSD outcome. 11 variables were significantly associated with the pre- to post-treatment change in Clinically Administered PTSD Scale (D. Blake, F. Weathers, F. Nogy, D. Kaloupek, G. Klauminzer, D. Charney, & T. Keane, 1990) severity scores. Of these, 3 (duration of therapy, gender and suicide risk) were selected into a step-wise multiple regression equation to explain 36.5% of the outcome. Similarly, 9 variables were significantly associated with the pretreatment to follow-up change with 3 variables (number of missed therapy sessions, residential status and co-morbid general anxiety disorder) being selected into the equation and explaining 36.9% of the outcome. The best predictor of outcome was inconsistent attendance at therapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Tarrier, Nicholas; Sommerfield, Claire; Pilgrim, Hazel; Faragher, Brian; Beck, Beck, Beck, Blake, Cooper, Ehlers, Eysenck, Foa, Goldberg, Hacker-Hughes, Hammarberg, Horowitz, Horowitz, Janoff-Bulman, Keane, Marks, McCann, McFarlane, McFarlane, Ormel, Pitman, Resick, Shalev, Spitzer, Tarrier, Tarrier, Vaughan",2000.0,,0,0,
3214,"The psychophysiological responses of PTSD patients: Habituation, responses to stressful and neutral vignettes and association with treatment outcome.","Investigated whether there were differences in habituation and psychophysiological reactivity between posttraumatic stress disorder (PTSD) patients and normals, and between patient subgroups depending on their symptoms and whether psychophysiological variables were associated with clinical outcome from a treatment trial. The authors predicted that those patients with lower levels of arousal and habituation would show a better response to cognitive behavioral treatment. Participants (mean age 36.65 yrs) were tested by measuring electrodermal activity to 2 sets of 15 auditory stimuli of different intensity, and to 6 vignettes, 4 neutral, 1 of general stress and 1 trauma related. Psychophysiological variables were entered into a multiple regression with clinical outcome as the dependent variable. There were no differences between patients and controls or within patients on the habituation paradigms. Patients differed from controls only on their response to the trauma related vignette. There were no differences on any within patient comparisons. There was no association with these measures and later clinical outcome. Psychophysiological differences between PTSD patients and normal controls are very specifically related to trauma related stimuli. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Tarrier, Nicholas; Sommerfield, Claire; Connell, John; Deakin, Bill; Pilgrim, Hazel; Reynolds, Martina; Ashcroft, Blake, Blanchard, Blanchard, Butler, Grillon, Guimaraes, Hassett, Haynes, Keane, Lader, Lader, Marks, Metzger, Morgan, Morgan, Orr, Orr, Orr, Pitman, Pitman, Shalev, Shalev, Shalev, Shalev, Siddle, Tarrier, Tarrier, Tarrier, Turpin, Venables",2002.0,,0,0,
3215,Factors associated with outcome of cognitive-behavioural treatment of chronic post-traumatic stress disorder.,"The study examined factors that were associated with outcome in the treatment of PTSD. A trial of cognitive therapy compared to imaginal exposure of chronic PTSD showed that although clinical improvements were obtained after treatment and at 6 month follow-up one type of treatment was not significantly superior to the other. Characteristics of the patient, the trauma and treatment and of pretreatment clinical measures were investigated as predictors of PTSD outcome. Eleven variables were significantly associated with the pre- to post-treatment change in CAPS severity scores. Of these, three (duration of therapy, gender and suicide risk) were selected into a step-wise multiple regression equation to explain 36.5% of the outcome. Similarly, nine variables were significant associated with the pretreatment to follow-up change with three variables (number of missed therapy sessions, residential status and co-morbid GAD) being selected into the equation and explaining 36.9% of the outcome. The best predictor of outcome was inconsistent attendance at therapy.",Tarrier N.; Sommerfield C.; Pilgrim H.; Faragher B.,2000.0,,0,0,
3216,Relatives' expressed emotion (EE) and PTSD treatment outcome.,"Expressed emotion (EE) is a measure that has been used to assess the quality of the relationship between patient and their key relative. It has been shown to be strongly predictive of clinical outcome in a range of psychiatric and medical disorders. This study investigated the effect of EE on treatment outcome in chronic post-traumatic stress disorder (PTSD). A prospective design was adopted. The key relatives of 31 PTSD patients participating in a treatment trial comparing imaginal exposure with cognitive therapy were interviewed and rated on EE prior to treatment allocation. The effect of EE on post-treatment clinical outcomes was assessed. Sixteen patients (52%) had high EE and 15 (48%) low EE relatives. Patients with high EE relatives showed lesser change scores on the main outcome variable of the trial, the total CAPS score, and on all the secondary outcome variables than those with low EE relatives. Using different multiple regression models the EE scales of criticism and hostility predicted just under 20% of the outcome variance. These two scales were highly correlated and criticism marginally predicted the greatest variance (19.7%). The results highlight the importance of the quality of the patient's social environment in influencing their response to cognitive and behavioural treatments.",Tarrier N.; Sommerfield C.; Pilgrim H.,1999.0,,0,0,
3217,A randomized trial of cognitive therapy and imaginal exposure in the treatment of chronic posttraumatic stress disorder.,"A randomized trial was performed in which imaginal exposure (IE) and cognitive therapy (CT) were compared in the treatment of chronic posttraumatic stress disorder (PTSD). Patients who continued to meet PTSD caseness at the end of a 4-week symptom-monitoring baseline period (n = 72) were randomly allocated to either IE or CT. There was a significant improvement in all measures over treatment and at follow-up, although there were no significant differences between the 2 treatments at any assessment. A significantly greater number of patients who showed worsening over treatment received IE, although this effect was not found at follow-up. Patients who worsened showed a greater tendency to miss treatment sessions, rated therapy as less credible, and were rated as less motivated by the therapist. It was concluded that either exposure or a challenge to cognition can result in symptom reduction, although neither resulted in complete improvement.",Tarrier N.; Pilgrim H.; Sommerfield C.; Faragher B.; Reynolds M.; Graham E.; Barrowclough C.,1999.0,,0,0,
3218,Subjective improvement in PTSD patients with treatment by imaginal exposure or cognitive therapy: session by session changes.,"A self-rating scale, the Subjective Symptom Checklist (SSC) was developed to assess PTSD patients' perception of their symptoms between treatment sessions. Reliability and validity of the scale were acceptable. The scale was used in a treatment trial comparing the efficacy of cognitive therapy versus imaginal exposure. Conventional pre-post treatment comparisons using standardized assessments showed no differences between the two treatments. However, when patients who failed to respond to treatment were excluded, group treatment effects became apparent. Patients who received imaginal exposure showed a significantly greater reduction in subjective ratings of their symptoms than did those who received cognitive therapy. It was cautiously concluded that although some PTSD patients could not tolerate exposure, those who could may receive greater subjective benefit than those who received cognitive therapy.",Tarrier N.; Humphreys L.,2000.0,,0,0,
3219,"Suicide risk in civilian PTSD patients--predictors of suicidal ideation, planning and attempts.","There appears to be a strong connection between suicidality and the experience of trauma. The study investigated suicidality in chronic civilian post-traumatic stress disorder (PTSD). Ninety-four participants suffering from chronic PTSD were assessed for suicidal ideation, plans and attempts since the index trauma as part of a comprehensive assessment. The prevalence of these was assessed and characteristics of those reporting suicide-related thoughts and behaviour were investigated through logistic and multinominal regression analyses. Over half of the sample (56.4%) reported some aspect of suicidality with 38.3% reporting ideation, 8.5% reporting suicide plans and 9.6% having made suicide attempts since the trauma. Of the nine participants who reported suicide attempts, six had made more than one attempt. The proportions of participants who reported suicidality in this sample were significantly greater than reported within the general population, when comparisons were made with an epidemiological study. Logistic regression analysis indicated that a unit increase in life impairment (OR = 3.1) and depression (OR = 1.14) scores were independently and significantly associated with suicidality. Multinominal regression indicated that life impairment (OR = 2.71) and depression (OR = 1.13) scores were associated with the presence of suicidal ideation compared to no ideation, and life impairment (OR = 5.75), depression (OR = 1.2) scores and receiving psychotropic medication (OR = 10.6) were associated with the presence of plans and attempts compared to no suicidal behaviour. Suicide risk is elevated in those suffering from chronic PTSD and is associated with impaired functioning in combination with depression.",Tarrier N.; Gregg L.,2004.0,10.1007/s00127-004-0799-4,0,0,
3220,Randomized controlled trial of postoperative exercise rehabilitation program after lumbar spine fusion: study protocol,"ER BACKGROUND: Lumbar spine fusion (LSF) effectively decreases pain and disability in specific spinal disorders; however, the disability rate following surgery remains high. This, combined with the fact that in Western countries the number of LSF surgeries is increasing rapidly it is important to develop rehabilitation interventions that improve outcomes.METHODS/DESIGN: In the present RCT-study we aim to assess the effectiveness of a combined back-specific and aerobic exercise intervention for patients after LSF surgery. One hundred patients will be randomly allocated to a 12-month exercise intervention arm or a usual care arm. The exercise intervention will start three months after surgery and consist of six individual guidance sessions with a physiotherapist and a home-based exercise program. The primary outcome measures are low back pain, lower extremity pain, disability and quality of life. Secondary outcomes are back function and kinesiophobia. Exercise adherence will also be evaluated. The outcome measurements will be assessed at baseline (3 months postoperatively), at the end of the exercise intervention period (15 months postoperatively), and after a 1-year follow-up.DISCUSSION: The present RCT will evaluate the effectiveness of a long-term rehabilitation program after LSF. To our knowledge this will be the first study to evaluate a combination of strength training, control of the neutral lumbar spine position and aerobic training principles in rehabilitation after LSF.TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT00834015.","Tarnanen, S; Neva, M H; Dekker, J; Häkkinen, K; Vihtonen, K; Pekkanen, L; Häkkinen, A",2012.0,10.1186/1471-2474-13-123,0,0,
3221,[Optimization of scanning and processing parameters for the three-dimensional reconstruction in computerized tomography of the facial bones].,"The evolution of computer technology has significantly improved the performances of three-dimensional reconstructions from Computed Tomographic images. The authors discuss the examination technique and the modalities of three-dimensional reconstruction based upon a new advanced workstation. This unit is based on a Sun Sparkstation linked with the main computer of the CT scanner. The workstation is extremely fast, the processing time for a high resolution three-dimensional image of the maxillofacial region being about 3 minutes. The scanning parameters, image reconstruction and visualization were investigated on cases of maxillofacial (mainly posttraumatic) conditions. The most important scanning parameters are slice thickness, table incrementation, dose, scan plane. Slice thickness and table incrementation are the parameters bearing the greatest influence on the quality of the three-dimensional images. Dose is also important but bears no influence on image quality: therefore it can be kept as low as possible to reduce patient exposure. The scanning plane has some minor effect; coronal images have some advantages over axial images but in many cases only axial images can be acquired. The reconstruction parameters are the threshold and the matrix. The threshold may range 70 to 300 HU but in most cases ranges 120 to 200 HU. An advantage offered by this system is that it allows threshold values to be changed after the reconstruction has been completed, without performing a new reconstruction. The visualization parameters include four rendering methods, i.e. the surface mode, the integral mode, the maximum intensity projection and the ray sum. The surface mode is the one yielding the best results for bones while the others are used for the reconstruction of soft tissues and vessels. The workstation enables the three-dimensional images to be processed with shading parameters, and to be modified with cut planes, disarticulation methods and other interactive methods.",Tarjàn Z.; Pozzi Mucelli F.; Pozzi Mucelli R.,1995.0,,0,0,
3222,Results of operative treatment for ulnar neuropathy in patients with a history of fracture of the lateral part of the humeral condyle in childhood.,"Fractures of the lateral part of the humeral condyle in childhood very often go undetected and are treated incorrectly, giving rise to numerous late complications. The study evaluated the outcomes of treatment of ulnar neuropathy secondary to a fracture of the lateral part of the humeral condyle in childhood. The study enrolled 12 patients aged 28-58 who had suffered fractures of the elbow at between 2 and 14 years of age. Arthrosis and a valgus deformity of the joint, contractures in flexion and extension of the elbow as well as ulnar neuropathy were observed after an average of about 30 years after the fracture. The patients accepted posttraumatic deformation of the axis and contractures of the elbow. The indication for operative treatment was the presence of signs of ulnar neuropathy. The treatment consisted in anterior transposition of the nerve. Postoperative follow-up lasted from 4 to 23 years. The long-term sequelae of these fractures are a valgus deformity of the elbow, arthrosis of the joint and neuropathy of the ulnar nerve. Ulnar nerve transposition relieves the patients from nerve compression symptoms arising at this level.",Tarczyńska M.; Kołodziej R.; Gagała J.,,,0,0,
3223,[Etiology and treatment results of laryngeal and tracheal stenosis].,"The paper provides results of examinations and surgical treatment in 190 patients with laryngeal and tracheal stenosis of different origin. The most favourable results were obtained in patients with postresuscitation stenosis, middle paralysis, posttraumatic stenosis: up to 75%, 71% and 55% of the responders, respectively. The canule remains for life in 20% of the surgical patients, because they have severe laryngeal and tracheal deformities associated with other affections.",Tarasov DI.; Folomeev VN.,,,0,0,
3224,Psychological group support attenuates distress of waiting in couples scheduled for assisted reproduction,"ER The aim of the study is to determine whether a cognitive-behavioral group treatment could lead to a decrease of psychological distress in couples waiting for assisted reproduction. Fifty consecutive couples included in the waiting list for IVF-ET or ICSI were randomly allocated either to receive Cognitive-Behavioral Treatment (CBT Group) or just waiting (Observation Group). The group is formed by 8-10 couples; 12 meetings are provided for a period of 4 months. Two psychometric test have been administered (Symptom Rating Test and Westbrook Coping Scales) at baseline and after 4 months. At baseline, females showed a higher level of SRT than males (F= 16.6+/-14.1; M = 10.2+/-9.0; p=0.01). This became evident for anxiety (F= 5.6+/-4.9; M =3.3+/-3.0, p = 0.004), somatization (F= 3.0+/-2.5; M = 1.8+/-2.1, p = 0.01) and feelings of inadequacy (F = 3.9+/-3.7; M = 2.3+/-2.7, p = 0.01). After 4 months in the males of Observation Group (from 2.3+/-2.0 to 4.0+/-2.8, p=0.01) there was an increase of the level of anxiety. No other meaningful differences in other variables were found. In females of CBT Group a trend towards a significant decrease in the total value of psychological uneasiness (the SRT) (from 17.7+/-13.7 to 14.1+/-14.0, p = 0.07) was found. A long wait before the scheduled intervention of assisted reproduction increased anxiety levels, namely in male partners. CBT avoids such a 'waiting stress' and could be useful for stimulating discussion and awareness inside the couple. Shortening the waiting list and psychological support would be provided by infertility centres","Tarabusi, M; Volpe, A; Facchinetti, F",2004.0,,0,0,
3225,Health-related quality of life in Behçet patients with ocular involvement,"Purpose: Health-related quality of life (HRQOL) is an important outcome factor in chronic diseases such as Behçet syndrome. We aimed to investigate the relation of HRQOL to the duration of illness, mental state, and visual acuity of patients with Behçet syndrome. Methods: We conducted a cross-sectional clinical trial of 45 consecutive Behçet patients with ocular involvement. The control group consisted of an age-, sex-, and education-matched group of 45 healthy individuals. All patients and the controls had been given a complete ophthalmic examination. In addition, they completed a questionnaire comprising the SF-36 Health Survey, Beck Depression Inventory, and Beck Anxiety Inventory. Eight multiple regression analyses were carried out in the patient group to determine whether total anxiety scores, total depression scores, duration of the disease, and visual acuity predicted the dependent variable SF-36 subscales. Results: Using the analysis of variance statistical method, comparisons of the patient and the control groups for depression, anxiety, and the subscales of the SF-36 Health Survey indicated a statistical significance for this battery of tests. Conclusions: Behçet patients with ocular involvement are susceptible to anxiety and depression when compared to age and sex matched controls. It is important for the ophthalmologist to know that changes in the mental state of his patient may trigger a new ocular attack, and to be aware that these changes may play a critical role in the management and preventive measures for Behçet syndrome. © 2003 Japanese Ophthalmological Society.",Tanriverdi N.; Taşkintuna I.; Dürü C.; Özdal P.; Ortaç S.; Firat E.,2003.0,10.1016/S0021-5155(02)00647-0,0,0,
3226,"Inspiratory support versus spontaneous breathing during preoxygenation in healthy subjects. A randomized, double blind, cross-over trial","Objective: Applying an inspiratory support (AI) and a positive end expiratory pressure (PEP) could increase the effectiveness of the preoxygenation. Study design: This randomized double blinded controlled study compares the impact on the expiratory oxygen fraction (FEO2) of two levels of AI with PEP to a traditional preoxygenation. Patients and methods: Twenty healthy volunteers were studied. The criteria of exclusion were a body mass index >30, the presence of beard or moustache and the claustrophobia. Each subject went through three modes of preoxygenation during 3minutes each in a random order: 1-spontaneous ventilation (VS), 2-preoxygenation with AI with 4cmH2O/PEP 4cmH2O (AI-4/PEP-4), 3-preoxygenation with AI with 6cmH2O/PEP 4cmH2O (AI-6/PEP-4). Subject's tolerance and leaks were also noted. Results: The FEO2 at the end of the 3minutes of preoxygenation was higher (p<0,001) with AI-4/PEP-4 (94±3%) and AI-6/PEP-4 (94±4%) than with technique VS (89±6%). One hundred percent and 90% of the participants reached one FEO2=90% with AI-4/PEP-4 and AI-6/PEP-4 respectively vs 65% with VS (p=0.0013). The participants tolerated better the VS and the AI-4/PEP-4 than the AI-6/PEP-4. More leaks were noted with the AI-6/PEP-4 than with the VS and the AI-4/PEP-4. Conclusion: This study shows applying AI plus PEP during preoxygenation improves its effectiveness in the healthy subjects. It also suggests that, in a population of healthy volunteers, combination AI-4/PEP-4 is preferable to AI-6/PEP-4 because so effective, but better tolerated. © 2009 Elsevier Masson SAS.",Tanoubi I.; Drolet P.; Fortier L.P.; Donati F.,2010.0,10.1016/j.annfar.2009.11.009,0,0,
3227,Short-term meditation training improves attention and self-regulation,"ER Recent studies suggest that months to years of intensive and systematic meditation training can improve attention. However, the lengthy training required has made it difficult to use random assignment of participants to conditions to confirm these findings. This article shows that a group randomly assigned to 5 days of meditation practice with the integrative body-mind training method shows significantly better attention and control of stress than a similarly chosen control group given relaxation training. The training method comes from traditional Chinese medicine and incorporates aspects of other meditation and mindfulness training. Compared with the control group, the experimental group of 40 undergraduate Chinese students given 5 days of 20-min integrative training showed greater improvement in conflict scores on the Attention Network Test, lower anxiety, depression, anger, and fatigue, and higher vigor on the Profile of Mood States scale, a significant decrease in stress-related cortisol, and an increase in immunoreactivity. These results provide a convenient method for studying the influence of meditation training by using experimental and control methods similar to those used to test drugs or other interventions.","Tang, Y Y; Ma, Y; Wang, J; Fan, Y; Feng, S; Lu, Q; Yu, Q; Sui, D; Rothbart, M K; Fan, M; Posner, M I",2007.0,10.1073/pnas.0707678104,0,0,
3228,Perceptions of surfboard riders regarding the need for protective headgear,"Objective.-To examine the use of protective headgear by surfers, their perceptions of its usefulness, and barriers to its use. Methods.-A researcher-administered questionnaire was used to undertake a cross-sectional survey of 646 surfboard riders at 8 popular surfing beaches in Victoria, Australia. The main outcome measures were rate of use of headgear, perceptions of head injury risk relative to a range of other activities, perceptions regarding headgear, and the reasons for not wearing headgear. Results.-Most surfers were men (90.2%), young (mean age 28.2 years), and experienced (mean years of surfing 11.6). Only 245 (38.0%, 95% CI 34.2-41.9) surfers considered the risk of head injury while surfing as moderate or high, and only 12 (1.9%, 95% CI 1.0-3.3) reported routine use of headgear. The surfers were more likely to believe that there was a higher risk of head injury in other sports and physical activities (P < .001). Although 475 surfers (73.8%, 95% CI 70.2-77.1) thought that surfers who wear headgear are less likely to become injured, 400 (62.1%, 95% CI 58.2-65.9) reported that headgear restricted surfing performance and that they would rather surf without it. The main reasons for not wearing headgear were ""no need,"" discomfort, claustrophobia, and effects upon the senses and balance. Conclusions.-Although most surfers acknowledge some risk of head injury, headgear is rarely used and barriers to its use are apparent. Research is required to clarify the risk of head injury among surfers and the effectiveness of headgear in reducing injury risk. Until this evidence is available, educational initiatives, improved headgear design, and profile within the surfing culture would be required to increase rates of wearing headgear.",Taylor D.M.; Bennett D.; Carter M.; Garewal D.; Finch C.,2005.0,,0,0,
3229,Modifying automatic approach action tendencies in individuals with elevated social anxiety symptoms.,"Research suggests that social anxiety is associated with a reduced approach orientation for positive social cues. In the current study we examined the effect of experimentally manipulating automatic approach action tendencies on the social behavior of individuals with elevated social anxiety symptoms. The experimental paradigm comprised a computerized Approach Avoidance Task (AAT) in which participants responded to pictures of faces conveying positive or neutral emotional expressions by pulling a joystick toward themselves (approach) or by moving it to the right (sideways control). Participants were randomly assigned to complete an AAT designed to increase approach tendencies for positive social cues by pulling these cues toward themselves on the majority of trials, or to a control condition in which there was no contingency between the arm movement direction and picture type. Following the manipulation, participants took part in a relationship-building task with a trained confederate. Results revealed that participants trained to approach positive stimuli displayed greater social approach behaviors during the social interaction and elicited more positive reactions from their partner compared to participants in the control group. These findings suggest that modifying automatic approach tendencies may facilitate engagement in the types of social approach behaviors that are important for relationship development.",Taylor CT.; Amir N.,2012.0,10.1016/j.brat.2012.05.004,0,0,
3230,Safety behaviors and judgmental biases in social anxiety disorder.,"Two experiments were conducted to examine the link between safety behaviors and social judgments in social anxiety disorder (SAD). Safety behaviors were manipulated in the context of a controlled laboratory-based social interaction, and subsequent effects of the manipulation on the social judgments of socially anxious participants (N = 50, Study 1) and individuals meeting diagnostic criteria for generalized SAD (N = 80, Study 2) were examined. Participants were randomly assigned to either a safety behavior reduction plus exposure condition (SB + EXP) or a graduated exposure (EXP) control condition, and then took part in a conversation with a trained experimental confederate. Results revealed across both studies that participants in the SB + EXP group were less negative and more accurate in judgments of their performance following safety behavior reduction relative to EXP participants. Study 2 also demonstrated that participants in the SB + EXP group displayed lower judgments about the likelihood of negative outcomes in a subsequent social event compared to controls. Moreover, reduction in safety behaviors mediated change in participant self-judgments and future social predictions. The current findings are consistent with cognitive theories of anxiety, and support the causal role of safety behaviors in the persistence of negative social judgments in SAD.",Taylor CT.; Alden LE.,2010.0,10.1016/j.brat.2009.11.005,0,0,
3231,To see ourselves as others see us: an experimental integration of the intra and interpersonal consequences of self-protection in social anxiety disorder.,"The current study investigated the mechanism through which safety behaviors perpetuate perceived and actual negative social outcomes hypothesized to maintain social anxiety disorder (SAD). Eighty individuals diagnosed with generalized SAD took part in a ""getting acquainted"" conversation with a trained experimental confederate. Participants were then randomly assigned to either a safety behavior reduction plus exposure condition (SB + EXP) or a graduated exposure (EXP) control condition and completed a 2nd conversation with the same interaction partner. Mediation analyses revealed that participants instructed to reduce their idiosyncratic safety behaviors displayed significantly greater increases in both perceived and actual positive interpersonal outcomes relative to the EXP group. However, whereas the safety behavior manipulation influenced participants' appraisals of their partner's reaction to them through reducing self-judgments about the visibility of anxiety-related behaviors, in reality, the SB + EXP group elicited more positive partner reactions because they displayed a greater increase in social approach behavior. Thus, although both parties recognized positive changes in the social exchange following the safety behavior manipulation, different sources of social information accounted for participant versus partner interpersonal judgments. The current findings point to the potential value of considering both the intra and interpersonal consequences of safety behaviors in SAD.",Taylor CT.; Alden LE.,2011.0,10.1037/a0022127,0,0,
3232,What good are positive emotions for treatment? Trait positive emotionality predicts response to cognitive behavioral therapy for anxiety.,"Objective: Cognitive behavioral therapy (CBT) is empirically supported for the treatment of anxiety disorders; however, not all individuals achieve recovery following CBT. Positive emotions serve a number of functions that theoretically should facilitate response to CBT-they promote flexible patterns of information processing and assimilation of new information, encourage approach-oriented behavior, and speed physiological recovery from negative emotions. We conducted a secondary analysis of an existing clinical trial dataset to test the a priori hypothesis that individual differences in trait positive emotions would predict CBT response for anxiety. Method: Participants meeting diagnostic criteria for panic disorder (n = 28) or generalized anxiety disorder (n = 31) completed 10 weekly individual CBT sessions. Trait positive emotionality was assessed at pre-treatment, and severity of anxiety symptoms and associated impairment was assessed throughout treatment. Results: Participants who reported a greater propensity to experience positive emotions at pre-treatment displayed the largest reduction in anxiety symptoms as well as fewer symptoms following treatment. Positive emotions remained a robust predictor of change in symptoms when controlling for baseline depression severity. Conclusions: Initial evidence supports the predictive value of trait positive emotions as a prognostic indicator for CBT outcome in a GAD and PD sample. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Taylor, Charles T; Knapp, Sarah E; Bomyea, Jessica A; Ramsawh, Holly J; Paulus, Martin P; Stein, Murray B; Appelhans, Ball, Bar-Haim, Barlow, Beck, Bostock, Brown, Bryan, Campbell-Sills, Clark, Costa, Craske, Craske, Craske, Davidson, de Kleine, de Wied, Diener, Dunn, Ehrenreich, Eisner, Estrada, Folkman, Forbes, Fredrickson, Fredrickson, Fredrickson, Fredrickson, Fredrickson, Hayes, Hofmann, Isen, Isen, Johnson, Johnson, Kahn, Kashdan, Kashdan, Kashdan, Kessler, Layous, Loerinc, McCraty, McMakin, Meyer, Nawijn, Niles, Norman, Norton, Olatunji, Papousek, Pollack, Reiss, Rosellini, Rowe, Rush, Schneider, Sheehan, Simons, Smillie, Smits, Taylor, Tugade, Wadlinger, Watson, Watson, Watson, Watson, Zbozinek, Zbozinek",2017.0,,0,0,
3233,A controlled comparison of relaxation and diazepam in panic disorder.,"Subjects with panic disorder (N = 23) were randomized into a crossover design involving diazepam, placebo, relaxation therapy, or control. Anxiety was measured by a 3-day hourly diary, psychological tests, and assessment of heart rate and skin conductance level during baseline, stress test, and interview. The greatest and only significant physiologic changes occurred with diazepam. The largest pre/posttreatment changes on the psychological tests and self-reported anxiety and depression occurred with relaxation, although the differences were not statistically significant. Relaxation therapy may be useful for treating the general anxiety associated with panic disorder.",Taylor CB.; Kenigsberg ML.; Robinson JM.,1982.0,,0,0,
3234,Social interpretation bias and generalized social phobia: The influence of developmental experiences,"Patients with generalized social phobia (N=42) and non-phobic community controls (N=42) engaged in a social interaction with an experimental assistant whose behavior was used to create either a positive or an ambiguous social environment. Participants then rated their own performance and their partner's behavior. As a group, social phobic patients displayed negatively biased self-judgments, but failed to display biased social interpretations. Among the social phobia group, a social developmental history marked by parental hostility was associated with negative interpretations of partner behavior and a history of parental overprotection was associated with less sensitivity to partner behavior. The results supported cognitive models of social phobia, which implicate negative learning experiences in the development of information processing biases. © 2004 Elsevier Ltd. All rights reserved.",Taylor C.T.; Alden L.E.,2005.0,10.1016/j.brat.2004.06.006,0,0,
3235,The effects of exercise training programs on psychosocial improvement in uncomplicated postmyocardial infarction patients,"ER To determine the effects of exercise training programs on psychosocial improvement in uncomplicated postmyocardial infarction patients, 210 male patients hospitalized for an acute myocardial infarction (MI) were randomized to three week symptom limited treadmill (TM) plus home exercise training, TM plus medically supervised gym training, TM without formal exercise program or control, where patients were seen only at six months post MI. Patients in this sample were at low risk for psychosocial disturbance (13% were moderate to severely depressed, 23% reported marital disturbance and 3% were extremely anxious). Patients in the training groups improved from 3 to 26 weeks post MI on all depression and anxiety measures. The gym training group showed a significant reduction on one depression measure compared to no training and on one anxiety measure compared to controls.","Taylor, C B; Houston-Miller, N; Ahn, D K; Haskell, W; DeBusk, R F",1986.0,,0,0,
3236,Fostering healthy futures: an innovative preventive intervention for preadolescent youth in out-of-home care,"ER Although we have not yet demonstrated empirically that the FHF program is effective in addressing mental health, behavioral, and academic issues among preadolescent youth placed in foster care, we believe we have a very promising model. We have successfully negotiated many challenges of conducting a RCT within a child welfare setting, in large part because of the collaboration and support of our community partners. The ultimate goal of this research is to develop more efficacious interventions, thereby reducing adverse life-course outcomes and promoting healthy futures, not only for youth in out-of-home care, but for all youth at risk.","Taussig, H N; Culhane, S E; Hettleman, D",2007.0,,0,0,
3237,Impact of a mentoring and skills group program on mental health outcomes for maltreated children in foster care,"ER OBJECTIVE: To evaluate the efficacy of the Fostering Healthy Futures program in reducing mental health problems and associated problems. DESIGN: Randomized controlled trial. SETTING: Denver metropolitan area. PARTICIPANTS: Children aged 9 to 11 years who were maltreated and placed in foster care. INTERVENTION: Children in the control group (n=77) received an assessment of their cognitive, educational, and mental health functioning. Children in the intervention group (n=79) received the assessment and participated in a 9-month mentoring and skills group program. MAIN OUTCOME MEASURES: Children and caregivers were interviewed at baseline prior to randomization, immediately following the intervention, and 6 months after the intervention. Teachers were interviewed 2 times after baseline. Measures included a multi-informant index of mental health problems, youth-reported symptoms of posttraumatic stress, dissociation, and quality of life, and caregiver- and youth-reported use of mental health services and psychotropic medications. RESULTS: After adjusting for covariates, intent-to-treat analyses demonstrated that the treatment group had fewer mental health problems on a multi-informant factor 6 months after the intervention (mean difference, -0.51; 95% confidence interval, -0.84 to -0.19), reported fewer symptoms of dissociation 6 months after the intervention (mean difference, -3.66; 95% confidence interval, -6.58 to -0.74), and reported better quality of life immediately following the intervention (mean difference, 0.11; 95% confidence interval, 0.03 to 0.19). Fewer youths in the intervention group than in the control group had received recent mental health therapy 6 months after the intervention according to youth report (53% vs 71%, respectively; relative risk=0.75; 95% confidence interval, 0.57 to 0.98). CONCLUSIONS: A 9-month mentoring and skills group intervention for children in foster care can be implemented with fidelity and high uptake rates, resulting in improved mental health outcomes. Trial Registration clinicaltrials.gov Identifier: NCT00809315.","Taussig, H N; Culhane, S E",2010.0,10.1001/archpediatrics.2010.124,0,0,
3238,The effects of mortality salience on relationship strivings and beliefs: the moderating role of attachment style,"ER This series of studies examined mortality salience effects on relationship strivings, while exploring the moderating role of attachment style. In the three studies, Israeli university students completed an attachment style scale, were assigned to a mortality salience or neutral condition, and then completed scales tapping specific relationship strivings and beliefs. Study 1 (N = 104) examined participants' willingness to initiate social interactions with a hypothetical same-sex person; Study 2 (N = 100) examined appraisals of interpersonal competence; and Study 3 (N = 108) examined reports of rejection sensitivity. Findings revealed that mortality salience led to more willingness to initiate social interactions, lower rejection sensitivity and more positive appraisals of interpersonal competence than a control condition. These mortality salience effects were found mainly among persons who scored low on attachment anxiety or attachment avoidance. Findings were discussed in light of the terror management function of close relationships.","Taubman-Ben-Ari, O; Findler, L; Mikulincer, M",2002.0,,0,0,
3239,Abbreviated upright Behavioral Relaxation Training for test anxiety among college students: Initial results.,"Effect of abbreviated upright Behavioral Relaxation Training (BRT) on two self-report measures of test anxiety was examined using a quasi-experimental pre-post between groups (N = 20) research design with selfreferred college students. At time 1 (T1) assessment, all participants completed the Abbreviated Test Anxiety Scale (ATAS) and were trained in the use of the Subjective Unit of Discomfort (SUD) rating scale. Participants recorded SUD ratings in vivo over a one-week period. Experimental group participants received two group sessions of upright BRT with instructions to practice BRT in vivo. Control group participants simply recorded SUD ratings during the intervention period. At time 2 (T2) assessment, all participants provided SUD rating data and completed the ATAS. Correlated t-tests indicated statistically significant differences in ATAS and SUD ratings in favor of abbreviated BRT. Robust effect, despite small sample size, provides further evidence for the effectiveness of BRT as an easy to learn, rapid relaxation training procedure for anxiety disorders. Application of abbreviated BRT in a group setting is a significant advance. Replication using a larger sample size with measurement of relaxed behavior and effect on academic performance is needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Tatum, Teresa; Lundervold, Duane A; Ament, Patrick; Bernstein, Chambless, Chapell, Hembee, Hopko, Hudeman, Lundervold, Lundervold, Lundervold, Poppen, Poppen, Powel, Powell, Rashid, Schwarzer, Sexton, Sexton, Sexton, Siepp, Smith, Wampold, Wolpe, Zeidner",2006.0,,0,0,
3240,Posttraumatic headache: an exploratory treatment study.,"Fourteen patients with posttraumatic headache (PTHA) were treated with a comprehensive treatment package targeting headache symptoms along with associated posttraumatic stress symptoms. Treatment consisted of some or all of the following depending on headache features: thermal biofeedback, electromyography biofeedback targeting the forehead and/or neck muscles, progressive muscle relaxation, education and cognitive-behavioral therapy. Mean improvement for the treatment group was 21%, whereas mean improvement for the wait-list group was--14% indicating a worsening of headache; however, the difference between groups was not statistically significant. There was a significant between groups difference on headache-free days. Within group results were modest with 29% mean improvement by the end of treatment. The reduction in headache index was significant. Minor reductions in psychopathology, most notably anxiety, were found after treatment. This study confirmed the treatment difficulties seen in this understudied population of headache sufferers, but offered hope for symptom relief.",Tatrow K.; Blanchard EB.; Silverman DJ.,2003.0,,0,0,
3241,Mindfulness-based therapy for drug-resistant epilepsy: an assessor-blinded randomized trial,"ER METHODS: We performed an assessor-blinded randomized control trial. Sixty patients with drug-resistant epilepsy were randomly allocated to MT or SS (30 per group). Each group received 4 biweekly intervention sessions. The primary outcome was the change in the total score of the Patient-Weighted Quality of Life in Epilepsy Inventory (QOLIE-31-P). Secondary outcomes included seizure frequency, mood symptoms, and neurocognitive functions. The assessors were blinded to the patient's intervention grouping. Results were analyzed using general linear model with repeated measure.RESULTS: Following intervention, both the MT (n=30) and SS (n=30) groups had an improved total QOLIE-31-P, with an improvement of +6.23 for MT (95% confidence interval [CI] +4.22 to +10.40) and +3.30 for SS (95% CI +1.03 to +5.58). Significantly more patients in the MT group had a clinically important improvement in QOLIE-31-P (+11.8 or above) compared to those who received SS (11 patients vs 4 patients). Significantly greater reduction in depressive and anxiety symptoms, seizure frequency, and improvement in delayed memory was observed in the MT group compared with the SS group.CONCLUSIONS: We found benefits of short-term psychotherapy on patients with drug-resistant epilepsy. Mindfulness therapy was associated with greater benefits than SS alone in quality of life, mood, seizure frequency, and verbal memory.CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that mindfulness-based therapy significantly improves quality of life in patients with drug-resistant epilepsy.OBJECTIVE: To investigate the effectiveness of mindfulness-based therapy (MT) and social support (SS) in patients with drug-resistant epilepsy.","Tang, V; Poon, W S; Kwan, P",2015.0,10.1212/WNL.0000000000001967,0,0,
3242,Personality change during depression treatment: a placebo-controlled trial.,"High neuroticism is a personality risk factor that reflects much of the genetic vulnerability to major depressive disorder (MDD), and low extraversion may increase risk as well. Both have been linked to the serotonin system. To test whether patients with MDD taking selective serotonin reuptake inhibitors (SSRIs) report greater changes in neuroticism and extraversion than patients receiving inert placebo, and to examine the state effect hypothesis that self-reported personality change during SSRI treatment is merely a change of depression-related measurement bias. A placebo-controlled trial. Research clinics. Patients Adult patients with moderate to severe MDD randomized to receive paroxetine (n = 120), placebo (n = 60), or cognitive therapy (n = 60). NEO Five-Factor Inventory and Hamilton Rating Scale for Depression. Patients who took paroxetine reported greater personality change than placebo patients, even after controlling for depression improvement (neuroticism, P < .001; extraversion, P = .002). The advantage of paroxetine over placebo in antidepressant efficacy was no longer significant after controlling for change in neuroticism (P = .46) or extraversion (P = .14). Patients taking paroxetine reported 6.8 times as much change on neuroticism and 3.5 times as much change on extraversion as placebo patients matched for depression improvement. Although placebo patients exhibited substantial depression improvement (Hamilton Rating Scale for Depression score, -1.2 SD, P < .001), they reported little change on neuroticism (-0.18 SD, P = .08) or extraversion (0.08 SD, P = .50). Cognitive therapy produced greater personality change than placebo (P </= .01); but its advantage on neuroticism was no longer significant after controlling for depression (P = .14). Neuroticism reduction during treatment predicted lower relapse rates among paroxetine responders (P = .003) but not among cognitive therapy responders (P = .86). Paroxetine appears to have a specific pharmacological effect on personality that is distinct from its effect on depression. If replicated, this pattern would disconfirm the state effect hypothesis and instead support the notion that SSRIs' effects on personality go beyond and perhaps contribute to their antidepressant effects.",Tang TZ.; DeRubeis RJ.; Hollon SD.; Amsterdam J.; Shelton R.; Schalet B.,2009.0,10.1001/archgenpsychiatry.2009.166,0,0,
3243,Eye movement desensitization and reprocessing for treating psychological disturbances in Taiwanese adolescents who experienced Typhoon Morakot.,"In this case-control study, we aimed to assess the intervention effects of four-session eye movement desensitization and reprocessing (EMDR) on reducing the severity of disaster-related anxiety, general anxiety, and depressive symptoms in Taiwanese adolescents who experienced Typhoon Morakot. A total of 83 adolescents with posttraumatic stress disorder related to Typhoon Morakot, major depressive disorder, or current moderate or high suicide risk after experiencing Typhoon Morakot were allocated to a four-session course of EMDR (N = 41) or to treatment as usual (TAU; N = 42). A multivariate analysis of covariance was performed to examine the effects of EMDR in reducing the severity of disaster-related anxiety, general anxiety, and depressive symptoms in adolescents by using preintervention severity values as covariates. The multivariate analysis of covariance results indicated that the EMDR group exhibited significantly lower preintervention severity values of general anxiety and depression than did the TAU group. In addition, the preintervention severity value of disaster-related anxiety in the EMDR group was lower than that in the TAU group (p = 0.05). The results of this study support that EMDR could alleviate general anxiety and depressive symptoms and reduce disaster-related anxiety in adolescents experiencing major traumatic disasters.",Tang TC.; Yang P.; Yen CF.; Liu TL.,2015.0,10.1016/j.kjms.2015.04.013,0,0,
3244,Post-traumatic psychological changes among survivors of the Lushan earthquake living in the most affected areas.,"The primary objective of our study was to investigate both the negative and positive psychological changes following the Lushan earthquake, and to explore the factors associated with psychological changes. Multi-stage random sampling was used to select respondents from Lushan County, Sichuan Province, China. A simplified Chinese version of the short form of Changes in Outlook Questionnaire (CiOQ-S) was used to assess psychological changes in earthquake survivors. Descriptive statistics, t-tests, ANOVA and stepwise linear regression analysis were used for data analysis. A total of 4972 respondents were investigated in the cross-sectional study. The mean scores of the positive and negative psychological changes were 26.61 and 8.12, respectively. The factors associated with positive psychological changes included ethnic minority, high level of education, high household income, not injured in the earthquake, not trapped during the earthquake, and having experienced the Wenchuan earthquake. The factors associated with negative psychological changes included female gender, ethnic minority, low household income, history of diseases, injured during the earthquake, and trapped during the earthquake. The current analysis helps expand our knowledge of the negative and positive psychological changes that may occur following an earthquake experience.",Tang B.; Kang P.; Liu X.; Liu Y.; Liu Z.; Wang B.; Lv Y.; Zhang L.,2014.0,10.1016/j.psychres.2014.07.050,0,0,
3245,Well-being and morbid obesity in women: a controlled therapy evaluation.,"Morbidly obese individuals are unlikely to reach and maintain normative weights. Thus, interventions aimed at alleviating corollary problems, independent of attempts at weight loss, are appropriate. A cognitive group treatment program (CT) was developed which incorporated a nondieting approach, regular exercise, and use of alternative coping skills. Weight loss per se was not a focus of the intervention. The purpose of the current work was to evaluate this program in a controlled, comparative treatment outcome study. Sixty-two obese women with a history of treatment failures were randomly assigned to the CT program, a behavior therapy weight loss program (BT), or a wait-list control group. For CT participants, depression, anxiety, and eating-related psychopathology decreased significantly over the course of treatment while perceptions of self-control increased; BT and control subjects showed no significant changes in these variables. Women in both active treatment groups lost significant amounts of weight, while members of the control group showed a nonsignificant increase in weight. At 6-month follow-up, treatment benefits were maintained. Findings suggest that interventions not directly aimed at weight loss can enhance psychological well-being and thus may be appropriate for some obese women.",Tanco S.; Linden W.; Earle T.,1998.0,,0,0,
3246,MOSAIC (MOthers' Advocates In the Community): protocol and sample description of a cluster randomised trial of mentor mother support to reduce intimate partner violence among pregnant or recent mothers.,"Intimate partner violence (IPV) is prevalent globally, experienced by a significant minority of women in the early childbearing years and is harmful to the mental and physical health of women and children. There are very few studies with rigorous designs which have tested the effectiveness of IPV interventions to improve the health and wellbeing of abused women. Evidence for the separate benefit to victims of social support, advocacy and non-professional mentoring suggested that a combined model may reduce the levels of violence, the associated mental health damage and may increase a woman's health, safety and connection with her children. This paper describes the development, design and implementation of a trial of mentor mother support set in primary care, including baseline characteristics of participating women. MOSAIC (MOtherS' Advocates In the Community) was a cluster randomised trial embedded in general practice and maternal and child health (MCH) nursing services in disadvantaged suburbs of Melbourne, Australia. Women who were pregnant or with infants, identified as abused or symptomatic of abuse, were referred by IPV-trained GPs and MCH nurses from 24 general practices and eight nurse teams from January 2006 to December 2007. Women in the intervention arm received up to 12 months support from trained and supported non-professional mentor mothers. Vietnamese health professionals also referred Vietnamese women to bilingual mentors in a sub-study. Baseline and follow-up surveys at 12 months measured IPV (CAS), depression (EPDS), general health (SF-36), social support (MOS-SF) and attachment to children (PSI-SF). Significant development and piloting occurred prior to trial commencement. Implementation interviews with MCH nurses, GPs and mentors assisted further refinement of the intervention. In-depth interviews with participants and mentors, and follow-up surveys of MCH nurses and GPs at trial conclusion will shed further light on MOSAIC's impact. Despite significant challenges, MOSAIC will make an important contribution to the need for evidence of effective partner violence interventions, the role of non-professional mentors in partner violence support services and the need for more evaluation of effective health professional training and support in caring for abused women and children among their populations. ACTRN12607000010493.",Taft AJ.; Small R.; Hegarty KL.; Lumley J.; Watson LF.; Gold L.,2009.0,10.1186/1471-2458-9-159,0,0,
3247,Cynophobic fear adaptively extends peri-personal space,"Peri-personal space (PPS) is defined as the space immediately surrounding our bodies, which is critical in the adaptation of our social behavior. As a space of interaction with the external world, PPS is involved in the control of motor action as well as in the protection of the body. The boundaries of this PPS are known to be flexible but so far, little is known about how PPS boundaries are influenced by unreasonable fear. We hypothesized that unreasonable fear extends the neural representation of the multisensory space immediately surrounding the body in the presence of a feared object, with the aim of expanding the space of protection around the body. To test this hypothesis, we explored the impact of unreasonable fear on the size of PPS in two groups of non-clinical participants: dog-fearful and non-fearful participants. The sensitivity to cynophobia was assessed with a questionnaire. We measured participants' PPS extent in the presence of threatening (dog growling) and non-threatening (sheep bleating) auditory stimuli. The sound stimuli were processed through binaural rendering so that the virtual sound sources were looming towards participants from their rear hemi-field. We found that, when in the presence of the auditory dog stimulus, the PPS of dog-fearful participants is larger than that of non-fearful participants. Our results demonstrate that PPS size is adaptively modulated by cynophobia and suggest that anxiety tailors PPS boundaries when exposed to fear-relevant features. Anxiety, with the exception of social phobia, has rarely been studied as a disorder of social interaction. These findings could help develop new treatment strategies for anxious disorders, by involving the link between space and interpersonal interaction in the approach of the disorder. © 2014 Taffou and Viaud-delmon.",Taffou M.; Viaud-Delmon I.,2014.0,10.3389/fpsyt.2014.00122,0,0,
3248,Regulation of hypothalamic-pituitary-adrenal activity in response to cognitive therapy in patients with generalized anxiety disorder.,"The aim of this study was to evaluate the efficacy of cognitive therapy (CT) in the treatment of generalized anxiety disorder (GAD), as it would be reflected through both psychological and psychoneuroendocrinological parameters. For this purpose, a group of outpatients with GAD were treated with CT for up to a maximum of 24 sessions. In order to assess psychological and biological changes, anxiety-related symptoms were evaluated according to the Hamilton Anxiety Rating Scale (HAM-A), and the hypothalamic-pituitary-adrenal (HPA) function was determined through assessment of circulating cortisol levels. A significant decrease in the HAM-A scores, along with significant changes in plasma cortisol levels, were observed after completion of treatment with CT. These observations contribute to demonstrate that the effect of certain psychotherapeutic approaches, such as CT, may be observed at both psychological and biological levels.",Tafet GE.; Feder DJ.; Abulafia DP.; Roffman SS.,2005.0,,0,0,
3249,[Total hip replacement in young patients with use of MAYO prosthesis--early result of treatment].,"Authors presented the results of the treatment of osteoarthritis of the hip with MAYO endoprosthesis. The paper is focused on young adults. 34 operations in the 2000-2006 were performed. Cementless MAYO stems were used. 32 patients (24 females and 8 males) were evaluated. The age of patients was 20-54 years (average 32,7 years). The main cause of the hip osteoarthritis was DDH (50%). Among others we identified posttraumatic deformities (14.7%), avascular necrosis of the head, multiepiphyseal dysplasia and the other (35.3%). Cementless press-fit Trilogy cup (Zimmer) was applied in 94.1% and cementless threaded acetabular cup in 5.9% patients. Results were analyzed according to clinical Hip Harris score and radiological assessment. After 7 years follow up good and very good outcomes were found in the majority of patients. Mayo stem causes minor damage of intertrochanteric region during procedure and has minimal effect on medullary cavity. It is an advantage in a case of the migration of endoprosthesis. It preserves the bone stock and allows Total Hip Replacement with cementless stem. Obtained results confirm the value of implantation of this kind of endoprosthesis in the case of young adults. Longer follow up period and bigger group of patients are required to confirm our observations.",Tadeusz N.; Adam N.; Lukasz N.,,,0,0,
3250,"Oxytocin, but not vasopressin, impairs social cognitive ability among individuals with higher levels of social anxiety: A randomized controlled trial.","Individuals with social anxiety are characterized by a high degree of social sensitivity, which can coincide with impairments in social cognitive functioning (e.g. theory of mind). Oxytocin (OT) and vasopressin (AVP) have been shown to improve social cognition, and OT has been theorized as a potential therapeutic agent for individuals with social anxiety disorder. However, no study has investigated whether these neuropeptides improve social cognitive ability among socially anxious individuals. In a randomized, double-blind, placebo controlled, between-subjects design we investigated whether social anxiety moderated the effects of OT or AVP (vs placebo) on social working memory (i.e. working memory that involves manipulating social information) and non-social working memory. OT vs placebo impaired social working memory accuracy in participants with higher levels of social anxiety. No differences were found for non-social working memory or for AVP vs placebo. Results suggest that OT administration in individuals with higher levels of social anxiety may impair social cognitive functioning. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Tabak, Benjamin A; Meyer, Meghan L; Dutcher, Janine M; Castle, Elizabeth; Irwin, Michael R; Lieberman, Matthew D; Eisenberger, Naomi I; Bartz, Bartz, Chevallier, Clark, Declerck, Domes, Feeser, Guastella, Hariri-Dahan, Hayes, Hezel, Leng, Liebowitz, Macdonald, Macdonald, Marin, Mattick, Meyer, Meyer, Meyer, Meyer-Lindenberg, Neumann, Niles, O'Toole, Plana, Radke, Rilling, Rilling, Shalev, Shamay-Tsoory, Spielberger, Sutterby, Tabak, Tabak, Tabak, Thompson, Thompson, Tibi-Elhanany",2016.0,,0,0,
3251,"Burn injuries, pain and distress: exploring the role of stress symptomatology.",Forty-three consecutive patients were assessed for post-traumatic stress 7 days after admission to hospital. Patients were asked to complete the Impact-of-Event Scale. Findings indicated that among the 43 patients 52.1 per cent experienced serious levels of stress symptomatology. A Visual Analog Thermometer was employed to measure the pain experienced at rest and during therapeutic procedures. High levels of post-traumatic stress were associated with higher pain scores during therapeutic procedures and more pain when at rest.,Taal LA.; Faber AW.,1997.0,,0,0,
3252,Dissociation as a predictor of psychopathology following burns injury.,"Forty-six burned adults were seen, on average 7 days after admission to hospital. Eighty per cent suffered from one or more dissociative symptoms during trauma and three or more dissociative phenomena were experienced by 19.5 per cent. Blunting or absence of emotion was the symptom most frequently reported. The number of dissociative phenomena during trauma was statistically significant and associated with extreme anxiety. The intensity of the dissociation-anxiety reaction during trauma was a predictor for psychopathology measured at the moment of discharge.",Taal LA.; Faber AW.,1997.0,,0,0,
3253,"Post-traumatic stress, pain and anxiety in adult burn victims.","This article describes the relationship between post-traumatic morbidity, anxious anticipation of pain and pain perception in 33 adult burn patients. Burn patients were assessed, on average, 7 days after admission to the hospital. Five times a day nurses asked the patients to provide pain ratings. The more patients suffered from post-traumatic stress, the more their anxiety state was elevated. The association between post-traumatic stress and pain perception was, controlling for the effects of anxious anticipation, spurious.",Taal LA.; Faber AW.,,,0,0,
3254,Prevention of anxiety and depression in the age group of 75 years and over: a randomised controlled trial testing the feasibility and effectiveness of a generic stepped care programme among elderly community residents at high risk of developing anxiety and depression versus usual care,"ER METHODS/DESIGNDESIGNrandomised controlled trial. (See figure 1: organisation chart) together with two other projects, this project is part of a national consortium that investigates the prevention of anxiety and depressive disorders in later life using a stepped care programme. The three projects have their own particular focus. This project is aimed at elderly living in the community.Inclusion: subjects with a high risk for depression and anxiety without clinical evidence of these syndromes. The participants are 75 years of age and over and have subthreshold symptoms of depression and or anxiety: they score above the cut-off point on the self-report Centre for Epidemiologic Studies Depression (CES-D) scale, but the criteria for a major depressive disorder or anxiety disorder (panic disorder, agoraphobia, social phobia, generalized anxiety disorder) according to a validated interview, the Mini International Neuropsychiatric Interview (MINI) are not fulfilled.OUTCOMESprimary outcome: incidence of a depressive or anxiety disorder over a period of two years (MINI); secondary outcome: a positive influence of the intervention, a stepped care programme, on symptoms of depression and anxiety and on quality of life as assessed with the CES D, the HADS A and the SF36 respectively (i.e. stabilisation or improvement of symptoms) [see table 1].MEASUREMENTSTake place at baseline and at 3, 6, 9, 12, 18 and 24 months. Trained independent evaluators assess depression and anxiety status, the primary end point (6, 12, 18, 24 months) [see table 2].DISCUSSIONLate-life depression and anxiety are characterised by high prevalence, unfavourable prognosis, reduced quality of life, excess mortality and substantial societal costs. No health service, however well equipped, will be able to effectively treat all elderly with depression and anxiety. Therefore, development of (cost) effective means to prevent these disorders is very important.BACKGROUNDIn frail elderly, the effects of depression and anxiety are deep encroaching. Indicated prevention studies, aimed at subjects with subthreshold disorder, have shown that well designed interventions are capable of reducing the incidence of depression and anxiety. In this randomised prevention trial for elderly, living in the community and suffering from subthreshold depression and anxiety, a stepped care programme was put together to be tested versus usual (GP) care.","'t, Veer-Tazelaar N; Marwijk, H; Oppen, P; Nijpels, G; Hout, H; Cuijpers, P; Stalman, W; Beekman, A",2006.0,10.1186/1471-2458-6-186,0,0,
3255,[Changes of sense of coherence (SOC) after psychotherapy in neurotic patients].,"Sense of coherence (SOC) is the central construct of the salutary model of health. Sense of coherence comprises comprehensibility, manageability and meaningfulness. The aim of the study was to check if the sense of coherence can change after psychotherapy in neurotic patients, if the value of the changes depends on the level of sense of coherence and if the obtained changes are stable. 101 patients (32 males, 69 females, aged between 17 and 48 years) with neurotic disorders defined according to ICD-10 criteria were the subject of the study. This group of patients were hospitalized in the Neurotic Ward of the Psychiatry Department in Lublin. They took part in a 10-week psychotherapeutic programme. In the study, the authorized Polish adaptation of the Orientation to Life Questionnaire (SOC-29) by Antonovsky was used to measure the sense of coherence. Patients were examined prior to and on completion of the treatment programme. In the next stage of the study patients filled in the SOC-29 Questionnaire after six months. Dependent sample t-test was used in data analysis. Significant favourable changes were found in patients with a low SOC level. The increase of SOC was observed after a 10-week treatment. The increase was stable in examination after six months. Changes in sense of coherence in the group with high SOC level were not observed. The results suggest that the therapy can be more effective in patients with a low SOC level.",Szymona K.,,,0,0,
3256,Fear of Spiders Questionnaire.,"The Fear of Spiders Questionnaire (FSQ), an 18-item self-report questionnaire assessing spider phobia, was developed in an attempt to complement the information provided by the Spider Phobia Questionnaire (SPQ). Data obtained from 338 undergraduates revealed that the FSQ was able to discriminate phobics from nonphobics, and indicated decrements in phobic responding from pretest to posttest following cognitive therapy. Test-retest data, obtained from non-treatment control groups, indicated that scores on the FSQ are stable over a one month period. The FSQ also demonstrated adequate convergent validity due to its significant correlations with the SPQ and a behavioral avoidance test. Finally, a factor analysis revealed two factors accounting for 55% of the variance. It is argued that, compared to the SPQ, items on the FSQ are more explicit regarding the time period to be assessed, and may be more sensitive to differences between phobics and nonphobics and decrements in phobic responding following treatment.",Szymanski J.; O'Donohue W.,1995.0,,0,0,
3257,Grey matter abnormalities in social anxiety disorder: a pilot study.,"While a number of studies have explored the functional neuroanatomy of social anxiety disorder (SAD), data on grey matter integrity are lacking. We conducted structural MRI scans to examine the cortical thickness of grey matter in individuals with SAD. 13 unmedicated adult patients with a primary diagnosis of generalized social anxiety disorder and 13 demographically (age, gender and education) matched healthy controls underwent 3T structural magnetic resonance imaging. Cortical thickness and subcortical volumes were estimated using an automated algorithm (Freesurfer Version 4.5). Compared to controls, social anxiety disorder patients showed significant bilateral cortical thinning in the fusiform and post central regions. Additionally, right hemisphere specific thinning was found in the frontal, temporal, parietal and insular cortices of individuals with social anxiety disorder. Although uncorrected cortical grey matter volumes were significantly lower in individuals with SAD, we did not detect volumetric differences in corrected amygdala, hippocampal or cortical grey matter volumes across study groups. Structural differences in grey matter thickness between SAD patients and controls highlight the diffuse neuroanatomical networks involved in both social anxiety and social behavior. Additional work is needed to investigate the causal mechanisms involved in such structural abnormalities in SAD.",Syal S.; Hattingh CJ.; Fouché JP.; Spottiswoode B.; Carey PD.; Lochner C.; Stein DJ.,2012.0,10.1007/s11011-012-9299-5,0,0,
3258,Failure to replicate the deleterious effects of safety behaviors in exposure therapy.,"The current study attempted to replicate the finding obtained by Powers, Smits, and Telch (2004; Journal of Consulting and Clinical Psychology, 72, 448-545) that both the availability and utilization of safety behaviors interfere with the efficacy of exposure therapy. An additional goal of the study was to evaluate which explanatory theories about the detrimental effects of safety behaviors best account for this phenomenon. Undergraduate students (N=58) with high claustrophobic fear were assigned to one of three treatment conditions: (a) exposure only, (b) exposure with safety behavior availability, and (c) exposure with safety behavior utilization. Participants in each condition improved substantially, and there were no significant between-group differences in fear reduction. Unexpectedly, exposure with safety behavior utilization led to significantly greater improvement in self-efficacy and claustrophobic cognitions than exposure only. The extent to which participants inferred danger from the presence of safety aids during treatment was associated with significantly less improvement on all outcome measures. The findings call into question the hypothesized deleterious effects of safety behaviors on the outcome of exposure therapy and highlight a possible mechanism through which the mere presence of safety cues during exposure trials might affect treatment outcomes depending on participants' perceptions of the dangerousness of exposure stimuli.",Sy JT.; Dixon LJ.; Lickel JJ.; Nelson EA.; Deacon BJ.,2011.0,10.1016/j.brat.2011.02.005,0,0,
3259,Arthroscopic assessment of medial malleolar reduction.,"Ankle fractures treated with open reduction internal fixation are fixed in an effort to reestablish anatomic bony alignment and avoid a malunion, thereby diminishing the risk of post-traumatic arthritis. For a medial malleolar fracture, an articular step-off is likely more related to the risk of post-traumatic arthritis than is a cortical step-off. However, the external cortical alignment is often used to judge the adequacy of reduction, as the articular component of the fracture is not as readily visualized. Arthroscopy has been used in various articular fractures as an aid to diagnosis and treatment. The current study prospectively assessed both the quality of medial malleolar reduction on the articular side using arthroscopy and the adequacy of using cortical cues to guide the articular reduction. Twelve consecutive patients were enrolled in this prospective diagnostic study. All patients had medial malleolar fractures that required fixation. The outcome variables of interest were extra-articular fracture displacement and articular surface displacement. After reduction and provisional fixation, 10 of the 12 patients had an anatomic reduction based on cortical cues. On arthroscopy 7 of the 12 patients had an anatomic reduction. Four of the patients had a slight gap (<1 mm) at the anterior edge of the fracture. The last patient had an anterior gap just under 2 mm. Two patients had impaction of the medial malleolus that made reduction difficult and was recognized during arthroscopy after obtaining a reduction based on cortical cues. The cortical reduction of the medial malleolus often matched up with the articular reduction. However, in some patients, impaction of the medial malleolus made it so that the two did not match up. There are some cases in which extra-articular cues are insufficient to evaluate for intra-articular reduction.",Swart EF.; Vosseller JT.,2014.0,10.1007/s00402-014-2031-7,0,0,
3260,Association between varus alignment and post-traumatic osteoarthritis after anterior cruciate ligament injury.,"To investigate the association between varus alignment and post-traumatic osteoarthritis (OA) after an anterior cruciate ligament (ACL) injury. One hundred subjects with an acute complete ACL tear were followed for 15 years. Anterior-posterior radiographs of the tibiofemoral joint were obtained with a knee flexion of 20°, and the patellofemoral joint was examined with skyline view at 50° knee flexion. Joint space narrowing and osteophytes were graded in the tibiofemoral and patellofemoral joints in the injured (ACL) and uninjured knee according to the radiographic atlas of the Osteoarthritis Research Society International. The alignment of the uninjured, contralateral knee was measured at follow-up, using full-limb radiographs of leg with the knee in full extension. Alignment was expressed as the hip-knee-ankle (HKA) angle. Alignment was defined as valgus (HKA ≤178°), neutral (179°-181°) or varus (≥182°). Data from 68 subjects were included in the analysis. Varus alignment of the uninjured knee at follow-up appeared to be associated with OA of the injured knee 15 years after an ACL injury (odds ratio (95% confidence interval) 3.9 (1.0-15.8, p = 0.052)). Varus alignment of the uninjured knee at follow-up may be associated with OA of the injured knee 15 years after an ACL injury. II.",Swärd P.; Fridén T.; Boegård T.; Kostogiannis I.; Neuman P.; Roos H.,2013.0,10.1007/s00167-013-2550-8,0,0,
3261,The use of the human figure drawing with pregnant women,"Human figure drawings (HFDs) taken from the Prenatal Art Therapy Intervention and Inventory (PATII) were scored in exploratory research using the adapted Formal Elements Art Therapy Scale (FEATS) and Content Tally Sheet [L. Gantt & C. Tabone (1998) Formal Elements Art Therapy Scale: the rating manual, Morgantown, WV: Gargoyle Press] to observe structural elements of the drawings. Out of three groups of 20 high risk outpatient (HRO), 20 high risk inpatient (HRI), and 20 low risk outpatient (LR) prenatal women (60 drawings), 10 HFDs from each group (30 drawings) were randomly selected and scored. Preliminary statistical analysis focused on five adapted FEATS scales scoring for visual structural elements assessing colour, space, detail, person, and implied energy. The structural elements of the drawings scored with the FEATS indicated that the two high risk groups consistently scored low, suggesting a tendency for depression, while the LR group scored high, suggesting an absence of this tendency. In addition, visual observations noted differences between the groups for transparencies, visibility of foetus, and colour usage. These data give a preliminary indication for future research using a nonverbal tool, like the HFD, to investigate prenatal emotions or psychological distress (such as depression or anxiety).",Swan-Foster N.; Foster S.; Dorsey A.,2003.0,10.1080/02646830310001622105,0,0,
3262,"Food craving, stress and limbic irritability","Recent findings show that food craving is strongly related to emotional distress. Stress-induced feeding is a phenomenon related to sensitization associated with repeated stress stimuli and related increase in incentive salience attributed to known familiar foods and increased craving. Because stress sensitization may also produce seizure-like activity, aim of the present study was to test a hypothesis that food craving could be linked to heightened level of seizure-like symptoms that present cognitive and affective symptoms related to temporo-limbic hyperexcitability. In order to achieve this goal we have measured indices of food craving, traumatic stress and seizure-like symptoms using psychometric measures in 257 university students. The results indicate statistically significant correlations of food craving with traumatic stress symptoms (r=0.26, p<0.05), dissociative symptoms (r=0.37, p<0.01) and seizure-like symptoms (r=0.41, p<0.01). These results present first supportive evidence that food craving in healthy persons may be related to traumatic stress and seizure-like symptoms. The present results also support findings that traumatic stress may lead to kindling-like sensitization that could play a role in food craving mechanisms.",Svetlak M.,2010.0,,0,0,
3263,Effects of cognitive-behavioral therapy on anxiety in children with autism spectrum disorders: a randomized controlled trial,"ER We compared the effects of a 16-week Cognitive-Behavioral Therapy (CBT) program and a Social Recreational (SR) program on anxiety in children with Autism Spectrum Disorders (ASD). Seventy children (9-16 years old) were randomly assigned to either of the programs (n (CBT) = 36; n (SR) = 34). Measures on child's anxiety using the Spence Child Anxiety Scale--Child (SCAS-C) and the Clinical Global Impression-Severity scale (CGI--S) were administered at pre-, post-treatment, and follow-ups (3- and 6-month). Children in both programs showed significantly lower levels of generalized anxiety and total anxiety symptoms at 6-month follow-up on SCAS-C. Clinician ratings on the CGI-S demonstrated an increase in the percentage of participants rated as ""Normal"" and ""Borderline"" for both programs. Findings from the present study suggest factors such as regular sessions in a structured setting, consistent therapists, social exposure and the use of autism-friendly strategies are important components of an effective framework in the management of anxiety in children and adolescents with ASD.","Sung, M; Ooi, Y P; Goh, T J; Pathy, P; Fung, D S; Ang, R P; Chua, A; Lam, C M",2011.0,10.1007/s10578-011-0238-1,0,0,
3264,Lactic acid response to caffeine in panic disorder: comparison with social phobics and normal controls,,"Tancer, M E; Stein, M B; Uhde, T W",1994.0,,0,0,
3265,Blunted growth hormone responses to growth hormone-releasing factor and to clonidine in panic disorder,"ER Blunted growth hormone (GH) responses to growth hormone-releasing factor (GH-RF) and clonidine have been reported in patients with panic disorder. In this study GH-RF and clonidine were administered to 13 patients with panic disorder and 20 healthy volunteers. Compared to the normal subjects, the patients with panic disorder had significantly blunted GH responses after both GH-RF and clonidine.","Tancer, M E; Stein, M B; Black, B; Uhde, T W",1993.0,10.1176/ajp.150.2.336,0,0,
3266,Salutary proximal processes and distal mood and anxiety vulnerability outcomes of mindfulness training: a pilot preventive intervention.,"The present study evaluated the effect of a brief mindfulness-based preventive intervention on (a) dispositional (MAAS; Brown & Ryan, 2003) and state (SMS; Tanay & Bernstein, 2010) mindfulness; (b) putative proximal factors/processes engendered through the development of mindfulness, including increased decentering (EQ-D; Fresco et al., 2007) and reduced experiential avoidance (AAQ; Hayes et al., 2004); and (c) distal mood and anxiety vulnerability factors, including reduced depression-related dysfunctional attitudes, (DAS; de Graaf, Roelofs, & Huibers, 2009), anxiety sensitivity (ASI-3; Taylor et al., 2007), and negative affectivity (PANAS-NA; Watson, Clark, & Tellegen, 1988) among a university-community sample in Israel. Fifty-three adult participants between the ages of 20 and 52 (M(age)=25.2 years, SD(age)=4.3 years; 65.4% women) were recruited from the Haifa University community. Nineteen participants were randomly assigned to an experimental condition (M(age)=25.3 years, SD(age)=4.3 years; 66% women) and studied prospectively over the course of a four-session (21-day) mindfulness skills training intervention; and 34 participants were randomly assigned to a no-intervention (control) condition (M(age)=24.9 years, SD(age)=2.4years; 64.7% women) and studied prospectively. Findings demonstrate statistically robust and clinically significant relations between mindfulness and the theorized proximal and distal mood and anxiety vulnerability factors. Findings are discussed with respect to their theoretical implications for better understanding mindfulness-psychopathology vulnerability relations, clinical implications for larger-scale universal and selective transdiagnostic prevention efforts, and future directions for this area of research.",Tanay G.; Lotan G.; Bernstein A.,2012.0,10.1016/j.beth.2011.06.003,0,0,
3267,[The TNK ankle: short- and mid-term results].,"Total ankle replacement has been introduced in the last 30 years. The TNK ankle is build from ceramics, and it was continuously improved. This prosthesis has the longest fellow-up times. Seventy ankle prostheses of the newest generation has been implanted between 1991 and 2001. Of these, 67 prostheses were assessed clinically and radiographically after 62 months (range, 24 to 132 months). Three ankles have been revised. The clinical score improved for the patients with primary or posttraumatic arthritis from 34 to 86, and for the patients with rheumatoid arthritis from 45 to 74. Loosening was found in 4 ankles with non-rheumatoid arthritis, and in 17 ankles with rheumatoid ankles. Total ankle replacement has emerged to a valuable alternative to ankle arthrodesis, and satisfactory results have been achieved with the current implants. The bone-implant interphase might play a most important factor for success. There is evidence that the biologic advantages of ceramics may help to improve long-lasting success in total ankle replacement.",Tanaka Y.; Takakura Y.,2006.0,10.1007/s00132-006-0942-x,0,0,
3268,A randomized effectiveness trial of interpersonal psychotherapy for depressed women with sexual abuse histories.,"Many depressed women seen in community mental health centers (CMHCs) have histories of childhood sexual abuse and are economically disadvantaged. Randomized trials are needed to test the effectiveness of evidence-based interventions in this population and setting. This study compared interpersonal psychotherapy with usual care psychotherapy among women in a CMHC. Among 1,100 women seeking treatment in a CMHC, 230 (21%) had major depression and histories of childhood sexual abuse. Seventy women with major depression and sexual abuse before age 18 were randomly assigned to interpersonal psychotherapy (N=37) or usual care psychotherapy (N=33). Staff clinicians provided all treatments. Participants were assessed at study entry and at ten, 24, and 36 weeks after random assignment. Generalized estimating equations were used to examine change over time. Compared with women assigned to usual care, women who received interpersonal psychotherapy had greater reductions in depressive symptoms (Hamilton Rating Scale, p=.05, d=.34; Beck Depression Inventory-II, p=.01, d=.29), posttraumatic stress disorder symptoms (p=.04, d=.76), and shame (p=.002, d=.38). Interpersonal psychotherapy and usual care yielded comparable improvements in social and mental health-related functioning. Interpersonal psychotherapy compared favorably to usual care psychotherapy in a CMHC in improving psychiatric symptoms and reducing shame among sexually abused women. However, there is a critical need for continued research to develop more effective treatments for the social and psychiatric sequelae of interpersonal trauma and socioeconomic disadvantage.",Talbot NL.; Chaudron LH.; Ward EA.; Duberstein PR.; Conwell Y.; O'Hara MW.; Tu X.; Lu N.; He H.; Stuart S.,2011.0,10.1176/ps.62.4.pss6204_0374,0,0,
3269,Subjective Social Status and Rumination in Relation to Anxiety and Depressive Symptoms and Psychopathology Among Economically Disadvantaged Latinos in Primary Care,"The present investigation examined the interactive effects of subjective social status and rumination in relation to anxiety/depressive symptoms and psychopathology among 276 Latinos (82% female; Mage = 39.2, SD = 11.1; 97.0% reported Spanish as first language) who attended a community-based primary health care clinic. Results indicated that the interaction between rumination and subjective social status was significantly associated with depression (B = -.04, t = -3.52, p < .001, 95% CI [-.06, -.02]), social anxiety (B = -.01, t = -3.84, p < .001, 95% CI [-.02, -.01]), and the number of mood and anxiety disorders (B = -.004, t = -2.80, p = .005, 95% CI [-.006, -.001]), after controlling for main effects of rumination and subjective social status. The form of the interactions suggested that the associations of rumination and the outcome variables were stronger for those with lower compared to higher subjective social status. For anxious arousal symptoms, however, there was not a statistically significant interaction. These findings underscore the potential importance of examining the interplay between rumination and subjective social status in regard to better understanding, and intervening to reduce, various forms of anxiety/depressive symptoms and disorders among Latinos in primary care settings. (PsycINFO Database Record",Talavera D.C.; Paulus D.J.; Garza M.; Ochoa-Perez M.; Lemaire C.; Valdivieso J.; Bogiaizian D.; Robles Z.; Bakhshaie J.; Manning K.; Walker R.; Businelle M.; Zvolensky M.J.,2017.0,10.1037/ort0000223,0,0,
3270,Isolation and characterization of enhanced berberine from the calli cultures of Coscinium fenestratum L. an endangered medicinal liana of Western Ghat India,"Present study describes in detail isolation and characterization of berberine isolated from the calli cultures of an endangered medicinal plant Coscinium fenestratum. Petiole derived calli cultures were established in MS medium supplemented with 2,4-D and BAP. Air dried calli cultures were homogenized with mortar and pestle then pure methanol was used repeatedly to extract until all the brown color had been removed from the material. Methanol was evaporated and the concentrated extract was separated by preparative TLC by using ethyl acetate: methanol (7:3). The crude extract was loaded into a silica column and eluted with different fractions of solvents from increasing polarity. The yellow fluorescent fraction showed the presence of berberine by TLC, was collected and evaporated by dryness. Yellow colored powder thus obtained was identified by comparing Rf- values on TLC. NMR data of the compound obtained from the calli cultures of C.fenestratum explain the presence of 20 carbons with 18 Protons. Observed molecular weight is 336 and molecular formula C 20H18NO4 indicated the compound as berberine which is similar to the authentic sample of berberine and it is about 18 folds higher compared to the petiole of intact plant is the first report of yielding maximum berberine content compare to earlier studies.",Talat K.; Krupadanam G.L.D.; Anwar S.Y.,2009.0,,0,0,
3271,"Confidence, not consistency, characterizes flashbulb memories.","On September 12, 2001, 54 Duke students recorded their memory of first hearing about the terrorist attacks of September 11 and of a recent everyday event. They were tested again either 1, 6, or 32 weeks later. Consistency for the flashbulb and everyday memories did not differ, in both cases declining over time. However, ratings of vividness, recollection, and belief in the accuracy of memory declined only for everyday memories. Initial visceral emotion ratings correlated with later belief in accuracy, but not consistency, for flashbulb memories. Initial visceral emotion ratings predicted later posttraumatic stress disorder symptoms. Flashbulb memories are not special in their accuracy, as previously claimed, but only in their perceived accuracy.",Talarico JM.; Rubin DC.,2003.0,10.1111/1467-9280.02453,0,0,
3272,Physiological changes in the treatment of acrophobia (fear of height).,"In order to investigate the physiological changes produced by the treatment of acrophobic patients body movement and Microvibration were measured before and after treatment. Eighteen acrophobic patients were assigned at random to 1 of the 2 groups: a treatment group (n = 8) and a non-treatment group (n = 10). The control group consisted of 16 healthy volunteers. Body movement area while viewing a slide of a high place or imagining a high place in the treatment group decreased significantly after treatment. Body movement of the control group showed almost no changes, and that of the non-treatment group was situated between the above-mentioned 2 groups. Simple body movements of the acrophobic patients without any stimulation of height were bigger than those of the control subjects. MV pattern of the treatment group had a tendency to improve under psycho-therapy. Acrophobic patients had more abnormal MV patterns than the normal subjects.",Takeya T.; Ohno Y.; Matsubara H.; Yasuda K.; Watanabe S.; Shinzato R.; Tanaka Y.; Noda S.,1979.0,,0,0,
3273,A randomized controlled trial of pharyngeal cooling system during cardiopulmonary resuscitation,"INTRODUCTION: The development of a technique that enables brain temperature to be immediately and selectively reduced without affecting systemic circulation is needed to perform resuscitative hypothermia in a clinical situation. Since bilateral common carotid arteries exist at 1 cm from the pharynx, cooling the pharyngeal region decreases the carotid arterial temperature first and subsequently decreases brain temperature before lowering cardiac temperature. A multi-center (12 of emergency critical care centers in Japan) prospectively randomized controlled trial of pharyngeal cooling system during cardiopulmonary resuscitation will start in June 2009. PURPOSE: This study will be performed to elucidate the effects of pharyngeal cooling initiated during resuscitation on tympanic temperature, neurological recovery and mortality rate Image presentes. INCLUSION CRITERIA: 1. Patients (16-89 years) with witnessed cardiogenic cardiac arrest or witnessed noncardiogenic cardiac arrest except posttraumatic cardiac arrest. 2. Patients who have been resuscitated by medical services within 15 min after the onset of cardiac arrest. TREATMENTS: Patients in the treatment group will undergo pharyngeal cooling during resuscitationorwithin30 minafter theonsetofspontaneouscirculation.Aftertracheal intubation, pharyngeal cooling cuff is inserted into the pharynx. Physiological saline (5°C) circulates into the pharyngeal cooling cuff at the rate of 500 ml/min for 2 h. Intra cuff pressure is controlled at 50 cmH2O. PRIMARY ENDPOINT AND POWER ANALYSIS: Lowering tympanic temperature greater than 1 degree centigrade.According to the power analysis, 300 cases will be needed. SECONDARY ENDPOINTS 1: Glasgow Coma Scale at 2 weeks after resuscitation. 2. Glasgow Pittsburgh cerebral performance and overall performance categories at 1 month and 6 months after resuscitation. 3. Mortality rates at 1 month, 3 months and 6 months after resuscitation.",Takeda Y.; Shiraishi K.; Naito H.; Morimoto N.; Morita K.,2009.0,,0,0,
3274,A randomized controlled trial of pharyngeal cooling system during cardiopulmonary resuscitation,"Introduction: The development of a technique that enables brain temperature to be immediately and selectively reduced without affecting systemic circulation is needed to perform resuscitative hypothermia in a clinical situation. Since bilateral common carotid arteries exist at 1 cm from the pharynx, cooling the pharyngeal region decreases the carotid arterial temperature first and subsequently decreases brain temperature before lowering cardiac temperature. A multi-center (12 of emergency critical care centers in Japan) prospectively randomized controlled trial of pharyngeal cooling system during cardiopulmonary resuscitation will start in June 2009. Purpose: This study is designed to elucidate the effects of pharyngeal cooling initiated during resuscitation on tympanic temperature, neurological recovery and mortality rate. Study Design: Randomized controlled trial. Inclusion Criteria 1. Patients (16 to 89 y) with witnessed cardiogenic cardiac arrest or witnessed non-cardiogenic cardiac arrest except posttraumatic cardiac arrest. 2. Patients who have been resuscitated by medical services within 15 minutes after the onset of cardiac arrest. Treatments Patients in the treatment group will undergo pharyngeal cooling during resuscitation or within 30 minutes after the onset of spontaneous circulation. After tracheal intubation, pharyngeal cooling cuff is inserted into the pharynx. Physiological saline (5°C) circulates into the pharyngeal cooling cuff at the rate of 500 mL/min for 2 hours. Intra cuff pressure is controlled at 50cmH2O. Primary endpoint and power analysis Lowering tympanic temperature greater than 1 degree centigrade. According to the power analysis, 300 cases will be needed. Secondary endpoints 1. Glasgow Coma Scale at 2 weeks after resuscitation 2. Glasgow Pittsburgh cerebral performance and overall performance categories at 1 month and 6 months after resuscitation 3. Mortality rates at 1 month, 3 months and 6 months after resuscitation. According to the power analysis, 1500 cases will be needed. Term of this experiment. June 1st 2009 - March 31 2011.",Takeda Y.; Shiraishi K.; Naito H.; Hagioka S.; Morimoto N.; Morita K.,2009.0,10.1097/01.ana.0000358102.35410.08,0,0,
3275,Differences between the physiologic and psychologic effects of aromatherapy body treatment.,"The wide use of herbal plants and essential oils for the prevention and treatment of diseases dates back to ancient times. However, the scientific basis for the beneficial effects of such plants and oils has not been precisely clarified. The purpose of this study was to evaluate the effects of aromatherapy body treatment on healthy subjects. We compared the physiologic and psychologic effects of aromatherapy body treatment (E), massage treatment with carrier oil alone (C), and rest in healthy adults. Seven (7) female and 6 male volunteers participated as subjects. Each subject underwent 3 trials, in which the Advanced Trail Making Test (ATMT) was given as a stress-inducing task before and after 1 of 3 treatments. The State Anxiety Inventory (SAI), the Visual Analog Scale, and the Face Scale were used to assess anxiety, feelings, and mood, respectively. After the treatments, the SAI score and the feelings of fatigue were decreased, the positive and comfortable feelings were increased, and mood improved significantly in C and E. Furthermore, significant declines in the feelings of mental and total fatigue were maintained even after the second ATMT in E. On the other hand, the cortisol concentration in the saliva did not show significant changes in any of the trials. Secretory immunoglobulin A levels in the saliva increased significantly after all treatments. We conclude that massage treatments, irrespective of the presence of essential oils, are more advantageous than rest in terms of psychologic or subjective evaluations but not in terms of physiologic or objective evaluations. Furthermore, as compared to massage alone, the aromatherapy body treatment provides a stronger and continuous relief from fatigue, especially fatigue of mental origin.",Takeda H.; Tsujita J.; Kaya M.; Takemura M.; Oku Y.,2008.0,10.1089/acm.2007.0591,0,0,
3276,A multicenter randomized controlled dose study of ursodeoxycholic acid for chronic hepatitis C,"ER The effect of ursodeoxycholic acid on liver function tests and on bile acid metabolism was investigated in a multi-center randomized controlled dose study for chronic hepatitis C. Twenty, 18 and 19 patients were administered 150, 600 and 900 mg/day, respectively of ursodeoxycholic acid every day for 16 wk. Serum liver parameters and bile acid composition in the treatment groups were compared with 17 control patients. A similarly significant decrease of serum alanine aminotransferase and serum gamma-glutamyltransferase was observed in patients administered 600 and 900 mg of ursodeoxycholic acid. Serum bile acid composition was determined by high-performance liquid chromatography. At entry, the relative proportions of major bile acids were similar to those observed in normal individuals. Maximal concentrations of total ursodeoxycholic acid were 0.30 mumol/L, 5.59 mumol/L, 21.42 mumol/L and 14.73 mumol/L in the control, 150, 600 and 900 mg/day groups, respectively. The fraction of the total ursodeoxycholic acid increased in a dose-dependent manner, and it was significantly higher than in controls (p < 0.001). The hydrophobicity index of bile acids was calculated by the method of Heuman, and its correlation with serum parameter levels was analyzed. In the 600 and 900 mg/day dose groups, serum alanine aminotransferase decreased in the cases in which hydrophobicity index significantly decreased during treatment. The same correlation was observed between the hydrophobicity index and serum gamma = glutamyltransferase in these two groups. There was no correlation between these parameters in the control and 150-mg groups. There was no correlation between reduction rate of serum alanine aminotransferase and initial liver histology.(ABSTRACT TRUNCATED AT 250 WORDS)","Takano, S; Ito, Y; Yokosuka, O; Ohto, M; Uchiumi, K; Hirota, K; Omata, M",1994.0,,0,0,
3277,"Efficacy of open-system social skills training in inpatients with mood, neurotic and eating disorders.","Open-system social skills training (SST) was performed in an open psychiatric ward of the hospital of Yokohama City University. Between June 1998 and March 2000, 223 patients were being treated for various mental disorders and 136 of these patients voluntarily participated in the open-system SST at least once. The SST participants' ages were 37.2 +/- 16.9 years and the admission period was 102.6 +/- 61.4 days, while non-participants' ages were 49.8 +/- 18.8 years and the admission period was 71.8 +/- 55.6 days. The correlation between participation time and the admission period showed a ratio of approximately 0.5. As for diagnoses, schizophrenia, eating disorder and personality disorder patients tended to participate in SST, while organic mental disorder patients tended to be non-participants. After October 1998 there were 26 patients continuing to attend SST who participated in the evaluation study that compared social skills estimation before SST with that after SST by self-evaluation and by the staff using a social skills questionnaire. After SST sessions, the average staff evaluation score was 43.9% in schizophrenia, 64.4% in mood disorder, 64.9% in neurotic disorder and 55.3% in eating disorders, while they were 29.1%, 33.8%, 44.4% and 34.5% before the sessions, respectively. After the SST sessions, mood disorder patients showed a 25-30% increase of both self-estimation and staff estimation in all subcategories of social skills. These findings suggest that SST was effective for all patients motivated to improve their social skills despite diagnoses and that the SST program had different effects in each diagnosis group.",Takahashi M.; Kosaka K.,2003.0,10.1046/j.1440-1819.2003.01120.x,0,0,
3278,Effects of nasal continuous positive airway pressure on panic disorder comorbid with obstructive sleep apnea syndrome.,"Both obstructive sleep apnea syndrome (OSAS) and panic disorder (PD) are common disorders that often coexist. Continuous positive airway pressure (CPAP) has been established as the first-line treatment for OSAS. In this study, we examined the efficacy of CPAP on PD comorbid with OSAS by conducting a randomized crossover study using sham CPAP as control. PD patients (n=12) with an apnea hypopnea index (AHI) of 20/h or higher completed the study. At baseline, the subjects were asked to write their own records pertaining to the frequency of attacks and their score on the panic disorder severity scale (PDSS), and then they participated in the randomized crossover trial period, which measured optimal CPAP and sham CPAP set at 4cmH(2)O during nighttime sleep for each 4-week assignment. The frequency of panic attacks, total PDSS score, and the frequency of alprazolam use for alleviating the attack symptoms were significantly decreased during the optimal CPAP period than during the baseline period and the sham CPAP period. Among the PDSS subitems, the frequency of attacks, panic distress, work impairment, and social impairment showed significant improvements during the optimal pressure period. Our results suggest that OSAS contributes to PD aggravation, and a combination of pharmaceutical treatment for PD and OSAS-specific treatments such as CPAP could be recommended for patients with PD comorbid with OSAS.",Takaesu Y.; Inoue Y.; Komada Y.; Kagimura T.; Iimori M.,2012.0,10.1016/j.sleep.2011.10.016,0,0,
3279,A randomized controlled trial testing the effectiveness of a universal school-based depression prevention program 'Op Volle Kracht' in the Netherlands,"ER METHOD: The effectiveness of OVK will be tested in a randomized controlled trial with two conditions, intervention (OVK) and control condition (care as usual). Schools are randomly assigned to research conditions. OVK will be incorporated in the school curriculum, maximizing program attendance. OVK consists of 16 lessons of 50 min, given by trained psychologists to groups of 11-15 students. OVK contains Cognitive Behavioral Therapy, social skills training, problem solving and decision making. Outcomes are measured at 6, 12, 18 and 24 months follow up, to monitor long term program effects. Primary outcome is level of depressive symptoms, secondary outcomes are: anxiety, hopelessness, cognitive bias, substance use, truancy, life satisfaction, coping, self-efficacy, optimism, happiness, friendship, school performance and school attitude. The questionnaires for students will be administered in the school setting. Parents will complete a questionnaire at baseline only.DISCUSSION: In this paper the study into the effectiveness of the depression prevention program OVK was described. It is expected that OVK will prevent the increase in depressive symptoms during adolescence and enhance positive development in the intervention condition, compared to the control condition. If OVK will be effective, it can be implemented in the school context by which numerous adolescents can be reached.TRIAL REGISTRATION: Netherlands Trial Register (NTR): NTR2879.BACKGROUND: The incidence of depressive symptoms increases during adolescence, from 10.0% to 24.5% at age 11 to 15, respectively. Experiencing elevated levels of depressive symptoms increases the risk of a depressive disorder in adulthood. A universal school-based depression prevention program Op Volle Kracht (OVK) was developed, based on the Penn Resiliency Program, aimed at preventing the increase of depressive symptoms during adolescence and enhancing positive development. In this study the effectiveness of OVK will be tested and possible mediators of program effects will be focus of study as well.","Tak, Y R; Zundert, R M; Kuijpers, R C; Vlokhoven, B S; Rensink, H F; Engels, R C",2012.0,10.1186/1471-2458-12-21,0,0,
3280,Secondary outcomes of a school-based universal resiliency training for adolescents: a cluster randomized controlled trial,"ER METHODS: A two-condition (intervention and control) cluster randomized controlled trial was conducted. All adolescents in the 8th grade were eligible to participate, unless they, or their parents, declined their participation. Schools were the unit of randomization. Missing data were imputed and intent to treat analyses were conducted. The results were analyzed using Latent Growth Curve Modeling across the 24-months follow-up period.RESULTS: The total sample consisted of 1341 adolescents (Mage = 13.91, SD =0.55, 47.3% girls, 83.1% Dutch ethnicity). The intervention and control condition consisted of 634 adolescents from 4 schools and 707 adolescents from 5 schools, respectively. OVK did not have an effect on depression, anxiety, hopelessness, happiness, and life satisfaction, but promoted cognitive coping over the course of the follow-up period. OVK showed small iatrogenic effects on optimism, active coping, social self-efficacy and school grades directly post intervention, but these effects disappeared during the follow-up period. Finally, none of the outcome variables moderated the intervention effect on depressive symptoms.CONCLUSIONS: The universal resiliency training OVK was not effective in this Dutch sample. Implications for research and practice were discussed.TRIAL REGISTRATION NUMBER: NTR2879.BACKGROUND: The study investigated the long-term effectiveness of the adolescent cognitive behavioral resiliency training Op Volle Kracht (OVK) on the secondary outcomes: anxiety symptoms, hopelessness, happiness, life satisfaction, optimism, coping, self-efficacy, and school functioning. In addition, the study analyzed whether the secondary outcomes moderated the intervention effect on depressive symptoms.","Tak, Y R; Kleinjan, M; Lichtwarck-Aschoff, A; Engels, R C",2014.0,10.1186/1471-2458-14-1171,0,0,
3281,Validity and psychometric properties of the General Health Questionnaire-12 in young Australian adolescents,"ER OBJECTIVE: (i) To assess the psychometric properties of the GHQ-12 among school students in grades 7-10; (ii) to validate it against other psychological tests; and (iii) to suggest a threshold score.METHOD: The survey was conducted in single sex and mixed schools from the state and private system in Perth, Western Australia. The survey contained the GHQ-12 and measures of anxiety, depression, self-esteem, stress, generalized self-efficacy, social desirability and negative affectivity.RESULTS: There were 336 students (female 55%) with an age range of 11-15 years (median 13). The GHQ showed good internal consistency (alpha 0.88). Girls had higher mean GHQ-12 scores than boys (F (1,326) 15.0, p < 0.001) and scores for both genders increased with school grade (F (3,326) 4.2, p < 0.01). Multiple linear regression showed that depression, anxiety, self-esteem and stress were significant independent predictors of GHQ scores. The model accounted for 68% of the variance (adjusted R 2). Screening indices were calculated by comparison with a combined depression and/or anxiety category. Threshold scores of 13/14 for males and 18/19 for females appeared optimal. General Health Questionnaire scores were compared with two criterion groups: adolescents in hospital with alcohol or drug (AOD) related problems and those with problems not related to AOD use. Only the former group had significantly higher total scores.CONCLUSIONS: The GHQ-12 showed good structural characteristics and was appropriately correlated with other measures of related traits. Overall, the GHQ-12 appears to be a valid index of psychological wellbeing in this population and was considerably shorter than some of the other instruments.BACKGROUND: The General Health Questionnaire (GHQ) is a measure of current mental wellbeing that has been extensively validated with adults. The instrument has also been used with adolescents.","Tait, R J; French, D J; Hulse, G K",2003.0,10.1046/j.1440-1614.2003.01133.x,0,0,
3282,H1N1 was not all that scary: uncertainty and stressor appraisals predict anxiety related to a coming viral threat,"ER H1N1 reached pandemic proportions in 2009, yet considerable ambivalence was apparent concerning the threat presented and the inclination to be vaccinated. The present investigation assessed several factors, notably appraisals of the threat, intolerance of uncertainty, and familiarity with the virus, that might contribute to reactions to a potential future viral threat. Canadian adults (N=316) provided with several scenarios regarding viral threats reported moderate feelings of anxiety, irrespective of whether the viral threat was one that was familiar versus one that was entirely unfamiliar to them (H1N1 recurrence, H5N1, a fictitious virus: D3N4). Participants appraised the stressfulness of the threats to be moderate and believed that they would have control in this situation. However, among individuals with high intolerance of uncertainty, the viral threat was accompanied by high levels of anxiety, which was mediated by aspects of appraisals, particularly control and stressfulness. In addition, among those individuals that generally appraised ambiguous life events as being stressful, the viral threat appraisals were accompanied by still greater anxiety. Given the limited response to potential viral threats, these results raise concerns that the public may be hesitant to heed recommendations should another pandemic occur.","Taha, S A; Matheson, K; Anisman, H",2014.0,10.1002/smi.2505,0,0,
3283,The effect of cognitive behavioural psycho-education on premenstrual syndrome and related symptoms.,"Premenstrual syndrome (PMS) is a distressing group of symptoms related to menstrual cycle during reproductive age. Its substantial burden on daily function and quality of life, particularly on mental aspects, was to the impetus for this study with the aim of determining the effectiveness of a psycho-educational package on premenstrual syndrome and related symptoms. In a randomized clinical trial, 123 (17-19-year-old) adolescent girls with PMS were randomized to psycho-educational intervention (including 62 subjects) and control (including 61) groups. The participants completed a demographic questionnaire, premenstrual syndrome symptom daily record scale and the Symptom Checklist-90-Revised (SCL-90-R). A paired and two independent samples t-test and chi-squared test were used for analysing data using SPSS statistical package. At the end of the study there was statistically significant decrease in severity of total PMS in intervention compared with control group (P < 0.001). Also, a significant difference in somatization, anxiety and hostility was observed between two groups (P < 0.05). However, depression marginally decreased (P < 0.1) in intervention group, and interpersonal sensitivity was not statistically different between intervention and control groups. Intervention alleviated the severity of PMS and related somatization, anxiety and hostility, yet it could not change the severity of depression and interpersonal sensitivity.",Taghizadeh Z.; Shirmohammadi M.; Feizi A.; Arbabi M.,2013.0,10.1111/j.1365-2850.2012.01965.x,0,0,
3284,An Examination of Family Adjustment Among Operation Desert Storm Veterans,"This study examined interrelationships among combat exposure, symptoms of posttraumatic stress disorder (PTSD), and family adjustment in a sample of male and female Operation Desert Storm veterans (N = 1,512). In structural equation models for both male and female veterans, higher combat exposure was associated with higher PTSD symptoms, which in turn were associated with poorer family adjustment, although these indirect effects did not reach statistical significance. The model for female veterans evidenced a significant direct negative association between combat exposure and family adjustment when it statistically accounted for PTSD symptoms. When the relative impacts of separate PTSD symptom groupings were examined, those reflecting withdrawal/numbing symptoms and arousal/lack of control symptoms significantly and indirectly accounted for the negative effects of combat exposure on family adjustment. Study findings indicate a number of possible pathways through which war-zone deployments negatively impact military families and suggest several avenues for future research. © 2008 American Psychological Association.",Taft C.T.; Schumm J.A.; Panuzio J.; Proctor S.P.,2008.0,10.1037/a0012576,0,0,
3285,Clomipramine administered during the luteal phase reduces the symptoms of premenstrual syndrome: a placebo-controlled trial,"ER In a previous controlled trial we have shown that premenstrual irritability and depressed mood (premenstrual syndrome) can be effectively reduced by low doses of the potent (but nonselective) serotonin reuptake inhibitor clomipramine taken each day of the menstrual cycle. The present study was undertaken to examine to what extent intermittent administration of clomipramine, during the luteal phase only, is also effective against premenstrual complaints. Twenty-nine nondepressed women displaying severe premenstrual irritability and/or depressed mood and fulfilling the DSM-III-R criteria of late luteal phase dysphoric disorder were treated daily from the day of ovulation until the onset of the menstruation either with clomipramine (25 to 75 mg) (n = 15) or with placebo (n = 14) for three consecutive menstrual cycles; another nine subjects (seven on clomipramine, two on placebo) dropped out during treatment. In both treatment groups self-rated premenstrual irritability and depressed mood (as registered daily using a visual analogue scale) were significantly reduced during treatment; in the placebo group, this symptom reduction was about 45%, whereas in the clomipramine group it was greater than 70%. The mean premenstrual ratings of irritability and depressed mood during the three treatment cycles were significantly lower in the clomipramine group than in the placebo group. Also with respect to the rating of global improvement, the result obtained with clomipramine was significantly better than that obtained with placebo. The study confirms the previously reported effectiveness of low doses of clomipramine in the treatment of premenstrual syndrome and demonstrates that the time lag between onset of medication and clinical effect is shorter when clomipramine is used for premenstrual syndrome than when it is used for depression, panic disorder, or obsessive compulsive disorder.","Sundblad, C; Hedberg, M A; Eriksson, E",1993.0,10.1038/npp.1993.52,0,0,
3286,Alterations in white matter microstructure as vulnerability factors and acquired signs of traffic accident-induced PTSD.,"It remains unclear whether white matter (WM) changes found in post-traumatic stress disorder (PTSD) patients are stress-induced or precursors for vulnerability. The current study aimed to identify susceptibility factors relating to the development of PTSD and to examine the ability of these factors to predict the course of longitudinal PTSD. Sixty two victims who had experienced traffic accidents underwent diffusion tensor imaging using a 3.0T MRI system within 2 days after their accidents. Of these, 21 were diagnosed with PTSD at 1 or 6 months using the Clinician-Administered Ptsd Scale (CAPS). Then, 11 trauma-exposed victims with PTSD underwent the second MRI scan. Compared with the victims without PTSD, the victims with PTSD showed decreased fractional anisotropy (FA) in WM of the anterior cingulate cortex, ventromedial prefrontal cortex (vmPFC), temporal lobes and midbrain, and increased mean diffusivity (MD) in the vmPFC within 2 days after the traumatic event. Importantly, decreased FA of the vmPFC in the acute phase predicted greater future CAPS scores. In addition, we found decreased FA in the insula in the follow-up scan in the victims with PTSD, which correlated with the decreased FA of the vmPFC in their baseline scan. These results suggested that the WM might have changed within 2 days after the traumatic event in the individuals who would later develop PTSD. Furthermore, decreased FA of the vmPFC could be a possible vulnerability marker predicting future development of PTSD and may provide an outcome prediction of the acquired signs.",Sun Y.; Wang Z.; Ding W.; Wan J.; Zhuang Z.; Zhang Y.; Liu Y.; Zhou Y.; Xu J.,2013.0,10.1371/journal.pone.0083473,0,0,
3287,"Noncredible psychiatric and cognitive symptoms in a workers' compensation ""stress"" claim sample","Information is lacking regarding the prevalence of fraudulent psychiatric and cognitive symptoms in the ""stress"" claim workers' compensation population. Using various validity indices (Negative Impression Scale, the Malingering Index, and the Rogers Discriminant Function) of the Personality Assessment Inventory (PAI), between 9 and 29% of 233 workers' compensation ""stress"" claim litigants were identified as exhibiting noncredible psychiatric symptoms. In addition, 15% of the subjects were determined to have noncredible cognitive symptoms on the Dot Counting Test, although only 8% displayed suspect effort on the 15-Item Memorization Test, with 5% of subjects failing both cognitive effort tests. The percentage of positive identifications on both a PAI and cognitive credibility index ranged from only 2 to 4%. Further, correlations between PAI validity indices and cognitive effort scales were nonexistent to modest, indicating that the psychiatric and cognitive credibility indices are measuring different aspects of noncredible symptom production. It was predicted that the PAI profiles of the participants displaying suspect cognitive symptoms would be elevated on the Somatic Concerns, Antisocial, and/or Borderline scales; however, elevations (relative to subjects with credible cognitive performance) were instead noted on the Somatic Concerns, Depression, Anxiety, Anxiety-Related Disorders, and Schizophrenia scales. Copyright © Taylor and Francis Group, LLC.",Sumanti M.; Boone K.B.; Savodnik I.; Gorsuch R.,2006.0,10.1080/13854040500428467,0,0,
3288,Effects of a 12-wk resistance exercise program on skeletal muscle strength in children with burn injuries,"ER The posttraumatic response to burn injury leads to marked and prolonged skeletal muscle catabolism and weakness, which persist despite standard rehabilitation programs of occupational and physical therapy. We investigated whether a resistance exercise program would attenuate muscle loss and weakness that is typically found in children with thermal injury. We assessed the changes in leg muscle strength and lean body mass in severely burned children with >40% total body surface area burned. Patients were randomized to a 12-wk standard hospital rehabilitation program supplemented with an exercise training program (n = 19) or to a home-based rehabilitation program without exercise (n = 16). Leg muscle strength was assessed before and after the 12-wk rehabilitation or training program at an isokinetic speed of 150 degrees /s. Lean body mass was assessed using dual-energy X-ray absorptiometry. We found that the participation in a resistance exercise program results in a significant improvement in muscle strength, power, and lean body mass relative to a standard rehabilitation program without exercise.","Suman, O E; Spies, R J; Celis, M M; Mlcak, R P; Herndon, D N",2001.0,,0,0,
3289,Correlates of severity in bulimia nervosa.,"We sought to clarify the correlates of severity in women with bulimia nervosa. We studied 114 bulimic women at entry to a randomized clinical trial. We used eight definitions of severity that encompassed the DSM-III-R criteria set for bulimia nervosa (i.e., binging, purging, and body dissatisfaction in the current and worst lifetime time frames) and global functioning and symptomatology. We operationalized 28 possible correlates of severity that covered demographic, Axis I psychiatric, personality, family background, symptoms, and neuropsychological domains. We used regression techniques to investigate the associations between the correlates and severity indices. The regression models were all statistically significant and tended to account for a sizeable proportion of variance. In particular, earlier age of onset of bulimia and lower character scores (measured by the Temperament and Character Inventory) correlated with greater severity. Worse mean parental care (from the Parental Bonding Instrument), the absence of any lifetime anxiety disorder, and the presence of any lifetime mood disorder emerged as independent correlates in several models. As these were hypothesis-generating analyses, confirmation or refutation of these results awaits further study. In particular, age of onset of bulimia and personality traits related to character may be important modifiers of the severity of illness in bulimia nervosa.",Sullivan PF.; Bulik CM.; Carter FA.; Joyce PR.,1996.0,10.1002/(SICI)1098-108X(199611)20:3<239::AID-EAT3>3.0.CO;2-P,0,0,
3290,The significance of a prior history of anorexia in bulimia nervosa.,"Some authors stratify women with current, normal-weight bulimia nervosa into groups defined by the presence or absence of a past history of anorexia nervosa. Unlike the distinction between current anorexia nervosa with or without bulimic symptoms, fewer studies have investigated the significance of stratifying bulimic women by a past history of anorexia. One hundred and fourteen women with bulimia nervosa in a clinical trial were studied via structured clinical interviews covering Axis I and II disorders and measures of personality and symptomatology. Prospective, 14-day dietary analysis was available for a subset of subjects. Bulimic women with a past history of anorexia nervosa were significantly more likely to have a lifetime anxiety disorder, lower current body mass index, increased cooperativeness on the Temperament and Character Inventory, and increased mature and neurotic scores on the Defense Style Questionnaire. These women also reported lower scores on the bulimia subscale of the Eating Disorders Inventory, but these self-report data were not consistent with the numbers of objective binges or reported energy intake. The prevalence of other Axis I disorders, Axis II personality disorders, and bulimic symptomatology was quite similar across groups. Although bulimic women with a prior history of anorexia nervosa differed in limited respects from those without such a history, the differences were outweighed by the similarities. A past history of anorexia nervosa did not appear to define particularly meaningful subgroups of women with current, normal-weight bulimia nervosa.",Sullivan PF.; Bulik CM.; Carter FA.; Gendall KA.; Joyce PR.,1996.0,10.1002/(SICI)1098-108X(199611)20:3<253::AID-EAT4>3.0.CO;2-N,0,0,
3291,"Pain, perceived injustice and the persistence of post-traumatic stress symptoms during the course of rehabilitation for whiplash injuries.","The present study assessed the role of pain and pain-related psychological variables in the persistence of post-traumatic stress symptoms following whiplash injury. Individuals (N=112) with whiplash injuries who had been admitted to a standardized multidisciplinary rehabilitation program were asked to complete measures of pain, post-traumatic stress symptoms, physical function and pain-related psychological variables at three different points during their treatment program. The findings are consistent with previous research showing that indicators of injury severity such as pain, reduced function and disability, and scores on pain-related psychological were associated with more severe post-traumatic stress symptoms in individuals with whiplash injuries. Contrary to expectations, indicators of pain severity did not contribute to the persistence of post-traumatic stress symptoms. Univariate analyses revealed that self-reported disability, pain catastrophizing and perceived injustice were significant determinants of the persistence of post-traumatic stress symptoms. In multivariate analyses, only perceived injustice emerged as a unique predictor of the persistence of post-traumatic stress symptoms. The results suggest that early adequate management of pain symptoms and disability consequent to whiplash injury might reduce the severity of post-traumatic stress symptoms. The development of effective intervention techniques for targeting perceptions of injustice might be important for promoting recovery of post-traumatic stress symptoms consequent to whiplash injury.",Sullivan MJ.; Thibault P.; Simmonds MJ.; Milioto M.; Cantin AP.; Velly AM.,2009.0,10.1016/j.pain.2009.06.031,0,0,
3292,The effects of disclosure on pain during dental hygiene treatment: The moderating role of catastrophizing,"Catastrophizers and non-catastrophizers were asked to disclose about their dental worries prior to undergoing dental hygiene treatment. It was hypothesized that the effects of emotional disclosure would vary as a function of the level of catastrophizing; where catastrophizers would be more likely than non-catastrophizers to show reductions in pain and emotional distress. The study also examined whether emotional disclosure influenced subsequent levels of catastrophizing and dental anxiety. Eighty undergraduate students were randomly assigned to a disclosure condition or a control condition prior to undergoing a scaling and root planing procedure. In the control condition, catastrophizers reported significantly more pain and emotional distress than non-catastrophizers. In the disclosure condition, catastrophizers and non-catastrophizers did not differ significantly in their pain and emotional distress. The interaction between condition and level of catastrophizing remained significant even when controlling for emotional distress and the emotional content of the thought records. While catastrophizers benefited from disclosure in regard to their immediate physical and emotional experience, their levels of catastrophizing and dental anxiety remained essentially unchanged. Theoretical and clinical implications of the findings are discussed. Copyright (C) 1999 International Association for the Study of Pain. Published by Elsevier Science B.V.",Sullivan M.J.L.; Neish N.,1999.0,10.1016/S0304-3959(98)00163-8,0,0,
3293,The effect of injury diagnosis on illness perceptions and expected postconcussion syndrome and posttraumatic stress disorder symptoms.,"To determine if systematic variation of diagnostic terminology (ie, concussion, minor head injury [MHI], mild traumatic brain injury [mTBI]) following a standardized injury description produced different expected symptoms and illness perceptions. We hypothesized that worse outcomes would be expected of mTBI, compared with other diagnoses, and that MHI would be perceived as worse than concussion. 108 volunteers were randomly allocated to conditions in which they read a vignette describing a motor vehicle accident-related mTBI followed by a diagnosis of mTBI (n = 27), MHI (n = 24), concussion (n = 31), or, no diagnosis (n = 26). All groups rated (a) event ""undesirability,"" (b) illness perception, and (c) expected postconcussion syndrome (PCS) and posttraumatic stress disorder (PTSD) symptoms 6 months after injury. There was a statistically significant group effect on undesirability (mTBI > concussion and MHI), PTSD symptomatology (mTBI and no diagnosis > concussion), and negative illness perception (mTBI and no diagnosis > concussion). In general, diagnostic terminology did not affect anticipated PCS symptoms 6 months after injury, but other outcomes were affected. Given that these diagnostic terms are used interchangeably, this study suggests that changing terminology can influence known contributors to poor mTBI outcome.",Sullivan KA.; Edmed SL.; Kempe C.,,10.1097/HTR.0b013e31828c708a,0,0,
3294,Systematic variation of the severity of motor vehicle accident-related traumatic brain injury vignettes produces different post-concussion symptom reports.,"This study investigated the specificity of the post-concussion syndrome (PCS) expectation-as-etiology hypothesis. Undergraduate students (n‚Äâ=‚Äâ551) were randomly allocated to one of three vignette conditions. Vignettes depicted either a very mild (VMI), mild (MI), or moderate-to-severe (MSI) motor vehicle-related traumatic brain injury (TBI). Participants reported the PCS and PTSD symptoms that they imagined the depicted injury would produce. Secondary outcomes (knowledge of mild TBI, and the perceived undesirability of TBI) were also assessed. After data screening, the distribution of participants by condition was: VMI (n‚Äâ=‚Äâ100), MI (n‚Äâ=‚Äâ96), and MSI (n‚Äâ=‚Äâ71). There was a significant effect of condition on PCS symptomatology, F(2, 264)‚Äâ=‚Äâ16.55, p‚Äâ<‚Äâ.001. Significantly greater PCS symptomatology was expected in the MSI condition compared to the other conditions (MSI‚Äâ>‚ÄâVMI; medium effect, r‚Äâ=‚Äâ.33; MSI‚Äâ> MI; small-to-medium effect, r‚Äâ=‚Äâ.22). The same pattern of group differences was found for PTSD symptoms, F(2, 264)‚Äâ=‚Äâ17.12, p‚Äâ<‚Äâ.001. Knowledge of mild TBI was not related to differences in expected PCS symptoms by condition; and the perceived undesirability of TBI was only associated with reported PCS symptomatology in the MSI condition. Systematic variation in the severity of a depicted TBI produces different PCS and PTSD symptom expectations. Even a very mild TBI vignette can elicit expectations of PCS symptoms.",Sullivan KA.; Edmed SL.,2012.0,10.1080/13854046.2012.735254,0,0,
3295,The effect of injury diagnosis on illness perceptions and expected postconcussion syndrome and posttraumatic stress disorder symptoms,"OBJECTIVE: To determine if systematic variation of diagnostic terminology (ie, concussion, minor head injury [MHI], mild traumatic brain injury [mTBI]) following a standardized injury description produced different expected symptoms and illness perceptions. We hypothesized that worse outcomes would be expected of mTBI, compared with other diagnoses, and that MHI would be perceived as worse than concussion. METHOD: 108 volunteers were randomly allocated to conditions in which they read a vignette describing a motor vehicle accident-related mTBI followed by a diagnosis of mTBI (n = 27), MHI (n = 24), concussion (n = 31), or, no diagnosis (n = 26). All groups rated (a) event ""undesirability,"" (b) illness perception, and (c) expected postconcussion syndrome (PCS) and posttraumatic stress disorder (PTSD) symptoms 6 months after injury. RESULTS: There was a statistically significant group effect on undesirability (mTBI > concussion and MHI), PTSD symptomatology (mTBI and no diagnosis > concussion), and negative illness perception (mTBI and no diagnosis > concussion). CONCLUSION: In general, diagnostic terminology did not affect anticipated PCS symptoms 6 months after injury, but other outcomes were affected. Given that these diagnostic terms are used interchangeably, this study suggests that changing terminology can influence known contributors to poor mTBI outcome. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams and Wilkins.",Sullivan K.A.; Edmed S.L.; Kempe C.,2014.0,10.1097/HTR.0b013e31828c708a,0,0,3293
3296,Does a quality improvement intervention for anxiety result in differential outcomes for lower-income patients?,"The authors examined the effects of a collaborative care intervention for anxiety disorders in primary care on lower-income participants relative to those with higher incomes. They hypothesized that lower-income individuals would show less improvement or improve at a lower rate, given that they would experience greater economic stress over the treatment course. An alternative hypothesis was that lower-income participants would improve at a higher rate because the intervention facilitates access to evidence-based treatment, which typically is less available to persons with lower incomes. Baseline demographic and clinical characteristics of patients with lower (N=287) and higher (N=717) income were compared using t tests and chi-square tests for continuous and categorical variables, respectively. For the longitudinal analysis of intervention effects by income group, the outcome measures were jointly modeled at baseline and at 6, 12, and 18 months by study site, income, time, intervention, time and intervention, income and time, income and intervention, and time, intervention, and income. Although lower-income participants were more ill and had greater disability at baseline than those with higher incomes, the two income groups were similar in clinical response. The lower-income participants experienced a comparable degree of clinical improvement, despite receiving fewer treatment sessions, less relapse prevention, and less continuous care. These findings contribute to the ongoing discussion as to whether or not, and to what extent, quality improvement interventions work equally well across income groups or require tailoring for specific vulnerable populations.",Sullivan G.; Sherbourne C.; Chavira DA.; Craske MG.; Gollineli D.; Han X.; Rose RD.; Bystritsky A.; Stein MB.; Roy-Byrne P.,2013.0,10.1176/appi.ajp.2012.12030375,0,0,
3297,Design of the Coordinated Anxiety Learning and Management (CALM) study: innovations in collaborative care for anxiety disorders.,"Despite a marked increase in the number of persons seeking help for anxiety disorders, the care provided may not be evidence based, especially when delivered by nonspecialists. Since anxiety disorders are most often treated in primary care, quality improvement interventions, such as the Coordinated Anxiety Learning and Management (CALM) intervention, are needed in primary care. This study is a randomized controlled trial of a collaborative care effectiveness intervention for anxiety disorders. Approximately 1040 adult primary care patients with at least one of four anxiety disorders (generalized anxiety disorder, panic disorder, posttraumatic stress disorder or social anxiety disorder) will be recruited from four national sites. Anxiety clinical specialists (ACSs) deliver education and behavioral activation to intervention patients and monitor their symptoms. Intervention patients choose cognitive-behavioral therapy, antianxiety medications or both in ""stepped-care"" treatment, which varies according to clinical needs. Control patients receive usual care from their primary care clinician. The innovations of CALM include the following: flexibility to treat any one of the four anxiety disorders, co-occurring depression, alcohol abuse or both; use of on-site clinicians to conduct initial assessments; and computer-assisted psychotherapy delivery. Anxiety symptoms, functioning, satisfaction with care and health care utilization are assessed at 6-month intervals for 18 months. CALM was designed for clinical effectiveness and easy dissemination in a variety of primary care settings.",Sullivan G.; Craske MG.; Sherbourne C.; Edlund MJ.; Rose RD.; Golinelli D.; Chavira DA.; Bystritsky A.; Stein MB.; Roy-Byrne PP.,,10.1016/j.genhosppsych.2007.04.005,0,0,
3298,Design of the Coordinated Anxiety Learning and Management (CALM) study: innovations in collaborative care for anxiety disorders,"ER RESEARCH DESIGNThis study is a randomized controlled trial of a collaborative care effectiveness intervention for anxiety disorders.SUBJECTSApproximately 1040 adult primary care patients with at least one of four anxiety disorders (generalized anxiety disorder, panic disorder, posttraumatic stress disorder or social anxiety disorder) will be recruited from four national sites.INTERVENTIONAnxiety clinical specialists (ACSs) deliver education and behavioral activation to intervention patients and monitor their symptoms. Intervention patients choose cognitive-behavioral therapy, antianxiety medications or both in ""stepped-care"" treatment, which varies according to clinical needs. Control patients receive usual care from their primary care clinician. The innovations of CALM include the following: flexibility to treat any one of the four anxiety disorders, co-occurring depression, alcohol abuse or both; use of on-site clinicians to conduct initial assessments; and computer-assisted psychotherapy delivery.EVALUATIONAnxiety symptoms, functioning, satisfaction with care and health care utilization are assessed at 6-month intervals for 18 months.CONCLUSIONCALM was designed for clinical effectiveness and easy dissemination in a variety of primary care settings.BACKGROUNDDespite a marked increase in the number of persons seeking help for anxiety disorders, the care provided may not be evidence based, especially when delivered by nonspecialists. Since anxiety disorders are most often treated in primary care, quality improvement interventions, such as the Coordinated Anxiety Learning and Management (CALM) intervention, are needed in primary care.","Sullivan, G; Craske, M G; Sherbourne, C; Edlund, M J; Rose, R D; Golinelli, D; Chavira, D A; Bystritsky, A; Stein, M B; Roy-Byrne, P P",2007.0,10.1016/j.genhosppsych.2007.04.005,0,0,3297
3299,"""Air bag"" organoleptic behavioral experiment for managing fear of oral malodor.","People suffering from the fear of oral malodor believe that they have halitosis, even though offensive oral malodor is absent. Management of such patients is challenging. A simple innovative technique, ""air bag"" breathing method can be used as a behavioral experiment to provide the patient with evidence that may disconfirm their pertinent belief. In this method air samples are collected in an odor free plastic bag from the patient and healthy volunteers and the patient blindly rates the odor quality of each sample.",Suhas S.; Sudarshan S.; Pai KM.,2004.0,10.1016/j.jbtep.2004.01.001,0,0,
3300,Factor structure of the Liebowitz Social Anxiety Scale in community-dwelling subjects in Japan,This study examined the internal consistency and structural/construct validity of the Liebowitz Social Anxiety Scale (LSAS) for community-dwelling subjects in Japan. A cross-sectional study that included 929 participants was conducted. Structural/construct validity was assessed on confirmatory factor analysis. The internal consistency reliability was good for the overall LSAS scale (α = 0.97) and for its original four factors (α = 0.92-0.89). The original four-factor model fit the observed data relatively better than alternative models. These findings indicate that the LSAS is a valid and reliable measure of anxiety symptoms for this community-dwelling population in Japan. © 2012 The Authors. Psychiatry and Clinical Neurosciences © 2012 Japanese Society of Psychiatry and Neurology.,Sugawara N.; Yasui-Furukori N.; Kaneda A.; Sato Y.; Tsuchimine S.; Fujii A.; Danjo K.; Takahashi I.; Matsuzaka M.; Kaneko S.,2012.0,10.1111/j.1440-1819.2012.02381.x,0,0,
3301,Mobile phone text messaging to assess symptoms after mild traumatic brain injury and provide self-care support: a pilot study,"ER PURPOSE: To examine whether patients with mild traumatic brain injury (mTBI) receiving text messaging-based education and behavioral support had fewer and less severe postconcussive symptoms than those not receiving text-message support. Our secondary objective was to determine the feasibility of using text messaging to assess daily symptoms and provide support to patients with mTBI.DESIGN: Randomized controlled trial with 14-day follow-up.PARTICIPANTS: Convenience sample of 43 adult emergency department patients with mTBI.INTERVENTION: Fourteen days of timed SMS (short-message service) symptom assessments (9 AM: headaches; 1 PM: difficulty concentrating; 5 PM: irritability or anxiety) with self-care support messages.MAIN MEASURES: SMS symptom reports, Rivermead Postconcussion Symptoms Questionnaire.RESULTS: Compared with the control group, intervention participants trended to lower odds of reporting headaches (odds ratio [OR] = 0.38; 95% confidence interval [CI]: 0.07-1.99), concentration difficulty (OR = 0.32; 95% CI: 0.04-2.24), and irritability or anxiety (OR = 0.33; 95% CI: 0.05-2.35). There were also trends of lower mean scores for headaches (0.99 vs 1.19; P = .5), difficulty concentrating (0.88 vs 1.23; P = .2), and irritability/anxiety (1.00 vs 1.62; P = .06). There were high response rate to SMS symptom assessments and high satisfaction with the intervention.CONCLUSION: Those receiving the text messaging-based education and support had fewer and less severe postconcussive symptoms than the controls but none of the differences reached statistical significance. Further evaluation of more robust mobile interventions and larger sample of participants are still needed.","Suffoletto, B; Wagner, A K; Arenth, P M; Calabria, J; Kingsley, E; Kristan, J; Callaway, C W",2013.0,10.1097/HTR.0b013e3182847468,0,0,
3302,Differences in metabolic network modulation between capsulotomy and deep-brain stimulation for refractory obsessive-compulsive disorder.,"Around 7%-10% of patients with obsessive-compulsive disorder (OCD) are refractory to first-line treatment. Neurosurgical approaches are available such as capsulotomy or deep-brain stimulation (DBS). There is strong evidence for central involvement of the corticostriatopallidothalamocortical (CSPTC) circuit in OCD, but the exact mechanism through which these interventions lead to clinical improvement and potential differences in network modulation are not fully understood. In total, 13 capsulotomy patients (aged 29-59 y, 10 men and 3 women) and 16 DBS patients (aged 25-56 y, 6 men and 10 women) were prospectively included. (18)F-FDG PET was performed before and after capsulotomy and before and after DBS in both stimulation-on and stimulation-off conditions. Presurgical scans were compared with scans of healthy volunteers using SPM8 and global scaling, and metabolic changes after DBS were compared with changes after capsulotomy. Correlations with clinical improvements were investigated using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Hamilton Depression Rating Scale (HAM-D). Both groups had similar pretreatment clinical morbidity as assessed by Y-BOCS and the Hamilton Depression Rating Scale. Preoperative superior frontal and supplementary motor cortex hypometabolism was common to both patient groups, and the subgenual anterior cingulate, occipital cortex (cuneus), and posterior cerebellum were relatively hypermetabolic. Postoperative metabolic decreases were common to both interventions in the anterior cingulate and the prefrontal and orbitofrontal cortices. Compared with DBS, capsulotomy resulted in more intense metabolic changes, with additional significant decreases in the mediodorsal thalamus, caudate nucleus, and cerebellum as well as increases in the precuneus and the fusiform and lingual gyrus. The stimulation-off condition of DBS patients showed no significant differences from the preoperative state. Improvement in Y-BOCS scores correlated with metabolic changes in the occipital cortex. Baseline metabolism in the subgenual anterior cingulate and superior temporal cortices were related to postoperative improvement of depressive symptoms. Capsulotomy and DBS lead to similar clinical improvement and similar metabolic network changes in the CSPTC circuit, with a prominent role for the subgenual anterior cingulate and other core structures of the CSPTC. However, metabolic changes are more pronounced and extended in capsulotomy than in DBS. Furthermore, cortical regions outside the CSPTC may also play an important role in OCD symptomatology.",Suetens K.; Nuttin B.; Gabriëls L.; Van Laere K.,2014.0,10.2967/jnumed.113.126409,0,0,
3303,The role of relaxation in systematic desensitization.,,Sue D.,1972.0,,0,0,
3304,Stigma towards people with mental disorders and its components – a perspective from multi-ethnic Singapore,"Aims.: The current study aimed to: (i) describe the extent of overall stigma as well as the differences in stigma towards people with alcohol abuse, dementia, depression, schizophrenia and obsessive compulsive disorder, as well as (ii) establish the dimensions of stigma and examine its correlates, in the general population of Singapore, using a vignette approach. Methods.: Data for the current study came from a larger nation-wide cross-sectional study of mental health literacy conducted in Singapore. The study population comprised Singapore Residents (Singapore Citizens and Permanent Residents) aged 18–65 years who were living in Singapore at the time of the survey. All respondents were administered the Personal and Perceived scales of the Depression Stigma scale and the Social Distance scale to measure personal stigma and social distance, respectively. Weighted mean and standard error of the mean were calculated for continuous variables, and frequencies and percentages for categorical variables. Exploratory structural equation modelling and confirmatory factor analysis were used to establish the dimensions of stigma. Multivariable linear regressions were conducted to examine factors associated with each of the stigma scale scores. Results.: The mean age of the respondents was 40.9 years and gender was equally represented (50.9% were males). The findings from the factor analysis revealed that personal stigma formed two distinct dimensions comprising ‘weak-not-sick’ and ‘dangerous/unpredictable’ while social distance stigma items loaded strongly into a single factor. Those of Malay and Indian ethnicity, lower education, lower income status and those who were administered the depression and alcohol abuse vignette were significantly associated with higher weak-not-sick scores. Those of Indian ethnicity, 6 years of education and below, lower income status and those who were administered the alcohol abuse vignette were significantly associated with higher dangerous/unpredictable scores. Those administered the alcohol abuse vignette were associated with higher social distance scores. Conclusion.: This population-wide study found significant stigma towards people with mental illness and identified specific groups who have more stigmatising attitudes. The study also found that having a friend or family member with similar problems was associated with having lower personal as well as social distance stigma. There is a need for well-planned and culturally relevant anti-stigma campaigns in this population that take into consideration the findings of this study.",Subramaniam M.; Abdin E.; Picco L.; Pang S.; Shafie S.; Vaingankar J.A.; Kwok K.W.; Verma K.; Chong S.A.,2016.0,10.1017/S2045796016000159,0,0,
3305,[Distribution of alexithymia as a personality-trait in psychosomatically ill in-patients--measured with TAS 20 and LEAS].,"Preliminary findings of an ongoing study of the distribution of alexithymia in different diagnostic-groups of psychosomatically ill in-patients (n = 240, will be increased to n = 400) are reported. Alexithymiea is measured simultaneousely by the Levels of Emotional Awareness Scale (LEAS, a performance-test) and the 20-item Toronto Alexithymia Scale (TAS 20, a self-report-scale). Measured by the LEAS and compared with other diagnostic groups (affective, anxiety and compulsive-obsessive disorders; adjustment disorders; eating disorders), patients with somatoform disorders showed a decreased ability to be aware of and to communicate their emotional states. This finding which meets theoretical considerations about the origin of alexithymia could not be found with the TAS 20. The TAS 20 did not differentiate between the diagnostic groups, but showed - in accordance with two other self-report-scales (STAI for self reported anxiety as a personality trait and SCL-90-R for self reported somatic und psychic complaints) - higher mean scores at the onset than at the end of treatment. Methodical implications of the different findings of the two alexithymia scales are discussed.",Subic-Wrana C.; Bruder S.; Thomas W.; Gaus E.; Merkle W.; Köhle K.,2002.0,10.1055/s-2002-35281,0,0,
3306,Cravings as a mediator and moderator of drinking outcomes in the COMBINE study.,"Investigators of the COMBINE (Combining Medications and Behavioral Interventions for Alcoholism) study examined whether combining medications with a behavioral intervention would improve outcomes over monotherapies. Unexpectedly, the combination did not offer any advantage over either treatment alone. This study aimed to explain the lack of incremental benefit offered by the combination over either monotherapy by assessing the role of cravings as a treatment mediator and moderator. Secondary mediation and moderation analyses of COMBINE study data. Eleven United States academic sites. A total of 863 patients randomized to one of four treatment groups: naltrexone (100 mg/day; n = 209), the combined behavioral intervention (CBI, n = 236), naltrexone and CBI combined (n = 213) and placebo naltrexone (n = 205). Percentage of days abstinent (PDA) measured between 13 and 16 weeks post-baseline. Cravings, the potential mediator/moderator, were measured at baseline, weeks 4 and 12 using the Obsessive-Compulsive Drinking Scale. Compared with placebo, naltrexone, CBI and the combination all increased PDA by an additional 6-10 percentage points for those with high cravings (P < 0.05 for all three treatment groups). None had significant effects on PDA for those with low cravings. The effects of all three treatments were mediated at least partially by cravings; craving reduction explained 48-53% of treatment effects (P < 0.05 for all three treatment groups). Furthermore, naltrexone appeared to reduce cravings at 4 weeks, while CBI did not reduce cravings until 12 weeks. The Combining Medications and Behavioral Interventions for Alcoholism (COMBINE) naltrexone + CBI combination may not be more beneficial than either monotherapy because craving reduction is a common mechanism of both.",Subbaraman MS.; Lendle S.; van der Laan M.; Kaskutas LA.; Ahern J.,2013.0,10.1111/add.12238,0,0,
3307,Depression inhibits the anti-inflammatory effects of leisure time physical activity and light to moderate alcohol consumption,"Light to moderate alcohol consumption and leisure time physical activity (LTPA) are independently associated with lower levels of high sensitivity C-reactive protein (CRP), a predictor of cardiometabolic risk. In contrast, depression, ranging from low mood disturbance to major depressive disorder, has been associated with elevated CRP. To test the hypothesis that depression attenuates the anti-inflammatory effects of LTPA and alcohol consumption, the current study tested the moderating effect of severity of depressive symptomatology on the relation of alcohol consumption and LTPA to CRP in 222 healthy adult men and women (18-65 years of age). Given the known effects of gender on inflammation, we also examined the effects of gender on the tested interactions. Depression was assessed using the Beck Depression Inventory. Frequency of alcohol consumption, hours of LTPA per week and other coronary risk/protective factors were assessed via self-report and structured interview. Fasting blood samples were used to measure CRP and lipids. As predicted, the interaction between LTPA and depressive symptomatology was significant (F = 5.29, p <.03) such that lower CRP was associated with the combination of decreased depressive symptomatology and increased LTPA. Among those with increased depressive symptoms, increased LTPA was not associated with higher CRP. Similarly, depression interacted with alcohol consumption in predicting CRP in men but not women (F = 5.03, p <.008) such that for men light to moderate alcohol consumption was associated with lower CRP but only among those with decreased depressive symptoms. Light to moderate alcohol consumption was not associated with lower CRP in those with increased depressive symptom severity. The pattern of the interactions between anti-inflammatory activities such as light to moderate alcohol consumption and LTPA and psychological distress as indexed by severity of depressive symptomatology suggests an important new avenue for future research. © 2013 Elsevier Inc.",Suarez E.C.; Schramm-Sapyta N.L.; Hawkins T.V.; Erkanli A.,2013.0,10.1016/j.bbi.2013.03.009,0,0,
3308,Patterns and impact of the alliance and affective arousal in psychotherapy: An application to cognitive therapy for avoidant and obsessive-compulsive personality disorders.,"In recent decades, the role of the client-therapist alliance in therapy process and outcome has received considerable attention from psychotherapy theorists and researchers. Empirical findings consistently demonstrate a relation between the strength of the alliance and outcome. A similar trend characterizes recent theoretical and empirical interest in the role of emotional arousal in the therapeutic change process. The current study endeavored to integrate and extend these two growing literatures. Hypotheses were tested on a sample of individuals diagnosed with either avoidant or obsessive-compulsive personality disorders who underwent a 52-week course of cognitive therapy. Results indicated a curvilinear association between variability in the alliance and outcome, which accounted for the significant relation between average strength of the alliance and outcome. The strength of the alliance moderated the relation between clients' affective arousal and outcome, with a strong alliance and high level of arousal predicting the most favorable outcomes. Results are discussed in the context of recent affiance rupture-repair theories of the change process and emotional processing literatures. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Strauss, Jennifer Leigh",2001.0,,0,0,
3309,Sleep Deprivation Disrupts Recall of Conditioned Fear Extinction,"Background Learned fear is crucial in the development and maintenance of posttraumatic stress disorder and other anxiety disorders, and extinction of learned fear is necessary for response to exposure-based treatments. In humans, research suggests that disrupted sleep impairs consolidation of extinction, though no studies have examined this experimentally using total sleep deprivation. Methods Seventy-one healthy control subjects underwent a paradigm to acquire conditioned fear to a visual cue. Twenty-four hours after fear conditioning, participants underwent extinction learning. Twenty-four hours after extinction learning, participants underwent extinction recall. Participants were randomized to three groups: 1) well-rested throughout testing (“normal sleep”; n = 21); 2) 36 hours’ total sleep deprivation before extinction learning (“pre-extinction deprivation”; n = 25); or 3) 36 hours’ total sleep deprivation after extinction learning and before extinction recall (“post-extinction deprivation”; n = 25). The groups were compared on blink electromyography reactivity to the condition stimulus during extinction learning and recall. Results There were no differences among the three groups during extinction learning. During extinction recall, the pre-extinction deprivation group demonstrated significantly less extinction recall than the normal sleep group did. There was no significant difference between the normal sleep and post-extinction deprivation group during extinction recall. Results indicated sleep deprivation before extinction training significantly disrupts extinction recall. Conclusions These findings suggest that 1) sleep deprivation in the immediate aftermath of trauma could be a potential contributor to posttraumatic stress disorder development and maintenance via interference with natural extinction processes and 2) management of sleep symptoms should be considered during extinction-based therapy.",Straus L.D.; Acheson D.T.; Risbrough V.B.; Drummond S.P.A.,2017.0,10.1016/j.bpsc.2016.05.004,0,0,
3310,"Self-guides, autobiographical memory, and anxiety and dysphoria: Toward a cognitive model of vulnerability to emotional distress","Several aspects of a cognitive model of vulnerability to emotional disorders based on self-discrepancy theory were tested. Anxious, dysphoric, anxious/dysphoric, and control subjects participated in 3 studies over a 4- month period: screening, assessment of self-guides and self-discrepancies, and an autobiographical memory task in which different types of retrieval cues (including self-guides) were presented and subjects reported childhood memories as they came to mind. Actual:ideal discrepancy was associated with persistent dysphoria, whereas actual:ought discrepancy was associated with persistent anxiety. Self-guide cues resulted in more efficient retrieval and greater unintended negative emotional content than comparable cue types. The groups were differentiated only by negative affect content in response to self-guide cues.",Strauman T.J.,1992.0,10.1037//0021-843X.101.1.87,0,0,
3311,Neural mechanisms of automatic and direct processing of phobogenic stimuli in specific phobia.,"The study aimed to identify brain activation during direct and automatic processing of phobogenic stimuli in specific phobia. Responses to phobia-related and neutral pictures (spiders and mushrooms) were measured by means of event-related functional magnetic resonance imaging during two different tasks. In the identification task, subjects were asked to identify the object (spider or mushroom). In a demanding distraction task, subjects had to match geometric figures displayed in the foreground of the pictures. Phobics showed greater responses to spiders versus mushrooms in the left amygdala, left insula, left anterior cingulate gyrus (ACC), and left dorsomedial prefrontal cortex (DMPFC) during the identification task and in the left and right amygdala during the distraction task. All of these activations were also significantly increased compared to control subjects who did not show stronger brain activation to spiders versus mushrooms under any task condition. Our findings propose specific neural correlates of automatic versus direct evaluation of phobia-relevant threat. While the amygdala, especially the right amygdala, seems to be crucially involved in automatic stimuli processing, activation of areas such as the insula, ACC and DMPFC is rather associated with direct threat evaluation and requires sufficient attentional resources.",Straube T.; Mentzel HJ.; Miltner WH.,2006.0,10.1016/j.biopsych.2005.06.013,0,0,
3312,Effects of cognitive-behavioral therapy on brain activation in specific phobia.,"Little is known about the effects of successful psychotherapy on brain function in subjects with anxiety disorders. The present study aimed to identify changes in brain activation following cognitive-behavioral therapy (CBT) in subjects suffering from specific phobia. Using functional magnetic resonance imaging (fMRI), brain activation to spider videos was measured in 28 spider phobic and 14 healthy control subjects. Phobics were randomly assigned to a therapy-group (TG) and a waiting-list control group (WG). Both groups of phobics were scanned twice. Between scanning sessions, CBT was given to the TG. Before therapy, brain activation did not differ between both groups of phobics. As compared to control subjects, phobics showed greater responses to spider vs. control videos in the insula and anterior cingulate cortex (ACC). CBT strongly reduced phobic symptoms in the TG while the WG remained behaviorally unchanged. In the second scanning session, a significant reduction of hyperactivity in the insula and ACC was found in the TG compared to the WG. These results propose that increased activation in the insula and ACC is associated with specific phobia, whereas an attenuation of these brain responses correlates with successful therapeutic intervention.",Straube T.; Glauer M.; Dilger S.; Mentzel HJ.; Miltner WH.,2006.0,10.1016/j.neuroimage.2005.07.007,0,0,
3313,The functional -1019C/G HTR1A polymorphism and mechanisms of fear.,"Serotonin receptor 1A gene (HTR1A) knockout mice show pronounced defensive behaviour and increased fear conditioning to ambiguous conditioned stimuli. Such behaviour is a hallmark of pathological human anxiety, as observed in panic disorder with agoraphobia (PD/AG). Thus, variations in HTR1A might contribute to neurophysiological differences within subgroups of PD/AG patients. Here, we tested this hypothesis by combining genetic with behavioural techniques and neuroimaging. In a clinical multicentre trial, patients with PD/AG received 12 sessions of manualized cognitive-behavioural therapy (CBT) and were genotyped for HTR1A rs6295. In four subsamples of this multicentre trial, exposure behaviour (n=185), defensive reactivity measured using a behavioural avoidance test (BAT; before CBT: n=245; after CBT: n=171) and functional magnetic resonance imaging (fMRI) data during fear conditioning were acquired before and after CBT (n=39). HTR1A risk genotype (GG) carriers more often escaped during the BAT before treatment. Exploratory fMRI results suggest increased activation of the amygdala in response to threat as well as safety cues before and after treatment in GG carriers. Furthermore, GG carriers demonstrated reduced effects of CBT on differential conditioning in regions including the bilateral insulae and the anterior cingulate cortex. Finally, risk genotype carriers demonstrated reduced self-initiated exposure behaviour to aversive situations. This study demonstrates the effect of HTR1A variation on defensive behaviour, amygdala activity, CBT-induced neural plasticity and normalization of defence behaviour in PD/AG. Our results, therefore, translate evidence from animal studies to humans and suggest a central role for HTR1A in differentiating subgroups of patients with anxiety disorders.",Straube B.; Reif A.; Richter J.; Lueken U.; Weber H.; Arolt V.; Jansen A.; Zwanzger P.; Domschke K.; Pauli P.; Konrad C.; Gerlach AL.; Lang T.; Fydrich T.; Alpers GW.; Ströhle A.; Wittmann A.; Pfleiderer B.; Wittchen HU.; Hamm A.; Deckert J.; Kircher T.,2014.0,10.1038/tp.2014.130,0,0,
3314,"Neural correlates of procedural variants in cognitive-behavioral therapy: a randomized, controlled multicenter FMRI study.","Cognitive behavioral therapy (CBT) is an effective treatment for panic disorder with agoraphobia (PD/AG). It is unknown, how variants of CBT differentially modulate brain networks involved in PD/AG. This study was aimed to evaluate the effects of therapist-guided (T+) versus self-guided (T-) exposure on the neural correlates of fear conditioning in PD/AG. In a randomized, controlled multicenter clinical trial in medication-free patients with PD/AG who were treated with 12 sessions of manualized CBT, functional magnetic resonance imaging (fMRI) was used during fear conditioning before (t1) and after CBT (t2). Quality-controlled fMRI data from 42 patients and 42 healthy subjects (HS) were obtained. Patients were randomized to two variants of CBT (T+, n = 22, and T-, n = 20). The interaction of diagnosis (PD/AG, HS), treatment group (T+, T-), time point (t1, t2) and stimulus type (conditioned stimulus: yes, no) revealed activation in the left hippocampus and the occipitotemporal cortex. The T+ group demonstrated increased activation of the hippocampus at t2 (t2 > t1), which was positively correlated with treatment outcome, and a decreased connectivity between the left inferior frontal gyrus and the left hippocampus across time (t1 > t2). After T+ exposure, contingency-encoding processes related to the posterior hippocampus are augmented and more decoupled from processes of the left inferior frontal gyrus, previously shown to be dysfunctionally activated in PD/AG. Linking single procedural variants to neural substrates offers the potential to inform about the optimization of targeted psychotherapeutic interventions.",Straube B.; Lueken U.; Jansen A.; Konrad C.; Gloster AT.; Gerlach AL.; Ströhle A.; Wittmann A.; Pfleiderer B.; Gauggel S.; Wittchen U.; Arolt V.; Kircher T.,2014.0,10.1159/000359955,0,0,
3315,"Effectiveness of a web-based self-help intervention for symptoms of depression, anxiety, and stress: randomized controlled trial","ER OBJECTIVEThe aim was to study whether a Web-based self-help intervention is effective in reducing depression, anxiety, and work-related stress (burnout).METHODSA total of 213 participants were recruited through mass media and randomized to the intervention (n = 107) or a waiting list control group (n = 106). The Web-based course took 4 weeks. Every week an automated email was sent to the participants to explain the contents and exercises for the coming week. In addition, participants were supported by trained psychology students who offered feedback by email on the completed exercises. The core element of the intervention is a procedure in which the participants learn to approach solvable problems in a structured way. At pre-test and post-test, we measured the following primary outcomes: depression (CES-D and MDI), anxiety (SCL-A and HADS), and work-related stress (MBI). Quality of life (EQ-5D) was measured as a secondary outcome. Intention-to-treat analyses were performed.RESULTSOf the 213 participants, 177 (83.1%) completed the baseline and follow-up questionnaires; missing data were statistically imputed. Of all 107 participants in the intervention group, 9% (n = 10) dropped out before the course started and 55% (n = 59) completed the whole course. Among all participants, the intervention was effective in reducing symptoms of depression (CES-D: Cohen's d = 0.50, 95% confidence interval (CI) 0.22-0.79; MDI: d = 0.33, 95% CI 0.03-0.63) and anxiety (SCL-A: d = 0.42, 95% CI 0.14-0.70; HADS: d = 0.33, 95% CI 0.04-0.61) as well as in enhancing quality of life (d = 0.31, 95% CI 0.03-0.60). Moreover, a higher percentage of patients in the intervention group experienced a significant improvement in symptoms (CES-D: odds ratio [OR] = 3.5, 95% CI 1.9-6.7; MDI: OR = 3.7, 95% CI 1.4-10.0; SCL-A: OR = 2.1, 95% CI 1.0-4.6; HADS: OR = 3.1, 95% CI 1.6-6.0). Patients in the intervention group also recovered more often (MDI: OR = 2.2; SCL-A: OR = 2.0; HADS < 8), although these results were not statistically significant. The course was less effective for work-related stress, but participants in the intervention group recovered more often from burnout than those in the control group (OR = 4.0, 95% CI 1.2-13.5).CONCLUSIONSWe demonstrated statistically and clinically significant effects on symptoms of depression and anxiety. These effects were even more pronounced among participants with more severe baseline problems and for participants who fully completed the course. The effects on work-related stress and quality of life were less clear. To our knowledge, this is the first trial of a Web-based, problem-solving intervention for people with different types of (comorbid) emotional problems. The results are promising, especially for symptoms of depression and anxiety. Further research is needed to enhance the effectiveness for work-related stress.TRIAL REGISTRATIONInternational Standard Randomized Controlled Trial Number (ISRCTN) 14881571.BACKGROUNDSelf-help therapies are often effective in reducing mental health problems. We developed a new Web-based self-help intervention based on problem-solving therapy, which may be used for people with different types of comorbid problems: depression, anxiety, and work-related stress.","Straten, A; Cuijpers, P; Smits, N",2008.0,10.2196/jmir.954,0,0,
3316,Emotion-induced retrograde amnesia is determined by a 5-HTT genetic polymorphism,"A polymorphism in the human serotonin transporter (5-HTT) gene is implicated in susceptibility to anxiety and depression and in enhanced emotion-induced activation in the amygdala. A role for 5-HTT polymorphism in the emotional modulation of human episodic memory has yet to be demonstrated. Here, we demonstrate that whereas emotional memory for aversive events per se is not influenced by 5-HTT polymorphism, an emotion-induced retrograde amnesia is expressed solely in the presence of the short allele. The findings indicate a critical role for the serotonin system in emotion-mediated memory disruption. Copyright © 2008 Society for Neuroscience.",Strange B.A.; Kroes M.C.W.; Roiser J.P.; Tan G.C.Y.; Dolan R.J.,2008.0,10.1523/JNEUROSCI.0834-08.2008,0,0,
3317,"Rationale, design and methods for a randomised and controlled trial of the impact of virtual reality games on motor competence, physical activity, and mental health in children with developmental coordination disorder","ER METHODS: This cross-over randomised and controlled trial will examine whether motor coordination is enhanced by access to active electronic games and whether daily activity, attitudes to physical activity and mental health are also enhanced. Thirty children aged 10-12 years with poor motor coordination (? 15th percentile) will be recruited and randomised to a balanced ordering of 'no active electronic games' and 'active electronic games'. Each child will participate in both conditions for 16 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is motor coordination, assessed by kinematic and kinetic motion analysis laboratory measures. Physical activity and sedentary behaviour will be assessed by accelerometry, coordination in daily life by parent report questionnaire and attitudes to physical activity, self-confidence, anxiety and depressed mood will be assessed by self report questionnaire. A sample of 30 will provide a power of > 0.9 for detecting a 5 point difference in motor coordination on the MABC-2 TIS scale (mean 17, sd = 5).DISCUSSION: This is the first trial to examine the impact of new virtual reality games on motor coordination in children with developmental coordination disorder. The findings will provide critical information to understand whether these electronic games can be used to have a positive impact on the physical and mental health of these children. Given the importance of adequate motor coordination, physical activity and mental health in childhood, this project can inform interventions which could have a profound impact on the long term health of this group of children.TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000400965.BACKGROUND: A healthy start to life requires adequate motor development and physical activity participation. Currently 5-15% of children have impaired motor development without any obvious disorder. These children are at greater risk of obesity, musculoskeletal disorders, low social confidence and poor mental health. Traditional electronic game use may impact on motor development and physical activity creating a vicious cycle. However new virtual reality (VR) game interfaces may provide motor experiences that enhance motor development and lead to an increase in motor coordination and better physical activity and mental health outcomes. VR games are beginning to be used for rehabilitation, however there is no reported trial of the impact of these games on motor coordination in children with developmental coordination disorder.","Straker, L M; Campbell, A C; Jensen, L M; Metcalf, D R; Smith, A J; Abbott, R A; Pollock, C M; Piek, J P",2011.0,10.1186/1471-2458-11-654,0,0,
3318,Long-term results after open Bankart operation for anterior shoulder instability. A 3- to 16-year follow-up.,"The open Bankart procedure is still considered the gold standard for patients with recurrent posttraumatic anterior shoulder instability. The purpose of this retrospective study was to analyze long-term results after open Bankart procedure in 83 patients that were operated between 1987 and 2000 and to evaluate the rate of recurrent instability, level of function and range of motion. The mean follow-up time was 9 (3-16) years. The postoperative recurrence rate including subluxations was 12%. The mean Constant score was 77 and the mean Rowe score was 63. Average loss of external rotation in 90 degrees of abduction was 19 degrees . The results were disappointing in terms of stability and function. In the absence of longterm prospective studies on newer arthroscopic techniques, the decision on the reconstruction method must still be based on the surgeon's experience and the patient's choice.",Strahovnik A.; Fokter SK.,2006.0,10.1007/s00508-006-0551-z,0,0,
3319,Home-based telehealth to deliver evidence-based psychotherapy in veterans with PTSD.,"Although medical service delivery via home-based telehealth technology (HBT) is gaining wider acceptance in managing chronic illnesses such as diabetes or chronic obstructive pulmonary disease, few studies have tested HBT applications of psychotherapy. Clinicians, administrators, and researchers question whether delivering psychotherapeutic services to patients in their homes via video-conferencing technology compromises patient safety, potency of treatment, or data security. Despite these concerns, HBT service delivery may increase access to evidence-based psychotherapies for veterans with posttraumatic stress disorder (PTSD), who may be less willing or less able to receive weekly treatment at a VA medical center or outpatient clinic due to symptom severity or other similar barriers to care. Indeed, although combat-exposed service members endorse high rates of psychiatric disorders, few appear to initiate mental health services or receive an adequate dose of treatment. Thus, using HBT technologies to administer evidence-based therapies remains uncharted territory in both the clinical and research arenas. This manuscript describes an ongoing four year randomized controlled trial comparing in-person Prolonged Exposure (PE) - a specialized evidence-based psychotherapy for PTSD - and PE delivered via HBT, with a particular focus on the selection, application, and strengths/weaknesses of HBT procedures.",Strachan M.; Gros DF.; Yuen E.; Ruggiero KJ.; Foa EB.; Acierno R.,2012.0,10.1016/j.cct.2011.11.007,0,0,
3320,An integrated approach to delivering exposure-based treatment for symptoms of PTSD and depression in OIF/OEF veterans: preliminary findings.,"Combat-exposed military personnel from the wars in Iraq and Afghanistan report high rates of PTSD and associated psychiatric problems. A formidable body of research supports exposure therapy as a front-line intervention for PTSD; however, relative to studies of civilians, fewer investigations have evaluated the effectiveness of exposure therapy using military samples. Specifically, barriers to care (e.g., stigma associated with receiving mental health services ) may compromise utilization of evidence-based psychotherapy. As such, researchers have argued that veterans with PTSD may require an integrated and innovative approach to the delivery of exposure techniques. This paper presents the rationale for and preliminary data from an ongoing clinical trial that compares the home-based telehealth (HBT) application of a brief, behavioral treatment (Behavioral Activation and Therapeutic Exposure; BA-TE) for veterans with PTSD to the standard, in-person application of the same treatment. Forty OIF/OEF veterans with PTSD and MDD were consented, enrolled, and randomized to condition (BA-TE in-person, or BA-TE HBT) and symptoms of anxiety and depression were assessed at pre- and posttreatment. Participants in both conditions experienced reductions in depression, anxiety, and PTSD symptoms between pre- and posttreatment, suggesting that HBT application of an integrated PTSD treatment may be feasible and effective.",Strachan M.; Gros DF.; Ruggiero KJ.; Lejuez CW.; Acierno R.,2012.0,10.1016/j.beth.2011.03.003,0,0,
3321,Reorganization of unresolved childhood traumatic memories following exposure therapy,"ER As part of an ongoing randomized clinical trial for childhood-abuse-related PTSD, this study examined the association between PTSD and unresolved attachment as measured by the Adult Attachment Interview in a sample of 52 female childhood-abuse survivors. Results revealed that 55% of the sample was classified as preoccupied and almost 75% was classified as unresolved with regard to trauma. In a preliminary sample of 18 women who completed treatment, 13 were unresolved before treatment and 8 lost their unresolved status following treatment. This effect was significantly more pronounced in the exposure condition compared to the skills training condition.","Stovall-McClough, K C; Cloitre, M",2003.0,,0,0,
3322,"Unresolved attachment, PTSD, and dissociation in women with childhood abuse histories","ER The primary objective of this study was to examine unresolved trauma as assessed by the Adult Attachment Interview and current psychiatric symptoms, focusing on posttraumatic stress disorder (PTSD) and dissociation, in a group of adult female childhood abuse survivors. The authors examined psychiatric symptoms and attachment representations in a group with (n = 30) and without (n = 30) abuse-related PTSD. The findings revealed that unresolved trauma carried a 7.5-fold increase in the likelihood of being diagnosed with PTSD and was most strongly associated with PTSD avoidant symptoms rather than dissociative symptoms. The utility of a PTSD framework for understanding unresolved trauma and the role of intentional avoidance of trauma cues in the maintenance of traumatized states of mind are discussed.","Stovall-McClough, K C; Cloitre, M",2006.0,10.1037/0022-006X.74.2.219,0,0,
3323,Influence of metoprolol dosage release formulation on the pharmacokinetic drug interaction with paroxetine,"Studies have demonstrated an influence of dosage release formulations on drug interactions and enantiomeric plasma concentrations. Metoprolol is a commonly used beta-adrenergic antagonist metabolized by CYP2D6. The CYP2D6 inhibitor paroxetine has previously been shown to interact with metoprolol tartrate. This open-label, randomized, 4-phase crossover study assessed the potential differential effects of paroxetine on stereoselective pharmacokinetics of immediate-release (IR) tartrate and extended-release (ER) succinate metoprolol formulations. Ten healthy participants received metoprolol IR (50 mg) and ER (100 mg) with and without paroxetine coadministration. Blood samples were collected over 24 hours for determination of metoprolol plasma enantiomer concentrations. Paroxetine coadministration significantly increased S and R metoprolol area under the plasma concentration-time curve from time 0 to the 24-hour blood draw (AUC0-24h) by 4- and 5-fold, respectively for IR, and 3- and 4-fold, respectively, for ER. S/R AUC ratios significantly decreased. These results demonstrate a pharmacokinetic interaction between paroxetine and both formulations of metoprolol. The interaction is greater with R metoprolol, and stereoselective metabolism is lost. This could theoretically result in greater beta-blockade and lost cardioselectivity. The magnitude of the interaction was similar between metoprolol formulations, which may be attributable to low doses/drug input rates employed. © 2011 The Author(s).",Stout S.M.; Nielsen J.; Welage L.S.; Shea M.; Brook R.; Kerber K.; Bleske B.E.,2011.0,10.1177/0091270010365559,0,0,
3324,D-cycloserine does not enhance exposure-response prevention therapy in obsessive-compulsive disorder.,"Obsessive-compulsive disorder is a common, chronic, and oftentimes disabling disorder. The only established first-line treatments for obsessive-compulsive disorder are exposure and response prevention therapy and the serotonin reuptake inhibitors. Many patients do not experience complete symptom resolution with either modality and require augmentation approaches. Recent animal and clinical data suggest that D-cycloserine, a partial agonist that acts at the strychnine-insensitive glycine-recognition site of the N-methyl-D-aspartate receptor complex, may enhance extinction learning that occurs in exposure-based psychotherapies. Given this, this study examined if D-cycloserine (250 mg) enhances the overall efficacy and rate of change of exposure and response prevention therapy for adult obsessive-compulsive disorder. Participants were 24 adults meeting Diagnostic and Statistical Manual of Mental Disorders-IV criteria for obsessive-compulsive disorder. The study design was a randomized, double-blinded, placebo-controlled augmentation trial examining exposure and response prevention therapy+D-cycloserine versus exposure and response prevention therapy+placebo. All patients received 12 weekly sessions of exposure and response prevention treatment. The first session involved building a ritual hierarchy and providing psychoeducation about obsessive-compulsive disorder. The second session involved a practice exposure. Sessions 3-12 involved exposure and response prevention exercises. D-cycloserine or placebo (250 mg) was taken 4 h before every session. No significant group differences were found across outcome variables. The rate of improvement did not differ between groups. The present results fail to support the use of D-cycloserine with exposure and response prevention therapy for adult obsessive-compulsive disorder. As this study is the first to explore this question and a number of methodological issues must be considered when interpreting the findings, the conclusions that may be drawn from our results are limited.",Storch EA.; Merlo LJ.; Bengtson M.; Murphy TK.; Lewis MH.; Yang MC.; Jacob ML.; Larson M.; Hirsh A.; Fernandez M.; Geffken GR.; Goodman WK.,2007.0,10.1097/YIC.0b013e32819f8480,0,0,
3325,"Florida Obsessive-Compulsive Inventory: development, reliability, and validity.","The Florida Obsessive-Compulsive Inventory (FOCI) is a new self-report questionnaire that has separate scales for symptom enumeration (The Checklist) and evaluation of symptom severity (Severity Scale). The present research investigated the FOCI in a sample of 113 patients with obsessive-compulsive disorder (OCD). The results indicated that the FOCI Severity Scale is internally consistent (alpha = .89) and highly correlated with the total score from the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; Goodman et al., 1989 a). The correlations of the FOCI Severity Scale with measures of depression and global severity of psychopathology were similar to those obtained with the Y-BOCS Total Severity Score. The FOCI Symptom Checklist had adequate reliability (K-R 20 = .83) and moderate correlations (rs < .45) with the FOCI Severity Scale, the Y-BOCS scales, and measures of depression and severity of psychopathology. These findings imply concurrent validity for the FOCI Severity Scale. A strength of the FOCI is that it offers a quick evaluation of both presence and severity of OCD symptoms. An important limitation is that the FOCI does not assess the severity of individual symptoms.",Storch EA.; Kaufman DA.; Bagner D.; Merlo LJ.; Shapira NA.; Geffken GR.; Murphy TK.; Goodman WK.,2007.0,10.1002/jclp.20382,0,0,
3326,Efficacy of Augmentation of Cognitive Behavior Therapy With Weight-Adjusted d-Cycloserine vs Placebo in Pediatric Obsessive-Compulsive Disorder: a Randomized Clinical Trial,"ER OBJECTIVES: To examine the relative efficacy of weight-adjusted d-cycloserine (25 or 50 mg) vs placebo augmentation of CBT for youth with OCD and to assess if concomitant antidepressant medication moderated effects.DESIGN, SETTING, AND PARTICIPANTS: In a placebo-controlled randomized clinical trial, 142 youths (age range, 7-17 years) enrolled between June 1, 2011, and January 30, 2015, at 2 academic health science centers (University of South Florida and Massachusetts General Hospital) with a primary diagnosis of OCD were randomized in a double-blind fashion to d-cycloserine plus CBT or placebo plus CBT. Intent-to-treat analysis was performed.INTERVENTIONS: Patients were randomly assigned in a 1:1 ratio to either 10 sessions of d-cycloserine plus CBT or placebo plus CBT. d-cycloserine (25 or 50 mg) or placebo was taken 1 hour before sessions 4 through 10.MAIN OUTCOMES AND MEASURES: Children's Yale-Brown Obsessive Compulsive Scale at randomization, biweekly, midtreatment, and posttreatment. Secondary outcomes included the Clinical Global Impressions-Severity or Clinical Global Impressions-Improvement, remission status, Children's Depression Rating Scale, Multidimensional Anxiety Scale for Children, and Children's Obsessive-Compulsive Impact Scale-Parent Version.RESULTS: The study cohort comprised 142 participants. Their mean (SD) age was 12.7 (2.9) years, and 53.5% (76 of 142) were female. A mixed-effects model using all available data indicated significant declines in the Children's Yale-Brown Obsessive Compulsive Scale total score and Clinical Global Impressions-Severity. No significant interaction between treatment group and changes in the Children's Yale-Brown Obsessive Compulsive Scale and Clinical Global Impressions-Severity indicated that the d-cycloserine plus CBT group and the placebo plus CBT group declined at similar rates per assessment point on the Children's Yale-Brown Obsessive Compulsive Scale total score (estimate, -2.31, 95% CI, -2.79 to -1.83 and estimate, -2.03, 95% CI, -2.47 to -1.58, respectively) and Clinical Global Impressions-Severity (estimate, -0.29, 95% CI, -0.35 to -0.22 and estimate, -0.23, 95% CI, -0.29 to -0.17, respectively). No group differences in secondary outcomes were present. Antidepressant medication use at baseline did not moderate changes for either group.CONCLUSIONS AND RELEVANCE: d-cycloserine augmentation of CBT did not confer additional benefit relative to placebo among youth with OCD. Other augmentation approaches should be examined to enhance outcome.TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00864123.IMPORTANCE: Cognitive behavior therapy (CBT) among youth with obsessive-compulsive disorder (OCD) is effective, but many patients remain symptomatic after intervention. d-cycloserine, a partial agonist at the N-methyl-d-aspartate receptor in the amygdala, has been associated with enhanced CBT outcome for OCD among adults but requires evaluation among youth.","Storch, E A; Wilhelm, S; Sprich, S; Henin, A; Micco, J; Small, B J; McGuire, J; Mutch, P J; Lewin, A B; Murphy, T K; Geller, D A",2016.0,10.1001/jamapsychiatry.2016.1128,0,0,
3327,A RANDOMIZED CONTROLLED TRIAL IN COMMUNITY MENTAL HEALTH CENTERS OF COMPUTER-ASSISTED COGNITIVE BEHAVIORAL THERAPY VERSUS TREATMENT AS USUAL FOR CHILDREN WITH ANXIETY,"ER OBJECTIVE: This study aims to examine the real-world effectiveness of a computer-assisted cognitive behavioral therapy (CBT) protocol relative to treatment as usual (TAU) among anxious children presenting at community mental health centers.METHODS: One hundred children (7-13 years) with clinically significant anxiety were randomized to receive either 12 weekly computer-assisted CBT sessions or TAU for an equivalent duration. Assessments were conducted by independent evaluators at screening/baseline, midtreatment, posttreatment, and 1-month followup (for computer-assisted CBT treatment responders).RESULTS: There were significant between-group effects favoring the computer-assisted CBT condition on primary anxiety outcomes. Thirty of 49 (61.2%) children randomized to computer-assisted CBT responded to treatment, which was superior to TAU (6/51, 11.8%). Relative to TAU, computer-assisted CBT was associated with greater reductions in parent-rated child impairment and internalizing symptoms, but not child-rated impairment and anxiety and depressive symptoms. Treatment satisfaction and therapeutic alliance in those receiving computer-assisted CBT was high. Treatment gains in computer-assisted CBT responders were maintained at 1-month followup.CONCLUSIONS: Within the limitations of this study, computer-assisted CBT is an effective and feasible treatment for anxious children when used in community mental health centers by CBT-naïve clinicians.","Storch, E A; Salloum, A; King, M A; Crawford, E A; Andel, R; McBride, N M; Lewin, A B",2015.0,10.1002/da.22399,0,0,
3328,A preliminary study of D-cycloserine augmentation of cognitive-behavioral therapy in pediatric obsessive-compulsive disorder,"ER METHODParticipants were 30 youth (aged 8-17) with a primary diagnosis of OCD. The study design was a randomized, double-blinded, placebo-controlled augmentation trial examining CBT + DCS versus CBT + Placebo (15 youth per group). All patients received seven exposure and response prevention sessions paired with DCS or placebo taken 1 hour before sessions.RESULTSAlthough not significantly different, compared with the CBT + Placebo group, youth in the CBT + DCS arm showed small-to-moderate treatment effects (d = .31-.47 on primary outcomes). No adverse events were recorded.CONCLUSIONSThese results complement findings in adult OCD and non-OCD anxiety disorders and provide initial support for a more extensive study of DCS augmentation of CBT among youth with OCD.BACKGROUNDResearch on the neural circuitry underlying fear extinction has led to the examination of D-cycloserine (DCS), a partial agonist at the N-methyl-D-aspartate receptor in the amygdala, as a method to enhance exposure therapy outcome. Preliminary results have supported the use of DCS to augment exposure therapy in adult anxiety disorders; however, no data have been reported in any childhood anxiety disorder. Thus, we sought to preliminarily examine whether weight-adjusted DCS doses (25 or 50 mg) enhanced the overall efficacy of cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD).","Storch, E A; Murphy, T K; Goodman, W K; Geffken, G R; Lewin, A B; Henin, A; Micco, J A; Sprich, S; Wilhelm, S; Bengtson, M; Geller, D A",2010.0,10.1016/j.biopsych.2010.07.015,0,0,
3329,A randomized controlled trial of cognitive-behavioral therapy versus treatment as usual for adolescents with autism spectrum disorders and comorbid anxiety,"ER Objective Examine the efficacy of a personalized, modular cognitive-behavioral therapy (CBT) protocol among early adolescents with high-functioning autism spectrum disorders (ASDs) and co-occurring anxiety relative to treatment as usual (TAU). Method Thirty-one children (11-16 years) with ASD and clinically significant anxiety were randomly assigned to receive 16 weekly CBT sessions or an equivalent duration of TAU. Participants were assessed by blinded raters at screening, posttreatment, and 1-month follow-up. Results Youth randomized to CBT demonstrated superior improvement across primary outcomes relative to those receiving TAU. Eleven of 16 adolescents randomized to CBT were treatment responders, versus 4 of 15 in the TAU condition. Gains were maintained at 1-month follow-up for CBT responders. Conclusions These data extend findings of the promising effects of CBT in anxious youth with ASD to early adolescents.","Storch, E A; Lewin, A B; Collier, A B; Arnold, E; Nadai, A S; Dane, B F; Nadeau, J M; Mutch, P J; Murphy, T K",2015.0,10.1002/da.22332,0,0,
3330,Family-based cognitive-behavioral therapy for pediatric obsessive-compulsive disorder: comparison of intensive and weekly approaches,"ER METHODForty children and adolescents with OCD (range 7-17 years) were randomized to receive 14 sessions of weekly or intensive (daily psychotherapy sessions) family-based CBT. Assessments were conducted at three time points: pretreatment, posttreatment, and 3-month follow-up. Raters were initially blind to randomization. Primary outcomes included scores on the Children's Yale-Brown Obsessive-Compulsive Scale, remission status, and ratings on the Clinical Global Impression-Severity and Clinical Global Improvement scales. Secondary outcomes included the Child Obsessive Compulsive Impact Scale-Parent Rated, Children's Depression Inventory, Multidimensional Anxiety Scale for Children, and Family Accommodation Scale. Adjunctive pharmacotherapy was not an exclusion criterion.RESULTSIntensive CBT was as effective as weekly treatment with some advantages present immediately after treatment. No group differences were found at follow-up, with gains being largely maintained over time. Although no group x time interaction was found for the Children's Yale-Brown Obsessive-Compulsive Scale (F(1,38) = 2.2, p = .15), the intensive group was rated on the Clinical Global Impression-Severity as less ill relative to the weekly group (F(1,38) = 9.4, p < .005). At posttreatment, 75% (15/20) of youths in the intensive group and 50% (10/20) in the weekly group met remission status criteria. Ninety percent (18/20) of youths in the intensive group and 65% (13/20) in the weekly group were considered treatment responders on the Clinical Global Improvement (chi1(2) = 3.6, p = .06).CONCLUSIONSBoth intensive and weekly CBT are efficacious treatments for pediatric OCD. Intensive treatment may have slight immediate advantages over weekly CBT, although both modalities have similar outcomes at 3-month follow-up.OBJECTIVETo examine the relative efficacy of intensive versus weekly cognitive-behavioral therapy (CBT) for children and adolescents with obsessive-compulsive disorder (OCD).","Storch, E A; Geffken, G R; Merlo, L J; Mann, G; Duke, D; Munson, M; Adkins, J; Grabill, K M; Murphy, T K; Goodman, W K",2007.0,10.1097/chi.0b013e31803062e7,0,0,
3331,Long-term outcome following Intensive Residential Treatment of Obsessive-Compulsive Disorder.,"IRT has been demonstrated as an effective treatment for severe, refractory OCD. Consecutive IRT subjects were ascertained over a 12 month period (female N=26, male N=35). Psychometric measures were completed at admission and discharge from the McLean/MGH OCD Institute IRT, including the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI) and the Work and Social Adjustment Scale (WSA)(N=61). These measures were repeated at one (N=57), three (N=42) and six months (N=36) following discharge. This study was IRB approved. OCD mean severity did not significantly worsen from discharge to the one (17.4, SD 6.5), three (16.5, SD 7.4) or six month (16.2, SD 7.3) follow-up (p>0.25). Furthermore, the significant improvement from admission was maintained at each of the one (17.4, SD 6.5), three (16.5, SD 7.4) and six month (16.2, SD SD 7.3) follow-up time points (p<0.001). Relapsers were significantly more likely to be living alone following discharge (p=0.01), and were less likely to have comorbid illnesses (p=0.02). There were no significant differences found between study dropouts and completers with regards to YBOCS scores (P>0.47). In the first OCD IRT long-term follow-up study to date, findings have indicated that mean treatment gains were maintained at one, three, and six months post-discharge. This finding is important as it suggests that improvements of OCD severity were subsequently retained in home and work environments. Improvement of depression severity from admission was also maintained.",Stewart SE.; Stack DE.; Tsilker S.; Alosso J.; Stephansky M.; Hezel DM.; Jenike EA.; Haddad SA.; Kant J.; Jenike MA.,2009.0,10.1016/j.jpsychires.2009.03.012,0,0,
3332,"Effectiveness of intensive residential treatment (IRT) for severe, refractory obsessive-compulsive disorder.","The aim of this study was to determine the effectiveness of an innovative Intensive Residential Treatment (IRT) program for severe refractory Obsessive-Compulsive Disorder (OCD). No formalized OCD IRT outcome studies have been completed to date in North America. Subjects admitted to the Massachusetts General Hospital/McLean OCD Institute (OCDI) between February 1997 and June 2003 comprised the intent-to-treat sample. Measures of OCD severity, depression severity and psychosocial well-being were determined at admission, interim and discharge points, and were subsequently compared via t-tests using a last-observation-carried-forward approach. Initial OCD severity subgroups and treatment length subgroups were created and analyzed. Correlations and stepwise linear regressions were conducted to determine treatment length predictors. The sample of 403 individuals (58.7% male) had an average 66 day treatment length. Mean YBOCS scores decreased by 30.1%, from 26.6 (SD 6.1) at admission to 18.6 (SD 7.2) at discharge, reflecting a clinically meaningful improvement (p<0.001). Psychosocial functioning, depression severity scores and self-report global functioning ratings also indicated significant improvement. Subgroups with longer treatment lengths tended to have earlier ages of OCD onset and increased OCD severity scores at admission. IRT deserves recognition as a therapeutic approach for severe, refractory OCD. In the largest study to date for IRT significant improvements of OCD severity, depression severity and quality of life were determined. IRT should be considered prior to more invasive approaches for severe refractory OCD.",Stewart SE.; Stack DE.; Farrell C.; Pauls DL.; Jenike MA.,2005.0,10.1016/j.jpsychires.2005.01.004,0,0,
3333,A single-blinded case-control study of memantine in severe obsessive-compulsive disorder.,"Background: Obsessive-compulsive disorder (OCD) is a common debilitating psychiatric illness that typically improves but does not remit with first-line medication and behavioral treatments. Serotonergic agents including selective serotonin reuptake inhibitors and clomipramine have provided the mainstay of OCD medication management for decades. Combined dopamine/serotonergic agents such as atypical antipsychotics are presently the only OCD-augmenting strategies proven effective via randomized controlled trials. Despite increasing evidence for a pathogenic role of glutamate in OCD, no controlled trials of glutamatergic augmenting agents have been reported. Methods: An intent-to-treat sample included 44 subjects receiving standard treatment at the McLean/Massachusetts General Hospital Intensive Residential Treatment (IRT) program, 22 of whom also received memantine augmentation. Admission, monthly and discharge measures of OCD, depression, and psychosocial functioning were collected by raters blinded to augmentation status. Matched controls were selected based on sex, initial OCD severity, psychosocial functioning, and timing of admission. The Clinical Global Improvement Scale captured global clinical change. Results: Mean (SD) Yale-Brown Obsessive Compulsive Scale score decreases were 7.2 (6.4) among the cases and 4.6 (5.9) among the matched controls, reflecting mean clinical improvement among the cases (27.0% decrease) but not the controls (16.5% decrease). Mean (SD) depression severity score decreases were 5.8 (9.5) among the cases and 4.7 (9.9) among the controls. Initial intrusive obsessions were significantly more severe among marked responders compared with limited response or nonresponse cases (4.4 vs 2.9; t = 2.15; P = 0.048). Conclusions: This study provides preliminary supportive evidence for the effectiveness of memantine as a glutamatergic augmenting agent in severe OCD. Future randomized double-blind placebo-controlled trials are warranted. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Stewart, S. Evelyn; Jenike, Eric A; Hezel, Dianne M; Stack, Denise Egan; Dodman, Nicholas H; Shuster, Louis; Jenike, Michael A; Ackerman, Arnold, Arnold, Beck, Bolton, Buchsbaum, Burt, Bystritsky, Cannistraro, Carlsson, Carlsson, Chakrabarty, Connor, Coric, Delorme, Denys, Dickel, Feusner, Foa, Geller, Goodman, Goodman, Goodman, Hezel, Hollander, Kaplan, Karno, Koran, Lafleur, Leckman, Li, Lieberman, Marazziti, Mataix-Cols, Mundt, Nissen, Pallanti, Pasqumi, Porter, Poyurovsky, Pralong, Rosenberg, Saxena, Shugart, Stewart, Stewart, Stewart, Stewart, Swedo, Szeszko, Van Ameringen, Welch, Yovel, Yucel",2010.0,,0,0,
3334,Cognitive-behavioral therapy for adult anxiety disorders in clinical practice: A meta-analysis of effectiveness studies.,"The efficacy of cognitive-behavioral therapy (CBT) for anxiety in adults is well established. In the present study, the authors examined whether CBT tested under well-controlled conditions generalizes to less-controlled, real-world circumstances. Fifty-six effectiveness studies of CBT for adult anxiety disorders were located and synthesized. Meta-analytic effect sizes are presented for disorder-specific symptom measures as well as symptoms of generalized anxiety and depression for each disorder, and benchmarked to results from randomized controlled trials. All pretest-posttest effect sizes for disorder-specific symptom measures were large, suggesting that CBT for adult anxiety disorders is effective in clinically representative conditions. Six studies included a control group, and between-groups comparisons yielded large effect sizes for disorder-specific symptoms in favor of CBT. Benchmarking indicated that results from effectiveness studies were in the range of those obtained in selected efficacy trials. To test whether studies that are more representative of clinical settings have smaller effect sizes, the authors coded studies for 9 criteria for clinical representativeness. Results indicate an inverse relationship between clinical representativeness and outcome, but the magnitude of the relationship is quite small. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stewart, Rebecca E; Chambless, Dianne L; Hunsley, Addis, Antony, Argras, Arntz, Bados, Bakker, Barlow, Barlow, Blomhoff, Borkovec, Borkovec, Burke, Chambless, Chambless, Chambless, Clark, Cohen, Crits-Christoph, Davidson, Deacon, Deacon, Dunlap, Durham, Ellis, Feske, Foa, Foa, Franklin, Friedman, Friedman, Garcia-Palacios, Gaston, Gillespie, Hahlweg, Hedges, Hedges, Heldt, Herbert, Herbert, Higgins, Hoagwood, Hunt, Jacobson, Kenardy, Levitt, Light, Lincoln, Linden, Lipsey, Marom, Martinsen, McEvoy, McLean, Mortberg, Mortberg, Norberg, Norton, Orwin, Persons, Resick, Rosenberg, Rosenthal, Rosenthal, Rothbaum, Sanderson, Schulte, Schultz, Seligman, Shadish, Sharp, Sharp, Sholomskas, Shrout, Stangier, Stanley, Stirman, Stirman, Tolin, Tolin, Van Noppen, Van Oppen, Wade, Warren, Warren, Weisz, Weisz, Weisz, Westbrook, Westen, Westen, Wetzel, White, Whittal, Ost",2009.0,,0,0,
3335,Neuroticism as a predictor of mood change: the effects of tryptophan depletion,"ER BACKGROUND: Acute tryptophan depletion (ATD) results in a transient lowering of mood in patients recovered from depression and in healthy volunteers with a family history of affective disorders. The personality trait of neuroticism is strongly associated with depression. AIMS: To assess whether neuroticism predicts mood change in response to ATD in healthy volunteers. METHOD: Healthy volunteers who scored at the top and bottom fifth percentiles of neuroticism scores (17 and 15 respectively) were selected. In a double-blind, crossover study they received a tryptophan-free or a control drink. Mood and cognition were assessed. RESULTS: Neuroticism did not predict the amount of mood change following ATD but did moderate performance on the verbal fluency test. A family history of affective disorder (n=5) predicted mood change but not cognitive function following ATD. CONCLUSIONS: Neuroticism moderates aspects of cognitive function, but in this study it was not strongly related with mood change via serotonin.","Stewart, M E; Deary, I J; Ebmeier, K P",2002.0,,0,0,
3336,Cognitive change following cognitive behavioural therapy for non-cardiac chest pain.,"The aim of the study was threefold: (1) does cognitive behavioral therapy (CBT) have a differential effect on cognitive measures; (2) does a relationship exist between improvement in non-cardiac chest pain and changes in cognitive measures; and (3) can panic be established as a moderator of the effect of treatment? 65 patients (aged 18-75 yrs) with non-cardiac chest pain completed a randomised trial comparing study CBT with ""care as usual."" Dependent measures were frequency of chest pain, anxiety, the fear of bodily sensations, attributions, and catastrophic cognitions. Follow-up assessments were made at 6 and 12 mo after the baseline interview. CBT had a differential effect on most of the cognitive measures. Pain reduction was associated with the development of more adequate cognitions with respect to chest pain, independent of anxiety reduction. Pain reduction following CBT may be cognitively mediated. The presence of panic did not affect the outcome of treatment, implying a broad applicability of the cognitive model for treatment of patients with non-cardiac chest pain. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Van Peski-Oosterbaan, Anke S; Spinhoven, Philip; Van der Does, A. J. Willem; Bruschke, Albert V. G; Rooijmans, Harry G. M; Arrindell, Barlow, Baron, Bass, Beitman, Chambless, Chignon, Clark, Cox, de Ruiter, Engel, Fleet, Holroyd, Klimes, Lantinga, Mayou, Mayou, Mayou, Salkovskis, Serlie, Spinhoven, van der Feltz-Cornelis, Van Peski-Oosterbaan, Van Peski-Oosterbaan, Warwick, Weismann, Whisman, Zigmund",1999.0,,0,0,
3337,"A double-blind, randomized, placebo-controlled study of mirtazapine in functional dyspepsia with weight loss.","Introduction: Therapeutic options in functional dyspepsia (FD) are limited, and this is especially challenging when symptoms are severe and associated with weight loss. Anecdotal observations suggest a therapeutic potential for mirtazapine, a dual action (noradrenergic-serotonergic) antidepressant with H1-, α2-, 5-HT2c- and 5-HT3-receptor antagonistic properties. Our aim was to conduct a placebo-controlled trial of mirtazapine in FD with weight loss. Methods: FD patients who lost >10% of original body weight and without depression or anxiety disorder were recruited for the study. After baseline assessment of solid and liquid gastric emptying, gastric barostat study and a nutrient challenge test, patients were randomized to placebo or mirtazapine 15 mg in the evening, in a double-blind randomized fashion. Evaluations during 2-week baseline and 8-week treatment period included FD symptom severity, the short form Nepean Dyspepsia Index (SF-NDI) quality of life in FD, the hospital anxiety and depression scale (HADS), patient health questionnaire (PHQ: somatization, panic & depression modules) and gastrointestinal-specific anxiety (visceral sensitivity index, VSI). Gastric emptying and nutrient challenge tests were repeated after 8 weeks. Data (mean±SEM) were compared by t-test and by two-way ANOVA. Results: We enrolled 19 FD patients (18 women, mean age 35±3) with a weight loss of 13.2±2.8 kg. Treatment with mirtazapine, but not placebo, was associated with a significant improvement of overall FD symptom severity scores (respectively 14.7±2.4 vs. 6.0±2.3, p<0.05 and 13.2±1.6 vs. 10.5±2.1, NS). Early satiety was significantly improved by mirtazapine (2.1±0.1 vs. 1.0±0.3, p<0.05), but not by placebo (1.6±0.3 vs. 1.7±0.3, NS). Significantly improved nutrient tolerance (increase of maximum tolerated nutrient volume 75±15 vs. -50±22 ml, p<0.05) and higher weight recovery (6.5±1.6 vs. 0.4±0.5 kg, p=0.001) occurred with mirtazapine compared to placebo. No significant changes occurred in gastric emptying rate, HADS or PHQ score. Mirtazapine, and not placebo, was associated with significant improvement in VSI score (respectively 62.7±5.8 vs. 71.6±5.6, p<0.05 and 58.8±5.2 vs. 60.7±5.8, NS) and in the NDI domains of interference with daily life and food/drink (both p<0.05 for mirtazapine and NS for placebo). Conclusion: Mirtazapine significantly improves overall FD symptoms, quality of life and gastrointestinal-specific anxiety in FD with weight loss. The favorable effect of mirtazapine is associated with improvement of early satiety and nutrient tolerance, and better recovery of weight loss.",Van Oudenhove L.; Holvoet L.; Bisschops R.; Caenepeel P.; Arts J.; De Wulf D.; Vos R.; Sifrim D.; Tack J.F.,2009.0,10.1016/S0016-5085(09)60210-9,0,0,
3338,Cognitive Therapy for Obsessive-Compulsive Disorder.,"This case report is about a 31-year-old married female with a variety of obsessions, primarily focusing on harming obsessions. Because of anxiety, numerous washing rituals have taken place as well as the avoidance of situations. This client was diagnosed with Obsessive-Compulsive Disorder (OCD) and was seen for 25 sessions of individual cognitive therapy. The aim of this study therefore was to illustrate the assessment, case conceptualization, and course of treatment in a severe obsessive-compulsive client, using cognitive therapy. Several specific cognitive interventions, which address the estimations of catastrophes and the perceptions of personal responsibility, are presented and illustrated. At posttreatment and at follow-up, a clinically significant change for improvement was demonstrated for the obsessive-compulsive symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Van Oppen, Patricia; Beck, Beck, Carr, Clark, Emmelkamp, Emmelkamp, Emmelkamp, Emmelkamp, Freeston, Freeston, Freeston, Goodman, Jacobson, Luteijn, McFall, Purdon, Rachman, Salkovskis, Salkovskis, Sanavio, Van Oppen, Van Oppen, Van Oppen, Van Oppen, Watson",2004.0,,0,0,
3339,Does the therapy manual or the therapist matter most in treatment of obsessive-compulsive disorder? A randomized controlled trial of exposure with response or ritual prevention in 118 patients.,"The importance of the therapist's education and experience for the successful behavior treatment of obsessive-compulsive disorder (OCD) has not been investigated. Data on the relative effectiveness of self-controlled versus therapist-controlled in vivo exposure with response or ritual prevention (ERP) have yielded conflicting results. The present study compared the effectiveness of 4 different modes of delivery of ERP in a referred sample of OCD patients. Of the 146 eligible OCD outpatients, 118 patients enrolled in this randomized controlled trial and were randomly assigned to (1) therapist-controlled ERP performed by experienced behavior therapists; (2) therapist-controlled ERP performed by master's students of clinical psychology; (3) self-controlled ERP performed by experienced behavior therapists; and (4) self-controlled ERP performed by master's students of clinical psychology. This trial was performed from January 1999 to January 2005. Our analyses revealed no significant differences in clinical outcome between any of the different modes of delivery of ERP at posttreatment. The different ERP modes of delivery were associated with significant pretreatment to posttreatment improvement on all measurements, with large effect sizes on the primary outcome measure, the Yale-Brown Obsessive Compulsive Scale. Our results indicate that clinically inexperienced master's students with no postgraduate training can be as capable as experienced and certified behavior therapists in treating OCD patients, as long as therapists adhere to a standardized treatment manual and adequate training and supervision is provided. In contrast to other studies, we did not find a supposed benefit of therapist-controlled ERP versus self-controlled ERP in patients with OCD. www.trialregister.nl Identifier: NTR1444.",van Oppen P.; van Balkom AJ.; Smit JH.; Schuurmans J.; van Dyck R.; Emmelkamp PM.,2010.0,10.4088/JCP.08m04990blu,0,0,
3340,Cognitive therapy and exposure in vivo alone and in combination with fluvoxamine in obsessive-compulsive disorder: a 5-year follow-up.,"Information regarding the long-term effectiveness of the combination of pharmacotherapy and cognitive-behavioral therapy (CBT) in the treatment of obsessive-compulsive disorder (OCD) is limited. Our study is the first to examine the long-term effectiveness of cognitive therapy (CT) and to compare long-term effectiveness of CT alone, exposure in vivo with response prevention (ERP) alone, and CBT (either CT or ERP) in combination with fluvoxamine in the treatment of OCD. Of 122 outpatients with primary DSM-III-R-defined OCD originally enrolled in 2 randomized controlled trials, 102 patients (45 male/57 female; mean +/- SD age = 36.2 +/- 10.7 years; range, 19-64 years) were available to be assessed for the presence and severity of OCD and comorbid psychopathology at follow-up. Follow-up data were collected from November 1996 to June 1999. After 5 years, 54% of the participants no longer met the DSM-III-R criteria for OCD. Long-term outcome did not differ between the 3 treatment groups. At follow-up, treatment dropouts appeared to have more severe OCD complaints compared with treatment completers. Compared with patients receiving CT alone, significantly (p < .005) more patients receiving CBT with fluvoxamine used antidepressants 5 years later. This study demonstrates that at 5-year follow-up (1) prevalence of OCD had declined in all 3 treatment conditions, (2) the clinical benefits of all 3 treatment conditions were maintained, (3) OCD complaints were more severe for treatment dropouts than for treatment completers, and (4) about half of the patients initially treated with fluvoxamine continued antidepressant use.",van Oppen P.; van Balkom AJ.; de Haan E.; van Dyck R.,2005.0,,0,0,
3341,The structure of obsessive-compulsive symptoms.,"In the present study, the structure of obsessive-compulsive symptoms was investigated by means of the Padua Inventory (PI). Simultaneous Components Analysis on data from obsessive-compulsives (n = 206), patients with other anxiety disorders (n = 222), and a non clinical sample (n = 430) revealed a five-factor solution. These factors are: (I) impulses; (II) washing; (III) checking; (IV) rumination; and (V) precision. Forty-one items were selected as measure of these factors. The reliability for the five subscales, assessing each of the five factors, was found to be satisfactory to excellent. Four subscales (washing, checking, rumination and precision) discriminated between panic disorder patients, social phobics and normals on the one hand and obsessive compulsives on the other. The Impulses subscale discriminated between obsessive-compulsives on the one hand and normals on the other, but not between obsessive-compulsives and social phobics or panic patients. Some evidence in support of the construct validity was found. The Padua Inventory-Revised (41-items) appears to measure the structure of obsessive compulsive symptoms: The main types of behaviours and obsessions as seen clinically are assessed by this questionnaire, apart from obsessional slowness.",Van Oppen P.; Hoekstra RJ.; Emmelkamp PM.,1995.0,,0,0,
3342,Cognitive therapy and exposure in vivo in the treatment of obsessive compulsive disorder.,"The present study is the first controlled study that evaluates the effects of cognitive therapy along the lines of Beck (1976) [Cognitive therapy and the emotional disorder. New York: International University Press] and Salkovskis (1985) [Behaviour Research and Therapy, 23, 571-583] in obsessive compulsive disorder (OCD) and compares these effects with those of self-controlled exposure in vivo with response prevention. Seventy-one patients were randomly assigned to either cognitive therapy or exposure in vivo. In each treatment condition seven patients dropped out. Both treatments consisted of 16 sessions. Cognitive therapy as well as exposure in vivo led to statistically significant improvement. Multivariate significant differences suggesting a superior efficacy of cognitive therapy in comparison to exposure in vivo on the obsessive compulsive measures and on the measures for associated psychopathology. However, no univariate differences were found. Further, in both treatment conditions a considerable percentage of the patients was rated as ""recovered"". Significantly more patients were rated as ""recovered"" in the cognitive therapy. The results show that this form of cognitive therapy is an effective treatment for OCD and suggest that cognitive therapy may be even more effective than exposure in vivo.",van Oppen P.; de Haan E.; van Balkom AJ.; Spinhoven P.; Hoogduin K.; van Dyck R.,1995.0,,0,0,
3343,Group and multifamily behavioral treatment for obsessive compulsive disorder: A pilot study.,"Presents results from an uncontrolled trial of 2 types of group behavioral treatments for obsessive compulsive disorder (OCD): group (GBT) and multifamily (MFBT). 17 patients (10 women and 7 men) diagnosed with OCD received a partially manualized GBT delivered by co-therapy teams in 3 groups of 10 2-hr sessions. Mean interview-based Yale-Brown Obsessive Compulsive Scale (YBOCS) scores reduced significantly at posttest and at 1-yr follow-up, as did measures of overall functioning on the Sheehan Disability Scale at posttest and follow-up. A second cohort of 19 patients was treated with MFBT that included spouses/partners and parents in 3 co-therapy groups. Two groups received 10 2-hr sessions and 1 received 12 2-hr sessions. YBOCS scores reduced significantly at posttest and at 1-yr follow-up, with corresponding gains in disability scores. Both group treatments showed large effects comparable to those reported for a more intensive individual behavioral treatment. Comparisons of treatments indicated that similar proportions of Ss were reliably changed at posttest and follow-up respectively, but more MFBT than GBT participants were clinically significantly improved. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Van Noppen, Barbara; Steketee, Gail; McCorkle, Brian H; Pato, Michele",1997.0,,0,0,
3344,A time-limited behavioral group for treatment of obsessive-compulsive disorder.,"Describes a time-limited 10-session behavioral therapy group for obsessive-compulsive disorder (OCD) whose key elements are exposure, response prevention, therapist and participant modeling, and cognitive restructuring. In a naturalistic open trial of 90 patients meeting Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) criteria for OCD who completed the 10-session group, self-administered Yale-Brown Obsessive-Compulsive Scale scores were 21.8 +/- 5.6 at baseline and 16.6 +/- 6.4 after the 10-wk treatment, a significant decrease. The Ss who were on medication showed a greater improvement than those who were medication-free. A descriptive analysis of the therapeutic elements of the group and its advantages over individual behavioral treatment are presented. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Van Noppen, Barbara L; Pato, Michele T; Marsland, Richard; Rasmussen, Steven A",1998.0,,0,0,
3345,Response to serotonin reuptake inhibitors in OCD is not influenced by common CYP2D6 polymorphisms.,"The cornerstone of pharmacotherapy for OCD is serotonin reuptake inhibition, either with clomipramine or with selective serotonin reuptake inhibitors (SSRIs). In spite of the success of serotonin reuptake inhibiting drugs, nearly half of OCD patients do not respond to treatment. Treatment response may be affected by genetic polymorphisms of the P450 metabolic system. The four most common enzyme-activity reducing polymorphisms of the P450 CYP2D6 enzyme were determined in 91 outpatients with primary OCD according to DSM-IV criteria, receiving dosages titrated upward to 300 mg/day of venlafaxine or 60 mg/day of paroxetine, using a fixed dosing schedule. Our results show that the investigated CYP2D6 polymorphisms are not a decisive factor in the response to paroxetine and venlafaxine treatment in OCD in spite of their highly significant effect on the blood levels of these medicines. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Van Nieuwerburgh, Filip C. W; Denys, Damiaan A. J. P; Westenberg, Herman G .M; Deforce, Dieter L. D; Bradford, Denys, Denys, Denys, Goodman, Hollander, Johansson, Kirchheiner, Koran, Marez, Raimundo, Solus, Tournel, YaryuraTobias",2009.0,,0,0,
3346,Changes in PTSD patients' narratives during prolonged exposure therapy: a replication and extension.,"Following E. B. Foa, C. Molnar, and L. Cashman (1995), narrative changes from the first to the last exposure session were compared for improved and nonimproved PTSD patients on fragmentation, organization, internal, and external events. Improved (n = 8) and nonimproved (n = 12) patients did not differ regarding changes in fragmentation or organized thoughts. However, improved patients showed a greater decrease in disorganized thoughts during treatment. Furthermore, all patients, independent of improvement, showed significant changes in the same direction; a decrease in disorganized thoughts and external events and an increase in internal events. Although previous results were partly replicated, it is concluded that narrative changes may be due to exposure treatment itself rather than to changes in memory representation.",van Minnen A.; Wessel I.; Dijkstra T.; Roelofs K.,2002.0,10.1023/A:1015263513654,0,0,
3347,When do trauma experts choose exposure therapy for PTSD patients? A controlled study of therapist and patient factors.,"To investigate when and why therapists opt for or rule out imaginal exposure (IE) for patients with posttraumatic stress disorder (PTSD), 255 trauma experts were randomized to two conditions in which they were presented with four cases in which the patients' comorbidity and treatment preferences were manipulated. The results confirmed IE to be an underutilized approach, with the majority of professionals being undertrained in the technique. As predicted, the patient factors influenced the expert's choice of therapy: in case of a comorbid depression, IE was significantly less preferred than medication. Also, IE was significantly more likely to be offered when patients expressed a preference for trauma-focused treatment. The therapist factors were also found to be importantly related to treatment preferences, with high credibility in the technique being positively related to the therapists' preference for IE. Perceived barriers to IE, such as a fear of symptom exacerbation and dropout, were negatively related to the perceived suitability of the treatment when patients had suffered multiple traumas in childhood. The results are discussed in the light of clinical implications and the need of exposure training for trauma professionals.",van Minnen A.; Hendriks L.; Olff M.,2010.0,10.1016/j.brat.2009.12.003,0,0,
3348,"Avoidance behaviour of patients with posttraumatic stress disorder. Initial development of a questionnaire, psychometric properties and treatment sensitivity.","In this study, the development of the Posttraumatic Avoidance Behaviour Questionnaire (PABQ) is described and validated in 437 participants; PTSD patients (N = 75), clinical controls (patients with panic disorder with agoraphobia; PDA) (N = 50), and non-clinical traumatized controls (N = 312). Item reduction and exploratory factor analyses yielded 25 items reflecting seven factors. Internal consistency, test-retest reliability, convergent and discriminative validity of the PABQ proved adequate. In a second study, the PABQ showed to be sensitive to change due to exposure treatment outcome (N = 26).",van Minnen A.; Hagenaars MA.,2010.0,10.1016/j.jbtep.2010.01.002,0,0,
3349,Stepped care for depression and anxiety in visually impaired older adults: multicentre randomised controlled trial.,"Is stepped care compared with usual care effective in preventing the onset of major depressive, dysthymic, and anxiety disorders in older people with visual impairment (caused mainly by age related eye disease) and subthreshold depression and/or anxiety? 265 people aged ‚â•50 were randomly assigned to a stepped care programme plus usual care (n=131) or usual care only (n=134). Supervised occupational therapists, social workers, and psychologists from low vision rehabilitation organisations delivered the stepped care programme, which comprised watchful waiting, guided self help based on cognitive behavioural therapy, problem solving treatment, and referral to a general practitioner. The primary outcome was the 24 month cumulative incidence (seven measurements) of major depressive dysthymic and/or anxiety disorders (panic disorder, agoraphobia, social phobia, and generalised anxiety disorder). Secondary outcomes were change in symptoms of depression and anxiety, vision related quality of life, health related quality of life, and adaptation to vision loss over time up to 24 months' follow-up. 62 participants (46%) in the usual care group and 38 participants (29%) from the stepped care group developed a disorder. The intervention was associated with a significantly reduced incidence (relative risk 0.63, 95% confidence interval 0.45 to 0.87; P=0.01), even if time to the event was taken into account (adjusted hazard ratio 0.57, 0.35 to 0.93; P=0.02). The number needed to treat was 5.8 (3.5 to 17.3). The dropout rate was fairly high (34.3%), but rates were not significantly different for the two groups, indicating that the intervention was as acceptable as usual care. Participants who volunteered and were selected for this study might not be representative of visually impaired older adults in general (responders were significantly younger than non-responders), thereby reducing the generalisability of the outcomes. Stepped care seems to be a promising way to deal with depression and anxiety in visually impaired older adults. This approach could lead to standardised strategies for the screening, monitoring, treatment, and referral of visually impaired older adults with depression and anxiety. Funded by ZonMw InZicht, the Dutch Organisation for Health Research and Development-InSight Society. There are no competing interests. Full dataset and statistical code are available from the corresponding author.Study registration www.trialregister.nl NTR3296.",van der Aa HP.; van Rens GH.; Comijs HC.; Margrain TH.; Gallindo-Garre F.; Twisk JW.; van Nispen RM.,2015.0,,0,0,
3350,Stepped-care to prevent depression and anxiety in visually impaired older adults--design of a randomised controlled trial.,"Subthreshold depression and anxiety are common in the growing population of visually impaired older adults and increase the risk of full-blown depressive or anxiety disorders. Adequate treatment may prevent the development of depression or anxiety in this high risk group. A stepped-care programme was developed based on other effective interventions and focus groups with professionals and patient representatives of three low vision rehabilitation organisations in The Netherlands and Belgium. The final programme consists of four steps: 1) watchful waiting, 2) guided self-help, 3) problem solving treatment, 4) referral to general practitioner. The (cost-)effectiveness of this programme is evaluated in a randomised controlled trial. Patients (N‚Äâ=‚Äâ230) are randomly assigned to either a treatment group (stepped-care) or a control group (usual care). The primary outcome is the incidence of depressive and anxiety disorders, measured with the Mini International Neuropsychiatric Interview (MINI). Preventive interventions for depression and anxiety have received little attention in the field of low vision. A stepped-care programme that focuses on both depression and anxiety has never been investigated in visually impaired older adults before. If the intervention is shown to be effective, this study will result in an evidence based treatment programme to prevent depression or anxiety in patients from low vision rehabilitation organisations. The pragmatic design of the study greatly enhances the generalisability of the results. However, a possible limitation is the difficulty to investigate the contribution of each individual step. Identifier: NTR3296.",van der Aa HP.; van Rens GH.; Comijs HC.; Bosmans JE.; Margrain TH.; van Nispen RM.,2013.0,10.1186/1471-244X-13-209,0,0,
3351,Stepped-care to prevent depression and anxiety in visually impaired older adults - design of a randomised controlled trial.,"Background: Subthreshold depression and anxiety are common in the growing population of visually impaired older adults and increase the risk of full-blown depressive or anxiety disorders. Adequate treatment may prevent the development of depression or anxiety in this high risk group. Method/design: A stepped-care programme was developed based on other effective interventions and focus groups with professionals and patient representatives of three low vision rehabilitation organisations in the Netherlands and Belgium. The final programme consists of four steps: 1) watchful waiting, 2) guided self-help, 3) problem solving treatment, 4) referral to general practitioner. The (cost-) effectiveness of this programme is evaluated in a randomised controlled trial. Patients (N = 230) are randomly assigned to either a treatment group (stepped-care) or a control group (usual care). The primary outcome is the incidence of depressive and anxiety disorders, measured with the Mini International Neuropsychiatric Interview (MINI). Discussion: Preventive interventions for depression and anxiety have received little attention in the field of low vision. A stepped-care programme that focuses on both depression and anxiety has never been investigated in visually impaired older adults before. If the intervention is shown to be effective, this study will result in an evidence based treatment programme to prevent depression or anxiety in patients from low vision rehabilitation organisations. The pragmatic design of the study greatly enhances the generalisability of the results. However, a possible limitation is the difficulty to investigate the contribution of each individual step. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Van der Aa, Hilde PA; Van Rens, Ger H. M. B; Comijs, Hannie C; Bosmans, Judith E; Margrain, Tom H; Van Nispen, Ruth M. A; Araya, Augustin, Balkom, Barrett, Beekman, Beekman, Beekman, Beekman, Breslau, Brody, Brody, Cairney, Callahan, Casten, Cuijpers, Davidson, Girdler, Haaga, Hakkaart-van Roijen, Hakkaart-van Roijen, Hakkaart-van Roijen, Hegel, Horowitz, Horowitz, Horowitz, Horowitz, Horowitz, Huang, King-Kallimanis, Kok, Kvaal, Kuhner, Limburg, Lynch, MacLeod, Margrain, Meadows, Miller, Mitchell, Nieuwsma, O'Donnell, Patel, Rees, Rovner, Rovner, Rovner, Schutser, Sheehan, Smit, Smits, Snaith, Soubrane, Unutzer, Van Nispen, van't Veer-Tazelaar, van't Veer-Tazelaar, Wolffsohn",2013.0,,0,0,
3352,Impact of alopecia and scalp cooling on the well-being of breast cancer patients.,"Chemotherapy-induced alopecia, a common and distressing side effect of chemotherapy, may be prevented by scalp cooling, which reduces toxicity of cytostatics in hair root cells. This is the first study designed to assess the effect of scalp cooling on well-being. A prospective multi-centre study was performed in 13 hospitals. Breast cancer patients treated with (N=98) and without (N=168) scalp cooling completed questionnaires (EORTC QLQ-C30 and EORTC-QLQ-BR23, BIS, MBA, HADS) before chemotherapy, and three weeks and six months after the last chemotherapy cycle. Scalp cooling was effective in 52% of the cases. Alopecia was considered among the most distressing problems at all three moments of measurement. A trend towards higher well-being was found in successfully scalp-cooled patients, as indicated by a general better health-related quality of life and better body image, whereas unsuccessfully scalp-cooled patients reported lowest well-being. Scalp cooling contributes not only to the well-being of successfully scalp-cooled patients but also seems to cause additional distress when patients lose their hair despite scalp cooling. This might be related to disappointment due to alopecia despite scalp cooling or possibly to a general higher biological availability of cytostatics. We recommend additional support for patients when scalp cooling is not successful and to spend more effort to maximise the effectiveness of scalp cooling.",van den Hurk CJ.; Mols F.; Vingerhoets AJ.; Breed WP.,2010.0,10.1002/pon.1615,0,0,
3353,Tones inferior to eye movements in the EMDR treatment of PTSD.,"Eye Movement Desensitization and Reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder (PTSD). During EMDR, patients make eye movements (EMs) while recalling traumatic memories, but recently therapists have replaced EMs by alternating beep tones. There are no outcome studies on the effects of tones. In an earlier analogue study, tones were inferior to EMs in the reduction of vividness of aversive memories. In a first EMDR session, 12 PTSD patients recalled trauma memories in three conditions: recall only, recall + tones, and recall + EMs. Three competing hypotheses were tested: 1) EMs are as effective as tones and better than recall only, 2) EMs are better than tones and tones are as effective as recall only, and 3) EMs are better than tones and tones are better than recall only. The order of conditions was balanced, each condition was delivered twice, and decline in memory vividness and emotionality served as outcome measures. The data strongly support hypothesis 2 and 3 over 1: EMs outperformed tones while it remained unclear if tones add to recall only. The findings add to earlier considerations and earlier analogue findings suggesting that EMs are superior to tones and that replacing the former by the latter was premature.",van den Hout MA.; Rijkeboer MM.; Engelhard IM.; Klugkist I.; Hornsveld H.; Toffolo MJ.; Cath DC.,2012.0,10.1016/j.brat.2012.02.001,0,0,
3354,"Exposure plus response prevention versus exposure plus safety behaviours in reducing feelings of contamination, fear, danger and disgust. An extended replication of Rachman, Shafran, Radomsky & Zysk (2011).","Safety behaviours are widely held to impede the beneficial effects of exposure, certainly in OCD. Recently, Rachman, Radomsky, Shafran, and Zysk (2011) challenged this view. Healthy volunteers repeatedly touched a contaminant in two sessions. Half of the participants did not engage in safety behaviours after touching (exposure + response prevention), while the other half did (exposure + safety behaviours, i.e., cleaning hands with a hygienic wipe). Scores of contamination, fear, danger, and disgust decreased in both sessions and the effects were not impeded by safety behaviours. Three potential artefacts were identified in the Rachman et al. study: a no-treatment control group was lacking, the stop rules for ending exposure differed between conditions, and positive expectations may have been induced in the safety behaviours group. We tried to critically replicate the main findings. The Rachman et al. (2011) study was replicated, with 44 volunteers but stop rules and expectations were similar between treatments, and effects were also assessed in a no-intervention control group. Relative to the control condition, both exposure interventions induced reliable decreases in feelings of contamination, fear, danger, and disgust. The decline followed an exponential curve with the largest gains at the first trials of each session. Findings were obtained from a non-clinical sample. The findings attest to the robustness of the Rachman et al. findings, and challenge the notion that safety behaviours should be dismissed categorically in exposure treatments.",van den Hout MA.; Engelhard IM.; Toffolo MB.; van Uijen SL.,2011.0,10.1016/j.jbtep.2011.02.009,0,0,
3355,Masked fear words produce increased SCRs: an anomaly for Ohman's theory of pre-attentive processing in anxiety.,"A. Ohman and J.J.F. Soares (1994) demonstrated that masked presentation of phobic pictures produces increased skin conductance responses (SCRs) in phobic subjects. A. Ohman (1993) explained this phenomenon in terms of a hypothetical ""feature detector"" that identifies physical characteristics of stimuli and activates the arousal system without involving significance evaluation or consciousness. By exposing spider phobics to spider words, general threat words, and neutral words instead of pictures, this explanation was tested. Words were presented both masked and unmasked while electrodermal activity was measured. Under unmasked conditions, SCRs were largest for spider words followed by general threat words, then neutral words. When masked, the difference between spider words and general threat words disappeared but SCRs remained significantly smaller for neutral words. It is concluded that activation of the arousal system by masked threat cues does not necessarily depend on their perceptual characteristics.",van den Hout MA.; De Jong P.; Kindt M.,2000.0,,0,0,
3356,Time-dependent effects of cortisol on the contextualization of emotional memories.,"Background: The inability to store fearful memories into their original encoding context is considered to be an important vulnerability factor for the development of anxiety disorders like posttraumatic stress disorder. Altered memory contextualization most likely involves effects of the stress hormone cortisol, acting via receptors located in the memory neurocircuitry. Cortisol via these receptors induces rapid nongenomic effects followed by slower genomic effects, which are thought to modulate cognitive function in opposite, complementary ways. Here, we targeted these time-dependent effects of cortisol during memory encoding and tested subsequent contextualization of emotional and neutral memories. Methods: In a double-blind, placebo-controlled design, 64 men were randomly assigned to one of three groups: 1) received 10 mg hydrocortisone 30 minutes (rapid cortisol effects) before a memory encoding task; 2) received 10 mg hydrocortisone 210 minutes (slow cortisol) before a memory encoding task; or 3) received placebo at both times. During encoding, participants were presented with neutral and emotional words in unique background pictures. Approximately 24 hours later, context dependency of their memories was assessed. Results: Recognition data revealed that cortisol's rapid effects impair emotional memory contextualization, while cortisol's slow effects enhance it. Neutral memory contextualization remained unaltered by cortisol, irrespective of the timing of the drug. Conclusions: This study shows distinct time-dependent effects of cortisol on the contextualization of specifically emotional memories. The results suggest that rapid effects of cortisol may lead to impaired emotional memory contextualization, while slow effects of cortisol may confer protection against emotional memory generalization. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","van Ast, Vanessa A; Cornelisse, Sandra; Meeter, Martijn; Joels, Marian; Kindt, Merel; Abercrombie, Acheson, Admon, Bouton, Bradley, Brewin, Brown, Chun, Cohen, Craik, Czock, Davachi, de Kloet, de Quervain, de Quervain, Diamond, Ehlers, Elzinga, Elzinga, Enkel, Gilbertson, Gilbertson, Godden, Henckens, Henckens, Henckens, Henckens, Hermans, Joels, Joels, Joels, Kalisch, Kaouane, Karst, Karst, Kensinger, Kensinger, Kirwan, Kukolja, Liberzon, Liebmann, Lovallo, Mather, McEwen, McEwen, Oitzl, Payne, Payne, Pruessner, Pruessner, Pu, Putman, Qin, Rao, Rasch, Resnick, Richter-Levin, Roozendaal, Sara, Schafe, Schwabe, Schwabe, Schwabe, Schwabe, Smith, Soravia, Spielberger, Squire, Stanislaw, Staresina, Talamini, Tambini, Tulving, van Marle, van Marle, van Stegeren, van Stegeren, Watson, Wiegert, Yonelinas",2013.0,,0,0,
3357,Contextual control over expression of fear is affected by cortisol,"At the core of anxiety disorders is the inability to use contextual information to modulate behavioral responses to potentially threatening events. Models of the pathogenesis of anxiety disorders incorporate stress and concomitant stress hormones as important vulnerability factors, while others emphasize sex as an important factor. However, translational basic research has not yet investigated the effects of stress hormones and sex on the ability to use contextual information to modulate responses to threat. Therefore, the purpose of the present study was threefold: first, we aimed at developing an experimental paradigm specifically capable of capturing contextual modulation of the expression of fear. Second, we tested whether cortisol would alter the contextualization of fear expression. Third, we aimed at assessing whether alterations in contextualization due to cortisol were different for men and women. Healthy participants (n = 42) received placebo or hydrocortisone (20 mg) prior to undergoing a newly developed differential contextual fear conditioning paradigm. The results indicated that people rapidly acquire differential contextual modulation of the expression of fear, as measured by fear potentiated startle and skin conductance responses. In addition, cortisol impaired the contextualization of fear expression leading to increased fear generalization on fear potentiated startle data in women. The opposite pattern was found in men. Finally, as assessed by skin conductance responses, cortisol impaired differential conditioning in men. The results are in line with models suggesting heightened vulnerability in women for developing anxiety disorders after stressful events. © 2012 Van Ast, Vervliet and Kindt.",van Ast V.A.; Vervliet B.; Kindt M.,2012.0,10.3389/fnbeh.2012.00067,0,0,
3358,"Rate of improvement during and across three treatments for panic disorder with or without agoraphobia: cognitive behavioral therapy, selective serotonin reuptake inhibitor or both combined.","Existing literature on panic disorder (PD) yields no data regarding the differential rates of improvement during Cognitive Behavioral Therapy (CBT), Selective Serotonin Reuptake Inhibitor (SSRI) or both combined (CBT+SSRI). Patients were randomized to CBT, SSRI or CBT+SSRI which each lasted one year including three months of medication taper. Participating patients kept record of the frequency of panic attacks throughout the full year of treatment. Rate of improvement on panic frequency and the relationship between rate of improvement and baseline agoraphobia (AG) were examined. A significant decline in frequency of panic attacks was observed for each treatment modality. SSRI and CBT+SSRI were associated with a significant faster rate of improvement as compared to CBT. Gains were maintained after tapering medication. For patients with moderate or severe AG, CBT+SSRI was associated with a more rapid improvement on panic frequency as compared to patients receiving either mono-treatment. Frequency of panic attacks was not assessed beyond the full year of treatment. Second, only one process variable was used. Patients with PD respond well to each treatment as indicated by a significant decline in panic attacks. CBT is associated with a slower rate of improvement as compared to SSRI and CBT+SSRI. Discontinuation of SSRI treatment does not result in a revival of frequency of panic attacks. Our data suggest that for patients without or with only mild AG, SSRI-only will suffice. For patients with moderate or severe AG, the combined CBT+SSRI treatment is recommended.",Van Apeldoorn FJ.; Van Hout WJ.; Timmerman ME.; Mersch PP.; den Boer JA.,2013.0,10.1016/j.jad.2013.04.012,0,0,
3359,Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia.,"To establish whether the combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRI) was more effective in treating panic disorder (PD) than either CBT or SSRI alone, and to evaluate any differential effects between the mono-treatments. Patients with PD (n = 150) with or without agoraphobia received CBT, SSRI or CBT + SSRI. Outcome was assessed after 9 months, before medication taper. CBT + SSRI was clearly superior to CBT in both completer and intent-to-treat analysis (ITT). Completer analysis revealed superiority of CBT + SSRI over SSRI on three measures and no differences between CBT and SSRI. ITT analysis revealed superiority of SSRI over CBT on four measures and no differences between CBT + SSRI and SSRI. Both the mono-treatments (CBT and SSRI) and the combined treatment (CBT + SSRI) proved to be effective treatments for PD. At post-test, CBT + SSRI was clearly superior to CBT, but differences between CBT + SSRI and SSRI, and between SSRI and CBT, were small.",van Apeldoorn FJ.; van Hout WJ.; Mersch PP.; Huisman M.; Slaap BR.; Hale WW.; Visser S.; van Dyck R.; den Boer JA.,2008.0,10.1111/j.1600-0447.2008.01157.x,0,0,
3360,A randomized trial of cognitive-behavioral therapy or selective serotonin reuptake inhibitor or both combined for panic disorder with or without agoraphobia: treatment results through 1-year follow-up.,"To establish the long-term effectiveness of 3 treatments for DSM-IV panic disorder with or without agoraphobia: cognitive-behavioral therapy (CBT), pharmacotherapy using a selective serotonin reuptake inhibitor (SSRI), or the combination of both (CBT + SSRI). As a secondary objective, the relationship between treatment outcome and 7 predictor variables was investigated. Patients were enrolled between April 2001 and September 2003 and were randomly assigned to treatment. Academic and nonacademic clinical sites participated. Each treatment modality lasted 1 year. Pharmacotherapists were free to choose between 5 SSRIs currently marketed in The Netherlands. Outcome was assessed after 9 months of treatment (posttest 1), after discontinuation of treatment (posttest 2), and 6 and 12 months after treatment discontinuation (follow-up 1 and follow-up 2). In the sample (N = 150), 48% did not suffer from agoraphobia or suffered from only mild agoraphobia, while 52% suffered from moderate or severe agoraphobia. Patients in each treatment group improved significantly from pretest to posttest 1 on the primary outcome measures of level of anxiety (P < .001), degree of coping (P < .001), and remitter status (P < .001), as well as on the secondary outcome measures of depressive symptomatology (P < .001), and from pretest to posttest 2 for health-related quality of life (P < .001). Gains were preserved from posttest 2 throughout the follow-up period. Some superiority of CBT + SSRI and SSRI as compared with CBT was observed at posttest 1. However, at both follow-ups, differences between treatment modalities proved nonsignificant. Client satisfaction appeared to be high at treatment endpoint, while patients receiving CBT + SSRI appeared slightly (P < .05) more satisfied than those receiving CBT only. No fall-off in gains was observed for either treatment modality after treatment discontinuation. SSRIs were associated with adverse events. Gains produced by CBT were slower to emerge than those produced by CBT + SSRI and SSRI, but CBT ended sooner. Netherlands Trial Register (www.trialregister.nl) Identifier: ISRCTN8156869.",van Apeldoorn FJ.; Timmerman ME.; Mersch PP.; van Hout WJ.; Visser S.; van Dyck R.; den Boer JA.,2010.0,10.4088/JCP.08m04681blu,0,0,
3361,"Cost-effectiveness of CBT, SSRI, and CBT+SSRI in the treatment for panic disorder.","The objective of this study was to assess the cost-effectiveness of three empirically supported treatments for panic disorder with or without agoraphobia: cognitive behavioral therapy (CBT), pharmacotherapy using a selective serotonin reuptake inhibitor (SSRI), or the combination of both (CBT+SSRI). Cost-effectiveness was examined based on the data from a multicenter randomized controlled trial. The Hamilton Anxiety Rating Scale was selected as a primary health outcome measure. Data on costs from a societal perspective (i.e., direct medical, direct non-medical, and indirect non-medical costs) were collected in the study sample (N=150) throughout a 24-month period in which patients received active treatment during the first twelve months and were seen twice for follow-up in the next twelve months. Total costs were largely influenced by costs of the interventions and productivity losses. The mean total societal costs were lower for CBT as compared to SSRI and CBT+SSRI. Costs of medication use were substantial for both SSRI and CBT+SSRI. When examining the balance between costs and health outcomes, both CBT and CBT+SSRI led to more positive outcomes than SSRI. Cognitive behavioral therapy is associated with the lowest societal costs. Cognitive behavioral therapy and CBT+SSRI are more cost-effective treatments for panic disorder with or without agoraphobia as compared to SSRI only.",van Apeldoorn FJ.; Stant AD.; van Hout WJ.; Mersch PP.; den Boer JA.,2014.0,10.1111/acps.12169,0,0,
3362,Internet versus face-to-face group cognitive-behavioral therapy for fibromyalgia: A randomized control trial,"ER Background: The aim of this study was to explore the effectiveness of Internet-delivered cognitive-behavioral therapy (iCBT) in treating fibromyalgia (FM) compared with an identical protocol using conventional group face-to-face CBT. Methods: Sixty participants were assigned to either (a) the waiting list group, (b) the CBT group, or (c) the iCBT group. The groups were assessed at baseline, after 10 weeks of treatment, and at 3-, 6-, and 12-month follow-ups. The primary outcome measured was the impact of FM on daily functioning, as measured by the Fibromyalgia Impact Questionnaire (FIQ). The secondary outcomes were psychological distress, depression, and cognitive variables, including self-efficacy, catastrophizing, and coping strategies. Results: In post-treatment, only the CBT group showed improvement in the primary outcome. The CBT and iCBT groups both demonstrated improvement in psychological distress, depression, catastrophizing, and utilizing relaxation as a coping strategy. The iCBT group showed an improvement in self-efficacy that was not obtained in the CBT group. CBT and iCBT were dissimilar in efficacy at follow-up. The iCBT group members improved their post-treatment scores at their 6- and 12-month follow-ups. At the 12-month follow-up, the iCBT group showed improvement over their primary outcome and catastrophizing post-treatment scores. A similar effect of CBT was expected, but the positive results observed at the post-treatment assessment were not maintained at follow-up. Conclusions: The results suggest that some factors, such as self-efficacy or catastrophizing, could be enhanced by iCBT. Specific characteristics of iCBT may potentiate the social support needed to improve treatment adherence.","Vallejo, M A; Ortega, J; Rivera, J; Comeche, M I; Vallejo-Slocker, L",2015.0,10.1016/j.jpsychires.2015.06.006,0,0,
3363,Association between the Rorschach Ego Impairment Index and the Level of Personality Organization interview assessment in depressive and anxiety disorder patients.,"The level of personality functioning, relevant for treatment planning, can be evaluated by the Rorschach Comprehensive System (CS) Ego Impairment Index-2 (EII-2) and by interview assessment of the severity of personality pathology. However, few studies on the association between these assessment methods have been reported. This study examines the strength of association between the EII-2 and its subcomponents with the interview-based Level of Personality Organization (LPO) assessment scale, and investigates their mutual associations with psychiatric symptoms, diagnoses, and history. Altogether, 315 mood or anxiety disorder outpatients without severe personality pathology were assessed with the LPO and tested with the CS, on which the EII-2 and its subcomponents (FQ-, WSum6, Critical contents, M-, PHR, GHR, and R) were calculated. Significant, but weak association between the EII-2 and the LPO was found. The WSum6, a measure of thought disorder, was the only EII-2 subcomponent significantly associated with the LPO. Both measures were consistently associated with psychiatric symptoms, diagnoses and history. The findings partially support the EII-2 and the LPO as consistently associated, relatively independent measures of the severity of personality pathology. More research on the incremental benefits of the measures is needed in clinical populations, covering non-severe and complex psychopathology. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Valkonen, Harri; Lindfors, Olavi; Knekt, Paul; Adrian, Barron, Beck, Beres, Campbell, Clarkin, Dawes, Dean, Derogatis, Diener, Exner, Gabbard, Ganellen, Hathaway, Hilsenroth, Janson, Kernberg, Kernberg, Knekt, Knekt, Knekt, Laaksonen, Lee, Mattlar, McClelland, Meyer, Meyer, Meyer, Meyer, Meyer, Nygren, Perry, Perry, Perry, Perry, Perry, Pyykkonen, Rothman, Searle, Stern, Stern, Viglione, Viglione, Viglione, Weinryb",2012.0,,0,0,
3364,Does anti-obsessional pharmacotherapy treat so-called comorbid depressive and anxiety states?,"Obsessive-compulsive disorder (OCD) is a chronic condition that normally presents high rates of psychiatric comorbidity. Depression, tic disorders and other anxiety disorders are among the most common comorbidities in OCD adult patients. There is evidence that the higher the number of psychiatric comorbidities, the worse the OCD treatment response. However, little is known about the impact of OCD treatment on the outcome of the psychiatric comorbidities usually present in OCD patients. The aim of this study was to investigate the impact of exclusive, conventional treatments for OCD on the outcome of additional psychiatric disorders of OCD patients, detected at baseline. Seventy-six patients with primary OCD admitted to the treatment protocols of the Obsessive-Compulsive Spectrum Disorders Program between July 2007 and December 2009 were evaluated at pre-treatment and after 12 months. Data were analyzed to verify possible associations between OCD treatment response and the outcome of psychiatric comorbidities. Results showed a significant association between OCD treatment response and improvement of major depression and dysthymia (p-value=0.002), other anxiety disorders (generalized anxiety disorder, social phobia, specific phobia, posttraumatic stress disorder, panic disorder, agoraphobia and anxiety disorder not otherwise specified) (p-value=0.054) and tic disorders (p-value=0.043). This is an open, non-blinded study, without rating scales for comorbid conditions. Further research is necessary focusing on the possible mechanisms by which OCD treatment could improve these specific disorders. Our results suggest that certain comorbid disorders may benefit from OCD-targeted treatment.",Valerio C.; Diniz JB.; Fossaluza V.; de Mathis MA.; Belotto-Silva C.; Joaquim MA.; Miguel Filho EC.; Shavitt RG.,2012.0,10.1016/j.jad.2012.02.002,0,0,
3365,Traumatic Incident Reduction I: Traumatized women inmates: Particulars of practice and research.,"Traumatic Incident Reduction (TIR) is a one session intervention that proved effective in reducing symptoms of depression, anxiety, and posttraumatic stress disorder in an experimental outcome study of a randomly assigned sample of 123 female federal prison inmates. TIR also proved effective in increasing levels of self-efficacy (expectancy of success) in these women. This article discusses in detail both the treatment protocol offered the women inmates and the research design and results of the experimental outcome study. The article also makes suggestions for practice and research related to traumatized women inmates. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Valentine, Pamela Vest",2000.0,,0,0,
3366,Evaluation of the dating skills program for improving heterosocial interactions in people with mental retardation.,"The effectiveness of a social skills training program for improving heterosocial interactions in persons with mental retardation was examined. Moderate to borderline mentally retarded subjects were selected based on problems with social anxiety and social skill deficits. Subjects were then randomly assigned to either a 12-session Dating Skills Program (DSP) or a wait list control (WLC) group. Assessments of social skills in a role-play test, knowledge about social/sexual situations, and social anxiety were obtained for all subjects at baseline, posttreatment, and at an 8-week follow-up. In addition, naturalistic observations were made of interactions of subjects in the DSP group. Subjects who participated in the DSP showed improvements in social skill and social/sexual knowledge at posttest and at follow-up compared to subjects in the WLC group. Social anxiety did not change over time for either group of subjects. Subjects who received the DSP increased interactions with persons of the opposite gender over time, while same-gender interactions decreased. The results replicate and extend previous research on the Dating Skills Program, and suggest that social skills training interventions may improve the heterosocial interactions of adults with mental retardation.",Valenti-Hein DC.; Yarnold PR.; Mueser KT.,1994.0,10.1177/01454455940181003,0,0,
3367,A comparison of the SPRINT and CAPS assessment scales for posttraumatic stress disorder.,"The Clinician-Administered PTSD Scale for DSM-IV (CAPS) is a widely used assessment tool for (posttraumatic stress disorder) (PTSD). However, a shorter assessment tool may be beneficial for clinical work. Here, we compare such a tool, the Short PTSD Rating Interview (SPRINT) to the CAPS. We found that the SPRINT rating scale performs similarly to the CAPS rating scale in the assessment of PTSD symptom clusters and total scores, and that the SPRINT takes significantly less time to administer than the CAPS.",Vaishnavi S.; Payne V.; Connor K.; Davidson JR.,2006.0,10.1002/da.20202,0,0,
3368,[Distal clavicle edema].,"Distal clavicle marrow edema: frequency, MRI in the early stage and macroscopic correlation to the bone marrow distribution and to evaluate frequency and diagnostic criteria of a posttraumatic clavicula disorder with an edema pattern on MRI. An additional macroscopic study of the clavicle should elucidate anatomic peculiarities which could explain the reaction of the distal clavicle. 285 MRI of traumatized patients were analyzed for edema pattern of the distal clavicle. Pattern A edema within the clavicle and the acromion was distinguished from pattern B edema within the clavicle only. Dissection in 20 cadavers should reveal vascular peculiarities and the bone marrow distribution within clavicle and acromion or vascular peculiarities. In 38 patients (13,3%) we found edema within the distal clavicle. Pattern A was found in 28 (9,8%) and pattern B in 10 patients (3,5%). Pattern A was usually associated with swelling of the AC joint (27 out of 28). Other injuries were not evident. 18 cadavers showed hematopoietic marrow within the distal clavicle and fatty marrow within the acromion. The distal clavicle can frequently react with edema pattern after trauma without evidence for another injury. Distinguish in cases with and cases without synovitis of the AC joint could have impact on therapy. A peculiar vascular supply of the distal clavicle could not be found.",Vahlensieck M.; Schmittke I.; Schmidt HM.,2006.0,10.1007/s00117-005-1240-z,0,0,
3369,[Changes in the duration of subjective temporal reference and short-term visual memory in healthy men during various types of weather as a function of the level of neuroticism].,,Vadziuk SN.; Mikula NM.,,,0,0,
3370,Effectiveness of providing self-help information following acute traumatic injury: randomised controlled trial.,"Patients attending an accident and emergency department may exhibit psychological disturbances post-injury. Early interventions have been suggested to reduce the risk of post-injury disorder, including psychoeducation. We assessed the efficacy of providing such self-help information. Patients who had experienced trauma were randomised to two groups: those given (n=75) and not given (n=67) a self-help booklet. Psychological assessments were completed within 2, 10-12 and 24-26 weeks. Post-traumatic stress disorder (PTSD), anxiety and depression decreased (P < 0.05) with time but there were no group differences in PTSD or anxiety. The controls were less depressed (P < 50.05) at follow-up. There was a reduction in PTSD caseness within the control (50%) compared with the intervention (20%) group which was almost significant (P < 0.06). This trial failed to support the efficacy of providing self-help information as a preventive strategy to ameliorate PTSD.",Turpin G.; Downs M.; Mason S.,2005.0,10.1192/bjp.187.1.76,0,0,
3371,Surgical anatomy of the nose in the elderly: Value of conservative rhinoplasty by the transoral route,"Functional or aesthetic rhinoplasty is being done later and later in life. It is essential to know the characteristics of morphological ageing of the nose in order to modify surgical techniques. An anatomical study was carried out on 40 fresh cadavers more than 70 years old. All the subjects studied were measured to define the external morphology of the nose. Amongst these 40 subjects, 20 were dissected plane by plane, 10 were operated on by a new conservative rhinoplasty technique utilizing a strictly transoral route and 10 were operated on by a classical rhinoplasty technique. The anatomy of the nose in the elderly subject is characterized by thinner skin, subcutaneous fat infiltrating in the muscles in 50% of cases and the small muscles of the tip of the nose undergoing complete involution. The technique of rhinoplasty described here shows the value of better respecting lesions at the tip of the nose which is particularly fragile in the aged subject. It maybe extended to post-traumatic rhinoplasties or to the nose which has already been operate on.",Vacher; Accioli J.; Lezy J.,2002.0,10.1007/s00276-002-0039-0,0,0,
3372,Danger ideation reduction therapy for obsessive-compulsive checking: preliminary findings.,"Danger Ideation Reduction Therapy (DIRT) is a cognitive treatment package developed in the mid-1990s to treat obsessive-compulsive (OC) washing. DIRT is solely directed at decreasing threat expectancies and does not involve direct or indirect exposure. The effectiveness of the DIRT package for OC washers has been examined, and to date a number of publications, including two randomised controlled trials, support its efficacy. Recently, the DIRT package was modified to treat people with the OC checking subtype. In the current study, three adult OC checkers received DIRT in 12 to 14 individual 1-hr sessions conducted by a clinical psychologist. At posttreatment, substantial and clinically significant reductions in scores on a range of standardized outcome measures of obsessive-compulsive disorder symptom severity were apparent for all three participants. Crucially, these improvements were maintained at 4-month follow-up. Although further research is clearly warranted, these preliminary findings suggest that DIRT for checkers may prove as effective as DIRT for OC washers.",Vaccaro LD.; Jones MK.; Menzies RG.; Wootton BM.,2010.0,10.1080/16506073.2010.512643,0,0,
3373,Contribution of psychological symptoms and lifetime drinking to the risk of road traffic accidents,"Purpose: To examine the contribution of psychological symptoms and lifetime drinking to accident risk. Methods: Using simple random sampling, 101 commercial drivers were recruited from 20 motor parks in Benin City. The 12 item version of the General Health Questionnaire GHQ12 and the CAGE Questionnaire were used to examine the contribution of psychological symptoms such as anxiety, depression and lifetime drinking to risk of road traffic accidents. The responses were analyzed using descriptive statistics. Results: GHQ12 questionnaire revealed that 28.7% of the participants had probable psychological problems and CAGE questionnaire indicated that 11.8% of the participants had alcohol use problem (5.9% being probable and the rest being definite). Drivers driving for up to 6 and more hours a day are more likely to be involved in accidents when compared to those driving for lesser periods. Those with less than 6 months experience on the roads were all involved in accidents. Conclusion: Short duration of driving experience and long distance driving appears to be a major factor in road traffic accidents. Policies that can address this problem and long distance driving by government and other stakeholders is vital in reducing carnage due to road traffic accidents on Nigerian highways.",Uwadiae E.; Ehikhamenor E.,2011.0,,0,0,
3374,"Evaluation of the relative efficacy of a couple cognitive-behaviour therapy (CBT) for Premenstrual Disorders (PMDs), in comparison to one-to-one CBT and a wait list control: A randomized controlled trial.","A randomised control trial (RCT) was conducted to examine the efficacy of couple-based cognitive behaviour therapy (CBT) for Premenstrual Disorders (PMDs), in comparison to one-to-one CBT and a wait-list control. Triangulation of quantitative and qualitative outcome measures evaluated changes pre-post intervention. Eighty three women were randomly allocated across three conditions, with 63 completing post-intervention measures, a retention rate of 76%. Repeated measures analysis of variance found a significant time by group interaction identifying that women in the two CBT conditions reported lower total premenstrual symptoms, emotional reactivity/mood, and premenstrual distress, in comparison to the wait list control. Significantly higher active behavioural coping post-intervention was found in the couple condition than in the one-to-one and wait list control groups. Qualitative analysis provided insight into the subjective experience of PMDs and participation in the intervention study. Across groups, women reported increased awareness and understanding of premenstrual change post-intervention. A larger proportion of women in the CBT conditions reported reduction in intensity and frequency of negative premenstrual emotional reactivity, increased communication and help-seeking, increased understanding and acceptance of embodied change, and the development of coping skills, post-intervention. Increased partner understanding and improved relationship post-intervention was reported by a greater proportion of participants in the CBT conditions, most markedly in the couple condition. These findings suggest that one-to-one and couple CBT interventions can significantly reduce women's premenstrual symptomatology and distress, and improve premenstrual coping. Couple based CBT interventions may have a greater positive impact upon behavioural coping and perceptions of relationship context and support. This suggests that CBT should be available for women reporting moderate-severe PMDs, with couple-based CBT offering additional benefits to a one-to-one modality.",Ussher JM.; Perz J.,2017.0,10.1371/journal.pone.0175068,0,0,
3375,Trait and state anxiety: relations to executive functioning in an at-risk sample,"ER Prior research with adults suggests mixed evidence for the relations of state and trait anxiety to prefrontal executive functions (EF). Trait anxiety is hypothesised to impair the efficiency of prefrontal areas and goal-directed attention and has been largely associated with poorer performance on executive functioning tasks. Fewer studies have investigated state anxiety, and the findings have been mixed. As studies of these processes in children have been limited by small sample sizes and a focus on working memory, we examine whether state and trait anxiety are associated with performance on two EF tasks in a sample of urban, low-income children, ages 9-12. Results indicated that higher trait anxiety predicted lower executive functioning on both tasks. In addition, higher state anxiety was related to better performance on the Stroop task. Results demonstrate that, consistent with the adult literature, higher trait anxiety is related to lower executive functioning in children.","Ursache, A; Raver, C C",2014.0,10.1080/02699931.2013.855173,0,0,
3376,Virtual reality-based attention bias modification training for social anxiety: A feasibility and proof of concept study,"Attention bias modification (ABM) programs have been considered as a promising new approach for the treatment of various disorders, including social anxiety disorder (SAD). However, previous studies yielded ambiguous results regarding the efficacy of ABM in SAD. The present proof-of-concept study investigates the feasibility of a newly developed virtual reality (VR)-based dot-probe training paradigm. It was designed to facilitate attentional disengagement from threatening stimuli in socially anxious individuals (N = 15). The following outcomes were examined: (a) self-reports of enjoyment, motivation, flow, and presence; (b) attentional bias for social stimuli; and (c) social anxiety symptoms. Results showed that ABM training is associated with high scores in enjoyment, motivation, flow, and presence. Furthermore, significant improvements in terms of attention bias and social anxiety symptoms were observed from pre- to follow-up assessment. The study suggests that VR is a feasible and presumably a promising new medium for ABM trainings. Controlled studies will need to be carried out.",Urech A.; Krieger T.; Chesham A.; Mast F.W.; Berger T.,2015.0,10.3389/fpsyt.2015.00154,0,0,
3377,A measure of disease-specific health-related quality of life for achalasia,"OBJECTIVES: To develop a measure of disease-specific health-related quality of life for achalasia for use as an outcome measure in clinical trials. METHODS: We generated a list of potential items for a measure of disease-specific health-related quality of life for achalasia by semistructured interviews with seven persons with achalasia, and by expert opinion. We then used factor analysis and item response theory methods for item reduction, using responses on the long-form questionnaire from 70 persons with achalasia. The severity measure underlying the item responses was constructed using a Rasch model. RESULTS: We developed a 10-item measure of disease-specific health-related quality of life that sampled the concepts of food tolerance, dysphagia-related behavior modifications, pain, heartburn, distress, lifestyle limitation, and satisfaction. The measure was reliable (person separation reliability 0.79, Cronbach's α 0.83), showed evidence of construct validity and good data-to-model fit (mean infit and outfit statistics for items, 1.00 and 0.98, respectively), and had a wide effective measurement range (able to discriminate between 87% of subjects with achalasia). The measure was recalibrated onto a 0-100 interval-level scale. CONCLUSIONS: We describe a reliable measure of achalasia disease-specific health-related quality of life that has a broad effective measurement range, interval-level properties, and evidence of construct validity. This measure is appropriate for use as an outcome measure in clinical trials and other evaluative studies on the effectiveness of treatment for achalasia. © 2005 by Am. Coll. of Gastroenterology.",Urbach D.R.; Tomlinson G.A.; Harnish J.L.; Martino R.; Diamant N.E.,2005.0,10.1111/j.1572-0241.2005.50141.x,0,0,
3378,Trauma-focused cognitive behavioral therapy with unaccompanied refugee minors: a case series.,"Unaccompanied refugee minors (URMs) are a group who are vulnerable to developing posttraumatic stress symptoms (PTSS). However, they rarely receive the treatment that is indicated and there are no treatment studies focusing exclusively on this group of adolescents. This case study evaluates the feasibility of trauma-focused cognitive behavioral therapy (TF-CBT) for URMs with PTSS. A health care utilization sample of N = 6 was assessed prior to and after treatment with TF-CBT. Therapists were asked to report differences in treatment application and content in comparison to TF-CBT standard protocol. We found moderate to high levels of PTSS at baseline and a clinically significant decrease in symptoms at posttest. Some modifications to the TF-CBT protocol were made with regard to affective modulation which required more sessions than usual whereas fewer caregiver sessions were conducted. TF-CBT is feasible in reducing PTSS in severely traumatized URMs. Further research with controlled trials is necessary. The trial registration: ClinicalTrials.gov Identifier NCT01516827. Registered 13 December 2011.",Unterhitzenberger J.; Eberle-Sejari R.; Rassenhofer M.; Sukale T.; Rosner R.; Goldbeck L.,2015.0,10.1186/s12888-015-0645-0,0,0,
3379,Attentional processing of emotional information in obsessive-compulsive disorder.,"In order to investigate attentional processing of emotional information in obsessive-compulsive disorder (OCD), 14 patients with OCD and 28 normal control (NC) subjects were asked to name the background colors of anxiety-relevant, compulsion-relevant, positive and neutral words (an emotional Stroop color-naming test). The stimulus words were presented subliminally, and supraliminally. The time of subliminal presentation for each subject was determined in advance by the lexical decision task. In the subliminal condition, the delay for anxiety- and compulsion-relevant words, when compared with neutral words, was greater in OCD patients, while no difference was found in NC subjects. In the supraliminal condition, no delay was found for both OCD patients and NC subjects. In other words, OCD patients were more sensitive to threat information when it could not be identified with consciousness. Moreover, the present study compared checking OCD with cleaning OCD in the attentional processing of emotional information. As a result, it was found that checking OCD patients responded more slowly in naming the background color of subliminal emotional words than cleaning OCD patients. The results indicate that OCD patients, especially with checking compulsion, may have a deficit in automatic processing of threat information.",Unoki K.; Kasuga T.; Matsushima E.; Ohta K.,1999.0,10.1046/j.1440-1819.1999.00618.x,0,0,
3380,The Nottingham Study of Neurotic Disorder: relationship between personality status and symptoms.,"Two hundred and ten psychiatric patients with one of three DSM-III diagnoses, generalized anxiety disorder (N = 71), panic disorder (N = 74) or dysthymic disorder (N = 65), were included in a clinical trial in which diazepam, dothiepin or placebo tablets, cognitive and behaviour therapy, or a self-help package were given over ten weeks. Personality status was assessed independently using a structured interview, the Personality Assessment Schedule. One hundred and ninety-eight patients had personality assessments, 89% with a close informant. Thirty-six per cent had a personality disorder and these patients had more severe psychopathology than those with no personality disorder. Personality disorder was more common in patients with dysthymic disorder and this group responded less well to treatment. The category of personality disorder had no apparent influence on symptoms.",Tyrer P.; Seivewright N.; Ferguson B.; Murphy S.; Darling C.; Brothwell J.; Kingdon D.; Johnson AL.,1990.0,,0,0,
3381,"""Cold calling"" in psychiatric follow up studies: is it justified?","The ethics of cold calling-visiting subjects at home without prior appointment agreed-in follow up research studies has received little attention although it is perceived to be quite common. We examined the ethical implications of cold calling in a study of subjects with defined neurotic disorders followed up 12 years after initial assessment carried out to determine outcome in terms of symptoms, social functioning, and contact with health services. The patients concerned were asked at original assessment if they would agree to be followed up subsequently and although they agreed no time limit was put on this. To decide if cold calling was ethically justifiable and, if so, to set guidelines for researchers. The study was a cohort study of patients with neurotic disorder treated initially for 10 weeks in a randomised controlled trial. At follow up by a research medical practitioner 18 of the 210 patients had died and of the remaining 192 patients 186 (97%) were seen or had a telephone interview. Four patients refused and two others did not have interviews but agreed to some data being obtained. However, only 104 patients (54%) responded to letters inviting them to make an appointment or to refuse contact and the remainder were followed up by cold calling, with most patients agreeing readily to the research interview. The findings illustrate the dilemma of the need to get the maximum possible data from such studies to achieve scientific validity (and thereby justify the ethics of the study) and the protection of subjects' privacy and autonomy. More attention needs to be paid to consent procedures if cold calling is to be defended on ethical grounds but it is unreasonable to expect this to be obtained at the beginning of a research study in a way that satisfies the requirements for informed consent. A suggested way forward is to obtain written consent for the research at the time that cold calling takes place before beginning the research.",Tyrer P.; Seivewright H.; Ferguson B.; Johnson T.,2003.0,,0,0,
3382,The outcome of neurotic disorders after out-patient and day hospital care.,"New psychiatric out-patients with depressive, phobic, and anxiety neurosis were randomly allocated to out-patient care or to one of two types of day hospital treatment, one specialising in psychotherapy and the other offering all forms of day care. Of 106 patients who entered the study, 78 had assessments of psychiatric symptomatology and social adjustment both before treatment and after 4, 8 and 24 months. There was no significant difference in outcome between depressive, phobic, and anxiety neurosis, and no overall difference in response to treatment between the three types of care. Suicidal symptoms were significantly less common in out-patients. In many respects, neurotic disorder can be regarded as a single syndrome.",Tyrer P.; Remington M.; Alexander J.,1987.0,,0,0,
3383,Treatment of agoraphobia by subliminal and supraliminal exposure to phobic cine film.,"Three groups of 5 chronically agoraphobic patients were treated by repeated exposure to cine film at weekly intervals for six weeks. A supraliminal group saw an agoraphobic film specially made for the study illustrating a range of phobic situations. A subliminal group viewed the same film at a level of illumination below the threshold of awareness. A control group saw a blank screen with no filmed material for the same length of time. The films were screened five times at each treatment and were alternated with neutral film shown under normal viewing conditions. Ratings of phobic and other symptoms were made by a separate assessor who was unaware of the patient's treatment. The supraliminal and subliminal groups improved significantly more than the control group with regard to phobic fears, avoidance, and overall assessment.",Tyrer P.; Horn S.; Lee I.,1978.0,,0,0,
3384,Randomised controlled trial of two models of care for discharged psychiatric patients,"ER DESIGNRandomised controlled trial.SETTINGInner London (Paddington and North Kensington) and outer London (Brent) psychiatric services.SUBJECTS155 patients with severe mental illness with a previous admission within the past 2 years.MAIN OUTCOME MEASURESRatings of clinical psychopathology, depression, anxiety, and social functioning; comprehensive costs of health care.RESULTSClinical outcomes were available for 133 patients and cost data for 144 patients after 1 year. The clinical outcomes of the two models of care were essentially similar, but admission to hospital was more likely in the hospital based care group and the costs of health care were 14% greater per patient than in the community group. This difference, however, was dwarfed by a twofold difference in the costs of care in the outer London services compared with those in inner London. This was explained largely by greater inpatient care for outer London patients (58 median bed days v 18 for inner London patients), more of which was provided by extracontractual referrals to other psychiatric hospitals as Brent had only 0.28/1000 beds available for acute adult patients compared with 0.82/1000 in Paddington and North Kensington over the period of the study.CONCLUSIONAftercare by community teams for psychiatric patients with severe mental illness has a similar outcome to hospital based aftercare but with fewer admissions to hospital. When psychiatric bed requirements are insufficient for a population, however, neither form of aftercare is effective as greater use of hospital beds elsewhere swamps any advantage of community care programmes, with disintegration and discontinuity of psychiatric services leading to escalating costs.OBJECTIVETo compare the clinical outcome and costs of care of psychiatric patients allocated to community multidisciplinary teams or to hospital based care programmes after discharge from inpatient care.","Tyrer, P; Evans, K; Gandhi, N; Lamont, A; Harrison-Read, P; Johnson, T",1998.0,,0,0,
3385,Clinical and cost-effectiveness of cognitive behaviour therapy for health anxiety in medical patients: a multicentre randomised controlled trial.,"Health anxiety has been treated by therapists expert in cognitive behaviour therapy with some specific benefit in some patients referred to psychological services. Those in hospital care have been less often investigated. Following a pilot trial suggesting efficacy we carried out a randomised study in hospital medical clinics. We undertook a multicentre, randomised trial on health anxious patients attending cardiac, endocrine, gastroenterological, neurological, and respiratory medicine clinics in secondary care. We included those aged 16-75 years, who satisfied the criteria for excessive health anxiety, and were resident in the area covered by the hospital, were not under investigation for new pathology or too medically unwell to take part. We used a computer-generated random scheme to allocate eligible medical patients to an active treatment group of five-to-ten sessions of adapted cognitive behaviour therapy (CBT-HA group) delivered by hospital-based therapists or to standard care in the clinics. The primary outcome was change in health anxiety symptoms measured by the Health Anxiety Inventory at 1 year and the main secondary hypothesis was equivalence of total health and social care costs over 2 years, with an equivalence margin of £150. Analysis was by intention to treat. The study is registered with controlled-trials.com, ISRCTN14565822. Of 28,991 patients screened, 444 were randomly assigned to receive either adapted cognitive behaviour therapy (CBT-HA group, 219 participants) or standard care (standard care group, 225), with 205 participants in the CBT-HA group and 212 in the standard care group included in the analyses of the primary endpoints. At 1 year, improvement in health anxiety in the patients in the CBT-HA group was 2·98 points greater than in those in the standard care group (95% CI 1·64-4·33, p<0·0001), and twice as many patients receiving cognitive behaviour therapy achieved normal levels of health anxiety compared with those in the control group (13·9% vs 7·3%; odds ratio 2·15, 95% CI 1·09-4·23, p=0·0273). Similar differences were observed at 6 months and 2 years, and there were concomitant reductions in generalised anxiety and, to a lesser extent, depression. Of nine deaths, six were in the control group; all were due to pre-existing illness. Social functioning or health-related quality of life did not differ significantly between groups. Equivalence in total 2-year costs was not achieved, but the difference was not significant (adjusted mean difference £156, 95% CI -1446 to 1758, p=0·848). This form of adapted cognitive behaviour therapy for health anxiety led to sustained symptomatic benefit over 2 years, with no significant effect on total costs. It deserves wider application in medical care. National Institute for Health Research Health Technology Assessment Programme.",Tyrer P.; Cooper S.; Salkovskis P.; Tyrer H.; Crawford M.; Byford S.; Dupont S.; Finnis S.; Green J.; McLaren E.; Murphy D.; Reid S.; Smith G.; Wang D.; Warwick H.; Petkova H.; Barrett B.,2014.0,10.1016/S0140-6736(13)61905-4,0,0,
3386,Therapist differences in a randomised trial of the outcome of cognitive behaviour therapy for health anxiety in medical patients.,"Health anxiety is common in medical settings and can be treated successfully by cognitive behaviour therapy. However it is not clear who might be best placed to deliver this therapy. In a planned secondary analysis of data from a randomised trial of adapted cognitive behaviour therapy for health anxiety we compared outcomes of therapy delivered by nurses and other professional groups. A randomised controlled trial with two treatment arms, 5-10 sessions of cognitive behaviour therapy adapted health anxiety or standard care. Cardiology, endocrine, gastroenterology, neurological and respiratory clinics in six general hospitals in the UK covering urban, suburban and rural areas. Medical patients attending the clinics who had pathological health anxiety and also scored for a diagnosis of hypochondriasis. Patients were randomised to one of two treatment arms, 5-10 sessions of cognitive behaviour therapy adapted health anxiety or standard care delivered by naive therapists (not randomised) who were trained in advance before delivering the treatment. Independent assessment of outcomes by researchers masked to allocation status at 3m, 6m, 12m and 24m. 444 patients were randomised in the trial, 219 to cognitive behaviour therapy adapted health anxiety and 225 to standard care. 373 (84%) completed assessments after two years. Those treated by nurses (n=66) had improvement in health anxiety, generalised anxiety and depression outcomes that were significantly better and twice as great as those of the professional groups of assistant psychologists (n=87) and graduate workers (n=66) (P<0.01 over all time points). The number needed to treat to show superiority of nurse-delivered treatment over other treatment delivery was 4 at 6 months and 6 at one year. General nurses, after suitable training, are very effective therapists for patients with health anxiety in medical clinics and should be the therapists of choice for patients in these settings.",Tyrer H.; Tyrer P.; Lisseman-Stones Y.; McAllister S.; Cooper S.; Salkovskis P.; Crawford MJ.; Dupont S.; Green J.; Murphy D.; Wang D.,2015.0,10.1016/j.ijnurstu.2014.11.013,0,0,
3387,A pilot randomised controlled trial of personalised care for depressed patients with symptomatic coronary heart disease in South London general practices: the UPBEAT-UK RCT protocol and recruitment,"ER BACKGROUND: Community studies reveal people with coronary heart disease (CHD) are twice as likely to be depressed as the general population and that this co-morbidity negatively affects the course and outcome of both conditions. There is evidence for the efficacy of collaborative care and case management for depression treatment, and whilst NICE guidelines recommend these approaches only where depression has not responded to psychological, pharmacological, or combined treatments, these care approaches may be particularly relevant to the needs of people with CHD and depression in the earlier stages of stepped care in primary care settings.METHODS: This pilot randomised controlled trial will evaluate whether a simple intervention involving a personalised care plan, elements of case management and regular telephone review is a feasible and acceptable intervention that leads to better mental and physical health outcomes for these patients. The comparator group will be usual general practitioner (GP) care.81 participants have been recruited from CHD registers of 15 South London general practices. Eligible participants have probable major depression identified by a score of ?8 on the Hospital Anxiety and Depression Scale depression subscale (HADS-D) together with symptomatic CHD identified using the Modified Rose Angina Questionnaire. Consenting participants are randomly allocated to usual care or the personalised care intervention which involves a comprehensive assessment of each participant's physical and mental health needs which are documented in a care plan, followed by regular telephone reviews by the case manager over a 6-month period. At each review, the intervention participant's mood, function and identified problems are reviewed and the case manager uses evidence based behaviour change techniques to facilitate achievement of goals specified by the patient with the aim of increasing the patient's self efficacy to solve their problems.Depressive symptoms measured by HADS score will be collected at baseline and 1, 6- and 12 months post randomisation. Other outcomes include CHD symptoms, quality of life, wellbeing and health service utilisation.DISCUSSION: This practical and patient-focused intervention is potentially an effective and accessible approach to the health and social care needs of people with depression and CHD in primary care.TRIAL REGISTRATION: ISRCTN21615909.","Tylee, A; Haddad, M; Barley, E; Ashworth, M; Brown, J; Chambers, J; Farmer, A; Fortune, Z; Lawton, R; Leese, M; Mann, A; McCrone, P; Murray, J; Pariante, C; Phillips, R; Rose, D; Rowlands, G; Sabes-Figuera, R; Smith, A; Walters, P",2012.0,10.1186/1471-244X-12-58,0,0,
3388,Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for veterans with traumatic brain injury: pilot randomized controlled trial.,"Traumatic brain injury (TBI) can result in cognitive impairments and persistent postconcussive symptoms that limit functional recovery, including return to work. We evaluated a 12 wk compensatory cognitive training intervention (Cognitive Symptom Management and Rehabilitation Therapy [CogSMART]) in the context of supported employment for Veterans with mild to moderate TBI. Participants were randomly assigned to receive 12 wk of supported employment plus CogSMART or enhanced supported employment that controlled for therapist attention (control). CogSMART sessions were delivered by the employment specialist and included psychoeducation regarding TBI; strategies to improve sleep, fatigue, headaches, and tension; and compensatory cognitive strategies in the domains of prospective memory, attention, learning and memory, and executive functioning. Compared with controls, those assigned to supported employment plus CogSMART demonstrated significant reductions in postconcussive symptoms (Cohen d = 0.97) and improvements in prospective memory functioning (Cohen d = 0.72). Effect sizes favoring CogSMART for posttraumatic stress disorder symptom severity, depressive symptom severity, and attainment of competitive work within 14 wk were in the small to medium range (Cohen d = 0.35-0.49). Those who received CogSMART rated the intervention highly. Results suggest that adding CogSMART to supported employment may improve postconcussive symptoms and prospective memory. These effects, as well as smaller effects on psychiatric symptoms and ability to return to work, warrant replication in a larger trial.",Twamley EW.; Jak AJ.; Delis DC.; Bondi MW.; Lohr JB.,2014.0,10.1682/JRRD.2013.01.0020,0,0,
3389,The prophylactic effect of valproate on glyceryltrinitrate induced migraine,"ER In this study the human glyceryltrinitrate (GTN) model of migraine was for the first time used to test the effect of a prophylactic drug. We chose to test valproate due to its well documented effect as a migraine prophylactic drug. Efficacy of this compound would support the usefulness of the model in prophylactic antimigraine drug development. Twelve patients with migraine without aura were included in a randomized double blind crossover study. Valproate 1000 mg or placebo was given daily, each for a minimum of 13 days. On the last treatment day of each arm a 20 min intravenous infusion of GTN (0.25 microg/kg/min) was given. Headache was registered for 12 h after the infusion and headache intensity was scored on a scale from 0 to 10. Fulfillment of IHS criteria was recorded for 24 h. The middle cerebral arteries were evaluated by transcranial Doppler and the diameter of the superficial temporal and radial arteries were measured with high frequency ultrasound. GTN evoked migraine fulfilling IHS criteria 1.1 in 6 patients after placebo and in 2 patients after valproate (P = 0.125). Including additionally 3 patients on placebo and 1 patient on valproate who felt they had suffered a migraine attack, but who had as associated symptoms only photophobia or phonophobia, a significant reduction in the number of patients with induced migraine after valproate was seen (P = 0.031). Median peak headache intensity was 1 (range 0-9) after valproate compared to 4.5 (range 0-8) after placebo (P = 0.120). Pretreatment with valproate as compared to placebo reduced the velocity in both middle cerebral arteries after GTN (left P = 0.021, right P = 0.031). No effect of valproate was seen in the diameter of the superficial temporal artery (P = 0.781) or the radial artery (P = 0.367) before or after GTN. The study indicates that a prophylactic effect of valproate may be demonstrated using the GTN human migraine model. Although, all headache parameters were reduced after valproate compared to placebo, only one parameter was statistically significantly reduced probably because of the small number of patients. The size of the effect was similar to that of valproate in clinical trials. The GTN model may therefore be a valid tool for testing new prophylactic antimigraine drugs.","Tvedskov, J F; Thomsen, L L; Iversen, H K; Gibson, A; Wiliams, P; Olesen, J",2004.0,10.1111/j.1468-2982.2003.00720.x,0,0,
3390,"Does a manual-based, disorder-focused psychotherapy reduce comorbid symptoms in bulimia nervosa?","Background: Several randomized controlled trials have shown that manual-based cognitive-behavioral therapy (CBT) is effective in the treatment of bulimia nervosa (BN). In order to test the generalizability of these findings, it is essential to evaluate evidence-based treatments in clinical service settings. In addition, it remains to be shown whether a symptom-focused CBT will also reduce comorbid symptoms that are often related to BN (e.g. anxiety, depressive symptoms). The present study aimed to investigate the effectiveness of a manual-based CBT in an outpatient service facility with respect to comorbid symptoms in bulimia. Patients and Methods: An unselected sample of patients (N = 66 completer) with the primary diagnosis of BN (DSM-III-R) participated in the treatment study. Outcome variables were questionnaire scores for depressive symptoms, anxiety, alcohol abuse, obsessions and compulsions. At post-treatment, the sample size consisted of 45 patients, 32 patients participated in the 1-year follow-up assessments. Results: At posttreatment as well as at follow-up, significant improvements were found in nearly all outcome variables. Effect sizes for outcome variables were within the range of those identified in randomized controlled trials. Discussion: Results of the present study may indicate that manual-based CBT can be an effective treatment not only for the core features of BN, but can also be useful for the reduction of frequent comorbid symptoms of the disorder. Importantly, the results show that this is not only true for the restricted area of controlled and randomized research studies but also with respect to psychotherapy within a naturalistic outpatient service setting. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Tuschen-Caffier, Brunna; Pook, Martin; Frank, Monika; Agras, Alpers, Beebe, Brewerton, Bulik, Cattanach, Dansky, Derogatis, Eversman, Fairburn, Fairburn, Feuerlein, Fichter, Fichter, Fichter, Franke, Godart, Hahlweg, Hartmann, Hautzinger, Hautzinger, Heatherton, Jacobi, Jacobi, Jacobi, Johnson, Killen, Killen, Klepsch, Koppe, Laessle, Laessle, Laux, Lesieur, Margraf, Margraf, Newman, Patton, Spielberger, Stice, Stice, Striegel-Moore, Thiel, Tuschen-Caffier, Tuschen-Caffier, Tuschen-Caffier, Wade, Wetzel, Whittal, Wilson, Wilson, Wilson, Wittchen, Wolfe",2008.0,,0,0,
3391,Clinical features affecting treatment outcome in social phobia.,"Characteristics of social phobics were examined to determine their effect on treatment acceptance, drop-out rate and amount of improvement at post-treatment. The rate of treatment non-acceptance was low and those who entered treatment differed from those who did not only on ratings of social phobia severity. The drop-out rate also was relatively low, and there were no differences between those who dropped out and those who completed treatment. When patients were divided on the specific versus generalized subtype dichotomy, a number of interesting findings emerged. Response to treatment was similar, but the specific subtype was significantly more improved at post-treatment than the generalized subtype. When compared on composite indexes of overall improvement and endstate functioning, there was no difference between the number of specific and generalized social phobics achieving significant or moderate improvement. However, a greater number of the specific subtype were judged to have high or moderate endstate status than the generalized subtype. A similar outcome was found when social phobics with comorbid disorders were compared with those who were non-comorbid. The results are discussed in terms of factors affecting outcome in social phobia treatment.",Turner SM.; Beidel DC.; Wolff PL.; Spaulding S.; Jacob RG.,1996.0,,0,0,
3392,A composite measure to determine improvement following treatment for social phobia: the Index of Social Phobia Improvement.,"This article describes the development of a composite index to determine improvement in treatment outcome research with social phobia. The index is comprised of 5 individual outcome measures that tap various domains of social phobia and assess the disorder via multiple methods (e.g. self-report, clinical ratings, behavioral performance). The ability of the index to determine improvement over treatment, and its initial concurrent validity are discussed.",Turner SM.; Beidel DC.; Wolff PL.,1994.0,,0,0,
3393,Behavioral and pharmacological treatment of obsessive-compulsive disorders,"Single-case experimental designs were used to evaluate behavioral and pharmacological treatments in obsessive-compulsive disorders. Four patients were treated in variants of the ABAB withdrawal design using behavioral and self-report data as dependent variables. Three of the four patients responded to behavioral or pharmacological treatment, whereas one patient responded to neither intervention.",Turner S.M.; Hersen M.; Bellack A.,1980.0,,0,0,
3394,Telephone cognitive-behavioral therapy for adolescents with obsessive-compulsive disorder: a randomized controlled non-inferiority trial,"ER Objective Many adolescents with obsessive-compulsive disorder (OCD) do not have access to evidence-based treatment. A randomized controlled non-inferiority trial was conducted in a specialist OCD clinic to evaluate the effectiveness of telephone cognitive-behavioral therapy (TCBT) for adolescents with OCD compared to standard clinic-based, face-to-face CBT. Method Seventy-two adolescents, aged 11 through 18 years with primary OCD, and their parents were randomized to receive specialist TCBT or CBT. The intervention provided differed only in the method of treatment delivery. All participants received up to 14 sessions of CBT, incorporating exposure with response prevention (E/RP), provided by experienced therapists. The primary outcome measure was the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Blind assessor ratings were obtained at midtreatment, posttreatment, 3-month, 6-month, and 12-month follow-up. Results Intent-to-treat analyses indicated that TCBT was not inferior to face-to-face CBT at posttreatment, 3-month, and 6-month follow-up. At 12-month follow-up, there were no significant between-group differences on the CY-BOCS, but the confidence intervals exceeded the non-inferiority threshold. All secondary measures confirmed non-inferiority at all assessment points. Improvements made during treatment were maintained through to 12-month follow-up. Participants in each condition reported high levels of satisfaction with the intervention received. Conclusion TCBT is an effective treatment and is not inferior to standard clinic-based CBT, at least in the midterm. This approach provides a means of making a specialized treatment more accessible to many adolescents with OCD. Clinical trial registration information-Evaluation of telephone-administered cognitive-behaviour therapy (CBT) for young people with obsessive-compulsive disorder (OCD); http://www.controlled-trials.com; ISRCTN27070832.","Turner, C M; Mataix-Cols, D; Lovell, K; Krebs, G; Lang, K; Byford, S; Heyman, I",2014.0,10.1016/j.jaac.2014.09.012,0,0,
3395,Internet treatment for social anxiety disorder in Romania: study protocol for a randomized controlled trial.,"Social anxiety disorder (SAD) is one of the most common anxiety disorders and is associated with marked impairments. However, a small proportion of individuals with SAD seek and receive treatment. Internet-administrated cognitive behavior therapy (iCBT) has been found to be an effective treatment for SAD. This trial will be the first Internet-delivered guided self-help intervention for SAD in Romania. Participants with social anxiety disorder (N = 96) will be recruited via newspapers, online banners and Facebook. Participants will be randomized to either: a) an active treatment, or b) a waiting list control group.The treatment will have a guided iCBT format and will last for nine weeks. Self-report questionnaires on social phobia, anxiety, depression, treatment credibility and irrational thinking will be used. All assessments will be collected pre, post and at follow-up (six months after intervention). Liebowitz Social Anxiety Scale - Self-Report version (LSAS-SR) will be the primary outcome measure and will be administrated on a weekly basis in both conditions. The present randomized controlled trial investigates the efficacy of an Internet-administered intervention in reducing social anxiety symptoms in a culture where this form of treatment has not been tested. This trial will add to the body of knowledge on the efficacy of iCBT, and the results might lead to an increase of the accessibility of evidence-based psychological treatment in Romania. ClinicalTrials.gov: NCT01557894.",Tulbure BT.; Månsson KN.; Andersson G.,2012.0,10.1186/1745-6215-13-202,0,0,
3396,Cognitive-behavioral therapy for obsessive-compulsive disorder as a comorbidity with schizophrenia or schizoaffective disorder.,,Tundo A.; Salvati L.; Di Spigno D.; Cieri L.; Parena A.; Necci R.; Sciortino S.,2012.0,10.1159/000329455,0,0,
3397,Effectiveness of an intercultural module added to the treatment guidelines for Moroccan and Turkish patients with depressive and anxiety disorders.,"Since the sixties of the last century, many people from Morocco and Turkey have migrated into the Netherlands. In the last decade, Moroccan and Turkish patients have found their way to organizations for mental health care. However, they often drop out of treatment. Problems in the communication with therapists and different expectations regarding treatment seem to be causal factors for the early drop-out of therapy. In the Netherlands as in other countries courses have been developed for training cultural competence of therapists. Yet, up to now, the effectiveness of increased cultural competence of therapists in reducing drop-out of treatment has not been studied. A randomized clinical trial was started in January 2010. Moroccan and Turkish adult patients who are referred to our outpatient clinics for mood and anxiety disorders are randomly assigned to mental health workers who are trained in a cultural module and to those who are not. The therapists have been trained in the Cultural Formulation and in techniques bridging the (cultural) gap between them and their Moroccan and Turkish patients. The target number of participants is 150 patients, 75 for each group. Drop-out of treatment is the primary outcome measure. Secondary outcome measures are no-show and patients' perspective of care. The study will give an answer to the question whether increasing cultural competence of therapists reduces drop-out of treatment in Moroccan and Turkish outpatients with depressive and anxiety disorders.",van Loon A.; van Schaik DJ.; Dekker JJ.; Beekman AT.,2011.0,10.1186/1471-244X-11-13,0,0,
3398,An effectiveness study of group therapy for anxiety disorders.,"This work examines the transportability of group cognitive-behavioral therapy (GCBT) for a wide range of anxiety disorders to a college counseling center. Participants were 31 clients with a primary diagnosis of generalized anxiety disorder, panic disorder with agoraphobia, social phobia, specific phobia, or obsessive-compulsive disorder who identified dysfunction in one or more of eight daily function areas. Clients were not excluded on the basis of medication use, severity or frequency of panic attacks, age, or comorbidity. Of the 31 participants, there were 17 treatment completers, defined by a minimum of 20 sessions in a flexibly bounded psychotherapy group, who achieved significant reductions in levels of anxiety-related dysfunction. The present study suggests that group cognitive behavioral therapy can be transported to a college counseling center.",van Ingen DJ.; Novicki DJ.,2009.0,10.1521/ijgp.2009.59.2.243,0,0,
3399,Key symptoms in the detection of affective disorders in medical patients,"Psychiatric disorder in medical patients often goes undetected. In this study we have attempted to identify a minimum set of key symptoms from an extensive research interview [Present State Examination (PSE)] that might assist in the identification of psychiatric disorders among general medical patients. Stepwise logistic regression analysis was used to identify PSE-items that contributed most to the PSE-CATEGO classification of psychiatric disorders in 192 Dutch medical out-patients. A risk score based on two core symptoms (panic and depressed mood) and five supplementary symptoms classified patients with a sensitivity of 0.94 and a specificity of 0.91. In a separate U.K. sample of medical in-patients, consisting of 37 PSE cases and age and sex matched controls, the risk score yielded a sensitivity and specificity of 0.89 and 0.97 respectively. The results suggest that a few questions concerning psychiatric symptoms may facilitate the identification of the majority of patients with anxiety and depressive disorders in medical populations.",Van Hemert A.M.; Hawton K.; Bolk J.H.; Fagg J.,1993.0,10.1016/0022-3999(93)90142-3,0,0,
3400,Multicomponent standardized treatment programs for fear of flying: Description and effectiveness.,"This paper has two objectives. The first is to describe a multimodal, standardized treatment program used by the VALK Foundation, an agency that specializes in the treatment of patients with fear of flying. The second is to present the results of an evaluation of this program, particularly with regard to the effectiveness of a 2-day cognitive-behavioral group treatment program and a 1-day behavioral group treatment program for flying phobics. On the basis of individualized assessment, patients (N = 1,026) were nonrandomly assigned to 1 of the 2 group treatment modalities. Self-report data and behavioral indicators for fear of flying were collected at pretreatment and at 3-, 6-, and 12-month follow-ups. Complete data were obtained from 757 participants. Results showed that both treatment programs produced statistically significant, clinically relevant decreases in self-reported anxiety and behavioral anxiety indices. This paper explains the procedures and outcomes of a well-established clinical program. Limitations of the study are discussed and future research suggested. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Van Gerwen, Lucas J; Spinhoven, Philip; Diekstra, Rene F. W; Van Dyck, Richard; Agras, Aitken, Arnarson, Arntz, Arrindell, Bandura, Borrill, Canton-Dutari, Clark, Cohen, Dean, Denholz, Derogatis, Deyoub, Diekstra, Diment, Ekeberg, Ekeberg, Ellis, Fodor, Fredrikson, Greco, Howard, Jacobson, Karoly, Ladouceur, Marks, McCarthy, Meldman, Menzies, Ost, Roberts, Rothbaum, Scrignar, Sederer, Sidley, Van Gerwen, Van Gerwen, Van Gerwen, Van Gerwen, Van Gerwen, Walder, Wilhelm, Williams",2002.0,,0,0,
3401,Myocardial Injury following Coronary Artery bypass Surgery compared with percutaneous coronary Angioplasty (MICASA) trial. A randomised controlled trial using magnetic resonance imaging,"Purpose: Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are widely used to treat patients with coronary artery disease (CAD). Late gadolinium enhancement on magnetic resonance imaging (MRI) is the most sensitive imaging technique available for detection of peri-procedural myocardial injury (PPI). We compared injury during revascularisation detected by enzyme release and MRI imaging and applied recent ESC/ACCF/AHA/WHF Task Force definitions of peri-procedural necrosis and myocardial infarction. Frequency of Troponin I and MRI defined PPI following PCI was compared with CABG for multi-vessel and/or left main CAD. Methods: Prospective, single centre randomised controlled trial (ISRCTN25699844). Patients with 3 vessel CAD (‚â•50% stenoses), or 2 vessel CAD including a type C lesion in the left anterior descending, and/or left main disease (‚â•50%) were eligible. MRI was performed before and 1 week post revascularisation. Troponin I was performed before, 1,6, 12 and 24 hours after treatment. Results: Eighty patients were enrolled (average age of 64 years). Diabetes was present in 14/80 (17.5%). Severity of CAD and risk were assessed using syntax and Logistic Euro scores respectively. Mean syntax scores were 23.3 vs. 21.9 (p=0.39) and mean Euro scores 1.85 vs. 2.31 (p=0.21) for PCI and CABG groups respectively. Forty patients underwent PCI with drug eluting stents and 39 had on-pump CABG (1 died prior to CABG). Of those remaining, 3 PCI and 7 CABG patients did not undergo MRI (5 claustrophobia, 3 renal impairment postrevascularisation, 2 inadequate images). In the PCI group 6/37 (16.2%) patients had late gadolinium enhancement, compared with 9/32 (28.1%) in the CABG group (p=0.25). Applying the new universal definition of peri-procedural necrosis and myocardial infarction, necrosis occured in 29/40 (72.5%) PCI patients and 35/35 (100%) CABG patients (p<0.0005), and myocardial infarction occurred in 19/40 (47.5%) PCI patients and 9/35 (25.7%) CABG patients (p=0.06). However only 6/19 (31.6%) patients in the PCI group who fulfilled the new criteria for periprocedural myocardial infarction had late gadolinium enhancement on MRI. Conclusion: The incidence of MRI defined infarction did not differ according to treatment assignment. Peri-procedural necrosis according to the new definition was universal in the CABG group and lower in the PCI group. Applying the new universal definition of PCI related myocardial infarction overestimates the number of patients with infarction detectable by MRI.",Van Gaa W.J.; Arnold R.; Testa L.; Lim C.C.S.; Ponnuthurai F.A.; Karamitsos T.; Selvanayagem J.; Westaby S.; Neubauer S.; Banning A.P.,2009.0,10.1093/eurheartj/ehp416,0,0,
3402,Online self-test identifies women at high familial breast cancer risk in population-based breast cancer screening without inducing anxiety or distress,"Introduction Identifying high familial breast cancer (FBC) risk improves detection of yet unknown BRCA1/2-mutation carriers, for whom BC risk is both highly likely and potentially preventable. We assessed whether a new online self-test could identify women at high FBC risk in population-based BC screening without inducing anxiety or distress. Methods After their visit for screening mammography, women were invited by email to take an online self-test for identifying highly increased FBC risk-based on Dutch guidelines. Exclusion criteria were previously diagnosed as increased FBC risk or a personal history of BC. Anxiety (State-Trait Anxiety Inventory Dutch Version), distress (Hospital Anxiety Depression Scale) and BC risk perception were assessed using questionnaires, which were completed immediately before and after taking the online self-test and 2 weeks later. Results Of the 562 women invited by email, 406 (72%) completed the online self-test while 304 also completed questionnaires (response rate 54%). After exclusion criteria, 287 (51%) were included for data analysis. Median age was 56 years (range 50–74). A high or moderate FBC risk was identified in 12 (4%) and three (1%) women, respectively. After completion of the online self-test, anxiety and BC risk perception were decreased while distress scores remained unchanged. Levels were below clinical relevance. Most women (85%) would recommend the self-test; few (3%) would not. Conclusion The online self-test identified previously unknown women at high FBC risk (4%), who may carry a BRCA1/2-mutation, without inducing anxiety or distress. We therefore recommend offering this self-test to women who attend population-based screening mammography for the first time.",van Erkelens A.; Sie A.S.; Manders P.; Visser A.; Duijm L.E.; Mann R.M.; ten Voorde M.; Kroeze H.; Prins J.B.; Hoogerbrugge N.,2017.0,10.1016/j.ejca.2017.03.014,0,0,
3403,Psychopathology of panic attacks in panic disorder.,"This study examined the relationships among certain subtypes of panic attacks (full vs. limited symptom; spontaneous vs. situational) and between these subtypes, panic disorder subtypes, and other characteristics of panic disorder, especially agoraphobia. Data were drawn from a large (n = 1,168) treatment study of panic disorder in which panic attacks were carefully subtyped and counted using a diary. Relationships between variables at baseline were examined primarily using non-parametric methods, and the course of improvement for panic subtypes among completers was plotted. The median number of spontaneous panic attacks per week at baseline was similar among patients with panic disorder without agoraphobia (PD), limited phobic avoidance (PDL), and agoraphobia (PDA). The median number of situational attacks and the median agoraphobia ratings rose progressively across diagnostic subtypes. Anticipatory anxiety, HAM-A, HAM-D, and disability scores were higher in PDA than in PD. Full and limited symptom panic attacks were positively correlated. The proportion of total attacks that were limited rose during the first two weeks of treatment, suggesting conversion of full to limited symptom attacks before complete disappearance. Spontaneous and situational attacks were correlated minimally or not at all. Agoraphobia ratings were more positively correlated with situational than with spontaneous panic attacks. Few of the correlations among measures at baseline were high. Full and limited symptom panic attacks differ primarily in severity. Spontaneous and situational attacks are relatively independent, and situational attacks are more closely related to agoraphobia. These findings are consistent with previous work suggesting that spontaneous attacks reflect a biological component, whereas situational attacks reflect a cognitive component in the psychopathology-- and possibly the pathogenesis-- of panic disorder. This provides a rationale for the use of combined pharmacotherapy and psychotherapy in the treatment of panic disorder. Future investigations of panic disorder should carefully separate panic attack subtypes.",Uhlenhuth EH.; Leon AC.; Matuzas W.,2006.0,10.1016/j.jad.2005.12.036,0,0,
3404,Specific anxiety syndromes: current therapeutic options.,,Uhlenhuth EH.,1981.0,,0,0,
3405,Music therapy can lower the heart rates of severely sick children,"ER METHODS: We performed a randomised clinical pilot study of 24 patients up to the age of 16 undergoing HSCT at Karolinska University Hospital, Huddinge, Sweden. Music therapy, including expressive and receptive elements, was performed twice a week in the treatment group and compared to standard care in the control group. Physiological parameters were evaluated according to the hospital's protocols.RESULTS: The music therapy group had significantly reduced evening heart rates compared to the control group (p < 0.001), and the effect was sustainable for four to eight hours after the intervention. There were no significant differences in saturation or blood pressure observed between the groups.CONCLUSION: Music therapy significantly lowered the heart rate of children undergoing HSCT for at least four to eight hours, indicating reduced stress levels and potentially lowering the risk of developing PTSD.AIM: Paediatric recipients of haematopoietic stem cell transplants (HSCT) are at increased risk of developing post-traumatic stress disorder (PTSD), and there is a need to identify interventions that can alleviate stress in this group. The aim of this study was to examine the previously unexplored effect of music therapy on children undergoing HSCT, by analysing physiological parameters and comparing them with a control group.","Uggla, L; Bonde, L O; Svahn, B M; Remberger, M; Wrangsjö, B; Gustafsson, B",2016.0,10.1111/apa.13452,0,0,
3406,"Psychological distress, needs and quality of life in people with inoperable lung cancer at the commencement of treatment","Background: People with lung cancer report a higher burden of unmet needs compared with other tumour groups. Specifically, patients with lung cancer have reported a higher number of psychological and daily living unmet needs. They are the most psychologically distressed and they experience more physical hardship than patients with other major cancers. Aim: This project aimed to examine levels of unmet psychosocial needs, psychological distress, and quality of life in inoperable lung patients beginning treatment. This presentation reports on baseline data from a randomised controlled trial testing the effectiveness of a tailored informational and supportive care intervention. Method: Patients were recruited at the start of their treatment. Consenting patients completed baseline questionnaires and were randomised to participate in a supportive care intervention or usual care. Data was collected on Perceived Needs, Anxiety and Depression, Psychological Distress, and Quality of Life, from established reliable and valid scales. Results: Data was collected for 108 patients. Most of the top needs (9 of the top 10) related to medical communication/information. Anxiety and depression means (and standard deviations) were 4.37 (2.85) and 4.39 (3.18) out of 21 respectively. Twenty-six patients (38.2%) reported psychological distress. Global quality of life was assessed at 61.94 out of 100. Translation into Practice: The present data indicates many lung cancer patients report high levels of unmet medical information needs, depressive symptoms and psychological distress, and a high burden of physical symptoms. This highlights the need for impeccable assessment of patients' supportive care needs when commencing treatment for inoperable disease.",Ugalde A.; Sharkey K.; Krishnasamy M.; Ball D.; Aranda S.; Schofield P.,2009.0,10.1111/j.1743-7563.2009.01252.x,0,0,
3407,"Psychological distress, needs and quality of life in People with inoperable lung cancer at the commencement of treatment","Objectives: People with lung cancer report a higher burden of unmet needs, specifically psychological and daily living unmet needs. They experience more psychological distress and more physical hardship than other tumor sites. This project examined the levels of unmet needs, psychological distress and quality of life in inoperable lung cancer patients towards the start of a treatment plan. Methods: This is a secondary analysis of baseline data from a randomised controlled trial testing the effectiveness of a tailored informational and supportive care intervention. Eligible lung cancer patients were approached to participate at a suitable time towards the start of their treatment plan. Consenting patients completed baseline questionnaires prior to randomisation. Data was collected on Perceived Needs, Anxiety and Depression, Psychological Distress and Quality of Life from established reliable and valid scales. Results: Data was collected for 109 participants. Most self-reported needs related to medical communication/information. Anxiety and depression means (and standard deviations) were 4.37 (2.85) and 4.39 (3.18) out of 21 respectively. Twenty-six patients (38.2%) reported a likely case of significant distress. Global quality of life was assessed at 61.94 out of 100, with several differences across specific subscales outlining the burdensome nature of their symptoms and the impact on quality of life. Conclusions: This data indicates that many lung cancer patients report levels of unmet medical information needs, depressive symptoms, psychological distress and a high burden of physical symptoms.",Ugalde A.; Sharkey K.; Krishnasamy M.; Ball D.; Aranda S.; Schofield P.,2009.0,10.1007/s00520-009-0643-1,0,0,3406
3408,"Psychological distress, needs and quality of life in people with inoperable lung cancer at the commencement of treatment","BACKGROUND: People with lung cancer report a higher burden of unmet needs, specifically psychological and daily living unmet needs. They are the most psychologically distressed and also experience more physical hardship than other tumor sites. This project examined the levels of unmet psychosocial needs, psychological distress, and quality of life in inoperable lung patients towards the start of a treatment plan. METHOD: This presentation reports on the baseline data from a randomised controlled trial testing the effectiveness of a tailored informational and supportive care intervention. Eligible lung cancer patients were approached to participate at a suitable time towards the start of their treatment plan. Consenting patients completed baseline questionnaires and were randomised to participate in a supportive care intervention or usual care. Data was collected on Perceived Needs, Anxiety and Depression, Psychological Distress, and Quality of Life, from established reliable and valid scales. RESULTS: Data was collected for 108 people with lung cancer. Most of the prevalent needs (9 of the top 10) related to medical communication/information. Anxiety and depression means (and standard deviations) were 4.37 (2.85) and 4.39 (3.18) out of 21 respectively. Twenty-six patients (38.2%) reported a likely case of significant distress. Global quality of life was assessed at 61.94 out of 100, with several differences between specific subscales outlining the burdensome nature of their symptoms and the impact on quality of life. CONCLUSIONS: The present data indicates that many lung cancer patients report high levels of unmet medical information needs, depressive symptoms and psychological distress, and a high burden of physical symptoms. RESEARCH IMPLICATIONS: There is a need for tailored, evidence-based interventions aimed at improving quality of life. Future research should investigate screening measures for identification of those with outstanding needs and psychological distress. CLINICAL IMPLICATIONS: This highlights the needs for assessment of patients' supportive care needs when commencing treatment for inoperable disease.",Ugalde A.; Sharkey K.; Krishnasamy M.; Ball D.; Aranda S.; Schofield P.,2009.0,10.1002/pon.1594,0,0,3406
3409,[Usefulness of ultrasonographic monitoring in muscle trauma for rehabilitation therapy].,"The authors studied the usefulness of Ultrasound imaging in the follow-up of post-traumatic muscle lesions, to allow correct rehabilitation therapy. Ultrasound (U.) made using high frequency probe (7.5 MHz) can distinguish the exact type of post-traumatic soft-tissue lesions both in contusion and stretching trauma. U. can differentiate both minor lesions such as contusions and strains and major lesions as partial and complete tears and ruptures. Minor lesions can be easily demonstrated by comparison with contralateral muscle structure. In case of major lesions U. can give an easy demonstration of possible associated lesions like hematomas and can also study their age and guide needle aspiration. More useful for a correct rehabilitation therapy approach is the U. follow-up study, so the therapy can be exactly tailored to patient's peculiar needs, and not on a possibly hazardous standardized therapy. U. imaging study follow-up has allowed us to achieve the best results in the cheapest way. The authors studied 252 patients which had major muscle lesions. U. follow-up studies allowed to value the evolution of those lesions and to decide the exact tailoring of rehabilitation therapy.",Uffredi S.; Pascarello A.; Tonella MC.; Marenzi R.; Malinverni AF.,,,0,0,
3410,Using a healing robot for the scientific study of shirodhara,,Uebaba K.; Xu F.-H.; Tagawa M.; Asakura R.; Itou T.; Tatsuse T.; Taguchi Y.; Ogawa H.; Shimabayashi M.; Hisajima T.,2005.0,10.1109/MEMB.2005.1411351,0,0,
3411,Role of decompressive surgery in the management of severe head injuries: prognostic factors and patient selection.,"Decompressive surgery or craniectomy (DC) is a treatment option, which should be considered when the intracranial pressure (ICP) cannot be treated by conservative methods. The purpose of this study was to evaluate the benefits of decompressive craniectomy in patients with intractable posttraumatic intracranial hypertension and to evaluate the patient selection criteria for this management protocol. In this study, 100 patients with severe head injuries were involved. All patients were treated according to the European Brain Injury Consortium (EBIC) guidelines for severe head injuries and were assessed based on individual initial Glasgow Coma Scores (GCS), age, Glasgow Outcome Score (GOS), presence of systemic injury, changes in ICP, presence of mass lesion and the right timing for DC. All patients presented with a GCS of 8 or below. Based on their initial GCS, the patients were divided in two groups of 60 (group I with GCS 4-5) and 40 (group II with GCS 6-8) in each, respectively. Prognosis was evaluated according to the (GOS). After treatment with DC, 84 of the patients (84%) showed unfavorable and 16 (16%) showed favorable outcomes. In group I, 58 patients (96.6%) showed unfavorable and two (3.4%) showed favorable outcomes. In group II, 26 (65%) patients showed unfavorable and 14 (25%) showed favorable outcomes. The importance of initial GCS and age in patient outcomes were statistically significant. The presence of systemic injuries or mass lesions in outcomes were not statistically significant. Based on our findings, we conclude that patients with Glasgow Coma Scores of 6-8 are the best candidates for DC treatment.",Ucar T.; Akyuz M.; Kazan S.; Tuncer R.,2005.0,10.1089/neu.2005.22.1311,0,0,
3412,Gestalt dialogues as a treatment for mild depression: time works just as well,"ER In a treatment analogue design, 44 moderately depressed volunteer subjects were divided randomly into four groups: attention-placebo; Gestalt empty chair dialogues designed to be personally relevant and high in affect; dialogues designed to be personally irrelevant and neutral in affect; and groups in which strong affect was encouraged, but no dialogues enacted. Groups met 1 hour per week for 4 weeks. Each group was pretested, post-tested, and follow-up tested with an abbreviated MMPI, the Depression Adjective Check List, and experimenter questionnaires. A series of 4 X 3 ANOVAs indicated significant main effects for time across all dependent variables. Also, anxiety and social introversion decreased over time in all groups. No other main or interactional effects were significant. These results suggest that mild depression, as well as anxiety and social introversion, dissipated over time and remained lower regardless of whether the subject had any treatment.","Tyson, G M; Range, L M",1987.0,,0,0,
3413,Controlled comparison of day-hospital and outpatient treatment for neurotic disorders.,"106 patients with anxiety, phobic, and depressive neuroses referred to the outpatient clinics of 6 psychiatrists were randomly assigned to outpatient care or two forms of psychiatric day care. Ratings of symptoms and social adjustment were recorded before treatment and after 4 and 8 months in 89 patients. There were no important differences in the outcome of day care and outpatient treatment although patients were more satisfied with the outpatient service. Because outpatient care is more economical of time and personnel it should be preferred to psychiatric day care for many neurotic disorders.",Tyrer PJ.; Remington M.,1979.0,,0,0,
3414,Cognitive behaviour therapy for non-cardiac pain in the chest (COPIC): a multicentre randomized controlled trial with economic evaluation.,"Most patients with chest pain have nothing wrong with their cardiac function. Psychological forms of treatment for this condition are more likely to be successful than others. A two-arm parallel controlled randomized trial of standard care versus a modified form of cognitive behaviour therapy for chest pain (CBT-CP) in patients who have attended emergency hospital services. Inclusion criteria include (i) emergency attendance more than once in the previous year with chest pain when no physical pathology has been found, (ii) aged between 16 and 75, (iii) signed consent to take part in the study. Exclusion criteria are (i) under current psychiatric care, (ii) those who have had new psychotropic drugs prescribed within the last two months, (iii) are receiving or about to receive a formal psychological treatment. Those satisfying these criteria will be randomized to 4-10 sessions of CBT-CP or to continue with standard care. Participants are randomized using a remote web-based system using permuted stacked blocks stratified by study centre. Assessment is carried out at baseline by researchers subsequently masked to allocation and at 6 months and 1 year after randomization. The primary outcome is the Health Anxiety Inventory score at 6 months, and secondary outcomes are generalised anxiety and depressive symptoms, the Lucock Health Anxiety Questionnaire adapted for chest pain, visual analogue scales for chest pain and discomfort (Inskip Scale), the Schedule for Evaluating Persistent Symptoms (SEPS), health related quality of life, social functioning and medical resource usage. Intention to treat analyses will be carried out with clinical and functioning data, and a cost-utility analysis will compare differences in total costs and differences in quality of life using QALYs derived from the EQ-5D. The data will also be linked to another parallel study in New Zealand where 126 patients with the same inclusion criteria have been treated in a similar trial; the form of analysis of the combined data has yet to be determined. The morbidity and costs of non-cardiac chest pain are substantial and if a simple psychological treatment given by health professionals working in medical departments is beneficial it should prove to be of great value. Combining data with a similar study in New Zealand is an additional asset. ISRCTN14711101 (registered 05/03/2015).",Tyrer P.; Tyrer H.; Cooper S.; Barrett B.; Kings S.; Lazarevic V.; Bransby-Adams K.; Whittamore K.; Walker G.; McNulty A.; Donaldson E.; Midgley L.; McCoy S.; Evered R.; Yang M.; Guo B.; Lisseman-Stones Y.; Doukani A.; Mulder R.; Morriss R.; Crawford M.,2015.0,10.1186/s40359-015-0099-7,0,0,
3415,Randomized controlled trial of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate self-harm: the POPMACT study,"ER METHODPatients presenting with recurrent deliberate self-harm in five centres were randomized to either MACT or (TAU) and followed up over 1 year. MACT patients received a booklet based on cognitive behaviour therapy (CBT) principles and were offered up to five plus two booster sessions of CBT from a therapist in the first 3 months of the study. Ratings of parasuicide risk, anxiety, depression, social functioning and global function, positive and negative thinking, and quality of life were measured at baseline and after 6 and 12 months.RESULTSFour hundred and eighty patients were randomized. Sixty per cent of the MACT group had both the booklet and CBT sessions. There were seven suicides, five in the TAU group. The main outcome measure, the proportion of those repeating deliberate self-harm in the 12 months of the study, showed no significant difference between those treated with MACT (39%) and treatment as usual (46%) (OR 0.78, 95% CI 0.53 to 1.14, P=0.20).CONCLUSIONBrief cognitive behaviour therapy is of limited efficacy in reducing self-harm repetition, but the findings taken in conjunctin with the economic evaluation (Byford et al. 2003) indicate superiority of MACT over TAU in terms of cost and effectiveness combined.BACKGROUNDWe carried out a large randomized trial of a brief form of cognitive therapy, manual-assisted cognitive behaviour therapy (MACT) versus treatment as usual (TAU) for deliberate self-harm.","Tyrer, P; Thompson, S; Schmidt, U; Jones, V; Knapp, M; Davidson, K; Catalan, J; Airlie, J; Baxter, S; Byford, S; Byrne, G; Cameron, S; Caplan, R; Cooper, S; Ferguson, B; Freeman, C; Frost, S; Godley, J; Greenshields, J; Henderson, J; Holden, N; Keech, P; Kim, L; Logan, K; Manley, C; MacLeod, A; Murphy, R; Patience, L; Ramsay, L; Munroz, S; Scott, J; Seivewright, H; Sivakumar, K; Tata, P; Thornton, S; Ukoumunne, O C; Wessely, S",2003.0,,0,0,
3416,Symptomatic treatment of agoraphobia and social phobias: a follow-up study.,"1. Twenty-six out of 28 out-patients with agoraphobia and social phobias who had originally been treated with phenelzine or placebo in a double-blind clinical trial were followed up for a mean period of one year. During the follow-up period patients received further pharmacotherapy or behaviour therapy, except that those patients originally receiving placebo were not allowed therapy with monoamine oxidase inhibitors. 2. Ratings of phobic and additional symptoms, social adjustment and degree of personality disorder were made after one year by one of the authors (D.S.) who had no prior knowledge of the treatment each patient had received. 3. There were no significant differences in any of the ratings between the patients of the two groups, but those originally receiving placebo had more additional treatment in the follow-up period. Patients continuing to receive phenelzine frequently experienced a return of symptoms if the drug was withdrawn before six months treatment had elapsed. 4. Degree of personality disorder showed a significant negative correlation (p = -0.6) with improvement in the phenelzine group but not in those receiving placebo originally. 5. Improvement in social adjustment items was less than improvement in symptoms at follow-up. The implications of this are discussed. 6. The results suggest that phenelzine is of comparable efficacy to other symptomatic treatments for agoraphobia and social phobias, but that it acts mainly by symptom suppression. Prolonged treatment in patients with personality disorders is not indicated, for improvement is less likely and the dangers of dependence are greater.",Tyrer P.; Steinberg D.,1975.0,,0,0,
3417,Long-term outcome of hypochondriacal personality disorder.,"Hypochondriacal personality disorder diagnosed according to the Personality Assessment Schedule, a structured clinical interview, was related to outcome after 2 years and 5 years in a randomized, controlled trial of treatment of generalized anxiety, panic, and dysthymic disorders. Seventeen individuals (9%) from a population of 181 patients had hypochondriacal personality disorder and they experienced a significantly worse outcome than other patients, including those with other personality disorders, in terms of symptomatic change and health service utilization. This lack of improvement was associated with persistent somatization in hypochondriacal personality disorder. The results give further support to the belief that hypochondriacal personality disorder is a valid clinical diagnosis that has important clinical correlates, but further work is needed to establish the extent of its overlap with hypochondriasis as a mental state disorder.",Tyrer P.; Seivewright N.; Seivewright H.,1999.0,,0,0,
3418,"The general neurotic syndrome: a coaxial diagnosis of anxiety, depression and personality disorder.","The validity of the general neurotic syndrome, a combination of anxiety, depression and dependent personality disorder, was examined in a 2-year study of outpatients with dysthymic, panic and generalized anxiety disorder diagnosed using a structured interview schedule. The general neurotic syndrome, found in a third of the patients, was associated with greater mental disorder and a significantly worse outcome than patients without the syndrome. It did not, however, predict response to treatment. Further analysis revealed that the general neurotic syndrome was a better predictor of short- and long-term outcome than any other variable apart from initial psychopathology score. It is argued that the syndrome may represent a personality diathesis that makes the individual more vulnerable to both anxiety and depressive symptoms.",Tyrer P.; Seivewright N.; Ferguson B.; Tyrer J.,1992.0,,0,0,
3419,"The Nottingham study of neurotic disorder. Effect of personality status on response to drug treatment, cognitive therapy and self-help over two years.","Repeated assessments of psychopathology, together with personality status, were made over two years on 181 psychiatric out-patients with generalised anxiety disorder (59), panic disorder (66), or dysthymic disorder (56) diagnosed using an interview schedule for DSM-III. Patients were randomly allocated to drug treatment, cognitive and behaviour therapy, or a self-help treatment programme. Although there were no overall differences in compliance rate and efficacy between the three modes of treatment, the psychological treatment methods, particularly self-help, were more effective in patients without personality disorder, and those with personality disorder responded better to drug treatment, primarily antidepressants. The findings suggest that assessment of personality status could be a valuable aid to selection of treatment in neurotic disorders and that self-help approaches are particularly valuable once personality disorder has been excluded.",Tyrer P.; Seivewright N.; Ferguson B.; Murphy S.; Johnson AL.,1993.0,,0,0,
3420,Behavioral activation for treatment of PTSD and depression in an Iraqi combat veteran with multiple physical injuries.,"Physical injury and psychological trauma associated with combat in the wars in Iraq and Afghanistan frequently lead to a constellation of symptoms including pain, post traumatic stress disorder (PTSD), and depression. This single case study describes the application of a behaviorally-based psychotherapy known as behavioral activation for the treatment of post traumatic stress disorder (PTSD) and depressive symptoms in a recent combat veteran with multiple physical injuries sustained from a blast injury. Treatment was provided concurrently with other rehabilitation services and consisted of weekly individual sessions for 4 months, followed by monthly sessions for 4 months. Clinically significant reductions in PTSD and depressive symptoms were noted between baseline and 1 year follow-up. Preliminary evidence from this case suggests that behavioral activation may be a promising treatment for PTSD and depression, and can be readily tailored to individuals with physical limitations such as pain and mobility restriction. Treatment can be provided in the context of concurrent interdisciplinary medical and rehabilitation care.",Turner AP.; Jakupcak M.,2010.0,10.1017/S1352465810000081,0,0,
3421,An integrated secondary prevention group programme reduces depression in cardiac patients,"ER OBJECTIVE: Depression is common following an acute cardiac event and can occur at a time when behaviour change is strongly recommended to reduce the risk of further cardiovascular events. The 'Beating Heart Problems' programme was designed to support cardiac patients in behaviour change and mood management.METHODS: The programme was based on cognitive behaviour therapy and motivational interviewing. A randomized controlled trial (RCT) comparing the 8-week group programme with usual care was undertaken between 2007 and 2010. All patients attended a hospital-based clinic for assessment of physiological risk factors at baseline (6 weeks after their acute event), and at 4- and 12-month follow up. Psychological and behavioural indicators were assessed by self-report questionnaires. Of the 275 patients enrolled into the RCT, 42 (15%) had Beck Depression Inventory-II scores >13 at baseline. Treatment and control group comparisons were undertaken for this subgroup, using growth curve modelling and testing for group differences over time in psychological, physiological, health behaviour, and self-efficacy measures.RESULTS: Significantly greater improvements (p?<?0.01) in depression symptoms and self-rated health were reported for the intervention group, as well as significantly larger gains in confidence in managing depression (p?<?0.05) and anger (p?<?0.01). Trends (0.05?<?p?<?0.10) for larger treatment group improvements were also seen for anxiety symptoms and confidence in managing anxiety.CONCLUSION: A group secondary-prevention programme that integrates behavioural and mood management strategies leads to decreased depression, increased confidence, and improved health perceptions in depressed cardiac patients.","Turner, A; Murphy, B M; Higgins, R O; Elliott, P C; Grande, M R; Goble, A J; Worcester, M U",2014.0,10.1177/2047487312467747,0,0,
3422,Randomised controlled trial of group cognitive behaviour therapy versus brief intervention for depression in cardiac patients,"ER OBJECTIVE: To determine whether a six-session group cognitive behaviour therapy (CBT) programme results in a greater reduction in depression symptoms than a brief intervention alone in cardiac patients with clinically significant symptoms of depression.METHOD: Fifty-seven community dwelling cardiac patients scoring >13 on the Beck Depression Inventory-II (BDI-II) received a single-session brief intervention. They were then block randomised to either six sessions of group CBT (n = 25) or no further intervention (BI; n = 32). All were re-assessed at 2, 6 and 12 months. Differences between treatment groups in the primary (BDI-II) and secondary [rates of depression; anxiety symptoms, as measured by the Hospital Anxiety and Depression Scale-Anxiety (HADS-A)] outcomes were examined using generalised linear mixed models with a random intercept term for the individual.RESULTS: Significant improvements were seen for the total group from baseline to 12 months on BDI-II and HADS-A scores. However, no differences were found between the CBT and BI conditions on change in BDI-II score, rates of major depressive episode or HADS-A score. Post hoc analysis on the total group found 12-month symptom non-remission was associated with higher baseline BDI-II score (p = 0.03), more visits to health professionals 12 months prior to baseline (p = 0.05) and a greater likelihood of either drinking alcohol over recommended levels or smoking at baseline (p = 0.01).CONCLUSIONS: Group CBT of up to six sessions did not result in greater reductions in depression or anxiety symptoms compared with a single-session brief intervention. Further work should focus on the efficacy and role of brief interventions, and addressing smoking and alcohol misuse in cardiac patients with depression.","Turner, A; Hambridge, J; Baker, A; Bowman, J; McElduff, P",2013.0,10.1177/0004867412460592,0,0,
3423,PRIME: impact of previous mental health problems on health-related quality of life in women with childbirth trauma,"ER We investigated the impact of pre-existing mental ill health on postpartum maternal outcomes. Women reporting childbirth trauma received counselling (Promoting Resilience in Mothers' Emotions; n?=?137) or parenting support (n?=?125) at birth and 6 weeks. The EuroQol Five dimensional (EQ-5D)-measured health-related quality of life at 6 weeks, 6 and 12 months. At 12 months, EQ-5D was better for women without mental health problems receiving PRIME (mean difference (MD) 0.06; 95 % confidence interval (CI) 0.02 to 0.10) or parenting support (MD 0.08; 95 % CI 0.01 to 0.14). Pre-existing mental health conditions influence quality of life in women with childbirth trauma.","Turkstra, E; Gamble, J; Creedy, D K; Fenwick, J; Barclay, L; Buist, A; Ryding, E L; Scuffham, P A",2013.0,10.1007/s00737-013-0384-5,0,0,
3424,Health services utilization of women following a traumatic birth.,"This cohort study compared 262 women with high childbirth distress to 138 non-distressed women. At 12 months, high distress women had lower health-related quality of life compared to non-distressed women (EuroQol five-dimensional (EQ-5D) scale 0.90 vs. 0.93, p = 0.008), more visits to general practitioners (3.5 vs. 2.6, p = 0.002) and utilized more additional services (e.g. maternal health clinics), with no differences for infants. Childbirth distress has lasting adverse health effects for mothers and increases health-care utilization.",Turkstra E.; Creedy DK.; Fenwick J.; Buist A.; Scuffham PA.; Gamble J.,2015.0,10.1007/s00737-014-0495-7,0,0,
3425,Cardiovascular Health in Anxiety or Mood Problems Study (CHAMPS): study protocol for a randomized controlled trial.,"Previous psychological and pharmacological interventions have primarily focused on depression disorders in populations with cardiovascular diseases (CVDs) and the efficacy of anxiety disorder interventions is only more recently being explored. Transdiagnostic interventions address common emotional processes and the full range of anxiety and depression disorders often observed in populations with CVDs. The aim of CHAMPS is to evaluate the feasibility of a unified protocol (UP) for the transdiagnostic treatment of emotional disorders intervention in patients recently hospitalized for CVDs. The current study reports the protocol of a feasibility randomized controlled trial to inform a future trial. This is a feasibility randomized, controlled trial with a single-center design. A total of 50 participants will be block-randomized to either a UP intervention or enhanced usual care. Both groups will receive standard CVD care. The UP intervention consists of 1) enhancing motivation, readiness for change, and treatment engagement; (2) psychoeducation about emotions; (3) increasing present focused emotion awareness; (4) increasing cognitive flexibility; (5) identifying and preventing patterns of emotion avoidance and maladaptive emotion-driven behaviors (EDBs, including tobacco smoking, and alcohol use); (6) increasing tolerance of emotion-related physical sensations; (7) interoceptive and situation-based emotion-focused exposure; and (8) relapse prevention strategies. Treatment duration is 12 to 18 weeks. Relevant outcomes include the standard deviation of self-rated anxiety, depression and quality of life symptoms. Other outcomes include intervention acceptability, satisfaction with care, rates of EDBs, patient adherence, physical activity, cardiac and psychiatric readmissions. Parallel to the main trial, a nonrandomized comparator cohort will be recruited comprising 150 persons scoring below the predetermined depression and anxiety severity thresholds. CHAMPS is designed to evaluate the UP for the transdiagnostic treatment of emotional disorders targeting emotional disorder processes in a CVD population. The design will provide preliminary evidence of feasibility, attrition, and satisfaction with treatment to design a definitive trial. If the trial is feasible, it opens up the possibility for interventions to target broader emotional processes in the precarious population with CVD and emotional distress. ACTRN12615000555550 , registered on 29/05/2015.",Tully PJ.; Turnbull DA.; Horowitz JD.; Beltrame JF.; Selkow T.; Baune BT.; Markwick E.; Sauer-Zavala S.; Baumeister H.; Cosh S.; Wittert GA.,2016.0,10.1186/s13063-015-1109-z,0,0,
3426,"Examining the interactive effect of posttraumatic stress disorder, distress tolerance, and gender on residential substance use disorder treatment retention.","[Correction Notice: An Erratum for this article was reported in Vol 27(3) of Psychology of Addictive Behaviors (see record 2013-33297-004). There was a copyediting error in Table 1. In the column Treatment completers, the value in parenthesis for Frequency of criminal behavior should have been (9.70). All versions of this article have been corrected.] An extensive body of research has demonstrated that patients with a co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) diagnosis are at high risk for a wide range of negative clinical outcomes, including treatment noncompletion. However, no studies to date have explored the effect of a PTSD-SUD diagnosis on residential SUD treatment completion, as well as potential moderators of this effect. Consequently, the goal of this study was to examine the interactive effect of a PTSD diagnosis, distress tolerance (DT), and gender on residential SUD treatment retention. Participants were 214 substance-dependent patients consecutively admitted to a residential SUD treatment facility. Participants were administered diagnostic interviews, completed a laboratory-based measure of DT, and were followed throughout the course of treatment. Although no significant main effects were found, results did reveal a significant PTSD x gender x DT interaction. Post hoc analyses indicated that, among men, those with a current diagnosis of PTSD and low DT completed a significantly lower proportion of residential SUD treatment compared to all other groups. The implications of the study's findings for identifying ways to improve residential SUD treatment retention among patients with a PTSD-SUD diagnosis are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Tull, Matthew T; Gratz, Kim L; Coffey, Scott F; Weiss, Nicole H; McDermott, Michael J; Anestis, Anestis, Anestis, Arfken, Back, Back, Baumeister, Berenz, Bernstein, Blake, Bornovalova, Bornovalova, Brady, Brady, Brooner, Brown, Brown, Chen, Coffey, Coffey, Coffey, Condelli, Cox, Dale, Daughters, Daughters, Daughters, Daughters, Deane, Elhai, First, Foa, Folstein, Forbes, Ford, Goodwin, Gorka, Gratz, Gratz, Gratz, Greenberg, Hien, Hien, Howell, Kessler, King, Lejuez, Lejuez, Linehan, MacCallum, Maglione, Marshall-Berenz, Martinez-Raga, McHugh, McLellan, Miller, Miller, Mills, Mills, Muraven, Najavits, Najavits, Najavits, Najavits, Najavits, Newton, Orsillo, Ouimette, Ouimette, Ouimette, Potter, Pulford, Read, Rielage, Riggs, Sayre, Schloss, Shalev, Shapiro, Sheskin, Simons, Simpson, Sonne, Stark, Tabachnick, Tate, Tull, Tull, Vujanovic, Vujanovic, Vujanovic, Weathers, West, Zanarini, Zanarini, Zlotnick, Zvolensky",2013.0,,0,0,
3427,Empowering patients undergoing in vitro fertilization by providing Internet access to medical data,"ER DESIGNRandomized clinical trial.SETTINGPatients undergoing IVF and intracytoplasmic sperm injection (ICSI) in an academic research environment.PATIENT(S)We selected patients who were undergoing an IVF or ICSI treatment, have an Internet connection, and speak fluent Dutch.INTERVENTION(S)An Internet-based personal health record that provides patients with general and personal information concerning their given treatment and that also provides facilities for communication with fellow patients and physicians.MAIN OUTCOME MEASURE(S)Patient empowerment (measured as a multidimensional concept consisting of self-efficacy, actual and perceived knowledge, and involvement in the decision process), patient satisfaction, meaning of infertility problems, social support, anxiety, and depression.RESULT(S)A total of 91 female and 89 male participants were suitable for analysis. No significant differences were observed in per person change in patient empowerment. We did not find any significant differences regarding per person change in patient satisfaction, the meaning of infertility problems, social support, anxiety, and depression.CONCLUSION(S)Usage of the personal health record did not have any effects on patient empowerment, but, at the same time, the study did not find that the personal health record had any significant adverse effects either.OBJECTIVETo study the effect of an Internet-based personal health record on the empowerment of patients undergoing IVF.","Tuil, W S; Verhaak, C M; Braat, D D; Vries, Robbé P F; Kremer, J A",2007.0,10.1016/j.fertnstert.2006.11.197,0,0,
3428,Group critical incident stress debriefing with emergency services personnel: a randomized controlled trial.,"Although single-session individual debriefing is contraindicated, the efficacy of group psychological debriefing remains unresolved. We conducted the first randomized controlled trial of critical incident stress debriefing (CISD) with emergency workers (67 volunteer fire-fighters) following shared exposure to an occupational potentially traumatic event (PTE). The goals of group CISD are to prevent post-traumatic stress and promote return to normal functioning following a PTE. To assess both goals we measured four outcomes, before and after the intervention: post-traumatic stress, psychological distress, quality of life, and alcohol use. Fire brigades were randomly assigned to one of three treatment conditions: (1) CISD, (2) Screening (i.e., no-treatment), or (3) stress management Education. Controlling for pre-intervention scores, CISD was associated with significantly less alcohol use post-intervention relative to Screening, and significantly greater post-intervention quality of life relative to Education. There were no significant effects on post-traumatic stress or psychological distress. Overall, CISD may benefit broader functioning following exposure to work-related PTEs. Future research should focus on individual, group, and organizational factors and processes that can promote recovery from operational stressors. Ultimately, an occupational health (rather than victim-based) approach will provide the best framework for understanding and combating potential threats to the health and well-being of workers at high risk for PTE exposure.",Tuckey MR.; Scott JE.,2014.0,10.1080/10615806.2013.809421,0,0,
3429,Group critical incident stress debriefing with emergency services personnel: A randomized controlled trial.,"Although single-session individual debriefing is contraindicated, the efficacy of group psychological debriefing remains unresolved. We conducted the first randomized controlled trial of critical incident stress debriefing (CISD) with emergency workers (67 volunteer fire-fighters) following shared exposure to an occupational potentially traumatic event (PTE). The goals of group CISD are to prevent post-traumatic stress and promote return to normal functioning following a PTE. To assess both goals we measured four outcomes, before and after the intervention: post-traumatic stress, psychological distress, quality of life, and alcohol use. Fire brigades were randomly assigned to one of three treatment conditions: (1) CISD, (2) Screening (i.e., no-treatment), or (3) stress management Education. Controlling for pre-intervention scores, CISD was associated with significantly less alcohol use post-intervention relative to Screening, and significantly greater post-intervention quality of life relative to Education. There were no significant effects on post-traumatic stress or psychological distress. Overall, CISD may benefit broader functioning following exposure to work-related PTEs. Future research should focus on individual, group, and organizational factors and processes that can promote recovery from operational stressors. Ultimately, an occupational health (rather than victim-based) approach will provide the best framework for understanding and combating potential threats to the health and well-being of workers at high risk for PTE exposure. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Tuckey, Michelle R; Scott, Jill E; Adler, Adler, Andrews, Bacharach, Bisson, Bond, Castro, Corneil, Deahl, Devilly, Devilly, Devilly, Endicott, Endicott, Everly, Hawker, Helzer, Hofmann, Hox, Janoff-Bulmann, Jeanette, Kessler, Litz, Marmar, McFarlane, McLennan, Mitchell, Mitchell, Mitchell, Mitchell, Rasbash, Raver, Rose, Rose, Tuckey, Tuckey, Wagner, Weiss, Weiss, Orner",2014.0,,0,0,
3430,Staying connected: a feasibility study linking American Indian and Alaska Native trauma survivors to their tribal communities.,"The objective of this investigation was to assess the feasibility of a culturally tailored care management intervention for physically injured American Indian/Alaska Native (AI/AN) patients. The intervention was initiated at a Level I trauma center and aimed to link AI/AN patients to their distant tribal communities. Thirty AI/AN patients were randomized to the intervention or to usual care. Assessments at baseline, 3 months, and 6 months included self-reported lifetime cumulative trauma burden, Native healing requests, and symptoms of posttraumatic stress, depression, and alcohol use. Generalized estimating equations ascertained differences between groups over time. Ninety-four percent of eligible patients participated; follow-up at 3 and 6 months was 83%. Participants had high numbers of lifetime traumas (mean = 5.1, standard deviation = 2.6). No differences between the intervention and control groups were observed in posttraumatic stress symptoms, depression symptoms, or alcohol use at baseline or follow-up time points. Among intervention patients, 60% either requested or participated in traditional Native healing practices and 75% reported that the intervention was helpful. This effectiveness trial demonstrated the feasibility of recruiting and randomizing injured AI/AN patients. Future efforts could integrate evidence-based interventions and traditional Native healing into stepped collaborative care treatment programs.",Tsosie U.; Nannauck S.; Buchwald D.; Russo J.; Trusz SG.; Foy H.; Zatzick D.,2011.0,10.1521/psyc.2011.74.4.349,0,0,
3431,Effectiveness of a relaxation intervention (progressive muscle relaxation and guided imagery techniques) to reduce anxiety and improve mood of parents of hospitalized children with malignancies: a randomized controlled trial in Republic of Cyprus and Greece,"ER METHOD: A randomized non-blinded control trial was conducted between April 2012 to October 2013, at two public paediatric hospitals. Fifty four eligible parents of children hospitalized with a malignancy were randomly assigned to the intervention (PMR and GI) (n = 29) and a control group (n = 25). The study evaluated the changes in anxiety levels(HAM-A) and mood changes(POMSb).RESULTS: There was a statistically significant difference in the mean scores of the subjects in the intervention group in HAM-A scale between the T0 (14.67 ± 9.93) and T1 (11.70 ± 8.15) measurements (p = 0.008) compared to the control group in which a borderline difference (16.00 ± 11.52 vs 13.33 ± 8.38) was found (p = 0.066). The effect size for the intervention group was low to moderate (0.37). Regarding mood changes, there was a statistically significant difference in tension for parents in the intervention group between T0 and T1 (11.15 ± 5.39 vs 9.78 ± 4.26), (p = 0.027). Furthermore, the parents in the intervention group were significantly less sad following the intervention (T1) (2.81 ± 1.07 vs 2.19 ± 1.21), (p = 0.001), and felt significantly less tense (2.93 ± 0.91 vs 2.26 ± 0.90), (p = 0.001) and anxiety (2.63 ± 1.21 vs 2.19 ± 1.07), (p = 0.031) compared to those in the control group.CONCLUSIONS: These findings provided evidence on the positive effect of the combination of PMR and GI in reducing anxiety and improving mood states in parents of children with malignancy.PURPOSE: To explore the effect of Progressive Muscle Relaxation (PMR) and Guided Imagery (GI),in reducing anxiety levels among parents of children diagnosed with any type of malignancy receiving active treatment at a Paediatric Oncology Unit in Republic of Cyprus and in Greece.","Tsitsi, T; Charalambous, A; Papastavrou, E; Raftopoulos, V",2017.0,10.1016/j.ejon.2016.10.007,0,0,
3432,Serotonergic involvement in the psychosocial dimension of personality,"ER Neurotransmitter systems have been associated with aspects of personality and changes in various dimensions have been shown after antidepressant treatment. A reduction in harm avoidance and an increase in self-directedness and cooperativeness, as measured by the Cloninger's Temperament and Character Inventory (TCI), have been reported in psychiatric patients receiving treatment with serotonergic antidepressants. However, some of these changes have been associated with clinical improvement. The present study therefore used a randomized, double-blind, placebo-controlled design to examine the role of the serotonergic system on these personality factors in the normal population. Twenty healthy male volunteers were randomly allocated to either placebo (n = 9) or citalopram treatment (n = 11) for 2 weeks. Baseline depression and anxiety scores were low and did not differ between groups. The TCI was administered pre- and post-treatment. There were no baseline differences on any TCI factor between groups. Citalopram induced a significant increase in self-directedness (p < 0.05) but not cooperativeness or harm avoidance ratings after treatment. Thus, citalopram has effects on personality aspects which appear to be separate from its antidepressant properties.","Tse, W S; Bond, A J",2001.0,10.1177/026988110101500313,0,0,
3433,Effects of acupressure therapy for patients having prolonged mechanical ventilation support,"ER BACKGROUNDPatients with chronic obstructive pulmonary disease who are using mechanical ventilation often experience dyspnoea and anxiety, which affects successful ventilator use.METHODSThe study had an experimental blocking design, using sex, age and length of ventilator use as a blocking factor. Qualified patients in two intermediate respiratory intensive care units were randomly assigned to an acupressure group and a comparison group. A total of 52 patients with chronic obstructive pulmonary disease in northern Taiwan participated. Those in the experimental group received daily acupressure therapy and massage treatment for 10 days. Patients in the comparison group received massage treatment and handholding. The primary outcome measures were the visual analogue scales for dyspnoea and anxiety, and physiological indicators of heart rate and respiratory rate. Data were collected every day from baseline (day 1), during the treatment (days 2-10) and follow-up (days 11-17). Data were analysed using generalized estimation equations. The study was carried out in 2003.RESULTSPatients with chronic obstructive pulmonary disease who were using prolonged mechanical ventilatory support experienced high levels of dyspnoea and anxiety. Dyspnoea (P = 0.009), anxiety (P = 0.011) and physiological indicators (P < 0.0001) in the acupressure group improved statistically significantly over time when compared with those of the comparison group.CONCLUSIONSThis results support the suggestion that acupressure therapy could decrease sympathetic stimulation and improve perceived symptoms of dyspnoea and anxiety in patients with chronic obstructive pulmonary disease who are using prolonged mechanical ventilation.AIMSThis paper reports an investigation of the effects of acupressure therapy on dyspnoea, anxiety and physiological indicators of heart rate and respiratory rate in patients with chronic obstructive pulmonary disease having mechanical ventilation support.","Tsay, S L; Wang, J C; Lin, K C; Chung, U L",2005.0,10.1111/j.1365-2648.2005.03576.x,0,0,
3434,Effects of reflexotherapy on acute postoperative pain and anxiety among patients with digestive cancer,"ER Even after receiving analgesia, patients with gastric and liver cancer still report moderate levels of postoperative pain. The purpose of the study was to investigate the efficacy of foot reflexotherapy as adjuvant therapy in relieving pain and anxiety in postoperative patients with gastric cancer and hepatocellular cancer. The study design was a randomized controlled trial. Data were collected from 4 surgical wards of a medical center in 2005 in Taipei, Taiwan. Sixty-one patients who had received surgery for gastric cancer or hepatocellular carcinoma were randomly allocated to an intervention (n = 30) or control (n = 31) group. Patients in the intervention group received the usual pain management plus 20 minutes of foot reflexotherapy during postoperative days 2, 3, and 4. Patients in the control group received usual pain management. Outcome measures included the short-form McGill Pain Questionnaire, visual analog scale for pain, summary of the pain medications consumed, and the Hospital Anxiety and Depression Scale. Results demonstrated that studied patients reported moderately high levels of pain and anxiety postoperatively while patients were managed with patient-controlled analgesia. Using generalized estimation equations and controlling for confounding variables, less pain (P < .05) and anxiety (P < .05) over time were reported by the intervention group compared with the control group. In addition, patients in the intervention group received significantly less opioid analgesics than the control group (P < .05). Findings from this study provide nurses with an additional treatment to offer postoperative digestive cancer patients.","Tsay, S L; Chen, H L; Chen, S C; Lin, H R; Lin, K C",2008.0,10.1097/01.NCC.0000305694.74754.7b,0,0,
3435,"Timing of treatment and return of fear: Effects of massed, uniform-, and expanding-spaced exposure schedules","Although exposure treatment has been shown to be highly effective in ameliorating phobias, the return of fear (ROF) is often evidenced (see Rachman, 1989). The present study compared the effects of massed (single session), uniform-spaced (5, 5, 5 intervening days), and expanding-spaced (1, 4, 10 intervening days) schedules on fear reduction and ROF in an analog sample with self-reported public-speaking anxiety. Treatment utilized a standardized speech exposure task. It was predicted that although massed treatment would produce the greatest fear reduction by posttreatment, it would yield the greatest ROF at 1-month follow-up. The uniform schedule was expected to produce intermediate fear reduction by posttreatment and at follow-up, whereas the expanding schedule was predicted to generate the lowest fear reduction by posttreatment, but the least ROF at follow-up. All groups unexpectedly demonstrated comparable fear reduction by posttreatment, but, as predicted, massed treatment produced the greatest ROF at follow-up - fear ratings in this group no longer differed from pretreatment levels. Expanding and uniform treatments showed an impressive lack of ROF at follow-up; possible explanations for the unexpectedly robust performance of the uniform group are discussed. Given the high rates of attrition for the uniform schedule (50%), results provide preliminary support for the utility of an expanding schedule. Limitations of the present study, and theoretical and practical issues regarding spacing of treatment, are discussed.",Tsao J.C.I.; Craske M.G.,2000.0,,0,0,
3436,Ethnicity moderates the outcomes of self-enhancement and self-improvement themes in expressive writing,"ER The current study examined whether writing content related to self-enhancing (viz., downward social comparison and situational attributions) and self-improving (viz., upward social comparison and persistence) motivations were differentially related to expressive writing outcomes among 17 Asian American and 17 European American participants. Content analysis of the essays revealed no significant cultural group differences in the likelihood of engaging in self-enhancing versus self-improving reflections on negative personal experiences. However, cultural group differences were apparent in the relation between self-motivation processes and changes in anxiety and depressive symptoms at 3-month follow-up. Among European Americans, writing that reflected downward social comparison predicted positive outcomes, whereas persistence writing themes were related to poorer outcomes. For Asian Americans, writing about persistence was related to positive outcomes, whereas downward social comparison and situational attributions predicted poorer outcomes. Findings provide evidence suggesting culturally distinct mechanisms for the effects of expressive disclosure. (PsycINFO Database Record","Tsai, W; Lau, A S; Niles, A N; Coello, J; Lieberman, M D; Ko, A C; Hur, C; Stanton, A L",2015.0,10.1037/cdp0000012,0,0,
3437,Clinical and sociodemographic characteristics associated with suicidal ideation in depressed outpatients.,"To identify clinical and sociodemographic characteristics associated with suicidal ideation (SI) among patients seeking care for depression in routine primary and psychiatric care settings. We examined data from 4041 treatment-seeking outpatients with major depressive disorder (MDD) to compare baseline sociodemographic and clinical characteristics of those with and without SI, and the presence or absence of baseline depressive symptoms and psychiatric comorbidities in those with SI. SI was significantly (P < 0.01) associated with numerous sociodemographic characteristics (that is, lower level of education, Caucasian or African American, male, unemployed, and treated in psychiatric care) and clinical features (that is, previous suicide attempt, younger age of MDD onset, greater baseline depressive symptom severity, greater number of depressive symptoms, and presence of agoraphobia and [or] generalized anxiety disorder). Elevated levels of SI at baseline were associated with decreased remission rates. Consistent with past findings, increased rates of SI were associated with greater depressive symptom severity as well as other features suggestive of severity of illness. Our results confirm previous findings of associations between SI and panic and (or) phobic symptoms and anxiety, but did not confirm previous findings of an association between SI and alcohol or drug use and (or) dependence. While selective serotonin reuptake inhibitor monotherapy appeared significantly helpful in reducing SI during the course of treatment, the presence of SI at baseline was found to be a associated with decreased treatment response, with patients reporting SI at the start of treatment being less likely to achieve remission. Sequenced Treatment Alternatives to Relieve Depression, NCT00021528.",Trivedi MH.; Morris DW.; Wisniewski SR.; Nierenberg AA.; Gaynes BN.; Kurian BT.; Warden D.; Stegman D.; Shores-Wilson K.; Rush AJ.,2013.0,10.1177/070674371305800209,0,0,
3438,Two treatments for fear of flying compared: Cognitive behavioral therapy combined with systematic desensitization or eye movement desensitization and reprocessing (EMDR).,"This study aimed to test a combined treatment with eye movement desensitization and reprocessing (EMDR) and cognitive behavioral therapy (CBT), compared with CBT integrated with systematic desensitization, in reducing fear of flying. Participants were patients with aerophobia, who were randomly assigned to two experimental groups in a before- and after-treatment research design. The Flight Anxiety Situations Questionnaire (FAS) and the Flight Anxiety Modality Questionnaire (FAM) were used. The efficacy of each program was evaluated comparing the pre- and post-treatment levels of fear of flying within subjects. A comparison of the post-treatment scores between subjects was also conducted. Results showed the effectiveness of each model with a significant improvement in the examined psychological outcomes in both groups. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Triscari, Maria Teresa; Faraci, Palmira; D'Angelo, Valerio; Urso, Viviana; Catalisano, Dario; Beckham, Bisson, Fernandez, Foa, Gattinara, Gauvreau, Goldstein, Gros, Haug, Howard, Mogotsi, Newgent, Protinsky, Roberts, Rothbaum, Schurmans, Shapiro, Van Gerwen, Van Gerwen",2011.0,,0,0,
3439,Gender differences in a controlled pilot study of psychosocial treatments in substance dependent patients with post-traumatic stress disorder: Design considerations and outcomes.,"Co-existing substance dependence and post-traumatic stress disorder is a common comorbidity, lacking a standard treatment. This paper reports gender-related findings from an N  = 19 controlled clinical trial using methadone maintained and primary-cocaine abusing subjects (aged 22-46 yrs). Treatments contrasted were Substance Dependency-Post-Traumatic Stress Disorder Therapy, an integrated, two-phase cognitive-behavioral therapy which uses existing treatment techniques including coping skills treatment for addictions, stress inoculation therapy and in vivo exposure; and Twelve-Step Facilitation Therapy. Female subjects at baseline differed from males in having higher Addiction Severity Index (ASI), psychiatric composite severity scores. No differences were seen between genders at end of treatment or followup. Improvement was observed across the sample in current posttraumatic stress disorder (PTSD) severity, number of PTSD symptoms, ASI psychiatric, drug composite severity scores and number of days using substances in the past 30 days. The absence of gender-based differences in baseline differences and treatment outcomes suggests that recruitment, assessment and treatment processes were applied equally and were equally effective to both genders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Triffleman, Elisa",2000.0,,0,0,
3440,Integrity of cognitive functions in trigeminal nerve stimulation trials in neuropsychiatry.,"Presents a study aims to present an exploratory analysis of cognitive assessments conducted in clinical trials undertaken by the neuromodulation group. As part of clinical trials performed to investigate the efficacy of trigeminal nerve stimulation (TNS) for neuropsychiatric disorders such as depression, generalized anxiety, fibromyalgia, panic disorder, posttraumatic stress disorder and obsessive-compulsive disorder, 64 patients have been evaluated for cognitive function before and after a TNS protocol, using the Montreal Cognitive Assessment (MOCA). Cognitive outcomes were analyzed continuously as the mean difference between baseline and final MOCA scores. Results were tested using analysis of variance (ANOVA). The significance level was set at p < 0.05. Statistical analysis was performed using standard statistical software (Stata version 13.1). A total of 64 patients (55 female) were enrolled. At baseline, patients had a mean age of 48.6+/-11.9 years. Mean baseline MOCA score was 25.01+/-4.4. This TNS protocol has been used in several clinical trials in neuropsychiatry and is potentially a safe and non-invasive brain stimulation strategy in terms of cognitive functions. Further studies assessing cognitive safety are of fundamental importance to clarify the effects of TNS on more specific cognitive functions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Trevizol, Alisson; Bonadia, Bianca; Gomes, July Silveira; Cordeiro, Quirino; Shiozawa, Pedro; McClintock, Shiozawa, Shiozawa, Shiozawa, Trevizol",2016.0,,0,0,
3441,Randomized trial of light versus deep sedation on mental health after critical illness.,": To investigate if light sedation favorably affects subsequent patient mental health compared with deep sedation. Symptoms of posttraumatic stress disorder are common in patients after they have undergone prolonged mechanical ventilation and are associated with sedation depth. : Randomized, open-label, controlled trial. : Single tertiary care center. : Adult patients requiring mechanical ventilation. : Patients were randomized to receive either light (patient awake and cooperative) or deep sedation (patient asleep, awakening upon physical stimulation). : Self-reported measures of posttraumatic stress disorder, anxiety, and depression were collected at intensive care unit discharge and 4 wks later. The primary outcomes were symptoms of posttraumatic stress disorder, anxiety, and depression 4 wks after intensive care unit discharge.A total of 137 patients were assigned to either the light (n = 69) or the deep sedation (n = 68) group. Seven patients withdrew consent and one patient was randomized in error, leaving 129 patients (n = 65 in light sedation and n = 64 in deep sedation) available for analysis. At the 4-wk follow-up, patients in the deep sedation group tended to have more posttraumatic stress disorder symptoms (p = .07); the deep sedation group had more trouble remembering the event (37% vs. 14%; p = .02) and more disturbing memories of the intensive care unit (18% vs. 4%; p = .05). Patients in the light sedation group had an average one day less being ventilated and 1.5 fewer days in the intensive care unit. There were no differences between the two groups in the occurrence of anxiety and depression, and also no difference in mortality or in the incidence of adverse events. : These data suggest that a strategy of light sedation affords benefits with regard to reduction of intensive care unit stay and duration of ventilation without negatively affecting subsequent patient mental health or patient safety.",Treggiari MM.; Romand JA.; Yanez ND.; Deem SA.; Goldberg J.; Hudson L.; Heidegger CP.; Weiss NS.,2009.0,10.1097/CCM.0b013e3181a5689f,0,0,
3442,Prolactin response to TRH in patients with panic disorder,"The effects of TRH administration (400 μg, i.v.) on the release of prolactin were examined in 15 patients who met DSM-III-R criteria for panic disorder and 15 normal control subjects. Four hundred micrograms TRH was given via IV route. Blood samples were taken before TRH administration (baseline values) and at 15, 30 and 60 min. The results demonstrate that prolactin responses to TRH did not differ between panic disorder patients and normal control subjects. When only women were evaluated, the findings indicate that women with PD tend to show excessive prolactin responses to TRH. The findings are discussed in view of findings from earlier reports. Copyright (C) 2000 Elsevier Science Ireland Ltd.",Tükel R.; Kora K.; Hekim N.; Oguz H.; Alagöl F.,2000.0,10.1016/S0165-1781(00)00147-5,0,0,
3443,Chronic back pain: What does biofeedback add to cognitive-behavioral treatment? A randomized controlled trial,"The purpose of the study was to examine the supplemental value of EMG biofeedback training when added to an outpatient cognitive-behavioral treatment of chronic back pain. One hundred and twenty-eight chronic back pain patients were assigned to Cognitive-Behavioral Therapy (CBT), Cognitive-Behavioral Therapy supported by biofeedback (CBTB), or Wait List Control (WLC). Measures (questionnaires as well as psychophysiological measures of stress reactivity to different stress conditions and muscle tension) were taken at pretreatment, post-treatment and 6-month follow up. The results at posttreatment indicated significant improvements in functioning on measures of pain intensity (ES = 0.79), perceived level of disability (ES = 0.52), coping strategies (ES = 1.09), psychological distress (ES = 0.41) and other outcome variables in both CBT and CBTB conditions. These improvements were not evident for the WCL condition. At 6-month follow-up, treatment gains were maintained for both treatment groups. These findings have important implications on treatment of chronic back pain. The advantages of including biofeedback in cognitive-behavioral treatment of chronic back pain will be discussed.",Trapp K.; Glombiewski J.A.; Hartwich-Tersek J.; Rief W.,2009.0,10.1111/j.1533-2500.2009.00267.x,0,0,
3444,Risk factors for missed HIV primary care visits among men who have sex with men.,"Benefits of anti-retroviral therapy (ART) depend on consistent HIV care attendance. However, appointment non-adherence (i.e. missed appointments) is common even in programs that reduce financial barriers. Demographic, health/treatment, and psychosocial contributors to appointment non-adherence were examined among men who have sex with men (MSM) attending HIV primary care. Participants (n = 503) completed questionnaires, and HIV biomarker data were extracted from medical records. At 12 months, records were reviewed to assess HIV primary care appointment non-adherence. Among MSM, 31.2% missed without cancellation at least one appointment during 12-month study period. Independent predictors (P < 0.05) were: low income (OR = 1.87); African American (OR = 3.00) and Hispanic/Latino (OR = 4.31) relative to non-Hispanic White; depression (OR = 2.01); and low expectancy for appointments to prevent/treat infection (OR = 2.38), whereas private insurance (OR = 0.48) and older age (OR = 0.94) predicted lower risk. Low self-efficacy predicted marginal risk (OR = 2.74, P = 0.10). The following did not independently predict risk for non-adherence: education, relationship status, general health, time since HIV diagnosis, ART history, post-traumatic stress disorder, HIV stigma, or supportive clinic staff. Appointment non-adherence is prevalent, particularly among younger and racial/ethnic minority MSM. Socioeconomic barriers, depression and low appointment expectancy and self-efficacy may be targets to increase care engagement. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Traeger, Lara; O'Cleirigh, Conall; Skeer, Margie R; Mayer, Kenneth H; Safren, Steven A; Asch, Bakken, Beach, Berg, Bing, Bodenlos, Cashman, Catz, Cohen, Curtin, Fischer, Fisher, Gardner, Gifford, Giordano, Giordano, Giordano, Israelski, Kagan, Kagan, Kelly, Keruly, Kessler, King, Kissinger, Knauz, Martin, Mayer, McGuire, Mellins, Melnikow, Meltzer-Brody, Moore, Mugavero, Mugavero, Neal, Palacio, Park, Rastegar, Rosenbaum, Safren, Sohler, Sol, Spitzer, Stutterheim, Swendeman, Torian, Trenouth, Tsao, van Ameringen, Van der Meer, Ware, Weinger, Weiser",2012.0,,0,0,
3445,The role of computerized rheoencephalography in the assessment of normal pressure hydrocephalus.,"The aim of this study was to determine the relationship between arterial compliance derived from rheoencephalography (REG), and the slope of the regression line between pulse amplitude and mean ICP (AMP/P) recorded during a lumbar infusion study. A hypothetical link between these two variables has been suggested in the past. Resistance to the outflow of cerebrospinal fluid (R(out)) and the slope of the amplitude pressure regression line (AMP/P) were calculated in 62 patients diagnosed with posttraumatic normal pressure hydrocephalus (NPH). In all patients, the changes in cerebral electrical impedance related to the pulsatile component of blood flow were studied noninvasively using computerized rheoencephalography. We classified the REG pulse-related waveform (REGpw) according to the number of the inflection points in the ascending branch, which are a manifestation of the elastic properties of the small arteries. In normal subjects, REGpw corresponded with only one inflection point in the ascending branch (category I). For the purpose of this study, we assumed that the presence of three or greater number of inflection points was characteristic of the regressive changes of the arterial wall (category II). The slope of the AMP/P in patients with the category I REGpw was significantly lower than that in patients with category II (p < 0.05). The association between REGpw category II and the increased slope of the aAMP/P regression line may be related to the transmission of the pulse pressure waveform arterial wall to the CSF compartment, which in turn depends on the elastic properties of the cerebral arteries. The outcome of shunting in patients with REGpw category I was significantly better than that in patients with category II, suggesting that small artery disease may be linked to worse clinical outcomes. Our study indicates that REG examination has potential clinical value in diagnosis and prognosis of NPH.",Traczewski W.; Moskala M.; Kruk D.; Gościński I.; Szwabowska D.; Polak J.; Wielgosz K.,2005.0,10.1089/neu.2005.22.836,0,0,
3446,Delivering early care in diabetes evaluation (DECIDE): a protocol for a randomised controlled trial to assess hospital versus home management at diagnosis in childhood diabetes,"ER METHODS/DESIGNThis is a multi-centre randomised controlled trial across eight UK paediatric diabetes centres. The study aims to recruit 240 children newly diagnosed with type 1 diabetes and their parents/carers. Eligible patients (aged 0-17 years) will be remotely randomised to either 'hospital' or 'home' management. Parents/carers of patients will also be recruited. Nursing management of participants and data collection will be co-ordinated by a project nurse at each centre. Data will be collected for 24 months after diagnosis; at follow up appointments at 3, 12 and 24 months and every 3-4 months at routine clinic visits.The primary outcome measure is patients' glycosylated haemoglobin (HbA1c) at 24 months after diagnosis. Additional measurements of HbA1c will be made at diagnosis and 3 and 12 months later. HbA1c concentrations will be analysed at a central laboratory.Secondary outcome measures include length of stay at diagnosis, growth, adverse events, quality of life, anxiety, coping with diabetes, diabetes knowledge, home/clinic visits, self-care activity, satisfaction and time off school/work. Questionnaires will be sent to participants at 1, 12 and 24 months and will include a questionnaire, developed and validated to measure impact of the diagnosis on social activity and independence. Additional qualitative outcome measures include the experience of both approaches by a subgroup of participants (n = 30) and health professionals. Total health service costs will be evaluated. A cost effectiveness analysis will assess direct and indirect health service costs against the primary outcome (HbA1c).DISCUSSIONThis will be the first randomised controlled trial to evaluate hospital and home management of children newly diagnosed with type 1 diabetes and the findings should provide important evidence to inform practice and national guidelines.TRIAL REGISTRATION NUMBERISRCTN: ISRCTN78114042.BACKGROUNDThere is increased incidence of new cases of type 1 diabetes in children younger than 15 years. The debate concerning where best to manage newly diagnosed children continues. Some units routinely admit children to hospital whilst others routinely manage children at home. A Cochrane review identified the need for a large well-designed randomised controlled trial to investigate any significant differences in comprehensive short and long-term outcomes between the two approaches. The DECIDE study will address these knowledge gaps, providing high quality evidence to inform national and international policy and practice.","Townson, J K; Gregory, J W; Cohen, D; Channon, S; Harman, N; Davies, J H; Warner, J; Trevelyan, N; Playle, R; Robling, M; Hood, K; Lowes, L",2011.0,10.1186/1471-2431-11-7,0,0,
3447,Can the absence of prejudice be more threatening than its presence? It depends on one's worldview,"ER The present research used validated cardiovascular measures to examine threat reactions among members of stigmatized groups when interacting with members of nonstigmatized groups who were, or were not, prejudiced against their group. The authors hypothesized that people's beliefs about the fairness of the status system would moderate their experience of threat during intergroup interactions. The authors predicted that for members of stigmatized groups who believe the status system is fair, interacting with a prejudiced partner, compared with interacting with an unprejudiced partner, would disconfirm their worldview and result in greater threat. In contrast, the authors predicted that for members of stigmatized groups who believe the system is unfair, interacting with a prejudiced partner, compared with interacting with an unprejudiced partner, would confirm their worldview and result in less threat. The authors examined these predictions among Latinas interacting with a White female confederate (Study 1) and White females interacting with a White male confederate (Study 2). As predicted, people's beliefs about the fairness of the status system moderated their experiences of threat during intergroup interactions, indicated both by cardiovascular responses and nonverbal behavior. The specific pattern of the moderation differed across the 2 studies.","Townsend, S S; Major, B; Sawyer, P J; Mendes, W B",2010.0,10.1037/a0020434,0,0,
3448,Subjective sleep quality and postconcussion symptoms following mild traumatic brain injury.,"The goal of this investigation is to examine the prevalence of poor subjective sleep in patients with a history of mild traumatic brain injury (mTBI) and examine the relationship between subjective sleep quality and postconcussive symptoms (PCS), above and beyond the typical demographic and psychological distress variables. Individuals with a history of mTBI completed online questionnaires. Regression analysis was utilized to determine if subjective sleep quality would predict PCS severity, above and beyond demographic variables and psychological distress. Individuals with a history of mTBI (n = 158) completed surveys online. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and PCS with the Neurobehavioral Symptom Inventory (NSI). Demographic information was collected and psychological distress was measured using the Brief Symptom Inventory-18 (BSI-18). In this sample, 92% of patients with mTBI reported poor sleep. Sleep quality significantly accounted for the variance in PCS, above and beyond demographics, time since injury and psychological distress (p < 0.001), although only a small amount of the variance in PCS was explained. Results indicate that poor subjective sleep quality is a significant problem in those with mTBI. While sleep is associated with PCS severity, psychological distress is a more potent predictor.",Towns SJ.; Silva MA.; Belanger HG.,2015.0,10.3109/02699052.2015.1045030,0,0,
3449,Individual mindfulness-based cognitive therapy and cognitive behavior therapy for treating depressive symptoms in patients with diabetes: results of a randomized controlled trial.,"Depression is a common comorbidity of diabetes, undesirably affecting patients' physical and mental functioning. Psychological interventions are effective treatments for depression in the general population as well as in patients with a chronic disease. The aim of this study was to assess the efficacy of individual mindfulness-based cognitive therapy (MBCT) and individual cognitive behavior therapy (CBT) in comparison with a waiting-list control condition for treating depressive symptoms in adults with type 1 or type 2 diabetes. In this randomized controlled trial, 94 outpatients with diabetes and comorbid depressive symptoms (i.e., Beck Depression Inventory-II [BDI-II] ‚â•14) were randomized to MBCT (n = 31), CBT (n = 32), or waiting list (n = 31). All participants completed written questionnaires and interviews at pre- and postmeasurement (3 months later). Primary outcome measure was severity of depressive symptoms (BDI-II and Toronto Hamilton Depression Rating Scale). Anxiety (Generalized Anxiety Disorder 7), well-being (Well-Being Index), diabetes-related distress (Problem Areas In Diabetes), and HbA1c levels were assessed as secondary outcomes. Results showed that participants receiving MBCT and CBT reported significantly greater reductions in depressive symptoms compared with patients in the waiting-list control condition (respectively, P = 0.004 and P < 0.001; d = 0.80 and 1.00; clinically relevant improvement 26% and 29% vs. 4%). Both interventions also had significant positive effects on anxiety, well-being, and diabetes-related distress. No significant effect was found on HbA1c values. Both individual MBCT and CBT are effective in improving a range of psychological symptoms in individuals with type 1 and type 2 diabetes.",Tovote KA.; Fleer J.; Snippe E.; Peeters AC.; Emmelkamp PM.; Sanderman R.; Links TP.; Schroevers MJ.,2014.0,10.2337/dc13-2918,0,0,
3450,Physiological and subjective anxiety responses to caffeine and stress in nonclinical panic,"Physiological and subjective anxiety responses to the combination of caffeine and film, cold presser, and mental arithmetic stressors were examined in 24 healthy females with and without nonclinical panic. Caffeine (3.3 mg/kg) and placebo were administered in a within-subject, double-blind, counterbalanced design on two consecutive days. Repeated measurements of blood pressure, cardiac interbeat interval, skin conductance, and subjective anxiety were obtained during a predrug resting baseline, a postdrug resting baseline, stressor tasks, and a recovery baseline. Panic subjects in the caffeine/placebo drug order exhibited a significantly greater anxiety response on the caffeine day, which combined additively with increases produced by stress. Caffeine and stress also produced additive increases in physiological arousal, although no significant group differences were observed.",Totten G.L.; France C.R.,1995.0,10.1016/0887-6185(95)00025-J,0,0,
3451,"A randomized, single-blind, controlled, parallel assignment study of exercise versus education as adjuvant in the treatment of peripheral neuropathic pain","ER OBJECTIVE: Some forms of chronic pain are receptive to exercise therapy for maintenance of pain relief. We evaluated the impact of a balanced exercise program in the management of human peripheral neuropathic pain compared with an educational intervention.METHODS: This was a single-center, randomized, single-blind, controlled study using an intention-to-treat protocol. Patients with confirmed neuropathic pain and a pain score ?4 (0 to 10 scale) on visual analog scale (VAS) continued their regular pain therapies and were randomized to 6 months of either a balanced exercise program or an educational program. VAS for pain severity was the primary outcome variable. Characteristics of pain, function, mood, anxiety, sleep, and quality of life along with Single Stage Treadmill Walking Test calculating maximal oxygen consumption (VO2) formed the secondary outcome measures.RESULTS: Seventy-eight patients were screened and 54 participated, with 28 randomized to exercise and 26 randomized to education. A total of 19 (68%) and 20 patients (77%) completed exercise and education, respectively. VAS scores improved 17% for the exercise group as compared with 9% for the education group (P=0.08). The only secondary outcome measure demonstrating improvement was VO2, which improved in exercise participants (25.6±4.5 mL/kg/min at baseline vs. 28.9±3.8 mL/kg/min at 6 mo).DISCUSSION: A balanced exercise program was beneficial for exercise capacity, but produced only a medium-sized effect without statistical significance. A small sample size and unexpectedly high dropout rates may have limited our ability to demonstrate statistically significant improvement in pain relief.","Toth, C; Brady, S; Gagnon, F; Wigglesworth, K",2014.0,10.1097/AJP.0b013e31828ccd0f,0,0,
3452,Virtual reality versus computer-aided exposure treatments for fear of flying.,"Evidence is growing that two modalities of computer-based exposure therapies--virtual reality and computer-aided psychotherapy--are effective in treating anxiety disorders, including fear of flying. However, they have not yet been directly compared. The aim of this study was to analyze the efficacy of three computer-based exposure treatments for fear of flying: virtual reality exposure therapy (VRET), computer-aided exposure with a therapist's (CAE-T) assistance throughout exposure sessions, and self-administered computer-aided exposure (CAE-SA). A total of 60 participants with flying phobia were randomly assigned to VRET, CAE-T, or CAE-SA. Results indicate that the three interventions were effective in reducing fear of flying at posttreatment and at 1-year follow-up; furthermore, there were no significant differences between them in any of the outcome measure. Large within-group effect sizes were found for all three treatment conditions at both posttreatment and at follow-up. The results suggest that therapist involvement might be minimized during computer-based treatments and that CAE can be as effective as VRET in reducing fear of flying.",Tortella-Feliu M.; Botella C.; Llabrés J.; Bretón-López JM.; del Amo AR.; Baños RM.; Gelabert JM.,2011.0,10.1177/0145445510390801,0,0,
3453,Effectiveness of functional neurosurgery in patients with obsessive compulsive disorder with depression diagnosis resistant to treatment.,"Introduction: Obsessive compulsive disorder is a disorder characterized by obsessions and compulsions, and it is estimated that affects 1-3% of general population. 10% of cases are clinically serious and one of each 400 is resistant to conventional treatment; in these cases functional neurosurgery is required. Objective: The purpose of this study is to present affective profile, functional profile, and personality profile results in three patients with obsessive compulsive disorder diagnosis with major depression comorbidity, submitted to a neurosurgical combined intervention: deep brain stimulation of nucleus accumbens and cingulo bilateral termo-ablation. Material and methods: Beck Depression Inventory, Beck Anxiety Inventory, Axis K, and Minnesota Multiphasic Personality Inventory-2 were applied to three patients. Results: Percentage of clinical positive change in total evaluations was 70.59%. With respect to affective profile 66.67% of patients improved depressive symptoms, and 100% improved anxiety symptoms. In relation to functional profile 100% of patients improved daily operation level. Personality profile improved 66.67% in most of Minnesota Multiphasic Personality Inventory-2 clinical scales. Conclusions: This procedure was effective for the three evaluated patients, since all improved part of symptomatology and their operation level. It is necessary to have broader cohorts in order to get concluding results. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Torres, Lucia A. Ledesma; Hernandez, Cristina Rodriguez; Espinosa, Omar Medrano; Luna, Oscar Meneses; Granados, Francisco J. Valencia; Salazar, Manuel Hernandez; Ballantine, Becerra, Beck, Cosgrove, Fantino, Feinstein, Hernandez, Martin, Meneses, Mindus, Mendez, Ryan, Ruck, Shah, Torres",2014.0,,0,0,
3454,"Goal Management Training Combined With External Cuing as a Means to Improve Emotional Regulation, Psychological Functioning, and Quality of Life in Patients With Acquired Brain Injury: a Randomized Controlled Trial","ER DESIGN: Randomized controlled trial with blinded outcome assessment at baseline, posttraining, and 6-month follow-up.SETTING: Outpatient.PARTICIPANTS: Persons with ABI and executive dysfunction (N=70; 64% traumatic brain injury; 52% men; mean age ± SD, 43±13y; mean time since injury ± SD, 8.1±9.4y).INTERVENTION: Eight sessions of GMT in groups, including a new module addressing emotional regulation, and external cuing. A psychoeducative control condition (Brain Health Workshop) was matched on amount of training, therapist contact, and homework.MAIN OUTCOME MEASURES: Emotional regulation was assessed with the Brain Injury Rehabilitation Trust Regulation of Emotions Questionnaire, the Emotional Control subscale and the Emotion Regulation factor (Behavior Rating Inventory of Executive Function-Adult Version), and the Positive and Negative Affect subscales from the Dysexecutive Questionnaire. Secondary outcome measures included psychological distress (Hopkins Symptom Checklist-25) and QOL (Quality of Life After Brain Injury Scale).RESULTS: Findings indicated beneficial effects of GMT on emotional regulation skills in everyday life and in QOL 6 months posttreatment. No intervention effects on measures of psychological distress were registered.CONCLUSIONS: GMT is a promising intervention for improving emotional regulation after ABI, even in the chronic phase. More research using objective measures of emotional regulation is needed to investigate the efficacy of this type of training.OBJECTIVE: To investigate whether goal management training (GMT) expanded to include external cuing and an emotional regulation module is associated with improved emotional regulation, psychological functioning, and quality of life (QOL) after chronic acquired brain injury (ABI).","Tornås, S; Løvstad, M; Solbakk, A K; Schanke, A K; Stubberud, J",2016.0,10.1016/j.apmr.2016.06.014,0,0,
3455,"Reduction of human avoidant behavior: a comparison of counterconditioning, expectancy, and cognitive information approaches.",,Tori C.; Worell L.,1973.0,,0,0,
3456,The effectiveness of video interaction guidance in parents of premature infants: a multicenter randomised controlled trial.,"Studies have consistently found a high incidence of neonatal medical problems, premature births and low birth weights in abused and neglected children. One of the explanations proposed for the relation between neonatal problems and adverse parenting is a possible delay or disturbance in the bonding process between the parent and infant. This hypothesis suggests that due to neonatal problems, the development of an affectionate bond between the parent and the infant is impeded. The disruption of an optimal parent-infant bond -on its turn- may predispose to distorted parent-infant interactions and thus facilitate abusive or neglectful behaviours. Video Interaction Guidance (VIG) is expected to promote the bond between parents and newborns and is expected to diminish non-optimal parenting behaviour. This study is a multi-center randomised controlled trial to evaluate the effectiveness of Video Interaction Guidance in parents of premature infants. In this study 210 newborn infants with their parents will be included: n = 70 healthy term infants (>37 weeks GA), n = 70 moderate term infants (32-37 weeks GA) which are recruited from maternity wards of 6 general hospitals and n = 70 extremely preterm infants or very low birth weight infants (<32 weeks GA) recruited by the NICU of 2 specialized hospitals. The participating families will be divided into 3 groups: a reference group (i.e. full term infants and their parents, receiving care as usual), a control group (i.e. premature infants and their parents, receiving care as usual) and an intervention group (i.e. premature infants and their parents, receiving VIG). The data will be collected during the first six months after birth using observations of parent-infant interactions, questionnaires and semi-structured interviews. Primary outcomes are the quality of parental bonding and parent-infant interactive behaviour. Parental secondary outcomes are (posttraumatic) stress symptoms, depression, anxiety and feelings of anger and hostility. Infant secondary outcomes are behavioral aspects such as crying, eating, and sleeping. This is the first prospective study to empirically evaluate the effect of VIG in parents of premature infants. Family recruitment is expected to be completed in January 2012. First results should be available by 2012. TRAIL REGISTRATION NUMBER: NTR3423.",Tooten A.; Hoffenkamp HN.; Hall RA.; Winkel FW.; Eliëns M.; Vingerhoets AJ.; van Bakel HJ.,2012.0,10.1186/1471-2431-12-76,0,0,
3457,Provocation of the electromagnetic distress syndrome.,"Many patients in Sweden are today distressed by fears of ""electric fields."" This phenomenon was almost unknown to occupational health clinics 10 years ago. A 35-year-old male plumber complained of fatigue, headache, lack of concentration, numbness and paresthesia in his arms, and a greasy feeling in his palms, where he observed tiny shiny spots. These symptoms made him unable to work. It all started after a period of high strain at the work. He feared negative influences, mainly from electric fields. Signs indicating nerve entrapment in the upper extremities were found in a clinical examination. The patient was blindly provocated in a whole-body electromagnetic coil at 34 or 100 microT randomly mixed with sham exposures. After being blinded against irrelevant external cues, he was not able to detect the existence of or any symptoms at either field intensity. He was informed about the results and was later able to return to his previous work. No sensitivity to electromagnetic fields could be objectively verified for this patient, who was suspected to suffer from a thoracic outlet syndrome.",Toomingas A.,1996.0,,0,0,
3458,A randomized controlled trial of a psycho-education intervention by midwives in reducing childbirth fear in pregnant women,"ER BACKGROUND: Childbirth fear is associated with increased obstetric interventions and poor emotional and psychological health for women. The purpose of this study is to test an antenatal psycho-education intervention by midwives in reducing women's childbirth fear.METHODS: Women (n = 1,410) attending three hospitals in South East Queensland, Australia, were recruited into the BELIEF trial. Participants reporting high fear were randomly allocated to intervention (n = 170) or control (n = 169) groups. All women received a decision-aid booklet on childbirth choices. The telephone counseling intervention was offered at 24 and 34 weeks of pregnancy. The control group received usual care offered by public maternity services. Primary outcome was reduction in childbirth fear (WDEQ-A) from second trimester to 36 weeks' gestation. Secondary outcomes were improved childbirth self-efficacy, and reduced decisional conflict and depressive symptoms. Demographic, obstetric & psychometric measures were administered at recruitment, and 36 weeks of pregnancy.RESULTS: There were significant differences between groups on postintervention scores for fear of birth (p < 0.001) and childbirth self-efficacy (p = 0.002). Decisional conflict and depressive symptoms reduced but were not significant.CONCLUSION: Psycho-education by trained midwives was effective in reducing high childbirth fear levels and increasing childbirth confidence in pregnant women. Improving antenatal emotional well-being may have wider positive social and maternity care implications for optimal childbirth experiences.","Toohill, J; Fenwick, J; Gamble, J; Creedy, D K; Buist, A; Turkstra, E; Ryding, E L",2014.0,10.1111/birt.12136,0,0,
3459,The role of self-monitoring and response inhibition in improving sleep behaviours,"ER BACKGROUND: Young adults tend to have poor sleep, which may be a result of poor self-regulation.PURPOSE: This study investigated whether manipulating two aspects of self-regulation: self-monitoring and response inhibition could improve sleep behaviours.METHOD: University students (N = 190) were randomly allocated to complete (1) a self-monitoring sleep diary and response inhibition training, (2) a sleep diary only, or (3) a control questionnaire daily for a period of 7 days.RESULTS: Outcome measures were three sleep hygiene behaviours previously found to be particularly important in this population: avoiding going to bed hungry and thirsty, avoiding anxiety and stress-provoking activity before bed, and making the bedroom and sleep environment restful. Those who completed diary-based self-monitoring successfully avoided anxiety and stress-provoking activity before bed more frequently than control participants, corresponding to a medium effect size, and further development may provide a simple intervention to improve aspects of sleep and other health behaviours.CONCLUSION: There was no incremental effect of response inhibition training. Modified response inhibition training tasks may be worth investigating in future research.","Todd, J; Mullan, B",2014.0,10.1007/s12529-013-9328-8,0,0,
3460,Pressor effect of hyperventilation in healthy subjects.,"Hyperventilation is an important feature of panic disorder, and an association has been reported between panic disorder and hypertension. We have examined the effect of hyperventilation on the blood pressure (BP) of healthy subjects. Twenty six subjects were randomised in a balanced two-period cross-over study to compare the effects of hyperventilation with that of normal breathing on sitting BP, heart rate and the electrocardiogram. Each study phase lasted 40 min, with 15 min of baseline observation, 5 min of hyperventilation or normal breathing, and 20 min of continued observation. Hyperventilation significantly increased SBP by 8.9 mm Hg (95% CI 3.8-13.8, P < 0.01), diastolic blood pressure by 8.2 mm Hg (95% CI 1.7-14.7, P < 0.05), mean arterial pressure by 10.0 mm Hg (95% CI 3.3-16.7, P < 0.01) and heart rate by 36 beats/min (95% CI 31-44, P < 0.01). The changes in diastolic and mean arterial pressure correlated significantly with the total volume of air expired during hyperventilation (r = 0.57, p < 0.01 and r = 0.50 P < 0.01, respectively), but not with the change in expired carbon dioxide. In the electrocardiogram, T wave changes occurred in the inferior leads in 10 of 26 subjects, but there were no significant changes in other measurements. Hyperventilation significantly increased the BP of healthy subjects, and the role of hyperventilation in the link between panic disorder and hypertension deserves further study.",Todd GP.; Chadwick IG.; Yeo WW.; Jackson PR.; Ramsay LE.,1995.0,,0,0,
3461,"Negative symptoms and concomitant attention deficits in schizophrenia: associations with prospective assessments of anxiety, social dysfunction, and avoidant coping.","Negative symptoms are a significant barrier to function and may have a range of etiological roots and links to outcome. A previous study identified a subgroup of patients with schizophrenia who had both higher levels of negative symptoms and relatively poorer attentional function who had uniquely lower self-esteem and greater internalized stigma. To determine whether participants previously classified as having High Negative/Poorer Attention would continue to have lower self-esteem, higher self-stigma, and also higher levels of anxiety and avoidant coping 5 months later. Participants were 77 (77.8%) of the original 99 participants who completed follow-up procedures. The High Negative/Poorer Attention group had significantly poorer social functioning, lower appraisal of their competence, higher levels of anxiety, and a higher preference for ignoring stressors five months after classification. Negative symptoms with concomitant attention deficits may lead to more social and psychological dysfunction than negative symptoms or attention deficits alone. Individuals with both high levels of negative symptoms and poor attention may represent a meaningful subgroup with unique psychosocial difficulties that persist over time.",Tsai J.; Lysaker PH.; Vohs JL.,2010.0,10.3109/09638230903469277,0,0,
3462,Acute stimulation effect of the ventral capsule/ventral striatum in patients with refractory obsessive-compulsive disorder-A double-blinded trial.,"Objective: Deep-brain stimulation (DBS) for treating refractory obsessive-compulsive disorder (OCD) has shown positive results in small clinical trials. Ventral capsule/ventral striatum (VC/VS) is one of the promising targets; however, whether or not acute stimulation test can provide substantial information for chronic stimulation is not yet known. We evaluated postoperative test stimulation and examined the relationship of acute simulation-induced smile/laughter and 15-month clinical outcome. Methods: Four adult patients with refractory OCD were implanted with Model 3387 leads bilaterally in an area of VC/VS. Postoperative test stimulation was performed at least 2 weeks after surgery. We performed double-blinded postoperative test stimulation with different contact and voltage. The relationship of stimulation-induced smile/laughter and chronic response was examined. Results: Patients presented smile, laughter, euphoria, increased heart rate, increased blood pressure, smell, chest vibration, dizziness, nausea, heat, or increased sexual drive during acute stimulation. We found that the higher the percentage of smile/laughter (34.3%, 31.3%, 56.3%, and 12.5% for four cases), the greater the reduction in the Yale-Brown Obsessive Compulsive Scale (30.6%, 38.9%, 58.8%, and 7.7% respectively at 15-month DBS). Conclusion: This study showed that acute DBS of the VC/VS might cause mood change, cardiovascular, sensory, or motor effects. These effects were transient or habituated over six months. We suggest stimulation-induced smile/laughter may be a possible predictor for long-term DBS outcome. Larger studies, genetic studies, and imaging studies are needed to evaluate the effects of different parameters and possible predictors in the treatment of OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Tsai, Hsin-Chi; Chang, Chun-Hung; Pan, Jiann-I; Hsieh, Hung-Jen; Tsai, Sheng-Tzung; Hung, Hsiang-Yi; Chen, Shin-Yuan; Abelson, Anderson, Aouizerate, Aouizerate, Baldo, Benabid, Franzini, Gabriels, Goodman, Greenberg, Greenberg, Haq, Huff, Kawakami, Kessler, Kopell, Krack, Kuhn, Mallet, Nuttin, Okun, Pallanti, Pallanti, Schober, Schoenen, Shapira, Springer, Stein, Sturm, Tsai, Vigneri",2014.0,,0,0,
3463,Pilot study of deep brain stimulation in refractory obsessive-compulsive disorder ethnic Chinese patients.,"Aims: Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) is a promising alternative to ablative surgery in treatment of refractory obsessive-compulsive disorder (OCD). A pilot study was conducted to assess 15-month outcomes of DBS in patients with refractory OCD in Taiwan. Methods: Four adult patients with a 3-year or more history of refractory OCD (Yale-Brown Obsessive-Compulsive Scale [Y-BOCS] score of at least 28) met the criteria for DBS surgery. DBS electrodes were implanted bilaterally in the VC/VS. Stimulation was adjusted for therapeutic benefit and absence of adverse effects. Psychiatric evaluation was conducted preoperatively, postoperatively, and at follow up at every 3 months for 15 months. Primary outcome measure was Y-BOCS. Secondary outcomes included the Hamilton Depression Rating Scale (HAM-D), and the Global Assessment of Function Scale. Results: Mean severity of OCD was a Y-BOCS score of 36.3 +/- 2.1. At the end of 15 months' follow up, there was a 33.06% decrease in OCD severity (P = 0.001). Similar findings were seen for HAM-D (32.51% reduction, P = 0.005), and Global Assessment of Function Scale (31.03% increase, P = 0.026). In terms of adverse effects, two patients suffered from hypomania episodes after several weeks of DBS stimulation, and one had transient hypomania-like syndrome during DBS initial programming. One patient (Case 1) had an allergic reaction to implantation of the pulse generator in the chest, and another patient (Case 3) exhibited vertigo. Conclusions: We confirm that DBS of the VC/VS appears to be beneficial for improvements in function and mood among patients with treatment-resistant OCD. Compared to previous studies examining the therapeutic effects of DBS, no serious adverse effects were observed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Tsai, Hsin-Chi; Chang, Chun-Hung; Pan, Jiann-I; Hsieh, Hung-Jen; Tsai, Sheng-Tzung; Hung, Hsiang-Yi; Chen, Shin-Yuan; Abelson, Anderson, Aouizerate, Benabid, Blond, Brett, Calder, Dougherty, Goodman, Greenberg, Greenberg, Hamilton, Krack, Lipsman, Mallet, Malone, Meyerson, Murray, Nuttin, Nuttin, Shapira, Tai, Tang, Tye",2012.0,,0,0,
3464,The effects of stress management on the quality of life of patients following acute myocardial infarction or coronary bypass surgery,"ER The objective of this study was to assess the impact of group-based stress management training on emotional well-being, functional status, social activity and chest pain in cardiac patients, within a randomized controlled trial. Fifty acute myocardial infarction and 50 coronary artery bypass patients were randomized to experimental (27 myocardial infarction and 23 coronary artery bypass) and control (23 myocardial infarction and 27 coronary artery bypass) groups 3 months after infarction or surgery. Experimental patients underwent a 10-week relaxation-based stress management programme, while the controls received normal care. Following assessment at the end of the treatment period, controls were offered the stress management programme. Follow-up data were collected 6 months post-treatment from both groups. Significantly greater improvements in emotional well-being as assessed on the Hospital Anxiety and Depression scale (P < 0.005) and the Psychological General Well-being Index (P < 0.001) were found in the experimental than control groups, and improvements were maintained at 6 month follow-up. Greater improvements were also recorded in experimental than control groups in activities of daily living (P < 0.005), satisfaction with health (P < 0.025), reports from spouses or relatives of patients' emotional state (P < 0.001), and in disruption due to chest pain (P < 0.001). Similar responses to stress management were observed in myocardial infarction and coronary artery bypass patients. When controls underwent treatment, they too showed significant reductions in anxiety and depression, but no changes in social or functional status. We conclude that stress management training may lead to improvements in the quality of life of myocardial infarction and coronary artery bypass patients. Such programmes might usefully be made available even to patients who have participated in formal rehabilitation.","Trzcieniecka-Green, A; Steptoe, A",1996.0,,0,0,
3465,Early intubation in severely injured patients.,"In a prospectively studied trauma population from 1986 to 1991 the influence of early intubation (EI) within 2 h after the accident on post-traumatic (multiple) organ failure (M)OF was compared with delayed intubation (DI) in 131 patients with multiple injuries (Injury severity score (ISS) 37). Indications for intubation were unconsciousness following severe head injury in 45 cases (45 EI, 0 DI), major chest trauma (AIS > or = 3) in 40 (31 EI, 9 DI) and the severity of injuries (no head or chest trauma, but ISS > 24) in 40 patients (30 EI, 10 DI). One hundred and six trauma victims (81%) have been intubated early and 19 patients (14.5%) required intubation and artificial ventilation later in the course, whereas 6 subjects (4.5%) could manage spontaneous breathing. The pattern of injured body regions and respiratory parameters on admission showed no remarkable difference in the two groups, but the severity of injury was significantly higher (p < 0.001) in the EI group (ISS 39) compared with the DI patients (ISS 29). Due to a significantly worse haemodynamic condition of the EI patients on admission, they showed significantly higher volume requirements throughout the resuscitation period. All patients were treated to a standard resuscitation protocol. Sixty-seven per cent of the EI patients developed at least one OF, 45% respiratory failure (RF), 28% multiple organ failure (MOF) and 15% died. The DI group showed almost the same incidence of RF (42%) and other OF (63%) and an even higher (n.s.) incidence of MOF (37%) and mortality rate (26%). Corresponding to the significantly lower injury severity of the DI group, the observed OF and mortality rates are inappropriately high in comparison with the incidence of OF and death in the EI group. We conclude that EI of multiple injured patients within 2 h after trauma along with ventilatory support--even in alert patients without major chest trauma or signs of cardiocirculatory or respiratory insufficiency, but a known or suspected ISS > 24--may help to reduce post-traumatic organ failure and improve outcome.",Trupka A.; Waydhas C.; Nast-Kolb D.; Schweiberer L.,1994.0,,0,0,
3466,Psychotherapy for sexually abused girls: psychopathological outcome findings and patterns of change,"ER AIMSTo compare the relative efficacy of focused individual or group therapy in symptomatic sexually abused girls, and to monitor psychiatric symptoms for persistence or change.METHODA multi-centre psychotherapy outcome study recruited 71 sexually abused girls aged 6-14 years who were randomly assigned to focused individual psychotherapy (up to 30 sessions) or psychoeducational group therapy (up to 18 sessions). Changes over the course of the study were monitored.RESULTSBoth treatment groups showed a substantial reduction in psychopathological symptoms and an improvement in functioning, but with no evident difference between individual and group therapy. However, individual therapy led to a greater improvement in manifestations of post-traumatic stress disorder (PTSD).CONCLUSIONSThe beneficial effects on PTSD support the use of individual therapy. However, the small sample size and lack of a control group limit conclusions about changes attributable to treatment.BACKGROUNDControversy exists about the efficacy of psychotherapy for the mental health problems of sexually abused children.","Trowell, J; Kolvin, I; Weeramanthri, T; Sadowski, H; Berelowitz, M; Glaser, D; Leitch, I; Glasser, D",2002.0,,0,0,
3467,"Sleeping under the Ocean: despite Total Isolation, Nuclear Submariners Maintain Their Sleep and Wake Patterns throughout Their Under Sea Mission","ER PURPOSE: A strictly controlled randomized crossover study with the polysomnography recorded twice during the mission.METHODS: Setting: Shift and night work with prolonged (70 days) social isolation from the real world (with no phone or Internet contact with families or friends during a routine mission aboard the ""Téméraire"" French Strategic Submarine with Ballistic Nuclear missiles (SSBN). Participants: 19 submariners working on a 24-hour shift for three days in a row schedule. Interventions: The participants attended two polysomnographic (PSG) recordings of night sleep on Day 21 (D21) and Day 51 (D51) of the 70-day patrol; urine cortisol levels were also taken after sleep, and subjective assessments of sleep, sleepiness, mood and anxiety on D21 and D51. The light and temperature on board were also recorded.RESULTS: PSG analyses showed that sleep did not significantly vary in length (total sleep time) or in quality between D21 and D51. The mariners reported the same subjective sleep, sleepiness, anxiety or mood (except for a slightly worse score for confusion on D51). Blood cortisol levels did not vary significantly.CONCLUSIONS: These results show that humans living in an isolated environment for more than two months with this specific shift schedule do not suffer from any significant effects on sleep, sleepiness and confusion between D21 and D51, when they follow an organized regular shift pattern with controlled light and temperature.BACKGROUND: To assess the effects of isolation, inadequate exposure to light and specific shift work on the subjective and objective measurements of sleep and alertness of submariners.","Trousselard, M; Leger, D; Beers, P; Coste, O; Vicard, A; Pontis, J; Crosnier, S N; Chennaoui, M",2015.0,10.1371/journal.pone.0126721,0,0,
3468,"A rapid, stability-indicating RP-HPLC method for the simultaneous determination of Formoterol fumarate, tiotropium bromide, and ciclesonide in a pulmonary drug product","A stability-indicating reversed-phase high performance liquid chromatography (RP-HPLC) method was developed for the simultaneous determination of Formoterol fumarate (FOR), Tiotropium bromide (TRI), and Ciclesonide (CLS) in a pulmonary drug product. The desired chromatographic separation was achieved on the Zorbax SB C8, 5 μm (150 x 4.6 mm) column, using gradient elution at 230 nm detector wavelength. The optimized mobile phase consisted of a 0.2% v/v perchloric acid as solvent-A and acetonitrile as solvent-B. The developed method separated FOR, TRI, and CLS in the presence of its five unknown degradation products within 10 minutes. The stability-indicating capability was established by forced degradation experiments and the separation of unknown degradation products. The developed RP-HPLC method was validated according to the International Conference on Harmonization (ICH) guidelines. This validated method was applied for the simultaneous estimation of FOR, TRI, and CLS in commercially available Triohale® pMDI (Pressurized Metered-Dose Inhaler) samples. Furthermore, this method can be extended for individual estimation of FOR, TRI, and CLS in various commercially available pulmonary dosage forms. © Trivedi et al.; licensee Österreichische Apotheker-Verlagsgesellschaft m. b. H., Vienna, Austria.",Trivedi R.K.; Chendake D.S.; Patel M.C.,2012.0,10.3797/scipharm.1204-06,0,0,
3469,Prehospital identification of trauma patients with early acute coagulopathy and massive bleeding: results of a prospective non-interventional clinical trial evaluating the Trauma Induced Coagulopathy Clinical Score (TICCS).,"Identifying patients who need damage control resuscitation (DCR) early after trauma is pivotal for adequate management of their critical condition. Several trauma-scoring systems have been developed to identify such patients, but most of them are not simple enough to be used in prehospital settings in the early post-traumatic phase. The Trauma Induced Coagulopathy Clinical Score (TICCS) is an easy-to-measure and strictly clinical trauma score developed to meet this medical need. TICCS is a 3-item clinical score (range: 0 to 18) based on the assessment of general severity, blood pressure and extent of body injury and calculated by paramedics on-site for patients with severe trauma. This non-interventional prospective study was designed to assess the ability of TICCS to discern patients who need DCR. These patients were patients with early acute coagulopathy of trauma (EACT), haemorrhagic shock, massive transfusion and surgical or endovascular haemostasis during hospitalization. Diagnosis of EACT was assessed by both thromboelastometry and conventional coagulation tests. During an 18-month period, 89 severe trauma patients admitted to the general emergency unit at our hospital were enrolled in the study, but 7 were excluded for protocol violations. Of the 82 remaining patients, 8 needed DCR and 74 did not. With receiver operating characteristic curve analysis, TICCS proved to be a powerful discriminant test (area under the curve = 0.98; 95% CI: 0.92 to 1.0). A cutoff of 10 on the TICCS scale provided the best balance between sensitivity (100%; 95% CI: 53.9 to 100) and specificity (95.9%; 95% CI: 88.2 to 99.2). The positive predictive value was 72.7%, and the negative predictive value was 100.0%. TICCS can be easily and rapidly measured by paramedics at the trauma site. In this study of blunt trauma patients, TICCS was able to discriminate between patients with and without need for DCR. TICCS on-site evaluation should allow initiation of optimal care immediately upon hospital admission of patients with severe trauma in need of DCR. However, a larger multicentre prospective study is needed for in-depth validation of TICCS. Clinicaltrials.gov ID: NCT02132208 (registered 6 May 2014).",Tonglet ML.; Minon JM.; Seidel L.; Poplavsky JL.; Vergnion M.,2014.0,10.1186/s13054-014-0648-0,0,0,
3470,Usability Comparisons of Head-Mounted vs. Stereoscopic Desktop Displays in a Virtual Reality Environment with Pain Patients.,"Researchers have shown that immersive Virtual Reality (VR) can serve as an unusually powerful pain control technique. However, research assessing the reported symptoms and negative effects of VR systems indicate that it is important to ascertain if these symptoms arise from the use of particular VR display devices, particularly for users who are deemed ""at risk,"" such as chronic pain patients Moreover, these patients have specific and often complex needs and requirements, and because basic issues such as 'comfort' may trigger anxiety or panic attacks, it is important to examine basic questions of the feasibility of using VR displays. Therefore, this repeated-measured experiment was conducted with two VR displays: the Oculus Rift's head-mounted display (HMD) and Firsthand Technologies' immersive desktop display, DeepStream3D. The characteristics of these immersive desktop displays differ: one is worn, enabling patients to move their heads, while the other is peered into, allowing less head movement. To assess the severity of physical discomforts, 20 chronic pain patients tried both displays while watching a VR pain management demo in clinical settings. Results indicated that participants experienced higher levels of Simulator Sickness using the Oculus Rift HMD. However, results also indicated other preferences of the two VR displays among patients, including physical comfort levels and a sense of immersion. Few studies have been conducted that compare usability of specific VR devices specifically with chronic pain patients using a therapeutic virtual environment in pain clinics. Thus, the results may help clinicians and researchers to choose the most appropriate VR displays for chronic pain patients and guide VR designers to enhance the usability of VR displays for long-term pain management interventions.",Tong X.; Gromala D.; Gupta D.; Squire P.,2016.0,,0,0,
3471,Cognitive-behavior therapy for concurrent anxiety and alcohol use disorder: A randomized control trial.,"Alcohol dependent individuals also diagnosed with an anxiety disorder were treated with one of two cognitive-behavioral treatments. Treatment ALC, consisting of 6 sessions of alcohol-specific treatment was compared to treatment ALCANX consisting of 6 sessions of alcohol-specific treatment followed by 4 anxiety-specific sessions. At the end-of-treatment no significant differences were found on measures of alcohol consumption or psychiatric (including anxiety) symptoms. Both groups improved to a significant degree. Implications for the cognitive-behavioral treatment of concurrent alcohol dependence and anxiety disorder are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Toneatto, Tony; Calderwood, Kim; Alegria, Baker, Beck, Beck, Boschloo, Bowen, Burns, Craske, Derogatis, Driessen, Fals-Stewart, Fydrich, Grant, Hall, Hesse, Hobbs, Kushner, Kushner, Marlatt, Pasche, Randall, Sanchez-Craig, Schade, Schuckit, Smith, Sobell, Sobell, Sobell, Toneatto, Toneatto, Wilbourne, Willinger",2015.0,,0,0,
3472,'Affinity' of isoproterenol to cardiac chronotropic β-receptor in the patients with neurocirculatory asthenia. A comparison with 'normal' subjects,,Tonai N.; Ito H.; Ishimura K.,1985.0,,0,0,
3473,The spinal stenosis pedometer and nutrition lifestyle intervention (SSPANLI): development and pilot,"ER BACKGROUND CONTEXT: Owing to mobility limitations, people with lumbar spinal stenosis (LSS) are at risk for diseases of inactivity, including obesity. Therefore, weight management in LSS is critical. Body mass index is the strongest predictor of function in LSS, suggesting that weight loss may promote physical activity and provide a unique treatment option. We propose a lifestyle modification approach of physical activity and nutrition education, delivered through an e-health platform.PURPOSE: The purpose of this study was to develop and pilot an e-health intervention aimed at increasing physical activity and decreasing fat mass in people with LSS.STUDY DESIGN: The study design was based on intervention development and pilot.PATIENT SAMPLE: Ten overweight or obese individuals with LSS were confirmed clinically and on imaging.OUTCOME MEASURES: Self-reported measures were food record, Short-Form 36 (SF-36), pain scales, Swiss Spinal Stenosis Symptom and Physical Function Scales, Oswestry Disability Index (ODI), Pain Catastrophizing Questionnaire, Tampa Scale for Kinesiophobia, Center for Epidemiologic Studies(Depression) Scale, Behavioral Regular in Exercise Questionnaire, and Regulation for Eating Behavior Scale and physiologic measures were dual-energy X-ray absorptiometry (DXA), blood draw, 7-day accelerometry, self-paced walking test, and balance test.METHODS: The e-health platform was developed.INTERVENTION: during Week 1, participants received a pedometer and a personalized consultation with a dietitian and an exercise physiologist. For 12 weeks, participants logged on to the e-health Web site to access personal step goals, nutrition education videos, and a discussion board. Follow-up occurred at Week 13.RESULTS: Nine participants had a mean age of 67.5±6.7 years (60% women). Significant improvements were observed for fat mass (DXA), trunk fat mass, symptom severity (Swiss Symptom Scale), energy intake, maximum continuous activity (accelerometry), and mental health (SF-36) (p<.05). Nonsignificant improvements were observed for waist circumference, pain, ODI, and obesity biomarkers. Seventy percent lost weight, 50% increased walking capacity, and 60% increased quality of life. The mean increase in steps was 15%.CONCLUSIONS: The spinal stenosis pedometer and nutrition lifestyle intervention was shown to be feasible, attractive to participants, and effective in this small sample. This intervention provides people with LSS the opportunity to participate in their own health management, potentially improving access to care. Efficacy is currently being assessed in a randomized trial.","Tomkins-Lane, C C; Lafave, L M; Parnell, J A; Rempel, J; Moriartey, S; Andreas, Y; Wilson, P M; Hepler, C; Ray, H A; Hu, R",2015.0,10.1016/j.spinee.2014.10.015,0,0,
3474,Differences of influencing factors of PPI and placebo responder in functional dyspepsia: Clinical advantage of effect on suppression of acid with rabeprazole in functional dyspepsia (the CAESAR study),"Background & Aim We gave the first report in Japan on the efficacy of PPI, Rabeprazole (RPZ) in Functional Dyspepsia (FD) derived from double-blind randomized placebo-controlled study (the Caesar study) (DDWAGA2010). Since the placebo response is great for FD patients in general, we investigated the effective factors for RPZ- or placebo-response in this study. Methods On hundred fifteen subjects with FD, diagnosed by the Rome III criteria, were randomly assigned to 4 weeks of either RPZ 10mg/day (Age 50.7±17.3, male/ female:13/ 36) or placebo (Age 49.6±16.7, male/ female:18/31). Severity of gastrointestinal symptoms was assessed using the Gastrointestinal Symptoms Rating Scale (GSRS). With GSRS, FD scores were calculated by summing scores of two symptoms (epigastric pain and hunger pain) of epigastric pain syndrome (EPS) and scores of two symptoms (nausea and satiety) of postprandial distress syndrome (PDS). Definition for responders is improvement rate 50% of FD, EPS, and PDS scores after 4-week administration. Background factors (age, sex, BMI, H. pylori infection, each GSRS score) for responders were analyzed by univariate analysis and the odds ratio was calculated. Results There were no significant factors having the effect of PPI and placebo on symptom improvement in age, sex, BMI, and H pylori infection. Factors influencing FD and EPS score responder are the following. In FD score responder, the strength of symptoms associated with pain, FD and EPS score in PPI had significant influence on increase response while the strength of symptoms associated with AGA Abstracts S-884 reflux in placebo had significant influence on decrease response. In EPS score responder, the same factors in PPI had significant impact on increase response and in placebo on decrease response. However, the strength of hunger pain and EPS score in both PPI and placebo had significant impacts on increase response. There were no symptom factors influencing PDS score responder (PPI:36.7%:18/49 , placebo:32.7%:16/49). Conclusions There might be differences of influencing factors of PPI and placebo responder in functional dyspepsia such as symptoms associated with pain and reflux. However, it may be difficult to predict placebo response, since the strength of hunger pain and EPS score in both PPI and placebo had impacts on increase response in EPS score responder.(Table presented).",Tominaga K.; Suzuki H.; Umegaki E.; Kusunoki H.; Tomotsugu N.; Higuchi K.; Haruma K.; Hibi T.; Arakawa T.,2011.0,10.1016/S0016-5085(11)63679-2,0,0,
3475,The 2-year course following detoxification treatment of substance abuse: the possible influence of psychiatric comorbidity.,"The influence of psychiatric comorbidity on the course and outcome in a nationwide representative sample (n = 351) of treatment-seeking substance users over a 28-month period was studied prospectively. The patients were administered the Diagnostic Interview Schedule and a questionnaire on drinking history. At 16 and 28 months after admission the patients returned a questionnaire on drinking history and mental health. In cases of those lacking information on either follow-up (45%), details on drinking status was obtained from informants. Completely abstinent were 16%. Generalized anxiety disorder and/or social phobia at the index admission predicted abstinence during the follow-up [odds ratio (OR) = 0.25], whereas onset of alcoholism among these patients after age 25 years predicted a worse prognosis (OR = 13.5). Also increasing number of social consequences related to abuse (OR = 1.3) and drinking more than the median (OR = 2.1) predicted a poor outcome. The abstinent group had significantly better mental health at follow-up. The patients with comorbid psychiatric disorders at admission were worse at follow-up. Although substance use disorders and comorbid psychiatric disorders have to a certain degree separate courses, there is nevertheless significant interaction between them. Early treatment and recognition of comorbid psychiatric disorders among substance abusers is necessary.",Tómasson K.; Vaglum P.,1997.0,,0,0,
3476,[Rational Rehabilitation in the treatment of post-traumatic stress disorder (PTSD). A pilot study].,"In a randomised controlled study, a type of cognitive behavior therapy known as Rational Rehabilitation proved effective in the treatment of patients with chronic mental symptoms. Post-traumatic stress disorder is a serious illness that occurs frequently and can last for many years. Rational Rehabilitation may also be an effective treatment for post-traumatic stress disorder. To investigate, via a pilot study, on the effect of Rational Rehabilitation in patients with post-traumatic stress disorder, whether a randomised controlled study is called for. Nineteen patients with post-traumatic stress disorder, who were awaiting regular treatment, opted to join the study. The effect of Rational Rehabilitation was studied in relation to: symptoms of post-traumatic stress disorder, degree of happiness experienced, autonomy, social support and need for further treatment. results Rational Rehabilitation seems to have a positive effect on all outcome measures, except flashbacks. A controlled study of the effect of Rational Rehabilitation in patients with post-traumatic stress disorder seems justified.",Tomasoa AT.; Appelo MT.,2007.0,,0,0,
3477,Rational Rehabilitation in the treatment of post-traumatic stress disorder (PTSD). A pilot study,"ER AIMTo investigate, via a pilot study, on the effect of Rational Rehabilitation in patients with post-traumatic stress disorder, whether a randomised controlled study is called for.METHODNineteen patients with post-traumatic stress disorder, who were awaiting regular treatment, opted to join the study. The effect of Rational Rehabilitation was studied in relation to: symptoms of post-traumatic stress disorder, degree of happiness experienced, autonomy, social support and need for further treatment. results Rational Rehabilitation seems to have a positive effect on all outcome measures, except flashbacks.CONCLUSIONA controlled study of the effect of Rational Rehabilitation in patients with post-traumatic stress disorder seems justified.BACKGROUNDIn a randomised controlled study, a type of cognitive behavior therapy known as Rational Rehabilitation proved effective in the treatment of patients with chronic mental symptoms. Post-traumatic stress disorder is a serious illness that occurs frequently and can last for many years. Rational Rehabilitation may also be an effective treatment for post-traumatic stress disorder.","Tomasoa, A T; Appelo, M T",2007.0,,0,0,3476
3478,"Predictors of study retention in a double-blind, placebo-controlled clinical trial of acamprosate in alcohol-dependent persons with co-morbid bipolar disorder","Alcohol dependence and other substance use disorders are strikingly high in individuals with bipolar disorder. Little treatment research has been conducted in this important clinical population. The present study evaluated baseline clinical and demographic characteristics as potential predictors of study retention in the first 18 subjects enrolled in an ongoing 14 week double-blind, placebo-controlled trial of acamprosate in alcohol-dependent bipolar subjects. Diagnostic substance use and psychiatric data were assessed using the Structured Clinical Interview for DSM-IV and the Mini International Neuropsychiatric Interview. Quantitative substance use data were assessed using the Timeline Follow-Back. In this preliminary sample, 78% of enrolled subjects completed all study visits. No differences were found between study completers and non-completers with regard to age, gender, race, education, or marital status. Bipolar subtype, number of previous hospitalizations, history of suicide attempts, and suicide risk score at baseline were not predictive of study retention. Baseline scores on the Young Mania Rating Scale and baseline alcohol use were significantly higher in study non-completers than in completers. In addition to alcohol dependence, study non-completers were somewhat more likely to meet criteria for lifetime cannabis dependence, opioid dependence and polysubstance dependence than study completers. Study non-completers reported higher lifetime rates of OCD, though not GAD, panic disorder, social phobia, or PTSD than study completers. The present study demonstrates that high retention rates are feasible in treatment studies of alcohol-dependent persons with comorbid bipolar disorder. Subjects with more severe psychiatric and substance use illness at study entry may be more difficult to retain independent of treatment assignment. Further treatment studies with larger sample sizes and improved study retention are urgently needed in this important clinical population.",Tolliver B.; Brown D.G.; Brady K.T.,2009.0,10.1080/10550490902928197,0,0,
3479,Psychophysiological responding to emotional memories in healthy young men after cortisol and propranolol administration,"Rationale: Propranolol is found to reduce physiological hyper-responsiveness in post traumatic stress disorder (PTSD), possibly by affecting reconsolidation after the reactivation of traumatic memories. Cortisol is found to attenuate declarative memory retrieval, but it is unknown whether it also reduces physiological responses to emotional memories. Objectives: To examine whether the effects of propranolol on physiological responding to emotional memories can also be found in healthy controls and to investigate the immediate and prolonged effects of cortisol on physiological responding to emotional memories, we tested these effects in 79 healthy young men. Materials and methods: After preparing a script of a negative disturbing memory, participants were instructed to imagine this event 1 week later after ingestion of either 35 mg cortisol, 80 mg propranolol, or a placebo. Physiological responding to the script-driven imagery was recorded. Another week later, after washout, the imagery was repeated again. During all three sessions as well as 8 months later, subjective emotional reactions to the memories were assessed. Results: The emotionality of the memories was reduced over time, which was not affected by the treatments, however. The personal emotional script did evoke higher skin conductance responses than a neutral story, which decreased 1 week later, but no effects were found of either propranolol or cortisol on this responsiveness. Conclusions: Whereas healthy males do show psychophysiological responding to personal emotional scripts, the effects of cortisol and propranolol on physiological responses to emotional memories might be specific to clinical groups characterized by hyper-responsiveness, like PTSD. Future studies using longer-acting doses and more elaborate reactivation procedures in both healthy men and women could shed more light on the effects of cortisol and propranolol on psychophysiological responding to emotional memories.",Tollenaar M.S.; Elzinga B.M.; Spinhoven P.; Everaerd W.,2009.0,10.1007/s00213-008-1427-x,0,0,
3480,Cognitive-behavioral therapy for medication nonresponders with obsessive-compulsive disorder: a wait-list-controlled open trial.,"Cognitive-behavioral therapy (CBT) is generally recommended for obsessive-compulsive disorder (OCD) patients who have failed to respond to approved medications. However, few studies of the efficacy of CBT have selected patients who did not respond to medications. We selected 20 adult OCD (DSM-IV criteria) patients with a history of inadequate response to adequate doses of multiple medications, as well as a high rate of comorbid disorders. After a 1-month wait-list period, patients received 15 sessions of outpatient CBT incorporating exposure and ritual prevention. OCD severity (as measured with the Yale-Brown Obsessive Compulsive Scale) decreased significantly (p <.05) after treatment, and gains appeared to have been maintained over a 6-month follow-up period. Analysis of clinical significance indicated that 53% (8/15) of treatment completers met this criterion at posttreatment and 40% (6/15) met the criterion at 6-month follow-up. The sample was characterized as having generally poor insight and putting low effort into CBT; these factors significantly (p <.05) predicted degree of improvement. CBT is a useful treatment for OCD patients who have failed to respond adequately to multiple serotonin reuptake inhibitor medications. However, these results were attenuated compared with previous trials. Patients with a long history of poor response to medication may have poor insight and/or not put sufficient effort into treatment; these factors are likely to diminish treatment outcome.",Tolin DF.; Maltby N.; Diefenbach GJ.; Hannan SE.; Worhunsky P.,2004.0,,0,0,
3481,Visual avoidance in specific phobia.,"Cognitive models of anxiety postulate that fear and anxiety serve as programs for avoidance of threat-relevant stimuli. We hypothesized that exposure to phobia-relevant stimuli would lead to visual avoidance in specific phobics. Spider phobic, blood-injection-injury phobic, and nonphobic participants were asked to view spider, injection, and neutral photographs through a three-channel tachistoscope that measured viewing time for each picture. Despite experimenter instructions to study the pictures carefully for a subsequent recognition test, phobic subjects showed decreased viewing times for threat-relevant pictures as compared to neutral pictures. Results are discussed in terms of cognitive models of anxiety disorders and implications for exposure-based therapies.",Tolin DF.; Lohr JM.; Lee TC.; Sawchuk CN.,1999.0,,0,0,
3482,A randomized controlled trial of self-directed versus therapist-directed cognitive-behavioral therapy for obsessive-compulsive disorder patients with prior medication trials.,"Cognitive-behavioral therapy incorporating exposure and response prevention (ERP) is widely considered a first-line psychosocial treatment for patients with obsessive-compulsive disorder (OCD). However, a number of obstacles prevent many patients from receiving this treatment, and self-administered ERP may be a useful alternative or adjunct. Forty-one adult outpatients with a primary diagnosis of OCD, who reported at least 1 current or previous adequate medication trial, were randomly assigned to self-administered or therapist-administered ERP. Patients in both treatment conditions showed statistically and clinically significant symptom reduction. However, patients receiving therapist-administered ERP showed a superior response in terms of OCD symptoms and self-reported functional impairment. We discuss several potential reasons for the superiority of therapist-administered treatment, and propose a stepped-care integration of self-administered and therapist-administered interventions for OCD.",Tolin DF.; Hannan S.; Maltby N.; Diefenbach GJ.; Worhunsky P.; Brady RE.,2007.0,10.1016/j.beth.2006.07.001,0,0,
3483,Directed forgetting in obsessive-compulsive disorder: replication and extension.,"Previous research indicates that patients with obsessive-compulsive disorder (OCD) show impaired ability to forget negative material (Behav Res Ther 34 (1996) 633). The present study was intended to replicate and extend these findings by separating emotional valence from personal relevance, using idiographic stimulus selection to control for heterogeneity of OCD concerns, and the addition of an anxious control group. We used a directed forgetting paradigm, in which participants were instructed to either remember or forget a series of words. No differences in impairment were found among the groups during a free recall test, in which they were asked to recall both ""remember"" and ""forget"" words. However, during a recognition test, OCD patients showed greater impaired forgetting for OCD-relevant words than did nonanxious and anxious controls. Valence of words did not emerge as a contributing factor to impaired forgetting.",Tolin DF.; Hamlin C.; Foa EB.,2002.0,,0,0,
3484,Stepped care versus standard cognitive-behavioral therapy for obsessive-compulsive disorder: a preliminary study of efficacy and costs.,"Exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD) is underutilized, in part because of costs and time requirements. This study extends pilot work investigating the use of a stepped care ERP administration, in which patients are first given a low-intensity, low-cost treatment and the more costly intervention is reserved for those who do not respond to the first intervention. Thirty adults with OCD were randomized to receive stepped care ERP or standard ERP. Those receiving stepped care started with three sessions over 6 weeks of low-intensity counseling with ERP bibliotherapy; patients failing to meet strict responder criteria after 6 weeks were given the more traditional treatment of therapist-administered ERP (17 sessions twice weekly). Those receiving standard ERP received the therapist-administered ERP with no lower-intensity lead-in. The two treatments were equally efficacious, with 67% of stepped care completers and 50% of standard treatment completers meeting criteria for clinically significant change at posttreatment. Similarly, no differences in client satisfaction ratings were obtained between the two groups. Examination of treatment costs, however, revealed that stepped care resulted in significantly lower costs to patients and third-party payers than did standard ERP, with large effect sizes. These results suggest that stepped care ERP can significantly reduce treatment costs, without evidence of diminished treatment efficacy or patient satisfaction. Additional research is needed to determine the long-term efficacy and costs of stepped care for OCD, and to examine the financial and therapeutic impact of implementing stepped care in community settings.",Tolin DF.; Diefenbach GJ.; Gilliam CM.,2011.0,10.1002/da.20804,0,0,
3485,A multisite benchmarking trial of capnometry guided respiratory intervention for panic disorder in naturalistic treatment settings.,"Panic disorder (PD) is associated with hyperventilation. The efficacy of a brief respiratory feedback program for PD has been established. The aim of the present study was to expand these results by testing a similar program with more clinically representative patients and settings. Sixty-nine adults with PD received 4 weeks of Capnometry Guided Respiratory Intervention (CGRI) using Freespira, which provides feedback of end-tidal CO2 (PETCO2) and respiration rate (RR), in four non-academic clinical settings. This intervention is delivered via home use following initial training by a clinician and provides remote monitoring of client adherence and progress by the clinician. Outcomes were assessed post-treatment and at 2- and 12-month follow-up. CGRI was associated with an intent-to-treat response rate of 83% and a remission rate of 54%, and large decreases in panic severity. Similar decreases were found in functional impairment and in global illness severity. Gains were largely sustained at follow-up. PETCO2 moved from the slightly hypocapnic range to the normocapnic range. Benchmarking analyses against a previously-published controlled trial showed very similar outcomes, despite substantial differences in sample composition and treatment settings. The present study confirms prior clinical results and lends further support to the viability of CGRI in the treatment of PD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Tolin, David F; McGrath, Patrick B; Hale, Lisa R; Weiner, Daniel N; Gueorguieva, Ralitza; Beck, Chambless, Furukawa, Guy, Klein, Leon, Ley, Meuret, Meuret, Meuret, Pollack, Reiss, Shear, Sheehan, Wilhelm",2017.0,,0,0,
3486,Defining Response in Clinical Trials for Obsessive-Compulsive Disorder: A Signal Detection Analysis of the Yale-Brown Obsessive Compulsive Scale.,"Objective: Many studies of the treatment of obsessive-compulsive disorder (OCD) have used percent reduction cutoffs on the Yale-Brown Obsessive Compulsive Scale (YBOCS) to classify patients as treatment responders. However, reduction criteria have varied from 20% to 50%, with studies of cognitive-behavioral therapy (CBT) using a more stringent criterion than studies of pharmacotherapy. The aim of this retrospective investigation was to determine optimal YBOCS reduction criteria for classifying patients as responders. Method: Data from 87 adult clinic and research outpatients meeting DSM-IV-TR criteria for OCD according to structured interview were examined, comparing the percent YBOCS reduction from pretreatment to posttreatment with 2 ""gold standard"" criteria from the Clinical Global Impressions (CGI) scale: much or very much improved and mild illness or better. Signal detection analyses were used to determine the sensitivity, specificity, predictive value of a positive test, predictive value of a negative test, and efficiency of various YBOCS reduction cutoffs. Results: A YBOCS reduction cutoff of 30% was optimal for predicting improvement on the CGI. The 20% cutoff used by many pharmacologic studies resulted in a high number of false positives, whereas the 50% cutoff used by most CBT studies resulted in a high number of false negatives. For predicting mild illness or better at posttreatment. a YBOCS reduction cutoff of 40% to 50% was optimal. Conclusions: A YBOCS reduction criterion of 30% appears to be optimal for determining clinical improvement, whereas a 40% to 50% reduction criterion is appropriate for predicting mild illness at posttreatment. Future studies should employ a standard definition of treatment response in order to facilitate cross-study comparisons. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Tolin, David F; Abramowitz, Jonathan S; Diefenbach, Gretchen J; Arrindell, Beck, Brown, Cottraux, Cottraux, DeVeaugh-Geiss, DeVeaugh-Geiss, Eisen, Fals-Stewart, Foa, Foa, Goodman, Goodman, Guy, Hollander, Jacobson, Jacobson, Kampman, Kazdin, Kozak, Kozak, Kraemer, Leon, Lindsay, Maltby, March, McDougle, McLean, Montgomery, Montgomery, O'Connor, Ogles, Pato, Pigott, Sheehan, Simpson, Spielberger, Steer, Steer, Steketee, Storch, Swets, Tollefson, van Balkom, van Balkom, Warren, Weiss",2005.0,,0,0,
3487,Pediatric trichotillomania: descriptive psychopathology and an open trial of cognitive behavioral therapy,"ER In study 1, 46 children and adolescents with trichotillomania who sought treatment at 2 specialty outpatient clinics were assessed. Most children reported pulling hair from multiple sites on the body, presented with readily visible alopecia, reported spending 30-60 minutes per day pulling or thinking about pulling, and reported experiencing significant distress about their symptoms. Most were described by their parents as having significant problems in school functioning. Few children met criteria for obsessive-compulsive disorder or tic disorder. Child and family rates of other forms of psychopathology were high. In study 2, 22 of these children were enrolled in an open trial of individual cognitive behavioral therapy with particular attention to relapse prevention. Trichotillomania severity decreased significantly and 77% of children were classified as treatment responders at post-treatment and 64% at 6-month follow-up.","Tolin, D F; Franklin, M E; Diefenbach, G J; Anderson, E; Meunier, S A",2007.0,10.1080/16506070701223230,0,0,
3488,School-based mental health intervention for children affected by political violence in Indonesia: a cluster randomized trial,"ER OBJECTIVETo assess the efficacy of a school-based intervention designed for conflict-exposed children, implemented in a low-income setting.DESIGN, SETTING, AND PARTICIPANTSA cluster randomized trial involving 495 children (81.4% inclusion rate) who were a mean (SD) age of 9.9 (1.3) years, were attending randomly selected schools in political violence-affected communities in Poso, Indonesia, and were screened for exposure (> or = 1 events), posttraumatic stress disorder, and anxiety symptoms compared with a wait-listed control group. Nonblinded assessment took place before, 1 week after, and 6 months after treatment between March and December 2006.INTERVENTIONFifteen sessions, over 5 weeks, of a manualized, school-based group intervention, including trauma-processing activities, cooperative play, and creative-expressive elements, implemented by locally trained paraprofessionals.MAIN OUTCOME MEASURESWe assessed psychiatric symptoms using the Child Posttraumatic Stress Scale, Depression Self-Rating Scale, the Self-Report for Anxiety Related Disorders 5-item version, and the Children's Hope Scale, and assessed function impairment as treatment outcomes using standardized symptom checklists and locally developed rating scales.RESULTSCorrecting for clustering of participants within schools, we found significantly more improvement in posttraumatic stress disorder symptoms (mean change difference, 2.78; 95% confidence interval [CI], 1.02 to 4.53) and maintained hope (mean change difference, -2.21; 95% CI, -3.52 to -0.91) in the treatment group than in the wait-listed group. Changes in traumatic idioms (stress-related physical symptoms) (mean change difference, 0.50; 95% CI, -0.12 to 1.11), depressive symptoms (mean change difference, 0.70; 95% CI, -0.08 to 1.49), anxiety (mean change difference, 0.12; 95% CI, -0.31 to 0.56), and functioning (mean change difference, 0.52; 95% CI, -0.43 to 1.46) were not different between the treatment and wait-listed groups.CONCLUSIONSIn this study of children in violence-affected communities, a school-based intervention reduced posttraumatic stress symptoms and helped maintain hope, but did not reduce traumatic-stress related symptoms, depressive symptoms, anxiety symptoms, or functional impairment.TRIAL REGISTRATIONisrctn.org Identifier: ISRCTN25172408.CONTEXTLittle is known about the efficacy of mental health interventions for children exposed to armed conflicts in low- and middle-income settings. Childhood mental health problems are difficult to address in situations of ongoing poverty and political instability.","Tol, W A; Komproe, I H; Susanty, D; Jordans, M J; Macy, R D; Jong, J T",2008.0,10.1001/jama.300.6.655,0,0,
3489,School-based mental health intervention for children in war-affected Burundi: a cluster randomized trial,"ER METHODS: We conducted a cluster randomized trial with 329 children in war-affected Burundi (aged 8 to 17 (mean 12.29 years, standard deviation 1.61); 48% girls). One group of children (n = 153) participated in a 15-session school-based intervention implemented by para-professionals, and the remaining 176 children formed a waitlist control condition. Outcomes were measured before, one week after, and three months after the intervention.RESULTS: No main effects of the intervention were identified. However, longitudinal growth curve analyses showed six favorable and two unfavorable differences in trajectories between study conditions in interaction with several moderators. Children in the intervention condition living in larger households showed decreases on depressive symptoms and function impairment, and those living with both parents showed decreases on posttraumatic stress disorder and depressive symptoms. The groups of children in the waitlist condition showed increases in depressive symptoms. In addition, younger children and those with low levels of exposure to traumatic events in the intervention condition showed improvements on hope. Children in the waitlist condition who lived on their original or newly bought land showed improvements in hope and function impairment, whereas children in the intervention condition showed deterioration on these outcomes.CONCLUSIONS: Given inconsistent effects across studies, findings do not support this school-based intervention as a treatment for posttraumatic stress disorder and depressive symptoms in conflict-affected children. The intervention appears to have more consistent preventive benefits, but these effects are contingent upon individual (for example, age, gender) and contextual (for example, family functioning, state of conflict, displacement) variables. Results suggest the potential benefit of school-based preventive interventions particularly in post-conflict settings.TRIAL REGISTRATION: The study was registered as ISRCTN42284825.BACKGROUND: Armed conflicts are associated with a wide range of impacts on the mental health of children and adolescents. We evaluated the effectiveness of a school-based intervention aimed at reducing symptoms of posttraumatic stress disorder, depression, and anxiety (treatment aim); and improving a sense of hope and functioning (preventive aim).","Tol, W A; Komproe, I H; Jordans, M J; Ndayisaba, A; Ntamutumba, P; Sipsma, H; Smallegange, E S; Macy, R D; Jong, J T",2014.0,10.1186/1741-7015-12-56,0,0,
3490,Mediators and moderators of a psychosocial intervention for children affected by political violence,"ER METHOD: The authors examined data from a cluster randomized trial, involving children aged 8-13 in Central Sulawesi, Indonesia (treatment condition n = 182, waitlist control condition n = 221). Mediators (hope, coping, peer/emotional/play social support) and moderators (gender, age, family connectedness, household size, other forms of social support, exposure to political violence, and displacement) of treatment outcome on posttraumatic stress symptoms and function impairment were examined in parallel process latent growth curve models.RESULTS: Compared with the waitlist group, those receiving treatment showed maintained hope, increased positive coping, maintained peer social support, and increased play social support. Of these putative mediators, only play social support was found to mediate treatment effects, such that increases in play social support were associated with smaller reductions in posttraumatic stress disorder (PTSD) symptoms. Furthermore, the authors identified a number of moderators: Girls showed larger treatment benefits on PTSD symptoms; girls, children in smaller households, and children receiving social support from adults outside the household showed larger treatment benefits on function impairment.CONCLUSIONS: Findings provide limited evidence for an ecological resilience theoretical framework. On the basis of these findings, the authors recommend a stronger separation between universal prevention (e.g., resilience promotion through play) and selective/indicated prevention (e.g., interventions aimed at decreasing posttraumatic stress symptoms). Play-based interventions should be careful to exclude children with psychological distress. In addition, treatment effects may be augmented by selecting girls and socially vulnerable children.OBJECTIVE: The authors examined moderators and mediators of a school-based psychosocial intervention for children affected by political violence, according to an ecological resilience theoretical framework.","Tol, W A; Komproe, I H; Jordans, M J; Gross, A L; Susanty, D; Macy, R D; Jong, J T",2010.0,10.1037/a0021348,0,0,
3491,Impact of regular relaxation training on the cardiac autonomic nervous system of hospital cleaners and bank employees,"ER The work-related strain of 50 female hospital cleaners and 48 female bank employees was recorded during a period of rationalization in the workplace, and the effect of daily relaxation to help the workers cope was tested. The subjects were arranged into age-matched pairs and randomly allocated into intervention and reference groups. The intervention period lasted six months. The relaxation method was brief and easily introduced as an alternative break in the workplace. Each training session lasted 15 min. A microcomputer-based system was used to record heart rate variability in response to quiet breathing, the Valsalva maneuver, deep breathing, and active orthostatic tests. Cardiac reflexes indicated that occupational strain (especially of a mental nature) caused the functioning of the autonomic nervous system to deteriorate. Regular deep relaxation normalized the function and improved the ability to cope.","Toivanen, H; Länsimies, E; Jokela, V; Hänninen, O",1993.0,,0,0,
3492,Stress and coping strategies among renal transplant candidates in a Thai medical center,,Toimamueang U.; Sirivongs D.; Limumnoilap S.; Paholpak S.; Phanphruk W.; Chunlertrith D.,2003.0,10.1016/S0041-1345(02)03849-6,0,0,
3493,Identifying symptom profiles of depression and anxiety in patients with an acute coronary syndrome using latent class and latent transition analysis.,"To identify symptom profiles of depression and anxiety in patients with an acute coronary syndrome (ACS), to examine changes in symptom profiles over time, and finally, to examine the effects of age and sex on patients' symptom profiles. One hundred ACS patients with mild to severe symptoms of depression and/or anxiety at 1 month post-hospital discharge were enrolled in a randomized trial of cognitive behavioral therapy. Latent class and latent transition analyses were used to identify symptom profiles and describe change over the time in profile membership. A two-class solution was selected to describe depression and anxiety symptom profiles. Class I (76% of patients at baseline) was labeled ""depression and some anxiety symptoms."" Class II (24% of patients at baseline) was labeled ""anxiety and some depression symptoms."" Approximately 25% of patients in the treatment condition transitioned from the depression and some anxiety symptoms class to the anxiety and some depression symptoms class at follow-up compared to 10% of patients in the control condition at follow-up; nearly 50% of patients in the control condition showed worsening of symptoms as compared to 28% in the treatment condition. Results suggested age differences in the probabilities of transitioning between the classes; older patients were more likely to continue having depression and some anxiety symptoms at the time of follow-up. Identifying symptom profiles of depression and anxiety in patients with an ACS may improve diagnostic practices and help to design tailored interventions.",Tisminetzky M.; Bray BC.; Miozzo R.; Aupont O.; McLaughlin TJ.,2011.0,10.2190/PM.42.2.g,0,0,
3494,"Classes of depression, anxiety, and functioning in acute coronary syndrome patients","ER OBJECTIVES: To describe change in subgroups characterized by patterns of depression, anxiety, and functional impairment; examine treatment effects on subgroup membership; examine effects of sex and age on subgroup membership.METHODS: Latent class models were used to meet the first 2 objectives using 79 patients with depression/anxiety. Generalized estimating equations were used to meet the third objective.RESULTS: Three subgroups characterized by different combinations of psychiatric disorders and functioning were identified. Patients who received treatment were more likely to transition to a less impaired subgroup.CONCLUSIONS: Unique information about holistic treatment effects can be gained when multiple outcomes are considered simultaneously.","Tisminetzky, M; Bray, B C; Miozzo, R; Aupont, O; McLaughlin, T",2012.0,,0,0,
3495,Outcome of idiopathic apparent life-threatening events: infant and mother perspectives.,"The objective of this study was to determine the neurodevelopmental and temperamental outcome of infants who suffered an idiopathic apparent life-threatening event (IALTE) and their mothers' perceptions of such an event, and to compare such infants with a matched group of babies hospitalized for nonthreatening events. Infants (N = 19) who were hospitalized at a mean age of 2.8 months for an IALTE with no underlying disease and matched controls hospitalized for an acute nonthreatening illness were sequentially recruited to the study at a mean age of 24 months (SD, 14 months). Physical, neurological, developmental, and temperamental status were assessed. Mothers' stress was assessed by their salivary cortisol response to the physical examination of their infants and completion of appropriate questionnaires assessing their infants' temperament. The investigators were not blinded to the assignment of the infants to each of the study groups. Infants' perceived ""difficultness"" was positively correlated with the time interval following the event (r = 0.5, P = 0.001), mothers' stress as related to their child (r = 0.4, P = 0.004), and mothers' cortisol response (r = 0.5, P = 0.01) among the study group mothers only. IALTE during early infancy was associated with developmentally and neurologically normal outcome in infancy. We conclude that mothers of infants with IALTE differed in the way they perceived their infants' temperament over time, and in their stress response compared to mothers of a control group of hospitalized children who had not experienced an IALTE.",Tirosh E.; Kessel A.; Jaffe M.; Cohen A.,1999.0,,0,0,
3496,External osteotomy in rhinoplasty: Piezosurgery vs osteotome.,"To achieve the desired outcome in rhinoplasty depends on many factors. Osteotomy and surgical reshaping of nasal bones are important steps that require careful planning and execution. The availability of different tools raises the question of which one provides significant advantages for both technique and surgical outcome. Our prospective randomized pilot study compared the outcome of post-traumatic rhinoplasty performed with two different external techniques: ultrasound osteotomic cut using the Piezosurgery Medical Device (Mectron, Carasco, Italy) and traditional external osteotomy. Forty-four lateral osteotomies of the nasal wall were performed in twenty-two patients. In twelve patients the osteotomies were conducted with a 2-mm traditional osteotome (control group), while in the remaining ten patients these were done with the Piezosurgery Medical Device (experimental group). At the postoperative evaluation, significantly lower pain, edema and ecchymosis were noticed in the experimental group (p<0.05). Moreover, the endoscopic evaluation showed fewer mucosal injuries in the experimental group (p<0.05), whereas bleeding, symmetry of the pyramid and presence of external scars, were similar in the two groups. In the present study, Piezosurgery Medical Device allowed for safe lateral osteotomies in rhinoplasty preliminarily demonstrating the potential to reduce some of the most frequent complications of rhinoplasty.",Tirelli G.; Tofanelli M.; Bullo F.; Bianchi M.; Robiony M.,,10.1016/j.amjoto.2015.05.006,0,0,
3497,Rapid Temporal Accumulation in Spider Fear: Evidence From Hierarchical Drift Diffusion Modelling,"Fear can distort sense of time-making time seem slow or even stand still. Here, I used hierarchical drift diffusion modeling (HDDM; Vandekerckhove, Tuerlinckx, and Lee, 2008, 2011; Wiecki, Sofer, and Frank, 2013) to test the idea that temporal accumulation speeds up during fear. Eighteen high fearful and 23 low fearful participants judged the duration of both feared stimuli (spiders) and nonfeared stimuli (birds) in a temporal bisection task. The drift diffusion modeling results support the main hypothesis. In high but not low fearful individuals, evidence accumulated more rapidly toward a long duration decision-drift rates were higher-for spiders compared with birds. This result and further insights into how fear affects time perception would not have been possible on the basis of analyses of choice proportion data alone. Further results were interpreted in the context of a recent 2-stage model of time perception (Balci and Simen, 2014). The results highlight the usefulness of diffusion modeling to test process-based explanations of disordered cognition in emotional disorders.",Tipples J.,2015.0,10.1037/emo0000079,0,0,
3498,"Effect of a multimedia-assisted informed consent procedure on the information gain, satisfaction, and anxiety of cataract surgery patients.","To assess whether a multimedia-assisted preoperative informed consent procedure has an effect on patients' knowledge concerning cataract surgery, satisfaction with the informed consent process, and reduction in anxiety levels. Hietzing Hospital, Vienna, Austria. Prospective randomized controlled clinical trial. Patients participated in an informed consent procedure for age-related cataract surgery that included the standard approach only (reading the information brochure and having a standardized face-to-face discussion) or supplemented with a computer-animated video. The main outcome was information retention assessed by a questionnaire. Further outcome measures used were the State-Trait Anxiety Inventory, the Visual Function-14 score, and an assessment of satisfaction. The study included 123 patients (64 in standard-only group; 59 in computer-animated video group). Both groups scored well on the questionnaire; however, patients who watched the video performed better (82% retention versus 72%) (P = .002). Scores tended to decrease with increasing age (r = -0.25, P = .005); however, this decrease was smaller in the group that watched the video. Both groups had elevated anxiety levels (means in video group: anxiety concerning the current situation [S-anxiety] = 63.8 ± 9.6 [SD], general tendency toward anxiety [T-anxiety] = 65.5 ± 7.9; means in control group: S-anxiety = 61.9 ± 10.3, T-anxiety = 66.2 ± 7.8). A high level of information retention was achieved using an informed consent procedure consisting of an information brochure and a standardized face-to-face discussion. A further increase in information retention was achieved, even with increasing patient age, by adding a multimedia presentation. No author has a financial or proprietary interest in any material or method mentioned.",Tipotsch-Maca SM.; Varsits RM.; Ginzel C.; Vecsei-Marlovits PV.,2016.0,10.1016/j.jcrs.2015.08.019,0,0,
3499,[Significance of the study of slow cerebral potentials in the psychiatric expert testimony in civil law cases].,,Timsit-Berthier M.; Timsit M.,1988.0,,0,0,
3500,Efficacy of a prevention program for postpartum obsessive-compulsive symptoms.,"Obsessive-Compulsive Disorder (OCD) has emerged as a common and impairing postpartum condition. Prospective studies have identified psychological vulnerabilities for the emergence of postpartum obsessive-compulsive symptoms (OCS), including general anxiety symptoms, pre-existing OCS, and specific cognitive distortions. The identification of these factors makes feasible the development of prevention programs that could reduce the impact of postpartum OCS. The present investigation examined a cognitive-behavioral prevention program using a randomized, double blind, controlled trial. Expecting mothers in their 2nd or 3rd trimester with an empirically established, malleable risk factor for postpartum OCS received either the prevention program (N=38) or a credible control program (N=33), both of which were incorporated into traditional childbirth education classes. Results revealed that at 1 month, 3 months, and 6 months postpartum, the prevention program was associated with significantly lower levels of obsessions and compulsions than was the control condition (all p's<0.05). Group differences remained significant even after controlling for baseline OCS and depression symptoms. Those in the prevention condition also reported decreasing levels of cognitive distortions, in contrast to the control condition (p's<0.05). Results support the potential utility of incorporating a CBT-based OCS prevention program into childbirth education classes.",Timpano KR.; Abramowitz JS.; Mahaffey BL.; Mitchell MA.; Schmidt NB.,2011.0,10.1016/j.jpsychires.2011.06.015,0,0,
3501,"The association between metacognitions, the obsessive compulsive symptom dimensions and hoarding: A focus on specificity","In recent year's metacognitive theories - particularly the self-regulatory executive function model proposed by Wells and colleagues - have emerged as a potentially useful perspective from which to extend current cognitive-behavioral models for the mood and anxiety disorders. Metacognitions refer to different beliefs individuals endorse about their thoughts, internal states, and effective coping strategies. Research has linked these attitudes to obsessive compulsive symptoms (OCS), yet it remains unclear whether there may be a differential association with the different OCS dimensions and hoarding. The current study aimed to investigate the specific relationships between the OCS dimensions, hoarding, and metacognitions controlling for general distress. The sample (N=160) was comprised of young adults at a large university in Germany. Although all symptom types were significantly linked with the various metacognitions assessed (all p's<.05), a series of linear regression analyses provided support for more nuanced and particular relationships. The analyses conducted allowed us to examine the specificity of any associations, by factoring out any shared variance between the different OCS dimensions and hoarding. Results revealed that (1) positive beliefs about worry were significantly associated with obsessions and ordering; (2) negative beliefs about uncontrollability were significantly associated with obsessions and checking; (3) cognitive confidence was significantly associated with ordering and hoarding; (4) beliefs about the need to control thoughts were significantly associated with obsessions, ordering, and hoarding; and (5) cognitive self-consciousness was significantly linked with obsessions and ordering. Additional analyses were conducted to examine the relationships between metacognitions, hoarding-specific beliefs, and hoarding symptoms. Results are discussed from the perspective of current theoretical models of OCD and hoarding and future directions are also highlighted. © 2013 Elsevier Ltd.",Timpano K.R.; Rasmussen J.L.; Exner C.; Rief W.; Wilhelm S.,2014.0,10.1016/j.jocrd.2013.10.001,0,0,
3502,"Chronic depression: response to placebo, imipramine, and phenelzine","ER We reanalyzed data from a larger, previously published study in order to directly address whether very chronically depressed patients could benefit from antidepressant medications. This study entered 598 depressed patients into a study randomizing patients to 6 weeks of double-blind treatment with imipramine, phenelzine, or placebo. Patients were assessed for chronicity on a four-point scale from ""mostly well"" to ""virtually always depressed."" The current analyses include only the 153 study completers who were rated as ""virtually always depressed."" In these patients, imipramine was effective for significantly more patients than was placebo (22 [46%] of 48 responding to imipramine vs. 9 [17%] of 52 responding to placebo; chi 2 = 9.50; p = 0.002), whereas phenelzine was significantly more effective than imipramine (37 [70%] of 53 responding to phenelzine; chi 2 = 5.96; p = .015). Patients with mild depression, early onset, or histories of panic attacks did not have substantially different outcomes than patients without these characteristics. These findings suggest that some chronically depressed patients may be good candidates for treatment with antidepressant medication. Because the majority (80%) of the sample met Columbia criteria for definite or probable atypical depression, too few chronic depressives were available to evaluate separately antidepressant efficacy in chronically depressed outpatients who did not have atypical depression. Hence, these results may be applicable only to patients with atypical depression.","Stewart, J W; McGrath, P J; Quitkin, F M; Rabkin, J G; Harrison, W; Wager, S; Nunes, E; Ocepek-Welikson, K; Tricamo, E",1993.0,,0,0,
3503,Effects of a behavioral sleep medicine intervention on trauma symptoms in adolescents recently treated for substance abuse.,"This study tested whether improvement in sleep by an integrative, behavioral sleep intervention was associated with improvement in traumatic stress (TS) symptoms in a sample of 20 adolescents who were recently treated for substance abuse. Sleep was measured throughout the intervention via daily sleep diaries, and traumatic stress symptoms were assessed by the Global Appraisal of Individual Needs (GAIN) at baseline, post-intervention, 3-months post-intervention, and 12-months post-intervention. Individuals with more time in bed and more total sleep time at the beginning of the intervention had more improvement in TS symptom trajectories across the intervention and at the 12-month follow-up assessment. Interaction trends also emerged indicating that adolescents who, throughout the sleep intervention, went to bed later and fell asleep faster had greater improvements in TS symptoms over time. Overall, these results indicate that stimulus control, a therapy that encourages patients to attempt sleep only when they are sleepy, may be particularly helpful for adolescents with TS symptoms, sleep disturbances, and substance abuse histories.",Stevens S.; Haynes PL.; Ruiz B.; Bootzin RR.,2007.0,10.1300/J465v28n02_04,0,0,
3504,A Trial of Telephone Support Services to Prevent Further Intimate Partner Violence.,"We conducted a randomized-controlled trial of telephone support services (TSS) versus enhanced usual care (EUC) for women who had reported intimate partner violence (IPV) within the past year during a visit to a pediatric emergency department. TSS nurse interventionists identified appropriate referrals to community programs, helped participants by problem-solving barriers to obtaining these local services, and provided social support. Three hundred women, ages 18 years and above were recruited. The TSS and EUC groups did not differ on any outcome variable, including IPV victimization, feelings of chronic vulnerability to a perpetrator, depressive symptoms, and posttraumatic stress disorder symptoms.",Stevens J.; Scribano PV.; Marshall J.; Nadkarni R.; Hayes J.; Kelleher KJ.,2015.0,10.1177/1077801215596849,0,0,
3505,Effectiveness and feasibility of Narrative Exposure Therapy (NET) in patients with borderline personality disorder and posttraumatic stress disorder-A pilot study.,"Background: This pilot study focused on the feasibility and potential effectiveness of a protocol based on Narrative Exposure Therapy (NET) that was integrated into a standard inpatient program to treat patients with comorbid Borderline Personality Disorder (BPD) and Posttraumatic Stress Disorder (PTSD). Methods: Eleven patients (1 male, 10 female) without previous stabilization periods or the absence of intentional self-injury received NET during a ten-week inpatient program. Patients were assessed again at post-treatment and a 12-month follow-up. Results: Drop-out rates during treatment were low, with 90.9 % completing NET. Furthermore, acceptance of NET was high, with only one patient rejecting treatment. The program was safe because it did not lead to aggravations in symptom severity at either the post-treatment or 12-month follow-up. Additionally, the rate of self-harming behaviors throughout the treatment phase was low (18.2 %). In fact, treatment was associated with positive effects on PTSD and BPD symptom severity as well as secondary outcome measures, including depression, dissociation and quality of life. Conclusions: The present study found that NET is feasible and safe in an inpatient setting for treating highly burdened patients with BPD and PTSD. There is also evidence for the potential effectiveness of NET in this highly burdened population. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Steuwe, Carolin; Rullkotter, Nina; Ertl, Verena; Berg, Michaela; Neuner, Frank; Beblo, Thomas; Driessen, Martin; Angermeyer, Barnicot, Becker, Bernstein, Bernstein, Bohus, Bohus, Bohus, Bradley, Clarke, Cohen, Ehlers, Feeny, Feigenbaum, First, First, Foa, Grant, Harned, Harned, Harned, Harned, Harned, Harned, Harned, Hautzinger, Jacobson, Jerschke, Jobst, Kliem, Leichsenring, Lieb, Linehan, Neuner, Pabst, Pabst, Pagura, Robjant, Schauer, Schauer, Schmid, Spitzer, Steil, van Minnen, Weierich, Zanarini",2016.0,,0,0,
3506,[Ambulatory short-term therapy of anxiety patients with autogenic training and hypnosis. Results of treatment and 3 months follow-up].,"The aim of the study was to examine the effects of a short-term outpatient treatment (6 sessions à 90 minutes) with autogenic training (Schultz 1932) or hypnosis (Erickson and Rossi 1979), concerning patients with anxiety- and panic disorders (according to DSM-III-R and ICD-10-criteria). 27 Outpatients were recruited by newspaper articles. Most of them had not been treated before. Both short-term treatments consisted of 6 weekly group sessions (4-6 patients). Psychological examinations were carried out before and after treatment and at a follow-up after 3 months. Trait anxiety (STAI-X2) and psychosomatic complaints (BfS/BL') decreased in both groups significantly after treatment. This therapeutic effect was stable during the following 3 months. The frequency of panic attacks decreased as well under treatment, and this effect was even more marked during the 3 month following treatment. The therapeutic success was influenced by the frequency of autosuggestive exercises carried out by the patients at home. This form of short-term treatment is not sufficient for all patients with anxiety disorders but the results of that study encourage to use short-term interventions with autogenic training and hypnosis as initial therapeutic approaches for such patients and to combine them with other therapeutic interventions.",Stetter F.; Walter G.; Zimmermann A.; Zähres S.; Straube ER.,1994.0,,0,0,
3507,Efficacy of exercise for menopausal symptoms: a randomized controlled trial.,"This study aims to determine the efficacy of exercise training for alleviating vasomotor and other menopausal symptoms. Late perimenopausal and postmenopausal sedentary women with frequent vasomotor symptoms (VMS) participated in a randomized controlled trial conducted in three sites: 106 women randomized to exercise and 142 women randomized to usual activity. The exercise intervention consisted of individual facility-based aerobic exercise training three times per week for 12 weeks. VMS frequency and bother were recorded on daily diaries at baseline and on weeks 6 and 12. Intent-to-treat analyses compared between-group differences in changes in VMS frequency and bother, sleep symptoms (Insomnia Severity Index and Pittsburgh Sleep Quality Index), and mood (Patient Health Questionnaire-8 and Generalized Anxiety Disorder-7 questionnaire). At the end of week 12, changes in VMS frequency in the exercise group (mean change, -2.4 VMS/d; 95% CI, -3.0 to -1.7) and VMS bother (mean change on a four-point scale, -0.5; 95% CI, -0.6 to -0.4) were not significantly different from those in the control group (-2.6 VMS/d; 95% CI, -3.2 to -2.0; P = 0.43; -0.5 points; 95% CI, -0.6 to -0.4; P = 0.75). The exercise group reported greater improvement in insomnia symptoms (P = 0.03), subjective sleep quality (P = 0.01), and depressive symptoms (P = 0.04), but differences were small and not statistically significant when P values were adjusted for multiple comparisons. Results were similar when considering treatment-adherent women only. These findings provide strong evidence that 12 weeks of moderate-intensity aerobic exercise do not alleviate VMS but may result in small improvements in sleep quality, insomnia, and depression in midlife sedentary women.",Sternfeld B.; Guthrie KA.; Ensrud KE.; LaCroix AZ.; Larson JC.; Dunn AL.; Anderson GL.; Seguin RA.; Carpenter JS.; Newton KM.; Reed SD.; Freeman EW.; Cohen LS.; Joffe H.; Roberts M.; Caan BJ.,2014.0,10.1097/GME.0b013e31829e4089,0,0,
3508,Obsessive ruminations: a controlled trial of thought-stopping technique.,,Stern RS.; Lipsedge MS.; Marks IM.,1973.0,,0,0,
3509,A preliminary report on clinical response and plasma levels of clomipramine and desmethylclomipramine in obsessive-compulsive neurosis.,,Stern RS.; Cobb JP.; Marks IM.; Jones RB.; Luscombe DK.,1977.0,,0,0,
3510,Brief and prolonged flooding. A comparison in agoraphobic patients.,,Stern R.; Marks I.,1973.0,,0,0,
3511,Physical and psychological factors maintain long-term predictive capacity post-whiplash injury.,"Higher initial levels of pain and disability, older age, cold hyperalgesia, impaired sympathetic vasoconstriction and moderate post-traumatic stress symptoms have been shown to be associated with poor outcome 6 months following whiplash injury. This study prospectively investigated the predictive capacity of these variables at a long-term follow-up. Sixty-five of an initial cohort of 76 acutely injured whiplash participants were followed to 2-3 years post-accident. Motor function (ROM; kinaesthetic sense; activity of the superficial neck flexors (EMG) during cranio-cervical flexion), quantitative sensory testing (pressure, thermal pain thresholds and brachial plexus provocation test), sympathetic vasoconstrictor responses and psychological distress (GHQ-28, TSK and IES) were measured. The outcome measure was Neck Disability Index (NDI) scores. Participants with ongoing moderate/severe symptoms at 2-3 years continued to manifest decreased ROM, increased EMG during cranio-cervical flexion, sensory hypersensitivity and elevated levels of psychological distress when compared to recovered participants and those with milder symptoms. The latter two groups showed only persistent deficits in cervical muscle recruitment patterns. Higher initial NDI scores (OR 1.00-1.1), older age (OR 1.00-1.13), cold hyperalgesia (OR 1.1-1.13) and post-traumatic stress symptoms (OR 1.03-1.2) remained significant predictors of poor outcome at long-term follow-up (r2=0.56). The robustness of these physical and psychological factors suggests that their assessment in the acute stage following whiplash injury will be important.",Sterling M.; Jull G.; Kenardy J.,2006.0,10.1016/j.pain.2006.01.014,0,0,
3512,Neurocognitive impairment in a large sample of homeless adults with mental illness.,"This study examines neurocognitive functioning in a large, well-characterized sample of homeless adults with mental illness and assesses demographic and clinical factors associated with neurocognitive performance. A total of 1500 homeless adults with mental illness enrolled in the At Home Chez Soi study completed neuropsychological measures assessing speed of information processing, memory, and executive functioning. Sociodemographic and clinical data were also collected. Linear regression analyses were conducted to examine factors associated with neurocognitive performance. Approximately half of our sample met criteria for psychosis, major depressive disorder, and alcohol or substance use disorder, and nearly half had experienced severe traumatic brain injury. Overall, 72% of participants demonstrated cognitive impairment, including deficits in processing speed (48%), verbal learning (71%) and recall (67%), and executive functioning (38%). The overall statistical model explained 19.8% of the variance in the neurocognitive summary score, with reduced neurocognitive performance associated with older age, lower education, first language other than English or French, Black or Other ethnicity, and the presence of psychosis. Homeless adults with mental illness experience impairment in multiple neuropsychological domains. Much of the variance in our sample's cognitive performance remains unexplained, highlighting the need for further research in the mechanisms underlying cognitive impairment in this population.",Stergiopoulos V.; Cusi A.; Bekele T.; Skosireva A.; Latimer E.; Schütz C.; Fernando I.; Rourke SB.,2015.0,10.1111/acps.12391,0,0,
3513,Changes in mindfulness and posttraumatic stress disorder symptoms among veterans enrolled in mindfulness-based stress reduction.,"Objectives: The current study assessed associations between changes in 5 facets of mindfulness (Acting With Awareness, Observing, Describing, Non-Reactivity, and Nonjudgment) and changes in 4 posttraumatic stress disorder (PTSD) symptom clusters (Re-Experiencing, Avoidance, Emotional Numbing, and Hyperarousal symptoms) among veterans participating in mindfulness-based stress reduction (MBSR). Method: Secondary analyses were performed with a combined data set consisting of 2 published and 2 unpublished trials of MBSR conducted at a large Veterans Affairs hospital. The combined sample included 113 veterans enrolled in MBSR who screened positive for PTSD and completed measures of mindfulness and PTSD symptoms before and after the 8-week intervention. Results: Increases in mindfulness were significantly associated with reduced PTSD symptoms. Increases in Acting With Awareness and Non-Reactivity were the facets of mindfulness most strongly and consistently associated with reduced PTSD symptoms. Increases in mindfulness were most strongly related to decreases in Hyperarousal and Emotional Numbing. Conclusions: These results extend previous research, provide preliminary support for changes in mindfulness as a viable mechanism of treatment, and have a number of potential practical and theoretical implications. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Stephenson, Kyle R; Simpson, Tracy L; Martinez, Michelle E; Kearney, David J; Amaya-Jackson, Arch, Baer, Baer, Baer, Baker, Banks, Becker, Boden, Brewin, Carmody, Dobkin, Eisen, First, Foa, Foa, Fukuda, Gates, Goodson, Gore, Grossman, Hayes, Hembree, Johnson, Kabat-Zinn, Karlin, Karlin, Kazdin, Kearney, Kearney, Khoury, King, King, Kroenke, Lang, Niles, Owens, Perconte, Polusny, Schnurr, Schnurr, Seal, Shapiro, Simpson, Taylor, Teasdale, Thomas, Thompson, Vujanovic, Wahbeh, Weathers",2017.0,,0,0,
3514,Imagery: a treatment for nursing student anxiety.,"This study examined the effectiveness of audiotaped imagery in reducing anxiety and improving test performance among first-year nursing students. Volunteer subjects were randomly assigned to three groups, imagery-only, imagery/relaxation, and a no-treatment control group. Pottest state anxiety scores in these groups were significantly lower (p = .001) than in the no-treatment control group. Test performance did not differ significantly (p = .067). Subjects using the audiotaped imagery reported an increased sense of well-being, improved ability to sleep, greater energy, and improved self-confidence.",Stephens RL.,1992.0,,0,0,
3515,Cognitively oriented behavioral rehabilitation in combination with Qigong for patients on long-term sick leave because of burnout: REST-A randomized clinical trial.,"Background: Despite an increase in the occurrence of burnout, there is no agreement on what kind of rehabilitation these patients should be offered. Purpose: Primary aim of this study was to evaluate effects on psychological variables and sick leave rates by two different group rehabilitation programs for patients on longterm sick leave because of burnout. Rehabilitation program A (Cognitively oriented Behavioral Rehabilitation (CBR) and Qigong) was compared with rehabilitation program B (Qigong only). Method: In a randomized clinical trial, 96 women and 40 men with a mean age of 41.6 +/- 7.4 years were allocated to one of the two rehabilitation programs. Results: A per-protocol analysis showed no significant difference in treatment efficacy between the groups. Both groups improved significantly over time with reduced levels of burnout, self-rated stress behavior, fatigue, depression, anxiety, obsessive-compulsive symptoms, and sick leave rates. In an intention-to-treat analysis, patients in program A had fewer obsessive-compulsive symptoms and larger effect sizes in self-rated stress behavior and obsessive-compulsive symptoms compared to patients in program B. Conclusion : This study showed no differences in effect between CBR and Qigong compared with Qigong only in a per-protocol analysis. Both rehabilitation programs showed positive effect for patients with burnout. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stenlund, Therese; Ahlgren, Christina; Lindahl, Bernt; Burell, Gunilla; Steinholtz, Katarina; Edlund, Curt; Nilsson, Leif; Knutsson, Anders; Birgander, Lisbeth Slunga; Bergdahl, Beurskens, Blonk, Brattberg, Brattberg, Brattberg, Burell, Claesson, Cohen-Katz, Dawson-Saunders, Ekstedt, Engstrom, Granath, Grossi, Hallsten, Hasson, Heiden, Jensen, Kushnir, Lee, Lee, Lindblom, Lund, Maslach, Mattila-Evenden, Melamed, Melamed, Michie, Mimura, Pines, Rowe, Sancier, Schaufeli, Shirom, Skoglund, Soares, Stenlund, Stenlund, Svanborg, Tsang, Van Der Klink, Van Rhenen",2009.0,,0,0,
3516,Experimental studies of virtual reality-delivered compared to conventional exercise programs for rehabilitation.,"This paper presents preliminary data from two clinical trials currently underway using flat screen virtual reality (VR) technology for physical rehabilitation. In the first study, we are comparing a VR-delivered exercise program to a conventional exercise program for the rehabilitation of shoulder joint range-of-motion in patients with chronic frozen shoulder. In the second study, we are comparing two exercise programs, VR and conventional, for balance retraining in subjects post-traumatic brain injury. Effective VR-based rehabilitation that is easily adapted for individuals to use both in inpatient, outpatient and home-based care could be used as a supplement or alternative to conventional therapy. If this new treatment approach is found to be effective, it could provide a way to encourage exercise and treatment compliance, provide safe and motivating therapy and could lead to the ability to provide exercises to clients in distant locations through telehealth applications of VR treatment. VR is a new technology and the possibilities for rehabilitation are only just beginning to be assessed.",Sveistrup H.; McComas J.; Thornton M.; Marshall S.; Finestone H.; McCormick A.; Babulic K.; Mayhew A.,2003.0,10.1089/109493103322011524,0,0,
3517,The clinical symptoms of Parkinson's disease,"In this review, the clinical features of Parkinson's disease, both motor and non-motor, are described in the context of the progression of the disease. Also briefly discussed are the major treatment strategies and their complications. (Figure presented.) Parkinson's disease is a slowly progressing neurodegenerative disorder, causing impaired motor function with slow movements, tremor and gait and balance disturbances. A variety of non-motor symptoms are common in Parkinson's disease. They include disturbed autonomic function with orthostatic hypotension, constipation and urinary disturbances, a variety of sleep disorders and a spectrum of neuropsychiatric symptoms. This article describes the different clinical symptoms that may occur and the clinical course of the disease. This article is part of a special issue on Parkinson disease.",Sveinbjornsdottir S.,2016.0,10.1111/jnc.13691,0,0,
3518,The effects of common and specific factors in short-term anxiety-provoking psychotherapy: a pilot process-outcome study.,"This study attempted to identify the necessary and sufficient change factors in short-term anxiety-provoking psychotherapy (STAPP). Twenty patients were randomly assigned to either STAPP or a form of nondirective therapy almost devoid of psychodynamic elements but with common factors of psychotherapy intact. Both treatments were 20 sessions long, were manualized, and therapists in both conditions were experienced clinicians receiving manual-guided supervision. Most patients had a diagnosis of anxiety. Results showed that patients in both treatments improved greatly symptomatically and that no further gains were made after termination. Treatments were equally effective. The therapeutic alliance was a strong predictor of symptom improvement. The findings underscore the importance of common factors pertaining to the therapeutic relationship, and they may open to question, to some degree, the therapeutic effectiveness of psychodynamic technique factors in STAPP. The way in which specific and common factors can be brought together under the umbrella of the concept of affect attunement is discussed.",Svartberg M.; Seltzer MH.; Stiles TC.,1998.0,,0,0,
3519,Music therapy in moderate and severe dementia of Alzheimer's type: a case-control study,"ER METHODSThis case-control study was carried out by qualified music therapists in two nursing homes and two psychogeriatric wards. The participants were 38 patients with moderate or severe Alzheimer's disease (AD) assigned randomly to a music therapy group and a control group.RESULTSThe study showed a significant reduction in activity disturbances in the music therapy group during a 6-week period measured with the Behavior Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). There was also a significant reduction in the sum of scores of activity disturbances, aggressiveness and anxiety. Other symptoms rated by subscales of the BEHAVE-AD did not decrease significantly. Four weeks later the effects had mostly disappeared.CONCLUSIONSMusic therapy is a safe and effective method for treating agitation and anxiety in moderately severe and severe AD. This is in line with the results of some non-controlled studies on music therapy in dementia.BACKGROUNDMusic therapy is a potential non-pharmacological treatment for the behavioral and psychological symptoms of dementia, but although some studies have found it to be helpful, most are small and uncontrolled.","Svansdottir, H B; Snaedal, J",2006.0,10.1017/S1041610206003206,0,0,
3520,Effects of effort and distress coping processes on psychophysiological and psychological stress responses,"The purpose of this study was to investigate the effects of coping processes on psychophysiological and psychological responses in stressful settings. In particular, we focused on the effects of a combination of active and avoidant coping processes. Subjects were 40 healthy undergraduate male students (mean=19.80, S.D.=0.97) who were randomly divided into four groups: (a) an effort coping group in which a subject faced a controllable stressor mobilizing an effortful and active coping behavior for a reward; (b) a distress coping group in which a subject faced a distressful stressor mobilizing an avoidant coping behavior for threat of punishment; (c) an effort-distress coping group in which a subject faced an ambivalent stressor mobilizing active coping behavior for a reward and avoidant coping behavior for threat of punishment; and (d) a control group. Initially, the effects of effort coping, distress coping, and effort-distress coping on psychophysiological and psychological responses were investigated. It was found that effort coping and effort-distress coping intensified cardiovascular responses, particularly blood pressure, and that distress coping and effort-distress coping intensified skin conductance level (SCL). Secondarily, the relationships between effort coping process, distress coping process, psychophysiological responses, and psychological responses were investigated. As a result of cluster analysis, the changes of heart rate and blood pressure were correlated to the change of the effort score, and the changes of SCL and psychological responses were correlated to the change of the distress score. These findings suggest that active coping processes and avoidant coping processes independently affect different response systems. © 2002 Elsevier Science B.V. All rights reserved.",Suzuki S.-I.; Kumano H.; Sakano Y.,2003.0,10.1016/S0167-8760(02)00120-4,0,0,
3521,The effect of effort-distress dimensions in stress coping process on psychological and psychophysiological responses,"The purpose of this study was to investigate psychological and psychophysiological responses under an effortful coping condition and an distress coping condition. Effortful coping condition was defined as a condition in which a subject reported high commitment to the task and engaged in active coping. Distress coping condition was defined as a condition in which a subject reported uncontrollability and engaged in passive coping. Subjects were 22 male undergraduate students and were divided into 2 groups: control group and experimental group. All of them underwent both effortful coping condition and distress coping condition. In effortful coping condition, Ss were engaged in 2 mental arithmetic task sessions (low effort task and high effort task). In the first session, Ss in both groups were requested to perform the low effort tasks under the same condition. In the second session, Ss in the experimental group were engaged in the high effort task session with rewards, and Ss in the control group were engaged in the low effort task session without rewards. In distress coping condition, Ss were engaged in 2 movie sessions (relaxation movie and aversire movie). In the first session, Ss in both groups were requested to watch the relaxation movie under the same condition. In the second session, Ss in the experimental group watched the aversive movie (eye surgery), and Ss in the control group watched the relaxation movie. Heart rate, systolic blood pressure, diastolic blood pressure, skin conductance level and skin temperature were recorded, and effort distress scores, and psychological responses were measured. Heart rate, blood pressure, and skin temperature were significantly aroused in effortful coping condition, and Depression-Anxiety score and skin conductance level were significantly aroused in distress coping condition. The results of ANOVAs revealed that a significant interaction among group, condition, and session was found in systolic blood pressure, diastolic blood pressure, and skin conductance level. These suggest that cardiovascular responses are associated with effort coping, and Depression-Anxiety and skin conductance level are associated with distress coping. Furthermore, the results of regression analyses revealed that the changes of diastolic blood pressure corresponded to the changes of effort score, and that the changes of skin conductance level corresponded to the changes of distress score. Finally, the specific relationship between effort-distress status in stress coping process and psychological-psychophysiological responses were discussed.",Suzuki S.-I.; Kumano H.; Sakano Y.,1998.0,,0,0,
3522,Family features in primary social withdrawal among young adults.,"The problem of 'social withdrawal' among young adults is the focus of considerable attention in Japan today. Among the various manifestations of social withdrawal, a 'primary social withdrawal' group has been identified that cannot be diagnosed by the established classification of mental disorders. In an earlier report it was suggested that the onset mechanism for primary social withdrawal is not merely a problem of the withdrawn person themselves, but also includes problems of family relationships. The aim of the present study was to identify the characteristics and problems in family relationships associated with primary social withdrawal. For that purpose a survey was conducted using David H. Olson's Family Adaptability and Cohesion Evaluation Scale as well as a questionnaire that the present authors devised on family interactions and the personal situation of the withdrawn person. The results pointed to the following four characteristics of primary social withdrawal families: (i). there are definite rules within the family; (ii). the families share values and an unfounded pride; (iii). there is a lack of emotional exchange in the family, and it is difficult for members to sympathize with each other's negative feelings; and (iv). although concerned about each other, there is little verbal exchange. From these family characteristics, the onset mechanism for withdrawal is triggered by insignificant matters such as minor setbacks in the developmental issues of youth. Then, given the person's personality traits and aforementioned characteristics in family relationships, the person becomes mired in social withdrawal.",Suwa M.; Suzuki K.; Hara K.; Watanabe H.; Takahashi T.,2003.0,10.1046/j.1440-1819.2003.01172.x,0,0,
3523,Changes in emotion regulation following cognitive-behavioral therapy for anxious youth,"ER This study examined emotion-related functioning following cognitive-behavioral therapy (CBT) with 37 youth with anxiety disorders (22 boys, 15 girls) ranging in age from 7 to 15 with a principal diagnosis of generalized anxiety disorder (n = 27), separation anxiety disorder (n = 12), and/or social phobia (n = 13). Treated youth exhibited a reduction in anxiety and increased anxiety self-efficacy and emotional awareness at posttreatment. Treated youth also demonstrated improved coping and less emotional dysregulation with worry but not with anger or sadness. The results suggest that the gains made in worry regulation do not generalize to other emotions that are not specifically targeted within the CBT protocol.","Suveg, C; Sood, E; Comer, J S; Kendall, P C",2009.0,10.1080/15374410902851721,0,0,
3524,Cognitive-behavioral therapy for anxiety-disordered youth: secondary outcomes from a randomized clinical trial evaluating child and family modalities,"ER This study examined secondary outcomes of a randomized clinical trial that evaluated an individual cognitive-behavioral (ICBT), family-based cognitive-behavioral (FCBT), and family-based education, support and attention (FESA) treatment for anxious youth. Participants (161) were between 7 and 14 years (M=10.27) of age and had a principal diagnosis of separation anxiety disorder, social phobia, and/or generalized anxiety disorder. Hierarchical linear modeling examined youth-reported depressive symptomatology and parent- and teacher-reported externalizing behavior and adaptive functioning at pretreatment, posttreatment, and 1-year follow-up. In general, youth in all treatments evidenced improvements in most domains, with improvements maintained at follow-up. Overall, gender and age did not moderate treatment outcomes. The results suggest that both child and family cognitive-behavioral therapy, and the family-based supportive approach used in this study, can be effective in addressing some of the associated symptoms and adaptive functioning deficits typically linked to anxiety in youth.","Suveg, C; Hudson, J L; Brewer, G; Flannery-Schroeder, E; Gosch, E; Kendall, P C",2009.0,10.1016/j.janxdis.2009.01.003,0,0,
3525,Prospective study of predictors of attendance for breast screening in inner London,"ER DESIGNProspective design in which women were interviewed or completed a postal questionnaire before being sent their invitation for breast screening. Sociodemographic factors, health behaviours, and attitudes, beliefs, and intentions were used as predictors of subsequent attendance. A randomised control group was included to assess the effect of being interviewed on attendance.SETTINGThree neighbouring health districts in inner south east London.PARTICIPANTSA total of 3291 women aged 50-64 years who were due to be called for breast screening for the first time. The analysis of predictors was based on a subsample of 1301, reflecting a response rate of 75% to interview and 36% to postal questionnaire.MAIN RESULTSAttendance was 42% overall, and 70% in those who gave an interview or returned a questionnaire. There was little evidence for an interview effect on attendance. The main findings from the analysis of predictors are listed below. (These were necessarily based on those women who responded to interview/questionnaire and so may not be generalisable to the full sample.) (1) Sociodemographic factors: Women in rented accommodation were less likely to go for screening but other indicators of social class and education were not predictive of attendance. Age and other risk factors for breast cancer were unrelated to attendance, as was the distance between home and the screening centre. Married or single women were more likely to attend than divorced, separated, or widowed women, and black women had a higher than average attendance rate; however, neither of these relationships was found in the interview sample. (2) Health behaviours: Attenders were less likely to have had a recent breast screen, more likely to have had a cervical smear, more likely to go to the dentist for check ups, and differed from non-attenders with regard to drinking frequency. Exercise, smoking, diet change, and breast self-examination were unrelated to attendance. (3) Attitudes, beliefs, and intentions: The two best predictors were measures of the perceived importance of regular screening for cervical and breast cancer and intentions to go for breast screening. Also predictive were beliefs about the following: the personal consequences of going for breast screening, the effectiveness of breast screening, the chances of getting breast cancer, and the attitudes of significant others (the woman's husband/partner and children). Women who reported a moderate amount of worry about breast cancer were more likely to attend than those at the two extremes.CONCLUSIONSAttenders and non-attenders differ in two broad areas: the health related behaviours they engage in and the attitudes, beliefs, and intentions they have towards breast cancer and breast screening. The latter are potentially amenable to change, and though different factors may operate among women who do not respond to questionnaires, the findings offer hope that attendance rates can be improved by targeting the relevant attitudes and beliefs. This could be done by changing the invitation letter and its accompanying literature, through national and local publicity campaigns, and by advice given by GPs, practice nurses, and other health professionals. It is essential that such interventions are properly evaluated, preferably in randomised controlled studies.OBJECTIVETo investigate the predictors of first-round attendance for breast screening in an inner city area.","Sutton, S; Bickler, G; Sancho-Aldridge, J; Saidi, G",1994.0,,0,0,
3526,Vitamin E supplement improves erythrocyte membrane fluidity of thalassemia: an ESR spin labeling study,"ER BACKGROUND: Beta-thalassemia/Hemoglobin E (beta-thal/Hb E) is prevalent in Thailand. The imbalance of globin chains in red blood cells is the primary cause of this anemic disease. The excess alpha-globin in beta-thal/Hb E causes typical damage(s) to membrane of erythroblasts and erythrocytes. By using three paramagnetic labeled compounds (5-, 12-, and 16-spin labeled stearic acids, SLS), the changes of the molecular motion in the lipid bilayer of thalassemic RBCs that have structural modification can be detected.OBJECTIVE: to investigate erythrocyte membrane fluidity and the effect of vitamin E treatment in beta-thalassemia/Hemoglobin E patients by using spin labeling techniques.MATERIAL AND METHOD: The erythrocyte membrane fluidity was investigated in nine splenectomized and five non-splenectomized beta-thalassemia/hemoglobin E (beta-thal/Hb E) patients using EPR spin labeling techniques. To determine the effect of vitamin E on erythrocyte membrane fluidity, only the splenectomized patients were enrolled. Patients were divided into two groups. The first group received 350 mg vitamin E daily for a period of 1 month (n = 5) and the second group received placebo for an equal period (n = 4). Three paramagnetic fatty acid, 5-, 12-, and 16-doxyl stearic acids, (5-, 12- and 16-DS) were used to label phospholipids layer near both the surface (5-DS) and the deeper hydrophobic region of membrane (12-and 16-DS). Lipid peroxidation (TBARs) was measured using a colorimetric method. Vitamin E was measured with high performance liquid chromatography (HPLC).RESULTS: Significantly higher values of erythrocyte membrane fluidity were revealed with 12-, 16-DS in splenectomized patients, as compared with non-splenectomized patients and normal subjects. In 3-thal/Hb E patients, fluidity values, both outer hyperfine splitting (2T(//)) and order parameter (S) of 12-DS showed inverse correlation with serum TBARs. There was no significant difference between the fluidity values measured with 5-DS. After vitamin E supplementation, the erythrocyte membrane fluidity was decreased in almost all patients. In contrast to the vitamin E supplementation group, increased erythrocyte membrane fluidity was demonstrated in the placebo group. Vitamin E supplementation also had effect on other clinical parameters such as increased plasma vitamin E, decreased serum TBARs and no change in hemoglobin.CONCLUSION: The present results suggested the abnormal motion of lipid in the deeper phospholipids region of membrane. In addition, vitamin E supplementation may have a role in the prevention of erythrocyte membrane damage of these patients.","Sutipornpalangkul, W; Morales, N P; Unchern, S; Sanvarinda, Y; Chantharaksri, U; Fucharoen, S",2012.0,,0,0,
3527,A 2-year follow-up of social phobia. Status after a brief medication trial.,"Although social phobia is thought to be a chronic disorder, little is known about its long-term course in patients who engage in brief treatment studies. We, therefore, conducted a follow-up study of social phobics who had participated in a brief, placebo-controlled treatment trial of clonazepam. Of the original 75 subjects, 56 were assessed through telephone interview and self-report questionnaires that evaluated current social phobia symptoms. Information was also gathered about treatment received in the 2-year interval since the initial pharmacotherapy trial. The group as a whole showed maintenance of the gains acquired during initial treatment. On a number of symptom scales, subjects initially treated with clonazepam exhibited significantly less severe scores compared with placebo subjects. This study provides evidence of long-term benefit for social phobics when treated with a brief medication trial.",Sutherland SM.; Tupler LA.; Colket JT.; Davidson JR.,1996.0,,0,0,
3528,Self-defining memories in post-traumatic stress disorder,"Objective. This study investigated the relationship between trauma survivors' goals and retrieval of self-defining memories in post-traumatic stress disorder (PTSD). Methods. Civilian trauma survivors with PTSD, trauma survivors with no PTSD and non-trauma-exposed control participants (N = 49) provided autobiographical memories of events that they believe shaped who they are. Participants also provided details about their major personal goals. Results. Participants with PTSD reported more self-defining memories that were trauma-related, negative valence and from adult years than non-PTSD and control participants. Further, retrieval of trauma-related self-defining memories was strongly associated with reporting personal goals that were related to traumatic experiences. Conclusions. These findings are discussed in terms of the proposition that trauma survivors' current concerns may direct retrieval of trauma-related memorie. © 2005 The British Psychological Society.",Sutherland K.; Bryant R.A.,2005.0,10.1348/014466505X64081,0,0,
3529,Cold pressor stress reduces left cradling preference in nulliparous human females,"The left cradling preference refers to the finding that women hold their infants more frequently on the left side of their own bodies. Several observational studies showed reduced left cradling during stressful circumstances, such as mother-infant separation, or domestic violence. However, until now no experimental study was conducted to investigate the immediate impact of stress on cradling behaviour. Half of the 64 female subjects participating were randomly assigned to a stressful bilateral cold pressor test. The remaining subjects performed a non-stressful control procedure. Before and after this intervention, cradling behaviour was assessed using a baby-like doll. Subjects showed a left cradling preference prior to the intervention. The cold pressor test increased blood pressure and heart rate significantly. A repeated ANOVA revealed an interaction of intervention (cold pressor vs. control) X assessment period (pre- vs. post-intervention), indicating that cold pressor stress reduces left cradling behaviour in female volunteers. Our data indicate that stress influences cradling preference. This may be of relevance for caregiver-infant interactions. © 2007 Informa UK Ltd.",Suter S.E.; Huggenberger H.J.; Schächinger H.,2007.0,10.1080/10253890601141259,0,0,
3530,"Low-frequency pulsed electromagnetic field therapy in fibromyalgia: a randomized, double-blind, sham-controlled clinical study","ER METHODSFifty-six women with FM, aged 18 to 60 years, were randomly assigned to either PEMF or sham therapy. Both the PEMF group (n=28) and the sham group (n=28) participated in therapy, 30 minutes per session, twice a day for 3 weeks. Treatment outcomes were assessed by the fibromyalgia Impact questionnaire (FIQ), visual analog scale (VAS), patient global assessment of response to therapy, Beck Depression Inventory (BDI), and Short-Form 36 health survey (SF-36), after treatment (at 4 wk) and follow-up (at 12 wk).RESULTSThe PEMF group showed significant improvements in FIQ, VAS pain, BDI score, and SF-36 scale in all domains at the end of therapy. These improvements in FIQ, VAS pain, and SF-36 pain score during follow-up. The sham group also showed improvement were maintained on all outcome measures except total FIQ scores after treatment. At 12 weeks follow-up, only improvements in the BDI and SF-36 scores were present in the sham group.CONCLUSIONLow-frequency PEMF therapy might improve function, pain, fatigue, and global status in FM patients.OBJECTIVETo evaluate the clinical effectiveness of low-frequency pulsed electromagnetic field (PEMF) therapy for women with fibromyalgia (FM).","Sutbeyaz, S T; Sezer, N; Koseoglu, F; Kibar, S",2009.0,10.1097/AJP.0b013e3181a68a6c,0,0,
3531,Cognitive desensitization as a model of systematic desensitization.,,Sushinsky LW.; Bootzin RR.,1970.0,,0,0,
3532,HIV risk among female sex workers in Miami: the impact of violent victimization and untreated mental illness.,"Street-based female sex workers constitute a vulnerable population for HIV, as they are often enmeshed in chronic patterns of substance use, sexual risk, homelessness, and violent victimization. This study examined the specific contributions of victimization history and abuse-related traumagenic factors to mental health functioning and sexual risk behaviors, while considering the impact of environmental risk factors as well. Using targeted sampling strategies, we enrolled 562 Miami-based female sex workers into an intervention trial testing the relative effectiveness of two alternative case management conditions in establishing linkages with health services and reducing risk for HIV. Lifetime prevalence of abuse was extremely elevated at 88%. Nearly half reported abuse before the age of 18, while 34% reported violent encounters with ""dates"" or clients in the past 90 days. Serious mental illness (SMI) was quite common, with 74% reporting severe symptoms of depression, anxiety, or traumatic stress. For those with histories of abuse, SMI appeared to mediate the association between abuse-related trauma and unprotected sex behaviors. Mental health treatment would appear to be an important component of effective HIV prevention among this vulnerable group, and should form part of a compendium of services offered to female sex workers.",Surratt HL.; Kurtz SP.; Chen M.; Mooss A.,2012.0,10.1080/09540121.2011.630342,0,0,
3533,HIV risk among female sex workers in Miami: The impact of violent victimization and untreated mental illness.,"Street-based female sex workers constitute a vulnerable population for HIV, as they are often enmeshed in chronic patterns of substance use, sexual risk, homelessness, and violent victimization. This study examined the specific contributions of victimization history and abuse-related traumagenic factors to mental health functioning and sexual risk behaviors, while considering the impact of environmental risk factors as well. Using targeted sampling strategies, we enrolled 562 Miami-based female sex workers into an intervention trial testing the relative effectiveness of two alternative case management conditions in establishing linkages with health services and reducing risk for HIV. Lifetime prevalence of abuse was extremely elevated at 88%. Nearly half reported abuse before the age of 18, while 34% reported violent encounters with ""dates"" or clients in the past 90 days. Serious mental illness (SMI) was quite common, with 74% reporting severe symptoms of depression, anxiety, or traumatic stress. For those with histories of abuse, SMI appeared to mediate the association between abuse-related trauma and unprotected sex behaviors. Mental health treatment would appear to be an important component of effective HIV prevention among this vulnerable group, and should form part of a compendium of services offered to female sex workers. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Surratt, Hilary L; Kurtz, Steven P; Chen, Minxing; Mooss, Angela; Baron, Basu, Blank, Blankenship, Bohlig, Carey, Church, Davis, Dennis, Devieux, El-Bassel, Epstein, Farley, Finkelhor, Finkelhor, Grauerholz, Hutton, Inciardi, Johnson, Kalichman, Kerrigan, Kessler, Kessler, Kilbourne, Kurtz, McKinnon, Meade, Meade, Messman, Messman-Moore, Perehinets, Rosenberg, Surratt, Surratt, Surratt, Surratt, Watters",2012.0,,0,0,
3534,Psychometric validation of the 16 Item Quick Inventory of Depressive Symptomatology Self-Report Version (QIDS-SR16) in military veterans with PTSD.,"Background: The Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16) is one example of a screening tool for depression, which has been utilized extensively following validation in a number of clinical populations. Despite the strengths of the QIDS-SR16, it has not been validated in military veterans, a particularly unique population considering their exposure to trauma and high rate of psychiatric comorbidities. The current report describes a psychometric validation of the QIDS-SR16 in a sample of United States military veterans diagnosed with military-related PTSD. Methods: Participants (n = 240) were administered the QIDS-SR16 and one of two gold-standard semi-structured interviews to establish diagnosis of a current Major Depressive Episode (MDE). The ability to discriminate between individuals with and without a current MDE using the QIDS-SR16 was tested with a stepwise logistic regression. Additionally, an optimal cutoff score for the QIDS-SR16 was established. Results: The QIDS-SR16 was able to reliabily discriminate between individuals with and without a current MDE. The optimal cutoff score of the QIDS-SR16 for a current MDE was 13, with a sensitivity of 77.55% and specificity of 56.25%. Limitations: Limitations of this study included underrepresentation of some racial/ethnic groups, the inability to disentangle the potential influence of trauma type and gender on results, and the use of two diagnostic interviews to diagnose current MDE. Discussion: The QIDS-SR16 can be effectively utilized in military veterans with comorbid PTSD. However, the calculated cutoff score for this population was higher than the cutoff score for the general population. This could result from the overlap between PTSD and MDE symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Suris, Alina; Holder, Nicholas; Holliday, Ryan; Clem, Matthew; Basco, Bauer, Bernstein, Bernstein, Bisson, Blake, Bromet, Brown, Cameron, Campbell, Cukor, Doraiswamy, Ferrari, First, Fiske, Fontana, Forbes, Gillespie, Ginzburg, Hamilton, Hedayati, Helzer, Helzer, Helzer, Hinton, Holliday, Iversen, Keane, Kessler, King, Lobbestael, Ma, McGee, Monson, Nezu, Nixon, Possemato, Rauch, Reilly, Robins, Robins, Robins, Rush, Rush, Rytwinski, Sareen, Schnurr, Schultz, Schulz, Seal, Segal, Shear, Shiner, Skre, Steiner, Suris, Suris, Suris, Trivedi, Trivedi, Tuerk, Uher, Ustun, Valkanova, Viera, Weathers, Wells, Williams, Zanarini, Zanarini, Zweig",2016.0,,0,0,
3535,Cognitive mediation of symptom change in exposure and response prevention for obsessive-compulsive disorder.,"This study examined cognitive mediators of symptom change during exposure and response prevention (EX/RP) for obsessive-compulsive disorder (OCD). Based on cognitive models of OCD, obsessive beliefs were hypothesized as a mediator of symptom change. Participants were 70 patients with primary OCD receiving EX/RP either as part of a randomized controlled trial (n = 38) or in open treatment following nonresponse to risperidone or placebo in the same trial (n = 32). Blinded evaluations of OCD severity and self-report assessments of three domains of obsessive beliefs (i.e., responsibility/threat of harm, importance/control of thoughts, and perfectionism/intolerance of uncertainty) were administered during acute (Weeks 0, 4 and 8) and maintenance treatment (Weeks 12 and 24). Study hypotheses were examined using cross-lagged multilevel modeling. Contrary to predictions, the obsessive beliefs domains investigated did not mediate subsequent OCD symptom reduction. In addition, OCD symptoms did not significantly mediate subsequent change in obsessive beliefs. The present study did not find evidence of cognitive mediation during EX/RP for OCD, highlighting the need to investigate other plausible mediators of symptom improvement. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Su, Yi-Jen; Carpenter, Joseph K; Zandberg, Laurie J; Simpson, Helen Blair; Foa, Edna B; Adams, Anholt, Anholt, Bagby, Clark, Conger, Cougle, Craske, Emmelkamp, First, Foa, Foa, Foa, Gillan, Goodman, Goodman, Hamilton, Hedeker, Kalanthroff, Kazdin, Kazdin, Kim, Koran, Kozak, Maas, MacKinnon, MacKinnon, McCoach, McLean, McLean, McLean, Olatunji, Ost, Preacher, Raudenbush, Rees, Simpson, Simpson, Simpson, Smits, Solem, Storchheim, Trajkovic, Tuerk, Wells, Whittal, Wilhelm, Wilhelm, Woody, Zandberg, Zimmerman",2016.0,,0,0,
3536,Change in self-concept differentiation after psychotherapy and its relation to psychological maladjustment.,"The research was carried out with a group of 105 psychotherapy participants, diagnosed with neurosis or personality disorders, and 36 controls. Analysis supported the hypotheses that self-concept differentiation (SCD) decreases after psychotherapeutic interventions and that the reduction in SCD is positively correlated with an improvement in neurotic symptoms and neurotic personality traits.",Styla R.,2012.0,10.2466/02.07.15.PR0.110.2.397-402,0,0,
3537,Cognitive rehabilitation in the elderly: a randomized trial to evaluate a new protocol.,"This study provides an introduction to, and overview of, several papers that resulted from a randomized control trial that evaluated a new cognitive rehabilitation protocol. The program was designed to improve general strategic abilities in ways that would be expressed in a broad range of functional domains. The trial, which was conducted on a sample of older adults who had experienced normal age-related cognitive decline, assessed performance in the following domains: memory, goal management, and psychosocial status. The general rationale for the trial, the overall experimental design, and the approach to statistical analyses that are relevant to each paper are described here. The results for each functional domain are reported in separate papers in this series.",Stuss DT.; Robertson IH.; Craik FI.; Levine B.; Alexander MP.; Black S.; Dawson D.; Binns MA.; Palmer H.; Downey-Lamb M.; Winocur G.,2007.0,10.1017/S1355617707070154,0,0,
3538,"The influence of age, anxiety and concern about falling on postural sway when standing at an elevated level.","Psychological processes may influence balance and contribute to the risk of falls in older people. While a self-reported fear of falling is associated with increased postural sway, inducing fear using an elevated platform can lead to reduced sway, suggesting different underlying mechanisms whereby fear may influence balance control. This study examined changes in postural sway, muscle activity and physiological measures of arousal while standing on a 65cm elevated platform, compared to floor level, in young and older adults. The older adults were classified as fall concerned or not fall concerned based on the Falls Efficacy Scale-International and anxious or not anxious based on the Goldberg Anxiety Scale. Fall concern did not affect the physiological and sway response to the elevated platform. In response to the postural threat, the anxious participants increased their sway frequency (p=0.001) but did not reduce sway range (p=0.674). Conversely, non-anxious participants showed an adaptive tightening of balance control, effectively reducing sway range in the elevated condition (p<0.001). Generalised anxiety in older adults appears to differentially affect postural control strategies under threatening conditions.",Sturnieks DL.; Delbaere K.; Brodie MA.; Lord SR.,2016.0,10.1016/j.humov.2016.06.014,0,0,
3539,Effects of unconditioned stimulus intensity and fear extinction on subsequent sleep architecture in an afternoon nap.,"Impaired fear extinction and disturbed sleep coincide in post-traumatic stress disorder (PTSD), but the nature of this relationship is unclear. Rapid eye movement (REM) sleep deprivation impairs fear extinction recall in rodents and young healthy subjects, and animal models have demonstrated both disrupted sleep after fear conditioning and normalized sleep after extinction learning. As a correlation between unconditioned stimulus (US) responding and subsequent sleep architecture has been observed in healthy subjects, the goal of this study was to test whether US intensity would causally affect subsequent sleep. Twenty-four young healthy subjects underwent a fear conditioning session with skin conductance response measurements before an afternoon session of polysomnographically recorded sleep (up to 120 min) in the sleep laboratory. Two factors were manipulated experimentally in a 2 × 2 design: US (electrical shock) was set at high or low intensity, and subjects did or did not receive an extinction session after fear conditioning. We observed that neither factor affected REM sleep amount, that high US intensity nominally increased sleep fragmentation (more Stage 1 sleep, stage shifts and wake after sleep onset), and that extinction increased Stage 4 amount. Moreover, reduced Stage 1 and increased Stage 4 and REM sleep were associated with subjective sleep quality of the afternoon nap. These results provide evidence for the notion that US intensity and extinction affect subsequent sleep architecture in young healthy subjects, which may provide a translational bridge from findings in animal studies to correlations observed in PTSD patients.",Sturm A.; Czisch M.; Spoormaker VI.,2013.0,10.1111/jsr.12074,0,0,
3540,How mild traumatic brain injury may affect declarative memory performance in the post-acute stage.,"Memory deficits are among the most frequently reported sequelae of mild traumatic brain injury (MTBI), especially early after injury. To date, these cognitive deficits remain poorly understood, as in most patients the brain is macroscopically intact. To identify the mechanism by which MTBI causes declarative memory impairments, we probed the functionality of the medial temporal lobe (MTL) and the prefrontal cortex (PFC), within 6 weeks after injury in 43 patients from a consecutive cohort, and matched healthy controls. In addition to neuropsychological measures of declarative memory and other cognitive domains, all subjects underwent functional magnetic resonance imaging (fMRI). Behavioral results showed poorer declarative memory performance in patients than controls, and decreasing performance with increasing duration of post-traumatic amnesia (a measure of injury severity). Task performance in the scanner was, as intended by the task and design, similar in patients and controls, and did not relate to injury severity. The task used reliably activated the MTL and PFC. Although we did not find significant differences in brain activity when comparing patients and controls, we revealed, in agreement with our neuropsychological findings, an inverse correlation between MTL activity and injury severity. In contrast, no difference in prefrontal activation was found between patients and controls, nor was there a relation with injury severity. On a behavioral level, injury severity was inversely related to declarative memory performance. In all, these findings suggest that reduced medial temporal functionality may contribute to poorer declarative memory performance in the post-acute stage of MTBI, especially in patients with longer post-traumatic amnesia.",Stulemeijer M.; Vos PE.; van der Werf S.; van Dijk G.; Rijpkema M.; Fern√°ndez G.,2010.0,10.1089/neu.2010.1298,0,0,
3541,Prediction of psilocybin response in healthy volunteers,"Responses to hallucinogenic drugs, such as psilocybin, are believed to be critically dependent on the user's personality, current mood state, drug pre-experiences, expectancies, and social and environmental variables. However, little is known about the order of importance of these variables and their effect sizes in comparison to drug dose. Hence, this study investigated the effects of 24 predictor variables, including age, sex, education, personality traits, drug pre-experience, mental state before drug intake, experimental setting, and drug dose on the acute response to psilocybin. The analysis was based on the pooled data of 23 controlled experimental studies involving 409 psilocybin administrations to 261 healthy volunteers. Multiple linear mixed effects models were fitted for each of 15 response variables. Although drug dose was clearly the most important predictor for all measured response variables, several non-pharmacological variables significantly contributed to the effects of psilocybin. Specifically, having a high score in the personality trait of Absorption, being in an emotionally excitable and active state immediately before drug intake, and having experienced few psychological problems in past weeks were most strongly associated with pleasant and mystical-type experiences, whereas high Emotional Excitability, low age, and an experimental setting involving positron emission tomography most strongly predicted unpleasant and/or anxious reactions to psilocybin. The results confirm that non-pharmacological variables play an important role in the effects of psilocybin. © 2012 Studerus et al.",Studerus E.; Gamma A.; Kometer M.; Vollenweider F.X.,2012.0,10.1371/journal.pone.0030800,0,0,
3542,Comparing in-person to videoconference-based cognitive behavioral therapy for mood and anxiety disorders: Randomized controlled trial.,"Background: Cognitive-behavioral therapy (CBT) has demonstrated efficacy and effectiveness for treating mood and anxiety disorders. Dissemination of CBT via videoconference may help improve access to treatment. Objective: The present study aimed to compare the effectiveness of CBT administered via videoconference to in-person therapy for a mixed diagnostic cohort. Methods: A total of 26 primarily Caucasian clients (mean age 30 years, SD 11) who had a primary Diagnostic and Statistical Manual of Mental Disorders, 4th edition text revision (DSM-IV-TR) diagnosis of a mood or anxiety disorder were randomly assigned to receive 12 sessions of CBT either in-person or via videoconference. Treatment involved individualized CBT formulations specific to the presenting diagnosis; all sessions were provided by the same therapist. Participants were recruited through a university clinic. Symptoms of depression, anxiety, stress, and quality of life were assessed using questionnaires before, after, and 6 weeks following treatment. Secondary outcomes at posttreatment included working alliance and client satisfaction. Results: Retention was similar across treatment conditions; there was one more client in the videoconferencing condition at posttreatment and at follow-up. Statistical analysis using multilevel mixed effects linear regression indicated a significant reduction in client symptoms across time for symptoms of depression (P < .001, d = 1.41), anxiety (P < .001, d = 1.14), stress (P < .001, d = 1.81), and quality of life (P < .001, d = 1.17). There were no significant differences between treatment conditions regarding symptoms of depression (P = .165, d = 0.37), anxiety (P = .41, d = 0.22), stress (P = .15, d = 0.38), or quality of life (P = .62, d = 0.13). There were no significant differences in client rating of the working alliance (P = .53, one-tailed, d = -0.26), therapist ratings of the working alliance (P = .60, one-tailed, d = 0.23), or client ratings of satisfaction (P = .77, one-tailed, d = -0.12). Fisher's Exact P was not significant regarding differences in reliable change from pre- to posttreatment or from pretreatment to follow-up for symptoms of depression (P = .41, P = .26), anxiety (P = .60, P = .99), or quality of life (P = .65, P = .99) but was significant for symptoms of stress in favor of the videoconferencing condition (P = .03, P = .035). Difference between conditions regarding clinically significant change was also not observed from pre- to posttreatment or from pretreatment to follow-up for symptoms of depression (P = .67, P = .30), anxiety (P = .99, P = .99), stress (P = .19, P = .13), or quality of life (P = .99, P = .62). Conclusions: The findings of this controlled trial indicate that CBT was effective in significantly reducing symptoms of depression, anxiety, and stress and increasing quality of life in both in-person and videoconferencing conditions, with no significant differences being observed between the two. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Stubbings, Daniel R; Rees, Clare S; Roberts, Lynne D; Kane, Robert T; Acarturk, Attkisson, Barlow, Beck, Beck, Bennett-Levy, Bernstein, Bisson, Bouchard, Brown, Bryk, Buckley, Butler, Craske, Cuijpers, Day, Diefenbach, Driessen, Dunstan, Erdfelder, Eysenbach, First, First, Foa, Fresco, Frueh, Garcia-Lizana, Grady, Griffiths, Himle, Jackson, Jacobson, Jones, Jong, Joosse, Joshi, Kessler, Kobak, Kopel, Lovibond, Lucock, McEvoy, Meyer, Mitchell, Mitte, Mitte, Morland, Nickelson, O'Reilly, Page, Parker, Rees, Richards, Richardson, Ritsner, Rosa-Alcazar, Ruskin, Saurman, Shafran, Shepherd, Simpson, Simpson, Smith, Smith, Sorvaniemi, Taylor, Taylor, Tracey, Tsai, Vaitheswaran, Vernmark, Yip, Zlomke",2013.0,,0,0,
3543,The influence of a visuospatial grounding task on intrusive images of a traumatic film,"Nonclinical participants watched a trauma film under two processing conditions. During part of the film participants carried out a concurrent visuospatial grounding task consisting of the construction of shapes out of plasticine (modelling clay), while the rest of the film constituted a control, no task condition. The visuospatial task was predicted to selectively compete for processing resources required for intrusive image formation. As predicted, spontaneous intrusive images during the succeeding week were significantly less common from those parts of the film that coincided with the concurrent task. The task had no effect on levels of distress or peritraumatic dissociation, consistent with the hypothesis that intrusions were reduced because the task competed for resources necessary for encoding into an image-based memory system. © 2005 Elsevier Ltd. All rights reserved.",Stuart A.D.P.; Holmes E.A.; Brewin C.R.,2006.0,10.1016/j.brat.2005.04.004,0,0,
3544,Effects of tryptophan depletion on central and peripheral chemoreflexes in man,"Klein (Arch. Gen. Psychiatry 50, 306-317, 1993) suggests that panic attacks are the result of a defective 'suffocation alarm' threshold that presents with carbon dioxide (CO2) hypersensitivity, exaggerated ventilatory response and panic in panic disorder (PD) patients. Serotonergic deficiencies enhance this ventilatory response in PD patients, as per 'suffocation alarm' theory predictions, suggesting that serotonin (5-HT) normalizes the ventilatory response. Other research supports a serotonin system-mediated stimulation of ventilation. Knowledge of 5-HT's role on ventilatory output and its neurophysiological sources impacts on the 'suffocation alarm' theory validity and predictive value. We used tryptophan depletion (TRP-) in concert with a modified Read rebreathing test to determine the effect of deficient serotonergic modulation on the central and peripheral chemoreflex threshold and sensitivity of response to CO2 in 11 healthy men. TRP- did not affect central or peripheral chemoreflex threshold or sensitivity of response to CO2. However, basal ventilation was significantly elevated during TRP-. In contrast to 'suffocation alarm' theory predictions, decreased 5-HT neurotransmission does not significantly affect the respiratory chemoreflex response to CO2, impacting on non-chemoreflex drives to breathe. Panic associated respiratory abnormalities may be related to defective 5-HT modulation of non-chemoreflex drives to breathe, unrelated to any respiratory chemoreflex abnormality. © 2002 Elsevier Science B.V. All rights reserved.",Struzik L.; Duffin J.; Vermani M.; Hegadoren K.; Katzman M.A.,2002.0,10.1016/S1569-9048(02)00170-2,0,0,
3545,Video testimony of long-term hospitalized psychiatrically ill Holocaust survivors.,"Many Holocaust survivors who have both psychotic disorders and residual symptoms of posttraumatic stress disorder (PTSD) remain chronically hospitalized in psychiatric institutions. This study investigated the clinical benefits of a therapeutic process facilitating a detailed videotaped account of traumatic experience (testimony method) in elderly long-term hospitalized Holocaust survivors. Twenty-four schizophrenia patients (mean age=72.2 years) who were chronically hospitalized in Israeli state psychiatric hospitals underwent assessment by blind rating with a battery of psychiatric rating scales before and 4 months after extensive videotaped interview. The rating scales included the Positive and Negative Syndrome Scale; Clinical Global Impression (CGI); Mini-Mental State Examination (MMSE); Clinician-Administered PTSD Scale, Form 2; and Structured Interview for Disorders of Extreme Stress. Full pre- and postinterview data were available for 21 patients. Thirty-eight percent of the patients met the criteria for PTSD at the first interview, compared with only 19% at the second interview. The patients had significant reductions in functional impairment and in the severity and intensity of all posttraumatic symptom clusters (intrusion, avoidance, hyperarousal); the avoidance cluster showed the most reduction. Eleven subjects had an improvement of 30% or more in total posttraumatic severity score. No differences in Positive and Negative Syndrome Scale, MMSE, Structured Interview for Disorders of Extreme Stress, and CGI total scores were noted postinterview or between the two preinterview evaluation batteries in the comparison group. Female patients had a higher prevalence of PTSD symptoms. Total Clinician-Administered PTSD Scale, Form 2, scores and total Positive and Negative Syndrome Scale scores were inversely correlated both at baseline and at follow-up. Study observations suggest clinical benefits of the testimony method in the alleviation of many posttraumatic symptoms, but not psychosis, in a cohort of psychiatrically ill Holocaust survivors, despite an interval of as many as 60 years since the traumatic events. The findings have implications for care and rehabilitation of patients many years after acute traumatic events.",Strous RD.; Weiss M.; Felsen I.; Finkel B.; Melamed Y.; Bleich A.; Kotler M.; Laub D.,2005.0,10.1176/appi.ajp.162.12.2287,0,0,
3546,Experimental studies in explicitly paradoxical interventions: results and implications.,"A dozen experimental studies have assessed the effectiveness of paradoxical interventions with agoraphobia, depression, insomnia and procrastination. The studies suggest that paradoxical interventions are more effective than no treatment and placebo treatment and are as effective and, in some instances, more effective than other behavioral interventions. Several studies show that the wording of paradoxical interventions affects their impact.",Strong SR.,1984.0,,0,0,
3547,The influence of ozone on self-evaluation of symptoms in a simulated aircraft cabin,"Simulated 4-h flights were carried out in a realistic model of a three-row, 21-seat section of an aircraft cabin that was reconstructed inside a climate chamber. Twenty-nine female subjects, age 19-27 years, were split into two groups; each group was exposed to four conditions: two levels of ozone (<2 and 60-80 p.p.b.) at two outside air supply rates (2.4 and 4.7 l/s per person). A companion study measured the chemicals present in the cabin air during each of the simulated flights. The subjects completed questionnaires to provide subjective assessments of air quality and symptoms typical of complaints experienced during actual flight. Additionally, the subjects' visual acuity, nasal peak flow and skin dryness were measured. Based on self-recorded responses after 31/4 h in the simulated aircraft cabin, they judged the air quality and 12 of the symptoms (including eye and nasal irritation, lip and skin dryness, headache, dizziness, mental tension, claustrophobia) to be significantly worse (P<0.05) for the ""ozone"" condition compared to the ""no ozone"" condition. The results indicate that ozone and products of ozone-initiated chemistry are contributing to such complaints, and imply previously unappreciated benefits when ozone is removed from the ventilation air supplied to an aircraft cabin. © 2008 Nature Publishing Group All rights reserved.",Strøm-Tejsen P.; Weschler C.J.; Wargocki P.; Myśków D.; Zarzycka J.,2008.0,10.1038/sj.jes.7500586,0,0,
3548,Long-term psychological effects of a no-sedation protocol in critically ill patients.,"A protocol of no sedation has been shown to reduce the time patients receive mechanical ventilation and to reduce intensive care and total hospital length of stay. The long-term psychological effects of this strategy have not yet been described. The purpose of the study was to test whether a strategy of no sedation alters long-term psychological outcome compared with a standard strategy with sedation. During intensive care stay, 140 patients requiring mechanical ventilation were randomized to either no sedation or sedation with daily interruption of sedation. This study was done as a single-blinded cohort study. After discharge, patients were interviewed by a neuropsychologist assessing quality of life, depression, anxiety, and posttraumatic stress disorder. Two years after randomization, 38 patients were eligible for interview, and 26 patients were interviewed (13 from each group). No difference was found with respect to quality of life (Medical Outcome Study, 36-item short-form health survey). Both mental and physical components were nonsignificant. The Beck depression index was low in both groups (one patient in intervention group versus three patients in the control group were depressed, p = 0.32). Evaluated with the Impact of Events Scale, both groups had low stress scores (one in the intervention group versus two in the control group had scores greater than 32; p = 0.50). State anxiety scores were also low (28 in the control group versus 30 in the intervention group, p = 0.58). Our data suggest that a protocol of no sedation applied to critically ill patients undergoing mechanical ventilation does not increase the risk of long-term psychological sequelae after intensive care compared with standard treatment with sedation.",Str√∏m T.; Stylsvig M.; Toft P.,2011.0,10.1186/cc10586,0,0,
3549,Acute exercise ameliorates reduced brain-derived neurotrophic factor in patients with panic disorder,"ER The neurotrophin brain-derived neurotrophic factor (BDNF) has been implicated in depression and anxiety. Antidepressants and exercise increase BDNF expression, and both have an antidepressant and anxiolytic activity. To further characterize the association of anxiety, BDNF and exercise, we studied panic disorder patients (n=12) and individually matched healthy control subjects (n=12) in a standardized exercise paradigm. Serum samples for BDNF analyses were taken before and after 30min of exercise (70 VO(2max)) or quiet rest. The two conditions were separated by 1 week and the order was randomized. Non-parametric statistical analyses were performed. There was a negative correlation of BDNF concentrations and subjective arousal at baseline (r=-0.42, p=0.006). Compared to healthy control subjects, patients with panic disorder had significantly reduced BDNF concentrations at baseline and 30min of exercise significantly increased BDNF concentrations only in these patients. Our results suggest that acute exercise ameliorates reduced BDNF concentrations in panic disorder patients and raise the question whether this is also found after long-term exercise training and if it is related to the therapeutic outcome.","Ströhle, A; Stoy, M; Graetz, B; Scheel, M; Wittmann, A; Gallinat, J; Lang, U E; Dimeo, F; Hellweg, R",2010.0,10.1016/j.psyneuen.2009.07.013,0,0,
3550,Increased response to a putative panicogenic nocebo administration in female patients with panic disorder,"ER Experimental challenge studies may generate and test hypotheses regarding the pathophysiology of panic disorder and may serve to identify pathophysiologically relevant subtypes. It has been suggested that gender-related differences may be relevant in the development and maintenance of panic disorder. In a randomized double blind design the effects of placebo and sodium lactate administration in 14 female and 16 male patients with panic disorder and 23 healthy control subjects were compared using the Acute Panic Inventory (API) score and derived formal criteria for a panic attack. Panic attack frequency following sodium lactate was 76.6% in the patient group. Although control subjects had a lactate-induced increase in the API score as well, this effect was much weaker. No panic attacks occurred in patients with panic disorder or healthy control subjects receiving a placebo. However, a gender effect was observed in the putative panicogenic placebo condition: female patients with panic disorder had more subthreshold panic anxiety as measured with the API score. The data give evidence for an increased nocebo response in female patients with panic disorder.","Ströhle, A",2000.0,,0,0,
3551,No effect of adjunctive fluoxetine on eating behavior or weight phobia during the inpatient treatment of anorexia nervosa: an historical case-control study.,"A six-week open label clinical trial investigated the response to fluoxetine in adolescents hospitalized for treatment of anorexia nervosa. Patients were drawn from consecutive admissions to a specialty treatment service and received fluxoetine as an add-on to their multidisciplinary treatment regimen beginning three weeks to one month postintake. Global clinical severity ratings of eating behavior and weight phobia were obtained at baseline and then at biweekly intervals. These ratings were compared to those obtained from matched historical case-controls who received an identical course of inpatient therapy but without adjunctive pharmacotherapy. Analyses failed to show any beneficial or detrimental effect of fluoxetine on these clinical measures. We conclude that fluoxetine has no robust additive or synergistic therapeutic benefit when measured against the effects of intensive, multidisciplinary inpatient therapy.",Strober M.; Pataki C.; Freeman R.; DeAntonio M.,1999.0,10.1089/cap.1999.9.195,0,0,
3552,Allelic variation in 5-HT1A receptor expression is associated with anxiety- and depression-related personality traits,"The 5-HT1A receptor plays a critical role in the pathophysiology of anxiety and depression as well as in the mode of action of anxiolytic and antidepressant drugs. Human 5-HT1A gene transcription is modulated by a common C-1016G single nucleotide polymorphism (SNP) in its upstream regulatory region. In the present study, we evaluated the role of the HTR1A-1019 polymorphism in the modulation of individual differences in personality traits by an association study of a sample of healthy volunteers. Personality traits were assessed with two different methods, NEO personality inventory (NEO-PI-R) and Tridimensional Personality Questionnaire (TPQ). There was a significant effect of the HTR1A-1019 polymorphism on NEO Neuroticism with carriers of the G allele showing higher scores than individuals homozygous for the C variant. The effect was primarily due to associations with the Neuroticism facets Anxiety and Depression. Carriers of the G allele also exhibited higher TPQ Harm Avoidance scores. Our findings indicate a role of allelic variation in 5-HT1A receptor expression in the development and modulation of anxiety- and depression-related personality traits.",Strobel A.; Gutknecht L.; Rothe C.; Reif A.; Mössner R.; Zeng Y.; Brocke B.; Lesch K.-P.,2003.0,10.1007/s00702-003-0072-0,0,0,
3553,The physiological and traumatic effects of childhood exposure to intimate partner violence,"This study compared the physiological functioning and trauma symptoms of a sample of adult college students who were exposed to intimate partner violence (IPV) as children to a sample physically or sexually abused as children and a sample with no history of abuse. Heart rates, levels of salivary cortisol, and trauma symptoms were measured before a stressor, during a stressor, and after relaxation following the stressor. Repeated measures analysis of variance indicated that there was a strong relationship between childhood exposure to IPV and the development of diagnosable post-traumatic stress symptoms in adulthood. Those exposed to IPV as children also exhibited increased heart rates. Implications for practice and intervention are discussed. © 2008 by The Haworth Press. All rights reserved.",Stride S.; Geffner R.; Lincoln A.,2008.0,10.1080/10926790801984507,0,0,
3554,Effect of arginine on insulin liberation during intra-abdominal operations,"ER During abdominal surgery the basal and glucose stimulated insulin secretion rate is reduced. An arginine-infusion of 0,5 g/kg over 30 minutes is able to stimulate the basal as well as the glucose stimulated insulin secretion under stress condition. A synergism between the effect of arginine and blood glucose concentration concerning the influence on insulin secretion can be proven. The results are important for the postoperative (posttraumatic) infusion therapy.","Stremmel, W; Kümmerle, K",1975.0,,0,0,
3555,An introduction to multivariate statistics.,"The more commonly known statistical procedures, such as the t-test, analysis of variance, or chi-squared test, can handle only one dependent variable (DV) at a time. Two types of problems can arise when there is more than one DV: 1. a greater probability of erroneously concluding that there is a significant difference between the groups when in fact there is none (a Type I error); and 2. failure to detect differences between the groups in terms of the patterns of DVs (a Type II error). Multivariate statistics are designed to overcome both of these problems. However, there are costs associated with these benefits, such as increased complexity, decreased power, multiple ways of answering the same question, and ambiguity in the allocation of shared variance. This is the first of a series of articles on multivariate statistical tests which will address these issues and explain their possible uses.",Streiner DL.,1993.0,,0,0,
3556,Gender differences among veterans deployed in support of the wars in Afghanistan and Iraq.,"The changing scope of women's roles in combat operations has led to growing interest in women's deployment experiences and post-deployment adjustment. To quantify the gender-specific frequency of deployment stressors, including sexual and non-sexual harassment, lack of social support and combat exposure. To quantify gender-specific post-deployment mental health conditions and associations between deployment stressors and posttraumatic stress disorder (PTSD), to inform the care of Veterans returning from the current conflicts. National mail survey of OEF/OIF Veterans randomly sampled within gender, with women oversampled. The community. In total, 1,207 female and 1,137 male Veterans from a roster of all Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans. Response rate was 48.6 %. Deployment stressors (including combat and harassment stress), PTSD, depression, anxiety and alcohol use, all measured via self-report. Women were more likely to report sexual harassment (OR = 8.7, 95% CI: 6.9, 11) but less likely to report combat (OR = 0.62, 95 % CI: 0.50, 0.76). Women and men were equally likely to report symptoms consistent with probable PTSD (OR = 0.87, 95 % CI: 0.70, 1.1) and symptomatic anxiety (OR = 1.1, 9 5% CI: 0.86, 1.3). Women were more likely to report probable depression (OR = 1.3, 95 % CI: 1.1, 1.6) and less likely to report problematic alcohol use (OR = 0.59, 9 5% CI: 0.47, 0.72). With a five-point change in harassment stress, adjusted odds ratios for PTSD were 1.36 (95 % CI: 1.23, 1.52) for women and 1.38 (95 % CI: 1.19, 1.61) for men. The analogous associations between combat stress and PTSD were 1.31 (95 % CI: 1.24, 1.39) and 1.31 (95 % CI: 1.26, 1.36), respectively. Although there are important gender differences in deployment stressors-including women's increased risk of interpersonal stressors-and post-deployment adjustment, there are also significant similarities. The post-deployment adjustment of our nation's growing population of female Veterans seems comparable to that of our nation's male Veterans.",Street AE.; Gradus JL.; Giasson HL.; Vogt D.; Resick PA.,2013.0,10.1007/s11606-013-2333-4,0,0,
3557,Impulsivity scores in patients with obsessive-compulsive disorder.,,Stein DJ.; Hollander E.; Simeon D.; Cohen L.,1994.0,,0,0,
3558,The DSM-IV-Based Generalized Anxiety Disorder Severity Scale: Preliminary validation using data from a trial of agomelatine versus placebo.,"Currently available symptom severity measures for Generalized Anxiety Disorder (GAD) are not optimal. This study investigates the reliability and validity of a new measure for GAD. The Generalized Anxiety Disorder Severity Scale (DGSS), comprising 8 DSM-IV GAD symptoms assessed in terms of frequency and intensity, was used in a trial of agomelatine versus placebo for the treatment of GAD. Internal reliability, concurrent validity, responsiveness to change, most robust items, and factor structure were computed. The DGSS demonstrated good internal reliability, correlated significantly with the Hamilton Anxiety Scale and Clinical Global Impression severity scale, and demonstrated a clear change in response to agomelatine. The most robust DGSS items were derived, and an exploratory factor analysis yielded a 2-factor structure of the DGSS. The DGSS is potentially a useful scale for the assessment of GAD in clinical trials of this disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Stein, Dan J; Fincham, Dylan; Seedat, Soraya; de Bodinat, Christian; Ahokas, Antti; Argyropoulos, Baldwin, Ballenger, Beck, Brown, Brown, Bruss, Field, Guy, Hamilton, Kaiser, Neuman, Pjrek, Shear, Shear, Spitzer, Stein",2009.0,,0,0,
3559,Efficacy of pregabalin in depressive symptoms associated with generalized anxiety disorder: A pooled analysis of 6 studies.,"Epidemiological evidence supports comorbidity of generalized anxiety disorder (GAD) and major depressive disorder (MDD) or dysthymia, and its association with significant disability. As pregabalin, a new alpha2-delta anxiolytic treatment for GAD, unlike most other licensed treatments for GAD has not undergone investigation in patients with MDD, we examined its efficacy in depressive symptoms associated with GAD, through a post-hoc analysis of the existing clinical trial database. The results provide consistent evidence that in patients with GAD pregabalin reduced associated symptoms of depression. This was seen in the 150 mg/day, 300-450 mg/day and 600 mg/day dosing groups. Even in subjects with more prominent depressive symptoms, pregabalin remained effective for both sub-syndromal depression and GAD symptoms, with pregabalin 300-450 mg/day demonstrating the most beneficial response. In conclusion, pregabalin, an alternative treatment option for GAD with a novel mechanism of action, also demonstrated efficacy in treating depressive symptoms typically encountered in GAD patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stein, Dan J; Baldwin, David S; Baldinetti, Francesca; Mandel, Francine; Alonso, Ansseau, Bagby, Baldwin, Bandelow, Bech, Bech, Bech, Bech, Bruce, Clayton, Cohen, Crofford, Dooley, Dooley, Dooley, Dworkin, Fawcett, Fehrenbacher, Feltner, Field, Fink, Freyhagen, Hamilton, Hamilton, Hettema, Hidalgo, Hunt, Hunt, Kendler, Kessler, Kroenke, Lesser, Lipman, Maneuf, Montgomery, Montgomery, Munk-Jorgensen, Murphy, Nutt, Nutt, Pande, Pohl, Pollack, Rapaport, Rapaport, Raskin, Richter, Rickels, Rosenstock, Roy-Byrne, Sabatowski, Sheehan, Siddall, Silverstone, Stein, Van Seventer, Wittchen",2008.0,,0,0,
3560,Behavioural response to m-chlorophenylpiperazine and clonidine in trichotillomania,"Administration of m-chlorophenyl-piperazine (m-CPP), a partial serotonin agonist, may lead to acute exacerbation of symptoms of obsessive-compulsive disorder (OCD), whereas administration of the alpha-2 adrenergic agonist, clonidine, may be followed by an acute decrease in symptoms. We studied behavioural response of 11 patients with trichotillomania, a disorder possibly related to OCD, to these agents and to placebo. No significant drug effects on specific trichotillomania symptoms were found. Patients experienced more of a 'high' feeling on m-CPP than on clonidine or placebo, a finding similar to that seen in patients with impulsive personality disorders.",Stein D.J.; Hollander E.; De Carcia C.; Cohen L.; Simeon D.,1997.0,,0,0,
3561,A mental health intervention for schoolchildren exposed to violence: a randomized controlled trial,"ER OBJECTIVETo evaluate the effectiveness of a collaboratively designed school-based intervention for reducing children's symptoms of PTSD and depression that has resulted from exposure to violence.DESIGNA randomized controlled trial conducted during the 2001-2002 academic year.SETTING AND PARTICIPANTSSixth-grade students at 2 large middle schools in Los Angeles who reported exposure to violence and had clinical levels of symptoms of PTSD.INTERVENTIONStudents were randomly assigned to a 10-session standardized cognitive-behavioral therapy (the Cognitive-Behavioral Intervention for Trauma in Schools) early intervention group (n = 61) or to a wait-list delayed intervention comparison group (n = 65) conducted by trained school mental health clinicians.MAIN OUTCOME MEASURESStudents were assessed before the intervention and 3 months after the intervention on measures assessing child-reported symptoms of PTSD (Child PTSD Symptom Scale; range, 0-51 points) and depression (Child Depression Inventory; range, 0-52 points), parent-reported psychosocial dysfunction (Pediatric Symptom Checklist; range, 0-70 points), and teacher-reported classroom problems using the Teacher-Child Rating Scale (acting out, shyness/anxiousness, and learning problems; range of subscales, 6-30 points).RESULTSCompared with the wait-list delayed intervention group (no intervention), after 3 months of intervention students who were randomly assigned to the early intervention group had significantly lower scores on symptoms of PTSD (8.9 vs 15.5, adjusted mean difference, - 7.0; 95% confidence interval [CI], - 10.8 to - 3.2), depression (9.4 vs 12.7, adjusted mean difference, - 3.4; 95% CI, - 6.5 to - 0.4), and psychosocial dysfunction (12.5 vs 16.5, adjusted mean difference, - 6.4; 95% CI, -10.4 to -2.3). Adjusted mean differences between the 2 groups at 3 months did not show significant differences for teacher-reported classroom problems in acting out (-1.0; 95% CI, -2.5 to 0.5), shyness/anxiousness (0.1; 95% CI, -1.5 to 1.7), and learning (-1.1, 95% CI, -2.9 to 0.8). At 6 months, after both groups had received the intervention, the differences between the 2 groups were not significantly different for symptoms of PTSD and depression; showed similar ratings for psychosocial function; and teachers did not report significant differences in classroom behaviors.CONCLUSIONA standardized 10-session cognitive-behavioral group intervention can significantly decrease symptoms of PTSD and depression in students who are exposed to violence and can be effectively delivered on school campuses by trained school-based mental health clinicians.CONTEXTNo randomized controlled studies have been conducted to date on the effectiveness of psychological interventions for children with symptoms of posttraumatic stress disorder (PTSD) that has resulted from personally witnessing or being personally exposed to violence.","Stein, B D; Jaycox, L H; Kataoka, S H; Wong, M; Tu, W; Elliott, M N; Fink, A",2003.0,10.1001/jama.290.5.603,0,0,
3562,Maternal cognitions and mother-infant interaction in postnatal depression and generalized anxiety disorder.,"Postnatal depression and anxiety have been shown to increase the risk of disturbances in mother-child interaction and child development. Research into mechanisms has focused on genetics and maternal behavior; maternal cognitions have received little attention. Our aim was to experimentally determine if worry and rumination in mothers with generalized anxiety disorder (GAD) and major depressive disorder (MDD), diagnosed in the postnatal 6 months, interfered with maternal responsiveness to their 10-month old infants. Mothers (N = 253: GAD n = 90; MDD n = 57; control n = 106) and their infants were randomized to either a worry/rumination prime (WRP) or a neutral prime (NP); mother-infant interactions were assessed before and after priming. Type of priming was a significant predictor of maternal cognitions, with WRP resulting in more negative thoughts, higher thought recurrence and more self-focus relative to NP across the entire sample. Interaction effects between group and priming were significant for two parenting variables: Compared with controls, WRP had a more negative impact on maternal responsiveness to infant vocalization for GAD, and to a lesser extent for MDD; WRP led to decreased maternal vocalization for GAD. Also, mothers with GAD used stronger control after the NP than WRP, as well as compared with other groups, and overall post-priming, their children exhibited lower emotional tone and more withdrawal. Across the entire sample, WRP was associated with increased child vocalization relative to NP. This study demonstrated that disturbances in maternal cognitions, in the context of postnatal anxiety and to a lesser degree depression, play a significant role in mother-child interaction.",Stein A.; Craske MG.; Lehtonen A.; Harvey A.; Savage-McGlynn E.; Davies B.; Goodwin J.; Murray L.; Cortina-Borja M.; Counsell N.,2012.0,10.1037/a0026847,0,0,
3563,Ligands of the GABA-benzodiazepine-receptor-complex - Recent clinical and neurobiological research,,Steiger A.; Bischoff R.C.; Dorow R.; Wetzel H.; Wiedemann K.,1992.0,,0,0,
3564,Study protocol for the OPTion randomised controlled trial on the effect of prioritising treatment goals among older patients with cancer in a palliative setting.,"Traditionally, general practitioners (GPs) are not involved in cancer-related treatment decisions, despite their often long relationship with patients, and their unique position to explore patients' values, especially with older patients. Therefore, we designed a randomised controlled trial to study the effect, on self-efficacy related to treatment decisions, of a conversation about treatment goals between GPs and patients with cancer in a palliative setting. We aim to include 168 patients aged ‚â•70 years with a diagnosis of non-curable cancer, due to consult their oncologist about treatment options. In the intervention group, patients will consult their GP using an Outcome Prioritisation Tool (OPT). The control group will receive care as usual. The primary outcome will be the score on a decision self-efficacy scale after the consultation with the oncologist. Secondary outcomes will be symptoms of depression, anxiety, or fatigue. In an embedded observational study of the intervention group, we aim to assess the prioritisation of treatment goals (i.e., OPT scores), and their determinants, over a six-month period. The OPTion study should provide relevant information about the effect on self-efficacy of a consultation between GPs and older patients with cancer, concerning preferred treatment goals in a palliative setting. Dutch Trial Register NTR5419.",Stegmann ME.; Schuling J.; Hiltermann TJ.; Reyners AK.; Burger H.; Berger MY.; Berendsen AJ.,2017.0,10.1016/j.maturitas.2016.11.014,0,0,
3565,Refractive stability of foldable intraocular lenses,"ER METHODThere was performed a two years (mean follow-up 7,4 +/- 1,2 months) prospective interventional case series study on 108 with senile cataract, without another ocular pathology which underwent cataract surgery by phacoemulsification and implantation of foldable intraocular lens (the same surgeon). Each patient had their refractive status measured at the 1-month postoperative visit, 3-months and at the 6-months follow-up visit. The results have been statistically analyzed using the Wilcoxon test.RESULTSThe postoperative refractive results were correlated with IOL design and material. The acrylic hydrophobic foldable intraocular lens with rigid haptics was more likely to move to hypermetropia and the acrylic hydrophobic foldable intraocular lens with pliable haptics showed minimal myopic movement.CONCLUSIONSOn long-term, the 1-piece acrylic hydrophobic IOL with soft acrylic loops had the most stable refractive results.PURPOSETo compare the refractive stability of different kind of foldable intraocular lenses.","Stefan, C; Nenciu, A; Cucea, R; Tebeanu, E; Malcea, C; Melinte, D; Sapundgieva, A",2006.0,,0,0,
3566,"Cost effectiveness of a multi-stage return to work program for workers on sick leave due to low back pain, design of a population based controlled trial","ER METHODSDESIGNAn RCT and cost-effectiveness evaluation in employees sick-listed for a period of 2 to 6 weeks due to low back pain. Interventions used are 1. Communication between general practitioner and occupational physician plus Participative Ergonomics protocol performed by an ergonomist. 2. Graded Activity based on cognitive behavioural principles by a physiotherapist. 3. Usual care, provided by an occupational physician according to the Dutch guidelines for the occupational health management of workers with low back pain. The primary outcome measure is return to work. Secondary outcome measures are pain intensity, functional status and general improvement. Intermediate variables are kinesiophobia and pain coping. The cost-effectiveness analysis includes the direct and indirect costs due to low back pain. The outcome measures are assessed before randomization (after 2-6 weeks on sick leave) and 12 weeks, 26 weeks and 52 weeks after first day of sick leave.DISCUSSIONThe combination of these interventions has been subject of earlier research in Canada. The results of the current RCT will: 1. crossvalidate the Canadian findings in an different sociocultural environment; 2. add to the cost-effectiveness on treatment options for workers in the sub acute phase of low back pain. Results might lead to alterations of existing (inter)national guidelines.BACKGROUNDTo describe the design of a population based randomized controlled trial (RCT), including a cost-effectiveness analysis, comparing participative ergonomics interventions between 2-8 weeks of sick leave and Graded Activity after 8 weeks of sick leave with usual care, in occupational back pain management.","Steenstra, I A; Anema, J R; Bongers, P M; Vet, H C; Mechelen, W",2003.0,10.1186/1471-2474-4-26,0,0,
3567,Waitlist-controlled trial of cognitive behavior therapy for hoarding disorder.,"This study investigated a multicomponent cognitive behavioral treatment (CBT) for hoarding based on a model proposed by Frost and colleagues and manualized in Steketee and Frost (2007). Participants with clinically significant hoarding were recruited from the community and a university-based anxiety clinic. Of the 46 patients randomly assigned to CBT or waitlist (WL), 40 completed the 12-week assessment and 36 completed 26 sessions. Treatment included education and case formulation, motivational interviewing, skills training for organizing and problem solving, direct exposure to nonacquiring and discarding, and cognitive therapy. Measures included the Saving Inventory-Revised (self-report), Hoarding Rating Scale-Interview, and measures of clinical global improvement. Between group repeated measures analyses using general linear modeling examined the effect of CBT versus WL on hoarding symptoms and moodstate after 12 weeks. Within group analyses examined pre-post effects for all CBT participants combined after 26 sessions. After 12 weeks, CBT participants benefited significantly more than WL patients on hoarding severity and mood with moderate effect sizes. After 26 sessions of CBT, participants showed significant reductions in hoarding symptoms with large effect sizes for most measures. At session 26, 71% of patients were considered improved on therapist clinical global improvement ratings and 81% of patients rated themselves improved; 41% of completers were clinically significantly improved. Multicomponent CBT was effective in treating hoarding. However, treatment refusal and compliance remain a concern, and further research with independent assessors is needed to establish treatment benefits and durability of gains.",Steketee G.; Frost RO.; Tolin DF.; Rasmussen J.; Brown TA.,2010.0,10.1002/da.20673,0,0,
3568,Outpatient treatment for male urethral strictures--dilatation versus internal urethrotomy,"ER Male patients with proven urethral strictures (total 210) were prospectively randomised to undergo either dilatation (106 patients) or internal urethrotomy (104 patients) as an outpatient procedure under local anaesthesia. The incidence of complications or failure during the performance of the procedure did not differ significantly between the two treatment groups. Complications or failure in performing urethral dilatation were significantly more common in patients who presented with retention or complications compared with symptoms only, and in those with a positive compared with negative urine cultures. Complications or failure in performing internal urethrotomy were significantly more common in patients with a positive than with a negative urine culture, and long (> 2 cm) rather than short ( 2 cm), post-traumatic, and previously untreated strictures are better managed with dilatation, whereas patients with complications or retention are better managed with internal urethrotomy. A positive urine culture is associated with a higher complication and failure rate in the performance of both procedures.","Steenkamp, J W; Heyns, C F; Kock, M L",1997.0,,0,0,
3569,Influence of buccal segment size on prevention of side effects from incisor intrusion,"ER METHODSTwenty patients, 9 to 14 years of age, seeking treatment at a private practice, were divided into 2 groups. Patients in the long buccal-segment group had maxillary buccal segments that included the canines, both premolars, and the first molars. In the short buccal-segment group, the buccal segments consisted of only the maxillary first molars. Patient records were taken at the beginning and end of maxillary incisor intrusion.RESULTSIntermolar width increased slightly in the short buccal-segment group and decreased slightly in the long buccal-segment group. More steepening of the buccal segment occurred in the short buccal-segment group, and more proclination of the anterior segment in the long buccal-segment group. The size of the buccal segment had no influence on the rate of incisor intrusion or on the amount of buccal-segment extrusion. In both groups, the mean amount of incisor intrusion exceeded 2 mm.CONCLUSIONSA buccal segment that extends from canine to first molar will help minimize the side effects of incisor intrusion.INTRODUCTIONDeep overbite can be corrected by maxillary incisor intrusion. The purpose of this study was to determine whether the size of the maxillary buccal segment influences the amount of steepening, extrusion, or narrowing of the buccal segments, or the rate of intrusion that occurs with maxillary incisor intrusion.","Steenbergen, E; Burstone, C J; Prahl-Andersen, B; Aartman, I H",2006.0,10.1016/j.ajodo.2004.06.039,0,0,
3570,Cognitive-behavioural treatment of space phobia: A case report.,"Space phobia is a well defined rare syndrome, similar but distinct from agoraphobia. Its key distinguishing feature is fear of absent visuospatial support (open spaces) and of falling. In the past, this condition has generally been considered resistant to treatment by exposure in vivo. We report a case of a 67-yr-old woman suffering from severe space phobia who received a cognitive-behavioral based treatment package. The gains that she made are described, but overall her condition remained relatively resistant to therapy. We suggest that a degree of caution regarding outcome goals at the start of any similar treatment of this rare disorder is wise. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Steels, Mark; Gilboy, Carol",1995.0,,0,0,
3571,Anterior cingulotomy for major depression: Clinical outcome and relationship to lesion characteristics.,"Background: Anterior cingulotomy (ACING) is a neurosurgical treatment for chronic refractory depression, pain, and obsessive-compulsive disorder. Anterior cingulotomy involves the placement of bilateral lesions in the anterior cingulate under stereotactic guidance. Although a long-established therapeutic intervention, the optimal location and volume of lesions are not known, but it is generally believed that efficacious lesions interrupt the fibers of the cingulum bundle. Methods: Using T2-weighted magnetic resonance imaging, we tested the hypothesis that lesions placed more anteriorly would be associated with a better clinical response. We also tested a secondary hypothesis that a superior clinical response would be associated with larger lesion volumes. Results: When assessed 12 months following surgery, a superior clinical response was associated with more anterior lesions but, unexpectedly, with smaller lesion volumes. Specifically, the best clinical response was associated with total (right plus left hemisphere) lesion volumes of 1,000 to 2,000 mm3 centered at Montreal Neurological Institute (MNI) coordinates (+/- 9,19,30). Conclusions: There is considerable evidence from neuroimaging studies that more rostral areas within the anterior cingulate cortex are functionally and structurally abnormal in patients with major depressive disorder. Anteriorly placed ACING lesions would target and modify function within such regions. It should not be assumed that larger lesions are associated with a better response. These findings of relationships between lesion characteristics and clinical response argue against the suggestion that ACING represents a placebo treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Steele, J. Douglas; Christmas, David; Eljamel, M. Sam; Matthews, Keith; Alexander, Bernard, Bush, Cohen, Devinski, Drevets, Earp, Ebmeier, Fava, Foltz, Friston, Hamilton, Matthews, McGuffin, Mega, Montgomery, Mufson, Guy, Peyron, Richter, Sackeim, Spangler, Steele, Steele, Talairach, Thase, Yen, Zigmond",2008.0,,0,0,
3572,Psycho-education and group cognitive-behavioural therapy for clinical perfectionism: a case-series evaluation.,"Research indicates that psycho-education and cognitive behavioural interventions can reduce perfectionism but to date no group treatments have been examined. The current study utilized a case series design to compare psycho-education materials and subsequent eight-week group cognitive behaviour therapy (CBT) to a baseline waitlist in an outpatient community psychiatry sample (n = 21). Participants were assessed on five occasions: baseline, 4 weeks later (waitlist), 4 weeks after receiving psycho-education material, post-treatment (8 weeks after receiving the group intervention), and 3-month follow-up. There was a main effect of time for perfectionism and negative affect from baseline to post-group (effect sizes ranging from 1.46 to 1.91) that were maintained at 3-month follow-up. These results suggested that group CBT for clinical perfectionism may be beneficial, but that psycho-education alone is not effective for reducing perfectionism or negative affect.",Steele AL.; Waite S.; Egan SJ.; Finnigan J.; Handley A.; Wade TD.,2013.0,10.1017/S1352465812000628,0,0,
3573,Preliminary results of an individually tailored psychosocial intervention for patients with advanced hepatobiliary carcinoma.,"A plethora of research now exists documenting the benefits of psychosocial interventions for cancer patients; however, no studies have been conducted with people diagnosed with hepatobiliary carcinoma. A total of 28 patients agreed to participate in the study in which 14 patients were randomized to the intervention arm of the study and 14 patients to an attention-standard of care arm. Evaluation of the benefits of the intervention was performed using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep), the Center for Epidemiological Studies-Depression, the State Trait Anxiety Index (STAI) to assess anxiety, peripheral blood leukocytes to measure immune system modulation, and survival. Results indicate that patients who were randomly assigned to the intervention arm of the study reported clinically, but not statistically, significant improvements on symptoms of depression and anxiety, disease-related symptoms and treatment side effects, health-related quality of life (HRQL), and modest improvements in peripheral blood leukocytes and survival when compared with the standard of care group. The findings of this study suggest that the individually tailored intervention was feasible and preliminary data suggested that the intervention may improve patients' HRQL, mood, and had modest improvements in immune system functioning and survival. Further research is needed with a larger sample size to test the statistical significance and generalizability of the individually tailored intervention.",Steel JL.; Nadeau K.; Olek M.; Carr BI.,2007.0,10.1300/J077v25n03_02,0,0,
3574,The PCL as a brief screen for posttraumatic stress disorder within schizophrenia.,"Objectives: To assess the utility of using the posttraumatic checklist (PCL) as a screening measure for identifying posttraumatic stress disorder (PTSD) in individuals diagnosed with a psychotic disorder. Methods: The PCL was administered to 165 participants as part of a clinical trial. Those scoring 44 or above on the PCL underwent further assessment using the clinician administered PTSD scale (CAPS). Results: Overall 18.2% of the sample exhibited a diagnostic level of PTSD symptoms, as indicated by the CAPS assessment. Only 29.7% of those who scored above the PCL threshold were diagnostic of PTSD. Conclusions: The use of PCL for identifying PTSD within this population is not recommended. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Steel, Craig; Doukani, Asmae; Hardy, Amy; Achim, Berry, Blake, Blanchard, Brewin, Brewin, De Bont, Frueh, Gearon, Grubaugh, Longden, McDonald, Mueser, Picken, Rose, Steel, Van den Berg, Weathers",2017.0,,0,0,
3575,Involuntary memories of emotional scenes: the effects of cue discriminability and emotion over time.,"Involuntary episodic memories come to mind spontaneously--that is, with no preceding retrieval attempts. Such memories are frequent in daily life, in which they are predominantly positive and often triggered by situational features matching distinctive parts of the memory. However, individuals suffering from psychological disorders, such as posttraumatic stress disorder, have stressful, repetitive, and unwanted involuntary memories about negative events in their past. These unwanted recollections are disturbing and debilitating. Although such intrusive involuntary memories are observed across a range of clinical disorders, there is no broadly agreed upon explanation of their underlying mechanisms and no successful experimental simulations of their retrieval. In a series of experiments, we experimentally manipulated the activation of involuntary episodic memories for emotional and neutral scenes and predicted their activation on the basis of manipulations carried out at encoding and retrieval. Our findings suggest that the interplay between cue discriminability at the time of retrieval and emotional arousal at the time of encoding are crucial for explaining intrusive memories following negative events. While cue distinctiveness is important directly following encoding of the scenes, emotional intensity influences retrieval after delays of 24 hr and 1 week. Voluntary remembering follows the same pattern as involuntary remembering. Our results suggest an explanatory model of intrusive involuntary memory for emotional events in clinical disorders.",Staugaard SR.; Berntsen D.,2014.0,10.1037/a0037185,0,0,
3576,Measuring alcohol craving: Development of the Alcohol Craving Experience questionnaire.,"Aims: To develop a measure of craving based on the Elaborated Intrusion (EI) theory of desire and to examine the construct, concurrent and discriminant validity of the instrument. Design: Cross-sectional. Setting and participants: Patients from a hospital alcohol and drug out-patient service (n = 230), participants in a randomized controlled trial (n = 219) and students in a university-based study of alcohol craving (n = 202) were recruited. Measurements: The Alcohol Craving Experience questionnaire (ACE) was developed to measure sensory aspects of craving (imagining taste, smell or sensations of drinking and intrusive cognitions associated with craving) when craving was maximal during the previous week (ACE-S: strength), and to assess frequency of desire-related thoughts in the past week (ACE-F: frequency). All participants completed the ACE and the Alcohol Use Disorders Identification Test (AUDIT). The Obsessive Compulsive Drinking Scale (OCDS) and the Depression Anxiety and Stress Scale (DASS) were completed by hospital patients and randomized control trial participants. Findings: Exploratory factor analysis on the ACE-S and ACE-F resulted in a three-factor structure representing imagery, intensity and intrusion. An attempt to confirm this factor structure required a reduction in items (two from ACE-S, five from ACE-F) before a good fit to the three-factor model was obtained. Concurrent validity with the OCDS, with severity of alcohol dependence and with depression, anxiety and stress, was demonstrated. The ACE discriminated between clinical and non-clinical populations and between those at higher risk of alcohol dependence and those at lower risk. Conclusions: A new scale, the Alcohol Craving Experience questionnaire, based on the Elaborated Intrusion theory of desire appears to capture key constructs of the theory and correlate with indices of alcohol dependence. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Statham, Dixie J; Connor, Jason P; Kavanagh, David J; Feeney, Gerald F. X; Young, Ross Mc. D; May, Jon; Andrade, Jackie; Anton, Anton, Anton, Anton, Babor, Bohn, Bottlender, Bush, Carter, Connor, Connor, Dolman, Flannery, Goodman, Hickie, Ho, Kavanagh, Kavanagh, Kemps, Kemps, Kranzler, Lovibond, May, May, Modell, Najmi, Nakovics, Pett, Saunders, Tabachnick, Yoon",2011.0,,0,0,
3577,The relationship of alexithymia to emotional dysregulation within an alcohol dependent treatment sample.,"Difficulties regulating emotions have implications for the development, maintenance, and recovery from alcohol problems. One construct thought to impede the regulation of emotion is alexithymia. Alexithymia is characterized by difficulties identifying, differentiating and expressing feelings, a limited imagination and fantasy life, and an externally-oriented thinking style (e.g., prefer talking about daily activities rather than feelings). Given that poor emotion regulation skills have been found to predict posttreatment levels of alcohol use, and that several defining characteristics of alexithymia bear similarity to deficits in emotion regulation skills, it is possible that alexithymia may predict poorer alcohol treatment outcomes. Thus, the present study first examined the relationship of alexithymia to several other emotion regulation measures and then investigated the impact of alexithymia on attrition and alcohol treatment outcomes in men and women (N=77) enrolled in a 12-week cognitive-behavioral intervention for alcohol dependence. At baseline, higher scores on alexithymia were associated poorer emotion regulation skills, fewer percent days abstinent, greater alcohol dependence severity, and several high-risk drinking situations. Alexithymia was unrelated to attrition and to level of alcohol consumption at posttreatment. Overall, the construct of alexithymia is shown to be related to several theoretically-related constructs (e.g., emotion regulation, mindfulness) but demonstrated a limited relationship to drinking outcomes in those seeking treatment for alcohol dependence.",Stasiewicz PR.; Bradizza CM.; Gudleski GD.; Coffey SF.; Schlauch RC.; Bailey ST.; Bole CW.; Gulliver SB.,2012.0,10.1016/j.addbeh.2011.12.011,0,0,
3578,Mood as input and catastrophic worrying.,"The authors describe 3 experiments investigating a ""mood-as-input"" approach to understanding catastrophic worrying. Experiment 1 found that induced negative mood increased the number of steps emitted in both a catastrophizing interview procedure and a positive iteration task. Experiment 2 found that the number of items that worriers emitted in an iterative item generation task was dependent on the stop rules specified by the procedure. Experiment 3 found that manipulating the stop rules for catastrophizing had differential effects on worriers and nonworriers, depending on the nature of the stop rules specified. These results suggest that mood provides information about continuing or terminating the catastrophizing process that is interpreted in the context of the stop rules for the task. It is argued that the mood-as-input hypothesis accounts for the facts of exacerbated catastrophizing in worriers better than explanations couched in terms of either mood congruency effects or worriers possessing a generalized perseverative iterative style.",Startup HM.; Davey GC.,2001.0,,0,0,
3579,Inflated responsibility and the use of stop rules for catastrophic worrying,"ER The present paper reports the results of two experiments designed to test some predictions from a mood-as-input explanation of catastrophic worrying (). In particular, these experiments attempted to identify whether worriers possess characteristics that would contribute to the use of relatively strict 'as many as can' closure rules for catastrophising. Experiment 1 demonstrated that high worriers begin a catastrophising task with higher self-reported levels of responsibility towards fully considering all issues involved, than low worriers. Experiment 2 suggested that inflated responsibility has a causal effect on perseveration at the catastrophising task (rather than being a simple non-causal by-product of excessive worrying), and that inflated responsibility exacerbates catastrophising only in conjunction with negative mood. This suggests a relatively complex relationship between responsibility and mood, where there are mood conditions in which high responsibility does not generate greater persistence than low responsibility. These findings are consistent with predictions from a mood-as-input account of catastrophic worrying, and provide evidence for a putative mechanism that mediates the influence of variables such as inflated responsibility on perseveration.","Startup, H M; Davey, G C",2003.0,,0,0,
3580,Effectiveness and underlying mechanisms of a group-based cognitive behavioural therapy-based indicative prevention program for children with elevated anxiety levels,"ER METHODS/DESIGN: Coping Cat will be tested in Dutch primary school children grades five through eight (ages 7 to 13) with elevated levels of anxiety. This RCT has two conditions: 130 children will be randomly assigned to the experimental (N=65, Coping Cat) and control groups (N=65, no program). All children and their mothers will be asked to complete baseline, post intervention, and 3-month follow-up assessments. In addition, children in both the experimental and control group will be asked to complete 12 weekly questionnaires matched to the treatment sessions. Main outcome measure will be the child's anxiety symptoms level (SCAS). Four potential mediators will be examined, namely active coping, positive cognitive restructuring, self efficacy and cognitions about ones coping ability (from now on coping cognitions).DISCUSSION: It is hypothesized that children in the experimental condition will experience reduced levels of anxiety in comparison with the control group. Further, active coping, positive cognitive restructuring, and coping cognitions are expected to mediate program effectiveness. If Coping Cat proves effective as a prevention program and working mechanisms can be found, this group-based approach might lead to the development of a cost-effective program suitable for prevention purposes that would be easily implemented on a large scale.TRIAL REGISTRATION: Nederlands Trial Register NTR3818.BACKGROUND: Anxiety is a problem for many children, particularly because of its negative consequences not only on the wellbeing of the child, but also on society. Adequate prevention and treatment might be the key in tackling this problem. Cognitive behavioural therapy (CBT) has been found effective for treating anxiety disorders. ""Coping Cat"" is one of the few evidence-based CBT programs designed to treat anxiety symptoms in children. The main aim of this project is to conduct a Randomized Controlled Trial (RCT) to evaluate the effectiveness of a Dutch version of Coping Cat as an indicative group-based prevention program. The second aim is to gain insight into the mechanisms underlying its effectiveness.","Starrenburg, M L; Kuijpers, R C; Hutschemaekers, G J; Engels, R C",2013.0,10.1186/1471-244X-13-183,0,0,
3581,Neurotransplantation--a new method of treatment in psychiatry?,"The authors present the results of their catamnestic evaluation of the first few patients (diagnosis of schizophreny; atrophic process posttraumatic and Alzheimer's dementia), in whom implantation of neuronal embryonal tissue into the brain was performed in the last few years. They warn against excessive publicity and optimistic appraisal by neurosurgeons because psychiatric examinations after some time fail to confirm the success of the operation.",St√°rkov√° L.; Mrna B.; Bartosov√° S.,1993.0,,0,0,
3582,Self-esteem treatment in anxiety: A randomized controlled crossover trial of Eye Movement Desensitization and Reprocessing (EMDR) versus Competitive Memory Training (COMET) in patients with anxiety disorders.,"Background and purpose: Little is known about treating low self-esteem in anxiety disorders. This study evaluated two treatments targeting different mechanisms: (1) Eye Movement Desensitization and Reprocessing (EMDR), which aims to desensitize negative memory representations that are proposed to maintain low self-esteem; and (2) Competitive Memory Training (COMET), which aims to activate positive representations for enhancing self-esteem. Methods: A Randomized Controlled Trial (RCT) was used with a crossover design. Group 1 received six sessions EMDR first and then six sessions COMET; group 2 vice versa. Assessments were made at baseline (T0), end of first treatment (T1), and end of second treatment (T2). Main outcome was self-esteem. We included 47 patients and performed Linear Mixed Models. Results: COMET showed more improvements in self-esteem than EMDR: effect-sizes 1.25 versus 0.46 post-treatment. Unexpectedly, when EMDR was given first, subsequent effects of COMET were significantly reduced in comparison to COMET as the first intervention. For EMDR, sequence made no difference. Reductions in anxiety and depression were mediated by better self-esteem. Conclusions: COMET was associated with significantly greater improvements in self-esteem than EMDR in patients with anxiety disorders. EMDR treatment reduced the effectiveness of subsequent COMET. Improved self-esteem mediated reductions in anxiety and depression symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Staring, A. B. P; van den Berg, D. P. G; Cath, D. C; Schoorl, M; Engelhard, I. M; Korrelboom, C. W; Baron, Beck, Brewin, Cohen, Craske, de Jongh, Durham, Engelhard, Hayes, Hayes, Julian, Kesting, Korrelboom, Korrelboom, Korrelboom, Leary, Lecomte, Lobbestael, Nijdam, Okun, Preacher, Schmitt, Shapiro, Shapiro, Sowislo, van den Hout, van den Hout, van der Gaag, van Tuijl, van Vliet, Wanders, Wongpakaran, Yen, Zeigler-Hill",2016.0,,0,0,
3583,Characteristics of agoraphobia in women and men with panic disorder with agoraphobia.,"We compared female and male patients with panic disorder with agoraphobia (PDA) in terms of characteristics of agoraphobia (AG). Ninety-five patients (73 women and 22 men) with the SCID-based diagnosis of PDA were administered the National Institute of Mental Health Panic Questionnaire (NIMH PQ), and women and men were compared on the items of the NIMH PQ that pertain to AG and symptoms of panic attacks. Male and female patients did not differ significantly with respect to demographic characteristics, age of onset of panic disorder and AG, duration of PDA, and severity and frequency of symptoms experienced during panic attacks. Women avoided more situations than did men, but this difference was not statistically significant. Women avoided buses and being in unfamiliar places alone significantly more often. The only situation that was avoided more often by men, although not significantly, was staying at home alone. Women were significantly more likely to stay at home to avoid agoraphobic situations and significantly less likely to go outside of home alone. When going outside, women required a companion significantly more often. There were significantly more married women than married men who required a spouse as a companion, and significantly more women with children than men with children who required a child as a companion. Women thought that AG had affected the overall quality of their lives significantly more adversely. Whereas the overall ""profile"" of agoraphobic situations does not seem to distinguish between female and male patients with AG, females may be more impaired and appear more dependent than men in terms of requiring companions to move outside of the home. Cultural and psychological factors may be most likely to account for these findings.",Starcevic V.; Djordjevic A.; Latas M.; Bogojevic G.,1998.0,,0,0,
3584,Discrimination between safe and unsafe stimuli mediates the relationship between trait anxiety and return of fear,"Individuals with anxiety disorders show deficits in the discrimination between a cue that predicts an aversive outcome and a safe stimulus that predicts the absence of that outcome. This impairment has been linked to increased spontaneous recovery of fear following extinction, however it is unknown if there is a link between discrimination and return of fear in a novel context (i.e. context renewal). It is also unknown if impaired discrimination mediates the relationship between trait anxiety and either spontaneous recovery or context renewal. The present study used a differential fear conditioning paradigm to examine the relationships between trait anxiety, discrimination learning, spontaneous recovery and context renewal in healthy volunteers. Fear learning was assessed using continuous ratings of US expectancy and subjective ratings of fear. Discrimination mediated the relationships between trait anxiety and both spontaneous recovery and context renewal such that elevated trait anxiety was associated with poorer discrimination, which in turn was associated with increased fear at test phases. Results are discussed in terms of the genesis and maintenance of anxiety disorders.",Staples-Bradley L.K.; Treanor M.; Craske M.G.,2016.0,10.1080/02699931.2016.1265485,0,0,
3585,"Evaluating the cognitive avoidance model of generalised anxiety disorder: impact of worry on threat appraisal, perceived control and anxious arousal.","Generalised anxiety disorder (GAD) is characterised by persistent and uncontrollable worry. According to the cognitive avoidance theory of GAD, worry may function as an affective dampening strategy motivated by intolerance of negative emotional states. By facilitating avoidance of more distressing cognitions and associated affect, worry is said to preclude modification of the fear representation in memory, maintaining threat associations and perpetuating further anxiety and worry. The present study evaluated these assumptions in a treatment-seeking GAD sample. Sixty-one participants were randomly allocated to conditions in which they were instructed to worry, imaginally process or relax in response to an anxiety trigger. Results supported the detrimental impact of worry, showing maintained threat expectancies and decreased control perceptions compared to other modes of processing. However, skin conductance level increased as a function of worry and there was no suggestion that worry suppressed affective responding. These findings highlight the need for clarification of the mechanisms involved in the maintenance of threat associations and worry in GAD.",Stapinski LA.; Abbott MJ.; Rapee RM.,2010.0,10.1016/j.brat.2010.07.005,0,0,
3586,"Outcomes from the Moving Beyond Cancer psychoeducational, randomized, controlled trial with breast cancer patients.","Evidence suggests that the re-entry phase (ie, early period after medical treatment completion) presents distinct challenges for cancer patients. To facilitate the transition to recovery, we conducted the Moving Beyond Cancer (MBC) trial, a multisite, randomized, controlled trial of psychoeducational interventions for breast cancer patients. Breast cancer patients were registered within 6 weeks after surgery. After medical treatment, they completed baseline measures and were randomly assigned to standard National Cancer Institute print material (CTL); standard print material and peer-modeling videotape (VID); or standard print material, videotape, two sessions with a trained cancer educator, and informational workbook (EDU). Two primary end points were examined: energy/fatigue and cancer-specific distress. Secondary end points were depressive symptoms and post-traumatic growth. Perceived preparedness for re-entry was analyzed as a moderator of effects. Of 558 women randomly assigned to treatment, 418 completed the 6-month assessment and 399 completed the 12-month assessment. In analyses controlling for study site and baseline depressive symptoms, VID produced significant improvement in energy/fatigue at 6 months relative to CTL, particularly among women who felt less prepared for re-entry at baseline. No significant main effect of the interventions emerged on cancer-specific distress, but EDU prompted greater reduction in this outcome relative to CTL at 6 months for patients who felt more prepared for re-entry. Between-group differences in the primary outcomes were not significant at 12 months, and no significant effects emerged on the secondary end points. A peer-modeling videotape can accelerate the recovery of energy during the re-entry phase in women treated for breast cancer, particularly among those who feel less prepared for re-entry.",Stanton AL.; Ganz PA.; Kwan L.; Meyerowitz BE.; Bower JE.; Krupnick JL.; Rowland JH.; Leedham B.; Belin TR.,2005.0,10.1200/JCO.2005.09.101,0,0,
3587,Project connect online: Trial of a web-based program to chronicle the breast cancer experience and facilitate social network communication,"Most commonly, breast cancer is not experienced in isolation, but rather by the woman within a nexus of loved ones and friends. Supportive relationships serve as buffers for the stresses accompanying breast cancer. Moreover, evidence suggests that expressing cancer-related emotions can promote psychological and physical health in breast cancer patients. However, communication with the social network and adaptive expression of feelings can pose challenges both for the person who confronts breast cancer and for supportive others. Project Connect Online is a preliminary randomized, controlled trial of an intervention for women with breast cancer to design personal web pages in order to chronicle their experience and communicate with their social network. Women (N = 88) diagnosed with breast cancer (any stage, any point since diagnosis) were assigned randomly to participate in a 3-hour workshop for hands-on creation of personal web pages, as well as a follow-up call to facilitate web page use, or to a standard care control. Assessed prior to randomization and 1 month and 6 months following the intervention, dependent variables included depressive symptoms (Center for Epidemiologic Studies-Depression scale), cancer-related intrusive thoughts (Impact of Event Scale-Intrusion), and selected subscales of the Posttraumatic Growth Inventory, a measure of perceived cancer-related benefits. Relative to control participants, women randomized to the intervention evidenced significant improvement at 6 months in depressive symptoms, F(1,70) = 4.02, p = .049, cancer-related intrusive thoughts, F(1,71) = 6.01, p = .017, and life appreciation, F(1,72) = 5.13, p = .027. Treatment status significantly moderated the intervention effects, such that women currently undergoing medical treatment benefitted more from the intervention than did women who had completed treatment. Findings suggest the promise of an intervention to facilitate the ability of women diagnosed with breast cancer to chronicle their experience and communicate with their social network.",Stanton A.L.; Thompson E.H.,2011.0,,0,0,
3588,Bringing late-late anxiety treatment to the community: Open trial of calmer life program,"Introduction: The prevalence of Generalized Anxiety Disorder (GAD) is high among older adults and is associated with multiple negative physical and mental health outcomes. Cognitive behavior therapy (CBT) is efficacious in treating GAD in older adults (Ayers, Sorrell, Thorp & Wetherell, 2007). However, all outcome studies have been conducted in academic and primary care settings and with relatively homogeneous samples, limiting translational value. Representation of minority groups in treatment of late-life anxiety remains low despite a push from NIMH to increase participation from minority and underrepresented groups in treatment research. Consequently, the field needs to move toward developing wide-ranging strategies to test CBT with a broader and more representative spectrum of older adults. The proposed poster will describe the Calmer Life program and present data on pilot participants. Methods: Calmer Life program is a treatment study targeting anxiety in older adults living in underserved, largely minority communities. To address barriers to minority participation in treatment studies, Calmer Life program established strong academic-community partnerships with faith-based and social service organizations to conduct community-based recruitment. Inclusion criteria were broadened to include both GAD and anxiety disorder NOS, and modifications in treatment procedures, content, and delivery options were added to facilitate participant tailoring and choice. The program was offered to people who live, work or worship in four targeted underserved geographic areas. Participants had options related to delivery site (community sites, telephone, in-home), number of sessions (6 to 12), and skills they wanted to learn, including the option to incorporate religious and/or spiritual coping skills to standard CBT coping skills. The decision to offer inclusion of religious and/or spiritual coping in the treatment content was informed by two converging lines of evidence, namely the positive role of religious/spiritual coping in mental health (Pargament & Raiya, 2007) and literature supporting use of religion/spiritual coping (Propst, Watkins, Dean & Mashburn, 1992; Taylor, Chatters, Jayakody & Levin, 1996; Taylor, Mattis & Chatters, 1999). These modifications were expected to enhance the efficacy and acceptability of CBT for anxiety among African Americans. Results: The pilot study is ongoing. Currently, 10 participants with GAD or ADNOS have been included and three participants have completed the active treatment. Participants were nine African American and one Caucasian female with a mean age of 62.2 years old (range 51-67 years). Four participants reported being married, two divorced, one separated, one widowed, and two never married. Mean education was 14.6 years (range 12-20 years) and two participants reported an income less than 10k, six reported income between 10k and 40k, and two participants reported income greater than 60k. For those who have completed treatment to date, average number of sessions was 6.33 (range 6-7). All three self-identified as Protestant, and two of the three chose to include religious/spiritual skills in their treatment. All sessions were conducted in person except for one phone session completed with one participant; two of the three participants met for sessions at a community center, and the third participant was seen in her home. Each participant received four core sessions (Awareness, Breathing, Calming Thoughts, and Maintenance). Other skills selected included Forgiveness of Others (n =1), Forgiveness of Self (n = 1), PMR (n = 2), Sleep Skills (n = 1), Thought Stopping (n = 1), and Changing Behavior for Worry (n = 1). Data on the three participants who have completed 3-month post treatment assessment suggest decrease in worry severity [PSWQ-A: baseline = 31 (SD = 3.61); 3-month = 23.7 (SD = 5.69)], anxiety [Geriatric Anxiety Inventory: baseline = 12 (SD = 1.73); 3-month = 4.3 (SD = 4.51)], and insomnia [Insomnia Severity Index: baseline = 10.7 (SD = 2.08); 3-month = 4.3 (SD = 2.08)]. Although depression severity was low, Geriatric Depression Scale scores decreased over time [baseline = 3.67 (SD = 2.08); 3month = 1.33 (SD = 2.31)]. Conclusions: It will be important to test the efficacy of the Calmer Life program in a randomized controlled trial with a larger sample of minority participants.",Stanley M.A.; Shrestha S.; Armento M.; Calleo J.S.; Bush A.; Scott-Gurnell K.; Harris T.B.; Kunik M.E.; Wilson N.,2011.0,10.1097/01.JGP.0000395253.20665.35,0,0,
3589,Transforming trauma: a qualitative feasibility study of integrative restoration (iRest) yoga Nidra on combat-related post-traumatic stress disorder.,"This eight-week study examined the feasibility of offering weekly classes in Integrative Restoration (iRest), a form of mindfulness meditation, to military combat veterans at a community mental health agency in the San Francisco Bay Area. Participants were 16 male combat veterans (15 Vietnam War and 1 Iraq War) of mixed ethnicity, aged 41 to 66 years, suffering from posttraumatic stress disorder (PTSD). The 11 participants who completed the study reported reduced rage, anxiety, and emotional reactivity, and increased feelings of relaxation, peace, self-awareness, and self-efficacy, despite challenges with mental focus, intrusive memories, and other concerns. All participants reported they would have attended ongoing iRest classes at the agency approximately once per week.",Stankovic L.,2011.0,,0,0,
3590,Cognitive therapy for social phobia: individual versus group treatment.,"Cognitive-behavioural group treatment is the treatment of choice for social phobia. However, as not all patients benefit, an additional empirically validated psychological treatment would be of value. In addition, few studies have examined whether a group treatment format is more effective than an individual treatment format. A randomized controlled trial addressed these issues by comparing individual cognitive therapy, along the lines advocated by Clark and Wells (Clark, D.M. and Wells, A., 1995. A cognitive model of social phobia. In: R. G. Heimberg, M. Liebowitz, D. Hope and F. Schneier (Eds.), Social Phobia: Diagnosis, assessment, and treatment (pp. 69-93). New York: Guilford.), with a group version of the treatment and a wait-list control condition. 71 patients meeting DSM-IV criteria for social phobia participated in the trial, 65 completed the posttreatment assessment and 59 completed a six-month follow-up. Social phobia measures indicated significant pretreatment to posttreatment improvement in both individual and group cognitive therapy. Individual cognitive therapy was superior to group cognitive therapy on several measures at both posttreatment and follow-up. The effects of treatment on general measures of mood and psychopathology were less substantial than the effects on social phobia. The results suggest that individual cognitive therapy is a specific treatment for social phobia and that it's effectiveness may be diminished by delivery in a group format.",Stangier U.; Heidenreich T.; Peitz M.; Lauterbach W.; Clark DM.,2003.0,,0,0,
3591,Neural markers of attention to aversive pictures predict response to cognitive behavioral therapy in anxiety and depression.,"Excessive attention toward aversive information may be a core mechanism underlying emotional disorders, but little is known about whether this is predictive of response to treatments. We evaluated whether enhanced attention toward aversive stimuli, as indexed by an event-related potential component, the late positive potential (LPP), would predict response to cognitive behavioral therapy (CBT) in patients with social anxiety disorder and/or major depressive disorder. Thirty-two patients receiving 12 weeks of CBT responded to briefly-presented pairs of aversive and neutral pictures that served as targets or distracters while electroencephaolography was recorded. Patients with larger pre-treatment LPPs to aversive relative to neutral distracters (when targets were aversive) were more likely to respond to CBT, and demonstrated larger reductions in symptoms of depression and anxiety following treatment. Increased attention toward irrelevant aversive stimuli may signal attenuated top-down control, so treatments like CBT that improve this control could be beneficial for these individuals. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Stange, Jonathan P; MacNamara, Annmarie; Barnas, Olga; Kennedy, Amy E; Hajcak, Greg; Phan, K. Luan; Klumpp, Heide; Andreescu, Bar-Haim, Bar-Haim, Barlow, Beck, Beck, Beesdo, Bishop, Bishop, Bishop, Brown, Bruder, Busner, Canli, Craske, Cuthbert, Desseilles, Desseilles, Dillon, Doehrmann, Etkin, Eysenck, First, Fu, Gibb, Hajcak, Hajcak, Hamilton, Hamilton, Hofmann, Hofmann, Hope, Jaycox, Johnco, Kashdan, Kaufman, Kemp, Kessler, Kessler, Kessler, Kircanski, Klumpp, Klumpp, Kujawa, Lang, Leutgeb, Li, Liu, MacNamara, MacNamara, MacNamara, MacNamara, MacNamara, Martell, Mathews, Mathews, Miller, Mineka, Paulus, Peckham, Pessoa, Phan, Pishyar, Proudfit, Proudfit, Ritchey, Rodebaugh, Sabatinelli, Sanislow, Siegle, Simpson, Stange, Stein, Streb, Tillfors, Tracy, Waters, Weinberg, Weinberg, Weinberg, Whalen, Whelton",2017.0,,0,0,
3592,Impact of threat relevance on P3 event-related potentials in combat-related post-traumatic stress disorder,"The purpose of this study was to examine electrophysiological response to trauma-relevant stimuli in combat-related post-traumatic stress disorder (PTSD). Study design incorporated comparison of 10 Vietnam War veterans with PTSD diagnosis to 10 Vietnam War veterans with no mental disorder diagnosis on P3 components in a series of two oddball tasks (trauma-relevant threat, trauma-irrelevant threat) counterbalanced for order. Each task included high probability emotionally neutral distractor words and low probability neutral target words, but differed in the content of low probability threat words. Whereas threat words in the trauma-relevant oddball task pertained directly to combat trauma, threat words in the trauma-irrelevant oddball task were socially threatening words. Results revealed that, in comparison to healthy combat veterans, those diagnosed with PTSD demonstrated: (a) attenuated P3 response to neutral target items at selected electrode sites across both oddball tasks; and (b) increased responsivity to trauma-relevant combat stimuli but not to trauma-irrelevant social-threat stimuli at frontal electrode sites (F3, F4). Results are consistent with resource allocation models of PTSD, which suggest that PTSD is characterized by attentional bias to threat stimuli at the expense of attention to emotionally neutral information. © 2001 Elsevier Science Ireland Ltd.",Stanford M.S.; Vasterling J.J.; Mathias C.W.; Constans J.I.; Houston R.J.,2001.0,10.1016/S0165-1781(01)00236-0,0,0,
3593,A randomized double blind group comparative study of sulpiride and amitriptyline in affective disorder,"ER A randomized double blind group comparison study of sulpiride and amitriptyline was carried out in 36 patients suffering from major depressive disorder (DSM III criteria). Sulpiride showed equivalent antidepressant activity to amitriptyline at 4, 6 and 12 weeks, using the Hamilton Rating Scale (HRS) and the Wakefield Self-Rating Scale for depression (WRS). However, at 24 weeks the antidepressant activity of amitriptyline was just statistically significantly better than that of sulpiride. Timing of onset of action was comparable in both drugs. The anxiolytic activity of sulpiride was equivalent to that of amitriptyline at 4, 6, 12 and 24 weeks using the Salkind Manifest Anxiety Inventory as a measure. There were no significant differences between the two groups, of variables measured by the Crown-Crisp Experiential Index, a life events scale and Paykel's Social Adjustment Scale.","Standish-Barry, H M; Bouras, N; Bridges, P K; Watson, J P",1983.0,,0,0,
3594,The effect of flavor principles on willingness to taste novel foods,"E. Rozin and P. Rozin have suggested that one of the functions of 'flavor principles' (the distinctive seasoning combinations which characterize many cuisines) is to facilitate the introduction of novel staple foods into a culture by adding sufficient familiarity to decrease the neophobia ordinarily produced by a new food. We tested this idea experimentally, predicting that the addition of a familiar flavor principle to a novel food would increase individuals willingness to taste it, in comparison to their willingness to taste the same food in the absence of the flavor principle. Since people have little reluctance to approach familiar foods, addition of a familiar flavor principle to a familiar food should have little effect on willingness to taste it. In a pilot study, subjects selected from a list, a sauce which was high in familiarity and liking for them. They then rated their willingness to taste one novel and one familiar food with the sauce and one of each with no sauce. Subjects did not actually see any foods - the familiar and novel foods were simply described - and they were aware that they would not actually be tasting any foods. In the study proper, subjects rated their willingness to try each of the four food/sauce combinations described above. In this study, they actually saw the foods they were rating and were under the impression their ratings would determine what they would taste later in the study. In both studies, the addition of a familiar sauce to a novel food increased subjects' willingness to taste it (in comparison to the same food with no sauce) while the addition of a sauce to a familiar food either had no effect or decreased subjects' willingness to taste it. In the pilot study, the 'flavor principle' effect interacted with subjects' levels of food adventurousness.",Stallberg-White C.; Pliner P.,1999.0,10.1006/appe.1999.0263,0,0,
3595,A randomised controlled trial to determine the effectiveness of an early psychological intervention with children involved in road traffic accidents,"ER DESIGNRandomised controlled trial.SETTINGAccident and Emergency Department, Royal United Hospital, Bath.SUBJECTS158 children aged 7-18. Follow-up assessment completed eight months post accident with 132 (70/82 of the experimental group and 62/76 in the control group).MAIN OUTCOME MEASURESSelf-completed measures of psychological distress; fulfilment of diagnostic criteria for post-traumatic stress disorder.RESULTSChildren in both groups demonstrated considerable improvements at follow-up. The early intervention did not result in any additional significant gains.CONCLUSIONSAlthough children in this study made significant improvements it is unclear whether these are better or worse than natural recovery rates. The specific intervention did not result in additional gains although the structured assessment provided for both groups may have been helpful in reducing subsequent pathology.OBJECTIVETo determine whether an early intervention using a psychological debriefing format is effective in preventing psychological distress in child road traffic accident survivors.","Stallard, P; Velleman, R; Salter, E; Howse, I; Yule, W; Taylor, G",2006.0,10.1111/j.1469-7610.2005.01459.x,0,0,
3596,"Computerized CBT (Think, Feel, Do) for depression and anxiety in children and adolescents: outcomes and feedback from a pilot randomized controlled trial","ER AIMSTo describe the development of a cCBT intervention (Think, Feel, Do) for young people, and preliminary outcomes and feedback from a pilot randomized controlled trial.METHODTwenty participants aged 11 to 16 with depression or anxiety were randomized to receive cCBT immediately or after a delay. Standardized measures were used to assess self-reported anxiety, depression, self-esteem and cognitions, as well as parent rated strengths and difficulties. A feedback form was also completed to assess young people's views of the programme.RESULTSA total of 15 participants completed the pre and post assessments in the trial, and 17 provided feedback on the intervention. Paired samples t-tests demonstrated significant improvements on 3 subscales in the control condition, compared to 7 subscales in the cCBT condition. Feedback showed moderate to high satisfaction for participants.CONCLUSIONSThis study provides encouraging preliminary results for the effectiveness and acceptability of cCBT with this age group.BACKGROUNDResearch has demonstrated the effectiveness of computerized cognitive behaviour therapy (cCBT) for depression and anxiety in adults, but there has been little work with children and adolescents.","Stallard, P; Richardson, T; Velleman, S; Attwood, M",2011.0,10.1017/S135246581000086X,0,0,
3597,A cluster randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of classroom-based cognitive-behavioural therapy (CBT) in reducing symptoms of depression in high-risk adolescents,"ER BACKGROUND: Depression in adolescents is a significant problem that impairs everyday functioning and increases the risk of severe mental health disorders in adulthood. Although this is a major problem, relatively few adolescents with, or at risk of developing, depression are identified and referred for treatment. This suggests the need to investigate alternative approaches whereby preventative interventions are made widely available in schools.OBJECTIVE: To investigate the clinical effectiveness and cost-effectiveness of classroom-based cognitive-behavioural therapy (CBT) in reducing symptoms of depression in high-risk adolescents.DESIGN: Cluster randomised controlled trial. Year groups ( n = 28) randomly allocated on a 1 : 1 : 1 basis to one of three trial arms once all schools were recruited and balanced for number of classes, number of students, Personal, Social and Health Education (PSHE) lesson frequency, and scheduling of PSHE.SETTING: Year groups 8 to 11 (ages 12-16 years) in mixed-sex secondary schools in the UK. Data were collected between 2009 and 2011.PARTICIPANTS: Young people who attended PSHE at participating schools were eligible ( n = 5503). Of the 5030 who agreed to participate, 1064 (21.2%) were classified as 'high risk': 392 in the classroom-based CBT arm, 374 in the attention control PSHE arm and 298 in the usual PSHE arm. Primary outcome data on the high-risk group at 12 months were available for classroom-based CBT ( n = 296), attention control PSHE ( n = 308) and usual PSHE ( n = 242).INTERVENTIONS: The Resourceful Adolescent Programme (RAP) is a focused CBT-based intervention adapted for the UK (RAP-UK) and delivered by two facilitators external to the school. Control groups were usual PSHE (usual school curriculum delivered by teachers) and attention control (usual school PSHE with additional support from two facilitators). Interventions were delivered universally to whole classes.PRIMARY OUTCOMES: Clinical effectiveness: symptoms of depression [Short Mood and Feelings Questionnaire (SMFQ)] in adolescents at high risk of depression 12 months from baseline. Cost-effectiveness: incremental cost-effectiveness ratios (ICERs) based on SMFQ score and quality-adjusted life-years (from European Quality of Life-5 Dimensions scores) between baseline and 12 months. Process evaluation: reach, attrition and qualitative feedback from service recipients and providers.RESULTS: SMFQ scores had decreased for high-risk adolescents in all trial arms at 12 months, but there was no difference between arms [classroom-based CBT vs. usual PSHE adjusted difference in means 0.97, 95% confidence interval (CI) -0.34 to 2.28; classroom-based CBT vs. attention control","Stallard, P; Phillips, R; Montgomery, A A; Spears, M; Anderson, R; Taylor, J; Araya, R; Lewis, G; Ukoumunne, O C; Millings, A; Georgiou, L; Cook, E; Sayal, K",2013.0,10.3310/hta17470,0,0,
3598,Insecure attachment as a predictor of outcome following inpatient trauma treatment for women survivors of childhood abuse.,"The role of insecure attachment as a predictor of outcome was investigated in 134 women who reported histories of child abuse and completed an inpatient program for treatment of traumatic stress. Multiple linear regressions were used to predict the change scores on four outcome measures at discharge and 6-month follow-up. Higher levels of feared loss of the attachment figure independent of demographics, symptomatic severity, and trauma exposure consistently predicted poorer outcome at both post-tests. Interventions that focus on internal models of attachment and current attachment relationships may improve outcome in women reporting severe abuse in childhood. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stalker, Carol A; Gebotys, Robert; Harper, Kim; Allen, Bloom, Bowlby, Cameron, Cohen, Courtois, Cutrona, Cutrona, Derogatis, Dozier, Falsetti, Falsetti, Forbes, Ford, Gottlieb, Herman, Muller, Muller, Palmer, Pearlman, Resnick, Roche, Rosenberg, Shalev, Silber, Stalker, Stalker, Stovall, van der Kolk, Vaux, West, West, West, West, West, West, West, Wright, Wright",2005.0,,0,0,
3599,A comparison of short-term group and individual therapy for sexually abused women.,"Compared the effectiveness of 10 sessions of group therapy with that of 10 sessions of individual therapy in a sample of 86 adult women seeking treatment for the effects of childhood sexual abuse. Participants were randomly assigned to the 2 treatment modalities and tested at assessment, pretherapy following a 10-wk wait condition, posttherapy, and 6-mo and 12-mo follow-up. Measures included the Symptom Check List, the Dissociative Experiences Scale, the Posttraumatic Stress Scale, and the Global Assessment Scale. Participants had fewer symptoms and better psychosocial functioning posttherapy and were further improved at the 6- and 12-mo follow-up. Neither treatment modality was superior to the other. Approximately one-half of the sample sought further treatment during the follow-up periods. Improvement in symptoms and functioning was associated with short-term treatment in both modalities, but many patients remained distressed and required further treatment. Future research should investigate whether sexually abused women who meet criteria for specific diagnoses require more focused and/or longer-term therapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stalker, Carol A; Fry, Richard",1999.0,,0,0,
3600,Improving the retention rate for residential treatment of substance abuse by sequential intervention for social anxiety.,"Residential drug rehabilitation is often seen as a treatment of last resort for people with severe substance abuse issues. These clients present with more severe symptoms, and frequent psychiatric comorbidities relative to outpatients. Given the complex nature of this client group, a high proportion of clients seeking treatment often do not enter treatment, and of those who do, many exit prematurely. Given the highly social nature of residential drug rehabilitation services, it has been argued that social anxieties might decrease the likelihood of an individual entering treatment, or increase the likelihood of them prematurely exiting treatment. The current paper reports on the protocol of a Randomised Control Trial which examined whether treatment of social anxiety prior to entry to treatment improves entry rates and retention in residential drug rehabilitation. A Randomised Control Trial comparing a social skills treatment with a treatment as usual control group was employed. The social skills training program was based on the principles of Cognitive Behaviour Therapy, and was adapted from Ron Rapee's social skills training program. A permutated block randomisation procedure was utilised. Participants are followed up at the completion of the program (or baseline plus six weeks for controls) and at three months following entry into residential rehabilitation (or six months post-baseline for participants who do not enter treatment). The current study could potentially have implications for addressing social anxiety within residential drug treatment services in order to improve entry and retention in treatment. The results might suggest that the use of additional screening tools in intake assessments, a focus on coping with social anxieties in support groups for clients waiting to enter treatment, and greater awareness of social anxiety issues is warranted. Australian New Zealand Clinical Trials Registry (ACTRN) registration number: ACTRN12611000579998.",Staiger PK.; Kyrios M.; Williams JS.; Kambouropoulos N.; Howard A.; Gruenert S.,2014.0,10.1186/1471-244X-14-43,0,0,
3601,Mindfulness-based cognitive group therapy for women with breast and gynecologic cancer: a pilot study to determine effectiveness and feasibility.,"Group-based mindfulness training is frequently described in psycho-oncology literature, but little is known of the effectiveness of mindfulness-based cognitive therapy (MBCT). We investigated the effectiveness and acceptability of MBCT for women with breast and gynecologic cancer. Fifty women were recruited to participate in eight weekly 2-h mindfulness sessions. Outcomes of distress, quality of life (QOL), post-traumatic growth, and mindfulness were assessed pre-intervention, post-intervention, and again 3 months later using validated measures. Data were analyzed with repeated measures ANOVAs with a Bonferroni correction. Participant satisfaction and evaluation were also assessed. Forty-two women completed the program, and complete data were available for 36 women. Significant improvements with large effect sizes (ηρ(2)) were observed for distress (P < 0.001; ηρ(2) = 0.238), QOL (P = 0.001; ηρ(2) = 0.204), mindfulness (P < 0.001; ηρ(2) = 0.363) and post-traumatic growth (P < 0.001; ηρ(2) = 0.243). Gains were maintained 3 months post-intervention. Improvements in outcomes did not differ based on diagnostic group, psychological status, or physical well-being at entry. Change indices further support these findings. Scores on measures of distress, QOL, and post-traumatic growth decreased as a function of increased mindfulness at each time point (all P < 0.05). Participants reported experiencing the program as beneficial, particularly its group-based nature, and provided positive feedback of the therapy as a whole as well as its individual components. Within the limits of a non-randomized trial, these findings provide preliminary support for the potential psychosocial benefits of MBCT in a heterogeneous group of women with cancer. Future, more comprehensive trials are needed to provide systematic evidence of this therapy in oncology settings.",Stafford L.; Foley E.; Judd F.; Gibson P.; Kiropoulos L.; Couper J.,2013.0,10.1007/s00520-013-1880-x,0,0,
3602,In vivo facilitation as a variable in the effectiveness of taped flooding.,,Stadter M.,1973.0,,0,0,
3603,Removal of bile acids by two different extracorporeal liver support systems in acute-on-chronic liver failure,"ER Acute-on-chronic liver failure (ACLF) is accompanied by marked intrahepatic cholestasis leading to accumulation of cytotoxic bile acids. Extracorporeal liver support systems efficiently remove bile acids, but their effect on bile acid composition in ACLF is unknown. The aim of the present study was to compare elimination of individual plasma bile acids by albumin dialysis (Molecular Adsorbents Recirculating System, MARS) and fractionated plasma separation (Prometheus). Eight consecutive patients with ACLF underwent alternating 6-hour sessions with MARS or Prometheus in a randomized, cross-over design. Serum samples were obtained before, during, and after each treatment, and individual bile acids including cholic acid and chenodeoxycholic acid (CDCA) were measured by gas chromatography. MARS and Prometheus removed total bile acids to a similar extent (reduction ratio, 45% and 46%, respectively). Both devices cleared cholic acid more efficiently than did CDCA. The molar fraction of CDCA (fCDCA) was elevated at baseline and correlated with the degree of liver dysfunction. Prometheus but not MARS treatments further increased fCDCA. Although both devices eliminate total bile acids to a similar extent, clearance of individual bile acids is different, leading to a slight change of the bile acid profile toward hydrophobic bile acids during Prometheus treatments.","Stadlbauer, V; Krisper, P; Beuers, U; Haditsch, B; Schneditz, D; Jung, A; Putz-Bankuti, C; Holzer, H; Trauner, M; Stauber, R E",2007.0,10.1097/01.mat.0000249852.71634.6c,0,0,
3604,Imagery rehearsal therapy for frequent nightmares in children,"ER This study examined the applicability of imagery rehearsal therapy (IRT) to children with frequent nightmares. Eleven boys and 9 girls aged 9 to 11, with moderate to severe primary nightmares (1 or more per week for 6 months) and without posttraumatic stress disorder, were randomly divided into an imagery rehearsal treatment group (n = 9) or a waiting-list (n = 11) group. ANCOVA with repeated measures revealed that, following a baseline period, IRT reduced the frequency of nightmares (p < .04; eta(2) = 0.22) in the treated group compared to the waiting-list group. This reduction was maintained over a 9-month follow-up. The effects of IRT on post-nightmare state distress could not be assessed due to low nightmare incidences. However, retrospective trait nightmare distress was not significantly reduced. Future research is needed to validate this simple approach for nightmare reduction and to evaluate its potential for the reduction of the associated nightmare distress.","St-Onge, M; Mercier, P; Koninck, J",2009.0,10.1080/15402000902762360,0,0,
3605,Meditation for the management of adjustment disorder anxiety and depression.,"To examine the effect of Meditation training on patients with adjustment disorder with anxiety and depression. In a pre-test/post-test control group design, patients (N = 30) with adjustment disorder with mixed anxiety and depression, were screened through a Clinical Global Impression-severity/Improvement Scale, Beck's Anxiety, Beck's Depression Inventory, and Global Assessment of Functioning. Sessions of meditation training (28 weeks) were held using the model of Yoga Meditation. The difference of means (pre- and post-assessment) was tested using a paired t-test method. Experimental group and control groups were similar at base line, whereas after concluding the 28th week of meditation practice a significant mean difference (t value: CGI-S 2.47 > .05; CGI-I2.82 > 0.05; BAI 17.58 > 0.05; BDI 10.13 > 0.05; GAF 12.29 > 0.05) was found between both groups. There was an incremental change in selected assessment parameters in both groups. But changes were more significant in pre- and post-assessment of experimental group.",Srivastava M.; Talukdar U.; Lahan V.,2011.0,10.1016/j.ctcp.2011.04.007,0,0,
3606,Between-session and within-session habituation in Prolonged Exposure Therapy for posttraumatic stress disorder: a hierarchical linear modeling approach.,"Prolonged Exposure Therapy is a frontline intervention for posttraumatic stress disorder, but the mechanisms underlying its efficacy are not fully understood. Previous research demonstrates that between- and within-session habituation of fear during exposure is associated with treatment outcome, but these calculations are historically performed with summary statistics such as mean subjective units of distress (SUDS). This question could be better assessed with an analytic technique that uses all SUDS measurements available within sessions. Hierarchical linear modeling was used to investigate the impact of treatment response on SUDS nested within therapy sessions nested within 14 patients. Symptom change (t=-2.43, p=.03) and responder status (t=-2.68, p=.02) predicted slope of SUDS across sessions, but did not reliably predict slope of SUDS within-session, indicating that high responders demonstrated differential between- but not within-session habituation. Thus, individuals who show greater habituation between treatment sessions may be more likely to respond to treatment.",Sripada RK.; Rauch SA.,2015.0,10.1016/j.janxdis.2015.01.002,0,0,
3607,DHEA enhances emotion regulation neurocircuits and modulates memory for emotional stimuli,"Dehydroepiandrosterone (DHEA) is a neurosteroid with anxiolytic, antidepressant, and antiglucocorticoid properties. It is endogenously released in response to stress, and may reduce negative affect when administered exogenously. Although there have been multiple reports of DHEA's antidepressant and anxiolytic effects, no research to date has examined the neural pathways involved. In particular, brain imaging has not been used to link neurosteroid effects to emotion neurocircuitry. To investigate the brain basis of DHEA's impact on emotion modulation, patients were administered 400 mg of DHEA (N=14) or placebo (N=15) and underwent 3T fMRI while performing the shifted-attention emotion appraisal task (SEAT), a test of emotional processing and regulation. Compared with placebo, DHEA reduced activity in the amygdala and hippocampus, enhanced connectivity between the amygdala and hippocampus, and enhanced activity in the rACC. These activation changes were associated with reduced negative affect. DHEA reduced memory accuracy for emotional stimuli, and also reduced activity in regions associated with conjunctive memory encoding. These results demonstrate that DHEA reduces activity in regions associated with generation of negative emotion and enhances activity in regions linked to regulatory processes. Considering that activity in these regions is altered in mood and anxiety disorders, our results provide initial neuroimaging evidence that DHEA may be useful as a pharmacological intervention for these conditions and invite further investigation into the brain basis of neurosteroid emotion regulatory effects. © 2013 American College of Neuropsychopharmacology. All rights reserved.",Sripada R.K.; Marx C.E.; King A.P.; Rajaram N.; Garfinkel S.N.; Abelson J.L.; Liberzon I.,2013.0,10.1038/npp.2013.79,0,0,
3608,Oxytocin enhances resting-state connectivity between amygdala and medial frontal cortex,"ER The neuropeptide oxytocin (OXT) plays an important role in complex socio-affective behaviours such as affiliation, attachment, stress and anxiety. Previous studies have focused on the amygdala as an important target of OXT's effects. However, the effects of OXT on connectivity of the amygdala with cortical regions such as medial frontal cortex, an important mediator of social cognition and emotion regulation, remain unexplored. In a randomized, double-blind, cross-over design, 15 volunteers received intranasal OXT or placebo prior to resting-state functional magnetic resonance imaging. OXT significantly increased connectivity between both amygdalae and rostral medial frontal cortex (rmFC), while having only negligible effects on coupling with other brain regions. These results demonstrate that OXT is a robust and highly selective enhancer of amygdala connectivity with rmFC, a region critical to social cognition and emotion regulation, and add to our understanding of the neural mechanisms by which OXT modulates complex social and cognitive behaviours.","Sripada, C S; Phan, K L; Labuschagne, I; Welsh, R; Nathan, P J; Wood, A G",2013.0,10.1017/S1461145712000533,0,0,
3609,Efficacy and safety of two dosing regimens of buspirone in the treatment of outpatients with persistent anxiety.,"This randomized, double-masked, comparative study evaluated efficacy and safety of buspirone (30 mg/d), administered twice (BID) or three times a day (TID) in 137 adult patients with generalized anxiety disorder. Ss received buspirone titrated from 15 mg/d to 30 mg/d, as either a BID or a TID regimen. Both groups demonstrated significant reductions in Hamilton Rating Scale for Anxiety total scores and on Clinical Global Impression measures, with no significant differences detected between the 2 groups for either measure at any time point. The overall incidence of adverse events was similar for both groups, except for a significantly greater incidence of amblyopia in Ss receiving buspirone 15 mg BID. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Sramek, John J; Frackiewicz, Edyta J; Cutler, Neal R",1997.0,,0,0,
3610,Bulimia complicated with diabetes mellitus: A clinical trial using exposure with response prevention.,"Using a nonconcurrent multiple baseline design, an exposure-plus-response prevention clinical protocol was instituted across 3 Type I diabetic bulimic women (aged 22, 23, and 28 yrs). The onset of treatment was associated with reduction in frequency and severity of bulimic and diabetic symptomatology. Questionnaire measures of eating disorder severity, depression and social anxiety were inconsistent. All 3 Ss were significantly improved at the end of treatment, and 2 maintained their improvement at follow-up. The 3rd met the criterion for improvement at 3 yrs posttreatment. Results suggest that diabetic bulimics can be treated with the same protocol as other bulimics but may require more sessions to reach criterion. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Spurdle, Elizabeth P; Giles, Thomas R",1990.0,,0,0,
3611,Implicit and explicit affect toward food and weight stimuli in anorexia nervosa.,"We know strikingly little about the core affective processes that drive the development and maintenance of, and recovery from anorexia nervosa (AN). To partially address this knowledge gap, we measured implicit and explicit affect toward pleasant, neutral, unpleasant, food-relevant, and weight-relevant images in three groups: in patients with acute AN, individuals recovered from AN, and healthy controls with no history of AN. Compared with the other two groups, acutely ill AN participants displayed significantly greater implicit positive affect toward pleasant images and significantly greater implicit negative affect toward unpleasant, high-calorie food, and overweight body type images. Recovered participants did not differ significantly from controls on any implicit affect measure. Explicit affective patterns were similar to implicit, but explicit measures yielded much smaller effect sizes and failed to detect certain group differences. Overall, negative implicit affect toward high-calorie foods and overweight body types may represent core affective processes that are operative during acute AN.",Spring VL.; Bulik CM.,2014.0,10.1016/j.eatbeh.2013.10.017,0,0,
3612,Cognitive bias modification versus CBT in reducing adolescent social anxiety: a randomized controlled trial.,"Social anxiety is a common mental disorder among adolescents and is associated with detrimental long term outcomes. Therefore, this study investigated the efficacy of two possible early interventions for adolescent social anxiety and test anxiety. An internet-based cognitive bias modification (CBM; n‚Ää=‚Ää86) was compared to a school-based cognitive behavioral group training (CBT; n‚Ää=‚Ää84) and a control group (n‚Ää=‚Ää70) in reducing symptoms of social and test anxiety in high socially and/or test anxious adolescents aged 13-15 years. Participants (n‚Ää=‚Ää240) were randomized at school level over the three conditions. CBM consisted of a 20-session at home internet-delivered training; CBT was a 10-session at school group training with homework assignments; the control group received no training. Participants were assessed before and after the intervention and at 6 and 12 month follow-up. At 6 month follow-up CBT resulted in lower social anxiety than the control condition, while for CBM, this effect was only trend-significant. At 12 month follow-up this initial benefit was no longer present. Test anxiety decreased more in the CBT condition relative to the control condition in both short and long term. Interestingly, in the long term, participants in the CBM condition improved more with regard to automatic threat-related associations than both other conditions. The results indicate that the interventions resulted in a faster decline of social anxiety symptoms, whereas the eventual end point of social anxiety was not affected. Test anxiety was influenced in the long term by the CBT intervention, and CBM lead to increased positive automatic threat-related associations. TrialRegister.nl NTR965.",Sportel BE.; de Hullu E.; de Jong PJ.; Nauta MH.,2013.0,10.1371/journal.pone.0064355,0,0,
3613,"Childhood maltreatment, maladaptive personality types and level and course of psychological distress: A six-year longitudinal study","Background Childhood maltreatment and maladaptive personality are both cross-sectionally associated with psychological distress. It is unknown whether childhood maltreatment affects the level and longitudinal course of psychological distress in adults and to what extent this effect is mediated by maladaptive personality. Methods A sample of 2947 adults aged 18-65, consisting of healthy controls, persons with a prior history or current episode of depressive and/or anxiety disorders according to the Composite Interview Diagnostic Instrument were assessed in six waves at baseline (T0) and 1 (T1), 2 (T2), 4 (T4) and 6 years (T6) later. At each wave psychological distress was measured with the Inventory of Depressive Symptomatology, Beck Anxiety Inventory, and Fear Questionnaire. At T0 childhood maltreatment types were measured with a semi-structured interview (Childhood Trauma Interview) and personality traits with the NEO-Five Factor Inventory. Results Using latent variable analyses, we found that severity of childhood maltreatment (emotional neglect and abuse in particular) predicted higher initial levels of psychological distress and that this effect was mediated by maladaptive personality types. Differences in trajectories of distress between persons with varying levels of childhood maltreatment remained significant and stable over time. Limitations Childhood maltreatment was assessed retrospectively and maladaptive personality types and level of psychological distress at study entry were assessed concurrently. Conclusions Routine assessment of maladaptive personality types and possible childhood emotional maltreatment in persons with severe and prolonged psychological distress seems warranted to identify persons who may need a different or more intensive treatment.",Spinhoven P.; Elzinga B.M.; Van Hemert A.M.; De Rooij M.; Penninx B.W.,2016.0,10.1016/j.jad.2015.11.036,0,0,
3614,Comment on the London/Toronto Study of Alprazolam and Exposure in Panic Disorder with Agoraphobia.,,Spiegel DA.; Roth M.; Weissman M.; Lavori P.; Gorman J.; Rush J.; Ballenger J.,1993.0,,0,0,
3615,Does cognitive behavior therapy assist slow-taper alprazolam discontinuation in panic disorder?,"The authors investigated whether cognitive behavioral treatment could facilitate discontinuation of alprazolam therapy and maintenance of drug abstinence among panic disorder patients treated with alprazolam doses sufficient to suppress spontaneous panic attacks. Twenty-one outpatients who met DSM-III-R criteria for panic disorder with mild to severe agoraphobia were made panic-free with alprazolam (mean dose = 2.2 mg/day) and were then randomly assigned to receive either supportive drug maintenance and slow, flexible drug taper or an identical medication treatment plus 12 weeks of concurrent, individual cognitive behavioral treatment. Taper in the combined treatment group was sequenced to conclude before cognitive behavioral treatment ended. Twenty subjects completed the study. There was no significant difference between groups in the rate of alprazolam discontinuation (80% and 90%, respectively, in the alprazolam-only group and the combined treatment group). However, during the 6-month follow-up period, half of the subjects who discontinued alprazolam without cognitive behavior therapy, but none of those who were given cognitive behavior therapy, relapsed and resumed alprazolam treatment. Cognitive behavioral treatment administered in parallel with alprazolam maintenance and taper was effective in preventing relapse after drug discontinuation. The results warrant further research on the thoughtful integration of these two therapeutic modalities.",Spiegel DA.; Bruce TJ.; Gregg SF.; Nuzzarello A.,1994.0,10.1176/ajp.151.6.876,0,0,
3616,Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer: a randomized prospective trial,"ER METHODSOne hundred twenty-five women with confirmed metastatic (n = 122) or locally recurrent (n = 3) breast cancer were randomly assigned either to the supportive-expressive group therapy condition (n = 64), where they received educational materials plus weekly supportive-expressive group therapy, or to the control condition (n = 61), where they received only educational materials for a minimum of 1 year. The treatment, 90 minutes once a week, was designed to build new bonds of social support, encourage expression of emotion, deal with fears of dying and death, help restructure life priorities, improve communication with family members and healthcare professionals, and enhance control of pain and anxiety.RESULTSOverall mortality after 14 years was 86%; median survival time was 32.8 months. No overall statistically significant effect of treatment on survival was found for treatment (median, 30.7 months) compared with control (median, 33.3 months) patients, but there was a statistically significant intervention site-by-condition interaction. Exploratory moderator analysis to explain that interaction revealed a significant overall interaction between estrogen-receptor (ER) status and treatment condition (P = .002) such that among the 25 ER-negative participants, those randomized to treatment survived longer (median, 29.8 months) than ER-negative controls (median, 9.3 months), whereas the ER-positive participants showed no treatment effect.CONCLUSIONSThe earlier finding that longer survival was associated with supportive-expressive group therapy was not replicated. Although it is possible that psychosocial effects on survival are relevant to a small subsample of women who are more refractory to current hormonal treatments, further research is required to investigate subgroup differences.BACKGROUNDThis study was designed to replicate our earlier finding that intensive group therapy extended survival time of women with metastatic breast cancer. Subsequent findings concerning the question of whether such psychosocial support affects survival have been mixed.","Spiegel, D; Butler, L D; Giese-Davis, J; Koopman, C; Miller, E; DiMiceli, S; Classen, C C; Fobair, P; Carlson, R W; Kraemer, H C",2007.0,10.1002/cncr.22890,0,0,
3617,Group support for patients with metastatic cancer. A randomized outcome study.,"The effects of weekly supportive group meetings for women with metastatic carcinoma of the breast were systematically evaluated in a one-year, randomized, prospective outcome study. The groups focused on the problems of terminal illness, including improving relationships with family, friends, and physicians and living as fully as possible in the face of death. We hypothesized that this invention would lead to improved mood, coping strategies, and self-esteem among those in the treatment group. Eighty-six patients were tested at four-month intervals. The treatment group had significantly lower mood-disturbance scores on the Profile of Mood States scale, had fewer maladaptive coping responses, and were less phobic than the control group. This study provides objective evidence that a supportive group intervention for patients with metastatic cancer results in psychological benefit. Mechanisms underlying the effectiveness of this group intervention are explored.",Spiegel D.; Bloom JR.; Yalom I.,1981.0,,0,0,
3618,Impact of evidence-based standardized assessment on the disability clinical interview for diagnosis of service-connected PTSD: a cluster-randomized trial.,"Posttraumatic stress disorder (PTSD) is one of the fastest growing compensated medical conditions. The present study compared usual disability examiner practices for PTSD with a standardized assessment that incorporates evidence-based assessments. The design was a multicenter, cluster randomized, parallel-group study involving 33 clinical examiners and 384 veterans at 6 Veterans Affairs medical centers. The standardized group incorporated the Clinician Administered PTSD Scale and the World Health Organization Disability Assessment Schedule-II into their assessment interview. The main outcome measures were completeness and accuracy of PTSD diagnosis and completeness of functional assessment. The standardized assessments were 85% complete for diagnosis compared to 30% for nonstandardized assessments (p < .001), and, for functional impairment, 76% versus 3% (p < .001). The findings demonstrate that the quality of PTSD disability examination would be improved by using evidence-based assessment.",Speroff T.; Sinnott PL.; Marx B.; Owen RR.; Jackson JC.; Greevy R.; Sayer N.; Murdoch M.; Shane AC.; Smith J.; Alvarez J.; Nwosu SK.; Keane T.; Weathers F.; Schnurr PP.; Friedman MJ.,2012.0,10.1002/jts.21759,0,0,
3619,"Comparison of an arthroscopic and an open procedure for posttraumatic instability of the shoulder: a prospective, randomized multicenter study.","From 1993 through 1996, a multicenter study was conducted on the surgical treatment of patients with posttraumatic recurrent anterior shoulder dislocations. Fifty-six patients (40 men, 16 women; mean age 26 years [range 18-51 years]), were evaluated with shoulder arthroscopy. If a Bankart lesion was present, the patients were randomly allocated to either an arthroscopic reconstruction with the use of biodegradable tacks or an open reconstruction with suture anchors. The postoperative rehabilitation protocol for the two groups was identical. In all patients, the range of shoulder motion, stability, and the Constant and Rowe scores were evaluated at 3, 12, and 24 months postoperatively. Thirty patients were surgically treated with the arthroscopic technique and 26 patients with the open technique. In the arthroscopic group, there were recurrences in 7 (23%) of 30 patients at a mean of 13 months (range 5 to 21 months) after surgery. All patients with stable shoulders had a negative apprehension test result. In the open group, there were recurrences in 3 (12%) of 26 patients at a mean of 10 months (range 2 to 23 months) after surgery (P = not significant). In the arthroscopic group, 2 patients had new traumatic redislocations, whereas 1 patient redislocated during an epileptic seizure. In the open group, 1 traumatic redislocation occurred. The 2-year results in this study demonstrate a large number of redislocations after reconstruction, even in the open surgery group. Patient noncompliance with the rehabilitation protocol and predisposing disease may partially explain these results. A tendency was seen toward more redislocations in the arthroscopic group, which emphasizes the importance of correct patient selection and careful surgical technique in the difficult surgical procedure.",Sperber A.; Hamberg P.; Karlsson J.; Swärd L.; Wredmark T.,,10.1067/mse.2001.112019,0,0,
3620,"Comparison of an arthroscopic and an open procedure for posttraumatic instability of the shoulder: a prospective, randomized multicenter study","ER From 1993 through 1996, a multicenter study was conducted on the surgical treatment of patients with posttraumatic recurrent anterior shoulder dislocations. Fifty-six patients (40 men, 16 women; mean age 26 years [range 18-51 years]), were evaluated with shoulder arthroscopy. If a Bankart lesion was present, the patients were randomly allocated to either an arthroscopic reconstruction with the use of biodegradable tacks or an open reconstruction with suture anchors. The postoperative rehabilitation protocol for the two groups was identical. In all patients, the range of shoulder motion, stability, and the Constant and Rowe scores were evaluated at 3, 12, and 24 months postoperatively. Thirty patients were surgically treated with the arthroscopic technique and 26 patients with the open technique. In the arthroscopic group, there were recurrences in 7 (23%) of 30 patients at a mean of 13 months (range 5 to 21 months) after surgery. All patients with stable shoulders had a negative apprehension test result. In the open group, there were recurrences in 3 (12%) of 26 patients at a mean of 10 months (range 2 to 23 months) after surgery (P = not significant). In the arthroscopic group, 2 patients had new traumatic redislocations, whereas 1 patient redislocated during an epileptic seizure. In the open group, 1 traumatic redislocation occurred. The 2-year results in this study demonstrate a large number of redislocations after reconstruction, even in the open surgery group. Patient noncompliance with the rehabilitation protocol and predisposing disease may partially explain these results. A tendency was seen toward more redislocations in the arthroscopic group, which emphasizes the importance of correct patient selection and careful surgical technique in the difficult surgical procedure.","Sperber, A; Hamberg, P; Karlsson, J; Swärd, L; Wredmark, T",2001.0,10.1067/mse.2001.112019,0,0,3619
3621,The relationship between tic disorders and Tourette's syndrome revisited,"ER METHODChildren with TS (n = 32) and children with chronic tics (n = 39) were ascertained from an unselected sample of the children referred for psychopharmacological treatment and examined using standardized diagnostic assessments and testing procedures.RESULTSChildren with TS and those with chronic tics were similar to each other and different from controls in clinical correlates that included psychiatric comorbidity, as well as school, neuropsychological, and psychosocial impairments. Patients with TS also had higher rates of obsessive-compulsive disorder, oppositional defiant disorder, and simple phobia than did patients with chronic tic disorder.CONCLUSIONSThese findings indicate that TS and chronic tic disorder are part of the same disease entity, with TS being a more severe form of tic disorder.OBJECTIVEThe relationship between Tourette's syndrome (TS) and chronic tic disorder is of great clinical and scientific importance because of uncertainties in both prognosis and pharmacotherapeutic strategies. One approach to evaluating the relationship between TS and chronic tics is to examine whether they share similar neuropsychological and psychiatric correlates.","Spencer, T; Biederman, J; Harding, M; Wilens, T; Faraone, S",1995.0,10.1097/00004583-199509000-00009,0,0,
3622,Does the absence of a supportive family environment influence the outcome of a universal intervention for the prevention of depression?,"ER To date, universal, school-based interventions have produced limited success in the long-term prevention of depression in young people. This paper examines whether family relationship support moderates the outcomes of a universal, school-based preventive intervention for depression in adolescents. It reports a secondary analysis of data from the beyondblue schools research initiative. Twenty-five matched pairs of secondary schools were randomly assigned to an intervention or control condition (N = 5633 Grade 8 students). The multi-component, school-based intervention was implemented over a 3-year period, with 2 years of follow-up in Grades 11 and 12. For those available at follow-up, small but significantly greater reductions in depressive and anxiety symptoms and improvements in emotional wellbeing were found over time for the intervention group compared to the control among those who experienced low family relationship support in Grade 8. For those who did not experience low family relationship support in Grade 8, no significant effects of the invention were found over the control condition. This pattern of results was also found for the intent-to-treat sample for measures of depression and anxiety. Previous research may have overlooked important moderating variables that influence the outcome of universal approaches to the prevention of depression. The findings raise issues of the relative costs and benefits of universal versus targeted approaches to the prevention of depression.","Spence, S H; Sawyer, M G; Sheffield, J; Patton, G; Bond, L; Graetz, B; Kay, D",2014.0,10.3390/ijerph110505113,0,0,
3623,The feasibility and outcome of clinic plus internet delivery of cognitive-behavior therapy for childhood anxiety,"ER Seventy-two clinically anxious children, aged 7 to 14 years, were randomly allocated to clinic-based, cognitive-behavior therapy, the same treatment partially delivered via the Internet, or a wait-list control (WL). Children in the clinic and clinic-plus-Internet conditions showed significantly greater reductions in anxiety from pre- to posttreatment and were more likely to be free of their anxiety diagnoses, compared with the WL group. Improvements were maintained at 12-month follow-up for both therapy conditions, with minimal difference in outcomes between interventions. The Internet treatment content was highly acceptable to families, with minimal dropout and a high level of therapy compliance.","Spence, S H; Holmes, J M; March, S; Lipp, O V",2006.0,10.1037/0022-006X.74.3.614,0,0,
3624,A randomized controlled trial of online versus clinic-based CBT for adolescent anxiety,"ER METHODParticipants included 115 clinically anxious adolescents aged 12 to 18 years and their parent(s). Adolescents were randomly assigned to NET, CLIN, or wait list control (WLC) conditions. The treatment groups received equivalent CBT content. Clinical diagnostic interviews and questionnaire assessments were completed 12 weeks after baseline and at 6- and 12-month follow-ups.RESULTSAssessment at 12 weeks post-baseline showed significantly greater reductions in anxiety diagnoses and anxiety symptoms for both NET and CLIN conditions compared with the WLC. These improvements were maintained or further enhanced for both conditions, with minimal differences between them, at 6- and 12-month follow-ups. Seventy-eight percent of adolescents in the NET group (completer sample) no longer met criteria for the principal anxiety diagnosis at 12-month follow-up compared with 80.6% in the CLIN group. Ratings of treatment credibility from both parents and adolescents were high for NET and equivalent to CLIN. Satisfaction ratings by adolescents were equivalent for NET and CLIN conditions, whereas parents indicated slightly higher satisfaction ratings for the CLIN format.CONCLUSIONSOnline delivery of CBT, with minimal therapist support, is equally efficacious as clinic-based, face-to-face therapy in the treatment of anxiety disorders among adolescents. This approach offers a credible alternative to clinic-based therapy, with benefits of reduced therapist time and greater accessibility for families who have difficulty accessing clinic-based CBT.OBJECTIVEThe study examined the relative efficacy of online (NET) versus clinic (CLIN) delivery of cognitive behavior therapy (CBT) in the treatment of anxiety disorders in adolescents.","Spence, S H; Donovan, C L; March, S; Gamble, A; Anderson, R E; Prosser, S; Kenardy, J",2011.0,10.1037/a0024512,0,0,
3625,Internet administration of the Edinburgh Depression Scale.,"Internet-based screening for depression is becoming increasingly important. The aim of this study is to validate the Edinburgh Depression Scale (EDS) for internet administration. In 407 participants (64% women; 36% men) with subthreshold depression (mean age=55 years; S.D.=4.9) positive predictive values for a syndromal CIDI diagnosis of clinical depression were calculated and compared to those from paper and pencil validation studies. At one-year follow-up, internal consistency and convergent validity of the internet-based EDS were determined in 177 participants by Cronbach's alpha and correlations with the internet-administered BDI and SCL-90 subscales depression and anxiety. Positive predictive values ranged between 29% and 33% at cut-off scores of 12 to 14. Cronbach's alpha for the internet-administered EDS was 0.87. The EDS correlated significantly with the internet-administered BDI (r=.75; p<.001) and two internet-administered subscales of the SCL-90: depression (r=.77; p<.001) and anxiety (r=.72; p<.001). A major limitation is that the study was conducted without a control group of healthy subjects. The psychometric properties of the internet-administered EDS are comparable to those of the paper and pencil EDS.",Spek V.; Nyklícek I.; Cuijpers P.; Pop V.,2008.0,10.1016/j.jad.2007.07.003,0,0,
3626,Mindfulness-based therapy in adults with an autism spectrum disorder: A randomized controlled trial.,"Research shows that depression and anxiety disorders are the most common psychiatric concern in autism spectrum disorders (ASD). Mindfulness-based therapy (MBT) has been found effective in reducing anxiety and depression symptoms, however research in autism is limited. Therefore, we examined the effects of a modified MBT protocol (MBT-AS) in high-functioning adults with ASD. 42 participants were randomized into a 9-week MBT-AS training or a wait-list control group. Results showed a significant reduction in depression, anxiety and rumination in the intervention group, as opposed to the control group. Furthermore, positive affect increased in the intervention group, but not in the control group. Concluding, the present study is the first controlled trial to demonstrate that adults with ASD can benefit from MBT-AS. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Spek, Annelies A; van Ham, Nadia C; Nyklicek, Ivan; Arnou, Arrindell, Baron-Cohen, Beck, Bogels, Borders, Buckelew, Burg, Cardaciotto, Chambers, Denollet, Derogatis, Frala, Frith, Hare, Hayes, Hobson, Hofmann, Hofvander, Jain, Kabat-Zinn, Kabat-Zinn, Lecavalier, Lord, McLaughlin, Nolen-Hoeksema, Nolen-Hoeksema, Nyklicek, Nyklicek, Ramel, Rumsey, Ryan, Sattler, Segal, Shtayermman, Singh, Singh, Skokauskas, Spek, Spek, Spek, Tager-Flusberg, Tantam, Teasdale, Trapnell, Watson, Watson, Wechsler, Weiss, Witwer",2013.0,,0,0,
3627,Mindfulness-based therapy in adults with an autism spectrum disorder: a randomized controlled trial,"ER Research shows that depression and anxiety disorders are the most common psychiatric concern in autism spectrum disorders (ASD). Mindfulness-based therapy (MBT) has been found effective in reducing anxiety and depression symptoms, however research in autism is limited. Therefore, we examined the effects of a modified MBT protocol (MBT-AS) in high-functioning adults with ASD. 42 participants were randomized into a 9-week MBT-AS training or a wait-list control group. Results showed a significant reduction in depression, anxiety and rumination in the intervention group, as opposed to the control group. Furthermore, positive affect increased in the intervention group, but not in the control group. Concluding, the present study is the first controlled trial to demonstrate that adults with ASD can benefit from MBT-AS.","Spek, A A; Ham, N C; Nyklí?ek, I",2013.0,10.1016/j.ridd.2012.08.009,0,0,
3628,Changes in intrusive memories associated with imaginal reliving in posttraumatic stress disorder.,"The study investigated changes in intrusive memories associated with imaginal reliving of traumatic events in posttraumatic stress disorder (PTSD). The study population comprised 44 patients treated with imaginal reliving in the context of cognitive therapy for PTSD [Behav. Res. Ther. 38 (2000) 319-345]. For most patients, imaginal reliving did not lead to exacerbations in intrusion frequency. The decrease in intrusion frequency after reliving was gradual, as was the decrease in their distress, vividness, and perceived ""nowness."" Poorer outcome, i.e., a smaller reduction in residual gain scores for intrusion frequency with reliving, was associated with greater initial PTSD severity, greater anger, greater perceived ""nowness"" of intrusive memories, and more negative interpretations of PTSD symptoms. The patient's anxiety, depression, self-blame, and dissociation were not predictive of response to reliving.",Speckens AE.; Ehlers A.; Hackmann A.; Clark DM.,2006.0,10.1016/j.janxdis.2005.02.004,0,0,
3629,Lucid dreaming treatment for nightmares: a pilot study.,"The goal of this pilot study was to evaluate the effects of the cognitive-restructuring technique 'lucid dreaming treatment' (LDT) on chronic nightmares. Becoming lucid (realizing that one is dreaming) during a nightmare allows one to alter the nightmare storyline during the nightmare itself. After having filled out a sleep and a posttraumatic stress disorder questionnaire, 23 nightmare sufferers were randomly divided into 3 groups; 8 participants received one 2-hour individual LDT session, 8 participants received one 2-hour group LDT session, and 7 participants were placed on the waiting list. LDT consisted of exposure, mastery, and lucidity exercises. Participants filled out the same questionnaires 12 weeks after the intervention (follow-up). At follow-up the nightmare frequency of both treatment groups had decreased. There were no significant changes in sleep quality and posttraumatic stress disorder symptom severity. Lucidity was not necessary for a reduction in nightmare frequency. LDT seems effective in reducing nightmare frequency, although the primary therapeutic component (i.e. exposure, mastery, or lucidity) remains unclear.",Spoormaker VI.; van den Bout J.,2006.0,10.1159/000095446,0,0,
3630,Effects of rapid eye movement sleep deprivation on fear extinction recall and prediction error signaling,"In a temporal difference learning approach of classical conditioning, a theoretical error signal shifts from outcome deliverance to the onset of the conditioned stimulus. Omission of an expected outcome results in a negative prediction error signal, which is the initial step towards successful extinction and may therefore be relevant for fear extinction recall. As studies in rodents have observed a bidirectional relationship between fear extinction and rapid eye movement (REM) sleep, we aimed to test the hypothesis that REM sleep deprivation impairs recall of fear extinction through prediction error signaling in humans. In a three-day design with polysomnographically controlled REM sleep deprivation, 18 young, healthy subjects performed a fear conditioning, extinction and recall of extinction task with visual stimuli, and mild electrical shocks during combined functional magnetic resonance imaging (fMRI) and skin conductance response (SCR) measurements. Compared to the control group, the REM sleep deprivation group had increased SCR scores to a previously extinguished stimulus at early recall of extinction trials, which was associated with an altered fMRI time-course in the left middle temporal gyrus. Post-hoc contrasts corrected for measures of NREM sleep variability also revealed between-group differences primarily in the temporal lobe. Our results demonstrate altered prediction error signaling during recall of fear extinction after REM sleep deprivation, which may further our understanding of anxiety disorders in which disturbed sleep and impaired fear extinction learning coincide. Moreover, our findings are indicative of REM sleep related plasticity in regions that also show an increase in activity during REM sleep. © 2011 Wiley Periodicals, Inc.",Spoormaker V.I.; Schröter M.S.; Andrade K.C.; Dresler M.; Kiem S.A.; Goya-Maldonado R.; Wetter T.C.; Holsboer F.; Sämann P.G.; Czisch M.,2012.0,10.1002/hbm.21369,0,0,
3631,Effects of ethanol intoxication and gender on blood coagulation,"Background: Ethanol intoxication is a common contributor to traumatic injury. It is unknown whether ethanol consumption contributes to the coagulation differences seen between men and women after trauma. Our aim was to examine the combined effect of ethanol intoxication and gender on coagulation. Methods: Fifty-eight healthy subjects participated and chose to enter into a control group (CG; n = 20; 10 men and 10 women) or drinking group (DG; n = 38; 20 men and 18 women). Venous blood samples for thrombelastography, plasminogen activator inhibitor, thrombin-antithrombin complex, and tissue plasminogen activator were drawn at the beginning of the study. Subjects then interacted in a social atmosphere for at least 2 hours, eating and consuming alcoholic (DG) or nonalcoholic (CG) beverages. After 2 hours, blood alcohol level was determined and blood was drawn for a second set of coagulation studies. Results: Demographics were similar between groups except for age (36.7 years CG vs. 29.9 years DG; p = 0.009). All baseline thrombelastography measurements were similar between the CG and DG. Blood alcohol levels in the DG were similar between genders at the end of study. At the end of study, a decreased rate of fibrin formation, decreased clot strength, and a decreased rate of fibrin cross-linking was seen in men but not in women. Fibrinolysis was inhibited in drinkers compared with controls. Conclusions: Consumption of commonly ingested quantities of alcohol correlated with the development of a hypocoagulable state in men but had no effect on coagulation status in women. This phenomenon may contribute to differences in post-trauma coagulation status previously noted between genders. © 2010 Lippincott Williams & Wilkins.",Spoerke N.; Underwood S.; Differding J.; Van P.; Sambasivan C.; Shapiro D.; Schreiber M.,2010.0,10.1097/TA.0b013e3181d86860,0,0,
3632,"A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients","ER METHODSA randomized, wait-list controlled design was used. A convenience sample of eligible cancer patients enrolled after giving informed consent and were randomly assigned to either an immediate treatment condition or a wait-list control condition. Patients completed the Profile of Mood States and the Symptoms of Stress Inventory both before and after the intervention. The intervention consisted of a weekly meditation group lasting 1.5 hours for 7 weeks plus home meditation practice.RESULTSNinety patients (mean age, 51 years) completed the study. The group was heterogeneous in type and stage of cancer. Patients' mean preintervention scores on dependent measures were equivalent between groups. After the intervention, patients in the treatment group had significantly lower scores on Total Mood Disturbance and subscales of Depression, Anxiety, Anger, and Confusion and more Vigor than control subjects. The treatment group also had fewer overall Symptoms of Stress; fewer Cardiopulmonary and Gastrointestinal symptoms; less Emotional Irritability, Depression, and Cognitive Disorganization; and fewer Habitual Patterns of stress. Overall reduction in Total Mood Disturbance was 65%, with a 31% reduction in Symptoms of Stress.CONCLUSIONSThis program was effective in decreasing mood disturbance and stress symptoms in both male and female patients with a wide variety of cancer diagnoses, stages of illness, and ages. cancer, stress, mood, intervention, mindfulness.OBJECTIVEThe objective of this study was to assess the effects of participation in a mindfulness meditation-based stress reduction program on mood disturbance and symptoms of stress in cancer outpatients.","Speca, M; Carlson, L E; Goodey, E; Angen, M",2000.0,,0,0,
3633,Attitudes of psychologists and psychologists-in-training to homosexual women and men: An australian study,"Homophobic reactions of Australian psychologists (n = 43), postgraduate psychology students (n = 17) and undergraduate psychology students (n = 44) were compared using Van de Ven's (1994) measures of cognitive, affective and behavioral dimensions of homophobia. Results suggested that undergraduates were significantly more homophobic than psychologists in their thinking, intentional behavior and feelings of fear or discomfort in relation to lesbians and gay men. No other significant group differences were found. Gender differences were found only in relation to one affective dimension of homophobia. Low levels of positive affective response to homosexuals were observed across groups and gender. The study underscores the importance of assessing homophobic response multidimensionally. Implications for the training of Australian psychologists are discussed.",Spark Jones L.,2000.0,,0,0,
3634,[Chronic osteomyelitis of the long bones: magnetic resonance imaging].,"To investigate MR capabilities in assessing the extent of disease in chronic osteomyelitis of long bones, we examined 6 consecutive patients, 4 men and 2 women (age range: 27-67 years; mean: 42 years), with posttraumatic chronic osteomyelitis diagnosed at clinics, US, CT and radiography. The diagnosis had surgical or bioptical confirmation. MR studies were performed with an 0.5 T superconducting magnet, a surface coil and T1-weighted SE sequences-before and after Gd-DTPA administration-STIR and T2-weighted SE sequences, on the axial and coronal or sagittal planes. The signal intensity of the inflammation area was hypointense on short TR and TE images and hyperintense on long TR and TE images. After Gd-DTPA administration, granulation tissue surrounding the infection was enhanced in all cases and also the areas of vascularized inflammation within bone marrow were enhanced in two cases. MRI provided accurate and detailed information as to soft tissue and medullary canal involvement depicted sinus tracts in 5 cases and confirmed the presence of sequestrum in 5 cases, in agreement with previous CT findings. In our experience, MRI proved to be a reliable tool to assess the intramedullary and extracompartmental extent of osteomyelitis and also to plan surgery. MR specificity, which is often affected by post-traumatic or postoperative changes, improves markedly if some morphological features typical of the condition are also considered, such as sequestrum and sinus tracts.",Sparacia G.; Barbiera F.; Lo Casto A.; Iovane A.; Rossello M.; Midiri M.; De Maria M.,,,0,0,
3635,The role of expectancy in exposure-generated fear reduction in agoraphobia.,,Southworth S.; Kirsch I.,1988.0,,0,0,
3636,Change in metacognitions predicts outcome in obsessive-compulsive disorder patients undergoing treatment with exposure and response prevention.,"Wells' (Wells, A. (1997). Cognitive therapy of anxiety disorders: a practice manual and conceptual guide. Chichester, UK: Wiley) metacognitive model of obsessive-compulsive disorder (OCD) predicts that metacognitions must change in order for psychological treatment to be effective. The aim of this study was to explore: (1) if metacognitions change in patients undergoing exposure treatment for OCD; (2) to determine the extent to which cognitive and metacognitive change predicts symptom improvement and recovery. The sample consisted of 83 outpatients with a diagnosis of OCD who completed exposure and response prevention treatment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Metacognitions Questionnaire (MCQ-30) and the Obsessive Beliefs Questionnaire (OBQ-44) were administered before treatment, after treatment, and at 12-month follow-up. Treatment resulted in significant changes in symptoms, metacognition score, responsibility and perfectionism. Regression analysis using post-treatment Y-BOCS as the dependent variable indicated that when the overlap between predictors was controlled for, only changes in metacognition were significant. Changes in metacognitions explained 22% of the variance in symptoms at post-treatment when controlling for pre-treatment symptoms and changes in mood. A further regression revealed that two MCQ-30 subscales made individual contributions. The patients had significantly higher scores compared to community controls on the MCQ-30. Patients who achieved clinical significant change had lower scores on the MCQ-30 compared to patients who did not change. The results did not change significantly from post-treatment to follow-up assessment. These findings provide further support for the importance of metacognitions in treating OCD.",Solem S.; Håland AT.; Vogel PA.; Hansen B.; Wells A.,2009.0,10.1016/j.brat.2009.01.003,0,0,
3637,Psychotic and schizotypal symptoms in non-psychotic patients with obsessive-compulsive disorder.,"Research is scarce with regard to the role of psychotic and schizotypal symptoms in treatment of obsessive-compulsive disorder (OCD). The aim of the current study was to investigate the occurrence and specificity of psychotic and schizotypal symptoms among non-psychotic OCD patients, and to examine whether such symptoms was associated with response to exposure and response prevention (ERP), and whether ERP for OCD had an impact on psychotic and schizotypal symptoms. Non-psychotic OCD patients (n = 133) and a general non-psychotic psychiatric outpatient sample (n = 110) were assessed using self-report inventories before and after psychological treatment. Non-psychotic OCD patients did not report greater degree of psychotic or schizotypal symptoms than the control group. Psychotic and schizotypal symptoms were not associated with OCD symptoms before or after ERP. Psychotic and schizotypal symptom were significantly reduced following ERP. Psychotic and schizotypal symptoms seem to be equally prevalent among non-psychotic OCD patients and non-psychotic psychiatric controls. These symptoms were more linked to depressive symptoms than OCD symptoms. In non-psychotic OCD patients, ERP seems sufficient in reducing OCD symptoms despite the presence of psychotic- and schizotypal symptoms, and reductions in psychotic- and schizotypal symptoms were observed following ERP.",Solem S.; Hagen K.; Wenaas C.; Håland ÅT.; Launes G.; Vogel PA.; Hansen B.; Himle JA.,2015.0,10.1186/s12888-015-0502-1,0,0,
3638,Psychological effects on patient's relatives regarding their presence during resuscitation,"Introduction: Presence of family and patients' relatives throughout resuscitation procedure is one of the most challenging concerns. Methods: In an interventional (quasi-experimental) study that was conducted during a 6 months period, the patients' relatives were randomly divided into two groups of intervention (the relatives who were eager to be present throughout the resuscitation procedure- under the family protection protocol, all of the procedure steps were explained to the relatives by an expert nurse who was not involved in the resuscitation procedure and control group (those who were not invited routinely to be present throughout the resuscitation procedure. However, if the control group were eager to be present, they were allowed to observe the procedure (these people were not supported by the protocol). After 90 days, subjects were contacted through telephone and filled standard questionnaires (Hospital Anxiety and Depression Scale [HADS]) and Impact of Event Scale (IES) were completed for all subjects. These questionnaires focus on anxiety, depression and posttraumatic stress disorder (PTSD). The obtained data were analyzed. Results: One hundred thirty three relatives were divided into two groups of control (59 subjects) and intervention (74 people). No significant difference was observed between two groups regarding demographic features. The evaluation after 90 days revealed depression, anxiety disorders and PTSD to be significantly more prevalent in control group than the intervention group (P < 0.0001 ). Conclusion: Emotional and psychological support and intervention on the patients' relatives are efficient and can prevent the emergence of psychological disorders.",Soleimanpour H.; Tabrizi J.S.; Rouhi A.J.; Golzari S.E.J.; Mahmoodpoor A.; Esfanjani R.M.; Soleimanpour M.,2017.0,10.15171/jcvtr.2017.19,0,0,
3639,Predictive variables of the therapeutic outcome in the cognitive-behavioral treatment of the social phobia.,"Social phobia frequently occurs in the general population. Several studies have shown that exposure and cognitive therapy are the most effective treatment for this disorder. In recent years the differential effects of some variables on treatment outcomes have been the subject of several studies. Educational level, age and comorbid disorders are analyzed as predictive variables on 10 patients who received cognitive-behavioral group therapy for social phobia. Age does not affect treatment outcome. Educational level predicts treatment outcome on most measures. There is a statistically significant relationship between comorbidity and changes in the fear of negative evaluation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sole, Josep A. Rodriguez; Guarch, Joana; Jorquera, Aurora; Puig, Olga; Salamero, Manel; Bados, Butler, Caballo, Caballo, Coles, Dingemans, Echeburua, Erwin, Fava, Fedoroff, Heimberg, Hope, Leahy, Levin, Reich, Salaberria, Schneier, Turner, Turner, Van Velzen, Wells",2004.0,,0,0,
3640,Intensive short-term dynamic residential treatment program for patients with treatment-resistant disorders.,"The study investigated the effectiveness of an Intensive Short-Term Dynamic (ISTDP) residential treatment program for patients with treatment resistant anxiety- and/or depressive disorders, with and without comorbid personality disorders. A non-randomized controlled trial examined the effects of an eight week intensive residential treatment program based on principles from ISTDP. Patients (N=60), who had repeated prior treatment failure for current mental disorder, sufficient dysfunction to warrant hospitalization, and evidencing capacity to take an intrapsychic perspective on own problems, were included. Outcome variables included measures of target complaints (depression/anxiety, social role dysfunction, and interpersonal distress), general symptom distress, and interpersonal functioning. Measures were administered throughout and after treatment. Change was assessed by multilevel growth curve modeling. Changes during and after treatment were compared to those reported by a sub-sample of wait-list controls taking treatment as usual (N=30). The treatment group evidenced significant improvements on all measures. By contrast, receiving treatment as usual while on the wait-list did not yield significant changes. Effect sizes in the treatment group were consistently large at both termination and follow-up. Fourteen months after treatment 50.0% of patients had recovered in terms of target complaints. Approximately 53.3% and 48.3%, respectively, had recovered in terms of general symptom distress and interpersonal functioning. Limitations included a relatively small sample size, inability to discern the effectiveness of separate components of the treatment program, and lack of randomization of patients to wait-list and treatment. ISTDP-based residential treatment with an eight-week time-limit appears to be effective for alleviating common and severe, treatment resistant mental disorders. The treatment program was superior to receiving treatment as usual while on the wait-list. Participation in the program quickly reduced target complaints, symptoms and interpersonal problems for patients who, based on previous treatment experiences, were expected to fare poorly in treatment. Gains were consistently maintained or improved further at follow-up. Results are promising for patients with chronic debilitating problems who often do not profit from traditional psychiatric treatment.",Solbakken OA.; Abbass A.,2015.0,10.1016/j.jad.2015.04.003,0,0,
3641,Symptom- and personality disorder changes in intensive short-term dynamic residential treatment for treatment-resistant anxiety and depressive disorders.,"The study investigated the effectiveness of an 8-week intensive residential treatment programme based on principles from intensive short-term dynamic psychotherapy for patients with known treatment-resistant anxiety- and/or depressive disorders (mainly with comorbid personality disorders). Patients (N=95) with prior repeated treatment failure were included. Changes in self-reported target complaints, symptom severity, and overall interpersonal problems have been presented for these patients in two previous articles. We now expand upon the existing knowledge by presenting novel data from a number of important observer-based and self-reported outcome domains (diagnostic changes on Axis I and II, changes in overall personality dysfunction, disorder complexity, medication use, health care utilisation, and occupational activity). There were pervasive and significant improvements on all measures during treatment, which were maintained or further improved during follow-up. Fourteen months after the end of treatment, 46.26% of patients had recovered in terms of Axis I pathology, 63.79% had recovered in terms of Axis II pathology, 71.18% had returned to work, and there was a 28.62% reduction in regular use of psychotropic medications. Health care utilisation was reduced by 65.55%, and there were large improvements in disorder complexity and levels of personality dysfunction. The treatment programme was highly effective for patients with common and complex treatment-resistant mental disorders. Results are encouraging for the relatively large number of patients who tend not to benefit from standard formats of treatment for debilitating psychological problems.",Solbakken OA.; Abbass A.,2016.0,10.1017/neu.2016.5,0,0,
3642,Preventive interventions in families with parental depression: children's psychosocial symptoms and prosocial behaviour,"ER The aim is to document the effectiveness of a preventive family intervention (Family Talk Intervention, FTI) and a brief psychoeducational discussion with parents (Let's Talk about the Children, LT) on children's psychosocial symptoms and prosocial behaviour in families with parental mood disorder, when the interventions are practiced in psychiatric services for adults in the finnish national health service. Patients with mood disorder were invited to participate with their families. Consenting families were randomized to the two intervention groups. The initial sample comprised 119 families and their children aged 8-16. Of these, 109 completed the interventions and the baseline evaluation. Mothers and fathers filled out questionnaires including standardized rating scales for children's symptoms and prosocial behaviour at baseline and at 4, 10 and 18 months post-intervention. The final sample consisted of parental reports on 149 children with 83 complete data sets. Both interventions were effective in decreasing children's emotional symptoms, anxiety, and marginally hyperactivity and in improving children's prosocial behaviour. The FTI was more effective than the LT on emotional symptoms particularly immediately after the intervention, while the effect of the LT emerged after a longer interval. The study supports the effectiveness of both interventions in families with depressed parents. The FTI is applicable in cultural settings other than the USA. Our findings provide support for including preventive child mental health measures as part of psychiatric services for mentally ill parents.","Solantaus, T; Paavonen, E J; Toikka, S; Punamäki, R L",2010.0,10.1007/s00787-010-0135-3,0,0,
3643,A randomised controlled trial of a CBT intervention for anxiety in children with Asperger syndrome,"ER METHODSSeventy-one children aged ten to twelve years were recruited to participate in the anxiety programme. All children were diagnosed with AS and the presence of anxiety symptoms was accepted on parent report via brief interview. Children were randomly assigned to one of three conditions: intervention for child only, intervention for child and parent, wait-list control.RESULTSThe two intervention groups demonstrated significant decreases in parent-reported anxiety symptoms at follow-up and a significant increase in the child's ability to generate positive strategies in an anxiety-provoking situation. There were a number of significant differences between the two interventions to suggest parent involvement as beneficial.CONCLUSIONSThe sample of children with AS in this study presented with a profile of anxiety similar to a sample of clinically diagnosed anxious children. The intervention was endorsed by parents as a useful programme for children diagnosed with Asperger syndrome and exhibiting anxiety symptoms, and active parent involvement enhanced the usefulness of the programme. Limitations of the study and future research are discussed.BACKGROUNDThe aim of the study was to evaluate the effectiveness of a brief CBT intervention for anxiety with children diagnosed with Asperger syndrome (AS). A second interest was to evaluate whether more intensive parent involvement would increase the child's ability to manage anxiety outside of the clinic setting.","Sofronoff, K; Attwood, T; Hinton, S",2005.0,10.1111/j.1469-7610.2005.00411.x,0,0,
3644,Stimulation of the noradrenergic system during memory formation impairs extinction learning but not the disruption of reconsolidation.,"The noradrenergic system plays a critical role in the 'consolidation' of emotional memory. If we are to target 'reconsolidation' in patients with anxiety disorders, the noradrenergic strengthening of fear memory should not impair the disruption of reconsolidation. In Experiment I, we addressed this issue using a differential fear conditioning procedure allowing selective reactivation of one of two fear associations. First, we strengthened fear memory by administering an alpha(2)-adrenergic receptor antagonist (ie, yohimbine HCl; double-blind placebo-controlled study) 30 min before acquisition (time for peak value yohimbine HCl < 1 h). Next, the reconsolidation of one of the fear associations was manipulated by administering a beta-adrenergic receptor antagonist (ie, propranolol HCl) 90 min before its selective reactivation (time for peak value propranolol HCl < 2 h). In Experiment II, we administered propranolol HCl after reactivation of the memory to rule out a possible effect of the pharmacological manipulation on the memory retrieval itself. The excessive release of noradrenaline during memory formation not only delayed the process of extinction 48 h later, but also triggered broader fear generalization. Yet, the beta-adrenergic receptor blocker during reconsolidation selectively 'neutralized' the fear-arousing aspects of the noradrenergic-strengthened memory and undermined the generalization of fear. We observed a similar reduction in fear responding when propranolol HCl was administered after reactivation of the memory. The present findings demonstrate the involvement of noradrenergic modulation in the formation as well as generalization of human fear memory. Given that the noradrenergic strengthening of fear memory impaired extinction learning but not the disruption of reconsolidation, our findings may have implications for the treatment of anxiety disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Soeter, Marieke; Kindt, Merel; Baeyens, Blechert, Bouton, Brewin, Brunei, Charney, Davies, Davis, Debiec, Dudai, Dudai, Eisenberg, Filion, Gilman, Grasing, Grillon, Grillon, Hamm, Han, Josselyn, Kindt, Klorman, LaBar, LaBar, Lang, Laxmi, Lee, Lissek, Lissek, Lovibond, Lovibond, McGaugh, Mineka, Mueller, Murray, Myers, Nader, Norrholm, Ouyang, Pedreira, Peskind, Peterson, Rothbaum, Schultz, Soeter, Soeter, Soeter, Spielberger, Squire, Stegeren, Stegeren, Sun, Suzuki, Thonberg, Wang, Weike, Weike",2012.0,,0,0,
3645,Disrupting reconsolidation: Pharmacological and behavioral manipulations,"We previously demonstrated that disrupting reconsolidation by pharmacological manipulations ""deleted"" the emotional expression of a fear memory in humans. If we are to target reconsolidation in patients with anxiety disorders, the disruption of reconsolidation should produce content-limited modifications. At the same time, the fear-erasing effects should not be restricted to the feared cue itself considering that fear generalization is a main characteristic of anxiety disorders. In Experiment I and Experiment Ib, we addressed these issues using a within-subject differential startle fear conditioning paradigm and a test of fear generalization. In Experiment II, we tested whether a behavioral approach targeting the reconsolidation through extinction learning was also effective in weakening the original fear memory. A behavioral procedure is evidently preferred over drug manipulations provided that similar effects can be obtained. Here, the extinction procedure subsequent to retrieval did not ""erase"" the emotional expression of the fear memory as the retrieval techniques (i.e., reminder shocks and reacquisition) unveiled a return of the startle fear response to the fear-relevant stimuli. In contrast, β-adrenergic receptor blockade during reconsolidation selectively deleted the fear-arousing aspects of the memory (i.e., startle fear response) along with its category-related information. The pharmacological manipulation rendered the core memory trace too weak to observe fear generalization after successful reacquisition. Hence, relearning following the disruption of reconsolidation seems to be qualitatively different from initial learning. Our findings demonstrate that disrupting reconsolidation by pharmacological manipulations, although selective, undermines the generalization of fear, a key feature of anxiety disorders. © 2011 Cold Spring Harbor Laboratory Press.",Soeter M.; Kindt M.,2011.0,10.1101/lm.2148511,0,0,
3646,Erasing fear for an imagined threat event,"Although memory for emotionally arousing and stressful experiences is strong and resistant to change, recent years have witnessed rapidly emerging evidence for the plasticity of fear memories. Upon retrieval a memory may be rendered labile and vulnerable to the disruptive effects of amnestic agents. This process is referred to as ""disrupting reconsolidation"" and may point to a novel therapeutic strategy for the permanent reduction of fear in patients suffering from anxiety disorders. However, the fear-reducing effects are thus far only demonstrated for freezing reactions in rodents and autonomic fear responding in humans. If disrupting reconsolidation will be of value for clinical practice, it should also target the subjective feelings of anxiety. Using an instructed fear-learning paradigm in humans, we here tested whether disrupting reconsolidation would diminish the subjective feelings of anxiety for a noxious event that was anticipated but never actually experienced. Beta-adrenergic receptor blockade during reconsolidation strongly diminished the behavioral expression of the instructed fear memory (i.e., startle responding) as well as the subjective feelings of anxiety 24. h later, yet without affecting both the physiological and cognitive component of the anticipation of threat (i.e., skin conductance responding, expectancy ratings). Together, the present findings suggest that the various memory traces of a learned fear association do not necessarily undergo reconsolidation in harmony. Considering that patients with anxiety disorders (1) often fear objects and situations that they have never actually experienced, and (2) primarily suffer from the subjective feelings of anxiety, the present findings may have important ramifications for psychotherapy. © 2012 Elsevier Ltd.",Soeter M.; Kindt M.,2012.0,10.1016/j.psyneuen.2012.03.011,0,0,
3647,Cost-effectiveness of psychotherapy for cluster C personality disorders: a decision-analytic model in the Netherlands.,"To conduct a formal economic evaluation of various dosages of psychotherapy for patients with avoidant, dependent, and obsessive-compulsive (ie, cluster C) personality disorders (Structured Interview for DSM-IV Personality criteria). We developed a decision-analytic model to assess the cost-effectiveness of 5 dosages of psychotherapy (ie, long-term outpatient psychotherapy, short-term and long-term day hospital psychotherapy, and short-term and long-term inpatient psychotherapy) over a 5-year time horizon in terms of cost per recovered patient-year and cost per quality-adjusted life-year (QALY). Model parameters were estimated using data from 466 patients with cluster C personality disorders who were admitted to 6 specialist centers of psychotherapy in The Netherlands and assigned to 1 of the 5 treatment groups. Probabilistic analysis was conducted to explore the stability of results over uncertain data ranges. Analyses were conducted from both societal and payer perspectives. From the societal perspective and below a threshold of € 2,637 (US $3,351.92) per recovered patient-year, short-term day hospital psychotherapy resulted in the highest level of benefit for its cost; above the threshold, short-term inpatient psychotherapy was the most cost-effective choice. In terms of cost per QALY, this switch point was at a threshold value of € 16,570 (US $21,062.29) per QALY. From the payer perspective, the optimal strategy changed from short-term day hospital psychotherapy to short-term inpatient psychotherapy at threshold values of € 9,874 (US $12,550.94) per recovered patient-year and € 66,302 (US $84,277.13) per QALY. This study indicates that short-term day hospital psychotherapy and short-term inpatient psychotherapy are the most cost-effective treatment strategies for patients with cluster C personality disorders. The ultimate selection depends on what cost-effectiveness threshold is considered acceptable and what perspective is adopted.",Soeteman DI.; Verheul R.; Meerman AM.; Ziegler U.; Rossum BV.; Delimon J.; Rijnierse P.; Thunnissen M.; Busschbach JJ.; Kim JJ.,2011.0,10.4088/JCP.09m05228blu,0,0,
3648,"A three-group study, internet-based, face-to-face based and standard- management after acute whiplash associated disorders (WAD) - choosing the most efficient and cost-effective treatment: study protocol of a randomized controlled trial","ER METHODS/DESIGNThe study is a randomized, prospective, experimental three-group study with analyses of cost-effectiveness up to two-years follow-up. Internet - based programme and face-to-face group treatment programme are compared to standard-treatment only. Patient follow-ups take place three, six, twelve and 24 months, that is, short-term as well as long-term effects are evaluated. Patients will be enrolled via the emergency ward during the first week after the accident.DISCUSSIONThis new self-help management will concentrate to those psychosocial factors that are shown to be predictive in long-term problems in whiplash associated disorders, i.e. the importance of self-efficacy, fear of movement, and the significance of catastrophizing as a coping strategy for restoring and sustaining activities of daily life. Within the framework of this project, we will develop, broaden and evaluate current physical therapy treatment methods for acute whiplash associated disorders. The project will contribute to the creation of a cost-effective behavioural medicine approach to management of acute whiplash associated disorders. The results of this study will answer an important question; on what extent and how should these patients be treated at acute stage and how much does the best management cost.TRIAL REGISTRATION NUMBERCurrent Controlled Trials ISRCTN61531337.BACKGROUNDThe management of whiplash associated disorders is one of the most complicated challenges with high expenses for the health care system and society. There are still no general guidelines or scientific documentation to unequivocally support any single treatment for acute care following whiplash injury. The main purpose of this study is to try a new behavioural medicine intervention strategy at acute phase aimed to reduce the number of patients who have persistent problems after the whiplash injury. The goal is also to identify which of three different interventions that is most cost-effective for patients with whiplash associated disorders. In this study we are controlling for two factors. First, the effect of behavioural medicine approach is compared with standard care. Second, the manner in which the behavioural medicine treatment is administered, Internet or face-to-face, is evaluated in it's effectiveness and cost-effectiveness.","Söderlund, A; Bring, A; Asenlöf, P",2009.0,10.1186/1471-2474-10-90,0,0,
3649,"[The psychotropic effect of the Pyrovalerone (F-1983), placebo, the milieu therapy and mental condition of the patients in forensic psychiatry].",,Söderholm S.; Viukari NM.; Rimón R.,1976.0,,0,0,
3650,A randomized controlled trial of aromatherapy massage in a hospice setting.,"Research suggests that patients with cancer, particularly in the palliative care setting, are increasingly using aromatherapy and massage. There is good evidence that these therapies may be helpful for anxiety reduction for short periods, but few studies have looked at the longer term effects. This study was designed to compare the effects of four-week courses of aromatherapy massage and massage alone on physical and psychological symptoms in patients with advanced cancer. Forty-two patients were randomly allocated to receive weekly massages with lavender essential oil and an inert carrier oil (aromatherapy group), an inert carrier oil only (massage group) or no intervention. Outcome measures included a Visual Analogue Scale (VAS) of pain intensity, the Verran and Snyder-Halpern (VSH) sleep scale, the Hospital Anxiety and Depression (HAD) scale and the Rotterdam Symptom Checklist (RSCL). We were unable to demonstrate any significant long-term benefits of aromatherapy or massage in terms of improving pain control, anxiety or quality of life. However, sleep scores improved significantly in both the massage and the combined massage (aromatherapy and massage) groups. There were also statistically significant reductions in depression scores in the massage group. In this study of patients with advanced cancer, the addition of lavender essential oil did not appear to increase the beneficial effects of massage. Our results do suggest, however, that patients with high levels of psychological distress respond best to these therapies.",Soden K.; Vincent K.; Craske S.; Lucas C.; Ashley S.,2004.0,10.1191/0269216304pm874oa,0,0,
3651,In vivo exposure for panic disorder and agoraphobia: Does a cognitive rationale enhance treatment efficacy?,"To investigate the efficacy of the elements of cognitive-behavioral therapy, the aim of the present study was to assess the effects of a cognitive rationale vs a behavioral (deconditioning) rationale in the treatment of panic disorder and agoraphobia (PDA) with in vivo exposure. D. M. Clark's (1986) cognitive theory of panic leads us to expect that in vivo exposure will be more efficacious when it is accompanied by a cognitive rationale rather than a deconditioning rationale (DCR). 33 patients (mean age 33 yrs) with a primary diagnosis of PDA were recruited. Patients received 8 2.5-hr weekly group sessions of in vivo exposure treatment for agoraphobia. Six groups of 4-6 patients received this treatment. Three groups received a cognitive rationale, whereas the other 3 groups received a DCR. Treatment-outcome variables were (1) number of panic attacks during the past month, (2) worry about having further panic attacks, (3) scores on the Anxiety Sensitivity Index, (4) scores on the Beck Anxiety Inventory, (5) agoraphobic avoidance when accompanied, and (6) agoraphobic avoidance while alone. The latter 2 measures were assessed by the Mobility Inventory for Agoraphobia. Overall, there was no evidence favoring the superior efficacy of the cognitive rationale. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Sochting, Ingrid; Taylor, Steven; Freeman, Wendy; De Koning, Erica; Segerstrom, Suzanne; Thordarson, Dana; Sanavio, E [Ed]",1998.0,,0,0,
3652,"Indoprofen and pentazocine in post-traumatic pain. A double-blind, parallel-group comparative trial","ER In a double-blind, randomized, parallel-group study involving sixty patients with severe pain due to fractures, the analgesic activity of indoprofen and pentazocine was evaluated. Each patient received one of the following treatments in random order: indoprofen 400 mg i.v., pentazocine 30 mg i.v., placebo. The analgesic effect was measured by rating the intensity of pain before treatment and after 1/2, 1, 2, 4 and 6 hours. Patients' final opinions on efficacy were assessed on the basis of categoric and visual analogue scales. Highly significant differences were found between the active drugs and placebo for all variables analyzed. Indoprofen was significantly superior to pentazocine when assessed through variables measuring total analgesic effects. Since both drugs were well tolerated, i.v. indoprofen appears to offer an effective and safe alternative to narcotic analgesics in acute pain due to fractures.","Soave, G; Lavezzari, M; Ferrati, G; Sacchetti, G",1983.0,10.1177/030006058301100606,0,0,
3653,Backward masking and skin conductance responses after conditioning to nonfeared but fear-relevant stimuli in fearful subjects,"The present study examined two issues. Are skin conductance responses conditioned to fear-relevant stimuli, as contrasted with responses conditioned to fear-irrelevant stimuli, elicited after merely an automatic, nonconscious analysis of the stimulus content? Do fearful subjects show better conditioning to nonfeared but fear-relevant stimuli (e.g., conditioning to spiders in snake-fearing subjects) than do nonfearful subjects? Subjects afraid of snakes, but not of spiders, or vice versa (n = 32) and nonfearful subjects (n = 32) were shown either fear-relevant stimuli (snakes or spiders and rats) or fear-irrelevant stimuli (flowers and mushrooms) in a differential conditioning paradigm, where one of the stimuli was followed by an electric shock. During a subsequent extinction phase, the conditioned stimuli were presented under backward masking conditions, preventing their conscious recognition. Consistent with our hypothesis, during the masked extinction of the conditioned stimuli, differential skin conductance responses to conditioning and control stimuli remained only for subjects conditioned to fear-relevant stimuli. Both fearful and nonfearful control subjects had significantly larger differential electrodermal responses to fear-relevant than to fear-irrelevant stimuli. However, contrary to our hypothesis, fearful subjects did not show enhanced conditionability to their nonfeared but fear-relevant stimuli as compared with nonfearful control subjects.",Soares J.J.F.; Ohman A.,1993.0,,0,0,
3654,Impact of state anxiety on the jumping to conclusions delusion bias.,"This is the first study to investigate the relationship between the level of state anxiety and the jumping to conclusions (JTC) reasoning bias in patients with first-episode psychosis using an experimental manipulation procedure. Thirty patients with psychotic delusions and 30 non-clinical controls, from Hong Kong, were randomized into an anxiety induction or an anxiety reduction imagery condition. Questionnaires were used to measure trait emotions, psychotic symptoms and delusional thinking at baseline. After the anxiety manipulation, participants completed two versions of an assessment of the JTC reasoning bias, the beads task. Both the patients and the non-clinical controls were responsive to the anxiety reduction imagery, but only the non-clinical controls responded to the anxiety induction imagery. The JTC reasoning bias was, as hypothesized, more common in patients than in controls, but was not significantly different between the anxiety manipulation conditions. Both patients and controls had higher rates of JTC than in previous studies. Patients with psychotic delusions have a marked JTC cognitive bias. This is the first JTC study in a Chinese sample, and the results suggest that the bias applies cross-culturally. The results indicate that state anxiety does not influence JTC. Limitations of the study include an inadequate anxiety state manipulation effect in psychotic patients using brief imagery, and unusually high rates of JTC in both patients and controls.",So SH.; Freeman D.; Garety P.,2008.0,10.1080/00048670802345466,0,0,
3655,Reactions of participants to the results of a randomised controlled trial: exploratory study,"ER DESIGNQualitative analysis of interviews.SETTINGParents' homes.SUBJECTSParents of 24 surviving babies enrolled in a UK randomised controlled trial comparing ventilatory support by extracorporeal membrane oxygenation with conventional management.MAIN OUTCOME MEASURESViews about contents of results, reactions to results, effect of hindsight, and importance of feedback.RESULTSInformation about mortality was well understood by the parents but morbidity was less clearly reported. Even when the content was emotionally exacting, the information was still wanted as it removed uncertainty; provided an endpoint to difficult events; promoted further discussion within couples; and acknowledged their contribution to answering an important clinical question.CONCLUSIONSFeedback of trial results to participants should be a consideration of researchers, but a careful approach is required. This study was based on a highly selective group of parents within a particularly sensitive trial. More research is needed to assess the extent to which these results can be generalised to other trials or to groups such as bereaved parents.OBJECTIVESTo assess views of parents of babies who participated in a neonatal trial, about feedback of trial results.","Snowdon, C; Garcia, J; Elbourne, D",1998.0,,0,0,
3656,On becoming neutral: effects of experimental neutralizing reconsidered.,"Behaviour Research and Therapy 34 (1996) 889-898 found that writing out a negative thought produced anxiety and an urge to neutralize the thought, that instructing participants to neutralize the thought reduced anxiety/neutralization urge in the short run (i.e. within 2 min), but that in the control group 20 min without instruction was attended by the same reduction in anxiety/urge to neutralize (""natural decay""). The observations were made with pariticipants who scored high on ""thought action fusion"" and the experiment was set up as exerimental model of obsessions. We repeated the study with participants that were not selected on thought action fusion. All the findings reported by Behaviour Research and Therapy 34 (1996) 889-898 were replicated. Correlational analysis indicated that the strength of the effect was not related to scores on scales measuring ""thought action fusion"". Behaviour Research and Therapy 34 (1996) 889-898 did not assess whether non-neutralizing was followed by immediate reductions in distress. We did assess this and found that the larger part of the immediate reduction of distress after neutralization also occurs when no neutralization instruction is given. The effects of neutralization instructions in the present type of experiment are considerably less powerful than suggested earlier.",van den Hout M.; van Pol M.; Peters M.,2001.0,,0,0,
3657,"Instructed neutralization, spontaneous neutralization and prevented neutralization after an obsession-like thought","Building on two earlier experiments (Behav. Res. Ther. 34 (1996) 889; 39 (2001) 1439) the present study investigated the effects of neutralizing the consequences of an obsession-like thought in healthy participants. Just like in the earlier studies, writing out and thinking over such a thought generated anxiety. After this provocation, 40 of the 120 participants were instructed to neutralize the effects of the thought for 2min, 40 participants did not receive a particular instruction, and the remaining 40 participants were instructed to do mental arithmetic aloud so as to prevent ""spontaneous"" attempts at neutralizing the thought. The no instruction group reported that they neutralized (spontaneously) to the same degree as the group that was instructed to neutralize. Within 2min, anxiety decreased to near base line levels and there were no differences between the three conditions. When the groups were asked to bring the obsession-like thought back to consciousness again, anxiety increased slightly. Yet, contrary to expectation, this increase in anxiety did not discriminate the ""neutralization prevention"" group from the other two groups. Limitations of the paradigm as a model for clinical obsessions are discussed. © 2003 Elsevier Science Ltd. All rights reserved.",Van Den Hout M.; Kindt M.; Weiland T.; Peters M.,2002.0,10.1016/S0005-7916(02)00048-4,0,0,
3658,Obsessive-compulsive disorder and the paradoxical effects of perseverative behaviour on experienced uncertainty,"Patients suffering from Obsessive-compulsive disorder (OCD) tend to check repeatedly and after checking episodes they tend to be uncertain about their memory for checked events. It seems plausible that memory distrust motivates checking, but why checking is repeated and why one check is not enough to reassure the patient is uncertain. To study this, an interactive computer animation displaying light bulbs or gas rings was developed and healthy participants were asked to engage in repeated checking. In five separate experiments we found that repeatedly checking the same class of items resulted in sharp decreases in detail and vividness of memory of the checked events while the accuracy of the memory remained intact. The phenomenological quality of the experienced memory distrust was highly similar to the ambivalence OCD patients tend to report about their memory after checking. Furthermore, there were some indications that repeated checking not only undermines trust in memory, but may also reduce the sense that one acted responsibly. The experimental preparation may be used as a model for OCD checking. The study suggests that repeated checking is sufficient to cause paradoxical effects on memory trust and that repeated checking is a counterproductive safety strategy. © 2004 Elsevier Ltd. All rights reserved.",Van Den Hout M.; Kindt M.,2004.0,10.1016/j.jbtep.2004.04.007,0,0,
3659,Phenomenological validity of an OCD-memory model and the remember/know distinction,"In earlier experiments using interactive computer animation with healthy subjects, it was found that displaying compulsive-like repeated checking behavior affects memory. That is, checking does not alter actual memory accuracy, but it does affect 'meta-memory': as checking continues, recollections are experienced as less vivid and less detailed while confidence in memory is undermined. This procedure provides a model of OCD checking and suggests that checking is a counterproductive strategy to reduce memory distrust. The present experiment was carried out to specify the phenomenological quality of memory distrust after checking and to see if repeated checking produces a shift in the memory source that is used to decide about the outcome of checking: from 'remembering' to 'knowing' (Tulving, 1985). Using the same interactive computer-animation, the earlier findings on vividness, detail and confidence were replicated. In addition, it was found that checking made participants endorse quotations from OCD patients (Reed, 1985) expressing a specific ambivalence about memory: 'It is as though the memory is there, but is isn't definite enough', 'I remember doing it in a way, but it's all fuzzy....' And 'I can remember that I've done it. But the memory isn't clear somehow'. This finding adds to the validity of the experimental model. Furthermore, after checking subjects' beliefs about the outcome of checking became based on (general) knowing instead of (specific) remembering. It is suggested that OCD checkers feel a general and relatively strong need to be certain about the veracity of recollections and that they have high standards for memory performance. This may explain earlier findings that OCD checkers have a general tendency to distrust their episodic memory. A need for certainty and a critical attitude towards memory performance may not be problematic or abnormal. It is suggested that clinical problems arise when the patient tries to fight memory distrust by repeated checking. The latter does not reduce distrust but rather increases distrust and the patient may get trapped in a spiral of mutually reinforcing checking behavior and memory distrust. © 2003 Elsevier Science Ltd. All rights reserved.",Van Den Hout M.; Kindt M.,2003.0,10.1016/S0005-7967(02)00097-9,0,0,
3660,Repeated checking causes memory distrust,"This paper attempts to explain why in obsessive-compulsive disorder (OCD) checkers distrust in memory persists despite extensive checking. It is argued that: (1) repeated checking increases familiarity with the issues checked; (2) increased familiarity promotes conceptual processing which inhibits perceptual processing; (3) inhibited perceptual processing makes recollections less vivid and detailed and finally; (4) reduction in vividness and detail promotes distrust in memory. An interactive computer animation was developed in which participants had to perform checking rituals on a virtual gas stove. Two separate experiments were carried out with n=39 (Experiment I) and n=40 (Experiment II) healthy participants. In both studies, the control group and the experimental group were given the same pre-test and post-test on the virtual gas stove. In between, the experimental group engaged in 'relevant checking', i.e. checking the gas stove, while the control group engaged in 'irrelevant checking', i.e. checking virtual light bulbs. In both experiments there were powerful effects of repeated 'relevant checking': while actual memory accuracy remained unaffected, the vividness and detail of the recollections were greatly reduced. Most pertinently, in both experiments relevant checking undermined confidence in memory. No such effects were observed in the control group. One might argue that the pre-test/post-test design may have made the control group anticipate a memory assessment at the post-test and that this artifact made them relatively alert producing memory confidence at post test that was artificially high. A third experiment was carried out (n=2×20) in which no pre-test was given while, other than that, Experiment III was identical to the first two experiments. Results confirmed earlier findings: compared to the irrelevant checking control group, recollections in the relevant checking group were non-vivid, non-detailed while confidences in memory was low. The theory and data suggest an answer to the question 'why memory distrust persists despite repetitive checking'. In people who check extensively, memory distrust may persist as a result of repetitive checking. OCD checking may be motivated by the wish to reduce uncertainty, but checking appears to be a counter-productive safety strategy. Rather than reducing doubt, checking fosters doubt and ironically increases meta-memory problems. © 2002 Elsevier Science Ltd. All rights reserved.",Van Den Hout M.; Kindt M.,2003.0,10.1016/S0005-7967(02)00012-8,0,0,
3661,"Exposure reduced agoraphobia but not panic, and cognitive therapy reduced panic but not agoraphobia.","Earlier studies showed that cognitive therapy has anti-panic effects and exposure has anti-agoraphobic effects while other studies suggest that agoraphobia is a secondary complication of panic disorder. It was therefore hypothesized that cognitive therapy not only reduces panic but also agoraphobia and that it potentiates the effects of exposure in vivo. Two groups of 12 severe agoraphobics were treated with 4 sessions of cognitive therapy followed by 8 sessions of cognitive therapy combined with in vivo exposure. The other 12 received 4 sessions of 'associative therapy', a presumably inert treatment that controls for therapist attention, followed by 8 sessions of in vivo exposure that was framed in common behavioral terms. The initial cognitive therapy produced a significant reduction in panic frequency, while associative therapy did not affect panic. Neither cognitive therapy alone, nor associate therapy alone significantly reduced depression, state or trait anxiety, self-rated agoraphobia or behavioral avoidance. After adding exposure however, these parameters were clearly and significantly reduced. Cognitive therapy did not potentiate exposure effects. The results are discussed.",van den Hout M.; Arntz A.; Hoekstra R.,1994.0,,0,0,
3662,On EMDR: Eye movements during retrieval reduce subjective vividness and objective memory accessibility during future recall,"In eye movement desensitization and reprocessing (EMDR), a treatment for post-traumatic stress disorder (PTSD), patients make eye movements (EM) during trauma recall. Earlier experimental studies found that EM during recall reduces memory vividness during future recalls, and this was taken as laboratory support for the underlying mechanism of EMDR. However, reduced vividness was assessed with self-reports that may be affected by demand characteristics. We tested whether recall+EM also reduces memory vividness on a behavioural reaction time (RT) task. Undergraduates (N=32) encoded two pictures, recalled them, and rated their vividness. In the EM group, one of the pictures was recalled again while making EM. In the no-EM group one of the pictures was recalled without EM. Then fragments from both the recalled and non-recalled pictures, and new fragments were presented and participants rated whether these were (or were not) seen before. Both pictures were rated again for vividness. In the EM group, self-rated vividness of the recalled+EM picture decreased, relative to the non-recalled picture. In the no-EM group there was no difference between the recalled versus non-recalled picture. The RT task showed the same pattern. Reduction of memory vividness due to recall+EM is also evident from non-self-report data. © 2013 Taylor & Francis.",van den Hout M.A.; Bartelski N.; Engelhard I.M.,2013.0,10.1080/02699931.2012.691087,0,0,
3663,Accuracy of general practitioner's prognosis of the 1-year course of depression and generalised anxiety,"Background: A prognosis serves important functions for the management of common mental disorders in primary care. Aims: To establish the accuracy of the general practitioner's (GP) prognosis. Method: The agreement between GP prognosis and observed course was determined for 138 cases of ICD-10 depression and 65 of generalised anxiety disorder, identified among consecutive attenders of 18 GPs. Results: Modest agreement between GP prognosis and course was found, both for depression (κ=0.21) and generalised anxiety (κ=0.11). Better agreement (κ=0.45 for depression, and κ=0.33 for generalised anxiety) was observed between the course and predictions from a statistical model based on information potentially available to the GP at the time the prognosis was made. This model assesses attainable performance for GPs. Conclusions: General practitioners do a fair job in predicting the I-year course of depression and generalised anxiety. Even so, their performance falls significantly short of attainable performance. Declaration of interest: No conflict of interest. Public funding detailed in Acknowledgements.",Van den Brink R.H.S.; Ormel J.; Van der Meer K.; Tiemens B.G.; Van Os T.W.D.P.; Smit A.; Jenner J.A.,2001.0,10.1192/bjp.178.1.18,0,0,
3664,Treating trauma in psychosis with EMDR: a pilot study.,"Initial studies have shown that posttraumatic stress disorder (PTSD) can be effectivelytreated in patients with a psychotic disorder. These studies however used adapted treatment protocols, avoided direct exposure to trauma related stimuli or preceded treatment with stabilizing techniques making treatment considerably longer in duration. An open trial in which adult subjects with a psychotic disorder and a comorbid PTSD (n = 27) received a maximum of six Eye Movement Desensitization and Reprocessing (EMDR) therapy sessions. PTSD symptoms, psychotic symptoms and additional symptoms were assessed at baseline and end-of-treatment. The dropout rate was 18.5 percent (five subjects). Only five of the twenty-two completers (22.7%) still met criteria for PTSD after treatment. PTSD symptoms, auditory verbal hallucinations, delusions, anxiety, depression, and self-esteem all improved significantly. Paranoid ideation and feelings of hopelessness did not improve significantly. Treatment did not lead to symptom exacerbation in subjects. There were no adverse events, such as suicide attempts, self-mutilation, aggressive behavior or admission to a general or psychiatric hospital. This pilot study shows that a short EMDR therapy is effective and safe in the treatment of PTSD in subjects with a psychotic disorder. Treatment of PTSD has a positive effect on auditory verbal hallucinations, delusions, anxiety symptoms, depression symptoms, and self-esteem. EMDR can be applied to this group of patients without adapting the treatment protocol or delaying treatment by preceding it with stabilizing interventions.",van den Berg DP.; van der Gaag M.,2012.0,10.1016/j.jbtep.2011.09.011,0,0,
3665,Predicting trauma-focused treatment outcome in psychosis.,"Objective: Although TF treatments are effective in patients with psychosis, it is unknown whether specific psychosis-related obstacles limit the effects, and what determines good outcome. Methods: Baseline posttraumatic stress disorder (PTSD) symptom severity and seven psychosis-specific variables were tested as predictors in patients with a psychotic disorder and PTSD (n = 108), who received eight sessions of TF treatment (Prolonged Exposure, or Eye Movement Desensitization and Reprocessing therapy) in a single-blind randomized controlled trial. Multiple regression analyses were performed. Results: Baseline PTSD symptom severity was significantly associated with posttreatment PTSD symptom severity, explaining 11.4% of the variance. Additionally, more severe PTSD at baseline was also significantly associated with greater PTSD symptom improvement during treatment. After correction for baseline PTSD symptom severity, the model with the seven baseline variables did not significantly explain the variance in posttreatment PTSD outcome. Within this non-significant model, the presence of auditory verbal hallucinations contributed uniquely to posttreatment outcome but explained little variance (5.4%). Treatment completers and dropouts showed no significant difference on any of the psychosis-related variables. Conclusions: Given the low predictive utility of baseline psychosis-related factors, we conclude that there is no evidence-based reason to exclude patients with psychotic disorders from TF treatments. Also, we speculate that patients with psychosis and severe baseline PTSD might derive more benefit if given more than eight sessions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","van den Berg, David P.G; van der Vleugel, Berber M; de Bont, Paul A. J. M; Staring, Anton B. P; Kraan, Tamar; Ising, Helga; de Roos, Carlijn; de Jongh, Ad; van Minnen, Agnes; van der Gaag, Mark; Achim, Andreasen, Austin, Babyak, Becker, Blake, Blanchard, Bradley, Cabin, Cloitre, de Bont, de Bont, De Jongh, de Kleine, DuBois, Elliott, Faber, Foa, Foa, Foa, Foa, Forbes, Forbes, Gairns, Goodson, Green, Gunter, Haddock, Harrell, Hassan, Hembree, Hembree, Karatzias, Lee, Lincoln, Lommen, Matheson, Meyer, Moncrieff, Moritz, Moser, Mueser, Mueser, Peduzzi, Polak, Popiel, Rauch, Rizvi, Ronconi, Saeedi, Salyers, Schneeberger, Schweizer, Shapiro, Sheehan, Sheehan, Speckens, Steketee, Taylor, Thrasher, van den Berg, van den Berg, van den Hout, van den Hout, van der Gaag, van Emmerik, van Minnen, Vittinghoff, Wittorf, Young",2016.0,,0,0,
3666,Treatment of the hyperventilation syndrome with bisoprolol: A placebo-controlled clinical trial.,"Examined the efficacy of the beta-blocker bisoprolol in treating the hyperventilation syndrome (HVS), a form of panic disorder associated with a relative increase in sympathomimetic tone. A double-blind, placebo-controlled, randomized, crossover trial involving 60 Dutch patients was conducted. Following a single-blind placebo prephase, patients who met the inclusion criteria were randomized to treatment with either 5 mg bisoprolol or an identical-looking placebo tablet once daily for 3 wks. They were then crossed over to the other treatment arm. The number of attacks decreased from 4.04 per week at baseline to 3.52 with placebo and to 1.26 with bisoprolol. Five milligrams of bisoprolol once daily is effective and safe in the maintenance of symptom reduction in patients with HVS. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Van de Ven, L. L. M; Mouthaan, B. J; Hoes, M. J. A. J. M",1995.0,,0,0,
3667,The COMT val158met polymorphism in ultra-endurance athletes,"Chronic levels of physical activity have been associated with increased dopamine (D2) receptors resulting in increased sensitivity to dopamine release. The catechol-O-methyltransferase enzyme, responsible for dopamine degradation, contains a functional polymorphism, which plays an important role in dopamine regulation within the prefrontal cortex. This polymorphism has previously been shown to affect human cognition and personality. However, the effect of this polymorphism has not been shown in ultra-endurance athletes. Aim: To examine the association of the COMT val158met variant with personality traits (harm avoidance, novelty seeking, reward dependence, resilience) and psychological distress (K10) of habitual physically active Ironman athletes compared to recreationally active controls. Methods: 51 ultra-endurance Ironman athletes and 56 recreationally active controls were genotyped for the catechol-O-methyltransferase val158met polymorphism. Of the 107 participants, 55 ultra-endurance athletes and 32 recreationally active controls completed online personality questionnaires (harm avoidance, novelty seeking, reward dependence, resilience) and a psychological distress questionnaire (K10). Results: The personality trait, harm avoidance (p=0.001) and psychological distress (p=0.003) were significantly lower in Ironman athlete participants. Novelty seeking was significantly higher (p=0.02) in Ironman athlete participants with a significantly higher (p=0.04) score in Met158 homozygous allele carriers. Conclusion: Chronic levels of physical activity, as seen in ultra-endurance athletes, show increased novelty seeking scores in Met158 homozygous allele carriers.",van Breda K.; Collins M.; Stein D.J.; Rauch L.,2015.0,10.1016/j.physbeh.2015.07.039,0,0,
3668,Computed tomography of the ankle in full plantar flexion: a reliable method for preoperative planning of arthroscopic access to osteochondral defects of the talus.,"The purpose of this study was to determine whether preoperative computed tomography (CT) of the ankle joint in full plantar flexion is a reliable and accurate tool to determine the anterior arthroscopic accessibility of talar osteochondral defects (OCDs). Twenty consecutive patients were prospectively studied. All patients had an OCD of the talar dome and had a preoperative CT scan of the affected ankle in maximum plantar flexion. Accessibility of the OCD was defined by the distance between the anterior border of the OCD and the anterior distal tibial rim. This distance was measured on sagittal CT reconstructions by 2 investigators. The reference standard was the distance between the same landmarks measured during anterior ankle arthroscopy by an orthopaedic surgeon blinded to the CT scans. Intraobserver and interobserver reliability of CT, as well as the correlation and agreement between CT and arthroscopy, were calculated. The measured distance between the anterior border of the OCD and the anterior distal tibial rim ranged from -3.1 to 9.1 mm on CT and from -3.0 to 8.5 mm on arthroscopy. The intraobserver and interobserver reliability of the measurements made on CT scans (intraclass correlation coefficients >0.99, P < .001), as well as the correlation between CT and arthroscopy, were excellent (r = 0.98, P < .001). Measurements on CT scans of the ankle in full plantar flexion are a reliable and accurate preoperative method to determine the in situ arthroscopic location of talar OCDs.",van Bergen CJ.; Tuijthof GJ.; Blankevoort L.; Maas M.; Kerkhoffs GM.; van Dijk CN.,2012.0,10.1016/j.arthro.2011.11.030,0,0,
3669,Vulnerability to 35% CO2 of panic disorder patients with a history of respiratory disorders,"Patients with panic disorder often report a history of respiratory pathology. Furthermore, panic disorder patients are vulnerable to CO 2 challenges. The increased CO2 vulnerability displayed by panic disorder patients may be related to lifetime respiratory pathology. We examined whether panic disorder patients with a history of respiratory disorders are more vulnerable to a 35% CO2 challenge than those without such a history. Ninety-six patients with panic disorder were interviewed about their lifetime respiratory status (asthma, bronchitis and various other respiratory conditions) and underwent the challenge. Immediately before and after the CO2 inhalation, the patients filled out the Visual Analogue Scale for Anxiety (VAS-A) and the Panic Symptom List (PSL). We found no differences between the two panic disorder groups on anxiety (VAS-A), panic symptoms (PSL) or panic attacks after the CO2 challenge. Our results suggest that having a PD is an important factor in CO2 vulnerability independent of a history of respiratory disorders. © 2003 Elsevier Ireland Ltd. All rights reserved.",Van Beek N.; Perna G.; Schruers K.; Verburg K.; Cucchi M.; Bellodi L.; Griez E.,2003.0,10.1016/S0165-1781(03)00164-1,0,0,
3670,The effects of an Internet based self-help course for reducing panic symptoms--Don't Panic Online: study protocol for a randomised controlled trial.,"Internet based self-help for panic disorder (PD) has proven to be effective. However, studies so far have focussed on treating a full-blown disorder. Panic symptoms that do not meet DSM-IV criteria are more prevalent than the full-blown disorder and patients with sub-clinical panic symptoms are at risk of developing PD. This study is a randomised controlled trial aimed to evaluate an Internet based self-help intervention for sub-clinical and mild PD compared to a waiting list control group. Participants with mild or sub-clinical PD (N = 128) will be recruited in the general population. Severity of panic and anxiety symptoms are the primary outcome measures. Secondary outcomes include depressive symptoms, quality of life, loss of production and health care consumption. Assessments will take place on the Internet at baseline and three months after baseline. Results will indicate the effectiveness of Internet based self-help for sub-clinical and mild PD. Strengths of this design are the external validity and the fact that it is almost completely conducted online.",van Ballegooijen W.; Riper H.; van Straten A.; Kramer J.; Conijn B.; Cuijpers P.,2011.0,10.1186/1745-6215-12-75,0,0,
3671,"Comorbid depression, but not comorbid anxiety disorders, predicts poor outcome in anxiety disorders.","Influence of type of comorbidity was studied over the course of 1 year in a sample of 141 outpatients with panic disorder with or without agoraphobia and generalized anxiety disorder, who were receiving different forms of cognitive behavior therapy. Influence of type of comorbidity was determined on the basis of change scores (linear regression analysis) and remission data (Kaplan-Meier survival analysis). Three categories, as assessed at baseline, were compared: no comorbidity, comorbidity among anxiety disorders, and comorbidity with mood disorders. Primary outcome variable: State-Trait Anxiety Inventory State subscale measured at four assessments (0, 12, 24, and 52 weeks). Analyses of change and remission indicated that comorbidity with mood disorders led to (i) less improvement and (ii) a lower remission rate than comorbidity among anxiety disorders and no comorbidity. Because comorbidity has a critical influence on prognosis, it seems to be important to make a reliable diagnosis of the disorders present.",van Balkom AJ.; van Boeijen CA.; Boeke AJ.; van Oppen P.; Kempe PT.; van Dyck R.,2008.0,10.1002/da.20386,0,0,
3672,Cognitive therapy versus fluvoxamine as a second-step treatment in obsessive-compulsive disorder nonresponsive to first-step behavior therapy.,"To compare the effectiveness of second-step treatment with cognitive therapy (CT) versus fluvoxamine in patients with obsessive-compulsive disorder (OCD) who are nonresponsive to exposure in vivo with response prevention (ERP). A 12-week randomized controlled trial at an outpatient clinic in the Netherlands comparing CT with fluvoxamine in OCD. Of 118 subjects with OCD treated with 12 weeks of ERP, 48 appeared to be nonresponders (Y-BOCS improvement score of less than one third). These nonresponders were randomized to CT (n = 22) or fluvoxamine (n = 26). The main outcome measure was the Y-BOCS severity scale. Statistical analyses were conducted in the intention-to-treat sample (n = 45) on an 'as randomized basis' and in the per-protocol sample (n = 30). Due to selective dropout in the fluvoxamine group, two additional sensitivity analyses were performed. Complete data could be obtained from 45 subjects (94%) after 12 weeks. Fifty percent of the patients refused fluvoxamine after randomization compared to 13% who refused CT [χ(2)(1) = 7.10; p = 0.01]. CT as a second-step treatment did not appear to be effective in this sample of nonresponders. Fluvoxamine was significantly superior to CT in the intention-to-treat sample, in the per-protocol sample and in the two separately defined samples in which the sensitivity analyses were performed. OCD patients who are nonresponsive to ERP may benefit more from a switch to treatment with an antidepressant instead of switching to CT. In clinical practice, it may be important to motivate this subgroup of patients to undergo psychopharmacological treatment, as this may improve their outcome considerably.",van Balkom AJ.; Emmelkamp PM.; Eikelenboom M.; Hoogendoorn AW.; Smit JH.; van Oppen P.,2012.0,10.1159/000339369,0,0,
3673,Cognitive and behavioral therapies alone versus in combination with fluvoxamine in the treatment of obsessive compulsive disorder.,"The purpose of this treatment package design study was to investigate the differential efficacy of cognitive therapy or exposure in vivo with response prevention for obsessive compulsive disorder (OCD) versus the sequential combination with fluvoxamine. Patients with OCD (N = 117) were randomized to one of the following five conditions: a) cognitive therapy for weeks 1 to 16, b) exposure in vivo with response prevention for weeks 1 to 16, c) fluvoxamine for weeks 1 to 16 plus cognitive therapy in weeks 9 to 16, d) fluvoxamine for weeks 1 to 16 plus exposure in vivo with response prevention in weeks 9 to 16, or e) waiting list control condition for weeks 1 to 8 only. Assessments took place before treatment (pretest) and after 8 (midtest), and 16 weeks (posttest). In the first 8 weeks, six treatment sessions were delivered. During weeks 9 to 16, another 10 sessions were given. Thirty-one patients dropped out. Outcome was assessed by patient-, therapist- and assessor-ratings of the Anxiety Discomfort Scale, the Yale-Brown Obsessive Compulsive Scale, and the Padua Inventory-Revised. In contrast with the four treatments, after 8 weeks the waiting list control condition did not result in a significant decrease of symptoms. After 16 weeks of treatment, all four treatment packages were effective on these OCD ratings, but they did not differ among each other in effectiveness. In OCD, the sequential combination of fluvoxamine with cognitive therapy or exposure in vivo with response prevention is not superior to either cognitive therapy or exposure in vivo alone.",van Balkom AJ.; de Haan E.; van Oppen P.; Spinhoven P.; Hoogduin KA.; van Dyck R.,1998.0,,0,0,
3674,Long-term benzodiazepine use is associated with smaller treatment gain in panic disorder with agoraphobia.,,van Balkom AJ.; de Beurs E.; Koele P.; Lange A.; van Dyck R.,1996.0,,0,0,
3675,Possible gender difference in anti-stress effect of β-cryptoxanthin,"Beta-cryptoxanthin [β-CRX, (3R)-β, β-caroten-3-ol] is a provitamin A and a potent antioxidant that is abundant in Satsuma mandarin orange (Citrus unshiu MARC.), which is the most popular fruit in Japan. The anti-stress effect of β-CRX on humans was evaluated in fifth-year university students during both routine daily life at the university and at pharmacy practice. The study design was a double-blind group comparison and participants (n=20; female 12, male 8) were randomly assigned to β-CRX-rich orange juice or placebo (β-CRX was removed from orange juice) groups. β- CRX or placebo juice (125 mL, once a day, after breakfast) were consumed from 10 d prior to the pharmacy practice and continued for 10 d into the practice period. To assess participants’ anxiety, the state-trait anxiety inventory test was carried out before the pharmacy practice. Salivary α-amylase activity (sAA) was measured as a marker of sympathetic nervous system activity. In the placebo-group, sAA in the evening (post-practice sAA) tended to be higher than sAA in the morning (pre-practice sAA) during both routine daily life at the university and during pharmacy practice. In the β- CRX-group, the increase of post-practice sAA was suppressed in females. These results suggested that β-CRX has an anti- stress effect, at least, in females.",Unno K.; Noda S.; Kawasaki Y.; Iguchi K.; Yamada H.,2016.0,10.1248/yakushi.16-00017,0,0,
3676,Schizophrenia with prominent catatonic features ('catatonic schizophrenia'): I. Demographic and clinical correlates in the chronic phase.,"This study set out to determine the frequency of catatonic syndrome in chronic schizophrenia and its association with sociodemographic, clinical, and treatment variables. A cross-sectional assessment of a randomly selected cohort of patients (n=225; mean age=42+/-7 years; mean length of illness=20.4+/-7.5 years) with DSM-IV schizophrenia was employed using standard rating instruments for catatonia, drug-induced extrapyramidal symptoms (EPS), and psychotic, depressive, and obsessive-compulsive symptoms. Using a rather narrow definition of catatonia [the presence of four or more signs/symptoms with at least one having a score '2' or above on the Bush-Francis Catatonia Rating Scale (BFCRS)], 72 subjects (32%) met the criteria for the catatonia group (mean number of catatonic signs/symptoms=5.9+/-2.0; mean sum score of 8.7+/-3.4 on the BFCRS). The frequency distribution of catatonic signs/symptoms in the catatonic group and in the whole sample was very similar, with mannerisms, grimacing, stereotypes, posturing, and mutism being the most frequent. In the logistic regression analysis, catatonic subjects had a significantly earlier age of onset, more negative symptoms, and were more likely to receive benzodiazepines than their noncatatonic counterparts. In multiple regression analysis, the severity of catatonia as indicated by the sum score of BFCRS was predicted only by earlier age of onset and negative symptoms. Using relatively narrow criteria, this study confirmed that, if methodically assessed, catatonic signs and symptoms are prevalent in patients with chronic schizophrenia. Catatonia can be differentiated from EPS. Catatonic features indicate a generally poor prognosis in the chronic phase of schizophrenia.",Ungvari GS.; Leung SK.; Ng FS.; Cheung HK.; Leung T.,2005.0,10.1016/j.pnpbp.2004.08.007,0,0,
3677,[Dorsal capsular imbrication for dorsal instability of the distal radioulnar joint].,"To stabilize the distal radioulnar joint (DRUJ) by performing dorsal capsular imbrication in patients presenting with dorsal instability. The goal was to reduce pain and prevent the occurrence of posttraumatic arthrosis. Posttraumatic dorsal instability of the DRUJ with missing block while performing translational activities in the DRUJ or subluxation while actively rotating the forearm. Cases, in which other stabilizing techniques, such as, sutures of the triangular fibrocartilage complex failed. DRUJ arthrosis, previous surgical interventions to the capsule area of the DRUJ, instabilities due to osseous reasons (malposition or pseudarthrosis) should already have been treated. Dorsal approach and opening of the 5th extensor compartment to expose the dorsal joint capsule. A longitudinal division of the capsule was performed and sufficient tissue on the radial and ulnar border was retained to ensure a solid suture technique. Then 2 U-shaped sutures using FiberWire suture material were made. Correction of the malposition and repositioning the forearm into supination. Tightening of the prepared capsule sutures and closing of the retinaculum with a resorbable suture. Patients wore a long-arm cast with the forearm being in supination for a period of 4 weeks. Following cast removal, patients wore a forearm splint for a period of 4 weeks to limit forearm pronation/supination at 45°. Full load on the wrist was allowed after 12 weeks. The subjective and functional outcomes of 20 patients having received capsular imbrication using this technique were good and entailed no significant complications. The postoperative DASH was 15.8 points. Of the 20 patients, 17 patients (85%) had a reduction of pain. Symptoms of DRUJ instability could be reduced in 18 patients (90%). Pronation/supination of the wrist was not restricted postoperatively.",Unglaub F.; Manz S.; Bruckner T.; Leclère FM.; Hahn P.; Wolf MB.,2013.0,10.1007/s00064-012-0223-2,0,0,
3678,"Abrupt discontinuation of alprazolam and cognitive style in patients with panic disorder: early effects on mood, performance, and vital signs.","The objective of this study was to ascertain the relationship of alprazolam plasma levels and an anxiety-prone cognitive style to the characteristics and severity of early withdrawal after abrupt discontinuation of alprazolam in 26 patients with panic disorder. After 8 and 9 weeks of fixed-dose treatment, patients were hospitalized for 24 hours. On 1 admission, ordered at random, treatment was maintained; on the other, placebo was substituted double blind. The Anxious Thoughts and Tendencies questionnaire was administered before treatment. Alprazolam plasma levels were measured 7 times on the day after each admission. Before each blood sampling, the Profile of Mood States and performance tasks were administered, and vital signs were recorded. On the day after abrupt discontinuation of alprazolam, Profile of Mood States anxiety, depression, fatigue, and confusion increased; vigor and elation decreased; speed on the digit symbol substitution task improved; and systolic blood pressure increased substantially over time. High Anxious Thoughts and Tendencies scores were related specifically to more anxiety. Our findings (1) confirm that dysphoric mood, fatigue, low energy, confusion, and elevated systolic blood pressure are part of the early syndrome of withdrawal from alprazolam in patients with panic disorder, notably as the drop in plasma levels approaches 50%; (2) indicate a psychomotor deficit persisting beyond dose stabilization; (3) suggest that an anxiety-prone cognitive style measurable before undertaking treatment may be a risk factor for more severe anxiety upon discontinuation; and (4) provide a rationale for applying cognitive behavior therapy during benzodiazepine taper.",Uhlenhuth EH.; Starcevic V.; Qualls C.; Antal EJ.; Matuzas W.; Javaid JI.; Barnhill J.,2006.0,10.1097/01.jcp.0000236653.85791.60,0,0,
3679,"Drug, doctor's verbal attitude and clinic setting in the symptomatic response to pharmacotherapy.",,Uhlenhuth EH.; Rickels K.; Fisher S.; Park LC.; Lipman RS.; Mock J.,1966.0,,0,0,
3680,Combined pharmacotherapy and psychotherapy.,,Uhlenhuth EH.; Lipman RS.; Covi L.,1969.0,,0,0,
3681,Poly-tobacco use among HIV-positive smokers: implications for smoking cessation efforts,"ER OBJECTIVE: To characterize the profile of poly-tobacco users (PTU) in a sample of HIV-positive smokers participating in a cessation program.METHODS: The study sample consisted of 474 HIV-positive smokers enrolled in a 2-group randomized controlled trial of cigarette smoking cessation comparing a cell phone-based intervention to usual care. Prevalence was determined, and risk factors for poly-tobacco use were evaluated using logistic regression.RESULTS: In this cohort of HIV-positive cigarette smokers, 21.6% of participants were PTU, with cigars (73.4%) the most common tobacco product consumed. Among PTU, 73.5% used other form(s) of tobacco some days, and 26.5% use them every day. Perceived discrimination and unemployment were significantly associated with poly-tobacco use after adjusting for other demographic, behavioral, and psychosocial factors. Analysis showed that participants in the cell phone group (vs. usual care) were more likely to report 24-hr abstinence, both among monocigarette users (16.6% vs. 6.3%, p < .001) and PTU (18.5% vs. 0%, p < .001).CONCLUSION: Poly-tobacco use prevalence among adult HIV-positive smokers was considerably higher than in the general population. Special attention must be placed on concurrent use of cigarettes and cigars among HIV-positive smokers. Because PTU are a unique population less likely to succeed in brief smoking cessation interventions, effective cessation programs are needed.INTRODUCTION: Poly-tobacco use is defined as cigarette and other tobacco consumption with either product used daily or nondaily. While concurrent use of different types of tobacco has been documented within the general population, less is known about poly-tobacco use among HIV-positive smokers and its impact on smoking cessation efforts.","Tamí-Maury, I; Vidrine, D J; Fletcher, F E; Danysh, H; Arduino, R; Gritz, E R",2013.0,10.1093/ntr/ntt107,0,0,
3682,Are anthropomorphic persuasive appeals effective? The role of the recipient's motivations,"ER Anthropomorphic persuasive appeals are prevalent. However, their effectiveness has not been well studied. The present research addresses this issue with two experiments in the context of environmental persuasion. It shows that anthropomorphic messages, relative to non-anthropomorphic ones, appear to motivate more conservation behaviour and elicit more favourable message responses only among recipients who have a strong need for effectance or social connection. Among recipients whose such need is weak, anthropomorphic appeals seem to backfire. These findings extend the research on motivation and persuasion and add evidence to the motivational bases of anthropomorphism. In addition, joining some recent studies, the present research highlights the implications of anthropomorphism of nature for environmental conservation efforts, and offers some practical suggestions for environmental persuasion.","Tam, K P",2015.0,10.1111/bjso.12076,0,0,
3683,Antenatal telephone support intervention with and without uterine artery Doppler screening for low risk nulliparous women: a randomised controlled trial,"ER METHODS: A three-arm randomised controlled trial involving 840 low risk nulliparous women was conducted at a large maternity unit in North East England. All women received antenatal care in line with current UK guidance. Women in the TSI group (T) received calls from a midwife at 28, 33 and 36 weeks and women in the telephone and Doppler group (T + D) received the TSI and additional UADS at 20 weeks' gestation. The main outcome measure was the total number of scheduled and unscheduled antenatal visits received after 20 weeks' gestation.RESULTS: The median number of unscheduled (n = 2.0), scheduled visits (n = 7.0) and mean number of total visits (n = 8.8) were similar in the three groups. The majority (67%) of additional antenatal visits were made to a Maternity Assessment Unit because of commonly occurring pregnancy complications. Additional TSI+/-UADS was not associated with differences in clinical outcomes, levels of anxiety, social support or satisfaction with care. There were challenges to the successful delivery of the telephone support intervention; 59% of women were contacted at 29 and 33 weeks gestation reducing to 52% of women at 37 weeks.CONCLUSIONS: Provision of additional telephone support (with or without UADS) in low risk nulliparous women did not reduce the number of unscheduled antenatal visits or reduce anxiety. This study provides a useful insight into the reasons why this client group attend for unscheduled visits.TRIAL REGISTRATION: ISRCTN62354584.BACKGROUND: The number of routine antenatal visits provided to low risk nulliparous women has been reduced in the UK, acknowledging this change in care may result in women being less satisfied with their care and having poorer psychosocial outcomes. The primary aim of the study was to investigate whether the provision of proactive telephone support intervention (TSI) with and without uterine artery Doppler screening (UADS) would reduce the total number of antenatal visits required. A secondary aim was to investigate whether the interventions affected psychological outcomes.","Snaith, V J; Hewison, J; Steen, I N; Robson, S C",2014.0,10.1186/1471-2393-14-121,0,0,
3684,Preventive care at home for very preterm infants improves infant and caregiver outcomes at 2 years,"ER METHODSA total of 120 very preterm infants (<30 weeks) were assigned randomly to intervention (n = 61) or control (n = 59) groups. The intervention group received the preventive care program (9 home visits over the first year from a physiotherapist and a psychologist, focusing on the parent-infant relationship, the parents' mental health, and the infant's development); and the control group received standard care. At corrected age of 2 years, developmental outcomes were assessed, and primary caregivers completed the Infant-Toddler Social and Emotional Assessment. The mental health of the primary caregivers was assessed with the Hospital Anxiety and Depression Scale.RESULTSAt 2 years of age, 115 children (96%) were assessed with the Bayley Scales of Infant and Toddler Development III and 100 children (83%) with the Infant-Toddler Social and Emotional Assessment; and 91 (86%) of 106 caregivers completed the Hospital Anxiety and Depression Scale. There were no statistically significant differences in cognitive, language, or motor composite scores between the treatment groups. However, children in the intervention group were reported by their primary caregivers to exhibit less externalizing and dysregulation behaviors and increased competence, compared with control subjects. Primary caregivers in the intervention group reported less anxiety and depression.CONCLUSIONA preventive care program for very preterm infants and their families improved behavioral outcomes for infants and reduced anxiety and depression for primary caregivers.OBJECTIVEThe objective of this study was to determine the effects of preventive care at home on child development and primary caregiver mental health at 2 years of age.","Spittle, A J; Anderson, P J; Lee, K J; Ferretti, C; Eeles, A; Orton, J; Boyd, R N; Inder, T; Doyle, L W",2010.0,10.1542/peds.2009-3137,0,0,
3685,Heart-focused anxiety as a mediating variable in the treatment of noncardiac chest pain by cognitive-behavioral therapy and paroxetine.,"We compared the efficacy of cognitive behavior therapy (CBT), paroxetine and placebo in the treatment of noncardiac chest pain (NCCP). We also investigated whether pre- to mid-treatment reduction of (heart-focused) anxiety mediated mid- to post-treatment pain reduction. Sixty-nine adults with NCCP were randomly assigned to 16 weeks of outpatient treatment with CBT, paroxetine or placebo. The comparison between placebo and paroxetine was carried out in a double-blind fashion. The main outcome measure was a chest pain index (duration*intensity) as derived from daily pain diaries. Putative mediator measures were general anxiety (HADS:A) and heart-focused anxiety (Cardiac Anxiety Questionnaire). Eleven patients treated with paroxetine or placebo dropped out prematurely. Intent-to-treat analysis showed that CBT was significantly superior to placebo and to paroxetine in reducing NCCP at posttreatment. Only CBT significantly reduced heart-focused anxiety compared to placebo at mid- and post-treatment. Pre- to mid-treatment reduction of heart-focused anxiety predicted mid- to post-treatment NCCP reduction. The indirect effect of CBT on pain reduction by reducing heart-focused anxiety was significant compared to placebo but not to paroxetine. CBT is an effective treatment option for patients with NCCP. Paroxetine is not more effective than placebo on the short term. Reduction of heart-focused anxiety by CBT seems to mediate subsequent reduction of NCCP compared to placebo. The results provide further support for cognitive-behavioral models of NCCP and point to the potential benefits of, in particular, cognitive-behavioral interventions to modify heart-focused anxiety.",Spinhoven P.; Van der Does AJ.; Van Dijk E.; Van Rood YR.,2010.0,10.1016/j.jpsychores.2010.02.005,0,0,
3686,Noradrenergic and serotonergic function in posttraumatic stress disorder,"ER METHODTwenty-six patients with PTSD and 14 healthy subjects each received an intravenous infusion of yohimbine hydrochloride (0.4 mg/kg), m-CPP (1.0 mg/kg), or saline solution on 3 separate test days in a randomized balanced order and in double-blind fashion. Behavioral and cardiovascular measurements were determined at multiple times.RESULTSEleven (42%) of the patients with PTSD experienced yohimbine-induced panic attacks and had significantly greater increases compared with controls in anxiety, panic, and PTSD symptoms, but not in cardiovascular measurements. Eight patients (31%) with PTSD experienced m-CPP-induced panic attacks and had significantly greater increases compared with controls in anxiety, panic, and PTSD symptoms, and in standing diastolic blood pressure. Yohimbine-induced panic attacks tended to occur in different patients from m-CPP-induced panic attacks.CONCLUSIONThese data suggest the presence of 2 neurobiological subgroups of patients with PTSD, one with a sensitized noradrenergic system, and the other with a sensitized serotonergic system.BACKGROUNDYohimbine hydrochloride produces marked behavioral and cardiovascular effects in combat veterans with posttraumatic stress disorder (PTSD). In the present study, yohimbine was used as a probe of noradrenergic activity, and meta-chlorophenylpiperazine (m-CPP) as a probe of serotonergic activity. To our knowledge, this is the first study to describe the behavioral and cardiovascular effects of meta-CPP in patients with PTSD, and to compare these effects with those of yohimbine.","Southwick, S M; Krystal, J H; Bremner, J D; Morgan, C A; Nicolaou, A L; Nagy, L M; Johnson, D R; Heninger, G R; Charney, D S",1997.0,,0,0,
3687,Does cognitive behavioral therapy for youth anxiety outperform usual care in community clinics? An initial effectiveness test,"ER METHODA randomized controlled trial methodology was used. Therapists were randomized to training and supervision in the Coping Cat CBT program or UC. Forty-eight youths (56% girls, 8 to 15 years of age, 38% Caucasian, 33% Latino, 15% African-American) diagnosed with DSM-IV anxiety disorders were randomized to CBT or UC.RESULTSAt the end of treatment more than half the youths no longer met criteria for their primary anxiety disorder, but the groups did not differ significantly on symptom (e.g., parent report, eta-square = 0.0001; child report, eta-square = 0.09; both differences favoring UC) or diagnostic (CBT, 66.7% without primary diagnosis; UC, 73.7%; odds ratio 0.71) outcomes. No differences were found with regard to outcomes of comorbid conditions, treatment duration, or costs. However, youths receiving CBT used fewer additional services than UC youths (?(2)(1) = 8.82, p = .006).CONCLUSIONSCBT did not produce better clinical outcomes than usual community clinic care. This initial test involved a relatively modest sample size; more research is needed to clarify whether there are conditions under which CBT can produce better clinical outcomes than usual clinical care. CLINICAL TRIAL REGISTRY INFORMATION: Community Clinic Test of Youth Anxiety and Depression Study, URL: http://clinicaltrials.gov, unique identifier: NCT01005836.OBJECTIVEMost tests of cognitive behavioral therapy (CBT) for youth anxiety disorders have shown beneficial effects, but these have been efficacy trials with recruited youths treated by researcher-employed therapists. One previous (nonrandomized) trial in community clinics found that CBT did not outperform usual care (UC). The present study used a more stringent effectiveness design to test CBT versus UC in youths referred to community clinics, with all treatment provided by therapists employed in the clinics.","Southam-Gerow, M A; Weisz, J R; Chu, B C; McLeod, B D; Gordis, E B; Connor-Smith, J K",2010.0,10.1016/j.jaac.2010.06.009,0,0,
3688,A randomized clinical trial of cognitive-behavioral group therapy and sertraline in the treatment of obsessive-compulsive disorder.,"Cognitive-behavioral group therapy (CBGT) and serotonin reuptake inhibitors have proven efficacy in reducing symptoms of obsessive-compulsive disorder (OCD). There is no consensus about which of these forms of treatment is more effective. This study was conducted to evaluate the efficacy of CBGT as compared to that of sertraline in reducing OCD symptoms. Fifty-six outpatients with an OCD diagnosis, according to DSM-IV criteria, participated in the randomized clinical trial: 28 took 100 mg/day of sertraline and 28 underwent CBGT for 12 weeks. Efficacy of treatments was rated according to the reduction in scores on the Yale-Brown Obsessive Compulsive Scale (YBOCS) and the Clinical Global Impressions-Severity of Illness scale. The trial was performed in 4 successive periods from March 2002 to December 2003. Both treatments were effective, although patients treated with CBGT obtained a mean YBOCS reduction of symptoms of 44%, while those treated with sertraline obtained only a 28% reduction (p = .033). Cognitive-behavioral group therapy was also significantly more effective in reducing the intensity of compulsions (p = .030). Further, 8 patients (32%) treated with CBGT presented a complete remission of OCD symptoms (YBOCS score < or = 8) as compared to only 1 patient (4%) among those who received sertraline (p = .023). Cognitive-behavioral group therapy and sertraline have shown to be effective in reducing OCD symptoms. Nevertheless, the rate of symptom reduction, intensity reduction of compulsions, and percentage of patients who obtained full remission were significantly higher in patients treated with CBGT.",Sousa MB.; Isolan LR.; Oliveira RR.; Manfro GG.; Cordioli AV.,2006.0,,0,0,
3689,Comparative evaluation of three heat and moisture exchangers during short-term postoperative mechanical ventilation,"ER This study compared performance of three heat and moisture exchangers (HME) during short-term postoperative mechanical ventilation. Temperature and absolute humidity (AH) were measured at various points of the ventilatory circuit. There was no statistical difference between the groups, regarding ambient and body To, body weight, fraction of inspired oxygen, tidal volume, and respiratory rate. Only the hygroscopic HME (groups 2 and 3) provide adequate conditioning with regard to AH and To of the inspiratory gases. The performance of hydrophobic HME (group 1) was inferior and appears to be unsatisfactory. Indirect evaluation (variations of inspiratory gases and tracheal temperatures, AH of the expired gases) confirmed the superiority of the hygroscopic HME. These data suggest that humidification of inspiratory gases with a hygroscopic HME is a defensible practice during short-term postoperative mechanical ventilation. Performance of hydrophobic HME may be weak and can expose the patient to an unacceptable risk of endotracheal tube occlusion.","Sottiaux, T; Mignolet, G; Damas, P; Lamy, M",1993.0,,0,0,
3690,Associations between traumatic events and suicidal behavior in South Africa.,"Research conducted predominantly in the developed world suggests that there is an association between trauma exposure and suicidal behavior. However, there are limited data available investigating whether specific traumas are uniquely predictive of suicidal behavior or the extent to which traumatic events predict the progression from suicide ideation to plans and attempts. A national survey was conducted with 4351 adult South Africans between 2002 and 2004 as part of the World Health Organization World Mental Health Surveys. Data on trauma exposure and subsequent suicidal behavior were collected. Bivariate and multivariate survival models tested the relationship between the type and number of traumatic events and lifetime suicidal behavior. A range of traumatic events are associated with lifetime suicide ideation and attempt; however, after controlling for all traumatic events in a multivariate model, only sexual violence (odds ratio = 4.7; confidence interval, 2.3 to 9.4) and having witnessed violence (odds ratio = 1.8; confidence interval, 1.1 to 2.9) remained significant predictors of lifetime suicide attempts. The disaggregation of the associations between traumatic events and suicide attempts indicates that they are largely caused by traumatic events predicting suicide ideation rather than by the progression from suicide ideation to attempt. This article highlights the importance of traumatic life events in the occurrence of suicidal thoughts and behaviors and provides important information about the nature of this association. Future research is needed to better understand how and why such experiences increase the risk of suicidal outcomes.",Sorsdahl K.; Stein DJ.; Williams DR.; Nock MK.,2011.0,10.1097/NMD.0b013e3182392c39,0,0,
3691,"Comparability of biosimilar filgrastim with originator filgrastim: protein characterization, pharmacodynamics, and pharmacokinetics","ER METHODS: An array of protein analytical techniques was used to compare the physicochemical properties of proposed biosimilar filgrastim (EP2006), US-approved originator filgrastim, and EU-approved originator filgrastim. Biological characterization involved surface plasmon resonance spectroscopy analyses and in vitro proliferation assays. A randomized, double-blind, two-way crossover, phase I study in healthy volunteers assessed the pharmacodynamics, pharmacokinetics, and safety profiles of EP2006 and US-approved originator filgrastim (administered as a single subcutaneous 10 µg/kg injection).RESULTS: EP2006 and originator filgrastim (US and EU approved) were highly similar with respect to primary, secondary, and tertiary protein structures; mass, size, purity, charge, and hydrophobicity. No differences in receptor binding affinity were observed, and all samples demonstrated similar in vitro bioactivity. In the phase I study, no statistically significant differences between EP2006 and US-approved originator filgrastim were noted in pharmacodynamic or pharmacokinetic parameters, and all confidence intervals were within the equivalence boundaries. The two products had similar safety profiles.CONCLUSION: These studies provide robust evidence of the structural and functional similarity between the proposed biosimilar filgrastim (EP2006) and the US-approved originator filgrastim.BACKGROUND: Biosimilars provide safety, purity, and potency similar to those of a reference biologic product.","Sörgel, F; Schwebig, A; Holzmann, J; Prasch, S; Singh, P; Kinzig, M",2015.0,10.1007/s40259-015-0124-7,0,0,
3692,Healing traumatizing provider interactions among women through short-term group therapy.,"A short-term, cognitive group therapy intervention method (Insight: A cognitive enhancement program for women) to reduce or resolve ongoing psychological disruption and/or trauma was tested among women who experienced traumatizing provider interactions (TPI) in their childbearing experience. The sample included nine married, Caucasian women, ages 26-45, college educated; one to five children (n=19). Birth Perception; Posttraumatic Childbirth Stress; and Traumatizing Provider Interaction scores among 19 births confirmed perinatal psychological trauma. Descriptive and statistical comparisons for UCLA Loneliness Scale III, Coopersmith Self-Esteem Scale, Spielberger's State-Trait Anxiety Index and Beck Depression Inventory II, revealed marked psychological improvement in postintervention measurements.",Sorenson DS.,2003.0,,0,0,
3693,The effect of exercise and diet on mental health and quality of life in middle-aged individuals with elevated risk factors for cardiovascular disease,"ER Mental health and quality of life were assessed before and after a one-year exercise and diet intervention among 219 healthy individuals, aged 41-50 years, with elevated risk factors for cardiovascular disease. The participants were randomized to four groups: diet (n = 55), diet and exercise (n = 67), exercise (n = 54) and no active intervention (n = 43). Quality of life was measured with one eight-item scale and two one-item scales. Mental health was measured by the General Health Questionnaire (30-item version). Depression, anxiety, feelings of competence and self-esteem, coping and social dysfunction were measured using subscales of the General Health Questionnaire. Somatic anxiety was measured by the anxiety subscale of the Symptom Check List-90. Exercise improved the total GHQ scores, perceived competence/self-esteem, and coping as measured by the GHQ subscales. There were no significant effects of diet or exercise on quality of life, depression or anxiety. A high rate of participation in the exercise programme (>70%) was associated with greater improvements in total GHQ scores, anxiety, perceived competence/self-esteem and coping.","S√∏rensen, M; Anderssen, S; Hjerman, I; Holme, I; Ursin, H",1999.0,10.1080/026404199365885,0,0,
3694,Self help programme for anxiety in general practice: controlled trial of an anxiety management booklet.,"Behavioural methods of treating anxiety have been shown to be highly effective but are not widely available in general practice where most people suffering from anxiety are treated. This study reports a development in service delivery which is simple, inexpensive and does not make great time demands on general practitioners or require them to extend their training and expertise. The study shows that for patients suffering from panic disorder or generalized anxiety disorder the use of an anxiety management booklet in addition to their usual treatment from their general practitioner produces clinically and statistically significant improvements. Of particular importance is the speed of response to the booklet. Within the first two weeks those patients who received the booklet were significantly less anxious than the controls. The booklet was acceptable to patients and recommendations are made about how to incorporate it into clinical practice.",Sorby NG.; Reavley W.; Huber JW.,1991.0,,0,0,
3695,Glucocorticoids enhance in vivo exposure-based therapy of spider phobia.,"Preclinical and clinical studies indicate that the administration of glucocorticoids may promote fear extinction processes. In particular, it has been shown that glucocorticoids enhance virtual reality based exposure therapy of fear of heights. Here, we investigate whether glucocorticoids enhance the outcome of in vivo exposure-based group therapy of spider phobia. In a double blind, block-randomized, placebo-controlled, between-subject study design, 22 patients with specific phobia of spiders were treated with two sessions of in vivo exposure-based group therapy. Cortisol (20 mg) or placebo was orally administered 1 hr before each therapy session. Patients returned for a follow-up assessment one month after therapy. Exposure-based group therapy led to a significant decrease in phobic symptoms as assessed with the Fear of Spiders Questionnaire (FSQ) from pretreatment to immediate posttreatment and to follow-up. The administration of cortisol to exposure therapy resulted in increased salivary cortisol concentrations and a significantly greater reduction in fear of spiders (FSQ) as compared to placebo at follow-up, but not immediately posttreatment. Furthermore, cortisol-treated patients reported significantly less anxiety during standardized exposure to living spiders at follow-up than placebo-treated subjects. Notably, groups did not differ in phobia-unrelated state-anxiety before and after the exposure sessions and at follow-up. These findings indicate that adding cortisol to in vivo exposure-based group therapy of spider phobia enhances treatment outcome.",Soravia LM.; Heinrichs M.; Winzeler L.; Fisler M.; Schmitt W.; Horn H.; Dierks T.; Strik W.; Hofmann SG.; de Quervain DJ.,2014.0,10.1002/da.22219,0,0,
3696,Psychosocial predictors of treatment outcome for trauma-affected refugees.,"Background: The effects of treatment in trials with trauma-affected refugees vary considerably not only between studies but also between patients within a single study. However, we know little about why some patients benefit more from treatment, as few studies have analysed predictors of treatment outcome. Objective: The objective of the study was to examine possible psychosocial predictors of treatment outcome for trauma-affected refugees. Method: The participants were 195 adult refugees with posttraumatic stress disorder (PTSD) who were enrolled in a 6- to 7-month treatment programme at the Competence Centre for Transcultural Psychiatry (CTP), Denmark. The CTP Predictor Index used in the study included 15 different possible outcome predictors concerning the patients' past, chronicity of mental health problems, pain, treatment motivation, prerequisites for engaging in psychotherapy, and social situation. The primary outcome measure was PTSD symptoms measured on the Harvard Trauma Questionnaire (HTQ). Other outcome measures included the Hopkins Symptom Check List-25, the WHO-5 Well-being Index, Sheehan Disability Scale, Hamilton Depression and Anxiety Scales, the somatisation scale of the Symptoms Checklist-90, Global Assessment of Functioning scales, and pain rated on visual analogue scales. The relations between treatment outcomes and the total score as well as subscores of the CTP Predictor Index were analysed. Results: Overall, the total score of the CTP Predictor Index was significantly correlated to pre- to post treatment score changes on the majority of the ratings mentioned above. While employment status was the only single item significantly correlated to HTQ-score changes, a number of single items from the CTP Predictor Index correlated significantly with changes in depression and anxiety symptoms, but the size of the correlation coefficients were modest. Conclusions: The total score of the CTP Predictor Index correlated significantly with outcomes on most of the rating scales, but correlations were modest in size, possibly due to the number of different factors influencing treatment outcome. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Sonne, Charlotte; Carlsson, Jessica; Bech, Per; Vindbjerg, Erik; Mortensen, Erik Lykke; Elklit, Ask; Bastin, Basogglu, Bech, Blair, Bogic, Buhmann, Buhmann, Carlsson, Crumlish, De Kleine, Derogatis, Drozzdek, Drozdek, Ferrie, Halvorsen, Hermansson, Holtz, Kivling-Boden, Levitt, Lie, Lin, McDonnell, McFarlane, Mollica, Mollica, Nickerson, Noerregaard, Nordbrandt, Palic, Porter, Schnyder, Sheehan, Shoeb, Silove, Silove, Silove, Sonne, Steel, Stenmark, Teodorescu, Teodorescu, Topp, Van Minnen, Van Wyk, Watts",2016.0,,0,0,
3697,Treatment of trauma-affected refugees with venlafaxine versus sertraline combined with psychotherapy-A randomised study.,"Background: The prevalence of trauma-related psychiatric disorders is high among refugees. Despite this, little is known about the effect of pharmacological treatment for this patient group. The objective of the present study was therefore to examine differences in the effects of venlafaxine and sertraline on Post-Traumatic Stress Disorder (PTSD), depression and functional impairment in trauma-affected refugees. Methods: The study was a randomised pragmatic trial comparing venlafaxine and sertraline in combination with psychotherapy and social counselling. PTSD symptoms were measured on the Harvard Trauma Questionnaire-part IV, which was the primary outcome measure. Other outcome measures included: Hopkins Symptom Check List-25 (depression and anxiety), Social Adjustment Scale-short version (social functioning), WHO-5 Well-being Index (quality of life), Crisis Support Scale (support from social network), Sheehan Disability Scale (disability in three areas of functioning), Hamilton Depression and Anxiety scale, the somatisation items of the Symptoms Checklist-90, Global Assessment of Functioning scales and the summarised score of pain in four body areas rated on visual analogue scales. Results: Two hundred seven adult refugee patients were included in the trial (98 in the venlafaxine and 109 in the sertraline group). Of these, 195 patients were eligible for intention-to-treat analyses. Small but significant pre-treatment to post-treatment differences were found on the Harvard Trauma Questionnaire and a number of other ratings in both groups. On the primary outcome measure, no difference was found in treatment effect between the sertraline and venlafaxine group. A significant group difference was found in favour of sertraline on the Sheehan Disability Scale. Conclusion: Sertraline had a slightly better outcome than venlafaxine on some of the secondary outcome measures, but not on the primary outcome measure. Furthermore, a higher percentage of dropouts was found in the venlafaxine group compared to the sertraline group. Although this could indicate that sertraline was better tolerated, which is supported by other studies, a final conclusion on tolerability cannot be drawn from the current study due to lack of systematic reporting of side effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sonne, Charlotte; Carlsson, Jessica; Bech, Per; Elklit, Ask; Mortensen, Erik Lykke; Bastin, Bech, Bisson, Braakman, Buhmann, Buhmann, Carlsson, Cipriani, Crumlish, Davidson, Hetrick, Hollifield, Hoskins, Ipser, Kinzie, Kleijn, McFarlane, Mollica, Mollica, Noerregaard, Norredam, Otto, Palic, Patel, Redrobe, Sheehan, Smajkic, Sonne, Sonne, Sonne, Sonne, Steel, Stein, Topp, Vindbjerg, Watts, Weissman",2016.0,,0,0,
3698,Treatment of traumatized refugees with sertraline versus venlafaxine in combination with psychotherapy - study protocol for a randomized clinical trial.,"Sufficient evidence is lacking to draw final conclusions on the efficiency of medical and psychological treatments of traumatized refugees with PTSD. The pharmacological treatments of choice today for post-traumatic stress disorder are antidepressants from the subgroup selective serotonin reuptake inhibitors, especially sertraline. The evidence for the use of selective serotonin reuptake inhibitors in the treatment of complex post-traumatic stress disorder in traumatized refugees is very limited. Venlafaxine is a dual-action antidepressant that works on several pathways in the brain. It influences areas in the brain which are responsible for the enhanced anxiety and hyper-arousal experienced by traumatized refugees and which some studies have found to be enlarged among patients suffering from post-traumatic stress disorder. This study will include approximately 150 patients, randomized into two different groups treated with either sertraline or venlafaxine. Patients in both groups will receive the same manual-based cognitive behavioral therapy, which has been especially adapted to this group of patients. The treatment period will be 6 to 7 months. The trial endpoints will be post-traumatic stress disorder and depressive symptoms and social functioning, all measured on validated ratings scales. Furthermore the study will examine the relation between a psycho-social resources and treatment outcome based on 15 different possible outcome predictors. This study is expected to bring forward new knowledge on treatment and clinical evaluation of traumatized refugees and the results are expected to be used in reference programs and clinical guidelines. ClinicalTrials.gov NCT01569685.",Sonne C.; Carlsson J.; Elklit A.; Mortensen EL.; Ekstr√∏m M.,2013.0,10.1186/1745-6215-14-137,0,0,
3699,Association Between Sleep and Physical Function in Older Veterans in an Adult Day Healthcare Program.,"To examine whether sleep disturbance is associated with poor physical function in older veterans in an adult day healthcare (ADHC) program. Cross-sectional. One ADHC program in a Veterans Affairs Ambulatory Care Center. Older veterans (N = 50) enrolled in a randomized controlled trial of a sleep intervention program who had complete baseline data. Information on participant characteristics (e.g., age, depression, relationship to caregiver, pain, comorbidity) was collected using appropriate questionnaires. Physical function was measured using activity of daily living (ADL) and instrumental ADL (IADL) total scores from the Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire. Sleep was assessed subjectively (Pittsburgh Sleep Quality Index, Insomnia Severity Index) and objectively (wrist actigraphy). Participants required substantial assistance with ADLs and IADLs. A regression model showed that participant characteristics (marital status, use of sleep medication, comorbidity, posttraumatic stress disorder) and living arrangement (living with a spouse or others) were significantly associated with poor physical function. Poorer objective sleep (total sleep time, total numbers of awakenings, total wake time) was significantly associated with poor physical function, accounting for a significant proportion of the variance other than participant characteristics. Objective measures of nighttime sleep disturbance were associated with poor physical function in older veterans in an ADHC program. Further research is needed to determine whether interventions to improve sleep will delay functional decline in this vulnerable population.",Song Y.; Dzierzewski JM.; Fung CH.; Rodriguez JC.; Jouldjian S.; Mitchell MN.; Josephson KR.; Alessi CA.; Martin JL.,2015.0,10.1111/jgs.13527,0,0,
3700,Advance care planning and end-of-life decision making in dialysis: a randomized controlled trial targeting patients and their surrogates.,"Few trials have examined long-term outcomes of advance care planning (ACP) interventions. We examined the efficacy of an ACP intervention on preparation for end-of-life decision making for dialysis patients and surrogates and for surrogates' bereavement outcomes. A randomized trial compared an ACP intervention (Sharing Patient's Illness Representations to Increase Trust [SPIRIT]) to usual care alone, with blinded outcome assessments. 420 participants (210 dyads of prevalent dialysis patients and their surrogates) from 20 dialysis centers. Every dyad received usual care. Those randomly assigned to SPIRIT had an in-depth ACP discussion at the center and a follow-up session at home 2 weeks later.  preparation for end-of-life decision making, assessed for 12 months, included dyad congruence on goals of care at end of life, patient decisional conflict, surrogate decision-making confidence, and a composite of congruence and surrogate decision-making confidence. bereavement outcomes, assessed for 6 months, included anxiety, depression, and posttraumatic distress symptoms completed by surrogates after patient death.  adjusting for time and baseline values, dyad congruence (OR, 1.89; 95% CI, 1.1-3.3), surrogate decision-making confidence (β=0.13; 95% CI, 0.01-0.24), and the composite (OR, 1.82; 95% CI, 1.0-3.2) were better in SPIRIT than controls, but patient decisional conflict did not differ between groups (β=-0.01; 95% CI, -0.12 to 0.10). 45 patients died during the study. Surrogates in SPIRIT had less anxiety (β=-1.13; 95% CI, -2.23 to -0.03), depression (β=-2.54; 95% CI, -4.34 to -0.74), and posttraumatic distress (β=-5.75; 95% CI, -10.9 to -0.64) than controls. Study was conducted in a single US region. SPIRIT was associated with improvements in dyad preparation for end-of-life decision making and surrogate bereavement outcomes.",Song MK.; Ward SE.; Fine JP.; Hanson LC.; Lin FC.; Hladik GA.; Hamilton JB.; Bridgman JC.,2015.0,10.1053/j.ajkd.2015.05.018,0,0,
3701,Racial differences in outcomes of an advance care planning intervention for dialysis patients and their surrogates.,"Background: African Americans' beliefs about end-of-life care may differ from those of whites, but racial differences in advance care planning (ACP) outcomes are unknown. Objective: The aim of this study was to compare the efficacy of an ACP intervention on preparation for end-of-life decision making and post-bereavement outcomes for African Americans and whites on dialysis. Method: A secondary analysis of data from a randomized trial comparing an ACP intervention (Sharing Patient's Illness Representations to Increase Trust [SPIRIT]) with usual care was conducted. There were 420 participants, 210 patient-surrogate dyads (67.4% African Americans), recruited from 20 dialysis centers in North Carolina. The outcomes of preparation for end-of-life decision making included dyad congruence on goals of care, surrogate decision-making confidence, a composite of the two, and patient decisional conflict assessed at 2, 6, and 12 months post-intervention. Surrogate bereavement outcomes included anxiety, depression, and post-traumatic distress symptoms assessed at 2 weeks, and at 3 and 6 months after the patient's death. Results: SPIRIT was superior to usual care in improving dyad congruence (odds ration [OR] = 2.31, p = 0.018), surrogate decision-making confidence (beta = 0.18, p = 0.021), and the composite (OR = 2.19, p = 0.028) 2 months post-intervention, but only for African Americans. SPIRIT reduced patient decisional conflict at 6 months for whites and at 12 months for African Americans. Finally, SPIRIT was superior to usual care in reducing surrogates' bereavement depressive symptoms for African Americans but not for whites (beta = -3.49, p = 0.003). Conclusion: SPIRIT was effective in improving preparation for end-of-life decision-making and post-bereavement outcomes in African Americans. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Song, Mi-Kyung; Ward, Sandra E; Lin, Feng-Chang; Hamilton, Jill B; Hanson, Laura C; Hladik, Gerald A; Fine, Jason P; Baker, Branch, Bredle, Charlson, Anderson, Davison, Davison, Dawson, Donovan, Donovan, Eid, Fried, Goff, Gonzalez, Hopp, Johnson, Kagawa-Singer, Karches, Koffman, Kwak, Luckett, McCambridge, McCambridge, Mor, Owen, Perry, Peterman, Pfeiffer, Phipps, Schell, Song, Song, Song, Song, Song, Song, Song, Thompson-Brenner, Torke, True, Wicher, Williams, Yan, Zigmond",2016.0,,0,0,
3702,"Early drop-outs, late drop-outs and completers: differences in the continuation phase of a clinical trial","ER METHODSThe authors studied 119 outpatients who were treatment responders in an 8-week open trial with fluoxetine 20 mg/day, and who were then enrolled in a 26-week clinical trial comparing the efficacy of fluoxetine versus fluoxetine and cognitive behavior therapy (CBT). Patients were assessed using the Structured Clinical Interview for DSM-III-R--Axis I (SCID-Patient Edition), Hamilton Depression Rating Scale (HAMD-17) and the following self-rated scales: Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), Anxiety Sensitivity Index (ASI) and the Symptom Questionnaire (SQ) prior to starting the 26-week continuation phase. We defined ""early drop-outs"" (EDs) as patients who dropped out either at or prior to Visit 2 (which was at 2 months into the 6-month continuation phase); those dropping out at Visit 3 or later were defined as ""late drop-outs"" (LDs) (ED 2 months). The Kruskal-Wallis and the Mann-Whitney U tests were used for data analysis.RESULTSOf the 119 patients, 83 were completers (mean age: 42.1+/-9.0 years; 46 [55%] women; age of onset of major depressive disorder [MDD] = 24.3+/-12.5 years), II were EDs (mean age: 38.1 + 13.0 years: 4 [36%] women; age of onset of MDD = 22.0+/-11.1 years) and 25 were LDs (mean age: 35.2+/-10.4 years; 12 [48%] women; age of onset of MDD = 24.6+/-11.6 years). LDs were significantly younger than completers (P<.01). There was no significant difference in age between EDs and LDs, nor between EDs and completers. EDs were more likely to have been depressed for a longer period of time compared to LDs (P< .05). EDs completers were depressed for a longer period of time compared to LDs (P< .05).CONCLUSIONSOur data suggest that late drop-outs are significantly younger than completers, although age is not a predictor between early drop-outs and late drop-outs. Further, early drop-outs are depressed for a longer duration compared to late drop-outs completers are depressed for a longer duration than late dropouts, and Early drop-outs have significantly more social impairment compared to completers. Our study identified some patient characteristics significantly associated with dropping out of a long-term clinical trial.OBJECTIVEThe purpose of this study was to assess the differences between early and late drop-outs and completers in the continuation phase of a clinical trial.","Sonawalla, S B; Farabaugh, A H; Leslie, V M; Pava, J A; Matthews, J D; Fava, M",2002.0,,0,0,
3703,The effects of a cognitive behavioural intervention in asthmatic patients.,"There is evidence that educational programmes may improve patient's compliance with asthma treatment and control symptoms. Whilst medical parameters have been thoroughly studied, few data are available concerning psychological intervention. The aim of our open pilot study was to verify whether any difference in perceived illness and response style to asthma existed in the patients enrolled in an Asthma Rehabilitation Group (ARG) and in a Control Group (CG). Forty consecutive asthmatics were randomly enrolled, all of whom were diagnosed, treated and followed-up according to the International Guidelines. Both groups underwent a psychological assessment at baseline and after one year. A battery of questionnaires was used to obtain data relating to baseline characteristics (anxiety, depression, psychophysiological disorders), emotional reactions to asthma attacks (panic-fear, etc,) and cognitive variables (external control, psychological stigma, internal beliefs, external chance, etc.) involved in the perceived illness. In addition, the Asthma Rehabilitation Group patients underwent an educational programme and a cognitive-behavioural intervention. In both groups, a reduction of anxiety and depression scores was observed, as well as a significant improvement of the medical parameters evaluated. Only the Asthma Rehabilitation Group reported lower scores on the Psychophysiological Questionnaire and on the External Control Subscale after 1 year. The Control Group reported higher score on the External Chance Scale. The data of our study seem to confirm the effectiveness of psychological intervention on the cognitive skills involved in the perception and management of asthma. Larger scale studies on this topic are suggested.",Sommaruga M.; Spanevello A.; Migliori GB.; Neri M.; Callegari S.; Majani G.,1995.0,,0,0,
3704,Behaviour therapy versus drug therapy in the treatment of phobic neurosis.,,Solyom L.; Heseltine GF.; McClure DJ.; Solyom C.; Ledwidge B.; Steinberg G.,1973.0,,0,0,
3705,"Posttraumatic Intrusion, Avoidance, and Social Functioning: A 20-Year Longitudinal Study","The study assesses posttraumatic intrusion, avoidance, and social functioning among 214 Israeli combat veterans from the first Lebanon War with and without combat stress reaction (CSR) 1, 2, 3, and 20 years after the war. CSR veterans reported higher intrusion and avoidance than did non-CSR veterans. With time, there was a decline in these symptoms. In addition, intrusion and avoidance were associated with problems in social functioning on a given year, and they longitudinally predicted social dysfunction 2, 3, and 20 years after the war. CSR veterans presented stronger temporal covariations between intrusion-avoidance and social functioning. The findings suggest that CSR is a marker for future psychopathology and point to the role of avoidance in social dysfunction. © 2007 American Psychological Association.",Solomon Z.; Mikulincer M.,2007.0,10.1037/0022-006X.75.2.316,0,0,
3706,Efficacy of treatments for posttraumatic stress disorder. An empirical review.,"OBJECTIVE--The purpose of this article is to review the empirical evidence for the efficacy of a range of treatments for posttraumatic stress disorder (PTSD). Reviewed studies focused on rape victims, combat veterans, the tragically bereaved, torture victims, accident victims, of physical assault, and child abuse victims. DATA SOURCES--Peer-reviewed journals (Psych-Info, MEDLINE), book chapters (PILOTS database), active investigators, abstracts from the 1990 and 1991 International Society for Traumatic Stress Studies. STUDY SELECTION--We identified 255 English-language reports of treatment for PTSD. We restricted our focus to randomized, clinical trials that included a systematic assessment of PTSD using DSM-III or DSM-III-R criteria (N = 11). DATA EXTRACTION--Studies were assessed according to methodological strength: random assignment to the treatment of interest, and either an alternative treatment or control group; sample selection; and inclusion of statistical tests of significance. DATA SYNTHESIS--Drug studies show a modest but clinically meaningful effect on PTSD. Stronger effects were found for behavioral techniques involving direct therapeutic exposure, particularly in terms of reducing PTSD intrusive symptoms. However, severe complications have also been reported from the use of these techniques in patients suffering from other psychiatric disorders. Studies of cognitive therapy, psychodynamic therapy, and hypnosis suggest that these approaches may also hold promise. However, further research is needed before any of these approaches can be pronounced effective as lasting treatment of PTSD. CONCLUSIONS--Further studies should specifically address combined treatment approaches, optimal treatment length and timing, effects of comorbidity, and unstudied traumatized populations.",Solomon SD.; Gerrity ET.; Muff AM.,1992.0,,0,0,
3707,A 3-year prospective study of the clinical performance of daily disposable contact lenses compared with frequent replacement and conventional daily wear contact lenses,"ER METHODS: This 3-year prospective study was conducted in 12 U.S. practices. Of 338 eligible subjects enrolled (126 conventional daily wear, 144 frequent replacement, and 68 daily disposable), 229 subjects disposable group were compared with the conventional daily wear group and two sub-groups of frequent replacement subjects: (a) those with replacement at 2-weak intervals and (b) those with replacement at 1 or 3 months.RESULTS: Comparing the daily disposable and conventional daily wear groups, the daily disposable subjects were more likely to be asymptomatic, reported fewer symptoms of redness, cloudy vision and grittiness/dirty sensation, reported better vision and overall satisfaction, and had fewer lens surface deposits, complications, tarsal abnormalities, and unscheduled visits, while conventional daily wear subjects reported better lens handling. Comparing the daily disposable and frequent replacement (1/3 months) groups, daily disposable subjects reported fewer symptoms of foreign body sensation, redness, cloudy vision and grittiness/dirty sensation, reported better subjective vision, comfort and overall satisfaction, and has fewer lens surface deposits, complications, and tarsal abnormalities, while frequent replacement (1/3 months) subjects reported fewer dryness symptoms and better lens handling. Comparing the daily disposable and frequent replacement (2-weeks) groups, daily disposable subjects reported better subjective vision and overall satisfaction and had fewer lens surface deposits and tarsal abnormalities, while frequent replacement (2-weeks) subjects reported fewer photophobia symptoms.CONCLUSIONS: The results indicate that daily disposable wear may be the most trouble-free way of wearing contact lenses.PURPOSE: To determine the clinical performance of daily disposable contact lens wear compared to conventional daily wear contact lenses and frequent replacement contact lenses.","Solomon, O D; Freeman, M I; Boshnick, E L; Cannon, W M; Dubow, B W; Kame, R T; Lanier, J C; Lopanik, R W; Quinn, T G; Rigel, L E; Sherrill, D D; Stiegmeier, M J; Teiche, R S; Zigler, L G; Mertz, G W; Nason, R J",1996.0,,0,0,
3708,Predicting optimal CPAP by neural network reduces titration failure: a randomized study,"ER METHODSOne hundred fifteen patients were randomized 1:1 to either conventional CPAP titration (n = 58) or to an ANN-guided CPAP titration (n = 57). Both groups were assessed for time to optimal CPAP pressure, for titration failure, and for CPAP compliance therapy.RESULTSPatients in the ANN-guided CPAP titration arm were able to achieve optimal CPAP at a shorter time interval compared to the conventional group (198.7 +/- 143.8 min versus 284.0 +/- 126.5 min) (p < 0.001). There was also a lower titration failure in patients randomized to the ANN-guided CPAP titration arm (16%) compared to the conventional arm (36%) (p = 0.02). Compliance with treatment did not differ across the two arms.CONCLUSIONSThe use of ANN for guiding CPAP titration may be superior to the conventional method in maximizing the time to achieve optimal CPAP and in reducing CPAP titration failure.PURPOSEContinuous positive airway pressure (CPAP) is considered the standard therapy for obstructive sleep apnea syndrome. In the absence of standard protocol, CPAP titration may be unsuccessful. The purpose of this study was to test the hypothesis that application of an artificial neural network (ANN) to CPAP titration would achieve an optimal CPAP pressure within a shorter time interval and would lead to a decrease in CPAP titration failure.","Solh, A; Akinnusi, M; Patel, A; Bhat, A; TenBrock, R",2009.0,10.1007/s11325-009-0247-5,0,0,
3709,Change in metacognitions predicts outcome in obsessive-compulsive disorder patients undergoing treatment with exposure and response prevention.,"Wells' (Wells, A. (1997). Cognitive therapy of anxiety disorders: a practice manual and conceptual guide. Chichester, UK: Wiley) metacognitive model of obsessive-compulsive disorder (OCD) predicts that metacognitions must change in order for psychological treatment to be effective. The aim of this study was to explore: (1) if metacognitions change in patients undergoing exposure treatment for OCD; (2) to determine the extent to which cognitive and metacognitive change predicts symptom improvement and recovery. The sample consisted of 83 outpatients with a diagnosis of OCD who completed exposure and response prevention treatment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Metacognitions Questionnaire (MCQ-30) and the Obsessive Beliefs Questionnaire (OBQ-44) were administered before treatment, after treatment, and at 12-month follow-up. Treatment resulted in significant changes in symptoms, metacognition score, responsibility and perfectionism. Regression analysis using post-treatment Y-BOCS as the dependent variable indicated that when the overlap between predictors was controlled for, only changes in metacognition were significant. Changes in metacognitions explained 22% of the variance in symptoms at post-treatment when controlling for pre-treatment symptoms and changes in mood. A further regression revealed that two MCQ-30 subscales made individual contributions. The patients had significantly higher scores compared to community controls on the MCQ-30. Patients who achieved clinical significant change had lower scores on the MCQ-30 compared to patients who did not change. The results did not change significantly from post-treatment to follow-up assessment. These findings provide further support for the importance of metacognitions in treating OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Solem, Stian; Haland, Ashild Tellefsen; Vogel, Patrick A; Hansen, Bjarne; Wells, Adrian; Beck, Beck, Brown, Hatton, Clark, Clark, Emmelkamp, First, Fisher, Fisher, Fisher, Frost, Frost, Goodman, Goodman, Gwilliam, Janeck, Kozak, Krone, Longmore, Myers, Myers, O'Connor, Purdon, Rachman, Rachman, Rees, Salkovskis, Salkovskis, Salkovskis, Salkovskis, Salkovskis, Sica, Steketee, van Oppen, Vogel, Wells, Wells, Wells, Whittal",2009.0,,0,0,
3710,Psychosurgery: Description and outcome study of a regional service.,"Presents the audit of a consecutive series of patients who underwent psychosurgery at the Yorkshire Regional Psychosurgery Service over a 10-year period. Of 12 referrals, 7 patients (aged 21-66 yrs) were recommended for, and underwent, psychosurgery. Pre-surgical assessments included the Global Assessment of Function, the Comprehensive Psychiatric Rating Scale, and the Hospital Anxiety and Depression Scale. The results indicate that a satisfactory psychosurgical service may be organized on a regional basis and that there are advantages of this. They also indicate that psychosurgery retains a role in the management of some severe obsessional and anxiety/depressive states which have not improved with other available treatments. In 3 of the 7 patients the improvement was very great and no patient regretted having undergone the treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Snaith, R. P; Dove, E; Marlowe, J; Pemberton, S; Price, D. J; Rawson, S; Wright, J. F; Butler, A; Coughlan, A. K; Hird, M; Trigwell, P",1997.0,,0,0,
3711,Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: a randomized trial,"ER OBJECTIVETo determine if writing about stressful life experiences affects disease status in patients with asthma or rheumatoid arthritis using standardized quantitative outcome measures.DESIGNRandomized controlled trial conducted between October 1996 and December 1997.SETTINGOutpatient community residents drawn from private and institutional practice.PATIENTSVolunteer sample of 112 patients with asthma (n = 61) or rheumatoid arthritis (n = 51) received the intervention; 107 completed the study, 58 in the asthma group and 49 in the rheumatoid arthritis group.INTERVENTIONPatients were assigned to write either about the most stressful event of their lives (n = 71; 39 asthma, 32 rheumatoid arthritis) or about emotionally neutral topics (n = 41; 22 asthma, 19 rheumatoid arthritis) (the control intervention).MAIN OUTCOME MEASURESAsthma patients were evaluated with spirometry and rheumatoid arthritis patients were clinically examined by a rheumatologist. Assessments were conducted at baseline and at 2 weeks and 2 months and 4 months after writing and were done blind to experimental condition.RESULTSOf evaluable patients 4 months after treatment, asthma patients in the experimental group showed improvements in lung function (the mean percentage of predicted forced expiratory volume in 1 second [FEV1] improved from 63.9% at baseline to 76.3% at the 4-month follow-up; P<.001), whereas control group patients showed no change. Rheumatoid arthritis patients in the experimental group showed improvements in overall disease activity (a mean reduction in disease severity from 1.65 to 1.19 [28%] on a scale of 0 [asymptomatic] to 4 [very severe] at the 4-month follow-up; P=.001), whereas control group patients did not change. Combining all completing patients, 33 (47.1%) of 70 experimental patients had clinically relevant improvement, whereas 9 (24.3%) of 37 control patients had improvement (P=.001).CONCLUSIONPatients with mild to moderately severe asthma or rheumatoid arthritis who wrote about stressful life experiences had clinically relevant changes in health status at 4 months compared with those in the control group. These gains were beyond those attributable to the standard medical care that all participants were receiving. It remains unknown whether these health improvements will persist beyond 4 months or whether this exercise will prove effective with other diseases.CONTEXTNonpharmacological treatments with little patient cost or risk are useful supplements to pharmacotherapy in the treatment of patients with chronic illness. Research has demonstrated that writing about emotionally traumatic experiences has a surprisingly beneficial effect on symptom reports, well-being, and health care use in healthy individuals.","Smyth, J M; Stone, A A; Hurewitz, A; Kaell, A",1999.0,,0,0,
3712,Facilitating public speaking fear reduction by increasing the salience of disconfirmatory evidence.,"The primary objective of the current study was to investigate whether adding videotape feedback procedures to exposure treatment would facilitate public speaking fear reduction. Participants meeting DSM-1V criteria for social phobia were randomized to receive non-pill placebo, exposure without videotape feedback, exposure with audience videotape feedback, or exposure with performance videotape feedback. Assessments were conducted at pretreatment, posttreatment, and 1-month follow-up. Having participants contrast actual audience responses to responses they imagined did not facilitate changes in participants' predictions about the negative consequences of appearing anxious in front of others, nor did it result in greater anxiety reduction compared to exposure alone. On the other hand, having participants contrast their imagined performance to their actual performance accelerated the speed of improvement in public speaking anxiety. Further, this differential effect appeared to be cognitively mediated. Specifically, the speedier improvement in the performance videotape feedback condition was partially accounted for by changes in participants' estimates of the likelihood of an anxious appearance when performing in front of others. Follow-up data revealed no differences among the exposure treatment conditions, suggesting that the enhanced efficacy associated with performance feedback was not durable. In general, the pattern of the findings underscored that social phobia is a severe form of anxiety pathology, that warrants a high dose of treatment. Theoretical and clinical implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Smits, Jasper Antonius",2005.0,,0,0,
3713,Cognitive-behavioral therapy for PTSD in children and adolescents: a preliminary randomized controlled trial,"ER METHODFollowing a 4-week symptom-monitoring baseline period, 24 children and young people (8-18 years old) who met full DSM-IV PTSD diagnostic criteria after experiencing single-incident traumatic events (motor vehicle accidents, interpersonal violence, or witnessing violence) were randomly allocated to a 10-week course of individual CBT or to placement on a waitlist (WL) for 10 weeks.RESULTSCompared to the WL group, participants who received CBT showed significantly greater improvement in symptoms of PTSD, depression, and anxiety, with significantly better functioning. After CBT, 92% of participants no longer met criteria for PTSD; after WL, 42% of participants no longer met criteria. CBT gains were maintained at 6-month follow-up. Effects of CBT were partially mediated by changes in maladaptive cognitions, as predicted by cognitive models of PTSD.CONCLUSIONSIndividual trauma-focused CBT is an effective treatment for PTSD in children and young people.OBJECTIVETo evaluate the efficacy of individual trauma-focused cognitive-behavioral therapy (CBT) for treating posttraumatic stress disorder (PTSD) in children and young people.","Smith, P; Yule, W; Perrin, S; Tranah, T; Dalgleish, T; Clark, D M",2007.0,10.1097/CHI.0b013e318067e288,0,0,
3714,Computerised CBT for depressed adolescents: Randomised controlled trial.,"Depression in adolescents is a common and impairing problem. Effective psychological therapies for depression are not accessed by most adolescents. Computerised therapy offers huge potential for improving access to treatment. To test the efficacy of Stressbusters, a Computerised-CBT (C-CBT) programme for depression in young people. Multi-site, schools-based, RCT of C-CBT compared to Waiting List, for young people (N = 112; aged 12-16) with significant symptoms of depression, using multiple-informants (adolescents, parents, teachers), with follow-up at 3 and 6 months. Relative to being on a Waiting List, C-CBT was associated with statistically significant and clinically meaningful improvements in symptoms of depression and anxiety according to adolescent self-report; and with a trend towards improvements in depression and anxiety according to parent-report. Improvements were maintained at follow-up. Treatment gains were similar for boys and girls across the participating age range. Treatment effect was partially mediated by changes in ruminative thinking. Teachers rated adolescents as having few emotional or behavioural problems, both before and after intervention. C-CBT had no detectable effect on academic attainment. In the month after intervention, young people who received C-CBT had significantly fewer absences from school than those on the Waiting List. C-CBT shows considerable promise for the treatment of mild-moderate depression in adolescents.",Smith P.; Scott R.; Eshkevari E.; Jatta F.; Leigh E.; Harris V.; Robinson A.; Abeles P.; Proudfoot J.; Verduyn C.; Yule W.,2015.0,10.1016/j.brat.2015.07.009,0,0,
3715,"Attachment and alliance in the treatment of depressed, sexually abused women","ER METHOD: Seventy women seeking treatment in a community mental health center who had Major Depressive Disorder and a childhood sexual abuse history were randomized to Interpersonal Psychotherapy or treatment as usual.RESULTS: Greater attachment avoidance and weaker working alliance were each related to worse depression symptom outcomes; these effects were independent of the presence of comorbid Borderline Personality Disorder and Post-Traumatic Stress Disorder. The effect of avoidant attachment on outcomes was not mediated by the working alliance. Further, working alliance had a stronger effect on depression outcomes in the Interpersonal Psychotherapy group.CONCLUSION: Understanding the influence of attachment style and the working alliance on treatment outcomes can inform efforts to improve the treatments for depressed women with a history of childhood sexual abuse.BACKGROUND: Depression among women with sexual abuse histories is less treatment responsive than in general adult samples. One contributor to poorer treatment outcomes may be abused women's difficulties in forming and maintaining secure relationships, as reflected in insecure attachment styles, which could also impede the development of a positive therapeutic alliance. The current study examines how attachment orientation (i.e. anxiety and avoidance) and development of the working alliance are associated with treatment outcomes among depressed women with histories of childhood sexual abuse.","Smith, P N; Gamble, S A; Cort, N A; Ward, E A; He, H; Talbot, N L",2012.0,10.1002/da.20913,0,0,
3716,Examining the relationships between job control and health status: A path analysis approach,"Objective: To examine the pathways through which job control affects health status; to examine if the effects of job control on health status are attenuated by including other measures associated with lower socioeconomic status, and to examine if the relationship between job control and health status is consistent across socioeconomic status groups. Design: A prospective observational cohort study over eight years (1994-2002). Participants: 4886 Respondents aged 25-60 years, who were non-self-employed labour force participants, working more than 20 hours per week, without physical or mental limitations restricting the type or amount of work they could do at baseline. After longitudinal attrition, the remaining study sample was 3411 (87% of the original study sample who did not die or become pregnant during the survey period). Main results: Low job control in 1994 was associated with worse than expected self-rated health in 2002, both directly and indirectly via a lower physical activity level in 1996. Adjustment for other factors associated with low socioeconomic status did not attenuate these relationships to a large extent. No differences were found in the effects of job control on physical activity or health status between socioeconomic groups (high and low education and high and low household income). Conclusions: The inclusion of other factors associated with lower socioeconomic status did not attenuate the direct and indirect effects of job control on health status. The finding that low job control is associated with lower physical activity levels deserves further investigation, given the increasing concern about rising levels of obesity in the developed world.",Smith P.M.; Frank J.W.; Mustard C.A.; Bondy S.J.,2008.0,10.1136/jech.2006.057539,0,0,
3717,Psychosocial Predictors of Mortality Following Lung Transplantation,"ER Lung transplantation has become an increasingly common treatment for patients with end-stage lung disease. Few studies have examined psychosocial risk factors for mortality in transplant recipients, despite evidence suggesting that elevated levels of negative affect are associated with greater mortality following major cardiac surgery. We therefore examined the relationship between negative affect early after lung transplantation and long-term survival in a sample of 132 lung transplant recipients (28 cystic fibrosis, 64 chronic obstructive pulmonary disease, 26 idiopathic pulmonary fibrosis, 14 other) followed for up to 13.5 years (median 7.4 years) following transplantation. Patients underwent both medical and psychosocial assessments 6 months following transplantation, which included the Beck Depression Inventory-II (BDI-II), Spielberger Anxiety Inventory, and General Health Questionnaire (GHQ). Over the course of follow-up, 80 (61%) participants died. Controlling for demographic factors, native lung disease, disease severity, family income, education level, social support, and frequency of posttransplant rejection, elevated symptoms of depression (BDI-II: HR?=?1.31, p?=?0.011) and distress (GHQ: HR?=?1.28, p?=?0.003) were associated with increased mortality. Higher levels of depression and general distress, but not anxiety, measured 6 months following lung transplantation are associated with increased mortality, independent of background characteristics and medical predictors.","Smith, P J; Blumenthal, J A; Trulock, E P; Freedland, K E; Carney, R M; Davis, R D; Hoffman, B M; Palmer, S M",2016.0,10.1111/ajt.13447,0,0,
3718,The impact of PTSD on pain experience in persons with HIV/AIDS.,"Pain is a common and pervasive symptom for persons infected with the human immunodeficiency virus (HIV). Individuals with persistent pain are known to be at heightened risk for posttraumatic stress disorder (PTSD), an anxiety disorder that manifests itself following exposure to a traumatic event. Moreover, research suggests that patients with persistent pain who develop PTSD often experience greater pain intensity and pain-related disability than those who do not develop PTSD. The purpose of this study was to assess the relation of PTSD to pain intensity and pain-related interference in HIV-infected persons suffering from persistent pain. Study participants included 145 ambulatory persons living with HIV/AIDS (PWHAs) who were enrolled in a randomized clinical trial assessing the impact of a pain communication intervention. Participants completed a series of self-report measures including the Stressful Life Events Checklist (SLE), the Posttraumatic Stress Disorder Checklist-Civilian (PCL-C), the Mental Health Inventory (MHI), and the Brief Pain Inventory (BPI). On average, participants reported being exposed to 6.3 different types of trauma over the course of their lifetime, of which receiving an HIV diagnosis was rated as being among the most stressful. Over half (53.8%) merited a PTSD diagnosis according to the PCL-C. Those with PTSD reported having significantly higher pain intensity and greater pain-related interference in performance of daily activities (i.e., working, sleeping, walking ability and general activity), and affect (i.e., mood, relations with other people, enjoyment of life) over time than those who did not meet the diagnostic criteria. Possible explanations for these findings are discussed along with implications for clinical care.",Smith MY.; Egert J.; Winkel G.; Jacobson J.,2002.0,,0,0,
3719,Computer-delivered modeling of exposure for spider phobia: relevant versus irrelevant exposure.,"Spider phobic subjects (n = 45) completed 3 x 40 minute computer-delivered treatment sessions. Questionnaire ratings of phobic severity were completed pre- and posttreatment (n = 45) and 6-12 month follow-up (n = 38). The program used interactive animations to model self-exposure treatment methods. Subjects were randomized to one of three treatment groups (n = 15), each receiving a different version of the program. These treatment conditions were relevant exposure with feedback (REF), relevant exposure with no feedback (RENoF), or irrelevant exposure with feedback (IEF). Relevant exposure modeled exposure to spiders, irrelevant exposure to elevators. All groups showed significant phobic improvement following the treatment, as measured on a variety of instruments. Learning on the programs was demonstrated by a significantly increased performance (time taken to reach a target score) within each group across the three computer treatment sessions. Outcome was not significantly affected either relevance of exposure or the manipulation of the onscreen feedback. Subjects' report of exposure treatment undertaken at home correlated positively with phobic improvement.",Smith KL.; Kirkby KC.; Montgomery IM.; Daniels BA.,,,0,0,
3720,A randomized trial to evaluate an education programme for patients and carers after stroke,"ER DESIGN: Randomized controlled trial.SUBJECTS AND SETTING: One hundred and seventy patients admitted to a stroke rehabilitation unit and 97 carers of these patients.INTERVENTIONS: The intervention group received a specifically designed stroke information manual and were invited to attend education meetings every two weeks with members of their multidisciplinary team. The control group received usual practice.MEASURES: Primary outcome was knowledge of stroke and stroke services. Secondary outcomes were handicap (London Handicap Scale), physical function (Barthel Index), social function (Frenchay Activities Index), mood (Hospital Anxiety and Depression Scale) and satisfaction (Pound Scale). Carer mood was measured by the General Health Questionnaire-28.RESULTS: There was no statistical evidence for a treatment effect on knowledge but there were trends that favoured the intervention. The education programme was associated with a significantly greater reduction in patient anxiety score at both three months (p =0.034) and six months (p =0.021) and consequently fewer 'cases' (Hospital Anxiety and Depression Scale anxiety subscale score > or =11). There were no other significant statistical differences between the patient or carer groups for other outcomes, although there were trends in favour of the education programme.CONCLUSION: An education programme delivered within a stroke unit did not result in improved knowledge about stroke and stroke services but there was a significant reduction in patient anxiety at six months post stroke onset.OBJECTIVES: To evaluate the effectiveness of an education programme for patients and carers recovering from stroke.","Smith, J; Forster, A; Young, J",2004.0,10.1191/0269215504cr790oa,0,0,
3721,A prospective evaluation of the Landing Error Scoring System (LESS) as a screening tool for anterior cruciate ligament injury risk.,"Anterior cruciate ligament (ACL) injuries are immediately disabling, costly, take a significant amount of time to rehabilitate, and are associated with an increased risk of developing posttraumatic osteoarthritis of the knee. Specific multiplanar movement patterns of the lower extremity, such as those associated with the drop vertical jump (DVJ) test, have been shown to be associated with an increased risk of suffering noncontact ACL injuries. The Landing Error Scoring System (LESS) has been developed as a tool that can be applied to identify individuals who display at-risk movement patterns during the DVJ. An increase in LESS score is associated with an increased risk of noncontact ACL injury. Case-control study; Level of evidence, 3. Over a 3-year interval, 5047 high school and college participants performed preseason DVJ tests that were recorded using commercial video cameras. All participants were followed for ACL injury during their sports season, and video data from injured participants and matched controls were then assessed with the LESS. Conditional logistic regression analysis was used to examine the association between LESS score and ACL injury risk in all participants as well as subgroups of female, male, high school, and college participants. There was no relationship between the risk of suffering ACL injury and LESS score whether measured as a continuous or a categorical variable. This was the case for all participants combined (odds ratio, 1.04 per unit increase in LESS score; 95% confidence interval, 0.80-1.35) as well as within each subgroup (odds ratio range, 0.99-1.14). The LESS did not predict ACL injury in our cohort of high school and college athletes.",Smith HC.; Johnson RJ.; Shultz SJ.; Tourville T.; Holterman LA.; Slauterbeck J.; Vacek PM.; Beynnon BD.,2012.0,10.1177/0363546511429776,0,0,
3722,An assessment of the demographic and clinical correlates of the dimensions of alcohol use behaviour.,"To identify population-based clinical and demographic correlates of alcohol use dimensions. Using data from a population-based sample of Great Britain (n = 7849), structural equation modelling (SEM) was used to identify associations between demographic and clinical variables and two competing dimensional models of the Alcohol Use Disorders Identification Test (AUDIT). A two-factor SEM fit best. In this model, Factor 1, alcohol consumption, was associated with male sex, younger age, lower educational attainment, generalized anxiety disorder (GAD) and suicide attempts. Factor 2, alcohol-related problems, was associated with the demographic variables (to a lesser extent) and to a wider range of clinical variables, including depressive episode, GAD, mixed anxiety and depressive disorder, obsessive compulsive disorder, phobia, suicidal thoughts and suicide attempts. The one-factor SEM was associated with demographic and all assessed clinical correlates; however, this model did not fit the data well. Two main conclusions justify the two-factor approach to alcohol use classification. First, the model fit was considerably superior and, second, the dimensions of alcohol consumption and alcohol-related problems vary considerably in their associations with measures of demographic and clinical risk. A one-factor representation of alcohol use, for instance, would fail to recognize that measures of affective/anxiety disorders are more consistently related to alcohol-related problems than to alcohol consumption. It is suggested therefore that to fully understand the complexity of alcohol use behaviour and its associated risk, future research should acknowledge the basic underlying dimensional structure of the construct.",Smith GW.; Shevlin M.; Murphy J.; Houston JE.,,10.1093/alcalc/agq052,0,0,
3723,The relationship of function-specific mental health measures to psychiatric diagnoses.,"This study examined the relationship of function-specific mental health measures, anxiety and depression subscales of the Mental Health Index (MHI), to psychiatric diagnoses of generalized anxiety disorder and major depression, as assessed by the Diagnostic Interview Schedule (DIS). Focusing on the clinical relevance of the MHI scales, we evaluated their performance in screening for DIS-diagnosable disorders in a sample of primary care patients with multiple unexplained somatic symptoms. Receiver Operating Characteristic curves and examples of sensitivity, specificity, and predictive value for different cutoff scores on the MHI are presented. When sensitivity is set at approximately 90%, positive predictive value exceeds 50%. Because the base rates of disorder in this sample are high, however, the screening measure has little independent usefulness. Similarly, cutoff scores yielding negative predictive value of approximately 90% fail to detect most of the true-negative cases. Future research should examine the use of these scales in other high-risk populations.",Smith GR.; Witt AS.; Golding JM.,1991.0,,0,0,
3724,An assessment of the demographic and clinical correlates of the dimensions of alcohol use behaviour,"ER METHODSUsing data from a population-based sample of Great Britain (n = 7849), structural equation modelling (SEM) was used to identify associations between demographic and clinical variables and two competing dimensional models of the Alcohol Use Disorders Identification Test (AUDIT).RESULTSA two-factor SEM fit best. In this model, Factor 1, alcohol consumption, was associated with male sex, younger age, lower educational attainment, generalized anxiety disorder (GAD) and suicide attempts. Factor 2, alcohol-related problems, was associated with the demographic variables (to a lesser extent) and to a wider range of clinical variables, including depressive episode, GAD, mixed anxiety and depressive disorder, obsessive compulsive disorder, phobia, suicidal thoughts and suicide attempts. The one-factor SEM was associated with demographic and all assessed clinical correlates; however, this model did not fit the data well.CONCLUSIONSTwo main conclusions justify the two-factor approach to alcohol use classification. First, the model fit was considerably superior and, second, the dimensions of alcohol consumption and alcohol-related problems vary considerably in their associations with measures of demographic and clinical risk. A one-factor representation of alcohol use, for instance, would fail to recognize that measures of affective/anxiety disorders are more consistently related to alcohol-related problems than to alcohol consumption. It is suggested therefore that to fully understand the complexity of alcohol use behaviour and its associated risk, future research should acknowledge the basic underlying dimensional structure of the construct.AIMSTo identify population-based clinical and demographic correlates of alcohol use dimensions.","Smith, G W; Shevlin, M; Murphy, J; Houston, J E",2010.0,10.1093/alcalc/agq052,0,0,3722
3725,Serotonergic modulation of dopamine measured with [11C]raclopride and PET in normal human subjects,"Objectve: This study was undertaken to measure serotonergic modulation of dopamine in vivo by using positron emission tomography (PET), a radiotracer for the striatal dopamine D2 receptor ([11C]raclopride), and a pharmacologic challenge of the serotonin system (d,1-fenfluramine). Method: Two PET studies using [11C]raclopride were performed in 11 normal male, subjects before administration of the serotonin-releasing agent and reuptake inhibitor fenfluramine (60 mg p.o.) and 3 hours afterward. A graphical analysis method was used with the [11C]raclopride data to derive the distribution volume of D2 receptors. Plasma levels of fenfluramine, norfenfluramine, homovanillic acid (HVA), cortisol, and prolactin were determined. Results: Levels of fenfluramine and prolactin were elevated 2 hours after fenfluramine administration and remained significantly elevated during the second scan, while levels of HVA and cortisol were not altered significantly during the time of scanning. A significant decrease in the specific binding (striatum) and the nonspecific binding subtracted from the specific binding (striatum minus cerebellum) of [11C]raclopride was observed. The rate of metabolism of [11C]raclopride and the nonspecific binding (cerebellum) were not significantly altered by the fenfluramine intervention. Conclusions: The observed decrease in [11C]raclopride binding is consistent with an increase in dopamine concentrations and with the ability of serotonin to stimulate dopamine activity. The ability to measure serotonergic modulation of dopamine in vivo may have implications for the study of etiologic and therapeutic mechanisms in schizophrenia, major depressive disorder, obsessive-compulsive disorder, and substance abuse.",Smith G.S.; Dewey S.L.; Brodie J.D.; Logan J.; Vitkun S.A.; Simkowitz P.; Schloesser R.; Alexoff D.A.; Hurley A.; Cooper T.; Volkow N.D.,1997.0,,0,0,
3726,Effects of affective and anxiety disorders on outcome in problem gamblers attending routine cognitive-behavioural treatment in South Australia.,"This study evaluated the influence of 12-month affective and anxiety disorders on treatment outcomes for adult problem gamblers in routine cognitive-behavioural therapy. A cohort study at a state-wide gambling therapy service in South Australia. Primary outcome measure was rated by participants using victorian gambling screen (VGS) 'harm to self' sub-scale with validated cut score 21+ (score range 0-60) indicative of problem gambling behaviour. Secondary outcome measure was Work and Social Adjustment Scale (WSAS). Independent variable was severity of affective and anxiety disorders based on Kessler 10 scale. We used propensity score adjusted random-effects models to estimate treatment outcomes for sub-populations of individuals from baseline to 12 month follow-up. Between July, 2010 and December, 2012, 380 participants were eligible for inclusion in the final analysis. Mean age was 44.1 (SD = 13.6) years and 211 (56 %) were males. At baseline, 353 (92.9 %) were diagnosed with a gambling disorder using VGS. For exposure, 175 (46 %) had a very high probability of a 12-month affective or anxiety disorder, 103 (27 %) in the high range and 102 (27 %) in the low to moderate range. For the main analysis, individuals experienced similar clinically significant reductions (improvement) in gambling related outcomes across time (p < 0.001). Individuals with co-varying patterns of problem gambling and 12 month affective and anxiety disorders who present to a gambling help service for treatment in metropolitan South Australia gain similar significant reductions in gambling behaviours from routine cognitive-behavioural therapy in the mid-term. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Smith, David; Harvey, Peter; Humeniuk, Rachel; Battersby, Malcolm; Pols, Rene; Andrews, Battersby, Battersby, Beck, Becona, Ben-Tovim, Berkson, Bondolfi, Brown, Brown, Carlbring, Cowlishaw, Crisp, d'Agostino, Daughters, Delfabbro, Dempster, Dowling, Gueorguieva, Hides, Hodgins, Jackson, Jacobson, Jimenez-Murcia, Kampman, Ladouceur, Ladouceur, Laird, Lorains, Langle, Marks, McMillen, Mundt, Nemeroff, Oakes, Ougrin, Pasche, Petry, Petry, Rabe-Hesketh, Raylu, Raylu, Shaffer, Slade, Smith, Smith, Soberay, Sylvain, Tolchard, Tolchard, Wardle, West, Winters, Wong, Wong",2015.0,,0,0,
3727,A randomised comparative trial of yoga and relaxation to reduce stress and anxiety,"ER DESIGNA randomised comparative trial was undertaken comparing yoga with relaxation.PARTICIPANTSOne hundred and thirty-one subjects with mild to moderate levels of stress were recruited from the community in South Australia.INTERVENTIONSTen weekly 1- h sessions of relaxation or hatha yoga.MAIN OUTCOME MEASURESChanges in the State Trait Personality Inventory sub-scale anxiety, General Health Questionnaire and the Short Form-36.RESULTSFollowing the 10 week intervention stress, anxiety and quality of life scores improved over time. Yoga was found to be as effective as relaxation in reducing stress, anxiety and improving health status on seven domains of the SF-36. Yoga was more effective than relaxation in improving mental health. At the end of the 6 week follow-up period there were no differences between groups in levels of stress, anxiety and on five domains of the SF-36. Vitality, social function and mental health scores on the SF-36 were higher in the relaxation group during the follow-up period.CONCLUSIONYoga appears to provide a comparable improvement in stress, anxiety and health status compared to relaxation.OBJECTIVETo compare yoga and relaxation as treatment modalities at 10 and 16 weeks from study baseline to determine if either of modality reduces subject stress, anxiety, blood pressure and improve quality of life.","Smith, C; Hancock, H; Blake-Mortimer, J; Eckert, K",2007.0,10.1016/j.ctim.2006.05.001,0,0,
3728,The effect of acupuncture on psychosocial outcomes for women experiencing infertility: a pilot randomized controlled trial,"ER OBJECTIVES: The study objectives were to examine the effectiveness of acupuncture for reducing infertility-related stress.DESIGN: The study design was a randomized controlled trial of acupuncture compared with a wait-list control.SETTING: The study was conducted at The University of Western Sydney.SUBJECTS: Thirty-two (32) women aged 20-45 years, with a diagnosis of infertility, or a history of unsuccessfully trying to conceive for 12 months or more, were the subjects of the study.INTERVENTIONS: Women received six sessions of acupuncture over 8 weeks.OUTCOME MEASURES: The primary outcomes were infertility self-efficacy, anxiety, and infertility-related stress. The women's experience of infertility and acupuncture is also reported.RESULTS: At the end of the 8-week intervention, women in the acupuncture group reported significant changes on two domains on the Fertility Problem Inventory with less social concern (mean difference [MD] -3.75, 95% confidence interval [CI] -7.58 to 0.84, p=0.05), and less relationship concern (","Smith, C A; Ussher, J M; Perz, J; Carmady, B; Lacey, S",2011.0,10.1089/acm.2010.0380,0,0,
3729,Short-form mindfulness-based stress reduction reduces anxiety and improves health-related quality of life in an inner-city population.,"Mindfulness-based stress reduction is a mindfulness-based intervention that is an effective treatment modality for many conditions including stress, anxiety, and depression. Using data from 23 patients who completed a short-form mindfulness-based stress reduction course at a federally qualified health center, a quasi-experimental design was used to assess the impact of participation on self-reported anxiety, stress, mindfulness, and quality of life. Mindfulness and stress showed improvements from pre- to posttests, but neither difference achieved statistical significance. Participants showed statistically significant decreases in anxiety (7-item Generalized Anxiety Disorder scale score: 7.8-4.4; P = .005) and improvements in health-related quality of life including the 36-item Medical Outcomes Study Short Form Health Survey Mental Component Summary (+9.1; P = .001), Physical Functioning (+6.6; P = .039), Vitality (+16.1; P = .001), Social Functioning (+16.9; P = .003), Role Physical (+16.8; P = .016), and Mental Health (+15.6; P < .001) subscales. These findings suggest that an abbreviated mindfulness-based stress reduction course can serve to reduce anxiety and improve quality of life in an underserved population.",Smith B.; Metzker K.; Waite R.; Gerrity P.,,10.1097/HNP.0000000000000075,0,0,
3730,Short-form mindfulness-based stress reduction reduces anxiety and improves health-related quality of life in an inner-city population,"ER Mindfulness-based stress reduction is a mindfulness-based intervention that is an effective treatment modality for many conditions including stress, anxiety, and depression. Using data from 23 patients who completed a short-form mindfulness-based stress reduction course at a federally qualified health center, a quasi-experimental design was used to assess the impact of participation on self-reported anxiety, stress, mindfulness, and quality of life. Mindfulness and stress showed improvements from pre- to posttests, but neither difference achieved statistical significance. Participants showed statistically significant decreases in anxiety (7-item Generalized Anxiety Disorder scale score: 7.8-4.4; P = .005) and improvements in health-related quality of life including the 36-item Medical Outcomes Study Short Form Health Survey Mental Component Summary (+9.1; P = .001), Physical Functioning (+6.6; P = .039), Vitality (+16.1; P = .001), Social Functioning (+16.9; P = .003), Role Physical (+16.8; P = .016), and Mental Health (+15.6; P < .001) subscales. These findings suggest that an abbreviated mindfulness-based stress reduction course can serve to reduce anxiety and improve quality of life in an underserved population.","Smith, B; Metzker, K; Waite, R; Gerrity, P",2015.0,10.1097/HNP.0000000000000075,0,0,3729
3731,Modulation of Cervical Facet Joint Nociception and Pain Attenuates Physical and Psychological Features of Chronic Whiplash: A Prospective Study.,"To investigate changes in clinical (physical and psychological) features of individuals with chronic whiplash-associated disorder who had previously undergone cervical radiofrequency neurotomy at the time point when the effects of radiofrequency neurotomy had dissipated and pain returned. Prospective cohort observational trial of consecutive patients. Tertiary spinal intervention centre in Calgary, Alberta, Canada. A total of 53 consecutive individuals with chronic whiplash-associated disorder. Individuals underwent radiofrequency neurotomy and were assessed before radiofrequency neurotomy, at 1 and 3 months postprocedure, and then after the return of pain (approximately 10 months postprocedure). Quantitative sensory tests (pressure; thermal pain thresholds; brachial plexus provocation test), nociceptive flexion reflex, and motor function (cervical range of movement; craniocervical flexion test) were measured. Self-reported disability, psychological distress, pain catastrophization, and posttraumatic stress disorder symptoms also were measured. Upon the return of pain after radiofrequency neurotomy, levels of disability increased (P < .0001), and were no different to those before radiofrequency neurotomy (P = .99). There also was a significant deterioration in quantitative sensory testing measures and reduced cervical range of motion after the return of pain (all P < .05); all approaching values were recorded before radiofrequency neurotomy (P > .22). There were no significant changes in pressure hyperalgesia (P > .054) or craniocervical flexion test performance (P > .07) after the return of pain. Psychological distress and pain catastrophizing increased significantly after the return of pain (P < .01), and again were no different than measures taken prior to radiofrequency neurotomy (P > .13). However, there was no difference in number or severity of posttraumatic stress symptoms after the return of pain (P > .30). Physical and psychological features of chronic whiplash-associated disorder are modulated dynamically with cervical radiofrequency neurotomy. These findings indicate that peripheral nociception is involved in the manifestations of chronic whiplash-associated disorder in this cohort of individuals.",Smith AD.; Jull G.; Schneider GM.; Frizzell B.; Hooper RA.; Sterling M.,2015.0,10.1016/j.pmrj.2015.03.014,0,0,
3732,Parent cognitive-behavioral intervention for the treatment of childhood anxiety disorders: a pilot study,"ER Strong evidence supports cognitive-behavioral therapy (CBT) for the treatment of childhood anxiety. Many studies suggest that parents play an etiological role in the development and maintenance of child anxiety. This pilot study examined the efficacy of a cognitive-behavioral intervention delivered to the parents of 31 anxious children (ages 7-13). Parents were randomly assigned to an individual parent-only CBT intervention (PCBT, n=18) or wait-list control (WL, n=13). PCBT demonstrated significant reductions in children's number of anxiety disorder diagnoses, parent-rated interference and clinician-rated severity of anxiety, and maternal protective behaviors at post-treatment, which were maintained at 3-months. WL did not demonstrate significant changes. There were no significant differences between conditions in child self-reported or parent-report of child anxiety symptoms. Findings were replicated in a combined sample of treated participants, as well as in an intent-to-treat sample. Parent-only CBT may be an effective treatment modality for child anxiety, though future research is warranted.","Smith, A M; Flannery-Schroeder, E C; Gorman, K S; Cook, N",2014.0,10.1016/j.brat.2014.08.010,0,0,
3733,Contextual modulation of pain sensitivity utilising virtual environments,"Background: Investigating psychological mechanisms that modulate pain, such as those that might be accessed by manipulation of context, is of great interest to researchers seeking to better understand and treat pain. The aim of this study was to better understand the interaction between pain sensitivity, and contexts with inherent emotional and social salience – by exploiting modern immersive virtual reality (VR) technology. Methods: A within-subjects, randomised, double-blinded, repeated measures (RM) design was used. In total, 25 healthy participants were exposed to neutral, pleasant, threatening, socially positive and socially negative contexts, using an Oculus Rift DK2. Pressure pain thresholds (PPTs) were recorded in each context, as well as prior to and following the procedure. We also investigated whether trait anxiety and pain catastrophisation interacted with the relationship between the different contexts and pain. Results: Pressure pain sensitivity was not modulated by context (p = 0.48). Anxiety and pain catastrophisation were not significantly associated with PPTs, nor did they interact with the relationship between context and PPTs. Conclusion: Contrary to our hypothesis, socially and emotionally salient contexts did not influence pain thresholds. In light of other research, we suggest that pain outcomes might only be tenable to manipulation by contextual cues if they specifically manipulate the meaning of the pain-eliciting stimulus, rather than manipulate psychological state generally – as per the current study. Future research might exploit immersive VR technology to better explore the link between noxious stimuli and contexts that directly alter its threat value.",Smith A.; Carlow K.; Biddulph T.; Murray B.; Paton M.; Harvie D.S.,2017.0,10.1177/2049463717698349,0,0,
3734,Cognitive mechanisms of social anxiety reduction: An examination of specificity and temporality.,"Cognitive theories posit that exposure-based treatments exert their effect on social anxiety by modifying judgmental biases. The present study provides a conservative test of the relative roles of changes in judgmental biases in governing social anxiety reduction and addresses several limitations of previous research. Longitudinal, within-subjects analysis of data from 53 adults with a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) social phobia diagnosis revealed that reductions in probability and cost biases accounted for significant variance in fear reduction achieved during treatment. However, whereas the reduction in probability bias resulted in fear reduction, the reduction in cost bias was merely a consequence of fear reduction. A potential implication is that exposure-based treatments for social anxiety might focus more attention on correcting faulty appraisals of social threat occurrence. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Smits, Jasper A. J; Rosenfield, David; McDonald, Renee; Telch, Michael J; Baron, Beck, Bruce, Clark, Clark, Clark, Davidson, Foa, Foa, Foa, Gursky, Harvey, Heimberg, Hofmann, Hofmann, Kazdin, Kenny, Kessler, Kirsch, Kirsch, Liebowitz, Lucock, Mackinnon, McManus, McNally, Menard, Menzies, Moscovitch, Paul, Poulton, Raudenbush, Reich, Reiss, Reiss, Reiss, Schultz, Shrout, Singer, Smits, Smits, Tein, Telch, Telch, Valentiner, Valentiner, Williams",2006.0,,0,0,
3735,The efficacy of vigorous-intensity exercise as an aid to smoking cessation in adults with elevated anxiety sensitivity: study protocol for a randomized controlled trial.,"Although cigarette smoking is a leading cause of death and disability in the United States (US), over 40 million adults in the US currently smoke. Quitting smoking is particularly difficult for smokers with certain types of psychological vulnerability. Researchers have frequently called attention to the relation between smoking and anxiety-related states and disorders, and evidence suggests that panic and related anxiety vulnerability factors, specifically anxiety sensitivity (AS or fear of somatic arousal), negatively impact cessation. Accordingly, there is merit to targeting AS among smokers to improve cessation outcome. Aerobic exercise has emerged as a promising aid for smoking cessation for this high-risk (for relapse) group because exercise can effectively reduce AS and other factors predicting smoking relapse (for example, withdrawal, depressed mood, anxiety), and it has shown initial efficacy for smoking cessation. The current manuscript presents the rationale, study design and procedures, and design considerations of the Smoking Termination Enhancement Project (STEP). STEP is a randomized clinical trial that compares a vigorous-intensity exercise intervention to a health and wellness education intervention as an aid for smoking cessation in adults with elevated AS. One hundred and fifty eligible participants will receive standard treatment (ST) for smoking cessation that includes cognitive behavioral therapy (CBT) and nicotine replacement therapy (NRT). In addition, participants will be randomly assigned to either an exercise intervention (ST+EX) or a health and wellness education intervention (ST+CTRL). Participants in both arms will meet 3 times a week for 15 weeks, receiving CBT once a week for the first 7 weeks, and 3 supervised exercise or health and wellness education sessions (depending on randomization) per week for the full 15-week intervention. Participants will be asked to set a quit date for 6 weeks after the baseline visit, and smoking cessation outcomes as well as putative mediator variables will be measured up to 6 months following the quit date. The primary objective of STEP is to evaluate whether vigorous-intensity exercise can aid smoking cessation in anxiety vulnerable adults. If effective, the use of vigorous-intensity exercise as a component of smoking cessation interventions would have a significant public health impact. Specifically, in addition to improving smoking cessation treatment outcome, exercise is expected to offer benefits to overall health, which may be particularly important for smokers. The study is also designed to test putative mediators of the intervention effects and therefore has the potential to advance the understanding of exercise-anxiety-smoking relations and guide future research on this topic. ClinicalTrials.gov, NCT01065506, http://clinicaltrials.gov/ct2/show/NCT01065506.",Smits JA.; Zvolensky MJ.; Rosenfield D.; Marcus BH.; Church TS.; Frierson GM.; Powers MB.; Otto MW.; Davis ML.; DeBoer LB.; Briceno NF.,2012.0,10.1186/1745-6215-13-207,0,0,
3736,"The role of blood pressure, cortisol, and prolactin among soldiers injured in the 1991-1993 war in Croatia","ER Ninety soldiers with at least three months of combat exposure--60 injured soldiers (30 with permanent disabling and 30 with nondisabling injuries), 30 noninjured soldiers and 30 healthy controls--were interviewed and investigated with physiological (Prolactine, Cortisol, BP, Hb) and psychological tests (MMPI), IES-15 (Impact of Event Scale), PTSS (Post-Traumatic Symptom Scale). Their war related injuries had a different effect on the physiological stress response of the soldiers as reflected in the levels of prolactine, cortisol, hemoglobin and blood pressure. In a report of personality characteristics of the same soldiers, we demonstrated that the experience of posttraumatic stress was not dependent upon physical injury, but rather on the psychological appraisal of the situation. The results of the present article confirm earlier findings that the relationship between physiological and psychological consequences of trauma are complex, and that the perception of an event and the social context within which the traumatized soldier exists is as important as the event itself. The physiological response to the trauma varied greatly among the soldiers regarding the psychosocial impact of the consequence of the injury. So the anticipation of future possible trauma among less severely wounded soldiers (expected to go back to war) was followed by pathological stress responses. Trauma seems to operate somewhat independently from the overt conscious appraisal of the situation and relationship between psychological, psychosocial, and physiological aspects are interrelated in a multifactorial way. An integrative approach is therefore of great importance in assessment as well as in treatment of Posttraumatic Stress Disorder (PTSD).","Sivik, T; Delimar, D; Korenjak, P; Delimar, N",1997.0,,0,0,
3737,Feasibility of integrating mental health screening and services into routine elder abuse practice to improve client outcomes,"ER The goal of this pilot program was to test the feasibility of mental health screening among elder abuse victims and of offering those victims a brief psychotherapy for depression and anxiety. Elder abuse victims who sought assistance from a large, urban elder abuse service were screened for depression and anxiety using standardized measures. Clients with clinically significant depression (PHQ-9) or anxiety (GAD-7) were randomized to receive one of three different interventions concurrent with abuse resolution services. Staff were able to screen 315 individuals, with 34% of clients scoring positive for depression or anxiety. Of those with mental health needs, only 15% refused all services. The mental health intervention (PROTECT) was successfully implemented in two different formats with collaboration between staff workers. These findings support both the need for mental health care among elder abuse victims and the feasibility of integrating mental health screening and treatment into routine elder abuse practice.","Sirey, J A; Berman, J; Salamone, A; DePasquale, A; Halkett, A; Raeifar, E; Banerjee, S; Bruce, M L; Raue, P J",2015.0,10.1080/08946566.2015.1008086,0,0,
3738,Cognitive behavioral and attachment based family therapy for anxious adolescents: phase I and II studies,"ER The goals of these two studies were to assess the acceptability and feasibility as well as to gather preliminary efficacy data on a modified combination cognitive behavioral (CBT) and attachment based family therapy (ABFT) for adolescents (ages 12-18), with the primary diagnosis of generalized (GAD), social phobia (SP), and separation (SAD) anxiety disorders. In Phase I, CBT was modified for an adolescent population and ABFT was modified for working with anxious adolescents in combination with CBT. Therapists were trained for both conditions and eight patients were treated as an open trial pilot of combined CBT-ABFT with positive results. In Phase II, 11 adolescents were randomly assigned to CBT alone or CBT and family based treatment (CBT-ABFT). Participants were evaluated at pre, post, and 6-9 months follow-up assessing diagnosis, psychiatric symptoms and family functioning. Results indicated significant decreases in anxiety and depressive symptoms by both clinical evaluator and self-reports with no significant differences by treatment. Sixty-seven percent of adolescents in CBT no longer met criteria for their primary diagnosis at post treatment as compared to 40% in CBT-ABFT with continued improvement of 100 and 80% at follow-up with no significant differences between treatments. Both CBT and CBT-ABFT appear to be promising treatments for anxious adolescents and more treatment development and evaluation is needed.","Siqueland, L; Rynn, M; Diamond, G S",2005.0,10.1016/j.janxdis.2004.04.006,0,0,
3739,Predisposing factors for traumatic dental injury in primary teeth and seeking of post-trauma care,"ER The aim of the present study was to investigate predisposing factors for traumatic dental injury (TDI) in the primary dentition and seeking of dental care after the occurrence of TDI. A randomized population-based cross-sectional study was carried out with 814 children aged 3 to 5 years enrolled at public and private preschools in the city of Campina Grande, PB, Brazil. Parents were asked to fill out a questionnaire on demographic data and the child's history of TDI. TDI was evaluated by clinical examinations performed by three previously calibrated dentists (Kappa: 0.85 to 0.90). Bivariate and multivariate Poisson regression models were constructed for TDI and the parent-reported search for dental care (?=0.05). The prevalence of TDI was 34.6%. The most common type of TDI was enamel fracture (55.0%). The central incisors were the most frequently affected teeth (87.5%). Predictors for TDI in the primary dentition were household income >U$312.50 (PR: 1.355; 95% CI: 1.050-1.724) and overjet >2 mm (PR: 1.539; 95% CI: 1.219-1.942). The predictor for seeking dental care following TDI was parent's age >30 years (PR: 1.753; 95% CI: 1.039-2.960). Household income and overjet were associated with TDI. Among children having suffered TDI, parent's age is a crucial determinant for seeking dental care.","Siqueira, M B; Gomes, M C; Oliveira, A C; Martins, C C; Granville-Garcia, A F; Paiva, S M",2013.0,10.1590/0103-6440201302352,0,0,
3740,Augmentation of in vivo exposure treatment for agoraphobia by the formation of neighbourhood self-help groups.,,Sinnott A.; Jones RB.; Scott-Fordham A.; Woodward R.,1981.0,,0,0,
3741,Systematic tailoring for the implementation of guideline recommendations for anxiety and depressive disorders in general practice: perceived usefulness of tailored interventions.,"The uptake of guideline recommendations in general practice can potentially be improved by designing implementation interventions that are tailored to prospectively identify barriers. However, there is insufficient evidence regarding the most effective and efficient approaches to tailoring. Our study provides an insight into the usefulness of tailored interventions to prospectively identified barriers affecting the uptake of guideline recommendations for anxiety and depressive disorders experienced by general practitioners (GPs) in their local context. A qualitative study was conducted, in which 23 GPs gave informed consent and 14 finally participated. To explore the barriers affecting the uptake of guideline recommendations, a face-to-face interview was conducted with each GP to generate a personalised list. In response to this list, interventions were tailored to remove the barriers experienced by the GPs. To examine the perceived usefulness of the tailored interventions, telephone interviews were conducted after one year and coded through thematic coding. The analysis was descriptive in nature. The most frequently perceived barriers were: a lack of knowledge and skills, no agreement on guideline recommendations, negative outcome expectancy, low self-efficacy, no consensus with patients, and a lack of information about treatments provided by mental health professionals, together with waiting lists. The tailored interventions 'peer group supervision' and 'individualised telephone consultations' were perceived as useful by most GPs. Besides the tailored interventions, a perceived benefit of using a self-rating scale, measuring depressive and anxiety symptoms, and the idea of delivering better patient care, were supportive in the uptake of guideline recommendations. Our findings suggest that tailoring interventions to prospectively identified barriers, affecting the uptake of guideline recommendations for anxiety and depressive disorders, as perceived by GPs, may enhance the implementation of these guideline recommendations.",Sinnema H.; Terluin B.; Wensing M.; Volker D.; Franx G.; van Balkom A.; de Lange J.,2013.0,10.1186/1471-2296-14-94,0,0,
3742,Randomised controlled trial of tailored interventions to improve the management of anxiety and depressive disorders in primary care.,"Anxiety and depressive disorders are highly prevalent disorders and are mostly treated in primary care. The management of these disorders by general practitioners is not always consistent with prevailing guidelines because of a variety of factors. Designing implementation strategies tailored to prospectively identified barriers could lead to more guideline-recommended care. Although tailoring of implementation strategies is promoted in practice, little is known about the effect on improving the quality of care for the early recognition, diagnosis, and stepped care treatment allocation in patients with anxiety or depressive disorders in general practice. This study examines whether the tailored strategy supplemented with training and feedback is more effective than providing training and feedback alone. In this cluster randomised controlled trial, a total of 22 general practices will be assigned to one of two conditions: (1) training, feedback, and tailored interventions and (2) training and feedback. The primary outcome measure is the proportion of patients who have been recognised to have anxiety and/or depressive disorder. The secondary outcome measures in patients are severity of anxiety and depressive symptoms, level of functioning, expectation towards and experience with care, quality of life, and economic costs. Measures are taken after the start of the intervention at baseline and at three- and six-month follow-ups. Secondary outcome measures in general practitioners are adherence to guideline-recommended care in care that has been delivered, the proportion of antidepressant prescriptions, and number of referrals to specialised mental healthcare facilities. Data will be gathered from the electronic medical patient records from the patients included in the study. In a process evaluation, the identification of barriers to change and the relations between prospectively identified barriers and improvement interventions selected for use will be described, as well as the factors that influence the provision of guideline-recommended care. It is hypothesised that the adherence to guideline recommendations will be improved by designing implementation interventions that are tailored to prospectively identified barriers in the local context of general practitioners. Currently, there is insufficient evidence on the most effective and efficient approaches to tailoring, including how barriers should be identified and how interventions should be selected to address the barriers. NTR1912.",Sinnema H.; Franx G.; Volker D.; Majo C.; Terluin B.; Wensing M.; van Balkom A.,2011.0,10.1186/1748-5908-6-75,0,0,
3743,"Combining relaxation, exposure and cognitive restructuring in the outpatient treatment of chronic social phobia: A single case study.","Cognitive-behaviour therapy has been mentioned as the choice of treatment for social phobias. A majority of the studies in this area have used exposure and cognitive restructuring together and have compared them against either of the two. The use of relaxation in the treatment of social phobia has not received much importance despite it being very effective in managing autonomic symptoms. Similarly, there is little mention about what dimension of social phobia is responsive to the cognitive-behavioural techniques. In this study of a 42-yr-old man with social phobia the combination as well as the specific efficacy of relaxation, exposure, and cognitive restructuring is analyzed in regard to treatment. The combination of therapies was very effective in reducing symptoms of social phobia. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sinha, Uday K; Jalan, Rekha K; Amies, Arrindell, Barlow, Beck, Beck, Benson, Biederman, Biederman, Braner, Bruch, Bruch, Bruch, Burns, Butler, Butler, Davidson, Davidson, Donohue, Heimberg, Heimberg, Heimberg, Herbert, Hope, Juster, Kaplan, Lelliott, Marks, Mattick, Miller, Mineka, Noyes, Oei, Ost, Potts, Rosenbaum, Rosenbaum, Stopa, Williams, Woodward",2001.0,,0,0,
3744,Physiological and behavioral effects of naloxone and lactate in normal volunteers with relevance to the pathophysiology of panic disorder,"This study investigates whether naloxone, an opioid receptor antagonist, could render normal controls, normally nonresponsive to panic inducing stimuli, sensitive to the physiological and behavioral effects of sodium lactate, a robust panicogen in panic disorder patients. Twelve normal controls received intravenous naloxone followed by sodium lactate. Four of these subjects underwent a separate infusion with naloxone followed by saline. Respiratory physiological symptoms were measured throughout. Clinical symptoms, assessed by the Acute Panic Inventory (API), an Anxiety Scale, and the Borg Breathlessness Scale, were recorded. Eight of the twelve subjects experienced strong physiological reactivity to naloxone-lactate manifested by significantly increased tidal volume. Concomitant increases in the API and Borg scales were demonstrated; however, fear or anxiety was not affected. The four subjects retested with naloxone followed by saline did not experience significant increases on any measure. These results provide preliminary evidence that endogenous opioid system function may be a key modulator of responsivity to sodium lactate. Dysregulation of the opioid system may potentially underlie critical aspects of panic disorder neurobiology, including respiratory abnormalities and suffocation sensitivity. © 2006 Elsevier Ireland Ltd. All rights reserved.",Sinha S.S.; Goetz R.R.; Klein D.F.,2007.0,10.1016/j.psychres.2004.11.011,0,0,
3745,A Mindfulness-Based Treatment of Obsessive-Compulsive Disorder.,"Of those who suffer from obsessive-compulsive disorder (OCD), a substantial number do not respond well to the standard treatment of two trials of serotonin reuptake inhibitors and cognitive-behavioral therapy. In addition to being refractory to current treatments, these individuals often have comorbid disorders that contribute to a compromised quality of life. The authors present the case of such an individual who was assisted to improve her quality of life by accepting her OCD as a strength and enhancing her mindfulness so that she was able to incorporate her OCD in her daily life. Results showed that she successfully overcame her debilitating OCD and was taken off all medication within 6 months of intervention. Three years of postintervention follow-up showed that she was well adjusted, had a full and healthy lifestyle and that although some obsessive thoughts remained, they did not control her behavior. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Singh, Nirbhay N; Wahler, Robert G; Winton, Alan S. W; Adkins, Angela D; The Mindfulness Research Group; Beck, Foa, Freeston, Goodman, Gunaratana, Hanh, Hanh, Hollander, Kabat-Zinn, Kabat-Zinn, Langer, March, McLeod, Segal, Singh, Singh, Swinson",2004.0,,0,0,
3746,Improving lysine production by Corynebacterium glutamicum through DNA microarray-based identification of novel target genes,"For the biotechnological production of l-lysine, mainly strains of Corynebacterium glutamicum are used, which have been obtained by classical mutagenesis and screening or selection or by metabolic engineering. Gene targets for the amplification and deregulation of the lysine biosynthesis pathway, for the improvement of carbon precursor supply and of nicotinamide adenine dinucleotide phosphate (reduced form) (NADPH) regeneration, are known. To identify novel target genes to improve lysine production, the transcriptomes of the classically obtained lysine producing strain MH20-22B and several other C. glutamicum strains were compared. As lysine production by the classically obtained strain, which possesses feedback-resistant aspartokinase and is leucine auxotrophic, exceeds that of a genetically defined leucine auxotrophic wild-type derivative possessing feedback-resistant aspartokinase, additional traits beneficial for lysine production are present. NCgl0855, putatively encoding a methyltransferase, and the amtA-ocd-soxA operon, encoding an ammonium uptake system, a putative ornithine cyclodeaminase and an uncharacterized enzyme, were among the genes showing increased expression in the classically obtained strain irrespective of the presence of feedback-resistant aspartokinase. Lysine production could be improved by about 40% through overexpression of NCgl0855 or the amtA-ocd-soxA operon. Thus, novel target genes for the improvement of lysine production could be identified in a discovery-driven approach based on global gene expression analysis. © 2007 Springer-Verlag.",Sindelar G.; Wendisch V.F.,2007.0,10.1007/s00253-007-0916-x,0,0,
3747,Response versus remission in obsessive-compulsive disorder.,"To investigate rates of response and remission in adults with obsessive-compulsive disorder (OCD) after 12 weeks of evidence-based treatment. Post hoc analyses of response and remission were conducted using data from a multisite, randomized, controlled trial comparing the effects of 12 weeks of exposure and ritual prevention (EX/RP), clomipramine (CMI), their combination (EX/RP+CMI), or pill placebo (PBO) in 122 adults with OCD (DSM-III-R or DSM-IV criteria). Response was defined as a decrease in symptoms; remission was defined as minimal symptoms after treatment. Different response and remission definitions were constructed based on criteria used in prior studies. For each definition, the proportion of responders or remitters in each treatment group was then compared. There were significant differences (p<.05) among the 4 treatment groups in the proportion of responders and remitters. In pairwise comparisons, EX/RP+CMI and EX/RP each produced significantly more responders and remitters than PBO; CMI produced significantly more responders and remitters than PBO for some definitions but not for others. When remission was defined as a Yale-Brown Obsessive Compulsive Scale (YBOCS) score of 12 or less, significantly more EX/RP+CMI (18/31 [58%]) and EX/RP (15/29 [52%]) patients entering treatment achieved remission than either CMI (9/36 [25%]) or PBO (0/26 [0%]) patients. However, even in treatment completers, many CMI and some EX/RP+CMI and EX/RP patients did not achieve remission (remission rates for YBOCS<or=12: EX/RP+CMI=13/19 [68%]; EX/RP=15/21 [71%]; CMI=8/27 [30%]; PBO=0/20 [0%]). EX/RP (with or without CMI) can lead to superior treatment outcome compared with CMI alone in OCD patients without comorbid depression. However, many OCD patients who receive evidence-based treatment do not achieve remission.",Simpson HB.; Huppert JD.; Petkova E.; Foa EB.; Liebowitz MR.,2006.0,,0,0,
3748,Cognitive-behavioral therapy as an adjunct to serotonin reuptake inhibitors in obsessive-compulsive disorder: an open trial.,"We report the results of an open trial of cognitive-behavioral therapy (CBT) using exposure and ritual prevention as an adjunct to serotonin reuptake inhibitors (SRIs) in obsessive-compulsive disorder (OCD). We hypothesized that exposure and ritual prevention would significantly reduce OCD symptoms in patients who remained symptomatic despite an adequate trial of an SRI and enable patients to discontinue their medication. OCD patients taking an adequate dose of an SRI > or = 12 weeks who remained symptomatic (i.e., a Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score > or = 16) were eligible. While taking a stable dose of an SRI, patients received 17 sessions of exposure and ritual prevention. For the intent-to-treat group, the paired t test was used to compare scores on the Y-BOCS, the National Institute of Mental Health (NIMH) Global OCD scale, the Clinical Global Impressions scale, and the Hamilton Rating Scale for Depression before and after exposure and ritual prevention. Six of 7 eligible patients entered the study, and 5 completed it. All 6 improved on all OCD measures. The mean +/- SD Y-BOCS score was 23.8 +/- 2.6 prior to exposure and ritual prevention and 12.2 +/- 4.3 after it (p < .001). The mean percentage decrease on the Y-BOCS was 49% (range, 26%-61%). Patients were rated by the therapist and rated themselves as much (N = 4) or very much (N = 2) improved. Blood drug levels did not change in most patients during exposure and ritual prevention; thus, the improvement was attributed to this type of therapy. No patients discontinued their medication. This open trial suggests that CBT using exposure and ritual prevention can lead to a significant reduction in OCD symptoms in patients who remain symptomatic despite an adequate trial of an SRI.",Simpson HB.; Gorfinkle KS.; Liebowitz MR.,1999.0,,0,0,
3749,Standard criteria for relapse are needed in obsessive-compulsive disorder.,"To assess how different criteria for relapse affect inferences about relapse in obsessive-compulsive disorder (OCD), a post hoc analysis of relapse was conducted using data from a multisite randomized controlled trial comparing clomipramine (CMI), exposure and ritual prevention (EX/RP), and its combination (EX/RP+CMI) in adults with OCD. Different relapse definitions were constructed based on criteria used in prior studies. For each definition, the number of relapsers was computed, and the proportion of relapsers and time to relapse were compared. When applied to this data set, relapse criteria used in prior OCD studies yielded different observed relapse rates (range: 27-63% for CMI; 0-50% for EX/RP; and 7-67% for EX/RP+CMI). Most criteria found that EX/RP responders (with or without CMI) had a significantly lower relapse rate and longer time to relapse after treatment discontinuation than did responders to CMI alone. However, some relapse criteria (e.g., those requiring minimal worsening) found no significant treatment differences in relapse rates or time to relapse, and some generated biases against one treatment or another. Most definitions concurred: in adults with primary OCD, EX/RP treatment (with or without CMI) can produce more durable short-term gains after treatment discontinuation than CMI alone. However, different relapse criteria can lead to very different observed relapse rates and even contradictory inferences about relapse. Standard criteria for relapse are needed in OCD to facilitate comparisons between studies (enabling better treatment guidelines) and to advance research on mechanisms of relapse and relapse prevention.",Simpson HB.; Franklin ME.; Cheng J.; Foa EB.; Liebowitz MR.,2005.0,10.1002/da.20052,0,0,
3750,Suicide prevention after traumatic brain injury: a randomized controlled trial of a program for the psychological treatment of hopelessness.,"To evaluate the efficacy of a psychological treatment to reduce moderate to severe hopelessness after severe traumatic brain injury (TBI). Randomized controlled trial. Participants were aged between 18 and 65 years, experienced posttraumatic amnesia more than 1day and moderate to severe hopelessness (Beck Hopelessness Scale [BHS]) and/or suicide ideation. Intervention comprised a 20-hour manualized group cognitive behavior therapy program. Participants were randomly allocated using concealed allocation (treatment n = 8; wait-list n = 9); all remained in their allocated group. Outcome variables were collected by assessors blind to group allocation. No between-groups differences were observed on demographic, injury, cognitive, and psychosocial variables at baseline (time 1). A significant group-by-time interaction was found for BHS in the treatment group (F1,15 = 13.20, P = .002), reflecting a reduction in mean BHS scores between time 1 and time 2 (posttreatment) with no main effects for group or time. At 3-month follow-up (time 3), the treatment gains were maintained or improved for 75% (6/8) of participants. Secondary outcome variables (suicide ideation, depression, social problem solving, self-esteem, hopefulness) displayed no significant group-by-time interactions or main effects. This trial provides initial evidence for the efficacy of a psychological intervention in reducing hopelessness among long-term survivors with severe TBI.",Simpson GK.; Tate RL.; Whiting DL.; Cotter RE.,,10.1097/HTR.0b013e3182225250,0,0,
3751,Suicide prevention after traumatic brain injury: a randomized controlled trial of a program for the psychological treatment of hopelessness,"ER METHODRandomized controlled trial. Participants were aged between 18 and 65 years, experienced posttraumatic amnesia more than 1day and moderate to severe hopelessness (Beck Hopelessness Scale [BHS]) and/or suicide ideation. Intervention comprised a 20-hour manualized group cognitive behavior therapy program. Participants were randomly allocated using concealed allocation (treatment n = 8; wait-list n = 9); all remained in their allocated group. Outcome variables were collected by assessors blind to group allocation.RESULTSNo between-groups differences were observed on demographic, injury, cognitive, and psychosocial variables at baseline (time 1). A significant group-by-time interaction was found for BHS in the treatment group (F1,15 = 13.20, P = .002), reflecting a reduction in mean BHS scores between time 1 and time 2 (posttreatment) with no main effects for group or time. At 3-month follow-up (time 3), the treatment gains were maintained or improved for 75% (6/8) of participants. Secondary outcome variables (suicide ideation, depression, social problem solving, self-esteem, hopefulness) displayed no significant group-by-time interactions or main effects.CONCLUSIONSThis trial provides initial evidence for the efficacy of a psychological intervention in reducing hopelessness among long-term survivors with severe TBI.OBJECTIVETo evaluate the efficacy of a psychological treatment to reduce moderate to severe hopelessness after severe traumatic brain injury (TBI).","Simpson, G K; Tate, R L; Whiting, D L; Cotter, R E",2011.0,10.1097/HTR.0b013e3182225250,0,0,3750
3752,Metacognitive therapy versus exposure and response prevention for pediatric obsessive-compulsive disorder. A case series with randomized allocation,"ER METHODSTen children and adolescents with OCD were randomly assigned to either MCT or ERP therapy condition. Patients were assessed before and after treatment and at the 3-month and 2-year follow-up by means of symptom severity interviews. Depressive symptoms were also assessed. Manualized treatment involved up to 20 sessions on a weekly basis.RESULTSWe found clinically and statistically significant improvements in symptom severity after treatment. At the 3-month and 2-year follow-up, the attained improvements during treatment were retained.CONCLUSIONSDespite some methodological limitations, results showed that MCT proved to be a promising psychotherapeutic alternative to the well-established ERP in the treatment of pediatric OCD. Further investigations into the efficacy of MCT are necessary to answer questions as to the working mechanisms underlying therapy for OCD.BACKGROUNDExposure with ritual prevention (ERP) is the psychotherapeutic treatment of choice for pediatric obsessive-compulsive disorder (OCD). In the present study, a new treatment rationale - metacognitive therapy (MCT) for children - was developed and evaluated.","Simons, M; Schneider, S; Herpertz-Dahlmann, B",2006.0,10.1159/000092897,0,0,
3753,Training and dissemination of cognitive behavior therapy for depression in adults: a preliminary examination of therapist competence and client outcomes.,"In this study, the authors examined the feasibility and effectiveness of training community therapists to deliver cognitive behavior therapy (CBT) for depression. Participants were therapists (n = 12) and clients (n = 116; mean age = 41 years, 63% women) presenting for treatment of depression at a not-for-profit and designated community mental health center for St. Joseph County, Indiana. The training model included a 2-day workshop followed by 1 year of phone consultations. CBT competence ratings from the Cognitive Therapy Scale were obtained prior to training and at 6 and 12 months posttraining. Two different groups of clients, a treatment-as-usual (TAU) group (n = 74) and a CBT group (n = 42), were compared with respect to decrease in symptoms of depression (assessed with the Beck Depression Inventory) and anxiety (assessed with the Beck Anxiety Inventory). Therapists showed significant increases in total scores from pretraining to 6 months posttraining, increases that were maintained at 12 months. The increase in the total score reflected gains on items that specifically measure CBT skills and structure. Although both TAU and CBT resulted in a significant decrease in depressive symptoms, the CBT clients showed significantly greater change than the TAU clients, F(2, 113) = 53.40, p < .001. The CBT clients also showed a significant decrease in anxiety symptoms, whereas the TAU clients did not. Although there remains a significant amount to learn to guide researchers' mission of improving the availability and effectiveness of treatment for individuals with depression, this study demonstrates that an empirically supported treatment can be implemented in a community mental health center and may result in improved outcomes.",Simons AD.; Padesky CA.; Montemarano J.; Lewis CC.; Murakami J.; Lamb K.; DeVinney S.; Reid M.; Smith DA.; Beck AT.,2010.0,10.1037/a0020569,0,0,
3754,Elevated peri-transplant distress in caregivers of allogeneic blood or marrow transplant patients,"Purpose A full-time 24/7 caregiver is required for 100 days or longer following an allogeneic blood or marrow transplant during which time caregivers have multiple demands. Although distress in caregivers is documented, generalization is limited by small sample sizes, restricted range of assessments, and lack of information as to which caregivers may be more vulnerable to distress. The purpose of this study was to describe the peri-transplant psychological status of a sample of caregivers of allogeneic transplant patients. Methods We assessed caregiver mood, stress, burden, and sleep using valid self-report measures in 109 caregivers of allogeneic transplant patients prior to stem cell transplantation. Caregivers' scores were compared with norms or established cutoff scores for behavioral measures. Additionally, demographic characteristics such as age and sex were tested as predictors of distress. Results Caregivers showed significant levels of anxiety, stress, intrusion and avoidance behaviors, and poor sleep at the start of transplant compared with established norms. Younger caregivers were more distressed than older caregivers. There were no differences in levels of distress between male and female caregivers. Conclusion The peri-transplant period is a time of heightened anxiety and distress for caregivers of allogeneic transplant patients. This study indicates that caregivers would benefit from support programs in the peri-transplant period. Recommendations for types of support that may be helpful to caregivers are provided, but additional research is needed to validate that these programs would help caregivers providing care to patients receiving an allogeneic transplant in the peri-transplant period. Copyright © 2013 John Wiley & Sons, Ltd. Copyright © 2013 John Wiley & Sons, Ltd.",Simoneau T.L.; Mikulich-Gilbertson S.K.; Natvig C.; Kilbourn K.; Spradley J.; Grzywa-Cobb R.; Philips S.; McSweeney P.; Laudenslager M.L.,2013.0,10.1002/pon.3259,0,0,
3755,Providing patient progress information and clinical support tools to therapists: effects on patients at risk of treatment failure.,"The current study examined the effects of providing treatment progress information and problem-solving tools to both patients and therapists during the course of psychotherapy. Three hundred and seventy patients were randomly assigned to one of two treatment groups: treatment-as-usual, or an experimental condition based on the use of patient/therapist feedback and clinical decision-support tools. Patients in the feedback condition were significantly more improved at termination than the patients in the treatment-as-usual condition. Treatment effects were not a consequence of different amounts of psychotherapy received by experimental and control clients. These findings are consistent with past research on these approaches although the effect size was smaller in this study. Not all therapists were aided by the feedback intervention.",Simon W.; Lambert MJ.; Harris MW.; Busath G.; Vazquez A.,2012.0,10.1080/10503307.2012.698918,0,0,
3756,Next-step strategies for panic disorder refractory to initial pharmacotherapy: a 3-phase randomized clinical trial.,"More data are needed to guide next-step interventions for panic disorder refractory to initial intervention. This 24-week randomized clinical trial (RCT) enrolled 46 patients with DSM-IV-defined panic disorder from November 2000 to April 2005 and consisted of 3 phases. Patients who failed to meet remission criteria were eligible for randomization in the next treatment phase. Phase 1 was a 6-week lead-in with open-label sertraline flexibly dosed to 100 mg (or escitalopram equivalent) to prospectively define treatment refractoriness (lack of remission). Phase 2 was a 6-week double-blind RCT of (1) increased-dose selective serotonin reuptake inhibitor (SSRI) versus (2) continued SSRI plus placebo. Phase 3 was a 12-week RCT of added cognitive-behavioral therapy (CBT) compared to ""medication optimization"" with SSRI plus clonazepam. Primary endpoints were remission and change in Panic Disorder Severity Scale (PDSS) score in the intent-to-treat sample in each phase. In phase 1, 20.5% (8/39) of the patients achieved remission, and only baseline severity predicted endpoint PDSS score (beta [SE] = 1.04 [0.15], t = 6.76, P < .001). In phase 2, increasing the SSRI dose did not result in greater improvement or remission rates (placebo 15% [n = 2] vs increased dose 9% [n = 1]: Fisher exact test P = NS). In phase 3, remission was minimal (medication optimization = 11% [n = 1]; CBT = 10% [n = 1]), with a lack of group difference in PDSS score reduction (t(17) = 0.51, P > .60) consistent with a small effect size (d = 0.24). Although power was limited and larger studies are needed, we failed to find evidence for greater benefit of increased SSRI dose versus continuation of current dose for panic disorder symptomatic after 6 weeks at moderate dose. Further, augmentation with CBT or medication optimization with clonazepam augmentation in nonremitted panic after 12 weeks of an SSRI did not differ, suggesting that both are reasonable next-step options. However, low overall remission rates in this comorbid refractory population suggest that better predictors of response to specific treatments over time and additional interventions are needed. clinicaltrials.gov Identifier: NCT00118417.",Simon NM.; Otto MW.; Worthington JJ.; Hoge EA.; Thompson EH.; Lebeau RT.; Moshier SJ.; Zalta AK.; Pollack MH.,2009.0,10.4088/JCP.08m04485blu,0,0,
3757,Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).,"The authors provide a detailed perspective on the correlates of comorbid anxiety in a large, well-characterized sample of bipolar disorder patients. Anxiety and its correlates were examined in a cross-sectional sample from the first 500 patients with bipolar I or bipolar II disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder, a multicenter project funded by the National Institute of Mental Health designed to evaluate the longitudinal outcome of patients with bipolar disorder. Lifetime comorbid anxiety disorders were common, occurring in over one-half of the sample, and were associated with younger age at onset, decreased likelihood of recovery, poorer role functioning and quality of life, less time euthymic, and greater likelihood of suicide attempts. Although substance abuse disorders were particularly prevalent among patients with anxiety disorders, comorbid anxiety appeared to exert an independent, deleterious effect on functioning, including history of suicide attempts (odds ratio=2.45, 95% CI=1.4-4.2). An independent association of comorbid anxiety with greater severity and impairment in bipolar disorder patients was demonstrated, highlighting the need for greater clinical attention to anxiety in this population, particularly for enhanced clinical monitoring of suicidality. In addition, it is important to determine whether effective treatment of anxiety symptoms can lessen bipolar disorder severity, improve response to treatment of manic or depressive symptoms, or reduce suicidality.",Simon NM.; Otto MW.; Wisniewski SR.; Fossey M.; Sagduyu K.; Frank E.; Sachs GS.; Nierenberg AA.; Thase ME.; Pollack MH.,2004.0,10.1176/appi.ajp.161.12.2222,0,0,
3758,Paroxetine CR augmentation for posttraumatic stress disorder refractory to prolonged exposure therapy.,"Little is known about the efficacy of ""next step"" strategies for patients with post-traumatic stress disorder (PTSD) who remain symptomatic despite treatment. This study prospectively examines the relative efficacy of augmentation of continued prolonged exposure therapy (PE) with paroxetine CR versus placebo for individuals remaining symptomatic despite a course of PE. Adult outpatients meeting DSM-IV criteria for PTSD were recruited from February 2003 to September 2005 at 4 academic centers. Phase I consisted of 8 sessions of individual PE over a 4- to 6-week period. Participants who remained symptomatic, defined as a score of >or= 6 on the Short PTSD Rating Interview (SPRINT) and a Clinical Global Impressions-Severity of Illness scale (CGI-S) score >or= 3, were randomly assigned to the addition of paroxetine CR or matched placebo to an additional 5 sessions of PE (Phase II). Consistent with prior studies, the 44 Phase I completers improved significantly with initial PE (SPRINT: paired t = 7.6, df = 41, p < .0001; CGI-S: paired t = 6.37, df = 41, p < .0001). Counter to our hypothesis, however, we found no additive benefit of augmentation of continued PE with paroxetine CR compared to pill placebo for the 23 randomly assigned patients, with relatively minimal further gains overall in Phase II. Although replication with larger samples is needed before definitive conclusions can be drawn, our data do not support the addition of paroxetine CR compared with placebo to continued PE for individuals with PTSD who remain symptomatic after initial PE, suggesting that the development of novel treatment approaches for PTSD refractory to PE is needed. ClinicalTrials.gov identifier NCT00215163.",Simon NM.; Connor KM.; Lang AJ.; Rauch S.; Krulewicz S.; LeBeau RT.; Davidson JR.; Stein MB.; Otto MW.; Foa EB.; Pollack MH.,2008.0,,0,0,
3759,Cost-effectiveness of child-focused and parent-focused interventions in a child anxiety prevention program,"ER In this study, the cost-effectiveness of three indicated anxiety prevention strategies was examined from a societal perspective. Children (aged 8-12) were recruited via primary schools, selecting children scoring as high-anxious on an anxiety screening questionnaire. Participating children and their parents were randomized to a child--a parent-focused, or non-intervention group. All groups completed a diagnostic interview and standardized cost-diaries at pretest, and 1- and 2-year follow-up. Incremental cost-effectiveness ratios per 'ADIS improved' child (based on diagnostic information) were calculated and cost-effectiveness acceptability curves and frontiers were plotted. The base-case and most secondary analyses showed it would be cost-effective to offer high-anxious children an intervention, and the parent-focused intervention to be the optimal strategy at lower monetary threshold values than the child-focused intervention and when parents were anxious. The child-focused intervention was dominant when analyses were performed from a healthcare perspective, for boys, and for children of grades 7-8 of primary school.","Simon, E; Dirksen, C; Bögels, S; Bodden, D",2012.0,10.1016/j.janxdis.2011.12.008,0,0,
3760,Efficacy of child-focused and parent-focused interventions in a child anxiety prevention study,"ER This study examined anxiety development in median- (n = 74) and high-anxious children (n = 183) aged 8-13, the effect of parent- and child-focused preventive interventions on child/parental anxiety, and the effect of parental anxiety on child anxiety. High-anxious children were randomized into a parent-focused (n = 69), child-focused (n = 58) or non-intervention (n = 56) group. Families completed a pretest and 1- and 2-year follow-ups. Children selected as high-anxious or at risk were found to remain more susceptible to having anxiety problems and developing anxiety disorders than median-anxious children. Both intervention types showed favorable outcomes compared to no intervention on the number of ""ADIS improved"" children. These findings underline the need for effective preventive interventions for child anxiety. General improvements over time were found for symptoms of child and parental anxiety, however, and parental anxiety did not predict improvement in child anxiety after controlling for intervention. Therefore, it may not be necessary to focus on parental anxiety in interventions aimed at preventing child anxiety.","Simon, E; Bogels, S M; Voncken, J M",2011.0,10.1080/15374416.2011.546039,0,0,
3761,Socioeconomic status differences in coping with a stressful medical procedure,"ER METHODSSigmoidoscopy screening for colorectal cancer was identified as a potential stressor. A subset of participants (N = 3535) from the U.K. Flexible Sigmoidoscopy Trial completed pre- and postscreening questionnaires regarding psychologic well-being. All trial participants were sent a postscreening questionnaire after 3 months (post-flexible sigmoidoscopy [FS] sample, N = 29,804), including measures of distress (the General Health Questionnaire), anxiety (State-Trait Anxiety Inventory), a single-item measure of bowel cancer worry, and a 6-item measure of positive consequences of screening. Socioeconomic status (SES) was coded from postcodes with the Townsend Index. SES differences in changes in emotional well-being over the course of screening were evaluated in the longitudinal sample. SES differences in postscreening well-being in relation to screening outcome were evaluated in the post-FS sample.RESULTSBowel cancer worry and anxiety were higher in lower SES groups before screening. Both reduced after screening, but there were no SES differences in the change. In the post-FS sample, there was an SES gradient in anxiety but not in distress. Lower SES groups indicated more positive reactions. There were no interactions between SES and screening outcome for any indicator of well-being.CONCLUSIONSLower SES was associated with worse psychologic well-being before and after screening, but lower SES participants did not show any differentially greater adverse reactions compared with higher SES participants. Moderately stressful experiences in everyday life do not necessarily more unfavorably affect those with fewer educational and economic resources.OBJECTIVEThe objective of this study was to test the hypothesis that socioeconomic disadvantage results in adverse emotional reactions to a novel, stressful, medical examination.","Simon, A E; Steptoe, A; Wardle, J",2005.0,10.1097/01.psy.0000155665.55439.53,0,0,
3762,Measuring the impact and costs of a universal group based parenting programme: protocol and implementation of a trial,"ER BACKGROUND: Sub-optimal parenting is a common risk factor for a wide range of negative health, social and educational outcomes. Most parenting programmes have been developed in the USA in the context of delinquency prevention for targeted or indicated groups and the main theoretical underpinning for these programmes is behaviour management. The Family Links Nurturing Programme (FLNP) focuses on family relationships as well as behaviour management and is offered on a universal basis. As a result it may be better placed to improve health and educational outcomes. Developed in the UK voluntary sector, FLNP is popular with practitioners, has impressed policy makers throughout the UK, has been found to be effective in before/after and qualitative studies, but lacks a randomised controlled trial (RCT) evidence base.METHODS/DESIGN: A multi-centre, investigator blind, randomised controlled trial of the FLNP with a target sample of 288 south Wales families who have a child aged 2-4 yrs living in or near to Flying Start/Sure Start areas. Changes in parenting, parent child relations and parent and child wellbeing are assessed with validated measures immediately and at 6 months post intervention. Economic components include cost consequences and cost utility analyses based on parental ranking of states of quality of life. Attendance and completion rates and fidelity to the FLNP course delivery are assessed. A nested qualitative study will assess reasons for participation and non-participation and the perceived value of the programme to families. By the end of May 2010, 287 families have been recruited into the trial across four areas of south Wales. Recruitment has not met the planned timescales with barriers including professional anxiety about families entering the control arm of the trial, family concern about video and audio recording, programme facilitator concern about the recording of FLNP sessions for fidelity purposes and delays due to the new UK research governance procedures.DISCUSSION: Whilst there are strong theoretical arguments to support universal provision of parenting programmes, few universal programmes have been subjected to randomised controlled trials. In this paper we describe a RCT protocol with quantitative and qualitative outcome measures and an economic evaluation designed to provide clear evidence with regard to effectiveness and costs. We describe challenges implementing the protocol and how we are addressing these.TRIAL REGISTRATION: Current Controlled Trials ISRCTN13919732.","Simkiss, D E; Snooks, H A; Stallard, N; Davies, S; Thomas, M A; Anthony, B; Winstanley, S; Wilson, L; Stewart-Brown, S",2010.0,10.1186/1471-2458-10-364,0,0,
3763,Severe recurrent vasovagal syncope and multidisciplinary rehabilitation: A prospective randomized pilot study.,,Siméon E.; Bernard A.; Clémenty N.; Herault G.; El-Hage W.; Monpère C.; Ivanés F.; Angoulvant T.; Babuty D.,2015.0,10.1016/j.ijcard.2015.03.340,0,0,
3764,Therapist adherence to interpersonal vs. supportive therapy for social anxiety disorder.,"We assessed therapist adherence to interpersonal therapy (IPT) and supportive therapy (ST) in a controlled trial for social anxiety disorder. Raters blindly scored n = 133 videotapes from 53 participants using the Collaborative Study Psychotherapy Rating Scale (CSPRS). Results reveal statistical differences across groups, but higher than expected overlap. Greater use of IPT in beginning sessions predicted better outcome in both therapies. Suboptimal adherence may be due to the crossed design in which the same therapists delivered both IPT and ST. Since switching between different approaches is a clinical reality for integrative psychotherapists, these findings may have important clinical implications. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sinai, Dana; Gur, Merav; Lipsitz, Joshua D; Barber, Barber, Butler, Diamond, Elkin, Elkin, Fairburn, Frank, Franklin, Heimberg, Heimberg, Hill, Hogue, Hogue, Hollon, Hoglend, Klerman, Liebowitz, Lipsitz, Lipsitz, Lipsitz, Lipsitz, Loeb, Luborsky, Luty, Markowitz, Markowitz, Norcross, Pinsker, Piper, Shapiro, Shrout, Startup, Startup, Wampold, Webb, Weissman",2012.0,,0,0,
3765,Therapist adherence to interpersonal vs. supportive therapy for social anxiety disorder.,"We assessed therapist adherence to interpersonal therapy (IPT) and supportive therapy (ST) in a controlled trial for social anxiety disorder. Raters blindly scored n = 133 videotapes from 53 participants using the Collaborative Study Psychotherapy Rating Scale (CSPRS). Results reveal statistical differences across groups, but higher than expected overlap. Greater use of IPT in beginning sessions predicted better outcome in both therapies. Suboptimal adherence may be due to the crossed design in which the same therapists delivered both IPT and ST. Since switching between different approaches is a clinical reality for integrative psychotherapists, these findings may have important clinical implications.",Sinai D.; Gur M.; Lipsitz JD.,2012.0,10.1080/10503307.2012.658452,0,0,
3766,Symptoms of posttraumatic stress predict craving among alcohol treatment seekers: results of a daily monitoring study.,"Alcohol use disorders (AUDs) and Posttraumatic Stress Disorder (PTSD) commonly co-occur. Craving for alcohol is a common aspect of AUD, with and without PTSD, and is one of the key predictors of continued problematic alcohol use among treatment seekers. The present study sought to investigate the self-medication hypothesis using daily Interactive Voice Response (IVR) reports to examine the relationships between PTSD symptomatology and both same-day and next-day alcohol craving. Twenty-nine individuals with an AUD (26 of whom screened positive for PTSD) entering AUD treatment provided daily IVR data for up to 28 days regarding their alcohol use, craving, and 7 symptoms of PTSD. Given the nested nature of daily data, generalized estimating equations using a negative binomial distribution and a log link function were used to test hypotheses. Results suggest that days with greater overall PTSD severity are associated with greater alcohol craving, and greater reports of startle and anger/irritability were particularly associated with same-day craving. The next-day results suggest that the combination of the 7 PTSD symptoms did not predict next-day craving. However, greater distress from nightmares the previous night, emotional numbing, and hypervigilance predicted greater next-day craving, while greater anger/irritability predicted lower next-day craving. These findings highlight the importance of assessing the relationship between specific symptoms of PTSD and alcohol cravings in order to increase our understanding of the functional interplay among them for theory building. Additionally, clinicians may be better able to refine treatment decisions to more efficiently break the cycle between PTSD-related distress and AUD symptoms.",Simpson TL.; Stappenbeck CA.; Varra AA.; Moore SA.; Kaysen D.,2012.0,10.1037/a0027169,0,0,
3767,"PTSD symptoms, substance use, and vipassana meditation among incarcerated individuals.","The present study evaluated whether Posttraumatic Stress Disorder (PTSD) symptom severity was associated with participation and treatment outcomes comparing a Vipassana meditation course to treatment as usual in an incarcerated sample. This study utilizes secondary data. The original study demonstrated that Vipassana meditation is associated with reductions in substance use. The present study found that PTSD symptom severity did not differ significantly between those who did and did not volunteer to take the course. Participation in the Vipassana course was associated with significantly greater reductions in substance use than treatment as usual, regardless of PTSD symptom severity levels. These results suggest that Vipassana meditation is worthy of further study for those with comorbid PTSD and substance use problems.",Simpson TL.; Kaysen D.; Bowen S.; MacPherson LM.; Chawla N.; Blume A.; Marlatt GA.; Larimer M.,2007.0,10.1002/jts.20209,0,0,
3768,A randomised controlled trial to evaluate the effectiveness and cost-effectiveness of counselling patients with chronic depression,"ER DESIGNA randomised controlled trial and economic evaluation with an initial assessment at randomisation and follow-ups at 6 and 12 months.SETTINGNine general practices that were well-established participants of the Derbyshire counselling in general practice scheme, and already had a counsellor in the practice team.SUBJECTSPatients were screened at GP practices, and asked to participate if they scored >/= 14 on the Beck Depression Inventory (BDI), had suffered depression or depression/anxiety for 6 months or more, were aged 18-70 and had no history of drug or alcohol abuse, psychoses or suicidal tendencies.INTERVENTIONSThe experimental group received usual GP treatment and were also referred to an experienced, well-qualified counsellor attached to their general practice. Of the eight counsellors, two practiced cognitive behavioural therapy (CBT) and six had a psychodynamic approach. The controls were referred back to their GP for routine treatment. There were no restrictions regarding the treatment that could be used, except that GPs could not refer controls to practice counsellors.OUTCOME MEASURESThe main outcome measure was the BDI. Others included the Brief Symptom Inventory, the Inventory of Interpersonal Problems and the Social Adjustment Scale. All tests were given at initial, 6- and 12-month assessments. Comprehensive costs were also estimated, and combined with changes in outcomes to examine between-group differences and whether counselling was more cost-effective than standard GP care.RESULTSThe trial recruited 181 patients. There was an overall significant improvement in the actual scores over time but no difference between groups or between CBT and psychodynamic counselling approaches at either 6 or 12 months. However, fewer experimental group patients were still 'cases' on the BDI than controls. This difference was statistically significant at 12 months and neared significance at 6 months (using logistic regression with the initial score as a covariate). In addition, most patients were very positive about the counselling and considered it helpful. Visual inspection of the outcomes suggested that more patients with mild or moderate depression at study entry had improved and ceased to be cases, and that more of these patients had become 'non-cases' in the experimental than the control group. However, a multiple regression analysis indicated no significant interactions between group and initial severity of depression. This could be partly due to there being no difference in outcome between the experimental and control group patients who were initially severely depressed and few of these patients ceasing to be cases at follow-up. There were no significant differences in the mean total costs, aggregate costs of services, or any of the service-group costs, except for primary care, between the experimental and control groups over time. The cost-burden to GP practices was significantly higher in the experimental than the control group at 6 months.CONCLUSIONSAlthough patients were generally appreciative of the counselling received, there was only limited evidence of improved outcomes in those referred to counselling. Stricter referral criteria to exclude the severely depressed may have yielded more conclusive results. It is also difficult to estimate the effect of recruitment by screening rather than GP referral, which may limit the applicability of the results to routine clinical practice, and may have interfered with the normal working alliance established between the GP, patient and counsellor. A patient preference trial may, therefore, have been more appropriate. The results indicated that there were similar improvements for both CBT and psychodynamic counselling, but aOBJECTIVESTo examine the effectiveness and cost-effectiveness of short-term counselling in general practice for patients with chronic depression or combined depression and anxiety, compared with general practitioner (GP) care alone.","Simpson, S; Corney, R; Fitzgerald, P; Beecham, J",2000.0,,0,0,
3769,A randomized controlled trial to evaluate the effectiveness and cost-effectiveness of psychodynamic counselling for general practice patients with chronic depression,"ER METHODA randomized controlled trial with an economic evaluation was carried out in Derbyshire. One hundred and forty-five patients were recruited at seven GP practices by screening using the Beck Depression Inventory. Both the experimental and control group received routine GP treatment but the experimental group were also referred to the practice counsellor. Depression, anxiety and other mental health symptoms, social and interpersonal functioning and social support were measured at baseline, 6 months and 12 months. Comprehensive costs were also estimated.RESULTSThere was an overall significant improvement in the actual scores over time, but there were no significant differences between the two groups on any of the measures at either 6 or 12 months. However fewer experimental group patients were still 'cases' on the BDI than controls at 12 months. There were no significant differences in the mean total costs, aggregate costs of services, or any service-group costs except for primary care, between the experimental and control groups over time.CONCLUSIONSThis trial demonstrates only very limited evidence of improved outcomes in those referred to counselling and increased primary care treatment costs in the short-term. Stricter referral criteria to exclude the more severely depressed in the group (BDI > or = 24) might have yielded more conclusive results.BACKGROUNDCounsellors have been employed in general practice with little evidence of effectiveness. This study examined the effectiveness and cost-effectiveness of short-term counselling in general practice for patients with chronic depression either alone or combined with anxiety.","Simpson, S; Corney, R; Fitzgerald, P; Beecham, J",2003.0,,0,0,
3770,Adding motivational interviewing to exposure and ritual prevention for obsessive--compulsive disorder: An open pilot trial.,"Exposure and ritual prevention (EX/RP) is an efficacious treatment for obsessive- compulsive disorder (OCD), but high dropout rates and variable treatment adherence limit its effectiveness. Motivational interviewing (MI) has shown promise as an adjunct to symptom-focused treatments for improving treatment adherence and outcomes. The authors developed a manual integrating MI with EX/RP, consisting of three information-gathering/motivational enhancement sessions and 15 EX/RP sessions with an optional MI module to be used as needed. Six patients with moderate to severe OCD symptoms (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score >= 16) underwent treatment. Five showed a decrease in their baseline Y-BOCS scores and an increase in their quality of life, with three achieving an excellent response (i.e. Y-BOCS <= 12 at Session 18). The authors briefly describe the motivational strategies used in the six cases and suggest that integrating MI with standard EX/RP is a promising method to increase and sustain patient engagement with EX/RP. Challenges in combining these treatments and maintaining the integrity of each as well as limitations of the study are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Simpson, Helen Blair; Zuckoff, Allan; Page, Jessica R; Franklin, Martin E; Foa, Edna B; Abramowitz, Burke, Carbonari, Carroll, Carroll, Endicott, First, Foa, Goodman, Goodman, Hamilton, Hettema, Maltby, McConnaughy, McConnaughy, Miller, Miller, Miller, Reiss, Simpson, Simpson, Sookman, Westra, Zuckoff, Zweben",2008.0,,0,0,
3771,Patient adherence to cognitive-behavioral therapy predicts long-term outcome in obsessive-compulsive disorder.,"Presents a study which aims to examine how patient adherence to cognitive behavioral therapy (CBT) predicts long term outcome in obsessive compulsive disorder (OCD). The authors capitalized on data from a clinical trial that provided CBT consisting of exposure and ritual prevention (EX/RP) to adults with OCD, measured homework adherence during acute treatment using a reliable and validated scale, and reevaluated severity of OCD six months later. Patient adherence was associated with OCD severity at 9th week. Patient homework adherence predicted OCD outcome not only after acute EX/RP treatment but also at 6-month followup and early adherence predicted 6-month outcome. Future research will need to investigate the mechanism of this long-term effect; perhaps those who adhere during acute EX/RP treatment are more likely to use the skills on their own after treatment has ended. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Simpson, Helen Blair; Marcus, Sue M; Zuckoff, Allan; Franklin, Martin; Foa, Edna B; Goodman, Goodman, Kozak, Simpson, Simpson, Simpson, Tolin, Whittal",2012.0,,0,0,
3772,Challenges using motivational interviewing as an adjunct to exposure therapy for obsessive-compulsive disorder.,"Exposure and response prevention (EX/RP) is an efficacious treatment for obsessive-compulsive disorder (OCD). However, patients often do not adhere fully to EX/RP procedures. Motivational interviewing (MI) has been shown to improve treatment adherence in other disorders. This pilot study used a randomized controlled design to examine whether MI can be successfully added to EX/RP and whether this intervention (EX/RP+MI) could improve patient adherence to between-session EX/RP procedures relative to EX/RP alone. Thirty adults with OCD were randomized to 18 sessions of EX/RP or EX/RP+MI. Therapists rated patient adherence at each exposure session. Independent evaluators assessed change in OCD and depressive symptoms, and patients completed self-report measures of readiness for change and quality of life. The two treatment conditions differed in degree of congruence with MI but not in conduct of EX/RP procedures. Both groups experienced clinically significant improvement in OCD symptoms, without significant group differences in patient adherence. There are several possible reasons why EX/RP+MI had no effect on patient adherence compared to standard EX/RP, each of which has important implications for the design of future MI studies in OCD. We recommend that MI be further evaluated in OCD by exploring alternative modes of delivery and by focusing on patients less ready for change than the current sample.",Simpson HB.; Zuckoff AM.; Maher MJ.; Page JR.; Franklin ME.; Foa EB.; Schmidt AB.; Wang Y.,2010.0,10.1016/j.brat.2010.05.026,0,0,
3773,Adding motivational interviewing to exposure and ritual prevention for obsessive-compulsive disorder: an open pilot trial.,"Exposure and ritual prevention (EX/RP) is an efficacious treatment for obsessive-compulsive disorder (OCD), but high dropout rates and variable treatment adherence limit its effectiveness. Motivational interviewing (MI) has shown promise as an adjunct to symptom-focused treatments for improving treatment adherence and outcomes. The authors developed a manual integrating MI with EX/RP, consisting of three information-gathering/motivational enhancement sessions and 15 EX/RP sessions with an optional MI module to be used as needed. Six patients with moderate to severe OCD symptoms (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score> or =16) underwent treatment. Five showed a decrease in their baseline Y-BOCS scores and an increase in their quality of life, with three achieving an excellent response (i.e. Y-BOCS< or =12 at Session 18). The authors briefly describe the motivational strategies used in the six cases and suggest that integrating MI with standard EX/RP is a promising method to increase and sustain patient engagement with EX/RP. Challenges in combining these treatments and maintaining the integrity of each as well as limitations of the study are discussed.",Simpson HB.; Zuckoff A.; Page JR.; Franklin ME.; Foa EB.,2008.0,10.1080/16506070701743252,0,0,
3774,Treatment of obsessive-compulsive disorder complicated by comorbid eating disorders.,"Eating disorders and obsessive-compulsive disorder (OCD) commonly co-occur, but there is little data for how to treat these complex cases. To address this gap, we examined the naturalistic outcome of 56 patients with both disorders, who received a multimodal treatment program designed to address both problems simultaneously. A residential treatment program developed a cognitive-behavioral approach for patients with both OCD and an eating disorder by integrating exposure and response prevention (ERP) treatment for OCD with ERP strategies targeting eating pathology. Patients also received a supervised eating plan, medication management, and social support. At admission and discharge, patients completed validated measures of OCD severity (the Yale-Brown Obsessive-Compulsive Scale--Self Report [Y-BOCS-SR]), eating disorder severity (the Eating Disorders Examination-Questionnaire), and depressive severity (the Beck Depression Inventory II [BDI-II]). Body mass index (BMI) was also measured. Paired-sample t-tests examined change on these measures. Between 2006 and 2011, 56 individuals completed all study measures at admission and discharge. Mean length of stay was 57 days (SD = 27). Most (89%) were on psychiatric medications. Significant decreases were observed in OCD severity, eating disorder severity, and depression. Those with bulimia nervosa showed more improvement than those with anorexia nervosa. BMI significantly increased, primarily among those underweight at admission. Simultaneous treatment of OCD and eating disorders using a multimodal approach that emphasizes ERP techniques for both OCD and eating disorders can be an effective treatment strategy for these complex cases.",Simpson HB.; Wetterneck CT.; Cahill SP.; Steinglass JE.; Franklin ME.; Leonard RC.; Weltzin TE.; Riemann BC.,2013.0,10.1080/16506073.2012.751124,0,0,
3775,Patient adherence predicts outcome from cognitive behavioral therapy in obsessive-compulsive disorder.,"To examine the effects of patient adherence on outcome from exposure and response prevention (EX/RP) therapy in adults with obsessive-compulsive disorder (OCD). Thirty adults with OCD were randomized to EX/RP (n = 15) or EX/RP augmented by motivational interviewing strategies (n = 15). Both treatments included 3 introductory sessions and 15 exposure sessions. Because there were no significant group differences in adherence or outcome, the groups were combined to examine the effects of patient adherence on outcome. Independent evaluators assessed OCD severity using the Yale-Brown Obsessive Compulsive Scale. Therapists assessed patient adherence to between-session EX/RP assignments at each session using the Patient EX/RP Adherence Scale (PEAS). Linear regression models were used to examine the effects of PEAS scores on outcome, adjusting for baseline severity. The relationship between patient adherence and other predictors of outcome was explored using structural equation modeling. Higher average PEAS ratings significantly predicted lower posttreatment OCD severity in intent-to-treat and completer samples. PEAS ratings in early sessions (5-9) also significantly predicted posttreatment OCD severity. The effects of other significant predictors of outcome in this sample (baseline OCD severity, hoarding subtype, and working alliance) were fully mediated by patient adherence. Patient adherence to between-session EX/RP assignments significantly predicted treatment outcome, as did early patient adherence and change in early adherence. Patient adherence mediated the effects of other predictors of outcome. Future research should develop interventions that increase adherence and then test whether increasing adherence improves outcome. If effective, these interventions could then be used to personalize care.",Simpson HB.; Maher MJ.; Wang Y.; Bao Y.; Foa EB.; Franklin M.,2011.0,10.1037/a0022659,0,0,
3776,"The 5-HT3 antagonist, BRL 46470 does not attenuate m-chlorophenylpiperazine (mCPP)-induced changes in human volunteers","Results from animal studies have suggested that serotonin (5-HT) antagonists acting on the 5-HT3 receptor may have anxiolytic properties. We have assessed whether pretreatment with the 5-HT3 receptor antagonist BRL 46470 (1 mg orally) attenuates the increase in anxiety induced in healthy volunteers by intravenous infusion of m-chlorophenylpiperazine (mCPP: 0.08 mg/kg over 2 min). In this double-blind placebo-controlled crossover study in 12 healthy men who were volunteers, infusion of mCPP caused significant increases in self-ratings for the psychological and physical symptoms of anxiety, for the symptoms of panic attack, and in the plasma levels of cortisol and prolactin, with four subjects (33%) experiencing an mCPP-induced 'panic attack.' Pretreatment with BRL 46470 did not attenuate any of these mCPP-induced changes. These results do not support suggestions from animal studies that 5-HT3 receptor antagonists can attenuate mCPP-induced anxiety, although it is conceivable that a different dose of BRL 46470 may have been effective.",Silverstone P.H.; Cowen P.J.,1994.0,10.1016/0006-3223(94)90628-9,0,0,
3777,Controlled evaluation of intravenous drugs in the specific desensitization of phobias.,,Silverstone JT.; Salkind MR.,1973.0,,0,0,
3778,Directionality of change in youth anxiety treatment involving parents: an initial examination,"ER This randomized clinical trial compared cognitive behavioral therapy (CBT) with minimal parent involvement to CBT with active parent involvement in a sample of 119 youths (7-16 years old; 33.6% Caucasian, 61.3% Latino) with anxiety disorders. The dynamics of change between youth anxiety and parent variables (positive-negative behaviors toward the child, conflict in the parent-youth relationship, and parental anxiety) in both treatment conditions over pretreatment, posttreatment, and 12-month follow-up were also examined. Results indicated that youth anxiety was significantly reduced with both treatments and that the dynamics of change may not solely flow from parent to youth but also from youth to parent. Findings highlight the need for research on directionality and mechanisms of change to move from evidence-based treatments toward evidence-based explanations of treatment outcome.","Silverman, W K; Kurtines, W M; Jaccard, J; Pina, A A",2009.0,10.1037/a0015761,0,0,
3779,"Contingency management, self-control, and education support in the treatment of childhood phobic disorders: a randomized clinical trial","ER This study evaluated the relative efficacy of an exposure-based contingency management (CM) treatment condition and an exposure-based cognitive self-control (SC) treatment condition relative to an education support (ES) control condition for treating children with phobic disorders. Eighty-one children and their parents completed a 10-week treatment program in which children and parents were seen in separate treatment sessions with the therapist, followed by a brief conjoint meeting. Children in both the CM and SC conditions showed substantial improvement on all of the outcome measures. These gains were maintained at 3-, 6-, and 12-month follow-ups. Interestingly, children in the ES condition also showed comparable improvements at posttreatment and at 3-, 6-, and 12-month follow-ups. Implications of the findings are discussed with respect to knowledge development and clinical practice.","Silverman, W K; Kurtines, W M; Ginsburg, G S; Weems, C F; Rabian, B; Serafini, L T",1999.0,,0,0,
3780,Treating anxiety disorders in children with group cognitive-behaviorial therapy: a randomized clinical trial,"ER A randomized clinical trial evaluated the therapeutic efficacy of group cognitive-behavioral therapy (GCBT) versus a wait-list control (WLC) condition to treat anxiety disorders in children. Results indicated that GCBT, with concurrent parent sessions, was highly efficacious in producing and maintaining treatment gains. Children in GCBT showed substantial improvement on all the main outcome measures, and these gains were maintained at 3-, 6-, and 12-month follow-ups. Children in the WLC condition did not show improvements from the pre- to the postwait assessment point. These findings are discussed in terms of the need to continue to advance the development of practical, as well as conceptual, knowledge of efficacious treatment for anxiety disorders in children.","Silverman, W K; Kurtines, W M; Ginsburg, G S; Weems, C F; Lumpkin, P W; Carmichael, D H",1999.0,,0,0,
3781,"A multicenter, randomized controlled trial of immediate total-body CT scanning in trauma patients (REACT-2).","Computed tomography (CT) scanning has become essential in the early diagnostic phase of trauma care because of its high diagnostic accuracy. The introduction of multi-slice CT scanners and infrastructural improvements made total-body CT scanning technically feasible and its usage is currently becoming common practice in several trauma centers. However, literature provides limited evidence whether immediate total-body CT leads to better clinical outcome then conventional radiographic imaging supplemented with selective CT scanning in trauma patients. The aim of the REACT-2 trial is to determine the value of immediate total-body CT scanning in trauma patients. The REACT-2 trial is an international, multicenter randomized clinical trial. All participating trauma centers have a multi-slice CT scanner located in the trauma room or at the Emergency Department (ED). All adult, non-pregnant, severely injured trauma patients according to predefined criteria will be included. Patients in whom direct scanning will hamper necessary cardiopulmonary resuscitation or who require an immediate operation because of imminent death (both as judged by the trauma team leader) are excluded. Randomization will be computer assisted. The intervention group will receive a contrast-enhanced total-body CT scan (head to pelvis) during the primary survey. The control group will be evaluated according to local conventional trauma imaging protocols (based on ATLS guidelines) supplemented with selective CT scanning. Primary outcome will be in-hospital mortality. Secondary outcomes are differences in mortality and morbidity during the first year post trauma, several trauma work-up time intervals, radiation exposure, general health and quality of life at 6 and 12 months post trauma and cost-effectiveness. The REACT-2 trial is a multicenter randomized clinical trial that will provide evidence on the value of immediate total-body CT scanning during the primary survey of severely injured trauma patients. If immediate total-body CT scanning is found to be the best imaging strategy in severely injured trauma patients it could replace conventional imaging supplemented with CT in this specific group. ClinicalTrials.gov: (NCT01523626).",Sierink JC.; Saltzherr TP.; Beenen LF.; Luitse JS.; Hollmann MW.; Reitsma JB.; Edwards MJ.; Hohmann J.; Beuker BJ.; Patka P.; Suliburk JW.; Dijkgraaf MG.; Goslings JC.;  .,2012.0,10.1186/1471-227X-12-4,0,0,
3782,Direct total body CT scan in multi-trauma patients,"ER BACKGROUND: Immediate total body computed tomography (CT) scanning has become important in the early diagnostic phase of trauma care because of its high diagnostic accuracy. However, literature provides limited evidence whether immediate total body CT leads to better clinical outcome then conventional radiographic imaging supplemented with selective CT scanning in trauma patients. The aim of the REACT-2 trial is to determine the value of immediate total body CT scanning in trauma patients.DESIGN: The REACT-2 trial is an international, multicenter randomized clinical trial.METHODS: All participating trauma centers have a multi-slice CT scanner located in the trauma room or at the Emergency Department (ED). All adult, non-pregnant, severely injured trauma patients according to predefined criteria will be included. The intervention group will receive a contrast-enhanced total body CT scan (head to pelvis) during the primary survey. The control group will be evaluated according to local conventional trauma imaging protocols (based on ATLS guidelines) supplemented with selective CT scanning. Primary outcome will be in-hospital mortality. Secondary outcomes are differences in mortality and morbidity during the first year post trauma, several trauma work-up time intervals, radiation exposure, general health and quality of life at 6 and 12 months post trauma and cost-effectiveness.CONCLUSION: The REACT-2 trial is the first multicenter randomized clinical trial that will provide evidence on the value of immediate total body CT scanning during the primary survey of severely injured trauma patients.","Sierink, J C; Saltzherr, T P; Edwards, M J; Beuker, B J; Patka, P; Goslings, J C; REACT-2-studiegroep",2012.0,,0,0,
3783,D-cycloserine does not improve but might slightly speed up the outcome of in-vivo exposure therapy in patients with severe agoraphobia and panic disorder in a randomized double blind clinical trial.,"D-cycloserine (DCS)-augmented exposure therapy has proven efficacy in the treatment of acrophobia, social phobia, panic disorder and OCD. Here we studied whether DCS can also improve the effect of cognitive behavioral therapy (CBT) in patients with agoraphobia and panic disorder. To this end, 39 patients with the diagnoses of agoraphobia and panic disorder were treated with 11 sessions of CBT including three individual in-vivo exposure sessions (flooding), augmented with either 50mg of DCS (N=20) or placebo (N=19) in a randomized double blind design. Primary outcome was the total score of the panic and agoraphobia scale. Both groups profited considerably from therapy and DCS did not significantly improve this outcome (p=0.475; η(2)p = 0.01). However, there was a statistical trend (p=0.075; η(2)p = 0.17) in the more severely ill patients that DCS accelerated symptom reduction in the primary outcome at post-therapy. No serious adverse effects occurred during the trial. We conclude that in patients with agoraphobia and panic disorder, DCS seems to lack an additional benefit to efficient cbt, probably due to a floor effect. Nonetheless, the acceleration of symptom reduction in severely ill patients might represent a valuable treatment option deserving further investigation.",Siegmund A.; Golfels F.; Finck C.; Halisch A.; Räth D.; Plag J.; Ströhle A.,2011.0,10.1016/j.jpsychires.2011.01.020,0,0,
3784,Symptom change and prognosis in clinic psychotherapy.,"Applicants for outpatient psychotherapy completed a symptom checklist that permitted evaluation of the duration, intensity, and patterning of presenting symptoms. Random assignment of patients acceptable for psychotherapy to immediate treatment or to the waiting list resulted in two comparable groups who repeated the symptom checklist after an average interval nine months. Patients in psychotherapy showed a greater reduction in average intensity of all symptoms than was observable in the waiting list group. In the waiting list group, improvements tended to be limited to those patients whose conditions were of comparatively brief duration. In the psychotherapy group, improvements of chronic patients were frequent; however, improvements tended to occur among those patients reporting some new symptoms rather than those giving no evidence of exacerbation. A predmoninance of ""neurotic"" over ""behavioral"" complaints also appeared to be predictive of a positive response to psychotherapy.",Siegel SM.; Rootes MD.; Traub A.,1977.0,,0,0,
3785,Very brief exposure: The effects of unreportable stimuli on fearful behavior,"A series of experiments tested the hypothesis that very brief exposure to feared stimuli can have positive effects on avoidance of the corresponding feared object. Participants identified themselves as fearful of spiders through a widely used questionnaire. A preliminary experiment showed that they were unable to identify the stimuli used in the main experiments. Experiment 2 (N = 65) compared the effects of exposure to masked feared stimuli at short and long stimulus onset asynchronies (SOA). Participants were individually administered one of three continuous series of backwards masked or non-masked stimuli: unreportable images of spiders (25-ms SOA), clearly visible images of spiders (500-ms SOA), or unreportable images of trees (25-ms SOA). Immediately thereafter, they engaged in a Behavioral Avoidance Test (BAT) with a live, caged tarantula. Exposure to unreportable images of spiders resulted in greater approach towards the tarantula than unreportable neutral images. A post-hoc comparison with clearly visible exposure to these same images approached significance. These effects were maintained at a 1-week follow-up (N = 57). In Experiment 3 (N = 26), participants engaged in the BAT 1 week prior to the exposure manipulation in order to provide a baseline measurement of their avoidant behavior, and again immediately after the exposure manipulation. Exposure to unreportable images of spiders reduced avoidance of the tarantula. Similar exposure to trees did not. Implications for the non-conscious basis of fear are discussed. © 2009 Elsevier Inc. All rights reserved.",Siegel P.; Weinberger J.,2009.0,10.1016/j.concog.2009.08.001,0,0,
3786,Delaying in vivo exposure to a tarantula with very brief exposure to phobic stimuli.,"Research has documented the very brief exposure (VBE) effect: the reduction of phobic fear by continuous presentation of masked phobic pictures. In prior studies, phobic participants approached a live tarantula immediately after the masked stimuli were presented. This study tested the hypothesis that VBE would reduce phobic avoidance of the tarantula 24 h later. 86 spider-phobic participants were identified with a fear questionnaire and Behavioral Avoidance Test (BAT) with a live tarantula indicative of a DSM-IV diagnosis of Specific Phobia. One week later, they were randomly assigned in double-blind fashion to presentation of a continuous series of 25 trials of masked images of either spiders or flowers (33-ms each), i.e., to VBE or control exposure. The participants gave subjective distress ratings just before and after these exposures. Then they engaged in the BAT again either immediately thereafter or 24 h later to measure changes in avoidance of the tarantula. Masked images of spiders reduced avoidance of the tarantula both immediately after exposure and 24 h later without causing subjective distress. The effect sizes at these two time points did not significantly differ from each other. We did not manipulate awareness of the spider images by presenting them unmasked to a third group. Conclusions about the effect of awareness of the stimuli cannot be drawn. VBE induces a process of fear reduction before phobic individuals engage in in vivo exposure, which is more distressing. Thus, VBE may help phobic-resistant individuals start treatment more gradually.",Siegel P.; Gallagher KA.,2015.0,10.1016/j.jbtep.2014.10.005,0,0,
3787,Very brief exposure II: The effects of unreportable stimuli on reducing phobic behavior,"This experiment compared the effects of exposure to masked phobic stimuli at a very brief stimulus-onset asynchrony on spider-phobic and non-phobic individuals. Participants were identified through a widely used questionnaire and a Behavioral Avoidance Test (BAT) with a live, caged tarantula to establish baseline levels of avoidance. One week later, they were individually administered one of two continuous series of masked images: spiders or flowers. Preliminary masking experiments showed that independent samples of participants from the same populations failed to recognize these stimuli. Participants in the main experiment reported ratings of subjective distress immediately before and after the exposure manipulation. Then they engaged in the BAT once again. Very brief exposure to images of spiders reduced phobic participants' avoidance of the tarantula. No effects were evidenced on subjective distress, or on non-phobic participants. Theoretical implications for the non-conscious basis of fear are discussed. © 2011 Elsevier Inc.",Siegel P.; Anderson J.F.; Han E.,2011.0,10.1016/j.concog.2010.09.003,0,0,
3788,Physiological problems of biofeedback control of the pulse rate.,"Data are presented in this article on the voluntary control of the heart rate in man as a function of individual typological differences in adaptive attributes, in the ecological features of the milieu of habitation and work, as well as in the presence of deviations in the state of health (neuroses, vegetovascular dystonias, etc.). The key significance of training of the rhythmic regulatory processes in the course of biofeedback control is substantiated.",Sidorov YuA .; Vasil'evskii NN.,,,0,0,
3789,"Metacognitive beliefs and strategies predict worry, obsessive - Compulsive symptoms and coping styles: A preliminary prospective study on an Italian non-clinical sample","Eighty undergraduate students completed the Italian versions of the Metacognition Questionnaire and Thought Control Questionnaire along with well-established measures of worry, obsessive-compulsive symptoms and coping styles on two occasions four months apart. A series of hierarchical regression analyses revealed that, after controlling the initial level of both worry and obsessionality, negative beliefs about worry focused on uncontrollability and danger appeared consistently associated with worry and obsessive symptoms at a four-month distance. In addition, positive beliefs about worry predicted maladaptive coping styles whereas cognitive self-consciousness and thought strategies aimed at distraction appeared to foster or facilitate adaptive coping styles. Results, implications and limitations are discussed according to Well's metacognitive model of emotional disorders. Copyright © 2007 John Wiley & Sons, Ltd.",Sica C.; Steketee G.; Ghisi M.; Chiri L.R.; Franceschini S.,2007.0,10.1002/cpp.520,0,0,
3790,School-Based Mindfulness Instruction: an RCT,"ER BACKGROUND AND OBJECTIVE: Many urban youth experience significant and unremitting negative stressors, including those associated with community violence, multigenerational poverty, failing educational systems, substance use, limited avenues for success, health risks, and trauma. Mindfulness instruction improves psychological functioning in a variety of adult populations; research on mindfulness for youth is promising, but has been conducted in limited populations. Informed by implementation science, we evaluated an adapted mindfulness-based stress reduction (MBSR) program to ameliorate the negative effects of stress and trauma among low-income, minority, middle school public school students. METHODS: Participants were students at two Baltimore City Public Schools who were randomly assigned by grade to receive adapted MBSR or health education (Healthy Topics [HT]) programs. Self-report survey data were collected at baseline and postprogram. Deidentified data were analyzed in the aggregate, comparing MBSR and HT classes, by using regression modeling. RESULTS: Three hundred fifth- to eighth-grade students (mean 12.0 years) were in MBSR and HT classes and provided survey data. Participants were 50.7% female, 99.7% African American, and 99% eligible for free lunch. The groups were comparable at baseline. Postprogram, MBSR students had significantly lower levels of somatization, depression, negative affect, negative coping, rumination, self-hostility, and posttraumatic symptom severity (all Ps < .05) than HT. CONCLUSIONS: These findings support the hypothesis that mindfulness instruction improves psychological functioning and may ameliorate the negative effects of stress and reduce trauma-associated symptoms among vulnerable urban middle school students. Additional research is needed to explore psychological, social, and behavioral outcomes, and mechanisms of mindfulness instruction.","Sibinga, E M; Webb, L; Ghazarian, S R; Ellen, J M",2016.0,10.1542/peds.2015-2532,0,0,
3791,Testing language effects in psychiatric epidemiology surveys with randomized experiments: results from the National Latino and Asian American Study.,"To evaluate the prevalence of mental disorders for persons of non-English-language origin, it is essential to use translated diagnostic interviews. The equivalence of translated surveys is rarely tested formally. In the National Latino and Asian American Study (NLAAS), the authors tested whether a carefully translated mental health survey administered in Spanish produced results equivalent to those obtained by the original English version, using a randomized survey experiment. The NLAAS is a nationally representative survey carried out in the United States in 2002-2003. Bilingual respondents from the Latino section of the NLAAS (n = 332) were randomly assigned to receive either a Spanish- or English-language version of the World Mental Health Survey Composite International Diagnostic Interview. In tests of differences in lifetime and 12-month prevalences of 11 diagnoses and four higher-order aggregate disorder categories, in only one case was there an apparent difference between randomized language groups: Lifetime reports of generalized anxiety disorder were more prevalent in the bilingual group assigned to English than in the group interviewed in Spanish. Detailed follow-up analyses did not implicate any specific question in the generalized anxiety disorder protocol. Translation and back-translation of surveys does not guarantee that response probabilities are exactly equivalent. Randomized survey experiments should be incorporated into cross-cultural psychiatric surveys when possible.",Shrout PE.; Alegría M.; Canino G.; Guarnaccia PJ.; Vega WA.; Duan N.; Cao Z.,2008.0,10.1093/aje/kwn116,0,0,
3792,Predictors of change in quality of life in older adults with generalized anxiety disorder.,"Quality of life (QOL) is lower in older adults with generalized anxiety disorder (GAD). QOL generally improves following cognitive-behavioral treatment for GAD. Little is known, however, about additional variables predicting changes in QOL in older adults with GAD. This study examined predictors of change in QOL among older participants in a randomized clinical trial of cognitive behavioral therapy (CBT) for GAD, relative to enhanced usual care (EUC). Hierarchical multilevel mixed-model analyses were used to examine inter-individual and intra-individual factors that predicted QOL over time. Predictors were categorized into treatment, personal and clinical characteristics. QOL improved over time, and there was significant variability between participants in change in QOL. Controlling for treatment condition, baseline general self-efficacy, baseline social support, within-person variation in worry and depression and average levels of depression across different time points predicted changes in QOL. QOL has increasingly been used as an outcome measure in treatment outcome studies to focus on overall improvement in functioning. Attention to improvement in symptoms of depression and worry, along with psychosocial variables, such as social support and self-efficacy, may help improve QOL in older adults with GAD. This study was a secondary study of data from a randomized clinical trial (NCT00308724) registered with clinical.trials.gov.",Shrestha S.; Stanley MA.; Wilson NL.; Cully JA.; Kunik ME.; Novy DM.; Rhoades HM.; Amspoker AB.,2015.0,10.1017/S1041610214002567,0,0,
3793,The effects of the Make a Wish intervention on psychiatric symptoms and health-related quality of life of children with cancer: a randomised controlled trial,"ER Objective: Children with life-threatening medical conditions frequently undergo invasive medical procedures that may elicit anxiety and distress. However, there are few empirically validated interventions that reduce mental health symptoms and increase the resilience of children during the acute stages of illness. This study aimed to evaluate the efficacy of the Make a Wish intervention for children with life-threatening cancer. Methods: The design was a wait-list-controlled trial with two parallel groups. Sixty-six children aged 5-12 with an initial diagnosis of life-threatening cancer were identified and randomly assigned to the Make a Wish intervention (n = 32) or a wait-list control group (n = 34). Children completed measures of psychiatric and health-related symptoms, positive and negative affect, hope, and optimism pre-intervention and post-intervention. After baseline data collection, children were interviewed and made an authentic wish that they wanted to come true. These wishes were made possible 5-6 months after baseline data collection, to fuel anticipation and excitement over the wish-fulfillment event. The post-intervention assessment point was 5 weeks after wish fulfillment (approximately 7 months after baseline data collection). Results: Children in the intervention group exhibited a significant reduction in general distress (d = 0.54), depression (d = 0.70), and anxiety symptoms (d = 0.41), improved health-related quality of life (d = 0.59), hope (d = 0.71), and positive affect (d = 0.80) compared to decrease in positive affect and no significant changes in the other measures in the control group. Conclusions: These findings emphasize the role of hope and positive emotions in fostering the well-being of children who suffer from serious illnesses.","Shoshani, A; Mifano, K; Czamanski-Cohen, J",2016.0,10.1007/s11136-015-1148-7,0,0,
3794,Evaluating the FRIENDS program: a cognitive-behavioral group treatment for anxious children and their parents,"ER Conducted the 1st randomized clinical trial evaluating the efficacy of the FRIENDS program, a family-based group cognitive-behavioral treatment (FGCBT) for anxious children. Children (n = 71) ranging from 6 to 10 years of age who fulfilled diagnostic criteria for separation anxiety (SAD), generalized anxiety disorder (GAD), or social phobia (SOP) were randomly allocated to FRIENDS or to a 10-week wait-list control group. The effectiveness of the intervention was evaluated at posttreatment and 12-month follow-up. Results indicated that 69% of children who completed FGCBT were diagnosis-free, compared to 6% of children completing the wait-list condition. At 12-month follow-up, 68% of children were diagnosis-free. Beneficial treatment effects were also evident on the self-report measures completed by the children and their mothers. Parents and children reported high treatment satisfaction. Results suggest that FRIENDS is an effective treatment for clinically anxious children. Limitations of this study and directions for future research are discussed.","Shortt, A L; Barrett, P M; Fox, T L",2001.0,10.1207/S15374424JCCP3004_09,0,0,
3795,The effects of an anxiety sensitivity intervention on insomnia symptoms.,"Recent work suggests a link between a transdiagnostic vulnerability factor, anxiety sensitivity (AS), and sleep disturbance. Although research has indicated that AS is malleable through brief interventions, no studies have yet examined whether interventions targeting AS will reduce symptoms of insomnia. Considering this gap in previous research, the current study tested the direct and indirect effects of a brief, computerized intervention targeting AS on self-reported insomnia symptoms. Community participants (N‚Äâ=‚Äâ97) were randomized into either the AS intervention (consisting of psychoeducation and interoceptive exposure) or a health information control condition, and they were assessed at baseline and at 1-month follow-up. Findings indicated that symptoms of insomnia were related to AS and its subfactors at baseline and follow-up. Moreover, there was an indirect effect of the treatment on insomnia symptoms through AS and its subfactors, which held after covarying for baseline symptoms of anxiety and depression. These preliminary findings suggest that targeting AS may be a brief and effective way to reduce symptoms of insomnia, but it should be replicated in a clinical sample of individuals with a diagnosis of insomnia disorder.",Short NA.; Allan NP.; Raines AM.; Schmidt NB.,2015.0,10.1016/j.sleep.2014.11.004,0,0,
3796,"The relationship between early maladaptive schemas, depression, and generalized anxiety among adults seeking residential treatment for substance use disorders.","Previous research has shown that early maladaptive schemas (EMS) play an important role in substance use, depression, and anxiety. However, few studies have examined the role of EMS within the context of all three concurrently. The goal of this study was to determine the role of EMS in predicting symptoms of Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) among adults in residential treatment for substance dependence. We used pre-existing patient records of adults diagnosed with a substance use disorder from a residential substance use treatment facility (N = 122). The EMS domains of disconnection and rejection and impaired limits were associated with symptoms of MDD and the domain of impaired autonomy and performance was associated with symptoms of GAD, even after controlling for age, gender, years of education, alcohol use, drug use, and symptoms of MDD (when predicting GAD) and GAD (when predicting MDD). Findings suggest that EMS may play an important role in comorbid mental health problems among men and women in residential substance use treatment. Continued treatment outcome research is needed to examine whether modification of EMS results in improved mental health and substance use outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Shorey, Ryan C; Elmquist, Joanna; Anderson, Scott; Stuart, Gregory L; Atalay, Babor, Ball, Ball, Bradizza, Brotchie, Bulik, Burns, Cockram, Camara, Delattre, Grant, Hawke, Hedley, Jacob, Kessler, Kessler, Kessler, Pinto-Gouveia, Renner, Riso, Roper, Saariaho, Saunders, Schmidt, Sempertegui, Sheeran, Shorey, Shorey, Shorey, Shorey, Shorey, Shorey, Shorey, Stuart, Stuart, Stuart, Young, Young, Zimmerman, Zimmerman",2015.0,,0,0,
3797,"A multicentre, randomised controlled study to validate the abbreviated westmead posttraumatic Amnesia scale","Objectives: Recent research has shown the measurement of posttraumatic amnesia (PTA) using the Revised-Westmead PTA Scale (R-WPTAS) is a better measure of cognitive change in individuals following mild traumatic Brain Injury (mTBI) than using the Glasgow Coma Scale (GCS) (Shores et al. 2008). The aim of the study is to demonstrate the Abbreviated-Westmead PTA Scale (A-WPTAS), a combined form of the GCS (orientation questions and GCS eye opening and motor response scores) and the memory items (3 picture cards) from the R-WPTAS, is capable of identifying the resolution of PTA in participants following mTBI. Method: A multicentre randomised group design, based on the revised CONSORT guidelines. Participants, aged 18 to 65 years, who presented consecutively to the Emergency Department (ED) of three hospitals, were eligible if they had sustained a mTBI or a non-brain physical injury. Each hospital had four groups (non-brain injured control R-WPTAS, non-brain injured control A-WPTAS, mTBI R-WPTAS, mTBI A-WPTAS). Estimates from power analysis suggested a sample size of 26 per group (104 patients from each hospital giving a total of 312 patients). Results: Hypotheses to be tested include: 1) Patients who present to an ED with a non-brain physical injury will perform better on the R-WPTAS, A-WPTAS, and the Westmead Selective Reminding Test (WSRT) than patients with a mTBI; 2) performances on the R-WPTAS and A-WPTAS and the WSRT (the reference memory test) in mTBI patients will not be different, and 3) performances on the R-WPTAS, A-WPTAS and the WSRT will not be affected by pain severity, acute posttraumatic stress symptoms, alcohol levels and opioids. The sample to date comprises of 78 mTBI and 110 nonbrain injured trauma controls. Conclusions: The results will be discussed.",Shores E.A.; Meares S.; Batchelor J.; Grouse A.; Holdgate A.; Robinson D.; Stewart D.; Cracknell R.; Daczko S.; Reed D.,2010.0,10.3109/02699051003648227,0,0,
3798,Reliability and validity of the Pediatric Intensity Level of Therapy (PILOT) scale: a measure of the use of intracranial pressure-directed therapies,"ER DESIGNCase-control study via retrospective review of medical records.SETTINGTertiary-care, university-based children's hospital intensive care unit.PATIENTSRandomly selected patients <or=18 yrs old admitted to the intensive care unit in 2002-2003 with severe TBI (cases: group 1, n = 27), mild-moderate TBI (control: group 2, n = 30), extracranial trauma (control: group 3, n = 29), or nontraumatic illnesses (control: group 4, n = 27).INTERVENTIONSNone.MEASUREMENTS AND MAIN RESULTSA 38-point scale was developed to quantify daily ICP-directed therapeutic effort. All currently recommended therapies are represented. Demographic and physiologic data were collected on all patients. A total of 24 of 27 patients with severe TBI received ICP-directed therapy; three did not because of judgments of futility. No control patients received ICP-directed therapy. The PILOT scale score was assessed for the first 7 days posttrauma or postadmission. Interrater reliability was 0.91 (intraclass correlation coefficient) and intrarater reliability was 0.94. The highest PILOT scale scores were in patients with severe TBI (11.7 +/- 5.6 vs. 1.3 +/- 1.7 vs. 2.0 +/- 2.1 vs. 1.9 +/- 1.8 for groups 1, 2, 3 and 4, respectively [mean +/- sd]; p < .001 by analysis of variance/Bonferroni). Patients with severe TBI who received ICP-directed therapy had higher PILOT scale scores (12.6 +/- 5.3 vs. 5.0 +/- 3.0, p = .001) than those who did not. Pearson's correlation coefficients of mean PILOT scale scores with measures of injury severity, outcome, and ICP were as follows: Glasgow Coma Scales score, -0.73 (p < .001); overall Injury Severity Score, 0.37 (p < .001); Injury Severity Score (head component only), 0.53 (p < .001); 6-month Glasgow Outcome Scale, -0.26 (p = .006); ICP burden (hours per day with ICP above treatment threshold), 0.59 (p = .002); and mean ICP, 0.41 (p = .044).CONCLUSIONSThe PILOT scale score can be obtained retrospectively and has good reliability. It can discriminate patients receiving ICP-directed therapy, even among patients with severe TBI, and correlates with measures of injury severity, outcome, and ICP in an expected way. Thus, it seems to be a valid measure of the use of ICP-directed therapy, although prospective, multiple-center validation is recommended.OBJECTIVETo test the reliability and validity of the Pediatric Intensity Level of Therapy (PILOT) scale, a novel measure of overall therapeutic effort directed at controlling intracranial pressure (ICP) in the setting of severe (Glasgow Coma Scale of <or= 8) pediatric traumatic brain injury (TBI).","Shore, P M; Hand, L L; Roy, L; Trivedi, P; Kochanek, P M; Adelson, P D",2006.0,10.1097/01.CCM.0000220765.22184.ED,0,0,
3799,Unconscious symbiotic fantasy: a ubiquitous therapeutic agent.,"Evidence is presented that supports the proposition that the deliberate or inadvertent activation of unconscious fantasies of symbiotic gratification can have an ameliorative effect on psychopathology of various kinds. The evidence includes (1) clinically based reports scattered in the psychoanalytic literature on the role of symbiotic gratification in everyday living, in nonanalytic therapies viewed as effecting transference improvements, in meditation, in group activity therapies, and in psychoanalytic treatment, and (2) data from a large number of laboratory experiments coonducted with double-blind procedures and other stringent investigatory controls. In addition to providing powerful support for the clinically derived proposition, the laboratory results allow for extending that proposition and for a more precise delineation of the fantasy that produces symptom amelioration, which when expressed in its verbal form, is most often conveyed by the words Mommy and I are one.",Silverman LH.,,,0,0,
3800,"Transcranial direct current stimulation for treatment-resistant obsessive-compulsive disorder: report on two cases and proposal for a randomized, sham-controlled trial.","Neuromodulation techniques for treating obsessive-compulsive disorder (OCD) have expanded through greater understanding of the brain circuits involved in this disorder. Transcranial direct current stimulation (tDCS), a non-invasive technique, has been studied as an alternative for treatment-resistant OCD. We describe the design of a clinical trial using tDCS for OCD and report on the outcomes from two patients with primary OCD who were resistant to cognitive-behavioral therapy and to selective serotonin reuptake inhibitors, and who received tDCS in an open manner during the training phase for the study procedures. Methodological description of a clinical trial using tDCS for treatment-resistant OCD at a university hospital; and a report on two cases. The proposed study is randomized, sham-controlled and double-blind. Forty-four patients will be randomized to either active or sham intervention. The active intervention consists of applying an electric current of 2 mA, with the cathode positioned in the region corresponding to the supplementary motor cortex (bilaterally) and the anode positioned in the deltoid. The primary outcome will be the reduction in baseline YBOCS (Yale-Brown Obsessive Compulsive Scale) score at the end of week 4. The secondary outcomes will be depression and anxiety symptoms. Genetic markers, cortical excitability and neurocognitive performance will be investigated. The first patient showed significant improvement, whereas the second remained symptomatic after four weeks and after six months. tDCS was well tolerated. tDCS for treatment-resistant OCD merits randomized controlled trials that test its effectiveness.",Silva RM.; Brunoni AR.; Miguel EC.; Shavitt RG.,,10.1590/1516-3180.2016.0155010716,0,0,
3801,"Transcranial direct current stimulation for treatment-resistant obsessive-compulsive disorder: report on two cases and proposal for a randomized, sham-controlled trial","ER DESIGN AND SETTING: Methodological description of a clinical trial using tDCS for treatment-resistant OCD at a university hospital; and a report on two cases.METHODS: The proposed study is randomized, sham-controlled and double-blind. Forty-four patients will be randomized to either active or sham intervention. The active intervention consists of applying an electric current of 2 mA, with the cathode positioned in the region corresponding to the supplementary motor cortex (bilaterally) and the anode positioned in the deltoid. The primary outcome will be the reduction in baseline YBOCS (Yale-Brown Obsessive Compulsive Scale) score at the end of week 4. The secondary outcomes will be depression and anxiety symptoms. Genetic markers, cortical excitability and neurocognitive performance will be investigated.RESULTS: The first patient showed significant improvement, whereas the second remained symptomatic after four weeks and after six months. tDCS was well tolerated.CONCLUSION: tDCS for treatment-resistant OCD merits randomized controlled trials that test its effectiveness.CONTEXT AND OBJECTIVE: Neuromodulation techniques for treating obsessive-compulsive disorder (OCD) have expanded through greater understanding of the brain circuits involved in this disorder. Transcranial direct current stimulation (tDCS), a non-invasive technique, has been studied as an alternative for treatment-resistant OCD. We describe the design of a clinical trial using tDCS for OCD and report on the outcomes from two patients with primary OCD who were resistant to cognitive-behavioral therapy and to selective serotonin reuptake inhibitors, and who received tDCS in an open manner during the training phase for the study procedures.","Silva, R M; Brunoni, A R; Miguel, E C; Shavitt, R G",2016.0,10.1590/1516-3180.2016.0155010716,0,0,3800
3802,Opposite effects of nefazodone in two human models of anxiety,"Rationale and objectives: To explore further the role of serotonin (5-HT) in anxiety, the effects of the 5-HT reuptake inhibitor and 5-HT2A receptor antagonist nefazodone (NF) were measured in two human models of anxiety. Methods: Twenty-nine adult healthy volunteers of both sexes underwent conditioning of skin conductance responses (CSCR) to a tone associated to an aversive white noise. Another 34 subjects performed a simulated public speaking (SPS) task, seemingly related to unconditioned fear. In both tests, subjective states were evaluated through the visual analogue mood scale (VAMS) and a bodily symptoms scale (BSS). In each experiment, subjects were randomly divided into three groups, which received 100 mg NF, 200 mg NF or placebo under double-blind condition. Results: In the CSCR test, NF decreased the number of spontaneous fluctuations of skin conductance (F=4.94; df=2,26; P=0.015). In addition, the increase in VAMS anxiety factor induced by the conditioning task was attenuated by NF (F=11.11; df=2,26; P<0.001). In contrast, the rise of VAMS anxiety induced by SPS was enhanced by NF (F=8.01; df=2,31; P=0.002). Conclusions: These results indicate that NF decreases conditioned anxiety, while enhancing unconditioned fear. Since the effects of NF may be due to impairment of 5-HT neurotransmission, consequent to overstimulation of autosomic 5-HT1A receptors and blockade of post-synaptic 5-HT2A receptors, the present results support the hypothesis that 5-HT facilitates conditioned anxiety, which may be related to generalised anxiety disorder, while inhibiting unconditioned fear, supposedly related to panic disorder.",Silva M.; Hetem L.A.B.; Guimar√£es F.S.; Graeff F.G.,2001.0,10.1007/s002130100752,0,0,
3803,Behavioral effects of transcranial direct current stimulation (tDCS) induced dorsolateral prefrontal cortex plasticity in alcohol dependence,"ER Transcranial Direct Current Stimulation (tDCS) has been shown to reduce acute substance craving in drug addicts, and improve cognition in neuropsychiatric patients. Here we aimed to explore further tDCS induced behavioral and neurophysiological modulation including assessment of relapse rate over a prolonged time course in alcoholism. We examined the effects of repeated anodal tDCS (2mA, 35 cm(2), 20min) over the left dorsolateral prefrontal cortex (DLPFC) on relapse to the use of alcohol in alcoholics from outpatient services, who received additional routine clinical treatment. Furthermore, event related potentials (ERPs), cognitive and frontal executive processes, craving, depressive and anxiety symptoms were obtained before and after treatment. From thirteen alcoholic subjects, seven were randomized to sham-tDCS and six to real tDCS treatment (once a week for five consecutive weeks). Depressive symptoms and craving were reduced to a larger extent in the tDCS group compared to the sham group (p=0.005 and p=0.015, respectively). On the other hand, active tDCS was able to block the increase in neural activation triggered by alcohol related and neutral cues in prefrontal cortex (PFC) as indexed by ERP as seen in the sham-tDCS group. Finally, there was a trend for increased change in executive function in the tDCS group compared to the sham-tDCS group (p=0.082), and, similarly, a trend for more relapses in the tDCS group compared to sham tDCS (four alcoholic subjects (66.7%) vs. one (14.3%), p=0.053).These results confirm the previous findings of tDCS effects on craving in alcoholism and also extend these findings as we showed also tDCS-related mood improvement. However, potential increase in relapse is possible; thus the clinical value of an increase in craving and improvement in depression and executive function needs to be carefully assessed in further studies; including investigation of optimal parameters of stimulation.","Silva, M C; Conti, C L; Klauss, J; Alves, L G; do Nascimento, Cavalcante H M; Fregni, F; Nitsche, M A; Nakamura-Palacios, E M",2013.0,10.1016/j.jphysparis.2013.07.003,0,0,
3804,Effects of orientation information on spouses' anxieties and attitudes toward hospitalization and surgery,,"Silva, M C",1979.0,,0,0,
3805,Explosive anger as a response to human rights violations in post-conflict Timor-Leste.,"Over several decades, clinicians have documented a pattern of explosive anger amongst survivors of gross human rights violations. Yet there is a dearth of epidemiological research investigating explosive anger in post-conflict countries. In the present study undertaken in Timor-Leste between March and November 2004, we identified an indigenous descriptor for explosive anger, including this index in the East Timor Mental Health Epidemiological Needs Study, a small area total population survey of 1544 adults living in an urban and a rural area. Other measures included indices of past trauma events, post-traumatic stress and general psychological distress, and socio-demographic variables. We found that 38% of the population reached the defined threshold of one attack of explosive anger a month (average=1 episode every 2-3 days). Only a minority of persons with explosive anger reached threshold scores for post-traumatic stress and general psychological distress. High levels of trauma exposure represented the strongest predictor of explosive anger. Latent class analysis identified three sub-groups with explosive anger: young trauma-affected adults living in the capital city who were unemployed; an older group, predominantly men, who had experienced extensive violence, including combat, assault and torture; and a less well characterized group of women. The findings offer support for a sequential model of explosive anger in which experiences of past persecution are compounded by frustrations in the post-conflict environment. The data provide a foundation for exploring further the role of trauma-induced anger in the cycles of violence that are prevalent in post-conflict countries.",Silove D.; Brooks R.; Bateman Steel CR.; Steel Z.; Hewage K.; Rodger J.; Soosay I.,2009.0,10.1016/j.socscimed.2009.06.030,0,0,
3806,Effects of resuscitation fluids on nonadaptive immune responses,"BACKGROUND: Colloidal plasma-expander fluids are commonly used as an alternative to blood components in the resuscitation of patients suffering from hemorrhagic shock and trauma. Of these, hydroxyethyl starch is also used as a cryopreservative and these dual properties have been utilized in the development of a blood storage system that allows the direct transfusion of red cells. The prolonged intravascular persistence of hydroxyethyl starch suggests that phagocytic clearance may be impaired and that the presence of hydroxyethyl starch could exacerbate transfusion-induced immunomodulation. STUDY DESIGN AND METHODS: The effects of colloidal resuscitation fluids on the activation response and phagocytic function of polymorphonuclear cells (PMNs) and monocytes in normal peripheral blood were examined. To mimic the hemolysis associated with cryopreservation, the effects of 1- and 5- percent red cell lysate were studied. Flow cytometric assays were used in all cases. RESULTS: The percentage of phagocytic monocytes and PMNs was not altered; nor were the rates of phagocytosis impaired after incubation with resuscitation fluids. Upregulation of cell surface integrin during activation was similarly unmodified by the fluids. CONCLUSION: Hydroxyethyl starch and other resuscitation fluids do not affect some important antimicrobial functions of the nonadaptive arm of the immune response. This suggests that posttrauma or transfusion-induced immunomodulation is not exacerbated by inhibition at this level.",Sillett H.K.; Whicher J.T.; Trejdosiewicz L.K.,1997.0,,0,0,
3807,"Gender Differences in Borderline Personality Disorder: Results From a Multinational, Clinical Trial Sample.","This study aims to extend previous research by considering gender differences in borderline personality (BPD) using both dimensional self-reported and clinical measures of symptomatology. Drawing from a cross-cultural, clinical trial sample, the authors compared female and male BPD subjects (N = 770; 211 male) between the ages of 18 and 65 using diagnostic and self-report data. The authors found that women with BPD have greater hostility and relationship disruption than men. Gender differences in eating disorders, particularly bulimia, are more divergent than in the general population. Generally, gender differences in BPD in this sample are consistent with known general population differences. Women show greater overall symptomatology, including depressive, anxious, and somatic symptoms. Men have higher rates of antisocial personality disorder and a trend toward higher rates of narcissistic personality disorder. However, several gender differences consistently found in the general population are not present in this BPD sample. There are no differences in aggression, suicidality, substance abuse, panic disorder, or obsessive-compulsive disorder. Gender differences in major depression and posttraumatic stress disorder are attenuated. These findings support the conclusion that BPD may diminish normal gender differences.",Silberschmidt A.; Lee S.; Zanarini M.; Schulz SC.,2015.0,10.1521/pedi_2014_28_175,0,0,
3808,Response analysis for multiple symptoms revealed differences between arms of a symptom management trial,"ER STUDY DESIGN AND SETTINGRandomized trial comparing a nurse-assisted symptom management (NASM) cognitive-behavioral intervention with an automated telephone symptom management (ATSM). Patients in both arms received six intervention contacts over 8 weeks. Analyses of the intervention contact data for 190 patients in NASM arm and 164 patients in the ATSM arm were conducted. Severities of 15 cancer-related symptoms were assessed at each intervention contact, and an anchor-based definition of response was adopted. Analyses were carried out using generalized estimating equations and Cox marginal proportional hazard models.RESULTSWhen compared with patients in the NASM, patients in the ATSM had better response to manage anxiety, depression, poor appetite, cough, and fatigue. NASM was more successful in managing cancer pain. Response and time to response were associated with several patient and disease characteristics.CONCLUSIONThe approach described here presents an analytic and clinical improvement over methods that examine each symptom separately or use summed scores of severity.OBJECTIVETo describe the methodology of evaluating the response of cancer patients to interventions directed at lowering severity of multiple symptoms, and to compare two arms of a symptom management trial to determine factors associated with response and time to response.","Sikorskii, A; Given, C W; You, M; Jeon, S; Given, B A",2009.0,10.1016/j.jclinepi.2008.09.007,0,0,
3809,A randomised controlled trial comparing two schedules of antenatal visits: the antenatal care project,"ER DESIGNRandomised controlled trial.SETTINGPlaces in south east London providing antenatal care for women receiving shared care and planning to deliver in one of three hospitals or at home.SUBJECT2794 women at low risk fulfilling the trial's inclusion criteria between June 1993 and July 1994.MAIN OUTCOME MEASURESMeasures of fetal and maternal morbidity, health service use, psychosocial outcomes, and maternal and professional satisfaction.RESULTSPregnant women allocated to new style care had fewer day admissions (0.8 v 1.0; P=0.002) and ultrasound scans (1.6 v 1.7; P=0.003) and were less often suspected of carrying fetuses that were small for gestational age (odds ratio 0.73; 95% confidence interval 0.54 to 0.99). They also had some poorer psychosocial outcomes; for example, they were more worried about fetal wellbeing antenatally and coping with the baby postnatally, and they had more negative attitudes to their babies, both in pregnancy and postnatally. These women were also more dissatisfied with the number of visits they received (odds ratio 2.50; 2.00 to 3.11).CONCLUSIONSPatterns of antenatal care involving fewer routine visits for women at low risk may lead to reduced psychosocial effectiveness and dissatisfaction with frequency of visits. The number of antenatal day admissions and ultrasound scans performed may also be reduced. For the variables reported, the visit schedules studied are similar in their clinical effectiveness. Uncertainty remains as to the clinical effectiveness of reduced visit schedules for rare pregnancy problems.OBJECTIVETo compare the clinical and psychological effectiveness of the traditional British antenatal visit schedule (traditional care) with a reduced schedule of visits (new style care) for low risk women, together with maternal and professional satisfaction with care.","Sikorski, J; Wilson, J; Clement, S; Das, S; Smeeton, N",1996.0,,0,0,
3810,Reductions in traumatic stress following a coping intervention were mediated by decreases in avoidant coping for people living with HIV/AIDS and childhood sexual abuse,"ER METHOD: In a randomized controlled trial, 247 participants completed measures of traumatic stress and avoidant coping at pre- and post intervention, and at 4-, 8-, and 12-month follow-ups. Latent growth curve modeling examined changes over the 5 time points; standardized path coefficients provide estimates of effects.RESULTS: As compared with the support intervention, the coping intervention led to a reduction in traumatic stress over time (b = -.20, p < .02). Participants in the coping intervention also reduced their use of avoidant coping strategies more than did participants in the support intervention (b = -.22, p < .05). Mediation analyses showed reductions in avoidant coping related to reductions in traumatic stress (b = 1.45, p < .001), and the direct effect of the intervention on traumatic stress was no longer significant (b = .04, ns), suggesting that changes in avoidant coping completely mediated intervention effects on traumatic stress.CONCLUSIONS: The LIFT intervention significantly reduced traumatic stress over time, and changes in avoidant coping strategies mediated this effect, suggesting a focus on current stressors and coping skills improvement are important components in addressing traumatic stress for adults living with HIV and CSA.OBJECTIVE: To examine whether (a) Living in the Face of Trauma (LIFT), a group intervention to address coping with HIV and childhood sexual abuse (CSA), significantly reduced traumatic stress over a 1-year follow-up period more than an attention-matched support group comparison intervention; and (b) reductions in avoidant coping over time mediated reductions in traumatic stress.","Sikkema, K J; Ranby, K W; Meade, C S; Hansen, N B; Wilson, P A; Kochman, A",2013.0,10.1037/a0030144,0,0,
3811,The interpersonal context of client motivational language in cognitive-behavioral therapy.,"Previous research has found that client motivational language (especially arguments against change or counterchange talk; CCT) in early therapy sessions is a reliable predictor of therapy process and outcomes across a broad range of treatments including cognitive-behavioral therapy (CBT). Existing studies have considered the general occurrence of CCT, but the present study differentiated 2 types of CCT in early CBT sessions for 37 clients with generalized anxiety disorder: (a) statements that are uttered to express ambivalence regarding change versus (b) statements that are intended to oppose the therapist or therapy. Two process coding systems were used to accomplish this differentiation. Findings indicated that a higher number of CCT statements that occurred in the presence of resistance (opposition to the therapist or therapy) were a substantive and consistent predictor of lower homework compliance and poorer outcomes, up to 1 year posttreatment. Moreover, when both types of CCT were considered together, only opposition CCT was related to outcomes, and ambivalent CCT was not significantly predictive of proximal and distal outcomes. These findings suggest that the interpersonal context in which CCT statements occur may be critically important to their predictive capacity. More broadly, the findings of this study have implications for the future study of client motivational language and underscore the clinical importance of detecting opposition CCT.",Sijercic I.; Button ML.; Westra HA.; Hara KM.,2016.0,10.1037/pst0000017,0,0,
3812,Problem Management Plus (PM+) for common mental disorders in a humanitarian setting in Pakistan; study protocol for a randomised controlled trial (RCT).,"In humanitarian settings common mental disorders (depression, anxiety disorders, posttraumatic stress disorder) are highly prevalent. The World Health Organization (WHO) has developed Problem Management Plus (PM+), a 5-session, individual psychological intervention program, delivered by paraprofessionals that addresses common mental disorders in people in communities affected by adversity. The objectives of this study are to test effectiveness and cost-effectiveness of the locally adapted PM+ compared to Treatment as usual (TAU) in Peshawar District, Pakistan. A randomised controlled trial will be conducted in 346 primary care attendees in 3 health care centres in Peshawar District, Pakistan. After informed consent, primary care attendees with high levels of psychological distress according to the General Health Questionnaire-12 (GHQ-12) and functional impairment (WHO Disability Assessment Schedule 2.0 (WHODAS)) will be assigned to PM+ (n = 173) or TAU (n = 173). At baseline, 1 week and 3 months following PM+, independent assessors will assess psychological distress with the Hospital Anxiety and Depression Scale (HADS), and functional disability with the WHODAS. Secondary outcomes are posttraumatic stress disorder (PTSD) symptoms, and client-perceived priority problems. Further, cost-effectiveness will be assessed using the Service Receipt Inventory (SRI). If proven effective, PM+ will be rolled out to other areas for further adaptation and testing in diverse humanitarian settings. ACTRN12614001235695. Registered 26 November 2014. Australian New Zealand Clinical Trials Registry.",Sijbrandij M.; Farooq S.; Bryant RA.; Dawson K.; Hamdani SU.; Chiumento A.; Minhas F.; Saeed K.; Rahman A.; van Ommeren M.,2015.0,10.1186/s12888-015-0602-y,0,0,
3813,The role of injury and trauma-related variables in the onset and course of symptoms of posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) affects a minority of trauma-exposed persons and is associated with significant impairment. This longitudinal study examined risk factors for PTSD. We tested whether the presence of injuries resulting from trauma exposure predicted the course of PTSD symptoms. In addition, we tested whether gender, trauma type, perceived life threat, and peritraumatic dissociation predicted the onset of PTSD symptoms. 236 trauma-exposed civilians were assessed for PTSD symptoms with a structured interview at four occasions during 6 months posttrauma. Path analysis showed that a model in which the female gender, assault, perceived life threat, and peritraumatic dissociation predicted PTSD severity at 1 week, and injury predicted PTSD severity 8 weeks after the traumatic event showed the best fit. However, a similar model without injury showed comparable fit. It is concluded that injuries have a negligible effect on the course of PTSD.",Sijbrandij M.; Engelhard IM.; de Vries GJ.; Luitse JS.; Carlier IV.; Gersons BP.; Olff M.,2013.0,10.1007/s10880-012-9348-6,0,0,
3814,Cognitive and clinical characteristics of sexual and religious obsessions.,"Sexual and religious obsessions are often grouped together a s unacceptable thoughts, symptoms of obsessive-compulsive disorder (OCD) hypothesized to be maintained by maladaptive beliefs about the importance and control of thoughts. Although there is empirical justification for this typology, there are several reasons to suspect that sexual and religious obsessions may differ with respect to associated obsessional beliefs and personality traits. In this study, we examined the associations between sexual and religious obsessions (separately) and (a) putatively obsessional cognitive styles, especially beliefs about the importance and control of thoughts, and responsibility; (b) obsessive-compulsive personality traits; and (c) schizotypal personality traits. Whereas sexual obsessions were predicted only by increased beliefs about the importance and control of thoughts, and contamination obsessions were predicted only by inflated responsibility appraisals and threat estimation, religious obsessions were independently predicted by both of these constructs. In addition, only religious obsessions were related to self-reported obsessive-compulsive personality traits. Researchers and clinicians should be cognizant of potentially important distinctions between sexual and religious obsessions, and the possibility that scrupulous OCD shares processes with both autogenous and reactive presentations (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Siev, Jedidiah; Steketee, Gail; Fama, Jeanne M; Wilhelm, Sabine; Abramowitz, Alonso, Bloch, Coles, Eisen, Ferrao, First, Fricke, Goodman, Grant, Huppert, Hyler, Lee, Lee, Lee, Lee, Mataix-Cols, Mataix-Cols, Minichiello, Moritz, Nelson, Okada, Pinto, Purdon, Rufer, Steketee, Tolin, Wheaton, Wilhelm, Wilhelm, Yovel",2011.0,,0,0,
3815,[Computerized helicoidal tomography of the coronary arteries vs coronary angiography].,"The calcium score (CS) of the coronary arteries by computed tomography (CT) is an useful procedure for the diagnosis of obstructive coronary disease (OCD), with an average sensitivity of 82 +/- 6%, specificity of 88 +/- 2%, positive predictive value (PPV) of 57 +/- 7% and negative predictive value (NPV) of 96 +/- 2%. The objective of this trial was to compare helicoidal CT Scan with the traditional method and define sensitivity, specificity, Positive predictive value and negative predictive value against the coronary angiography. From June of 1998 to March of 1999, one hundred and sixty six patients with coronary arteries CT were studied. The CT was done with an ELSCINT-CT Twin equipment and a software for the quantification of the coronary arteries CS in Hounsfield units. In forty one, coronary angiography was performed. A significant obstructive lesion was defined as > or = 70% of luminal stenosis in at least one artery, or > or = 50% in the left main and > or = 50% if some other artery was involved. This group was divided in accordance to the CS in two subgroups: A with a CS < or = 150 and B those with a CS > or = 151. In group A, 45% had significative lesions vs 95% in group B (p = 0.001). The sensitivity was 65%, specificity 95%, PPV 64% and the NPV 92%. Relative risk 2.08 (CI 95% 1.38-3.54) and Odds ratio 21.6 (CI 95% 2.43-191.37). Even though the small sample, CT is an useful procedure for the diagnosis of the OCD.",Sierra-Galán LM.; Hernández-López JE.; Portos-Silva JM.,,,0,0,
3816,Computerized helicoidal tomography of the coronary arteries vs coronary angiography,"ER METHODSFrom June of 1998 to March of 1999, one hundred and sixty six patients with coronary arteries CT were studied. The CT was done with an ELSCINT-CT Twin equipment and a software for the quantification of the coronary arteries CS in Hounsfield units. In forty one, coronary angiography was performed. A significant obstructive lesion was defined as > or = 70% of luminal stenosis in at least one artery, or > or = 50% in the left main and > or = 50% if some other artery was involved. This group was divided in accordance to the CS in two subgroups: A with a CS  or = 151.RESULTSIn group A, 45% had significative lesions vs 95% in group B (p = 0.001). The sensitivity was 65%, specificity 95%, PPV 64% and the NPV 92%. Relative risk 2.08 (CI 95% 1.38-3.54) and Odds ratio 21.6 (CI 95% 2.43-191.37).CONCLUSIONSEven though the small sample, CT is an useful procedure for the diagnosis of the OCD.INTRODUCTIONThe calcium score (CS) of the coronary arteries by computed tomography (CT) is an useful procedure for the diagnosis of obstructive coronary disease (OCD), with an average sensitivity of 82 +/- 6%, specificity of 88 +/- 2%, positive predictive value (PPV) of 57 +/- 7% and negative predictive value (NPV) of 96 +/- 2%. The objective of this trial was to compare helicoidal CT Scan with the traditional method and define sensitivity, specificity, Positive predictive value and negative predictive value against the coronary angiography.","Sierra-Galán, L M; Hernández-López, J E; Portos-Silva, J M",2000.0,,0,0,3815
3817,[Direct total body CT scan in multi-trauma patients].,"Immediate total body computed tomography (CT) scanning has become important in the early diagnostic phase of trauma care because of its high diagnostic accuracy. However, literature provides limited evidence whether immediate total body CT leads to better clinical outcome then conventional radiographic imaging supplemented with selective CT scanning in trauma patients. The aim of the REACT-2 trial is to determine the value of immediate total body CT scanning in trauma patients. The REACT-2 trial is an international, multicenter randomized clinical trial. All participating trauma centers have a multi-slice CT scanner located in the trauma room or at the Emergency Department (ED). All adult, non-pregnant, severely injured trauma patients according to predefined criteria will be included. The intervention group will receive a contrast-enhanced total body CT scan (head to pelvis) during the primary survey. The control group will be evaluated according to local conventional trauma imaging protocols (based on ATLS guidelines) supplemented with selective CT scanning. Primary outcome will be in-hospital mortality. Secondary outcomes are differences in mortality and morbidity during the first year post trauma, several trauma work-up time intervals, radiation exposure, general health and quality of life at 6 and 12 months post trauma and cost-effectiveness. The REACT-2 trial is the first multicenter randomized clinical trial that will provide evidence on the value of immediate total body CT scanning during the primary survey of severely injured trauma patients.",Sierink JC.; Saltzherr TP.; Edwards MJ.; Beuker BJ.; Patka P.; Goslings JC.;  .,2012.0,,0,0,
3818,Wound 'dechronification' with negatively-charged polystyrene microspheres: a double-blind RCT,"ER OBJECTIVE: To compare the efficacy and safety of negatively-charged polystyrene microspheres (NCM)with controls (saline soaks) in the treatment of hard-to-heal wounds of various aetiologies.METHOD: Patients with one or more hard-to-heal wounds, defined as refractory to healing for at least 4 weeks, or those with exposed bone, tendon or ligament, were eligible for inclusion and were randomised to either NCM (PolyHeal; MediWound Ltd.) or controls, both applied twice daily for 4 weeks. Patients were monitored bi-weekly for an additional 8 weeks, while treated by standard wound care, at the investigators' discretion, and were re-evaluated 2 years after inclusion. The primary endpoint was defined as coverage of> 75% of the wound area by light-red granulation tissue after 4 weeks of treatment.RESULTS: Fifty-eight patients completed the study, 32 in the NCM group and 26 in the control group. The two most common wound types were those with primary etiologies of venous insufficiency and postoperative/post trauma. In the NCM group 47% of patients achieved > 75% light red granulation tissue after 4 weeks compared with 15% of patients in the control group (p=O.O I). The mean wound surface area in the NCM group was reduced by 39.0% after 4 weeks compared with 14.9% in the control group (p=0.02).The achievement of> 75% light red granulation tissue and reduction of mean wound surface area was also observed in the two main sub-groups (venous insufficiency and postoperative/post trauma), although it was not statistically significant, possibly due to the small sample size in each sub-group.CONCLUSION: This study demonstrates that compared to control treatment, NCM treatment of hard to-heal and chronic wounds improves formation of healthy granulation tissue and reduces wound size thus in fact 'kick-starting' the healing process and 'dechronifying' chronic wounds.","Shoham, Y; Kogan, L; Weiss, J; Tamir, E; Krieger, Y; Barnea, Y; Regev, E; Vigoda, D; Haikin, N; Inbal, A; Arnon, O; Bogdanov-Berezovsky, A; Silberstein, E",2013.0,10.12968/jowc.2013.22.3.144,0,0,
3819,An aerobic walking programme versus muscle strengthening programme for chronic low back pain: a randomized controlled trial.,"To assess the effect of aerobic walking training as compared to active training, which includes muscle strengthening, on functional abilities among patients with chronic low back pain. Randomized controlled clinical trial with blind assessors. Outpatient clinic. Fifty-two sedentary patients, aged 18-65 years with chronic low back pain. Patients who were post surgery, post trauma, with cardiovascular problems, and with oncological disease were excluded. Experimental 'walking' group: moderate intense treadmill walking; control 'exercise' group: specific low back exercise; both, twice a week for six weeks. Six-minute walking test, Fear-Avoidance Belief Questionnaire, back and abdomen muscle endurance tests, Oswestry Disability Questionnaire, Low Back Pain Functional Scale (LBPFS). Significant improvements were noted in all outcome measures in both groups with non-significant difference between groups. The mean distance in metres covered during 6 minutes increased by 70.7 (95% confidence interval (CI) 12.3-127.7) in the 'walking' group and by 43.8 (95% CI 19.6-68.0) in the 'exercise' group. The trunk flexor endurance test showed significant improvement in both groups, increasing by 0.6 (95% CI 0.0-1.1) in the 'walking' group and by 1.1 (95% CI 0.3-1.8) in the 'exercise' group. A six-week walk training programme was as effective as six weeks of specific strengthening exercises programme for the low back.",Shnayderman I.; Katz-Leurer M.,2013.0,10.1177/0269215512453353,0,0,
3820,Associations between functioning and PTSD symptom clusters in a dismantling trial of cognitive processing therapy in female interpersonal violence survivors.,"This study conducted secondary analyses of a published trial and sought to determine if different domains of psychosocial functioning (e.g., daily living, work, nonfamily relationships) improved following trauma-focused treatment for posttraumatic stress disorder (PTSD). Cognitive processing therapy (CPT), an empirically supported treatment that involves evaluating trauma-related beliefs and written trauma accounts, was compared to its components: CPT without the written accounts or written accounts only in a sample of 78 women with PTSD secondary to interpersonal violence. Overall and individual domains of functioning significantly improved with treatment and results were similar across treatment groups, Fs (2, 150) ≥ 11.87, ps < .001. Additionally, we investigated whether changes in different PTSD symptom clusters were associated with outcomes in domains of psychosocial functioning, after collapsing across treatment condition. Multiple hierarchical linear regression analyses revealed that overall clinician-assessed PTSD symptom reduction was associated with outcomes in all domains of functioning, βs = .44 to .68, ps < .001. Additionally, improvements in the emotional numbing symptom cluster were associated with outcomes in the nonfamily relationships domain, β = .42, p < .001, and improvements in the hyperarousal symptom cluster were associated with outcomes in the overall, daily living, and household tasks domains, βs = .34 to .39, ps < .01. Results suggest that it may be important to monitor improvements in emotional numbing and hyperarousal symptoms throughout treatment to increase the likelihood of changes in psychosocial functioning.",Shnaider P.; Vorstenbosch V.; Macdonald A.; Wells SY.; Monson CM.; Resick PA.,2014.0,10.1002/jts.21954,0,0,
3821,The effect of cholecystokinin tetrapeptide on respiratory resistance in healthy volunteers.,"Studied the effects of cholescystokinin tetrapeptide (CCK-4) on respiratory resistance in 14 healthy volunteers by the registration of slow vital capacity and flow volume loop during forced respiration test. The administration of CCK-4 was performed in a double-blind and placebo-controlled design. Injections of CCK-4 induced prominent and time-limited panic-like symptoms in all healthy Ss. Four volunteers experienced a panic attack. Subjective dyspnea was experienced by the majority of Ss at the peak of CCK-4 effect and seemed related to a diminution in vital capacity parameters; however, the forced respiration test did not reveal bronchoconstriction after CCK-4 challenge. Administration of CCK-4 also induced a short-lasting increase in heart rate and skin blood flow. Results suggest that dyspnea induced by CCK-4 is not related to changes in respiratory resistance. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Shlik, Jakov; Vasar, Veiko; Aluoja, Anu; Peet-Henn, Kingisepp; Jagomagi, Kersti; Vasar, Eero; Rago, Lembit; Bradwejn, Jacques",1997.0,,0,0,
3822,Cognitive behavioral therapy for depressed adolescents exposed to interpersonal trauma: an initial effectiveness trial.,"Four clinical trials have shown that a history of interpersonal trauma is associated with diminished response to cognitive-behavioral therapy (CBT) for adolescent depression. An efficacious CBT protocol for adolescent depression was modified to address cognitive deficits and distortions associated with interpersonal trauma. Initial feasibility, acceptability, and treatment impact of the modified treatment (m-CBT) were evaluated in a randomized effectiveness trial conducted in community clinics. Clients were 43 referred adolescents with a depressive disorder and a history of interpersonal trauma. Adolescents either received m-CBT or usual care (UC) therapy. Results indicated that m-CBT was delivered with good fidelity by community clinicians, but that number of sessions completed was attenuated in both m-CBT and UC. Adolescents reported high levels of treatment satisfaction and acceptability for the new treatment. There were significant reductions in depressive symptoms over time, but no differences in outcomes between groups. Although the new treatment produced promising results, it did not outperform UC. Implications for treatment development are considered.",Shirk SR.; Deprince AP.; Crisostomo PS.; Labus J.,2014.0,10.1037/a0034845,0,0,
3823,Computational biomechanics of articular cartilage of human knee joint: Effect of osteochondral defects,"Articular cartilage and its supporting bone functional conditions are tightly coupled as injuries of either adversely affects joint mechanical environment. The objective of this study was set to quantitatively investigate the extent of alterations in the mechanical environment of cartilage and knee joint in presence of commonly observed osteochondral defects. An existing validated finite element model of a knee joint was used to construct a refined model of the tibial lateral compartment including proximal tibial bony structures. The response was computed under compression forces up to 2000 N while simulating localized bone damage, cartilage-bone horizontal split, bone overgrowth and absence of deep vertical collagen fibrils. Localized tibial bone damage increased overall joint compliance and substantially altered pattern and magnitude of contact pressures and cartilage strains in both tibia and femur. These alterations were further exacerbated when bone damage was combined with base cartilage split and absence of deep vertical collagen fibrils. Local bone boss markedly changed contact pressures and strain patterns in neighbouring cartilage. Bone bruise/fracture and overgrowth adversely perturbed the homeostatic balance in the mechanical environment of articulate cartilage surrounding and opposing the lesion as well as the joint compliance. As such, they potentially contribute to the initiation and development of post-traumatic osteoarthritis. © 2009 Elsevier Ltd. All rights reserved.",Shirazi R.; Shirazi-Adl A.,2009.0,10.1016/j.jbiomech.2009.07.022,0,0,
3824,Hydration and dehydration periods of crown fragments prior to reattachment,"ER INTRODUCTION: Tooth fragment bonding is an excellent treatment option in dealing with traumatic injuries of the anterior teeth. Rewetting the tooth fragment has been shown to increase restoration durability. The present study examined the effect various dry and wet storage periods had on the reattached fragment's bond to the tooth.MATERIALS AND METHODS: One hundred and eight human mandibular incisors were fractured and assigned to undergo a dehydration period of 30 minutes, six hours, 24 hours, or three days before the rewetting procedure. After fracturing the teeth and drying the fragments, each of the specimens was assigned to one of the three main groups (A, B, or C) intended to evaluate the effect of different rehydration periods. Groups A and B underwent a 30-minute and a 24-hour rewetting period, respectively. Group C served as a control (without a rewetting stage). Tooth fragments were then reattached and prepared for the strength test. Force was applied on the lingual side of the tooth at a 1 mm/min rate until failure.RESULTS: The mean loads (N) required to fracture the restored teeth were as follows: 204.43 ± 33.48 N, 322.59 ± 34.62 N, and 253.25 ± 29.05 N for groups A, B, and C, respectively. Two-way analysis of variance (p0.05), except in the case of the 30-minute dehydrated specimens (p<0.05).CONCLUSION: Compared to a 30-minute period, a 24-hour rehydration of the tooth fragment before treatment seems to salvage enough moisture to result in an increase in reattachment strength.","Shirani, F; Malekipour, M R; Sakhaei, Manesh V; Aghaei, F",2012.0,10.2341/10-130-L,0,0,
3825,Music therapy as an adjunct to standard treatment for obsessive compulsive disorder and co-morbid anxiety and depression: A randomized clinical trial.,"Previous studies have highlighted the potential therapeutic benefits of music therapy as an adjunct to standard care, in a variety of psychiatric ailments including mood and anxiety disorders. However, the role of music in the treatment of obsessive-compulsive disorder (OCD) have not been investigated to date. In a single-center, parallel-group, randomized clinical trial (NCT02314195) 30 patients with OCD were randomly assigned to standard treatment (pharmacotherapy and cognitive-behavior therapy) plus 12 sessions of individual music therapy (n = 15) or standard treatment only (n = 15) for one month. Maudsley Obsessive-Compulsive Inventory, Beck Anxiety Inventory, and Beck Depression Inventory-Short Form were administered baseline and after one month. Thirty patients completed the study. Music therapy resulted in a greater decrease in total obsessive score (post-intervention score: music therapy+standard treatment: 12.4 ± 1.9 vs standard treatment only: 15.1 ± 1.7, p < 0.001, effect size = 56.7%). For subtypes, significant between-group differences were identified for checking (p = 0.004), and slowness (p = 0.019), but not for washing or responsibility. Music therapy was significantly more effective in reducing anxiety (post-intervention score: music therapy + standard treatment: 16.9 ± 7.4 vs standard treatment only: 22.9 ± 4.6, p < 0.001, effect size = 47.0%), and depressive symptoms (post-intervention score: music therapy + standard treatment: 10.8 ± 3.8 vs standard treatment: 17.1 ± 3.7, p < 0.001, effect size = 47.0%). Inclusion of a small sample size, lack of blinding due to the nature of the intervention, short duration of follow-up. In patients with OCD, music therapy, as an adjunct to standard care, seems to be effective in reducing obsessions, as well as co-morbid anxiety and depressive symptoms.",Shirani Bidabadi S.; Mehryar A.,2015.0,10.1016/j.jad.2015.04.011,0,0,
3826,Correlation of placebo responses and personality characteristics in myofascial pain-dysfunction (MPD) patients.,,Shipman WG.; Greene CS.; Laskin DM.,1974.0,,0,0,
3827,Treatment-related reductions in PTSD and changes in physical health symptoms in women.,"This study examined the relationship between change in posttraumatic stress disorder (PTSD) symptoms over the course of PTSD treatment and the association with changes in general physical health symptoms. Both positive health habits (e.g., exercise) and negative (e.g., smoking), were examined to determine if they accounted for the association between changes in PTSD severity over time and changes in physical health. Participants were 150 women seeking treatment for PTSD. Latent growth curve modeling indicated a substantial relationship (R (2) = 34%) between changes in PTSD and changes in physical health that occurred during and shortly following treatment for PTSD. However, there was no evidence to suggest that changes in health behaviors accounted for this relationship. Thus, PTSD treatment can have beneficial effects on self-reported physical health symptoms, even without direct treatment focus on health per se, and is not accounted for by shifts in health behavior.",Shipherd JC.; Clum G.; Suvak M.; Resick PA.,2014.0,10.1007/s10865-013-9500-2,0,0,
3828,A preliminary examination of treatment for posttraumatic stress disorder in chronic pain patients: a case study.,"Manualized treatments have become popular, despite concern about their use when comorbid diagnoses are present. In this report, the efficacy of manualized posttraumatic stress disorder (PTSD) treatment was examined in the presence of chronic pain. Additionally, the effect of PTSD treatment on chronic pain and additional psychiatric diagnoses was explored. Six female patients with both PTSD and chronic pain following motor vehicle accidents were treated for PTSD using a multiple baseline design. The results indicate that manualized treatment for PTSD was effective in reducing PTSD symptoms in these patients. Although there were no changes in subjective pain, there were pain-related functional improvements and reductions in other psychiatric diagnoses for the majority of patients.",Shipherd JC.; Beck JG.; Hamblen JL.; Lackner JM.; Freeman JB.,2003.0,10.1023/A:1025754310462,0,0,
3829,Effect of autogenic training on general improvement in patients with irritable bowel syndrome: a randomized controlled trial,"ER Autogenic training (AT) is a useful and comprehensive relaxation technique. However, no studies have investigated the effects of AT on irritable bowel syndrome (IBS). In this study we tested the hypothesis that AT improves symptoms of IBS. Twenty-one patients with IBS were randomly assigned to AT (n = 11, 5 male, 6 female) or control therapy (n = 10, 5 male, 5 female). AT patients were trained intensively, while the control therapy consisted of discussions about patients' meal habits and life styles. All patients answered a question related to adequate relief (AR) of IBS symptoms and four questionnaires: Self-induced IBS Questionnaire (SIBSQ), Self-reported Depression Scale (SDS), State-Trait Anxiety Inventory (STAI), and Medical Outcome Short Form 36 Health Survey (SF-36). The proportion of AR in the last AT session in the AT group (9/11, 81.8%) was significantly higher than that in the controls (3/10, 30.0%, Chi-square test, p = 0.048). Two subscales of the SF-36, i.e., social functioning and bodily pain, were significantly improved in the AT group (p < 0.05) as compared to the control group. Role emotional (p = 0.051) and general health (p = 0.068) showed a tendency for improvement in the AT group. AT may be useful in the treatment of IBS by enhancing self-control.","Shinozaki, M; Kanazawa, M; Kano, M; Endo, Y; Nakaya, N; Hongo, M; Fukudo, S",2010.0,10.1007/s10484-009-9125-y,0,0,
3830,"The impact of a lay counselor led collaborative care intervention for common mental disorders in public and private primary care: a qualitative evaluation nested in the MANAS trial in Goa, India.","The MANAS trial evaluated the effectiveness of a lay counselor led collaborative stepped care intervention for Common Mental Disorders (CMD) in public and private sector primary care settings in Goa, India. This paper describes the qualitative findings of the experience of the intervention and its impact on health and psychosocial outcomes. Twenty four primary care facilities (12 public and private each) were randomized to provide either collaborative stepped care (CSC) or enhanced usual care (EUC) to adults who screen positive for CMDs. Participants were sampled purposively based on two criteria: gender and, in the CSC arm, adherence with the intervention. The qualitative study component involved two semi-structured interviews with participants of both arms (N = 115); the first interview within 2 months of recruitment and the second 6-8 months after recruitment. Data were collected between September 2007 and November 2009. More participants in the CSC than EUC arm reported relief from symptoms and an improvement in social functioning and positive impact on work and activities of daily life. The CSC participants attributed their improvement both to medication received from the doctors and the strategies suggested by the lay Health Counselors (HC). However, two key differences were observed in the results for the two types of facilities. First, the CSC participants in the public sector clinics were more likely to consider the HCs to be an important component of providing care who served as a link between patient and the doctor, provided them skills on stress management and helped in adherence to medication. Second, in the private sector, doctors performed roles similar to those of the HCs and participants in both arms placed much faith in the doctor who acted as a confidante and was perceived to understand the participant's health and context intimately. Lay counselors working in a CSC model have a positive effect on symptomatic relief, social functioning and satisfaction with care in patients with CMD attending primary care clinics although the impact, compared with usual care, is greater in the public sector.",Shinde S.; Andrew G.; Bangash O.; Cohen A.; Kirkwood B.; Patel V.,2013.0,10.1016/j.socscimed.2013.04.002,0,0,
3831,Altered neural circuit for working memory before and after symptom provocation in patients with obsessive-compulsive disorder.,"The authors compared the neural circuits recruited for working memory (WM) in obsessive-compulsive disorder (OCD) patients both at a neutral state and at a symptom provoked state. Twelve OCD patients, and 12 age-, and sex-matched healthy subjects underwent [(15)O]H(2)O positron emission tomography (PET) scanning, while performing WM task. In the patients, the tasks were performed both in the neutral and in the symptom provoked states. In the OCD patients, the right caudate and the right superior parietal cortex (rSPC) displayed activations for WM at the neutral state, while the right cingulate cortex and rSPC displayed activations for WM at the symptom provoked state. Path analysis revealed that the activity of the caudate and orbitofrontal cortex was altered according to the interaction between WM and symptom provocation. The interaction between symptom provocation and WM occurring in the fronto-striatal system may hold the key to the neurobiology of OCD.",Shin YW.; Kwon JS.; Kim JJ.; Kang DH.; Youn T.; Kang KW.; Kang E.; Lee DS.; Lee MC.,2006.0,10.1111/j.1600-0447.2005.00709.x,0,0,
3832,Comparison of anxiety-related traits between early and late onset panic disorder,"Objectives: It has been suggested that there are some difference between early-versus late-onset panic disorders. Previous study reported that late-onset patients exhibited lesser severity of the disorder, greater comorbidity with dysthymia, and less family history of panic disorder [1]. There is some suggestion of a bimodal distribution in age of onset of panic attacks with a first peak in young adulthood and a second peak at age 55 to 59 years [2]. This observation of discontinuity in onset of panic attacks suggests that there may be a discrete group of subjects of late onset [3]. However, it is still unclear that this distinction of early-versus late-onset panic disorder is valid clinical classification. The aim of this study is to investigate possible difference of anxiety-related traits between early and late onset panic disorder. Therefore, we have compared anxiety-related traits between these two groups after controlling age difference between them. Methods: Subjects were evaluated by trained psychiatrist with the aid of the MINI neuropsychiatric interview. Patients with current panic disorder according to DSM-IV criteria were invited to participate in this study. Written informed consents were obtained form 240 patients with panic disorder. The patients were requested to complete the Anxiety Sensitivity Index (ASI) and the Trait form of the State-Trait Anxiety Inventory (STAI-T). We divided the patients into 2 groups based on their age at the onset of their panic attacks in accordance with previous report [3]: (a) early onset (n = 202), when they were up to 50 years old at the onset, and (b) late onset (n = 38), when they were older than 50 years at the onset of their symptoms. For the analysis of continuous and categorical data, differences between groups were assessed by independent t test and chi-square test, respectively. Analysis of covariance was used for the comparison of mean score of scales between groups of subjects for adjusting age difference. Results: The mean age of our sample was 41.14±11.04 years. Early onset subjects were significantly younger than their late-onset counterparts (early onset = 38.10±8.88, late onset = 57.28±6.35, t = 13.986, P < 0.001). Statistical difference in total score of ASI (early onset = 39.68±14.48, late onset = 34.03±17.02, t = 2.147, P = 0.033) and psychological subscale of ASI (early onset = 10.94±5.49, late onset = 8.89±5.93, t = 2.056, P = 0.041) between two groups of panic disorder which was observed by independent t-test was insignificant (ASI total: F = 0.175, P = 0.676, psychological ASI: F = 0.116, P = 0.734) after controlling the age difference between these two groups by ANCOVA. Conclusions: Comparison of anxiety-related traits did not show any difference between early and late onset subgroups of panic disorder after controlling age difference between two groups. These results suggest that early and late onset distinction of panic disorder may be a relatively arbitrary cut in same disorder. However, subjects in this study have high comorbidity with other axis I disorders. This can be a major weakness of this study. Further inverstigations with a larger sample size and more controlled study design are warranted to elucidate our findings.",Shin Y.C.; Lim S.W.; Choi S.W.; Wang I.K.; Oh K.S.,2008.0,,0,0,
3833,Associations of psychotherapy dose and SSRI or SNRI refills with mental health outcomes among veterans with PTSD.,"Objective: This study assessed associations between psychotherapy and pharmacotherapy for posttraumatic stress disorder (PTSD) and longitudinal changes in PTSD, depression, and mental health functioning among U.S. veterans diagnosed as having PTSD. Methods: Information about self-reported symptoms experienced from .5 to over three years was collected from 482 veterans diagnosed as having PTSD. Administrative data from the U.S. Department of Veterans Affairs (VA) were used to calculate initiation of a course of selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs), days of medication coverage, and number of PTSD-related psychotherapy visits during the year after a baseline survey. Hierarchical linear modeling was used to analyze the effects of psychotherapy dose, initiation of an SSRI or SNRI, and medication coverage on symptoms over one year. Results: In the year after baseline, over half of the sample (55%) received no psychotherapy for PTSD, and only 8% met the VA's proposed standard of eight PTSD-related sessions within 14 weeks. Nearly half of the participants (47%) were prescribed an SSRI or SNRI and 37% completed a 90-day trial in the year after baseline. Participants' symptoms improved slightly over time. Participants who received eight or more psychotherapy sessions in 14 weeks, completed a 90-day course of SSRIs or SNRIs, or had more days of medication coverage did not improve more than participants who received less treatment. Conclusions: These dose-of- care benchmarks were not related to symptom improvement, highlighting the importance of directly assessing the impact of particular treatments on patient outcomes rather than solely relying on process measures. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Shin, Hana J; Greenbaum, Mark A; Jain, Shaili; Rosen, Craig S; Chard, Eftekhari, Forbes, Fortney, Jain, Karve, Kehle, Lockwood, Lu, Mohamed, Pawloski, Radloff, Raudenbush, Rosen, Seal, Shiner, Spoont, Ware, Weiss",2014.0,,0,0,
3834,Insight in obsessive-compulsive disorder: a comparative study of insight measures in an Israeli clinical sample.,"Attempts to identify the characteristics of OCD patients with poor insight have not produced a coherent picture. This may be related to the wide variety of the available insight assessment tools. The study aimed to compare five principal measure for assessing insight in OCD and to investigate the relationships between insight and central demographic and clinical variables. Sixty outpatients diagnosed with OCD (36 men, 24 women) were assessed with the following insight measures: DSM-IV insight criterion, Over-Valued Ideas Scale (OVIS), Item 11 of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Brown Assessment of Beliefs Scale (BABS) and Beck Cognitive Insight Scale (BCIS). Correlation coefficients indicated high correspondence between all insight measures with the exception of the BCIS. At the same time, the relations of the various insight measures with demographic and clinical variables were distinctive and in some cases measure-specific. The most robust correlation was between insight and current medical treatment, so that medicated participants showed higher insight levels on most insight measures compared to non-medicated participants. Some insight measures were correlated with co-morbidity, onset age and gender. Insight levels did not correlate with OCD symptom severity. Limitations of this study include its cross-sectional design, modest sample size and an incomplete representation of the available insight measures. The diversity of measures used in previous studies cannot account for the inconsistent findings on the role of insight in OCD.",Shimshoni Y.; Reuven O.; Dar R.; Hermesh H.,2011.0,10.1016/j.jbtep.2011.02.011,0,0,
3835,Effects of anxiety disorder on impairment and recovery from stroke.,"The effect of anxiety disorder on recovery from impairment following stroke was examined in 142 patients with acute stroke who had follow-up evaluations. Anxiety disorder significantly interacted with depression to influence the severity and course of depression, outcome of activities of daily living, and social functioning. Anxiety disorder, however, did not affect cognitive impairment, which was influenced only by major depression. These data suggest that the existence of anxiety disorders plays an important role in the prognosis of patients with poststroke depression. These data also suggest that depression and anxiety disorder may have different mechanisms.",Shimoda K.; Robinson RG.,1998.0,10.1176/jnp.10.1.34,0,0,
3836,The impact of cognitive restructuring and mindfulness strategies on postevent processing and affect in social anxiety disorder.,"Postevent processing (PEP; reviewing a past social event in detail) is a key maintenance factor of social anxiety disorder (SAD). The current study examined the efficacy of a single session cognitive restructuring or mindfulness strategy on decreasing PEP and its associated effects, and investigated the cognitive processes involved. Fifty-six individuals with SAD completed a speech task to elicit PEP and were taught a cognitive restructuring, mindfulness, or control strategy to manage their negative thoughts. Participants in the cognitive restructuring and mindfulness conditions reported significantly reduced PEP and improved affect as compared to the control condition. There were no significant differences between the cognitive restructuring and mindfulness conditions. Participants in the cognitive restructuring condition reported decreased probability and cost biases. Regardless of study condition, decreases in cost biases and maladaptive beliefs significantly predicted reductions in PEP. Cognitive restructuring and mindfulness appear to be promising strategies to decrease PEP and improve affect.",Shikatani B.; Antony MM.; Kuo JR.; Cassin SE.,2014.0,10.1016/j.janxdis.2014.05.012,0,0,
3837,The Teasing Questionnaire - Revised: Measurement of childhood teasing in adults,"This study examined the reliability of the Teasing Questionnaire - Revised (TQ-R) and the relations between recalled childhood teasing and current psychological distress. Three hundred and three undergraduate college students were administered the TQ-R, Beck Depression Inventory-II, Brief Fear of Negative Evaluation Scale, Social Phobia and Anxiety Inventory, and UCLA Loneliness Scale. A sub-sample was administered the TQ-R two weeks later. Test-retest reliability of the TQ-R ranged from moderate to strong for the TQ-R scores. Internal consistency for the TQ-R scores ranged from acceptable to good. Intercorrelations among factors were moderate suggesting that the factors measure related but distinct teasing domains. The TQ-R Total Score and Appearance, Performance, and Social factors were related to later psychopathology with correlations of a moderate effect size. Implications of these findings and areas for future research are discussed. © 2004 Elsevier Inc. All rights reserved.",Strawser M.S.; Storch E.A.; Roberti J.W.,2005.0,10.1016/j.janxdis.2004.09.005,0,0,
3838,Social skills problems in neurotic outpatients. Social skills training with and without cognitive modification.,"Twenty-two ""socially dysfunctional"" outpatients had 12 1 1/2-hour sessions of social skills training either alone or combined with cognitive modification (each, n = 11). Two raters who were blind to the treatment regimen significantly differentiated the two treatments, as judged from audiotapes of treatment sessions. Measurement was by an independent assessor in a structured interview, by self-monitoring of several activities and of anxiety felt during them, and by self-rated questionnaires. In each treatment regimen, patients' conditions improved significantly and equally on reported behavioral and cognitive measures both during and after treatment, and at six-month follow-up. Outcome did not differ significantly between the two treatment conditions at any time on any measure. Patients reported increased levels of social activities and less anxiety during these, less isolation, better relations with their colleagues at work, less depression, and loss of many irrational social beliefs. During multiple baseline monitoring for up to nine weeks, no improvement occurred. Performance of each social task or ""target"" increased significantly after training was begun for it, and subjective anxiety decreased similarly during social performance. Untreated targets improved much less, and more slowly. Social skills training was followed by lasting and worthwhile improvement that was not enhanced by the addition of cognitive modification.",Stravynski A.; Marks I.; Yule W.,1982.0,,0,0,
3839,Preliminary investigation of web-camera delivered cognitive-behavioral therapy for youth with obsessive-compulsive disorder,"ER This study reports a waitlist controlled randomized trial of family-based cognitive-behavioral therapy delivered via web-camera (W-CBT) in children and adolescents with obsessive-compulsive disorder (OCD). Thirty-one primarily Caucasian youth with OCD (range=7-16years; 19 male) were randomly assigned to W-CBT or a Waitlist control. Assessments were conducted immediately before and after treatment, and at 3-month follow-up (for W-CBT arm only). Primary outcomes included the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), clinical global improvement rates, and remission status. When controlling for baseline group differences, W-CBT was superior to the Waitlist control on all primary outcome measures with large effect sizes (Cohen's d?1.36). Thirteen of 16 youth (81%) in the W-CBT arm were treatment responders, versus only 2/15 (13%) youth in the Waitlist arm. Similarly, 9/16 (56%) individuals in the W-CBT group met remission criteria, versus 2/15 (13%) individuals in the Waitlist control. Gains were generally maintained in a naturalistic 3-month follow-up for those randomized to W-CBT. This preliminary study suggests that W-CBT may be helpful in reducing obsessive-compulsive symptoms in youth with OCD. Given considerable access issues, such findings hold considerable promise for treatment dissemination.","Storch, E A; Caporino, N E; Morgan, J R; Lewin, A B; Rojas, A; Brauer, L; Larson, M J; Murphy, T K",2011.0,10.1016/j.psychres.2011.05.047,0,0,
3840,"Randomized, placebo-controlled trial of cognitive-behavioral therapy alone or combined with sertraline in the treatment of pediatric obsessive-compulsive disorder","ER BACKGROUND: To examine the efficacy of sequential sertraline and cognitive-behavioral therapy (CBT) treatment relative to CBT with pill placebo over 18 weeks in children and adolescents with obsessive-compulsive disorder (OCD).METHODS: Forty-seven children and adolescents with OCD (Range = 7-17 years) were randomized to 18-weeks of treatment in one of three arms: 1) sertraline at standard dosing + CBT (RegSert + CBT); 2) sertraline titrated slowly but achieving at least 8 weeks on the maximally tolerated daily dose + CBT (SloSert + CBT); or 3) pill placebo + CBT (PBO + CBT). Assessments were conducted at screening, baseline, weeks 1-9, 13, and 17, and post-treatment. Raters and clinicians were blinded to sertraline (but not CBT) randomization status. Primary outcomes included the Children's Yale-Brown Obsessive-Compulsive Scale, and response and remission status. Secondary outcomes included the Child Obsessive Compulsive Impact Scale-Parent/Child, Children's Depression Rating Scale-Revised, Multidimensional Anxiety Scale for Children, and Clinical-Global Impressions-Severity.RESULTS: All groups exhibited large within-group effects across outcomes. There was no group by time interaction across all outcomes suggesting that group changes over time were comparable.CONCLUSIONS: Among youth with OCD, there was no evidence that sequentially provided sertraline with CBT differed from those receiving placebo with CBT.CLINICALTRIALSGOV IDENTIFIER: NCT00382291.","Storch, E A; Bussing, R; Small, B J; Geffken, G R; McNamara, J P; Rahman, O; Lewin, A B; Garvan, C S; Goodman, W K; Murphy, T K",2013.0,10.1016/j.brat.2013.09.007,0,0,
3841,"Effectiveness of a stepped care intervention for anxiety and depression in people with diabetes, asthma or COPD in primary care: A randomized controlled trial.","Depression and anxiety are common in people with a chronic somatic disease. Although guidelines recommend stepped care, the effectiveness of this approach has not been evaluated in people with diabetes, asthma, or COPD in primary care. 3559 People were sent screening questionnaires (41% response). Of 286 persons with anxiety and/or depression (Generalized Anxiety Disorder questionnaire, GAD-7, cut-off ≥ 8 and/or Patient Health Questionnaire, PHQ-9, cut-off ≥ 7), 46 were randomized into the intervention (stepped care and monitoring of symptoms; n = 23) or control (usual care) group (n = 23). Main outcomes were symptoms of anxiety and depression after the 12-months intervention and six months post intervention. Analysis of covariance was first adjusted for condition and baseline GAD-7/PHQ-9 scores and additionally for age, sex and education. The intervention group had a significantly lower level of anxiety symptoms at the end of the program (GAD-7 6 ± 6 vs. 9 ± 6; Cohen's d = 0.61). This effect was still present six months post intervention. The effect on depression was statistically significant in the first model (PHQ-9 6 ± 4 vs. 9 ± 6; p = 0.035), but not in the fully adjusted model (p = 0.099), despite a large effect size (d = 0.63). At six months post intervention there was no statistically significant difference in symptoms of depression between the two groups although the difference in symptoms was still clinically significant (Cohen's d = 0.61). Many people were screened, but relatively few participated in the randomized controlled trial. Stepped care with monitoring resulted in a lower level of symptoms of anxiety and depression in people with a chronic condition.",Stoop CH.; Nefs G.; Pommer AM.; Pop VJ.; Pouwer F.,2015.0,10.1016/j.jad.2015.05.063,0,0,
3842,"Effectiveness of a stepped care intervention for anxiety and depression in people with diabetes, asthma or COPD in primary care: A randomized controlled trial.","Background: Depression and anxiety are common in people with a chronic somatic disease. Although guidelines recommend stepped care, the effectiveness of this approach has not been evaluated in people with diabetes, asthma, or COPD in primary care. Methods: 3559 People were sent screening questionnaires (41% response). Of 286 persons with anxiety and/or depression (Generalized Anxiety Disorder questionnaire, GAD-7, cut-off >= 8 and/or Patient Health Questionnaire, PHQ-9, cut-off >= 7), 46 were randomized into the intervention (stepped care and monitoring of symptoms; n = 23) or control (usual care) group (n = 23). Main outcomes were symptoms of anxiety and depression after the 12-months intervention and six months post intervention. Analysis of covariance was first adjusted for condition and baseline GAD-7/PHQ-9 scores and additionally for age, sex and education. Results: The intervention group had a significantly lower level of anxiety symptoms at the end of the program (GAD-7 6 +/- 6 vs. 9 +/- 6; Cohen's d = 0.61). This effect was still present six months post intervention. The effect on depression was statistically significant in the first model (PHQ-9 6 +/- 4 vs. 9 +/- 6; p = 0.035), but not in the fully adjusted model (p = 0.099), despite a large effect size (d = 0.63). At six months post intervention there was no statistically significant difference in symptoms of depression between the two groups although the difference in symptoms was still clinically significant (Cohen's d = 0.61). Limitations: Many people were screened, but relatively few participated in the randomized controlled trial. Conclusions: Stepped care with monitoring resulted in a lower level of symptoms of anxiety and depression in people with a chronic condition. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stoop, C. H; Nefs, G; Pommer, A. M; Pop, V. J. M; Pouwer, F; Ali, Baas, Barbui, Bower, Cohen, Cuijpers, Ell, Fortney, Gilbody, Hardeveld, Joling, Katon, Katon, Katon, Katon, Kroenke, Kroenke, Lamers, Lavoie, Lin, Morgan, Muntingh, Nefs, Perk, Piek, Pommer, Pouwer, Pouwer, Pouwer, Rollman, Seekles, Smith, Spijker, Stoop, Tylee, Van Balkom, Van der Weele, Van Dooren, Van Montfort, Van Vliet, Van't Veer-Tazelaar, Vestbo, Xu, Yohannes, Yonkers",2015.0,,0,0,
3843,Liquid courage: alcohol fosters risky sexual decision-making in individuals with sexual fears,"ER The interaction of sexual fear and acute alcohol intoxication on the likelihood of risky sexual behavior was explored. Participants (Ps; N = 115) completed a measure of sexual fears and were randomly assigned to no-, low-, or high-dose alcohol conditions. Ps then read an eroticized vignette, where they were the protagonist, and rated their likelihood of sex with a new partner when no condom was available. Controlling for gender and social desirability, compared to sober Ps, highly intoxicated Ps indicated that they were more likely to engage in risky sexual behaviors. Sexual fear was modestly negatively related to risky sex likelihood among sober or mildly intoxicated Ps but strongly positively related to risky sex likelihood among highly intoxicated Ps. Findings underscore the notion that alcohol affects different types of individuals differently and indicate that alcohol may foster sexual risk-taking, in part, by attenuating or counteracting fear or anxiety.","Stoner, S A; George, W H; Peters, L M; Norris, J",2007.0,10.1007/s10461-006-9137-z,0,0,
3844,Effects of sensory-enhanced yoga on symptoms of combat stress in deployed military personnel.,"We examined the effects of sensory-enhanced hatha yoga on symptoms of combat stress in deployed military personnel, compared their anxiety and sensory processing with that of stateside civilians, and identified any correlations between the State-Trait Anxiety Inventory scales and the Adolescent/Adult Sensory Profile quadrants. Seventy military personnel who were deployed to Iraq participated in a randomized controlled trial. Thirty-five received 3 wk (‚â•9 sessions) of sensory-enhanced hatha yoga, and 35 did not receive any form of yoga. Sensory-enhanced hatha yoga was effective in reducing state and trait anxiety, despite normal pretest scores. Treatment participants showed significantly greater improvement than control participants on 16 of 18 mental health and quality-of-life factors. We found positive correlations between all test measures except sensory seeking. Sensory seeking was negatively correlated with all measures except low registration, which was insignificant. The results support using sensory-enhanced hatha yoga for proactive combat stress management.",Stoller CC.; Greuel JH.; Cimini LS.; Fowler MS.; Koomar JA.,,,0,0,
3845,Effects of sensory-enhanced yoga on symptoms of combat stress in deployed military personnel,"ER OBJECTIVE: We examined the effects of sensory-enhanced hatha yoga on symptoms of combat stress in deployed military personnel, compared their anxiety and sensory processing with that of stateside civilians, and identified any correlations between the State-Trait Anxiety Inventory scales and the Adolescent/Adult Sensory Profile quadrants.METHOD: Seventy military personnel who were deployed to Iraq participated in a randomized controlled trial. Thirty-five received 3 wk (?9 sessions) of sensory-enhanced hatha yoga, and 35 did not receive any form of yoga.RESULTS: Sensory-enhanced hatha yoga was effective in reducing state and trait anxiety, despite normal pretest scores. Treatment participants showed significantly greater improvement than control participants on 16 of 18 mental health and quality-of-life factors. We found positive correlations between all test measures except sensory seeking. Sensory seeking was negatively correlated with all measures except low registration, which was insignificant.CONCLUSION: The results support using sensory-enhanced hatha yoga for proactive combat stress management.","Stoller, C C; Greuel, J H; Cimini, L S; Fowler, M S; Koomar, J A",2012.0,,0,0,3844
3846,Cognitive bias in symptomatic and recovered agoraphobics,"Symptomatic agoraphobics, recovered agoraphobics, and normal control subjects completed a series of sentence stems that had either ambiguous or unambiguous meanings, and had either a potentially threatening or a nonthreatening connotation. The written completions made by subjects to these stems were classified as indicating either a biased (i.e. threat-related) or unbiased interpretation of the meaning of the stem, and if a biased interpretation was made, whether the subject indicated efforts at adaptive coping with the perceived threat. Results indicated that symptomatic agoraphobics exhibited strong biases for interpreting information as threatening, relative to normal control subjects. Moreover, recovered agoraphobics resembled symptomatic agoraphobics more than normal control subjects, thus indicating that cognitive biases may persist following cessation of panic attacks and reductions in avoidance behavior. However, recovered agoraphobics also exhibited tendencies to cope adaptively with perceived threats whereas symptomatic agoraphobics did not.",Stoler L.S.; McNally R.J.,1991.0,10.1016/0005-7967(91)90004-M,0,0,
3847,"Enhancing treatment gains in a school-based intervention for children of divorce through skill training, parental involvement, and transfer procedures","ER The school-based Children's Support Group procedure teaches skills to cope with divorce-related events and provides strategies for mastering disrupted developmental tasks. Ss were 103 3rd-through 5th-grade children of separated or divorced parents who were assigned to 1 of 3 treatment groups: support; support and skill building; support, skill building, transfer, and parent training procedures; or no-treatment control. Twenty-six children from intact homes served as nonstressed controls. The two skill-building conditions yielded durable improvements in adjustive behaviors in the home. Transfer components yielded additional improvements in affect, but the absence of substantial increments in benefits suggests the need for a closer look at the format and expectations of the transfer vehicle. The benefits of the support-alone condition were experienced most by children who entered the intervention with significant problems, with the greatest reductions in clinical symptomatology at follow-up being found in this group.","Stolberg, A L; Mahler, J",1994.0,,0,0,
3848,Engaging in imagery versus verbal processing of worry: Impact on negative intrusions in high worriers.,"Chronic, excessive, and uncontrollable worry is the defining characteristic of generalised anxiety disorder. Worry largely consists of verbal thought and it has been postulated that this predominance of verbal thought in worry may contribute to its perseveration. In an investigation of this issue, high worriers were trained to engage in either imagery or verbal processing. Mentation was sampled before and after a five-minute period of worry during which participants engaged in either imagery of the worry topic or verbal processing of the worry topic. Verbal worry resulted in a significant increase in negative intrusions, consistent with previous research. Furthermore, imagery was associated with a decrease in negative intrusions. The results support the theory that the predominantly verbal nature of worry may be responsible for the uncontrollability and maintenance of worry.",Stokes C.; Hirsch CR.,2010.0,10.1016/j.brat.2009.12.011,0,0,
3849,Investigating the 'bath salt' panic: the rarity of synthetic cathinone use among students in the United States,"ER INTRODUCTION AND AIMS: Until recently, synthetic cathinones marketed as 'bath salts' were legally sold at convenience stores and online in the USA. Media reports initiated concerns of a growing 'bath salt' epidemic. Despite media attention and the recent legal action banning synthetic cathinones, little is known about its prevalence or users.DESIGN AND METHODS: A self-report survey was administered to 2349 students in 40 randomly selected courses at a large university in the Southeastern United States. The resulting sample was 51.6% female, 68.9% white, 24.4% black, 2.8% Hispanic and 4.0% other races, with a mean age of 20.06 years and median family income of $75?000-99?999.RESULTS: Only 25 (1.07%) of the students reported using synthetic cathinones at least once. Synthetic cathinone use was found to be more common among men (1.68% vs. 0.50% of women, P?=?0.005), Hispanics (4.7%) and Native Americans (4.3% vs. 0.89% of whites and 0.72% of blacks, P?=?0.002), and student athletes (4.0% vs. 0.90% of non-athletes, P?=?0.001), but in each of these groups, synthetic cathinones were used more rarely than marijuana (58.14%, P?<?0.001), cocaine (9.08%, P?<?0.001), Salvia divinorum (7.89%, P?<?0.001), synthetic cannabinoids (14.28%, P?<?0.001), methamphetamines (1.92%, P?=?0.002), 3,4-methylenedioxy-N-methylamphetamine (MDMA) (12.54%, P?<?0.001) and several other drugs and pharmaceuticals.DISCUSSION AND CONCLUSIONS: 'Bath salts' have received a great deal of media attention in the USA, yet the prevalence of synthetic cathinone use among our sample was extremely rare. We suggest that the media attention focusing on synthetic cathinone use as a growing epidemic may be largely misplaced.","Stogner, J M; Miller, B L",2013.0,10.1111/dar.12055,0,0,
3850,Extensive practice does not eliminate human switch costs,"Numerous human task-switching studies have shown that decision making that follows a task switch is slower and less accurate than that which follows a task repetition. Stoet and Snyder (2003a) tested humans and rhesus monkeys on a task-switching paradigm, but found, surprisingly, no switch costs in the monkeys. We hypothesized that the exceptional monkey behavior may have been due to the more extensive practice the monkeys received in comparison with human subjects. In the present study, we tested the hypothesis that extensive practice can abolish switch costs in humans. Four human subjects each performed 23,000 trials in a task-switching paradigm. We found that this amount of practice does not abolish switch costs. Copyright 2007 Psychonomic Society, Inc.",Stoet G.; Snyder L.H.,2007.0,,0,0,
3851,[Continuous cryotherapy--progress in therapy of post-traumatic and postoperative edema].,"In patients with foot and ankle trauma, surgery and postoperative mobilization are often delayed owing to swelling. The aim of this study was to assess whether continuous cryotherapy is better than standard therapy with intermittently applied cool packs. For continuous cryotherapy the Polar Care Model 500 (BREG) was used. From May to November 1993, a series of 40 patient (22 ankle fractures, 13 ruptured lateral ankle ligaments, 4 calcaneus fractures, 1 metatarsal fracture) were prospectively randomized to continuous or intermittent cryotherapy. After 24 h treatment the patients with continuous cryotherapy showed an average reduction of 34% in swelling around ankle, midfoot and forefoot. With intermittent cryotherapy the swelling was reduced by 18%. After 4 days of treatment in the postoperative period the swelling subsided by 43% with intermittent cryotherapy, as against 69% with continuous cryotherapy. Continuous cryotherapy proved to be highly effective in treating posttraumatic and postoperative edema. It therefore seems preferable to the therapy with cool packs regarded as standard hitherto.",Stöckle U.; Hoffmann R.; Südkamp NP.; Haas N.,1995.0,,0,0,
3852,Continuous cryotherapy--progress in therapy of post-traumatic and postoperative edema,"ER In patients with foot and ankle trauma, surgery and postoperative mobilization are often delayed owing to swelling. The aim of this study was to assess whether continuous cryotherapy is better than standard therapy with intermittently applied cool packs. For continuous cryotherapy the Polar Care Model 500 (BREG) was used. From May to November 1993, a series of 40 patient (22 ankle fractures, 13 ruptured lateral ankle ligaments, 4 calcaneus fractures, 1 metatarsal fracture) were prospectively randomized to continuous or intermittent cryotherapy. After 24 h treatment the patients with continuous cryotherapy showed an average reduction of 34% in swelling around ankle, midfoot and forefoot. With intermittent cryotherapy the swelling was reduced by 18%. After 4 days of treatment in the postoperative period the swelling subsided by 43% with intermittent cryotherapy, as against 69% with continuous cryotherapy. Continuous cryotherapy proved to be highly effective in treating posttraumatic and postoperative edema. It therefore seems preferable to the therapy with cool packs regarded as standard hitherto.","Stöckle, U; Hoffmann, R; Südkamp, N P; Haas, N",1995.0,,0,0,3851
3853,Fastest reduction of posttraumatic edema: continuous cryotherapy or intermittent impulse compression?,"Sixty patients with foot or ankle trauma were randomized and treated in three groups. In intermittent impulse compression, an air pad under the foot was inflated every 20 seconds, thus activating the venous foot pump. In continuous cryotherapy, ice water circulates between the ice box and the cold pad. The ice water was changed once per day. In standard therapy, the injured extremity was treated with cool packs, which were changed 4 times per day. Beginning at admission, every 24 hours the circumference was measured around the ankle, midfoot, and forefoot. After 24 hours of treatment, there was a 47% reduction in swelling with the A-V impulse System, 33% with continuous cryotherapy, and 17% with cool packs. After 4 days of postoperative treatment, the A-V impulse System reduced the swelling by 74% versus 70% with continuous cryotherapy and 45% with cool packs. Both new methods are preferable to cool packs. Because of the better preoperative results, the A-V impulse System proved to be the most effective device.",Stöckle U.; Hoffmann R.; Schütz M.; von Fournier C.; Südkamp NP.; Haas N.,1997.0,10.1177/107110079701800711,0,0,
3854,[Intermittent impulse compression. An alternative in therapy of post-traumatic and postoperative edema].,"In patients with foot and ankle trauma, surgery and postoperative mobilization are often delayed because of swelling. The aim of this study was to assess if intermittent impulse compression of the foot is better than the standard therapy of applying cool packs at intervals. For intermittent impulse compression the AV impulse device was used (Novamedix Inc.). From May to November 1993, 40 patients (20 ankle fractures, 8 ruptured ligaments, 6 calcaneal fractures, 4 distal tibial fractures, 1 talus fracture, 1 subtalar dislocation) were prospectively assigned at random to the two groups and treated. After 24 h of treatment, the patients with intermittent impulse compression of the foot showed an average reduction of swelling of 47% around the ankle, midfoot and forefoot. With cryotherapy it was 17%. After 4 days of treatment in the postoperative course the swelling subsided at a rate of 74% with impulse compression and 45% with cryotherapy. Intermittent impulse compression of the foot proved to be a highly effective method of treating post-traumatic and postoperative edema. It seems preferable to the standard therapy using cold packs.",Stöckle U.; Hoffmann R.; Raschke M.; Südkamp NP.; Haas N.,1996.0,,0,0,
3855,Intermittent impulse compression. An alternative in therapy of post-traumatic and postoperative edema,"ER In patients with foot and ankle trauma, surgery and postoperative mobilization are often delayed because of swelling. The aim of this study was to assess if intermittent impulse compression of the foot is better than the standard therapy of applying cool packs at intervals. For intermittent impulse compression the AV impulse device was used (Novamedix Inc.). From May to November 1993, 40 patients (20 ankle fractures, 8 ruptured ligaments, 6 calcaneal fractures, 4 distal tibial fractures, 1 talus fracture, 1 subtalar dislocation) were prospectively assigned at random to the two groups and treated. After 24 h of treatment, the patients with intermittent impulse compression of the foot showed an average reduction of swelling of 47% around the ankle, midfoot and forefoot. With cryotherapy it was 17%. After 4 days of treatment in the postoperative course the swelling subsided at a rate of 74% with impulse compression and 45% with cryotherapy. Intermittent impulse compression of the foot proved to be a highly effective method of treating post-traumatic and postoperative edema. It seems preferable to the standard therapy using cold packs.","Stöckle, U; Hoffmann, R; Raschke, M; Südkamp, N P; Haas, N",1996.0,,0,0,3854
3856,Weekly assessment of worry: An adaptation of the Penn State Worry Questionnaire for monitoring changes during treatment,"An adaptation of the Penn State Worry Questionnaire (PSWQ) for weekly assessment of worry was evaluated in a brief treatment study. Cognitive restructuring techniques were taught to 28 nonclinical high-worriers, 14 of whom served as a control group in a lagged waiting-list design. Results showed that the Penn State Worry Questionnaire-Past Week (PSWQ-PW) was highly reliable and substantially valid in the assessment of both (a) weekly status of worry and (b) treatment-related changes in worry: average Cronbach's alpha was 0.91; average convergent correlation with a past-week adaptation of the Worry Domains Questionnaire was 0.63 and pre-post improvement on PSWQ-PW showed a 0.7.1 correlation with the Questionnaire of Changes in Experiencing and Behavior. It is concluded that the PSWQ-PW is a useful instrument for monitoring pathological worry in experimental and applied settings.",Stöber J.; Bittencourt J.,1998.0,10.1016/S0005-7967(98)00031-X,0,0,
3857,The applicability of randomized controlled trials of psychosocial treatments for PTSD to a veteran population.,"The extent to which the results of randomized controlled trials can be expected to generalize to clinical populations has been the subject of much debate. To examine this issue among a population of individuals diagnosed with posttraumatic stress disorder (PTSD), the clinical characteristics of Veterans Affairs (VA) patients with PTSD were compared to the eligibility criteria for clinical trials of psychosocial treatments for PTSD. Administrative data for 239,668 patients who received a diagnosis of PTSD within the VA healthcare system during the 2003 fiscal year were compared with inclusion and exclusion criteria of 31 clinical trials for PTSD. Based on available data, all patients appeared to be eligible for at least one study, and half (50%) were eligible for between 16 and 21 (50% or more) of the 31 studies examined. The studies for which the most veterans with PTSD would have been eligible targeted combat-related trauma or did not specify type of trauma in their eligibility criteria. Veterans who exhibited psychotic symptoms (3% of the sample) were ineligible for most, but not all, of the studies. However, most veterans with comorbid Axis I conditions, such as depression, anxiety disorders, and substance use disorders, were eligible for multiple studies. These findings, which indicate that the existing literature on the efficacy of psychosocial treatment may inform the treatment of the majority of veterans who present with PTSD, have applications for the design of future clinical trials and for consultation of the literature regarding appropriate treatments for veterans with PTSD.",Stirman SW.,2008.0,10.1097/01.pra.0000327309.58411.e0,0,0,
3858,Yohimbine-induced withdrawal and anxiety symptoms in opioid-dependent patients.,"Alteration in noradrenergic regulation as well as alteration in the hypothalamic-pituitary-adrenal (HPA) axis have been associated with opioid dependence and acute abstinence symptoms. This double-blind, placebo-controlled study evaluated subjective, physiologic, and biochemical responses to yohimbine in 8 patients (mean age 38 yrs old) receiving methadone and compared results to those from a pool of 9 healthy volunteers. All Ss were compared for panic anxiety symptom scale (PASS) scores, systolic and diastolic blood pressure, heart rate, plasma 3-methoxy-4 hydroxyphenethyleneglycol (MHPG), and cortisol. Yohimbine elicited objective and subjective opioid withdrawal and elevated craving for opioid drugs in methadone patients. Significant yohimbine effects were seen across the combined subject group for PASS, physiologic measures, MHPG, and cortisol. Methadone patients had lower baseline MHPG levels. Methadone group interactions with yohimbine were seen for systolic blood pressure and cortisol levels. Methadone-maintained patients are sensitive to the postsynaptic effects of noradrenergic-facilitating medications, experiencing greater physiologic and psychological symptoms, including an increase in craving. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stine, Susan M; Southwick, Steven M; Petrakis, Ismene L; Kosten, Thomas R; Charney, Dennis S; Krystal, John H; Aghajanian, Arndt, Berger, Beuger, Bird, Charney, Charney, Childress, Cushman, Dekirmenjian, Gawin, Gawin, Ghodse, Gold, Gold, Gold, Grabowski, Hamburg, Hameedi, Himmelsbach, Judd, Kennedy, Kessler, Korf, Kosten, Kreek, Kreek, Kreek, Kreek, Kreek, Krystal, Krystal, Krystal, Krystal, Lannon, Lasagna, Llorens, Maany, Maas, Margolin, Martin, Morgan, Naber, Nestler, O'Brien, Peachey, Pepper, Peroutka, Regier, Renault, Rosen, Rosen, Rounsaville, Satel, Southwick, Spitzer, Stine, Stine, Taylor, van Oene, Volavka, Volavka, Washton, Washton, Weiss",2002.0,,0,0,
3859,Verbal exchange structure of brief psychodynamic-interpersonal and cognitive-behavioral psychotherapy.,"A verbal exchange is a set of 2 people's co-occurring speech-act categories that accomplish some subtask within an interpersonal encounter. Factor analysis of verbal response mode (speech act) frequencies in 1,630 segments (each approximately 10 to 12 min) drawn from the brief psychodynamic-interpersonal or cognitive-behavioral treatment of 39 mainly depressed clients identified 6 exchanges in each treatment--4 that were the same in both treatments (Revealing, Storytelling, Explaining, and Inquiring) and 2 that distinguished each treatment (Exploring and Interpreting in psychodynamic-interpersonal treatment; Prescribing and Reframing in cognitive-behavioral treatment). The exchanges showed distinctive temporal patterns across segments of sessions and across sessions of each time-limited treatment. The verbal exchange is a midsize concept that links atomistic verbal codes with clinical or theoretical concepts.",Stiles WB.; Shapiro DA.,1995.0,,0,0,
3860,Comorbid anxiety as a differential treatment predictor for telephone versus face-to-face administered cognitive behavioral therapy for depression.,"The present study examines the role of comorbid anxiety on depression outcomes for those receiving cognitive behavioral therapy (CBT) for depression by telephone (T-CBT) or face-to-face (FtF-CBT). Three hundred twenty-five participants were randomized to T-CBT or FtF-CBT. Comorbid anxiety was measured using the Mini International Neuropsychiatric Interview and Generalized Anxiety Disorder 7. Depression was measured using the Hamilton Rating Scale for Depression and Patient Health Questionnaire 9. A hierarchical model including the two-way interaction of treatment assignment and anxiety status indicated a significant effect for all outcome variables (Ps < .05). Post hoc t tests indicated T-CBT participants with comorbid anxiety disorders had significantly higher symptom severity over time compared to their T-CBT counterparts without anxiety (Ps < .001) and FtF-CBT counterparts with comorbid anxiety (Ps < .003). There were no significant differences in outcomes between those with and without comorbid anxiety disorders receiving FtF-CBT, or between T-CBT and FtF-CBT among those without comorbid anxiety disorders. The findings indicate that the presence of baseline anxiety impacts the overall effect of T-CBT for the treatment of depression.",Stiles-Shields C.; Kwasny MJ.; Cai X.; Mohr DC.,2014.0,10.1002/da.22323,0,0,
3861,Parent characteristics and conceptualizations associated with the emergence of infant colic,"The goal of the present study was to examine parental characteristics associated with the emergence of infant colic using a prospective longitudinal study. When infants were 2 weeks of age, parent measures of personality, marital satisfaction, parenting stress, and social support were obtained. In addition, parents were asked about their definition of colic. When infants were 6 weeks of age, parents completed a 4 day, 24 hour cry diary. Parents also completed a stress questionnaire. Based on the fussing/crying data derived from the diaries, 22 of the 128 infants were identified as having colic. Results showed colic infants to have distinctive crying and fussing patterns. Differences in parent conceptualizations of colic were also identified for colic and non-colic families. Results indicated that parental variables, particularly parenting stress and marital satisfaction, may have contributed to the parents' report of excessive crying and fussing.",Stifter C.A.; Bono M.; Spinrad T.,2003.0,10.1080/02646830310001622123,0,0,
3862,Subjective findings in emotionally stable and labile subjects following oral application of flupenthixol in small doses,"ER The mood-changing effects of flupentixol (Fluanxol 0.5 mg) were evaluated in a double-blind study with 107 healthy male subjects. Experimental factors were dosage (0, 1 and 2 mg flupentixol/day), time of measurement (before, during, and after 4 days of treatment), and the trait variable ""neuroticism"" (high vs. low score on a questionnaire scale). Drug effects were measured by means of rating scales and symptom checklists. Statistical analyses revealed that state anxiety and bodily symptoms associated with depressive states were diminished by flupentixol. Moreover, emotionally labile subjects reported an impairment of vigilance under drug treatment. Placebo effects proved to be more substantiated in the group of emotionally stabile subjects than in the group of emotionally labile subjects.","Stieglitz, R D; Rösler, F; Manzey, D",1986.0,,0,0,
3863,Validity of an illness severity measure for headache in a population sample of migraine sufferers.,"The headache impact questionnaire (HImQ) is used to measure pain and activity limitations from headache over a 3-month recall period. In a prior study, the test-retest reliability of the eight-item HImQ score was found to be relatively high (0.86). In the current study, we examined the validity of the eight-item HImQ by comparing the overall score and individual items to equivalent measures from a 90-day diary. Pain and activity limitations due to headache were assessed in a population-based sample of 132 migraine headache sufferers enrolled in a 90-day daily diary study who completed the HImQ at the end of the study. The HImQ score was derived from four frequency-based questions (i.e. number of headaches, missed days of work, missed days of chores, or missed days of non-work activity) and four summary measures of average experience across headaches (i.e. average pain intensity, and average reduced effectiveness when having a headache at work, during household chores, and in non-work activity). Diary based measures were used as the gold standard in evaluating the HImQ score. Mean and median values of frequency-based HImQ items (e.g. number of headaches) were similar to equivalent diary measures, indicating no systematic bias. In contrast, HImQ measures of average experience across attacks (e.g. average pain intensity) overestimated equivalent diary measures and, in general, better approximated diary measures for migraine headaches, rather than all headaches. The highest correlations between HImQ and diary items were observed for headache frequency and average pain intensity, the two general headache measures, followed by measures of reduced effectiveness. Among frequency-based measures, the strength of the correlation was directly related to the magnitude of the mean. The higher the mean value, the higher the correlation. The correlation between the HImQ score and diary based score was 0.49. The HImQ score is moderately valid. Frequency-based items (e.g. number of missed work days) were found to be unbiased and the highest correlation coefficients were observed for frequency-based items with relatively high mean counts (number of headaches, number of missed non-work days). These findings have implications for measuring severity of chronic episodic conditions like headache, asthma, back pain, arthritis, epilepsy, and panic disorder, which can cause limitations to activities. The validity of illness severity measures may be improved by using frequency-based questions to assess both missed activity days and days with significantly reduced effectiveness or productivity (e.g. by 50% or more). By combining the count for both missed days and days where productivity is substantially reduced, the mean of the frequency-based measure will be increased, a factor which may improve the overall validity of the item. A severity measure can be derived from such items by simple addition and provides a scale with intuitively meaningful units.",Stewart WF.; Lipton RB.; Simon D.; Liberman J.; Von Korff M.,1999.0,,0,0,
3864,Cognitively oriented behavioral rehabilitation in combination with Qigong for patients on long-term sick leave because of burnout: REST--a randomized clinical trial.,"Despite an increase in the occurrence of burnout, there is no agreement on what kind of rehabilitation these patients should be offered. Primary aim of this study was to evaluate effects on psychological variables and sick leave rates by two different group rehabilitation programs for patients on long-term sick leave because of burnout. Rehabilitation program A (Cognitively oriented Behavioral Rehabilitation (CBR) and Qigong) was compared with rehabilitation program B (Qigong only). In a randomized clinical trial, 96 women and 40 men with a mean age of 41.6 +/- 7.4 years were allocated to one of the two rehabilitation programs. A per-protocol analysis showed no significant difference in treatment efficacy between the groups. Both groups improved significantly over time with reduced levels of burnout, self-rated stress behavior, fatigue, depression, anxiety, obsessive-compulsive symptoms, and sick leave rates. In an intention-to-treat analysis, patients in program A had fewer obsessive-compulsive symptoms and larger effect sizes in self-rated stress behavior and obsessive-compulsive symptoms compared to patients in program B. This study showed no differences in effect between CBR and Qigong compared with Qigong only in a per-protocol analysis. Both rehabilitation programs showed positive effect for patients with burnout.",Stenlund T.; Ahlgren C.; Lindahl B.; Burell G.; Steinholtz K.; Edlund C.; Nilsson L.; Knutsson A.; Birgander LS.,2009.0,10.1007/s12529-008-9011-7,0,0,
3865,Effects of recombinant human growth hormone on basal metabolic rate in adults with pituitary deficiency,"ER The effect of recombinant human growth hormone (rhGH) on basal metabolic rate (BMR) was studied in a placebo-controlled, double-blind, crossover trial. Ten patients with a history of complete pituitary insufficiency were randomized for 26 weeks in each period. Three patients were excluded due to withdrawal, fever, and claustrophobia, respectively. All patients had received adrenal, thyroid, and gonadal substitution therapy for at least 1 year before the study. The dose of rhGH was 0.25 to 0.5 U/kg/wk, administered subcutaneously once a day in the evening. BMR was determined by indirect calorimetry in a computerized ventilated open-hood system. Body composition was examined using four different methods--computed tomography (CT), tritium dilution, 40K determinations, and total body nitrogen (TBN) measured with neutron activation. The body composition data have previously been reported. Fat-free mass (FFM) increased and body fat (BF) decreased during the first 6 weeks of rhGH treatment, but no further changes in body composition occurred between 6 and 26 weeks. Baseline BMRs in GH-deficient (GHD) patients were in the lower part of the reference range, but BMR and the ratio between BMR and FFM (BMR/FFM) were not significantly lower than in a carefully selected control group. BMR increased between 0 and 6 weeks (mean +/- SD: from 6.68 +/- 1.55 to 7.75 +/- 1.35 MJ/24 h, P < .001) and then remained unchanged between 6 and 26 weeks. The increase in BMR was closely related to the increase in FFM (r = .91, P < .01).(ABSTRACT TRUNCATED AT 250 WORDS)","Stenlöf, K; Sjöström, L; Lönn, L; Bosaeus, I; Kvist, H; Tölli, J; Lindstedt, G; Bengtsson, B A",1995.0,,0,0,
3866,[Stigma experiences of patients with obsessive compulsive disorders].,"Only in recent years has research shown interest in stigma experiences of patients with mental disorders. However, subjective experiences of patients with OCD have not been published until now. Fifty-one patients with OCD were questioned about anticipated and actual stigmatization experiences as well as their stigma coping strategies, using a questionnaire especially developed for this study. Most of the patients expected negative reactions from their environment. Eighty per cent of the respondents were convinced that they would be rejected at work when it became known that they are mentally ill. Two thirds of the respondents feared that they would be rejected in a partnership. Concrete stigmatization was rarely reported by patients with OCD. Contrary to patients with depression and schizophrenia, the group of patients with OCD showed some differences between anticipated and actually experienced stigmatization. Concealing is a relevant strategy for dealing with the illness for three quarters of the respondents. Possibilities of reducing stigmatization and discrimination because of mental illness in general and OCD in particular are discussed.",Stengler-Wenzke K.; Beck M.; Holzinger A.; Angermeyer MC.,2004.0,10.1055/s-2003-812450,0,0,
3867,Mental distress and personality in women undergoing GnRH agonist versus GnRH antagonist protocols for assisted reproductive technology,"ER STUDY QUESTION: Do mental distress and mood fluctuations in women undergoing GnRH agonist and GnRH antagonist protocols for assisted reproductive technology (ART) differ depending on protocol and the personality trait, neuroticism?SUMMARY ANSWER: ART treatment did not induce elevated levels of mental distress in either GnRH antagonist or agonist protocols but neuroticism was positively associated with increased mental distress, independent of protocols.WHAT IS KNOWN ALREADY: ART treatment may increase mental distress by mechanisms linked to sex hormone fluctuations. General psychological characteristics, such as personality traits indexing negative emotionality, e.g. neuroticism, are likely to affect mental distress during ART treatment.STUDY DESIGN, SIZE, DURATION: A total of 83 women undergoing their first ART cycle were consecutively randomized 1:1 to GnRH antagonist (n = 42) or GnRH agonist (n = 41) protocol. The study population was a subgroup of a larger ongoing Danish clinical randomized trial and was established as an add-on in the period 2010-2012.PARTICIPANTS/MATERIALS, SETTING, METHODS: Women in the GnRH antagonist protocol received daily injections with recombinant follicle-stimulating hormone, Puregon(®) and subcutaneous injections with GnRH antagonist, Orgalutran(®). Women in the GnRH agonist protocol received nasal administration of the GnRH agonist, Synarela(®) and subcutaneous injections with FSH, Puregon(®). The study design did not allow for a blinding procedure. All women self-reported the Profile of Mood States, the Perceived Stress Scale, the Symptom Checklist-92-Revised, and the Major Depression Inventory questionnaires, at baseline, at ART cycle day 35, on the day of oocyte pick-up, and on the day of hCG testing. Also, a series of Profile of Mood States were reported daily during pharmacological treatment to monitor mood fluctuations. The personality trait Neuroticism was assessed at baseline by the self-reported NEO-PI-R questionnaire.MAIN RESULTS AND THE ROLE OF CHANCE: ART did not induce within- or between-protocol changes in any of the applied measures of mental distress. However, the GnRH antagonist protocol was associated with more pronounced median mood fluctuations during the stimulation phase (antagonist, 11.0 SD, [IQR = 21.1-6.1]; agonist, 8.9 SD, [IQR = 11.3-5.7], P = 0.025). This association became non-significant after applying a Bonferroni-Holm correction. Neuroticism was highly positively associated with increased levels of mental distress throughout treatment independent of protocols (all P-values <0.006), and cross-sectional analysis revealed that women with high or low Neuroticism scores at baseline showed a significant trend towards lower chances of a positive pregnancy test (P-value =0.028).LIMITATIONS, REASONS FOR CAUTION: Information on prognostic factors such as preceding length of infertility, number of retrieved oocytes and number of prior insemination treatments was not accounted for in the analyses. The stratification of protocols by age in the subgroups of women included in this study was suboptimal. Women with prior or current use of antidepressant medication were excluded from our study.WIDER IMPLICATIONS: Our results imply that mental distress emerging during ART treatment is not causally linked to hypogonadism per se or to the choice of protocol. Rather, our data highlight the potential importance of (i) rapid increases in ovarian steroids and (ii) addressing personality traits indexing negative emotionality, i.e. Neuroticism, in women undergoing ART treatment, to optimize both emotional adjustment and, possibly, the chances of obtaining pregnancy.STUDY FUNDING/COMPETING INTERESTS: The Danish Research Council for Independent Research and MSD, Denmark kindly supported the study. The authors declare no competing financial interests.TRIAL REGISTRATION NUMBER: Eudra","Stenbæk, D S; Toftager, M; Hjordt, L V; Jensen, P S; Holst, K K; Bryndorf, T; Holland, T; Bogstad, J; Pinborg, A; Hornnes, P; Frokjaer, V G",2015.0,10.1093/humrep/deu294,0,0,
3868,Group and individual treatment of compulsive hoarding: A pilot study.,"Examined the effects of a cognitive and behavioral intervention (CBI) specifically designed to address components of the model for hoarding described by R. O. Frost and T. Hartl (see record 1996-01004-005). Ss were 7 individuals (aged 36-61 yrs) seeking treatment for problems with excessive hoarding. All Ss were diagnosed with clinical compulsive hoarding. Treatment consisted of 6 Ss receiving CBI (group and individual) for a period of 20 wks. Three Ss continued in treatment for a period of 48 wks. The remaining client received 20 weekly-sessions of individual treatment only. The CBI focused on 5 general areas: education about hoarding, practice in decision-making, organizing skills training, behavioral exposure, and cognitive restructuring. Outcome was assessed by the Yale-Brown Obsessive Compulsive Scale (adapted for hoarding behavior). Also, Ss rated their improvement in specific areas targeted. The findings show that, after 20 wks, a noticeable improvement in several hoarding symptoms was experience by 5 of the 7 Ss. Further, 3 of the 4 Ss who continued treatment for about 1 yr showed even greater improvement although none felt entirely recovered. The client individually treated also made substantial gains but later became depressed and experienced a return of symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Steketee, Gail; Frost, Randy O; Wincze, Jeff; Greene, Kamala A. I; Douglass, Heidi; Ball, Black, Brown, Cermele, Constans, Frost, Frost, Frost, Frost, Frost, Frost, Frost, Goodman, Goodman, Greenberg, Hartl, Reed, Shafran, Warren, Winsberg",2000.0,,0,0,
3869,Subjective distress after seclusion or mechanical restraint: one-year follow-up of a randomized controlled study.,"Patients who participated in a randomized controlled trial comparing subjective distress and traumatic impact after seclusion or mechanical restraint were interviewed about the coercive measure about one year later. Between May and December 2006, patients were interviewed about one year after experiencing seclusion or mechanical restraint as an inpatient. Items from the Coercion Experience Scale (CES) were used in the original and the follow-up studies to assess distress on a 5-point scale, with higher scores indicating greater distress. Patients were also asked about subjective feelings about the coercive measure and completed the Impact of Event Scale-Revised (IES-R) to assess symptoms of posttraumatic stress disorder (PTSD). Sixty (59%) of the 102 patients in the original sample were included for follow-up. Although the original study found no differences between patients who experienced seclusion or mechanical restraint, the follow-up study found significantly higher mean scores for CES items among patients who had experienced mechanical restraint (2.5 and 3.7, respectively, p<.001). IES-R scores did not differ significantly. IES-R scores for two patients who experienced mechanical restraint and one who experienced seclusion indicated probable PTSD. Patients reported experiencing a wide range of negative feelings during the measure, most frequently helplessness, tension, fear, and rage. However, 58% reported some positive effects. Contact with staff was most helpful in alleviating distress during the coercive measure. Contrary to the original study, the follow-up study suggested that seclusion might be a less restrictive alternative for most patients. The incidence of PTSD seemed lower than expected.",Steinert T.; Birk M.; Flammer E.; Bergk J.,2013.0,10.1176/appi.ps.201200315,0,0,
3870,Comparative efficacy of eletriptan and zolmitriptan in the acute treatment of migraine,"ER Eletriptan 40 mg and 80 mg have shown greater efficacy in acute migraine than oral sumatriptan 100 mg and naratriptan 2.5 mg. This study continues the systematic series of active comparator trials in the eletriptan clinical development programme. In a multicentre double-blind, double-dummy, parallel-groups trial, 1587 outpatients with migraine by IHS criteria were randomised in a 3: 3 : 3: 1 ratio to eletriptan 80 mg, eletriptan 40 mg, zolmitriptan 2.5 mg or placebo. Of these, 1312 treated a single migraine attack and recorded baseline and outcome data to be included in the intention-to-treat population. The primary analysis was between eletriptan 80 mg and zolmitriptan. For the primary efficacy end-point of 2-h headache response, rates were 74% on eletriptan 80 mg, 64% on eletriptan 40 mg, 60% on zolmitriptan (P < 0.0001 vs. eletriptan 80 mg) and 22% on placebo (P < 0.0001 vs. all active treatments). Eletriptan 80 mg was superior to zolmitriptan on all secondary end-points at 1, 2 and 24 h, in most cases with statistical significance. Eletriptan 40 mg had similar efficacy to zolmitriptan 2.5 mg in earlier end-points, and significantly (P < 0.05) lower recurrence rate and need for rescue medication over 24 h. All treatments were well tolerated; 30-42% of patients on active treatments and 40% on placebo reported all-causality adverse events that were mostly mild and transient. On patients' global ratings of treatment, both eletriptan doses scored significantly better than zolmitriptan.","Steiner, T J; Diener, H C; MacGregor, E A; Schoenen, J; Muirheads, N; Sikes, C R",2003.0,10.1046/j.1468-2982.2003.00617.x,0,0,
3871,Glutamate induces apoptosis in cultured spiral ganglion explants,"Traumatic sound exposure, aminoglycoside antibiotics, cochlea ischemia or traumatic stress leads to an excessive release of glutamate from inner hair cells into the synaptic cleft. The high glutamate concentration can cause a swelling and destruction of the dendrites of spiral ganglion neurons of type I as well as a reduction in the number of neurons. This may be a cause of hearing loss. The mechanism causing the reduction of neurons is still not known. Apoptosis, also called programmed cell death, could be involved. In this study, cultured spiral ganglion explants were incubated with glutamate in high concentrations. Neurite outgrowth was determined and additionally a new method was established for studying the morphology of single spiral ganglion neurons. For the first time it was shown that glutamate induces apoptosis of spiral ganglion neurons, which could be blocked selectively by a caspase-3 inhibitor. This could offer a new therapeutic strategy for hearing disorders. © 2007 Elsevier Inc. All rights reserved.",Steinbach S.; Lutz J.,2007.0,10.1016/j.bbrc.2007.03.098,0,0,
3872,Trajectories of response to treatment for posttraumatic stress disorder.,"Research on the predictors of response to cognitive-behavioral treatments for PTSD has often produced inconsistent or ambiguous results. We argue this is in part due to the use of statistical techniques that explore relationships among the entire sample of participants rather than homogeneous subgroups. Using 2 large randomized controlled trials of Cognitive Processing Therapy (CPT), CPT components, and Prolonged Exposure, we employed growth mixture modeling to identify distinct trajectories of treatment response and to determine the predictors of those trajectories. We determined that the participants' trajectories could be best represented by 2 latent classes, which we subsequently labeled responders (87% of the sample) and nonresponders (13% of the sample). Notably, there was not a separate class for partial responders. Assignment to the nonresponder class was associated with receiving the written accounts (WA) component of CPT, a pretreatment diagnosis of major depression (MDD), and more pretreatment hyperarousal symptoms. Thus, it appears that some individuals do not benefit from merely writing about their trauma and processing it with the therapist; they may also need to engage in cognitive restructuring to successfully ameliorate their symptoms. Additionally, those who meet criteria for MDD or have high levels of hyperarousal at the onset of treatment might require additional treatment or support. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Stein, Nathan R; Dickstein, Benjamin D; Schuster, Jennifer; Litz, Brett T; Resick, Patricia A; Beck, Benish, Berger, Blake, Blake, Bradley, Chard, Cloitre, Dickstein, Diggle, Ehlers, Elliott, Feindler, First, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Gan, Griffin, Jung, Kubany, Lester, Muthen, Muthen, Nagin, Nagin, Resick, Resick, Resick, Resick, Resick, Rizvi, Rowan, Sloan, Spielberger, Spielberger, Tarrier, Taylor, van Minnen, Weathers",2012.0,,0,0,
3873,Development of a brief diagnostic screen for panic disorder in primary care.,"The purpose of this study was to determine the utility of a brief screening tool for panic disorder in the primary care setting. A total of 1476 primary care outpatients in three primary care medical clinics on the West Coast of the United States were studied. Patients completed a brief self-report measure, the five-item Autonomic Nervous System Questionnaire (ANS), while in the waiting room. The presence of DSM-IV panic disorder was subsequently determined in groups of ""screen-positive"" and ""screen-negative"" subjects using the Composite International Diagnostic Interview. A subset of patients (N = 511) also completed the 21-item Beck Anxiety Inventory. Indices of diagnostic utility were calculated using receiving operating characteristic analyses to guide the selection of optimal cutoff levels. The two-question version of the ANS had excellent sensitivity (range = 0.94-1.00 across the three clinic sites) and negative predictive value (0.94-1.00) but low specificity (0.25-0.59) and positive predictive value (range 0.18-0.40). The three- and five-question versions of the ANS had only modestly improved specificity, and this was achieved at the cost of reduced sensitivity and increased respondent burden to complete the questionnaire. The 21-item Beck Anxiety Inventory had maximal clinical utility at a cutoff level of > or =20, but sensitivity was lower than desirable for a screening instrument (0.67). The two-question version of the ANS shows promise as a screening instrument for panic disorder in the primary care setting.",Stein MB.; Roy-Byrne PP.; McQuaid JR.; Laffaye C.; Russo J.; McCahill ME.; Katon W.; Craske M.; Bystritsky A.; Sherbourne CD.,,,0,0,
3874,Quality of and patient satisfaction with primary health care for anxiety disorders.,"Most patients with anxiety disorders receive their care from primary care practitioners (PCPs). The purpose of this study was to evaluate quality of and patient satisfaction with primary health care for anxiety disorders. A survey was performed among 1,004 outpatients with anxiety disorders (diagnosed according to DSM-IV) referred by their PCPs from 17 primary care clinical settings (3 of which were university-affiliated) in 4 regions of the United States for participation in the Coordinated Anxiety Learning and Management (CALM) study, a therapeutic trial. Participating research institutions were the University of Washington at Seattle, the University of California at San Diego and Los Angeles, and the University of Arkansas for Medical Sciences at Little Rock. Enrollment took place between June 2006 and April 2008. Patients were contacted by telephone after enrollment to provide information about previous care received (during the 6 months prior to referral) and satisfaction with that care. Quality-of-care indicators were self-reported type, dose, and duration of antianxiety medication treatment and self-reported psychotherapy with cognitive-behavioral therapy (CBT) elements. A total of 576 patients (57.4%) had received an appropriate antianxiety medication in the previous 6 months, but only 289 patients (29.4% of 983 who answered this question) had received the medication at adequate dose for at least 2 months. A total of 465 patients (46.3%) had received some counseling with at least 1 element of CBT, but only 213 patients (21.2%) had received counseling with a strong (3+ elements) CBT focus. Overall, 416 patients (41.4%) had received quality pharmacotherapy or psychotherapy, and 81 patients (8.1%) had received both. Only 432 patients (44.8% of 964 who answered this question) were at least somewhat satisfied with their mental health care. Receipt of quality psychotherapy was the sole positive predictor (adjusted odds ratio = 2.71; 95% CI, 1.94-3.80; P < .0005) of satisfaction with mental health care for anxiety. Moreover, there was a dose-response relationship between the number of CBT elements consistently delivered and satisfaction with care (test for trend, z = 4.06, P < .0005). Despite recognition of these patients' anxiety disorders and referral by their PCPs to an anxiety treatment study, fewer than half of the patients had in the prior 6 months received quality pharmacologic and/or psychosocial mental health care. Receipt of CBT-oriented, quality psychosocial (but not pharmacologic) care showed a strong dose-response relationship with satisfaction with mental health care.",Stein MB.; Roy-Byrne PP.; Craske MG.; Campbell-Sills L.; Lang AJ.; Golinelli D.; Rose RD.; Bystritsky A.; Sullivan G.; Sherbourne CD.,2011.0,10.4088/JCP.09m05626blu,0,0,
3875,Do selective serotonin re-uptake inhibitors enhance the efficacy of very brief cognitive behavioral therapy for panic disorder? A pilot study.,"Selective serotonin re-uptake inhibitors (SSRIs) and cognitive behavioral therapies (CBTs) are both considered as first-line treatments for panic disorder, but the advantages of a combined therapy have yet to be definitively demonstrated. We evaluated in this pilot study the effects of combining SSRIs (vs. a placebo) with a very brief form of cognitive-behavioral therapy provided to all participants. Thirty-three subjects with DSM-IV panic disorder, with or without agoraphobia, were randomized to receive either paroxetine or a placebo with flexible dosing (10-50 mg/day). Medication visits were brief (15 min), infrequent (6 in total) and non-directive. An expert cognitive-behavior therapist administered one initial 45-min session and one subsequent 30-min session of very brief CBT (vbCBT) at weeks 5 and 7, respectively. Sessions were supplemented with educational and directive reading materials. Patients in both groups (i.e. vbCBT+paroxetine; vbCBT+placebo) improved similarly and substantially on most measures during the 10 weeks of acute treatment. At week 10, the proportion of panic-free patients was significantly higher in the paroxetine-treated group than in the placebo group (80 vs. 25%; P<0.007), as was the proportion of subjects who rated themselves as 'very much improved' at week 10 (60 vs. 13%; P<0.017). These findings point to the need for additional studies to confirm the effectiveness of very brief forms of CBT, and to document the circumstances in which combined treatment with an SSRI would be warranted.",Stein MB.; Ron Norton G.; Walker JR.; Chartier MJ.; Graham R.,2000.0,,0,0,
3876,Heart rate and plasma norepinephrine responsivity to orthostatic challenge in anxiety disorders: Comparison of patients with panic disorder and social phobia and normal control subjects,"Heart rate and plasma norepinephrine responsivity to a physiologic challenge, ie, orthostasis, were measured in 20 patients with panic disorder (PD) and 20 age- and sex-matched normal control subjects. While the two groups exhibited similar supine heart rates, patients with PD had a significantly greater heart rate response to orthostatic challenge. Plasma norepinephrine responses did not differ between patients with PD and normal control subjects. In a matched subgroup of 14 patients with PD, 14 normal control subjects, and 14 patients with social phobia, the patients with social phobia exhibited supine and upright plasma norepinephrine levels that were significantly higher than those of the other two diagnostic groups. Taken together, and in the context of findings from other studies, these preliminary observations suggest that the anxiety disorders may demonstrate differing patterns of autonomic dysfunction.",Stein M.B.; Tancer M.E.; Uhde T.W.,1992.0,,0,0,
3877,The QK(d) interval in panic disorder: An assessment of end-organ thyroid hormone responsivity,The QK(d) interval was utilized as a presumptive index of end-organ thyroid hormone effect to test the hypothesis that patients with panic disorder might have abnormal tissue-level responsivity to normal levels of peripherally circulating thyroid hormones. No significant differences in QK(d) intervals were found between 15 patients with panic disorder (230 ± 50 msec) and 20 normal controls (224 ± 29 msec) while drug-free. These findings suggest that patients with panic disorder have normal tissue-level responsivity to thyroid hormone.,Stein M.B.; Muir-Nash J.; Uhde T.W.,1991.0,10.1016/0006-3223(91)90328-J,0,0,
3878,The meaning of distress in older cancer patients: Are we missing the boat?,"Introduction: Currently 60% of cancer diagnoses are made in patients 65 and older; by 2020, this proportion will reach 70%. Clinically significant psychological distress has been found in cancer patients at rates of 15-50%, using a wide assortment of definitions of “distress” and assessments. Most research in the psycho-oncology literature focuses on middle-aged adults, while less attention has been paid to distress or, more narrowly, depressive symptoms, in older cancer patients. The literature suggests that older patients experience less distress than do younger patients. What accounts for this observed difference is unclear. We examined the literature regarding distress and depression in people older than 65 with cancer. Methods: A literature search of PubMed was performed to identify studies that reported on psychological distress in older patients with cancer. Search terms used were “aged,” “cancer,” and “depression” or “distress.” We included randomized controlled trials, cross-sectional and longitudinal studies. Retrieved studies were categorized by the primary study topic: distress in cancer patients; distress in older cancer patients; depression in cancer patients; and depression in older cancer patients. Results: Thirteen studies met our inclusion criteria. No studies were found that explicitly examined subsyndromal depressive symptoms in older cancer patients. Distress and depression correlated with levels of social support, physical function, and co-morbid medical problems. Among the older cancer patients included in the studies, conflicting findings were found regarding levels of distress and depression. Some studies found that older patients had lower levels of distress or depression than younger patients, while other studies found equivalent levels. Limitations of the studies included the inclusion of patients primarily seen at academic cancer centers, the use of cut-points on symptom measures (vs. use of continuous outcomes), mixed cancer diagnosis populations, and minimal information on prior psychiatric history. Conclusions: Although some studies report that older cancer patients experience less distress than younger patients, the literature is limited to date. Major areas require further study. The definition of “distress” should be examined in more depth, both quantitatively and qualitatively, in older cancer patients, as this concept may have different meanings for different cancer populations and individuals. Also needed are data on the prevalence of subsyndromal depressive symptoms; examination of the potential mediating roles of social support, physical functioning, sense of well-being, and personality and coping styles; refinement and validation of measures to accurately identify older cancer patients needing supportive services during and after the cancer experience; and identifying distress in older cancer patients' caregivers, who often experience “hidden morbidity” themselves when caring for a seriously ill relative.",Stein E.F.; Shumay D.; Miaskowski C.; Dunn L.B.,2010.0,10.1097/01.JGP.0000369161.13792.ad,0,0,
3879,Recent advances in the behavioral treatment of obsessive-compulsives.,"The last decade has witnessed remarkable progress in the treatment of obsessive-compulsives, with the introduction of response prevention and deliberate exposure to feared situations in vivo and in imagination. In a series of studies, the effects of the single components of this program were investigated. The results suggest that the optimal treatment includes a combination of all three procedures. It appears that in vivo exposure mainly affects anxiety/discomfort associated with cues for ritualizing; response prevention affects primarily compulsive behavior; and imaginal exposure assists in maintenance of treatment gains, perhaps through its impact on fears of future catastrophes associated with obsessions.",Steketee G.; Foa EB.; Grayson JB.,1982.0,,0,0,
3880,My Disaster Recovery: a pilot randomized controlled trial of an Internet intervention.,"This pilot study tested the efficacy of the My Disaster Recovery (MDR) website to decrease negative affect and increase coping self-efficacy. Fifty-six survivors of Hurricane Ike were recruited from a larger study being conducted at the University of Texas Medical Branch at the first anniversary of the storm. Restricted randomization was used to assign participants to the MDR website, an information-only website, or a usual care condition. Group√ótime interactions indicated that MDR reduced participant worry more than the other conditions. A similar trend was also identified for depression. Both websites were accessed a small to moderate amount and participants reported mixed satisfaction for both websites. Although the effect sizes for worry and depression were in the moderate to large range, small sample size and timing of the intervention qualify the findings. These preliminary findings encourage further evaluation of MDR with a larger, demographically diverse sample and indicate that the MDR website might be helpful in reducing worry and depression.",Steinmetz SE.; Benight CC.; Bishop SL.; James LE.,2012.0,10.1080/10615806.2011.604869,0,0,
3881,Do patterns of change during treatment for panic disorder predict future panic symptoms?,"Background and objectives: Cognitive-behavioral therapies are currently the gold standard for panic disorder treatment, with well-documented treatment response. However, following interventions, some individuals continue to improve, while others experience a return of symptoms. The field lacks reliable ways to predict follow-up symptomatology. In the current study, a cluster analysis with a repeated measures design was conducted to examine change patterns over 12 weeks of cognitive behavioral group therapy for panic disorder. The central aim of the study was to evaluate if change patterns predict level of panic symptom severity at a six month follow-up in this sample. Methods: Individuals with panic disorder (N = 36) completed a measure of panic symptoms (Panic Disorder Severity Scale) at the outset of every therapy session and at a six month follow-up. Results: Results revealed three patterns of change in this specific trial, which significantly predicted level of panic symptoms six months post-treatment, beyond initial or final level of panic symptoms, and beyond total symptom change. Limitations: Given the relatively small, lab-based sample, replications in other settings and samples will be important. Conclusions: Overall, results provide initial evidence that change patterns are meaningful predictors of panic symptom severity well after the final session of treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Steinman, Shari A; Hunter, Michael D; Teachman, Bethany A; Aaronson, Barlow, Beck, Casey, Cattell, Chambers, Clerkin, Cohen, Cox, Cuijpers, Dolnicar, Everitt, First, Forgy, Gould, Hanish, Hofmann, Jacobson, Krause, Lambert, Lambert, Lipkovich, Lutz, Marks, Maxwell, Meijering, Mooi, Ost, Otto, Penava, Ramnero, Reiss, Shear, Stanley, Steketee, Stulz, Tang, Teachman, Teachman, Teachman, Telch, Telch, Woodman",2013.0,,0,0,
3882,Training less threatening interpretations over the Internet: Does the number of missing letters matter?,"Cognitive Bias Modification to reduce threat interpretations (CBM-I) trains individuals to resolve ambiguous scenarios via completion of word fragments that assign benign meanings to scenarios. The current study tested: 1) whether Internet-based CBM-I can shift interpretations to be more positive/less negative, and 2) whether varying the number of letters missing in the word fragments (assumed to increase task difficulty) moderates CBM-I's effects. Participants (N = 350) completed a brief online version of CBM-I, followed by assessments of interpretation bias, fear of negative evaluation, and anticipatory anxiety. Participants were randomly assigned to 1 of 5 conditions: control (half of scenarios ended positively, half negatively), or 4 positive conditions (all scenarios ended positively, but word fragments varied on number of letters missing, from 0 to 3). Relative to the control condition, all positive conditions led to more positive/less negative interpretations. When analyses were re-run with only a highly socially anxious subset of the sample (n = 100), conditions in which the final word of scenarios was missing 0, 1, or 2 letters led to more positive/less negative interpretations compared to the control condition, but the condition missing 3 letters did not differ from the control condition. There were no differences between conditions on other outcome measures. Training was brief, and an unselected sample was used. Results suggest a brief Internet-based CBM-I paradigm can shift interpretation bias, but not necessarily other anxiety-relevant outcomes. Making the task too difficult may blunt effects for highly socially anxious individuals.",Steinman SA.; Teachman BA.,2015.0,10.1016/j.jbtep.2014.12.004,0,0,
3883,Do patterns of change during treatment for panic disorder predict future panic symptoms?,"Cognitive-behavioral therapies are currently the gold standard for panic disorder treatment, with well-documented treatment response. However, following interventions, some individuals continue to improve, while others experience a return of symptoms. The field lacks reliable ways to predict follow-up symptomatology. In the current study, a cluster analysis with a repeated measures design was conducted to examine change patterns over 12 weeks of cognitive behavioral group therapy for panic disorder. The central aim of the study was to evaluate if change patterns predict level of panic symptom severity at a six month follow-up in this sample. Individuals with panic disorder (N = 36) completed a measure of panic symptoms (Panic Disorder Severity Scale) at the outset of every therapy session and at a six month follow-up. Results revealed three patterns of change in this specific trial, which significantly predicted level of panic symptoms six months post-treatment, beyond initial or final level of panic symptoms, and beyond total symptom change. Given the relatively small, lab-based sample, replications in other settings and samples will be important. Overall, results provide initial evidence that change patterns are meaningful predictors of panic symptom severity well after the final session of treatment.",Steinman SA.; Hunter MD.; Teachman BA.,2013.0,10.1016/j.jbtep.2012.09.003,0,0,
3884,The application of exposure therapy and D-cycloserine to the treatment of anorexia nervosa: a preliminary trial.,"Novel approaches to the treatment of anorexia nervosa (AN) are needed. This preliminary study examined the utility and safety of an exposure therapy intervention and D-cycloserine (DCS) in a population of patients with AN. Eleven participants completed a series of 6 laboratory meals, including pre- and post-exposure test meals and four exposure sessions. Participants were randomly assigned to receive either DCS or placebo in double-blind fashion before each of the 4 exposure sessions. These results were compared to data from a previously studied group of patients who received treatment as usual. Total caloric intake increased significantly from the baseline meal session to the post-test meal session in the patients who received the exposure therapy intervention. Caloric intake did not increase significantly in the comparison group. These data suggest that an exposure therapy intervention specifically focused on meal consumption may be helpful in increasing intake of a test meal.",Steinglass J.; Sysko R.; Schebendach J.; Broft A.; Strober M.; Walsh BT.,2007.0,10.1097/01.pra.0000281484.89075.a8,0,0,
3885,Young and old Pavlovian fear memories can be modified with extinction training during reconsolidation in humans.,"Extinction training during reconsolidation has been shown to persistently diminish conditioned fear responses across species. We investigated in humans if older fear memories can benefit similarly. Using a Pavlovian fear conditioning paradigm we compared standard extinction and extinction after memory reactivation 1 d or 7 d following acquisition. Participants who underwent extinction during reconsolidation showed no evidence of fear recovery, whereas fear responses returned in participants who underwent standard extinction. We observed this effect in young and old fear memories. Extending the beneficial use of reconsolidation to older fear memories in humans is promising for therapeutic applications.",Steinfurth EC.; Kanen JW.; Raio CM.; Clem RL.; Huganir RL.; Phelps EA.,2014.0,10.1101/lm.033589.113,0,0,
3886,Subjective distress after seclusion or mechanical restraint: One-year follow-up of a randomized controlled study.,"Objective: Patients who participated in a randomized controlled trial comparing subjective distress and traumatic impact after seclusion or mechanical restraint were interviewed about the coercive measure about one year later. Methods: Between May and December 2006, patients were interviewed about one year after experiencing seclusion or mechanical restraint as an inpatient. Items from the Coercion Experience Scale (CES) were used in the original and the follow-up studies to assess distress on a 5-point scale, with higher scores indicating greater distress. Patients were also asked about subjective feelings about the coercive measure and completed the Impact of Event Scale-Revised (IES-R) to assess symptoms of posttraumatic stress disorder (PTSD). Results: Sixty (59%) of the 102 patients in the original sample were included for followup. Although the original study found no differences between patients who experienced seclusion or mechanical restraint, the follow-up study found significantly higher mean scores for CES items among patients who had experienced mechanical restraint (2.5 and 3.7, respectively, p < .001). IES-R scores did not differ significantly. IES-R scores for two patients who experienced mechanical restraint and one who experienced seclusion indicated probable PTSD. Patients reported experiencing a wide range of negative feelings during the measure, most frequently helplessness, tension, fear, and rage. However, 58% reported some positive effects. Contact with staff was most helpful in alleviating distress during the coercive measure. Conclusions: Contrary to the original study, the follow-up study suggested that seclusion might be a less restrictive alternative for most patients. The incidence of PTSD seemed lower than expected. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Steinert, Tilman; Birk, Michael; Flammer, Erich; Bergk, Jan; Appelbaum, Bergk, Bergk, Bergk, Bowers, Frueh, Georgieva, Haglund, Katsakou, Kessler, Kingdon, Langle, Maercker, Mason, Meyer, Roe, Sailas, Shaw, Steenfeldt-Foss, Steinert, Steinert, Steinert, Veltkamp, Weiss, Whittington",2013.0,,0,0,
3887,Effect of combined multiple contexts and multiple stimuli exposure in spider phobia: A randomized clinical trial in virtual reality.,"Background: Our previous study indicated that treatment in multiple contexts (MC) improved the outcome of exposure treatment by reducing return of fear. This effect was evident when the test was conducted immediately post treatment. In the present study, we conducted a treatment analogue study where we investigated whether an exposure to multiple stimuli (MS) and a combination of both MS and MC would further improve treatment efficacy in the short and long terms. Method: Spider-phobic patients (N = 58) were randomly allocated to one of four groups. Each group received virtual reality (VR) exposure treatment in either one or four different contexts and was exposed to either one or four different spiders. All participants completed both a VR test with a novel spider in a novel context and an in vivo behavioral avoidance test (BAT) pre-, post-treatment and at follow-up. Results: Short-term but not long-term return of fear was attenuated by multiple context exposure in VR. Long-term effect of fear attenuation was observed only in the MS single context group. In the BAT, the multiple stimuli condition seemed to be more beneficial in both the short and long term. Notably, there was no evidence for superiority of the combined multiple stimuli and contexts condition. Conclusion: Change of contexts during exposure significantly reduced return of fear post treatment; however, similar results could not be observed with a follow-up test. The implementation of multiple stimuli during exposure seems to have both short-term and long-lasting beneficial effects on the treatment outcome. We recommend further investigation of this phenomenon and introduce further possible improvements to our paradigm. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Shiban, Youssef; Schelhorn, Iris; Pauli, Paul; Muhlberger, Andreas; Andreatta, Arntz, Balooch, Bjork, Bouton, Bouton, Bouton, Craske, Craske, Deacon, Denniston, First, Foa, Glautier, Glotzbach-Schoon, Grillon, Laborda, Laux, Lobbestael, MacKillop, MacKillop, Meyerbroker, Mystkowski, Neumann, Opris, Possel, Possel, Rinck, Rowe, Rowe, Shao, Shiban, Shiban, Szymanski, Thomas, Turner, Vervliet, Vervliet, Wittchen",2015.0,,0,0,
3888,Effect of combined multiple contexts and multiple stimuli exposure in spider phobia: A randomized clinical trial in virtual reality.,"Our previous study indicated that treatment in multiple contexts (MC) improved the outcome of exposure treatment by reducing return of fear. This effect was evident when the test was conducted immediately post treatment. In the present study, we conducted a treatment analogue study where we investigated whether an exposure to multiple stimuli (MS) and a combination of both MS and MC would further improve treatment efficacy in the short and long terms. Spider-phobic patients (N = 58) were randomly allocated to one of four groups. Each group received virtual reality (VR) exposure treatment in either one or four different contexts and was exposed to either one or four different spiders. All participants completed both a VR test with a novel spider in a novel context and an in vivo behavioral avoidance test (BAT) pre-, post-treatment and at follow-up. Short-term but not long-term return of fear was attenuated by multiple context exposure in VR. Long-term effect of fear attenuation was observed only in the MS single context group. In the BAT, the multiple stimuli condition seemed to be more beneficial in both the short and long term. Notably, there was no evidence for superiority of the combined multiple stimuli and contexts condition. Change of contexts during exposure significantly reduced return of fear post treatment; however, similar results could not be observed with a follow-up test. The implementation of multiple stimuli during exposure seems to have both short-term and long-lasting beneficial effects on the treatment outcome. We recommend further investigation of this phenomenon and introduce further possible improvements to our paradigm.",Shiban Y.; Schelhorn I.; Pauli P.; Mühlberger A.,2015.0,10.1016/j.brat.2015.05.014,0,0,
3889,Influence of perceptual cues and conceptual information on the activation and reduction of claustrophobic fear.,"Fear reactions in phobic patients can be activated by specific perceptual cues (C) or by conceptual fear-related information (I). An earlier study with spider phobic participants documented that perceptual stimuli are particularly potent to trigger fear responses. Because fear of spiders is activated by very circumscribed stimuli, we set out to investigate whether another phobia with more contextual fear-elicitation (i.e., a situational phobia) would yield similar patterns. Thus, we investigate the two paths of fear activation (cues vs. information) and fear reduction during exposure in claustrophobic patients. Forty-eight claustrophobic patients and 48 healthy control participants were randomly assigned to one of three virtual reality exposure conditions: C, I, or a combination of both (CI). Exposure lasted 5 min and was repeated 4 times. Self-report and physiological reactions were assessed. Claustrophobic patients experienced more initial self-reported fear when confronted with fear-relevant perceptual cues than conceptual information, when the perceptual cues were combined with conceptual information there was no significant enhancement. Furthermore, fear habituated more in the perceptual condition. For the physiological parameters, groups differed and in claustrophobic patients heart rate decreased differently in the conditions. Longer exposure duration and long-term effects of the manipulation were not investigated. We found similar patterns in a situational phobia as compared to a specific-cue related phobia (animal type). Thus, once more this highlights the central role of visual cues in phobic fear and the potential of virtual reality for conducting exposure therapy.",Shiban Y.; Peperkorn H.; Alpers GW.; Pauli P.; Mühlberger A.,2016.0,10.1016/j.jbtep.2015.11.002,0,0,
3890,Effect of multiple context exposure on renewal in spider phobia.,"Renewal of fear is one form of relapse that occurs after successful exposure therapy as a result of an encounter with a feared object in a context different from the exposure context. The current study is the first to examine whether virtual reality (VR) exposure conducted in multiple contexts reduces the likelihood of renewal. Thirty spider-phobic patients were randomly allocated to one of two groups that were exposed to a virtual spider four times either in a single context or in multiple contexts. All participants completed a renewal test in a novel virtual context, and an in-vivo behavior avoidance test with a real spider before and after exposure. As reflected in the ratings, skin conductance level, and behavioral measures, the fear of spiders decreased significantly in both groups within and between the exposure trials and from pre to post exposure. Importantly, extinction in multiple contexts was able to significantly reduce renewal compared to extinction in a single context. Based on highly controlled context manipulations using VR, this study was able to successfully transfer animal work to phobic patients. These findings strongly suggest that exposure in multiple contexts improves the generalizability of exposure to a new context. Consequently, we recommend the application of multiple context exposures in a clinical setting to reduce the likelihood of renewal. In addition, virtual reality was demonstrated to be a helpful tool for inducing contextual shifts during the exposures.",Shiban Y.; Pauli P.; Mühlberger A.,2013.0,10.1016/j.brat.2012.10.007,0,0,
3891,Fear reactivation prior to exposure therapy: does it facilitate the effects of VR exposure in a randomized clinical sample?,"The current study is the first to examine whether reactivation of fear memory prior to exposure therapy reduces relapse in a randomized clinical sample. In a standardized treatment protocol combining virtual reality and in-vivo exposure, patients underwent a fear reactivation procedure using a virtual spider 10 min prior to a virtual reality (VR) exposure (reactivation group: RG, n = 15). A control group (CG, n = 17) was exposed to a virtual plant 10 min prior to the VR exposure. Outcome measures were a VR spontaneous recovery test (SRT) and in-vivo a behavioral avoidance test assessed 24 h after VR exposure. One week later an in-vivo exposure session followed. Additionally, a follow-up using psychometric assessment was conducted six months after the first session. Both groups benefitted significantly and equally from the combined treatment, and importantly, the SRT revealed no return of fear in both groups. Furthermore, follow-up tests showed long-term treatment effects with no group differences. Due to different study components (VR treatment and in-vivo), we were not able to determine which treatment module was mainly responsible for the long-term treatment effect. Furthermore, no direct measure of memory destabilization was possible in this study. Our treatment package was highly effective in reducing phobic fear up to 6 months following treatment. Explicit fear reactivation prior to exposure was not beneficial in VR exposure treatment, possibly due to a failure to induce a memory destabilization or due to an implicit fear reactivation prior to treatment in both groups.",Shiban Y.; Brütting J.; Pauli P.; Mühlberger A.,2015.0,10.1016/j.jbtep.2014.09.009,0,0,
3892,Sex/Gender Differences in Metabolism and Behavior: Influence of Sex Chromosomes and Hormones,,Shi H.; Brown L.M.; Rahimian R.,2015.0,10.1155/2015/245949,0,0,
3893,Treatment of complicated grief: a randomized controlled trial.,"Complicated grief is a debilitating disorder associated with important negative health consequences, but the results of existing treatments for it have been disappointing. To compare the efficacy of a novel approach, complicated grief treatment, with a standard psychotherapy (interpersonal psychotherapy). Two-cell, prospective, randomized controlled clinical trial, stratified by manner of death of loved one and treatment site. A university-based psychiatric research clinic as well as a satellite clinic in a low-income African American community between April 2001 and April 2004. A total of 83 women and 12 men aged 18 to 85 years recruited through professional referral, self-referral, and media announcements who met criteria for complicated grief. Participants were randomly assigned to receive interpersonal psychotherapy (n = 46) or complicated grief treatment (n = 49); both were administered in 16 sessions during an average interval of 19 weeks per participant. Treatment response, defined either as independent evaluator-rated Clinical Global Improvement score of 1 or 2 or as time to a 20-point or better improvement in the self-reported Inventory of Complicated Grief. Both treatments produced improvement in complicated grief symptoms. The response rate was greater for complicated grief treatment (51%) than for interpersonal psychotherapy (28%; P = .02) and time to response was faster for complicated grief treatment (P = .02). The number needed to treat was 4.3. Complicated grief treatment is an improved treatment over interpersonal psychotherapy, showing higher response rates and faster time to response.",Shear K.; Frank E.; Houck PR.; Reynolds CF.,2005.0,10.1001/jama.293.21.2601,0,0,
3894,Repetitive Transcranial Magnetic Stimulation Improved Symptoms of Obsessive-Compulsive Disorders but Not Executive Functions: Results from a Randomized Clinical Trial with Crossover Design and Sham Condition.,"Whereas there is growing evidence that repetitive transcranial magnetic stimulation (rTMS) favorably impacts on symptoms of obsessive-compulsive disorders (OCD), less is known regarding the influence of rTMS on cognitive performance of patients with OCD. Here, we tested the hypothesis that rTMS has a positive impact both on symptom severity and executive functions in such patients. We assessed 10 patients diagnosed with OCD (mean age: 33.5 years) and treated with a standard medication; they were randomly assigned either to a treatment-first or to a sham-first condition. Symptom severity (experts' ratings) and executive functions (Wisconsin Card Sorting Test) were assessed by independent raters unaware of the patients' group assignments at baseline, after 2 and 4 weeks. After 2 weeks, treatment switched to sham condition, and sham condition switched to treatment condition. Under treatment but not under sham conditions, symptom severity decreased. Performance on the executive function test increased continuously with every new assessment and was unrelated to rTMS treatment. Whereas the present study confirmed previous research suggesting that rTMS improved symptoms of OCD, rTMS did not improve executive functions to a greater degree than sham treatment. More research is needed to investigate the effect of rTMS on executive functions in patients with OCD.",Shayganfard M.; Jahangard L.; Nazaribadie M.; Haghighi M.; Ahmadpanah M.; Sadeghi Bahmani D.; Bajoghli H.; Holsboer-Trachsler E.; Brand S.,2016.0,10.1159/000457128,0,0,
3895,Prevention of traumatic stress in mothers with preterm infants: a randomized controlled trial.,"The current study evaluates a treatment intervention developed with the goal of reducing symptoms of posttraumatic stress, depression, and anxiety in parents of premature infants. A total of 105 mothers of preterm infants (25-34 weeks' gestational age; >600 g) were randomized to receive a 6-session intervention developed to target parental trauma as well as facilitate infant redefinition (n = 62) or to an active comparison group (n = 43). Mothers in the intervention group received a combination of trauma-focused treatments, including psychoeducation, cognitive restructuring, progressive muscle relaxation, and development of their trauma narrative. The intervention also incorporated material targeting infant redefinition, defined as the process of changing the mother's negative perceptions of her infant and the parenting experience. Mothers in the intervention group reported a greater reduction in both trauma symptoms (Cohen's d = 0.41, P = .023) and depression (Cohen's d = 0.59, P < .001) compared with the comparison group. Patients under both conditions improved significantly in terms of anxiety, with no differences between groups. Results of the moderator analysis showed that mothers with higher ratings of baseline NICU stress benefited more from the intervention compared with mothers who had lower ratings (P = .036). This short, highly manualized intervention for mothers of preterm infants statistically significantly reduced symptoms of trauma and depression. The intervention is feasible, can be delivered with fidelity, and has high ratings of maternal satisfaction. Given that improvements in mothers' distress may lead to improved infant outcomes, this intervention has the potential for a high public health impact.",Shaw RJ.; St John N.; Lilo EA.; Jo B.; Benitz W.; Stevenson DK.; Horwitz SM.,2013.0,10.1542/peds.2013-1331,0,0,
3896,Prevention of traumatic stress in mothers of preterms: 6-month outcomes.,"Symptoms of posttraumatic stress disorder are a well-recognized phenomenon in mothers of preterm infants, with implications for maternal health and infant outcomes. This randomized controlled trial evaluated 6-month outcomes from a skills-based intervention developed to reduce symptoms of posttraumatic stress disorder, anxiety, and depression. One hundred five mothers of preterm infants were randomly assigned to (1) a 6- or 9-session intervention based on principles of trauma-focused cognitive behavior therapy with infant redefinition or (2) a 1-session active comparison intervention based on education about the NICU and parenting of the premature infant. Outcome measures included the Davidson Trauma Scale, the Beck Depression Inventory II, and the Beck Anxiety Inventory. Participants were assessed at baseline, 4 to 5 weeks after birth, and 6 months after the birth of the infant. At the 6-month assessment, the differences between the intervention and comparison condition were all significant and sizable and became more pronounced when compared with the 4- to 5-week outcomes: Davidson Trauma Scale (Cohen's d = -0.74, P < .001), Beck Anxiety Inventory (Cohen's d = -0.627, P = .001), Beck Depression Inventory II (Cohen's d = -0.638, P = .002). However, there were no differences in the effect sizes between the 6- and 9-session interventions. A brief 6-session intervention based on principles of trauma-focused cognitive behavior therapy was effective at reducing symptoms of trauma, anxiety, and depression in mothers of preterm infants. Mothers showed increased benefits at the 6-month follow-up, suggesting that they continue to make use of techniques acquired during the intervention phase.",Shaw RJ.; St John N.; Lilo E.; Jo B.; Benitz W.; Stevenson DK.; Horwitz SM.,2014.0,10.1542/peds.2014-0529,0,0,
3897,Prevention of traumatic stress in mothers with preterm infants: A randomized controlled trial.,"Objective: The current study evaluates a treatment intervention developed with the goal of reducing symptoms of posttraumatic stress, depression, and anxiety in parents of premature infants. Methods: A total of 105 mothers of preterm infants (25-34 weeks' gestational age; .600 g) were randomized to receive a 6-session intervention developed to target parental trauma as well as facilitate infant redefinition (n = 62) or to an active comparison group (n = 43). Mothers in the intervention group received a combination of trauma-focused treatments, including psychoeducation, cognitive restructuring, progressive muscle relaxation, and development of their trauma narrative. The intervention also incorporated material targeting infant redefinition, defined as the process of changing the mother's negative perceptions of her infant and the parenting experience. Results: Mothers in the intervention group reported a greater reduction in both trauma symptoms (Cohen's d = 0.41, P = .023) and depression (Cohen's d = 0.59, P < .001) compared with the comparison group. Patients under both conditions improved significantly in terms of anxiety, with no differences between groups. Results of the moderator analysis showed that mothers with higher ratings of baseline NICU stress benefited more from the intervention compared with mothers who had lower ratings (P = .036). Conclusion: This short, highly manualized intervention for mothers of preterm infants statistically significantly reduced symptoms of trauma and depression. The intervention is feasible, can be delivered with fidelity, and has high ratings of maternal satisfaction. Given that improvements in mothers' distress may lead to improved infant outcomes, this intervention has the potential for a high public health impact. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Shaw, Richard J; St. John, Nick; Lilo, Emily A; Jo, Booil; Benitz, William; Stevenson, David K; Horwitz, Sarah M; Als, Als, Anderson, Bakermans-Kranenburg, Beck, Beck, Bernard, Brisch, Browne, Cardena, Carter, Cohen, Davidson, Harrison, Holditch-Davis, Horbar, Jotzo, Kaaresen, Kersting, Kraemer, Kraemer, Kraemer, Little, McCormick, Melnyk, Melnyk, Meyer, Miceli, Miles, Miles, Minde, Muthen, Nemeroff, Peebles-Kleiger, Pierrehumbert, Preyde, Raudenbush, Roman, Ross, Schechter, Schechter, Shaw, Shaw, Shaw, Shaw, Sheehan, Singer, Tarkan, Vanderbilt, Vrana, Wightman, Zatzick, Zupancic",2013.0,,0,0,
3898,An Experimental Investigation of the Effect of Stress on Saving and Acquiring Behavioral Tendencies: The Role of Distress Tolerance and Negative Urgency,"Stress has been implicated as a risk factor for hoarding, although past research has relied on cross-sectional and self-report designs. Using experimental methods and objective hypothetical behavioral hoarding paradigms, we investigated the direct effect of stress on in-the-moment saving and acquiring behavioral tendencies. We also evaluated whether distress tolerance (DT) and negative urgency interacted with stress to predict saving and acquiring behavioral tendencies. A sample of young adults (N= 80) completed questionnaires about DT and negative urgency. Participants were randomized to either a psychosocial stressor or nonstressful control task prior to completing two hypothetical behavioral hoarding paradigms. The discarding task asked participants to choose between saving and disposing of items. For the acquiring task, participants completed a computer-simulated shopping spree that measured items acquired. Unexpectedly, participants in the stress condition saved and acquired fewer items than those in the control condition. As hypothesized, stress interacted with DT to predict saving tendencies. The current study should be replicated in a clinical sample. Longitudinal studies are needed to further examine the long-term effect of stress on hoarding. This is the first examination of the direct effect of stress on saving and acquiring tendencies. Although some study hypotheses were not supported, several results are consistent with our predictions and suggest a complex relationship between stress and hoarding. If findings are replicated in a clinical sample, it may be that hoarding patients could benefit from treatments incorporating DT strategies.",Shaw A.M.; Timpano K.R.,2016.0,10.1016/j.beth.2015.10.003,0,0,
3899,Sleep quality subtypes in midlife women,"Eighty-two midlife women (40-59 years) were classified as poor or good sleepers according to either self-reported sleep quality or a sleep efficiency index (SEI) criterion, for comparison of wakefulness, fragmentation and other somnographic sleep variables; as well as psychological (SCL-90) and somatic symptom distress. When classified solely by self-report, the good and poor sleeper groups did not differ on any somnographic variables but self-declared poor sleepers had higher psychological distress scores than good sleepers (p ≤ 0.01). When classified solely by the SEI criterion, the good and poor sleepers did not differ on psychological distress but, as expected, differed on various somnographic wakefulness as well as rapid eye movement and stage 2 sleep variables. Further analysis of four subgroups derived by combining objective and subjective, good and poor sleep scores indicated that 15% of this sample (n = 12) perceived but had no objective evidence of poor sleep, and this group scored highest in psychological distress. Only seven women perceived poor sleep in concert with demonstrating low SEI. They scored highest in menopausal symptoms but not in general psychological distress.",Shaver J.L.F.; Giblin E.; Paulsen V.,1991.0,,0,0,
3900,Comparative efficacy of EMDR and alternative procedures in reducing the vividness of mental images.,"Compared the effectiveness of rapid eye movement desensitization (EMDR; F. Shapiro, see records 76-40656 and 77-23235) with 2 simpler relaxation procedures designed to reduce the intensity of mental images of major memories. 16 non-clinical Ss (aged 24-48 yrs) were administered a Vividness of Image (VOI) scale, developed from G. H. Betts's Vividness of Imagery Scale (1909), before and after treatment with EMDR followed or preceded by Rapid Induction (RI) instructions to roll their eyes upwards. Eight controls were simply instructed to relax. VOI ratings indicate that while EMDR was significantly effective in reducing the vividness of a mental image based on a major memory, so was the RI procedure. EMDR, however, was significantly more effective in reducing the VOI than either RI or relaxation. RI was not found to be significantly more effective in reducing VOI than relaxation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sharpley, Christopher F; Montgomery, Iain M; Scalzo, Lina A",1996.0,,0,0,
3901,Non-pharmacological approaches to treatment,"ER Chronic fatigue syndrome (CFS) as currently defined overlaps with other syndromes including chronic pain, fibromyalgia, anxiety and depression. It also resembles historical descriptions of neurasthenia. The role of psychological (cognitive) and behavioural therapies in CFS is examined. There are both pragmatic and theoretical arguments for their application to CFS. It is pragmatic to target obvious and treatable factors including inactivity and depression. A theoretical model in which psychological, physiological and social factors interact offers a plausible rationale for such treatment but is not yet empirically proven. While there is evidence for the efficacy of this type of therapy in related syndromes, the evidence in CFS is inconclusive. A randomized controlled trial of combined cognitive and behavioural therapy currently in progress is described. Initial results suggest that most patients receiving cognitive behaviour therapy improve, especially in terms of functional impairment. It remains to be seen whether this therapy will prove to be more effective than standard general practitioner care. In the meantime cognitive behaviour therapy offers a pragmatic and rational therapy for patients with CFS.","Sharpe, M",1993.0,,0,0,
3902,Long-term efficacy of a cognitive behavioural treatment from a randomized controlled trial for patients recently diagnosed with rheumatoid arthritis.,"This study examined the long-term efficacy of a cognitive behavioural intervention for patients with recent-onset, seropositive rheumatoid arthritis (RA). Fifty-three consecutive patients with less than a 2-yr history of classic or definite RA were recruited into the trial. All participants received routine medical management during the study, and half were randomly allocated to receive an 8-week adjunctive psychological intervention. All assessments were conducted blind to the allocation. This paper reports intention-to-treat analyses of the 18-month follow-up. Consistent with short-term results, significant differences were found between the groups in depressive symptoms. The intervention group maintained improvements in joint function, although those in routine care made similar improvements over the ensuing 18 months. At follow-up, group differences emerged for disability and anxiety. These results indicate that cognitive behavioural intervention offered as an adjunct to standard clinical management early in the course of RA is efficacious in producing improvements in both psychological and physical indices. Furthermore, improvements appear to increase 18 months after a brief, time-limited psychological treatment.",Sharpe L.; Sensky T.; Timberlake N.; Ryan B.; Allard S.,2003.0,,0,0,
3903,Randomized trial on two types of thermoplastic masks for patient immobilization during radiation therapy for head-and-neck cancer.,"Radiation therapy for head-and-neck cancer requires a reliable immobilization for an accurate and consistent treatment setup. This prospective, randomized study was done to compare two types of Posicast thermoplastic face masks, in terms of reproducibility, patient comfort, tolerability, and skin damage. The patients were randomly assigned to use a head mask (HM) or a head-and-shoulder mask (HSM). Three-dimensional treatment planning was followed by fractionated external-beam radiation therapy. Reproducibility was assessed by comparing port films with simulator films twice during treatment and by comparing actual treatment table positions weekly. Patient tolerability and comfort were studied weekly. The radiation-induced skin damage was assessed every week according to the World Health Organization toxicity scale. A total of 260 patients were included, and 241 (93%) were evaluated. There were no statistically significant differences between the groups (HM or HSM) in terms of reproducibility. Patients using HSM experienced significantly more claustrophobia (p = 0.023). Patients allocated to HSM receiving > or = 60 Gy were found to have more skin reactions. The smaller HM reduced feelings of claustrophobia, as well as skin reactions, for patients receiving > or = 60 Gy. The smaller mask did not compromise the reproducibility of the setup.",Sharp L.; Lewin F.; Johansson H.; Payne D.; Gerhardsson A.; Rutqvist LE.,2005.0,10.1016/j.ijrobp.2004.04.047,0,0,
3904,Impact of post-colposcopy management on women's long-term worries: results from the UK population-based TOMBOLA trial,"ER AIM: To compare worries about cervical cancer, future fertility, having sex, and general health between women managed by alternative policies at colposcopy.DESIGN: Multicentre individually-randomised controlled trial, nested within the National Health Service Cervical Screening Programmes.SETTING: UK.METHODS: 1515 women, aged 20-59?years, with low-grade cytology who attended colposcopy during February 2001-October 2002, were randomised to immediate loop excision or punch biopsies with recall for treatment if cervical intraepithelial neoplasia (CIN)2/3 was confirmed. Women completed questionnaires at recruitment and after 12, 18, 24 and 30?months. Outcomes were prevalence of worries at each time-point (point prevalence) and at any time-point during follow-up (12-30?months; cumulative prevalence). Primary analysis was by intention-to-treat (ITT); secondary per-protocol analysis compared groups according to management received among women with an abnormal transformation zone.RESULTS: Cumulative prevalence of worries was: cervical cancer 40%; having sex 26%, future fertility 24%, and general health 60%. In ITT analyses, there were no statistically significant differences between management arms in cumulative or point prevalence of any of the worries. In per-protocol analyses, between-group differences were significant only for future fertility; cumulative prevalence was highest in women who underwent punch biopsies and treatment.CONCLUSIONS: There is no difference in the prevalence of specific worries in women randomised to alternative post-colposcopy management policies.CLINICAL TRIAL REGISTRATION:ISRCTN: 34841617.BACKGROUND: Effective cervical screening reduces cancer incidence and mortality. However, these benefits may be accompanied by some harms, potentially including, adverse psychological impacts. Studies suggest women may have concerns about various specific issues, such as cervical cancer.","Sharp, L; Cotton, S; Cruickshank, M; Gray, N; Smart, L; Whynes, D; Little, J",2016.0,10.1136/jfprhc-2015-101170,0,0,
3905,Factors associated with psychological distress following colposcopy among women with low-grade abnormal cervical cytology: a prospective study within the Trial Of Management of Borderline and Other Low-grade Abnormal smears (TOMBOLA).,"Little is known about psychological after-effects of colposcopy and associated investigations and treatment in women with low-grade abnormal cervical cytology. We investigated psychological distress following colposcopy and related procedures. Nine hundred and eighty-nine women aged 20-59 years with routine cytology showing low-grade abnormalities were recruited to the Trial of Management of Borderline and other Low-grade Abnormal smears and attended colposcopy. If the cervical transformation zone (TZ) was colposcopically abnormal, women had immediate loop excision or diagnostic punch biopsies, with treatment if these showed cervical intraepithelial neoplasia grade 2/3 (CIN2/3). Women completed socio-demographic and psychosocial questionnaires at recruitment and before colposcopy. Six weeks after their last procedure, women completed the Impact of Event Scale (IES). Logistic regression was used to determine factors associated with significant psychological distress (IES ‚â• 9). Analyses were stratified by colposcopic impression. The response rate was 74%. Six weeks after the last procedure, 86 (21%) of 391 women with a normal TZ had significant distress compared with 144 (42%) of 337 with an abnormal TZ. In both groups, significant distress was associated with anxiety pre-colposcopy and pain or discharge afterwards. Additional variables predicting distress in women with a normal TZ were worries about having sex and dissatisfaction with support from others. In women with an abnormal TZ, additional predictors of distress were younger age, CIN2/3, bleeding following colposcopy and worries about having cancer. Substantial proportions of women experience psychological distress after colposcopy and related procedures, even when the colposcopy is normal. This is an important cost of cervical screening. Interventions to alleviate these adverse psychological effects are required.",Sharp L.; Cotton S.; Carsin AE.; Gray N.; Thornton A.; Cruickshank M.; Little J.;  .,2013.0,10.1002/pon.2097,0,0,
3906,"A randomised, controlled trial of the psychological effects of reflexology in early breast cancer.","To conduct a pragmatic randomised controlled trial (RCT) to evaluate the effects of reflexology on quality of life (QofL) in women with early breast cancer. One hundred and eighty-three women were randomised 6 weeks post-breast surgery to self-initiated support (SIS) (comparator intervention), SIS plus reflexology, or SIS plus scalp massage (control for physical and social contact). Reflexology and massage comprised eight sessions at weekly intervals. The primary end-point was 18 weeks post surgery; the primary outcome measure was the Trial Outcome Index (TOI) of the Functional Assessment of Cancer Therapy (FACT-B) - breast cancer version. The secondary end-point was 24 weeks post surgery. Secondary outcome measures were the Hospital Anxiety and Depression Scale (HADS) and the Mood Rating Scale (MRS). At primary end-point, massage, but not reflexology, was significantly better than SIS on the TOI. Reflexology and massage were both better than SIS for MRS relaxation. Massage was better than reflexology and SIS for MRS easygoingness. At secondary end-point, reflexology, but not massage, was better than SIS on the TOI and MRS relaxation. There were no significant differences between reflexology or massage. There were no significant between group differences in HADS anxiety and depression. Self-reported use of out of study complementary therapies indicated that this was unlikely to have a significant effect on findings. When compared to SIS, reflexology and massage have statistically significant, and, for reflexology, clinically worthwhile, effects on QofL following surgery for early breast carcinoma.",Sharp DM.; Walker MB.; Chaturvedi A.; Upadhyay S.; Hamid A.; Walker AA.; Bateman JS.; Braid F.; Ellwood K.; Hebblewhite C.; Hope T.; Lines M.; Walker LG.,2010.0,10.1016/j.ejca.2009.10.006,0,0,
3907,Reducing therapist contact in cognitive behaviour therapy for panic disorder and agoraphobia in primary care: global measures of outcome in a randomised controlled trial.,"Panic disorder, with and without agoraphobia, is a prevalent condition presenting in general practice. Psychological treatments are effective but are limited by restricted availability. Interest has grown in methods by which the efficiency and thus availability of psychological treatments can be improved, with particular emphasis on reduced therapist contact formats. To evaluate the relative efficacy in a primary care setting of a cognitive behaviour therapy (CBT) delivered at three levels of therapist contact: standard contact, minimum contact, and bibliotherapy. A total of 104 patients were randomly allocated to receive standard therapist contact, minimum therapist contact or bibliotherapy, with 91 patients completing treatment. All patients received an identical treatment manual and were seen by the same psychologist therapist. Outcome was reported in terms of brief global ratings of severity of illness, change in symptoms, and levels of social disruption. These brief measures were chosen to be suitable for use in general practice and were used at treatment entry and endpoint. The standard therapist contact group had the strongest and most comprehensive treatment response, showing significant differences from the bibliotherapy group on all, and the minimum therapist contact group on some, endpoint measures. Some reduction in efficacy was therefore found for the reduced therapist contact groups. The standard therapist contact group showed the greatest treatment efficacy in the present study. As it was of notably shorter duration than many other current formulations of CBT, it represents a useful and efficient treatment for panic disorder and agoraphobia in primary care.",Sharp DM.; Power KG.; Swanson V.,2000.0,,0,0,
3908,Changes in spontaneous brain bioelectrical activity during transcranial electrical and electromagnetic stimulation.,"The systems responses of the brain to therapeutic transcranial electrical and electromagnetic stimulation were studied and the neurophysiological criteria for assessing the efficacy of this treatment were identified using comparative clinical and experimental studies with analysis of spontaneous bioelectrical activity, along with assessment of behavioral and clinical measures. Study groups consisted of six patients with chronic post-traumatic unconscious states during courses of transcranial electrical stimulation and 17 intact Wistar rats subjected to transcranial electromagnetic stimulation. A relationship was found between the effects of transcranial stimulation and the initial level of intercenter interactions of brain bioelectrical activity assessed in terms of coherence. Hypersynchronization of biopotentials, identified as a major element in the reactivity to this type of stimulation, may be of the greatest value in the recovery of patients with cerebral pathology in cases with initially reduced levels of intercenter interactions in the absence of pathologically increased functional connections in the brain.",Sharova EV.; Mel'nikov AV.; Novikova MR.; Kulikov MA.; Grechenko TN.; Shekhter ED.; Zaslavskii AY.,2007.0,10.1007/s11055-007-0034-3,0,0,
3909,[EEG effects of therapeutic electric stimulation in the human brain in posttraumatic unconscious state].,,Sharova EV.; Amcheslavskiĭ VG.; Potapov AA.; Anizimirov VL.; Zaĭtsev OS.; Emel'ianov VK.; Shabalov VA.,,,0,0,
3910,EEG effects of therapeutic electrical stimulation of the human brain in the posttraumatic unconscious state.,"The effects of therapeutic spinal cord stimulation (SCS) and transcranial electric stimulation on the functional activity of the brain in 7 patients in the posttraumatic unconscious state were compared. The therapeutic transcranial stimulation was shown to exert a positive effect on the EEG and the characteristics of its spatial-temporal organization in most cases, which corresponds with positive shifts in the mental and motor sphere. The phasic character of changes in the bioelectric activity reflecting the sequence of involvement of the cerebral structures (primary activation of the deep frontal lobe divisions, activation of the subcortical-diencephalic structures, ""activation"" of the cortex) in the developing adaptive reactions, which helps us understand their neurophysiological mechanisms, is described. It was established that the formation of the foci of persistent pathological activity with dominant characteristics in the brain is one of the possible complications of both SCS and transcranial electric stimulation. The data may serve as the basis for further clinical study of the influence of transcranial electric stimulation on the recovery of patients in postcomatose unconscious states. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sharova, E. V; Amcheslavskii, V. G; Potapov, A. A; Anzimirov, V. L; Zaitsev, O. S; Emel'yanov, V. K; Shabalov, V. A; Artyukhina, Bekhtereva, Beteleva, Deliac, Dobrokhotova, Eolchiyan, Funahashi, Gambarelli, Gimranov, Grosswasser, Koptelov, Korsakov, Kositsyn, Makarenko, Matsui, Ohira, Pavlygina, Podachin, Rusinov, Rusinova, Sharova, Sharova, Skrebitskii, Sudakov, Takizawa, Tsubokawa, Zaitsev",2001.0,,0,0,
3911,An aerobic walking programme versus muscle strengthening programme for chronic low back pain: A randomized controlled trial.,"Objective: To assess the effect of aerobic walking training as compared to active training, which includes muscle strengthening, on functional abilities among patients with chronic low back pain. Design: Randomized controlled clinical trial with blind assessors. Setting: Outpatient clinic. Subjects: Fifty-two sedentary patients, aged 18-65 years with chronic low back pain. Patients who were post surgery, post trauma, with cardiovascular problems, and with oncological disease were excluded. Intervention: Experimental 'walking' group: moderate intense treadmill walking; control 'exercise' group: specific low back exercise; both, twice a week for six weeks. Main measures: Six-minute walking test, Fear-Avoidance Belief Questionnaire, back and abdomen muscle endurance tests, Oswestry Disability Questionnaire, Low Back Pain Functional Scale (LBPFS). Results: Significant improvements were noted in all outcome measures in both groups with non-significant difference between groups. The mean distance in metres covered during 6 minutes increased by 70.7 (95% confidence interval (CI) 12.3-127.7) in the 'walking' group and by 43.8 (95% CI 19.6-68.0) in the 'exercise' group. The trunk flexor endurance test showed significant improvement in both groups, increasing by 0.6 (95% CI 0.0-1.1) in the 'walking' group and by 1.1 (95% CI 0.3-1.8) in the 'exercise' group. Conclusions: A six-week walk training programme was as effective as six weeks of specific strengthening exercises programme for the low back. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Shnayderman, Ilana; Katz-Leurer, Michal; Abenhaim, Al-Obaidi, Brownson, Chatzitheodorou, Deutscher, Deutscher, Dishman, Dubbert, Dunn, Ferreira, Fritz, Hart, Hartvigsen, Hayden, Holm, Hurley, Jacob, Klaber Moffet, Lamoth, Ljungqust, Mannion, Miranda, Mirovsky, Pate, Penedo, Tang, Taylor, Van Tulder, Wang",2013.0,,0,0,
3912,Effectiveness of therapeutic massage for generalized anxiety disorder: a randomized controlled trial.,"Although massage is one of the most popular complementary and alternative medical (CAM) treatments for anxiety, its effectiveness has never been rigorously evaluated for a diagnosed anxiety disorder. This study evaluates the effectiveness of therapeutic massage for persons with generalized anxiety disorder (GAD). Sixty-eight persons with GAD were randomized to therapeutic massage (n=23), thermotherapy (n=22), or relaxing room therapy (n=23) for a total of 10 sessions over 12 weeks. Mean reduction in anxiety was measured by the Hamilton Anxiety Rating Scale (HARS). Secondary outcomes included 50% reduction in HARS and symptom resolution of GAD, changes in depressive symptoms (Patient Health Questionnaire (PHQ-8)), worry and GAD-related disability. We compared changes in these outcomes in the massage and control groups posttreatment and at 6 months using generalized estimating equation (GEE) regression. All groups had improved by the end of treatment (adjusted mean change scores for the HARS ranged from -10.0 to -13.0; P<.001) and maintained their gains at the 26-week followup. No differences were seen between groups (P=.39). Symptom reduction and resolution of GAD, depressive symptoms, worry and disability showed similar patterns. Massage was not superior to the control treatments, and all showed some clinically important improvements, likely due to some beneficial but generalized relaxation response. Because the relaxing room treatment is substantially less expensive than the other treatments, a similar treatment packaged in a clinically credible manner might be the most cost effective option for persons with GAD who want to try relaxation-oriented CAM therapies.",Sherman KJ.; Ludman EJ.; Cook AJ.; Hawkes RJ.; Roy-Byrne PP.; Bentley S.; Brooks MZ.; Cherkin DC.,2010.0,10.1002/da.20671,0,0,
3913,Gender differences among treatment-seeking adults with cannabis use disorder: Clinical profiles of women and men enrolled in the Achieving Cannabis Cessation-Evaluating N-acetylcysteine Treatment (ACCENT) study.,"Background and Objectives Recent evidence suggests that women may fare worse than men in cannabis trials with pharmacologic interventions. Identifying baseline clinical profiles of treatment-seeking cannabis-dependent adults could inform gender-specific treatment planning and development. Methods The current study compared baseline demographic, cannabis use, and psychiatric factors between women (n = 86) and men (n = 216) entering the Achieving Cannabis Cessation-Evaluating N-acetylcysteine Treatment (ACCENT) study, a multi-site, randomized controlled trial conducted within the National Drug Abuse Treatment Clinical Trials Network. Results Women reported greater withdrawal intensity (p = .001) and negative impact of withdrawal (p = .001), predominantly due to physiological and mood symptoms. Women were more likely to have lifetime panic disorder (p = .038) and current agoraphobia (p = .022), and reported more days of poor physical health (p = .006) and cannabis-related medical problems (p = .023). Women reporting chronic pain had greater mean pain scores than men with chronic pain (p = .006). Men and women did not differ on any measures of baseline cannabis use. Discussion and Conclusions Cannabis-dependent women may present for treatment with more severe and impairing withdrawal symptoms and psychiatric conditions compared to cannabis-dependent men. This might help explain recent evidence suggesting that women fare worse than men in cannabis treatment trials of pharmacologic interventions. Baseline clinical profiles of treatment-seeking adults can inform gender-specific treatment planning and development. Scientific Significance Cannabis-dependent women may benefit from integrated treatment focusing on co-occurring psychiatric disorders and targeted treatment of cannabis withdrawal syndrome. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Sherman, Brian J; McRae-Clark, Aimee L; Baker, Nathaniel L; Sonne, Susan C; Killeen, Therese K; Cloud, Kasie; Gray, Kevin M; Allsop, Buckner, Cooper, Cooper, Copeland, Copersino, Davis, de Dios, Fattore, Feise, First, Franken, Hall, Harte-Hargrove, Heatherton, Heishman, Hernandez-Avila, Herrmann, Herrmann, Khan, Lev-Ran, Lopez-Quintero, Mariani, McClure, McRae-Clark, Schulz, Sheehan, Sherman, Sherman, Sidak, Sobell, Stephens, Stephens, Volkow, Ware, Wilsey, Zigmond",2017.0,,0,0,
3914,Clinical use of the 193-nm excimer laser in the treatment of corneal scars.,"Phototherapeutic keratectomy using a 193-nm excimer laser was performed at four centers on 33 sighted patients with corneal opacity and/or irregular astigmatism. Pathologic conditions included anterior stromal and superficial scarring from postinfectious and posttraumatic causes, including inactive herpes simplex virus, anterior corneal dystrophies, recurrent erosions, granular dystrophy, and band keratopathy. Most patients received peribulbar anesthesia and underwent removal of the epithelium prior to laser ablation. A majority of patients had a reduction in the amount of corneal scarring and approximately half had improved visual acuity. No intraocular reaction or changes in endothelial counts were seen, and some patients avoided the need for penetrating keratoplasty. Reepithelialization usually occurred within 4 or 5 days and we noted no significant scarring secondary to use of the laser. It was difficult to eliminate preexisting irregular astigmatism despite the use of surface modulators, such as methylcellulose. A hyperopic shift secondary to corneal flattening was encountered in approximately 50% of the patients. A combination of myopic ablation, followed immediately by a secondary hyperopic steepening, may minimize this refractive change. The 193-nm excimer laser is an effective new tool in the treatment of selected patients with superficial corneal opacity from a variety of conditions.",Sher NA.; Bowers RA.; Zabel RW.; Frantz JM.; Eiferman RA.; Brown DC.; Rowsey JJ.; Parker P.; Chen V.; Lindstrom RL.,1991.0,,0,0,
3915,Stress-response-dampening effects of alcohol: Attention as a mediator and moderator,"The present study sought to characterize alcohol's stress-response- dampening (SRD) effects on multiple measures of stress and whether these effects are mediated by reductions in sustained attention and, further, whether baseline levels of sustained attention moderate SRD. One hundred six men consumed either an alcohol (0.70 g/kg) or a placebo beverage prior to learning that they would deliver a self-disclosing speech. Structural equation models controlling for multiple baseline periods indicated that alcohol directly reduced self-reported anxiety and skin conductance levels in response to the stressor. Alcohol's effect on reducing heart rate response, in contrast, was indirect and mediated by effects on prestress baseline. As hypothesized, differences in sustained attention partially mediated the effects of alcohol on skin conductance (but not heart rate or self-reported anxiety) and served as a moderator of alcohol's effects on skin conductance response. Findings are discussed in terms of theoretical links among alcohol consumption, specific cognitive abilities, and stress reactivity. © 2007 APA, all rights reserved.",Sher K.J.; Bartholow B.D.; Peuser K.; Erickson D.J.; Wood M.D.,2007.0,10.1037/0021-843X.116.2.362,0,0,
3916,Evaluation of dog-appeasing pheromone as a potential treatment for dogs fearful of fireworks,"Thirty dogs that showed signs of fear in response to fireworks participated in an open clinical trial to assess the potential value of dog-appeasing pheromone for the alleviation on their behavioural signs. The treatment was delivered continuously into the atmosphere of each dog's home with an electrically heated diffuser. At the baseline assessments, the owners identified the behavioural signs of fear that their dogs normally displayed in response to fireworks, rated their frequency and assessed the overall severity of their responses. These measures were repeated at the final assessment and the owners also rated the change in their dog's responses. There were significant improvements in the owners' rating of nine of the 14 behavioural signs of fear that were examined, and in their ratings of the overall severity of the responses. The treatment was generally associated with a reduction in the intensity of fear but there were variations in the responses of individual dogs.",Sheppard G.; Mills D.S.,2003.0,,0,0,
3917,Biochemical changes associated with severe trauma,"ER The effects of different intravenous nutritional regimens on a number of biochemical indices of nutritional status were studied during the 8-day period following severe trauma. The inclusion of large amounts of amino acids (high nitrogen (N) was shown to greatly improve N balance over an isocaloric regimen containing no amino acids (O g N). The concentration of serum albumin, transferrin, prealbumin, and retinol-binding protein all fell during the study period in both patient groups, whereas the serum concentrations of acute phase reactants and of ribonuclease increased in the two groups. The sum of plasma levels of branched-chain amino acids and the essential amino acids was increased to a greater extent in the high N group. These amino acid totals and the ratio of glycine/valine showed a significant correlation with N balance in this group. Despite the marked difference in N balance, 3-methylhistidine excretion was increased but equal in the two nutritional groups, suggesting an increased rate of muscle protein breakdown in both groups, which appears not to be influenced by amino acid nutrition. It is concluded that N balance can be significantly improved in the immediate posttrauma period by provision of amino acids together with energy substrates. None of the biochemical variables measured, with the exception of plasma levels of essential amino acids, reflected these marked differences in N balance.","Shenkin, A; Neuhäuser, M; Bergström, J; Chao, L; Vinnars, E; Larsson, J; Liljedahl, S O; Schildt, B; Fürst, P",1980.0,,0,0,
3918,Effects of electro-acupuncture combined general anesthesia on myocardial injury of high blood sugar patients with coronary heart disease in the perioperative phase,"ER OBJECTIVE: To investigate the effects of electro-acupuncture (EA) combined general anesthesia on myocardial injury of high blood sugar patients with coronary heart disease (CHD) in the perioperative phase.METHODS: Recruited were 40 senile patients with glycosylated hemoglobin (HbA1c) more than 6.5%. They were more than 60 years old. They received post-traumatic fracture reduction surgery of four limbs. They were randomly assigned to two groups, Group N (treated by general intravenous anesthesia) and Group D (treated by EA combined with general intravenous anesthesia), 20 in each group. All patients were maintained anesthesia by propofol, fentanyl, and vecuronium. Prior to the induction of anesthesia, patients in Group D received induction of EA at Neiguan (PC6) and Baihui (DU20) for 20 min, which lasted to the end of the surgery. At before intubation (T0), immediately after intubation (T1), 5 min (T2), immediately after extubation (T3), 5 min (T4), 60 min (T5), 180 min (T6), the fast blood glucose (FBG), plasma vasoactive substance TXB2 and 6-K-prostacycline (6-K-PGF1alpha) were detected in the two groups. The glucose coefficient of variation (GluCV) and the ratio of TXB2/6-K-PGF1alpha were calculated. The changes of ST-segment elevation (mV, sampling 1 min after each time point, and the mean calculated) was recorded.RESULTS: There was no statistical difference in all the tested values between the two groups at T0 (P>0.05). The FBG, ST elevation, and the ratio of TXB2/6-K-PGF1alpha were significantly higher at each time point than at T0 in Group N (P0.05). The ratio of TXB2/6-K-PGF1alpha and ST elevation were significantly higher in Group N than in Group D (P<0.01). The TXB2 and 6-K-PGF1alpha were significantly higher at each time point than at T0 in the two groups (P<0.05). The increment of TXB2 was obviously lower in Group D than in Group N (P<0.05), but the increment of 6-K-PGF1alpha was obviously higher in Group D than in Group N (P<0.05).CONCLUSION: EA could reduce the perioperative stress response to the injury of coronary vascular endothelial cells, and improve myocardial ischemia and CHD patients' prognosis by regulating the central nervous system, the cardiovascular active substances, and anti-oxygen free radicals.","Shen, H; Chen, Y J",2012.0,,0,0,
3919,Clinical treatment of orthostatic hypotension after spinal cord injury with training based on electric uprise bed coupled with remote ECG and BP monitor.,"The treatment for orthostatic hypotension (OH) after spinal cord injury (SCI) is an important part of rehabilitation in late-stage SCI. Electric uprise bed training is a relatively commonly used method in treating OH, and how to carry out uprise bed training safely and effectively is an urgent problem. In the early stage of SCI, we used a remote monitoring system to monitor the whole process of uprise bed training, and we explored a safe and efficient method of electric uprise bed training. The experimental group consisted of 36 patients diagnosed with orthostatic hypotension (OH) after SCI and who received training with an electric uprise bed coupled with remote monitoring system, and the control group of 18 subjects who used a traditional training method. There were no differences in baseline data between the 2 groups. There were no severe symptoms during training in the experimental group, but 3 patients had severe symptoms in the control group. Among the 32 enrolled subjects reaching upright training status within 30 days (17 subjects in the experimental group and 15 subjects in the control group), time interval of training from horizontal position to erect position in the experimental group was 18.00±3.12 days and 21.40±4.95 days in the control group. Time interval in the experimental group was significantly less than in the control group. However, among all 36 subjects, by combining results of follow-up, there was no significant difference of time interval of training from horizontal position to erect position between the experimental group and the control group. In the experimental group 90.52% of patients finished training compared to 78.19% in the control group (P<0.01). After training, values of OCs and OCd of the experimental group were lower than in the control group. There was no significant difference between groups in number of re-diagnosed OH. Implementation of training with electric uprise bed coupled with remote monitoring system is generally safe for patients with OH after SCI. For patients who could reach standing training status within 30 days, implementation can improve efficiency of training by shortening time interval of training from horizontal position to erect position. It can increase orthostatic blood pressure change during position change.",Shen D.; Huang H.; Yuan H.; Zhang X.; Li M.,2014.0,10.12659/MSM.891137,0,0,
3920,Symptoms of posttraumatic stress disorder in patients who have had a myocardial infarction.,Symptoms of posttraumatic stress disorder (PTSD) and risk factors for recurrent ischemia were evaluated in 65 survivors of a myocardial infarction (MI) at baseline and 6 months afterward. PTSD patients had more uncontrolled cardiovascular risk factors at baseline. Patients with PTSD (N=14) were offered trauma-focused cognitive-behavior treatment (CBT) plus a nonspecific intervention to improve adherence to medical recommendations. Adherence to aspirin improved in recipients of the nonspecific intervention (N=8); PTSD symptoms and cardiovascular risk improved in patients who received CBT (N=6). PTSD may be a treatable risk factor for poor post-MI outcome. Further research is needed to evaluate treatment options.,Shemesh E.; Koren-Michowitz M.; Yehuda R.; Milo-Cotter O.; Murdock E.; Vered Z.; Shneider BL.; Gorman JM.; Cotter G.,,10.1176/appi.psy.47.3.231,0,0,
3921,"Evaluation of universal, indicated, and combined cognitive-behavioral approaches to the prevention of depression among adolescents","ER A cluster, stratified randomized design was used to evaluate the impact of universal, indicated, and combined universal plus indicated cognitive- behavioral approaches to the prevention of depression among 13- to 15-year-olds initially reporting elevated symptoms of depression. None of the intervention approaches differed significantly from a no-intervention condition or from each other on changes in depressive symptoms, anxiety, externalizing problems, coping skills, and social adjustment. All high-symptom students, irrespective of condition, showed a significant decline in depressive symptoms and improvement in emotional well-being over time although they still demonstrated elevated levels of psychopathology compared with the general population of peers at 12-month follow-up. There were also no significant intervention effects for the universal intervention in comparison with no intervention for the total sample of students in those conditions.","Sheffield, J K; Spence, S H; Rapee, R M; Kowalenko, N; Wignall, A; Davis, A; McLoone, J",2006.0,10.1037/0022-006X.74.1.66,0,0,
3922,The temporastability of self-ratings of neuroticsymptoms.,,Sheffield BF.; Kellner R.,1970.0,,0,0,
3923,Personality pathology factors predict recurrent major depressive disorder in emerging adults.,"Prior investigations consistently indicate that personality pathology is a risk factor for recurrence of major depressive disorder (MDD). Lack of emipircal support, however, for the Diagnostic and Statistical Manual of Mental Disorders (DSM) Fourth Edition organization of Axis II disorders supports the investigation of empirically derived factors of personality pathology as predictors of recurrence. A sample of 130 previously depressed emerging adults (80% female; aged 18 to 21 years) were assessed for personality disorder symptoms at baseline. Participants were then followed for 18 months to identify MDD recurrence during the first 2 years of college. Based on a previous factor analysis of DSM personality disorder criteria, eight personality pathology factors were examined as predictors of MDD recurrence. Survival analysis indicated that factors of interpersonal hypersensitivity, antisocial conduct, and social anxiety were associated with increased risk of MDD recurrence. These findings suggest that an empirically based approach to personality pathology organization may yield useful predictors of MDD recurrence during emerging adulthood.",Sheets ES.; Duncan LE.; Bjornsson AS.; Craighead LW.; Craighead WE.,2014.0,10.1002/jclp.22028,0,0,
3924,Recent developments in the treatment of panic disorder.,"The focus of this paper is the treatment of panic disorder with alprazolam. Drug treatments alone are sometimes not sufficient by themselves, to adequately control all of the symptoms or components of this disorder. In the typical case we can identify four targets of treatment: The first target is the biological core of the condition, that is characterized by the unexpected, unprovoked attacks of anxiety. This responds best to medication. The second target is the phobic avoidance behaviour. It appears to be a conditioned or learned complication of the biological core, and appears to follow the laws of learning theory. Unlearning treatments, like behaviour therapy (notably in vivo exposure) are usually necessary to make a full impact against the phobic avoidance behaviour. Thirdly, there is no drug that reverses the psycho-social problems these patients have. Not all of them have such problems, but those that do may need psychotherapy to deal with their conflicts and stresses. Finally, the evidence in several chronic studies, suggest that this is a chronic relapsing disorder in the majority of cases. It is not enough to treat these patients acutely. They must be followed chronically and monitored carefully over many years, if they are to be protected against relapse.",Sheehan DV.; Soto S.,1987.0,,0,0,
3925,"Treatment of endogenous anxiety with phobic, hysterical, and hypochondriacal symptoms.","Endogenous anxiety (anxiety hysteria, agoraphobia with panic attacks) is characterized by sudden, spontaneous panic attacks accompanied by multiple autonomic symptoms, overwhelming fear, a flight response, and polyphobic behavior. Psychotherapy, behavior therapy, and tranquillizers have been of limited success in treating this syndrome. Fifty-seven patients severely disabled by the syndrome for a mean period of 13 years completed the three-month study. Randomly assigned in a double-blind, placebo-controlled design to imipramine hydrochloride, pheneizine sulfate, or placebo, they were seen in supportive group therapy every two weeks. Patients in the pheneizine and imipramine cells showed significant improvement ovehe persistent trend for pheneizine to be superior to imipramine achieved significance only on the Work and Social Disability Scale and the Sympton Severity and Phobic Avoidance Scale. The implications for classification and theory are discussed.",Sheehan DV.; Ballenger J.; Jacobsen G.,1980.0,,0,0,
3926,Current concepts in psychiatry. Panic attacks and phobias.,,Sheehan DV.,1982.0,10.1056/NEJM198207153070304,0,0,
3927,Assessing remission in major depressive disorder and generalized anxiety disorder clinical trials with the discan metric of the Sheehan disability scale.,"Relatively little research has focused on the relationship between functional remission and symptomatic remission in mood and anxiety disorders. This study investigates the relationship and synchrony between symptomatic and functional remission in outpatients with major depressive disorder (MDD) and generalized anxiety disorder (GAD). Using data from three MDD (N = 1419) and four GAD (N = 1847) randomized, placebo-controlled duloxetine studies, we calculated the percentages of patients meeting symptomatic, functional, and combined functional-symptomatic remission criteria for each disorder. We also calculated mean depression [17-item Hamilton depression rating scale (HAMD17), Montgomery-Asberg depression rating scale] scores and mean anxiety (Hamilton anxiety rating scale) scores for patients meeting Sheehan disability scale (SDS) functional remission and the mean SDS scores for patients with symptomatic remission. Among the patients with MDD, 38% achieved symptomatic remission (HAMD17 <= 7), 32% achieved functional remission (SDS <= 6), and 23% achieved combined functional-symptomatic remission. Mean HAMD17 and Montgomery-Asberg depression rating scale scores for patients with functional remission were approximately 6. Mean SDS total scores for patients with symptomatic remission were 7.1 (patients with HAMD17 <= 7) and 8.6 (patients with Montgomery-Asberg depression rating scale <= 10). Among the patients with GAD, 30% achieved symptomatic remission (Hamilton anxiety rating scale <= 7), 45% achieved functional remission (SDS <= 6), and 25% achieved combined symptomatic-functional remission. The mean Hamilton anxiety rating scale score in GAD was approximately 8 for patients with functional remission and the mean SDS total score was approximately 4 in patients with symptomatic remission. The study shows that functional remission does not always move in tandem with symptom remission and provides useful anchor points or rules of thumb for evaluating symptomatic and functional remission in MDD and GAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sheehan, David V; Harnett-Sheehan, Kathy; Spann, Melissa E; Thompson, Harry F; Prakash, Apurva; Ballenger, Bijl, Detke, Giller, Grant, Greenberg, Greenberg, Guy, Hamilton, Hamilton, Hamilton, Hartford, Keller, Kelsey, Kennedy, Kessler, Koponen, Leon, Lipman, Miller, Mintz, Montgomery, Murray, Nicolini, Nierenberg, Ormel, Papakostas, Perahia, Pigott, Pollack, Raskin, Rickels, Rush, Rynn, Sheehan, Sheehan, Sheehan, Simon, Trivedi, Weissman, Wittchen, Zigmond",2011.0,,0,0,
3928,Groups for children and adolescents with trauma-related symptoms: outcomes and processes,"ER The study was conducted in Israel following the 2006 Lebanon war. The purpose was to examine the impact of counseling groups employing an expressive-supportive modality on children and adolescents with war-related or divorce/loss-related trauma symptoms. The 164 children were placed into 18 small groups for 10 weekly sessions. The children were screened for traumatic stress symptoms and then randomly divided into experimental and control (wait-list) conditions. All participants completed the measures of the dependent variables (trauma symptoms, anxiety), a social support measure, and group-process measures (group relationships, group cohesion, and catharsis). Results indicated a significantly sharper reduction in trauma symptoms and anxiety in the experimental group than in the control group, regardless of type of trauma. A reduction in anxiety was predicted by gains in social support and group cohesiveness.","Shechtman, Z; Mor, M",2010.0,10.1521/ijgp.2010.60.2.221,0,0,
3929,Attention bias modification treatment augmenting effects on cognitive behavioral therapy in children with anxiety: randomized controlled trial,"ER METHOD: Sixty-three treatment-seeking children with anxiety disorder were randomly assigned to 1 of the following 3 treatment groups: ABMT + CBT; ABMT placebo + CBT; and CBT-alone. Participants in the 2 ABMT conditions received repeated training on dot-probe tasks either designed to shift attention away from threats (active) or designed to induce no changes in attention patterns (placebo). Primary outcome measures were frequency and severity of anxiety symptoms as determined by a clinician using a semi-structured interview. Self- and parent-rated anxiety measures and threat-related attention bias scores were also measured before and after treatment.RESULTS: Both the active and placebo ABMT groups showed greater reductions in clinician-rated anxiety symptoms than the CBT-alone group. Furthermore, only the active ABMT group showed significant reduction in self- or parent-rated anxiety symptoms. Finally, all groups showed a shift in attention patterns across the study, starting with a bias toward threat at baseline and shifting attention away from threat after treatment.CONCLUSIONS: Active and placebo ABMT might augment the clinical response to CBT for anxiety. This effect could arise from benefits associated with performing computer-based paradigms such as the dot-probe task. Given the absence of group differences in attention-bias changes during treatment, possible mechanisms and methodological issues underlying the observed findings are discussed. Clinical trial registration information-Augmenting Effects of ABMT on CBT in Anxious Children: A Randomized Clinical Trial; http://clinicaltrials.gov/; NCT01730625.OBJECTIVE: Attention bias modification treatment (ABMT) is a promising novel treatment for anxiety disorders, but clinical trials have focused largely on stand-alone formats among adults. This randomized controlled trial examined the augmenting effects of threat-based ABMT on cognitive behavioral therapy (CBT) in clinically anxious youth.","Shechner, T; Rimon-Chakir, A; Britton, J C; Lotan, D; Apter, A; Bliese, P D; Pine, D S; Bar-Haim, Y",2014.0,10.1016/j.jaac.2013.09.016,0,0,
3930,Traumatic grief treatment: a pilot study.,"The effects of a treatment program targeting debilitating grief symptoms were tested in a pilot study. Twenty-one individuals experiencing traumatic grief were recruited for participation, and 13 completed the full 4-month protocol. The treatment protocol used imaginal re-living of the death, in vivo exposure to avoided activities and situations, and interpersonal therapy. Significant improvement in grief symptoms and associated anxiety and depression was observed for both completer and intent-to-treat groups. The traumatic grief treatment protocol appears to be a promising intervention for debilitating grief.",Shear MK.; Frank E.; Foa E.; Cherry C.; Reynolds CF.; Vander Bilt J.; Masters S.,2001.0,10.1176/appi.ajp.158.9.1506,0,0,
3931,Multicenter collaborative panic disorder severity scale.,"To address the lack of a simple and standardized instrument to assess overall panic disorder severity, the authors developed a scale for the measurement of panic disorder severity. Ten independent evaluators used the seven-item Panic Disorder Severity Scale to assess 186 patients with principal DSM-III-R diagnoses of panic disorder (with no or mild agoraphobia) who were participating in the Multicenter Collaborative Treatment Study of Panic Disorder. In addition, 89 of these patients were reevaluated with the same scale after short-term treatment. A subset of 24 patients underwent two independent assessments to establish interrater reliability. Internal consistency, convergent and discriminant validity, and sensitivity to change were also determined. The Panic Disorder Severity Scale was associated with excellent interrater reliability, moderate internal consistency, and favorable levels of validity and sensitivity to change. Individual items showed good convergent and discriminant validity. Analysis suggested a two-factor model fit the data best. The Panic Disorder Severity Scale is a simple, efficient way for clinicians to rate severity in patients with established diagnoses of panic disorder. However, further research with more diverse groups of panic disorder patients and with a broader range of convergent and discriminant validity measures is needed.",Shear MK.; Brown TA.; Barlow DH.; Money R.; Sholomskas DE.; Woods SW.; Gorman JM.; Papp LA.,1997.0,10.1176/ajp.154.11.1571,0,0,
3932,Cognitive-behavioral therapy for panic: an open study.,"This paper reports results of an open prospective study of 26 patients who met DSM-III criteria for panic disorder or agoraphobia with panic attacks. Cognitive-behavioral treatment alone produced clinically and statistically significant improvement in panic symptoms, including both full-blown and limited symptom episodes. In addition, the treatment produced improvement in associated symptoms of phobic avoidance and generalized anxiety. This work provides further preliminary indication of the usefulness of cognitive-behavioral strategies as an alternative to medication in symptom-oriented treatments.",Shear MK.; Ball G.; Fitzpatrick M.; Josephson S.; Klosko J.; Frances A.,1991.0,,0,0,
3933,Vulnerability to sodium lactate in panic disorder patients given cognitive-behavioral therapy.,"Six patients (aged 17-37 yrs) with panic disorder who had panicked during sodium lactate infusion were given cognitive-behavioral treatment for 12-24 wks. After treatment, they underwent another lactate infusion, and 4 patients were rated as having no panic, suggesting that reduced vulnerability to lactate accompanies remission of panic. Controlled trials of cognitive-behavioral therapy and use of lactate infusion as a measure of remission are recommended. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Shear, M. Katherine; Fyer, Abby J; Ball, Gordon; Josephson, Stephen; Fitzpatrick, Mary; Gitlin, Bonnie; Frances, Allen; Gorman, Jack; Liebowitz, Michael; Klein, Donald F",1991.0,,0,0,
3934,[The influence of 5-week relaxation therapy on psychological state of patients with borderline hypertension].,"The aim of the present was to evaluate the influence of 5-week relaxation therapy on psychic state of patients with borderline hypertension. The study group consisted of 30 hypertensives. We observed significant changes in anxiety scale, defensiveness, self-confidence, intraception, nurturance, affiliation, heterosexuality, change and succorance scales. In conclusion, 5-week relaxation changes significantly psychological status of patients with borderline hypertension.",Sharma VK.; Borys B.; Narkiewicz K.; Furmański J.; Majkowicz M.; Krupa-Wojciechowska B.,1998.0,,0,0,
3935,Bibliotherapy to decrease stress and anxiety and increase resilience and mindfulness: a pilot trial.,"Interventions to decrease stress and enhance resiliency and mindfulness are more likely to be widely implemented if they can be offered without the need for in-person training. The purpose of this study was to assess effectiveness of a self-directed Stress Management and Resiliency Training (SMART) program delivered using only written material for improving stress, resiliency, and mindfulness. A total of 37 employees at a large medical center were recruited and given written material on the SMART program. Subjects were instructed to practice the skills presented in the written materials without any additional training. The skills included education about the neuropsychology of stress and resilience, training attention to focus in the present moment, and refining interpretations. Primary outcome measures assessed resilience, perceived stress, anxiety, and quality of life. Out of 37 employees, 34 (89%) enrolled subjects completed the study and provided the baseline and follow-up data. A statistically significant improvement in perceived stress, resilience, mindfulness, anxiety, and quality of life was observed at 12 weeks. This study demonstrated that a brief, self-directed program to decrease stress and enhance resilience and mindfulness provided excellent short-term effectiveness for enhancing resilience, mindfulness and quality of life, and decreasing stress and anxiety.",Sharma V.; Sood A.; Prasad K.; Loehrer L.; Schroeder D.; Brent B.,,10.1016/j.explore.2014.04.002,0,0,
3936,Mental health management of pathological gamblers by counseling and relaxation practices.,"The present study examines the mental health management of pathological gamblers by counseling and relaxation practices. Fifty-five treated and 55 non-treated pathological gamblers were evaluated at S. I. Mental and Physical Health Society, Varanasi, India. The two groups were matched by age, ranging 20 to 53 years with a mean age of 36.2 years and mean length of uncontrollable gambling of 7.3 years. The Middlesex Hospital Questionnaire and the Death Anxiety Scale were administered to ascertain mental health and death anxiety on seven selected dimensions, including: anxiety, obsession, phobia, somatization, depression, hysteria, and death anxiety. Mean scores obtained on different variables were analyzed using a t-test of significance. Results indicated that the characteristic associated with treated pathological gamblers was phobia whereas the characteristics associated with non-treated pathological gamblers were anxiety, obsession, somatization, depression, and death anxiety.",Sharma MG.; Upadhyay A.; Sharma V.,2013.0,10.1080/15433714.2012.760960,0,0,
3937,Written disclosure therapy for patients with chronic lung disease undergoing pulmonary rehabilitation,"ER METHODSA prospective, randomized, controlled trial was performed to evaluate the effect of using WDT in patients (N = 66) participating in a pulmonary rehabilitation program. Patients were randomly assigned to write about a particularly traumatic life event (WDT group) or to write about an emotionally neutral subject (control group). Exercise capacity, dyspnea and quality of life, and values of spirometry were recorded at baseline, at the end of the program, and at 6 months.RESULTSThe 6-minute walk distance (6MWD) significantly improved in both groups at 2 months, from 278 to 327 m in WDT and from 269 to 314 m in control groups (P < .01 in both groups). There was no difference in improvement in 6MWD between groups (P = .88). At 6 months, the gains made in 6MWD were no longer present. Dyspnea severity, as well as most of the other domains of the Chronic Respiratory Disease Questionnaire and the St. George's Respiratory Questionnaire, showed improvement within each group, but not between WDT and control groups.CONCLUSIONWDT did not add any additional benefit in patients with chronic obstructive pulmonary disease or idiopathic pulmonary fibrosis when included as a component of pulmonary rehabilitation. These results are in contrast to previously seen benefits in patients with asthma.PURPOSEChronic lung diseases are typically associated with impaired quality of life, stress, and anxiety. Written disclosure therapy (WDT) reduces stress in patients with a variety of chronic illnesses. We sought to determine whether WDT benefits patients with chronic lung disease.","Sharifabad, M A; Hurewitz, A; Spiegler, P; Bernstein, M; Feuerman, M; Smyth, J M",2010.0,10.1097/HCR.0b013e3181e174c4,0,0,
3938,Effects of psycho-educational intervention on health-related quality of life (QOL) of patients with chronic liver disease referring to Shiraz University of Medical Sciences,"ER METHODS: An interventional study was conducted on 110 patients with CLDs in Shiraz Liver Transplantation Center (SLTC). Subjects with the required CLDs criteria were selected and randomly divided into experimental (55) and control (55) groups. A two part questionnaire with 25 items concerning demographic and general information and 29 items regarding QOL was used. The psycho-educational needs of the experimental group were assessed in a session before the intervention, then the experimental group took part in 3 sessions individually and one session in groups. The questionnaires were filled in again for both groups but the control group did not receive the intervention program. The questionnaires were filled in again for both groups one day and three months after the intervention.RESULTS: Findings revealed no significant differences between the two groups from the view point of demographic characteristics such as marital status, gender, etc... (p > 0.05) and from the point of clinical variables no statistically significant differences were found (p > 0.05). Findings revealed statistically significant differences in all domain of QOL in the experimental group three months after the intervention (p = 0.001), while there was no statistically significant differences in the control group.CONCLUSION: The results of this study revealed that psycho-educational intervention had a significant effect on QOL of patients with CLDs.BACKGROUND: Chronic liver diseases (CLDs) are progressive disorder which has a significant impact on the well-being of patients and leads to significant morbidity. CLDs are characterized by disturbances in physical, psychological and social aspects of well-being. It causes significant health-related quality of life (QOL) impairment. Psycho-educational interventions targeting to functional factors could be beneficial for patients with CLDs.","Sharif, F; Mohebbi, S; Tabatabaee, H R; Saberi-Firoozi, M; Gholamzadeh, S",2005.0,10.1186/1477-7525-3-81,0,0,
3939,"Helping Aged Victims of Crime (the HAVoC Study): Common Crime, Older People and Mental Illness.","Limited data suggest that crime may have a devastating impact on older people. Although identification and treatment may be beneficial, no well-designed studies have investigated the prevalence of mental disorder and the potential benefits of individual manualized CBT in older victims of crime. To identify mental health problems in older victims of common crime, provide preliminary data on its prevalence, and conduct a feasibility randomized controlled trial (RCT) using mixed methods. Older victims, identified through police teams, were screened for symptoms of anxiety, depression or post-traumatic stress disorder (PTSD) one (n = 581) and 3 months (n = 486) after experiencing a crime. Screen positive participants were offered diagnostic interviews. Of these, 26 participants with DSM-IV diagnoses agreed to be randomized to Treatment As Usual (TAU) or TAU plus our manualized CBT informed Victim Improvement Package (VIP). The latter provided feedback on the VIP. Recruitment, assessment and intervention are feasible and acceptable. At 3 months 120/486 screened as cases, 33 had DSM-IV criteria for a psychiatric disorder; 26 agreed to be randomized to a pilot trial. There were trends in favour of the VIP in all measures except PTSD at 6 months post crime. This feasibility RCT is the first step towards improving the lives of older victims of common crime. Without intervention, distress at 3 and 6 months after a crime remains high. However, the well-received VIP appeared promising for depressive and anxiety symptoms, but possibly not posttraumatic stress disorder.",Serfaty M.; Ridgewell A.; Drennan V.; Kessel A.; Brewin CR.; Leavey G.; Wright A.; Laycock G.; Blanchard M.,2016.0,10.1017/S1352465814000514,0,0,
3940,Clinical effectiveness of individual cognitive behavioral therapy for depressed older people in primary care: a randomized controlled trial,"ER OBJECTIVETo determine the clinical effectiveness of CBT delivered in primary care for older people with depression.DESIGNA single-blind, randomized, controlled trial with 4- and 10-month follow-up visits.PATIENTSA total of 204 people aged 65 years or older (mean [SD] age, 74.1 [7.0] years; 79.4% female; 20.6% male) with a Geriatric Mental State diagnosis of depression were recruited from primary care.INTERVENTIONSTreatment as usual (TAU), TAU plus a talking control (TC), or TAU plus CBT. The TC and CBT were offered over 4 months.OUTCOME MEASURESBeck Depression Inventory-II (BDI-II) scores collected at baseline, end of therapy (4 months), and 10 months after the baseline visit. Subsidiary measures were the Beck Anxiety Inventory, Social Functioning Questionnaire, and Euroqol. Intent to treat using Generalized Estimating Equation and Compliance Average Causal Effect analyses were used.RESULTSEighty percent of participants were followed up. The mean number of sessions of TC or CBT was just greater than 7. Intent-to-treat analysis found improvements of -3.07 (95% confidence interval [CI], -5.73 to -0.42) and -3.65 (95% CI, -6.18 to -1.12) in BDI-II scores in favor of CBT vs TAU and TC, respectively. Compliance Average Causal Effect analysis compared CBT with TC. A significant benefit of CBT of 0.4 points (95% CI, 0.01 to 0.72) on the BDI-II per therapy session was observed. The cognitive therapy scale showed no difference for nonspecific, but significant differences for specific factors in therapy. Ratings for CBT were high (mean [SD], 54.2 [4.1]).CONCLUSIONCognitive behavioral therapy is an effective treatment for older people with depressive disorder and appears to be associated with its specific effects.TRIAL REGISTRATIONisrctn.org Identifier: ISRCTN18271323.CONTEXTIn older people, depressive symptoms are common, psychological adjustment to aging is complex, and associated chronic physical illness limits the use of antidepressants. Despite this, older people are rarely offered psychological interventions, and only 3 randomized controlled trials of individual cognitive behavioral therapy (CBT) in a primary care setting have been published.","Serfaty, M A; Haworth, D; Blanchard, M; Buszewicz, M; Murad, S; King, M",2009.0,10.1001/archgenpsychiatry.2009.165,0,0,
3941,Prevalence and characteristics of multiple psychiatric disorders in cardiac rehabilitation patients,"ER METHODS: Participants were 143 CHD patients (M age, 61 years; SD, 11.2; 70% men, 91% Caucasian, 64% married) entering CR who were evaluated via a semistructured, psychiatric interview to assess both current and lifetime prevalence rates of PD. Demographic, medical, and psychosocial variables were also assessed.RESULTS: Approximately 45% met criteria for at least 1 anxiety disorder, and 20% met criteria for either major depressive disorder or dysthymic disorder either at the time of evaluation or in their lifetime. Across all participants, 26% met criteria for >or=2 PD. Of those with a depressive disorder, 76% also met criteria for at least 1 anxiety disorder. Participants with comorbid PD were of younger age and female and reported less education (P < .01). Comorbidity was also associated with self-reported overall diminished physical, emotional, and social quality of life, depression, and anxiety.CONCLUSION: Comorbid PD are highly prevalent in the CR setting and are associated with specific demographic characteristics and reduced quality of life. These data offer additional support that routine screening for PD is warranted in outpatient cardiac settings.PURPOSE: Anxiety and depressive disorders have been established as independent risk factors for the development of and recovery from coronary heart disease (CHD). However, few studies have reported on the prevalence and personal characteristics of comorbid psychiatric disorders (PD) among cardiac populations. This project examined the prevalence of comorbid depressive and anxiety disorders among men and women with CHD commencing cardiac rehabilitation (CR) and the demographic, medical, and psychosocial characteristics among those meeting multiple PD criteria.","Serber, E R; Todaro, J F; Tilkemeier, P L; Niaura, R",2009.0,10.1097/HCR.0b013e3181a33365,0,0,
3942,The prevention of depression and anxiety.,"Posted 12/21/1999. A brief and inexpensive cognitive-behavioral prevention program was given to university students at risk for depression. At risk was defined as being in the most pessimistic quarter of explanatory style. 231 students were randomized into either an 8-wk prevention workshop that met in groups of 10, once per week for 2 hr, or into an assessment-only control group. Ss were followed for 3 yrs and the authors report the preventive effects of the workshop on depression and anxiety. First, the workshop group had significantly fewer episodes of generalized anxiety disorder than the control group and showed a trend toward fewer major depressive episodes. The workshop group had significantly fewer moderate depressive episodes but no fewer severe depressive episodes. Second, the workshop group had significantly fewer depressive symptoms and anxiety symptoms than the control group, as measured by self-report but not by clinicians' ratings. Third, the workshop group had significantly greater improvements in explanatory style, hopelessness, and dysfunctional attitudes than the control group and these were significant mediators of depressive symptom prevention in the workshop group. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Seligman, Martin E. P; Schulman, Peter; DeRubeis, Robert J; Hollon, Steven D; Beck, Beck, Beck, Beck, Beck, Beck, Beck, Beck, Beck, Blackburn, Brown, Clarke, Cox, Dobson, Evans, Gillham, Gillham, Greenberg, Greenhouse, Hamilton, Hamilton, Hollon, Hollon, Hollon, Hollon, Jaycox, Keller, Littel, Mantel, Peterson, Peterson, Seligman, Seligman, Shapiro, Shea, Shrout, Simons, Sobel, Spitzer, Spitzer, Weissman, White, Williams",1999.0,,0,0,
3943,Perceived partner responsiveness moderates the association between received emotional support and all-cause mortality,"The aim of this study was to investigate whether perceived partner responsiveness (PPR) moderates the association between received partner emotional support (RPES) and all-cause mortality in a national U.S. sample. Method: Data were from the National Survey of Midlife Development in the United States, a national probability survey of health and aging. Participants included respondents who were married or cohabiting with a romantic partner. Results: Hierarchical logistic regression analyses indicated that after adjusting for demographics, physical health status, health behaviors, psychological symptoms, and personality traits, high RPES was associated with increased mortality risk among participants who reported low PPR, but it was unrelated to mortality risk among participants who reported high PPR. Conclusions: This study is the first to document that perceived partner responsiveness moderates the association between received partner emotional support and mortality risk, thus contributing to the literature on the contextual factors altering the effects of received support on health outcomes. © 2012 American Psychological Association.",Selcuk E.; Ong A.D.,2013.0,10.1037/a0028276,0,0,
3944,A feasibility study of the clinical effectiveness and cost-effectiveness of individual cognitive behavioral therapy for panic disorder in a Japanese clinical setting: an uncontrolled pilot study.,"In Japan, cognitive behavioral therapy (CBT) for panic disorder (PD) is not well established. Therefore, a feasibility study of the clinical effectiveness and cost-effectiveness of CBT for PD in a Japanese clinical setting is urgently required. This was a pilot uncontrolled trial and the intervention consisted of a 16-week CBT program. The primary outcome was Panic Disorder Severity Scale (PDSS) scores. Quality of life was assessed using the EuroQol's EQ-5D questionnaire. Assessments were conducted at baseline, 8 weeks, and at the end of the study. Fifteen subjects completed outcome measures at all assessment points. At post-CBT, the mean reduction in PDSS scores from baseline was -6.6 (95 % CI 3.80 to -9.40, p < 0.001) with a Cohen's d = 1.77 (95 % CI 0.88-2.55). Ten (66.7 %) participants achieved a 40 % or greater reduction in PDSS. By calculating areas under the curve for EQ-5D index changes, we estimated that patients gained a minimum of 0.102 QALYs per 1 year due to the CBT. This study demonstrated that individual CBT for PD may be useful in Japanese clinical settings but further randomized control trials are needed. UMIN-CTR UMIN000022693 (retrospectively registered).",Seki Y.; Nagata S.; Shibuya T.; Yoshinaga N.; Yokoo M.; Ibuki H.; Minamitani N.; Kusunoki M.; Inada Y.; Kawasoe N.; Adachi S.; Yoshimura K.; Nakazato M.; Iyo M.; Nakagawa A.; Shimizu E.,2016.0,10.1186/s13104-016-2262-5,0,0,
3945,Longitudinal study of the influence of life events and personality status on diagnostic change in three neurotic disorders.,"It has been known for many years that diagnosis within the neurotic spectrum of disorders is temporally unstable and also that life events can be major precipitants of change in symptoms. Reasons for this instability could include inherent inadequacy of current diagnostic practice, the influence of life events as an agent of diagnostic shift, and an innate course of disorder with features dependent on the stage at which disorder presents (e.g., development of panic to agoraphobia). These possibilities were examined in a prospective study that was initially a randomised controlled trial. Two hundred ten patients recruited from primary care psychiatric clinics with DSM-III diagnosed dysthymic, generalised anxiety, and panic disorders were randomly allocated to either drug treatment (mainly antidepressants), cognitive-behaviour therapy, or self-help therapy over a 2 year period, irrespective of original diagnosis. Life events were recorded by using a standard procedure over the period 6 months before starting treatment and at five occasions over 2 years; 181 (86%) of the patients had follow-up data and 76% maintained compliance with the original treatment allocated over the 2 years; and 155 of the 181 patients (86%) had at least one diagnostic change in this period. There was no difference in the number of diagnostic changes between the three original diagnostic groups, but dysthymic disorder changed more frequently to major depressive episode than did GAD or panic disorder (20; 11; 12) (%) and panic disorder changed more frequently to agoraphobia (with or without panic) than did dysthymia or GAD (18; 8; 6) (%). There was no relationship between loss events and depressive diagnoses or between addition events and anxiety diagnoses, but greater numbers of conflict events were associated with diagnostic change. More life events were associated with the flamboyant and dependent personality disorders, reinforcing other evidence that many life events are internally generated by personality characteristics and cannot be regarded as truly independent.",Seivewright N.; Tyrer P.; Ferguson B.; Murphy S.; Johnson T.,2000.0,,0,0,
3946,Change in personality status in neurotic disorders.,"Personality disorders are generally thought not to change by much over time. We assessed the personality status of 202 patients who had a defined diagnostic and statistical manual (DSM)-III neurotic disorder, dysthymia, panic disorder, or generalised anxiety. All patients had had drug and psychological treatment in a randomised controlled trial. 12 years after entry to the study, we reassessed the personality status of 178 (88%) of these patients using the same test (personality assessment schedule). The personality traits of patients in the cluster B flamboyant group (antisocial, histrionic) became significantly less pronounced over 12 years, but those in the cluster A odd, eccentric group (schizoid, schizotypal, paranoid), and the cluster C anxious, fearful group (obsessional, avoidant) became more pronounced. The measure of agreement between baseline and 12-year personality clusters was poor or slight (kappa=0.14, 95% CI 0.04-0.23). Our results suggest that the assumption that personality characteristics do not change with time is incorrect.",Seivewright H.; Tyrer P.; Johnson T.,2002.0,10.1016/S0140-6736(02)09266-8,0,0,
3947,Prediction of outcome in neurotic disorder: a 5-year prospective study.,"There have been no previous studies of the outcome of different neurotic disorders in which a prospective group with original randomization to treatment have been followed up over a long period. Such studies are important in identifying the factors associated with good and poor outcome. A 5-year follow-up assessment was made of a cohort of 210 psychiatric out-patients seen in general practice psychiatric clinics with a DSM-III diagnosis of generalized anxiety disorder (71), panic disorder (74) or dysthymic disorder (65) and randomized to drug treatment, cognitive and behaviour therapy, and self-help. A total of 182 of the patients (87%) were assessed after 5 years by examination of hospital and GP records using a standardized procedure and outcome determined with a four-point outcome scale. One hundred and seven (60%) of the patients had a favourable outcome but the remainder continued to be handicapped either intermittently or continuously throughout the 5-year period. Analysis of the value of initial data in predicting outcome using polychotomous step-wise logistic regression revealed that five variables were significant predictors of poor prognosis: older age; recurrent episodes; the presence of personality disorder at entry; general neurotic syndrome at entry; and symptom severity after 10 weeks. The initial DSM diagnosis and original treatment given, together with ten other variables, were of no predictive value. The long-term outcome of neurotic disorder is better predicted by age, personality and recency of onset than by other clinical variables with the exception of initial response to treatment.",Seivewright H.; Tyrer P.; Johnson T.,1998.0,,0,0,
3948,Cognitive-behavioural therapy for health anxiety in a genitourinary medicine clinic: randomised controlled trial.,"Little is known about the management of health anxiety and hypochondriasis in secondary care settings. To determine whether cognitive-behavioural therapy (CBT) along with a supplementary manual was effective in reducing symptoms and health consultations in patients with high health anxiety in a genitourinary medicine clinic. Patients with high health anxiety were randomly assigned to brief CBT and compared with a control group. Greater improvement was seen in Health Anxiety Inventory (HAI) scores (primary outcome) in patients treated with CBT (n=23) than in the control group (n=26) (P=0.001). Similar but less marked differences were found for secondary outcomes of generalised anxiety, depression and social function, and there were fewer health service consultations. The CBT intervention resulted in improvements in outcomes alongside higher costs, with an incremental cost of pound 33 per unit reduction in HAI score. Cognitive-behavioural therapy for health anxiety within a genitourinary medicine clinic is effective and suggests wider use of this intervention in medical settings.",Seivewright H.; Green J.; Salkovskis P.; Barrett B.; Nur U.; Tyrer P.,2008.0,10.1192/bjp.bp.108.052936,0,0,
3949,Internet-based psychotherapy in young adult survivors of pediatric cancer: Feasibility and participants' satisfaction.,"The Internet-based psychotherapeutic intervention Onco-STEP for adolescent and young adult (AYA)-aged survivors of pediatric cancer was developed, implemented, and participants' satisfaction was evaluated by use of questionnaires. The intervention consisted of two modules: ""Looking Back,"" aimed to reduce posttraumatic stress symptoms, and ""Looking Ahead,"" supported coping with cancer-related fears of relapse and progression. The writing program was fully completed by 20 participants (Mage = 27.3 +/- 4.8 years at study; 70% female). The majority was satisfied and perceived the treatment components as helpful. Results demonstrate that an Internet-based psychotherapeutic intervention for AYA-aged survivors of pediatric cancer is feasible and accepted by the target population. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Seitz, Diana C. M; Knaevelsrud, Christine; Duran, Gabriele; Waadt, Sabine; Goldbeck, Lutz; Amstadter, Andersson, Barak, D'Agostino, Dieluweit, Duffecy, Ehlers, Gould, Gray, Herschbach, Herschbach, Hobbie, Kazak, Knaevelsrud, Lange, Langeveld, Leykin, Michel, Rourke, Schwartz, Seitz, Seitz, Seitz, Servitzoglou, Zigmond",2014.0,,0,0,
3950,Autonomic reactivity and hormonal secretion in lactate-induced panic attacks,"ER To compare autonomic and neuroendocrine responses during lactate-induced panic attacks, heart rate variability and cortisol and atrial natriuretic hormone (ANH) levels were measured in patients with panic attacks and in healthy control subjects. In a randomized double-blind design, all subjects received either 10 ml/kg body weight of 0.5 M racemic sodium lactate or normal saline from 1100 to 1120. Spectral analysis of the R-R interval of analog electrocardiograms was performed, and total (0.001-0.45 Hz), low-frequency (0.01-0.05 Hz), midfrequency (0.05-0.15 Hz), and high-frequency power (0.15-0.45 Hz) were computed. Cortisol was measured 12 times in the period from 0900 to 1300, and ANH was measured at 1100, 1120, and 1200 by radioimmunoassay. In both panickers (n = 6) and nonpanickers (n = 8), an infusion of lactate resulted in an acceleration of heart rate, a reduction in total spectral power, and a decrease in the high- and low-frequency components of spectral power. Panickers showed a significant enhancement of the high-frequency power, whereas in nonpanickers, a shift from the mid- and high-frequency toward the low-frequency power emerged. ANH plasma concentrations during lactate infusion in panickers showed a significant increase (115 and 131% at 1120 and 1200, respectively, over concentrations at 1100) in contrast to nonpanickers (20 and 74%, respectively). No group or treatment effects on cortisol secretion emerged, which is in line with former reports. Our study supports preliminary observations that lactate-induced panic attacks enhance the release of ANH, a vasodilatator and inhibitor of sympathetic activity. Hence this hormone not only could inhibit the secretion of the stress hormone cortisol but, in parallel, could also attenuate the sympathetic stimulation to the heart. These inhibitory effects of ANH could explain the so-far-unresolved dissociation between psychopathological alterations and autonomic and endocrine responses of panic attacks.","Seier, F E; Kellner, M; Yassouridis, A; Heese, R; Strian, F; Wiedemann, K",1997.0,,0,0,
3951,Behaviorally oriented roleplays in the setting of psychodynamically oriented in-patient psychotherapy.,"Based on a short description of psychodynamic inpatient psychotherapy and behaviorally oriented therapeutic roleplays for the enhancement of social skills, an evaluation a time-limited combination of both treatment approaches is presented. Results indicate that especially patients with high levels of social anxiety or a diagnosis of social phobia show clear improvement in measure of social-phobic symptomatology. Problems due to implementation of elements of cognitive-behavior therapy in a psychodynamically oriented treatment setting as well as a increase in acceptance of this combination within the therapeutic staff are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Seidler, Gunter H; Fydrich, Thomas; Schowalter, Marion",2000.0,,0,0,
3952,Worry affects the immune response to phobic fear.,"Worry, the cognitive enumeration and anticipation of potential future negative events, is associated with autonomic dysregulation, which may in turn have implications for the immune system. People endorsing high (n = 7) and normal levels of trait worry (n = 8) were briefly exposed to a phobic stimulus and the autonomic and immune responses and recovery were assessed. A time-matched control group (n = 6) was not exposed to any stimulus. Both worry groups showed increased heart rate and skin conductance in response to phobic fear. However, only the normal worry group showed a concomitant increase in natural killer cells in peripheral blood. Patterns of change during the follow-up period suggested that phobic fear had disrupted a normal circadian increase in natural killer cells. Adrenergic and hypothalamus-pituitary-adrenal mechanisms may be responsible for the differences between high and normal worry groups in their natural killer cell response to and recovery from phobic fear.",Segerstrom SC.; Glover DA.; Craske MG.; Fahey JL.,1999.0,10.1006/brbi.1998.0544,0,0,
3953,Effects of emotional expression on adjustment to spousal loss among older adults.,"Investigated the therapeutic effects of verbally disclosing thoughts and feelings about loss of a spouse in 30 distressed, bereaved 51-85 yr olds participating in an exposure intervention. Ss were randomly assigned to treatment (4 20-min vocal expression sessions within a 2-wk period) or delayed treatment (DT). Outcome and process measures included the Brief Symptom Inventory, the Geriatric Depression Scale, and the Positive and Negative Affect Scale. The only immediate effect of treatment was that Ss receiving treatment showed a decrease in hopelessness relative to Ss in DT. After treatment was provided to the DT group, combined data from both groups indicated significant decreases in hopelessness, intrusive thoughts, obsessive-compulsive symptoms, and depression from baseline to 1 mo follow-up. Feelings of painfulness and negative affect decreased steadily over sessions. Correlational analyses indicated that higher levels of arousal of negative affect were associated with greater decreases in depression, hopelessness, intrusive thoughts, and avoidance from pretest to follow-up, whereas positive affect appeared unrelated to therapeutic change. Results suggests that confronting painful feelings can potentially reduce psychological distress among bereaved elderly. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Segal, Daniel L; Bogaards, Jay A; Becker, Lee A; Chatman, Carla; Bowling, Clayton, Derogatis, Donnelly, Esterling, Esterling, Fry, Fry, Greenberg, Greenberg, Holmes, Horowitz, Hughes, Hunt, Lazarus, Meuser, Murray, Murray, Nichols, Olin, Pennebaker, Pennebaker, Pennebaker, Segal, Spera, Stroebe, Tavris, Thompson, Watson, Worden, Yesavage",1999.0,,0,0,
3954,Expressing Thoughts and Feelings Following a Collective Trauma: Immediate Responses to 9/11 Predict Negative Outcomes in a National Sample,"Collective traumas can negatively affect large numbers of people who ostensibly did not experience events directly, making it particularly important to identify which people are most vulnerable to developing mental and physical health problems as a result of such events. It is commonly believed that successful coping with a traumatic event requires expressing one's thoughts and feelings about the experience, suggesting that people who choose not to do so would be at high risk for poor adjustment. To test this idea in the context of collective trauma, 2,138 members of a nationally representative Web-enabled survey panel were given the opportunity to express their reactions to the terrorist attacks of September 11, 2001, on that day and those following. Follow-up surveys assessing mental and physical health outcomes were completed over the next 2 years. Contrary to common belief, participants who chose not to express any initial reaction reported better outcomes over time than did those who expressed an initial reaction. Among those who chose to express their immediate reactions, longer responses predicted worse outcomes over time. Implications for myths of coping, posttrauma interventions, and psychology in the media are discussed. © 2008 American Psychological Association.",Seery M.D.; Silver R.C.; Holman E.A.; Ence W.A.; Chu T.Q.,2008.0,10.1037/0022-006X.76.4.657,0,0,
3955,Effectiveness of guided self-help for depression and anxiety disorders in primary care: A pragmatic randomized controlled trial.,"The objective of this study is to evaluate the effectiveness of (guided) self-help in primary care for patients diagnosed with a minor or major mood and/or anxiety disorder. The study population consists of 120 (screened) primary care patients aged 18-65 years with at least one mood and/or anxiety disorder. The primary focus is the reduction of depressive and anxiety symptoms. The self-help courses (Problem Solving Treatment and exposure) took 6 weeks to complete. The self-help group reported slightly better outcomes than the care-as-usual group but these results were not significant: d =-0.18 (95% CI = -2.29 to 7.31) for symptoms of depression and d =-0.20 (95% CI=-0.74 to 2.29) for symptoms of anxiety. For patients with an anxiety disorder only, the anxiety symptoms decreased significantly compared to the care-as-usual group (d =-0.68; 95% CI = 0.25 to 4.77). Self-help seems only slightly superior to care-as-usual and therefore might not be an effective tool in general practice. But the lack of results could also be due to our selection of patients or to our selection of GPs (with interest in psychiatric disorders). Nonetheless the promising signals with respect to anxiety disorders warrant further research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Seekles, Wike; van Straten, Annemieke; Beekman, Aartjan; van Marwijk, Harm; Cuijpers, Pim; Andrews, Andrews, Babor, Bijl, Bijl, Bower, Cardol, Cohen, Cuijpers, Cuijpers, Cuijpers, de Graaf, Furmark, Gilbody, Griffiths, Hirai, Jordanova, Katon, Kempen, Kessler, Lipsey, Marrs, Mead, Morgan, Mundt, Neumeyer-Gromen, Proudfoot, Rush, Schulberg, Schulberg, Seekles, Sijtsma, Simon, Spinhoven, Stewart, Trivedi, Ustun, van Boeijen, Van Schaik, van Straten, von Korff, Wang, Warmerdam, Warrilow, Wells, Zigmond, Zwarenstein",2011.0,,0,0,
3956,Effectiveness of guided self-help for depression and anxiety disorders in primary care: a pragmatic randomized controlled trial.,"The objective of this study is to evaluate the effectiveness of (guided) self-help in primary care for patients diagnosed with a minor or major mood and/or anxiety disorder. The study population consists of 120 (screened) primary care patients aged 18-65 years with at least one mood and/or anxiety disorder. The primary focus is the reduction of depressive and anxiety symptoms. The self-help courses (Problem Solving Treatment and exposure) took 6 weeks to complete. The self-help group reported slightly better outcomes than the care-as-usual group but these results were not significant: d=-0.18 (95% CI=-2.29 to 7.31) for symptoms of depression and d=-0.20 (95% CI=-0.74 to 2.29) for symptoms of anxiety. For patients with an anxiety disorder only, the anxiety symptoms decreased significantly compared to the care-as-usual group (d=-0.68; 95% CI=0.25 to 4.77). Self-help seems only slightly superior to care-as-usual and therefore might not be an effective tool in general practice. But the lack of results could also be due to our selection of patients or to our selection of GPs (with interest in psychiatric disorders). Nonetheless the promising signals with respect to anxiety disorders warrant further research.",Seekles W.; van Straten A.; Beekman A.; van Marwijk H.; Cuijpers P.,2011.0,10.1016/j.psychres.2010.11.015,0,0,
3957,Hypervigilance and avoidance in visual attention in children with social phobia,"ER BACKGROUND AND OBJECTIVES: Attentional bias towards threat in socially anxious adults is well documented; however, research on this bias in children with social phobia is rather scarce. The present study investigates whether the hypervigilance-avoidance hypothesis also applies to children with social phobia.METHODS: Thirty children (aged 8-12) with social phobia and 43 control children participated in an eye-tracking experiment while their attentional distribution was recorded. Social anxiety was induced in half of the children before the eye-tracking task. Stimuli were presented for 3000 ms, and bias scores for initial fixations and the time span of attention were assessed.RESULTS: Results indicated initial vigilance towards angry faces for all children independent of anxiety induction, while hypervigilance (but not avoidance) was only established in children with social phobia for angry-neutral face pairs and with social fears induced. Self-report measures of anxiety correlated with bias towards threat with more pronounced associations occurring in the anxiety induction condition.LIMITATIONS: We did not record reaction times simultaneously which limits the opportunity to compare our results to some previous studies which focused on this variable as an indicator of attention.CONCLUSIONS: Cognitive biases in elementary school children (between 8 and 12 years) relate to hypervigilant rather than to avoidant information processing. Attentional distribution varies over time. Differences between clinical anxious and healthy children seem to be modified by anxiety induction, symptom severity and contextual stimuli, such as the emotional valence of a face and the context in which the threat stimulus appears.","Seefeldt, W L; Krämer, M; Tuschen-Caffier, B; Heinrichs, N",2014.0,10.1016/j.jbtep.2013.09.004,0,0,
3958,Effects of 7.5% CO2 challenge in generalized anxiety disorder,"ER We have previously developed a putative model of generalized anxiety disorder in healthy volunteers using a 20-minute 7.5% carbon dioxide (CO(2)) inhalation challenge. The aim of this study was to validate the 7.5% CO(2) paradigm by assessing its effects in patients with generalized anxiety disorder in a test-retest design. Twelve medication-free generalized anxiety disorder patients attended our lab for two study days. On each study day placebo (compressed air) and 7.5% CO(2) mixture were randomly administered over 20?min, at least 30?min apart, in a single blind, randomized, placebo-controlled cross-over design. Subjective ratings, cardiovascular measures and cortisol levels were collected throughout. CO(2) challenge significantly increased ratings for anxiety and other subjective symptoms associated with generalized anxiety disorder, compared with air. It also significantly increased systolic blood pressure on day 2, indicating increased autonomic arousal. There was no change between the two test days in mean anxiety rating scores, and there also appeared to be a correlation for individual scores on a number of the subjective measures. In conclusion, 20?min of 7.5% CO(2) gas inhalation increases anxiety responses in patients with generalized anxiety disorder, and this is reliable over time.","Seddon, K; Morris, K; Bailey, J; Potokar, J; Rich, A; Wilson, S; Bettica, P; Nutt, D J",2011.0,10.1177/0269881110364270,0,0,
3959,The ICD shock and stress management program: a randomized trial of psychosocial treatment to optimize quality of life in ICD patients,"ER METHODSThe purpose of this study was to test an ICD stress and shock management program delivered in either a six-week format or a one-day workshop format. This intervention was aimed at reducing psychological (anxiety) and physiological (salivary cortisol) markers of distress in ICD patients. Secondary endpoints included measures of quality of life (QOL) and patient acceptance of device therapy, as well as biological mediators of inflammation (TNFalpha and IL-6).RESULTSThe ICD stress and shock management program resulted in the reduction of anxiety (P < 0.05) and cortisol levels (P < 0.05) in both the six weekly sessions format and the one-day workshop. Measures of anxiety decreased more rapidly with weekly intervention (P = 0.05). Both formats also resulted in a significant increase in patient acceptance of the ICD (P < 0.01). Follow-up assessment from posttreatment (T2) to four-month follow-up (T4) indicated no significant change in depression scores from posttreatment for all groups taken together, but there was a significant group by time effect, such that the workshop group displayed an increase in depression scores from T2 (M = 8.71, SD = 4.39) to T4 (M = 13.57, SD = 11.90), P < 0.05.CONCLUSIONSThese results suggest that structured interventions for shocked ICD patients involving ICD education and cognitive-behavioral strategies can reduce psychological distress and improve quality of life, regardless of format.BACKGROUNDImplantable cardioverter defibrillator (ICD) patients potentially face significant psychological distress because of their risk for life-threatening arrhythmias and the occurrence of ICD shock.","Sears, S F; Sowell, L D; Kuhl, E A; Kovacs, A H; Serber, E R; Handberg, E; Kneipp, S M; Zineh, I; Conti, J B",2007.0,10.1111/j.1540-8159.2007.00773.x,0,0,
3960,Sagittal plane motion of the hindfoot following ankle arthrodesis: a prospective analysis.,"The progression of subtalar and midfoot arthritis is well documented following ankle arthrodesis, and gait analysis has suggested that a functional gait pattern following arthrodesis may be due to tarsal hypermobility compensating for lost tibiotalar motion. We present a prospective radiographic study comparing the pre- and postoperative range of motion of the foot following ankle arthrodesis utilizing reliable anatomic landmarks to measure the sagittal range of motion. Between 2002 and 2006, we performed 154 arthrodesis procedures of the ankle. Patients were suitable for inclusion in this study if an isolated arthrodesis of the ankle was performed for post traumatic arthritis only with a minimum of 1-year followup and who had not undergone any prior nor subsequent hindfoot surgery. Standardized pre- and postoperative passive plantar- and dorsiflexion radiographs were obtained, and reproducible anatomic landmarks were then used to measure and compare tibiotalar, subtalar and medial column (talonavicular, naviculo-middle cuneiform and middle cuneiform-first metatarsal) motion. These measurements were repeated at 6, 12, and a mean of 33 months at final followup evaluation. The SF-36, calcaneal pitch, and the presence of radiographic and symptomatic hindfoot arthritis were noted for each patient pre and postoperatively. There were 48 patients who met the inclusion criteria. The mean preoperative sagittal motion (tibiotalar, medial column and subtalar combined) was 37.2 degrees, of which 17.8 degrees was tibiotalar motion. This decreased to a mean of 22.6 degrees postoperatively. The postoperative mean subtalar range of motion increased by 4.1 degrees (from 5.2 degrees to 9.3 degrees) (p < 0.0001), and the medial column motion increased by 2.1 degrees postoperatively (from 14.3 degrees to 16.4 degrees) (p < 0.003). Both of these results were statistically significant. There was a compensatory increase of the combined subtalar and medial column motion after arthrodesis of 10.8%. Using regression analysis, there was a significant correlation between the preoperative tibiotalar motion and the final difference in the subtalar range of motion (p = 0.03) and the combined motion of the medial column and the subtalar joint (p < 0.0001). Quality of life was positively associated with increased compensatory motion of the hindfoot and midfoot after ankle arthrodesis. There was an inverse association between the calcaneal pitch angle and the range of motion postoperatively. This prospective study demonstrated a statistically significant relative hypermobility of the subtalar and medial column joints following ankle arthrodesis, and may account for the functional gait which can be achieved following ankle arthrodesis. The significantly increased subtalar range of movement appeared to cause impingement of the posterior part of the posterior facet of the subtalar joint which may account for the increased incidence of subtalar arthritis following arthrodesis. Preoperative arch height can be used to predict both residual motion and function after ankle arthrodesis.",Sealey RJ.; Myerson MS.; Molloy A.; Gamba C.; Jeng C.; Kalesan B.,2009.0,10.3113/FAI.2009.0187,0,0,
3961,A randomised controlled trial of a pilot intervention to encourage early presentation of oral cancer in high risk groups,"ER OBJECTIVE: Prognosis for oral cancer is substantially improved when diagnosed early. This research aimed to evaluate an intervention to promote early presentation of oral cancer.METHODS: Participants were randomly assigned to a leaflet group (n = 42), a one-to-one group (n = 46) or a control group (n = 24). Participants in the leaflet group read a theory-based (Extended Self-Regulatory Model; Social Cognitive Theory) leaflet on how to spot oral cancer early. Those in the one-to-one group received a brief, interactional discussion on early presentation of oral cancer and were then asked to read the leaflet. Participants in the control group received no information about oral cancer.RESULTS: The leaflet and the one-to-one instruction led to more accurate knowledge of oral cancer, decreased anticipated delay, and increased understanding, likelihood and confidence to perform self-examination. Neither intervention raised participants' anxiety. There were minimal differences between the two interventions, yet both were superior to the control group.CONCLUSION: This piloting indicates the initial effectiveness of an brief intervention purposefully designed for people at risk of developing oral cancer.PRACTICE IMPLICATION: A low cost intervention may be a useful tool to encourage early detection of oral cancer. This could be embedded into routine consultations or an early detection programme.","Scott, S E; Khwaja, M; Low, E L; Weinman, J; Grunfeld, E A",2012.0,10.1016/j.pec.2012.03.015,0,0,
3962,Self-discrepancies in clinically anxious and depressed university students,"Self-discrepancy theory proposes that anxiety and depression are the result of different types of conflicting self-beliefs. This study examined self-discrepancies in four groups of university students who completed a questionnaire assessing levels of self-discrepancy and were characterized by the following disorders: (a) depression, (b) anxiety, (c) both anxiety and depression, or (d) no psychiatric disorder. As predicted, subjects with anxiety or depressive disorders had higher levels of self-discrepancy than normal subjects. Depressive subjects had higher levels of actual:ideal discrepancies than nondepressive subjects. Anxious subjects (with or without depressive disorders) had higher levels of actual:ought discrepancies than nonanxious subjects (normals and depressed-only subjects). Results provided general support for self-discrepancy theory in accounting for depressive and anxiety disorders.",Scott L.; O'Hara M.W.,1993.0,10.1037//0021-843X.102.2.282,0,0,
3963,Verbal memory functioning moderates psychotherapy treatment response for PTSD-related nightmares.,"Posttraumatic stress disorder (PTSD) is associated with cognitive deficits in attention, executive control, and memory, although few studies have investigated the relevance of cognitive difficulties for treatment outcomes. We examined whether cognitive functioning and history of traumatic brain injury (TBI) were associated with response to cognitive-behavioral therapy (CBT) for PTSD-related sleep problems. In a randomized controlled trial of Imagery Rehearsal (IR) added to components of CBT for Insomnia (IR + cCBT-I) compared to cCBT-I alone for PTSD-related recurrent nightmares, 94 U.S. veterans completed a battery of cognitive tests. TBI was assessed via structured clinical interview. Mixed-effects models examined main effects of cognitive functioning and interactions with time on primary sleep and nightmare outcomes. Significant verbal immediate memory by time interactions were found for nightmare distress, nightmare frequency, and sleep quality, even after controlling for overall cognitive performance and depression. TBI exhibited main effects on outcomes but no interactions with time. Findings indicated that individuals with lower verbal memory performance were less likely to respond to treatment across two sleep interventions. Veterans with TBI displayed greater symptoms but no altered trajectories of treatment response. Together with prior literature, findings suggest that verbal memory functioning may be important to consider in PTSD treatment implementation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Scott, J. Cobb; Harb, Gerlinde; Brownlow, Janeese A; Greene, Jennifer; Gur, Ruben C; Ross, Richard J; Almasy, Aupperle, Belanger, Belicki, Belicki, Bigler, Breslau, Brewin, Brewin, Brewin, Brewin, Brownlow, Bryant, Buysse, Buysse, Carpenter, Chard, Cohen, Cooper, Davis, Delis, Dikmen, Ehlers, Etkin, First, Forbes, Gehrman, Geuze, Gilbertson, Goldman-Mellor, Gur, Gur, Gutner, Haagen, Harb, Harvey, Jak, Kessler, Kiluk, Koenen, Krakow, Krakow, Krakow, Lane, Levin, Macklin, Manber, Martinez, McNally, Meares, Moore, Nijdam, Parslow, Pascual-Leone, Patkar, Roalf, Rohling, Ruff, Satterthwaite, Scott, Smith, Swagerman, Teichner, Teichner, Thomas, Vasterling, Verfaellie, Vermetten, Weathers, Wild, Wolf, Wolf, Wrocklage, Yehuda",2017.0,,0,0,
3964,[Posttraumatic dystrophy. Diagnosis and therapy after distal radius fractures and hand injuries].,"Posttraumatic dystrophy manifests as signs and symptoms of endothelial dysfunction in the microcirculation with pronounced involvement of arteriovenous (AV) anastomosis. Blood gas analysis was performed in 28 patients with persistent painful swelling 6-14 weeks after distal radius fracture or hand injury. The patients showed higher levels of venous oxygenation on the affected side in comparison to the contralateral arm. Furthermore, an increased perfusion and an AV shunt situation were proven by radionuclide angiography. These findings correlate with insufficient oxygen utilization by the tissue (dystrophy = capillary malperfusion). Pathophysiologically, complex processes must be assumed which require a multimodal therapy and treatment focuses on open AV shunts. The disastrous consequences of hand dystrophy (loss of function due to fibrosis) could be prevented in all patients. Statistical analyses between affected and normal hands showed significant differences. Posttraumatic dystrophy needs early detection for successful therapy and should not be identified under the umbrella term ""complex regional pain syndrome"" (CRPS).",Scola A.; Scola E.,2013.0,10.1007/s00113-013-2450-x,0,0,
3965,Anxiety in children with attention-deficit/hyperactivity disorder,"ER OBJECTIVES: Although anxiety is common in children with attention-deficit/hyperactivity disorder (ADHD), it is unclear how anxiety influences the lives of these children. This study examined the association between anxiety comorbidities and functioning by comparing children with ADHD and no, 1, or ?2 anxiety comorbidities. Differential associations were examined by current ADHD presentation (subtype).METHODS: Children with diagnostically confirmed ADHD (N = 392; 5-13 years) were recruited via 21 pediatrician practices across Victoria, Australia. Anxiety was assessed by using the Anxiety Disorders Interview Schedule for Children-IV. Functional measures included parent-reported: quality of life (QoL; Pediatric Quality of Life Inventory 4.0), behavior and peer problems (Strengths and Difficulties Questionnaire), daily functioning (Daily Parent Rating of Evening and Morning Behavior), and school attendance. Teacher-reported behavior and peer problems (Strengths and Difficulties Questionnaire) were also examined. Linear and logistic regression controlled for ADHD severity, medication use, comorbidities, and demographic factors.RESULTS: Children with ?2 anxiety comorbidities (n = 143; 39%) had poorer QoL (effect size: -0.8) and more difficulties with behavior (effect size: 0.4) and daily functioning (effect size: 0.3) than children without anxiety (n = 132; 36%). Poorer functioning was not observed for children with 1 anxiety comorbidity (n = 95; 26%). Two or more anxiety comorbidities were associated with poorer functioning for children with both ADHD-Inattentive and ADHD-Combined presentation.CONCLUSIONS: Children with ADHD demonstrate poorer QoL, daily functioning and behavior when ?2 anxiety comorbidities are present. Future research should examine whether treating anxiety in children with ADHD improves functional outcomes.","Sciberras, E; Lycett, K; Efron, D; Mensah, F; Gerner, B; Hiscock, H",2014.0,10.1542/peds.2013-3686,0,0,
3966,Osteopathic treatment of patients with long-term sequelae of whiplash injury: effect on neck pain disability and quality of life.,"The clinical sequelae and manifestation resulting from whiplash injury are defined as late whiplash syndrome (LWS). The objective of this study was to investigate whether a series of osteopathic treatments of patients with LWS may improve their symptoms. The study was designed as a two-phase (pre-post) clinical intervention study. In phase one, the patients received no treatment for 6 weeks; in phase two, they received five test-dependent osteopathic treatments. Forty-two (42) patients (mean age 39 years) suffering from LWS due to car rear-end collisions were included. Five (5) individualized and custom-tailored osteopathic treatments at 1-week intervals were performed. Main outcome parameters were the neck-related pain and disability (determined by the Neck Pain and Disability Scale [NPAD]) and the quality of life (assessed on the SF-36). The presence of a post-traumatic stress disorder (PTSD) was diagnosed. A direct comparison between the untreated period and the treatment period revealed clinically relevant and statistically significant improvements in the osteopathic treatment period for the NPAD. In the intervention phase, the NPAD dropped from 41.5 to 26.0 points, which corresponds to an improvement of 37% (95% confidence interval=11.1-19.8; p<0.0005). For the SF-36, both the physical and the mental component summary showed a significant and substantial improvement during treatment phase (p=0.009 versus p=0.02). Prior to treatment, 17 patients (43.6%) were diagnosed with a positive PTSD; this number fell to only 6 (15.4%) during observation. Five (5) osteopathic treatments had a beneficial effect on the physical as well as the mental aspects of LWS and lives up to its claim of being a complementary modality in the treatment regimen of this condition. Based on these preliminary findings, rigorous randomized controlled studies are warranted.",Schwerla F.; Kaiser AK.; Gietz R.; Kastner R.,2013.0,10.1089/acm.2012.0354,0,0,
3967,The impact of affective contexts on working memory capacity in healthy populations and in individuals with PTSD,"Individual differences in working memory capacity (WMC) strongly predict variations in real-world cognitive functioning. However, little is known about how WMC is influenced by the ubiquitously present affective information in our everyday environments. Here, we present a series of 3 experiments investigating a novel WMC paradigm performed in affective (vs. neutral) contexts. The paradigm requires simultaneous performance of a visuospatial search and a verbal storage task. These tasks are performed in the presence of either neutral or negative emotional distractor images. Experiments 1 and 2 confirmed our prediction that WMC would be reduced in the context of emotional compared with neutral distractors in student and community samples. Experiment 3 extended these findings to a clinical sample. WMC in motor vehicle accident survivors with a history of posttraumatic stress disorder (PTSD) was selectively reduced in the presence of trauma-related emotional distraction compared with survivors without a history of PTSD. Implications of these findings for affective cognitive science are discussed.",Schweizer S.; Dalgleish T.,2016.0,10.1037/emo0000072,0,0,
3968,Carbamazepine treatment in patients discontinuing long-term benzodiazepine therapy. Effects on withdrawal severity and outcome,"ER Forty patients with a history of difficulty discontinuing long-term, daily benzodiazepine therapy were randomly assigned, under double-blind conditions, to treatment with carbamazepine (200 to 800 mg/d) or placebo. A gradual taper (25% per week reduction) off benzodiazepine therapy was then attempted. Five weeks after taper, significantly more patients who had received carbamazepine than placebo remained benzodiazepine free, this despite the fact that no statistically significant differences in withdrawal severity could be demonstrated. Patients receiving carbamazepine reported a larger reduction in withdrawal severity than patients receiving placebo, but only at a trend level, and only on the daily patient-rated withdrawal checklist. Eleven patients (28%) required antidepressant therapy for depression or panic when assessed at 12-weeks follow-up. The results of this pilot investigation suggest that carbamazepine might have promise as an adjunctive drug therapy for the benzodiazepine withdrawal syndrome, particularly in patients receiving benzodiazepines in daily dosages of 20 mg/d or greater of diazepam equivalents.","Schweizer, E; Rickels, K; Case, W G; Greenblatt, D J",1991.0,,0,0,
3969,Short-term psychotherapeutic interventions for somatizing patients in the general hospital: a randomized controlled study.,"Treatment acceptance and motivation for psychotherapy of somatizing patients in the general hospital is low. Patients (n = 91) fulfilling the criteria for somatization were randomized into an intervention group (n = 49) and a control group (n = 42). The patients in the intervention group attended 5 psychotherapeutic sessions based on the modified reattribution model. The patients in the control group received psychoeducational reading material. The primary outcomes were motivation for psychotherapy and contacting a psychotherapist after discharge. The secondary outcomes consisted of changes regarding somatoform symptoms, emotional distress and quality of life. Patients from the intervention group were significantly more motivated for psychotherapy (p = 0.001) than patients from the control group. At the 3-month follow-up, 42% of the patients from the intervention group had contacted a psychotherapist, compared to 20% of the patients from the control group (p = 0.045). At the 6-month follow-up, however, the ratio of patients having contacted a psychotherapist had changed to 44 and 29%, respectively, and was no longer significant. The intensity of somatoform symptoms and the anxiety symptoms decreased and mental functioning improved significantly over time for patients from both groups. Short-term psychotherapeutic interventions for somatizing patients in general hospitals have a moderately better effect on motivation for psychotherapy and contacting a psychotherapist than psychoeducational reading material alone. Future studies should attempt to prove the effectiveness of short-term psychoeducational interventions for somatizing patients in the general hospital.",Schweickhardt A.; Larisch A.; Wirsching M.; Fritzsche K.,2007.0,10.1159/000107561,0,0,
3970,[Patients with versus without psychological disorders in orthopedic rehabilitation].,In this study it was examined whether orthopedic rehabilitants with versus without a comorbid mental disorder profit from inpatient orthopedic rehabilitation to the same degree. It was also investigated whether there were differential treatment effects between the traditional and behavioral-medical rehabilitation approaches. Questionnaires which assess pain-specific and associated variables were issued to a total of 361 patients on admission and discharge from rehabilitation. In some aspects patients with a mental disorder benefited more from the treatment than patients without comorbidities. Differential treatment effects were found only in patients with a mental disorder and improvements were higher in the behavioral-medical than in the traditional rehabilitation approaches. Psychological interventions in the inpatient orthopedic rehabilitation are recommended in order to adequately deal with the higher rate of persons with comorbid mental disorders.,Schwarz S.; Mangels M.; Sohr G.; Holme M.; Worringen U.; Rief W.,2008.0,10.1007/s00482-007-0603-y,0,0,
3971,Patients with versus without psychological disorders in orthopedic rehabilitation,ER METHODQuestionnaires which assess pain-specific and associated variables were issued to a total of 361 patients on admission and discharge from rehabilitation.RESULTSIn some aspects patients with a mental disorder benefited more from the treatment than patients without comorbidities. Differential treatment effects were found only in patients with a mental disorder and improvements were higher in the behavioral-medical than in the traditional rehabilitation approaches.CONCLUSIONPsychological interventions in the inpatient orthopedic rehabilitation are recommended in order to adequately deal with the higher rate of persons with comorbid mental disorders.BACKGROUNDIn this study it was examined whether orthopedic rehabilitants with versus without a comorbid mental disorder profit from inpatient orthopedic rehabilitation to the same degree. It was also investigated whether there were differential treatment effects between the traditional and behavioral-medical rehabilitation approaches.,"Schwarz, S; Mangels, M; Sohr, G; Holme, M; Worringen, U; Rief, W",2008.0,10.1007/s00482-007-0603-y,0,0,3970
3972,States-of-mind model: cognitive balance in the treatment of agoraphobia.,,Schwartz RM.; Michelson L.,1987.0,10.1037/0022-006X.55.4.557,0,0,
3973,Toward a task analysis of assertive behavior,,"Schwartz, R M; Gottman, J M",1976.0,,0,0,
3974,Teaching coping skills enhances quality of life more than peer support: results of a randomized trial with multiple sclerosis patients.,"This 2-year randomized trial of multiple sclerosis patients compared a coping skills group (n = 64) with peer telephone support (n = 68). Growth curve analyses that adjusted for neurological deterioration and gender revealed that the coping skills intervention yielded gains in psychosocial role performance, coping behavior, and numerous aspects of well-being. In contrast, the peer support intervention increased external health locus of control but did not influence psychosocial role performance or well-being. Subgroup analyses revealed that patients with affective problems were more likely to benefit from the peer support intervention than the coping skills group in terms of reported depression, anxiety, use of avoidant coping, and some aspects of well-being. The coping group is discussed as a vehicle for facilitating response shift, helping patients to change their internal referents, their conceptualization of quality of life, and their priorities.",Schwartz CE.,1999.0,,0,0,
3975,Neural signature of reconsolidation impairments by propranolol in humans,"Background: The retrieval of consolidated memories may result in their destabilization, requiring a restabilization process called reconsolidation. During reconsolidation, memories become sensitive to psychological and pharmacological modifications again, thus providing an opportunity to alter unwanted memories. Although such reconsolidation manipulations might open the door to novel treatment approaches for psychiatric disorders such as posttraumatic stress disorder, the brain mechanisms underlying reconsolidation processes in humans are completely unknown. Here, we asked whether a β-adrenergic receptor antagonist might interfere with the reconsolidation of emotional episodic memories and what brain mechanisms are involved in these effects. Methods: Healthy participants were administered the β-adrenergic receptor antagonist propranolol or a placebo before they reactivated previously learned neutral and emotional material. Recognition memory was tested 24 hours later. Functional magnetic resonance images were collected during reactivation and recognition testing. Results: Propranolol during reactivation specifically reduced the subsequent memory for emotional pictures; memory for neutral pictures remained unaffected. This emotional memory impairment was associated with significantly increased activity in the amygdala and the hippocampus for correctly recognized pictures at test. Most interestingly, the same structures were active (but not modulated by propranolol) during memory reactivation. Memory reactivation alone or propranolol without reactivation had no effect on subsequent memory. Conclusions: Our results demonstrate how the consequences of memory reconsolidation processes are represented in the human brain, suggesting that the brain areas that are recruited during reactivation undergo changes in activity that are associated with subsequent memory recall. © 2012 Society of Biological Psychiatry.",Schwabe L.; Nader K.; Wolf O.T.; Beaudry T.; Pruessner J.C.,2012.0,10.1016/j.biopsych.2011.10.028,0,0,
3976,Epidemiology and prognosis of mild traumatic brain injury in returning soldiers: A cohort study.,"Objective: Mild traumatic brain injury (mTBI; concussion) is common in returning service members yet limited definitive evidence exists on its prognosis. Methods: Almost 25,000 non-medically evacuated soldiers returning from Afghanistan or Iraq to 2 military bases between 2009 and 2014 were screened for mTBI. We invited a random sample to participate in the present study, oversampling those screening positive, resulting in 557 mTBI cases and 1,010 controls, of whom 366 cases and 599 controls completed 3-month follow-up evaluations. The criterion measure of screened mTBI was the Ohio State University Traumatic Brain Injury Identification Method. Postconcussive symptoms (PCS) were measured at follow-up with the Neurobehavioral Symptom Inventory. Symptoms reported at a severe or very severe level were considered clinically relevant. Results: About half (47%) of soldiers who had sustained an mTBI during this latest deployment reported PCS at 3-month follow-up vs 25% of controls: adjusted odds ratio 2.4 (1.8-3.2). The most commonly reported symptoms (cases vs controls) were sleep problems (30% vs 14%), forgetfulness (21% vs 9%), irritability (17% vs 8%), and headaches (15% vs 5%). mTBI cases were about twice as likely as controls to report receiving rehabilitative services and fair or poor health. Other predictors of PCS included posttraumatic stress, combat exposure, and noncephalic pain. A majority of both cases and controls reported traumatic brain injuries predating this latest deployment. Conclusions: In this nonclinical population of recently deployed soldiers, a substantial proportion of those who had sustained an mTBI were symptomatic 3 months postdeployment. Future studies need to include longer follow-up to measure symptom resolution. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Schwab, Karen; Terrio, Heidi P; Brenner, Lisa A; Pazdan, Renee M; McMillan, Henry P; MacDonald, Margaret; Hinds, Sidney R; Scher, Ann I; Baldassarre, Belanger, Blanchard, Bliese, Boyle, Brenner, Cassidy, Chase, Cicerone, Corrigan, Dikmen, Hoge, Iverson, Kashluba, Katz, Kennedy, King, Kontos, Lange, Lange, Lew, Lew, Ling, Mac Donald, Mac Donald, McCrea, Miller, O'Neil, Schneiderman, Scholten, Schwab, Selassie, Stein, Tanielian, Terrio, Terrio, von Korff, Warden, Wilk",2017.0,,0,0,
3977,[Predictors of the discharge status in acute day-hospital and inpatient care - a comparison between the two settings within a randomised controlled trial].,"To search for predictors of the discharge status in day-hospital patients and inpatients, within a randomized controlled trial on the effectiveness of acute psychiatric day hospital treatment as compared to inpatient treatment. The study was conducted at the Department of Psychiatry and Psychotherapy, Dresden University of Technology. Regression analyses assessing the relationship between theoretically chosen predictor variables and the discharge status as measured using the Brief Psychiatric Rating Scale (BPRS 4.0) were conducted on a sample of 69 day-hospital patients and a sample of 76 inpatients. In both settings, admission status was the strongest predictor of discharge status. As concerns day-hospital patients, those suffering from a personality disorder as well as those showing a higher degree of social disability were discharged with a higher level of psychopathological symptoms. Among inpatients, those suffering from an anxiety, obsessive-compulsive, or adjustment disorder as well as those being retired or unemployed benefited less from treatment. Given the explorative character of the present study, further prospective studies are needed in order to cross-validate findings on the potential criteria for allocating acute mentally ill either to day-hospital or inpatient treatment.",Schützwohl M.; Koch R.; Kallert TW.,2006.0,10.1055/s-2004-834757,0,0,
3978,Predictors of the discharge status in acute day-hospital and inpatient care - a comparison between the two settings within a randomised controlled trial,"ER METHODThe study was conducted at the Department of Psychiatry and Psychotherapy, Dresden University of Technology. Regression analyses assessing the relationship between theoretically chosen predictor variables and the discharge status as measured using the Brief Psychiatric Rating Scale (BPRS 4.0) were conducted on a sample of 69 day-hospital patients and a sample of 76 inpatients.RESULTSIn both settings, admission status was the strongest predictor of discharge status. As concerns day-hospital patients, those suffering from a personality disorder as well as those showing a higher degree of social disability were discharged with a higher level of psychopathological symptoms. Among inpatients, those suffering from an anxiety, obsessive-compulsive, or adjustment disorder as well as those being retired or unemployed benefited less from treatment.CONCLUSIONSGiven the explorative character of the present study, further prospective studies are needed in order to cross-validate findings on the potential criteria for allocating acute mentally ill either to day-hospital or inpatient treatment.OBJECTIVETo search for predictors of the discharge status in day-hospital patients and inpatients, within a randomized controlled trial on the effectiveness of acute psychiatric day hospital treatment as compared to inpatient treatment.","Schützwohl, M; Koch, R; Kallert, T W",2006.0,10.1055/s-2004-834757,0,0,3977
3979,Development and validation of a brief measure of therapeutically-induced change.,"A premise of cognitive behavioural treatment is that individuals make cognitive, behavioural and situational changes prompted by interventions and that these changes bring about improvements in targeted outcomes. The present project set out to provide reliability and validity information for a brief measure of therapeutically induced change. A total of 281 participants, comprising three samples who took part in three different intervention studies, completed items relating to cognitive, behavioural and situational changes and completed measures relating to the intervention in which they participated. The internal consistency of the scale assessing therapeutically induced change was high in the three samples. The scale showed evidence of validity through association with (1) more involvement in an intervention (2) reporting that an intervention was meaningful (3) being instructed to incorporate insights gained from an intervention into one's daily life (4) greater decreases in psychological distress and negative affect from pre-intervention to post-intervention, and (5) greater increases in positive affect from pre-intervention to post-intervention. The therapeutically-induced change scale may have utility as a process measure in various interventions.",Schutte NS.; Malouff JM.,2011.0,10.1017/S1352465811000257,0,0,
3980,Imaging in early posttraumatic complex regional pain syndrome: a comparison of diagnostic methods.,"The complex regional pain syndrome type I (CRPS I) still is difficult to diagnose in posttraumatic patients. As CRPS I is a clinical diagnosis the characteristic symptoms have to be differentiated from normal posttraumatic states. Several diagnostic procedures are applied to facilitate an early diagnosis, although their value for diagnosing posttraumatic CRPS I is unclear. One hundred fifty-eight consecutive patients with distal radial fracture were followed up for 16 weeks after trauma. To assess the diagnostic value of the commonly applied methods a detailed clinical examination was carried out 2, 8, and 16 weeks after trauma in conjunction with bilateral thermography, plain radiographs of the hand skeleton, three phase bone scans (TPBSs), and contrast-enhanced magnetic resonance imaging (MRI). All imaging procedures were assessed blinded. At the end of the observation period 18 patients (11%) were clinically identified as having CRPS I and 13 patients (8%) revealed an incomplete clinical picture which were defined as CRPS borderline cases. The sensitivity of all diagnostic procedures used was poor and decreased between the first and the last examinations (thermography: 45% to 29%; TPBS: 19% to 14%; MRI: 43% to 13%; bilateral radiographs: 36%). In contrast a high specificity was observed in the TPBS and MRI at the eighth and sixteenth-week examinations (TPBS: 96%, 100%; MRI: 78%, 98%) and for bilateral radiographs 8 weeks after trauma (94%). The thermography presented a fair specificity that improved from the second to the sixteenth week (50% to 89%). The poor sensitivity of all tested procedures combined with a reasonable specificity produced a low positive predictive value (17% to 60%) and a moderate negative predictive value (79% to 86%). These results suggest, that those procedures cannot be used as screening tests. Imaging methods are not able to reliably differentiate between normal posttraumatic changes and changes due to CRPS I. Clinical findings remain the gold standard for the diagnosis of CRPS I and the procedures described above may serve as additional tools to establish the diagnosis in doubtful cases.",Schürmann M.; Zaspel J.; Löhr P.; Wizgall I.; Tutic M.; Manthey N.; Steinborn M.; Gradl G.,2007.0,10.1097/AJP.0b013e31805c9e66,0,0,
3981,Assessment of peripheral sympathetic nervous function for diagnosing early post-traumatic complex regional pain syndrome type I.,"Clinical diagnosis of complex regional pain syndrome type I (CRPS I) in post-traumatic patients is often delayed since the clinical appearance of this disease resembles normal post-traumatic states to a certain extent (pain, edema, loss of function). The purpose of this study was to assess the incidence of specific clinical features in CRPS I patients and normal post-traumatic patients and to evaluate the diagnostic value of a bedside test that measures the sympathetic nervous function. Fifty patients with post-traumatic CRPS I of the upper limb and 50 patients 8 weeks after distal radius fracture with an undisturbed course of disease were subjected to a detailed clinical examination. Pain was assessed using the VAS (visual analog scale), skin temperature measured with an infrared camera and grip-strength with a pneumatic manometer. In CRPS I patients, motor disturbances defined as an impaired active range of motion of the hand, were most frequent (96%, fracture patients: 40%), followed by edema (88%, fracture patients: 80%) and spontaneous pain (VAS 4.0 +/- 2.3, fracture patients: VAS 1.3 +/- 0.6). Systematic temperature differences (>1 degree C) between the affected and unaffected limbs were seen in only 42% of CRPS I patients and in 34% of the fracture patients. Further sensory, sudomotor or trophic changes of the hands were rare. As expected, there were significant differences in the quantity of edema, motor disturbances and sensory disturbances between CRPS I patients and normal fracture patients. However, normal fracture patients still suffered from several of the evaluated symptoms 8 weeks after trauma, which makes an early clinical diagnosis of the complication more difficult. Using a newly developed bedside test, the peripheral sympathetic nervous function was assessed in both groups of patients and in 50 age-matched healthy controls. The decrease in skin blood flow following sympathetic provocation maneuvers, detected by laser Doppler flowmetry, was quantified as sympathetic reactivity. In the affected hands of CRPS I patients, as well as in the contralateral hands, the sympathetic reactivity was obliterated or diminished in contrast to the age-matched controls and normal fracture patients. A multivariate analysis did not reveal any correlation between sympathetic function and the severity of any clinical symptom. Sympathetic reactivity seems to be an independent variable in CRPS I and the test presented may facilitate the difficult clinical diagnosis of this disease.",Schürmann M.; Gradl G.; Andress HJ.; Fürst H.; Schildberg FW.,1999.0,,0,0,
3982,fMRI in anxiety,,Schunk T.; Gilles E.; Gilles C.; Hode Y.; Namer I.J.; Fuder H.; Luthringer R.,2003.0,,0,0,
3983,Couple Treatment for Alcohol Use Disorder and Posttraumatic Stress Disorder: Pilot Results From U.S. Military Veterans and Their Partners.,"We studied 13 U.S. male military veterans and their female partners who consented to participate in an uncontrolled trial of couple treatment for alcohol use disorder and posttraumatic stress disorder (CTAP). CTAP is a 15-session, manualized therapy, integrating behavioral couples therapy for alcohol use disorder (AUD) with cognitive-behavioral conjoint therapy for posttraumatic stress disorder (PTSD). Due to ineligibility (n = 1) and attrition (n = 3), 9 couples completed the study, and 7 completed 12 or more sessions. There were 8 veterans who showed clinically reliable pre- to posttreatment reduction of PTSD outcomes. There were also significant group-level reductions in clinician-, veteran-, and partner-rated PTSD symptoms (d = 0.94 to 1.71). Most veterans showed clinically reliable reductions in percentage days of heavy drinking. Group-level reduction in veterans' percentage days of heavy drinking was significant (d = 1.01). There were 4 veterans and 3 partners with clinically reliable reductions in depression, and group-level change was significant for veterans (d = 0.93) and partners (d = 1.06). On relationship satisfaction, 3 veterans and 4 partners had reliable improvements, and 2 veterans and 1 partner had reliable deterioration. Group-level findings were nonsignificant for veteran relationship satisfaction (d = 0.26) and for partners (d = 0.52). These findings indicate that CTAP may be a promising intervention for individuals with comorbid PTSD and AUD who have relationship partners.",Schumm JA.; Monson CM.; O'Farrell TJ.; Gustin NG.; Chard KM.,2015.0,10.1002/jts.22007,0,0,
3984,Who is stressed? A pilot study of salivary cortisol and alpha-amylase concentrations in agoraphobic patients and their novice therapists undergoing in vivo exposure.,"In cognitive behavioural therapy of phobic anxiety, in vivo exposure is considered as an effective treatment strategy. Apparently, it involves the experience of stress and anxiety in patients. Given the therapist's role during exposure sessions, it is conceivable that the performance is also accompanied with the experience of stress in therapists, especially when unversed in conducting psychotherapy. Studies confirmed that cognitive behavioural therapists tend to avoid therapist-guided in vivo exposure. The objective of this study was the simultaneous investigation of therapist's and patient's stress response during in vivo exposure. Therefore, 23 agoraphobic patients and their 23 treating therapists in training provided five saliva samples during an in vivo exposure and five samples during an ordinary therapy session. Before and during exposure session, subjective evaluations of stress and anxiety were assessed. Results suggested that therapists reported similar levels of perceived stress as patients before exposure. Both groups displayed significantly elevated salivary cortisol (sC) levels during exposure compared to the control session and a trend for alterations in salivary alpha-amylase (sAA) activity was found. Therapists reached peak concentrations of sC before start of the intervention followed by a decline during exposure, while patients displayed peak levels of cortisol secretion after 60 min of exposure. In vivo exposure seems to be a demanding intervention not only for the patient, but also for therapists in training. However, it was also demonstrated that physiological and subjective stress rather decrease during the intervention and that both groups rated exposure to be substantially successful. Based on the presented results, another potential factor contributing to the under-usage of exposure treatment is conceivable and needs to be addressed in future research.",Schumacher S.; Gaudlitz K.; Plag J.; Miller R.; Kirschbaum C.; Fehm L.; Fydrich T.; Ströhle A.,2014.0,10.1016/j.psyneuen.2014.07.016,0,0,
3985,Attentional bias modification in Dutch veterans with posttraumatic stress disorder-A case series with a personalized treatment version.,"Beneficial effects of attentional bias modification have been claimed for a number of anxiety disorders, but study results are variable. A recent trial in patients with posttraumatic stress disorder (PTSD) showed no therapeutic effects. The use of personally relevant and verbal stimuli might increase the efficacy of attentional bias modification. In an A-B case series design, we hypothesized that individualized attentional bias modification would lead to reduction of attentional bias and a decrease in PTSD symptoms. Six Dutch male war veterans (mean age 39.33 years) who had developed PTSD after peacekeeping missions underwent the treatment. No therapeutic effects were observed. Inter- and intraindividual attentional bias scores varied widely and did not respond to attentional bias modification as hypothesized. This study provides no evidence that individualized attentional bias modification is an effective treatment for PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schoorl, Maartje; Putman, Peter; Mooren, Trudy M; Van Der Werff, Steven; Van Der Does, Willem; Amir, Amir, Amir, Bar-Haim, Barlow, Blake, Boettcher, Carlbring, Davidson, Hakamata, Hallion, Hazen, Jacobson, MacLeod, Neubauer, Putman, Ratcliff, Resick, Schmidt, Schoorl, Sheehan",2014.0,,0,0,
3986,Go no-go performance under psychosocial stress: beneficial effects of implementation intentions,"ER Acute stress has been found to have negative and implementation intentions (IIs) to have positive effects on cognitive performance. This study was the first to examine the effects of IIs on executive action control under acute psychosocial stress. Forty-two male subjects aged 21-39 years were randomly assigned to the Trier Social Stress Test (TSST) versus a rest condition. In addition, the instruction to the executive task (a go no-go task) was manipulated (IIs versus standard instruction). After the stress test, a dual-task procedure including a go no-go task was conducted. The TSST resulted in increases in cortisol response, heart rate and state anxiety compared to the rest condition. Acute stress significantly impaired go no-go performance, but only in the group without IIs. We conclude that under acute stress conditions executive functioning is reduced, but the use of IIs can be an effective strategy to overcome this negative effect.","Scholz, U; Marca, R; Nater, U M; Aberle, I; Ehlert, U; Hornung, R; Martin, M; Kliegel, M",2009.0,10.1016/j.nlm.2008.09.002,0,0,
3987,Treatment of functional cardiac disorders with the beta blocking agent metipranolol. Results of a double-blind cross-over trial,,Scholtze J.; Chorianopoulos E.; Smolarz A.,1978.0,,0,0,
3988,Hindfoot endoscopy for posterior ankle impingement.,"The surgical treatment of posterior ankle impingement is associated with a high rate of complications and a substantial time to recover. An endoscopic approach to the posterior ankle (hindfoot endoscopy) may lack these disadvantages. We hypothesized that hindfoot endoscopy causes less morbidity and facilitates a quick recovery compared with open surgery. Fifty-five consecutive patients with posterior ankle impingement were treated with an endoscopic removal of bone fragments and/or scar tissue. The symptoms were caused by trauma (65%) or overuse (35%). All patients were enrolled in a prospective protocol. At baseline, the age, sex, work and sports activities, American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scores, and preinjury Tegner scores were determined for all patients. At the time of follow-up, AOFAS hindfoot scores and Tegner scores were assessed and the time to return to work and sports activities was determined. Complications were recorded. Patients scored the overall result as poor, fair, good, or excellent by means of a 4-point Likert scale. The median duration of follow-up was thirty-six months, and no patient was lost to follow-up. The median AOFAS hindfoot score increased from 75 points preoperatively to 90 points at the time of final follow-up. The median time to return to work and sports activities was two and eight weeks, respectively. At the time of follow-up, patients in the overuse group were more satisfied than those in the posttraumatic group, and the AOFAS hindfoot scores were higher in patients in the overuse group (median, 100 points) compared with patients in the posttraumatic group (median, 90 points). A complication occurred in one patient who had a temporary loss of sensation of the posteromedial aspect of the heel. The outcome after endoscopic treatment of posterior ankle impingement compares favorably with the results of open surgery reported in the literature. Hindfoot endoscopy appears to cause less morbidity than open ankle surgery and facilitates a quick recovery. Patients treated for posterior ankle impingement caused by overuse have better results than those treated following trauma.",Scholten PE.; Sierevelt IN.; van Dijk CN.,2008.0,10.2106/JBJS.F.00188,0,0,
3989,Treatment of generalized social phobia: Results at long-term follow-up.,"Investigated the long-term follow-up effectiveness of group vs individual cognitive behavioral treatment (CBT) for generalized social phobia. 50 patients were reassessed 18 mo after they had finished 1 of the following treatment packages: (1) exposure in vivo; (2) CBT followed by exposure in vivo, or (3) a CBT in which both strategies were used. Half of the Ss were individually treated. Repeated measures multivariate analysis of variance (MANOVA) demonstrated significant time effects, indicating lasting improvement. Between the posttest and the follow-up no significant changes were observed. An analysis of covariance (ANCOVA) showed a significant interaction at follow-up between treatment package and treatment modality on 3 of the 4 compound outcome variables. Group treatment with exposure in vivo alone had been the most effective in the longer term, the integrated group treatment the least effective, while the individual treatments had given improvements in-between. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Scholing, Agnes; Emmelkamp, Paul M. G",1996.0,,0,0,
3990,"Cognitive and behavioural treatments of fear of blushing, sweating or trembling.","Social phobic patients (n = 30) with fear of blushing, sweating or trembling as the predominant complaint were randomly assigned to three treatment conditions: (1) exposure in vivo followed by cognitive therapy, (2) cognitive therapy followed by exposure in vivo, or (3) a cognitive-behavioural treatment in which both strategies were integrated from the start. Each treatment condition consisted of 16 sessions, given in two treatment blocks of 4 weeks each, separated by a no-treatment phase of 4 weeks. Self-report assessments were held before and after the treatment blocks and at 3-months follow-up. No significant differences were found between effects of the first treatment block vs those of the 4-weeks waiting-list period. After the second block treatment was significantly more effective than waiting-list. The analyses showed significant time effects after both treatment blocks and at follow-up, indicating improvement for the group as a whole. After two treatment blocks and at follow-up no significant differences among the different treatment packages were found on target problems, avoidance of social situations, cognitions and somatic complaints. After discussion of the results recommendations for further research will be given.",Scholing A.; Emmelkamp PM.,1993.0,,0,0,
3991,Exposure with and without cognitive therapy for generalized social phobia: effects of individual and group treatment.,"Patients with generalized social phobia (n = 73) were randomly allocated to two treatment modalities: (1) group or (2) individual treatment, and to three treatment packages: (1) two blocks of exposure in vivo (2) a block cognitive therapy followed by a block exposure in vivo, or (3) two blocks cognitive-behavioural treatment in which both strategies were integrated from the start. All treatments consisted of 16 sessions, given in two treatment blocks of 4 weeks each, separated by a no-treatment phase of 4 weeks. Self-report assessments were held before and after the treatment blocks and at 3-months follow-up. Significant differences were found between effects of the first treatment block vs those of the 4-weeks waiting-list period. Repeated measures MANOVA's demonstrated significant time effects after both treatment blocks and at follow-up, indicating improvement for the group as a whole. After the first treatment block the integrated treatment did significantly worse than either exposure in vivo or cognitive therapy in decreasing somatic complaints. On the other variables no differences among the treatments were found. At follow-up a significant interaction was found between treatment package and modality on the variable cognitions: largest progress was found in the group treatment with cognitive therapy followed by exposure in vivo; smallest progress was found in the integrated group treatment. Results are discussed and recommendations for further research are given.",Scholing A.; Emmelkamp PM.,1993.0,,0,0,
3992,Prediction of treatment outcome in social phobia: a cross-validation.,"This study was a replication of a study on the prediction of treatment outcome in social phobic patients [Chambless, D. L., Tran, G. Q. Glass, C.R. (1997). Predictors of response to cognitive-behavioral group therapy for social phobia. Journal of Anxiety Disorders, 11 221-240]. Results at the posttest and the 18-months follow-up were analyzed for DSM-III-R social phobic patients, with either a generalized social phobia (n = 50) or a nongeneralized fear, i.e. fear of blushing, trembling or sweating in social situations (n = 26). Predictors were pretreatment depression, personality disorder traits, clinician rated severity of impairment and frequency of negative self-statements during social interactions. The criterium variable was (the residual gain score of) self-reported avoidance of social situations. In line with Chambless et al., pretreatment depression showed some predictive value, but smaller and only at the posttest. Change in the frequency of negative self-statements paralleled, but did not predict, change in social phobia symptoms. In contrast with Chambless et al., clinician rated severity was (slightly) predictive for treatment outcome, whereas avoidant personality traits had reverse correlations with outcome in both subgroups. The results are discussed and directions for further research are given.",Scholing A.; Emmelkamp PM.,1999.0,,0,0,
3993,"Treatment of fear of blushing, sweating, or trembling. Results at long-term follow-up.","This study investigated the long-term effectiveness of cognitive-behavioral treatments for patients with a specific type of social phobia: fear of showing bodily symptoms (blushing, sweating, or trembling). Patients were reassessed 18 months after they had finished one of the following treatments: (a) exposure in vivo followed by cognitive therapy, (b) cognitive therapy followed by exposure in vivo, or (c) a cognitive-behavioral treatment in which both strategies were integrated from the start. All patients were individually treated. Self-report assessments were held before and after treatment and at 3-month and 18-month follow-ups. Repeated measures MANOVAs for the patients who completed the 18-month follow-up (n = 26) demonstrated significant time effects from pretest to follow-up, indicating overall improvement. Between the posttest and the 18-month follow-up, no significant change was observed. No differences among the treatment packages were found, although the cognitive-exposure treatment showed a trend to be less effective than both other treatments.",Scholing A.; Emmelkamp PM.,1996.0,10.1177/01454455960203006,0,0,
3994,Treatment of generalized social phobia: results at long-term follow-up.,"This study investigated the long-term follow-up effectiveness of (cognitive-) behavioural group and individual treatments for generalized social phobia. Patients were reassessed 18 months after they had finished one of the following treatment packages: (1) exposure in vivo; (2) cognitive therapy followed by exposure in vivo; or (3) a cognitive-behavioural treatment in which both strategies were integrated from the start. Half of the patients were individually treated, the other half in a group. Self-report assessments were held before and after treatment and at 3-month and 18-month follow-ups. Repeated measures MANOVAs on the patients who completed the long-term follow-up (n = 50) demonstrated significant time effects, indicating lasting improvement compared with the pretest. Between the posttest and the 18-month follow-up no significant changes were observed. ANCOVAs either with the pretest or the posttest as covariate showed a significant interaction at 18-month follow-up between treatment package and treatment modality on three of the four compound outcome variables. The group treatment with exposure in vivo alone had been the most effective in the longer term, the integrated group treatment the least effective, while the individual treatments had given improvements in-between. Results are qualified in view of numbers of dropouts, additional treatments in the respective treatment conditions, and clinical relevance.",Scholing A.; Emmelkamp PM.,,,0,0,
3995,A randomised controlled trial to assess the effectiveness of providing self-help information to people with symptoms of acute stress disorder following a traumatic injury.,"Patients attending accident and emergency (A&E) may develop long-term psychological difficulties. Psycho-education has been suggested to reduce the risk of post-injury disorders. We tested the efficacy of providing self-help information to a high-risk sample. A&E attenders were screened for acute stress disorder and randomised to two groups: patients (n=116) receiving a self-help booklet and those who did not (n=111). A sample of 'low' scorers was also included (n=120); they did not receive a booklet. Psychological assessments were completed at baseline (within 1 month post-injury) and 3 and 6 months post-injury. Post-traumatic stress disorder (PTSD), anxiety and depression decreased (p<0.001) across time but there were no group differences in these measures or quality of life. However, subjective ratings of the usefulness of the self-help booklet were very high. This trial failed to support the efficacy of providing self-help information, as a preventative strategy to ameliorate PTSD.",Scholes C.; Turpin G.; Mason S.,2007.0,10.1016/j.brat.2007.06.009,0,0,
3996,A replication and extension of the PEERS intervention: examining effects on social skills and social anxiety in adolescents with autism spectrum disorders,"ER This study aimed to evaluate the Program for the Education and Enrichment of Relational Skills (PEERS: Laugeson et al. in J Autism Dev Disord 39(4):596-606, 2009). PEERS focuses on improving friendship quality and social skills among adolescents with higher-functioning ASD. 58 participants aged 11-16 years-old were randomly assigned to either an immediate treatment or waitlist comparison group. Results revealed, in comparison to the waitlist group, that the experimental treatment group significantly improved their knowledge of PEERS concepts and friendship skills, increased in their amount of get-togethers, and decreased in their levels of social anxiety, core autistic symptoms, and problem behaviors from pre-to post-PEERS. This study provides the first independent replication and extension of the empirically-supported PEERS social skills intervention for adolescents with ASD.","Schohl, K A; Hecke, A V; Carson, A M; Dolan, B; Karst, J; Stevens, S",2014.0,10.1007/s10803-013-1900-1,0,0,
3997,"Hope, optimism and survival in a randomised trial of chemotherapy for metastatic colorectal cancer.","Psychological responses to cancer are widely believed to affect survival. We investigated associations between hope, optimism, anxiety, depression, health utility and survival in patients starting first-line chemotherapy for metastatic colorectal cancer. Four hundred twenty-nine subjects with metastatic colorectal cancer in a randomised controlled trial of chemotherapy completed baseline questionnaires assessing the following: hopefulness, optimism, anxiety and depression and health utility. Hazard ratios (HRs) and P values were calculated with Cox models for overall survival (OS) and progression-free survival (PFS) in univariable and multivariable analyses. Median follow-up was 31 months. Univariable analyses showed that OS was associated negatively with depression (HR 2.04, P < 0.001) and positively with health utility (HR 0.56, P < 0.001) and hopefulness (HR 0.75, P = 0.013). In multivariable analysis, OS was also associated negatively with depression (HR 1.72, P < 0.001) and positively with health utility (HR 0.73, P = 0.014), but not with optimism, anxiety or hopefulness. PFS was not associated with hope, optimism, anxiety or depression in any analyses. Depression and health utility, but not optimism, hope or anxiety, were associated with survival after controlling for known prognostic factors in patients with advanced colorectal cancer. Further research is required to understand the nature of the relationship between depression and survival. If a causal mechanism is identified, this may lead to interventional possibilities.",Schofield PE.; Stockler MR.; Zannino D.; Tebbutt NC.; Price TJ.; Simes RJ.; Wong N.; Pavlakis N.; Ransom D.; Moylan E.; Underhill C.; Wyld D.; Burns I.; Ward R.; Wilcken N.; Jefford M.,2016.0,10.1007/s00520-015-2792-8,0,0,
3998,Meeting the psychological and information needs and improving the quality of life of patients with inoperable lung cancer through an innovative supportive care intervention,"BACKGROUND: Lung cancer is the leading cause of cancer death. It is associated with a high level of morbidity, particularly fatigue, pain, breathlessness and coughing. These symptoms can have a substantial impact on quality of life. Given the poor prognosis and high symptom burden, it is not surprising that theythe most psychologically distressed group of all cancer types. This study investigated the impact of a multidisciplinary, supportive care intervention on unmet needs, psychological distress and quality of life.METHOD: A randomised controlled trial design adhering to CONSORT criteria was used. Patients were recruited prior to or at treatment commencement, and randomised to receiving the intervention or usual care post-baseline. Measures included Needs Assessment for Advanced Cancer Patients (NA-ACP), Hospital Anxiety and Depression Scale, Distress Thermometer, and EORTC Quality of Life C30. Data was collected at baseline, and at 8 and 12 week follow-up. The intervention consisted of two sessions of less than an hour with a psychologist at treatment commencement and completion. The sessions involved assessing patient needs, active listening, selfcare education and reporting of unmet needs to the multidisciplinary team for action. RESULTS: 108 patients participated in the study (consent rate of 59%).controlling for baseline levels, significant differences were detected in NA-ACP Symptom subscale (p<0.05) and EORTC QLQC30 Appetite Loss sub-scale (p<0.05) at 8 week follow-up in the expected direction. No other significant results were found. CONCLUSIONS: The intervention was effective in reducing unmet symptom needs and improving appetite loss at 8 weeks post baseline. These findings demonstrates the importance of needs assessment and communicating patient unmet needs to the multidisciplinary team for action. RESEARCH IMPLICATIONS: Further interventions can be targeted to assist people with lung cancer at other times of their treatment trajectory. Interventions and study commitments need to be kept to a minimum in order to minimise burden. CLINICAL IMPLICATIONS: This intervention was feasible and clinically acceptable. The results of this study will assist in development of future clinical services for people with lung cancer.",Schofield P.; Ugalde A.; Sharkey K.; Reece J.; Krishnasamy M.; Carey M.; Ball D.; Aranda S.,2009.0,10.1002/pon.1594,0,0,
3999,"A tailored, supportive care intervention using systematic assessment designed for people with inoperable lung cancer: a randomised controlled trial","ER OBJECTIVE: People with inoperable lung cancer experience higher levels of distress, more unmet needs and symptoms than other cancer patients. There is an urgent need to test innovative approaches to improve psychosocial and symptom outcomes in this group. This study tested the hypothesis that a tailored, multidisciplinary supportive care programme based on systematic needs assessment would reduce perceived unmet needs and distress and improve quality of life.METHODS: A randomised controlled trial design was used. The tailored intervention comprised two sessions at treatment commencement and completion. Sessions included a self-completed needs assessment, active listening, self-care education and communication of unmet psychosocial and symptom needs to the multidisciplinary team for management and referral. Outcomes were assessed with the Needs Assessment for Advanced Lung Cancer Patients, Hospital Anxiety and Depression Scale, Distress Thermometer and European Organization of Research and Treatment of Cancer Quality of Life Q-C30 V2.0.RESULTS: One hundred and eight patients with a diagnosis of inoperable lung or pleural cancer (including mesothelioma) were recruited from a specialist facility before the trial closed prematurely (original target 200). None of the primary contrasts of interest were significant (all p > 0.10), although change score analysis indicated a relative benefit from the intervention for unmet symptom needs at 8 and 12 weeks post-assessment (effect size = 0.55 and 0.40, respectively).CONCLUSION: Although a novel approach, the hypothesis that the intervention would benefit perceived unmet needs, psychological morbidity, distress and health-related quality of life was not supported overall.","Schofield, P; Ugalde, A; Gough, K; Reece, J; Krishnasamy, M; Carey, M; Ball, D; Aranda, S",2013.0,10.1002/pon.3306,0,0,
4000,Five-months-postoperative neuropsychological outcome from a pilot prospective randomized clinical trial of thalamic deep brain stimulation for Tourette syndrome.,"Tourette syndrome (TS) is a neuropsychiatric disorder presenting with motor and/or sonic tics associated with frontostriatal dysfunction. This study provided pilot data of the neuropsychological safety of bilateral thalamic deep brain stimulation (DBS) to treat medication-refractory TS in adults. This study used a repeated-measures design with pretest and 3-month follow-up from start of continuous bilateral DBS. Five male patients underwent DBS surgery for medically refractory TS. Repeated-measures ANOVA was used to evaluate for any change in neuropsychological test scores, employing a false discovery rate. Outcome measures included 14 neuropsychological tests assessing psychomotor speed, attention, memory, language, visuoconstructional, and executive functions, as well as subjective mood ratings of depression and anxiety. Average age was 28.2 years (SD = 7.5) with 12-17 years of education. Participants were disabled by tics, with a tic frequency of 50-80 per minute before surgery. At baseline, subjects' cognitive function was generally average, although mild deficits in sequencing and verbal fluency were present, as were clinically mild obsessive-compulsive symptoms. At 3 months of continuous DBS (5 months after implantation), 3 of 5 participants had clinical reductions in motor and sonic tics. Cognitive scores generally remained stable, but declines of moderate to large effect size (Cohen's d > 0.6) in verbal fluency, visual immediate memory, and reaction time were observed. Fewer symptoms of depression and anxiety, as well as fewer obsessions and compulsions, were reported after 3 months of continuous high-frequency DBS. Bilateral centromedian-parafascicular thalamic DBS for medically refractory TS shows promise for treatment of medically refractory TS without marked neuropsychological morbidity. Symptoms of depression and anxiety improved.",Schoenberg MR.; Maddux BN.; Riley DE.; Whitney CM.; Ogrocki PK.; Gould D.; Maciunas RJ.,2015.0,10.1111/ner.12233,0,0,
4001,The Appraisal of Social Concerns Scale: Psychometric Validation With a Clinical Sample of Patients With Social Anxiety Disorder.,"The Appraisal of Social Concerns (ASC) Scale was created by Telch et al. (2004) to improve upon existing self-report measures of social anxiety-related cognition. In a largely nonclinical sample, the ASC was found to possess three factors and was psychometrically sound. In a smaller clinical sample, the ASC demonstrated sensitivity to the effects of cognitive behavioral therapy. In the present study, the psychometric properties of the ASC were examined in a larger sample of patients with social anxiety disorder. In this sample, the ASC exhibited a 2-factor structure; the nature of the factors was similar to the primary factors originally reported by Telch et al. The ASC also demonstrated strong validity, internal consistency, and sensitivity to treatment effects. It is concluded that the ASC may be useful in the assessment of cognition and cognitive change in patients with social anxiety disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schultz, Luke T; Heimberg, Richard G; Rodebaugh, Thomas L; Schneier, Franklin R; Liebowitz, Michael R; Telch, Michael J; Amir, Beck, Beck, Bentler, Brown, Brown, Cattell, Clark, Cohen, Coles, DiNardo, First, Floyd, Foa, Foa, Fresco, Glass, Gorsuch, Gorsuch, Hamilton, Harvey, Heimberg, Heimberg, Heimberg, Hirsch, Hofmann, Hofmann, Hu, Hu, Huppert, Jones, Kessler, Kessler, Leary, Ledley, Liebowitz, Liebowitz, Mattick, McManus, Meng, Meyer, Narrow, Okazaki, Peterson, Poulton, Rapee, Reiss, Reiss, Ries, Rodebaugh, Scott, Telch, Tucker, Turk, Turner, Ventura, Watson, Weeks, West, Zinbarg, Zung",2006.0,,0,0,
4002,Behavioural analysis: Does it matter?,"Discusses the assumption of treatment utility of problem analysis and tests 2 premises of problem analysis. Empirical data of a sample of patients with phobias and panic disorders, mostly agoraphobia, showed that assigning patients to standard treatment merely on the basis of clinical diagnoses provides results equal to or even better than those of optimized individual therapy strategies. It could be shown that therapists would diagnose different problem conditions not only for patients with different types of phobia, but also, as expected, for patients with identical diagnoses. However, this did not-as would be expected according to the second premise of problem analysis-result in choosing different individual therapy strategies. One reason for these findings could be that behavior therapy research has been able to provide treatment programs that have been differentiated and gradually optimized for specific diagnostic groups. To decide on the application of these treatment programs, clinical diagnoses are necessary. It is suggested that clinical diagnosis and problem analysis should be complementary. An integrative model is suggested. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schulte, Dietmar",1997.0,,0,0,
4003,Quality of life among women after surgery for ovarian cancer,"ER METHODS: Subjects were recruited to participate in a clinical trial that tested a specialized nursing intervention addressing psychological and physical care among women post-surgical for ovarian cancer. QOL was measured using five standardized self-report measures: the State-Trait Anxiety Scale (SAS), the Center for Epidemiological Studies Depression Scale (CES-D), the Mishel Uncertainty in Illness Scale (MUIS), the Symptom Distress Scale (SDS), and the Short-Form Health Survey (SF-12). Baseline data were collected while women were hospitalized following surgery.RESULTS: The sample (n=145) included women with ovarian cancer (58%) and other cancers metastasized to the ovaries and abdomen (42%). Mean scores on the measures were consistent with or higher than previously reported means for similar populations. Women reporting the lowest QOL were more likely to be younger, more educated, and have early stage disease.SIGNIFICANCE OF RESULTS: Women who have undergone surgery for ovarian malignancies have psychological needs that are often considered secondary to physical needs. Interventions should include routine screening for distress and referral to appropriate psychological and social services, thereby facilitating quality cancer care.OBJECTIVES: Difficulties with diagnosis and aggressive, long-term treatment may result in lower quality of life (QOL), including high levels of anxiety, depression, and uncertainty, greater symptom distress, and lower overall QOL among women with ovarian cancer. The purpose of this study was to describe demographic, clinical, and other risk factors associated with compromised QOL among women who have undergone surgery for ovarian malignancies.","Schulman-Green, D; Ercolano, E; Dowd, M; Schwartz, P; McCorkle, R",2008.0,10.1017/S1478951508000497,0,0,
4004,"Eye movements matter, but why? Psychophysiological correlates of EMDR therapy to treat trauma in Timor-Leste.","This preliminary study examined the physiological correlates of eye movement desensitization and reprocessing (EMDR) therapy when effectively used to treat trauma symptoms in a postconflict, developing nation, Timor-Leste. Participants were 20 Timorese adults with posttraumatic stress disorder (PTSD) symptoms treated with EMDR therapy. PTSD, depression, and anxiety decreased significantly after an average of 4.15 (SD = 2.06) sessions. Continuous measures of heart rate, skin conductance, and respiration were collected during the first and last desensitization sessions. Physiological activity decreased in EMDR desensitization sessions, and eye movement sets were associated with an immediate significant decrease in heart rate and an increase in skin conductance, consistent with an orienting response. This response habituated within and across eye movement sets. These findings suggest that effective EMDR therapy is associated with de-arousal within sessions and that eye movement sets are associated with distinct physiological changes that may aid memory processing. The findings offer insight into the working mechanisms of EMDR when used to treat PTSD symptoms in a real-world, cross-cultural, postwar/conflict setting. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Schubert, Sarah J; Lee, Christopher W; Drummond, Peter D; Aubert-Khalfa, Boudewyns, Bradley, Cahill, Christman, Davidson, Elofsson, Hobson, Kuiken, Lee, Lee, Levin, Maxfield, Modvig, Mollica, Oren, Pole, Raboni, Sack, Sack, Sack, Schnyder, Schubert, Schubert, Shapiro, Smeets, Sokolov, Stickgold, Stickgold, Sondergaard, Wilson, Wolpe, Wright",2016.0,,0,0,
4005,The experience and impact of intrusive thoughts in individuals with late bedtimes,"There is increasing awareness of the interplay among sleep, circadian rhythms, and psychopathology. Recent findings show that obsessive-compulsive disorder (OCD) is associated with late bedtimes. Sleep disruption may exacerbate impairments in executive functioning in individuals with OCD, making these individuals vulnerable to experiencing intrusive thoughts that come from ""out of the blue"" (autogenous obsessions; AO) and to having difficulty dismissing them. The current study investigated types of intrusive thoughts experienced by individuals with (DB) and without (NDB) delayed bedtimes. Bedtime, and AO (uncued, affectively negative) vs. reactive obsessions (RO; triggered by environment, affectively neutral) were examined in 212 adults. As hypothesized, individuals with DB reported more frequent intrusive thoughts, as well as more AO, than NDB individuals. Additionally, DB participants reported a greater urge to neutralize intrusive thoughts than NDB participants. Future work should test the replicability of these findings and explore circadian disruptions in OCD using biological markers.",Schubert J.R.; Coles M.E.,2015.0,10.1080/09291016.2014.948741,0,0,
4006,Effects of tryptophan depletion on carbon dioxide provoked panic in panic disorder patients,"ER Results of an earlier study in healthy volunteers suggest that the serotonergic system is involved in anxiety-related mechanisms. We studied the influence of tryptophan depletion on the response to a 35% carbon dioxide challenge. Twenty-four panic disorder patients received a mixture of amino acids, either with or without tryptophan, under double-blind conditions. There was a significant increase in anxiety as well as in neurovegetative symptoms in the depletion group, compared to the placebo condition. Furthermore, when we compare the results of the placebo group with earlier panic provocation studies, it also seems that a balanced amino acid mixture might have a protective effect against a panic provocation. We conclude that the panic-enhancing effect of tryptophan depletion as well as the potential protective effect of tryptophan administration in panic disorder patients can be explained by the Deakin-Graeff theory of anxiety.","Schruers, K; Klaassen, T; Pols, H; Overbeek, T; Deutz, N E; Griez, E",2000.0,,0,0,
4007,Genetic moderation of CO2-induced fear by 5-HTTLPR genotype,"ER Inhalation of an increased concentration of carbon dioxide (CO(2)) has been shown to induce a state of negative affect in healthy subjects that is closely related to the clinical phenomenon of panic. It has been suggested that the vulnerability to CO(2) is moderated by differences in serotonin (5-HT) activity, caused by a functional polymorphism in the promoter region of the 5-HT transporter (5-HTTLPR) gene. Our aim was to examine the relationship between bi- and tri-allelic 5-HTTLPR genotype and the affective response to different dosages of inhaled CO(2) in healthy volunteers. Ninety-six subjects performed a double inhalation of four mixtures containing, respectively, 0%, 9%, 17.5% and 35% CO(2), following a double-blind, cross-over, randomized design. Affective responses were measured with a visual analogue scale for fear and the Panic Symptom List. 5-HTTLPR genotype was expressed as LL, SL and SS. Subjects with the SL and SS genotype reported less fear than LL subjects. A significant interaction effect was found between genotype and CO(2) dosage: the SS genotype showed lower fear scores than the LL genotype, particularly in the 17.5% CO(2) dose condition. The present study suggests that the dose-dependent fear reaction to CO(2) is moderated by a polymorphism in the 5-HT transporter gene, particularly at intermediate CO(2) dosages. It also underscores the usefulness of the introduction of an intermediate phenotype related to panic to reveal an underlying genetic vulnerability otherwise staying elusive. These results are in line with current theories on the role of 5-HT in both panic and respiration.","Schruers, K; Esquivel, G; Duinen, M; Wichers, M; Kenis, G; Colasanti, A; Knuts, I; Goossens, L; Jacobs, N; Rozendaal, J; Smeets, H; Os, J; Griez, E",2011.0,10.1177/0269881110372543,0,0,
4008,L-5-hydroxytryptophan induced increase in salivary cortisol in panic disorder patients and healthy volunteers,"ER METHODSalivary cortisol levels were measured in 24 panic disorder patients and 24 healthy volunteers, following ingestion of 200 mg L-5-hydroxytryptophan or placebo.RESULTSA significant rise in cortisol was observed in both patients and controls following ingestion of L-5-hydroxytryptophan. No such effects were seen in the placebo condition.CONCLUSIONThe results show that L-5-hydroxytryptophan stimulated salivary cortisol is a useful probe of serotonin function in healthy volunteers as well as panic disorder patients, and provide some evidence against a serotonin receptor hypersensitivity in panic disorder.BACKGROUNDHypersensitivity of brain serotonin receptors has been proposed as a causal mechanism in the pathophysiology of panic disorder. This theory can be tested, using serotonergic stimulation of the HPA axis. Up to now, plasma cortisol has generally been used as the outcome measure in such studies. Assessment of salivary cortisol is a non-invasive alternative to measure HPA axis activity.","Schruers, K; Diest, R; Nicolson, N; Griez, E",2002.0,10.1007/s00213-002-1072-8,0,0,
4009,Transfer of fear reduction through systematic densensitization.,,Schroeder HE.; Dietrich RR.,1973.0,,0,0,
4010,Posterior capsule opacification and neodymium:YAG laser capsulotomy rates with 2 microincision intraocular lenses: Four-year results,"ER PURPOSE: To compare the development of posterior capsule opacification (PCO) and neodymium:YAG (Nd:YAG) capsulotomy rates between 2 microincision intraocular lenses (IOLs) 4 years after surgery.SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.DESIGN: Prospective randomized clinical trial.METHODS: Patients randomly received a Y-60H 3-piece hydrophobic IOL (hydrophobic group) in 1 eye and an MI60 1-piece hydrophilic IOL (hydrophilic group) in the contralateral eye during simultaneous bilateral cataract surgery. Eyes were examined 1 week, 20 months, and 4 years postoperatively. Digital retroilluminated images of each eye were evaluated using Automated Quantification of After-Cataract software. The Nd:YAG laser capsulotomy rate was recorded.RESULTS: Sixty patients were enrolled. Objective PCO was significantly higher in the hydrophobic group than in the hydrophilic group before capsulotomy 2 years after cataract surgery (mean score 2.1 ± 1.8 (SD) versus 1.2 ± 1.4) (P =.031). At the 4-year follow-up, the hydrophobic group had a statistically significantly higher Nd:YAG rate than the hydrophilic group (77% versus 50%) (P =.012).CONCLUSION: Comparison of 2 microincision IOLs indicated a statistically significant difference in PCO and Nd:YAG capsulotomy rates, with very high Nd:YAG rates 4 years after surgery.","Schriefl, S M; Menapace, R; Stifter, E; Zaruba, D; Leydolt, C",2015.0,10.1016/j.jcrs.2014.09.037,0,0,
4011,Enhancement of fatty acid mobilization and oxidation by glucose-xylitol compared to glucose alone in posttraumatic and septic patients,"ER METHODSIn study I 18 metabolically normal patients undergoing coronary artery bypass grafting operation were randomly assigned into three groups. Group I (C I, n = 6) received 2 mg/kgBW/min of glucose, group II (C II, n = 6) 2 mg/kgBW/min of a glucose/xylitol mixture (1:1) and group III (C III, n = 6) 1 ml/kgBW/min of an isotonic saline solution. Infusions were applied over a 24-h-period following operation. Concentrations of glucose, lactate, insulin and single free fatty acids were measured before and after surgery and at 6-h-intervals over 36 hours postoperatively. In study II 5 septic patients were intravenously given 4 mg/kgBW/min glucose over a 6-h-period. Energy supply was then changed to a glucose/xylitol (1:1) regimen in an equicaloric dosage of 4 mg/kgBW/min for six hours again. Hepatic glucose production ([6,6-d2]-glucose), palmitate oxidation ([1-13C]-palmitate) and lactate concentrations were analyzed at the end of each infusion regime with the help of stable isotope technique and an enzymatic test, respectively.RESULTSIn study I glucose and insulin concentrations in C II and III were significantly lower than in C I during the postoperative infusion period. Highest lactate concentrations were measured in C I after 6 hours of infusion. Free fatty acids in C I remained at significantly lower levels compared to C II and III until glucose infusion was stopped. In septic patients (study II) xylitol led to significant lower hepatic glucose production rates and lactate concentrations than glucose, whereas palmitate oxidation increased.CONCLUSIONSDuring the acute phase after trauma and during sepsis a carbohydrate supplementation with xylitol was superior to glucose alone because high plasma glucose concentrations were avoided, highly energy consuming hepatic glucose production was reduced and the release and oxidative utilization of free fatty acids was enhanced.INTRODUCTIONThe objective of this study was to provide further information about the influence of xylitol on glucose and fatty acid metabolism after trauma and during sepsis.","Schricker, T; Gross, G; Wölfel, R; Georgieff, M",1995.0,,0,0,
4012,Primary care patients with mental health problems: outcome of a randomised clinical trial.,"The prevalence of patients with mental health problems in general practice is high, and at least one-third of these problems last for 6 months or longer. Patients with these problems take up more time during a consultation and attend more frequently. This study investigated the effectiveness of problem-solving treatment for primary care patients with mental health problems. The hypothesis was that patients receiving problem-solving treatment from a nurse would have fewer symptoms after 3 months, or a lower attendance rate, compared with patients receiving the usual care from the GP. Randomised clinical trial. Twelve general practices in Amsterdam and 12 nurses from a mental healthcare institution. A sample of patients aged >or=18 years were screened for mental health problems with the general health questionnaire (GHQ-12) in the waiting room of the general practices, and were randomised. Patients receiving the problem-solving treatment were required to complete four to six treatment sessions, while patients in the control group were treated as usual by the GP. No significant difference was found between the groups in terms of improved psychopathology or a decrease in attendance rate. Post-hoc analyses showed a sub-group of patients with more severe pathology who may benefit from problem-solving treatment. The main results show that problem-solving treatment provided by a nurse adds little to the usual care from the GP for frequent attenders with mental health problems. Post-hoc analyses show that there may be a sub-group of more severely depressed patients who could benefit from problem-solving treatment.",Schreuders B.; van Marwijk H.; Smit J.; Rijmen F.; Stalman W.; van Oppen P.,2007.0,10.3399/096016407782317829,0,0,
4013,Value of the early electroencephalogram after a first unprovoked seizure.,"Studies on the predictive value of the electroencephalogram (EEG) concerning the risk of seizure recurrence have shown contradictory results. We prospectively studied the predictive value of the standard EEG and EEG with sleep deprivation for seizure relapse in adult patients presenting with a first unprovoked seizure. EEGs were performed on 157 adult patients within the first 48 hours of the first seizure. Additional EEGs with sleep deprivation were obtained in 60 cases. The standard EEG was abnormal in 70.7% and significantly associated with an increased risk of seizure recurrence [risk ratio 4.5, 95% confidence interval (CI) 1.8; 11.3, p=0.001]. Subgroup analysis revealed the highest recurrence rates for patients with focal epileptiform activity (risk ratio 2.2, CI 1.2; 4.2, p=0.01). EEGs with sleep deprivation were abnormal in 48.3% of all cases and revealed epileptiform discharges in 13.3% of the patients who had no epileptiform activity in the standard EEG. Routine EEG revealed abnormalities in 60 of 94 patients who presented with normal neurologic status on admission. Further neuroradiological examinations detected previously unknown brain lesions in 19 of these cases, particularly cerebrovascular disease (CVD, n=7), brain tumors (n=6), and posttraumatic scars (n=4). In conclusion, the EEG is important for the early detection of focal nonepileptic and epileptic abnormalities after a first unprovoked seizure in adult patients and may provide valuable information on previously unknown disorders, particularly CVD and cerebral tumors. The abnormal EEG is a highly significant predictor for seizure recurrence. An additional EEG with sleep deprivation is helpful in cases when standard EEG does not reveal epileptiform discharges.",Schreiner A.; Pohlmann-Eden B.,2003.0,,0,0,
4014,"Posttraumatic stress symptoms in children after mild to moderate pediatric trauma: a longitudinal examination of symptom prevalence, correlates, and parent-child symptom reporting","ER METHODFrom July 1998 through October 2000, 83 children/adolescents between the ages of 7 and 17 and their caregivers were interviewed within 24 hours of hospital admission and assessed for PTSD symptomatology, trauma history, and other measures of child and family functioning. Interviews were repeated at 1 month, 6 months, and 18 months after the initial hospitalization. Patients with at least mild symptomatology at the initial interview were randomized to receive either an art therapy intervention or standard hospital services alone.RESULTSA total of 69% of children were found to have at least mild PTSD symptoms at baseline, 57% at 1 month, 59% at 6 months, and 38% at 18 months postinjury. Younger age and the severity of parental PTSD symptoms were correlated with symptom presence in children. Parents initially underreported their child's symptom severity when compared with the child's report, but assessments converged over time. The art therapy intervention showed no sustained effects on the reduction of PTSD symptoms.CONCLUSIONThe presence of PTSD symptoms in children after traumatic injury is very high. Parental distress and characteristics of the family environment appear to be more relevant to the presence of child symptoms than the family make-up, course of hospitalization, or extent of the child's injuries. Parents may not initially recognize the degree to which their children experience such symptoms. The high presence of symptoms in this population underscores the need for treatment efficacy studies and parent/medical staff education in identification of PTSD.BACKGROUNDFull recovery from injury may be hindered by both physical ailments and psychologic distress. Little information is available on the psychologic response of children to physical trauma, although long-term dysfunction may result if psychologic needs are not identified and addressed. This study examined the prevalence and correlates of posttraumatic stress disorder (PTSD) symptoms in children and adolescents after an acute traumatic event resulting in mild to moderate physical injury. We were also interested in analyzing the discrepancies between parent/child reporting of the child's PTSD symptomatology. Because of the paucity of research evaluating interventions for pediatric PTSD, and as a secondary objective for this study, we collected preliminary data on the effectiveness of a single-session art therapy intervention designed to reduce PTSD symptoms.","Schreier, H; Ladakakos, C; Morabito, D; Chapman, L; Knudson, M M",2005.0,,0,0,
4015,Implicit affective evaluation bias in hypochondriasis: findings from the Affect Misattribution Procedure.,"Cognitive theories of hypochondriasis (HYP) suggest that catastrophic misinterpretations of benign body sensations are a core feature for the maintenance of the disorder. There is tentative support from an analog sample that the interpretation of illness-related information also involves an implicit affective component. This is the first study to examine this negative affective evaluation bias implicitly in patients with HYP. An adapted version of the Affect Misattribution Procedure (AMP) with illness, symptom and neutral primes was used in 80 patients with HYP, and compared to 83 patients with an anxiety disorder (AD), as well as 90 healthy controls (CG). The HYP group showed significantly more negative affective reactions in illness prime trials, compared to both control groups, as well as more negative implicit evaluations on symptom prime trials, compared to the CG. Significant inverse relationships were observed only between the implicit evaluations of illness words and health anxiety questionnaires. Thus, an implicit negative affective evaluation bias of serious illnesses rather than symptoms is a unique feature of HYP.",Schreiber F.; Neng JM.; Heimlich C.; Witthöft M.; Weck F.,2014.0,10.1016/j.janxdis.2014.07.004,0,0,
4016,"Cognitive therapy for social anxiety disorder: the impact of the ""self-focused attention and safety behaviours experiment"" on the course of treatment.","Several studies have shown that cognitive therapy is an effective treatment for social anxiety disorder (SAD). However, it remains unclear which of the complex interventions are associated with an anxiety reduction during the course of treatment. The aim of this study was to examine the impact of the intervention referred to as the ""self-focused attention and safety behaviours experiment"" on treatment outcome. This study was part of a randomized controlled trial including 16 sessions of either individual cognitive therapy (CT) or interpersonal therapy (IPT) for SAD. Of particular importance, a concomitant time-series analysis was used to investigate the impact of the self-focused attention and safety behaviours experiment on subsequent social anxiety (1, 2, 3, and 4 weeks after the intervention) in 32 patients with SAD, who are receiving cognitive treatment. The results revealed a significant reduction of social anxiety after the self-focused attention and safety behaviours experiment during the subsequent month of treatment. The findings of the current study confirm current cognitive theories of SAD and demonstrate the importance of interventions that target self-focused attention and safety behaviour in cognitive therapy for SAD.",Schreiber F.; Heimlich C.; Schweitzer C.; Stangier U.,2015.0,10.1017/S1352465813000672,0,0,
4017,Sexual function outcomes in women treated for posttraumatic stress disorder.,"This study examined dysfunctional sexual behavior and sexual concerns in women treated for posttraumatic stress disorder (PTSD). There were three objectives: to characterize the relationship between symptoms of PTSD and sexual outcomes, to examine the effect of treatment on sexual outcomes, and to examine the relationship between change in PTSD and change in sexual outcomes. Female veterans and active duty personnel with PTSD (n = 242), 93% of whom had experienced sexual trauma, were randomly assigned to receive 10 weekly sessions of either Prolonged Exposure or Present-Centered Therapy. PTSD and sexual outcomes were assessed before and after treatment and then 3 and 6 months later. At baseline, the reexperiencing, numbing, and hyperarousal symptom clusters were related to one or both sexual outcomes. Although prior analyses had shown that Prolonged Exposure resulted in better PTSD outcomes, there were no differences between treatments for either dysfunctional sexual behavior or sexual concerns. However, loss of PTSD diagnosis was associated with improvements in sexual concerns. The findings suggest that clinically meaningful improvements in PTSD are necessary in order to reduce sexual problems in traumatized women.",Schnurr PP.; Lunney CA.; Forshay E.; Thurston VL.; Chow BK.; Resick PA.; Foa EB.,2009.0,10.1089/jwh.2008.1165,0,0,
4018,SYMPTOM BENCHMARKS OF IMPROVED QUALITY OF LIFE IN PTSD.,"Although research has shown that PTSD symptom change relates to improved quality of life, the question of how much improvement in PTSD symptoms is necessary to result in meaningful improvements in quality of life remains unanswered. We used data from a randomized clinical trial of psychotherapy for PTSD in female military veterans and active duty personnel to examine the correspondence between benchmarks of improvement in PTSD symptoms and changes in quality of life. Participants were 235 female veterans and Army soldiers who were randomized to 10 weekly sessions of Prolonged Exposure or Present-Centered Therapy. We operationalized PTSD symptom change in terms of four progressively stringent mutually exclusive definitions-No Response, Response, Loss of Diagnosis, and Remission-successively comparing each category to the prior one: No Response versus Response, Response versus Loss of Diagnosis, and Loss of Diagnosis versus Remission. Outcomes were clinically meaningful improvements and good endpoints in domains of clinician-rated and self-reported quality of life. Response was associated with improvement on almost all measures, but with only one good endpoint. Loss of Diagnosis was associated with improvement on all measures except self-rated social functioning and with achieving a good endpoint on all measures. Remission was associated with improvement in clinician-rated social impairment and a good endpoint in clinician-rated occupational impairment. For most domains of quality of life, treating a patient until the patient no longer meets diagnostic criteria would be optimal. For some domains, further improvements may result by helping a patient achieve remission.",Schnurr PP.; Lunney CA.,2016.0,10.1002/da.22477,0,0,
4019,Work-related outcomes among female veterans and service members after treatment of posttraumatic stress disorder.,"This study examined the effect of treatment for posttraumatic stress disorder (PTSD) on work-related quality-of-life outcomes and the relationship between clinically significant change during treatment and work-related outcomes. Additional analyses explored whether current depression and employment status moderated the effects of treatment and clinically significant change. Participants were 218 female veterans and soldiers with current PTSD who participated in a randomized clinical trial of treatment for PTSD. They received ten weekly sessions of prolonged exposure or present-centered therapy and were assessed before and after treatment and at three- and six-month follow-ups. Outcomes were clinician-rated and self-rated occupational impairment and self-rated satisfaction with work. Both treatment groups had improvements in occupational impairment, and the degree of improvement by the two groups was similar. There was no pre- to posttreatment change in work satisfaction. At the end of treatment, participants who no longer met diagnostic criteria for PTSD had greater improvements in all domains of work-related quality of life than participants who still had PTSD. Although prolonged exposure resulted in better PTSD symptom outcomes than present-centered therapy in the randomized clinical trial, it did not result in better work-related quality-of-life outcomes. The improvement in occupational impairment associated with loss of diagnosis suggests the importance of continuing treatment until clinically meaningful change has been attained.",Schnurr PP.; Lunney CA.,2012.0,10.1176/appi.ps.201100415,0,0,
4020,Longitudinal analysis of the relationship between symptoms and quality of life in veterans treated for posttraumatic stress disorder.,This study examined how change in posttraumatic stress disorder (PTSD) symptoms relates to change in quality of life. The sample consisted of 325 male Vietnam veterans with chronic PTSD who participated in a randomized trial of group psychotherapy. Latent growth modeling was used to test for synchronous effects of PTSD symptom change on psychosocial and physical health-related quality of life within the same time period and lagged effects of initial PTSD symptom change on later change in quality of life. PTSD symptoms were associated with reduced quality of life before treatment. There were synchronous effects of symptom change on change in quality of life but no significant lagged effects. Results indicate the importance of measuring quality of life in future investigations of PTSD treatment.,Schnurr PP.; Hayes AF.; Lunney CA.; McFall M.; Uddo M.,2006.0,10.1037/0022-006X.74.4.707,0,0,
4021,"Design of VA Cooperative Study #591: CERV-PTSD, comparative effectiveness research in veterans with PTSD.","CERV-PTSD is a randomized controlled trial of two of the most effective treatments for PTSD, Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT). Despite solid evidence that both treatments are effective, there is limited evidence about their effectiveness relative to one another. The primary objective is to compare the effectiveness of PE and CPT for reducing PTSD symptom severity in a healthcare system that offers both treatments. The secondary objective is to compare the effectiveness of PE and CPT for reducing the severity of comorbid mental health problems and service utilization as well as improving functioning and quality of life. The tertiary objective is to examine whether discrepancy between patient preferences and treatment assignment reduces the effectiveness of each treatment. Exploratory analyses will examine whether demographic and clinical characteristics predict differential response to PE and CPT. The study is designed to randomize 900 male and female veterans with PTSD due to any traumatic military event to receive PE or CPT. The standard dose of treatment is 12 weekly sessions but veterans who improve more rapidly may finish in fewer sessions and veterans who improve more slowly may have additional sessions. The primary outcome is improvement in PTSD symptoms, measured during and after treatment and then 3 and 6 months later. As a large multi-site trial with men and women, CERV-PTSD is designed to advance the delivery of care for PTSD by providing conclusive information about whether one treatment is better than the other, overall, and for different types of patients.",Schnurr PP.; Chard KM.; Ruzek JI.; Chow BK.; Shih MC.; Resick PA.; Foa EB.; Marx BP.; Huang GD.; Lu Y.,2015.0,10.1016/j.cct.2014.11.017,0,0,
4022,Symptom benchmarks of improved quality of life in PTSD.,"Background: Although research has shown that PTSD symptom change relates to improved quality of life, the question of how much improvement in PTSD symptoms is necessary to result in meaningful improvements in quality of life remains unanswered. We used data from a randomized clinical trial of psychotherapy for PTSD in female military veterans and active duty personnel to examine the correspondence between benchmarks of improvement in PTSD symptoms and changes in quality of life. Methods: Participants were 235 female veterans and Army soldiers who were randomized to 10 weekly sessions of Prolonged Exposure or Present-Centered Therapy. We operationalized PTSD symptom change in terms of four progressively stringent mutually exclusive definitions-No Response, Response, Loss of Diagnosis, and Remission-successively comparing each category to the prior one: No Response versus Response, Response versus Loss of Diagnosis, and Loss of Diagnosis versus Remission. Outcomes were clinically meaningful improvements and good endpoints in domains of clinician-rated and self-reported quality of life. Results: Response was associated with improvement on almost all measures, but with only one good endpoint. Loss of Diagnosis was associated with improvement on all measures except self-rated social functioning and with achieving a good endpoint on all measures. Remission was associated with improvement in clinician-rated social impairment and a good endpoint in clinician-rated occupational impairment. Conclusions: For most domains of quality of life, treating a patient until the patient no longer meets diagnostic criteria would be optimal. For some domains, further improvements may result by helping a patient achieve remission. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Schnurr, Paula P; Lunney, Carole A; Blake, Bluett, Cloitre, Darlington, Davidson, Ehlers, Ehlers, Eisen, Foa, Foa, Frisch, Galovski, Gladis, Jonas, Kazdin, Kazdin, Kessler, Kessler, Krystal, Laska, Levitt, Lunney, Markowitz, Mendlowicz, Monson, Morina, Nemeroff, Olatunji, Ramchand, Resick, Resick, Schneier, Schnurr, Schnurr, Schnurr, Schnurr, Schnurr, Spitzer, Steenkamp, Van Minnen, Wachen, Ware, Weathers, Weathers, Weathers, Wisco, Wise, Wyrwich",2016.0,,0,0,
4023,Work-related quality of life and posttraumatic stress disorder symptoms among female veterans.,"Background: Posttraumatic stress disorder (PTSD) can have pervasive, negative effects on multiple aspects of quality of life. We investigated the relationship between PTSD symptom clusters and work-related quality of life among female veterans. Although prior studies have shown that PTSD symptom clusters are differentially related to work-related quality of life, no study has assessed these relationships in women specifically. Methods: Participants were 253 female veterans with current PTSD. We assessed three components of work-related quality of life (employment status, clinician-rated occupational impairment, and self-rated occupational satisfaction) and performed analyses with and without adjusting for self-reported depression symptoms. Results: None of the PTSD symptom clusters were associated with employment status. All PTSD symptom clusters had significant independent associations with occupational impairment. All PTSD symptom clusters except avoidance were significantly associated with lower occupational satisfaction, but none had independent associations with occupational satisfaction. No single PTSD symptom cluster emerged as most strongly associated with occupational outcomes. Symptoms of depression had substantial associations across all occupational outcomes, independent of PTSD symptoms. Conclusion: Knowledge about how PTSD relates to occupational outcomes in women veterans is important for addressing the needs of this growing segment of the VA patient population, in which PTSD is a prevalent condition. Because PTSD had differential relationships with the three components of work-related quality of life, measuring only one component, or using an aggregate measure, may obscure important distinctions. Resolving depression symptoms also may be integral to achieving meaningful recovery. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schnurr, Paula P; Lunney, Carole A; Beck, Boardman, Breslau, Dobie, Druss, Foa, Fontana, Franklin, Frayne, Frisch, Gladis, Hoge, Ikin, Jahoda, Johnson, Keane, Kessler, Kessler, Kimerling, King, Kuhn, Llena-Nozal, Lunney, MacDonald, Magruder, Matthews, McKnight, Mendlowicz, Mogotsi, North, Orsillo, Pietrzak, Ramchand, Resnick, Sanderson, Savoca, Schnurr, Schnurr, Schnurr, Schnurr, Scott, Shea, Smith, Spitzer, Stein, Street, Taylor, Wald, Weathers, Zatzick, Zatzick",2011.0,,0,0,
4024,Work-related outcomes among female veterans and service members after treatment of posttraumatic stress disorder.,"Objective: This study examined the effect of treatment for posttraumatic stress disorder (PTSD) on work-related quality-of-life outcomes and the relationship between clinically significant change during treatment and work-related outcomes. Additional analyses explored whether current depression and employment status moderated the effects of treatment and clinically significant change. Methods: Participants were 218 female veterans and soldiers with current PTSD who participated in a randomized clinical trial of treatment for PTSD. They received ten weekly sessions of prolonged exposure or present-centered therapy and were assessed before and after treatment and at three- and six-month follow ups. Outcomes were clinician-rated and self-rated occupational impairment and self-rated satisfaction with work. Results: Both treatment groups had improvements in occupational impairment, and the degree of improvement by the two groups was similar. There was no pre- to posttreatment change in work satisfaction. At the end of treatment, participants who no longer met diagnostic criteria for PTSD had greater improvements in all domains of work-related quality of life than participants who still had PTSD. Conclusions: Although prolonged exposure resulted in better PTSD symptom outcomes than present-centered therapy in the randomized clinical trial, it did not result in better work-related quality-of-life outcomes. The improvement in occupational impairment associated with loss of diagnosis suggests the importance of continuing treatment until clinically meaningful change has been attained. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schnurr, Paula P; Lunney, Carole A; Adler, Adler, Alonso, Beck, Blanchard, Boardman, Brady, Breslau, Carlier, Clark, Cohen, Dobie, Falsetti, First, Foa, Foa, Fontana, Forbes, Frank, Frisch, Gladis, Hoge, Jahoda, Kenward, Kessler, Kessler, Kimerling, Lerner, Littell, Llena-Nozal, MacDonald, Marshall, Matthews, Mendlowicz, Najavits, Nandi, North, Ogles, Paunovic, Plaisier, Proudfoot, Ramchand, Rapaport, Resnick, Rizvi, Satcher, Savoca, Schnurr, Schnurr, Schnurr, Schnurr, Schnurr, Schoenbaum, Simon, Smith, Stein, Taylor, Trivedi, Tucker, Vinokur, Wang, Weathers, Zatzick",2012.0,,0,0,
4025,[Postoperative implant-associated osteomyelitis of the shoulder: Hardware-retaining revision concept using temporary drainage].,"Posttraumatic and postoperative osteomyelitis (PPO) is a subgroup of bone infections with increasing importance. However, to date no standardized reoperation concept exists particularly for patients with PPO of the shoulder region. Therefore the purpose of this study was to evaluate a revision concept including débridement, irrigation, and insertion of temporary drainage with hardware retention until healing. A total of 31 patients with PPO were included with a proximal humerus fracture (n = 14), clavicle fracture (n = 10), or AC-joint separation (n = 7). In all, 27 of these patients could be followed for > 1 year. Hardware retention until fracture or ligament healing could be achieved in > 83%. Six patients required follow-up débridement due to recurrent infections, but then were unremarkable. Clinical outcome showed excellent Constant scores (91.6 ± 2.8). A cost-efficient, simple, and successful revision concept for patients with PPO of the shoulder region is described.",Schnetzke M.; Aytac S.; Herrmann P.; Wölfl C.; Grützner PA.; Heppert V.; Guehring T.,2015.0,10.1007/s00113-013-2520-0,0,0,
4026,Fear and avoidance of eye contact in social anxiety disorder.,"Background: Excessive fear of scrutiny is a defining feature of social anxiety disorder. Eye contact may trigger feelings of being scrutinized, and although eye contact is commonly feared in persons with social anxiety disorder, it has been studied little. The purpose of this study was to characterize fear and avoidance of eye contact in patients with social anxiety disorder and in nonpatient samples. Methods: Gaze fears and avoidance, social anxiety, and depression were assessed in 44 patients with generalized social anxiety disorder, 17 matched healthy comparison subjects, and 79 undergraduates. Patients were reassessed after 8 to 12 weeks of treatment with paroxetine. A new self-report instrument, the Gaze Anxiety Rating Scale (GARS), was used to assess fear and avoidance of eye contact, and its psychometric properties were analyzed. Results: Patients with generalized social anxiety disorder, in comparison with healthy control participants, reported significantly increased levels of fear and avoidance of eye contact, which decreased significantly after 8 to 12 weeks of treatment with paroxetine. Fear and avoidance of eye contact were significantly associated with severity of social anxiety in all 3 samples. The GARS demonstrated excellent internal consistency within each sample. Conclusions: Self-reported fear and avoidance of eye contact are associated with social anxiety in both nonpatient and social anxiety disorder samples. Preliminary psychometric analyses suggest that the GARS has utility in the assessment of gaze anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schneier, Franklin R; Rodebaugh, Thomas L; Blanco, Carlos; Lewin, Hillary; Liebowitz, Michael R; Allan, Baker, Baker, Beck, Blair, Brunet, Choy, Cohen, Doherty-Sneddon, Emery, Etkin, First, Gilbert, Grant, Hamilton, Heimberg, Heimberg, Hoffman, Horley, Horley, Kessler, Liebowitz, Liebowitz, Mattick, Meng, Mogg, Moukheiber, Rodebaugh, Rodebaugh, Rodebaugh, Rodebaugh, Ruscio, Safren, Schneier, Senju, Steer, Stein, White, Wieser, Wieser, Ohman",2011.0,,0,0,
4027,Combined prolonged exposure therapy and paroxetine for PTSD related to the World Trade Center attack: a randomized controlled trial.,"Selective serotonin reuptake inhibitors (SSRIs) are often recommended in combination with established cognitive-behavioral therapies (CBTs) for posttraumatic stress disorder (PTSD), but combined initial treatment of PTSD has not been studied under controlled conditions. There are also few studies of either SSRIs or CBT in treating PTSD related to terrorism. The authors compared prolonged exposure therapy (a CBT) plus paroxetine (an SSRI) with prolonged exposure plus placebo in the treatment of terrorism-related PTSD. Adult survivors of the World Trade Center attack of September 11, 2001, with PTSD were randomly assigned to 10 weeks of treatment with prolonged exposure (10 sessions) plus paroxetine (N=19) or prolonged exposure plus placebo (N=18). After week 10, patients discontinued prolonged exposure and were offered 12 additional weeks of continued randomized treatment. Patients treated with prolonged exposure plus paroxetine experienced significantly greater improvement in PTSD symptoms (incidence rate ratio=0.50, 95% CI=0.30-0.85) and remission status (odds ratio=12.6, 95% CI=1.23-129) during 10 weeks of combined treatment than patients treated with prolonged exposure plus placebo. Response rate and quality of life were also significantly more improved with combined treatment. The subset of patients who continued randomized treatment for 12 additional weeks showed no group differences. Initial treatment with paroxetine plus prolonged exposure was more efficacious than prolonged exposure plus placebo for PTSD related to the World Trade Center attack. Combined treatment medication and prolonged exposure therapy deserves further study in larger samples with diverse forms of PTSD and over longer follow-up periods.",Schneier FR.; Neria Y.; Pavlicova M.; Hembree E.; Suh EJ.; Amsel L.; Marshall RD.,2012.0,10.1176/appi.ajp.2011.11020321,0,0,
4028,Social anxiety and functional impairment in patients seeking surgical evaluation for hyperhidrosis.,"Primary hyperhidrosis is characterized by excessive sweating and often accompanied by social avoidance. Social anxiety disorder (SAD) is characterized by fear and avoidance of social situations, often partly related to fears of showing signs of excessive autonomic nervous system activation, such as sweating. To clarify the relationship of hyperhidrosis and SAD, this study assessed severity of sweating, overall social anxiety and social anxiety due to sweating, and disability in 2 groups: patients seeking surgical treatment for hyperhidrosis (n = 40) and patients seeking treatment for SAD (n = 64). Hyperhidrosis and SAD patients overlapped in severity of overall social anxiety and social anxiety related to sweating. Hyperhidrosis patients reported elevated levels of social anxiety, with mean severity near the threshold for the generalized subtype of SAD, but significantly lower social anxiety than in the SAD patients. Significantly more hyperhidrosis patients than SAD patients attributed most of their social anxiety to sweating (76% vs 20%). Among hyperhidrosis patients, the pattern of correlations of sweating, social anxiety, and disability was consistent with a model of social anxiety as a mediator of sweating-related disability. The overlap of symptoms in patients presenting for treatment of SAD or hyperhidrosis suggests that both social anxiety and sweating should be assessed in these patients and considered as potential targets of treatment.",Schneier FR.; Heimberg RG.; Liebowitz MR.; Blanco C.; Gorenstein LA.,2012.0,10.1016/j.comppsych.2012.04.009,0,0,
4029,Escitalopram for persistent symptoms of generalized anxiety disorder after CBT: a pilot study.,"Cognitive behavioral therapy (CBT) and pharmacotherapy are each efficacious for generalized anxiety disorder (GAD). It is not known, however, whether GAD partial and nonresponders to one treatment modality benefit from the other. This study explored acceptability and efficacy of escitalopram for persons with persistent GAD symptoms after a course of CBT. Twenty-four patients with GAD were treated with CBT and 15 completed at least 12 sessions. Eight completers continued to have clinically significant symptoms and were offered 12 weeks of treatment with escitalopram, and 7 started escitalopram treatment. During CBT, patients evidenced significant improvement in GAD, depression, and quality of life. During escitalopram treatment, patients evidenced trends toward further improvement in GAD, depression, and quality of life. Escitalopram phase completers had initially reported low-to-moderate preferences for medication treatment. Escitalopram may benefit GAD patients with clinically significant symptoms after CBT and merits further study under controlled conditions in a larger sample.",Schneier FR.; Belzer KD.; Kishon R.; Amsel L.; Simpson HB.,2010.0,10.1097/NMD.0b013e3181da4d77,0,0,
4030,[Open reconstruction of radius head fractures with and without accompanying ligament instability. Treatment results].,"The treatment of fractures of the radial head is commonly based on the Mason classification. Fractures of the radial head caused by a dislocation of the elbow are summarized as Mason type IV fractures. The purpose of this study was to investigate the outcome and the influence of additional ligamentous injuries after reconstruction of fractures of the radial head. One hundred three patients with a fracture of the radial head were treated by open reduction and internal fixation between 2004 and 2009. Fifty-eight of them could be evaluated at an average of 3.6 years after surgery. Forty-one patients had no additional ligamentous injury and 17 had a fracture combined with complete dislocation of the elbow. At the final follow-up examination, all patients were assessed clinically, bilateral radiographs were taken, and the Broberg and Morrey and Kellgren & Lawrence scores were determined. Ten patients had a Mason type II, 31 a Mason type III and 17 a Mason type IV fracture. With regard to the Broberg and Morrey score, patients without ligamentous injury achieved a significantly better functional outcome, with good to excellent results in 97.5% of cases compared to 64.6% for patients with ligamentous injuries. Twelve percent of the patients without ligamentous injury and 47% of the patients with ligamentous injuries developed moderate or severe posttraumatic arthritis. Heterotopic ossification was found in 19.5% of the patients without and in 47% of those with ligamentous injury. Reconstruction of radial head fractures without ligamentous instability led to significantly superior functional results and lower rates of posttraumatic arthritis and heterotopic ossifications than osteosynthesis of fractures with additional ligamentous injury. In these cases primary endoprosthetic replacement might be considered.",Schneiders W.; Stryer V.; Olbrich A.; Rammelt S.; Zwipp H.,2013.0,10.1007/s00113-012-2257-1,0,0,
4031,The efficacy of a family-based cognitive-behavioral treatment for separation anxiety disorder in children aged 8-13: a randomized comparison with a general anxiety program,"ER BACKGROUND: This randomized controlled trial examines the relative efficacy of a disorder-specific treatment program (TrennungsAngstprogramm Für Familien [TAFF]; English: Separation Anxiety Family Therapy) for children suffering from separation anxiety disorder (SAD) in comparison with a general anxiety program.METHOD: Sixty-four children aged 8-13 with SAD and their parents were assigned either to a 16-session disorder-specific SAD treatment program, including parent training and classical cognitive-behavioral therapy (CBT) components (TAFF), or to a general child-focused 16-week comparison group (Coping Cat [CC]) without any parent training. Diagnoses and parent cognitions were assessed at baseline and at follow-ups. Global success ratings were collected at end of treatment and at follow-up. Ratings for anxiety, impairment/distress, and life quality were collected at Baseline 1, again after a 4-week waiting period, repeatedly throughout treatment, at 4 weeks, and at 1-year follow-up.RESULTS: The response rate (no SAD diagnosis) at 4-week follow-up among the 52 treatment completers was 87.5% vs. 82.1% (TAFF vs. CC; intent-to-treat: 67.7% vs. 69.7%). At 1-year follow-up, the response was 83.3% versus 75% (TAFF vs. CC; intent to treat: 64.5% vs. 63.6%). Differences were nonsignificant. Results from rating scales indicated improvement for both groups across time points and assessment areas, with few between-group differences, and some small effects favoring the TAFF program. Both treatment programs yielded a reduction in parental dysfunctional beliefs.CONCLUSIONS: Results indicate a slight advantage of the TAFF program over a general child-based treatment for SAD. However, these differences were less strong than hypothesized, indicating that the inclusion of parent training does not add large effects to classical child-based CBT in school-age children with SAD. (PsycINFO Database Record (c) 2013 APA, all rights reserved).","Schneider, S; Blatter-Meunier, J; Herren, C; In-Albon, T; Adornetto, C; Meyer, A; Lavallee, K L",2013.0,10.1037/a0032678,0,0,
4032,Disorder-specific cognitive-behavioral therapy for separation anxiety disorder in young children: a randomized waiting-list-controlled trial,"ER METHODSForty-three children (ages 5-7) with SAD and their parents were assigned to either a 16-session disorder-specific SAD treatment program including parent training and classical cognitive-behavioral therapy (CBT) components, or to a 12-week waiting list group. Categorical and/or continuous data for anxiety, impairment/distress and quality of life were collected at baseline, after treatment/waiting list condition, and at a 4-week follow-up.RESULTSIntention-to-treat analyses indicate that 76.19% of children allocated to the treatment group definitively no longer fulfilled DSM-IV criteria for SAD at follow-up, compared to 13.64% in the waiting list group. Between 91 and 100% of children rated themselves or were rated by their father, mother or therapist as very much or much improved on the global success rating immediately after treatment. Results indicated large time by treatment condition interaction effect sizes (d = 0.98-1.41) across informants for reduction of distress/avoidance in separation situations after the test for the treatment condition. Further, parents reported significant improvements in impairment/distress in the child's major life domains and the child's quality of life. Treatment gains were maintained at the 4-week follow-up assessment.CONCLUSIONSResults indicate the short-term efficacy of a disorder-specific treatment approach for SAD, and are among the first to indicate that CBT programs work with young children.BACKGROUNDSeparation anxiety disorder (SAD) is one of the earliest and most common mental disorders in childhood, and a strong predictor of adult psychopathology. Despite significant progress in psychotherapy research on childhood anxiety disorders, no randomized controlled trial has been conducted with a disorder-specific treatment program for young children suffering from SAD.","Schneider, S; Blatter-Meunier, J; Herren, C; Adornetto, C; In-Albon, T; Lavallee, K",2011.0,10.1159/000323444,0,0,
4033,The influence of the serotonergic system on the personality and quality of life of postmenopausal women,"The aim of this study was to establish the relationship between personality traits of postmenopausal women and the presence of the 44-bp VNTR polymorphism in the serotonin transporter (5-HTT) (SLC6A4) promoter region and the 30-bp VNTR polymorphism in the MAO-A promoter region. The study’s aim was also to determine the influence of personality traits on the quality of postmenopausal women’s lives. The study involved 214 postmenopausal women from northwest Poland, with an average age of 56.8±4.08 years. It was performed using the Temperament and Character Inventory-Revised and the Short Form Health Survey. DNA polymorphisms were identified by means of polymerase chain reaction. Analysis demonstrated that the s/s genotype was significantly more common than the l/l genotype in women with higher fear of uncertainty. In a group with higher enlightened second nature and empathy, the l/s genotype was considerably more common than the l/l genotype. There were statistically significant associations between selected aspects of quality of life and personality traits such as enlightened second nature, transpersonal identification, purposefulness, and self-transcendence. The s/s genotype of the 44-bp VNTR polymorphism in the 5-HTT (SLC6A4) promoter region may increase the tendency to avoid harm within the fear of uncertainty dimension. Carriers of this genotype may have predisposition to anxiety and depressive disorders. The l/s genotype of the 44-bp VNTR polymorphism in the 5-HTT (SLC6A4) promoter region contributes to increased expression of enlightened second nature and empathy. Some personality traits may influence the quality of women’s lives.",Schneider-Matyka D.; Jurczak A.; Szkup M.; Samochowiec A.; Grzywacz A.; Wieder-Huszla S.; Grochans E.,2017.0,10.2147/CIA.S133712,0,0,
4034,Internet-delivered cognitive behaviour therapy for depressive symptoms: An exploratory examination of therapist behaviours and their relationship to outcome and therapeutic alliance.,"Background: A previous study of therapist-assisted Internet-delivered cognitive behaviour therapy (ICBT) for generalized anxiety (Paxling et al., 2013) identified eight distinct therapist behaviours in ICBT (task reinforcement, self-efficacy shaping, task prompting, alliance bolstering, psychoeducation, empathetic utterances, deadline flexibility, and self-disclosure). It is unknown how generalizable these behaviours are across ICBT programs. Aims: We systematically examined the frequency of these eight therapist behaviours and additional newly identified behaviours in e-mails sent to patients during the course of ICBT for depressive symptoms. We also conducted exploratory analyses to examine relationships between therapist behaviours, symptom improvement, and therapeutic alliance. Method: Data was obtained from a previously published open trial (Hadjistavropoulos et al., 2014). A total of 1013 e-mails sent from therapists (n = 24) to patients (n = 41) during ICBT for depressive symptoms were analyzed. Therapist behaviours were correlated with symptom change scores and ratings of therapeutic alliance at mid- and post-treatment. Results: Therapist behaviours described by Paxling et al. were reliably identified in the e-mails using qualitative content analysis; the frequencies of these behaviours differed, however, from the Paxling et al. study and three additional therapist behaviours were identified (administrative statements, questionnaire feedback, asking clarifying questions). Several therapist behaviours (e.g. administrative statements, task prompting) were associated with lower symptom improvement at post-treatment. Questionnaire feedback and task reinforcement were associated with higher patient ratings of therapeutic alliance. Conclusions: The study provides partial support for the generalizability of therapist-assistance across ICBT programs. Experimental research is needed to examine the impact of varying therapist-assistance on patient outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schneider, Luke H; Hadjistavropoulos, Heather D; Faller, Y. Nichole; Andersson, Baumeister, Cameron, Elo, Hadjistavropoulos, Hadjistavropoulos, Hedman, Hsieh, Johansson, Kiropoulos, Klein, Klein, Kroenke, Kroenke, Lovibond, Luborsky, McHugh, Ng, Paxling, Spitzer, Steketee",2016.0,,0,0,
4035,[Results of a psychooncological group intervention in male cancer patients aged 60 years or older].,,Schneider G.; Kropff B.; Unrath M.; Floeth S.; Semjonow A.; Doering S.,2016.0,10.13109/zptm.2016.62.4.336,0,0,
4036,Results of a psychooncological group intervention in male cancer patients aged 60 years or older,,"Schneider, G; Kropff, B; Unrath, M; Floeth, S; Semjonow, A; Doering, S",2016.0,10.13109/zptm.2016.62.4.336,0,0,4035
4037,Competitive Memory Training (COMET) for OCD: a self-treatment approach to obsessions.,"Competitive Memory Training (COMET) is a cognitive intervention that aims to change the maladaptive cognitive-emotional networks underlying obsessive-compulsive disorder (OCD). COMET has not been previously tried as a self-help intervention. The present study tested the preliminary feasibility, acceptability, and effectiveness of COMET for OCD implemented as a self-help intervention. Sixty-five participants with OCD recruited through online OCD self-help fora completed an online baseline assessment including measures of OCD symptoms, self-esteem, and depression. Participants were randomly assigned to either COMET or a wait-list control group. All participants were approached 4 weeks later to complete an online post-assessment. There was no evidence for a greater decline of OCD symptoms or depression under COMET. When analyses were limited to only those participants who reported reading the entire manual at least once, self-esteem was higher at post-assessment in the COMET group. Although 78.1% of patients in the COMET group rated it as appropriate for self-administration, only 56.5% performed COMET exercises regularly and 26.4% read the entire manual at least once. The feasibility and effectiveness of COMET as a self-help internet intervention for OCD was not supported in this study. Further work is needed to better understand if modifications to our implementation of COMET may yield improved outcomes.",Schneider BC.; Wittekind CE.; Talhof A.; Korrelboom K.; Moritz S.,2015.0,10.1080/16506073.2014.981758,0,0,
4038,Release of pro- and anti-inflammatory cytokines during different anesthesia procedures,"ER The modulation of immune functions, induced by trauma, surgical interventions and anaesthesia, is thought to play a crucial role in the development of post-traumatical or postoperative disorders. The balance of pro- and anti-inflammatory cytokines was shown to affect the outcome of the patients. This work studied the effects of different anaesthesiological procedures--total intravenous anaesthesia using Propofol/Sufentanil (TIVA) versus balanced inhalational anaesthesia using Trapanal/Sevoflurane (BIA) in patients with elective lumbal discectomia--on the secretion of various cytokines and their correlation to endocrine stress response. The concentrations of the pro-inflammatory cytokines IL-2, IL-6, IL-12 and IFN-gamma and their soluble receptor molecules as well as the concentrations of the anti-inflammatory cytokines IL-10, IL-1RA and TGF-beta were determined in plasma samples obtained pre-, intra- and postoperatively. Additionally, the plasma concentrations of the stress-related hormones cortisol, epinephrine and norepinephrine were measured. Changes in the cytokine profile were observed immediately after induction of anaesthesia. Significant differences were found particularly in IL-6 production as well as in the release of the soluble IL-2R alpha and the IL-1 receptor antagonist (IL-1RA). Whereas under BIA, the concentrations of IL-6 were found to be significantly elevated during the course of the study, the release of the soluble IL-2R alpha and the production of IL-1RA were reduced in this patient group in comparison to the TIVA group. The increase of the postoperative concentrations of cortisol, epinephrine and norepinephrine under BIA indicated enhanced activation of the hypothalamo-pituitary-adrenal axis and the sympathetic system. Thus, with respect to limitation of surgery-associated stress, total intravenous anaesthesia seems to have a favourable effect. Moreover, induction of the release of anti-inflammatory mediators under TIVA might contribute to the prevention of excessive postoperative inflammation. Taken together, these data suggest that the anaesthesiological management may have considerable influence on the postoperative inflammatory process. This might be of particular relevance for surgical interventions in patients after injuries, infections or malignant diseases which are known to be associated with immune dysfunction.","Schneemilch, C E; Bank, U",2001.0,,0,0,
4039,Comparison of the standard and the computerized versions of the Symptom Check List (SCL-90-R): a randomized trial.,"The purpose of this study was to examine whether computer administration of the Symptom Check List (SCL-90-R) is equivalent to paper-and-pencil originals. 282 psychosomatic outpatients were randomly assigned to computer or paper-and-pencil conditions. Statistical equivalence tests were used to examine psychometric equivalence for the means. Reliabilities and correlations were compared for the two methods of administration. No systematic differences were observed in group means for most of the subscales. Subjects of the computer-administered group scored higher on the SCL-90-R subscale 'Obsessive-Compulsive' and 'Anger-Hostility' than the control subjects. Gender and administration mode interaction was observed for one subscale, while age and administration interaction was observed for another subscale. Using computer-administered tests makes administration and scoring of tests more efficient. The differences between the two administration modes were small, although noticeable. Further research is needed to determine whether computer environment, computer experience and age may influence the test results.",Schmitz N.; Hartkamp N.; Brinschwitz C.; Michalek S.; Tress W.,2000.0,,0,0,
4040,"You don't like me, do you? Enhanced ERP responses to averted eye gaze in social anxiety","Social anxiety is associated with an attentional bias toward angry and fearful faces, along with an enhanced processing of faces per se. However, little is known about the processing of gaze direction, a subtle but important social cue. Participants with high or low social anxiety (HSA/LSA) observed eye pairs with direct or averted gaze while subjective ratings and event-related potentials (ERPs) were measured. Behaviorally, all participants rated averted gaze as more unpleasant than direct gaze. Neurally, only HSA participants showed a trend for higher P100 amplitudes to averted gaze and significantly enhanced processing at late latencies (Late positive potential [LPP]), indicative of a specific processing bias for averted gaze. Furthermore, HSA individuals showed enhanced processing of both direct and averted gaze relative to the LSA group at intermediate latencies (Early posterior negativity [EPN]). Both general and specific attentional biases play a role in social anxiety. Averted gaze - a potential sign of disinterest - deserves more attention in the attentional bias literature. © 2012 Elsevier B.V.",Schmitz J.; Scheel C.N.; Rigon A.; Gross J.J.; Blechert J.,2012.0,10.1016/j.biopsycho.2012.07.004,0,0,
4041,D-cycloserine enhancement of fear extinction is specific to successful exposure sessions: evidence from the treatment of height phobia.,"Whereas some studies have shown clear evidence for an augmentation effect of D-cycloserine (DCS) on exposure therapy for anxiety disorders, other studies have shown weak effects or no effect at all. Some preclinical data suggest that the DCS augmentation effect is moderated by the success of extinction learning. Therefore, we conducted a reanalysis of existing data to examine whether the effects of DCS on clinical outcome would vary as a function of response to the exposure session (i.e., exposure success). In a clinical trial, patients with height phobia received two sessions involving 30 minutes of virtual reality exposure therapy and were randomly assigned to a pill placebo (n = 14) or 50 mg of DCS (n = 15) immediately after each session. Mixed-effects regression analysis showed that the effects of DCS administration on clinical improvement was moderated by the level of fear experienced just before concluding exposure sessions. Patients receiving DCS exhibited significantly greater improvement in symptoms relative to patients who received placebo when fear was low at the end of the exposure. In contrast, when end fear was still elevated, patients receiving DCS improved less compared with those receiving placebo. D-cycloserine appears to enhance the benefits of exposure treatment when applied after a successful session, but it seems to have detrimental effects when administered after inadequate/unsuccessful exposure sessions.",Smits JA.; Rosenfield D.; Otto MW.; Powers MB.; Hofmann SG.; Telch MJ.; Pollack MH.; Tart CD.,2013.0,10.1016/j.biopsych.2012.12.009,0,0,
4042,D-cycloserine enhancement of exposure therapy for social anxiety disorder depends on the success of exposure sessions.,"The evidence for the efficacy of D-cycloserine (DCS) for augmenting cognitive behavioral therapy (CBT) for anxiety disorders has been mixed. Guided by preclinical research and initial findings from a small-scale study involving humans, we tested the hypothesis that DCS enhancement of exposure therapy would be specific to successful exposure sessions. Medication-free adults with generalized social anxiety disorder (N = 145) received 50 mg of DCS or placebo 1 h before each of 5 exposure sessions that were part of a standardized 12-session group CBT protocol. Participants provided fear ratings at the beginning and just before the end of exposure exercises. Independent raters, blind to group assignment, administered the clinical global impression improvement and severity scales at each session and at posttreatment. Mixed-effects analyses revealed that, among patients who reported low fear at the end of an exposure session, those who had received DCS evidenced significantly greater clinical improvement at the next session, relative to those who had received placebo. In contrast, when exposure end fear was high, patients receiving DCS exhibited less clinical improvement at the following session than patients receiving placebo. Similarly, patients who had received DCS evidenced lower clinical severity at posttreatment, relative to patients who had received placebo, only when their average end fear for medication-augmented sessions had been in the low to moderate range. Finally, these moderating effects of exposure success as indexed by end fear were not better accounted for by within-session extinction. The efficacy of DCS for augmenting exposure-based CBT depends on the success of exposure sessions. These findings may help guide the development of an algorithm for the effective use of DCS for augmenting exposure-based CBT. http://www.ClinicalTrials.gov, ID# NCT00633984, http://www.clinicaltrials.gov/ct2/show/NCT00633984.",Smits JA.; Rosenfield D.; Otto MW.; Marques L.; Davis ML.; Meuret AE.; Simon NM.; Pollack MH.; Hofmann SG.,2013.0,10.1016/j.jpsychires.2013.06.020,0,0,
4043,Cognitive mechanisms of social anxiety reduction: an examination of specificity and temporality.,"Cognitive theories posit that exposure-based treatments exert their effect on social anxiety by modifying judgmental biases. The present study provides a conservative test of the relative roles of changes in judgmental biases in governing social anxiety reduction and addresses several limitations of previous research. Longitudinal, within-subjects analysis of data from 53 adults with a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) social phobia diagnosis revealed that reductions in probability and cost biases accounted for significant variance in fear reduction achieved during treatment. However, whereas the reduction in probability bias resulted in fear reduction, the reduction in cost bias was merely a consequence of fear reduction. A potential implication is that exposure-based treatments for social anxiety might focus more attention on correcting faulty appraisals of social threat occurrence.",Smits JA.; Rosenfield D.; McDonald R.; Telch MJ.,2006.0,10.1037/0022-006X.74.6.1203,0,0,
4044,Yohimbine enhancement of exposure therapy for social anxiety disorder: a randomized controlled trial.,"Preclinical and clinical trials suggest that yohimbine may augment extinction learning without significant side effects. However, previous clinical trials have only examined adults with specific phobias. Yohimbine has not yet been investigated in the augmentation of exposure therapy for other anxiety disorders. Adults (n = 40) with a DSM-IV diagnosis of social anxiety disorder were randomized to placebo or yohimbine HCl (10.8 mg) 1 hour before each of four exposure sessions. Outcome measures were collected at baseline, each treatment session, posttreatment, and 1-month follow-up. Yohimbine was well tolerated. Yohimbine augmentation, relative to placebo augmentation, resulted in faster improvement and better outcomes on self-report measures of social anxiety disorder severity (Liebowitz Social Anxiety Scale, d = .53) and depressed mood severity (Beck Depression Inventory, d = .37) but not on the clinician-rated measures (Clinical Global Impressions-Severity Scale, d = .09; Clinical Global Impressions-Improvement Scale, d = .25). Between-group differences on the Liebowitz Social Anxiety Scale were moderated by the level of fear reported at the end of an exposure exercise (end fear), such that the advantage of yohimbine over placebo was only evident among patients who reported low end fear. The results provide moderate support for yohimbine as a therapeutic augmentation strategy for exposure therapy in social anxiety disorder, one that may be especially effective when coupled with successful exposure experiences. Beneficial effects for yohimbine were readily evident for self-report measures but not for clinician-rated outcomes of social anxiety severity and improvement.",Smits JA.; Rosenfield D.; Davis ML.; Julian K.; Handelsman PR.; Otto MW.; Tuerk P.; Shiekh M.; Rosenfield B.; Hofmann SG.; Powers MB.,2014.0,10.1016/j.biopsych.2013.10.008,0,0,
4045,Outcomes of acute phase cognitive therapy in outpatients with anxious versus nonanxious depression.,"Compared to nonanxious depressed patients, anxious depressed patients respond less to pharmacotherapy, prompting consideration of alternate treatments. Based on the transdiagnostic principles of cognitive therapy (CT), we predicted that anxious depressed patients would respond as well to CT as nonanxious depressed patients. Adults (n = 523) with recurrent major depressive disorder received 12-14 weeks of CT as part of the Continuation Phase Cognitive Therapy Relapse Prevention Trial. Anxious depressed patients (n = 264; 50.4%) were compared to nonanxious depressed patients (n = 259; 49.6%) on demographic variables, initial severity, attrition, and rates and patterns of response and remission. Anxious depressed patients presented with greater illness severity and had significantly lower response (55.3 vs. 68.3%) and remission rates (26.9 vs. 40.2%) based on clinician-administered measures. By contrast, smaller between-group differences for attrition, and for response (59.1 vs. 64.9%) and remission (41.7 vs. 48.7%) rates on self-report measures were not significant. Further, anxious depressed patients had greater speed of improvement on self-reported anxiety symptom severity and clinician-rated depressive and anxiety symptom severity measures. Consistent with prior reports, anxious depressed patients presented with greater severity and, following CT, had lower response and remission rates on clinician-administered scales. However, anxious depressed patients improved more rapidly and response and remission rates on self-report measures were not significantly different from nonanxious depressed patients. Our findings suggest that anxious depressed patients may simply need additional time or more CT sessions to reach outcomes fully comparable to those of less anxious patients.",Smits JA.; Minhajuddin A.; Thase ME.; Jarrett RB.,2012.0,10.1159/000334909,0,0,
4046,Cognitive therapy for depressed adults with comorbid social phobia.,"Evidence suggests that comorbid depression influences the outcome of cognitive-behavioral treatment for patients presenting with social phobia. Little is known, however, about the influence of comorbid social phobia on the response to cognitive therapy (CT) for depression among adults presenting with recurrent major depressive disorder (MDD). These analyses seek to clarify this relationship. Patients (N=156) with recurrent DSM-IV MDD entered CT (20% also met DSM-IV criteria for social phobia). Every week during the course of CT, clinicians assessed depressive symptoms and patients completed self-report instruments measuring severity of depression and anxiety. At presentation, outpatients with comorbid social phobia reported greater levels of depressive symptoms and clinicians rated their impairment as more severe, compared to their counterparts without social phobia. Patients with or without comorbid social phobia did not differ significantly in (1) attrition rates; (2) response or sustained remission rates; (3) time to response or sustained remission; or (4) rate of improvement in symptoms of depression or anxiety. The lack of domain-specific measures limits inference with respect to the improvements in social anxiety that occur with CT of depression. These findings introduce the hypothesis that CT for depression may be flexible enough to treat the depressive symptoms of patients presenting with MDD who also suffer from social phobia.",Smits JA.; Minhajuddin A.; Jarrett RB.,2009.0,10.1016/j.jad.2008.08.008,0,0,
4047,D-cycloserine augmentation of cognitive behavioral group therapy of social anxiety disorder: prognostic and prescriptive variables.,"The aim of the current study was to identify individual characteristics that (a) predict symptom improvement with group cognitive behavioral therapy (CBT) for social anxiety disorder (SAD; i.e., prognostic variables) or (b) moderate the effects of d-cycloserine (DCS) versus placebo augmentation of CBT for SAD (i.e., prescriptive variables). Adults with SAD (N = 169) provided Liebowitz Social Anxiety Scale scores in a trial evaluating DCS augmentation of group CBT. Rate of symptom improvement during therapy and posttreatment symptom severity were evaluated using multilevel modeling. As predictors of these 2 parameters, we selected the range of variables assessed at baseline (demographic characteristics, clinical characteristics, personality traits). Using step-wise analyses, we first identified prognostic and prescriptive variables within each of these domains and then entered these significant predictors simultaneously in 1 final model. African American ethnicity and cohabitation status were associated with greater overall rates of improvement during therapy and lower posttreatment severity. Higher initial severity was associated with a greater improvement during therapy but also higher posttreatment severity (the greater improvement was not enough to overcome the initial higher severity). DCS augmentation was evident only among individuals low in conscientiousness and high in agreeableness. African American ethnicity, cohabitation status, and initial severity are prognostic of favorable CBT outcomes in SAD. DCS augmentation appears particularly useful for patients low in conscientiousness and high in agreeableness. These findings can guide clinicians in making decisions about treatment strategies and can help direct research on the mechanisms of these treatments.",Smits JA.; Hofmann SG.; Rosenfield D.; DeBoer LB.; Costa PT.; Simon NM.; O'Cleirigh C.; Meuret AE.; Marques L.; Otto MW.; Pollack MH.,2013.0,10.1037/a0034120,0,0,
4048,Reducing anxiety sensitivity with exercise.,"Exercise interventions repeatedly have been shown to be efficacious for the treatment of depression, and initial studies indicate similar efficacy for the treatment of anxiety conditions. To further study the potential beneficial role of prescriptive exercise for anxiety-related conditions, we examined the role of exercise in reducing fears of anxiety-related sensations (anxiety sensitivity). We randomly assigned 60 participants with elevated levels of anxiety sensitivity to a 2-week exercise intervention, a 2-week exercise plus cognitive restructuring intervention, or a waitlist control condition. Assessment of outcome was completed at pretreatment, midtreatment, 1-week posttreatment, and 3-week follow-up. We found that both exercise conditions led to clinically significant changes in anxiety sensitivity that were superior to the waitlist condition, representing a large controlled effect size (d=2.15). Adding a cognitive component did not facilitate the effects of the exercise intervention. Consistent with hypotheses, changes in anxiety sensitivity mediated the beneficial effects of exercise on anxious and depressed mood. We discuss these findings in terms of the potential role of exercise as an additional psychosocial intervention for conditions such as panic disorder, where anxiety sensitivity is a prominent component of pathology.",Smits JA.; Berry AC.; Rosenfield D.; Powers MB.; Behar E.; Otto MW.,2008.0,10.1002/da.20411,0,0,
4049,The effects of acute exercise on CO(2) challenge reactivity,"ER The present study examined the effects of acute exercise on anxiogenic responding to 65% O(2)/35% CO(2) challenge. Participants (N=92) were 51 female and 41 male volunteers ranging in age from 17 to 24 (M=19.43, SD=1.31). Participants had no history of panic attacks and were randomized to moderate treadmill exercise (i.e., 70% of HR(max)) or quiet rest prior to taking a single vital capacity inhalation of 35% CO(2)/65% O(2). Gender and measures of negative affectivity and anxiety sensitivity were included in the design as control variables. Results indicated participants who exercised prior to challenge showed significantly reduced reactivity compared to their counterparts who rested prior to challenge. Importantly, the effect sizes for the advantage of exercise over rest remained in the medium to large range (i.e., partial eta(2)>.07) after controlling for the effects of gender, anxiety sensitivity, and negative affectivity. These findings are the first to demonstrate that the anti-panic effects of exercise are unique from, and cannot be better explained by, established risk factors of CO(2) challenge reactivity.","Smits, J A; Meuret, A E; Zvolensky, M J; Rosenfield, D; Seidel, A",2009.0,10.1016/j.jpsychires.2008.05.009,0,0,
4050,Randomized Controlled Pilot Trial of Behavioral Insomnia Treatment for Chronic Migraine With Comorbid Insomnia,"ER Background Migraine frequently co-occurs with and is triggered by sleep disturbance, particularly insomnia, and the large majority of patients with chronic migraine (CM) have comorbid insomnia. Limited evidence suggests that behavioral regulation of sleep may reduce migraine frequency, but studies to date have not assessed the viability of stimulus control and sleep restriction interventions or included objective measurement of sleep parameters. The aim of this study, thus, was to pilot-test the efficacy of a brief behavioral insomnia intervention for adults with CM and comorbid insomnia; headache diaries and actigraphy were included to assess outcomes throughout the trial. Methods This randomized parallel-arm pilot trial recruited adults with both CM and comorbid insomnia. Participants were randomly assigned to three 30-minute biweekly sessions of cognitive-behavioral therapy for insomnia (CBTi) or control treatment. Participants were blinded to treatment and control conditions to control for outcome expectations. Each treatment condition involved training in and daily practice in 5 instructions/skills. The CBTi group learned and practiced skills pertaining to stimulus control and sleep restriction. The control intervention was the same as used by Calhoun and Ford (2007) and involved training in and daily practice of skills pertaining to keeping a consistent food/liquid intake, range of motion exercises, and acupressure. Participants provided outcome data via daily headache diaries, actigraphy, and self-report measures. The primary outcome was reduction in headache frequency at 2 weeks post-treatment and 6-week follow-up; secondary outcomes included other headache parameters, objective actigraphic and subjective changes in sleep, and treatment effect sizes and perceived credibility. Generalized estimating equations with a binomial logit link and inverse probability weights were used to assess the primary outcome among the intent-to-treat sample, and repeated measures generalized linear models were used to assess changes in secondary outcomes after controlling for baseline values. Results The intent-to-treat analyses included 31 adults (M age = 30.8 [12.9] years; 90.3% female; 80.6% white) with CM and comorbid insomnia. Both interventions yielded reductions in headache frequency at post-treatment (26.9% reduction for CBTi vs 36.2% for control) and follow-up (48.9% for CBTi vs 25.0% for control). At follow-up the odds of experiencing headache were 60% lower for CBTi than for control treatment, indicative of a large effect size that did not reach statistical significance after Bonferroni correction for assessing two primary endpoints (odds ratio: 0.40; 95% CI: 0.17, 0.91; P =.028). CBTi produced significantly larger increases than control treatment in total sleep time and sleep efficiency as quantified by actigraphy, as well as in self-reported insomnia severity. Adherence was high and treatments were perceived as credible without differences between groups, but the control group experienced a higher rate of dropouts. No adverse events were reported. Conclusions Behavioral treatment of comorbid insomnia in individuals with CM produced large reductions in headache frequency, though some improvement in headache occurred with a behavioral intervention not focused on modifying sleep. Among the CBTi group only, both headache frequency and sleep parameters continued to improve after treatment, suggesting the presence of enduring effects over time. Directly treating insomnia using components of stimulus control and sleep restriction holds promise for reducing comorbid migraine. Development of and comparison to a truly inert pseudotherapy control presents unique challenges that future studies should address.","Smitherman, T A; Walters, A B; Davis, R E; Ambrose, C E; Roland, M; Houle, T T; Rains, J C",2016.0,10.1111/head.12760,0,0,
4051,Are reports of posttraumatic growth positively biased?,"This study examines positivity bias in reports of growth following exposure to traumatic events. Participants (N = 276) from an urban university and a superior court jury pool were randomly assigned to one of two methodological groups. In one, participants responded to the Posttraumatic Growth Inventory (PTGI) in relation to a specific stressful event. In the other, PTGI questions were not linked to specific events. Findings indicate that current methods for assessing posttraumatic growth (PTG) may actually underestimate growth. That is, linking questions about growth to specific stressors may have led participants to be cautious about attributing their growth experiences to a traumatic event. These findings contradict notions that current methods of measuring PTG create a positivity bias. Suggestions for future research include the use of prospective designs and corroborating reports of growth.",Smith SG.; Cook SL.,2004.0,10.1023/B:JOTS.0000038485.38771.c6,0,0,
4052,The use of cranial electrotherapy stimulation in the treatment of closed-head-injured patients.,"This double-blind study sought to discover if cranial electrotherapy stimulation (CES), which is a known treatment of depression, anxiety and insomnia in non-head-injured patients, could be an effective, drug-free treatment of stress-related symptoms in the closed-head-injured (CHI) patient. In this study 10 CHI patients treated for 45 min daily, 4 days a week for 3 weeks, responded significantly on all negative mood factors of the Profile Of Mood States, while five sham-treated and six placebo controls did not. While the majority of the patients were known seizure cases, no patient suffered a seizure during CES therapy. No placebo effects were found, nor were any negative effects from CES treatment seen.",Smith RB.; Tiberi A.; Marshall J.,,,0,0,
4053,"The effectiveness of intensive training for residents in interviewing. A randomized, controlled study","ER OBJECTIVETo determine the effects of a training program in interviewing on 1) residents' attitudes toward and skills in interviewing and 2) patients' physical and psychosocial well-being and satisfaction with care.DESIGNRandomized, controlled study.SETTINGTwo university-based primary care residencies.PARTICIPANTS63 primary care residents in postgraduate year 1.INTERVENTIONA 1-month, full-time rotation in interviewing and related psychosocial topics.MEASUREMENTSResidents and their patients were assessed before and after the 1-month rotation. Questionnaires were used to assess residents' commitment to interviewing and psychosocial medicine, estimate of the importance of such care, and confidence in their ability to provide such care. Knowledge of interviewing and psychosocial medicine was assessed with a multiple-choice test. Audiotaped interviews with real patients and videotaped interviews with simulated patients were rated for specific interviewing behaviors. Patients' anxiety, depression, and social dysfunction; role limitations; somatic symptom status; and levels of satisfaction with medical visits were assessed by questionnaires and telephone interviews.RESULTSTrained residents were superior to untrained residents in knowledge (difference in adjusted post-test mean scores, 15.7% [95% CI, 11% to 20%]); attitudes, such as confidence in psychological sensitivity (difference, 0.61 points on a 7-point scale [CI, 0.32 to 0.91 points]); somatization management (difference, 0.99 points [CI, 0.64 to 1.35 points]); interviewing of real patients (difference, 1.39 points on an 11-point scale [CI, 0.32 to 2.45 points]); and interviewing (data gathering) of simulated patients (difference, 2.67 points [CI, 1.77 to 3.56 points]). Mean differences between the study groups were consistently in the appropriate direction for patient satisfaction and patient well-being, but effect sizes were too small to be considered meaningful.CONCLUSIONAn intensive 1-month training rotation in interviewing improved residents' knowledge about, attitudes toward, and skills in interviewing.BACKGROUNDInterviewing and the physician-patient relationship are crucial elements of medical care, but residencies provide little formal instruction in these areas.","Smith, R C; Lyles, J S; Mettler, J; Stoffelmayr, B E; Egeren, L F; Marshall, A A; Gardiner, J C; Maduschke, K M; Stanley, J M; Osborn, G G; Shebroe, V; Greenbaum, R B",1998.0,,0,0,
4054,The use of cranial electrotherapy stimulation in the treatment of closed-head-injured patients,"ER This double-blind study sought to discover if cranial electrotherapy stimulation (CES), which is a known treatment of depression, anxiety and insomnia in non-head-injured patients, could be an effective, drug-free treatment of stress-related symptoms in the closed-head-injured (CHI) patient. In this study 10 CHI patients treated for 45 min daily, 4 days a week for 3 weeks, responded significantly on all negative mood factors of the Profile Of Mood States, while five sham-treated and six placebo controls did not. While the majority of the patients were known seizure cases, no patient suffered a seizure during CES therapy. No placebo effects were found, nor were any negative effects from CES treatment seen.","Smith, R B; Tiberi, A; Marshall, J",1994.0,,0,0,4052
4055,Tryptophan depletion in obsessive-compulsive patients,"ER Twelve patients with obsessive-compulsive disorder were studied after the administration of a mixture of amino acids devoid of tryptophan (TRP) or a mixture containing all the essential amino acids, in a double-blind, crossover design. The TRP-free mixture caused a marked depletion of plasma TRP. After TRP decrease, mean ratings of obsessions and compulsions, measured by Visual Analogue Scales (VAS) ratings, did not worsen. In contrast with other reports in literature, TRP depletion also failed to alter mood in our subjects.","Smeraldi, E; Diaferia, G; Erzegovesi, S; Lucca, A; Bellodi, L; Moja, E A",1996.0,10.1016/0006-3223(95)00393-2,0,0,
4056,"Elastic stable intramedullary nailing versus nonoperative treatment of displaced midshaft clavicular fractures-a randomized, controlled, clinical trial.","To compare elastic stable intramedullary nailing (ESIN) with nonoperative treatment of fully displaced midshaft clavicular fractures in adults. The study was a randomized, controlled, clinical trial. Level 1 trauma center. Sixty patients between 18 and 65 years of age participated and completed the study. They were randomized to either operative or nonoperative treatment with a 2-year follow-up. Thirty patients were treated with a simple shoulder sling and 30 patients with ESIN within 3 days after trauma. Complications after operative and nonoperative treatments, Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant Shoulder Score for outcome measurement, and clavicular shortening. Fracture union was achieved in all patients in the operative group, whereas nonunion was observed in 3 of 30 patients of the nonoperative group. Two symptomatic malunions required corrective osteotomy in the nonoperative group. Medial nail protrusion occurred in 7 cases in the operative group. Implant failure with revision surgery was necessary in 2 patients after an additional adequate trauma. DASH scores were lower in the operative group throughout the first 6 months and 2 years after trauma, with a significant difference during the first 18 weeks. Constant scores were significantly higher after 6 months and 2 years after intramedullary stabilization. Patients in the operative group showed a significant improvement of posttraumatic clavicular shortening; they were also more satisfied with cosmetic appearance and overall outcome. ESIN of displaced midshaft clavicular fractures resulted in a lower rate of nonunion and delayed union, a faster return to daily activities, and a better functional outcome. Clavicular shortening was significantly lower, and overall satisfaction was higher in the operative group.",Smekal V.; Irenberger A.; Struve P.; Wambacher M.; Krappinger D.; Kralinger FS.,2009.0,10.1097/BOT.0b013e318190cf88,0,0,
4057,Elastic stable intramedullary nailing is best for mid-shaft clavicular fractures without comminution: results in 60 patients.,"Elastic stable intramedullary nailing (ESIN) of displaced mid-shaft clavicular fractures is a minimally invasive technique which was reported to be an easy procedure with low complication rates, good cosmetic and functional results, restoration of clavicular length and fast return to daily activities. Recent studies, however, also report on higher complication rates and specific problems with the use of this technique. This prospective study compares ESIN with non-operative treatment of displaced mid-shaft clavicular fractures. Between December 2003 and August 2007, 120 patients volunteered to participate. Of these, 112 patients completed the study (60 in the operative and 52 in the non-operative group). Patients in the non-operative group were treated with a simple shoulder sling. In the operative group, intramedullary stabilisation was performed within 3 days of the trauma. Clavicular shortening was determined after trauma and after osseous consolidation on thorax posteroanterior radiographs as the proportional length difference between the left and right side with the uninjured side serving as a control for clavicular length (100%). Radiographic union was assessed every 4 weeks on 20 degrees cephalad anteroposterior and posteroanterior radiographs of the clavicle. Constant shoulder scores and DASH scores (DASH, disabilities of the arm, shoulder and hand) were assessed at final follow-up after 2 years. ESIN led to faster osseous healing and better restoration of clavicular length in simple fractures. We were not able to restore clavicular length in comminuted fractures using ESIN. Functional outcome at a mean follow-up of 24 months (range: 22-27 months) was better in the operative group. Delayed union and non-union accounted for the majority of complications in the non-operative group. In the operative group, telescoping was the main complication, which occurred in complex fractures with severe post-traumatic shortening only. We recommend ESIN for all simple displaced mid-shaft clavicular fractures in order to minimise the rate of delayed union, non-union and symptomatic mal-union. We also recommend ESIN in comminuted fractures with moderate (< or = 7%) post-traumatic shortening, as they will heal with moderate shortening. In comminuted fractures with severe shortening, however, we recommend plate osteosynthesis in order to provide for stability, clavicular length and endosteal blood supply.",Smekal V.; Irenberger A.; Attal RE.; Oberladstaetter J.; Krappinger D.; Kralinger F.,2011.0,10.1016/j.injury.2010.02.033,0,0,
4058,Is the fear avoidance model associated with the reduced level of aerobic fitness in patients with chronic low back pain?,"ER DESIGNA case-comparison study.SETTINGRehabilitation centers.PARTICIPANTSPatients with CLBP (n=223), and normative data from healthy subjects (n=18,082).INTERVENTIONSNot applicable.MAIN OUTCOME MEASURESMaximal oxygen uptake (VO2max) was estimated on the basis of a modified submaximal Astrand bicycle test performed by patients with CLBP (observed level of aerobic fitness) and compared with the normative data of healthy controls matched for age, sex, and level of sport activity (expected level of aerobic fitness). Pain (visual analog scale); disability (Roland Disability Questionnaire); pain-related fear (Tampa Scale for Kinesiophobia); depression (Beck Depression Inventory); catastrophizing (Pain Catastrophizing Scale); and the level of activity during sport, work/household, and leisure time (Baecke Physical Activity Questionnaire) were assessed. Multiple linear regression analysis was performed with the difference of the observed and expected level of aerobic fitness as dependent variable and putative influential factors including those of the fear avoidance model as independent variables.RESULTSVO2max could be calculated in 175 (78%) of the patients. Both men and women with CLBP had significant lower VO2max than expected (10.3mL/kg lean body mass (LBM)xmin(-1) and 6.5mL/kg LBMxmin(-1), respectively; P<.001). The levels of activity during leisure time and work/household were significantly associated with this reduced level of aerobic fitness. However, the variables of the fear avoidance model were not.CONCLUSIONSMost patients with CLBP-associated disability have a lower level of aerobic fitness, but this is not associated with fear avoidance.OBJECTIVESTo compare aerobic fitness of patients with chronic low back pain (CLBP) against healthy controls and to assess whether variables of the fear avoidance model are associated with loss of aerobic fitness.","Smeets, R J; Geel, K D; Verbunt, J A",2009.0,10.1016/j.apmr.2008.07.009,0,0,
4059,Time-course of eye movement-related decrease in vividness and emotionality of unpleasant autobiographical memories.,"The time-course of changes in vividness and emotionality of unpleasant autobiographical memories associated with making eye movements (eye movement desensitisation and reprocessing, EMDR) was investigated. Participants retrieved unpleasant autobiographical memories and rated their vividness and emotionality prior to and following 96 seconds of making eye movements (EM) or keeping eyes stationary (ES); at 2, 4, 6, and 10 seconds into the intervention; then followed by regular larger intervals throughout the 96-second intervention. Results revealed a significant drop compared to the ES group in emotionality after 74 seconds compared to a significant drop in vividness at only 2 seconds into the intervention. These results support that emotionality becomes reduced only after vividness has dropped. The results are discussed in light of working memory theory and visual imagery theory, following which the regular refreshment of the visual memory needed to maintain it in working memory is interfered with by eye movements that also tax working memory, which affects vividness first.",Smeets MA.; Dijs MW.; Pervan I.; Engelhard IM.; van den Hout MA.,2012.0,10.1080/09658211.2012.665462,0,0,
4060,"Immigrant women's views about care during labor and birth: An Australian study of Vietnamese, Turkish, and Filipino women","Background: Few studies of immigrant women's views of maternity care in their new homelands have been conducted. In Victoria, Australia, approximately 1 woman in 7 giving birth was born overseas in a non-English speaking country. This paper examines the views of three groups of immigrant women about the care they received in hospital for the birth of their babies and compares the findings with a population-based statewide survey. Methods: Mothers in a New Country was a study of 318 Vietnamese, Turkish, and Filipino women interviewed about their maternity care experiences by bicultural interviewers 6 months after giving birth in Melbourne, Australia. The interview schedule was adapted from the 1994 Victorian Survey of Recent Mothers, a population-based postal survey of 1336 women. Results: Of the 3 groups, 27 percent of Vietnamese, 48 percent of Turkish, and 39 percent of Filipino women reported their care during labor and birth as ""very good,"" figures significantly lower than for the statewide survey, in which 61 percent of women experiencing similar models of care described their care as ""very good."" This significant differential in views about care was also present for many individual aspects of care. In the current study of mothers in a new country, comments about aspects of care with which women were particularly happy and unhappy highlighted their appreciation of care that was safe, kind, supportive, and respectful, and conversely, illustrated how distressed women were when care failed to meet these basic standards. Conclusions: What immigrant women wanted from their maternity care proved to be extremely similar to what Australian-born women - and women the world over - want. Unfortunately, immigrant women were much less likely to experience care that gave them what they wanted.",Small R.; Yelland J.; Lumley J.; Brown S.; Liamputtong P.,2002.0,10.1046/j.1523-536X.2002.00201.x,0,0,
4061,Alterations in neural processing and psychopathology in children raised in institutions,"ER OBJECTIVE: To examine whether abnormalities in the neural processing of facial and emotional stimuli are related to the high rates of psychopathology observed among institutionally reared children.DESIGN, SETTING, AND PARTICIPANTS: Data were drawn from the Bucharest Early Intervention Project, a cohort of children raised in institutions in Romania and an age-matched sample of community control subjects. At entry to the study (mean age, 22 months), event-related potentials were used to measure neural processing in 2 tasks: familiar and unfamiliar faces (n=114) and facial displays of emotion (n=74).MAIN OUTCOME MEASURES: Psychiatric symptoms were assessed using the Preschool Age Psychiatric Assessment among children aged 54 months.RESULTS: As previously reported, institutionally reared children had elevated symptoms of attention-deficit/hyperactivity disorder (ADHD), anxiety, depression, and disruptive behavior compared with control children, and peak amplitudes of the P100 and P700 in response to facial stimuli were blunted among institutionalized children compared with community children in both tasks. Current analyses reveal that children with reduced P100 and P700 amplitudes in response to facial stimuli exhibited higher levels of ADHD and anxiety symptoms. Peak amplitude of the P700 in response to facial stimuli significantly mediated the association between institutional rearing and ADHD symptoms at 54 months.CONCLUSION: Exposure to institutional rearing disrupts the P700, conferring risk for the onset of psychopathology. The high levels of ADHD symptoms among children exposed to early life deprivation may be attributable, in part, to abnormal patterns of neurodevelopment generated by these adverse rearing environments.CONTEXT: Young children raised in institutional settings experience severe deprivation in social, emotional, and cognitive stimulation. Although this deprivation is likely to disrupt brain development in ways that increase the risk for psychopathology, neurodevelopmental mechanisms linking adverse early environments to psychopathology remain poorly understood.","Slopen, N; McLaughlin, K A; Fox, N A; Zeanah, C H; Nelson, C A",2012.0,10.1001/archgenpsychiatry.2012.444,0,0,
4062,Is surgical fixation for stress-positive unstable ankle fractures cost effective? Results of a multicenter randomized control trial.,"A recent multicenter randomized control trial demonstrated similar quality of life at 1 year after open reduction and internal fixation (ORIF) compared with nonoperative treatment for stress-positive unstable isolated lateral malleolar fractures. We sought to determine the cost-effectiveness of ORIF compared with nonoperative management of these isolated lateral malleolar fractures. Cost-utility analysis using decision tree and Markov modeling based on data from a prospective randomized control trial and previously published literature. A single-payer perspective with 1-year and lifetime time horizons was adopted. Clinical trial data from 6 Canadian level I trauma hospitals. Lateral malleolus ORIF versus nonoperative treatment. Incremental cost-effectiveness ratio (ICER). The base case 1-year ICER of the ORIF treatment was $205,090 per quality-adjusted life year gained, favoring nonoperative treatment. For the lifetime time horizon, ORIF becomes the preferred treatment with an ICER of $16,404 per quality-adjusted life year gained. This conclusion is stable provided ORIF lowers the lifetime incidence of ankle arthrosis by >3% compared with nonoperative treatment. Probabilistic sensitivity analysis demonstrated that 33% of model simulations favored ORIF in the 1-year time horizon and 65% of simulations in the lifetime time horizon. From a single-payer governmental perspective, ORIF does not seem to be cost effective in the 1-year time horizon; however, if operative fixation decreases the lifetime incidence of posttraumatic ankle arthrosis by >3%, then ORIF becomes the economically preferred treatment. Economic Level II. See Instructions for Authors for a complete description of levels of evidence.",Slobogean GP.; Marra CA.; Sadatsafavi M.; Sanders DW.;  .,2012.0,10.1097/BOT.0b013e31824aec42,0,0,
4063,Characteristics of Young Children with Obsessive-Compulsive Disorder: baseline Features from the POTS Jr. Sample,"ER Pediatric obsessive-compulsive disorder (OCD) is a chronic and impairing condition that can emerge early in childhood and persist into adulthood. The primary aim of this paper is to examine the characteristics of a large sample of young children with OCD (age range from 5 to 8). The sample will be described with regard to: demographics, OCD symptoms/severity, family history and parental psychopathology, comorbidity, and global and family functioning. The sample includes 127 youth with a primary diagnosis of OCD who participated in a multi-site, randomized control clinical trial of family-based exposure with response prevention. Key findings include moderate to severe OCD symptoms, high rates of impairment, and significant comorbidity, despite the participants' young age. Discussion focuses on how the characteristics of young children compare with older youth and with the few other samples of young children with OCD. Considerations regarding generalizability of the sample and limitations of the study are discussed.","Skriner, L C; Freeman, J; Garcia, A; Benito, K; Sapyta, J; Franklin, M",2016.0,10.1007/s10578-015-0546-y,0,0,
4064,A parent-based intervention to promote healthy eating and active behaviours in pre-school children: evaluation of the MEND 2-4 randomized controlled trial,"ER OBJECTIVESWe conducted a randomized controlled trial to evaluate the efficacy of a parent-based obesity prevention intervention for pre-schoolers - MEND (Mind, Exercise, Nutrition???Do It!) 2-4 on child diet, eating habits, physical activity/sedentary behaviours, and body mass index (BMI).METHODSParent-child dyads attended 10 weekly 90-min workshops relating to nutrition, physical activity and behaviours, including guided active play and healthy snack time. Assessments were conducted at baseline, immediately post-intervention, and 6 and 12 months post-intervention; child intake of vegetables, fruit, beverages, processed snack foods, fussiness, satiety responsiveness, physical activity, sedentary behaviour and neophobia were assessed via parent proxy report. Parent and child height and weight were measured.RESULTSTwo hundred one parent-child dyads were randomized to intervention (n?=?104) and control (n?=?97). Baseline mean child age was 2.7 (standard deviation [SD] 0.6) years, and child BMI-for-age z-score (World Health Organization) was 0.66 (SD 0.88). We found significant positive group effects for vegetable (P?=?0.01) and snack food (P?=?0.03) intake, and satiety responsiveness (P?=?0.047) immediately post-intervention. At 12 months follow-up, intervention children exhibited less neophobia (P?=?0.03) than controls.CONCLUSIONFuture research should focus on additional strategies to support parents to continue positive behaviour change. ACTRN12610000200088.BACKGROUNDThere is a paucity of studies evaluating targeted obesity prevention interventions in pre-school children.","Skouteris, H; Hill, B; McCabe, M; Swinburn, B; Busija, L",2016.0,10.1111/ijpo.12011,0,0,
4065,The effect of verbal and imagery-based worry versus distraction on the emotional response to a stressful in-vivo situation.,"According to the Contrast Avoidance Model of worry, worrying induces prolonged negative affect and arousal and thereby suppresses sharp shifts in negative affect. The verbal and abstract nature of worry may be responsible for these effects as verbal thinking has been found to lead to less emotional and physiological responding than imagery. The present study was designed to test the Contrast Avoidance Model and to examine the role of verbal vs. imagery-based thinking during worrying.. 125 participants were exposed to a social-evaluative stressor. Before the stressor, they were randomized into three different groups (1) verbal worrying about the upcoming stressor, (2) imagery-based worrying, or (3) distraction. Self-reported affect and physiological arousal, as well as heart rate, respiratory sinus arrhythmia and skin conductance level (SCL) were monitored. In line with the Contrast Avoidance Model, worrisome thinking (1) led to immediately increased self-reported negative affect and arousal as well as SCL, but (2) attenuated a further increase in self-reported negative affect and arousal in response to the stressor. No effect of style of worrying (verbal vs. imagery) was found.. Effects were rather small and mostly confined to self-report data. By and large, our findings support the Contrast Avoidance Model of worry with regard to self-report measures and extend earlier findings by using an in-vivo stressor. The role of thinking style on the contrast avoidance effect as well as the contrast avoidance effect on physiological measures need to be explored in more detail..",Skodzik T.; Zettler T.; Topper M.; Blechert J.; Ehring T.,2016.0,10.1016/j.jbtep.2016.03.003,0,0,
4066,Paracetamol versus placebo: effects on post-operative course,"Paracetamol was compared with placebo in a double-blind crossover study, in which essentially the same operation was performed on two separate occasions in 24 healthy patients, namely surgical removal of bilateral impacted wisdom teeth. Commencing on the day of surgery, either paracetamol (Panodil®; 1.0g x 4 for 2 days, then 0.5g x 4 for the next 2 days) or placebo tablets were given, followed by crossover to the alternative treatment at the second operation about 4 weeks later. Several objective and subjective assessments were recorded for paired comparison of post-operative courses. Swelling on the 3rd day after operation when paracetamol was given averaged 71% of that measured when placebo was given (p>0.05). After paracetamol, a tendency was noted towards reduced local hyperpyrexia and less post-operative bleeding. The pain and preference scores were clearly in favour of paracetamol. The results provide evidence to suggest that paracetamol may reduce an acute, posttraumatic inflammatory reaction.",Skjelbred P.; Lokken P.,1979.0,10.1007/BF00563555,0,0,
4067,"HPV.edu study protocol: a cluster randomised controlled evaluation of education, decisional support and logistical strategies in school-based human papillomavirus (HPV) vaccination of adolescents","ER BACKGROUND: The National Human Papillomavirus (HPV) Vaccination Program in Australia commenced in 2007 for females and in 2013 for males, using the quadrivalent HPV vaccine (HPV 6,11,16,18). Thus far, we have demonstrated very substantial reductions in genital warts and in the prevalence of HPV among young Australian women, providing early evidence for the success of this public health initiative. Australia has a long history of school-based vaccination programs for adolescents, with comparatively high coverage. However, it is not clear what factors promote success in a school vaccination program. The HPV.edu study aims to examine: 1) student knowledge about HPV vaccination; 2) psycho-social outcomes and 3) vaccination uptake.METHODS/DESIGN: HPV.edu is a cluster randomised trial of a complex intervention in schools aiming to recruit 40 schools with year-8 enrolments above 100 students (approximately 4400 students). The schools will be stratified by Government, Catholic, and Independent sectors and geographical location, with up to 20 schools recruited in each of two states, Western Australia (WA) and South Australia (SA), and randomly allocated to intervention or control (usual practice). Intervention schools will receive the complex intervention which includes an adolescent intervention (education and distraction); a decisional support tool for parents and adolescents and logistical strategies (consent form returns strategies, in-school mop-up vaccination and vaccination-day guidelines). Careful process evaluation including an embedded qualitative evaluation will be undertaken to explore in depth possible mechanisms for any observed effect of the intervention on primary and secondary outcomes.DISCUSSION: This study is the first to evaluate the relative effectiveness of various strategies to promote best practice in school-based vaccination against HPV. The study aims to improve vaccination-related psychosocial outcomes, including adolescent knowledge and attitudes, decision-making involvement, self-efficacy, and to reduce fear and anxiety. The study also aims to improve school vaccination program logistics including reduction in time spent vaccinating adolescents and increased number of consent forms returned (regardless of decision). Less anxiety in adolescents will likely promote more efficient vaccination, which will be more acceptable to teachers, nurses and parents. Through these interventions, it is hoped that vaccination uptake will be increased.TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry, ACTRN12614000404628 , 14.04.2014.","Skinner, S R; Davies, C; Cooper, S; Stoney, T; Marshall, H; Jones, J; Collins, J; Hutton, H; Parrella, A; Zimet, G; Regan, D G; Whyte, P; Brotherton, J M; Richmond, P; McCaffrey, K; Garland, S M; Leask, J; Kang, M; Braunack-Mayer, A; Kaldor, J; McGeechan, K",2015.0,10.1186/s12889-015-2168-5,0,0,
4068,Chewing gum modifies state anxiety and alertness under conditions of social stress,"ER OBJECTIVES: The finding that chewing gum can moderate state anxiety under conditions of acute stress has proved difficult to replicate. The present study examines the extent to which chewing gum can moderate state anxiety under conditions of acute social stress.METHOD: In a between-participants design, 36 participants completed a task comprising a mock job interview (a variation on the Trier Social Stress Task, which included a mental arithmetic component) while either chewing gum or without chewing gum. Self-rated measures of mood and anxiety were taken at baseline, after a 10-minute presentation preparation stage, after the 10-minute presentation, and following a 5-minute recovery stage.RESULTS: Post-presentation measures reflected increased state anxiety and decreased self-rated calmness and contentedness. Chewing gum attenuated the rise in state anxiety while increasing self-rated alertness. Chewing gum did not affect contentedness or calmness.CONCLUSIONS: The findings indicate that chewing gum can act to reduce anxiety under conditions of acute social stress: a finding consistent with Scholey et al. Furthermore, the data add to the growing body of literature demonstrating that chewing gum can increase alertness.","Sketchley-Kaye, K; Jenks, R; Miles, C; Johnson, A J",2011.0,10.1179/1476830511Y.0000000017,0,0,
4069,Do law students stand apart from other university students in their quest for mental health: A comparative study on wellbeing and associated behaviours in law and psychology students,"We are not producing a product, but a well-balanced person. It is well-documented that law students experience higher levels of psychological distress than members of the general population and university students in other professional disciplines. In 2014, we published our findings on an empirical study identifying the correlations between law student wellbeing and student behaviour both at and away from law school. The results of the study informed the development of an evidence-based 'behavioural toolkit' to assist law students and law schools in making informed choices and decisions that promote and even improve the mental health of students. The study we undertook was not, however, limited to law students. It extended to collecting quantitative data on psychological distress and associated behaviours in psychology students. This article reports on the comparative findings of the study and provides a comparative basis for understanding the contextual influences on the wellbeing of law students.",Skead N.K.; Rogers S.L.,2015.0,10.1016/j.ijlp.2015.08.011,0,0,
4070,"Tics Moderate Sertraline, but Not Cognitive-Behavior Therapy Response in Pediatric Obsessive-Compulsive Disorder Patients Who Do Not Respond to Cognitive-Behavior Therapy","ER Objective: The purpose of this study was to investigate whether the presence of tic disorder is negatively associated with sertraline (SRT) outcomes, but not with continued cognitive-behavioral therapy (CBT), in a sample of youth who were unresponsive to an initial full course of CBT. Methods: In the Nordic Long-Term OCD Study, children and adolescents with OCD who were rated as nonresponders to 14 weeks of open-label CBT were randomized to continued CBT (n=28) or SRT treatment (n=22) for an additional 16 weeks of treatment. We investigated whether the presence or absence of comorbid tic disorder moderated treatment outcomes on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Results: Twelve out of 50 (24.0%) participants were diagnosed with comorbid tic disorder, with 7 receiving continued CBT and 5 receiving SRT, respectively. In patients without tic disorder, results showed no significant between-group differences on average CY-BOCS scores. However, in patients with comorbid tic disorder, those who received SRT had significantly lower average CY-BOCS scores than those who received continued CBT. Conclusions: Children and adolescents with OCD and comorbid tic disorder, who are nonresponders to an initial 14 week course of CBT, may benefit more from a serotonin reuptake inhibitor (SRI) than from continued CBT.","Skarphedinsson, G; Compton, S; Thomsen, P H; Weidle, B; Dahl, K; Nissen, J B; Torp, N C; Hybel, K; Melin, K H; Valderhaug, R; Wentzel-Larsen, T; Ivarsson, T",2015.0,10.1089/cap.2014.0167,0,0,
4071,The role of perpetrator motivation in two crime scenarios,"ER Undergraduate volunteers (n = 134) were randomly assigned in a 2 √ó 2 design that manipulated type of crime (rape vs. robbery) and perpetrator motivation (anger vs. desire). After reading one of the crime scenarios, participants responded to a series of attitude items regarding responsibility for the crime, assigned blame to agents mentioned in the scenario, and assigned a prison sentence to the perpetrator. A two-way ANOVA showed a significant interaction of motivation and crime (p = .026), with the victim rated least responsible in the anger-motivated rape scenario. Likewise, the assignment of blame produced a significant interaction of motivation and crime (p = .034); the victim was blamed the least in the anger-motivated rape scenario. Although the perpetrator was viewed as more responsible for the crime of rape than robbery (p = .022) and received a significantly longer sentence for rape (p < .001), perpetrator motivation did not affect perceptions of the perpetrator's responsibility for either crime. These results stand in contrast to those of Mitchell, Angelone, Kohlberger, and Hirschman (2009) and suggest their findings may have been the result of homophobic statements by the perpetrator rather than anger per se.","Sizemore, O J",2013.0,10.1177/0886260512448843,0,0,
4072,Modifying thought-action fusion via a single-session computerized interpretation training,"Thought-action fusion (TAF) is an important cognitive bias in various emotional disorders, especially, obsessive-compulsive disorder (OCD). TAF leads individuals to interpret the presence of unwanted mental intrusions as morally equivalent to acting on them, and/or increasing the likelihood of the feared consequence. We sought to test the feasibility of a brief computerized cognitive bias modification for interpretations (CBM-I) as a potential intervention to reduce TAF among undergraduates who reported obsessional intrusions. We also examined if the TAF-focused CBM-I can decrease participants’ emotional reactions towards a variety of obsessional thoughts, including personally-relevant intrusions. Participants were randomized to (a) the TAF-incongruent condition (TAF-INC), designed to decrease TAF linked to obsessional thoughts, or (b) the TAF-congruent condition (TAF-CON), designed to render TAF-like interpretation of obsessional thoughts unchallenged. Results indicate the TAF-INC group displayed a significantly greater reduction in the severity of total TAF and TAF moral than the TAF-CON group. Reductions on TAF likelihood did not differ by group. Emotional reaction to personally-relevant obsessional intrusions was also shown to be lower after training in the TAF-INC group. Overall, this study presents preliminary data supporting the feasibility of CBM-I to be used as an effective intervention for TAF.",Siwiec S.G.; Davine T.P.; Kresser R.C.; Rohde M.M.; Lee H.-J.,2017.0,10.1016/j.jocrd.2016.11.005,0,0,
4073,Patient characteristics and outcome in psychotherapy and behavior therapy.,,Sloane RB.; Staples FR.; Cristol AH.; Yorkston NJ.; Whipple K.,1976.0,,0,0,
4074,Short-term analytically oriented psychotherapy versus behavior therapy.,"Ninety-four outpatients with anxiety neurosis or personality disorder were randomly assigned for four months to a waiting list, behavior therapy, or psychoanalytically oriented therapy. The target symptoms of all three groups improved significantly, but the two treated groups improved equally well and significantly more than those on the waiting list. There were no significant differences among the groups in work or social adjustment; however, the patients who received behavior therapy had a significant overall improvement at four months. One year and two years after the initial assessment, all groups were found to be equally and significantly improved.",Sloane RB.; Staples FR.; Cristol AH.; Yorkston NJ.,1975.0,10.1176/ajp.132.4.373,0,0,
4075,The effects of safety-seeking behavior and guided threat reappraisal on fear reduction during exposure: an experimental investigation.,"We examined the effects of safety-seeking behavior and guided threat focus and reappraisal on fear reduction during exposure. Participants (N=46) displaying marked claustrophobic fear were randomized to one of three 30-min exposure conditions: (a) guided threat focus and reappraisal; (b) safety-behavior utilization; or (c) exposure only control. Tripartite outcome assessments during a behavioral approach test, along with measures of suffocation and restriction fears were obtained at pre- and post-treatment, and at a 2-week follow-up. Treatment process measures were collected throughout treatment and consisted of indices of fear activation; within and between-trial fear habituation; and suffocation and entrapment expectancies. Measures of safety behavior utilization and attentional focus were also collected to assess the integrity of the experimental manipulations. Consistent with prediction, those encouraged to utilize safety-behaviors during exposure showed significantly more fear at post-treatment and follow-up relative to those encouraged to focus and reevaluate their core threat(s) during exposure. Moreover, growth curve analyses of treatment process data analyses revealed that safety-behavior utilization exerted a detrimental effect on between-trial habituation; whereas guided threat reappraisal enhanced between-trial habituation.",Sloan T.; Telch MJ.,2002.0,,0,0,
4076,Substance abuse and psychiatric illness: treatment experience.,"The purpose of this paper is to describe an outpatient dual-diagnosis treatment program and 1-year clinical outcome and hospital utilization data. Subjects were 118 consecutive admissions to the Seattle Veterans Affairs (VA) Medical Center's Dual Disorders program over the period from June 1, 1992, to August 31, 1994. Program eligibility requirements included having a current substance use disorder and an active non-substance-related major Axis I disorder (typically major depression, post-traumatic stress disorder [PTSD], bipolar disorder, or schizoaffective disorder). The treatment frame involved group-based programming (including support, medications management, and psychoeducation), routine urine drug screening, and crisis interventions. Results showed that subjects averaged 1.5 non-substance-related Axis I psychiatric disorders (54% involving psychotic symptoms) and 1.8 active substance use disorders. Patients stayed engaged in treatment for a median of 217 days, with 60% of patients having no positive drug screens, and the overall sample having a 40% reduction in the number of inpatient bed days in the year after intake. Conclusions were that, for a number of patients with comorbid disorders, psychiatric stabilization and cessation of substance use can be accomplished within an outpatient treatment frame that averages two completed clinical contacts per week.",Sloan KL.; Rowe G.,1998.0,,0,0,
4077,Cognitive-behavioral group treatment for veterans diagnosed with PTSD: Design of a hybrid efficacy-effectiveness clinical trial.,"Despite significant advances in individual treatment approaches for PTSD, knowledge of group approaches has lagged behind. Much of the reason knowledge about group treatment for PTSD has been limited is due to the complexity of conducting randomized controlled trials in the group treatment context. This limited empirical knowledge is unfortunate given the frequency with which group treatment for PTSD is used in clinical settings, including the Department of Veteran Affairs. The goal of this study is to examine the efficacy of a group cognitive-behavioral treatment (GCBT) for PTSD relative to group supportive counseling approach (i.e. group present centered treatment; GPCT). The sample consists of 196 veterans diagnosed with PTSD who are randomly assigned to either GCBT (n=98) or GPCT (n=98). Both treatments are administered by two therapists over the course of 14 sessions. Assessments take place at baseline, mid-treatment, post-treatment and 3-, 6-, and 12-month follow-up. The primary outcome measure is the PTSD symptom severity assessed with a semi-structured diagnostic instrument. Given the substantial rise of veterans presenting for PTSD treatment services, identifying an efficacious group treatment approach is invaluable.",Sloan DM.; Unger W.; Gayle Beck J.,2016.0,10.1016/j.cct.2015.12.016,0,0,
4078,Does altering the writing instructions influence outcome associated with written disclosure?,"This study examined the effect of changing the instructional set for written disclosure on psychological and physical health reports among traumatized college students with current posttraumatic stress symptoms. Eighty-two participants were randomly assigned to one of three writing conditions that focused on emotional expression (EE), insight and cognitive assimilation, or to a control condition. Participants assigned to the EE condition reported significant improvements in psychological and physical health 1 month following the writing sessions relative to the other two conditions. The EE participants also reported and displayed significantly greater initial psychophysiological reactivity and subsequent habituation compared with the other two conditions. These findings suggest the importance of emphasizing emotional expression during written disclosure and underscore the importance of examining how modifying the written disclosure protocol can affect outcome.",Sloan DM.; Marx BP.; Epstein EM.; Lexington JM.,2007.0,10.1016/j.beth.2006.06.005,0,0,
4079,A closer examination of the structured written disclosure procedure.,"The current study examined psychological and physical health outcomes of the written disclosure paradigm and the hypothesis that the principles of therapeutic exposure account for the beneficial effects of the paradigm. Participants were randomly assigned to either a written disclosure condition or a control condition. Reactivity to the writing sessions was examined using both subjective and physiological measures. Measures of psychological and physical health were completed before and 1 month after the sessions. Participants assigned to the disclosure condition reported fewer psychological and physical symptoms at follow-up compared with control participants, though reductions were clinically significant for only 1 outcome measure. Physiological activation to the 1st disclosure session was associated with reduced psychological symptoms at follow-up for disclosure participants. Subjective reports of emotional responding corresponded with physiological reactivity. Implications of these findings are discussed.",Sloan DM.; Marx BP.,2004.0,10.1037/0022-006X.72.2.165,0,0,
4080,Written exposure therapy for veterans diagnosed with PTSD: a pilot study.,"There is a need to identify alternative treatment options for posttraumatic stress disorder (PTSD), especially among veterans where PTSD tends to be more difficult to treat and dropout rates are especially high. One potential alternative is written exposure therapy, a brief intervention shown to treat PTSD among civilians effectively. This study investigated the feasibility and tolerability of written exposure therapy in an uncontrolled trial with a sample of 7 male veterans diagnosed with PTSD. Findings indicated that written exposure therapy was well tolerated and well received. Only 1 of the 7 veterans dropped out of treatment, no adverse events occurred during the course of treatment, and veterans provided high treatment satisfaction ratings. Clinically significant improvements in PTSD symptom severity were observed for 4 veterans at posttreatment and 6 veterans at the 3-month follow up. Moreover, 5 of the 7 veterans no longer met diagnostic criteria for PTSD 3 months following treatment. These findings suggest that written exposure therapy holds promise as a brief, well tolerated treatment for veterans with PTSD. However, additional research using randomized controlled trial methodology is needed to confirm its efficacy.",Sloan DM.; Lee DJ.; Litwack SD.; Sawyer AT.; Marx BP.,2013.0,10.1002/jts.21858,0,0,
4081,The effects of different methods of emotional disclosure: differentiating post-traumatic growth from stress symptoms.,"Research on emotional disclosure should test the effects of different disclosure methods and whether symptoms are affected differently than post-traumatic growth. We randomized 214 participants with unresolved stressful experiences to four disclosure conditions (written, private spoken, talking to a passive listener, talking to an active facilitator) or two control conditions. All groups had one 30-minute session. After 6 weeks, disclosure groups reported more post-traumatic growth than controls, and disclosure conditions were similar in this effect. All groups decreased in stress symptoms (intrusions, avoidance, psychological and physical symptoms), but disclosure did not differ from control. We conclude that 30 minutes of disclosure leads to post-traumatic growth but not necessarily symptom reduction, and various disclosure methods have similar effects. Research on the effects of disclosure should focus on the benefits of growth as well as symptom reduction.",Slavin-Spenny OM.; Cohen JL.; Oberleitner LM.; Lumley MA.,2011.0,10.1002/jclp.20750,0,0,
4082,Therapeutic interventions related to outcome in psychodynamic psychotherapy for anxiety disorder patients.,"This is the first study with acceptable inter-rater reliability to examine specific therapeutic techniques related to change in anxiety disorder patients during short-term psychodynamic psychotherapy. The study first examined the effectiveness of short-term psychodynamic psychotherapy and results showed significant and positive pre-/post-treatment changes on both patient and independent clinical ratings for anxiety, global symptomatology, relational, social, and occupational functioning. Likewise, the majority of patients (76%) reported anxiety symptoms within a normal distribution at termination. Importantly, psychodynamic interventions rated early in treatment (third/fourth session) were positively related to changes in anxiety symptoms. Further, results showed that several individual psychodynamic techniques were meaningfully related to outcome including (1) focusing on wishes, fantasies, dreams, and early memories; (2) linking current feelings or perceptions to the past; (3) highlighting patients' typical relational patterns; and (4) helping patients to understand their experiences in new ways. Clinical applications are discussed.",Slavin-Mulford J.; Hilsenroth M.; Weinberger J.; Gold J.,2011.0,10.1097/NMD.0b013e3182125d60,0,0,
4083,"Catch, treat, and release: Veteran Treatment Courts address the challenges of returning home.","After a decade of war, there is a great need for treatment and alternatives to incarceration for justice-involved veterans. U.S. military service members are returning from combat with substantial mental health challenges, which increase the potential for justice involvement. Veteran Treatment Courts are starting across the nation to meet this need for therapeutic justice. These problem solving courts provide access to treatment and motivation for engagement. Preliminary evidence from a Substance Abuse and Mental Health Services Administration-funded evaluation suggests that significant improvements in posttraumatic stress disorder and substance use are just a few of the positive outcomes that these courts may help veterans achieve.",Slattery M.; Dugger MT.; Lamb TA.; Williams L.,2013.0,10.3109/10826084.2013.797468,0,0,
4084,The effects of inhaling a 35 per cent CO2-65 per cent O2 mixture upon anxiety level in neurotic patients.,,Slater SL.; Leavy A.,1966.0,,0,0,
4085,[Private and public self-awareness changes in psychotherapy of alcohol-addicted felons].,"Testing effectiveness of psychotherapy by evaluating changes in private and public self-consciousness of alcohol addicted persons and imprisoned felons. The questionnaire known as Self-Consiousness Scale Fenigstein, Scheier, Buss's was applied. The tool is based on the theory of Duval and Wicklund and that of Carver and Scheier. Treatment curriculum--was based on two models of alcohol addiction. the psychological one and the other derived of assumptions defined in the Alcoholics Anonymous movement. In the course of the psychotherapeutic treatment--discordantly with prior research expectations--neither the so-called private nor the public self-consciousness changed. In turn, as hypothesised, social anxiety decreased significantly. 1. Decrease of social anxiety shows effectiveness of the therapeutic approach, which is higher than that of the sole Alcoholics Anonymous programme. 2. Further research should be focused on refinement of both the tool measuring self-consciousness changes and some elements of the therapeutic agenda.",Slaski S.,,,0,0,
4086,"Health, performance and emotional intelligence: An exploratory study of retail managers","Contemporary theories place emotions and self-regulation at the centre of a dynamic process of stress. Emotional Intelligence (EQ) is the ability to perceive, understand and reflectively manage one's own emotions and those of others. This study, which was situated within the management population (n = 224) of a large retail organization, investigates the relationship between a measure of EQ, subjective stress, distress, general health, morale, quality of working life and management performance. Significant correlations in the expected direction were found, indicating that managers who scored higher in EQ suffered less subjective stress, experienced better health and well-being, and demonstrated better management performance. © 2002 John Wiley & Sons, Ltd.",Slaski M.; Cartwright S.,2002.0,10.1002/smi.926,0,0,
4087,Changes in staff anxiety and attitudes during a double blind study of haloperidol in acute schizophrenics within a structured milieu.,,Singh MM.; Di Scipio WJ.,1972.0,,0,0,
4088,The stress of combat,,Singh M.K.,2012.0,10.1126/scitranslmed.3004988,0,0,
4089,A non-randomised trial of an art therapy intervention for patients with haematological malignancies to support post-traumatic growth.,"The aim of this study was to determine the effect of art therapy on post-traumatic growth in patients with haematological malignancies in a non-randomised trial (n = 36, intervention group; n = 129, control group). Art therapy was administered over a period of 22 weeks in small groups. Post-traumatic growth was measured with the Stress-Related Growth Scale. After controlling for the effect of potential confounders, no difference in post-traumatic growth was observed between the intervention and control groups after 22 weeks. There was no evidence for an effect of weekly group sessions with art therapy on post-traumatic growth in patients with haematological malignancies.",Singer S.; Götze H.; Buttstädt M.; Ziegler C.; Richter R.; Brown A.; Niederwieser D.; Dorst J.; Jäkel N.; Geue K.,2013.0,10.1177/1359105312458332,0,0,
4090,Maternal psychological distress and parenting stress after the birth of a very low-birth-weight infant,"Context Few studies document how parents adapt to the experience of a very low-birth-weight (VLBW; <1500 g) birth despite societal concerns about the ethics and justification of intensive care for these infants. Objective To determine the degree and type of stress experienced over time by mothers whose infants vary in degree of prematurity and medical and developmental risk. Design Longitudinal prospective follow-up study of a cohort of mothers of high- and low-risk VLBW and term infants from birth to 3 years. Setting All level III neonatal intensive care units from a large midwestern metropolitan region. Participants Mothers and infants prospectively and consecutively enrolled in a longitudinal study between 1989 and 1991. High- risk VLBW infants were diagnosed as having bronchopulmonary dysplasia, and comparison groups were low-risk VLBW infants without bronchopulmonary dysplasia and term infants (>36 weeks, >2500 g). Main Outcome Measures Standardized, normative self-report measures of maternal psychological distress, parenting stress, family impact, and life stressors. Results Mothers of VLBW infants (high risk, n = 122; low risk, n = 84) had more psychological distress than mothers of term infants (n=123) at 1 month (13% vs 1%; P = .003). At 2 years, mothers of low-risk VLBW infants did not differ from term mothers, while mothers of high-risk infants continued to report psychological distress. By 3 years, mothers of high-risk VLBW children did not differ from mothers of term children in distress symptoms, while parenting stress remained greater. Severity of maternal depression was related to lower child developmental outcomes in both VLBW groups. Conclusions The impact of VLBW birth varies with child medical risk status, age, and developmental outcome. Follow-up programs should incorporate psychological screening and support services for mothers of VLBW infants in the immediate postnatal period, with monitoring of mothers of high-risk VLBW infants.",Singer L.T.; Salvator A.; Guo S.; Collin M.; Lilien L.; Baley J.,1999.0,10.1001/jama.281.9.799,0,0,
4091,The relationship between introversion and response to casework in a prison setting.,,Sinclair IA.; Shaw MJ.; Troop J.,1974.0,,0,0,
4092,Effect of metabolism-oriented substrate administration on energy and protein metabolism in polytraumatized artificial respiration patients,"ER An adequate ""individually tailored"" infusion and nutritional therapy is one of the essential prerequisites for an optimal healing process - especially in ventilated, polytraumatized patients with reduced compensatory capacities. There are nevertheless practically no publications dealing with the effect of substrate application adjusted to the measured metabolic rate on the energy and protein metabolism of the critically ill. In order to clarify this situation a prospective study was carried out on a group of 40 polytraumatized, ventilated patients, who were randomized into four groups, each receiving different infusion and nutritional regimen. The O2-consumption, energy expenditure, nitrogen balance and substrate concentrations in plasma and urine were determined, and the urea production rate and substrate turnover of all patients calculated. In the groups given nutritional support carbohydrate application adjusted to O2-consumption - lead to blood glucose concentrations which were persistently high. However, median values did not exceed 10 mmol/l and insulin application was never necessary. Energy expenditure - calculated from O2-consumption - averaged about 3000 kcal/day and was clearly below values previously reported in the literature for patients comparable to those studied in this investigation. There was no difference in energy expenditure between the patients treated with various infusion regimen. In none of the groups the median plasma urea concentration did exceed reference range. Despite an apparent improvement in nitrogen retention rate - through an increased amino-acid intake and a balanced energy input - an increased urea production rate resulted. When a balanced delivery of energy-yielding substrates is given, 2 g amino-acids/kg/day seems to be the upper limit of nitrogen support in the critically ill. 3-methylhistidine excretion in urine was parallel to urea production rate, indicating that the amino-acid sparing effect of carbohydrates is mainly derived from amino-acid conservation in muscle. These results seem to indicate that even in the early posttraumatic period a substrate application, adjusted to the measured turnover is possible without leading to a disturbance in homeostasis.","Schmitz, J E",1984.0,,0,0,
4093,Cognitive frontal lobe dysfunction in obsessive-compulsive disorder.,"There is evidence that dysfunction within associative frontostriatal circuits represents a feature of obsessive-compulsive disorder (OCD). Previous neuropsychologic studies have yielded diverging results, which may in part be explained by differences in the selection of subjects and methods. The present study focused on the question of cognitive frontal lobe performance in OCD. Twenty-nine unmedicated OCD patients were compared to a double-size control group of normal subjects matched individually for age, sex, and intelligence. A series of 12 neuropsychologic tests was applied, most of which are thought to be sensitive to different aspects of cognitive frontal lobe function. OCD patients were unimpaired at tests of abstraction, problem solving, set-shifting, response inhibition, active memory search, and choice reaction speed. Deficits of approximately one standard deviation were observed at timed tests of verbal and nonverbal fluency, attentional processing, and weight sorting. OCD patients exhibited selective deficits in tasks involving controlled attentional processing and self-guided, spontaneous behavior. We discuss a link between this neuropsychologic profile and dysfunctioning within the anterior cingulate, but not the dorsolateral prefrontal circuit.",Schmidtke K.; Schorb A.; Winkelmann G.; Hohagen F.,1998.0,,0,0,
4094,The effects of treatment compliance on outcome in cognitive-behavioral therapy for panic disorder: Quality versus quantity.,"Cognitive-behavioral therapy (CBT) is skill based and assumes active patient participation in regard to treatment-related assignments. The effects of patient compliance in CBT outcome studies are equivocal, however, and 1 gap in the literature concerns the need to account for the quality versus the quantity of assigned work. In this study, both quality and quantity of home-based practice were assessed to better evaluate the effects of treatment compliance in patients with panic disorder (N = 48) who participated in a 12-session CBT protocol. Patient estimates of compliance were not significantly associated with most outcome measures. On the other hand, therapist ratings of compliance significantly predicted positive changes on most outcome measures. Moreover, therapist and independent rater estimates of the quality of the participant's work, relative to the quantity of the work, were relatively better predictors of outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schmidt, Norman B; Woolaway-Bickel, Kelly; Ballenger, Barlow, Baron, Beck, Chambless, Edelman, First, Foa, Mavissakalian, Meng, Michelson, Nunnally, Primakoff, Rachman, Schmidt, Schmidt, Schmidt, Shear, Sheehan, Telch, Wolfe, Young",2000.0,,0,0,
4095,Anxiety sensitivity risk reduction in smokers: A randomized control trial examining effects on panic.,"Empirical evidence has identified several risk factors for panic psychopathology, including smoking and anxiety sensitivity (AS; the fear of anxiety-related sensations). Smokers with elevated AS are therefore a particularly vulnerable population for panic. Yet, there is little knowledge about how to reduce risk of panic among high AS smokers. The present study prospectively evaluated panic outcomes within the context of a controlled randomized risk reduction program for smokers. Participants (N = 526) included current smokers who all received a state-of-the-art smoking cessation intervention with approximately half randomized to the AS reduction intervention termed Panic-smoking Program (PSP). The primary hypotheses focus on examining the effects of a PSP on panic symptoms in the context of this vulnerable population. Consistent with prediction, there was a significant effect of treatment condition on AS, such that individuals in the PSP condition, compared to those in the control condition, demonstrated greater decreases in AS throughout treatment and the follow-up period. In addition, PSP treatment resulted in lower rates of panic-related symptomatology. Moreover, mediation analyses indicated that reductions in AS resulted in lower panic symptoms. The present study provides the first empirical evidence that brief, targeted psychoeducational interventions can mitigate panic risk among smokers. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Schmidt, Norman B; Raines, Amanda M; Allan, Nicholas P; Zvolensky, Michael J; Abrams, Allan, Association, Barlow, Breslau, Breslau, Broman-Fulks, Brown, Brown, Chou, Cinciripini, Cudeck, Ehlers, Farris, Farris, Feingold, Feldner, Fiore, First, Gardenswartz, Graham, Hall, Hayward, Heatherton, Houck, Hu, Keough, Kline, Lasser, Leen-Feldner, MacCallum, MacKinnon, Maller, McNally, McNally, Mueser, Muthen, Norr, Osher, Otto, Parrott, Pechter, Preacher, Prochaska, Rabian, Reiss, Schmidt, Schmidt, Schmidt, Schmidt, Schmidt, Schmidt, Schmidt, Shear, Smits, Taylor, Taylor, Telch, Weems, Westling, Wothke, Zvolensky, Zvolensky, Zvolensky, Zvolensky, Zvolensky",2016.0,,0,0,
4096,Anxiety sensitivity: prospective prediction of panic attacks and Axis I pathology.,"Emerging evidence suggests that anxiety sensitivity (AS) predicts subsequent development of anxiety symptoms and panic attacks. However, evidence regarding whether AS serves as a premorbid risk factor for the development of clinical syndromes is lacking. The primary aim of the present study was to determine whether AS acts as a vulnerability factor in the pathogenesis of psychiatric diagnoses. A large nonclinical sample of young adults (N=404) was prospectively followed over two years. The Anxiety Sensitivity Index (ASI: Reiss S, Peterson RA, Gursky DM, McNally RJ. Anxiety sensitivity, anxiety frequency, and the prediction of fearfulness. Behaviour Research and Therapy 1986; 24: 1-8.) and trait anxiety served as predictors. Consistent with prior reports, AS predicted the development of spontaneous panic attacks in those with no history of panic. Importantly, AS was found to predict the incidence of anxiety disorder diagnoses and overall Axis I diagnoses in those with no history of Axis I diagnoses at study entry. These are the first data to provide strong prospective evidence for AS as a risk factor in the development of anxiety disorders.",Schmidt NB.; Zvolensky MJ.; Maner JK.,2006.0,10.1016/j.jpsychires.2006.07.009,0,0,
4097,Antidepressant discontinuation in the context of cognitive behavioral treatment for panic disorder.,"Cognitive behavioral treatment (CBT) has been shown to reduce risk for adverse reactions (e.g., rebound panic) following benzodiazepine taper for patients with panic disorder (PD). This study evaluated the effects of antidepressant discontinuation for patients with PD in the context of CBT. Patients with PD (n=21) on a stable dose of antidepressants completed a 12-week group CBT treatment and were randomly assigned to discontinue antidepressants during week 8 of the treatment. There were no statistically significant differences between groups at posttreatment or 6-month follow-up. Data indicate no apparent immediate or long-term adverse effects for antidepressant discontinuation for patients with PD receiving CBT.",Schmidt NB.; Wollaway-Bickel K.; Trakowski JH.; Santiago HT.; Vasey M.,2002.0,,0,0,
4098,Efficacy of a brief psychosocial treatment for panic disorder in an active duty sample: implications for military readiness.,"The efficacy of a brief cognitive-behavioral treatment for panic in military personnel was evaluated. Active duty military patients (N = 37) presenting at outpatient psychiatry and psychology clinics were randomly assigned to immediate or delayed treatment conditions. All patients met Diagnostic and Statistical Manual of Mental Disorders criteria for a primary diagnosis of panic disorder with or without agoraphobia. At posttreatment, 80% of the immediate treatment group, compared to 0% of the delayed treatment group, met recovery criteria on all major clinical facets of panic disorder (i.e., panic attacks, panic-related worry, phobic avoidance). At follow-up, 75% of the treated group continued to meet recovery criteria, suggesting maintenance of treatment gains. A majority of those patients (58%) taking benzodiazepines at the start of treatment were successfully discontinued by posttreatment. Brief, skill-based treatments for panic disorder are effective for a majority of active duty personnel. These treatments may also improve military readiness by facilitating benzodiazepine discontinuation.",Schmidt NB.; Staab JP.; Trakowski JH.; Sammons M.,1997.0,,0,0,
4099,"Pain in patients with panic disorder: relation to symptoms, cognitive characteristics and treatment outcome.","Although there has been a link between certain types of pain, notably chest pain, and panic disorder, the relation between pain and panic disorder has not been systematically evaluated. In the present study, the relation between pain symptoms (headache, chest pain, stomach pain, joint pain) and the clinical presentation of patients with panic disorder was evaluated. Pain was generally hypothesized to be related to increased symptoms of anxiety, panic-relevant cognitive domains and treatment outcome. In terms of specific pain domains, headache and chest pain were expected to be more closely related to anxiety-related symptoms. Patients (n=139) meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition for panic disorder completed a set of standardized clinician-rated and self-reported measures. Moderator analyses were used in a subset of these patients completing a treatment outcome study. Approximately two-thirds of the participants endorsed at least one current pain symptom. The hypotheses were partially supported, with pain being associated with higher levels of anxiety and depression symptoms, as well as panic frequency. Pain was also related to several cognitive features, including anxiety sensitivity and panic appraisals. Headache and chest pain were more highly associated with anxiety symptoms than was joint pain. Cognitive measures did not mediate the relation between anxiety and pain, and pain did not significantly moderate outcome in response to cognitive-behavioural therapy. Co-occurring pain symptoms appear to be more highly related to phenomenology than to treatment response in patients with panic disorder.",Schmidt NB.; Santiago HT.; Trakowski JH.; Kendren JM.,2002.0,,0,0,
4100,Anxiety sensitivity risk reduction in smokers: A randomized control trial examining effects on panic.,"Empirical evidence has identified several risk factors for panic psychopathology, including smoking and anxiety sensitivity (AS; the fear of anxiety-related sensations). Smokers with elevated AS are therefore a particularly vulnerable population for panic. Yet, there is little knowledge about how to reduce risk of panic among high AS smokers. The present study prospectively evaluated panic outcomes within the context of a controlled randomized risk reduction program for smokers. Participants (N = 526) included current smokers who all received a state-of-the-art smoking cessation intervention with approximately half randomized to the AS reduction intervention termed Panic-smoking Program (PSP). The primary hypotheses focus on examining the effects of a PSP on panic symptoms in the context of this vulnerable population. Consistent with prediction, there was a significant effect of treatment condition on AS, such that individuals in the PSP condition, compared to those in the control condition, demonstrated greater decreases in AS throughout treatment and the follow-up period. In addition, PSP treatment resulted in lower rates of panic-related symptomatology. Moreover, mediation analyses indicated that reductions in AS resulted in lower panic symptoms. The present study provides the first empirical evidence that brief, targeted psychoeducational interventions can mitigate panic risk among smokers.",Schmidt NB.; Raines AM.; Allan NP.; Zvolensky MJ.,2016.0,10.1016/j.brat.2015.12.011,0,0,
4101,Anxiety sensitivity as an incremental predictor of later anxiety symptoms and syndromes.,"Although anxiety sensitivity (AS) has been shown to predict anxiety symptoms and panic, this literature is limited in regard to evaluating AS as an incremental predictor of anxiety psychopathology relative to other established risk factors including sex and negative affect. The present report prospectively evaluated whether AS was predictive of later changes in anxiety symptoms after controlling for potential confounding factors. Consistent with hypothesis, AS was found to be a significant, incremental predictor of anxiety symptoms over time, even after controlling for sex and negative affectivity. These data provide novel evidence for the unique association between AS of the development of anxiety symptoms.",Schmidt NB.; Mitchell MA.; Richey JA.,,10.1016/j.comppsych.2007.12.004,0,0,
4102,Effects of heart-rate feedback on estimated cardiovascular fitness in patients with panic disorder.,"Psychological parameters that are believed to affect estimations of cardiovascular fitness were examined in patients with panic disorder and nonclinical controls. Fifty-four participants [panic disorder patients (n = 27) and age- and sex-matched nonclinical controls (n = 27)] completed a cycle ergometer test and were compared on the basis of estimated VO2 max. Participants were randomly assigned to experimental conditions in which they received heart-rate feedback or no feedback during the test. Patients with panic disorder exhibited lower VO2 max and decreased exercise tolerance (i.e., were more likely to discontinue the test) than nonclinical controls. Furthermore, individuals with high anxiety sensitivity (i.e., a fear of autonomic arousal), but not a panic disorder diagnosis per se, achieved significantly lower VO2 max when provided with heart-rate feedback. Moreover, diagnostic status interacted with levels of anxiety sensitivity to predict VO2 max. Patients with panic disorder display poorer cardiovascular fitness after controlling for anxiety and other factors that underestimate performance during fitness testing.",Schmidt NB.; Lerew DR.; Santiago H.; Trakowski JH.; Staab JP.,2000.0,10.1002/1520-6394(2000)12:2<59::AID-DA1>3.0.CO;2-G,0,0,
4103,The overprediction of fear and panic in panic disorder.,"The present study examined changes in the prediction of fear and panic in a clinical sample of patients (N = 25) meeting DSM-III-R criteria for panic disorder with agoraphobia (PDA). Data were collected for approx. 2000 trials of in vivo exposure. As expected, PDA patients displayed a bias for overpredicting both the level of fear and the likelihood of panic during an exposure trial. This overprediction bias was evidenced across several domains including heights, transportation and social situations. Although patients learned to make more accurate predictions within an exposure session, the level of overprediction remained relatively stable after the third trial within a session. Changes in fear overprediction differed across fear domains. Patients showed significant reductions in overprediction during exposure to transportation and social situations, but failed to show reductions in overprediction during exposure to heights. Unexpectedly, patients did not show increased prediction accuracy across sessions. These findings concur with earlier laboratory studies indicating that anxiety patients show an overprediction bias for panic and fear which decreases with practice. However, our findings indicate that the overprediction bias does not remit even after significant practice. The persistence of the overprediction bias is discussed within an evolutionary context.",Schmidt NB.; Jacquin K.; Telch MJ.,1994.0,,0,0,
4104,Randomized clinical trial evaluating the efficacy of a brief intervention targeting anxiety sensitivity cognitive concerns.,"Anxiety sensitivity (AS) is a well-established, malleable risk factor for anxiety and other forms of psychopathology. Structural evaluation models of AS suggest it can be decomposed into physical, social, and cognitive concerns, and emerging work indicates that these components may be differentially related to various adverse outcomes. In particular, AS cognitive concerns have been consistently linked with suicide. Prior work has also shown that brief interventions can effectively reduce overall AS, but these treatments tend to focus on its physical subcomponent. The aim of the current investigation was to design and evaluate the efficacy of an AS treatment more specifically focused on its cognitive component. Non-treatment-seeking participants (N = 108) with elevated AS were randomly assigned to a 1-session intervention utilizing psychoeducation and interoceptive exposure techniques to target AS or a health information control intervention and assessed posttreatment and at 1-month follow-up. The active treatment condition produced significantly greater reductions in AS at posttreatment. Group differences persisted at 1-month follow-up that were specific to AS cognitive concerns. Moreover, changes in cognitive AS mediated symptom change at follow-up including suicide outcomes. Despite the brevity of the treatment intervention, findings demonstrate that it resulted in substantial reductions in AS cognitive concerns that were linked with symptom improvement.",Schmidt NB.; Capron DW.; Raines AM.; Allan NP.,2014.0,10.1037/a0036651,0,0,
4105,Fear responding to 35% CO(2) challenge as a vulnerability marker for later social anxiety symptoms,"ER The majority of biological challenge studies have focused on panic disorder though there is a small literature suggesting that patients with social anxiety disorder (SAD) show comparable responding. These cross-sectional studies suggest that CO(2) reactivity may be a marker of vulnerability to social anxiety. However, the nature of this association is unclear due to design limitations in this literature. The present report prospectively evaluated whether response to a 20% CO(2) challenge was predictive of later changes in social anxiety symptoms. A large non-clinical sample of young adults (N=404) screened for axis I disorders completed a 20% CO(2) challenge and were followed for approximately 18 months. Consistent with the vulnerability hypothesis, those showing greater reactivity to the CO(2) challenge showed increased social anxiety symptoms over time. This significant association was maintained after controlling for gender and trait anxiety. These data provide novel evidence suggesting that CO(2) sensitivity is predictive of the development of social anxiety symptoms.","Schmidt, N B; Timpano, K R; Buckner, J D",2008.0,10.1016/j.jpsychires.2007.08.005,0,0,
4106,Diagnosing agoraphobia in the context of panic disorder: Examining the effect of DSM-IV criteria on diagnostic decision-making,"A diagnostic and statistical manual (DSM)-IV diagnosis of agoraphobia in the context of panic disorder (PD) is based on three nosologically sufficient criteria: (1) avoidance, (2) use of companions, and (3) endurance of situations despite distress. Therefore, an agoraphobia diagnosis can be made across an extremely broad range of cases including when there are no avoidance behaviors (e.g., the patient endures the situation). It was hypothesized that clinicians do not weight these criteria equally and that the DSMs individual, sufficient criteria lead to poor inter-rater reliability. Clinicians (N=48) rated hypothetical patients with symptom profiles emphasizing each of these three criteria. Consistent with expectation, clinicians differentially weighted these criteria. Avoidance was relatively more apt to produce a diagnosis when only one criterion was emphasized in clinical vignettes. Inter-rater reliability was poor in instances when only one sufficient criterion was highlighted. Knowledge concerning DSM criteria resulted in a greater rate of agoraphobia endorsement, but knowledge did not account for the overall pattern of findings. © 2004 Elsevier Ltd. All rights reserved.",Schmidt N.B.; Salas D.; Bernert R.; Schatschneider C.,2005.0,10.1016/j.brat.2004.09.004,0,0,
4107,Differential effects of safety in extinction of anxious responding to a CO2 challenge in patients with panic disorder,"ER Safety-relevant parameters are hypothesized to be important to the maintenance of pathological anxiety. The authors examined the effects of safety information and safety cues on anxious responding to a repeated 35% CO2 challenge in 31 patients with panic disorder. Patients were randomly assigned to one of three conditions: (a) safety information, (b) safety information plus a safety cue, or (c) no safety information. In the safety information group, patients received accurate information regarding the benign effects of the CO2 challenge. In the combined group, patients also received a safety cue that is salient for many patients with panic disorder (i.e., access to an anxiolytic pill during the challenge). The experimental manipulations did not differentially affect anxious responding following an initial challenge. However, after access to the anxiolytic was removed and the challenge procedure was repeated, those in the safety information alone condition showed lower subjective anxiety compared to those in the combined safety information/safety cue group. Findings suggest that safety information facilitates extinction of anxiety but only in the absence of safety cues.","Schmidt, N B; Richey, J A; Maner, J K; Woolaway-Bickel, K",2006.0,10.1037/0021-843X.115.2.341,0,0,
4108,Discomfort intolerance: Development of a construct and measure relevant to panic disorder,"The construct of discomfort intolerance (proposed as an individual difference in the ability to tolerate uncomfortable sensations) is introduced and psychometric properties of a measure of this trait are provided. The Discomfort Intolerance Scale (DIS), a self-report measure of discomfort intolerance, was evaluated using a variety of samples (total N approximately 1700), including patients with panic disorder, clinical controls, and nonclinical community members. Factor analyses suggest the DIS contains two factors, including a factor indexing the ability to tolerate discomfort and pain (Factor 1: α = .91), and a factor, which appears to measure avoidance of physical discomfort (Factor 2: α = .72). Cross-time reliability shows good stability across 12 weeks (Factor 1 = .63, Factor 2 = .66). Convergent and discriminant validity coefficients indicated that the DIS performed as expected against established measures of psychopathology. The DIS appears to be a sound measure of a broad individual difference variable tapping the ability to tolerate a variety of uncomfortable sensations and may be relevant to the pathogenesis of anxiety disorders. © 2005 Elsevier Inc. All rights reserved.",Schmidt N.B.; Richey J.A.; Fitzpatrick K.K.,2006.0,10.1016/j.janxdis.2005.02.002,0,0,
4109,Anxiety sensitivity as an incremental predictor of later anxiety symptoms and syndromes,"ER Although anxiety sensitivity (AS) has been shown to predict anxiety symptoms and panic, this literature is limited in regard to evaluating AS as an incremental predictor of anxiety psychopathology relative to other established risk factors including sex and negative affect. The present report prospectively evaluated whether AS was predictive of later changes in anxiety symptoms after controlling for potential confounding factors. Consistent with hypothesis, AS was found to be a significant, incremental predictor of anxiety symptoms over time, even after controlling for sex and negative affectivity. These data provide novel evidence for the unique association between AS of the development of anxiety symptoms.","Schmidt, N B; Mitchell, M A; Richey, J A",2008.0,10.1016/j.comppsych.2007.12.004,0,0,4101
4110,Effects of anxiety sensitivity on anxiety and pain during a cold pressor challenge in patients with panic disorder,"Fear of anxiety symptoms, or anxiety sensitivity (AS), has been extensively studied in anxiety disorders and more recently has been linked to other psychopathological conditions including pain. Asmundson and colleagues have suggested that AS may act as a risk factor for chronic pain and several studies have demonstrated an association between AS, avoidance behaviors and pain. The present study assessed whether AS levels would be predictive of pain and anxiety during a brief pain induction task. Clinical participants meeting DSM-IV criteria for panic disorder (n=22) were age and sex matched with nonclinical controls (n=22) and exposed to a 2-min cold pressor challenge. Diagnostic status and AS were significantly predictive of pain and anxiety during the cold pressor task. Moreover, AS appears to mediate the relationship between diagnostic status and pain. However, AS appears to be only indirectly associated with pain through its contribution to anxiety. Copyright (C) 1999 Elsevier Science Ltd.",Schmidt N.B.; Cook J.H.,1999.0,10.1016/S0005-7967(98)00139-9,0,0,
4111,"Cold pressor ""Augmentation"" does not differentially improve treatment response for spider phobia","An emerging literature suggests that memory enhancement may augment the effects of learning-based treatments such as cognitive behavioral therapy. Release of stress hormones, such as cortisol, has been shown to enhance memory. In this report, we evaluated whether a cold pressor stressor (CPS), which reliably generates stress hormones, may also augment treatment for specific phobias. Spider phobics were randomly assigned to CPS or warm water bath following a standardized session of exposure therapy. Inconsistent with our hypothesis, the CPS condition showed no significant enhancement in fear reduction compared to the control condition. © 2010 Springer Science+Business Media, LLC.",Schmidt N.B.; Anthony Richey J.; Funk A.P.; Mitchell M.A.,2010.0,10.1007/s10608-010-9310-6,0,0,
4112,The PRESERVE mortality risk score and analysis of long-term outcomes after extracorporeal membrane oxygenation for severe acute respiratory distress syndrome.,"This study was designed to identify factors associated with death by 6 months post-intensive care unit (ICU) discharge and to develop a practical mortality risk score for extracorporeal membrane oxygenation (ECMO)-treated acute respiratory distress syndrome (ARDS) patients. We also assessed long-term survivors' health-related quality of life (HRQL), respiratory symptoms, and anxiety, depression and post-traumatic stress disorder (PTSD) frequencies. Data from 140 ECMO-treated ARDS patients admitted to three French ICUs (2008-2012) were analyzed. ICU survivors contacted >6 months post-ICU discharge were assessed for HRQL, psychological and PTSD status. Main ARDS etiologies were bacterial (45%), influenza A[H₁N₁] (26%) and post-operative (17%) pneumonias. Six months post-ICU discharge, 84 (60%) patients were still alive. Based on multivariable logistic regression analysis, the PRESERVE (PRedicting dEath for SEvere ARDS on VV-ECMO) score (0-14 points) was constructed with eight pre-ECMO parameters, i.e. age, body mass index, immunocompromised status, prone positioning, days of mechanical ventilation, sepsis-related organ failure assessment, plateau pressure andpositive end-expiratory pressure. Six-month post-ECMO initiation cumulative probabilities of survival were 97, 79, 54 and 16% for PRESERVE classes 0-2, 3-4, 5-6 and ≥7 (p < 0.001), respectively. HRQL evaluation in 80% of the 6-month survivors revealed satisfactory mental health but persistent physical and emotional-related difficulties, with anxiety, depression or PTSD symptoms reported, by 34, 25 or 16%, respectively. The PRESERVE score might help ICU physicians select appropriate candidates for ECMO among severe ARDS patients. Future studies should also focus on physical and psychosocial rehabilitation that could lead to improved HRQL in this population.",Schmidt M.; Zogheib E.; Rozé H.; Repesse X.; Lebreton G.; Luyt CE.; Trouillet JL.; Bréchot N.; Nieszkowska A.; Dupont H.; Ouattara A.; Leprince P.; Chastre J.; Combes A.,2013.0,10.1007/s00134-013-3037-2,0,0,
4113,Responses to α2-adrenoceptor blockade by idazoxan in healthy male and female volunteers,"Seven male and five female volunteers underwent double-blind infusions of the α2-adrenoceptor antagonist idazoxan (100 and 200 μg/kg) and placebo in random order. Blood pressure, plasma norepinephrine, growth hormone and subjective responses were measured. The higher dose of idazoxan produced increases in blood pressure, norepinephrine and growth hormone and slight increases in anxiety. Both subject age and sex appeared to influence the magnitude of responses.",Schmidt M.E.; Risinger R.C.; Hauger R.L.; Schouten J.L.; Henry M.; Potter W.Z.,1997.0,10.1016/S0306-4530(96)00045-5,0,0,
4114,Sepsis survivors monitoring and coordination in outpatient health care (SMOOTH): study protocol for a randomized controlled trial.,"Sepsis sequelae include critical illness polyneuropathy, myopathy, wasting, neurocognitive deficits, post-traumatic stress disorder, depression and chronic pain. Little is known howlong-term sequelae following hospital discharge are treated. The aim of our study is to determine the effect of a primary care-based, long-term program on health-related quality of life in sepsis survivors. In a two-armed randomized multicenter interventional study, patients after sepsis (n = 290) will be assessed at 6, 12 and 24 months. Patients are eligible if severe sepsis or septic shock (ICD-10), at least two criteria of systemic inflammatory response syndrome (SIRS), at least one organ dysfunction and sufficient cognitive capacity are present. The intervention comprises 1) discharge management, 2) training of general practitioners and patients in evidence-based care for sepsis sequelae and 3) telephone monitoring of patients. At six months, we expect an improved primary outcome (health-related quality of life/SF-36) and improved secondary outcomes such as costs, mortality, clinical-, psycho-social- and process-of-care measures in the intervention group compared to the control group. This study evaluates a primary care-based, long-term program for patients after severe sepsis. Study results may add evidence for improved sepsis care management. General practitioners may contribute efficiently to sepsis aftercare. U1111-1119-6345. DRKS00000741, CCT-NAPN-20875 (25 February 2011).",Schmidt K.; Thiel P.; Mueller F.; Schmuecker K.; Worrack S.; Mehlhorn J.; Engel C.; Brenk-Franz K.; Kausche S.; Jakobi U.; Bindara-Klippel A.; Schneider N.; Freytag A.; Davydow D.; Wensing M.; Brunkhorst FM.; Gensichen J.;  .,2014.0,10.1186/1745-6215-15-283,0,0,
4115,Does 'mental kinesiophobia' exist?,"In this study the relevance of the concept of mental kinesiophobia (respectively cogniphobia or fear of mental exertion) for clients with chronic stress problems was explored. It was hypothesized that cognitive, chronic stress complaints, such as concentration problems or decreased problem solving abilities, could be catastrophized as signs of heightened personal vulnerability, with a chance of becoming permanent. As a consequence, mental exertion is avoided. This line of reasoning comes from the existing concept of kinesiophobia. This concept describes the avoidance behavior in chronic benign pain patients and refers to their fear of inflicting irreversible bodily damage due to physical exertion. An illustrative case of cogniphobia is presented. In an explorative pilot-study it was demonstrated that chronically stressed clients scored significantly higher on an experimental questionnaire measuring avoidance tendencies for mental exertion, compared with actively working employees. Consequences for treatment and suggestions for further study are discussed. © 2003 Elsevier Ltd. All rights reserved.",Schmidt A.J.M.,2003.0,10.1016/S0005-7967(03)00155-4,0,0,
4116,Ulnar shortening with the ulna osteotomy locking plate.,"Ulnar shortening for ulnocarpal unloading using a new device enabling parallel osteotomy, rotation-secured compressive shortening, lag screw placement and hybrid stabilization combined in a solely locking plate construct. Idiopathic ulnar impaction syndrome. Posttraumatic radial shortening without major tilting of the radius in the sagittal or frontal plane, rotation deformity and/or translation of the distal fragment. Advanced arthritis of the distal radioulnar joint (DRUJ), DRUJ type III according to Tolat, malunion of the distal radius with major tilting of the radius in the sagittal or frontal plane, rotation deformity and/or translation of the distal fragment. Mounting of the UOL plate system on the palmar surface of the ulna using standard ulnopalmar exposure. Two parallel 45° osteotomies are performed using an osteotomy guide followed by rotation secured shortening and compression. Stabilization is gained by inserting an interfragmentary lag screw perpendicular to the osteotomy site and applying locking and compression screws. Lower arm cast for 4 weeks until radiological signs of bone healing become apparent. To limit negative influence of rotational forces during bone healing, patients were instructed to limit forearm rotation up to 30° in pro-/supination. Sixteen ulnar shortening osteotomies were performed in 15 patients (6 men, 9 women, average age 49 years) and evaluated retrospectively. In 10 cases a trauma-related pathology was the indication for the procedure. The average follow-up time was 53 weeks (range 12-93 weeks). Bone union was observed at a median of 10 weeks (range 6-33 weeks). Overall good clinical results could be achieved with an average shortening of 3.7 mm (range 2.1-16 mm). In this series, there was one nonunion.",Schmidle G.; Arora R.; Gabl M.,2012.0,10.1007/s00064-011-0037-7,0,0,
4117,Intracutaneous injections of platelets cause acute pain and protracted hyperalgesia.,"Suspensions of autologous, washed platelets were intracutaneously injected at the volar forearms of healthy volunteers. Injections of serum and vehicle served as control. Subjects and experimenter were blind with respect to the sequence of injections. In contrast to serum and solvent solution, platelets induced graded burning pain lasting several minutes. Platelet but not serum or vehicle injections dose-dependently caused large axon-reflex flares. At the site of platelet injections an induration developed and in parallel delayed mechanical and heat hyperalgesia was observed. Hyperalgesia to pressure and impact stimulation reached a maximum after 6 h and subsided during the following 48 h. Also, the threshold to heat stimuli decreased moderately by about 1 degree C, on average, after 24 h. Neither indurations nor hyperalgesia could be detected at the injection sites of serum or vehicle. The pathophysiological significance of this new inflammatory model for the research of posttraumatic hyperalgesia is discussed.",Schmelz M.; Osiander G.; Blunk J.; Ringkamp M.; Reeh PW.; Handwerker HO.,1997.0,,0,0,
4118,Synovial cytokine expression in ankle osteoarthritis depends on age and stage,"ER PURPOSE: Aim of the study was the analysis of cytokine expression in ankle osteoarthritis (OA) hypothesizing age-dependent regulation patterns.METHODS: Forty-nine patients undergoing an arthroscopy of the ankle with different stages of chronic OA were prospectively included in a clinical trial comparing the group <18 years (n = 9, Ø15.1 ± 2.0 years) with the older patients (?18 years, n = 40, Ø36.5 ± 11.9). Lavage fluids were analysed by ELISA for levels of aggrecan, BMP-2/7, IGF-1/R, bFGF, CD105, MMP-13, and IL-1?. Additionally, clinical parameters and scores (FFI, CFSS, AOFAS) were evaluated and supplemented by radiographic scores [Kellgren-Lawrence Score (KLS) for conventional X-rays, Ankle Osteoarthritis Scoring System (AOSS) for MRI].RESULTS: In contrast to distribution of gender and BMI (p < 0.005), parameters characterizing the cartilage defect as ICRS grading, size, and duration of symptoms were not dependent on age. The incidence of osteochondritis dissecans (OCD) was higher in the group <18 years (p < 0.006), but the average degree of OCD grading was not different. KLS and AOSS were significantly higher in the group ?18 years (p < 0.02). Correlating with the higher degree of OA in the elderly, clinical function measured by FFI and AOFAS was statistically significantly worse (p < 0.05). Intra-articular concentrations of aggrecan (3.1-fold), bFGF (8.7-fold), BMP-7 (2.7-fold), and CD105 (1.5-fold) were statistically significantly higher in the group ?18 years (p < 0.03).CONCLUSIONS: Confirming the hypothesis, increased synovial levels of aggrecan, bFGF, BMP-7, and CD105 were found in patients over 18 years. This correlated with a higher stage of OA determined by radiographic changes or deteriorated function and may offer starting points for new diagnostics and interventional strategies.LEVEL OF EVIDENCE: II.","Schmal, H; Henkelmann, R; Mehlhorn, A T; Reising, K; Bode, G; Südkamp, N P; Niemeyer, P",2015.0,10.1007/s00167-013-2719-1,0,0,
4119,"Pain sensitivity is reduced in borderline personality disorder, but not in posttraumatic stress disorder and bulimia nervosa.","Several studies revealed reduced pain sensitivity in patients suffering from borderline personality disorder (BPD) under baseline and stress conditions. To establish whether these findings are specific for BPD, we compared pain thresholds in patients with BPD, posttraumatic stress disorder (PTSD), bulimia nervosa, and healthy controls. The study included 76 female subjects: 16 patients with BPD, 16 patients with PTSD, 20 patients with bulimia nervosa and 24 healthy controls. Heat and cold pain thresholds were assessed under baseline and stress conditions, using a contact thermode. Mental stress was induced by the Paced Auditory Serial Addition Task. Under baseline conditions, pain thresholds in patients with BPD were significantly higher compared to healthy controls. Patients with PTSD and bulimia nervosa did not show significant differences in pain thresholds compared to healthy controls. Under stress conditions, the difference between BPD patients and healthy controls became even more prominent, whereas the results in the other patient groups remained insignificant. Our results support the hypothesis that reduced pain sensitivity is a prominent feature of BPD, which may differentiate this disorder from other stress-related psychiatric conditions.",Schmahl C.; Meinzer M.; Zeuch A.; Fichter M.; Cebulla M.; Kleindienst N.; Ludäscher P.; Steil R.; Bohus M.,2010.0,10.3109/15622970701849952,0,0,
4120,Psychophysiological reactivity to traumatic and abandonment scripts in borderline personality and posttraumatic stress disorders: a preliminary report,"ER Borderline personality disorder (BPD) is a highly prevalent and disabling condition linked to early stressors including traumatic abuse and abandonment. While much work has addressed traumatic events in childhood, little is known about the biological sequelae of BPD including how this disorder may be differentiated from other stress-related disorders such as posttraumatic stress disorder (PTSD). The purpose of this study was to investigate psychophysiological effects of different types of stressful reminders in BPD and in PTSD. Psychophysiological measures including heart rate, skin conductance responses, systolic and diastolic blood pressure in response to standardized neutral scripts, and personalized scripts of traumatic and abandonment situations were compared among subjects with BPD, PTSD and controls, all with a reported history of sexual and/or physical abuse before age 18. Significant script by diagnosis interactions were found for skin conductance and systolic blood pressure. No significant effects were found for diastolic blood pressure or heart rate. In the PTSD group the greatest systolic blood pressure responses were to traumatic scripts, whereas patients with BPD showed a tendency towards greater skin conductance responses to abandonment scripts. Our findings reveal only partially different psychophysiological responses to traumatic and abandonment scripts in PTSD and BPD. A divergence in pathophysiology in these two disorders is suggested that may be linked to childhood trauma. However, this interpretation must be tested in a larger population.","Schmahl, C G; Elzinga, B M; Ebner, U W; Simms, T; Sanislow, C; Vermetten, E; McGlashan, T H; Bremner, J D",2004.0,10.1016/j.psychres.2004.01.005,0,0,
4121,Efficacy of a moisture-tolerant material for fissure sealing: a prospective randomised clinical trial,"ER OBJECTIVES: Fissure sealings offer nearly complete protection against fissure caries, provided that they are adequately applied, for composite-based sealants with sufficient moisture control. This is not always attainable, particularly in children with low compliance. To counter this problem, a moisture-tolerant sealant has been developed. The present randomised clinical trial compared such a moisture-tolerant material (Embrace) with a conventional sealant (Helioseal).MATERIAL AND METHODS: In 55 participants (mean age, 10?±?3 years), corresponding molar pairs were sealed with either Embrace or Helioseal. Retention, quality of sealing, and caries were clinically examined, both tactilely and visually, immediately and after 1 year.RESULTS: After 1 year, 93% of Helioseal sealings were complete, whereas 60% of Embrace sealings showed partial and 13% complete loss. The surface quality of Embrace was significantly worse than that of Helioseal. After the use of Embrace, the sealant margin was noticeable as a slight (distinct) step in 36% (15%). The visual (tactile) examination showed a rough surface in 78% (33%) in the case of Embrace. The Helioseal surfaces were shiny (smooth) in all cases (all differences between Helioseal and Embrace, p???0.001). Caries was found only after the use of Embrace (4%, n.s. compared to Helioseal).CONCLUSION: The moisture-tolerant material Embrace was distinctly inferior to Helioseal because Embrace showed weaknesses in retention and surface quality.CLINICAL RELEVANCE: Even if a moisture-tolerant sealant would be desirable in particular for children with low compliance, the tested material does not represent an alternative to the standard preparation.","Schlueter, N; Klimek, J; Ganss, C",2013.0,10.1007/s00784-012-0740-2,0,0,
4122,Trait anxiety moderates the impact of performance pressure on salivary cortisol in everyday life,"Stress and negative affective states are associated with cortisol in everyday life. However, it remains unclear what types of stressors and which affective states yield these associations, and the effect of trait anxiety is unknown. This study investigates the associations of specific task-related stressors and negative affective states in everyday life with salivary cortisol, and explores the mediating and moderating role of state negative affect and trait anxiety, respectively. Salivary cortisol, subjective stress, and state negative affect were measured three times a day on 2 days in 71 participants in everyday life, using a handheld computer to collect self-reports and time stamps and an electronic device to monitor saliva sampling compliance. Stress measures comprised the experience of performance pressure and failure during daily tasks; measures of negative affect comprised worn-out, tense, unhappy, and angry. Effects were tested using multilevel fixed-occasion models. Momentary performance under pressure was related to higher momentary cortisol measures, while mean task failure was related to lower daily cortisol concentrations. The association of performance pressure with cortisol varied between subjects, and this variation was explained by trait anxiety, yielding stronger associations in participants scoring high on trait anxiety. No evidence was found for a mediating role of state negative affect. These results describe the well-documented associations of everyday stressors and affect with salivary cortisol more precisely, suggesting that performance pressure is a significant condition related to short-term changes in cortisol. Subjects scoring high on trait anxiety seem to process stress-relevant information in a way that amplifies the association of performance pressure with reactions of the hypothalamus-pituitary-adrenal axis. © 2006 Elsevier Ltd. All rights reserved.",Schlotz W.; Schulz P.; Hellhammer J.; Stone A.A.; Hellhammer D.H.,2006.0,10.1016/j.psyneuen.2005.11.003,0,0,
4123,Synthesis of a novel photopolymerized nanocomposite hydrogel for treatment of acute mechanical damage to cartilage,"Intra-articular fractures initiate a cascade of pathobiological and pathomechanical events that culminate in post-traumatic osteoarthritis (PTOA). Hallmark features of PTOA include destruction of the cartilage matrix in combination with loss of chondrocytes and acute mechanical damage (AMD). Currently, treatment of intra-articular fractures essentially focuses completely on restoration of the macroanatomy of the joint. However, current treatment ignores AMD sustained by cartilage at the time of injury. We are exploring aggressive biomaterial-based interventions designed to treat the primary pathological components of AMD. This study describes the development of a novel injectable co-polymer solution that forms a gel at physiological temperatures that can be photocrosslinked, and can form a nanocomposite gel in situ through mineralization. The injectable co-polymer solution will allow the material to fill cracks in the cartilage after trauma. The mechanical properties of the nanocomposite are similar to those of native cartilage, as measured by compressive and shear testing. It thereby has the potential to mechanically stabilize and restore local structural integrity to acutely injured cartilage. Additionally, in situ mineralization ensures good adhesion between the biomaterial and cartilage at the interface, as measured through tensile and shear testing. Thus we have successfully developed a new injectable co-polymer which forms a nanocomposite in situ with mechanical properties similar to those of native cartilage, and which can bond well to native cartilage. This material has the potential to stabilize injured cartilage and prevent PTOA. © 2011 Acta Materialia Inc.",Schlichting K.E.; Copeland-Johnson T.M.; Goodman M.; Lipert R.J.; Prozorov T.; Liu X.; McKinley T.O.; Lin Z.; Martin J.A.; Mallapragada S.K.,2011.0,10.1016/j.actbio.2011.04.010,0,0,
4124,Parental psychopathology and treatment outcome for anxious youth: roles of family functioning and caregiver strain,"ER Objective: Research has examined the effects of parental psychopathology, family functioning, and caregiver strain on treatment response in anxious youths. Although these variables have shown individual links to youth treatment response, theoretical models for their combined effects remain unexplored. This study tested the hypothesis that improvements in family functioning and reductions in caregiver strain explained the effects of parental psychopathology on youth treatment outcome in an anxiety treatment trial. Method: A multiple mediation technique was used to test the proposed model across independent evaluator (IE), parent, and youth informants in 488 youths, aged 7 17 years (50% female; mean age 10.7) meeting Diagnostic and Statistical Manual of Mental Disorders criteria for social phobia, separation anxiety, and/or generalized anxiety disorder. Youths were randomized to receive 12 weeks of cognitive-behavioral treatment (Coping Cat), medication (sertraline), their combination, or a pill placebo. At pre- and posttreatment, parents completed self-report measures of global psychopathology symptoms, family functioning, and caregiver strain; parents, youths, and IEs rated youths' anxiety symptom severity. Results: Changes in family functioning and caregiver strain jointly explained relations between parental psychopathology and reductions in youth anxiety. Specifically, across IE and parent informants, families with higher pretreatment parental psychopathology showed more improvement in family functioning and caregiver strain, which in turn predicted greater youth anxiety reductions. Further, higher pretreatment parental psychopathology predicted greater caregiver strain reductions and, in turn, greater youth anxiety reductions, based on youths' reports of their own anxiety. Conclusions: Findings suggest that improvements in family functioning and reductions in caregiver strain can influence treatment outcomes for anxious youths, especially among youths with more distressed parents.","Schleider, J L; Ginsburg, G S; Keeton, C P; Weisz, J R; Birmaher, B; Kendall, P C; Piacentini, J; Sherrill, J; Walkup, J T",2015.0,10.1037/a0037935,0,0,
4125,Group treatment for spouse abuse: Are women with PTSD appropriate participants?,"Evaluated the treatment outcome of 27 women (mean age 37.2 yrs) diagnosed with posttraumatic stress disorder (PTSD) and 57 women without PTSD (mean age 34.3 yrs) who were seeking therapy with their husbands in a group treatment program for spouse abuse. Results indicated that across all women, avoidance symptomatology significantly differentiated treatment completers from dropouts. Although women with PTSD began treatment in worse condition (lower marital satisfaction, higher depressive symptomatology, greater fear of spouse), post-assessment revealed they achieved positive treatment gains parallel to those of women without PTSD. Women with PTSD improved on each outcome variable measured, including a reduction in fear of spouse. Women with PTSD also did not differentially drop out of either treatment condition (men's/women's vs conjoint groups) which lends support to the appropriateness of conjoint treatment for spouse abuse. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schlee, Karin A; Heyman, Richard E; O'Leary, K. Daniel",1998.0,,0,0,
4126,Effects of alcohol and expectancy on self-disclosure and anxiety in male and female social drinkers,"ER To study the effects of alcohol consumption and expectancy on self-disclosure and self-reported anxiety during a social interaction, 32 male and 32 female social drinkers were assigned to one of four groups comprising a 2 x 2 factorial balanced-placebo design. Alcohol expectancy reduced the intimacy level of self-disclosure but not the amount of self-disclosure. Alcohol consumption had no effect. Thus, in contrast to the common view that alcohol functions as a ""social lubricant,"" it served to inhibit social interaction. There was a three-way interaction among alcohol consumption, expectancy, and gender of subjects, such that the largest increase in anxiety was reported by male subjects who expected but did not receive alcohol. Thus, the previously reported inverse relationship between anxiety and self-disclosure was not confirmed, and alcohol's effect on anxiety seems unrelated to its effect on self-disclosure.","Schippers, G M; Boer, M C; Staak, C P; Cox, W M",1997.0,,0,0,
4127,"No effect of traction in patients with low back pain: a single centre, single blind, randomized controlled trial of Intervertebral Differential Dynamics Therapy","ER Low back pain (LBP) poses a significant problem to society. Although initial conservative therapy may be beneficial, persisting chronic LBP still frequently leads to expensive invasive intervention. A novel non-invasive therapy that focuses on discogenic LBP is Intervertebral Differential Dynamics Therapy (IDD Therapy, North American Medical Corp. Reg U.S.). IDD Therapy consists of intermittent traction sessions in the Accu-SPINA device (Steadfast Corporation Ltd, Essex, UK), an FDA approved, class II medical device. The intervertebral disc and facet joints are unloaded through axial distraction, positioning and relaxation cycles. The purpose of this study is to investigate the effect of IDD Therapy when added to a standard graded activity program for chronic LBP patients. In a single blind, single centre, randomized controlled trial; 60 consecutive patients were assigned to either the SHAM or the IDD Therapy. All subjects received the standard conservative therapeutic care (graded activity) and 20 sessions in the Accu-SPINA device. The traction weight in the IDD Therapy was systematically increased until 50% of a person's body weight plus 4.45 kg (10 lb) was reached. The SHAM group received a non-therapeutic traction weight of 4.45 kg in all sessions. The main outcome was assessed using a 100-mm visual analogue scale (VAS) for LBP. Secondary outcomes were VAS scores for leg pain, Oswestry Disability Index (ODI), Short-Form 36 (SF-36). All parameters were measured before and 2, 6 and 14 weeks after start of the treatment. Fear of (re)injury due to movement or activities (Tampa Scale for Kinesiophobia), coping strategies (Utrecht Coping List) and use of pain medication were recorded before and at 14 weeks. A repeated measures analysis was performed. The two groups were comparable at baseline in terms of demographic, clinical and psychological characteristics, indicating that the random allocation had succeeded. VAS low back pain improved significantly from 61 (+/-25) to 32 (+/-27) with the IDD protocol and 53 (+/-26) to 36 (+/-27) in the SHAM protocol. Moreover, leg pain, ODI and SF-36 scores improved significantly but in both groups. The use of pain medication decreased significantly, whereas scores for kinesiophobia and coping remained at the same non-pathological level. None of the parameters showed a difference between both protocols. Both treatment regimes had a significant beneficial effect on LBP, leg pain, functional status and quality of life after 14 weeks. The added axial, intermittent, mechanical traction of IDD Therapy to a standard graded activity program has been shown not to be effective.","Schimmel, J J; Kleuver, M; Horsting, P P; Spruit, M; Jacobs, W C; Limbeek, J",2009.0,10.1007/s00586-009-1044-3,0,0,
4128,Extinction during reconsolidation of threat memory diminishes prefrontal cortex involvement,"Controlling learned defensive responses through extinction does not alter the threat memory itself, but rather regulates its expression via inhibitory in fluence of the prefrontal cortex (PFC) over amygdala. Individual differences in amygdala-PFC circuitry function have been linked to trait anxiety and posttraumatic stress disorder. This finding suggests that exposure-based techniques may actually be least effective in those who suffer from anxiety disorders. A theoretical advantage of techniques influencing reconsolidation of threat memories is that the threat representation is altered, potentially diminishing reliance on this PFC circuitry, resulting in a more persistent reduction of defensive reactions. We hypothesized that timing extinction to coincide with threat memory reconsolidation would prevent the return of defensive reactions and diminish PFC involvement. Two conditioned stimuli (CS) were paired with shock and the third was not. A day later, one stimulus (reminded CS+) but not the other (nonreminded CS+) was presented 10 min before extinction to reactivate the threat memory, followed by extinction training for all CSs. The recovery of the threat memory was tested 24 h later. Extinction of the nonreminded CS+ (i.e., standard extinction) engaged the PFC, as previously shown, but extinction of the reminded CS+ (i.e., extinction during reconsolidation) did not. Moreover, only the nonreminded CS+ memory recovered on day 3. These results suggest that extinction during reconsolidation prevents the return of defensive reactions and diminishes PFC involvement. Reducing the necessity of the PFC-amygdala circuitry to control defensive reactions may help overcome a primary obstacle in the long-term efficacy of current treatments for anxiety disorders.",Schiller D.; Kanen J.W.; LeDoux J.E.; Monfils M.-H.; Phelps E.A.,2013.0,10.1073/pnas.1320322110,0,0,
4129,Guidelines for differential diagnoses in a population with posttraumatic stress disorder.,"In a large posttraumatic stress disorder (PTSD) and depression treatment outcome study, thorough diagnostic assessments of veterans at pretreatment, posttreatment, and 3 follow-up times were completed. The research team that reviewed these assessments encountered several challenges in the differential diagnosis of PTSD because of high comorbidity and symptoms shared with or resembling other disorders. For example, how do mental health professionals distinguish symptoms of agoraphobia from avoidance and hypervigilance symptoms of PTSD? When are hallucinations symptomatic of PTSD (e.g., flashbacks) versus a nonpsychotic near-death experience or an independent psychotic disorder? How do mental health professionals differentiate overlapping symptoms of PTSD and depressive disorders? To help make reliable diagnoses, the team developed clarifying questions and diagnostic guidelines, which may prove useful to other clinicians and researchers working with PTSD populations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schillaci, Jeanne; Yanasak, Elisia; Adams, Jennifer Harned; Dunn, Nancy Jo; Rehm, Lynn P; Hamilton, Joseph D; Blake, Blank, Bollinger, Brady, Brown, Dunn, Dunn, Dunn, Falsetti, First, First, Fleiss, Folstein, Friedman, Hamilton, Hamner, Keane, Keane, Kulka, McNally, Najavits, Orsillo, Rehm, Roberts, Roszell, Solomon, Southwick",2009.0,,0,0,
4130,"Affect changes observed with right versus left lateral visual field stimulation in psychotherapy patients: possible physiological, psychological, and therapeutic implications.","Seventy psychotherapy patients were given two pairs of goggles each taped over to allow vision from only the left or the right lateral visual field (LVF and RVF). Sixty percent reported at least a one-point difference between visual fields on a five-point anxiety scale; 23% reported at least a two-point difference. Among 21 patients with major depression, 11 reported greater anxiety through the LVF, four reported greater anxiety through the RVF, and six reported no difference. Among 18 with posttraumatic stress disorder (PTSD), 10 reported greater anxiety from the RVF and four from the LVF, and four reported no difference. The absolute difference in anxiety ratings was significantly greater (P < .001) between the two pairs of experimental goggles than between two pairs of control goggles allowing monocular vision among 40 patients in whom the four pairs were tested. During a subsequent psychiatric interview, 40 of 49 patients who were responsive while using the experimental goggles manifested an intensification of their usual symptoms on one side and an alleviation on the other. The possible physiological, psychological, and therapeutic implications of these findings are discussed.",Schiffer F.,,,0,0,
4131,"Affect changes observed with right versus left lateral visual field stimulation in psychotherapy patients: possible physiological, psychological, and therapeutic implications","ER Seventy psychotherapy patients were given two pairs of goggles each taped over to allow vision from only the left or the right lateral visual field (LVF and RVF). Sixty percent reported at least a one-point difference between visual fields on a five-point anxiety scale; 23% reported at least a two-point difference. Among 21 patients with major depression, 11 reported greater anxiety through the LVF, four reported greater anxiety through the RVF, and six reported no difference. Among 18 with posttraumatic stress disorder (PTSD), 10 reported greater anxiety from the RVF and four from the LVF, and four reported no difference. The absolute difference in anxiety ratings was significantly greater (P < .001) between the two pairs of experimental goggles than between two pairs of control goggles allowing monocular vision among 40 patients in whom the four pairs were tested. During a subsequent psychiatric interview, 40 of 49 patients who were responsive while using the experimental goggles manifested an intensification of their usual symptoms on one side and an alleviation on the other. The possible physiological, psychological, and therapeutic implications of these findings are discussed.","Schiffer, F",1997.0,,0,0,4130
4132,"Exposure to terrorism and Israeli youths' cigarette, alcohol, and cannabis use.","We investigated the consequences of exposure to acts of terrorism among Israeli adolescents. We examined whether exposure to terrorism predicted adolescents' use of cigarettes, alcohol (including binge drinking), and cannabis after we controlled for posttraumatic stress and depressive symptoms and background variables. Anonymous self-administered questionnaires were given to a random sample of 960 10th and 11th grade students (51.6% boys, 48.4% girls) in a large city in northern Israel. Close physical exposure to acts of terrorism predicted higher levels of alcohol consumption (including binge drinking among drinkers) and cannabis use. These relationships remained even after we controlled for posttraumatic stress and depressive symptoms. In addition to posttraumatic stress symptoms, negative consequences of terrorism exposure among adolescents included substance abuse. The similarity between our findings among Israeli adolescents and previous findings among US adults suggests cross-cultural generalizability. Given the risks for later problems from early-onset substance abuse, the consequences of terrorism exposure among adolescents merit greater research and clinical attention.",Schiff M.; Zweig HH.; Benbenishty R.; Hasin DS.,2007.0,10.2105/AJPH.2006.090514,0,0,
4133,Effects of low-frequency magnetic fields on electrocortical activity in humans: a sferics simulation study.,"A previously recorded electromagnetic impulse of natural origin, a 10 kHz-sferic, was simulated and presented to 20 subjects. The magnetic component of the signal with a maximum field amplitude of 50 nT and a duration of 500 microseconds was applied over a duration of 10 minutes with a pulse repetition rate that varied statistically between 7 and 20 Hz. After sferics exposure, an additional 20 minutes without treatment were recorded in order to examine possible prolonged effects of sferics stimulation. The control group (n = 20) received no treatment. As a dependent measure, electrocortical changes throughout the course of the experiment were determined by means of EEG spectral analysis and compared between the two groups. Sferics exposure provoked increases in alpha and beta power. The effect was present during stimulation and continued for 10 minutes after the end of treatment. A longer lasting influence of sferics exposure was displayed by subjects with a high degree in weather sensitivity, somatic complaints, and neuroticism, who continued to stay on an enhanced alpha power level until the end of registration (20 minutes after the end of exposure). With these results a general electrocortical sensitivity towards sferics as well as individual differences in sferics reactivity could be demonstrated.",Schienle A.; Stark R.; Walter B.; Vaitl D.; Kulzer R.,1997.0,,0,0,
4134,Randomized placebo-controlled D-cycloserine with cognitive behavior therapy for pediatric posttraumatic stress,"ER METHODS: Seven to 18 year-old youth with exposure to trauma and PTSD were offered a 12 session, manualized CBT treatment. Those who remained in treatment at the fifth session were randomly allocated (n=57) to either CBT and DCS or CBT and placebo.RESULTS: Youth in the CBT and DCS group had significant reductions in symptoms, but these reductions were not greater than those in the CBT and placebo group. There was a trend toward DCS speeding PTSD symptom recovery during the exposure-based sessions, and evidence that the CBT and DCS group better maintained stability of gains on inattention ratings from posttreatment to the 3 month follow-up.CONCLUSIONS: This initial study of CBT and DCS to treat pediatric PTSD provided suggestive and preliminary evidence for more rapid symptom recovery and beneficial effects on attention, but did not show an overall greater effect for reducing PTSD symptoms. It appears that augmentation with DCS represents unique challenges in PTSD. Because PTSD involves complex, life-threatening trauma memories, as opposed to the imagined dreadful outcomes of other anxiety disorders, the use of DCS may require greater attention to how its use is coupled with exposure-based techniques. DCS may have inadvertently enhanced reconsolidation of trauma memories rather than more positive and adaptive memories. In addition, the results suggest that future research could focus on the longer-term benefits of DCS on attention and ways to capitalize on attention-enhancing therapies. ClinicalTrials.gov registry: Effect of D-cycloserine on Treatment of Posttraumatic Stress Disorder (PTSD) in Youth, #NCT01157416, http://clinicaltrials.gov/ct2/results?term=NCT01157416&Search=Search , and D-cycloserine Adjunctive Treatment for Posttraumatic Stress Disorder (PTSD) in Adolescents, #NCT01157429, http://clinicaltrials.gov/ct2/results?term=NCT01157429&Search=Search .UNLABELLED: Abstract Objective: Research on D-cycloserine (DCS), a partial N-methyl-d-aspartic acid (NMDA) agonist, has suggested that it may enhance exposure-based therapies for anxiety disorders. RESULTS with DCS in adult posttraumatic stress disorder (PTSD) have been conflicting; however, no data have been reported on children with PTSD. Although many individuals with PTSD respond to exposure-based cognitive behavioral therapy (CBT), there are subgroups of individuals who are nonresponders, and many responders still have substantial residual symptoms. This randomized, triple-blind, placebo-controlled study tested DCS as an adjunct to CBT to improve and speed treatment response for PTSD in youth.","Scheeringa, M S; Weems, C F",2014.0,10.1089/cap.2013.0106,0,0,
4135,Brief psychological intervention with traumatized young women: the efficacy of eye movement desensitization and reprocessing.,"To study the efficacy of eye movement desensitization and reprocessing (EMDR) with traumatized young women, 60 women between the ages of 16 and 25 were randomly assigned to two sessions of either EMDR or an active listening (AL) control. Factorial ANOVA interaction effects and simple main effects for outcome measure (Beck Depression Inventory, State-Trait Anxiety Inventory, Penn Inventory for Posttraumatic Stress Disorder, Impact of Event Scale, Tennessee Self-Concept Scale) indicated significant improvement for both groups and significantly greater pre-post change for EMDR-treated participants. Pre-post effect sizes for the EMDR group averaged 1.56 compared to 0.65 for the AL group. Despite treatment brevity, the posttreatment outcome variable means of EMDR-treated participants compared favorably with nonpatient or successfully treated norm groups on all measures.",Scheck MM.; Schaeffer JA.; Gillette C.,1998.0,10.1023/A:1024400931106,0,0,
4136,"Recent studies on selective serotonergic antidepressants: Trazodone, fluoxetine, and fluvoxamine","In recent years, the role of serotonin in the pathophysiology of depressive disorders has been intensively studied. These studies have been complemented by the development of newer antidepressant agents that exert specific effects on serotonin systems. This paper reviews the pharmacology of these newer compounds and contrasts it with those of the standard tricyclic antidepressants. The current status of various serotonergic agents is discussed. Results are reviewed from recent double-blind studies comparing three compounds (trazodone, fluoxetine, and fluvoxamine) to a standard tricyclic antidepressant. Relative efficacy, dropout rates, optimal dosages, and side effects are emphasized. Data from studies on trazodone and fluoxetine suggest that lower dosages may prove as effective (if not more effective) than very high dosages. Implications of these data are discussed. Side effects of fluoxetine and fluvoxamine include primarily nausea, weight loss, insomnia, and anxiety. Possible application of specific serotonin reuptake blockers in the treatment of obsessive-compulsive disorder and in the reduction of alcohol consumption is also reviewed.",Schatzberg A.F.; Dessain E.; O'Neil P.; Katz D.L.; Cole J.O.,1987.0,,0,0,
4137,Source localization of late electrocortical positivity during symptom provocation in spider phobia: An sLORETA study,"This symptom provocation study on spider phobia investigated sources of late event-related potentials (ERPs) using sLORETA (standardized low resolution brain electromagnetic tomography). Twenty-five phobic female patients and 20 non-phobic controls were confronted with phobia-relevant, generally fear-inducing, disgust-inducing and affectively neutral pictures while an electroencephalogram was recorded. Mean amplitudes of ERPs were extracted in the time windows 340-500 ms (P300) and 550-770 ms (late positive potential, LPP). Phobics showed enhanced P300 and LPP amplitudes in response to spider pictures relative to controls. Sources were mainly located in areas engaged in visuo-attentional processing (occipital and parietal regions, ventral visual pathway). Moreover, there were sources in areas which are crucial for emotional processing and the representations of aversive bodily states (cingulate cortex, insula). Further sources were located in premotor areas reflecting the priming of flight behaviour. Our findings are in good accordance with existing brain imaging studies and underline that source localization is a useful alternative for identifying phobia-relevant cortical regions. © 2011 Elsevier B.V.",Scharmüller W.; Leutgeb V.; Schäfer A.; Köchel A.; Schienle A.,2011.0,10.1016/j.brainres.2011.04.018,0,0,
4138,"The relationship between activating affects, inhibitory affects, and self-compassion in patients with Cluster C personality disorders.","In the short-term dynamic psychotherapy model termed ""Affect Phobia Treatment,"" it is assumed that increase in patients' defense recognition, decrease in inhibitory affects (e.g., anxiety, shame, guilt), and increase in the experience of activating affects (e.g., sadness, anger, closeness) are related to enhanced self-compassion across therapeutic approaches. The present study aimed to test this assumption on the basis of data from a randomized controlled trial, which compared a 40-session short-term dynamic psychotherapy (N = 25) with 40-session cognitive treatment (N = 25) for outpatients with Cluster C personality disorders. Patients' defense recognition, inhibitory affects, activating affects, and self-compassion were rated with the Achievement of Therapeutic Objectives Scale (McCullough et al., 2003b) in Sessions 6 and 36. Results showed that increase in self-compassion from early to late in therapy significantly predicted pre- to post-decrease in psychiatric symptoms, interpersonal problems, and personality pathology. Decrease in levels of inhibitory affects and increase in levels of activating affects during therapy were significantly associated with higher self-compassion toward the end of treatment. Increased levels of defense recognition did not predict higher self-compassion when changes in inhibitory and activating affects were statistically controlled for. There were no significant interaction effects with type of treatment. These findings support self-compassion as an important goal of psychotherapy and indicate that increase in the experience of activating affects and decrease in inhibitory affects seem to be worthwhile therapeutic targets when working to enhance self-compassion in patients with Cluster C personality disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schanche, Elisabeth; Stiles, Tore C; McCullough, Leigh; Svartberg, Martin; Nielsen, Geir Hostmark; Ablon, Alberti, Alexander, Arnett, Arnold, Beck, Benjamin, Blagys, Blatt, Campbell, Carley, Derogatis, Diener, Elliot, Gaston, Germer, Gibbons, Gilbert, Gilbert, Gilbert, Goldried, Grawe, Gray, Gude, Hayes, Hayes, Horowitz, Jones, Junkert-Tress, Kabat-Zinn, Klein, Leichsenring, Levy, Linehan, Malan, McCullough, McCullough, McCullough, McCullough, McCullough-Vaillant, Menninger, Millon, Monsen, Neff, Neff, Neff, Ogden, Rogers, Safran, Schanche, Shore, Shrout, Siefert, Silberschatz, Svartberg, Valen, Vangeneugden, Winston, Young",2011.0,,0,0,
4139,"The relationship between activating affects, inhibitory affects, and self-compassion in patients with Cluster C personality disorders.","In the short-term dynamic psychotherapy model termed ""Affect Phobia Treatment,"" it is assumed that increase in patients' defense recognition, decrease in inhibitory affects (e.g., anxiety, shame, guilt), and increase in the experience of activating affects (e.g., sadness, anger, closeness) are related to enhanced self-compassion across therapeutic approaches. The present study aimed to test this assumption on the basis of data from a randomized controlled trial, which compared a 40-session short-term dynamic psychotherapy (N = 25) with 40-session cognitive treatment (N = 25) for outpatients with Cluster C personality disorders. Patients' defense recognition, inhibitory affects, activating affects, and self-compassion were rated with the Achievement of Therapeutic Objectives Scale (McCullough et al., 2003b) in Sessions 6 and 36. Results showed that increase in self-compassion from early to late in therapy significantly predicted pre- to post-decrease in psychiatric symptoms, interpersonal problems, and personality pathology. Decrease in levels of inhibitory affects and increase in levels of activating affects during therapy were significantly associated with higher self-compassion toward the end of treatment. Increased levels of defense recognition did not predict higher self-compassion when changes in inhibitory and activating affects were statistically controlled for. There were no significant interaction effects with type of treatment. These findings support self-compassion as an important goal of psychotherapy and indicate that increase in the experience of activating affects and decrease in inhibitory affects seem to be worthwhile therapeutic targets when working to enhance self-compassion in patients with Cluster C personality disorders.",Schanche E.; Stiles TC.; McCullough L.; Svartberg M.; Nielsen GH.,2011.0,10.1037/a0022012,0,0,
4140,"Event-related potentials during an auditory discrimination with prepulse inhibition in patients with schizophrenia, obsessive-compulsive disorder and healthy subjects.","Prepulse inhibition (PPI) is a measure of the influence of a stimulus (S1) on the response elicited by a second stimulus (S2) occurring shortly afterwards. Most S1/S2 measures of gating have used behavioural startle and the P50 event-related potential (ERP) amplitudes to detect PPI in a simple paired stimulus paradigm. We report on two behavioural (reaction time, RT, and the electromyographically recorded response of the musculus orbicularis oculi, EMG) and 5 ERP measures of PPI where S2 was the target in an auditory two-tone discrimination. Subjects were 21 healthy controls (CON), 11 obsessive-compulsive (OCD) and 9 schizophrenic patients (SCH). The prepulse 100 ms before S2 induced more omission errors and longer RTs compared to 500ms S1-S2 interval in all subjects. PPI was also evident in EMG, P50, N1, P3 but not P2 or N2 amplitudes of CON subjects. SCH patients showed attenuation of PPI on the same measures. OCD patients were characterized only by their slow RT and a marginal attenuation of PPI of the EMG response. A correlational analysis implied separate relationships of ERP indices of PPI to the cognitive and psychomotor consequences of the prepulse on behavioural and discrimination responses. However, SCH patients showed a general rather than a specific impairment of these indices.",Schall U.; Schön A.; Zerbin D.; Eggers C.; Oades RD.,1996.0,,0,0,
4141,A left temporal lobe impairment of auditory information processing in schizophrenia: an event-related potential study.,"A measure of auditory prepulse inhibition (PPI) is the reduction of the scalp-recorded P1 event-related potential (ERP) after a sound that is preceded by 100-300 ms by a click as prepulse. This measure of sensory gating was adapted to study the effect of a prepulse on processing tones that were part of a 'go no-go' discrimination. ERPs were recorded at right and left, frontal and temporal sites in groups of patients with schizophrenia (SCH) or obsessive compulsive disorder (OCD) and healthy controls (CON). A prepulse 100 ms but not 500 ms before either tone reduced the P1 ERP amplitude in healthy and OCD subjects but not SCH patients. At frontal and temporal recording sites the P1 amplitude was similar bilaterally in controls but showed a right temporal shift in the SCH patients. If the tone was the 'no-go' tone, the prepulse reduced the N1 amplitude in both the CON and SCH groups. The N1 was similar, bilaterally in controls but again showed a right temporal shift in the SCH group. These results show a reduction of a PPI-like effect on early processing (P1) that is more marked in the left hemisphere of SCH patients and may affect channel selection for processing information (N1) about task-relevant sounds.",Schall U.; Schön A.; Zerbin D.; Bender S.; Eggers C.; Oades RD.,1997.0,,0,0,
4142,Characteristics of women at risk for psychosocial distress in the year after breast cancer,"ER PATIENTS AND METHODS: A sample of 227 newly diagnosed breast cancer patients were systematically interviewed by a clinical social worker and classified for risk of psychosocial distress in the year after diagnosis. They completed a battery of standardized instruments to assess quality of life (QL), rehabilitation needs, and psychologic distress. The primary QL instrument, the Cancer Rehabilitation Evaluation System (CARES), provides a detailed listing of rehabilitation needs. Descriptive CARES data are presented with comparisons between the two groups.RESULTS: The at-risk women had significantly more problems with greater severity than the low-risk women in all areas (physical, psychosocial, medical interaction, sexual, and marital). While both groups showed improvement over the year following diagnosis, the at-risk group had significantly more problems 1 year later. Many physical problems subside, but problems at the local surgical site, psychologic distress, communication with marital partners, and negative body image are more persistent in the at-risk group 1 year later, while half of both groups continue to have sexual dysfunction.CONCLUSION: The detailed listing of problems provided by the CARES may be helpful to clinicians in their interactions with patients. The need for preventive and early intervention for the at-risk patients is underscored.PURPOSE: To provide a detailed description of rehabilitation problems of women, considered to be low risk and at risk for psychosocial morbidity, diagnosed with stage I and II breast cancer 1 month and 1 year after primary treatment.","Schag, C A; Ganz, P A; Polinsky, M L; Fred, C; Hirji, K; Petersen, L",1993.0,10.1200/JCO.1993.11.4.783,0,0,
4143,[Evidence of validity of the German version of the TAS-20. Contribution to the 52nd conference of the German Board of Psychosomatic Medicine in Bad Honnef (2001)].,"419 patients (psychosomatic-C/L-service unit; neurotic spectrum, somatoform and personality disorders) were investigated by collecting data of clinical and psychometrical variables (SCL-90-R, NEO-FFI, IIP-D). The aim was to evaluate whether the sum score and the three factors of the German 20-item-version of the Toronto-Alexithymia-Scale (TAS-20) postulated by Bagby correlate with other clinical variables in a convergent way. The TAS-20 sum score and the factors (F1) ""Difficulties identifying feelings"" and (F2) ""Difficulties describing one's feelings"" correlated convergently with the NEO-FFI-scales ""neuroticism"" and ""openness for new experiences"", with numerous scales of the SCL-90-R, as well as with the scales ""cool/repelling"" and ""introverted/social avoiding"" interaction style of the IIP-D. Factor (F3) ""Externally oriented thinking"" correlated with ""Extraversion"" but was not related to clinical impairment (SCL-90 R). The results could be interpreted in terms of convergent validity of the TAS-20. In addition, alexithymic patients seem to be impaired with respect to interpersonal communication and they are subjectively able to perceive appreciate this restriction.",Schäfer R.; Schneider C.; Sitte W.; Franz M.,2002.0,10.1055/s-2002-35279,0,0,
4144,Early detection of psychotic disorders,"ER INCLUSION CRITERIA1. Age 13 to 24 years 2. High Risk (HR) as classified by Yung et al. (1998) HR criteria: one or more of following characteristics occurred within the last 12 months: 1. Frank psychotic symptoms  1 week, several times per week 3. Drop in GAF of > 30% (>1 months) plus family history of psychosis or individual has schizotypal personality disorder Other psychiatric measures: SCID for DSM-IV, PANSS, MADRS, and the UKU side effect rating scale. Between May 2004 and June 2005, 140 individuals were referred to our service for suspected psychosis. 69 individuals (49,3%) met HR criteria, 21 (15%) were detected with first-episode psychosis at initial presentation; 50 (35,7%) individuals did not meet criteria for HR or DSM-IV psychotic disorder. 42 (60,9%) of 69 individuals with HR agreed to participate in the proposed EPA/DHA treatment trial. Co-morbidity of axis-I disorders was high in the HR group: 54,3% affective disorders, 40% anxiety/obsessive-compulsive disorders, 14,3 substance related disorders, 11,4% eating disorders and 2,9% somatoform disorders. To date 6 (14,3%) individuals have made a transition to psychotic disorder. These subjects scored significantly higher at the negative and at the general psychopathology scale ofPANSS and at the MADRS at time of randomization. Early detection and intervention in psychotic disorders seems to be a feasible goal which can be achieved in an outpatient setting. Individuals with HR can be detected and already show a substantial loss of functioning. In the process of screening for individuals with HR a high number of undiscovered cases of psychosis can be found. Given their high prevalence, treatment of comorbid axis-I conditions should be carefully addressed in HR and studied in relation to the risk of progression to psychosis. In contrast to antipsychotics, Omega-3 fatty acids have a high acceptance among youth and parents. At this stage the role of Omega-3 fatty acids remains unclear because the trial is not finished yet.UNLABELLEDOver the last decade there has been considerable interest in early intervention in schizophrenia and other psychotic disorders, driven by observations that early intervention might favorably alter the course of illness. New clinical and research programs have been established around the globe aiming to reduce treatment delays in psychosis and, more recently, to identify and possibly treat individuals in the pre-psychotic phase who are at imminent risk of developing psychosis. Since May 2004, a service for individuals at high risk (HR) for psychosis has been established at Vienna General Hospital. Individuals are offered comprehensive assessment and treatment which includes participation in a RCT investigating the effects of Omega-3 fatty acids versus placebo in addition to standard care. The aim of this article is to describe (1) classification of psychotic symptoms in incipient psychosis and (2) findings of the screening process as well as baseline characteristics in individuals with and without transition to psychosis.","Schäfer, M R; Klier, C M; Papageorgiou, K; Friedrich, M H; Amminger, G P",2007.0,,0,0,
4145,Anxiety disorders: treatable regardless of the severity of comorbid alcohol dependence.,"Clinical and epidemiological research has shown that comorbidity is the rule rather than exception in the case of psychiatric disorders. Cognitive behavioral therapy (CBT) has been clearly demonstrated to be effective in treating anxiety and avoidance symptoms in patient samples of social phobia and agoraphobia without comorbid alcohol use disorders. It has recently been shown that treatment of comorbid anxiety disorders in alcohol-dependent patients can also be very successful. The purpose of the present study was to find predictors of treatment success for comorbid anxiety disorders in alcohol-dependent patients. The study was conducted in a sample of 34 completers with a double diagnosis of alcohol dependence and agoraphobia or social phobia who received CBT for their comorbid anxiety disorder in a 32-week randomized controlled trial comparing alcohol and CBT anxiety disorder treatment with alcohol treatment alone. In the current report, treatment success was defined as a clinically significant change (recovery) on the anxiety discomfort scale. The severity of comorbid alcohol dependence did not influence the beneficial effect of CBT on the anxiety disorder. Psychological distress (SCL-90), neuroticism (NEO N), conscientiousness (NEO C), gender, employment and age of onset of alcohol dependence showed some predictive value. Alcohol-dependent males with a comorbid anxiety disorder seem to benefit most from CBT if their alcohol dependence started after age 25, if they are employed and if their general psychopathology is less severe. The most important conclusion, however, is that even severely alcohol-dependent patients with an anxiety disorder can benefit from psychotherapy for their anxiety disorder.",Schadé A.; Marquenie LA.; van Balkom AJ.; Koeter MW.; de Beurs E.; van Dyck R.; van den Brink W.,2007.0,10.1159/000097941,0,0,
4146,The effectiveness of anxiety treatment on alcohol-dependent patients with a comorbid phobic disorder: a randomized controlled trial.,"Evidence has emerged which indicates that the post-treatment relapse rate for alcohol-dependent patients with a comorbid anxiety disorder is higher than for alcohol-dependent patients without a comorbid anxiety disorder. The question raised by this evidence is whether the relapse rate in these dually diagnosed patients could be reduced if they were given additional treatment for the comorbid anxiety disorder. We attempted to answer this question by conducting a trial among patients with a double diagnosis of alcohol dependence and agoraphobia or social phobia. We conducted a 32-week randomized controlled trial among 96 abstinent patients with a primary diagnosis of alcohol dependence and a comorbid anxiety disorder involving agoraphobia or social phobia. The patients were randomly assigned to an intensive psychosocial relapse-prevention program on its own (n = 49) or in combination with an anxiety treatment program comprising cognitive behavioral therapy (CBT) and optional pharmacotherapy consisting of an SSRI (n = 47). The primary outcome measure was the percentage of patients who suffered an alcohol relapse during a 32-week period. The secondary outcome measures were total abstinence, a reduction in the days of heavy drinking, and less severe anxiety symptoms. Although the additional therapy clearly reduced the anxiety symptoms, it had no significant effect on the alcohol relapse rates. Anxiety treatment for alcohol-dependent patients with a comorbid anxiety disorder can alleviate anxiety symptoms, but it has no significant effect on the outcome of alcohol treatment programs.",Schadé A.; Marquenie LA.; van Balkom AJ.; Koeter MW.; de Beurs E.; van den Brink W.; van Dyck R.,2005.0,,0,0,
4147,[The effectiveness of anxiety treatment on alcohol-dependent patients with a comorbid phobic disorder: a randomised controlled trial].,"There is evidence that the post-treatment relapse rate for alcohol-dependent patients with a comorbid anxiety disorder is higher than for alcohol-dependent patients without this disorder. aim To discover whether the post-treatment relapse rate in alcohol-dependent patients who suffer from both alcohol-dependence and a comorbid anxiety disorder can be lowered by giving them additional treatment specifically for the comorbid anxiety disorder. A 32-week randomised controlled trial among 96 abstinent patients with a primary diagnosis of alcohol dependence and a comorbid anxiety disorder involving agoraphobia or social phobia. The patients were randomly assigned either to an intensive psychosocial relapse-prevention programme only (n = 49) or to a combined programme in which the aforementioned programme was supplemented by an anxiety treatment programme comprising cognitive behavioural therapy and optional pharmacotherapy in the form of an SSRI (n = 47). The primary outcome measure was the percentage of patients who suffered an alcohol relapse during a 32-week period. The secondary outcome measures were: total abstinence, a reduction in the number of days of heavy drinking and a reduction in anxiety symptoms. results Although the anxiety symptoms in the group receiving cognitive behavioural therapy diminished more than in the group not receiving this therapy, the alcohol relapse rates in the former group were not significantly lower than in the latter group. Anxiety treatment for alcohol-dependent patients with a comorbid anxiety disorder can alleviate anxiety symptoms but has no significant effect on the outcome of alcohol treatment programmes.",Schadé A.; Marquenie LA.; van Balkom AJ.; Koeter MM.; van den Brink W.; van Dyck R.,2008.0,,0,0,
4148,The effectiveness of anxiety treatment on alcohol-dependent patients with a comorbid phobic disorder: A randomised controlled trial.,"Background: There is evidence that the post-treatment relapse rate for alcohol-dependent patients with a comorbid anxiety disorder is higher than for alcohol-dependent patients without this disorder. Aim: To discover whether the post-treatment relapse rate in alcohol-dependent patients who suffer from both alcohol-dependence and a comorbid anxiety disorder can be lowered by giving them additional treatment specifically for the comorbid anxiety disorder. Method: A 32-week randomised controlled trial among 96 abstinent patients with a primary diagnosis of alcohol dependence and a comorbid anxiety disorder involving agoraphobia or social phobia. The patients were randomly assigned either to an intensive psychosocial relapse-prevention programme only (n = 49) or to a combined programme in which the aforementioned programme was supplemented by an anxiety treatment programme comprising cognitive behavioural therapy and optional pharmacotherapy in the form of an SSRI (n = 47). The primary outcome measure was the percentage of patients who suffered an alcohol relapse during a 32-week period. The secondary outcome measures were: total abstinence, a reduction in the number of days of heavy drinking and a reduction in anxiety symptoms. Results: Although the anxiety symptoms in the group receiving cognitive behavioural therapy diminished more than in the group not receiving this therapy, the alcohol relapse rates in the former group were not significantly lower than in the latter group. Conclusion: Anxiety treatment for alcohol-dependent patients with a comorbid anxiety disorder can alleviate anxiety symptoms but has no significant effect on the outcome of alcohol treatment programmes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Schade, A; Marquenie, L. A; Van Balkom, A. J. L. M; Koeter, M. W. J; Van Den Brink, W; Van Dyck, R; Beck, Borg, Bowen, Brady, Cohen, Derogatis, Driessen, Fals-Stewart, First, Kessler, Kokkevi, Kranzler, Kushner, Kushner, LaBounty, Marks, Marquenie, Nathan, Oosterbaan, Randall, Regier, Reynaud, Rounsaville, Schade, Schade, Schneider, Schuckit, Watson",2008.0,,0,0,
4149,Incentivizing attendance to prolonged exposure for PTSD with opioid use disorder patients: A randomized controlled trial.,"Objective: To determine whether contingent monetary incentives increase opioid use disorder patients' attendance to Prolonged Exposure (PE) therapy and whether attendance is associated with improvement in posttraumatic stress disorder (PTSD) and substance use disorder (SUD) outcomes. Method: Patients (N = 58) with PTSD were offered PE or PE with incentives (PE + I; max $480) to attend PE sessions. Participants were assessed at baseline and weeks 6, 12, and 24 postrandomization. Results: Participants were mostly women (79%) and Caucasian (71%); mean age 37.43 years (SD = 11.33). PE + I participants attended a median of 9 (of 12) sessions compared to 1 session for PE participants (p < .001), which included more exposure sessions (PE + I mdn = 6; PE mdn = 0; p < .001). A Time x treatment condition interaction indicated that PE + I participants exhibited a greater decrease in PTSD severity over time than PE participants (OR = 3.1; 95% CI = 0.4-5.7; p = .024). PE + I participants remained in substance use treatment longer than PE participants (mdn days = 262 vs. 192; p = .039). There were no group differences in drug use. Conclusions: Monetary incentives increased SUD patients' attendance to an otherwise poorly attended treatment for PTSD. Better attendance in the incentivized group was associated with greater PTSD improvement, better SUD treatment retention, and no increased drug use. Incentives are well supported for improving adherence to substance use treatment goals and promising as a means to improve therapy attendance, which may improve the effectiveness of existing psychotherapies in difficult-to-treat populations. (PsycINFO Database Record (c) 2017 APA, all rights reserved) Impact Statement What is the public health significance of this article?-Patients with comorbid opioid use disorder and PTSD are much more likely to attend Prolonged Exposure therapy sessions if they are incentivized to do so. Prolonged Exposure is associated with greater improvement in PTSD symptoms and substance use disorder treatment retention when patients attend more sessions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Schacht, Rebecca L; Brooner, Robert K; King, Van L; Kidorf, Michael S; Peirce, Jessica M; Back, Berenz, Bisson, Blake, Brady, Bragdon, Brooner, Brooner, Coffey, Coffey, Cottler, Cukor, Derogatis, Devilly, Endicott, Falsetti, First, First, Foa, Foa, Foa, Folstein, Friborg, Gratz, Halpern, Hasin, Hien, Hien, Horvath, Kazdin, Kirby, Kubany, Ledgerwood, Mangrum, McGovern, McLellan, Mick, Mills, Mills, Mills, Mills, Morgan-Lopez, Mulvey, Nacasch, Najavits, Najavits, Olmstead, Ouimette, Paap, Peirce, Peirce, Petry, Petry, Petry, Petry, Pinto, Pitman, Powers, Prinz, Rash, Read, Reger, Reynolds, Rieckmann, Roberts, Sannibale, Stitzer, Triffleman, Triffleman, van Minnen, Weathers, Weathers",2017.0,,0,0,
4150,[Gallbladder blunt trauma: comparison between radiologic and anatomo-surgical findings].,"To assess the diagnostic accuracy and the possible role of ultrasonography (US) and Computed Tomography (CT) in a small group of patients who had a blunt abdominal trauma involving the gallbladder. We retrospectively reviewed the US and CT findings of five patients with surgically confirmed post-traumatic gallbladder injury. The whole series consisted of 196 consecutive patients submitted to laparotomy for blunt abdominal trauma in the past 7 years. The following US and CT findings were considered at least suggestive of a possible post-traumatic gallbladder injury: pericholecystic fluid collection, ill-defined wall margin, collapsed lumen, high intraluminal density. At surgery, the following findings were observed: gallbladder hematoma (1 case), acute colecystitis (1 cases), gallbladder tear (3 cases), gallbladder tear associated with post-traumatic hepatic injuries (2 cases), duodenal tear (2 cases), hemoperitoneum alone (2 cases), hemoperitoneum associated with choleperitoneum (1 case), choleperitoneum alone (1 case). The US and CT findings were pericholecystic fluid collections (4 cases), ill-defined gallbladder wall margins (3 cases), collapsed lumen with intraluminal high density (1 case) and free intraperitoneal fluid collections (4 cases). They were suggestive of a possible post-traumatic gallbladder injury in all the five patients. The radiologic findings of our five patients were suggestive of a gallbladder damage but did not permit to distinguish minor from major injuries, the latter requiring surgical treatment. US proves to be a useful screening tool which can also help timing surgery in these patients. CT confirmed the US suspicions and also permitted accurate assessment of associated post-traumatic injuries to the liver and duodenum. Nevertheless, the clinical presentation was the most important factor as to the therapeutic management of these blunt abdominal trauma patients.",Scaglione M.; Rossi G.; Pinto F.; Forner AL.; Giovine S.; Pinto A.; Vicenzo E.; Romano L.,1998.0,,0,0,
4151,The effect of alcohol on emotional response to a social stressor,"ER Social drinkers were administered either an alcoholic, placebo or no-alcohol control beverage. Subjects were next informed that they were to give a self-disclosing speech about their body and physical appearance. Subjects' heart rate and videotapes of their facial expression were recorded during this instruction. Facial reactions to the stressor were analyzed using a system based on the Maximally Discriminative Facial Coding System (Izard, 1979). Subjects who were intoxicated showed significantly less negative emotion, as measured by the facial expression analysis, than those subjects consuming either the control or placebo beverage. We attribute this effect of alcohol to its actions on subjects' appraisal of anxiety-inducing information.","Sayette, M A; Smith, D W; Breiner, M J; Wilson, G T",1992.0,,0,0,
4152,An evaluation of the balanced placebo design in alcohol administration research,"ER Results from a study using the balanced placebo design to assess alcohol's effects on anxiety raise serious doubts about the utility of the design even at moderate blood alcohol concentrations. Despite being informed that they were not drinking alcohol, 44% of the subjects who were administered alcohol reported consuming at least some alcohol. Moreover, subjects' scores on the Marlowe-Crowne Social Desirability Index (MCSD) were associated with deception success, suggesting that individual differences in reporting bias influence the manipulation. In contrast, only 6% of subjects who were told that they had consumed alcohol but were given tonic water were not deceived. Among subjects in this placebo condition, scores on the MCSD were not associated with success of the deception. These data suggest that at a moderate dose of alcohol, drink deception in the antiplacebo condition is much more difficult to execute than in the placebo condition, and that deception in the former condition may be confounded with experimenter demand.","Sayette, M A; Breslin, F C; Wilson, G T; Rosenblum, G D",1994.0,,0,0,
4153,Parental history of alcohol abuse and the effects of alcohol and expectations of intoxication on social stress,"ER Male and female social drinkers, half of whom had a biological father who abused alcohol, were exposed to a social stressor (anticipation and delivery of a public speech) after consuming either a moderate dose of alcohol or tonic water. Half of each group were led to believe that they had consumed alcohol, the other half tonic water, yielding a 2 x 2 x 2 x 2 factorial design. Intoxication, but not beliefs about having consumed alcohol, significantly reduced subjective anxiety and negative self-evaluation in response to the stressor in both men and women. Parental history of alcohol abuse differentially affected alcohol's influence on mood, but not measures of subjective intoxication, subjective physiological responses to alcohol, beliefs about alcohol's effects on behavior, or reactivity to the stressor.","Sayette, M A; Breslin, F C; Wilson, G T; Rosenblum, G D",1994.0,,0,0,
4154,Randomized Controlled Trial of Online Expressive Writing to Address Readjustment Difficulties Among U.S. Afghanistan and Iraq War Veterans.,"We examined the efficacy of a brief, accessible, nonstigmatizing online intervention-writing expressively about transitioning to civilian life. U.S. Afghanistan and Iraq war veterans with self-reported reintegration difficulty (N = 1,292, 39.3% female, M = 36.87, SD = 9.78 years) were randomly assigned to expressive writing (n = 508), factual control writing (n = 507), or no writing (n = 277). Using intention to treat, generalized linear mixed models demonstrated that 6-months postintervention, veterans who wrote expressively experienced greater reductions in physical complaints, anger, and distress compared with veterans who wrote factually (ds = 0.13 to 0.20; ps < .05) and greater reductions in PTSD symptoms, distress, anger, physical complaints, and reintegration difficulty compared with veterans who did not write at all (ds = 0.22 to 0.35; ps ≤ .001). Veterans who wrote expressively also experienced greater improvement in social support compared to those who did not write (d = 0.17). Relative to both control conditions, expressive writing did not lead to improved life satisfaction. Secondary analyses also found beneficial effects of expressive writing on clinically significant distress, PTSD screening, and employment status. Online expressive writing holds promise for improving health and functioning among veterans experiencing reintegration difficulty, albeit with small effect sizes.",Sayer NA.; Noorbaloochi S.; Frazier PA.; Pennebaker JW.; Orazem RJ.; Schnurr PP.; Murdoch M.; Carlson KF.; Gravely A.; Litz BT.,2015.0,10.1002/jts.22047,0,0,
4155,A retrospective review of clinical characteristics and treatment response in body dysmorphic disorder versus obsessive-compulsive disorder.,"Although body dysmorphic disorder (BDD) has many features in common with obsessive-compulsive disorder (OCD) and is frequently comorbid with OCD, few studies have directly compared the 2 disorders. Although BDD and OCD respond to similar medications and cognitive-behavioral therapy (CBT), their response to treatment has never been directly compared. We studied 107 consecutive patients with DSM-III-R OCD (N = 96) or BDD (N = 11) treated openly for 6 weeks with intensive CBT, medication, and psychosocial rehabilitation, in a specialized partial hospitalization program for severely ill OCD patients. All patients were assessed, before and after treatment, with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Rating Scale for Depression (HAM-D), Hamilton Rating Scale for Anxiety (HAM-A), and Global Assessment Scale (GAS). Retrospectively, we compared the clinical characteristics, symptom severity, and response to treatment of BDD patients with those of OCD patients. BDD patients and OCD patients had similar sex ratio, age, treatment duration, prevalence of comorbid major depression, and pretreatment Y-BOCS and GAS scores. BDD patients had significantly higher pretreatment HAM-D and HAM-A scores. The proportions of patients treated with serotonin reuptake inhibitors and antipsychotics did not differ between groups. Both groups improved with treatment, with significant (p < .001) changes in Y-BOCS, HAM-D, HAM-A, and GAS scores. Change in Y-BOCS did not differ between groups, but changes in HAM-D and HAM-A were significantly greater in BDD patients than in OCD patients. While BDD may be associated with greater severity of depressive and anxiety symptoms than OCD, this study suggests that BDD may respond to intensive, multimodal treatment.",Saxena S.; Winograd A.; Dunkin JJ.; Maidment K.; Rosen R.; Vapnik T.; Tarlow G.; Bystritsky A.,2001.0,,0,0,
4156,Rapid effects of brief intensive cognitive-behavioral therapy on brain glucose metabolism in obsessive-compulsive disorder.,"Brief intensive cognitive-behavioral therapy (CBT) using exposure and response prevention significantly improves obsessive-compulsive disorder (OCD) symptoms in as little as 4 weeks. However, it has been thought that much longer treatment was needed to produce the changes in brain function seen in neuroimaging studies of OCD. We sought to elucidate the brain mediation of response to brief intensive CBT for OCD and determine whether this treatment could induce functional brain changes previously seen after longer trials of pharmacotherapy or standard CBT. [(18)F]-fluorodeoxyglucose positron emission tomography brain scans were obtained on 10 OCD patients before and after 4 weeks of intensive individual CBT. Twelve normal controls were scanned twice, several weeks apart, without treatment. Regional glucose metabolic changes were compared between groups. OCD symptoms, depression, anxiety and overall functioning improved robustly with treatment. Significant changes in normalized regional glucose metabolism were seen after brief intensive CBT (P=0.04). Compared to controls, OCD patients showed significant bilateral decreases in normalized thalamic metabolism with intensive CBT but had a significant increase in right dorsal anterior cingulate cortex activity that correlated strongly with the degree of improvement in OCD symptoms (P=0.02). The rapid response of OCD to intensive CBT is mediated by a distinct pattern of changes in regional brain function. Reduction of thalamic activity may be a final common pathway for improvement in OCD, but response to intensive CBT may require activation of dorsal anterior cingulate cortex, a region involved in reappraisal and suppression of negative emotions.",Saxena S.; Gorbis E.; O'Neill J.; Baker SK.; Mandelkern MA.; Maidment KM.; Chang S.; Salamon N.; Brody AL.; Schwartz JM.; London ED.,2009.0,10.1038/sj.mp.4002134,0,0,
4157,Cervical kinematic training with and without interactive VR training for chronic neck pain - a randomized clinical trial,"ER Impairments in cervical kinematics are common in patients with neck pain. A virtual reality (VR) device has potential to be effective in the management of these impairments. The objective of this study was to investigate the effect of kinematic training (KT) with and without the use of an interactive VR device. In this assessor-blinded, allocation-concealed pilot clinical trial, 32 participants with chronic neck pain were randomised into the KT or kinematic plus VR training (KTVR) group. Both groups completed four to six training sessions comprising of similar KT activities such as active and quick head movements and fine head movement control and stability over five weeks. Only the KTVR group used the VR device. The primary outcome measures were neck disability index (NDI), cervical range of motion (ROM), head movement velocity and accuracy. Kinematic measures were collected using the VR system that was also used for training. Secondary measures included pain intensity, TAMPA scale of kinesiophobia, static and dynamic balance, global perceived effect and participant satisfaction. The results demonstrated significant (p < 0.05) improvements in NDI, ROM (rotation), velocity, and the step test in both groups post-intervention. At 3-month post-intervention, these improvements were mostly sustained; however there was no control group, which limits the interpretation of this. Between-group analysis showed a few specific differences including global perceived change that was greater in the KTVR group. This pilot study has provided directions and justification for future research exploring training using kinematic training and VR for those with neck pain in a larger cohort.","Sarig, Bahat H; Takasaki, H; Chen, X; Bet-Or, Y; Treleaven, J",2015.0,10.1016/j.math.2014.06.008,0,0,
4158,"Safety, pharmacokinetics and pharmocodynamics of recombinant human porphobilinogen deaminase in healthy subjects and asymptomatic carriers of the acute intermittent porphyria gene who have increased porphyrin precursor excretion","ER STUDY DESIGNForty individuals participated in this two-part study: 20 asymptomatic porphobilinogen deaminase-deficient subjects (both male and female) with > or =4 times the upper reference urinary porphobilinogen level, and 20 healthy male subjects. Four different doses of recombinant human porphobilinogen deaminase were studied (0.5, 1, 2 and 4 mg/kg bodyweight). Part A included 12 asymptomatic porphobilinogen deaminase-deficient subjects, and the enzyme was administered in an open-label, single-dose design. Part B included 20 asymptomatic porphobilinogen deaminase-deficient subjects and 20 healthy subjects. The same enzyme dosages were administered as divided doses every 12 hours for 4 consecutive days in a randomised, double-blinded, placebo-controlled design. The washout period between Parts A and B was 2 weeks.METHODSThe concentrations of recombinant human porphobilinogen deaminase and titres of antibodies against recombinant human porphobilinogen deaminase were analysed by ELISA. Plasma porphobilinogen and 5-aminolevulinic acid concentrations were analysed using a novel liquid chromatography-tandem mass spectrometry method. Urinary porphobilinogen, 5-aminolevulinic acid and porphyrin concentrations, as well as plasma porphyrin concentrations, were analysed using standard methods. The pharmacodynamic effect of the enzyme was studied through changes in plasma porphobilinogen concentrations.RESULTSNo serious adverse events were observed. Seven subjects (four healthy men and three asymptomatic porphobilinogen deaminase-deficient subjects) developed antibodies against recombinant human porphobilinogen deaminase but did not experience allergic manifestations. The mean elimination half-lives of the highest doses of recombinant human porphobilinogen deaminase ranged between 1.7 and 2.5 hours for both healthy men and asymptomatic porphobilinogen deaminase-deficient subjects. The area under the plasma concentration-time curve was proportional to the respective dose. In asymptomatic porphobilinogen deaminase-deficient subjects, plasma porphobilinogen concentrations decreased below measurable levels almost instantaneously after administration of any dose of the enzyme. The effect lasted for approximately 2 hours, after which the plasma porphobilinogen concentration slowly increased, reaching about 70% of the initial values 12 hours after administration. There was no effect on plasma 5-aminolevulinic acid concentrations, and there was a transitory increment in porphyrin concentrations. The corresponding concentrations of metabolites in the urine reflected the pattern observed in the plasma.CONCLUSIONSThe recombinant human porphobilinogen deaminase enzyme preparation was found to be safe to administer and effective for removal of the accumulated metabolite porphobilinogen from plasma and urine. The pharmacokinetic profile of recombinant human porphobilinogen deaminase showed dose proportionality, and the elimination half-life was about 2.0 hours for the two highest doses. Thus, clinical grounds were established for investigation of the therapeutic efficacy of the enzyme during periods of overt disease in patients with acute intermittent porphyria.BACKGROUND AND OBJECTIVEAcute intermittent porphyria is an autosomal dominant disorder caused by deficient activity of the third enzyme in the haem biosynthetic pathway, porphobilinogen deaminase. It is characterised by acute, potentially life-threatening neurological attacks that are precipitated by various drugs, reproductive hormones and other factors. During acute attacks, the porphyrin precursors 5-aminolevulinic acid and porphobilinogen accumulate and are excreted at high concentrations in the urine. Current treatment is based on glucose loading and parenteral haem replenishment, which reduce the accumulation of 5-aminolevulinic acid and porphobilinogen. Recently, a new form of treatment based on porphobilinogen deaminase enzyme replacement therapy has been shown to be effective in an acute intermittent porphyria mouse model which, during phenobarbital (phenobarbitone) induction of haem biosynthesis, mimics the biochemical pattern of acute porphyric attacks. The objective of the present study was to investigate the safety, pharmacokinetics and pharmacodynamics of recombinant human porphobilinogen deaminase (P 9808), administered to healthy subjects and asymptomatic porphobilinogen deaminase-deficient subjects with high concentrations of porphobilinogen, the substrate of porphobilinogen deaminase.","Sardh, E; Rejkjaer, L; Andersson, D E; Harper, P",2007.0,10.2165/00003088-200746040-00006,0,0,
4159,The effects of aerobic exercise training on psychosocial aspects of men with type 2 diabetes mellitus,"ER METHODS: 53 men who had type 2 diabetes mellitus for a mean duration of the disease for 3±5 years were selected purposely and classified randomly into experimental (27 patients) and a control group (26 patients). Patients in the experimental group did aerobic exercise training three times a week for eight weeks. The exercise included an aerobic activity for 45 to 60 minutes during which the patients' heart rates were maintained at 60-70 percent of heart rate reserve on ergo meter bikes.RESULTS: The eight-week aerobic exercise training had significant effects on mental health (p = 0.002), subscales of physical symptoms (p = 0.006), and anxiety and insomnia (p = 0.001). It had no significant effects on subscales related to disorder of social functioning (p = 0.117) and depression (p = 0.657).CONCLUSIONS: Aerobic exercise training can be considered as an appropriate program for improving the health of the patients with type 2 diabetes mellitus, and it also can improve their mental health.AIM: This study was conducted to examine the effects of aerobic exercise training on psychosocial aspects (mental health, the aspects of physical symptoms, anxiety and insomnia, social functioning, and depression) in patients with type 2 diabetes mellitus.","Sardar, M A; Boghrabadi, V; Sohrabi, M; Aminzadeh, R; Jalalian, M",2014.0,10.5539/gjhs.v6n2p196,0,0,
4160,Relationships among attention networks and physiological responding to threat,"Although researchers have long hypothesized a relationship between attention and anxiety, theoretical and empirical accounts of this relationship have conflicted. We attempted to resolve these conflicts by examining relationships of attentional abilities with responding to predictable and unpredictable threat – related but distinct motivational process implicated in a number of anxiety disorders. Eighty-one individuals completed a behavioral task assessing efficiency of three components of attention – alerting, orienting, and executive control (Attention Network Test - Revised). We also assessed startle responding during anticipation of both predictable, imminent threat (of mild electric shock) and unpredictable contextual threat. Faster alerting and slower disengaging from non-emotional attention cues were related to heightened responding to unpredictable threat, whereas poorer executive control of attention was related to heightened responding to predictable threat. This double dissociation helps to integrate models of attention and anxiety and may be informative for treatment development.",Sarapas C.; Weinberg A.; Langenecker S.A.; Shankman S.A.,2017.0,10.1016/j.bandc.2016.09.012,0,0,
4161,Acupuncture in alcoholism treatment: a randomized out-patient study,"ER Seventy-two alcoholics were treated with acupuncture to the ear in a randomized single-blind controlled design over 10 weeks. Orthodox points and incorrect points 3-5 mm from orthodox points were used. No initial differences were found regarding social characteristics, the responses to the Swedish version of the Alcohol Use Inventory and the Three-dimensional Personality Questionnaire, indicating a successful randomization. There were non-significant tendencies towards gender differential response after acupuncture treatment (P = 0.07). There was no difference in the number of drinking days or level of craving between treatment and control patients. Among females, those in the treatment group reported reduction of anxiety after 1 month, more often than those in the control group (P < 0.05). Response to acupuncture was not related to personality or drinking pattern. Patients' experience of needle placement was similar in the study and control groups. The effects of acupuncture were less pronounced than those previously reported.","Sapir-Weise, R; Berglund, M; Frank, A; Kristenson, H",1999.0,,0,0,
4162,Yoga versus education for Veterans with chronic low back pain: study protocol for a randomized controlled trial.,"Chronic low back pain is the most frequent pain condition in Veterans and causes substantial suffering, decreased functional capacity, and lower quality of life. Symptoms of post-traumatic stress, depression, and mild traumatic brain injury are highly prevalent in Veterans with back pain. Yoga for low back pain has been demonstrated to be effective for civilians in randomized controlled trials. However, it is unknown if results from previously published trials generalize to military populations. This study is a parallel randomized controlled trial comparing yoga to education for 120 Veterans with chronic low back pain. Participants are Veterans ≥18 years old with low back pain present on at least half the days in the past six months and a self-reported average pain intensity in the previous week of ≥4 on a 0-10 scale. The 24-week study has an initial 12-week intervention period, where participants are randomized equally into (1) a standardized weekly group yoga class with home practice or (2) education delivered with a self-care book. Primary outcome measures are change at 12 weeks in low back pain intensity measured by the Defense and Veterans Pain Rating Scale (0-10) and back-related function using the 23-point Roland Morris Disability Questionnaire. In the subsequent 12-week follow-up period, yoga participants are encouraged to continue home yoga practice and education participants continue following recommendations from the book. Qualitative interviews with Veterans in the yoga group and their partners explore the impact of chronic low back pain and yoga on family relationships. We also assess cost-effectiveness from three perspectives: the Veteran, the Veterans Health Administration, and society using electronic medical records, self-reported cost data, and study records. This study will help determine if yoga can become an effective treatment for Veterans with chronic low back pain and psychological comorbidities. ClinicalTrials.gov: NCT02224183.",Saper RB.; Lemaster CM.; Elwy AR.; Paris R.; Herman PM.; Plumb DN.; Sherman KJ.; Groessl EJ.; Lynch S.; Wang S.; Weinberg J.,2016.0,10.1186/s13063-016-1321-5,0,0,
4163,Use of perfluothane as a component of neurorehabilitation therapy in the acute period in patients with craniocerebral injuries,"ER The effects of perfluothane on the course of posttraumatic period are evaluated in patients with craniocerebral injuries. Forty patients were divided into 2 groups treated and not with perfluothane. Hemodynamics, hemostasis, gaseous exchange and lung ventilation functions, and neurological status were evaluated over the course of treatment. The data evidence a favorable effect of perfluothane on the course of the posttraumatic period in patients with craniocerebral injuries.","Sapaniuk, A I; Kuklova, I I; Bobrinskaia, I G",2002.0,,0,0,
4164,A randomized controlled trial of the child anxiety multi-day program (CAMP) for separation anxiety disorder,"ER While the efficacy of cognitive behavior therapy for childhood anxiety disorders, including separation anxiety disorder (SAD), has been established, tailoring such treatments to particular interests and needs may enhance uptake of evidence-based interventions. The current investigation evaluates the feasibility and preliminary efficacy of an intensive, cognitive-behavioral intervention for girls with SAD provided within the novel context of a 1-week camp-like setting, the Child Anxiety Multi-Day Program (CAMP). Twenty-nine female children aged 7-12 with a principal diagnosis of SAD were randomized to immediate CAMP treatment (n = 15) or waitlist (i.e., delayed treatment; n = 14) condition during the course of this randomized controlled trial. Children in the immediate treatment group evidenced significant reductions in SAD severity, functional impairment, and parent report of child anxiety symptoms relative to the waitlist condition. The intervention's positive therapeutic response suggests one possible delivery model for surmounting difficulties faced in the dissemination of weekly treatments for SAD.","Santucci, L C; Ehrenreich-May, J",2013.0,10.1007/s10578-012-0338-6,0,0,
4165,Caffeine reduces reaction time and improves performance in simulated-contest of taekwondo,"ER The aim of this study was to investigate the effects of caffeine on reaction time during a specific taekwondo task and athletic performance during a simulated taekwondo contest. Ten taekwondo athletes ingested either 5 mg·kg?¹ body mass caffeine or placebo and performed two combats (spaced apart by 20 min). The reaction-time test (five kicks ""Bandal Tchagui"") was performed immediately prior to the first combat and immediately after the first and second combats. Caffeine improved reaction time (from 0.42 ± 0.05 to 0.37 ± 0.07 s) only prior to the first combat (P = 0.004). During the first combat, break times during the first two rounds were shorter in caffeine ingestion, followed by higher plasma lactate concentrations compared with placebo (P = 0.029 and 0.014, respectively). During the second combat, skipping-time was reduced, and relative attack times and attack/skipping ratio was increased following ingestion of caffeine during the first two rounds (all P  0.05), but combat intensity was decreased following placebo (all P < 0.05). In conclusion, caffeine reduced reaction time in non-fatigued conditions and delayed fatigue during successive taekwondo combats.","Santos, V G; Santos, V R; Felippe, L J; Almeida, J W; Bertuzzi, R; Kiss, M A; Lima-Silva, A E",2014.0,10.3390/nu6020637,0,0,
4166,Ethnic/Racial diversity and posttraumatic distress in the acute care medical setting.,"Recent commentary has advocated for epidemiological investigation as a foundational science for understanding disparities in the delivery of mental health care and for the development of early trauma-focused interventions. Few acute care investigations have examined the diversity of ethnic/racial heritages or compared variations in early posttraumatic distress in representative samples of injured trauma survivors. Hospitalized injury survivors at two United States level I trauma centers were randomly approached in order to document linguistic and ethnic/racial diversity. Approximately 12% of patients approached were non-English speaking with 16 languages represented. English speaking, inpatients were screened for posttraumatic stress disorder, peritraumatic dissociative, and depressive symptoms. For 269 English speaking study participants, ethnic/racial group status was clearly categorized into one group for 72%, two groups for 25%, and three groups for 3% of participants. Regression analyses that adjusted for relevant clinical and demographic characteristics revealed that relative to whites, patients from American Indian, African American, Hispanic, and Asian heritages demonstrated significant elevations in one or more posttraumatic symptom clusters. A remarkable diversity of heritages was identified, and posttraumatic distress was elevated in ethnic/racial minority patients. Policy-relevant clinical investigations that combine evidence-based treatments, bilingual/bicultural care-management strategies, and support for trauma center organizational capacity building may be required in order to enhance the quality of mental health care for diverse injured trauma survivors.",Santos MR.; Russo J.; Aisenberg G.; Uehara E.; Ghesquiere A.; Zatzick DF.,2008.0,10.1521/psyc.2008.71.3.234,0,0,
4167,The construct validity of the health utilities index mark 3 in assessing health status in lung transplantation.,"To assess the cross-sectional construct validity of the Health Utilities Index Mark 3 (HUI3) in lung transplantation. Two hundred and thirteen patients (103 pre-transplant and 110 post-transplant) with mean age 53 years old (SD 13) were recruited during a randomized controlled clinical trial at the out-patient clinic in a tertiary institution. At baseline, patients self-completed measures that included the HUI3, EuroQol EQ-5D, Hospital Anxiety and Depression Scale (HADS) and socio-demographic questionnaire. Six-minute walk test scores and forced expiratory volume in 1 second data were collected from patient's medical records. A priori hypotheses were formulated by members of the transplant team about the expected degree of association between the measures. Correlation coefficients of < 0.1 were considered as negligible, 0.1 to < 0.3 as small, 0.3 to < 0.5 as medium, and ‚â• 0.5 as large. Of the ninety predictions made, forty three were correct but in 31 the correlation was slightly lower than predicted and in 7 the correlations were much higher than predicted. In 48% of the cases, predicted and observed associations were in agreement. Predictions of associations were off by one category in 42% of the cases; in 10% of the cases the predictions were off by two categories. This is the first study providing evidence of cross-sectional construct validity of HUI3 in lung transplantation. Results indicate that the HUI3 was able to capture the burden of lung disease before transplantation and that post-transplant patients enjoyed higher health-related quality of life than pre-transplant patients.",Santana MJ.; Feeny D.; Ghosh S.; Nador RG.; Weinkauf J.; Jackson K.; Schafenacker M.; Zuk D.; Hubert G.; Lien D.,2010.0,10.1186/1477-7525-8-110,0,0,
4168,Benzodiazepine Exposure and History of Trauma [4],,Sansone R.A.; Hruschka J.; Vasudevan A.; Miller S.N.,2003.0,10.1176/appi.psy.44.6.523,0,0,
4169,Imagining the future in health anxiety: the impact of rumination on the specificity of illness-related memory and future thinking.,"Individuals with health anxiety experience catastrophic fears relating to future illness. However, little research has explored cognitive processes involved in how health anxious individuals picture the future. Ruminative thinking has been shown to impede the ability to recall specific autobiographical memories, which in turn is related to maladaptive, categoric future thinking processes. This study examined the impact of rumination on memory and future thinking among 60 undergraduate participants with varying health anxiety (35% clinical-level health anxiety). Participants were randomized to experiential/ruminative self-focus conditions, then completed an Autobiographical Memory Test and Future Imaginings Task. Responses were coded for specificity and the presence of illness concerns. Rumination led to more specific illness-concerned memories overall, yet at the same time led to more categoric illness-related future imaginings. Rumination and health anxiety together best predicted overgeneral illness-related future imaginings. Highly specific illness-related memories may be maintained due to their personal salience. However, more overgeneral illness-related future imaginings may reflect cognitive avoidance in response to the threat of future illness. This divergent pattern of results between memory and future imaginings may exacerbate health anxiety, and may also serve to maintain maladaptive responses among individuals with realistic medical concerns, such as individuals living with chronic illness.",Sansom-Daly UM.; Bryant RA.; Cohn RJ.; Wakefield CE.,2014.0,10.1080/10615806.2014.880111,0,0,
4170,Testing the Job Demand-Control-Support model with anxiety and depression as outcomes: the Hordaland Health Study,"ER METHODSFive thousand five hundred and sixty-two workers with valid Demand-Control-Support Questionnaire (DCSQ) scores were examined with the sub-scales of the Hospital Anxiety and Depression Scale as outcomes. Multiple statistical methods were applied.RESULTSThe strain and iso-strain hypotheses were confirmed. Generally, additive and non-interaction effects were found between psychological demands, control and social support. The buffer hypotheses were refuted. Results from analyses testing different interaction operationalizations were complementary.CONCLUSIONSHigh demands, low control and low support individually, but particularly combined, are risk factors for anxiety and depression. Support is the DCSQ index most strongly associated with anxiety and depression in women. Assessment of psychosocial work environment may identify workers at risk, and serve as a basis for job-redesign.AIMTo test the strain/iso-strain, interaction and buffer hypotheses of the Job Demand-Control-Support model in relation to anxiety and depression.","Sanne, B; Mykletun, A; Dahl, A A; Moen, B E; Tell, G S",2005.0,10.1093/occmed/kqi071,0,0,
4171,Effect of high-voltage pulsed current plus conventional treatment on acute ankle sprain.,"The effectiveness of high-voltage pulsed current (HVPC) treatments in humans as a means of controlling edema and post-traumatic pain has not yet been established. To analyze the effects of HVPC plus conventional treatment on lateral ankle sprains. This was a randomized, controlled, double-blind clinical trial with three intervention groups: CG (control group with conventional treatment); HVPC(-) group (conventional treatment plus negative polarity HVPC); HVPC+ group (conventional treatment plus positive polarity HVPC). Twenty-eight participants with lateral ankle sprain (2 to 96 h post-trauma) were evaluated. Conventional treatment consisted of cryotherapy (20 min) plus therapeutic exercises. Additionally, the HVPC(-) and HVPC+ groups received 30 min of electrical stimulation (submotor level; 120 pps). Pain, edema, range of motion (ROM) and gait were assessed before the first treatment session and after the last treatment session. At the final evaluation, there were no significant differences between groups. Nevertheless, the HVPC(-) group had greater values in all assessed parameters. The data analysis showed that the HVPC(-) group had greater reductions in volume and girth, and greater recovery of ROM and gait velocity. This group also reached the end of the treatment (1.7 weeks; range 1.2-2.2) faster than the HVPC+ group and the CG (2.2 weeks; range 1.8-2.6). There were no differences between the study groups, but the results suggest that HVPC(-) can accelerate the initial phase of recovery from ankle sprain. Article registered in the Clinical Trials.gov under the number NCT 00732017.",Sandoval MC.; Ramirez C.; Camargo DM.; Salvini TF.,,,0,0,
4172,Effect of high-voltage pulsed current plus conventional treatment on acute ankle sprain,"ER OBJECTIVETo analyze the effects of HVPC plus conventional treatment on lateral ankle sprains.METHODSThis was a randomized, controlled, double-blind clinical trial with three intervention groups: CG (control group with conventional treatment); HVPC(-) group (conventional treatment plus negative polarity HVPC); HVPC+ group (conventional treatment plus positive polarity HVPC). Twenty-eight participants with lateral ankle sprain (2 to 96 h post-trauma) were evaluated. Conventional treatment consisted of cryotherapy (20 min) plus therapeutic exercises. Additionally, the HVPC(-) and HVPC+ groups received 30 min of electrical stimulation (submotor level; 120 pps). Pain, edema, range of motion (ROM) and gait were assessed before the first treatment session and after the last treatment session.RESULTSAt the final evaluation, there were no significant differences between groups. Nevertheless, the HVPC(-) group had greater values in all assessed parameters. The data analysis showed that the HVPC(-) group had greater reductions in volume and girth, and greater recovery of ROM and gait velocity. This group also reached the end of the treatment (1.7 weeks; range 1.2-2.2) faster than the HVPC+ group and the CG (2.2 weeks; range 1.8-2.6).CONCLUSIONSThere were no differences between the study groups, but the results suggest that HVPC(-) can accelerate the initial phase of recovery from ankle sprain. Article registered in the Clinical Trials.gov under the number NCT 00732017.BACKGROUNDThe effectiveness of high-voltage pulsed current (HVPC) treatments in humans as a means of controlling edema and post-traumatic pain has not yet been established.","Sandoval, M C; Ramirez, C; Camargo, D M; Salvini, T F",2010.0,,0,0,4171
4173,Long-term effects of the family bereavement program on multiple indicators of grief in parentally bereaved children and adolescents,"ER METHOD: Participants were 244 youths (ages 8-16, mean age = 11.4 years) from 156 families that had experienced the death of a parent. The sample consisted of 53% boys and 47% girls; ethnicity was 67% non-Hispanic White and 33% ethnic minority. Families were randomly assigned to the FBP (N = 135) or a literature control condition (N = 109). Two grief measures, the Texas Revised Inventory of Grief and the Intrusive Grief Thoughts Scale (IGTS) were administered at 4 times over 6 years: pretest, posttest, and 11-month and 6-year follow-ups. A 3rd measure, an adaptation of the Inventory of Traumatic Grief (ITG) was administered only at the 6-year follow-up.RESULTS: Compared with the control group, the FBP group showed a greater reduction in their level of problematic grief (IGTS) at posttest and 6-year follow-up and in the percentage at clinical levels of problematic grief at the posttest. The FBP also reduced scores on a dimension of the ITG, Social Detachment/Insecurity, at 6-year follow-up for 3 subgroups: those who experienced lower levels of grief at program entry, older youths, and boys.CONCLUSION: These are the first findings from a randomized trial with long-term follow-up of the effects of a program to reduce problematic levels of grief of parentally bereaved youths.OBJECTIVES: This article reports on results from a randomized experimental trial of the effects of the Family Bereavement Program (FBP) on multiple measures of grief experienced by parentally bereaved children and adolescents over a 6-year period.","Sandler, I N; Ma, Y; Tein, J Y; Ayers, T S; Wolchik, S; Kennedy, C; Millsap, R",2010.0,10.1037/a0018393,0,0,
4174,The generalizability of cognitive behavior therapy for panic disorder.,"Examined the generalizability of manual-driven cognitive-behavior therapy (CBT) for panic disorder to a clinical setting representing an ethnically diverse population. This treatment had previously been shown to be effective in a controlled clinical trial at a research clinic (D. H. Barlow et al; see record 1989-33676-001). In the present study, 30 patients with panic disorder with agoraphobia received 12 sessions of CBT. Patients were evaluated at pre- and posttreatment with measures assessing the full spectrum of symptoms associated with panic disorder (panic attacks, agoraphobia, generalized anxiety, depression). Following treatment, there were significant and clinically meaningful reductions on all measures. In order to determine how well the efficacy of CBT generalizes to nonresearch clinical settings and to ethnically diverse urban populations, data in the study were compared to those collected by Barlow et al. Patients in the present clinical setting showed higher pretreatment levels of symptomatology than patients in Barlow and colleagues' research setting, but similar posttreatment symptom levels and response rates. Thus, this study provides evidence for the generalizability of CBT from clinical research centers to clinically representative settings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Sanderson, William C; Raue, Patrick J; Wetzler, Scott",1998.0,,0,0,
4175,Eye movement desensitization versus image confrontation: A single-session crossover study of 58 phobic subjects,"Eye movement desensitization (EMD) and a control procedure, image confrontation (IC) were compared in a group of 58 phobics, 31 of them arachnophobes. Subjects confronted disturbing images in a single-session crossover trial. Anxiety levels were recorded on the SUD Scale. Whenever practicable, SUDs to feared objects were also recorded. EMD and IC were equally effective in reducing anxiety levels. After 1 month, during which subjects were encouraged to use IC daily, improvement was maintained. Since exposure to the disturbing image is common to both methods it must be presumed to be the basis of change when EMD is used in cases of phobia.",Sanderson A.; Carpenter R.,1992.0,10.1016/0005-7916(92)90049-O,0,0,
4176,Atmospheric electromagnetism: individual differences in brain electrical response to simulated sferics.,"The living organism is constantly affected by natural electromagnetic influences covering a wide range of frequencies and amplitudes. One of these natural influences is represented by a phenomenon called atmospherics or sferics. Sferics are very weak electromagnetic impulses generated by atmospheric discharges (lightning). With a newly developed simulation system it was possible to reproduce a previously registered sferics signal and present it to 52 subjects while recording the electroencephalogram (EEG). The repeated application of this stimulus for ten minutes evoked a significant decrease in alpha power in parietal and occipital regions compared to the control condition without sferics presentation. Two constitutional factors were revealed as mediators of sferics effectiveness: the general physical condition of the subjects, and their neuroticism. Individuals with many somatic complaints and a high degree of emotional lability did not respond to the sferics stimulation. This absence of a response is interpreted as an adaptational deficit in reaction to variations in atmospheric parameters.",Schienle A.; Stark R.; Kulzer R.; Klöpper R.; Vaitl D.,,,0,0,
4177,"Neural responses of OCD patients towards disorder-relevant, generally disgust-inducing and fear-inducing pictures.","This functional magnetic resonance imaging study investigated the disgust- and fear-reactivity of patients suffering from obsessive-compulsive disorder (OCD). Ten OCD patients were scanned while viewing blocks of pictures showing OCD triggers from their personal environment and OCD-irrelevant disgust-inducing, fear-inducing and neutral scenes. Afterwards, the patients rated the intensity of the induced disgust, fear and OCD symptoms. The responses were compared with those of 10 healthy control subjects. The disorder-relevant pictures provoked intense OCD symptoms in the clinical group associated with increased activation in the bilateral prefrontal cortex, the left insula, the right supramarginal gyrus, the left caudate nucleus and the right thalamus. The patients gave higher disgust and fear ratings than the controls for all aversive picture categories. Neural responses towards the disorder-irrelevant disgusting and fear-inducing material included more pronounced insula activation in patients than controls. Summarizing, photos of individual OCD-triggers are an effective means of symptom provocation and activation of the fronto-striato-thalamo-parietal network. The increased insular reactivity of OCD patients during all aversive picture conditions might mirror their susceptibility to experience negative somatic states.",Schienle A.; Schäfer A.; Stark R.; Walter B.; Vaitl D.,2005.0,10.1016/j.ijpsycho.2004.12.013,0,0,
4178,The effects of self-administered cognitive therapy on social-evaluative anxiety.,"Investigated the efficacy of self-administered cognitive therapy (RET) in the treatment of high and chronic social anxiety. Forty-five socially anxious volunteer students, who scored in the upper 15% of 570 students prescreened with the Social Avoidance and Distress Scale, were matched on SAD scores and randomly assigned to self-administered cognitive therapy (RET), a self-administered attention placebo condition (Logo-therapy), or a no-treatment control condition. Pretest and posttest measures included the Social Avoidance and Distress Scale (SAD), Fear of Negative Evaluation Scale (FNE), State-Trait Anxiety Inventory, and Rotter's Internal-External Locus of Control Scale. Results indicated that self-administered cognitive therapy significantly decreased social anxiety and fear of negative evaluation and also suggested a generalization of effects as trait anxiety significantly decreased. Comparisons of mean change scores with therapist administered studies lend support to the conclusion that self-administered cognitive restructuring is an effective means of decreasing social-evaluative anxiety. Mean change scores suggest that participants may have attained therapeutic benefits as a consistent trend toward decreased anxiety across variables.",Schelver SR.; Gutsch KU.,1983.0,,0,0,
4179,The impact of addiction medications on treatment outcomes for persons with co-occurring PTSD and opioid use disorders.,"Previous research has been inconclusive about whether adding psychosocial treatment to medication assisted treatment (MAT) improves outcomes for patients with co-occurring psychiatric and opioid use disorders. This study evaluated the impact of MAT and psychosocial therapies on treatment outcomes for patients with co-occurring opioid use disorders and PTSD. Patients meeting criteria for PTSD and substance use disorders were randomly assigned to one of three treatment conditions: Standard Care (SC) alone, Integrated Cognitive Behavioral Therapy (ICBT) plus SC, or Individual Addiction Counseling (IAC) plus SC. Substance use and psychiatric symptoms were assessed at baseline and 6 months. Only patients with opioid use disorders were included in the present analyses (n‚Äâ=‚Äâ126). Two-way ANOVAS and logistic regression analyses were used to examine associations between treatment conditions and MAT, for substance use and psychiatric outcomes. MAT patients receiving ICBT had significantly decreased odds of a positive urine drug screen, compared to non-MAT patients receiving SC alone (OR‚Äâ=‚Äâ.07, 95% CI‚Äâ=‚Äâ.01, .81, p‚Äâ=‚Äâ.03). For PTSD symptoms, a significant MAT by psychosocial treatment condition interaction demonstrated that MAT patients had comparable declines in PTSD symptoms regardless of psychosocial treatment type (F(2, 88)‚Äâ=‚Äâ4.74, p‚Äâ=‚Äâ.011). Non-MAT patients in ICBT had significantly larger reductions in PTSD. For patients with co-occurring opioid use disorders and PTSD, MAT plus ICBT is associated with more significant improvement in substance use. For non-MAT patients, ICBT is most beneficial for PTSD symptoms.",Saunders EC.; McGovern MP.; Lambert-Harris C.; Meier A.; McLeman B.; Xie H.,2015.0,10.1111/ajad.12292,0,0,
4180,Emotional hyper-reactivity in borderline personality disorder is related to trauma and interpersonal themes.,"Heightened emotional reactivity is one of the core features of borderline personality disorder (BPD). However, recent findings could not provide evidence for a general emotional hyper-reactivity in BPD. The present study examines the emotional responding to self-relevant pictures in dependency of the thematic category (e.g., trauma, interpersonal interaction) in patients with BPD. Therefore, women with BPD (n=31), women with major depression disorder (n=29) and female healthy controls (n=33) rated pictures allocated to thematically different categories (violence, sexual abuse, interaction, non-suicidal self-injury, and suicide) regarding self-relevance, arousal, valence and the urge of non-suicidal self-injury. Compared to both control groups, patients with BPD reported higher self-relevance regarding all categories, but significantly higher emotional ratings only for pictures showing sexual abuse and interpersonal themes. In addition, patients with BPD and comorbid posttraumatic stress disorder showed higher emotional reactivity in violence pictures. Our data provide clear evidence that patients with BPD show a specific emotional hyper-reactivity with respect to schema-related triggers like trauma and interpersonal situations. Future studies are needed to investigate physiological responses to these self-relevant themes in patients with BPD.",Sauer C.; Arens EA.; Stopsack M.; Spitzer C.; Barnow S.,2014.0,10.1016/j.psychres.2014.06.041,0,0,
4181,"Effect of integrated yoga on anxiety, depression & well being in normal pregnancy.","To study the effect of integrated yoga on Pregnancy experience, anxiety, and depression in normal pregnancy. This Prospective Randomized control study recruited 96 women in 20th week of normal pregnancy. Yoga group (n = 51) practiced integrated yoga and control group (n = 45) did standard antenatal exercises, one hour daily, from 20th to 36th week of gestation. Mann-Whitney and Wilcoxon's tests were used for statistical analysis. There was significant difference between groups (Mann-Whitney p < 0.001) in all variables. There were significant changes within groups (Wilcoxon's p < 0.001) in both groups. Pregnancy related experience (PEQ) reduced in yoga by 26.86%, State (STAI I) anxiety (decreased 15.65% in yoga, increased 13.76% in control), Trait (STAI II) anxiety (decreased 8.97% in yoga, increased 5.02% in control) and Depression (HADS) (decreased 30.67% in yoga, increased 3.57% in control). Yoga reduces anxiety, depression and pregnancy related uncomfortable experiences.",Satyapriya M.; Nagarathna R.; Padmalatha V.; Nagendra HR.,2013.0,10.1016/j.ctcp.2013.06.003,0,0,
4182,A double-blind crossover comparison of clomipramine and desipramine in the treatment of panic disorder.,"Compared the efficacy of clomipramine hydrochloride (CMI), a serotonin reuptake inhibitor with the noradrenergic tricyclic antidepressant agent, and desipramine hydrochloride (DMI) for patients with panic disorder (PD). Following a 2-wk, single-blind placebo washout phase, 17 PD outpatients (aged 26-55 yrs) completed a 16-wk, double-blind, crossover comparison of CMI and DMI. Key outcome measures included panic attack frequency; the NIMH Global Scales for Anxiety, Depression, and Impairment; Hamilton Anxiety Scale (Psychic and Somatic Subscales); Zung Anxiety Inventory (Raw and Index Subscales); and the Spielberger State Anxiety Scale. Results show that both CMI and DMI led to significant improvement from baseline placebo state in panic attack frequency and behavioral ratings. CMI led to a greater reduction in the frequency of panic attacks and was superior to DMI on ratings of anxiety: NIMH Global Anxiety, Zung Anxiety Scale (Raw and Index), and the Spielberger Anxiety Scale. No difference was found between the drugs on the NIMH Global Impairment Scale and the Hamilton Somatic and Psychic Scales. Both drugs appeared to have significant therapeutic effects in patients with PD, but CMI appeared to be more effective. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sasson, Yehuda; Iancu, Iulian; Fux, Mendel; Taub, Migdala; Dannon, Pinhas N; Zohar, Joseph",1999.0,,0,0,
4183,Treatment of dyspnea in COPD. A controlled clinical trial of dyspnea management strategies.,"We conducted a randomized clinical trial to evaluate a limited pulmonary rehabilitation program focused on coping strategies for shortness of breath but without exercise training. Eighty-nine patients with COPD were randomly assigned to either 6-week treatment or general health education control groups. Treatment consisted of instruction and practice in techniques of progressive muscle relaxation, breathing retraining, pacing, self-talk, and panic control. Tests of 6-min walk distance, quality of well-being, and psychological function as well as six dyspnea measures were administered at baseline, posttreatment, and 6 months after the intervention. Baseline pulmonary function tests also were obtained. At the end of the 6-week treatment, there were no significant differences between the treatment and control groups on any outcome measure. At the 6-month follow-up, a significant group difference was seen on only one variable, Mahler's transition dyspnea index. The results of this evaluation suggest that a treatment program of dyspnea management strategies, without structured exercise training or other components of a comprehensive pulmonary rehabilitation program, is not sufficient to produce significant improvement in dyspnea, exercise tolerance, health-related quality of well-being, anxiety, or depression.",Sassi-Dambron DE.; Eakin EG.; Ries AL.; Kaplan RM.,1995.0,,0,0,
4184,Some clinical and social aspects of lysergic acid diethylamide. I.,,Sarwer-Foner GJ.,,,0,0,
4185,Psychophysiological assessment of driving phobia,"Sixteen driving phobic subjects were compared with 15 non-phobic controls on various psychological and physiological measures. Some measures were taken in standardized anxiety-eliciting situations that were part of an in vivo Behavioral Avoidance Test (BAT) with 10 steps, beginning with 'Sitting in the driver's seat in the parked car' and ending with 'Changing lanes on a freeway.' At the end of each step, a rating of subjective anxiety was obtained. Throughout the BAT, physiological data were recorded with a portable 4-channel tape recorder. The following variables were calculated: Heart rate (HR), T-wave amplitude, respiratory rate, respiratory minute volume, respiratory sinus arrhythmia, and body movement. The mean of the first four 30-sec epochs of each BAT step was entered into statistical analyses. Compared to the controls, phobic subjects exhibited higher trait and state anxiety, more agoraphobic avoidance, a higher depression score, and less perceived internal control. Five driving phobics failed to complete the BAT. Phobics showed greater increases over successive BAT steps than controls in HR and subjective anxiety. In addition, respiratory minute volume was higher in phobics than controls when subjective anxiety was at a maximum. There were no group differences in respiratory rate, respiratory sinus arrhythmia, or T-wave amplitude.",Sartory G.; Roth W.T.; Kopell M.L.,1992.0,,0,0,
4186,Vagal innervation techniques in the treatment of panic disorder.,,Sartory G.; Olajide D.,1988.0,,0,0,
4187,Safety-signal therapy in agoraphobics: a preliminary test.,"It has been argued that persistent avoidance behaviour is strongly influenced by safety signals, and that agoraphobic avoidance behaviour is a clinical example of this influence. It was proposed that agoraphobic avoidance can be reduced by the judicious use of safety signals, and specifically, by training patients to travel towards rather than away from safety. A safety-signal technique in which the patient travelled towards the therapist at the most fear-inducing situations was compared with conventional therapist-assisted exposure. In the second part of the treatment programme, both groups of agoraphobics were given homework assignments. The safety-signal technique resulted in slightly better clinical gains than those achieved by therapist assisted exposure, but after these relatively brief programmes, the improvements in both groups were weak. Global clinical outcome was influenced by age, chronicity and long-term benzodiazepine use.",Sartory G.; Master D.; Rachman S.,1989.0,,0,0,
4188,"Effects of diazepam on approach, self-reported fear and psychophysiological responses in snake phobics.","The effects of diazepam was assessed on a number of measures of phobic anxiety. Snake-phobic subjects underwent two sessions on either diazepam or placebo in a crossover design. In addition to a habituation series, a slide with the phobic object was displayed as well as a live snake which subjects were asked to approach. The anxiolytic effect of diazepam was manifest in only one measure of fear, namely self-rated fear at the point of closest approach when it also attained the highest level. The result would indicate that diazepam has an anxiolytic only on high levels of subjective anxiety. The magnitude of the phasic cardiac reaction to the slide was highly and positively correlated with self-rated fear of the slide.",Sartory G.; MacDonald R.; Gray JA.,1990.0,,0,0,
4189,Maintenance of within session habituation of the cardiac response to phobic stimulation,"Previous studies suggested that high intensity exposure and retarded habituation within a session facilitated the return of fear. The effect of these two conditions on maintenance of habituation was assessed for short and long latency cardiac responses and electrodermal activity (EDA) in phobic subjects. Slides of phobic material were presented 6 times in each of two sessions, with a 24 hour period between sessions. Subjects were allocated to groups according to the magnitude of the initial phasic cardiac response to the slide and further subdivided according to habituation of that response within the first session. The majority of high cardiac responders also showed cardiac long-latency responses. All groups evidenced response recovery in the second session. However, high cardiac responders who had shown retarded habituation within the first session again exhibited delayed habituation in the second session compared with all other groups. While initial cardiac reactivity was not reflected in EDA, the degree of cardiac habituation was associated with differences in both tonic and phasic EDA. Response recovery in the second session could thus not be shown to be a function of either initial response magnitude or within session habituation alone. Instead the simultaneous presence of both conditions resulted in retarded habituation during the second session.",Sartory G.; Eves F.; Foa E.,1987.0,,0,0,
4190,Anxiolytic effect of carbamazepine in experimentally-induced anxiety,"The effects of a single oral dose of carbamazepine (CBZ, 200mg), diazepam (DZP, 5mg) or placebo (PLA) were studied in healthy volunteers submitted to the Video-Recorded Stroop Color-Word Test (VRSCWT), under double-blind conditions. Twenty-four subjects were randomly assigned to each treatment group (eight in each) and submitted to the State-Trait Anxiety Inventory (STAI) before, during and after the test situation. The results showed that CBZ treatment prevented the increase of state-anxiety scores observed after submitting the subjects to the VRSCWT. Anxiety scores after DZP did not differ from the PLA or CBZ group. We concluded that carbamazepine exerts a possible anxiolytic effect in the Stroop-Color Word model of anxiety induction.",Sartori V.A.; Andreatini R.; Leite J.R.,1993.0,,0,0,
4191,Clinical effectiveness of a hydrophobic coating used in conjunction with a one-step self-etch adhesive: an 18-month evaluation,"ER The purpose of this randomized clinical trial was to evaluate the clinical performance of a one-step self-etch adhesive in noncarious cervical lesions with inclusion of a hydrophobic bonding layer not included in the original bonding system as a test of potentially improved bonding. Patients with noncarious cervical lesions received two or four restorations after being randomly assigned to two adhesive technique protocols (n=32): EB, application of Adper Easy Bond (3M ESPE) following manufacturer's instructions; and EB+B, application of Adper Easy Bond, immediately followed by the application of a hydrophobic resin coat (Scotchbond Multi-Purpose Bonding Agent, 3M ESPE). All restorations were restored with a microhybrid composite (Filtek Z250, 3M ESPE). Clinical effectiveness was recorded in terms of retention, marginal discoloration, marginal integrity, postoperative sensitivity, recurrent caries, periodontal health, and pulpal vitality, according to the modified USPHS criteria, for 18 months. Data were analyzed using chi-square, Fisher exact, and McNemar tests at ?=0.05. Two restorations of each group were debonded after six months, leading to an overall clinical success rate of 93.8% for both groups. At the 18-month evaluation period, no new restoration was debonded. However, one restoration of the EB group displayed recurrent caries at the dentin margin, decreasing the overall success rate to 90.6% in comparison to 93.8% of EB+B. The success rate between EB and EB+B was not statistically significant (p=0.5). The application of a hydrophobic resin coat over EB did not increase bonding effectiveness in noncarious cervical lesions after 18 months.","Sartori, N; Peruchi, L D; Guimar√£es, J C; Silva, S B; Monteiro, S; Baratieri, L N; Belli, R",2013.0,10.2341/12-014-C,0,0,
4192,Participant characteristics as modifiers of response to N-acetyl cysteine (NAC) in obsessive-compulsive disorder.,"We previously reported on a 16-week, double-blind, randomized placebo-controlled trial (RCT) using 3 grams per day of N-acetyl cysteine (NAC) (1.5 grams twice per day) in 44 participants (aged 18-70) with DSM-5-diagnosed obsessive-compulsive disorder (OCD). We now report on an analysis of age, severity and duration of illness, OCD presentation type, baseline anxiety and depression scores, as well as the use of antidepressant medications as potentially modifying factors. Results revealed a significant effect (p = .037) for younger participants (under mean age of 34) responding to NAC. This remained significant using OCD severity as a covariate (p = .044). For those under 34 years of age with less than 17 years of OCD duration, this was also significant (p = .037). Regression analysis within the NAC treatment group also revealed that duration of OCD presentation was a significant predictor of Yale-Brown Obsessive Compulsive Scale (YBOCS) change at study endpoint (p = .019), whereas baseline Montgomery-Asberg Depression Rating Scale scores were also a trend-level predictor (p = .060) of YBOCS change in the NAC group. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Sarris, Jerome; Oliver, Georgina; Camfield, David A; Dean, Olivia M; Afshar, Bandelow, Berk, Berk, Bloch, Choy, Costa-Campos, De Rosa, Deepmala, Franklin, Garcia, Garcia, Giustarini, Goldberg, Goodman, Grant, Guy, Hamilton, Han, Magalhaes, Miyamoto, Montgomery, Moran, Oliver, Pallanti, Pauls, Sarris, Slade, Steullet, Van Ameringen, Wheaton",2016.0,,0,0,
4193,"The Kava Anxiety Depression Spectrum Study (KADSS): A randomized, placebo-controlled crossover trial using an aqueous extract of Piper methysticum.","Rationale Piper methysticum (Kava) has been withdrawn in European, British, and Canadian markets due to concerns over hepatotoxic reactions. The WHO recently recommended research into ""aqueous"" extracts of Kava. Objective The objective of this study was to conduct the first documented human clinical trial assessing the anxiolytic and antidepressant efficacy of an aqueous extract of Kava. Design and participants The Kava Anxiety Depression Spectrum Study was a 3-week placebo-controlled, double-blind crossover trial that recruited 60 adult participants with 1 month or more of elevated generalized anxiety. Five Kava tablets per day were prescribed containing 250 mg of kavalactones/day. Results The aqueous extract of Kava reduced participants' Hamilton Anxiety Scale score in the first controlled phase by -9.9 (CI = 7.1, 12.7) vs. -0.8 (CI = -2.7, 4.3) for placebo and in the second controlled phase by -10.3 (CI = 5.8, 14.7) vs. +3.3 (CI = -6.8, 0.2). The pooled effect of Kava vs. placebo across phases was highly significant (p < 0.0001), with a substantial effect size (d = 2.24, eta2p = 0.428). Pooled analyses also revealed highly significant relative reductions in Beck Anxiety Inventory and Montgomery-Asberg Depression Rating Scale scores. The aqueous extract was found to be safe, with no serious adverse effects and no clinical hepatotoxicity. Conclusions The aqueous Kava preparation produced significant anxiolytic and antidepressant activity and raised no safety concerns at the dose and duration studied. Kava appears equally effective in cases where anxiety is accompanied by depression. This should encourage further study and consideration of globally reintroducing aqueous rootstock extracts of Kava for the management of anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sarris, J; Kavanagh, D. J; Byrne, G; Bone, K. M; Adams, J; Deed, G; Alonso, Beck, Beck, Blumenthal, Boerner, Chouinard, Clouatre, Coulter, Currie, Dundar, Hamilton, Kessler, Lebot, Lecrubier, Martin, Mathews, Mitte, Montgomery, Morris, Nerurkar, Pittler, Pittler, Posternak, Rickels, Robins, Sarris, Singh, Stevinson, Thompson, Tyrer, Wittchen, Witte",2009.0,,0,0,
4194,Emotional sensitization highlights the attentional bias in blood-injection-injury phobics: an ERP study.,"The presence of an attentional bias towards disorder-related stimuli has not been consistently demonstrated in blood phobics. The present study was aimed at investigating whether or not an attentional bias, as measured by event-related potentials (ERPs), could be highlighted in blood phobics by inducing cognitive-emotional sensitization through the repetitive presentation of different disorder-related pictures. The mean amplitudes of the N100, P200, P300 and late positive potentials to picture onset were assessed along with subjective ratings of valence and arousal in 13 blood phobics and 12 healthy controls. Blood phobics, but not controls, showed a linear increase of subjective arousal over time, suggesting that cognitive-emotional sensitization did occur. The analysis of cortical responses showed larger N100 and smaller late positive potentials in phobics than in controls in response to mutilations. These findings suggest that cognitive-emotional sensitization induced an attentional bias in blood phobics during picture viewing, involving early selective encoding and late cognitive avoidance of disorder-related stimuli depicting mutilations.",Sarlo M.; Buodo G.; Devigili A.; Munafò M.; Palomba D.,2011.0,10.1016/j.neulet.2010.12.016,0,0,
4195,Efficacy and cerebral haemodynamics of adjunctive repetitive transcranial magnetic stimulation (rTMS) in obsessive compulsive disorder: A sham controlled study,"Aim: To examine the efficacy and change in cerebral blood flow following adjunctive right prefrontal high-frequency (rapid) rTMS treatment in OCD patients. Method: 42 patients of OCD were randomly assigned to 10 sessions of add-on high frequency right prefrontal active rTMS (10 Hz, 110% of motor threshold) or sham stimulation. They were rated at baseline and after 2 and 4 weeks with YBOCS, HAM-D and CGI-S and cerebral blood flow velocities were measured with transcranial Doppler (TCD). Results: There was no significant difference in improvement in YBOCS scores between the active and control groups, whereas significant difference in improvement in HAM-D scores was found implying efficacy of active rTMS in improving co-morbid depressive symptoms in OCD. Statistically significant difference was not noted for TCD variables on either side over time across active or sham groups. Conclusion: Adjunctive high frequency right prefrontal rTMS does not have any significant effect in the treatment of OCD. However, its effective in treatment of co-morbid depressive symptoms in patients with OCD.",Sarkhel S.; Sinha V.K.,2009.0,,0,0,
4196,A randomized controlled trial of brief intervention for problem alcohol use in persons with traumatic brain injury.,"Objective: To investigate the effectiveness of brief intervention for modifying alcohol expectancies, readiness to change, and problem alcohol use in persons with traumatic brain injury (TBI). Design: Randomized controlled trial, with 3-month follow-up. Setting: Three level I Trauma Centers. Participants: One hundred four persons with complicated mild, moderate, or severe TBI, with preinjury problem alcohol use, who had emerged from posttraumatic amnesia. Intervention: Twenty- to 30-minute brief intervention (education and motivational interview). Main Measures: Alcohol Expectancy Questionnaire-III Global Positive Expectancies and Cognitive and Physical Impairment scales; Readiness to Change Questionnaire; problem alcohol use. Results: After controlling for relevant covariates, there was an effect of treatment on expectation that alcohol use would result in cognitive and physical impairment. This effect was moderated by injury severity, and was only effective for those with severe injury. There was no treatment effect on global positive expectancies, readiness to change, or problem alcohol use. Attribution of injury to alcohol use was associated with the expectation that alcohol use would result in cognitive and physical impairment, and at one center, in greater readiness to change. Conclusions: Although the brief intervention did not have an impact on problem alcohol use, positive alcohol expectancies, or readiness to change, the results of this study suggest that brief intervention can be effective for educating on the negative impact of alcohol use for people with severe TBI who have emerged from posttraumatic amnesia. Attribution of the injury to alcohol use could potentially increase readiness to change in some settings, and might be used to generate discussion about the negative impact of alcohol use. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sander, Angelle M; Bogner, Jennifer; Nick, Todd G; Clark, Allison N; Corrigan, John D; Rozzell, Monica; Baguley, Barnett, Bogner, Bombardier, Bombardier, Bombardier, Bombardier, Bombardier, Brown, Brown, Carlson, Cherner, Christiansen, Connors, Corrigan, Corrigan, Corrigan, Corrigan, Corrigan, Critchlow, Dhalia, Dikmen, Drubach, Ewing, Gentilello, George, Graham, Gustafson, Hart, Heather, Heltemes, Horner, Jones, Jorge, Kaplan, Kelly, Kidorf, Kline, Kreutzer, Leigh, Leigh, Levin, MacMillan, Miller, Olson-Madden, Parry-Jones, Ponsford, Prochaska, Reese, Rollnick, Schermer, Sherer, Simpson, Skinner, Soderstrom, Sommers, Tate, Taylor, Teasdale, Velez-Blasini, Vickery, Wagner, Whitlock, Young",2012.0,,0,0,
4197,A randomized controlled trial of brief intervention for problem alcohol use in persons with traumatic brain injury.,": To investigate the effectiveness of brief intervention for modifying alcohol expectancies, readiness to change, and problem alcohol use in persons with traumatic brain injury (TBI). : Randomized controlled trial, with 3-month follow-up. : Three level I Trauma Centers. : One hundred four persons with complicated mild, moderate, or severe TBI, with preinjury problem alcohol use, who had emerged from posttraumatic amnesia. : Twenty- to 30-minute brief intervention (education and motivational interview). : Alcohol Expectancy Questionnaire-III Global Positive Expectancies and Cognitive and Physical Impairment scales; Readiness to Change Questionnaire; problem alcohol use. : After controlling for relevant covariates, there was an effect of treatment on expectation that alcohol use would result in cognitive and physical impairment. This effect was moderated by injury severity, and was only effective for those with severe injury. There was no treatment effect on global positive expectancies, readiness to change, or problem alcohol use. Attribution of injury to alcohol use was associated with the expectation that alcohol use would result in cognitive and physical impairment, and at one center, in greater readiness to change. : Although the brief intervention did not have an impact on problem alcohol use, positive alcohol expectancies, or readiness to change, the results of this study suggest that brief intervention can be effective for educating on the negative impact of alcohol use for people with severe TBI who have emerged from posttraumatic amnesia. Attribution of the injury to alcohol use could potentially increase readiness to change in some settings, and might be used to generate discussion about the negative impact of alcohol use.",Sander AM.; Bogner J.; Nick TG.; Clark AN.; Corrigan JD.; Rozzell M.,,10.1097/HTR.0b013e318269838c,0,0,
4198,A randomized controlled trial of brief intervention for problem alcohol use in persons with traumatic brain injury,"ER OBJECTIVE: : To investigate the effectiveness of brief intervention for modifying alcohol expectancies, readiness to change, and problem alcohol use in persons with traumatic brain injury (TBI).DESIGN: : Randomized controlled trial, with 3-month follow-up.SETTING: : Three level I Trauma Centers.PARTICIPANTS: : One hundred four persons with complicated mild, moderate, or severe TBI, with preinjury problem alcohol use, who had emerged from posttraumatic amnesia.INTERVENTION: : Twenty- to 30-minute brief intervention (education and motivational interview).MAIN MEASURES: : Alcohol Expectancy Questionnaire-III Global Positive Expectancies and Cognitive and Physical Impairment scales; Readiness to Change Questionnaire; problem alcohol use.RESULTS: : After controlling for relevant covariates, there was an effect of treatment on expectation that alcohol use would result in cognitive and physical impairment. This effect was moderated by injury severity, and was only effective for those with severe injury. There was no treatment effect on global positive expectancies, readiness to change, or problem alcohol use. Attribution of injury to alcohol use was associated with the expectation that alcohol use would result in cognitive and physical impairment, and at one center, in greater readiness to change.CONCLUSIONS: : Although the brief intervention did not have an impact on problem alcohol use, positive alcohol expectancies, or readiness to change, the results of this study suggest that brief intervention can be effective for educating on the negative impact of alcohol use for people with severe TBI who have emerged from posttraumatic amnesia. Attribution of the injury to alcohol use could potentially increase readiness to change in some settings, and might be used to generate discussion about the negative impact of alcohol use.","Sander, A M; Bogner, J; Nick, T G; Clark, A N; Corrigan, J D; Rozzell, M",2012.0,10.1097/HTR.0b013e318269838c,0,0,4197
4199,The POSE study - panic control treatment versus panic-focused psychodynamic psychotherapy under randomized and self-selection conditions: study protocol for a randomized controlled trial.,"Panic disorder with or without agoraphobia is a commonly occurring disorder affecting 2 to 3% of the population in Sweden. Untreated, panic disorder is a chronic condition that significantly increases the risk for psychiatric comorbidity, morbidity and mortality, employment difficulties, and healthcare utilization. Cognitive behavioral approaches are the recommended first-line treatment for panic disorder; however, many patients in routine care receive another evidence-based psychotherapy, including psychodynamic therapy. Allowing patients to choose among evidence-based approaches to panic disorder may improve outcomes and reduce overall health costs. Trials comparing the 'gold standard' treatment for panic disorder to other evidence-based psychotherapies are needed, and also trials that can separate patient preferences for treatment from randomization effects on outcome, disability and healthcare utilization in the longer term. A phase 2/3 doubly-randomized controlled trial carried out in routine care with 216 adults (aged 18 to 70 years) with a primary diagnosis of DSM-IV Panic Disorder (with or without Agoraphobia). Within each clinic, patients are randomized to self-selection, random assignment of treatment, or wait-list. Patients choose or are randomly assigned to either Panic Control Treatment or Panic-Focused Psychodynamic Psychotherapy. Primary outcomes are changes in panic symptom severity, occupational status, and sickness-related absences from work at post-treatment and 6, 12 and 24 months post-treatment. Secondary outcomes include changes in agoraphobic avoidance, psychiatric comorbidity, disability, and healthcare utilization. The study also employs elements of an effectiveness trial as therapist and service-related effects on outcome will be estimated. Putative change mechanisms for the two treatments are also assessed. Cognitive behavioral and psychodynamic therapies are both evidence-based approaches that are routinely offered to panic disordered patients in Sweden. However, little is known about the relative effectiveness of these two approaches for panic/agoraphobia, work-related disability and healthcare utilization over the longer term. The current trial (POSE) also addresses the important but understudied issue of whether patient preference for a particular psychotherapeutic approach moderates outcome. ClinicalTrials.gov NCT01606592 (registered 19 March 2012).",Sandell R.; Svensson M.; Nilsson T.; Johansson H.; Viborg G.; Perrin S.,2015.0,10.1186/s13063-015-0656-7,0,0,
4200,Clinical features of migraine according to the questionnaire 'Alcoi-92' in the Comtat area,"ER OBJECTIVESTo carry out a randomized transverse study in a rural population using the validated questionnaire 'Alcoi-92', and to determine the clinical characteristics of the headaches detected.PATIENTS AND METHODSA door to door survey was done by randomized selection of 790 persons aged over 18 and living in the Comarca del Comtat. A validated self-questionnaire was sent and this was followed by an interview with a doctor.RESULTSFive hundred and forty-eight persons were interviewed. The standard prevalence of migraine is 19.6% with a sex incidence of 1:2.4 and an average age of 46.1 years. The average age of onset was 20.64 years. There were family histories of cerebrovascular accidents in 26.4% and of migraine in 57.1%. There were no differences in the use of toxic substances, of socio-economic status or of marital status. The commonest pre-existing pathology was arterial hypertension. The number of episodes of headache was one to seven per year in 50% of those with migraine, with an average duration of 4-24 hours, predominantly bilateral presentation and pulsatile in character with moderate repercussion in everyday activities. The commonest associated symptoms were photophobia and sonophobia. There were prodromal symptoms in 36.9%, most commonly confusion and photopsy.CONCLUSIONThe questionnaire 'Alcoi-92' has been shown to be a useful tool for definition of the clinical characteristics of migraine.INTRODUCTIONHeadache is one of the commonest reasons for consultation and it might be useful to know its characteristics in order to determine which patients may need medical attention.","Sánchez-Pérez, R; Asensio, M; Melchor, A; Montiel, I; Falip, R; Moltó, J M; Matías-Guiu, J",1999.0,,0,0,
4201,Depressive symptoms and associated clinical characteristics in outpatients seeking community-based treatment for alcohol and drug problems.,"Background: Comorbid psychiatric and substance use disorders are common and associated with poorer treatment engagement, retention, and outcomes. This study examines the presence of depressive symptoms and the demographic and clinical correlates in a diverse sample of substance abuse treatment seekers to better characterize patients with co-occurring depressive symptoms and substance use disorders and understand potential treatment needs. Methods: Baseline data from a randomized clinical effectiveness trial of a computer-assisted, Web-delivered psychosocial intervention were analyzed. Participants (N = 507) were recruited from 10 geographically diverse outpatient drug treatment programs. Assessments included the self-report Patient Health Questionnaire, and measures of coping strategies, social functioning, physical health status, and substance use. Results: One fifth (21%; n = 106) of the sample screened positive for depression; those screening positive for depression were significantly more likely to screen positive for anxiety (66.9%) and posttraumatic stress disorder (PTSD; 42.9%). After controlling for anxiety and PTSD symptoms, presence of depressive symptoms remained significantly associated with fewer coping strategies (P = .001), greater impairment in social adjustment (P < .001), and poorer health status (P < .001), but not to days of drug use in the last 90 days (P = .14). Conclusions: Depression is a clinically significant problem among substance abusers, and, in this study, patients who screened positive for depression were more likely to have co-occurring symptoms of anxiety and PTSD. Additionally, the presence of depressive symptoms was associated with fewer coping strategies and poorer social adjustment. Coping skills are a significant predictor of addiction outcomes, and it may be especially important to screen for and enhance coping among depressed patients. Evidence-based interventions that target coping skills and global functioning among substance abusers with depressive symptoms may be important adjuncts to usual treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sanchez, Katherine; Walker, Robrina; Campbell, Aimee N. C; Greer, Tracy L; Hu, Mei-Chen; Grannemann, Bruce D; Nunes, Edward V; Trivedi, Madhukar H; Andrews, Bickel, Bizzarri, Brady, Budney, Campbell, Cohen, Compton, Compton, Conway, Dakwar, Davis, DeLongis, Dolan, Dum, Goldberg, Grant, Grant, Hasin, Hasin, Hepner, Howland, Kessler, Kessler, Kroenke, Kroenke, Litt, McWilliams, Nunes, Nunes, Nunes, Petry, Sobell, Spitzer, Spitzer, Stitzer, Thornton, Vitaliano, Walters, Weissman",2015.0,,0,0,
4202,Effectiveness of Cognitive-Behavioural Group Therapy in Patients with Anxiety Disorders.,"This study evaluates the data obtained from 44 patients with different anxiety disorders for whom cognitive-behavioural group therapy was prescribed. No significant differences were appreciated between treatment participants and controls with regard to sociodemographic, previous stress, alexithymia, coping styles and diagnosis variables. The results indicate that the clinical course in those who attended the majority of the sessions is significantly more favourable than in controls: the follow-up at one year shows that more of them were discharged (73.68% vs. 28%) and more had their benzodiazepine dose reduced (44.44% vs. 10.52%) compared to those in the control group. Among the post-treatment measures obtained were reduced values in state-anxiety, depression and emotional distress (p < .05); there was also an improvement, albeit less statistically significant, in subjective appreciation of physical state, while frequency of perceived physical distress decreased. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sanchez-Garcia, Manuel; Bagby, Bagby, Barlow, Beck, Beck, Botella Arbona, Brace, Cautela, Craske, Davis, Deffenbacher, DiFilippo, Dugas, Echeburua Odriozola, Echeburua Odriozola, Martinez Sanchez, Labrador, Manning, Margraf, Munoz, Neron, Petterson, Rudd, Schulze, Sharp, Teich, Van den Hout, Vila, White, Woodman",2004.0,,0,0,
4203,Medication-overuse headache and personality: a controlled study by means of the MMPI-2.,"The main aim of this study involves comparing the personality profiles of patients with medication-overuse headache (MOH) and episodic headaches, in order to elucidate the role of personality characteristics, according to one of the most widely used and validated personality assessment tool: Minnesota Multiphasic Personality Inventory (MMPI-2). Many studies have assessed the personality of headache patients by means of MMPI-2 only using clinical and content scales. In this study the supplementary scales were also used as they evaluate different aspects of personality, particularly broad personality characteristics, generalized emotional distress and behavioral dyscontrol. We recruited 219 subjects (151 women and 68 men) who were grouped in the following categories: MOH group (n = 82); episodic headache group (n = 82; 58 migraine aura; 6 migraine with aura; 6 frequent episodic tension-type headache; 12 migraine+infrequent episodic tension-type headache) and 1 group of 55 healthy controls. MMPI-2 was employed. Data were computed with one-way anova and post hoc analyses. Medication-overuse headache and episodic headache patients (EH) showed a very similar pattern, differentiating each other only in the Hypochondriasis (Hs) (P = .007; MOH: mean 14.18 [SD 5.53]; EH: mean 11.93 [SD 5.88] and Health Concerns [HEA]) (P = .005; MOH: mean 14.06 [SD 5.38]; EH: mean 11.81 [SD 5.59]) scales. Surprisingly, no differences were found between the 3 groups in the scales measuring dependence-related behavior such as Addiction Potential Scale (Aps) and Addiction Admission Scale (Aas). MOH and episodic headache patients scored significantly higher in the so-called neurotic scales Hs (P < .0001; MOH: mean 14.18 [SD 5.53]; EH: mean 11.93 [SD 5.88]; mean 5.91 [SD 3.57]), Depression (D) (P < .0001; MOH: mean 26.44 [SD 7.01]; EH: mean 26.09 [SD 5.85]; mean 21.47 [SD 4.90]), and Hysteria (Hy) (P < .0001; MOH: mean 27.33 [SD 5.51]; EH: mean 26.81 [SD 5.68]; mean 21.95 [3.85]) and in many other scales such as Paranoia (Pa), Psychasthenia (Pt), Schizophrenia (Sc) while they scored significantly lower on Ego Strength (Es) and Dominance (Do) scales when compared with controls. Patients with MOH and episodic headache showed very similar patterns, differentiating only in the Hypochondriasis and Health Concerns scales. Surprisingly, there were no significant differences in the scores of the scales measuring dependence-related behavior. The clinical role of MMPI-2 in discriminating MOH patients with dependency from drugs is discussed, in order to implement a complete tests' battery for headache patients' assessment.",Sances G.; Galli F.; Anastasi S.; Ghiotto N.; De Giorgio G.; Guidetti V.; Firenze C.; Pazzi S.; Quartesan R.; Gallucci M.; Nappi G.,2010.0,10.1111/j.1526-4610.2009.01593.x,0,0,
4204,The Value of Screening Parents for Their Risk of Developing Psychological Symptoms After PICU: a Feasibility Study Evaluating a Pediatric Intensive Care Follow-Up Clinic,"ER DESIGN AND SETTINGParents of children consecutively admitted to a PICU were assessed for risk of developing posttraumatic stress disorder at discharge using the Posttraumatic Adjustment Scale.INTERVENTIONSHigh-risk parents were then randomized to the intervention (follow-up clinic, 2 mo after discharge) or control condition.MEASUREMENTS AND MAIN RESULTSAll parents completed Impact of Event Scale-Revised and Hospital Anxiety and Depression Scale at 6 months. Of the 209 parents of 145 children recruited to the study, 78 (37%) were identified, on the basis of their Posttraumatic Adjustment Scale score at baseline, as being at risk of developing posttraumatic stress disorder, and randomized to the control or intervention condition. Follow-up data were provided by 157 of 209 parents (75%). Logistic regression analyses controlling for parent gender and child length of stay showed that high-risk control parents (n = 32) were significantly more likely to score above the clinical cutoff for all three psychological outcomes than parents deemed low risk at baseline (n = 89) (posttraumatic stress: odds ratio = 3.39; 95% CI, 1.28-8.92; p = 0.014; anxiety: odds ratio = 6.34; 95% CI, 2.55-15.76; p < 0.001; depression: odds ratio = 4.13; 95% CI, 1.47-11.61; p = 0.007). Only 14 of 38 (37%) high-risk intervention parents attended the follow-up clinic appointment they were offered. At follow-up, there were no statistically significant differences between the intervention and control groups, but there were small effect sizes in favor of the intervention for anxiety scores (Cohen d = 0.209) and depression scores (Cohen d = 0.254) CONCLUSIONS:: Screening parents for psychological vulnerability using measures such as the Posttraumatic Adjustment Scale may enable more efficient targeting of support. However, further research is needed on how best to provide effective follow-up intervention for families.OBJECTIVESThis study aimed to assess whether prospectively screening parents for psychological vulnerability would enable beneficial targeting of a subsequent follow-up clinic.","Samuel, V M; Colville, G A; Goodwin, S; Ryninks, K; Dean, S",2015.0,10.1097/PCC.0000000000000488,0,0,
4205,Psychometric Characteristics of the Hebrew Version of the Professional Quality-of-Life Scale,"Context Exposure to human suffering may have ramifications for the professional quality of life (ProQol) of palliative care teams. The ProQol scale was designed to assess both negative and positive work-related outcomes and has been used recently for the evaluation of work-related outcomes among palliative care workers. However, the assessment of ProQol among Israeli hospice workers is scant. Objectives The aim of this study was to assess the psychometric properties and the factor structure of the Hebrew version of the 30-item ProQol questionnaire. Methods The study population included 1100 health care providers including physicians, nurses, and social workers in primary health care and palliative care settings. Result A total of 380 workers participated in the study, representing a response rate of 34.5%. The confirmatory factor analysis did not show an adequate “goodness to fit.” Using a factor coefficient of 0.35 or greater for inclusion, the exploratory factor analysis revealed a 23-item solution, loaded onto three factors: compassion satisfaction, secondary traumatic stress, and burnout (BU). The internal consistency subscales were 0.87, 0.82, and 0.69, respectively. The subscales showed good convergent and exploratory validity because of significant correlations with measures that examine BU, work engagement, and peritraumatic dissociative experiences. Conclusions Although the findings are consistent with those from studies in other languages, they are different from the original 30-item three-factor structure reported by Stamm. The Hebrew version of the compassion satisfaction subscale was found to be reliable and valid for studies among health care professionals, but further research is needed to improve the BU and secondary traumatic stress subscales.",Samson T.; Iecovich E.; Shvartzman P.,2016.0,10.1016/j.jpainsymman.2016.03.019,0,0,
4206,Absorbable versus nonabsorbable graft: outcome of bone anchored male sling for post-radical prostatectomy incontinence.,"We determined the outcome of the bone anchored male sling procedure for stress urinary incontinence in men regarding the graft material used. A total of 39 men with post-radical prostatectomy incontinence received a perineal bone anchored male sling. Patients with previous salvage external beam radiotherapy and high serum prostate specific antigen, incontinence due to neurogenic or posttraumatic etiology, or previous benign prostatectomy were excluded. Urodynamic evaluation was performed preoperatively. The number of pads daily used by patients was recorded preoperatively and during postoperative visits. To compress the urethra 2 types of materials were used. Absorbable biomaterials were used in the first 12 patients and nonabsorbable material was used in the following 27. Mean patient age +/- SD was 67.3 years (range 50 to 79). The mean duration between radical prostatectomy and male sling surgery was 57.9 +/- 40.4 months (range 5 to 135). The procedure was successful in 26 patients (96.2%) in the nonabsorbable group and in 1 (8.3%) in the absorbable group at a mean followup of 18.9 and 28.8 months, respectively. The absorbable sling materials that were used for the bone anchored male sling demonstrated disintegration of the material. Autolysis of these absorbable materials removed active compression forces on the urethra after a short period. Nonabsorbable graft is associated with the best outcome following the perineal bone anchored male sling procedure.",Samli M.; Singla AK.,2005.0,10.1097/01.ju.0000150106.65523.16,0,0,
4207,Chlordiazepoxide-induced hostility in a small group setting,,"Salzman, C; Kochansky, G E; Shader, R I; Porrino, L J; Harmatz, J S; Swett, C P",1974.0,,0,0,
4208,Long-term effects of short-term psychodynamic psychotherapy and cognitive-behavioural therapy in generalized anxiety disorder: 12-month follow-up.,"In a previous randomized controlled trial (RCT), short-term efficacy of cognitive-behavioural therapy (CBT) and short-term psychodynamic psychotherapy (STPP) in generalized anxiety disorder (GAD) was demonstrated. In this article, long-term stability of these effects will be examined. Effects of CBT and STPP will be compared. In the original RCT, patients with GAD were treated with either CBT (n = 29) or STPP (n = 28). Treatments were carried out according to manuals and included up to 30 sessions. As the primary outcome measure the Hamilton Anxiety Rating Scale was used. In addition to short-term outcome previously reported, treatment effects were assessed 12 months after termination of treatment. Both CBT and STPP yielded large improvements at 12-month follow-up. No significant differences were found between treatments concerning the primary outcome measure. This result was corroborated by 3 self-report measures of anxiety. However, in measures of trait anxiety and worry, CBT was superior. Concerning depression, differences reported at posttreatment were no longer significant at 12-month follow-up. In GAD, both CBT and STPP yield large and stable effects 12 months after treatment. Concerning trait anxiety and worry, CBT seems to be superior. For STPP, further studies should be carried out to confirm the results.",Salzer S.; Winkelbach C.; Leweke F.; Leibing E.; Leichsenring F.,2011.0,10.1177/070674371105600809,0,0,
4209,Interpersonal subtypes and change of interpersonal problems in the treatment of patients with generalized anxiety disorder: a pilot study.,"Interpersonal problems are highly relevant to the treatment of generalized anxiety disorder (GAD) patients. Previous studies using the Inventory of Interpersonal Problems identified several interpersonal subtypes in GAD patients. In this study, we wanted to replicate earlier findings of interpersonal subtypes in GAD. We investigated whether these interpersonal subtypes are characterized by different types of interpersonal problems and different levels of interpersonal distress, and we further examined whether they differed with regard to improvement of interpersonal problems after short-term treatment. This study is based on results from a randomized controlled trial that investigated short-term treatments in GAD outpatients. For secondary analysis, interpersonal subtypes were identified by cluster analysis and Inventory of Interpersonal Problems profiles were calculated for both the total sample (N = 52) and the interpersonal subtypes using the Structural Summary Method for Circumplex Data. This study confirmed previous results demonstrating the existence of interpersonal subtypes in GAD. Four interpersonal subtypes were identified: Overly Nurturant, Intrusive, Socially Avoidant, and Nonassertive. Short-term treatment significantly improved interpersonal problems (d = 0.46) within the total GAD sample. Interestingly, the effect sizes of the four clusters differed considerably (d = 0.19-1.24) and the clusters displayed different changes in the two circumplex axes Dominance and Nurturance. Our study indicates that change of interpersonal problems needs to be specifically analyzed, even within homogenous diagnostic groups.",Salzer S.; Pincus AL.; Winkelbach C.; Leichsenring F.; Leibing E.,2011.0,10.1037/a0022013,0,0,
4210,"A randomized, controlled study of Internet peer-to-peer interactions among women newly diagnosed with breast cancer","ER METHODSThis pilot study involved seventy-eight women who were recently diagnosed with breast cancer. Participants were randomly assigned to either an Internet peer support condition or Internet-based educational control condition. Data were gathered at baseline and 4- and 12-months. Primary outcomes of interest were psychological distress and quality of life.RESULTSContrary to hypotheses, participants in the Internet peer support condition tended to do worse over time on primary outcome measures. There were no differences between groups on secondary outcomes of perceived social support, self-efficacy, or hope. Paradoxically, many women in the Internet peer support condition actively participated and reported high levels of satisfaction, suggesting some self-perceived benefits.CONCLUSIONSThese results suggest that Internet based peer-to-peer interactions may not necessarily be universally beneficial despite the positive experiences reported by many participants. Further research is needed to understand the magnitude of this effect with a larger sample. Moreover, these results raise questions about the need to understand the comparative effectiveness of Internet-based communications by group structure (i.e., unstructured/structured; unmoderated/moderated) and the effect of content (i.e., expression of fear/anxiety, insightful disclosures, etc.) on outcomes.OBJECTIVEPeer-to-peer interactions are associated with enhanced psychosocial adjustment among women with breast cancer. Millions of women with cancer and others with various health conditions use the Internet to establish peer relationships, usually without professional moderation. This paper reports findings from the first randomized, controlled study of the benefits of these types of Internet-based peer interactions.","Salzer, M S; Palmer, S C; Kaplan, K; Brusilovskiy, E; Have, T; Hampshire, M; Metz, J; Coyne, J C",2010.0,10.1002/pon.1586,0,0,
4211,Threat bias in attention orienting: evidence of specificity in a large community-based study,"ER BACKGROUND: Preliminary research implicates threat-related attention biases in paediatric anxiety disorders. However, major questions exist concerning diagnostic specificity, effects of symptom-severity levels, and threat-stimulus exposure durations in attention paradigms. This study examines these issues in a large, community school-based sample. Method A total of 2046 children (ages 6-12 years) were assessed using the Development and Well Being Assessment (DAWBA), Childhood Behavior Checklist (CBCL) and dot-probe tasks. Children were classified based on presence or absence of 'fear-related' disorders, 'distress-related' disorders, and behavioural disorders. Two dot-probe tasks, which differed in stimulus exposure, assessed attention biases for happy-face and threat-face cues. The main analysis included 1774 children.RESULTS: For attention bias scores, a three-way interaction emerged among face-cue emotional valence, diagnostic group, and internalizing symptom severity (F = 2.87, p < 0.05). This interaction reflected different associations between internalizing symptom severity and threat-related attention bias across diagnostic groups. In children with no diagnosis (n = 1411, mean difference = 11.03, s.e. = 3.47, df = 1, p < 0.001) and those with distress-related disorders (n = 66, mean difference = 10.63, s.e. = 5.24, df = 1, p < 0.05), high internalizing symptoms predicted vigilance towards threat. However, in children with fear-related disorders (n = 86, mean difference = -11.90, s.e. = 5.94, df = 1, p < 0.05), high internalizing symptoms predicted an opposite tendency, manifesting as greater bias away from threat. These associations did not emerge in the behaviour-disorder group (n = 211).CONCLUSIONS: The association between internalizing symptoms and biased orienting varies with the nature of developmental psychopathology. Both the form and severity of psychopathology moderates threat-related attention biases in children.","Salum, G A; Mogg, K; Bradley, B P; Gadelha, A; Pan, P; Tamanaha, A C; Moriyama, T; Graeff-Martins, A S; Jarros, R B; Polanczyk, G; do, Ros√°rio M C; Leibenluft, E; Rohde, L A; Manfro, G G; Pine, D S",2013.0,10.1017/S0033291712001651,0,0,
4212,An evaluation of a Shockroom located CT scanner: a randomized study of early assessment by CT scanning in trauma patients in the bi-located trauma center North-West Netherlands (REACT trial).,"Trauma is a major source of morbidity and mortality, especially in people below the age of 50 years. For the evaluation of trauma patients CT scanning has gained wide acceptance in and provides detailed information on location and severity of injuries. However, CT scanning is frequently time consuming due to logistical (location of CT scanner elsewhere in the hospital) and technical issues. An innovative and unique infrastructural change has been made in the AMC in which the CT scanner is transported to the patient instead of the patient to the CT scanner. As a consequence, early shockroom CT scanning provides an all-inclusive multifocal diagnostic modality that can detect (potentially life-threatening) injuries in an earlier stage, so that therapy can be directed based on these findings. The REACT-trial is a prospective, randomized trial, comparing two Dutch level-1 trauma centers, respectively the VUmc and AMC, with the only difference being the location of the CT scanner (respectively in the Radiology Department and in the shockroom). All trauma patients that are transported to the AMC or VUmc shockroom according to the current prehospital triage system are included. Patients younger than 16 years of age and patients who die during transport are excluded. Randomization will be performed prehospitally. Study parameters are the number of days outside the hospital during the first year following the trauma (primary outcome), general health at 6 and 12 months post trauma, mortality and morbidity, and various time intervals during initial evaluation. In addition a cost-effectiveness analysis of this shockroom concept will be performed. Regarding primary outcome it is estimated that the common standard deviation of days spent outside of the hospital during the first year following trauma is a total of 12 days. To detect an overall difference of 2 days within the first year between the two strategies, 562 patients per group are needed. (alpha 0.95 and beta 0.80). The REACT-trial will provide evidence on the effects of a strategy involving early shockroom CT scanning compared with a standard diagnostic imaging strategy in trauma patients on both patient outcome and operations research. ISRCTN55332315.",Saltzherr TP.; Fung Kon Jin PH.; Bakker FC.; Ponsen KJ.; Luitse JS.; Scholing M.; Giannakopoulos GF.; Beenen LF.; Henny CP.; Koole GM.; Reitsma HB.; Dijkgraaf MG.; Bossuyt PM.; Goslings JC.,2008.0,10.1186/1471-227X-8-10,0,0,
4213,An experimental investigation of the role of safety-seeking behaviours in the maintenance of panic disorder with agoraphobia.,"This study evaluates the hypothesis that safety-seeking behaviours play an important role in maintaining anxiety because they prevent patients from benefiting from disconfirmatory experience. Patients suffering from panic disorder with agoraphobia carried out a behaviour test, closely followed by an experimental session, which included a brief (15 min) period of exposure during which participants either stopped or maintained within-situation safety-seeking behaviours. When the behaviour test was repeated within two days, patients who had stopped their safety-seeking behaviours during the experimental session showed a significantly greater decrease in catastrophic beliefs and anxiety than those who had maintained safety-seeking behaviour. This difference was also reflected in questionnaires measuring clinical anxiety. These results are consistent with the cognitive hypothesis.",Salkovskis PM.; Clark DM.; Hackmann A.; Wells A.; Gelder MG.,1999.0,,0,0,
4214,Treatment of panic attacks using cognitive therapy without exposure or breathing retraining.,"Cognitive treatment of panic attacks is based on the hypothesis that panic results from the catastrophic misinterpretation of bodily sensations, and that changing such misinterpretations will block the occurrence of panic. The treatment normally involves an integrated set of cognitive and behavioural techniques. In a consecutive series of panic patients, a multiple baseline across subjects design was used to investigate whether a modified form of treatment involving only cognitive procedures could reduce panic attack frequency. The results provide preliminary evidence that cognitive procedures directed at changing misinterpretations of bodily sensations can reduce panic attack frequency, and also that cognitive procedures which do not target misinterpretations may not reduce panic.",Salkovskis PM.; Clark DM.; Hackmann A.,1991.0,,0,0,
4215,"Induced mood, phobic responding and the return of fear.","The link between depression and phobic responding is poorly understood. Forty-eight spider phobics were exposed to videotaped spider sequences whilst in relatively depressed or relatively elated moods, then presented the same stimuli whilst in a neutral mood. Results indicated that depressed mood increased initial responding, and was associated with greater return of fear during the second (non-mood) sequence. The return of fear was not attributable solely to differential habituation rates during the first sequence, suggesting that the differences observed may have been due to cognitive effects.",Salkovskis P.; Mills I.,1994.0,,0,0,
4216,Rehabilitation after critical illness: could a ward-based generic rehabilitation assistant promote recovery?,"The aim of this paper is to explore issues surrounding the implementation of a generic rehabilitation assistant (GRA) to provide ward-based rehabilitation after critical illness. Following critical illness a range of both physical and psychological problems can occur that include muscle wasting and weakness, fatigue, reduced appetite, post-traumatic stress, anxiety and depression. Limited research exists evaluating the provision of rehabilitation to this patient group. This paper explores one possible service delivery model providing ward-based rehabilitation after critical illness. The model explored is a GRA working in conjunction with ward-based staff. We describe how a GRA worked effectively with ward-based teams to provide additional rehabilitation in the period after discharge from intensive care. Benefits included greater continuity of care that was flexible to the individual needs of patients. Some aspects of the role were challenging for the GRA and highlighted the need for good communication skills. A need for comprehensive training of the GRA was demonstrated. Our experience demonstrates that it is feasible to deliver ward-based rehabilitation after critical illness using the GRA service delivery model. This model of service delivery offers the potential to improve outcomes for patients after a critical illness. Further research evaluating this model of care is required before implementation into clinical practice.",Salisbury LG.; Merriweather JL.; Walsh TS.,,10.1111/j.1478-5153.2010.00382.x,0,0,
4217,Rehabilitation after critical illness: could a ward-based generic rehabilitation assistant promote recovery?,"ER BACKGROUNDFollowing critical illness a range of both physical and psychological problems can occur that include muscle wasting and weakness, fatigue, reduced appetite, post-traumatic stress, anxiety and depression. Limited research exists evaluating the provision of rehabilitation to this patient group. This paper explores one possible service delivery model providing ward-based rehabilitation after critical illness. The model explored is a GRA working in conjunction with ward-based staff.RESULTSWe describe how a GRA worked effectively with ward-based teams to provide additional rehabilitation in the period after discharge from intensive care. Benefits included greater continuity of care that was flexible to the individual needs of patients. Some aspects of the role were challenging for the GRA and highlighted the need for good communication skills. A need for comprehensive training of the GRA was demonstrated.CONCLUSIONSOur experience demonstrates that it is feasible to deliver ward-based rehabilitation after critical illness using the GRA service delivery model.RELEVANCE TO CLINICAL PRACTICEThis model of service delivery offers the potential to improve outcomes for patients after a critical illness. Further research evaluating this model of care is required before implementation into clinical practice.AIMThe aim of this paper is to explore issues surrounding the implementation of a generic rehabilitation assistant (GRA) to provide ward-based rehabilitation after critical illness.","Salisbury, L G; Merriweather, J L; Walsh, T S",2010.0,10.1111/j.1478-5153.2010.00382.x,0,0,4216
4218,EEG mapping and low-resolution brain electromagnetic tomography (LORETA) in diagnosis and therapy of psychiatric disorders: evidence for a key-lock principle.,"Different psychiatric disorders, such as schizophrenia with predominantly positive and negative symptomatology, major depression, generalized anxiety disorder, agoraphobia, obsessive-compulsive disorder, multi-infarct dementia, senile dementia of the Alzheimer type and alcohol dependence, show EEG maps that differ statistically both from each other and from normal controls. Representative drugs of the main psychopharmacological classes, such as sedative and non-sedative neuroleptics and antidepressants, tranquilizers, hypnotics, psychostimulants and cognition-enhancing drugs, induce significant and typical changes to normal human brain function, which in many variables are opposite to the above-mentioned differences between psychiatric patients and normal controls. Thus, by considering these differences between psychotropic drugs and placebo in normal subjects, as well as between mental disorder patients and normal controls, it may be possible to choose the optimum drug for a specific patient according to a key-lock principle, since the drug should normalize the deviant brain function. This is supported by 3-dimensional low-resolution brain electromagnetic tomography (LORETA), which identifies regions within the brain that are affected by psychiatric disorders and psychopharmacological substances.",Saletu B.; Anderer P.; Saletu-Zyhlarz GM.; Pascual-Marqui RD.,2005.0,10.1177/155005940503600210,0,0,
4219,A longitudinal examination of dyadic distress patterns following a skills intervention for carers of adolescents with anorexia nervosa,"ER Family interventions in anorexia nervosa (AN) have been developed to ameliorate maladaptive patterns of patient-carer interaction that can play a role in illness maintenance. The primary aim of this study is to examine the inter-relationship between baseline and post-treatment distress in dyads of carers and patients with AN to examine the interdependence between carers and patients. The secondary aim is to examine whether a carer skills intervention [Experienced Carer Helping Others (ECHO)] impacts on this inter-relationship. Dyads consisting of treatment-seeking adolescents with AN and their primary carer (n = 149; mostly mothers) were randomised to receive a carer skills intervention (ECHO) in addition to treatment as usual (TAU), or TAU alone, as part of a larger clinical trial. Carers and patients completed a standardised measure of psychological distress (The Depression, Anxiety, and Stress Scale) at baseline and 12 months post-treatment. The Actor Partner Interdependence Model was used to examine longitudinal changes in interdependence by treatment group. As expected, post-treatment levels of distress were related to baseline levels in both groups (actor effects). Moreover, carer distress at 12 months was related to patient distress at baseline for the TAU (partner effects), but not for the ECHO group. Finally, carers' distress change was not a significant predictor of patients' body mass index (BMI) change in the two treatment conditions. These findings are limited to predominantly mother-offspring dyads and may not generalise to other relationships. The ECHO intervention which is designed to teach carers skills in illness management and emotion regulation may be an effective addition to TAU for ameliorating interdependence of distress in patients and their primary carers over time.","Salerno, L; Rhind, C; Hibbs, R; Micali, N; Schmidt, U; Gowers, S; Macdonald, P; Goddard, E; Todd, G; Tchanturia, K; Lo, Coco G; Treasure, J",2016.0,10.1007/s00787-016-0859-9,0,0,
4220,Augmentation of Treatment As Usual with online Cognitive Bias Modification of Interpretation training in adolescents with Obsessive Compulsive Disorder: A pilot study.,"Cognitive Behavioral Therapy for children and adolescents with Obsessive Compulsive Disorder (OCD) is effective. However, since almost half of patients remain symptomatic after treatment, there remains room for improvement. Cognitive Bias Modification training of Interpretations (CBM-I) is a promising new intervention, as it targets misinterpretation of intrusions, which is seen as an important characteristic in OCD. To date, there have been no published studies of CBM-I in adolescents with OCD. The aim of the current pilot study was to examine the added value of online CBM-I training as an adjunctive treatment to the Treatment As Usual (TAU; that included CBT and pharmacotherapy) in adolescents with OCD. Patients receiving TAU were randomly assigned to either an additional CBM-I training (n = 9), or to an additional placebo variant of this procedure (n = 7). Immediate, on-line interpretations changed in response to the CBM-I training, while no such effects were observed on slower retrospective off-line interpretations. Patients in the CBM-I training condition reported fewer obsessive compulsive symptoms after training, and clinicians rated them as having fewer obsessive symptoms (corresponding to medium-large effect sizes). No such changes were observed in the placebo group. The small sample size precludes strong conclusions and replication is necessary to test the robustness of the findings. This small randomized controlled trial is suggestive, although not conclusive, regarding the promising additive value of OC-related CBM-I training as an adjunctive intervention to TAU in an adolescent clinical population.",Salemink E.; Wolters L.; de Haan E.,2015.0,10.1016/j.jbtep.2015.02.003,0,0,
4221,Modifying threat-related interpretive bias in adolescents.,"Socially anxious feelings sharply increase during adolescence and such feelings have been associated with interpretive biases. Studies in adults have shown that interpretive biases can be modified using Cognitive Bias Modification procedures (CBM-I) and subsequent effects on anxiety have been observed. The current study was designed to examine whether the CBM-I procedure has similar effects in adolescents. Unselected adolescents were randomly allocated to either a positive interpretation training (n‚Äâ=‚Äâ88) or a placebo-control condition (n‚Äâ=‚Äâ82). Results revealed that the training was successful in modifying interpretations and effects generalized to a new task. The interpretive bias effects were most pronounced in individuals with a threat-related interpretive bias at pre-test. No effects on state anxiety were observed. The current findings are promising with regard to applying bias modification procedures to adolescents, while further research is warranted regarding emotional effects.",Salemink E.; Wiers RW.,2011.0,10.1007/s10802-011-9523-5,0,0,
4222,Effects of positive interpretive bias modification in highly anxious individuals.,"Over the past 20 years evidence has accumulated that individuals suffering from anxiety tend to interpret ambiguous information as threatening. Considering the causal role of this interpretive bias in anxiety, it was recently established that modifying interpretive biases influences anxiety. This suggests that anxiety can be clinically treated by directly targeting this interpretive bias. The present study was designed to modify a negative interpretive bias in highly anxious individuals, and subsequently assess the hypothesized beneficial effects on clinical measures. High trait-anxious participants were randomly assigned to one of two conditions: a positive interpretational Cognitive Bias Modification (CBM-I) or a control condition (n=2 x 17). The program was offered online for eight consecutive days. Upon completing the program, participants who had followed positive CBM-I were less state and trait-anxious compared to the control group. Additionally, positively trained participants scored lower on a measure of general psychopathology (SCL-90). No effects were observed on social anxiety and stress vulnerability. The mixed pattern of findings renders them rather inconclusive, leaving interpretations of the potential therapeutic merits of CBM-I open for future research.",Salemink E.; van den Hout M.; Kindt M.,2009.0,10.1016/j.janxdis.2009.02.006,0,0,
4223,Generalisation of modified interpretive bias across tasks and domains,"Patients with an anxiety disorder are characterised by a tendency to impose threatening interpretations on ambiguous information. Past research has examined the causal relationship between experimentally modified interpretive bias and its effects on anxiety. Effective modification of interpretation bias is typically shown on two specific tasks: an on-line reaction-time task and a post-training ""recognition task"". Both tasks measure accessibility of negative or positive interpretations in a specific domain (social anxiety). From a theoretical and clinical perspective, it is important to know whether the effect of altered interpretation bias generalises to other tasks or domains. Therefore, in the present experiment, both the generalisation of Cognitive Bias Modification (CBM) to other tasks (a vignette and a video task) and the transfer to another domain (academic performance) were investigated. Results showed that the modified interpretive bias did not generalise to the other tasks, while it did transfer to another domain. © 2009 Psychology Press.",Salemink E.; van den Hout M.; Kindt M.,2010.0,10.1080/02699930802692053,0,0,
4224,Internet-based cognitive bias modification of interpretations in patients with anxiety disorders: a randomised controlled trial.,"Previous research suggests that negative interpretation biases stimulate anxiety. As patients with an anxiety disorder tend to interpret ambiguous information negatively, it was hypothesised that training more positive interpretations reduces negative interpretation biases and emotional problems. In a randomised, double-blind placebo-controlled trial, patients with different anxiety disorders were trained online over eight days to either generate positive interpretations of ambiguous social scenarios (n = 18) or to generate 50% positive and 50% negative interpretations in the placebo control condition (n = 18) (Study 1). Positively trained patients made more positive interpretations and less negative ones than control patients. This training was followed by a decrease in anxiety, depression, and general psychological distress, but this effect was also observed in the control group. To get a better understanding of these unexpected results, we tested a 100% neutral placebo control group (Study 2, n = 19); now the scenarios described neutral, non-emotional situations and no valenced interpretations were generated. The results from this neutral group were comparable to the effects from the other control group. An advantage, but potentially also a disadvantage of the study is that CBM-I training was performed online with less control over the procedures and setting. In addition, the scenarios were not matched to the specific concerns of each patient and the training sessions were performed in close proximity to one another. Compared to both control conditions, CBM-I had superior effects on interpretations, but not on emotions. The current findings showed the boundary conditions for CBM-I.",Salemink E.; Kindt M.; Rienties H.; van den Hout M.,2014.0,10.1016/j.jbtep.2013.10.005,0,0,
4225,Low-intensity pulsed ultrasound shortens the treatment time in tibial distraction osteogenesis.,"Low-intensity pulsed ultrasound (LIPUS) has been used successfully to accelerate healing of fresh fractures and non-unions. It also improved callus maturation with distraction osteogenesis in animal trials. However, only few clinical studies are available to support its widespread use for the latter indication in humans. Twenty-one patients undergoing callus distraction for posttraumatic tibial defects were randomized into two groups: the trial group (12 men; mean age 32 years) which received 20 minutes LIPUS daily during treatment and the control group (six men and three women; mean age 29 years) without LIPUS treatment. The Ilizarov ring fixator was used in all cases. Results were examined clinically and radiologically, analysing callus maturation with a computer-assisted measurement. Patients in the LIPUS group needed a mean of 33 days to consolidate every 1 cm of new bone in comparison to 45 days in the control group. The healing index was therefore shortened by 12 days/cm in the LIPUS group. This means that callus maturation was 27 % faster in the LIPUS group. The fixator time was shortened by 95 days in the LIPUS group. The overall daily increase in radiographic callus density was 33 % more in the LIPUS group than in the control group. LIPUS treatment is an effective non-invasive adjuvant method to enhance callus maturation in distraction osteogenesis. With the help of this treatment, the healing time and the duration of external fixation can be reliably shortened.",Salem KH.; Schmelz A.,2014.0,10.1007/s00264-013-2254-1,0,0,
4226,Long-term results with the Ilizarov technique for tibiocalcaneal fusion.,"Talar necrosis and infection are serious complications that have challenged orthopedic surgeons for years. In this study, 6 patients who underwent tibiocalcaneal fusion using the Ilizarov technique, predominantly for post-traumatic talar osteitis, were reviewed after mean follow-up of 8 years. Solid fusion was obtained in all cases. In 5 patients, simultaneous lengthening was performed through a proximal tibial corticotomy. Complications were related primarily to pin insertion sites. The Ilizarov technique can be used successfully for tibiocalcaneal fusion in complex cases with talar osteitis that otherwise may ultimately require amputation.",Salem KH.,2008.0,,0,0,
4227,FAMily-Oriented Support (FAMOS): development and feasibility of a psychosocial intervention for families of childhood cancer survivors.,"We developed and tested the feasibility of a manualized psychosocial intervention, FAMily-Oriented Support (FAMOS), a home-based psychosocial intervention for families of childhood cancer survivors. The aim of the intervention is to support families in adopting healthy strategies to cope with the psychological consequences of childhood cancer. The intervention is now being evaluated in a nationwide randomized controlled trial (RCT). FAMOS is based on principles of family systems therapy and cognitive behavioral therapy, and is delivered in six sessions at home. Families were recruited from all four pediatric oncology departments in Denmark after the end of intensive cancer treatment. We evaluated the feasibility of the intervention and of a RCT design for comparing the intervention with usual care. The evaluation was conducted among families enrolled in the study by tracking procedures and parents' evaluations. A total of 68 families (68 mothers, 60 fathers, 68 children with cancer and 73 siblings) were enrolled, with a participation rate of 62% of families. Fathers were highly represented (88% of families); also families with single parents (12%) and parents with basic education (7-12 years of primary, secondary, and grammar school education) were represented (12%). The dropout rate was 12% of families (all in the control group), and two families did not complete the intervention because of relapse. Evaluation by parents in the intervention group showed overall satisfaction with the format, timing, and content of the intervention. The results indicate that the FAMOS intervention is feasible in terms of recruitment, retention, and acceptability. The effects of the intervention on post-traumatic stress, depression, anxiety, family functioning, and quality of life will be reported after the nationwide RCT has been completed.",Salem H.; Johansen C.; Schmiegelow K.; Winther JF.; Wehner PS.; Hasle H.; Rosth√∏j S.; Kazak AE.; E Bidstrup P.,2017.0,10.1080/0284186X.2016.1269194,0,0,
4228,Comparison of group cognitive behavioral therapy and interactive lectures in reducing anxiety during pregnancy: A quasi experimental trial.,"Anxiety during pregnancy and its adverse effects on mother and baby is a health concern worldwide. This study aimed to investigate the effects of group cognitive behavioral therapy (GCBT) compared with interactive lectures (IL) on anxiety during pregnancy. This quasi experimental trial was conducted in Sari city, in north Iran, from March to July 2015. Participants were 91 obstetrically and medically low-risk nulliparous women with a mild to moderate anxiety level, as assessed by Spielberger's State-Trait Anxiety Inventory. Participants were selected from the general population by cluster sampling and assigned to 3 groups: a cognitive behavioral therapy (CBT) group (n = 31), an IL group (n = 30), and a control group (n = 30). All participants completed a demographic characteristics form and the Speilberger State-Trait Anxiety Inventory. The inventory was completed again by the CBT and IL groups 4 weeks after the interventions, and 4 weeks after the initial questionnaire by the control group. Data were analyzed with chi-squared tests, independent t-tests, paired t-tests, ANOVA, and Dunnett post hoc test. A significant decline in state and trait anxiety was found in the CBT and IL groups at 4 weeks (P‚Ää<‚Ää0.001). GCBT was more effective than IL in reducing participants' anxiety, but the difference was not significant (P‚Ää>‚Ää0.05). GCBT and IL had beneficial effects in reducing anxiety in pregnancy. The psychological status of pregnant women in prenatal care services should be investigated and either of these methods used to manage maternal anxiety, depending on the available healthcare service resources.",Salehi F.; Pourasghar M.; Khalilian A.; Shahhosseini Z.,2016.0,10.1097/MD.0000000000005224,0,0,
4229,The effects of selected relaxing music on anxiety and depression during hemodialysis: A randomized crossover controlled clinical trial study.,"The aim of this study was to determine the effect of selected relaxing music on anxiety and depression in patients during hemodialysis. This crossover clinical trial involved 102 patients undergoing hemodialysis at a leading hospital in an urban setting. Patients were randomly assigned to groups A (treatment) and B (control) and their levels of anxiety and depression at the beginning and the end of the hemodialysis were measured using Spielberger State-Trait Anxiety Inventory and Beck Depression Inventory tests, respectively. Both groups consecutively, and with a two-week washout, listened to experimenter selected instrumental music on their earphones individually for three hours. Data were analyzed using SPSS software, version 18. No significant differences in BDI-II (P = 0.253), t-anxiety (P = 0.546), and s-anxiety (P = 0.253), T-Anxiety (P = 0.546), and S-Anxiety (P = 0.776) was observed between the two groups prior to hemodialysis. There was not any significant difference in BDI-II (P = 0.253) and T-anxiety (P = 0.253) and T-Anxiety (P = 0.546) between the two groups after hemodialysis. However, a significant difference was observed between the two groups regarding s-anxiety (PS-Anxiety (P = 0.021). Yet, this difference did not imply the positive effect of listening to music in reducing the s-Anxiety level. The findings indicate that the use of recorded music did not reduce depression and anxiety in HD patients. However, due to the limited number of studies into the effect of music listening for patients receiving hemodialysis, further investigations in this matter are recommended. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Salehi, Bahman; Salehi, Mona; Nsirnia, Kaivan; Soltani, Parvin; Adalatnaghad, Mahnaz; Kalantari, Nasim; Ghebleh, Fariba; Moghaddam, Shadi; Aldridge, Bally, Beck, Cantekin, Chilcot, Gallagher, Gerogianni, Ginieri-Coccossis, Guetin, Hanser, Horne-Thompson, Hou, Karamanidou, Kim, Lin, Meredith, Mohammadi, Panahi, Pelletier, Peters, Radbruch, Satei, Smith, Smith, Suhartini, Theofilou, Theofilou, Watnick",2016.0,,0,0,
4230,Effects of live exposure on symptoms of posttraumatic stress disorder: the role of reduced behavioral avoidance in improvement.,"Although the effectiveness of cognitive-behavioral treatment in posttraumatic stress disorder (PTSD) is well established, few studies examined its effects on individual PTSD symptoms and possible mechanisms of improvement in symptoms. In a previous randomized controlled study [Başog lu, M., Salciog lu, E., Livanou, M., Kalender, D., & Acar, G. (2005). Single-session behavioral treatment of earthquake-related posttraumatic stress disorder: A randomized waitlist controlled trial. Journal of Traumatic Stress, 18, 1-11] a single session of behavioral treatment involving self-exposure instructions was highly effective in reducing earthquake-related PTSD. In the present study we examined the effects of treatment on each PTSD symptom and which symptoms improved early in treatment. Because the intervention focused solely on behavioral avoidance, we hypothesized that avoidance would be the first symptom to change and that reduction in avoidance would generalize to all other symptoms. The results showed significant between-groups treatment effect on only behavioral avoidance early in treatment (week 6). At 6 months post-treatment recovery rates ranged from 60% to 89% for 15 PTSD symptoms, including the numbing symptoms. Lack of improvement in avoidance was associated with lack of improvement in 12 symptoms. The critical process in recovery thus appeared to be increased sense of control associated with reduction in avoidance. These findings imply that live exposure to fear cues designed to enhance sense of control might be sufficient for recovery from PTSD.",Salcioğlu E.; Başoğlu M.; Livanou M.,2007.0,10.1016/j.brat.2007.04.012,0,0,
4231,Cognitive rehabilitation for traumatic brain injury: A randomized trial. Defense and Veterans Head Injury Program (DVHIP) Study Group.,"Traumatic brain injury (TBI) is a principal cause of death and disability in young adults. Rehabilitation for TBI has not received the same level of scientific scrutiny for efficacy and cost-efficiency that is expected in other medical fields. To evaluate the efficacy of inpatient cognitive rehabilitation for patients with TBI. Single-center, parallel-group, randomized trial conducted from January 1992 through February 1997 at a US military medical referral center. One hundred twenty active-duty military personnel who had sustained a moderate-to-severe closed head injury, manifested by a Glasgow Coma Scale score of 13 or less, or posttraumatic amnesia lasting at least 24 hours, or focal cerebral contusion or hemorrhage on computed tomography or magnetic resonance imaging. Patients were randomly assigned to an intensive, standardized, 8-week, in-hospital cognitive rehabilitation program (n=67) or a limited home rehabilitation program with weekly telephone support from a psychiatric nurse (n=53). Return to gainful employment and fitness for military duty at 1-year follow-up, compared by intervention group. At 1-year follow-up, there was no significant difference between patients who had received the intensive in-hospital cognitive rehabilitation program vs the limited home rehabilitation program in return to employment (90% vs 94%, respectively; P=.51; difference, 4% [95% confidence interval ¬øCI¬ø, -5% to 14%]) or fitness for duty (73% vs 66%, respectively; P=. 43; difference, 7% [95% CI, -10% to 24%]). There also were no significant differences in cognitive, behavioral, or quality-of-life measures. In a post-hoc subset analysis of patients who were unconscious for more than 1 hour (n = 75) following TBI, the in-hospital group had a greater return-to-duty rate (80% vs 58%; P=. 05). In this study, the overall benefit of in-hospital cognitive rehabilitation for patients with moderate-to-severe TBI was similar to that of home rehabilitation. These findings emphasize the importance of conducting randomized trials to evaluate TBI rehabilitation interventions. JAMA. 2000;283:3075-3081",Salazar AM.; Warden DL.; Schwab K.; Spector J.; Braverman S.; Walter J.; Cole R.; Rosner MM.; Martin EM.; Ecklund J.; Ellenbogen RG.,2000.0,,0,0,
4232,The immediate effect of a brief energy psychology intervention (Emotional Freedom Techniques) on specific phobias: a pilot study.,"Specific phobia is one of the most prevalent anxiety disorders. Emotional Freedom Techniques (EFT) has been shown to improve anxiety symptoms; however, their application to specific phobias has received limited attention. This pilot study examined whether EFT, a brief exposure therapy that combines cognitive and somatic elements, had an immediate effect on the reduction of anxiety and behavior associated with specific phobias. The study utilized a crossover design with participants randomly assigned to either diaphragmatic breathing or EFT as the first treatment. The study was conducted at a regional university in the Southwestern United States. Twenty-two students meeting criteria for a phobic response to a specific stimulus (‚â•8 on an 11-point subjective units of distress scale). Participants completed a total of five two-minute rounds in each treatment intervention. Study measures included a behavioral approach test (BAT), Subjective Units of Distress Scale (SUDS), and Beck Anxiety Inventory (BAI). Emotional Freedom Techniques significantly reduced phobia-related anxiety (BAI P = .042; SUDS P = .002) and ability to approach the feared stimulus (BAT P = .046) whether presented as an initial treatment or following diaphragmatic breathing. When presented as the initial treatment, the effects of EFT remained through the presentation of the comparison intervention. The efficacy of EFT in treating specific phobias demonstrated in several earlier studies is corroborated by the current investigation. Comparison studies between EFT and the most effective established therapies for treating specific phobias are recommended.",Salas MM.; Brooks AJ.; Rowe JE.,,10.1016/j.explore.2011.02.005,0,0,
4233,"A comparison of dual attention, eye movements, and exposure only during eye movement desensitization and reprocessing for posttraumatic stress disorder: Results from a randomized clinical trial.","Background: Currently, there is controversy on the possible benefits of dual-attention tasks during eye movement desensitization and reprocessing (EMDR) for patients with posttraumatic stress disorder (PTSD). Methods: A total of 139 consecutive patients (including 85 females) suffering from PTSD were allocated randomly among 3 different treatment conditions: exposure with eyes moving while fixating on the therapist's moving hand (EM), exposure with eyes fixating on the therapist's nonmoving hand (EF), and exposure without explicit visual focus of attention as control condition (EC). Except for the variation in stimulation, treatment strictly followed the standard EMDR manual. Symptom changes from pre- to posttreatment were measured with the Clinician-Administered PTSD Scale (CAPS) by an investigator blinded to treatment allocation. Results: In total, 116 patients completed the treatment, with an average of 4.6 sessions applied. Intention-to-treat analysis revealed a significant improvement in PTSD symptoms with a high overall effect size (Cohen's d = 1.96, 95% CI: 1.67-2.24) and a high remission rate of PTSD diagnosis (79.8%). In comparison to the control condition, EM and EF were associated with significantly larger pre-post symptom decrease (DELTACAPS: EM = 35.8, EF = 40.5, EC = 31.0) and significantly larger effect sizes (EM: d = 2.06, 95% CI: 1.55-2.57, EF: d = 2.58, 95% CI: 2.01-3.11, EC: d = 1.44, 95% CI: 0.97-1.91). No significant differences in symptom decrease and effect size were found between EM and EF. Conclusions: Exposure in combination with an explicit external focus of attention leads to larger PTSD symptom reduction than exposure alone. Eye movements have no advantage compared to visually fixating on a nonmoving hand. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sack, Martin; Zehl, Stefanie; Otti, Alexander; Lahmann, Claas; Henningsen, Peter; Kruse, Johannes; Stingl, Markus; Andrade, Barrowcliff, Beck, Bernstein, Bisson, Blake, Cahill, Cohen, Davidson, Ehlers, Engelhard, Foa, Galecki, Gunter, Hautzinger, Hiller, Holmes, Horowitz, Jeffries, Kemps, Kleinbaum, Lee, Lee, Maercker, Oliver, Parsons, Rubin, Schnyder, Schubert, Schwabe, Servan-Schreiber, Shapiro, Shapiro, Solomon, Verbeke, Wittchen",2016.0,,0,0,
4234,"A Comparison of Dual Attention, Eye Movements, and Exposure Only during Eye Movement Desensitization and Reprocessing for Posttraumatic Stress Disorder: Results from a Randomized Clinical Trial.","Currently, there is controversy on the possible benefits of dual-attention tasks during eye movement desensitization and reprocessing (EMDR) for patients with posttraumatic stress disorder (PTSD). A total of 139 consecutive patients (including 85 females) suffering from PTSD were allocated randomly among 3 different treatment conditions: exposure with eyes moving while fixating on the therapist's moving hand (EM), exposure with eyes fixating on the therapist's nonmoving hand (EF), and exposure without explicit visual focus of attention as control condition (EC). Except for the variation in stimulation, treatment strictly followed the standard EMDR manual. Symptom changes from pre- to posttreatment were measured with the Clinician-Administered PTSD Scale (CAPS) by an investigator blinded to treatment allocation. In total, 116 patients completed the treatment, with an average of 4.6 sessions applied. Intention-to-treat analysis revealed a significant improvement in PTSD symptoms with a high overall effect size (Cohen's d = 1.96, 95% CI: 1.67-2.24) and a high remission rate of PTSD diagnosis (79.8%). In comparison to the control condition, EM and EF were associated with significantly larger pre-post symptom decrease (ΔCAPS: EM = 35.8, EF = 40.5, EC = 31.0) and significantly larger effect sizes (EM: d = 2.06, 95% CI: 1.55-2.57, EF: d = 2.58, 95% CI: 2.01-3.11, EC: d = 1.44, 95% CI: 0.97-1.91). No significant differences in symptom decrease and effect size were found between EM and EF. Exposure in combination with an explicit external focus of attention leads to larger PTSD symptom reduction than exposure alone. Eye movements have no advantage compared to visually fixating on a nonmoving hand.",Sack M.; Zehl S.; Otti A.; Lahmann C.; Henningsen P.; Kruse J.; Stingl M.,2016.0,10.1159/000447671,0,0,
4235,An experimental investigation of the effect of worry on responses to a discrimination learning task.,"The current study examined the impact of both the tendency to worry (trait worry) and the process of worry (state worry) on subsequent behavioral responding in a schedule discrimination learning task. High and low trait worriers were randomly assigned to a state worry or relaxation incubation condition and completed a test of executive functioning and a dual contingency learning task that utilized neutral discriminative cues over the course of 2 contingency phases. Although state and trait worry did not impact executive functioning, the state worry condition was associated with diminished sensitivity to learning task contingencies over the course of the first contingency learning trials in comparison to the relaxation condition. This relationship was unique to the state worry condition above and beyond shared variance with subjective anxiety level. Results suggest that state worry may lead to a decrement in selective behavioral responding to neutral discriminative cues in the environment. The findings suggest that the process of worry may lead to less adaptive responding to neutral cues and interfere with adaptive behaviors, which may thereby contribute to and maintain anxiety.",Salters-Pedneault K.; Suvak M.; Roemer L.,2008.0,10.1016/j.beth.2008.01.001,0,0,
4236,The Bankart repair versus the Putti-Platt procedure: a randomized study with WOSI score at 10-year follow-up in 62 patients.,"This randomized study compared clinical results after surgery for posttraumatic shoulder instability with either an anatomical repair or an older, less anatomical but commonly used method. The less anatomical procedure has been considered quicker and less demanding, but it has been questioned regarding the clinical result. We therefore wanted to compare the clinical outcome of the two different procedures. Our hypothesis was that the anatomical repair would give less residual impairment postoperatively. Patients with anterior posttraumatic shoulder instability were consecutively randomized on the day before surgery to either a Bankart repair using Mitek GI/GII anchors combined with capsular imbrication (B) (n = 33) or a Putti-Platt procedure (P) (n = 33). Follow-up was performed by examination at 2 years and using a self-evaluation score at 10 years. At the 2-year follow-up, we found no difference in muscle strength between patients treated with the two surgical methods and there were no statistically significant differences in the Rowe scores (mean 90 units for both groups). Compared to preoperatively, the decrease in external rotation 2 years after surgery was 10 degrees in the P group and 3 degrees in the B group (p = 0.03). 10 years after surgery, 62 of 66 patients replied to a questionnaire sent by mail. It included a self-evaluating quality of life score for shoulder instability (WOSI) for evaluation of their shoulder function. In the P group 15 patients and in the B group 19 patients reported they had experienced either a redislocation or a subluxation with a new feeling of shoulder instability. Mean WOSI score was similar in the P and B groups: 80% and 83%, respectively. The WOSI score was 87% for patients with stable shoulders (n = 28) and 77% for those with unstable shoulders (n= 34) (p = 0.005). With assessment of pain and general shoulder function, only a small difference was found between the two methods. The WOSI scores for stable shoulders indicated that some shoulders still had impaired function even though the shoulders had become stable.",Salomonsson B.; Abbaszadegan H.; Revay S.; Lillkrona U.,2009.0,10.3109/17453670902988345,0,0,
4237,Promoting positive motherhood among nulliparous pregnant women with an intense fear of childbirth: RCT intervention.,"This RCT intervention among nulliparous pregnant women with an intense fear of childbirth sought to promote preparedness for childbirth and to enhance positive parenting. Pregnant women (n = 8,611) filled in a 'fear of childbirth' questionnaire. Nulliparous women with severe fear of childbirth (n = 355) were randomized into intervention (n = 131; 41 refused) and control (n = 224) groups. They rated themselves on a preparedness scale in middle and late pregnancy, and on a motherhood scale three months after childbirth. The intervention included six psycho-education group sessions during pregnancy and one after childbirth. This intervention increased the mothers' preparedness for childbirth, which predicted an increase in positive motherhood.",Salmela-Aro K.; Read S.; Rouhe H.; Halmesmäki E.; Toivanen RM.; Tokola MI.; Saisto T.,2012.0,10.1177/1359105311421050,0,0,
4238,Stepped care versus standard trauma-focused cognitive behavioral therapy for young children,"ER METHODS: A total of 53 children (ages 3-7 years) who were experiencing PTSS were randomly assigned (2:1) to receive SC-TF-CBT or TF-CBT. Assessments by a blinded evaluator occurred at screening/baseline, after Step One for SC-TF-CBT, posttreatment, and 3-month follow-up.TRIAL REGISTRATION: ClinicalTrials.gov: https://www.clinicaltrials.gov/ct2/show/NCT01603563.RESULTS: There were comparable improvements over time in PTSS and secondary outcomes in both conditions. Noninferiority of SC-TF-CBT compared to TF-CBT was supported for the primary outcome of PTSS, and the secondary outcomes of severity and internalizing symptoms, but not for externalizing symptoms. There were no statistical differences in comparisons of changes over time from pre- to posttreatment and pre- to 3-month follow-up for posttraumatic stress disorder diagnostic status, treatment response, or remission. Parent satisfaction was high for both conditions. Costs were 51.3% lower for children in SC-TF-CBT compared to TF-CBT.CONCLUSIONS: Although future research is needed, preliminary evidence suggests that SC-TF-CBT is comparable to TF-CBT, and delivery costs are significantly less than standard care. SC-TF-CBT may be a viable service delivery system to address treatment barriers.BACKGROUND: To compare the effectiveness and cost of stepped care trauma-focused cognitive behavioral therapy (SC-TF-CBT), a new service delivery method designed to address treatment barriers, to standard TF-CBT among young children who were experiencing posttraumatic stress symptoms (PTSS).","Salloum, A; Wang, W; Robst, J; Murphy, T K; Scheeringa, M S; Cohen, J A; Storch, E A",2016.0,10.1111/jcpp.12471,0,0,
4239,Evaluation of individual and group grief and trauma interventions for children post disaster,"ER This study evaluated a community-based grief and trauma intervention for children conducted postdisaster. Fifty six children (7 to 12 years old) who reported moderate to severe levels of symptoms of posttraumatic stress were randomly assigned to group or individual treatment. Treatment consisted of a manualized 10-session grief- and trauma-focused intervention and a parent meeting. Measures of disaster-related exposure, posttraumatic stress symptoms, depression, traumatic grief, and distress were administered at preintervention, postintervention, and 3 weeks postintervention. There was a significant decrease in all outcome measures over time, and there were no differences in outcomes between children who participated in group intervention and those who participated in individual intervention. Results suggest that this intervention using either treatment modality may be effective for addressing childhood grief and trauma postdisaster.","Salloum, A; Overstreet, S",2008.0,10.1080/15374410802148194,0,0,
4240,Grief and trauma intervention for children after disaster: exploring coping skills versus trauma narration,"ER This study evaluated the differential effects of the Grief and Trauma Intervention (GTI) with coping skills and trauma narrative processing (CN) and coping skills only (C). Seventy African American children (6-12 years old) were randomly assigned to GTI-CN or GTI-C. Both treatments consisted of a manualized 11-session intervention and a parent meeting. Measures of trauma exposure, posttraumatic stress symptoms, depression, traumatic grief, global distress, social support, and parent reported behavioral problems were administered at pre, post, 3 and 12 months post intervention. In general, children in both treatment groups demonstrated significant improvements in distress related symptoms and social support, which, with the exception of externalizing symptoms for GTI-C, were maintained up to 12 months post intervention. Results suggest that building coping skills without the structured trauma narrative may be a viable intervention to achieve symptom relief in children experiencing trauma-related distress. However, it may be that highly distressed children experience more symptom relief with coping skills plus narrative processing than with coping skills alone. More research on the differential effects of coping skills and trauma narration on child distress and adaptive functioning outcomes is needed.","Salloum, A; Overstreet, S",2012.0,10.1016/j.brat.2012.01.001,0,0,
4241,Barriers to access and participation in community mental health treatment for anxious children,"ER METHODBarriers to access and participation, demographics, anxiety severity/impairment, treatment credibility and satisfaction were assessed among parents and children with anxiety (N=100; ages 7-13) who were enrolled in a community-based randomized clinical trial.RESULTSThe most common access barrier was parents not knowing where or from whom to seek services (66%). Differences among completers and non-completers were related to stigma, confidentiality, and costs. The most common parent-reported barrier to participating was stress (32.4%) and child-reported barrier to participation was not having enough time to complete homework (22.1%). Of the sociodemographic, clinical and treatment characteristics, minority status, satisfaction, and treatment response were associated with barriers to treatment participation, although these associations varied by barriers related to treatment and external factors.LIMITATIONSCross sectional design and lack of well-established psychometric properties for barriers measures were limitations.CONCLUSIONFindings suggest that accessible, time-efficient, cost-effective service delivery methods that minimize stigma and maximize engagement when delivering evidence-based treatment for pediatric anxiety are needed.BACKGROUNDAnxiety disorders are the most common psychiatric disorders among children in the United States; yet many children do not receive treatment due to barriers to treatment access and participation. This study examined common barriers to treatment access and participation among anxious children who participated in computer-assisted cognitive behavioral therapy. Differences in barriers reported by treatment completers/non-completers were examined, as was the association with sociodemographic characteristics, anxiety severity, and impairment. The impact of barriers on treatment response was assessed, as well as the relationship with treatment expectancy and satisfaction.","Salloum, A; Johnco, C; Lewin, A B; McBride, N M; Storch, E A",2016.0,10.1016/j.jad.2016.02.026,0,0,
4242,Effects of neutralizing on intrusive thoughts: an experiment investigating the etiology of obsessive-compulsive disorder.,"A large sample of non-clinical subjects were screened and those who reported experiencing relatively frequent intrusive thoughts with associated neutralizing were selected. These subjects were randomly allocated to one of two conditions: both groups listened to repeated recorded presentations of one of their intrusive thoughts and were then required either to (a) neutralize it, or (b) distract themselves for a similar period. Ratings of discomfort were taken during this procedure (first phase), and during identical presentations of the same thought without neutralizing or distracting (second phase). Results showed that the group who neutralized during the first phase experienced significantly more discomfort during the second phase and significantly stronger urges to neutralize and distract. There was also evidence that engaging in neutralizing responses during the first phase made it difficult to stop neutralizing during the second phase. The results are considered in the context of the cognitive-behavioural hypothesis that obsessional disorders develop as a consequence of neutralizing normal intrusive thoughts.",Salkovskis PM.; Westbrook D.; Davis J.; Jeavons A.; Gledhill A.,1997.0,,0,0,
4243,Neutralizing increases discomfort associated with obsessional thoughts: an experimental study with obsessional patients.,"Cognitive-behavioral theories suggest that the development of neutralizing is crucial in the development and persistence of obsessional problems (OCD). Twenty-nine patients with a Diagnostic and Statistical Manual of Mental Disorders (4th ed., American Psychiatric Association, 1994) diagnosis of OCD were randomly allocated to 2 conditions. Both listened to repeated recorded presentations of their intrusive thoughts and either neutralized (experimental group) or distracted themselves (control). Discomfort was rated during this 1st phase and then during a 2nd phase without neutralizing or distraction. The experimental group showed a similar level of discomfort in the 1st phase, which significantly reduced during the period compared with controls. The experimental group experienced significantly more discomfort during the 2nd phase, and significantly stronger urges to neutralize and distract at the end of this phase than controls.",Salkovskis PM.; Thorpe SJ.; Wahl K.; Wroe AL.; Forrester E.,2003.0,10.1037/0021-843X.112.4.709,0,0,
4244,Belief disconfirmation versus habituation approaches to situational exposure in panic disorder with agoraphobia: a pilot study.,"Exposure therapy and cognitive behaviour therapy (CBT) are both effective in the treatment of panic disorder with agoraphobia. Cognitive theories suggest that the way in which exposure to avoided situations is implemented in either treatment may be crucial. In particular, it is suggested that clinical improvement will be greatest if opportunities for disconfirmation of feared catastrophes are maximized. In a small pilot study, 16 patients with panic disorder and (moderate or severe) agoraphobia were randomly allocated to either habituation based exposure therapy (HBET) or exposure planned as a belief disconfirmation strategy and accompanied by dropping of safety-seeking behaviours. Both treatments were brief (total of 3.25 h of exposure) and were similar in terms of expectancy of change. Patients in the CBT condition showed significantly greater improvements in self-report measures of anxiety, panic and situational avoidance. They also completed significantly more steps in a standardized behavioural walk, during which they experienced significantly less anxiety. The controlled effect sizes for CBT were substantial (range 1.7-2.7), which suggests it may be a particularly efficient way of managing therapeutic exposure to feared situations in panic disorder with agoraphobia. Further research is needed to clarify the mechanism of change involved.",Salkovskis PM.; Hackmann A.; Wells A.; Gelder MG.; Clark DM.,2007.0,10.1016/j.brat.2006.02.008,0,0,
4245,The immediate effect of a brief energy psychology intervention (Emotional Freedom Techniques) on specific phobias: a pilot study,"ER OBJECTIVEThis pilot study examined whether EFT, a brief exposure therapy that combines cognitive and somatic elements, had an immediate effect on the reduction of anxiety and behavior associated with specific phobias.DESIGNThe study utilized a crossover design with participants randomly assigned to either diaphragmatic breathing or EFT as the first treatment.SETTINGThe study was conducted at a regional university in the Southwestern United States.PARTICIPANTSTwenty-two students meeting criteria for a phobic response to a specific stimulus (?8 on an 11-point subjective units of distress scale).INTERVENTIONParticipants completed a total of five two-minute rounds in each treatment intervention.OUTCOME MEASURESStudy measures included a behavioral approach test (BAT), Subjective Units of Distress Scale (SUDS), and Beck Anxiety Inventory (BAI).RESULTSEmotional Freedom Techniques significantly reduced phobia-related anxiety (BAI P = .042; SUDS P = .002) and ability to approach the feared stimulus (BAT P = .046) whether presented as an initial treatment or following diaphragmatic breathing. When presented as the initial treatment, the effects of EFT remained through the presentation of the comparison intervention.CONCLUSIONSThe efficacy of EFT in treating specific phobias demonstrated in several earlier studies is corroborated by the current investigation. Comparison studies between EFT and the most effective established therapies for treating specific phobias are recommended.BACKGROUNDSpecific phobia is one of the most prevalent anxiety disorders. Emotional Freedom Techniques (EFT) has been shown to improve anxiety symptoms; however, their application to specific phobias has received limited attention.","Salas, M M; Brooks, A J; Rowe, J E",2011.0,10.1016/j.explore.2011.02.005,0,0,4232
4246,Breathing-based meditation decreases posttraumatic stress disorder symptoms in U.S. military veterans: a randomized controlled longitudinal study.,"Given the limited success of conventional treatments for veterans with posttraumatic stress disorder (PTSD), investigations of alternative approaches are warranted. We examined the effects of a breathing-based meditation intervention, Sudarshan Kriya yoga, on PTSD outcome variables in U.S. male veterans of the Iraq or Afghanistan war. We randomly assigned 21 veterans to an active (n = 11) or waitlist control (n = 10) group. Laboratory measures of eye-blink startle and respiration rate were obtained before and after the intervention, as were self-report symptom measures; the latter were also obtained 1 month and 1 year later. The active group showed reductions in PTSD scores, d = 1.16, 95% CI [0.20, 2.04], anxiety symptoms, and respiration rate, but the control group did not. Reductions in startle correlated with reductions in hyperarousal symptoms immediately postintervention (r = .93, p < .001) and at 1-year follow-up (r = .77, p = .025). This longitudinal intervention study suggests there may be clinical utility for Sudarshan Kriya yoga for PTSD.",Seppälä EM.; Nitschke JB.; Tudorascu DL.; Hayes A.; Goldstein MR.; Nguyen DT.; Perlman D.; Davidson RJ.,2014.0,10.1002/jts.21936,0,0,
4247,A randomized controlled trial of mindfulness-based stress reduction for Parkinson's disease patients and their partners,"Background: Parkinson's disease (PD) is a progressive, neurodegenerative disorder associated with psychological distress and motor control loss. Data on stress-related psychoneuroimmune effects and potential benefits of psychosocial intervention are needed in this population. A small randomized controlled trial tested the efficacy of Mindfulness-Based Stress Reduction (MBSR) among 18 PD patient-partner dyads to evaluate feasibility for a larger-scale project. MBSR was hypothesized to increase mindfulness, reduce psychological distress and ameliorate stress-related autonomic, endocrine, and immune disruption. Methods: Demographic and medical information were obtained from medical records and interviews. Dyads were randomized after baseline data collection to MBSR treatment (N=10) or usual clinical care (UCC; N=8). Assessments included self-reported mindfulness, perceived stress, coping, anxiety, depressive symptoms, and health-related quality of life. Psychophysiological recordings, diurnal salivary cortisol, and cytokine profiles were also collected at baseline and 2-month follow-up. Dyad scores were created for psychological and physiological measures using the mean for each patient-partner pair. Treatment efficacy was tested using linear regressions with MBSR versus UCC group assignment as the independent variable and the slope of change in dyad mean scores as the dependent variable. Results: MBSR participation significantly increased mindful observing, appraisal of support, and coping through venting/expressiveness. Treatment participants exhibited a significant reduction in respiration rate. MBSR enhanced diurnal cortisol rhythmicity and reduced evening cortisol levels. Conclusions: Results require replication, but suggest that MBSR may ameliorate disease-related distress and related physiological disruption among families contending with PD. Dyad-based interventions are worthy of further investigation among PD sufferers and partners.",Sephton S.E.; Dreeben S.J.; Jablonski M.E.; Litvan I.; Houghton D.; Giese-Davis J.; Sokhadze E.; Fernandez-Botran R.; Eismann E.A.; Hanneman S.M.; Salmon P.,2011.0,,0,0,
4248,Adjunctive low-frequency repetitive transcranial magnetic stimulation over the right dorsolateral prefrontal cortex in patients with treatment-resistant obsessive-compulsive disorder: A randomized controlled trial.,"Objective: The present study aimed to evaluate the efficacy of low frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the right dorsolateral prefrontal cortex (DLPFC) for the treatment of obsessive-compulsive disorder (OCD). Methods: Twenty-seven patients with treatment resistant OCD were randomly assigned to 3 week either active (n = 14) or sham (n = 13) rTMS. The active rTMS parameters consisted of 1 Hz, 20-minute trains (1,200 pulses/day) at 100% of the resting motor threshold (MT). OCD symptoms, mood, and anxiety were assessed at baseline and every week throughout the treatment period. Results: A repeated-measures analysis of variance (ANOVA) was used to evaluate changes on the Yale-Brown Obsessive Compulsive Scale (YBOCS). Our results revealed a significant reduction in YBOCS scores in the active group compared with the sham group after 3 weeks. Similarly, a repeated-measures ANOVA revealed significant effect of time and time x group interaction on scores on the Hamilton Depression Rating Scale and the Clinical Global Impression-Severity scale. There were no reports of any serious adverse effects following the active and sham rTMS treatments. Conclusion: LF rTMS over the right DLPFC appeared to be superior to sham rTMS for relieving OCD symptoms and depression in patients with treatment-resistant OCD. Further trials with larger sample sizes should be conducted to confirm the present findings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Seo, Ho-Jun; Jung, Young-Eun; Lim, Hyun Kook; Um, Yoo-Hyun; Lee, Chang Uk; Chae, Jeong-Ho; Abramowitz, Abudy, Adler, Alonso, Aouizerate, Bais, Baxter, Beck, Cho, Cohen, Deng, DuPont, George, George, George, George, Gershon, Goodman, Goodman, Greenberg, Grisaru, Guy, Hamilton, Hamilton, Hoehn-Saric, Jaafari, Kang, Karno, Knoch, Kunde, Lapidus, Mansur, Mantovani, Nakao, Nordahl, Pallanti, Palmieri, Pascual-Leone, Prasko, Rauch, Rauch, Sachdev, Sachdev, Sarkhel, Saxena, Schutter, Simpson, Singh, Stein, Strafella, Swedo, Teneback, Wassermann, Weissman",2016.0,,0,0,
4249,Mirtazapine in combination with amitriptyline: A drug-drug interaction study in healthy subjects,"Objective. To assess the steady-state pharmacokinetics of mirtazapine (30 mg/day orally) and amitriptyline (75 mg/day orally) during combined administration compared with that of either drug administered alone. To evaluate the tolerability and effects on psychometric tests of acute and subchronic administration of both drugs combined and alone. Methods. In a single-blind, three-way cross-over study, 24 (12 male and 12 female) healthy subjects were randomly assigned to six different sequences of three 9-day treatments, i.e. racemic mirtazapine (30 mg/day), amitriptyline (75 mg/day) or the combination of these drugs. To control for acute pharmacodynamic assessments, during the first treatment period, a placebo group (n = 8; 4 females and 4 males) was added. Serial blood samples were drawn for plasma level measurements that were subsequently subjected to pharmacokinetic analysis. Psychometric tests assessed attentional performance, and a computer-assisted telephone questionnaire assessed self-ratings of drowsiness/alertness and sleep quality. Results. Amitriptyline increased the Cmax of mirtazapine (+36%, p < 0.05) in male subjects only. Mirtazapine altered the Cmax of amitriptyline in both male (+23%, p < 0.05) and female (-23%, p < 0.05) subjects. No changes were observed for other pharmacokinetic parameters. Metabolite parameters were not affected. Changes in parent compound levels mainly resulted from effects on absorption. The psychometric test results did not reveal significant changes between combined and single drug treatments. The telephone registrations of VAMRS and LSEQ did not show clinically relevant differences between the active treatments. Conclusion. Combined administration of mirtazapine (30 mg/day) and amitriptyline (75 mg/day) alters the pharmacokinetics of either compound to a minor extent. Adding one drug to the other and substituting one drug by the other had no major effects on tolerability. Nevertheless, caution is warranted when combining amitriptyline and mirtazapine. Copyright © 2003 John Wiley & Sons, Ltd.",Sennef C.; Timmer C.J.; Sitsen J.M.A.,2003.0,10.1002/hup.441,0,0,
4250,Well that changes everything! The genesis of memory bias for threat with implications for delayed onset in anxiety disorders.,"A number of aetiological pathways have been proposed in the development of anxiety disorders, including those associated with stressful triggering situations. Life events can provide new meaning to past situations, potentially leading to the delayed onset of a disorder. Whether or not a disorder will emerge is theoretically related to one's appraisal and memory of prior events, and memory biases are proposed to exist for threat-related information in association with anxiety. Given that new events may change the meaning of past experiences, threatening information may change one's memory for once-neutral events. The current study aimed to examine the effect of threatening information on memory for previously encoded (neutral) stimuli. Undergraduate participants (n = 81) interacted with 30 neutral objects (displayed in two boxes) and completed a recall memory test for these objects. They were then randomly assigned to receive either new threatening or new neutral information about half (one box) of the already-learned objects; a second recall test was then administered. Individuals given threatening information showed a greater proportion of memory for items that were manipulated to total items recalled than did individuals given new non-threatening information. A nonclinical sample reported relatively low ratings of disgust and anxiety. Additionally, the time between the two memory tests was brief, likely differing from the actual occurrence of delayed onset disorders. Results showed the genesis of a memory bias for threat in the presumed absence of an attentional bias, and are discussed in terms of the delayed onset of anxiety disorders.",Senn JM.; Radomsky AS.,2012.0,10.1016/j.jbtep.2012.04.003,0,0,
4251,Utility of telephone assessments in an older adult population.,"Telephone assessments are commonly used in mental health research and may be especially beneficial in older populations. The current study assessed the psychometric properties of the Penn State Worry Questionnaire (T. J. Meyer, M. L. Miller, R. L. Metzger, & T. D. Borkovec, 1990) and the Beck Depression Inventory--II (A. T. Beck, R. A. Steer, & G. K. Brown, 1996), when administered over the telephone in an older adult population. Results indicate no differences in mean symptom level or internal consistency across two modes of administration. Correlations between the in-person and telephone-administered measures and diagnostic categories suggest adequate validity of the telephone-administered measures. With this demonstrated evidence, the telephone assessment method can be applied in a variety of research and clinical settings.",Senior AC.; Kunik ME.; Rhoades HM.; Novy DM.; Wilson NL.; Stanley MA.,2007.0,10.1037/0882-7974.22.2.392,0,0,
4252,Dreamy states and psychoses in temporal lobe epilepsy: mediating role of affect.,"Among 104 patients with temporal lobe epilepsy treated in our clinic between 1992-1995, thirteen patients with repeated dreamy states were evaluated for affective manifestations of dreamy states and their relationship with psychotic states. The types of dreamy states were classified as déjà vu, jamais vu and reminiscence. The affective experiences during dreamy states were evaluated as positive, negative or neutral. As a result, seven patients had déjà vu and/or reminiscence: seizure manifestations in four of these patients were affectively evaluated as positive (familiar and/or pleasurable), and three as neutral. Six cases had experience of jamais vu: five of them were affectively evaluated as negative (mostly fear), and one as neutral. Psychiatrically, only four patients with jamias vu accompanied by feelings of fear had mental disorders: a chronic paranoid-hallucinatory state in two cases, a chronic paranoid state in one case, and obsessive-compulsive symptoms in one case. Other patients who had positive or neutral affect did not demonstrate psychiatric disturbances. Thus, most patients with jamais vu were accompanied by negative affect of fear, and those patients with jamais vu tended to show more psychotic symptoms than those with reminiscence or déjà vu, which were associated with positive or neutral affects. Based on these results, we discuss the possibility that repeated negative feelings associated with jamais vu are one of the causes for developing epileptic psychoses.",Sengoku A.; Toichi M.; Murai T.,1997.0,,0,0,
4253,Cost effectiveness of individual vs. group cognitive behavior therapy for problems of depression and anxiety in an HMO population.,"Randomly assigned 44 outpatient Ss, enrollees of the George Washington University Health Plan, a Health Maintenance Organization (HMO), to one of three treatment modalities: (1) a cognitive behavior therapy group; (2) a traditional process-oriented interpersonal group; and (3) cognitive behavior therapy in an individual format. All Ss were referred by their physicians to the HMO Mental Health Practice for treatment for anxiety and/or depression. Beck's Depression Inventory, Speilberger's State-Trait Anxiety Inventory and Gay and Galassi's Adult Self-Expression Scale (an assertion measure) were administered pre- and post-treatment to all Ss. A subsample of these Ss also were rated pre- and post-treatment on the Hamilton Rating Scale for Depression by experienced clinicians blind to the treatment groups. All three experimental groups significantly improved on all dependent measures from pre- to post-treatment, and no differential treatment effects were found.",Shapiro J.; Sank LI.; Shaffer CS.; Donovan DC.,1982.0,,0,0,
4254,Two-year follow-up of the Sheffield Psychotherapy Project.,"Of 40 depressed and anxious patients who received treatment during the Sheffield Psychotherapy Project, 31 completed the BDI and SCL-90 at two-year follow-up. At both group and individual levels, outcomes were very similar to those obtained at the completion of treatment. Substantial minorities of patients reported major life events and seeking further help for psychological problems during the two years, but these reports were not reliably associated with symptoms at follow-up. Patients recalled very different elements in prescriptive and exploratory therapies as helpful, with a notable emphasis upon prescriptive therapy's relaxation and anxiety management as a source of problem solution.",Shapiro DA.; Firth-Cozens J.,1990.0,,0,0,
4255,Clinical case report: efficacy of yogic techniques in the treatment of obsessive compulsive disorders.,"The aim of this study was to investigate the clinical efficacy of yogic techniques in the treatment of eight adults with obsessive-compulsive disorder (OCD). A specific yogic breathing pattern has been prescribed for the treatment of OCD, as well as others for treating generalized anxiety. A one year course of therapy was followed. Subjects improved on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) comparing baseline with three, six, nine, & 12 month results (one-way ANOVA for repeated measures, F(4,12) = 3.343, p < or = .046). Five patients completed the study (Y-BOCS results were 83%, 79%, 65%, 61% improvement, and one at-18%), group mean improvement of +54%. The Symptoms Checklist-90-R showed significant improvement comparing baseline and 12 months using two-tailed T-tests for OCD (t = 13.856, p < .001), anxiety (t = 3.167, p < .051), and global severity indexes (t = 7.314, p = .005). Perceived Stress Scale scores showed significant improvement for the five test periods (one-way ANOVA for repeated measures, F(4,12) = 9.114, p < or = .001). Five patients were well stabilized on fluoxetine prior to the study, three stopped medication after seven months or less, and two significantly reduced it, one by 25% and the other by 50%. These techniques, merit further study under controlled conditions and could help lead to new approaches for the treatment of OCD and perhaps other impulse control and anxiety-related disorders.",Shannahoff-Khalsa DS.; Beckett LR.,1996.0,,0,0,
4256,Infectious diseases during the first world war,"The First World War was a key transition point towards scientific medicine, medical officers having incorporated the Pasteur paradigm shift of understanding micro-organisms as the cause of infectious diseases and therefore susceptible to rational control and treatment measures even in the preantibiotic era. Typhoid vaccination was successful in avoiding the disastrous epidemics of previous wars. Tetanus was probably decreased by giving millions of doses of horse anti-toxin to wounded soldiers. Quinine treated but could not control malaria; its use required mass compulsion. Tuberculosis was not a great military problem during the war although civilian populations experienced huge mortality increases. Sexually transmitted diseases remained a matter of aversive conditioning with invasive antiseptics in the absence of antibiotics. Pandemic influenza in 1918-19 killed more than the entire war, graphically demonstrating how much remained beyond the capability of our scientific great-grandfathers who fought infectious diseases during the GreatWar. The modern evolution of multi-drug resistant microorganisms raises the possibility that our medical progress against infectious diseases may not continue in an uninterrupted trajectory.",Shanks G.D.,2015.0,10.1111/imj.12782-77,0,0,
4257,Effects of predictability of shock timing and intensity on aversive responses,"ER An important characteristic of aversive stimuli that determines emotional responses is whether the stimuli are predictable. Human laboratory studies in this area have typically operationalized predictability as being able to predict the occurrence of aversive events, but animal studies suggest that being able to predict other characteristics of the stimuli may also play a role in aversive responding. To examine this, the present study examined two characteristics: the timing and intensity of aversive stimuli. Specifically, participants were randomly assigned to receive shocks that were either predictable or unpredictable in terms of when they would occur (timing) and/or their intensity. Indicators of aversive emotional responses were EMG startle responses and subjective anxiety ratings. Results revealed that aversive responding was elevated for unpredictable timing and intensity suggesting that the predictability of both characteristics play a role in aversive responding (though the effects for timing were stronger). In sum, the anxiogenic effects of unpredictability may generalize to situations beyond unpredictable timing.","Shankman, S A; Robison-Andrew, E J; Nelson, B D; Altman, S E; Campbell, M L",2011.0,10.1016/j.ijpsycho.2011.02.008,0,0,
4258,The efficacy of a cognitive-behavioral treatment program in the treatment of anxiety disorders.,"Research on the effectiveness of treatment is essential in order to develop confidence in the psychological community. The purpose of this present study was to determine if there is a statistical significant relationship between the Anxiety Treatment Network's Cognitive-Behavioral Treatment plan and the self-reported reduction of anxiety in the subjects studied. This study includes a five week program for 14 subjects suffering from an anxiety disorder. Pretreatment-posttreatment changes were charted and a comparison was made as to the significance of the changes reported. The instruments used to measure the changes were the self-report type. The discussion focuses on the usefulness of the program studied and improvements that were needed. Further discussion centered around the need for further research with more clearly established procedures. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Shalley, James Alan",1997.0,,0,0,
4259,Starting to develop self-help for social anxiety associated with vitiligo: using clinical significance to measure the potential effectiveness of enhanced psychological self-help.,"Vitiligo can be associated with high levels of distress, yet there are currently no self-help interventions available. To describe the initial development of a psychosocial self-help intervention designed to reduce social anxiety associated with vitiligo. Also to examine whether including a planning exercise, aimed at increasing use of the intervention (termed implementation intentions), has the potential to achieve a clinically significant reduction in distress. Participants (n = 75) were randomized to one of three groups: cognitive behavioural self-help (CBSH), CBSH augmented with implementation intentions (CBSH+), or no intervention. Participants were assessed at baseline and after 8 weeks on measures of social anxiety, anxiety and depression, and appearance-related concern. The two intervention groups also completed a questionnaire evaluating their use of, and satisfaction with, the intervention. High levels of social anxiety and concern over appearance were reported. Twenty-four per cent of participants in the CBSH+ group experienced clinically significant change on the measure of social anxiety compared with 8% in the CBSH group and 0% in the control group. In addition, 58% of the control group deteriorated during the study period. There were no significant differences between the conditions on the other outcome measures. Participants reported that the self-help leaflets were helpful. The findings demonstrate that augmented CBSH provides a relatively simple and accessible intervention that can result in a clinically significant reduction in social anxiety. The augmented intervention has potential and might be further developed and evaluated in subsequent trials.",Shah R.; Hunt J.; Webb TL.; Thompson AR.,2014.0,10.1111/bjd.12990,0,0,
4260,Cerebrospinal fluid pharmacokinetics and pharmacodynamics of intrathecal neostigmine methylsulfate in humans,"Background: This study defines the cerebrospinal fluid (CSF) pharmacokinetics of neostigmine after intrathecal injection in humans and its effect on CSF acetylcholine, and it correlates physiologic effects with neostigmine dose and CSF acetylcholine concentrations. Methods: The CSF was sampled via an indwelling spinal catheter in 12 volunteers receiving intrathecal neostigmine (50-750 μg) and analyzed for neostigmine and acetylcholine. Pharmacokinetic and pharmacodynamic analyses were performed with NONMEM. Effect-site models linked the time course of the neostigmine concentration with the time course of analgesia. Results: Acetylcholine concentrations increased from <20 pmol/ml at baseline to > 100 pmol/ml within 15 min of neostigmine injection. The pharmacokinetics of intrathecal neostigmine were best described by a triexponential function with an absorption phase. Individual predicted concentrations varied 100-fold. Post hoc Bayesian estimates described the observed neostigmine concentrations with a median error of 22% and did not show systematic model misspecification. Individual estimates of effect site concentration producing a 50% maximal effect for foot visual analog scale analgesia correlated with the magnitude of individual CSF neostigmine concentrations. Conclusions: Intrathecal neostigmine concentrations can be well described by a triexponential disposition function, but the intersubject variability is large. The correlation between intersubject variability in concentration and intersubject variability in 50% maximal effect for foot analgesia suggests that both are offset by a common scalar, possibly the distance from the site of injection to the sampling and effect sites. These data provide the basis for the hypothesis of 'observation at a distance' to describe the pharmacodynamics of intrathecally administered drugs.",Shafer S.L.; Eisenach J.C.; Hood D.D.; Tong C.,1998.0,,0,0,
4261,Stimulus fading and differential reinforcement for the treatment of needle phobia in a youth with autism.,"Stimulus fading in the form of gradually increased exposure to a fear-evoking stimulus, often combined with differential reinforcement, has been used to treat phobias in children who are otherwise normal and in children with autism. In this investigation, we applied stimulus fading plus differential reinforcement with an adolescent with autism and diabetes whose needle phobia had prevented medical monitoring of his blood glucose levels for over 2 years. Results showed that the treatment was successful in obtaining daily blood samples for measuring glucose levels. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Shabani, Daniel B; Fisher, Wayne W; Braff, Davidson, DeLeon, Jones, Love, McDowell, Zambanini",2006.0,,0,0,
4262,Anxiety and the neural processing of threat in faces.,"This study examined the relationship between social anxiety and the neural processing of threat in faces. Twenty-one adults with different levels of society anxiety were tested for their event-related potential responses to unattended threatening and nonthreatening faces, presented upright and upside-down, at three points in time: 160-210 ms (vertex positive potential), 300-350 ms (N3) and 440-500 ms (P3). Social anxiety was significantly correlated with the size of P3 to upright angry faces but not happy faces. This supports the theory that anxiety diverts attention towards goal-irrelevant threat cues, and suggests that this threat-related shift in attention starts to affect the processing of faces at 440-500 ms.",Sewell C.; Palermo R.; Atkinson C.; McArthur G.,2008.0,10.1097/WNR.0b013e32830baadf,0,0,
4263,Social functioning in youth with anxiety disorders: association with anxiety severity and outcomes from cognitive-behavioral therapy,"ER Social functioning was assessed using the Child Behavior Checklist and Teacher Report Form for children with anxiety disorders who participated in a randomized clinical trial (N = 161, aged 7-14). Significant relationships were found between severity of children's principal anxiety disorder and most measures of social functioning, such that poorer social functioning was associated with more severe anxiety. Among youth who received cognitive-behavioral therapy (n = 111), significant associations were found between parent-reported social competence and both absence of principal anxiety disorder and lower anxiety severity at posttreatment and 1-year follow-up, controlling for the severity of the child's principal anxiety disorder at pretreatment. Findings support a relationship between anxiety severity and social difficulties, and suggest the importance of social competence for a favorable treatment response.","Settipani, C A; Kendall, P C",2013.0,10.1007/s10578-012-0307-0,0,0,
4264,Prophylactic treatment of posttraumatic epilepsy: Results of a long-term follow-up in Czechoslovakia,"The results of a long-term study of prophylactic treatment of post-traumatic epilepsy performed in Czechoslovakia during the years 1963 through 1980 are reported. The prophylactically treated group of 144 patients with severe brain injuries was compared with a control group of 24 equally damaged cases without prophylactic treatment. The preventive treatment lasting 2 years in the great majority of cases was performed with relatively low doses of phenytoin (160-240 mg/day) and phenobarbital (30-60 mg/day) administered orally. The incidence of late posttraumatic epilepsy was 25% in the control and 2.1% in the prophylactically treated group. Only one patient (0.7%), however, developed seizures during the course of the prophylactic treatment. The efficiency of prophylactic pharmacotherapy has been proved in long-term observations lasting 8 to 13 years.",Servit Z.; Musil F.,1981.0,,0,0,
4265,"Eye movement desensitization and reprocessing for posttraumatic stress disorder: a pilot blinded, randomized study of stimulation type.","Eye movement desensitization and reprocessing (EMDR) is becoming a recognized and accepted form of psychotherapy for posttraumatic stress disorder (PTSD). Yet, its mechanism of action remains unclear and much controversy exists about whether eye movements or other forms of bilateral kinesthetic stimulation contribute to its clinical effects beyond the exposure elements of the procedure. Twenty-one patients with single-event PTSD (average Impact of Event Scale score: 49.5) received three consecutive sessions of EMDR with three different types of auditory and kinesthetic stimulation (tones and vibrations): intermittent alternating right-left (as commonly used with the standard EMDR protocol), intermittent simultaneous bilateral, and continuous bilateral. Therapists were blinded to the type of stimulation they delivered, and stimulation type assignment was randomized and counterbalanced. All three stimulation types resulted in clinically significant reductions of subjective units of distress (SUD). Yet, alternating stimulation resulted in faster reductions of SUD when only sessions starting with a new target memory were considered. There are clinically significant effects of the EMDR procedure that appear to be independent of the nature of the kinesthetic stimulation used. However, alternating stimulation may confer an additional benefit to the EMDR procedure that deserves attention in future studies.",Servan-Schreiber D.; Schooler J.; Dew MA.; Carter C.; Bartone P.,2006.0,10.1159/000093950,0,0,
4266,Planning a social activity to improve psychological well-being and quality of life of hemodialysis patients: a pilot study,"ER We aimed to investigate the impact of social activity on anxiety-depression, self-esteem and quality of life in hemodialysis patients. Ninety-one patients were recruited to the current study. Of these, 31 patients wanted to take part in a theater play, while 60 patients (group C) did not. Thirty-one patients were randomly assigned to two groups: Group A (N = 15) started activities immediately and group B (N = 16) was assigned to a waiting list to be included in the activity of theater acting four months later. Beck Depression Inventory, Beck Anxiety Inventory, Rosenberg Self-esteem Scale and World Health Organization Quality of Life Scale short form (WHOQOL-BREF) were used to compare psychological parameters and quality of life of the groups before and after the social activity. The patients who were younger, more literate, and wealthier, had longer disease duration, and who were feeling physically and psychologically well, were willing to participate in social activity. The impact of social activity was evaluated between group A and C. After the social activity, there were significant differences in terms of depression (P = 0.008), self-esteem (P = 0.003), and physical (P = 0.04) and psychological (P = 0.05) sub-dimensions of quality of life between the groups. The depression score of the patients in group A decreased while their self-esteem increased, but the increase in the physical and psychological sub-dimension scores of quality of life scale did not reach statistical significance. This pilot study showed that social activity primarily improved depression and self-esteem in hemodialysis patients.","Sertoz, O O; Asci, G; Toz, F; Duman, S; Elbi, H; Ok, E",2009.0,10.1111/j.1744-9987.2009.00690.x,0,0,
4267,"Validation and cross-cultural adjustment of PDQL-questionnaire, Spanish version (Ecuador) (PDQL-EV)","ER METHODCross-sectional study of patients with Parkinson's Disease attending a Movement Disorders Clinic. MEASURES APPLIED: Hoehn and Yahr (HY), Unified Parkinson's Disease Rating Scale (UPDRS-3.0), Schwab and England Scale (SES), Pfeiffer Questionnaire (SPMSQ), Hospital Anxiety and Depression Scale (HADS). PDQ-39 and PDQL-EV were applied, the latter after translation and back translation.RESULTSThe study included 137 patients with an age range of 69.43 +/- 10.18 years (mean +/- SD), duration of illness 5.87 +/- 2.58 years, and HY 2.28 +/- 0.77. The PDQL-EV internal consistency (Cronbach's alpha) yielded: Parkinson's symptoms (PS) 0.85; systemic symptoms (SS) 0.69; social function (SF) 0.81; and emotional function (EF) 0.78. The correlation between measurements varied from 0.68 (PS-SS) to 0.46 (SS-EF), and total measurement correlation from 0.58 (EF) to 0.74 (PS) (altogether, p < 0.0001). The correlation of PDQL with clinical variables was:","Serrano-Dueñas, M; Martínez-Martín, P; Vaca-Baquero, V",2004.0,10.1016/j.parkreldis.2004.05.002,0,0,
4268,A reminiscence program intervention to improve the quality of life of long-term care residents with Alzheimer's disease: a randomized controlled trial,"ER OBJECTIVE: A single-blinded, parallel-groups (intervention, active and passive control groups) randomized controlled trial (RCT) was chosen to investigate whether a specific reminiscence program is associated with higher levels of quality of life in nursing home residents with dementia.METHODS: The intervention used a life-story approach, while the control groups participated in casual discussions. The Social Engagement Scale (SES) and Self Reported Quality of Life Scale (SRQoL) were used as the outcome measures, which were examined at baseline (T0), 12 weeks (T1), and six months (T2) after the intervention. The final sample had 135 subjects (active control group = 45; passive control group = 45; intervention group = 45).RESULTS: The Wilcoxon test showed significant differences in the intervention group between T2 and T0, and between T1 and T0 in the SES, and there were significant differences between T0 and T1 (intervention effect size = 0.267) and T1 and T2 (intervention effect size = 0.450) in the SRQoL. The univariate logistic regression scores showed that predictors of change in the SRQoL were associated with fewer baseline anxiety symptoms and lower depression scores.CONCLUSIONS: The intervention led to significant differences between the three groups over time, showing a significant improvement in the quality of life and engagement of the residents in the intervention group.","Serrani, Azcurra D J",2012.0,,0,0,
4269,Linking changes in pain severity to changes in other outcomes in patients with posttraumatic peripheral neuropathic pain treated with pregabalin,"Introduction: Understanding the relationship between pain severity and corresponding levels in patient-reported function can inform treatment decisions and guide assessment of outcomes. Objectives: To evaluate the relationship between pain (0-10 numerical rating scale, NRS), and the patient-reported outcomes (PROs) of function (Pain Interference Index from the modified Brief Pain Inventory), mood (Hospital Anxiety and Depression Scale), sleep (Medical Outcomes Study Sleep Scale), and sleep interference (0-10 NRS) in patients with posttraumatic pain. Methods: Relationships between the 8-week change from baseline (last observation carried forward) using PRO scores as the outcome and pain as the predictor were modeled and analyzed using clinical trial data of pregabalin in patients with posttraumatic peripheral neuropathic pain (N = 254).(Graph presented). Results: Mean changes in pain were significantly (P < 0.0001) associated with change in sleep interference (Figure) and other PROs, and were linked to specific score changes on all PROs - e.g., a 2-point improvement in pain, reflected by a decrease in NRS score, was linked to an improvement in sleep disturbance equivalent to a change in score of -1.64-points (95% confidence interval, -1.86 to -1.43). Results from subgroup analyses (=30% or =50% pain responders, pregabalin or placebo treatment) were generally consistent with the results from the overall sample, suggesting robustness of findings. Conclusions: Changes in pain levels during treatment with pregabalin were associated with changes in sleep, function, anxiety, and depression. Additional confirmatory studies are encouraged.",Serpell M.; Seventer R.V.; Bach F.; Morlion B.J.; Zlateva G.; Bushmakin A.G.; Cappelleri J.C.; Nimour M.,2010.0,10.1016/S1754-3207(10)70313-8,0,0,
4270,Characterization of native and denatured ricin using MALDI-TOF/MS,"Ricin is a toxic protein present in the seeds of castor bean plant. It can be inactivated by heat; therefore characterization of denatured ricin is essential to differentiate it from native ricin and to avoid any ambiguity in its identification. In this study, potential of mass spectrometry using MALDI-TOF/MS has been exploited to investigate the effects of heat treatment on ricin and spiked food matrices. The molecular weights of ricin, ricin A (A1 and A2) and B chain were found to be 62.8 kDa, 31.2 kDa, 32.5 kDa and 32 kDa respectively. The mass spectrum revealed a polypeptide chain of 11.1 kDa for denatured ricin. The peptide mass fingerprinting showed 24 peptides, six were common both in native and denatured ricin. The differentiating peptide at position 294-318 (m/z 934.533) was observed only in denatured ricin. The three selected marker peptides m/z 1013.6, 1310.7, 1728.9 are chosen for identification of ricin inactivated by heat in spiked apple juice and milk samples by immunocapture analysis. There is always a probability of denatured non- toxic ricin being confused with native (toxic) ricin to create unnecessary panic. Keeping this probability in mind, our study will be of immense value in minimising such risk. © 2010 C.M.B. Edition.",Sehgal P.; Rao M.K.; Kumar O.; Vijayaraghavan R.,2010.0,10.1170/158,0,0,
4271,Interdependent anxiety and psychological distress in women with breast cancer and their partners,"ER The purpose of this study was to determine the extent of interdependence on anxiety within dyads where one person was undergoing treatment for breast cancer. Perceptions of relationship quality were expected to mitigate the anxiety experienced by both members of the dyad. 96 dyads participated in a 3-wave longitudinal study that took place over 10 weeks. Dyads were composed of a woman with stage I-III breast cancer who was currently undergoing treatment, and a partner who she nominated to participate in the study along with her. Results indicated that anxiety felt by women with breast cancer was consistently associated with that of her partner. Structural equation analyses suggest that the within-dyad influence runs mostly from partners' anxiety to the anxiety of women with breast cancer. Partners' anxiety was also associated with other indicators of the women's well being including depression, fatigue, and symptom management. Perceptions of relationship quality from women with breast cancer and their partners were negatively associated with partners' anxiety. However, women's anxiety was only correlated with their partners', but not their own, perceptions of relationship quality. These findings underscore the benefit of having partners who are able to cope with or get help for their own personal distress as women cope with the stress of breast cancer and its treatment.","Segrin, C; Badger, T; Dorros, S M; Meek, P; Lopez, A M",2007.0,10.1002/pon.1111,0,0,
4272,Psychological Distress as a Mediator of the Relation Between Perceived Maternal Parenting and Normative Maladaptive Eating Among Adolescent Girls,"Burgeoning research on the adolescent (e.g., middle-school) years suggests that this is a particularly vulnerable period for the development of maladaptive eating patterns. Prior research has established a link between perceptions of maternal parenting practices and adolescent onset of problematic eating behaviors. The authors hypothesized that adolescents' internalized psychological distress accounts for this relation, and they tested this hypothesis via a longitudinal, mediational study of 73 adolescent girls followed from 6th to 8th grade. Results of structural equation modeling using latent variables supported the hypothesis, identifying a time-ordered process that emphasizes the significance of the mother-adolescent relationship and the importance of targeting counseling interventions at improving parenting practices and helping adolescents to regulate negative affect as a means of preventing the development of maladaptive eating. © 2007 American Psychological Association.",Salafia E.H.B.; Gondoli D.M.; Corning A.F.; McEnery A.M.; Grundy A.M.,2007.0,10.1037/0022-0167.54.4.434,0,0,
4273,PTSD symptom severity as a predictor of cue-elicited drug craving in victims of violent crime.,"This study examined posttraumatic stress disorder (PTSD) symptom severity as a predictor of cue-elicited craving among alcohol- and cocaine-dependent individuals with a history of at least one physical and/or sexual assault. Approximately half of the sample had current PTSD. Severity of PTSD symptoms was measured via the Impact of Events Scale-Revised (IES-R) total severity score. Subjects listened to four trials of a brief narrative imagery script followed by the presentation of an in vivo cue. The script presentation consisted of a description of either the subject's worst traumatic event or a neutral scene. The in vivo cues consisted of the presentation of either the subject's preferred drug or neutral cues. Craving was measured in response to both the script and in vivo cues. Results indicated a high degree of correlation between self-report craving and (a) PTSD symptom severity, (b) type of substance use disorder (SUD) [alcohol dependence (AD) vs. cocaine dependence (CD)], and (c) sex and race of participant. A series of stepwise multiple regressions indicated that PTSD severity was significantly predictive of trauma cue-elicited craving and drug cue-elicited craving. The results are discussed in the context of current research, theory, and clinical practice.",Saladin ME.; Drobes DJ.; Coffey SF.; Dansky BS.; Brady KT.; Kilpatrick DG.,2003.0,,0,0,
4274,Understanding comorbidity between PTSD and substance use disorders: two preliminary investigations,"ER While there is high level of comorbidity of PTSD and substance use disorders (SUDs), little research has focused on the overlapping symptom constellation characteristic of both PTSD and substance use/withdrawal. This report describes two preliminary investigations that address this area. In the first study, the pattern of PTSD symptoms in a sample of women (n = 28) seeking treatment for a SUD and comorbid with PTSD was compared with the symptom pattern of a sample of women (n = 28) with PTSD only. The PTSD + SUD group evidenced significantly more symptoms in the avoidance and arousal symptom clusters than the PTSD-only group. At the individual symptom level, the PTSD + SUD group reported significantly more sleep disturbance than the PTSD-only group. It was also determined that the PTSD + SUD group reported greater traumatic-event exposure than the PTSD-only group. In the second study, PTSD symptoms were compared in a sample of alcohol- dependent and a sample of cocaine-dependent individuals with PTSD. The alcohol- dependent group exhibited significantly more arousal symptoms than the cocaine-dependent group. Implications of the results for the assessment of individuals with comorbid PTSD and SUDs are discussed.","Saladin, M E; Brady, K T; Dansky, B S; Kilpatrick, D G",1995.0,,0,0,
4275,Using problem-solving skills training to reduce negative affectivity in mothers of children with newly diagnosed cancer: report of a multisite randomized trial,"ER Mothers of children with cancer experience significant distress associated with their children's diagnosis and treatment. The efficacy of problem-solving skills training (PSST), a cognitive-behavioral intervention based on problem-solving therapy, was assessed among 430 English- and Spanish-speaking mothers of recently diagnosed patients. Participants were randomized to usual psychosocial care (UPC; n=213) or UPC plus 8 sessions of PSST (PSST; n=217). Compared with UPC mothers, PSST mothers reported significantly enhanced problem-solving skills and significantly decreased negative affectivity. Although effects were largest immediately after PSST, several differences in problem-solving skills and distress levels persisted to the 3-month follow-up. In general, efficacy for Spanish-speaking mothers exceeded that for English-speaking mothers. Findings also suggest young, single mothers profit most from PSST.","Sahler, O J; Fairclough, D L; Phipps, S; Mulhern, R K; Dolgin, M J; Noll, R B; Katz, E R; Varni, J W; Copeland, D R; Butler, R W",2005.0,10.1037/0022-006X.73.2.272,0,0,
4276,Specificity of problem-solving skills training in mothers of children newly diagnosed with cancer: results of a multisite randomized clinical trial,"ER PURPOSE: Diagnosis of cancer in a child can be extremely stressful for parents. Bright IDEAS, a problem-solving skills training (PSST) intervention, has been shown to decrease negative affectivity (anxiety, depression, post-traumatic stress symptoms) in mothers of newly diagnosed patients. This study was designed to determine the specificity of PSST by examining its direct and indirect (eg, social support) effects compared with a nondirective support (NDS) intervention.PATIENTS AND METHODS: This randomized clinical trial included 309 English- or Spanish-speaking mothers of children diagnosed 2 to 16 weeks before recruitment. Participants completed assessments prerandomization (T1), immediately postintervention (T2), and at 3-month follow-up (T3). Both PSST and NDS consisted of eight weekly 1-hour individual sessions. Outcomes included measures of problem-solving skill and negative affectivity.RESULTS: There were no significant between-group differences at baseline (T1). Except for level of problem-solving skill, which was directly taught in the PSST arm, outcome measures improved equally in both groups immediately postintervention (T2). However, at the 3-month follow-up (T3), mothers in the PSST group continued to show significant improvements in mood, anxiety, and post-traumatic stress; mothers in the NDS group showed no further significant gains.CONCLUSION: PSST is an effective and specific intervention whose beneficial effects continue to grow after the intervention ends. In contrast, NDS is an effective intervention while it is being administered, but its benefits plateau when active support is removed. Therefore, teaching coping skills at diagnosis has the potential to facilitate family resilience over the entire course of treatment.","Sahler, O J; Dolgin, M J; Phipps, S; Fairclough, D L; Askins, M A; Katz, E R; Noll, R B; Butler, R W",2013.0,10.1200/JCO.2011.39.1870,0,0,
4277,Item factor analysis of the Italian version of the death anxiety scale,"The 15 items of the Italian edition of the Templer's Death Anxiety Scale (DAS) were subjected to a principal components factor analysis with a sample of 257 subjects. Three factors, selected by the scree test, were rotated using the Direct Oblimin procedure. Cronbach alpha-coefficients are reported for the scale and the factors together with their intercorrelations. The results demonstrate that the DAS is a multidimensional scale. Therefore, its utility is questioned. Suggestions are made for future research.",Saggino A.; Kline P.,1996.0,10.1002/(SICI)1097-4679(199605)52:3<329::AID-JCLP11>3.0.CO;2-K,0,0,
4278,Therapeutic strategies for pancreatic pseudocysts.,"During the last 15 years, a total of 26 patients were treated for pancreatic pseudocysts, at the 2nd Department of Propaedeutic Surgery, University of Athens. There were 16 (61.5%) men and 10 (38.5%) women aged between 19 and 82 years old (mean age 61 years). Dominating symptoms in most patients were epigastric mass and pain, nausea, vomiting, mild fever and leucocytosis, and persistent elevation of serum amylase. Imaging studies, such as ultrasound, CT scan, and ERCP, were mostly helpful in establishing diagnosis. In most cases, attack of acute pancreatitis preceded with the exception of two cases where there was chronic pancreatitis and another which was post-traumatic. Rapid progression of underlying pancreatitis led to urgent laparotomy in two patients (7.7%). Elective surgery was performed in 22 patients (84.6%), 1-7 months after onset of pancreatitis (median 2 months). Selection of operative procedure depended on the patient and cyst condition. Cystogastrostomy was performed in 18 patients (69.2%), cystojejunostomy in three patients (11.5%), and external drainage in three patients (11.5%). There were three postoperative deaths (11.5%). Haemorrhage and infection were the main complications. Percutaneous drainage was performed in two cases (7.7%) (one for a cyst remnant after an operative procedure), and medical treatment with somatostatin in another case (3.8%) with excellent clinical results. In conclusion, conservative treatment of pancreatic pseudocysts has good clinical results, but it is not always indicated. Surgical drainage remains the preferred method of treatment.",Safioleas M.; Misiakos E.; Karatzas G.; Manti C.; Marselos P.; Tzatzadakis N.,1995.0,,0,0,
4279,"""It was never that bad"" Biased recall of grief and long-term adjustment to the death of a spouse","At 6 months following the death of their spouse, 37 participants reported their grief-related symptoms and thoughts, and then, approximately 4.5 years later, they attempted to recall how they felt at the time of the 6-month report. Although participants were far less distressed at recall than initially, they recalled their 6-month grief rather accurately. Participants did however overestimate prior grief-related intrusive ideation. Participant's current level of grief predicted what they recalled slightly better than the actual initial grief. Conversely, what they recalled predicted current levels of grief across various measures. Participants whose grief diminished relatively little over time tended to overestimate prior grief more. The retrospective reappraisal that one's past grief was not severe may indicate effective coping.",Safer M.A.; Bonanno G.A.; Field N.P.,2001.0,10.1080/09658210143000065,0,0,
4280,"Safety and efficacy of sildenafil citrate in treating erectile dysfunction in patients with combatrelated post traumatic stress disorder: A doubleblind, randomized and placebocontrolled study","Introduction and Objective: More than 80% of combat veterans with post traumatic stress disorder (PTSD) experience sexual dysfunction. Our aim was to evaluate safety and efficacy of sildenafil citrate (a phosphodiesterase type 5 inhibitor) in treatment of erectile dysfunction (ED) in patients with combat related PTSD. Materials and Methods: A total of 266 combatexposed war veterans with ED (aged 37-59 years) were recruited. They met DSM-IV criteria for PTSD according to the Structured Clinical Interview for Patients, Investigator Version (SCID-I). Only subjects with psychogenic ED were included in the study. Patients with comorbid conditions included diabetes mellitus, hypercholesterolemia, hypertension, Peyronie's disease and smokers of more than five cigarettes daily were excluded. They were randomly divided into group 1 (n=133), those who received 100 mg on demand sildenafil 45 minutes to 2 hours prior to sexual stimulation and group 2 (n= 133), who received placebo. Patients were asked to use at least 16 doses/attempts at home. The efficacy of two treatments was assessed every 4 attempts during treatment, and at the end of study, using responses to the 15-question International Index of Erectile Function (IIEF), Sexual Encounter Profile (SEP), diary questions 2 and 3, Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire, patients' event logs of sexual activity, and a Global Assessment Question (GAQ) about erections. Results: Sildenafil did not produce significantly and substantially greater improvement than placebo in each of the primary and secondary outcome measures (P=0.08). A normal EF domain score (a 26) at endpoint was reported by 13 (9.8%), and 11 (8.3%) of the patients on the sildenafil and placebo regimens, respectively (P=0.09). Patients treated with sildenafil did not have a statistically significantly greater improvement in the five sexual function domains of the IIEF questionnaire than those treated with placebo (P=0.08). The incidences of treatmentemergent adverse events were significantly greater in the sildenafil arm compared with the placebo group (P= 0.01). Conclusions: Sildenafil is no better than placebo in treatment of PTSD-emergent ED. Further randomized clinical trials (RCTs) are warranted in combat veterans and other populations with PTSD to better elucidate the role of phosphodiesterase type 5 inhibitors in treatment of PTSD-emergent ED.",Safarinejad M.; Kolahi A.; Ghaedi G.,2009.0,10.1016/j.urology.2009.07.114,0,0,
4281,The effectiveness of cognitive behavioral group psychotherapy for obsessive-compulsive disorder.,"Objective: The aim of this study was to determine the effectiveness of cognitive behavioral group therapy (CBGT) in the treatment of the obsessive-compulsive disorder (OCD). MATERIALS AND Methods: The study included 82 patients diagnosed as OCD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). In all, 37 patients that had their diagnosis confirmed via the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and agreed to participate were provided group therapy as 14 weekly 90-120-min sessions. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Yale-Brown Obsessive Compulsive Scale-Symptom Checklist (Y-BOCS-SC), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were administered to the patients prior to group therapy (baseline) and again after sessions 2, 5, 8, 12, and 14. Results: In all, 8 patients dropped out of the study for various reasons and 29 completed the group therapy. There were significant reductions in BAI, BDI, and Y-BOCS scores in the patients that completed the group therapy. Additionally, BAI, BDI, and Y-BOCS score did not differ according to age, gender, or level of education. Conclusions: CBGT was associated with significant improvement in OCD symptoms. Neither demographic characteristics (age, gender, and education level), nor clinical characteristics (disease duration, type of obsession, compulsion type, treatment history, and comorbidity pattern) had an effect on treatment outcome. In light of these findings, we think CBGT is an effective option for the treatment of OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Safak, Yasir; Karadere, Mehmet Emrah; Ozdel, Kadir; Ozcan, Turkan; Turkcapar, Mehmet Hakan; Kuru, Erkan; Yucens, Bengu; Abramowirz, Abramowitz, Abramowitz, Alonso, Anderson, Antony, Beck, Beck, Benazon, Bieling, Black, Centraux, Clark, Cordioli, Eddy, Fais-Stewart, First, Foa, Foa, Foa, Franklin, Franklin, Goodman, Goodman, Himle, Hisli, Houghton, Jonsson, Jonsson, Karamustafahoglu, Keijsers, Mataix-Cols, McLean, O'Connor, O'Connor, Rufer, Rufer, Sadock, Steketee, Summerfeldt, Tek, Tezcan, Tukel, Tutkcpapat, Ulusoy, Van Balkom, Van Balkom, Van Noppen, Van Oppen, Zohar, Olatunji, Ozkurkcugil, Ozturk",2014.0,,0,0,
4282,The effectiveness of cognitive behavioral group psychotherapy for obsessive-compulsive disorder.,"The aim of this study was to determine the effectiveness of cognitive behavioral group therapy (CBGT) in the treatment of the obsessive-compulsive disorder (OCD). The study included 82 patients diagnosed as OCD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). In all, 37 patients that had their diagnosis confirmed via the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and agreed to participate were provided group therapy as 14 weekly 90-120-min sessions. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Yale-Brown Obsessive Compulsive Scale-Symptom Checklist (Y-BOCS-SC), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were administered to the patients prior to group therapy (baseline) and again after sessions 2, 5, 8, 12, and 14. In all, 8 patients dropped out of the study for various reasons and 29 completed the group therapy. There were significant reductions in BAI, BDI, and Y-BOCS scores in the patients that completed the group therapy. Additionally, BAI, BDI, and Y-BOCS score did not differ according to age, gender, or level of education. CBGT was associated with significant improvement in OCD symptoms. Neither demographic characteristics (age, gender, and education level), nor clinical characteristics (disease duration, type of obsession, compulsion type, treatment history, and comorbidity pattern) had an effect on treatment outcome. In light of these findings, we think CBGT is an effective option for the treatment of OCD.",Safak Y.; Karadere ME.; Ozdel K.; Ozcan T.; Türkçapar MH.; Kuru E.; Yücens B.,2014.0,,0,0,
4283,Effect of preoperative education on recovery time of laparoscopic cholecystectomy: A randomized clinical trial.,"Background: Nowadays, new methods are emerging each month for a better operation with fewer complications. Laparoscopic surgery have remarkable advantages, Compared to open, such as smaller incision, less manipulation of the digestive system, less postoperative pain, fewer wound complication and faster discharge from the hospital. Therefore it is preferred by patients and surgeons and is replacing the traditional open surgical methods. However, any operation causes significant panic for patients and lack of knowledge about the surgical method is found to cause poor surgical outcomes, such as recovery time after the surgery we evaluated the effect of preoperative education on the recovery time of laparoscopic cholecystectomy candidates. Methods: This randomized clinical control trial was performed at Imam Khomeini and Alborz Hospitals in Karaj from February 2010 till January 2011. Using randomized sampling method, 100 female candidates for laparoscopic cholecystectomy were divided into two equal groups of case and control. The case group received detailed information about operating room's condition, surgical equipment, anesthesia method, advantages and disadvantages of laparoscopic procedures, and patient's role in self-care at recovery, whilst the control group received no education before the surgery. The two groups were compared regarding recovery time based on Aldrete modified checklist and mean time to reach the Aldrete consciousness score of 9 and the incidence of nausea was assessed among them. Results: The analysis showed that there was a significant difference between the mean time to reach Aldrete consciousness modified checklist score of 9 between the case and control group (18.04 +/- 3.87 vs. 29.66 +/- 5.44, respectively, P < 0.001), therefore the case group had shorter recovery time than the control group. 10 of the case group (20%) and 3 of the control group (6%) had nausea after recovery (P = 0.037, OR = 0.255 (CI 95%: 0.066-0.992)). Conclusion: Preoperative education of patients can significantly decrease the recovery time after laparoscopic cholecystectomy surgery. Therefore, it is strongly recommended to include the preoperative education in routine care of laparoscopic cholecystectomy patients for better surgical outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sadati, Leila; Golchini, Ehsan; Pazouki, Abdolreza; Jesmi, Fatemeh; Pishgahroudsari, Mohadeseh; Anderson, Arthur, Asghari, Bailey, Black, Brown, Carter, Chlan, Coles, Halaszynski, Hosseini, Hughes, Jawaid, Johansson, Kehlet, Korhan, Kruzik, Litwin, Moteahedian, Orihuela-Perez, Pritchard, Royse, Sadati, Sadati, Smith, Truong, Valenzuela Millan, Wennstrom",2014.0,,0,0,
4284,Long-term efficacy of adding a sharp posterior optic edge to a three-piece silicone intraocular lens on capsule opacification: five-year results of a randomized study,"ER DESIGNRandomized, controlled, double-blind clinical trial with intraindividual comparison.METHODSFifty-one patients with bilateral age-related cataract were included (102 eyes). Each patient had had cataract surgery in both eyes and received a Microsil IOL with a sharp optic edge design (model S) in one eye and a Microsil IOL with a round optic edge design (model R) in the fellow eye. Both IOLs had an identical haptic design (nonangulated polymethylmethacrylate) and silicone optic material. The patients were examined at the slit lamp, best-corrected visual acuity was assessed, and standardized high-resolution digital retroillumination images of the posterior capsule were taken 5 years after surgery. The intensity of regeneratory posterior capsule opacification (rPCO), fibrotic PCO (fPCO), and anterior capsule opacification (ACO) was assessed subjectively at the slit lamp, and of rPCO, objectively using automated image analysis software (AQUA). The need for an Nd:YAG laser capsulotomy (Nd:YAG-LCT) was noted.RESULTSThe mean AQUA PCO score was 1.2 for the model S and 2.4 for the model R lens (P = .001). The model S lens also led to less peripheral fPCO (P = .003). Concerning ACO, there was no significant difference between both IOL groups (P = .72). Whereas no capsulotomy was required with the model S, four cases (16%) had been performed in the model R group.CONCLUSIONFive years postoperatively, the sharp-edged silicone IOL showed less rPCO and fPCO than the round-edged IOL. However, regarding ACO, there was no significant difference between both IOL styles.PURPOSETo compare the intensity of capsule opacification with the sharp and the round optic edge variant of an open-loop hydrophobic silicone intraocular lens (IOL).","Sacu, S; Menapace, R; Findl, O; Kiss, B; Buehl, W; Georgopoulos, M",2005.0,10.1016/j.ajo.2004.12.050,0,0,
4285,Comparison of posterior capsule opacification between the 1-piece and 3-piece Acrysof intraocular lenses: two-year results of a randomized trial,"ER DESIGNA randomized, patient- and examiner-masked clinical trial with intraindividual comparison.PARTICIPANTSFifty-two patients with bilateral age-related cataract (104 eyes).METHODSEach patient had cataract surgery in both eyes and received a 1-piece Acrysof IOL in one eye and a 3-piece Acrysof IOL in the fellow eye. Follow-up examinations were at 1 week, 1 month, 6 months, 1 year, and 2 years. Patients were examined at the slit lamp, visual acuity (VA) was determined, and standardized high-resolution digital retroillumination images of the posterior capsule were taken. The intensity of PCO was assessed subjectively at the slit lamp and objectively using automated image analysis software.MAIN OUTCOME MEASUREPosterior capsule opacification score (scale, 0-10).RESULTSThere was no significant difference between IOL styles in best-corrected VA, rhexis/IOL overlap, capsular folds, and amount of anterior capsule opacification during the follow-up period. One year postoperatively, the amount of regeneratory PCO was higher for the 1-piece Acrysof eyes (image analysis software score: 1.3) than for the 3-piece Acrysof eyes (score: 0.9; P = 0.002). However, 2 years postoperatively, there was no significant difference between the 2 IOL styles (1-piece: 1.5; 3-piece: 1.3; P = 0.3). Neodymium:yttrium-aluminum-garnet capsulotomy was not performed in the study.CONCLUSIONOne year postoperatively, the 1-piece Acrysof showed slightly more regeneratory PCO than the 3-piece Acrysof. However, 2 years postoperatively, the barrier effect of the 1-piece design was comparable to that of the 3-piece haptic design, with low PCO intensity.PURPOSETo compare intensity of posterior capsule opacification (PCO) between the 1-piece and 3-piece haptic designs of an open-loop hydrophobic acrylic intraocular lens (IOL).","Sacu, S; Findl, O; Menapace, R; Buehl, W; Wirtitsch, M",2004.0,10.1016/j.ophtha.2004.03.028,0,0,
4286,Posttraumatic stress disorder across two generations of Cambodian refugees.,"To examine the expression of war-related trauma as manifested by DSM-III-R rates of posttraumatic stress disorder (PTSD) and major depressive disorder in two generations of Cambodian refugees living in the western United States. A probability sample of 209 Khmer adolescents and one of their parents were interviewed using portions of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version and the PTSD section of the Diagnostic Interview for Children and Adolescents. Interviews were conducted in English by a master's-level clinician with a Khmer interpreter. PTSD was found to be significantly related across parent-child generations. A nonsignificant generational trend was also found for depressive disorders. A number of environmental variables measured in the study (amount of reported war trauma, loss, living arrangements, treatment received, socioeconomic status) were not related to these findings. Parents were more likely to report an earlier onset of PTSD symptoms. This study suggests that PTSD in refugees may cluster in families. Whether this phenomenon is caused by a genetic susceptibility to trauma awaits further research. PTSD and depressive disorders in refugee populations, while often comorbid, appear to follow different courses over time.",Sack WH.; Clarke GN.; Seeley J.,1995.0,10.1097/00004583-199509000-00013,0,0,
4287,Consequences of the Diagnostic Criteria Proposed for the ICD-11 on the Prevalence of PTSD in Children and Adolescents,"ER In 2013, a working group of the World Health Organization (WHO) proposed a reformulation of the posttraumatic stress disorder (PTSD) diagnostic criteria for the upcoming 11(th) edition of the International Classification of Diseases (ICD-11; Maercker, Brewin, Bryant, Cloitre, van Ommeren, et al., 2013). This study investigated the consequences of the proposed ICD-11 PTSD symptom reduction on the prevalence of PTSD in children and adolescents. Prevalence rates of PTSD in a clinical sample of 159 traumatized children and adolescents were compared applying criteria according to the 4(th) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994), the ICD-10 (WHO, 1992), and the ICD-11. The prevalence rate was 76.1% using DSM-IV, 88.1% using ICD-10, and 61.0% using ICD-11. The use of the criteria proposed for ICD-11 resulted in 27.1% less positive cases compared with ICD-10 and 15.1% less positive cases compared with DSM-IV. Our results showed that in a clinical sample of children and adolescents the prevalence of PTSD was significantly affected by the use of different diagnostic systems. This will constitute a major challenge for research and practice because, depending on the algorithm used, different groups of patients will be included in studies and different groups of individuals will be able to access medical care and therapy.","Sachser, C; Goldbeck, L",2016.0,10.1002/jts.22080,0,0,
4288,Gender related disabilities in panic disorder.,"Gender differences with regard to specific psychosocial factors were investigated in 100 outpatients with the diagnosis of panic disorder (DSM-IV) with and without agoraphobia (78% with agoraphobia). Patients were recruited for a randomized clinical trial of paroxetine alone versus paroxetine plus a specific form of group psychotherapy. Similar to previous results, no significant differences were found on measures of demographic data, symptomatology and comorbidity. However, psychosocial disabilities and interpersonal problems were associated with being female. Family function was more highly impaired in women than in men, and women had a higher rate of catastrophic thinking. Women differed from men in one interpersonal factor, namely being, overly expressive. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sachs, Gabriele; Amering, M; Berger, P; Katschnig, H; Barzega, Beck, Bekker, Breslau, Chambless, Chambless, Chambless, Clark, Cox, First, Hafner, Horowitz, Horowitz, Horowitz, Katschnig, Kendler, Kendler, Kessler, Kiesler, Lepola, Lewinsohn, McCarthy, Guy, Noyes, O'Rourke, Pearlin, Scheibe, Shear, Sheehan, Sullivan, Turgeon, Weich, Wittchen, Yonkers, Zuckerman",2002.0,,0,0,
4289,Right versus left prefrontal transcranial magnetic stimulation for obsessive-compulsive disorder: a preliminary investigation.,"There is preliminary evidence that repetitive transcranial magnetic stimulation (rTMS) may be useful for the treatment of obsessive-compulsive disorder (OCD), but no definitive study has been published, and the effect of laterality of stimulation is uncertain. Subjects (N = 12) with resistant OCD were allocated randomly to either right or left prefrontal rTMS daily for 2 weeks and were assessed by an independent rater at 1 and 2 weeks and 1 month later. Subjects had an overall significant improvement in the obsessions (p < .01), compulsions (p < .01), and total (p < .01) scores on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) after 2 weeks and at 1-month follow-up. This improvement was significant for obsessions (p < .05) and tended to significance for total Y-BOCS scores (p = .06) after correction for changes in depression scores on the Montgomery-Asberg Depression Rating Scale. There was no significant difference between right- and left-sided rTMS on any of the parameters examined. Two subjects (33%) in each group showed a clinically significant improvement that persisted at I month but with relapse later in I subject. A proportion (about one quarter) of patients with resistant OCD appear to respond to rTMS to either prefrontal lobe, although in the absence of a sham treatment group in this study, we cannot rule out the possibility of this being a placebo response. This treatment warrants further investigation to better establish its efficacy and examine the best parameters for response.",Sachdev PS.; McBride R.; Loo CK.; Mitchell PB.; Malhi GS.; Croker VM.,2001.0,,0,0,
4290,Repetitive transcranial magnetic stimulation for the treatment of obsessive compulsive disorder: a double-blind controlled investigation.,"To determine the efficacy and tolerability of repetitive transcranial magnetic stimulation (rTMS) as a treatment for obsessive compulsive disorder (OCD) in a double-blind placebo-controlled study. Subjects with treatment-resistant OCD were randomized to rTMS (n = 10) or sham rTMS (n = 8) for 10 sessions of daily stimulation over the left dorsolateral prefrontal cortex (DLPFC), with subjects and raters being blind to the treatment. Subjects were offered an open extension of up to 20 sessions of rTMS. The two groups did not differ on change in Yale-Brown Obsessive Compulsive Scale (YBOCS) or Maudsley Obsessive-Compulsive Inventory scores over 10 sessions, with or without correction for depression ratings. Over 20 sessions, there was a significant reduction in total YBOCS scores, but not after controlling for depression. rTMS over 20 sessions was well tolerated. Two weeks of rTMS over the left DLPFC is ineffective for treatment-resistant OCD.",Sachdev PS.; Loo CK.; Mitchell PB.; McFarquhar TF.; Malhi GS.,2007.0,10.1017/S0033291707001092,0,0,
4291,Site and size of lesion and psychosurgical outcome in obsessive-compulsive disorder: a magnetic resonance imaging study.,,Sachdev P.; Hay P.,1996.0,10.1016/0006-3223(95)00610-9,0,0,
4292,Perfectionism and self-consciousness in social phobia and panic disorder with agoraphobia.,"Social phobics were compared to patients with panic disorder with agoraphobia and normal controls on perfectionism and self-consciousness. On concern over mistakes and doubts about action, social phobics scored higher than patients with panic disorder. Social phobics also demonstrated a higher level of public self-consciousness than patients with panic disorder and when this difference was controlled for the significant differences on perfectionism disappeared. Within each patient group, however, perfectionism was more robustly related to social anxiety than was public self-consciousness, which replicates the findings of Saboonchi and Lundh [Saboonchi, F. & Lundh, L. G. (1997). Perfectionism, self-consciousness and anxiety. Personality and Individual Differences, 22, 921-928.] from a non-clinical sample. The results are discussed in terms of public self-consciousness being a differentiating characteristic of the more severe kind of social anxiety which is typical of social phobia.",Saboonchi F.; Lundh LG.; Ost LG.,1999.0,,0,0,
4293,On potential interactions between non-selective cation channel TRPM4 and sulfonylurea receptor SUR1,"The sulfonylurea receptor SUR1 associates with Kir6.2 or Kir6.1 to form KATP channels, which link metabolism to excitability in multiple cell types. The strong physical coupling of SUR1 with Kir6 subunits appears exclusive, but recent studies argue that SUR1 also modulates TRPM4, a member of the transient receptor potential family of non-selective cation channels. It has been reported that, following stroke, brain, or spinal cord injury, SUR1 is increased in neurovascular cells at the site of injury. This is accompanied by up-regulation of a non-selective cation conductance with TRPM4-like properties and apparently sensitive to sulfonylureas, leading to the postulation that posttraumatic non-selective cation currents are determined by TRPM4/SUR1channels.Toinvestigate the mechanistic hypothesis for the coupling between TRPM4 and SUR1, we performed electrophysiological and FRET studies in COSm6 cells expressing TRPM4 channels with or without SUR1. TRPM4-mediated currents were Ca2+-activated, voltage-dependent, underwent desensitization, and were inhibited by ATP but were insensitive to glibenclamide and tolbutamide. These properties were not affected by cotransfection with SUR1. When the same SUR1 was cotransfected with Kir6.2, functional K ATP channels were formed. In cells cotransfected with Kir6.2, SUR1, and TRPM4, we measured KATP-mediated K+ currents and Ca2+-activated, sulfonylurea-insensitive Na+ currents in the same patch, further showing that SUR1 controls KATP channel activity but not TRPM4 channels. FRET signal between fluorophore-tagged TRPM4 subunits was similar to that between Kir6.2 and SUR1, whereas there was no detectable FRET efficiency between TRPM4 and SUR1. Our data suggest that functional or structural association of TRPM4 and SUR1 is unlikely. © 2012 by The American Society for Biochemistry and Molecular Biology, Inc.",Sala-Rabanal M.; Wang S.; Nichols C.G.,2012.0,10.1074/jbc.M111.336131,0,0,
4294,Effect of slowed respiration on cardiac parasympathetic response to threat.,"The present study was designed to examine the effect of voluntarily slowed respiration on the cardiac parasympathetic response to a threat: the anticipation of an electric shock. Thirty healthy college students were randomly assigned to the slow, fast, and nonpaced breathing groups (10 subjects each). Subjects in the slow and fast paced breathing groups regulated their breathing rate to 8 and 30 cpm, respectively, and those in the nonpaced breathing group breathed spontaneously. Immediately after the period of paced or nonpaced breathing for 5 minutes, the subjects were exposed for 2 minutes to the anticipation of an electric shock during breathing paced at 15 cpm. The amplitude of the high frequency (HF) component of the heart rate variability, an index of cardiac parasympathetic tone, significantly decreased during the threat in the fast and nonpaced breathing groups, whereas it was unchanged in the slow paced breathing group. No significant difference was observed among the three groups in the amplitude of respiration during the threat. Results suggest that a slowed respiration decreases the cardiac parasympathetic withdrawal response to the threat. This study provides a rationale for the therapeutic uses of the slowed respiration maneuver in attenuating the cardiac autonomic responses in patients with anxiety disorder.",Sakakibara M.; Hayano J.,,,0,0,
4295,Effect of slowed respiration on cardiac parasympathetic response to threat,"ER The present study was designed to examine the effect of voluntarily slowed respiration on the cardiac parasympathetic response to a threat: the anticipation of an electric shock. Thirty healthy college students were randomly assigned to the slow, fast, and nonpaced breathing groups (10 subjects each). Subjects in the slow and fast paced breathing groups regulated their breathing rate to 8 and 30 cpm, respectively, and those in the nonpaced breathing group breathed spontaneously. Immediately after the period of paced or nonpaced breathing for 5 minutes, the subjects were exposed for 2 minutes to the anticipation of an electric shock during breathing paced at 15 cpm. The amplitude of the high frequency (HF) component of the heart rate variability, an index of cardiac parasympathetic tone, significantly decreased during the threat in the fast and nonpaced breathing groups, whereas it was unchanged in the slow paced breathing group. No significant difference was observed among the three groups in the amplitude of respiration during the threat. Results suggest that a slowed respiration decreases the cardiac parasympathetic withdrawal response to the threat. This study provides a rationale for the therapeutic uses of the slowed respiration maneuver in attenuating the cardiac autonomic responses in patients with anxiety disorder.","Sakakibara, M; Hayano, J",1996.0,,0,0,4294
4296,Changes in cerebral glucose utilization in patients with panic disorder treated with cognitive-behavioral therapy.,"Several neuroanatomical hypotheses of panic disorder have been proposed focusing on the significant role of the amygdala and PAG-related ""panic neurocircuitry."" Although cognitive-behavioral therapy is effective in patients with panic disorder, its therapeutic mechanism of action in the brain remains unclear. The present study was performed to investigate regional brain glucose metabolic changes associated with successful completion of cognitive-behavioral therapy in panic disorder patients. The regional glucose utilization in patients with panic disorder was compared before and after cognitive-behavioral therapy using positron emission tomography with (18)F-fluorodeoxyglucose. In 11 of 12 patients who showed improvement after cognitive-behavioral therapy, decreased glucose utilization was detected in the right hippocampus, left anterior cingulate, left cerebellum, and pons, whereas increased glucose utilization was seen in the bilateral medial prefrontal cortices. Significant correlations were found between the percent change relative to the pretreatment value of glucose utilization in the left medial prefrontal cortex and those of anxiety and agoraphobia-related subscale of the Panic Disorder Severity Scale, and between that of the midbrain and that of the number of panic attacks during the 4 weeks before each scan in all 12 patients. The completion of successful cognitive-behavioral therapy involved not only reduction of the baseline hyperactivity in several brain areas but also adaptive metabolic changes of the bilateral medial prefrontal cortices in panic disorder patients.",Sakai Y.; Kumano H.; Nishikawa M.; Sakano Y.; Kaiya H.; Imabayashi E.; Ohnishi T.; Matsuda H.; Yasuda A.; Sato A.; Diksic M.; Kuboki T.,2006.0,10.1016/j.neuroimage.2006.06.017,0,0,
4297,"Functional regulation of serotonin transporter, a molecule involved in the pathogenesis of anxiety disorder","The serotonin transporter (SET) is a member of the Na+/Cl --dependent neurotransmitter transporter family and functions as a membrane protein which terminates the serotonergic neuronal transmission by re-uptaking serotonin into the pre-synaptic terminal. SET is thought to be involved in the pathogenesis of affective disorders, drug abuse and anxiety disorder. We have focused on SET regulation by phosphorylation/dephosphorylation since SET has many putative phosphorylation sites in its intracellular region. Our previous studies have revealed that phorbolesters, activators of PKC, decreased in SET uptake activity. Based on a mutagenesis analysis of PKC phosphorylation sites and an in vivo phosphorylation study of SET, we have concluded that PKC regulates SET activity via an indirect mechanism, probably via alternating actin cytoskeleton status. Recent reports and our investigation have demonstrated that the SET C-terminal region interacts with actin binding proteins, suggesting the crucial roles of this region in functional regulation of SET.",Sakai N.,2004.0,,0,0,
4298,Application of autogenic training for anxiety disorders: a clinical study in a psychiatric setting.,"The effects of autogenic training for anxiety disorders were investigated in a psychiatric setting of a medical school hospital and the predictors of this treatment outcome were identified. Fifty-five patients who meet the DSM-III-R criteria for anxiety disorders were treated individually with autogenic training by the author from October 1981 to October 1995. The medical records of the patients were investigated retrospectively. The results showed that the autogenic training was successful. Twenty-eight patients (51%) were cured, fourteen (25%) much improved, eight (15%) improved and five (9%) unchanged at the end of the treatment. Forty-two patients (76%) were assessed as having had successful treatment. Pretreatment variables, such as patient's clinical characteristics, did not provide a useful guide to the outcome. Four treatment variables did have a bearing on outcome. First, practicing the second standard autogenic training exercise was a satisfactory predictor of a better outcome. Second, practicing generalization training also was a useful predictor. Third, the application of other behavioral treatment techniques was found to be positively associated with outcome. Fourth, longer treatment periods were associated with a better outcome. These findings suggested that autogenic training could be of significant benefit for the treatment of anxiety disorders.",Sakai M.,1997.0,,0,0,
4299,Thought Field Therapy clinical applications: utilization in an HMO in behavioral medicine and behavioral health services.,"Thought Field Therapy (TFT) is a self-administered treatment developed by psychologist Roger Callahan. TFT uses energy meridian treatment points and bilateral optical-cortical stimulation while focusing on the targeted symptoms or problem being addressed. The clinical applications of TFT summarized included anxiety, adjustment disorder with anxiety and depression, anxiety due to medical condition, anger, acute stress, bereavement, chronic pain, cravings, depression, fatigue, nausea, neurodermatitis, obsessive traits, panic disorder without agoraphobia, parent-child stress, phobia, posttraumatic stress disorder, relationship stress, trichotillomania, tremor, and work stress. This uncontrolled study reports on changes in self-reported Subjective Units of Distress (SUD; Wolpe, 1969) in 1,594 applications of TFT, treating 714 patients. Paired t-tests of pre- and posttreatment SUD were statistically significant in 31 categories reviewed. These within-session decreases of SUD are preliminary data that call for controlled studies to examine validity, reliability, and maintenance of effects over time. Illustrative case and heart rate variability data are presented.",Sakai C.; Paperny D.; Mathews M.; Tanida G.; Boyd G.; Simons A.; Yamamoto C.; Mau C.; Nutter L.,2001.0,,0,0,
4300,Restorative retelling for violent loss: An open clinical trial.,"Those impacted by the loss of a loved one to violent death (i.e., homicide, suicide, or accident) may be at risk for posttraumatic stress, depression, and prolonged grief. Restorative retelling (RR) is a structured group intervention developed to improve coping skills, integrate commemoration of the deceased, and approach traumatic memories. This article provides initial evidence for the use of RR in reducing trauma, depression, and prolonged grief symptoms in a records review open trial of 51 violent loss survivors at a community counseling clinic. Results suggested that RR was well tolerated with a significant decrease in symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Saindon, Connie; Rheingold, Alyssa A; Baddeley, Jenna; Wallace, Meghan M; Brown, Clara; Rynearson, Edward K; Acierno, Amick-McMullan, Beck, Beck, Burke, Currier, Gallagher, Horowitz, Layne, Layne, Lobb, Melhem, Murphy, Murphy, Murphy, Neimeyer, Norris, Prigerson, Rynearson, Rynearson, Rynearson, Rynearson, Rynearson, Rynearson, Salloum, Salloum, Saltzman, Schafer, Shear, Shear, Shear, Sung, Videka-Sherman, Weiss, Zinzow",2014.0,,0,0,
4301,Restorative retelling for violent loss: an open clinical trial.,"Those impacted by the loss of a loved one to violent death (i.e., homicide, suicide, or accident) may be at risk for posttraumatic stress, depression, and prolonged grief. Restorative retelling (RR) is a structured group intervention developed to improve coping skills, integrate commemoration of the deceased, and approach traumatic memories. This article provides initial evidence for the use of RR in reducing trauma, depression, and prolonged grief symptoms in a records review open trial of 51 violent loss survivors at a community counseling clinic. Results suggested that RR was well tolerated with a significant decrease in symptoms.",Saindon C.; Rheingold AA.; Baddeley J.; Wallace MM.; Brown C.; Rynearson EK.,,10.1080/07481187.2013.783654,0,0,
4302,Behaviour-therapeutic treatment in obsessive-compulsive neurosis: Theory and practice.,"Evaluates the effectiveness of the combined behavior therapeutic techniques of progressive relaxation, cognitive flooding and modeling in treating obsessive compulsive disorder (OCD), and explores the contribution of client characteristics to therapeutic status and process. 28 OCD patients were assessed regarding age and the traits of obsession, anxiety, fear, rigidity, extraversion, neuroticism, and conditionability. Therapeutic outcome was evaluated at 5 time points up to 6 mo after termination of therapy. The sample was divided into an immediate success group, a delayed success group, and a failure group. This variation in outcome can be attributed to client personality variables. Results indicate that the mild/moderate degrees of these traits are linked with therapeutic success, and higher age and higher degree of trait scores are associated with slow improvement or failure. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sahoo, D; Gillis, John S; Misra, S. K; Bandura, Beech, Borkovec, Brokovec, Catts, Clark, Emmelkamp, Foa, Foa, Frost, Nicassio, Purdon, Rachman, Rachman, Rachman., Rachman., Sahoo, Salkovskis, Salkovskis, Schandler., Wells",2001.0,,0,0,
4303,Massage as adjuvant therapy in the management of post-cesarean pain and anxiety: A randomized clinical trial.,"The present study was conducted to determine the effect of massage on post-cesarean pain and anxiety. The present single-blind clinical trial was conducted on 156 primiparous women undergone elective cesarean section. The participants were randomly divided into three groups, including a hand and foot massage group, a foot massage group and a control group (n = 52 per group). The patients' intensity of pain, vital signs and anxiety level were measured before, immediately after and 90 min after the massage. A significant reduction was observed in the intensity of pain immediately and 90 min after massage (P < 0.001). Moreover, changes in some of the physiological parameters, including blood pressure and respiration rate, were significant after massage (P < 0.001); however, this change was not significant for pulse rate. A significant reduction was also observed in the level of anxiety (P < 0.001) and a significant increase in the frequency of breastfeeding (P < 0.001) after massage. As an effective nursing intervention presenting no side-effects, hand and foot massage can be helpful in the management of postoperative pain and stress.",Saatsaz S.; Rezaei R.; Alipour A.; Beheshti Z.,2016.0,10.1016/j.ctcp.2016.05.014,0,0,
4304,Breast reduction alleviates depression and anxiety and restores self-esteem: a prospective randomised clinical trial.,"Of women who seek reduction mammaplasty, up to a third have pathological degrees of anxiety or depression, or both. The psychological aspect of reduction mammaplasty is therefore an important consideration. We did a prospective randomised clinical trial to see how reduction mammaplasty affected macromastia patients' depression, anxiety, and self-esteem. Eighty-two patients were randomised, 40 to have the operation, and 42 patients to conservative treatment. Both groups were followed for six months. The patients completed the RBDI questionnaire (Raitasalo's modification of the short form of the Beck Depression Inventory). Twenty-nine patients in the operated group and 35 patients in the conservative group completed the study. At the second examination, the patients who had been operated on, had significantly less depression (p<0.01) and better self-esteem (p=0.03) than the conservative group. The proportions of depressed (p<0.01) and anxious (p=0.04) patients were also smaller in the group who were operated on. There is significantly less depression and anxiety after reduction mammaplasty, and patients' self-esteem is restored.",Saariniemi KM.; Joukamaa M.; Raitasalo R.; Kuokkanen HO.,2009.0,10.1080/02844310903258910,0,0,
4305,"Wellness program for anesthesiology residents: a randomized, controlled trial","ER BACKGROUND: Multiple reports illustrate the deleterious effects of stress on physicians' mental and physical health, as well as on patient care. This study evaluates the effects of a wellness program on anesthesiology residents' well-being.METHODS: Sixty residents were randomly assigned to one of three groups: (1) wellness intervention group, (2) no-treatment control with release time, and (3) no-treatment control with routine duties. Coping, stressors, social support, psychological symptoms, and alcohol and tobacco use were measured using a pre-test-post-test design.RESULTS: Residents in the wellness program reported significantly fewer stressors in their role as parent, increased social support at work, greater problem-solving coping, and less anxiety as compared with one or both of the control groups. Findings related to reducing avoidance coping and alcohol consumption also were suggestive of positive intervention effects.CONCLUSIONS: An intervention to increase the use of active coping and social support, to reduce reliance on avoidance coping, and to decrease work and family stressors had an overall pattern of beneficial effects on residents' well-being. The importance of offering such programs during residency training, ways to strengthen intervention effectiveness, and areas for future research are discussed.","Saadat, H; Snow, D L; Ottenheimer, S; Dai, F; Kain, Z N",2012.0,10.1111/j.1399-6576.2012.02705.x,0,0,
4306,Predictors of psychological distress in Lebanese hostages of war,"A cross-sectional study addressed the experience of Lebanese hostages of war in Lebanon. It specifically assessed the prevalence of general distress and its relationship to captivity-related factors and selected psychosocial variables. Trained field researchers using standard measurements interviewed 118 Lebanese hostages released from Khiam prison, an Israeli detention center in Lebanon. Questionnaires administered included the GHQ-12 and the Harvard Trauma Questionnaire. Individuals were detained for 3.4 years on average, and 86% were tortured. Psychological distress was present in 42.1% of the sample compared to 27.8% among the control group. In the multivariate analysis, the significant predictors for distress were: years of education and increase in religiosity after release. In conclusion, even after 2 years of release, more than one-third of the Lebanese hostages released from Khiam prison were found to have psychological distress. Caregivers need to pay special attention to the mental health of hostages of war. The paper discusses the meaning and implications of the factors predicting resilience and vulnerability in this particular population. © 2003 Elsevier Science Ltd. All rights reserved.",Saab B.R.; Chaaya M.; Doumit M.; Farhood L.,2003.0,10.1016/S0277-9536(02)00505-1,0,0,
4307,Perceived group climate as a predictor of long-term outcome in a randomized controlled trial of cognitive-behavioural group therapy for patients with comorbid psychiatric disorders.,"Research on group therapy indicates that various dimensions of the helpful relationship qualities (cohesion, climate, empathy, alliance) are associated with outcome. However, the use of a wide variety of empirical scales makes comparisons between studies as well as generalizations somewhat difficult. Although a generic, trans-theoretical measure such as the Group Climate Questionnaire-Short Form (GCQ-S; MacKenzie, 1983) is available and applicable to most treatment conditions, it has never been tested with cognitive-behavioural group therapy. To investigate perceived dimensions of group climate (engagement, avoidance and conflict) as predictors of long-term (1 year) follow-up in a manualized, structured time-limited cognitive-behavioural group therapy (CBGT) for out-patients with comorbid psychiatric disorders. Data from 27 patients were analysed using hierarchical multiple regression analyses. Outcome measures used were general symptomatic complaints (SCL-90-R), interpersonal problems (IIP-64), specific mood- and anxiety symptoms (BDI; BAI) and early maladaptive schemas (YSQ). After controlling for scores on the relevant dependent variables at both intake and treatment termination, dimensions of group climate measured close to termination were entered as predictors in separate analyses. Higher ratings of engagement were associated with reduced scores on all outcome measures at follow-up, except for anxiety symptoms (BAI). Higher ratings of avoidance were associated with lower anxiety symptoms at follow up, whereas ratings of conflict were unrelated to all follow-up scores. The results provide partial support for the use of the GCQ-S as a predictor of long-term follow-up in CBGT, and highlights perceived engagement as the most important dimension. Clinical implications are discussed.",Ryum T.; Hagen R.; Nordahl HM.; Vogel PA.; Stiles TC.,2009.0,10.1017/S1352465809990208,0,0,
4308,Are PTSD treatment choices and treatment beliefs related to depression symptoms and depression-relevant treatment rationales?,"Given high rates of depression and low rates of treatment utilization among individuals with posttraumatic stress disorder (PTSD), we examined how depression symptoms impact PTSD treatment beliefs and preference (prolonged exposure (PE), sertraline, or PE plus sertraline). We also examined whether PTSD treatment rationales tailored to individuals with symptoms of depression impact PTSD treatment preference/beliefs. Undergraduates (N = 439) were given an ""imagine self"" scenario where they either had symptoms of PTSD or PTSD and depression in the future. Trauma-exposed community members (N = 203) reported their own PTSD and depression symptoms. All participants watched standardized treatment rationales for PE and sertraline that were systematically manipulated to include information on depression or not. Across both samples, depression symptoms were associated with significantly increased odds of selecting combination treatment relative to PE alone. For those in the community sample who received the depression-relevant treatment rationale, higher depression symptoms were associated with significantly greater PE credibility and more positive reactions toward PE. Taken together, depression may be associated with a greater preference for combination treatment. However, treatment providers may be able to improve treatment beliefs about PE by offering a treatment rationale that explains that PE tends to help improve symptoms of PTSD and depression.",Rytwinski NK.; Rosoff CB.; Feeny NC.; Zoellner LA.,2014.0,10.1016/j.brat.2014.07.013,0,0,
4309,Child/Adolescent anxiety multimodal study: evaluating safety,"ER METHODParticipants ages 7 to 17 years (mean = 10.7 years) meeting the DSM-IV criteria for 1 or more of the following disorders: separation anxiety disorder, generalized anxiety disorder, or social phobia were randomized (2:2:2:1) to cognitive-behavioral therapy (CBT, n = 139), sertraline (SRT, n = 133), a combination of both (COMB, n = 140), or pill placebo (PBO, n = 76). Data on AEs were collected via a standardized inquiry method plus a self-report Physical Symptom Checklist (PSC).RESULTSThere were no differences between the double-blinded conditions (SRT versus PBO) for total physical and psychiatric AEs or any individual physical or psychiatric AEs. The rates of total physical AEs were greater in the SRT-alone treatment condition when compared to CBT (p < .01) and COMB (p < .01). Moreover, those who received SRT alone reported higher rates of several physical AEs when compared to COMB and CBT. The rate of total psychiatric AEs was higher in children (?12 years) across all arms (31.7% versus 23.1%, p < .05). Total PSC scores decreased over time, with no significant differences between treatment groups.CONCLUSIONThe results support the tolerability/safety of selective serotonin reuptake inhibitor (SSRI) treatment for anxiety disorders even after adjusting for the number of reporting opportunities, leading to no differences in overall rates of AEs. Few differences occurred on specific items. Additional monitoring of psychiatric AEs is recommended in children (?12 years). Clinical trial registration information-Child and Adolescent Anxiety Disorders (CAMS); http://clinicaltrials.gov; NCT00052078.OBJECTIVETo evaluate the frequency of adverse events (AEs) across 4 treatment conditions in the Child/Adolescent Anxiety Multimodal Study (CAMS), and to compare the frequency of AEs between children and adolescents.","Rynn, M A; Walkup, J T; Compton, S N; Sakolsky, D J; Sherrill, J T; Shen, S; Kendall, P C; McCracken, J; Albano, A M; Piacentini, J; Riddle, M A; Keeton, C; Waslick, B; Chrisman, A; Iyengar, S; March, J S; Birmaher, B",2015.0,10.1016/j.jaac.2014.12.015,0,0,
4310,Group counseling for mothers after emergency cesarean section: a randomized controlled trial of intervention.,"An emergency cesarean section is often a traumatic experience for women, and can be associated with postnatal depression and posttraumatic stress. Various types of interventions have been tested to prevent such consequences. The purpose of this study was to test a model of group counseling for mothers after emergency cesarean section, and to examine its possible effects. After undergoing an emergency cesarean section, 162 Swedish-speaking women were randomized to group counseling or the control group. The participation rate was 75 percent. The counseling consisted of 2 sessions, conducted at about 2 months postpartum; 72 percent of the women randomized to the counseling group actually attended the sessions. At 6 months postpartum, all study participants completed a postal questionnaire (response rates were 92% in the counseling group and 89% in the control group). No difference between the groups was found in terms of the level of fear after childbirth, symptoms of posttraumatic stress, or postnatal depression at 6 months after the emergency cesarean. The group counseling was much appreciated by the participating women, some of whose experiences are reported in this paper. Group counseling for mothers after emergency cesarean section did not influence their views on the recent delivery or prevent symptoms of posttraumatic stress or postnatal depression. It was, however, appreciated and did no harm. In future studies, other outcomes should be measured.",Ryding EL.; Wirén E.; Johansson G.; Ceder B.; Dahlström AM.,2004.0,10.1111/j.0730-7659.2004.00316.x,0,0,
4311,Web-based coping skills training for women whose partner has a drinking problem,"ER Spouses whose partner has an alcohol use disorder can experience considerable psychological distress. Yet, because of social, financial, relationship, and psychological barriers they often remain hidden and underserved. To partially reduce treatment barriers for this population, this study evaluated the short-term efficacy of a self-paced, web-delivered coping skills training program for women experiencing distress as a result of living with a partner with an alcohol use disorder. Participants (N 89) were randomly assigned to either 8 weeks of an Internet-administered coping skills training program (iCST), or an 8-week delayed treatment control (DTC). Participation in, and satisfaction with iCST was high. At the end of the 8-week access/delay period, iCST participants exhibited a significantly higher level of coping skills relative to DTC, d = 1.02, 95% confidence interval [CI;.64, 1.51], and reported significantly fewer depressive symptoms, d = .65, 95% CI [-1.21,-.35], and situational anger, d =-.70, 95% CI [-1.62,-.64]. Moreover, iCST appeared to prevent an increase in symptoms among those with low baseline symptom levels; DTC did not. Skill acquisition appeared to partially mediate changes observed. Online coping skills training may be an effective way of reaching and helping a large number of this frequently underserved population.","Rychtarik, R G; McGillicuddy, N B; Barrick, C",2015.0,10.1037/adb0000032,0,0,
4312,A randomized controlled trial to evaluate intensity of community-based rehabilitation provision following stroke or hip fracture in old age,"ER DESIGN: Parallel single-blind randomized control trial.SETTING: Domiciliary provided multidisciplinary rehabilitation.SUBJECTS: One hundred and sixty patients aged 65 or over recently discharged from hospital after suffering a stroke or hip fracture.INTERVENTION: Patients assigned to receive six or more face-to-face contacts or three or less face-to-face contacts from members of a multidisciplinary rehabilitation team.MAIN MEASURES: Patients assessed using the Barthel Index, Therapy Outcome Measure, Euroqol 5D (EQ-5D), Hospital Anxiety and Depression Scale (HADS) and Frenchay Activities Index (FAI) at three months. All follow-up assessments were conducted blind to allocation.RESULTS: Subgroup analysis was conducted on the basis of incident condition (stroke or hip fracture). Significant differences were detected for the stroke subgroup at three months [Therapy Outcome Measure Handicap (median difference 0.5 (P< 0.05)) and EQ-5D (median difference 0.17 (P< 0.05))] and in change at three months [Therapy Outcome Measure (mean difference 0.52 (SD 0.85) 95% CI (0.16, 0.88)) and EQ-5D (mean difference 0.15 (SD 0.25) 95% CI (0.05, 0.26))]. No significant differences were detected between the two arms of the study for the hip fracture subgroup.CONCLUSION: Following stroke older people who receive a more intensive community-based multidisciplinary rehabilitation service may experience short-term benefit in relation to social participation and some aspects of health-related quality of life. A more intensive service after discharge from hospital following a hip fracture is unlikely to result in similar patient benefit.OBJECTIVE: To compare intensive with non-intensive home-based rehabilitation provision following stroke or hip fracture in old age (65 years+).","Ryan, T; Enderby, P; Rigby, A S",2006.0,10.1191/0269215506cr933oa,0,0,
4313,Cognitive mediational delicits and the role of coping styles in pedophile and ephebophile Roman Catholic clergy,"This study was designed to examine hypothesized differences between sex offending and nonoffending Roman Catholic clergy on cognitive mediation abilities as measured by the Rorschach Inkblot Test (H. Rorschach, 1921/1942). This study compared 78 priest pedophiles and 77 priest ephebophiles with 80 nonoffending priest controls on the Inkblot test using J. E. Exner's (2003) Comprehensive System. The three groups were compared on seven variables that constitute Exner's Cognitive Mediation cluster. Additionally, the groups' coping styles were compared to examine the interaction of coping style and cognitive mediational abilities. We found interactions between coping style and offending status across most of the cognitive variables indicating impairment in the mild to pathological ranges. Moreover, significantly higher unusual thinking styles (Xu%) and significantly lower conventional thinking styles (X+%) in offenders compared to nonoffenders. Those with an Extratensive style (n = 31) showed significantly higher distorted thinking when compared to the Introversive (n = 81), Ambitent (n = 73), and Avoidant (n = 50) coping styles. This study suggests that offenders display significantly higher distorted thinking styles than do non-offenders. Possible reasons for these discrepancies and the role of coping styles in abusive behaviors were discussed. © 2007 Wiley Periodicals, Inc.",Ryan G.P.; Baerwald J.P.; McGlone G.,2008.0,10.1002/jclp.20428,0,0,
4314,Do post-traumatic stress disorder symptoms worsen during trauma focus group treatment?,"Studied the effect of participation in trauma focus group treatment on symptoms of male inpatient veterans with treatment-resistant chronic combat-related posttraumatic stress disorder (PTSD). The 78 patients were assessed immediately before and after group completion at time of discharge. Standard measures of core PTSD symptoms, depression, and anxiety were used. In addition, changes in PTSD symptoms were tracked on a weekly basis for the duration of group participation. Results indicate that a single direct elicitation of war-related traumatic memories in a group setting was not associated with symptom worsening. However, veterans also did not show improvement in symptom severity. Possible reasons for this lack of impact are discussed along with implications for future treatment design and evaluation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Ruzek, Josef I; Riney, Sherry J; Leskin, Greg; Drescher, Kent D; Foy, David W; Gusman, Fred D; Beck, Beck, Beck, Black, Blake, Boudewyns, Cooper, Fairbank, Foa, Foa, Foa, Follette, Fontana, Fontana, Foy, Foy, Foy, Frueh, Frueh, Fydrich, Glynn, Hammerberg, Hayman, Hyer, Johnson, Johnson, Johnson, Keane, Keane, Keane, Keane, King, King, Kulka, Litz, McFall, Mueser, Mueser, Nishith, Pitman, Resick, Rogers, Scurfield, Weathers, Weathers, Woodward, Yarnold",2001.0,,0,0,
4315,"Online self-administered training for post-traumatic stress disorder treatment providers: design and methods for a randomized, prospective intervention study.","This paper presents the rationale and methods for a randomized controlled evaluation of web-based training in motivational interviewing, goal setting, and behavioral task assignment. Web-based training may be a practical and cost-effective way to address the need for large-scale mental health training in evidence-based practice; however, there is a dearth of well-controlled outcome studies of these approaches. For the current trial, 168 mental health providers treating post-traumatic stress disorder (PTSD) were assigned to web-based training plus supervision, web-based training, or training-as-usual (control). A novel standardized patient (SP) assessment was developed and implemented for objective measurement of changes in clinical skills, while on-line self-report measures were used for assessing changes in knowledge, perceived self-efficacy, and practice related to cognitive behavioral therapy (CBT) techniques. Eligible participants were all actively involved in mental health treatment of veterans with PTSD. Study methodology illustrates ways of developing training content, recruiting participants, and assessing knowledge, perceived self-efficacy, and competency-based outcomes, and demonstrates the feasibility of conducting prospective studies of training efficacy or effectiveness in large healthcare systems.",Ruzek JI.; Rosen RC.; Marceau L.; Larson MJ.; Garvert DW.; Smith L.; Stoddard A.,2012.0,10.1186/1748-5908-7-43,0,0,
4316,Online self-administered training of PTSD treatment providers in cognitive-behavioral intervention skills: results of a randomized controlled trial.,"Despite potential advantages in scalability and efficiency of web-based training for trauma providers, few controlled trials of feasibility and effectiveness of web-based mental health training have been performed. Our study compared web-based training in 3 intervention skills (motivation enhancement [ME], goal setting [GS], behavioral task assignment [BTA]) with web-based training plus telephone consultation, and a no-training control. The primary outcome measures included objective measures of skills acquisition (standardized patient assessments). Results showed significant differences among the training conditions. The overall tests of differences among the groups were statistically significant for ME and BTA skills (p < .001 and p = .005, respectively), but not for GS (p = .245). The web training plus consultation group improved in ME skills by 0.35 units compared to 0.12 units in the web only group (p < .001) and no change in the control group (p = .001). For BTA skills, the web training plus consultation improved by 0.27 units compared to 0.17 units in the web only group (p = .175) and no change in the control group (p = .004). Overall, these findings support the use of web-based dissemination for large-scale training programs for trauma providers in health care delivery systems. Further studies are needed to clarify the specific role of consultation as an adjunct to web-based training.",Ruzek JI.; Rosen RC.; Garvert DW.; Smith LD.; Sears KC.; Marceau L.; Harty B.; Stoddard AM.,2014.0,10.1002/jts.21977,0,0,
4317,An open trial of an acceptance-based behavior therapy for generalized anxiety disorder.,"Research suggests that experiential avoidance may play an important role in generalized anxiety disorder (GAD; see Roemer, L., & Orsillo, S.M. (2002). Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models. Clinical Psychology: Science and Practice, 9, 54-68, for a review). Therefore, a treatment that emphasizes experiential acceptance, as well as intentional action, may lead to both reduced symptomatology and improved quality of life and functioning for individuals with this chronic disorder. In an open trial of a newly developed acceptance-based behavior therapy for GAD, 16 treated clients demonstrated significant reductions in clinician-rated severity of GAD and reports of anxiety and depressive symptoms and fear and avoidance of their internal experience, as well as significant improvements in reports of quality of life, at both posttreatment and 3-month follow-up. Directions for future treatment development and research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Roemer, Lizabeth; Orsillo, Susan M; Antony, Beck, Beck, Beck, Beck, Berg, Bernstein, Borkovec, Borkovec, Borkovec, Borkovec, Borkovec, Borkovec, Borkovec, Borkovec, Brown, Brown, Brown, Brown, Brown, Butler, Campbell-Sills, Cohen, Davis, DiNardo, Dugas, Dugas, Eifert, Eifert, Freeston, Frisch, Germer, Goldstein, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Jaccard, Kabat-Zinn, Kabat-Zinn, Kessler, Kessler, Ladouceur, Levitt, Linehan, Linehan, Lovibond, Ma, MacLeod, Mennin, Mennin, Metzger, Meyer, Molina, Newman, Orsillo, Roemer, Roemer, Roemer, Roemer, Roemer, Segal, Stein, Stober, Teasdale, Wells, Wells, Wetherell, Williams, Wilson, Yonkers",2007.0,,0,0,
4318,Study protocol of effectiveness of a biopsychosocial multidisciplinary intervention in the evolution of non-specific sub-acute low back pain in the working population: cluster randomised trial,"ER METHODS/DESIGNA Cluster randomised clinical trial will be conducted in 38 Primary Health Care Centres located in Barcelona, Spain and its surrounding areas. The centres are randomly allocated to the multidisciplinary intervention or to usual clinical care. Patients between 18 and 65 years old (n = 932; 466 per arm) and with a diagnostic of a non-specific sub-acute low back pain are included. Patients in the intervention group are receiving the recommendations of clinical practice guidelines, in addition to a biopsychosocial multidisciplinary intervention consisting of group educational sessions lasting a total of 10 hours. The main outcome is change in the score in the Roland Morris disability questionnaire at three months after onset of pain. Other outcomes are severity of pain, quality of life, duration of current non-specific low back pain episode, work sick leave and duration, Fear Avoidance Beliefs and Goldberg Questionnaires. Outcomes will be assessed at baseline, 3, 6 and 12 months. Analysis will be by intention to treat. The intervention effect will be assessed through the standard error of measurement and the effect-size. Responsiveness of each scale will be evaluated by standardised response mean and receiver-operating characteristic method. Recovery according to the patient will be used as an external criterion. A multilevel regression will be performed on repeated measures. The time until the current episode of low back pain takes to subside will be analysed by Cox regression.DISCUSSIONWe hope to provide evidence of the effectiveness of the proposed biopsychosocial multidisciplinary intervention in avoiding the chronification of low back pain, and to reduce the duration of non-specific low back pain episodes. If the intervention is effective, it could be applied to Primary Health Care Centres.TRIAL REGISTRATIONISRCTN21392091.BACKGROUNDNon-specific low back pain is a common cause for consultation with the general practitioner, generating increased health and social costs. This study will analyse the effectiveness of a multidisciplinary intervention to reduce disability, severity of pain, anxiety and depression, to improve quality of life and to reduce the incidence of chronic low back pain in the working population with non-specific low back pain, compared to usual clinical care.","Rodriguez-Blanco, T; Fernández-San-Martin, I; Balagué-Corbella, M; Berenguera, A; Moix, J; Montiel-Morillo, E; Núñez-Juárez, E; González-Moneo, M J; Pie-Oncins, M; Martín-Peñacoba, R; Roura-Olivan, M; Núñez-Juárez, M; Pujol-Ribera, E",2010.0,10.1186/1472-6963-10-12,0,0,
4319,Context-specificity of relapse: effects of therapist and environmental context on return of fear.,"Context-specificity of fear extinction was tested among 65 participants who were fearful of spiders by manipulating the contexts used for exposure treatment and two-week follow-up assessment. Context was defined by both meaningful (presence of a particular therapist) and incidental (room location and furnishings) environmental cues. Distinct phobic stimuli were used to examine interactions of context with stimulus. Physiological, behavioral and verbal indices of fear were measured. Results provided modest support for context-specific return of fear. With one stimulus, participants assessed in a non-treatment context at follow-up exhibited greater returns in heart rate levels. In addition, three of four participants who could not touch the stimulus at follow-up had been tested in a non-treatment context. Future investigations may benefit from greater distinctions between contexts or manipulation of contextual features more directly relevant to fear. Finally, post hoc analyses identified high trait anxiety, slow treatment response, recovery of phobic cognitions and long duration/high intensity phobic encounters post-treatment as significant predictors of increased return of fear.",Rodriguez BI.; Craske MG.; Mineka S.; Hladek D.,1999.0,,0,0,
4320,A high-throughput clinical assay for testing drug facilitation of exposure therapy.,"Several studies have demonstrated that D-cycloserine (DCS) facilitates exposure therapy. We developed a standardized test of this facilitation (i.e., a clinical assay), with the goal of testing for facilitation more quickly and inexpensively than a full clinical trial. We developed a standardized brief exposure in which participants with social anxiety disorder gave a videotaped speech. Participants were randomized to receive a single capsule of 250 mg DCS or a matching placebo prior to preparation for the speech. Distress levels were rated during the speech and again, approximately 1 week later, during a speech in an identical situation. Our primary measure of DCS's exposure-facilitating effect was between-session habituation: whether or not the participants showed less distress during the second speech compared to the first. We also measured levels of subjective anxiety and fear of scrutiny. Subjects randomized to receive DCS prior to their first speech were more likely to show between-session habituation than those who received placebo. We also found greater reduction of performance-related fear overall in the DCS group. Our clinical assay was able to detect exposure facilitation effects rapidly and in a highly standardized way, and is estimated to take a fraction of the time and costs of a clinical trial. Given the increasing interest in using medications to enhance learning-based psychotherapy, this high-throughput clinical assay approach may be a favorable method for testing novel mechanisms of action, and clarifying optimal parameters, for therapy facilitation.",Rodebaugh TL.; Levinson CA.; Lenze EJ.,2013.0,10.1002/da.22047,0,0,
4321,Thinking about social situations: the moderated effects of imposing structure.,"Previous research indicates that people with social anxiety disorder tend to experience escalating distress when thinking about past social situations. We investigated whether such distress could be limited by either an intervention or the participant's pre-existing abilities. Participants were 38 undergraduate students who reported problematic levels of social anxiety. Participants who endorsed a poor ability to purposefully engage with thoughts about stressful social situations reported a deterioration of mood after 25 min of unstructured writing about a recent problematic social situation, whereas those who demonstrated low levels of purposeful engagement but received writing prompts (based on cognitive restructuring techniques) did not show a strong deterioration of mood. In contrast, participants who endorsed greater purposeful engagement ability did not show such deterioration. Results suggest that the negative effects of thinking about social situations might be ameliorated, for at least some participants, if they are provided with structure.",Rodebaugh TL.; Jakatdar TA.; Rosenberg A.; Heimberg RG.,2009.0,10.1016/j.brat.2008.10.019,0,0,
4322,"I might look OK, but I'm still doubtful, anxious, and avoidant: the mixed effects of enhanced video feedback on social anxiety symptoms.","Previous experiments suggest that cognitive preparation for video feedback enhances its effects. In the current experiment, which included 95 speech-anxious undergraduates, these effects were more fully assessed, including those on self-perception, anxiety, and speech-avoidance behavior, with an attention-control preparation as a comparison condition. A possible mechanism of the cognitive preparation's effects, moderation of the effects of self-observer discrepancy, was also tested. Results indicated that the cognitive preparation showed strong effects in regard to self-perception of performance, weak effects in anxiety reduction, and null effects in behavior. Consistent with previous research, self-observer discrepancy showed a robust tendency to predict participant response across conditions.",Rodebaugh TL.,2004.0,10.1016/j.brat.2003.10.004,0,0,
4323,A high-throughput clinical assay for testing drug facilitation of exposure therapy.,"Objective: Several studies have demonstrated that D-cycloserine (DCS) facilitates exposure therapy. We developed a standardized test of this facilitation (i.e., a clinical assay), with the goal of testing for facilitation more quickly and inexpensively than a full clinical trial. Method: We developed a standardized brief exposure in which participants with social anxiety disorder gave a videotaped speech. Participants were randomized to receive a single capsule of 250 mg DCS or a matching placebo prior to preparation for the speech. Distress levels were rated during the speech and again, approximately 1 week later, during a speech in an identical situation. Our primary measure of DCS's exposure-facilitating effect was between-session habituation: whether or not the participants showed less distress during the second speech compared to the first. We also measured levels of subjective anxiety and fear of scrutiny. Results: Subjects randomized to receive DCS prior to their first speech were more likely to show between-session habituation than those who received placebo. We also found greater reduction of performance-related fear overall in the DCS group. Conclusion: Our clinical assay was able to detect exposure facilitation effects rapidly and in a highly standardized way, and is estimated to take a fraction of the time and costs of a clinical trial. Given the increasing interest in using medications to enhance learning-based psychotherapy, this high-throughput clinical assay approach may be a favorable method for testing novel mechanisms of action, and clarifying optimal parameters, for therapy facilitation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rodebaugh, Thomas L; Levinson, Cheri A; Lenze, Eric J; Chasson, Clark, Davis, Deveney, Graham, Guastella, Guastella, Heimberg, Hofmann, Hope, Kalisch, Kessler, Kola, Langton, Leon, Liebowitz, Mattick, Mennin, Millan, Miller, Mystkowski, Mystkowski, Norberg, Otto, Paul, Ressler, Rodebaugh, Ruscio, Sheehan, Stein, Wells, Wells, Werner-Seidler, Wolpe",2013.0,,0,0,
4324,Level of ego development and psychotherapy outcome in phobic patients.,"forty male and 86 female phobic outpatients were randomly assigned to three treatment conditions (behaviour therapy with Imipramine: behaviour therapy with placebo; and supportive therapy with Imipramine) and seen in therapy for a 26-week period. They were initially assessed for level of ego development on Loevinger's Sentence Completion measure and evaluated for initial level of pathology and therapy outcome. A stepwise multiple regression analysis, performed separately for the female and male groups, yielded results as follows: (1) patients at the preconformist level improved significantly less than the patients at the other levels; (2) an interaction between the use of medication and level of ego development was also found, with postconformist patients reporting the least benefit from the drug. These findings were significant only for the female patients.",Rock MH.; Goldberger L.,1981.0,,0,0,
4325,The YOU CALL-WE CALL randomized clinical trial: Impact of a multimodal support intervention after a mild stroke,"ER BACKGROUND: Comparison of a multimodal intervention WE CALL (study initiated phone support/information provision) versus a passive intervention YOU CALL (participant can contact a resource person) in individuals with first mild stroke.METHODS AND RESULTS: This study is a single-blinded randomized clinical trial. Primary outcome includes unplanned use of health services (participant diaries) for adverse events and quality of life (Euroquol-5D, Quality of Life Index). Secondary outcomes include planned use of health services (diaries), mood (Beck Depression Inventory II), and participation (Assessment of Life Habits [LIFE-H]). Blind assessments were done at baseline, 6, and 12 months. A mixed model approach for statistical analysis on an intention-to-treat basis was used where the group factor was intervention type and occasion factor time, with a significance level of 0.01. We enrolled 186 patients (WE=92; YOU=94) with a mean age of 62.5 ± 12.5 years, and 42.5% were women. No significant differences were seen between groups at 6 months for any outcomes with both groups improving from baseline on all measures (effect sizes ranged from 0.25 to 0.7). The only significant change for both groups from 6 months to 1 year (n=139) was in the social domains of the LIFE-H (increment in score, 0.4/9 ± 1.3 [95% confidence interval, 0.1-0.7]; effect size, 0.3). Qualitatively, the WE CALL intervention was perceived as reassuring, increased insight, and problem solving while decreasing anxiety. Only 6 of 94 (6.4%) YOU CALL participants availed themselves of the intervention.CONCLUSIONS: Although the 2 groups improved equally over time, WE CALL intervention was perceived as helpful, whereas YOU CALL intervention was not used.CLINICAL TRIAL REGISTRATION: URL: http://www.controlled-trials.com. Unique identifier: ISRCTN95662526.","Rochette, A; Korner-Bitensky, N; Bishop, D; Teasell, R; White, C L; Bravo, G; Côté, R; Green, T; Lebrun, L H; Lanthier, S; Kapral, M; Bayley, M",2013.0,10.1161/CIRCOUTCOMES.113.000375,0,0,
4326,Comparison of a functional restoration program with active individual physical therapy for patients with chronic low back pain: a randomized controlled trial,"ER DESIGNProspective randomized controlled study.SETTINGTwo rehabilitation centers and private ambulatory physiotherapy facilities.PARTICIPANTSOne hundred thirty-two adults with chronic low back pain. Fifty-one percent of patients on sick leave or out of work (mean duration, 180d in the 2y before treatment).INTERVENTIONSFor 5 weeks, FRP (at 25h/wk) or AIT (at 3h/wk).MAIN OUTCOME MEASURESTrunk flexibility, back flexor, and extensor endurance (Ito and Sorensen tests), general endurance, pain intensity, Dallas Pain Questionnaire (DPQ) scores, daily activities, anxiety depression, social interest, and work and leisure activities, and self-reported improvement (work ability, resumption of sport and leisure activities).RESULTSAll outcome measures improved after treatment except endurance in AIT. There was no between-group difference for pain intensity or DPQ daily activities or work and leisure activities scores. Better results were observed in FRP for all other outcome measures. There was a significant effect of treatment and the initial value for the gain of the Sorensen score with a treatment or initial value interaction; a significant effect of treatment and initial value on the gains of Ito, endurance, and DPQ social interest and anxiety depression scores, with no treatment or initial value interaction; and a significant effect of initial value but not treatment for the gains of DPQ daily activities and work and leisure activities scores.CONCLUSIONSLow-cost ambulatory AIT is effective. The main advantage of FRP is improved endurance. We speculate that this may be linked to better self-reported work ability and more frequent resumption of sports and leisure activities.OBJECTIVETo compare the short-term outcomes of active individual therapy (AIT) with those of a functional restoration program (FRP).","Roche, G; Ponthieux, A; Parot-Shinkel, E; Jousset, N; Bontoux, L; Dubus, V; Penneau-Fontbonne, D; Roquelaure, Y; Legrand, E; Colin, D; Richard, I; Fanello, S",2007.0,10.1016/j.apmr.2007.07.014,0,0,
4327,Psychological effect of witnessed resuscitation on bereaved relatives,"ER METHODSIn this pilot study, relatives of patients who required resuscitation were given the option to remain with the patient during resuscitation or were not given this choice and directed to the relatives' room (control group). The unit of randomisation was the patient who required resuscitation and not the relatives. One close relative was paired with each patient. All relatives were accompanied by a chaperone who gave emotional support and provided technical information on the resuscitation. Relatives were followed up 1 month after the resuscitation. We used a questionnaire to ask about the decision to be present or absent during resuscitation. Bereaved relatives also completed five standardised psychological questionnaires to assess anxiety, depression, grief, intrusive imagery, and avoidance behaviour.FINDINGS25 patients underwent resuscitation (13 in witnessed resuscitation group, 12 in control group). Three patients in the witnessed group survived, all the control-group patients died. Two relatives in each group were lost to follow-up. Thus, eight relatives who witnessed resuscitation and ten control-group relatives were followed up. There were no reported adverse psychological effects among the relatives who witnessed resuscitation, all of whom were satisfied with their decision to remain with the patient. The clinical team became convinced of the benefits to relatives of allowing them to witness resuscitation if they wished, so the trial was terminated.INTERPRETATIONIn the context of the emergency department, routine exclusion of relatives from the resuscitation room may no longer be appropriate.BACKGROUNDEstablished practice is for the relatives of critically ill patients to be excluded from the clinical area during resuscitation. We aimed to discover whether relatives wanted to be present during the resuscitation of a family member and whether witnessing resuscitation had any adverse psychological effects on bereaved relatives.","Robinson, S M; Mackenzie-Ross, S; Campbell, Hewson G L; Egleston, C V; Prevost, A T",1998.0,,0,0,
4328,Unstable in more ways than one: reaction time variability and the neuroticism/distress relationship.,"The authors hypothesized that a greater degree of stimulus-response variability could either serve adaptive or maladaptive control purposes, depending on levels of Neuroticism. Specifically, a more variable relation between stimulus and response may be emotionally beneficial if such flexibility is used to support non-neurotic forms of self-regulation, but costly if it is used to support neurotic forms of self-regulation. To investigate these ideas, the authors asked 232 college undergraduates within three studies to perform several choice reaction time (RT) tasks. On the basis of performance, we could quantify stimulus-response variability in terms of RT variability from trial to trial. Such a measure of stimulus-response variability interacted with Neuroticism in predicting momentary negative affect (Study 1), informant judgments of negative affect (Study 2), and informant judgments of anxious symptoms (Study 3). As hypothesized, greater stimulus-response variability tended to be associated with less distress among individuals low in Neuroticism, but more distress among individuals high in Neuroticism. The results highlight the manner in which Neuroticism may ""taint"" control functions, in turn reinforcing Neuroticism-linked outcomes.",Robinson MD.; Wilkowski BM.; Meier BP.,2006.0,10.1111/j.1467-6494.2005.00377.x,0,0,
4329,Neuroticism as mental noise: a relation between neuroticism and reaction time standard deviations.,"Those higher in neuroticism are often more variable in their behavior and experience. On the basis of this observation, the authors hypothesized that the trait of neuroticism might be correlated with the variability of performance pertaining to relatively basic cognitive operations. Three studies involving 242 college undergraduates supported this prediction in that neuroticism correlated positively with the variability of performance across trials of reaction time tasks. These results link neuroticism to cognitive noise that intervenes between stimulus and response. Such noise has been associated with executive dysfunctions (e.g., frontal lobe injury) in previous research. The present findings are potentially useful for understanding why neuroticism often correlates with variations in the functionality of cognition and behavior.",Robinson MD.; Tamir M.,2005.0,10.1037/0022-3514.89.1.107,0,0,
4330,Internet treatment for generalized anxiety disorder: a randomized controlled trial comparing clinician vs. technician assistance.,"Internet-based cognitive behavioural therapy (iCBT) for generalized anxiety disorder (GAD) has been shown to be effective when guided by a clinician. The present study sought to replicate this finding, and determine whether support from a technician is as effective as guidance from a clinician. Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program and 150 participants with GAD were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for GAD comprising six online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 10 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Penn State Worry Questionnaire (PSWQ) and the Generalized Anxiety Disorder-7 Item (GAD-7). Completion rates were high, and both treatment groups reduced scores on the PSWQ (p<0.001) and GAD-7 (p<0.001) compared to the delayed treatment group, but did not differ from each other. Within group effect sizes on the PSWQ were 1.16 and 1.07 for the clinician- and technician-assisted groups, respectively, and on the GAD-7 were 1.55 and 1.73, respectively. At 3 month follow-up participants in both treatment groups had sustained the gains made at post-treatment. Participants in the clinician-assisted group had made further gains on the PSWQ. Approximately 81 minutes of clinician time and 75 minutes of technician time were required per participant during the 10 week treatment program. Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment/control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for GAD. This form of treatment has potential to increase the capacity of existing mental health services. Australian New Zealand Clinical Trials Registry ACTRN12609000563268.",Robinson E.; Titov N.; Andrews G.; McIntyre K.; Schwencke G.; Solley K.,2010.0,10.1371/journal.pone.0010942,0,0,
4331,"""That chair work thing was great"": A pilot study of group-based emotion-focused therapy for anxiety and depression.","Emotion-focused therapy (EFT) is an evidence-based treatment for depression and it has shown promise for the treatment of anxiety. Only one other published study has examined EFT in a group therapy setting. Using mixed-methods, the current study explored the feasibility and outcomes of an EFT group with adults referred for anxiety and depression. Pre-, post-, and 12-month follow-up measures of depression, anxiety, and difficulties in emotion regulation were administered in addition to a semi-structured interview at one-year follow-up. The analysis of individual interviews suggested improvements in various areas of functioning and quantitative data revealed a significant decrease in emotion regulation difficulties. The results of this study provide preliminary support for the application and further study of group-based EFT for clinical presentations of anxiety and depression. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Robinson, Adele Lafrance; McCague, Elizabeth A; Whissell, Cynthia; Beck, Beck, Beebe, Catanzaro, Cisler, Courtois, Creswell, Creswell, Demyttenaere, Elliott, Ellison, Engle, Gendlin, Goldberg, Goldman, Grant, Grats, Gratz, Gray, Greenberg, Greenberg, Greenberg, Greenberg, Greenberg, Hays, Kepner, Kimball, Leiberman, MacLeod, Merriam, Page, Paivio, Paivio, Paivio, Pascual-Leone, Pascual-Leone, Pascual-Leone, Pos, Pos, Rosner, Scott, Seamoore, Smith, Smith, Stewart, Tiuraniemi, Watson, Wnuk, Yalom",2014.0,,0,0,
4332,Imagery in phobic subjects: a psychophysiological study.,,Robinson A.; Reading C.,1985.0,,0,0,
4333,Increased baseline sway contributes to increased losses of balance in older people following triazolam,"OBJECTIVE: Although it has been stated frequently that older people are more sensitive to benzodiazepines, the relative roles of impaired baseline performance, impaired elimination, and altered responsiveness have not been defined. We evaluated postural sway and plasma triazolam concentrations after administration of placebo and triazolam 0.375 mg in both young and older healthy subjects. DESIGN: Double-blind placebo-controlled trial. PARTICIPANTS: Nine young and nine older healthy men. INTERVENTION: All subjects received triazolam 0.375 mg or placebo on different study days, which were separated by at least 48 hours. MEASUREMENTS: Postural sway, visual analog scale of drowsiness, and plasma triazolam levels. RESULTS: The older subjects swayed more during triazolam than did the younger subjects, and this resulted in an increased number of losses of balance. This difference appeared to be caused by greater baseline sway in the older subjects rather than higher concentrations or increased responsiveness. A subset of older people had a much greater number of losses of balance during triazolam than did the rest of the subjects, and these individuals could be identified from their baseline sway. CONCLUSIONS: In this study, the increase in drug effect seen in the older subjects was of similar magnitude to that of the young, but it resulted in greater postural sway after drug administration than was seen in the young. The higher postural sway and the corresponding increased instability seen in the older subjects may put these older persons at increased risk of drug-related falls. This study also suggests that it should be possible to develop techniques that will identify individuals at particular risk of drug-induced postural instability.",Robin D.W.; Hasan S.S.; Edeki T.; Lichtenstein M.J.; Shiavi R.G.; Wood A.J.J.,1996.0,,0,0,
4334,A controlled comparison of family versus individual therapy for adolescents with anorexia nervosa.,"To compare the effectiveness of behavioral family systems therapy (BFST) with that of ego-oriented individual therapy (EOIT) as treatments for adolescents with anorexia nervosa. Thirty-seven adolescents meeting DSM-III-R criteria for anorexia nervosa were randomly assigned to receive BFST or EOIT, in addition to a common medical and dietary regimen. In BFST, the family was seen conjointly, the parents were placed in control of the adolescent's eating, distorted beliefs were targeted through cognitive restructuring, and strategic/behavioral interventions were used to change family interactions. In EOIT, the adolescent was seen individually, with an emphasis on building ego strength and uncovering the dynamics blocking eating; parents were seen collaterally. Measures administered before, after, and at 1-year follow-up tapped body mass index, menstruation, eating attitudes, ego functioning, depression, and family interactions. BFST produced greater weight gain and higher rates of resumption of menstruation than EOIT. Both treatments produced comparably large improvements in eating attitudes, depression, and eating-related family conflict, but very few changes occurred on ego functioning. BFST and EOIT proved to be effective treatments for adolescents with anorexia nervosa, but BFST produced a faster return to health.",Robin AL.; Siegel PT.; Moye AW.; Gilroy M.; Dennis AB.; Sikand A.,1999.0,10.1097/00004583-199912000-00008,0,0,
4335,Rationing out-patients: a defence of the waiting list.,"New psychiatric out-patients were offered immediate or delayed appointments (average delay 12 weeks) in random order. The two groups thus formed, comprising 234 patients, were shown to be comparable in some important respects. Immediate appointments were taken up significantly more frequently than delayed appointments, and 12 per cent of immediate and 22 per cent of delayed patients did not receive any psychiatric service. No evidence was found that delay increased other medical services supplied. Non-attenders were presumed to suffer from ""neurosis"" and ""personality problem"". Initial attenders used more services than those who failed to keep their first appointment but came later. A waiting list is proposed as a screening device to limit out-patient referrals.",Robin A.,1976.0,,0,0,
4336,Anxiety and presence during VR immersion: a comparative study of the reactions of phobic and non-phobic participants in therapeutic virtual environments derived from computer games.,"Virtual reality can be used to provide phobic clients with therapeutic exposure to phobogenic stimuli. However, purpose-built therapeutic VR hardware and software can be expensive and difficult to adapt to individual client needs. In this study, inexpensive and readily adaptable PC computer games were used to provide exposure therapy to 13 phobic participants and 13 non-phobic control participants. It was found that anxiety could be induced in phobic participants by exposing them to phobogenic stimuli in therapeutic virtual environments derived from computer games (TVEDG). Assessments were made of the impact of simulator sickness and of sense of presence on the phobogenic effectiveness of TVEDGs. Participants reported low levels of simulator sickness, and the results indicate that simulator sickness had no significant impact on either anxiety or sense of presence. Group differences, correlations, and regression analyses indicate a synergistic relationship between presence and anxiety. These results do not support Slater's contention that presence and emotion are orthogonal.",Robillard G.; Bouchard S.; Fournier T.; Renaud P.,2003.0,10.1089/109493103769710497,0,0,
4337,Phase II clinical trial of atorvastatin in mild traumatic brain injury.,"Statins constitute a class of medications commonly used in the treatment of elevated cholesterol. However, in experimental studies, statins also have other non-cholesterol-mediated mechanisms of action, which may have neuroprotective effects. The aim of this study was to determine whether administration of atorvastatin for 7 days post-injury would improve neurological recovery in patients with mild traumatic brain injury (mTBI). The hypothesis was that atorvastatin administration would reduce post-concussion symptoms and also that atorvastatin administration for 1 week post-injury would be safe. One hundred forty patients with mTBI were planned to be enrolled and randomly assigned to receive atorvastatin 1 mg/kg (up to 80 mg/kg) per day or placebo for 7 days starting within 24 h of injury. Assessments of post-concussion syndrome, post-traumatic stress and depressive symptoms, cognition, memory, verbal fluency, functional, and work status were performed at baseline, 1 week, and 1 and 3 months. The result on the Rivermead Post-Concussion Symptoms Questionnaire at 3 months was the primary outcome. Enrollment in the trial was stopped early because of difficulty in recruiting sufficient numbers of subjects. Fifty-two patients with mTBI were enrolled; 28 patients received atorvastatin and 24 received placebo. The median Rivermead score was 2 for the atorvastatin group, compared to 3.5 for the placebo group, at 3 months post-injury (chi2(1) = 0.0976; p = 0.7547). The change in the Rivermead score between baseline and 3 months was also analyzed. The median decrease in score was 4 for the atorvastatin group and 10.5 for the placebo group (chi2(1) = 0.8750; p = 0.3496). No serious adverse events occurred, and there was no significant difference in the incidence of adverse events in the two treatment groups. Atorvastatin administration for 7 days post-injury was safe, but there were no significant differences in neurological recovery post-mTBI with atorvastatin. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Robertson, Claudia S; McCarthy, James J; Miller, Emmy R; Levin, Harvey; McCauley, Stephen R; Swank, Paul R; Mission Connect Mild TBI Translation Research Consortium Clinical Working Group; Amarenco, Chen, Chen, Chen, Farooqui, Govindarajan, Hasan, Indraswari, Johnson-Anuna, Kay, Kureishi, Levin, Lu, Lu, Lu, Lu, Lu, Lynch, McCauley, Mountney, Narayana, Naval, Pan, Qu, Stoll, Tapia-Perez, Turkoglu, Wang, Wilde, Wu, Wu",2017.0,,0,0,
4338,Acceptance and Commitment Therapy with older adults: Rationale and case study of an 89-year-old with depression and generalized anxiety disorder.,"Acceptance and Commitment Therapy (ACT) is gaining traction as an effective therapy for a wide range of presenting concerns. Limited research and discussion has been published focused on utilizing ACT with older adults. The ACT model is proposed to be a good fit for this population because many older adults may already be values orientated due to awareness that their lifetime is limited. A trans-diagnostic approach that normalizes experiences common to older age may be advantageous given older adults often present with heterogeneous issues and life experiences. A case study of an 89-year-old woman experiencing late-life clinical depression and generalized anxiety disorder is presented. A significant factor contributing to her distress was her struggle with the cognitive and physical changes associated with aging. Results suggest that a brief ACT course implemented by a relative novice ACT therapist was effective in reducing psychological inflexibility as well as reducing distress to non-clinical levels at 6 weeks post therapy. Potential implications for adapting ACT with older adults are discussed, as well as reflections on some of the potential challenges for clinicians who are ACT beginners. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Roberts, Sarah L; Sedley, Ben; Alonso, Baltes, Bond, Delis, Edelstein, Fisher, Flint, Fluckiger, Harris, Hayes, Hayes, Hayes, Jourdain, Knight, Laidlaw, Laidlaw, Laidlaw, Loi, Pachana, Petkus, Ruiz, Schaie, Schaie, Segal, Tiwari, Wechsler, Wechsler, Wetherell, Wetherell, Wolitzky-Taylor, Woods, Yesavage, Zigmond",2016.0,,0,0,
4339,The prevention of anxiety and depression in children from disadvantaged schools,"ER A randomised controlled trial evaluated the Aussie Optimism Program in preventing anxiety and depression. Grade 7 students (n = 496) from disadvantaged government schools in Perth Western Australia, participated. Six schools were randomly assigned to Aussie Optimism and six schools received their usual health education lessons. Students completed questionnaires on depression, anxiety, attribution style, and social skills. Parents completed the Child Behavior Checklist. No significant group effects were found for student-reported data. Parents of intervention group only students reported reductions in internalizing problems at post-test. No follow-up group effects were significant. Students and teachers found the program acceptable.","Roberts, C M; Kane, R; Bishop, B; Cross, D; Fenton, J; Hart, B",2010.0,10.1016/j.brat.2009.09.002,0,0,
4340,Parents' Perceptions of Novel Treatments for Child and Adolescent Specific Phobia and Anxiety Disorders,"ER This study aimed to examine parents' perceptions of established treatments, including cognitive behaviour therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs), relative to novel treatments of D-cycloserine (DCS) and attention bias modification (ABM) augmented CBT to determine if novel treatments are perceived as more or less favorable than established treatments. Participants included parents of children with a specific phobia, enrolled in one of two randomized controlled trials of either one-session augmented DCS (n = 38, Gold Coast) or ABM augmented one-session treatment (n = 34, Brisbane), as well as parents from a community sample (n = 38). Parents of children with a specific phobia perceived CBT most favorably. There was no difference between the sites on perceptions of ABM. However, parents of children enrolled in the DCS trial perceived DCS more favorably than parents of children enrolled in the ABM trial and the community sample. These results demonstrate parents' greater acceptance of psychological treatments over pharmacological treatments for the treatment of childhood phobias, highlighting the importance of educating parents to novel treatments.","Roberts, C L; Farrell, L J; Waters, A M; Oar, E L; Ollendick, T H",2016.0,10.1007/s10578-015-0579-2,0,0,
4341,The prevention of depressive symptoms in rural school children: a randomized controlled trial,"ER A controlled trial was conducted to evaluate a prevention program aimed at reducing depressive and anxious symptoms in rural school children. Seventh-grade children with elevated depression were selected. Nine primary schools (n = 90) were randomly assigned to receive the program, and 9 control schools (n = 99) received their usual health education classes. Children completed questionnaires on depression, anxiety, explanatory style, and social skills. Parents completed the Child Behavior Checklist (T. M. Achenbach, 1991). No intervention effects were found for depression. Intervention group children reported less anxiety than the control group after the program and at 6-month follow-up and more optimistic explanations at postintervention. Intervention group parents reported fewer child internalizing and externalizing symptoms at postintervention only.","Roberts, C; Kane, R; Thomson, H; Bishop, B; Hart, B",2003.0,,0,0,
4342,Imipramine treatment in pediatric burn patients with symptoms of acute stress disorder: a pilot study,"ER METHODTwenty-five children, aged 2 to 19 years, received either imipramine or chloral hydrate for 7 days. A structured interview (clinically useful, but validity and reliability not yet established) was used to assess the presence and frequency of ASD symptoms both before treatment and 3 times during the treatment period.RESULTSEleven females and 14 males participated, with a mean total burn surface area of 45% (SD = 23%) and mean age of 8 years (SD = 6). Imipramine was more effective than chloral hydrate in treating ASD symptoms (chi 2 [1, N = 25] = 5.24, p < .02). Five of 13 were positive responders to chloral hydrate (38%). Ten of 12 were positive responders to low-dose imipramine (83%).CONCLUSIONSThis pilot study suggests a place for cautious initial use of imipramine to reduce ASD symptoms in burned children. Care must be taken to minimize cardiovascular risks in an off-label application of imipramine in children, especially those receiving additional medications.OBJECTIVEPediatric burn patients often exhibit acute stress disorder (ASD) symptoms. Information on psychopharmacological treatment of ASD symptoms in children is scarce. This pilot study used a prospective, randomized, double-blind design to test whether thermally injured children suffering ASD symptoms benefit from imipramine.","Robert, R; Blakeney, P E; Villarreal, C; Rosenberg, L; Meyer, W J",1999.0,10.1097/00004583-199907000-00018,0,0,
4343,[Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation: a review of 28 cases].,"The knee has little capacity for spontaneous regeneration of deep cartilage defects. In 1999, the French Society of Arthroscopy initiated a multicentric clinical trial on autologous chondrocyte transplantation using the technique described by Brittberg and Peterson. The protocol of this prospective study was validated by the ethics committee and all patients provided the informed consent for participation. Patients underwent surgery in seven hospitals: 28 patients (7 female, 21 male, mean age 28 years, age range 18-45 years). The underlying condition was: osteochondritis (n=14), isolated posttraumatic chondropathy (n=8), chondropathy plus ACL tear (n=6). All patients presented deep condylar cartilage defects (ICRS grades 3 and 4). Mean surface area involved after debridement was 490 mm2 (range 150-1050 mm2). Patients were reviewed two years at least after transplantation for functional assessment and an MRI performed 2 to 3 years after transplantation. Control arthroscopy was also performed in 13 patients with biopsy for histology and immunohistochemistry for 10. Twenty-six patients were reviewed with more than two years follow-up (mean 2 years 9 months). There were no general complications; three patients presented a partial avulsion of the autograft treated arthroscopically and one arthrolysis was performed at six months. Function was improved in all patients but four, but pain persisted in one patient. The mean ICRS score improved from 41 points (19-55 points) to 74 points (54-86 points), for an 80% gain. Follow-up MRI was available for 16 knees: the graft was hypertrophied in 11, at level in 3 and insufficient in 2; marginal integration was good in 10 knees and fair in 6. Items of marginal and subchondral integration had a very high positive predictive value for good clinical outcome. The arthroscopic score was nearly normal (range 8-11) in 8 knees and abnormal (range 4-7) in 5. The Knutsen histological groups according to richness of hyaline cartilage were: group 1 (>60%) (n=1); group 2 (>40%) (n=3), group 3 (<40%) n(=4) and group 4 (bone or fibrous tissue) (n=1). The function scores (r=0.80) and the MRI scores (r=0.76) were correlated with the arthroscopy scores. There was no correlation between the histological findings but the sample size was too small for meaningful analysis. The clinical results demonstrate an improvement in more than 80% of knees, findings similar to earlier reports. The arthroscopic and histological results were equivalent to those reported by Knutsen, but less satisfactory than those reported by Bentley or Peterson. Cell injections under a periosteal patch constitute the first generation of autologous chondrocyte grafts. Resorbable matrices loaded with chondrocytes before implantation are under development and have provided promising early results.",Robert H.; Bahuaud J.; Kerdiles N.; Passuti N.; Capelli M.; Pujol JP.; Hartman D.; Locker B.; Hulet C.; Hardy P.; Coudane H.; Rochverger A.; Francheschi JP.;  .,2007.0,,0,0,
4344,Examining the latent class structure of CO2 hypersensitivity using time course trajectories of panic response systems,Conclusions Two classes potentially representing different risk pathways were observed. Implications of results will be discussed in the context of panic risk research.,Roberson-Nay R.; Beadel J.R.; Gorlin E.I.; Latendresse S.J.; Teachman B.A.,2015.0,10.1016/j.jbtep.2014.10.013,0,0,
4345,"Cognitive-behavioral treatment for panic disorder with agoraphobia: A randomized, controlled trial and cost-effectiveness analysis.","A randomized, controlled trial was conducted to examine the cost-effectiveness of cognitive-behavioral treatment (CBT) for panic disorder with agoraphobia. A total of 100 participants were randomly assigned to standard (n = 33), group (n = 35), and brief (n = 32) treatment conditions. Results show significant clinical and statistical improvement on standard symptom measures and quality of life from baseline to posttreatment and 3-month follow-up, with no significant differences between treatment conditions. Compared with standard CBT, brief and group CBT incurred lower treatment costs and had a superior cost-effectiveness ratio, suggesting the potential of these alternative treatment conditions in increasing access to effective treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Roberge, Pasquale; Marchand, Andre; Reinharz, Daniel; Savard, Pierre; Bandelow, Beck, Buller, Carlbring, Chambless, Chambless, Clark, Craske, Craske, DiNardo, DuPont, Duquette, Fava, Gauthier, Gould, Gould, Greenberg, Hecker, Jacobson, Jaycox, Katon, Kessler, Lave, Lepine, Levesque, Lidren, Macfarlane, Mavissakalian, Newman, Otto, Pollack, Reiss, Roberge, Roberge, Roy-Byrne, Stephenson, Stephenson, Stephenson, Stephenson, Swinson, Wang, White, Wittchen, Young",2008.0,,0,0,
4346,Changes in trauma-potentiated startle with treatment of posttraumatic stress disorder in combat Veterans.,"Emotional Processing Theory proposes that habituation to trauma-related stimuli is an essential component of PTSD treatment. However, the mechanisms underlying treatment-related habituation are not well understood. We examined one psychophysiological measure that holds potential for elucidating the biological processes involved in treatment response: trauma-potentiated startle response. Seventeen OEF/OIF combat Veterans participated in the study and completed three assessments using a trauma-potentiated startle paradigm over PTSD treatment. Results revealed different patterns of trauma-potentiated startle across treatment for responders and nonresponders, but no differences in within task habituation. Responders showed an increase followed by a decrease in trauma-potentiated startle, whereas nonresponders showed a relatively flat response profile. Results suggested that PTSD patients who engage with emotional content as demonstrated by greater startle reactivity may be more likely to respond to PTSD treatment. Furthermore, trauma-potentiated startle shows promise as an objective measure of psychophysiological responses involved in PTSD recovery.",Robison-Andrew EJ.; Duval ER.; Nelson CB.; Echiverri-Cohen A.; Giardino N.; Defever A.; Norrholm SD.; Jovanovic T.; Rothbaum BO.; Liberzon I.; Rauch SA.,2014.0,10.1016/j.janxdis.2014.04.002,0,0,
4347,Group desensization of a phobia in massed sessions.,,Robinsonc .; Suinn RM.,1969.0,,0,0,
4348,Randomized clinical trial of therapeutic music video intervention for resilience outcomes in adolescents/young adults undergoing hematopoietic stem cell transplant: a report from the Children's Oncology Group,"ER BACKGROUND: To reduce the risk of adjustment problems associated with hematopoietic stem cell transplant (HSCT) for adolescents/young adults (AYAs), we examined efficacy of a therapeutic music video (TMV) intervention delivered during the acute phase of HSCT to: 1) increase protective factors of spiritual perspective, social integration, family environment, courageous coping, and hope-derived meaning; 2) decrease risk factors of illness-related distress and defensive coping; and 3) increase outcomes of self-transcendence and resilience.METHODS: This was a multisite randomized, controlled trial (COG-ANUR0631) conducted at 8 Children's Oncology Group sites involving 113 AYAs aged 11-24 years undergoing myeloablative HSCT. Participants, randomized to the TMV or low-dose control (audiobooks) group, completed 6 sessions over 3 weeks with a board-certified music therapist. Variables were based on Haase's Resilience in Illness Model (RIM). Participants completed measures related to latent variables of illness-related distress, social integration, spiritual perspective, family environment, coping, hope-derived meaning, and resilience at baseline (T1), postintervention (T2), and 100 days posttransplant (T3).RESULTS: At T2, the TMV group reported significantly better courageous coping (Effect Size [ES], 0.505; P?=?.030). At T3, the TMV group reported significantly better social integration (ES, 0.543; P?=?.028) and family environment (ES, 0.663; P?=?.008), as well as moderate nonsignificant effect sizes for spiritual perspective (ES, 0.450; P?=?.071) and self-transcendence (ES, 0.424; P?=?.088).CONCLUSIONS: The TMV intervention improves positive health outcomes of courageous coping, social integration, and family environment during a high-risk cancer treatment. We recommend the TMV be examined in a broader population of AYAs with high-risk cancers.","Robb, S L; Burns, D S; Stegenga, K A; Haut, P R; Monahan, P O; Meza, J; Stump, T E; Cherven, B O; Docherty, S L; Hendricks-Ferguson, V L; Kintner, E K; Haight, A E; Wall, D A; Haase, J E",2014.0,10.1002/cncr.28355,0,0,
4349,Development and early evaluation of the Virtual Iraq/Afghanistan exposure therapy system for combat-related PTSD.,"Numerous reports indicate that the growing incidence of posttraumatic stress disorder (PTSD) in returning Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) military personnel is creating a significant health care and economic challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. Virtual reality-delivered exposure therapy for PTSD has been previously used with reports of positive outcomes. The current paper will detail the development and early results from use of the Virtual Iraq/Afghanistan exposure therapy system. The system consists of a series of customizable virtual scenarios designed to represent relevant Middle Eastern contexts for exposure therapy, including a city and desert road convoy environment. The process for gathering user-centered design feedback from returning OEF/OIF military personnel and from a system deployed in Iraq (as was needed to iteratively evolve the system) will be discussed, along with a brief summary of results from an open clinical trial using Virtual Iraq with 20 treatment completers, which indicated that 16 no longer met PTSD checklist-military criteria for PTSD after treatment.",Rizzo AS.; Difede J.; Rothbaum BO.; Reger G.; Spitalnick J.; Cukor J.; McLay R.,2010.0,10.1111/j.1749-6632.2010.05755.x,0,0,
4350,Cognitive and affective predictors of treatment outcome in Cognitive Processing Therapy and Prolonged Exposure for posttraumatic stress disorder.,"This study examined cognitive and affective predictors of treatment dropout and treatment efficacy in Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) for PTSD. Study participants were women with PTSD from a sexual assault who received at least one session of either treatment (n = 145) as part of a randomized clinical trial. Results revealed that younger age, lower intelligence, and less education were associated with higher treatment dropout, whereas higher depression and guilt at pretreatment were associated with greater improvement in PTSD symptomatology. Results by treatment condition indicated that women with higher anger at pretreatment were more likely to dropout of PE and that older women in PE and younger women in CPT had the best overall outcomes. These findings have implications for efforts to enhance treatment efficacy and retention in CBT treatment protocols.",Rizvi SL.; Vogt DS.; Resick PA.,2009.0,10.1016/j.brat.2009.06.003,0,0,
4351,Modifying instructions on the posttraumatic stress disorder checklist for military populations does not change symptom reporting.,"This study investigates whether modifying the instructions of the Posttraumatic Stress Disorder Checklist (PCL) for military survey research changes posttraumatic stress disorder (PTSD) symptom reporting or prevalence. The sample consisted of 1691 soldiers who were randomly assigned to complete 1 of 3 versions of the PCL, which differed only in the wording of the instructions. Group differences in demographic variables, combat exposure, mean PTSD symptoms, and PTSD prevalence estimates were examined. Results showed that there were no statistically significant differences in the outcomes across the PCL versions. The findings indicate that researchers may make modifications to the PCL instructions to meet research needs without affecting PTSD symptom reporting or prevalence estimates.",Riviere LA.; Edens EN.; Adler AB.; Bliese PD.; Klocko RP.; Hoge CW.,2011.0,10.1097/NMD.0b013e31820caee4,0,0,
4352,The relationship between fear of social and physical threat and its effect on social distress and physical pain perception,"Past research has found that measuring individuals' fear of pain predicts their physical pain perceptions: those reporting higher levels of fear of pain report higher levels of pain. We investigated links between fear of social threat and fear of physical pain, testing whether these fears predict responses to social distress and physical pain. In 3 studies, we found that fear of social and physical threat were related yet distinct psychological constructs (study 1), that fear of social (but not physical) threat predicted the perception of social distress (study 2), and that fear of physical (but not social) pain predicted the perception of physical pain (study 3). Thus, we found that, similar to the influence of fear of physical pain on physical pain perception, fear of social threat moderated the perception of social distress. However, we also found that these effects were specific, such that each type of fear uniquely predicted the experience of the same type of distress. We argue that timely identification of high levels of social threat-related fear is critical for identifying individuals who will benefit most from preventative interventions aimed to limit negative cycles of high avoidance and increased social threat perception. Furthermore, our work sets a boundary condition to pain overlap theory by showing that high levels of fear of one type of pain (e.g., social) are specifically linked to increased perception of that particular type of pain (e.g., social) but not the other (e.g., physical). © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.",Riva P.; Williams K.D.; Gallucci M.,2014.0,10.1016/j.pain.2013.11.006,0,0,
4353,Feminist principles in survivor's groups: Out-of-group contact.,"Theory from feminist therapy is extended to analyze group themes and out-of-group contact in group treatment of female survivors of abuse. The group in the example was an ongoing outpatient therapy group of 35-50 yr old female survivors of sexual or physical and emotional abuse and other childhood traumas. Ss had a mixture of psychiatric diagnoses, including major depression and posttraumatic stress disorder (PTSD). Analysis of group progress notes and member questionnaire responses supports the usefulness of feminist group therapy and of out-or-group contact in such a group where isolation, trust, and establishment of relationships are important issues. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rittenhouse, JoAn",1997.0,,0,0,
4354,StressModEx--Physiotherapist-led Stress Inoculation Training integrated with exercise for acute whiplash injury: study protocol for a randomised controlled trial.,"Whiplash associated disorders are the most common non-hospitalised injuries following a road traffic crash. Up to 50% of individuals who experience a whiplash injury will not fully recover and report ongoing pain and disability. Most recovery, if it occurs, takes place in the first 2-3 months post injury, indicating that treatment provided in the early stages is critical to long-term outcome. However, early management approaches for people with acute whiplash associated disorders are modestly effective. One reason may be that the treatments have been non-specific and have not targeted the processes shown to be associated with poor recovery, such as post-traumatic stress symptoms. Targeting and modulating these early stress responses in the early management of acute whiplash associated disorders may improve health outcomes. Early aggressive psychological interventions in the form of psychological debriefing may be detrimental to recovery and are now not recommended for management of early post-traumatic stress symptoms. In contrast, Stress Inoculation Training (SIT) is a cognitive behavioural approach that teaches various general problem-solving and coping strategies to manage stress-related anxiety (ie, relaxation training, cognitive restructuring and positive self-statements) and provides important information to injured individuals about the impact of stress on their physical and psychological wellbeing. While referral to a psychologist may be necessary in some cases where acute stress disorder or other more significant psychological reactions to stress are evident, in the case of acute whiplash injuries, it is neither feasible nor necessary for a psychologist to deliver the early stress modulation intervention to all injured individuals. The feasibility of using other specially trained health professionals to deliver psychological interventions has been explored in conditions such as chronic low back pain, chronic whiplash and cancer, but few trials have studied this approach in acute musculoskeletal conditions with the aim of preventing the development of chronic pain. As physiotherapy is the most common intervention received by individuals with a whiplash injury, physiotherapists are ideally placed to provide SIT in conjunction with standard physical rehabilitation. This study (StressModEx) will target individuals in the acute stage of injury and address the stress responses associated with the accident or injury (event-related distress) with the aim of improving both physical and mental health outcomes. Is SIT integrated with standard physiotherapy exercise and delivered by physiotherapists more effective than physiotherapy exercise alone in reducing neck pain and disability in individuals with acute whiplash associated disorders? Parallel randomised controlled trial with blinded outcome assessment. 100 individuals with grade II or III (no fracture/dislocation or neurological loss) acute whiplash associated disorder<4 weeks duration and at least moderate neck pain-related disability and hyper-arousal symptoms will be recruited for the study. Participants will be assessed via online surveys or in-person at a university research laboratory. Interventions will be provided at community physiotherapy practices in Brisbane, Gold Coast, Toowoomba and Mackay, Queensland, Australia. Clinical-guideline-recommended supervised physiotherapy exercise sessions (10 sessions) integrated with six (once per week) SIT sessions. Clinical-guideline-recommended supervised physiotherapy exercise sessions (10) only. Primary (Neck Disability Index) and secondary (Acute Stress Disorder Scale; Post-traumatic Stress Diagnostic Scale; Depression, Anxiety and Stress Scale; Pain Catastrophisingo Scale; Pain Self-Efficacy Questionnaire; Coping Strategies Questionnaire; Global impression of recovery; pain intensity; SF36) outcomes will be measured at baseline, 6 weeks, 6 months and 12 months after randomisation. Data analysis will be blinded and by intention to treat. Outcomes will be analysed using linear mixed and logistic regression models that will include baseline scores as covariates, participants as random effects and treatment conditions as fixed factors. This study will be the first to address early stress responses following acute whiplash injury through a novel intervention that integrates SIT and physiotherapy exercise.",Ritchie C.; Kenardy J.; Smeets R.; Sterling M.,2015.0,10.1016/j.jphys.2015.04.003,0,0,
4355,A stepped care stress management intervention on cancer-related traumatic stress symptoms among breast cancer patients—a randomized study in group vs. individual setting.,"To evaluate the mode of delivery of a stress management intervention, in a group or individual setting, on self-reported cancer-related traumatic stress symptoms. A secondary aim was to evaluate a stepped care approach. All study participants (n = 425), who were female, newly diagnosed with breast cancer and receiving standard oncological care were offered Step I of the stepped care approach, a stress management education (SME). Thereafter, they were screened for cancer-related traumatic stress symptoms, and, if present (n = 304), were invited to join Step II, a more intense intervention, derived from cognitive behavioral therapy, to which they were randomized to either a group (n = 77) or individual (n = 78) setting. To assess cancer-related traumatic stress symptoms, participants completed the Impact of Event Scale and the Hospital Anxiety and Depression Scale at the time of inclusion, three-months post-inclusion and approximately 12-months post-inclusion. The SME did not significantly decrease any of the cancer-related traumatic stress symptoms. No statistically significant differences were found between the group and the individual setting interventions. However, only 54% of the participants attended the group setting compared to 91% for the individual setting. The mode of delivery had no effect on the cancer-related traumatic stress symptoms; however, the individual setting was preferred. In future studies, a preference-based RCT design will be recommended for evaluating the different treatment effects.",Rissanen R.; Nordin K.; Ahlgren J.; Arving C.,2015.0,10.1002/pon.3763,0,0,
4356,A stepped care stress management intervention on cancer-related traumatic stress symptoms among breast cancer patients-a randomized study in group vs. individual setting,"ER METHODSAll study participants (n?=?425), who were female, newly diagnosed with breast cancer and receiving standard oncological care were offered Step I of the stepped care approach, a stress management education (SME). Thereafter, they were screened for cancer-related traumatic stress symptoms, and, if present (n?=?304), were invited to join Step II, a more intense intervention, derived from cognitive behavioral therapy, to which they were randomized to either a group (n?=?77) or individual (n?=?78) setting. To assess cancer-related traumatic stress symptoms, participants completed the Impact of Event Scale and the Hospital Anxiety and Depression Scale at the time of inclusion, three-months post-inclusion and approximately 12-months post-inclusion.RESULTSThe SME did not significantly decrease any of the cancer-related traumatic stress symptoms. No statistically significant differences were found between the group and the individual setting interventions. However, only 54% of the participants attended the group setting compared to 91% for the individual setting.CONCLUSIONThe mode of delivery had no effect on the cancer-related traumatic stress symptoms; however, the individual setting was preferred. In future studies, a preference-based RCT design will be recommended for evaluating the different treatment effects.OBJECTIVETo evaluate the mode of delivery of a stress management intervention, in a group or individual setting, on self-reported cancer-related traumatic stress symptoms. A secondary aim was to evaluate a stepped care approach.","Rissanen, R; Nordin, K; Ahlgren, J; Arving, C",2015.0,10.1002/pon.3763,0,0,4355
4357,Using mental imagery with subclinical OCD to 'freeze' contamination in its place: Evidence for looming vulnerability theory,"The present research examines the possibility that 'freezing' or slowing-down the rate at which threats can advance and thereby blocking a sense of looming vulnerability can reduce fears of contamination and avoidance behavior among individuals with obsessional symptoms. Mental imagery was used to reduce the rate at which threat can advance by means of instructions to imagine that contamination was 'frozen' in place and unable to move. Measures included self-reports of anxiety and worry, and indirect assessments of fear and avoidance behavior. A parallel mental imagery condition was used to examine the possibility that accentuating the spread or contamination, or its 'looming', would in turn accentuate fear and avoidance. The results, particularly of the more unobtrusive measures, indicated that freeze imagery reduced fear and avoidance for the relatively obsessional participants. In addition, support was found that it reduced fear for participants with relatively higher levels of imagination. However, the freeze imagery paradoxically seemed to sensitize the non-obsessional participants to possibilities of contamination they had not previously considered, and thus increased their fear. The results provide support for the looming vulnerability model of anxiety and suggest applications to treatment.",Riskind J.H.; Wheeler D.J.; Picerno M.R.,1997.0,10.1016/S0005-7967(97)00023-5,0,0,
4358,Therapeutic Exercise Training to Reduce Chronic Headache in Working Women: design of a Randomized Controlled Trial,"ER OBJECTIVE: The aim of this study is to investigate whether a progressive, group-based therapeutic exercise program decreases the intensity and frequency of chronic headache among women compared with a control group receiving a sham dose of transcutaneous electrical nerve stimulation (TENS) and stretching exercises.DESIGN: A randomized controlled trial with 6-month intervention and follow-up was developed. The participants were randomly assigned to either a treatment group or a control group.SETTING: The study is being conducted at 2 study centers.PATIENTS: The participants are women aged 18 to 60 years with chronic cervicogenic headache or migraine.INTERVENTION: The treatment group's exercise program consisted of 6 progressive therapeutic exercise modules, including proprioceptive low-load progressive craniocervical and cervical exercises and high-load exercises for the neck muscles. The participants in the control group received 6 individually performed sham TENS treatment sessions.MEASUREMENTS: The primary outcome is the intensity of headache. The secondary outcomes are changes in frequency and duration of headache, neck muscle strength, neck and shoulder flexibility, impact of headache on daily life, neck disability, fear-avoidance beliefs, work ability, and quality of life. Between-group differences will be analyzed separately at 6, 12, and 24 months with generalized linear mixed models. In the case of count data (eg, frequency of headache), Poisson or negative binomial regression will be used.LIMITATIONS: The therapists are not blinded.CONCLUSIONS: The effects of specific therapeutic exercises on frequency, intensity, and duration of chronic headache and migraine will be reported.BACKGROUND: Cervicogenic headache and migraine are common causes of visits to physicians and physical therapists. Few randomized trials utilizing active physical therapy and progressive therapeutic exercise have been previously published. The existing evidence on active treatment methods supports a moderate effect on cervicogenic headache.","Rinne, M; Garam, S; Häkkinen, A; Ylinen, J; Kukkonen-Harjula, K; Nikander, R",2016.0,10.2522/ptj.20150267,0,0,
4359,Training approach-avoidance of smiling faces affects emotional vulnerability in socially anxious individuals,"Previous research revealed an automatic behavioral bias in high socially anxious individuals (HSAs): although their explicit evaluations of smiling faces are positive, they show automatic avoidance of these faces. This is reflected by faster pushing than pulling of smiling faces in an Approach-Avoidance Task (AAT; Heuer et al., 2007). The current study addressed the causal role of this avoidance bias for social anxiety. To this end, we used the AAT to train HSAs, either to approach smiling faces or to avoid them. We examined whether such an AAT training could change HSAs' automatic avoidance tendencies, and if yes, whether AAT effects would generalize to a new approach task with new facial stimuli, and to mood and anxiety in a social threat situation (a video-recorded self-presentation). We found that HSAs trained to approach smiling faces did indeed approach female faces faster after the training than HSAs trained to avoid smiling faces. Moreover, approach-faces training reduced emotional vulnerability: it led to more positive mood and lower anxiety after the self-presentation than avoid-faces training. These results suggest that automatic approach-avoidance tendencies have a causal role in social anxiety, and that they can be modified by a simple computerized training. This may open new avenues in the therapy of social phobia. © 2013 Rinck, Telli, Kampmann, Woud, Kerstholt, te Velthuis, Wittkowski and Becker.",Rinck M.; Telli S.; Kampmann I.L.; Woud M.L.; Kerstholt M.; te Velthuis S.; Wittkowski M.; Becker E.S.,2012.0,10.3389/fnhum.2013.00481,0,0,
4360,A new approach on stress-related depression and anxiety: neuro-Psycho- Physical-Optimization with Radio Electric Asymmetric-Conveyer,"ER METHODS: Psychological stress was measured in a group of 888 patients using the Psychological Stress Measure (PSM) test, a self-administered questionnaire. Data were collected immediately before and after the 4-wk therapy cycle. The detection of anxiety and depression clusters by PSM test has been based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, APA, 2000) criteria. Six hundred and eighty eight patients (212 males, 476 females, average PSM test total scores 107.9 +/- 23.13) were treated with REAC-CRM therapy; 200 (64 males, 136 females, average PSM test total scores 107.86 +/- 25.80) were treated with ""placebo REAC-CRM therapy""and used as control.RESULTS: This study showed a significant reduction in scores measuring subjective perceptions of stress in the patients treated with a cycle of REAC-CRM therapy. At the end-point the number of patients reporting symptoms of stress-related anxiety and depression on the PSM test was significantly reduced (P<0.001); in the placebo group no significant difference was highlighted.INTERPRETATION & CONCLUSIONS: NPPO therapy with a cycle of REAC-CRM was shown to reduce subjective perceptions of stress measured by the PSM test and in particular, symptoms of stress-related anxiety and depression.BACKGROUND & OBJECTIVES: Chronic social stress is an important factor responsible for the worsening of depressive disorders in humans. In this study we present the relational Neuro-Psycho-Physical Optimization (NPPO) with Radio Electric Asymmetric Conveyer (REAC-CRM) as the treatment to tackle the unconscious dysfunction adjustments carried out by the central nervous system as a response to environmental stresses.","Rinaldi, S; Fontani, V; Moretti, E; Rosettani, B; Aravagli, L; Saragò, G; Collodel, G",2010.0,,0,0,
4361,The role of muscle relaxation in participant modeling.,,Rimm DC.; Medeiros DC.,1970.0,,0,0,
4362,The application of reinforcement and participant modeling procedures in the treatment of snake-phobic behavior.,,Rimm DC.; Mahoney MJ.,1969.0,,0,0,
4363,The role of muscle relaxation in participant modeling.,"The present investigation compared the effectiveness of three different treatment procedures in alleviating snake phobic behavior in adults. The procedures employed were Relaxation plus Participant Modeling, in which, following training in deep muscle relaxation, S observed a fearless model going through a graduated series of interactions with a harmless snake. followed by S going through a similar series of interactions; Participant Modeling without relaxation, which was identical to the above except relaxation induction was omitted, and relaxation alone. A fourth group of Ss received no treatment of any kind. Both groups experiencing Participant Modeling evidenced a very large, generalizable and lasting reduction in snake avoidance behavior; improvement was not significantly potentiated by the inclusion of the relaxation induction procedure. The results are discussed in relation to Systematic Desensitization. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rimm, David C; Medeiros, Donald C; Bandura, Blanchard, Davison, Hays, Litvak, Rachman, Rimm, Ritter, Rttter, Winer, Wolpe, Wolpe",1970.0,,0,0,
4364,"Daily stressors, trauma exposure, and mental health among stateless Rohingya refugees in Bangladesh","The Rohingya of Myanmar are a severely persecuted minority who form one of the largest groups of stateless people; thousands of them reside in refugee camps in southeastern Bangladesh. There has been little research into the mental health consequences of persecution, war, and other historical trauma endured by the Rohingya; nor has the role of daily environmental stressors associated with continued displacement, statelessness, and life in the refugee camps, been thoroughly researched. This cross-sectional study examined: trauma history, daily environmental stressors, and mental health outcomes for 148 Rohingya adults residing in Kutupalong and Nayapara refugee camps in Bangladesh. Results indicated high levels of mental health concerns: posttraumatic stress disorder (PTSD), depression, somatic complaints, and associated functional impairment. Participants also endorsed local idioms of distress, including somatic complaints and concerns associated with spirit possession. The study also found very high levels of daily environmental stressors associated with life in the camps, including problems with food, lack of freedom of movement, and concerns regarding safety. Regression and associated mediation analyses indicated that, while there was a direct effect of trauma exposure on mental health outcomes (PTSD symptoms), daily environmental stressors partially mediated this relationship. Depression symptoms were associated with daily stressors, but not prior trauma exposure. These findings indicate that daily stressors play a pivotal role in mental health outcomes of populations affected by collective violence and statelessness. It is, therefore, important to consider the role and effects of environmental stressors associated with life in refugee camps on the mental health and psychosocial well-being of stateless populations such as the Rohingya, living in protracted humanitarian environments.",Riley A.; Varner A.; Ventevogel P.; Taimur Hasan M.M.; Welton-Mitchell C.,2017.0,10.1177/1363461517705571,0,0,
4365,"Psychosocial differences as predictors for recovery from chronic low back pain following manipulation, stabilizing exercises and physician consultation or physician consultation alone","ER METHODSOf 204 voluntarily recruited patients with chronic low back pain, 102 were randomized to a combined manipulation, exercise and physician consultation group (called the combination group) and 102 to a consultation-alone group.RESULTSAlthough all subjects showed improvement during follow-up both on the Oswestry index and the Visual Analogue Scale, the dysfunctional profile patients in the combination group improved the most. Their high pre-treatment ratings on Oswestry and Visual Analogue-scales fell at the 5- and 12-month follow-ups to the same level as those of the adaptive copers or interpersonally distressed patients, and they were on a significantly lower level than the dysfunctional profile patients in consultation group during follow-up. All dysfunctional profile patients also showed a decrease in affective distress, equally in combination and consultation groups.CONCLUSIONWe suggest that dysfunctional profile patients are more sensitive to respond even to treatment without any specific psychosocial elements. This should be considered when evaluating any treatment effects. Among dysfunctional profile patients, pain-related anxiety and decreased acceptance of pain may contribute to their sensitivity to treatment.OBJECTIVEThree psychosocial profile groups are introduced in the Multidimensional Pain Inventory for chronic pain patients. Patients with the dysfunctional profile have shown a more favourable outcome after multidisciplinary treatments, due to the suggested effects of specific psychosocial treatment elements. In this study we explored, among patients with chronic low back pain, whether the Multidimensional Pain Inventory patient profile groups might respond differently to treatment without planned psychosocial elements.","Riipinen, M; Niemistö, L; Lindgren, K A; Hurri, H",2005.0,10.1080/16501970410022426,0,0,
4366,A randomized group intervention trial to enhance mood and self-efficacy in people with multiple sclerosis,"ER DESIGNA randomized controlled intervention trial assessing outcomes at five time points over a 1-year follow-up.METHODSParticipants with MS were assigned to one of three groups: one receiving brief group psychological intervention (PG) comprising three 90 minute cognitive behavioural sessions supported by an Information Booklet dealing with mental and emotional issues relating to MS; a group provided only with educational material - the information booklet group (IBG); and a group who not only received the booklet but also participated in non-structured social discussion (SDG) sessions similar in length and number to PG participants. Outcomes were documented using questionnaires.RESULTSOutcomes were assessed using area under the curve (AUC) analysis: a summary measure that considers individual changes serially over time to provide a more meaningful picture than the one based on single time points. Ninety participants were followed up over the 12-month post-intervention, and their data are included in the analysis. Analyses indicated benefits in all outcome dimensions for the psychotherapeutic (PG) and social discussion groups (SDG) relative to the IBG group, but no differences between PG and SDG.CONCLUSIONThe study indicates benefits from psychosocial intervention compared with bibliotherapy, with some additional benefit from psychological intervention compared with a social discussion group. Results suggest that much of the benefit may derive from non-specific therapeutic components. Without psychosocial intervention, the psychological status of people with MS worsened over time.OBJECTIVESTo document mood, self-efficacy, and resiliency in people with multiple sclerosis (MS) following a brief group psychological intervention, and to examine whether benefits were greater than those derived from provision of education or group social interaction.","Rigby, S A; Thornton, E W; Young, C A",2008.0,10.1348/135910707X241505,0,0,
4367,Can biased symptom perception explain false-alarm choking sensations?,"ER METHODSSixty-four children and adolescents with asthma, aged 9-18 years, were randomly assigned to; (1) standardized physical exercise for induction of general symptoms; (2) equipment causing itching through skin irritation; or (3) physical exercise combined with equipment causing itching through skin irritation. Pre-test and post-test measures were: lung function; breathlessness; general symptoms; itching; state anxiety; and worry.RESULTSLung function decreased within normal parameters (3.8%, 1.1%, 2.6%, respectively) and did not differ significantly between conditions. Breathlessness increased significantly after exercise, particularly in condition 3. Breathlessness correlated with general symptoms and worrying, but not with changes in lung function, age, or asthma severity.CONCLUSIONBiased symptom perception can explain unrealistic breathlessness. Prerequisites are situational cues triggering selective perception and ambiguous sensations associated with the anticipated (feared) physical state. Excessive breathlessness may often warrant objective confirmation by means of lung-function testing.BACKGROUNDBreathlessness in asthma often cannot be explained with objective variables indicating airways obstruction. The hypothesis that unrealistic breathlessness results from false interpretation of sensations was tested.","Rietveld, S; Everaerd, W; Vanbeest, I",1999.0,,0,0,
4368,[Are there therapy algorithms in isolated and combined atlas fractures?].,"Injuries of the atlas are always a challenge in diagnostics and therapy. Different clinical manifestations, inconspicuous neurological results, uncertain findings of radiological diagnostics and possible accompanying injuries require individual therapeutic concepts. Patients with injuries of C1 and C2 seen between 2001-2007 were evaluated and especially the morbidity and treatment of the C1-injured patients were verified. To systematise the injuries, a subdivision in isolated and combined trauma took place. Furthermore, the post-traumatic as well as post-therapeutic accompanying neurological deficits were evaluated. Altogether 121 fractures/injuries of the upper cervical spine (C1/C2) were counted, 22 (18.2 %) concerning the atlas. There were 11 fractures of type Gehweiler I, 9 of type III and 1 each of types II and IV. Isolated fractures of type I (5/11) were treated conservatively, combined injuries (6/11), depending on the stability and location of the attendant injuries, were treated with semi-rigid collars, anterior or posterior fusions. Stable fractures of type III (2/9) were primarily treated in Halo extension. Because of an attending dens fracture type Anderson II in 1 case, a spondylodesis of the dens was additionally performed in the conservative treatment of the atlas. The therapy of isolated unstable atlas fractures of type III (4/9) ranged, depending on the general conditions, from Halo extension, transoral C1 stabilisation, anterior transarticular C1/C2 fusion to posterior occipitocervical fusions. The therapeutic regime of combined unstable type III injuries (2/9) depended on the additional trauma: anterior fusion in C6/7 luxation fracture combined with Halo extension for C1, posterior C0/C3 fusion in unstable dens fractures of type Anderson II. The therapy for atlas fractures orientates on the type of the C1 fracture, the accompanying injuries and the general condition of the patient. Isolated stable C1 fractures without dislocation can be treated conservatively (cervical collar), unstable fractures, depending on the general condition, should be referred to surgical therapy or halo extension. In combined atlas fractures the strategy of treatment has to take the stability of the C1 fractures into consideration, but also the additional injuries of the rest of the cervical spine and the attendant circumstances.",Riesner HJ.; Blattert TR.; Katscher S.; Josten C.,,10.1055/s-0029-1185621,0,0,
4369,Overactive Performance Monitoring as an Endophenotype for Obsessive-Compulsive Disorder: Evidence From a Treatment Study.,"Overactive performance monitoring, as measured by the error-related negativity in the event-related brain potential, represents one of the most robust psychophysiological alterations in obsessive-compulsive disorder (OCD). It has been proposed as an endophenotype for OCD because it is heritable and more prevalent in families of OCD patients. Consistent with this notion, it is also independent of symptom profile and symptom severity in cross-sectional studies. Longitudinally, it has been shown to be state independent in pediatric patients with OCD. The purpose of the present study was to investigate the state dependency of error monitoring by examining adult OCD patients before and after symptom reduction through cognitive-behavioral therapy (CBT). Error-related and correct-related negativity as electrophysiological indicators of performance monitoring were recorded from 45 OCD patients and 39 healthy comparison subjects while performing a flanker task. Patients were assessed before starting and after completing a standard 30-session CBT, including exposure and response prevention, and healthy comparison subjects were tested after a comparable time interval. Pretreatment, patients with OCD were characterized by enhanced error-related and correct-related negativity compared with healthy comparison subjects. This difference persisted after treatment when symptoms were substantially reduced. There was no significant correlation between symptom improvement and changes in performance monitoring and no difference in performance monitoring between treatment responders and nonresponders. This is the first longitudinal study in adult OCD patients showing stability of enhanced error monitoring following successful symptom reduction through CBT. It supports the hypothesis that overactive performance monitoring is an endophenotype that indicates vulnerability for OCD.",Riesel A.; Endrass T.; Auerbach LA.; Kathmann N.,2015.0,10.1176/appi.ajp.2014.14070886,0,0,
4370,Augmentation of youth cognitive behavioral and pharmacological interventions with attention modification: a preliminary investigation.,"Recent research suggests the efficacy of attention modification programs (AMP) in treating adult anxiety.([1]) Though some research supports the success of AMP treatment in anxious youths,([2, 3]) to date no study has examined the efficacy of AMP as an adjunctive treatment to other psychosocial and pharmacological interventions for anxious youths within the community. In the current study, we examined the efficacy of AMP as an adjunctive treatment to standard care at a residential anxiety treatment facility. Adolescents (N = 42) completed either an active (attention modification program, AMP; n = 21) or a control (attention control condition, ACC; n = 21) condition, in addition to the facility's standard treatment protocol, which included cognitive behavioral therapy with or without medication. While anxiety symptoms decreased for participants across both groups, participants in the AMP group experienced a significantly greater decrease in anxiety symptoms from point of intake to point of discharge, in comparison to participants in the ACC group. These results suggest that AMP is an effective adjunctive treatment to the standard treatments of choice for anxiety disorders, and may hold promise for improving treatment response in highly anxious youths.",Riemann BC.; Kuckertz JM.; Rozenman M.; Weersing VR.; Amir N.,2013.0,10.1002/da.22127,0,0,
4371,Influence of venovenous hemofiltration on posttraumatic inflammation and hemodynamics,,"Riegel, W; Ziegenfuss, T; Rose, S; Bauer, M; Marzi, I",1995.0,,0,0,
4372,Virtual reality-based multidimensional therapy for the treatment of body image disturbances in obesity: a controlled study,"ER The main goal of this paper is a preliminary evaluation of the efficacy of a virtual reality VR-based multidimensional approach to the treatment of body image attitudes and related constructs. The female obese patients (n = 28) involved in a residential weight control treatment, including low-calorie diet (1,200 kcal/day) and physical training, were randomly assigned either to the VR treatment or to psychonutritional groups based on the cognitive-behavior approach. Patients were administered a battery of outcome measures assessing eating disorders symptomatology, attitudes toward food, body dissatisfaction, level of anxiety, motivation for change, level of assertiveness, and general psychiatric symptoms. In the short-term, the VR treatment was more effective than the traditional cognitive-behavioral psychonutritional groups in improving the overall psychological state of the patients. In particular, it was more effective in improving body satisfaction, self-efficacy, and motivation for change. The improvement was associated with a reduction in problematic eating and social behaviors. The possibility of inducing a significant change in body image and its associated behaviors using a VR-based short-term therapy can improve body satisfaction in traditional weight reduction programs. However, given that this research that does not include a follow-up study, the obtained results are preliminary.","Riva, G; Bacchetta, M; Baruffi, M; Molinari, E",2001.0,10.1089/109493101750527079,0,0,
4373,Evaluating the effectiveness of ACT for anxiety disorders in a self-help context: Outcomes from a randomized wait-list controlled trial.,"Rigorous evaluations of cognitive behavioral self-help books for anxiety in pure self-help contexts are lacking. The present study evaluated the effectiveness of an Acceptance and Commitment Therapy (ACT) self-help workbook for anxiety-related concerns, with no therapist contact, in an international sample. Participants (N = 503; 94% mental health diagnosis) were randomized to an immediate workbook (n = 256) or wait-list condition (n = 247). Assessments at pretreatment, 12 weeks, 6 months, and 9 months evaluated anxiety and related symptoms, quality of life, and ACT treatment processes (e.g., psychological flexibility). Participants in the wait-list arm crossed over to the workbook following the 12-week assessment. The workbook condition yielded significant improvements on all assessments from pre- to posttreatment relative to wait-list, and these gains were maintained at follow-ups. The pattern observed in the wait-list condition was virtually identical to the active treatment arm after receiving the workbook, but not before. Attrition was notable, but supplemental analyses suggested dropout did not influence treatment effects for all but one measure. Overall, findings provide preliminary support for the effectiveness of this self-help workbook and suggest ACT-based self-help bibliotherapy might be a promising low-cost intervention for people experiencing significant anxiety-related concerns. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ritzert, Timothy R; Forsyth, John P; Sheppard, Sean C; Boswell, James F; Berghoff, Christopher R; Eifert, Georg H; Abramowitz, Amico, Arch, Arch, Armijo-Olivo, Barlow, Barlow, Bauer, Beck, Beck, Beck, Beck, Behar, Brown, Brown, Buwalda, Carroll, Castonguay, Cunningham, den Boer, Diggle, Eifert, Eysenbach, Farrand, Fledderus, Forman, Forman, Forsyth, Frisch, Frisch, Gallop, Ghosh, Gloster, Gueorguieva, Hamer, Hayes, Hayes, Hayes, Hayes, Hecker, Hedeker, Herzberg, Hirai, Hofmann, Jacobson, Jeffcoat, Kazdin, Kessler, Kessler, Kessler, Kessler, Lambert, Levin, Mains, Malouff, Mataix-Cols, McKendree-Smith, Meyer, Miller, Mohr, Molina, Muto, Neff, Newman, Peterson, Peterson, Pocock, Redding, Reiss, Rosen, Singer, Smith, Somers, Sprinkle, Swain, Swift, Taylor, Thorsell, Unnebrink, Wang, Williams, Zinbarg",2016.0,,0,0,
4374,Treatment of acrophobia with contact desensitization.,,Ritter B.,1969.0,,0,0,
4375,Responses to activation and rest in patients with panic disorder and major depression.,"Physical activity may be a trigger for panic attacks in patients with panic disorder, while exercise may have an antidepressant effect in patients with major depression. In order to examine reactions to rest as well as to exercise periods, we assessed physiological responses (heart rate, blood pressure), subjective responses on a visual analogue scale, and attentional responses with the span of apprehension test. Twenty participants met the diagnostic criteria for panic disorder, 20 patients had major depression, and 20 participants served as controls. Patients with major depression showed slower reaction times than participants in the other groups; this difference was more pronounced with increased task difficulty. Physical activation led to lower depression scores in all groups. Patients with panic disorder had elevated anxiety scores after physical activation, but also after rest. Heart rate as well as systolic blood pressure showed the expected acceleration after physical activation, but there were no differences between the groups. Activation did not seem to influence attentional performance as measured by the span of apprehension test. Results are consistent with a cognitive view of panic disorder. In contrast to patients with panic disorder, patients with major depression seem to have an attentional deficit which is more pronounced with more complex cognitive processing.",Rief W.; Hermanutz M.,1996.0,,0,0,
4376,Newly diagnosed epilepsy: can nurse specialists help? A randomized controlled trial. Epilepsy Care Evaluation Group,"ER METHODSNeurologists in the United Kingdom (U.K.) recruited adults with newly diagnosed epilepsy. Patients were randomized to receive the offer of two appointments with an epilepsy nurse specialist or usual medical care. The main outcome measures were a questionnaire assessing patients' knowledge of epilepsy, the Hospital Anxiety and Depression Scale, and patients' reported satisfaction with the advice and explanations provided on key epilepsy-related topics.RESULTSNinety people with new epilepsy completed the trial. At baseline, fewer than half the patients reported having been given enough advice on epilepsy, and there were important differences in patients' knowledge of epilepsy. Lack of a U.K. school-leaving examination pass (General Certificate School Examination) was associated with lower knowledge of epilepsy (p = 0.03). At follow-up, the patients randomized to see the nurse specialist were significantly more likely to report that enough advice had been provided on most epilepsy-related topics compared with the control group. There were no significant differences in knowledge of epilepsy scores. However, there were significant differences in the group who, at baseline, had knowledge scores in the lowest quartile; those randomized to the nurse had higher knowledge scores (42.7 vs. 37.2; p < 0.01). Compared with doctors, the nurse was highly rated for providing clear explanations.CONCLUSIONSPatients who have less general education have less knowledge of epilepsy. The introduction of a nurse specialist in epilepsy is associated with a significant increase in patient reports that enough advice has been provided. Nurse intervention appears to help those with the least knowledge of epilepsy improve their knowledge scores.PURPOSETo describe a group of people with newly diagnosed epilepsy and to test the effect of an epilepsy nurse specialist on patients' knowledge of epilepsy, satisfaction with the advice provided, and psychological well-being.","Ridsdale, L; Kwan, I; Cryer, C",2000.0,,0,0,
4377,The effect of a special nurse on patients' knowledge of epilepsy and their emotional state. Epilepsy Evaluation Care Group,"ER AIM: To describe social differences in the knowledge of epilepsy of people with the condition and test the potential effect of a nurse intervention in general practice on patients' knowledge and depression levels.METHOD: A questionnaire that included measures of knowledge, anxiety, and depression was sent to people with epilepsy aged over 15 years who were registered with 37 general practitioners. Responders were randomized to a controlled trial, offering either two appointments with an epilepsy nurse or usual care. Six months later they were reassessed.RESULTS: Two hundred and fifty-one out of 283 (89%) of the patients with epilepsy completed questionnaires and entered the study at Stage 1. One hundred and ninety-six out of 232 (84%) of those who entered the study, who remained in the practices and were eligible, returned questionnaires at Stage 2. The average duration of epilepsy was 23 years (range 2-79 years). There were significant differences in patients' levels of knowledge of epilepsy at Stage 1. Younger people, those who had left school after 16 years of age, those with GCSEs, and people who belonged to self-help groups had higher knowledge levels, and these were independent effects. Older people and those with a recent epilepsy attack had significantly higher depression scores. Knowledge scores did not differ significantly after the nurse intervention (Stage 2). At Stage 2, the risk of depression was less in the group randomized to be offered nurse input; the effect was mainly in a subgroup of patients with no recent epilepsy attack; their risk of depression was a third of the risk in the control group.CONCLUSIONS: Knowledge of epilepsy differs significantly, with social factors and self-help group membership having independent effects. A nurse-run clinic reduced the risk of depression for people with no recent epilepsy attack, but knowledge levels were not affected. This does not exclude the potential for patients learning more about epilepsy; it may be useful to suggest that patients join self-help groups early on.BACKGROUND: People with epilepsy often report being given insufficient information and support. However, there is little evidence from general practice about how much they know and how they feel.","Ridsdale, L; Kwan, I; Cryer, C",1999.0,,0,0,
4378,"The effect of counselling, graded exercise and usual care for people with chronic fatigue in primary care: a randomized trial.","To evaluate the effectiveness of graded exercise therapy (GET), counselling (COUNS) and usual care plus a cognitive behaviour therapy (CBT) booklet (BUC) for people presenting with chronic fatigue in primary care. A randomized controlled trial in general practice. The main outcome measure was the change in the Chalder fatigue score between baseline and 6 months. Secondary outcomes included a measure of global outcome, including anxiety and depression, functional impairment and satisfaction. The reduction in mean Chalder fatigue score at 6 months was 8.1 [95% confidence interval (CI) 6.6-10.4] for BUC, 10.1 (95% CI 7.5-12.6) for GET and 8.6 (95% CI 6.5-10.8) for COUNS. There were no significant differences in change scores between the three groups at the 6- or 12-month assessment. Dissatisfaction with care was high. In relation to the BUC group, the odds of dissatisfaction at the 12-month assessment were less for the GET [odds ratio (OR) 0.11, 95% CI 0.02-0.54, p=0.01] and COUNS groups (OR 0.13, 95% CI 0.03-0.53, p=0.004). Our evidence suggests that fatigue presented to general practitioners (GPs) tends to remit over 6 months to a greater extent than found previously. Compared to BUC, those treated with graded exercise or counselling therapies were not significantly better with respect to the primary fatigue outcome, although they were less dissatisfied at 1 year. This evidence is generalizable nationally and internationally. We suggest that GPs ask patients to return at 6 months if their fatigue does not remit, when therapy options can be discussed further.",Ridsdale L.; Hurley M.; King M.; McCrone P.; Donaldson N.,2012.0,10.1017/S0033291712000256,0,0,
4379,Chronic fatigue in general practice: is counselling as good as cognitive behaviour therapy? A UK randomised trial,"ER AIMTo compare the effectiveness of cognitive behaviour therapy (CBT) with counselling for patients with chronic fatigue and to describe satisfaction with care.DESIGN OF STUDYRandomised trial with parallel group design.SETTINGTen general practices located in London and the South Thames region of the United Kingdom recruited patients to the trial between 1996 and 1998. Patients came from a wide range of socioeconomic backgrounds and lived in urban, suburban, and rural areas.METHODData were collected before randomisation, after treatment, and six months later. Patients were offered six sessions of up to one hour each of either CBT or counselling. Outcomes include: self-report of fatigue symptoms six months later, anxiety and depression, symptom attributions, social adjustment and patients' satisfaction with care.RESULTSOne hundred and sixty patients with chronic fatigue entered the trial, 45 (28%) met research criteria for chronic fatigue syndrome; 129 completed follow-up. All patients met Chalder et al's standard criteria for fatigue. Mean fatigue scores were 23 on entry (at baseline) and 15 at six months' follow-up. Sixty-one (47%) patients no longer met standard criteria for fatigue after six months. There was no significant difference in effect between the two therapies on fatigue (1.04 [95% CI = -1.7 to 3.7]), anxiety and depression or social adjustment outcomes for all patients and for the subgroup with chronic fatigue syndrome. Use of antidepressants and consultations with the doctor decreased after therapy but there were no differences between groups.CONCLUSIONCounselling and CBT were equivalent in effect for patients with chronic fatigue in primary care. The choice between therapies can therefore depend on other considerations, such as cost and accessibility.BACKGROUNDFatigue is a common symptom for which patients consult their doctors in primary care. With usual medical management the majority of patients report that their symptoms persist and become chronic. There is little evidence for the effectiveness of any fatigue management in primary care.","Ridsdale, L; Godfrey, E; Chalder, T; Seed, P; King, M; Wallace, P; Wessely, S",2001.0,,0,0,
4380,Patient mortality in the 12 years following enrolment into a pre-surgical cardiac rehabilitation programme.,"This study examined whether involvement in a pre-surgical cardiac rehabilitation programme conferred a long-term survival benefit. Patients randomly allocated to a pre-surgical cardiac rehabilitation programme intervention or a control group were tracked through national databases at a point approximately 12 years later, and all causes of mortality were identified from death records. Kaplan-Meier survival analyses based on involvement in a cardiac rehabilitation programme and known pre-surgical risk factors were carried out. Two health boards in the west of Scotland, referring to a single cardiothoracic tertiary centre. Patients admitted to the waiting list for coronary artery bypass surgery. Patients were randomly allocated to a control group ('usual' care) or an intervention group (nurse-led cardiac rehabilitation) in the pre-operative phase. They were followed up at 12 years post surgery. The only outcome measure used for analysis was survival. Measures of anxiety and depression, and physiological and lifestyle risk factors were included as independent variables in analysis of death. The initial study included 110 patients--none were lost to follow-up. Relative risk of death associated with inclusion in the cardiac rehabilitation programme was 0.814; risk of death increased with increasing pre-surgical depression (RR 1.07) and anxiety (RR 1.09). Undertaking pre-surgical cardiac rehabilitation confers a long-term survival advantage over patients not offered this service. Increased anxiety and depression in the pre-surgical phase are additional risk factors for increased mortality.",Rideout A.; Lindsay G.; Godwin J.,2012.0,10.1177/0269215511429161,0,0,
4381,Protocol for economic evaluation alongside a cluster-randomised controlled trial of a psychoeducational intervention for the primary prevention of postnatal mental health problems in first-time mothers.,"Postnatal mental health problems, which are an international public health priority, are a suitable target for preventive approaches. The financial burden of these disorders is borne across sectors in society, including health, early childhood, education, justice and the workforce. This paper describes the planned economic evaluation of What Were We Thinking, a psychoeducational intervention for the prevention of postnatal mental health problems in first-time mothers. The evaluation will be conducted alongside a cluster-randomised controlled trial of its clinical effectiveness. Cost-effectiveness and costs-utility analyses will be conducted, resulting in estimates of cost per percentage point reduction in combined 30-day prevalence of depression, anxiety and adjustment disorders and cost per quality-adjusted life year gained. Uncertainty surrounding these estimates will be addressed using non-parametric bootstrapping and represented using cost-effectiveness acceptability curves. Additional cost analyses relevant for implementation will also be conducted. Modelling will be employed to estimate longer term cost-effectiveness if the intervention is found to be clinically effective during the period of the trial. Approval to conduct the study was granted by the Southern Health (now Monash Health) Human Research Ethics Committee (24 April 2013; 11388B). The study was registered with the Monash University Human Research Ethics Committee (30 April 2013; CF12/1022-2012000474). The Education and Policy Research Committee, Victorian Government Department of Education and Early Childhood Development approved the study (22 March 2012; 2012_001472). Use of the EuroQol was registered with the EuroQol Group; 16 August 2012. The trial was registered with the Australian New Zealand Clinical Trials Registry on 7 May 2012 (registration number ACTRN12613000506796).",Ride J.; Rowe H.; Wynter K.; Fisher J.; Lorgelly P.,2014.0,10.1136/bmjopen-2014-006226,0,0,
4382,Combat stress or hemorrhage? Evidence for a decision-assist algorithm for remote triage,"Introduction: In the setting of remote military triage, when physical access to the patient is not possible, traditional physiological measurements available to a combat medic may not differentiate between a wounded soldier and an active soldier. We tested the hypothesis that changes in high-frequency R-R interval spectral power (RRI HF) and pulse pressure (PP) would differ between progressive central hypovolemia (simulated hemorrhage) and exercise to evaluate their potential for remotely distinguishing active from bleeding soldiers. The RRI HF and PP were used because of their ability to track central hypovolemia. Methods: There were 12 (8 female/4 male) healthy, normotensive, non-smoking subjects (age 27 ± 2 yr; height 169 ± 3 cm; weight 68 ± 5 kg) who were exposed to progressive lower body negative pressure (LBNP) and a supine cycle ergometer protocol. ECG and blood pressure were measured continuously. Exercise workloads were determined by matching the heart rate (HR) responses to each LBNP level. Data were analyzed in time and frequency domains. Results: HR increased from 67 ± 3 bpm at rest to 101 ± 4 bpm by -60 mmHg LBNP and was matched within 5% during exercise. By the final stage, RRI HF decreased by a similar magnitude during both LBNP (-78 ± 7%) and exercise (-85 ± 6%). PP decreased by 30 ± 4% with LBNP compared with an increase of 20 ± 6% during exercise. Conclusion: Monitoring PP in combination with RRI HF would distinguish a bleeding from an active soldier. Technologies that incorporate telemetry to track these derived vital signs would provide a combat medic with remote decision support to assess soldier status on the battlefield. Copyright © by the Aerospace Medical Association.",Rickards C.A.; Ryan K.L.; Cooke W.H.; Romero S.A.; Convertino V.A.,2008.0,10.3357/ASEM.2223.2008,0,0,
4383,Posterior instrumentation of the cervical spine using the neon occipito-cervical system. Part 2: cervical and cervicothoracic instrumentation.,"Posterior cervical and cervicothoracic stabilization, if necessary, in combination with posterior spondylodesis, after closed or open reduction as well as with or without neural decompression as clinically indicated. Instabilities and deformities of rheumatoid, traumatic, neoplastic, infectious, iatrogenic or congenital origin. Multilevel cervical spinal stenosis with degenerative instability or kyphosis of the affected spinal segment. Corrective spondylodesis for posttraumatic or postinfectious kyphosis. Infection in the operative field. Inability to undergo anesthesia. Prone position, rigid head fixation, e. g., with Mayfield tongs. If appropriate, closed reduction under lateral image intensification. Midline posterior surgical approach at the level of the segment to be instrumented. If necessary, open reduction. Insertion of the cervical/upper thoracic screws. If necessary, posterior decompression. Instrumentation with prebent longitudinal rods. If a fusion is to be obtained, decortication of the posterior bone elements with a burr and onlay of cancellous bone. 44 patients, 13 women and 31 men, with an average age of 57 years were operated on between August 2000 and August 2003. All patients underwent a follow-up examination 4-39 months (average 15.7 months) after the initial surgery. Fusion was achieved in all patients who had undergone a posterior spondylodesis: no implant failure, no implant removal or reoperation. The preoperatively planned instrumentation could be implemented intraoperatively in all patients.",Richter M.,2005.0,10.1007/s00064-005-1153-z,0,0,
4384,Exploring the Impact of Childhood Abuse on HIV Social and Attitudinal Factors Among Adults With and Without this History in Sub-Saharan Africa: findings from NIMH Project Accept (HPTN 043),"ER Using data from four sites in three African countries, this community randomized study examined the association between childhood sexual and/or physical abuse (CSA and/or CPA) and HIV disclosure, HIV-related stigma, stress, and social support among adults with and without a history of abuse. A history of abuse among men was associated with higher levels of adult-reported stress and HIV-related stigma, and with significantly lower rates of HIV test result disclosure to current partners. Women with a history of CSA and/or CPA had significantly higher perceived stigma, discrimination and stress. Although childhood abuse was significantly associated with adult stress and stigmatization, participants with histories of CSA and/or CPA also reported significantly higher perceived social support compared to people without such experiences. These findings may reflect support received in response to disclosure of CSA or CPA or emotional ambivalence in relationships that have been found to be associated with child abuse. We conclude that it is critical for HIV prevention interventions to advocate for the primary prevention of child abuse, for early identification of adolescents and adults who report experiencing childhood abuse, and to address stigma and stress-related attitudinal, behavioral and relationship difficulties experiences as an aftermath of early abuse that increase their risk of HIV.","Richter, L; Makusha, T; Kom√°rek, A; Daniels, J; Coates, T",2016.0,10.1007/s10461-015-1166-z,0,0,
4385,[Waiting for Asylum: Psychiatric Diagnosis in Bavarian Admission Center].,"In 2014, 15% of about 140,000 asylum seekers were distributed to Bavaria. The Bavarian State Ministry of Labour and Social Affairs, Family and Integration promoted a project under which, first, the frequency and nature of psychiatric diagnoses among asylum seekers in the ZAE Zirndorf should be examined and, secondly, recommendations on psychiatric-psychological care of asylum seekers should be carried out. A total 283 asylum seekers were examined. The sample was composed of 2 sample groups: self-referrals and a randomized group. A structured diagnostic interview and several self- and external assessment scales were used (MINI, BSI, MADRS, WHO-5, ETI, PSQI). In 180 (63,6%) asylum seekers, one or more psychiatric diagnoses were made. The most common diagnosis was posttraumatic stress disorder (F43,1) followed by depressive, recurrent depressive episodes (F32, F33), adjustment disorder (F43,2) and chronic insomnia (51,0 F). Suicidal thoughts were explored in 26% of self-referrals and only in 6% in the random sample. We recommend a low-threshold psychiatric emergency care for asylum seekers in the central refugee reception facility. This should not be done on voluntary basis, but must be regulated by law. For comprehensive care by national healthcare physicians, the social welfare law on asylum seekers (1993) must be revised.",Richter K.; Lehfeld H.; Niklewski G.,2015.0,10.1055/s-0035-1564075,0,0,
4386,Waiting for Asylum: psychiatric Diagnosis in Bavarian Admission Center,"ER METHODSA total 283 asylum seekers were examined. The sample was composed of 2 sample groups: self-referrals and a randomized group. A structured diagnostic interview and several self- and external assessment scales were used (MINI, BSI, MADRS, WHO-5, ETI, PSQI).RESULTSIn 180 (63,6%) asylum seekers, one or more psychiatric diagnoses were made. The most common diagnosis was posttraumatic stress disorder (F43,1) followed by depressive, recurrent depressive episodes (F32, F33), adjustment disorder (F43,2) and chronic insomnia (51,0 F). Suicidal thoughts were explored in 26% of self-referrals and only in 6% in the random sample.CONCLUSIONWe recommend a low-threshold psychiatric emergency care for asylum seekers in the central refugee reception facility. This should not be done on voluntary basis, but must be regulated by law. For comprehensive care by national healthcare physicians, the social welfare law on asylum seekers (1993) must be revised.INTRODUCTIONIn 2014, 15% of about 140,000 asylum seekers were distributed to Bavaria. The Bavarian State Ministry of Labour and Social Affairs, Family and Integration promoted a project under which, first, the frequency and nature of psychiatric diagnoses among asylum seekers in the ZAE Zirndorf should be examined and, secondly, recommendations on psychiatric-psychological care of asylum seekers should be carried out.","Richter, K; Lehfeld, H; Niklewski, G",2015.0,10.1055/s-0035-1564075,0,0,4385
4387,"Sibship size, sibship position, parental rearing and psychopathological manifestations in adults: preliminary analysis.","Almost all investigations concerning the relationships between sibship size, sibship position and psychiatric disorders addressed more formal aspects, i.e. frequency and position, with contradictory and inconsistent results. Analyses considering sibship size and birth order as mediating factors between parental rearing and psychopathological manifestations in adults are lacking. The present results of an investigation of 1,013 psychiatric inpatients and 251 healthy volunteers support a systematic association between sibship size and parental rearing, mainly in terms of a reversed relationship between emotional warmth, overprotection and number of siblings. An excess of psychiatric patients in the middle position of a sibling seems to be related to specific unfavourable rearing patterns. A validation of our preliminary results would be required in terms of preventive measures for children of risk populations.",Richter J.; Richter G.; Eisemann M.; Mau R.,1997.0,,0,0,
4388,"Comparative efficacy of spirituality, cognitive, and emotional support groups for treating eating disorder inpatients","ER Spiritual interventions are rarely used in contemporary treatment programs and little empirical evidence is available concerning their effectiveness. The purpose of the present study was to evaluate the effectiveness of a spiritual group intervention for eating disorder inpatients. We compared the effectiveness of a Spirituality group with Cognitive and Emotional Support groups using a randomized, control group design. Participants were 122 women receiving inpatient eating disorder treatment. Patients in the Spirituality group tended to score significantly lower on psychological disturbance and eating disorder symptoms at the conclusion of treatment compared to patients in the other groups, and higher on spiritual well-being. On weekly outcome measures, patients in the Spirituality group improved significantly more quickly during the first four weeks of treatment. This study provides preliminary evidence that attending to eating disorder patients' spiritual growth and well-being during inpatient treatment may help reduce depression and anxiety, relationship distress, social role conflict, and eating disorder symptoms.","Richards, P S; Berrett, M E; Hardman, R K; Eggett, D L",2006.0,10.1080/10640260600952548,0,0,
4389,"Social anxiety, acute social stress, and reward parameters interact to predict risky decision-making among adolescents.","Risk-taking behavior increases during adolescence, leading to potentially disastrous consequences. Social anxiety emerges in adolescence and may compound risk-taking propensity, particularly during stress and when reward potential is high. However, the manner in which social anxiety, stress, and reward parameters interact to impact adolescent risk-taking is unclear. To clarify this question, a community sample of 35 adolescents (15-18yo), characterized as having high or low social anxiety, participated in a study over two separate days, during each of which they were exposed to either a social stress or a control condition, while performing a risky decision-making task. The task manipulated, orthogonally, reward magnitude and probability across trials. Three findings emerged. First, reward magnitude had a greater impact on the rate of risky decisions in high social anxiety (HSA) than low social anxiety (LSA) adolescents. Second, reaction times (RTs) were similar during the social stress and the control conditions for the HSA group, whereas the LSA group's RTs differed between conditions. Third, HSA adolescents showed the longest RTs on the most negative trials. These findings suggest that risk-taking in adolescents is modulated by context and reward parameters differentially as a function of social anxiety.",Richards JM.; Patel N.; Daniele-Zegarelli T.; MacPherson L.; Lejuez CW.; Ernst M.,2015.0,10.1016/j.janxdis.2014.10.001,0,0,
4390,Effects of disclosure of traumatic events on illness behavior among psychiatric prison inmates,"ER To assess the health effects of writing about traumatic events in a clinical population, 98 psychiatric prison inmates were randomly assigned to 1 of 3 conditions in which they were asked to write about their deepest thoughts and feelings surrounding upsetting experiences (trauma writing condition), write about trivial topics (trivial writing control), or go about their daily routine without writing (no-writing control). Both writing groups wrote for 20 min per day for 3 consecutive days. Participants in the trauma condition reported experiencing more physical symptoms subsequent to the intervention relative to those in the other conditions. Despite this, controlling for prewriting infirmary visits, sex offenders in the trauma writing condition decreased their postwriting infirmary visits. These results are congruent with predictions based on stigmatization and inhibition.","Richards, J M; Beal, W E; Seagal, J D; Pennebaker, J W",2000.0,,0,0,
4391,Interoceptive accuracy in nonclinical panic,"The psychological models of panic disorder predict that people with this anxiety disorder are able to accurately estimate changes in somatic sensations. This study investigated whether nonclinical panickers, at risk for developing panic disorder, demonstrate enhanced interoceptive ability for changes in sympathetic arousal. Twenty people with nonclinical panic and 36 nonpanic controls estimated changes in overall sympathetic arousal, as measured by pulse transit time. A greater proportion of the nonclinical panickers than nonpanic controls met criterion for accurate interoceptive ability. As a group, nonclinical panickers also demonstrated more accurate perception of sympathetic arousal but only when it changed in predictable ways. Anxiety sensitivity and trait anxiety also appeared related to enhanced interoception, particularly in people who had experienced nonclinical panic. People who are at risk for the development of panic disorder may therefore demonstrate enhanced interoceptive ability for sympathetic arousal.",Richards J.C.; Cooper A.J.; Winkelman J.H.,2003.0,10.1023/A:1025476514714,0,0,
4392,Improving access to psychological therapies: phase IV prospective cohort study.,"To determine the effects of implementing stepped care evidence-based psychological treatments for anxiety and depression in routine practice using a collaborative care implementation model. Observational prospective cohort study/Phase IV field trial. We collected data on depression and anxiety from a prospective cohort of 3,994 consecutive patients referred to the UK Improving Access to Psychological Therapies demonstration site in Doncaster for 12 months from August 2006 using PHQ-9 and GAD-7. We collected demographic and process information including the type and methods of treatments received. We calculated effect sizes, remission, and recovery rates for patients competing treatment and those who dropped out or were considered to be unsuitable. Two thousand seven hundred and ninety-five patients received an assessment, out of which 2,017 received two or more appointments. Out of these, 869 had completed treatment by the census date, 743 remained in treatment, 319 had dropped out, and 85 had been found to be unsuitable. Pre-post treatment effect sizes for anxiety and depression in those patients completing treatment were 1.39 and 1.41, respectively, with post-treatment relative risks of depression and anxiety 0.29 and 0.34. The combined remission and recovery rates were 76% for depression and 74% for anxiety. The mean number of treatment sessions was 5.15 in a mean time of 2 h and 45 min. On an average, patients received at least three of these contacts by telephone. Outcomes are comparable with benchmarked trials, reviews, and routine datasets. Combining low-intensity stepped care psychological treatment with a telephony-based collaborative care organizational system can deliver good clinical outcomes in routine practice.",Richards DA.; Suckling R.,2009.0,10.1348/014466509X405178,0,0,
4393,Post-traumatic stress disorder: evaluation of a behavioral treatment program.,"The relative values of imaginal and real-life exposure exercises were tested in this study by randomizing 14 patients who met DSM-III-R criteria for PTSD at least 6 months after the initiating trauma to one of two groups. Group 1 (n = 7) had four, weekly, hour-long sessions of imaginal exposure followed by four, weekly, hour-long sessions of live exposure. Group 2 (n = 7) had the reverse order of four live exposure sessions followed by four imaginal exposure sessions. both groups improved significantly on both PTSD-specific measures and measures of general health post-treatment, and significantly further on 7 out of 12 measures at follow up 12 months post-treatment. Clinical improvement was in the older of 65-80% reduction in target symptoms. On one measure only (problem 2--phobic avoidance), live exposure yielded more improvement than imaginal exposure whether given first or second. The importance of both live and imaginal exposure to all relevant cues, behavioral and cognitive, is discussed, together with the value of self-exposure homework for patients with PTSD.",Richards DA.; Lovell K.; Marks IM.,1994.0,,0,0,
4394,Clinical effectiveness of collaborative care for depression in UK primary care (CADET): cluster randomised controlled trial.,"To compare the clinical effectiveness of collaborative care with usual care in the management of patients with moderate to severe depression. Cluster randomised controlled trial. 51 primary care practices in three primary care districts in the United Kingdom. 581 adults aged 18 years and older who met ICD-10 (international classification of diseases, 10th revision) criteria for a depressive episode on the revised Clinical Interview Schedule. We excluded acutely suicidal patients and those with psychosis, or with type I or type II bipolar disorder; patients whose low mood was associated with bereavement or whose primary presenting problem was alcohol or drug abuse; and patients receiving psychological treatment for their depression by specialist mental health services. We identified potentially eligible participants by searching computerised case records in general practices for patients with depression. Collaborative care, including depression education, drug management, behavioural activation, relapse prevention, and primary care liaison, was delivered by care managers. Collaborative care involved six to 12 contacts with participants over 14 weeks, supervised by mental health specialists. Usual care was family doctors' standard clinical practice. Depression symptoms (patient health questionnaire 9; PHQ-9), anxiety (generalised anxiety disorder 7; GAD-7), and quality of life (short form 36 questionnaire; SF-36) at four and 12 months; satisfaction with service quality (client satisfaction questionnaire; CSQ-8) at four months. 276 participants were allocated to collaborative care and 305 allocated to usual care. At four months, mean depression score was 11.1 (standard deviation 7.3) for the collaborative care group and 12.7 (6.8) for the usual care group. After adjustment for baseline depression, mean depression score was 1.33 PHQ-9 points lower (95% confidence interval 0.35 to 2.31, P=0.009) in participants receiving collaborative care than in those receiving usual care at four months, and 1.36 points lower (0.07 to 2.64, P=0.04) at 12 months. Quality of mental health but not physical health was significantly better for collaborative care than for usual care at four months, but not 12 months. Anxiety did not differ between groups. Participants receiving collaborative care were significantly more satisfied with treatment than those receiving usual care. The number needed to treat for one patient to drop below the accepted diagnostic threshold for depression on the PHQ-9 was 8.4 immediately after treatment, and 6.5 at 12 months. Collaborative care has persistent positive effects up to 12 months after initiation of the intervention and is preferred by patients over usual care. ISRCTN32829227.",Richards DA.; Hill JJ.; Gask L.; Lovell K.; Chew-Graham C.; Bower P.; Cape J.; Pilling S.; Araya R.; Kessler D.; Bland JM.; Green C.; Gilbody S.; Lewis G.; Manning C.; Hughes-Morley A.; Barkham M.,2013.0,,0,0,
4395,Clinical effectiveness and cost-effectiveness of collaborative care for depression in UK primary care (CADET): a cluster randomised controlled trial.,"Collaborative care is effective for depression management in the USA. There is little UK evidence on its clinical effectiveness and cost-effectiveness. To determine the clinical effectiveness and cost-effectiveness of collaborative care compared with usual care in the management of patients with moderate to severe depression. Cluster randomised controlled trial. UK primary care practices (n = 51) in three UK primary care districts. A total of 581 adults aged ≥ 18 years in general practice with a current International Classification of Diseases, Tenth Edition depressive episode, excluding acutely suicidal people, those with psychosis, bipolar disorder or low mood associated with bereavement, those whose primary presentation was substance abuse and those receiving psychological treatment. Collaborative care: 14 weeks of 6-12 telephone contacts by care managers; mental health specialist supervision, including depression education, medication management, behavioural activation, relapse prevention and primary care liaison. Usual care was general practitioner standard practice. Blinded researchers collected depression [Patient Health Questionnaire-9 (PHQ-9)], anxiety (General Anxiety Disorder-7) and quality of life (European Quality of Life-5 Dimensions three-level version), Short Form questionnaire-36 items) outcomes at 4, 12 and 36 months, satisfaction (Client Satisfaction Questionnaire-8) outcomes at 4 months and treatment and service use costs at 12 months. In total, 276 and 305 participants were randomised to collaborative care and usual care respectively. Collaborative care participants had a mean depression score that was 1.33 PHQ-9 points lower [n = 230; 95% confidence interval (CI) 0.35 to 2.31; p = 0.009] than that of participants in usual care at 4 months and 1.36 PHQ-9 points lower (n = 275; 95% CI 0.07 to 2.64; p = 0.04) at 12 months after adjustment for baseline depression (effect size 0.28, 95% CI 0.01 to 0.52; odds ratio for recovery 1.88, 95% CI 1.28 to 2.75; number needed to treat 6.5). Quality of mental health but not physical health was significantly better for collaborative care at 4 months but not at 12 months. There was no difference for anxiety. Participants receiving collaborative care were significantly more satisfied with treatment. Differences between groups had disappeared at 36 months. Collaborative care had a mean cost of £272.50 per participant with similar health and social care service use between collaborative care and usual care. Collaborative care offered a mean incremental gain of 0.02 (95% CI -0.02 to 0.06) quality-adjusted life-years (QALYs) over 12 months at a mean incremental cost of £270.72 (95% CI -£202.98 to £886.04) and had an estimated mean cost per QALY of £14,248, which is below current UK willingness-to-pay thresholds. Sensitivity analyses including informal care costs indicated that collaborative care is expected to be less costly and more effective. The amount of participant behavioural activation was the only effect mediator. Collaborative care improves depression up to 12 months after initiation of the intervention, is preferred by patients over usual care, offers health gains at a relatively low cost, is cost-effective compared with usual care and is mediated by patient activation. Supervision was by expert clinicians and of short duration and more intensive therapy may have improved outcomes. In addition, one participant requiring inpatient treatment incurred very significant costs and substantially inflated our cost per QALY estimate. Future work should test enhanced intervention content not collaborative care per se. Current Controlled Trials ISRCTN32829227. This project was funded by the Medical Research Council (MRC) (G0701013) and managed by the National Institute for Health Research (NIHR) on behalf of the MRC-NIHR partnership.",Richards DA.; Bower P.; Chew-Graham C.; Gask L.; Lovell K.; Cape J.; Pilling S.; Araya R.; Kessler D.; Barkham M.; Bland JM.; Gilbody S.; Green C.; Lewis G.; Manning C.; Kontopantelis E.; Hill JJ.; Hughes-Morley A.; Russell A.,2016.0,10.3310/hta20140,0,0,
4396,Parkinson's disease: A preliminary study of yohimbine challenge in patients with anxiety.,"In this pilot study, we performed an oral yohimbine challenge in 6 patients with Parkinson's disease (PD) and anxiety or depression, 2 parkinsonian patients without psychiatric illness, and 2 healthy control Ss to determine whether patients with PD and anxiety respond to this adrenergic agent in the same way patients with idiopathic anxiety disorders respond. Given the atypical nature of depression in PD (characterized by prominent anxiety), we also wanted to see if patients with PD and depression (but no history of anxiety) are susceptible to yohimbine-induced panic. PD patients with anxiety developed panic attacks at frequencies comparable to primary psychiatric patients with panic disorder. The one patient with PD and a history of major depression alone developed a panic attack. Regardless of their history of anxiety or depression, PD patients demonstrated a vulnerability to yohimbine-induced somatic symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Richard, Irene Hegeman; Szegethy, Eva; Lichter, David; Schiffer, Randolph B; Kurlan, Roger; Caldirola, Cash, Charney, Charney, Cummings, Flint, Harrison, Montastruc, Richard, Schiffer, Targum, Villeneuve, Weiner",1999.0,,0,0,
4397,Biofeedback treatments of generalized anxiety disorder: preliminary results.,"Forty-five individuals with generalized anxiety (38 with GAD as defined by DSM-III) were randomized to 4 treatment conditions or a waiting list control. Patients received 8 sessions of either frontal EMG biofeedback, biofeedback to increase EEG alpha, biofeedback to decrease EEG alpha, or a pseudomeditation control condition. All treated subjects showed significant reductions in STAI-Trait Anxiety and psychophysiologic symptoms on the Psychosomatic Symptom Checklist. Only alpha-increase biofeedback subjects showed significant reductions in heart rate reactivity to stressors at a separate psychophysiological testing session. Decreased self-report of anxiety was maintained at 6 weeks posttreatment.",Rice KM.; Blanchard EB.; Purcell M.,1993.0,,0,0,
4398,A case of early dementia in a schizoaffective disorder patient,"Establishing a differential diagnosis in psychiatry may be very laboring. The authors aim to illustrate diagnostic complexity and its therapeutic implications, through the presentation and discussion of a presumable dementia clinical picture. We present the case of a fifty six-year old woman, attending our outpatient clinics since her twenties with the diagnosis of schizoaffective disorder. On April of 2007 the patient was admitted to a fifteen-day hospitalization due to psychotic symptoms, which remitted with therapeutic doses of risperidone and ansiolytics. One week after being discharged the patient was readmitted to the hospital due to an abrupt onset of a clinical picture characterized by behavioral changes, motor agitation and repetitive behaviors, refusal to eat, depressive mood, mystical delusions, hallucinatory activity, loss of insight, and severe impairment in occupational and social functioning. Although several clinical trials of antipsychotics, antidepressants and mood stabilizers were tried, along with electroconvulsive therapy, her general clinical state has remained unchanged for the fifteen months of hospitalization. Blood and urine examinations, tumoral markers, infectious and immunological study, lumbar puncture, neuroimaging, EEG and brain biopsy were performed, without conclusive results. We consider that the presumptive diagnosis is a Frontotemporal Dementia (FTD). Due to this entity's distinct neuropsychiatric manifestations, its diagnosis can be challenging. This presentation also emphasizes the importance of a holistic analyzes of clinical situations and of a multidisciplinary approach.",Ribeiro A.; Ramalho E Silva F.; Matos M.,2009.0,,0,0,
4399,Affective modulation of pain in substance-dependent veterans.,"Prior work suggests that positive affect inhibits pain while negative affect facilitates it. The current study sought to determine whether: 1) affective modulation of pain extends to a patient population; 2) cocaine and alcohol dependence influences the pattern of modulation; and 3) affective modulation of pain is mediated by changes in arm temperature. Thirty-seven participants with and without substance dependence (14 alcohol, 13 cocaine, 10 none) attended three experimental sessions intended to induce emotions (negative, neutral, positive) by picture-viewing. Following emotion-induction, participants were asked to submerge their arm in 33 degrees F water and keep it there until they reached tolerance. During submersion, pain ratings were made on a mechanical visual analog scale (M-VAS). Latency from submersion to first movement of the M-VAS (pain threshold) and latency to arm removal (pain tolerance) were measured. Arm temperature and manipulation checks for emotion-induction (corrugator electromyogram, heart rate, skin conductance, self-report) were also recorded. Manipulation checks confirmed that targeted affective states were achieved. Pain threshold and tolerance were higher after viewing pleasant pictures than after unpleasant ones. Although arm temperature did vary based on the affect induced, analyses suggested that temperature did not influence pain outcomes. Affect modulates pain perception in patients and does not appear to be mediated by changes in arm temperature. Additionally, pain modulation was not significantly influenced by cocaine or alcohol dependence. These data are encouraging, because they suggest that nonpharmacological methods of pain modulation may be effective in substance-dependent individuals.",Rhudy JL.; Dubbert PM.; Parker JD.; Burke RS.; Williams AE.,,10.1111/j.1526-4637.2006.00237.x,0,0,
4400,Fear and anxiety: divergent effects on human pain thresholds,"ER Animal studies suggest that fear inhibits pain whereas anxiety enhances it; however it is unclear whether these effects generalize to humans. The present study examined the effects of experimentally induced fear and anxiety on radiant heat pain thresholds. Sixty male and female human subjects were randomly assigned to 1 of 3 emotion induction conditions: (1) fear, induced by exposure to three brief shocks; (2) anxiety, elicited by the threat of shock; (3) neutral, with no intervention. Pain thresholds were tested before and after emotion induction. Results suggest that findings from animal studies extend to humans: fear resulted in decreased pain reactivity, while anxiety led to increased reactivity. Pain rating data indicated that participants used consistent subjective criteria to indicate pain thresholds. Both subjective and physiological indicators (skin conductance level, heart rate) confirmed that the treatment conditions produced the targeted emotional states. These results support the view that emotional states modulate human pain reactivity.","Rhudy, J L; Meagher, M W",2000.0,,0,0,
4401,Cost and outcome of behavioural activation versus cognitive behaviour therapy for depression (COBRA): study protocol for a randomised controlled trial,"ER METHODS/DESIGN: COBRA is a two-arm, non-inferiority, patient-level randomised controlled trial, including clinical, economic, and process evaluations comparing CBT delivered by highly trained professional therapists to BA delivered by junior professional or para-professional mental health workers to establish whether the clinical effectiveness of BA is non-inferior to CBT and if BA is cost effective compared to CBT. Four hundred and forty patients with major depressive disorder will be recruited through screening in primary care. We will analyse for non-inferiority in per-protocol and intention-to-treat populations. Our primary outcome will be severity of depression symptoms (Patient Health Questionnaire-9) at 12 months follow-up. Secondary outcomes will be clinically significant change and severity of depression at 18 months, and anxiety (General Anxiety Disorder-7 questionnaire) and health-related quality of life (Short-Form Health Survey-36) at 12 and 18 months. Our economic evaluation will take the United Kingdom National Health Service/Personal Social Services perspective to include costs of the interventions, health and social care services used, plus productivity losses. Cost-effectiveness will explored in terms of quality-adjusted life years using the EuroQol-5D measure of health-related quality of life.DISCUSSION: The clinical and economic outcomes of this trial will provide the evidence to help policy makers, clinicians and guideline developers decide on the merits of including BA as a first-line treatment of depression.TRIAL REGISTRATION: Current Controlled Trials ISRCTN27473954.BACKGROUND: Cognitive behaviour therapy (CBT) is an effective treatment for depression. However, CBT is a complex therapy that requires highly trained and qualified practitioners, and its scalability is therefore limited by the costs of training and employing sufficient therapists to meet demand. Behavioural activation (BA) is a psychological treatment for depression that may be an effective alternative to CBT and, because it is simpler, might also be delivered by less highly trained and specialised mental health workers.","Rhodes, S; Richards, D A; Ekers, D; McMillan, D; Byford, S; Farrand, P A; Gilbody, S; Hollon, S D; Kuyken, W; Martell, C; O'Mahen, H A; O'Neill, E; Reed, N; Taylor, R S; Watkins, E R; Wright, K A",2014.0,10.1186/1745-6215-15-29,0,0,
4402,Can classification tree analyses help improve decision making about treatments for depression and anxiety disorders? A preliminary investigation,"Objective: To identify how decisions about treatment are being made in secondary services for anxiety disorders and depression and, specifically, whether it was possible to predict the decisions to refer for evidence-based treatments. Method: Post hoc classification tree analysis was performed using a sample from an audit on implementation of the National Institute for Health and Clinical Excellence Guidelines for Depression and Anxiety Disorders. The audit was of 5 teams offering secondary care services; they included psychiatrists, psychologists, community psychiatric nurses, social workers, dual-diagnosis workers, and vocational workers. The patient sample included all of those with a primary problem of depression (n = 56) or an anxiety disorder (n = 16) who were offered treatment from February 16 to April 3, 2009. The outcome variable was whether or not evidence-based treatments were offered, and the predictor variables were presenting problem, risk, comorbid problem, social problems, and previous psychiatric history. Results: Treatment decisions could be more accurately predicted for anxiety disorders (93% correct) than for depression (55%). For anxiety disorders, the presence or absence of social problems was a good predictor for whether evidence-based or non-evidence-based treatments were offered; 44% (4/9) of those with social problems vs 100% (6/6) of those without social problems were offered evidence-based treatments. For depression, patients' risk rating had the largest impact on treatment decisions, although no one variable could be identified as individually predictive of all treatment decisions. Conclusions: Treatment decisions were generally consistent for anxiety disorders but more idiosyncratic for depression, making the development of a decision-making model very difficult for depression. The lack of clarity of some terms in the clinical guidelines and the more complex nature of depression could be factors contributing to this difficulty. Further research is needed to understand the complex nature of decision making with depressed patients. © 2011 Physicians Postgraduate Press, Inc.",Rhodes L.; Naumann U.M.; Brown J.S.L.,2011.0,10.4088/PCC.10m01124,0,0,
4403,Claiming peaceful embodiment through yoga in the aftermath of trauma.,"The purpose of this study was to describe the experiences of practicing yoga and its role within processes of healing for adult women with complex trauma histories. Using a hermeneutic phenomenological method, data were analyzed from interviews with 39 women. Results showed that the core meaning of participants' experience of healing through yoga is claiming peaceful embodiment. This is an ongoing process occurring on a continuum whereby women experienced improved connections with and sense of ownership and control over their bodies, emotions and thoughts, and a greater sense of well-being, calmness, and wholeness in their bodies and minds. A number of interconnected essential themes related to this core meaning were also identified, illuminating processes that supported claiming peaceful embodiment and capabilities that were enabled by being more peacefully embodied. Additional themes were identified highlighting factors that facilitated or impeded participants' engagement with yoga and their experiences of healing through yoga.",Rhodes AM.,2015.0,10.1016/j.ctcp.2015.09.004,0,0,
4404,Yoga for Adult Women with Chronic PTSD: A Long-Term Follow-Up Study.,"Yoga-the integrative practice of physical postures and movement, breath exercises, and mindfulness-may serve as a useful adjunctive component of trauma-focused treatment to build skills in tolerating and modulating physiologic and affective states that have become dysregulated by trauma exposure. A previous randomized controlled study was carried out among 60 women with chronic, treatment-resistant post-traumatic stress disorder (PTSD) and associated mental health problems stemming from prolonged or multiple trauma exposures. After 10 sessions of yoga, participants exhibited statistically significant decreases in PTSD symptom severity and greater likelihood of loss of PTSD diagnosis, significant decreases in engagement in negative tension reduction activities (e.g., self-injury), and greater reductions in dissociative and depressive symptoms when compared with the control (a seminar in women's health). The current study is a long-term follow-up assessment of participants who completed this randomized controlled trial. Participants from the randomized controlled trial were invited to participate in long-term follow-up assessments approximately 1.5 years after study completion to assess whether the initial intervention and/or yoga practice after treatment was associated with additional changes. Forty-nine women completed the long-term follow-up interviews. Hierarchical regression analysis was used to examine whether treatment group status in the original study and frequency of yoga practice after the study predicted greater changes in symptoms and PTSD diagnosis. Group assignment in the original randomized study was not a significant predictor of longer-term outcomes. However, frequency of continuing yoga practice significantly predicted greater decreases in PTSD symptom severity and depression symptom severity, as well as a greater likelihood of a loss of PTSD diagnosis. Yoga appears to be a useful treatment modality; the greatest long-term benefits are derived from more frequent yoga practice.",Rhodes A.; Spinazzola J.; van der Kolk B.,2016.0,10.1089/acm.2014.0407,0,0,
4405,Functional and dysfunctional perfectionists: Are they different on compulsive-like behaviors?,"Both perfectionism and excessive responsibility have been linked to obsessive compulsive disorder (OCD). Up to now however, a greater number of studies have focused on the role of responsibility. The present study compared compulsive-like behavior of people with different styles of perfectionism. Sixteen functional perfectionists (FP) and 16 dysfunctional perfectionists (DP) were compared on three different tasks in order to explore OC type behavior such as doubting, checking and intrusions. Results show that DP participants, compared to FP participants, scored higher on an OC behavior scale, took significantly more time to complete a precision task and precipitated their decision when confronted with ambiguity. The two groups also tended to differ in their intrusive thoughts following an unsolved problem; FP participants were more preoccupied about solving the problem than about the quality of their performance, contrary to DP subjects. Results are discussed according to theoretical models of OCD. Copyright (C) 2000 Elsevier Science Ltd.",Rhéaume J.; Freeston M.H.; Ladouceur R.; Bouchard C.; Gallant L.; Talbot F.; Vallières A.,2000.0,10.1016/S0005-7967(98)00203-4,0,0,
4406,A comparative study of diagnostic practice in psychiatry in Northern Norway and Northwest Russia,"Background: The co-operation between psychiatrists in Norway and Russia is increasing. The object of this study was to find out whether there were differences in diagnostic practice of psychiatrists in both countries, to look at the nature of the differences and to examine whether these differences affected diagnostic quality. Method: Thirty medical doctors working at psychiatric hospitals in both countries diagnosed 12 clinical case vignettes selected from a wide spectre of psychiatric disorders. Results: The Russian clinicians used a larger range of diagnoses than the Norwegians. The Russians tended to diagnose schizophrenia and schizophrenia-like disorders in cases that presented psychotic syndromes, and somatoform disorders in cases that presented agoraphobia. The Norwegians tended to evaluate affective aspects in preference to psychotic symptoms in the case of schizoaffective disorder and overestimate the degree of depression. In general, the Russians had lower total score of correct answers than the Norwegians. Conclusion: In spite of the limitations due to minor differences in the data collection phase in the two countries, the study clearly demonstrates differences in diagnostic practice between the countries.",Rezvyy G.; √òiesvold T.; Parniakov A.; Olstad R.,2005.0,10.1007/s00127-005-0894-1,0,0,
4407,[Clinical picture and treatment of panic disorder accompanied with generalized anxiety].,,Reznik AM.; Arbuzov AL.; Khurbatova IG.,2007.0,,0,0,
4408,Randomized controlled trial of parent-enhanced CBT compared with individual CBT for obsessive-compulsive disorder in young people,"ER OBJECTIVE: Obsessive-compulsive disorder (OCD) in young people can be effectively treated with Cognitive Behavior Therapy (CBT). Practice guidelines in the United Kingdom recommend that CBT be delivered with parental or family involvement; however, there is no evidence from randomized trials that this enhances effectiveness. The aim of this trial was to assess if CBT with high parental involvement was more effective than CBT with low parental involvement (individual CBT) in reducing symptoms of OCD.METHOD: Fifty young people ages 12-17 years with OCD were randomly allocated to individual CBT or parent-enhanced CBT. In parent-enhanced CBT parents attended all treatment sessions; in individual CBT, parents attended only Sessions 1, 7, and the final session. Participants received up to 14 sessions of CBT. Data were analyzed using intent-to-treat and per-protocol methods. The primary outcome measure was the Children's Yale-Brown Obsessive Compulsion Scale (Scahill et al., 1997).RESULTS: Both forms of CBT significantly reduced symptoms of OCD and anxiety. Change in OCD symptoms was maintained at 6 months. Per-protocol analysis suggested that parent-enhanced CBT may be associated with significantly larger reductions in anxiety symptoms.CONCLUSIONS: High and low parental involvement in CBT for OCD in young people were both effective, and there was no evidence that 1 method of delivery was superior on the primary outcome measure. However, this study was small. Future trials should be adequately powered and examine interactions with the age of the young person and comorbid anxiety disorders.","Reynolds, S A; Clark, S; Smith, H; Langdon, P E; Payne, R; Bowers, G; Norton, E; McIlwham, H",2013.0,10.1037/a0034429,0,0,
4409,Monitoring of intrusions in post-traumatic stress order: a report of single case studies.,"The effect of monitoring on frequency and duration of intrusions, and on reported symptomatology in patients with a diagnosis of post-traumatic stress disorder (PTSD) was investigated. Six patients were asked to monitor their intrusions over a period of two months. The patients were reassessed after completing the monitoring and followed up after three months. Four patients recovered and no longer met criteria for PTSD, one patient was still experiencing some symptoms, and one still met criteria for a diagnosis of PTSD.",Reynolds M.; Tarrier N.,1996.0,,0,0,
4410,Long-term outcomes of cognitive-behavioral treatments for posttraumatic stress disorder among female rape survivors.,"We conducted a long-term follow-up (LTFU) assessment of participants from a randomized controlled trial comparing cognitive processing therapy (CPT) with prolonged exposure (PE) for posttraumatic stress disorder (PTSD). Competing hypotheses for positive outcomes (i.e., additional therapy, medication) were examined. Intention-to-treat (ITT) participants were assessed 5-10 years after participating in the study (M = 6.15, SD = 1.22). We attempted to locate the 171 original participants, women with PTSD who had experienced at least one rape. Of 144 participants located, 87.5% were reassessed (N = 126), which constituted 73.7% of the original ITT sample. Self-reported PTSD symptoms were the primary outcome. Clinician-rated PTSD symptoms, comorbid diagnoses, and self-reported depression were secondary outcomes. Substantial decreases in symptoms due to treatment (as reported in Resick, Nishith, Weaver, Astin, & Feuer, 2002) were maintained throughout the LTFU period, as evidenced by little change over time from posttreatment through follow-up (effect sizes ranging from pr = .03 to .14). No significant differences emerged during the LTFU between the treatment conditions (Cohen's d = 0.06-0.29). The ITT examination of diagnostics indicated that 22.2% of CPT and 17.5% of PE participants met the diagnosis for PTSD according to the Clinician-Administered PTSD Scale (Blake et al., 1995) at the LTFU. Maintenance of improvements could not be attributed to further therapy or medications. CPT and PE resulted in lasting changes in PTSD and related symptoms over an extended period of time for female rape victims with extensive histories of trauma.",Resick PA.; Williams LF.; Suvak MK.; Monson CM.; Gradus JL.,2012.0,10.1037/a0026602,0,0,
4411,Effect of Group vs Individual Cognitive Processing Therapy in Active-Duty Military Seeking Treatment for Posttraumatic Stress Disorder: A Randomized Clinical Trial.,"Cognitive processing therapy (CPT), an evidence-based treatment for posttraumatic stress disorder (PTSD), has not been tested as an individual treatment among active-duty military. Group CPT may be an efficient way to deliver treatment. To determine the effects of CPT on PTSD and co-occurring symptoms and whether they differ when administered in an individual or a group format. In this randomized clinical trial, 268 active-duty servicemembers consented to assessment at an army medical center from March 8, 2012, to September 23, 2014, and were randomized to group or individual CPT. Inclusion criteria were PTSD after military deployment and stable medication therapy. Exclusion criteria consisted of suicidal or homicidal intent or psychosis. Data collection was completed on June 15, 2015. Analysis was based on intention to treat. Participants received CPT (the version excluding written accounts) in 90-minute group sessions of 8 to 10 participants (15 cohorts total; 133 participants) or 60-minute individual sessions (135 participants) twice weekly for 6 weeks. The 12 group and individual sessions were conducted concurrently. Primary measures were scores on the Posttraumatic Symptom Scale-Interview Version (PSS-I) and the stressor-specific Posttraumatic Stress Disorder Checklist (PCL-S); secondary measures were scores on the Beck Depression Inventory-II (BDI-II) and the Beck Scale for Suicidal Ideation (BSSI). Assessments were completed by independent evaluators masked to treatment condition at baseline and 2 weeks and 6 months after treatment. Among the 268 participants (244 men [91.0%]; 24 women [9.0%]; mean [SD] age, 33.2 [7.4] years), improvement in PTSD severity at posttreatment was greater when CPT was administered individually compared with the group format (mean [SE] difference on the PSS-I, -3.7 [1.4]; Cohen d‚Äâ=‚Äâ0.6; P‚Äâ=‚Äâ.006). Significant improvements were maintained with the individual (mean [SE] PSS-I, -7.8 [1.0]; Cohen d‚Äâ=‚Äâ1.3; mean [SE] PCL-S, -12.6 [1.4]; Cohen d‚Äâ=‚Äâ1.2) and group (mean [SE] PSS-I, -4.0 [0.97]; Cohen d‚Äâ=‚Äâ0.7; mean [SE] PCL-S, -6.3 [1.4]; Cohen d‚Äâ=‚Äâ0.6) formats, with no differences in remission or severity of PTSD at the 6-month follow-up. Symptoms of depression and suicidal ideation did not differ significantly between formats. Individual treatment resulted in greater improvement in PTSD severity than group treatment. Depression and suicidal ideation improved equally with both formats. However, even among those receiving individual CPT, approximately 50% still had PTSD and clinically significant symptoms. In the military population, improving existing treatments such as CPT or developing new treatments is needed. clinicaltrials.gov identifier: NCT02173561.",Resick PA.; Wachen JS.; Dondanville KA.; Pruiksma KE.; Yarvis JS.; Peterson AL.; Mintz J.;  .; Borah EV.; Brundige A.; Hembree EA.; Litz BT.; Roache JD.; Young-McCaughan S.,2017.0,10.1001/jamapsychiatry.2016.2729,0,0,
4412,The impact of childhood abuse among women with assault-related PTSD receiving short-term cognitive-behavioral therapy.,"This study examined the effect of child sexual or physical abuse on brief cognitive-behavioral therapy treatments with adults with posttraumatic stress disorder (PTSD). We analyzed secondary data from two randomized controlled trials (Resick, Nishith, Weaver, Astin, & Feuer, 2002; Resick et al., 2008) that included women with PTSD who did or did not have child sexual abuse (CSA) or child physical abuse (CPA) histories to determine whether childhood abuse impacted dropout rate or reduction in PTSD symptoms. In Study 1, presence, duration, or severity of CSA was not associated with dropout; however, frequency of CSA significantly predicted dropout (OR = 1.23). A significant CPA Severity × Treatment Group interaction emerged such that CPA severity was associated with greater dropout for prolonged exposure (PE; OR = 1.45), but not cognitive processing therapy (CPT; OR = 0.90). Study 2 found no differences in dropout. Study 1, comparing CPT and PE among women who experienced at least 1 rape found no differences in outcome based on childhood abuse history (rp (2) s = .000-.009). Study 2, a dismantling study of CPT with women seeking treatment for adult or child sexual or physical abuse found that for those with no childhood abuse, CPT-C, the cognitive-only version of CPT, had an advantage, whereas both forms of CPT worked best for those with higher frequency of childhood abuse; the effect size was small.",Resick PA.; Suvak MK.; Wells SY.,2014.0,10.1002/jts.21951,0,0,
4413,The use of biofeedback in clinical virtual reality: the intrepid project.,"In our protocol for the treatment of Generalized Anxiety Disorders we use Virtual reality (VR) to facilitate emotional regulation and the relaxation process. Using a biofeedback biomonitoring system (GSR, HR, Thermal) the patient is made aware of his or her reactions through the modification of some features of the VR environment in real time. Using mental exercises the patient learns to control these physiological parameters and using the feedback provided by the virtual environment is able to gauge his or her success. To test this concept, we planned a randomized controlled trial (NCT00602212), including three groups of 15 patients each (for a total of 45 patients): (1) the VR group, (2) the non-VR group, and (3) the waiting list (WL) group.",Repetto C.; Gorini A.; Algeri D.; Vigna C.; Gaggioli A.; Riva G.,2009.0,,0,0,
4414,Active-imaginal exposure: examination of a new behavioral treatment for cynophobia (dog phobia).,"The aims of this study were to investigate exposure-based treatments for cynophobia (dog phobia) and to test a newly developed hybrid imaginal exposure treatment that we have named active imaginal exposure. The treatment introduces an in vivo coping component to imaginal exposure whereby the patient physically performs coping responses to an imagined feared stimulus. Eighty-two participants meeting DSM-IV criteria for specific phobia (animal subtype) were randomly assigned to one of three 30-min. treatments: (a) active-imaginal exposure (AI), (b) imaginal exposure alone (IE), or (c) graduated in vivo exposure (IV). Participants completed a behavioral approach test at pre, post, and four-week follow-up. Significant pre- to posttreatment improvement was observed in all three treatment conditions. Response rates at posttreatment were 51.9, 62.1, and 73.1% for the IE, AI, and IV groups respectively. Likewise, effect sizes at posttreatment were 0.76, 1.41, and 1.55 for the IE, AI, and IV groups respectively. Although in the predicted direction, the between group differences were not significant. A similar pattern of results was observed at follow-up. Further, safety behavior utilization during treatment was associated with less improvement--particularly in the two imaginal treatment conditions. Exposure treatments of dog phobia appear feasible and effective in reducing phobic fear and avoidance associated with dog phobia. Furthermore, preliminary evidence suggests that our active-imaginal exposure treatment may be a viable alternative to in vivo exposure.",Rentz TO.; Powers MB.; Smits JA.; Cougle JR.; Telch MJ.,2003.0,,0,0,
4415,Partners' attributions for service members' symptoms of combat-related posttraumatic stress disorder.,"The association of service members' combat-related PTSD with partners' distress is weaker when spouses/partners believe that service members experienced more traumatic events during deployment. Also, when simultaneously examining partners' perceptions of all PTSD symptoms, perceptions of reexperiencing symptoms (the symptoms most obviously connected to traumatic events) are significantly negatively related to distress in partners. These findings are consistent with the notion that partners may be less distressed if they make external, rather than internal, attributions for service members' symptoms. The present study explicitly tests this possibility. Civilian wives of active duty service members completed measures regarding their own marital satisfaction, their perceptions of service members' combat exposure during deployments, their perceptions of service members' symptoms of PTSD, and their attributions for those symptoms. External attributions were significantly positively associated with perceptions of combat exposure (rp = .31) and reexperiencing symptoms (beta = .33) and significantly negatively associated with perceptions of numbing/withdrawal symptoms (rp = -.22). In contrast, internal attributions were significantly negatively associated with perceptions of reexperiencing symptoms (beta = -.18) and significantly positively associated with perceptions of numbing/ withdrawal symptoms (beta = .46). Internal attributions significantly moderated the negative association of PTSD symptoms with marital satisfaction, such that the association strengthened as internal attributions increased. These findings are the first explicit support for an attributional understanding of distress in partners of combat veterans. Interventions that alter partners' attributions may improve marital functioning. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Renshaw, Keith D; Allen, Elizabeth S; Carter, Sarah P; Markman, Howard J; Stanley, Scott M; Aiken, Allen, Allen, Barrowclough, Beckham, Bliese, Bonds, Calhoun, Campbell, Campbell, Caska, Cook, Dekel, Dekel, Dirkzwager, Erbes, Evans, Fredman, Hoge, Keane, Kulka, Lambert, Manguno-Mire, Meis, Milliken, Monson, Nademin, Nelson Goff, Pratt, Renshaw, Renshaw, Renshaw, Renshaw, Schumm, Seal, Solomon, Stanley, Taft, Vogt, Weathers, Weiner, Yufik",2014.0,,0,0,
4416,Cognitive and symptomatic effects of standardized behavior therapy: Evaluation of an outpatient group program.,"Examined a standardized outpatient program on the basis of cognitive behavior therapy for patients with anxiety disorders, depression, and schizophrenia to determine whether the expected decrease of symptoms is accompanied by a reduction of cognitive conflict. A total of 59 anxiety and depressive patients were administered the SCL-90-R as a generic measure of symptomatology in Austria. Ss were also administered disorder-specific measures and an instrument for the assessment of personal conflict. Anxiety patients and depressives reported a significant and stable reduction of their symptoms, but only anxiety patients revealed a distinct decrease of conflict. Persons with schizophrenia who had participated mainly for relapse prevention showed little effect on either the symptomatic or on cognitive level. The authors conclude that depressives need a more individualized therapeutic procedure and that complementary rehabilitative measures are necessary for persons with schizophrenia. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Renner, Walter; Platz, Thomas",1999.0,,0,0,
4417,Eye movement desensitization: a partial dismantling study.,"Twenty-three PTSD subjects were exposed to either: (1) standard eye movement desensitization (EMD), (2) a variant of EMD in which eye movements were engendered through a light tracking task, or (3) a variant of EMD in which fixed visual attention replaced eye movements. All three interventions produced significant positive changes in all dependent measures and these changes were maintained at follow-up. No significant differences between groups were observed. It was concluded that the eye movements peculiar to EMD are not essential to treatment outcome. The implications of the present findings and previous reports are discussed and recommendations for future research provided.",Renfrey G.; Spates CR.,1994.0,,0,0,
4418,The Hot Flush Beliefs Scale: A tool for assessing thoughts and beliefs associated with the experience of menopausal hot flushes and night sweats,"Objectives: Approximately 15-20% of women experience their hot flushes and night sweats as problematic. There is some evidence that cognitive appraisals may help explain individual variation, and that cognitive behaviour therapy can alleviate related distress. This paper describes the development of the Hot Flush Beliefs Scale (HFBS), a questionnaire to assess women's appraisals, and reports on the reliability, validity and factor structure of the scale. Methods: An initial pool of 63 items was generated from several sources: empirical literature, clinicians' views, and in-depth interviews, with the aim of reflecting common thoughts and beliefs about flushes and sweats. A total of 103 women, aged 41-64 years completed the initial measure. Principal components analysis and principal axis factoring were applied to the data, with both orthogonal and oblique rotation to determine the most coherent and interpretable solution. Results: Exploratory factor analysis culminated in a 27-item measure comprising three dimensions: beliefs about self in social context; beliefs about coping with hot flushes; beliefs about coping with night sweats/sleep. The HFBS was internally consistent, with subscale alphas ranging from 0.78 to 0.93, and test-retest reliability 0.74-0.78. Validity was supported through correlations with other measures of mood and menopause beliefs. Conclusions: Preliminary analysis of the HFBS reveals it to be a psychometrically sound instrument. The HFBS has the benefit of being grounded in women's experiences and shows initial promise as a tool to aid further clinical and theoretical understanding of the impact of hot flushes and night sweats. © 2008 Elsevier Ireland Ltd. All rights reserved.",Rendall M.J.; Simonds L.M.; Hunter M.S.,2008.0,10.1016/j.maturitas.2008.05.001,0,0,
4419,Behavioral avoidance dynamics in the presence of a virtual spider.,"Tracking behavior with a virtual spider and a neutral target is compared in fearful and nonfearful subjects. Head-tracking in virtual environments appears to be a scale-free behavior with long-range fractal-like patterns. Moreover, these fractal patterns change according to what the target affords the tracker and the level of behavioral avoidance manifested by the subjects. Results are interpreted in terms of ecological psychology and nonlinear dynamics, and implications for virtual reality (VR) psychology are outlined.",Renaud P.; Bouchard S.; Proulx R.,2002.0,,0,0,
4420,Activities and participation of children and adolescents after mild traumatic brain injury and the effectiveness of an early intervention (Brains Ahead!): study protocol for a cohort study with a nested randomised controlled trial,"ER METHODS/DESIGN: This paper presents the Brains Ahead! study design, a randomised controlled trial nested within a multicentre, longitudinal, prospective cohort study. The eligible participants include children and adolescents between 6 and 18 years of age who have experienced a mild traumatic brain injury within the last 2 weeks. The cohort study will include 500 children and adolescents with a mild traumatic brain injury and their caregivers. A subset of 140 participants and their caregivers will be included in the randomised controlled trial. Participants in the randomised controlled trial will be randomly assigned to either the psychoeducational intervention group or the usual care control group. The psychoeducational intervention involves one face-to-face contact and one phone contact with the interventionist, during which the consequences of mild traumatic brain injury and advice for coping with these consequences to prevent long-term problems will be discussed. Information will be provided both verbally and in a booklet. The primary outcome domain is activities and participation, which will be evaluated using the Child and Adolescent Scale of Participation. Participants are evaluated 2 weeks, 3 months and 6 months after the mild traumatic brain injury.DISCUSSION: The results of this study will provide insight into which children with mild traumatic brain injury are at risk for long-term participation problems and may benefit from a psychoeducational intervention.TRIAL REGISTRATION: Netherlands Trial Register identifier NTR5153 . Registered on 17 Apr 2015.BACKGROUND: Approximately 20 % of children and adolescents who have sustained mild traumatic brain injuries may experience long-term consequences, including cognitive problems, post-traumatic stress symptoms and reduced load-bearing capacity. The underestimation and belated recognition of these long-term consequences may lead to chronic and disruptive problems, such as participation problems in school and in social relationships. The aim of this study is to examine the level of activities and participation of children and adolescents up to 6 months after a mild traumatic brain injury and to identify possible outcome predictors. Another aim is to investigate the effectiveness of an early psychoeducational intervention and compare the results with those obtained with usual care.","Renaud, M I; Lambregts, S A; Kloet, A J; Catsman-Berrevoets, C E; Port, I G; Heugten, C M",2016.0,10.1186/s13063-016-1357-6,0,0,
4421,The effect of a single hf-rtms session over the left DLPFC on the physiological stress response as measured by heart rate variability,"Previous research has demonstrated that prefrontal activity is related to control over stress responses. However, the causal mechanisms are not well understood. In this study we investigated the possible influence of brain stimulation on the physiological stress response system. Because an increased stress response is known to precipitate psychiatric disorders, further inquiry can have important clinical implications. Method: In 38 healthy, right-handed female participants, we examined the effects of a single sham-controlled high-frequency (HF) repetitive Transcranial Magnetic Stimulation (rTMS) session over the left (n = 19) and right (n = 19) dorsolateral prefrontal cortex (DLPFC) on the autonomic nervous system stress response, as measured by heart rate variability (HRV). Stress was transiently induced through evaluative negative feedbacks. Results: Although the induction procedure was efficient in increasing self-reported distress in all groups and conditions, only after real HF-rTMS over the left DLPFC the physiological stress response was diminished, as indicated by a significant increase in HRV. No effects were found in the sham or right side stimulation condition. Conclusions: These findings demonstrate that increasing brain activity by HF-rTMS over the left DLPFC can help attenuating physiological stress reactions. Results are indicative of the positive effects of rTMS on stress resilience and underscore the possible benefit of HF-rTMS as a transdiagnostic intervention. Finally, the results also show that effects only occur when stimulating the left DLPFC, which is in line with the therapeutic effects of HF-rTMS in affective disorders.",Remue J.; Vanderhasselt M.-A.; Baeken C.; Rossi V.; Tullo J.; De Raedt R.,2016.0,10.1037/neu0000255,0,0,
4422,Mediators of change in cognitive behaviour therapy and mebeverine for irritable bowel syndrome,"ER BACKGROUND: Cognitive behaviour therapies (CBTs) have through several trials been demonstrated to reduce symptoms and disability in irritable bowel syndrome (IBS) patients, but the mechanisms responsible for the changes are still unknown. The aim of this study was to test a theoretical model of CBT and investigate if cognitions and/or behaviour mediated the changes seen in CBT for IBS.METHOD: To assess for possible mediating effects, we applied path analysis to the dataset of 149 diagnosed participants randomized to mebeverine hydrochloride plus CBT or mebeverine hydrochloride alone. Primary outcome was symptom severity, while secondary outcomes were work and social adjustment and anxiety.RESULTS: The path analyses supported mediational paths for all outcomes. Changes in behaviour and cognitions mediated all three outcomes, with models placing behaviour change 'upstream' of cognition change having best fit. The analyses of model fits revealed best fit for the anxiety model and hence provide increased confidence in the causal model of anxiety.CONCLUSIONS: Changes in behaviour and cognitions mediate the change in CBT given to IBS patients. The results strengthen the validity of a theoretical model of CBT by confirming the interaction of cognitive, emotional and behavioural factors in IBS.","Reme, S E; Stahl, D; Kennedy, T; Jones, R; Darnley, S; Chalder, T",2011.0,10.1017/S0033291711000328,0,0,
4423,Predictors of treatment outcome after cognitive behavior therapy and antispasmodic treatment for patients with irritable bowel syndrome in primary care,"ER METHODSRegression analyses were used to identify predictors of work and social adjustment 12 months after treatment ended. The intervention groups were analyzed separately in order to look at the separate effects in each group.RESULTSLower levels of psychological distress (anxiety and depression) at baseline predicted a good outcome in the mebeverine group [beta=0.388 (95% CI: 0.065-0.936), P=.025] but not in the mebeverine+CBT group. In the adjusted model for the mebeverine+CBT group less adaptive IBS related behavioral coping predicted a good outcome [beta=0.285 (95% CI: 0.002-0.210), P=.045].CONCLUSIONDifferent factors are associated with outcome depending on the treatment received. At assessment clinicians should assess patients coping styles and may want to consider recommending CBT to those patients with IBS in primary care who are engaging in unhelpful coping behavior.OBJECTIVETo examine predictors of treatment outcome in IBS-patients who participated in a randomized controlled trial in primary care, where 149 irritable bowel syndrome (IBS) patients were randomized to mebeverine hydrochloride (n=77) or mebeverine+cognitive behavior therapy (CBT) (n=72). CBT offered additional benefit over mebeverine alone.","Reme, S E; Kennedy, T; Jones, R; Darnley, S; Chalder, T",2010.0,10.1016/j.jpsychores.2010.01.003,0,0,
4424,"REM latency, dexamethasone suppression test, and thyroid releasing hormone stimulation test in posttraumatic stress disorder","ER 1. Twenty-one patients with post-traumatic stress disorder (PTSD) were included in a study utilizing baseline rapid eye movement (REM) latency measurements, the dexamethasone suppression test (DST), and the protirelin (thyroid releasing hormone; TRH) stimulation test. The DST and TRH stimulation test were repeated after double blind treatment with desipramine. 2. A high number of patients (75%) exhibited a REM latency of 60 min or less and blunted thyroid stimulating hormone (TSH) response to TRH (61.9%) on baseline tests while only one patient showed cortisol escape from dexamethasone suppression. 3. After four weeks of desipramine treatment, significant improvements were reported in the Hamilton Rating Scale for depression, but not for anxiety symptoms, PTSD symptoms, or self-rated depressive symptoms. 4. Desipramine treatment did not affect hormonal responses to TRH. 5. The findings of shortened REM latency and altered TRH stimulation test suggest PTSD and depression may share some pathophysiological abnormalities.","Reist, C; Kauffmann, C D; Chicz-Demet, A; Chen, C C; Demet, E M",1995.0,,0,0,
4425,"Stress doses of hydrocortisone, traumatic memories, and symptoms of posttraumatic stress disorder in patients after cardiac surgery: a randomized study","ER METHODSPatients (n = 91) were prospectively randomized to receive either stress doses of hydrocortisone or standard treatment during the perioperative period of CS. Of 48 available patients at 6 months after CS, 26 had received stress doses of hydrocortisone and 22 standard treatment. Traumatic memories and PTSD symptoms were diagnosed with previously validated questionnaires.RESULTSAs compared with patients after standard therapy, patients from the hydrocortisone group had significantly lower chronic stress symptom scores (p <.05). There was no significant difference regarding the number or type of traumatic memories between the hydrocortisone and the standard treatment groups.CONCLUSIONSStress doses of hydrocortisone in patients undergoing CS are associated with a lower intensity of chronic stress and PTSD symptoms at 6 months after CS.BACKGROUNDTraumatic experiences associated with cardiac surgery (CS) can result in traumatic memories and posttraumatic stress disorder (PTSD). Because it is known that subjects who develop PTSD often show sustained reductions in circulating cortisol concentrations, we performed a prospective, randomized study to examine whether exogenously administered stress doses of hydrocortisone during the perioperative period of CS reduces the long-term incidence of chronic stress and PTSD symptoms.","Schelling, G; Kilger, E; Roozendaal, B; Quervain, D J; Briegel, J; Dagge, A; Rothenhäusler, H B; Krauseneck, T; Nollert, G; Kapfhammer, H P",2004.0,10.1016/j.biopsych.2003.09.014,0,0,
4426,Good scent in MRI: can scent management optimize patient tolerance?,"Psychological distress for patients undergoing magnetic resonance imaging (MRI) may range from mild anxiety to serious panic attacks. Scents associated with a sense of wellbeing have been used to diminish psychological stress in various clinical conditions. To evaluate the influence of inhalation aromatherapy in the reduction of artifacts in patients undergoing MRI. Based on the assumption aromatherapy will lead to significant reduction of patient-related motion artifacts (PRMA) in MRI, a randomized controlled trial with two groups of 54 patients was enrolled. The primary endpoint was the number of sequences with PRMAs. Secondary outcomes were improvements of mood measured with the ASTS questionnaire as well as patient's recommendation to fellow patients tested by a visual analogue scale. Incidence and intensity of adverse events were documented. Ninety-five patients were included in the statistical analysis. We were not able to detect a significant reduction of PRMAs. There were also no significant differences in mood or in relation to the feeling before and after examination. The only differences that neared significance were ""positive mood"" and ""recommendation"". No adverse reaction was observed. Although aromatherapy has been effective in enhancing patient's mood or wellbeing in a variety of stressful clinical settings, we were not able to find a similar effect. Neither the primary nor the secondary endpoints reached a clinical meaningful magnitude.",Schellhammer F.; Ostermann T.; Krüger G.; Berger B.; Heusser P.,2013.0,10.1177/0284185113482606,0,0,
4427,Can endoscopic ultrasound or magnetic resonance cholangiopancreatography replace ERCP in patients with suspected biliary disease? A prospective trial and cost analysis.,"ERCP is the gold standard for pancreaticobiliary evaluation but is associated with complications. Less invasive diagnostic alternatives with similar capabilities may be cost-effective, particularly in situations involving low prevalence of disease. The aim of this study was to compare the performance of endoscopic ultrasound (EUS) with magnetic resonance cholangiopancreatography (MRCP) and ERCP in the same patients with suspected extrahepatic biliary disease. The economic outcomes of EUS-, MRCP-, and ERCP-based diagnostic strategies were evaluated. Prospective cohort study of patients referred for ERCP with suspected biliary disease. MRCP and EUS were performed within 24 h before ERCP. The investigators were blinded to the results of the alternative imaging studies. A cost-utility analysis was performed for initial ERCP, MRCP, and EUS strategies for these patients. A total of 30 patients were studied. ERCP cholangiogram failed in one patient, and another patient did not complete MRCP because of claustrophobia. The final diagnoses (N = 28) were CBD stone (mean = 4 mm; range = 3-6 mm) in five patients; biliary stricture in three patients, and normal biliary tree in 20. Two patients had pancreatitis after therapeutic ERCP, one after precut sphincterotomy followed by a normal cholangiogram. EUS was more sensitive than MRCP in the detection of choledocolithiasis (80% vs 40%), with similar specificity. MRCP had a poor specificity and positive predictive value for the diagnosis of biliary stricture (76%/25%) compared to EUS (100%/100%), with similar sensitivity. The overall accuracy of MRCP for any abnormality was 61% (95% CI = 0.41-0.78) compared to 89% (CI = 0.72-0.98) for EUS. Among those patients with a normal biliary tree, the proportion correctly identified with each test was 95% for EUS and 65% for MRCP (p < 0.02). The cost for each strategy per patient evaluated was $1346 for ERCP, $1111 for EUS, and $1145 for MRCP. In this patient population with a low disease prevalence, EUS was superior to MRCP for choledocholithiasis. EUS was most useful for confirming a normal biliary tree and should be considered a low-risk alternative to ERCP. Although MRCP had the lowest procedural reimbursement, the initial EUS strategy had the greatest cost-utility by avoiding unnecessary ERCP examinations.",Scheiman JM.; Carlos RC.; Barnett JL.; Elta GH.; Nostrant TT.; Chey WD.; Francis IR.; Nandi PS.,2001.0,10.1111/j.1572-0241.2001.04245.x,0,0,
4428,"About the Treatment of Anxiety Disorders by Psychotherapeutic Riding: Long-Term Observations and Results of an Experimental Clinical Study, Carried out at the District Psychiatric Hospital Haar/Munich (BKH Haar).","After a short introduction into the indication for, the process of, the specific goals set and the quality control of Psychotherapeutic Riding at the district psychiatric hospital Haar/Munich (BKH Haar) the article reports on a specific strategy in the treatment of anxiety disorders involving the aid of horses. Examples from everyday therapy will illustrate the way in which the use of horses provides a specific and particularly valuable contribution in the treatment of anxiety disorder symptoms. Changing the connotations of anxiety leads to a reinterpretation of anxieties in the sense of an increase of the value attributed to them thereby enabling much better coping behaviour. An experimental clinical study with a psychological and movement therapy study design compares trait and state anxiety levels of adult horse riding novices and in-patients showing specific change effects due to Therapeutic Riding. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Scheidhacker, M; Friedrich, D; Bender, W; Bateson, Baum, Blendinger, Bower, Fischer, Fischer-Munch, Friedrich, Greiffenhagen, Grimm, Kluwer, Laux, Leimer, Liljenroth-Denk, Mehlem, Otterstedt, Riemann, Scheidhacker, Scheidhacker, Scheidhacker, Scheidhacker, Scheidhacker, Scheidhacker, Scheidhacker, Scheidhacker, Scheidhacker, Scheidhacker, Scheidhacker, Scheidhacker, Scheidhacker, Scheidhacker, Scheidhacker, Scheidhacker, Schmeer, Sommermeier, Teichmann-Engel, Watzlawick, Zimmermann",2002.0,,0,0,
4429,Pretreatment anxiety level as differential predictor in outpatients with panic disorder,"ER The pretreatment anxiety level is supposed to be a very important unspecific treatment factor. Main purpose of this study is to test whether the patients' pretreatment anxiety level is a general or a specific predictor of treatment response and whether mildly, moderately, and severely anxious patients can be differentially characterized by other diagnostic and clinical variables. 103 patients (37 males, 66 females; mean +/- sd age 35.6 +/- 9.5 years), a subsample of the Second Phase of the Cross-National Collaborative Panic Study, were included in the present study. A high positive correlation of initial anxiousness with the number of panic attacks at the end of treatment was found, moreover high positive correlations with most other baseline assessments. Initially severely anxious patients are the severest ill patients with the least treatment response, and that in all treatment groups. The pretreatment anxiety level predicts the number of panic attacks as well as the degree of avoidance behavior in both drug groups, whereas it predicts anticipatory anxiety intensity in the placebo group.","Scheibe, G; Nutzinger, D; Buller, R; Walther, A U",1992.0,,0,0,
4430,Predictors and outcome in panic disorder: a 2-year prospective follow-up study.,"53 patients presenting at an outpatient unit for anxiety disorders were included in the present prospective 2-year follow-up study. Sociodemographic, illness history, index rating, and 2-year follow-up data were evaluated. A multiple stepwise regression analysis was carried out in order to find predictors of the 2-year outcome. Results indicate that panic patients without episode at follow-up show less symptoms and a better psychosocial functioning than patients with episode at follow-up. Comorbid generalized anxiety disorder, duration of illness, and phobic avoidance behavior were found to be the best predictors of outcome. Conclusively, the present study confirms the most important predictors in patients with panic disorder.",Scheibe G.; Albus M.,1997.0,,0,0,
4431,Predictors of outcome in panic disorder: a 5-year prospective follow-up study.,"A prospective 5-year follow-up study in patients with panic disorder was carried out in order to determine predictors of outcome. 50 patients presenting at an outpatient clinic for anxiety disorders were enrolled initially in a controlled treatment study using either imipramine or doxepin in addition to supportive psychotherapy and were then followed under naturalistic treatment conditions. By means of multiple stepwise regression analyses comorbidity with current depression, severity of illness and agoraphobic avoidance turned out to be the strongest predictors. These data confirm the findings of shorter-term prospective follow-up studies and of retrospective studies. In contrast to several reports, illness-related social impairment at baseline was not found to affect outcome.",Scheibe G.; Albus M.,1996.0,,0,0,
4432,Efficacy of a brief manualized intervention Managing Cancer and Living Meaningfully (CALM) adapted to German cancer care settings: study protocol for a randomized controlled trial.,"Although psycho-oncological interventions have been shown to significantly reduce symptoms of anxiety and depression and enhance quality of life, a substantial number of patients with advanced cancer do not receive psycho-oncological interventions tailored to their individual situation. Given the lack of reliable data on the efficacy of psycho-oncological interventions in palliative care settings, we aim to examine the efficacy of a brief, manualized individual psychotherapy for patients with advanced cancer: Managing Cancer and Living Meaningfully (CALM). CALM aims to reduce depression and death anxiety, to strengthen communication with health care providers, and to enhance hope and meaning in life. We adapted the intervention for German cancer care settings. We use a single-blinded randomized-controlled trial design with two treatment conditions: intervention group (IG, CALM) and control group (CG). Patients in the CG receive a usual non-manualized supportive psycho-oncological intervention (SPI). Patients are randomized between the IG and CG and assessed at baseline (t0), after three (t1) and after 6 months (t2). We include patients with a malignant solid tumor who have tumor stages of III or IV (UICC classification). Patients who are included in the study are at least 18 years old, speak German fluently, score greater than or equal to nine on the PHQ-9 or/and greater than or equal to five on the Distress Thermometer. It is further necessary that there is no evidence of severe cognitive impairments. We measure depression, anxiety, distress, quality of life, demoralization, symptom distress, fatigue as well as spiritual well-being, posttraumatic growth and close relationship experiences using validated questionnaires. We hypothesize that patients in the IG will show a significantly lower level of depression 6 months after baseline compared to patients in the CG. We further hypothesize a significant reduction in anxiety and fatigue as well as significant improvements in psychological and spiritual well-being, meaning and post-traumatic growth in the IG compared to CG 6 months after baseline. Our study will contribute important statistical evidence on whether CALM can reduce depression and existential distress in a German sample of advanced and highly distressed cancer patients. ClinicalTrials.gov NCT02051660.",Scheffold K.; Philipp R.; Engelmann D.; Schulz-Kindermann F.; Rosenberger C.; Oechsle K.; Härter M.; Wegscheider K.; Lordick F.; Lo C.; Hales S.; Rodin G.; Mehnert A.,2015.0,10.1186/s12885-015-1589-y,0,0,
4433,Trauma-focused cognitive-behavioral therapy for posttraumatic stress disorder in three-through six year-old children: a randomized clinical trial,"ER METHODSProcedures and feasibilities of the protocol were refined in Phase 1 with 11 children. Then 64 children were randomly assigned in Phase 2 to either 12-session manualized TF-CBT or 12-weeks wait list.RESULTSIn the randomized design the intervention group improved significantly more on symptoms of PTSD, but not on depression, separation anxiety, oppositional defiant, or attention deficit/hyperactivity disorders. After the waiting period, all participants were offered treatment. Effect sizes were large for PTSD, depression, separation anxiety, and oppositional defiant disorders, but not attention-deficit/hyperactivity disorder. At six-month follow-up, the effect size increased for PTSD, while remaining fairly constant for the comorbid disorders. The frequencies with which children were able to understand and complete specific techniques documented the feasibility of TF-CBT across this age span. The majority were minority race (Black/African-American) and without a biological father in the home, in contrast to most prior efficacy studies.CONCLUSIONSThese preliminary findings suggest that TF-CBT is feasible and more effective than a wait list condition for PTSD symptoms, and the effect appears lasting. There may also be benefits for reducing symptoms of several comorbid disorders. Multiple factors may explain the unusually high attrition, and future studies ought to oversample on these demographics to better understand this understudied population.BACKGROUNDThe evidence base for trauma-focused cognitive behavioral therapy (TF-CBT) to treat posttraumatic stress disorder (PTSD) in youth is compelling, but the number of controlled trials in very young children is few and limited to sexual abuse victims. These considerations plus theoretical limitations have led to doubts about the feasibility of TF-CBT techniques in very young children. This study examined the efficacy and feasibility of TF-CBT for treating PTSD in three- through six-year-old children exposed to heterogeneous types of traumas.","Scheeringa, M S; Weems, C F; Cohen, J A; Amaya-Jackson, L; Guthrie, D",2011.0,10.1111/j.1469-7610.2010.02354.x,0,0,
4434,Exposure to disgust-evoking imagery and information processing biases in blood-injection-injury phobia.,"Biased processing of threat-relevant information is a central construct among contemporary theories of anxiety. However, biases in attentional and memory processes have not been systematically investigated in blood-injection-injury (BII) phobia. Theory has suggested that disgust rather than fear characterizes BII phobia and may mediate processing biases differently. We investigated the effects of a disgust mood induction on attention and memory in BII phobic and nonphobic participants. The Stroop task failed to demonstrate an attentional bias toward medical and disgust words, even under conditions of disgust provocation. However, an implicit memory task showed that BII phobics completed more medical and disgust word stems than nonphobics. These results suggest that BII phobia may be characterized by a similar implicit memory, but not an attentional, bias found in other anxiety disorders. As such, information processing in BII phobia may be qualitatively different from other anxiety disorders. Implications for further research regarding information processing biases in BII phobia are discussed.",Sawchuk CN.; Lohr JM.; Lee TC.; Tolin DF.,1999.0,,0,0,
4435,Predictors of Dropout by Female Obese Patients Treated with a Group Cognitive Behavioral Therapy to Promote Weight Loss,"ER Objective: To investigate predictors of dropout from a group cognitive behavioral therapy (CBT) intervention for overweight or obese women. Methods: 119 overweight and obese Japanese women aged 25-65 years who attended an outpatient weight loss intervention were followed throughout the 7-month weight loss phase. Somatic characteristics, socioeconomic status, obesity-related diseases, diet and exercise habits, and psychological variables (depression, anxiety, self-esteem, alexithymia, parenting style, perfectionism, and eating attitude) were assessed at baseline. Significant variables, extracted by univariate statistical analysis, were then used as independent variables in a stepwise multiple logistic regression analysis with dropout as the dependent variable. Results: 90 participants completed the weight loss phase, giving a dropout rate of 24.4%. The multiple logistic regression analysis demonstrated that compared to completers the dropouts had significantly stronger body shape concern, tended to not have jobs, perceived their mothers to be less caring, and were more disorganized in temperament. Of all these factors, the best predictor of dropout was shape concern. Conclusion: Shape concern, job condition, parenting care, and organization predicted dropout from the group CBT weight loss intervention for overweight or obese Japanese women.","Sawamoto, R; Nozaki, T; Furukawa, T; Tanahashi, T; Morita, C; Hata, T; Komaki, G; Sudo, N",2016.0,10.1159/000442761,0,0,
4436,"Do others judge us as harshly as we think? Overestimating the impact of our failures, shortcomings, and mishaps.","When people suffer an embarrassing blunder, social mishap, or public failure, they often feel that their image has been severely tarnished in the eyes of others. Four studies demonstrate that these fears are commonly exaggerated. Actors who imagined committing one of several social blunders (Study 1), who experienced a public intellectual failure (Studies 2 and 3), or who were described in an embarrassing way (Study 4) anticipated being judged more harshly by others than they actually were. These exaggerated fears were produced, in part, by the actors' tendency to be inordinately focused on their misfortunes and by their resulting failure to consider the wider range of situational factors that tend to moderate onlookers' impressions. Discussion focuses on additional mechanisms that may contribute to overly pessimistic expectations as well as the role of such expectations in producing unnecessary social anxiety.",Savitsky K.; Epley N.; Gilovich T.,2001.0,,0,0,
4437,The Khmer Adolescent Project: III. A study of trauma from Thailand's Site II refugee camp.,"To determine the prevalence rates of posttraumatic stress disorder (PTSD) and depression in a sample of 99 Cambodian youths, aged 18 to 25 years, living in the Site II refugee camps along the Thai-Cambodian border; to compare these rates to data collected in a similarly aged sample of Cambodian refugees living in the United States; and to illustrate the findings with case vignettes and a brief description of the refugee camp at Site II. The senior author describes the main features of life in the Site II camp while being employed in one of its medical clinics. A Khmer translated version of the depression section of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version and the PTSD section of Diagnostic Interview Schedule for Children and Adolescents were used in interview format by trained bilingual research assistants. Khmer versions of the Beck Depression Inventory and the Impact of Events Scale were also administered. The enduring nature of PTSD was evident in this sample of Khmer youths who had survived the Pol Pot regime as children. Similar rates of Pol Pot-related PTSD were found when compared to rates from the US sample. Subclinical forms of PTSD were found in those who reported their worst trauma during life in the camp, while the full PTSD syndrome was associated with those who reported trauma occurring during the earlier Pol Pot regime. Extremely high rates of depressive disorder were found which were interpreted as related to the repatriation back to Cambodia as this study was undertaken. PTSD in this sample appears to be specifically related to earlier war trauma, while depressive symptoms appear more related to recent stressors. As with other findings from the Khmer adolescent project, this study reaffirms the strong connection between the diagnosis of current PTSD and earlier war trauma in an additional sample of youths at Site II, Thailand. Depressive symptoms, on the other hand, appear to be related to the vicissitudes of recent stressful events in this refugee population.",Savin D.; Sack WH.; Clarke GN.; Meas N.; Richart I.,1996.0,,0,0,
4438,Validation of candidate anxiety disorder genes using a carbon dioxide challenge task,"Few replicable genetic variants have been identified in the etiology of heritable anxiety disorders such as panic disorder. Endophenotypic measures that have reduced heterogeneity may provide more powerful targets for gene identification. We assessed hypersensitivity to carbon dioxide (a reliable endophenotype of panic and anxiety) in 174 Caucasian college students, who were genotyped on 26 polymorphic markers from 11 genes previously associated with panic/anxiety. Individual trajectories of respiratory and subjective anxiety response to carbon dioxide were measured and tested for association with these genetic markers. One marker in the acid-sensing ion channel 1 (ASIC1) gene, rs1108923, had a significant association with respiratory rate. No genes had a significant association with subjective anxiety response. Our findings support previously reported associations between ASIC1 and panic/anxiety, but not other genes previously associated with anxiety disorders. The use of endophenotypic markers is a promising avenue for gene identification in anxiety and other complex disorders.",Savage J.E.; McMichael O.; Gorlin E.I.; Beadel J.R.; Teachman B.; Vladimirov V.I.; Hettema J.M.; Roberson-Nay R.,2015.0,10.1016/j.biopsycho.2015.04.006,0,0,
4439,Recall and recognition memory in obsessive-compulsive disorder.,"This study examined recall and recognition memory in 20 nonmedicated patients with obsessive-compulsive disorder (OCD) and 20 matched control subjects. As hypothesized, OCD subjects showed abnormalities affecting delayed recall of nonverbal information but showed normal recognition. These results are interpreted as providing preliminary evidence of a nonverbal memory retrieval deficit consistent with proposed corticostriatal system dysfunction in OCD.",Savage CR.; Keuthen NJ.; Jenike MA.; Brown HD.; Baer L.; Kendrick AD.; Miguel EC.; Rauch SL.; Albert MS.,1996.0,10.1176/jnp.8.1.99,0,0,
4440,Structured approach therapy for combat-related PTSD in returning U.S. Veterans: Complementary mediation by changes in emotion functioning.,"To address the impact of combat-related posttraumatic stress disorder (PTSD) on U.S. Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans, the investigators developed a 12-session manualized PTSD treatment for couples called structured approach therapy (SAT). A randomized controlled trial had shown that 29 OEF/OIF veterans with combat-related PTSD who had participated in SAT showed significantly greater reductions in PTSD compared to 28 veterans receiving a 12-session PTSD family education intervention (Sautter, Glynn, Cretu, Senturk, & Vaught, 2015). We conducted supplemental follow-up and mediation analyses, which tested the hypothesis that changes in emotion functioning play a significant role in the decreases in PTSD symptoms primarily observed in veterans who had received SAT. Veterans assigned to the SAT condition showed significantly greater decreases than those assigned to PTSD family education in emotion regulation problems (p < .001, Cohen's f2 = .18) and fear of intense emotions (p < .001, Cohen's f2 = .152). Decreases in both emotion regulation problems (mediated effect:ab= .36), and fear of intense emotions (mediated effect:ab = .24) were found to be complementary mediators of reductions in PTSD symptoms greater with SAT. These findings suggest that SAT may aid veterans in improving their ability to regulate trauma-related emotions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Sautter, Frederic J Jr.; Glynn, Shirley M; Becker-Cretu, Julia J; Senturk, Damla; Armelie, Aaron P; Wielt, Dustin B; Badour, Blake, Erbes, Gratz, Hoge, Miles, Monson, Preacher, Ruscio, Sautter, Taft, Williams, Zhao",2016.0,,0,0,
4441,Improving clinical retention of one-step self-etching adhesive systems with an additional hydrophobic adhesive layer,"ER METHODSThirty participants, each of whom had at least two pairs of similar-sized noncarious cervical lesions, took part in this study. The authors placed 120 restorations, 30 in each of four groups: Clearfil S3 Bond (Kuraray, Osaka, Japan) (CS) and iBond Gluma inside (Heraeus Kulzer, Hanau, Germany) (IB), and Clearfil S3 Bond (CSB) and iBond Gluma inside (IBB) with an extra layer of hydrophobic adhesive applied on top of them. They placed the restorations incrementally, using a resin-based composite. The authors evaluated the restorations at baseline and at 18 months following modified U.S. Public Health Service criteria.RESULTSAt 18 months, the retention rate for the IB group was statistically lower than those for the CS, IBB and CSB groups. Marginal discoloration occurred in all groups and was statistically worse in the IB group.CONCLUSIONSThe conversion of the iBond Gluma inside and Clearfil S3 Bond adhesive systems into two-step systems by means of applying an extra hydrophobic adhesive layer improved the clinical performance of these materials after 18 months of clinical service.CLINICAL IMPLICATIONSThe application of an extra hydrophobic adhesive layer over OSSE adhesive systems, layers improved the OSSE systems clinical performance, mainly in terms of retention rate.BACKGROUNDThe durability of restorations bonded with one-step self-etching (OSSE) adhesive systems is inferior compared with that of restorations bonded with conventional adhesives. The authors conducted an 18-month randomized clinical study to evaluate the clinical performance of two OSSE systems in noncarious cervical lesions applied as recommended or with an extra layer of hydrophobic adhesive layer after 18 months of clinical service.","Reis, A; Leite, T M; Matte, K; Michels, R; Amaral, R C; Geraldeli, S; Loguercio, A D",2009.0,,0,0,
4442,Transdiagnostic group CBT for anxiety disorders: The unified protocol in mental health services.,"Comorbidity among the anxiety disorders is common and may negatively impact treatment outcome. Potentially, transdiagnostic cognitive-behavioral treatments (CBT) deal more effectively with comorbidity than standard CBT. The present study tested the effectiveness of The Unified Protocol (UP) applied to Mental Health Services. Pre-post-treatment effects were examined for psychiatric outpatients with anxiety disorders receiving UP treatment in groups. Forty-seven patients (mean-age = 34.1 (SD = 9.92), 77% females) with a principal diagnosis of anxiety were included. We found significant and clinically meaningful changes in the primary outcomes Clinical Global Impression Severity Scale (CGI-S; d = 1.36), Hamilton Anxiety Scale (HARS; d = .71), and WHO-5 Well-being Index (WHO-5; d = .54). Also, comorbid depressive symptoms and levels of positive and negative affect changed significantly after treatment. Patients with high levels of comorbidity profited as much as patients with less comorbidity; however, these patients had higher scores after treatment due to higher symptom burden at onset. Patients with comorbid depression profited more from treatment than patients without comorbid depression. The treatment effects found in the present study correspond to treatment effects of other TCBT studies, other UP group studies, and effectiveness studies on standard CBT for outpatients. The results indicate that the UP can be successfully applied to a MHS group setting, demonstrating positive effects on anxiety and depressive symptoms for even highly comorbid cases. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Reinholt, Nina; Aharoni, Ruth; Winding, Clas; Rosenberg, Nicole; Rosenbaum, Bent; Arnfred, Sidse; Barlow, Barlow, Bech, Bech, Beck, Beck, Boswell, Brown, Brown, Bullis, Carl, Cohen, Cuijpers, Davis, de Ornelas Maia, Derogatis, Di Nardo, Ellard, Farchione, Fisher, Goldberg, Guy, Hamilton, Hans, Kessler, Kessler, Lowe, McDermut, McEvoy, McManus, Moran, Newnham, Norton, Norton, Norton, Olatunji, Osma, Reinholt, Rosenberg, Sauer-Zavala, Shadish, Watson, Whiteford, Wilamowska",2017.0,,0,0,
4443,Randomized controlled evaluation of an early intervention to prevent post-rape psychopathology.,"A randomized between-group design was used to evaluate the efficacy of a video intervention to reduce post-traumatic stress disorder (PTSD) and other mental health problems, implemented prior to the forensic medical examination conducted within 72 h post-sexual assault. Participants were 140 female victims of sexual assault (68 video/72 nonvideo) aged 15 years or older. Assessments were targeted for 6 weeks (Time 1) and 6 months (Time 2) post-assault. At Time 1, the intervention was associated with lower scores on measures of PTSD and depression among women with a prior rape history relative to scores among women with a prior rape history in the standard care condition. At Time 2, depression scores were also lower among those with a prior rape history who were in the video relative to the standard care condition. Small effects indicating higher PTSD and Beck Anxiety Inventory (BAI) scores among women without a prior rape history in the video condition were observed at Time 1. Accelerated longitudinal growth curve analysis indicated a videoxprior rape history interaction for PTSD, yielding four patterns of symptom trajectory over time. Women with a prior rape history in the video condition generally maintained the lowest level of symptoms.",Resnick H.; Acierno R.; Waldrop AE.; King L.; King D.; Danielson C.; Ruggiero KJ.; Kilpatrick D.,2007.0,10.1016/j.brat.2007.05.002,0,0,
4444,[Operative treatment of traumatic fractures of the thoracic and lumbar spinal column: Part III: Follow up data].,"In this third and final part, the Spine Study Group (AG WS) of the German Trauma Association (DGU) presents the follow-up (NU) data of its second, prospective, internet-based multicenter study (MCS II) for the treatment of thoracic and lumbar spinal injuries including 865 patients from 8 trauma centers. Part I described in detail the epidemiologic data of the patient collective and the subgroups, whereas part II analyzed the different methods of treatment and radiologic findings. The study period covered the years 2002 to 2006 including a 30-month follow-up period from 01.01.2004 until 31.05.2006. Follow-up data of 638 (74%) patients were collected with a new internet-based database system and analyzed. Results in part III will be presented on the basis of the same characteristic treatment subgroups (OP, KONS, PLASTIE) and surgical treatment subgroups (Dorsal, Ventral, Kombi) in consideration of the level of injury (thoracic spine, thoracolumbar junction, lumbar spine). After the initial treatment and discharge from hospital, the average duration of subsequent inpatient rehabilitation was 4 weeks, which lasted significantly longer in patients with persistent neurologic deficits (mean 10.9 weeks) or polytraumatized patients (mean 8.6 weeks). Following rehabilitation on an inpatient basis, subsequent outpatient rehabilitation lasted on average 4 months. Physical therapy was administered significantly longer to patients with neurologic deficits (mean 8.7 months) or type C injuries (mean 8.6 months). The level of injury had no influence of the duration of the inpatient or outpatient rehabilitation. A total of 382 (72.2%) patients who were either operated from posterior approach only or in a combined postero-anterior approach had an implant removal after an average 12 months. During the follow-up period 56 (8.8%) patients with complications were registered and of these 18 (2.8%) had to have surgical revision. The most common complications reported were infection, loss of correction, or implant-associated complications. Clinical data showed a 2.9 higher relative risk for smokers compared to non-smokers to suffer from wound healing problems. The neurologic status of 81 (60.4%) out of 134 patients with neurologic deficits at the time of injury improved until follow-up. Neurologic deterioration was documented in 8 (1.3%) cases. Complete neurologic deficits after injury to the thoracic spine improved in 9% of the cases, whereas 59% of the cases with complete neurologic deficit improved after injury to the thoracolumbar junction. The surgical approach (posterior or combined postero-anterior) had no significant influence on neurological results at follow-up. Patient age, sex and neurologic deficits showed a statistically significant influence (p<0.05) on the fingertip-floor distance (FBA) at follow-up. Patient back function improved during the follow-up period. More than 2 years after the time of injury 32.2% of the patients had no complaints with respect to back function. The relative frequency of patients with unrestrained back function was greater after posterior surgery (24.2%), than anterior surgery (13.8%), or combined surgery (17.3%) (p=0.005; chi(2)-test). At follow-up there were no statistically significant differences of unrestrained back function between different levels of injury (thoracic spine 17.4%, TL junction 22.5% and lumbar spine 13.6%). The relative frequency of patients with injury to the thoracolumbar junction who reported ""no complaints from the anterior approach"" at follow-up, was calculated to be 55.6% after open versus 63.8% after endoscopic approaches with no significant differences. Of the patients 56.3% reported no donor site morbidity following iliac crest bone harvesting. The VAS spine score at follow-up was calculated within different treatment subgroups: OP 58.4 points, KONS 59.8 points, and PLASTIE 59.7 points. Statistically significant differences of the VAS spine score between posterior (64.9 points) versus combined surgery (47.8 points) were only verified at the level of injury of the thoracic spine (p=0.004). The relative frequency of patients regaining at least 80% of the initial score level was OP (posterior 60.4%, anterior 61.1%, combined 51.4%), 52.9% KONS and 67.6% PLASTIE. After surgery the mean period of incapacity from work was 4 months. Patients with a sedentary occupation before the time of injury were fully reintegrated into work in 71.1% of the cases. Patients with a physical occupation were fully reintegrated in 38.9% of the cases at follow-up. At follow-up 87 (31.2%) patients after posterior and 50 (20.1%) after combined surgery had no restrictions to their recreational activities (p=0.001). Treatment subgroups PLASTIE and KONS show a similar radiological result at follow-up with a bisegmental kyphotic deformity (GDW) of -9 degrees and -8.5 degrees, respectively. With all operative methods it was possible to correct or partly correct the posttraumatic kyphotic deformity. Until follow-up there was a loss of correction depending on the surgical approach and level of injury. Combined postero-anterior stabilization gave statistically significant better radiological results with less kyphotic deformity (-3.8 degrees) than posterior stabilization alone (-6.1 degrees) (p=0.005; ANOVA). Thus combined surgery was superior in its capability to restore spinal alignment within the observational period. At follow-up the use of titanium vertebral body replacement implants (cages) to reconstruct and support the anterior column showed significantly better radiological results with less kyphotic deformity and loss of correction (GDW 0.3 degrees) than the use of iliac bone strut grafts (-3.7 degrees ) (p<0.001). Neither additional anterior plates nor the combination of anterior plates with a cage or bone graft had a statistically significant influence on the kyphotic deformity measured at follow-up. A matched-pair analysis of anterior surgery alone versus combined surgery for the treatment of compression fractures (type A) at the thoracolumbar junction showed a significantly greater intraoperative blood loss but better radiological results in terms of monosegmental and bisegmental kyphotic deformity after combined surgery (p<0.05). A matched-pair analysis of treatment results between non-operative and operative treatment for burst fractures (type A3.1-2) showed a period of inability to work (6 months) which was twice as long for the non-operative treatment group. At the same time significantly better radiological results at follow-up were achieved after operative treatment of these fractures (p<0.05).",Reinhold M.; Knop C.; Beisse R.; Audigé L.; Kandziora F.; Pizanis A.; Pranzl R.; Gercek E.; Schultheiss M.; Weckbach A.; Bühren V.; Blauth M.,2009.0,10.1007/s00113-008-1539-0,0,0,
4445,[Operative treatment of traumatic fractures of the thorax and lumbar spine. Part II: surgical treatment and radiological findings].,"The Spine Study Group (AG WS) of the German Trauma Association (DGU) presents its second prospective Internet-based multicenter study (MCS II) for the treatment of thoracic and lumbar spinal injuries. This second part of the study report focuses on the surgical treatment, course of treatment, and radiological findings in a study population of 865 patients. A total of 158 (18,3%) thoracic, 595 (68,8%) thoracolumbar, and 112 (12,9%) lumbar spine injuries were treated. Of these, 733 patients received operative treatment (OP group). Fifty-two patients were treated non-operatively and 69 patients were treated with kyphoplasty/vertebroplasty without additional instrumentation (Plasty group). In the OP group, 380 (51.8%) patients were instrumented from a posterior (dorsal) position, 34 (4.6%) from an anterior (ventral) position, and 319 (43.5%) cases with a combined posteroanterior procedure. Angular stable internal spine fixator systems were used in 86-97% of the cases for posterior and/or combined posteroanterior procedures. For anterior procedures, angular stable plate systems were used in a majority of cases (51.1%) for the instrumentation of mainly one or two segment lesions (72.7%). In 188 cases (53,3%), vertebral body replacement implants (cages) were used and were mainly implanted via endoscopic approaches (67,4%) to the thoracic spine and/or the thoracolumbar junction. The average operating time was 152 min in posterior-, 208 min in anterior-, and 298 min in combined postero-anterior procedures (p<0,001). The average blood loss was highest in combined operations, measuring 959 ml vs. 650 ml in posterior vs. 534 ml in anterior operations (p<0,001).Computer-assisted intraoperative navigation systems were used in 95 cases. At the time of hospital admission, 58,7% of the patients had spinal canal narrowing of an average of 36% (5-95%) at the level of their injury. The average spinal canal narrowing in patients with a complete spinal cord injury (Frankel/ASIA A) was calculated to be 70%, vs. 50% in patients with incomplete neurologic deficits (Frankel/ASIA B-D), and 20% in patients without neurologic deficits (Frankel/ASIS E; p<0,001). The average procedure in the plasty treatment subgroup was 50 min (18-145 min) to address one (n=59) or two (n=10) injured vertebral bodies. In patients with nonoperative treatment mainly three-point-corsets (n=36) were administered for a duration of 6-12 weeks. During their hospital stay 93 of 195 (44,7%) patients with initial neurologic deficits improved at least one Frankel/ASIA grade until the day of discharge. Two patients (0,2%) showed a neurologic deterioration. The highest rate of complete spinal cord injury (n=36, 23%) was associated with thoracic spine injuries. Nine (1%) patients died during the initial course of treatment. A total of 105 (14,3%) cases with intraoperative (n=56) and/or postoperative complications (n=69) were registered. The most common intraoperative complication was bleeding (n=35, 4,8%). A higher relative frequency of intraoperative complications was noticed in combined (n=34, 10,7%) vs. isolated posterior (n=22, 5,9%; p=0,021) procedures. The most common postoperative complication was associated with wound healing problems in 14 (1,9%) patients. Except in the non-operative treatment subgroup, a correction of the posttraumatic measured radiological deformity was achieved to a different extent within every treatment subgroup. There were no statistically significant differences between the postoperative radiological results of the treatment subgroups (dorsal vs. combination), taking into consideration the influence of relevant parameters such as different fracture types, patient age, and the amount of posttraumatic deformity (p=0,34, ANOVA).",Reinhold M.; Knop C.; Beisse R.; Audigé L.; Kandziora F.; Pizanis A.; Pranzl R.; Gercek E.; Schultheiss M.; Weckbach A.; Bühren V.; Blauth M.,2009.0,10.1007/s00113-008-1538-1,0,0,
4446,Factor structure of PTSD symptoms in opioid-dependent patients rating their overall trauma history.,"The current standard for posttraumatic stress disorder (PTSD) diagnosis is a 3-factor model (re-experiencing, avoidance, and hyperarousal). Two 4-factor models of PTSD, the emotional numbing model (re-experiencing, avoidance, emotional numbing, and hyperarousal) and the dysphoria model (re-experiencing, avoidance, dysphoria, and hyperarousal), have considerable empirical support in the extant literature. However, a newer 5-factor model of PTSD has been introduced that is receiving interest. The 5-factor model differs from the four-factor models in its placement of three symptoms (irritability, sleep disturbance, and concentration difficulties) into a separate cluster termed dysphoric arousal. We empirically compared the theoretical factor structures of 3-, 4-, and 5-factor models of PTSD symptoms to find the best fitting model in a sample of opioid-dependent hospitalized patients. Confirmatory factor analyses were conducted on the 17 self-reported PTSD symptoms of the Posttraumatic Checklist - Civilian Version (PCL-C) in a sample of 151 men and women with opioid dependence. Both four-factor models fit the observed data better than the three-factor model of PTSD; the dysphoria model was preferred to the emotional numbing model in this sample. The recently introduced five-factor model fit the observed data better than either four factor model. PTSD is a heterogeneous disorder comprised of symptoms of re-experiencing, avoidance, numbing, and dysphoria. Three symptoms, irritability, sleep disturbance, and concentration difficulties, may represent a unique latent construct separate from these four symptom clusters in opioid-dependent populations who have experienced traumatic events.",Reddy MK.; Anderson BJ.; Liebschutz J.; Stein MD.,2013.0,10.1016/j.drugalcdep.2013.04.009,0,0,
4447,Physical abuse is associated with HIV-related drug risk.,"Those who have experienced abuse may be prone to engaging in risky sexual behavior and risky drug use. The relationship between sexual abuse and risky behavior has been well established in the literature, but the association between physical abuse and risky drug use has been equivocal. We hypothesize that the experience of PTSD symptoms following physical abuse leads to risky drug use. Therefore, we examined the associations among physical abuse history, PTSD symptoms, and HIV-related drug risk in a sample of 121 opioid-dependent persons to determine whether PTSD symptoms mediated the relationship between physical abuse history and drug risk. Participants were recruited during an acute care hospital inpatient stay. Physical abuse history was associated with increased drug risk, and PTSD symptoms were associated with increased drug risk. However, PTSD symptoms were not found to be a mediator of the association between physical abuse history and HIV-related drug risk. These findings highlight the importance of assessing abuse history in high-risk samples of opioid users. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Reddy, Madhavi K; Anderson, Bradley J; Liebschutz, Jane; Stein, Michael D; Baron, Bensley, Chilcoat, Chuang, Cohen, Cohen, Fritz, Kang, Liebschutz, MacKinnon, McHugo, Metzger, Mills, Navaline, Plotzker, Reddy, Sansone, Sobel, Tourian, Weathers",2014.0,,0,0,
4448,Cognitive change and the therapeutic alliance: The role of technical and nontechnical factors in cognitive therapy.,"Tests whether there are reciprocal interactions between the technical and nontechnical aspects of cognitive therapy (CT). 47 outpatients (mean age 36.8 yrs) with a depressive and/or anxiety disorder were treated with a 20-week, manualized CT intervention. Measures included the Beck Depression Inventory, the Dysfunctional Attitude Scale, and the Working Alliance Inventory. Results indicate that pretreatment depressogenic cognitions impact on the ability to form an early therapeutic alliance, whereas pretreatment depression severity is unrelated to alliance formation. Second, the degree to which patients were in agreement with the goals and tasks of therapy was predictive of subsequent change in depressogenic cognitions. Third, the 2-way interaction between the therapeutic bond and cognitive-change scores was found to predict depression outcomes: patients who reported a better therapeutic bond and who experienced greater reduction in their depressogenic cognitions, experienced the most favorable clinical outcomes. Certain aspects of the therapeutic alliance (i.e., goals and tasks) may facilitate the implementation of the technical factors of CT, while other aspects of the alliance (i.e., bond) act in concert with technical factors to produce direct effects on depressed symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rector, Neil A; Zuroff, David C; Segal, Zindel V; Aiken, Beck, Beck, Beck, Beck, Beck, Blatt, Bordin, Burns, Cane, Castonguay, DeRubeis, Gluhoski, Hatcher, Hollon, Horvath, Horvath, Imber, Lambert, Orlinsky, Persons, Persons, Persons, Raue, Rush, Safran, Teasdale, Weissman, Whisman",1999.0,,0,0,
4449,A Pilot Test of the Additive Benefits of Physical Exercise to CBT for OCD.,"The majority of ""responders"" to first-line cognitive-behavioural therapy (CBT) and pharmacological treatments for obsessive-compulsive disorder (OCD) are left with residual symptoms that are clinically relevant and disabling. Therefore, there is pressing need for widely accessible efficacious alternative and/or adjunctive treatments for OCD. Accumulating evidence suggests that physical exercise may be one such intervention in the mood and anxiety disorders broadly, although we are aware of only two positive small-scale pilot studies that have tested its clinical benefits in OCD. This pilot study aimed to test the feasibility and preliminary efficacy of adding a structured physical exercise programme to CBT for OCD. A standard CBT group was delivered concurrently with a 12-week customized exercise programme to 11 participants. The exercise regimen was individualized for each participant based on peak heart rate measured using an incremental maximal exercise test. Reports of exercise adherence across the 12-week regimen exceeded 80%. A paired-samples t-test indicated very large treatment effects in Yale-Brown Obsessive-Compulsive Scale scores from pre- to post-treatment in CBT group cohorts led by expert CBT OCD specialists (d = 2.55) and junior CBT clinician non-OCD specialists (d = 2.12). These treatment effects are very large and exceed effects typically observed with individual and group-based CBT for OCD based on leading meta-analytic reviews, as well as previously obtained treatment effects for CBT using the same recruitment protocol without exercise. As such, this pilot work demonstrates the feasibility and significant potential clinical utility of a 12-week aerobic exercise programme delivered in conjunction with CBT for OCD.",Rector NA.; Richter MA.; Lerman B.; Regev R.,2015.0,10.1080/16506073.2015.1016448,0,0,
4450,Psychological treatment of obsessive-compulsive disorder in patients with major depression: a pilot randomized controlled trial.,"To examine the efficacy of cognitive-behavioural therapy (CBT) for obsessive-compulsive disorder (OCD) in patients with comorbid major depressive disorder (MDD). Participants (n = 29) diagnosed with comorbid OCD and MDD were randomized to receive standard CBT for OCD or integrated CBT that included an exclusive focus on treating MDD in the first phase of treatment and OCD in the second phase of treatment. Both treatments resulted in statistically significant improvements in OCD and MDD symptoms. Treatment effects and recovery rates in the intent-to-treat sample were lower in both treatments, compared with past studies that excluded patients with MDD. However, among treatment completers, both treatments resulted in statistically significant and clinically meaningful improvements in OCD and MDD symptoms. CBT holds promise as an efficacious treatment for people with comorbid OCD and MDD. The high treatment dropout rate with comorbid patients suggests that additional treatment strategies are required to enhance retention and optimize clinical outcomes.",Rector NA.; Cassin SE.; Richter MA.,2009.0,10.1177/070674370905401208,0,0,
4451,Group cognitive behavior therapy for children with high-functioning autism spectrum disorders and anxiety: a randomized trial,"ER METHODS: Fifty children with high-functioning ASD and anxiety were randomizedto group CBT or treatment-as-usual (TAU) for 12 weeks. Independent clinical evaluators, blind to condition, completed structured interviews (Anxiety Disorders Interview Schedule ? Parent Version;ADIS-P) pre- and post-intervention condition.RESULTS: Forty-seven children completed either the CBT or TAU condition. Results indicated markedly better outcomes for the CBT group. Significant differences by group were noted in Clinician Severity Ratings, diagnostic status, and clinician ratings of global improvement. In the intent-to-treat sample, 10 of 20 children (50%) in the CBT group had a clinically meaningful positive treatment response, compared to 2 of 23 children (8.7%) in the TAU group.CONCLUSIONS: Initial results from this randomized, designed treatment study suggest that agroup CBT intervention specifically developed for children with ASD may be effective in decreasing anxiety. Limitations of this study include small sample size, lack of an attention control group, and use of outcome measures normed with typically developing childrenBACKGROUND: Children with high-functioning autism spectrum disorders (ASD) are at high risk for developing significant anxiety. Anxiety can adversely impact functioning across school, home and community environments. Cognitive behavioral therapies (CBT) are frequently used with success for children with anxiety symptoms. Modified CBT interventions for anxiety in children with ASD have also yielded promising results.","Reaven, J; Blakeley-Smith, A; Culhane-Shelburne, K; Hepburn, S",2012.0,,0,0,
4452,A field test of group based exposure therapy with 102 veterans with war-related posttraumatic stress disorder.,"Group-based exposure therapy (GBET) was field-tested with 102 veterans with war-related posttraumatic stress disorder (PTSD). Nine to 11 patients attended 3 hours of group therapy per day twice weekly for 16-18 weeks. Stress management and a minimum of 60 hours of exposure was included (3 hours of within-group war-trauma presentations per patient, 30 hours of listening to recordings of patient's own war-trauma presentations and 27 hours of hearing other patients' war-trauma presentations). Analysis of assessments conducted by treating clinicians pre-, post- and 6-month posttreatment suggests that GBET produced clinically significant and lasting reductions in PTSD symptoms for most patients on both clinician symptoms ratings (6-month posttreatment effect size delta = 1.22) and self-report measures with only three dropouts.",Ready DJ.; Thomas KR.; Worley V.; Backscheider AG.; Harvey LA.; Baltzell D.; Rothbaum BO.,2008.0,10.1002/jts.20326,0,0,
4453,The impact of group-based exposure therapy on the PTSD and depression of 30 combat veterans.,"Thirty combat veterans with chronic posttraumatic stress disorder (PTSD) completed group-based exposure therapy (GBET) in three cohorts of 10 within a U.S. Department of Veterans Affairs Health Care system (VA) outpatient program. GBET cohorts met twice a week, 3 hr per day, for 16 weeks. Participants made two within-group combat-related presentations and were asked to listen to recordings of these at least 10 times. The PTSD Checklist (PCL) and Beck Depression Inventory 2 (BDI-2) were administered at pretreatment, posttreatment, and 7-11-month follow-up. PTSD symptoms were significantly lower on both posttreatment assessments with a large effect size (d = .89). Moderate effects were found on depressive symptoms (d = .70) at follow-up. At follow-up, 73% of participants endorsed reliable reductions on either the PCL (<7), the BDI-2 (<8), or both. Moreover, 36% no longer met the criteria for PTSD on the PCL (<=50) at follow-up. There was relatively high compliance with participants reporting completion of almost all assignments. A higher ""dose"" of reported listening to recordings of war-related presentations seems to reduce PCLs at follow-up. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ready, David J; Sylvers, Patrick; Worley, Virginia; Butt, Jon; Mascaro, Nathan; Bradley, Bekh; Angelis, Arnau, Beck, Beck, Beckham, Blake, Blake, Bradley, Burriss, Card, Creamer, Crowe, Donovan, Foa, Follette, Friedman, Green, Grieger, Hembree, Humphreys, Jacobsen, Kessler, Koenen, Momartin, Monson, Orsillo, Orsillo, Palmieri, Rauch, Ready, Ready, Resick, Rothbaum, Rothbaum, Sapolsky, Schnurr, Schnurr, Segal, Thompson, Weathers, Zappert",2012.0,,0,0,
4454,"The effects of hypnosis, context reinstatement, and anxiety on eyewitness memory","ER The effects of hypnosis, context reinstatement, and motivational instructions on accuracy of recall for factual information and facial recognition accuracy following a stressful event were assessed. None of the three techniques had a significant effect on factual memory or susceptibility to suggestion as assessed by true-false and multiple-choice tests. However, participants high in hypnotic susceptibility showed somewhat better memory on the true-false test, and hypnosis affected performance on the two photograph line-ups. In addition, hypnosis appeared to enhance facial recognition accuracy for participants who were low in anxiety, but not for those high in anxiety. Finally, there was evidence of a curvilinear relationship between self-reported anxiety at time of retrieval and facial recognition accuracy.","Ready, D J; Bothwell, R K; Brigham, J C",1997.0,10.1080/00207149708416106,0,0,
4455,"Coping, PTSD symptoms, and alcohol involvement in trauma-exposed college students in the first three years of college","The objective of the present study was to examine prospective, bidirectional associations among posttraumatic stress disorder (PTSD) symptoms, coping style, and alcohol involvement (use, consequences) in a sample of trauma-exposed students just entering college. We also sought to test the mechanistic role that coping may play in associations between PTSD symptoms and problem alcohol involvement over time. Participants (N = 734) completed measures of trauma exposure, PTSD symptoms, coping, and alcohol use and consequences in September of their first college year and again each September for the next 2 years. We observed reciprocal associations between PTSD and negative coping strategies. In our examination of a mediated pathway through coping, we found an indirect association from alcohol consequences and PTSD symptoms via negative coping, suggesting that alcohol consequences may exacerbate posttraumatic stress over time by promoting negative coping strategies. Trauma characteristics such as type (interpersonal vs. noninterpersonal) and trauma reexposure did not moderate these pathways. Models were also invariant across gender. Findings from the present study point to risk that is conferred by both PTSD and alcohol consequences for using negative coping approaches, and through this, for posttraumatic stress. Interventions designed to decrease negative coping may help to offset this risk, leading to more positive outcomes for those students who enter college with trauma exposure.",Read J.P.; Griffin M.J.; Wardell J.D.; Ouimette P.,2014.0,10.1037/a0038348,0,0,
4456,The effect of fluoxetine on anxiety and depression symptoms in cancer patients.,"A double-blind placebo-controlled study was designed to assess the effectiveness of fluoxetine in controlling anxiety/depression in cancer patients and to examine the incidence of side effects which may cause premature discontinuation of therapy. Of 115 cancer patients who fulfilled entry criteria for levels of distress, 45 patients (mean age 53.2 yrs) were randomized to a fluoxetine treatment group and 46 patients (mean age 52.6 yrs) to a placebo group after a 1-wk placebo period designed to exclude placebo responders. Treatment efficacy was assessed via the Montgomery and Asberg Depression Scale, the Hamilton Anxiety Scale, the Hospital Anxiety and Depression Scale, the Revised Symptom Checklist, and the Spitzer Quality of Life Index. Overall results showed that patients improved to a greater extent on fluoxetine treatment than on placebo. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Razavi, Darius; Allilaire, J. -F; Smith, M; Salimpour, A; Verra, M; Desclaux, B; Saltel, P; Piollet, I; Gauvain-Piquard, A; Trichard, C; Cordier, B; Fresco, R; Guillibert, E; Sechter, D; Orth, J. -P; Bouhassira, M; Mesters, P; Blin, P",1996.0,,0,0,
4457,Treatment of phobias by systematic densensitization. Comparison of standard vs methohexital-aided densensitization.,,Razani J.,1974.0,,0,0,
4458,Religious--sociocultural psychotherapy in patients with anxiety and depression.,"To show the effectiveness of incorporating religious-sociocultural components in the management of patients with generalised anxiety disorders and major depression who have strong religious and cultural backgrounds as compared with a normal psychotherapeutic approach. One hundred and three cases of anxiety and 100 cases of depression with strong religious and cultural backgrounds were randomly assigned to the study or control groups. Both groups received standard treatment for their respective illnesses. The study group was given additional religious-sociocultural psychotherapy. They were followed for 6 months and were assessed in a double-blind fashion using the Hamilton Anxiety Rating Scale or the Hamilton Depression Rating Scale. Patients receiving additional religious-sociocultural psychotherapy responded significantly faster than those who received standard treatment. However, the difference became non-significant at the end of 6 months. Incorporating a religious and sociocultural component in the treatment program rapidly improved anxiety and depressive symptoms in patients with strong religious and cultural backgrounds. The present study demonstrates a need for more sensitivity to religious-sociocultural issues in the field of mental health.",Razali SM.; Hasanah CI.; Aminah K.; Subramaniam M.,1998.0,10.3109/00048679809073877,0,0,
4459,A randomised controlled trial of specialist health visitor intervention for failure to thrive,"ER AIMS: To determine whether home intervention by a specialist health visitor affects the outcome of children with failure to thrive. METHODS: Children referred for failure to thrive were randomised to receive conventional care, or conventional care and additional specialist home visiting for 12 months. Outcomes measured were growth, diet, use of health care resources, and Bayley, HAD (hospital anxiety and depression), and behavioural scales. RESULTS: Eighty three children, aged 4-30 months, were enrolled, 42 received specialist health visitor intervention. Children in both groups showed good weight gain (mean (SD) increase in weight SD score for the specialist health visitor intervention group 0.59 (0.63) v 0.42 (0.62) for the control group). Children < 12 months in the intervention group showed a higher mean (SD) increase in weight SD score than the control group (0.82 (0.86) v 0.42 (0.79)). Both groups improved in developmental score and energy intake. No significant differences were found for the primary outcome measures, but controls had significantly more dietary referrals, social service involvement, and hospital admissions, and were less compliant with appointments. CONCLUSIONS: The study failed to show that specialist health visitor intervention conferred additional benefits for the child. However, the specialist health visitor did provide a more coordinated approach, with significant savings in terms of health service use. Problems inherent to health service research are discussed.","Raynor, P; Rudolf, M C; Cooper, K; Marchant, P; Cottrell, D",1999.0,,0,0,
4460,Perceptual alternation in obsessive compulsive disorder - Implications for a role of the cortico-striatal circuitry in mediating awareness,"Mounting evidence suggests that obsessive compulsive disorder (OCD) results from functional aberrations of the fronto-striatal circuitry. However, empirical studies of the behavioral manifestations of OCD have been relatively lacking. The present study employs a behavioral task that allows a quantitative measure of how alternative percepts are formed from one moment to another, a process mimicking the brain state in which different thoughts and imageries compete for access to awareness. Eighteen patients with OCD, 12 with generalized anxiety disorder, and 18 normal subjects participated in the experiment, in which they viewed one of the three Schroder staircases and responded by pressing a key to each perceptual reversal. The results demonstrate that the patients with OCD have a higher perceptual alternation rate than the normal controls. Moreover, the frequency of perceptual alternation is significantly correlated with the Yale-Brown obsessive compulsive and the Hamilton anxiety scores. The increase in the frequency of perceptual reversals cannot easily be accounted for by learning or by different patterns of eye fixations on the task. These results provide further evidence that an impairment of the inhibitory function of the cortico-striatal circuitry might underlie the etiology of OCD. The implications of the results for a general role of the cortico-striatal circuitry in mediating awareness are discussed. Copyright (C) 2000 Elsevier Science B.V.",Ray Li C.-S.; Chen M.-C.; Yang Y.-Y.; Chang H.-L.; Liu C.-Y.; Shen S.; Chen C.-Y.,2000.0,10.1016/S0166-4328(00)00140-6,0,0,
4461,Effectiveness of a nurse-managed follow-up program for rehabilitation patients after discharge,"ER Former patients in a rehabilitation unit at a large Midwestern hospital continued to actively seek services provided by the inpatient nursing staff, primarily through telephone contact, long after their discharge. A proactive formal follow-up program managed by an advanced practice nurse in rehabilitation was proposed as a better means of providing continuing care for rehabilitation patients after discharge. To examine the efficacy of the nurse-managed follow-up program, a randomized clinical trial was conducted. One hundred patients were randomly assigned to either the intervention group or the control group. Comparisons were made between the two groups on several outcome measures at 4 months after discharge. Outcomes included Functional Independence Measure (FIM) instrument scores, complication rates, rehospitalizations, and anxiety levels. The organizational outcomes included number and types of calls to staff, as well as time spent by staff nurses and social workers. The results indicated significant differences between the intervention and control groups in terms of anxiety levels, the number of calls made to the unit, and the amount of time spent by staff nurses and social workers.","Rawl, S M; Easton, K L; Kwiatkowski, S; Zemen, D; Burczyk, B",1998.0,,0,0,
4462,Mindfulness-based cognitive therapy for patients with medically unexplained symptoms: a randomized controlled trial,"ER BACKGROUND: Patients with medically unexplained symptoms make heavy demands on the health care system. An offer for psychological treatment is often declined. There is a need for acceptable and effective treatments. We assessed the acceptability and effectiveness of mindfulness-based cognitive therapy (MBCT) for patients with persistent medically unexplained symptoms.METHOD: A randomized controlled trial comparing MBCT (n = 64) to enhanced usual care (EUC; n = 61). Participants were the 10% most frequently attending patients in primary care. The primary outcome measure was general health status at the end of treatment. Secondary outcome measures were mental and physical functioning. Assessments took place at the end of treatment and at the 9-month follow-up.RESULTS: Health status and physical functioning did not significantly differ between groups. However, participants in the MBCT group reported a significantly greater improvement in mental functioning at the end of treatment (adjusted mean difference, 3.9; 95% CI, 0.24-7.6), in particular with regard to vitality and social functioning. In addition, at 9 months of follow-up, the mindfulness skills 'observing' and 'describing' were significantly higher in the MBCT group. Within the MBCT group, almost half of the outcome measures had significantly improved at the end of treatment, whereas in the EUC group none had.CONCLUSIONS: MBCT was feasible for frequently attending patients with persistent medically unexplained symptoms in primary care. Although MBCT did not lead to a significant difference in general health status between the two groups, it did result in a significant improvement in mental functioning.","Ravesteijn, H; Lucassen, P; Bor, H; Weel, C; Speckens, A",2013.0,10.1159/000348588,0,0,
4463,[Morbidity and mortality in para-articular femoral fractures in advanced age. Results of a prospective study].,"This study was designed to determine risk factors and individual dispositions associated with morbidity and mortality in the operative treatment of hip fractures in elderly patients. In a prospective clinical trial, a consecutive series of 278 patients (mean age: 78.7 +/- 6.2 years) with a hip fracture treated by internal fixation or arthroalloplasty was recorded prospectively concerning preexistent diseases and risk factors. Based upon a multivariate analysis the data were related to perioperative complications and mortality. A follow-up during the first postoperative year was performed to determine mortality rate and causes of deaths. Polymorbidity within the meaning of 3 preexistent diseases was present in 117 cases; a solitary disease was found in 25 patients. Only 19 patients were without significant risks representing a comorbidity of 93.2%. In 64.4% diseases of the cardiovascular system were detected followed by diabetes mellitus (21.9%) and diseases of the respiratory tract (20.1%). In the postoperative course systemic complications were observed in 118 patients indicating a general morbidity of 42.4%. According to the preexistent diseases recorded, cardiovascular complications (25.5%), obstructive ventilatory diseases (10.1%) and pneumonias (12.2%) were the most common complications. During hospital stay 21 patients died (mortality: 7.6%). A total of 76 patients died during the first postoperative year corresponding to a mortality rate of 27.3%. Postoperative complications were observed in patients with polymorbidity at 68.4% which differs significantly with the morbidity of low-risk patients at 23.6% (p < 0.001). Multivariate analysis revealed a combination of polymorbidity and age beyond 78 years as significant risk factors towards morbidity and mortality. In detail, a prevalence of cardiovascular insufficiency, pulmonary disease and disturbance of renal function was found to be a significant disposition. During the preoperative course high risk patients should be identified according to the data presented above in order to take all measures necessary in critical care during the perioperative period. Furthermore, the results underline the importance of an early operative treatment within a posttraumatic period of 12-24 hours. Concerning the method of fracture stabilization procedures allowing a primary full loading should be favoured with regard to early rehabilitation.",Raunest J.; Engelmann R.; Jonas M.; Derra E.,2001.0,,0,0,
4464,Assessing food neophobia: The role of stimulus familiarity,"The present study assesses the effects of food familiarity on food ratings of neophobics and neophilics by having them sample and evaluate familiar and novel foods. Level of neophobia was assessed using the Food Neophobia Scale (FNS). Participants rated their familiarity with each food, their willingness to try the foods and expected liking for the foods, as well as their actual liking for the foods after they were sampled. Willingness to try the foods again in the future, and the amount of food sampled were also assessed. Evaluations of the foods were more positive for familiar vs. unfamiliar foods across all study participants. The responses of neophobics and neophilics were similar for familiar foods, but differed when the foods were unfamiliar, with neophobics making more negative evaluations. Neophobics and neophilics differed least in their liking ratings of the stimuli that were made after the foods were actually sampled, and differed most in their ratings of willingness to try the foods. It is concluded that neophobics have different expectancies about unfamiliar foods, and that these expectancies influence food sampling and rating behaviors. The neophobic's negative attitude toward an unfamiliar food may be ameliorated, but is not eliminated, once sensory information about the food is obtained.",Raudenbush B.; Frank R.A.,1999.0,10.1006/appe.1999.0229,0,0,
4465,Effect of sensory education on willingness to taste novel food in children,"ER As part of 'EduSens', a project aiming to measure the effect of a sensory education program developed in France on the food behaviour of school children, the present paper shows the results regarding neophobia. One hundred and eighty children (8-10 years old) were involved in the study. Half of them (experimental group) were educated during school-time with the 12 sessions of taste lessons ""Les classes du goût"" by J. Puisais. The others served as a control group. Food neophobia was evaluated before and after the education period of the experimental group and once again 10 months later. An adapted food neophobia scale was used (AFNS) and the willingness to taste novel food (WTNF) was evaluated by the presentation of eight unknown foods. To improve involvement in the expressed willingness to taste new foods, the children were told that they would have to eat one of the not rejected unknown foods afterwards. Results revealed that, at the end of the education period, in the educated group, declarative food neophobia decreased significantly and participants' willingness to taste novel food seemed to increase compared to the control group. Nevertheless, these effects had disappeared 10 months later. Thus, we have shown that sensory education can influence childrens' food neophobia, but does so only temporarily. This is especially true for the WTNF test, which measures the expression of neophobia in concrete situations, whereas neophobia measured as a psychological trait by the AFNS test hardly changes.","Reverdy, C; Chesnel, F; Schlich, P; Köster, E P; Lange, C",2008.0,10.1016/j.appet.2008.01.010,0,0,
4466,Cortisol as an indicator of dopaminergic effects on nicotine craving,"There is evidence that glucocorticoids mediate the activity of mesencephalic dopaminergic neurons which play an important role in drug-seeking behaviour and that the absence or presence of glucocorticoids determines the intensity of drug self-administration. Moreover, some experiments indicate that corticoids are increased after substance induced dopaminergic stimulation. These findings could imply (a) that differences in basal glucocorticoid levels are associated with differences in craving or (b) that dopamine (DA) induced corticoid release is an indicator of the sensitivity of the dopaminergic system. Therefore, in a sample of 36 male smokers whose DA system was challenged by a DA agonist (lisuride = LIS) and a DA antagonist (fluphenazine = FLU) in a balanced placebo controlled double-blind crossover design, it was investigated if (a) basal cortisol differences and (b) drug induced cortisol responses are related to the amount of nicotine craving after 3.5 h of deprivation from smoking. There were no differences in craving between subjects with high and low basal cortisol levels irrespective of the pharmacological treatment. However, the size of the cortisol change after the DA challenge and deprivation emerged as a good predictor for the amount of craving in that drug condition in which the cortisol response was most pronounced. Findings were interpreted as evidence for the role of cortisol as an indicator of DA sensitivity. Copyright © 2003 John Wiley & Sons, Ltd.",Reuter M.; Hennig J.,2003.0,10.1002/hup.503,0,0,
4467,Interpretation bias modification for youth and their parents: a novel treatment for early adolescent social anxiety,"ER Social anxiety is the most prevalent anxiety disorder of late adolescence, yet current treatments reach only a minority of youth with the disorder. Effective and easy-to-disseminate treatments are needed. This study pilot tested the efficacy of a novel, online cognitive bias modification for interpretation (CBM-I) intervention for socially anxious youth and their parents. The CBM-I intervention targeted cognitive biases associated with early adolescents' maladaptive beliefs regarding social situations, and with parents' intrusive behavior, both of which have been theoretically linked with the maintenance of social anxiety in youth. To investigate the efficacy of intervening with parents and/or children, clinically diagnosed early adolescents (ages 10-15; N=18) and their mothers were randomly assigned to one of three conditions: the first targeted early adolescents' cognitive biases related to social anxiety (Child-only condition); the second targeted parents' biases associated with intrusive behavior (Parent-only condition); and the third targeted both youth and parents' biases in tandem (Combo condition). The use of a multiple baseline design allowed for the efficient assessment of causal links between the intervention and reduction in social anxiety symptoms in youth. Results provided converging evidence indicating modest support for the efficacy of CBM-I, with no reliable differences across conditions. Taken together, results suggest that online CBM-I with anxious youth and/or their parents holds promise as an effective and easily administered component of treatment for child social anxiety that deserves further evaluation in a larger trial.","Reuland, M M; Teachman, B A",2014.0,10.1016/j.janxdis.2014.09.011,0,0,
4468,Models to enhance stroke diagnosis in the field: FAST-MAG experience,"Background: Acceptable diagnostic accuracy poses an important challenge to fieldimplemented stroke clinical trials. We previously showed that low rates of misclassification can be attained when the Field Administration of Stroke Therapy - Magnesium (FAST-MAG) inclusion and exclusion criteria are used. Here, we evaluate the accuracy of 2 simple diagnostic schemes to predict stroke in the field. Methods: FAST-MAG is a randomized, double-blind, placebo-controlled, phase 3 trial of Magnesium Sulfate administered by paramedics to patients with suspected stroke within 2 hours after symptom onset. Stroke screening consists of Los Angeles Prehospital Stroke Screen (LAPSS) administered by paramedics to identify potential stroke patients at the scene, followed by a short report to a central study neurologist via cell phone. The neurologist speaks to the patient or available family, performs a rapid assessment, and renders a diagnosis of likely stroke. Classification trees (binary recursive splitting method), and logistic regression were used to develop diagnostic prediction schemes on the first 567 enrolled patients. Accuracy was defined as the unweighted average of sensitivity and specificity. Results: Diagnosis of stroke was confirmed in 96.5% of enrolled cases. Acute ischemic stroke (AIS) was diagnosed in 411 (72.5%), intracranial hemorrhage (ICH) in 136 (24%), and mimics in 20 (3.5%) patients. Seizures or intracranial neoplasms accounted for most mimics (30% each). Other sources of diagnostic confusion included anxiety disorders, migraine, metabolic abnormalities and urosepsis. Classification trees using LAPSS, systolic blood pressure, NIHSS and pulse rate had accuracy of 86% at predicting AIS (see figure) and 89.5% for ICH, while logistic regression models using pulse rate, LAPSS, NIHSS and alcohol use were 74.5-84% accurate. Conclusion: s: Classification trees and logistic regression models can be used to accurately predict AIS and ICH in the field. Such models may exhibit over-fitting due to small mimic numbers. The merit of these prediction schemes will be tested prospectively in FAST-MAG's final phase. (Figure presented).",Restrepo L.; Sanossian N.; Liebeskind D.S.; Ali L.K.; Starkman S.; Saver J.,2011.0,10.1161/STR.0b013e3182074d88,0,0,
4469,Cognitive enhancers as adjuncts to psychotherapy: use of D-cycloserine in phobic individuals to facilitate extinction of fear.,"Traditional pharmacological approaches to treating psychiatric disorders focus on correcting presumed biochemical abnormalities. However, some disorders, particularly the anxiety-related disorders exemplified by specific phobia, have an emotional learning component to them that can be facilitated with psychotherapy. To determine whether D-cycloserine (DCS), a partial agonist at the N-methyl-d-aspartate receptor that has previously been shown to improve extinction of fear in rodents, will also improve extinction of fear in human phobic patients undergoing behavioral exposure therapy. Randomized, double-blind, placebo-controlled trial examining DCS vs placebo treatment in combination with a precisely controlled exposure paradigm. Participants were recruited from the general community to a research clinic. Twenty-eight subjects with acrophobia diagnosed by the Structured Clinical Interview for DSM-IV were enrolled. After we obtained pretreatment measures of fear, subjects were treated with 2 sessions of behavioral exposure therapy using virtual reality exposure to heights within a virtual glass elevator. Single doses of placebo or DCS were taken prior to each of the 2 sessions of virtual reality exposure therapy. Subjects, therapists, and assessors were blind to the treatment condition. Subjects returned at 1 week and 3 months posttreatment for measures to determine the presence and severity of acrophobia symptoms. Included were measures of acrophobia within the virtual environment, measures of acrophobia in the real world, and general measures of overall improvement. An objective measure of fear, electrodermal skin fluctuation, was also included during the virtual exposure to heights. Symptoms were assessed by self-report and by independent assessors at approximately 1 week and 3 months posttreatment. Exposure therapy combined with DCS resulted in significantly larger reductions of acrophobia symptoms on all main outcome measures. Subjects receiving DCS had significantly more improvement compared with subjects receiving placebo within the virtual environment (1 week after treatment, P</=.001; 3 months later, P</=.05). Subjects receiving DCS also showed significantly greater decreases in posttreatment skin conductance fluctuations during the virtual exposure (P</=.05). Additionally, subjects receiving DCS had significantly greater improvement compared with subjects receiving placebo on general measures of real-world acrophobia symptoms (acrophobia avoidance [P</=.02], acrophobia anxiety [P</=.01], attitudes toward heights [P</=.04], clinical global improvement [P</=.01], and number of self-exposures to real-world heights [P</=.01]); the improvement was evident early in treatment and was maintained at 3 months. These pilot data provide initial support for the use of acute dosing of DCS as an adjunct to exposure-based psychotherapy to accelerate the associative learning processes that contribute to correcting psychopathology.",Ressler KJ.; Rothbaum BO.; Tannenbaum L.; Anderson P.; Graap K.; Zimand E.; Hodges L.; Davis M.,2004.0,10.1001/archpsyc.61.11.1136,0,0,
4470,Development of CRIS: measure of community reintegration of injured service members.,"Identification and prevention of community reintegration problems of veterans is an important public health mandate. However, no veteran-specific measure exists. Study purposes were to (1) develop the Community Reintegration for Service Members (CRIS) measure and (2) test the validity and reliability of the measure. Formative research identified challenges in community reintegration postdeployment. The World Health Organization's International Classification of Functioning, Disability and Health participation domain guided item-bank development. Items were refined through cognitive interviews and clinician consultation. Pilot studies with 126 veterans examined unidimensionality, internal consistency, reliability, and construct validity. Three unidimensional CRIS scales were developed. Working subjects had better CRIS scores then unemployed subjects. Subjects with posttraumatic stress disorder, substance abuse, or mental health problems had worse scores than subjects without these conditions. The correlations between the CRIS and the 36-Item Short Form Health Survey scales of role physical, role emotional, and social functioning were 0.44-0.80. CRIS has strong reliability, conceptual integrity, and construct validity.",Resnik L.; Plow M.; Jette A.,2009.0,,0,0,
4471,An acute post-sexual assault intervention to prevent drug abuse: updated findings.,"Sexual assault and rape routinely produce extreme distress and negative psychological reactions in victims. Further, past research suggests that victims are at increased risk of developing substance use or abuse post-rape. The post-rape forensic medical exam may itself exacerbate peritraumatic distress because it includes cues that may serve as reminders of the assault, thereby potentiating post-assault negative sequelae. To address these problems, a two-part video intervention was developed to take advantage of the existing sexual assault forensic exam infrastructure, and to specifically (a) minimize anxiety/discomfort during forensic examinations, thereby reducing risk of future emotional problems, and (b) prevent increased substance use and abuse following sexual assault. Updated findings with a sample of 268 sexual assault victims participating in the forensic medical exam and completing one or more follow-up assessments at: (1)<3 months post-assault; (2) 3 to 6 months post-assault; or (3) 6 months or longer post-assault indicated that the video was associated with significantly lower frequency of marijuana use at each time point, among women who reported use prior to the assault.",Resnick HS.; Acierno R.; Amstadter AB.; Self-Brown S.; Kilpatrick DG.,2007.0,10.1016/j.addbeh.2007.01.001,0,0,
4472,Prevention of post-rape psychopathology: preliminary findings of a controlled acute rape treatment study.,"Violent sexual assault such as rape typically results in extremely high levels of acute distress. The intensity of these acute psychological reactions may play a role in later recovery, with higher levels of immediate distress associated with poorer outcome. Unfortunately, post-rape forensic evidence collection procedures may serve to increase, rather than reduce initial distress, potentially exacerbating future psychopathology. To address these concerns, an acute time-frame hospital-based video intervention was developed to: (a) minimize anxiety during forensic rape exams, and (b) prevent post-rape posttraumatic stress disorder (PTSD), panic, and anxiety. Preliminary data indicated that (1) psychological distress at the time of the exam was strongly related to PTSD symptomatology 6 weeks post-rape, and (2) the video intervention successfully reduced distress during forensic exams.",Resnick H.; Acierno R.; Holmes M.; Kilpatrick DG.; Jager N.,,,0,0,
4473,Optimizing physical activity among older adults post trauma: Overcoming system and patient challenges.,"By 2050 it is anticipated that close to half (40%) of all trauma patients will be over the age of 65. Recovery for these individuals is more complicated than among younger individuals. Early mobilization has been shown to improve outcomes. Unfortunately, there are many challenges to early mobilization. The Function Focused Care Intervention was developed to overcome these challenges. The purpose of this paper was to describe the initial recruitment of the first 25 participants and delineate the challenges and successes associated with implementation of this intervention. Overall recruitment rates were consistent with other studies and the intervention was implemented as intended. Most patients were female, white and on average 79 years of age. Optimizing physical activity of patients was a low priority for the nurses with patient safety taking precedence. Patients spent most of the time in bed. Age, depression and tethering were the only factors that were associated with physical activity and functional outcomes of patients. Ongoing work is needed to keep patients physically active in the immediate post trauma recovery period.",Resnick B.; Galik E.; Wells CL.; Boltz M.; Holtzman L.,2015.0,10.1016/j.ijotn.2015.03.007,0,0,
4474,Early attrition from treatment among women with cooccurring substance use disorders and PTSD.,"Participant retention is one of the more challenging issues in the treatment of substance use disorders. Using data from the National Institute on Drug Abuse Clinical Trials Network's Women and Trauma Study (recruitment in 2004-2005), we examine prominent factors associated with early attrition among women with cooccurring substance use disorders and posttraumatic stress disorder (N = 340). Early treatment attrition is associated with a history of youth partner violence, perceived need for psychological treatment, and abuse of alcohol, opioids, and stimulants. Logistical barriers (e.g., transportation, having children) were not significantly associated with early attrition. Findings provide insight into characteristics of women who might need additional supports to engage in treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Resko, Stella M; Mendoza, Natasha S; Aday, Agosti, Amaro, Amaro, Andersen, Ashley, Ball, Blake, Brady, Brady, Brocato, Cahill, Charney, Claus, Derogatis, Donovan, Elbreder, Foa, Graff, Green, Greenfield, Greenfield, Grella, Grubaugh, Hien, Hien, Hien, Hosmer, Hubbard, Joe, Johnson, Kang, Kelly, Kessler, Levin, Lewis, Maglione, Marks, Marsh, Martinez-Raga, McLellan, McLellan, Menard, Mertens, Miller, Moos, Najavits, Najavits, Najavits, Najavits, Nelson-Zlupko, Nishimoto, Ondersma, Pinto, Prochaska, Prochaska, Sacks, Schmitz, Schober, Schutzwohl, Scott-Lennox, Siddiqi, Simon, Simpson, Simpson, Simpson, Stark, Tarrier, Taylor, Weathers, Weisner, Weisner, Winhusen, Zayfert, Zemore, Zlotnick, Zweben",2012.0,,0,0,
4475,Integrating a portable biofeedback device into clinical practice for patients with anxiety disorders: Results of a pilot study.,"This study examined the effectiveness of a portable Respiratory Sinus Arrhythmia (RSA) biofeedback device as an adjunct to CBT in persons with anxiety disorders and other disorders associated with autonomic dysfunction attending outpatient treatment. Participants were 24 individuals attending outpatient cognitive behavioral treatment for a range of anxiety disorders. Participants were assessed over a 3 week period. Outcomes included measures of anxiety (STAI-Y), sleep disturbances (PSQI), anger (STAEI), and subjective questions about the effectiveness of the device as a treatment adjunct. Significant reductions were found for anxiety and anger and for certain sleep variables (e.g. sleep latency). There was a significant dos-effect in that those who were more compliant had significantly greater reductions in most domains including sleep, anger and trait anxiety. Overall, participants found the device more helpful than other relaxation techniques such as mediation, yoga and unassisted breathing techniques but less helpful than exercise. The most frequently endorsed side effects were dizziness (15%) and sleepiness (55%). These preliminary results suggest that portable RSA biofeedback appears to be a promising treatment adjunct for disorders of autonomic arousal and is easily integrated into treatment. Results support the need for further investigation with more rigorous experimental designs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Reiner, Robert; Backhaus, Barlow, Berntson, Bonnet, Buysee, Cox, Delaney, Eckberg, Fouad, Fried, Friedman, Gevirtz, Greenberg, Hughes, Katona, Kazantzis, Kazantzis, Lehrer, Lehrer, Lehrer, Lehrer, Mashin, Murdoch, Mussgay, Porges, Sandercock, Scheel, Schipke, Schwartz, Spielberger, Spielberger, Spielberger, Strauss-Blasche, Sultanoff, Taylor, Thayer, Tripathi, Vaschillo, Virtanen, Watkins, Williams, Yeragani, Yucha",2008.0,,0,0,
4476,The impact of imagery rescripting on memory appraisals and core beliefs in social anxiety disorder.,"Negative mental images in social anxiety disorder (SAD) are often rooted in autobiographical memories of formative, distressing life events. In the present study, 25 participants with SAD retrieved an idiosyncratic negative mental image and associated autobiographical memory. Participants were then randomly assigned either to a single-session of imagery rescripting (IR) targeting the retrieved autobiographical memory or to a non-intervention control condition (no-IR). Outcomes were assessed one week later. Compared to control participants, those who received IR experienced substantial reduction in SAD symptoms accompanied by more positive and less negative appraisals of their autobiographical memories. Moreover, IR relative to no-IR participants reported marked shifts in the content, validity, and accuracy of their memory-derived negative core beliefs about self and others, but not about the world. Results support the promise of IR as a stand-alone intervention for SAD and suggest important directions for future research to enhance our understanding of the cognitive mechanisms that underlie its effects.",Reimer SG.; Moscovitch DA.,2015.0,10.1016/j.brat.2015.10.007,0,0,
4477,Lateral parabrachial nucleus lesions in the rat: Neophobia and conditioned taste aversion,"The present study investigated the hypothesis that the conditioned taste aversion (CTA) deficit consequent to lesions of the lateral parabrachial nucleus (LPBN) may be due to a disruption of neophobia. In Experiment 1, subjects were tested with one of three taste stimuli (alanine, saccharin, or quinine) and two nontaste stimuli (capsaicin and almond odor). Ibotenic acid lesions of the LPBN eliminated neophobia to alanine and saccharin but had no influence on the neophobic response to quinine, capsaicin, or almond odor. In Experiment 2, all the LPBN-lesioned (LPBNX) rats failed to develop a CTA. These results do not support the experimental hypothesis. Not only was the lesion-induced disruption of neophobia restricted to taste stimuli, the deficit was selective within that category. It is already known that LPBNX rats are unable to acquire conditioned aversions to capsaicin as well as alanine. Thus, the absence of a conditioned ingestional aversion in LPBNX rats is not predicated upon the absence of a neophobic response to the target stimulus. The present results, although exposing a stimulus selective disruption of neophobia, suggest that this deficit is independent of, rather than responsible for, the absence of conditioned ingestional aversions in rats with LPBN lesions. © 2001 Elsevier Science Inc.",Reilly S.; Trifunovic R.,2001.0,10.1016/S0361-9230(01)00517-2,0,0,
4478,Cognitive therapy for the suicidal patient: A case study.,"A suicidal 28-yr-old woman diagnosed with major depressive disorder, recurrent, severe, and generalized anxiety disorder was successfully treated with 40 sessions of standard cognitive therapy. Within 10 sessions after her 2nd suicidal crisis, the S had moved out of her parent's home, initiated social outings, and begun to look at other career options. The S's goals were met, including increasing her tolerance for negative affect, decreasing self-critical statements, and defining what she wanted in specific situations. The case illustrates therapeutic strategies used to increase cognitive flexibility, decrease sensitivity to perceived social expectations, and increase tolerance of anxiety in problem solving and interpersonal conflicts. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Reilly, Christine E",1998.0,,0,0,
4479,Effects of high-dose corticosteroids on post-traumatic inflammatory mediators,"ER PATIENTS AND METHODSIn 20 consecutive patients, an osteotomy of the lumbar spine was done. By concealed random allocation, 10 of the patients were given 10 mg/kg of methylprednisolone pre-operatively. The control patients received the same amount of saline. Samples of arterial blood and local blood from the surgical site were sampled and analysed for inflammatory cytokines and prostaglandin E2.RESULTSThere were significant increments in systemic levels of IL-6, IL-10 and sTNF-R1. Corticosteroids significantly reduced the increases of IL-6 and significantly increased the levels of IL-10 and sTNF-R1. Locally, the expressions of TNF-alpha, IL-1beta, IL-6 and sTNF-R1 were significantly increased in both groups post-operatively. Corticosteroids significantly increased the local expressions of IL-10 and sTNF-R1. There were significantly higher local than systemic levels of inflammatory mediators except for TNF-alpha.CONCLUSIONThis study shows that in traumatic injury there are generally higher local than systemic expressions of inflammatory mediators, and that the main anti-inflammatory effects of high-dose corticosteroids are suppression of systemic IL-6 and increased expressions of IL-10 and sTNF-R1, both systemically and locally.OBJECTIVEPlasma concentrations of inflammatory mediators are substantially increased in major orthopaedic surgery. It was our hypothesis that corticosteroids would reduce the post-operative levels of inflammatory mediators in patients with ankylosing spondylitis, and we performed a single-centre randomised controlled trial.","Reikerås, O; Helle, A; Krohn, C D; Brox, J I",2009.0,10.1007/s00011-009-0061-3,0,0,
4480,Support for the predictive validity of the SASC-R: linkages with reactions to an in vivo peer evaluation manipulation,"ER The present study examined the predictive validity of the Social Anxiety Scale for Children-Revised (SASC-R) by investigating associations between children's social anxiety symptoms and their cognitive and behavioral reactions in response to an in vivo peer evaluation manipulation. Participants (N=115) ages 10-13, played a computer game based on the television show Survivor and were randomized to either a peer rejection (i.e., receiving the lowest total 'likeability' score from a group of peer-judges), a peer success (i.e., receiving the highest score), or a neutral peer feedback condition. Children reporting higher levels of social anxiety displayed more negative game-relevant performance expectations as well as more negative cognitive evaluations of both success and failure feedback. Moreover, regardless of feedback valence, children scoring higher on social anxiety reported greater reluctance to engage in game-related social activities. These findings provide support for the predictive validity of the SASC-R.","Reijntjes, A; Dekovic, M; Telch, M J",2007.0,10.1016/j.janxdis.2006.10.007,0,0,
4481,Prevalence of mental health symptoms in Dutch military personnel returning from deployment to Afghanistan: A 2-year longitudinal analysis,"Objective: Recent studies in troops deployed to Iraq and Afghanistan have shown that combat exposure and exposure to deployment-related stressors increase the risk for the development of mental health symptoms. The aim of this study is to assess the prevalence of mental health symptoms in a cohort of Dutch military personnel prior to and at multiple time-points after deployment. Methods: Military personnel ( n= 994) completed various questionnaires at 5 time-points; starting prior to deployment and following the same cohort at 1 and 6. months and 1 and 2. years after their return from Afghanistan. Results: The prevalence of symptoms of fatigue, PTSD, hostility, depression and anxiety was found to significantly increase after deployment compared with pre-deployment rates. As opposed to depressive symptoms and fatigue, the prevalence of PTSD was found to decrease after the 6-month assessment. The prevalence of sleeping problems and hostility remained relatively stable. Conclusions: The prevalence of mental health symptoms in military personnel increases after deployment, however, symptoms progression over time appears to be specific for various mental health symptoms. Comprehensive screening and monitoring for a wide range of mental health symptoms at multiple time-points after deployment is essential for early detection and to provide opportunities for intervention. Declaration of interest: This project was funded by the Dutch Ministry of Defence.",Reijnen A.; Rademaker A.R.; Vermetten E.; Geuze E.,2015.0,10.1016/j.eurpsy.2014.05.003,0,0,
4482,MAOA and mechanisms of panic disorder revisited: from bench to molecular psychotherapy.,"Panic disorder with agoraphobia (PD/AG) is a prevalent mental disorder featuring a substantial complex genetic component. At present, only a few established risk genes exist. Among these, the gene encoding monoamine oxidase A (MAOA) is noteworthy given that genetic variation has been demonstrated to influence gene expression and monoamine levels. Long alleles of the MAOA-uVNTR promoter polymorphism are associated with PD/AG and correspond with increased enzyme activity. Here, we have thus investigated the impact of MAOA-uVNTR on therapy response, behavioral avoidance and brain activity in fear conditioning in a large controlled and randomized multicenter study on cognitive behavioral therapy (CBT) in PD/AG. The study consisted of 369 PD/AG patients, and genetic information was available for 283 patients. Carriers of the risk allele had significantly worse outcome as measured by the Hamilton Anxiety scale (46% responders vs 67%, P=0.017). This was accompanied by elevated heart rate and increased fear during an anxiety-provoking situation, that is, the behavioral avoidance task. All but one panic attack that happened during this task occurred in risk allele carriers and, furthermore, risk allele carriers did not habituate to the situation during repetitive exposure. Finally, functional neuroimaging during a classical fear conditioning paradigm evidenced that the protective allele is associated with increased activation of the anterior cingulate cortex upon presentation of the CS+ during acquisition of fear. Further differentiation between high- and low-risk subjects after treatment was observed in the inferior parietal lobes, suggesting differential brain activation patterns upon CBT. Taken together, we established that a genetic risk factor for PD/AG is associated with worse response to CBT and identify potential underlying neural mechanisms. These findings might govern how psychotherapy can include genetic information to tailor individualized treatment approaches.",Reif A.; Richter J.; Straube B.; Höfler M.; Lueken U.; Gloster AT.; Weber H.; Domschke K.; Fehm L.; Ströhle A.; Jansen A.; Gerlach A.; Pyka M.; Reinhardt I.; Konrad C.; Wittmann A.; Pfleiderer B.; Alpers GW.; Pauli P.; Lang T.; Arolt V.; Wittchen HU.; Hamm A.; Kircher T.; Deckert J.,2014.0,10.1038/mp.2012.172,0,0,
4483,Side-effects of SSRIs disrupt multimodal treatment for pediatric OCD in a randomized-controlled trial,"ER Objective: Activation Syndrome (AS) is a side-effect of antidepressants consisting of irritability, mania, self-harm, akathisia, and disinhibition. The current study was conducted to analyze how AS may hinder treatment outcome for multimodal treatment for children and adolescents with Obsessive-Compulsive Disorder. Methods: Fifty-six children or adolescents were recruited at two treatment sites in a double-blind randomized-controlled trial where participants received Cognitive-Behavioral Therapy and were randomized to slow titration of sertraline, regular titration of sertraline or placebo. Results: Using a recently developed measure of AS, results suggested that higher average levels of irritability, akathisia, and disinhibition significantly interfered with treatment response and explained 18% of the variance in obsessive-compulsive symptoms during treatment. Interestingly, only session-to-session increases in irritability resulted in a session-to-session increase in obsessive-compulsive symptoms. The observed results were unchanged with the addition of SSRI dosage as a covariate. Conclusions: Results provide empirical support for the proposed hypothesis that AS may hinder multimodal treatment outcome for pediatric OCD. These findings suggest that dosage changes due to AS do not explain why those with higher AS had worse multimodal outcome. Other possible mechanisms explaining this observed disruption are proposed, including how AS may interfere with Cognitive-Behavioral Therapy.","Reid, A M; McNamara, J P; Murphy, T K; Guzick, A G; Storch, E A; Goodman, W K; Geffken, G R; Bussing, R",2015.0,10.1016/j.jpsychires.2015.10.006,0,0,
4484,A placebo-controlled trial shows no effect of vasopressin on recovery from closed head injury,"Vasopressin and its analogues have been claimed to benefit patients with posttraumatic amnesia. To test this hypothesis a double-blind, placebo-controlled, prospective trial of vasopressin was carried out in the chronic (rehabilitation) phase of recovery from closed head injury. Seven patients who received vasopressin and 6 who received a placebo were comparable in age, sex, and degree of disability upon entry into the study. Both groups improved at the same rate in mental status, neurological status, and activities of daily living.",Reichert W.H.; Blass J.P.,1982.0,10.1002/ana.410120412,0,0,
4485,“Don't put me down but don't be too nice to me either”: fear of positive vs. negative evaluation and responses to positive vs. negative social-evaluative films.,"The bivalent fear of evaluation (BFOE) model suggests that fears of negative evaluation (FNE) and positive evaluation (FPE) are distinct features in social anxiety disorder as well as in non-clinical variations of social anxiety. The constructs can be measured utilizing the Brief Fear of Negative Evaluation Scale – Revised (BFNE-R) and the Fear of Positive Evaluation Scale (FPES), respectively. Whereas the distinction between FNE and FPE has been well examined in survey studies, concomitant evidence from laboratory tasks is scarce. The present study tested whether subjective unpleasantness responses to short films simulating positive and negative evaluation from others are related to individual differences in FNE and FPE. Ninety-eight unselected individuals watched 24 short films displaying actors expressing positive, negative and neutral sentences and rated their responses on unpleasantness. Furthermore, pride responses to positive films were examined since these can be expected to discriminate between FPE and FNE. As expected, higher BFNE-R scores were related to more unpleasant responding to negative films, whereas higher FPES scores were related to more unpleasant responding to positive films. Furthermore, experience of pride following positive films correlated positively with BFNE-R, but negatively with FPES scores. Participants were university students which limits representativeness. The study revealed that measures of FNE and FPE show distinct relationships with positive and negative social feedback which provides further evidence for the BFOE model in a laboratory setting.",Reichenberger J.; Wiggert N.; Wilhelm FH.; Weeks JW.; Blechert J.,2015.0,10.1016/j.jbtep.2014.10.004,0,0,
4486,?Don't put me down but don't be too nice to me either?: fear of positive vs. negative evaluation and responses to positive vs. negative social-evaluative films,"ER BACKGROUND AND OBJECTIVES: The bivalent fear of evaluation (BFOE) model suggests that fears of negative evaluation (FNE) and positive evaluation (FPE) are distinct features in social anxiety disorder as well as in non-clinical variations of social anxiety. The constructs can be measured utilizing the Brief Fear of Negative Evaluation Scale ? Revised (BFNE-R) and the Fear of Positive Evaluation Scale (FPES), respectively. Whereas the distinction between FNE and FPE has been well examined in survey studies, concomitant evidence from laboratory tasks is scarce.METHODS: The present study tested whether subjective unpleasantness responses to short films simulating positive and negative evaluation from others are related to individual differences in FNE and FPE. Ninety-eight unselected individuals watched 24 short films displaying actors expressing positive, negative and neutral sentences and rated their responses on unpleasantness. Furthermore, pride responses to positive films were examined since these can be expected to discriminate between FPE and FNE.RESULTS: As expected, higher BFNE-R scores were related to more unpleasant responding to negative films, whereas higher FPES scores were related to more unpleasant responding to positive films. Furthermore, experience of pride following positive films correlated positively with BFNE-R, but negatively with FPES scores.LIMITATIONS: Participants were university students which limits representativeness.CONCLUSIONS: The study revealed that measures of FNE and FPE show distinct relationships with positive and negative social feedback which provides further evidence for the BFOE model in a laboratory setting.","Reichenberger, J; Wiggert, N; Wilhelm, F H; Weeks, J W; Blechert, J",2015.0,10.1016/j.jbtep.2014.10.004,0,0,4485
4487,DSM-III-R personality disorders in seasonal affective disorder: change associated with depression.,"Forty-five patients with winter Seasonal Affective Disorder (SAD) completed the Personality Diagnostic Questionnaire-Revised (PDQ-R) in a depressed state before starting therapy (light or medication), and again 14 weeks later when the scores on the Montgomery Asberg Depression Rating Scale (MADRS) had been reduced by an average of 74%. Prevalence and pattern of personality disorders (PDs) before treatment were similar to that found in patients with nonseasonal major depressive disorder (MDD) during a depressive episode. Number of categorical diagnoses were lower at follow-up for most PDs, but differences were not statistically significant. However, for dimensional scores (number of positive DSM-III-R criteria) significant changes were found for schizotypal, histrionic, narcissistic, and obsessive-compulsive PD, and for total dimensional score in cluster B and total score for all PDs. These changes differ from findings in similar studies of outpatients with nonseasonal MDD. Whether this indicates a specific pattern of change for patients with SAD is discussed. Multiple regression analysis showed a significant association between changes in positive PD criteria between the depressed and nondepressed state and change in depression score. No significant relationship was found between changes in PD criteria and Global Seasonality Score (GSS), a measure reflecting the sum of ratings of seasonal variation in sleep length, social activity, mood, weight, appetite, and energy level.",Reichborn-Kjennerud T.; Lingjaerde O.; Dahl AA.,,,0,0,
4488,"A prospective, follow-along study of the course of social phobia: II. Testing for basic predictors of course.","This study examined the 65-week outcome of a group of subjects with social phobia to determine predictors of course. Social phobic patients in the Harvard/Brown Anxiety Disorders Research Project study were followed for 65 weeks using the Longitudinal Interval Follow-Up Evaluation-UpJohn scale. The following variables did not predict outcome over the course of the study: sex, age of onset, duration of illness, lifetime history of various anxiety disorders, current comorbidity of anxiety or depressive disorders, Global Assessment Scale score, or measures of role functioning. We find that in a social phobic population with a mean duration of illness of 18 years, none of the tested variables examined predicted 65-week outcome.",Reich J.; Goldenberg I.; Goisman R.; Vasile R.; Keller M.,1994.0,,0,0,
4489,Ankle arthroplasty in patients with rheumatoid arthritis history and future development,"The main indications for the implantation of an ankle endoprosthesis are inflammatory diseases, post-traumatic cases and primary ankle osteoarthrosis. The first implants for destroyed upper ankles came out in the early 1970s. In the meantime ankle arthroplasties of the third generation are commonly used which consist of two metal components with a polyethylene inlay in-between. In contrast to the arthroplasty of other joints the upper ankle prosthesis until today competes with ankle fusion (still the gold standard). In contrast hereto, rheumatic diseases are considered advantageous for the ankle arthroplasty because of the normal gait pattern, the protection of the proximal and distal joints and because of elevated non-union rates after arthrodeses compared to other illnesses. Requirements for a total ankle arthroplasty consist generally in sufficient bone stock, solid ligaments and an acceptable axis of the ankle. © Georg Thieme Verlag KG Stuttgart.",Rehart S.; Grebe P.; Schill S.; Fink B.,2010.0,10.1055/s-0030-1249664,0,0,
4490,Hemispheric dorsolateral prefrontal cortex lateralization in the regulation of empathy for pain,"The dorsolateral prefrontal cortex (DLPFC) is involved in the cognitive appraisal and modulation of the pain experience. In this sham-controlled study, with healthy volunteers, we used bi-hemispheric transcranial direct current stimulation (tDCS) over the DLPFC to assess emotional reactions elicited by pain observation. Left-cathodal/right-anodal tDCS decreased valence and arousal evaluations compared to other tDCS conditions. Compared to sham condition, both left-cathodal/right-anodal and left-anodal/right-cathodal tDCS decreased hostility, sadness and self-pain perception. These decreased sensations after both active tDCS suggest a common role for left and right DLPFC in personal distress modulation. However, the differences in arousal and valence evaluations point to distinct roles of lateralized DLPFC in cognitive empathy, probably through distinct emotion regulation mechanisms.",Rêgo G.G.; Lapenta O.M.; Marques L.M.; Costa T.L.; Leite J.; Carvalho S.; Gonçalves T.F.; Brunoni A.R.; Fregni F.; Boggio P.S.,2015.0,10.1016/j.neulet.2015.03.042,0,0,
4491,A meta-analysis of the effects of Internet-and computer-based cognitive-behavioral treatments for anxiety,"Internet-and computer-based cognitive-behavioral treatments have been introduced as novel approaches to deliver standard, quality treatment that may reduce barriers to care. The purpose of this review is to quantitatively summarize the literature examining the treatment effects of Internet- or computer-based treatment (ICT) on anxiety. Nineteen randomized controlled ICT trials were identified and subjected to fixed and random effects meta-analytic techniques. Weighted mean effect sizes (Cohen's d) showed that ICT was superior to waitlist and placebo assignment across outcome measures (ds = .49-1.14). The effects of ICT also were equal to therapist-delivered treatment across anxiety disorders. However, conclusions were limited by small sample sizes, the rare use of placebo controls, and other methodological problems. In addition, the number of available studies limited the opportunity to conduct analyses by diagnostic group; there was preliminary support for the use of ICT for panic disorder and phobia. Large, well-designed, placebo-controlled trials are needed to confirm and extend the results of this meta-analysis. © 2008 Wiley Periodicals, Inc.",Reger M.A.; Gahm G.A.,2009.0,10.1002/jclp.20536,0,0,
4492,A controlled study of assisted bibliotherapy: an assisted self-help treatment for mild to moderate stress and anxiety.,,Reeves T.,2010.0,10.1111/j.1365-2850.2009.01544.x,0,0,
4493,"The premonitory urge to tic: measurement, characteristics, and correlates in older adolescents and adults.","In addition to motor and/or vocal tics, many individuals with Tourette syndrome (TS) or chronic tic disorder (CTD) report frequent, uncomfortable sensory phenomena that immediately precede the tics. To date, examination of these premonitory sensations or urges has been limited by inconsistent assessment tools. In this paper, we examine the psychometric properties of a nine-item self-report measure, the Premonitory Urge to Tic Scale (PUTS) and examine the characteristics and correlates of the premonitory urge to tic in a clinical sample of 122 older adolescents and adults with TS or CTD. The PUTS demonstrated adequate internal consistency, temporal stability, and concurrent validity. Premonitory urges were endorsed by the majority of individuals. Most individuals reported some relief from the urges after completing a tic and being able to stop their tics even if only temporarily. Degree of premonitory urges was not significantly correlated with age, and we did not observe any gender differences. Degree of premonitory urges was significantly correlated with estimated IQ and tic severity, but not severity of comorbid obsessive-compulsive disorder or attention-deficit hyperactivity disorder. Also, it was not related to concomitant medication status. These findings represent another step forward in our understanding of the premonitory sensations associated with TS and CTD.",Reese HE.; Scahill L.; Peterson AL.; Crowe K.; Woods DW.; Piacentini J.; Walkup JT.; Wilhelm S.,2014.0,10.1016/j.beth.2013.09.002,0,0,
4494,Attention training for reducing spider fear in spider-fearful individuals.,"Cognitive theorists propose that attentional biases for threatening information play an important role in the development and maintenance of anxiety disorders. If attentional biases for threat figure in the maintenance of anxiety, then the experimental reduction of the bias for threat (attention training) should reduce anxiety. We randomly assigned 41 spider-fearful individuals to receive either attention training (n=20) or control procedures (n=21). We used a modified dot-probe discrimination paradigm with photographs of spiders and cows to train attention. Training reduced attentional bias for spiders, but only temporarily. Although both groups declined in spider fear and avoidance, reduction in attentional bias did not produce significantly greater symptom reduction in the training group than in the control group. However, reduction in attentional bias predicted reduction in self-reported fear for the training group. The reduction in attentional bias for threat may have been insufficiently robust to produce symptom reduction greater than that produced by exposure to a live spider and spider photographs alone. Alternatively, attention training may be an unsuitable intervention for spider fear.",Reese HE.; McNally RJ.; Najmi S.; Amir N.,2010.0,10.1016/j.janxdis.2010.04.006,0,0,
4495,Medical utilisation and costs in panic disorder: a comparison with social phobia.,"There is considerable evidence that people with panic disorder utilise the physical health care system more frequently than people in the general community and so incur for themselves, and impose on the public health care system, considerably greater costs. Although this is probably because of specific characteristics to do with panic disorder, it may also be a function of having any anxiety disorder where panic is prominent. This study represents one of the few comparisons of medical utilisation and costs incurred by people with panic disorder to those incurred by people with another anxiety disorder, in this case, social phobia. Before treatment, 41 people with panic disorder, 15 with social phobia and 43 nonanxious controls were interviewed about their use of the medical care system over the previous 12 months. As expected, people with panic disorder had significantly higher utilisation rates than either the nonanxious controls or the socially phobic subjects, and incurred substantially higher costs. Adequate screening for panic disorder at the primary medical care level together with appropriate treatment referral therefore have the potential to substantially reduce the personal and community costs incurred by people with panic disorder.",Rees CS.; Richards JC.; Smith LM.,,,0,0,
4496,Cephalic phase salivary response differences characterize level of food neophobia.,,Raudenbush B.; Corley N.; Flower NR.; Kozlowski A.; Meyer B.,2003.0,,0,0,
4497,Physiological responses of food neophobics and food neophilics to food and non-food stimuli.,"Individual differences in human food neophobia (the reluctance to try novel foods) and food neophilia (the overt willingness to try novel foods) influence the evaluation of tastes and odors, as well as the sampling of such stimuli. Past research also notes an association of food neophobia to PTC sensitivity, body weight, and cephalic phase salivary response. The present study assessed physiological reactions of food neophobics and neophilics to pictures of food and non-food stimuli. Stimuli pictures were presented in random order on a computer screen for a period of 5 min. No significant differences were found between the groups in relation to non-food stimuli. However, pulse, GSR, and respirations were significantly increased in food neophobics when presented pictures of food stimuli. Thus, further evidence is provided to support a physiological component at least partially responsible for differences noted between neophobics and neophilics in sensitivity, psychophysical ratings, and ""willingness to try"" personality. Such a component may also lead to differences in weight, nutrition, and overall health.",Raudenbush B.; Capiola A.,2012.0,10.1016/j.appet.2012.02.042,0,0,
4498,"[Diagnostic utility of the Minnesota multiphasic personality inventory (MMPI) in clinical psychodiagnostic practice. Results of a comparative experimental study of psychically healthy subjects, addicts (alcohol and drug-dependents), and neurotics].",,Rauchfleisch U.,1971.0,,0,0,
4499,Arrhythmias and increased neuro-endocrine stress response during physicians' night shifts: a randomized cross-over trial,"ER METHODS AND RESULTSThe study was designed as a prospective randomized cross-over trial with each physician completing a 24 h (h) OCD and a 24 h control period including a regular 8 h non-OCD. Thirty healthy physicians with a median age of 33.5 years (range 29.0-45.0) were analysed. Twenty-four hours ECG and BP monitoring were performed and participants were instructed to fill out an event diary and perform a 24 h urine collection. Furthermore, blood was drawn before and after OCD and control day. Twenty-four hours ECG showed a higher rate of ventricular premature beats (VPB) during early morning hours (VPB 0-6 h, 0.5 vs. 0.0, P = 0.047) and increased low-frequency normalized units (29.3 vs. 25.5, P = 0.050) during night shift when compared with respective control night at home. During OCD, BP monitoring revealed a greater diastolic BP throughout 24 h (83.5 vs. 80.2 mmHg, P = 0.025) as well as during night-time (75.4 vs. 73.0, P = 0.028) associated with a higher rate of systolic BP more than 125 mmHg during sleep time. Tumour necrosis factor alpha concentrations increased significantly during night shift (0.76 vs. 0.05 pg/mL, P = 0.045). Urinary noradrenaline excretion was greater during OCD when compared with control day (46.0 vs. 36.0 microg/24 h, P = 0.007).CONCLUSIONOur results highlight the association of OCD with an increased risk profile for cardiovascular disease. In addition to the acute effects observed, frequent night-calls over a longer period possibly elicit sustained alterations in cardiovascular homeostasis.AIMSTo evaluate the effects of a 24 h (h) physicians on-call duty (OCD) ('night shift') on 24 h electrocardiogram (ECG), heart rate variability, blood pressure (BP), and various biochemical serum and urine 'stress markers' compared with a 'regular' day at work.","Rauchenzauner, M; Ernst, F; Hintringer, F; Ulmer, H; Ebenbichler, C F; Kasseroler, M T; Joannidis, M",2009.0,10.1093/eurheartj/ehp268,0,0,
4500,The role of safety cues in mediating the response to inhalations of CO2 in agoraphobics,"ER Eighteen subjects meeting DSM-III-R criteria for panic disorder with agoraphobia were randomly allocated to either a safety or non-safety condition and underwent 15 min inhalations of 5.5% CO2 in air. In the safety condition, both a senior and junior experimenter were present, the junior experimenter was presented as a professional, and subjects were in personal contact with the senior experimenter throughout the procedure. In the non-safety condition, the senior experimenter left on a bogus emergency, the junior experimenter was introduced as a ""student"" and was dressed casually, and subjects were alone in the experimental room throughout the procedure. Despite these dramatic manipulations, there was no significant difference between groups on either the number of subjects experiencing a panic attack or on pre-inhalation safety scores. However, a median-split analysis on safety scores indicated that those subjects who perceived themselves to be less safe before the inhalation were more likely to experience a panic attack.","Rapee, R M; Telfer, L A; Barlow, D H",1991.0,,0,0,
4501,Prevention and early intervention of anxiety disorders in inhibited preschool children,"ER This article reports results from an early intervention program aimed at preventing the development of anxiety in preschool children. Children were selected if they exhibited a high number of withdrawn/inhibited behaviors--one of the best identified risk factors for later anxiety disorders--and were randomly allocated to either a 6-session parent-education program or no intervention. The education program was group based and especially brief to allow the potential for public health application. Children whose parents were allocated to the education condition showed a significantly greater decrease in anxiety diagnoses at 12 months relative to those whose parents received no intervention. However, there were no significant effects demonstrated on measures of inhibition/withdrawal. The results demonstrate the value of (even brief) very early intervention for anxiety disorders, although these effects do not appear to be mediated through alterations of temperament.","Rapee, R M; Kennedy, S; Ingram, M; Edwards, S; Sweeney, L",2005.0,10.1037/0022-006X.73.3.488,0,0,
4502,Bibliotherapy for children with anxiety disorders using written materials for parents: a randomized controlled trial,"ER The current trial examined the value of modifying empirically validated treatment for childhood anxiety for application via written materials for parents of anxious children. Two hundred sixty-seven clinically anxious children ages 6-12 years and their parents were randomly allocated to standard group treatment, waitlist, or a bibliotherapy version of treatment for childhood anxiety. In general, parent bibliotherapy demonstrated benefit for children relative to waitlist but was not as efficacious as standard group treatment. Relative to waitlist, use of written materials for parents with no therapist contact resulted in around 15% more children being free of an anxiety disorder diagnosis after 12 and 24 weeks. These results have implications for the dissemination and efficient delivery of empirically validated treatment for childhood anxiety.","Rapee, R M; Abbott, M J; Lyneham, H J",2006.0,10.1037/0022-006X.74.3.436,0,0,
4503,Detection of somatic sensations in panic disorder,"ER Twenty-four panic disorder patients and 25 nonclinical subjects underwent double-breath inhalations of 5, 10, and 20% carbon dioxide (CO2) or room air. All subjects were blind to inhalation content and were required to guess if the inhalation contained CO2. There was no significant difference between groups in the accuracy with which they were able to detect CO2 at any concentration. Similarly, the number of somatic symptoms reported to each inhalation did not differ between groups. The findings question suggestions that individuals with panic disorder are more accurate at detecting changes in physiology than other individuals.","Rapee, R M",1994.0,,0,0,
4504,"Acute Swedish Massage Monotherapy Successfully Remediates Symptoms of Generalized Anxiety Disorder: A Proof-of-Concept, Randomized Controlled Study.","Generalized anxiety disorder (GAD) is a prevalent and costly disorder for which many patients may prefer nontraditional treatment. A proof-of-concept study of was conducted to evaluate the acute effects of Swedish massage therapy (SMT) as a monotherapy for the treatment of subjects with GAD. A randomized, single-masked, clinical trial was conducted between March 2012 and May 2013 at the Mood and Anxiety Disorders Program of Emory University. Forty-seven currently untreated subjects with a DSM-IV diagnosis of GAD were randomly assigned to twice-weekly SMT versus a light touch control condition for 6 weeks. The primary outcome measure was reduction in Hamilton Anxiety Rating Scale (HARS) scores after 6 weeks of treatment for SMT versus light touch, as determined by mixed model repeated-measures analysis of 40 evaluable subjects. Mean HARS baseline scores were 20.05 (SD = 3.34) for SMT and 19.58 (SD = 4.90) for light touch. At week 6, the difference in mean (standard error of the mean [SEM]) HARS score reduction was 3.26 points (SMT: -11.67 [1.09]; light touch: -8.41 [1.01]; t‚ÇÅ‚ÇÄ‚ÇÜ = -2.19; P = .030; effect size = -0.69). Treatment group differences were significant (P < .05) starting at the end of week 3. This first monotherapy trial suggests that a complementary and alternative manual therapy, SMT, is an effective acute treatment for GAD. ClinicalTrials.gov identifier: NCT01337713.",Rapaport MH.; Schettler P.; Larson ER.; Edwards SA.; Dunlop BW.; Rakofsky JJ.; Kinkead B.,2016.0,10.4088/JCP.15m10151,0,0,
4505,"A comparison of demographic variables, symptom profiles, and measurements of functioning in symptomatic volunteers and an outpatient clinical population.","There is consistent concern about the generalizability of research findings generated by clinical trials. There are several reasons for concern about these findings: (1) most clinical trials involve symptomatic volunteers who are recruited by means of advertisements rather than patients recruited from general clinical populations; (2) most clinical trials have restrictive criteria for admission into the study; and (3) the design of most trials is not representative of prescribing practices in the community. These methodological issues require investigators to question whether results from trials adequately model what will be seen in a general clinical situation. This report begins to evaluate the representativeness of initial samples by studying the demographic characteristics, symptom profiles, and measurements of functional disability for clinical outpatients and symptomatic volunteers recruited for clinical trials. We found that symptomatic volunteers were statistically more likely to be older than outpatients, were less likely to be single, and reported using more alcohol and cigarettes than outpatients. The two groups had similar levels of functional impairment and similar ages at onset of symptoms, but symptomatic volunteers reported more symptoms of depression and anxiety than outpatients. However, we believe the differences identified in this study did not seem to be clinically significant.",Rapaport MH.; Frevert T.; Babior S.; Zisook S.; Judd LL.,1995.0,,0,0,
4506,The efficacy of new pharmacological treatments for panic disorder: evaluating the trials.,,Rapaport MH.; Davidson JR.,1998.0,,0,0,
4507,The efficacy and safety of dolobid and distalgesic in post-traumatic pain and immobility,,"Rao, S K; Sharma, S K",1982.0,,0,0,
4508,Randomized controlled clinical trial of surgery versus no surgery in patients with mild asymptomatic primary hyperparathyroidism.,"Parathyroidectomy is the definitive therapy for patients with symptomatic primary hyperparathyroidism. However, the role of surgery in mild asymptomatic primary hyperparathyroidism remains controversial. Accordingly, we conducted a prospective, randomized, controlled clinical trial of parathyroidectomy to determine the benefits of surgery vs. adverse effects of no surgery. Fifty-three patients were randomly assigned to either parathyroidectomy (n = 25) or regular follow-up (n = 28). Bone mineral density (BMD), biochemical indices of the disease, quality of life, and psychological function were measured at 6- or 12-month intervals for at least 24 months. Twenty-three of the 25 patients randomized to parathyroidectomy had surgery within the specified time of the protocol and three of the 28 patients randomized to regular follow-up had parathyroidectomy during follow-up. After parathyroidectomy, there was an increase in BMD of the spine (1.2%/yr, P < 0.001), femoral neck (0.4%/yr, P = 0.031), total hip (0.3%/yr, P = 0.07), and forearm (0.4%/yr, P < 0.001) and an expected fall in serum total and ionized calcium, serum PTH, and urine calcium (P < 0.001 for all). In contrast, patients followed up without surgery lost BMD at the femoral neck (-0.4%/yr, P = 0.117) and total hip (-0.6%/yr, P = 0.007) but gained at the spine (0.5%/yr; P = ns) and forearm (0.2%/yr, P = 0.047), with no significant changes in biochemical indices of disease. Consequently, a significant effect of parathyroidectomy on BMD was evident only at the femoral neck (a group difference of 0.8%/yr; P = 0.01) and total hip (a group difference of 1.0%/yr; P = 0.001) but not at the spine (a group difference of 0.6%/yr) or forearm (a group difference of 0.2%/yr). Quality-of-life scores as measured by a 36-item short-form health survey showed significant declines in five of the nine domains (social functioning, physical problem, emotional problem, energy, and health perception) in patients followed up without surgery but in only one of the nine domains (physical function) in the patients who had parathyroidectomy. Consequently, a modest measurable benefit of parathyroidectomy was evident in social and emotional role function (P = 0.007 and 0.012, respectively). Psychological function as assessed by the symptom checklist revised did not change significantly in either group, except for a significant decline in anxiety (P = 0.003) and phobia (P = 0.024) in patients who had surgery in comparison with those who did not. We conclude that it is feasible to conduct a randomized, controlled clinical trial of parathyroidectomy in patients with mild asymptomatic primary hyperparathyroidism, and measurable benefits of surgery on BMD, quality of life, and psychological function can be demonstrated. However, the small but significant benefits of parathyroidectomy must be weighed against the risks of surgery in these otherwise healthy individuals.",Rao DS.; Phillips ER.; Divine GW.; Talpos GB.,2004.0,10.1210/jc.2004-0028,0,0,
4509,Long-term results of endoscopic sympathetic block using the Lin-Telaranta classification.,"Endoscopic thoracic sympathectomy has been used successfully in the treatment of blushing, excessive sweating, and social phobia. However, the adverse effects of endoscopic thoracic sympathectomy are more severe and frequent than the adverse effects of endoscopic sympathetic block (ESB). The use of different blocking levels for different indications in ESB according to the Lin-Telaranta classification further decreases the postoperative adverse effects. However, there are few data on the long-term results of ESB performed using the Lin-Telaranta classification. Ninety-five patients (55 men, 40 women) were interviewed by before the surgery using our routine questionnaire, and the same questionnaire was answered postoperatively by the patients. In addition, a long-term follow-up questionnaire was sent to all patients whose address was known. Forty-seven patients (24 men, 23 women) answered to this questionnaire. The Davidson brief social phobia scale and the Liebowitz quality of life scale were used. Patients were divided to 3 categories: category 1, patients with sweating problems; category 2, patients with blushing; and category 3, and patients with symptoms other than sweating or blushing. Among patients in category 1, social phobia decreased from 12.43 to 6.71 (p = 0.004), in category 2 from 13.97 to 7.69 (p < 0.001), and in category 3 from 13.18 to 9.64 (p = 0.007) during long-term follow-up. Among patients with severe sweating problems preoperatively, sweating decreased from 2.50 to 1.29 (p = 0.003) among patients in category 1 and from 1.86 to 1.16 (p < 0.001) among patients in category 2. Among patients with unbearable blushing, blushing decreased from 4 to 1.80 (p < 0.001). Patients got a clear help from ESB performed using the Lin-Telaranta classification to treat blushing, excessive sweating, and social phobia with and without physical symptoms. In addition, compensatory sweating increased only slightly.",Rantanen T.; Telaranta T.,2013.0,10.1007/s00464-013-2995-3,0,0,
4510,Local-global processing in obsessive-compulsive disorder and comorbid Tourette's syndrome.,"Neuropsychological and neuroimaging studies implicate attentional difficulties in obsessive-compulsive disorder (OCD), but results are inconsistent due possibly to sample heterogeneity and lack of control of comorbid disorders, such as Tourette's syndrome (TS). Nevertheless, it has been suggested that OCD symptomatology may be a result of over-focused attention at a local level. Therefore, this study aimed to examine the ability of OCD patients (pure and comorbid OCD + TS) to process local and global stimuli. Using a local-global paradigm, participants were required to respond to the directed level (local or global) of various stimuli. Results indicate that pure OCD participants were impaired on the global task, whereas comorbid OCD + TS participants had difficulty processing local information. Results are consistent with previously reported lateralisation anomalies and suggest that OCD negatively affects the ability to process hierarchically presented stimuli.",Rankins D.; Bradshaw JL.; Georgiou-Karistianis N.,2005.0,10.1016/j.bandc.2005.04.003,0,0,
4511,The semantic Simon effect in Tourette's syndrome and obsessive-compulsive disorder,"Core symptoms of Tourette's syndrome (TS) and obsessive-compulsive disorder (OCD) may be attributed to an impairment in inhibitory control. Neuropsychological studies have addressed inhibition in both disorders, but findings have been inconsistent. The aim of this study was to examine cognitive inhibition, using a semantic Simon effect paradigm, in patients with TS and OCD. Furthermore, to address comorbidity a group of TS + OCD patients was also examined. Results indicated that patients with TS and OCD were affected by the inhibitory components of the task. TS groups performed similarly to controls on simple and choice RT tasks, but were particularly compromised as increasingly complex inhibitory demands were imposed. OCD patients were slower and committed more errors than controls, especially in the more cognitively demanding conditions, and were particularly disadvantaged by incongruent stimulus-response compatibilities. Findings implicate possible fronto-striatal dysfunction, are consistent with previously reported inhibitory deficits in TS and OCD, and support the theory that comorbid TS + OCD is more closely linked to pure TS than OCD. © 2006 Elsevier Inc. All rights reserved.",Rankins D.; Bradshaw J.L.; Georgiou-Karistianis N.,2006.0,10.1016/j.bandc.2006.01.002,0,0,
4512,Perceived functional impact of abnormal facial appearance.,"Functional facial deformities are usually described as those that impair respiration, eating, hearing, or speech. Yet facial scars and cutaneous deformities have a significant negative effect on social functionality that has been poorly documented in the scientific literature. Insurance companies are declining payments for reconstructive surgical procedures for facial deformities caused by congenital disabilities and after cancer or trauma operations that do not affect mechanical facial activity. The purpose of this study was to establish a large, sample-based evaluation of the perceived social functioning, interpersonal characteristics, and employability indices for a range of facial appearances (normal and abnormal). Adult volunteer evaluators (n = 210) provided their subjective perceptions based on facial physical appearance, and an analysis of the consequences of facial deformity on parameters of preferential treatment was performed. A two-group comparative research design rated the differences among 10 examples of digitally altered facial photographs of actual patients among various age and ethnic groups with ""normal"" and ""abnormal"" congenital deformities or posttrauma scars. Photographs of adult patients with observable congenital and posttraumatic deformities (abnormal) were digitally retouched to eliminate the stigmatic defects (normal). The normal and abnormal photographs of identical patients were evaluated by the large sample study group on nine parameters of social functioning, such as honesty, employability, attractiveness, and effectiveness, using a visual analogue rating scale. Patients with abnormal facial characteristics were rated as significantly less honest (p = 0.007), less employable (p = 0.001), less trustworthy (p = 0.01), less optimistic (p = 0.001), less effective (p = 0.02), less capable (p = 0.002), less intelligent (p = 0.03), less popular (p = 0.001), and less attractive (p = 0.001) than were the same patients with normal facial appearances. Facial deformity caused by trauma, congenital disabilities, and postsurgical sequelae present with significant adverse functional consequences. Facial deformities have a significant negative effect on perceptions of social functionality, including employability, honesty, and trustworthiness. Adverse perceptions of patients with facial deformities occur regardless of sex, educational level, and age of evaluator.",Rankin M.; Borah GL.,2003.0,10.1097/01.PRS.0000060105.63335.0C,0,0,
4513,Effect of bonding amalgam on the reinforcement of teeth,"ER PURPOSEThe purpose of this study was to determine the effect of a bonded amalgam restoration on reinforcement of weakened tooth structure.MATERIAL AND METHODSForty extracted noncarious maxillary premolars were collected. The teeth were prepared individually with mesio-occluso-distal (MOD) cavities with specific dimensions (cavity width buccolingually, 1.8 to 2.1 mm; palatal cusp width, 1.7 to 2.2 mm; cusp height, 4.7 to 5.0 mm) and divided into 4 groups (n=10). The first group was prepared and not restored (control). The other 3 groups were restored with amalgam (Megalloy), bonding agent (Syntac) with amalgam, and amalgam with an adhesive resin luting agent (Resinomer), respectively. Fracture load (in kg) for specimens in all groups was determined by applying a vertical splitting load through a specially shaped steel rod at a crosshead speed of 1 mm/min. The data were analyzed by 1-way analysis of variance and least significant difference statistical tests (alpha=.01).RESULTSThe mean force and standard deviation values required to fracture the cusp of the control and amalgam groups were 25.2+/-3.27 kg and 26.1+/-3.07 kg , respectively, with no significant difference between the 2 groups (P>.01). Significant differences were found between control and Syntac groups (29.8+/-2.80 kg), as well as between control and Resinomer groups (37.9+/-3.55 kg). Significant difference was also noted between Syntac and Resinomer groups (P>.01)CONCLUSIONIt was concluded that the use of resin cement increased the fracture resistance of the tooth with an MOD amalgam restoration.STATEMENT OF PROBLEMExtensively weakened maxillary premolars may be more prone to fracture due to their small size. The weakening may be due to excessive demineralization of supporting tooth structure caused by dental caries or nonconservative or traumatic tooth preparation.","Rasheed, A A",2005.0,10.1016/j.prosdent.2004.10.014,0,0,
4514,"Modification of avoidance behavior: expectancy, autonomic reactivity, and verbal report.",,Rappaport H.,1972.0,,0,0,
4515,The effects of yoga in women with generalized anxiety disorder,"Introduction: GAD is one of the most common disorders in psychiatry, usually observed twice in women than in men. Aims: Considering the side effects of drugs and their financial burden, the purpose of this research was to study the effects of yoga as a complementary treatment on GAD in women. Methods: In a single blind clinical trial the effects of yoga on GAD was studied in 40 women who were diagnosed with GAD by psychiatrist interview, SADS questionnaire and spilberger's anxiety scale in psychiatric clinics. The participants were randomly divided into two intervention and control. All the participants took the usual drugs (SSRIs). The intervention group was given Hata yoga instruction for six weeks, while the control group was only watching movies. At the end of the six week period the spilberger anxiety scale was refilled for both groups. Finally the comparison was done by statistical methods for both groups. Results: The mean ages of intervention and control groups were 37.7± 9.87 and 37.65±10.42 respectively. Improvement was observed in both groups after the six week period. The grades of state and trait anxiety were declined according to spilberger anxiety scale but no statistical difference was observed in two groups regarding improvement. Conclusions: In the present study no statistical difference was observed between two groups however the participants of intervention group were inclined to continue their yoga sessions due to sense of well being. So it is concluded that yoga can have a positive effect on anxiety in long terms.",Ranjbar F.; Hemmati L.; Rezaei S.,2011.0,10.1016/S0924-9338(11)73385-5,0,0,
4516,Caregiver burden and distress following the patient's discharge from psychiatric hospital,"Aims and method Caring for someone with a mental illness is increasingly occurring within the community. As a result, family members who fulfil a caregiving role may experience substantial levels of burden and psychological distress. This study investigates the level of burden and psychological distress reported by caregivers after the patient's admission. Results This study found that the overall level of burden and psychological distress experienced by caregivers did not differ according to the patient's legal status. However, the caregivers of those who were voluntarily admitted supervised the person to a significantly greater extent than the caregivers of those who were involuntarily admitted. Approximately 15% of caregivers revealed high levels of psychological distress. Clinical implications This study may emphasise a need for mental health professionals to examine the circumstances of caregivers, particularly of those caring for patients who are voluntarily admitted, a year after the patient's admission.",Ranieri V.; Madigan K.; Roche E.; McGuinness D.; Bainbridge E.; Feeney L.; Hallahan B.; McDonald C.; O'Donoghue B.,2017.0,10.1192/pb.bp.115.053074,0,0,
4517,Concurrent alcoholism and social anxiety disorder: A first step toward developing effective treatments.,"Investigated if simultaneous treatment of social anxiety disorder (SAD) and alcohol dependence (ALD), compared with treatment of ALD alone, improves alcohol use and social anxiety for clients with dual diagnoses of SAD and ALD. Ss were 93 individuals (mean age 38 yrs) who met Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) diagnostic criteria for both ALD and SAD. Methodology involved a 2-group experimental design that used 12 wks of individual cognitive-behavioral therapy for ALD only (44 Ss) or concurrent treatment for both ALD and SAD (49 Ss). Baseline measures of alcohol usage and social anxiety were completed before treatment start. Outcome data were collected at the end of the 12 wks of treatment and at 3-mo followup. The results show that, although both groups improved significantly from baseline on all drinking outcome measures, the group receiving concurrent alcohol and social anxiety treatment actually faired worse than the group receiving only alcohol treatment. Specifically, alcohol-dependent Ss in the dual treatment group drank more frequently, drank more total drinks, and experienced more frequent heavy drinking days than alcohol-dependent Ss with alcohol-only treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Randall, Carrie L; Thomas, Suzanne; Thevos, Angelica K; Antony, Ballenger, Beck, Beidel, Brown, Butler, Cameron, Carroll, Chambless, Chavira, Coles, Cottraux, Cox, Feske, Gelernter, Hazen, Heimberg, Heimberg, Heimberg, Heimberg, Herbert, Himle, Johnson, Kadden, Kessler, Kessler, Kessler, Kushner, Kushner, Lamberg, Lepine, Liebowitz, Litten, Masia, McLellan, Merikangas, Miller, Moggi, Moutier, Otto, Pande, Randall, Regier, Ross, Schneier, Schneier, Schneier, Schneier, Schuckit, Spitzer, Stein, Stravynski, Thevos, Thomas, Tonigan, Turner, Watson, Weinstock, Zweben",2001.0,,0,0,
4518,Motivational Interviewing as an Adjunct to Cognitive Behavior Therapy for Anxiety Disorders: A Critical Review of the Literature,"Cognitive behavior therapy (CBT) is efficaciously and effectively used in the treatment of anxiety disorders; however, as CBT for anxiety routinely utilizes exposure components, clients often experience ambivalence about treatment and their clinicians often must deal with resistance. Motivational Interviewing (MI) is a therapeutic strategy that addresses ambivalence about change in clinical interventions. MI has been applied as an adjunct for treatments such as CBT in order to increase motivation for and commitment to the intervention, especially when components of the treatment may be challenging (e.g., exposure, cognitive restructuring). Though researchers have commented specifically on the use of MI as a supplement to CBT for anxiety disorders, no comprehensive review has systematically assessed the strengths and limitations of extant literature on the topic, nor across anxiety disorders. Findings are summarized from 6 case studies and uncontrolled trials and 11 randomized controlled trials published through March 2016. An integrated critique of this literature also is offered. Limitations and the preliminary nature of the work in this area notwithstanding, it appears that it is feasible to supplement or integrate CBT with MI and that doing so has the potential to improve treatment initiation and engagement, as well as clinical outcomes. A number of directions for future research are addressed, such as determining which MI approaches to implement, with whom, when, and in what contexts.",Randall C.L.; McNeil D.W.,2017.0,10.1016/j.cbpra.2016.05.003,0,0,
4519,Active music therapy approach in amyotrophic lateral sclerosis: a randomized-controlled trial.,"This randomized controlled study assessed the efficacy of active music therapy (AMT) on anxiety, depression, and quality of life in amyotrophic lateral sclerosis (ALS). Communication and relationship during AMT treatment were also evaluated. Thirty patients were assigned randomly to experimental [AMT plus standard of care (SC)] or control (SC) groups. AMT consisted of 12 sessions (three times a week), whereas the SC treatment was based on physical and speech rehabilitation sessions, occupational therapy, and psychological support. ALS Functional Rating Scale-Revised, Hospital Anxiety and Depression Scale, McGill Quality of Life Questionnaire, and Music Therapy Rating Scale were administered to assess functional, psychological, and music therapy outcomes. The AMT group improved significantly in McGill Quality of Life Questionnaire global scores (P=0.035) and showed a positive trend in nonverbal and sonorous-music relationship during the treatment. Further studies involving larger samples in a longer AMT intervention are needed to confirm the effectiveness of this approach in ALS.",Raglio A.; Giovanazzi E.; Pain D.; Baiardi P.; Imbriani C.; Imbriani M.; Mora G.,2016.0,10.1097/MRR.0000000000000187,0,0,
4520,Efficacy of music therapy in the treatment of behavioral and psychiatric symptoms of dementia.,"Music therapy (MT) has been proposed as valid approach for behavioral and psychologic symptoms (BPSD) of dementia. However, studies demonstrating the effectiveness of this approach are lacking. To assess MT effectiveness in reducing BPSD in subjects with dementia. Fifty-nine persons with dementia were enrolled in this study. All of them underwent a multidimensional assessment including Mini Mental State Examination, Barthel Index and Neuropsychiatry Inventory at enrollment and after 8, 16, and 20 weeks. Subjects were randomly assigned to experimental (n=30) or control (n=29) group. The MT sessions were evaluated with standardized criteria. The experimental group received 30 MT sessions (16 wk of treatment), whereas the control group received educational support or entertainment activities. NPI total score significantly decreased in the experimental group at 8th, 16th, and 20th weeks (interaction time x group: F3,165=5.06, P=0.002). Specific BPSD (ie, delusions, agitation, anxiety, apathy, irritability, aberrant motor activity, and night-time disturbances) significantly improved. The empathetic relationship and the patients' active participation in the MT approach, also improved in the experimental group. The study shows that MT is effective to reduce BPSD in patients with moderate-severe dementia.",Raglio A.; Bellelli G.; Traficante D.; Gianotti M.; Ubezio MC.; Villani D.; Trabucchi M.,,10.1097/WAD.0b013e3181630b6f,0,0,
4521,Efficacy of music therapy in the treatment of behavioral and psychiatric symptoms of dementia,"ER OBJECTIVETo assess MT effectiveness in reducing BPSD in subjects with dementia.METHODFifty-nine persons with dementia were enrolled in this study. All of them underwent a multidimensional assessment including Mini Mental State Examination, Barthel Index and Neuropsychiatry Inventory at enrollment and after 8, 16, and 20 weeks. Subjects were randomly assigned to experimental (n=30) or control (n=29) group. The MT sessions were evaluated with standardized criteria. The experimental group received 30 MT sessions (16 wk of treatment), whereas the control group received educational support or entertainment activities.RESULTSNPI total score significantly decreased in the experimental group at 8th, 16th, and 20th weeks (interaction time x group: F3,165=5.06, P=0.002). Specific BPSD (ie, delusions, agitation, anxiety, apathy, irritability, aberrant motor activity, and night-time disturbances) significantly improved. The empathetic relationship and the patients' active participation in the MT approach, also improved in the experimental group.CONCLUSIONSThe study shows that MT is effective to reduce BPSD in patients with moderate-severe dementia.BACKGROUNDMusic therapy (MT) has been proposed as valid approach for behavioral and psychologic symptoms (BPSD) of dementia. However, studies demonstrating the effectiveness of this approach are lacking.","Raglio, A; Bellelli, G; Traficante, D; Gianotti, M; Ubezio, M C; Villani, D; Trabucchi, M",2008.0,10.1097/WAD.0b013e3181630b6f,0,0,4520
4522,"Role of yoga in modulating fatigue, sleep disturbances, salivary cortisol, and immune measures in breast cancer survivors: A randomized controlled trial","Background: Psychological distress is high in breast cancer patients with metastases and affects their circadian rhythms of sleep and stress hormones. Yoga as a stress reduction and mind-body intervention is increasingly becoming popular among cancer patients globally. In this study we evaluate the effects of an integrated yoga program vs. supportive therapy on these psychoimmune and endocrine outcomes. Methods: Sixty-Six breast cancer survivors with metastatic disease and adequate performance status (Zubrods 0-2) were recruited and randomized to receive yoga or supportive therapy for a period of12 weeks. Subjects completed Pittsburg Insomnia Rating Scale and Fatigue symptom inventory before and after intervention. Diurnal saliva samples were collected and assessed for cortisol (am and pm) using enzyme Immune assay and morning blood samples for Natural killer cell counts determined by flow cytometry before and after intervention. Results: ANCOVA done with respective baseline measure as a covariate between two groups showed significant reductions in fatigue severity (p < 0.001), fatigue interference (p = 0.001), symptom distress (p = 0.008), sleep parameters (p = 0.03), sleep quality of life (p = 0.04) and NK Cell % (p = 0.03). Paired t test showed significant decrease in salivary cortisol in yoga group (p = 0.03) alone. Conclusions: The results offer preliminary support for stress reduction benefits of yoga intervention. However larger randomized controlled trials are needed to validate these findings.",Raghavendra R.M.; Ajaikumar B.S.; Vadiraja H.S.; Patil S.; Diwakar R.B.; Sashidhara P.; Nagarathna R.,2010.0,,0,0,
4523,Relapse following combined treatment discontinuation in a placebo-controlled trial for panic disorder.,"A recent double-blind, placebo-controlled trial (Barlow et al., 2000 JAMA. 283:2529-2536) examined separate and synergistic effects of psychological and pharmacological treatments for panic disorder. One finding warranting further investigation involved relatively high relapse rates of participants who received cognitive-behavioral therapy (CBT) + imipramine when compared with those receiving CBT + placebo. In this article, we investigate why CBT was less effective in protecting against relapse for individuals in the active drug condition. We hypothesized that participants correctly deduced treatment assignments and, for those taking imipramine, this was associated with the belief that they were no longer taking active drug after discontinuation, accounting for increased relapse rates. Contrary to hypothesis, there were no group differences in frequencies of guessing drug or placebo, nor were specific beliefs about taking drug or placebo differentially associated with relapse. Other possible reasons for differential relapse rates and treatment implications are discussed.",Raffa SD.; Stoddard JA.; White KS.; Barlow DH.; Gorman JM.; Shear MK.; Woods SW.,2008.0,10.1097/NMD.0b013e31817cf6f7,0,0,
4524,Anxiogenic effects of the CCKB agonist pentagastrin in humans and dose-dependent increase in plasma C-peptide levels,"Rationale: Cholecystokinin type B (CCKB) receptor agonists such as pentagastrin or CCK-4 have panic-like anxiogenic effects in humans. It has also been shown that CCK-4 can stimulate insulin release and thus C-peptide release from pancreatic islet cells. Combined, these mechanisms may provide a basis for a bioassay. Objectives: Our aim was to study if a pentagastrin bolus injection evokes insulin release (as measured by C-peptide) and if the levels of C-peptide correlate to the anxiogenic effect of pentagastrin. Methods: Pentagastrin was given in bolus IV injections to healthy volunteers at increasing doses (0.003, 0.012, 0.05 and 0.2 μg/kg). Results: A significant increase in the plasma level of C-peptide was observed 2-4 min after the highest dose of pentagastrin. This increase was accompanied by a transient panic-like anxiety within 2 min following pentagastrin, measured using a state anxiety scale. Also, 0.05 μg/kg pentagastrin gave a minor but significant subjective discomfort at the same time interval. The basal plasma level of C-peptide preceding the pentagastrin injection showed a positive correlation to the intensity of the subsequent pentagastrin-induced panic-like anxiety as rated on the state anxiety scale. In addition, basal plasma levels of cortisol were positively correlated to the subsequent pentagastrin-induced increase in plasma C-peptide levels. Conclusions: Our results imply a possible relationship between insulin/C-peptide release and sensitivity to psychotropic activation by CCKB receptor stimulation. Furthermore, we postulate that both basal and pentagastrin-induced plasma levels of C-peptide may possess characteristic phenotype properties for anxiety related traits.",Radu D.; Åhlin A.; Svanborg P.; Lindefors N.,2002.0,10.1007/s00213-002-1044-z,0,0,
4525,Pentagastrin test for anxiety - Psychophysiology and personality,"Rationale: CCKB receptor agonists such as pentagastrin or CCK4 have anxiogenic panic-like effects in humans. Our previous findings are in agreement with a relationship between C-peptide plasma levels (as a measure of insulin release) and sensitivity to psychotropic activation by CCKB receptor stimulation. Objectives: Our present aim was to study the transient humoral, physiological and psychotropic effects of pentagastrin bolus injection and whether personality might affect the outcome. Methods: Pentagastrin was given in bolus i.v. injections to healthy volunteers at increasing doses (0.003, 0.012, 0.05 and 0.2 μg/kg). Physiological parameters were recorded before and during each pentagastrin challenge and humoral variables described previously were included in the analyzes. Subjects rated the discomfort following pentagastrin administration on the state anxiety and discomfort scale (SADS). The Karolinska scale of personality (KSP), anxiety sensitivity index (ASI) and Hamilton anxiety scale (HAS) were used to characterize the subjects before the test. Results: Galvanic skin response (GSR) and heart rate (HR) were significantly increased within 1 min following 0.2 μg/kg pentagastrin, the GSR increase correlating negatively to the C-peptide increase and positively to ratings on SADS. Even the lower dose (0.05 μg/kg pentagastrin) induced a significant increase in GSR. ASI measures correlated weakly to the increase in ratings on SADS following 0.05 μg/kg and 0.2 μg/kg pentagastrin. Conclusions: We found correlations between psychophysiology, humoral response and subjective ratings following pentagastrin administration. CCKB receptor stimulation might reveal phenotype properties predictive of anxiety-related traits, measurable through serum levels of C-peptide. Furthermore, our results support the predictive value of ASI for fearfulness.",Radu D.; Åhlin A.; Svanborg P.; Lindefors N.,2003.0,,0,0,
4526,"Job strain, bullying and violence at work and asthma in peruvian cleaners","Epidemiological studies indicate that cleaners are at increased risk of asthma. Many cleaners work in precarious employment conditions potentially leading to stress, a known risk factor for asthma. Therefore, we aimed to analyse whether the high prevalence of asthma in cleaners might partly be explained by psychosocial working conditions. The study population of this cross-sectional study included 199 cleaners employed at regional public health services in Puno province (Peru). They were compared to 79 unexposed workers from Lima, Peru (response 83%). Both groups answered the short version of the European Working Condition Survey and a modified version of the European Community Respiratory Health screening questionnaire. After multiple imputation, the association between type of job, employment conditions, job strain and control, social support, bullying, violence, distress and asthma (wheeze without cold or use of asthma medication) was assessed. The 12-months prevalence of asthma was 22% among cleaners compared to 5% among unexposed workers (pChi2 = 0.001). Cleaners were more likely than unexposed workers to be female, be non-smokers, work with temporary contracts and as subcontractors, have a high employment insecurity, high strain working conditions and low social support (all pChi2 < 0.05). Twenty six percent vs. 10% reported a high bullying score; 39% vs. 8% had experienced violence during the 12-months prior to the study (both pChi2 < 0.001). High bullying score (adjusted Odds Ratio 5.6; 95% Confidence Interval 1.5-21.4) and violence at the workplace (2.4; 1.1-5.4) were main predictors of asthma. Taking these factors into account, being a cleaner was no longer statistically significantly associated with the outcome (3.5; 0.9-13.8). The poor psychosocial working conditions of cleaners may partly explain the high prevalence of asthma in this group. The underlying mechanism might be a stress-induced inflammatory immune response.",Radon K.; Llanqui U.; Arce A.; Herrera R.; Herbig B.,2016.0,10.1136/oemed-2016-103951.17,0,0,
4527,An informational pathway to the development of a contamination-related memory bias.,"Following from previous research in which post-encoding suggestions of threat led to the development of a memory bias (in the presumed absence of an attentional bias; Senn & Radomsky, 2012), we sought to examine whether the development of a similar threat-relevant memory bias could be fostered via a purely informational pathway. A vignette about a classroom interaction was read aloud to (n = 96) undergraduate participants who then completed a post-encoding recall test. Participants were told that the experimenter forgot to read the last sentence of the vignette, and were then randomly assigned either to the Threat condition, in which the additional statement indicated that a character in the vignette had a highly contagious flu, or to the No-Threat condition, in which the additional statement indicated that a character in the vignette had been accepted to graduate school. A second recall test was then administered. Participants in the Threat condition (but not those in the No-Threat condition) demonstrated aproportionate memory bias in favor of threatening information. This bias was not evident at the initial recall test. Time spent engaging in active recall was not assessed. Also, although the study was designed to minimize demand characteristics, it is possible that these played a role. An explicit memory bias for threat can be created through informational means alone, even when no threat was present at encoding. Results are discussed in terms of pathways to fear and of cognitive approaches to understanding and treating anxiety disorders.",Radomsky AS.; Senn JM.; Lahoud M.; Gelfand LA.,2014.0,10.1016/j.jbtep.2014.02.006,0,0,
4528,"Memory bias, confidence and responsibility in compulsive checking.","Recent research suggests that there is a positive memory bias for threatening information in compulsive cleaners. However, the relationship between OCD and memory is likely to be more complex when the compulsive behaviour is checking. Hence, we decided to explore this relationship in a clinical sample of people who check compulsively. Participants completed a diagnostic interview and were then asked to complete a standard 'baseline' check which normally causes distress/discomfort. Two additional checks were then completed--one under conditions of high responsibility and one under low responsibility. The order of responsibility manipulation was randomized across participants. After each check, participants completed a Memory and Confidence Interview which assessed memory for threat-relevant and threat-irrelevant aspects of the check, and also confidence in memory for the check. One week later, participants came into the laboratory to complete additional Memory and Confidence Interviews after watching a videotape of the checks completed earlier in their own homes. These videotaped checks were taken as conditions of 'no responsibility'. Results show a positive memory bias for threat-relevant information. As responsibility was inflated, this positive memory bias was amplified. Under conditions of no responsibility, no memory bias was detectable. Also, responsibility appears to have had a greater impact on confidence in memory than on memory itself in OCD. The results are discussed in terms of the mnestic deficit theory of OCD and in terms of cognitive-behavioural approaches to understanding the disorder.",Radomsky AS.; Rachman S.; Hammond D.,2001.0,,0,0,
4529,Memory bias in obsessive-compulsive disorder (OCD).,"There is a memory bias associated with depression, and good reason to expect a memory bias associated with anxiety. However, the results of studies reported to date have been ambiguous. Accordingly, an experiment was conducted to assess memory for contamination in people with different types of anxiety. Memory for contaminated stimuli among participants who met DSM-IV criteria for obsessive-compulsive disorder (OCD) and indicated a fear of contamination (n = 10) was compared to memory in a group of anxious controls (n = 10), and in undergraduate students (n = 20). Participants were shown 50 objects, 25 of which were contaminated by the experimenter and 25 which were touched but not contaminated. They then completed a neuropsychological memory assessment, after which the participants were asked to recall all of the objects touched by the experimenter. They were then asked to approach each object and to rate their anxiety about touching it. Finally, participants were asked about their perceptions of the cleanliness of each object. The OCD group had better memory for contaminated objects than for clean ones. Neither control group showed such a bias. Neuropsychological test scores indicated that this bias is not the result of differences in general memory ability. The results are discussed in terms of the memory-deficit theory of OCD and of behavioural and cognitive approaches to understanding the role of information processing in fear and anxiety.",Radomsky AS.; Rachman S.,1999.0,,0,0,
4530,The importance of importance in OCD memory research.,"Investigations of memory and associated phenomena in obsessive-compulsive disorder (OCD) can advance our understanding of this often debilitating problem. Theoretical models predict both the presence and absence of memory biases in favour of threat-relevant information in association with anxiety disorders generally, and with OCD specifically. Two previous experiments (one involving compulsive washing and another involving compulsive checking) that demonstrated such a memory bias are reviewed in the context of the existing literature. Additionally, a new experiment failing to demonstrate such a bias (in association with compulsive ordering and arranging) is presented. The results are discussed in terms of cognitive-behavioural and information processing approaches to understanding OCD. It is argued that experiments which utilize stimuli that are low in ecological validity are unlikely to detect explicit memory biases in OCD. As such, experimental paradigms that are perceived as particularly significant, relevant and important to participants with OCD are encouraged.",Radomsky AS.; Rachman S.,2004.0,10.1016/j.jbtep.2004.04.005,0,0,
4531,The Claustrophobia Questionnaire,"The content and psychometric properties of the Claustrophobia Questionnaire (CLQ) are described. An earlier version of the CLQ was developed to test the hypothesis that claustrophobia is comprised of two distinct but related fears - the fear of suffocation and the fear of restriction [J. Anxiety Disord. 7 (1993) 281.]. The scale was used to assess patients undergoing the magnetic resonance imaging (MRI) procedure [J. Behav. Med. 21 (1998) 255.] and in participants with panic disorder [J. Abnorm. Psychol. 105 (1996) 146; Taylor, S., Rachman, S., & Radomsky, A. S. (1996). The prediction of panic: a comparison of suffocation false alarm and cognitive theories. Unpublished data.]. On the basis of these studies, we decided to revise and shorten the CLQ, collect normative data, and provide information on the scale's predictive and discriminant validity as well as its internal consistency and test-retest reliability. This was done through a set of four interconnected studies that included psychometric analyses of undergraduate and community adult questionnaire responses and behavioural testing. Results indicate that the CLQ has good predictive and discriminant validity as well as good internal consistency and test-retest reliability. The CLQ appears to be a reliable and sensitive measure of claustrophobia and its component fears. We encourage the use of the CLQ in a variety of clinical and research applications. The scale is provided in this paper for public use. Copyright © 2001 Elsevier Science Inc.",Radomsky A.S.; Rachman S.; Thordarson D.S.; McIsaac H.K.; Teachman B.A.,2001.0,10.1016/S0887-6185(01)00064-0,0,0,
4532,A comparison of posttraumatic stress disorder in veterans with and without spinal cord injury.,"The authors assessed effects of paraplegic and quadriplegic spinal cord injuries (SCIs) on posttraumatic stress disorder (PTSD) by comparing severity and prevalence of PTSD in these groups to a sample of controls who experienced traumatic injuries other than SCI. The authors found that veterans with quadriplegia reported significantly less severe current PTSD symptoms than controls who were not significantly different from veterans with paraplegia. These results suggest that sustaining a quadriplegic SCI decreases risk of current PTSD, whereas sustaining a paraplegic SCI is associated with greater risk of PTSD, although the risk is no greater than that incurred from experiencing the trauma itself.",Radnitz CL.; Hsu L.; Tirch DD.; Willard J.; Lillian LB.; Walczak S.; Festa J.; Perez-Strumolo L.; Broderick CP.; Binks M.; Schlein I.; Bockian N.; Green L.; Cytryn A.,1998.0,,0,0,
4533,Effectiveness of group anxiety management with elderly clients of a community psychogeriatric team.,"This study examined the feasibility and efficacy of group cognitive-behavioural treatment of anxiety in elderly patients referred to a community mental health team for the elderly. The referral of elderly anxious patients by GPs to the team was low over the study period. In a small within-subjects controlled trial, treatment was associated with a significant reduction in anxiety symptoms on two of the three primary outcome measures. Change was greatest for cognitive symptoms of anxiety. The impact of the treatment was less in patients with significant physical ill-health and those with chronic anxiety; different management strategies may be needed for these groups.",Radley M.; Redston C.; Bates F.; Pontefract M.,1997.0,,0,0,
4534,Multimodal exposure-based group treatment for peacekeepers with PTSD: A preliminary evaluation.,"Group therapy can effectively reduce posttraumatic stress symptoms. However, the available literature on multifaceted programs for military samples is limited and available studies typically do not evaluate outcomes on a broad range of related problems. This study describes a retrospective evaluation of a multimodal, exposure-based group treatment program for posttraumatic stress disorder (PTSD) and associated symptoms in 22 peacekeeping veterans who successfully completed treatment. Treatment consisted of exposure-based CBT, case management, psycho-education, creative arts therapy, psychomotor therapy, psychodrama, and socio-therapy, which were provided one day a week for approximately 21 months. Analysis of pre- and posttreatment assessments showed that coping styles and professional and personality functioning had improved and that anxiety, somatic, depressive, and PTSD symptoms were reduced after treatment. Because significant improvement was observed on several parameters, the program may have successfully addressed a broad range of problems frequently reported by veterans with complex and chronic PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rademaker, Arthur R; Vermetten, Eric; Kleber, Rolf J; Adams, Agaibi, Allen, Arrindell, Arrindell, Bisson, Bolton, Bradley, Brom, Brown, Butcher, Davidson, Derksen, Derogatis, Evers, Foa, Forbes, Ford, Foy, Frueh, Frueh, Glynn, Hovens, Hovens, Johnson, Kessler, Lyons, Magruder, McNally, Meijer, Owens, Piotrkowski, Rosen, Schnurr, Schreurs, Seligman, Shatan, Solomon, Strassberg, Van der Kolk, Van der Kolk, Van Etten, Yalom",2009.0,,0,0,
4535,The effect of an aversive event on the return of fear.,"An experiment on the return-of-fear (ROF) was carried out on 40 snake- or spider-phobic subjects in order to determine whether an arousing event that occurs shortly before retest influences the magnitude of the ROF. Additionally, we attempted to produce a reinstatement of fear by introducing an unrelated aversive event (shock) after the fear had been reduced. The arousal manipulation successfully increased subjective arousal but not heartrate responsiveness. The increases in subjective arousal were not followed by increases in ROF, and the attempt to produce a reinstatement of fear did not succeed. A significant correlation between speed of fear-reduction and ROF was obtained.",Rachman S.; Whittal M.,1989.0,,0,0,
4536,Reducing contamination by exposure plus safety behaviour.,"It has been proposed that the judicious use of safety behaviour can facilitate improvements in the acceptability of cognitive behaviour therapy (CBT). It was decided to explore the possibility of facilitating CBT by introducing a form of safety behaviour. We sought to assess the degree to which Exposure plus Safety Behaviour (E + SB) is an effective intervention for contamination fears. A comparison was made between the effects of a control condition (Exposure and Response Prevention; ERP) and an experimental condition (Exposure plus Safety Behaviour; E + SB) in which each exposure to a contaminant was followed by the use of a hygienic wipe in a sample of (n = 80) undergraduate students. In session one, each participant touched a confirmed contaminant 20 times. After each exposure participants were asked to report their feelings of contamination, fear, disgust, and danger. In the second session, two weeks later, the same procedure was carried out for a further 16 trials. The ERP and the E + SB conditions both produced large, significant and stable reductions in contamination. Significant reductions in fear, danger and disgust were also reported in both conditions. The treatment was provided to an analogue sample and over two sessions. The use of hygienic wipes, the safety behaviour used in this experiment, did not preclude significant reductions in contamination, disgust, fear and danger. If it is replicated and extended over a longer time-frame, this finding may enable practitioners to enhance the acceptability of cognitive behavioural treatments and boost their effectiveness.",Rachman S.; Shafran R.; Radomsky AS.; Zysk E.,2011.0,10.1016/j.jbtep.2011.02.010,0,0,
4537,How to remain neutral: An experimental analysis of neutralization,"Many patients with obsessive-compulsive problems engage in neutralizing activity to reduce or 'cancel out' the effects of the obsession. In many cases, neutralization is covert and therefore difficult to assess or manipulate experimentally. We hypothesize that neutralization resembles overt compulsions. In particular, it was predicted that: (i) neutralization reduces the anxiety evoked by unacceptable thoughts, and (ii) if neutralization is delayed, anxiety and the urge to neutralize will decay naturally. To test the hypothesis, 63 Ss prone to a cognitive bias known to be associated with obsessional complaints (thought-action fusion) were asked to write a sentence that would evoke anxiety. Measures of anxiety (and other variables of interest such as guilt, responsibility and the likelihood of harm) were taken. Subjects were then instructed to either immediately neutralize (n = 29) or delay for 20 min (n = 34), after which time anxiety and urge to neutralize were re-assessed. The Ss who had neutralized were then instructed to delay, and the Ss who had delayed were now instructed to neutralize, after which time the final assessments were taken. The results confirmed the predictions and supported the hypothesis that neutralization resembles overt compulsions. Of note, there were no differences between anxiety reduction after a 20-min delay, and after immediate neutralization. The problems involved in designing and conducting experiments on covert phenomena are discussed, and the clinical implications of the study are considered.",Rachman S.; Shafran R.; Mitchell D.; Trant J.; Teachman B.,1996.0,10.1016/S0005-7967(96)00051-4,0,0,
4538,Return of fear: underlearning and overlearning.,,Rachman S.; Lopatka C.,1988.0,,0,0,
4539,Sleep Quality Improvement During Cognitive Behavioral Therapy for Anxiety Disorders.,"Despite the ubiquity of sleep complaints among individuals with anxiety disorders, few prior studies have examined whether sleep quality improves during anxiety treatment. The current study examined pre- to posttreatment sleep quality improvement during cognitive behavioral therapy (CBT) for panic disorder (PD; n = 26) or generalized anxiety disorder (GAD; n = 24). Among sleep quality indices, only global sleep quality and sleep latency improved significantly (but modestly) during CBT. Sleep quality improvement was greater for treatment responders, but did not vary by diagnosis. Additionally, poor baseline sleep quality was independently associated with worse anxiety treatment outcome, as measured by higher intolerance of uncertainty. Additional intervention targeting sleep prior to or during CBT for anxiety may be beneficial for poor sleepers.",Ramsawh HJ.; Bomyea J.; Stein MB.; Cissell SH.; Lang AJ.,2016.0,10.1080/15402002.2014.981819,0,0,
4540,Predicting treatment failure in pathological gambling: the role of personality traits.,"The aim of this study was twofold: First, to assess the personality profile of treatment-seeking adult outpatients with pathological gambling compared to a matched control group under the Alternative Five Factor Model perspective, and second, to determine which personality variables would predict treatment outcome. The final total sample consisted of 44 consecutive treatment-seeking pathological gamblers (PGs) and 88 controls paired by age and sex who completed the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ). Twelve months after starting an open program of individual cognitive-behavioral therapy, PGs were categorized as abstinent or treatment failure. PGs scored significantly higher on Neuroticism-Anxiety. Those who had relapsed or dropped out showed higher Impulsivity and Sensation Seeking scores. Impulsivity emerged as a significant predictor of treatment failure. Treatment-seeking PGs scored higher on Neuroticism-Anxiety and Impulsivity appeared as a risk factor of relapsing or dropping out. Our findings support the importance of individual differences in personality on therapy outcomes. The ZKPQ may constitute a useful tool to identify these individual differences that might be considered when making personalized treatment decisions to improve the effectiveness and quality of treatment interventions.",Ramos-Grille I.; Gomà-i-Freixanet M.; Aragay N.; Valero S.; Vallès V.,2015.0,10.1016/j.addbeh.2014.12.010,0,0,
4541,[Operative treatment of central talar fractures].,"Anatomic reduction of talar neck and body fractures with axial realignment and restoration of the articular surfaces of the talus. Displaced talar neck and body fractures. High perioperative risk, soft tissue infection, neurogenic osteoarthropathy. Reduction of the axial alignment of the talus and its joints via bilateral approaches according to the preoperative CT-based planning. A medial malleolar osteotomy may be necessary to approach the talar dome. The blood supply via the deltoid ligament and the sinus tarsi has to be respected. Manipulation of the main fragments with K-wires introduced temporarily; a mini-distractor is helpful in restoring the length. Internal fixation is tailored to the individual fracture pattern, including conventional and headless screws, bioresorbable pins, lost K-wires, and/or minifragment plates. Joint transfixation for 6 weeks to ensure ligamentous healing if instability persists after internal fixation. With severe soft tissue damage, temporary tibiometatarsal external fixation is applied until soft tissue consolidation. Range of motion exercises of the ankle and subtalar joints starting postoperative day 2 except for cases with joint transfixation. Partial weight bearing of 20 kg for 10-12 weeks. Use of a cast or walker for 6 weeks followed by intensive active and passive range of motion exercises of the ankle and subtalar joints. Over 8 years 79 fractures of the talar neck and body were treated. In all, 43 patients with 45 talar neck (n = 30) and body (n = 15) fractures were re-examined clinically and radiologically (mean follow-up 3 years). Definite treatment consisted of open reduction and screw fixation of the talus in 41 cases and small plate fixation in 2 cases supplemented by temporary external fixation for 1-3 weeks in 12 cases. At follow-up, the Maryland Foot Score averaged 86.1 and the AOFAS Ankle/Hindfoot Score averaged 78.9. The Hawkins classification was of prognostic value in talar neck fractures. The functional results and the rate of avascular necrosis (AVN) were unaffected by the time to definite internal fixation. AVN was observed in 11 cases (24%); with only partial AVN involving less than one third of the talar body in 8 of these patients. Due to complete AVN with collapse of the talar dome, 3 patients (6.7%) required fusion. Signs of posttraumatic arthritis of the tibiotalar or subtalar joint were seen in 21 cases (47%). The rate of symptomatic posttraumatic arthritis correlated with the occurrence of total AVN, but not with partial AVN.",Rammelt S.; Winkler J.; Zwipp H.,2013.0,10.1007/s00064-013-0245-4,0,0,
4542,Anxiety management training for anxiety states: positive compared with negative self-statements.,"Twelve patients complaining of chronic free-floating anxiety, usually also with panic attacks, were assigned at random to treatment by six hour-long sessions of anxiety-management training, either with positive or with negative self-statements, given over six weeks. Patients in both treatment conditions improved, with a small trend favouring positive over negative self-instruction, especially at follow-up. It is unclear how much self-instruction, rather than therapeutic attention or mere passage of time, accounted for the bulk of the modest improvement obtained.",Ramm E.; Marks IM.; Yuksel S.; Stern RS.,1982.0,,0,0,
4543,Posttraumatic Distress and Physical Functioning: A Longitudinal Study of Injured Survivors of Community Violence,"This study examines the cross-lagged relationships between posttraumatic distress symptoms and physical functioning, using a sample of 413 persons who were hospitalized for injuries resulting from community violence. Posttraumatic distress was assessed at 1 week, 3 months, and 12 months postinjury, and posttraumatic physical functioning was assessed at 3 months and 12 months. Structural equation modeling was used to assess the prospective relationship between posttraumatic distress symptoms and physical functioning while controlling for demographic characteristics and objective measures of injury severity. Results indicate that posttraumatic distress and physical functioning are reciprocally related. Individuals with high levels of psychological distress at 1 week posttrauma have worse physical functioning at 3 months. Psychological distress at 3 months was not significantly associated with subsequent change in physical functioning at 12 months. Individuals with poor physical functioning at 3 months had higher than expected levels of psychological distress at 12 months. These findings demonstrate a reciprocal relationship between physical and mental health following traumatic injury. Interventions targeting physical recovery may influence subsequent mental health, and therapies aimed at improving early mental health may also have long-term benefits for physical recovery. © 2008 American Psychological Association.",Ramchand R.; Marshall G.N.; Schell T.L.; Jaycox L.H.,2008.0,10.1037/0022-006X.76.4.668,0,0,
4544,Two-year outcomes of MOBILITY Total Ankle Replacement.,"There is little literature on patient-reported outcomes following total ankle replacement in patients with osteoarthritis, posttraumatic osteoarthritis, and rheumatoid arthritis. We compared the differences in demographic data and clinical and patient-reported outcomes among patients with those types of arthritis who underwent total ankle replacement performed with use of the MOBILITY Total Ankle System. Patients were divided into three groups based on the preoperative diagnosis of type of arthritis. We analyzed patient demographic data, American Orthopaedic Foot & Ankle Society (AOFAS) scores, and patient-reported outcomes as measured with use of the Foot and Ankle Outcome Score (FAOS), the 36-item Short-Form (SF-36) Health Survey, and patient-satisfaction scores, collected preoperatively and at one and two years postoperatively. The study included 106 consecutive patients who underwent total ankle replacement between March 2006 and December 2009. The posttraumatic osteoarthritis group, which had twenty-eight patients, was significantly younger (mean age, 54.8 yrs; p < 0.05) than the other groups; the rheumatoid arthritis group, which had twenty-two patients, had a significantly lower mean body mass index (24.5 kg/m(2); p < 0.05); and the osteoarthritis group, which had fifty-six patients, had a higher proportion of males (41 males; p < 0.05). The posttraumatic osteoarthritis group reported better scores for two of the eight domains of the SF-36 preoperatively. At one year postoperatively, the posttraumatic osteoarthritis group and the rheumatoid arthritis group had better FAOS results regarding pain than those of the osteoarthritis group, and the posttraumatic osteoarthritis group also reported better scores for the general health domain of the SF-36. At two years, the posttraumatic group continued to show significantly higher scores for the general health domain of the SF-36. There was no significant difference between the groups in terms of the AOFAS scores, other FAOS results, or the patient-satisfaction scores at one and two years postoperatively. Our findings suggest that early outcomes after total ankle replacement for patients with posttraumatic osteoarthritis are comparable with those for patients with osteoarthritis and rheumatoid arthritis.",Ramaskandhan JR.; Kakwani R.; Kometa S.; Bettinson K.; Siddique MS.,2014.0,10.2106/JBJS.L.00536,0,0,
4545,Is supervision necessary? Examining the effects of internet-based CBT training with and without supervision.,"To investigate the effect of Internet-based training (IBT), with and without supervision, on therapists' (N = 61) cognitive-behavioral therapy (CBT) skills in routine clinical practice. Participants were randomized into 3 conditions: (1) Internet-based training with use of a consultation worksheet (IBT-CW); (2) Internet-based training with CBT supervision via Skype (IBT-S); and (3) ""delayed-training"" controls (DTs), who did not receive the training until all data collection was completed. The IBT participants received access to training over a period of 3 months. CBT skills were evaluated at pre-, mid- and posttraining/wait using assessor competence ratings of recorded therapy sessions. Hierarchical linear analysis revealed that the IBT-S participants had significantly greater CBT competence at posttraining than did IBT-CW and DT participants at both the mid- and posttraining/wait assessment points. There were no significant differences between IBT-CW and the delayed (no)-training DTs. IBT programs that include supervision may be a scalable and effective method of disseminating CBT into routine clinical practice, particularly for populations without ready access to more-traditional ""live"" methods of training. There was no evidence for a significant effect of IBT without supervision over a nontraining control, suggesting that merely providing access to IBT programs may not be an effective method of disseminating CBT to routine clinical practice.",Rakovshik SG.; McManus F.; Vazquez-Montes M.; Muse K.; Ougrin D.,2016.0,10.1037/ccp0000079,0,0,
4546,Web-Based Parenting Skills Program for Pediatric Traumatic Brain Injury Reduces Psychological Distress Among Lower-Income Parents,"ER METHODSPrimary caregivers of 37 children aged 3 to 9 years who sustained a moderate/complicated mild to severe TBI were randomly assigned to the intervention or control group, and both groups were equipped with home Internet access. The online parent training program was designed to increase positive parenting skills and improve caregiver stress management. It consisted of 10 core sessions and up to 4 supplemental sessions. Each session included self-guided Web content, followed by a videoconference call with a therapist to discuss content and practice parenting skills with live feedback. Families in the control group received links to TBI Web resources.RESULTSParent income moderated treatment effects on parent functioning. Specifically, lower-income parents in the parenting skills group reported significant reductions in psychological distress compared with lower-income parents in the control group. No differences were found among higher-income parents for depression, parenting stress, or caregiver efficacy.CONCLUSIONSParent training interventions post-TBI may be particularly valuable for lower-income parents who are vulnerable to both environmental and injury-related stresses.OBJECTIVETo examine changes in parent depression, psychological distress, parenting stress, and self-efficacy among participants in a randomized trial of a Web-based parent training program for pediatric traumatic brain injury (TBI).","Raj, S P; Antonini, T N; Oberjohn, K S; Cassedy, A; Makoroff, K L; Wade, S L",,10.1097/HTR.0000000000000052,0,0,
4547,Cognitive-behavioural intervention in deliberate self-harm.,"The objective of the study was to find the efficacy of cognitive behaviour therapy (CBT) in the management of deliberate self-harm (DSH) patients. The experimental group (n=20) was given 10 sessions of CBT. CBT included cognitive methods, behavioural methods, problem-solving skills training and behavioural counselling to significant others. The control group (n=20) was given routine medical treatment. Post-assessment was done for both groups at the end of 3 months. The analysis of pre-post-assessment revealed that only the experimental group showed significant improvement on all the variables, except on impulsivity. CBT was effective in the management of DSH patients.",Raj M AJ.; Kumaraiah V.; Bhide AV.,2001.0,,0,0,
4548,Effects of clutter on information processing deficits in individuals with hoarding disorder.,"Current cognitive behavioral models of hoarding view hoarding as a multifaceted problem stemming from various information processing deficits. However, there is also reason to suspect that the consequences of hoarding may in turn impact or modulate deficits in information processing. The current study sought to expand upon the existing literature by manipulating clutter to examine whether the presence of a cluttered environment affects information processing. Participants included 34 individuals with hoarding disorder. Participants were randomized into a clutter or non-clutter condition and asked to complete various neuropsychological tasks of memory and attention. Results revealed that hoarding severity was associated with difficulties in sustained attention. However, individuals in the clutter condition relative to the non-clutter condition did not experience greater deficits in information processing. Limitations include the cross-sectional design and small sample size. The current findings add considerably to a growing body of literature on the relationships between information processing deficits and hoarding behaviors. Research of this type is integral to understanding the etiology and maintenance of hoarding.",Raines AM.; Timpano KR.; Schmidt NB.,2014.0,10.1016/j.jad.2014.04.074,0,0,
4549,Examination of a brief anxiety sensitivity cognitive concerns intervention on suicidality among individuals with obsessive-compulsive symptoms.,"A growing body of research has demonstrated elevated rates of suicidality among individuals with obsessive-compulsive disorder (OCD). Recently, it has been proposed that the cognitive concerns component of anxiety sensitivity (AS) may be one factor contributing to this association. AS cognitive concerns, which reflect fears of mental incapacitation, has been found to be associated with OCD and increased suicidality in a number of populations. However, questions remain as to whether reductions in AS cognitive concerns will lead to subsequent reductions in suicidality among individuals with OCD symptoms. In the current study, the sample (N=54) was comprised of individuals with elevated OCD symptoms recruited from the community who were participating in a larger randomized clinical trial. Individuals were randomly assigned to a one-session AS cognitive concerns intervention or a health information control intervention and assessed at post-treatment and one-month follow-up. Results indicated that the active intervention produced significantly greater reductions in AS cognitive concerns immediately post-intervention. Moreover, changes in AS cognitive concerns following the intervention mediated changes in suicidality at one-month follow-up. Findings are discussed in regard to adjunct interventions for OCD.",Raines AM.; Short NA.; Allan NP.; Oglesby ME.; Schmidt NB.,2015.0,10.1016/j.cct.2015.09.006,0,0,
4550,A comparative study of repetition of long sentences skill in Persian-speaking multiple sclerosis patients and healthy subjects,"Introduction: People with progressive neurological diseases such as multiple sclerosis (MS) not only experience speech production deficiencies but also language disorders. Inability in repetition of long sentences is a language difficulty. Ability in repetition of long sentence is a clinical marker of language and cognitive impairment and it can help speech and language therapists to design and implement treatment plans. Therefore, this study carried out with the aim of comparing repetition skill of long sentences in Persian-speaking MS patients and healthy people. Materials and Methods: This is a descriptive-epidemiologic study in which repetition of long sentences was carried out on 20 MS patients from the MS Society of Khuzestan (Iran). The age range of the participants was between 21-54 years (mean age 39.55) and 20 healthy people (mean age 39.50). Data including long sentence repetition skill, the number of errors in functional word omission, and content word omission, and number of spoken words were obtained and analyzed. Results: Results showed that there was a significant different between MS patients and the control group in the mean of long sentence repetition skill (P=0.0001), the number of errors in functional word omission (P=0.004) the number of errors in content word omission (P=0.005) and number of spoken words (P=0.001). Conclusion: Results of this study showed that repetition of long sentence skill and some of the syntactic skills have impaired in MS patients. The results can help speech and language therapists in clinical assessment and interventional programs for MS patients.",Rahimifar P.; Soltani M.; Moradi N.; Madjdinasab N.; Latifi S.M.,2017.0,,0,0,
4551,The efficacy of surgical decompression before 24 hours versus 24 to 72 hours in patients with spinal cord injury from T1 to L1--with specific consideration on ethics: a randomized controlled trial.,"There is no clear evidence that early decompression following spinal cord injury (SCI) improves neurologic outcome. Such information must be obtained from randomized controlled trials (RCTs). To date no large scale RCT has been performed evaluating the timing of surgical decompression in the setting of thoracolumbar spinal cord injury. A concern for many is the ethical dilemma that a delay in surgery may adversely effect neurologic recovery although this has never been conclusively proven. The purpose of this study is to compare the efficacy of early (before 24 hours) verse late (24-72 hours) surgical decompression in terms of neurological improvement in the setting of traumatic thoracolumbar spinal cord injury in a randomized format by independent, trained and blinded examiners. In this prospective, randomized clinical trial, 328 selected spinal cord injury patients with traumatic thoracolumbar spinal cord injury are to be randomly assigned to: 1) early surgery (before 24 hours); or 2) late surgery (24-72 hours). A rapid response team and set up is prepared to assist the early treatment for the early decompressive group. Supportive care, i.e. pressure support, immobilization, will be provided on admission to the late decompression group. Patients will be followed for at least 12 months posttrauma. This study will hopefully assist in contributing to the question of the efficacy of the timing of surgery in traumatic thoracolumbar SCI. RCT registration number: ISRCTN61263382.",Rahimi-Movaghar V.; Saadat S.; Vaccaro AR.; Ghodsi SM.; Samadian M.; Sheykhmozaffari A.; Safdari SM.; Keshmirian B.,2009.0,10.1186/1745-6215-10-77,0,0,
4552,Effectiveness of short-term specialized inpatient treatment for war-related posttraumatic stress disorder: a role for adventure-based counseling and psychodrama.,"Psychological tests were administered to 24 participants of an inpatient posttraumatic stress disorder (PTSD) treatment program both immediately before and following completion of treatment. Responses were compared to a treatment/wait list comparison group composed of 24 subjects awaiting entry into the program. All treatment/wait list comparison group subjects received weekly PTSD outpatient group therapy. Significant improvements were found in the inpatient treatment group in areas of hopelessness, feelings of guilt and shame, loneliness, and emotional expressiveness. Other indices of psychological functional, including interpersonal skills, gender role stress, anxiety, anger, and PTSD symptomatology did not change significantly in response to treatment. No positive changes in any area of psychological function occurred in the treatment/wait list comparison group. Implications for PTSD and areas of future research are discussed.",Ragsdale KG.; Cox RD.; Finn P.; Eisler RM.,1996.0,,0,0,
4553,Influence of dinner music on food intake and symptoms common in dementia.,"The influence of dinner music on food intake and symptoms common in dementia such as depressed mood, irritability and restlessness was studied. The study was carried out in a nursing-home ward in Sweden. Soothing music was played as dinner music for weeks, Swedish tunes form the 1920s and 1930s for two weeks and pop music for two weeks. Prior to these periods, there was one week without music, and at the end of the intervention there was a two-week control period. The effects of the intervention were assessed by psychological ratings and by weighing the food helpings. It was found that during all three music periods the patients ate more in total. The difference was particularly significant for the dessert. The staff were thought to be influenced by the music, as they served the patients more food, both main course and dessert, whenever music was played. The patients were less irritable, anxious and depressed during the music periods. The results of the study suggest that dinner music, particularly soothing music, can reduce irritability, fear-panic and depressed mood and can stimulate demented patients in a nursing-home ward into eating more.",Ragneskog H.; Bråne G.; Karlsson I.; Kihlgren M.,1996.0,,0,0,
4554,Treatment of an obsessional-compulsive disorder by modelling.,,Rachman S.; Hodgson R.; Marzillier J.,1970.0,,0,0,
4555,The treatment of chronic obsessive-compulsive neurosis.,,Rachman S.; Hodgson R.; Marks IM.,1971.0,,0,0,
4556,Studies in desensitization: II. Flooding.,"Investigates the effectiveness of ""flooding"" as a technique for reducing fear. 3 normal Ss who were spider-phobic were given 10 sessions of flooding treatment in which they were exposed to intensely disturbing imaginal stimuli involving spiders. Although strong emotional reactions were provoked by this procedure it did not produce a reduction in fear of the phobic object. The results obtained from Ss in the flooding group were compared with earlier findings and it was found that they did not differ from no-treatment control Ss. The results obtained with Ss who received desensitization under relaxation were superior to those of the flooding and control groups. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rachman, S",1966.0,,0,0,
4557,The moderating effect of self-efficacy on intervention response in women family caregivers of older adults with dementia,"ER This study performed moderator analyses to determine if self-efficacy predicted differential outcome in a randomized trial comparing a cognitive behavior psychoeducational intervention and an enhanced support group (ESG). The four key outcomes were depression, anxiety, social support, and coping. Low baseline self-efficacy scores were hypothesized to be more predictive of positive response in the psychoeducational intervention than in the support group. Change from pre- to posttreatment (baseline to three months) for 213 female caregivers of older adult relatives with dementia (122 Anglos and 91 Latinos) are presented. Caregivers were randomly assigned to either the coping with caregiving class (CWC), a skill-building, small group intervention designed to reduce caregiving stress, or to an enhanced support group (ESG), which used guided discussion and empathic listening to develop within-group reciprocal support. The findings showed that low baseline self-efficacy scores better predicted positive response to treatment in the CWC intervention than in the ESG intervention. This study supports the use of self-efficacy as a screening tool for appropriate caregiver intervention assignment.","Rabinowitz, Y G; Mausbach, B T; Coon, D W; Depp, C; Thompson, L W; Gallagher-Thompson, D",2006.0,10.1097/01.JGP.0000192496.73673.e5,0,0,
4558,Metacognitive therapy for body dysmorphic disorder patients in Iran: acceptability and proof of concept.,"The purpose of the present study was to determine the effect of metacognitive therapy (MCT) on symptoms of body dysmorphic disorder (BDD) and on symptoms of thought-fusion, by means of a wait-list controlled clinical trial. Participants were referred from dermatology and cosmetic surgery clinics in the city of Isfahan, Iran, and 20 patients were selected on the basis of DSM-IV-TR diagnostic criteria for BDD. They were randomly assigned to either the experimental or the wait-list control group. The Yale-Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS) and the Thought-Fusion Inventory (TFI) were used as the outcome measures. The experimental group received 8 weekly metacognitive intervention sessions. The control group was in the waiting-list until the end of the follow-up. Measures were taken at pre-test, post-test (after 2 months) and follow-up (after 6-months). The results of analysis of variance showed that MCT significantly reduced the symptoms of BDD and of thought-fusion, compared to the wait-list. Effects on both outcome measures were maintained at 6-months follow-up.",Rabiei M.; Mulkens S.; Kalantari M.; Molavi H.; Bahrami F.,2012.0,10.1016/j.jbtep.2011.09.013,0,0,
4559,Cardiovascular correlates of motor vehicle accident related posttraumatic stress disorder and its successful treatment.,"Persons with posttraumatic stress disorder (PTSD) have been shown to display elevated baseline cardiovascular activity and a heightened physiological reactivity to trauma-related stimuli. Study 1 examined differences in baseline heart rate (HR) and HR reactivity in 68 survivors of motor vehicle accidents (MVAs) and healthy controls without MVA. MVA survivors with PTSD (n=26), subsyndromal PTSD (n=22), traumatized controls without PTSD (non-PTSD with MVA, n=20) and healthy controls without MVA (HC, n=27) underwent measurement of HR during baseline and exposure to a neutral, positive, negative, and trauma-related picture. PTSD patients showed elevated baseline HR and increased HR reactivity only during exposure to the trauma-related picture. Study 2 investigated whether the elevated physiological responses observed in Study 1 normalized after cognitive behavioral therapy (CBT). We conducted a randomized, controlled treatment trial comparing CBT (n=17) to a Wait-list condition (WLC, n=18). Results showed a greater decrease in HR reactivity for CBT than for WLC. The change in HR reactivity was associated with clinical improvement. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rabe, Sirko; Dorfel, Denise; Zollner, Tanja; Maercker, Andreas; Karl, Anke; Beck, Blake, Blake, Blanchard, Blanchard, Blanchard, Blanchard, Blanchard, Blanchard, Boudewyns, Buckley, Casada, First, Foa, Hautzinger, Hickling, Karl, Keane, Krohne, Lang, Laux, Maercker, Marshall, McDonagh-Coyle, Orr, Orr, Orr, Orr, Rabe, Schnyder, Schuetzwohl, Shalev, Shalev, Tomarken, Veazey, Watson, Wittchen, Zollner",2006.0,,0,0,
4560,Cardiovascular correlates of motor vehicle accident related posttraumatic stress disorder and its successful treatment.,"Persons with posttraumatic stress disorder (PTSD) have been shown to display elevated baseline cardiovascular activity and a heightened physiological reactivity to trauma-related stimuli. Study 1 examined differences in baseline heart rate (HR) and HR reactivity in 68 survivors of motor vehicle accidents (MVAs) and healthy controls without MVA. MVA survivors with PTSD (n=26), subsyndromal PTSD (n=22), traumatized controls without PTSD (non-PTSD with MVA, n=20) and healthy controls without MVA (HC, n=27) underwent measurement of HR during baseline and exposure to a neutral, positive, negative, and trauma-related picture. PTSD patients showed elevated baseline HR and increased HR reactivity only during exposure to the trauma-related picture. Study 2 investigated whether the elevated physiological responses observed in Study 1 normalized after cognitive behavioral therapy (CBT). We conducted a randomized, controlled treatment trial comparing CBT (n=17) to a Wait-list condition (WLC, n=18). Results showed a greater decrease in HR reactivity for CBT than for WLC. The change in HR reactivity was associated with clinical improvement.",Rabe S.; Dörfel D.; Zöllner T.; Maercker A.; Karl A.,2006.0,10.1007/s10484-006-9027-1,0,0,
4561,Impact of comorbid depression on quality of life in male combat Veterans with posttraumatic stress disorder.,"For Veterans with posttraumatic stress disorder (PTSD), depression is a highly comorbid condition. Both conditions have been associated with decreased quality of life, and research suggests that comorbid PTSD and depression may result in worse quality of life than PTSD alone. However, research is needed to elucidate the effect of comorbidity on a broader variety of quality of life domains. In this study, we used baseline data of 158 male combat Veterans taking part in a PTSD treatment trial and examined the unique relationships between quality of life domains and PTSD symptom clusters, major depressive disorder (MDD) diagnosis, and self-reported depressive symptoms. Veterans with comorbid PTSD-MDD reported significantly worse satisfaction-related quality of life than those with PTSD alone, although this finding was largely attributable to PTSD numbing symptoms. Subsequent analyses comparing the effect of numbing symptoms to depressive symptoms revealed that depression exerted a stronger influence, although numbing symptoms were still uniquely associated with quality of life. We discuss implications for treatment and research, as well as the need to address negative affect in Veterans with PTSD.",Raab PA.; Mackintosh MA.; Gros DF.; Morland LA.,2015.0,10.1682/JRRD.2014.05.0130,0,0,
4562,A randomized controlled trial to assess the psychological impact of a family history screening questionnaire in general practice,"Background. It has been postulated that systematic enquiry about patients' family histories of inherited illnesses would lead to a population of 'worried well'. Objective. The purpose of the present study was to evaluate if the use of a family history screening questionnaire (FHSQ) as part of a general practice health check leads to psychological distress. Method. We conducted a randomized controlled trial of a self-administered FHSQ in a single general practice. Individuals who had not had a health check within the previous 2 years were randomized within three age group strata to intervention group (receiving health check and FHSQ) or control group (only receiving health check). A total of 156 patients were offered health checks; 100 accepted and 76 of them were followed through to the 3-month end point. Responses to the six-item Spielberger State-Trait Anxiety Inventory (STAI), Perception of Health questionnaire and Family History Concern questionnaire were compared between intervention and control groups. Results. A two-way analysis of variance on the STAI scores 1 and 2 weeks after the health check with baseline scores as a covariate showed that at both times anxiety was higher in the intervention group than in the controls (F = 6.4; d.f. = 1,73; P = 0.014). Three months later, there was no significant difference between the two groups. The Perception of Health questionnaire only showed a significant result at 1 week, the intervention group having a more pessimistic response to the question eliciting patient's concerns about future health (P = 0.025). Conclusion. Short-term psychological distress due to the family history screening questionnaire was identified but did not persist.",Qureshi N.; Standen P.J.; Hapgood R.; Hayes J.,2001.0,,0,0,
4563,Phenelzine and imipramine in mood reactive depressives. Further delineation of the syndrome of atypical depression,"ER Sixty patients who met Research Diagnostic Criteria for major, intermittent, or minor depressive disorder and had reactive mood without atypical symptoms were treated with imipramine hydrochloride, phenelzine sulfate, or a placebo. These patients, referred to as simple mood reactive depressives, were contrasted with previously published data from 180 atypical depressives. Atypical depressives had the presence of at least one vegetative atypical sign (hypersomnia, hyperphagia, leaden feeling, or rejection sensitivity) but were otherwise indistinguishable from simple mood reactive depressives. In contrast to the atypical depressives for whom phenelzine was effective and imipramine was relatively ineffective, both medications were equivalently good in simple mood reactive depressives. Since all groups did poorly when given a placebo and well when given phenelzine, the salient feature of atypical symptoms may be that they predict poor response to imipramine. Since the difference between imipramine and placebo depends on the diagnostic group, pharmacologic dissection suggests that atypical symptoms in patients with nonautonomous mood may delineate a qualitatively distinct subgroup.","Quitkin, F M; McGrath, P J; Stewart, J W; Harrison, W; Wager, S G; Nunes, E; Rabkin, J G; Tricamo, E; Markowitz, J; Klein, D F",1989.0,,0,0,
4564,"Atypical depression, panic attacks, and response to imipramine and phenelzine. A replication","ER In an initial study with 120 patients with reactive mood and associated atypical symptoms, phenelzine sulfate was superior to imipramine hydrochloride and placebo. Since their response to phenelzine appears to be unique, this suggests that atypical depression may be a distinct subgroup of unipolar depressive illness. Unexpectedly, the benefit of antidepressants was limited to patients who also had spontaneous panic attacks. To help establish the validity of this syndrome, a new sample of 90 atypical depressives was studied. The clinical and demographic characteristics of the original and replication sample were virtually identical at baseline. In addition, the treatment response with either placebo, imipramine, or phenelzine was also indistinguishable in the two patient groups. The outcome in the replication study supports the hypothesis that this may be a distinct unipolar depressive subgroup. In the replication sample, a history of panic attacks did not appear to be a relevant predictor. We discuss the explanations for this discrepancy in the two patient samples.","Quitkin, F M; McGrath, P J; Stewart, J W; Harrison, W; Tricamo, E; Wager, S G; Ocepek-Welikson, K; Nunes, E; Rabkin, J G; Klein, D F",1990.0,,0,0,
4565,Developing a culturally sensitive treatment of post-traumatic stress disorder for Hispanic clients.,"This study presents a model program for the treatment of PTSD among Hispanic clients. The proposed treatment was based on several theoretical formulations such as the constructivist model by Stewart (1992), the developmental perspective within the constructivist model by Mahoney (1991) and Carlsen (1991), and Lazarus and Folkman's appraisal model (1984), and other related cognitive theoretical principals. Program formulation rests on the assumption that Hispanics experience and manifest traumatic disorders in a distinctive way. In particular, it is theorized that there are coping behaviors that are culture specific to the Hispanic clients. Specific techniques and treatment strategies are recommended in light of culture specific attributional styles. The use of anthropological techniques improves understanding between client and therapist, and are described in detail. A historical review of the PTSD concept was carried out in order to better understand its development and evolution. Developmental etiology, symptomatology, and treatment of PTSD among different ethnocultural groups were reviewed. Special emphasis was placed on those articles dealing with the Hispanic population. A critical review of some of the most widely used PTSD assessment instruments was also conducted. Among other factors, this study elaborated on (1) the particular characteristics of the Hispanics as an ethnocultural group; (2) the impact of such characteristics on the development and treatment of PTSD; (3) suggestions for the adaptation of certain cognitive strategies for a better treatment of PTSD among Hispanic clients; (4) a goal attaintment scaling was suggested as a means to evaluate treatment outcomes. Results of this study suggested that the treatment of PTSD among Hispanic clients can be substantially improved by implementing culturally sensitive strategies, specifically designed to address the need of specific subgroups. Continuing research on culture specific approaches to PTSD intervention were also recommended. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Quintana, Rodolfo Alejandro",1997.0,,0,0,
4566,PKC? is genetically linked to memory capacity in healthy subjects and to risk for posttraumatic stress disorder in genocide survivors,"ER Strong memory of a traumatic event is thought to contribute to the development and symptoms of posttraumatic stress disorder (PTSD). Therefore, a genetic predisposition to build strong memories could lead to increased risk for PTSD after a traumatic event. Here we show that genetic variability of the gene encoding PKC? (PRKCA) was associated with memory capacity--including aversive memory--in nontraumatized subjects of European descent. This finding was replicated in an independent sample of nontraumatized subjects, who additionally underwent functional magnetic resonance imaging (fMRI). fMRI analysis revealed PRKCA genotype-dependent brain activation differences during successful encoding of aversive information. Further, the identified genetic variant was also related to traumatic memory and to the risk for PTSD in heavily traumatized survivors of the Rwandan genocide. Our results indicate a role for PKC? in memory and suggest a genetic link between memory and the risk for PTSD.","Quervain, D J; Kolassa, I T; Ackermann, S; Aerni, A; Boesiger, P; Demougin, P; Elbert, T; Ertl, V; Gschwind, L; Hadziselimovic, N; Hanser, E; Heck, A; Hieber, P; Huynh, K D; Klarhöfer, M; Luechinger, R; Rasch, B; Scheffler, K; Spalek, K; Stippich, C; Vogler, C; Vukojevic, V; Stetak, A; Papassotiropoulos, A",2012.0,10.1073/pnas.1200857109,0,0,
4567,Detection of occult wrist fractures by quantitative radioscintigraphy: a prospective study on selected patients.,"To determine the value of quantitative radioscintigraphy (QRS) in the diagnosis of wrist trauma occult fractures. Because of the risk of non-union, the diagnosis of wrist fractures, including scaphoid fractures, is essential but remains difficult despite many imaging modalities. The aim of the study was to assess the benefits of QRS in the diagnosis of occult post-trauma wrist fractures. This prospective study included all patients presenting at the orthopaedic department at Brest University Hospital for wrist pain after trauma with initial normal plain radiographs. Patients with normal radiographs but strongly suspected of fracture underwent QRS consisting of three-phase bone scintigraphy with quantitative analysis. When a fracture was suspected the radiograph and scintigraphy were fused to precisely locate the fracture if the index was higher than 2. If the index was lower than 1.9, fracture was excluded. Between these two indices, other investigations, such as magnetic resonance imaging, were performed. All patients were followed for at least 3 months and reviewed by the same surgeon. Patients underwent a physical examination and possibly other investigations. From April 2006 to July 2008, 87 patients were enrolled (34 women, 53 men; median age 29 years; range, 15-87 years). Among the 46 pathologic bone scintigrams, 55 occult fractures were highlighted. At follow-up, none presented non-union. One had an undetermined QRS. Among the 40 negative results for QRS at follow-up, only one had a non-union. Sensitivity and negative predictive value were 97 and 98%, respectively for carpal fractures. This study highlights the benefit of QRS, which allows the detection of most occult carpal fractures and reduces the risks of complications such as pseudoarthritis.",Querellou S.; Moineau G.; Le Duc-Pennec A.; Guillo P.; Turzo A.; Cotonea Y.; Le Nen D.; Salaun PY.,2009.0,10.1097/MNM.0b013e3283306f87,0,0,
4568,The trajectories of adolescent anxiety and depressive symptoms over the course of a transdiagnostic treatment.,"Anxiety and depressive disorders commonly co-occur during adolescence, share multiple vulnerability factors, and respond to similar psychosocial and pharmacological interventions. However, anxiety and depression may also be considered distinct constructs and differ on some underlying properties. Prior research efforts on evidence-based treatments for youth have been unable to examine the concurrent trajectories of primary anxiety and depressive concerns across the course of treatment. The advent of transdiagnostic approaches for these emotional disorders in youth allows for such examination. The present study examined the separate trajectories of adolescent anxiety and depressive symptoms over the course of a transdiagnostic intervention, the Unified Protocol for the Treatment of Emotional Disorders in Adolescence (UP-A; Ehrenreich et al., 2008), as well as up to six months following treatment. The sample included 59 adolescents ages 12-17 years old (M=15.42, SD=1.71) who completed at least eight sessions of the UP-A as part of an open trial or randomized, controlled trial across two treatment sites. Piecewise latent growth curve analyses found adolescent self-rated anxiety and depressive symptoms showed similar rates of improvement during treatment, but while anxiety symptoms continued to improve during follow-up, depressive symptoms showed non-significant improvement after treatment. Parent-rated symptoms also showed similar rates of improvement for anxiety and depression during the UP-A to those observed for adolescent self-report, but little improvement after treatment across either anxiety or depressive symptoms. To a certain degree, the results mirror those observed among other evidence-based treatments for youth with anxiety and depression, though results hold implications for future iterations of transdiagnostic treatments regarding optimization of outcomes for adolescents with depressive symptoms.",Queen AH.; Barlow DH.; Ehrenreich-May J.,2014.0,10.1016/j.janxdis.2014.05.007,0,0,
4569,Laser acupuncture for mild to moderate depression in a primary care setting--a randomised controlled trial.,"Depression is a major public health problem. There is some evidence supporting the effectiveness of needle acupuncture in its treatment. Laser stimulation, regarded here as a modality of acupuncture, is non-invasive and therefore free of infection risk; and it is acceptable to patients with needle phobia. The technique is relatively easily learned by community-based general practitioners. It is also amenable to sham control and therefore double-blinding in clinical trials. A double-blind randomised controlled trial was conducted to test the efficacy of low level laser acupuncture in mild to moderate depression. Thirty patients with depression were randomised to receive either active or inactive laser treatment. The laser unit could be switched to one of two settings. One switch position delivered active laser acupuncture and the other was inactive (sham). In the active mode, 0.5J was delivered to each of six to eight individually tailored acupuncture sites per visit. All patients were treated twice weekly for four weeks then weekly for a further four weeks. The patients and the acupuncturist were both blinded to conditions. Outcome was assessed using the Beck Depression Inventory at baseline, weeks four and eight during treatment, and at 4 and 12 weeks following the treatment. At the end of the treatment period, Beck Depression Inventory scores fell from baseline by 16.1 points in the intervention group and by 6.8 points in the sham control group (P<0.001). The difference showed only a trend four weeks later, but was again significant after 12 weeks (P=0.007). Laser acupuncture was well tolerated with transient fatigue as the most common adverse effect. Laser acupuncture may be worth further investigation as a treatment for mild to moderate depression in primary care.",Quah-Smith JI.; Tang WM.; Russell J.,2005.0,,0,0,
4570,Intervention effectiveness among war-affected children: a cluster randomized controlled trial on improving mental health,"ER We examined the effectiveness of a psychosocial intervention in reducing mental health symptoms among war-affected children, and the role of peritraumatic dissociation in moderating the intervention impact on posttraumatic stress symptoms (PTSS). School classes were randomized into intervention (n = 242) and waitlist control (n = 240) conditions in Gaza, Palestine. The intervention group participated in 16 extracurriculum sessions of teaching recovery techniques (TRT) and the controls received normal school-provided support. Participants were 10- to 13-year-old Palestinian girls (49.4%) and boys (50.6%). Data on PTSS, depressive symptoms, and psychological distress were collected at baseline (T1), postintervention (T2), and 6-month follow-up (T3). Peritraumatic dissociation was assessed only at baseline. Regression analyses that took regression to the mean and cluster sampling into account were applied. The results on intervention effectiveness were specific to gender and peritraumatic dissociation. At T2, the intervention significantly reduced the proportion of clinical PTSS among boys, and both the symptom level (R(2) = .24), and proportion of clinical PTSS among girls who had a low level of peritraumatic dissociation. The results have implications for risk-specific tailoring of psychosocial interventions in war conditions.","Qouta, S R; Palosaari, E; Diab, M; Punamäki, R L",2012.0,10.1002/jts.21707,0,0,
4571,[Psychological status and its influencing factors on patients undergoing electrophysiology studies and radiofrequency catheter ablation].,"To study the psychological status and its influencing factors in patients before and after electrophysiology studies and radiofrequency catheter ablation (RFCA). 125 inpatients (71 men, 54 women, mean age 42.91 years +/- 16.1 years) who underwent a scheduled electrophysiology studies and RFCA for the first time and fulfilled entry criteria, were enrolled. They were randomly assigned to receiving either a consent which did not detail specific risk (group B) regarding the procedure or one that detailed the risks (group A). All patients were examined by the Chinese version of Symptom Check List-90 (SCL-90) within 24 hours before the procedure (after the consent) and on the third day after. (1) Before the electrophysiology studies and RFCA, scores of anxiety and phobic anxiety constructs were higher than the norm. After the procedure, no specific construct score became higher. (2) After the procedure, patients showed a significantly decrease in the scores of obsessive-compulsive, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychotism constructs, global severity index, total positive symptoms and positive symptom severity index. (3) Women scored higher on somatization, depression, anxiety, phobic anxiety constructs, global severity index and positive symptom total before the procedure. (4) Detail informed consent was not associated with increased mental symptoms when compared with consent that did not detail specific risks. In this study, patients showed slightly anxiety and phobic anxiety before electrophysiology studies and RFCA with women having more mental symptoms before the procedure that called for special attention. Detail information including the course and specific risk regarding the procedure was not associated with increased psychological symptoms. It was suggested that the patients should receive detail information before electrophysiology studies and RFCA.",Qiu YG.; Zhang FR.; Chen JZ.; Zhu JH.; Tao QM.; Zheng LR.; Xu Y.; Zhao LL.,2003.0,,0,0,
4572,Psychological status and its influencing factors on patients undergoing electrophysiology studies and radiofrequency catheter ablation,"ER METHODS125 inpatients (71 men, 54 women, mean age 42.91 years +/- 16.1 years) who underwent a scheduled electrophysiology studies and RFCA for the first time and fulfilled entry criteria, were enrolled. They were randomly assigned to receiving either a consent which did not detail specific risk (group B) regarding the procedure or one that detailed the risks (group A). All patients were examined by the Chinese version of Symptom Check List-90 (SCL-90) within 24 hours before the procedure (after the consent) and on the third day after.RESULTS(1) Before the electrophysiology studies and RFCA, scores of anxiety and phobic anxiety constructs were higher than the norm. After the procedure, no specific construct score became higher. (2) After the procedure, patients showed a significantly decrease in the scores of obsessive-compulsive, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychotism constructs, global severity index, total positive symptoms and positive symptom severity index. (3) Women scored higher on somatization, depression, anxiety, phobic anxiety constructs, global severity index and positive symptom total before the procedure. (4) Detail informed consent was not associated with increased mental symptoms when compared with consent that did not detail specific risks.CONCLUSIONSIn this study, patients showed slightly anxiety and phobic anxiety before electrophysiology studies and RFCA with women having more mental symptoms before the procedure that called for special attention. Detail information including the course and specific risk regarding the procedure was not associated with increased psychological symptoms. It was suggested that the patients should receive detail information before electrophysiology studies and RFCA.OBJECTIVETo study the psychological status and its influencing factors in patients before and after electrophysiology studies and radiofrequency catheter ablation (RFCA).","Qiu, Y G; Zhang, F R; Chen, J Z; Zhu, J H; Tao, Q M; Zheng, L R; Xu, Y; Zhao, L L",2003.0,,0,0,4571
4573,Effects of unilateral decompressive craniectomy on patients with unilateral acute post-traumatic brain swelling after severe traumatic brain injury.,"Acute post-traumatic brain swelling (BS) is one of the pathological forms that need emergent treatment following traumatic brain injury. There is controversy about the effects of craniotomy on acute post-traumatic BS. The aim of the present clinical study was to assess the efficacy of unilateral decompressive craniectomy (DC) or unilateral routine temporoparietal craniectomy on patients with unilateral acute post-traumatic BS. Seventy-four patients of unilateral acute post-traumatic BS with midline shifting more than 5 mm were divided randomly into two groups: unilateral DC group (n = 37) and unilateral routine temporoparietal craniectomy group (control group, n = 37). The vital signs, the intracranial pressure (ICP), the Glasgow outcome scale (GOS), the mortality rate and the complications were prospectively analysed. The mean ICP values of patients in the unilateral DC group at hour 24, hour 48, hour 72 and hour 96 after injury were much lower than those of the control group (15.19 +/- 2.18 mmHg, 16.53 +/- 1.53 mmHg, 15.98 +/- 2.24 mmHg and 13.518 +/- 2.33 mmHg versus 19.95 +/- 2.24 mmHg, 18.32 +/- 1.77 mmHg, 21.05 +/- 2.23 mmHg and 17.68 +/- 1.40 mmHg, respectively). The mortality rates at 1 month after treatment were 27% in the unilateral DC group and 57% in the control group (p = 0.010). Good neurological outcome (GOS Score of 4 to 5) rates 1 year after injury for the groups were 56.8% and 32.4%, respectively (p = 0.035). The incidences of delayed intracranial hematoma and subdural effusion were 21.6% and 10.8% versus 5.4% and 0, respectively (p = 0.041 and 0.040). Our data suggest that unilateral DC has superiority in lowering ICP, reducing the mortality rate and improving neurological outcomes over unilateral routine temporoparietal craniectomy. However, it increases the incidence of delayed intracranial hematomas and subdural effusion, some of which need secondary surgical intervention. These results provide information important for further large and multicenter clinical trials on the effects of DC in patients with acute post-traumatic BS. ISRCTN14110527.",Qiu W.; Guo C.; Shen H.; Chen K.; Wen L.; Huang H.; Ding M.; Sun L.; Jiang Q.; Wang W.,2009.0,10.1186/cc8178,0,0,
4574,Understanding the psychological motives behind microblogging,"ER This research aims to understand the psychological motives behind microblogging. We conducted two studies to investigate if social exclusion and existential anxiety would lead to a high tendency to microblog. Our results show that participants did not use microblogging to satisfy their needs for social connection and affiliation, but highly extraverted participants did use it to relieve their existential anxiety.","Qiu, L; Leung, A K; Ho, J H; Yeung, Q M; Francis, K J; Chua, P F",2010.0,,0,0,
4575,Diffusion tensor imaging studies on chinese patients with social anxiety disorder.,"The aim of this study was to explore white-matter disruption in social anxiety disorder (SAD) patients by using diffusion tensor imaging (DTI) and to investigate the relationship between cerebral abnormalities and the severity of the symptoms. Eighteen SAD patients and age- and gender-matched healthy controls were recruited. DTI scans were performed to measure fractional anisotropy (FA) and apparent diffusion coefficient (ADC) for each subject. We used voxel-based analysis to determine the differences of FA and ADC values between the two groups with two-sample t-tests. The SAD patient showed significantly decreased FA values in the white matter of the left insula, left inferior frontal gyrus, left middle temporal gyrus, and left inferior parietal gyrus and increased ADC values in the left insula, bilateral inferior frontal gyrus, bilateral middle temporal gyrus, and left inferior parietal gyrus. In SAD patients, we observed a significant negative correlation between FA values in the left insula and the total LSAS scores and a positive correlation between the ADC values in the left inferior frontal gyrus and the total LSAS scores. Above results suggested that white-matter microstructural changes might contribute to the neuropathology of SAD.",Qiu C.; Zhu C.; Zhang J.; Nie X.; Feng Y.; Meng Y.; Wu R.; Huang X.; Zhang W.; Gong Q.,2014.0,10.1155/2014/860658,0,0,
4576,A prospective study of anxiety in ICD patients with a pilot randomized controlled trial of cognitive behavioral therapy for patients with moderate to severe anxiety.,"Stress and anxiety are potential consequences from arrhythmias and implantable cardioverter defibrillator (ICD) shocks that can contribute to substantial morbidity. We assessed anxiety associated with an ICD and whether cognitive behavioral therapy (CBT) reduces anxiety. The study consisted of two parts: part 1 (N = 690) was a prospective cross-sectional observational study of consecutive ICD patients. Patients completed the Beck Anxiety Inventory (BAI), Generalized Anxiety Disorder Scale (GAD-7), Florida Shock Anxiety Scale (FSAS), and Florida Patient Acceptance Survey (FPAS) psychometric tests. Part 2 (N = 29) was a pilot randomized controlled trial of CBT (three sessions in 3 months) vs. usual care (UC) in patients with BAI ≥ 19 from part 1. The median BAI and GAD-7 scores were 5 and 2, respectively. By BAI scores, 64.5 % had minimal and 3.9 % had severe anxiety. By GAD-7 scores, 73.0 % had low probability of anxiety and 2.9 % had high anxiety. Higher anxiety levels were associated with recent (p = 0.017) and total number of shocks (p = 0.002). Any shock was associated with fear about shocks (FSAS, p < 0.001) and reduced patient ICD acceptance (FPAS, p = 0.019). In the pilot trial of CBT, median BAI scores decreased from 24.5 to 11 at 1 year (p = 0.031) in the CBT group and GAD-7 scores from 12.5 to 7 (p = 0.063); no significant changes in anxiety scores were observed in the UC group. Severe anxiety was present in a small proportion of ICD patients, but higher anxiety was associated with recent and total number of shocks. The small pilot study suggested that a simple program of CBT might lower moderate-high anxiety with lasting effects to 1 year and supports the need for a larger trial to validate these results. ClinicalTrials.gov identifier: NCT00851071. URL: http://clinicaltrials.gov/ct2/show/NCT00851071?term=anxiety+in+icd+patients+cleveland+clinic&rank=1.",Qintar M.; George JJ.; Panko M.; Bea S.; Broer KA.; St John J.; Blissett KA.; Ching E.; Sears SF.; Pedersen SS.; Pozuelo L.; Chung MK.,2015.0,10.1007/s10840-015-9990-7,0,0,
4577,Norepinephrine challenges in panic patients.,"Six subjects with agoraphobia with panic attacks were pretreated with placebo and restricted use of lorazepam for 4 or 5 days. Then l-norepinephrine was infused intravenously with stepwise increases to 4 to 16 micrograms/min. All subjects developed DSM-III symptoms of a panic attack. Subjective results including idiosyncratic symptoms closely resembled the spontaneous panic attacks of these subjects. Cardiac rhythm and rate changes contradicted subjective reports of racing heart and palpitations. Tachypneic and hypertensive reactivities were benign. Both anxiety symptoms and cardiovascular changes reversed rapidly and spontaneously upon discontinuation of the infusion. To validate the possibility that norepinephrine infusion may specifically and reliably simulate spontaneous panic attacks, the authors recommend further work, particularly blinded controlled studies.",Pyke RE.; Greenberg HS.,1986.0,,0,0,
4578,A single administration of cortisol acutely reduces preconscious attention for fear in anxious young men,"ER Chronically elevated HPA activity has often been associated with fear and anxiety, but there is evidence that single administrations of glucocorticoids may acutely reduce fear. Moreover, peri-traumatic cortisol elevation may protect against development of post-traumatic stress disorder. Hypervigilant processing of threat information plays a role in anxiety disorders and although relations with HPA functioning have been established, causality of these relations remains unclear. Presently, self-reported anxiety and response time patterns on a masked emotional Stroop task with fearful faces were measured in 20 healthy young men after double-blind, placebo-controlled oral administration of 40 mg cortisol. The masked fearful Stroop task measures vocal colornaming response latencies for pictures of neutral and fearful faces presented below the threshold for conscious perception. Results showed increased response times on trials for fearful compared to neutral faces after placebo, but this emotional Stroop effect was acutely abolished by cortisol administration. This effect was most pronounced in subjects with heightened anxiety levels. This is the first evidence showing that exogenous cortisol acutely reduces anxiety-driven selective attention to threat. These results extend earlier findings of acute fear reduction after glucocorticoid administration. This suggests interactions of HPA functioning and vigilant attention in the pathogenesis of anxiety disorders. Possible neuroendocrine mechanisms of action are discussed.","Putman, P; Hermans, E J; Koppeschaar, H; Schijndel, A; Honk, J",2007.0,10.1016/j.psyneuen.2007.05.009,0,0,
4579,Anxiety meets fear in perception of dynamic expressive gaze,"ER This study investigated in 2 experiments whether reflexive cuing of attention that occurs after perception of a gaze cue is greater for fearful than for happy faces in normal participants, as hypothesized from a social neuroscience perspective. To increase neuroecological validity, dynamic stimulus presentation was used to display faces that simultaneously morphed from a neutral expression into a happy or fearful one and shifted eye gaze from the center to the periphery. Shifts of attention resulting from a natural fearful gaze were expected to be related to participants' anxiety traits, in agreement with the often found increased selective attention to threat in anxious participants. Both hypotheses were confirmed: Fearful faces induced stronger gaze cuing than happy faces, and the strength of this cuing effect was correlated to participants' anxiety levels. These results suggest a neural network, which integrates the processing of gaze, expression, and emotional states to adaptively prime vigilance under threatening circumstances.","Putman, P; Hermans, E; Honk, J",2006.0,10.1037/1528-3542.6.1.94,0,0,
4580,Interpersonal problems and outcome in outpatient psychotherapy: findings from a long-term longitudinal study in Germany.,"We used a comprehensive longitudinal data set from Germany to examine trajectories of symptom distress depending on interpersonal problems at study intake measured via the Inventory of Interpersonal Problems-64 (IIP-64; Horowitz, Strau, & Kordy, 1994). Participants (N=622) underwent mid- or long-term outpatient psychotherapy (either psychodynamically oriented psychotherapy, cognitive behavioral therapy, or analytic psychotherapy). Data comprises up to 5 assessments during a 2-year period and was analyzed via hierarchical linear modeling. In the analytic psychotherapy subgroup, initial symptom level was higher in submissive patients. Initial interpersonal problems were not predictive of the rate of symptom change during therapy. Only in psychodynamic treatments, low affiliation positively affected treatment outcome. Interpersonal problems at intake were not related to the number of utilized sessions and utilization rate across treatment subgroups. We discuss the findings and outline future research topics.",Puschner B.; Kraft S.; Bauer S.,2004.0,10.1207/s15327752jpa8303_06,0,0,
4581,Covariation bias for blood-injury stimuli and aversive outcomes,"Three illusory correlation experiments were conducted to determine whether a fear-relevant covariation bias could be demonstrated using different types of fear-relevant stimuli from the blood-injury phobia category. In each experiment, women high and low on blood-injury fear were presented with fear-relevant slides depicting blood or injury, as well as slides from two neutral categories. A shock (aversive outcome), or a tone or no outcome (neutral outcomes) followed each of the 72 slides. Although the relationship between slide types and outcomes was random, subjects in all three experiments overestimated the co-occurrence of shock and blood-injury slides relative to all other slide-outcome combinations. However, there was no significant effect of blood-injury fear on this bias, indicating that, regardless of their blood-injury fear level, humans show an associative bias to selectively associate blood-injury stimuli with aversive outcomes.",Pury C.L.S.; Mineka S.,1997.0,10.1016/S0005-7967(96)00075-7,0,0,
4582,"Suppression of obsession-like thoughts in nonclinical individuals: impact on thought frequency, appraisal and mood state.","Wegner's (1994, Psychological Review, 101, 34-52) research on the paradoxical effect of thought suppression has been incorporated into contemporary cognitive-behavioural models of obsessive-compulsive disorder. However, findings on the effects of thought suppression on thought frequency have been inconsistent and few studies have actually examined the suppression of thoughts that are obsessional in nature. In the present study 219 nonclinical participants were randomly assigned to suppress or not suppress a neutral, obsessional or positive thought during an initial monitoring interval. In a second thought monitoring interval, all participants received instructions not to suppress their target thought. No paradoxical effect of suppression on frequency was observed for any type of thought, although suppression of obsessional thoughts was associated with greater subsequent discomfort and a more negative mood state than suppression of positive or neutral target thoughts.",Purdon C.; Clark DA.,2001.0,,0,0,
4583,A prospective study of the precursors to problem drinking in young adulthood,"ER This study was part of the Jyväskylä Longitudinal Study on Social Development. The subjects (196 males, 173 females) were studied at age 8, 14 and 26. Three components in drinking habits were obtained at age 26: social, problem and controlled drinking. Moderate to severe problem drinking was obtained for 26% of the men and 1% of the women, and mild problem drinking for 23% of the men and 15% of the women. Problem drinking (defined by the CAGE Questionnaire, arrest for alcohol abuse and other indicators of heavy drinking) was directly accounted for by poor school success at age 14 and, for men, by conduct problems and low anxiety. Variables at age 8 that contributed indirectly to adult problem drinking were aggression, low anxiety, low prosociality and poor school success for men, and high anxiety and poor school success for women. Women and men differed in the effect of social anxiety; in men, anxiety was a protective factor against problem drinking; in women, it was a risk factor. Although conduct problems often precede severe problem drinking, other risk factors may exist among sons of alcoholic parents. Parental drinking had a significant threshold effect on male off-springs' drinking: if parental drinking was low, there was less problem drinking among the male offspring than if a mild dependence on alcohol was observed in the parents.","Pulkkinen, L; Pitkänen, T",1994.0,,0,0,
4584,Anxiety disorders in typically developing youth: autism spectrum symptoms as a predictor of cognitive-behavioral treatment,"ER Symptoms of autism spectrum disorder (ASD) were assessed (Social Responsiveness Scale-Parent (SRS-P); coded in-session behavior) in typically-developing, anxiety-disordered children (N = 50) treated with cognitive-behavioral therapy (CBT). Study 1: children with moderate autistic symptomology (per SRS-P) were significantly more likely to improve from family CBT (FCBT) than individual CBT (ICBT; OR = 8.67). Coded behavior did not predict outcome. Study 2: CBT components were compared by treatment and ASD symptom status. At-home exposure completion was greater in FCBT and there was an interaction in child involvement for treatment and ASD status. Though both treatments reduced anxiety, FCBT outperformed ICBT for children with moderate ASD symptoms, a benefit potentially linked to more at-home exposures and greater child involvement in FCBT.","Puleo, C M; Kendall, P C",2011.0,10.1007/s10803-010-1047-2,0,0,
4585,Weight bias among dietetics students: implications for treatment practices.,"Several studies have examined attitudes about obesity among food and nutrition professionals, yielding mixed results, and no experimental research has tested the impact of dietitians' attitudes on their treatment practices or health evaluations with obese patients. This study investigated attitudes of dietetics students toward obese persons and tested whether a patient's body weight influences students' treatment decisions and health evaluations within a randomized experiment. Between the months of September and December 2007, a convenience sample of 182 dietetics undergraduate students (92% women; mean age 23.1+/-5.4 years) from colleges throughout the United States completed online self-report surveys to assess weight bias (using the Fat Phobia Scale). Participants were also randomly assigned to read one of four mock health profiles of patients who varied only by weight-related characteristics (eg, obese or average weight) and sex (male or female), and asked to make judgments about the patient's health status and participation in treatment. To compare group data, multiple analysis of variance was used to test for an effect of the patient's body mass index on participants' health evaluations and their perceptions of patients in each of the four experimental conditions. Correlations were calculated between mean fat phobia scores and perceptions of patients. Participants in all conditions expressed a moderate amount of fat phobia (mean=3.7), and students rated obese patients as being less likely to comply with treatment recommendations compared with nonobese patients (P<0.05). Results from multivariate analysis of variance tests showed students also evaluated obese patients' diet quality and health status to be poorer than nonobese patients, despite equivalent nutritional and health information across weight categories for each sex in patient profiles. In contrast, obese and nonobese patients were rated to be similarly motivated, receptive, and successful in treatment. Implications of these findings for education and intervention in dietetics training are discussed, with emphasis on increasing awareness of weight bias in existing dietetics curricula.",Puhl R.; Wharton C.; Heuer C.,2009.0,10.1016/j.jada.2008.11.034,0,0,
4586,An evidence-based group coping intervention for women living with HIV and history of childhood sexual abuse.,"Women living with HIV/A IDS and a history of childhood sexual abuse often exhibit sexual trauma symptoms and elevated rates of HIV-risk behaviors. In this paper, we describe a coping skills group intervention that reduced traumatic stress and sexual-risk behavior in a recent randomized clinical trial, We focused on clinical issues that emerged among female participants receiving the intervention. Clinical observations showed that recognizing connections between trauma, psychological distress, and high risk behaviors was a new and powerful experience for many participants. Participants successfully applied psychoeducational material, expressing an increased sense of power and control over their relationships and behaviors as they developed more adaptive cognitive and behavioral skills. Women expressed high levels of satisfaction with the intervention. Recommendations for clinical practice are provided. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Puffer, Eve S; Kochman, Arlene; Hansen, Nathan B; Sikkema, Kathleen J; Allers, Arriola, Beck, Beck, Boakes, Bornovalova, Briere, Briere, Briere, Catz, Catz, Cohen, Finkelhor, Folkman, Gore-Felton, Himelhoch, Kalichman, Kalichman, Kaplan, Kimerling, Lazarus, Liebschutz, Masten, Merrill, Najavitz, Noll, Semple, Senn, Sherman, Sikkema, Sikkema, Simonton, Stein, Thompson, Whetten, Wilson, Wilson, Wyatt, Yalom, Zierler",2011.0,,0,0,
4587,An evidence-based group coping intervention for women living with HIV and history of childhood sexual abuse,"ER Women living with HIV/AIDS and a history of childhood sexual abuse often exhibit sexual trauma symptoms and elevated rates of HIV-risk behaviors. In this paper, we describe a coping skills group intervention that reduced traumatic stress and sexual-risk behavior in a recent randomized clinical trial. We focused on clinical issues that emerged among female participants receiving the intervention. Clinical observations showed that recognizing connections between trauma, psychological distress, and high risk behaviors was a new and powerful experience for many participants. Participants successfully applied psychoeducational material, expressing an increased sense of power and control over their relationships and behaviors as they developed more adaptive cognitive and behavioral skills. Women expressed high levels of satisfaction with the intervention. Recommendations for clinical practice are provided.","Puffer, E S; Kochman, A; Hansen, N B; Sikkema, K J",2011.0,10.1521/ijgp.2011.61.1.98,0,0,
4588,Are visual measures of mood superior to questionnaire measures in non-Western settings?,"We hypothesised that, in a non-Western setting where literacy was not universal, a visual measure (the FACES test) would be more valid than a traditional psychiatric questionnaire [the General Health Questionnaire (GHQ)] as a screening test for mood disorders. The study was nested within a randomised controlled trial of 450 patients with a common mental disorder (CMD). Subjects were evaluated at 2, 6 and 12 months after enrolment with the Clinical Interview Standardised-Revised (CISR) (the gold standard), the GHQ5 (the shortened version of the GHQ-12) and the FACES test. Correlation coefficients and Receiver Operating Characteristic (ROC) curves show superiority of the GHQ5 in the detection of CMD based on the CISR, compared with the visual FACES test. Less-educated subjects had particular difficulty completing the FACES. The kappa coefficient of agreement between the two instruments, using the cut-off point for the GHQ5 estimated by the ROC curves, was between 0.70 and 0.75. Contrary to our hypothesis, the questionnaire-based measure was significantly superior to a visual measure of mood, especially for less-educated subjects. A short five-item version of the GHQ has a good discriminatory ability for CMD and may be used as a brief alternative to standardised interviews in clinical and survey settings.",Puertas G.; Patel V.; Marshall T.,2004.0,10.1007/s00127-004-0800-2,0,0,
4589,Psychiatric comorbidity and psychosocial stress in patients with tension-type headache from headache centers in Italy. The Italian Collaborative Group for the Study of Psychopathological Factors in Primary Headaches.,"A multicenter study was carried out in 10 Italian Headache Centers to investigate the prevalence of psychosocial stress and psychiatric disorders listed by the IHS classification as the ""most likely causative factors"" of tension-type headache (TTH). Two hundred and seventeen TTH adult outpatients consecutively recruited underwent a structured psychiatric interview (CIDI-c). The assessment of psychosocial stress events was carried out using an ad hoc questionnaire. The psychiatric disorders that we included in the three psychiatric items of the fourth digit of the IHS classification were depressive disorders for the item depression, anxiety disorders for the item anxiety, and somatoform disorders for the item headache as a delusion or an idea. Diagnoses were made according to DSM-III-R criteria. At least one psychosocial stress event or a psychiatric disorder was detected in 84.8% of the patients. Prevalence of psychiatric comorbidity was 52.5% for anxiety, 36.4% for depression, and 21.7% for headache as a delusion or an idea. Psychosocial stress was found in 29.5% of the patients and did not differ between patients with and without psychiatric comorbidity. Generalized anxiety disorder (83.3%) and dysthymia (45.6%) were the most frequent disorders within their respective psychiatric group. The high prevalence of psychiatric disorders observed in this wide sample of patients emphasizes the need for a systematic investigation of psychiatric comorbidity aimed at a more comprehensive and appropriate clinical management of TTH patients.",Puca F.; Genco S.; Prudenzano MP.; Savarese M.; Bussone G.; D'Amico D.; Cerbo R.; Gala C.; Coppola MT.; Gallai V.; Firenze C.; Sarchielli P.; Guazzelli M.; Guidetti V.; Manzoni G.; Granella F.; Muratorio A.; Bonuccelli U.; Nuti A.; Nappi G.; Sandrini G.; Verri AP.; Sicuteri F.; Marabini S.,1999.0,10.1046/j.1468-2982.1999.1903159.x,0,0,
4590,Effect of propofol on the medial temporal lobe emotional memory system: A functional magnetic resonance imaging study in human subjects,"Background: Subclinical doses of propofol produce anterograde amnesia, characterized by an early failure of memory consolidation. It is unknown how propofol affects the amygdala-dependent emotional memory system, which modulates consolidation in the hippocampus in response to emotional arousal and neurohumoral stress. We present an event-related functional magnetic resonance imaging study of the effects of propofol on the emotional memory system in human subjects. Methods: Thirty-five healthy subjectswere randomized to receive propofol, at an estimated brain concentration of 0.90 μgml-1, or placebo. During drug infusion, emotionally arousing and neutral images were presented in a continuous recognition task, while blood-oxygen-level-dependent activation responses were acquired. After a drug-free interval of 2 h, subsequent memory for successfully encoded items was assessed. Imaging analysis was performed using statistical parametric mapping and behavioural analysis using signal detection models. Results: Propofol had no effect on the stereotypical amygdalar response to emotional arousal, but caused marked suppression of the hippocampal response. Propofol caused memory performance to become uncoupled from amygdalar activation, but it remained correlated with activation in the posterior hippocampus, which decreased in proportion to amnesia. Conclusions: Propofol is relatively ineffective at suppressing amygdalar activation at sedative doses, but abolishes emotional modulation and causes amnesia via mechanisms that commonly involve hyporesponsiveness of the hippocampus. These findings raise the possibility that amygdala-dependent fear systems may remain intact even when a patient has diminished memory of events. This may be of clinical importance in the perioperative development of fear-based psychopathologies, such as post-Traumatic stress disorder.",Pryor K.O.; Root J.C.; Mehta M.; Stern E.; Pan H.; Veselis R.A.; Silbersweig D.A.,2015.0,10.1093/bja/aev038,0,0,
4591,The impact of social support: an analogue investigation of the aftermath of trauma exposure.,"Recent meta-analytic studies suggest that social support plays an important role in regulating the severity of post-traumatic adjustment; however, few studies have manipulated potential underlying mechanisms. This analogue study examined how various social reactions, following trauma exposure, influenced subsequent anxiety, affect, and intrusive thoughts. Ninety-three participants viewed a distressing videotape followed by a portrayal of positive, negative, or neutral social reactions. While negative reactions increased initial negative affect, neutral reactions increased later frequency and severity of intrusive thoughts. Based on this, it was suggested that ""neutral"" social reactions following trauma exposure may have the potential for being highly invalidating and in some circumstances may actually have more negative later effects than overtly negative ones.",Pruitt LD.; Zoellner LA.,2008.0,10.1016/j.janxdis.2007.02.005,0,0,
4592,"A randomized controlled trial of exposure, relaxation, and rescripting therapy and relaxation training for chronic nightmares in trauma-exposed persons: Findings at one week posttreatment.","Nightmares and difficulties with sleep onset and maintenance are frequently reported subsequent to trauma, often become chronic conditions, are significant sources of distress in and of themselves, and are associated with psychopathology. Moreover, nightmares and other sleep problems are often resistant to broader treatments for PTSD. Exposure, Relaxation, and Rescripting Therapy (ERRT) was developed to target trauma-related nightmares. Two randomized controlled trials of ERRT have demonstrated improvements in PTSD symptoms, depression, and sleep quality in addition to nightmare frequency and intensity in comparison to a waitlist control group. This study extended findings by randomizing trauma-exposed, community-dwelling adults to ERRT (n = 16) or relaxation training (RT; n = 13). At 1-week posttreatment, results indicated no differences between ERRT and RT after controlling for scores at baseline. Within group analyses showed ERRT and RT improved sleep quality, insomnia severity, fear of sleep, and daytime sleepiness. However, only the ERRT group showed improvements in nights with nightmares per week, nightmares in the past week, and PTSD symptoms. Analyses of sleep log data was limited due to low return rates but indicated ERRT improved nights with nightmares in the past week, number of nightmares in the past week, and sleep efficiency whereas RT improved number of awakenings. These limited preliminary findings suggest ERRT may be superior to RT, but a larger sample with greater power is needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pruiksma, Kristi M. Ensor",2012.0,,0,0,
4593,Residual sleep disturbances following PTSD treatment in active duty military personnel.,"Objective: Sleep disturbances, including nightmares and insomnia, are frequently reported symptoms of posttraumatic stress disorder (PTSD). Insomnia is one of the most common symptoms to persist after evidence-based PTSD treatment. The purpose of this study was to examine the prevalence of sleep disturbances in a sample of active duty military personnel before and after receiving therapy for PTSD in a clinical trial and to explore the associations of insomnia and nightmares with PTSD diagnosis after treatment. Method: Sleep parameters were evaluated with the PTSD Checklist in 108 active duty U.S. Army soldiers who had completed at least one deployment in support of the wars in Iraq and Afghanistan and who participated in a randomized clinical trial comparing Group Cognitive Processing Therapy-Cognitive Only Version with Group Present-Centered Therapy. Results: Insomnia was the most frequently reported symptom before and after treatment, with 92% reporting insomnia at baseline and 74%-80% reporting insomnia at follow-up. Nightmares were reported by 69% at baseline and by 49%-55% at follow-up. Among participants who no longer met criteria for PTSD following treatment, 57% continued to report insomnia, but only 13% continued to report nightmares. At baseline, 54% were taking sleep medications, but sleep medication use did not affect the overall results. Conclusions: Insomnia was found to be one of the most prevalent and persistent problems among service members receiving PTSD treatment. Nightmares were relatively more positively responsive to treatment. For some service members with PTSD, the addition of specific treatments targeting insomnia and/or nightmares may be indicated. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pruiksma, Kristi E; Taylor, Daniel J; Wachen, Jennifer Schuster; Mintz, Jim; Young-McCaughan, Stacey; Peterson, Alan L; Yarvis, Jeffrey S; Borah, Elisa V; Dondanville, Katherine A; Litz, Brett T; Hembree, Elizabeth A; Resick, Patricia A; Babson, Belleville, Casement, Chard, Foa, Frost, Galovski, Gehrman, Germain, Ho, Keen, McLay, Ohayon, Pruiksma, Resick, Schnurr, Schnurr, Spoormaker, Taylor, Weathers, Zayfert",2016.0,,0,0,
4594,Age and gender predict volume decline in the anterior and posterior hippocampus in early adulthood.,"Magnetic Resonance Imaging (MRI) provides a noninvasive method for investigating brain morphology. Within the medial temporal lobe, special attention has been paid to the hippocampus (HC) and amygdala (AG) because of their role in memory, depression, emotion, and learning. Volume changes in these areas have been observed in conjunction with certain disease states, e.g. Alzheimer's disease, post-traumatic stress disorder, and depression. Aging has also been shown to result in gray matter volume loss of the overall brain, including the HC. With regard to gender specificity, results suggest a larger shrinkage for men of brain gray matter, with controversial observations being made for the HC. With recently refined MRI acquisition and segmentation protocols, the HC and AG of 80 subjects in early adulthood (39 men and 41 women, age 18-42 years) were investigated. Whereas the volume of the AG appeared to be independent of age and gender, a significant negative correlation with age for both left and right HC was found in men (r = -0.47 and -0.44, respectively) but not in women (r = 0.01 and 0.02, respectively). The volume decline in men appeared to be linear, starting at the beginning of the third life decade and approximating 1.5% per annum. Using voxel-based regressional analysis, it was shown that changes with age occurred mostly in the head and tail of the HC. This finding underscores the need to include sociodemographic variables in functional and anatomical MRI designs.",Pruessner JC.; Collins DL.; Pruessner M.; Evans AC.,2001.0,,0,0,
4595,The effectiveness of online cognitive behavioral treatment in routine clinical practice.,"Randomized controlled trails have identified online cognitive behavioral therapy as an efficacious intervention in the management of common mental health disorders. To assess the effectiveness of online CBT for different mental disorders in routine clinical practice. An uncontrolled before-after study, with measurements at baseline, posttest, 6-week follow-up, and 1-year follow-up. 1500 adult patients (female: 67%; mean age: 40 years) with a GP referral for psychotherapy were treated at a Dutch online mental health clinic for symptoms of depression (n = 413), panic disorder (n = 139), posttraumatic stress (n = 478), or burnout (n = 470). Manualized, web-based, therapist-assisted CBT, of which the efficacy was previously demonstrated in a series of controlled trials. Standardized duration of treatment varied from 5 weeks (online CBT for Posttraumatic stress) to 16 weeks (online CBT for Depression). Validated self-report questionnaires of specific and general psychopathology, including the Beck Depression Inventory, the Impact of Event Scale, the Panic Disorder Severity Scale-Self Report, the Oldenburg Burnout Inventory, and the Depression Anxiety Stress Scales. Treatment adherence was 71% (n = 1071). Study attrition was 21% at posttest, 33% at 6-week FU and 65% at 1-year FU. Mixed-model repeated measures regression identified large short-term reductions in all measures of primary symptoms (d = 1.9±0.2 to d = 1.2±0.2; P<.001), which sustained up to one year after treatment. At posttest, rates of reliable improvement and recovery were 71% and 52% in the completer sample (full sample: 55%/40%). Patient satisfaction was high. Results suggest that online therapist-assisted CBT may be as effective in routine practice as it is in clinical trials. Although pre-treatment withdrawal and long-term outcomes require further study, results warrant continued implementation of online CBT.",Ruwaard J.; Lange A.; Schrieken B.; Dolan CV.; Emmelkamp P.,2012.0,10.1371/journal.pone.0040089,0,0,
4596,Diagnostic and prognostic value of compound motor action potential of lower limbs in acute paraplegic patients.,"To evaluate the diagnostic and prognostic contribution of motor nerve conduction studies (NCS) in addition to neurological examination in patients with acute paraplegia. In 79 patients with acute onset of paraplegia due to traumatic or ischaemic damage of the conus medullaris/cauda equina (conus/cauda) or lesion of the mid-thoracic spinal cord (epiconal) neurological (initial and follow-up clinical motor and sensory scores; outcome of ambulatory capacity determined at least 6 months post-trauma) and electrophysiological examinations (motor nerve conduction velocity (MNCV) and compound motor action potential (CMAP) of tibial and peroneal nerves) were performed in parallel. Severe axonal motor neuropathies were significantly caused by conus/cauda lesions (loss of tibial CMAP in 71% and of peroneal CMAP in 68%) compared to patients with epiconal lesion (no loss of tibial CMAP and abolished peroneal CMAP in 14%). The CMAPs were deemed acutely pathological 4 - 14 days post-trauma and were indicative of the severity of conus/cauda lesion while the MNCV remained normal. Follow-up recordings (up to 1 year post trauma) revealed no significant change in the CMAP values. The clinical examination according to the American Spinal Injury Association (ASIA protocol) in contrast to the CMAP values was significantly related to the outcome of ambulatory capacity. In contrast to patients with an epiconal SCI almost all patients with damage of the conus/cauda present a severe axonal neuropathy of the tibial and peroneal nerves. Pathological CMAPs develop as early as 1 - 2 weeks after onset of acute paraplegia. They allow, at an early stage, to differentiate between conus/cauda or epiconal lesion and to assess the severity of conus/cauda lesion. Thereafter follow-up examinations remain stable and a developing worsening of peripheral nerve or spinal cord function, eg due to post-traumatic syringomyelia, may be indicated by a secondary deterioration of CMAP values. The clinical examination, according to the ASIA protocol, in acute paraplegia patients, in contrast to the motor nerve conduction studies, is of prognostic value in predicting the outcome of ambulatory capacity.",Rutz S.; Dietz V.; Curt A.,2000.0,,0,0,
4597,The prognostic significance of psychological factors in the management of chronic bronchitis.,"Eighty-three chronic obstructive bronchitic patients were psychologically assessed before being randomly allocated to 1 of 3 management regimes. The following measures were taken: psychiatric disturbance, personality, social-desirability response set, vocabulary, expectations about treatment, attitudes and beliefs about bronchitis, effect of patient's bronchitis on the family, work, self, physical exercise, smoking, and general health. Outcome was assessed after one month and again one year later, and the measures included physiological tests of lung functioning, an exercise tolerance test, reported symptoms, time off work, drop-out, and death. Contrary to expectations, it was found that psychological variables had some prognostic significance for outcome assessed by medical measures of illness severity. More important was the finding that, in bronchitics under retiring age, weeks off work during the year of the study could be predicted by psychological variables but not by physiological measures of illness severity.",Rutter BM.,1979.0,,0,0,
4598,"Associations between post-traumatic stress symptoms, stimulant use, and treatment outcomes: A secondary analysis of NIDA's Women and Trauma Study.","Background and Objectives: To examine the associations between post-traumatic stress disorder (PTSD) symptoms, stimulant use, and treatment outcomes among dually diagnosed women. Methods: Participants were 141 women who participated in a multisite clinical trial of group treatments for PTSD and addictions. Results: Generalized linear models indicated Seeking Safety (SS; a cognitive-behavioral intervention) was significantly more effective than Women's Health Education (WHE; a control group intervention) in reducing stimulant use at follow-up among women who were heavy stimulant users at pre-treatment and who showed improvements in PTSD symptoms. There were no significant differences between the interventions among women who were light stimulant users at treatment entry. Conclusions and Scientific Significance: These findings suggest that integrated treatment of co-occurring PTSD and addictions may be more effective than general health education approaches for heavy stimulant users. Assessment of frequency of stimulant use among individuals with PTSD symptoms may inform treatment selection for this population. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ruglass, Lesia M; Hien, Denise A; Hu, Mei-Chen; Campbell, Aimee N. C; Back, Back, Baker, Blake, Brady, Cacciola, Chilcoat, Chilcoat, Diggle, Gray, Greenfield, Hien, Hien, Jacobsen, Kessler, Khantzian, Khantzian, McLellan, Miller, Mills, Najavits, Najavits, Najavits, Ouimette, Ouimette, Reynolds, Smith, Stewart, van der Kolk, Weathers",2014.0,,0,0,
4599,"Associations between post-traumatic stress symptoms, stimulant use, and treatment outcomes: a secondary analysis of NIDA's Women and Trauma study","ER BACKGROUND AND OBJECTIVES: To examine the associations between post-traumatic stress disorder (PTSD) symptoms, stimulant use, and treatment outcomes among dually diagnosed women.METHODS: Participants were 141 women who participated in a multisite clinical trial of group treatments for PTSD and addictions.RESULTS: Generalized linear models indicated Seeking Safety (SS; a cognitive-behavioral intervention) was significantly more effective than Women's Health Education (WHE; a control group intervention) in reducing stimulant use at follow-up among women who were heavy stimulant users at pre-treatment and who showed improvements in PTSD symptoms. There were no significant differences between the interventions among women who were light stimulant users at treatment entry.CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: These findings suggest that integrated treatment of co-occurring PTSD and addictions may be more effective than general health education approaches for heavy stimulant users. Assessment of frequency of stimulant use among individuals with PTSD symptoms may inform treatment selection for this population.","Ruglass, L M; Hien, D A; Hu, M C; Campbell, A N",2014.0,10.1111/j.1521-0391.2013.12068.x,0,0,
4600,Web Intervention for Adolescents Affected by Disaster: Population-Based Randomized Controlled Trial.,"To assess the efficacy of Bounce Back Now (BBN), a modular, Web-based intervention for disaster-affected adolescents and their parents. A population-based randomized controlled trial used address-based sampling to enroll 2,000 adolescents and parents from communities affected by tornadoes in Joplin, MO, and several areas in Alabama. Data collection via baseline and follow-up semi-structured telephone interviews was completed between September 2011 and August 2013. All families were invited to access the BBN study Web portal irrespective of mental health status at baseline. Families who accessed the Web portal were assigned randomly to 1 of 3 groups: BBN, which featured modules for adolescents and parents targeting adolescents' mental health symptoms; BBN plus additional modules targeting parents' mental health symptoms; or assessment only. The primary outcomes were adolescent symptoms of posttraumatic stress disorder (PTSD) and depression. Nearly 50% of families accessed the Web portal. Intent-to-treat analyses revealed time √ó condition interactions for PTSD symptoms (B = -0.24, SE = 0.08, p < .01) and depressive symptoms (B = -0.23, SE = 0.09, p < .01). Post hoc comparisons revealed fewer PTSD and depressive symptoms for adolescents in the experimental versus control conditions at 12-month follow-up (PTSD: B = -0.36, SE = 0.19, p = .06; depressive symptoms: B = -0.42, SE = 0.19, p = 0.03). A time √ó condition interaction also was found that favored the BBN versus BBN + parent self-help condition for PTSD symptoms (B = 0.30, SE = 0.12, p = .02) but not depressive symptoms (B = 0.12, SE = 0.12, p = .33). Results supported the feasibility and initial efficacy of BBN as a scalable disaster mental health intervention for adolescents. Technology-based solutions have tremendous potential value if found to reduce the mental health burden of disasters. Web-based Intervention for Disaster-Affected Youth and Families; http://clinicaltrials.gov; NCT01606514.",Ruggiero KJ.; Price M.; Adams Z.; Stauffacher K.; McCauley J.; Danielson CK.; Knapp R.; Hanson RF.; Davidson TM.; Amstadter AB.; Carpenter MJ.; Saunders BE.; Kilpatrick DG.; Resnick HS.,2015.0,10.1016/j.jaac.2015.07.001,0,0,
4601,Psychometric properties of the PTSD Checklist-Civilian Version.,"We examined the psychometric properties of the PTSD Checklist (PCL), a self-report instrument designed to assess symptoms of posttraumatic stress disorder. Three hundred ninety-two participants recruited in a university setting completed the PCL in addition to several well-established self-report instruments designed to assess various forms of psychopathology (e.g., depression, general anxiety, PTSD). Ninety participants returned for readministration of selected measures. Findings provided support for psychometric properties of the PCL, including internal consistency, test-retest reliability, convergent validity, and discriminant validity. Additional strengths of the PCL are discussed.",Ruggiero KJ.; Del Ben K.; Scotti JR.; Rabalais AE.,2003.0,10.1023/A:1025714729117,0,0,
4602,Bounce Back Now! Protocol of a population-based randomized controlled trial to examine the efficacy of a Web-based intervention with disaster-affected families,"ER Disasters have far-reaching and potentially long-lasting effects on youth and families. Research has consistently shown a clear increase in the prevalence of several mental health disorders after disasters, including depression and posttraumatic stress disorder. Widely accessible evidence-based interventions are needed to address this unmet need for youth and families, who are underrepresented in disaster research. Rapid growth in Internet and Smartphone access, as well as several Web based evaluation studies with various adult populations has shown that Web-based interventions are likely to be feasible in this context and can improve clinical outcomes. Such interventions also are generally cost-effective, can be targeted or personalized, and can easily be integrated in a stepped care approach to screening and intervention delivery. This is a protocol paper that describes an innovative study design in which we evaluate a self-help Web-based resource, Bounce Back Now, with a population-based sample of disaster affected adolescents and families. The paper includes description and justification for sampling selection and procedures, selection of assessment measures and methods, design of the intervention, and statistical evaluation of critical outcomes. Unique features of this study design include the use of address-based sampling to recruit a population-based sample of disaster-affected adolescents and parents, telephone and Web-based assessments, and development and evaluation of a highly individualized Web intervention for adolescents. Challenges related to large-scale evaluation of technology-delivered interventions with high-risk samples in time-sensitive research are discussed, as well as implications for future research and practice.","Ruggiero, K J; Davidson, T M; McCauley, J; Gros, K S; Welsh, K; Price, M; Resnick, H S; Danielson, C K; Soltis, K; Galea, S; Kilpatrick, D G; Saunders, B E; Nissenboim, J; Muzzy, W; Fleeman, A; Amstadter, A B",2015.0,10.1016/j.cct.2014.11.018,0,0,
4603,Traditional acupuncture for people with medically unexplained symptoms: a longitudinal qualitative study of patients' experiences,"ER AIMTo ascertain how patients with MUPS perceive and experience five-element acupuncture treatment.DESIGN AND SETTINGA longitudinal qualitative interview study, nested in a randomised controlled trial was carried out in four general practices in socioeconomically diverse areas of London.METHODA purposive sample of 20 trial participants was interviewed twice, at the start and the end of 6 months of acupuncture treatment. Semi-structured interviews were transcribed, coded, and analysed thematically, summarising both across-case as themes and within-case individual vignettes.RESULTSAcupuncture, initially accepted as 'just another referral' - one like many others that had been tried and proved unsuccessful - was valued for the amount of time allotted with a caring practitioner who listened and responded, as well as for the interactive and holistic nature of the sessions. These attributes encouraged many patients to take an active role in their treatment, including making cognitive or behavioural lifestyle changes. Interviewees cited a wide range of changes in their health that spanned physical, psychological, and social dimensions. These were largely positive and included an increase in physical and/or mental energy, as well as feelings of greater personal control, calmness, and relaxation. Three interviewees reported worsening health but did not ascribe this to acupuncture.CONCLUSIONMany patients who were treated with five-element acupuncture perceived a range of positive effects and appeared to take on a more active role in consultations and self-care.BACKGROUNDPeople with medically unexplained physical symptoms (MUPS) are helped by interventions that combine physical and psychological explanations and treatment. Traditional acupuncture may offer such a perspective, but its use for these patients has not been investigated.","Rugg, S; Paterson, C; Britten, N; Bridges, J; Griffiths, P",2011.0,10.3399/bjgp11X577972,0,0,
4604,A Prospective Study of Alexithymia in Obsessive-Compulsive Patients Treated with Multimodal Cognitive-Behavioral Therapy.,"Alexithymia as a predictor of treatment outcome in psychotherapy has often been discussed but rarely evaluated in prospective studies. The present study evaluated the absolute and relative stability of alexithymia in patients with obsessive-compulsive disorder (OCD), and the predictive value of alexithymia for the outcome of treatment. In the methodology, we conducted a prospective study with 42 inpatients receiving intensive, multimodal cognitive-behavioral therapy (CBT). Patients were assessed for alexithymia at pre- and post-treatment with the 20-item Toronto Alexithymia Scale (TAS-20), for obsessive-compulsive symptoms and depression with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the 21-item Hamilton Depression Rating Scale (HDRS). The results stated that OCD and comorbid depression showed a highly significant symptom-reduction from pre- to post-treatment while no absolute changes in the TAS-20 total scores and its factors 1 and 3 occurred. Only factor 2 scores decreased significantly, but with a smaller effect size than the effect sizes for the changes in Y-BOCS and HDRS. It was concluded that our findings support the view that alexithymia is a stable personality trait rather than a state-dependent phenomenon in obsessive-compulsive patients. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Rufer, Michael; Hand, Iver; Braatz, Anne; Alsleben, Heike; Fricke, Susanne; Peter, Helmut; Aarela, Bach, Bach, Bach, Bagby, Bagby, Bagby, Bankier, Cohen, de Zwaan, Derogatis, Elzinga, Fukunishi, Fukunishi, Goodman, Grabe, Hamilton, Hand, Hand, Haviland, Hohagen, Honkalampi, Luminet, Moritz, Parker, Parker, Picardi, Pinard, Porcelli, Porcelli, Saarijarvi, Salminen, Santor, Schmidt, Sifenos, Sifneos, Sifneos, Spitzer, Steketee, Steketee, Taylor, Taylor, Vaiera, Viinamaki, Wise, Wise, Zeitlin, Zeitlin",2004.0,,0,0,
4605,Dissociation as a predictor of cognitive behavior therapy outcome in patients with obsessive-compulsive disorder.,"Previous studies have found a strong association between dissociation and obsessive-compulsive disorder (OCD). The purpose of the present study was to evaluate whether dissociation is a predictor of cognitive behavior therapy (CBT) outcome in patients with OCD. Fifty-two patients with OCD were assessed using the Dissociative Experience Scale (DES), the Yale-Brown Obsessive-Compulsive Scale and the Beck Depression Inventory. CBT lasted on average 9.5 weeks and included exposure therapy. Patients who dropped out due to noncompliance had higher baseline DES scores and depression scores compared to the 43 patients (83%) who completed the study. Significant OCD symptom reduction at posttreatment was observed in study completers with a large effect size (d = 1.7). More severe OCD symptoms at posttreatment were associated with higher DES scores at baseline, and treatment nonresponders had significantly higher baseline DES scores compared to responders. These associations with outcome were mainly due to the DES subfactor absorption-imaginative involvement. In regression analyses, higher absorption-imaginative involvement scores at baseline predicted poorer CBT outcome, even after controlling for depressive symptoms, comorbid axis I disorders and concomitant psychotropic drugs. Results from this preliminary study suggest that higher levels of dissociation (particularly absorption-imaginative involvement) in patients with OCD might predict poorer CBT outcome. If our results can be replicated, treatment outcome might be improved by additional interventions for those patients with OCD who indicate high levels of dissociation, for example by using interventions aimed at improving coping with emotionally stressful situations.",Rufer M.; Held D.; Cremer J.; Fricke S.; Moritz S.; Peter H.; Hand I.,2006.0,10.1159/000089225,0,0,
4606,A prospective study of alexithymia in obsessive-compulsive patients treated with multimodal cognitive-behavioral therapy.,"Alexithymia as a predictor of treatment outcome in psychotherapy has often been discussed but rarely evaluated in prospective studies. The present study evaluated the absolute and relative stability of alexithymia in patients with obsessive-compulsive disorder (OCD), and the predictive value of alexithymia for the outcome of treatment. We conducted a prospective study with 42 inpatients receiving intensive, multimodal cognitive-behavioral therapy (CBT). Patients were assessed for alexithymia at pre- and post-treatment with the 20-item Toronto Alexithymia Scale (TAS-20), for obsessive-compulsive symptoms and depression with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the 21-item Hamilton Depression Rating Scale (HDRS). OCD and comorbid depression showed a highly significant symptom-reduction from pre- to post-treatment while no absolute changes in the TAS-20 total scores and its factors 1 and 3 occurred. Only factor 2 scores decreased significantly, but with a smaller effect size than the effect sizes for the changes in Y-BOCS and HDRS. Alexithymia scores at pre-treatment correlated significantly with alexithymia scores at the end of treatment, indicating its relative stability. In the linear regression analyses, no variables were identified that predicted significantly the outcome of treatment. Our findings support the view that alexithymia is a stable personality trait rather than a state-dependent phenomenon in obsessive-compulsive patients. Alexithymia scores do not predict response to multimodal CBT in OCD. It might be an effect of CBT that patients could at least partly regain or newly learn the capability to describe their feelings.",Rufer M.; Hand I.; Braatz A.; Alsleben H.; Fricke S.; Peter H.,,10.1159/000075541,0,0,
4607,A prospective study of alexithymia in obsessive-compulsive patients treated with multimodal cognitive-behavioral therapy,"ER METHODSWe conducted a prospective study with 42 inpatients receiving intensive, multimodal cognitive-behavioral therapy (CBT). Patients were assessed for alexithymia at pre- and post-treatment with the 20-item Toronto Alexithymia Scale (TAS-20), for obsessive-compulsive symptoms and depression with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the 21-item Hamilton Depression Rating Scale (HDRS).RESULTSOCD and comorbid depression showed a highly significant symptom-reduction from pre- to post-treatment while no absolute changes in the TAS-20 total scores and its factors 1 and 3 occurred. Only factor 2 scores decreased significantly, but with a smaller effect size than the effect sizes for the changes in Y-BOCS and HDRS. Alexithymia scores at pre-treatment correlated significantly with alexithymia scores at the end of treatment, indicating its relative stability. In the linear regression analyses, no variables were identified that predicted significantly the outcome of treatment.CONCLUSIONSOur findings support the view that alexithymia is a stable personality trait rather than a state-dependent phenomenon in obsessive-compulsive patients. Alexithymia scores do not predict response to multimodal CBT in OCD. It might be an effect of CBT that patients could at least partly regain or newly learn the capability to describe their feelings.BACKGROUNDAlexithymia as a predictor of treatment outcome in psychotherapy has often been discussed but rarely evaluated in prospective studies. The present study evaluated the absolute and relative stability of alexithymia in patients with obsessive-compulsive disorder (OCD), and the predictive value of alexithymia for the outcome of treatment.","Rufer, M; Hand, I; Braatz, A; Alsleben, H; Fricke, S; Peter, H",2004.0,10.1159/000075541,0,0,4606
4608,Long-term course and outcome of obsessive-compulsive patients after cognitive-behavioral therapy in combination with either fluvoxamine or placebo: a 7-year follow-up of a randomized double-blind trial.,"Longitudinal studies with very long follow-up periods of patients with obsessive-compulsive disorder (OCD) who have received adequate treatment are rare. In the current study, 30 of 37 inpatients (81%) with severe OCD were followed up 6-8 years after treatment with cognitive-behavioral therapy (CBT) in combination with either fluvoxamine or placebo in a randomized design. The significant improvements (with large effectsizes) in obsessive-compulsive symptoms from pre- to post-treatment (41% reduction on the Y-BOCS) remained stable at follow-up (45 %). Responder rates, defined as > or = 35% reduction on the Y-BOCS, were 67% and 60%, respectively. Depressive symptoms decreased significantly not only from pre- to post-treatment but also during follow-up. Re-hospitalization, which occurred in 11 patients (37 %), was associated with more severe depressive symptoms at pre-treatment and living without a partner. Full symptom remission at follow-up, defined as both Y-BOCS total score < or = 7 and no longer meeting diagnostic criteria for OCD, was achieved by 8 patients (27 %). Patients without full remission at follow-up had a significantly longer history of OCD, assessed at pretreatment, compared to remitted patients. The shortterm treatment outcome had no predictive value for the long-term course. Throughout the naturalistic follow-up, nearly all patients (29 patients) received additional psychotherapy and/or medication. This might indicate that such chronic OCD patients usually need additional therapeutic support after effective inpatient treatment to maintain their improvements over long periods.",Rufer M.; Hand I.; Alsleben H.; Braatz A.; Ortmann J.; Katenkamp B.; Fricke S.; Peter H.,2005.0,10.1007/s00406-004-0544-8,0,0,
4609,Comparison between Vitros 5.1 FS and Cobas Integra 800 in a hospital laboratory,"Objectives: As part of an organizational review, our laboratory was brought to test Vitros 5.1 FS system Ortho Clinical Diagnostics (OCD), in comparison with our existing system. Material: We first evaluated the Vitros 5.1 FS, based on dry and liquid chemistry. Then we compared it with our routine automate, Cobas Integra 800, Roche Diagnostics, characterized by photometry, turbidimetry, fluorescence polarization and specific electrodes. Methods: We evaluated the Vitros 5.1 FS on technical, computer and analytic aspects, calibrations, reproducibility and repeatability being assayed on control material, precision and linearity on serum samples. A comparative study of reproducibility (control material) in comparison with Cobas Integra 800 and correlations on blood and urinary samples were also performed. Conclusion: The Vitros 5.1 FS represents a good alternative to a Cobas Integra 800 for a middle-sized laboratory, if a PC equipped with a validation software and quality control analysis is added. © 2009 Elsevier Masson SAS. All rights reserved.",Roy T.; Demol L.; Debois R.; Blasioli V.; Mairesse J.,2009.0,10.1016/j.immbio.2009.02.004,0,0,
4610,Improvement in cerebral function with treatment of posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) are signature illnesses of the Iraq and Afghanistan wars, but current diagnostic and therapeutic measures for these conditions are suboptimal. In our study, functional magnetic resonance imaging (fMRI) is used to try to differentiate military service members with: PTSD and mTBI, PTSD alone, mTBI alone, and neither PTSD nor mTBI. Those with PTSD are then randomized to virtual reality exposure therapy or imaginal exposure. fMRI is repeated after treatment and along with the Clinician-Administered PTSD Scale (CAPS) and Clinical Global Impression (CGI) scores to compare with baseline. Twenty subjects have completed baseline fMRI scans, including four controls and one mTBI only; of 15 treated for PTSD, eight completed posttreatment scans. Most subjects have been male (93%) and Caucasian (83%), with a mean age of 34. Significant improvements are evident on fMRI scans, and corroborated by CGI scores, but CAPS scores improvements are modest. In conclusion, CGI scores and fMRI scans indicate significant improvement in PTSD in both treatment arms, though CAPS score improvements are less robust.",Roy MJ.; Francis J.; Friedlander J.; Banks-Williams L.; Lande RG.; Taylor P.; Blair J.; McLellan J.; Law W.; Tarpley V.; Patt I.; Yu H.; Mallinger A.; Difede J.; Rizzo A.; Rothbaum B.,2010.0,10.1111/j.1749-6632.2010.05689.x,0,0,
4611,Compelling evidence that exposure therapy for PTSD normalizes brain function.,"Functional magnetic resonance imaging (fMRI) is helping us better understand the neurologic pathways involved in posttraumatic stress disorder (PTSD). We previously reported that military service members with PTSD after deployment to Iraq or Afghanistan demonstrated significant improvement, or normalization, in the fMRI-measured activation of the amygdala, prefrontal cortex and anterior cingulate gyrus following exposure therapy for PTSD. However, our original study design did not include repeat scans of control participants, rendering it difficult to discern how much of the observed normalization in brain activity is attributable to treatment, rather than merely a practice effect. Using the same Affective Stroop task paradigm, we now report on a larger sample of PTSD-positive combat veterans that we treated with exposure therapy, as well as a combat-exposed control group of service members who completed repeat scans at 3-4 month intervals. Findings from the treatment group are similar to our prior report. Combat controls showed no significant change on repeat scanning, indicating that the observed differences in the intervention group were in fact due to treatment. We continue to scan additional study participants, in order to determine whether virtual reality exposure therapy has a different impact on regional brain activation than other therapies for PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Roy, Michael J; Costanzo, Michelle E; Blair, James R; Rizzo, Albert A; Blair, Cox, Forbes, Kerns, Koenigs, Roy, Weathers",2014.0,,0,0,
4612,Exposure therapy for PTSD returns brain function to normal,"Functional magnetic resonance imaging (fMRI) is helping us better understand the neurologic pathways involved in posttraumatic stress disorder (PTSD). We previously reported that military service members with PTSD after deployment to Iraq or Afghanistan demonstrated significant improvement, or normalization, in the fMRI-measured activation of the amygdala, prefrontal cortex and anterior cingulate gyrus following exposure therapy for PTSD. However, our original study design did not include repeat scans of control participants, rendering it difficult to discern how much of the observed normalization in brain activity is attributable to treatment, rather than merely a practice effect. Using the same Affective Stroop task paradigm, we now report on a larger sample of PTSD-positive combat veterans that we treated with exposure therapy, as well as a combat-exposed control group of service members who completed repeat scans at 3-4 month intervals. Findings from the treatment group are similar to our prior report. Combat controls showed no significant change on repeat scanning, indicating that the observed differences in the intervention group were in fact due to treatment. We continue to scan additional study participants, in order to determine whether virtual reality exposure therapy has a different impact on regional brain activation than other therapies for PTSD.",Roy M.J.; Costanzo M.E.; Blair J.R.; Rizzo A.A.,2014.0,,0,0,
4613,Panic disorder in primary care: biopsychosocial differences between recognized and unrecognized patients.,"Studies suggest that the recognition of depression by primary care physicians (PCPs) is most likely in more symptomatic and impaired patients. As part of a randomized effectiveness study in primary care patients with panic disorder, we examined the baseline characteristics of study patients who were recruited by waiting room screen procedure (n=69) versus patients who were referred to the study by their PCP (n=41). Patients referred by their physicians had a significantly higher frequency of panic attacks, more intense attacks, and more anticipatory anxiety on the Panic Disorder Severity Scale, while screen-identified patients were more medically ill and had worse physical functioning on the SP36. There were no differences in anxiety sensitivity, phobic avoidance, depression, other SF36 measures, disability, or medical service utilization. In conclusion, differences in referred versus screened patients are mostly specific for panic attack-related symptoms, consistent with the notion that patients with more prominent physical symptoms (i.e., panic attacks) are more often recognized and referred in busy clinical settings. The better medical status and physical functioning of referred patients may indicate greater physician recognition of panic in patients who appear less medically ill. However, the many clinical and functional similarities between these two patient samples suggests that symptomatic primary care patients with panic may not always be identified by their PCPs and argues for the value of population-based screening for panic in primary care.",Roy-Byrne PP.; Katon W.; Cowley DS.; Russo JE.; Cohen E.; Michelson E.; Parrot T.,,,0,0,
4614,Cognitive-behavioral therapy augmentation of SSRI reduces cortisol levels in older adults with generalized anxiety disorder: A randomized clinical trial.,"Objectives: Elevated cortisol in stress and aging, such as has been seen in late-life anxiety disorders, is postulated to accelerate cognitive and physiological decline in this large and increasing population. Selective serotonin-reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) are both effective treatments for generalized anxiety disorder (GAD) in older adults. On the other hand, there is very little research examining the effect of combining these therapies on peak cortisol levels. For the current analyses, we examined the effectiveness of CBT augmentation on peak cortisol levels in older adults diagnosed with GAD. Methods: The sample consisted of 42 individuals with late-life GAD who received an acute course of the SSRI escitalopram and then entered a 16-week randomized phase. Twenty-one participants were randomized to receive 16 sessions of CBT in addition to continuing escitalopram and the remaining 21 participants continued on escitalopram without CBT. Generalized estimating equations were performed to assess the effectiveness of CBT augmentation on peak cortisol levels (30 min after waking). Results: Older adults with GAD who received both escitalopram and CBT demonstrated a significant reduction in peak cortisol levels at posttreatment compared to the group who received escitalopram without CBT augmentation. Conclusions: CBT augmentation of SSRI treatment reduced peak cortisol levels for older adults with GAD. Since persistently high cortisol levels in aging are thought to increase age-related cognitive and medical problems, our findings suggest that there may be a benefit to health and cognition of CBT augmentation for late-life anxiety disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Impact Statement What is the public health significance of this article?-The current study provides support for a physiological benefit using CBT augmentation of SSRI in older adults with GAD. If in fact chronically high cortisol is causally influencing the range of deleterious health and cognitive outcomes of late-life anxiety and other stress disorders, this behavioral strategy could mitigate these outcomes via cortisol reduction. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rosnick, Christopher B; Wetherell, Julie L; White, Kamila S; Andreescu, Carmen; Dixon, David; Lenze, Eric J; Abelson, Abelson, Angst, Ansseau, Ayers, Beekman, Brand, Butters, Byers, Campbell, Carter, Caudle, Chaudieu, Dierckx, Donegan, First, Fisher, Folstein, Goncalves, Goncalves, Gould, Grant, Gum, Gunay, Hamilton, Katz, Kirschbaum, Lenze, Lenze, Lenze, Lenze, Lenze, Liang, Mantella, Mantella, Meyer, Miller, Mitte, Mohlman, Mohlman, Nater, Pinquart, Porensky, Pruessner, Romera, Rosnick, Schuurmans, Stanley, Stanley, Sunderland, Tafet, Thorp, Vasiliadis, Wetherell, Wetherell, Wetherell, Wolitzky-Taylor, Wurz",2016.0,,0,0,
4615,Cognitive-behavioral therapy augmentation of SSRI reduces cortisol levels in older adults with generalized anxiety disorder: A randomized clinical trial.,"Elevated cortisol in stress and aging, such as has been seen in late-life anxiety disorders, is postulated to accelerate cognitive and physiological decline in this large and increasing population. Selective serotonin-reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) are both effective treatments for generalized anxiety disorder (GAD) in older adults. On the other hand, there is very little research examining the effect of combining these therapies on peak cortisol levels. For the current analyses, we examined the effectiveness of CBT augmentation on peak cortisol levels in older adults diagnosed with GAD. The sample consisted of 42 individuals with late-life GAD who received an acute course of the SSRI escitalopram and then entered a 16-week randomized phase. Twenty-one participants were randomized to receive 16 sessions of CBT in addition to continuing escitalopram and the remaining 21 participants continued on escitalopram without CBT. Generalized estimating equations were performed to assess the effectiveness of CBT augmentation on peak cortisol levels (30 min after waking). Older adults with GAD who received both escitalopram and CBT demonstrated a significant reduction in peak cortisol levels at posttreatment compared to the group who received escitalopram without CBT augmentation. CBT augmentation of SSRI treatment reduced peak cortisol levels for older adults with GAD. Since persistently high cortisol levels in aging are thought to increase age-related cognitive and medical problems, our findings suggest that there may be a benefit to health and cognition of CBT augmentation for late-life anxiety disorders.",Rosnick CB.; Wetherell JL.; White KS.; Andreescu C.; Dixon D.; Lenze EJ.,2016.0,10.1037/a0040113,0,0,
4616,Developmentally adapted cognitive processing therapy for adolescents and young adults with PTSD symptoms after physical and sexual abuse: study protocol for a randomized controlled trial.,"Although childhood sexual and/or physical abuse (CSA/CPA) is known to have severe psychopathological consequences, there is little evidence on psychotherapeutic interventions for adolescents and young adults suffering from post-traumatic stress disorder (PTSD). Equally sparse are data on moderators of treatment response on PTSD-related epigenetic changes, health care costs and loss of productivity, alterations in cognitive processing, and on how successful interventions affect all of these factors. Early treatment may prevent later (co)morbidity. In this paper, we present a study protocol for the evaluation of a newly developed psychotherapeutic manual for PTSD after CSA/CPA in adolescents and young adults - the Developmentally Adapted Cognitive Processing Therapy (D-CPT). In a multicenter randomized controlled trial (RCT) D-CPT is compared to treatment as usual (TAU). A sample of 90 adolescent outpatients aged 14 to 21 years will be randomized to one of these conditions. Four assessments will be carried out at baseline, at end of treatment, and 3 and 6 months after end of therapy. Each time, patients will be assessed via clinical interviews and a wide range of questionnaires. In addition to PTSD symptoms and comorbidities, we will evaluate moderators of treatment response, epigenetic profiles, direct and indirect costs of this disorder, and neurophysiological processing of threat cues in PTSD and their respective changes in the course of these two treatments (D-CPT and TAU). The study will provide new insights in the understudied field of PTSD in adolescents and young adults. A newly developed intervention will be evaluated in this therapeutically underserved population. Results will provide data on treatment efficacy, direct and indirect treatment costs, as well as on associations of treatment outcome and PTSD intensity both to epigenetic profiles and to the neurobiological processing of threat cues. Besides, they will help to learn more about the psychopathology and possible new objective correlates of PTSD. Germanctr.de identifier: DRKS00004787.",Rosner R.; König HH.; Neuner F.; Schmidt U.; Steil R.,2014.0,10.1186/1745-6215-15-195,0,0,
4617,A brief measure of core religious beliefs for use in psychiatric settings.,"Results from several national studies in the United States suggests that: (1) religious beliefs and practices are highly prevalent; (2) spirituality and religion are statistically and clinically relevant to mental health and symptoms; and (3) many patients have a preference for spiritually integrated care. However, existing protocols that assess for salient religious themes in psychiatric settings are time-consuming to administer, relevant only to specific populations (e.g., Christians), and have poor psychometric properties. Further, evidence suggests that religious beliefs can take on a positive and negative valence, and both of these dimensions are worthy of assessment. We, therefore, developed a brief (six-item) self-report measure of positive and negative core beliefs about God which is uniquely suited for use with a broad range of religious patients. Across three studies, we evaluated its psychometric properties and ability to predict symptoms of anxiety and depression. Results provide support for the validity and reliability of our measure and further highlight the salience of both positive and negative religious beliefs to psychiatric symptoms. It is hoped that this measure will help to decrease the burden of spiritual assessment in psychiatric and medical settings, and further have research utility for this area of study.",Rosmarin DH.; Pirutinsky S.; Pargament KI.,2011.0,10.2190/PM.41.3.d,0,0,
4618,"""Young people, adult worries"": RCT of an internet-based self-support method ""Feel the ViBe"" for children, adolescents and young adults exposed to family violence, a study protocol","ER METHODS/DESIGN: This study is a randomized controlled trial using the method of minimization to randomize the participants in two parallel groups with a 1:1 allocation ratio, being an intervention group, having access to ""Feel the ViBe"" and usual care (UC), and a control group, having access to minimally enhanced usual care (mEUC) followed by access to the intervention after twelve weeks. Outcomes are measured with questionnaires on PTSD symptoms, mental health and sexual and reproductive health. Routine Outcome Measurement (ROM) will be used to measure a direct effect of participating in the intervention. Data from a web evaluation questionnaire (WEQ), user statistics and qualitative analysis of online data will be used to support the findings. To compare results Cohen's d effect sizes will be used.DISCUSSION: A RCT and process evaluation will test effectiveness and provide information of how the effects can be explained, how the intervention meets the expectation of participants and which possible barriers and facilitators for implementation exist. A qualitative analysis of the data will add information to interpret the quantitative data. This makes ""Feel the ViBe"" unique in its field.TRIAL REGISTRATION: The Netherlands National Trial Register (NTR), trial ID NTR3692.BACKGROUND: Violence in families affects children. Exposure to violence is seen as child abuse. Figures show that about one third of children exposed to violence become victim or perpetrator in their adult life: known as intergenerational transmission. Violence also affects sexual and reproductive health. To prevent problems in adult life, children need help and support. However, while trying to protect their parents, children often do not seek help, or perceive the threshold as too high. Since almost all children of the current generation have access to the internet, an online intervention will make help better available for this target group. In 2011, an internet-based self-support method for children, adolescents and young adults exposed to family violence was developed in the Netherlands: ""Feel the ViBe"". The intervention was developed in close collaboration with the target group. This article describes the protocol of the RCT to study the effectiveness of this intervention.","Rosmalen-Nooijens, K A; Prins, J B; Vergeer, M; Wong, S H; Lagro-Janssen, A L",2013.0,10.1186/1471-2458-13-226,0,0,
4619,How can psychological interventions for OCD patients be more accessible and outcomes improved?,"Obsessive-compulsive disorder (OCD) is a prevalent and disabling disorder where Cognitive Behavioural Therapy (CBT) is recommended as a first line treatment. Unfortunately, CBT is not accessible to the vast majority of patients. Barriers to receive treatment include a shortage trained CBT therapists, financial, practical, and logistic problems related to treatment-seeking, and embarrassment due to symptoms. As a response to the lack of CBT supply, Internetbased CBT (ICBT) has been developed. In ICBT, a patient logs on to a secure websiteand works with written self-help materials and homework assignments, andreceives online support by a clinician. CBT has the advantage of being more accessible and requiring less therapist time than face-to-face (f2f) CBT. We have tested ICBT for OCD in 3 different studies and consistently shown large effect sizes compared to waitlist control [1-3] and also studied the addition of d-cycloserine as an adjunct [4]. This talk will try to provide an overview of the current shortcomings of conventional treatments and if ICBT in its different forms could be helpful and what the limitations of the current evidence is (including the lack of comparison with gold-standard treatment). It will also cover some recent advances in Body Dysmorphic Disorder [5] and Hoarding Disorder. The evidence available to daysuggests that ICBT is a promising and durable treatment alternative for manypatients with OCD who would not otherwise have access to evidence-basedtreatment.",Rück C.,2016.0,,0,0,
4620,"The effect of the one-to-one interaction process with group supportive psychotherapy on the levels of hope, anxiety and self-care practice for patients that have experienced organ loss: an alternative nursing care model.","This quasi-experimental research examined the effect of the one-to-one interaction process with group supportive psychotherapy on the levels of hope, anxiety and self-care practice for patients that have experienced organ loss. Eighty patients from the hospital units were selected by matched pairs and paired according to gender, interval of age, type and time length of organ loss. Simple-random sampling was used to allocate each subject in the experimental and control groups, which consisted of 40 pairs. Questionnaires included hope, anxiety and self-care practice assessments. The experimental treatments consisted of the one-to-one interaction process with group psychotherapy. The results showed that the patients that received treatments in the experimental group had higher mean scores regarding the differences in levels of hope, anxiety and self-care practice than those in the control group. This integrative approach is an alternative method for giving patients self-confidence in their self-care practice, in maintaining hope and in reducing anxiety. The method assisted patients in understanding their own problems and corrective actions so that they could be accepted by others by exchanging their feelings, thoughts, opinions and experiences through confrontation and self-exploration both individually and in group.",Ruchiwit M.,2012.0,10.1111/j.1440-172X.2012.02053.x,0,0,
4621,Treatment-emergent suicidal ideation during 4 months of acute management of unipolar major depression with SSRI pharmacotherapy or interpersonal psychotherapy in a randomized clinical trial.,"To date, few randomized controlled trials (RCTs) of major depression have examined suicidal ideation as an outcome measure. Our aim is to determine the incidence of treatment-emergent suicidal ideation (ESI) and behaviors during the acute phase of treatment with an SSRI antidepressant or interpersonal psychotherapy (IPT) in patients with unipolar major depression. In a two-site RCT, 291 adult outpatients with nonpsychotic major depression and a Hamilton Depression Rating Scale (HDRS) score ≥15 were randomly allocated to IPT or SSRI. Participants who did not remit with monotherapy received augmentation with the other treatment. ESI was defined as a post-baseline HDRS suicidality item score ≥2 or a post-baseline Quick Inventory of Depressive Symptomatology (QIDS) score ≥2 in patients with a baseline score ≤1. Of the 231 participants who had no suicidal ideation at baseline, 32 (13.8%) subsequently exhibited ESI on at least one post-baseline visit. Time to suicidal ideation was significantly longer in patients allocated to SSRI compared to those allocated to IPT (HR = 2.21, 95% CI 1.04-4.66, P = .038), even after controlling for treatment augmentation, benzodiazepine use, and comorbidity with anxiety disorders. Worsening of suicidal ideation occurred in 7/60 patients who had suicidal ideation at baseline. In the large majority of cases, suicidal ideation was successfully managed with the study protocol. In the context of careful monitoring and frequent contact, selective serotonin reuptake inhibitor (SSRI) was associated with a lower risk of ESI than IPT and both SSRI and IPT appeared to be safe treatments for patients with past suicide attempts, none of whom exhibited ESI during the study.",Rucci P.; Frank E.; Scocco P.; Calugi S.; Miniati M.; Fagiolini A.; Cassano GB.,2011.0,10.1002/da.20758,0,0,
4622,Community pharmacist intervention in depressed primary care patients (PRODEFAR study): randomized controlled trial protocol,"ER METHODS/DESIGNA randomized controlled trial, with 6-month follow-up, comparing patients receiving a pharmaceutical care support programme in primary care with patients receiving usual care. The total sample comprises 194 patients (aged between 18 and 75) diagnosed with depressive disorder in a primary care health centre in the province of Barcelona (Spain). Subjects will be asked for written informed consent in order to participate in the study. Diagnosis will be confirmed using the SCID-I. The intervention consists of an educational programme focused on improving knowledge about medication, making patients aware of the importance of compliance, reducing stigma, reassuring patients about side-effects and stressing the importance of carrying out general practitioners' advice. Measurements will take place at baseline, and after 3 and 6 months. Main outcome measure is compliance with antidepressants. Secondary outcomes include; clinical severity of depression (PHQ-9), anxiety (STAI-S), health-related quality of life (EuroQol-5D), satisfaction with the treatment received, side-effects, chronic physical conditions and socio-demographics. The use of healthcare and social care services will be assessed with an adapted version of the Client Service Receipt Inventory (CSRI).DISCUSSIONThis trial will provide valuable information for health professionals and policy makers on the effectiveness and cost-effectiveness of a pharmaceutical intervention programme in the context of primary care.TRIAL REGISTRATIONNCT00794196.BACKGROUNDTreatment of depression, the most prevalent and costly mental disorder, needs to be improved. Non-concordance with clinical guidelines and non-adherence can limit the efficacy of pharmacological treatment of depression. Through pharmaceutical care, pharmacists can improve patients' compliance and wellbeing. The aim of this study is to evaluate the effectiveness and cost-effectiveness of a community pharmacist intervention developed to improve adherence and outcomes of primary care patients with depression.","Rubio-Valera, M; Serrano-Blanco, A; Travé, P; Peñarrubia-María, M T; Ruiz, M; Pujol, M M",2009.0,10.1186/1471-2458-9-284,0,0,
4623,Dosed versus prolonged exposure in the treatment of fear: an experimental evaluation and review of behavioral mechanisms.,"Exposure-based treatments have proven effective in treating a range of fears and phobias and can be accounted for by mechanisms described in behavioral theory. Enhanced dosed and dosed-only exposure are promising new behavioral approaches for treating fears and phobias. Thirty-nine participants with speech anxiety were randomly assigned to a prolonged exposure (PE) condition, a positively enhanced dosed exposure (PDE) condition, a dosed-only exposure (DE) condition, or a negatively-supplemented dosed exposure (NDE) condition. Results indicated that both the PDE and DE conditions produced less measured aversive arousal and significantly more rapid arousal reduction than the tested alternatives. These techniques may represent an important advancement, in that the treatment gains of traditional exposure therapies might be achieved without the degree of aversive arousal (and possibly high drop out rates) typically seen in exposure therapies. Additionally, these data contradict prevailing opinion concerning the necessity for sustained aversive arousal during exposure-based treatment.",Rubin S.; Spates CR.; Johnson DA.; Jouppi L.,2009.0,10.1016/j.janxdis.2009.03.005,0,0,
4624,The normative and the personal life: Individual differences in life scripts and life story events among USA and Danish undergraduates,"Life scripts are culturally shared expectations about the order and timing of life events in a prototypical life course. American and Danish undergraduates produced life story events and life scripts by listing the seven most important events in their own lives and in the lives of hypothetical people living ordinary lives. They also rated their events on several scales and completed measures of depression, PTSD symptoms, and centrality of a negative event to their lives. The Danish life script replicated earlier work; the American life script showed minor differences from the Danish life script, apparently reflecting genuine differences in shared events as well as less homogeneity in the American sample. Both consisted of mostly positive events that came disproportionately from ages 15 to 30. Valence of life story events correlated with life script valence, depression, PTSD symptoms, and identity. In the Danish undergraduates, measures of life story deviation from the life script correlated with measures of depression and PTSD symptoms.",Rubin D.C.; Berntsen D.; Hutson M.,2009.0,10.1080/09658210802541442,0,0,
4625,Improving patient quality of life with feedback to physicians about functional status,"ER INTERVENTION1) Computer-generated feedback to physicians about the patient's functional status, the patient's self-reported ""chief complaint,"" and problem-specific resource and management suggestions; and 2) two brief interactive educational sessions for physicians.DESIGNRandomized controlled trial.SETTINGUniversity primary care clinic.PARTICIPANTSAll 73 internal medicine house officers and 557 of their new primary care patients.MEASURES1) Change in patient functional status from enrollment until six months later, using the Functional Status Questionnaire (FSQ); 2) management plans and additional information about functional status abstracted from the medical record; and 3) physician attitude about whether internists should address functional status problems.RESULTSEmotional well-being scores improved significantly for the patients of the experimental group physicians compared with those of the control group physicians (p  or = 70 years of age) individuals in the experimental group compared with the control group (p < 0.03). The experimental group physicians diagnosed more symptoms of stress or anxiety than did the control group physicians (p < 0.001) and took more actions recommended by the feedback form (p < 0.02).CONCLUSIONSComputer-generated feedback of functional status screening results accompanied by resource and management suggestions can increase physician diagnoses of impaired emotional well-being, can influence physician management of functional status problems, and can assist physicians in improving emotional well-being and social functioning among their patients.OBJECTIVETo improve functional status among primary care patients.","Rubenstein, L V; McCoy, J M; Cope, D W; Barrett, P A; Hirsch, S H; Messer, K S; Young, R T",1995.0,,0,0,
4626,Negative effects of Internet interventions: A qualitative content analysis of patients' experiences with treatments delivered online.,"Internet interventions are defined as the delivery of health care-related treatments via an online or a smartphone interface, and have been shown to be a viable alternative to face-to-face treatments. However, not all patients benefit from such treatments, and it is possible that some may experience negative effects. Investigations of face-to-face treatments indicate that deterioration occurs in 5-10% of all patients. The nature and scope of other negative effects of Internet interventions is, however, largely unknown. Hence, the current study explored patients' reported negative experiences while undergoing treatments delivered via the Internet. Data from four large clinical trials (total N = 558) revealed that 9.3% of patients reported some type of negative effects. Qualitative content analysis was used to explore the patients' responses to open-ended questions regarding their negative experiences. Results yielded two broad categories and four subcategories of negative effects: patient-related negative effects (insight and symptom) and treatment-related negative effects (implementation and format). Results emphasize the importance of always considering negative effects in Internet-based interventions, and point to several ways of preventing such experiences, including regular assessment of negative events, increasing the flexibility of treatment schedules and therapist contact, as well as prolonging the treatment duration. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rozental, Alexander; Boettcher, Johanna; Andersson, Gerhard; Schmidt, Brad; Carlbring, Per; Andersson, Andersson, Andersson, Andrews, Barak, Barlow, Bendelin, Bergin, Bergin, Bergman Nordgren, Berk, Boettcher, Boettcher, Boisvert, Bystedt, Carlbring, Carlbring, Christensen, Clark, Crown, Dimidjian, Dirkse, Elo, Graneheim, Hadley, Hannan, Hatfield, Hayes, Heins, Hesser, Hsieh, Johansson, Johnston, Keller, Kivi, Krippendorff, Krosnick, Lambert, Lambert, Lambert, Lilienfeld, Linden, Linden, Lindner, Ljotsson, Mays, Mays, Mohr, Nestoriuc, O'Mahen, Olsson Halmetoja, Palmqvist, Parker, Paxling, Proudfoot, Rozental, Rozental, Sandelowski, Schwarz, Seggar, Strupp, Strom, Titov, van Straten, Wagner, White",2015.0,,0,0,
4627,Internet-based cognitive-behavior therapy for procrastination: A randomized controlled trial.,"Procrastination can be a persistent behavior pattern associated with personal distress. However, research investigating different treatment interventions is scarce, and no randomized controlled trial has examined the efficacy of cognitive-behavior therapy (CBT). Meanwhile, Internet-based CBT has been found promising for several conditions, but has not yet been used for procrastination. Participants (N = 150) were randomized to guided self-help, unguided self-help, and wait-list control. Outcome measures were administered before and after treatment, or weekly throughout the treatment period. They included the Pure Procrastination Scale, the Irrational Procrastination Scale, the Susceptibility to Temptation Scale, the Montgomery √Ösberg Depression Rating Scale-Self-report version, the Generalized Anxiety Disorder Assessment, and the Quality of Life Inventory. The intention-to-treat principle was used for all statistical analyses. Mixed-effects models revealed moderate between-groups effect sizes comparing guided and unguided self-help with wait-list control; the Pure Procrastination Scale, Cohen's d = 0.70, 95% confidence interval (CI) [0.29, 1.10], and d = 0.50, 95% CI [0.10, 0.90], and the Irrational Procrastination Scale, d = 0.81 95% CI [0.40, 1.22], and d = 0.69 95% CI [0.29, 1.09]. Clinically significant change was achieved among 31.3-40.0% for guided self-help, compared with 24.0-36.0% for unguided self-help. Neither of the treatment conditions was found to be superior on any of the outcome measures, Fs(98, 65.17-72.55) < 1.70, p > .19. Internet-based CBT could be useful for managing self-reported difficulties due to procrastination, both with and without the guidance of a therapist.",Rozental A.; Forsell E.; Svensson A.; Andersson G.; Carlbring P.,2015.0,10.1037/ccp0000023,0,0,
4628,A prolonged motor imagery session alter imagined and actual movement durations: Potential implications for neurorehabilitation,"Mental practice with motor imagery improves motor performance, for example reducing the duration of goal-directed movements. However, it is not known whether an experimental session involving prolonged sequences of motor imagery induces mental fatigue and alters motor and mental performances. In this study, participants imagined 100 point-to-point arm movements combined with actual pointing movements every 10 or 50 imagined movements. Participants reported a subjective feeling of mental fatigue after imagining 100 pointing movements. When participants performed actual movements every 50 imagined movements, the duration of both actual and imagined movements increased at the end of the protocol. On the contrary, no change in actual and imagined movement duration was observed when participants performed actual movements every 10 imagined movements. These results suggested that the repetition of many imagined movements induced mental fatigue and altered the mental simulation and the actual execution processes of the movement. However, the regular execution of actual movements seemed to counteract the negative effect of mental fatigue as both actual and imagined movement duration remained constant with actual trials inserted between mental rehearsals. We suggest that during training or rehabilitation programs, actual movements should be executed and/or imagined movement duration should be controlled to avoid the negative effects of mental fatigue on motor performance.",Rozand V.; Lebon F.; Stapley P.J.; Papaxanthis C.; Lepers R.,2016.0,10.1016/j.bbr.2015.09.036,0,0,
4629,Prospective randomized trial of high thoracic epidural analgesia for coronary artery bypass surgery,"ER METHODSEighty patients were randomized to HTEA or intravenous morphine analgesia (control). Patients received coronary artery bypass surgery (CABG) with cardiopulmonary bypass. Pain was measured by visual analogue scale 0 to 10. Psychologic morbidity, intraoperative hemodynamics, ventricular function, lung function, and physiotherapy cooperation were also assessed. On the third postoperative day HTEA and morphine were ceased and only oral medications were used. Acetaminophen, indomethacin, and tramadol were allowed as supplemental analgesics in both groups.RESULTSThe primary endpoint of pain scores was significantly less with HTEA on postoperative days 1 and 2 at rest, 0.02 +/- 0.2 versus 0.8 +/- 1.8 (p = 0.008) and 0.1 +/- 0.4 versus 1.2 +/- 2.7 (p = 0.022), respectively, and with coughing 1.2 +/- 1.7 versus 4.4 +/- 3.1 (p < 0.001) and 1.5 +/- 2.0 versus 3.6 +/- 3.1 (p = 0.001), respectively. When HTEA and morphine were ceased on day 3, there were no significant differences. The secondary endpoints of postoperative depression (p = 0.033) and posttraumatic stress subscales (p = 0.021) of the Minnesota Multiphasic Personality Inventory were lower with HTEA. Extubation occurred earlier with HTEA, 2.6 versus 5.4 hours (p < 0.001). HTEA showed improved physiotherapy cooperation (p < 0.001), arterial oxygen tension (p = 0.041), and peak expiratory flow rate (p = 0.001). Mean arterial pressure was lower with HTEA (p = 0.036), otherwise there were no differences in intraoperative hemodynamics or ventricular function.CONCLUSIONSEpidural analgesia reduces pain after coronary operation and is associated with improved physiotherapy cooperation, earlier extubation, and reduced risk of depression and posttraumatic stress.BACKGROUNDPostoperative pain may be severe after coronary artery bypass surgery. High thoracic epidural analgesia (HTEA) provides intense analgesia.","Royse, C; Royse, A; Soeding, P; Blake, D; Pang, J",2003.0,,0,0,
4630,Short-term interpersonal psychotherapy in methadone-maintained opiate addicts.,"A clinical trial was used to evaluate short-term interpersonal psychotherapy (IPT) as treatment for psychiatric disorders in opiate addicts who were also participating in a full-service methadone hydrochloride maintenance program. Seventy-two opiate addicts were randomly assigned to one of two treatment conditions for six months: (1) IPT, consisting of weekly individual psychotherapy, and (2) low-contact treatment, consisting of one brief meeting per month. Recruitment was a problem, as only 5% of eligible clients agreed to participate and only around half of the subjects completed the study treatment. The outcome was similar for the two study groups. However, in many of the outcome areas, subjects in both treatment conditions attained significant clinical improvement. Several factors limited the generalizability of findings and may have biased against showing a psychotherapy effect.",Rounsaville BJ.; Glazer W.; Wilber CH.; Weissman MM.; Kleber HD.,1983.0,,0,0,
4631,Distinct and convergent visual processing of high and low spatial frequency information in faces,"We tested for differential brain response to distinct spatial frequency (SF) components in faces. During a functional magnetic resonance imaging experiment, participants were presented with ""hybrid"" faces containing superimposed low and high SF information from different identities. We used a repetition paradigm where faces at either SF range were independently repeated or changed across consecutive trials. In addition, we manipulated which SF band was attended. Our results suggest that repetition and attention affected partly overlapping occipitotemporal regions but did not interact. Changes of high SF faces increased responses of the right inferior occipital gyrus (IOG) and left inferior temporal gyrus (ITG), with the latter response being also modulated additively by attention. In contrast, the bilateral middle occipital gyrus (MOG) responded to repetition and attention manipulations of low SF. A common effect of high and low SF repetition was observed in the right fusiform gyrus (FFG). Follow-up connectivity analyses suggested direct influence of the MOG (low SF), IOG, and ITG (high SF) on the FFG responses. Our results reveal that different regions within occipitotemporal cortex extract distinct visual cues at different SF ranges in faces and that the outputs from these separate processes project forward to the right FFG, where the different visual cues may converge. © 2007 The Authors.",Rotshtein P.; Vuilleumier P.; Winston J.; Driver J.; Dolan R.,2007.0,10.1093/cercor/bhl180,0,0,
4632,Combined use of disulfiram and metronidazole in treatment of alcoholism.,,Rothstein E.; Clancy DD.,1970.0,,0,0,
4633,Virtual reality exposure therapy for combat-related posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) is a chronic, debilitating, psychological condition that occurs in a subset of individuals who experience or witness life-threatening traumatic events. PTSD is highly prevalent in those who served in the military. In this paper, we present the underlying theoretical foundations and existing research on virtual reality exposure therapy, a recently emerging treatment for PTSD. Three virtual reality scenarios used to treat PTSD in active duty military and combat veterans and survivors of terrorism are presented: Virtual Vietnam, Virtual Iraq, and Virtual World Trade Center. Preliminary results of ongoing trials are presented.",Rothbaum BO.; Rizzo AS.; Difede J.,2010.0,10.1111/j.1749-6632.2010.05691.x,0,0,
4634,"A randomized, double-blind evaluation of D-cycloserine or alprazolam combined with virtual reality exposure therapy for posttraumatic stress disorder in Iraq and Afghanistan War veterans.","The authors examined the effectiveness of virtual reality exposure augmented with D-cycloserine or alprazolam, compared with placebo, in reducing posttraumatic stress disorder (PTSD) due to military trauma. After an introductory session, five sessions of virtual reality exposure were augmented with D-cycloserine (50 mg) or alprazolam (0.25 mg) in a double-blind, placebo-controlled randomized clinical trial for 156 Iraq and Afghanistan war veterans with PTSD. PTSD symptoms significantly improved from pre- to posttreatment across all conditions and were maintained at 3, 6, and 12 months. There were no overall differences in symptoms between D-cycloserine and placebo at any time. Alprazolam and placebo differed significantly on the Clinician-Administered PTSD Scale score at posttreatment and PTSD diagnosis at 3 months posttreatment; the alprazolam group showed a higher rate of PTSD (82.8%) than the placebo group (47.8%). Between-session extinction learning was a treatment-specific enhancer of outcome for the D-cycloserine group only. At posttreatment, the D-cycloserine group had the lowest cortisol reactivity and smallest startle response during virtual reality scenes. A six-session virtual reality treatment was associated with reduction in PTSD diagnoses and symptoms in Iraq and Afghanistan veterans, although there was no control condition for the virtual reality exposure. There was no advantage of D-cycloserine for PTSD symptoms in primary analyses. In secondary analyses, alprazolam impaired recovery and D-cycloserine enhanced virtual reality outcome in patients who demonstrated within-session learning. D-cycloserine augmentation reduced cortisol and startle reactivity more than did alprazolam or placebo, findings that are consistent with those in the animal literature.",Rothbaum BO.; Price M.; Jovanovic T.; Norrholm SD.; Gerardi M.; Dunlop B.; Davis M.; Bradley B.; Duncan EJ.; Rizzo A.; Ressler KJ.,2014.0,10.1176/appi.ajp.2014.13121625,0,0,
4635,Early intervention following trauma may mitigate genetic risk for PTSD in civilians: a pilot prospective emergency department study.,"Civilian posttraumatic stress disorder (PTSD) and combat PTSD are major public health concerns. Although a number of psychosocial risk factors have been identified related to PTSD risk, there are no accepted, robust biological predictors that identify who will develop PTSD or who will respond to early intervention following trauma. We wished to examine whether genetic risk for PTSD can be mitigated with an early intervention. 65 emergency department patients recruited in 2009-2010 at Grady Memorial Hospital in Atlanta, Georgia, who met criterion A of DSM-IV PTSD received either 3 sessions of an exposure intervention, beginning in the emergency department shortly after trauma exposure or assessment only. PTSD symptoms were assessed 4 and 12 weeks after trauma exposure. A composite additive risk score was derived from polymorphisms in 10 previously identified genes associated with stress-response (ADCYAP1R1, COMT, CRHR1, DBH, DRD2, FAAH, FKBP5, NPY, NTRK2, and PCLO), and gene x treatment effects were examined. The intervention included 3 sessions of imaginal exposure to the trauma memory and additional exposure homework. The primary outcome measure was the PTSD Symptom Scale-Interview Version or DSM-IV-based PTSD diagnosis in patients related to genotype and treatment group. A gene x intervention x time effect was detected for individual polymorphisms, in particular the PACAP receptor, ADCYAP1R1, as well as with a combined genotype risk score created from independent SNP markers. Subjects who did not receive treatment had higher symptoms than those who received intervention. Furthermore, subjects with the ""risk"" genotypes who did not receive intervention had higher PTSD symptoms compared to those with the ""low-risk"" or ""resilience"" genotypes or those who received intervention. Additionally, PTSD symptoms correlated with level of genetic risk at week 12 (P < .005) in the assessment-only group, but with no relationship in the intervention group, even after controlling for age, sex, race, education, income, and childhood trauma. Using logistic regression, the number of risk alleles was significantly associated with likelihood of PTSD diagnosis at week 12 (P < .05). This pilot prospective study suggests that combined genetic variants may serve to predict those most at risk for developing PTSD following trauma. A psychotherapeutic intervention initiated in the emergency department within hours of the trauma may mitigate this risk. The role of genetic predictors of risk and resilience should be further evaluated in larger, prospective intervention and prevention trials. ClinicalTrials.gov identifier: NCT00895518.",Rothbaum BO.; Kearns MC.; Reiser E.; Davis JS.; Kerley KA.; Rothbaum AO.; Mercer KB.; Price M.; Houry D.; Ressler KJ.,2014.0,10.4088/JCP.13m08715,0,0,
4636,Virtual reality exposure therapy for Vietnam veterans with posttraumatic stress disorder.,"Virtual reality (VR) integrates real-time computer graphics, body-tracking devices, visual displays, and other sensory input devices to immerse a participant in a computer-generated virtual environment that changes in a natural way with head and body motion. VR exposure (VRE) is proposed as an alternative to typical imaginal exposure treatment for Vietnam combat veterans with posttraumatic stress disorder (PTSD). This report presents the results of an open clinical trial using VRE to treat Vietnam combat veterans who have DSM-IV PTSD. In 8 to 16 sessions, 10 male patients were exposed to 2 virtual environments: a virtual Huey helicopter flying over a virtual Vietnam and a clearing surrounded by jungle. Clinician-rated PTSD symptoms as measured by the Clinician Administered PTSD Scale, the primary outcome measure, at 6-month follow-up indicated an overall statistically significant reduction from baseline (p = .0021) in symptoms associated with specific reported traumatic experiences. All 8 participants interviewed at the 6-month follow-up reported reductions in PTSD symptoms ranging from 15% to 67%. Significant decreases were seen in all 3 symptom clusters (p < .02). Patient self-reported intrusion symptoms as measured by the Impact of Event Scale were significantly lower (p < .05) at 3 months than at baseline but not at 6 months, although there was a clear trend toward fewer intrusive thoughts and somewhat less avoidance. Virtual reality exposure therapy holds promise for treating PTSD in Vietnam veterans.",Rothbaum BO.; Hodges LF.; Ready D.; Graap K.; Alarcon RD.,2001.0,,0,0,
4637,Augmentation of sertraline with prolonged exposure in the treatment of posttraumatic stress disorder.,The present study was designed to determine whether augmenting sertraline with prolonged exposure (PE) would result in greater improvement than continuation with sertraline alone. Outpatient men and women with chronic PTSD completed 10 weeks of open label sertraline and then were randomly assigned to five additional weeks of sertraline alone (n = 31) or sertraline plus 10 sessions of twice-weekly PE (n = 34). Results indicated that sertraline led to a significant reduction in PTSD severity after 10 weeks but was associated with no further reductions after five more weeks. Participants who received PE showed further reduction in PTSD severity. This augmentation effect was observed only for participants who showed a partial response to medication.,Rothbaum BO.; Cahill SP.; Foa EB.; Davidson JR.; Compton J.; Connor KM.; Astin MC.; Hahn CG.,2006.0,10.1002/jts.20170,0,0,
4638,Behavioral treatment of obsessive-compulsive disorder in a naturalistic setting.,"This report describes a naturalistic study of an outpatient cognitive-behavioral treatment of obsessive-compulsive disorder (OCD). Treatment consisted of exposure and response prevention. Over the course of 7 yrs, 39 patients received a diagnosis of OCD and had a baseline Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score. Of those, 23 Ss (aged 18-77 yrs) received treatment (total number of sessions 7-25) and completed the Y-BOCS following treatment. Y-BOCS scores fell from 24.3 at pretreatment to 7.9 at posttreatment for the 23 patients who received treatment. Results are discussed in the context of randomized clinical trials vs naturalistic applications. In addition, a case summary of a 32-yr-old woman is presented highlighting some of the treatment issues in delivering exposure and response prevention in an outpatient clinical setting. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Rothbaum, Barbara Olasov; Shahar, Fran; Foa, Foa, Foa, Goodman, Greist, Meyer, Seligman",2000.0,,0,0,
4639,Virtual Reality Exposure Therapy of Combat-Related PTSD: A Case Study Using Psychophysiological Indicators of Outcome.,"This article describes the treatment by exposure therapy of a Vietnam veteran for PTSD related to his war experiences. There are several unique features of this particular treatment and case report. One, the exposure treatment was delivered in conjunction with virtual reality. The patient was exposed to two virtual Vietnam environments, a virtual Huey helicopter and a virtual landing zone, while engaging in exposure to his most traumatic Vietnam memories. Two, the nature of several of these traumatic memories included guilt over acts that the patient committed in Vietnam, which is often times not considered a good candidate for exposure therapy. Three, psychophysiological monitoring occurred throughout the treatment as well as at pretreatment and posttreatment. His responses to treatment, in terms of guilt, anger, and anxiety, standardized symptom measures at pretreatment and posttreatment and follow-ups of 3 months and 6 months, and psychophysiological treatment responding, are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Rothbaum, Barbara Olasov; Ruef, Anna Marie; Litz, Brett T; Han, Hyemee; Hodges, Larry; Beck, Blake, Boudewyns, Carlin, Cason, Derogatis, First, Foa, Jaycox, Keane, Keane, Keane, Keane, Kubany, Kulka, Llabre, Lykken, Niles, Pitman, Rothbaum, Rothbaum",2003.0,,0,0,
4640,The use of virtual reality exposure in the treatment of anxiety disorders.,"One possible alternative to standard in vivo exposure may be virtual reality exposure (VRE). Virtual reality integrates real-time computer graphics, body tracking devices, visual displays, and other sensory input devices to immerse a participant in a computer-generated virtual environment. VRE is potentially an efficient and cost-effective treatment of anxiety disorders. B. O. Rothbaum et al (1995), in a case study with a 19-yr-old male patient and in a controlled study with 17 undergraduates, successfully used VRE therapy to reduce acrophobia. In the latter study, outcome was assessed on measures of anxiety, avoidance, attitudes, and distress. Significant group differences were found on all measures such that the VRE group was significantly improved at posttreatment but the control group was unchanged. The efficacy of VRE therapy was also demonstrated in the case of a 42-yr-old female patient with fear of flying. The potential for VRE treatment for these and other disorders, e.g., posttraumatic stress disorder (PTSD), is discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rothbaum, Barbara Olasov; Hodges, Larry F; Agras, Bajura, Beckham, Bergman, Breslau, Brooks, Carlin, Davidson, Foa, Foa, Foley, Girodo, Hettinger, Hodges, Howard, Kalawsky, Kijima, Kilpatrick, Lamson, McFarlane, McNally, Mitchell, Pausch, Reeves, Roberts, Rothbaum, Rothbaum, Rothbaum, Rothbaum, Strickland, Sutherland, Sutherland, Weiss",1999.0,,0,0,
4641,A pooled analysis of gender and trauma-type effects on responsiveness to treatment of PTSD with venlafaxine extended release or placebo.,"Objective: To examine effects of gender and trauma type on response to treatment with venlafaxine extended release (ER) or placebo in patients with posttraumatic stress disorder (PTSD). Method: Data were pooled from 2 flexible-dose, parallel-group, randomized, double-blind, placebo-controlled trials: a 12-week trial conducted in the United States (March 2001 to December 2002) and a 24-week trial conducted in 12 countries outside the United States (October 2001 to December 2003). Six hundred eighty-seven outpatients with DSM-IV-diagnosed PTSD and a 17-item Clinician-Administered PTSD Scale abbreviated 1-week Symptom Status version (CAPS-SX-17) score >= 60 were randomly assigned to treatment with venlafaxine ER (37.5 mg/day-300 mg/day, N = 340) or placebo (N = 347). The primary efficacy end point was the CAPS-SX-17 total score at week 12. Secondary end points included CAPS-SX-17 cluster scores for re experiencing, avoidance/numbing, and hyperarousal and scores on the Connor-Davidson Resilience Scale (CD-RISC), Clinical Global Impressions-Severity of Illness scale, Sheehan Disability Scale (SDS), and 17-item Hamilton Rating Scale for Depression (HAM-D-17). Analysis-of-covariance models were used to test for differences by gender and trauma type (accidental injury, combat, nonsexual abuse, adult sexual abuse, childhood sexual abuse, unexpected death, and other), treatment (venlafaxine ER vs. placebo), and the treatment-by-trauma-type interaction. Results: Using last-observation-carried-forward analysis, significant effects of treatment with venlafaxine ER were found on the CAPS-SX-17 total score and on all CAPS-SX-17 cluster scores and most other secondary measures. No significant treatment-by-gender interactions were observed. Trauma type significantly affected treatment responsiveness on symptom-related disability (SDS, p = .0057) and resilience (CD-RISC, p = .0012), with a nearly significant effect on depression (HAM-D-17, p = .0625). Conclusion: Overall, there does not appear to be a significant effect of gender on the efficacy of venlafaxine ER in the treatment of PTSD. Trauma type may affect treatment outcome but seems to affect domains such as disability and resilience more than core PTSD symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rothbaum, Barbara O; Davidson, Jonathan R. T; Stein, Dan J; Pedersen, Ron; Musgnung, Jeff; Tian, Xiao Wei; Ahmed, Saeeduddin; Baldwin, David S; Asms, Baca, Baker, Baldwin, Ballenger, Ballenger, Blake, Brady, Brcslau, Bresiau, Bteslau, Connor, Davidson, Davidson, English, Guy, Hamilton, Hcrtzbcrg, Heim, Johnson, Kate, Kcssler, Kessler, Kessler, Komstem, Lautcrbach, Nemeroff, Olff, Oqucndo, Sarccn, Scedat, Scott, Sheehan, Thase, Tucker, Turner, Ursano, van der Kolk, Wang, Weiss, Yehuda, Zohar",2008.0,,0,0,
4642,Autonomic changes after treatment of agoraphobia with panic attacks.,"Twenty-three patients meeting DSM-III criteria for agoraphobia with panic attacks and 14 age-, race-, and sex-matched nonanxious controls were tested in the laboratory and on a test walk in a shopping mall. The patients were tested before and after about 15 weeks of treatment with placebo and exposure therapy, imipramine and exposure therapy, or imipramine and initial antiexposure instructions. Controls were tested twice at a similar interval, but without any treatment. On test day 1, patients compared to controls showed higher average heart rate and skin conductance levels and greater numbers of skin conductance fluctuations in the laboratory, and higher heart rates before and during the test walk. Between pretreatment and posttreatment tests, clinical ratings improved and skin conductance levels decreased in all treatment groups. Heart rate levels in the laboratory, on the other hand, decreased in patients on placebo and rose in patients on imipramine. Thus, imipramine compromises the usefulness of heart rate as a measure of emotional arousal. Higher pretreatment heart rates predicted greater clinical improvement.",Roth WT.; Telch MJ.; Taylor CB.; Agras WS.,1988.0,,0,0,
4643,Skin conductance habituation in panic disorder patients.,"Skin conductance habituation was compared between 38 patients meeting DSM-III criteria for Panic Disorder and 29 normal controls. Approximately half of each group was randomly assigned to be given 100 dB SPL tones and the other half 75 dB tones. All indices pointed to slowed habituation in patients compared with normals: number of trials to response habituation, total number of responses, and slope of decline of skin conductance level. Patient-normal differences were not significantly larger for 100 dB than for 75 dB. In addition, patients compared with normals had more nonspecific fluctuations, higher skin conductance levels, and a shorter response latency to the first stimulus. Stepwise discriminant analyses classified patients and normals better in the 100 dB than in the 75 dB condition, and showed that the various skin conductancy variables were largely redundant at the higher intensity.",Roth WT.; Ehlers A.; Taylor CB.; Margraf J.; Agras WS.,1990.0,,0,0,
4644,Stress test reactivity in panic disorder,"The psychological and physiological reactivity of 52 patients with panic disorder to mental arithmetic, cold pressor, and 5% carbon dioxide inhalation tests was compared with that of 26 age- and sex-matched normal subjects. In general, patients with panic disorder were neither more physiologically reactive to these stressors than normal subjects nor slower to recover from them, but they were tonically more anxious and much more likely to ask to stop carbon dioxide inhalation or to report panic attacks during this test. Patients who reported panic attacks (46%) had manifested greater anticipatory anxiety before the gas was delivered, accompanied with increased β- adrenergic cardiac tone. Thus, anticipatory anxiety can be an important factor in panic provocation. Physiological measures varied greatly in their sensitivity to phasic or tonic anxiety. Carbon dioxide stimulated large increases in respiratory minute volume, but these increases were no greater for patients than for normal subjects.",Roth W.T.; Margraf J.; Ehlers A.; Taylor C.B.; Maddock R.J.; Davies S.; Agras W.S.,1992.0,,0,0,
4645,Speed and accuracy on tests of executive function in obsessive-compulsive disorder,"Slowness in obsessive-compulsive disorder (OCD) has been attributed to intrusive thoughts or meticulousness. Recent research suggests that slowness in OCD may be particularly evident on tests of executive function subserved by frontostriatal circuitry. In the present study, the speed and accuracy of responding on neuropsychological tests of executive functions and psychomotor speed were investigated in 27 non-depressed, unmedicated adults with OCD and 27 healthy controls. The only group difference was that patients took significantly longer to copy a complex geometric design than controls. This finding was unrelated to residual depression or overall OCD symptom severity. Results suggest that slowness in OCD may be most apparent on executive tests requiring self-initiated organizational strategies, consistent with frontostriatal abnormality. © 2004 Elsevier Inc. All rights reserved.",Roth R.M.; Baribeau J.; Milovan D.L.; O'Connor K.,2004.0,10.1016/j.bandc.2004.02.053,0,0,
4646,Relationship between pain and post-traumatic stress symptoms in palliative care.,"Previous research suggests that patients receiving palliative care may simultaneously experience poorly managed pain and post-traumatic stress disorder (PTSD)-related symptoms as a result of their deteriorating health. To: 1) examine predictors of PTSD-related symptoms in patients requiring palliative care; 2) assess whether anxiety, depression, pain catastrophizing, and pain anxiety mediate the relationship between pain interference and PTSD-related symptoms; and 3) evaluate the impact of these variables on pain interference and PTSD-related symptoms. One hundred patients receiving palliative care at one of two palliative care sites in London, ON, Canada, completed the PTSD Checklist-Civilian version (PCL-C), the Hospital Anxiety and Depression Scale (HADS), the Pain Catastrophizing Scale (PCS), the Brief Pain Inventory-Short Form (BPI-SF), and the Pain Anxiety Symptoms Scale-20 (PASS-20). Hierarchical multiple regressions were used to examine HADS-Anxiety, HADS-Depression, PCS and PASS-20 scores as predictors of PCL-C scores; and mediation analyses were used to test the effect of HADS-Anxiety, HADS-Depression, PCS, and PASS-20 on the relationship between BPI-SF interference and PCL-C. Mediators that significantly affected this relationship in the individual mediator models were entered into a multiple mediator model. Only pain anxiety and pain catastrophizing emerged as significant mediators of the relationship between pain interference and PTSD-related symptoms. After being entered in a multiple mediator model, pain anxiety emerged as the strongest mediator. The findings of the present study reveal that pain and PTSD-related symptoms are important concerns in palliative care, and that pain must be addressed to best meet the needs of this population.",Roth ML.; St Cyr K.; Harle I.; Katz JD.,2013.0,10.1016/j.jpainsymman.2012.07.015,0,0,
4647,Impact of efforts to reduce inpatient costs on clinical effectiveness: Treatment of posttraumatic stress disorder in the Department of Veterans Affairs.,"Evaluated the clinical impact of cost-cutting changes in the delivery of inpatient psychiatric care to US veterans. Outcome data on 6,397 veterans treated 1993-2000 at 35 specialized VA inpatient and residential programs for posttraumatic stress disorder (PTSD) were used to compare changes in effectiveness (improvement from admission to 4 mo after discharge) of programs that either shortened average length of stay or converted from a hospital-based to a low-cost residential rehabilitation program. For comparison, outcome data are presented for PTSD programs that did not experience program change. Measures addressed baseline characteristics and 4-mo postdischarge outcome measures of PTSD symptoms, substance abuse, violent behavior, and employment. analysis of covariance (ANCOVA) showed no significant change in outcomes at inpatient programs that either reduced length of stay or did not change. However, effectiveness declined on some measures at inpatient programs that converted to residential treatment, but improved at previously established residential programs. Although there was no deterioration in effectiveness related to reduced length of inpatient stay, programs that converted to a residential model showed decreased effectiveness. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rosenheck, Robert; Fontana, Alan; Blake, Bryk, Connor, Davidson, Foa, Fontana, Fontana, Fontana, Fontana, Fontana, Glynn, Goldman, Kulka, Leslie, Lieberman, Ma, McLellan, Medak, Rosenheck, Rosenheck, Rosenheck, Rosenheck, Rosenheck, Rosenheck, Rosenheck, Solomon, Spitzer, Steinwachs, Weathers",2001.0,,0,0,
4648,Impact of efforts to reduce inpatient costs on clinical effectiveness: treatment of posttraumatic stress disorder in the Department of Veterans Affairs.,"There have been major reductions in the availability of inpatient psychiatric care in the United States in recent years. The objective of this study was to evaluate the clinical impact of cost-cutting changes in the delivery of inpatient psychiatric care. This was a nonequivalent control group pre/post design. Outcome data on 6,397 veterans treated between 1993 and 2000 at 35 specialized VA inpatient and residential programs for posttraumatic stress disorder (PTSD) were used to compare changes in effectiveness (measured as patient improvement from admission to 4 months after discharge) at programs that either shortened their average length of stay or converted from a hospital-based program to a low-cost residential rehabilitation program. For comparison, outcome data are also presented over the same years from both inpatient PTSD programs and residential PTSD programs that did not experience program change. Measures addressed baseline characteristics and 4-month postdischarge outcome measures of PTSD symptoms, substance abuse, violent behavior, and employment. Analyses of covariance showed no significant change in outcomes at inpatient programs that either reduced their length of stay or did not change at all. However, effectiveness declined on some measures at inpatient programs that converted to residential treatment during this period but improved at residential treatment programs that had been established before this period of change. Although there was no deterioration in effectiveness related to reduced length of inpatient stay, programs that converted to a residential model showed decreased effectiveness.",Rosenheck R.; Fontana A.,2001.0,,0,0,
4649,Repetitive transcranial magnetic stimulation treatment of comorbid posttraumatic stress disorder and major depression.,"Twelve patients with comorbid posttraumatic stress disorder (PTSD) and major depression underwent repetitive transcranial magnetic stimulation (rTMS) to left frontal cortex as an open-label adjunct to current antidepressant medications. rTMS parameters were as follows: 90% of motor threshold, 1 Hz or 5 Hz, 6,000 stimuli over 10 days. Seventy-five percent of the patients had a clinically significant antidepressant response after rTMS, and 50% had sustained response at 2-month follow-up. Comparable improvements were seen in anxiety, hostility, and insomnia, but only minimal improvement in PTSD symptoms. Left frontal cortical rTMS may have promise for treating depression in PTSD, but there may be a dissociation between treating mood and treating core PTSD symptoms.",Rosenberg PB.; Mehndiratta RB.; Mehndiratta YP.; Wamer A.; Rosse RB.; Balish M.,2002.0,10.1176/jnp.14.3.270,0,0,
4650,Relationships among self-report assessments of craving in binge-drinking university students,"ER To assess the relationships among self-report craving questionnaires, and between craving and alcohol consumption, we administered four previously published measures of craving (Alcohol Urge Questionnaire, Obsessive-Compulsive Drinking Scale, Penn Alcohol Craving Scale, Temptation-Restraint Inventory), five single-item Visual Analog Scales (need, urge, craving, desire, compulsion), and measures of alcohol consumption and drinking consequences to 112 university students attending a large, public state university who reported at least two binge-drinking episodes (5+ drinks in a row by men; 4+ drinks in a row by women) in the previous 30 days. The associations among the multi-item self-report measures of craving were often larger for men than women, but the coefficients were typically statistically significant and meaningful regardless of gender, indicating good convergent validity despite differences in phrasing of items, response formats, and time periods over which craving was assessed. Generally smaller correlations among the VAS items indicated that these five terms were not inter-changeable among themselves (nor were they inter-changeable with scores on the multi-item questionnaires). Similarly to investigations using clinical samples, regression analyses revealed that recent drinking by binge-drinking students was associated with certain measures of self-reported craving.","Rosenberg, H; Mazzola, J",2007.0,10.1016/j.addbeh.2007.04.019,0,0,
4651,Intensive meditation training influences emotional responses to suffering.,"Meditation practices purportedly help people develop focused and sustained attention, cultivate feelings of compassionate concern for self and others, and strengthen motivation to help others who are in need. We examined the impact of 3 months of intensive meditative training on emotional responses to scenes of human suffering. Sixty participants were assigned randomly to either a 3-month intensive meditation retreat or a wait-list control group. Training consisted of daily practice in techniques designed to improve attention and enhance compassionate regard for others. Participants viewed film scenes depicting human suffering at pre- and posttraining laboratory assessments, during which both facial and subjective measures of emotion were collected. At post-assessment, training group participants were more likely than controls to show facial displays of sadness. Trainees also showed fewer facial displays of rejection emotions (anger, contempt, disgust). The groups did not differ on the likelihood or frequency of showing these emotions prior to training. Self-reported sympathy--but not sadness or distress--predicted sad behavior and inversely predicted displays of rejection emotions in trainees only. These results suggest that intensive meditation training encourages emotional responses to suffering characterized by enhanced sympathetic concern for, and reduced aversion to, the suffering of others.",Rosenberg EL.; Zanesco AP.; King BG.; Aichele SR.; Jacobs TL.; Bridwell DA.; MacLean KA.; Shaver PR.; Ferrer E.; Sahdra BK.; Lavy S.; Wallace BA.; Saron CD.,2015.0,10.1037/emo0000080,0,0,
4652,"Among inpatients, posttraumatic stress disorder symptom severity is negatively associated with time spent walking.","This study aimed to determine whether posttraumatic stress disorder (PTSD) symptom severity and psychological and functional variables were associated with physical activity (PA) upon admission to an inpatient facility. PTSD symptoms, depression, anxiety and stress, sleep quality, and PA participation were assessed among 76 participants (age, 47.6 +/- 11.9 years; 83% male). Backward stepwise regression analyses identified variables independently associated with time spent walking and engaging in moderate-vigorous PA (MVPA). No significant correlations were found between any of the variables and MVPA. Total PTSD symptoms (r = -0.39, p < 0.001), combined symptoms of depression, anxiety, and stress (r = -0.31, p < 0.01), and sleep behavior (r = -0.24, p< 0.05)were significantly and negatively associated with total walking time. Total PTSD symptoms were the only significant predictor of walking time (B = -0.03, SE = 0.008, beta = -0.4; t = -3.4; p < 0.001). Results indicate that increased PTSD symptoms are associated with lower levels of walking. Results highlight the importance of considering symptoms when designing PA programs for people with PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rosenbaum, Simon; Vancampfort, Davy; Tiedemann, Anne; Stubbs, Brendon; Steel, Zachary; Ward, Philip B; Berle, David; Sherrington, Catherine; Ahmadi, Babson, Boscarino, Bruins, Caspersen, Craig, de Assis, Dedert, Diaz, Ensari, Eraly, Farr, Fetzner, Field, Fu, Germain, Hanson, Hoerster, Janssen, Jayakody, Kessler, Kleinbaum, Kodama, Lamarche, Lovibond, Mammen, Marshall, Mitchell, Richardson, Roberts, Rosenbaum, Rosenbaum, Rosenbaum, Rosenbaum, Soundy, Soundy, Soundy, Talbot, van der Kolk, Vancampfort, Vancampfort, Vancampfort, Weathers",2016.0,,0,0,
4653,Exercise augmentation compared with usual care for post-traumatic stress disorder: A randomized controlled trial.,"Objective: To investigate the impact of a 12-week exercise programme in addition to usual care for post-traumatic stress disorder (PTSD). Method: An assessor-blinded randomized controlled trial was conducted among 81 participants with a DSM-IV-TR diagnosis of primary PTSD. Participants were recruited after admission to an in-patient programme at a private hospital. Participants were randomized to receive either usual care (n = 42), or exercise in addition to usual care (n = 39). The exercise intervention involved three, 30-min resistance-training sessions/week and a pedometer-based walking programme. Usual care involved psychotherapy, pharmaceutical interventions, and group therapy. Primary outcome was PTSD symptoms assessed via the PTSD checklist-civilian version (PCL-C). Secondary outcomes included symptoms of depression, anthropometry, physical activity, mobility, strength, and sleep quality. Results: Participants had a mean (SD) age of 47.8 years (12.1), 84% male. PTSD symptoms in the intervention group significantly reduced compared with the usual care group (mean difference = -5.4, 95%","Rosenbaum, S; Sherrington, C; Tiedemann, A; Alberti, Blake, Borg, Boscarino, Buysse, Carlier, Chalder, Cohen, Coldham, Cooney, Craig, de Assis, Diaz, Enright, Forbes, Forbes, Germain, Hass, Imel, Jayakody, Johannessen, Katzmarzyk, Lamarche, Lawrence, Lovibond, Nocon, Ratamess, Richardson, Rosenbaum, Rosenbaum, Scheewe, Schulz, Slade, Stanton, Sterne, Stubbs, Trivedi, Tudor-Locke, Vocks, Weathers, Wilkins, Youngstedt",2015.0,,0,0,
4654,Exercise augmentation compared with usual care for post-traumatic stress disorder: a randomized controlled trial.,"To investigate the impact of a 12-week exercise programme in addition to usual care for post-traumatic stress disorder (PTSD). An assessor-blinded randomized controlled trial was conducted among 81 participants with a DSM-IV-TR diagnosis of primary PTSD. Participants were recruited after admission to an in-patient programme at a private hospital. Participants were randomized to receive either usual care (n=42), or exercise in addition to usual care (n=39). The exercise intervention involved three, 30-min resistance-training sessions/week and a pedometer-based walking programme. Usual care involved psychotherapy, pharmaceutical interventions, and group therapy. Primary outcome was PTSD symptoms assessed via the PTSD checklist-civilian version (PCL-C). Secondary outcomes included symptoms of depression, anthropometry, physical activity, mobility, strength, and sleep quality. Participants had a mean (SD) age of 47.8 years (12.1), 84% male. PTSD symptoms in the intervention group significantly reduced compared with the usual care group (mean difference=-5.4, 95% CI -10.5 to -0.3, P=0.04, n=58). There were significant between-group differences at follow-up for depressive symptoms, waist circumference, sleep quality, and sedentary time. This study provides the first evidence that an exercise intervention is associated with reduced PTSD and depressive symptoms, reduced waist circumference, and improved sleep quality.",Rosenbaum S.; Sherrington C.; Tiedemann A.,2015.0,10.1111/acps.12371,0,0,
4655,Exercise augmentation compared to usual care for post traumatic stress disorder: a randomised controlled trial (the REAP study: Randomised Exercise Augmentation for PTSD).,"The physical wellbeing of people with mental health conditions can often be overlooked in order to treat the primary mental health condition as a priority. Exercise however, can potentially improve both the primary psychiatric condition as well as physical measures that indicate risk of other conditions such as diabetes mellitus and cardiovascular disease. Evidence supports the role of exercise as an important component of treatment for depression and anxiety, yet no randomised controlled trials (RCT's) have been conducted to evaluate the use of exercise in the treatment of people with post traumatic stress disorder (PTSD). This RCT will investigate the effects of structured, progressive exercise on PTSD symptoms, functional ability, body composition, physical activity levels, sleep patterns and medication usage. Eighty participants with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis of PTSD will be recruited. Participants will have no contraindications to exercise and will be cognitively able to provide consent to participate in the study. The primary outcome measures will be PTSD symptoms, measured through the PTSD Checklist Civilian (PCL-C) scale. Secondary outcome measures will assess depression and anxiety, mobility and strength, body composition, physical activity levels, sleep patterns and medication usage. All outcomes will be assessed by a health or exercise professional masked to group allocation at baseline and 12 weeks after randomisation. The intervention will be a 12 week individualised program, primarily involving resistance exercises with the use of exercise bands. A walking component will also be incorporated. Participants will complete one supervised session per week, and will be asked to perform at least two other non-supervised exercise sessions per week. Both intervention and control groups will receive all usual non-exercise interventions including psychotherapy, pharmaceutical interventions and group therapy. This study will determine the effect of an individualised and progressive exercise intervention on PTSD symptoms, depression and anxiety, mobility and strength, body composition, physical activity levels, sleep patterns and medication usage among people with a DSM-IV diagnosis of PTSD. ACTRN12610000579099.",Rosenbaum S.; Nguyen D.; Lenehan T.; Tiedemann A.; van der Ploeg HP.; Sherrington C.,2011.0,10.1186/1471-244X-11-115,0,0,
4656,The pharmacotherapy of panic disorder.,"Reviews literature on the efficacy in treating panic disorder of (1) antidepressants, including tricyclic antidepressants, MAO inhibitors, and selective serotonin ((5-hydroxytryptamine [5-HT]) reuptake inhibitors; benzodiazepines; and other agents and (2) integrated treatments that coadminister medications within or across classes or combine pharmacological and nonpharmacological (e.g., cognitive behavioral) therapies. Research regarding the relative efficacy of concurrent or sequential combination treatments is examined. Individualized treatment plans maximize the benefits of integrated treatments. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rosenbaum, Jerrold F; Pollock, Rachel A; Jordan, Sarah K; Pollack, Mark H",1996.0,,0,0,
4657,Racial differences in veterans' satisfaction with examination of disability from posttraumatic stress disorder.,"The examination that determines if a veteran has service-connected posttraumatic stress disorder (PTSD) affects veterans' lives for years. This study examined factors potentially associated with veterans' perception of their examination's quality. Veterans (N=384) being evaluated for an initial PTSD service-connection claim were randomly assigned to receive either a semistructured interview or the examiner's usual interview. Immediately after the interview, veterans completed confidential ratings of the examinations' quality and of their examiners' interpersonal qualities and competence. Extensive data characterizing the veterans, the 33 participating examiners, and the examinations themselves were collected. Forty-seven percent of Caucasian veterans and 34% of African-American veterans rated their examination quality as excellent. African Americans were less likely than Caucasians to assign a higher quality rating (odds ratio=.61, 95% confidence interval=.38-.99, p=.047). Compared with Caucasians, African Americans rated their examiners as having significantly worse interpersonal qualities but not lower competence. Ratings were not significantly related to the veterans' age, gender, marital status, eventual diagnosis of PTSD, Global Assessment of Functioning score, the examiner's perception of the prevalence of malingering, or the presence of a third party during the examination. Ratings of disability examinations were generally high, although ratings were less favorable among African-American veterans than among Caucasian veterans.",Rosen MI.; Afshartous DR.; Nwosu S.; Scott MC.; Jackson JC.; Marx BP.; Murdoch M.; Sinnott PL.; Speroff T.,2013.0,10.1176/appi.ps.201100526,0,0,
4658,A controlled study to assess the clinical efficacy of totally self-administered systematic desensitization.,,Rosen GM.; Glasgow RE.; Barrera M.,1976.0,,0,0,
4659,Telephone monitoring and support after discharge from residential PTSD treatment: a randomized controlled trial.,"This study assessed whether adding a telephone care management protocol to usual aftercare improved the outcomes of veterans in the year after they were discharged from residential treatment for posttraumatic stress disorder (PTSD). In a multisite randomized controlled trial, 837 veterans entering residential PTSD treatment were assigned to receive either standard outpatient aftercare (N=425) or standard aftercare plus biweekly telephone monitoring and support (N=412) for three months after discharge. Symptoms of PTSD and depression, violence, substance use, and quality of life were assessed by self-report questionnaires at intake, discharge, and four and 12 months postdischarge. Treatment utilization was determined from the Department of Veterans Affairs administrative data. Telephone case monitors reached 355 participants (86%) by phone at least once and provided an average of 4.5 of the six calls planned. Participants in the telephone care and treatment-as-usual groups showed similar outcomes on all clinical measures. Time to rehospitalization did not differ by condition. In contrast with prior studies reporting poor treatment attendance among veterans, participants in both telephone monitoring and treatment as usual completed a mental health visit an average of once every ten days in the year after discharge. Many participants had continuing problems despite high utilization of outpatient care. Telephone care management had little incremental value for patients who were already high utilizers of mental health services. Telephone care management could potentially be beneficial in settings where patients experience greater barriers to engaging with outpatient mental health care after discharge from inpatient treatment.",Rosen CS.; Tiet QQ.; Harris AH.; Julian TF.; McKay JR.; Moore WM.; Owen RR.; Rogers S.; Rosito O.; Smith DE.; Smith MW.; Schnurr PP.,2013.0,10.1176/appi.ps.201200142,0,0,
4660,Do benzodiazepines reduce the effectiveness of exposure therapy for posttraumatic stress disorder?,"Benzodiazepines, other anxiolytics, or sedative hypnotics are prescribed for 30%-50% of posttraumatic stress disorder (PTSD) patients. Prior data and theory suggest that these medications may inhibit response to exposure therapy, one of the most effective PTSD treatments. The present post hoc study reanalyzed results from a psychotherapy trial to assess whether benzodiazepine use was associated with reduced response to exposure therapy. Between August 2002 and October 2005, 283 female veterans and soldiers meeting DSM-IV criteria for PTSD were randomly assigned to 10 weekly 90-minute sessions of either prolonged exposure (n = 140) or present-centered psychotherapy (n = 143). Benzodiazepine use (n = 57) or non-use (n = 226) at intake was not randomly assigned. Multilevel modeling was used to assess the effects of benzodiazepine status, psychotherapy condition, and their interaction on changes on the Clinician-Administered PTSD Scale and the PTSD Checklist during the treatment and 6-month follow-up periods. Consistent with prior reports from these data, prolonged exposure psychotherapy produced greater reductions per week in PTSD symptoms than did present-centered psychotherapy (b = -0.48, P = .02). Patients prescribed benzodiazepines did not have weaker response to prolonged exposure, but demonstrated poorer posttreatment maintenance of gains from present-centered psychotherapy (b = -0.78, P < .001). Prolonged exposure is a sufficiently robust treatment that patients who are taking benzodiazepines can benefit from it. It is unclear whether benzodiazepine use or other patient factors accounted for benzodiazepine recipients' poorer maintenance of gains in present-centered psychotherapy. ClinicalTrials.gov identifier: NCT00032617.",Rosen CS.; Greenbaum MA.; Schnurr PP.; Holmes TH.; Brennan PL.; Friedman MJ.,2013.0,10.4088/JCP.13m08592,0,0,
4661,Telephone monitoring and support for veterans with chronic posttraumatic stress disorder: A pilot study.,"Dropout from outpatient mental health treatment may contribute to high rates of relapse and rehospitalization among veterans with chronic posttraumatic stress disorder (PTSD). In a quasi-experimental cohort study, 87 male and 17 female veterans discharging from residential PTSD treatment received either standard referral to outpatient care (N = 77) or standard referrals supplemented by biweekly telephone calls (N = 27). Telephone monitoring and support was feasible and acceptable to 85% of clients. Compared to prior patient cohorts, clients receiving telephone support were twice as likely (88% vs. 43%) to complete an outpatient visit within 1 month of discharge and reported higher satisfaction with care. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rosen, Craig S; DiLandro, Caryn; Corwin, Kim N; Drescher, Kent D; Cooney, Jean H; Gusman, Fred; Dietrich, Fontana, Hartl, Hilton, Jerant, Keane, MacDonald, McKay, McLellan, Piette, Ronis",2006.0,,0,0,
4662,Treatment response for late-life generalized anxiety disorder: moving beyond symptom-based measures.,"Response to treatment of late-life generalized anxiety disorder has been defined by a variety of methods, all based on statistically significant reductions in symptom severity. However, it is unknown whether these improvements in symptom severity are associated with meaningful differences in everyday functioning. The current study used four methods to define response to treatment for 115 primary-care patients 60 years and older, with a principal or coprincipal diagnosis of generalized anxiety disorder. The methods examined included percentage of improvement, reliable change index, and minimal clinically significant differences. Agreement among classification methods and their associations with general and mental health-related quality of life were assessed. Results indicated moderate agreement among symptom-based classification methods and significant associations with measures of quality of life.",Roseman AS.; Cully JA.; Kunik ME.; Novy DM.; Rhoades HM.; Wilson NL.; Bush AL.; Stanley MA.,2011.0,10.1097/NMD.0b013e31822feda6,0,0,
4663,"Integration of fur, paws, whiskers and hooves into your agency-enhancing patients' lives through pet therapy","Objectives • Describe the benefits of and process to develop a pet therapy program. • Compare and contrast Animal Assisted Activity versus Animal Assisted Therapy and therapy versus service animals. Pet therapy is a positive opportunity to diversify the psychosocial programs that hospice and palliative care agencies offer. There is wide agreement on the benefits of pet therapy, including but not limited to: • positive sensory stimulation • distraction from pain, distress and agitation • lightened mood • facilitation of communication and movement • lowered blood pressure • . and more Patients, families and staff talk about pet therapy nationally. fromthe research findings, to firsthand accounts, to sharing amazing stories posted on social media. This session will discuss how to offer pet therapy as an additional integrative therapy for hospice/palliative care clients. Participants will learn how to create and maintain a pet therapy program. People assume the first step to pet therapy is acquiring the pets. As important as this is, the many other intermediary steps such as the following will be elaborated upon in the session: • Weigh pros and cons and decide on providing Animal Assisted Visits and/or Animal Assisted Therapy. • Obtain budget, support, and resources from administration, volunteer services, quality/risk, infection control, employee health and other related departments. • Write and approve policies. • Create referral process; educate and disseminate to appropriate staff. • Obtain or identify Volunteer Coordinator(s) to recruit, interview, orient, assign and supervise pet therapy volunteers including assurance of pet therapy specific compliance issues. • Become informed and clear on the differences between therapy and service animals. In lieu of creating an internal agency program, alternative community options will be discussed. Participants will leave the session with the tools necessary to build a successful pet therapy program.",Roseman A.,2017.0,10.1016/j.jpainsymman.2016.12.107,0,0,
4664,A randomized controlled trial of individual psychological debriefing for victims of violent crime.,"It has been suggested that giving people the opportunity talk about a traumatic experience may prevent the development of later disorder. We tested the efficacy of two brief interventions, education and psychological debriefing, designed to prevent adverse psychological reactions to criminal victimization. Individuals who had been the victims of a violent crime within the past month were written to and invited to take part in a study of their attitudes to crime and punishment: 2161 were contacted and 243 replied, of whom 157 were eligible and were randomly assigned either to an education condition, to a psychological debriefing plus education condition, or to an assessment only condition. Education involved providing information about normal post-traumatic reactions. Debriefing involved in-depth probing about events, thoughts and feelings experienced during the crime. Subjects were recruited from police and hospital sources and interviewed in their own homes: 138 were followed up at 6 months, and 92 at 11 months. Outcome was assessed using a DSM-III-R diagnosis of PTSD, the Post-traumatic Symptom Scale, the Impact of Event Scale and the Beck Depression Inventory. All groups improved over time but there were no between-group differences. No evidence was found to support the efficacy of brief one-session interventions for preventing post-traumatic symptoms in individual victims of violent crime.",Rose S.; Brewin CR.; Andrews B.; Kirk M.,1999.0,,0,0,
4665,"A randomized controlled trial of a self-guided, multimedia, stress management and resilience training program.","Stress is a common and costly behavioral health issue. Technology-based behavioral health programs (e.g., computer or web-based programs) are effective for treating anxiety or depression. These programs increase availability of evidence-based interventions to individuals who are not able or willing to receive such in-person treatments. Stress management training has empirical support, but little data exists on its efficacy with stressed but healthy individuals, and there are no prior studies employing a self-guided, multimedia intervention. We conducted a randomized controlled trial of a self-guided, multimedia stress management and resilience training program (SMART-OP) with a stressed but healthy sample. Participants (N = 66) were randomized to SMART-OP or an attention control (AC) group that received marketed videos and published material on stress management. Participants were evaluated on self-report measures and Trier Social Stress Test (TSST) performance. Analyses were based on study completers (N = 59). SMART-OP group reported significantly less stress, more perceived control over stress, and rated SMART-OP as significantly more useful than AC. During the TSST, the data suggests the SMART-OP group showed greater within-task α-amylase recovery at post-assessment. SMART-OP is highly usable and is a more effective and useful stress management training program than an educational comparison.",Rose RD.; Buckey JC.; Zbozinek TD.; Motivala SJ.; Glenn DE.; Cartreine JA.; Craske MG.,2013.0,10.1016/j.brat.2012.11.003,0,0,
4666,Breathing biofeedback as an adjunct to exposure in cognitive behavioral therapy hastens the reduction of PTSD symptoms: a pilot study.,"Although trauma-focused cognitive behavioral therapy (TF-CBT) with exposure is an effective treatment for posttraumatic stress disorder (PTSD), not all patients recover. Addition of breathing biofeedback to exposure in TF-CBT is suggested as a promising complementary technique to improve recovery of PTSD symptoms. Patients (n = 8) with chronic PTSD were randomized to regular TF-CBT or TF-CBT with complementary breathing biofeedback to exposure. PTSD symptoms were measured before, during and after TF-CBT with the Impact of Event Scale-Revised. The results show that breathing biofeedback is feasible and can easily be complemented to TF-CBT. Although PTSD symptoms significantly decreased from pre to post treatment in both conditions, there was a clear trend towards a significantly faster (p = .051) symptom reduction in biofeedback compared to regular TF-CBT. The most important limitation was the small sample size. The hastened clinical improvement in the biofeedback condition supports the idea that breathing biofeedback may be an effective complementary component to exposure in PTSD patients. The mechanism of action of breathing biofeedback may relate to competing working memory resources decreasing vividness and emotionality, similar to eye movement desensitization and reprocessing. Future research is needed to examine this.",Rosaura Polak A.; Witteveen AB.; Denys D.; Olff M.,2015.0,10.1007/s10484-015-9268-y,0,0,
4667,Selective attention to fearful faces during pregnancy,"Background: There is some evidence that pregnancy may be associated with cognitive affective changes, including increased ability to encode emotional faces signaling threat and increased anxiety. Nevertheless, findings to date are inconsistent, and there are few data on correlations with endocrine and hormonal measures. The aim of this study was to investigate danger sensitivity, as measured by selective attention to fearful and angry faces during pregnancy, and to correlate findings with distress and anxiety levels, glucocorticoid (cortisol) and gonadal hormones (estrogen, progesterone and testosterone). Methods: Selective attention to fearful, angry and happy faces was assessed in pregnant women (n = 44) and non-pregnant controls (n = 25) using a modified version of an emotional Stroop task. General distress was assessed using the K-10, and state and trait anxiety using the Spielberger State-Trait Inventory. Levels of cortisol, estrogen, progesterone and testosterone were determined at trimester 2 and 3. Analyses of variance, regression and correlational analyses were used to investigate associations between variables. Results: Pregnant women showed altered attentional responses to fearful faces, in comparison to controls. When analyzed according to different levels of distress (K-10 > 20 or K-10 ≤ 20), distressed pregnant women had significantly increased selective attention to fearful faces compared to distressed non-pregnant controls. Attention to fear was significantly associated with increased levels of estrogen and progesterone at trimester 2, and decreased levels of cortisol at trimester 3 of pregnancy. Conclusion: Heightened sensitivity to danger cues during pregnancy is consistent with a perspective that emphasizes the importance of parental precaution and the adaptive significance of responding to potentially hazardous stimuli during this period. Such changes may be particularly apparent in distressed women, and may be mediated by changes in glucocorticoid and gonadal hormone systems during pregnancy. © 2011 Elsevier Inc.",Roos A.; Lochner C.; Kidd M.; van Honk J.; Vythilingum B.; Stein D.J.,2012.0,10.1016/j.pnpbp.2011.11.012,0,0,
4668,Reducing depression in 9-10 year old children in low SES schools: a longitudinal universal randomized controlled trial,"ER The Aussie Optimism: Positive Thinking Skills Program (AOP-PTS) is an innovative curriculum-based mental health promotion program based on cognitive and behavioural strategies. The program is aimed at preventing depressive and anxiety symptoms and disorders in middle primary school children aged 9-10 years. Students from 22 low SES primary schools (N = 910) were randomly assigned to an intervention or a control group and assessed at baseline, post-test, 6 months and 18 months. The intervention group received the program implemented by teachers and the control group received their regular Health Education curriculum. Students completed questionnaires on depression, anxiety, and attribution style. At risk students were further assessed with the computerised Diagnostic Interview for Children and Adolescents. Parents reported on their children's externalising and internalising problems at home. Children in the intervention condition reported a significant pre-post reduction in depressive symptoms, and there was a significant pre-post reduction in parent-reported emotional difficulties which was maintained at 6 month follow-up; no changes were evident in the control group. Both groups showed significant improvements in child-reported anxiety and attribution style, and significant improvements in parent-reported pro-social behaviours. For both groups, there were no significant post-baseline changes in incidence and recovery rates for depression, anxiety, or internalising symptoms. These findings suggest that AOP-PTS has the potential to treat depressive symptomatology in the immediate term but the effects were not sustained. There is also evidence of improved emotional resilience up to 6 months following the program. Further follow-up to investigate longer term effects is needed.","Rooney, R; Hassan, S; Kane, R; Roberts, C M; Nesa, M",2013.0,10.1016/j.brat.2013.09.005,0,0,
4669,A pilot study of coupled plasma filtration with adsorption in septic shock,"ER DESIGNProspective, pilot, crossover clinical trial.SETTINGGeneral intensive care unit in a teaching hospital.SUBJECTSTen patients with hyperdynamic septic shock.INTERVENTIONSPatients were randomly allocated to 10 hrs of either coupled plasma filtration adsorption plus hemodialysis (treatment A) or continuous venovenous hemodiafiltration (treatment B) in random order. We measured the change in mean arterial pressure, norepinephrine requirements, and leukocyte tumor necrosis factor-alpha (TNF-alpha) production (both spontaneous and lipopolysaccharide-stimulated) after 10 hrs of each treatment. We also tested TNF-alpha production from normal human adherent monocytes incubated with patients' plasma obtained before and after the resin, both with or without incubation with an anti-interleukin-10 monoclonal antibody.RESULTSMean arterial pressure increased after 10 hr by 11.8 mm Hg with treatment A and by 5.5 mm Hg with treatment B (p =.001). There was an average decrease of norepinephrine requirement of 0.08 microg/kg/min with treatment A and 0.0049 microg/kg/min with treatment B (p =.003). All patients but one survived. Spontaneous and lipopolysaccharide-induced TNF-alpha production from patients' whole blood increased over time with treatment A. This increase was more marked in blood drawn after the device (plasmafiltrate-sorbent plus hemodialyzer) (p =.009). Preresin plasma suppressed lipopolysaccharide-stimulated production of TNF-alpha by 1 x 10(6)cultured adherent monocytes from healthy donors. This suppressive effect was significantly reduced after passage of plasma through the resin (p =.019) and after incubation with anti-interleukin-10 monoclonal antibodies (p =.028).CONCLUSIONSIn patients with septic shock, coupled plasmafiltration-adsorption combined with hemodialysis was associated with improved hemodynamics compared with continuous venovenous hemodiafiltration. This result might be related to its ability to restore leukocyte responsiveness to lipopolysaccharide. These findings suggest a potential role for blood purification in the treatment of septic shock.OBJECTIVETo test the hypothesis that nonselective plasma adsorption by a hydrophobic resin (coupled plasmafiltration and adsorption) could improve hemodynamics and restore leukocyte responsiveness in patients with septic shock.","Ronco, C; Brendolan, A; Lonnemann, G; Bellomo, R; Piccinni, P; Digito, A; Dan, M; Irone, M; Greca, G; Inguaggiato, P; Maggiore, U; Nitti, C; Wratten, M L; Ricci, Z; Tetta, C",2002.0,,0,0,
4670,Post-deployment screening for mental disorders and tailored advice about help-seeking in the UK military: A cluster randomised controlled trial.,"Background: The effectiveness of post-deployment screening for mental disorders has not been assessed in a randomised controlled trial. We aimed to assess whether post-deployment screening for post-traumatic stress disorder (PTSD), depression, anxiety, or alcohol misuse was effective. We defined screening as the presumptive identification of a previously unrecognised disorder using tests to distinguish those who probably had the disorder from those who probably did not so that those people with a probable disorder could be referred appropriately, and assessed effectiveness and consequences for help-seeking by the odds ratio at follow-up between those receiving tailored help-seeking advice and those who received general mental health advice. Methods: We did a cluster randomised controlled trial among Royal Marines and Army personnel in the UK military after deployment to Afghanistan. Platoons were randomly assigned (1:1 initially, then 2:1) by stratified block randomisation with randomly varying block sizes of two and four to the screening group, which received tailored help-seeking advice, or the control group, which received general mental health advice. Initial assessment took place 6-12 weeks after deployment; follow-up assessments were done 10-24 months later. Follow-up measures were the PTSD Checklist-Civilian Version, Patient Health Questionnaire-9, Generalised Anxiety Disorder-7 scale, Alcohol Use Disorder Identification Test (AUDIT), and self-reported help-seeking from clinical and welfare providers comparing those receiving tailored advice and those receiving only general advice. All participants and all investigators other than the person who analysed the data were masked to allocation. The primary outcomes were PTSD, depression or generalised anxiety disorder, and alcohol misuse at follow-up. A key secondary outcome was assessment of whether post-deployment screening followed by tailored advice would modify help-seeking behaviour. Comparisons were made between screening and control groups, with primary analyses by intention to treat. This trial is registered with the ISRCTN Registry, number ISRCTN19965528. Findings: Between Oct 24, 2011, and Oct 31, 2014, 434 platoons comprising 10 190 personnel were included: 274 (6350 personnel) in the screening group and 160 (3840 personnel) in the control group. 5577 (88%) of 6350 personnel received screening and 3996 (63%) completed follow-up, whereas 3149 (82%) of 3840 received the control questionnaire and 2369 (62%) completed follow-up. 1958 (35%) of 5577 personnel in the screening group declined to see the tailored advice, but those with PTSD (83%) or anxiety or depression (84%) were more likely than non-cases (64%) to view the advice (both p < 0.0001). At follow-up, there were no significant differences in prevalence between groups for PTSD (adjusted odds ratio 0.92, 95% CI 0.75-1.14), depression or anxiety (0.91, 0.71-1.16), alcohol misuse (0.88, 0.73-1.06), or seeking support for mental disorders (0.92, 0.78-1.08). Interpretation: Post-deployment screening for mental disorders based on tailored advice was not effective at reducing prevalence of mental health disorders nor did it increase help-seeking. Countries that have implemented post-deployment screening programmes for mental disorders should consider monitoring the outcomes of their programmes. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Rona, Roberto J; Burdett, Howard; Khondoker, Mizanur; Chesnokov, Melanie; Green, Kevin; Pernet, David; Jones, Norman; Greenberg, Neil; Wessely, Simon; Fear, Nicola T; Adler, Babor, Berntsen, Blanchard, Bliese, Bonanno, Burdett, Eekhout, Fear, Hines, Hoge, Hoge, Hoge, Iverson, Jones, Keeling, Kehle-Forbes, Kroenke, Lee, Lee, Milliken, Rabe-Hesketh, Rona, Rona, Rona, Rona, Rona, Rona, Seal, Spitzer, Steenkamp, Steenkamp, Torgerson, Tran, Vasterling, Vermetten, Ware, Warner, Warner, White, Wong, Zamorski",2017.0,,0,0,
4671,Predicting persistent posttraumatic stress disorder (PTSD) in UK military personnel who served in Iraq: a longitudinal study.,"In a longitudinal study we assessed which baseline risk factors are associated with persistent and partially remitted PTSD in comparison to fully remitted PTSD. 6427 (68%) of a randomly selected sample of UK service personnel completed the PTSD checklist (PCL) between 2004 and 2006 (Phase 1) and between 2007 and 2009 (Phase 2). 230 (3.9%) had possible PTSD at baseline. 66% of those with possible PTSD at baseline remitted (PCL score <30) or partially remitted (PCL score 30-49) by phase 2 of the study. Associations of persistent PTSD with the fully remitted group for risk factors at phase 1 adjusted for confounders were having discharged from service (OR 2.97, 95% CI 1.26-6.99), higher educational qualification (OR 2.74, 95% 1.23-6.08), feeling unsupported on return from deployment (OR 10.97, 95% CI 3.13-38.45), deployed not with parent unit (OR 5.63, 95% CI 1.45-21.85), multiple physical symptoms (OR 3.36, 95% CI 1.44-7.82), perception of poor or fair health (OR 2.84, 95% CI 1.28-6.27), older age and perception of risk to self (increasing with the number of events reported, p = 0.04). Deploying but not with a parent unit and psychological distress were associated in the partially remitted PTSD when compared to the fully remitted group. The positive and negative likelihood ratios for the factors most highly associated with persistent PTSD indicated they were of marginal value to identify those whose presumed PTSD would be persistent. Many factors contribute to the persistence of PTSD but none alone is useful for clinical prediction.",Rona RJ.; Jones M.; Sundin J.; Goodwin L.; Hull L.; Wessely S.; Fear NT.,2012.0,10.1016/j.jpsychires.2012.05.009,0,0,
4672,Screening for physical and psychological illness in the British Armed Forces: I: The acceptability of the programme.,"To assess the response to a self-administered questionnaire and attendance of a medical centre for physical and psychological health screening. 4500 men and women from the three services were randomly selected to receive either a full or abridged screening questionnaire. The full questionnaire included the General Health Questionnaire-12 (GHQ-12) and Post-traumatic Stress Disorder (PTSD) checklist, 15 symptoms, a self-assessed health status question and three questions on alcohol behaviour (WHO Audit). The abridged questionnaire included GHQ-4, a slightly shortened PTSD checklist and five symptoms, but excluded questions on alcohol behaviour. All 'screen-positive' and a random 'screen-negative' sample were invited to attend a medical centre. 67.1% of the servicemen completed a questionnaire; slightly but significantly more the abridged than the full questionnaire (4.9%, 95% confidence interval 2.3-7.4%). Of those receiving a full or abridged questionnaire, 32% and 22.5% respectively were 'screen-positives', most of the difference (7.5%) attributable to alcohol behaviour. Less than 30% of the servicemen invited to attend a medical centre accepted the invitation, even fewer during the preparation for deployment to Iraq. Those who fulfilled the criteria for PTSD, alcohol behaviour or multi-criteria 'screen-positive' were more reluctant than controls to attend. Screening for psychological illness has little support among servicemen, perhaps because they may not wish to share concerns with a military doctor. Avoidance behaviour among those with a psychological condition may also selectively reduce willingness to attend a medical centre. Screening during pre-deployment periods has even less support than at other times.",Rona RJ.; Jones M.; French C.; Hooper R.; Wessely S.,2004.0,10.1258/0969141041732193,0,0,
4673,Cost-effectiveness of blended vs. face-to-face cognitive behavioural therapy for severe anxiety disorders: study protocol of a randomized controlled trial.,"Anxiety disorders are among the most prevalent psychiatric conditions, and are associated with poor quality of life and substantial economic burden. Cognitive behavioural therapy is an effective treatment to reduce anxiety symptoms, but is also costly and labour intensive. Cost-effectiveness could possibly be improved by delivering cognitive behavioural therapy in a blended format, where face-to-face sessions are partially replaced by online sessions. The aim of this trial is to determine the cost-effectiveness of blended cognitive behavioural therapy for adults with anxiety disorders, i.e. panic disorder, social phobia or generalized anxiety disorder, in specialized mental health care settings compared to face-to-face cognitive behavioural therapy. In this paper, we present the study protocol. It is hypothesized that blended cognitive behavioural therapy for anxiety disorders is clinically as effective as face-to-face cognitive behavioural therapy, but that intervention costs may be reduced. We thus hypothesize that blended cognitive behavioural therapy is more cost-effective than face-to-face cognitive behavioural therapy. In a randomised controlled equivalence trial 156 patients will be included (n‚Äâ=‚Äâ78 in blended cognitive behavioural therapy, n‚Äâ=‚Äâ78 in face-to-face cognitive behavioural therapy) based on a power of 0.80, calculated by using a formula to estimate the power of a cost-effectiveness analysis: [Formula: see text]. Measurements will take place at baseline, midway treatment (7 weeks), immediately after treatment (15 weeks) and 12-month follow-up. At baseline a diagnostic interview will be administered. Primary clinical outcomes are changes in anxiety symptom severity as measured with the Beck Anxiety Inventory. An incremental cost-effectiveness ratio will be calculated to obtain the costs per quality-adjusted life years (QALYs) measured by the EQ-5D (5-level version). Health-economic outcomes will be explored from a societal and health care perspective. This trial will be one of the first to provide information on the cost-effectiveness of blended cognitive behavioural therapy for anxiety disorders in routine specialized mental health care settings, both from a societal and a health care perspective. Netherlands Trial Register NTR4912. Registered 13 November 2014.",Romijn G.; Riper H.; Kok R.; Donker T.; Goorden M.; van Roijen LH.; Kooistra L.; van Balkom A.; Koning J.,2015.0,10.1186/s12888-015-0697-1,0,0,
4674,Influence of the noradrenergic system on the formation of intrusive memories in women: An experimental approach with a trauma film paradigm.,"Background: Intrusive memories of traumatic events are a core feature of post-traumatic stress disorder but little is known about the neurobiological formation of intrusions. The aim of this study was to determine whether the activity of the noradrenergic system during an intrusion-inducing stressor would influence subsequent intrusive memories. Method: We conducted an experimental, double-blind, placebo-controlled study in 118 healthy women. Participants received a single dose of either 10 mg yohimbine, stimulating noradrenergic activity, or 0.15 mg clonidine, inhibiting noradrenergic activity, or placebo. Subsequently, they watched an established trauma film which induced intrusions. The number of consecutive intrusions resulting from the trauma film, the vividness of the intrusions, and the degree of distress evoked by the intrusions were assessed during the following 4 days. Salivary cortisol and alpha-amylase were collected before and after the trauma film. Results: A significant time x treatment interaction for the number of intrusions and the vividness of intrusions indicated a different time course of intrusions depending on treatment. Post-hoc tests revealed a delayed decrease of intrusions and a delayed decrease of intrusion vividness after the trauma film in the yohimbine group compared with the clonidine and placebo groups. Furthermore, after yohimbine administration, a significant increase in salivary cortisol levels was observed during the trauma film. Conclusions: Our findings indicate that pharmacological activation of the noradrenergic system during an emotionally negative event makes an impact on consecutive intrusive memories and their vividness in healthy women. The noradrenergic system seems to be involved in the formation of intrusive memories. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rombold, F; Wingenfeld, K; Renneberg, B; Hellmann-Regen, J; Otte, C; Roepke, S; Andreano, Arntz, Bailey, Bernstein, Breslau, Bryant, Chamberlain, Cheung, Chou, Debiec, Ehlers, Ehlers, Faul, Felmingham, Finsterwald, First, Gazarini, Gurguis, Hagenaars, Holmes, Holmes, Horowitz, Kessler, Krystal, Kuffel, Kuhlmann, Lemieux, Lorentz, McNally, Nater, Nicholson, Otte, Owen, Pruessner, Reid, Roozendaal, Roozendaal, Schwabe, Segal, Segal, Shalev, Smeets, Sommer, Southwick, Southwick, Spielberger, Strange, Takarangi, Taylor, Thoma, Tiplady, Van Stegeren, Van Stegeren, Weidmann, Wingenfeld, Wittchen",2016.0,,0,0,
4675,Usefulness and feasibility of psychophysical and electrophysiological olfactory testing in the rhinology clinic.,"Olfactory dysfunction may be assessed in the clinic with psychophysical testing and electrophysiological recording. Chemosensory event-related potentials (CSERPs) constitute an objective method to assess chemosensory function. Olfactory and trigeminal stimuli activate chemoreceptors from the olfactory neuroepithelium and from the nasal mucosa to evoke an electrophysiological response respectively called olfactory (OERPs) and trigeminal ERPs (TERPs). The purpose of this study is to assess the usefulness and feasibility of these diagnostic tools in the rhinology clinic and to correlate these results to the olfactory disorder aetiology. This study encompasses a cohort of 229 patients with a complaint of olfactory dysfunction from different origins. Orthonasal (Sniffing stick test with the treshold-discrimination-identification score: maximal score 48) and retronasal olfactory (maximal score 20) testing as well as CSERPs both after olfactory and trigeminal stimuli have been routinely performed. Olfactory dysfunction aetiologies were as follows: congenital (Cong.), chronic rhinosinusitis (CRS), idiopathic (Idiop.), post-medication (PM), neurologic (Neuro.), post-traumatic (PT) and post-infection (PI). Mean orthonasal and retronasal scores were respectively: 11.8 and 10.1 for Cong., 18.5 and 13.1 for CRS, 15.6 and 10.4 for Idiop., 15.3 and 10.2 for PM, 17 and 10.6 for Neuro., 15 and 9.9 for PT and 18.3 and 12 for PI. Correlations between orthonasal and retronasal scores were present for all subgroups except congenital and chronic rhinosinusitis subgroups. Orthonasal and retronasal scores were different (p < 0.05) when comparing CRS vs Cong., CRS vs PT and PT vs PI. Technical problems (olfactometer or olfactory stimulation, EEG amplifier,...) and patients discomfort (anxiety, stress,...) did not allow to draw any conclusion in 2 patients. Three patients after olfactory stimulus and 6 patients after trigeminal stimulus demonstrated too much eye blinking or muscular artifacts that did not allow us to perform electrophysiological analysis and averaging as 60% of artifact-free recording was not achieved. Olfactory ERPs were recorded in 28% of the patients and trigeminal ERPs were obtained in almost every patient (95%). There was no statistical difference between each subgroup regarding the presence or absence of OERPs. Psychophysical olfactory testing is a useful method to assess olfactory function in patients with olfactory loss and may help us to obtain a semi-objective and a basal evaluation of the olfactory performances. Feasibility and usefulness of CSERPs are also underlined in this study with only a limited number of patients who did not complete the examination. Psychophysical testing gives different results according to the aetiology of the olfactory disorder, which was not the case for electrophysiological recording. Olfactory acuity assessment should be based on psychophysical and CSERPs evaluation in a clinical setting.",Rombaux P.; Mouraux A.; Collet S.; Eloy P.; Bertrand B.,2009.0,,0,0,
4676,A new method to reduce pin-prick pain of intra-muscular and subcutaneous injections.,"Although about 10% of the normal population is thought to be needle-phobic, no method to reduce pin-prick pain is currently available for large scale application. We describe a new simple and easy-to-do method to reduce pin-prick pain through the pressure of multiple blunt pins at the injection site. Two-hundred and twelve patients were randomly assigned to 2 groups. The treated group (n= 106) received intramuscular and subcutaneous injections with the application of the blunt pins and the control group (n= 106) with a placebo device. Pain was tested with the visual analogue scale on a 0 (no pain)-10 (maximum pain) scale. After intramuscular injections a significant (P< 0.0001) pain reduction in the treated group compared to placebo was observed: 1.90+/-1.27 versus 5.16+/-1.37 (mean pain reduction: 63.2%); 88.5% of the patients in the treated group and 11.4% in placebo group rated the pain as = or < 3. After subcutaneous injections mean reported pain in the treated group compared to placebo was: 0.32+/-0.51 versus 2.61+/-0.77 (mean pain reduction: 87.7%) (P< 0.0001); 95.1% of the patients in the treated group and 9.8% in the placebo rated the pain as = or <1. No side effects were observed. Multiple blunt pins pressure on the skin, at the time of intramuscular or subcutaneous injection is able to significantly reduce pin-prick pain. The underlying physiological mechanisms are briefly discussed.",Romanò CL.; Cecca E.,2005.0,,0,0,
4677,Symptomatic severity of PRIME-MD diagnosed episodes of panic and generalized anxiety disorder in primary care.,"Panic disorder (PD) and generalized anxiety disorder (GAD) are often unrecognized by primary care physicians (PCPs). The Primary Care Evaluation of Mental Disorders (PRIME-MD) has been used as a case-finding instrument for depression. Yet, little is known on its usefulness as a case-finding tool for anxiety disorders within the context of a clinical trial. To examine the: (1) completion rate of the PRIME-MD by patients approached to enroll in a treatment study for PD and GAD; (2) distribution of anxiety diagnoses generated; (3) severity of PD and GAD episodes thus identified; and (4) level of PCPs' agreement with these diagnoses. Cross-sectional interview. Individuals aged 18 to 64 who presented for care at 4 primary care practices. The PRIME-MD, Structured Interview Guide for the Hamilton Anxiety Rating Scale (SIGH-A), and the Panic Disorder Severity Scale (PDSS). Of the 6,700 patients who completed the PRIME-MD Patient Questionnaire (PQ), 2,926 (44%) screened positive for an anxiety disorder, and 1,216 (42%) met preliminary study eligibility and consented to the PRIME-MD Anxiety Module. Of these, 619 (51%) had either GAD (308), PD (94), or both (217) disorders. Later, 329 completed a telephone interview. Of these, 59% with GAD and 68% with PD reported moderate or greater levels of anxiety symptoms on the SIGH-A and PDSS, respectively, and PCPs agreed with the PRIME-MD diagnosis for 98% of these patients. The PRIME-MD can efficiently screen patients for PD and GAD. Although patients thus identified endorse a wide range of anxiety symptoms, PCPs often agree with the diagnosis.",Rollman BL.; Belnap BH.; Mazumdar S.; Zhu F.; Kroenke K.; Schulberg HC.; Katherine Shear M.,2005.0,10.1111/j.1525-1497.2005.0120.x,0,0,
4678,Independent evaluator knowledge of treatment in a multicenter comparative treatment study of panic disorder.,"The purpose of this study was to examine independent evaluators' (IEs) blindness to treatment condition during a Multicenter Comparative Treatment Study of Panic Disorder. IEs were 15 doctoral- and masters-level clinicians in psychology, social work, and medicine. They conducted three post-treatment assessments with each patient. Immediately after each assessment interview, IEs completed a form indicating which of the five possible treatments they believed the patient had received and any specific information that provided IEs with information about a patient's treatment condition. These forms were completed for 170 patients. Analyses were conducted to determine the accuracy of guesses about treatment condition by IEs during post-treatment assessments, the relationship between accuracy of IE guessing and actual treatment assignment, the relationship between accurate guessing and outcome ratings, and contributors to the breaking of the blind. A significant relationship was found between IE guesses and actual treatment at all three assessment points, across individual IEs, treatment sites, and IE professional affiliations. IEs were no more accurate in their guessing about patients taking medication than those receiving behavior therapy. Patients and project staff inadvertently provided information to IEs that enhanced the rates of accurate guessing. Implications of these findings on interpretation of the treatment study are discussed, and recommendations are made for improving blindness procedures.",Roll D.; Ray SE.; Marcus SM.; Passarelli V.; Money R.; Barlow DH.; Woods SW.; Shear MK.; Gorman JM.,2004.0,10.1038/sj.npp.1300373,0,0,
4679,Musculoskeletal Pain as a Marker of Health Quality. Findings from the Epidemiological Sleep Study among the Adult Population of S√£o Paulo City.,"We are witnessing the growth of urban populations, particularly in the developing world. S√£o Paulo, the largest city in South America, continues to grow, and this growth is dramatically effecting the environment and human health. The aim of this study was to estimate the point prevalence of chronic pain in S√£o Paulo city dwellers and to explore the influence of aspects related to urbanicity. A two-stage cluster randomized sample included 1100 individuals of the city of Sao Paulo, representing the population proportionally in terms of gender, age and social classes in 2007. For this observational cross-sectional study, the household sample was interviewed using validated questionnaires for sociodemographic aspects, the Beck inventories for anxiety and depression, the WHOQoL-REF for quality of life, the Chalder Fatigue Scale. Musculoskeletal pain was defined as diffuse pain or pain located in the back, joints or limbs. Data regarding sleep complaints and polysomnography were obtained from the Epidemiologic Sleep Study conducted in S√£o Paulo city in 2007. The prevalence estimate of chronic musculoskeletal pain was approximately 27%, with a female/male ratio of approximately 2.6/1. The predictors were being in the age-range of 30-39 years, low socioeconomic and schooling levels, obesity, sedentarism, fatigue, non-restorative sleep, daytime sleepiness, poor sleep quality, poor life quality, anxiety and depression symptoms. Psychological wellbeing was the main discriminator between responders with chronic musculoskeletal pain and the controls, followed by depression for the participants with poor psychological wellbeing, and fatigue, for the remaining ones. Insomnia syndrome was the third-level discriminator for those with fatigue, whereas sleep quality for those without fatigue. Musculoskeletal pain was frequently reported by S√£o Paulo city dwellers and its correlates with psychological and sleep aspects are suggestive of a response to urbanicity. ClinicalTrials.gov NCT00596713.",Roizenblatt S.; Souza AL.; Palombini L.; Godoy LM.; Tufik S.; Bittencourt LR.,2015.0,10.1371/journal.pone.0142726,0,0,
4680,The effect of acute tryptophan depletion on the neural correlates of emotional processing in healthy volunteers,"ER The processing of affective material is known to be modulated by serotonin (5-HT), but few studies have used neurophysiological measures to characterize the effect of changes in 5-HT on neural responses to emotional stimuli. We used functional magnetic resonance imaging to investigate the effect of acute tryptophan depletion, which reduces central 5-HT synthesis, on neural responses to emotionally valenced verbal stimuli. Though no participants experienced significant mood change, emotional information processing was substantially modified following 5-HT depletion. A behavioral bias toward positive stimuli was attenuated following depletion, which was accompanied by increased hemodynamic responses during the processing of emotional words in several subcortical structures. Inter-individual differences in tryptophan depletion-elicited anxiety correlated positively with the caudate bias toward negative stimuli. These data suggest that 5-HT may play an important role in mediating automatic negative attentional biases in major depression, as well as resilience against negative distracting stimuli in never-depressed individuals.","Roiser, J P; Levy, J; Fromm, S J; Wang, H; Hasler, G; Sahakian, B J; Drevets, W C",2008.0,10.1038/sj.npp.1301581,0,0,
4681,"Stress management training as a prevention program for heavy social drinkers: cognitions, affect, drinking, and individual differences","ER The effectiveness of cognitive-affective stress management training (SMT) as a drinking reduction program for heavy social drinking college students was investigated. The SMT package included muscle relaxation and meditation training, cognitive restructuring, and coping skill rehearsal during induced affect. Treated and control subjects rated the frequency and intensity of their anxiety, anger and depression and recorded their alcohol consumption on a daily basis over a 6-month period. SMT significantly reduced posttreatment daily anxiety ratings and was associated with changes in four of ten irrational beliefs and a shift toward more internal locus of control in treated subjects. Reduction in anxiety was no longer evident at the 2 1/2- and 5 1/2-month follow-ups. The men in the SMT group showed a significant decrease in daily drinking rates at posttreatment and at the 2 1/2-month follow-up, but drinking returned to baseline levels by 5 1/2 months for the group as a whole. However, significant improvement variance in daily moods and in drinking rates over all posttreatment periods was accounted for by individual difference variables in the trained subjects but not in the control group, suggesting that these cognitive, personality, and social support variables are associated with response to stress management training. Implications of these results for future prevention research are discussed.","Rohsenow, D J; Smith, R E; Johnson, S",1985.0,,0,0,
4682,Control over interpersonal evaluation and alcohol consumption in male social drinkers,"ER Studies testing the tension reduction hypothesis of alcohol drinking have found contradictory results. Marlatt proposes instead that social drinkers drink to gain control over stressful situations. To test this, 60 male heavy social drinkers were threatened with a social evaluation, then some were given some control over this threat by hearing that they could critique the evaluation and evaluate their evaluator (retaliate). This group was expected to drink less than a threatened group not given control, or a nonthreatened group, and heavy drinkers were expected to be affected more than light drinkers. Then, to determine if people do retaliate after an unfavorable evaluation, subjects received bogus evaluations or no evaluation, and then evaluated ""their evaluator."" Those receiving favorable or unfavorable evaluations responded in kind, supporting the coping method provided in the evaluation-with-coping condition. However, although the group that was evaluated and given no control reported more anxiety and took fewer sips than the other groups, they did not differ in wine consumption. The results did not support either the tension reduction or the control hypothesis.","Rohsenow, D J",1982.0,,0,0,
4683,Changing psychobiological stress reactions by manipulating cognitive processes,"This study aimed at manipulating psychobiological reactions to public speaking stress by means of verbal comments during the anticipation period. Sixty male students were instructed to give a public talk in 10 min. Twenty subjects each were randomly assigned to one of three experimental conditions: During anticipation of the speech the experimenter remained silent in the control condition, gave feedback that the subject was physiologically aroused and nervous in the second (arousing manipulation), or that he was physiologically calm and relaxed in the third condition (reassuring manipulation). Within the three stress conditions heart rate, systolic blood pressure, cortisol, and electrodermal responses were highest in the condition with reassuring manipulation and lowest in the condition without manipulation. Emotional stress reactions were highest in the condition with arousing manipulation and lowest in the condition with reassuring manipulation. Compared to the group without manipulation clear intraindividual discrepancies between emotional and somatic stress reactions could be observed in the group with reassuring manipulation (emotional<somatic arousal) and the group with arousing manipulation (emotional>somatic arousal). The two groups were significantly different in their discrepancy scores. It was concluded that the arousing manipulation seemed to have induced a sensitive, the reassuring manipulation a defensive coping style. Copyright (C) 1999 Elsevier Science B.V.",Rohrmann S.; Hennig J.; Netter P.,1999.0,10.1016/S0167-8760(99)00036-7,0,0,
4684,Prospective randomised comparison of ring versus rail fixator in infected gap nonunion of tibia treated with distraction osteogenesis.,"This is a prospective randomised study which compares the radiological and functional outcomes of ring and rail fixators in patients with an infected gap (> 3 cm) nonunion of the tibia. Between May 2008 and February 2013, 70 patients were treated at our Institute for a posttraumatic osseocutaneous defect of the tibia measuring at least 3 cm. These were randomised into two groups of 35 patients using the lottery method. Group I patients were treated with a ring fixator and group II patients with a rail fixator. The mean age was 33.2 years (18 to 64) in group I and 29.3 years (18 to 65) in group II. The mean bone gap was 5.84 cm in group I and 5.78 cm in group II. The mean followup was 33.8 months in group I and 32.6 months in group II. Bone and functional results were assessed using the classification of the Association for the Study and Application of the Method of Ilizarov (ASAMI). Functional results were also assessed at six months using the short musculoskeletal functional assessment (SMFA) score. The bone result was excellent, good, fair and poor in 21, 12, 0 and 2 in group I; and 14, 15, 3, and 3 in group II, respectively. The functional results were excellent, good, fair, poor and failure in 16, 17, 1, 0 and 1 in group I; and 22, 10, 0, 3 and 0 in group II, respectively. Both fixator systems achieved comparable rates of union and functional outcomes. The rate of deep pintract infection was significantly higher in the rail fixator group but patients found it more comfortable. We recommend the use of a ring fixator in patients with a bone gap of more than 6 cm. Patients with a bone gap up to 6 cm can be managed with either a ring or rail fixator. Cite this article: Bone Joint J 2016;98B:1399-1405.",Rohilla R.; Wadhwani J.; Devgan A.; Singh R.; Khanna M.,2016.0,10.1302/0301-620X.98B10.37946,0,0,
4685,Randomized Trial of Cognitive-Behavioral Therapy Versus Light Therapy for Seasonal Affective Disorder: acute Outcomes,"ER Objective: Whereas considerable evidence supports light therapy for winter seasonal affective disorder (SAD), data on cognitive- behavioral therapy for SAD (CBT-SAD) are promising but preliminary. This study estimated the difference between CBT-SAD and light therapy outcomes in a large, more definitive test. Method: The participants were 177 adults with a current episode of major depression that was recurrent with a seasonal pattern. The randomized clinical trial compared 6 weeks of CBT-SAD (N=88) and light therapy (N=89). Light therapy consisted of 10,000-lux cool-white florescent light, initiated at 30 minutes each morning and adjusted according to a treatment algorithm based on response and side effects. CBT-SAD comprised 12 sessions of the authors' SAD-tailored protocol in a group format and was administered by Ph.D. psychologists in two 90-minute sessions per week. Outcomes were continuous scores on the Structured Interview Guide for the Hamilton Rating Scale for Depression-SAD Version (SIGH-SAD, administered weekly) and Beck Depression Inventory-Second Edition (BDI-II, administered before treatment, at week 3, and after treatment) and posttreatment remission status based on cut points. Results: Depression severity measured with the SIGH-SAD and BDI-II improved significantly and comparably with CBT-SAD and light therapy. Having a baseline comorbid diagnosis was associated with higher depression scores across all time points in both treatments. CBT-SAD and light therapy did not differ in remission rates based on the SIGH-SAD (47.6% and 47.2%, respectively) or the BDI-II (56.0% and 63.6%). Conclusions: CBT-SAD and light therapy are comparably effective for SAD during an acute episode, and both may be considered as treatment options.","Rohan, K J; Mahon, J N; Evans, M; Ho, S Y; Meyerhoff, J; Postolache, T T; Vacek, P M",2015.0,10.1176/appi.ajp.2015.14101293,0,0,
4686,"A single session, group study of exposure and Eye Movement Desensitization and Reprocessing in treating posttraumatic stress disorder among Vietnam War veterans: Preliminary data.","Summarizes data gathered from an ongoing study. Two groups (12 Ss total) of Vietnam War veterans diagnosed with posttraumatic stress disorder (PTSD) received a single session of exposure or Eye Movement Desensitization and Reprocessing (EMDR) focusing on the veterans' most distressing war experience. Group assignment was random, treatment providers were blind to assessment data, and the pre- and posttreatment assessor was blind to treatment assignment. Both groups showed improvement on the Impact of Event Scale. EMDR treatment resulted in greater positive changes in within-session Subjective Units of Discomfort levels and on self-monitored severity of intrusive recollection. A trend toward decreased heart rate reactivity was observed in both groups. Results must be considered carefully due to the small number of Ss used in the study. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rogers, Susan; Silver, Steven M; Goss, James; Obenchain, Jeanne; Willis, Amy; Whitney, Robert L",1999.0,,0,0,
4687,"A single session, group study of exposure and Eye Movement Desensitization and Reprocessing in treating Posttraumatic Stress Disorder among Vietnam War veterans: preliminary data.","This report summarizes data gathered thus far from an ongoing study. Two groups (total N = 12) of Vietnam War veterans diagnosed with Posttraumatic Stress Disorder (PTSD) received a single session of exposure or Eye Movement Desensitization and Reprocessing (EMDR) focusing on the veterans' most distressing war experience. Group assignment was random, treatment providers were blind to assessment data, and the pre- and posttreatment assessor was blind to treatment assignment. Both groups showed improvement on the Impact of Event Scale. EMDR treatment resulted in greater positive changes in within-session Subjective Units of Discomfort levels and on self-monitored severity of intrusive recollection. A trend toward decreased heart rate reactivity was observed in both groups. Results must be considered carefully due to the small number of subjects used in the study.",Rogers S.; Silver SM.; Goss J.; Obenchain J.; Willis A.; Whitney RL.,,,0,0,
4688,Behavioral treatment of PTSD in a perpetrator of manslaughter: A single case study.,"Presents the outcome of behavioral treatment in the case of a patient with posttraumatic stress disorder (PTSD) consequential to being a perpetrator of manslaughter. A divorced female (aged 51 yrs) under enforced hospital treatment suffered from major depression but showed no evidence of PTSD at conviction. Presence and severity of symptoms relating to the offence were measured with the PTSD Symptom Scale (E. B. Foa et al, 1993) (PSS) and the Revised Impact of Event Scale (M. Horowitz et al, 1979) (IES). Depression was measured with the Beck Depression Inventory (BDI). Weekly treatment over a 4 mo period consisted of a graded approach to manage arousal levels and reduce the relapse risk of depression. Results show significant differences in symptom scores on the IES, PSS, and BDI between pretreatment and posttreatment and between pretreatment and 3-, 8-, and 30-mo follow-ups. It is concluded that PTSD acts as a chronic stressor when comorbid with another mental illness such as depression or schizophrenia. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rogers, Paul; Gray, Nicola S; Williams, Tegwyn; Kitchiner, Neil",2000.0,,0,0,
4689,Biobehavioral factors mediate exercise effects on fatigue in breast cancer survivors,"ER PURPOSE: This study aimed to examine mediators of fatigue response to an exercise intervention for breast cancer survivors in a pilot randomized controlled trial.METHODS: Postmenopausal breast cancer survivors (n = 46; ?stage 2), off primary treatment, and reporting fatigue and/or sleep dysfunction were randomized to a 3-month exercise intervention (160 min·wk of moderate-intensity aerobic walking, twice weekly resistance training with resistance bands) or control group. Six discussion group sessions provided behavioral support to improve adherence. Fatigue, serum cytokines, accelerometer physical activity, cardiorespiratory fitness, sleep dysfunction, and psychosocial factors were assessed at baseline and 3 months.RESULTS: The exercise intervention effect sizes for fatigue were as follows: fatigue intensity d = 0.30 (P = 0.34), interference d = -0.38 (P = 0.22), and general fatigue d = -0.49 (P = 0.13). Using the Freedman-Schatzkin difference-in-coefficients tests, increase in fatigue intensity was significantly mediated by interleukin 6 (IL-6) (82%), IL-10 (94%), IL-6/IL-10 (49%), and tumor necrosis factor-? (TNF-?):IL-10 (78%) with reduced sleep dysfunction increasing the relationship between intervention and fatigue intensity rather than mediating intervention effects (-88%). Decrease in fatigue interference was mediated by sleep dysfunction (35%), whereas IL-10 and pro-anti-inflammatory cytokine ratios increased the relationship between intervention and interference (-25% to -40%). The reduction in general fatigue was significantly mediated by minutes of physical activity (76%), sleep dysfunction (45%), and physical activity enjoyment (40%), with IL-10 (-40%) and IL-6/IL-10 (-11%) increasing the intervention-fatigue relationship. In the intervention group, higher baseline fatigue, anxiety, depression, and perceived exercise barrier interference predicted a greater decline in fatigue interference and/or general fatigue during the intervention.CONCLUSIONS: Biobehavioral factors mediated and enhanced intervention effects on fatigue, whereas psychosocial factors predicted fatigue response. Further study is warranted to confirm our results and to improve understanding of relationships that mediate and strengthen the intervention-fatigue association.","Rogers, L Q; Vicari, S; Trammell, R; Hopkins-Price, P; Fogleman, A; Spenner, A; Rao, K; Courneya, K S; Hoelzer, K S; Robbs, R; Verhulst, S",2014.0,10.1249/MSS.0000000000000210,0,0,
4690,Flumazenil reduces midazolam-induced cognitive impairment without altering pharmacokinetics,"Objectives: Intravenous midazolam is used as an in vivo biomarker of hepatic cytochrome P450 (CYP) 3A activity. Midazolam is a central nervous system depressant and can produce cognitive impairment. The purpose of this study was 2-fold: (1) to determine whether administration of intravenous flumazenil given before intravenous midazolam minimizes cognitive impairment and (2) to determine whether flumazenil pretreatment has an effect on midazolam pharmacokinetics during hepatic CYP3A phenotyping. Methods: Eleven healthy subjects (8 men) received intravenous flumazenil (0.005 mg/kg) or placebo followed 7 minutes later by intravenous midazolam (0.025 mg/kg) in a randomized, double-blind crossover study. Plasma midazolam concentrations were obtained before dosing and at 5, 30, 60, 120, 240, 300, and 360 minutes after dosing and were assayed by liquid chromatography-tandem mass spectrometry. Midazolam pharmacokinetics were determined by noncompartmental methods. The two 1-sided tests procedure was used to compare area under the curve (AUC) between study phases. Data were log-transformed before analysis, and bioequivalence criteria were applied. Digit symbol substitution tests, performed before dosing and at 5, 30, 60, 120, 240, 300, and 360 minutes after dosing, were used to measure cognition. General linear modeling was used to compare scores between study phases. Results: Midazolam AUC extrapolated to infinity [AUC(0-∞)] between phases was bioequivalent. The AUC ratio (flumazenil plus midazolam/midazolam) was 0.99, with a 90% confidence interval of 0.98 to 1.00. Statistically significant differences(P ≤ .05) in digit symbol substitution test scores between phases were determined relative to time and a phase-by-time interaction. Conclusions: Flumazenil minimizes midazolam-induced cognitive impairment without influencing midazolam pharmacokinetics. However, the risk of side effects (ie, panic attack) caused by flumazenil should be thoroughly considered before implementation of this drug combination during phenotyping in healthy subjects.",Rogers J.F.; Morrison A.L.; Nafziger A.N.; Jones C.L.; Rocci Jr. M.L.; Bertino Jr. J.S.,2002.0,10.1067/mcp.2002.128866,0,0,
4691,The dysfunctional attitudes scale: psychometric properties in depressed adolescents,"ER The psychometric properties and factor structure of the Dysfunctional Attitudes Scale were examined in a sample of 422 male and female adolescents (ages 12-17) with current major depressive disorder. The scale demonstrated high internal consistency (alpha = .93) and correlated significantly with self-report and interview-based measures of depression. Confirmatory factor analysis indicated that a correlated 2-factor model, with scales corresponding to perfectionism and need for social approval, provided a satisfactory fit to the data. The goodness-of-fit was equivalent across sexes and age groups. The findings support the use of the Dysfunctional Attitudes Scale and its subscales in the assessment of clinically depressed adolescents.","Rogers, G M; Park, J H; Essex, M J; Klein, M H; Silva, S G; Hoyle, R H; Curry, J F; Feeny, N C; Kennard, B; Kratochvil, C J; Pathak, S; Reinecke, M A; Rosenberg, D R; Weller, E B; March, J S",2009.0,10.1080/15374410903259007,0,0,
4692,Uveal and capsular biocompatibility of two foldable acrylic intraocular lenses in patients with endogenous uveitis--a prospective randomized study,"ER METHODSProspective, randomized study in patients with noninfectious uveitis after phacoemulsification and implantation of either a hydrophobic AcrySof (group 1, n = 30) or a hydrophilic Akreos adapt (group 2, n = 30), sharp-edged acrylic IOL. The primary outcome was uveal biocompatibility, detected by giant-cell deposition, anterior chamber cell count and laserflare photometry over a 6-month follow-up period. Secondary outcome measures were capsular biocompatibility, as detected by posterior capsule opacification (PCO), lens epithelial cell outgrowth and Nd:YAG capsulotomies, and visual outcome.RESULTSThe groups did not differ with respect to anatomic type of uveitis, immunosuppressive treatment, associated systemic disease, and intraoperative manipulation. The number of giant cells on the anterior IOL surface was higher in group 1 than in group 2 (p = 0.03). The number of anterior chamber cells, laser flare photometry levels, and uveitis reactivations after surgery did not differ between the groups. After 6 months, the number of patients with PCO development (p = 1.0) and Nd:YAG capsulotomies (p = 0.21), lens epithelial cell outgrowth, visual outcome and uveitis complications were comparable in both groups.CONCLUSIONSBoth of the acrylic IOLs used had good uveal and capsular biocompatibility, leading to significant improvement in BCVA in patients with noninfectious uveitis. No obvious differences were detected at 6 months with respect to uveal and capsular biocompatibility and visual outcome.BACKGROUNDTo compare a hydrophobic and a hydrophilic acrylic single-piece intraocular lens (IOL) in uveitis patients with respect to biocompatibility and visual outcome.","Roesel, M; Heinz, C; Heimes, B; Koch, J M; Heiligenhaus, A",2008.0,10.1007/s00417-008-0886-4,0,0,
4693,An open trial of an acceptance-based behavior therapy for generalized anxiety disorder.,"Research suggests that experiential avoidance may play an important role in generalized anxiety disorder (GAD); see . Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models. Clinical Psychology: Science and Practice, 9, 54-68, for a review). Therefore, a treatment that emphasizes experiential acceptance, as well as intentional action, may lead to both reduced symptomatology and improved quality of life and functioning for individuals with this chronic disorder. In an open trial of a newly developed acceptance-based behavior therapy for GAD, 16 treated clients demonstrated significant reductions in clinician-rated severity of GAD and reports of anxiety and depressive symptoms and fear and avoidance of their internal experience, as well as significant improvements in reports of quality of life, at both posttreatment and 3-month follow-up. Directions for future treatment development and research are discussed.",Roemer L.; Orsillo SM.,2007.0,10.1016/j.beth.2006.04.004,0,0,
4694,A self-report diagnostic measure of generalized anxiety disorder.,"The present study tested the reliability of a self-report diagnostic measure of generalized anxiety disorder (GAD) based on DSM criteria. Among two samples of undergraduate students, 47-80% of the GAD diagnoses by questionnaire were confirmed by diagnostic interview, with the higher rate being associated with DSM-IV criteria. Categorization of a participant as Non-GAD by questionnaire was found to be 100% reliable by interview. Given these findings as well as prior empirical support for the validity of the measure, this questionnaire has utility for identifying analogue GAD and Non-GAD participants from undergraduate populations for use in preliminary investigations of the mechanisms and functions associated with chronic worry and GAD.",Roemer L.; Borkovec M.; Posa S.; Borkovec TD.,1995.0,,0,0,
4695,The effects of stress-induced cortisol responses on approach-avoidance behavior,"High glucocorticoid stress-responses are associated with prolonged freezing reactions and decreased active approach and avoidance behavior in animals. The present study was designed to investigate the effects of cortisol responses and trait avoidance on approach-avoidance behavior in humans. Twenty individuals were administered a computerized approach-avoidance (AA)-task before and after stress-induction (Trier Social Stress Test). The AA-task involved a reaction time (RT) task, in which participants made affect congruent and affect incongruent arm movements towards positive and threatening social stimuli. Affect congruent responses involved arm extension (avoidance) in response to angry faces and arm flexion (approach) in response to happy faces. Reversed responses were made in affect incongruent instruction conditions. As expected, participants with high cortisol responses showed significantly decreased RT congruency-effects in a context of social stress. Low trait avoidance was also associated with diminished congruency-effects during stress. However, the latter effect disappeared after controlling for the effects of cortisol. In sum, in agreement with animal research, these data suggest that high cortisol responses are associated with a decrease in active approach-avoidance behavior during stress. These findings may have important implications for the study of freezing and avoidance reactions in patients with anxiety disorders, such as social phobia and post-traumatic stress disorder. © 2005 Elsevier Ltd. All rights reserved.",Roelofs K.; Elzinga B.M.; Rotteveel M.,2005.0,10.1016/j.psyneuen.2005.02.008,0,0,
4696,Esuba: A psychoeducation group for incarcerated survivors of abuse.,"This study examined the effects associated with a trauma and abuse-focused psychoeducation group for incarcerated women on decreasing trauma symptoms. A total of 320 women participated in 34 groups in five prisons that followed a manualized intervention. A one-group pretest-posttest design was used to examine changes on 10 Trauma Symptom Inventory subscales (Anxious Arousal, Depression, Anger/Irritability, Intrusive Experiences, Defensive Avoidance, Dissociation, Sexual Concerns, Dysfunctional Sexual Behavior, Impaired Self-Reference, and Tension Reduction Behavior). Analyses indicated significant improvement on all 10 trauma subscales. Small effect sizes were found on all of the subscales. The findings of this study are encouraging and are the first step toward more rigorous evaluation of this pilot program. These findings provide initial support for the use of group psychoeducation intervention to address traumatic stress symptoms with incarcerated women. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Roe-Sepowitz, Dominique E; Bedard, Laura E; Pate, Kerensa N; Hedberg, E. C; Baldwin, Bedard, Bloom, Briere, Briere, Briere, Briere, Briere, Brown, Cambell, Cameron, Chesney-Lind, Cohen, Cummings, Dziegielewski, Foa, Fristad, Gendrau, Glass, Herman, Kagan, Kessler, Kubiak, Leonard-Barton, Lewis, Lindquist, McClendon, McDaniels-Wilson, Mendenhall, Paulhus, Paulhus, Petersilia, Pomeroy, Pomeroy, Pomeroy, Pomeroy, Putnam, Roe-Sepowitz, Rosenberg, Sabol, Stalker, Steffensmeier, Teplin, Thompson, Visher, Ward, West, Young, Zlotnick, Zlotnick",2014.0,,0,0,
4697,Effectiveness of association splitting in reducing unwanted intrusive thoughts in a nonclinical sample.,"Association Splitting (AS) is a novel cognitive technique, which has shown some promise for the reduction of obsessive thoughts in patients with obsessive-compulsive disorder (OCD). Its effect on unwanted intrusive thoughts (UITs) in the general population is yet unknown. Our experimental study tested the effect of AS in 49 participants who reported UITs as a regular problem. Participants were randomly allocated either to an AS versus waitlist control (WL) condition. The White Bear Suppression Inventory (WBSI) was used for measuring changes over time. Significant group differences were found across time. Relative to WL, AS exerted a positive effect on the reduction of UITs yielding a large effect size. According to self-report AS exerted a positive effect 6 days after the participants had initiated the exercises. All subjects in the AS condition judged the technique as effective. Results suggest that AS could be a suitable intervention to help people with a potential vulnerability to a clinical problem to control their UITs.",Rodríguez-Martín BC.; Moritz S.; Molerio-Pérez O.; Gil-Pérez P.,2013.0,10.1017/S1352465812000513,0,0,
4698,Early placement of prophylactic vena caval filters in injured patients at high risk for pulmonary embolism.,"Pulmonary embolism (PE) is a major problem in patients with multiple injuries. We present our experience with early placement of prophylactic vena caval filters (VCFs). Prospective study group with historical control. From March 1993 to December 1993, VCFs were placed in 40 consecutive patients with three or more risk factors for PE and had demographic, physiologic, venous thromboembolic prophylaxis, and outcome data collected prospectively (VCF group). They were compared to 80 injured patients admitted between November 1991 and February 1993 who survived > 48 hours and who were matched with the VCF group for mechanism of injury and risk factors for PE (NO VCF group). VCF placement affected a significant reduction in the incidence of PE (2.5% vs. 17%) and a clinical reduction in PE-related mortality. Embolic trapping was suggested by a 10% incidence of documented vena caval thrombi and although two patients developed significant venous stasis disease, no other VCF-related morbidity was noted. In spite of long-term morbidity, early prophylactic VCF placement is safe and should be considered in the prophylaxis of PE in the high-risk injured patients. This intervention may be effective in eliminating PE as a major cause of posttrauma morbidity and mortality.",Rodriguez JL.; Lopez JM.; Proctor MC.; Conley JL.; Gerndt SJ.; Marx MV.; Taheri PA.; Greenfield LJ.,1996.0,,0,0,
4699,Experiences of physical violence exported by their partner of women in prison,"Violence against women is an everyday problem which is expressed in various ways, whether physically, sexually or emotionally, and it may occur at either public or private level. The subject of violence against women has been regarded as a worldwide priority, since it obstructs every area of women's development. Society has acknowledged the fact that this violence ""prevents the achievement of the objectives of equality, development and peace and that it violates, reduces or prevents (women's) enjoyment of human rights and fundamental liberties. A recent report by the Johns Hopkins School of Public Health and the Center for Health and Gender Equity shows that at least one out of every three women has been physically mistreated, forced to engage in sexual relations or suffered some type of abuse in the course of their lives. In Mexico as in other countries, violent behavior has been regarded as ""natural"" in relation to the way how to treat women; norms and everyday life have kept it hidden. Epidemiological surveys, however, show figures that reflect the scope of the problem, which in turn has meant that it is now considered as a serious health problem. Consequently, approaching the issue of intra-familial violence compels one to consider a characteristic cultural aspect: the questionable fact of referring to its existence solely within the private sphere. It is felt that what goes on inside a home is an intimate affair and that outsiders should not be aware of this, far less intervene. The same happens when one discusses the violence experienced by women living in prison, since they often continue to experience violence or abuse when they receive their conjugal visits; or else at the hands of other prisoners or from the institute itself and no-one seems willing to intervene. Women living in a penitentiary environment designed essentially for men, occupy a secondary position and are marginalized as regards planned work, cultural, sports, and recreational programs, partly due to the fact that the prison population is thought to be primarily male (1990 to 1994 reports). As Barquin notes, most women in prison experienced violence from their parents or witnessed their mothers being mistreated, and therefore became used to this type of behavior and more tolerant of it. This does not mean that these experiences should be regarded as the reason why women commit a crime or the main cause why they were admitted to the penal system. The cycle of violence that begins in the family is perpetuated in marriage and would appear to be completed in prisons, recommencing when women are released from prison. Being deprived of freedom as a result of imprisonment, together with the abuse that take place in jail appear to be a further link in the chain of multiple types of violence which constitute the path for some part of this population. Human Rights Watch is an organization that has undertaken specialized research in prisons since 1987 and in its 1988 report points out that Venezuelan prisons housed a total population of 25381 individuals, 4% of which were women. This same source reported that drug-related crimes led to a 55% increase in the jail population. In 1991, the percentage of female prisoners held in US state prisons for violent crimes was 32.2%, although that the majority had been imprisoned for non-violent crimes. Donzinger points out that the majority of women prisoners that had been sentenced for the murder of someone close to them had been victims of mistreatment or sexual abuse at some time in their lives, and thus violence against women should become an important issue for the authorities, as it is one of the most outstanding problems that reflects the current situation of the living conditions in prison centers. Given the importance that has violence against women in general, and the lack of statistical indicators on the issue of women in prison, the main objective of this paper was to describe the types of physical violence exercised by the partners of 213 women, interviewed at a Preventive Center and at Social Re-adaptation Center, in order to determine the scope of the problem and to propose intervention strategies. A non-probabilistic sample of 213 women, selected for reasons of convenience, was used. A specially designed instrument was used, consisting of a semistructured interview with 242 questions, covering the following areas of the lives of the women interviewed: demographic data, school history, current family, family of origin, legal status, previous history of imprisonment, work experience, social networks depression, suicide risk, anguish, alcohol consumption variables, alcohol consumption measurement, variables for measuring the use of medical and non-medical drugs, scale of motives for consumption, treatment barriers, intimate relationships and sexuality, sexual abuse, violence/victimization, criminal violence, post-traumatic stress, prison environment, general health, and life styles and impulsiveness. The most important demographic characteristics of women found were: most were in the group aged from 28 to 40 year (45.5%), had six years or less of schooling (41.3%), secondary school (36.2%) and high school or technical college (16.4%) and were single (48.6%) or living with their partners (21.6%) while 50.7% had children under the age of 18. Of the 213 women interviewed, only 161 reported having suffered violence at the hands of their partners; 29.2% had experienced 1 to 5 acts, 23.4% had experienced 6 to 10, and 23.4% had been the object of 11 to 17 acts of violence. Statistics presented in this article in various research studies on family violence in most countries only show a small part of all the violence produced in families, and the results found in this research show that violence is higher among the group of female prisoners. One should not forget that prison reflects an exercise of the system that performs a marginalizing function, as it includes the poorest women from the most disadvantaged sectors, with low educational level. As Lima suggests, women are doubly stigmatized in prison, as they suffer first as women and second as criminals, not only because they belong to an underprivileged group in every social aspect, but because they belong to the group that has violated the classic image of women imposed by society, a fact for which they are severely punished, while the violence and abuse they have suffered is ignored.",Rodríguez E.Ma.; Mendoza M.R.; Durand-Smith A.; Bermúdez E.C.; Hernández G.S.,2006.0,,0,0,
4700,Can exposure-based CBT extend the effects of intravenous ketamine in obsessive-compulsive disorder? an open-label trial.,,Rodriguez CI.; Wheaton M.; Zwerling J.; Steinman SA.; Sonnenfeld D.; Galfalvy H.; Simpson HB.,2016.0,10.4088/JCP.15l10138,0,0,
4701,The effects of video feedback on self-perception of performance: A replication and extension,"Video feedback has been shown to increase performance estimates on the part of speech anxious individuals (R. M. Rapee & K. Hayman, 1996). The present experiment tested a video feedback condition against 2 control conditions. A possible moderator of video feedback effects, the degree to which participants underrated their initial speech, was also tested, as was the possibility of mediation of video feedback's effects by increases in self-efficacy. Participants were 90 speech anxious undergraduate students. Although video feedback showed transitory effects across the sample as a whole, the effect was consistently positive for participants who highly underrated their first speech. Self-efficacy was an important predictor of change in self-perception of performance, but was not a mediator of video feedback's effects.",Rodebaugh T.L.; Chambless D.L.,2002.0,10.1023/A:1020357210137,0,0,
4702,Caregivers' distress: youth with attention-deficit/hyperactivity disorder and comorbid disorders assessed via telemental health,"ER OBJECTIVE: This article evaluates the additive effects of children's comorbid conditions with attention-deficit/hyperactivity disorder (ADHD) in relation to caregivers' distress, in a clinical trial conducted through telemental health (TMH).METHODS: The Children's ADHD Telemental Health Treatment Study (CATTS) is examining the effectiveness of treatment delivered via TMH for children with ADHD who are living in underserved communities. The CATTS trial recruited 223 children (?=9.53±2.06 years) and their caregivers. Diagnoses of ADHD and comorbid oppositional defiant disorder (ODD) and anxiety disorders (ADs) were established with the Child Behavior Checklist and the Computerized Diagnostic Interview Schedule for Children. We took advantage of rich baseline data from the CATTS trial to investigate associations between caregivers' distress and children's comorbid mental health conditions. Caregivers' distress was assessed with the Patient Health Questionnaire-9, Parenting Stress Index, and Caregiver Strain Questionnaire. ANOVAs were used to compare children with ADHD alone with children having one comorbid condition (ODD or ADs) and children having two comorbid conditions (ODD and ADs).RESULTS: Three quarters (75.3%) of participants met criteria for ODD and/or AD comorbid with ADHD: 24.7% had neither comorbidity; 47.5% had ODD or AD; and 27.8% had both ODD and AD comorbidities. The parents of children with multiple comorbid conditions experienced the highest levels of depression, stress, and burden of care.CONCLUSIONS: The CATTS sample that was recruited from underserved communities provided evidence of additive effects of child psychiatric comorbidities with caregivers' distress, echoing earlier findings from the Multi-modal Treatment of ADHD (MTA) study that was conducted with a metropolitan sample of youth. Results indicate that caregivers' distress should be addressed in developing treatment models for children with ADHD.CLINICAL TRIALS REGISTRY: http://clinicaltrials.gov/show/NCT00830700 .","Rockhill, C; Violette, H; Vander, Stoep A; Grover, S; Myers, K",2013.0,10.1089/cap.2013.0019,0,0,
4703,Psychological indices and phantom shocks in patients with ICD.,"Some patients with ICDs experience the sensation of a shock in the absence of true therapy (phantom shock). We hypothesize that phantom shocks may be a manifestation of anxiety, depression or PTSD. All patients over 18 years old with an ICD were eligible to enroll in the study. The first 75 subjects who agreed to participate were enrolled and divided into three groups: ICD patients with phantom shocks (n = 19); ICD patients who had actual shocks (n = 28) and ICD patients who had no shocks (n = 28). During a clinic visit a demographic questionnaire and three psychological rating scales were administered: the Spielberger State-Trait Anxiety Inventory (STAI); the Center for Epidemiologic Studies Depression Scale (CES-D) and the Posttraumatic Stress Checklist (PCL-C). No significant differences between groups were found in gender, race, age, history of MI or cardiac surgery status. Data analysis of the psychological indices using one-way ANOVA showed that the group with phantom shocks had more depression (CES-D p = 0.011) and more anxiety (STAI p = 0.010) than the other groups. Multiple comparisons of group means showed a greater percentage of clinically depressed patients in the phantom shock group than in the other groups. Patients with phantom shocks are more likely to be clinically depressed and have higher levels of anxiety than other ICD patients, regardless of history of actual shocks.",Prudente LA.; Reigle J.; Bourguignon C.; Haines DE.; DiMarco JP.,2006.0,10.1007/s10840-006-9010-z,0,0,
4704,Effects of adjunctive peer support on perceptions of illness control and understanding in an online psychoeducation program for bipolar disorder: a randomised controlled trial,"ER OBJECTIVES: To examine the comparative effectiveness of an online psychoeducation program for people diagnosed with bipolar disorder within the previous 12 months, completed alone or with adjunctive peer support, on symptoms and perceived control over the illness.METHOD: Participants were randomly allocated to an eight-week online psychoeducation program (n=139), a psychoeducation program plus online peer support (n=134) or an attentional control condition (n=134).RESULTS: Increased perceptions of control, decreased perceptions of stigmatisation and significant improvements in levels of anxiety and depression, from pre- to post-intervention were found across all groups. There were no significant differences between groups on outcome measures, although a small clinical difference was found between the supported and unsupported conditions in depression symptoms and in functional impairment at the six-month follow-up. Adherence to the treatment program was significantly higher in the supported intervention than in the unsupported program. Gender and age were also significant predictors of adherence, with females and those over the age of 30 showing greater adherence.LIMITATIONS: Mood state at study entry was measured by self-report rather than by clinical interview.CONCLUSIONS: The pattern of outcomes suggests a primary influence of non-specific or common therapeutic factors across all three intervention groups. A personally tailored intervention may be more suitable for individuals recently diagnosed with bipolar disorder, and longer term coaching may increase program adherence and long-term improvement in symptoms and functioning.","Proudfoot, J; Parker, G; Manicavasagar, V; Hadzi-Pavlovic, D; Whitton, A; Nicholas, J; Smith, M; Burckhardt, R",2012.0,10.1016/j.jad.2012.04.007,0,0,
4705,"Computerized, interactive, multimedia cognitive-behavioural program for anxiety and depression in general practice","ER METHODOne hundred and sixty-seven adults suffering from anxiety and/or depression and not receiving any form of psychological treatment or counselling were randomly allocated to receive, with or without medication, BtB or treatment as usual (TAU). Measures were taken on five occasions: prior to treatment, 2 months later, and at 1, 3 and 6 months follow-up using the Beck Depression Inventory, Beck Anxiety Inventory and Work and Social Adjustment Scale.RESULTSPatients who received BtB showed significantly greater improvement in depression and anxiety compared to TAU by the end of treatment (2 months) and to 6 months follow-up. Symptom reduction was paralleled by improvement in work and social adjustment. There were no interactions of BtB with concomitant pharmacotherapy or duration of illness, but evidence, on the Beck Anxiety Inventory only, of interaction with primary care practice. Importantly, there was no interaction between the effects of BtB and baseline severity of depression, from which we conclude that the effects of the computer program are independent of starting level of depression.CONCLUSIONSThese results demonstrate that computerized interactive multimedia cognitive-behavioural techniques under minimal clinical supervision can bring about improvements in depression and anxiety, as well as in work and social adjustment, with and without pharmacotherapy and in patients with pre-treatment illness of durations greater or less than 6 months. Thus, our results indicate that wider dissemination of cognitive-behavioural techniques is possible for patients suffering from anxiety and/or depression.BACKGROUNDCognitive-behavioural therapy (CBT) brings about significant clinical improvement in anxiety and depression, but therapists are in short supply. We report the first phase of a randomized controlled trial of an interactive multimedia program of cognitive-behavioural techniques, Beating the Blues (BtB), in the treatment of patients in general practice with anxiety, depression or mixed anxiety/depression.","Proudfoot, J; Goldberg, D; Mann, A; Everitt, B; Marks, I; Gray, J A",2003.0,,0,0,
4706,"Impact of a mobile phone and web program on symptom and functional outcomes for people with mild-to-moderate depression, anxiety and stress: a randomised controlled trial","ER METHOD: Community-based volunteers with mild-to-moderate depression, anxiety and/or stress (N?=?720) were randomly assigned to the myCompass program, an attention control intervention, or to a waitlist condition for seven weeks. The interventions were fully automated, without any human input or guidance. Participants' symptoms and functioning were assessed at baseline, post-intervention and 3-month follow-up, using the Depression, Anxiety and Stress Scale and the Work and Social Adjustment Scale.RESULTS: Retention rates at post-intervention and follow-up for the study sample were 72.1% (n?=?449) and 48.6% (n?=?350) respectively. The myCompass group showed significantly greater improvement in symptoms of depression, anxiety and stress and in work and social functioning relative to both control conditions at the end of the 7-week intervention phase (between-group effect sizes ranged from d?=?.22 to d?=?.55 based on the observed means). Symptom scores remained at near normal levels at 3-month follow-up. Participants in the attention control condition showed gradual symptom improvement during the post-intervention phase and their scores did not differ from the myCompass group at 3-month follow-up.CONCLUSIONS: The myCompass program is an effective public health program, facilitating rapid improvements in symptoms and in work and social functioning for individuals with mild-to-moderate mental health problems.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN 12610000625077.BACKGROUND: Mobile phone-based psychological interventions enable real time self-monitoring and self-management, and large-scale dissemination. However, few studies have focussed on mild-to-moderate symptoms where public health need is greatest, and none have targeted work and social functioning. This study reports outcomes of a CONSORT-compliant randomised controlled trial (RCT) to evaluate the efficacy of myCompass, a self-guided psychological treatment delivered via mobile phone and computer, designed to reduce mild-to-moderate depression, anxiety and stress, and improve work and social functioning.","Proudfoot, J; Clarke, J; Birch, M R; Whitton, A E; Parker, G; Manicavasagar, V; Harrison, V; Christensen, H; Hadzi-Pavlovic, D",2013.0,10.1186/1471-244X-13-312,0,0,
4707,Biodegradable implants for Pipkin fractures.,"The current study was designed to clarify whether biodegradable poly-L/DL lactide pins provide an operative alternative for fixation of Pipkin fractures. Nine patients with Pipkin fractures (one with Pipkin Type I, one with Pipkin Type II, and seven with Pipkin Type IV fractures) were treated surgically between 1996 and 2002. In all patients, the femoral head fractures were fixed with biodegradable, 2.7-mm and 2.0-mm polylactide pins. Eight patients were followed up for an average of 54.2 months. One patient died before the final followup. Eight fractures healed uneventfully. In one patient, a persisting femoral head defect led to posttraumatic arthritis requiring insertion of a femoral endoprosthesis at 1 year. The average range of motion of the affected hips of all patients at followup was 109 degrees -0 degrees -0 degrees in flexion and extension. External and internal rotation averaged 37 degrees -0 degrees -29 degrees . One patient had Brooker Grade I heterotopic ossification develop, and another had a Grade II heterotopic develop. Merle d'Aubigne and Postel ratings showed two excellent and five satisfactory results (average score, 13.1). Adverse effects from the polylactide implants were not observed. Pipkin fractures can be fixed successfully with biodegradable polylactide pins.",Prokop A.; Helling HJ.; Hahn U.; Udomkaewkanjana C.; Rehm KE.,2005.0,,0,0,
4708,Identifying patterns of co-occurring substance use disorders and mental illness in a jail population.,"Although the co-occurrence of mental health and substance use disorders (SUDs) is well documented among correctional populations, less explored are the actual patterns that exist between specific SUDs and additional mental health disorders in combination. This study examines prevalence and correlates of psychiatric comorbidity in incarcerated men who screened positive for a SUD and the ability of a practical structured interview to document diagnostic indications of SUDs and co-occurring disorders. Comprehensive Addictions and Psychological Evaluation (CAAPE) interview data from 176 substance-dependent male inmates incarcerated in a local jail facility were analyzed. The most common substance dependence diagnoses were for alcohol (81%) and cocaine (35%). Posttraumatic stress disorder (PTSD) was the most common co-occurring mental health condition (55%), followed by antisocial personality disorder and major depressive episodes (51% each). Patterns related to the presence of PTSD and major depressive episodes accounted for a vast majority of inmates with both two and three diagnostic indications. Cronbach's alphas for the individual CAAPE diagnostic subscales ranged from 0.74 to 0.97. The design and implementation of treatment programs for substance-dependent inmates must consider co-occurring mental health issues. Several of the diagnostic categories evinced a bimodal pattern of responses in terms of severity. Negative correlations among many of the SUDs suggest that those with a greater level of severity involving some substances are less likely to manifest dependence and high severity for other substances. The observed Cronbach's alphas for the various subscales demonstrated acceptable preliminary support for the use of the CAAPE as a practical instrument in indentifying co-occurring disorders in a jail setting. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Proctor, Steven L; Hoffmann, Norman G; Alexander, Basco, Campbell, Clark, Cortina, Draine, Drake, Fist, Gallagher, Grant, Grant, Haning, Hasin, Hayes, Hiday, Hoffmann, Hoffmann, Hoffmann, James, Jones, Jordan, Karberg, Kessler, Kessler, Lintonen, Muthen, Nunnally, Parry, Proctor, Proctor, Sabol, Shearer, Smith, Steadman, Sullivan, Swartz, Urofsky, Walters, Watkins, Young, Zywiak",2012.0,,0,0,
4709,The effectiveness of interactive journaling in reducing recidivism among substance-dependent jail inmates.,"The present study sought to evaluate the influence of interactive journaling on criminal recidivism and identify significant predictors of recidivism among a sample of 183 male inmates incarcerated in a local jail facility randomly assigned to either an interactive journaling condition or a control group. All participants met DSM-IV-TR criteria for substance dependence, had their current offense indicate substance involvement, and had a minimum of one previous arrest in the prior 12 months. The recidivism rate (51%), in terms of subsequent bookings within a 12-month period, for the journaling group was significantly lower than the recidivism rate (66%) for the control group, χ(2)(1, 183) = 4.13, p < .05. The three most significant independent predictors of subsequent bookings were severity of posttraumatic stress disorder, group assignment (journaling vs. placebo), and employment status. Interactive journaling appears to show promise as a brief treatment intervention strategy for substance dependence in local jail settings and may have the potential for reducing recidivism.",Proctor SL.; Hoffmann NG.; Allison S.,2012.0,10.1177/0306624X11399274,0,0,
4710,"Health status of Persian Gulf War veterans: self-reported symptoms, environmental exposures and the effect of stress","ER METHODSStratified, random samples of two cohorts of PGW veterans, from the New England area (n = 220) and from the New Orleans area (n = 71), were selected from larger cohorts being followed longitudinally since arrival home from the Gulf. A group of PGW-era veterans deployed to Germany (n = 50) served as a comparison group. The study protocol included questionnaires, a neuropsychological test battery, an environmental interview, and psychological diagnostic interviews. This report focuses on self-reported health symptoms and exposures of participants who completed a 52-item health symptom checklist and a checklist of environmental exposures.RESULTSThe prevalence of reported symptoms was greater in both Persian Gulf-deployed cohorts compared to the Germany cohort. Analyses of the body-system symptom scores (BSS), weighted to account for sampling design, and adjusted by age, sex, and education, indicated that Persian Gulf-deployed veterans were more likely to report neurological, pulmonary, gastrointestinal, cardiac, dermatological, musculoskeletal, psychological and neuropsychological system symptoms than Germany veterans. Using a priori hypotheses about the toxicant effects of exposure to specific toxicants, the relationships between self-reported exposures and body-system symptom groupings were examined through multiple regression analyses, controlling for war-zone exposure and post-traumatic stress disorder (PTSD). Self-reported exposures to pesticides, debris from Scuds, chemical and biological warfare (CBW) agents, and smoke from tent heaters each were significantly related to increased reporting of specific predicted BSS groupings.CONCLUSIONSVeterans deployed to the Persian Gulf have higher self-reported prevalence of health symptoms compared to PGW veterans who were deployed only as far as Germany. Several Gulf-service environmental exposures are associated with increased health symptom reporting involving predicted body-systems, after adjusting for war-zone stressor exposures and PTSD.BACKGROUNDMost US troops returned home from the Persian Gulf War (PGW) by Spring 1991 and many began reporting increased health symptoms and medical problems soon after. This investigation examines the relationships between several Gulf-service environmental exposures and health symptom reporting, and the role of traumatic psychological stress on the exposure-health symptom relationships.","Proctor, S P; Heeren, T; White, R F; Wolfe, J; Borgos, M S; Davis, J D; Pepper, L; Clapp, R; Sutker, P B; Vasterling, J J; Ozonoff, D",1998.0,,0,0,
4711,Multiple risk-behavior profiles of smokers with serious mental illness and motivation for change.,"Individuals with serious mental illness (SMI) are dying on average 25 years prematurely. The leading causes are chronic preventable diseases. In the context of a tobacco-treatment trial, this exploratory study examined the behavioral risk profiles of adults with SMI to identify broader interventional needs. Recruited from five acute inpatient psychiatry units, participants were 693 adult smokers (recruitment rate = 76%, 50% male, 45% Caucasian, age M = 39, 49% had income < $10,000) diagnosed with mood disorders (71%), substance-use disorders (63%), posttraumatic stress disorder (39%), psychotic disorders (25%), and attention deficit-hyperactivity disorder (25%). The Staging Health Risk Assessment, the primary measure used in this study, screened for risk status and readiness to change 11 health behaviors, referencing the period prior to acute hospitalization. Participants averaged 5.2 (SD = 2.1) risk behaviors, including smoking (100%), high-fat diet (68%), inadequate fruits/vegetables (67%), poor sleep (53%), physical inactivity (52%), and marijuana use (46%). The percent prepared to change ranged from 23% for tobacco and marijuana to 76% for depression management. Latent class analysis differentiated three risk groups: the global higher risk group included patients elevated on all risk behaviors; the global lower risk group was low on all risks; and a mood and metabolic risk group, characterized by inactivity, unhealthy diet, sleep problems, and poor stress and depression management. The global higher risk group (11% of sample) was younger, largely male, and had the greatest number of risk behaviors and mental health diagnoses; had the most severe psychopathologies, addiction-treatment histories, and nicotine dependence; and the lowest confidence for quitting smoking and commitment to abstinence. Most smokers with SMI engaged in multiple risks. Expanding targets to treat co-occurring risks and personalizing treatment to individuals' multibehavioral profiles may increase intervention relevance, interest, and impact on health.",Prochaska JJ.; Fromont SC.; Delucchi K.; Young-Wolff KC.; Benowitz NL.; Hall S.; Bonas T.; Hall SM.,2014.0,10.1037/a0035164,0,0,
4712,Hostility and facial expression in young men and women: Is social regulation more important than negative affect?,"Behavioral differences may clarify the link between hostility and health. This study examined facial expression. Seventy-two low- and high-hostile undergraduates underwent the Type A Structured Interview (SI) and a test of social anxiety. Facial behavior was measured with the Facial Action Coding System. Low-hostile participants displayed non-Duchenne smiles more frequently than high-hostile participants during the SI. There were no group differences in the expression of disgust. The results identify differences in the nonverbal behavior of hostile people. Restricted use of non-Duchenne smiles may reflect limited use of appeasement, contributing to uncomfortable interpersonal relations and limited social support. The findings are consistent with a behavioral ecology perspective and suggest that social regulation may be as important as negative affect in determining the consequences of hostility.",Prkachin K.M.; Silverman B.E.,2002.0,10.1037//0278-6133.21.1.33,0,0,
4713,Cognition in test-anxious children: the role of on-task and coping cognition reconsidered,"ER This study investigated cognition in children with high, moderate, and low test anxiety under naturalistic test-taking conditions. Children with high test anxiety not only reported more negative self-evaluations and more off-task thoughts but also more on-task and coping thoughts. Consistent with previous research, no ""task-facilitating"" role for these on-task and coping cognitions was found. This finding lends support to the notion of ""the power of non-negative thinking"". The only facilitating role was for positive self-evaluations. It was hypothesized that positive cognition could be task-facilitating under certain conditions. Limited support was found for this idea.","Prins, P J; Groot, M J; Hanewald, G J",1994.0,,0,0,
4714,Effect of psychiatric disorders on outcome of cognitive-behavioural therapy for chronic fatigue syndrome.,Psychiatric disorders have been associated with poor outcome in individuals with chronic fatigue syndrome (CFS). This study examines the impact of psychiatric disorders on outcome of cognitive-behavioural therapy (CBT). Psychiatric diagnoses were assessed with a structured psychiatric interview in a CBT trial of 270 people with CFS. Lifetime and current psychiatric disorders were found in 50 and 32% respectively. No significant differences in fatigue severity and functional impairment following treatment were found between participants with and without psychiatric diagnoses.,Prins J.; Bleijenberg G.; Rouweler EK.; van der Meer J.,2005.0,10.1192/bjp.187.2.184,0,0,
4715,Does engagement with exposure yield better outcomes? Components of presence as a predictor of treatment response for virtual reality exposure therapy for social phobia.,"Virtual reality exposure (VRE) has been shown to be effective for treating a variety of anxiety disorders, including social phobia. Presence, or the level of connection an individual feels with the virtual environment, is widely discussed as a critical construct both for the experience of anxiety within a virtual environment and for a successful response to VRE. Two published studies show that whereas generalized presence relates to fear ratings during VRE, it does not relate to treatment response. However, presence has been conceptualized as multidimensional, with three primary factors (spatial presence, involvement, and realness). These factors can be linked to other research on the facilitation of fear during exposure, inhibitors of treatment response (e.g., distraction), and more recent theoretical discussions of the mechanisms of exposure therapy, such as Bouton's description of expectancy violation. As such, one or more of these components of presence may be more strongly associated with the experience of fear during VRE and treatment response than the overarching construct. The current study (N = 41) evaluated relations between three theorized components of presence, fear ratings during VRE, and treatment response for VRE for social phobia. Results suggest that total presence and realness subscale scores were related to in-session peak fear ratings. However, only scores on the involvement subscale significantly predicted treatment response. Implications of these findings are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Price, Matthew; Mehta, Natasha; Tone, Erin B; Anderson, Page L; Altmaier, Altman, Anderson, Anderson, Blote, Bouton, Bouton, Daly, Des Jarlais, First, Foa, Grayson, Harris, Kamphuis, Kirsch, Klinger, Krijn, Krijn, Lawm, Lee, Niklas, Olfson, Parsons, Paul, Phillips, Price, Price, Ravaja, Regenbrecht, Robillard, Rothbaum, Schubert, Telch, Wells, Wiederhold, Witmer",2011.0,,0,0,
4716,Vigilant and avoidant attention biases as predictors of response to cognitive behavioral therapy for social phobia.,"Attention bias for socially threatening information, an empirically supported phenomenon, figures prominently in models of social phobia. However, all published studies examining this topic to date have relied on group means to describe attention bias patterns; research has yet to examine potential subgroups of attention bias among individuals with social phobia (e.g., vigilant or avoidant). Furthermore, almost no research has examined how attention biases in either direction may predict change in symptoms as a result of treatment. This study (N = 24) compared responses to cognitive behavioral therapy (CBT) for social phobia between individuals with avoidant and vigilant biases for threatening faces at pretreatment. Participants with avoidant biases reported significantly and clinically higher symptom levels at posttreatment than did those with vigilant biases. These findings suggest that an avoidant attention bias may be associated with reduced response to CBT for social phobia.",Price M.; Tone EB.; Anderson PL.,2011.0,10.1002/da.20791,0,0,
4717,Maternal and child expressed emotion as predictors of treatment response in pediatric obsessive-compulsive disorder,"ER Expressed emotion (EE) is associated with symptoms and treatment outcome in various disorders. Few studies have examined EE in pediatric OCD and none of these has assessed the child's perspective. This study examined the relationship among maternal and child EE, child OCD severity, and OCD-related functioning pre- and post-treatment. At pre-treatment, mothers completed speech samples about the child with OCD and an unaffected sibling. Children with OCD completed speech samples about parents. There were low rates of high maternal EE (child with OCD: 16.1%; sibling: 2.6%) and high child EE about parents (mothers: 11.9%; fathers: 10.2%). High EE was primarily characterized by high criticism, not high overinvolvement. High maternal EE and child EE regarding fathers were associated with pre-treatment child OCD severity but not post-treatment severity. High child and maternal EE were predictive of post-treatment OCD-related functioning. EE may be an important child and maternal trait associated with pre-treatment OCD severity and generalization of treatment gains.","Przeworski, A; Zoellner, L A; Franklin, M E; Garcia, A; Freeman, J; March, J S; Foa, E B",2012.0,10.1007/s10578-011-0268-8,0,0,
4718,Does engagement with exposure yield better outcomes? Components of presence as a predictor of treatment response for virtual reality exposure therapy for social phobia.,"Virtual reality exposure (VRE) has been shown to be effective for treating a variety of anxiety disorders, including social phobia. Presence, or the level of connection an individual feels with the virtual environment, is widely discussed as a critical construct both for the experience of anxiety within a virtual environment and for a successful response to VRE. Two published studies show that whereas generalized presence relates to fear ratings during VRE, it does not relate to treatment response. However, presence has been conceptualized as multidimensional, with three primary factors (spatial presence, involvement, and realness). These factors can be linked to other research on the facilitation of fear during exposure, inhibitors of treatment response (e.g., distraction), and more recent theoretical discussions of the mechanisms of exposure therapy, such as Bouton's description of expectancy violation. As such, one or more of these components of presence may be more strongly associated with the experience of fear during VRE and treatment response than the overarching construct. The current study (N=41) evaluated relations between three theorized components of presence, fear ratings during VRE, and treatment response for VRE for social phobia. Results suggest that total presence and realness subscale scores were related to in-session peak fear ratings. However, only scores on the involvement subscale significantly predicted treatment response. Implications of these findings are discussed.",Price M.; Mehta N.; Tone EB.; Anderson PL.,2011.0,10.1016/j.janxdis.2011.03.004,0,0,
4719,"An investigation of outcome expectancies as a predictor of treatment response for combat veterans with PTSD: comparison of clinician, self-report, and biological measures.","Outcome expectancy, or the degree to which a client believes that therapy will result in improvement, is related to improved treatment outcomes for multiple disorders. There is a paucity of research investigating this relation in regards to posttraumatic stress disorder (PTSD). Additionally, the bulk of the research on outcome expectancy and treatment outcomes has relied mostly on self-report outcome measures. The relation between outcome expectancy on self-report measures, clinician-rated measures, and two biological indices (fear-potentiated startle and cortisol reactivity) of PTSD symptoms was explored. The sample included combat veterans (N = 116) treated with virtual reality exposure therapy for PTSD. Results supported a negative association between outcome expectancy and both self-report and clinician-rated symptoms at the conclusion of treatment, but outcome expectancy was related to the magnitude of change during treatment for self-report measures only. Outcome expectancy was unrelated to biological measures of treatment response. These findings suggest that outcome expectancy may be related to patient and clinician perceptions of outcomes, but not biological indices of outcome for PTSD.",Price M.; Maples JL.; Jovanovic T.; Norrholm SD.; Heekin M.; Rothbaum BO.,2015.0,10.1002/da.22354,0,0,
4720,Latent growth curve analysis of fear during a speech task before and after treatment for social phobia.,"Models of social phobia highlight the importance of anticipatory anxiety in the experience of fear during a social situation. Anticipatory anxiety has been shown to be highly correlated with performance anxiety for a variety of social situations. A few studies show that average ratings of anxiety during the anticipation and performance phases of a social situation decline following treatment. Evidence also suggests that the point of confrontation with the feared stimulus is the peak level of fear. No study to date has evaluated the pattern of anxious responding across the anticipation, confrontation, and performance phases before and after treatment, which is the focus of the current study. Socially phobic individuals (N = 51) completed a behavioral avoidance task before and after two types of manualized cognitive behavioral therapy, and gave ratings of fear during the anticipation and performance phases. Results from latent growth curve analysis were the same for the two treatments and suggested that before treatment, anxiety sharply increased during the anticipation phase, was highly elevated at the confrontation, and gradually increased during the performance phase. After treatment, anxiety increased during the anticipation phase, although at a much slower rate than at pretreatment, peaked at confrontation, and declined during the performance phase. The findings suggest that anticipatory experiences are critical to the experience of fear for public speaking and should be incorporated into exposures.",Price M.; Anderson PL.,2011.0,10.1016/j.brat.2011.08.004,0,0,
4721,The impact of cognitive behavioral therapy on post event processing among those with social anxiety disorder.,"Individuals with social anxiety are prone to engage in post event processing (PEP), a post mortem review of a social interaction that focuses on negative elements. The extent that PEP is impacted by cognitive behavioral therapy (CBT) and the relation between PEP and change during treatment has yet to be evaluated in a controlled study. The current study used multilevel modeling to determine if PEP decreased as a result of treatment and if PEP limits treatment response for two types of cognitive behavioral treatments, a group-based cognitive behavioral intervention and individually based virtual reality exposure. These hypotheses were evaluated using 91 participants diagnosed with social anxiety disorder. The findings suggested that PEP decreased as a result of treatment, and that social anxiety symptoms for individuals reporting greater levels of PEP improved at a slower rate than those with lower levels of PEP. Further research is needed to understand why PEP attenuates response to treatment.",Price M.; Anderson PL.,2011.0,10.1016/j.brat.2010.11.006,0,0,
4722,Greater expectations: using hierarchical linear modeling to examine expectancy for treatment outcome as a predictor of treatment response.,"A client's expectation that therapy will be beneficial has long been considered an important factor contributing to therapeutic outcomes, but recent empirical work examining this hypothesis has primarily yielded null findings. The present study examined the contribution of expectancies for treatment outcome to actual treatment outcome from the start of therapy through 12-month follow-up in a clinical sample of individuals (n=72) treated for fear of flying with either in vivo exposure or virtual reality exposure therapy. Using a piecewise hierarchical linear model, outcome expectancy predicted treatment gains made during therapy but not during follow-up. Compared to lower levels, higher expectations for treatment outcome yielded stronger rates of symptom reduction from the beginning to the end of treatment on 2 standardized self-report questionnaires on fear of flying. The analytic approach of the current study is one potential reason that findings contrast with prior literature. The advantages of using hierarchical linear modeling to assess interindividual differences in longitudinal data are discussed.",Price M.; Anderson P.; Henrich CC.; Rothbaum BO.,2008.0,10.1016/j.beth.2007.12.002,0,0,
4723,The role of presence in virtual reality exposure therapy.,"A growing body of literature suggests that virtual reality is a successful tool for exposure therapy in the treatment of anxiety disorders. Virtual reality (VR) researchers posit the construct of presence, defined as the interpretation of an artificial stimulus as if it were real, to be a presumed factor that enables anxiety to be felt during virtual reality exposure therapy (VRE). However, a handful of empirical studies on the relation between presence and anxiety in VRE have yielded mixed findings. The current study tested the following hypotheses about the relation between presence and anxiety in VRE with a clinical sample of fearful flyers: (1) presence is related to in-session anxiety; (2) presence mediates the extent that pre-existing (pre-treatment) anxiety is experienced during exposure with VR; (3) presence is positively related to the amount of phobic elements included within the virtual environment; (4) presence is related to treatment outcome. Results supported presence as a factor that contributes to the experience of anxiety in the virtual environment as well as a relation between presence and the phobic elements, but did not support a relation between presence and treatment outcome. The study suggests that presence may be a necessary but insufficient requirement for successful VRE.",Price M.; Anderson P.,2007.0,10.1016/j.janxdis.2006.11.002,0,0,
4724,[Theoretical bases of the chemotherapy of neuroses].,,Predesco V.; Vianu I.,,,0,0,
4725,"Clinical trial of modulatory effects of oxytocin treatment on higher-order social cognition in autism spectrum disorder: A randomized, placebo-controlled, double-blind and crossover trial.","Background: Autism spectrum disorders are neurodevelopmental conditions with severe impairments in social communication and interaction. Pioneering research suggests that oxytocin can improve motivation, cognition and attention to social cues in patients with autism spectrum disorder. The aim of this clinical trial is to characterize basic mechanisms of action of acute oxytocin treatment on neural levels and to relate these to changes in different levels of socio-affective and -cognitive functioning. Methods: This clinical study is a randomized, double-blind, cross-over, placebo-controlled, multicenter functional magnetic resonance imaging study with two arms. A sample of 102 male autism spectrum disorder patients, diagnosed with Infantile Autistic Disorder (F84.0 according to ICD-10), Asperger Syndrome (F84.5 according to ICD-10), or Atypical Autism (F84.1 according to ICD-10) will be recruited and will receive oxytocin and placebo nasal spray on two different days. Autism spectrum disorder patients will be randomized to determine who receives oxytocin on the first and who on the second visit. Healthy control participants will be recruited and case-control matched to the autism spectrum disorder patients. The primary outcome will be neural network activity, measured with functional magnetic resonance imaging while participants perform socio-affective and -cognitive tasks. Behavioral markers such as theory of mind accuracy ratings and response times will be assessed as secondary outcomes in addition to physiological measures such as skin conductance. Trait measures for alexithymia, interpersonal reactivity, and social anxiety will also be evaluated. Additionally, we will analyze the effect of oxytocin receptor gene variants and how these potentially influence the primary and secondary outcome measures. Functional magnetic resonance imaging assessments will take place at two time points which will be scheduled at least two weeks apart to ensure a sufficient wash-out time after oxytocin treatment. The study has been approved by an ethical review board and the competent authority. Discussion: Revealing the mechanisms of acute oxytocin administration, especially on the socio-affective and -cognitive domains at hand, will be a further step towards novel therapeutic interventions regarding autism. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Preckel, Katrin; Kanske, Philipp; Singer, Tania; Paulus, Frieder M; Krach, Soren; Althaus, Anagnostou, Andari, Andari, Anger, Bagby, Baron-Cohen, Baron-Cohen, Barratt, Bird, Burri, Busner, Carver, Dadds, Davis, Derogatis, Di Martino, Dolen, Domes, Domes, Eckstein, Eckstein, Eckstein, Friston, Frith, Grabe, Guastella, Hariri, Hollander, Hollander, Hollander, Janca, Kanske, Kanske, Kirsch, Knutson, Kohls, Krach, Kuehner, Kuhner, Kumsta, Laux, Lee, Marcus, Marcus, Mattick, McCall, McDougle, Meyer-Lindenberg, Nickels, Paulus, Paulus, Preckel, Preckel, Preti, Rademacher, Rademacher, Schultz, Schulz, Silani, Singer, Spreckelmeyer, Tachibana, Tombaugh, Trimmer, Watanabe, Watanabe, Yatawara, Zink",2016.0,,0,0,
4726,Oxytocin facilitates social approach behavior in women,"In challenging environments including both numerous threats and scarce resources, the survival of an organism depends on its ability to quickly escape from dangers and to seize opportunities to gain rewards. The phylogenetically ancient neurohormonal oxytocin (OXT) system has been shown to influence both approach and avoidance (AA) behavior in men, but evidence for comparable effects in women is still lacking. We thus conducted a series of pharmacological behavioral experiments in a randomized double-blind study involving 76 healthy heterosexual women treated with either OXT (24 IU) or placebo intranasally. In Experiment 1, we tested how OXT influenced the social distance subjects maintained between themselves and either a female or male experimenter. In Experiment 2, we applied a reaction time based AA task. In Experiment 3 we investigated effects on peri-personal space by measuring the lateral attentional bias in a line bisection task. We found that OXT specifically decreased the distance maintained between subjects and the male but not the female experimenter and also accelerated approach toward pleasant social stimuli in the AA task. However, OXT did not influence the size of peri-personal space, suggesting that it does not alter perception of personal space per se, but rather that a social element is necessary for OXT's effects on AA behavior to become evident. Taken together, our results point to an evolutionarily adaptive mechanism by which OXT in women selectively promotes approach behavior in positive social contexts. © 2014 Preckel, Scheele, Kendrick, Maier and Hurlemann.",Preckel K.; Scheele D.; Kendrick K.M.; Maier W.; Hurlemann R.,2014.0,10.3389/fnbeh.2014.00191,0,0,
4727,"Information-processing, storage characteristics and worry","Eysenck suggested that storage characteristics may be an important determinant of worry, and postulated that prolonged worry occurs in individuals who have tightly organised clusters of worry-related information stored in long-term memory. These clusters reflect areas or domains of worry. Because the information is stored in tight clusters, it becomes more accessible, more rapidly activated and therefore, retrieved more quickly. The Worry Domains Questionnaire (WDQ) is used to determine which domain worried subjects most (Primary) and least (Secondary). Two experiments are reported using a word allocation task, which requires subjects to make categorical decisions, based on these worry domains. It is reported that priming facilitates the emergence of domain effects, thus providing support for a structural Hypothesis. High worriers take longer to reject negative words if they are from the Primary domain and have difficulty rejecting Primary domain words when they are under a congruent heading. In addition, high worriers are reported to show retarded latencies when attempting to process ambiguous information, consistent with Metzger et al.'s studies. It is suggested that the initiation and maintenance of worry is largely attributable to an elevated evidence requirement and this may link to the personality trait of perfectionism.",Pratt P.; Tallis F.; Eysenck M.,1997.0,10.1016/S0005-7967(97)00057-0,0,0,
4728,"Panic disorder, autonomic nervous system and dissociation - changes during therapy.","Alarming somatic symptoms and in particular the cardiovascular symptoms, are the characteristic features of panic attacks. Increased cardiac mortality and morbidity have been proposed in these patients. Power spectral analysis of electrocardiogram R-R intervals is known to be a particularly successful tool in the detection of autonomic instabilities in various clinical disorders. Heart rate variability (HRV) has been found to be the outcome of rapidly reacting cardiovascular control systems. The aim of our study is to measure very low frequency band (VLF), low frequency band (LF) and high frequency band (HF) components of R-R interval during orthostatic experiment in patients with panic disorder before and after treatment and compares it with healthy controls. We assessed heart rate variability in 19 patients with panic disorder before and after 6-weeks treatment with antidepressants combined with cognitive behavioral therapy (CBT) and in 18 healthy controls. Diagnosis was done according to the ICD-10 research diagnostic criteria confirmed with MINI (MINI international neuropsychiatric interview). Patients were treated with CBT and psychotropics. They were regularly every week assessed using CGI (Clinical Global Impression), BAI (Beck Anxiety Inventory) and BDI (Beck Depression Inventory). Heart rate variability was assessed during 3 positions (1st - 5 min supine; 2nd - 5 min standing; 3rd - 5 min supine) before and after the treatment. Power spectra were computed for very low frequency - VLF (0.0033-0.04 Hz), low-frequency - LF (0.04-0.15 Hz) and high frequency - HF (0.15-0.40 Hz) bands using fast Fourier transformation. Nineteen panic disorder patients resistant to pharmacological treatment entered a 6-week open-label treatment study with combination of SSRI and CBT. The combination of CBT and pharmacotherapy proved to be an effective treatment in these patients. The patients significantly improved during the study period in all rating scales. There were highly statistical significant differences between panic patients and control group in all components of power spectral analysis in 2nd (VLF, LF and H in standing) and in two component of 3rd (LF and HF in supine) positions. There was also a statistically significant difference between these two groups in LF/HF ratio in standing position (2nd). During therapy there was a tendency increasing values in all three positions in components of HRV power spectra, but HF in 1st supine position was the only component where the increase reached the level os statistical significance. These findings demonstrate a lower autonomic activity in panic disorder patients measured during the changes of postural position in comparison with healthy controls and tendency to increase this autonomic power during the treatment.",Prasko J.; Latalova K.; Diveky T.; Grambal A.; Kamaradova D.; Velartova H.; Salinger J.; Opavsky J.; Silhan P.,2011.0,,0,0,
4729,Influence of personality disorder on the treatment of panic disorder--comparison study.,"Most clinicians tend to believe that the occurrence of the anxiety disorder in comorbidity with a personality disorder often leads to longer treatment, worsens the prognosis, and thus increasing treatment costs. The study is designed to compare the short-term effectiveness of combination of cognitive behavioral therapy and pharmacotherapy in patient suffering with panic disorder with and without personality disorder. We compare the efficacy of 6th week therapeutic program and 6th week follow up in patients suffering with panic disorder and/or agoraphobia and comorbid personality disorder (29 patients) and panic disorder and/or agoraphobia without comorbid personality disorder (31 patients). Diagnosis was done according to the ICD-10 research diagnostic criteria confirmed with MINI and support with psychological methods: IPDE, MCMI-III and TCI. Patients were treated with CBT and psychopharmacs. They were regularly assessed in week 0, 2, 4, 6 and 12 by an independent reviewer on the CGI (Clinical Global Improvement) for severity and change, PDSS (Panic Disorder Severity Scale), HAMA (Hamilton Anxiety Rating Scale), SDS (Sheehan Disability Scale), HDRS (Hamilton Depression Rating Scale), and in self-assessments BAI (Beck Anxiety Inventory) and BDI (Beck Depression Inventory). A combination of CBT and pharmacotherapy proved to be the effective treatment of patients suffering with panic disorder and/or agoraphobia with or without comorbid personality disorder. The 12th week treatment efficacy in the patients with panic disorder without personality disorder had been showed significantly better compared with the group with panic disorder comorbid with personality disorder in CGI and specific inventory for panic disorder--PDSS. Also the scores in depression inventories HDRS and BDI showed significantly higher decrease during the treatment comparing with group without personality disorder. But the treatment effect between groups did not differ in objective anxiety scale HAMA, and subjective anxiety scale BAI.",Prasko J.; Houbov√° P.; Nov√°k T.; Z√°lesk√Ω R.; Espa-Cerven√° K.; Paskov√° B.; Vyskocilov√° J.,2005.0,,0,0,
4730,The change of regional brain metabolism (18FDG PET) in panic disorder during the treatment with cognitive behavioral therapy or antidepressants.,"The goal of our study was to identify brain structures in patients with panic disorder (PD) that show changes in 18FDG PET during the treatment with cognitive behavioral therapy (CBT) or antidepressants. Twelve patients suffering from panic disorder were studied with [18F]-2-fluoro-deoxyglucose positron emission tomography (18FDG PET) scanning during resting state (condition of random episodic silent thinking, REST). After PET examination patients were randomly assigned to either cognitive behavioral treatment group (6 patients) or antidepressants treatment group (6 patients). After a 3 month period 18FDG PET examination was repeated in both groups. Psychopathology was assessed using the rating scales HAMA, CGI and Panic Disorder Severity Scale (PDSS). Data were analysed using software for statistical parametric mapping (SPM99). The scores of psychopathology rating scales (CGI, HAMA, PDSS) decreased in both groups. Changes of 18FDG uptake in the pharmacotherapy group: decreases were found in the a priori hypothesized regions in the right hemisphere, in the superior, middle, medial and inferior frontal gyrus, superior and middle temporal gyrus, and increases were detected in the a priori hypothesized regions, mainly in the left hemisphere in medial and middle frontal gyrus, superior, middle and transverse temporal gyrus. Changes of 18FDG uptake in the CBT group: decreases were found in the a priori hypothesized regions of the right hemisphere in the inferior temporal gyrus, superior and inferior frontal gyrus, and increases were detected in the a priori hypothesized region, mostly in the left hemisphere: inferior frontal gyrus, middle temporal gyrus and insula. We did not detect changes in 18FDG uptake in the limbic region (hippocampus, parahippocampal gyrus and amygdala). Changes in brain metabolism (18FDG uptake) after the treatment either with CBT or with antidepressants were similar in number of brain areas, with prominent right-left difference. This is in concordance with the asymmetry of brain activity noted in patients with PD according to previous PET (and SPECT) studies.",Prasko J.; Horácek J.; Záleský R.; Kopecek M.; Novák T.; Pasková B.; Skrdlantová L.; Belohlávek O.; Höschl C.,2004.0,,0,0,
4731,Moclobemide and cognitive behavioral therapy in the treatment of social phobia. A six-month controlled study and 24 months follow up.,"The aim of the study was to assess the 6-months treatment efficacy and 24-month follow up of three different therapeutic programs (A. moclobemide and supportive guidance, B. group cognitive-behavioral therapy and pill placebo, and C. combination of moclobemide and group cognitive-behavioral therapy) in patients with a generalized form of social phobia. Eighty one patients (38 males and 43 females) were randomly assigned to three different therapeutic programs. Patients were regularly assessed on a monthly basis by an independent rater on the LSAS (Liebowitz Social Anxiety scale), CGI (Clinical Global Impression) for severity and change and BAI (Beck Anxiety Inventory). Altogether, sixty-six patients completed the six month treatment period and 15 patients dropped out. All therapeutic groups showed significant improvement. A combination of CBT and pharmacotherapy yielded the most rapid effect. Moclobemide was superior for the reduction of the subjective general anxiety (BAI) during the first 3 months of treatment, but its influence on avoidant behavior (LSAS avoidance subscale) was less pronounced. Conversely, CBT was the best choice for reduction of avoidant behavior while a reduction of subjective general anxiety appeared later than in moclobemide. After 6 months of treatment there were best results reached in groups treated with CBT and there was no advantage of the combined treatment. The relapse rate during the 24-month follow up was significantly lower in the group treated with CBT in comparison with the group A. formerly treated with moclobemide alone.",Prasko J.; Dockery C.; Horácek J.; Houbová P.; Kosová J.; Klaschka J.; Pasková B.; Praskova H.; Seifertová D.; Záleský R.; Höschl C.,2006.0,,0,0,
4732,The effect of attributional processes concerning medication taking on return of fear.,"In this investigation, the authors examined the effect of attributional processes concerning medication taking on return of fear following exposure-based treatment. Participants (87% undergraduate students and 13% community volunteers) displaying marked claustrophobic fear (N = 95) were randomly allocated to a waitlist condition, a psychological placebo condition, a 1-session exposure-based treatment, or the same exposure treatment given in conjunction with an inactive pill. Attributions concerning medication taking were manipulated by further randomly assigning participants in the exposure-based treatment plus pill condition to 1 of 3 instructional sets immediately following treatment completion and posttreatment assessment: (1) The pill was described as a sedating herb that likely made exposure treatment easier; (2) the pill was described as a stimulating herb that likely made exposure treatment more difficult; or (3) the pill was described as a placebo that had no effect on exposure treatment. Return of fear rates for the 3 conditions were 39%, 0%, and 0%, respectively. Moreover, the deleterious effects of the sedation instructions were mediated by reduced self-efficacy. These findings highlight the importance of assessing patient attributions regarding the improvements achieved with combined exposure-based and pharmacological treatments for anxiety disorders.",Powers MB.; Smits JA.; Whitley D.; Bystritsky A.; Telch MJ.,2008.0,10.1037/0022-006X.76.3.478,0,0,
4733,Facilitation of fear extinction in phobic participants with a novel cognitive enhancer: a randomized placebo controlled trial of yohimbine augmentation.,"Preliminary animal research suggests that yohimbine hydrochloride, a selective competitive alpha2-adrenergic receptor antagonist, accelerates fear extinction and converts ineffective extinction regimens (long intertrial intervals) to effective ones. This randomized placebo controlled study examined the potential exposure enhancing effect of yohimbine hydrochloride in claustrophobic humans. Participants (71% undergraduate students and 29% community volunteers) displaying marked claustrophobic fear (n=24) were treated with 2 1-h in vivo exposure sessions. Participants were randomly allocated to take 10.8mg yohimbine hydrochloride (n=12) or placebo (n=12) prior to each exposure session. Outcome measures included peak fear during a behavioral avoidance task, the Claustrophobia Questionnaire, and the Claustrophobic Concerns Questionnaire. Results showed that both conditions improved significantly at post-treatment with no significant difference between groups. Consistent with prediction the group that took yohimbine hydrochloride prior to exposure sessions showed significantly greater improvement in peak fear at the one-week follow-up behavioral assessment (d=1.68). This was also true across other outcome measures with large to very large effect sizes. These data provide initial support for exposure enhancing effect of single-dose yohimbine hydrochloride in a clinical application.",Powers MB.; Smits JA.; Otto MW.; Sanders C.; Emmelkamp PM.,2009.0,10.1016/j.janxdis.2009.01.001,0,0,
4734,Exercise Augmentation of Exposure Therapy for PTSD: Rationale and Pilot Efficacy Data.,"Brain-derived neurotrophic factor (BDNF) is associated with synaptic plasticity, which is crucial for long-term learning and memory. Some studies suggest that people suffering from anxiety disorders show reduced BDNF relative to healthy controls. Lower BDNF is associated with impaired learning, cognitive deficits, and poor exposure-based treatment outcomes. A series of studies with rats showed that exercise elevates BDNF and enhances fear extinction. However, this strategy has not been tested in humans. In this pilot study, we randomized participants (N = 9, 8 females, M(Age) = 34) with posttraumatic stress disorder (PTSD) to (a) prolonged exposure alone (PE) or (b) prolonged exposure+exercise (PE+E). Participants randomized to the PE+E condition completed a 30-minute bout of moderate-intensity treadmill exercise (70% of age-predicted HR(max)) prior to each PE session. Consistent with prediction, the PE+E group showed a greater improvement in PTSD symptoms (d = 2.65) and elevated BDNF (d = 1.08) relative to the PE only condition. This pilot study provides initial support for further investigation into exercise augmented exposure therapy.",Powers MB.; Medina JL.; Burns S.; Kauffman BY.; Monfils M.; Asmundson GJ.; Diamond A.; McIntyre C.; Smits JA.,2015.0,10.1080/16506073.2015.1012740,0,0,
4735,Reliability and validity of the PDS and PSS-I among participants with PTSD and alcohol dependence.,"The prevalence of alcohol use disorder (e.g., alcohol dependence; AD) among individuals with posttraumatic stress disorder (PTSD) is quite high, with estimates of 52% for men and 30% for women (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). There are several interviews and self-report measures of PTSD with good published psychometric properties, and they are routinely used with comorbid AD and PTSD. However, none of these instruments was validated with this population. The current study fills this gap by examining the psychometric properties of the PTSD Symptom Scale-Interview (PSS-I) and the self-report PTSD Diagnostic Scale (PDS) in individuals diagnosed with current PTSD and AD. Both scales comprised of 17 items provide diagnostic and symptom severity information according to DSM-IV-TR criteria. Participants were 167 individuals who were diagnosed with AD and chronic PTSD and were enrolled in a randomized controlled treatment study. Results revealed excellent internal consistency of both the PSS-I and the PDS, good test-retest reliability over a 1-month period, and good convergent validity with the SCID. The specificity of the PSS-I diagnosis of PTSD was better than the PDS diagnosis, the latter exhibiting a greater percentage of false positives. In sum, the results showed that the PSS-I and PDS performed well in this population and can be used with confidence to assess PTSD diagnosis and symptom severity.",Powers MB.; Gillihan SJ.; Rosenfield D.; Jerud AB.; Foa EB.,2012.0,10.1016/j.janxdis.2012.02.013,0,0,
4736,Do conversations with virtual avatars increase feelings of social anxiety?,"Virtual reality (VR) technology provides a way to conduct exposure therapy with patients with social anxiety. However, the primary limitation of current technology is that the operator is limited to pre-programed avatars that cannot be controlled to interact/converse with the patient in real time. The current study piloted new technology allowing the operator to directly control the avatar (including speaking) during VR conversations. Using an incomplete repeated measures (VR vs. in vivo conversation) design and random starting order with rotation counterbalancing, participants (N = 26) provided ratings of fear and presence during both VR and in vivo conversations. Results showed that VR conversation successfully elevated fear ratings relative to baseline (d = 2.29). Participants also rated their fear higher during VR conversation than during in vivo conversation (d = 0.85). However, in vivo conversation was rated as more realistic than VR conversation (d = 0.74). No participants dropped out and 100% completed both VR and in vivo conversations. Qualitative participant comments suggested that the VR conversations would be more realistic if they did not meet the actor/operator and if they were not in the same room as the participant. Overall, the data suggest that the novel technology allowing real time interaction/conversation in VR may prove useful for the treatment of social anxiety in future studies.",Powers MB.; Briceno NF.; Gresham R.; Jouriles EN.; Emmelkamp PM.; Smits JA.,2013.0,10.1016/j.janxdis.2013.03.003,0,0,
4737,Changing core beliefs with trial-based cognitive therapy may improve quality of life in social phobia: a randomized study.,"To determine whether there are differences in quality of life (QoL) improvement after treatment with the trial-based thought record (TBTR) versus conventional cognitive therapy (CCT) in patients with social anxiety disorder (SAD). A randomized trial comparing TBTR with a set of CCT techniques, which included the standard 7-column dysfunctional thought record (DTR) and the positive data log (PDL) in patients with SAD, generalized type. Repeated measures analysis of variance (ANOVA) revealed a significant time effect in the general health, vitality, social functioning, and mental health domains of the Short Form 36. It also indicated significant treatment effects on the bodily pain, social functioning, role-emotional, and mental health domains, with higher scores in the TBTR group. One-way analysis of covariance (ANCOVA), using pretreatment values as covariates, showed that TBTR was associated with significantly better QoL post-treatment (bodily pain, social functioning and role-emotional) and at follow-up (role-emotional). A significant treatment effect on the role-emotional domain at 12-month follow-up denoted a sustained effect of TBTR relative to CCT. This study provided preliminary evidence that TBTR is at least as effective as CCT in improving several domains of QoL in SAD, specifically when the standard 7-column DTR and the PDL are used.",Powell VB.; Oliveira OH.; Seixas C.; Almeida C.; Grangeon MC.; Caldas M.; Bonfim TD.; Castro M.; Galv√£o-de Almeida A.; Galv√£o-de Almeida .; Moraes Rde O.; Sudak D.; de-Oliveira IR.,,10.1590/1516-4446-2012-0863,0,0,
4738,Patient education to encourage graded exercise in chronic fatigue syndrome. 2-year follow-up of randomised controlled trial.,An earlier trial demonstrated good outcomes after 1 year for patients with chronic fatigue syndrome (CFS) who received an educational intervention designed to encourage graded activity. To determine 2-year outcomes for the same treated patients and the response to treatment of patients formerly in the control condition. Patients in the treatment groups (n=114) were followed up at 2 years; 32 patients from the control group were offered the intervention after 1 year and were assessed 1 year later. Assessments were the self-rated measures used in the original trial. At 2 years 63 of the treated patients (55%) no longer fulfilled trial criteria for CFS compared with 64 patients (56%) at 1 year. Fourteen of 30 crossover patients (47%) achieved a good outcome at 1 year and seven (23%) no longer fulfilled criteria for CFS. Benefits of the intervention were maintained at 2 years. Delaying treatment is associated with reduced efficacy and required more intensive therapy.,Powell P.; Bentall RP.; Nye FJ.; Edwards RH.,2004.0,,0,0,
4739,Effectiveness of a web-based cognitive-behavioral tool to improve mental well-being in the general population: Randomized controlled trial.,"Background: Interventions to promote mental well-being can bring benefits to the individual and to society. The Internet can facilitate the large-scale and low-cost delivery of individually targeted health promoting interventions. Objective: To evaluate the effectiveness of a self-directed Internet-delivered cognitive-behavioral skills training tool in improving mental well-being in a population sample. Methods: This was a randomized trial with a waiting-list control. Using advertisements on a national health portal and through its mailing list, we recruited 3070 participants aged 18 or over, resident in England, and willing to give their email address and access a fully automated Web-based intervention. The intervention (MoodGYM) consisted of 5 interactive modules that teach cognitive-behavioral principles. Participants in the intervention arm received weekly email reminders to access the intervention. The control group received access to the intervention after the trial was completed and received no specific intervention or email reminders. Outcomes were assessed by using self-completion questionnaires. The primary outcome was mental well-being measured with the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Secondary outcomes were Center for Epidemiologic Studies Depression scale (CES-D) depression scores, Generalized Anxiety Disorder 7-item scale (GAD-7) anxiety scores, EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D) quality of life scores, physical activity, and health service use. All outcomes were measured at baseline, and at 6- and 12-week follow-ups. Results: A total of 1529 (49.80%) participants completed final follow-up at 12 weeks. Retention was 73.11% (1123/1536) in the control arm and 26.47% (406/1534) in the intervention arm. No relationship between baseline measures and withdrawal could be established. The analysis of WEMWBS mental well-being scores using a linear mixed model for repeated measures showed no difference between intervention and control group at baseline (difference -0.124 points, 95%","Powell, John; Hamborg, Thomas; Stallard, Nigel; Burls, Amanda; McSorley, Jaime; Bennett, Kylie; Griffiths, Kathleen M; Christensen, Helen; Abbott, Altman, Barrera, Calear, Christensen, Christensen, Christensen, Christensen, Corbett, Donkin, Donkin, Eysenbach, Graveling, Griffiths, Griffiths, Lindsay, Mackinnon, Mitchell, Mitchell, Mohr, Neil, Parks-Sheiner, Proudfoot, Richardson, Riper, Schueller, Seligman, Shapira, Sin, Slade, Stiglitz, Tennant, Venning, White, Winer",2013.0,,0,0,
4740,Reduction and refinement are essential ingredients of good science and corporate responsibility,"The 3Rs of replacement, reduction, and refinement are central to the European and national legislative framework regulating the care and use of live animals for scientific purposes. Where replacement of animals is not yet possible, the objective should be to use the most optimal experimental design and the least number of animals necessary to reach the scientific goals. It is not enough to just apply proper statistics, but also to implement proper colony management for example to keep the number of surplus animals in breeding as low as possible. The quality of the science is highly dependent on the quality of the animals used. This quality is not limited to the microbiology and the genetic constitution of the animals, but extends to the whole of mental and physical wellbeing. The five freedoms, sometimes known as Brambell's five freedoms, are a compact of rights for animals under human control and could be regarded as fundamental to mental and physical wellbeing. They include freedom from hunger and thirst; from discomfort; from pain, injury, and disease; from fear and distress; and to express most normal behaviour. The five freedoms are certainly not fully met with animals kept for scientific purposes. Our housing and care is at best a compromise that should include application of the full extent of possible refinement alternatives. It is our responsibility to use only the best animal model suited to achieve a given scientific goal which includes good mental and physical health.",Prins J.-B.,2015.0,,0,0,
4741,Fear-relevant outcomes modulate the neural correlates of probabilistic classification learning,"Although much work has implicated the contributions of frontostriatal and medial temporal lobe (MTL) systems during probabilistic classification learning, the impact of emotion on these learning circuits is unknown. We used a modified version of the weather prediction task in which two participant groups were scanned with identical neutral cue cards probabilistically linked to either emotional (snake/spider) or neutral (mushroom/flower) outcomes. Owing to the differences in visual information shown as outcomes, analyses were restricted to the cue phase of the trials. Learning rates did not differ between the two groups, although the Emotional group was more likely to use complex strategies and to respond more slowly during initial learning. The Emotional group had reduced frontostriatal and MTL activation relative to the Neutral group, especially for participants who scored higher on snake/spider phobia questionnaires. Accurate performance was more tied to medial prefrontal activity in the Emotional group early in training, and to MTL activity in the Neutral group later in training. Trial-by-trial fluctuations in functional connectivity between the caudate and MTL were also reduced in the Emotional group compared to the Neutral group. Across groups, reaction time indexed a switch in learning systems, with faster trials mediated by the caudate and slower trials mediated by the MTL and frontal lobe. The extent to which the caudate was activated early in training predicted later performance improvements. These results reveal insights into how emotional outcomes modulate procedural learning systems, and the dynamics of MTL-striatal engagement across training trials. © 2011 Elsevier Inc.",Prince S.E.; Thomas L.A.; Kragel P.A.; LaBar K.S.,2012.0,10.1016/j.neuroimage.2011.07.027,0,0,
4742,Initial disturbances of consciousness and resultant impaired awareness in Spanish patients with traumatic brain injury.,"The purpose of this prospective, between-subjects study was to look at impaired awareness cross-culturally in patients with traumatic brain injury (TBI) and to relate impaired awareness after injury to the initial estimates of disturbed consciousness at time of injury. The study was conducted in community and inpatient and outpatient rehabilitation centers in Barcelona and Madrid. Participants were 30 persons with primarily moderate to severe TBI who could complete a written questionnaire concerning their functioning and 28 age- and gender-matched controls. A Spanish translation of the Patient Competency Rating Scale (PCRS) was administered to each participant. Relatives or significant others also completed this scale on each participant using the relative's version (PCRS-R). Difference scores, obtained by subtracting PCRS-R from PCRS-P (PCRS-P minus PCRS-R), were used as a marker of impaired awareness. Individuals with TBI were rated (by self and significant others) as being less competent than controls. Forty percent of Spanish patients with TBI who suffered severe injuries tended to overestimate their behavioral competencies. The PCRS-P minus the PCRS-R difference scores tended to correlate with admitting Glasgow Coma Scale (GCS) scores and retrospective estimates of posttraumatic amnesia (PTA). Initial disturbances of consciousness, one measure of severity of brain injury, appeared to relate to later measures of impaired self-awareness in Spanish patients with TBI. Non-brain-injured controls did not tend to report levels of competency that differed from their relatives' reports.",Prigatano GP.; Bruna O.; Mataro M.; Muñoz JM.; Fernandez S.; Junque C.,1998.0,,0,0,
4743,Stress debriefing after childbirth: a randomised controlled trial.,"To test whether critical incident stress debriefing after childbirth reduces the incidence of postnatal psychological disorders. Randomised single-blind controlled trial stratified for parity and delivery mode. Two large maternity hospitals in Perth. 1745 women who delivered healthy term infants between April 1996 and December 1997 (875 allocated to intervention and 870 to control group). An individual, standardised debriefing session based on the principles of critical incident stress debriefing carried out within 72 hours of delivery. Diagnosis of stress disorders or depression in the 12 months postpartum, using structured psychological interview and criteria of the Diagnostic and statistical manual of mental disorders, 4th edition. Follow-up information was available for 1730 women (99.1%), 482 of whom underwent psychological interview. There were no significant differences between control and intervention groups in scores on Impact of Events or Edinburgh Postnatal Depression Scales at 2, 6 or 12 months postpartum, or in proportions of women who met diagnostic criteria for a stress disorder (intervention, 0.6% v control, 0.8%; P = 0.58) or major or minor depression (intervention, 17.8% v control, 18.2%; relative risk [95% CI], 0.99 [0.87-1.11]) during the postpartum year. Nor were there differences in median time to onset of depression (intervention, 6 [interquartile range, 4-9] weeks v control, 4 [3-8] weeks; P = 0.84), or duration of depression (intervention, 24 [12-46] weeks v control, 22 [10-52] weeks; P = 0.98). There is a high prevalence of depression in women during the first year after childbirth. A session of midwife-led, critical incident stress debriefing was not effective in preventing postnatal psychological disorders, but had no adverse effects.",Priest SR.; Henderson J.; Evans SF.; Hagan R.,2003.0,,0,0,
4744,Vigilant and avoidant attention biases as predictors of response to cognitive behavioral therapy for social phobia.,"Background: Attention bias for socially threatening information, an empirically supported phenomenon, figures prominently in models of social phobia. However, all published studies examining this topic to date have relied on group means to describe attention bias patterns; research has yet to examine potential subgroups of attention bias among individuals with social phobia (e.g., vigilant or avoidant). Furthermore, almost no research has examined how attention biases in either direction may predict change in symptoms as a result of treatment. Methods: This study (N = 24) compared responses to cognitive behavioral therapy (CBT) for social phobia between individuals with avoidant and vigilant biases for threatening faces at pretreatment. Results: Participants with avoidant biases reported significantly and clinically higher symptom levels at posttreatment than did those with vigilant biases. Conclusions: These findings suggest that an avoidant attention bias may be associated with reduced response to CBT for social phobia. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Price, Matthew; Tone, Erin B; Anderson, Page L; Amir, Amir, Anderson, Baker, Bradley, Bogels, Chen, Clark, First, Foa, Fresco, Gamble, Kamphuis, Lundh, Mansell, Mathews, Mogg, Mogg, Monk, Moscovitch, Pine, Pishyar, Pourtois, Price, Rapee, Rothbaurn, Rothbaurn, Schmidt, Schmukle, Schultz, Sposari, Telch, Telzer, Tone, Wilson",2011.0,,0,0,
4745,Effectiveness of an Extended Yoga Treatment for Women with Chronic Posttraumatic Stress Disorder.,"Yoga has been found to be an effective posttraumatic stress disorder (PTSD) treatment for a variety of trauma survivors, including females with chronic PTSD. Aim/Purpose: The current study builds on extant research by examining an extended trauma-sensitive yoga treatment for women with chronic PTSD. The study sought to optimize the results of a treatment protocol examined in a recent randomized controlled trial with a shorter duration and without assignment or monitoring of home practice. The authors examined a 20-week trauma-sensitive yoga treatment in a non-randomized single-group treatment feasibility study for women with chronic treatment-resistant PTSD (N‚Äâ=‚Äâ9). The authors examined PTSD and dissociation symptom reduction over several assessment periods. The results indicate that participants experienced significant reductions in PTSD and dissociative symptomatology above and beyond similar treatments of a shorter duration. The findings suggest that more intensive trauma-sensitive yoga treatment characterized by longer duration and intentional assignment and monitoring of home practice may be more advantageous for individuals with severe and chronic PTSD. The implications of the findings for the potentially more substantial role of yoga as an intervention for a subset of adults with chronic treatment-resistant PTSD are discussed.",Price M.; Spinazzola J.; Musicaro R.; Turner J.; Suvak M.; Emerson D.; van der Kolk B.,2017.0,10.1089/acm.2015.0266,0,0,
4746,Emergency department predictors of posttraumatic stress reduction for trauma-exposed individuals with and without an early intervention.,"Recent data have supported the use of an early exposure intervention to promote a reduction in acute stress and posttraumatic stress disorder (PTSD) symptoms after trauma exposure. The present study explored a comprehensive predictive model that included history of trauma exposure, dissociation at the time of the trauma and early intervention, and physiological responses (cortisol and heart rate) to determine which variables were most indicative of reduced PTSD symptoms for an early intervention or treatment as usual. Participants (n = 137) were randomly assigned to the early intervention condition (n = 68) or assessment-only condition (n = 69) while receiving care at the emergency department of a Level 1 trauma center. Follow-up assessments occurred at 4 and 12 weeks posttrauma. Findings suggested that dissociation at the time of the 1st treatment session was associated with reduced response to the early intervention. No other predictors were associated with treatment response. For treatment as usual, cortisol levels at the time of acute care and dissociation at the time of the traumatic event were positively associated with PTSD symptoms. Dissociation at the time at which treatment starts may indicate poorer response to early intervention for PTSD. Similarly, dissociation at the time of the event was positively related to PTSD symptoms in those who received treatment as usual.",Price M.; Kearns M.; Houry D.; Rothbaum BO.,2014.0,10.1037/a0035537,0,0,
4747,Predictors of using mental health services after sexual assault.,"Sexual assault increases the risk for psychopathology. Despite the availability of effective interventions, relatively few victims who need treatment receive care in the months following an assault. Prior work identified several factors associated with utilizing care, including ethnicity, insurance, and posttraumatic stress disorder (PTSD) symptoms. Few studies, however, have examined predictors of treatment utilization prospectively from the time of assault. The present study hypothesized that White racial status, younger age, being partnered, having health insurance, having previously received mental health treatment, and having more PTSD and depression symptoms would predict utilization of care in the 6 months postassault. This was examined in a sample of 266 female sexual assault victims with an average age of 26.2 years, of whom 62.0% were White and 38.0% were African American assessed at 1.5 and 6 months postassault. Available information on utilizing care varied across assessments (1.5 months, n = 214; 3 months, n = 126; 6 months, n = 204). Significant predictors included having previously received mental health treatment (OR = 4.09), 1 day depressive symptoms (OR = 1.06), and having private insurance (OR = 2.24) or Medicaid (OR = 2.19). Alcohol abuse and prior mental health care were associated with a substantial increase in treatment utilization (OR = 4.07). The findings highlight the need to help victims at risk obtain treatment after sexual assault.",Price M.; Davidson TM.; Ruggiero KJ.; Acierno R.; Resnick HS.,2014.0,10.1002/jts.21915,0,0,
4748,Outcome expectancy as a predictor of treatment response in cognitive behavioral therapy for public speaking fears within social anxiety disorder.,"Outcome expectancy, the extent that clients anticipate benefiting from therapy, is theorized to be an important predictor of treatment response for cognitive-behavioral therapy. However, there is a relatively small body of empirical research on outcome expectancy and the treatment of social anxiety disorder. This literature, which has examined the association mostly in group-based interventions, has yielded mixed findings. The current study sought to further evaluate the effect of outcome expectancy as a predictor of treatment response for public-speaking fears across both individual virtual reality and group-based cognitive-behavioral therapies. The findings supported outcome expectancy as a predictor of the rate of change in public-speaking anxiety during both individual virtual reality exposure therapy and group cognitive-behavioral therapy. Furthermore, there was no evidence to suggest that the impact of outcome expectancy differed across virtual reality or group treatments.",Price M.; Anderson PL.,2012.0,10.1037/a0024734,0,0,
4749,Changing Beliefs about Trauma: A Qualitative Study of Cognitive Processing Therapy.,"Controlled qualitative methods complement quantitative treatment outcome research and enable a more thorough understanding of the effects of therapy and the suspected mechanisms of action. Thematic analyses were used to examine outcomes of cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) in a randomized controlled trial of individuals diagnosed with military-related PTSD (n = 15). After sessions 1 and 11, participants wrote ""impact statements"" describing their appraisals of their trauma and beliefs potentially impacted by traumatic events. Trained raters coded each of these statements using a thematic coding scheme. An analysis of thematic coding revealed positive changes over the course of therapy in participants' perspective on their trauma and their future, supporting the purported mechanisms of CPT. Implications of this research for theory and clinical practice are discussed.",Price JL.; MacDonald HZ.; Adair KC.; Koerner N.; Monson CM.,2016.0,10.1017/S1352465814000526,0,0,
4750,The treatment of anxiety disorders in a primary care HMO setting.,"Anxiety disorders are common, yet under diagnosed, in primary care settings. Many patients with anxiety and other psychiatric disorders do not seek care in mental health care settings. An integrated primary care/mental health model offers one approach to improving outcomes for patients with anxiety disorders. This model has been researched for the treatment of depression with positive results but has not been well studied for the treatment of anxiety disorders. We describe the results of care for a cohort of adult patients with Generalized Anxiety Disorder (GAD) and clinically significant anxiety secondary to Major Depressive Disorder (MDD) treated in an integrated model. Compared to a matched cohort of adults treated in a primary care setting with usual care, the intervention cohort experienced significantly improved reduction in symptoms of anxiety at 6 months. The intervention cohort also was significantly more satisfied with care.",Price D.; Beck A.; Nimmer C.; Bensen S.,2000.0,,0,0,
4751,Is a behavioral graded activity program more effective than manual therapy in patients with subacute neck pain? Results of a randomized clinical trial.,"A randomized clinical trial. To compare the effectiveness of a behavioral graded activity program with manual therapy in patients with subacute (4-12 weeks) nonspecific neck pain. Neck pain is a common complaint, for which many conservative therapies are available in primary care. There is strong evidence for manual therapy in combination with exercises. Psychosocial factors are also believed to play a role in chronic pain. The evidence of the effectiveness of a program focused on these factors is still unknown. A randomized clinical trial was conducted, involving 146 patients with subacute nonspecific neck pain. The BGA program can be described as a time-contingent increase in activities from baseline toward predetermined goals. Manual therapy consists of specific spinal mobilization techniques and exercises. Primary outcomes were global perceived effect, the Numerical Rating Scale for pain and the Neck Disability Index. Secondary outcomes were the Tampa Scale for Kinesiophobia, the 4 Dimensional Symptom Questionnaire, and the Pain Coping and Cognition List. Measurements were carried out at baseline and 6, 13, 26, and 52 weeks after randomization. Data are analyzed according to the intention-to-treat principle, using multilevel analysis. The success rates at 52 weeks, based on the GPE were 89.4% for the BGA program and 86.5% for MT. This difference was not statistically significant. For pain and disability, a difference was found in favor of the BGA program; mean difference for pain = 0.99 (95% CI 0.15-1.83) and mean difference for NDI = 2.42 (95% CI 0.52-4.32). All other differences between the interventions in the primary and secondary outcomes were not statistically significant. Based on this trial it can be concluded that there are only marginal, but not clinically relevant, differences between a BGA program and MT.",Pool JJ.; Ostelo RW.; Knol DL.; Vlaeyen JW.; Bouter LM.; de Vet HC.,2010.0,10.1097/BRS.0b013e3181c212ee,0,0,
4752,Comparison of the effectiveness of a behavioural graded activity program and manual therapy in patients with sub-acute neck pain: design of a randomized clinical trial,"ER The objective is to present the design of a randomized clinical trial (RCT) on the effectiveness and cost effectiveness of a behavioural graded activity programme compared with manual therapy in patients with sub-acute neck pain. Sub-acute is defined as pain existing for 4-12 weeks. The behavioural graded activity programme is a time-contingent increase in activities from baseline towards pre-determined goals. Manual therapy consists mainly of specific spinal mobilization techniques and exercises. The primary outcomes are global perceived effect and functional status. Secondary outcomes are kinesiophobia, distress, coping, depression and somatization. The intensity and persistence of the pain and its interference with activities are also assessed. Direct and indirect costs are measured by means of cost diaries. Measurements take place at baseline and 6 and 12 weeks after randomization. To assess the long-term effect, measurements will also take place after 6 and 12 months. Finally some challenges are discussed concerning the use of a behavioural graded activity programme, manual therapy and outcomes.","Pool, J J; Ostelo, R W; Köke, A J; Bouter, L M; Vet, H C",2006.0,10.1016/j.math.2005.07.006,0,0,
4753,Global cerebral blood flow after CO2 inhalation in normal subjects and patients with panic disorder determined with [15O]water and PET,"Objective: To determine the effect of CO2 inhalation on global cerebral blood flow (gCBF) and pCO2-adjusted gCBF in normal subjects and panic disorder patients. Method: Global cerebral blood flow was determined using quantitative [15O]water imaging in normal subjects (n=12) and panic disorder patients (n=14) after inhalations of medical grade air and of 35%/65% CO2/O2 mixture, a known inducer of panic. The gCBF was calculated as an area-weighted mean value. The pCO2-adjusted gCBF values were calculated based on the formula of Reiman et al. [Am. J. Psychiatr. 143 (1986) 469]. Data were analyzed using repeated-measures ANOVA and regression analyses. Results: The pCO2 values did not differ statistically between normals and panic patients. Panic patients exhibited a decrease in gCBF and stable pCO2-adjusted gCBF values in comparisons of AIR and CO2 inhalations, whereas normals exhibited stable gCBF and increasing pCO2-adjusted gCBF values. Conclusions: Patients with panic disorder, especially when symptomatic, exhibited an abnormal pattern in gCBF response to provocation. © 2002 Elsevier Science Inc. All rights reserved.",Ponto L.L.B.; Kathol R.G.; Kettelkamp R.; Watkins G.L.; Richmond J.C.W.; Clark J.; Hichwa R.D.,2002.0,10.1016/S0887-6185(02)00094-4,0,0,
4754,Resilience in children undergoing stem cell transplantation: results of a complementary intervention trial,"ER BACKGROUND: Children undergoing stem cell transplantation (SCT) are thought to be at risk for increased distress, adjustment difficulties, and impaired health-related quality of life (HRQL). We report results of a multisite trial designed to improve psychological adjustment and HRQL in children undergoing SCT.METHODS: A total of 171 patients and parents from 4 sites were randomized to receive a child-targeted intervention; a child and parent intervention; or standard care. The child intervention included massage and humor therapy; the parent intervention included massage and relaxation/imagery. Outcomes included symptoms of depression and posttraumatic stress, HRQL, and benefit finding. Assessments were conducted by patient and parent report at admission and SCT week+24.RESULTS: Across the sample, significant improvements were seen on all outcomes from admission to week+24. Surprisingly, patients who had SCT reported low levels of adjustment difficulties at admission, and improved to normative or better than average levels of adjustment and HRQL at week+24. Benefit finding was high at admission and increased at week+24; however, there were no statistically significant differences between intervention arms for any of the measures.CONCLUSIONS: Although the results do not support the benefits of these complementary interventions in pediatric SCT, this may be explained by the remarkably positive overall adjustment seen in this sample. Improvements in supportive care, and a tendency for patients to find benefit in the SCT experience, serve to promote positive outcomes in children undergoing this procedure, who appear particularly resilient to the challenge.","Phipps, S; Peasant, C; Barrera, M; Alderfer, M A; Huang, Q; Vannatta, K",2012.0,10.1542/peds.2011-1816,0,0,
4755,Self-administered systematic desensitization.,,Phillips RE.; Johnson GD.; Geyer A.,1972.0,,0,0,
4756,Randomized controlled trial of computerized cognitive behavioural therapy for depressive symptoms: effectiveness and costs of a workplace intervention,"ER METHOD: The study was a phase III two-arm, parallel randomized controlled trial whose main outcome was total score on the Work and Social Adjustment Scale (WSAS). Depression, anxiety, psychological functioning, costs and acceptability of the online process were also measured. Most data were collected online for 637 participants at baseline, 359 at 6 weeks marking the end of the intervention and 251 participants at 12 weeks post-baseline.RESULTS: In both experimental and control groups depression scores improved over 6 weeks but attrition was high. There was no evidence for a difference in the average treatment effect of MoodGYM on the WSAS, nor for a difference in any of the secondary outcomes.CONCLUSIONS: This study found no evidence that MoodGYM was superior to informational websites in terms of psychological outcomes or service use, although improvement to subthreshold levels of depression was seen in nearly half the patients in both groups.BACKGROUND: Depression and anxiety are major causes of absence from work and underperformance in the workplace. Cognitive behavioural therapy (CBT) can be effective in treating such problems and online versions offer many practical advantages. The aim of the study was to investigate the effectiveness of a computerized CBT intervention (MoodGYM) in a workplace context.","Phillips, R; Schneider, J; Molosankwe, I; Leese, M; Foroushani, P S; Grime, P; McCrone, P; Morriss, R; Thornicroft, G",2014.0,10.1017/S0033291713001323,0,0,
4757,A comparison of delusional and nondelusional body dysmorphic disorder in 100 cases.,"A controversial issue that was debated for DSM-IV is whether body dysmorphic disorder (BDD)--a preoccupation with an imagined defect in appearance--can be psychotic. BDD is classified separately from its delusional counterpart (delusional disorder, somatic type) in DSM-IV, but does it have a psychotic variant that overlaps with, and may even be the same diagnostic entity as, its delusional disorder variant? One hundred consecutive patients with DSM-III-R-defined BDD or its delusional variant were assessed with a semistructured interview, the Structured Clinical Inverview for DSM-III-R, and a modified version of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The 48 patients with nondelusional BDD were compared with the 52 patients with delusional BDD (i.e., delusional disorder, somatic type). The two groups did not differ significantly in terms of most variables examined, including demographics, phenomenology, course, associated features, comorbidity, and treatment response. Thus, BDD may have a psychotic subtype that significantly overlaps with, and may even be the same disorder as, its delusional disorder variant. However, delusional subjects had higher total scores on the modified Y-BOCS, suggesting that the delusional variant of BDD may be a more severe form of the disorder. Although preliminary, these findings have implications for BDD's treatment and classification, suggesting that inclusion of a delusional (psychotic) subtype of BDD should be considered for future editions of DSM.",Phillips KA.; McElroy SL.; Keck PE.; Hudson JI.; Pope HG.,1994.0,,0,0,
4758,"A severity rating scale for body dysmorphic disorder: development, reliability, and validity of a modified version of the Yale-Brown Obsessive Compulsive Scale.","The authors developed the Yale Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS), a 12-item semistructured clinician-rated instrument designed to rate severity of body dysmorphic disorder (BDD). The scale was administered to 125 subjects with BDD, and interviews with 15 subjects were rated by 3 other raters. Test-retest reliability was assessed in 30 subjects. Other scales were administered to assess convergent and discriminant validity, and sensitivity to change was evaluated in a study of fluvoxamine. Each item was frequently endorsed across a range of severity. Good interrater reliability, test-retest reliability, and internal consistency were obtained. BDD-YBOCS scores correlated with global severity scores but not with a measure of general psychopathology; they were modestly positively correlated with depression severity scores. Three factors accounted for 59.6 percent of the variance. The scale was sensitive to change in BDD severity. The BDD-YBOCS appears to be a reliable and valid measure of BDD severity and is a suitable outcome measure in treatment studies of BDD.",Phillips KA.; Hollander E.; Rasmussen SA.; Aronowitz BR.; DeCaria C.; Goodman WK.,1997.0,,0,0,
4759,Experimentally induced anxiety attenuates alcohol-related aggression in men,"ER The purpose of this study was to test the hypothesis that state anxiety operates as moderator of the alcohol-aggression relation. Participants were 80 healthy male social drinkers between 21 and 33 years of age. They were randomly assigned to 1 of 4 groups: (a) alcohol + anxiety induction (n = 20), (b) placebo + anxiety induction (n = 20), (c) alcohol + no anxiety induction (n = 20), and (d) placebo + no anxiety induction (n = 20). Anxiety was induced by informing participants that they had to deliver a speech about what they liked and disliked about their body in front of a video camera. A modified version of the Taylor Aggression Paradigm (S. Taylor, 1967) was then used to measure aggressive behavior in a situation where electric shocks were administered to, and received from, a fictitious opponent under the guise of a competitive reaction time task. Results indicated that the anxiety induction was successful in suppressing aggression for participants who received alcohol equal to levels seen in placebo controls. Findings are discussed within the context of a number of theories of alcohol's anxiolytic effects in relation to intoxicated aggression.","Phillips, J P; Giancola, P R",2008.0,10.1037/1064-1297.16.1.43,0,0,
4760,Serum cholesterol in patients with obsessive compulsive disorder during treatment with behavior therapy and SSRI or placebo.,"Patients with panic disorder are reported to have elevated cholesterol levels. There is also some evidence that cholesterol elevation is not so much a specific condition in panic disorder but is generally associated with anxiety. So far, there is little data on cholesterol levels in patients with obsessive compulsive disorders (OCD) which is also classified as anxiety disorder. Thirty-three patients with OCD participated in the study. Serum cholesterol was measured as pretreatment and at the end of a ten-week treatment-period. All patients received behavior therapy and, in a double-blind fashion, fluvoxamine or placebo. Severity of OCD was assessed by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Pretreatment cholesterol values of OCD patients were compared with cholesterol levels of thirty panic disorder patients and thirty normal controls. OCD patients had elevated cholesterol levels comparable with those of panic disorder patients. Cholesterol levels decreased significantly from pre- to posttreatment. OCD patients with high cholesterol levels (> or = 240 mg/dl, n = 7) could make best use of the treatment whereas patients with desirable cholesterol levels (< 200 mg/dl, n = 11) did not change their cholesterol during treatment. Our data support the assumption that not only panic disorder but also other anxiety disorders, e.g., obsessive compulsive disorders, may be associated with serum cholesterol elevations. Effective treatment (behavior therapy and/or treatment with a selective serotonin reuptake inhibitor [SSRI]) seems to decrease cholesterol levels, especially in patients with pathological cholesterol elevations.",Peter H.; Tabrizian S.; Hand I.,2000.0,10.2190/APWF-N1XU-Y7A0-TCBW,0,0,
4761,"Sodium lactate and hypertonic sodium chloride induce equivalent panic incidence, panic symptoms, and hypernatremia in panic disorder","ER METHODSWe compared in panic disorder and healthy subjects behavioral, electrolyte, endocrine, and acid-base responses to three double-blind randomly ordered equal volume 20-min infusions: 0.5 mol/L sodium lactate, hypertonic saline (3% sodium chloride), and normal saline placebo.RESULTSSodium lactate (0.5 mol/L) and hypertonic saline produced the same high incidence of panic and equivalent increases in panic symptoms, serum sodium, and plasma vasopressin in the panic disorder subjects. Neither hypertonic infusion increased cortisol or adrenocorticotropin. No normal subject experienced panic in any condition. The 0.5-mol/L sodium lactate infusion induced alkalosis, whereas hypertonic saline and normal saline induced a mild acidosis.CONCLUSIONSHypertonic sodium solution containing either chloride or lactate anion induces panic in panic disorder. The large sodium loads delivered by hypertonic saline and 0.5 mol/L sodium lactate may be involved in the mechanism of panic induction.BACKGROUNDAlthough experimental induction of panic by infusion of 0.5 mol/L sodium lactate in persons with panic disorder was described three decades ago, the mechanism underlying this observation remains unclear. Here we asked if the rapid administration of the large sodium load contained in the 0.5-mol/L sodium lactate infusion might be involved in panic induction.","Peskind, E R; Jensen, C F; Pascualy, M; Tsuang, D; Cowley, D; Martin, D C; Wilkinson, C W; Raskind, M A",1998.0,,0,0,
4762,The impact of the stimulus features and task instructions on facial processing in social anxiety: An ERP investigation,"Social anxiety has been characterized by an attentional bias towards threatening faces. Electrophysiological studies have demonstrated modulations of cognitive processing from 100. ms after stimulus presentation. However, the impact of the stimulus features and task instructions on facial processing remains unclear. Event-related potentials were recorded while high and low socially anxious individuals performed an adapted Stroop paradigm that included a colour-naming task with non-emotional stimuli, an emotion-naming task (the explicit task) and a colour-naming task (the implicit task) on happy, angry and neutral faces. Whereas the impact of task factors was examined by contrasting an explicit and an implicit emotional task, the effects of perceptual changes on facial processing were explored by including upright and inverted faces. The findings showed an enhanced P1 in social anxiety during the three tasks, without a moderating effect of the type of task or stimulus. These results suggest a global modulation of attentional processing in performance situations. © 2013 Elsevier B.V.",Peschard V.; Philippot P.; Joassin F.; Rossignol M.,2013.0,10.1016/j.biopsycho.2013.01.009,0,0,
4763,Psychological wellbeing after laparoscopic and abdominal hysterectomy--a randomised controlled multicentre study.,"To compare laparoscopic hysterectomy and abdominal total hysterectomy regarding influence on postoperative psychological wellbeing and surgical measures. A prospective, open, randomised multicentre trial. Five hospitals in the South East of Sweden. Hundred and twenty-five women scheduled for hysterectomy for benign conditions were enrolled in the study, and 119 women completed the study. Fifty-six women were randomised to abdominal hysterectomy and 63 to laparoscopic hysterectomy. Psychometric tests measuring general wellbeing, depression and anxiety preoperatively and 5 weeks and 6 months postoperatively. Effects of operating method on the psychological wellbeing postoperatively. Analysis of data regarding operating time, peroperative and postoperative complications, blood loss, hospital stay and recovery time. No significant differences in the scores were observed between the two groups in any of the four psychometric tests. Both the surgical methods were associated with a significantly higher degree of psychological wellbeing 5 weeks postoperatively compared with preoperatively. The operating time was significantly longer for the laparoscopic hysterectomy group, but the duration of the stay in hospital and sick-leave were significantly shorter for laparoscopic hysterectomy group compared with the abdominal hysterectomy group. General psychological wellbeing is equal after laparoscopic and abdominal hysterectomy within 6 months after the operation. The advantages of the laparoscopic hysterectomy are the shorter stay in hospital and shorter sick-leave, but these issues must be balanced by a longer duration of the operation.",Persson P.; Wijma K.; Hammar M.; Kj√∏lhede P.,2006.0,10.1111/j.1471-0528.2006.01025.x,0,0,
4764,A 1-year follow up of psychological wellbeing after subtotal and total hysterectomy--a randomised study.,"To compare subtotal abdominal hysterectomy (SH) and total abdominal hysterectomy (TH) regarding influence on postoperative psychological wellbeing and surgical outcome measurements. A prospective, open, randomised multicentre trial. Seven hospitals and one private clinic in the south-east of Sweden. Two-hundred women scheduled for abdominal hysterectomy for benign conditions were enrolled in the study; 179 women completed the study (94 SH and 85 TH). Four different psychometric tests were used to measure general wellbeing, depression and anxiety preoperatively, and at 6 and 12 months postoperatively. Statistical analysis of variance and covariance were used. Effects of operating method on psychological wellbeing postoperatively. Analysis of demographic, clinical and surgical data, including peri- and postoperative complications and complaints at follow up. No significant differences were observed between the two groups in any of the psychometric tests. Both surgical methods were associated with a significantly higher degree of psychological wellbeing at 6 and 12 months postoperatively, compared with preoperatively. No significant differences were found in the clinical measures including complications. A substantial number of women experienced persistent cyclic vaginal bleedings after SH. Neither minor or major postoperative complications, nor serum concentration of sex hormones, were associated with general psychological wellbeing 12 months after the operation. General psychological wellbeing is equally improved after both SH and TH within 12 months of the operation, and does not seem to be associated with the occurrence of peroperative complications or serum concentration of sex hormones.",Persson P.; Brynhildsen J.; Kj√∏lhede P.;  .,2010.0,10.1111/j.1471-0528.2009.02467.x,0,0,
4765,"Agoraphobics and social phobics: differences in background factors, syndrome profiles and therapeutic response.","Seventy-three agoraphobic and 31 social phobic women, all rated unsuitable for insight-oriented psychotherapy, were compared regarding family and personal history, intelligence, personality and factors pertaining to the disorder. The same patients, with 11 men included in the social phobic group, were also compared regarding response to four randomly assigned types of treatment given over a 3 month period, with a 9 months' follow-up. The following differences were revealed: 1) Social phobias were associated with a higher social class of the parental home, higher education, higher scores on verbal intelligence, and a higher social class of the patient. 2) Social phobics scored higher on the personality factor, aggressive non-conformance, otherwise there were no differences in the personality factor. 3) Agoraphobias were associated with mother working outside home during the patient's childhood, neurotic symptoms in childhood, and current economic difficulties. Agoraphobics more often gave experience of death as a cause of the disorder. 4) Social phobias started at an earlier age. 5) Target phobia and the global rating were of equal severity in the two syndromes, but the agoraphobics had higher ratings on free anxiety and depersonalization. 6) Social phobics responded better to prolonged exposure in vivo, while agoraphobics responded better to supportive therapy of dynamic type, or to a simple basal therapy. Social phobics more often wanted the therapists to give advice and guidance.",Persson G.; Nordlund CL.,1985.0,,0,0,
4766,Expectations of improvement and attitudes to treatment processes in relation to outcome with four treatment methods for phobic disorders.,"One hundred and three agora- or sociophobic women who were not suitable for insight-oriented psychotherapy filled in an inventory with questions pertaining to expectations as to improvement, and attitudes towards goal of treatment and function of the therapist. The patients received one of four randomly assigned types of outpatient treatment for 3 months. All patients received basal therapy in the form of medication, standardized information and self-exposure instructions. One group received this treatment only once a month (B). The others received in addition either therapist-directed prolonged exposure in vivo (PE), dynamically oriented supportive therapy (ST), or relaxation therapy (R). The patients were rated by an independent rater with regard to symptoms and functions at the start and termination of the treatment, and at the end of the follow-up period 9 months after termination. 1) The patient's expectation as to improvement was positively associated with outcome with R and B, but there was no association with PE and ST. Thus, expectancy was associated with outcome when the treatment given was fairly unspecific. 2) A good match between the patient's pretreatment attitude to the goal of treatment and how the therapist should function was associated with a better outcome.",Persson G.; Nordlund CL.,1983.0,,0,0,
4767,Are results of randomized controlled trials useful to psychotherapists?,"Two clinicians provided opposite answers to the title question: Persons argued that information from randomized controlled trials (RCTs) is vital to clinicians, and Silherschatz argued that information from RCTs is irrelevant to clinicians. Persons argued that clinicians cannot provide top quality care to their patients without attending to findings of RCTs and that clinicians have an ethical responsibility to inform patients about, recommend, and provide treatments supported by RCTs before informing patients about, recommending, and providing treatments shown to be inferior in RCTs or not evaluated in RCTs. Silberschatz argued that RCTs do not and cannot answer questions that concern practicing clinicians. He advocates alternative research approaches (effectiveness studies, quasi-experimental methods, case- specific research) for studying psychotherapy.",Persons J.B.; Silberschatz G.,1998.0,10.1037/0022-006X.66.1.126,0,0,
4768,Obsessive-compulsive disorder: a treatment review.,"Obsessive-compulsive disorder, which may affect 2% to 3% of the U.S. population, can be severely disabling, permeating an individual's personal, social, and work life. Only within the past 2 decades have effective treatments been proposed and tested. Specific behavior therapies such as exposure in vivo and response prevention have proved successful in decreasing compulsive rituals in 70% to 80% of patients who accept and comply with treatment. For those patients who do not respond to behavior therapy, medications should be used. To date the tricyclic clomipramine is the only medication that has been consistently effective in controlled studies. However, for certain patients other medications may be of benefit. For the minority of patients who do not respond to either behavior therapy or medication, psychosurgery--specifically stereotactic limbic leucotomy--should be considered a viable option.",Perse T.,1988.0,,0,0,
4769,Food neophobia and its association with diet quality and weight in children aged 24 months: a cross sectional study,"ER METHODS: Secondary analysis of data from 330 parents of children enrolled in the NOURISH RCT (control group only) and SAIDI studies was performed using data collected at child age 24 months. Neophobia was measured at 24 months using the Child Food Neophobia Scale (CFNS). The cross-sectional associations between total CFNS score and fruit and vegetable variety, discretionary food intake and BMI (Body Mass Index) Z-score were examined via multiple regression models; adjusting for significant covariates.RESULTS: At 24 months, more neophobic children were found to have lower variety of fruits (??=?-0.16, p?=?0.003) and vegetables (??=?-0.29, p?<?0.001) but have a greater proportion of daily energy from discretionary foods (??=?0.11, p?=?0.04). There was no significant association between BMI Z-score and CFNS score.CONCLUSIONS: Neophobia is associated with poorer dietary quality. Results highlight the need for interventions to (1) begin early to expose children to a wide variety of nutritious foods before neophobia peaks and (2) enable health professionals to educate parents on strategies to overcome neophobia.BACKGROUND: Food neophobia, the rejection of unknown or novel foods, may result in poor dietary patterns. This study investigates the cross-sectional relationship between neophobia in children aged 24 months and variety of fruit and vegetable consumption, intake of discretionary foods and weight.","Perry, R A; Mallan, K M; Koo, J; Mauch, C E; Daniels, L A; Magarey, A M",2015.0,10.1186/s12966-015-0184-6,0,0,
4770,Peer mentoring: a culturally sensitive approach to end-of-life planning for long-term dialysis patients,"ER METHODSA controlled randomized intervention study with 203 patients from 21 dialysis centers across Michigan explored the impact of peer mentors, dialysis patients trained to help other patients, on end-of-life planning.RESULTSCommunicating information on advance directives (ADs) through peer mentoring significantly influenced the completion of ADs overall compared with distributing standard printed material or no specific designed intervention. However, the influence was most prominent among African Americans, not only increasing actual completion of ADs (P < 0.001) and comfort discussing ADs (P < 0.01), but also improving subjective well-being (P < 0.05) and anxiety (P < 0.05) during the study period. These effects of peer mentoring did not appear among white patients, although printed material on ADs decreased reported suicidal ideation (P < 0.05).CONCLUSIONThese results suggest the importance of addressing specific cultural factors in the process of AD education. Common practice assumes that printed materials are effective in educating patients about health care and decision making. However, peer mentoring, a relationship-centered person-to-person approach, may be more effective in some cultural groups because it partakes of oral, rather than written, traditions. Acknowledging cultural differences and tailoring our approach could be powerful in enhancing trust and participation and decreasing potential disparities in health care outcomes.BACKGROUNDThis study is designed to explore the impact of peer mentoring on end-of-life decision making.","Perry, E; Swartz, J; Brown, S; Smith, D; Kelly, G; Swartz, R",2005.0,,0,0,
4771,Don't stand so close to me: A behavioral and ERP study of preferred interpersonal distance,"The space between people, or interpersonal distance, creates and defines the dynamics of social interactions. Given that invasion of one's interpersonal space may trigger threat and anxiety, a critical question is if high vulnerability to social anxiety (SA) is associated with avoidance and attentional biases when anticipating invasion to one's interpersonal space. Therefore, the current study sought to examine the behavioral mechanisms, time course and neural correlates underlying the threat of interpersonal distance invasion with a focus on different SA levels, using both a behavioral and an ERP experiment. Preferred interpersonal distance was assessed using a paradigm that involves responding to different virtual protagonists (friend or stranger) approaching the participant by indicating where one would like the protagonist to stop. In addition, participants' level of social anxiety was measured. The behavioral experiment indicated that levels of SA predicted one's preferred interpersonal distance such that higher SA individuals preferred further distance from a stranger. At the neural level, across groups, early (N1) but not late (LPP) differences were found between stranger and friend conditions. Importantly, SA individuals were characterized by attenuated early ERP responses, suggesting less attentional resources allocated to social stimuli. The results suggest that high SA individuals feel discomfort earlier than others in social engagement, which may lead them to stand further away, thus creating less communicative social interactions. © 2013 Elsevier Inc.",Perry A.; Rubinsten O.; Peled L.; Shamay-Tsoory S.G.,2013.0,10.1016/j.neuroimage.2013.07.042,0,0,
4772,[Post-traumatic syringomyelia].,"Clinical and neuroradiological data were recorded in a series of 73 spinal cord injured patients (33 in Nantes, 40 in Paris-Bicêtre) in whom a post traumatic syringomyelia (PTS) developed. These findings and a review of the literature allow to point out some of the main characteristics in such a pathology. Clinical symptoms are frequent, the commonest of them are pain and sensory loss but any alteration of the neurological status after spinal cord injury has to be considered. Magnetic resonance imaging (MRI), sagittal and axial T1 and T2 weighted images, confirms the diagnosis of syrinx (area with the same signal intensity as CSF extending beyond the site of the initial lesion at least on 2 vertebral segments). MRI allows the diagnosis when it is performed in the follow up of asymptomatic patients. So PTS is not infrequent in spinal cord injured patients, for some of them in the first year after the trauma. The highest incidence is found in patients with complete thoracic lesions. Pathophysiology and surgical management have to take into account post traumatic residual stenosis of the vertebral canal.",Perrouin-Verbe B.; Robert R.; Lefort M.; Agakhani N.; Tadié M.; Mathé JF.,1999.0,,0,0,
4773,Post-traumatic syringomyelia and post-traumatic spinal canal stenosis: a direct relationship: review of 75 patients with a spinal cord injury.,"This study aims to demonstrate predictive factors for post traumatic syringomyelia (PTS), and in particular to correlate the role of insufficiency of reduction of a spinal fracture with the occurrence of syringomyelia. One hundred and twenty-eight spinal cord injured patients (SCI) were studied during the years 1992 and 1993. Among them, 75 underwent a complete and reliable evaluation including: review of the initial vertebral lesion, and of the surgery report, and a radiological study of the lesion site with standard X-rays, a CT scan, and an MRI. The CT Scan included slices in sagittal reconstructions and in the axial plane at the site of injury with the calculation of a percentage of canal stenosis in the two planes of the space. An MRI was carried out with T1 and T2 weighted images, including sagittal entire cord images in addition to sagittal and axial slices centred on the site of injury. A syrinx was diagnosed in 28% of the patients. The occurrence of a syrinx is significantly correlated with spinal canal stenosis in the sagittal plane (delta D) with a P < 0.001 and in the axial plane (delta S) (P < 0.05). This present study demonstrates the major role of the insufficiency of reduction of the vertebral lesion in the genesis of a syrinx. The quality of the initial treatment of the vertebral injury is the first step in the prevention of a syrinx. The treatment of a syrinx, besides techniques of drainage, must also take into account the spinal realignment.",Perrouin-Verbe B.; Lenne-Aurier K.; Robert R.; Auffray-Calvier E.; Richard I.; Mauduyt de la Grève I.; Mathé JF.,1998.0,,0,0,
4774,"Modification of 35% carbon dioxide hypersensitivity across one week of treatment with clomipramine and fluvoxamine: A double-blind, randomized, placebo-controlled study.","Effects of short treatments (7 days) with clomipramine (CIM) and fluvoxamine on the reactivity to inhalations of 36% CO2/65% O2 were compared in 39 panic patients who had positive responses to 35% CO2 inhalations. A double-blind, randomized, placebo-controlled design was applied. Each S was given the 35% CO2 challenge on days 0 (before starting treatment), 3, and 7. Findings show Ss on placebo did not report any significant changes in their reactivity to 35% CO2 across the 3 sessions, whereas Ss on CIM and fluvoxamine reported a significant attenuation of the reactivity on day 7. These results indicate that treatments with CIM and fluvoxamine decrease hypersensitivity to 35% CO2 after a few days, suggesting a relevant role of the modulation of CO2 sensitivity by the serotonergic system in antipanic properties of these compounds. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Perna, Giampaolo; Bertani, Angelo; Gabriele, Angela; Politi, Ernestina; Bellodi, Laura",1997.0,,0,0,
4775,A long-term prospective evaluation of first-degree relatives of panic patients who underwent the 35% CO2 challenge,"ER METHODSThirty-one relatives who underwent the 35% CO2 challenge 3-4 years before and 14 relatives, free from psychiatric diagnoses in the same period, were directly reevaluated for the presence of anxiety disorders and panic attacks.RESULTSNone developed anxiety disorders and only 1, among relatives previously tested with the 35% CO2 challenge, reported sporadic panic attacks.CONCLUSIONSThe 35% CO2 challenge is a safe research paradigm in the investigation of healthy subjects with a familial vulnerability to panic, and CO2 hypersensitivity might be considered a trait marker of an underlying familial vulnerability to panic disorder.BACKGROUNDThis follow-up study investigated the potential priming effect of the 35% CO2 challenge on the development of anxiety disorders and/or panic attacks in healthy first-degree relatives of panic patients across a period of 3-4 years subsequent to the challenge.","Perna, G; Cocchi, S; Allevi, L; Bussi, R; Bellodi, L",1999.0,,0,0,
4776,Asthma and panic attacks.,"Panic disorder (PD) and asthma share many common characteristics and have been found in epidemiological studies to be significantly comorbid. To investigate possible reasons for this overlapping, the authors evaluated 51 patients with asthma, assessing the prevalence of PD and sporadic panic attacks, the temporal relationship between these two disorders, and the familial risk for PD in the families of asthmatics. The results showed significantly higher prevalences of PD, sporadic panic attacks, and social phobia in asthmatics than those reported for the general population. In 9 (90%) of the asthmatics with PD, asthma appeared first. Finally, the morbidity risk for PD in families of asthmatics with PD (13.5%) was significantly higher than in families of asthmatics without evidence of panic (2%). Our results suggest that the high prevalence of PD in asthmatics might be related to a facilitating effect of asthma on the development of PD in subjects with familial predisposition to PD.",Perna G.; Bertani A.; Politi E.; Colombo G.; Bellodi L.,1997.0,10.1016/S0006-3223(96)00436-2,0,0,
4777,"The effects of spinal manipulation on the intensity of emotional arousal in phobic subjects exposed to a threat stimulus: a randomized, controlled, double-blind clinical trial","ER DESIGNRandomized, controlled, double-blind clinical trial.SETTINGCommunity college campus.SUBJECTSEighteen phobic community college student volunteers randomized into treatment and control groups.INTERVENTIONVisual analog scale (VAS) and pulse rates were obtained in response to the subjects' viewing their phobogenic stimulus. Spinal manipulation was performed while the subjects experienced emotional responses. Manual muscle testing was utilized to ascertain the associated spinal segments and involved emotion.RESULTSData were analyzed using analysis of variance for a repeated measures experimental design and Least Significant Differences (LSDs) for mean comparisons. Baseline, preintervention and postintervention pulse rates were not statistically different for the control and treatment groups (p = .0807). VAS postintervention mean for the spinal manipulation group was significantly lower than the control means (p = .05) and from its corresponding preintervention mean (p = .001).CONCLUSIONSpinal manipulation significantly decreased the intensity of emotional arousal reported by phobic subjects. The mechanism for this effect is not known.OBJECTIVETo determine the effect of spinal manipulation upon the intensity of emotional arousal in phobic subjects exposed to a threat stimulus.","Peterson, K B",1997.0,,0,0,
4778,Smoking cessation and care management for veterans with posttraumatic stress disorder: a study protocol for a randomized controlled trial.,"Smoking remains the leading cause of preventable illness and mortality in the United States. Individuals with Posttraumatic Stress Disorder (PTSD) have smoking rates higher than that of others and fewer individuals with PTSD have quit smoking. This randomized controlled trial was designed to test the effectiveness of integrating telehealth care management and smoking cessation with motivational interviewing for Veterans with PTSD. All smokers with PTSD, regardless of their desire to quit, were invited to participate. Enrollment occurred between November 2009 and April 2013. Target enrollment was 120 participants. Enrolled participants were randomized to either the control group, receiving usual care including a telehealth PTSD program, with a device that delivered PTSD information and in-home care management, or the intervention group, which included (1) a telehealth PTSD program, (2) motivational interviewing-based smoking cessation curricula via the telehealth device, and (3) weekly motivational interviewing counseling phone calls. Outcomes are self-reported 24-hour quit attempts, progression along the stages of change and 7-day point prevalence quit smoking rates for the intervention group compared to usual care alone. Secondary outcomes include participants' perception of care coordination, patient satisfaction with motivational interviewing, PTSD symptoms, pain, depression and quality of life. Motivational interviewing has been shown to increase readiness for change and smoking cessation care has been shown to be more successful when incorporated into in-person mental health care. Our study builds on previous studies. It integrates a written smoking cessation curriculum and phone-based motivational interviewing counseling into an established PTSD home telehealth care coordination program. This paper describes the design and methods of our randomized control trial. ClinicalTrials.gov, NCT00908882, May 22, 2009.",Peterson J.; Prochazka AV.; Battaglia C.,2015.0,10.1186/s12913-015-0706-6,0,0,
4779,"The effect of 3 different exercise approaches on neck muscle endurance, kinesiophobia, exercise compliance, and patient satisfaction in chronic whiplash","ER OBJECTIVE: The purpose of this study was to compare the effects of 3 different exercise approaches on neck muscle endurance (NME), kinesiophobia, exercise compliance, and patient satisfaction in patients with chronic whiplash.METHODS: This prospective randomized clinical trial included 216 individuals with chronic whiplash. Participants were randomized to 1 of 3 exercise interventions: neck-specific exercise (NSE), NSE combined with a behavioral approach (NSEB), or prescribed physical activity (PPA). Measures of ventral and dorsal NME (endurance time in seconds), perceived pain after NME testing, kinesiophobia, exercise compliance, and patient satisfaction were recorded at baseline and at the 3- and 6-month follow-ups.RESULTS: Compared with individuals in the prescribed physical activity group, participants in the NSE and NSEB groups exhibited greater gains in dorsal NME (P = .003), greater reductions in pain after NME testing (P = .03), and more satisfaction with treatment (P  .07).CONCLUSION: Among patients with chronic whiplash, a neck-specific exercise intervention (with or without a behavioral approach) appears to improve NME. Participants were more satisfied with intervention including neck-specific exercises than with the prescription of general exercise.","Peterson, G E; Landén, Ludvigsson M H; O'Leary, S P; Dedering, Å M; Wallman, T; Jönsson, M I; Peolsson, A L",2015.0,10.1016/j.jmpt.2015.06.011,0,0,
4780,"A double-blind, placebo-controlled, crossover trial of an antiandrogen in the treatment of Tourette's syndrome.","Documents the effects of androgen receptor blockade on tic and obsessive-compulsive symptoms in Tourette's syndrome (TS) patients. 13 adult TS Ss, 10 men and 3 women, completed 3 wks of each phase of a double-blind, placebo-controlled, crossover trial of flutamide, a selective androgen receptor antagonist. Symptom severity ratings and hormone levels were obtained at each of the trial's 6 clinic visits. Flutamide was well-tolerated and produced a significant reduction in motor but not phonic tic symptom severity. It modestly improved symptoms of obsessive-compulsive disorder in the men who had this disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Peterson, Bradley S; Zhang, Heping; Anderson, George M; Leckman, James F",1998.0,,0,0,
4781,Family history of panic disorder and hypersensitivity to CO2 in patients with panic disorder,"ER METHODMorbidity risks for panic disorder were calculated for families of 203 patients with panic disorder, each of whom was challenged with 35% CO2.RESULTSPatients who reacted with a positive response to the 35% CO2 challenge showed a genetic risk for panic disorder (morbidity risk = 14.4%) that was significantly higher than that for patients who did not react (morbidity risk = 3.9%).CONCLUSIONSThese findings support the idea that hypersensitivity to CO2 might be associated with a subtype of panic disorder specifically related to a greater familial loading.OBJECTIVEThe authors investigated the relationships between hypersensitivity to CO2 and familial-genetic risk for panic disorder in patients with panic disorder.","Perna, G; Bertani, A; Caldirola, D; Bellodi, L",1996.0,10.1176/ajp.153.8.1060,0,0,
4782,35% CO2 challenge in panic and mood disorders,"ER 20 patients with Panic Disorder (PD), 19 patients with Mood Disorder (MD) and 20 healthy controls inhaled one vital capacity of 35% CO2-65% O2 gas mixture and of compressed air in a double-blind, random, cross-over design. Only PD patients showed a strong reaction to 35% CO2 while MD patients and controls did not react significantly. These results support the specificity of the 35% CO2 challenge in PD patients and suggest that PD and MD are separate disorders.","Perna, G; Barbini, B; Cocchi, S; Bertani, A; Gasperini, M",1995.0,,0,0,
4783,Therapeutic plasma exchange and intravenous immunoglobulin for obsessive-compulsive disorder and tic disorders in childhood,"ER METHODSChildren with severe, infection-triggered exacerbations of obsessive-compulsive disorder (OCD) or tic disorders, including Tourette syndrome, were randomly assigned treatment with plasma exchange (five single-volume exchanges over 2 weeks), IVIG (1 g/kg daily on 2 consecutive days), or placebo (saline solution given in the same manner as IVIG). Symptom severity was rated at baseline, and at 1 month and 12 months after treatment by use of standard assessment scales for OCD, tics, anxiety, depression, and global function.FINDINGS30 children entered the study and 29 completed the trial. Ten received plasma exchange, nine IVIG, and ten placebo. At 1 month, the IVIG and plasma exchange groups showed striking improvements in obsessive-compulsive symptoms (mean improvement on children's Yale-Brown obsessive compulsive scale score of 12 [45%] and 13 [58%], respectively), anxiety (2.1 [31%] and 3.0 [47%] improvement on National Institute of Mental Health anxiety scale), and overall functioning (2.9 [33%] and 2.8 [35%] improvement on National Institute of Mental Health global scale). Tic symptoms were also significantly improved by plasma exchange (mean change on Tourette syndrome unified rating scale of 49%). Treatment gains were maintained at 1 year, with 14 (82%) of 17 children ""much"" or ""very much"" improved over baseline (seven of eight for plasma exchange, seven of nine for IVIG).INTERPRETATIONPlasma exchange and IVIG were both effective in lessening of symptom severity for children with infection-triggered OCD and tic disorders. Further studies are needed to determine the active mechanism of these interventions, and to determine which children with OCD and tic disorders will benefit from immunomodulatory therapies.BACKGROUNDIn children, exacerbations of tics and obsessive symptoms may occur after infection with group A beta-haemolytic streptococci. If post-streptococcal autoimmunity is the cause of the exacerbations, then children might respond to immunomodulatory treatments such as plasma exchange or intravenous immunoglobulin (IVIG). We studied whether plasma exchange or IVIG would be better than placebo (sham IVIG) in reducing severity of neuropsychiatric symptoms.","Perlmutter, S J; Leitman, S F; Garvey, M A; Hamburger, S; Feldman, E; Leonard, H L; Swedo, S E",1999.0,10.1016/S0140-6736(98)12297-3,0,0,
4784,Predictors of recurrence in bipolar disorder: primary outcomes from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).,"Little is known about clinical features associated with the risk of recurrence in patients with bipolar disorder receiving treatment according to contemporary practice guidelines. The authors looked for the features associated with risk of recurrence. The authors examined prospective data from a cohort of patients with bipolar disorder participating in the multicenter Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study for up to 24 months. For those who were symptomatic at study entry but subsequently achieved recovery, time to recurrence of mania, hypomania, mixed state, or a depressive episode was examined with Cox regression. Of 1,469 participants symptomatic at study entry, 858 (58.4%) subsequently achieved recovery. During up to 2 years of follow-up, 416 (48.5%) of these individuals experienced recurrences, with more than twice as many developing depressive episodes (298, 34.7%) as those who developed manic, hypomanic, or mixed episodes (118, 13.8%). The time until 25% of the individuals experienced a depressive episode was 21.4 weeks and until 25% experienced a manic/hypomanic/mixed episode was 85.0 weeks. Residual depressive or manic symptoms at recovery and proportion of days depressed or anxious in the preceding year were significantly associated with shorter time to depressive recurrence. Residual manic symptoms at recovery and proportion of days of elevated mood in the preceding year were significantly associated with shorter time to manic, hypomanic, or mixed episode recurrence. Recurrence was frequent and associated with the presence of residual mood symptoms at initial recovery. Targeting residual symptoms in maintenance treatment may represent an opportunity to reduce risk of recurrence.",Perlis RH.; Ostacher MJ.; Patel JK.; Marangell LB.; Zhang H.; Wisniewski SR.; Ketter TA.; Miklowitz DJ.; Otto MW.; Gyulai L.; Reilly-Harrington NA.; Nierenberg AA.; Sachs GS.; Thase ME.,2006.0,10.1176/appi.ajp.163.2.217,0,0,
4785,In our own voice-family companion: reducing self-stigma of family members of persons with serious mental illness,"ER OBJECTIVE: This article reports preliminary findings from a novel, family peer-based intervention designed to reduce self-stigma among family members of people with serious mental illness.METHODS: A total of 158 primary caregivers of patients with schizophrenia were recruited from a large urban mental health facility (93 caregivers) or from a family and consumer advocacy organization (65 caregivers). Caregivers (N=122) who reported they perceived at least a moderate level of mental illness-related stigma were evaluated on measures of self-stigma, withdrawal, secrecy, anxiety, and social comparison and randomly assigned to receive one of two, one-session group interventions: a peer-led intervention (In Our Own Voice-Family Companion [IOOV-FC]) designed to stimulate group discussion or a clinician-led family education session, which delivered information about mental illness in a structured, didactic format. IOOV-FC consisted of playing a videotape of family members who describe their experiences coping with stigma, which was followed by a discussion led by two family peers who modeled sharing their own experiences and facilitated group sharing.RESULTS: Of 24 family members and ten consumers, 96% rated the videotape above a predetermined acceptability threshold on a 19-item scale assessing cultural sensitivity, respect for different stakeholders, relevance of content, and technical quality (?=.92). Caregivers receiving IOOV-FC with low to moderate pretreatment anxiety reported a substantial reduction in self-stigma (effect size=.50) relative to those receiving clinician-led family education (p=.017) as well as significant reductions in secrecy (p=.031).CONCLUSIONS: Peer-led group interventions may be more effective in reducing family self-stigma than clinician-led education, at least for persons reporting experiencing low to moderate anxiety levels on a standard questionnaire","Perlick, D A; Nelson, A H; Mattias, K; Selzer, J; Kalvin, C; Wilber, C H; Huntington, B; Holman, C S; Corrigan, P W",2011.0,10.1176/appi.ps.001222011,0,0,
4786,Flight behaviour in humans is intensified by a candidate genetic risk factor for panic disorder: Evidence from a translational model of fear and anxiety,,Perkins A.M.; Ettinger U.; Williams S.C.R.; Reuter M.; Hennig J.; Corr P.J.,2011.0,10.1038/mp.2010.2,0,0,
4787,Advancing the defensive explanation for anxiety disorders: Lorazepam effects on human defense are systematically modulated by personality and threat-type,"Clinically effective drugs against human anxiety and fear systematically alter the innate defensive behavior of rodents, suggesting that in humans these emotions reflect defensive adaptations. Compelling experimental human evidence for this theory is yet to be obtained. We report the clearest test to date by investigating the effects of 1 and 2mg of the anti-anxiety drug lorazepam on the intensity of threat-avoidance behavior in 40 healthy adult volunteers (20 females). We found lorazepam modulated the intensity of participants' threat-avoidance behavior in a dose-dependent manner. However, the pattern of effects depended upon two factors: type of threat-avoidance behavior and theoretically relevant measures of personality. In the case of flight behavior (one-way active avoidance), lorazepam increased intensity in low scorers on the Fear Survey Schedule tissuedamage fear but reduced it in high scorers. Conversely, in the case of risk-assessment behavior (two-way active avoidance), lorazepam reduced intensity in low scorers on the Spielberger trait anxiety but increased it in high scorers. Anti-anxiety drugs do not systematically affect rodent flight behavior; therefore, we interpret this new finding as suggesting that lorazepam has a broader effect on defense in humans than in rodents, perhaps by modulating general perceptions of threat intensity. The different patterning of lorazepam effects on the two behaviors implies that human perceptions of threat intensity are nevertheless distributed across two different neural streams, which influence effects observed on one-way or two-way active avoidance demanded by the situation. © 2013 Macmillan Publishers Limited.",Perkins A.M.; Ettinger U.; Weaver K.; Schmechtig A.; Schrantee A.; Morrison P.D.; Sapara A.; Kumari V.; Williams S.C.R.; Corr P.J.,2013.0,10.1038/tp.2013.20,0,0,
4788,Effects of lorazepam and citalopram on human defensive reactions: Ethopharmacological differentiation of fear and anxiety,"Drugs that are clinically effective against generalized anxiety disorder preferentially alter rodent risk assessment behavior, whereas drugs that are clinically effective against panic disorder preferentially alter rodent flight behavior. The theoretical principle of ""defensive direction"" explains the pattern of associations between emotion and defensive behavior in terms of the differing functional demands arising from cautious approach to threat (anxiety) versus departure from threat (fear), offering the prospect that clinically important emotions may be explained using a single rubric of defense. We used a within-subjects, placebo-controlled, design to test this theory, measuring the effects of citalopram and lorazepam on the defensive behavior of 30 healthy adult male humans. We indexed human defensive behavior with a translation of an active avoidance task used to measure rodent defense and found that lorazepam significantly reduced the intensity of defensive behavior during approach to threat (hypothetically anxiety-related) but not departure from threat (hypothetically fear-related). Contrary to prediction, citalopram did not affect either form of defensive reaction. Since lorazepam is a drug with well established anxiety reducing properties, these data support the hypothesis that anxiety is an emotion elicited by threat stimuli that require approach. These data also contribute to the validation of a novel human analog of an established experimental model of rodent fear and anxiety. Copyright © 2009 Society for Neuroscience.",Perkins A.M.; Ettinger U.; Davis R.; Foster R.; Williams S.C.R.; Corr P.J.,2009.0,10.1523/JNEUROSCI.2696-09.2009,0,0,
4789,Family factors predict treatment outcome for pediatric obsessive-compulsive disorder,"ER METHOD: We analyzed data from a sample of youths who were randomized to FCBT (n = 49; 59% male; M age = 12.43 years) as part of a larger randomized clinical trial. Youths and their families were assessed by an independent evaluator (IE) pre- and post-FCBT using a standardized battery of measures evaluating family functioning and OCD symptom severity. Family conflict and cohesion were measured via parent self-report on the Family Environment Scale (Moos & Moos, 1994), and parental blame was measured using parent self-report on the Parental Attitudes and Behaviors Scale (Peris, Benazon, et al., 2008b). Symptom severity was rated by IEs using the Children's Yale-Brown Obsessive Compulsive Scale (Scahill et al., 1997).RESULTS: Families with lower levels of parental blame and family conflict and higher levels of family cohesion at baseline were more likely to have a child who responded to FCBT treatment even after adjusting for baseline symptom severity compared with families who endorsed higher levels of dysfunction prior to treatment. In analyses using both categorical and continuous outcome measures, higher levels of family dysfunction and difficulty in more domains of family functioning were associated with lower rates of treatment response. In addition, changes in family cohesion predicted response to FCBT, controlling for baseline symptom severity.CONCLUSION: Findings speak to the role of the family in treatment for childhood OCD and highlight potential targets for future family interventions.OBJECTIVE: To examine family conflict, parental blame, and poor family cohesion as predictors of treatment outcome for youths receiving family-focused cognitive behavioral therapy (FCBT) for obsessive-compulsive disorder (OCD).","Peris, T S; Sugar, C A; Bergman, R L; Chang, S; Langley, A; Piacentini, J",2012.0,10.1037/a0027084,0,0,
4790,Optimizing treatment for complex cases of childhood obsessive compulsive disorder: a preliminary trial,"ER Family factors such as conflict, blame, and poor cohesion have been found to attenuate response to cognitive behavior therapy (CBT) for pediatric obsessive compulsive disorder (OCD). This study examined the feasibility and acceptability of a brief, personalized intervention for cases of pediatric OCD complicated by these family features. Twenty youth with a primary Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis of OCD (M age = 12.50 years; 55% male; 60% Caucasian) and their families participated. To be included in the study, families were required to evidence poor functioning on measures of blame, conflict, and/or cohesion. Eligible families were randomly assigned either to standard treatment (ST) with 12 weeks of individual child CBT that included weekly parent check-ins and psychoeducation or to Positive Family Interaction Therapy (PFIT), which consisted of 12 weeks of individual child CBT plus an additional 6 sessions of family treatment aimed at shifting family dynamics. Clinical outcomes were determined by blind independent evaluators using the Clinician's Global Impressions-Improvement (CGI-I) scale. All families completed the study. High levels of satisfaction were reported among participants in both arms of the study, despite the added burden of attending the PFIT sessions. Both mothers and fathers attended 95% of the PFIT family sessions. Families in the ST condition demonstrated a 40% response rate on the CGI-I; families in the PFIT condition demonstrated a 70% response rate. Treatment gains were maintained in both conditions at 3-month follow-up. Preliminary data suggest that PFIT is acceptable and feasible. Further testing and treatment development are needed to optimize outcomes for complicated cases of pediatric OCD.","Peris, T S; Piacentini, J",2013.0,10.1080/15374416.2012.673162,0,0,
4791,"Differentiation of obsessive-compulsive-, panic-, obsessive-compulsive personality-, and non-disordered individuals by variation in the promoter region of the serotonin transporter gene","Past research investigating the role of the serotonin transporter gene in OCD has produced mixed findings. One possible reason for the mixed findings is comorbidity. In this study, non-comorbid OCD individuals were compared to non-disordered controls. A sample of panic disordered individuals was also compared to a non-disordered group. Finally, as an exploratory analysis, individuals were assessed for OCPD and their allelic frequencies were also compared to non-disordered individuals. Analyses revealed that there were higher frequencies of the s/s genotype among the OCD group when compared to non-disordered controls. There were no differences in allelic frequencies on the serotonin transporter gene between the panic disordered group, the OCPD group, and the non-disordered control group. This study found that non-comorbid OCD individuals tended to have a higher percentage of the homozygous short genotype than non-disordered individuals. The s/s genotype might serve as a contributory risk factor for OCD. © 2005 Elsevier Ltd. All rights reserved.",Perez M.; Brown J.S.; Vrshek-Schallhorn S.; Johnson F.; Joiner Jr. T.E.,2006.0,10.1016/j.janxdis.2005.09.001,0,0,
4792,Time-specific contribution of the supplementary motor area to intermanual transfer of procedural knowledge,"The supplementary motor area (SMA) makes a crucial contribution to intermanual transfer: the ability to use one hand to perform a skill practiced and learned with the other hand. However, the timing of this contribution relative to movement remains unknown. Here, 33 healthy volunteers performed a 12 item sequence in the serial reaction time task. During training, each participant responded to a sequence of visual cues presented at 1 Hz by pressing one of four keys with their right hand. The measure of intermanual transfer was response time (RT) during repetition of the trained sequence with the left hand, which was at rest during learning. Participants were divided into three groups, which did not differ in their learning rates or amounts. In two groups, 1 Hz repetitive transcranial magnetic stimulation induced transient virtual lesions of the SMA during training, either 100 ms before each cue (the premovement group) or during each key press (the movement group). The third group received sham stimulation (the sham group). After training with the right hand, RTs for performance with the left (transfer) hand were longer for the premovement group than for the movement or sham groups. Thus, the most crucial contribution of SMA to intermanual transfer occurs in the interval between movements, when the memory of a previous movement plays a role in encoding specific sequences. These results provide insight into frontal lobe contributions to procedural knowledge. Copyright © 2008 Society for Neuroscience.",Perez M.A.; Tanaka S.; Wise S.P.; Willingham D.T.; Cohen L.G.,2008.0,10.1523/JNEUROSCI.3416-08.2008,0,0,
4793,Cerebral blood flow changes during retrieval of traumatic memories before and after psychotherapy: a SPECT study.,"Traumatic memory is a key symptom in psychological trauma victims and may remain vivid for several years. Psychotherapy has shown that neither the psychopathological signs of trauma nor the expression of traumatic memories are static over time. However, few studies have investigated the neural substrates of psychotherapy-related symptom changes. We studied 16 subthreshold post-traumatic stress disorder (PTSD) subjects by using a script-driven symptom provocation paradigm adapted for single photon emission computed tomography (SPECT) that was read aloud during traumatic memory retrieval both before and after exposure-based and cognitive restructuring therapy. Their neural activity levels were compared with a control group comprising 11 waiting-list subthreshold PTSD patients, who were age- and profile-matched with the psychotherapy group. Significantly higher activity was observed in the parietal lobes, left hippocampus, thalamus and left prefrontal cortex during memory retrieval after psychotherapy. Positive correlations were found between activity changes in the left prefrontal cortex and left thalamus, and also between the left prefrontal cortex and left parietal lobe. Neural mechanisms involved in subthreshold PTSD may share neural similarities with those underlying the fragmented and non-verbal nature of traumatic memories in full PTSD. Moreover, psychotherapy may influence the development of a narrative pattern overlaying the declarative memory neural substrates.",Peres JF.; Newberg AB.; Mercante JP.; Sim√£o M.; Albuquerque VE.; Peres MJ.; Nasello AG.,2007.0,10.1017/S003329170700997X,0,0,
4794,Preoperative anxiety in ambulatory surgery: the impact of an empathic patient-centered approach on psychological and clinical outcomes,"ER Objective: This study aims to evaluate the influence of an empathic patient-centered approach on preoperative anxiety and surgical outcomes in ambulatory surgery patients. Methods: A sample of 104 patients undergoing general ambulatory surgery was randomly assigned to the intervention (IG) and the control (CG) groups. Before surgery, the IG received personalized information through an empathic patient-centered interview. The CG received standardized information on surgical procedures. Anxiety was assessed before and after the preoperative interview and after the surgery. Wound healing, post-surgical recovery and satisfaction with the quality of preoperative information were assessed after the surgery. Results: The two groups were identical at baseline regarding anxiety, socio-demographic and clinical characteristics. After the patient-centered intervention, the IG showed lower levels of preoperative anxiety (p < 0.001) and pain (p < 0.001), better surgery recovery (p < 0.01) and higher levels of daily activity (p < 0.001) and of satisfaction with the information received (p < 0.01) than the CG. The IG also showed better wound healing (tissue type, p < 0.01; local pain, p < 0.01). Conclusion: An empathic patient-centered intervention can reduce preoperative anxiety and increase surgical recovery, wound healing and patient satisfaction. Practice implications: This approach is applicable in pre-surgical interviews and can potentially be used in the routine care of various surgical contexts.","Pereira, L; Figueiredo-Braga, M; Carvalho, I P",2016.0,10.1016/j.pec.2015.11.016,0,0,
4795,Microtensile bond strengths and interfacial examination of a polyalkenoate-based 1-step adhesive,"ER METHODSMiddle dentin was exposed in 30 extracted molars and randomly divided into six groups: (1) AEB applied as per manufacturer's directions; (2) as in AEB, but one coat of hydrophobic resin (HR) was applied and cured over AEB (AEB+HR); (3) etching with 35% H3PO4 for 15 seconds followed by AEB (Etch+AEB); (4) as in group Etch+AEB, but one coat of HR was applied and cured over AEB (Etch+AEB+HR); (5) Adper Single Bond Plus, the 2-step etch-&-rinse adhesive control (ASB); (6) Adper Scotchbond Multi-Purpose, the 3-step etch-&-rinse adhesive control (SBMP). Buildups were constructed with Filtek Z250 and cured in three increments of 2 mm each. Specimens were sectioned with a slow-speed diamond saw under water in X and Y directions to obtain bonded sticks with a cross section of 0.8 +/- 0.2 mm2 and tested to failure in tension mode at a crosshead speed of 1 mm/minute. Statistical analyses were computed using one-way ANOVA followed by Duncan's post-hoc test at P<0.05. For marginal sealing, 36 Class V preparations were restored with one of the six adhesive combinations and processed with 50% ammoniacal silver nitrate. After sectioning, specimens were observed under a backscattered FE-SEM to evaluate silver infiltration into the resin-dentin interface, which was measured in ranks (0-4) and compared with non-parametric statistical tests (P<0.05).RESULTSAEB resulted in statistically lower mean microTBS than all other groups at P0.05. All the remaining groups resulted in statistically similar mean microTBS. For marginal sealing, data were grouped in three statistical subsets: Groups AEB and AEB+HR resulted in statistically less silver infiltration than groups Etch+AEB and Etch+AEB+HR. Groups ASB and SBMP resulted in similar silver infiltration compared to Groups AEB and AEB+HR. The nanoleakage pattern consisted of agglomerates of silver deposits located predominantly in the hybrid layer, while reticular or water-tree silver deposits were observed in both the AEB and ASB adhesive layers.PURPOSETo study the effect of acid etching and the application of a hydrophobic bonding resin on the microtensile bond strengths (microTBS) and marginal sealing of the 1-step self-etch adhesive Adper Easy Bond (AEB).","Perdig√£o, J; Sezinando, A; Gomes, G",2011.0,,0,0,
4796,A tailored compassion-focused therapy program for sexual minority young adults with depressive symotomatology: study protocol for a randomized controlled trial,"ER METHODS: The CFT intervention consists of 8 units with self-directed reading and activities tailored to LGB young adults, and 8 x weekly 1-hour consultations with a therapist. The CBT intervention consists of 8 units with self-guided reading and activities, with 1 x 1-hour session with a therapist at the mid-point of therapy. Fifty LGB individuals with scores of 13 or above on the Beck Depression Inventory-II will be randomized to either the CFT or CBT condition. The primary outcome measure is depressive symptomatology. Secondary outcome measures are symptoms of anxiety, suicidal ideation, internalized homophobia, self-compassion, and shame and guilt proneness. Assessments will occur at pre-intervention, post-intervention, and at 3-month post-intervention.DISCUSSION: This study is an RCT to test the preliminary efficacy of an LGB-tailored compassion-focused intervention for young LGB adults with depressive symptomatology. If this intervention is efficacious, this could begin to address the substantial mental health disparities amongst sexual minorities.TRIAL REGISTRATION: ACTRN12616001018404 . Prospective registration, registered 02/08/2016.BACKGROUND: Lesbian, gay, and bisexual (LGB) men and women represent one of the highest-risk populations for depressive symptomatology and disorders, with young LGB adults being at greatest risk. To date, there have been no randomized controlled trials (RCT) to specifically target depressive symptoms in young LGB adults. This is despite research highlighting unique predictors of depressive symptomatology in this population. Here we outline a protocol for an RCT that will test the preliminary efficacy of a tailored compassion-focused therapy (CFT) intervention for young LGB adults compared with a self-directed cognitive behavioral therapy (CBT) program with no specific tailoring for LGB individuals.","Pepping, C A; Lyons, A; McNair, R; Kirby, J N; Petrocchi, N; Gilbert, P",2017.0,10.1186/s40359-017-0175-2,0,0,
4797,Heart rate variability biofeedback in patients with alcohol dependence: A randomized controlled study.,"Background and objective: In patients with alcohol dependence, ethyl-toxic damage of vasomotor and cardiac autonomic nerve fibers leads to autonomic imbalance with neurovascular and cardiac dysfunction, the latter resulting in reduced heart rate variability (HRV). Autonomic imbalance is linked to increased craving and cardiovascular mortality. In this study, we sought to assess the effects of HRV biofeedback training on HRV, vasomotor function, craving, and anxiety. Methods: We conducted a randomized controlled study in 48 patients (14 females, ages 25-59 years) undergoing inpatient rehabilitation treatment. In the treatment group, patients (n = 24) attended six sessions of HRV biofeedback over 2 weeks in addition to standard rehabilitative care, whereas, in the control group, subjects received standard care only. Psychometric testing for craving (Obsessive Compulsive Drinking Scale), anxiety (Symptom Checklist-90-Revised), HRV assessment using coefficient of variation of R-R intervals (CVNN) analysis, and vasomotor function assessment using laser Doppler flowmetry were performed at baseline, immediately after completion of treatment or control period, and 3 and 6 weeks afterward (follow-ups 1 and 2). Results: Psychometric testing showed decreased craving in the biofeedback group immediately postintervention (OCDS scores: 8.6 +/- 7.9 post-biofeedback versus 13.7 +/- 11.0 baseline [mean +/- standard deviation], P < 0.05), whereas craving was unchanged at this time point in the control group. Anxiety was reduced at follow-ups 1 and 2 post-biofeedback, but was unchanged in the control group (P,0.05). Following biofeedback, CVNN tended to be increased (10.3% +/- 2.8% post-biofeedback, 10.1% +/- 3.5% follow-up 1, 10.1% +/- 2.9% follow-up 2 versus 9.7% +/- 3.6% baseline; P = not significant). There was no such trend in the control group. Vasomotor function assessed using the mean duration to 50% vasoconstriction of cutaneous vessels after deep inspiration was improved following biofeedback immediately postintervention and was unchanged in the control group (P,0.05). Conclusion: Our data indicate that HRV biofeedback might be useful to decrease anxiety, increase HRV, and improve vasomotor function in patients with alcohol dependence when complementing standard rehabilitative inpatient care. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Penzlin, Ana Isabel; Siepmann, Timo; Illigens, Ben Min-Woo; Weidner, Kerstin; Siepmann, Martin; Agelink, Angelone, Anton, Beck, Benarroch, Bottlender, Derogatis, Eddie, Freeman, Hodges, Illigens, Jansen, Johnson, Johnson, Johnston, Kaplan, Karavidas, Lehrer, Low, Low, McCusker, Melgaard, Meule, Muck-Weymann, Nakovics, Oslin, Quintana, Rechlin, Schacht, Schneekloth, Siepmann, Wittchen, Zucker",2015.0,,0,0,
4798,Screening and brief interventions for hazardous and harmful alcohol use among university students in South Africa: results from a randomized controlled trial.,"The aim of this study was to assess the effectiveness of Screening and Brief Intervention (SBI) for alcohol problems among university students in South Africa. The study design for this efficacy study is a randomized controlled trial with 6- and 12-month follow-ups to examine the effects of a brief alcohol intervention to reduce alcohol use by hazardous and harmful drinkers in a university setting. The unit of randomization is the individual university student identified as a hazardous or harmful drinker attending public recruitment venues in a university campus. University students were screened for alcohol problems, and those identified as hazardous or harmful drinkers were randomized into an experimental or control group. The experimental group received one brief counseling session on alcohol risk reduction, while the control group received a health education leaflet. Results indicate that of the 722 screened for alcohol and who agreed to participate in the trial 152 (21.1%) tested positive for the Alcohol Use Disorder Identification Test (AUDIT) (score 8 or more). Among the 147 (96.7%) university students who also attended the 12-month follow-up session, the intervention effect on the AUDIT score was -1.5, which was statistically significant (P = 0.009). Further, the depression scores marginally significantly decreased over time across treatment groups, while other substance use (tobacco and cannabis use), self-rated health status and Posttraumatic Stress Disorder (PTSD) scores did not change over time across treatment groups. The study provides evidence of effective brief intervention by assistant nurses with hazardous and harmful drinkers in a university setting in South Africa. The short duration of the brief intervention makes it a realistic candidate for use in a university setting.",Pengpid S.; Peltzer K.; van der Heever H.; Skaal L.,2013.0,10.3390/ijerph10052043,0,0,
4799,Posttraumatic stress disorder and chronic musculoskeletal pain: How are they related?,"Symptoms of post-traumatic stress disorder (PTSD) are a common comorbidity in veterans seeking treatment of chronic musculoskeletal pain (CMP). However, little is known regarding the mutual influence of PTSD and CMP in this population. Using cross-sectional and longitudinal data from a randomized clinical trial evaluating a stepped care intervention for CMP in Iraq/Afghanistan veterans (ESCAPE), this dissertation examined the relationships between PTSD and CMP along with other factors including depression, anxiety, catastrophizing and health-related quality of life. The Classification and Regression Tree (CART) analysis was conducted to identify key factors associated with baseline PTSD besides CMP severity. A series of statistical analyses including logistical regression analysis, mixed model repeated measure analysis, confirmatory factor analysis and cross-lagged panel analysis via structural equation modeling were conducted to test five competing models of PTSD symptom clusters, and to examine the mutual influences of PTSD symptom clusters and CMP outcomes. Results showed baseline pain intensity and pain disability predicted PTSD at 9 months. And baseline PTSD predicted improvement of pain disability at 9 months. Moreover, direct relationships were found between PTSD and the disability component of CMP, and indirect relationships were found between PTSD, CMP and CMP components (intensity and disability) mediated by depression, anxiety and pain catastrophizing. Finally, the coexistence of PTSD and more severe pain was associated with worse SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Together these findings provided empirical support for the mutual maintenance theory. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Peng, Xiaomei",2015.0,,0,0,
4800,Relationship between psychiatric disorders and quality of life in nondialysis patients with chronic kidney disease.,"The aim of this study was to investigate the relationship between psychiatric disorders (anxiety and depression) and quality of life (QOL) in nondialysis patients with chronic kidney disease (CKD). QOL was evaluated in a sample of 57 nondialysis patients with CKD using the 36-item Short Form Health Survey questionnaire comprising 8 scales, including the physical component summary and mental component summary measures. Depression and anxiety were estimated using the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale, respectively. Depression and anxiety scores were negatively correlated with 7 of the 8 scales of the Short Form 36 questionnaire, and with the physical component summary and mental component summary scores, despite 38.6% patients with depression and 54.4% with anxiety, whereas QOL in the depression group, the anxiety group, and the anxiety and depression comorbid group was lower than that for those without the corresponding psychiatric disorders (P < 0.05). This study demonstrates that depression and anxiety, commonly encountered in patients with CKD, could be a risk factor for QOL in these patients.",Peng T.; Hu Z.; Guo L.; Xia Q.; Li D.; Yang X.,2013.0,10.1097/MAJ.0b013e318255a561,0,0,
4801,Effect of group therapy on social anxiety of college students.,"Compared the effects of cognitive group therapy and behavior group therapy on social anxiety of college students. 52 college students with high scores (total scores >13 or subscale scores >7) on the Social Avoidance and Distress Scale were randomly assigned to a cognitive therapy group and a behavior therapy group for 8 sessions of intervention (2 hrs per session). The effects of intervention were assessed with the Social Anxiety and Avoidance Scale (SAD), Eysenck Personality Scale (EPQ), Interaction Anxiety Scale (IAS), Automatic Thought Questionnaire, the Symptom Checklist, and through clinical assessment. After intervention, both groups decreased social anxiety and enhanced personality, showing in the scores of subjective experience, avoidance, self-rating symptoms, cognition, and neuroticism and extraversion. However, there were no significant difference between the 2 therapy groups. The study concludes that both cognitive therapy and behavior therapy are effective with social anxiety levels of college students. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Peng, Chunzi; Yan, Liangshi; Ma, Xiaohong; Wu, Wenli; Davidson, Emmelkamp, Heimberg, Heimberg, Heimberg, Scholing",2003.0,,0,0,
4802,Rate of improvement during cognitive-behavioral group treatment for panic disorder.,"Treatment was a standard program of 12 sessions that emphasized information, interoceptive and situational exposure, and cognitive restructuring, but also included diaphragmatic breathing and relaxation training as elements of treatment. Ss were 37 patients selected from sequential admissions into an outpatient treatment program; all data were derived from ongoing quality assurance measures that are a standard part of clinical monitoring. Ss completed the Panic Disorder Severity Scale (K. M. Shear et al, 1997) and the Anxiety Sensitivity Index at baseline, and at sessions 4, 8, and 12. Ss achieved significant treatment gains on all panic disorder dimensions assessed, and the largest reduction in symptoms was during the first third of the treatment program, thereby challenging the notion that cognitive-behavioral therapy delivers its gains slowly over time. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Penava, Susan J; Otto, Michael W; Maki, Kristin M; Pollack, Mark H",1998.0,,0,0,
4803,Cognitive remediation therapy for outpatients with chronic schizophrenia: a controlled and randomized study,"ER Cognitive Remediation Therapy (CRT) is a novel rehabilitation approach designed to improve neurocognitive abilities such as attention, memory and executive functioning. The aim of the present study is to evaluate the effect of CRT on neurocognition, and secondarily on symptomatology and psychosocial functioning. Cognitive Behavioural Therapy (CBT) was used as a control condition because it aims to improve emotional problems and positive symptoms, focusing on modification of maladaptive beliefs and schemas, but neurocognition is not targeted. A total of 40 chronic patients with DSM-IV schizophrenia disorder were randomly assigned for 4 months to one of two treatment groups: CRT or CBT. Repeated assessments were conducted before and after the treatments and at the end of a follow-up period of 6 months. Additionally, a method to establish reliable change was calculated from a separate sample of 20 schizophrenic patients who were under standard medication without any kind of psychological treatment. Results showed that CRT produced an overall improvement on neurocognition (Mean effect size=0.5), particularly in verbal and nonverbal memory, and executive function. CBT showed the expected treatment effect on general psychopathology (anxiety and depression) but produced only a slight non-specific improvement in neurocognition (Working Memory). Furthermore, patients receiving CRT showed improvement in social functioning, demonstrating that cognitive improvements are clinically meaningful. These gains were still present at the 6 month follow-up.","Penadés, R; Catalán, R; Salamero, M; Boget, T; Puig, O; Guarch, J; Gastó, C",2006.0,10.1016/j.schres.2006.04.019,0,0,
4804,Anxiety and depression symptoms following smoking cessation and/or brief alcohol treatment among moderate risk smokers and drinkers.,"The goal of this study was to examine the change in anxiety and depression symptoms following a smoking cessation and brief alcohol intervention. Participants were 620 hospital out-patients (males = 97.7%; 33.6 years of age, SD = 11.6), in Nakhon Pathom province, Thailand, who screened positive for moderate risk for tobacco and alcohol use. The patients were involved in a randomised controlled trial comparing smoking cessation treatment that integrated a brief alcohol intervention consisting of smoking cessation treatment only or brief alcohol intervention only. Alcohol use and smoking, and anxiety and depressive symptoms were assessed at baseline, and 3 and 6-month following treatment. Findings from generalised estimation equations (GEE) analysis suggested that overall anxiety and depression scores to be significantly reduced following treatment. The tobacco only intervention significantly reduced anxiety and depression symptoms, while the alcohol only intervention significantly reduced depression symptoms. Smoking abstinence significantly reduced anxiety and depression symptoms and low risk alcohol use significantly reduced anxiety symptoms but not depression symptoms. Smoking cessation and/or brief alcohol treatment may be accompanied by improved psychological well-being. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Peltzer, Karl; Pengpid, Supa; Berlin, Bjelland, Grothues, Humeniuk, Kahler, McDermott, Molenberghs, Nilchaikovit, Pengpid, Sobell, Torres, Zigmond",2015.0,,0,0,
4805,Prevention of heterotopic ossification with irradiation after total hip arthroplasty. Radiation therapy with a single dose of eight hundred centigray administered to a limited field.,"Sixty-two hips in fifty-five patients who were considered to be at risk for postoperative heterotopic ossification were randomly divided into two groups: one received a single 800-centigray dose of limited-field radiation and the other, 1000 centigray of limited-field radiation in divided doses. The risk for heterotopic-bone formation was identified on the basis of previously described criteria, which included previous heterotopic ossification after an operation about the hip, hypertrophic osteoarthritis or post-traumatic osteoarthrosis characterized by formation of extensive osteophytes, radiographic evidence of diffuse idiopathic skeletal hyperostosis, ankylosing spondylitis, and male sex. The treatment portals excluded prosthetic surfaces that were intended for biological fixation by ingrowth of bone. At a minimum six-month follow-up, progression of heterotopic ossification had occurred in seven (21 per cent) of thirty-four hips in the first group and in six (21 per cent) of twenty-eight hips in the second group. The ossification had advanced more than one grade in only one hip. Extra-field ossification occurred in fifteen (43 per cent) of thirty-five hips that had not had previous heterotopic ossification. Since the time of the study, the treatment portal has been modified to include the lateral aspect of the greater trochanter, so that the risk of bursitis associated with ossification in this area is minimized. Single-dose limited-field radiation is effective for the prevention of heterotopic ossification, without compromise of early fixation of an uncemented implant.",Pellegrini VD.; Konski AA.; Gastel JA.; Rubin P.; Evarts CM.,1992.0,,0,0,
4806,Preoperative irradiation for prevention of heterotopic ossification following total hip arthroplasty.,"Eighty-six hips in eighty-five patients who were considered to be at risk for heterotopic ossification following a total hip arthroplasty were prospectively randomized or assigned to one of two treatment groups that received a single 800-centigray dose of limited-field radiation either preoperatively (Group I) or postoperatively (Group II). The risk factors for postoperative heterotopic ossification included previous heterotopic ossification following an operation about the hip, hypertrophic osteoarthrosis or post-traumatic osteoarthrosis characterized by the presence of extensive osteophytes, radiographic evidence of diffuse idiopathic skeletal hyperostosis, and ankylosing spondylitis. The hips in Group I were irradiated within 6.1 hours before the operation and those in Group II, within 51.3 hours after the operation. Either extra-field ossification or heterotopic ossification was observed in forty-one (48 per cent) of the eighty-six hips, thereby confirming the high risk for the population in this study. After a minimum duration of follow-up of six months, thirty-seven (76 per cent) of the forty-nine hips that had been treated with preoperative irradiation exhibited no new heterotopic ossification and eleven, progression to grade-I or II ossification. The remaining hip in that group was in a woman who had Paget disease as well as previous grade-IV (ankylosing) heterotopic ossification about the ipsilateral hip; heterotopic ossification progressed from grade II on the radiographs made immediately after the index revision procedure to grade III at the most recent follow-up assessment. Of the thirty-seven hips that had been treated with postoperative irradiation, twenty-seven (73 per cent) exhibited no new heterotopic ossification and nine had progression from grade-0 to grade-I ossification. The remaining hip in that group was in a man who had Parkinson disease and previous grade-III ossification about the ipsilateral hip; heterotopic ossification progressed from grade III immediately post-operatively to grade IV at the time of the most recent evaluation. Extra-field ossification was identified in twelve (24 per cent) of the forty-nine hips that had been irradiated preoperatively compared with three (8 per cent) of the thirty-seven hips that had been irradiated postoperatively (p = 0.05). Extra-field ossification was not associated with clinical symptoms of bursitis of the greater trochanter in any hip. Three of the ten hips that had a revision operation subsequently had a non-union of the greater trochanter; all three had been treated with preoperative irradiation. The findings of the present study suggest that pre-operative irradiation is effective for the prevention of heterotopic ossification following total hip arthroplasty and that it eliminates the discomfort and morbidity that are associated with conventional postoperative treatment. Furthermore, the efficacy of preoperative irradiation suggests that osteogenic precursor cells that are active in this process are derived from the local tissues within the operative field rather than from distant blood-borne cell lines.",Pellegrini VD.; Gregoritch SJ.,1996.0,,0,0,
4807,Child characteristics associated with outcome for children with autism in a school-based behavioral intervention,"ER This study examined the extent to which clinical and demographic characteristics predicted outcome for children with autism spectrum disorder. Participants included 152 students with autism spectrum disorder in 53 kindergarten-through-second-grade autism support classrooms in a large urban public school district. Associations between child characteristics (including age, language ability, autism severity, social skills, adaptive behavior, co-occurring psychological symptoms, and restrictive and repetitive behavior) and outcome, as measured by changes in cognitive ability following one academic year of an intervention standardized across the sample were evaluated using linear regression with random effects for classroom. While several scales and subscales had statistically significant bivariate associations with outcome, in adjusted analysis, only age and the presence of symptoms associated with social anxiety, such as social avoidance and social fearfulness, as measured through the Child Symptom Inventory-4, were associated with differences in outcome. The findings regarding the role of social anxiety are new and have important implications for treatment. Disentangling the construct of social anxiety to differentiate between social fearfulness and social motivation has important implications for shifting the focus of early treatment for children with autism spectrum disorder.","Pellecchia, M; Connell, J E; Kerns, C M; Xie, M; Marcus, S C; Mandell, D S",2016.0,10.1177/1362361315577518,0,0,
4808,"Impulse magnetic-field therapy for migraine and other headaches: a double-blind, placebo-controlled study.","This double-blind, placebo-controlled study assessed the efficacy of 4 weeks of impulse magnetic-field therapy (16 Hz, 5 microTs), delivered through a small device, for different types of headache and migraine. Eighty-two patients were randomly assigned to receive either active treatment or placebo (n = 41 each) and were characterized according to one of seven diagnoses (migraine, migraine combined with tension, tension, cluster, weather-related, posttraumatic, or other). Efficacy was assessed in terms of duration, severity, and frequency of migraine and headache attacks, as well as ability to concentrate. Data for 77 patients were analyzed. In the active-treatment group, all assessed criteria were significantly improved at the end of the study (P < .0001 vs baseline and placebo). Seventy-six percent of active-treatment patients experienced clear or very clear relief of their complaints. Only 1 placebo-patient (2.5%) felt some relief; 8% noted slight and 2% reported significant worsening of symptoms. No side effects were noted.",Pelka RB.; Jaenicke C.; Gruenwald J.,,,0,0,
4809,"Impulse magnetic-field therapy for migraine and other headaches: a double-blind, placebo-controlled study","ER This double-blind, placebo-controlled study assessed the efficacy of 4 weeks of impulse magnetic-field therapy (16 Hz, 5 microTs), delivered through a small device, for different types of headache and migraine. Eighty-two patients were randomly assigned to receive either active treatment or placebo (n = 41 each) and were characterized according to one of seven diagnoses (migraine, migraine combined with tension, tension, cluster, weather-related, posttraumatic, or other). Efficacy was assessed in terms of duration, severity, and frequency of migraine and headache attacks, as well as ability to concentrate. Data for 77 patients were analyzed. In the active-treatment group, all assessed criteria were significantly improved at the end of the study (P < .0001 vs baseline and placebo). Seventy-six percent of active-treatment patients experienced clear or very clear relief of their complaints. Only 1 placebo-patient (2.5%) felt some relief; 8% noted slight and 2% reported significant worsening of symptoms. No side effects were noted.","Pelka, R B; Jaenicke, C; Gruenwald, J",2001.0,,0,0,4808
4810,Repetitive transcranial magnetic stimulation to supplementary motor area in refractory obsessive-compulsive disorder treatment: A sham-controlled trial.,"Background: Repetitive transcranial magnetic stimulation has been explored in patients with obsessive-compulsive disorder, but with negative or conflicting results. This randomized double-blind study was designed to assess the efficacy of 1-Hz repetitive transcranial magnetic stimulation over the presupplementary area. Methods: Forty medication-resistant patients were assigned to 4 weeks of either active or sham repetitive transcranial magnetic stimulation targeting the presupplementary area with the help of a neuronavigation system. Results: According to the Yale-Brown obsessive-compulsive scale, the baseline-week 4 evolution showed no significant differences between groups. Responder rates at week 4 were not different between groups (repetitive transcranial magnetic stimulation 10.5% vs sham 20%; P = .63). Conclusion: Low-frequency repetitive transcranial magnetic stimulation applied to the presupplementary area seems ineffective for the treatment of obsessive-compulsive disorder patients, at least in severe and drug-refractory cases such as those included in this study. Further research is required to determine profiles of responder patients and appropriate repetitive transcranial magnetic stimulation parameters for obsessive-compulsive disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Pelissolo, Antoine; Harika-Germaneau, Ghina; Rachid, Fady; Gaudeau-Bosma, Christian; Tanguy, Marie-Laure; BenAdhira, Rene; Bouaziz, Noomane; Popa, Traian; Wassouf, Issa; Saba, Ghassen; Januel, Dominique; Jaafari, Nematollah; Bais, Gaynes, Gomes, Grassi, Huppert, Jaafari, Kang, Ma, Mantovani, Mantovani, Mantovani, Mantovani, Modirrousta, Nauczyciel, Overbeek, Pallanti, Ruffini, Ruscio, Saba, Sheehan, Vogel, Wu",2016.0,,0,0,
4811,"[Anxiety disorders in private practice psychiatric out-patients: prevalence, comorbidity and burden (DELTA study)].","Few data are currently available on the prevalence and associated characteristics of anxiety disorders in psychiatric out-patients in France, in particular in the private health-care. However, this represents one of the principal systems of care for patients suffering from anxiety disorders, with a possible direct access and several types of treatments available (pharmacotherapy but also different kinds of psychotherapy). The aim of our study was to describe the prevalence of anxiety disorders in a large sample of patients consulting in the private sector, and in addition to study the comorbidity, the severity of the disorders, their consequences on quality of life and health care consumption. The studied patients were included and assessed by 501 psychiatrists from all the country, at the time of a first visit. Inclusions were to be made in a consecutive way, but with the exclusion of psychotic disorders and dementia. A sample of 1 955 patients was obtained, and all subjects had a standardized diagnostic assessment with the Mini International Neuropsychiatric Interview (MINI) and with various dimensional scales of symptomatology severity, quality of life, and health care consumption. On the whole, at least one current anxiety disorder was found in 64.3% of the patients, while 55% had a depressive disorder. Individually, the prevalence rates are 29.4% for generalized anxiety disorder, 25.9% for agoraphobia, 19.2% for panic disorder, 15.3% for social phobia, 11.4% for obsessive-compulsive disorder, and 5.4% for post-traumatic stress disorder (PTSD). A history of suicide attempts was found in 12-20% of patients, and an elevated suicide risk was found for example in 25% of PTSD patients. The scores of the symptomatic scales, adaptation and quality of life measure show a very significant anxious symptomatology, with serious functional consequences. Approximately 75% of patients had another medical consultation during the three previous months, and 9% have been hospitalized. An interruption of work was found in 25% of the patients during the last three months, in average for 35 days. Concerning drug consumption before the visit by anxiety disorders patients, the preponderance of anxiolytic use is notable (85 to 98% according to categories of anxiety disorders) when compared to that of antidepressants (20 to 40%). Moreover, 38.4% of the whole sample took an anxiolytic once a day for at least three months and about 40% of them had dependence symptoms. In conclusion, this study showed the quantitative importance of anxiety disorders among psychiatric out-patients in the private practice sector in France, all the categories of anxiety being represented, and the high level of severity and burden of these disorders. Compared to some data published before, the prevalence rates of these anxiety disorders seem to be increasing.",Pélissolo A.; André C.; Chignon JM.; Dutoit D.; Martin P.; Richard-Berthe C.; Tignol J.,,,0,0,
4812,Deductive and inductive reasoning in obsessive-compulsive disorder.,"This study tested the hypothesis that people with obsessive-compulsive disorder (OCD) show an inductive reasoning style distinct from people with generalized anxiety disorder (GAD) and from participants in a non-anxious (NA) control group. The experimental procedure consisted of administering a range of six deductive and inductive tasks and a probabilistic task in order to compare reasoning processes between groups. Recruitment was in the Montreal area within a French-speaking population. The participants were 12 people with OCD, 12 NA controls and 10 people with GAD. Participants completed a series of written and oral reasoning tasks including the Wason Selection Task, a Bayesian probability task and other inductive tasks, designed by the authors. There were no differences between groups in deductive reasoning. On an inductive ""bridging task"", the participants with OCD always took longer than the NA control and GAD groups to infer a link between two statements and to elaborate on this possible link. The OCD group alone showed a significant decrease in their degree of conviction about an arbitrary statement after inductively generating reasons to support this statement. Differences in probabilistic reasoning replicated those of previous authors. The results pinpoint the importance of examining inference processes in people with OCD in order to further refine the clinical applications of behavioural-cognitive therapy for this disorder.",Pélissier MC.; O'Connor KP.,2002.0,,0,0,
4813,[A revised Iowa collateral head injury interview: a new instrument for the assessment of traumatic psychosocial frontal symptoms].,"To validate a semi-structured Revised Iowa Collateral Head Injury Interview (RICHII) to assess post-traumatic, psychosocial frontal symptoms. 1. To revise the RICHII in the light of recent research findings and previous pilot studies. 2. External experts assure face and content validity. 3. Standard reliability and validity study in a sample of consecutive patients fulfilling inclusion and exclusion criteria of severe head trauma. 4. Principal component analysis and distribution of results of RICHII administration to the full sample (N= 55). Several original items were modified and two new items (inappropriate euphoria and affective unstableness) were incorporated, as well as a new, graded scoring system. Feasibility, internal consistency (Cronbach's alfa= 0.94), inter-rater reliability (n= 40, kappa= 0.60) and test-retest reliability (n= 25, kappa= 0.70) were quite acceptable. Four factors emerged in the factor analysis, explaining a high percentage of the variance; they tend to reflect modern knowledge in the field and are judged to support the construct validity of the RICHII. More than two thirds of patients (70.9%) scored high in at least one of the items. This is the first report about the reliability and validity of a collateral interview to assess post-traumatic, psychosocial frontal symptoms.",Pelegrín Valero C.; Gómez-Hernández R.; Lobo Satúe A.,,,0,0,
4814,Empathy during consoling touch is modulated by mu-rhythm: An EEG study,"The aim of the present study was to examine the mechanisms of empathy for pain that contribute to consoling touch, a distress-alleviating contact behavior carried out by an observer in response to the suffering of a target. We tested romantic couples in a paradigm that involves consoling touch and examined the attenuation of the mu/alpha rhythm (8-13. Hz) in the consoling partner. During the task, the toucher either held the consoled partner's right hand (human touch) or held onto the armrest of the chair (non-human touch), while the consoled partner experienced inflicted pain (pain condition) or did not experience any pain (no-pain condition). In accordance with our hypotheses, the results revealed an interaction between touch and pain at in mu/alpha rhythms in all central sites (C3, C4, Cz). Specifically, we found that the toucher's mu suppression was higher in the consoling touch condition, i.e., while touching the partner who is in pain, compared to the three control conditions. Additionally, we found that in the consoling touch condition, mu suppression at electrode C4 of the toucher correlated with a measure of situational empathy. Our findings suggest that electrophysiological and behavioral measures that have been associated with empathy for pain are modulated during consoling touch.",Peled-Avron L.; Goldstein P.; Yellinek S.; Weissman-Fogel I.; Shamay-Tsoory S.G.,2017.0,10.1016/j.neuropsychologia.2017.04.026,0,0,
4815,Fluorescence spectroscopy for monitoring reduction of natural organic matter and halogenated furanone precursors by biofiltration,"The application of fluorescence spectroscopy to monitor natural organic matter (NOM) reduction as a function of biofiltration performance was investigated. This study was conducted at pilot-scale where a conventional media filter was compared to six biofilters employing varying enhancement strategies. Overall reductions of NOM were identified by measuring dissolved organic carbon (DOC), and UV absorbance at 254 nm, as well as characterization of organic sub-fractions by liquid chromatography-organic carbon detection (LC-OCD) and parallel factors analysis (PARAFAC) of fluorescence excitation-emission matrices (FEEM). The biofilter using granular activated carbon media, with exhausted absorptive capacity, was found to provide the highest removal of all identified PARAFAC components. A microbial or processed humic-like component was found to be most amenable to biodegradation by biofilters and removal by conventional treatment. One refractory humic-like component, detectable only by FEEM-PARAFAC, was not well removed by biofiltration or conventional treatment. All biofilters removed protein-like material to a high degree relative to conventional treatment. The formation potential of two halogenated furanones, 3-chloro-4(dichloromethyl)-2(5H)-furanone (MX) and mucochloric acid (MCA), as well as overall treated water genotoxicity are also reported. Using the organic characterization results possible halogenated furanone and genotoxicity precursors are identified. Comparison of FEEM-PARAFAC and LC-OCD results revealed polysaccharides as potential MX/MCA precursors.",Peleato N.M.; McKie M.; Taylor-Edmonds L.; Andrews S.A.; Legge R.L.; Andrews R.C.,2016.0,10.1016/j.chemosphere.2016.03.018,0,0,
4816,Characterization of hydraulically reversible and irreversible fouling species in ultrafiltration drinking water treatment systems using fluorescence EEM and LC-OCD measurements,"The application of the fluorescence excitation-emission matrix (EEM) approach and liquid chromatography-organic carbon detection (LC-OCD) analysis for the characterization of hydraulically reversible and irreversible fouling species, extracted from hollow fiber ultrafiltration (UF) membranes used in drinking water treatment, was demonstrated. Hydraulically reversible and irreversible fouling species were extracted from two pilot UF membrane systems operated in parallel with lake water as the feed. Two membrane cleaning protocols, hydraulic- and chemical-based (NaOCl and citric acid) cleaning, were considered. Colloidal/particulate matter together with protein-like and metal species in water appeared to contribute to the formation of a hydraulically removable fouling layer on the membranes. Hydraulically irreversible fouling, in contrast, was impacted considerably by humic substances (HS) and protein-like matter. The formation of an irreversible fouling layer was also likely influenced by interactions between the colloidal/particulate matter and metal species together with HS and protein-like matter. LC-OCD analysis revealed the presence of predominant levels of lower molecular weight HS-like matter - compared to the HS-like matter commonly present in lake water - in the citric acid extracted foulant fraction. The permeability loss due to hydraulically irreversible UF fouling was considerably greater than the permeability loss due to hydraulically reversible UF fouling. A permanent permeability loss (~25-35% of the initial permeability) was present even after the application of considerably strong chemical cleaning protocols on both pilot systems. This study indicated that the fluorescence EEM approach can be applied for monitoring and characterization of membrane cleaning procedures and as a potential diagnostic tool for assessing the effectiveness of hydraulic- and chemical-based cleaning protocols employed in UF drinking water treatment operations using rapid off-line measurements. On the other hand, since the LC-OCD analysis technique is a comparatively time consuming method, it may be used for verification of the fluorescence EEM-based results of the foulant fractions. © IWA Publishing 2013.",Peiris R.H.; Jaklewicz M.; Budman H.; Legge R.L.; Moresoli C.,2013.0,10.2166/ws.2013.130,0,0,
4817,Assessing nanofiltration fouling in drinking water treatment using fluorescence fingerprinting and LC-OCD analyses,"The natural organic matter (NOM) components causing fouling of nanofiltration membranes used in drinking water applications consists in a complex mixture of humic and fulvic acids, proteins, and carbohydrates of various molecular size and functional groups. Understanding the characteristics of NOM fractions such as humic substances (HS) and biopolymers (proteins and polysaccharides) as foulants is of paramount importance to develop fouling control strategies. Fluorescence spectroscopy is becoming an increasingly popular method for characterizing NOM and shows good potential for online monitoring, as minimal sample pre-treatment and preparation is required, high instrumental sensitivity is available and the technique is non-destructive in nature. In this research an innovative approach involving both fluorescence and LC-OCD analyses is used to identify and to characterise organic membrane foulant. © IWA Publishing 2008.",Peiris B.R.H.; Hallé C.; Haberkamp J.; Legge R.L.; Peldszus S.; Moresoli C.; Budman H.; Amy G.; Jekel M.; Huck P.M.,2008.0,10.2166/ws.2008.095,0,0,
4818,A randomized trial of on-pump beating heart and conventional cardioplegic arrest in coronary artery bypass surgery patients with impaired left ventricular function using cardiac magnetic resonance imaging and biochemical markers,"ER METHODS AND RESULTSIn a single-center randomized trial, 50 patients with impaired ventricular function were randomly assigned to ONBEAT or ONSTOP. Patients underwent cardiac magnetic resonance imaging for function and delayed hyperenhancement early and later after surgery. Serial assessment of biochemical markers was also undertaken. Preoperative characteristics were well matched; cardiac index was 2.85+/-0.53 (ONBEAT) and 2.62+/-0.59 L x min(-1) x m(-2) (ONSTOP). Early after surgery, there was a trend toward a greater reduction in end-systolic volume index in ONSTOP patients versus ONBEAT (-9+/-8 versus -4+/-11 mL x m(-2); P=0.06). The changes were sustained and significant at 6 months (-14+/-18 versus -2+/-19 mL x m(-2); P=0.04). Furthermore, the incidence of new hyperenhancement at 6 days was higher in ONBEAT patients (P=0.05), with 6 of 17 (35%) sustaining 8.2+/-5.2 g of new hyperenhancement each versus 2 of 23 (9%) in the ONSTOP group, each with 9.8+/-9.0 g (P=0.86). Finally, median area under the curve for troponin was higher in ONBEAT at 461 (interquartile range, 226 to 1141) microg/L versus 160 (interquartile range, 98 to 357) microg/L for ONSTOP (P=0.002).CONCLUSIONSThe incidence of new irreversible myocardial injury was significantly higher in ONBEAT than in ONSTOP patients. Furthermore, at 6 months, only ONSTOP patients demonstrated an improvement in ventricular geometry. The most likely mechanism is inadequate coronary perfusion to distal myocardial territories in patients with severe proximal coronary disease.BACKGROUNDBeating heart coronary artery bypass grafting (CABG) improves early postoperative cardiac function in patients with normal ventricular function, but its effect in patients with impaired function is uncertain. We compared a novel hybrid technique of on-pump beating heart CABG (ONBEAT) with conventional on-pump CABG (ONSTOP) in patients with impaired ventricular function.","Pegg, T J; Selvanayagam, J B; Francis, J M; Karamitsos, T D; Maunsell, Z; Yu, L M; Neubauer, S; Taggart, D P",2008.0,10.1161/CIRCULATIONAHA.108.785105,0,0,
4819,Psychophysiological evidence for cortisol-induced reduction in early bias for implicit social threat in social phobia,"ER The stress hormone cortisol is important for the regulation of social motivational processes. High cortisol levels have been associated with social fear and avoidance, which play an important role in social anxiety disorder (SAD), as does hypervigilant processing of social threat. However, causal effects of cortisol on threat processing in SAD remain unclear. In an event-related potential (ERP) study we investigated the effects of cortisol on task-irrelevant (implicit) processing of social threat in SAD, exploring the temporal dynamics as well as the role of symptom severity and stimulus awareness. Angry face processing was measured in participants with clinical SAD after double-blind, within-subject oral administration of cortisol (50mg) and placebo, using a masked and an unmasked emotional Stroop task. Both tasks showed significantly increased P2 midline ERP amplitudes for angry compared to neutral and happy faces in the placebo condition, reflecting an early attentional bias for social threat in SAD. Furthermore, cortisol administration significantly decreased P2 amplitudes for masked angry faces. This effect correlated with social anxiety, showing stronger decreases in patients with higher levels of social anxiety. These results indicate a highly specific effect of cortisol on early motivated attention to social threat and, together with previous findings, highlight the importance of motivational context (stimulus- or task-relevance) as well as symptom severity.","Peer, J M; Spinhoven, P; Roelofs, K",2010.0,10.1016/j.psyneuen.2009.09.012,0,0,
4820,Patients with chronic whiplash can be subgrouped on the basis of symptoms of sensory hypersensitivity and posttraumatic stress.,"The lack of efficacy of rehabilitative approaches to the management of chronic whiplash-associated disorders (WAD) may be in part due to heterogeneity of the clinical presentation of this patient population. The aim of this study was to identify homogeneous subgroups of patients with chronic WAD on the basis of symptoms of PTSD and sensory hypersensitivity and to compare the clinical presentation of these subgroups. Successive k-means cluster analyses using 2, 3 and 4 cluster solutions were performed by using data for 331 (221 female) patients with chronic (>3 months) WAD. The 4 cluster solution was identified as the most clinically relevant, yielding 4 distinct clusters: no to mild posttraumatic stress symptoms and no sensory hypersensitivity (nPnH), no to mild posttraumatic stress symptoms and sensory hypersensitivity (nPH), moderate to severe posttraumatic stress and no sensory hypersensitivity (PnH) and moderate to severe posttraumatic stress and sensory hypersensitivity (PH). The nPnH cluster was the largest cluster, comprising 43.5% of the sample. The PH cluster had significantly worse disability, pain intensity, self-reported mental health status and cervical range of motion in comparison to the nPnH and nPH clusters. These data provide further evidence of the heterogeneity of the chronic WAD population and the association of a more complex clinical presentation with higher disability and pain in this patient group. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pedler, Ashley; Sterling, Michele; Altis, Arnold, Arnold, Bardin, Bauer, Belmonte, Buitenhuis, Burns, Cameron, Carroll, Curatolo, Dunne, Dyer, Elliott, Foa, Geuze, Goldsmith, Jenewein, Jull, Jull, Kamper, Kamper, Kamper, Kasch, Kasch, Kasch, Kivioja, Kongsted, Lemming, Liberzon, Lim, Lowry, Lunn Michael, McLean, Meh, Michaleff, Mykletun, Nederhand, Norman, Oaklander, Pato, Pringle, Raphael, Robinson, Soderlund, Spitzer, Sterling, Sterling, Sterling, Sterling, Sterling, Sterling, Sterling, Sterling, Sullivan, Sullivan, Soderlund, Tan, Teasell, Teasell, Tobbackx, Van Oosterwijck, Vangronsveld, Verhagen, Vernon, Wallin, Walton, Zhao",2013.0,,0,0,
4821,"Increased anxiety in partners of patients with a cardioverter-defibrillator: the role of indication for ICD therapy, shocks, and personality.","The partner of the implantable cardioverter-defibrillator (ICD) patient serves as an important source of support for the patient, which may be hampered if the partner experiences increased distress. We examined (1) potential differences in anxiety and depressive symptoms in ICD patients compared to their partners, and (2) the extent to which the partner's personality is a more important determinant of partner distress than patient clinical characteristics, using a prospective design. Consecutively implanted ICD patients (n = 196) and their partners (n = 196) completed a set of psychological questionnaires at baseline and 6 months after implantation. Analysis of variance with repeated measures showed that partners had significantly higher levels of anxiety compared to patients (F(1,390) = 16.431; P < 0.001) but not depressive symptoms (F(1,390) = 0.186; P = 0.67). There was a significant overall reduction in anxiety (F(1,390) = 79.552; P < 0.001) and depressive symptoms (F(1,390) = 39.868; P < 0.001) over 6 months, with group (i.e., patient vs partner) exerting a stable effect on anxiety (F(1,390) = 0.966; P = 0.33) and depressive symptoms (F(1,390) = 0.025; P = 0.87). These results remained in adjusted analysis. Determinants of anxiety and depressive symptoms in partners included secondary prophylaxis in patients (Ps < 0.001-0.002), Type D personality of the partner (Ps < 0.001-0.001), secondary prophylaxis by shock interaction (P = 0.002; anxiety only), and secondary prophylaxis by Type D interaction (Ps = 0.001-0.003). Partners had higher levels of anxiety but not depression than ICD patients. Partner distress could be attributed not only to the partner's personality, but also to patient clinical characteristics, primarily secondary prophylaxis for ICD therapy. These results indicate that information on the clinical characteristics of the patient in addition to partner characteristics may help identify partners at risk of distress.",Pedersen SS.; VAN DEN Berg M.; Erdman RA.; VAN Son J.; Jordaens L.; Theuns DA.,2009.0,10.1111/j.1540-8159.2008.02201.x,0,0,
4822,Integrating carthage-specific T1rho MRI into knee clinic diagnostic imaging.,"With a rise in post-traumatic osteoarthritis, OA no longer is considered just a disease of aging. The 'gold standard' for OA diagnosis has long been planar radiographs for visualizing osteophytes, joint space narrowing and sclerotic changes. A typical magnetic resonance imaging (MRI) protocol will acquire proton density, T1, T2, and fat suppressed images that give a comprehensive picture of morphologic changes associated with injury and subsequent degenerative processes. However, the earliest events of cartilage degeneration occur within the tissue, before measureable changes in morphology. MRI methods have been proposed to display and quantify changes in composition and integrity of such elements of cartilage extracellular matrix as collagen and proteoglycan (PG) content in vivo. T1ρ the spin-lattice relaxation time in the rotating frame, has come to the forefront for visualizing water proton-PG interactions in articular cartilage. The purpose of this T1ρ MRI study was to define an objective femoral condyle-specific registration method, in which zone-dependent cartilage compositional changes could be assessed from the bone outward through the existing cartilage, at pre-ACL reconstruction and subsequent follow-up times, when the loss of thickness to surface-down cartilage erosion might occur later in the OA pathogenesis. Additionally, this study explores the effects of reducing the number of spin-lock times on the absolute T1ρ relaxation times; a major parameter in expanding T1ρ coverage to the whole joint while satisfying clinical imaging time and specific absorption rate (SAR) safety constraints. The developed image analysis tools serve as the first step toward quantitative functional assessment of cartilage health with noninvasive T1ρ MRI, which has the potential to become an important new tool for the early diagnosis of cartilage degeneration following ACL trauma.",Pedersen DR.; Klocke NF.; Thedens DR.; Martin JA.; Williams GN.; Amendola A.,2011.0,,0,0,
4823,Neural correlates associated with symptom provocation in pediatric obsessive compulsive disorder after a single session of sham-controlled repetitive transcranial magnetic stimulation,"ER Treatments for pediatric obsessive-compulsive disorder (OCD) could be enhanced if the physiological changes engendered by treatment were known. This study examined neural correlates of a provocation task in youth with OCD, before and after sham-controlled repetitive transcranial magnetic stimulation (rTMS). We hypothesized that rTMS to the right dorsolateral prefrontal cortex would inhibit activity in cortico-striato-thalamic (CST) circuits associated with OCD to a greater extent than sham rTMS. After baseline (Time 1) functional magnetic resonance imaging (fMRI) during a provocation task, subjects received one session of either fMRI-guided sham (SG; n=8) or active (AG; n=10) 1-Hz rTMS over the rDLPFC for 30min. During rTMS, subjects were presented with personalized images that evoked OCD-related anxiety. Following stimulation, fMRI and the provocation task were repeated (Time 2). Contrary to our prediction for the provocation task, the AG was associated with no changes in BOLD response from Times 1 to 2. In contrast, the SG had a significant increase at Time 2 in BOLD response in the right inferior frontal gyrus and right putamen, which persisted after adjusting for age, gender, and time to scanner as covariates. This study provides an initial framework for TMS interrogation of the CST circuit in pediatric OCD.","Pedapati, E; DiFrancesco, M; Wu, S; Giovanetti, C; Nash, T; Mantovani, A; Ammerman, R; Harris, E",2015.0,10.1016/j.pscychresns.2015.07.020,0,0,
4824,Fluoxetine in panic disorder: Pharmacologic and tritiated platelet imipramine and paroxetine binding study.,"Examined 28 patients (aged 18-62 yrs) who were treated for 8 wks with fluoxetine and who fulfilled Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) criteria of panic disorder with agoraphobia. Serotonergic implication in panic disorder has been demonstrated by the efficacy of serotonin reuptake blockers in treatment; fluoxetine, a potent 5-hydroxytryptamine (5-HT) reuptake blocker, has been suggested to have anti-panic efficacy. Of the Ss who started medication, 64% completed the clinical trial and 36% dropped out of treatment because of increased anxiety or a lack of efficacy. 32% had zero panic attacks by Week 3. By the end of 8 wks, 48% had zero panic attacks, and there was a significant reduction in anxiety and phobic avoidance and panic attacks. Tritiated platelet imipramine and paroxetine bindings revealed significantly lower maximal binding for Ss with panic disorder in comparison with controls. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pecknold, J. C; Luthe, L; Iny, L; Ramdoyal, D",1995.0,,0,0,
4825,Prevention of late post-traumatic epilepsy by phenytoin in severe brain injuries. 2 years' follow-up,"ER The high incidence rate and the invalidating nature of post-traumatic epilepsy after severe brain injury have encouraged the authors to review the prophylactic treatment of this type of epilepsy. Thirty-four out of 86 randomised patients with brain injuries admitted into a neurotraumatology intensive care unit were treated prophylactically, immediately after the injury, with an intravenous hydantoin injection in a dose sufficient to provide stable and effective blood levels. This was followed by dose-adjusted oral administration maintained for a minimum period of 3 months. After a 2 years' follow-up, there was a significant difference between treated and untreated patients, since only 6 per cent of the patients treated suffered from post-traumatic epilepsy, as against 42 percent in the untreated group.","Pechadre, J C; Lauxerois, M; Colnet, G; Commun, C; Dimicoli, C; Bonnard, M; Gibert, J; Chabannes, J",1991.0,,0,0,
4826,Contextual representations increase analogue traumatic intrusions: evidence against a dual-representation account of peri-traumatic processing.,"Information processing accounts of post-traumatic stress disorder (PTSD) state that intrusive memories emerge due to a lack of integration between perceptual and contextual trauma representations in autobiographical memory. This hypothesis was tested experimentally using an analogue trauma paradigm in which participants viewed an aversive film designed to elicit involuntary recollections. Participants viewed scenes from the film either paired with contextual information or with the contextual information omitted. After viewing the film participants were asked to record for one week any involuntary intrusions for the film using a provided intrusions diary. The results revealed a significant increase in analogue intrusions for the film when viewed with contextual information in comparison to when the film was viewed with the contextual information omitted. In contrast there was no effect of contextual information on valence ratings or voluntary memory for the film, or on the reported vividness and emotionality of the intrusions. The analogue trauma paradigm may have failed to reproduce the effect of extreme stress on encoding that is postulated to occur during PTSD. The findings have potential implications for trauma intervention as they suggest that the contextual understanding of a scene during encoding can be integral to the subsequent occurrence of traumatic intrusions. The pattern of results found in the study are inconsistent with dual-representation accounts of intrusive memory formation, and instead provide new evidence that contextual representations play a casual role in increasing the frequency of involuntary intrusions for traumatic material.",Pearson DG.,2012.0,10.1016/j.jbtep.2012.04.002,0,0,
4827,Behavioral desensitization of phobic anxiety using thiopental sodium,"The author evaluated a random sample of 25 patients suffering from a variety of phobic anxiety states who were treated with desensitization using thiopental sodium combined with progressive reduction in the use of oral anxiolytic medication. At 24-week follow-up, 11 of the patients reported mild symptoms of phobic anxiety and 14 reported none; 9 of the patients reported their use of tranquilizers had decreased and 15 reported they had used none for at least 2 weeks. These results demonstrate the usefulness of the treatment in producing sustained reduction of phobic anxiety and tranquilizer use.",Pearlman T.,1980.0,,0,0,
4828,The management of atypical non-cardiac chest pain,"ER Atypical, non-cardiac chest pain is common and disabling, and often persists despite negative medical investigations. Aetiology is disputed and management is difficult. A multi-causal model in which both psychological and physical factors play a part is helpful; a fundamental factor is continued misinterpretation of minor physical symptoms as evidence of heart disease. We report supportive evidence and describe a psychological treatment derived from the model. In a randomized trial, cognitive behavioural methods were effective in reducing chest pain, disability and use of medication, in patients both with and without psychiatric disorder. The clinical implications are discussed.","Pearce, M J; Mayou, R A; Klimes, I",1990.0,,0,0,
4829,A multifaceted behavioral intervention for pill-taking avoidance associated with Tylenol poisoning.,"The effectiveness of relaxation training, imaginal exposure and in vivo exposure to pills in the treatment of pill-taking avoidance resulting from a fear of poisoning associated with Tylenol was investigated. Following relaxation training and imaginal exposure to vitamin consumption, one session of in vivo exposure to vitamin taking resulted in daily vitamin use. One session of in vivo exposure to aspirin and placebo capsules (substitutes for prescribed medication) resulted in consumption of aspirin as needed and daily ingestion of placebo pills. Interestingly, treatment effects generalized to leftovers and wine, two related phobic stimuli, without additional intervention. At three and six month follow-up, the subject reported maintenance of treatment effects. Psychophysiological assessment data were consistent with the subject's self-report.",Pbert LA.; Goetsch VL.,1988.0,,0,0,
4830,"Trauma and memory: effects of post-event misinformation, retrieval order, and retention interval.","The present study concerned effects of misinformation, retrieval order, and retention interval on eyewitness memory for a traumatic event (a vivid murder). Relations between misinformation acceptance and compliance were also examined. The classic three-stage misinformation paradigm (Loftus, 1979) was employed, with a multi-component recognition test added. Either immediately or 2 weeks after viewing a distressing film, 232 adults read a narrative (misleading or control) about the murder and then took a recognition test that tapped memory for central and peripheral details. Test-item order either matched the chronology of the film or was randomly determined. Significant misinformation effects were obtained. Moreover, control participants were more accurate in response to questions about central than peripheral information; however, this was not so for misinformed participants. Sequential but not random retrieval order resulted in a higher proportion of correct responses for central as opposed to peripheral misinformation questions. Compliance was significantly related to misinformation effects. Delay increased participants' suggestibility, impaired memory accuracy, and produced higher confidence ratings for misinformed participants compared to controls. Findings indicate that even for a highly negative event, adults' memory is not immune to inaccuracies and suggestive influences.",Paz-Alonso PM.; Goodman GS.,2008.0,10.1080/09658210701363146,0,0,
4831,Behavioural changes in children following minor surgery--is premedication beneficial?,"ER One hundred and twenty-three male children, aged one to ten years, were studied to determine the influence of premedication on changes in patterns of behaviour following hospitalization for repair of inguinal hernias. Four comparable groups were selected for premedication regimen: (1) A control group without premedication; (2) oral trimeprazine tartrate 2 mg/kg, methadone 0.1 mg/kg and droperidol 0.15 mg/kg; (3) oral midazolam 0.45 mg/kg; (4) intramuscular midazolam 0.15 mg/kg. Standard inhalational anesthesia was used and caudal blocks employed for analgesia. The parents returned a questionnaire at two weeks. Changes in behaviour were reported in 78% of the children and overall, premedication showed little benefit. However, midazolam premedication was associated with a significantly lower incidence of night-time crying and awakening, compared with no premedication. Only for night-time crying and day-time toilet training did age below five years prove to be a significant contributing factor.","Payne, K A; Coetzee, A R; Mattheyse, F J; Heydenrych, J J",1992.0,,0,0,
4832,The impact of stress on neutral and emotional aspects of episodic memory,"ER The present experiment demonstrates that exposure to a significant psychological stressor (administered before watching a slide show) preserves or even enhances memory for emotional aspects of an event, and simultaneously disrupts memory for non-emotional aspects of the same event. Stress exposure also disrupted memory for information that was visually and thematically central to the event depicted in the slide show. Memory for peripheral information, on the other hand, was unaffected by stress. These results are consistent with theories invoking differential effects of stress on brain systems responsible for encoding and retrieving emotional memories (the amygdala) and non-emotional memories (e.g., the hippocampal formation), and inconsistent with the view that memories formed under high levels of stress are qualitatively the same as those formed under ordinary emotional circumstances. These data, which are also consistent with results obtained in a number of studies using animals and humans, have implications for the traumatic memory debate and theories regarding human memory.","Payne, J D; Jackson, E D; Ryan, L; Hoscheidt, S; Jacobs, J W; Nadel, L",2006.0,10.1080/09658210500139176,0,0,
4833,"Relationships between personality dimensions: neuroticism and extraversion against obsessive, hysterical and oral personality.",,Paykel ES.; Prusoff BA.,1973.0,,0,0,
4834,Community psychiatric nursing for neurotic patients: a controlled trial.,"Seventy-one neurotic patients requiring follow-up were randomly assigned to routine psychiatric out-patient care or to supportive home visiting from community psychiatric nurses as their main treatment agents and were assessed every six months for 18 months. No differences were found between effectiveness of the two modes of service on symptoms, social adjustment or family burden. Patients seeing community psychiatric nurses reported greater satisfaction with treatment. Community psychiatric nursing resulted in a marked reduction in out-patient contacts with psychiatrists and other staff, more discharges, and a small increase in general practitioner contact for prescribing. Care of such patients by community psychiatric nurses is a valuable alternative mode of deployment within the psychiatric team.",Paykel ES.; Mangen SP.; Griffith JH.; Burns TP.,1982.0,,0,0,
4835,Therapist behaviours in internet-delivered cognitive behaviour therapy: analyses of e-mail correspondence in the treatment of generalized anxiety disorder.,"Internet-delivered cognitive behaviour therapy (iCBT) has been found to be an effective way to disseminate psychological treatment, and support given by a therapist seems to be important in order to achieve good outcomes. Little is known about what the therapists actually do when they provide support in iCBT and whether their behaviour influences treatment outcome. This study addressed the content of therapist e-mails in guided iCBT for generalized anxiety disorder. We examined 490 e-mails from three therapists providing support to 44 patients who participated in a controlled trial on iCBT for generalized anxiety disorder. Through content analysis of the written correspondence, eight distinguishable therapist behaviours were derived: deadline flexibility, task reinforcement, alliance bolstering, task prompting, psychoeducation, self-disclosure, self-efficacy shaping, and empathetic utterances. We found that task reinforcement, task prompting, self-efficacy shaping and empathetic utterances correlated with module completion. Deadline flexibility was negatively associated with outcome and task reinforcement positively correlated with changes on the Penn State Worry Questionnaire. Different types of therapist behaviours can be identified in iCBT, and though many of these behaviours are correlated to each other, different behaviours have an impact on change in symptoms and module completion.",Paxling B.; Lundgren S.; Norman A.; Almlöv J.; Carlbring P.; Cuijpers P.; Andersson G.,2013.0,10.1017/S1352465812000240,0,0,
4836,Assessment of patient engagement with a mobile application among service members in transition.,"This article examines engagement with a mobile application (""mCare"") for wounded Service Members rehabilitating in their communities. Many had behavioral health problems, Traumatic Brain Injury (TBI), and/or post-traumatic stress disorder (PTS). The article also examines associations between Service Members' background characteristics and their engagement with mCare. This analysis included participants who received mCare (n = 95) in a randomized controlled trial. mCare participants received status questionnaires daily for up to 36 weeks. Participant engagement encompasses exposure to mCare, percentage of questionnaires responded to, and response time. Participants were grouped by health status-that is, presence/absence of behavioral health problems, PTS, and/or TBI. Histograms and regression analyses examined engagement by participants' health status and background characteristics. Exposure to mCare did not differ by health status. Participants usually responded to ≥60% of the questionnaires weekly, generally in ≤10 h; however, participants with behavioral health problems had several weeks with <50% response and the longest response times. Total questionnaires responded to and response time did not differ statistically by health status. Older age and higher General Well-Being Schedule scores were associated with greater and faster response. The sustained response to the questionnaires suggests engagement. Overall level of response surpassed trends reported for American's usage of mobile applications. With a few exceptions, Service Members engaged with mCare irrespective of health status. Mobile health has the potential to increase the quantity and quality of patient-provider communications in a community-based, rehabilitation care setting, above that of standard care.",Pavliscsak H.; Little JR.; Poropatich RK.; McVeigh FL.; Tong J.; Tillman JS.; Smith CH.; Fonda SJ.,2016.0,10.1093/jamia/ocv121,0,0,
4837,Vidarabine therapy of simple and IDU-complicated herpetic keratitis,"ER Large scale, multiclinic evaluations of vidarabine (Ara-A, Vira A, adenine arabinoside) for treating herpetic keratitis have been conducted as double-blind studies (169 patients) in comparison with IDU and open studies (146 patients). In the open studies, the disease in the majority of patients had been refractory to IDU. The effects of vidarabine and IDU were approximately the same in improvement of symptoms (lacrimination, photophobia, sensitivity) and percent of and time for corneal reepithelialization. With vidarabine, significantly more patients had improved distant visual acuity than did with IDU. In the open studies, vidarabine also was effective. Of 116 patients whose ulcers had not responded to IDU, 91 (78%) had reepithelialization within four weeks of treatment with vidarabine. On the basis of results from these studies, vidarabine appears to be a safe and effective drug for treating herpes simplex keratitis.","Pavan-Langston, D; Buchanan, R",1976.0,,0,0,
4838,Cognitive-behavior therapy vs exposure therapy in the treatment of PTSD in refugees.,"The present study investigated the efficacy of cognitive-behavior therapy (CBT) and exposure therapy (E) in the treatment of post-traumatic stress disorder (PTSD) in refugees. Sixteen outpatients fulfilling the DSM-IV criteria for PTSD were randomized to one of the two treatments. Assessor and self-report measures of PTSD-symptoms, generalized anxiety, depression, quality of life and cognitive schemas were administered before and after treatment, and at a 6-month follow-up. The patients were treated individually for 16-20 weekly sessions. The results showed that both treatments resulted in large improvements on all the measures, which were maintained at the follow-up. There was no difference between E and CBT on any measure. E and CBT led to a 48 and 53% reduction on PTSD-symptoms, respectively, a 49 and 50% reduction on generalized anxiety, and a 54 and 57% reduction on depression. The results were maintained at the 6-month follow-up. The conclusion that can be drawn is that both E and CBT can be effective treatments for PTSD in refugees.",Paunovic N.; Ost LG.,2001.0,,0,0,
4839,Cognitive behavioral therapy for compulsive buying disorder.,"To our knowledge, no psychotherapy treatment studies for compulsive buying have been published. The authors conducted a pilot trial comparing the efficacy of a group cognitive behavioral intervention designed for the treatment of compulsive buying to a waiting list control. Twenty-eight subjects were assigned to receive active treatment and 11 to the waiting list control group. The results at the end of treatment showed significant advantages for cognitive behavioral therapy (CBT) over the waiting list in reductions in the number of compulsive buying episodes and time spent buying, as well as scores on the Yale-Brown Obsessive Compulsive Scale--Shopping Version and the Compulsive Buying Scale. Improvement was well-maintained at 6-month follow-up. The pilot data suggests that a cognitive behavioral intervention can be quite effective in the treatment of compulsive buying disorder. This model requires further testing.",Mitchell JE.; Burgard M.; Faber R.; Crosby RD.; de Zwaan M.,2006.0,10.1016/j.brat.2005.12.009,0,0,
4840,Safety behaviour does not necessarily interfere with exposure therapy.,"There has been much recent controversy regarding whether or not the use of safety and other neutralizing behaviour interferes with exposure-based therapy. The aim of this study was to examine the role of safety behaviour in the treatment of specific phobia. Sixty-two snake-fearful participants were randomized to a 45-min exposure session with or without the use of safety gear, such as gloves and goggles. During the treatment, participants in the safety behaviour group were able to achieve a significantly closer initial distance of approach to the snake compared to controls. When tested post-treatment without any safety gear, both groups demonstrated comparable treatment gains involving significant reductions in fearful cognitions and subjective anxiety, as well as significant improvements in distance of approach. Results suggest that reliance on safety behaviour during exposure therapy for anxiety disorders may not interfere with treatment outcome.",Milosevic I.; Radomsky AS.,2008.0,10.1016/j.brat.2008.05.011,0,0,
4841,"Cognitive and behavioral treatments of agoraphobia: clinical, behavioral, and psychophysiological outcomes.",,Michelson L.; Mavissakalian M.; Marchione K.,1985.0,,0,0,
4842,Psychophysiological outcome of behavioral and pharmacological treatments of agoraphobia.,,Michelson L.; Mavissakalian M.,1985.0,,0,0,
4843,"The relationship of attributional style to agoraphobia severity, depression, and treatment outcome.","The present study examined the relationship of attributional style, as measured with a revised version of the Attributional Style Questionnaire (ASQ) and measures of agoraphobia severity, depression, and treatment outcome in 73 Ss who met DSM-III criteria for agoraphobia with panic attacks and participated in one of three 13-week treatment conditions: paradoxical intention, graduated exposure, or progressive deep muscle relaxation training. Subjects completed assessments at four periods: pretreatment, midtreatment, posttreatment, and at 3 month follow-up. In addition to the three dimensions typically examined on the ASQ, this revised version also measured Ss' estimates of the perceived importance, and future likelihood for both positive and negative events. Congruent with previous research, moderate but somewhat inconsistent associations were observed between attributional style and depression both within and across assessment periods. Predictions about associations between attributional style and agoraphobic severity were not supported; however, an interaction was observed between depression and attributional style with respect to severity of agoraphobia. There was no evidence of group differences across treatment types, although there were several significant changes in attributional style across time. Attributions for health related events were also examined. Conceptual, clinical, and research issues related to the findings are discussed.",Michelson LK.; Bellanti CJ.; Testa SM.; Marchione N.,1997.0,,0,0,
4844,"Treatment consonance and response profiles in agoraphobia: the role of individual differences in cognitive, behavioral and physiological treatments.",,Michelson L.,1986.0,,0,0,
4845,The clinical effectiveness of guided self-help versus waiting-list control in the management of anxiety and depression: a randomized controlled trial,"ER METHODA total of 114 patients were randomized either to guided self-help or a waiting-list control group. All patients were followed up 3 months later, prior to starting conventional psychological therapy. Measures included self-reported adherence to the intervention, anxiety and depressive symptoms, social functioning and patient satisfaction.RESULTSAdherence to the guided self-help intervention was acceptable and patients reported satisfaction with the intervention. However, there were no statistically significant differences between groups in anxiety and depression symptoms at 3 months.CONCLUSIONSThe results demonstrate that this model of guided self-help did not provide additional benefit to patients on a waiting list for psychological therapy. The results are considered in the context of possible internal and external validity threats, and compared with previous trials of minimal interventions. The implications of the results for the design of future minimal interventions are considered.BACKGROUNDThere are significant barriers to accessing effective psychological therapy in primary care resulting from a lack of suitably trained therapists to meet current demand. More efficient service delivery using minimal interventions (such as bibliotherapy) provided by paraprofessional therapists may be one method of overcoming these problems, and is the subject of attention in the UK and elsewhere. A randomized trial was conducted to test the clinical effectiveness of this model. Assistant psychologists delivered a guided self-help intervention to patients with anxiety and depression who were currently waiting for psychological therapy.","Mead, N; MacDonald, W; Bower, P; Lovell, K; Richards, D; Roberts, C; Bucknall, A",2005.0,10.1017/S003329170500560X,0,0,
4846,"A randomized, controlled trial of virtual reality-graded exposure therapy for post-traumatic stress disorder in active duty service members with combat-related post-traumatic stress disorder.","Abstract Virtual reality (VR)-based therapy has emerged as a potentially useful means to treat post-traumatic stress disorder (PTSD), but randomized studies have been lacking for Service Members from Iraq or Afghanistan. This study documents a small, randomized, controlled trial of VR-graded exposure therapy (VR-GET) versus treatment as usual (TAU) for PTSD in Active Duty military personnel with combat-related PTSD. Success was gauged according to whether treatment resulted in a 30 percent or greater improvement in the PTSD symptom severity as assessed by the Clinician Administered PTSD Scale (CAPS) after 10 weeks of treatment. Seven of 10 participants improved by 30 percent or greater while in VR-GET, whereas only 1 of the 9 returning participants in TAU showed similar improvement. This is a clinically and statistically significant result (χ(2) = 6.74, p < 0.01, relative risk 3.2). Participants in VR-GET improved an average of 35 points on the CAPS, whereas those in TAU averaged a 9-point improvement (p < 0.05). The results are limited by small size, lack of blinding, a single therapist, and comparison to a relatively uncontrolled usual care condition, but did show VR-GET to be a safe and effective treatment for combat-related PTSD.",McLay RN.; Wood DP.; Webb-Murphy JA.; Spira JL.; Wiederhold MD.; Pyne JM.; Wiederhold BK.,2011.0,10.1089/cyber.2011.0003,0,0,
4847,Effectiveness of operationalized Gestalt therapy role-playing in the treatment of phobic behaviors.,"The Gestalt therapy role-playing technique applied to dreams is based on the assumption that unwarranted avoidance behaviors in a dream are maintained by failing to recognize that the aversive properties attributed to avoided stimuli are self-created. This study extrapolates that the recognition of these projections through the Gestalt role-playing technique also can reduce avoidance in phobic behavior. 24 Ss with phobias were assigned to 3 groups. The role-playing technique varied as follows: full treatment (FT), role-playing both phobic responses and aversive properties attributed to the phobic stimulus; stimulus role-playing (SRP), role-playing only aversive properties attributed to the phobic stimulus; and response role-playing (RRP), role-playing only phobic responses. The groups that role-played aversive properties attributed to the phobic stimulus (FT and SRP) were significantly more effective in reducing their phobias than the RRP group. Results are interpreted as support for the Gestalt therapy projections construct. The cognitive restructuring related to the reduction of a phobic response may be achieved more effectively through a role-playing technique focusing on reenacting the aversive properties attributed to the phobic stimulus rather than on the phobic response. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Martinez, Mario E; Cohen, Endler, Fagan, Johnson, Kirk, Langer, Marks, Moxnes, Osgood, Paul, Perls, Perls, Perls, Polster, Raming, Speilberger, Wolpe",2002.0,,0,0,
4848,Alprazolam and exposure alone and combined in panic disorder with agoraphobia. A controlled study in London and Toronto.,"A cross-national randomised trial of alprazolam for chronic panic disorder with agoraphobia was run. Compared with previous trials it had three new features: an exposure therapy contrast group, a six-month treatment-free follow-up, and a low rate of early placebo drop-outs ('non-evaluables'). The dose of alprazolam was high (5 mg/day). The 154 patients had eight weeks of: alprazolam and exposure (combined treatment); or alprazolam and relaxation (a psychological placebo); or placebo and exposure; or placebo and relaxation (double placebo). Drug taper was from weeks 8 to 16. Follow-up was to week 43. Results were similar at both sites. Treatment integrity was good. All four treatment groups, including double placebo, improved well on panic throughout. On non-panic measures, by the end of treatment, both alprazolam and exposure were effective, but exposure had twice the effect size of alprazolam. During taper and follow-up, gains after alprazolam were lost, while gains after exposure were maintained. Combining alprazolam with exposure marginally enhanced gains during treatment, but impaired improvement thereafter. The new features put previous trails in a fresh light. By the end of treatment, though gains on alprazolam were largely as in previous studies, on phobias and disability they were half those with exposure. Relapse was usual after alprazolam was stopped, whereas gains persisted to six-month follow-up after exposure ceased. Panic improved as much with placebo as with alprazolam or exposure.",Marks IM.; Swinson RP.; Başoğlu M.; Kuch K.; Noshirvani H.; O'Sullivan G.; Lelliott PT.; Kirby M.; McNamee G.; Sengun S.,1993.0,,0,0,
4849,Drug versus behavioral treatment of obsessive-compulsive disorder.,,Marks I.,1990.0,,0,0,
4850,Treatment preferences of psychotherapy patients with chronic PTSD.,"Patient treatment preference may moderate treatment effect in major depressive disorder (MDD) studies. Little research has addressed preference in posttraumatic stress disorder (PTSD); almost none has assessed actual patients' PTSD psychotherapy preferences. From a 14-week trial of chronic PTSD comparing prolonged exposure, relaxation therapy, and interpersonal psychotherapy, we report treatment preferences of the 110 randomized patients, explore preference correlates, and assess effects on treatment outcome. Patients recruited between 2008 and 2013 with chronic DSM-IV PTSD (Clinician-Administered PTSD Scale [CAPS] score ‚â• 50) received balanced, scripted psychotherapy descriptions prerandomization and indicated their preferences. Analyses assessed relationships of treatment attitudes to demographic and clinical factors. We hypothesized that patients randomized to preferred treatments would have better outcomes, and to unwanted treatment worse outcomes. Eighty-seven patients (79%) voiced treatment preferences or disinclinations: 29 (26%) preferred prolonged exposure, 29 (26%) preferred relaxation therapy, and 56 (50%) preferred interpersonal psychotherapy (Cochran Q = 18.46, P < .001), whereas 29 (26%) were disinclined to prolonged exposure, 18 (16%) to relaxation therapy, and 3 (3%) to interpersonal psychotherapy (Cochran Q = 22.71, P < .001). Several baseline clinical variables correlated with treatment preferences. Overall, treatment preference/disinclination did not predict change in CAPS score, treatment response, or dropout. Comorbidly depressed patients receiving unwanted treatment had worse final CAPS scores. These exploratory findings are the first relating patients' PTSD psychotherapy preferences to outcome. Despite explanations emphasizing prolonged exposure's greater empirical support, patients significantly preferred interpersonal psychotherapy. Preference subtly affected psychotherapy outcome; depression appeared an important moderator of the effect of unwanted treatment on outcome. Potential biases to avoid in future research are discussed. ClinicalTrials.gov identifier: NCT00739765.",Markowitz JC.; Meehan KB.; Petkova E.; Zhao Y.; Van Meter PE.; Neria Y.; Pessin H.; Nazia Y.,2016.0,10.4088/JCP.14m09640,0,0,
4851,Evaluation of a DVD-based self-help program in highly socially anxious individuals--pilot study.,"High social anxiety is a risk factor for the incidence of social anxiety disorder (SAD). Early diagnosis and intervention may prevent more severe psychiatric courses. Self-help programs may be a convenient, accessible, and effective intervention. This study examined the efficacy of a newly developed self-help program for SAD in individuals with subthreshold social anxiety. A total of 24 highly socially anxious individuals were randomly assigned to a DVD-based self-help program or to a wait-list control group. The self-help program is based on the cognitive model according to Clark and Wells (1995; adapted to German by Stangier, Clark, & Ehlers, 2006) and comprises eight sessions. ANOVAs based on an intention-to-treat model were used for data analyses. The self-help program was well accepted; just one person withdrew during the intervention. There were significant Time√ó Group interactions on all primary outcome measures. For the intervention group moderate to high within-groups effect sizes up to Cohen's d = 1.05 were obtained. Between-groups effect sizes ranged from 0.24 to 0.65 in favor of the active intervention. The newly developed DVD-based self-help program seems to be a promising intervention for highly socially anxious individuals as it reduces social anxiety symptoms.",Mall AK.; Mehl A.; Kiko S.; Kleindienst N.; Salize HJ.; Hermann C.; Hoffmann T.; Bohus M.; Steil R.,2011.0,10.1016/j.beth.2010.11.007,0,0,
4852,Occupational impact of internet-delivered cognitive behaviour therapy for depression and anxiety: reanalysis of data from five Australian randomised controlled trials.,"To determine whether internet-delivered cognitive behaviour therapy (iCBT) for depression and anxiety reduces self-reported absenteeism in employed individuals. We reanalysed data from five randomised controlled trials of iCBT: two for depression (conducted from September 2008 to February 2009 and from June 2009 to January 2010), two for generalised anxiety disorder (conducted from March 2009 to June 2009 and from July 2009 to January 2010) and one for social phobia (conducted from May 2008 to July 2008). Participants across Australia were recruited via a website. The inclusion criteria were: (i) meets criteria for the disorder of interest; (ii) aged 18 years or over; (iii) no previous history of a psychotic disorder or drug or alcohol misuse; (iv) not actively suicidal. The iCBT courses each consisted of six online lessons (to be completed within 11 weeks), homework assignments, automatic emails and resource documents. The number of days absent (self-reported absenteeism) in the previous week. We included 284 participants in our analysis. When data for the three disorders were combined, participants who received iCBT had significant reductions in self-reported absenteeism compared with those in the control groups (who were on a waitlist) (P = 0.03). When data for the three disorders were analysed separately, reductions in self-reported absenteeism for participants who received iCBT were not significantly different to those for participants in the control groups. Using data from five RCTs, we showed that iCBT was associated with reductions in self-reported absenteeism. Future research should focus on replicating these findings in other contexts, such as other disorders and other iCBT courses.",Mackenzie A.; Harvey S.; Mewton L.; Andrews G.,2014.0,,0,0,
4853,Comorbidity in the prediction of Cognitive Processing Therapy treatment outcomes for combat-related posttraumatic stress disorder.,"This paper examines clinical predictors of posttraumatic stress disorder (PTSD) treatment outcomes following Cognitive Processing Therapy (CPT) in Australian military veterans. Fifty nine treatment seeking veterans were enrolled in a randomized controlled trial comparing 12 sessions of CPT (n = 30) with usual treatment (n = 29) at three community-based veterans counseling centers. PTSD and key co-morbidities (depression, anxiety, anger and alcohol use) were measured. Growth curve modeling was used to examine factors which influenced PTSD severity post-treatment. For the CPT condition, baseline anger was the only co-morbidity predictive of change in PTSD severity over time. Participants with higher anger scores showed less of a decrease in PTSD severity over time. Higher anxiety in participants in treatment as usual was significantly associated with better treatment gains. This research suggests that veterans experiencing high levels of anger might benefit from targeted anger reduction strategies to increase the effectiveness of CPT treatment for PTSD.",Lloyd D.; Nixon RD.; Varker T.; Elliott P.; Perry D.; Bryant RA.; Creamer M.; Forbes D.,2014.0,10.1016/j.janxdis.2013.12.002,0,0,
4854,Cognitive behavioral wisdom psychotherapy in the treatment of Posttraumatic Embitterment Disorders,"Background: Negative life events can result in adjustment disorders. If there are feelings of having been treated unfair, been let down or been humiliated one type of reaction are prolonged states of embitterment, which has been described as Posttraumatic Embitterment Disorder, PTED. A new approach in the treatment of PTED is cognitive behavioral psychotherapy which uses special strategies based on wisdom psychology. Wisdom has been defined as the capacity to cope with unsolvable and serious problems and questions in life. Method: In a controlled clinical trial psychosomatic inpatients which suffered from PTED, were randomly assigned to “wisdom therapy” (N=28), which focusses on the reframing of the traumatic event and to “wisdom and headonia therapy” (N=29), which additionally encourages patients to focus on positive aspects in life. Another group of PTED patients (N=50) and patients with other mental disorders (N=50) received treatment as usual. Results: PTED patients who were treated with wisdom psychotherapy showed a reduction in the SCL-90-PST score of initially 55,7 and at the end of 40,1 and those treated with hedonia therapy of initially 58,7 and at the end of 41,3. Measures of therapist adherence showed that therapists in both groups used wisdom strategies. PTED controls started initially with a SCL-90-PST score of 52,2 and ended with 50,2. Other patients started treatment with 39,3 and finished with 25,9. Discussion: This first treatment study on cognitive wisdom therapy suggests that wisdom can be helpful in the treatment of adjustment and embitterment disorders.",Linden M.; Baumann K.; Lieberei B.,2010.0,10.1016/S0924-9338(10)71047-6,0,0,
4855,Effects of psychotherapy on regional cerebral blood flow during trauma imagery in patients with post-traumatic stress disorder: a randomized clinical trial.,"Functional brain-imaging studies in post-traumatic stress disorder (PTSD) have suggested functional alterations in temporal and prefrontal cortical regions. Effects of psychotherapy on these brain regions have not yet been examined. Twenty civilian PTSD out-patients and 15 traumatized control subjects were assessed at baseline using psychometric ratings. Cerebral blood flow was measured using trauma script-driven imagery during 99mtechnetium hexamethyl-propylene-amine-oxime single-photon emission computed tomography scanning. All 20 out-patients were randomly assigned to treatment or wait-list conditions. Treatment was brief eclectic psychotherapy (BEP) in 16 weekly individual sessions. At baseline, greater activation was found in the right insula and right superior/middle frontal gyrus in the PTSD group than in the control group. PTSD patients treated with BEP significantly improved on all PTSD symptom clusters compared to those on the waiting list. After effective psychotherapy, lower activation was measured in the right middle frontal gyrus, compared to the PTSD patients on the waiting list. Treatment effects on PTSD symptoms correlated positively with activation in the left superior temporal gyrus, and superior/middle frontal gyrus. BEP induced clinical recovery in PTSD patients, and appeared to modulate the functioning of specific PTSD-related sites in the prefrontal cortical regions.",Lindauer RJ.; Booij J.; Habraken JB.; van Meijel EP.; Uylings HB.; Olff M.; Carlier IV.; den Heeten GJ.; van Eck-Smit BL.; Gersons BP.,2008.0,10.1017/S0033291707001432,0,0,
4856,Cognitive-behavior therapy vs exposure therapy in the treatment of PTSD in refugees.,"Investigated the efficacy of cognitive-behavior therapy (CBT) and exposure therapy (E) in the treatment of post-traumatic stress disorder (PTSD) in refugees. 16 outpatients (aged 22-48 yrs) fulfilling the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for PTSD were randomized to one of the two treatments. Assessor and self-report measures of PTSD-symptoms, generalized anxiety, depression, quality of life and cognitive schemas were administered before and after treatment, and at a 6-mo follow-up. The patients were treated individually for 16-20 weekly sessions. The results showed that both treatments resulted in large improvements on all the measures, which were maintained at the follow-up. There was no difference between E and CBT on any measure. E and CBT led to a 48 and 53% reduction on PTSD-symptoms, respectively, a 49 and 50% reduction on generalized anxiety, and a 54 and 57% reduction on depression. The results were maintained at the 6-mo follow-up. The conclusion that can be drawn is that both E and CBT can be effective treatments for PTSD in refugees. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Paunovic, Nenad; Ost, Lars-Goran; Agger, Beck, Beck, Beck, Blake, Blake, Brown, Carlson, Cheung, Cienfuegos, Davidson, Egli, Ehlers, Foa, Foa, Foa, Foa, Foa, Frisch, Gorst-Unsworth, Hamilton, Hamilton, Helzer, Hoberman, Jacobson, Janoff-Bulman, Janoff-Bulman, Kinzie, Lavik, Marks, Meichenbaum, Ost, Perkonigg, Petersen, Resick, Resnick, Spielberger, Tarrier, Weine, Weiss",2001.0,,0,0,
4857,Reliability and acceptability of psychiatric diagnosis via telecommunication and audiovisual technology.,"The reliability of psychiatric diagnoses made remotely by telecommunication was examined. Two trained interviewers each interviewed the same 30 psychiatric inpatients using the Structured Clinical Interview for DSM-III-R. Fifteen subjects had two in-person interviews, and 15 subjects had one in-person and one remote interview via telecommunication. Interrater reliability was calculated for the four most common diagnoses: major depression, bipolar disorder, panic disorder, and alcohol dependence. For each diagnosis, interrater reliability (kappa statistic) was identical or almost identical for the patients who had two in-person interviews and those who had an in-person and a remote interview, suggesting that reliable psychiatric diagnoses can be made via telecommunication.",Ruskin PE.; Reed S.; Kumar R.; Kling MA.; Siegel E.; Rosen M.; Hauser P.,1998.0,10.1176/ps.49.8.1086,0,0,
4858,Pain catastrophizing and pain-related emotions: Influence of age and type of pain,"Objectives: One of the most important determinants of the individual pain experience is pain catastrophizing, reflecting an excessively negative cognitive and emotional orientation toward pain. Its assessment by standard questionnaires, which ask participants to reflect on idiosyncratic past painful experiences, is important. It is currently not known whether different types of pain differently shape pain catastrophizing. Furthermore, as the regulation of emotions changes during the life span, age may affect pain catastrophizing, as well. Methods: In this study, 134 healthy participants, differentiated into 2 age groups (20 to 40 y and 50 to 70 y), completed the Pain Catastrophizing Scale with reference to their past experiences with 3 common types of day-to-day pain (headache, back pain, dental pain). Results: On average, the different types of pain shared one-third of the variance in pain catastrophizing. Pain-type-specific catastrophizing scores were more strongly related to ratings of sensory and emotional pain characteristics than standard catastrophizing scores. In younger adults, pain catastrophizing was preferentially associated with emotional responses to pain whereas in older adults, it was preferentially associated with pain intensity ratings. Discussion: This study indicates that for day-to-day pain, catastrophizing significantly depends on pain type. The results suggest the use of pain-type-specific instructions for catastrophizing questionnaires because it may lead to better prediction of clinically relevant pain characteristics, such as pain intensity. Furthermore, pain catastrophizing seems to change during the life span, with a higher engagement of emotional versus sensory pain processing in younger compared with older adults. Copyright © 2011 by Lippincott Williams & Wilkins.",Ruscheweyh R.; Nees F.; Marziniak M.; Evers S.; Flor H.; Knecht S.,2011.0,10.1097/AJP.0b013e31820fde1b,0,0,
4859,Virtual reality exposure and imaginal exposure in the treatment of fear of flying: a pilot study.,"Fear of flying (FF) is an impairing psychological disorder that is extremely common in developed countries. The most effective treatment for this particular type of phobia is exposure therapy. However, there are few studies comparing imaginal exposure (IE) and virtual reality (VR) exposure for the treatment of FF. The present study compared the effectiveness of these two approaches using two manualized interventions based on the exposure technique. Patients with FF (N = 15) were randomly assigned to either VR (n = 7) or IE therapy (n = 8), consisting of a total of eight sessions: two assessment sessions (pre-treatment and after the real flight) and six exposure therapy sessions, which were conducted twice a week. During each exposure session, subjective perceived anxiety was measured every 5 min. Participants were also asked to sit through a real flight immediately after the treatment. The results showed no differences between the two treatments in relation to reduced clinical symptomatology associated with the FF, although participants in the VR group experienced less anxiety during the real flight after treatment. Furthermore, at 6-month follow-up, danger expectations and flight anxiety continued to decrease in participants who had received the VR exposure therapy, and four of these seven participants took at least one more flight.",Rus-Calafell M.; Gutiérrez-Maldonado J.; Botella C.; Baños RM.,2013.0,10.1177/0145445513482969,0,0,
4860,Cognitive remediation therapy during treatment for alcohol dependence.,"Cognitive impairments in individuals with alcohol dependence may interfere with the progress of treatment and contribute to the progression of the disease. This study aimed to determine whether cognitive remediation (CR) therapy applied during treatment for alcohol dependence improves cognitive functioning in alcohol-dependent inpatients. A secondary aim was to evaluate whether the benefits of CR generalize to noncognitive clinically meaningful outcomes at the end of inpatient treatment. Forty-one alcohol-dependent patients entering inpatient treatment for alcohol dependence were randomly assigned to receive conventional treatment (n = 21) or an additional 12 sessions of computer-assisted CR focusing on cognitive enhancement in attention/executive function and memory domains (n = 20). Assessments of cognitive abilities in these domains as well as of psychological well-being and alcohol craving were conducted at baseline (at the beginning of inpatient treatment) and after CR (at the end of treatment). Results indicated that, relative to patients completing conventional treatment, those who received supplemental CR showed significant improvement in attention/executive function and memory domains, particularly in attention (alertness, divided attention), working memory, and delayed memory (recall). In addition, patients receiving CR during alcohol-dependence treatment showed significantly greater improvements in psychological well-being (Symptom Checklist-90-Revised) and in the compulsion aspect of craving (Obsessive Compulsive Drinking Scale-German version). CR during inpatient treatment for alcohol dependence is effective in improving cognitive impairments in alcohol-dependent patients. The benefits generalize to noncognitive outcomes, demonstrating that CR may be an efficacious adjunctive intervention for the treatment of alcohol dependence.",Rupp CI.; Kemmler G.; Kurz M.; Hinterhuber H.; Fleischhacker WW.,2012.0,,0,0,
4861,The psychological impact of Buddhist counseling for patients suffering from symptoms of anxiety.,"The purpose of this study was to examine the outcomes of individual Buddhist counseling interventions for patients suffering from symptoms of anxiety. A single-group pretest and posttest design was used to measure outcomes. Twenty-one patients participated in the study as voluntary subjects, all of whom completed two sessions of Buddhist counseling interventions. The individual Buddhist counseling program was developed by the investigators based on the Buddhist doctrine. The outcomes were evaluated with the use of the State-Trait Anxiety Inventory. Data were analyzed using the Friedman test, which provides an indicator for evidence-based outcomes related to anxiety reduction scores. The results revealed that the scores on the state anxiety test in relation to the trait anxiety test had been reduced at the 1-month follow-up. The findings from content analysis showed that when the patients practiced mindfulness, they were able to accept unpleasant situations calmly. Sixteen patients were prescribed lower doses of antianxiety medications. Furthermore, medication was discontinued for two patients, and three other patients continued their prescribed medication regimen completely. The study indicates that counseling as a basis from Buddhist principles has the potential to benefit patients with emotional anxiety-based problems. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rungreangkulkij, Somporn; Wongtakee, Wiwat; Awutkom, Baer, Blair, Brewin, Desai, Fishel, Kabat-Zinn, King, Miller, Naka, Otto, Prayudh, Rickels, Roemer, Smith, Speca, Spielberger, Tanphaichitr, Weiss, Wood, Zaider",2008.0,,0,0,
4862,The psychological impact of Buddhist counseling for patients suffering from symptoms of anxiety.,"The purpose of this study was to examine the outcomes of individual Buddhist counseling interventions for patients suffering from symptoms of anxiety. A single-group pretest and posttest design was used to measure outcomes. Twenty-one patients participated in the study as voluntary subjects, all of whom completed two sessions of Buddhist counseling interventions. The individual Buddhist counseling program was developed by the investigators based on the Buddhist doctrine. The outcomes were evaluated with the use of the State-Trait Anxiety Inventory. Data were analyzed using the Friedman test, which provides an indicator for evidence-based outcomes related to anxiety reduction scores. The results revealed that the scores on the state anxiety test in relation to the trait anxiety test had been reduced at the 1-month follow-up. The findings from content analysis showed that when the patients practiced mindfulness, they were able to accept unpleasant situations calmly. Sixteen patients were prescribed lower doses of antianxiety medications. Furthermore, medication was discontinued for two patients, and three other patients continued their prescribed medication regimen completely. The study indicates that counseling as a basis from Buddhist principles has the potential to benefit patients with emotional anxiety-based problems.",Rungreangkulkij S.; Wongtakee W.,2008.0,10.1016/j.apnu.2007.07.004,0,0,
4863,Non-conscious modulation of cardiac defense by masked phobic pictures.,"The present study investigated the modulation of cardiac defense by presenting emotional pictures under both effective and non-effective masking procedures. The aim was to test Ohman's model of pre-attentive processing of fear. Participants were 48 women volunteers with intense fear of spiders. The stimulus to elicit cardiac defense was a white noise of 105 dB, 500 ms duration and instantaneous risetime. Subjects had two trials of picture-noise presentation-one with a picture of a spider and one with a picture of a flower-, either under an effective masking procedure (30 ms duration) or a non-effective masking procedure (500 ms duration). Order of presentation was counterbalanced. Dependent variables were heart rate and subjective assessment of the noise. Results showed an increased cardiac response in the first trial and a less reduced cardiac response in the second trial when the noise was preceded by the phobic picture under both masking procedures. The response was accompanied by an increase in the subjective unpleasantness of the noise. These results provide support to Ohman's theoretical model.",Ruiz-Padial E.; Mata JL.; Rodríguez S.; Fernández MC.; Vila J.,2005.0,10.1016/j.ijpsycho.2004.12.010,0,0,
4864,Adaptation of the trier social stress test to virtual reality: Psycho-phsyiological and neuroendocrine modulation,"The Trier Social Stress Test (TSST; Kirschbaum et al., 1993) is currently the most commonly used psychosocial stressor to generate a response of the axes involved in stress. The TSST has proven effective in the activation of the hypothalamic-pituitary-adrenal axis. In addition, new technologies, such as virtual reality (VR), are being integrated into stress research protocols (Kelly et al., 2007). To determine whether TSST as applied to VR leads to the sympathetic and neuroendocrine activation in a group of healthy individuals. Also, this study aims to connect this response with different psychological variables regarding stress vulnerability, psychopathology, and personality. Twenty-one university students (6 male and 15 female) were exposed to a modified version of the TSST adapted to a virtual environment (VE), in which they have to deliver a speech. Electrodermal activity and salivary cortisol secretion were simultaneously registered at different instances. After the task, sympathetic activation was observed in all participants, as well as increase in the cortisol secretion in 14 of the students. This increase was statistically significant in the moment prior to the speech and the moment after in the responder group. In the same fashion, statistically significant differences were found in the responder group only regarding obsession and compulsion scales and extroversion, which were higher in the responder group. Our findings support the use of the TSST paradigm in VR as an experimental situation appropriate to research designs in laboratory aiming to study the modulation of the axes implied in response to stress. © Virtual Reality Medical Institute.",Ruiz A.S.; Peralta-Ramirez M.I.; Garcia-Rios M.C.; Muñoz M.A.; Navarrete-Navarrete N.; Blazquez-Ortiz A.,2010.0,,0,0,
4865,Well-Being Therapy of generalized anxiety disorder. A controlled clinical trial.,"Background: There is increasing awareness that the goal of treatment in Generalized Anxiety Disorder (GAD) should not simply be a response, but restoration of normal function. The aim of this study was to apply a novel psychotherapeutic approach for increasing the level of remission in GAD. Methods: Twenty patients with DSM-IV GAD devoid of comorbid conditions were randomly assigned to 8 sessions of Cognitive Behavioral Therapy (CBT) or the sequential administration of 4 sessions of CBT followed by other 4 sessions of Well-Being Therapy (WBT). Assessment methods included the Anxiety and Depression Scales of Paykel's Clinical Interview for Depression (CID), Ryff's Psychological Well-Being Scales (PWB) and Kellner's Symptom Questionnaire (SQ). A one-year follow-up was undertaken. Results: Significant advantages of the CBT-WBT sequential combination over CBT only were observed with both observer and self-rated methods after treatment. Such gains were maintained at follow-up. Conclusions: These preliminary results suggest the feasibility and clinical advantages of adding WBT to the treatment of GAD. They lend support to a sequential use of treatment components for achieving a more sustained recovery. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Ruini, Chiara; Rafanelli, Chiara; Belaise, Carlotta; Mangelli, Lara; Fabbri, Stefania; Fava, Giovanni Andrea; Ballenger, Bech, Beck, Borkovec, Borkovec, Butler, Endicott, Fava, Fava, Fava, Fava, Fava, Fava, Fava, Fava, Fava, Fava, Goldthorpe, Gorman, Keller, Kellner, Marks, Marks, Ottolini, Paykel, Pesarin, Ruini, Ruini, Ruini, Ryff, Ryff, Vaillant",2006.0,,0,0,
4866,Racial/ethnic match and treatment outcomes for women with PTSD and substance use disorders receiving community-based treatment.,"This study examined the relationship between racial/ethnic match and treatment outcomes for 224 women who participated in a clinical trial of group treatments for posttraumatic stress disorder (PTSD) and substance use disorders. Generalized estimating equations were used to examine the effect of client-therapist racial/ethnic match on outcomes. Results revealed racial/ethnic match was not significantly associated with session attendance. There was a significant three-way interaction between client race/ethnicity, baseline level of PTSD symptoms, and racial/ethnic match on PTSD outcomes. White clients, with severe PTSD symptoms at baseline, who attended treatment groups where they were matched with their therapist, had greater reductions in PTSD symptoms at follow-up than their counterparts who were racially/ethnically mismatched with their group therapist. Racial/ethnic match did not confer additional benefits for Black clients in terms of PTSD outcomes. Racial/ethnic match interacted with baseline substance use to differentially influence substance use outcomes at follow-up for all women. Clinical implications are discussed.",Ruglass LM.; Hien DA.; Hu MC.; Campbell AN.; Caldeira NA.; Miele GM.; Chang DF.,2014.0,10.1007/s10597-014-9732-9,0,0,
4867,"Associations between post-traumatic stress symptoms, stimulant use, and treatment outcomes: a secondary analysis of NIDA's Women and Trauma study.","To examine the associations between post-traumatic stress disorder (PTSD) symptoms, stimulant use, and treatment outcomes among dually diagnosed women. Participants were 141 women who participated in a multisite clinical trial of group treatments for PTSD and addictions. Generalized linear models indicated Seeking Safety (SS; a cognitive-behavioral intervention) was significantly more effective than Women's Health Education (WHE; a control group intervention) in reducing stimulant use at follow-up among women who were heavy stimulant users at pre-treatment and who showed improvements in PTSD symptoms. There were no significant differences between the interventions among women who were light stimulant users at treatment entry. These findings suggest that integrated treatment of co-occurring PTSD and addictions may be more effective than general health education approaches for heavy stimulant users. Assessment of frequency of stimulant use among individuals with PTSD symptoms may inform treatment selection for this population.",Ruglass LM.; Hien DA.; Hu MC.; Campbell AN.,,10.1111/j.1521-0391.2013.12068.x,0,0,4599
4868,"Helping alliance, retention, and treatment outcomes: A secondary analysis from the NIDA clinical trials network women and trauma study.","We examined the association between the therapeutic alliance and treatment outcomes among 223 women with posttraumatic stress disorder (PTSD) and substance use disorders who participated in a multisite clinical trial of group treatments for trauma and addictions in the United States throughout 2004 and 2005. General linear models indicated that women who received Seeking Safety, a cognitive-behavioral treatment, had significantly higher alliance ratings than those in Women's Health Education, a control group. Alliance was related to significant decreases in PTSD symptoms and higher attendance in both interventions. Alliance was not related to substance use outcomes. Implications and limitations of the findings are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ruglass, Lesia M; Miele, Gloria M; Hien, Denise A; Campbell, Aimee N. C; Hu, Mei-Chen; Caldeira, Nathilee; Jiang, Huiping; Litt, Lisa; Killeen, Therese; Hatch-Maillette, Mary; Najavits, Lisa; Brown, Chanda; Robinson, James A; Brigham, Gregory S; Nunes, Edward V; Abouguendia, Barber, Baron, Belding, Blake, Brady, Briere, Cacciola, Carroll, Cloitre, Connors, Constantino, Cummings, De Weert-Van Oene, De Weert-Van Oene, Diggle, Foa, Folstein, Gaiton, Hasin, Herman, Hien, Hien, Hien, Horvath, Horvath, Horvath, La Salvia, Luborsky, Luborsky, Martin, McLellan, Meier, Meier, Miller, Mills, Morgan-Lopez, Najavits, Najavits, Najavits, Najavits, Ouimette, Paivio, Price, Tunis, Wampold, Weathers, Zlotnick",2012.0,,0,0,
4869,Effects of pain and prescription opioid use on outcomes in a collaborative care intervention for anxiety.,"To determine the effects of pain and opioid pain medication use on clinical and functional outcomes in 1004 primary care patients with an anxiety disorder randomized to receive the Coordinated Anxiety Learning and Management (CALM) collaborative care intervention (cognitive-behavioral therapy and/or medication) versus usual care. A total of 1004 patients with panic disorder, generalized anxiety disorder, social anxiety disorder, or posttraumatic stress disorder were randomized to CALM or usual care. Outcomes at 6, 12, and 18 months were compared in patients with and without moderate pain interference (for the entire anxiety disorder group and then just those with comorbid major depression) and in patients taking and not taking opioid medication (entire group, just those with comorbid major depression, and just those with moderate pain interference). Patients with pain interference and patients taking opioid pain medication were more anxious [Brief Symptom Inventory anxiety subscale] and disabled (Sheehan Disability) at baseline, improved over time at similar rates, but at 18 months had lower response and remission rates. There was no moderating effect on the intervention. In patients with comorbid major depression, patients using opioid medications showed a trend for less disability improvement over time, and in patients with pain, patients using opioids showed less sustained anxiety response at 18 months. Anxious patients with pain benefit as much as those without pain from cognitive-behavioral therapy and medication treatment. Among patients with pain, however, there is some evidence of a reduced anxiety treatment response in those taking opioid medication, which should be further studied.",Roy-Byrne P.; Sullivan MD.; Sherbourne CD.; Golinelli D.; Craske MG.; Sullivan G.; Stein MB.,2013.0,10.1097/AJP.0b013e318278d475,0,0,
4870,Medical illness and response to treatment in primary care panic disorder.,"Although studies have suggested that comorbid medical illness can affect the outcome of patients with depression, little is known about whether medical illness comorbidity affects treatment outcome in patients with anxiety. Primary care patients with panic disorder (n=232), participating in a randomized collaborative care intervention of CBT and pharmacology, were divided into those above (n=125) and below (n=107) the median for burden of chronic medical illness and assessed at 3, 6, 9 and 12 months. Subjects with a greater burden of medical illness were more psychiatrically ill at baseline, with greater anxiety symptom severity, greater disability and more psychiatric comorbidity. The intervention produced significant and similar increases in amount of evidence-based care, and reductions in clinical symptoms and disability that were comparable in the more and less medically ill groups. The comparable response of individuals with more severe medical illness suggests that CBT and pharmacotherapy for panic disorder work equally well regardless of medical illness comorbidity. However, the more severe psychiatric illness both at baseline and follow-up in these same individuals suggest that treatment programs may need to be extended in time to optimize treatment outcome.",Roy-Byrne P.; Stein MB.; Russo J.; Craske M.; Katon W.; Sullivan G.; Sherbourne C.,,10.1016/j.genhosppsych.2005.03.007,0,0,
4871,Poverty and response to treatment among panic disorder patients in primary care.,"Despite well-established links between poverty and poor mental illness outcome as well as recent reports exploring racial and ethnic health disparities, little is known about the outcomes of evidence-based psychiatric treatment for poor individuals. Primary care patients with panic disorder (N=232) who were participating in a randomized controlled trial comparing a cognitive behavior therapy (CBT) and pharmacotherapy intervention to usual care were divided into those patients above (N=152) and below (N=80) the poverty line. Telephone assessments at 3, 6, 9, and 12 months were used to compare the amount of evidence-based care received as well as clinical and functional outcomes. Poor subjects were more severely ill at baseline, with more medical and psychiatric comorbidity. The increases in the amount of evidence-based care and reductions in clinical symptoms and disability were comparable in the two groups such that poorer individuals, although responding equivalently, continued to be more ill and disabled at 12 months. The comparable response of poor individuals in this study suggests that standard CBT and pharmacotherapy treatments for panic disorder do not need to be ""tailored"" to be effective in poor populations. However, the more severe illness both at baseline and follow-up in these poor individuals suggests that treatment programs may need to be extended in order to treat residual symptoms and disability in these patients so that they might achieve comparable levels of remission.",Roy-Byrne P.; Sherbourne C.; Miranda J.; Stein M.; Craske M.; Golinelli D.; Sullivan G.,2006.0,10.1176/ajp.2006.163.8.1419,0,0,
4872,Microvascular angina and panic disorder,"ER Recent cardiac studies have suggested that patients with chest pain and angiographically normal coronaries have ""microvascular angina"" (MVA). In contrast, prior psychiatric studies have shown that some of these patients have panic disorder (PD). We compared the clinical and psychologic characteristics of fifteen patients with MVA and fifteen patients with panic disorder (PD), and examined response to lactate infusion in a subgroup of MVA patients. Although 40 percent of MVA patients met criteria for PD and had chest pain following lactate infusion, there were psychologic and symptomatic differences between the MVA and PD groups. These results reflect either co-morbidity of MVA and PD in some patients or two types of MVA, one of primary cardiac origin and one a centrally mediated epiphenomenon of the increased autonomic arousal seen in PD.","Roy-Byrne, P P; Schmidt, P; Cannon, R O; Diem, H; Rubinow, D R",1989.0,,0,0,
4873,Panic disorder in primary care: biopsychosocial differences between recognized and unrecognized patients,"ER Studies suggest that the recognition of depression by primary care physicians (PCPs) is most likely in more symptomatic and impaired patients. As part of a randomized effectiveness study in primary care patients with panic disorder, we examined the baseline characteristics of study patients who were recruited by waiting room screen procedure (n=69) versus patients who were referred to the study by their PCP (n=41). Patients referred by their physicians had a significantly higher frequency of panic attacks, more intense attacks, and more anticipatory anxiety on the Panic Disorder Severity Scale, while screen-identified patients were more medically ill and had worse physical functioning on the SP36. There were no differences in anxiety sensitivity, phobic avoidance, depression, other SF36 measures, disability, or medical service utilization. In conclusion, differences in referred versus screened patients are mostly specific for panic attack-related symptoms, consistent with the notion that patients with more prominent physical symptoms (i.e., panic attacks) are more often recognized and referred in busy clinical settings. The better medical status and physical functioning of referred patients may indicate greater physician recognition of panic in patients who appear less medically ill. However, the many clinical and functional similarities between these two patient samples suggests that symptomatic primary care patients with panic may not always be identified by their PCPs and argues for the value of population-based screening for panic in primary care.","Roy-Byrne, P P; Katon, W; Cowley, D S; Russo, J E; Cohen, E; Michelson, E; Parrot, T",2000.0,,0,0,4613
4874,Attention bias toward threat in pediatric anxiety disorders,"ER METHODStudy participants included 101 children and adolescents (ages 7-18 years) with generalized anxiety disorder, social phobia, and/or separation anxiety disorder enrolled in a multisite anxiety treatment study. Nonanxious youths (n = 51; ages 9-18 years) were recruited separately. Participants were administered a computerized visual probe task that presents pairs of faces portraying threat (angry), positive (happy), and neutral expressions. They pressed a response key to indicate the spatial location of a probe that replaced one of the faces on each trial. Attention bias scores were calculated from response times to probes for each emotional face type.RESULTSCompared to healthy youths, anxious participants demonstrated a greater attention bias toward threat faces. This threat bias in anxious patients did not significantly vary across the anxiety disorders. There was no group difference in attention bias toward happy faces.CONCLUSIONSThese results suggest that pediatric anxiety disorders are associated with an attention bias toward threat. Future research may examine the manner in which cognitive bias in anxious youths changes with treatment.OBJECTIVETo examine attention bias toward threat faces in a large sample of anxiety-disordered youths using a well-established visual probe task.","Roy, A K; Vasa, R A; Bruck, M; Mogg, K; Bradley, B P; Sweeney, M; Bergman, R L; McClure-Tone, E B; Pine, D S",2008.0,10.1097/CHI.0b013e3181825ace,0,0,
4875,Neuroticism and depression in alcoholics.,To examine neuroticism as a possible determinant of depression in alcoholics. 24 euthymic depressed alcoholics and 18 never-depressed alcoholic controls completed the Eysenck Personality Questionnaire. Euthymic depressed alcoholics had significantly higher neuroticism scores than alcoholic controls. No women alcoholics were studied. Neuroticism may be a risk factor for depression in alcoholics.,Roy A.,,,0,0,
4876,Effects of an expanding-spaced vs massed exposure schedule on fear reduction and return of fear.,"The current investigation assessed the relative benefits of a massed vs an expanding-spaced exposure schedule. The study was a 2 (distribution of sessions) x 3 (assessment occasion) design, in which two spider-fearful groups (N = 31) were compared across three different occasions: pre-training, post-training, and follow-up. Four exposure trials were conducted within the same day for participants in the massed exposure (ME) group, whereas sessions were distributed over the course of 1 week (inter-trial intervals doubled between sessions) for the expanding-spaced exposure (ESE) group. As predicted, although the ME group demonstrated significantly more habituation than the ESE group across exposure trials, they also showed a clear return of fear (ROF) in response to the training spider at a 1-month follow-up assessment, whereas the ESE group showed no increase in fear. Additionally, the ME group showed ROF in response to novel spiders post-training and at the 1-month follow-up, whereas ESE participants did not. These findings offer support for the beneficial effects of an expanding-spaced schedule and challenge the reliance on indices of fear activation and habituation as accurate signals of the permanence of fear reduction.",Rowe MK.; Craske MG.,,,0,0,
4877,A cluster randomised controlled trial of a brief couple-focused psychoeducational intervention to prevent common postnatal mental disorders among women: study protocol.,"Postnatal common mental disorders among women are an important public health problem internationally. Interventions to prevent postnatal depression have had limited success. What Were We Thinking (WWWT) is a structured, gender-informed, psychoeducational group programme for parents and their first infant that addresses two modifiable risks to postnatal mental health. This paper describes the protocol for a cluster randomised controlled trial to test the clinical effectiveness and cost-effectiveness of WWWT when implemented in usual primary care. 48 maternal and child health (MCH) centres from six diverse Local Government Areas, in Victoria, Australia are randomly allocated to the intervention group (usual care plus WWWT) or the control group (usual care). The required sample size is 184 women in each group. English-speaking primiparous women receiving postpartum healthcare in participating MCH centres complete two computer-assisted telephone interviews: baseline at 4‚ÄÖweeks and outcome at 6‚ÄÖmonths postpartum. Women attending intervention MCH centres are invited to attend WWWT in addition to usual care. The primary outcome is meeting Diagnostic and Statistical Manual-IV (DSM-IV) diagnostic criteria for major depressive episode; generalised anxiety disorder; panic disorder with or without agoraphobia, agoraphobia with or without panic, social phobia, adult separation anxiety or adjustment disorder with depressed mood, anxiety or mixed depressed mood and anxiety within the past 30‚ÄÖdays at 6‚ÄÖmonths postpartum. Secondary outcomes are self-rated general and emotional health, infant sleep problems, method of infant feeding, quality of mother-infant relationship and intimate partner relationship, and healthcare costs and outcomes. Approval to conduct the study has been granted. A comprehensive dissemination plan has been devised. Australian New Zealand Clinical Trials Registry ACTRN12613000506796. UTN: U1111-1125-8208.",Rowe H.; Wynter K.; Lorgelly P.; Amir LH.; Ranasinha S.; Proimos J.; Cann W.; Hiscock H.; Bayer J.; Burns J.; Ride J.; Bobevski I.; Fisher J.,2014.0,10.1136/bmjopen-2014-006436,0,0,
4878,Family and individual factors associated with substance involvement and PTS symptoms among adolescents in greater New Orleans after Hurricane Katrina.,"This study examined the influence of hurricane impact as well as family and individual risk factors on posttraumatic stress (PTS) symptoms and substance involvement among clinically referred adolescents affected by Hurricane Katrina. A total of 80 adolescents (87% male; 13-17 years old; mean age = 15.6 years; 38% minorities) and their parents were interviewed at the adolescent's intake into substance abuse treatment, 16 to 46 months postdisaster. Independent measures included hurricane impact variables (initial loss/disruption and perceived life threat); demographic and predisaster variables (family income, gender, predisaster adolescent substance use, predisaster trauma exposure, and parental substance abuse); postdisaster family factors (parental psychopathology, family cohesion, and parental monitoring); and postdisaster adolescent delinquency. Hierarchical multivariate regression analyses showed that adolescent substance involvement was associated with higher family income, lower parental monitoring (adolescent report), and more adolescent delinquency. Adolescent-reported PTS symptoms were associated with greater hurricane-related initial loss/disruption, lower family cohesion (adolescent report), and more adolescent delinquency, whereas parent-reported adolescent PTS symptoms were associated with greater parental psychopathology, lower parental monitoring (adolescent report), and lower family cohesion (parent report). The results suggest that hurricane impact was related only to adolescent-reported PTS. However, certain postdisaster family and individual risk factors (low family cohesion and parental monitoring, more adolescent delinquency) were associated both with adolescent substance involvement and with PTS symptoms. Identification of these factors suggests directions for future research as well as potential target areas for screening and intervention with substance-abusing adolescents after disasters.",Rowe CL.; La Greca AM.; Alexandersson A.,2010.0,10.1037/a0020808,0,0,
4879,Office-based vs home-based behavioral treatment for obsessive-compulsive disorder: a preliminary study.,"The current study investigated whether exposure with response prevention (ERP) for obsessive compulsive disorder (OCD) is more effective when administered in a participant's home or other natural environments where symptoms tend to occur, than in a therapist's office. Twenty-eight outpatients with a principal diagnosis of OCD were randomly assigned to receive ERP in their therapist's office vs. wherever their symptoms usually occur (e.g., at home, at work, in public places, in the car, etc.). Participants received 14, 90-min sessions of ERP with an individual therapist. Participants were assessed at pretreatment, post-treatment, and at 3- and 6-month follow-up. Assessments included both self-report as well as clinician-rated indicators of OCD symptom severity, depression, and functional impairment. Results suggested that participants improved significantly, regardless of where treatment occurred. There were no differences in efficacy between the home-based and office-based treatment for OCD. Implications of these findings are discussed.",Rowa K.; Antony MM.; Summerfeldt LJ.; Purdon C.; Young L.; Swinson RP.,2007.0,10.1016/j.brat.2007.02.009,0,0,
4880,"Adjusting to death: the effects of mortality salience and self-esteem on psychological well-being, growth motivation, and maladaptive behavior","ER This research builds on terror management theory to examine the relationships among self-esteem, death cognition, and psychological adjustment. Self-esteem was measured (Studies 1-2, 4-8) or manipulated (Study 3), and thoughts of death were manipulated (Studies 1-3, 5-8) or measured (Study 4). Subsequently, satisfaction with life (Study 1), subjective vitality (Study 2), meaning in life (Studies 3-5), positive and negative affect (Studies 1, 4, 5), exploration (Study 6), state anxiety (Study 7), and social avoidance (Study 8) were assessed. Death-related cognition (a) decreased satisfaction with life, subjective vitality, meaning in life, and exploration; (b) increased negative affect and state anxiety; and (c) exacerbated social avoidance for individuals with low self-esteem but not for those with high self-esteem. These effects occurred only when death thoughts were outside of focal attention. Parallel effects were found in American (Studies 1-4, 6-8) and Chinese (Study 5) samples.","Routledge, C; Ostafin, B; Juhl, J; Sedikides, C; Cathey, C; Liao, J",2010.0,10.1037/a0021431,0,0,
4881,Comparison of hydrophobic heat and moisture exchangers with heated humidifier during prolonged mechanical ventilation,"ER Inspired gases must be warmed and humidified during mechanical ventilation. In a prospective randomized study we compared the performance of a heated humidifier (HH) (Draegger Aquaport) and a heat and moisture exchanger (HME) (Pall Filter BB 2215). A total of 116 patients requiring mechanical ventilation (Servo 900 C Siemens) were enrolled into the study and were randomly assigned to 2 groups. Patients in group I were ventilated with a traditional breathing circuit with HH and patients in group II using a simplified circuit with HME. Pre-existing and hospital acquired atelectasis and pneumonia, occurrence of endotracheal tube (ET) occlusion and ventilatory parameters (respiratory rate, tidal volume) were studied. No statistical difference was found between groups for each parameter except the greater frequency of ET occlusions in the II group (0/61 vs 9/55) (p = 0.0008). Pall Filter (PF), a hydrophobic filter, humidifies the dry gases from the condensed water which is put down on the HME surfaces during cooling of saturated expired gases. This purely physical property is linked to the magnitude of the thermic gradient between the expired gases and the ambiant temperature. Performance impairment of PF in our study might be due to high ambiant temperature in the intensive care unit (usually around 28 degrees C) which reduces thermic gradient and water exchanges. We conclude that efficiency of PF may be weak in some conditions of ambiant temperature.","Roustan, J P; Kienlen, J; Aubas, P; Aubas, S; du, Cailar J",1992.0,,0,0,
4882,Examining the efficacy of the unified transdiagnostic treatment on social anxiety and positive and negative affect in students,"Background: Social anxiety is an extremely harmful disorder affectingmanyaspects of life and causes limited capability of encountering social situations among individuals. Objectives: The purpose of this study was to examine the efficacy of the unified transdiagnostic treatment on social anxiety and positive and negative affect in students. Methods: The statistical population of this study included all female undergraduate students with social anxiety in Ahvaz Jundishapur University of Medical Sciences. 32 female undergraduate students of medical sciences university of Ahvaz were selected among those with social anxiety score of 19 or more (cut-off score) through multistage random samplingmethodand were randomly placed in experimental and control groups. Social phobia inventory (SPIN) and positive and negative affect schedule (PANAS) were implemented on subjects of both groups before and after conducting the intervention. Unified transdiagnostic treatment was performed on the experimental group within 8 sessions of 90 minutes, but the control group received no intervention. Data were analyzed by multivariate covariance analysis. Results: Results showed a significant difference between experimental and control groups in terms of social anxiety and negative and positive affect, and unified transdiagnostic treatmenthas reduced social anxiety and negative affect and also has increased positive affect in experimental group. Conclusions: It may be concluded based on the results of this study that unified transdiagnostic treatment is effective on recovery of social anxiety and negative and positive affects among the students. Therefore, clinical therapists are advised to use this intervention.",Roushani K.; Nejad S.B.; Arshadi N.; Honarmand M.M.; Fakhri A.,2016.0,10.17795/rijm41233,0,0,
4883,Therapist Training and Supervision in Clinical Trials: Implications for Clinical Practice,"Background: Researchers in clinical trials usually pay close attention to therapist selection, training, supervision and monitoring, but the extent of this input has not been systematically documented. Aims: To describe the extent of training and supervision activity within clinical trials, and to consider any implications for transporting therapies from research to routine clinical contexts. Method: Twenty-seven randomized studies examining the efficacy of CBT interventions for people with depression or anxiety disorders were selected on the basis of their quality and impact on the field. Published and unpublished sources were used to gather information about therapist selection, training and supervision within these trials. Results: The review identified the extent of investment by researchers in assuring therapist expertise, adherence and competence. It also indicated inconsistencies in the clarity with which this input was reported. Conclusions: The ubiquity of intervention-specific training in research contexts risks being overlooked when commissioning evidence-based therapies in routine practice. This has clear implications for the likely effectiveness of interventions. Greater consistency in the reporting of training in clinical trials may help to draw attention to the role of training and supervision in maximizing clinical outcomes.",Roth A.D.; Pilling S.; Turner J.,2010.0,10.1017/S1352465810000068,0,0,
4884,Effectiveness of an educational and physical program in reducing accompanying symptoms in subjects with head and neck pain: a workplace controlled trial.,"The objective of this study is to evaluate the effectiveness of an educational and physical program in reducing behavioral or somatic symptoms along with headache, neck and shoulder pain in a working community. A controlled, non-randomized trial was carried out in a working community and 384 employees were enrolled and divided into a study group (Group 1) and a control group (Group 2). The Group 1 received a physical and educational intervention, consisting of relaxation and posture exercises and the use of visual feedback. After 6 months, the intervention was administered to the Group 2. Both groups were then followed for an additional 6 months until the end of the trial. The presence of accompanying symptoms was investigated with a semi-structured interview using a checklist of 20 items, along with headache, neck, and shoulder pain parameters and the prevalence of generalized anxiety disorder and depression, in three clinical examinations at baseline, after 6 months and after 12 months. For each symptom, as well as the presence of any type of symptom, the differences between groups in the prevalence at the clinical examinations following the baseline were evaluated by applying logistic models. After 6 months, the probability of the presence of any type of symptom was significantly lower in the Group 1 (OR 0.69, 95% CI 0.56-0.85) with respect to the Group 2. After 12 months, the pooled estimation did not show any significant difference of symptom prevalence between groups (OR 0.80, 95% CI 0.64-1.00). In conclusion, this is the first longitudinal study relative to accompanying symptoms. Its results suggest the effectiveness of this cognitive program in reducing the burden of physical and psychiatric complaints in a large, working population.",Rota E.; Evangelista A.; Ciccone G.; Ferrero L.; Ugolini A.; Milani C.; Ceccarelli M.; Galassi C.; Mongini F.,2011.0,10.1007/s10194-011-0291-y,0,0,
4885,Awareness of high blood pressure influences on psychological and sympathetic responses,"ER The aim of the present study was to examine the effects of awareness of hypertension on psychological factors and whether there was an association between psychological and sympathetic responses. To avoid self-selection bias 32 19-yr old white men, all with mean blood pressure of 116 mm Hg were randomized into two groups. One group was informed that the blood pressure was elevated and asked to come to a second examination while the other was invited to take part in a coronary heart disease prevention program. A cold pressor test was undertaken and the subjects completed the Karolinska Scale of Personality (KSP). Assessed by the KSP, the informed group showed lower verbal aggression (p less than 0.01), irritability (p less than 0.05), monotony avoidance (p less than 0.05) and impulsiveness (p less than 0.05), higher detachment (p less than 0.05) but no significant differences in the other subscales like anxiety, psychasthenia or factors of hostility. Information significantly increased resting blood pressure and increments in heart rate and plasma adrenaline responses to cold pressor test. Thus, both psychological and sympathetic responses were influenced by awareness of high blood pressure. There were significant correlations between less assertive behaviour and increased plasma catecholamines.","Rostrup, M; Ekeberg, O",1992.0,,0,0,
4886,Reduced Processing of Facial and Postural Cues in Social Anxiety: Insights from Electrophysiology,"Social anxiety is characterized by fear of evaluative interpersonal situations. Many studies have investigated the perception of emotional faces in socially anxious individuals and have reported biases in the processing of threatening faces. However, faces are not the only stimuli carrying an interpersonal evaluative load. The present study investigated the processing of emotional body postures in social anxiety. Participants with high and low social anxiety completed an attention-shifting paradigm using neutral, angry and happy faces and postures as cues. We investigated early visual processes through the P100 component, attentional fixation on the P2, structural encoding mirrored by the N170, and attentional orientation towards stimuli to detect with the P100 locked on target occurrence. Results showed a global reduction of P100 and P200 responses to faces and postures in socially anxious participants as compared to non-anxious participants, with a direct correlation between self-reported social anxiety levels and P100 and P200 amplitudes. Structural encoding of cues and target processing were not modulated by social anxiety, but socially anxious participants were slower to detect the targets. These results suggest a reduced processing of social postural and facial cues in social anxiety. © 2013 Rossignol et al.",Rossignol M.; Fisch S.-A.; Maurage P.; Joassin F.; Philippot P.,2013.0,10.1371/journal.pone.0075234,0,0,
4887,"Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial","ER METHODS62 children with autism recruited from 6 centers, ages 2-7 years (mean 4.92 +/- 1.21), were randomly assigned to 40 hourly treatments of either hyperbaric treatment at 1.3 atmosphere (atm) and 24% oxygen (""treatment group"", n = 33) or slightly pressurized room air at 1.03 atm and 21% oxygen (""control group"", n = 29). Outcome measures included Clinical Global Impression (CGI) scale, Aberrant Behavior Checklist (ABC), and Autism Treatment Evaluation Checklist (ATEC).RESULTSAfter 40 sessions, mean physician CGI scores significantly improved in the treatment group compared to controls in overall functioning (p = 0.0008), receptive language (p < 0.0001), social interaction (p = 0.0473), and eye contact (p = 0.0102); 9/30 children (30%) in the treatment group were rated as ""very much improved"" or ""much improved"" compared to 2/26 (8%) of controls (p = 0.0471); 24/30 (80%) in the treatment group improved compared to 10/26 (38%) of controls (p = 0.0024). Mean parental CGI scores significantly improved in the treatment group compared to controls in overall functioning (p = 0.0336), receptive language (p = 0.0168), and eye contact (p = 0.0322). On the ABC, significant improvements were observed in the treatment group in total score, irritability, stereotypy, hyperactivity, and speech (p < 0.03 for each), but not in the control group. In the treatment group compared to the control group, mean changes on the ABC total score and subscales were similar except a greater number of children improved in irritability (p = 0.0311). On the ATEC, sensory/cognitive awareness significantly improved (p = 0.0367) in the treatment group compared to the control group. Post-hoc analysis indicated that children over age 5 and children with lower initial autism severity had the most robust improvements. Hyperbaric treatment was safe and well-tolerated.CONCLUSIONChildren with autism who received hyperbaric treatment at 1.3 atm and 24% oxygen for 40 hourly sessions had significant improvements in overall functioning, receptive language, social interaction, eye contact, and sensory/cognitive awareness compared to children who received slightly pressurized room air.TRIAL REGISTRATIONclinicaltrials.gov NCT00335790.BACKGROUNDSeveral uncontrolled studies of hyperbaric treatment in children with autism have reported clinical improvements; however, this treatment has not been evaluated to date with a controlled study. We performed a multicenter, randomized, double-blind, controlled trial to assess the efficacy of hyperbaric treatment in children with autism.","Rossignol, D A; Rossignol, L W; Smith, S; Schneider, C; Logerquist, S; Usman, A; Neubrander, J; Madren, E M; Hintz, G; Grushkin, B; Mumper, E A",2009.0,10.1186/1471-2431-9-21,0,0,
4888,Autonomic response to intravenous injection of inactive fluid in mental patients.,,Rossi R.; Giberti F.; Conforto C.,1968.0,,0,0,
4889,"Advice alone versus structured detoxification programmes for complicated medication overuse headache (MOH): a prospective, randomized, open-label trial","ER BACKGROUND: The aim of this study was to compare the effectiveness of an educational strategy (advice to withdraw the overused medication/s) with that of two structured pharmacological detoxification programmes in patients with complicated medication overuse headache (MOH) plus migraine.METHODS: One hundred and thirty-seven complicated MOH patients participated in the study. MOH was defined as complicated in patients presenting at least one of the following: a) a diagnosis of co-existent and complicating medical illnesses; b) a current diagnosis of mood disorder, anxiety disorder, eating disorder, or substance addiction disorder; c) relapse after previous detoxification treatment; d) social and environmental problems; e) daily use of multiple doses of symptomatic medications. Group A (46 patients) received only intensive advice to withdraw the overused medication/s. Group B (46 patients) underwent a standard detoxification programme as outpatients (advice+steroids+preventive treatment). Group C (45 patients) underwent a standard inpatient withdrawal programme (advice+steroids+fluid replacement and antiemetics preventive treatment). Withdrawal therapy was considered successful if, after two months, the patient had reverted to an intake of NSAIDs lower than 15 days/month or to an intake of other symptomatic medication/s lower than 10 days/month.RESULTS: Twenty-two patients failed to attend follow-up visits (11 in Group A, 9 in Group B, 2 in Group C, p<0.03). Overall, we detoxified 70% of the whole cohort, 60.1% of the patients in Group A and in Group B, and 88.8% of those in Group C (p<0.01).CONCLUSIONS: Inpatient withdrawal is significantly more effective than advice alone or an outpatient strategy in complicated MOH patients.","Rossi, P; Faroni, J V; Tassorelli, C; Nappi, G",2013.0,10.1186/1129-2377-14-10,0,0,
4890,Psychological aftermath of the King's Cross fire.,"The King's Cross fire occurred at the end of the evening rush hour, on 18 November 1987. King's Cross station is within the department's health district and we felt a responsibility to respond to the psychological aftermath. The unique features of our intervention were the degree of inter agency coordination, the use of a systematic outreach and screening programme, the collection of psychotherapy outcome measures and the development of an ongoing clinic. The work represents a sustained attempt to assess the nature and prevalence of post-traumatic reactions and the most medically and economically effective form of intervention. In this paper we describe the way our team responded to the high level of psychological distress that we found, we present some preliminary results, outline two therapeutic trials, and refer to the longterm consequences for the work of our department.",Rosser R.; Dewar S.; Thompson J.,1991.0,10.1177/014107689108400103,0,0,
4891,"Physical activity promotion in the primary care setting in pre- and type 2 diabetes - the Sophia step study, an RCT","ER METHODS/DESIGN: Sophia Step Study is a randomized controlled trial and participants are randomly assigned to either a multi-component intervention group (A), a pedometer group (B) or a control group (C). In total, 310 patients will be included and followed for 24 months. Group A participants are offered pedometers and a website to register steps, physical activity on prescription with yearly follow-ups, motivational interviewing (10 occasions) and group consultations (including walks, 12 occasions). Group B participants are offered pedometers and a website to register steps. Group C are offered usual care. The theoretical framework underpinning the interventions is the Health Belief Model, the Stages of Change Model, and the Social Cognitive Theory. Both the multi-component intervention (group A) and the pedometer intervention (group B) are using several techniques for behavior change such as self-monitoring, goal setting, feedback and relapse prevention. Measurements are made at week 0, 8, 12, 16, month 6, 9, 12, 18 and 24, including metabolic and cardiovascular biomarkers (HbA1c as primary health outcome), accelerometry and daily steps. Furthermore, questionnaires were used to evaluate dietary intake, physical activity, perceived ability to perform physical activity, perceived support for being active, quality of life, anxiety, depression, well-being, perceived treatment, perceived stress and diabetes self- efficacy.DISCUSSION: This study will show if a multi-component intervention using pedometers with group- and individual consultations is more effective than a single- component intervention using pedometers alone, in increasing physical activity and improving HbA1c, other metabolic and cardiovascular risk factors, physical activity levels and overall health in patients with pre- and type 2 diabetes.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02374788 . Registered 28 January 2015.BACKGROUND: Physical activity prevents or delays progression of impaired glucose tolerance in high-risk individuals. Physical activity promotion should serve as a basis in diabetes care. It is necessary to develop and evaluate health-promoting methods that are feasible as well as cost-effective within diabetes care. The aim of Sophia Step Study is to evaluate the impact of a multi-component and a single component physical activity intervention aiming at improving HbA1c (primary outcome) and other metabolic and cardiovascular risk factors, physical activity levels and overall health in patients with pre- and type 2 diabetes.","Rossen, J; Yngve, A; Hagströmer, M; Brismar, K; Ainsworth, B E; Iskull, C; Möller, P; Johansson, U B",2015.0,10.1186/s12889-015-1941-9,0,0,
4892,Frequency and duration of hierarchy item exposure in a systematic desensitization analogue.,,Ross SM.; Proctor S.,1973.0,,0,0,
4893,Early intervention may prevent the development of posttraumatic stress disorder: a randomized pilot civilian study with modified prolonged exposure.,"Posttraumatic stress disorder (PTSD) is a major public health concern with long-term sequelae. There are no accepted interventions delivered in the immediate aftermath of trauma. This study tested an early intervention aimed at modifying the memory to prevent the development of PTSD before memory consolidation. Patients (n = 137) were randomly assigned to receive three sessions of an early intervention beginning in the emergency department compared with an assessment only control group. Posttraumatic stress reactions (PTSR) were assessed at 4 and 12 weeks postinjury and depression at baseline and week 4. The intervention consisted of modified prolonged exposure including imaginal exposure to the trauma memory, processing of traumatic material, and in vivo and imaginal exposure homework. Patients were assessed an average of 11.79 hours posttrauma. Intervention participants reported significantly lower PTSR than the assessment group at 4 weeks postinjury, p < .01, and at 12 weeks postinjury, p < .05, and significantly lower depressive symptoms at week 4 than the assessment group, p < .05. In a subgroup analysis, the intervention was the most effective at reducing PTSD in rape victims at week 4 (p = .004) and week 12 (p = .05). These findings suggest that the modified prolonged exposure intervention initiated within hours of the trauma in the emergency department is successful at reducing PTSR and depression symptoms 1 and 3 months after trauma exposure and is safe and feasible. This is the first behavioral intervention delivered immediately posttrauma that has been shown to be effective at reducing PTSR.",Rothbaum BO.; Kearns MC.; Price M.; Malcoun E.; Davis M.; Ressler KJ.; Lang D.; Houry D.,2012.0,10.1016/j.biopsych.2012.06.002,0,0,
4894,Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience--a randomised controlled trial.,"Previous studies on the treatment of women with fear of childbirth have focused on the delivery mode. Women with fear of childbirth often suffer from anxiety and/or depression, and treatment therefore also needs to target postnatal psychological well-being and the early mother-infant relationship. Three hundred and seventy-one nulliparous women out of 4575 scored ≥100 in prospective screening (Wijma Delivery Expectancy Questionnaire, W-DEQ-A), indicating severe fear of childbirth. These women were randomised to psychoeducative group intervention with relaxation (n = 131; six sessions during pregnancy, one postnatal) or to conventional care (n = 240) by community nurses (referral if necessary). Psycho-emotional and psychosocial evaluations [Edinburgh Postnatal Depression Scale (EPDS), social support, Maternal Adjustment and Attitudes (MAMA), Traumatic Events Scale (TES) and the Wijma Delivery Experience Questionnaire (W-DEQ-B)] were completed twice during pregnancy and/or 3 months postpartum. Postnatal maternal adjustment (MAMA mean score 38.1 ± 4.3 versus 35.7 ± 5.0, p = 0.001) and childbirth experience (mean W-DEQ-B sum score 63.0 ± 29 versus 73.7 ± 32, p = 0.008) were better in the intervention group compared with controls. In hierarchical regression, social support, participating in intervention, and less fearful childbirth experience predicted better maternal adjustment. The level of postnatal depressive symptoms was significantly lower in the intervention group (mean sum score 6.4 ± 5.4 versus 8.0 ± 5.9 p = 0.04). There were no differences in the frequency of post-traumatic stress symptoms between the groups. In nulliparous women with severe fear of childbirth, participation in a targeted psychoeducative group resulted in better maternal adjustment, a less fearful childbirth experience and fewer postnatal depressive symptoms, compared with conventional care.",Rouhe H.; Salmela-Aro K.; Toivanen R.; Tokola M.; Halmesmäki E.; Ryding EL.; Saisto T.,2015.0,10.3109/0167482X.2014.980722,0,0,
4895,Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience-A randomised controlled trial.,"Background: Previous studies on the treatment of women with fear of childbirth have focused on the delivery mode. Women with fear of childbirth often suffer from anxiety and/or depression, and treatment therefore also needs to target postnatal psychological well-being and the early mother-infant relationship. Methods: Three hundred and seventy-one nulliparous women out of 4575 scored >= 100 in prospective screening (Wijma Delivery Expectancy Questionnaire, W-DEQ-A), indicating severe fear of childbirth. These women were randomised to psychoeducative group intervention with relaxation (n = 131; six sessions during pregnancy, one postnatal) or to conventional care (n = 240) by community nurses (referral if necessary). Psycho-emotional and psychosocial evaluations [Edinburgh Postnatal Depression Scale (EPDS), social support, Maternal Adjustment and Attitudes (MAMA), Traumatic Events Scale (TES) and the Wijma Delivery Experience Questionnaire (W-DEQ-B)] were completed twice during pregnancy and/or 3 months postpartum. Results: Postnatal maternal adjustment (MAMA mean score 38.1 +/- 4.3 versus 35.7 +/- 5.0, p = 0.001) and childbirth experience (mean W-DEQ-B sum score 63.0 +/- 29 versus 73.7 +/- 32, p = 0.008) were better in the intervention group compared with controls. In hierarchical regression, social support, participating in intervention, and less fearful childbirth experience predicted better maternal adjustment. The level of postnatal depressive symptoms was significantly lower in the intervention group (mean sum score 6.4 +/- 5.4 versus 8.0 +/- 5.9 p = 0.04). There were no differences in the frequency of post-traumatic stress symptoms between the groups. Conclusions: In nulliparous women with severe fear of childbirth, participation in a targeted psychoeducative group resulted in better maternal adjustment, a less fearful childbirth experience and fewer postnatal depressive symptoms, compared with conventional care. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rouhe, Hanna; Salmela-Aro, Katariina; Toivanen, Riikka; Tokola, Maiju; Halmesmaki, Erja; Ryding, Elsa-Lena; Saisto, Terhi; Aalto, Ajzen, Areskog, Areskog, Ayers, Bastani, Bilszta, Bryant, Borjesson, Cacciatore, Carter, Chuang, Cox, Fairbrother, Fink, Fonagy, Gedde-Dahl, Hoghughi, Hurskainen, Koubaa, Kringeland, Kumar, Landry, Landry, Larsson, Laursen, Lukasse, Martins, Meichenbaum, Melender, Nerum, Nieminen, Pacheco, Poobalan, Rouhe, Rouhe, Rouhe, Rubertsson, Ryding, Ryding, Ryding, Ryding, Ryding, Raisanen, Sahlin, Saisto, Saisto, Saisto, Saisto, Saisto, Salmela-Aro, Sjogren, Soderquist, Soderquist, Soderquist, Storksen, Sydsjo, Taylor, Waldenstrom, Webster, Wijma, Wijma, Zar, Ziv",2015.0,,0,0,
4896,A randomized psychosocial intervention study on the effect of home visits on the well-being of Danish colorectal cancer patients--the INCA Project,"ER Home visits by health care professionals may constitute a formalized social relationship in which cancer patients can be given emotional and informational support. We aimed at studying the effect of home visits on the well-being of colorectal cancer patients. A total of 249 Danish colorectal cancer patients undergoing abdominal surgery were randomly assigned to a control group or to an intervention group. The intervention group received 10 home visits carried out by a project nurse or a medical doctor during the first 2 years after discharge. Participants were interviewed 3, 6, 12, and 24 months after discharge in order to assess well-being. Using a linear mixed model, we found no overall effect of the intervention on well-being. We recommend that future psychosocial intervention studies include baseline screening for distress and recommend testing the effect of shorter but intensive interventions carried out by trained therapists.","Ross, L; Thomsen, B L; Karlsen, R V; Boesen, E H; Johansen, C",2005.0,10.1002/pon.899,0,0,
4897,"In a randomized controlled trial, missing data led to biased results regarding anxiety","ER METHODSA randomized clinical trial of the effect of psychosocial intervention on well-being after an operation for colorectal cancer was conducted in Denmark. Patients were interviewed 3, 6, 12, and 24 months after discharge from hospital.RESULTSWe found that the probability of nonresponse decreased with increasing anxiety score in the intervention group, but it increased with increasing anxiety score in the control group. This could lead to severe bias in an analysis of the effect of intervention on anxiety. Low physical functioning and low global health status and quality of life were related to an increased probability of dying before the next follow-up, and this association could explain the associations between anxiety and depression, respectively, and the probability of dying observed in crude analyses.CONCLUSIONOur study emphasizes the importance of performing specific missing data analyses in any study of well-being variables.BACKGROUND AND OBJECTIVERandomization does not protect against bias due to missing observations. In addition, different reasons for missing observations may lead to different invalid results. The purpose of this study was to illustrate how randomized intervention studies can be threatened by bias due to missing observations because of death or nonresponse.","Ross, L; Thomsen, B L; Boesen, E H; Johansen, C",2004.0,10.1016/j.jclinepi.2004.03.010,0,0,
4898,Pain catastrophizing moderates changes in spinal control in response to noxiously induced low back pain,"It is generally accepted that spine control and stability are relevant for the prevention and rehabilitation of low back pain (LBP). However, there are conflicting results in the literature in regards to how these variables are modified in the presence of LBP. The aims of the present work were twofold: (1) to use noxious stimulation to induce LBP in healthy individuals to assess the direct effects of pain on control (quantified by the time-dependent behavior of kinematic variance), and (2) to assess whether the relationship between pain and control is moderated by psychological features (i.e. pain catastrophizing (PC) and kinesiophobia). Participants completed three conditions (baseline, pain, recovery) during a task involving completion of 35 cycles of a repetitive unloaded spine flexion/extension movement. The neuromuscular control of spine movements was assessed during each condition using maximum finite-time Lyapunov exponents (λmax). Nociceptive stimulus involved injection of hypertonic saline into the interspinous ligament, eliciting pain that was greater than baseline and recovery (p < 0.001). Although there was no overall main effect of the nociceptive stimulation (i.e. pain) on λmax when the whole group was included in the statistical model (p = 0.564), when data were considered separately for those with high and low PC, two distinct and well established responses to the pain were observed. Specifically, those with high PC tightened their control (i.e. stabilized), whereas those with low PC loosened their control (i.e. destabilized). This study provides evidence that individuals’ beliefs and attitudes towards pain are related to individual-specific motor behaviors, and suggests that future research studying spine control/stability and LBP should account for these variables.",Ross G.B.; Sheahan P.J.; Mahoney B.; Gurd B.J.; Hodges P.W.; Graham R.B.,2017.0,10.1016/j.jbiomech.2017.04.010,0,0,
4899,A proposed trial of dialectical behavior therapy and trauma model therapy.,Dissociative identity disorder and borderline personality disorder resemble each other in trauma histories and comorbidity. Each disorder is frequently comorbid with the other. Treatment outcome data for Dialectical Behavior Therapy of borderline personality disorder and Trauma Model Therapy of dissociative identity disorder are reviewed. The author proposes a psychotherapy treatment study in which there are three subject groups and two treatment conditions. The subject groups are borderline personality disorder without dissociative identity disorder; dissociative identity disorder without borderline personality disorder; and both conditions present concurrently. Subjects would be randomized to receive Dialectical Behavior Therapy or Trauma Model Therapy. Such a study could provide answers to controversies in the field about a better treatment approach for dissociative identity disorder and potentially could broaden and strengthen the indications for Dialectical Behavior Therapy.,Ross CA.,2005.0,10.2466/pr0.96.3c.901-911,0,0,
4900,Symptom dimensions in obsessive- compulsive disorder: Prediction of cognitive-behavior therapy outcome.,"Objective: A significant number of patients with obsessive-compulsive disorder (OCD) fail to benefit sufficiently from treatments. This study aimed to evaluate whether certain OCD symptom dimensions were associated with cognitive-behavioral therapy (CBT) outcome. Method: Symptoms of 104 CBT-treated in-patients with OCD were assessed with the clinician-rated Yale-Brown Obsessive-Compulsive Scale symptom checklist. Logistic regression analyses examined outcome predictors. Results: The most frequent OCD symptoms were aggressive and contamination obsessions, and compulsive checking and cleaning. Patients with hoarding symptoms at baseline (n = 19) were significantly less likely to become treatment responders as compared to patients without these symptoms. Patients with sexual and religious obsessions tended to respond less frequently, although this failed to reach statistical significance (P = 0.07). Regression analyses revealed that higher scores on the hoarding dimension were predictive of nonresponse, even after controlling for possible confounding variables. Conclusion: Our results strongly indicate that in-patients with obsessive-compulsive hoarding respond poorly to CBT. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Rufer, M; Fricke, S; Moritz, S; Kloss, M; Hand, I; Abramowitz, Alonso, AuBuchon, Baer, Barlow, Basoglu, Beck, Bobes, Braga, Christensen, Christensen, Denys, Foa, Foa, Foa, Foa, Fricke, Frost, Frost, Frost, Goodman, Hand, Hand, Hautzinger, Leckman, Lecrubier, Lelliott, Maier, Marks, Mataix-Cols, Mataix-Cols, Mataix-Cols, Mataix-Cols, Mataix-Cols, Mataix-Cols, Mataix-Cols, McKenzie, Moritz, Moritz, O'Connor, Pallanti, Rufer, Rufer, Samuels, Saxena, Saxena, Schaible, Schruers, Sheehan, Steketee, Steketee, van Oppen",2006.0,,0,0,
4901,Narrative exposure therapy for 7- to 16-year-olds: a randomized controlled trial with traumatized refugee children,"ER The authors examined the effectiveness of narrative exposure therapy for children (KIDNET) in treating posttraumatic stress disorder (PTSD) in refugee children living in exile. Twenty-six children traumatized by organized violence were randomly assigned to KIDNET or to a waiting list. Significant treatment by time interactions on all PTSD-relevant variables indicated that the KIDNET group, but not the controls, showed a clinically significant improvement in symptoms and functioning. Success of the KIDNET group remained stable at 12-month follow-up. This study confirms previous findings that, if left untreated, PTSD in children may persist for an extended period. However, it also shows that it is possible to effectively treat chronic PTSD and restore functioning in traumatized refugee children in only 8 treatment sessions.","Ruf, M; Schauer, M; Neuner, F; Catani, C; Schauer, E; Elbert, T",2010.0,10.1002/jts.20548,0,0,
4902,A randomized controlled evaluation of an online chronic pain self management program,"ER Internet-based educational and therapeutic programs (e-health applications) are becoming increasingly popular for a variety of psychological and physical disorders. We tested the efficacy of an online Chronic Pain Management Program, a comprehensive, fully self-directed and self-paced system that integrates social networking features and self-management tools into an interactive learning environment. Of 305 adult participants (196 women, 109 men), a total of 162 individuals with chronic pain were randomly assigned unsupervised access to the program for approximately 6 weeks; 143 were assigned to the wait-listed control group with treatment as usual. A comprehensive assessment was administered before the study and approximately 7 and 14 weeks thereafter. All recruitment, data collection, and participant involvement took place online. Participation was fully self-paced, permitting the evaluation of program effectiveness under real-world conditions. Intent-to-treat analysis that used linear growth models was used as the primary analytic tool. Results indicated that program utilization was associated with significant decreases in pain severity, pain-related interference and emotional burden, perceived disability, catastrophizing, and pain-induced fear. Further, program use led to significant declines in depression, anxiety, and stress. Finally, as compared to the wait-listed control group, the experimental group displayed a significant increase in knowledge about the principles of chronic pain and its management. Study limitations are considered, including the recognition that not all persons with chronic pain are necessarily good candidates for self-initiated, self-paced, interactive learning.","Ruehlman, L S; Karoly, P; Enders, C",2012.0,10.1016/j.pain.2011.10.025,0,0,
4903,[Results of psychoanalytic therapy].,"Within a naturalistic design 44 psychoanalytic treated patients are examined with regard to qualitative and quantitative outcome. The results are compared to 56 dynamic and 164 inpatient therapies. A comparison of symptoms, diagnoses and motivation before therapy leads to the conclusion that there are very different patient groups treated within this different settings. Therefore randomization seems to be an inadequate strategy to compare groups in different therapeutic settings. Using different criteria of outcome it can be demonstrated that psychoanalytic treated patients improve very well and to a larger extent than psychodynamically treated patients or inpatients. Different criteria of outcome and different observing perspectives (patient/therapist) lead to interesting results. Patients report primarily improvements in somatic, anxiety and depressive complaints. Therapists moreover report substantial improvements in interactional symptoms and behaviour. The different results in using several criteria are presented and discussed with regard to the methodology of outcome measurement. Finally recommendations for further studies in the psychoanalytic context are presented.",Rudolf G.; Manz R.; Ori C.,1994.0,,0,0,
4904,Implicit self-esteem compensation: automatic threat defense,"ER Four experiments demonstrated implicit self-esteem compensation (ISEC) in response to threats involving gender identity (Experiment 1), implicit racism (Experiment 2), and social rejection (Experiments 3-4). Under conditions in which people might be expected to suffer a blow to self-worth, they instead showed high scores on 2 implicit self-esteem measures. There was no comparable effect on explicit self-esteem. However, ISEC was eliminated following self-affirmation (Experiment 3). Furthermore, threat manipulations increased automatic intergroup bias, but ISEC mediated these relationships (Experiments 2-3). Thus, a process that serves as damage control for the self may have negative social consequences. Finally, pretest anxiety mediated the relationship between threat and ISEC (Experiment 3), whereas ISEC negatively predicted anxiety among high-threat participants (Experiment 4), suggesting that ISEC may function to regulate anxiety. The implications of these findings for automatic emotion regulation, intergroup bias, and implicit self-esteem measures are discussed.","Rudman, L A; Dohn, M C; Fairchild, K",2007.0,10.1037/0022-3514.93.5.798,0,0,
4905,Comparing counseling and dignity therapies in home care patients: a pilot study,"ER METHOD: We developed a pilot randomized controlled trial at the Home Care Unit of the General University Hospital of Valencia (Spain). Some 70 patients were assigned to two therapy groups. The measurement instruments employed included the Patient Dignity Inventory (PDI), the Hospital Anxiety and Depression Scale (HADS), the Brief Resilient Coping Scale (BRCS), the GES Questionnaire, the Duke-UNC-11 Functional Social Support Questionnaire, and two items from the EORTC Quality of Life C30 Questionnaire (EORTC-QLQ-C30).RESULTS: The results of repeated-measures t tests showed statistically significant differences with respect to the dimensions of dignity, anxiety, spirituality, and quality of life for both groups. However, depression increased in the DT group after the intervention, and there were no differences with respect to resilience. Therapy in the counseling group did not negatively affect depression, and resilience did improve. When post-intervention differences between groups were calculated, statistically significant differences in anxiety were found, with lower scores in the counseling group (t(68) = -2.341, p = 0.022, d = 0.560).SIGNIFICANCE OF RESULTS: Our study provided evidence for the efficacy of dignity therapy and counseling in improving the well-being of palliative home care patients, and it found better results in the counseling therapy group with respect to depression, resilience, and anxiety.OBJECTIVE: Several studies have successfully tested psychosocial interventions in palliative care patients. Counseling is the technique most often employed. Dignity therapy (DT) has recently emerged as a tool that can be utilized to address patients' needs at the end of life. The aims of our study were to examine the effects of DT and counseling and to offer useful information that could be put into practice to better meet patients' needs.","Rudilla, D; Galiana, L; Oliver, A; Barreto, P",2016.0,10.1017/S1478951515001182,0,0,
4906,Reflective functioning in panic disorder patients: a pilot study.,,Rudden M.; Milrod B.; Target M.; Ackerman S.; Graf E.,2006.0,10.1177/00030651060540040109,0,0,
4907,Consequences of worksite hypertension screening. Differential changes in psychosocial function,"ER To evaluate reports of psychosocial dysfunction after worksite screening, a three-stage blood pressure screening was performed using standardized screening and labeling procedures. Of a heterogeneous group of 5,888 workers, 296 with sustained hypertension were identified and randomly assigned to traditional arousal or reassurance debriefings, matching each hypertensive subject with one to three normotensive control subjects on eight sociodemographic and occupational variables. Subjects exhibiting absenteeism increases or persistent hypertension six months after screening were randomly assigned to worksite health education programs or no intervention. After adjustment for values among matched control subjects, previously unaware hypertensive subjects had significant post-screening decreases in anxiety that were significantly associated with specific worksites and with reassurance rather than traditional debriefing (p less than 0.05). The health education program did not significantly affect anxiety, blood pressure, or absenteeism. Increased absenteeism was associated with higher baseline anxiety levels (p less than 0.05). It is concluded that worksite hypertension screening produces minimal adverse psychosocial changes, reassurance debriefing may be beneficial, and unspecified worksite characteristics may determine consequences of similar preventive medicine efforts.","Rudd, P; Price, M G; Graham, L E; Beilstein, B A; Tarbell, S J; Bacchetti, P; Fortmann, S P",1986.0,,0,0,
4908,Brief cognitive-behavioral therapy effects on post-treatment suicide attempts in a military sample: results of a randomized clinical trial with 2-year follow-up,"ER Objective: The authors evaluated the effectiveness of brief cognitive-behavioral therapy (CBT) for the prevention of suicide attempts in military personnel. Method: In a randomized controlled trial, active-duty Army soldiers at Fort Carson, Colo.,who either attempted suicide or experienced suicidal ideation with intent, were randomly assigned to treatment as usual (N=76) or treatment as usual plus brief CBT (N=76). Assessment of incidence of suicide attempts during the follow-up period was conducted with the Suicide Attempt Self-Injury Interview. Inclusion criteria were the presence of suicidal ideation with intent to die during the past week and/or a suicide attempt within the past month. Soldiers were excluded if they had a medical or psychiatric condition that would prevent informed consent or participation in outpatient treatment, such as active psychosis or mania. To determine treatment efficacy with regard to incidence and time to suicide attempt, survival curve analyses were conducted. Differences in psychiatric symptoms were evaluated using longitudinal random-effects models. Results: From baseline to the 24-month follow-up assessment, eight participants in brief CBT (13.8%) and 18 participants in treatment as usual (40.2%) made at least one suicide attempt (hazard ratio=0.38, 95% CI=0.16-0.87, number needed to treat=3.88), suggesting that soldiers in brief CBT were approximately 60% less likely to make a suicide attempt during follow-up than soldiers in treatment as usual. There were no between-group differences in severity of psychiatric symptoms. Conclusions: Brief CBT was effective in preventing follow-up suicide attempts among active-duty military service members with current suicidal ideation and/or a recent suicide attempt.","Rudd, M D; Bryan, C J; Wertenberger, E G; Peterson, A L; Young-McCaughan, S; Mintz, J; Williams, S R; Arne, K A; Breitbach, J; Delano, K; Wilkinson, E; Bruce, T O",2015.0,10.1176/appi.ajp.2014.14070843,0,0,
4909,Exaggerated amygdala response to masked facial stimuli in posttraumatic stress disorder: a functional MRI study.,"Converging lines of evidence have implicated the amygdala in the pathophysiology of posttraumatic stress disorder (PTSD). We previously developed a method for measuring automatic amygdala responses to general threat-related stimuli; in conjunction with functional magnetic resonance imaging, we used a passive viewing task involving masked presentations of human facial stimuli. We applied this method to study veterans with PTSD and a comparison cohort of combat-exposed veterans without PTSD. The findings indicate that patients with PTSD exhibit exaggerated amygdala responses to masked-fearful versus masked-happy faces. Although some previous neuroimaging studies of PTSD have demonstrated amygdala recruitment in response to reminders of traumatic events, this represents the first evidence for exaggerated amygdala responses to general negative stimuli in PTSD. Furthermore, by using a probe that emphasizes automaticity, we provide initial evidence of amygdala hyperresponsivity dissociated from the ""top-down"" influences of medial frontal cortex.",Rauch SL.; Whalen PJ.; Shin LM.; McInerney SC.; Macklin ML.; Lasko NB.; Orr SP.; Pitman RK.,2000.0,,0,0,
4910,"Antidepressant effectiveness of deep Transcranial Magnetic Stimulation (dTMS) in patients with Major Depressive Disorder (MDD) with or without Alcohol Use Disorders (AUDs): a 6-month, open label, follow-up study.","Co-occurrence of Major Depressive (MDD) and Alcohol Use Disorders (AUDs) is frequent, causing more burden than each disorder separately. Since the dorsolateral prefrontal cortex (DLPFC) is critically involved in both mood and reward and dysfunctional in both conditions, we aimed to evaluate the effects of dTMS stimulation of bilateral DLPFC with left prevalence in patients with MDD with or without concomitant AUD. Twelve MDD patients and 11 with concomitant MDD and AUD (MDD+AUD) received 20 dTMS sessions. Clinical status was assessed through the Hamilton Depression Rating Scale (HDRS) and the Clinical Global Impressions severity scale (CGIs), craving through the Obsessive Compulsive Drinking Scale (OCDS) in MDD+AUD, and functioning with the Global Assessment of Functioning (GAF). There were no significant differences between the two groups in sociodemographic (age, sex, years of education and duration of illness) and baseline clinical characteristics, including scores on assessment scales. Per cent drops on HDRS and CGIs scores at the end of the sessions were respectively 62.6% and 78.2% for MDD+AUD, and 55.2% and 67.1% for MDD (p<0.001). HDRS, CGIs and GAF scores remained significantly improved after the 6-month follow-up. HDRS scores dropped significantly earlier in MDD+AUD than in MDD LIMITATIONS: The small sample size and factors inherent to site and background treatment may have affected results. High frequency bilateral DLPFC dTMS with left preference was well tolerated and effective in patients with MDD, with or without AUD. The antidepressant effect of dTMS is not affected by alcohol abuse in patients with depressive episodes. The potential use of dTMS for mood modulation as an adjunct to treatment in patients with a depressive episode, with or without alcohol abuse, deserves further investigation.",Rapinesi C.; Curto M.; Kotzalidis GD.; Del Casale A.; Serata D.; Ferri VR.; Di Pietro S.; Scatena P.; Bersani FS.; Raccah RN.; Digiacomantonio V.; Ferracuti S.; Bersani G.; Zangen A.; Angeletti G.; Girardi P.,2015.0,10.1016/j.jad.2014.11.015,0,0,
4911,The Yin and Yang of support from significant others: Influence of general social support and partner support of avoidance in the context of treatment for social anxiety disorder.,"Support from social networks is generally considered to protect against mental disorder but in some circumstances support for negative behaviours (such as avoidance) may be counterproductive. Given the critical interplay between social anxiety disorder and social interactions, it is surprising that the relationship of support from significant others to this disorder has received so little attention. The current study evaluated the reciprocal relationships between perceived social support and perceived partner support for avoidance behaviours (avoidance support) among a sample of 131 participants with social anxiety disorder who were assessed three times within the context of a treatment outcome study. A new measure of partner support for avoidance behaviours was developed, called the Avoidance Support Measure, and showed adequate internal consistency and construct validity. Correlations at baseline showed significant negative relationships between perceived social support and social anxiety and significant positive relationships between avoidance support and social anxiety. Path analysis showed that perceived social support at Times 1 and 2 negatively predicted future social anxiety at Times 2 and 3. On the other hand, only a single predictive relationship involving avoidance support was significant and showed that social anxiety at Time 1 positively predicted avoidance support at Time 2. These early results point to the different ways that support from significant others might relate to social anxiety and suggest that further work in this area may be fruitful.",Rapee RM.; Peters L.; Carpenter L.; Gaston JE.,2015.0,10.1016/j.brat.2015.03.012,0,0,
4912,Integrating cognitive bias modification into a standard cognitive behavioural treatment package for social phobia: a randomized controlled trial.,"The aim of the current study was to integrate recent developments in the retraining of attentional biases towards threat into a standard cognitive behavioural treatment package for social phobia. 134 participants (M age-32.4: 53% female) meeting DSM-IV criteria for social phobia received a 12-week cognitive behavioural treatment program. They were randomly allocated to receive on a daily basis using home practice, either an additional computerised probe procedure designed to train attentional resource allocation away from threat, or a placebo variant of this procedure. Measures included diagnostic severity, social anxiety symptoms, life interference, and depression as well as state anxiety in response to a laboratory social threat. At the end of treatment there were no significant differences between groups in attentional bias towards threat or in treatment response (all p's>0.05). Both groups showed similar and highly significant reductions in diagnostic severity, social anxiety symptoms, depression symptoms, and life interference at post-treatment that was maintained and in most cases increased at 6 month follow-up (uncontrolled effect sizes ranged from d=0.34 to d=1.90). The current results do not indicate that integration of information processing-derived attentional bias modification procedures into standard treatment packages as conducted in this study augments attentional change or enhances treatment efficacy. Further refinement of bias modification techniques, and better methods of integrating them with conventional approaches, may be needed to produce better effects.",Rapee RM.; MacLeod C.; Carpenter L.; Gaston JE.; Frei J.; Peters L.; Baillie AJ.,2013.0,10.1016/j.brat.2013.01.005,0,0,
4913,The effects of video feedback on the self-evaluation of performance in socially anxious subjects.,"Previous research has demonstrated that socially anxious subjects appraise their own social performance as worse than it is seen by independent observers, but are able to appraise the performance of others accurately. Three studies are reported in which socially anxious subjects evaluated their own social performance after viewing it via video. In each study, ratings made following video were closer to those made by independent observers than were ratings made without the benefit of video. In addition, this effect was similar in both socially anxious and nonanxious people. A model is proposed in which self evaluation of one's social performance is based on a mental representation of one's external appearance which receives input from long term memory, internal cues, and external cues.",Rapee RM.; Hayman K.,1996.0,,0,0,
4914,Cognitive mediation in the affective component of spontaneous panic attacks,"ER Single inhalations of a 50% carbon dioxide/50% oxygen gas mixture were administered to 16 subjects with spontaneous panic attacks and to 16 social phobics who did not experience such attacks. Half of each diagnostic category was randomly allocated to either a no explanation condition in which minimal instructions on expected outcome were provided, or an explanation condition in which all possible sensations were described and attributed to the effects of the gas. Subjects with panic attacks who were given no explanation reported a greater proportion of catastrophic cognitions, greater panic, and a greater similarity of the overall experience to a naturally-occurring panic attack than those with panic attacks who received a full explanation. In contrast, both groups of social phobics reported similar effects to each other, regardless of the explanation given. The results provide support for cognitive mediation in the ""panic"" component of spontaneous panic attacks.","Rapee, R; Mattick, R; Murrell, E",1986.0,,0,0,
4915,Outcomes following mindfulness-based cognitive therapy in a heterogeneous sample of adult outpatients.,"Research on mindfulness-based cognitive therapy (MBCT; Segal, Williams, & Teasdale, 2002a) has supported the effectiveness of this approach for use with preventing relapse in recurrent depression. This study evaluated the use of MBCT in a heterogeneous sample of 26 psychiatric outpatients with mood and/or anxiety disorders. Results from both completer and intent to treat analyses showed that MBCT was associated with statistically significant improvements in depression, anxiety, stress, and insomnia symptoms. Rates of clinically significant improvement were comparable with effectiveness studies of cognitive behaviour therapy and mindfulness-based stress reduction in heterogeneous samples. It is concluded that MBCT may be of value for a range of psychological presentations, administered in heterogeneous groups. Future, controlled, research is required to further evaluate this conclusion and to investigate mechanisms of change. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ree, Melissa J; Craigie, Mark A; Baer, Baer, Bastien, Beck, Beck, Borkovec, Borkovec, Breslin, Brown, Carlson, Chambless, Cohen, Craske, Devilly, Diebold, Grossman, Hayes, Kabat-Zinn, Kabat-Zinn, Kabat-Zinn, Kabat-Zinn, Kabat-Zinn, Kristeller, Lovibond, Lovibond, Ma, Majumdar, Mennin, Miller, Pauzano-Slamm, Reibel, Roemer, Rosenberg, Segal, Segal, Shadish, Shapiro, Singh, Speca, Tacon, Teasdale, Teasdale, Teasdale, Weissbecker, Wells, Westbrook",2007.0,,0,0,
4916,"Olfactory function in patients with postinfectious and posttraumatic smell disorders before and after treatment with vitamin A: a double-blind, placebo-controlled, randomized clinical trial",,"Reden, J; Lill, K; Zahnert, T; Haehner, A; Hummel, T",2012.0,10.1002/lary.23405,0,0,
4917,The effect of a yoga intervention on alcohol and drug abuse risk in veteran and civilian women with posttraumatic stress disorder.,"Background: Individuals with posttraumatic stress disorder (PTSD) often exhibit high-risk substance use behaviors. Complementary and alternative therapies are increasingly used for mental health disorders, although evidence is sparse. Objectives: Investigate the effect of a yoga intervention on alcohol and drug abuse behaviors in women with PTSD. Secondary outcomes include changes in PTSD symptom perception and management and initiation of evidence-based therapies. Materials and Methods: The current investigation analyzed data from a pilot randomized controlled trial comparing a 12-session yoga intervention with an assessment control for women age 18 to 65 years with PTSD. The Alcohol Use Disorder Identification Test (AUDIT) and Drug Use Disorder Identification Test (DUDIT) were administered at baseline, after the intervention, and a 1-month follow-up. Linear mixed models were used to test the significance of the change in AUDIT and DUDIT scores over time. Treatment-seeking questions were compared by using Fisher exact tests. Results: The mean AUDIT and DUDIT scores decreased in the yoga group; in the control group, mean AUDIT score increased while mean DUDIT score remained stable. In the linear mixed models, the change in AUDIT and DUDIT scores over time did not differ significantly by group. Most yoga group participants reported a reduction in symptoms and improved symptom management. All participants expressed interest in psychotherapy for PTSD, although only two participants, both in the yoga group, initiated therapy. Conclusions: Results from this pilot study suggest that a specialized yoga therapy may play a role in attenuating the symptoms of PTSD, reducing risk of alcohol and drug use, and promoting interest in evidence-based psychotherapy. Further research is needed to confirm and evaluate the strength of these effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Reddy, Shivani; Dick, Alexandra M; Gerber, Megan R; Mitchell, Karen; Astin, Babor, Barnes, Behere, Berman, Birdee, Bock, Carter, Dobie, Emerson, First, Foa, Foa, Frayne, Frayne, Freedy, Goldblatt, Hien, Hoge, Jacobson, Kessler, Kessler, Kessler, Khalsa, Khalsa, Kulka, Libby, Libby, McGovern, Mills, Mills, Mills, Mitchell, Mitchell, Nazarian, Ouimette, Pietrzak, Riggs, Sannibale, Schnurr, Schottenbauer, Seal, Seal, Seal, Shaffer, Smith, Stein, Strauss, Streeter, Vedamurthachar, White, Wisco",2014.0,,0,0,
4918,The effect of a yoga intervention on alcohol and drug abuse risk in veteran and civilian women with posttraumatic stress disorder.,"Individuals with posttraumatic stress disorder (PTSD) often exhibit high-risk substance use behaviors. Complementary and alternative therapies are increasingly used for mental health disorders, although evidence is sparse. Investigate the effect of a yoga intervention on alcohol and drug abuse behaviors in women with PTSD. Secondary outcomes include changes in PTSD symptom perception and management and initiation of evidence-based therapies. The current investigation analyzed data from a pilot randomized controlled trial comparing a 12-session yoga intervention with an assessment control for women age 18 to 65 years with PTSD. The Alcohol Use Disorder Identification Test (AUDIT) and Drug Use Disorder Identification Test (DUDIT) were administered at baseline, after the intervention, and a 1-month follow-up. Linear mixed models were used to test the significance of the change in AUDIT and DUDIT scores over time. Treatment-seeking questions were compared by using Fisher exact tests. The mean AUDIT and DUDIT scores decreased in the yoga group; in the control group, mean AUDIT score increased while mean DUDIT score remained stable. In the linear mixed models, the change in AUDIT and DUDIT scores over time did not differ significantly by group. Most yoga group participants reported a reduction in symptoms and improved symptom management. All participants expressed interest in psychotherapy for PTSD, although only two participants, both in the yoga group, initiated therapy. Results from this pilot study suggest that a specialized yoga therapy may play a role in attenuating the symptoms of PTSD, reducing risk of alcohol and drug use, and promoting interest in evidence-based psychotherapy. Further research is needed to confirm and evaluate the strength of these effects.",Reddy S.; Dick AM.; Gerber MR.; Mitchell K.,2014.0,10.1089/acm.2014.0014,0,0,
4919,The functional neuroanatomy of anxiety: a study of three disorders using positron emission tomography and symptom provocation.,"Previous neuroimaging research has contributed insights regarding the neural substrates of specific psychiatric disorders. The purpose of this study was to determine the shared mediating neuroanatomy of anxiety symptoms across three different anxiety disorders. Data were pooled from 23 right-handed adult outpatients meeting criteria for obsessive-compulsive disorder, simple phobia, or posttraumatic stress disorder. Relative regional cerebral blood flow (rCBF) was measured using positron emission tomography in the context of symptom provocation paradigms. Symptom severity was measured via self-reports. The analysis of pooled imaging data indicated activation in right inferior frontal cortex, right posterior medial orbitofrontal cortex, bilateral insular cortex, bilateral lenticulate nuclei, and bilateral brain stem foci during the symptomatic versus control conditions. A positive correlation was found between rCBF at one brain stem locus and subjective anxiety scores (r = .744, p < .001). These findings suggest that elements of the paralimbic belt together with right inferior frontal cortex and subcortical nuclei mediate symptoms across different anxiety disorders. In addition, activation at one brain stem locus appears to be associated with the subjective severity of anxiety. Further studies are warranted to determine whether these same brain systems mediate normal anxiety states as well.",Rauch SL.; Savage CR.; Alpert NM.; Fischman AJ.; Jenike MA.,1997.0,10.1016/S0006-3223(97)00145-5,0,0,
4920,Probing striatal function in obsessive-compulsive disorder: a PET study of implicit sequence learning.,"Positron emission tomography was employed to contrast the brain activation pattern in patients with obsessive-compulsive disorder (OCD) to that of matched control subjects while they performed an implicit learning task. Although patients and control subjects evidenced comparable learning, imaging data from control subjects indicated bilateral inferior striatal activation, whereas OCD patients did not activate right or left inferior striatum and instead showed bilateral medial temporal activation. The findings further implicate corticostriatal dysfunction in obsessive-compulsive disorder. Furthermore, when OCD patients are confronted with stimuli that call for recruitment of corticostriatal systems, they instead appear to access brain regions normally associated with explicit (conscious) information processing.",Rauch SL.; Savage CR.; Alpert NM.; Dougherty D.; Kendrick A.; Curran T.; Brown HD.; Manzo P.; Fischman AJ.; Jenike MA.,1997.0,10.1176/jnp.9.4.568,0,0,
4921,Cerebral metabolic correlates as potential predictors of response to anterior cingulotomy for obsessive compulsive disorder.,"As interventions for severe, treatment-refractory obsessive compulsive disorder (OCD), neurosurgical procedures are associated with only modest efficacy. The purpose of this study was to identify cerebral metabolic correlates as potential predictors of treatment response to anterior cingulotomy for OCD. Clinical data were analyzed in the context of a retrospective design. Ss were 11 patients (aged 22-61 yrs) who underwent stereotactic anterior cingulotomy for OCD. Symptom severity was measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) before and at approximately 6 mo postoperative. Preoperative F-18 fluorodeoxyglucose-positron emission tomography (FDG-PET) data were available. Statistical parametric mapping methods were used to identify loci of significant correlation between preoperative regional cerebral metabolism and postoperative reduction in Y-BOCS scores. One locus within right posterior cingulate cortex was identified, where preoperative metabolism was significantly correlated with improvement in OCD symptom severity following cingulotomy. Specifically, higher preoperative rates of metabolism at that locus were associated with better postoperative outcome. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Rauch, Scott L; Dougherty, Darin D; Cosgrove, G. Rees; Cassem, Edwin H; Alpert, Nathaniel M; Price, Bruce H; Nierenberg, Andrew A; Mayberg, Helen S; Baer, Lee; Jenike, Michael A; Fischman, Alan J; Alpert, Alpert, Baer, Beck, Brody, Busatto, Cavada, Cosgrove, Duncan, Friston, Friston, Friston, Goodman, Kemp, Lippitz, MacLean, Maddock, Manno, Mayberg, Mayberg, McGuire, Olson, Pandya, Papez, Rauch, Rauch, Rauch, Rauch, Rauch, Rauch, Rauch, Saxena, Saxena, Spangler, Spitzer, Sutherland, Swedo, Talairach, Theodore, Vogt, Vogt, Vogt, Worsley, Zald",2001.0,,0,0,
4922,Changes in Salivary Cortisol During Psychotherapy for Posttraumatic Stress Disorder: A Pilot Study in 30 Veterans.,"Convergent evidence suggests that the hypothalamic-pituitary-adrenal (HPA) axis is disrupted in posttraumatic stress disorder (PTSD) and that HPA axis normalization may be associated with symptom improvement. Thus, the current study was designed to test the association between HPA axis reactivity and treatment response in psychotherapy for PTSD. Thirty returning veterans with DSM-IV-TR PTSD were randomly assigned to receive 10 sessions of prolonged exposure therapy or present-centered therapy as part of a previously published randomized clinical trial (2008-2010). Treatment groups were collapsed for the current analyses. Salivary cortisol was collected 3 times during 3 therapy sessions. Cortisol reactivity was calculated by area under the curve with respect to ground. Hierarchical linear modeling was used to measure longitudinal change in salivary cortisol nested within patients and to test the effects of treatment responder status at both levels. Session number was significant in the final model, indicating linear increases in cortisol output across sessions (β = 1.06, P = .02). In addition, responder status significantly predicted slope of cortisol reactivity across sessions (β = 1.35, P = .04). Compared to high responders, low responders exhibited a 1.35 (μg/dL) mean increase in cortisol reactivity between sessions. Responder status accounted for 6% of the previously unexplained variance in cortisol reactivity. As compared to high treatment responders, low treatment responders showed greater increases in salivary cortisol output over the course of treatment. These results indicate that increases in HPA axis reactivity over the course of psychotherapy may be associated with worse treatment response. Future work is needed to investigate how modulation of HPA axis reactivity may be targeted in order to optimize PTSD treatment outcomes. ClinicalTrials.gov identifier: NCT00475241​.",Rauch SAM.; King AP.; Liberzon I.; Sripada RK.,2017.0,10.4088/JCP.15m10596,0,0,
4923,Imagery vividness and perceived anxious arousal in prolonged exposure treatment for PTSD.,"The present paper examines imagery vividness and anxiety during Prolonged Exposure (PE) for chronic PTSD among 69 female survivors of sexual or nonsexual assault. All participants received between 9 and 12 individual sessions of either PE alone or in combination with cognitive restructuring. As hypothesized, vividness and anxiety ratings from early imaginal exposure sessions were moderately to highly correlated, but these correlations decreased in later sessions. Both subjective distress and vividness decreased significantly with exposure. Greater reductions in subjective distress between the first and last exposure session were related to better outcome. However, contrary to hypothesis, vividness was not related to outcome. Theoretical implications of the results are discussed.",Rauch SA.; Foa EB.; Furr JM.; Filip JC.,2004.0,10.1007/s10960-004-5794-8,0,0,
4924,Prolonged exposure for PTSD in a Veterans Health Administration PTSD clinic.,"With the move toward dissemination of empirically supported treatments in the Veterans Health Administration (VHA), dissemination of additional data concerning the effectiveness of prolonged exposure (PE) among veterans is important. The authors present clinical treatment data from veterans with chronic posttraumatic stress disorder (PTSD) treated in a VHA PTSD clinic (N = 10). Veterans demonstrated significant reductions in total PTSD symptoms from pre- to posttreatment. Returning veterans from the conflicts in Afghanistan and Iraq and other era veterans (Vietnam Veterans and military sexual trauma veterans) demonstrated significant reductions in PTSD. In addition, veterans demonstrated significant reductions in depression from pre- to posttreatment. In conclusion, PE is effective in reducing the symptoms of PTSD in veterans.",Rauch SA.; Defever E.; Favorite T.; Duroe A.; Garrity C.; Martis B.; Liberzon I.,2009.0,10.1002/jts.20380,0,0,
4925,Instigation of assertive behavior through videotape-mediated assertive models and directed practice,,"Rathus, S A",1973.0,,0,0,
4926,Evaluation of a Cognitive-Behavioral Therapy of Inpatients with DSM-IV Panic Disorder.,"Objective: We herein present first results from a 5-week standardized in-patient cognitive-behavioural therapy programme for anxiety disorders at the centre of mental health, Ingolstadt. 44 patients with panic disorder according to DSM-IV (38% with isolated panic disorder, 62% with at least one comorbid psychiatric disorder) were included. Methods: The severity of symptomatology was determined using psychometric scales at baseline and at the end of therapy. Results: In general, therapy was highly effective. Panic symptoms as well as anxious cognitions and avoidance behaviour were significantly lower at the end of therapy. Conclusions: The therapy programme was highly effective in a special group of patients with severe pure as well as comorbid panic disorder according to DSM-IV. The most relevant finding of the present study is from our point of view the proof of efficacy of the treatment programme in a sample of patients which also included severely ill patients with comorbid psychiatric disorders. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Rathgeb-Fuetsch, Martina; Beer, Ulrike; Pollmacher, Thomas; Schuld, Andreas",2007.0,,0,0,
4927,Short- and long- term efficacy of cognitive behavioral therapy for DSM-IV panic disorder in patients with and without severe psychiatric comorbidity.,"Cognitive behavioral therapy (CBT) and/or pharmacological therapy are considered to be effective in the treatment of anxiety disorders. Anxiety patients frequently suffer from comorbid psychiatric disorders such as depression or substance disorders. Ongoing substance disorders and/or severe depressive symptomatology often are the reason why patients are not treated by outpatient psychotherapy. The present study was designed to evaluate whether CBT is comparably effective both in anxiety patients with and without comorbid axis-I-diagnoses. In a 5-weeks standardized inpatient CBT program for anxiety disorders at the Center of Mental Health, Ingolstadt, 48 patients with panic disorder according to DSM-IV were included. 42% of the patients suffered from panic disorder only, 58% from at least one further mental disorder, mainly from affective and/or substance disorders. The severity of symptomatology was determined using psychometric scales at admission, at discharge and at the follow-up investigation. In general, therapy was highly effective. Panic symptoms as well as anxious cognitions and avoidance behavior were significantly reduced at discharge and results remained stable until the follow-up investigation. Therapy was equally effective in both groups, in patients with pure and patients with comorbid panic disorder at discharge as well as at the follow-up investigation. Thus, patients with comorbid affective or substance disorders should not be excluded from psychotherapeutic programs in future.",Rathgeb-Fuetsch M.; Kempter G.; Feil A.; Pollmächer T.; Schuld A.,2011.0,10.1016/j.jpsychires.2011.03.018,0,0,
4928,Thought-action fusion as a causal factor in the development of intrusions.,"Thought-action fusion refers to the tendency to treat thoughts and actions as equivalents. Some authors (e.g., Rachman, 1997; Behaviour Research and Therapy, 35, 793-802) have suggested that thought-action fusion plays a role in the etiology of obsessive intrusions. The present study sought to test this idea. Subjects (n = 19) in the experimental condition underwent a bogus EEG recording session. They were informed that the apparatus was able to pick up the word 'apple' and that thoughts of that word could result in the administration of electrical shocks to another person. After having spent 15 minutes in the EEG laboratory, experimental subjects and controls (n = 26) completed a short questionnaire containing items about characteristics of the target thought (e.g., frequency, aversiveness). Results indicate that thought-action fusion, indeed, promotes intrusive thinking in that it results in a higher frequency of target thoughts, more discomfort, and more resistance. Thus, the current findings support the idea that thought-action fusion may contribute to the development of obsessive intrusions.",Rassin E.; Merckelbach H.; Muris P.; Spaan V.,1999.0,,0,0,
4929,The thought-action fusion scale: Further evidence for its reliability and validity,"Thought-action fusion (TAF) refers to a set of cognitive biases that are thought to play a role in the development of obsessional phenomena. To measure these biases, R. Shafran, D. S. Thordarson, and S. Rachman (1996; Journal of Anxiety Disorders, 10, 379-391) developed the TAF-scale. They concluded that the TAF-scale possesses adequate psychometric qualities. The current study sought to further explore the reliability and validity of the TAF-scale. Results indicate that the TAF-scale has good internal consistency. TAF-scores correlated with self-reports of obsessional problems. Furthermore, mean scores in a mixed sample of anxiety disordered patients were higher than those in a normal sample. However, temporal consistency was somewhat disappointing. Also, the question remains whether TAF is specific to obsessive-compulsive disorder or taps more pervasive biases that play a role in a variety of disorders. Copyright © 2001 Elsevier Science Ltd.",Rassin E.; Merckelbach H.; Muris P.; Schmidt H.,2001.0,10.1016/S0005-7967(00)00031-0,0,0,
4930,Thought-action fusion and thought suppression in obsessive-compulsive disorder.,"To examine the significance of thought-action fusion (TAF) and thought suppression tendencies, the present study obtained pre- and post-treatment questionnaire data on these constructs in a sample of OCD patients (n=24) and non-OCD anxiety patients (n=20). Results indicate that TAF and suppression are correlated with severity of psychopathology. Yet, the associations between TAF and psychopathology are not typical for OCD, but do also occur in other anxiety disorders (e.g., panic disorder, post traumatic stress disorder, and social phobia). As well, mean scores on the TAF and thought suppression measures dropped significantly from pre- to post-treatment, indicating that TAF and thought suppression are susceptible to change during psychotherapy.",Rassin E.; Diepstraten P.; Merckelbach H.; Muris P.,2001.0,,0,0,
4931,The contribution of thought-action fusion and thought suppression in the development of obsession-like intrusions in normal participants,"Both thought-action fusion (TAF: i.e., a cognitive bias implying an inflated sense of responsibility for one's own thoughts) and thought suppression have been claimed to contribute to the development of obsession-like intrusions. Therefore, it seems plausible that conjunction of these phenomena results in highly intense intrusions. However, possible interactions between TAF and thought suppression have not yet been investigated experimentally. In the current study, healthy volunteers were exposed to a TAF-like intrusion. They were, then, randomly assigned to a suppression (n=21) or non-suppression condition (n=19). Next, visual analogue scales (VASs) were completed measuring anxiety, feelings of responsibility and guilt, urge to neutralise and so on. Contrary to expectation, several VAS scores were lower for participants in the suppression group than for those in the non-suppression group. Hence, it is concluded that thought suppression may, at least in the short term, alleviate discomfort caused by TAF-like intrusions. Copyright © 2001 Elsevier Science Ltd.",Rassin E.,2001.0,10.1016/S0005-7967(00)00075-9,0,0,
4932,"A preliminary study of tryptophan depletion on tics, obsessive-compulsive symptoms, and mood in Tourette's syndrome.","The effects of acute tryptophan depletion in 6 26-46 yr old patients (4 males, 2 females) with Tourette's syndrome (TS) were studied in a randomized, double-blind, placebo-controlled fashion in 2 2-day sessions spaced 1 wk apart. On day 1, Ss received a 3-meal diet containing 160 mg tryptophan, supplemented with 3 500 mg tryptophan capsules. On day 2, Ss received a 16 amino acid drink containing 2.3 g tryptophan. Statistical analyses showed no worsening of tics, obsessive-compulsive symptoms, or mood in response to tryptophan depletion in TS. There were no significant differences between the control and tryptophan depletion conditions in symptom changes over time, and S-rated tics actually decreased across time in both conditions. These data suggest that decreases in plasma tryptophan, which presumably decrease CNS levels of tryptophan and 5-hydroxytryptamine (5-HT), do not influence TS symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Rasmusson, Ann M; Anderson, George M; Lynch, Kimberly A; McSwiggan-Hardin, Maureen; Scahill, Lawrence D; Mazure, Carolyn M; Goodman, Wayne K; Price, Lawrence H; Cohen, Donald J; Leckman, James F",1997.0,,0,0,
4933,Plasma neuropeptide Y (NPY) increases in humans in response to the α2 antagonist yohimbine,"Previous studies have shown that the intravenous administration of yohimbine, an α2 antagonist, increases norepinephrine turnover and has related anxiogenic effects in humans. We herein report that yohimbine also increases plasma neuropeptide Y (NPY) in healthy human subjects. This finding is consistent with previous reports in animals, but contrasts with a previously reported study in humans. NPY is a 36 amino acid peptide neurotransmitter located in sympathetic and nonsympathetic nerve fibers, as well as in brain structures such as the locus coeruleus, where it is colocalized with norepinephrine. NPY has been shown to inhibit locus coeruleus neuronal firing, decrease norepinephrine release, and increase postsynaptic noradrenergic signal transduction. When administered centrally, NPY also has anxiolytic properties. This study therefore suggests that yohimbine challenge may be useful in assessing NPY and noradrenergic system interactions in neuropsychiatric disorders such as panic disorder or post traumatic stress disorder in which noradrenergic system dysfunction has been observed.",Rasmusson A.M.; Southwick S.M.; Hauger R.L.; Charney D.S.,1998.0,10.1016/S0893-133X(97)00199-1,0,0,
4934,Psychosocial consequences in the Danish randomised controlled lung cancer screening trial (DLCST),"ER OBJECTIVES: To measure the psychosocial consequences in the Danish lung cancer screening trial (DLCST) and compare those between the computed tomography (CT) group and the control group.MATERIALS AND METHODS: This study was a single centre randomised controlled trial with five annual screening rounds. Healthy current or former heavy smokers aged 50-70 years (men and women) were randomised 1:1 to a CT group and a control group. Heavy smokers were defined by having smoked ?20 pack years and former smokers by being abstinent ?10 years. Both groups were invited annually to the screening clinic to complete the validated lung-cancer-specific questionnaire consequences of screening lung cancer (COS-LC). The CT group was also offered a low dose CT scan of the lungs. The COS-LC measures nine scales with psychosocial properties: Anxiety, Behaviour, Dejection, Negative impact on sleep, Self-blame, Focus on Airway Symptoms, Stigmatisation, Introvert, and Harm of Smoking.RESULTS: 4104 participants were randomised to the DLCST and the COS-LC completion rates for the CT group and the control group were 95.5% and 73.6%, respectively. There was a significant increase in negative psychosocial consequences from baseline through rounds 2-5 for both the CT group and the control group (mean increase >0, p0 and p<.033).CONCLUSIONS: Lung cancer CT-screening trials induced more negative psychosocial reactions in both the CT group and the control group compared with the baseline psychosocial profile. The CT group experienced less negative psychosocial consequences compared with the control group, which might be explained by reassurance among those with normal screening results.TRIAL REGISTRATION: ClinicalTrials.gov: NCT00496977.","Rasmussen, J F; Siersma, V; Pedersen, J H; Brodersen, J",2015.0,10.1016/j.lungcan.2014.11.003,0,0,
4935,"A multi-faceted workplace intervention targeting low back pain was effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence: stepped wedge cluster randomised trial","ER METHODS: A stepped wedge cluster randomised, controlled trial with 594 nurses' aides was conducted. The intervention lasted 12 weeks and consisted of physical training (12 sessions), cognitive behavioural training (two sessions) and participatory ergonomics (five sessions). Occupational lifting, fear avoidance, physical exertion, muscle strength, support from management, work ability and sickness absence due to low back pain were measured every 3 months. Before and after the intervention we measured physical capacity, kinesiophobia and need for recovery. Linear mixed models adjusted for baseline values of the outcome were used to estimate the effect.RESULTS: Significant reduction in occupational lifting (-0.35 (95% confidence interval -0.61 to -0.08)), and improvement in two measures of fear avoidance ((-0.75 (95% confidence interval -1.05 to -0.45) and -0.45 (95% confidence interval -0.80 to -0.11)) were found for the intervention group compared to the control. There were no significant effects on physical exertion, muscle strength, support from management, work ability or sickness absence due to low back pain. After the intervention, significant increased physical capacity and improvements in kinesiophobia were found, but no change in need for recovery. CONCLUSIONS THE INTERVENTION WAS SIGNIFICANTLY EFFECTIVE FOR PHYSICAL WORK DEMANDS AND MALADAPTIVE PAIN BEHAVIOURS, BUT NOT FOR WORK ABILITY AND SICKNESS ABSENCE DUE TO LOW BACK PAIN TO IMPROVE WORK ABILITY OR REDUCE SICKNESS ABSENCE DUE TO LOW BACK PAIN MORE SPECIFIC INTERVENTIONS SHOULD PROBABLY BE DEVELOPED.AIMS: The aims of this study were to test whether a multi-faceted intervention effective for low back pain was effective for physical capacity, work demands, maladaptive pain behaviours, work ability and sickness absence due to low back pain.","Rasmussen, C D; Holtermann, A; J√∏rgensen, M B; √òrberg, A; Mortensen, O S; S√∏gaard, K",2016.0,10.1177/1403494816653668,0,0,
4936,Posttraumatic stress disorder among refugees: Measurement invariance of Harvard Trauma Questionnaire scores across global regions and response patterns.,"Despite the central role of posttraumatic stress disorder (PTSD) in international humanitarian aid work, there has been little examination of the measurement invariance of PTSD measures across culturally defined refugee subgroups. This leaves mental health workers in disaster settings with little to support inferences made using the results of standard clinical assessment tools, such as the severity of symptoms and prevalence rates. We examined measurement invariance in scores from the most widely used PTSD measure in refugee populations, the Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992), in a multinational and multilingual sample of asylum seekers from 81 countries of origin in 11 global regions. Clustering HTQ responses to justify grouping regional groups by response patterns resulted in 3 groups for testing measurement invariance: West Africans, Himalayans, and all others. Comparing log-likelihood ratios showed that while configural invariance seemed to hold, metric and scalar invariance did not. These findings call into question the common practice of using standard cut-off scores on PTSD measures across culturally dissimilar refugee populations. In addition, high correlation between factors suggests that the construct validity of scores from North American and European measures of PTSD may not hold globally.",Rasmussen A.; Verkuilen J.; Ho E.; Fan Y.,2015.0,10.1037/pas0000115,0,0,
4937,A trial of prazosin for combat trauma PTSD with nightmares in active-duty soldiers returned from Iraq and Afghanistan.,"The authors conducted a 15-week randomized controlled trial of the alpha-1 adrenoreceptor antagonist prazosin for combat trauma nightmares, sleep quality, global function, and overall symptoms in active-duty soldiers with posttraumatic stress disorder (PTSD) returned from combat deployments to Iraq and Afghanistan. Sixty-seven soldiers were randomly assigned to treatment with prazosin or placebo for 15 weeks. Drug was titrated based on nightmare response over 6 weeks to a possible maximum dose of 5 mg midmorning and 20 mg at bedtime for men and 2 mg midmorning and 10 mg at bedtime for women. Mean achieved bedtime doses were 15.6 mg of prazosin (SD=6.0) and 18.8 mg of placebo (SD=3.3) for men and 7.0 mg of prazosin (SD=3.5) and 10.0 mg of placebo (SD=0.0) for women. Mean achieved midmorning doses were 4.0 mg of prazosin (SD=1.4) and 4.8 mg of placebo (SD=0.8) for men and 1.7 mg of prazosin (SD=0.5) and 2.0 mg of placebo (SD=0.0) mg for women. Primary outcome measures were the nightmare item of the Clinician-Administered PTSD Scale (CAPS), the Pittsburgh Sleep Quality Index, and the change item of the Clinical Global Impressions Scale anchored to functioning. Secondary outcome measures were the 17-item CAPS, the Hamilton Depression Rating Scale, the Patient Health Questionnaire-9, and the Quality of Life Index. Maintenance psychotropic medications and supportive psychotherapy were held constant. Prazosin was effective for trauma nightmares, sleep quality, global function, CAPS score, and the CAPS hyperarousal symptom cluster. Prazosin was well tolerated, and blood pressure changes did not differ between groups. Prazosin is effective for combat-related PTSD with trauma nightmares in active-duty soldiers, and benefits are clinically meaningful. Substantial residual symptoms suggest that studies combining prazosin with effective psychotherapies might demonstrate further benefit.",Raskind MA.; Peterson K.; Williams T.; Hoff DJ.; Hart K.; Holmes H.; Homas D.; Hill J.; Daniels C.; Calohan J.; Millard SP.; Rohde K.; O'Connell J.; Pritzl D.; Feiszli K.; Petrie EC.; Gross C.; Mayer CL.; Freed MC.; Engel C.; Peskind ER.,2013.0,10.1176/appi.ajp.2013.12081133,0,0,
4938,Sustained recovery from chronic alcohol dependence with prazosin treatment of PTSD,"Distressing and disabling reexperiencing and hyperarousal symptoms (such as trauma nightmares, sleep disruption, hypervigilance and irritability with anger outbursts) in combat trauma posttraumatic stress disorder (PTSD) have generally been refractory to psychotropic medications or psychotherapy. The majority of Vietnam veterans with chronic PTSD have resorted to alcohol as “self medication” to gain a few hours of sleep and to suppress daytime irritability. Alcohol dependence has been a common consequence. Because enhanced adrenergic activity contributes to the pathophysiology of PTSD, we evaluated the effect of the brain active generic alpha-1 adrenoreceptor antagonist prazosin for PTSD nightmares, sleep disruption and global sense of well-being in two African-American Vietnam combat veterans with chronic PTSD. The alpha-1 adrenoreceptor mediates arousal and alarm by multiple mechanisms including the stimulatory regulation of CRF release. Both combat veterans had severe chronic alcohol dependence and had failed multiple alcohol dependence treatments. The 3-item Audit C score for both veterans was 15. Nightmares remitted, sleep normalized and daytime sense of well-being markedly improved after achieving a maintenance prazosin dose of 5 mg twice daily and 10 mg at bedtime. Alcohol use completely stopped and both veterans have remained free of any alcohol use for the past 12 years to the present (2008). Prazosin dose has been held constant. Prazosin efficacy for PTSD trauma nightmares, sleep disruption and global clinical status has been confirmed in three placebo-controlled trials in both veterans and civilians. Prazosin anecdotally helped study subjects and other persons with PTSD reduce or eliminate alcohol use. These clinical observations stimulated the preclinical and clinical studies of prazosin effects on alcohol dependence to be presented in this symposium.",Raskind M.A.,2009.0,10.1111/j.1530-0277.2009.00948.x,0,0,
4939,Antidepressants in black and white inpatients. Differential response to a controlled trial of chlorpromazine and imipramine,"ER Differential effects of chlorpromazine, imipramine hydrochloride, and a placebo were examined in 159 black and 555 white depressed patients in a multihospital collaborative study. In making these comparisons, the effects of age and social class were controlled. The major study findings were the differential effects of the active drugs for the black men and women. Chlorpromazine was the most efficacious treatment for black women, whereas imipramine was most efficacious for black men. These differences occurred on global ratings of improvement as well as on specific symptoms such as depression, anxiety, guilt-worthlessness, sleep disturbances, and social participation. Black patients also evidenced a higher improvement rate at one week, irrespective of treatment, than did the white patients.","Raskin, A; Crook, T H",1975.0,,0,0,
4940,Effectiveness of depression and anxiety prevention in adolescents with high familial risk: study protocol for a randomized controlled trial,"ER METHODS/DESIGN: We designed a randomized controlled trial to test the effectiveness of an indicated and selective prevention program aimed at depression and anxiety in adolescent girls. Adolescents aged between 11 and 15 years old with depressive and/or anxiety symptoms and with parents who show indicators of parental psychopathology will be randomly assigned to the experimental (N = 80) or control groups (N = 80). Participants in the experimental group will follow a preventive intervention, consisting of six sessions of 90 minutes each. All participants will complete baseline, intervention phase 1 (after session 2), intervention phase 2 (after session 4), post-intervention, 6 month follow-up, and 12 month follow-up assessments. Furthermore, parents will be asked to complete assessments at baseline, post-intervention, and 12-month follow-up. Primary outcome will be depressive symptoms. Secondary outcomes will be anxiety symptoms, suicidal ideation, response style, negative cognitive errors, parental emotional support and parental control, parental psychopathology, parenting stress and adolescents' depression and anxiety symptoms according to the parents.DISCUSSION: This paper described the study designed to evaluate a program for preventing depression and/or anxiety in high-risk adolescents over a 12-month follow-up period. If the program showed to be effective in reducing symptoms of depression and anxiety and preventing adolescents from developing clinical levels of these disorders, our results would be relevant to practice. Thus, the intervention could be used on a large scale. Moreover, this study aims to contribute to the evidence-based prevention of depression and anxiety of adolescents.TRIAL REGISTRATION: Dutch Trial Register NTR3720.BACKGROUND: Depression and anxiety disorders during adolescence can have detrimental consequences. Both disorders are related to negative outcome in various areas during adolescence and are also predictive of depression and anxiety disorders later in life. Especially parental psychopathology and being female are risk factors that increase the probability of developing one of these disorders during adolescence. Research has shown that prevention programs have promising results, especially for adolescents who have these risk factors. Therefore, in this study, we will focus on the effectiveness of a prevention program 'A jump forward' that has been developed for adolescent girls with a familial risk of depression and/or anxiety.","Rasing, S P; Creemers, D H; Janssens, J M; Scholte, R H",2013.0,10.1186/1471-244X-13-316,0,0,
4941,Covariation bias in panic-prone individuals,"Covariation estimates between fear-relevant (FR; emergency situations) or fear-irrelevant (FI; mushrooms and nudes) stimuli and an aversive outcome (electrical shock) were examined in 10 high-fear (panic-prone) and 10 low- fear respondents. When the relation between slide category and outcome was random (illusory correlation), only high-fear participants markedly overestimated the contingency between FR slides and shocks. However, when there was a high contingency of shocks following FR stimuli (83%) and a low contingency of shocks following FI stimuli (17%), the group difference vanished. Reversal of contingencies back to random induced a covariation bias for FR slides in high-and low-fear respondents. Results indicate that panic- prone respondents show a covariation bias for FR stimuli and that the experience of a high contingency between FR slides and aversive outcomes may foster such a covariation bias even in low-fear respondents.",Pauli P.; Montoya P.; Martz G.-E.,1996.0,10.1037/0021-843X.105.4.658,0,0,
4942,Electrocortical evidence for an early abnormal processing of panic-related words in panic disorder patients.,"Panic patients are hypothesized to have particularly elaborated cortical networks for panic-related stimuli, and this characteristic should be associated with an abnormal automatic processing of these stimuli. Panic-related and neutral words were presented to 25 panic patients and 25 matched healthy controls either at individually determined perception thresholds (threshold condition) or for 1000 ms (above threshold condition). Word recognition for words presented at perception threshold (threshold words), and event-related brain potentials (ERPs) triggered by threshold and above threshold words were analyzed. In the threshold condition, both panic patients and control participants correctly recognized more panic-related than neutral words. An additional analysis restricted to participants who used an intuitive strategy for word identification revealed an enhanced frequency of correctly identified panic-related words in panic patients. In the ERPs, only panic patients exhibited enhanced positive potentials during early time windows (200-400 ms after stimulus presentation) triggered by panic-related compared to neutral threshold words. In late (400-600 ms) and very late (600-1000 ms) time windows, both groups showed a greater ERP positivity for panic-related than for neutral words. These data suggest that panic patients are characterized by an early automatic and elaborated processing of disorder-relevant stimuli.",Pauli P.; Amrhein C.; Mühlberger A.; Dengler W.; Wiedemann G.,2005.0,10.1016/j.ijpsycho.2005.01.009,0,0,
4943,Peaceful Mind: an open trial of cognitive-behavioral therapy for anxiety in persons with dementia.,"Anxiety has a high prevalence among individuals with dementia, and it has a significant negative impact on their functioning; yet intervention studies are lacking. We developed Peaceful Mind, a cognitive-behavioral intervention for persons with dementia. In this paper, we describe the intervention and results of an open trial evaluating the feasibility and utility of the intervention and assessment procedures. Peaceful Mind is implemented over a period of three months in the participant's home with involvement of a caregiver or ""collateral."" Dyads are followed for an additional three months via telephone. An assortment of simplified skills is offered, including self-awareness, breathing, behavioral activation, calming thoughts, and sleep skills. Nine participants were enrolled, eight completed the three-month assessment, and seven completed the six-month assessment. Overall, participants and collaterals were satisfied with the intervention and reported that they benefited in terms of anxiety, depression, and collateral distress. A randomized controlled trial would help determine whether this promising new treatment has a statistically significant impact on anxiety in this population.",Paukert AL.; Calleo J.; Kraus-Schuman C.; Snow L.; Wilson N.; Petersen NJ.; Kunik ME.; Stanley MA.,2010.0,10.1017/S1041610210000694,0,0,
4944,A prospective study of the effects of optimism on adolescent health risks,"ER METHODSThis was a 3-wave longitudinal study of health and social development in younger adolescents from 3 Australian states. The 5634 student participants, initially aged 12 to 14 years, were assessed for optimistic thinking style, emotional problems, substance use, and antisocial behaviors.RESULTSCross-sectional associations between optimism and each of the study outcomes were strongly protective but tended to differ according to gender in extent. In prospective analyses of the onset of new cases of each study outcome, protective associations were weaker. Those in the highest optimism quartile had risks for depressive symptoms that were reduced by almost half (odds ratio: 0.54 [95% confidence interval: 0.42-0.70]) compared with those in the lowest category. No effect was seen in prevention of anxiety symptoms after adjustment for other aspects of psychological style. In predicting the onset of heavy substance use and antisocial behavior, high optimism had modest protective effects.CONCLUSIONSOptimistic thinking style is somewhat protective against adolescent health risks; the clearest effects are seen against depressive symptoms. Promoting optimism along with other aspects of psychological and emotional style has a role in mental health promotion that is likely to be enhanced if an intervention also addresses risk and protective factors in an adolescent's social context.CONTEXTThe promotion of optimism has been widely advocated for children and adolescents, but epidemiologic data to support this approach are scant.","Patton, G C; Tollit, M M; Romaniuk, H; Spence, S H; Sheffield, J; Sawyer, M G",2011.0,10.1542/peds.2010-0748,0,0,
4945,The reliability and construct validity of two measures of addictive personality.,"Gossop and Eysenck developed a subscale of the EPQ that discriminates between drug addicts in treatment and nonaddicts. They called this scale the Addiction Scale (AS). Previously, MacAndrew developed an Alcoholism Scale (MAC) by comparing alcoholics and nonalcoholic psychiatric patients' responses on the MMPI. In the present report both scales were completed by 615 men and 642 women as part of the Winnipeg Health and Drinking Survey, a longitudinal study of personality and health. The reliability of both scales is quite low, .64 for the AS and .57 for the MAC. Correlations with other personality measures indicate that the MAC is more associated with extraversion-related characteristics whereas the AS is more associated with neuroticism-related factors. The AS was not associated with the level of smoking, and the MAC was correlated with smoking for men only. Both scales were significantly correlated with various drinking measures, and the correlations were slightly higher for the MAC.",Patton D.; Barnes GE.; Murray RP.,1994.0,,0,0,
4946,Return of symptoms after discontinuation of clomipramine in patients with obsessive-compulsive disorder.,"To evaluate the need for maintenance drug therapy in patients with obsessive-compulsive disorder, the authors assessed 21 patients with obsessive-compulsive disorder who manifested sustained improvement during 5 to 27 months of clomipramine treatment and who agreed to participate in a double-blind discontinuation study. Of 18 patients who completed the study, 16 had substantial recurrence of obsessive-compulsive symptoms by the end of the 7-week placebo period. In addition, 11 had a significant increase in depressive symptoms. Treatment duration before discontinuation of clomipramine was not related to the frequency or severity of obsessive-compulsive or depressive symptom appearance. These findings suggest that prolonged drug treatment may be warranted for obsessive-compulsive disorder.",Pato MT.; Zohar-Kadouch R.; Zohar J.; Murphy DL.,1988.0,10.1176/ajp.145.12.1521,0,0,
4947,Prediction of global outcome with acute neuropsychological testing following closed-head injury.,"Delaying assessment until emergence from post-traumatic amnesia increases completion rates, but this practice causes variable time delays from the date of injury to testing, which can complicate the interpretation of research findings. In the current study, the performance of 105 head injury survivors on simple tests of language comprehension and attention was used to predict global outcome. It was hypothesized that 1 month performance on these measures would aid in the prediction of Disability Rating Scale (DRS) and Glasgow Outcome Scale (GOS) scores collected at 6 months post injury. Only raw scores on the modified Test of Complex Ideational Material accounted for a significant amount of the variance in DRS scores (4.4%) above that accounted for by age, education, Glasgow Coma Scale score, and pupil response. However, testability at 1 month post injury on all four tests consistently accounted for a larger portion of the variance in DRS scores (10.1-13.2%) and significantly improved prediction of GOS scores. Galveston Orientation and Amnesia Test scores collected at 1 month post injury accounted for substantially less variance in DRS scores (7.7-8.4%). Neuropsychological data, including the testability of patients, collected uniformly at 1 month following injury can contribute to the prediction of global outcome.",Pastorek NJ.; Hannay HJ.; Contant CS.,2004.0,,0,0,
4948,Effects of unilateral repetitive transcranial magnetic stimulation of the motor cortex on chronic widespread pain in fibromyalgia,"ER Non-invasive unilateral repetitive transcranial magnetic stimulation (rTMS) of the motor cortex induces analgesic effects in focal chronic pain syndromes, probably by modifying central pain modulatory systems. Neuroimaging studies have shown bilateral activation of a large number of structures, including some of those involved in pain processing, suggesting that such stimulation may induce generalized analgesic effects. The goal of this study was to assess the effects of unilateral rTMS of the motor cortex on chronic widespread pain in patients with fibromyalgia. Thirty patients with fibromyalgia syndrome (age: 52.6 +/- 7.9) were randomly assigned, in a double-blind fashion, to two groups, one receiving active rTMS (n = 15) and the other sham stimulation (n = 15), applied to the left primary motor cortex in 10 daily sessions. The primary outcome measure was self-reported average pain intensity over the last 24 h, measured at baseline, daily during the stimulation period and then 15, 30 and 60 days after the first stimulation. Other outcome measures included: sensory and affective pain scores for the McGill pain Questionnaire, quality of life (assessed with the pain interference items of the Brief Pain Inventory and the Fibromyalgia Impact Questionnaire), mood and anxiety (assessed with the Hamilton Depression Rating Scale, the Beck Depression Inventory and the Hospital Anxiety and Depression Scale). We also assessed the effects of rTMS on the pressure pain threshold at tender points ipsi- and contralateral to stimulation. Follow-up data were obtained for all the patients on days 15 and 30 and for 26 patients (13 in each treatment group) on day 60. Active rTMS significantly reduced pain and improved several aspects of quality of life (including fatigue, morning tiredness, general activity, walking and sleep) for up to 2 weeks after treatment had ended. The analgesic effects were observed from the fifth stimulation onwards and were not related to changes in mood or anxiety. The effects of rTMS were more long-lasting for affective than for sensory pain, suggesting differential effects on brain structures involved in pain perception. Only few minor and transient side effects were reported during the stimulation period. Our data indicate that unilateral rTMS of the motor cortex induces a long-lasting decrease in chronic widespread pain and may therefore constitute an effective alternative analgesic treatment for fibromyalgia.","Passard, A; Attal, N; Benadhira, R; Brasseur, L; Saba, G; Sichere, P; Perrot, S; Januel, D; Bouhassira, D",2007.0,10.1093/brain/awm189,0,0,
4949,Effectiveness of oral hygiene protocol in patients with post-traumatic splinting,"ER MATERIALS AND METHODSThis study was carried out on 82 selected patients with post-traumatic splinting due to traumatic avulsion and severe luxation. They were divided into 2 groups, comparable for age, sex, type of trauma and splinting. The group A patients underwent an oral hygiene protocol, managed by a dental hygienist, while the group B patients were followed without the help of the hygienist. Plaque indexes were observed and compared in all cases during 6 weeks-follow up.RESULTSOur results showed that at the 6th week follow up the plaque indexes of dental hygienist-assisted traumatized patients were significantly (p=0.001) lower than those of not assisted patients.CONCLUSIONTherefore, the role of dental hygienists is essential in the management of dental trauma with periodontal damage, which needs specific oral hygiene protocols.AIMIn dental trauma with severe periodontal tissue involvement, as dental avulsion and severe luxation, the splinting procedure requires the patient to maintain a scrupulous hygiene of the affected zone, so to allow an effective tissue healing. The aim of this study was to assess the effectiveness of a specific oral hygiene protocol in the treatment of patients with post-traumatic splinting, comparing the plaque indexes of dental hygienist-helped patients versus not helped.","Pasini, S; Bardellini, E; Casula, I; Flocchini, P; Majorana, A",2006.0,,0,0,
4950,Effectiveness of aspiration in knee joint effusion management: a prospective randomized controlled study.,"Knee effusion is a common symptom in various knee disorders of both traumatic and non-traumatic aetiology. Although intra-articular aspiration is a widespread treatment approach, its beneficial effect has not been confirmed by a randomized controlled study. The purpose was to evaluate the effectiveness and safety of joint aspiration in acute knee effusion, in relation to traumatic or non-traumatic aetiology. One hundred and sixty-seven consecutive patients with acute knee joint effusion were allocated in a randomized controlled fashion into two groups. In the first group, joint aspiration was performed, while in the second group, no aspiration was performed. Range of motion, pain relief, use of analgesics and oedema were evaluated post management. The Knee Society Score and the International Knee Documentation Committee Subjective Evaluation Form were also obtained. In addition, a subgroup analysis of our results in relation to the presence of trauma or not was performed. Aspiration exhibited a temporary improvement in all clinical parameters evaluated, especially in the post-traumatic effusion. However, this improvement lasted only for the first week, due to the early re-accumulation of the effusion. There was no difference between the different groups regarding the clinical outcome in neither trauma or non-trauma patients at the end of the follow-up period. Aspiration aided in earlier establishment of the diagnosis in the non-trauma cases of effusion. Aspiration resulted in only temporary improvement of the outcome in the treatment of traumatic or not traumatic knee effusion. Aspiration is suggested in effusions of unknown origin in order to establish the diagnosis and for immediate clinical relief. However, aspiration should be performed with consideration in the presence of trauma.",Paschos NK.; Giotis D.; Abuhemoud K.; Georgoulis AD.,2014.0,10.1007/s00167-013-2379-1,0,0,
4951,The effectiveness of a cognitive-behavioral intervention for pathological gambling: A country-wide study.,"Background: Clinicians lack adequate data on the effectiveness of treatment for pathological gambling in low- and middle-income countries. Methods: We evaluated a manualized treatment program that included components of cognitive-behavioral therapy, motivational interviewing, and imaginal exposure in a sample of 128 participants diagnosed with pathological gambling. Our team recruited participants via the helpline of the National Responsible Gambling Program (NRGP) of South Africa between May 2011 and February 2012. Eligible participants, who met the DSM-IV-TR criteria for pathological gambling as assessed by the Structured Clinical Interview for Pathological Gambling (SCI-PG), were referred to practitioners who had been trained in the intervention technique. We then compared pre- and post-treatment scores obtained on the Yale-Brown Obsessive-Compulsive Scale Adapted for Pathological Gambling (PG-YBOCS), the primary outcome measure, and the Sheehan Disability Scale (SDS), the secondary outcome measure. Results: Scores obtained on the PG-YBOCS and the SDS both decreased significantly from the first to the final session (t[127] = 23.74, P < .001, r = .9; t[127] = 19.23, P < .001, r = .86, respectively). Conclusions: The urges and disability symptoms related to pathological gambling were significantly reduced among participants completing treatment. These preliminary results hold promise for individuals with pathological gambling in South Africa and other low- and middle-income countries. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pasche, Sonja C; Sinclair, Heidi; Collins, Peter; Pretorius, Adele; Grant, Jon E; Stein, Dan J; Arbuckle, Ashley, Blanco, Champine, Collins, Field, Grant, Grant, Grant, Grant, Hodgins, Hodgins, Ladouceur, McConaghy, Melville, Otsubo, Pallanu, Petry, Raylu, Sheehan, Sheehan, Sylvain, van Holst, van Vliet",2013.0,,0,0,
4952,Bright light improves vitality and alleviates distress in healthy people,"Background: The relative shortage of light during the decreasing photoperiod may compromise well-being. Earlier studies suggest that bright-light exposure may be of help to alleviate winter-bound symptoms. Methods: We carried out a field study with exposure to bright light on office employees during winter. Results: Repeated bright-light exposure improved vitality and reduced depressive symptoms. The benefit was observed not only in healthy subjects with season-dependent symptoms but also in those not having the seasonal variation. Conclusions: Bright-light exposure during winter appears to be effective at improving the health-related quality of life and alleviating distress in healthy subjects. Clinical implications: Administration of bright light is a useful option to improve vitality and mood among subjects working indoors in wintertime. Limitations of study: Our field setting used self-reports, not interviews, for the assessment of outcome. Copyright (C) 2000 Elsevier Science B.V.",Partonen T.; Lönnqvist J.,2000.0,10.1016/S0165-0327(99)00063-4,0,0,
4953,Randomized trial showed requesting medical records with a survey produced a more representative sample than requesting separately.,"The objective of the study was to compare the effect of two approaches to requesting medical records on survey response rates, sample representativeness, and the quality of self-reported screening. Eight hundred ninety veterans aged 50-75 years from the Minneapolis VA Medical Center were randomly assigned to (1) records request included with a colorectal cancer screening survey (""with-survey"" group) or (2) request in a separate mailing following a completed survey (""after-survey"" group). Analyses compared response rates, the proportion and characteristics of patients providing records, and the validity of self-reported screening, by group. Response rates did not vary by group (with-survey 76%; after-survey 78%, P=0.45). 54% of with-survey and 47% of after-survey participants provided complete medical records (P = 0.06). In the with-survey group, patients with complete medical records were significantly more likely to be married and to have a diagnosis of posttraumatic stress disorder; in the after-survey group, they were more likely to be aged 65-75 years, Caucasian, to have a family history of colorectal cancer, and to report being screened. Validity of self-reported screening did not vary significantly by group. The with-survey approach did not significantly reduce response rates or the quality of self-reported screening and produced a higher number and more representative sample with complete records.",Partin MR.; Burgess DJ.; Halek K.; Grill J.; Vernon SW.; Fisher DA.; Griffin JM.; Murdoch M.,2008.0,10.1016/j.jclinepi.2007.11.015,0,0,
4954,Listening to infant distress vocalizations enhances effortful motor performance,,Parsons C.E.; Young K.S.; Parsons E.; Stein A.; Kringelbach M.L.,2012.0,10.1111/j.1651-2227.2011.02554.x,0,0,
4955,Predictors of partially met or unmet need reported by consumers of mental health services: An analysis of data from the Australian National Survey of Mental Health and Wellbeing,"Objective: We examined data from the 1997 National Survey of Mental Health and Wellbeing to identify factors associated with consumers of mental health help reporting that their needs were unmet or only partially met. Predictor factors included sociodemographic variables, psychological morbidity measures and type of health practitioner seen. Method: Five types of mental health help were considered: information, medication, psychological therapy, social interventions and skills training. A respondent's unmet need for each type of mental health help was given one of three values: 0: no unmet need reported; 1: some but not enough help of this type provided; and 2: no help of this type provided although it was needed. Multiple ordered logistic regressions were undertaken to identify predictor variables associated with reporting unmet need for each type of help. Results: Few sociodemographic factors were found to be associated with consumers reporting unmet need for mental health help. Those with less education were more likely to report unmet need for medication. Being male, living alone and being unemployed were associated with unmet need for skills training. Having seen a general practitioner for mental health reasons was found to be associated with reporting unmet need for both information and social interventions. Self-identifying, or being diagnosed, as having an anxiety disorder was associated with reporting unmet need for four of the five types of help. Conclusions: In this exploratory analysis, we examined factors associated with consumers of mental health help reporting that their needs were unmet or partially met. We found that the needs of those with anxiety problems were not generally well met. Our findings also indicate there is a need to continue to improve collaboration between the medical and community services sectors.",Parslow R.A.; Jorm A.F.,2001.0,10.1046/j.1440-1614.2001.00924.x,0,0,
4956,"The STRIDE (Strategies to Increase confidence, InDependence and Energy) study: cognitive behavioural therapy-based intervention to reduce fear of falling in older fallers living in the community - study protocol for a randomised controlled trial","ER METHODS/DESIGN: We are conducting a two-phase study examining the role of individual cognitive behavioural therapy delivered by healthcare assistants in improving fear of falling in older adults. In Phase I, the intervention was developed and taught to healthcare assistants, while Phase II is the pragmatic randomised controlled study examining the efficacy of the intervention in improving fear of falling in community-dwelling elders attending falls services. A qualitative process evaluation study informed by Normalization Process Theory is being conducted throughout to examine the potential promoters and inhibitors of introducing such an intervention into routine clinical practice, while a health economic sub-study running alongside the trial is examining the costs and benefits of such an approach to the wider health economy.TRIAL REGISTRATION: Current Controlled Trials ISRCTN78396615.BACKGROUND: Around 30% to 62% of older individuals fall each year, with adverse consequences of falls being by no means limited to physical injury and escalating levels of dependence. Many older individuals suffer from a variety of adverse psychosocial difficulties related to falling including fear, anxiety, loss of confidence and subsequent increasing activity avoidance, social isolation and frailty. Such 'fear of falling' is common and disabling, but definitive studies examining the effective management of the syndrome are lacking. Cognitive behavioural therapy has been trialed with some success in a group setting, but there is no adequately powered randomised controlled study of an individually based cognitive behavioural therapy intervention, and none using non-mental health professionals to deliver the intervention.","Parry, S W; Deary, V; Finch, T; Bamford, C; Sabin, N; McMeekin, P; O'Brien, J; Caldwell, A; Steen, N; Whitney, S L; Macdonald, C; McColl, E",2014.0,10.1186/1745-6215-15-210,0,0,
4957,Cognitive behavioural intervention for adults with anxiety complications of asthma: prospective randomised trial.,"High levels of asthma-related fear and panic exacerbate asthma symptoms and complicate the management of asthma. Asthma-specific fear may be reduced by a cognitive behavioural intervention. We aimed to test if there is a reduction in asthma-specific fear after cognitive behavioural intervention compared with routine treatment. Adults with asthma registered with family doctors in Sheffield UK were screened for anxiety and 94 highly anxious patients were randomly allocated to receive either a cognitive behavioural intervention to improve self-management of their anxiety (n = 50) or routine clinical care (n = 44). Asthma-specific fear at the end of treatment and at six month follow up were the primary endpoints. Service usage in the six months prior to and six months following the intervention was monitored to allow estimation of costs. Data were analysed by intention to treat. At the end of treatment, there was a significantly greater reduction in asthma-specific fear for people in the CBT group compared with controls. At six months after treatment the reduction in asthma-specific fear in the CBT group was increased and the difference between treatment and control group was statistically significant. Service use costs were not reduced in the CBT group. A brief cognitive behavioural intervention was found to have efficacy in reducing asthma-specific panic fear immediately after treatment and at 6 months follow up. There was no cost advantage to cognitive behavioural treatment.",Parry GD.; Cooper CL.; Moore JM.; Yadegarfar G.; Campbell MJ.; Esmonde L.; Morice AH.; Hutchcroft BJ.,2012.0,10.1016/j.rmed.2012.02.006,0,0,
4958,Pain-related fear and catastrophizing predict pain intensity and disability independently using an induced muscle injury model,"Timing of assessment of psychological construct is controversial and results differ based on the model of pain induction. Previous studies have not used an exercise-induced injury model to investigate timing of psychological assessment. Exercise-induced injury models may be appropriate for these investigations because they approximate clinical pain conditions better than other experimental stimuli. In this study we examined the changes of psychological constructs over time and determined whether timing of assessment affected the construct's association with reports of pain intensity and disability. One-hundred twenty-six healthy volunteers completed the Fear of Pain Questionnaire (FPQ-III), Pain Catastrophizing Scale (PCS), and Tampa Scale of Kinesiophobia (TSK) prior to inducing muscle injury to the shoulder. The PCS and TSK were measured again 48 and 96 hours postinjury induction. Pain intensity and disability were collected at 48 and 96 hours and served as dependent variables in separate regression models. Results indicated that the FPQ-III had the strongest prediction of pain intensity from baseline to 96 hours. After baseline the PCS and TSK were stronger predictors of pain intensity and disability, respectively. These data provide support for the use of psychological constructs in predicting outcomes from shoulder pain. However, they deviate from the current theoretical model indicating that fear of pain is a consequence of injury and instead suggests that fear of pain before injury may influence reports of pain intensity. Perspective: The current study provides evidence that fear of pain can be assessed prior to injury. Furthermore, it supports that after injury pain catastrophizing and kinesiophobia are independently associated with pain and disability. Overall these data suggest that timing of psychological assessment may be an important consideration in clinical environments. © 2012 by the American Pain Society.",Parr J.J.; Borsa P.A.; Fillingim R.B.; Tillman M.D.; Manini T.M.; Gregory C.M.; George S.Z.,2012.0,10.1016/j.jpain.2011.12.011,0,0,
4959,Social anxiety in adolescents: the effect of video feedback on anxiety and the self-evaluation of performance,"ER METHODThirty-six highly socially anxious adolescents (13 to 17-year-olds) were randomly assigned to one of two groups: VF or no VF. Both groups gave two brief speeches to a video camera. Self-rated measures of anticipatory anxiety, predicted performance and actual performance during the speeches were completed at several time points. The speeches were also rated by two independent observers.RESULTSAdolescents who received VF, in comparison with control participants, developed more positive appraisals of their performance during the first speech. Predictions of their performance on the second speech also improved, and a reduction in state anxiety was observed. Furthermore, a more positive appraisal of performance was generalized to the second speech. The independent observers could not distinguish between the participants who received VF and those who did not.CONCLUSIONSWhen used with socially anxious adolescents, VF may be a beneficial therapeutic technique in correcting a distorted self-perception of performance, reducing anxiety prior to entering a stressful social task and enhancing predictions of performance for future tasks.BACKGROUNDA negative self-generated image is thought to play a role in the development and maintenance of social anxiety. Video feedback (VF) is an effective therapeutic technique for correcting this distorted image with adults during stressful social tasks. This study investigated the effectiveness of VF with adolescents.","Parr, C J; Cartwright-Hatton, S",2009.0,10.1002/cpp.599,0,0,
4960,Social anxiety in adolescents: the effect of video feedback on anxiety and the self-evaluation of performance.,"A negative self-generated image is thought to play a role in the development and maintenance of social anxiety. Video feedback (VF) is an effective therapeutic technique for correcting this distorted image with adults during stressful social tasks. This study investigated the effectiveness of VF with adolescents. Thirty-six highly socially anxious adolescents (13 to 17-year-olds) were randomly assigned to one of two groups: VF or no VF. Both groups gave two brief speeches to a video camera. Self-rated measures of anticipatory anxiety, predicted performance and actual performance during the speeches were completed at several time points. The speeches were also rated by two independent observers. Adolescents who received VF, in comparison with control participants, developed more positive appraisals of their performance during the first speech. Predictions of their performance on the second speech also improved, and a reduction in state anxiety was observed. Furthermore, a more positive appraisal of performance was generalized to the second speech. The independent observers could not distinguish between the participants who received VF and those who did not. When used with socially anxious adolescents, VF may be a beneficial therapeutic technique in correcting a distorted self-perception of performance, reducing anxiety prior to entering a stressful social task and enhancing predictions of performance for future tasks.",Parr CJ.; Cartwright-Hatton S.,,10.1002/cpp.599,0,0,4959
4961,"Treatment of lower extremity telangiectasias in women by foam sclerotherapy vs. Nd:YAG laser: a prospective, comparative, randomized, open-label trial.","Telangiectasias of the lower extremities are very common. There are no blinded, randomized, controlled clinical trials comparing laser modalities with the gold standard sclerotherapy, while the few available studies encompass small patients cohorts. This prospective, randomized, open-label trial compares the efficacy of sclerotherapy with polidocanol vs. long-pulsed neodymium-doped yttrium aluminium garnet (Nd:YAG) laser in the treatment of leg telangiectasias. Fifty-six female patients with primary leg telangiectasias and reticular veins (C1A or SEpAS1PN) were included in the study. One leg was randomly assigned to get treatment with the multiple synchronized long-pulsed Nd:YAG laser, while the other received foam sclerotherapy with polidocanol 0.5%. The patients were treated in two sessions at intervals of 6 weeks. The patients were evaluated by the handling physician after 6 weeks and 6 months. Two investigators assessed blindly at the end of the study the photographs for clearing of the vessels using a six-point scale from 1 (no change) to 6 (100% cleared). Patients reported about pain sensation and outcome satisfaction. According to the handling dermatologist, at the last follow-up, there was an improvement of 30-40% with a median of 3 (IQR 2) and a good improvement of 50-70% with a median of 4 (IQR 2) after laser treatment and sclerotherapy respectively. In contrast, according to the blinded investigators, there was a median of 5 (IQR 1) with a very good improvement of >70% after both therapies. Improvement was achieved more quickly by sclerotherapy, although at the last follow-up visit there was no difference in clearance between the two groups as assessed by the blinded experts (P-value 0.84). The degree of patient's satisfaction was very good and similar with both therapeutic approaches. There was a significant difference (P-value 0.003) regarding pain perception between the types of therapy. Laser was felt more painful than sclerotherapy. Telangiectasias of the lower extremities can be successfully treated with either synchronized long-pulsed Nd:YAG laser or sclerotherapy. The 1064-nm long-pulsed Nd:YAG laser is associated with more pain and is suitable especially in case of needle phobia, allergy to sclerosants and in presence of small veins with telangiectatic matting, while sclerotherapy can also treat the feeder veins.",Parlar B.; Blazek C.; Cazzaniga S.; Naldi L.; Kloetgen HW.; Borradori L.; Buettiker U.,2015.0,10.1111/jdv.12627,0,0,
4962,Chronic care management for substance dependence in primary care among patients with co-occurring disorders.,"Co-occurring mental and substance use disorders are associated with worse outcomes than a single disorder alone. In this exploratory subgroup analysis of a randomized trial, the authors hypothesized that providing chronic care management (CCM) for substance dependence in a primary care setting would have a beneficial effect among persons with substance dependence and major depressive disorder or posttraumatic stress disorder (PTSD). Adults (N=563) with alcohol dependence, drug dependence, or both were assigned to CCM or usual primary care. CCM was provided by a nurse care manager, social worker, internist, and psychiatrist. Clinical outcomes (any use of opioids or stimulants or heavy drinking and severity of depressive and anxiety symptoms) and treatment utilization (emergency department use and hospitalization) were measured at three, six, and 12 months after enrollment. Longitudinal regression models were used to compare randomized arms within the subgroups of participants with major depressive disorder or PTSD. Among all participants, 79% met criteria for major depressive disorder and 36% met criteria for PTSD at baseline. No significant effect of CCM was observed within either subgroup for any outcome, including any use of opioids or stimulants or heavy drinking, depressive symptoms, anxiety symptoms, and any hospitalizations or number of nights hospitalized. Among participants with depression, those receiving CCM had fewer days in the emergency department compared with the control group, but the finding was of only borderline significance (p=.06). Among patients with co-occurring substance dependence and mental disorders, CCM was not significantly more effective than usual care for improving clinical outcomes or treatment utilization.",Park TW.; Cheng DM.; Samet JH.; Winter MR.; Saitz R.,2015.0,10.1176/appi.ps.201300414,0,0,
4963,Deep brain stimulation in anorexia nervosa: Hope for the hopeless or exploitation of the vulnerable? The Oxford neuroethics gold standard framework.,"Neurosurgical interventions for psychiatric disorders have a long and troubled history (1, 2) but have become much more refined in the last few decades due to the rapid development of neuroimaging and robotic technologies (2). These advances have enabled the design of less invasive techniques, which are more focused, such as deep brain stimulation (DBS) (3). DBS involves electrode insertion into specific neural targets implicated in pathological behavior, which are then repeatedly stimulated at adjustable frequencies. DBS has been used for Parkinson's disease and movement disorders since the 1960s (4-6) and over the last decade has been applied to treatment-refractory psychiatric disorders, with some evidence of benefit in obsessive-compulsive disorder (OCD), major depressive disorder, and addictions (7). Recent consensus guidelines on best practice in psychiatric neurosurgery (8) stress, however, that DBS for psychiatric disorders remains at an experimental and exploratory stage. The ethics of DBS-in particular for psychiatric conditions-is debated (1, 8-10). Much of this discourse surrounds the philosophical implications of competence, authenticity, personality, or identity change following neurosurgical interventions, but there is a paucity of applied guidance on neuroethical best practice in psychiatric DBS, and health-care professionals have expressed that they require more (11). This paper aims to redress this balance by providing a practical, applied neuroethical gold standard framework to guide research ethics committees, researchers, and institutional sponsors. We will describe this as applied to our protocol for a particular research trial of DBS in severe and enduring anorexia nervosa (SE-AN) (https://clinicaltrials.gov/ct2/show/NCT01924598, unique identifier NCT01924598), but believe it may have wider application to DBS in other psychiatric disorders. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Park, Rebecca J; Singh, Ilina; Pike, Alexandra C; Tan, Jacinta O. A; Agid, Appelbaum, Balestrieri, Barbier, Bell, Bell, Benabid, Benabid, Berkman, Binder, Birmingham, Braun, Bulik, Carney, Carney, Carter, Charland, Chee, Coman, Crow, De Zwaan, Denys, DuBois, Elias, Fisher, Frank, Franko, Gilbert, Godier, Godier, Godier, Godier, Grisso, Henderson, Hope, Hsu, Insel, Israel, Jimenez, Keel, Kleiner-Fisman, Kramer, Kuhn, Lidz, Liggins, Lipsman, Lipsman, Lipsman, Maslen, McLaughlin, Merkel, Muller, Nuttin, Oudijn, Palmer, Park, Phillipou, Schermer, Schmitz-Luhn, Serpell, Smink, Steinhausen, Sturm, Synofzik, Tan, Tan, Tan, Tan, Touyz, Treasure, Wade, Wang, Woopen, Wu",2017.0,,0,0,
4964,The subjective experience of the research patient: an investigation of psychiatric outpatients' reactions to the research treatment situation.,,Park L.C.; Slaughter R.; Covi L.; Kniffin Jr. H.G.,1966.0,,0,0,
4965,Clinical and heuristic value of clinical drug research.,,Park LC.; Imboden JB.,1970.0,,0,0,
4966,Are intrusive thoughts subject to habituation?,,"Parkinson, L; Rachman, S",1980.0,,0,0,
4967,Rehabilitation of older patients: day hospital compared with rehabilitation at home. A randomised controlled trial,"ER DESIGNTwo-arm randomised controlled trial.SETTINGFour trusts in England providing both HBR and DHR.PARTICIPANTSClinical staff reviewed consecutive referrals to identify subjects who were potentially suitable for randomisation according to the defined inclusion criteria.INTERVENTIONSPatients were randomised to receive either HBR or DHR.MAIN OUTCOME MEASURESThe primary outcome measure was the Nottingham Extended Activities of Daily Living (NEADL) scale. Secondary outcome measures included the EuroQol 5 dimensions (EQ-5D), Hospital Anxiety and Depression Scale (HADS), Therapy Outcome Measures (TOMs), hospital admissions and the General Health Questionnaire (GHQ-30) for carers.RESULTSOverall, 89 subjects were randomised and 42 received rehabilitation in each arm of the trial. At the primary end point of 6 months there were 32 and 33 patients in the HBR and DHR arms respectively. Estimated mean scores on the NEADL scale at 6 months, after adjustment for baseline, were not significantly in favour of either HBR or DHR [DHR 30.78 (SD 15.01), HBR 32.11 (SD 16.89), p = 0.37; mean difference -2.139 (95%","Parker, S G; Oliver, P; Pennington, M; Bond, J; Jagger, C; Enderby, P M; Curless, R; Chater, T; Vanoli, A; Fryer, K; Cooper, C; Julious, S; Donaldson, C; Dyer, C; Wynn, T; John, A; Ross, D",2009.0,10.3310/hta13390,0,0,
4968,"The treatment of nonmelancholic depression: when antidepressants fail, does psychotherapy work?","Treatment-resistant depression (TRD) is used as a descriptive or diagnostic term and has generated many management guidelines weighting antidepressant (AD) therapy, but which may be an inappropriate paradigm for the nonmelancholic disorders where psychotherapy may be a more salient modality. This study sought to evaluate the effectiveness of psychological therapy in patients whose nonmelancholic depressive condition had been resistant to at least 2 ADs. Principal analyses compared 32 patients, diagnosed with a nonmelancholic depression who received 12 weeks of psychological therapy, with a small control group. Comparative analyses failed to find a distinct therapeutic effect, leading to an extension study pursuing candidate explanatory factors for this lack of response, including psychosocial factors. While our sample showed a 41% response and 22% remission rate to psychotherapy, their improvement pattern was similar to the control group, thus arguing against any specific therapeutic benefit. Explanatory factors nominated by the treating psychologist weighted personality issues for 35% of the patients, distal stressors for 22%, and comorbid anxiety conditions for 18%. When sample members were compared with an age- and sex-matched sample of patients with nonmelancholic depression who improved distinctly during a similar 12-week period, rates of such putative personality, stress, and anxiety risk factors did not differ, arguing against the likelihood of these factors compromising improvement. Patients with nonmelancholic TRD also failed to demonstrate a clear response to a psychotherapeutic approach, while our pursuit of clinically explanatory variables was not supported empirically.",Parker G.; Graham R.; Sheppard E.,2014.0,10.1177/070674371405900703,0,0,
4969,Study of subjectivity in the perception of cesarean birth,"This study defined the structural patterns of subjectivity in the perception of cesarean birth. Q methodology was used on 71 statements collected through interviews with seven persons, and a literature review followed. Twenty-nine Q samples were selected and administered to 22 persons, and four types of subjectivity were revealed by the QUANL PC Program. Type 1, or the 'naturalist', is characterized by a passive tendency and dislikes artificial methods, feeling that they are performed for hospital income and the trend for social preference. Type 2, 'logical thinker', thinks that cesarean birth should be selected if there are obstetric complications and severe anxiety about labor, even though it results in low intimacy with the baby. Type 3, 'maternal instinctivism', values the maternal-baby relationship and the sense of accomplishment from childbirth. Type 4, 'egocentric', thinks that cesarean section should be chosen when the woman has severe anxiety about labor or when the obstetric condition becomes dangerous. Before commencement of the patient's labor pains, the nurses and medical personnel who are participating in the delivery should assess the structural pattern on parturient woman's subjectivity in the perception of cesarean section. As a further step, they should encourage the woman and her family to participate in the decision-making process for considering the type of delivery the mother wants.",Park C.S.; Yeoum S.G.; Choi E.S.,2005.0,10.1111/j.1442-2018.2005.00206.x,0,0,
4970,Barriers and facilitators to dental care among HIV-Infected adults,"ER Oral health problems can significantly compromise HIV-infected individuals' general health and well-being, yet many of them experience an unmet need for oral care. The barriers and facilitators of obtaining dental care in a sample of HIV-infected adults, all of whom were eligible for Ryan White Part A funding for their treatment, were investigated through qualitative interviews with HIV-positive individuals who had not received dental services in the prior 12 months (n = 44). Identified barriers were as follows: (1) dental anxiety and fear, (2) cumbersome administrative procedures, (3) long waits at the dental office, (4) problem focused care-seeking behavior, (5) transportation difficulties, (6) dentists' reluctance to treat people like them, and (7) psychological issues. Identified facilitating factors were as follows: (1) coverage for dental care, (2) being treated with respect and acceptance, and (3) having an assigned case manager or social worker. Many of the barriers uncovered in this qualitative study can be addressed and overcome by case management services, but other approaches are needed to address the additional psychological and stigma-related factors that are impeding access to oral healthcare in this population.","Parish, C; Siegel, K; Pereyra, M; Liguori, T; Metsch, L",2015.0,10.1111/scd.12132,0,0,
4971,"A randomized, controlled trial of vicarious experience through peer support for male first-time cardiac surgery patients: impact on anxiety, self-efficacy expectation, and self-reported activity","ER DESIGNA randomized, controlled trial was used to evaluate an intervention that linked volunteers who had recovered from cardiac surgery in dyadic support with patients about to undergo similar surgery. The linking was achieved by means of visits during the hospitalization and recovery period.SUBJECTSFifty-six first-time male patients undergoing coronary artery bypass graft (CABG) surgery, with a mean age of 56.5 years, were randomly assigned to an experimental (n = 27) or control group (n = 29).OUTCOME MEASURESAnxiety was measured at 48 hours and 24 hours before surgery, and again at 5 days and 4 weeks after surgery. Self-efficacy expectation and self-reported activity were both evaluated at 5 days and 4 weeks after surgery.RESULTSOnly the experimental group showed a significant decrease in anxiety during hospitalization. At all measurement times after the first intervention, the experimental group reported significantly lower levels of anxiety compared with the control group. The experimental group reported significantly higher levels of self-efficacy expectation and self-reported activity for general activities, walking, and climbing stairs evaluated at 5 days, and for general activities at 4 weeks after surgery.CONCLUSIONSVicarious experience provided through dyadic support is effective in helping patients undergoing cardiac surgery cope with surgical anxiety and in improving self-efficacy expectations and self-reported activity after surgery. Dyadic support is a valuable tool for recovery from cardiac surgery that needs to be maintained and explored through nursing practice and research.OBJECTIVESThe purpose of this study was to determine whether vicarious experience, in which former patients exemplify the active lives they are leading, reduces anxiety and increases self-efficacy expectation and self-reported activity in patients after cardiac surgery.","Parent, N; Fortin, F",2000.0,10.1067/mhl.2000.110626,0,0,
4972,Social support intervention by former model patients for persons undergoing heart surgery,"ER The objectives of this study were to determine whether vicarious experiences, in which expatients exemplify the active lives they are leading, can strengthen the belief in the restorability of cardiac functions. An experimental research design was used to evaluate an intervention designed to link volunteers who have successfully recovered from cardiac surgery in dyadic support with those individuals about to undergo similar surgery, by means of visits during the hospitalisation and recovery period. The intervention was intended to reduce anxiety and increase self-efficacy and activity performance. Through a randomised trial, 55 bypass surgery patients, aged 40-69 years, were allocated to either the experimental intervention (n = 27) or usual care (n = 28). The anxiety level was measured with the SPIELBERGER, GORSUCH and LUSHENE (1970) scale; self-efficacy and activity performance were measured with JENKIN's scales (1989). Data analysis with independent t tests revealed significant (p < 0.05) differences between groups in the anxiety level at 24 hours before surgery, and at 5 days and 4 weeks after surgery. Only the experimental group showed a significant (p < 0.02) decrease in anxiety during hospitalisation. Repeated analysis of variance showed significant (p < 0.05) differences between groups in perceived self-efficacy and performance of activities at 5 days and at 4 weeks after surgery. These results indicate that dyadic social support that volunteers offer cardiac surgery patients seems to be effective in helping the latter deal with cardiac events. Implications and recommendations for nursing practice and research were generated.","Parent, N",1997.0,,0,0,
4973,The development of callous-unemotional traits and antisocial behavior in children: are there shared and/or unique predictors?,"ER Callous and unemotional (CU) traits have been linked to severe antisocial behavior in youth, but studies examining the etiology of CU traits are lacking. Based on prior research, it was hypothesized that childhood anxiety and parenting practices would interact to predict changes in CU traits over time. Hypotheses were tested using a sample of 120 moderate to highly aggressive fifth graders followed over a 1-year period. Although CU traits displayed moderate temporal stability and predicted increases in antisocial behavior, evidence suggested that these features were not immutable. Children exposed to lower levels of physical punishment showed decreases in CU traits over time, whereas higher levels of child-reported parental warmth and involvement predicted decreases in both CU traits and antisocial behavior over time. Lower levels of anxiety were uniquely related to increased CU traits for children who described their primary caregiver as exhibiting low warmth and involvement.","Pardini, D A; Lochman, J E; Powell, N",2007.0,10.1080/15374410701444215,0,0,
4974,Instructional set does not alter outcome of respiratory challenges in panic disorder.,"In an attempt to reproduce the findings of Rapee et al (1986) that instructional set could alter the anxiogenic effects of carbon dioxide inhalation, 45 patients with panic disorder received two sets of instructions and then underwent a series of respiratory challenges (room air hyperventilation, 5% and 7% CO2 inhalation). The instructions failed to alter the anxiogenic response to any of the interventions.",Papp LA.; Welkowitz LA.; Martinez JM.; Klein DF.; Browne S.; Gorman JM.,1995.0,10.1016/0006-3223(95)00047-X,0,0,
4975,Characterization and treatment response of anxious children with asthma,"ER METHOD: A sample of 36 children with comorbid anxiety and asthma, aged 8 to 12 years, were matched for age, sex, and specific anxiety disorder with 36 children with an Axis I anxiety disorder but no asthma. Parents and children completed standardized questionnaires.RESULTS: Children with comorbid anxiety and asthma had significantly more perinatal complications (P = 0.001), and higher total (P = 0.000) and psychological stressors (P = 0.02), especially parent-child problems (P = 0.01), but lower levels of depression (P = 0.03) and anxiety (P = 0.05), compared with anxious, nonasthmatic children. All children reported decreased anxiety (P = 0.001) and depression (P = 0.000) posttreatment, with a trend toward less improvement in anxiety in anxious children with asthma.CONCLUSIONS: Although replication is needed, addressing psychosocial stress and parent-child problems may increase CBT efficacy in children with comorbid anxiety and asthma.OBJECTIVES: To compare children with Axis I anxiety disorders and asthma with a matched group of anxious children without asthma on questionnaire measures and response to cognitive-behavioural treatment (CBT) for anxiety.","Papneja, T; Manassis, K",2006.0,10.1177/070674370605100610,0,0,
4976,Effect of continuous change in axial position in treatment of post-traumatic lung failure (ARDS). A clinical study,"ER In the treatment of posttraumatic adult respiratory distress syndrome (ARDS) so far no breakthrough has been achieved. In several cases of severe ARDS we have seen improvements of lung function by means of continuous body positioning. We therefore compared the effect of kinetic positioning (KIN) on lung function and hemodynamics in ARDS patients to conventional (KON) supine positioning. 22 ARDS patients with multiple trauma treated by supportive continuous body positioning (KIN) (KCI-Mediscus) and without continuous positioning (KON) were investigated daily. Pulmonary and systemic hemodynamics were determined on the basis of pulmonary artery catheter measurements. Oxygenation ratio (PaO2/FiO2) and pulmonary shunt (Qs/Qt,%) were calculated. Extravascular lung water (EVLW, ml/kg body weight) was determined by double indicator thermodilution technique. Total injury severity by injury severity score (ISS) was 29.6 +/- 6 points (KIN) and 31.6 +/- 5 points (KON). The oxygenation ratio (PaO2/FiO2) increased significantly from 140 +/- 45 (day 0) to 237 +/- 40 (p < 0.05) [day 5] (KIN), in KON patients no improvement (143 +/- 48 [day 0], 133 +/- 44 [ay 5]) was seen (p < 0.05 between groups). There were no significant changes of systemic hemodynamics between the groups or compared to day 0. Pulmonary shunt decreased significantly from 26.6 +/- 4% (day 0) to 12.5 +/- 2% (day 5) (p < 0.05) in KIN patients and was 36.6 +/- 6% at day 0 and 31.4 +/- 2% at day 5 in KON patients (p < 0.05 between groups). EVLW was 11.1 +/- 2 ml/kg body weight at day 0 and 9.4 +/- 1 ml/kg body weight at day 5 (KIN)-EVLW was 12.9 +/- 2 ml/kg body weight at day 0 and 17.4 +/- 3 ml/kg body weight at day 5 (KON) (not significant). We found no hemodynamic side effects from continuous body positioning. In ARDS-patients submitted to body positioning oxygenation and pulmonary shunt improved significantly and were significantly better compared to those with conventional supine positioning. Continuous body positioning appears to represent a promising supportive treatment regimen in posttraumatic ARDS.","Pape, H C; Regel, G; Borgmann, W; Sturm, J; Tscherne, H",1993.0,,0,0,
4977,Human genome-guided identification of memory-modulating drugs,"ER In the last decade there has been an exponential increase in knowledge about the genetic basis of complex human traits, including neuropsychiatric disorders. It is not clear, however, to what extent this knowledge can be used as a starting point for drug identification, one of the central hopes of the human genome project. The aim of the present study was to identify memory-modulating compounds through the use of human genetic information. We performed a multinational collaborative study, which included assessment of aversive memory--a trait central to posttraumatic stress disorder--and a gene-set analysis in healthy individuals. We identified 20 potential drug target genes in two genomewide-corrected gene sets: the neuroactive ligand-receptor interaction and the long-term depression gene set. In a subsequent double-blind, placebo-controlled study in healthy volunteers, we aimed at providing a proof of concept for the genome-guided identification of memory modulating compounds. Pharmacological intervention at the neuroactive ligand-receptor interaction gene set led to significant reduction of aversive memory. The findings demonstrate that genome information, along with appropriate data mining methodology, can be used as a starting point for the identification of memory-modulating compounds.","Papassotiropoulos, A; Gerhards, C; Heck, A; Ackermann, S; Aerni, A; Schicktanz, N; Auschra, B; Demougin, P; Mumme, E; Elbert, T; Ertl, V; Gschwind, L; Hanser, E; Huynh, K D; Jessen, F; Kolassa, I T; Milnik, A; Paganetti, P; Spalek, K; Vogler, C; Muhs, A; Pfeifer, A; Quervain, D J",2013.0,10.1073/pnas.1314478110,0,0,
4978,Treatment of alcohol dependence with low-dose topiramate: an open-label controlled study.,"GABAergic anticonvulsants have been recommended for the treatment of alcohol dependence and the prevention of relapse. Several studies have demonstrated topiramate's efficacy in improving drinking behaviour and maintaining abstinence. The objective of the present open-label controlled study was to assess efficacy and tolerability of low-dose topiramate as adjunctive treatment in alcohol dependence during the immediate post-detoxification period and during a 16-week follow-up period after alcohol withdrawal. Following a 7-10 day inpatient alcohol detoxification protocol, 90 patients were assigned to receive either topiramate (up to 75 mg per day) in addition to psychotherapeutic treatment (n = 30) or psychotherapy alone (n = 60). Symptoms of depression and anxiety, as well as craving, were monitored for 4-6 weeks immediately following detoxification on an inpatient basis. Thereafter, both groups were followed as outpatients at a weekly basis for another 4 months in order to monitor their course and abstinence from alcohol. A marked improvement in depressive (p < 0.01), anxiety (p < 0.01), and obsessive-compulsive drinking symptoms (p < 0.01) was observed over the consecutive assessments in both study groups. However, individuals on topiramate fared better than controls (p < 0.01) during inpatient treatment. Moreover, during the 4-month follow up period, relapse rate was lower among patients who received topiramate (66.7%) compared to those who received no adjunctive treatment (85.5%), (p = 0.043). Time to relapse in the topiramate augmentation group was significantly longer compared to the control group (log rank test, p = 0.008). Thus, median duration of abstinence was 4 weeks for the non-medicated group whereas it reached 10 weeks for the topiramate group. No serious side effects of topiramate were recorded throughout the study. Low-dose topiramate as an adjunct to psychotherapeutic treatment is well tolerated and effective in reducing alcohol craving, as well as symptoms of depression and anxiety, present during the early phase of alcohol withdrawal. Furthermore, topiramate considerably helps to abstain from drinking during the first 16-week post-detoxification period.",Paparrigopoulos T.; Tzavellas E.; Karaiskos D.; Kourlaba G.; Liappas I.,2011.0,10.1186/1471-244X-11-41,0,0,
4979,"Effects of heart rate information on anxiety, perspective taking, and performance in high and low social-evaluative anxiety","In a cognitive model, Clark and Wells (1995) proposed that individuals with social phobia use bodily information to construct a distorted impression of their observable selves. In this study, we conducted a preliminary test of this hypothesis by manipulating the provision of heart rate information in four groups of participants scoring high or low on social-evaluative anxiety (SEA), and examined the effects of this manipulation on anxiety, perspective taking, and social performance. Comparisons were made between two high SEA and two low SEA groups who received information suggesting their heart rate had increased, or no information, prior to a threatening social interaction task. The results showed that high SEA individuals receiving information concerning an increase in heart rate reported significantly greater anxiety, negative social performance, and greater proportion of observer perspectives than high SEA individuals receiving no such information. This bodily information, however, did not affect participants' heart rates. The results provide support for Clark and Wells's model.",Papageorgiou C.; Wells A.,2002.0,,0,0,
4980,A randomized open trial assessing the feasibility of behavioral activation for pathological grief responding.,"This study investigated the feasibility of using behavioral activation to treat enduring postbereavement mental health difficulties using a two-arm, multiple baseline design comparing an immediate start group to a delayed start group at baseline, 12-, 24-, and 36-weeks postrandomization. Participants received 12-14 sessions of behavioral activation within a 12-week intervention period starting immediately after the first assessment or after 12weeks for the delayed start group. Prolonged grief, posttraumatic stress, and depression symptoms were assessed as outcomes. Compared with no treatment, behavioral activation was associated with large reductions in prolonged, complicated, or traumatic grief; posttraumatic stress disorder; and depression symptoms in the intent-to-treat analyses. Seventy percent of the completer sample at posttreatment and 75 percent at follow-up responded to treatment with 45 percent at posttreatment and 40 percent at follow-up being classified as evidencing high-end state functioning at 12-week follow-up.",Papa A.; Sewell MT.; Garrison-Diehn C.; Rummel C.,2013.0,10.1016/j.beth.2013.04.009,0,0,
4981,A randomized open trial assessing the feasibility of behavioral activation for pathological grief responding.,"This study investigated the feasibility of using behavioral activation to treat enduring postbereavement mental health difficulties using a two-arm, multiple baseline design comparing an immediate start group to a delayed start group at baseline, 12-, 24-, and 36-weeks postrandomization. Participants received 12-14 sessions of behavioral activation within a 12-week intervention period starting immediately after the first assessment or after 12 weeks for the delayed start group. Prolonged grief, posttraumatic stress, and depression symptoms were assessed as outcomes. Compared with no treatment, behavioral activation was associated with large reductions in prolonged, complicated, or traumatic grief; posttraumatic stress disorder; and depression symptoms in the intent-to-treat analyses. Seventy percent of the completer sample at posttreatment and 75 percent at follow-up responded to treatment with 45 percent at posttreatment and 40 percent at follow-up being classified as evidencing high-end state functioning at 12-week follow-up. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Papa, Anthony; Sewell, M. Todd; Garrison-Diehn, Christina; Rummel, Clair; Acierno, Addis, Allison, Arnau, Atkins, Blanchard, Boelen, Boelen, Boelen, Boelen, Bonanno, Bonanno, Bonanno, Bonanno, Borkovec, Carroll, Cohen, Crawford, Cuijpers, Daughters, Devilly, Dimidjian, Dyregrov, Ekers, Ekers, Ferster, Foa, Forstmeier, Gavin, Giesbrecht, Herrnstein, Hill, Hirschfeld, Holland, Hopko, Hopko, Hopko, Jacobson, Jacobson, Jakupcak, Kenward, Kersting, Kraemer, Ladouceur, Latham, Lejuez, Lewinsohn, Litz, Lovibond, MacPherson, Mairs, Martell, Mazzucchelli, McDonald, Middleton, Oishi, Ott, Pagoto, Papa, Perepletchikova, Perepletchikova, Prigerson, Roberts, Roemer, Rosenthal, Rounsaville, Saunders, Schulz, Shear, Shear, Shear, Simon, Simon, Stroebe, Wagner, Wagner, Walker, Weathers, Wittouck, Zimmerman",2013.0,,0,0,
4982,Compensatory processes in the evolution of severe jargon aphasia,"A longitudinal study is reported of the conversational speech of a neologistic jargon aphasic patient, P.Z., at four sampling dates, from 3 months to 3 yr post trauma. The incidence of neologisms in conversational speech declined sharply in the first 10 months. However, while naming improved during this period, active speech vocabulary became smaller. Analyses of vocabulary, pauses and neologisms, along with other tests of linguistic ability, indicate that the changes in speech should be attributed to modifications in speech strategies rather than to functional recovery. The implications of these findings for the interpretation of the evolution of jargon and the value of longitudinal studies of aphasia in distinguishing functional recovery from modification of strategies are discussed.",Panzeri M.; Semenza C.; Butterworth B.,1987.0,10.1016/0028-3932(87)90096-0,0,0,
4983,Socially anxious and confident men interact with a forward virtual woman: An experimental study,"Background: Male volunteers entered an immersive virtual reality that depicted a party, where they were approached by a lone virtual woman who initiated a conversation. The goal was to study how socially anxious and socially confident men would react to this event. Interest focused on whether the socially anxious participants would exhibit sustained anxiety during the conversation or whether this would diminish over time, and differ from the responses of the more socially confident men. Methodology: The scenario was a party with five virtual characters, four sitting at a distance from the participant and talking amongst themselves and one lone woman standing closer. The woman approached the participant, introduced herself and initiated a conversation that was first about mundane matters and then became more personal and intimate. Participants were men who were either relatively socially confident (18) or socially anxious in their relationships with women (18). A second experimental factor was whether or not the other four characters occasionally looked towards the participant. There was a post-trial questionnaire about social anxiety in relation to the experience, and skin conductance and ECG physiological measures were recorded. Our expectation was that the socially anxious participants would show greater anxiety throughout. Conclusions: Compared to baseline readings both socially confident and socially anxious groups on average showed signs of significantly increased stress at the initial approach of the virtual woman. The stress then diminished once the conversation entered into the mundane phase and then did not significantly change. Comparing pre- and post-questionnaire anxiety scores there was no change for the more confident participants but a significant decrease in average score amongst the anxious group. The methodology of placing socially anxious participants in a virtual reality where they can gain experience of how to act in a stressful situation promises a novel way forward for treating social anxiety. © 2012 Pan et al.",Pan X.; Gillies M.; Barker C.; Clark D.M.; Slater M.,2012.0,10.1371/journal.pone.0032931,0,0,
4984,Effectiveness of anxiety management training in the treatment of posttraumatic stress disorder: a preliminary report.,"This preliminary study investigated the effectiveness of anxiety management training (AMT), a coping skills treatment similar to systematic desensitization, in comparison to implosive therapy (IT), an exposure-based treatment, for treating six Vietnam combat veterans with posttraumatic stress disorder (PTSD). The Clinician Administered PTSD Interview Scale (CAPS; Blake et al. (1988), The Behaviour Therapist, 18, 187-188) and a self-monitoring measure (Weathers et al., 1991) were used as dependent measures. A single-subject, multiple-baseline, crossover design (ABC/ACB) was employed. A new statistic for such designs (Mueser et al. (1991), Behaviour Modification, 15, 134-155), based on classical test theory, was used to assess treatment effects on intrusive war memories and avoidance of stimuli reminiscent of war. Within-subject results indicated that AMT and IT were similarly effective in reducing the frequency and intensity of intrusions and avoidance. This preliminary report therefore suggests that it may be productive to investigate multidimensional approaches (combining coping skills, exposure-based, and other approaches) to the treatment of combat-related PTSD as Foa et al. (1991), Journal of Consulting and Clinical Psychology, 59, 715-723 and Nishith et al. (1995), Behaviour Therapy, 26, 319-335 have for rape-related PTSD.",Pantalon MV.; Motta RW.,1998.0,,0,0,
4985,Implosive therapy versus anxiety management training in the treatment of combat-related posttraumatic stress disorder.,"This study compared the effectiveness of Implosive Therapy and Anxiety Management Training for treating Vietnam combat veterans with posttraumatic stress disorder. Implosive Therapy focused on extinguishing anxiety in response to recollections of war trauma, while Anxiety Management Training focused on teaching self-control of anxiety through relaxation in a variety of situations. Expert judges rated audiotaped segments of sessions and concluded that both treatments were implemented correctly. The Mississippi Combat-Related Posttraumatic Stress Disorder Scale, the Impact of Event Scale-Revised, the Clinician Administered Posttraumatic Stress Disorder Scale, Self-Monitoring, the Beck Depression Inventory, the State-Trait Anxiety Inventory, self-reported anxiety, and a behavioral measure of anxiety, were used as dependent measures. Six white, male, Vietnam combat veterans meeting the Diagnostic and Statistical Manual-Third Edition-Revised Posttraumatic Stress Disorder criteria participated in the study. Subjects ranged in age from 44 to 46 years. A multiple baseline design across subjects was employed where each subject received both treatments. The order of the two treatments was counterbalanced (crossed-over) across two groups of three subjects each so as to control for order effects. Each treatment consisted of six weekly, two-hour sessions. Total contact time was 14 to 16 weeks. Treatment effects on intrusive memories and avoidance of stimuli reminiscent of war trauma were assessed through visual inspection. In addition, a statistical analysis technique for single-case designs provided for the objective and reliable analysis of the current data which were serially dependent (i.e., data which tend to remain unchanged over many points). The main findings were: (1) Anxiety Management Training was as, or somewhat more, effective than Implosive Therapy in reducing both intrusions and avoidance; (2) Anxiety Management Training was as, or somewhat more, effective in redu (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pantalon, Michael Vincent",1995.0,,0,0,
4986,Iatrogenic prostatic urethral strictures: classification and endoscopic treatment.,"The treatment of posterior urethral strictures is a controversial subject. For proper treatment, it is important to differentiate between iatrogenic prostatic urethral strictures and post-traumatic membranous urethral strictures. Iatrogenic strictures of the prostatic urethra have been classified according to location and etiology into three categories: type I, located exclusively at the bladder neck; type II, located in the midportion of the prostatic fossa; and type III, when the whole prostatic fossa is replaced by stricture. From 1970 to 1996, 163 patients with postoperative strictures of the prostatic urethra were treated endoscopically. The results obtained in 122 patients are reported; 41 patients are not evaluable. The median follow-up was 63 months (range 12 to 239). Seven patients required a second endoscopic procedure to attain cure. Good results were achieved in 54 (91%) of 59 patients with type I strictures, in 45 (98%) of 46 patients with type II strictures, and in 13 (76%) of 17 patients with type III strictures. The overall success rate was 92% (112 of 122). Complications occurred in 21 patients (17%), including postoperative urinary tract infection (11%), incontinence (4%), stress incontinence (1%), and severe bleeding (1%). Postoperative strictures of the prostatic urethra must be recognized and can be easily treated with endoscopic therapy.",Pansadoro V.; Emiliozzi P.,1999.0,,0,0,
4987,Anxiety sensitivity and expectation of arousal differentially affect the respiratory response to caffeine,"ER RATIONALE: This study aimed to test how expectations and anxiety sensitivity influence respiratory and autonomic responses to caffeine.OBJECTIVES: The current study investigated the effects of expected vs. unexpected caffeine ingestion in a group of persons prone to the anxiety-provoking effect of caffeine (high anxiety sensitive persons, that is, persons scoring at least one SD above the mean on the Anxiety Sensitivity Index (Peterson and Reiss 1992)) as compared to low-anxious controls.METHODS: Autonomic arousal (heart rate, skin conductance level), respiratory responding (expired CO2, minute ventilation), and subjective report were assessed in high and low anxiety sensitive participants immediately after beverage consumption and at absorption peak (30 min post-consumption) in four separate sessions during which either coffee (expectation of caffeine) or bitter lemon soda (no expectation of caffeine) was crossed with 4 mg/kg caffeine vs. no drug.RESULTS: High and low anxiety sensitive persons showed comparable autonomic arousal and symptom reports to caffeine which was modulated by expectation, i.e., greater for coffee. Respiratory responding (CO2 decrease, minute ventilation increase) was more accentuated when caffeine was both expected and administered in the low anxiety sensitive group but more accentuated when caffeine was unexpectedly administered in the high anxiety sensitive group. Autonomic arousal and respiratory effects were observable within a few minutes after caffeine administration and were most pronounced at maximum absorption.CONCLUSIONS: The results highlight the modulating role of expectancies in respiratory responding to caffeine in low vs. high anxiety sensitive persons and might have important implications for the better understanding of unexpected panic attacks.","Pané-Farré, C A; Alius, M G; Modeß, C; Methling, K; Blumenthal, T; Hamm, A O",2015.0,10.1007/s00213-014-3828-3,0,0,
4988,"Culturally adapted versus standard exposure treatment for phobic Asian Americans: Treatment efficacy, moderators, and predictors.","This study is a 6-month follow-up of a randomized pilot evaluation of standard one-session treatment (OST-S) versus culturally adapted OST (OST-CA) with phobic Asian Americans. OST-CA included seven cultural adaptations drawn from prior research with East Asians and Asian Americans. Results from 1-week and 6-month follow-up show that both OST-S and OST-CA were effective at reducing phobic symptoms compared with self-help control. Moreover, OST-CA was superior to OST-S for several outcomes. For catastrophic thinking and general fear, moderator analyses indicated that low-acculturation Asian Americans benefitted more from OST-CA than OST-S, whereas both treatments were equally effective for high-acculturation participants. Although cultural process factors (e.g., facilitating emotional control, exploiting the vertical therapist-client relationship) and working alliance were predictive of positive outcomes, they did not mediate treatment effects. This study offers a potential model for evaluating cultural adaptation effects, as well as the mechanisms that account for such effects.",Pan D.; Huey SJ.; Hernandez D.,2011.0,10.1037/a0022534,0,0,
4989,"A randomized, double-blind, placebo-controlled trial on the efficacy and tolerability of sertraline in Iranian veterans with post-traumatic stress disorder.","Background: Unlike civilian post-traumatic stress disorder (PTSD), the efficacy of sertraline for the treatment of combat-related PTSD has not yet been proven. The present study aimed to evaluate the clinical efficacy of sertraline against combat-related PTSD in a randomized, double-blind, placebo-controlled trial. Method: Seventy Iranian veterans of the Iran-Iraq war who met the DSM-IV criteria for diagnosis of PTSD were randomized to receive either flexibly dosed sertraline (50-200 mg/day) (n = 35, completers = 32) or placebo (n = 35, completers = 30) for 10 weeks. Efficacy was evaluated by the Impact of Event Scale-Revised (IES-R) and the Clinical Global Impression scale-Severity (CGI-S) and Improvement (CGI-I) ratings. Responder criteria were defined as a >=30% reduction in the IES-R total score plus a CGI-I rating of 'much' or 'very much' improved. Results: On both intention-to-treat (ITT) and per protocol (completer) methods of analysis, the mean reductions in the IES-R total and subscale (re-experiencing/intrusion, avoidance/numbing and hyperarousal) scores (p < 0.001) and also in the CGI-S score (p < 0.01) were significantly greater in the sertraline group than in the placebo group. For the CGI-I, the mean endpoint score was significantly lower in the sertraline group than in the placebo group (p <= 0.001). The number of responders in the sertraline group was significantly higher than in the placebo group (44% v. 3%, p <= 0.001). Sertraline was well tolerated, with a 6% discontinuation rate as a result of adverse reactions. Conclusions: The results of this study suggest that sertraline can be an effective, safe and tolerable treatment for combat-related PTSD in Iranian veterans. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Panahi, Y; Moghaddam, B. Rezazadeh; Sahebkar, A; Nazari, M. Abbasi; Beiraghdar, F; Karami, G; Saadat, A. R; Boscarino, Brady, Chung, Creamer, Davidson, Davidson, De Boer, Dow, Friedman, Friedman, Hertzberg, Kessler, Kessler, Mannar, Marshall, Martenyi, Martenyi, Martenyi, Resnick, Tucker, Ursano, Zatzick, Zohar",2011.0,,0,0,
4990,Experimental emotional disclosure in women undergoing infertility treatment: are drop outs better off?,"ER So far, the beneficial effects of personal written emotional disclosure have been mainly examined in relation to past or current stressful/traumatic experiences. The anticipation of a medical event has rarely been studied within this paradigm. This randomized-controlled study examined whether written emotional disclosure would reduce emotional distress and increase pregnancy rates in women undergoing in-vitro fertilization treatment. Participants recruited from women who were undergoing IVF in the north of Greece (n=148) were randomized to an emotional-writing condition, a fact-writing condition and a control condition. Outcomes included fertility-related distress, general distress and a positive indication of pregnancy. Psychological and medical information about women who refused to participate were also collected, and this represented a fourth group for analysis (n=66). Results indicated no significant difference between groups in terms of emotional distress. However, a significant difference was observed with regard to pregnancy results, with the non-participants group reporting the highest percentage of pregnancies. The present study did not support the hypotheses that emotional disclosure will reduce infertility-related or general psychological distress and improve pregnancy outcomes in women undergoing in-vitro fertilization treatment. However, women who refused to participate in the study were more likely to get pregnant. Differences in the beneficial effects of emotional disclosure are discussed.","Panagopoulou, E; Montgomery, A; Tarlatzis, B",2009.0,10.1016/j.socscimed.2009.06.031,0,0,
4991,Effectiveness of care and improvement of quality of life in patients with panic disorder.,"To investigate how practice guidelines or recommendations can be applied in the assessment of quality of care, 72 subjects beginning specialty treatment for panic disorder were enrolled. The Panic Outcomes Module assessed symptoms, health status, and treatment at baseline and after 8 weeks. Using published guidelines, the authors developed specific criteria to rate whether subjects' reports reflected appropriate treatment, including antipanic medication or three or more subsequent visits that involved antipanic behavioral therapy elements. Sixty-nine subjects (96%) completed the Panic Outcomes Module at both baseline and follow-up. Improvement in symptoms and health status was not different between subjects receiving appropriate and inappropriate care.",Owen RR.; Rost K.; Hollenberg J.; Humphrey JB.; Lazorite M.; Bartlett J.; Smith GR.,1997.0,10.1177/0193841X9702100315,0,0,
4992,Cerebral blood flow velocity in untreated panic disorder patients: A transcranial Doppler ultrasonography study,"Background: The aim of this study was to compare resting cerebral blood flow velocity values of unmedicated patients in the acute phase of panic disorder with resting values of healthy control subjects. Methods: Nineteen unmedicated panic disorder patients were assessed for degree of anxiety using the Hamilton Anxiety Scale. The patients and 20 healthy age-matched control subjects were then insonated at rest using transcranial Doppler ultrasonography (TCD). For TCD, the anterior, the middle, and the posterior cerebral arteries were insonated bilaterally in all patients. Results: Compared with healthy age-matched control subjects, acute unmedicated panic disorder patients showed a significant increase in cerebral blood flow velocity, bilaterally in the middle and the anterior cerebral artery, and unilaterally in the left posterior cerebral artery. Cerebral blood flow velocity in the right middle cerebral artery correlated positively to the item ""Fear"" on the Hamilton Anxiety Scale, whereas pulsatility index in the posterior cerebral artery bilaterally and in the left middle cerebral artery correlated negatively to the item ""Mood."" Conclusions: Transcranial Doppler ultrasonography agrees well with validated psychometric methods. If follow-up studies confirm our findings, TCD could allow an objective assessment of the mental state of panic disorder patients and reliably discriminate panic disorder patients from normal control subjects. © 2001 Society of Biological Psychiatry.",Owega A.; Sabri O.; Klingelhofer J.; Albers M.,2001.0,10.1016/S0006-3223(00)01115-X,0,0,
4993,The effect of neck-specific exercise with or without a behavioral approach on psychological factors in chronic whiplash-associated disorders: A randomized controlled trial with a 2-year follow-up.,"To investigate the effect of neck-specific exercise with (NSEB) or without (NSE) a behavioural approach and prescribed physical activity (PPA) on general pain disability and psychological factors in chronic whiplash-associated disorders (WAD), grade 2 and 3, with a 2-year follow-up. A randomized controlled multi-centre study of 3 exercise interventions (NSE, NSEB or PPA) including a 2-year follow-up. A total of 216 volunteers with chronic WAD were recruited and 194 were analyzed, mean age 40.4 (Standard Deviation [SD] 11.4). Measures of general pain disability, pain catastrophizing, anxiety and depression, and kinesiophobia were evaluated at baseline, and 3, 6, 12 and 24 months with linear mixed models. General pain disability decreased by 28% in the NSEB group from baseline to 3 months (P < 0.001) and the improvements in disability were maintained over time (6, 12 and 24 months P < 0.01) compared to the NSE (P > 0.42) and PPA groups (P > 0.43). Pain catastrophizing decreased in the NSE group from baseline to 6 and 12 months (P < 0.01) and in the NSEB group from baseline to 3 and 24 months (P < 0.01) compared to the PPA group (P > 0.82) that showed no change over time. The NSE group improved in kinesiophobia over time from baseline to12 months (P < 0.01) compared to the NSEB (P = 0.052) and the PPA groups (P > 0.74). Anxiety decreased over time from baseline to 12 and 24 months in the NSE group (P > 0.02), but not in the NSEB (P > 0.25) or the PPA (P > 0.50) groups. The PPA had no effect on general disability or any of the measured psychological factors. This randomised controlled trial with a 2-year follow-up shows that physiotherapist-led neck-specific exercise with or without the addition of a behavioural approach had superior outcome on general disability and most psychological factors compared to the mere prescription of physical activity.",Overmeer T.; Peterson G.; Landén Ludvigsson M.; Peolsson A.,2016.0,10.1097/MD.0000000000004430,0,0,
4994,Effectiveness of specific factors in community-based intervention for child-witnesses of interparental violence: a randomized trial,"ER A community-based intervention with specific factors for children and parents exposed to interparental violence (IPV) was compared with a control intervention based on non-specific factors. We hypothesized that participation in an intervention with specific factors, focused on IPV, parenting and coping, would be associated with better recovery. IPV exposed children and parents were group randomized over a specific factors- and control intervention. Baseline, posttest and follow-up measurements of 155 parents and children (aged 6-12 years, 55.5% boys) were fitted in a multilevel model. Outcomes were parent and teacher reported children's internalizing and externalizing problems (CBCL, TRF), child self-reported depressive symptoms (CDI) and parent and child reported children's post-traumatic stress symptoms (TSCYC, TSCC). Based on intention-to-treat and completer analyses, children in the specific factors intervention did not show better recovery than children in the control intervention. Children in both interventions decreased significantly in parent-reported children's internalizing and externalizing problems and post-traumatic stress symptoms. Children reported a decrease in their mean level of depressive and post-traumatic stress symptoms. Teachers reported a decrease in internalizing problems, but not in externalizing problems. No association between time since exposure and level and course of symptoms was found. Treatment differentiation was assessed and both programs were significantly different on hypothesized effective factors. Higher treatment adherence in both programs did not result in a larger difference in recovery. IPV exposed children improve over the course and after participating in a community-based child- and parent program, but specific factors in intervention may not carry additional benefits when implemented in community settings.","Overbeek, M M; Schipper, J C; Lamers-Winkelman, F; Schuengel, C",2013.0,10.1016/j.chiabu.2013.07.007,0,0,
4995,Risk factors as moderators of recovery during and after interventions for children exposed to interparental violence,"ER High family risk was tested as an impediment to recovery in children exposed to interparental violence (IPV) participating in community-based intervention. Characteristics of IPV were also explored as moderators for the effect of an IPV-focused intervention over a common factors intervention. Baseline, posttest and follow-up measurements of 155 parents and children (aged 6 to 12 years; 55.5% boys) were fitted in a multilevel model. Outcomes were clinical classifications of internalizing and externalizing problems, and posttraumatic stress symptoms. Tested moderators were child maltreatment, symptoms of disordered attachment, parental psychopathology, parenting stress, poverty, and IPV characteristics. Children without symptoms of disinhibited social engagement disorder, children of parents with high levels of psychopathology, and children of parents with high levels of parenting stress showed strongest recovery. Participation in an IPV-focused intervention was not more effective than in a common factors intervention, irrespective of the nature of the IPV. Based on rate of recovery, participation in community-based group interventions does not need to be contraindicated for children facing high family risk after being exposed to IPV, except for children with symptoms of disinhibited social engagement disorder.","Overbeek, M M; Schipper, J C; Lamers-Winkelman, F; Schuengel, C",2014.0,10.1037/ort0000007,0,0,
4996,Hemispheric laterality and memory bias for threat in anxiety disorders.,"The authors examined auditory perceptual asymmetries and explicit memory biases for threat in patients with panic disorder and generalized anxiety disorder relative to healthy control subjects. They did not find a greater explicit memory bias for threat in the anxiety patients. However, explicit memory biases for threat were associated with perceptual asymmetry scores; patients with a greater right-ear (left hemisphere) advantage exhibited an explicit memory bias for threat material, whereas patients with a lower right-ear advantage displayed apparent cognitive avoidance of threat material. Memory for threat words was unrelated to perceptual asymmetry in healthy control subjects. These findings suggest that neuropsychological variables may partly determine the degree to which anxiety patients process threatening stimuli.",Otto MW.; McNally RJ.; Pollack MH.; Chen E.; Rosenbaum JF.,1994.0,,0,0,
4997,Treatment of pharmacotherapy-refractory posttraumatic stress disorder among Cambodian refugees: a pilot study of combination treatment with cognitive-behavior therapy vs sertraline alone.,"Cambodian refugees with posttraumatic stress disorder (PTSD) represent a cohort in severe need of treatment, but little information is available to guide treatment choices. We selected a sample of pharmacotherapy-refractory individuals to test the efficacy of combination treatment with sertraline and cognitive-behavior therapy (CBT) for treating PTSD. Participants in this pilot study were ten Khmer-speaking women who had been at a mean age of 22-26 years during the Pol Pot period (1975-1979). These patients were randomly assigned to either sertraline alone or combined treatment. We found that combined treatment offered additional benefit in the range of medium to large effect sizes for PTSD and associated symptoms. Our findings indicate that substantial gains can be achieved by adding CBT to pharmacotherapy for PTSD, and that a program of CBT emphasizing information, exposure, and cognitive-restructuring can be successfully modified for Khmer-speaking refugees.",Otto MW.; Hinton D.; Korbly NB.; Chea A.; Ba P.; Gershuny BS.; Pollack MH.,2003.0,,0,0,
4998,Promoting psychosocial well-being in adolescence. A controlled study,"ER INTRODUCTION: In the recent years a large body of literature has focused its attention to the study of the positive aspects of adolescence, in particular quality of life, happiness and social functioning. The school is an ideal setting for promoting learning abilities, educational processes and also optimal human and social development.AIM: A new school program for the promotion of psychological well-being has been tested and compared to an attention-placebo intervention in a high school setting.METHODS: Nine classes (227 students) were enrolled in the study and randomized to: a) School Well-Being Therapy intervention (5 classes); b)attention-placebo (4 classes). 1) Symptom Questionnaire (SQ); 2) Psychological Well-Being Scales (PWB); 3) Revised Children's Manifest Anxiety Scale (RCMAS) were administered at pre- and post-intervention, and after six months.RESULTS: WBT school intervention was associated to an improved Personal Growth (PWB), and to decreased distress (Somatization (SQ), Physical Well-being (SQ), Anxiety (SQ), and RCMAS Physiological Anxiety).DISCUSSION AND CONCLUSIONS: A school intervention focused on the promotion of positive emotions and psychological well-being has resulted to be effective not only in increasing these dimensions in high school students, but also in decreasing distress, in particular anxiety and somatization.","Ottolini, F; Ruini, C; Belaise, C; Tomba, E; Offidani, E; Albieri, E; Visani, D; Caffo, E; Fava, G A",2012.0,10.1708/1175.13034,0,0,
4999,"Blockade of the mineralocorticoid receptor in healthy men: Effects on experimentally induced panic symptoms, stress hormones, and cognition","Animal studies have shown that blockade of central mineralocorticoid receptors (MR) has anxiolytic effects and impairs several aspects of cognitive function. No study to date assessed the effects of MR blockade on anxiety and cognitive function in humans. In the present study, 16 healthy young men were treated either with placebo or with 300 mg spironolactone, a MR-antagonist, at 1100, 1330, and 1630 hours in a balanced cross-over design with the two study conditions being 1 week apart. At 1500 hours, the panic symptoms provoking compound cholecystokinin-tetrapeptide (CCK-4) was administered i.v. on both occasions and panic symptoms were assessed. We measured plasma ACTH and cortisol between 1300 and 1900 hours and assessed cognitive function between 1800 and 1900 hours. CCK-4 elicited panic symptoms and increased ACTH and cortisol secretion in both conditions. Intensity of panic symptoms after CCK-4 was not different between spironolactone and placebo. Spironolactone significantly impaired selective attention and delayed recall of visuospatial memory, and diminished set shifting/mental flexibility on a trend level. Pretreatment with spironolactone led to higher baseline cortisol levels compared to placebo whereas no differences in stimulated cortisol, baseline ACTH, and stimulated ACTH emerged. Blockade of MR with spironolactone increases baseline cortisol secretion and impairs cognitive function but has no effect on experimentally induced panic symptoms in humans, for the study design and dosage of spironolactone used. The domains of cognitive function that are impaired after blockade of MR in men, that is, selective attention, visuospatial memory, and mental flexibility/set shifting appear to be remarkably similar to those described in animal studies. © 2007 Nature Publishing Group All rights reserved.",Otte C.; Moritz S.; Yassouridis A.; Koop M.; Madrischewski A.M.; Wiedemann K.; Kellner M.,2007.0,10.1038/sj.npp.1301217,0,0,
5000,Prolactin but not ACTH increases during sodium lactate-induced panic attacks,"ER Paradoxically, the pituitary-adrenal axis is not activated during sodium lactate-induced panic. We measured the response of another stress-sensitive hormone, prolactin, to standard lactate and placebo infusion in a double-blind randomised design in eight patients with panic disorder and eight matched normal controls. Prolactin release was significantly elevated (P < 0.05) in panickers compared with non-panickers, whereas ACTH secretion was not activated at all. This differential stress response needs further investigation.","Otte, C; Kellner, M; Arlt, J; Jahn, H; Holsboer, F; Wiedemann, K",2002.0,,0,0,
5001,Autonomic correlates of physical and moral disgust.,"Given that the hypothesis of a common origin of physical and moral disgust has received sparse empirical support, this study aimed to shed light on the subjective and autonomic signatures of these two facets of the same emotional response. Participants (20 men, 20 women) were randomly assigned to physical or moral disgust induction by the use of audio scripts while their electrocardiogram was continuously recorded. Affect ratings were obtained before and after the induction. Time and frequency domain heart rate variability (HRV) measures were obtained. After controlling for disgust sensitivity (DS-R) and obsessive-compulsive (OCI-R) tendencies, both scripts elicited disgust but whereas the physical script elicited a feeling of dirtiness, the moral script evoked more indignation and contempt. The disgust-induced subjective responses were associated with opposite patterns of autonomic reactivity: enhanced activity of the parasympathetic nervous system without concurrent changes in heart rate (HR) for physical disgust and decreased vagal tone and increased HR and autonomic imbalance for moral disgust. Results suggest that immorality relies on the same biological root of physical disgust only in subjects with obsessive compulsive tendencies. Disgust appears to be a heterogeneous response that varies based on the individuals' contamination-based appraisal.",Ottaviani C.; Mancini F.; Petrocchi N.; Medea B.; Couyoumdjian A.,2013.0,10.1016/j.ijpsycho.2013.05.003,0,0,
5002,Safety and side-effects of alprazolam. Controlled study in agoraphobia with panic disorder.,"The widespread use of benzodiazepines has led to increasing recognition of their unwanted effects. The efficacy of alprazolam and placebo in panic disorder with agoraphobia, and the side-effect and adverse effect profiles of both drug groups were measured. In London and Toronto 154 patients who met DSM-III criteria for panic disorder with agoraphobia were randomised to alprazolam or placebo. Subjects in each drug group also received either exposure or relaxation. Treatment was from weeks 0 to 8 and was then tapered from weeks 8 to 16. Mean alprazolam dose was 5 mg daily. Compared with placebo subjects, alprazolam patients developed more adverse reactions (21% v. 0%) of depression, enuresis, disinhibition and aggression; and more side-effects, particularly sedation, irritability, impaired memory, weight loss and ataxia. Side-effects tended to diminish during treatment but remained significant at week 8. Despite this, the drop-out rate was low. Alprazolam caused side-effects and adverse effects during treatment but many patients were willing to accept these.",O'Sullivan GH.; Noshirvani H.; Başoğlu M.; Marks IM.; Swinson R.; Kuch K.; Kirby M.,1994.0,,0,0,
5003,Psychological distress during treatment for primary ovarian cancer: Factors associated with consent for mental health services,"OBJECTIVES: Psychological distress in cancer is frequently reported, but inadequately treated. Although clinicians may refer cancer patients for mental health (MH) services, some distressed patients refuse treatment. Ovarian cancer patients are prone to distress due to aggressive regimens with uncertain outcomes. This study compares patient demographics, problems, and nursing interventions of two groups of distressed women after ovarian cancer surgery, those who received and those who refused MH services within the intervention arm of a clinical trial. METHOD: A secondary analysis of data from 24 distressed women was performed from study records of a completed clinical trial investigating QOL outcomes in gynecologic cancer. Eighteen records per patient for six months following surgery were coded by content analysis, using the Omaha System to categorize patient problems and nursing interventions. Group demographic and clinical characteristics, patient problems, and nursing interventions were compared using chi-square and t-tests. RESULTS: Of 24 subjects, 18 consented, 6 refused MH evaluations. Mean Distress Thermometer Scores: 6.94 for consenting, 5.67 for non-consenting subjects. Group demographic and clinical characteristics not significantly different. Mean numbers of contacts: 17.56 (±2.20) for consenting, 14.17 (±3.87) for non-consenting women. The Mental Health Problem most frequent and of longest duration for both groups. Nursing interventions most frequent for Physical Problems. Non-consenting subjects had higher proportion of interventions for Environmental Problems. MH evaluations identified 8 women with psychiatric diagnoses. CONCLUSIONS: Psychological issues represent important clinical problems for women with ovarian cancer. Women who refuse MH services for distress may suffer from unique challenges that are not well-addressed within our current healthcare system. Nurses may play a critical role in helping to identify and promote treatment for MH problems for these patients.",O'Sullivan C.; Ercolano E.; McCorkle R.,2010.0,10.1002/pon.1776,0,0,
5004,Targeting advanced practice nursing interventions to patient problems in ovarian cancer,"PURPOSE: Ovarian cancer patients are prone to psychological distress due to aggressive treatment with uncertain outcomes. Distress identification and treatment are often inadequate, while best practices for distress among this population are yet to be determined. This study explores patient problems and advanced practice nursing (APN) interventions provided to ovarian cancer patients in light of distress level and receipt of mental health (MH) services. METHODS: Secondary analysis of data from 32 women was performed from study records of a completed clinical trial investigating QOL outcomes in ovarian cancer. 18 APN records per patient (n = 534 records) for 6 months following surgery were coded by content analysis, using the Omaha System to categorize patient problems and nursing interventions. High distress patients were offered mental health referral and treatment plans by a psychiatric consult-liaison nurse (PCLN). Patient groups included: High Distress ( > 4 DT score) + PCLN; High Distress/ Refused PCLN; and Low Distress ( < 4 DT score). Patient demographics, clinical characteristics, problems, and nursing interventions were compared using chi-square and ANO- VA. RESULTS: 24/32 (75%) women reported high distress. Of these, 18 consented and 6 refused PCLN referral. Psychiatric diagnoses identified in eight women from MH evaluations. Reasons for refusing MH services included denial of coping problems, feeling overwhelmed, wanting to focus on positive things, seeing other practitioners for counseling, and adequate support from family, friends, and APN. High Distress + PCLN and Low Distress sub-samples received more interventions at study onset, but progressively fewer by study termination. The High Distress/Refused PCLN sub-sample received the fewest interventions at study onset, but the most interventions by study termination. This sub-sample received proportionately more nursing interventions for Environmental Problems, but less Teaching, Guidance, and Counseling for Coping with Mental Health Problems than the other two sub-samples. CONCLUSIONS: Advanced practice nursings play a critical role in helping to identify and promote treatment for MH problems in ovarian cancer. Some women who refuse MH services for distress may suffer from unique challenges that are not well-addressed within our current health care system. RESEARCH IMPLICATIONS: This study identifies linkages between patient demographic and clinical problems, patient problems, and resulting APN interventions which may assist the researcher in identifying best practices in addressing psychological distress among women with ovarian cancer. CLINICAL IMPLICATIONS: Long-term nurse- patient relationships may be necessary to assist patients in learning self-management strategies for coping with cancer. FUNDING: Parent study funding: NIH, NINR, 1R01NR07778; United States Department of Defense Breast Cancer Pre- doctoral Fellowship, DAMD 17-00-1-0509.",O'Sullivan C.; Ercolano E.; McCorkle R.,2011.0,10.1111/j.1755-148X.2011.01915.x,0,0,
5005,Prospective and retrospective life-charting in posttraumatic stress disorder (the PTSD-LCM): A pilot study.,"Evaluated the utility of a longitudinal, graphic approach to the symptoms of posttraumatic stress disorder (PTSD). Seven PTSD patients (aged 24-56 yrs) were instructed in the use of a daily prospective life-chart; they were interviewed and their past medical records were examined for monthly retrospective life-charting. The life charts were used to record life events, activating and inhibiting PTSD symptoms, comorbid symptoms, and treatment. Results show that patients readily completed the prospective life-chart and retrospectively rated symptoms associated with traumatic and nontraumatic life events. Life-charting facilitated longitudinal depiction of the relationship of life experiences to PTSD symptoms and comorbidities, and the tracking of responses to medications. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Osuch, Elizabeth A; Brotman, Melissa A; Podell, Daniel; Geraci, Marilla; Touzeau, P. Lynn; Leverich, Gabriele S; McCann, Una D; Post, Robert M; Bremner, Denicoff, Frye, Harding, Kraepelin, Leverich, Meyer, Rahe, Uhde",2001.0,,0,0,
5006,Trait anxiety and the dynamics of attentional control,"According to recent theoretical approaches dispositional anxiety is fundamentally linked to neural mechanisms of cognitive control (Braver et al., 2007; Eysenck et al., 2007). The present study was conducted to further investigate this topic by focusing on the relation between trait anxiety, conflict-processing and dynamic adjustments in attentional allocation. Participants completed a modified version of the face-word Stroop task while an electroencephalogram was recorded. We analyzed behavioral and electrophysiological correlates of conflict processing and conflict-driven modulations in target and distractor processing. Anxiety was not related to general conflict-sensitivity but to individual differences in conflict-driven adjustments in attentional allocation: following a high level of stimulus-response conflict, highly anxious participants allocated more attentional resources to the processing of predominantly task-relevant information and withdrew attention from the processing of predominantly task-irrelevant information. Thus, trait anxiety appears to be closely related to individual differences in dynamic adjustments of attentional control. © 2011 Elsevier B.V.",Osinsky R.; Gebhardt H.; Alexander N.; Hennig J.,2012.0,10.1016/j.biopsycho.2011.10.016,0,0,
5007,Exploring the longitudinal trajectories of posttraumatic stress disorder in injured trauma survivors.,"The goal of this study was to examine the longitudinal trajectories of posttraumatic stress disorder (PTSD) symptoms in a sample of acutely injured hospitalized civilian trauma survivors who participated in a randomized clinical trial. Prior longitudinal descriptive research has shown that there are distinct trajectories of PTSD symptoms over time in trauma survivors. Limited clinical trial research exists that describes the patterns of the trajectories as well as the risk factors that influence the trajectories for seriously injured trauma-exposed patients. Semiparametric, group-based approach trajectory modeling was used to examine four group trajectories of a subset of data obtained from a previous longitudinal clinical trial. Trajectories examined included resilience, recovery, relapsing/remitting, and chronic symptom patterns. One hundred and ninety-four patients who participated in the randomized clinical trial were assessed at baseline in the days and weeks after injury and then randomized. The associations between previously identified PTSD risk factors and the four trajectories were examined. The risk factors of ethnocultural minority status, psychiatric history, additional life stressors, and depressive symptoms, as well as intervention versus control group status, were found to significantly affect the probability of trajectory group membership for PTSD symptom severity. These findings suggest that there is a need for early PTSD interventions that anticipate differences in injured patients' PTSD trajectory profiles. Stepped care intervention procedures may optimally address the diverse PTSD trajectory patterns observed in injured trauma survivors through the tailoring of intervention timing and dosing.",Osenbach JE.; Lewis C.; Rosenfeld B.; Russo J.; Ingraham LM.; Peterson R.; Wang J.; Zatzick DF.,2014.0,10.1521/psyc.2014.77.4.386,0,0,
5008,The comparison of effect of a psycho-educational program for preventing traumatic stress with individual help-seeking styles,"Wessely et al. (2008) argued that psycho-education could be effective in the prevention of traumatic stress. However, empirical research about the effectiveness of psycho-education is scant. Previous studies (e.g., Ehlers & Steil, 1995; Michael et al., 2005) have shown that the pain caused by traumatic memory recall may be a factor causing the maintenance or exacerbation of posttraumatic stress responses such as symptoms of posttraumatic stress disorder (PTSD). On the basis of these previous studies, Osawa (2015, 2016) conducted the psycho-educational program focused on traumatic memory recall and indicates that the program may have an effect on promoting self-efficacy for recall and preventing traumatic stress responses from getting worse. The purpose of this study is to compare the effect of psycho-educational program with individual helpseeking styles. Participants of this study were eighty-one Japanese undergraduates (Male=18, Female=63; mean ages=19.86, SD= .67). The psycho-educational program was designed by some cognitivebehavioural techniques. A total of 2 sessions (60-70 minutes per 1 session) was conducted. As the measures of help-seeking styles, participants completed the scale for measuring help-seeking styles (Nagai, 2013) at pre-sessions. As the measures of the effect of the program, participants also rated the degree of fear of recall (0-100), the degree of probability of coping with recall (0-100), and the degree of probability of helping traumatized people with recovering from distress caused by recall (0-100) at pre- sessions, post-sessions and 1-month follow-up. Implications of this study for the development possibility and availability of psycho-education for preventing traumatic stress were discussed.",Osawa K.,2016.0,10.1111/eip.12397,0,0,
5009,A comparative trial of exposure and respiratory relief therapies.,,Orwin A.; le Boeuf A.; Dovey J.; James S.,1975.0,,0,0,
5010,"Treatment of the phobic obsessive-compulsive patient with oxazepam, an improved benzodiazepine compound.",,Orvin GH.,,10.1016/S0033-3182(67)71943-X,0,0,
5011,Continuity of psychopathology in a community sample of adolescents,"ER METHODThe sample consisted of 236 youngsters selected from the larger (n = 1,507) population of adolescents (aged 14 through 18 years) from the Oregon Adolescent Depression Project who had been assessed on two occasions, approximately 1 year apart.RESULTSResults support the continuity hypothesis for the categories of disorder studied (major depression, anxiety, disruptive, substance use), with the exception of dysthymia. Primary dysthymia did not result in the diagnosis of secondary dysthymia, because most adolescents who had dysthymia had not recovered within the time frame of the study and were chronic cases, often with secondary anxiety. Also presented are data on age of onset of disorder (lowest for anxiety and highest for substance use) and information on remission intervals between episodes (well time) (lowest for substance use and highest for anxiety).CONCLUSIONSThe findings are interpreted as providing support for the ""breed true"" hypothesis, although clearly not all second episodes are identical with the first. While the psychosocial factors examined did not predict the nature of the second disorder, this clearly needs further study.OBJECTIVETo examine the continuity between the primary (first) diagnosis and secondary (second) diagnosis of those adolescents who have more than one episode of psychiatric disorder. Data were examined to determine whether the second episode ""breeds true"" (i.e., remains within the same diagnostic category as the first) or involves a different disorder.","Orvaschel, H; Lewinsohn, P M; Seeley, J R",1995.0,10.1097/00004583-199511000-00020,0,0,
5012,Subthreshold rTMS over pre-motor cortex has no effect on tics in patients with Gilles de la Tourette syndrome.,"A previous study showed no effect of 1Hz repetitive transcranial magnetic stimulation (rTMS) on tics in Gilles de la Tourette Syndrome (GTS). We modified the rTMS protocol in order to investigate some of the possible methodological reasons for the negative outcome in that study. In a single blinded placebo-controlled cross-over study in five GTS patients without obsessive compulsive disorder we probed whether longer trains (1800 stimuli) of 1 Hz pre-motor cortex rTMS at 80% of active motor threshold and application to both hemispheres can improve tics in GTS. This was measured with the Yale Global Tic severity rating scale, the MOVES self-rating scale and video analysis. We found no significant effect of either left pre-motor cortex stimulation alone, or left pre-motor followed by right pre-motor cortex stimulation. These results suggest that the rTMS protocol used in this study is not useful for the treatment of tics in GTS. rTMS protocols need to be modified substantially in order to explore their potential for the treatment of tics in GTS.",Orth M.; Kirby R.; Richardson MP.; Snijders AH.; Rothwell JC.; Trimble MR.; Robertson MM.; Münchau A.,2005.0,10.1016/j.clinph.2004.10.003,0,0,
5013,The development and psychometric evaluation of the emotional reactivity and numbing scale,"Recent research has highlighted the role of hyperresponsivity and numbing of emotions in posttraumatic stress disorder. Preliminary research suggests that emotional numbing symptoms impact the development, maintenance, and treatment of posttraumatic stress disorder. However, research in this area has been hindered, in part, due to the absence of a psychometrically sound, conceptually based measure of emotional numbing. The present study examined the psychometric properties of the Emotional Reactivity and Numbing Scale in a sample of 92 trauma-exposed men and women veterans. Results provide preliminary support for the internal consistency, test-retest reliability, convergent, and discriminant validity of the measure. Implications for future research are discussed. © 2007 Lippincott Williams & Wilkins, Inc.",Orsillo S.M.; Theodore-Oklota C.; Luterek J.A.; Plumb J.,2007.0,10.1097/NMD.0b013e318156816f,0,0,
5014,Physiologic responses to loud tones in Israeli veterans of the 1973 Yom Kippur War.,"Eyeblink and autonomic components of the acoustic startle response were evaluated in a community sample of Israeli veterans of the Yom Kippur war. Individuals were solicited by mail and telephone to participate in the study; they were not seeking treatment or compensation. Nineteen Israeli veterans with current posttraumatic stress disorder (PTSD) and 74 veterans without PTSD were exposed to 15 consecutive 95-dB, 500-msec, 1000-Hz tones with 0-msec rise and fall times, while orbicularis oculi electromyogram, skin conductance, and heart rate responses were measured. Individuals with PTSD produced larger averaged heart rate responses, and a slower decline in skin conductance responses, across the 15 tone presentations compared to non-PTSD subjects. There was no group difference in the magnitude of the averaged electromyogram response. Results of this study replicate previous findings of increased autonomic responses to loud tone stimuli in this disorder.",Orr SP.; Solomon Z.; Peri T.; Pitman RK.; Shalev AY.,1997.0,,0,0,
5015,Heart rate and blood pressure resting levels and responses to generic stressors in Vietnam veterans with posttraumatic stress disorder.,"Resting heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured on 3 successive mornings in the homes of drug-free Vietnam combat veterans, classified on the basis of DSM-III-R criteria into current posttraumatic stress disorder (PTSD; n = 20) or non-PTSD (n = 15). Responses to three generic stressor challenges (orthostatic, mental arithmetic, and cold pressor) were also measured. In the orthostatic stressor condition, DBP increased over time in the non-PTSD, but not in the PTSD, veterans, suggesting a paradoxically reduced autonomic response in PTSD. There were no other significant group differences in resting levels or responses to any of the challenges for any measure.",Orr SP.; Meyerhoff JL.; Edwards JV.; Pitman RK.,1998.0,10.1023/A:1024421502881,0,0,
5016,Results of a pilot multicenter genotype-based randomized placebo-controlled trial of propranolol to reduce pain after major thermal burn injury.,"Background: Results of previous studies suggest that beta-adrenoreceptor activation may augment pain, and that beta-adrenoreceptor antagonists may be effective in reducing pain, particularly in individuals not homozygous for the catechol-O-methyltransferase (COMT) high-activity haplotype. Materials and Methods: Consenting patients admitted for thermal burn injury at participating burn centers were genotyped; those who were not high-activity COMT homozygotes were randomized to propranolol 240 mg/d or placebo. Primary outcomes were study feasibility (consent rate, protocol completion rate) and pain scores on study days 5 to 19. Secondary outcomes assessed pain and posttraumatic stress disorder symptoms 6 weeks postinjury. Results: Seventy-seven percent (61/79) of eligible patients were consented and genotyped, and 77% (47/61) were genotype eligible and randomized. Ninety-one percent (43/47) tolerated study drug and completed primary outcome assessments. In intention-to-treat and per-protocol analyses, patients randomized to propranolol had worse pain scores on study days 5 to 19. Conclusions: Genotype-specific pain medication interventions are feasible in hospitalized burn patients. Propranolol is unlikely to be a useful analgesic during the first few weeks after burn injury. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Orrey, Danielle C; Halawa, Omar I; Bortsov, Andrey V; Shupp, Jeffrey W; Jones, Samuel W; Haith, Linwood R; Hoskins, Janelle M; Jordan, Marion H; Bangdiwala, Shrikant I; Roane, Brandon R; Platts-Mills, Timothy F; Holmes, James H; Hwang, James; Cairns, Bruce A; McLean, Samuel A; Bartlett, Bender, Bijur, Brunet, Catz, Choinier, Cramer, Diamond, Diatchenko, Diatchenko, Eisen, Eldon, Famularo, Farrar, Foa, Foa, Gallagher, Herndon, Hocking, Kaplan, Khasar, Khasar, LaBorde, Liang, Mannisto, McGhee, Moher, Murray, Nackley, Nuesch, Orrey, Parker, Pereira, Pereira, Perry, Pitman, Rosen, Scadding, Shyong, Stein, Summer, Sweet, Taylor, Tchivileva, Tchivileva, Tolstoy, Vaiva, Vargas-Alarcon, Vlasnik, Winkler, Zeger",2015.0,,0,0,
5017,Learning to re-appraise the self during video feedback for social anxiety: Does depth of processing matter?,"Video feedback (VF) with cognitive preparation (CP) has been widely integrated into cognitive-behavioral therapy (CBT) protocols for social anxiety disorder (SAD) due to its presumed efficacy in improving negative self-perception. However, previous experimental studies have demonstrated that improvements in negative self-perception via VF+CP do not typically facilitate anxiety reduction during subsequent social interactions - a troubling finding for proponents of cognitive models of social anxiety. We examined whether VF+CP could be optimized to enhance participants' processing of corrective self-related information through the addition of a post-VF cognitive review (CR). Sixty-eight socially anxious individuals were randomly assigned to perform two public speeches in one of the following conditions: a) exposure alone (EXP); b) CP+VF; and c) CP+VF+CR. Those in the CP+VF+CR condition demonstrated marginally significant reductions in anxiety from speech 1 to speech 2 relative to those who received EXP - an improvement not shown for those in the CP+VF condition. Furthermore, only those who received CP+VF+CR demonstrated significant improvements in self-perception and performance expectations relative to EXP. Decreases in anxiety among participants who received CP+VF+CR relative to EXP were fully mediated by improvements in self-perception. Implications are discussed in the context of cognitive models of social anxiety and mechanisms of exposure-based learning.",Orr EM.; Moscovitch DA.,2010.0,10.1016/j.brat.2010.04.004,0,0,
5018,Physical appearance anxiety impedes the therapeutic effects of video feedback in high socially anxious individuals.,"Video feedback (VF) interventions effectively reduce social anxiety symptoms and negative self-perception, particularly when they are preceded by cognitive preparation (CP) and followed by cognitive review. In the current study, we re-examined data from a study on the efficacy of a novel VF intervention for individuals high in social anxiety to test the hypothesis that physical appearance anxiety would moderate the effects of VF. Data were analyzed from 68 socially anxious participants who performed an initial public speech, and were randomly assigned to an Elaborated VF condition (VF plus cognitive preparation and cognitive review), a Standard VF condition (VF plus cognitive preparation) or a No VF condition (exposure alone), and then performed a second speech. As hypothesized, when appearance concerns were low, both participants who received Elaborated and Standard VF were significantly less anxious during speech 2 than those in the No VF condition. However, when levels of appearance concern were high, neither Elaborated nor Standard VF reduced anxiety levels during speech 2 beyond the No VF condition. Results from our analog sample suggest the importance of tailoring treatment protocols to accommodate the idiosyncratic concerns of socially anxious patients.",Orr EM.; Moscovitch DA.,2014.0,10.1017/S1352465812001038,0,0,
5019,Physical appearance anxiety impedes the therapeutic effects of video Feedback in high socially anxious individuals.,"Background: Video feedback (VF) interventions effectively reduce social anxiety symptoms and negative self-perception, particularly when they are preceded by cognitive preparation (CP) and followed by cognitive review. Aims: In the current study, we re-examined data from a study on the efficacy of a novel VF intervention for individuals high in social anxiety to test the hypothesis that physical appearance anxiety would moderate the effects of VF. Method: Data were analyzed from 68 socially anxious participants who performed an initial public speech, and were randomly assigned to an Elaborated VF condition (VF plus cognitive preparation and cognitive review), a Standard VF condition (VF plus cognitive preparation) or a No VF condition (exposure alone), and then performed a second speech. Results: As hypothesized, when appearance concerns were low, both participants who received Elaborated and Standard VF were significantly less anxious during speech 2 than those in the No VF condition. However, when levels of appearance concern were high, neither Elaborated nor Standard VF reduced anxiety levels during speech 2 beyond the No VF condition. Conclusions: Results from our analog sample suggest the importance of tailoring treatment protocols to accommodate the idiosyncratic concerns of socially anxious patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Orr, Elizabeth M. J; Moscovitch, David A; Aiken, Baker, Beck, Brewin, Clark, Clark, Connor, Davidson, Fang, Foa, Fydic, Hart, Harvey, Herbert, Hofmann, Holmbeck, Izgic, Kim, Kuyken, Lutwak, McCroskey, Mortberg, Moscovitch, Moscovitch, Mulkens, Neziroglu, Neziroglu, Norton, Orr, Otto, Parr, Phillips, Rapee, Rapee, Rapee, Rapee, Reed, Rodebaugh, Rodebaugh, Rodebaugh, Rodebaugh, Segrin, Strahan, Trower, Veale, Veale, Veale, Wlazlo",2014.0,,0,0,
5020,The Galway study of panic disorder IV. Temporal stability of diagnosis by present state examination test-retest.,"Administered the Present State Examination (PSE) to 66 patients with panic disorder at baseline and 5-6 yrs after a controlled trial of treatment. PSE test-retest and individual within-patient change scores on various PSE syndromes were assessed for consistency with either a categorical view of panic disorder as a stable clinical entity or panic disorder as 1 facet only of a general neurotic syndrome. Results indicate that PSE profile at baseline was virtually identical with that at follow-up. Data are supportive of the concept of Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) panic disorder as a stable clinical entity and are correspondingly difficult to reconcile with the view that panic disorder is but 1 facet only of a general neurotic syndrome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","O'Rourke, D; Fahy, T. J; Prescott, P",1996.0,,0,0,
5021,Short and long-term effectiveness of group anxiety management training.,"This study explored both the short-term and long-term effectiveness of group anxiety management training. The treatment package employed used cognitive-behavioral principles. Participants were Ss with phobic symptoms with agoraphobia type problems or symptoms of general anxiety. Ss completed the Beck Depression Inventory, the Trait scale of the Spieldberger State-Trait Anxiety Inventory Form Y, and a Anxiety Management Group Rating Scale constructed by the author. At follow-up, Ss were asked to rate the usefulness of the group and whether they still used the techniques taught. Consistent with previous evaluations, the groups had a significant effect on levels of anxiety and depression. Participants rated ""meeting people with similar problems"" and ""learning about anxiety"" as the two most important therapeutic ingredients. At a follow-up period of greater than 2 yrs, therapeutic gains, at least in part, seemed to have been maintained. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ormrod, John",1995.0,,0,0,
5022,The therapeutic alliance in treatment of traumatized youths: relation to outcome in a randomized clinical trial,"ER OBJECTIVE: We examined the contribution of alliance to the outcome of therapy with traumatized youths across two different treatment conditions (trauma-focused cognitive behavioral therapy [TF-CBT] and therapy as usual [TAU]).METHOD: Participants were 156 youths (M age = 15.1 years, range = 10-18; 79.5% girls), randomly assigned to TF-CBT or TAU. Symptoms were assessed pretreatment, midtreatment (Session 6), and posttreatment (Session 15). Alliance was assessed after Sessions 1 and 6, using the Therapeutic Alliance Scale for Children-Revised (TASC-R).RESULTS: Alliance scores were comparable across treatment conditions, but TF-CBT participants had significantly lower posttraumatic stress symptoms (PTSS) posttreatment (d = 0.51). Hierarchical regression analyses showed that there were no significant alliance effects in models without an Alliance √ó Treatment Group interaction: Alliance ratings were significant predictors of reduction in PTSS (Est. = -0.53, p = .003, 95% confidence interval [CI] = -0.87 to -0.18) and additional outcomes measured in TF-CBT but not in TAU (PTSS posttreatment: Est. = 0.01, p = .647, 95% CI = -0.29 to 0.47).CONCLUSION: This study was the first to investigate the contribution of alliance to outcome among adolescents with posttraumatic symptoms, treated with TF-CBT or TAU. Our findings indicated that there was an important interaction between alliance and therapeutic approach, as alliance predicted outcome in TF-CBT, but not in the nonspecific treatment condition. A positive working relationship appeared to be especially important in the context of this evidence-based treatment, which requires youth involvement in specific therapy tasks. Further, findings showed that use of a manual did not compromise alliance formation.","Ormhaug, S M; Jensen, T K; Wentzel-Larsen, T; Shirk, S R",2014.0,10.1037/a0033884,0,0,
5023,"Individual cognitive stimulation therapy for dementia: a clinical effectiveness and cost-effectiveness pragmatic, multicentre, randomised controlled trial","ER BACKGROUND: Group cognitive stimulation therapy programmes can benefit cognition and quality of life for people with dementia. Evidence for home-based, carer-led cognitive stimulation interventions is limited.OBJECTIVES: To evaluate the clinical effectiveness and cost-effectiveness of carer-delivered individual cognitive stimulation therapy (iCST) for people with dementia and their family carers, compared with treatment as usual (TAU).DESIGN: A multicentre, single-blind, randomised controlled trial assessing clinical effectiveness and cost-effectiveness. Assessments were at baseline, 13 weeks and 26 weeks (primary end point).SETTING: Participants were recruited through Memory Clinics and Community Mental Health Teams for older people.PARTICIPANTS: A total of 356 caregiving dyads were recruited and 273 completed the trial.INTERVENTION: iCST consisted of structured cognitive stimulation sessions for people with dementia, completed up to three times weekly over 25 weeks. Family carers were supported to deliver the sessions at home.MAIN OUTCOME MEASURES: Primary outcomes for the person with dementia were cognition and quality of life. Secondary outcomes included behavioural and psychological symptoms, activities of daily living, depressive symptoms and relationship quality. The primary outcome for the family carers was mental/physical health (Short Form questionnaire-12 items). Health-related quality of life (European Quality of Life-5 Dimensions), mood symptoms, resilience and relationship quality comprised the secondary outcomes. Costs were estimated from health and social care and societal perspectives.RESULTS: There were no differences in any of the primary outcomes for people with dementia between intervention and TAU [cognition: mean difference -0.55, 95% confidence interval (CI) -2.00 to 0.90; p-value?=?0.45; self-reported quality of life: mean difference -0.02, 95%","Orgeta, V; Leung, P; Yates, L; Kang, S; Hoare, Z; Henderson, C; Whitaker, C; Burns, A; Knapp, M; Leroi, I; Moniz-Cook, E D; Pearson, S; Simpson, S; Spector, A; Roberts, S; Russell, I T; Waal, H; Woods, R T; Orrell, M",2015.0,10.3310/hta19640,0,0,
5024,"A study of the personalities of excessive drinkers and their wives, using the approaches to Leary and Eysenck.",,Orford J.,1976.0,,0,0,
5025,Neural response suppression predicts repetition priming of spoken words and pseudowords,"An important method for studying how the brain processes familiar stimuli is to present the same item on more than one occasion and measure how responses change with repetition. Here we use repetition priming in a sparse functional magnetic resonance imaging (fMRI) study to probe the neuroanatomical basis of spoken word recognition and the representations of spoken words that mediate repetition priming effects. Participants made lexical decisions to words and pseudowords spoken by a male or female voice that were presented twice, with half of the repetitions in a different voice. Behavioral and neural priming was observed for both words and pseudowords and was not affected by voice changes. The fMRI data revealed an elevated response to words compared to pseudowords in both posterior and anterior temporal regions, suggesting that both contribute to word recognition. Both reduced and elevated activation for second presentations (repetition suppression and enhancement) were observed in frontal and posterior regions. Correlations between behavioral priming and neural repetition suppression were observed in frontal regions, suggesting that repetition priming effects for spoken words reflect changes within systems involved in generating behavioral responses. Based on the current results, these processes are sufficiently abstract to display priming despite changes in the physical form of the stimulus and operate equivalently for words and pseudowords. © 2006 Massachusetts Institute of Technology.",Orfanidou E.; Marslen-Wilson W.D.; Davis M.H.,2006.0,10.1162/jocn.2006.18.8.1237,0,0,
5026,Things happen: Individuals with high obsessive-compulsive tendencies omit agency in their spoken language,"The study examined the prediction that obsessive-compulsive tendencies are related to an attenuated sense of agency (SoA). As most explicit agency judgments are likely to reflect also motivation for and expectation of control, we examined agency in sentence production. Reduced agency can be expressed linguistically by omitting the agent or by using grammatical framings that detach the event from the entity that caused it. We examined the use of agentic language of participants with high vs. low scores on a measure of obsessive-compulsive (OC) symptoms, using structured linguistic tasks in which sentences are elicited in a conversation-like setting. As predicted, high OC individuals produced significantly more non-agentic sentences than low OC individuals, using various linguistic strategies. The results suggest that OC tendencies are related to attenuated SoA. We discuss the implications of these findings for explicating the SoA in OCD and the potential contribution of language analysis for understanding psychopathology.",Oren E.; Friedmann N.; Dar R.,2016.0,10.1016/j.concog.2016.03.012,0,0,
5027,The Nature of the Association between Anxiety Sensitivity and Pain-Related Anxiety: Evidence from Correlational and Intervention Studies.,"High anxiety sensitivity (AS) has been associated with elevated pain-related anxiety in anxiety and pain samples. The present study investigated (a) the associations among the lower order dimensions of AS and pain-related anxiety, using a robust measure of AS, and (b) the pain-related anxiety outcomes of a telephone-delivered cognitive behavioural treatment (CBT) designed to reduce high AS. Participants were 80 anxiety treatment-seeking participants with high AS (M age = 36 years; 79% women). After providing baseline data on AS and pain-related anxiety, participants were randomly assigned to an eight-week telephone CBT or a waiting list control. At baseline, bivariate correlations showed AS physical and cognitive, but not social, concerns were significantly associated with pain-related fear and arousal but not escape/avoidance behaviours. Multiple regression revealed that after accounting for emotional distress symptoms, AS physical, but not cognitive or social, concerns uniquely predicted pain-related anxiety. Multilevel modelling showed that the AS-targeted CBT reduced pain-related anxiety and treatment-related changes in global AS and AS physical concerns mediated changes in pain-related anxiety. Results suggest that an AS-targeted intervention may have implications for reducing pain-related anxiety. Further research is needed in a chronic pain sample.",Olthuis JV.; Watt MC.; Mackinnon SP.; Potter SM.; Stewart SH.,2015.0,10.1080/16506073.2015.1048823,0,0,
5028,Telephone-delivered cognitive behavioral therapy for high anxiety sensitivity: A randomized controlled trial.,"Objective: High anxiety sensitivity (AS) is associated with the development and maintenance of anxiety and depressive symptoms and is theorized to be a mediator of treatment outcomes for anxiety and depression. The present study tested the efficacy of a telephone-delivered cognitive behavioral therapy (CBT) intervention in reducing high AS and its associated anxiety and depressive symptoms. Method: Treatment-seeking participants with high AS were recruited from the community (N = 80; M age = 36 years; 79% women; 76% Caucasian) and were randomly assigned to an 8-week telephone-delivered CBT program or a waiting list control. Participants completed anxiety and depression symptom and diagnostic measures at pre- and posttreatment, after a subsequent 4 weeks of continued interoceptive exposure, and 8 weeks later. Results: Multilevel modeling showed the treatment was successful in reducing AS, as well as panic, social phobia, posttraumatic stress symptoms, and number of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnoses per participant when compared to a waiting list control. These gains were maintained at follow-up. Generalized anxiety and depressive symptoms, however, did not improve as a result of treatment. Mediated moderation analyses suggested that treatment-related changes in AS may mediate anxiety symptom changes. Conclusion: Results of the present study provide promising evidence for this transdiagnostic treatment approach. Reductions in anxiety symptoms across diagnostic categories stemming from this AS-targeted intervention may have implications for helping a broad array of clients with various anxiety disorders that share AS as a common risk or maintenance factor. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Olthuis, Janine V; Watt, Margo C; Mackinnon, Sean P; Stewart, Sherry H; Allen, Alonso, Andrews, Antony, Arch, Asmundson, Badour, Baker, Barlow, Barlow, Beck, Bee, Bijl, Broman-Fulks, Broman-Fulks, Brown, Brown, Bruce, Capron, Chambless, Clark, Collins, Costa, Cox, Cox, Deacon, Deacon, Egan, Ellard, Falsetti, Farchione, Farris, Feingold, First, Fresco, Furmark, Graham, Grubaugh, Gueorguieva, Hatcher, Hauenstein, Hecker, Heimberg, Hofmann, Jacobson, Johnston, Keogh, Keough, Keough, Kessler, Kessler, Leon, Lickel, Liebowitz, Lingely-Pottie, Lovell, Lovibond, MacKinnon, Marshall, McEvoy, McGrath, Meyer, Meyers, Mojtabai, Molina, Mroczek, Norton, Norton, Norton, Norton, Ohayon, Olatunji, Otto, Peterson, Preacher, Preacher, Preacher, Rector, Reiss, Reiss, Reiss, Rodriguez, Sabourin, Sauer-Zavala, Schmidt, Shephard, Smits, Smits, Smits, Spek, Stephenson, Stewart, Taylor, Taylor, Taylor, Taylor, Taylor, Titov, Titov, Tsao, Viana, Vriends, Watt, Watt, Wells, White, Wolfe, Zanarini, Zvolensky",2014.0,,0,0,
5029,Ability to perform a single heel-rise is significantly related to patient-reported outcome after Achilles tendon rupture.,"This study evaluated the short-term recovery of function after an acute Achilles tendon rupture, measured by a single-legged heel-rise test, with main emphasis on the relation to the patient-reported outcomes and fear of physical activity and movement (kinesiophobia). Eighty-one patients treated surgically or non-surgically with early active rehabilitation after Achilles tendon rupture were included in the study. Patient's ability to perform a single-legged heel-rise, physical activity level, patient-reported symptoms, general health, and kinesiophobia was evaluated 12 weeks after the injury. The heel-rise test showed that 40 out of 81 (49%) patients were unable to perform a single heel-rise 12 weeks after the injury. We found that patients who were able to perform a heel-rise were significantly younger, more often of male gender, reported a lesser degree of symptoms, and also had a higher degree of physical activity at 12 weeks. There was also a significant negative correlation between kinesiophobia and all the patient-reported outcomes and the physical activity level. The heel-rise ability appears to be an important early achievement and reflects the general level of healing, which influences patient-reported outcome and physical activity. Future treatment protocols focusing on regaining strength early after the injury therefore seem to be of great importance. Kinesiophobia needs to be addressed early during the rehabilitation process.",Olsson N.; Karlsson J.; Eriksson BI.; Brorsson A.; Lundberg M.; Silbernagel KG.,2014.0,10.1111/j.1600-0838.2012.01497.x,0,0,
5030,The effects of dissociation on information processing for analogue trauma and neutral stimuli: A laboratory study,"This study investigated the effects of high and low levels of dissociation on information processing for analogue trauma and neutral stimuli. Fifty-four undergraduate females who reported high and low levels of trait dissociation were presented with two films, one depicting traumatic events, the other containing neutral material. Participants completed a divided attention task (yielding a proxy measure of attention), as well as explicit memory (free-recall) and implicit memory (word-stem completion) tasks for both films. Results indicated that the high DES group showed less attention and had poorer recall for the analogue trauma stimuli, relative to the neutral stimuli and the low DES group. These findings suggest that high levels of trait dissociation are associated with reductions in attention and memory for analogue trauma stimuli, relative to neutral stimuli and relative to low trait dissociation. Implications for the role of cognitive factors in the etiology of negative post-trauma responses are discussed. © 2011 Elsevier Ltd.",Olsen S.A.; Beck J.G.,2012.0,10.1016/j.janxdis.2011.11.003,0,0,
5031,The effects of a school-based psychosocial intervention on resilience and health outcomes among vulnerable children,"ER Responding to the psychosocial health needs of the vulnerable population has been considered as a significant public health issue that must be addressed through access to public health professionals. The study adopted a quasi-experimental design to evaluate the impact of a training program on nurses and teachers' knowledge of psychosocial health needs of vulnerable children and the impact this had on children's resilience and psychosocial health outcomes (self-esteem, social connection, anxiety, and depression). The result showed a significant increase in the knowledge mean scores of both nurses and teachers 6 weeks post intervention. Children's depression scores significantly reduced post intervention. Their resilience, self-esteem, and social connection were also significantly improved, while no significant reduction was found in their anxiety scores. The results of the pilot study suggest that a more rigorous study be conducted to further ascertain the effectiveness of the various interventions used in this study while taking into consideration the challenges raised by the authors.","Olowokere, A E; Okanlawon, F A",2014.0,10.1177/1059840513501557,0,0,
5032,One-session treatment of specific phobias in youth: a randomized clinical trial in the United States and Sweden,"ER One hundred and ninety-six youth, ages 7-16, who fulfilled Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for various specific phobias were randomized to a one-session exposure treatment, education support treatment, or a wait list control group. After the waiting period, the wait list participants were offered treatment and, if interested, rerandomized to 1 of the 2 active treatments. The phobias were assessed with semistructured diagnostic interviews, clinician severity ratings, and behavioral avoidance tests, whereas fears, general anxiety, depression, and behavior problems were assessed with self- and parent report measures. Assessments were completed pretreatment, posttreatment, and at 6 months following treatment. Results showed that both treatment conditions were superior to the wait list control condition and that 1-session exposure treatment was superior to education support treatment on clinician ratings of phobic severity, percentage of participants who were diagnosis free, child ratings of anxiety during the behavioral avoidance test, and treatment satisfaction as reported by the youth and their parents. There were no differences on self-report measures. Treatment effects were maintained at follow-up. Implications of these findings are discussed.","Ollendick, T H; Ost, L G; Reuterskiöld, L; Costa, N; Cederlund, R; Sirbu, C; Davis, T E; Jarrett, M A",2009.0,10.1037/a0015158,0,0,
5033,Comorbidity in youth with specific phobias: impact of comorbidity on treatment outcome and the impact of treatment on comorbid disorders,"ER The purpose of the present study was twofold. In an analysis of data from an existing randomized control trial of brief cognitive behavioral treatment on specific phobias (One-Session Treatment, OST; Ollendick et al., 2009), we examined 1) the effect of comorbid specific phobias and other anxiety disorders on treatment outcomes, and 2) the effect of treatment of the specific phobia on these co-occurring disorders. These relations were explored in 100 youth presenting with animal, natural environment, situational, and ""other"" types of phobia. Youth were reliably diagnosed with the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent versions (Silverman & Albano, 1996). Clinician severity ratings at post-treatment and 6-month follow-up were examined as were parent and child treatment outcome satisfaction measures. Results indicated that the presence of comorbid phobias or anxiety disorders did not affect treatment outcomes; moreover, treatment of the targeted specific phobias led to significant reductions in the clinical severity of other co-occurring specific phobias and related anxiety disorders. These findings speak to the generalization of the effects of this time-limited treatment approach. Implications for treatment of principal and comorbid disorders are discussed, and possible mechanisms for these effects are commented upon.","Ollendick, T H; Ost, L G; Reuterskiöld, L; Costa, N",2010.0,10.1016/j.brat.2010.05.024,0,0,
5034,Separation anxiety in young adults: A preliminary examination,"In this study, the presence of Separation Anxiety Disorder among college students was explored. Using structured questionnaires to measure anxiety and affective disorders in childhood and adulthood, three groups of students were identified: a group who reported meeting diagnostic criteria for current SAD, a group who reported meeting diagnostic criteria for past childhood anxiety disorders but not current SAD (diagnostic controls), and a group who did not meet diagnostic criteria for any past or current psychiatric disorder (normal controls). Results indicated that the SAD group evinced more adjustment problems than the diagnostic or normal comparison groups. The implications of these findings for SAD in young adults are discussed.",Ollendick T.H.; Lease C.A.; Cooper C.,1993.0,10.1016/0887-6185(93)90026-H,0,0,
5035,Specific phobias in youth: a randomized controlled trial comparing one-session treatment to a parent-augmented one-session treatment,"ER Objective: Examine the efficacy of a parent-augmented One-Session Treatment (A-OST) in treating specific phobias (SP) in youth by comparing this novel treatment to child-focused OST, a well-established treatment. Method: A total of 97 youth (ages 6-15, 51.5% female, 84.5% White) who fulfilled diagnostic criteria for SP were randomized to either A-OST or OST. SPs were assessed with semistructured diagnostic interviews, clinician improvement ratings, and parent and child improvement ratings. In addition, measures of treatment satisfaction and parental self-efficacy were obtained. Blind assessments were completed pretreatment, posttreatment, and 1. month and 6. months following treatment. Analyses were undertaken using mixed models. In addition, gender, age, internalizing/externalizing problems, parent overprotection, and parent anxiety were examined as potential predictors and moderators of treatment outcome. Results: Both treatment conditions produced similar outcomes with approximately 50% of youth in both treatments diagnosis free and judged to be much or very much improved at posttreatment and 1-month follow-up. At 6-month follow-up, however, the treatments diverged with OST resulting in marginally superior outcomes to A-OST, contrary to predictions. Only age of child predicted treatment outcome across the two treatments (older children did better); unexpectedly, none of the variables moderated treatment outcomes. Conclusions: Parent augmentation of OST produced no appreciable gains in treatment outcomes. Directions for future research are highlighted.","Ollendick, T H; Halldorsdottir, T; Fraire, M G; Austin, K E; Noguchi, R J; Lewis, K M; Jarrett, M A; Cunningham, N R; Canavera, K; Allen, K B; Whitmore, M J",2015.0,10.1016/j.beth.2014.09.004,0,0,
5036,Effects of internal and external distraction and focus during exposure to blood-injury-injection stimuli.,"The present study examined the effects of attentional focus on fear reduction during exposure. Participants were randomly assigned to experimental conditions: exposure plus internal focus, exposure plus external focus, exposure plus internal distraction, exposure plus external distraction or exposure alone. Fifty blood-injury-injection fearful participants received 3 weekly exposure sessions. Participants in the distraction group reported the greatest fear reduction, with most notable reductions occurring for the external distraction condition. The distraction group also achieved a greater number of steps on a behavioral avoidance task at post-treatment, with the external distraction condition displaying greater approach behavior at follow-up. At follow-up the distraction group also displayed a greater increase in perceived control than the focusing group. Thus, distraction reduces fear within and between sessions and increases approach behavior in the longer-term, with exposure plus external distraction further facilitating this effect.",Oliver NS.; Page AC.,2008.0,10.1016/j.janxdis.2007.01.006,0,0,
5037,Fear reduction during in vivo exposure to blood-injection stimuli: distraction vs. attentional focus.,"This study extends Penfold and Page's (1999) finding that exposure plus distraction enhanced within-session fear reduction to a phobic stimulus by examining whether the within-session advantage could be replicated and translated into longer-term gains. To test the effects of distraction, participants were assigned randomly to one of three experimental conditions; exposure plus focusing, exposure plus distraction, or exposure alone. Blood-injection fearful participants (N = 48) were assigned randomly to receive 3 weekly sessions of 10-min exposure under one of the experimental conditions. Consistent with the previous finding, exposure plus distraction showed the greatest within-session fear reduction. Participants in the exposure plus distraction condition also reported the greatest reduction in fear between sessions, at post-treatment, and at 1-month follow-up. Furthermore, participants in the exposure plus distraction condition reported continued increases in perceived control over their anxiety during the month following the exposure sessions. The data suggest that conversation is a distraction that can increase perceived control over anxiety and assists anxiety reduction.",Oliver NS.; Page AC.,2003.0,10.1348/014466503762841986,0,0,
5038,Bilateral anterior capsulotomy for refractory obsessive-compulsive disorders.,"A prospective study on the effects of bilateral anterior capsulotomy in patients with refractory obsessive-compulsive disorder (OCD) is presented. A total of 18 procedures were performed in 15 patients. The mean duration of the OCDs was 18.1 +/- 5.6 years (range 11-26 years). The mean total Yale-Brown Scale (Y-BOCS) score was 29.67 and mean Global Assessment of Functioning was 43.61. The results throughout the follow-up period remained the same as at 1 month postoperatively. The observed mean recovery on the Y-BOCS was 33.2% (p = 0.017). 52.9% of the patients showed a 33% recovery, 29.4% of the cases showed a 50% recovery and 17% showed a 66% recovery. Global Assessment of Functioning recovered by 19% (p = 0.111). No cognitive deficit was disclosed by neuropsychological screening tests. Complications were observed in 3 cases, 1 with transitory hallucinations, 1 with a single epileptic seizure and 1 case who developed a progressive behavior disorder that became permanent. We conclude that bilateral anterior capsulotomy is a safe and effective procedure.",Oliver B.; Gascón J.; Aparicio A.; Ayats E.; Rodriguez R.; Maestro De León JL.; García-Bach M.; Soler PA.,2003.0,75110,0,0,
5039,"Systematic desensitization, therapeutically oriented instructions and selective positive reinforcement.",,Oliveau DC.; Agras WS.; Leitenberg H.; Moore RC.; Wright DE.,1969.0,,0,0,
5040,Systematic desensitization in an experimental setting: a follow-up study.,,Oliveau DC.,1969.0,,0,0,
5041,Changes in cortisol and DHEA plasma levels after psychotherapy for PTSD.,"Post-traumatic stress disorder (PTSD) has been associated with dysregulation of the neuroendocrine system. In this study we examine the effects of psychotherapy in 21 PTSD patients, with and without coexisting depression, on the levels of six stress-related hormones: cortisol, dehydroepiandrosterone (DHEA), and dehydroepiandrosterone-sulfate (DHEA-S), prolactin, thyrotropin (TSH) and free thyroxin (fT4). The results show that after brief eclectic psychotherapy (BEP) significant changes occurred in levels of cortisol and DHEA. Responders showed an increase in cortisol and DHEA levels, while in non-responders both hormone levels decreased. Differences were only found after controlling for depressive symptoms. In conclusion, effective psychotherapy for PTSD may alter dysregulations in the Hypothalamus-pituitary-adrenal (HPA)-axis, but comorbid depressive symptoms should be taken into account.",Olff M.; de Vries GJ.; Güzelcan Y.; Assies J.; Gersons BP.,2007.0,10.1016/j.psyneuen.2007.04.001,0,0,
5042,Calcitonin gene-related peptide receptor antagonist BIBN 4096 BS for the acute treatment of migraine,"ER METHODSIn an international, multicenter, double-blind, randomized clinical trial of BIBN 4096 BS, a highly specific and potent nonpeptide CGRP-receptor antagonist, 126 patients with migraine received one of the following: placebo or 0.25, 0.5, 1, 2.5, 5, or 10 mg of BIBN 4096 BS intravenously over a period of 10 minutes. A group-sequential adaptive treatment-assignment design was used to minimize the number of patients exposed.RESULTSThe 2.5-mg dose was selected, with a response rate of 66 percent, as compared with 27 percent for placebo (P=0.001). The BIBN 4096 BS group as a whole had a response rate of 60 percent. Significant superiority over placebo was also observed with respect to most secondary end points: the pain-free rate at 2 hours; the rate of sustained response over a period of 24 hours; the rate of recurrence of headache; improvement in nausea, photophobia, phonophobia, and functional capacity; and the time to meaningful relief. An effect was apparent after 30 minutes and increased over the next few hours. The overall rate of adverse events was 25 percent after the 2.5-mg dose of the drug and 20 percent for the BIBN 4096 BS group as a whole, as compared with 12 percent for placebo. The most frequent side effect was paresthesia. There were no serious adverse events.CONCLUSIONSThe CGRP antagonist BIBN 4096 BS was effective in treating acute attacks of migraine.BACKGROUNDCalcitonin gene-related peptide (CGRP) may have a causative role in migraine. We therefore hypothesized that a CGRP-receptor antagonist might be effective in the treatment of migraine attacks.","Olesen, J; Diener, H C; Husstedt, I W; Goadsby, P J; Hall, D; Meier, U; Pollentier, S; Lesko, L M",2004.0,10.1056/NEJMoa030505,0,0,
5043,"Two-year impact of personality-targeted, teacher-delivered interventions on youth internalizing and externalizing problems: a cluster-randomized trial.","To assess the 2-year impact of teacher-delivered, brief, personality-targeted interventions on internalizing and externalizing symptoms in an adolescent U.K. sample. This cluster-randomized trial was run in 19 London schools (N = 1,024 adolescents). Trained school-based professionals delivered two 90-minute, CBT-based group interventions targeting 1 of 4 personality-risk profiles: anxiety sensitivity, hopelessness, impulsivity, or sensation seeking. Self-report depression, anxiety, and conduct disorder symptoms were assessed at 6-month intervals. Interventions were associated with significantly reduced depressive, anxiety, and conduct symptoms (p < .05) over 2 years in the full sample, reduced odds of severe depressive symptoms (odds ratio [OR] = 0.74, CI = 0.58-0.96), and conduct problems (OR = 0.79, CI = 0.65-0.96), and a nonsignificant reduction in severe anxiety symptoms (OR = 0.79, CI = 0.59-1.05). Evaluating a priori personality-specific hypotheses revealed strong evidence for impulsivity-specific effects on severe conduct problems, modest evidence of anxiety sensitivity-specific effects on severe anxiety, and no evidence for hopelessness-specific effects on severe depressive symptoms. Brief, personality-targeted interventions delivered by educational professionals can have a clinically significant impact on mental health outcomes in high-risk youth over 2 years, as well as personality-specific intervention effects in youth most at risk for a particular problem, particularly for youth with high levels of impulsivity. Clinical trial registration information-Adventure: The Efficacy of Personality-Targeted Interventions for Substance Misuse and Other Risky Behaviors as Delivered by Educational Professionals.",O'Leary-Barrett M.; Topper L.; Al-Khudhairy N.; Pihl RO.; Castellanos-Ryan N.; Mackie CJ.; Conrod PJ.,2013.0,10.1016/j.jaac.2013.05.020,0,0,
5044,"Mechanisms of personality-targeted intervention effects on adolescent alcohol misuse, internalizing and externalizing symptoms.","This study aims to explore the mechanisms of personality-targeted intervention effects on problematic drinking, internalizing and externalizing symptoms. As part of a cluster-randomized trial, 1,210 high-risk students (mean age 13.7 years) in 19 London high schools (42.6% White, 54% male) were identified using the Substance Use Risk Profile Scale. Intervention school participants were invited to participate in personality-matched interventions by trained school staff. MacKinnon's products of coefficients method was used to compare 3 complementary mechanism hypotheses, namely, whether early changes in (a) alcohol use, (b) internalizing and externalizing symptoms, or (c) personality during the 6 months postintervention accounted for intervention effects over 2 years. Early intervention effects on drinking behaviors during the 6 months postintervention partially accounted for longer term intervention effects on the onset of binge drinking (95% confidence interval [CI] [-.349, -.062]) and drinking problems (95% CI [-.206, -.016]) over 2 years. Intervention effects on anxiety symptoms and conduct problems were partially mediated by early reductions in depressive symptoms (95% CI [-.013, -.001]; 95% CI [-.047, -.001]), and intervention effects on internalizing symptoms were also partially mediated by reductions in anxiety sensitivity (95% CI [-.003, 0]). 2-year intervention effects on problematic drinking were largely accounted for by early changes in drinking behaviors, and were not mediated by changes in mental health symptoms or personality risk factors. Early improvements in mood and anxiety sensitivity partially mediated longer term reductions in mental health problems.",O'Leary-Barrett M.; Castellanos-Ryan N.; Pihl RO.; Conrod PJ.,2016.0,10.1037/ccp0000082,0,0,
5045,Pilot Study of a Telehealth-Delivered Medication-Augmented Exposure Therapy Protocol for PTSD.,"Posttraumatic stress disorder (PTSD) is a serious condition, with certain occupations at increased risk due to greater trauma exposure. These same individuals face multiple barriers to care. This study aimed to investigate the feasibility of conducting a research trial with exposure therapy delivered via videoconferencing. Eleven adults working in occupations at risk with PTSD enrolled and seven completed 12 to 15 sessions. Individuals were randomized to receive the cognitive enhancer D-cycloserine or placebo, and participants provided saliva samples for genetic analysis. Treatment completers demonstrated decreases in PTSD and depressive symptomatology (measured by CAPS [p < 0.001, d = 2.79] and BDI-II [p = 0.004, d = 0.92]). Participants reported high therapeutic alliance, treatment satisfaction, and telehealth satisfaction. There were no significant technical, medication, or safety issues, and no clinical emergencies. The results suggest that it may be feasible to conduct clinical research using telehealth for PTSD and to use telehealth to increase access to care.",Olden M.; Wyka K.; Cukor J.; Peskin M.; Altemus M.; Lee FS.; Finkelstein-Fox L.; Rabinowitz T.; Difede J.,2017.0,10.1097/NMD.0000000000000563,0,0,
5046,Altered EEG lagged coherence during rest in obsessive-compulsive disorder.,"Functional magnetic resonance imaging (fMRI) studies found alterations of functional connectivity in obsessive compulsive disorder (OCD). However, there is little knowledge about region of interest (ROI) based electroencephalogram (EEG) connectivity, i.e. lagged non-linear and linear coherence in OCD. Goal of this study was to compare these EEG measures during rest and at different vigilance stages between patients and healthy controls (HC). A 15 min resting-state EEG was recorded in 30 unmedicated patients and 30 matched HC. Intracortical lagged non-linear coherence of the main EEG-frequency bands within a set of frontal ROIs and within the default mode network (DMN) were computed and compared using intracortical exact low resolution electromagnetic tomography (eLORETA) software. Lagged non-linear but not linear coherence was significantly decreased for patients in comparison to HC for the beta 2 frequency between frontal brain areas but not within the DMN. When analysing separate EEG-vigilance stages, only high vigilance stages yielded decreased frontal phase synchronisation at beta and theta frequencies. The results underline an altered neuronal communication within frontal brain areas during rest in OCD. These findings encourage further research on connectivity measures as possible biomarkers for physiological homogeneous subgroups.",Olbrich S.; Olbrich H.; Adamaszek M.; Jahn I.; Hegerl U.; Stengler K.,2013.0,10.1016/j.clinph.2013.05.031,0,0,
5047,A small particle size diet reduces upper gastrointestinal symptoms in patients with diabetic gastroparesis: a randomized controlled trial,"ER OBJECTIVES: Gastroparesis is a well-known complication to diabetes mellitus (DM). Dietary advice is considered to be of importance to reduce gastrointestinal (GI) symptoms in patients with diabetic gastroparesis, but no randomized controlled trials exist. Our aim was to compare GI symptoms in insulin treated DM subjects with gastroparesis eating a diet with small particle size (""intervention diet"") with the recommended diet for DM (""control diet"").METHODS: 56 subjects with insulin treated DM and gastroparesis were randomized to the intervention diet or the control diet. The patients received dietary advice by a dietitian at 7 occasions during 20 weeks. GI symptom severity, nutrient intake and glycemic control were measured before and after the intervention.RESULTS: A significantly greater reduction of the severity of the key gastroparetic symptoms-nausea/vomiting (P=0.01), postprandial fullness (P=0.02) and bloating (P=0.006)-were seen in patients who received the intervention diet compared with the control diet, and this was also true for regurgitation/heartburn (P=0.02), but not for abdominal pain. Anxiety was reduced after the intervention diet, but not after the control diet, whereas no effect on depression or quality of life was noted in any of the groups. A higher fat intake in the intervention group was noted, but otherwise no differences in body weight, HbA1c or nutrient intake were seen.CONCLUSIONS: A small particle diet improves the key symptoms of gastroparesis in patients with diabetes mellitus. (ClinicalTrials.gov NCT01557296).","Olausson, E A; Störsrud, S; Grundin, H; Isaksson, M; Attvall, S; Simrén, M",2014.0,10.1038/ajg.2013.453,0,0,
5048,Disgust propensity potentiates evaluative learning of aversion.,"Although disgust propensity (DP) has been implicated in the development of some anxiety disorders, the mechanism that may account for this association has not been fully elucidated. The present study examined the extent to which the potentiation of learned aversion might be one such mechanism. Participants (n = 103) were randomized to one of two evaluative conditioning (EC) paradigms consisting of 12 reinforced conditioned stimulus (CS+) pairings of the word ""part"" (condition one) or ""some"" (condition two) with 12 aversive unconditioned stimulus (US) images, and 12 pairings of the CS- word ""cylinder"" with 12 neutral images. Participants then completed measures of DP and trait anxiety and provided subjective affective ratings for the aversive US. The findings revealed that participants experienced significantly more disgust, anxiety, anger, sadness, and less happiness toward their respective CS+. In contrast, participants experienced significantly more happiness toward the CS-. Examination of the magnitude of evaluative change to the CS+ revealed the strongest effect for disgust. DP, but not trait anxiety, also predicted a greater increase in disgust, anger, and anxiety in response to the CS+ relative to the CS-. Furthermore, the association between DP and greater disgust, anger, and anxiety in response to the CS+ was mediated by more intense negative affective responding to the US among those higher in DP. The implication of these findings for better understanding how DP may confer risk for anxiety-related psychopathology is discussed.",Olatunji BO.; Tomarken A.; Puncochar BD.,2013.0,10.1037/a0032743,0,0,
5049,Examination of the decline in fear and disgust during exposure to threat-relevant stimuli in blood-injection-injury phobia,"In the present study, participants (N = 22) displaying marked fear of blood-injection-injury (BII) stimuli were provided 30 min of in vivo exposure to threat-relevant stimuli, during which time their fear and disgust levels were repeatedly assessed. Growth curve analyses were then conducted to examine the decay slopes in both fear and disgust and their relationship. Results indicated that exposure led to significant declines in fear and disgust across trials. However, the decay slope observed for fear was significantly greater than that for disgust. Further analyses revealed that the decline in fear across trials remained significant after accounting for the changes in disgust. However, the effect of trial on disgust was no longer significant after controlling for the reduction in fear. Global disgust sensitivity levels prior to exposure did not moderate the level of fear activation or fear reduction during exposure. BII-specific digust sensitivity was also not associated with intial levels of fear. However, levels of BII-specific disgust sensitivity were independently negatively associated with fear decline. Theoretical and clinical implications of the findings are discussed. © 2006 Elsevier Ltd. All rights reserved.",Olatunji B.O.; Smits J.A.J.; Connolly K.; Willems J.; Lohr J.M.,2007.0,10.1016/j.janxdis.2006.05.001,0,0,
5050,"Information processing biases in spider phobia: Application of the Stroop and ""White Noise"" Paradigm","The present study examines attentional and implicit memory biases in spider phobic and nonphobic participants. The results showed that spider phobics demonstrated increased interference for neutral, negative, and spider-relevant words on a computerized Stroop task. However, no group differences emerged when adjusting for differences in color-naming speed. Prior exposure to a dead spider did result in higher overall Stroop interference in spider phobics and this appeared to be mostly pronounced for spider-relevant words. Implicit memory bias for threat was examined with a noise judgment task. Participants first heard neutral and spider-relevant sentences and implicit memory for these sentences was evaluated by having participants rate the volume of noise accompanying the presentation of old sentences intermixed with new sentences. An implicit memory bias is indicated if participants rate noise accompanying old sentences as less loud than noise accompanying new sentences. No evidence was found for an implicit memory bias in spider phobics. These findings are discussed in relation to the role of information processing biases in spider phobia. © 2007 Elsevier Ltd. All rights reserved.",Olatunji B.O.; Sawchuk C.N.; Lee T.C.; Lohr J.M.; Tolin D.F.,2008.0,10.1016/j.jbtep.2007.03.002,0,0,
5051,Behavioral versus cognitive treatment of obsessive-compulsive disorder: an examination of outcome and mediators of change.,"To examine symptom change over time, the effect of attrition on treatment outcome, and the putative mediators of cognitive therapy (CT) versus behavior therapy (BT) for obsessive-compulsive disorder (OCD) using archival data. Sixty-two adults with OCD were randomized to 20 sessions of CT (N = 30) or BT (N = 32) that consisted of 4 weeks of intensive treatment (16 hr total) and 12 weeks of maintenance sessions (4 hr). Independent evaluators assessed OCD severity using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) at baseline and at Weeks 4, 16 (posttreatment), 26, and 52 (follow-up). Behavioral avoidance, depressive symptoms, and dysfunctional beliefs regarding responsibility were also measured at each assessment. Study hypotheses were tested using multilevel modeling. The slope of change in Y-BOCS scores was significantly greater in BT than in CT (d = 0.69), and those receiving BT had lower Y-BOCS scores at the final assessment than those receiving CT (d = 1.17). The greater slope of change in BT versus CT did not differ for dropouts versus completers. Reduction in depressed mood mediated changes in Y-BOCS across the 2 treatments, but a reduction in sense of responsibility and a decrease in avoidance did not. Instead, Y-BOCS improvements appeared to precede a decrease in avoidance. BT may have some therapeutic advantage over CT in the treatment of OCD, and this advantage does not appear to be due to a differential pattern of responding for treatment dropouts versus completers. Further, inconsistent with hypotheses, improvements in OCD symptoms were mediated by reductions in depressed mood instead of decreases in avoidance and responsibility. Theoretical, methodological, and clinical implications are discussed.",Olatunji BO.; Rosenfield D.; Tart CD.; Cottraux J.; Powers MB.; Smits JA.,2013.0,10.1037/a0031865,0,0,
5052,Using facial expressions as CSs and fearsome and disgusting pictures as UCSs: Affective responding and evaluative learning of fear and disgust in blood-injection-injury phobia,"Two experiments examine use of an evaluative conditioning (EC) paradigm in the acquisition of fear and disgust responding to neutral facial expressions. In Experiment 1, 60 participants were randomly assigned to one of three evaluative learning conditions in which neutral facial expressions were paired with fearsome, disgusting, or neutral pictures. No statistically significant differences were detected between the three conditions. However, significant differences emerged within subjects as post-exposure of fear and disgust ratings were higher among expressions that were paired with pictorial stimuli. Experiment 2 sought to examine if an analogue sample of BII phobics would be more susceptible than nonphobic controls to fear and disgust EC utilizing a similar experimental design, given the co-occurrence of fear and disgust in BII-phobic responding. Results failed to demonstrate an EC effect specific to the analogue phobic group, although both groups showed an evaluative shift toward disgust for those facial expressions paired with BII-relevant pictures. Consistent with previous findings, examination of picture rating data suggested that analogue BII phobics rated the BII pictures as significantly more disgusting than fearful. The role of EC processes and a priori expectancy biases in the associative learning of disgust in BII phobia is discussed. © 2004 Elsevier Inc. All rights reserved.",Olatunji B.O.; Lohr J.M.; Sawchuk C.N.; Westendorf D.H.,2005.0,10.1016/j.janxdis.2004.05.002,0,0,
5053,Predicting response to cognitive behavioral therapy in contamination-based obsessive-compulsive disorder from functional magnetic resonance imaging.,"Background: Although cognitive behavioral therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD), few reliable predictors of treatment outcome have been identified. The present study examined the neural correlates of symptom improvement with CBT among OCD patients with predominantly contamination obsessions and washing compulsions, the most common OCD symptom dimension. Method: Participants consisted of 12 OCD patients who underwent symptom provocation with contamination-related images during functional magnetic resonance imaging (fMRI) scanning prior to 12 weeks of CBT. Results: Patterns of brain activity during symptom provocation were correlated with a decrease on the Yale-Brown Obsessive Compulsive Scale (YBOCS) after treatment, even when controlling for baseline scores on the YBOCS and the Beck Depression Inventory (BDI) and improvement on the BDI during treatment. Specifically, activation in brain regions involved in emotional processing, such as the anterior temporal pole and amygdala, was most strongly associated with better treatment response. By contrast, activity in areas involved in emotion regulation, such as the dorsolateral prefrontal cortex, correlated negatively with treatment response mainly in the later stages within each block of exposure during symptom provocation. Conclusions: Successful recruitment of limbic regions during exposure to threat cues in patients with contamination-based OCD may facilitate a better response to CBT, whereas excessive activation of dorsolateral prefrontal regions involved in cognitive control may hinder response to treatment. The theoretical implications of the findings and their potential relevance to personalized care approaches are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Olatunji, B. O; Ferreira-Garcia, R; Caseras, X; Fullana, M. A; Wooderson, S; Speckens, A; Lawrence, N; Giampietro, V; Brammer, M. J; Phillips, M. L; Fontenelle, L. F; Mataix-Cols, D; Abramowitz, Alpers, Aupperle, Basoglu, Beck, Brammer, Breakspear, Brody, Bullmore, Bullmore, Bullmore, Caseras, Christensen, Doehrmann, Etkin, First, Foa, Foa, Foa, Fontenelle, Fu, Goldin, Goldin, Goodman, Goodman, Greist, Greist, Hariri, Harrison, Hoexter, Husted, Larson, Mataix-Cols, Mataix-Cols, Mataix-Cols, Mataix-Cols, Milad, Milad, MourAo-Miranda, Ochsner, Olatunji, Olatunji, Phelps, Phillips, Phillips, Rachman, Rauch, Rauch, Rauch, Salkovskis, Sanematsu, Saxena, Saxena, Schienle, Sergerie, Siegle, Steketee, Swedo, Talairach, van Balkom, van den Heuvel, Visser",2014.0,,0,0,
5054,Effects of experienced disgust on habituation during repeated exposure to threat-relevant stimuli in blood-injection-injury phobia.,"Despite growing evidence implicating disgust in the etiology of blood-injection-injury (BII) phobia, the relevance of disgust for exposure-based treatment of BII phobia remains largely unknown. Individuals with BII phobia were randomly assigned to a disgust (view vomit videos) or neutral activation (view waterfall videos) condition. They were then exposed to 14 videotaped blood draws, during which fear and disgust levels were repeatedly assessed. Participants then engaged in a behavioral avoidance test (BAT) consisting of exposure to threat-relevant stimuli. Examination of outcome comparing the identical first and last blood-draw clips revealed that fear and disgust toward blood draws was significantly reduced in both groups. Disgust levels were also found to be more intense for the video stimuli relative to fear levels whereas the opposite was true for BAT stimuli. Contrary to predictions, the disgust induction did not enhance reductions in negative responses to the target video or reduce behavioral avoidance. Growth curve analyses did show that individuals with BII phobia exposed to the disgust induction showed greater initial fear levels during repeated exposure than those in the neutral condition. However, this effect was not consistently observed across different analytic approaches. Changes in fear during exposure were also found to be independent of changes in disgust but not vice versa, and greater initial fear levels during repeated exposure to threat was associated with fear and disgust levels during the BAT. The implications of these findings for conceptualizing the role of disgust in etiology and treatment of BII phobia are discussed.",Olatunji BO.; Ciesielski BG.; Wolitzky-Taylor KB.; Wentworth BJ.; Viar MA.,2012.0,10.1016/j.beth.2011.04.002,0,0,
5055,Threat modulation of visual search efficiency in PTSD: A comparison of distinct stimulus categories,"Although an attentional bias for threat has been implicated in posttraumatic stress disorder (PTSD), the cues that best facilitate this bias are unclear. Some studies utilize images and others utilize facial expressions that communicate threat. However, the comparability of these two types of stimuli in PTSD is unclear. The present study contrasted the effects of images and expressions with the same valence on visual search among veterans with PTSD and controls. Overall, PTSD patients had slower visual search speed than controls. Images caused greater disruption in visual search than expressions, and emotional content modulated this effect with larger differences between images and expressions arising for more negatively valenced stimuli. However, this effect was not observed with the maximum number of items in the search array. Differences in visual search speed by images and expressions significantly varied between PTSD patients and controls for only anger and at the moderate level of task difficulty. Specifically, visual search speed did not significantly differ between PTSD patients and controls when exposed to angry expressions. However, PTSD patients displayed significantly slower visual search than controls when exposed to anger images. The implications of these findings for better understanding emotion modulated attention in PTSD are discussed.",Olatunji B.O.; Armstrong .; Bilsky S.A.; Zhao M.,2015.0,10.1016/j.psychres.2015.05.090,0,0,
5056,Evaluative learning and emotional responding to fearful and disgusting stimuli in spider phobia.,"The present study explores possible changes between spider phobics (N=22) and nonphobics (N=28) in fear, disgust, and neutral ratings of neutral expressions as a result of their pairing with spiders. No statistically significant differences were detected between pre and post fear ratings of the expressions as a result of their association with spiders. However, post disgust ratings were marginally higher than pre disgust ratings and post neutral ratings were significantly lower than pre neutral ratings. The present study also examined differences in fear and disgust responding to threat-relevant and disgust-relevant stimuli between spider phobics and nonphobics. Spider phobics reported significantly more fear and disgust than nonphobics towards threat and disgust-relevant stimuli. The relation between spider phobia and disgust responding to spiders was partially mediated by fear whereas the relation between spider phobia and disgust responding to rotting foods and body products was fully mediated by fear. Emotional responding to threat-relevant and disgust-relevant stimuli was also significantly associated with disgust sensitivity when controlling for trait anxiety. These findings support the notion that the disgust response in spider phobia is independent of fear to the extent that it is specifically bound to spiders.",Olatunji BO.,2006.0,10.1016/j.janxdis.2006.01.005,0,0,
5057,Yale-brown obsessive compulsive scale: Psychometric properties of the self-report version in a student sample,"The aim of the present study was to investigate the psychometric properties of an Icelandic translation of the self-report version of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR). The Y-BOCS-SR was administered to a sample of 427 Icelandic university students along with another measure of OCD symptoms (OCI-R) and measures of general anxiety and worry (GADQ- IV and PSWQ). The internal consistency of the Y-BOCSSR total severity score and its obsession and compulsion subscales was very good. Confirmatory factor analysis supported the original two- factor structure of the severity dimensions but a three-factor model with obsession, compulsion and resistance/control factors fitted the data equally well. Five factors described best the latent structure of the symptom dimensions. Support was found for the convergent and divergent validity of the Y-BOCS-SR. The results indicate that the Y-BOCS-SR is a reliable and valid instrument for assessing the severity of obsessions and compulsions in a student population. © Springer Science + Business Media, LLC 2009.",Ólafsson R.P.; Snorrason I.; Smári J.,2010.0,10.1007/s10862-009-9146-0,0,0,
5058,Replacing intrusive thoughts: Investigating thought control in relation to OCD symptoms,"Background and objectives Control of obsessive thoughts in Obsessive Compulsive Disorder (OCD) involves both avoidance and removal of undesirable intrusive thoughts. Thought suppression tasks tap both of these processes but experimental results have been inconsistent. Experimental tasks allowing more focused study of the processes involved in controlling intrusive thoughts may be needed. In two experiments, control over neutral, standardized intrusive and personal intrusive thoughts was investigated as participants attempted to replace them with neutral thoughts. Methods Non-selected university students (Experiment 1: N = 61) and university students scoring high and low on self-report measure of OC symptoms (Experiment 2: N = 40) performed a computerized thought replacement task. Results In experiment 1 replacing personal intrusive thoughts took longer than replacing neutral thoughts. Self-reports showed that intrusive thoughts were rated more difficult to replace and were associated with greater thought reoccurrence during replacement, larger emotional reaction and more discomfort. These results were largely replicated in experiment 2. Furthermore, the high OC symptom group experienced greater overall difficulty controlling thoughts on the replacement task, experienced more reoccurrences of personal intrusive thoughts, larger emotional reactions and discomfort associated with them, and felt a greater urge to remove them. Limitations All participants were non-clinical university students, and older adults with OCD should be tested. Conclusions The findings are in line with cognitive behavioural theories of OCD. They support the usefulness of thought replacement as a research paradigm to study thought control in OCD and possibly other psychological conditions characterized by repetitive thoughts. © 2014 Elsevier Ltd. All rights reserved.",Ólafsson R.P.; Snorrason Í.; Bjarnason R.K.; Emmelkamp P.M.G.; Ólason D.P.; Kristjánsson Á.,2014.0,10.1016/j.jbtep.2014.07.007,0,0,
5059,Suppressing disgust related thoughts and performance on a subsequent behavioural avoidance task: Implications for OCD,"We tested whether suppressing disgust related thoughts, compared with no suppression, differentially affected target thought frequency and emotional responses, and whether this was related to participants' cognitive inhibition abilities. We also tested whether different control instructions during a thought control task would affect performance on a subsequent behavioural avoidance task involving disgust related stimuli. Sixty university students, pre-selected on their level of disgust propensity/sensitivity, were instructed to either suppress or not to suppress all target-related thoughts following viewing of a disgust-related film fragment. Thought suppression immediately reduced target thought frequency, but only for participants with good inhibitory control. Thought suppression led to sustained thought frequency and levels of disgust after suppression was lifted, whereas a significant drop was observed for these measures in the no-suppression group. Thought control instructions did not affect performance on the behavioural avoidance task at the group level. However, regression analyses showed that changes in thought frequency during thought suppression interacted with beliefs concerning importance of thoughts and thought control when predicting fear and disgust reactions during the behavioural task. © 2012 Elsevier Ltd.",Ólafsson R.P.; Emmelkamp P.M.G.; Gunnarsdóttir E.R.; Snæbjörnsson T.; Ólason D.T.; Kristjánsson T.,2013.0,10.1016/j.brat.2012.11.008,0,0,
5060,"Fluvoxamine in the treatment of demented elderly patients: a double-blind, placebo-controlled study","ER The efficacy of fluvoxamine on cognitive functioning and behavioral changes was evaluated in a double-blind, placebo-controlled study of 46 elderly demented patients. The patients had a DSM-III diagnosis of primary degenerative dementia or multi-infarct dementia and were aged greater than or equal to 65 years. Twenty-two patients were given 150 mg fluvoxamine per day and 24 received placebo tablets; 14 and 15 patients, respectively, completed 6 weeks of treatment. Within treatments, there were no significant changes in median scores on neuropsychological tests (picture recall and recognition, trail making and finger tapping) or the GBS scale scores (degrees of dementia) or GBS subscale score (clinical profiles, including symptoms common in dementia, motor, emotional and intellectual functioning). Between treatments, the median changes in psychometric test scores did not differ significantly. However, within and between treatments, there were trends favoring fluvoxamine on symptoms common in dementia (confusion, irritability, anxiety, fear-panic, mood level and restlessness). In conclusion, the study does not support the hypothesis that fluvoxamine improves cognitive functioning or behavioral changes in elderly dementia patients.","Olafsson, K; J√∏rgensen, S; Jensen, H V; Bille, A; Arup, P; Andersen, J",1992.0,,0,0,
5061,"Burnout, psychological distress and job satisfaction among secondary school teachers in Enugu, south east Nigeria","Teachers in all levels of education are very crucial in the educational development of any society and their satisfaction will basically affect the quality of services they render to the educational sector. However, the teaching profession is associated with a lot of stress arising from work overload and poor remuneration. This can lead to high prevalence of burnout, psychological distress and low level of job satisfaction among teachers. This study assessed the prevalence of burnout, psychological distress and job satisfaction among teachers in secondary schools in Enugu, south east Nigeria. The Maslach burnout inventory, the General health questionnaire (GHQ-12) and the Generic job satisfaction scale were used to assess 432 teachers working in secondary schools in Enugu south east Nigeria for prevalence of burnout, psychological distress and level of job satisfaction. The prevalence of burnout was 40% for emotional exhaustion, 39.4% for depersonalization and 36.8% for reduced personal accomplishment. 32.9% had psychological distress while 39.6% had low level of job satisfaction. There was high prevalence of burnout, psychological distress and low level of job satisfaction among the teachers.",Okwaraji F.E.; Aguwa E.N.,2015.0,10.4172/Psychiatry.1000198,0,0,
5062,Oncologists may have difficulty in assessing their patients' physical and psychological symptoms,"BACKGROUND: Accurate evaluation of symptom severity is crucial to the provision of optimal symptom management. The purpose of this study was to investigate the accuracy of oncologists' recognition of their patients' physical and psychological symptoms. METHOD: Two oncologists and a sample of randomly sampled outpatients with breast cancer that they saw at a breast cancer outpatient clinic at a Japanese university hospital participated. This study was approved by the Institutional Review Board and full written informed consent was obtained from each patient. Patients reported the severity of their 12 physical and 2 psychological symptoms using EORTCQLQ- C30 and HADS, respectively. Oncologists completed a survey in which they indicated their recognition of each patient's level of these symptoms immediately following their consultation. These two data were compared statistically by calculating Cohen's kappa index, sensitivity, specificity, PPV, and NPV. RESULTS: Complete data were available from 408 patients. Among them, 23% had advanced cancer (stage III, IV, or recurrence). Kappa index was generally low, mean was 0.12, ranging 0 (for constipation) to 0.43 (for hair loss). Sensitivity was less than 40% and specificity was greater than 85% for all other physical symptoms except pain (59% and 70%, respectively). Sensitivity and specificity for anxiety was greatest (78%) and lowest (27%) and PPVs for anxiety and depression were lowest (22% and 19% respectively) among all of symptoms. CONCLUSIONS: Oncologists' recognition may not accurately reflect their patients' physical and psychological symptoms. Especially low PPVs for depression and anxiety indicated that detection of presence of psychological distress must be the difficult task for them. Incorporating standard symptom assessment in clinical practice may heighten oncologists' awareness of their patients' symptoms. RESEARCH IMPLICATIONS: A small number of physicians included in this study and that majority of participants was in good condition may limit the external validity of the findings. Further research should be conducted taking these limitations into account. Also clinical trials to investigate the efficacy of interventions helping physicians recognizing patients' symptoms on improving patients' outcome should be done. CLINICAL IMPLICATIONS: Oncologists may have less-than-optimal level of awareness of patients' reported physical and psychological symptoms. Psycho-oncologists are expected to facilitate physicians to heighten their recognition of their patients' symptoms.",Okuyama T.; Akechi T.; Yamashita H.; Toyama T.; Endo C.; Sagawa R.; Uchida M.; Furukawa T.,2009.0,10.1002/pon.1594,0,0,
5063,Acute and Chronic Mood and Apathy Outcomes from a randomized study of unilateral STN and GPi DBS.,"To study mood and behavioral effects of unilateral and staged bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) for Parkinson's disease (PD). There are numerous reports of mood changes following DBS, however, most have focused on bilateral simultaneous STN implants with rapid and aggressive post-operative medication reduction. A standardized evaluation was applied to a subset of patients undergoing STN and GPi DBS and who were also enrolled in the NIH COMPARE study. The Unified Parkinson Disease Rating Scale (UPDRS III), the Hamilton depression (HAM-D) and anxiety rating scales (HAM-A), the Yale-Brown obsessive-compulsive rating scale (YBOCS), the Apathy Scale (AS), and the Young mania rating scale (YMRS) were used. The scales were repeated at acute and chronic intervals. A post-operative strategy of non-aggressive medication reduction was employed. Thirty patients were randomized and underwent unilateral DBS (16 STN, 14 GPi). There were no baseline differences. The GPi group had a higher mean dopaminergic dosage at 1-year, however the between group difference in changes from baseline to 1-year was not significant. There were no differences between groups in mood and motor outcomes. When combining STN and GPi groups, the HAM-A scores worsened at 2-months, 4-months, 6-months and 1-year when compared with baseline; the HAM-D and YMRS scores worsened at 4-months, 6-months and 1-year; and the UPDRS Motor scores improved at 4-months and 1-year. Psychiatric diagnoses (DSM-IV) did not change. No between group differences were observed in the cohort of bilateral cases. There were few changes in mood and behavior with STN or GPi DBS. The approach of staging STN or GPi DBS without aggressive medication reduction could be a viable option for managing PD surgical candidates. A study of bilateral DBS and of medication reduction will be required to better understand risks and benefits of a bilateral approach.",Okun MS.; Wu SS.; Fayad S.; Ward H.; Bowers D.; Rosado C.; Bowen L.; Jacobson C.; Butson C.; Foote KD.,2014.0,10.1371/journal.pone.0114140,0,0,
5064,Deep brain stimulation in the internal capsule and nucleus accumbens region: responses observed during active and sham programming.,"Recently, anterior limb of the internal capsule and nucleus accumbens deep brain stimulation (DBS) has been used in the treatment of medication-refractory obsessive-compulsive disorder (OCD). This region has been previously explored with lesion therapy, but with the advent of DBS there exists the possibility of monitoring the acute and chronic effects of electrical stimulation. The stimulation-induced benefits and side effects can be reversibly and blindly applied to a variety of locations in this region. To explore the acute effects of DBS in the anterior limb of the internal capsule and nucleus accumbens region. Ten total DBS leads in five patients with chronic and severe treatment-refractory OCD were tested. Patients were examined 30 days after DBS placement and received either ""sham"" testing or actual testing of the acute effects of DBS (the alternative condition tested 30 days later). Pooled responses were reviewed for comparability of distribution using standard descriptive methods, and relationships between the variables of interest were sought using chi2 analysis. A total of 845 stimulation trials across the five patients were recorded and pooled. Of these 16% were elicited from sham stimulation and 17% from placebo (0 V stimulation). A comparison of active to sham trials showed that sham stimulation was not associated with significant side effects or responses from patients. Non-mood-related responses were found to be significantly associated with the ventral lead contacts (0 and 1) (p = 0.001). Responses such as taste, smell and smile were strongly associated with the most ventral lead positions. Similarly, physiological responses--for example, autonomic changes, increased breathing rate, sweating, nausea, cold sensation, heat sensation, fear, panic and panic episodes--were significantly associated with ventral stimulation (p = 0.001). Fear and panic responses appeared clustered around the most ventral electrode (0). Acute stimulation resulted in either improved or worsened mood responses in both the dorsal and ventral regions of the anterior limb of the internal capsule. The acute effects of DBS in the region of the anterior limb of the internal capsule and nucleus accumbens, particularly when obtained in a blinded fashion, provide a unique opportunity to localise brain regions and explore circuitry.",Okun MS.; Mann G.; Foote KD.; Shapira NA.; Bowers D.; Springer U.; Knight W.; Martin P.; Goodman WK.,2007.0,10.1136/jnnp.2006.095315,0,0,
5065,"Collaborative multicenter field trial of the Draft of ICD-10 in Japan--interdiagnostician reliability and disagreement: a report from the WHO project on ""field trials of ICD-10, Chapter V"".","The Draft of ""ICD-10, Chapter V, Clinical Descriptions and Diagnostic Guidelines"" was tested in a multicenter field trial in Japan. We have previously reported good results in suitability, confidence and ease of diagnosis, and adequacy of descriptions of the Draft. In this paper, the interdiagnostician reliability of the Draft is reported. Among the two-character categories, ""Schizophrenia, Schizotypal States and Delusional Disorders (F2)"" (ICC = .80) and ""Mood Disorders (F3)"" (ICC = .80) proved reliable. ""Neurotic, Stress-Related, and Somatoform Disorders (F4)"" was less reliable (ICC = .65). The ICCs of the 17 major categories (three-character code) and the 21 subcategories (four-character code) were also calculated. The finding that in Japan subtyping schizophrenia with ICD-10 was more reliable than that made using DSM-III Diagnostic Criteria supports the need to use a descriptive version of ICD-10 as the basis for several versions serving different purposes. The nature of disagreements with unreliable categories was also investigated. The results are discussed with special reference to the changes in the final Draft of Chapter V, which contained a feedback of the results from field trials from all over the world.",Okubo Y.; Komiyama M.; Nakane Y.; Takahashi T.; Yamashita I.; Nishizono M.; Takahashi R.,1992.0,,0,0,
5066,Trauma-related shame and guilt as time-varying predictors of posttraumatic stress disorder symptoms during imagery exposure and imagery rescripting--A randomized controlled trial.,The specific aims of this study are to examine trauma-related shame and guilt as time-varying predictors of symptoms of posttraumatic stress disorder (PTSD). Sixty-five patients were included in the statistical analyses and the multilevel modeling analyses supported three major findings. (i) Patients with a higher level of shame and guilt at the start of treatment displayed a higher level of PTSD symptoms over the course of treatment compared to other patients. (ii) Time-specific change in shame and guilt predicted the level of PTSD symptoms 3 days later from session to session during treatment. (iii) No significant differences were evident between prolonged exposure (PE) and modified PE to include imagery rescripting in the within-person process of change in PTSD symptoms from session to session during therapy. This trial reports the first evidence that within-person change in shame and guilt predicts change in PTSD symptoms from session to session during treatment.,√òktedalen T.; Hoffart A.; Langkaas TF.,2015.0,10.1080/10503307.2014.917217,0,0,
5067,Fear-related pictures deteriorate the performance of university students with high fear of snakes or spiders.,"Despite research regarding emotional processing, it is still unclear whether fear-evoking stimuli are processed when they are irrelevant and when attention is oriented elsewhere. In this study, 63 healthy university students with high fear from snakes or spiders participated in two different experiments. In an emotional modification of the spatial cueing task, 31 subjects (5 males) were asked to detect a target letter while ignoring a neutral or fear-related distracting picture. The distribution of attention was independently manipulated by a spatial cue that preceded the appearance of the picture and the target letter. In an emotional modification of the cognitive load paradigm, 32 subjects (4 males) were asked to discriminate between two target letters, while ignoring a central neutral or fear-related picture, and additional 1, 3, or 5 distracting letters that created a varied attentional load. Fear-related pictures interfered with the performance of highly fearful participants, even when the pictures were presented outside the focus of attention and when the task taxed attentional resources. We suggest that highly fearful individuals process fear-related information automatically, either inattentively or with prioritized attention capture over competing items, leading to deteriorated cognitive performance. Different results were shown in healthy individuals while processing negative--but not phobic--pictures, suggesting that emotional processing depends on the fear value of the stimulus for a specific observer.",Okon-Singer H.; Alyagon U.; Kofman O.; Tzelgov J.; Henik A.,2011.0,10.3109/10253890.2010.527401,0,0,
5068,Trial of CBT for impulse control behaviors affecting Parkinson patients and their caregivers,"ER OBJECTIVE: To test the effects of a novel cognitive-behavioral therapy (CBT)-based intervention delivered by a nurse therapist to patients with Parkinson disease (PD) with clinically significant impulse control behaviors (ICB).METHODS: This was a randomized controlled trial comparing up to 12 sessions of a CBT-based intervention compared to a waiting list control condition with standard medical care (SMC). A total of 27 patients were randomized to the intervention and 17 to the waiting list. Patients with a Mini-Mental State Examination score of <24 were excluded. The coprimary outcomes were overall symptom severity and neuropsychiatric disturbances in the patients and carer burden and distress after 6 months. Secondary outcome measures included depression and anxiety, marital satisfaction, and work and social adjustment in patients plus general psychiatric morbidity and marital satisfaction in carers.RESULTS: There was a significant improvement in global symptom severity in the CBT intervention group vs controls, from a mean score consistent with moderate to one of mild illness-related symptoms (?(2) = 16.46, p < 0.001). Neuropsychiatric disturbances also improved significantly (p = 0.03), as did levels of anxiety and depression and adjustment. Measures of carer burden and distress showed changes in the desired direction in the intervention group but did not change significantly. General psychiatric morbidity did improve significantly in the carers of patients given CBT.CONCLUSIONS: This CBT-based intervention is the first to show efficacy in ICB related to PD in terms of patient outcomes. The hoped-for alleviation of carer burden was not observed. The study demonstrates the feasibility and potential benefit of a psychosocial treatment approach for these disturbances at least in the short term, and encourages further larger-scale clinical trials.CLASSIFICATION OF EVIDENCE: The study provides Class IV evidence that CBT plus SMC is more effective than SMC alone in reducing the severity of ICB in PD, based upon Clinical Global Impression assessment (?(2) = 16.46, p < 0.001): baseline to 6-month follow-up, reduction in symptom severity CBT group, 4.0-2.5; SMC alone group, 3.7-3.5.","Okai, D; Askey-Jones, S; Samuel, M; O'Sullivan, S S; Chaudhuri, K R; Martin, A; Mack, J; Brown, R G; David, A S",2013.0,10.1212/WNL.0b013e3182840678,0,0,
5069,"Alleviation of moral disgust, shame, and guilt in posttraumatic stress reactions: an evaluation of comprehensive distancing.","Research suggests that moral disgust, shame, and guilt are present in posttraumatic psychopathology. However, it is unclear that these emotional states are responsive to empirically supported interventions for posttraumatic stress symptoms (PTSS). This study explored the relations among moral disgust, shame, guilt, and PTSS, and examined comprehensive distancing (CD) as a novel intervention for these emotional states in undergraduates with elevated PTSS. Participants were randomly assigned to use a CD or a cognitive challenge task in response to personalized scripts of a traumatic event. Both interventions were associated with decreases in disgust, moral disgust, shame, and guilt. Contrary to predictions, there were no significant differences between the exercises in the reduction of negative emotions. In addition, PTSS severity was correlated with trauma-related guilt as well as state guilt and shame, but not trait or state measures of disgust or moral disgust. This proof of concept project sets the stage for further research examining CD as an alternative or adjunctive intervention for posttraumatic stress reactions with strong features of moral disgust, shame, and guilt.",Ojserkis R.; McKay D.; Badour CL.; Feldner MT.; Arocho J.; Dutton C.,2014.0,10.1177/0145445514543465,0,0,
5070,Effectiveness of brief cognitive group therapy for persons with panic disorder with and without agoraphobia.,"The purpose of this study was to assess the effectiveness of cognitive group therapy for the treatment of persons with panic disorder--with or without agoraphobia. 18 outpatients, 15 of whom were DSM-IV diagnosed as having panic disorder, were treated with group cognitive therapy during a period of fourteen weeks. Participants were evaluated before treatment, directly after treatment and again six months after the cessation of treatment. Different types of measurements were used to evaluate overall function and symptom levels. In general, patients showed a significant improvement in overall function while at the same time they experienced a reduction in panic frequency and anxiety related symptoms. Participants were to a large extent satisfied with treatment. The improvements mentioned above were still evident six months after the conclusion of treatment. The study did not include a control group. Furthermore, half of the participants were medicated during the study. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Oiesvold, Margit; Aaroe, Rolf; Allgulander, Barlow, Beck, Beck, Beck, Cameron, Chambless, Chignon, Craske, Derogatis, Glum, Horowitz, Katerndahl, Markowitz, Myers, Roth, Wells",2003.0,,0,0,
5071,Hemodynamic responses of eye movement desensitization and reprocessing in posttraumatic stress disorder.,"[Correction Notice: An erratum for this article was reported in Vol 66(2) of Neuroscience Research (see record 2010-01438-002). The publisher regrets that the surname of Dr. Ohtani was incorrectly spelt in the original article. The corrected author listing is given in the erratum.] Eye movement desensitization and reprocessing (EMDR) is an effective psychological intervention for posttraumatic stress disorder (PTSD). Trauma-related recall (Recall) with eye movements (EMs) is thought to reduce distress. However, the neural mechanisms underlying this process remain unknown. Thirteen patients with PTSD received EMDR treatment over the course of 2-10 weeks. We assessed the change in hemoglobin concentration in the lateral prefrontal cortex (PFC) during Recall with and without EM using multi-channel near-infrared spectroscopy (NIRS). Clinical diagnosis and improvement were evaluated using the Clinician-Administered PTSD Scale. Recall with EM was associated with a significant decrease in oxygenated hemoglobin concentration ([oxy-Hb]) in the lateral PFC as compared with Recall without EM. Longitudinally, [oxy-Hb] during Recall significantly decreased and the amount of decrease was significantly correlated with clinical improvement when the post-treatment data was compared with that of the pre-treatment. Our results suggest that performing EM during Recall reduces the over-activity of the lateral PFC, which may be part of the biological basis for the efficacy of EMDR in PTSD. NIRS may be a useful tool for objective assessment of psychological intervention in PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ohta ni, Toshiyuki; Matsuo, Koji; Kasai, Kiyoto; Kato, Tadafumi; Kato, Nobumasa; Asukai, Asukai, Barrowcliff, Blake, Boas, Bremner, Bremner, Brody, Carlson, Devilly, Edmond, Forbes, Friedman, Furmark, Gilboa, Goldapple, Gsell, Herbert, Hock, Hoshi, Huppert, Kameyama, Kavanagh, Kono, Lamprecht, Lanius, Lansing, Levin, Linden, Lipke, Maquet, Marcus, Martin, Matsuo, Ohtani, Oldfield, Paquette, Pitman, Rogers, Scheck, Seedat, Seidler, Shalev, Shapiro, Sheehan, Shin, Shin, Shin, Spirberger, Stickgold, Strangman, Strangman, Strangman, Suto, Toronov, Van der Kolk, Etten, Vaughan, Wang, Watanabe, Weiss, Wilson, Wilson, Wolpe, Yamasue",2009.0,,0,0,
5072,Randomized controlled trial to test a computerized psychosocial cancer assessment and referral program: methods and research design,"ER The National Cancer Coalition Network, National Cancer Institute, and American College of Surgeons all emphasize the need for oncology providers to identify, address, and monitor psychosocial needs of their patients. The Mental Health Assessment and Dynamic Referral for Oncology (MHADRO) is a patient-driven, computerized, psychosocial assessment that identifies, addresses, and monitors physical, psychological, and social issues faced by oncology patients. This paper presents the methodology of a randomized controlled trial (RCT) that tested the impact of the MHADRO on patient outcomes at 2, 6, and 12 months. Patient outcomes including overall psychological distress, depression, anxiety, functional disability, and use of psychosocial resources will be presented in future publications after all follow-up data is gathered. Eight hundred and thirty six cancer patients with heterogeneous diagnoses, across three comprehensive cancer centers in different parts of the United States, were randomized to the MHADRO (intervention) or an assessment-only control group. Patients in the intervention group were provided detailed, personalized reports and, when needed, referrals to mental health services; their oncology provider received detailed reports designed to foster clinical decision making. Those patients who demonstrated high levels of psychosocial problems were given the option to authorize that a copy of their report be sent electronically to a ""best match"" mental health professional. Demographic and patient cancer-related data as well as comparisons between patients who were enrolled and those who declined enrollment are presented. Challenges encountered during the RCT and strategies used to address them are discussed.","O'Hea, E L; Cutillo, A; Dietzen, L; Harralson, T; Grissom, G; Person, S; Boudreaux, E D",2013.0,10.1016/j.cct.2013.02.001,0,0,
5073,Emphasizing appearance versus health outcomes in exercise: the influence of the instructor and participants' reasons for exercise,"ER The objectifying nature of exercise environments may prevent women from reaping psychological benefits of exercise. The present experiment manipulated self-objectification through an exercise class taught by an instructor who emphasized exercise as either a means of acquiring appearance or health outcomes. The purpose of this study was to test for interactions between the class emphasis and participants' reasons for exercise (i.e., appearance, health) predicting participants' state self-objectification, state social physique anxiety, exercise class enjoyment, and future intentions of returning to a similar exercise class. Results, obtained via pre- and post-exercise questionnaires, revealed a significant interaction between class emphasis and health reasons for exercise predicting state self-objectification. Participants with lower health reasons for exercise reported greater state self-objectification in the appearance-focused class compared to those with higher health reasons for exercise. Adopting stronger health reasons for exercise may buffer exercise participants from the more objectifying aspects of the group exercise environment.","O'Hara, S E; Cox, A E; Amorose, A J",2014.0,10.1016/j.bodyim.2013.12.004,0,0,
5074,Effect of patient gender on outcome in two forms of short-term individual psychotherapy.,"This study examined the relationship of patient gender and outcome for two forms (interpretive, supportive) of short-term, individual psychotherapy. Female and male patients (N=89) were randomly assigned to either interpretive or supportive therapy. Outcome was measured in the areas of depression, anxiety, and general symptomatic distress. A significant interaction effect between patient gender and form of therapy was found for measures of depression and general symptomatic distress at post-therapy. Male patients had better outcome in interpretive therapy than in supportive therapy. Female patients had better outcome in supportive therapy than in interpretive therapy. The findings suggest that patient gender may be differentially influential with different forms of short-term therapy.",Ogrodniczuk JS.; Piper WE.; Joyce AS.; McCallum M.,2001.0,,0,0,
5075,Anxiety sensitivity cognitive concerns predict suicide risk.,"Anxiety sensitivity (AS) cognitive concerns, which reflects fears of mental incapacitation, have been previously associated with suicidal ideation and behavior. The first study aim was to replicate and extend upon previous research by investigating whether AS cognitive concerns can discriminate between those at low risk versus high risk for suicidal behavior. Secondly, we aimed to test the incremental predictive power of AS cognitive concerns above and beyond known suicide risk factors (i.e., thwarted belongingness and insomnia). The sample consisted of 106 individuals (75% meeting current criteria for an Axis I disorder) recruited from the community. Results revealed that AS cognitive concerns were a robust predictor of elevated suicide risk after covarying for negative affect, whereas AS social and physical concerns were not. Those with high, relative to low, AS cognitive scores were 3.67 times more likely to be in the high suicide risk group. Moreover, AS cognitive concerns significantly predicted elevated suicide risk above and beyond relevant suicide risk factors. Results of this study add to a growing body of the literature demonstrating a relationship between AS cognitive concerns and increased suicidality. Incorporating AS cognitive concerns amelioration protocols into existing interventions for suicidal behavior may be beneficial.",Oglesby ME.; Capron DW.; Raines AM.; Schmidt NB.,2015.0,10.1016/j.psychres.2014.12.057,0,0,
5076,"Psychosocial stressors, social support and socio-demographic variables as determinants of quality of life of Turkish breast cancer patients","ER RESULTS: It was found that increase of cancer stage triggers a decrease in psychological quality of life (p<0,05); overall global life quality (p<0,001), perceived social support and performance status (p<0,05), all of these being negatively affected by family stressors. The patients with increased social support, better psychological and overall quality of life (p<0,01) and younger age had more physical wellness besides overall quality of life (p<0,05); lower incomes negatively affected overall global life quality (p<0,01) and working at a job decreased the psychological stressors (p<0,05).CONCLUSION: From these results, it can be postulated that psychosocial stressors, social support and some socio-demographic variables mostly affected quality of life of the breast cancer patients.PURPOSE: The aim of the present study was to investigate the effects of psychosocial stressors, social support and socio-demographic variables on quality of life of breast cancer patients. TOOLS AND METHODS: The study was conducted between December 2004 and May 2005 and included 101 patients, treated in the Oncology Departments of Ege and Pamukkale University Hospitals and Denizli State Hospital. Patients' demographic data were collected by questionnaire. The methods used in the interviews were the Rotterdam Symptom Checklist (RSCL), and the Multidimensional Scale of Perceived Social Support (MSPSS), the Karnofsky Performance Status (KPS). Psychosocial stressors were classified according to life events using the DSM-IV multi-axial diagnostic system.","Ogce, F; Ozkan, S; Baltalarli, B",2007.0,,0,0,
5077,Impact of exercise on patients with depression and anxiety,"ER AIMSTo investigate if patients with depressive and/or anxiety disorders can achieve a level of physical activity meeting public health recommendations, increase their physical fitness and quality of life (QoL) through participation in a physical exercise programme.METHODSIn a non-blinded controlled study, 48 patients referred by private psychiatric clinics and private general practices were either treated in an intervention (n=27) or a control group (n=21). The intervention group took part in 20 weeks of group exercise consisting of aerobic training and non-aerobic weight-lifting. All participants were interviewed and tested at baseline, week 20 and at week 32.RESULTSThe intervention group increased in physical activity (120 min/week) and VO(2)max (0.48 ml O(2)/min). The VO(2)max increase was maintained after a 12-week follow-up period. Findings should be conservatively interpreted because of high attrition rate.CONCLUSIONSPatients with anxiety and/or depressive disorders who participated in a structured, supervised exercise programme achieved in accordance with public health recommendations a higher level of physical activity and VO(2)max.CLINICAL IMPLICATIONSThe clinical implications of the study may be a suggestion of offering physical exercise to milder and moderate severe cases of depression and anxiety.BACKGROUNDPersons with common mental disorders are at risk of lowered physical activity.","Oeland, A M; Laessoe, U; Olesen, A V; Munk-J√∏rgensen, P",2010.0,10.3109/08039480903511373,0,0,
5078,Does concurrent drug intake affect the long-term outcome of group cognitive behaviour therapy in panic disorder with or without agoraphobia?,"The present study investigated the impact of pre-existing pharmacotherapy regimes on the long-term outcome of brief intensive group cognitive-behavioural therapy (BIGCBT) in the treatment of panic disorder with or without agoraphobia in 106 patients (74 females). Forty patients were allocated to BIGCBT without medication, 40 to BIGCBT plus anti-anxiety medication, 10 to BIGCBT plus anti-depressant medication and 16 to BIGCBT plus combined anti-anxiety and anti-depressant medications. The mean follow-up period was 3.2 yr and ranged from 1.1 to 6.2 yr. The results demonstrated that patients who received BIGCBT concurrent with pre-existing medication regimes did not differ significantly (P > 0.001) from each other or from patients who underwent BIGCBT without medication on any of the dependent measures either at pre-treatment assessment or long-term follow-up. However, BIGCBT (with or without pharmacotherapy) was associated with significant (P < 0.001) long-term improvements in frequency of panic attacks, avoidance behaviour and questionnaire measures of anxiety, depression and agoraphobia. Furthermore, the large majority (80%) of patients in the BIGCBT without medication group remained medication-free at long-term follow-up. Of those patients who underwent BIGCBT concurrent with pre-existing pharmacotherapy, a large percentage (44%) reported no longer taking medication for their condition at long-term follow-up. Overall, it is concluded that pre-existing medication regimes (anti-anxiety, anti-depressant or combinations of these) do not significantly enhance or detract from the long-term outcome of a BIGCBT program used in the treatment of panic disorder and agoraphobia.",Oei TP.; Llamas M.; Evans L.,1997.0,,0,0,
5079,Changes in quality of life following group CBT for anxiety and depression in a psychiatric outpatient clinic.,"The present study examined the relationship between quality of life and symptom change following group CBT treatment for anxiety or depression in a psychiatric hospital outpatient setting. One hundred seventy seven outpatients undergoing eight sessions of group CBT for anxiety (n = 124) or mood disorders (n = 53) participated. The Beck Anxiety Inventory (BAI), Zung Self-Rating Depression Scale (Zung-SRDS), Quality of Life Inventory (QOLI), and Satisfaction with Life Scale (SWLS) were administered at baseline and post-treatment. Additionally, the QOLI and SWLS scores of those who achieved reliable improvement or clinically significant symptom change were compared to those who experienced no reliable symptom improvement. There were significant changes across the QOLI, SWLS, BAI and Zung-SRDS outcome measures between baseline and post-treatment, with moderate to very large effect sizes observed. Patients with reliable or clinically significant change in their symptoms experienced significant increases in QOLI and SWLS scores when compared to those whose symptoms did not change reliably. Overall, in a psychiatric hospital outpatient setting, group CBT appeared to be successful in increasing quality of life and satisfaction with life in addition to reducing anxiety and depression symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Oei, Tian Po; McAlinden, Niamh May; Barlow, Baune, Beck, Butler, Chambless, DeRubeis, Diener, DuPont, Dwyer, Eng, Eng, Frisch, Frisch, Gillis, Gladis, Grant, Hansson, Heldt, Hirschfeld, Hofmann, Horvath, Jacobson, Katschnig, Kuyken, Luborsky, Martin, McAlinden, McDonagh, McLennan, Messer, Oei, Oei, Oei, Oei, Oei, Oei, Olatunji, Ost, Papakostas, Parabiaghi, Petrocelli, Quilty, Safren, Schneier, Schneier, Sherbourne, Stanley, Stanley, Stewart, Telch, Tucker, Van Noppen, Vittengl, Wampold, Westbrook, Zung",2014.0,,0,0,
5080,"A randomized, controlled pilot study of MDMA (± 3,4-Methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD).","Psychiatrists and psychotherapists in the US (1970s to 1985) and Switzerland (1988-1993) used MDMA legally as a prescription drug, to enhance the effectiveness of psychotherapy. Early reports suggest that it is useful in treating trauma-related disorders. Recently, the first completed pilot study of MDMA-assisted psychotherapy for PTSD yielded encouraging results. Designed to test the safety and efficacy of MDMA-assisted psychotherapy in patients with treatment-resistant PTSD; our randomized, double-blind, active-placebo controlled trial enrolled 12 patients for treatment with either low-dose (25 mg, plus 12.5 mg supplemental dose) or full-dose MDMA (125 mg, plus 62.5 mg supplemental dose). MDMA was administered during three experimental sessions, interspersed with weekly non-drug-based psychotherapy sessions. Outcome measures used were the Clinician-Administered PTSD Scale (CAPS) and the Posttraumatic Diagnostic Scale (PDS). Patients were assessed at baseline, three weeks after the second and third MDMA session (end of treatment), and at the 2-month and 1-year follow-ups. We found that MDMA-assisted psychotherapy can be safely administered in a clinical setting. No drug-related serious adverse events occurred. We did not see statistically significant reductions in CAPS scores (p = 0.066), although there was clinically and statistically significant self-reported (PDS) improvement (p = 0.014). CAPS scores improved further at the 1-year follow-up. In addition, three MDMA sessions were more effective than two (p = 0.016).",Oehen P.; Traber R.; Widmer V.; Schnyder U.,2013.0,10.1177/0269881112464827,0,0,
5081,"A randomized, controlled pilot study of mdma (+/-3,4-methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic post-traumatic stress disorder (PTSD).","Psychiatrists and psychotherapists in the US (1970s to 1985) and Switzerland (1988-1993) used MDMA legally as a prescription drug, to enhance the effectiveness of psychotherapy. Early reports suggest that it is useful in treating trauma-related disorders. Recently, the first completed pilot study of MDMA-assisted psychotherapy for PTSD yielded encouraging results. Designed to test the safety and efficacy of MDMA-assisted psychotherapy in patients with treatment-resistant PTSD; our randomized, double-blind, active-placebo controlled trial enrolled 12 patients for treatment with either low-dose (25 mg, plus 12.5 mg supplemental dose) or full-dose MDMA (125 mg, plus 62.5 mg supplemental dose). MDMA was administered during three experimental sessions, interspersed with weekly non-drug-based psychotherapy sessions. Outcome measures used were the Clinician-Administered PTSD Scale (CAPS) and the Posttraumatic Diagnostic Scale (PDS). Patients were assessed at baseline, three weeks after the second and third MDMA session (end of treatment), and at the 2-month and 1-year follow-ups. We found that MDMA-assisted psychotherapy can be safely administered in a clinical setting. No drug-related serious adverse events occurred. We did not see statistically significant reductions in CAPS scores (p = 0.066), although there was clinically and statistically significant self-reported (PDS) improvement (p = 0.014). CAPS scores improved further at the 1-year follow-up. In addition, three MDMA sessions were more effective than two (p = 0.016). (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Oehen, Peter; Traber, Rafael; Widmer, Verena; Schnyder, Ulrich; Bedi, Benedek, Benzenhoefer, Berkowitz, Bonny, Bouso, Brady, Breslau, Brunner, Brunner, Charuvastra, Cloitre, Davidson, Dumont, Ehlers, Farre, Foa, Foa, Foa, Frewen, Greer, Grob, Harris, Hepp, Hoge, Hysek, Jacobsen, Johansen, Kessler, Landolt, Liechti, Marshall, McFarlane, Metzner, Mithoefer, Mithoefer, Mithoefer, Ogden, Panagioti, Passie, Perkonigg, Rauch, Schnurr, Schnyder, Schnyder, Spitzer, Stein, Tucker, Van Etten, Vollenweider, Weathers, Widmer, Wolff",2013.0,,0,0,
5082,Cognitive behavioural therapy in chronic fatigue syndrome: a randomised controlled trial of an outpatient group programme,"ER DESIGNA double-blind, randomised controlled trial was adopted with three arms. Outcomes were assessed at baseline and 6 and 12 months after first assessment and results were analysed on an intention-to-treat basis.SETTINGA health psychology department for the management of chronic illness in a general hospital in Bristol, UK.PARTICIPANTSAdults with a diagnosis of CFS/ME referred by their GP.INTERVENTIONSThe three interventions were group CBT incorporating graded activity scheduling, education and support group (EAS) and standard medical care (SMC).OUTCOME MEASURESThe primary outcome measure was the Short Form with 36 Items (SF-36) physical and mental health summary scales. Other outcome measures included the Chalder fatigue scale, Hospital Anxiety and Depression Scale, General Health Questionnaire, physical function (shuttles walked, walking speed and perceived fatigue), health utilities index and cognitive function (mood, recall and reaction times).RESULTSA total of 153 patients were recruited to the trial and 52 were randomised to receive CBT, 50 to EAS and 51 to SMC. Twelve patients failed to attend for the 12-month follow-up and 19 patients attended one follow-up, but not both. The sample was found to be representative of the patient group and the characteristics of the three groups were similar at baseline. Three outcome measures, SF-36 mental health score, Chalder fatigue scale and walking speed, showed statistically significant differences between the groups. Patients in the CBT group had significantly higher mental health scores [difference +4.35, 95% confidence interval (CI) +0.72 to +7.97, p = 0.019], less fatigue (difference -2.61, 95%","O'Dowd, H; Gladwell, P; Rogers, C A; Hollinghurst, S; Gregory, A",2006.0,,0,0,
5083,Does access to compensation have an impact on recovery outcomes after injury?,"To conduct a descriptive study investigating the effect of access to motor vehicle accident (MVA) compensation on recovery outcomes at 24 months after injury. Longitudinal cohort study conducted in two Level 1 trauma hospitals in Victoria, Australia. Participants were 391 randomly selected injury patients with moderate-to-severe injuries. Compensable and non-compensable patients were compared at 24 months after injury on a number of health outcomes. Health outcomes at 24 months, including anxiety and depression severity, quality of life and disability. Medical records identified two groups of compensation patients: MVA-compensable and non-compensable patients. After controlling for baseline variables, the MVA-compensable patients, at 24 months, had higher levels of post-traumatic stress disorder, anxiety and depression, and were less likely to have returned to their pre-injury number of work hours. However, some patients in the non-compensable group had accessed other forms of compensation (eg, private health care or compensation for victims of crime). When these were removed from the non-compensable group, the differences between MVA-compensable and non-compensable groups all but disappeared. Our findings do not support previous research showing that access to compensation is associated with poor recovery outcomes. The relationship between access to compensation and health outcomes is complex, and more high-level research is required.",O'Donnell ML.; Creamer MC.; McFarlane AC.; Silove D.; Bryant RA.,2010.0,,0,0,
5084,Ongoing life stressors and suicidal ideation among HIV-infected adults with depression,"ER METHODS: A randomized controlled trial testing the effect of evidence-based decision support for depression treatment on antiretroviral adherence (the SLAM DUNC study) included monthly assessments of incident STLEs, and quarterly assessments of suicidal ideation (SI). We examined the association between STLEs and SI during up to one year of follow-up among 289 Southeastern US-based participants active in the study between 7/1/2011 and 4/1/2014, accounting for time-varying confounding by depressive severity with the use of marginal structural models.RESULTS: Participants were mostly male (70%) and black (62%), with a median age of 45 years, and experienced a mean of 2.36 total STLEs (range: 0-12) and 0.48 severe STLEs (range: 0-3) per month. Every additional STLE was associated with an increase in SI prevalence of 7% (prevalence ratio (PR) (95% confidence interval (CI)): 1.07 (1.00, 1.14)), and every additional severe STLE with an increase in SI prevalence of 19% (RR (95% CI): 1.19 (1.00, 1.42)).LIMITATIONS: There was a substantial amount of missing data and the exposures and outcomes were obtained via self-report; methods were tailored to address these potential limitations.CONCLUSIONS: STLEs were associated with increased SI prevalence, which is an important risk factor for suicide attempts and completions.BACKGROUND: Suicidal ideation is the most proximal risk factor for suicide and can indicate extreme psychological distress; identification of its predictors is important for possible intervention. Depression and stressful or traumatic life events (STLEs), which are more common among HIV-infected individuals than the general population, may serve as triggers for suicidal thoughts.","O'Donnell, J K; Gaynes, B N; Cole, S R; Edmonds, A; Thielman, N M; Quinlivan, E B; Shirey, K; Heine, A D; Modi, R; Pence, B W",2016.0,10.1016/j.jad.2015.09.054,0,0,
5085,Does geriatric evaluation and management improve the health behavior of older veterans in psychological distress?,"A randomized, controlled trial compared prospective 16-month health service use among 160 frail, elderly veterans receiving outpatient geriatric evaluation and management (GEM) or usual primary care (UPC). In this secondary analysis, multivariable regression was used to determine if the psychosocial assessment and support provided by the GEM team moderated the use of medical services by patients in psychological distress. The results indicate that GEM reduced outpatient use among patients who scored higher on a measure of somatization (p less than or equal to .05), but GEM increased outpatient use among patients with higher manifest anxiety (p less than or equal to .05) Psychological distress was not a factor in the use of inpatient services. GEM had a modest beneficial effect on the health behavior of frail older persons manifesting some symptoms of psychological distress.",O'Donnell JC.; Toseland RW.,1997.0,10.1177/089826439700900403,0,0,
5086,[First traumatic anterior shoulder dislocation: postoperative results 6 months and 2 years after arthroscopic stabilization in young patients].,"The purpose of this prospective clinical trial was to report about results of primary or early secondary arthroscopic stabilization after first traumatic anterior dislocation of the shoulder. Within 2 weeks or in the 7th to 12th week post trauma, 51 subjects between 16 and 30 years received arthroscopic stabilization and rehabilitation. The patients were followed-up 6 months and 2 years post operation and assessed with the Rowe and the Constant scores. At a mean follow-up of 27.9+/-4.3 months all patients returned to work in their profession. Of the patients, 79.2% were satisfied with the result of the operation; 91.7% returned to their sports. During the follow-up period five patients (10.4%) suffered redislocation. There was no difference in the result comparing the time of operation. The Rowe and Constant scores showed excellent results. Arthroscopic stabilization after first traumatic anterior shoulder dislocation of the young patient is an appropriate approach and regardless of whether it is performed as a primary or early secondary operation it significantly lowers the redislocation rate. The method leads to quick reintegration into professional life and sports activities.",Odenwald S.; Lemke J.; Bauer GJ.; Mauch F.; Brunner UH.; Krackhard T.,2008.0,10.1007/s00113-008-1443-7,0,0,
5087,"Improving the body image, eating attitudes, and behaviors of young male and female adolescents: a new educational approach that focuses on self-esteem","ER METHODAll 470 eligible students (63% female) aged 11-14 years volunteered to participate. The intervention group students participated in the program, whereas the control group students received their scheduled personal development and health class.RESULTSThe program significantly improved the body satisfaction of the intervention students and significantly changed aspects of their self-esteem; social acceptance, physical appearance, and athletic ability became less important for the intervention students and more important for control students. Female intervention students rated their physical appearance as perceived by others significantly higher than control students and allowed their body weight to increase appropriately by preventing the age increase in weight-losing behaviors of the control students. One year after the intervention, body image and attitude changes were still present. These findings also held for the 116 students (63% females) with low self-esteem and higher anxiety, who were considered at risk for the development of eating disorders. These students also had significantly lower drive for thinness and greater body satisfaction following the intervention and the decreased importance of physical appearance to their self-esteem was present at 12 months. Control at-risk students significantly decreased their body weight, whereas the weight of the intervention at-risk students significantly increased. The intervention program was effective, safe, having no effect on measures of students' anxiety or depression, and was rated highly by students.DISCUSSIONThis is the first controlled educational intervention to successfully improve body image and to produce long-term changes in the attitudes and self-image of young adolescents. This new approach to prevent the development of eating disorders by improving self-esteem may be effective, particularly if reinforced by teachers and family.OBJECTIVEThis study examines the effect of an interactive, school-based, self-esteem education program on the body image and eating attitudes and behaviors of young male and female adolescents following the program and after 12 months.","O'Dea, J A; Abraham, S",2000.0,,0,0,
5088,The effects of mindfulness-based cognitive therapy on depressive symptoms in elderly bereaved people with loss-related distress: A controlled pilot study.,"We examined the effects of mindfulness-based cognitive therapy (MBCT) on symptom severity of depression, complicated grief, posttraumatic stress, and working memory in elderly bereaved people with long-term bereavement-related distress. A non-randomized, controlled pilot design was used in a sample of elderly bereaved people (mean age = 77 years) with long-term bereavement-related distress. Results were compared between MBCT intervention group completers (n = 12), intervention group intention to treat (n = 18), and wait list controls (n = 18) at pre- and post-intervention and at a 5-month follow-up. Compared to wait list controls, MBCT reduced depressive symptoms significantly in intervention completers at follow-up (Hedges' g = 0.84, p = 0.04) with significant interaction between group and time (Hedges' g = 0.88, p = 0.02). No other significant outcome differences between groups were observed, although the interaction effect on working memory at post-intervention approached a significant level (Hedges' g = 0.35, p = 0.09). In the wait list group, 29 % had elevated depressive symptoms both before intervention and at follow-up. In the intervention group, 50 % of the completers had elevated depressive symptoms before intervention, but 0 % had elevated symptoms at follow-up. MBCT appears to reduce depressive symptoms in this sample of elderly bereaved people, but further studies of the effects of MBCT in this population are needed for firm conclusions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","O'Connor, Maja; Piet, Jacob; Hougaard, Esben; Beck, Beck, Beck, Berntsen, Boelen, Bonanno, Bonanno, Carr, Cohen, Didonna, Hansson, Harmer, Hedges, Hoffmann, Ivanovski, Jacobs, Jha, Johanson, Kabat-Zinn, Kumar, Litz, Mollica, Mulsant, O'Connor, Papadatou-Pastou, Piet, Piet, Prigerson, Raphael, Schafer, Segal, Segal, Smith, Splevins, Stroebe, Unverzagt, Wechsler, Williams, Woods, Young, Zeidan",2014.0,,0,0,
5089,Evaluation of a cognitive-behavioural program for the management of chronic tic and habit disorders.,"Evaluated the efficacy of a manualized cognitive-behavioural program based on habit reversal for the management of chronic tic disorder (CTD) and habit disorder (HD). 47 CTD and 43 HD received a 4-mo treatment program. 22 CTD and 16 HD were waitlisted controls, who subsequently received treatment. The treatment approach combined awareness training, relaxation (including modification of a tension-producing style of action), and habit-reversal training, with more general cognitive restructuring of anticipations linked to ticcing. The Social Self-esteem Inventory, the Life Experience Survey, the Speilberger State-trait Anxiety Inventory, the Beck Depressive Inventory, the General Health Questionnaire 12-item version, the Maudsley Obsessional-Compulsive Inventory, and the Eysenck Personality Inventory were administered. 65% of completers reported between 75 and 100% control over the tic. At 2-yr follow-up, 52% rated 75-100% control. There were also significant changes post-treatment in measures of self-esteem, anxiety, depression and style of planning action. Successful tic/habit modification was associated in CTD and HD groups with successful change in style of planning action. There were no consistent differences in any outcome measures between CTD and HD groups. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","O'Connor, K. P; Brault, M; Robillard, S; Loiselle, J; Borgeat, F; Stip, E; Azrin, Azrin, Azrin, Azrin, Beck, Bernstein, Carr, Carr, Christenson, Comings, Eysenck, Frost, Goldberg, Hadley, Harcherik, Hicks, Kay, Kazdin, Lavigne, Lawson, Leckman, Lohr, Marlatt, Miltenberger, Miltenberger, Minichiello, O'Connor, O'Connor, O'Connor, O'Connor, Ost, Peterson, Peterson, Pingitore, Rachman, Rothbaum, Sallee, Sarason, Scotti, Shapiro, Speilberger, Stanley, Woods",2001.0,,0,0,
5090,"Cognitive-behavioural, pharmacological and psychosocial predictors of outcome during tapered discontinuation of benzodiazepine.","Eighty-six participants wishing to stop benzodiazepine and who met DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed. American Psychological Association, 1994) criteria for anxiety disorder or insomnia were assessed pre- and post-taper on clinical, pharmacological and psychosocial measures. An initial cohort of 41 participants received treatment as usual (taper only) plus physician counselling in the same clinic setting. A second cohort of 45 participants were randomly allocated to group cognitive-behavioural therapy (CBT) plus taper, or group support (GS) plus taper. At 3 months follow-up, the outcomes in both the CBT and the GS subgroups were equivalent. Intention to treat analysis revealed a slight advantage to the CBT over the GS group and the CBT group showed higher self-efficacy post-taper.Over all 86 participants, a high-baseline level of psychological distress, anxiety and dosage predicted a poor outcome, but increase in self-efficacy contributed to a successful outcome particularly in those with initially poor baseline predictors. Although there was a decrease in positive affect during preliminary stages of tapered discontinuation compared to baseline, there was no significant overall increase in negative affect.",O'Connor K.; Marchand A.; Brousseau L.; Aardema F.; Mainguy N.; Landry P.; Savard P.; Léveillé C.; Lafrance V.; Boivin S.; Pitre D.; Robillard S.; Bouthillier D.,,10.1002/cpp.556,0,0,
5091,Stress-related thinking predicts the cortisol awakening response and somatic symptoms in healthy adults,"ER OBJECTIVE: Perseverative cognition (i.e., worry, stress-related thinking) may prolong stress-related physiological activation. However, its role within the context of the written emotional disclosure paradigm has not been examined. This study explored: (1) the effects of stress-related thinking on the cortisol awakening response and upper respiratory infection symptoms and; (2) the efficacy of two expressive writing interventions on these health outcomes.METHODS: Participants were randomly assigned to write about their most stressful life experience (using the Guided Disclosure Protocol; n=39) or positive life experiences (n=42) or plans for the day (n=41) for 20 min on 3 consecutive days. Participants reported the extent to which they thought about their assigned writing topic during the study and in the past (event-related thought). Cortisol was measured at 0, 15, 30 and 45 min after awakening on 2 consecutive days at baseline and 4 weeks post-intervention. Upper respiratory infection (URI) symptoms were assessed at baseline, at 4 weeks and at 6 months.RESULTS: Results showed that the writing interventions had no beneficial effects on any of the outcome measures. However, a significant interaction was found between event-related thought and condition on the cortisol awakening response at 1 month follow-up and URI symptoms at 6 months. Among participants who wrote about stressful/traumatic events, higher stress-related thinking during the study predicted increased cortisol levels and URI symptoms compared to participants who reported low stress-related thinking.DISCUSSION: These findings are broadly consistent with Brosschot et al.'s (2006) perseverative cognition hypothesis and highlight the importance of ruminative thinking in understanding stress-health processes.","O'Connor, D B; Walker, S; Hendrickx, H; Talbot, D; Schaefer, A",2013.0,10.1016/j.psyneuen.2012.07.004,0,0,
5092,"Transcranial direct current stimulation of the motor cortex in the treatment of chronic nonspecific low back pain: a randomized, double-blind exploratory study","ER OBJECTIVES: To test the proof of principle that active anodal transcranial direct current stimulation (tDCS) applied to the motor cortex reduces pain significantly more than sham stimulation in a group of participants with chronic nonspecific low back pain.METHODS: The study utilized a within-participants sham-controlled, interrupted time series design. A sample of 8 participants was recruited. After 3 days of baseline measures, patients entered a 15-day experimental period (Mondays to Fridays) for 3 consecutive weeks. During this period each patient received sham stimulation daily until a randomly allocated day when active stimulation was commenced. Active stimulation was then given daily for the remaining days of the experimental period. Both the participants and the assessors were blinded. The primary outcomes were average pain intensity and unpleasantness in the last 24 hours measured using a visual analogue scale. Secondary outcomes included self-reported disability, depression and anxiety, a battery of cognitive tests to monitor for unwanted effects of stimulation, and patients' perceptions of whether they had received active or sham stimulation. Data were analyzed using generalized estimating equations.RESULTS: No significant effect was seen in the primary outcomes between active and sham stimulation (average pain intensity P = 0.821, unpleasantness P = 0.937) or across any other clinical variables. There was evidence that patients may have been able to distinguish between the active and sham conditions (P = 0.035).DISCUSSION: These results do not provide evidence that tDCS is effective in the treatment of chronic back pain. The use of a small convenience sample limits the generalizability of these findings and precludes definitive conclusions on the efficacy of tDCS in chronic nonspecific low back pain.","O'Connell, N E; Cossar, J; Marston, L; Wand, B M; Bunce, D; Souza, L H; Maskill, D W; Sharp, A; Moseley, G L",2013.0,10.1097/AJP.0b013e318247ec09,0,0,
5093,Efficacy of a cognitive-behavioral treatment for insomnia among Afghanistan and Iraq (OEF/OIF) veterans with PTSD.,"Sleep disturbances are a core and salient feature of PTSD and can maintain or exacerbate associated symptoms. Recent research demonstrates that cognitive-behavioral sleep-focused interventions improve sleep disturbances as well as PTSD symptoms. The present study is a randomized controlled trial comparing Cognitive Behavioral Therapy for Insomnia (CBT-I) to a waitlist control group. Conducted at a Veterans Affairs Medical Center, the study: (1) compared subjective outcome measures of sleep amongst veterans assigned to either a treatment group (CBT-I) or a waitlist control group; (2) examined the influence of the intervention on measures of PTSD, general mood and daytime functioning, comparing veterans in a treatment group to those in a waitlist control group and (3) examined the effect of the CBT-I intervention using objective measures of sleep for veterans included in the treatment arm of the study. Study participants were (n = 40) combat veterans who served in Afghanistan and/or Iraq (OEF/OIF). Participants were randomized to either a CBT-I treatment group or a waitlist control group. Those in the treatment condition participated in four CBT-I sessions over six weeks. CBT-I included sleep restriction, stimulus control, cognitive restructuring, sleep education, sleep hygiene and imagery rehearsal therapy. All participants completed subjective and objective measures at baseline and post-treatment. At six weeks post treatment, veterans who participated in CBT-I reported improved sleep, a reduction in PTSD symptom severity and PTSD-related nightmares, as well as a reduction in depression and distressed mood compared to veterans in the waitlist control group. When controlling for current participation in evidence-based PTSD treatment, veterans in the CBT-I group reported a reduction in PTSD symptom severity while their waitlist counterparts demonstrated an increase in these PTSD symptoms. Veterans in the treatment group also reported improved objectively measured sleep quality between baseline and posttreatment. These data suggest that CBT-I is an effective treatment for insomnia, nightmares and PTSD symptoms in OEF/OIF veterans with combat related PTSD and should be used as an adjunctive therapy to standard PTSD treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ochsner Margolies, Skye",2012.0,,0,0,
5094,Things will get better: the anxiety-buffering qualities of progressive hope,"ER Terror management theory argues that people can cope with the psychological threat of their own death by bolstering faith in their cultural worldviews. Based on the notion that-since the Age of Enlightenment-belief or faith in progress has become one of the defining qualities of modern Western thinking, we expected that this belief serves as a buffer against mortality concerns. Three experiments were conducted to test the relationship between existential anxiety and belief in progress. Results of Experiment 1 show that mortality salience increased participants' disagreement with an essay on the illusory notion of human progress. The same essay increased death-thought accessibility in Experiment 2. In Experiment 3, belief in progress and mortality salience were manipulated. Results show that bolstering belief in progress buffered the effects of mortality salience on death-thought accessibility and diminished subsequent defensive reactions to a cultural worldview-threatening essay.","Rutjens, B T; Pligt, J; Harreveld, F",2009.0,10.1177/0146167208331252,0,0,
5095,Negative selectivity effects and emotional selectivity effects in anxiety: Differential attentional correlates of state and trait variables,"There is debate concerning whether anxiety-linked attentional bias represents selective processing of emotional stimuli in general (emotional selectivity), or of negative material specifically (negative selectivity). We hypothesised that emotional selectivity is mediated exclusively by state anxiety, while negative selectivity is interactively mediated by both state and trait anxiety. Negative, positive, and neutral words were presented in an emotional Stroop task to high and low trait anxious students on occasions of low and high state anxiety. With elevations in state anxiety: (1) all participants showed emotional selectivity (greater interference from emotional vs. control words); and (2) high trait anxious, relative to low trait anxious, participants showed negative selectivity (greater interference from negative vs. positive words), supporting our hypothesis. © 2004 Psychology Press Ltd.",Rutherford E.M.; MacLeod C.; Campbell L.W.,2004.0,10.1080/02699930341000121,0,0,
5096,Psychological treatment for obsessive-compulsive disorder in people with autism spectrum disorders-A pilot study.,"High rates of anxiety and mood disorders, and particularly obsessive-compulsive disorder (OCD), have been reported in children and adults with autism spectrum disorders (ASD). Here we report the results of a non-randomized, non-blind controlled trial comparing CBT for OCD with treatment as usual (TAU) in 24 (21 male, 3 female) high-functioning adults with ASD and co-morbid OCD who were referred to our specialist ASD clinic. The main outcome measure was the Yale-Brown Obsessive Compulsive Scale (YBOCS) severity scale. The CBT and TAU groups did not differ with respect to gender, IQ or length of time between symptom measurement, which averaged at 15.9 months (SD = 10.7). The TAU group was significantly older than the CBT group TAU group mean age = 32.1 (SD = 9.8), CBT group mean age = 23.8. Despite the overall success of the intervention, 40% of the participants in the CBT group were not 'treatment responders'. Our sample size was too small to make any meaningful analysis of variables which have been associated with treatment outcome in other studies. With respect to autism-specific factors, theory of mind and executive function impairments might have the potential to affect an individual's ability to participate effectively in psychological treatment for OCD, but this remains to be investigated. Our study had several limitations. Participants were allocated to the 2 treatment arms in a non-random fashion. Changes in medication were introduced at mid-treatment in some cases, although this did not occur disproportionately between the groups and was equally associated with treatment failure and treatment response. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Russell, A. J; Mataix-Cols, D; Anson, M. A. W; Murphy, D. G. M; Foa, Ghaziuddin, Ghazuiddin, Goodman, Goodman, Green, Happe, Kim, Le Couteur, Lindley, Lord, McDougle, Ozonoff, Reaven, Rumsey, Russell, Salkovskis, Sofronoff, South, Szatmari, Tantum, Wechsler",2008.0,,0,0,
5097,Body-oriented therapy in recovery from child sexual abuse: an efficacy study,"ER OBJECTIVETo examine the efficacy and the perceived influence on abuse recovery of body-oriented therapy. Massage therapy served as a relative control condition to address the lack of touch-based comparisons in bodywork research.DESIGNA 2-group, repeated measures design was employed, involving randomization to either body-oriented therapy or massage group, conducted in 8, hour-long sessions by 1 of 4 research clinicians. Statistical and qualitative analysis was employed to provide both empirical and experiential perspectives on the study process.SETTINGParticipants were seen in treatment rooms of a university in the northwestern United States and in clinician's private offices.PARTICIPANTSTwenty-four adult females in psychotherapy for child sexual abuse.INTERVENTIONSBody-oriented therapy protocol was delivered in three stages, involving massage, body awareness exercises, and inner-body focusing process. Massage therapy protocol was standardized. Both protocols were delivered over clothes.MAIN OUTCOME MEASURESThe outcomes reflected 3 key constructs--psychological well being, physical well-being, and body connection. Repeated measures included: Brief Symptom Inventory, Dissociative Experiences Scale, Crime-Related Post Traumatic Stress Disorder Scale, Medical Symptoms Checklist, Scale of Body Connection and Scale of Body Investment. Results were gathered at 6 time points: baseline, 2 times during intervention, post-intervention, and at 1 month and 3 months follow-up, To examine the experiential perspective of the study process, written questionnaires were administered before and after intervention and at 1 month and 3 months follow-up.RESULTSRepeated measures analysis of variance (ANOVA) indicated significant improvement on all outcome measures for both intervention groups, providing support for the efficacy of body therapy in recovery from childhood sexual abuse. There were no statistically significant differences between groups; however, qualitative analysis of open-ended questions about participant intervention experience revealed that the groups differed on perceived experience of the intervention and its influence on therapeutic recovery.CONTEXTThere has been little research on body therapy for women in sexual abuse recovery. This study examines body-oriented therapy--an approach focused on body awareness and involving the combination of bodywork and the emotional processing of psychotherapy.","Price, C",2005.0,,0,0,
5098,[Factor structure and validity of a german version of the barratt impulsiveness scale].,"Impulsive traits are key characteristics in a number of psychiatric disorders and are part of the normal behavior spectrum. The BIS-5 is an instrument developed to assess impulsivity. The aim of this study is to evaluate the BIS-5 in two German psychiatric inpatient samples and healthy controls proving the originally proposed four-factor structure as well as convergent and discriminate validity. 159 alcohol-dependent subjects and 77 suicidal inpatients were recruited in an University psychiatric hospital. 182 healthy subjects were recruited from town community. BIS-5 items were translated and back-translated. Principal component analysis with oblique rotation was conducted in the whole group. Furthermore, the discriminate and convergent validity of the BIS-5 was evaluated by correlation with other instruments measuring impulsive traits and comparing sample subgroups. A two-factor solution could be identified in this German sample. Alcohol-dependent individuals showed significantly higher factor 1 values compared to suicidal patients. The group of suicidal patients had higher scores in factor 2 compared to controls. Factor 1 correlated most significantly with extraversion-related personality traits while factor 2 showed significant relationships with irritability and neuroticism. A two-factor solution may be more appropriate in using the BIS-5 scale in German samples. These two factors might reflect different aspects of impulsive behavior and might be useful to characterize impulsive behavior in psychiatric and non-psychiatric samples.",Preuss UW.; Rujescu D.; Giegling I.; Koller G.; Bottlender M.; Engel RR.; Möller HJ.; Soyka M.,2003.0,10.1055/s-2003-42872,0,0,
5099,"Controlled cross-over study in normal subjects of naloxone-preceding-lactate infusions; respiratory and subjective responses: relationship to endogenous opioid system, suffocation false alarm theory and childhood parental loss","ER METHOD: Randomized cross-over sequences of intravenous naloxone (2 mg/kg) followed by lactate (10 mg/kg), or saline followed by lactate, were given to 25 volunteers. Respiratory physiology was objectively recorded by the LifeShirt. Subjective symptomatology was also recorded.RESULTS: Impairment of the endogenous opioid system by naloxone accentuates TV and symptomatic response to lactate. This interaction is substantially lessened by CPL.CONCLUSIONS: Opioidergic dysregulation may underlie respiratory pathophysiology and suffocation sensitivity in PD. Comparing specific anti-panic medications with ineffective anti-panic agents (e.g. propranolol) can test the specificity of the naloxone+lactate model. A screen for putative anti-panic agents and a new pharmacotherapeutic approach are suggested. Heuristically, the experimental unveiling of the endogenous opioid system impairing effects of CPL and separation in normal adults opens a new experimental, investigatory area.BACKGROUND: The expanded suffocation false alarm theory (SFA) hypothesizes that dysfunction in endogenous opioidergic regulation increases sensitivity to CO2, separation distress and panic attacks. In panic disorder (PD) patients, both spontaneous clinical panics and lactate-induced panics markedly increase tidal volume (TV), whereas normals have a lesser effect, possibly due to their intact endogenous opioid system. We hypothesized that impairing the opioidergic system by naloxone could make normal controls parallel PD patients' response when lactate challenged. Whether actual separations and losses during childhood (childhood parental loss, CPL) affected naloxone-induced respiratory contrasts was explored. Subjective panic-like symptoms were analyzed although pilot work indicated that the subjective aspect of anxious panic was not well modeled by this specific protocol.","Preter, M; Lee, S H; Petkova, E; Vannucci, M; Kim, S; Klein, D F",2011.0,10.1017/S0033291710000838,0,0,
5100,In vivo detection of brain glycine with echo-time-averaged 1H magnetic resonance spectroscopy at 4.0 T,"A single-voxel proton magnetic resonance spectroscopy (1H-MRS) method is described that enables the in vivo measurement of endogenous brain glycine (Gly) levels in human subjects. At 4.0 T, TE-averaging 1H-MRS dramatically attenuates the overlapping myo-inositol (ml) resonances at 3.52 ppm, permitting a more reliable measure of the Gly singlet peak. This methodology initially is described and tested in phantoms. The phantom data infers that the 3.55-ppm peak predominantly is Gly with a smaller contribution from ml. The composite resonance thus is differentiated from pure Gly and ml and is labeled Gly*. The ml contribution was calculated as <2% of the total Gly* signal for a 1:1 ml/Gly mixture. The technique subsequently was used to acquire TE-averaged 1H-MRS data from the occipital cortex of healthy control subjects. The resultant spectra closely resembled experimental phantom data. LC-model analysis provided a means for quantifying TE-averaged 1H-MRS spectra and a mean test-retest variability measure of 15% was established for brain Gly* levels in studies of six healthy subjects. © 2006 Wiley-Liss, Inc.",Prescot A.P.; Frederick B.D.B.; Wang L.; Brown J.; Jensen J.E.; Kaufman M.J.; Renshaw P.F.,2006.0,10.1002/mrm.20807,0,0,
5101,Community based rehabilitation after severe traumatic brain injury: a randomised controlled trial,"ER METHODSA randomised controlled trial compared outreach treatment (mean of two sessions a week for 27.3 (SD 19.1) weeks) in community settings such as participants' homes, day centres, or workplaces, with provision of written information detailing alternative resources. Follow up for an average of 24.8 months after initial allocation was by a blinded independent assessor. Participants were aged 16-65, had sustained severe TBI between 3 months and 20 years previously, and had no other neurological conditions. Of 110 initially allocated, 48 outreach and 46 information participants were successfully followed up. Primary outcome measures (Barthel index (BI) and the brain injury community rehabilitation outcome-39 (BICRO-39)) focused on levels of activity and participation. Secondary measures were the functional independence measure and the functional assessment measure (FIM+FAM) and, in a subgroup of 46 participants, the hospital anxiety and depression scale. Analyses were non-parametric.RESULTSoutreach participants were significantly more likely to show gains on the BI and the BICRO-39 total score and self organisation and psychological wellbeing subscales. There were likewise strong trends (p<0.10) for BICRO personal care and mobility, and on the FIM+FAM for personal care and cognitive functions. Differential improvements were not seen for indices of socializing, productive employment, anxiety, or depression. Median changes on individual subscales were small, reflecting the diversity of the clinical population; however, 40% of outreach but only 20% of information participants made a clinically significant improvement of 2+ points on at least one BICRO-39 scale. Time since injury was unrelated to the magnitude of gains.CONCLUSIONSThis is the first RCT of multidisciplinary community rehabilitation after severe TBI, and suggests that even years after injury it can yield benefits which outlive the active treatment period.OBJECTIVEEvaluation of multidisciplinary community based outreach rehabilitation after severe traumatic brain injury (TBI).","Powell, J; Heslin, J; Greenwood, R",2002.0,,0,0,
5102,Effectiveness of a web-based cognitive-behavioral tool to improve mental well-being in the general population: randomized controlled trial.,"Interventions to promote mental well-being can bring benefits to the individual and to society. The Internet can facilitate the large-scale and low-cost delivery of individually targeted health promoting interventions. To evaluate the effectiveness of a self-directed Internet-delivered cognitive-behavioral skills training tool in improving mental well-being in a population sample. This was a randomized trial with a waiting-list control. Using advertisements on a national health portal and through its mailing list, we recruited 3070 participants aged 18 or over, resident in England, and willing to give their email address and access a fully automated Web-based intervention. The intervention (MoodGYM) consisted of 5 interactive modules that teach cognitive-behavioral principles. Participants in the intervention arm received weekly email reminders to access the intervention. The control group received access to the intervention after the trial was completed and received no specific intervention or email reminders. Outcomes were assessed by using self-completion questionnaires. The primary outcome was mental well-being measured with the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Secondary outcomes were Center for Epidemiologic Studies Depression scale (CES-D) depression scores, Generalized Anxiety Disorder 7-item scale (GAD-7) anxiety scores, EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D) quality of life scores, physical activity, and health service use. All outcomes were measured at baseline, and at 6- and 12-week follow-ups. A total of 1529 (49.80%) participants completed final follow-up at 12 weeks. Retention was 73.11% (1123/1536) in the control arm and 26.47% (406/1534) in the intervention arm. No relationship between baseline measures and withdrawal could be established. The analysis of WEMWBS mental well-being scores using a linear mixed model for repeated measures showed no difference between intervention and control group at baseline (difference -0.124 points, 95% CI -0.814 to 0.566), and significant improvements for the intervention group at 6 weeks (2.542 points, 95% CI 1.693-3.390) and at 12 weeks (2.876 points, 95% CI 1.933-3.819). The model showed a highly significant (P<.001) intervention by time interaction effect. There were also significant improvements in self-rated scores of depression and anxiety. Given the high level of attrition, a sensitivity analysis with imputed missing values was undertaken that also showed a significant positive effect of the intervention. Participants allocated to the intervention arm had an average increase of approximately 3 points on the WEMWBS scale compared to no increase for participants in the control group. Three points on this scale is approximately one-third of a standard deviation. In a low-cost automated intervention designed to shift the population distribution of mental well-being, a small difference per individual could yield a major benefit in population terms. In common with other Web-based interventions, there were high rates of attrition. Further work is needed to improve acceptability, to evaluate against placebo effect, and to disaggregate the effect on mental well-being from the effect on depression and anxiety. International Standard Randomised Controlled Trial Number Register ISRCTN 48134476; http://www.controlled-trials.com/ISRCTN48134476 (Archived by WebCite® at http://www.webcitation.org/6DFgW2p3Q).",Powell J.; Hamborg T.; Stallard N.; Burls A.; McSorley J.; Bennett K.; Griffiths KM.; Christensen H.,2012.0,10.2196/jmir.2240,0,0,
5103,Subjective craving for opiates: evaluation of a cue exposure protocol for use with detoxified opiate addicts,"ER Cue exposure has been advocated as an intervention for reducing relapse rates in detoxified addicts, by extinguishing classically conditioned drug effects/craving which may have developed. Several studies with alcoholics have found cue exposure to be associated with reductions in craving, but no controlled study has yet shown such an effect in opiate addicts. The present controlled group design evaluates a protocol which draws from experience in the treatment of anxiety and requires that each stimulus exposure should be continued until within-session habituation has occurred. It also explores whether there is any benefit of using a 'cognitive aversion' strategy during cue exposure, based on the social learning analysis that craving derives from expectancies of positive drug effects. A total of 21 detoxified in-patients were randomized to routine ward treatment plus two sessions of either cue exposure (Group E) or cue exposure and cognitive aversion (Group E/CA), or to routine treatment alone (Group C). A specially designed Craving Test was carried out before and after treatment, to assess change in cue-elicited reactions. The two treated groups showed significantly greater reductions in craving than Group C, but did not differ from each other. The cue exposure protocol has therefore been adopted for use in an ongoing clinical trial.","Powell, J; Gray, J; Bradley, B",1993.0,,0,0,
5104,Combat and social support as variables in perceived symptomatology of combat-related posttraumatic stress disorder.,"This study used an analog approach to the perceptions of tour of duty, combat and noncombat, and levels of social support, high and low. Their influence was assessed in the symptomatology of Posttraumatic Stress Disorder. 80 subjects were randomly assigned to read one of four vignettes depicting levels of combat and social support as main effects. Results were congruent with recent research indicating significant main effects for combat and social support in the symptomatology of Posttraumatic Stress Disorder.",Powell GJ.; Doan RE.,1992.0,10.2466/pr0.1992.70.3c.1187,0,0,
5105,Behavioral treatment of debilitating test anxiety among medical students.,"This article presents and illustrates the behavioral treatment of medical students and physicians whose debilitating test anxiety was associated with their failure to pass the United States Medical Licensing Examination (USMLE) or a specialty board test. Seventy-two medical trainees were treated consecutively because of at least one failure to pass these professional examinations. Behavioral treatment focused on their anxiety, which resulted in the ""dual deficits"" of poor test preparation, poor test performance, or both. Treatment featured progressive muscle relaxation, systematic desensitization, the self-control triad, behavioral rehearsal, and a psychoeducational component. Ninety-three percent of the clients eventually passed the examination while in treatment. Pass rates for this group were substantially higher than the national average for repeat USMLE test takers. Limitations of this treatment method are that it seemed too elaborate for some medical trainees and was less effective with those who had difficulty evoking anxiety.",Powell DH.,2004.0,10.1002/jclp.20043,0,0,
5106,Daily Life Stress and the Cortisol Awakening Response: Testing the Anticipation Hypothesis,"The cortisol awakening response (CAR) is a distinct facet of the circadian cortisol rhythm associated with various health conditions and risk factors. It has repeatedly been suggested that the CAR could be a result of the anticipated demands of the upcoming day (stress anticipation) and could support coping with daily life stress. In a sample of 23 healthy participants CARs were assessed on two consecutive days by measures of salivary cortisol upon awakening (S1) and 30 and 45 minutes later, which were aggregated to the area under the curve increase (AUCI). Stress anticipation was assessed immediately after awakening. On the same days, daily life stress and distress were assessed six times per day based on a quasi-randomized design using handheld computers. Associations were tested by day using regression analysis and standard multilevel/mixed effects models for longitudinal data. The CAR AUCI moderated the effect of daily life stress on distress; higher CAR increases were associated with attenuated distress responses to daily life stress on both days (day 1: p =. 039; day 2: p =. 004) adjusted for age, gender, sleep quality, time of awakening and oral contraceptive use. Lagged-effects and redundancy models showed that this effect was not due to prior-day CAR increases but specific for same day CARs. On day 2, associations between daily life stress and distress were stronger when individuals showed a higher S1 cortisol level, but this effect was similar for S1 on day 1, and the day 2 effect of S1 became non-significant when S1 on day 1 was controlled. No associations were found between stress anticipation and CARs. Findings indicate that the CAR increase is associated with successful coping with same-day daily life stress. © 2012 Powell, Schlotz.",Powell D.J.; Schlotz W.,2012.0,10.1371/journal.pone.0052067,0,0,
5107,"A double-blind, placebo-controlled study of nortriptyline and bromocriptine in male alcoholics subtyped by comorbid psychiatric disorders","ER This double-blind, placebo-controlled, 6-month follow-up treatment study investigated the efficacy of bromocriptine and nortriptyline in attenuating drinking behavior and psychiatric symptoms in 216 male alcoholic patients subtyped by comorbid psychiatric disorder(s). Three well-defined subtypes were examined: alcoholism only, alcoholism + affective/anxiety disorder, and alcoholism + antisocial personality disorder. It was hypothesized that both medications would relieve negative affective symptoms associated with alcohol use and would be particularly effective for the affective/anxiety subgroup. Contrary to our predictions, the only significant effects found were with the antisocial personality disorder patients who were receiving nortriptyline. One interpretation of the results was that nortriptyline may have reduced impulsive drinking in the antisocial personality disorder subgroup by actions on serotonergic neurotransmission.","Powell, B J; Campbell, J L; Landon, J F; Liskow, B I; Thomas, H M; Nickel, E J; Dale, T M; Penick, E C; Samuelson, S D; Lacoursiere, R B",1995.0,,0,0,
5108,Brief intervention effective in reducing weight bias in medical students.,"Medical students are exposed to a growing number of obese patients in clinical encounters. Many medical students harbor negative attitudes and stereotypes regarding obese patients, which lead to negative interpersonal behaviors. This study pilot tested the effectiveness of an educational intervention in reducing bias toward obese patients. Second- and third-year medical students (n=64) watched a 17- minute video, ""Weight Bias in Health Care,"" and participated in interactive discussion to share experiences with encountering obese patients. The Beliefs About Obese Persons (BAOP), Attitudes Toward Obese Persons (ATOP), and Fat Phobia Scales (FPS) were administered before and after intervention. Change in mean scores from before to after the intervention was tested for statistical significance using the paired samples t test. General linear models were used to examine associations of subject characteristics with mean scores for each scale. The intervention increased beliefs that genetic and environmental factors play an important role in the cause of obesity as opposed to lack of personal control (mean BAOP increased from 16.53 to 19.27). It also decreased students' negative stereotypes regarding obese patients (mean FPS decreased from 3.65 to 3.45). There were independent associations of subject characteristics with post-intervention ATOP scores, with more positive attitudes in younger, male, and white participants. Implementing a short educational intervention was effective in improving medical students' beliefs and stereotypes regarding obese patients. This widely accessible and easily replicable program can serve as a model and springboard for further development of educational interventions to reduce weight bias among medical students.",Poustchi Y.; Saks NS.; Piasecki AK.; Hahn KA.; Ferrante JM.,2013.0,,0,0,
5109,Validation of the French Version of the Brief Pain Inventory in Canadian Veterans Suffering from Traumatic Stress,"Although pain is a significant clinical problem in individuals suffering from post-traumatic stress disorder (PTSD), reliable and valid measures of pain for this population are lacking. The goal of this study was to validate the Brief Pain Inventory (BPI) in French-speaking veterans suffering from PTSD (n = 130). We administered the BPI, as well as measures of PTSD, health status, quality of life, and social desirability, to veterans being assessed or treated for PTSD at a Veterans Affairs Canada clinic. The BPI showed strong internal consistency, as evidenced by Cronbach's alphas of 0.90 and 0.92 for the severity and interference subscales, respectively. Similar to previous findings, a two-factor structure (pain severity and pain interference) was found using an exploratory factor analysis. The two factors explained nearly 73% of the variance of the instrument. The BPI was also strongly correlated with health status and quality of life in the physical domain. In this veteran sample, nearly 87% of the veterans suffered from significant current pain. Veterans in our sample reported rates of pain severity that were similar to or higher than most of those reported by cancer patients and others with significant physical disability/illness. Overall, the French version of the BPI is a reliable, valid measure of pain in PTSD-suffering populations. Pain is a major issue in veterans with PTSD, and should be screened for with instruments such as the BPI. © 2007 U.S. Cancer Pain Relief Committee.",Poundja J.; Fikretoglu D.; Guay S.; Brunet A.,2007.0,10.1016/j.jpainsymman.2006.09.031,0,0,
5110,"Randomised, waiting list controlled trial of cognitive-behavioural therapy for persistent postconcussional symptoms after predominantly mild-moderate traumatic brain injury.","Persistent postconcussional symptoms (PCS) can be a source of distress and disability following traumatic brain injury (TBI). Such symptoms have been viewed as difficult to treat but may be amenable to psychological approaches such as cognitive-behavioural therapy (CBT). To evaluate the effectiveness of a 12-session individualised, formulation-based CBT programme. Two-centre randomised waiting list controlled trial with 46 adults with persistent PCS after predominantly mild-to-moderate TBI (52% with post-traumatic amnesia (PTA)≤24 hours), but including some with severe TBIs (20% with PTA>7 days). Improvements associated with CBT were found on the primary outcome measures relating to quality of life (using the Quality of Life Assessment Schedule and the Brain Injury Community Rehabilitation Outcome Scale). Treatment effects after covarying for treatment duration were also found for PCS and several secondary outcomes, including measures of anxiety and fatigue (but not depression or post-traumatic stress disorder (PTSD)). Improvements were more apparent for those completing CBT sessions over a shorter period of time, but were unrelated to medicolegal status, injury severity or length of time since injury. This study suggests that CBT can improve quality of life for adults with persistent PCS and potentially reduce symptoms for some, in the context of outpatient brain injury rehabilitation services. ISRCTN49540320.",Potter SD.; Brown RG.; Fleminger S.,2016.0,10.1136/jnnp-2015-312838,0,0,
5111,Cognitive behavioural therapy for persistent PCS: Preliminary results from a randomised control trial,"Objectives: Whilst the nature of persistent postconcussional symptoms (PCS) continues to provoke debate, research around treatment remains limited. Psychological interventions have largely been focussed on prophylaxis after mild traumatic Brain Injury (MTBI), typically involving brief psychoeducational approaches in the first few days after injury. Although the results of these early intervention studies are broadly positive, individuals with persistent symptoms have traditionally been seen as “difficult to treat. Nonetheless, a number of biopsychosocial models for persistent symptoms have been presented (e.g. Lishman, 1988; Kay, 1993; Wood, 2004), which emphasise that individuals may find themselves in a variety of vicious cycles that maintain postconcussional symptoms over time. Cognitive-behavioural therapy (CBT) appears well-placed to address many of these issues, both in addressing significant co-morbid or overlapping psychiatric diagnoses, and in more idiosyncratic modifications tailored to PCS. Method: CBT for persistent PCS was evaluated in a pilot randomised waiting list-controlled trial (ISRCTN 49540320). Individuals were identified from two out-patient Brain Injury services in north and south London in the UK. After an initial assessment (typically including both neuropsychiatric and neuropsychological components) individuals with persistent postconcussional symptoms were randomised between an active treatment arm (consisting of 12 sessions of cognitive behavioural therapy) and a four month waiting-list control group. Symptoms were required to meet ICD-10 criteria for postconcussional disorder, and to have been present for at least six months post-injury. Individuals were also required to have sustained an injury meeting at least ACRM criteria for MTBI, although individuals with more severe injuries (e.g. posttraumatic amnesias longer than 24 hours) were not excluded. Outcomes were assessed using a number of selfreport questionnaires. Primary outcome measures focussed on more general postconcussional symptoms (RPQ) and quality of life (BICRO; QOLAS). Secondary outcome measures included indices of anxiety and depression (HADS), PTSD (IES-R), fatigue (CIS-20R) and irritability (STAXI-2). Results: 46 individuals (25 men, 21 women) were seen as part of the trial. The majority (52%) had sustained mild TBIs with posttraumatic amnesia of less than 24 hours. A significant number were experiencing chronic symptoms: 46% had sustained their injuries at least 2 years before entering the trial. 72% had been or were involved in ongoing medicolegal claims. Preliminary results from the T1 (baseline) and T2 (post-treatment for the active treatment group, postwaiting list for the control) outcome measures will be reported from the end of this phase of the trial (anticipated to be November 2009). Conclusions: [n/a].",Potter S.; Fleminger S.; Brown R.,2010.0,10.3109/02699051003648227,0,0,
5112,"Ego Identity, Social Anxiety, Social Support, and Self-Concealment in Lesbian, Gay, and Bisexual Individuals","This study examined a model in which the relationship between social anxiety and two dimensions of ego identity (commitment and exploration) was expected to be mediated by social support and self-concealment for a sample of lesbian, gay, and bisexual individuals (N = 347). Statistically significant paths were found from social anxiety to social support and self-concealment. Statistically significant paths were also found from social support to commitment, exploration, and self-concealment. There were no significant paths from social anxiety to commitment or exploration. Structural equation analyses and bootstrap procedures revealed support for the potential mediational role of social support in the association between social anxiety and the two dimensions of ego identity as well as in the link between social anxiety and self-concealment. © 2007 American Psychological Association.",Potoczniak D.J.; Aldea M.A.; DeBlaere C.,2007.0,10.1037/0022-0167.54.4.447,0,0,
5113,Effect of virtual reality exposure therapy on social participation in people with a psychotic disorder (VRETp): study protocol for a randomized controlled trial.,"Many patients with a psychotic disorder participate poorly in society. When psychotic disorders are in partial remission, feelings of paranoia, delusions of reference, social anxiety and self-stigmatization often remain at diminished severity and may lead to avoidance of places and people. Virtual reality exposure therapy (VRET) is an evidence-based treatment for several anxiety disorders. For patients with a psychotic disorder, the VRETp was developed to help them experience exposure to feared social situations. The present study aims to investigate the effects of VRETp on social participation in real life among patients with a psychotic disorder. The study is a single-blind randomized controlled trial with two conditions: the active condition, in which participants receive the virtual reality treatment together with treatment as usual (TAU), and the waiting list condition, in which participants receive TAU only. The two groups are compared at baseline, at 3 months posttreatment and at 6 months follow-up. All participants on the waiting list are also offered the virtual reality treatment after the follow-up measurements are completed. The primary outcome is social participation. Secondary outcomes are quality of life, interaction anxiety, depression and social functioning in general. Moderator and mediator analyses are conducted with stigma, cognitive schemata, cognitive biases, medication adherence, simulator sickness and presence in virtual reality. If effective, a cost-effectiveness analysis will be conducted. Results from the posttreatment measurement can be considered strong empirical indicators of the effectiveness of VRETp. The 6-month follow-up data may provide reliable documentation of the long-term effects of the treatment on the outcome variables. Data from pre-treatment and mid-treatment can be used to reveal possible pathways of change. Current Controlled Trials: ISRCTN12929657 . Date of registration: 8 September 2015.",Pot-Kolder R.; Veling W.; Geraets C.; van der Gaag M.,2016.0,10.1186/s13063-015-1140-0,0,0,
5114,An evaluation of bimedial leucotomy.,,Post F.; Rees WL.; Schurr PH.,1968.0,,0,0,
5115,Using PTSD Coach in primary care with and without clinician support: A pilot randomized controlled trial.,"Objective: This study aims to evaluate the feasibility and potential effectiveness of two approaches to using the PTSD Coach mobile application in primary care: Self-Managed PTSD Coach and Clinician-Supported PTSD Coach. This study also aims to gather preliminary data to investigate if clinician support improves the benefits of using PTSD Coach on posttraumatic stress disorder (PTSD) severity and specialty mental healthcare utilization. Method: Twenty primary care veterans with PTSD symptoms were randomized to either Self-Managed PTSD Coach consisting of one 10-min session providing instructions for application use or Clinician-Supported PTSD Coach consisting of four 20-min sessions focused on setting symptom reduction goals and helping veterans fully engage with application content. Results: Research procedures and intervention conditions appear feasible as indicated by high rates of assessment and intervention retention and high clinician fidelity and satisfaction. Both treatments resulted in reductions in PTSD symptoms, with 7 Clinician-Supported PTSD Coach and 3 Self-Managed PTSD Coach participants reporting clinically significant improvements. Clinician-Supported PTSD Coach resulted in more specialty PTSD care use postintervention and possibly greater reductions in PTSD symptoms. Conclusions: Both PTSD Coach interventions are feasible and potentially helpful. The addition of clinician support appears to increase the effectiveness of self-management alone. A larger-scale randomized controlled trial is warranted to confirm these encouraging preliminary findings. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Possemato, Kyle; Kuhn, Eric; Johnson, Emily; Hoffman, Julia E; Owen, Jason E; Kanuri, Nitya; De Stefano, Leigha; Brooks, Emily; Davis, Eysenbach, Frueh, Gillock, Hankin, Hirai, Hoffman, Kroenke, Kuhn, Leon, Magruder, Miner, Mohr, Murphy, Newman, Pearson, Possemato, Possemato, Prins, Rauch, Smith, Spoont, Stein, Vogt, Weathers",2016.0,,0,0,
5116,A brief self-guided telehealth intervention for post-traumatic stress disorder in combat veterans: a pilot study.,"To engage more US combat veterans in PTSD treatment, we offered a psychological intervention that could be initiated in primary care and completed using the Internet. Participants (n = 31) were randomized to complete either Written Emotional Disclosure (WED) or time management narratives on a secure Internet website. In the WED group, participants wrote about their thoughts and emotions regarding one traumatic combat experience in three 20-min sessions. Writing instructions encouraged exposure to traumatic memories and cognitive processing of trauma. The intervention was found to be feasible and safe to implement. Although follow-up assessments did not reveal significant group differences in PTSD symptoms, half of the WED participants reported symptom reductions. Content analyses revealed that participants who expressed more emotion and cognitions were significantly more likely to experience decreased PTSD symptoms. WED may have promise as a brief intervention for veterans with PTSD.",Possemato K.; Ouimette P.; Knowlton P.,2011.0,10.1258/jtt.2011.100909,0,0,
5117,Using PTSD Coach in primary care with and without clinician support: a pilot randomized controlled trial.,"This study aims to evaluate the feasibility and potential effectiveness of two approaches to using the PTSD Coach mobile application in primary care: Self-Managed PTSD Coach and Clinician-Supported PTSD Coach. This study also aims to gather preliminary data to investigate if clinician support improves the benefits of using PTSD Coach on posttraumatic stress disorder (PTSD) severity and specialty mental healthcare utilization. Twenty primary care veterans with PTSD symptoms were randomized to either Self-Managed PTSD Coach consisting of one 10-min session providing instructions for application use or Clinician-Supported PTSD Coach consisting of four 20-min sessions focused on setting symptom reduction goals and helping veterans fully engage with application content. Research procedures and intervention conditions appear feasible as indicated by high rates of assessment and intervention retention and high clinician fidelity and satisfaction. Both treatments resulted in reductions in PTSD symptoms, with 7 Clinician-Supported PTSD Coach and 3 Self-Managed PTSD Coach participants reporting clinically significant improvements. Clinician-Supported PTSD Coach resulted in more specialty PTSD care use postintervention and possibly greater reductions in PTSD symptoms. Both PTSD Coach interventions are feasible and potentially helpful. The addition of clinician support appears to increase the effectiveness of self-management alone. A larger-scale randomized controlled trial is warranted to confirm these encouraging preliminary findings.",Possemato K.; Kuhn E.; Johnson E.; Hoffman JE.; Owen JE.; Kanuri N.; De Stefano L.; Brooks E.,,10.1016/j.genhosppsych.2015.09.005,0,0,
5118,Caregiver-assisted coping skills training for lung cancer: results of a randomized clinical trial,"ER OBJECTIVESThis study tested the efficacy of a caregiver-assisted CST protocol in a sample of patients with lung cancer.METHODSTwo hundred thirty-three lung cancer patients and their caregivers were randomly assigned to receive 14 telephone-based sessions of either caregiver-assisted CST or education/support involving the caregiver. Patients completed measures assessing pain, psychological distress, quality of life (QOL), and self-efficacy for symptom management; caregivers completed measures assessing psychological distress, caregiver strain, and self-efficacy for helping the patient manage symptoms.RESULTSPatients in both treatment conditions showed improvements in pain, depression, QOL, and self-efficacy, and caregivers in both conditions showed improvements in anxiety and self-efficacy from baseline to four-month follow-up. Results of exploratory analyses suggested that the CST intervention was more beneficial to patients/caregivers with Stage II and III cancers, whereas the education/support intervention was more beneficial to patients/caregivers with Stage I cancer.CONCLUSIONTaken together with the broader literature in this area, results from this study suggest that psychosocial interventions can lead to improvements in a range of outcomes for cancer patients. Suggestions for future studies include the use of three-group designs (e.g., comparing two active interventions with a standard-care control) and examining mechanisms of change.CONTEXTLung cancer is one of the most common cancers in the United States and is associated with high levels of symptoms, including pain, fatigue, shortness of breath, and psychological distress. Caregivers and patients are adversely affected. However, previous studies of coping skills training (CST) interventions have not been tested in patients with lung cancer nor have systematically included caregivers.","Porter, L S; Keefe, F J; Garst, J; Baucom, D H; McBride, C M; McKee, D C; Sutton, L; Carson, K; Knowles, V; Rumble, M; Scipio, C",2011.0,10.1016/j.jpainsymman.2010.04.014,0,0,
5119,"Prolonged exposure, paroxetine and the combination in the treatment of PTSD following a motor vehicle accident. A randomized clinical trial - The ""TRAKT"" study.","Little is known about direct comparisons of the efficacy of trauma-focused psychotherapies and SSRIs. This is the first randomized clinical trial comparing the efficacy of prolonged exposure (PE), paroxetine (Ph) and their combination (Comb) in a sample of adults diagnosed with PTSD following motor vehicle accidents (MVA). A total of 228 people were randomly assigned to a twelve-week treatment of PE (N = 114), Ph (N = 57) or Comb (N = 57). The ITT analyses showed that the remission rate of PTSD was significantly greater after PE (65.5%) compared with Ph (43.3%), whereas Comb (51.2%) did not differ from either. The differences in dropout rates were not significant between treatments (18.4% - PE; 12.2% - Ph; 22.8% - Comb), while the differences in numbers of refusers were significant (3.5% PE <31.6% Comb <47.4% Ph; p < .01). The changes in self-rated PTSD were significant for each treatment and without significant differences between treatments. Differences between clinician and self-rated outcomes can be explained by depressive symptoms influencing self-rating by the PDS. At a 12 month follow-up treatment results were maintained and different trajectories of functioning were identified. Larger samples would allow analyses of predictors of treatment response, dropout and refusal. In this, largest to date study comparing PE, paroxetine and combination treatment in PTSD PE was more effective than Ph in achieving remission of PTSD. The additive effect of Comb over any monotherapy was not shown.",Popiel A.; Zawadzki B.; Pragłowska E.; Teichman Y.,2015.0,10.1016/j.jbtep.2015.01.002,0,0,
5120,Anxiety and speech in the initial interview,,"Pope, B; Siegman, A W",1970.0,,0,0,
5121,Influence of personalized therapeutic approach on quality of life and psychiatric comorbidity in patients with advanced colonic cancer requiring palliative care,"ER Personalized medical care has been consistently proven in literature as contributing to the maintenance of psychological balance and quality of life in patients suffering from chronic conditions. However, limited research has investigated the role of personalized approach in improving these parameters in patients with advanced incurable diseases. The scope of this paper was to investigate the possible impact of personalized care condition in advanced colon cancer patients, requiring palliative care. 60 patients (32 M, 28 F) (mean age 64.6) suffering from this disease were randomly assigned to a standard or to a personalized care condition. The latest implied (a) frequent (at least 2 monthly) meetings with the doctor, (b) possibility to be involved in treatment decisions, (c) more information given about diagnosis and prognosis and (d) psychological support provided to the patient and his/her family members, to deal better with daily problems and needs. The design of the study was prospective and consisted of two successive evaluations of quality of life (SF-36 questionnaire) and anxiety and depression (HAD test). Cancer patients pertaining to the personalized treatment approach had both superior quality of life scores (p < 0.05) and lower anxiety (p < 0,01) and depression (p < 0.05) than the control group. A more detailed analysis showed significant differences of vitality and social functioning for subjects pertaining to the study group (p < 0.05), as well as a lower ratio between latent and manifest anxiety (p < 0,01). These results argue in favor of the benefits of a personalized treatment approach for patients with advanced incurable diseases.","Popa-Velea, O; Cernat, B; Tambu, A",2010.0,,0,0,
5122,Distinct panicogenic activity of sodium lactate and cholecystokinin tetrapeptide in patients with panic disorder,"ER BACKGROUND: The validity of experimentally induced panic attacks as a model to study the pathophysiology of panic disorder has been questioned. Unspecific, unpleasant and aversive effects as well as specific patterns of psychovegetative symptoms pointing to different subtypes of panic disorder patients have been observed. These findings raise the question of challenge paradigms as a valuable tool to identify different vulnerabilities in patients with panic disorder.METHODS: We compared the two most widely studied panicogenic drugs sodium lactate and cholecystokinine tetrapeptide (CCK-4) with placebo in 25 patients with panic disorder and matched healthy control subjects. Psychophysiological changes were measured using the Acute Panic Inventory (API) and visual analogue scales for anxiety and arousal.RESULTS: In patients with panic disorder 18 out of 25 experienced a sodium lactate- or a CCK-4 induced panic attack. Lactate or CCK-4 induced symptoms and induced panic attacks were only correlated in healthy controls, but not in patients with panic disorder.CONCLUSION: The mechanisms of lactate and CCK-4 induced panic attacks are distinct in panic disorder patients but not in healthy controls. Different neurobiological vulnerabilities may be uncovered by different challenges.","Plag, J; Gaudlitz, K; Zschucke, E; Yassouridis, A; Pyrkosch, L; Wittmann, A; Holsboer, F; Ströhle, A",2012.0,,0,0,
5123,Effect of combined cognitive-behavioural therapy and endurance training on cortisol and salivary alpha-amylase in panic disorder.,"Current data point to an alteration of both the hypothalamo-pituitary-adrenal (HPA)-system and the peripheral transmission of catecholamines in anxiety disorders. There is also some evidence for the effect of several components of cognitive-behavioural interventions such as coping and control and for an effect of exercise training on the neuroendocrine stress response in healthy subjects as well as patients suffering from distinct (mental) disorders. This double-blind, controlled study investigated the effect of cognitive-behavioural therapy (CBT) in combination with either high-level endurance training or low-level exercise on salivary cortisol (sC) and on levels of salivary alpha-amylase (sAA) in patients suffering from panic disorder (PD) with and without agoraphobia. In comparison to the low-level exercise condition, there were significantly lower sC-levels in the experimental group performing high-level endurance training at a 7-month follow-up. In contrast, there were no group differences in sAA levels during the study period. In this trial, we found evidence for a decelerated effect of endurance-training on HPA-system's functioning in PD. Further studies addressing the alteration of sAA levels in this population might investigate physical exercise different in intensity and duration.",Plag J.; Gaudlitz K.; Schumacher S.; Dimeo F.; Bobbert T.; Kirschbaum C.; Ströhle A.,2014.0,10.1016/j.jpsychires.2014.07.008,0,0,
5124,Increased perceived stress is associated with blunted hedonic capacity: Potential implications for depression research,"Preclinical studies suggest that stress exerts depressogenic effects by impairing hedonic capacity; in humans, however, the precise mechanisms linking stress and depression are largely unknown. As an initial step towards better understanding the association between stress and anhedonia, the present study tested, in two independent samples, whether individuals reporting elevated stress exhibit decreased hedonic capacity. The Perceived Stress Scale (PSS) measured the degree to which participants appraised their daily life as unpredictable, uncontrollable, and overwhelming. Hedonic capacity was objectively assessed using a signal-detection task based on a differential reinforcement schedule. Decreased reward responsiveness (i.e., the participants' propensity to modulate behavior as a function of reward) was used as an operational measure of hedonic capacity. In both Study 1 (n=88) and Study 2 (n=80), participants with high PSS scores displayed blunted reward responsiveness and reported elevated anhedonic symptoms. Additionally, PSS scores predicted reduced reward responsiveness even after controlling for general distress and anxiety symptoms. These findings are consistent with preclinical data highlighting links between stress and anhedonia, and offer promising insights into potential mechanisms linking stress to depression. © 2007 Elsevier Ltd. All rights reserved.",Pizzagalli D.A.; Bogdan R.; Ratner K.G.; Jahn A.L.,2007.0,10.1016/j.brat.2007.07.013,0,0,
5125,Treatment with thyrotropin-releasing hormone (TRH) in patients with traumatic spinal cord injuries,"ER Numerous preclinical studies have demonstrated that posttraumatic treatment of spinal cord injury (SCI) with thyrotropin-releasing hormone (TRH) or TRH analogs improves long-term behavioral recovery. The purpose of the present study is to provide preliminary data regarding the safety and potential efficacy of TRH in patients with acute SCI. A total of 20 patients with SCI were classified by clinical examination into complete and incomplete injury groups within 12 h of trauma and randomly assigned in double-blinded fashion to treatment with either TRH (0.2 mg/kg intravenous bolus followed by 0.2 mg/kg/h infusion over 6 h) or vehicle (equal volume physiological saline) placebo. A variety of physiological variables were followed during treatment. Clinical examination included motor and sensory testing, as well as assigning a Sunnybrook score based upon level of function. Patients were examined at 24 h, 72 h, 1 week, 1 month, 4 months, and 12 months after injury. TRH infusions were well tolerated. There appeared to be no discernible treatment effect in patients with complete injuries although data were available from only six such patients at 4 months. For the incomplete injury group, a total of 6 treated and 5 placebo patients had 4-month evaluations. TRH treatment was associated with significantly higher motor, sensory, and Sunnybrook scores than placebo treatment. Because of patients lost to subsequent follow-up, 12-month data were not highly informative. These observations must be interpreted with considerable caution because of the small patient numbers, but together with extensive animal studies they support the need for a larger multicenter clinical trial of TRH.","Pitts, L H; Ross, A; Chase, G A; Faden, A I",1995.0,10.1089/neu.1995.12.235,0,0,
5126,Amygdala and anterior cingulate cortex activation during affective startle modulation: A PET study of fear,"The human startle response is modulated by emotional experiences, with startle potentiation associated with negative affect. We used positron emission tomography with 15O-water to study neural networks associated with startle modulation by phobic fear in a group of subjects with specific snake or spider phobia, but not both, during exposure to pictures of their feared and non-feared objects, paired and unpaired with acoustic startle stimuli. Measurement of eye electromyographic activity confirmed startle potentiation during the phobic as compared with the non-phobic condition. Employing a factorial design, we evaluated brain correlates of startle modulation as the interaction between startle and affect, using the double subtraction contrast (phobic startle vs. phobic alone) vs. (non-phobic startle vs. non-phobic alone). As a result of startle potentiation, a significant increase in regional cerebral blood flow was found in the left amygdaloid-hippocampal region, and medially in the affective division of the anterior cingulate cortex (ACC). These results provide evidence from functional brain imaging for a modulatory role of the amygdaloid complex on startle reactions in humans. They also point to the involvement of the affective ACC in the processing of startle stimuli during emotionally aversive experiences. The co-activation of these areas may reflect increased attention to fear-relevant stimuli. Thus, we suggest that the amygdaloid area and the ACC form part of a neural system dedicated to attention and orientation to danger, and that this network modulates startle during negative affect.",Pissiota A.; Frans Ö.; Michelgård Å.; Appel L.; Långström B.; Flaten M.A.; Fredrikson M.,2003.0,10.1046/j.1460-9568.2003.02855.x,0,0,
5127,Oronasal mask versus helmet in acute hypercapnic respiratory failure,"ER The choice of the interface for noninvasive ventilation (NIV) is a key factor in NIV success. We hypothesised that a new helmet specifically design to improve performance in hypercapnic patients would be clinically equivalent to a standard oronasal mask. In a multicentre, short-term, physiological, randomised trial in chronic obstructive pulmonary disease patients facing an acute hypercapnic respiratory failure episode, we compared the changes in arterial blood gases (ABGs) and tolerance score obtained using the helmet or mask, and, as secondary end-points, dyspnoea, vital signs, early NIV discontinuation and rate of intubation. 80 patients were randomly assigned to receive NIV either with the helmet (n=39) or mask (n=41), using an intensive care unit ventilator. Compared with baseline, in the first 6 h, NIV improved ABGs, dyspnoea and respiratory rate (p<0.05) in both groups. Changes in ABGs and discomfort were similar with the two groups, while dyspnoea decreased more (p<0.005) using the mask. The rate of intubation and the need for interface change during the whole period of NIV were very low and not different between groups. The new helmet may be a valid alternative to a mask in improving ABGs and achieving a good tolerance during an episode of acute hypercapnic respiratory failure.","Pisani, L; Mega, C; Vaschetto, R; Bellone, A; Scala, R; Cosentini, R; Musti, M; Forno, M; Grassi, M; Fasano, L; Navalesi, P; Nava, S",2015.0,10.1183/09031936.00053814,0,0,
5128,Calcium supplementation during lactation blunts erythrocyte lead levels and delta-aminolevulinic acid dehydratase zinc-reactivation in women non-exposed to lead and with marginal calcium intakes,"ER The purpose of this study was to evaluate the effect of calcium supplementation during lactation on changes in blood lead indices from late pregnancy to early lactation in women with low calcium intakes and low lead-exposure. Forty-seven women, non-occupationally exposed to lead and with habitually low calcium intake ( approximately 600 mg/d), participated in the study from 29 to 38 weeks of pregnancy to 7-8 weeks post-partum, non-supplemented (n=25) and supplemented (n=22) with calcium (500 mg/d) during 6 weeks after delivery. Erythrocyte lead (PbRBC) and in vitro reactivation with zinc of blood delta-aminolevulinic acid dehydratase (Zn-delta-ALAD% reactivation) were used as lead indices. In the non-supplemented group, PbRBC and Zn-delta-ALAD% reactivation increased significantly (P<0.001) from pregnancy (0.202+/-0.049 microg Pb/g protein and 18.3+/-6.0%) to lactation (0.272+/-0.070 microg Pb/g protein and 22.7+/-6.2%). No significant changes of these indices were observed in the calcium-supplemented group from pregnancy (0.203+/-0.080 microg Pb/g protein and 15.8+/-4.5%) to lactation (0.214+/-0.066 microg Pb/g protein and 16.3+/-4.1%). PbRBC levels and Zn-delta-ALAD% reactivation at lactation were lower (P<0.05) and hematocrit levels were higher (P<0.05) in the calcium-supplemented compared to the non-supplemented women. Calcium supplementation during lactation appears to blunt the lactation-induced increase in maternal blood lead and its inhibitory effect on delta-ALAD and possibly on maternal erythropoiesis.","Pires, J B; Miekeley, N; Donangelo, C M",2002.0,,0,0,
5129,Aquatic exercise and pain neurophysiology education versus aquatic exercise alone for patients with chronic low back pain: a randomized controlled trial,"ER DESIGNSingle-blind randomized controlled trial.SETTINGOutpatient clinic.SUBJECTSSixty-two chronic low back pain patients were randomly allocated to receive aquatic exercise and pain neurophysiology education (n = 30) or aquatic exercise alone (n = 32).INTERVENTIONSTwelve sessions of a 6-week aquatic exercise programme preceded by 2 sessions of pain neurophysiology education. Controls received only 12 sessions of the 6-week aquatic exercise programme.MAIN MEASURESThe primary outcomes were pain intensity (Visual Analogue Scale) and functional disability (Quebec Back Pain Disability Scale) at the baseline, 6 weeks after the beginning of the aquatic exercise programme and at the 3 months follow-up. Secondary outcome was kinesiophobia (Tampa Scale of Kinesiophobia).RESULTSFifty-five participants completed the study. Analysis using mixed-model ANOVA revealed a significant treatment condition interaction on pain intensity at the 3 months follow-up, favoring the education group (mean SD change: -25.4± 26.7 vs -6.6 ± 30.7, P < 0.005). Although participants in the education group were more likely to report perceived functional benefits from treatment at 3 months follow-up (RR=1.63, 95%CI: 1.01-2.63), no significant differences were found in functional disability and kinesiophobia between groups at any time.CONCLUSIONSThis study's findings support the provision of pain neurophysiology education as a clinically effective addition to aquatic exercise.OBJECTIVEThe aim of this study was to compare the effectiveness of a combination of aquatic exercise and pain neurophysiology education with aquatic exercise alone in chronic low back pain patients.","Pires, D; Cruz, E B; Caeiro, C",2015.0,10.1177/0269215514549033,0,0,
5130,Human choice strategy varies with anatomical projections from ventromedial prefrontal cortex to medial striatum,"Two distinct systems, goal-directed and habitual, support decision making. It has recently been hypothesized that this distinction may arise from two computational mechanisms, model-based and model-free reinforcement learning, neuronally implemented in frontostriatal circuits involved in learning and behavioral control. Here, we test whether the relative strength of anatomical connectivity within frontostriatal circuits accounts for variation in human individuals’ reliance on model-based and model-free control. This hypothesis was tested by combining diffusion tensor imaging with a multistep decision task known to distinguish model-based and model-free control in humans. We found large interindividual differences in the degree of model-based control, and those differences are predicted by the structural integrity of white-matter tracts from the ventromedial prefrontal cortex to the medial striatum. Furthermore, an analysis based on masking out of bottom-up tracts suggests that this effect is driven by top-down influences from ventromedial prefrontal cortex to medial striatum. Our findings indicate that individuals with stronger afferences from the ventromedial prefrontal cortex to the medial striatum are more likely to rely on a model-based strategy to control their instrumental actions. These findings suggest a mechanism for instrumental action control through which medial striatum determines, at least partly, the relative contribution of model-based and model-free systems during decision-making according to top-down model-based information from the ventromedial prefrontal cortex. These findings have important implications for understanding the neural circuitry that might be susceptible to pathological computational processes in impulsive/compulsive psychiatric disorders.",Piray P.; Toni I.; Cools R.,2016.0,10.1523/JNEUROSCI.2033-15.2016,0,0,
5131,An outcome study of group therapy.,"Outcome research in a group therapy program was conducted with therapists in training who had little prior experience with group therapy. Significantly greater improvement over an initial three-month period was found for treated patients when compared with control patients on a multivariate combination of five outcome criteria. Some, but not all, of the five separate criteria indicated such a difference. Only slight, nondifferentiating improvement was found for target symptoms. Significantly greater improvement over the three-month period on the multivariate combination was also found for treated patients who had begun therapy during the second year of the program when compared with treated patients who had begun therapy during the first year of the program. Finally, significant improvement over the three-month period on the multivariate combination was found for both treated and control patients.",Piper WE.; Debbane EG.; Garant J.,1977.0,,0,0,
5132,"Anxiety diagnoses in smokers seeking cessation treatment: Relations with tobacco dependence, withdrawal, outcome and response to treatment.","Aims: To understand the relations among anxiety disorders and tobacco dependence, withdrawal symptoms, response to smoking cessation pharmacotherapy and ability to quit smoking. Design: Randomized placebo-controlled clinical trial. Participants received six 10-minute individual counseling sessions and either: placebo, bupropion SR, nicotine patch, nicotine lozenge, bupropion SR + nicotine lozenge or nicotine patch + nicotine lozenge. Setting Two urban research sites. Participants: Data were collected from 1504 daily smokers (>9 cigarettes per day) who were motivated to quit smoking and did not report current diagnoses of schizophrenia or psychosis or bupropion use. Measurements: Participants completed baseline assessments, the Composite International Diagnostic Interview and ecological momentary assessments for 2 weeks. Findings: A structured clinical interview identified participants who ever met criteria for a panic attack (n = 455), social anxiety (n = 199) or generalized anxiety disorder (n = 99), and those who qualified for no anxiety diagnosis (n = 891). Smokers with anxiety disorders reported higher levels of nicotine dependence and pre-quit withdrawal symptoms. Those ever meeting criteria for panic attacks or social anxiety disorder showed greater quit-day negative affect. Smokers ever meeting criteria for anxiety disorders were less likely to be abstinent at 8 weeks and 6 months post-quit and showed no benefit from single-agent or combination-agent pharmacotherapies. Conclusions: Anxiety diagnoses were common among treatment-seeking smokers and were related to increased motivation to smoke, elevated withdrawal, lack of response to pharmacotherapy and impaired ability to quit smoking. These findings could guide treatment assignment algorithms and treatment development for smokers with anxiety diagnoses. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Piper, Megan E; Cook, Jessica W; Schlam, Tanya R; Jorenby, Douglas E; Baker, Timothy B; Baker, Beck, Bowen, Brandon, Breslau, Brozovich, Clark, Coambs, Coles, Cougle, Dani, Ferguson, Fiore, Gamez, Gloria, Grant, Heatherton, Hovatta, Hughes, John, Kessler, Knekt, Kotov, Kotov, Lang, Lasser, MacPherson, McCarthy, McClave, Mennin, Mykletun, Piasecki, Piasecki, Piper, Piper, Piper, Piper, Piper, Piper, Reiss, Shiffman, Smith, Snyder, Watson, Wittchen, Ziedonis, Ziedonis, Zvolensky, Zvolensky, Zvolensky",2011.0,,0,0,
5133,Psychiatric disorders in smokers seeking treatment for tobacco dependence: relations with tobacco dependence and cessation,"ER METHODData were collected from 1,504 smokers (58.2% women; 83.9% White; mean age = 44.67 years, SD = 11.08) making an aided smoking cessation attempt as part of a clinical trial. Psychiatric diagnoses were determined with the Composite International Diagnostic Interview structured clinical interview. Tobacco dependence was assessed with the Fagerström Test of Nicotine Dependence (FTND) and the Wisconsin Inventory of Smoking Dependence Motives (WISDM).RESULTSDiagnostic groups included those who were never diagnosed, those who had ever been diagnosed (at any time, including in the past year), and those with past-year diagnoses (with or without prior diagnosis). Some diagnostic groups had lower follow-up abstinence rates than did the never diagnosed group (ps < .05). At 8 weeks after quitting, strong associations were found between cessation outcome and both past-year mood disorder and ever diagnosed anxiety disorder. At 6 months after quitting, those ever diagnosed with an anxiety disorder (OR = .72, p = .02) and those ever diagnosed with more than one psychiatric diagnosis (OR = .74, p = .03) had lower abstinence rates. The diagnostic categories did not differ in smoking heaviness or the FTND, but they did differ in dependence motives assessed with the WISDM.CONCLUSIONInformation on recent or lifetime psychiatric disorders may help clinicians gauge relapse risk and may suggest dependence motives that are particularly relevant to affected patients. These findings also illustrate the importance of using multidimensional tobacco dependence assessments.OBJECTIVEThe present research examined the relation of psychiatric disorders to tobacco dependence and cessation outcomes.","Piper, M E; Smith, S S; Schlam, T R; Fleming, M F; Bittrich, A A; Brown, J L; Leitzke, C J; Zehner, M E; Fiore, M C; Baker, T B",2010.0,10.1037/a0018065,0,0,
5134,"The effect of maintenance cimetidine therapy on the medical, social and economic aspects of patients with chronic gastric ulcers. A placebo-controlled prospective study","ER We studied the effect of cimetidine maintenance therapy on the socioeconomic life of patients with gastric ulcers in the year after healing and the extent to which treatment was cost-effective. One hundred and seventy patients with a healed ulcer were studied for periods of up to one year after healing; 116 patients completed one year of observation. A double-blind randomized prospective study was performed that compared cimetidine (400 mg at night) with placebo. Analysis was performed on the intention-to-treat principle. The treated group showed benefit over the placebo group; major or minor symptoms were experienced on fewer days, and more months were symptom-free. Male patients were wakened with ulcer pain on fewer nights, led a more normal social life, and had less ulcer-related sick-leave; female patients had less total sick leave. The proven ulcer recurrence rate was lower in the treated group. Fewer endoscopies were performed in this group and the resultant cost saving was equivalent to the cost expenditure on cimetidine treatment. A modest saving in wages was afforded treated patients in the workforce, due to the reduction in sick leave. The principal benefit of cimetidine treatment appeared to be the lessening of the pain and discomfort and, hence, the distress and anxiety that was associated with ulcer disease. The cost-saving due to the reduced number of endoscopies compensated for the cost-expenditure of the cimetidine treatment.","Piper, D W; Pym, B M; Toy, S; Gellatly, R; Byth, K; Seville, P",1986.0,,0,0,
5135,Temperament differentially influences early information processing in men and women: Preliminary electrophysiological evidence of attentional biases in healthy individuals,"Preferential processing of threat-related information is a robust finding in anxiety disorders. The observation that attentional biases are also present in healthy individuals suggests factors other than clinical symptoms to play a role. Using a dot-probe paradigm while event-related potentials were recorded in 59 healthy adults, we investigated whether temperament and gender, both related to individual variation in anxiety levels, influence attentional processing. All participants showed protective attentional biases in terms of enhanced attention engagement with positive information, indexed by larger N1 amplitudes in positive compared to negative conditions. Taking gender differences into account, we observed that women showed enhanced attention engagement with negative compared to neutral information, indicated by larger P2 amplitudes in congruent than in incongruent negative conditions. Attentional processing was influenced by the temperament traits negative affect and effortful control. Our results emphasize that gender and temperament modulate attentional biases in healthy adults.",Pintzinger N.M.; Pfabigan D.M.; Pfau L.; Kryspin-Exner I.; Lamm C.,2017.0,10.1016/j.biopsycho.2016.07.007,0,0,
5136,Obsessive compulsive personality disorder as a predictor of exposure and ritual prevention outcome for obsessive compulsive disorder.,"Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score >= 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 sessions of EX/RP over 8 weeks. OCD severity was assessed with the YBOCS pre- and post-treatment by independent evaluators. At baseline, 34.7% of the OCD sample met criteria for comorbid DSM-IV OCPD, assessed by structured interview. OCPD was tested as a predictor of outcome both as a diagnostic category and as a dimensional score (severity) based on the total number of OCPD symptoms coded as present and clinically significant at baseline. Both OCPD diagnosis and greater OCPD severity predicted worse EX/RP outcome, controlling for baseline OCD severity, Axis I and II comorbidity, prior treatment, quality of life, and gender. When the individual OCPD criteria were tested separately, only perfectionism predicted worse treatment outcome, over and above the previously mentioned covariates. These findings highlight the importance of assessing OCPD and suggest a need to directly address OCPD-related traits, especially perfectionism, in the context of EX/RP to minimize their interference in outcome. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Pinto, Anthony; Liebowitz, Michael R; Foa, Edna B; Simpson, H. Blair; Agosti, Albert, Ansell, Ansell, Ansell, AuBuchon, Baer, Blatt, Blatt, Calvo, Cavedini, Coles, Costa, Crane, Diaconu, Endicott, Fairburn, Fineberg, First, First, Fricke, Garyfallos, Gibbs, Goodman, Grilo, Grilo, Grilo, Hummelen, Lenane, Lock, Maher, McGlashan, McGlashan, Nestadt, Pinto, Pinto, Riley, Samuels, Samuels, Simpson, Skodol, Steketee, Strober, Swedo, Torgersen, Villemarette-Pittman, Wentz, Zuroff",2011.0,,0,0,
5137,Obsessive compulsive personality disorder as a predictor of exposure and ritual prevention outcome for obsessive compulsive disorder.,"Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ‚â• 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 sessions of EX/RP over 8 weeks. OCD severity was assessed with the YBOCS pre- and post-treatment by independent evaluators. At baseline, 34.7% of the OCD sample met criteria for comorbid DSM-IV OCPD, assessed by structured interview. OCPD was tested as a predictor of outcome both as a diagnostic category and as a dimensional score (severity) based on the total number of OCPD symptoms coded as present and clinically significant at baseline. Both OCPD diagnosis and greater OCPD severity predicted worse EX/RP outcome, controlling for baseline OCD severity, Axis I and II comorbidity, prior treatment, quality of life, and gender. When the individual OCPD criteria were tested separately, only perfectionism predicted worse treatment outcome, over and above the previously mentioned covariates. These findings highlight the importance of assessing OCPD and suggest a need to directly address OCPD-related traits, especially perfectionism, in the context of EX/RP to minimize their interference in outcome.",Pinto A.; Liebowitz MR.; Foa EB.; Simpson HB.,2011.0,10.1016/j.brat.2011.04.004,0,0,
5138,"Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial","ER DESIGN: Researcher blind, multicentre, randomised controlled trial.SETTING: UK primary care (Lothian, Scotland).PARTICIPANTS: Adults with at least one admission for chronic obstructive pulmonary disease (COPD) in the year before randomisation. We excluded people who had other significant lung disease, who were unable to provide informed consent or complete the study, or who had other significant social or clinical problems.INTERVENTIONS: Participants were recruited between 21 May 2009 and 28 March 2011, and centrally randomised to receive telemonitoring or conventional self monitoring. Using a touch screen, telemonitoring participants recorded a daily questionnaire about symptoms and treatment use, and monitored oxygen saturation using linked instruments. Algorithms, based on the symptom score, generated alerts if readings were omitted or breached thresholds. Both groups received similar care from existing clinical services.MAIN OUTCOME MEASURES: The primary outcome was time to hospital admission due to COPD exacerbation up to one year after randomisation. Other outcomes included number and duration of admissions, and validated questionnaire assessments of health related quality of life (using St George's respiratory questionnaire (SGRQ)), anxiety or depression (or both), self efficacy, knowledge, and adherence to treatment. Analysis was intention to treat.RESULTS: Of 256 patients completing the study, 128 patients were randomised to telemonitoring and 128 to usual care; baseline characteristics of each group were similar. The number of days to admission did not differ significantly between groups (adjusted hazard ratio 0.98, 95% confidence interval 0.66 to 1.44). Over one year, the mean number of COPD admissions was similar in both groups (telemonitoring 1.2 admissions per person (standard deviation 1.9) v control 1.1 (1.6); P=0.59). Mean duration of COPD admissions over one year was also similar between groups (9.5 days per person (standard deviation 19.1) v 8.8 days (15.9); P=0.88). The intervention had no significant effect on SGRQ scores between groups (68.2 (standard deviation 16.3) v 67.3 (17.3); adjusted mean difference 1.39 (95% confidence interval -1.57 to 4.35)), or on other questionnaire outcomes. Conclusions In participants with a history of admission for exacerbations of COPD, telemonitoring was not effective in postponing admissions and did not improve quality of life. The positive effect of telemonitoring seen in previous trials could be due to enhancement of the underpinning clinical service rather than the telemonitoring communication.TRIAL REGISTRATION: ISRCTN96634935. Funding: The trial was funded by an NHS applied research programme grant from the Chief Scientist Office of the Scottish government (ARPG/07/03). The funder had no role in study design and the collection, analysis, and interpretation of data and the writing of the article and the decision to submit it for publication. NHS Lothian supported the telemonitoring service and the clinical services.OBJECTIVE: To test the effectiveness of telemonitoring integrated into existing clinical services such that intervention and control groups have access to the same clinical care.","Pinnock, H; Hanley, J; McCloughan, L; Todd, A; Krishan, A; Lewis, S; Stoddart, A; Pol, M; MacNee, W; Sheikh, A; Pagliari, C; McKinstry, B",2013.0,,0,0,
5139,Needs of relatives of breast cancer patients: the perspectives of families and nurses,"ER PURPOSE: Breast cancer is not only a stressful event for those afflicted, but also for their family and friends. In Germany, attention and support from professional nurses is almost exclusively given to the patient. But even relatives require information and support in order to keep their anxiety levels low and strength up. The aim of this study is to survey those needs and the current level of satisfaction, as well as to ascertain which needs are perceived by nurses.METHOD: Data were collected in a German-wide descriptive cross-sectional study surveying 242 relatives and 356 nurses from 150 randomly chosen certified breast care centers between August 2008 and February 2009. Two questionnaires developed for this study were used.RESULTS: The findings indicate that relatives need above all a) security and trust, followed by b) partnership of care and c) emotional support. Regarding satisfaction, relatives consider the need for ""security and trust"" to be most satisfied. Least fulfilled were those for ""partnership of care"" and ""emotional support"". The nurses regarded the importance of most of the relatives' needs to be higher than the relatives themselves. Even the fulfillment of needs was over-estimated.CONCLUSIONS: The targeted and professional involvement of relatives in the care of breast cancer patients is still not common practice. An initial step toward better family nursing is viewing families as an integral part of the patient and intentionally planning contact.","Pinkert, C; Holtgräwe, M; Remmers, H",2013.0,10.1016/j.ejon.2011.10.006,0,0,
5140,Identification of psychiatric distress by primary care physicians.,"The aims of the present study were to evaluate the extent to which primary care physicians' (PCPs) identification of psychiatric distress is related to a number of nonpsychopathological factors, such as patient sociodemographic and health-related characteristics, and to assess the impact of depression on PCP identification of psychiatric distress, controlling for patient sociodemographic and health-related characteristics. Two patient samples were chosen to explore these issues: 1) patients not fulfilling any ICD-10-defined or subthreshold psychiatric diagnosis and, 2) patients with an ICD-10 diagnosis of current depression. Patients attending 46 primary care clinics during an index period were screened by the General Health Questionnaire (GHQ)-12 and selected for a second stage interview according to GHQ score. Among the 559 interviewed patients, 123 had no mental disorder and 66 had an ICD-10 current depressive disorder. Identification of psychiatric distress by the PCP was associated with retirement among subjects without mental disorders but not among depressed patients. Patient's negative overall health self-perception and severity of physical illness were significantly related to identification of psychiatric distress in the two groups, whereas neither disability nor reason for medical consultation had a significant effect. Patients with current depression, compared with those without, were 4.3 times more likely to be identified by PCPs as having psychiatric distress when adjusting for all the above nonpsychopathological variables. Patients with depression and comorbid anxiety disorders were more likely to be recognized by the PCP as compared with those with pure depression. Finally, among depressive symptoms, diurnal variation and symptoms related to suicidal tendencies were predictive of identification of psychiatric distress, whereas increase of appetite was negatively associated with PCP recognition.",Pini S.; Berardi D.; Rucci P.; Piccinelli M.; Neri C.; Tansella M.; Ferrari G.,1997.0,,0,0,
5141,Delayed verbal reactions are specifically impaired in patients with schizophrenia.,"Recent neuropsychological, psychophysiological and neuroimaging studies have shown that specific changes in attention and information processes occur in schizophrenic disorders. A verbal delayed reaction methodology, determined by our group since 1992, has provided similar quantitative data. Visual verbal stimuli, occurring in random sequence, are presented to the subject who is requested to utter immediately the perceived word in a first trial; in a second one, a delay (foreperiod) between the word presentation and a 'go' signal (eight asterisks) is interposed. Acousticograms and orbicularis oris EMG are recorded as responses. The ratio of the 1.5-s foreperiod delayed reaction time to the immediate reaction time reveals a facilitation of the executive system occurring during sustained purposeful attention, a characteristic function of the prefrontal cortex. A further ratio, with a 0.1-s foreperiod, has been measured to investigate the effect of interference processes. These trials have been performed including 18 patients with schizophrenia, 31 with idiopathic Parkinson's disease, four patients with extrapyramidal degenerative diseases, five affected by obsessive compulsive disorder and in age-matched normal controls. Both ratios were significantly increased in schizophrenic patients and, on the contrary, decreased in patients with obsessive-compulsive disorder. These changes are in agreement with the neuroimaging findings of 'hypofrontality' in the schizophrenic patients. Verbal delayed reaction methodology seems a reliable and easily applicable tool for investigating sustained purposeful attention processes in clinical conditions.",Pinelli P.; Ceriani F.; Colombo R.; Pasetti C.; Terazzi M.; Castignoli G.,2000.0,,0,0,
5142,Interpersonal appraisals of emotionally distressed persons by anxious and dysphoric individuals,"ER Coyne [J. Abnorm. Psychol. 85 (1976a) 186; Psychiatry 29 (1976b) 28] first reported that depressed persons were negatively appraised interpersonally by interaction partners. The purpose of the current study was to replicate previous findings extending Coyne's theory to anxious individuals and to assess how anxiety and depression of the raters may affect these ratings. Anxious, dysphoric, and control participants watched a video of an actor portraying anxious, depressed, or neutral affect (n = 208). Results indicated that the actor portraying depressed affect was assessed more negatively than the actor portraying anxious affect who, in turn, was assessed more negatively than the actor portraying neutral affect. However, anxious and dysphoric participants did not differ from control participants in their ratings of the videos.","Pineles, S L; Mineka, S; Nolan, S A",2004.0,10.1016/j.janxdis.2003.10.002,0,0,
5143,Methods for developmental studies of fear conditioning circuitry,"Psychophysiologic studies use air puff as an aversive stimulus to document abnormal fear conditioning in children of parents with anxiety disorders. This study used functional magnetic resonance imaging (fMRI) to examine changes in amygdala activity during air-puff conditioning among adults. Blood oxygen level-dependent (BOLD) signal was monitored in seven adults during 16 alternating presentations of two different colored lights (CS+ vs. CS-), one of which was consistently paired with an aversive air puff. A region-of-interest analysis demonstrated differential change in BOLD signal in the right but not left amygdala across CS+ versus CS- viewing. The amygdala is engaged by pairing of a light with an air puff. Given that prior studies relate air-puff conditioning to risk for anxiety in children, these methods may provide an avenue for directly studying the developmental neurobiology of fear conditioning. © 2001 Society of Biological Psychiatry.",Pine D.S.; Fyer A.; Grun J.; Phelps E.A.; Szeszko P.R.; Koda V.; Li W.; Ardekani B.; Maguire E.A.; Burgess N.; Bilder R.M.,2001.0,10.1016/S0006-3223(01)01159-3,0,0,
5144,Avoidant decision-making in social anxiety disorder: A laboratory task linked to in vivo anxiety and treatment outcome.,"Recent studies on reward-based decision-making in the presence of anxiety-related stimuli demonstrated that approach-avoidance conflicts can be assessed under controlled laboratory conditions. However, the clinical relevance of these decision conflicts has not been demonstrated. To this end, the present study investigated avoidant decisions in treatment-seeking individuals with social anxiety disorder (SAD). In a gambling task, advantageous choices to maximize gains were associated with task-irrelevant angry faces and disadvantageous choices with happy faces. The clinical relevance of avoidant decisions for in vivo anxiety in a social stress situation (public speaking) were examined (n = 44). In a subsample (n = 20), the predictive value for a reduction of avoidance following behavioral therapy was also evaluated. Results indicated a close link between more frequent avoidant decisions and elevated in vivo anxiety. Moreover, individuals who showed a deficit in the goal-directed adjustment of their decisions also showed higher and sustained distress during the social stressor and reported less decrease of avoidance following treatment. The findings highlight the importance of an avoidant decision-making style for the experience of acute distress and the maintenance of avoidance in SAD. Assessing avoidant decision-making may help to predict the response to behavioral treatments. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pittig, Andre; Alpers, Georg W; Niles, Andrea N; Craske, Michelle G; Alpers, Alvares, Arch, Averbeck, Balleine, Bechara, Bechara, Benjamini, Brown, Chen, Craske, Craske, Craske, Craske, Dezfouli, Eifert, Fresco, Furl, Gilboa-Schechtman, Goschke, Hartley, Heimberg, Heuer, Hofmann, Hofmann, Hope, Horstmann, Kashdan, Klein, Lundqvist, Mannuzza, Marsh, Mogg, Mogg, Moscovitch, Mowrer, Pittig, Pittig, Pittig, Pollard, Rachman, Raudenbush, Raudenbush, Rinck, Schulz, Seidel, Starcke, Starcke, Stein, Taylor, Tolin, Wieser",2015.0,,0,0,
5145,The cost of fear: Avoidant decision making in a spider gambling task,"Individuals with anxiety disorders typically avoid fear-relevant stimuli even if they miss potential rewards. However, few studies have accounted for such costs of fear-related avoidance in doing so. In this study, 51 spider fearful and 49 non-fearful participants completed the Spider Gambling Task, our modification of the Iowa Gambling Task, to investigate whether fear-relevant stimuli trigger avoidant decisions in the presence of potential rewards. In one version, advantageous choices were associated with pictures of spiders, whereas the same pictures were associated with disadvantageous choices in another version. Fearful participants generally avoided choices associated with pictures of spiders, which resulted in lower overall gains in the version with advantageous spider decks. Although this relative avoidance was sustained, fearful participants progressively approach more advantageous spider choices. These findings demonstrate that phobic fear results in irrational avoidant decisions which can result in considerable cost. Potential long-term rewards for approach may, however, diminish absolute avoidance behavior. © 2014.",Pittig A.; Brand M.; Pawlikowski M.; Alpers G.W.,2014.0,10.1016/j.janxdis.2014.03.001,0,0,
5146,"Heart rate and heart rate variability in panic, social anxiety, obsessive-compulsive, and generalized anxiety disorders at baseline and in response to relaxation and hyperventilation.","It remains unclear if diminished high frequency heart rate variability (HF-HRV) can be found across anxiety disorders. HF-HRV and heart rate (HR) were examined in panic (PD), generalized anxiety (GAD), social anxiety (SAD), and obsessive-compulsive disorder (OCD) relative to healthy controls at baseline and during anxiety stressors. All disorders evidenced diminished baseline HF-HRV relative to controls. Baseline HRV differences were maintained throughout relaxation. For hyperventilation, PD and GAD demonstrated greater HR than controls. Psychotropic medication did not account for HF-HRV differences except in OCD. Age and sex evidenced multiple main effects. Findings suggest that low baseline HF-HRV represents a common index for inhibitory deficits across PD, GAD, and SAD, which is consistent with the notion of autonomic inflexibility in anxiety disorders. Elevated HR responses to hyperventilation, however, are specific to PD and GAD.",Pittig A.; Arch JJ.; Lam CW.; Craske MG.,2013.0,10.1016/j.ijpsycho.2012.10.012,0,0,
5147,Avoidant decision-making in social anxiety disorder: A laboratory task linked to in vivo anxiety and treatment outcome.,"Recent studies on reward-based decision-making in the presence of anxiety-related stimuli demonstrated that approach-avoidance conflicts can be assessed under controlled laboratory conditions. However, the clinical relevance of these decision conflicts has not been demonstrated. To this end, the present study investigated avoidant decisions in treatment-seeking individuals with social anxiety disorder (SAD). In a gambling task, advantageous choices to maximize gains were associated with task-irrelevant angry faces and disadvantageous choices with happy faces. The clinical relevance of avoidant decisions for in vivo anxiety in a social stress situation (public speaking) were examined (n = 44). In a subsample (n = 20), the predictive value for a reduction of avoidance following behavioral therapy was also evaluated. Results indicated a close link between more frequent avoidant decisions and elevated in vivo anxiety. Moreover, individuals who showed a deficit in the goal-directed adjustment of their decisions also showed higher and sustained distress during the social stressor and reported less decrease of avoidance following treatment. The findings highlight the importance of an avoidant decision-making style for the experience of acute distress and the maintenance of avoidance in SAD. Assessing avoidant decision-making may help to predict the response to behavioral treatments.",Pittig A.; Alpers GW.; Niles AN.; Craske MG.,2015.0,10.1016/j.brat.2015.08.003,0,0,
5148,[Contribution of relaxation to a psychoeducational intervention program for family carers of persons with Alzheimer's disease].,"Family caregivers of people with Alzheimer's disease are at high risk of psychological and physical morbidity due to the daily caring experience. to evaluate the impact of a psychoeducational program involving relaxation techniques on caregivers' burden and mental health status. in this prospective study, 50 family caregivers were randomly assigned to one of two conditions: standard (CG: Control group; 12‚Äâ√ó‚Äâ90 minutes weekly sessions: psychoeducational group intervention) and experimental intervention (RG: Relaxation group; 12‚Äâ√ó‚Äâ150 minutes sessions: standard intervention + relaxation techniques). Caregivers' burden and mental health status were assessed using the Zarit burden interview (global score and three dimensions from the factor analysis of the French version: social consequences, psychological burden and feelings of guilt) and the General health questionnaire-28 at baseline, after 3 (M3) and 6-months follow-up. Inter-individual statistics and intra-individual changes were calculated. social consequences and psychological burden decreased in RG. The between-group analysis showed that social consequences scores at M3 improved more in RG than in CG. No change in mental health was observed. For burden and anxiety/insomnia, intra-individual analyses showed that RG intervention was beneficial for more carers than CG intervention. this study suggests that integrating relaxation techniques into psychoeducational interventions is beneficial for caregivers of people with Alzheimer's disease.",Pitteri F.; Soulas T.; Essertaise AL.; Roux J.,2013.0,10.1684/pnv.2013.0426,0,0,
5149,Contribution of relaxation to a psychoeducational intervention program for family carers of persons with Alzheimer's disease,"ER UNLABELLED: Family caregivers of people with Alzheimer's disease are at high risk of psychological and physical morbidity due to the daily caring experience.OBJECTIVES: to evaluate the impact of a psychoeducational program involving relaxation techniques on caregivers' burden and mental health status.METHODS: in this prospective study, 50 family caregivers were randomly assigned to one of two conditions: standard (CG: Control group; 12?√ó?90 minutes weekly sessions: psychoeducational group intervention) and experimental intervention (RG: Relaxation group; 12?√ó?150 minutes sessions: standard intervention + relaxation techniques). Caregivers' burden and mental health status were assessed using the Zarit burden interview (global score and three dimensions from the factor analysis of the French version: social consequences, psychological burden and feelings of guilt) and the General health questionnaire-28 at baseline, after 3 (M3) and 6-months follow-up. Inter-individual statistics and intra-individual changes were calculated.RESULTS: social consequences and psychological burden decreased in RG. The between-group analysis showed that social consequences scores at M3 improved more in RG than in CG. No change in mental health was observed. For burden and anxiety/insomnia, intra-individual analyses showed that RG intervention was beneficial for more carers than CG intervention.DISCUSSION: this study suggests that integrating relaxation techniques into psychoeducational interventions is beneficial for caregivers of people with Alzheimer's disease.","Pitteri, F; Soulas, T; Essertaise, A L; Roux, J",2013.0,10.1684/pnv.2013.0426,0,0,5148
5150,Interpersonal subtypes of anxiety disorder patients: Relationship to assessment and treatment variables.,"We attempted to replicate earlier findings of interpersonal subtypes in patients with anxiety disorder (Psychotherapy. 2011;48:304-310) and examine whether these subtypes are characterized by different types of pathology and respond differently to treatment. Interpersonal problems were measured by the Inventory of Interpersonal Problems (Inventory of Interpersonal Problems Manual. San Antonio, TX: Psychological Cooperation; 2000) in a sample of 31 patients with anxiety disorder. Results demonstrated the existence of 4 interpersonal subtypes. The subtypes did not differ in severity of anxiety and global levels of symptoms at pretreatment or in Reliable Change Index of anxiety symptoms over the course of treatment. However, they were significantly different in terms of overall interpersonal problems (p = 0.004). Regarding treatment variables, half of the patients in the nonassertive cluster discontinued treatment prematurely. The number of psychotherapy sessions attended was significantly different across the 4 clusters (p = 0.04), with socially avoidant patients attending significantly greater number of sessions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pitman, Seth R; Hilsenroth, Mark J; Alden, Blagys, Book, Cain, Cain, Constantino, Crits-Christoph, Curran, Derogatis, Dyck, Gurtman, Haggerty, Haggerty, Hilsenroth, Hilsenroth, Hilsenroth, Horowitz, Horowitz, Horowitz, Jacobson, Kachin, Kiesler, Kuutmann, Leichsenring, Luborsky, Luborsky, McCullough, Pincus, Pincus, Pitman, Przeworski, Safran, Salzer, Salzer, Speer, Strupp, Thomas, Wachtel, Zilcha-Mano",2016.0,,0,0,
5151,Emotional processing and outcome of imaginal flooding therapy in Vietnam veterans with chronic posttraumatic stress disorder.,"This study examined emotional processing and outcome in 20 Vietnam veterans with chronic posttraumatic stress disorder (PTSD) who underwent imaginal flooding therapy. Results supported the occurrence of emotional processing, as manifest in significant activation, within-session habituation, and partial across-session habituation of physiologic and self-reported process variables. The flooding therapy produced only modest overall improvement, which was statistically significant for avoidance symptomatology measured by the impact of Events Scale (IOES) and number of intrusions per day recorded by the subject in a log. Symptomatic improvement appeared to generalize from a treated to an untreated experience. Heart rate activation during the first flooding session predicted a decrease in daily number of intrusive combat memories across the therapy. Otherwise, there was little association between extent of emotional processing and therapeutic outcome. The results provide limited support for the notion that mobilization of psychophysiologic arousal during exposure therapy predicts improvement.",Pitman RK.; Orr SP.; Altman B.; Longpre RE.; Poiré RE.; Macklin ML.; Michaels MJ.; Steketee GS.,,,0,0,
5152,Emotional processing during eye movement desensitization and reprocessing therapy of Vietnam veterans with chronic posttraumatic stress disorder.,"This study examined emotional processing and outcome in 17 Vietnam veterans with chronic posttraumatic stress disorder (PTSD) who underwent eye movement desensitization and reprocessing (EMDR) therapy, with and without the eye movement component, in a crossover design. Results supported the occurrence of partial emotional processing, but there were no differences in its extent in the eye-movement versus eyes-fixed conditions. Therapy produced a modest to moderate overall improvement, mostly on the impact of Event Scale. There was slightly more improvement in the eyes-fixed than eye-movement condition. There was little association between the extent of emotional processing and therapeutic outcome. In our hands, EMDR was at least as efficacious for combat-related PTSD as imaginal flooding proved to be in a previous study, and was better tolerated by subjects. However, results suggest that eye movements do not play a significant role in processing of traumatic information in EMDR and that factors other than eye movements are responsible for EMDR's therapeutic effect.",Pitman RK.; Orr SP.; Altman B.; Longpre RE.; Poiré RE.; Macklin ML.,,,0,0,
5153,Emotional processing during eye movement desensitization and reprocessing therapy of Vietnam veterans with chronic posttraumatic stress disorder,"ER This study examined emotional processing and outcome in 17 Vietnam veterans with chronic posttraumatic stress disorder (PTSD) who underwent eye movement desensitization and reprocessing (EMDR) therapy, with and without the eye movement component, in a crossover design. Results supported the occurrence of partial emotional processing, but there were no differences in its extent in the eye-movement versus eyes-fixed conditions. Therapy produced a modest to moderate overall improvement, mostly on the impact of Event Scale. There was slightly more improvement in the eyes-fixed than eye-movement condition. There was little association between the extent of emotional processing and therapeutic outcome. In our hands, EMDR was at least as efficacious for combat-related PTSD as imaginal flooding proved to be in a previous study, and was better tolerated by subjects. However, results suggest that eye movements do not play a significant role in processing of traumatic information in EMDR and that factors other than eye movements are responsible for EMDR's therapeutic effect.","Pitman, R K; Orr, S P; Altman, B; Longpre, R E; Poiré, R E; Macklin, M L",1996.0,,0,0,5152
5154,Naloxone-reversible analgesic response to combat-related stimuli in posttraumatic stress disorder. A pilot study,"ER We tested the hypothesis that exposure to a stimulus resembling the original traumatic event would induce naloxone-reversible analgesia in patients with posttraumatic stress disorder (PTSD). Eight medication-free Vietnam veterans with PTSD and eight veterans without PTSD, matched for age and combat severity, viewed a 15-minute videotape of dramatized combat under naloxone hydrochloride and placebo conditions in a randomized double-blind crossover design. In the placebo condition, the subjects with PTSD showed a 30% decrease in reported pain intensity ratings of standardized heat stimuli after the combat videotape. No decrease in pain ratings occurred in the subjects with PTSD in the naloxone condition. The subjects without PTSD did not show a decrease in pain ratings in either condition. The results are consistent with the induction of opioid-mediated stress-induced analgesia in the patients with PTSD.","Pitman, R K; Kolk, B A; Orr, S P; Greenberg, M S",1990.0,,0,0,
5155,Cognitive-behavioral treatment of panic disorder in adolescence.,"This investigation represents the first randomized controlled trial to evaluate the feasibility and efficacy of Panic Control Treatment for Adolescents (PCT-A). Thirteen adolescents, ages 14 to 17, were randomized to 11 weekly sessions of PCT-A treatment, whereas 13 were randomized to a self-monitoring control group. Results indicate that adolescents receiving immediate PCT-A showed a significant reduction in clinician-rated severity of panic disorder and in self-reported anxiety, anxiety sensitivity, and depression, in comparison to control group participants. These treatment gains were maintained at 3- and 6-month follow-up. Clinical severity of panic continued to improve from posttreatment to 3-month follow-up and then remained stable at 6-month follow-up. In light of study limitations, these findings suggest that cognitive-behavioral treatment for panic disorder in adolescence is a feasible and potentially efficacious intervention for this debilitating condition in youth.",Pincus DB.; May JE.; Whitton SW.; Mattis SG.; Barlow DH.,2010.0,10.1080/15374416.2010.501288,0,0,
5156,Indicated prevention and early intervention for childhood anxiety: a randomized trial with Caucasian and Hispanic/Latino youth,"ER METHOD: A total of 88 youth (M = 10.36 years; 45 girls, 52 Latino) received 1 of 2 protocols with varying degrees of parent involvement, and response was measured at posttest and 6-month follow-up.RESULTS: Findings showed that child anxiety symptoms improved significantly across protocols, although additional gains were found for children in the child plus parent condition. Program effects did not vary by Latino ethnicity or Spanish language use in the intervention.CONCLUSIONS: The cognitive and behavioral strategies established for Caucasian children may be promising for Hispanic/Latino children when applied in a culturally responsive manner.OBJECTIVE: This trial of a randomized indicated anxiety prevention and early intervention explored initial program effects as well as the role of ethnicity and language on measured outcomes.","Pina, A A; Zerr, A A; Villalta, I K; Gonzales, N A",2012.0,10.1037/a0029460,0,0,
5157,Children of currently depressed mothers: a STAR*D ancillary study,"ER METHODTreatment-seeking mothers with a current DSM-IV diagnosis of MDD and with at least 1 child 7 to 17 years old were assessed during a major depressive episode (MDE). For each mother, 1 child was assessed (if a mother had more than 1 child, 1 was randomly selected). Maternal features assessed for this study were history of MDEs, severity of current MDE, comorbid conditions, depressive symptom features, and social functioning. Children were assessed for selected psychiatric diagnoses (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version [K-SADS-PL]), psychopathologic symptoms and social functioning (Child Behavior Checklist), and global functioning (Children's Global Assessment Scale). Data were gathered from December 2001 to April 2004.RESULTSA large proportion (72%) of mothers were severely depressed (17-item Hamilton Rating Scale for Depression score >/= 22). About a third (34%) of children had a current psychiatric disorder, including disruptive behavior (22%), anxiety (16%), and depressive (10%) disorders. Nearly half (45%) had a lifetime psychiatric disorder, including disruptive behavior (29%), anxiety (20%), and depressive (19%) disorders. Atypical depressive features in the mother were associated with a 3-fold increase in the odds of having a child with depressive (OR = 3.3 [95% CI = 1.2 to 9.5]; p = .02) or anxiety (OR = 2.6 [95% CI = 1.1 to 6.9]; p = .03) disorders. A history of maternal suicide attempts and the presence of comorbid panic disorder with agoraphobia were associated with a 3-fold increase and an 8-fold increase in the odds of depressive disorders in the offspring, respectively. The final model showed significant associations (p </= .05) between the following characteristics of maternal depression and offspring disorders: maternal comorbid panic disorder with agoraphobia and offspring depressive and anxiety disorders, maternal irritable depression and offspring disruptive behavior disorders and any disorder, and maternal substance use disorders and any disorder.CONCLUSIONSChildren of mothers in the midst of a current MDE are at high risk for disruptive behavior and anxiety disorders. The elevated risk of psychopathology among children of depressed mothers may recommend assessment of these children when clinically suggested. Children of depressed mothers with comorbid panic disorder with agoraphobia are at high risk for depressive and anxiety disorders and deserve special attention from clinicians.OBJECTIVETo assess the current and lifetime prevalence of psychiatric disorders among children of currently depressed mothers and to assess the association of clinical features of maternal depression (i.e., severity, chronicity, and clinical features) with child psychopathology. Mothers were participants in the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) multisite trial, designed to compare effectiveness and acceptability of different treatment options for outpatients with non-psychotic major depressive disorder (MDD).","Pilowsky, D J; Wickramaratne, P J; Rush, A J; Hughes, C W; Garber, J; Malloy, E; King, C A; Cerda, G; Sood, A B; Alpert, J E; Wisniewski, S R; Trivedi, M H; Talati, A; Carlson, M M; Liu, H H; Fava, M; Weissman, M M",2006.0,,0,0,
5158,Factors associated with post-traumatic stress symptoms experienced in the acute phase following haemopoietic stem cell transplant.,,Pillay B.; Lee SJ.; Katona L.; De Bono S.; Burney S.; Avery S.,2016.0,10.1038/bmt.2015.259,0,0,
5159,Effectiveness of Global Postural Re-education in Patients With Chronic Nonspecific Neck Pain: randomized Controlled Trial,"ER OBJECTIVE: The purpose of this study was to evaluate the effectiveness of applying GPR compared with a manual therapy (MT) intervention to patients with chronic nonspecific NP.DESIGN: An RCT was conducted.PATIENTS: Ninety-four patients with chronic nonspecific NP (72 women and 22 men; average age=47.5 years, SD=11.3) were randomly assigned to receive either a GPR intervention or an MT intervention.OUTCOME MEASURES: Pain intensity (visual analog scale), disability (Neck Disability Index), cervical range of motion, and kinesiophobia (Tampa Scale of Kinesiophobia) were assessed.METHODS: The experimental group received GPR, and the reference group received MT. Both groups received nine 60-minute-long sessions with one-to-one supervision from physical therapists as the care providers. All participants were asked to follow ergonomic advice and to perform home exercises. Measures were assessed before treatment, following treatment, and at a 6-month follow-up.RESULTS: No important baseline differences were found between groups. The experimental group exhibited a statistically significant reduction in pain following treatment and in disability 6 months after the intervention compared with the reference group.LIMITATIONS: Randomization did not lead to completely homogeneous groups. It also was noted that the time spent integrating the movements practiced during the session into daily routines at the end of each session was requested only of participants in the GPR group and may have had an impact on patient adherence that contributed to a better outcome.CONCLUSIONS: The results suggest that GPR was more effective than MT for reducing pain after treatment and for reducing disability at 6-month follow-up in patients with chronic nonspecific NP.BACKGROUND: Global postural re-education (GPR) has shown positive results for patients with musculoskeletal disorders, but no previous randomized controlled trial (RCT) has investigated its effectiveness as the sole procedure for adult patients with chronic nonspecific neck pain (NP).","Pillastrini, P; Lima E Sá, Resende F; Banchelli, F; Burioli, A; Ciaccio, E; Guccione, A A; Villafañe, J H; Vanti, C",2016.0,10.2522/ptj.20150501,0,0,
5160,"An examination of the relationship between general life stress, racism-related stress, and psychological health among black men","This study explored the relationship among general life stress, racism-related stress, and psychological health in a sample of 220 Black men. Participants completed a personal data form, the Perceived Stress Scale (S. Cohen, T. Kamarck, & R. Mermelstein, 1983), a modified version of the Schedule of Racist Events (H. Landrine & E. A. Klonoff, 1996), and the Mental Health Inventory (C. T. Veit & J. E. Ware, 1983). Results of hierarchical regressions indicated that when general stress was controlled, racism-related stress predicted an additional 4% of variance in psychological distress for working class men and an additional 7% for middle-upper class men. Racism-related stress also predicted an additional 5% of variance in psychological well-being for middle-upper class men; however, it was not predictive of psychological well-being for working class men. Implications for counseling practice and future research are discussed. Copyright 2007 by the American Psychological Association.",Pieterse A.L.; Carter R.T.,2007.0,10.1037/0022-0167.54.1.101,0,0,
5161,The effect of mindfulness-based therapy on symptoms of anxiety and depression in adult cancer patients and survivors: A systematic review and meta-analysis.,"Objective: The use of mindfulness-based therapy (MBT) in oncology settings has become increasingly popular, and research in the field has rapidly expanded. The objective was by means of a systematic review and meta-analysis to evaluate the current evidence for the effect of MBT on symptoms of anxiety and depression in adult cancer patients and survivors. Method: Electronic databases were searched, and researchers were contacted for further relevant studies. Twenty-two independent studies with a total of 1,403 participants were included. Studies were coded for quality (range: 0-4), and overall effect size analyses were performed separately for nonrandomized studies (K = 13, n = 448) and randomized controlled trials (RCTs; K = 9, n = 955). Effect sizes were combined using the random-effects model. Results: In the aggregated sample of nonrandomized studies (average quality score: 0.5), MBT was associated with significantly reduced symptoms of anxiety and depression from pre- to posttreatment corresponding to moderate effect sizes (Hedges\'s g) of 0.60 and 0.42, respectively. The pooled controlled effect sizes (Hedges\'s g) of RCTs (average quality score: 2.9) were 0.37 for anxiety symptoms (p < .001) and 0.44 for symptoms of depression (p < .001). These effect sizes appeared robust. Furthermore, in RCTs, MBT significantly improved mindfulness skills (Hedges\'s g = 0.39). Conclusion: While the overall quality of existing clinical trials varies considerably, there appears to be some positive evidence from relatively high-quality RCTs to support the use of MBT for cancer patients and survivors with symptoms of anxiety and depression. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Piet, Jacob; Wurtzen, Hanne; Zachariae, Robert; Allison, Andresen, Baer, Baer, Baer, Barlow, Bech, Beck, Birnie, Bleiker, Bohlmeijer, Borenstein, Branstrom, Branstrom, Brown, Burgess, Carlson, Carlson, Carlson, Carlson, Carlson, Carlson, Carmody, Chambers, Chambers, Chambless, Chiesa, Christensen, Cohen, Dantzer, Dantzer, Derogatis, DerSimonian, Devine, Dobkin, Duval, Egger, Fann, Finucane, Foley, Garland, Grossman, Hamilton, Hamilton, Harvey, Hedges, Hedges, Hedges, Higgins, Hirschfeld, Hoffman, Hofmann, Honda, Hopko, Howren, Jadad, Johns, Kabat-Zinn, Kabat-Zinn, Kessler, Kieviet-Stijnen, Kingston, Kroenke, Kuyken, Kuyken, Labelle, Leckie, Ledesma, Lengacher, Lengacher, Lerman, Massie, Matchim, Matousek, McNair, Mitchell, Moher, Moussavi, Newell, Nezu, Olfson, Ott, Piet, Pinquart, Prieto, Publications, Radloff, Reich, Rosenthal, Rosenthal, Rosenthal, Rosenthal, Rowland, Schafer, Schulz, Segal, Sharplin, Sheard, Shennan, Smith, Speca, Speca, Spiegel, Spielberger, Spitzer, Sterne, Tacon, Tacon, Walach, Williams, Wurtzen, Zabora, Zigmond",2012.0,,0,0,
5162,A randomized pilot study of mindfulness-based cognitive therapy and group cognitive-behavioral therapy for young adults with social phobia.,"Twenty-six young participants, 18-25 years, with social phobia (SP) were randomly assigned to eight 2-hour sessions of group mindfulness-based cognitive therapy (MBCT) and twelve 2-hour sessions of group cognitive-behavioral therapy (CBT) in a crossover design with participants receiving treatments in reversed order. Outcome was assessed after treatments, and at 6- and 12-month follow-ups. MBCT achieved moderate-high pre-post effect sizes (d=0.78 on a composite SP measure), not significantly different from, although numerical lower than those of CBT (d=1.15). Participants in both groups further improved in the periods following their first and second treatment until 6-months follow-up (pre-follow-up ds = 1.42 and 1.62). Thus, MBCT might be a useful, low cost treatment for SP, although, probably, less efficacious than CBT.",Piet J.; Hougaard E.; Hecksher MS.; Rosenberg NK.,2010.0,10.1111/j.1467-9450.2009.00801.x,0,0,
5163,Effects of aerobic exercise on cognitive and psychosocial functioning in patients with mild hypertension.,"The effects of 16 weeks of physical exercise training on the psychological functioning of 90 patients with mild hypertension were examined. At baseline and after 16 weeks of training, patients completed a psychometric test battery that included objective measures of neuropsychological performance and standardized self-report measures of psychosocial functioning. Patients were randomly assigned to one of three groups: aerobic exercise, strength training and flexibility exercise, or a waiting list control group. After training, there were no group differences on any of the psychological measures, even though patients who engaged in exercise perceived themselves as functioning better in a number of psychological domains.",Pierce TW.; Madden DJ.; Siegel WC.; Blumenthal JA.,1993.0,,0,0,
5164,"Effect of treatment of temporomandibular disorders (TMD) in patients with cervicogenic headache: a single-blind, randomized controlled study","ER The present study was comprised of 43 patients (16 men) with cervicogenic headaches for over three months, diagnosed according to the International Classification of Diagnostic Criteria of Headaches (ICDH-II). The patients were randomly assigned to receive either manual therapy for the cervical region (usual care group) or additional manual therapy techniques to the temporomandibular region to additionally influence temporomandibular disorders (TMD). All patients were assessed prior to treatment, after six sessions of treatment, and at a six-month follow-up. The outcome criteria were: intensity of headaches measured on a colored analog scale, the Neck Disability Index (Dutch version), the Conti Anamnestic Questionnaire, noise registration at the mandibular joint using a stethoscope, the Graded Chronic Pain Status (Dutch version), mandibular deviation, range of mouth opening, and pressure/pain threshold of the masticatory muscles. The results indicate in the studied sample of cervicogenic headache patients, 44.1% had TMD. The group that received additional temporomandibular manual therapy techniques showed significantly decreased headache intensities and increased neck function after the treatment period. These improvements persisted during the treatment-free period (follow-up) and were not observed in the usual care group. This trend was also reflected on the questionnaires and the clinical temporomandibular signs. Based on these observations, we strongly believe that treatment of the temporomandibular region has beneficial effects for patients with cervicogenic headaches, even in the long-term.","Piekartz, H; Lüdtke, K",2011.0,10.1179/crn.2011.008,0,0,
5165,Orofacial manual therapy improves cervical movement impairment associated with headache and features of temporomandibular dysfunction: a randomized controlled trial,"ER There is evidence that temporomandibular disorder (TMD) may be a contributing factor to cervicogenic headache (CGH), in part because of the influence of dysfunction of the temporomandibular joint on the cervical spine. The purpose of this randomized controlled trial was to determine whether orofacial treatment in addition to cervical manual therapy, was more effective than cervical manual therapy alone on measures of cervical movement impairment in patients with features of CGH and signs of TMD. In this study, 43 patients (27 women) with headache for more than 3-months and with some features of CGH and signs of TMD were randomly assigned to receive either cervical manual therapy (usual care) or orofacial manual therapy to address TMD in addition to usual care. Subjects were assessed at baseline, after 6 treatment sessions (3-months), and at 6-months follow-up. 38 subjects (25 female) completed all analysis at 6-months follow-up. The outcome criteria were: cervical range of movement (including the C1-2 flexion-rotation test) and manual examination of the upper 3 cervical vertebra. The group that received orofacial treatment in addition to usual care showed significant reduction in all aspects of cervical impairment after the treatment period. These improvements persisted to the 6-month follow-up, but were not observed in the usual care group at any point. These observations together with previous reports indicate that manual therapists should look for features of TMD when examining patients with headache, particularly if treatment fails when directed to the cervical spine.","Piekartz, H; Hall, T",2013.0,10.1016/j.math.2012.12.005,0,0,
5166,"Rationale, design and methods for a randomised and controlled trial to evaluate ""Animal Fun""--a program designed to enhance physical and mental health in young children","ER METHODSThe proposed randomized and controlled trial uses a multivariate nested cohort design to examine the physical (motor coordination) and psychosocial (self perceptions, anxiety, social competence) outcomes of the program. The Animal Fun program is a teacher delivered universal program incorporating animal actions to facilitate motor skill and social skill acquisition and practice. Pre-intervention scores on motor and psychosocial variables for six control schools and six intervention schools will be compared with post-intervention scores (end of Pre-Primary year) and scores taken 12 months later after the children's transition to primary school Year 1. 520 children aged 4.5 to 6 years will be recruited and it is anticipated that 360 children will be retained to the 1 year follow-up. There will be equal numbers of boys and girls.DISCUSSIONIf this program is found to improve the child's motor and psychosocial skills, this will assist in the child's transition into the first year of school. As a result of these changes, it is anticipated that children will have greater enjoyment participating in physical activities which will further promote long term physical and mental health.TRIAL REGISTRATIONThis trial is registered in the Australian and New Zealand Clinical trials Registry (ACTRN12609000869279).BACKGROUNDChildren with poor motor ability have been found to engage less in physical activities than other children, and a lack of physical activity has been linked to problems such as obesity, lowered bone mineral density and cardiovascular risk factors. Furthermore, if children are confident with their fine and gross motor skills, they are more likely to engage in physical activities such as sports, crafts, dancing and other physical activity programs outside of the school curriculum which are important activities for psychosocial development. The primary objective of this project is to comprehensively evaluate a whole of class physical activity program called Animal Fun designed for Pre-Primary children. This program was designed to improve the child's movement skills, both fine and gross, and their perceptions of their movement ability, promote appropriate social skills and improve social-emotional development.","Piek, J P; Straker, L M; Jensen, L; Dender, A; Barrett, N C; McLaren, S; Roberts, C; Reid, C; Rooney, R; Packer, T; Bradbury, G; Elsley, S",2010.0,10.1186/1471-2431-10-78,0,0,
5167,Using memory restructuring strategy to enhance dental behaviour,"ER DESIGNThe design compared 'usual care' plus an intervention designed to positively restructure memory with 'usual care' plus a control for 45 children, ages 6-9 years, who were in need of two restorative treatment visits. The intervention occurred at the second visit immediately before the dental treatment and focused on restructuring the child's memory of the first treatment visit. Children were asked to recall how much fear and pain they experienced during the first dental treatment.RESULTSThe child's behaviour improved from the first dental treatment visit to the second in the intervention group but not in the control condition. When compared to the controls, those in the intervention group changed their memory of the fear they experienced at the first treatment and their memory of experienced pain.CONCLUSIONSRestructuring memory may be effective in reducing fear for future treatment, and is easily adaptable to clinical practice in other healthcare situations.AIMSThis study sought to 'restructure' memory of dental treatment to help children develop positive memories and cooperate more fully with the dentist at future visits.","Pickrell, J E; Heima, M; Weinstein, P; Coolidge, T; Coldwell, S E; Skaret, E; Castillo, J; Milgrom, P",2007.0,10.1111/j.1365-263X.2007.00873.x,0,0,
5168,"Traumatic events, posttraumatic stress disorder, attachment style, and working alliance in a sample of people with psychosis.","There is a high incidence of trauma and posttraumatic stress disorder (PTSD) in people with a diagnosis of psychosis. Sequelae of trauma may affect the ability to engage in both attachment and therapeutic relationships. This study investigated associations between trauma histories, PTSD, attachment styles, and working alliance in a sample of 110 individuals with psychosis and substance misuse. Anxious attachment was associated with number of interpersonal traumas and PTSD reported, but there were no associations between trauma and alliance. There were discrepancies in number of traumatic events reported by care coordinators and patients. The findings of this study highlight the potential use of attachment theory in working with trauma and PTSD in psychosis.",Picken AL.; Berry K.; Tarrier N.; Barrowclough C.,2010.0,10.1097/NMD.0b013e3181f4b163,0,0,
5169,Trauma and comorbid posttraumatic stress disorder in individuals with schizophrenia and substance abuse.,"The aim of this study was to investigate the occurrence of trauma and comorbid posttraumatic stress disorder (PTSD) in dual diagnosis patients and whether the trauma was related to the patient's behavior or illness. One hundred ten patients with schizophrenia and comorbid substance or alcohol abuse were assessed for PTSD using self-report and structured interview. Traumatic events were classified as independent or dependent upon the patient's behavior, illness, or symptoms. One hundred patients (91%) reported at least 1 trauma (mean, 4.3). Sixty-three patients (57%) reported a traumatic event that met modified-criterion A for PTSD. Thirty-one patients (28%) met criteria for full PTSD, and 18 (16%) had a trauma directly related to their illness. Patients with PTSD had significantly higher scores on positive psychotic symptoms and depression. Exposures to traumatic events and comorbid PTSD are high but are inflated by reactions to illness-related events such as hospitalization and psychotic symptoms.",Picken A.; Tarrier N.,,10.1016/j.comppsych.2010.10.008,0,0,
5170,Trauma and comorbid posttraumatic stress disorder in individuals with schizophrenia and substance abuse,"ER METHODOne hundred ten patients with schizophrenia and comorbid substance or alcohol abuse were assessed for PTSD using self-report and structured interview. Traumatic events were classified as independent or dependent upon the patient's behavior, illness, or symptoms.RESULTSOne hundred patients (91%) reported at least 1 trauma (mean, 4.3). Sixty-three patients (57%) reported a traumatic event that met modified-criterion A for PTSD. Thirty-one patients (28%) met criteria for full PTSD, and 18 (16%) had a trauma directly related to their illness. Patients with PTSD had significantly higher scores on positive psychotic symptoms and depression.CONCLUSIONSExposures to traumatic events and comorbid PTSD are high but are inflated by reactions to illness-related events such as hospitalization and psychotic symptoms.OBJECTIVESThe aim of this study was to investigate the occurrence of trauma and comorbid posttraumatic stress disorder (PTSD) in dual diagnosis patients and whether the trauma was related to the patient's behavior or illness.","Picken, A; Tarrier, N",2011.0,10.1016/j.comppsych.2010.10.008,0,0,5169
5171,Attachment style and immunity: a 1-year longitudinal study,"ER Previous cross-sectional studies suggested an association between attachment-related avoidance and altered immune function. We aimed at testing this hypothesis with longitudinal data. A random sample of 65 female nurses provided a blood sample and completed measures of perceived stress, social support, alexithymia, and attachment style. Immune assays included lymphocyte proliferative response (LPR) to Phytohemagglutinin and NK cell cytotoxicity (NKCC). State measures (perceived stress and support) and immune measures were collected again after 4, 8, and 12 months. Linear mixed effects models were used to examine the relationship between attachment and immunity. While low to moderate levels of attachment-related avoidance were not associated with NKCC, there was a significant negative association (beta -.35; p=.005) between high levels of avoidance and NKCC. No association was observed between NKCC and attachment-related anxiety, and between LPR and both attachment dimensions. While our findings should be interpreted with caution due to study limitations such as the relatively small sample size and the inclusion of only female participants, they corroborate the notion that attachment is linked to physiology and health.","Picardi, A; Miglio, R; Tarsitani, L; Battisti, F; Baldassari, M; Copertaro, A; Mocchegiani, E; Cascavilla, I; Biondi, M",2013.0,10.1016/j.biopsycho.2012.10.001,0,0,
5172,Controlled comparison of family cognitive behavioral therapy and psychoeducation/relaxation training for child obsessive-compulsive disorder,"ER METHOD: A total of 71 youngsters 8 to 17 years of age (mean 12.2 years; range, 8-17 years, 37% male, 78% Caucasian) with primary OCD were randomized (70:30) to 12 sessions over 14 weeks of FCBT or PRT. Blind raters assessed outcomes with responders followed for 6 months to assess treatment durability.RESULTS: FCBT led to significantly higher response rates than PRT in ITT (57.1% vs 27.3%) and completer analyses (68.3% vs. 35.3%). Using HLM, FCBT was associated with significantly greater change in OCD severity and child-reported functional impairment than PRT and marginally greater change in parent-reported accommodation of symptoms. These findings were confirmed in some, but not all, secondary analyses. Clinical remission rates were 42.5% for FCBT versus 17.6% for PRT. Reduction in family accommodation temporally preceded improvement in OCD for both groups and child functional status for FCBT only. Treatment gains were maintained at 6 months.CONCLUSIONS: FCBT is effective for reducing OCD severity and impairment. Importantly, treatment also reduced parent-reported involvement in symptoms with reduced accommodation preceding reduced symptom severity and functional impairment. CLINICAL TRIALS REGISTRY INFORMATION: Behavior Therapy for Children and Adolescents with Obsessive-Compulsive Disorder (OCD); http://www.clinicaltrials.gov; NCT00000386.OBJECTIVE: To examine the efficacy of exposure-based cognitive-behavioral therapy (CBT) plus a structured family intervention (FCBT) versus psychoeducation plus relaxation training (PRT) for reducing symptom severity, functional impairment, and family accommodation in youths with obsessive-compulsive disorder (OCD).","Piacentini, J; Bergman, R L; Chang, S; Langley, A; Peris, T; Wood, J J; McCracken, J",2011.0,10.1016/j.jaac.2011.08.003,0,0,
5173,Updating versus Exposure to Prevent Consolidation of Conditioned Fear.,"Targeting the consolidation of fear memories following trauma may offer a promising method for preventing the development of flashbacks and other unwanted re-experiencing symptoms that characterise Posttraumatic Stress Disorder (PTSD). Research has demonstrated that performing visuo-spatial tasks after analogue trauma can block the consolidation of fear memory and reduce the frequency of flashbacks. However, no research has yet used verbal techniques to alter memories during the consolidation window. This is surprising given that the most effective treatments for PTSD are verbally-based with exposure therapy and trauma-focused cognitive behavioural therapy gaining the most evidence of efficacy. Psychological therapies aim to reduce the conditioned fear response, which is in keeping with the preliminary finding that an increased propensity for fear conditioning may be a vulnerability factor for PTSD. Our research had two aims. We investigated the degree to which individual differences in fear conditioning predict the development of PTSD symptoms. We also compared the preventative effects of two clinically informed psychological techniques administered during the consolidation window: exposure to the trauma memory and updating the meaning of the trauma. 115 healthy participants underwent a fear conditioning paradigm in which traumatic film stimuli (unconditioned stimuli) were paired with neutral stimuli (conditioned stimuli). Participants were randomly allocated to an updating, exposure or control group to compare the effects on the conditioned fear response and on PTSD symptomatology. The results showed that stronger conditioned responses at acquisition significantly predicted the development of PTSD symptoms. The updating group, who verbally devalued the unconditioned stimulus within the consolidation window, experienced significantly lower levels of PTSD symptoms during follow-up than the exposure and control groups. These findings are consistent with clinical interventions for chronic PTSD and have important implications for identifying those at risk as well as for designing novel early interventions to prevent the development of PTSD.",Pile V.; Barnhofer T.; Wild J.,2015.0,10.1371/journal.pone.0122971,0,0,
5174,Individual characteristics of aggressive beer and distilled beverage drinkers,"ER Sixty male social drinkers completed the MMPI and a drinking history and attitude questionnaire. These individuals were then randomly divided into four groups, receiving either a distilled or brewed beverage, or two comparable placebos. Subjects in the alcohol groups became equally intoxicated (BAC = .71) and rated themselves as significantly more intoxicated than placebo subjects. All subjects then participated in a Buss aggression task. Aggression scales were related to the pretask personality, history, and attitude measures. Differences were found between factors descriptive of subjects who became aggressive after consuming or believing they had consumed a distilled versus a brewed beverage. In particular, a history of lack of positive alcohol effects and social maladjustment were typical of high-aggressive distilled alcohol and alcohol-placebo subjects, while the presence of family problems and anxiety typified high-aggressive beer and placebo-beer subjects.","Pihl, R O; Smith, M; Farrell, B",1984.0,,0,0,
5175,The effect of alcohol and placebo on affective reactions of social drinkers to a procedure designed to induce depressive affect anxiety and hostility,"ER Randomly assigned 33 males to one of three alcohol conditions: High dose (two groups), placebo, and no-dose. All Ss after drinking performed a pseudo test of intelligence. One group of high-dose Ss received feedback that indicated an extremely good performance on the intelligence task (Incentive Gain), while all other Ss received extremely poor performance scores (Incentive Loss). Analysis of pre-post feedback scores on the Multiple Affect Adjective Check List indicated differential effect of alcohol and placebo with no change of depressive affect in the two high-dose alcohol groups, but an increase in placebo Ss. Furthermore, incentive loss high-dose Ss rated themselves as significantly more intoxicated than did incentive gain high-dose Ss. The results are discussed in terms of attribution for success and failure, cognitions and depressive affect, and tension reduction models of alcoholism.","Pihl, R O; Segal, Z; Yankofsky, L",1980.0,,0,0,
5176,The effect of interpersonal psychotherapy for depression on insomnia symptoms in a cohort of women with sexual abuse histories,"ER Insomnia frequently occurs with trauma exposure and depression, but can ameliorate with improvements in depression. Insomnia was assessed by the insomnia subscale of the Hamilton Rating Scale for Depression in 106 women with childhood sexual abuse (CSA) and major depression receiving interpersonal psychotherapy (IPT) in an uncontrolled pilot (n = 36) and an immediately subsequent randomized controlled trial (n = 70) comparing IPT to treatment as usual. Depression improved in each study and in both treatment conditions; insomnia had smaller, nonsignificant improvements. Overall, 95 women (90%) endorsed insomnia on the Structured Clinical Interview for DSM-IV at baseline and, of those, 90% endorsed insomnia following treatment. Despite improvements in depression, insomnia persists for most women with CSA.","Pigeon, W R; May, P E; Perlis, M L; Ward, E A; Lu, N; Talbot, N L",2009.0,10.1002/jts.20456,0,0,
5177,Diazepam and Jacobson's progressive relaxation show similar attenuating short-term effects on stress-related brain glucose consumption,"ER A non-pharmacological method to reduce anxiety is ""progressive relaxation"" (PR). The aim of the method is to reduce mental stress and associated mental processes by means of progressive suppression of muscle tension. The study was addressed to evaluate changes in brain glucose metabolism induced by PR in patients under a stressing state generated by a diagnostic medical intervention. The effect of PR was compared to a dose of sublingual diazepam, with the prediction that both interventions would be associated with a reduction in brain metabolism. Eighty-four oncological patients were assessed with 18F-fluorodeoxyglucose-positron emission tomography. Maps of brain glucose distribution from 28 patients receiving PR were compared with maps from 28 patients receiving sublingual diazepam and with 28 patients with no treatment intervention. Compared to reference control subjects, the PR and diazepam groups showed a statistically significant, bilateral and generalized cortical hypometabolism. Regions showing the most prominent changes were the prefrontal cortex and anterior cingulate cortex. No significant differences were identified in the direct comparison between relaxation technique and sublingual diazepam. Our findings suggest that relaxation induced by a physical/psychological procedure can be as effective as a reference anxiolytic in reducing brain activity during a stressful state.","Pifarré, P; Simó, M; Gispert, J D; Plaza, P; Fernández, A; Pujol, J",2015.0,10.1016/j.eurpsy.2014.03.002,0,0,
5178,Elucidating the transdiagnostic dimensional structure of trauma-related psychopathology: Findings from VA cooperative study 504-Risperidone treatment for military service related chronic post traumatic stress disorder.,"Background: Three of the most common trauma-related mental disorders-posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD)-are highly comorbid and share common transdiagnostic symptom dimensions of threat (i.e., fear) and loss (i.e., dysphoria) symptomatology. However, empirical evaluation of the dimensional structure of component aspects of these disorders is lacking. Methods: Using structured clinical interview data from U.S. military veterans with chronic military-related PTSD, we evaluated the transdiagnostic dimensional structure of PTSD, MDD, and GAD symptoms. We then examined the relationship between the best-fitting transdiagnostic model of these symptoms, and measures of physical and mental functioning, and life satisfaction and well-being. Results: Exploratory factor analysis revealed that a 3-factor transdiagnostic model comprised of loss (i.e., dysphoria), threat (i.e., anxious arousal, re-experiencing, and avoidance symptoms), and somatic anxiety (i.e., physiological manifestations of anxiety) symptoms provided the best representation of trauma-related PTSD, MDD, and GAD symptoms. Somatic anxiety symptoms were independently associated with physical functioning, while loss symptoms were independently associated with mental functioning and life satisfaction and well-being. Limitations: Evaluation of study aims in a relatively homogeneous sample of veterans with chronic, military-related PTSD. Conclusions: Results of this study suggest that a 3-factor transdiagnostic model best characterizes the dimensional structure of PTSD, MDD, and GAD symptoms in military veterans with chronic military-related PTSD. This model evidenced external validity in demonstrating differential associations with measures of physical and mental functioning, and life satisfaction and well-being. Results provide support for emerging contemporary models of psychopathology, which emphasize transdiagnostic and dimensional conceptualizations of mental disorders. Such models may have utility in understanding the functional status of trauma survivors. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pietrzak, Robert H; Rosenheck, Robert A; Cramer, Joyce A; Vessichio, Jennifer C; Tsai, Jack; Southwick, Steven M; Krystal, John H; VA CSP 504 Collaborative Group; Armour, Beck, Blake, Cohen, Cuthbert, Cuthbert, Cuthbert, Forbes, Forbes, Forbes, Grant, Hamilton, Harpaz-Rotem, Hays, Insel, Keane, Krystal, Montgomery, Muthen, Parker, Pett, Pietrzak, Pietrzak, Pietrzak, Schnurr, Serretti, Smith, Tsai, Weathers, Zoellner",2015.0,,0,0,
5179,Resilience in the face of disaster: prevalence and longitudinal course of mental disorders following hurricane Ike.,"Natural disasters may increase risk for a broad range of psychiatric disorders, both in the short- and in the medium-term. We sought to determine the prevalence and longitudinal course of posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), depression, and suicidality in the first 18 months after Hurricane Ike. Six hundred fifty-eight adults representative of Galveston and Chambers Counties, Texas participated in a random, population-based survey. The initial assessment was conducted 2 to 5 months after Hurricane Ike struck Galveston Bay on September 13, 2008. Follow-up assessments were conducted at 5 to 9 and 14 to 18 months after Hurricane Ike. Past-month prevalence of any mental disorder (20.6% to 10.9%) and hurricane-related PTSD (6.9% to 2.5%) decreased over time. Past-month prevalence of PTSD related to a non-disaster traumatic event (5.8% to 7.1%), GAD (3.1% to 1.8%), PD (0.8% to 0.7%), depression (5.0% to 5.6%), and suicidality (2.6% to 4.2%) remained relatively stable over time. PTSD, both due to the hurricane and due to other traumatic events, was the most prevalent psychiatric disorder 2 to 5 months after Hurricane Ike. Prevalence of psychiatric disorders declined rapidly over time, suggesting that the vast majority of individuals exposed to this natural disaster 'bounced back' and were resilient to long-term mental health consequences of this large-scale traumatic event.",Pietrzak RH.; Tracy M.; Galea S.; Kilpatrick DG.; Ruggiero KJ.; Hamblen JL.; Southwick SM.; Norris FH.,2012.0,10.1371/journal.pone.0038964,0,0,
5180,The Impact of Event Scale: validation of an Italian version.,"To validate an Italian version of the Impact of Event Scale (IES) in patients addressing the emotional impact of a recent road accident. Seventy-nine subjects were examined within 1-34 weeks after an accident by means of (1). an Italian version of the IES, (2). a free description of the accident, and (3). a questionnaire assessing subjects' behaviour and feelings. IES data were analysed by means of the principal component analysis (PCA) method, followed by a quartimax rotation, obtaining a two-factor solution interpreted as intrusion (Factor 1) and avoidance (Factor 2). Furthermore, the scores to the two subscales were considered in order to assess their predictive value on some variables linked to the traumatic event. Intrusion significantly discriminated the emotional intensity and fear level of subjects as a consequence of the accident. The IES is a two-dimensional test capable of evaluating posttraumatic stress. The intrusion and avoidance factors explained 40% of the total variance. The two-factor solution has a psychological counterpart and is similar to the findings of earlier studies conducted on a larger number of subjects in other countries.",Pietrantonio F.; De Gennaro L.; Di Paolo MC.; Solano L.,2003.0,,0,0,
5181,The Well London program--a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results,"ER METHODS: The CRT involved 20 matched pairs of intervention and control communities (defined as UK census lower super output areas (LSOAs); ranked in the 11% most deprived LSOAs in London by the English Indices of Multiple Deprivation) across 20 London boroughs. The primary trial outcomes, sociodemographic information, and environmental neighbourhood characteristics were assessed in three quantitative components within the Well London CRT at baseline: a cross-sectional, interviewer-administered adult household survey; a self-completed, school-based adolescent questionnaire; a fieldworker completed neighborhood environmental audit. Baseline data collection occurred in 2008. Physical activity, healthy eating, and mental wellbeing were assessed using standardized, validated questionnaire tools. Multiple imputation was used to account for missing data in the outcomes and other variables in the adult and adolescent surveys.RESULTS: There were 4,107 adults and 1,214 adolescent respondents in the baseline surveys. The intervention and control areas were broadly comparable with respect to the primary outcomes and key sociodemographic characteristics. The environmental characteristics of the intervention and control neighborhoods were broadly similar. There was greater between-cluster variation in the primary outcomes in the adult population compared to the adolescent population. Levels of healthy eating, smoking, and self-reported anxiety/depression were similar in the Well London adult population and the national Health Survey for England. Levels of physical activity were higher in the Well London adult population but this is likely to be due to the different measurement tools used in the two surveys.CONCLUSIONS: Randomization of social interventions such as Well London is acceptable and feasible and in this study the intervention and control arms are well-balanced with respect to the primary outcomes and key sociodemographic characteristics. The matched design has improved the statistical efficiency of the study amongst adults but less so amongst adolescents. Follow-up data collection will be completed 2012.BACKGROUND: The Well London program used community engagement, complemented by changes to the physical and social neighborhood environment, to improve physical activity levels, healthy eating, and mental wellbeing in the most deprived communities in London. The effectiveness of Well London is being evaluated in a pair-matched cluster randomized trial (CRT). The baseline survey data are reported here.","Phillips, G; Renton, A; Moore, D G; Bottomley, C; Schmidt, E; Lais, S; Yu, G; Wall, M; Tobi, P; Frostick, C; Clow, A; Lock, K; Petticrew, M; Hayes, R",2012.0,10.1186/1745-6215-13-105,0,0,
5182,5-Hz Transcranial Magnetic Stimulation for Comorbid Posttraumatic Stress Disorder and Major Depression.,"Current treatment options for posttraumatic stress disorder (PTSD) offer modest benefits, underscoring the need for new treatments. Repetitive transcranial magnetic stimulation (rTMS) depolarizes neurons in a targeted brain region with magnetic fields typically pulsed at low (1 Hz) or high (10 Hz) frequency to relieve major depressive disorder (MDD). Prior work suggests an intermediate pulse frequency, 5 Hz, is also efficacious for treating comorbid depressive and anxiety symptoms. In this chart review study, we systematically examined the clinical and safety outcomes in 10 patients with comorbid MDD and PTSD syndromes who received 5-Hz rTMS therapy at the Providence VA Medical Center Neuromodulation Clinic. Self-report scales measured illness severity prior to treatment, after every 5 treatments, and upon completion of treatment. Results showed significant reduction in symptoms of PTSD (p = .003, effect size = 1.12, 8/10 with reliable change) and MDD (p = .005, effect size = 1.09, 6/10 with reliable change). Stimulation was well tolerated and there were no serious adverse events. These data indicate 5-Hz rTMS may be a useful option to treat these comorbid disorders. Larger, controlled trials are needed to confirm the benefits of 5-Hz protocols observed in this pilot study.",Philip NS.; Ridout SJ.; Albright SE.; Sanchez G.; Carpenter LL.,2016.0,10.1002/jts.22065,0,0,
5183,Psychological correlates of sexual dysfunction in female rectal and anal cancer survivors: analysis of baseline intervention data.,"Sexual dysfunction represents a complex and multifactorial construct that can affect both men and women and has been noted to often deteriorate significantly after treatment for rectal and anal cancer. Despite this, it remains an understudied, underreported, and undertreated issue in the field of cancer survivorship. This study examined the characteristics of women enrolled in an intervention trial to treat sexual dysfunction, and explored the relationship between sexual functioning and psychological well-being. There were 70 female posttreatment anal or rectal cancer survivors assessed as part of the current study. Participants were enrolled in a randomized intervention trial to treat sexual dysfunction and completed outcome measures prior to randomization. The main outcome measures are quality of life (QOL) (European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire [EORTC-QLQ-C30] and Colorectal Cancer-Specific Module [QLQ-CR38]), sexual functioning (Female Sexual Functioning Index), and psychological well-being (Brief Symptom Inventory Depression/Anxiety, Impact of Events Scale-Revised, CR-38 Body Image). Women enrolled in the study intervention were on average 55 years old, predominantly Caucasian (79%), married (57%), and a median of 4 years postprimary treatment. For those reporting sexual activity at baseline (N=41), sexual dysfunction was associated with a range of specific measures of psychological well-being, all in the hypothesized direction. The Sexual/Relationship Satisfaction subscale was associated with all measures of psychological well-being (r=-0.45 to -0.70, all P<0.01). Body image, anxiety, and cancer-specific posttraumatic distress were notable in their association with subscales of sexual functioning, while a global QOL measure was largely unrelated. For sexually active female rectal and anal cancer survivors enrolled in a sexual health intervention, sexual dysfunction was significantly and consistently associated with specific measures of psychological well-being, most notably Sexual/Relationship Satisfaction. These results suggest that sexual functioning may require focused assessment by providers, beyond broad QOL assessments, and that attention to Sexual/Relationship Satisfaction may be critical in the development and implementation of interventions for this cohort of patients.",Philip EJ.; Nelson C.; Temple L.; Carter J.; Schover L.; Jennings S.; Jandorf L.; Starr T.; Baser R.; DuHamel K.,2013.0,10.1111/jsm.12152,0,0,
5184,The use and utility of EMG biofeedback with chronic schizophrenic patients,"ER This study examined the efficacy of muscle relaxation training via electromyographic (EMG) biofeedback from the frontalis and forearm extensor muscles of schizophrenic inpatients. Thirty chronically hospitalized patients were randomly assigned to one of three conditions: EMG biofeedback from the forearm extensor and frontalis muscles, progressive relaxation, and a control group. Treatment consisted of one session of orientation and baseline, and six sessions of training. The results indicated that the schizophrenic patients receiving EMG training had significantly lower EMG recordings than the progressive relaxation group, which, in turn, was significantly lower than the control group. Analyses of covariance on the Tension-Anxiety scale from the Profile of Mood States revealed no significant effects, while finger-tapping rates were significantly improved only for the arm receiving feedback training in the EMG group. On the Nurses Observation Scale for Inpatient Evaluation the biofeedback group significantly improved on the Social Competence and Social Interest factors.","Pharr, O M; Coursey, R D",1989.0,,0,0,
5185,The relationship between a history of trauma and client satisfaction within a substance abuse treatment sample.,"Much research has been done on substance abuse, trauma, and co-occurring disorders and the research suggests that using integrated treatment strategies produces better treatment outcomes. Although integrated treatment has been shown to have greater positive treatment outcomes, individuals continue to have positive treatment results when receiving treatment that address only one of their mental health issues. There are many factors that have been studied that influence treatment outcomes but for the purpose of this study the researcher explored the factor of client satisfaction. This study examined the correlational relationship between psychological symptoms in individuals that have a co-occuring trauma and substances use disorder and treatment satisfaction. This study is based on the research of Ankuta and Abeles (1993), Behavioral treatment of posttraumatic stress disorder and co-occurring substance abuse, Lunnen and Ogles (1998), A multiperspective, multivariable evaluation of reliable change, and Pekarik and Wolff (1996), Relationship of satisfaction to symptom change, follow-up adjustment, and clinical significance, and a detailed description is given of these studies. The hypothesis is that clients with high levels of psychological distress will experience lower levels of satisfaction. The study gave background information and discussed past research on the factors. The methodology used in the study is given and the results of the experiement is discussed. The researcher gave the limitations of the study that the reader should take into consideration before apply these findings in real life practice. The implications for future research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pharr, Andrea N",2010.0,,0,0,
5186,Cannabinoid modulation of amygdala reactivity to social signals of threat in humans,"ER The cannabinoid (CB) system is a key neurochemical mediator of anxiety and fear learning in both animals and humans. The anxiolytic effects of delta(9)-tetrahydrocannabinol (THC), the primary psychoactive ingredient in cannabis, are believed to be mediated through direct and selective agonism of CB(1) receptors localized within the basolateral amygdala, a critical brain region for threat perception. However, little is known about the effects of THC on amygdala reactivity in humans. We used functional magnetic resonance imaging and a well validated task to probe amygdala responses to threat signals in 16 healthy, recreational cannabis users after a double-blind crossover administration of THC or placebo. We found that THC significantly reduced amygdala reactivity to social signals of threat but did not affect activity in primary visual and motor cortex. The current findings fit well with the notion that THC and other cannabinoids may have an anxiolytic role in central mechanisms of fear behaviors and provide a rationale for exploring novel therapeutic strategies that target the cannabinoid system for disorders of anxiety and social fear.","Phan, K L; Angstadt, M; Golden, J; Onyewuenyi, I; Popovska, A; Wit, H",2008.0,10.1523/JNEUROSCI.5603-07.2008,0,0,
5187,"Feasibility and efficacy of an mHealth game for managing anxiety: ""Flowy"" randomized controlled pilot trial and design evaluation.","Objective: Meeting the complex needs of patients with chronic common mental health disorders (CMHDs) may be the greatest challenge facing organized medical practice. On the basis of a well-established and proven theoretical foundation for controlled respiration as a behavioral intervention for CMHDs, as well as preliminary evidence that gamification can improve health outcomes through increasing patient engagement, this randomized controlled pilot study evaluated the feasibility and clinical efficacy of a mobile health game called ""Flowy"" (www.flowygame.com) that digitally delivered breathing retraining exercises for anxiety, panic, and hyperventilation symptom management. Materials and Methods: We designed an unblinded, Web-based, parallel-group randomized controlled trial focusing on feasibility, clinical efficacy, and design proof of concept. In the intervention condition (n = 31), participants received free access to ""Flowy"" for 4 weeks. In the control condition (n = 32), participants were placed on a waitlist for 4 weeks before being offered free access to ""Flowy."" Online measurements using psychological self-report questionnaires were made at 2 and 4 weeks post-baseline. Results: At trial conclusion, participants found ""Flowy"" acceptable as an anxiety management intervention. ""Flowy"" engaged participants sufficiently to endorse proactive gameplay. Intent-to-treat analysis revealed a reduction in anxiety, panic, and self-report hyperventilation scores in both trial arms, with the intervention arm experiencing greater quality of life. Participants perceived ""Flowy"" as a fun and useful intervention, proactively used ""Flowy"" as part of their care, and would recommend ""Flowy"" to family and friends. Conclusions: Our results suggest that a digital delivery of breathing retraining exercises through a mobile health game can manage anxiety, panic, and hyperventilation symptoms associated with CMHDs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pham, Quynh; Khatib, Yasmin; Stansfeld, Stephen; Fox, Simon; Green, Tobias; Balas, Beamish, Bingham, Bingham, Brown, Brown, Buijink, Cafazzo, Chambless, Chao, Chu, Clark, Cohen, Collins, Cotton, D'Cruz, Davis, Deci, Deterding, Donker, Driesmans, Endicott, Everly, Eysenbach, Eysenbach, Ferrero, Fish, Fox, Garde, Glasgow, Gorini, Granic, Gutierrez, Haffey, Heron, Jozkowski, Kato, Kato, Kato, Kim, Kottink, Krishna, Kumar, Leutwyler, Lewis, Ley, Ley, Lin, Lozano-Quilis, Lum, Lyons, Mathers, McCartney, McCurdie, Meuret, Misra, Mohr, Mohr, Moller, Mueser, Norman, Norman, Piantadosi, Pilling, Proffitt, Przybylski, Rapee, Rapee, Roepke, Rosser, Rounsaville, Saha, Sanchez-Meca, Sato, Saxena, Schneider, Shear, Shepherd, Skapinakis, Spitzer, Stinson, Szturm, Taylor, van Dixhoorn, Wolf, Wyatt, Young, Zichermann",2016.0,,0,0,
5188,Hypervigilance-avoidance pattern in spider phobia,"Cognitive-motivational theories of phobias propose that patients' behavior is characterized by a hypervigilance-avoidance pattern. This implies that phobics initially direct their attention towards fear-relevant stimuli, followed by avoidance that is thought to prevent objective evaluation and habituation. However, previous experiments with highly anxious individuals confirmed initial hypervigilance and yet failed to show subsequent avoidance. In the present study, we administered a visual task in spider phobics and controls, requiring participants to search for spiders. Analyzing eye movements during visual exploration allowed the examination of spatial as well as temporal aspects of phobic behavior. Confirming the hypervigilance-avoidance hypothesis as a whole, our results showed that, relative to controls, phobics detected spiders faster, fixated closer to spiders during the initial search phase and fixated further from spiders subsequently. © 2003 Elsevier Inc. All rights reserved.",Pflugshaupt T.; Mosimann U.P.; Von Wartburg R.; Schmitt W.; Nyffeler T.; Müri R.M.,2005.0,10.1016/j.janxdis.2003.12.002,0,0,
5189,Internal focus of attention in anxiety-sensitive females up-regulates amygdale activity: an fMRI study,"Cognitive behavioral models of panic disorder (PD) stress the importance of an increased attentional focus towards bodily symptoms in the onset and maintenance of this debilitating anxiety disorder. In this fMRI mental tracking paradigm, we looked at the effects of focusing one’s attention internally (interoception) vs. externally (exteroception) in a well-studied group at risk for PD—that is anxiety-sensitive females (AS-high). We hypothesized that AS-high subjects compared to control subjects will present higher arousal and decreased valence scores during interoception and parallel higher activity in brain areas which are associated with fear and interoception. 24 healthy female students with high levels of anxiety sensitivity and 24 healthy female students with normal levels of anxiety sensitivity serving as control group were investigated by 3 T fMRI. Subjects either focused their attention on their heartbeats (internal condition) or on neutral tones (external condition). Task performance was monitored by reporting the number of heartbeats or tones after each block. State of arousal and emotional valence were also assessed. The high anxiety-sensitive group reported higher arousal scores compared to controls during the course of the experiment. Simultaneously, fMRI results indicated higher activation in anxiety-sensitive participants than in controls during interoception in a network of cortical and subcortical brain regions (thalamus, amygdala, parahippo-campus) that overlaps with known fear circuitry structures. In particular, the activity of the right amygdala was upregulated. Future prospective-longitudinal studies are needed to validate the role of the amygdala for transition to disorder. Attention to internal body functions up-regulates the activity of interoceptive and fear-relevant brain regions in anxiety-sensitive females, a high-risk group for the development of anxiety disorders.",Pfleiderer B.; Berse T.; Stroux D.; Ewert A.; Konrad C.; Gerlach A.L.,2014.0,10.1007/s00702-014-1248-5,0,0,
5190,Psychopathology and religious commitment--a controlled study.,"The relationship between psychopathology and religious commitment was explored in a group of psychiatric patients (n = 44) with depression, anxiety disorders and personality disorders, compared with a control group of healthy subjects (n = 45). Neuroticism and the degree of religious involvement were measured in all probands. The findings did not show any correlation between neuroticism and religiosity. While life satisfaction was negatively correlated with neuroticism, there was a significantly positive correlation with religious commitment. Anxiety concerning sexuality, superego conflicts and childhood fears of God was primarily associated with neuroticism and not with religious commitment. The findings support the clinical observations that the primary factor in explaining neurotic functioning in religious patients is not their personal religious commitment but their underlying psychopathology.",Pfeifer S.; Waelty U.,1995.0,,0,0,
5191,Preventing anxiety and depression in gynaecological cancer: a randomised controlled trial.,"To examine the effect of counselling and relaxation intervention on psychological symptoms in patients with gynaecological cancer between the post-operative period and the six-week review. Randomised controlled trial. Fifty-three patients with gynaecological cancer. Three Australian tertiary referral hospitals. Fifty-three patients were randomised to control or intervention and completed the baseline Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire-28 (GHQ-28) questionnaires. The intervention consisted of a relaxation and counselling session performed by a senior doctor. Follow up questionnaires were completed at six weeks. Demographic and tumour data were collated independently. Complete data were available on 50 patients. There were no significant differences in demographic, social support or tumour characteristics between the two groups. Multivariate analysis determined that only the intervention and baseline score were significant predictors of outcome. The intervention was associated with a significant reduction in total HADS score (P = 0.002). The reduction was seen in both anxiety and moderate depression subscales (P = 0.001 and P = 0.02). The intervention was also associated with a significant reduction in total GHQ-28 score and in three of the four subscale scores (somatisation, anxiety and personality development; all P < 0.02). However, no significant difference was found in the fourth subscale of major depression. A relaxation and counselling intervention performed by a treating doctor reduces psychological symptoms in women with a new diagnosis of gynaecological cancer.",Petersen RW.; Quinlivan JA.,2002.0,,0,0,
5192,A randomised controlled trial of cognitive behaviour therapy for psychosis in a routine clinical service,"ER METHODParticipants (N = 74) were randomised into immediate therapy or waiting list control groups. The therapy group was offered 6 months of therapy and followed up 3 months later. The waiting list group received therapy after waiting 9 months (becoming the delayed therapy group).RESULTSDepression improved in the combined therapy group at both the end of therapy and follow-up. Other significant effects were found in only one of the two therapy groups (positive symptoms; cognitive flexibility; uncontrollability of thoughts) or one of the two time points (end of therapy: general symptoms, anxiety, suicidal ideation, social functioning, resistance to voices; follow-up: power beliefs about voices, negative symptoms). There was no difference in costs between the groups.CONCLUSIONThe only robust improvement was in depression. Nevertheless, there were further encouraging but modest improvements in both emotional and cognitive variables, in addition to psychotic symptoms.OBJECTIVETo evaluate cognitive behaviour therapy for psychosis (CBTp) delivered by non-expert therapists, using CBT relevant measures.","Peters, E; Landau, S; McCrone, P; Cooke, M; Fisher, P; Steel, C; Evans, R; Carswell, K; Dawson, K; Williams, S; Howard, A; Kuipers, E",2010.0,10.1111/j.1600-0447.2010.01572.x,0,0,
5193,Efficacy of the epilepsy nurse: results of a randomized controlled study,"ER METHODS: Patients with epilepsy treated by neurologists in outpatient clinics were consecutively enrolled and randomly allocated to either the epilepsy nurse (EN) group (n = 92) or the control group (n = 95). Patients in the EN group were advised according to their needs by epilepsy nurses. The control group received routine care without additional counseling. The EN group completed the questionnaires before the first consultation (T1) and 6 months later (T2); the control group completed the questionnaires twice with an interval of 6 months. Primary outcome measure was satisfaction of patients with information and support. Secondary outcome measures were satisfaction with patient-doctor relationship, organization of treatment, epilepsy knowledge, coping, and restrictions in daily life. Anxiety and depression (Hospital Anxiety and Depression Scale) and global Quality of Life (item from QOLIE-31) were also assessed. Statistical analysis included generalized estimating equation (GEE) and nonparametric tests.RESULTS: Satisfaction with information and support improved significantly in the EN group compared to the control group (GEE, interaction group × time, p = 0.001). In addition, Epilepsy Knowledge (p = 0.014) and Coping (subscale Information Seeking) (p = 0.023) improved. Increase in satisfaction with counseling was dependent on patients' needs for information and on the amount of received information (Jonckheere-Terpstra test, p < 0.001). No differences between the groups were observed on other epilepsy-specific scales.SIGNIFICANCE: A reliable questionnaire for satisfaction with epilepsy care has been developed. Epilepsy nurses improve the satisfaction of patients with counseling and information about epilepsy and concomitant problems.OBJECTIVE: We investigated the efficacy of epilepsy nurses on satisfaction with counseling about epilepsy in a randomized, controlled, prospective trial.","Pfäfflin, M; Schmitz, B; May, T W",2016.0,10.1111/epi.13424,0,0,
5194,Text Message and Internet Support for Coronary Heart Disease Self-Management: results From the Text4Heart Randomized Controlled Trial,"ER OBJECTIVE: The aim was to investigate the effectiveness of a mHealth-delivered comprehensive CR program (Text4Heart) to improve adherence to recommended lifestyle behaviors (smoking cessation, physical activity, healthy diet, and nonharmful alcohol use) in addition to usual care (traditional CR).METHODS: A 2-arm, parallel, randomized controlled trial was conducted in New Zealand adults diagnosed with CHD. Participants were recruited in-hospital and were encouraged to attend center-based CR (usual care control). In addition, the intervention group received a personalized 24-week mHealth program, framed in social cognitive theory, sent by fully automated daily short message service (SMS) text messages and a supporting website. The primary outcome was adherence to healthy lifestyle behaviors measured using a self-reported composite health behavior score (?3) at 3 and 6 months. Secondary outcomes included clinical outcomes, medication adherence score, self-efficacy, illness perceptions, and anxiety and/or depression at 6 months. Baseline and 6-month follow-up assessments (unblinded) were conducted in person.RESULTS: Eligible patients (N=123) recruited from 2 large metropolitan hospitals were randomized to the intervention (n=61) or the control (n=62) group. Participants were predominantly male (100/123, 81.3%), New Zealand European (73/123, 59.3%), with a mean age of 59.5 (SD 11.1) years. A significant treatment effect in favor of the intervention was observed for the primary outcome at 3 months (AOR 2.55, 95% CI 1.12-5.84; P=.03), but not at 6 months (AOR 1.93, 95% CI 0.83-4.53; P=.13). The intervention group reported significantly greater medication adherence score (mean difference: 0.58, 95% CI 0.19-0.97; P=.004). The majority of intervention participants reported reading all their text messages (52/61, 85%). The number of visits to the website per person ranged from zero to 100 (median 3) over the 6-month intervention period.CONCLUSIONS: A mHealth CR intervention plus usual care showed a positive effect on adherence to multiple lifestyle behavior changes at 3 months in New Zealand adults with CHD compared to usual care alone. The effect was not sustained to the end of the 6-month intervention. A larger study is needed to determine the size of the effect in the longer term and whether the change in behavior reduces adverse cardiovascular events.TRIAL REGISTRATION: ACTRN 12613000901707; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364758&isReview=true (Archived by WebCite at http://www.webcitation.org/6c4qhcHKt).BACKGROUND: Mobile technology has the potential to deliver behavior change interventions (mHealth) to reduce coronary heart disease (CHD) at modest cost. Previous studies have focused on single behaviors; however, cardiac rehabilitation (CR), a component of CHD self-management, needs to address multiple risk factors.","Pfaeffli, Dale L; Whittaker, R; Jiang, Y; Stewart, R; Rolleston, A; Maddison, R",2015.0,10.2196/jmir.4944,0,0,
5195,"Psychological distress, hopelessness and welfare","This article assesses the validity of the claim that welfare in itself has deleterious psychological consequences for single mothers. The analysis compares single mothers who are recipients of AFDC with single mothers who are not recipients in terms of their depressive symptoms (as measured by the CES-D) and hopelessness (as measured by Pearlin Mastery Scale). The analysis uses data from the National Longitudinal Survey of Youth and the National Survey of Families and Households. The authors find that higher levels of both depression and hopelessness among welfare recipients can be explained by their material hardship rather than the stigma attached to welfare. They show that AFDC recipients report similar levels of depression and hopelessness as jobless non-recipients as well as low-wage non-recipients. An additional finding is that long-term welfare recipients do not experience greater emotional problems than short-term welfare recipients. Finally, the paper shows that feelings of hopelessness mediate the relationship between material deprivation and psychological distress for both recipients and non-recipients. © 2001 by the Haworth Press, Inc.",Petterson S.M.; Friel L.V.,2001.0,10.1300/J013v32n01_04,0,0,
5196,Contingency management treatments decrease psychiatric symptoms.,"Objective: Contingency management (CM) is an empirically validated treatment for substance use disorders, but its effects on psychiatric symptoms have not been systematically examined. The purpose of this study was to examine the impact of CM on psychiatric symptoms of cocaine dependent patients receiving CM with standard care versus standard care alone. Method: Psychiatric symptoms were evaluated in 393 patients participating in 1 of 3 randomized trials of CM at treatment initiation and 1, 3 (posttreatment), 6, and 9 months later. Results: Patients randomized to CM evidenced significant reductions in psychiatric symptoms over time throughout the 9-month follow-up. In contrast, psychiatric symptoms remained stable relative to baseline in patients randomized to standard care. A significant time by treatment condition effect was noted (p < .05) for overall psychiatric distress as well as for specific indices of depression, hostility, interpersonal sensitivity, phobic anxiety and psychoticism symptoms. Reductions in drug use mediated the effects of CM on psychiatric symptoms. Conclusions: These data demonstrate that the effects of CM extend beyond their impact on drug use behaviors and the period in which reinforcers are in effect. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Petry, Nancy M; Alessi, Sheila M; Rash, Carla J; Baron, Beutler, Conway, Curran, Derogatis, Falck, First, Grant, Higgins, Higgins, Higgins, Johnson, Kelly, Lussier, McLellan, Petry, Petry, Petry, Petry, Polcin, Rosenthal, Tang, Wang",2013.0,,0,0,
5197,Disclosure of trauma and immune response to a hepatitis B vaccination program,"ER This study investigated whether emotional expression of traumatic experiences influenced the immune response to a hepatitis B vaccination program. Forty medical students who tested negative for hepatitis B antibodies were randomly assigned to write about personal traumatic events or control topics during 4 consecutive daily sessions. The day after completion of the writing, participants were given their first hepatitis B vaccination, with booster injections at 1 and 4 months after the writing. Blood was collected before each vaccination and at a 6-month follow-up. Compared with the control group, participants in the emotional expression group showed significantly higher antibody levels against hepatitis B at the 4 and 6-month follow-up periods. Other immune changes evident immediately after writing were significantly lower numbers of circulating T helper lymphocytes and basophils in the treatment group. The finding that a writing intervention influences immune response provides further support for a link between emotional disclosure and health.","Petrie, K J; Booth, R J; Pennebaker, J W; Davison, K P; Thomas, M G",1995.0,,0,0,
5198,Long-Term Caregiver Mental Health Outcomes Following a Predominately Online Intervention for Adolescents With Complicated Mild to Severe Traumatic Brain Injury,"ER METHODS: This randomized clinical trial compared CAPS (n?=?65), a predominantly online problem-solving intervention, with an Internet resource comparison (n?=?67) program. Families of adolescents with TBI completed a baseline assessment and follow-up assessments 6, 12, and 18 months later. General linear mixed models were used to examine longitudinal changes in caregiver global psychological distress, depressive symptoms, and caregiving self-efficacy. Family income and injury severity were examined as moderators of treatment efficacy.RESULTS: Family income moderated long-term changes in caregiver psychological distress. For lower-income caregivers, the CAPS intervention was associated with lower levels of psychological distress at 6, 12, and 18 months post baseline.CONCLUSIONS: These findings support the utility of Web-based interventions in improving long-term caregiver psychological distress, particularly for lower-income families.OBJECTIVE: To examine the efficacy of counselor-assisted problem solving (CAPS) in improving long-term caregiver psychological functioning following traumatic brain injury (TBI) in adolescents.","Petranovich, C L; Wade, S L; Taylor, H G; Cassedy, A; Stancin, T; Kirkwood, M W; Maines, Brown T",2015.0,10.1093/jpepsy/jsv001,0,0,
5199,Efficacy of benzopyrenes in posttraumatic inflammations / Clinical double blind study in the postoperative treatment of episiotomy,"A clinical double-blind study of the effectiveness of the benzopyrene product 5,6-benzo-α-pyron + 3',4',7'-tris(hydroxy-ethyl)-rutin (coumarin + troxerutin, Venalot®) was investigated in 560 patients following medio-lateral episiotomy. The compound was investigated at various dose levels, and its active components coumarin and troxerutin separately. It was shown that the symptoms of posttraumatic inflammation like edema, rubor around the incision wound, and posttraumatic pain as well as consumption of analgesics and the postoperative scar formation were beneficially influenced by the drug. As a guideline for dosing, 1 mg/kg/d related to the coumarin content, was calculated. The efficacy of the combination of the active compounds was superior to that found with the components applied separately. The significance of episiotomy as clinical model for posttraumatic inflammation in general is discussed and application of the benzopyrene product above all in plastic surgery is suggested.",Pethoe A.,1981.0,,0,0,
5200,Traumatic Life Events Prior to Alcohol-Related Admission of Injured Acute Care Inpatients: A Brief Report.,"Approximately 30 million Americans present to acute care medical settings annually after incurring traumatic injuries. Posttraumatic stress disorder (PTSD) and depressive symptoms are endemic among injury survivors. Our article is a replication and extension of a previous report documenting a pattern of multiple traumatic life events across patients admitted to Level I trauma centers for an alcohol-related injury. This study is a secondary analysis of a nationwide 20-site randomized trial of an alcohol brief intervention with 660 traumatically injured inpatients. Pre-injury trauma history was assessed using the National Comorbidity Survey trauma history screen at the six-month time point. Most common traumatic events experienced by our population of alcohol-positive trauma survivors were having had someone close unexpectedly die, followed by having seen someone badly beaten or injured. Of particular note, there is high reported prevalence of rape/sexual assault, and childhood abuse and neglect among physically injured trauma survivors. Additional trauma histories are increasingly common among alcohol-positive patients admitted for a traumatic injury. Due to the high rate of experienced multiple traumatic events among acutely injured inpatients, the trauma history screen could be productively integrated into screening and brief intervention procedures developed for acute care settings.",Peterson R.; Russo J.; Darnell D.; Wang J.; Ingraham L.; Zatzick D.,2015.0,10.1080/00332747.2015.1061313,0,0,
5201,A preliminary inquiry into manual muscle testing response in phobic and control subjects exposed to threatening stimuli.,"To determine phobic and nonphobic subject response to a provocative threat stimulus and to determine variables that confound the response. Randomized blind examiner test-retest of randomized phobic and control subjects with qualitative, semistructured, informal postint-ervention interview. Private chiropractic clinic. Thirteen phobic individuals, as determined by the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised (DSM-III-R), and 14 control volunteer subjects. Manual muscle testing was performed while each subject viewed a threat stimulus (i.e., a cue word on a printed card). The results were recorded as ""weak"" or ""strong."" The analysis of data demonstrates poor inter- (K = -0.19) and intraexaminer reliability (K = -0.14(-) +0.29) the test for independence for valid muscle testing was strong for both examiners (p = .462, p = 1.00). When confounding variables were corrected for, the validity of muscle testing increased to 91%. This preliminary inquiry demonstrates the need for musculoskeletal, attentional and presensitized subject variables to be controlled to ascertain if muscle testing can be reliably used as a tool to identify emotional arousal.",Peterson KB.,1996.0,,0,0,
5202,"The effects of spinal manipulation on the intensity of emotional arousal in phobic subjects exposed to a threat stimulus: a randomized, controlled, double-blind clinical trial.","To determine the effect of spinal manipulation upon the intensity of emotional arousal in phobic subjects exposed to a threat stimulus. Randomized, controlled, double-blind clinical trial. Community college campus. Eighteen phobic community college student volunteers randomized into treatment and control groups. Visual analog scale (VAS) and pulse rates were obtained in response to the subjects' viewing their phobogenic stimulus. Spinal manipulation was performed while the subjects experienced emotional responses. Manual muscle testing was utilized to ascertain the associated spinal segments and involved emotion. Data were analyzed using analysis of variance for a repeated measures experimental design and Least Significant Differences (LSDs) for mean comparisons. Baseline, preintervention and postintervention pulse rates were not statistically different for the control and treatment groups (p = .0807). VAS postintervention mean for the spinal manipulation group was significantly lower than the control means (p = .05) and from its corresponding preintervention mean (p = .001). Spinal manipulation significantly decreased the intensity of emotional arousal reported by phobic subjects. The mechanism for this effect is not known.",Peterson KB.,,,0,0,4777
5203,Neural correlates of individual differences in pain-related fear and anxiety.,"Although individual differences in fear and anxiety modulate the pain response and may even cause more suffering than the initiating physical stimulus, little is known about the neural systems mediating this relationship. The present study provided the first examination of the neural correlates of individual differences in the tendency to (1) feel anxious about the potentially negative implications of physical sensations, as measured by the anxiety sensitivity index (ASI), and (2) fear various types of physical pain, as indexed by the fear of pain questionnaire (FPQ). In separate sessions, participants completed these questionnaires and experienced alternating blocks of noxious thermal stimulation (45-50 degrees C) and neutral thermal stimulation (38 degrees C) during the collection of whole-brain fMRI data. Regression analyses demonstrated that during the experience of pain, ASI scores predicted activation of a medial prefrontal region associated with self-focused attention, whereas FPQ scores predicted activation of a ventral lateral frontal region associated with response regulation and anterior and posterior cingulate regions associated with monitoring and evaluation of affective responses. These functional relationships cannot be wholly explained by generalized anxiety (indexed by STAI-T scores), which did not significantly correlate with activation of any regions. The present findings may help clarify both the impact of individual differences in emotion on the neural correlates of pain, and the roles in anxiety, fear, and pain processing played by medial and orbitofrontal systems.",Ochsner KN.; Ludlow DH.; Knierim K.; Hanelin J.; Ramachandran T.; Glover GC.; Mackey SC.,2006.0,10.1016/j.pain.2005.10.014,0,0,
5204,[Fractures of the anterior process of the calcaneus].,"Anatomical repositioning of isolated fractures of the anterior process of the calcaneus. Internal fixation for sufficiently large fragment sizes, for small fragments and evidence of instability of the calcaneocuboid (CC) joint in association with Chopart luxation fractures, transfixation of the CC joint. Dislocated fragments and intra-articular fractures (contraindication to open repositing: critical soft tissue relationships) and temporary stabilization for Chopart luxation fractures. Infections and peripheral arterial occlusive disease (pAOD). Supine position especially with accompanying injuries or placing in a side position for isolated fractures. Anterolateral access, fine repositioning by manipulation of the fragments with Kirschner wires, control of joint repositioning, definitive internal fixation with small fragments or miniscrews. For fragments not to be addressed, resection if necessary and transfixation with Kirschner wires. Movement exercises of the ankle joint from postoperative day 1. From day 2 mobilization with partial loading of the affected leg with 20 kg for 6-8 weeks. After transfixation, removal of the wires after 6 weeks and gradually increased loading. After subsidence of postoperative edema, patients can wear their own shoes or if necessary use a walker. Isolated fractures of the the anterior process of the calcaneus are rare and often initially overlooked injuries of the foot. In the literature there are only few case descriptions. From November 2009 to June 2011 a total of 5 isolated dislocated fractures of the anterior process with large fragments (type III), of which 3 were initially overlooked, were treated by osteosynthesis. In all cases the exact diagnosis could only be confirmed by computed tomography. In the follow-up after 2 years and 5 months all patients showed consolidation of the fractures, especially those with delayed therapy. Clinically all patients had recovered full function with no evidence of posttraumatic arthrosis. In this small case series extended diagnostics in cases of suitable fracture mechanisms seems to be reasonable in order not to overlook rare fractures of the calcaneus. Operative therapy by anatomical repositioning and internal fixation of fractures of the anterior process of the calcaneus is a suitable therapy for treatment of these rare injuries.",Ochman S.; Evers J.; Raschke MJ.,2013.0,10.1007/s00064-013-0248-1,0,0,
5205,"A randomized controlled trial of trauma-focused cognitive behavioral therapy for sexually exploited, war-affected Congolese girls","ER OBJECTIVE: To assess the efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) delivered by nonclinical facilitators in reducing posttraumatic stress, depression, and anxiety and conduct problems and increasing prosocial behavior in a group of war-affected, sexually exploited girls in a single-blind, parallel-design, randomized,+ controlled trial.METHOD: Fifty-two 12- to 17-year-old, war-affected girls exposed to rape and inappropriate sexual touch in the Democratic Republic of Congo were screened for trauma, depression and anxiety, conduct problems, and prosocial behavior. They were then randomized to a 15 session, group-based, culturally modified TF-CBT (n = 24) group or a wait-list control group (n = 28). Primary analysis, by intention-to-treat, involving all randomly assigned participants occurred at pre- and postintervention and at 3-month follow-up (intervention group only).RESULTS: Compared to the wait list control, the TF-CBT group experienced significantly greater reductions in trauma symptoms (F(1,49) = 52.708, p<0·001, ?(p)2 = 0.518). In addition, the TF-CBT group showed a highly significant improvement in symptoms of depression and anxiety, conduct problems, and prosocial behavior. At 3-months follow-up the effect size (Cohen's d) for the TF-CBT group was 2.04 (trauma symptoms), 2.45 (depression and anxiety), 0.95 (conduct problems), and-1.57 (prosocial behavior).CONCLUSIONS: A group-based, culturally modified, TF-CBT intervention delivered by nonclinically trained Congolese facilitators resulted in a large, statistically significant reduction in posttraumatic stress symptoms and psychosocial difficulties among war-affected girls exposed to rape or sexual violence. Clinical trial registration information-An RCT of TF-CBT with sexually-exploited, war-affected girls in the DRC; http://clinicaltrials.gov/; NCT01483261.","O'Callaghan, P; McMullen, J; Shannon, C; Rafferty, H; Black, A",2013.0,10.1016/j.jaac.2013.01.013,0,0,
5206,"A pilot study of a family focused, psychosocial intervention with war-exposed youth at risk of attack and abduction in north-eastern Democratic Republic of Congo","ER Rural communities in the Haut-Uele Province of northern Democratic Republic of Congo live in constant danger of attack and/or abduction by units of the Lord's Resistance Army operating in the region. This pilot study sought to develop and evaluate a community-participative psychosocial intervention involving life skills and relaxation training and Mobile Cinema screenings with this war-affected population living under current threat. 159 war-affected children and young people (aged 7-18) from the villages of Kiliwa and Li-May in north-eastern DR Congo took part in this study. In total, 22% of participants had been abduction previously while 73% had a family member abducted. Symptoms of post-traumatic stress reactions, internalising problems, conduct problems and pro-social behaviour were assessed by blinded interviewers at pre- and post-intervention and at 3-month follow-up. Participants were randomised (with an accompanying caregiver) to 8 sessions of a group-based, community-participative, psychosocial intervention (n=79) carried out by supervised local, lay facilitators or a wait-list control group (n=80). Average seminar attendance rates were high: 88% for participants and 84% for caregivers. Drop-out was low: 97% of participants were assessed at post-intervention and 88% at 3 month follow-up. At post-test, participants reported significantly fewer symptoms of post-traumatic stress reactions compared to controls (Cohen's d=0.40). At 3 month follow up, large improvements in internalising symptoms and moderate improvements in pro-social scores were reported, with caregivers noting a moderate to large decline in conduct problems among the young people. Trial Registration clinicalTrials.gov, Identifier: NCT01542398.","O'Callaghan, P; Branham, L; Shannon, C; Betancourt, T S; Dempster, M; McMullen, J",2014.0,10.1016/j.chiabu.2014.02.004,0,0,
5207,Evaluation of the Family Integrated Care model of neonatal intensive care: a cluster randomized controlled trial in Canada and Australia,"ER METHODS/DESIGN: FICare is being evaluated in a cluster randomized controlled trial among infants born at ??33 weeks' gestation admitted to 19 Canadian, 6 Australian, and 1 New Zealand tertiary-level NICU. Trial enrollment began in April, 2013, with a target sample size of 675 infants in each arm, to be completed by August, 2015. Participating sites were stratified by country, and by NICU size within Canada, for randomization to either the FICare intervention or control arm. In intervention sites, parents are taught how to provide most of their infant's care and supported by nursing staff, veteran parents, a program coordinator, and education sessions. In control sites standard NICU care is provided. The primary outcome is infants' weight gain at 21 days after enrollment, which will be compared between the FICare and control groups using Student's t-test adjusted for site-level clustering, and multi-level hierarchical models accounting for both clustering and potential confounders. Similar analyses will examine secondary outcomes including breastfeeding, clinical outcomes, safety, parental stress and anxiety, and resource use. The trial was designed, is being conducted, and will be reported according to the CONSORT 2010 guidelines for cluster randomized controlled trials.DISCUSSION: By evaluating the impact of integrating parents into the care of their infant in the NICU, this trial may transform the delivery of neonatal care.TRIAL REGISTRATION: NCT01852695 , registered December 19, 2012.BACKGROUND: Admission to the neonatal intensive care unit (NICU) may disrupt parent-infant interaction with adverse consequences for infants and their families. Several family-centered care programs promote parent-infant interaction in the NICU; however, all of these retain the premise that health-care professionals should provide most of the infant's care. Parents play a mainly supportive role in the NICU and continue to feel anxious and unprepared to care for their infant after discharge. In the Family Integrated Care (FICare) model, parents provide all except the most advanced medical care for their infants with support from the medical team. Our hypothesis is that infants whose families complete the FICare program will have greater weight gain and better clinical and parental outcomes compared with infants provided with standard NICU care.","O'Brien, K; Bracht, M; Robson, K; Ye, X Y; Mirea, L; Cruz, M; Ng, E; Monterrosa, L; Soraisham, A; Alvaro, R; Narvey, M; Silva, O; Lui, K; Tarnow-Mordi, W; Lee, S K",2015.0,10.1186/s12887-015-0527-0,0,0,
5208,[Obstacles to the routine use of magnetic resonance imaging--results of a multicenter study for evaluating nuclear magnetic resonance tomography].,"Within the framework of this study, the factors that impair the value of MR scans were also investigated and analysed. It was found that artifacts occurred in a large number of examinations that exercised a negative effect on the results. Artifacts are particularly seen in the thorax (54%) and upper abdomen (57%), but they have also been reported in 23% of the CNS examinations. The sources of such artifacts were mainly movements in the investigated layer, whereas other causes were negligible. In the 21,633 examined patients no undesirable effects caused by the examination were noted that would have impaired the patient or the course of the study. On an average, 88% of the examinations were performed with normal tolerance of the examination. In the remaining cases there was motor unrest or claustrophobia requiring special measures, thus hampering the course of the examination.",Oberstein A.; Meves M.; Bockenheimer S.; Schlaps D.,1990.0,,0,0,
5209,Pain after whiplash: a prospective controlled inception cohort study.,"In Lithuania, there is little awareness of the notion that chronic symptoms may result from rear end collisions via the so-called whiplash injury. After most such collisions no contact with the health service is established. An opportunity therefore exists to study post-traumatic pain without the confounding factors present in western societies. In a prospective, controlled inception cohort study, 210 victims of a rear end collision were consecutively identified from the daily records of the Kaunas traffic police. Neck pain and headache were evaluated by mailed questionnaires shortly after the accident, after 2 months, and after 1 year. As controls, 210 sex and age matched subjects were randomly taken from the population register of the same geographical area and evaluated for the same symptoms immediately after their identification and after 1 year. Initial pain was reported by 47% of accident victims; 10% had neck pain alone, 18% had neck pain together with headache, and 19% had headache alone. The median duration of the initial neck pain was 3 days and maximal duration 17 days. The median duration of headache was 4.5 hours and the maximum duration was 20 days. After 1 year, there were no significant differences between the accident victims and the control group concerning frequency and intensity of these symptoms. In a country were there is no preconceived notion of chronic pain arising from rear end collisions, and thus no fear of long term disability, and usually no involvement of the therapeutic community, insurance companies, or litigation, symptoms after an acute whiplash injury are self limiting, brief, and do not seem to evolve to the so-called late whiplash syndrome.",Obelieniene D.; Schrader H.; Bovim G.; Miseviciene I.; Sand T.,1999.0,,0,0,
5210,Online support: impact on anxiety in women who experience an abnormal screening mammogram,"ER Objectives: To determine whether an online support tool can impact anxiety in women experiencing an abnormal mammogram. Materials and methods: We developed an online support system using the Comprehensive Health Enhancement Support System (CHESS) designed for women experiencing an abnormal mammogram as a model. Our trial randomized 130 of these women to online support (the intervention group) or to a list of five commonly used Internet sites (the comparison group). Surveys assessed anxiety and breast cancer worry, and patient satisfaction at three important clinical time points: when women were notified of their abnormal mammogram, at the time of diagnostic imaging, and at the time of biopsy (if biopsy was recommended). Results: Study participants in the intervention group showed a significant decrease in anxiety at the time of biopsy compared to the comparison group (. p=0.017). However, there was no significant difference in anxiety between the intervention group and the comparison group at the time of diagnostic work-up. We discontinued assessment of patient satisfaction after finding that many women had substantial difficulty answering the questions that referenced their physician, because they did not understand who their physician was for this process of care. Conclusion: The combination of the inability to identify the physician providing care during the mammography work-up and anxiety effects seen only after an interaction with the breast imaging team may indicate that online support only decreases the anxiety of women in concert with direct interpersonal support from the healthcare team.","Obadina, E T; Dubenske, L L; McDowell, H E; Atwood, A K; Mayer, D K; Woods, R W; Gustafson, D H; Burnside, E S",2014.0,10.1016/j.breast.2014.08.002,0,0,
5211,Influence of husbands on the outcome of their agoraphobic wives' therapy.,"Of 30 agoraphobic married women undertaking home-based behaviour therapy, 15 each had a female friend as co-therapist and 15 had their own husband as co-therapist. At 12 months follow-up, women spent a mean of approximately 40 minutes a day more outside the home alone than at baseline. Women assisted by female friends made somewhat more behavioural gains than those assisted by husbands. Women in both groups whose husbands had been more depressed 2 months after the beginning of therapy did less well at 6 months. Husbands who become more depressed may retard their wives' progress in therapy, but the effect was small, and was outweighed by other considerations.",Oatley K.; Hodgson D.,1987.0,,0,0,
5212,Evidence of focal small-fiber axonal degeneration in complex regional pain syndrome-I (reflex sympathetic dystrophy).,"CRPS-I consists of post-traumatic limb pain and autonomic abnormalities that continue despite apparent healing of inciting injuries. The cause of symptoms is unknown and objective findings are few, making diagnosis and treatment controversial, and research difficult. We tested the hypotheses that CRPS-I is caused by persistent minimal distal nerve injury (MDNI), specifically distal degeneration of small-diameter axons. These subserve pain and autonomic function. We studied 18 adults with IASP-defined CRPS-I affecting their arms or legs. We studied three sites on subjects' CRPS-affected and matching contralateral limb; the CRPS-affected site, and nearby unaffected ipsilateral and matching contralateral control sites. We performed quantitative mechanical and thermal sensory testing (QST) followed by quantitation of epidermal neurite densities within PGP9.5-immunolabeled skin biopsies. Seven adults with chronic leg pain, edema, disuse, and prior surgeries from trauma or osteoarthritis provided symptom-matched controls. CRPS-I subjects had representative histories and symptoms. Medical procedures were unexpectedly frequently associated with CRPS onset. QST revealed mechanical allodynia (P<0.03) and heat-pain hyperalgesia (P<0.04) at the CRPS-affected site. Axonal densities were highly correlated between subjects' ipsilateral and contralateral control sites (r=0.97), but were diminished at the CRPS-affected sites of 17/18 subjects, on average by 29% (P<0.001). Overall, control subjects had no painful-site neurite reductions (P=1.00), suggesting that pain, disuse, or prior surgeries alone do not explain CRPS-associated neurite losses. These results support the hypothesis that CRPS-I is specifically associated with post-traumatic focal MDNI affecting nociceptive small-fibers. This type of nerve injury will remain undetected in most clinical settings.",Oaklander AL.; Rissmiller JG.; Gelman LB.; Zheng L.; Chang Y.; Gott R.,2006.0,10.1016/j.pain.2005.09.036,0,0,
5213,The clinical efficacy of citalopram in treatment of emotional disturbances in dementia disorders. A Nordic multicentre study,"ER In this multicenter study, the clinical efficacy of citalopram was investigated in 98 patients with moderate AD/SDAT or VD using a combined double-blind and open technique with placebo and citalopram. Analyses were made for each diagnosis after four weeks of double-blind treatment. Patients with AD/SDAT treated with citalopram showed a significant improvement in emotional bluntness, confusion, irritability, anxiety, fear/panic, depressed mood and restlessness. Those improvements were not found after treatment with placebo. There were no significant improvements in patients with VD. No improvements were recorded in motor or cognitive impairment. Citalopram provoked few and comparatively mild side-effects. None of the changes observed during the double-blind withdrawal period were identified as withdrawal symptoms or rebound phenomena.","Nyth, A L; Gottfries, C G",1990.0,,0,0,
5214,A brief mindfulness based intervention for increase in emotional well-being and quality of life in percutaneous coronary intervention (PCI) patients: the MindfulHeart randomized controlled trial,"ER In this study effects of a brief mindfulness-based stress reduction intervention were examined in cardiac patients who had a percutaneous coronary intervention (PCI). One-hundred-and-fourteen patients (mean age 55 + 7 years, 18 % women) were randomly assigned to a 4-session mindfulness group intervention or a minimal mindfulness self-help control group that received a booklet containing identical information. Compared to self-help, the group intervention showed larger increases in psychological and social quality of life (p < .05, partial (2) = .04 and .05, respectively). For symptoms of anxiety and depression, and for perceived stress, this effect was evident only in patients younger than 60 years (p < .01, partial (2) = .10 and .15, respectively). These effects were partially or fully mediated by increase in mindfulness. The brief group mindfulness intervention seems beneficial for cardiac PCI patients regarding general psychosocial quality of life, although for specific psychological symptoms, this intervention can be recommended only for nonelderly patients.","Nyklí?ek, I; Dijksman, S C; Lenders, P J; Fonteijn, W A; Koolen, J J",2014.0,10.1007/s10865-012-9475-4,0,0,
5215,[Ultrasonographic diapeutics of the hepatic abscess. Possibilities and achievements].,"Transcutaneous interventions (TI) under ultrasonographic control were applied in 163 patients (the main group) for primary pyogenic hepatic abscess (PPHA). For comparative group 31 patients were included, in whom an operative intervention was done (disclosure, sanation and external drainage of the focal lesions). While treating PPHA in 91 patients the TI punctures under ultrasonographic control were made and in 72--transcutaneous drainage was performed. The puncture treatment appeared effective in 88 (96.7%) patients, drainage--in 70 (97.2%), summarized efficacy of TI had constituted 96.9%. The morbidity ratio after miniinvasive treatment of PPHA was lesser than after routine operative treatment. The TI application for PPHA is an effective method of the patients treatment, not dependent on their foci size and the patient general state, it permit to lower morbidity, lethality and period of hospitalization significantly, and to improve the results meaningfully. TI under ultrasonographic control constitutes the method of choice in PPHA treatment, excluding posttraumatic abscesses, chronic hepatic abscesses and intracavitary sequesteres presence.",Nychytaĭlo MIu.; Moshkivs'kyĭ HIu.; Kostyliev MV.; Lebedieva EIu.,2010.0,,0,0,
5216,Long-term electrical capsular stimulation in patients with obsessive-compulsive disorder.,"Because of the irreversibility of lesioning procedures and their possible side effects, we studied the efficacy of replacing bilateral anterior capsulotomy with chronic electrical capsular stimulation in patients with severe, long-standing, treatment-resistant obsessive-compulsive disorder. We stereotactically implanted quadripolar electrodes in both anterior limbs of the internal capsules into six patients with severe obsessive-compulsive disorder. Psychiatrists and psychologists performed a double-blind clinical assessment. A blinded random crossover design was used to assess four of those patients, who underwent continuous stimulation thereafter. The psychiatrist-rated Yale-Brown Obsessive Compulsive Scale score was lower in the stimulation-on condition (mean, 19.8 +/- 8.0) than in the postoperative stimulator-off condition (mean, 32.3 +/- 3.9), and this stimulation-induced effect was maintained for at least 21 months after surgery. The Clinical Global Severity score decreased from 5 (severe; standard deviation, 0) in the stimulation-off condition to 3.3 (moderate to moderate-severe; standard deviation, 0.96) in the stimulation-on condition. The Clinical Global Improvement scores were unchanged in one patient and much improved in the other three during stimulation. During the stimulation-off period, symptom severity approached baseline levels in the four patients. Bilateral stimulation led to increased signal on functional magnetic resonance imaging studies, especially in the pons. Digital subtraction analysis of preoperative [(18)F]2-fluoro-2-deoxy-d-glucose positron emission tomographic scans and positron emission tomographic scans obtained after 3 months of stimulation showed decreased frontal metabolism during stimulation. These observations indicate that capsular stimulation reduces core symptoms 21 months after surgery in patients with severe, long-standing, treatment-refractory obsessive-compulsive disorder. The stimulation elicited changes in regional brain activity as measured by functional magnetic resonance imaging and positron emission tomography.",Nuttin BJ.; Gabriëls LA.; Cosyns PR.; Meyerson BA.; Andréewitch S.; Sunaert SG.; Maes AF.; Dupont PJ.; Gybels JM.; Gielen F.; Demeulemeester HG.,2003.0,,0,0,
5217,Electrical stimulation in anterior limbs of internal capsules in patients with obsessive-compulsive disorder.,Chronic electrical stimulation instead of bilateral capsulotomy was done in four selected patients with long-standing treatment-resistant obsessive-compulsive disorder. In three of them beneficial effects were observed.,Nuttin B.; Cosyns P.; Demeulemeester H.; Gybels J.; Meyerson B.,1999.0,10.1016/S0140-6736(99)02376-4,0,0,
5218,"CERAMENT treatment of fracture defects (CERTiFy): protocol for a prospective, multicenter, randomized study investigating the use of CERAMENT? BONE VOID FILLER in tibial plateau fractures","ER METHODS/DESIGN: CERTiFy (CERament? Treatment of Fracture defects) is a prospective, multicenter, controlled, randomized trial. We plan to enroll 136 patients with fresh traumatic depression fractures of the proximal tibia (types AO 41-B2 and AO 41-B3) in 13 participating centers in Germany. Patients will be randomized to receive either autologous iliac crest bone graft or CBVF after reduction and osteosynthesis of the fracture to reconstruct the subchondral bone defect and prevent the subsidence of the articular surface. The primary outcome is the SF-12 Physical Component Summary at week 26. The co-primary endpoint is the pain level 26 weeks after surgery measured by a visual analog scale. The SF-12 Mental Component Summary after 26 weeks and costs of care will serve as key secondary endpoints. The study is designed to show non-inferiority of the CBVF treatment to the autologous iliac crest bone graft with respect to the physical component of quality of life. The pain level at 26 weeks after surgery is expected to be lower in the CERAMENT bone void filler treatment group.DISCUSSION: CERTiFy is the first randomized multicenter clinical trial designed to compare quality of life, pain, and cost of care in the use of the CBVF and the autologous iliac crest bone graft in the treatment of tibia plateau fractures. The results are expected to influence future treatment recommendations.TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT01828905.BACKGROUND: Bone graft substitutes are widely used for reconstruction of posttraumatic bone defects. However, their clinical significance in comparison to autologous bone grafting, the gold-standard in reconstruction of larger bone defects, still remains under debate. This prospective, randomized, controlled clinical study investigates the differences in pain, quality of life, and cost of care in the treatment of tibia plateau fractures-associated bone defects using either autologous bone grafting or bioresorbable hydroxyapatite/calcium sulphate cement (CERAMENT?|BONE VOID FILLER (CBVF)).","Nusselt, T; Hofmann, A; Wachtlin, D; Gorbulev, S; Rommens, P M",2014.0,10.1186/1745-6215-15-75,0,0,
5219,Feedback of true heart rate during exposure in vivo. Partial replication with methodological improvement.,"Ten specific phobics improved during a mean of two sessions of experimental treatment by exposure in vivo in a balanced design. Short-term results replicated those of a previous study that self-control of heart rate with the aid of biofeedback significantly reduced heart rate during treatment, but this did not hasten reduction of subjective anxiety, nor of respiratory rate or skin conductance responses. An hour's pretreatment training in self-control of heart rate with the aid of feedback did not enhance the effect. Mere instructions to lower heart rate without feedback had a significant effect during treatment, but the addition of heart rate feedback to instructions significantly augmented the decline in heart rate.",Nunes JS.; Marks IM.,1976.0,,0,0,
5220,Imipramine treatment of alcoholism with comorbid depression,"ER Of 60 depressed alcoholics who completed an open trial of imipramine, 27 (45%) responded with improvement in both mood and drinking behavior, and eight (13%) responded after further dosage increases or treatment with disulfiram. In a subsequent 6-month, randomized discontinuation trial, four of 13 subjects (31%) relapsed during imipramine treatment and seven of 10 (70%) relapsed while taking placebo. This suggests a potential treatment approach for a high-risk subgroup of alcoholics.","Nunes, E V; McGrath, P J; Quitkin, F M; Stewart, J P; Harrison, W; Tricamo, E; Ocepek-Welikson, K",1993.0,10.1176/ajp.150.6.963,0,0,
5221,Relaxation and guided imagery program in patients with breast cancer undergoing radiotherapy is not associated with neuroimmunomodulatory effects.,"Treatment of breast cancer is usually associated with significant psychological stress. In this study, we examined the effects of relaxation and visualization therapy (RVT) on psychological distress, cortisol levels, and immunological parameters of breast cancer patients undergoing radiotherapy. Participants were randomly assigned to either the experimental (n=20) who underwent group RVT for 24 consecutive days or control group (n=14) who were on radiotherapy only. Psychological scores (stress, anxiety, and depression) were measured by structured clinical interviews. Salivary cortisol was assessed along the day. Lymphocytes were isolated and cultured to measure T-cell proliferation and sensitivity to glucocorticoids (GCs). RVT was effective to reduce stress, anxiety, and depression scores (all P<.05). However, cortisol levels as well as proliferation remained unchanged following RVT. Although T cells of experimental group were more sensitive to GCs than cells of controls at baseline, no changes were noted following RVT. Cortisol levels were positively correlated to anxiety and depression scores and inversely correlated to T-cell proliferation and sensitivity to GCs. We conclude that the psychological intervention was capable to attenuate the emotional distress presented during radiotherapy treatment. A longer RVT or worse psychological morbidity at baseline may be necessary to translate psychological into biological changes.",Nunes DF.; Rodriguez AL.; da Silva Hoffmann F.; Luz C.; Braga Filho AP.; Muller MC.; Bauer ME.,2007.0,10.1016/j.jpsychores.2007.07.004,0,0,
5222,[Intensive Naikan therapy for generalized anxiety disorder and panic disorder: clinical outcomes and background].,"Intensive Naikan therapy (INT) is used to treat irrational recognition, and to develop awareness of others and self-reflection. Several reports have also shown that INT is effective for treating anxiety disorders. The purpose of the present systematic study was to investigate the factors contributing to the efficacy and clinical outcomes of INT by assessing the background, psychological evolution, and treatment required after such therapy. Twenty-eight anxiety disorder inpatients at Tottori University Hospital, 15 with general anxiety disorders (GAD) and 13 with panic disorders (PD), were treated with INT. Age, sex, duration of the present anxiety episode, and diagnosis were investigated. The Tokyo University Egogram (TEG), Yatabe-Guilford personality inventory (YG test) and Rosenzweig picture frustration (PF) study were conducted before and after INT to investigate psychological changes. The long-term efficacy of INT for PD and GAD was assessed with Global Assessment of Functioning (GAF). Whether the patients achieved awareness of others, awareness of egocentricity, feelings of love, and self reflection after INT were investigated. 1) All patients showed improved GAF; the average GAF score increased from 51 +/- 8 (before Naikan therapy) to 83.2 +/- 15 (after therapy). The clinical outcomes of INT were as follows: 17 patients showed extremely effective results (60.7%), 6 were effective (21.4%), 3 were slightly effective (10.7%), and 2 were unchanged (7.1%). Overall, 23 patients (82.1%) showed remarkable improvements as a result of INT (improved group) and 5 showed no remarkable improvements (not improved group). 2) The improved group included significantly more patients with obsessive tendencies or nervous personalities such as a premorbid personality. In addition, significantly more of the patients in this group underwent daily INT and improved more rapidly in the short-term. 3) According to the STAI (state trait anxiety inventory), both state-(S-anxiety), and trait-anxiety (T-anxiety) significantly decreased after INT. The PD group showed significantly reduced S and T-anxiety, but the GAD group only showed significantly reduced T-anxiety. The adult (A) and free child (FC) TEG scales significantly increased, and according to YG, nervousness (N) and depression (D) significantly decreased while general activity (G) and social extraversion (S) significantly increased. Furthermore, according to the PF study, extraggression (E -A) after INT significantly decreased and imaggression (I-A) significantly increased. In the improved group, significantly more patients became more aware of their partners (Naikan) and achieved an objective outlook, awareness of egocentricity, feelings of love and self-reflection after INT. Our results suggest that INT for PD and GAD is extremely effective, and a very important form of psychotherapy. Attainment of self-reflection caused psychological changes that motivated the patients to continue Naikan therapy daily. We consider this a key factor in maintaining the efficacy of INT.",Nukina S.; Wang H.; Kamei K.; Kawahara R.,2005.0,,0,0,
5223,Post traumatic cerebral oedema in severe head injury is related to intracranial pressure and cerebral perfusion pressure but not to cerebral compliance.,"This was a prospective cohort study, carried out in the Neuro Intensive Care Unit, Department of Neurosciences, Hospital Universiti Sains Malaysia, Kubang Kerian Kelantan. The study was approved by the local ethics committee and was conducted between November 2005 and September 2007 with a total of 30 patients included in the study. In our study, univariate analysis showed a statistically significant relationship between mean intracranial pressure (ICP) as well as cerebral perfusion pressure (CPP) with both states of basal cistern and the degree of diffuse injury and oedema based on the Marshall classification system. The ICP was higher while CPP and compliance were lower whenever the basal cisterns were effaced in cases of cerebral oedema with Marshall III and IV. In comparison, the study revealed lower ICP, higher mean CPP and better mean cerebral compliance if the basal cisterns were opened or the post operative CT brain scan showed Marshall I and II. These findings suggested the surgical evacuation of clots to reduce the mass volume and restoration of brain anatomy may reduce vascular engorgement and cerebral oedema, therefore preventing intracranial hypertension, and improving cerebral perfusion pressure and cerebral compliance. Nevertheless the study did not find any significant relationship between midline shifts and mean ICP, CPP or cerebral compliance even though lower ICP, higher CPP and compliance were frequently observed when the midline shift was less than 0.5 cm. As the majority of our patients had multiple and diffuse brain injuries, the absence of midline shift did not necessarily mean lower ICP as the pathology was bilateral and even when after excluding the multiple lesions, the result remained insignificant. We assumed that the CT brain scan obtained after evacuation of the mass lesion to assess the state basal cistern and classify the diffuse oedema may prognosticate the intracranial pressure and cerebral perfusion pressure thus assisting in the acute post operative management of severely head injured patients. Hence post operative CT brain scans may be done to verify the ICP and CPP readings postoperatively. Subsequently, withdrawal of sedation for neurological assessment after surgery could be done if the CT brain scan showed an opened basal cistern and Marshall I and II coupled with ICP of less than 20 mmHg.",Nujaimin U.; Saufi A.; Rahman AG.; Badrisyah I.; Sani S.; Zamzuri I.; Kamarul M.; Jafri A.,2009.0,,0,0,
5224,Age-related differences in the effect of social desirability on self-reported emotional state,"ER MATERIAL AND METHODSWe randomly assigned 149 individuals (92 university students and 52 older adults) to one of three groups: a control group and two intervention groups in which anxiety was experimentally induced.RESULTSSocial desirability scores were significantly higher in older persons (Hedges'g=1.22). No statistically significant correlations were found in any age group between social desirability and measures of emotional well-being. Likewise, in a series of univariate ANOVAs, no differences were found according to the degree of social desirability in changes in emotional state after anxiety induction. Overall, social desirability was not related to the changes produced by experimental anxiety induction.CONCLUSIONSThe present study confirms the association between social desirability and age. However, social desirability did not seem to correlate with emotional well-being in any age group. Moreover, social desirability was not related to changes in emotional state after experimental anxiety induction. These results do not support the view that social desirability is a threat to the validity of experimental studies in the elderly.INTRODUCTIONIt is usually assumed that social desirability increases with ageing, correlates with measures of emotional well-being, and represents a potential threat to research in older adults, and should therefore be systematically controlled. However, this assumption is controversial and lacks a strong empirical basis. The present study aimed to analyze the association between social desirability and measures of emotional well-being, as well as to test for age-related differences in the changes produced in emotional state after experimental anxiety induction.","Nuevo, R; Montorio, I; Márquez-González, M; Cabrera, I; Izal, M; Pérez-Rojo, G",2009.0,10.1016/j.regg.2008.10.003,0,0,
5225,Personality traits associated with panic disorder: change associated with treatment,"ER Eighty-two subjects with panic disorder completed the Personality Diagnostic Questionnaire (PDQ) before treatment and again after a period of relatively stable improvement 3 years later. At baseline, panic subjects scored higher than normal control subjects, who had been matched for age and sex, on avoidant, dependent, histrionic, and paranoid personality subscales. Improvement in panic symptoms after 3 years was associated with reductions in these same subscale scores. Examination of individual items that distinguished panic from normal subjects showed themes of dependency, lack of self-confidence, emotional instability, and sensitivity to criticism that reflected demoralization in the panic disorder subjects. To a large extent, the findings reveal nonspecific, state-dependent effects of panic and agoraphobic symptoms on the personality functioning and morale of patients with panic disorder.","Noyes, R; Reich, J H; Suelzer, M; Christiansen, J",1991.0,,0,0,
5226,Personality traits associated with panic disorder: change associated with treatment.,"Eighty-two subjects with panic disorder completed the Personality Diagnostic Questionnaire (PDQ) before treatment and again after a period of relatively stable improvement 3 years later. At baseline, panic subjects scored higher than normal control subjects, who had been matched for age and sex, on avoidant, dependent, histrionic, and paranoid personality subscales. Improvement in panic symptoms after 3 years was associated with reductions in these same subscale scores. Examination of individual items that distinguished panic from normal subjects showed themes of dependency, lack of self-confidence, emotional instability, and sensitivity to criticism that reflected demoralization in the panic disorder subjects. To a large extent, the findings reveal nonspecific, state-dependent effects of panic and agoraphobic symptoms on the personality functioning and morale of patients with panic disorder.",Noyes R.; Reich JH.; Suelzer M.; Christiansen J.,,,0,0,5225
5227,Outcome of panic disorder. Relationship to diagnostic subtypes and comorbidity,"Eighty-nine subjects with panic disorder, who had been naturalistically treated, and 46 nonanxious controls were followed up after 3 years. Although they remained symptomatic, most subjects with panic disorder reported relatively little distress or social maladjustment. The course of panic disorder was characterized by fluctating anxiety and depressive symptoms. Panic subtypes (uncomplicated, limited phobic avoidance, and extensive phobic avoidance) and Axis I and II comorbidity (major depression and personality disorders) were highly predictive of symptoms and social adjustment after 3 years. Abnormal personality was, in fact, the strongest predictor of social maladjustment in both subjects with panic disorder and controls. The results showed that while panic disorder has a favorable outcome, the illness is a chronic one that may require continuing treatment. They also show that subtypes and comorbid disturbances are important predictors of outcome.",Noyes Jr. R.; Reich J.; Christiansen J.; Suelzer M.; Pfohl B.; Coryell W.A.,1990.0,,0,0,
5228,"Modifying interpretation biases: Effects on symptomatology, behavior, and physiological reactivity in social anxiety.","The present study investigated the effects of computerized interpretation training and cognitive restructuring on symptomatology, behavior, and physiological reactivity in an analogue social anxiety sample. Seventy-two participants with elevated social anxiety scores were randomized to one session of computerized interpretation training (n = 24), cognitive restructuring (n = 24), or an active placebo control condition (n = 24). Participants completed self-report questionnaires focused on interpretation biases and social anxiety symptomatology at pre and posttraining and a speech task at posttraining during which subjective, behavioral, and physiological measures of anxiety were assessed. Only participants in the interpretation training condition endorsed significantly more positive than negative interpretations of ambiguous social situations at posttraining. There was no evidence of generalizability of interpretation training effects to self-report measures of interpretation biases and symptomatology or the anxiety response during the posttraining speech task. Participants in the cognitive restructuring condition were rated as having higher quality speeches and showing fewer signs of anxiety during the posttraining speech task compared to participants in the interpretation training condition. The present study did not include baseline measures of speech performance or computer assessed interpretation biases. The results of the present study bring into question the generalizability of computerized interpretation training as well as the effectiveness of a single session of cognitive restructuring in modifying the full anxiety response. Clinical and theoretical implications are discussed.",Nowakowski ME.; Antony MM.; Koerner N.,2015.0,10.1016/j.jbtep.2015.04.004,0,0,
5229,Level of emotional awareness as a differentiating variable between individuals with and without generalized anxiety disorder,"Using Mennin, Heimberg, Turk, and Fresco's [Emotion regulation deficits as a key feature of generalized anxiety disorder: Testing a theoretical model, submitted for publication] conceptualization of generalized anxiety disorder (GAD) as a syndrome involving emotion dysregulation and an overuse of cognitive control strategies, this study sought to differentiate individuals with GAD from controls by offering differences in emotional awareness as one of the central distinctions between these groups. This study employs the Levels of Emotional Awareness Scale (LEAS) [Lane et al., 1990Lane, R. D., Quinlan, D. M., Schwartz, G. E., Walker, P. A., & Zeitlin, S. B. (1990). The Levels of Emotional Awareness Scale: a cognitive-developmental measure of emotion. Journal of Personality Assessment, 55, 124-134] a rater-coded measure, to assess level of emotional awareness, a methodological improvement over previous tests of the model, which relied upon self-report. Individuals with GAD scored significantly higher than controls on emotional awareness. These findings are discussed in light of the theoretical implications for GAD. © 2004 Elsevier Inc. All rights reserved.",Novick-Kline P.; Turk C.L.; Mennin D.S.; Hoyt E.A.; Gallagher C.L.,2005.0,10.1016/j.janxdis.2004.06.001,0,0,
5230,The clinical phenotype of major depression with suicidal ideation (MDD-SI).,"Our overall goal of this investigation was to broaden our understanding of MDD-SI. Specifically, we sought to document the associated features of MDD-SI, understand the phenomenology of MDD-SI, develop a clinical phenotype of MDD-SI, and discern whether the MDD-SI phenotype is associated with an unfavorable or differential initial response to treatment. We conceptualized this work as a preliminary investigation of the specific treatment needs of individuals with MDD-SI and potential identification of one subset of individuals who fail to experience an initial response to first-line monotherapies for major depression. To this end, we completed a secondary analysis of data from a two-site, cross-national clinical trial in which individuals presenting in an episode of major depression were randomly allocated to an initial treatment protocol consisting of SSRI antidepressant pharmacotherapy (SSRI) or interpersonal psychotherapy (IPT). In comparisons between individuals with MDD-SI and individuals without current, baseline suicidal ideation (MDD), we found that (1) few pre-treatment socio-demographic or baseline clinical characteristics significantly distinguished MDD-SI and MDD, (2) lifetime experiences of suicidal ideation and suicidal behavior were significantly different between MDD-SI and MDD, and (3) lifetime history and past month experiences of some mood and panic-agoraphobic spectrum symptoms were significantly different between MDD-SI and MDD. In addition, we demonstrated that MDD-SI is negatively associated with initial treatment response, such that individuals with MDD-SI were significantly more depressed after six weeks of treatment than were individuals with MDD. Nonetheless, after six weeks of treatment, interviewer-rated suicidal ideation resolved for over 90% of individuals with MDD-SI and self-reported suicidal ideation resolved for all but about 11%. Our findings provide preliminary support for the usefulness of assessing both syndromal and subsyndromal manifestations of major depression, establishing a lifetime assessment of suicidality as routine clinical practice, and conceptualizing MDD-SI as a subtype and clinical phenotype of major depression. Further research, including replication of our findings, is needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Novick, Danielle M",2011.0,,0,0,
5231,Psychological factors associated with emergency room visits among asthmatic patients.,"This study was designed to investigate physiological and psychological characteristics of subjects with high-frequency emergency room (ER) visits. Asthma status, psychological functioning and predispositions, psychosocial adaptation to asthma, and health behaviors were measured for 30 patients who had two or more ER visits during the last 2 years. These subjects were matched for age, sex, and corticosteroid use with 30 subjects who had no unscheduled ER visits for the same period. No significant differences were found for measures of asthma status. Among the asthma-specific variables, the number of hyperventilation-bronchoconstriction symptoms did not distinguish between the groups. High attenders reported more panic-fear symptoms, lower self-efficacy, and more perceived interference. There were no differences for measures of anxiety/depression, self-focused attention, or health locus of control. However, these variables were found to be significant predictors of panic-fear symptoms, lower self-efficacy, and more perceived interference.",Nouwen A.; Freeston MH.; Labbé R.; Boulet LP.,1999.0,10.1177/0145445599232002,0,0,
5232,Psychophysiological effects of an iTBS modulated virtual reality challenge including participants with spider phobia.,"Preliminary evidence suggests beneficial effects of transcranial magnetic stimulation (TMS) on anxiety. The objective of this study was to investigate the effects of intermittent theta burst stimulation (iTBS) as a form of TMS on acute anxiety provoked by a virtual reality (VR) scenario. Participants with spider phobia (n=41) and healthy controls (n=42) were exposed to a spider scenario in VR after one session of iTBS over the prefrontal cortex or sham treatment. Participants with spider phobia reacted with more anxiety compared to healthy controls. Their heart rate and skin conductance increased compared to baseline. Contrary to expectations, iTBS did not influence these reactions, but modulated heart rate variability (HRV). Sympathetic influence on HRV showed an increase in the active iTBS group only. This study does not support the idea of beneficial effects of a single session of iTBS on anxiety, although other protocols or repeated sessions might be effective.",Notzon S.; Deppermann S.; Fallgatter A.; Diemer J.; Kroczek A.; Domschke K.; Zwanzger P.; Ehlis AC.,2015.0,10.1016/j.biopsycho.2015.10.003,0,0,
5233,Treatment of co-occurring PTSD-AUD: effects of exposure-based and non-trauma focused psychotherapy on alcohol and trauma cue-reactivity.,"Laboratory studies have shown that exposure to trauma memories increases both craving and salivation responses to alcohol cues among individual with co-occurring posttraumatic stress disorder (PTSD) and alcohol dependence (AD). The purpose of the present study was to examine 1) whether this cue reactivity is dampened following exposure-based treatment for PTSD and 2) how changes in reactivity to trauma cues correspond to changes in alcohol cue-reactivity. Adults with current PTSD and AD (N = 120) were randomly assigned to 9-12 sessions of either Trauma-focused Exposure Therapy (EXP) for PTSD or Health & Lifestyles (HLS, a non-trauma focused comparison treatment), concurrent with 6-week residential AD treatment-as-usual. Participants completed trauma and alcohol cue-reactivity laboratory sessions before and after treatment. Compared to HLS, individuals receiving EXP showed significantly greater reductions in negative affect elicited by trauma cues following treatment. Both treatments demonstrated similar, moderate to large reductions in craving and salivary reactivity over time. Interestingly, latent change in trauma cue-elicited distress over the course of treatment predicted latent change in both trauma cue-elicited alcohol craving and salivation. Overall, findings highlight the utility of integrating trauma-focused therapies like EXP into substance use treatment in the interests of reducing PTSD symptoms and distress associated with trauma cues.",Nosen E.; Littlefield AK.; Schumacher JA.; Stasiewicz PR.; Coffey SF.,2014.0,10.1016/j.brat.2014.07.003,0,0,
5234,Psychological and physical benefits of circuit weight training in law enforcement personnel,"ER The effects of circuit weight training on mood, perceived stress, job satisfaction, and physical symptoms were investigated in a sample of state law enforcement officers. Forty-three male officers who were not regularly exercising were assigned to either 4 months of circuit weight training or a wait-list control condition. Four months of circuit weight training led to a significant increase in strength on cardiovascular fitness. Subjects also demonstrated significant improvements in mood, including decreases in somatization, anxiety, depression, and hostility. Circuit weight training also resulted in a decrease in reports of physical symptoms and in improvements in job satisfaction. Results indicated that subjects who dropped out of the exercise training program evidenced significantly greater anxiety, depression, and hostility at pretreatment than subjects who completed the program. These findings suggest that circuit weight training programs may contribute to important psychological benefits.","Norvell, N; Belles, D",1993.0,,0,0,
5235,Preliminary evaluation of a broad-spectrum cognitive-behavioral group therapy for anxiety.,"This study involved the development and outcome evaluation of a cognitive-behavioral group treatment program for anxiety disorder using a randomized controlled design. This treatment program deviated from traditional anxiety disorder treatment protocols in that anxiety diagnosis was de-emphasized and treatment focused on shared common features across the anxiety disorders. Twenty-three participants were recruited and randomly assigned to either immediate treatment or waitlist control conditions. Nine randomly assigned participants representing a range of anxiety diagnoses completed the 12-week group treatment, and were compared with 10 waitlist control participants who stayed in the study during the waitlist period. Participants in the two conditions were compared on change in diagnosis, diagnostic severity, self-report fear on ideographic measures, and self-report questionnaires of anxiety and state negative affect. Results were generally supportive of the efficacy of the treatment program. Compared to controls participants, those receiving treatment showed significantly greater improvement on diagnostic measures and ideographic fear-avoidance hierarchies. Data from self-report measures of anxiety and state negative affect were less supportive of the treatment efficacy. Implications for emerging conceptualizations of anxiety disorders, as well as implications for treatment and treatment dissemination, are discussed.",Norton PJ.; Hope DA.,2005.0,10.1016/j.jbtep.2004.07.002,0,0,
5236,Effects of a transdiagnostic group treatment for anxiety on secondary depression.,"Researchers have recently explored transdiagnostic anxiety treatments based on models of anxiety emphasizing a single common pathway across diagnostic categories. Results from a previous study [Norton and Hope, in press] indicated that a transdiagnostic approach was effective for both targeted and untargeted anxiety disorders. Consistent with the tripartite model, the transdiagnostic treatment should also influence symptoms of a broader pathology such as negative affectivity. This follow-up to Norton and Hope found significant decreases in depressed mood for clients undergoing transdiagnostic treatment for anxiety when compared to wait-list control participants. Although not statistically established, severity of depressive diagnoses seemed to generally decrease across treatment, whereas no change in severity occurred for those not receiving treatment.",Norton PJ.; Hayes SA.; Hope DA.,2004.0,10.1002/da.20045,0,0,
5237,Effect of transdiagnostic cbt for anxiety disorders on comorbid diagnoses.,"The present study examines the effectiveness of a 12-week transdiagnostic cognitive-behavioral group in reducing comorbid diagnoses. Data from 79 treatment completers (60.8% women; M age = 32.57 years) during three previous trials of transdiagnostic cognitive behavior therapy (CBT) were examined to compare treatment effects between those with and without comorbid diagnoses. Additionally, rates of remission of comorbid diagnoses were compared to published diagnosis-specific CBT trials. Results indicate that a majority of clients (64.6%) had at least one comorbid disorder and that those with comorbid diagnoses had higher primary diagnosis severity scores than did those without comorbid diagnoses. The presence of a comorbid diagnosis at pretreatment was not associated with differential improvement in primary diagnosis severity following treatment. Two-thirds of completers with comorbid diagnoses at pretreatment (66.7%) no longer met criteria for a clinically severe comorbid diagnosis at posttreatment, a rate higher than that associated with most trials of diagnosis-specific CBT for anxiety disorders used as benchmarks. These results suggest that transdiagnostic cognitive-behavioral group treatment for anxiety may be associated with greater decreases in comorbidity than traditional diagnosis-specific CBT.",Norton PJ.; Barrera TL.; Mathew AR.; Chamberlain LD.; Szafranski DD.; Reddy R.; Smith AH.,2013.0,10.1002/da.22018,0,0,
5238,Transdiagnostic versus diagnosis-specific cbt for anxiety disorders: a preliminary randomized controlled noninferiority trial.,"Transdiagnostic cognitive-behavioral treatments for anxiety disorders have been gaining increased attention and empirical study in recent years. Despite this, research on transdiagnostic anxiety treatments has, to date, relied on open trials, or comparisons to waitlist conditions, published benchmarks, or relaxation-based interventions. The current study was a randomized clinical trial examining the efficacy of a 12-week transdiagnostic cognitive-behavioral group treatment in comparison to 12-week diagnosis-specific group Cognitive-Behavioral Therapy (CBT) protocols for panic disorder, social anxiety disorder, and generalized anxiety disorder. Results from 46 treatment initiators suggested significant improvement during treatment, strong evidence for treatment equivalence across transdiagnostic and diagnosis-specific CBT conditions, and no differences in treatment credibility. This study provides evidence supporting the efficacy of transdiagnostic CBT by comparison to current gold-standard diagnosis-specific CBT for social anxiety disorder, generalized anxiety disorder, and panic disorder. Transdiagnostic group CBT has the benefit of potentially easing dissemination and increasing access to evidence-based treatments for anxiety without sacrificing efficacy.",Norton PJ.; Barrera TL.,2012.0,10.1002/da.21974,0,0,
5239,An open trial of a transdiagnostic cognitive-behavioral group therapy for anxiety disorder.,"Transdiagnostic models of anxiety, and cognitive-behavioral treatments based on these models, have been gaining increased attention in recent years. Preliminary efficacy studies generally suggest strong treatment effects, although few of these studies have examined to what extent treatment effects are similar across clients with different anxiety disorders. The purpose of the current study was to examine the efficacy of a 12-week transdiagnostic group cognitive-behavioral therapy for anxiety disorders and compare outcome across diagnoses. Mixed-effect regression modeling of data from 52 participants with anxiety disorders (predominantly panic disorder and social phobia) participating in an open outcome trial indicated that participants tended to improve over treatment, with no differential outcome for any primary or comorbid disorders. The results of this study add to the growing evidence base for transdiagnostic anxiety treatment models and provide preliminary support for the assumption that individuals with different anxiety diagnoses can be treated equally within the same treatment protocol.",Norton PJ.,2008.0,10.1016/j.beth.2007.08.002,0,0,
5240,Transdiagnostic versus diagnosis-specific CBT for anxiety disorders: A preliminary randomized controlled noninferiority trial.,"Background: Transdiagnostic cognitive-behavioral treatments for anxiety disorders have been gaining increased attention and empirical study in recent years. Despite this, research on transdiagnostic anxiety treatments has, to date, relied on open trials, or comparisons to waitlist conditions, published benchmarks, or relaxation-based interventions. Methods: The current study was a randomized clinical trial examining the efficacy of a 12-week transdiagnostic cognitive-behavioral group treatment in comparison to 12-week diagnosis-specific group Cognitive-Behavioral Therapy (CBT) protocols for panic disorder, social anxiety disorder, and generalized anxiety disorder. Results: Results from 46 treatment initiators suggested significant improvement during treatment, strong evidence for treatment equivalence across transdiagnostic and diagnosis-specific CBT conditions, and no differences in treatment credibility. Conclusions: This study provides evidence supporting the efficacy of transdiagnostic CBT by comparison to current gold-standard diagnosis-specific CBT for social anxiety disorder, generalized anxiety disorder, and panic disorder. Transdiagnostic group CBT has the benefit of potentially easing dissemination and increasing access to evidence-based treatments for anxiety without sacrificing efficacy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Norton, Peter J; Barrera, Terri L; Barlow, Barlow, Beck, Borkovec, Brown, Brown, Butler, Clark, Clark, Craske, Craske, Craske, Craske, Craske, Dugas, Dugas, Ellard, Erickson, Erickson, Erickson, Fisher, Hedeker, Hedman, Heimberg, Heimberg, Hofmann, Ledley, Lovell, Mansell, McEvoy, McEvoy, McHugh, McManus, Muthen, Newman, Norton, Norton, Norton, Norton, Norton, Norton, Norton, Norton, Norton, Norton, Piaggio, Roemer, Schmidt, Sharp, Shear, Spielberger, Telch, Wiens",2012.0,,0,0,
5241,A comparison of people with and without nocturnal panic attacks.,"This study examined differences in frequency and severity of diurnal panic attacks between patients with (n = 22) and without (n = 21) a history of nocturnal panic attacks. Subjects were assessed with a modified version of the SCID, and completed daily panic attack diaries, the Anxiety Sensitivity Index, and the Fear Questionnaire. No differences were found between the groups in the actual number of expected or unexpected diurnal panic attacks experienced. Subjects in the nocturnal panic group experienced significantly more symptoms during diurnal panic attacks than did the diurnal only group. More specifically, the nocturnal panic group experienced more symptoms during expected diurnal panic attacks, but not during unexpected/spontaneous diurnal panic attacks. A greater proportion of the nocturnal panic subjects reported ""chest pain"" during diurnal panic attacks and a trend toward greater ""fear of dying"". Otherwise, the two groups were very similar. Implications of the findings are discussed in relation to the findings of other recent studies of nocturnal panic.",Norton GR.; Norton PJ.; Walker JR.; Cox BJ.; Stein MB.,1999.0,,0,0,
5242,Randomized controlled trial of biofeedback for fecal incontinence,"ER METHODSA total of 171 patients with fecal incontinence were randomized to 1 of 4 groups: (1) standard care (advice); (2) advice plus instruction on sphincter exercises; (3) hospital-based computer-assisted sphincter pressure biofeedback; and (4) hospital biofeedback plus the use of a home electromyelogram biofeedback device. Outcome measures included diary, symptom questionnaire, continence score, patient's rating of change, quality of life (short-form 36 and disease specific), psychologic status (Hospital Anxiety and Depression scale), and anal manometry.RESULTSBiofeedback yielded no greater benefit than standard care with advice (53% improved in group 3 vs. 54% in group 1). There was no difference between the groups on any of the following measures: episodes of incontinence decreased from a median of 2 to 0 per week (P < 0.001). Continence score (worst = 20) decreased from a median of 11 to 8 (P < 0.001). Disease-specific quality of life, short-form 36 (vitality, social functioning, and mental health), and Hospital Anxiety and Depression scale all significantly improved. Patients improved resting, squeeze, and sustained squeeze pressures (all P < 0.002). These improvements were largely maintained 1 year after finishing treatment.CONCLUSIONSConservative therapy for fecal incontinence improves continence, quality of life, psychologic well-being, and anal sphincter function. Benefit is maintained in the medium term. Neither pelvic floor exercises nor biofeedback was superior to standard care supplemented by advice and education.BACKGROUND & AIMSBehavioral treatment (biofeedback) has been reported to improve fecal incontinence but has not been compared with standard care.","Norton, C; Chelvanayagam, S; Wilson-Barnett, J; Redfern, S; Kamm, M A",2003.0,,0,0,
5243,Complaints of constipation in obsessive-compulsive disorder.,"Psychoanalytic observation has launched a long tradition in medical literature that links constipation with obsessive-compulsive traits. This association, however, has never been tested empirically. The current investigation sought to test this hypothesized association empirically using a large, randomly sampled population database. Data from the Epidemiologic Catchment Area project collected with the Diagnostic Interview Schedule were analyzed to determine the association, if any, of complaint of medically unexplained constipation (ascertained from the somatization disorder section of the interview) with a DIS diagnosis of obsessive compulsive disorder (OCD). Reported history of constipation was significantly associated with a lifetime diagnosis of OCD in women (not men), even when controlling for symptom-reporting biases using number of other positive somatoform symptoms. This association was specific to constipation and OCD and did not apply to other functional bowel symptoms including diarrhea, bloating (gas), and abdominal pain. Other psychiatric disorders commonly implicated with functional bowel complaints--major depression and panic disorder--were not significantly associated with constipation controlling for effects of other somatoform symptoms. The lack of association of constipation with OCD in men in a general population sample fails to support psychoanalytic concepts that historically have linked these two phenomena, but a special relationship of OCD with constipation was present in women.",North CS.; Napier M.; Alpers DH.; Spitznagel EL.,1995.0,,0,0,
5244,Baseline psychophysiological and cortisol reactivity as a predictor of PTSD treatment outcome in virtual reality exposure therapy.,"Baseline cue-dependent physiological reactivity may serve as an objective measure of posttraumatic stress disorder (PTSD) symptoms. Additionally, prior animal model and psychological studies would suggest that subjects with greatest symptoms at baseline may have the greatest violation of expectancy to danger when undergoing exposure based psychotherapy; thus treatment approaches which enhanced the learning under these conditions would be optimal for those with maximal baseline cue-dependent reactivity. However methods to study this hypothesis objectively are lacking. Virtual reality (VR) methodologies have been successfully employed as an enhanced form of imaginal prolonged exposure therapy for the treatment of PTSD. Our goal was to examine the predictive nature of initial psychophysiological (e.g., startle, skin conductance, heart rate) and stress hormone responses (e.g., cortisol) during presentation of VR-based combat-related stimuli on PTSD treatment outcome. Combat veterans with PTSD underwent 6 weeks of VR exposure therapy combined with either D-cycloserine (DCS), alprazolam (ALP), or placebo (PBO). In the DCS group, startle response to VR scenes prior to initiation of treatment accounted for 76% of the variance in CAPS change scores, p < 0.001, in that higher responses predicted greater changes in symptom severity over time. Additionally, baseline cortisol reactivity was inversely associated with treatment response in the ALP group, p = 0.04. We propose that baseline cue-activated physiological measures will be sensitive to predicting patients' level of response to exposure therapy, in particular in the presence of enhancement (e.g., DCS). (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Norrholm, Seth Davin; Jovanovic, Tanja; Gerardi, Maryrose; Breazeale, Kathryn G; Price, Matthew; Davis, Michael; Duncan, Erica; Ressler, Kerry J; Bradley, Bekh; Rizzo, Albert; Tuerk, Peter W; Rothbaum, Barbara O; Binder, Blake, Blanchard, Blanchard, Blumenthal, Bradley, Buckley, Costanzo, Craske, Davis, Davis, Delamater, Diemer, Difede, Dravid, Ferdinand, Foa, Foa, Foa, Foa, Foa, Foa, Griffin, Guastella, Heim, Hofmann, Hofmann, Jaycox, Jovanovic, Kushner, Ledgerwood, Ledgerwood, Ledgerwood, Lindauer, Lund, Mackintosh, Mackintosh, McTeague, Meewisse, Norrholm, Norrholm, Norrholm, Orr, Orr, Otto, Pearce, Pole, Price, Price, Rabe, Rasmusson, Rauch, Ressler, Rhudy, Richardson, Rizzo, Robison-Andrew, Rodrigues, Rothbaum, Rothbaum, Rothbaum, Roy, Roy, Shalev, Sheehan, Sherman, Steenkamp, Telch, Tuerk, Vachon, van Minnen, van Minnen, Vermetten, Vervliet, Walker, Wilhelm, Yehuda, Yehuda",2016.0,,0,0,
5245,Generalization of fear-potentiated startle in the presence of auditory cues: A parametric analysis,"Intense fear responses observed in trauma-, stressor-, and anxiety-related disorders can be elicited by a wide range of stimuli similar to those that were present during the traumatic event. The present study investigated the experimental utility of fear-potentiated startle paradigms to study this phenomenon, known as stimulus generalization, in healthy volunteers. Fear-potentiated startle refers to a relative increase in the acoustic startle response to a previously neutral stimulus that has been paired with an aversive stimulus. Specifically, in Experiment 1 an auditory pure tone (500 Hz) was used as the conditioned stimulus (CS+) and was reinforced with an unconditioned stimulus (US), an airblast to the larynx. A distinct tone (4000 Hz) was used as the nonreinforced stimulus (CS‚àí) and was never paired with an airblast. Twenty-four hours later subjects underwent Re-training followed by a Generalization test, during which subjects were exposed to a range of generalization stimuli (GS) (250, 1000, 2000, 4000, 8000 Hz). In order to further examine the point at which fear no longer generalizes, a follow-up experiment (Experiment 2) was performed where a 4000 Hz pure tone was used as the CS+, and during the Generalization test, 2000 and 8000 Hz were used as GS. In both Experiment 1 and 2 there was significant discrimination in US expectancy responses on all stimuli during the Generalization Test, indicating the stimuli were perceptually distinct. In Experiment 1, participants showed similar levels of fear-potentiated startle to the GS that were adjacent to the CS+, and discriminated between stimuli that were 2 or more degrees from the CS+. Experiment 2 demonstrated no fear-potentiated startle generalization. The current study is the first to use auditory cues to test generalization of conditioned fear responses; such cues may be especially relevant to combat posttraumatic stress disorder (PTSD) where much of the traumatic exposure may involve sounds.",Norrholm S.D.; Jovanovic T.; Briscione M.A.; Anderson K.M.; Kwon C.K.; Warren V.T.; Bosshardt L.; Bradley B.,2014.0,10.3389/fnbeh.2014.00361,0,0,
5246,Versatility of fear-potentiated startle paradigms for assessing human conditioned fear extinction and return of fear,"Fear conditioning methodologies have often been employed as testable models for assessing learned fear responses in individuals with anxiety disorders such as post-traumatic stress disorder (PTSD) and specific phobia. One frequently used paradigm is measurement of the acoustic startle reflex under conditions that mimic anxiogenic and fear-related conditions. For example, fear-potentiated startle is the relative increase in the frequency or magnitude of the acoustic startle reflex in the presence of a previously neutral cue (e.g., colored shape; termed the conditioned stimulus or CS+) that has been repeatedly paired with an aversive unconditioned stimulus (e.g., airblast to the larynx). Our group has recently used fear-potentiated startle paradigms to demonstrate impaired fear extinction in civilian and combat populations with PTSD. In the current study, we examined the use of either auditory or visual CSs in a fear extinction protocol that we have validated and applied to human clinical conditions. This represents an important translational bridge in that numerous animal studies of fear extinction, upon which much of the human work is based, have employed the use of auditory CSs as opposed to visual CSs. Participants in both the auditory and visual groups displayed robust fear-potentiated startle to the CS+, clear discrimination between the reinforced CS+ and non-reinforced CS-, significant extinction to the previously reinforced CS+, and marked spontaneous recovery. We discuss the current results as they relate to future investigations of PTSD-related impairments in fear processing in populations with diverse medical and psychiatric histories. © 2011 Norrholm, Anderson, Olin, Jovanovic, Kwon, Warren, McCarthy, Bosshardt, Sabree, Duncan, Rothbaum and Bradley.",Norrholm S.D.; Anderson K.M.; Olin I.W.; Jovanovic T.; Kwon C.; Warren V.T.; McCarthy A.; Bosshardt L.; Sabree J.; Duncan E.J.; Rothbaum B.O.; Bradley B.,2011.0,10.3389/fnbeh.2011.00077,0,0,
5247,"The effects of an anxiety sensitivity intervention on anxiety, depression, and worry: Mediation through affect tolerances.","Recently there has been increased interest in emotional and physical tolerance risk factors for mood and anxiety disorders. Three tolerance risk factors that have been shown to be related are anxiety sensitivity (AS), distress tolerance (DT), and discomfort intolerance (DI). Although previous research has demonstrated these constructs are malleable, no research has investigated the effects of an AS intervention on DT or DI. Further, no studies have investigated whether changes in DT or DI play a role in mood and anxiety symptom amelioration due to an AS intervention. Participants (N = 104), who were selected for elevated levels of AS, completed a single-session computer-assisted AS intervention or a control intervention and follow-up assessments at 1-week and 1-month post intervention. Results revealed that the intervention reduced AS and increased DT, but did not affect DI at the 1-week follow-up. Mediation analyses revealed that changes in AS and DT both mediated changes in symptoms (depression, anxiety, worry) due to the intervention at 1-month follow-up, however, when AS and DT were considered in the same model only the effect via AS remained significant. These results have important implications for the nature of the relationships between AS, DT, and DI as well as the specific mechanistic pathways through which an AS intervention ameliorates symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Norr, Aaron M; Allan, Nicholas P; Macatee, Richard J; Keough, Meghan E; Schmidt, Norman B; Allan, Anestis, Beck, Beck, Beekman, Beesdo, Bernstein, Bonn-Miller, Bornovalova, Broman-Fulks, Buckner, Capron, Cox, Cox, de Graaf, Dennhardt, DeVellis, Ellis, Feldner, Gardenswartz, Gorka, Grant, Hu, Huang, Kapson, Kendler, Kendler, Keough, Keough, Kessler, Leyro, Lotan, Macatee, MacCallum, McHugh, McHugh, Meyer, Mitchell, Mitchell, Moffitt, Muthen, Norr, Olthuis, Preacher, Reiss, Schmidt, Schmidt, Schmidt, Schmidt, Schmidt, Simons, Smits, Starr, Tabachnick, Taylor, Timpano, Tull, Viana, Watt, Watt, Williams, Zhao, Zvolensky, Zvolensky",2014.0,,0,0,
5248,Maximizing the utility of a single site randomized controlled psychotherapy trial.,"There is increasing interest in including measures of biological mechanisms as mediators and moderators of treatment outcome in randomized controlled trials (RCT's) of psychotherapy efficacy. However, examining biological mechanisms is often expensive and budget caps of most major funding agencies have remained stable in recent years. The goal of this manuscript is to describe how a psychotherapy efficacy trial is using a model of collaborative, affiliated grants to maximize resources and the potential knowledge to be gained from a single site RCT. Principal results and conclusions: The trial is an ongoing RCT comparing two psychotherapies for the treatment of concurrent posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) with a sample of treatment seeking veterans. Through collaboration with a team of investigators with independently-funded but affiliated grants, measures of select sleep, neurobiological, and genetic biomarkers were integrated into this single site RCT. This model has allowed us to pose research questions regarding the role of biological mechanisms, maximize the utility of recruitment, and be efficient in maximizing knowledge to be gained in a way that would not be possible solely on the funding of a single site RCT. Challenges of this model include high participant burden in regard to assessment and complicated coordinating procedures among studies. Strategies to address these challenges are described.",Norman SB.; Haller M.; Spadoni AD.; Drummond SP.; Risbrough V.; Hamblen JL.; Trim RS.; Blanes EX.,2015.0,10.1016/j.cct.2015.04.011,0,0,
5249,Efficacy and safety of Labisia pumila var alata water extract among pre- and postmenopausal women,"ER This study evaluated the effectiveness and safety of Labisia pumila var alata (L. pumila) water extract for improving quality of life, cardiovascular and hormonal balance. A randomized, double-blind, placebo-controlled, parallel group, 16-week study in healthy pre- and postmenopausal women aged 40-60 years was conducted in Kelantan, Malaysia. The subjects were randomized to 400?mg propriety extract of L. pumila or placebo. A Women's Health Questionnaire was used to assess quality of life. Repeated-measures analysis of variance was used to evaluate the data. A total of 197 subjects (L. pumila: n=102 and placebo: n=95) were analyzed. Subjects in the herbal group showed improved memory/concentration, vasomotor symptoms, menstrual symptoms, and sleep problems by 8.3%, 15.9%, 11.8%, and 31.0%, respectively. The greatest improvement was observed for the question: ""I get frightened or panic feelings for apparently no reason at all"" with a 53% decrease as compared with placebo. Improvements were also seen in the cardiovascular parameters, and the safety profiles were normal. Postmenopausal women supplemented with L. pumila showed no changes in gynecological relevant hormones luteinizing hormone (LH), follicle-stimulating hormone (FSH), and 17?-Estradiol. Water extract of L. pumila was shown to be safe and effective for improving several parameters of quality of life and cardiovascular risks factors (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C]).","Norhayati, M N; George, A; Hazlina, N H; Azidah, A K; Idiana, H I; Law, K S; Bahari, I S; Zahiruddin, W M; Liske, E; Azreena, A",2014.0,10.1089/jmf.2013.2953,0,0,
5250,Social and individual determinants of adolescents' acceptance of novel healthy and cool snack products,"ER Four new, healthy snack products, consisting of fruit, vegetables, bread, dip and topping, were tested with 600 Danish adolescents aged 9-16. Participants could view, handle, and test the products in a school setting. Acceptance was measured by overall buying intention, as well as buying intention contingent on specific substitutes and on the social situation. Price consciousness, health consciousness, snack neophobia, peer influence, social activities and word-of-mouth were measured as potential determinants of acceptance of the novel products. An exploratory analysis in TETRAD suggested that the measured constructs form three layers, with overall buying intention as the terminal causal effect, health consciousness, word of mouth, snack neophobia and peer influence as endogenous determinants, and social activities and the contingent buying intentions as mediators. Estimation of the causal relationships was conducted in LISREL. Findings show a predominance of social factors as determinants of novel snack acceptance, whereas health consciousness had only a weak and indirect effect on buying intentions and the effect of snack neophobia was partly mediated by social factors.","N√∏rgaard, M K; S√∏rensen, B T; Grunert, K G",2014.0,10.1016/j.appet.2014.08.028,0,0,
5251,Expanding the limits of bibliotherapy for panic disorder: randomized trial of self-help without support but with a clear deadline.,"Cognitive behavioral bibliotherapy for panic disorder has been found to be less effective without therapist support. In this study, participants were randomized to either unassisted bibliotherapy (n=20) with a scheduled follow-up telephone interview or to a waiting list control group (n=19). Following a structured psychiatric interview, participants in the treatment group were sent a self-help book consisting of 10 chapters based on cognitive behavioral strategies for the treatment of panic disorder. No therapist contact of any kind was provided during the treatment phase, which lasted for 10 weeks. Results showed that the treatment group had, in comparison to the control group, improved on all outcome measures at posttreatment and at 3-month follow-up. The tentative conclusion drawn from these results is that pure bibliotherapy with a clear deadline can be effective for people suffering from panic disorder with or without agoraphobia.",Nordin S.; Carlbring P.; Cuijpers P.; Andersson G.,2010.0,10.1016/j.beth.2009.06.001,0,0,
5252,Expanding the limits of bibliotherapy for panic disorder: Randomized trial of self-help without support but with a clear deadline.,"Cognitive behavioral bibliotherapy for panic disorder has been found to be less effective without therapist support. In this study, participants were randomized to either unassisted bibliotherapy (n = 20) with a scheduled follow-up telephone interview or to a waiting list control group (n =19). Following a structured psychiatric interview, participants in the treatment group were sent a self-help book consisting of 10 chapters based on cognitive behavioral strategies for the treatment of panic disorder. No therapist contact of any kind was provided during the treatment phase, which lasted for 10 weeks. Results showed that the treatment group had, in comparison to the control group, improved on all outcome measures at posttreatment and at 3-month follow-up. The tentative conclusion drawn from these results is that pure bibliotherapy with a clear deadline can be effective for people suffering from panic disorder with or without agoraphobia. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Nordin, Sara; Carlbring, Per; Cuijpers, Pim; Andersson, Gerhard; Andersson, Andersson, Barlow, Beck, Beck, Bergstrom, Bower, Carlbring, Carlbring, Carlbring, Carlbring, Carlbring, Carlbring, Carlbring, Carlbring, Chambless, Chambless, Chambless, Clum, Cuijpers, den Boer, Febbraro, Febbraro, First, Frisch, Gould, Gould, Guy, Hecker, Hecker, Hirai, Jacobson, Klein, Lidren, Marks, Montgomery, Newell, Newman, Palmqvist, Powers, Rapee, Richards, Rohde, Rosen, Rosen, Shear, Spek, Svanborg, Taylor, Wilson",2010.0,,0,0,
5253,Cognitive behavioural therapy in multiple sclerosis: a randomized controlled pilot study of acceptance and commitment therapy.,"The aim of this study was to design a trial that could evaluate the effect of acceptance and commitment therapy as a group-intervention for multiple sclerosis patients with psychological distress. Randomized controlled trial with assessment at pretreatment, end of treatment, and at 3-month follow-up. Multiple sclerosis outpatients with elevated symptoms of anxiety and/or depression (n‚Äâ=‚Äâ21). Patients were randomly assigned to acceptance and commitment therapy or relaxation training. Both treatments consisted of 5 sessions over 15 weeks containing didactic sessions, group discussions, and exercises. Outcome was assessed by self-rated symptoms of anxiety, depression, and a measure of acceptance. At 3-month follow-up, the relaxation training group had a significant decline in anxiety symptoms whereas the acceptance and commitment therapy group showed a maintained improvement in rated acceptance at follow-up. The results reflect the different emphases of the therapies. Acceptance and commitment therapy is aimed at living an active, valued life and increasing acceptance, while relaxation training focuses directly on coping strategies to handle emotional symptoms. The results are preliminary, but supportive of further study of brief group interventions for reducing psychological distress in patients with multiple sclerosis.",Nordin L.; Rorsman Ia.,2012.0,10.2340/16501977-0898,0,0,
5254,Design of the study: how can health care help female breast cancer patients reduce their stress symptoms? A randomized intervention study with stepped-care.,"A life threatening illness such as breast cancer can lead to a secondary diagnosis of PTSD (post traumatic stress disorder) with intrusive thoughts and avoidance as major symptoms. In a former study by the research group, 80% of the patients with breast cancer reported a high level of stress symptoms close to the diagnosis, such as intrusive thoughts and avoidance behavior. These symptoms remained high throughout the study. The present paper presents the design of a randomized study evaluating the effectiveness and cost-effectiveness of a stress management intervention using a stepped-care design. Female patients over the age of 18, with a recent diagnosis of breast cancer and scheduled for adjuvant treatment in the form of chemotherapy, radiation therapy and/or hormonal therapy are eligible and will consecutively be included in the study. The study is a prospective longitudinal intervention study with a stepped-care approach, where patients will be randomised to one of two interventions in the final stage of treatment. The first step is a low intensity stress-management intervention that is given to all patients. Patients who do not respond to this level are thereafter given more intensive treatment at later steps in the program and will be randomized to more intensive stress-management intervention in a group setting or individually. The primary out-come is subjective distress (intrusion and avoidance) assessed by the Impact of Event Scale (IES). According to the power-analyses, 300 patients are planned to be included in the study and will be followed for one year. Other outcomes are anxiety, depression, quality of life, fatigue, stress in daily living and utilization of hospital services. This will be assessed with well-known psychometric tested questionnaires. Also, the cost-effectiveness of the intervention given in group or individually will be evaluated. This randomized clinical trial will provide additional empirical evidence regarding the effectiveness of a stress-management program given in group or individually during adjuvant therapy in terms of decreased stress, minimizing fatigue, and maintaining or enhancing patients' quality of life and psychological well-being. ClinicalTrials.gov Identifier: NCT01555645.",Nordin K.; Rissanen R.; Ahlgren J.; Burell G.; Fjällskog ML.; Börjesson S.; Arving C.,2012.0,10.1186/1471-2407-12-167,0,0,
5255,Brief dynamic psychotherapy with older adults.,"This article is based on experiences in implementing a clinical training program applying individual psychotherapy with older adults in a university outpatient clinic. A case illustration of a 68-yr-old married woman with an anxiety disorder is introduced to demonstrate how presenting complaints are translated into cyclical maladaptive patterns, a formulation used as a heuristic to help the therapist generate, recognize, and organize relevant psychotherapeutic information. The goal of the brief dynamic therapy is to help the client change her maladaptive interpersonal patterns, focusing on new experiences and new understandings that emanate from the therapeutic relationship. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Nordhus, Inger Hilde; Nielsen, Geir Hostmark",1999.0,,0,0,
5256,Outcome predictors in guided and unguided self-help for social anxiety disorder.,"Internet-based self-help with therapist guidance has shown promise as an effective treatment and may increase access to evidence-based psychological treatment for social anxiety disorder (SAD). Although unguided self-help has been suggested primarily as a population-based preventive intervention, some studies indicate that patients with SAD may profit from unguided self-help. Gaining knowledge about predictors of outcome in guided and unguided self-help for SAD is important to ensure that these interventions can be offered to those who are most likely to respond. Utilizing a sample of 245 patients who received either guided or unguided self-help for SAD, the present study examined pre-treatment symptoms and program factors as predictors of treatment adherence and outcome. The results were in line with previous findings from the face-to-face treatment literature: namely, the intensity of baseline SAD symptoms, but not depressive symptoms, predicted treatment outcomes in both unguided and guided self-help groups. Outcomes were unrelated to whether a participant has generalized versus specific SAD. Furthermore, for the unguided self-help group, higher credibility ratings of the treatment program were associated with increased treatment adherence. The findings suggest that guided and unguided self-help may increase access to SAD treatment in a population that is more heterogeneous than previously assumed.",Nordgreen T.; Havik OE.; Ost LG.; Furmark T.; Carlbring P.; Andersson G.,2012.0,10.1016/j.brat.2011.10.009,0,0,
5257,Stepped Care Versus Direct Face-to-Face Cognitive Behavior Therapy for Social Anxiety Disorder and Panic Disorder: A Randomized Effectiveness Trial.,"The aim of this study was to assess the effectiveness of a cognitive behavioral therapy (CBT) stepped care model (psychoeducation, guided Internet treatment, and face-to-face CBT) compared with direct face-to-face (FtF) CBT. Patients with panic disorder or social anxiety disorder were randomized to either stepped care (n=85) or direct FtF CBT (n=88). Recovery was defined as meeting two of the following three criteria: loss of diagnosis, below cut-off for self-reported symptoms, and functional improvement. No significant differences in intention-to-treat recovery rates were identified between stepped care (40.0%) and direct FtF CBT (43.2%). The majority of the patients who recovered in the stepped care did so at the less therapist-demanding steps (26/34, 76.5%). Moderate to large within-groups effect sizes were identified at posttreatment and 1-year follow-up. The attrition rates were high: 41.2% in the stepped care condition and 27.3% in the direct FtF CBT condition. These findings indicate that the outcome of a stepped care model for anxiety disorders is comparable to that of direct FtF CBT. The rates of improvement at the two less therapist-demanding steps indicate that stepped care models might be useful for increasing patients' access to evidence-based psychological treatments for anxiety disorders. However, attrition in the stepped care condition was high, and research regarding the factors that can improve adherence should be prioritized.",Nordgreen T.; Haug T.; Öst LG.; Andersson G.; Carlbring P.; Kvale G.; Tangen T.; Heiervang E.; Havik OE.,2016.0,10.1016/j.beth.2015.10.004,0,0,
5258,Unreliability of putative fMRI biomarkers during emotional face processing,"There is considerable need to develop tailored approaches to psychiatric treatment. Numerous researchers have proposed using functional magnetic resonance imaging (fMRI) biomarkers to predict therapeutic response, in particular by measuring task-evoked subgenual anterior cingulate (sgACC) and amygdala activation in mood and anxiety disorders. Translating this to the clinic relies on the assumption that blood-oxygen-level dependent (BOLD) responses in these regions are stable within individuals. To test this assumption, we scanned a group of 29 volunteers twice (mean test-retest interval=14.3 days) and calculated the within-subject reliability of the amplitude of the amygdalae and sgACC BOLD responses to emotional faces using three paradigms: emotion identification; emotion matching; and gender classification. We also calculated the reliability of activation in a control region, the right fusiform face area (FFA). All three tasks elicited robust group activations in the amygdalae and sgACC (which changed little on average over scanning sessions), but within-subject reliability was surprisingly low, despite excellent reliability in the control right FFA region. Our findings demonstrate low statistical reliability of two important putative treatment biomarkers in mood and anxiety disorders.",Nord C.L.; Gray A.; Charpentier C.J.; Robinson O.J.; Roiser J.P.,2017.0,10.1016/j.neuroimage.2017.05.024,0,0,
5259,Treatment of traumatised refugees with basic body awareness therapy versus mixed physical activity as add-on treatment: Study protocol of a randomised controlled trial.,"Treatment of traumatised refugees is one of the fields within psychiatry, which has received little scientific attention. Evidence based treatment and knowledge on the efficiency of the treatment for this complex patient group is therefore scarce. This leads to uncertainty as to which treatment should be offered and potentially lowers the quality of life for the patients. Chronic pain is very common among traumatised refugees and it is believed to maintain the mental symptoms of trauma. Hence, treating chronic pain is believed to be of high clinical value for this patient group. In clinical studies, physical activity has shown a positive effect on psychiatric illnesses such as depression and anxiety and for patients with chronic pain. However, scientific knowledge about physical activity as part of the treatment for traumatised refugees is very limited and no guidelines exist on this topic. This study will include approximately 310 patients, randomised into three groups. All three groups receive psychiatric treatment as usual for the duration of 6-7 months, consisting of consultations with a medical doctor including pharmacological treatment and manual-based Cognitive Behavioural Therapy. The first group only receives treatment as usual while the second and the third groups receive either Basic-Body Awareness Therapy or mixed physical activity as add-on treatments. Each physical activity is provided for an individual 1-hour consultation per week, for the duration of 20 weeks. The study is being conducted at the Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup in the Capital Region of Denmark. The primary endpoint of the study is symptoms of Post Traumatic Stress Disorder; the secondary endpoints are depression and anxiety as well as quality of life, functional capacity, coping with pain, body awareness and physical fitness. This study will examine the effect of physical activity for traumatised refugees. This has not yet been done in a randomised controlled setting on such a large scale before. Hereby the study will contribute to important knowledge that is expected to be used in future clinical guidelines and reference programs. ClinicalTrials.gov NCT01955538 . Date of registration: 18 September 2013.",Nordbrandt MS.; Carlsson J.; Lindberg LG.; Sandahl H.; Mortensen EL.,2015.0,10.1186/s13063-015-0974-9,0,0,
5260,"Social anxiety and work status: the role of negative metacognitive beliefs, symptom severity and cognitive-behavioural factors","Background: Psychological health has a profound effect on personal and occupational functioning with Social Anxiety Symptoms in particular having a major effect on ability to work. Recent initiatives have focused on treating psychological illness with cognitive-behavioural models with a view to increasing return to work. However, the psychological correlates of work status amongst individuals with elevated mental health symptoms such as social anxiety are under-explored. Aims: This study reports a test of unique predictors of work status drawing on variables that have been given centre stage in cognitive-behavioural models and in the metacognitive model of psychological disorder. Methods: The sample consisted of high socially anxious individuals who reported to be working (n = 102) or receiving disability benefits (n = 102). Results: A comparison of these groups showed that those out of work and receiving benefits had greater symptom severity, higher avoidance and use of safety behaviours, greater self-consciousness, and elevated negative metacognitive beliefs and beliefs about the need to control thoughts. However, when the covariance’s between these variables were controlled, only negative metacognitive beliefs significantly predicted out-of-work status. Conclusions: Our finding might be important because CBT does not focus on metacognitive beliefs, but targets components that in our analysis had no unique predictive value for work status.",Nordahl H.; Wells A.,2017.0,10.1080/09638237.2017.1340622,0,0,
5261,Association between bullying at work and mental disorders: gender differences in the Italian people.,"In the last few years the international literature has shown an increasing attention for the work as life-event stressor, for its organizational characteristics as well as for job insecurity and interpersonal conflicts. We have studied 707 subjects who approached the Work Psychopathology Medical Centre of Naples to evaluate the DSM IV diagnoses and the degree of bullying at the workplace according to Leymann's definition. Two groups, with high and with low severity of bullying, were compared, mainly in relation to gender differences. The more frequent diagnoses were anxiety disorders (8.7% of the total), mood disorders (31.5%) and adjustment disorders (58.3%). The patients with higher degree of bullying were 55.7% among the subjects with anxiety disorders, 51.4% among the patients with adjustment disorders and 81.25% in the group with mood disorders. The odds of patients with severe bullying was 1.602 times higher for males than for females. Independently by the gender, the odds of patients being in the group with severe bullying were more than three times higher for subjects with mood disorders than for patients suffering from anxiety and adjustment disorders. In the male gender, the psychiatric disturbances are more correlated to bullying at the workplace and this datum is especially linked to the gender differences found in the relationship between severity of bullying and adjustment disorders. Among female employees the psychopathological dimensions could be linked with a more multifactorial genesis in relation to their psychosocial role in the cultural context we examined (Southern Italy).",Nolfe G.; Petrella C.; Zontini G.; Uttieri S.; Nolfe G.,2010.0,10.1007/s00127-009-0155-9,0,0,
5262,Patient-controlled epidural analgesia following post-traumatic pelvic reconstruction. A comparison with continuous epidural analgesia,"ER A randomised, single-blinded study was conducted to compare patient-controlled epidural analgesia with continuous infusion epidural analgesia for the treatment of pain following post-traumatic pelvic reconstruction. The patient-controlled group (n = 11) received a background infusion of 4 ml.h-1 of bupivacaine 0.125% with fentanyl 1 microgram.ml-1, and 3-6 ml bolus doses, self administered, as required (with a 15 min lockout interval). The continuous infusion group (n = 12) received a continuous infusion of the same solution through an identical apparatus, but with the demand button deactivated. This was started at 10 ml.h-1 and adjusted by the anaesthetist, as required, up to a maximum of 25 ml.h-1. Pain scores, side effects, and the volumes of drug infused were recorded over the first 3 postoperative days. One patient from each group was withdrawn because of catheter-related problems. Pain scores were similar and the incidence of nausea and pruritus was low in both groups. There was no recorded instance of respiratory depression or hypotension and there was no significant difference between the groups in the volumes of drug solution received. Patient satisfaction was equally very good in both groups. Patient-controlled epidural analgesia is an effective means of providing pain relief after post-traumatic pelvic reconstruction, but did not significantly reduce analgesic requirements in comparison with continuous infusion epidural analgesia.","Nolan, J P; Dow, A A; Parr, M J; Dauphinee, K; Kalish, M",1992.0,,0,0,
5263,Effects of five-minute internet-based cognitive behavioral therapy and simplified emotion-focused mindfulness on depressive symptoms: A randomized controlled trial.,"Background: Notwithstanding a high expectation for internet-based cognitive behavioral therapy (iCBT) for reducing depressive symptoms, many of iCBT programs have limitations such as temporary effects and high drop-out rates, possibly due to their complexity. We examined the effects of a free, simplified, 5-minute iCBT program by comparing it with a simplified emotion-focused mindfulness (sEFM) exercise and with a waiting list control group. Methods: A total of 974 participants, who were recruited using the website of a market research company, were randomly assigned to the iCBT group, the sEFM group, and the control group. Those in the intervention arms performed each exercise for 5 weeks. The primary outcome measure was the Center for Epidemiological Studies Depression scale (CES-D) at postintervention. Secondary outcome measures were the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 scale (GAD-7). Intention-to-treat analyses were conducted. Results: During postintervention assessment, there were no significant differences between the intervention arms and the control group in the CES-D, although the difference between the iCBT arm and control group was close to significance (p = 0.05) in favor of iCBT. There was a significant difference in the PHQ-9 in favor of the sEFM group compared with the control group. There were no significant differences in outcome measures between the three groups at the 6-week follow-up. Conclusions: Although both iCBT and sEFM have the potential to temporarily reduce depressive symptoms, substantial improvements are required to enhance and maintain their effects. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Noguchi, Remi; Sekizawa, Yoichi; So, Mirai; Yamaguchi, Sosei; Shimizu, Eiji; Andersson, Andrews, Beck, Dan-Glauser, Donker, Faul, Faul, Goldin, Gross, Hayes, Hofmann, Kabat-Zinn, Kaji, Kawakami, Keng, Kivity, Kohl, Kroenke, Muramatsu, Muramatsu, Radloff, Segal, Seligman, Shallcross, Shallcross, Shima, Singer, Singer, Siu, Smoski, So, Spitzer, Wolgast",2017.0,,0,0,
5264,"Design strengths and issues of SAMHSA's Women, Co-occurring Disorders, and Violence Study.","In 1998 the Substance Abuse and Mental Health Services Administration launched the Women, Co-occurring Disorders, and Violence Study (WCDVS). The WCDVS developed, implemented, and evaluated the outcomes and costs of comprehensive, trauma-informed treatment programs for women with a history of violence and trauma who have substance use and mental health disorders. This article discusses the overall design features of the study, issues related to such a design, results of the outcomes and cost evaluations, and suggestions for future research. The nine WCDVS sites were located across the continental United States, with six sites on the East Coast, two on the West Coast, and one in Colorado. A total of 2,729 women (1,415 in the intervention condition and 1,314 in the comparison condition) were enrolled over the 13.5-month baseline accrual period (January 2001 through February 2002). Follow-up interviews were conducted with all participants at three, six, nine and 12 months post-baseline. Women in the intervention and the comparison groups showed improvement in outcomes in four areas: alcohol use, drug use, mental health, and trauma. At six months women in the intervention group scored modestly better than women in the usual-care group for outcome measures for drug use, trauma, and mental health. At 12 months women in the intervention group maintained their improvement in drug use outcomes and continued to improve in mental health and trauma outcomes. After a start-up period, costs for services were not significantly different between the intervention and comparison groups at both follow-up points. Despite their very modest nature, the WCDVS results are promising.",Noether CD.; Finkelstein N.; VanDeMark NR.; Savage A.; Reed BG.; Moses DJ.,2005.0,10.1176/appi.ps.56.10.1233,0,0,
5265,"Personality factors, stoicism and motivation in subjects under hypoxic stress in extreme environments","Previous studies on the physiological and psychological adaptation of subjects to survival conditions involving high-altitude hypoxia (>6500 m) have shown that personality factors are important in this adaptation. We, therefore, proposed personality traits assessments in two groups of subjects engaged in sporting activities under extreme hypoxic environmental conditions: a group of mountaineers at high altitudes (>5500 m) and a group of free-lung divers at great depths (<30-60 m). These subjects were compared with two control groups: a group of subjects practicing no sport and another one practicing various compeitive athletic activities involving speed constraints. The personality traits assessed concerned mainly the subjects' attitudes and their propensities to act out their feelings and fantasies; they were assessed using projective procedures, the Hand Test and Clark's Situational Pain Questionnaire based on the Sensory Decision Theory. Subjects trained in mountaineering and free-lung diving under extreme environmental conditions displayed a high degree of stoicism. These individuals shared some personality traits with other sportsmen, particularly aggressive tendencies and introversion although not to an extent which interfered with normal interpersonal relationships. However, at least when practicing these extreme sports, the subjects did retreat from society. One of our questions concerns the grounds for this social withdrawal, that is, whether it derives from a inner compulsion founded on personality factors or if it is merely an artifact of our perceptions of the subjects, created by the confluence of the individualistic nature of these sports and the extreme environments in which they are performed.",Noël-Jorand M.C.; Joulia F.; Braggard D.,2001.0,,0,0,
5266,Cognitive processing therapy for the treatment of acute stress disorder following sexual assault: A randomised effectiveness study.,"The effectiveness of individually administered cognitive processing therapy (CPT) when compared with treatment as usual (TAU) in a community sexual assault centre was tested. Trauma survivors with acute stress disorder (ASD) following sexual assault were randomised to either CPT (n = 25) or TAU (n = 22), and assessed at pretreatment, posttreatment, and 3-, 6- and 12-month follow-up. Both groups demonstrated large reductions in PTSD and depression symptoms following treatment, and these gains were maintained over the course of follow-ups (Cohen's ds for PTSD symptom reductions ranging between 0.76 to 1.45). Although smaller and not always consistent, between-group effect sizes typically favoured CPT. Effect sizes (d) ranged between 0.13-0.50 for posttraumatic stress and 0.13-0.41 for depression over the course of follow-ups. Independent assessment of PTSD severity indicated more CPT participants reached good end-state functioning at 12-month follow-up (50%) than TAU (31%). Although both treatments were effective, there were some indications that CPT led to better outcomes relative to therapists delivering their usual therapy. The present study demonstrates that evidence-based, trauma-focused therapy such as CPT can be effective when delivered as an early intervention in a routine mental health setting. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Nixon, Reginald D. V; Best, Talitha; Wilksch, Sarah R; Angelakis, Samantha; Beatty, Lisa J; Weber, Nathan; Beck, Becker, Benish, Blake, Bryant, Bryant, Bryant, Bryant, Bryant, Bryant, Bryant, Chard, Chard, Chard, Cook, Cumming, Cumming, deRoon-Cassini, Devilly, Ehlers, Elklit, Faul, Faulkner, Foa, Foa, Foa, Foa, Forbes, Galovski, Gilboa-Schechtman, Kliem, Koucky, McNally, Monson, Nixon, O'Donnell, Raghunathan, Resick, Resick, Resick, Resick, Resick, Rothbaum, Rothbaum, Russell, Schafer, Schnurr, Steenkamp, Tracey, van Buuren, Wampold, Weathers, Weathers",2016.0,,0,0,
5267,Using cognitive processing therapy for assault victims with acute stress disorder.,"Cognitive processing therapy (CPT) was designed as a cognitive-behavioural treatment for posttraumatic stress disorder following sexual assault, and has been well supported empirically. Given its strong cognitive restructuring component, CPT is also likely to be beneficial for a range of comorbid problems associated with trauma (e.g., depression, other anxiety disorders, chronic pain). This chapter presents a description of CPT and preliminary results from a randomised controlled trial of CPT for assault victims with ASD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Nixon, Reginald D. V; Alonso, Altman, Beck, Blake, Bryant, Bryant, Bryant, Bryant, Bryant, Bryant, Bryant, Dunlop, Ehlers, First, Foa, Foa, Foa, Foa, Foa, Foa, Jaycox, Kaysen, Monson, Nishith, Resick, Resick, Resick, Resick; Einstein, Danielle A [Ed]",2007.0,,0,0,
5268,The effect of cognitive load and hyperarousal on negative intrusive memories,"Clinical theories of post-traumatic stress suggest that encoding processes at the time of a trauma are critical in determining whether intrusive memories will develop. Potential mechanisms that might influence the development of intrusive memories were studied, as was objective memory performance. In an analogue design, 65 participants were randomised to three conditions (cognitive load, hyperventilation, and control), and then watched a film of traumatic content. Intrusive memories were recorded during the experimental phase and at 1-week follow-up. Support was found for the prediction that verbal cognitive load and hyperventilation would facilitate intrusion development immediately following exposure to the trauma film; however, this was not maintained at follow-up. Consistent with cognitive models of post-traumatic stress, thought suppression and the distress associated with intrusive experiences mediated the relationship between distress caused by the film and intrusions at 1-week follow-up. Objective memory testing indicated that the three experimental groups showed similar recall and recognition performance for the content of the film; however, relative to the control group, individuals in the cognitive load condition were significantly less able to place film scenes in the correct order. © 2007 Elsevier Ltd. All rights reserved.",Nixon R.D.V.; Nehmy T.; Seymour M.,2007.0,10.1016/j.brat.2007.06.010,0,0,
5269,Spouse-assisted training in pain coping skills and the outcome of multidisciplinary pain management for chronic low back pain treatment: a 1-year randomized controlled trial,"ER This study examined the comparative efficacy of three interventions: a spouse-assisted coping skills training protocol for patients undergoing a multidisciplinary pain management programme (SA-MPMP), conventional patient-oriented multidisciplinary pain management programme (P-MPMP) and standard medical care (SMC). Thirty-six chronic low back pain (CLBP) patients and their spouses were randomly assigned to one of the three conditions. The SA-MPMP condition consisted of seven, weekly, 2-h, group sessions of training in dyadic pain coping and couple skills, delivered by a clinical psychologist with support of a multidisciplinary team of specialists, to patients together with their spouses. P-MPMP consisted of the SA-MPMP training delivered to the patient only (i.e., no spouse participation and assistance). The SMC condition entailed continuation of routine treatment, entailing medical care only. Data analysis revealed that, at the 12-month follow-up time point, patients receiving SA-MPMP had significant improvements in kinesiophobia and rumination about pain compared to those receiving P-MPMP and SMC. In patients suffering from CLBP, an intervention that combines spouse-assisted coping skills training with a multidisciplinary pain management programme can improve fear of movement and rumination about low back pain.","Abbasi, M; Dehghani, M; Keefe, F J; Jafari, H; Behtash, H; Shams, J",2012.0,10.1002/j.1532-2149.2011.00097.x,0,0,
5270,Nutritional support in the patient with acute renal failure,"ER Nutritional support in the patient with acute renal failure is of great importance in lessening the degree of catabolism when energy demands are high and may also result in salutary metabolic effects. Overall treatment considerations in the posttraumatic or postsurgical patient with acute renal failure will be discussed, including fluid and electrolyte balance and energy and nutritional considerations. The application of the Giordano and Giovannetti principles to the field of parenteral nutritional support enables modifications of treatment programs of total parenteral nutrition to be applied to patients with acute renal failure. Utilizing an intravenous mixture of eight essential l-amino acids, hypertonic dextrose, and vitamins, we observed salutary biochemical effects in surgical patients. A prospective, randomized double-blind study of that treatment regimen compared to patients receiving hypertonic dextrose and vitamins alone resulted in improved survival and a decreased duration of renal failure in the treated group. Management considerations of these patients and possible application of these principles to other patients in renal failure will be discussed.","Abel, R M",1983.0,,0,0,
5271,Differential effectiveness of directive and nondirective group therapies as a function of client internal-external control,,"Abramowitz, C V; Abramowitz, S I; Roback, H B; Jackson, C",1974.0,,0,0,
5272,Effect of relaxation training on personal adjustment and perceptions of organizational climate,"ER The chief aim of the present study was to investigate the effect of relaxation training on personal adjustment and perceptions of organizational climate. The Stern Activity Index and Organizational Climate Index along with the Bendig Manifest Anxiety Scale were administered to 71 volunteer Ss (28 males and 43 females) as pre- and post-test measures. The Ss were randomly assigned to three groups, seminar and relaxation training, seminar and a placebo condition, and no treatment. A one-way multivariate analysis showed a significant mean difference. Results obtained from t tests indicated a significant reduction in anxiety and an increase in personal adjustment. Changes in perceptions of organizational climate, although in the predicted direction, were not statistically significant.","Aderman, M; Tecklenburg, K",1983.0,10.1080/00223980.1983.9915434,0,0,
5273,"Clodronate increases mineralization of callus after Colles' fracture: a randomized, double-blind, placebo-controlled, prospective trial in 32 patients","ER In a randomized study of 32 postmenopausal women with a Colles' fracture, we studied whether 8 weeks of treatment with clodronate, a bisphosphonate, could prevent posttraumatic osteopenia. The patients were treated with a plaster splint for 4 weeks. The bone mineral density (BMD) of the forearm bones was measured at 2 levels with dual-energy x-ray absorptiometry (DEXA) 2, 6 and 12 months after the fracture. At 2 months, in the clodronate group, there was a median 53% higher BMD in the fracture region of the radius than in the uninjured radius. In the placebo group, we found a 33% higher BMD in the fractured radius at that level than in the uninjured radius. This increase in BMD of the fractured radius, caused by clodronate, was statistically significant. At 12 months, the BMD of the fracture side had been reduced by 17% and 12%, respectively, at that time it was still significantly increased in the clodronate group alone. In the ulna at the same level, we found no significant changes in BMD in either group on either side at any time. At 2 months, at the level between the distal and middle thirds, in the fractured radius, the median BMD was 7% lower in the clodronate group and 6% lower in the placebo group than in the uninjured radius. Although the reduction in BMD at that level was significant, there was no difference between the two treatment groups. At this level, the ulna on the fractured side showed a similar pattern, with a 5% lower BMD in the clodronate group and a 4% lower BMD in the placebo group. This osteopenia showed a small but significant progression on the fractured side after 6 and 12 months.","Adolphson, P; Abbaszadegan, H; Bodén, H; Salemyr, M; Henriques, T",2000.0,10.1080/000164700317413193,0,0,
5274,Auto-Targeted Neurostimulation Is Not Superior to Placebo in Chronic Low Back Pain: a Fourfold Blind Randomized Clinical Trial,"ER OBJECTIVE: To examine whether the Nervomatrix Soleve® auto-targeted neurostimulation device is superior over placebo for the treatment of CLBP.STUDY DESIGN: A fourfold-blind randomized controlled trial was conducted.SETTING: Brussels University Hospital, health care centers and pharmacies around Belgium.METHODS: Participants with CLBP for at least 3 months were randomly assigned to the experimental (the Nervomatrix Soleve® auto-targeted neurostimulation device providing TENS-stimulation and mechanical pressure) or placebo group (the Nervomatrix Soleve® auto-targeted neurostimulation device providing mechanical pressure alone without current). The treatment protocol in both groups consisted of 6 treatment sessions per patient. Participants were evaluated at baseline prior to the intervention, immediately following treatment, and at one month follow-up. Pain and pain behavior (steps climbed) were assessed as primary outcome measures. Secondary outcome measures were pain functioning, health beliefs, symptoms of central sensitization, pain catastrophizing, and kinesiophobia.RESULTS: In total, 39 participants were included in the study. Participants in both groups improved significantly for pain and functioning, but no significant differences were observed between groups. These improvements were not clinically meaningful for any of the reported measures. The health beliefs changed significantly in both groups (P < 0.05), with superior results at follow-up in the placebo group.LIMITATIONS: The follow-up period is limited to one month.CONCLUSIONS: Treatment of MTrPs with the Nervomatrix Soleve® auto-targeted neurostimulation device in patients with CLBP does not result in a better outcome than placebo-treatment in terms of pain, pain behavior, functioning, central sensitization, pain catastrophizing, and health beliefs.BACKGROUND: Myofascial trigger points (MTrPs) are common in people with musculoskeletal pain and may play a role in chronic nonspecific low back pain (CLBP). One of the potential treatments of MTrPs is the Nervomatrix Soleve® auto-targeted neurostimulation device, providing targeted transcutaneous electrical nerve stimulation (TENS) to MTrPs in the lower back muscles. To date, no controlled studies have evaluated the effectiveness of this device for the pain management of this population.","Aguilar, Ferrándiz M E; Nijs, J; Gidron, Y; Roussel, N; Vanderstraeten, R; Dyck, D; Huysmans, E; Kooning, M",2016.0,,0,0,
5275,The effects of spiritual intervention and changes in dopamine receptor gene expression in breast cancer patients,"ER Breast cancer is the most common cancer in females in Iran and in most of the developed countries. Studies have shown that having chronic stress in individuals predisposes several types of cancer including breast cancer. Research results showed that spiritual factors correlate with indices of physical consequences such as heart disease, cancer, and death, so do psychiatric conditions and changes in receptor gene expression in depression, anxiety, and social dysfunction. Different studies demonstrated the role of neurotransmitters in occurrence and progression of cancers. They affected cells by their various types of receptors. An effective gene in mental and physical conditions is Dopamine receptor. Accordingly, the study was conducted to evaluate effects of psychotherapy (spiritual intervention) on changes in Dopamine receptor gene expressions in breast cancer patients. 90 female volunteers, including 30 healthy individuals and 60 diagnosed with breast cancer, considering exclusion criteria, were selected for the purpose of the study. The breast cancer patients were further categorized into experimental and control groups of 30 each. Blood samples were collected both prior to and following the spiritual intervention to analyze changes in their dopamine gene receptor expressions. We observed that DRD2-DRD4 in the control group (breast cancer patients) PBMC increased compared to healthy individuals. Also, DRD2-DRD4 in intervention group PBMC decreased compared to the control group and to even lower than those of healthy individuals. The findings were of great significance in management and treatment of cancer because they revealed the possibility of using alternative treatments (e.g., spiritual interventions) apart from conventional medical treatments.","Akbari, M E; Kashani, F L; Ahangari, G; Pornour, M; Hejazi, H; Nooshinfar, E; Kabiri, M; Hosseini, L",2016.0,10.1007/s12282-015-0658-z,0,0,
5276,"A stepwise psychotherapy intervention for reducing risk in coronary artery disease (SPIRR-CAD) - rationale and design of a multicenter, randomized trial in depressed patients with CAD","ER METHODSMen and women (N=569, age 18-75 years) with any manifestation of CAD and depression scores ? 8 on the Hospital Anxiety and Depression Scale (HADS), will be randomized (allocation ratio 1:1) into the intervention or control group. Patients with severe heart failure, acutely life-threatening conditions, chronic inflammatory disease, severe depressive episodes or other severe mental illness are excluded. Both groups receive usual medical care. Patients in the intervention group receive three initial sessions of supportive individual psychotherapy. After re-evaluation of depression (weeks 4-8), patients with persisting symptoms receive an additional 25 sessions of combined psychodynamic and cognitive-behavioral group therapy. The control group receives one psychosocial counseling session. Primary efficacy variable is the change of depressive symptoms (HADS) from baseline to 18 months. Secondary endpoints include cardiac events, remission of depressive disorder (SCID) and Type D pattern, health-related quality of life, cardiovascular risk profile, neuroendocrine and immunological activation, heart rate variability, and health care utilization, up to 24 months of follow-up (ISRCTN: 76240576; NCT00705965). Funded by the German Research Foundation.OBJECTIVEDepressive symptoms are highly relevant for the quality of life, health behavior, and prognosis in patients with coronary artery disease (CAD). However, previous psychotherapy trials in depressed CAD patients produced small to moderate effects on depression, and null effects on cardiac events. In this multicentre psychotherapy trial, symptoms of depression are treated together with the Type D pattern (negative affectivity and social inhibition) in a stepwise approach.","Albus, C; Beutel, M E; Deter, H C; Fritzsche, K; Hellmich, M; Jordan, J; Juenger, J; Krauth, C; Ladwig, K H; Michal, M; Mueck-Weymann, M; Petrowski, K; Pieske, B; Ronel, J; Soellner, W; Waller, C; Weber, C; Herrmann-Lingen, C",2011.0,10.1016/j.jpsychores.2011.02.013,0,0,
5277,Corticosteroids in patients with a high risk of fat embolism syndrome,"ER The effects of methylprednisolone on the clinical fat embolism syndrome were studied in a series of 60 patients who had at least two fractures of the pelvis, femur and tibia and who did not have any other important injuries. This series was dichotomized at random, and 29 patients were given 10 milligrams per kilogram of methylprednisolone three times, once upon admission and, then, at eight and 16 hours post-traumatically. Thirty-one patients served as controls. Fat embolism syndrome was defined as a combination of hypoxemia, bilateral ""snow storm"" infiltrations of the lungs, petechial rash, mental disturbances, pyrexia, anemia and thrombocytopenia. Varying degrees of the syndrome were observed in two patients given methylprednisolone and in 15 patients in the control group. Methylprednisolone reduced all individual signs. There were no fatalities in this series of fracturers. No complications were observed from the use of methylprednisolone. Methylprednisolone in an early pharmacologic dosage is effective in fulminant instances of fat embolism that occur in spite of adequate respiratory care and the proper treatment of fractures.","Alho, A; Saikku, K; Eerola, P; Koskinen, M; Hämäläinen, M",1978.0,,0,0,
5278,"Heart palpitation relief with Melissa officinalis leaf extract: double blind, randomized, placebo controlled trial of efficacy and safety","ER OBJECTIVEHeart palpitation is a common complaint that is often benign and associated with a marked distress that makes the condition difficult to treat. Herbal medicines provide an alternative to conventional drugs for treating various kinds of diseases. This study was done as a double blind randomized placebo-controlled clinical trial to evaluate the efficacy and safety of the dried extract of M. officinalis on adults suffering from benign palpitations.MATERIALS AND METHODSEligible volunteers were randomly assigned as outpatients to a 14 day treatment with 500 mg twice a day of lyophilized aqueous extract of M. officinalis leaves (or placebo). Participants in the tests, physicians and researchers were blind to group assignments. Both primary and secondary outcomes were patient-reported. Primary outcomes were obtained from two measures: mean frequency of palpitation episodes per week, derived from patients? diaries, and mean intensity of palpitation estimated through Visual Analogue Scale (VAS) in a self-report questionnaire. Psychiatric symptoms (somatization, anxiety and insomnia, social dysfunction and severe depression) were evaluated as secondary outcomes by General Health Questionnaire-28 (GHQ-28), before and after intervention.RESULTSFifty-five volunteers out of 71 recruited study subjects completed the trial. Results showed that 14-day of treatment with lyophilized aqueous extract of M. officinalis leaves reduced frequency of palpitation episodes and significantly reduced the number of anxious patients in comparison to the placebo (P=0.0001, P=0.004 resp.). Also, M. officinalis extract showed no indication of any serious side effects.CONCLUSIONLyophilized aqueous extract of M. officinalis leaves may be a proper and safe herbal drug for the treatment of benign palpitations.ETHNOPHARMACOLOGICAL RELEVANCEIn Traditional Iranian Medicine (TIM), Melissa officinalis L. is commonly regarded as an effective therapy for heart palpitations.","Alijaniha, F; Naseri, M; Afsharypuor, S; Fallahi, F; Noorbala, A; Mosaddegh, M; Faghihzadeh, S; Sadrai, S",2015.0,10.1016/j.jep.2015.02.007,0,0,
5279,Comparative performance of intraocular lenses in eyes with cataract and uveitis,"ER SETTINGMulticenter (19) international study.METHODSThis prospective randomized comparative interventional case series comprised 140 eyes of 140 patients who had phacoemulsification and implantation of IOLs of various materials: hydrophobic acrylic (n = 48), silicone (n = 44), poly(methyl methacrylate) (PMMA) (n = 26), or heparin-surface-modified PMMA (HSM PMMA) (n = 22). Preoperative and postoperative grading and control of intraocular inflammation were performed. Clinically significant observations, visual outcomes, and the incidence of postoperative complications were recorded.RESULTSAt the final follow-up, 64 eyes (46.3%) had a best corrected visual acuity of 20/40 or better, an improvement that was highly significant (P <.0001). One day after surgery, the acrylic group had the lowest inflammation values and the silicone group the highest (P =.02). The acrylic group continued to have the lowest inflammation grade values until the 3-month follow-up. The acrylic and HSM PMMA groups had the lowest incidence of relapses. Posterior capsule opacification developed in 48 eyes (34.2%), with the highest incidence in the silicone group.CONCLUSIONSPhacoemulsification with IOL implantation in selected uveitic eyes was safe and effective. Acrylic IOLs provided a better visual outcome and lower complication rate than IOLs of other materials.PURPOSETo evaluate the postoperative outcomes in uveitic eyes after phacoemulsification and posterior chamber intraocular lens (IOL) implantation.","Alió, J L; Chipont, E; BenEzra, D; Fakhry, M A",2002.0,,0,0,
5280,Nabiximols as an agonist replacement therapy during cannabis withdrawal: a randomized clinical trial,"ER IMPORTANCE: There are no medications approved for treating cannabis dependence or withdrawal. The cannabis extract nabiximols (Sativex), developed as a multiple sclerosis treatment, offers a potential agonist medication for cannabis withdrawal.OBJECTIVE: To evaluate the safety and efficacy of nabiximols in treating cannabis withdrawal.DESIGN, SETTING, AND PARTICIPANTS: A 2-site, double-blind randomized clinical inpatient trial with a 28-day follow-up was conducted in New South Wales, Australia. Participants included 51 DSM-IV-TR cannabis-dependent treatment seekers.INTERVENTIONS: A 6-day regimen of nabiximols (maximum daily dose, 86.4 mg of ?9-tetrahydrocannabinol and 80 mg of cannabidiol) or placebo with standardized psychosocial interventions during a 9-day admission.MAIN OUTCOMES AND MEASURES: Severity of cannabis withdrawal and cravings (Cannabis Withdrawal Scale), retention in withdrawal treatment, and adverse events. Secondary outcomes include postwithdrawal cannabis use, health outcomes, and psychosocial outcomes.RESULTS: Nabiximols treatment significantly reduced the overall severity of cannabis withdrawal relative to placebo (F8,377.97?=?2.39; P?=?.01), including effects on withdrawal-related irritability, depression, and cannabis cravings. Nabiximols had a more limited, but still positive, therapeutic benefit on sleep disturbance, anxiety, appetite loss, physical symptoms, and restlessness. Nabiximols patients remained in treatment longer during medication use (unadjusted hazard ratio, 3.66 [95% CI, 1.18-11.37]; P?=?.02), with 2.84 the number needed to treat to achieve successful retention in treatment. Participants could not reliably differentiate between nabiximols and placebo treatment (?21?=?0.79; P?=?.67), and those receiving nabiximols did not report greater intoxication (F1,6?=?0.22; P?=?.97). The number (F1,50?=?0.3; P?=?.59) and severity (F1,50?=?2.69; P?=?.10) of adverse events did not differ significantly between groups. Both groups showed reduced cannabis use at follow-up, with no advantage of nabiximols over placebo for self-reported cannabis use (F1,48?=?0.29; P?=?.75), cannabis-related problems (F1,49?=?2.33; P?=?.14), or cannabis dependence (F1,50?<?0.01; P?=?.89).CONCLUSIONS AND RELEVANCE: In a treatment-seeking cohort, nabiximols attenuated cannabis withdrawal symptoms and improved patient retention in treatment. However, placebo was as effective as nabiximols in promoting long-term reductions in cannabis use following medication cessation. The data support further evaluation of nabiximols for management of cannabis dependence and withdrawal in treatment-seeking populations.TRIAL REGISTRATION: anzctr.org.au Identifier: ACTRN12611000398909.","Allsop, D J; Copeland, J; Lintzeris, N; Dunlop, A J; Montebello, M; Sadler, C; Rivas, G R; Holland, R M; Muhleisen, P; Norberg, M M; Booth, J; McGregor, I S",2014.0,10.1001/jamapsychiatry.2013.3947,0,0,
5281,Cognitive bias modification to prevent depression (COPE): study protocol for a randomised controlled trial,"ER BACKGROUND: Depression is a leading cause of disability worldwide and, although efficacious treatments are available, their efficacy is suboptimal and recurrence of symptoms is common. Effective preventive strategies could reduce disability and the long term social and health complications associated with the disorder, but current options are limited. Cognitive bias modification (CBM) is a novel, simple, and safe intervention that addresses attentional and interpretive biases associated with anxiety, dysphoria, and depression. The primary aim of this trial is to determine if CBM decreases the one-year onset of a major depressive episode among adults with subsyndromal depression.DESIGN AND METHODS: This randomised controlled trial will recruit 532 adults with subsyndromal symptoms of depression living in the Australian community (parallel design, 1:1 allocation ratio). Participants will be free of clinically significant symptoms of depression and of psychotic disorders, sensory and cognitive impairment, and risky alcohol use. The CBM intervention will target attentional and interpretive biases associated with depressive symptoms. The sessions will be delivered via the internet over a period of 52 weeks. The primary outcome of interest is the onset of a major depressive episode according the DSM-IV-TR criteria over a 12-month period. Secondary outcomes of interest include change in the severity of depressive symptoms as measured by the Patient Health Questionnaire (PHQ-9), use of antidepressants or benzodiazepines, and changes in attention and interpretive biases. The assessment of outcomes will take place 3, 6, 9, and 12 months after randomisation and will occur via the internet.DISCUSSION: We propose to test the efficacy of an innovative intervention that is well grounded in theory and for which increasing empirical evidence for an effect on mood is available. The intervention is simple, inexpensive, easy to access, and could be easily rolled out into practice if our findings confirm a role for CBM in the prevention of depression.TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12613001334796. Date: 5th December 2013.","Almeida, O P; MacLeod, C; Ford, A; Grafton, B; Hirani, V; Glance, D; Holmes, E",2014.0,10.1186/1745-6215-15-282,0,0,
5282,A cognitive behavior therapy-based intervention among poorly controlled adult type 1 diabetes patients--a randomized controlled trial,"ER METHODSNinety-four type 1 diabetes patients were randomly assigned to either an intervention group or a control group. The intervention was based on CBT and was mainly delivered in group format, but individual sessions were also included. All subjects were provided with a continuous glucose monitoring system (CGMS) during two 3-day periods. HbA(1c), self-care behaviors and psychosocial factors were measured up to 48 weeks.RESULTSSignificant differences were observed with respect to HbA(1c) (P<0.05), well-being (P<0.05), diabetes-related distress (P<0.01), frequency of blood glucose testing (P<0.05), avoidance of hypoglycemia (P<0.01), perceived stress (P<0.05), anxiety (P<0.05) and depression (P<0.05), all of which showed greater improvement in the intervention group compared with the control group. A significant difference (P<0.05) was registered with respect to non-severe hypoglycemia, which yielded a higher score in the intervention group.CONCLUSIONThis CBT-based intervention appears to be a promising approach to diabetes self-management.PRACTICE IMPLICATIONSDiabetes care may benefit from applying tools commonly used in CBT. For further scientific evaluation in clinical practice, there is a need for specially educated diabetes care teams, trained in the current approach, as well as cooperation between diabetes care teams and psychologists trained in CBT.OBJECTIVETo examine the impact of a Cognitive Behavior Therapy (CBT)-based intervention on HbA(1c), self-care behaviors and psychosocial factors among poorly controlled adult type 1 diabetes patients.","Amsberg, S; Anderbro, T; Wredling, R; Lisspers, J; Lins, P E; Adamson, U; Johansson, U B",2009.0,10.1016/j.pec.2009.01.015,0,0,
5283,Predictors of self-efficacy in women on long-term sick leave,"ER Self-efficacy has been shown to be related to sick leave and to be a predictor of return to work after sickness absence. The aim of this study was to investigate whether factors related to sick leave predict self-efficacy in women on long-term sick leave because of pain and/or mental illness. This cross-sectional study uses baseline data from 337 Swedish women with pain and/or mental illness. All included women took part in vocational rehabilitation. Data were collected through a sick leave register and a baseline questionnaire. General self-efficacy, sociodemographics, self-rated health, anxiety, depression, view of the future, and social support were measured and analyzed by univariate and multivariate linear regression analyses. The full multivariate linear regression model, which included mental health factors together with all measured factors, showed that anxiety and depression were the only predictive factors of lower self-efficacy (adjusted R2=0.46, P<0.001) and explained 46% of the variance in self-efficacy. The mean scores of general self-efficacy were low, especially in women born abroad, those with low motivation, those with uncertainties about returning to work, and women reporting distrust. Anxiety and depression are important factors to consider when targeting self-efficacy in vocational rehabilitation.","Andersén, Å; Larsson, K; Lytsy, P; Kristiansson, P; Anderzén, I",2015.0,10.1097/MRR.0000000000000129,0,0,
5284,"Psychological, behavioral, and immune changes after a psychological intervention: a clinical trial","ER PATIENTS AND METHODS: We studied 227 women who were surgically treated for regional breast cancer. Before adjuvant therapy, women completed interviews and questionnaires assessing emotional distress, social adjustment, and health behaviors. A 60-mL blood sample was drawn for immune assays. Patients were randomly assigned to either the intervention group or assessment only group. The intervention was conducted in small patient groups, with one session per week for 4 months. The sessions included strategies to reduce stress, improve mood, alter health behaviors, and maintain adherence to cancer treatment and care. Reassessment occurred after completion of the intervention.RESULTS: As predicted, patients receiving the intervention showed significant lowering of anxiety, improvements in perceived social support, improved dietary habits, and reduction in smoking (all P <.05). Analyses of adjuvant chemotherapy dose-intensity revealed significantly more variability (ie, more dispersion in the dose-intensity values) for the assessment arm (P <.05). Immune responses for the intervention patients paralleled their psychological and behavioral improvements. T-cell proliferation in response to phytohemagglutinin and concanavalin A remained stable or increased for the Intervention patients, whereas both responses declined for Assessment patients; this effect was replicated across three concentrations for each assay (all P <.01).CONCLUSION: These data show a convergence of significant psychological, health behavior, and biologic effects after a psychological intervention for cancer patients.PURPOSE: This randomized clinical trial tests the hypothesis that a psychological intervention can reduce emotional distress, improve health behaviors and dose-intensity, and enhance immune responses.","Andersen, B L; Farrar, W B; Golden-Kreutz, D M; Glaser, R; Emery, C F; Crespin, T R; Shapiro, C L; Carson, W E",2004.0,10.1200/JCO.2004.06.030,0,0,
5285,Efficacy of 'Tailored Physical Activity' or 'Chronic Pain Self-Management Program' on return to work for sick-listed citizens: design of a randomised controlled trial,"ER METHODS: This protocol describes the design of a parallel randomised controlled trial on the efficacy of 'Tailored Physical Activity' or a 'Chronic Pain Self-management Program' versus a reference group for sick-listed citizens with complaints of pain in the back or upper body. Participants will have been absent from work due to sick-listing for 3 to 9 weeks at the time of recruitment. All interventions will be performed at the 'Health Care Center' in the Sonderborg Municipality, and a minimum of 138 participants will be randomised into one of the three groups.All participants will receive 'Health Guidance', a (1.5-hour) individualised dialogue focusing on improving ways of living, based on assessments of risk behavior, motivation for change, level of self-care and personal resources. In addition, the experimental groups will receive either 'Tailored Physical Activity' (three 50-minute sessions/week over 10 weeks) or 'Chronic Pain Self-Management Program' (2.5-hours per week over 6 weeks). The reference group will receive only 'Health Guidance'.The primary outcome is the participants' sick-listed status at 3 and 12 months after baseline. The co-primary outcome is the time it takes to return to work. In addition, secondary outcomes include anthropometric measurements, functional capacity and self-reported number of sick days, musculoskeletal symptoms, general health, work ability, physical capacity, kinesiophobia, physical functional status, interpersonal problems and mental disorders.DISCUSSION: There are few evidence-based interventions for rehabilitation programmes assisting people with musculoskeletal pain-related work absence. This study will compare outcomes of interventions on return to work in order to increase the knowledge of evidence-based rehabilitation of sick-listed citizens to prevent long-term sick-leave and facilitate return to work.TRIAL REGISTRATION: The trial is registered in the ClinicalTrials.gov, number NCT01356784.BACKGROUND: Pain affects quality of life and can result in absence from work. Treatment and/or prevention strategies for musculoskeletal pain-related long-term sick leave are currently undertaken in several health sectors. Moreover, there are few evidence-based guidelines for such treatment and prevention. The aim of this study is to evaluate the efficacy of 'Tailored Physical Activity' or 'Chronic Pain Self-Management Program' for sick-listed citizens with pain in the back and/or the upper body.","Andersen, L N; Juul-Kristensen, B; Roessler, K K; Herborg, L G; S√∏rensen, T L; S√∏gaard, K",2013.0,10.1186/1471-2458-13-66,0,0,
5286,Efficacy of 'Tailored Physical Activity' in reducing sickness absence among health care workers: design of a randomised controlled trial,"ER METHODS/DESIGN: This protocol describes the design of a randomised controlled trial to assess the efficacy of 'Tailored Physical Activity' versus a reference group for health care workers in the Sonderborg Municipality. Inclusion criteria to be fulfilled: health care workers with daily work that includes manual work and with the experience of work-related musculoskeletal pain in the back or upper body.All participants will receive 'Health Guidance', a (90-minute) individualised dialogue focusing on improving life style, based on assessments of risk behaviour, on motivation for change and on personal resources. In addition, the experimental groups will receive 'Tailored Physical Activity' (three 50-minute sessions per week over 10 weeks). The reference group will receive only 'Health Guidance'.The primary outcome measure is the participants' self-reported sickness absence during the last three months due to musculoskeletal troubles, measured 3 and 12 months after baseline.In addition, secondary outcomes include anthropometric measurements, functional capacity and self-reported number of sick days, musculoskeletal symptoms, self-reported health, work ability, work productivity, physical capacity, kinesiophobia and physical functional status.DISCUSSION: The results from this study will contribute to the knowledge about evidence-based interventions for prevention of sickness absence among health care workers.TRIAL REGISTRATION: ClinicalTrials.gov: NCT01543984.BACKGROUND: Health care workers have high physical work demands, involving patient handling and manual work tasks. A strategy for prevention of work-related musculoskeletal disorders can enhance the physical capacity of the health care worker. The aim of this study is to evaluate the efficacy of 'Tailored Physical Activity' for health care workers in the Sonderborg Municipality.","Andersen, L N; Juul-Kristensen, B; Roessler, K K; Herborg, L G; S√∏rensen, T L; S√∏gaard, K",2013.0,10.1186/1471-2458-13-917,0,0,
5287,Longer term follow-up on effects of Tailored Physical Activity or Chronic Pain Self-Management Programme on return-to-work: a randomized controlled trial,"ER DESIGN: A randomized controlled trial.SUBJECTS: A total of 141 sick-listed subjects with pain in the back or upper body.METHODS: All participants received health guidance for 1.5 h and were randomly assigned to TPA (n?=?47), CPSMP (n?=?47) or a reference group (n?=?47). The primary end-point was the proportion of participants returning to work and the co-primary end-point was the duration of the sickness absence period retrieved 11 months after the first day on sick leave. Secondary outcomes were pain level, body mass index, aerobic capacity, work ability and kinesiophobia.RESULTS: TPA and CPSMP were no more effective than the reference group as regards return-to-work. Compared with the reference group no other benefits of TPA and CPSMP were evident regarding pain, work ability, kinesiophobia or physical capacity.CONCLUSION: After 11 months TPA, the reference group, and CPSMP show similar patterns of facilitating return-to-work. This is additional knowledge, compared with the 3-month findings reported previously, showing that TPA seems to facilitate a faster return-to-work.OBJECTIVE: To evaluate the longer term efficacy of the interventions Tailored Physical Activity (TPA) and Chronic Pain Self-management Program (CPSMP) against a reference group on return-to-work for sick-listed subjects with pain in the back or upper body.","Andersen, L N; Juul-Kristensen, B; S√∏rensen, T L; Herborg, L G; Roessler, K K; S√∏gaard, K",2016.0,10.2340/16501977-2159,0,0,
5288,Efficacy of Tailored Physical Activity or Chronic Pain Self-Management Programme on return to work for sick-listed citizens: a 3-month randomised controlled trial,"ER METHODSUsing a randomised controlled trial design all participants (n= 141) received health guidance for 1.5 hours and were randomised to TPA, CPSMP or REF. Characteristics of participants were collected from a questionnaire. The primary endpoint was proportion of participants returned to work as registered by the municipality and the co-primary endpoint was duration of the sickness absence period. Secondary outcomes consisted of pain, body mass index, aerobic capacity, grip strength, work ability and kinesiophobia. The trial was conducted in Sonderborg Municipality from March 2011 to October 2013.RESULTSTPA was more effective on return to work than REF, while CPSMP only tended to be more effective than REF, and the primary outcome was the only between-groups significant difference. TPA participants also reached a highly significant reduction in pain from baseline to follow-up with no similar effect seen in CPSMP or REF. In contrast, no benefit of TPA and CPSMP was evident regarding work ability, kinesiophobia or physical capacity after 3 months of follow-up.CONCLUSIONSThe results suggest that TPA is a promising intervention to facilitate return to work and reduce pain among sick-listed citizens with pain related to the back or upper body compared to REF.OBJECTIVESThe aim was to evaluate the efficacy of 'Tailored Physical Activity' (TPA) and a 'Chronic Pain Self-management Programme' (CPSMP) compared with a reference group (REF) on return to work after 3 months as sick-listed citizens with pain related to the back or the upper body.","Andersen, L N; Juul-Kristensen, B; S√∏rensen, T L; Herborg, L G; Roessler, K K; S√∏gaard, K",2015.0,10.1177/1403494815591687,0,0,
5289,What is a typical rape? Effects of victim and participant gender in female and male rape perception,"ER The study had three research aims: (1) to examine the current perception of female rape. Given recent changes in public awareness of female rape, it was predicted that respondents would conceptualize a typical female rape as an acquaintance rape rather than as the stranger rape stereotype; (2) to examine whether these perceptions differ according to respondents' gender; (3) to examine the 'cultural lag' theory of male rape, where it was hypothesized that if the public perception of male rape lags behind female rape, then a typical male rape will be conceptualized as the classic stranger rape stereotype. Findings showed that contrary to predictions, a typical female rape was conceptualized according to the stranger rape stereotype. It was also found that instead of lagging behind female rape along the stranger-acquaintance rape dimension, male rape was viewed predominantly in terms of 'other' factors (factors not found on the stranger-acquaintance dimension, e.g. victim/rapist sexual orientation, rapist calls victim names), which were erroneous, sexualizing and homophobic.","Anderson, I",2007.0,10.1348/014466606X101780,0,0,
5290,Randomised controlled non-inferiority trial with 3-year follow-up of internet-delivered versus face-to-face group cognitive behavioural therapy for depression,"ER BACKGROUND: Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in the treatment of mild to moderate depression, but there have been no direct comparisons with the more established group-based CBT with a long-term follow-up.METHOD: Participants with mild to moderate depression were recruited from the general population and randomized to either guided ICBT (n=33) or to live group treatment (n=36). Measures were completed before and after the intervention to assess depression, anxiety, and quality of life. Follow-ups were conducted at one-year and three-year after the treatment had ended.RESULTS: Data were analysed on an intention-to-treat basis using linear mixed-effects regression analysis. Results on the self-rated version of the Montgomery-√Ösberg Depression Scale showed significant improvements in both groups across time indicating non-inferiority of guided ICBT, and there was even a tendency for the guided ICBT group to be superior to group-based CBT at three year follow-up. Within-group effect sizes for the ICBT condition at post-treatment showed a Cohen's d=1.46, with a similar large effect at 3-year follow-up, d=1.78. For the group CBT the corresponding within-group effects were d=0.99 and d=1.34, respectively.LIMITATIONS: The study was small with two active treatments and there was no placebo or credible control condition.CONCLUSIONS: Guided ICBT is at least as effective as group-based CBT and long-term effects can be sustained up to 3 years after treatment.","Andersson, G; Hesser, H; Veilord, A; Svedling, L; Andersson, F; Sleman, O; Mauritzson, L; Sarkohi, A; Claesson, E; Zetterqvist, V; Lamminen, M; Eriksson, T; Carlbring, P",2013.0,10.1016/j.jad.2013.08.022,0,0,
5291,Optimizing the perceived benefits and health outcomes of writing about traumatic life events,"ER Expressive writing, which involves disclosing one's deepest thoughts and feelings about a stressful life event by using a first-person perspective, has been linked to gains in health and well-being, though effect sizes range widely. Assuming a third-person perspective is a natural and effective way of coping with highly distressing events. Therefore, the current study examined whether a distanced, third-person approach to expressive writing might be more beneficial than a traditional, first-person intervention for high baseline levels of event-linked intrusive thinking. Randomly assigned participants wrote expressively about traumatic life events by using a first-person or third-person-singular perspective. Linguistic analyses showed that assuming a first-person perspective is linked to higher levels of in-text cognitive engagement, whereas a third-person perspective is linked to lower cognitive engagement. However, in a context of higher levels of intrusive thinking, third-person expressive writing, relative to a traditional first-person approach, yielded (1) greater perceived benefits and positive, long-lasting effects as well as (2) fewer days of activity restriction due to illness. Although more research is needed, these results suggest that third-person expressive writing may be an especially fitting technique for recovering from traumatic or highly stressful life events.","Andersson, M A; Conley, C S",2013.0,10.1002/smi.2423,0,0,
5292,Psychiatric diagnostic interviews for children and adolescents: a comparative study,"ER OBJECTIVE: To compare examples of three styles of psychiatric interviews for youth: the Diagnostic Interview Schedule for Children (DISC) (""respondent-based""), the Child and Adolescent Psychiatric Assessment (CAPA) (""interviewer-based""), and the Development and Well-Being Assessment (DAWBA) (""expert judgment"").METHOD: Roughly equal numbers of males and females of white and African American ethnicity, aged 9 to 12 and 13 to 16 years, were recruited from primary care pediatric clinics. Participants (N = 646) were randomly assigned to receive two of the three interviews, in counterbalanced order. Five modules were used: any depressive disorder, anxiety disorders, oppositional defiant disorder, conduct disorder, and attention-deficit/hyperactivity disorder. At two sessions about 1 week apart, parent and child completed one of two interviews plus five screening questionnaires.RESULTS: When interviewed with the DAWBA, 17.7% of youth had one or more diagnoses, compared with 47.1% (DISC) and 32.4% (CAPA). The excess of DISC diagnoses was accounted for by specific phobias. Agreement between interview pairs was 0.13 to 0.48 for DAWBA-DISC comparisons, 0.21 to 0.61 for DISC-CAPA comparisons, and 0.23 to 0.48 for CAPA-DAWBA comparisons. DAWBA-only cases were associated with higher parent-report questionnaire scores than DISC/DAWBA cases, but equivalent child-report scores.CONCLUSIONS: The DAWBA is shorter and cases were probably more severe, making it a good choice for clinical trials, but the user cannot examine the data in detail. The DISC and CAPA are similar in length and training needs. Either would be a better choice where false-negative results must be avoided, as in case-control genetic studies, or when researchers need to study individual symptoms in detail.","Angold, A; Erkanli, A; Copeland, W; Goodman, R; Fisher, P W; Costello, E J",2012.0,10.1016/j.jaac.2012.02.020,0,0,
5293,"Complex realities: community engagement for a paediatric randomized controlled malaria vaccine trial in Kilifi, Kenya","ER METHODS: Social scientists independent of the trial held in-depth individual interviews with trial researchers (n=5), community leaders (n=8) and parents (15 with enrolled children and 4 without); and group discussions with fieldworkers (n=6) and facility staff (n=2). We conducted a survey of participating households (n=200) and observed over 150 CE activities.RESULTS: The overall CE plan was similar across the three study sites, although less community-based information in site C. Majority perceived CE activities to clear pre-existing concerns and misconceptions; increase visibility, awareness of and trust in trial staff. Challenges included: some community leaders attempting to exert pressure on people to enrol; local wording in information sheets and consent forms feeding into serious anxieties about the trial; and concerns about reduced CE over time. Negative effects of these challenges were mitigated through changes to on-going CE activities, and final information sharing and consent being conducted individually by trained clinical staff. One year after enrolment, 31% (n = 62) of participants' parents reported malaria prevention as the main aim of the activities their children were involved in, and 93% wanted their children to remain involved.CONCLUSION: The trial teams' goals for CE were relatively clear from the outset. Other actors' hopes and expectations (like higher allowances and future employment) were not openly discussed, but emerged over the course of engagements. Encouraging open discussion of all actors' intentions and goals from the outset takes time, risks raising expectations that cannot be met, and is complex. However, doing so in future similar trials may allow successes here to be built upon, and some challenges minimized or avoided.TRIAL REGISTRATION: ClinicalTrials.gov NCT00866619 (registration 19-Mar-2009).BACKGROUND: Community engagement (CE) is increasingly promoted for biomedical research conducted in resource poor settings for both intrinsic and instrumental purposes. Given the potential importance of CE, but also complexities and possibility of unexpected negative outcomes, there is need for more documentation of CE processes in practice. We share experiences of formal CE for a paediatric randomized controlled malaria vaccine trial conducted in three sites within Kilifi County, Kenya.","Angwenyi, V; Kamuya, D; Mwachiro, D; Kalama, B; Marsh, V; Njuguna, P; Molyneux, S",2014.0,10.1186/1745-6215-15-65,0,0,
5294,Association of reduction in waist circumference with normalization of mood in obese women initiating exercise supported by the Coach Approach protocol,"ER METHODSObese women volunteers with high tension (anxiety) (T), depression (D), or total mood disturbance (TMD) scores, who were previously randomized into conditions of (1) exercise supported by The Coach Approach: a protocol based on social cognitive and self-efficacy theory (CA; n = 53, 66, and 60, respectively), (2) personal demonstration and follow up of exercise methods (EX; n = 27, 27, and 21, respectively), and (3) exercise suggested through written information only (INFO; n = 24, 28, and 20, respectively), were subjects. Identical nutrition information was provided to all subjects in a small group format.RESULTSMinutes of exercise over the 6-month study were greatest in the CA condition, with minutes in the EX condition greater than the INFO condition. T, D, and TMD scores were reduced to normal levels mostly in the CA condition, with the EX condition having significantly more normalized D scores than the INFO. Across conditions, normalized mood scores generally predicted a greater reduction in waist circumference, with CA associated with additional benefits when D scores were considered.CONCLUSIONProperly accounting for exercise-induced mood change may be important in the behavioral treatment of obesity.BACKGROUNDInterrelations of exercise, mood, and weight reduction are unclear in the behavioral treatment of obesity.","Annesi, J J; Gorjala, S",2010.0,10.1097/SMJ.0b013e3181de0eb5,0,0,
5295,Cognitive-behavioral stress management reduces distress and 24-hour urinary free cortisol output among symptomatic HIV-infected gay men,"ER METHODSSymptomatic HIV-infected gay men who were randomized to either a 10-week group-based CBSM intervention or a 10-week wait-list period provided psychological responses and urine samples pre-post intervention.RESULTSOf the 59 participants providing matched questionnaire data, men assigned to CBSM (n = 40) showed significantly lower posttreatment levels of self-reported depressed affect, anxiety, anger, and confusion than those in the wait-list control group (n = 19). Among the 47 men providing urine samples (34 CBSM, 13 controls), those assigned to CBSM revealed significantly less cortisol output as compared to controls. At the individual level, depressed mood decreases paralleled cortisol reductions over this period across the entire sample.CONCLUSIONA time-limited CBSM intervention reduced distress symptoms and urinary free cortisol output in symptomatic HIV+ gay men and greater reductions in some aspects of distress, especially depressed mood, paralleled greater decreases in cortisol over the intervention period. If persisting stressors and depressed mood contribute to chronic HPA axis activation in HIV-infected persons, then interventions such as CBSM, which teaches them to relax, alter cognitive appraisals, use new coping strategies, and access social support resources, may decrease distress and depressed mood and normalize HPA axis functioning.BACKGROUNDStress management interventions can reduce symptoms of distress as well as modulate certain immune system components in persons infected with human immunodeficiency virus (HIV). These effects may occur in parallel with reductions in hypothalamic-pituitary-adrenal (HPA) axis hormones such as cortisol, which has been related in other work to a down-regulation of immune system components relevant to HIV infection. The present study tested the effects of a multimodal cognitive-behavioral stress management (CBSM) intervention on 24-hour urinary free cortisol levels and distressed mood in symptomatic HIV+ gay men.","Antoni, M H; Cruess, S; Cruess, D G; Kumar, M; Lutgendorf, S; Ironson, G; Dettmer, E; Williams, J; Klimas, N; Fletcher, M A; Schneiderman, N",2000.0,,0,0,
5296,An Internet- and mobile-based tailored intervention to enhance maintenance of physical activity after cardiac rehabilitation: short-term results of a randomized controlled trial,"ER OBJECTIVE: Our trial assessed the effect of a longitudinally tailored Internet- and mobile-based intervention for physical activity as an extension of a face-to-face cardiac rehabilitation stay. We hypothesized that users of the tailored intervention would maintain their physical activity level better than users of the nontailored version.METHODS: The study population included adult participants of a cardiac rehabilitation program in Norway with home Internet access and a mobile phone. The participants were randomized in monthly clusters to a tailored or nontailored (control) intervention group. All participants had access to a website with information regarding cardiac rehabilitation, an online discussion forum, and an online activity calendar. Those using the tailored intervention received tailored content based on models of health behavior via the website and mobile fully automated text messages. The main outcome was self-reported level of physical activity, which was obtained using an online international physical activity questionnaire at baseline, at discharge, and at 1 month and 3 months after discharge from the cardiac rehabilitation program.RESULTS: Included in the study were 69 participants. One month after discharge, the tailored intervention group (n=10) had a higher median level of overall physical activity (median 2737.5, IQR 4200.2) than the control group (n=14, median 1650.0, IQR 2443.5), but the difference was not significant (Kolmogorov-Smirnov Z=0.823, P=.38, r=.17). At 3 months after discharge, the tailored intervention group (n=7) had a significantly higher median level of overall physical activity (median 5613.0, IQR 2828.0) than the control group (n=12, median 1356.0, IQR 2937.0; Kolmogorov-Smirnov Z=1.397, P=.02, r=.33). The median adherence was 45.0 (95% CI 0.0-169.8) days for the tailored group and 111.0 (95% CI 45.1-176.9) days for the control group; however, the difference was not significant (P=.39). There were no statistically significant differences between the 2 groups in stage of change, self-efficacy, social support, perceived tailoring, anxiety, or depression.CONCLUSIONS: Because of the small sample size and the high attrition rate at the follow-up visits, we cannot make conclusions regarding the efficacy of our approach, but the results indicate that the tailored version of the intervention may have contributed to the long-term higher physical activity maintained after cardiac rehabilitation by participants receiving the tailored intervention compared with those receiving the nontailored intervention.TRIAL REGISTRATION: ClinicalTrials.gov: NCT01223170; http://clinicaltrials.gov/show/NCT01223170 (Archived by WebCite at http://www.webcitation.org/6Nch4ldcL).BACKGROUND: An increase in physical activity for secondary prevention of cardiovascular disease and cardiac rehabilitation has multiple therapeutic benefits, including decreased mortality. Internet- and mobile-based interventions for physical activity have shown promising results in helping users increase or maintain their level of physical activity in general and specifically in secondary prevention of cardiovascular diseases and cardiac rehabilitation. One component related to the efficacy of these interventions is tailoring of the content to the individual.","Antypas, K; Wangberg, S C",2014.0,10.2196/jmir.3132,0,0,
5297,Testing models of care for terminally ill people who live alone at home: is a randomised controlled trial the best approach?,"ER This project implemented and evaluated two models of care for terminally ill people living alone at home: installing personal alarms (PA) and providing extra care aide (CA) support. The primary aim was to assess the feasibility of using a randomised controlled trial (RCT) approach with this group. A secondary aim was to assess the potential impact of the models of care on the participants' quality of life, symptom distress, anxiety and depression, and perceived benefits and barriers to their use. The two models of care were piloted in collaboration with Silver Chain Hospice Care Service (SCHCS) in Western Australia during 2009-2010. Using a pilot RCT design, equal numbers of participants were randomised to receive extra CA time, PAs or standard care. Attrition reduced the sample size from 20 in each group to 12, 14 and 17 respectively. The intervention period was between 6 and 12 weeks depending on prognosis. The participants were functionally and psychologically well and the majority lived alone by choice. There were physical and psychological benefits associated with provision of the two models of care, particularly for the group supported by CAs in terms of improved sleeping and appetite. However, the impact was mostly not statistically significant due to small sample sizes. The study has highlighted two methodological challenges: the wide variation in the degree of living alone at home leading to complex inclusion criteria, and an RCT approach with attrition differing across groups and patients not wanting to be included in the assigned group. The RCT approach is not considered appropriate for the 'home alone' palliative care population that would have been better supported by providing each participant with a personalised model of care according to needs. However, the outcomes of the project have prompted changes in SCHCS practice when providing care to these patients.","Aoun, S M; O'Connor, M; Breen, L J; Deas, K; Skett, K",2013.0,10.1111/hsc.12002,0,0,
5298,Two-year follow-up of a randomized controlled trial of stepped care cognitive behavioral therapy to prevent recurrence of depression in an older population,"ER OBJECTIVE: This study aims to determine the long-term effect of a stepped care cognitive behavioral therapy prevention program for depression in older people and the factors predicting or moderating outcome.METHODS: In a randomized controlled trial, 136 participants, aged 55?years or older, who had been treated for depression, received during 12?months a stepped care program (SCP) or care as usual (CAU) and were then followed up for a second year. Outcome was defined as the start of a new mental health treatment for depression in a specialized outpatient setting, as recorded in the patients' electronic medical records.RESULTS: Of the 123 patients, 38 required new mental health treatment. Survival analysis showed that participants in SCP (n?=?27) required new treatment significantly more than patients receiving CAU (n?=?11). Negative life events in the last year were predictive for new treatment in CAU but not in SCP.CONCLUSIONS: An SCP seems to lower the threshold for new specialized mental health treatment for depression, whereas new treatment in CAU patients occurs more often in reaction to recent life events.","Apil, S R; Spinhoven, P; Haffmans, P M; Hoencamp, E",2014.0,10.1002/gps.4010,0,0,
5299,A randomised controlled trial of a psychoeducational intervention for women at increased risk of breast cancer,"ER This study aimed to compare the impact of two versions of a psychoeducational written intervention on cancer worry and objective knowledge of breast cancer risk-related topics in women who had been living with an increased risk of familial breast cancer for several years. Participants were randomised to three conditions: scientific and psychosocial information pack (Group 1), scientific information pack only (Group 2) or standard care control (Group 3). They completed postal questionnaires at baseline (n=163) and 4 weeks (n=151). As predicted, there was a significant decrease in cancer worry for Group 1, but not Group 2. Objective knowledge significantly improved for both Group 1 and Group 2 as expected, but not Group 3. However, there was an unpredicted decline in cancer worry for Group 3. This study supports the value of a scientific and psychosocial information pack in providing up-to-date information related to familial risk of breast cancer for long-term attendees of a familial breast cancer clinic. Further research is warranted to determine how the information pack could be incorporated into the existing clinical service, thus providing these women with the type of ongoing psychosocial support that many familial breast cancer clinics are currently lacking.","Appleton, S; Watson, M; Rush, R; Garcia-Minaur, S; Porteous, M; Campbell, J; Anderson, E; Cull, A",2004.0,10.1038/sj.bjc.6601519,0,0,
5300,Brazilian validation of the Questionnaire of Smoking Urges,"ER This study was designed to validate the Brazilian version of the Questionnaire of Smoking Urges (QSU). The design was experimental, and participants were randomly distributed in groups of zero, 30, and 60 minutes of tobacco abstinence. The total sample was 201, with 67 males and 134 females, age ranging from 18 to 65 (M = 38.15). The instruments applied, besides QSU, were the Social and Demographic Data Form, Visual Analogue Scale to evaluate craving, Fagerström Test for Nicotine Dependence, and Beck Anxiety and Depression Inventories. Total variation in the two-factor factorial analysis was 57.76%, with a high inter-correlation (r = 0.726; p = 0.000). Factor 1 represented the anticipated relief of negative affect, nicotine abstinence symptoms, and urgent and overwhelming desire to smoke. Factor 2 represented the desire to smoke and the anticipation of smoking pleasure. Such results are contrary to those found in the original QSU. The Brazilian version proved to be an adequate and reliable instrument that can be used in both research and patient treatment.","Araujo, R B; Oliveira, Mda S; Mansur, M A",2006.0,,0,0,
5301,Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: a Randomized Controlled Trial,"ER PERSPECTIVE: This study investigated a targeted cognitive-behavioral-based physical therapy program for patients after lumbar spine surgery. Findings lend support to the hypothesis that incorporating cognitive-behavioral strategies into postoperative physical therapy may address psychosocial risk factors and improve pain, disability, general health, and physical performance outcomes.UNLABELLED: The purpose of this study was to determine the efficacy of a cognitive-behavioral-based physical therapy (CBPT) program for improving outcomes in patients after lumbar spine surgery. A randomized controlled trial was conducted on 86 adults undergoing a laminectomy with or without arthrodesis for a lumbar degenerative condition. Patients were screened preoperatively for high fear of movement using the Tampa Scale for Kinesiophobia. Randomization to either CBPT or an education program occurred at 6 weeks after surgery. Assessments were completed pretreatment, posttreatment and at 3-month follow-up. The primary outcomes were pain and disability measured by the Brief Pain Inventory and Oswestry Disability Index. Secondary outcomes included general health (SF-12) and performance-based tests (5-Chair Stand, Timed Up and Go, 10-Meter Walk). Multivariable linear regression analyses found that CBPT participants had significantly greater decreases in pain and disability and increases in general health and physical performance compared with the education group at the 3-month follow-up. Results suggest a targeted CBPT program may result in significant and clinically meaningful improvement in postoperative outcomes. CBPT has the potential to be an evidence-based program that clinicians can recommend for patients at risk for poor recovery after spine surgery.","Archer, K R; Devin, C J; Vanston, S W; Koyama, T; Phillips, S E; George, S Z; McGirt, M J; Spengler, D M; Aaronson, O S; Cheng, J S; Wegener, S T",2016.0,10.1016/j.jpain.2015.09.013,0,0,
5302,A goal management intervention for polyarthritis patients: rationale and design of a randomized controlled trial,"ER METHODS/DESIGN: The protocol-based psycho-educational program consists of six group-based meetings and homework assignments, led by a trained nurse. Participants are introduced to goal management strategies and learn to use these strategies to cope with threatened personal goals. Four general hospitals participate in a randomized controlled trial with one intervention group and a waiting list control condition.DISCUSSION: The purpose of this study is to evaluate the effectiveness of a goal management intervention. The study has a holistic focus as both the absence of psychological distress and presence of well-being are assessed. In the intervention, applicable goal management competencies are learned that assist people in their choice of behaviors to sustain and enhance their quality of life.TRIAL REGISTRATION: Nederlands Trial Register = NTR3606, registration date 11-09-2012.BACKGROUND: A health promotion intervention was developed for inflammatory arthritis patients, based on goal management. Elevated levels of depression and anxiety symptoms, which indicate maladjustment, are found in such patients. Other indicators of adaptation to chronic disease are positive affect, purpose in life and social participation. The new intervention focuses on to improving adaptation by increasing psychological and social well-being and decreasing symptoms of affective disorders. Content includes how patients can cope with activities and life goals that are threatened or have become impossible to attain due to arthritis. The four goal management strategies used are: goal maintenance, goal adjustment, goal disengagement and reengagement. Ability to use various goal management strategies, coping versatility and self-efficacy are hypothesized to mediate the intervention's effect on primary and secondary outcomes. The primary outcome is depressive symptoms. Secondary outcomes are anxiety symptoms, positive affect, purpose in life, social participation, pain, fatigue and physical functioning. A cost-effectiveness analysis and stakeholders' analysis are planned.","Arends, R Y; Bode, C; Taal, E; Laar, M A",2013.0,10.1186/1471-2474-14-239,0,0,
5303,Predictability of complications associated with prolongation of pregnancy,"ER The frequency of complications and fetal macrosomia occurring in 243 patients with excellent dates indicating that their pregnancy was prolonged beyond 40 weeks (280 days) was analyzed and compared with that from a control group of 250 normal patients whose pregnancy ended spontaneously between 38 and 40 weeks of gestation. Complications (intrapartum fetal distress, traumatic deliveries, meconium aspiration, postmaturity syndrome) were significantly more frequent in patients in the study group (25.1%) than in the controls (5.6%). Similarly, fetal macrosomia occurred significantly more often in the study patients (29.6%) than in the controls (10.4%). To study the efficacy of antepartum surveillance in predicting these abnormal events, the postterm patients were randomized between two plans of management: 126 were followed with weekly nonstress testing (NST), and 117 with NST plus weekly ultrasound evaluation of fetal size, amniotic fluid volume, and placental grade. Contraction stress testing (CST) was used if the NST was nonreactive. Electronic monitoring had positive and negative predictive values of 42.8 and 87.7%, respectively, whereas ultrasound-plus-electronic monitoring had values of 50 and 65.3%, respectively. These results indicate that the increased incidence of complications in pregnancy prolonged beyond 40 weeks cannot be adequately predicted with antepartum electronic monitoring and ultrasound evaluation of fetal size, placental grade, and amniotic fluid volume.","Arias, F",1987.0,,0,0,
5304,Use of mental simulations to change theory of planned behaviour variables,"ER DESIGNParticipants (N=146) were randomized to one of four conditions: outcome simulation only, process simulation only, process-plus-outcome simulation and a distractor control condition. The dependent variables were state anxiety, and intention attitude, subjective norm and perceived control from the theory of planned behaviour.METHODSParticipants were asked to empty their mind and visualize themselves: (a) after donating blood (outcome manipulation), (b) preparing to donate blood (process manipulation), (c) both preparing to donate blood and after having donated blood (process-plus-outcome manipulation) or (d) both preparing to get a high mark and after having got a high mark on their course (control condition). Following mental rehearsal, participants completed the dependent variables.RESULTSThere were no main effects of outcome simulation, but process simulation successfully increased intention, subjective norm and perceived control. There was also a significant outcome simulation x process simulation interaction for attitude. The effect of the process manipulation on intention was mediated by subjective norm and perceived control.CONCLUSIONSThe findings show promise for the use of mental simulations in changing cognitions and further research is required to extend the present findings to other health behaviours.OBJECTIVESThe predictive validity of the theory of planned behaviour is well established, but much less is known about: (a) whether there are causal relationships between key components of the model and (b) how to go about changing the theory of planned behaviour variables. This study tested the ability of outcome and process simulations to change variables specified in the theory of planned behaviour in relation to blood donation.","Armitage, C J; Reidy, J G",2008.0,10.1348/135910707X227088,0,0,
5305,Antecedents and consequences of caregiving structure on young mothers and their infants,"ER This study describes the multigenerational caregiving structure of infants born to young women, the prenatal predictors of caregiving structure, and the effects of caregiving structure on the health of young mothers and their infants 6 months postpartum. The sample consisted of 784 young mothers involved in a longitudinal study in two U.S. cities. Women were classified into eight caregiving structure groups based on the mother's report of herself as a caregiver and her selection of the baby's father and/or grandparents as caregivers. ANCOVA analyses identified predictors and 6 month postpartum outcomes of caregiving structure. Planned comparisons explored the relationships among caregiving structure groups. A majority of women reported caregiving structures other than herself and the father as caregivers (87.1%). Grandparents were indicated as caregivers by most women (62.2%). Postpartum caregiving groups differed on prenatal social support, self-esteem, attachment avoidance and anxiety, relationship status, and living with the baby's father. While mother's self esteem significantly predicted father involvement, there were no differences on predictors between when the mother and father were caregivers, versus when the mother and grandparents were caregivers. Differences existed between groups on mother and child outcomes, including parenting stress, distress, and child dysfunction. Women reported significantly less parenting stress, child dysfunction, and negative child emotions when she and the father were caregivers, versus when she and grandparents were caregivers. The family system and the intergenerational dynamics within a multigenerational caregiving structure are critical to the health and well-being of both mothers and their children.","Arnold, A; Lewis, J; Maximovich, A; Ickovics, J; Kershaw, T",2011.0,10.1007/s10995-010-0650-3,0,0,
5306,Psychosocial predictors of first attendance for organised mammography screening,"ER SETTING: Finnish screening programme based on personal first round invitations in 1992-94, and with 90% attendance rate.METHODS: Attenders (n = 946) belonged to a 10% random sample (n = 1680 women, age 50, response rate 64%) of the target population (n = 16,886), non-attenders (n = 641, 38%) came from the whole target population. Predictors were measured one month before the screening invitation. Measures included items for social and behavioural factors, Breast Cancer Susceptibility Scale, Illness Attitude Scale, Health Locus of Control Scale, Anxiety Inventory, and Depression Inventory. Univariate and multivariate logistic regression analyses were used to predict attendance.RESULTS: Those most likely to attend were working, middle income, and averagely educated women, who had not had a mass mammogram recently, but who regularly visited gynaecologists, attended for Pap smear screening, practised breast self examination, and who did not smoke. Low confidence in their own capabilities in breast cancer prevention, overoptimism about the sensitivity of mammography, and perception of breast cancer risk as moderate were also predictive of attendance. Expectation of pain at mammography was predictive of non-attendance.CONCLUSION: Mammography screening organised as a public health service was well accepted. A recent mammogram, high reliance on self control of breast cancer, and an expectation of pain at mammography deterred attendance at screening. Further information about these factors and health information on screening are needed.OBJECTIVE: To study psychosocial predictors of attendance at an organised breast cancer screening programme.","Aro, A R; Koning, H J; Absetz, P; Schreck, M",1999.0,10.1136/jms.6.2.82,0,0,
5307,Effects of enhanced external counterpulsation on Health-Related Quality of Life continue 12 months after treatment: a substudy of the Multicenter Study of Enhanced External Counterpulsation,"ER OBJECTIVETo determine whether a 35-hour course of EECP affects the HQOL of patients with symptomatic coronary artery disease, 12 months following treatment.METHODSSeventy-one of the 139 patients enrolled in MUST-EECP provided evaluable patient-completed questionnaires at baseline, at the end of treatment, and 12 months post-treatment. The Medical Outcomes Study 36-Item Short-Form Health Survey and the Quality of Life Index-Cardiac Version III were used to assess effects on HQOL.RESULTSBoth groups had similar HQOL scores at baseline. At end of treatment and at 12-month follow up, patients who had active-CP reported greater improvement than those who had inactive-CP in all nine quality of life scales, including ability to perform activities of daily living, ability to work, bodily pain, confidence in health, energy, ability to engage in social activities with family and friends, anxiety and depression, and quality of life issues from the effects of angina on health and functioning. Despite small sample sizes, active-CP patients demonstrated significantly greater improvement at 12 months following treatment in bodily pain, social functioning, and quality of life specific to cardiac patients compared with inactive-CP patients.CONCLUSIONSignificant health-related quality of life improvements were measurable up to 12 months after the completion of treatment with EECP. Improvements in this controlled study are consistent with HQOL changes reported in case series and patient registries. Larger studies are warranted.BACKGROUNDThe Multicenter Study of Enhanced External Counterpulsation (MUST-EECP) was the first prospective, randomized, blinded, sham-controlled study of enhanced external counterpulsation (EECP) in the treatment of chronic stable angina. We previously reported that EECP therapy lengthens the time to exercise-induced myocardial ischemia and reduces angina. We now describe the effects of EECP therapy versus a sham-treated control group in terms of patients' functioning, their senses of well-being and other Health-Related Quality Of Life (HQOL) parameters from baseline to end of treatment and from baseline to 12 months after treatment.","Arora, R R; Chou, T M; Jain, D; Fleishman, B; Crawford, L; McKiernan, T; Nesto, R; Ferrans, C E; Keller, S",2002.0,10.2310/6650.2002.33514,0,0,
5308,"Effect of a preoperative intervention on preoperative and postoperative outcomes in low-risk patients awaiting elective coronary artery bypass graft surgery. A randomized, controlled trial","ER OBJECTIVETo examine the effect of a multidimensional preoperative intervention on presurgery and postsurgery outcomes in low-risk patients awaiting elective CABG.DESIGNRandomized, controlled trial.SETTINGA regional cardiovascular surgery center in a tertiary care hospital, southwestern Ontario, Canada.PATIENTS249 patients on a waiting list for elective CABG whose surgeries were scheduled for a minimum of 10 weeks from the time of study recruitment.INTERVENTIONDuring the waiting period, the treatment group received exercise training twice per week, education and reinforcement, and monthly nurse-initiated telephone calls. After surgery, participation in a cardiac rehabilitation program was offered to all patients.MEASUREMENTSPostoperative length of stay was the primary outcome. Secondary outcomes were exercise performance, general health-related quality of life, social support, anxiety, and utilization of health care services.RESULTSLength of stay differed significantly between groups. Patients who received the preoperative intervention spent 1 less day [95% CI, 0.0 to 1.0 day] in the hospital overall (P = 0.002) and less time in the intensive care unit (median, 2.1 hours [CI, -1.2 to 16 hours]; P = 0.001). During the waiting period, patients in the intervention group had a better quality of life than controls. Improved quality of life continued up to 6 months after surgery. Mortality rates did not differ.CONCLUSIONThe waiting period for elective procedures, such as CABG, may be used to enhance in-hospital and early-phase recovery, improving patients' functional abilities and quality of life while reducing their hospital stay.BACKGROUNDIn publicly funded health care systems, a waiting period for such services as coronary artery bypass graft surgery (CABG) is common. The possibility of using the waiting period to improve patient outcomes should be investigated.","Arthur, H M; Daniels, C; McKelvie, R; Hirsh, J; Rush, B",2000.0,,0,0,
5309,"Satisfaction, utilisation and perceived benefit of individual psychosocial support for breast cancer patients--a randomised study of nurse versus psychologist interventions","ER METHODSBetween December 1997 and December 1999, consecutive breast cancer patients (n=120) were included at start of adjuvant therapy (chemo-, endocrine and/or loco-regional radiotherapy). Data were collected by an extended version of the 'IPS-patient satisfaction questionnaire' within 1 week after termination of the support intervention. Questionnaires were also mailed to all patients 6, 12 and 18-24 months after inclusion. Levels of distress were collected with the Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale (IES) questionnaires.RESULTSThe patients were highly satisfied with the individual psychosocial support intervention they received, irrespective of which profession provided the support. However, the patients in the INS group reported higher levels of benefit regarding disease-related problems, regardless if the patients at baseline reported low or high levels of distress.CONCLUSIONSPatients were highly satisfied with an individual psychosocial support intervention. In areas dealing with somatic aspects, the group intervened by nurses were more satisfied than the one by psychologists.PRACTICE IMPLICATIONSIndividual psychosocial support by specially trained nurses is a realistic alternative in routine cancer care.OBJECTIVEIn a prospective, randomised study, individual psychosocial support performed by: (1) specially trained oncology nurses (INS) or (2) psychologists (IPS) were compared with respect to utilisation, satisfaction and perceived benefit.","Arving, C; Sjödén, P O; Bergh, J; Lindström, A T; Wasteson, E; Glimelius, B; Brandberg, Y",2006.0,10.1016/j.pec.2005.07.008,0,0,
5310,Cardiac rehabilitation to improve physical functioning in refractory angina: a pilot study,"ER OBJECTIVES: Refractory angina patients suffer debilitating chest pain despite optimal medical therapy and previous cardiovascular intervention. Cardiac rehabilitation is often not prescribed due to a lack of evidence regarding potential efficacy and patient suitability. A randomised controlled study was undertaken to explore the impact of cardiac rehabilitation on cardiovascular risk factors, physical ability, quality of life and psychological morbidity among refractory angina sufferers.METHODS: Forty-two refractory angina patients (65.1 ± 7.3 years) were randomly assigned to an 8-week Phase III cardiac rehabilitation program or symptom diary control. Physical assessment, Progressive Shuttle Walk test, Hospital Anxiety and Depression Scale, Health Anxiety Questionnaire, the York Angina Beliefs scale, ENRICHD Social Support Instrument and SF-36 were completed before and after intervention and at 8-week follow-up.RESULTS: Following cardiac rehabilitation, patients demonstrated improved physical ability compared with controls in Progressive Shuttle Walk level attainment (p = 0.005) and total distance covered (p = 0.015). Angina frequency and severity remained unchanged in both groups, with the control demonstrating worsening SF-36 pain scale (63.43 ± 22.28 vs. 55.46 ± 23.98, p = 0.025). Cardiac rehabilitation participants showed improved Health Anxiety Questionnaire reassurance (1.71 ± 1.72 vs. 1.14 ± 1.23, p = 0.026) and York Beliefs anginal threat perception (12.42 ± 4.58 vs. 14.35 ± 4.73, p = 0.05) after cardiac rehabilitation. Physical measures were broadly unaffected.CONCLUSIONS: Cardiac rehabilitation can be prescribed to improve physical ability without affecting angina frequency or severity among patients with refractory angina.","Asbury, E A; Webb, C M; Probert, H; Wright, C; Barbir, M; Fox, K; Collins, P",2012.0,10.1159/000339224,0,0,
5311,Feasibility of bimanual microincision phacoemulsification in hard cataracts,"ER SETTINGAin-Shams University Hospitals, Ophthalmology Department, Cairo, Egypt.DESIGNA randomized prospective noncomparative study.METHODSA randomized prospective study of 33 consecutive cases (N3+ or more) was conducted, phacoemulsification using a bimanual microincision technique using the Sovereign with WhiteStar technology phacoemulsification machine. One phaco mode was used in all eyes. The ultrasound power was set at 30-25% according to the hardness of the nuclei, duty cycle of 33%, flow rate of 20-28 cm3/min, and vacuum of 240 mmHg. Occlusion mode was on. Nine eyes received rollable intraocular lenses (IOL) of ThinOptx, whereas 24 eyes had been implanted with hydrophobic acrylic foldable IOL (Sensar OptiEdge SA40e of AMO) through a third incision. Study parameters were effective phacotime (EPT), presence of wound burn, degree of immediate postoperative iritis, amount of infusion solution used, and total operating time.RESULTSThe mean EPT was 4.3 s with an average ultrasound used of 5.7%. The mean operating time was 11 min and 20 s. Although the nuclear hardness was of grade 3 or above (in a scale of 5), there were no cases of thermal burn; P=0.005. Only three eyes suffered postoperative iritis 2+, which resolved within 1 week on topical steroids, statistically nonsignificant, P=0.2. The amount of infusion solution was less than that used in conventional coaxial phaco. This technique induced considerably less corneal astigmatism than surgery using conventional corneal incisions.CONCLUSIONSHard cataracts of N3 or more could be safely removed through an incision of 1.4 mm incision using bimanual micro-phaco.PURPOSEThe purpose of this work was to assess the feasibility of bimanual phacoemulsification in hard cataracts of N3+ using WhiteStar technology of Soveriegn (Advanced Medical Optics, Santa Ana, CA, USA).","Assaf, A; El-Moatassem, Kotb A M",2007.0,10.1038/sj.eye.6702356,0,0,
5312,Time-dependent effects of cortisol on the contextualization of emotional memories,"ER BACKGROUND: The inability to store fearful memories into their original encoding context is considered to be an important vulnerability factor for the development of anxiety disorders like posttraumatic stress disorder. Altered memory contextualization most likely involves effects of the stress hormone cortisol, acting via receptors located in the memory neurocircuitry. Cortisol via these receptors induces rapid nongenomic effects followed by slower genomic effects, which are thought to modulate cognitive function in opposite, complementary ways. Here, we targeted these time-dependent effects of cortisol during memory encoding and tested subsequent contextualization of emotional and neutral memories.METHODS: In a double-blind, placebo-controlled design, 64 men were randomly assigned to one of three groups: 1) received 10 mg hydrocortisone 30 minutes (rapid cortisol effects) before a memory encoding task; 2) received 10 mg hydrocortisone 210 minutes (slow cortisol) before a memory encoding task; or 3) received placebo at both times. During encoding, participants were presented with neutral and emotional words in unique background pictures. Approximately 24 hours later, context dependency of their memories was assessed.RESULTS: Recognition data revealed that cortisol's rapid effects impair emotional memory contextualization, while cortisol's slow effects enhance it. Neutral memory contextualization remained unaltered by cortisol, irrespective of the timing of the drug.CONCLUSIONS: This study shows distinct time-dependent effects of cortisol on the contextualization of specifically emotional memories. The results suggest that rapid effects of cortisol may lead to impaired emotional memory contextualization, while slow effects of cortisol may confer protection against emotional memory generalization.","Ast, V A; Cornelisse, S; Meeter, M; Joëls, M; Kindt, M",2013.0,10.1016/j.biopsych.2013.06.022,0,0,
5313,Breath alcohol estimation training: behavioral effects and predictors of success,"ER AIMS: Breath alcohol concentration (BrAC) estimation training has been effective in increasing estimation accuracy in social drinkers. Predictors of estimation accuracy may identify populations to target for training, yet potential predictors typically are not evaluated. In addition, the therapeutic efficacy of estimation training as a preventive strategy for problematic drinking is unknown.METHODS: Forty-six social drinkers with a recent binge history were randomly assigned to an intervention or control group (n = 23 per group). In each of three sessions (pretraining, training, testing), participants consumed alcohol (0.32, 0.24, 0.16 and 0.08 g/kg, in random order) every 30 min (total dose: 0.8 g/kg). Participants provided five BrAC estimates within 3 h of alcohol administration. The intervention group, but not control group, received internal and external training. During testing, participants provided BrAC estimates, but received no feedback. Participants returned for two follow-up visits to complete self-report measures.RESULTS: BrAC estimation training improved intervention group estimation accuracy within the laboratory. Together, training, low trait anxiety and low risk expectancy predicted high testing accuracy. There were no significant group differences in subsequent alcohol consumption, behavior under the influence or risk expectancy regarding potentially hazardous behaviors.CONCLUSION: BrAC estimation training is effective in the laboratory but may not translate into naturalistic settings.","Aston, E R; Neiberg, R H; Liguori, A",2013.0,10.1093/alcalc/agt047,0,0,
5314,Tactical differences in coping with rejection sensitivity: the role of prevention pride,"ER Prevention pride reflects a person's subjective history of success in preventing negative outcomes, leading to a strategic avoidance of errors of commission (e.g., explicit mistakes) in new situations. Two studies examined the impact of prevention pride on the strategies that highly rejection sensitive (HRS) people use to cope with the anxiety of anticipated rejection and the negative feelings elicited by perceived rejection. It was hypothesized that prevention pride orientation would lead HRS people toward covert and passive rather than overt and active forms of negative coping. Results indicated that HRS individuals who were also high in prevention pride reported increased use of self-silencing, presumably to prevent rejection. When rejection was perceived, however, they expressed hostility passively, by reducing positive behavior (e.g., withdrawing love and support) while inhibiting direct, active acts of hostility (e.g., yelling).","Ayduk, O; May, D; Downey, G; Higgins, E T",2003.0,10.1177/0146167202250911,0,0,
5315,Psychosocial interventions to improve quality of life in prostate cancer survivors and their intimate or family partners,"ER METHODSThis study used a three-wave repeated measures experimental design. Both the interpersonal counseling intervention (TIP-C) and health education attention condition (HEAC) were delivered using the telephone.RESULTSImprovements in depression, negative affect, stress, fatigue, and spiritual well-being were significantly higher for survivors in the HEAC than for those in the TIP-C condition. Partners in the HEAC condition showed significantly greater improvements in depression, fatigue, social support from family members, social well-being, and spiritual well-being compared to partners in the TIP-C condition. The results revealed superior outcomes for those assigned to the HEAC intervention.CONCLUSIONSThe psychosocial interventions in this study were effective in maintaining or improving the QOL for prostate cancer survivors and their partners. Both the survivor and their intimate partner or family member benefitted from the interventions. Future research is needed to determine the optimal timing and client characteristics for each intervention.PURPOSEThe primary purpose was to test the effectiveness of two telephone-delivered psychosocial interventions for maintaining and improving quality of life (QOL) (psychological, physical, social, and spiritual well-being) among 71 prostate cancer survivors and the 70 intimate or family partners who were supporting them in their recovery.","Badger, T A; Segrin, C; Figueredo, A J; Harrington, J; Sheppard, K; Passalacqua, S; Pasvogel, A; Bishop, M",2011.0,10.1007/s11136-010-9822-2,0,0,
5316,Time-limited thematic group with post-mastectomy patients,"ER Twenty-four post-mastectomy women participated in thematic time-limited groups. About half of the women reported that the groups helped them a lot, and in these women a significant decrease in psychological distress, especially anxiety and depression, was found. In the few who reported they were not helped, an increase in psychological distress was found, especially in hostility. The main concerns of the post-mastectomy women are described, as well as the need to develop predictors about who can benefit from time-limited groups. The preliminary data seems to indicate that patients became less prone to improvement with time (after the operation) and that patients who have the wish to share their experience with others do especially well in groups.","Baider, L; Amikam, J C; De-Nour, A K",1984.0,,0,0,
5317,Expressive writing and positive writing for participants with mood disorders: an online randomized controlled trial,"ER INTRODUCTION: Expressive writing--writing about traumatic, stressful or emotional events--often leads to improvements in physical and psychological health in non-clinical and clinical populations. Recent studies have shown that positive writing may also be beneficial. Research has not yet investigated whether either expressive writing or positive writing offers benefits for people with mood disorders.METHOD: Participants were recruited online and were randomly allocated to expressive writing, positive writing or control writing. The following questionnaires were completed online: Centre for Epidemiological Studies-Depression Scale (CES-D), Depression Anxiety Stress Scales (DASS), Pennebaker Inventory of Limbic Languidness (PILL), overall health questions, Temperament and Personality Questionnaire (TPQ) and COPE Inventory (COPE). Participants then wrote for 20 min on 4 occasions, and then completed follow-up questionnaires.RESULTS: Linear mixed models with custom contrasts were conducted to assess differences between groups and over time. All 3 groups showed significant improvements over time on mental health and some physical health outcomes. There were no significant differences between groups and no significant group by time interactions. These results were not moderated by demographic factors, personality subtypes or coping styles.CONCLUSION: The expressive writing, positive writing and time management control writing groups all reported significantly fewer mental and physical symptoms for at least 4 months post-writing. When expressive and positive writing groups were combined, the resulting `emotional writing group' showed significantly lower scores on the DASS stress subscale than the control writing group at all time-points. Potential reasons are discussed and areas of further study identified.","Baikie, K A; Geerligs, L; Wilhelm, K",2012.0,10.1016/j.jad.2011.11.032,0,0,
5318,"A feasibility study for a randomised controlled trial of the Positive Reappraisal Coping Intervention, a novel supportive technique for recurrent miscarriage","ER METHODS AND ANALYSIS: A randomised controlled trial (RCT) feasibility study will establish the viability of conducting a multicentre RCT to definitively test the effects of the PRCI on the psychological well-being of women who have experienced RM during the initial waiting period of a subsequent pregnancy. A second component consists of a qualitative process evaluation exploring the initial experience of pregnancy following repeated miscarriages. Participants (n=50) will be randomised into one of two groups. The PRCI intervention group will receive the PRCI card and weekly questionnaires to assess their psychological well-being during the waiting period of their new pregnancy. The non-intervention group will be asked to complete the same weekly questionnaires. The qualitative process analysis will employ semistructured interviews (n=20) to address relevant aspects of the study objectives.ETHICS AND DISSEMINATION: Ethics approval has been obtained from the National Research Ethics Service Committee South Central-Hampshire A. Participating centres have given National Health Service R&D approval. Study findings will be disseminated through peer reviewed journals, national and international conferences and lay user groups.TRIAL REGISTRATION NUMBER: ISRCTN43571276. This study was registered with the ISRCTN 18/02/2014 following adoption onto the United Kingdom Clinical Research Network (UKCRN) portfolio. Recruitment of the first participant occurred 04/02/2014.INTRODUCTION: Recurrent miscarriage (RM) is diagnosed when a woman has had three or more miscarriages. Increased levels of distress and anxiety are common during the waiting period of any subsequent pregnancies, posing a significant threat to psychological well-being. However, only limited support and therapy are available for these women, and many are left to cope alone. The Positive Reappraisal Coping Intervention (PRCI) is a novel self-administered supportive technique which has been shown to be effective in patients awaiting the outcome of in vitro fertilisation treatment. The primary objective of this study is to assess the feasibility and effectiveness of the PRCI in improving quality of life in the difficult waiting period which women with previous RM endure before an ongoing pregnancy can be confirmed.","Bailey, S; Bailey, C; Boivin, J; Cheong, Y; Reading, I; Macklon, N",2015.0,10.1136/bmjopen-2014-007322,0,0,
5319,Physiological emotional under-arousal in individuals with mild head injury,"ER PRIMARY OBJECTIVES: This study examined the potential emotional sequelae following self-reported mild head injury (MHI; e.g. 'altered state of consciousness' [ASC]) in university students with a particular focus on arousal status and responsivity to experimental manipulation of arousal.RESEARCH DESIGN: A quasi-experimental design (n = 91) was used to examine arousal status (self-reported and physiological indices) and response to manipulated arousal (i.e. induced psychosocial stress/activation; reduced activation/relaxation) between persons who acknowledged prior MHI and persons with no-MHI.MAIN OUTCOME AND RESULTS: University students who self-reported MHI were physiologically under-aroused and less responsive to stressors (both laboratory and environmental) compared to their no-MHI cohort. Those with reported loss of consciousness demonstrated the most attenuated emotional arousal responses (i.e. flattened electrodermal responsivity) relative to those with only a reported ASC, followed by those with no-MHI.CONCLUSIONS: The under-arousal in traumatic brain injury has been hypothesized to be associated with ventromedial prefrontal cortex disruption. This under-arousal may be mirrored in persons who self-report experiencing subtle head trauma. Students who reported MHI may be less able to physiologically respond and/or cognitively appraise stressful experiences as compared to their no-MHI cohort; and experience subtle persistent consequences despite the subtle nature of the reported head trauma.","Baker, J M; Good, D E",2014.0,10.3109/02699052.2013.857787,0,0,
5320,Effect of nasal obstruction on subjective assessment of sleep quality by the patients with obstructive sleep apnea,"ER In 52 patients with Obstructive Sleep Apnea Syndrome (OSAS) and nasal obstruction due to nasal septum deformation, hypertrophy of inferior nasal concha or posttraumatic external nose deformity the evaluation of the day somnolence using the Epworth Scale was carried out. The patients were randomly divided in to two groups. The first group consisted of 40 patients who were subjected to appropriate corrective surgery of the nasal obstruction. The remaining 12 patients constituted the control group. After 3 month each of the patients was asked to fill in the same questionnaire. Among the patients who underwent the surgical procedure day somnolence intensity was decreased approximately 2 times whereas in the control group no significant changes were observed. Results of this study could be crucial for the discussion concerning the complex influence of the nasal obstruction on the pathomechanism and symptomatology of obstructive breathing disorders during sleep.","Balcerzak, J; Arcimowicz, M; By?kiniewicz, K; Bielicki, P; Korczy?ski, P; Niemczyk, K; Chazan, R",2005.0,,0,0,
5321,Cobalamin level is related to self-reported and clinically rated mood and to syndromal depression in bereaved HIV-1(+) and HIV-1(-) homosexual men,"ER METHODSThe relationship of a continuous measure of cobalamin level to psychological distress was examined, while controlling for HIV-1 serostatus, life stressors, social support, and coping styles.RESULTSOf this sample, 23.9% were either overtly or marginally cobalamin deficient; however, the deficiency rate was not significantly different by HIV-1 serostatus. Cobalamin level was inversely related to self-reported overall distress level and specifically to depression, anxiety, and confusion subscale scores, as well as to clinically rated depressed and anxious mood. Lower plasma cobalamin levels also were associated with the presence of symptoms consistent with major depressive disorder.CONCLUSIONThese findings suggest that cobalamin level may be physiologically related to depressed and anxious mood level, as well as to syndromal depression.OBJECTIVEAn examination of the relationship of plasma cobalamin (vitamin B(12)) level to overall psychological distress, specific mood states, and major depressive disorder was conducted in 159 bereaved men (90 HIV-1(+) and 69 HIV-1(-)).","Baldewicz, T T; Goodkin, K; Blaney, N T; Shor-Posner, G; Kumar, M; Wilkie, F L; Baum, M K; Eisdorfer, C",2000.0,,0,0,
5322,Mindfulness training effects for parents and educators of children with special needs,"ER Parents and teachers of children with special needs face unique social-emotional challenges in carrying out their caregiving roles. Stress associated with these roles impacts parents' and special educators' health and well-being, as well as the quality of their parenting and teaching. No rigorous studies have assessed whether mindfulness training (MT) might be an effective strategy to reduce stress and cultivate well-being and positive caregiving in these adults. This randomized controlled study assessed the efficacy of a 5-week MT program for parents and educators of children with special needs. Participants receiving MT showed significant reductions in stress and anxiety and increased mindfulness, self-compassion, and personal growth at program completion and at 2 months follow-up in contrast to waiting-list controls. Relational competence also showed significant positive changes, with medium-to-large effect sizes noted on measures of empathic concern and forgiveness. MT significantly influenced caregiving competence specific to teaching. Mindfulness changes at program completion mediated outcomes at follow-up, suggesting its importance in maintaining emotional balance and facilitating well-being in parents and teachers of children with developmental challenges.","Benn, R; Akiva, T; Arel, S; Roeser, R W",2012.0,10.1037/a0027537,0,0,
5323,"Effects of cognitive behavioral stress management on HIV-1 RNA, CD4 cell counts and psychosocial parameters of HIV-infected persons","ER METHODSA randomized controlled trial in four HIV outpatient clinics of 104 HIV-infected persons taking combination antiretroviral therapy (cART), measuring HIV-1 surrogate markers, adherence to therapy and well-being 12 months after 12 group sessions of 2 h CBSM training.RESULTSIntent-to-treat analyses showed no effects on HIV-1 surrogate markers in the CBSM group compared with the control group: HIV-1 RNA < 50 copies/ml in 81.1% [95% confidence interval (CI), 68.0-90.6] and 74.5% (95% CI, 60.4-85.7), respectively (P = 0.34), and mean CD4 cell change from baseline of 53.0 cells/microl (95% CI, 4.1-101.8) and 15.5 cells/microl (95% CI, -34.3 to 65.4), respectively (P = 0.29). Self-reported adherence to therapy did not differ between groups at baseline (P = 0.53) or at 12 month's post-intervention (P = 0.47). Significant benefits of CBSM over no intervention were observed in mean change of quality of life scores: physical health 2.9 (95% CI, 0.7-5.1) and -0.2 (95% CI, -2.1 to 1.8), respectively (P = 0.05); mental health 4.8 (95% CI, 1.8-7.3) and -0.5 (95% CI, -3.3 to 2.2) (P = 0.02); anxiety -2.1 (95% CI, -3.6 to -1.0) and 0.3 (95% CI, -0.7 to 1.4), respectively (P = 0.002); and depression -2.1 (95% CI, -3.2 to -0.9) and 0.02 (95% CI, -1.0 to 1.1), respectively (P = 0.001). Alleviation of depression and anxiety symptoms were most pronounced among participants with high psychological distress at baseline.CONCLUSIONCBSM training of HIV-infected persons taking on cART does not improve clinical outcome but has lasting effects on quality of life and psychological well-being.OBJECTIVETo determine the effects of cognitive-behavioral stress management (CBSM) training on clinical and psychosocial markers in HIV-infected persons.","Berger, S; Schad, T; Wyl, V; Ehlert, U; Zellweger, C; Furrer, H; Regli, D; Vernazza, P; Ledergerber, B; Battegay, M; Weber, R; Gaab, J",2008.0,10.1097/QAD.0b013e3282f511dc,0,0,
5324,Surgical and behavioral treatments for vestibulodynia: two-and-one-half year follow-up and predictors of outcome,"ER METHODSIn a university hospital, 51 of the 78 women from the original study were reassessed 2.5 years after the end of their treatment. They completed 1) a gynecologic examination involving the cotton-swab test, 2) a structured interview, and 3) validated pain and sexual functioning measures.RESULTSResults from the multivariate analysis of variance conducted on the pain measures showed a significant time main effect (P<.05) and a significant treatment main effect (P<.01), indicating that participants had less pain at the 2.5-year follow-up than at the previous 6-month follow-up. Results from the multivariate analysis of variance conducted on sexual functioning measures showed that participants remained unchanged between the 6-month and 2.5-year follow-up and that there were no group differences. Higher pretreatment pain intensity predicted poorer outcomes at the 2.5-year follow-up for vestibulectomy (P<.01), biofeedback (P<.05), and cognitive-behavioral therapy (P<.01). Erotophobia also predicted a poorer outcome for vestibulectomy (P<.001).CONCLUSIONTreatment gains were maintained at the 2.5-year follow-up. Outcome was predicted by pretreatment pain and psychosexual factors.LEVEL OF EVIDENCEII.OBJECTIVETo estimate whether treatment gains for provoked vestibulodynia participants randomly assigned to vestibulectomy, biofeedback, and cognitive-behavioral therapy in a previous study would be maintained from the last assessment-a 6-month follow-up-to the present 2.5-year follow-up. Although all three treatments yielded significant improvements at 6-month follow-up, vestibulectomy resulted in approximately twice the pain reduction as compared with the two other treatments. A second goal of the present study was to identify predictors of outcome.","Bergeron, S; Khalifé, S; Glazer, H I; Binik, Y M",2008.0,10.1097/01.AOG.0000295864.76032.a7,0,0,
5325,Combining the perspectives of midwives and doctors improves risk assessment in early pregnancy,"ER METHODSIn a cluster randomised trial, a planning conference, where midwives reported new mothers to a doctor, replaced the routine consultation with the doctor. Ten ANC-clinics with the new program (942 mothers) were compared to 10 clinics with standard care (758 mothers). Risk factors were registered independently by midwives and doctors. Degree of agreement in risk identification between midwives and doctors was estimated by the kappa coefficient.RESULTSThe degree of agreement in risk registration was good for previous pregnancy complications (kappa = 0.62; CI: 0.55-0.68), and recommendations for the doctor's consultation (kappa = 0.67; CI: 0.62-0.72); fair for social problems (kappa = 0.29; CI: 0.03-0.55), and poor for registration of symptoms and problems in index pregnancy (kappa = 0.09; CI: 0.03-0.21) and psychosocial aspects, such as anxiety (kappa = 0.09; CI: 0.03-0.21). Significantly more risk factors were registered in the study group.CONCLUSIONSReplacing the routine consultation with the doctor early in pregnancy with a planning conference had no negative impact on risk identification. The results support that the different perspectives of the two professions in combination are important for the safety of surveillance and the psychosocial support expected from antenatal care.BACKGROUNDTraditionally, risk identification in early pregnancy in Swedish antenatal care [ANC] is performed by the midwife at booking, and confirmed by the doctor at a routine visit in early pregnancy, but this extra visit has been questioned. This study compared the risk assessment by the two professions.","Berglund, A; Lindberg, M; Nyström, L; Lindmark, G",2007.0,,0,0,
5326,Predictive factors of the outcome of primary surgical treatment of stress incontinence in women,"ER Forty-five women with stress incontinence (mean age 50 years) scheduled for surgical treatment randomized either to retropubic urethrocystopexy or to pubococcygeal repair were prospectively studied. Fifty healthy women were used as a reference group. No difference emerged concerning the outcome for these two surgical techniques in terms of success rate. Consequently, the subjects were treated as one group. The aim of the study was to test for predictive factors of the outcome of surgical treatment. Age of the patient, duration of stress incontinence, parity, personality, psychological and social factors were investigated. The outcome of surgical treatment was estimated both subjectively and objectively (pad test). The women were classified as cured or improved/failure. There was an 80% concordance between subjective and objective methods. In the stress incontinent women who were improved/failure one year after surgery, a high degree of neuroticism, low degree of extraversion, high degree of somatic anxiety, psychic anxiety, psychasthenia and suspicion was observed compared to the cured women. Furthermore, the improved/failure women had a lower level of social integration, in terms of loneliness compared to the cured women. Our findings point to the need of psychosocial support and care in addition to the medical treatment. According to a stepwise logistic regression analysis three variables have been found of importance as predictors of the outcome of the surgical treatment: duration of stress incontinence, neuroticism and age of patient.","Berglund, A L; Eisemann, M; Lalos, A; Lalos, O",1997.0,,0,0,
5327,Changes in quality of life after hormonal treatment of endometriosis,"ER METHODSIn a prospective, randomized, double-blind, double-dummy study on 48 women with verified endometriosis, the pain pattern and quality of life were registered before, during and after treatment with nafarelin or medroxyprogesterone acetate. The distribution of the studied parameters were tested by means of a Skewness test. ANOVA analysis was used for normally distributed variables and Friedman's analysis and Mann-Whitney U-test for non normally distributed variables.RESULTSThere was a difference between the 30 women who participated all through the study and the 18 who dropped out. It was noticeable that anxiety-depression and sleep disturbances were significantly more common among the drop outs. There was a significant reduction in symptom score during the study, without any significant difference between the treatment groups. The sleep disturbances and anxiety-depression score improved significantly from before treatment to the end of the follow-up, but the anxiety-depression score increased during the nafarelin treatment period. There was a statistically significant improvement of paid working life in the nafarelin treated group. All the other psycho-social parameters as well as emotional balance improved during the study period without difference between groups.CONCLUSIONWhen hormonal treatment is planned it is very important to take into consideration previous psychosocial experiences of the patient. Factors of importance for quality of life such as sleep disturbances and anxiety-depression improved significantly after treatment with nafarelin or medroxyprogesterone acetate.BACKGROUNDTo assess whether hormonal treatment of endometriosis improves quality of life for women with endometriosis.","Bergqvist, A; Theorell, T",2001.0,,0,0,
5328,Change in self-efficacy during cardiac rehabilitation and the role of perceived overprotectiveness,"ER Self-efficacy (SE) is an important outcome following cardiac rehabilitation (CR) when claiming benefits to patients and improving existing programs. This study evaluated change in SE during 6 weeks of multidisciplinary CR with either a high or low-frequency exercise training program. The role of overprotectiveness of the spouse, as it potentially counteracts improvement in SE, was examined. Coronary patients (n = 114) were randomized into both types of program. Overprotectiveness (patient perception) was assessed prior to rehabilitation. Self-efficacy in the domains controlling symptoms (SE-CS) and maintaining function (SE-MF), were assessed prior to and immediately after rehabilitation. Three findings pertain to program improvement: (1) As predicted, the low-frequency program enhanced SE-CS more than the high-frequency program, suggesting that experiencing success in daily activities and active engagement of the patient seem more decisive factors in improving SE than the frequency of exercise. (2) Changes in SE in both programs fell short of clinical meaning, suggesting the need to use self-efficacy theory more vigorously. (3) Overprotectiveness significantly predicted adverse change in SE in the high-frequency program, suggesting the need to include counseling for cardiac couples in CR when applicable.","Berkhuysen, M A; Nieuwland, W; Buunk, B P; Sanderman, R; Rispens, P",1999.0,,0,0,
5329,"Long-term follow-up after voluntary human immunodeficiency virus/sexually transmitted infection counseling, point-of-service testing, and referral to substance abuse treatment from the emergency department","ER OBJECTIVES: Public health initiatives have lowered human immunodeficiency virus (HIV) transmission risk associated with injection drug use in the United States, making sexual risk behaviors a greater source of transmission. Strategies are therefore needed to reduce these risk behaviors among all emergency department (ED) patients who use drugs, regardless of route of administration. Although recent articles have focused on the opportunity for early HIV detection and treatment through an array of ED screening and testing strategies, the effect of voluntary HIV testing and brief counseling (VT/C) on the sexual behaviors of out-of-treatment drug users over time has not yet been reported.METHODS: From November 2004 to May 2008, the study screened 46,208 urban ED patients aged 18 to 54 years; 2,148 (4.6%) reported cocaine or heroin use within 30 days, 1,538 met eligibility criteria (Drug Abuse Severity Test [DAST] scores ?3 and were either English- or Spanish-speaking), and 1,030 were enrolled. These data were obtained in the course of a randomized, controlled trial (Project SAFE) of a brief motivational intervention focused on reducing risky sexual behaviors. Although the intervention itself did not demonstrate any differential effect on the number or percentage of unprotected sexual acts, both control and intervention group participants received baseline VT/C and referral for drug treatment as part of the study protocol. This study is a report of a secondary analysis of cohort data to describe changes in sexual behaviors over time among drug users after the VT/C and referral.RESULTS: The mean (±SD) age of enrollees was 35.8 (±8.4) years; 67% were male, 39% were non-Hispanic black or African American, 41% were white non-Hispanic, and 19% were Hispanic. Half injected drugs, and 53% met criteria for posttraumatic stress disorder (PTSD). At baseline testing, 8.8% were HIV-positive on enzyme-linked immunosorbent assay. Follow-ups were conducted at 6 and 12 months, with an attrition rate of 22%. Known HIV-positive patients accounted for 84 of 1,030 cases (8.1%), and 13 new cases were discovered: 7 of 946 at were discovered at the baseline contact (0.74%), 2 of 655 were discovered at 6 months (0.3%), and 4 of 706 (0.57%) were discovered at the 12-month contact. Twelve of the 13 returned for confirmatory testing and were actively enrolled in our infectious disease clinic. For all partners, there was a reduction in the percentage of unprotected sex acts over time (p < 0.0001), with decreases at 6 months versus baseline (odds ratio [OR] = 0.70, 95% confidence interval [CI] = 0.60 to 0.83), sustained at 12 months versus baseline (OR = 0.69, 95% CI = 0.58 to 0.82). For the outcome of percentage of sex acts while high, there was also a significant reduction over time (p < 0.0001), with a drop-off at 6 months versus baseline (OR = 0.31, 95% CI = 0.25 to 0.37) that was sustained at 12 months (OR vs. baseline 0.25, 95% CI = 0.20 to 0.30). In an adjusted model, male sex, older age, and HIV positivity predicted significant declines over time in the likelihood of unprotected sexual acts. Older age and higher baseline drug severity predicted significant decreases over time in the likelihood of sex acts while high.CONCLUSIONS: Voluntary testing and counseling for HIV or sexually transmitted infections, accompanied by referral to drug treatment, for this population of ED cocaine and heroin users was associated with reduction in unprotected sex acts and fewer sex acts while high.","Bernstein, E; Heeren, T; Winter, M; Ashong, D; Bliss, C; Madico, G; Ayalew, B; Bernstein, J",2012.0,10.1111/j.1553-2712.2012.01314.x,0,0,
5330,Psychosomatic rehabilitation: effects of pre-treatment counselling under the statutory pension insurance scheme,"ER METHODSAs part of a randomized controlled pre-post design the Patients' questionnaire of therapy motivation (PAREMO) and the Brief Symptom Inventory (BSI) were distributed to 166 patients in psychosomatic rehabilitation. The selection of patients with prior knowledge of psychosomatic rehabilitation was made according to the scale ""knowledge"" of the patients' questionnaire. Changes were tested by analysis of variance at two treatment points.RESULTSAlthough there were positive effects of rehabilitation, no interaction was found between measurement points and groups. The analyses of patients without prior knowledge of psychosomatic rehabilitation showed different outcomes for males and females. Higher rehabilitation outcomes for females than for males were found on the BSI scales ""somatisation"", ""phobic anxiety"", and ""psychoticism"".CONCLUSIONSThe findings show that pre-treatment facilitates the patients' approach to psychosomatic rehabilitation. Apart from receiving information patients should be motivated more strongly and their confidence in psychosomatic rehabilitation strengthened.BACKGROUNDCurrently, little is known about the influence of pre-treatment in rehabilitation outcomes of patients with psychosomatic symptoms. This study examines whether there are differences in therapy motivation and impairment between patients with and those without pre-treatment measures. Additionally, the outcome for patients with prior knowledge of psychosomatic rehabilitation is analyzed.","Best, M; Lange, M; Karpinski, N; Hessel, A; Söpper-Terborg, B; Sieling, W; Petermann, F",2009.0,10.1055/s-0029-1239544,0,0,
5331,Ursodeoxycholic acid for treatment of primary sclerosing cholangitis: a placebo-controlled trial,"ER The efficacy and safety of ursodeoxycholic acid for the treatment of primary sclerosing cholangitis were evaluated in a prospective, randomized, double-blind, placebo-controlled trial. Fourteen patients with primary sclerosing cholangitis documented by cholestatic serum enzyme pattern, liver histological appearance and endoscopic retrograde cholangiography were included in the trial. Six patients received ursodeoxycholic acid (13 to 15 mg/kg body wt/day), and eight patients received placebo. Two patients had to be withdrawn from the study, one because of UDCA-related diarrhea and the other because of worsening of the disease during placebo treatment. Patients in the ursodeoxycholic acid group improved significantly during 1 yr of treatment with respect to serum levels of bilirubin (median = -50%), alkaline phosphatase (median = -67%), gamma-glutamyltransferase (median = -53%), AST (median = -54%) and ALT (median = -36%) compared with the placebo group, but not with respect to serum levels of hydrophobic bile acids. During ursodeoxycholic acid treatment, histopathological features also improved significantly, as evaluated by multiparametric score. Expression of human leukocyte antigen class I molecules appeared to be markedly reduced on liver cells after ursodeoxycholic acid treatment. We conclude that ursodeoxycholic acid is beneficial in reducing disease activity in patients with primary sclerosing cholangitis.","Beuers, U; Spengler, U; Kruis, W; Aydemir, U; Wiebecke, B; Heldwein, W; Weinzierl, M; Pape, G R; Sauerbruch, T; Paumgartner, G",1992.0,,0,0,
5332,Efficacy of short-term psychodynamic psychotherapy (STPP) with depressed breast cancer patients: results of a randomized controlled multicenter trial,"ER BACKGROUND: There is a lack of trials of psychodynamic treatments of depression in breast cancer patients. The purpose of this trial was to determine the efficacy of short-term psychodynamic psychotherapy (STPP) in non-metastatic breast cancer patients diagnosed with depression, one of the most frequent mental comorbidities of breast cancer.PATIENTS AND METHODS: In a multicenter prospective trial, 157 breast cancer patients with comorbid depression were randomized to either individual STPP (intervention group, N=78) or 'treatment as usual' (control group, TAU, N=79). As our primary outcome measure, we hypothesized a higher rate of remission defined as no diagnosis of depression (Structured Clinical Interview for DSM-IV) and reduction in depression score by at least 2 points (Hospital Anxiety and Depression Scale, HADS-D) in STPP versus TAU at treatment termination. Secondary outcomes mainly refer to quality of life (QoL).RESULTS: In the intention to treat (ITT) analysis, 44% of the STPP group achieved highly significantly more remission than TAU (23%). STPP treatment (OR=7.64; P<0.001) was the strongest predictor for remission post-treatment; time was also significant (OR=0.96; P<0.05). A high effect favoring STPP (d=0.82) was observed for the HADS-D score post-treatment (secondary outcome). Regarding further secondary outcomes (QoL), analyses of covariance yielded main effects for group (favoring STPP with an effect size of at least d=0.5) for global QoL, role, emotional and social functioning, pain, treatment side-effects, breast symptoms and upset by hair loss.CONCLUSIONS: STPP is an effective treatment of a broad range of depressive conditions in breast cancer patients improving depression and functional QoL. Findings are limited by the drop-out rate (?1/3) and delayed post-treatment assessments. Future trials may consider stepped-care approaches, tailored to patients' needs and requirements in the acute treatment phase.","Beutel, M E; Weißflog, G; Leuteritz, K; Wiltink, J; Haselbacher, A; Ruckes, C; Kuhnt, S; Barthel, Y; Imruck, B H; Zwerenz, R; Brähler, E",2014.0,10.1093/annonc/mdt526,0,0,
5333,Psychiatric morbidity among repatriated Greek migrants in a rural area,"ER This paper reports on psychiatric case identification by the application of the Structured Clinical Interview for DSM-III-R (SCID) in a sample of 198 Greek migrants repatriated from western europe in a northwestern province of Greece. The current (1 month) prevalence of psychiatric morbidity, based on the total number of diagnosed cases, was found to be 43.4%. Lifetime prevalence of psychiatric disorders was found to be higher (49.4%). The majority of the sample were diagnosed as suffering from anxiety disorders and dysthymia. Psychiatric disorders were found to be more prevalent among middle-aged respondents. Duration of stay in the foreign country was a factor correlated with psychiatric morbidity. Of short-term migrants 54% were found to suffer from specific nosological entities, whereas 32% of long-term migrants were diagnosed as cases. The results are discussed within the framework of the existing sociocultural context of emigration and repatriation.","Bilanakis, N; Madianos, M G; Liakos, A",1995.0,,0,0,
5334,"""Treating"" prejudice: an exposure-therapy approach to reducing negative reactions toward stigmatized groups","ER One of the ways in which therapists treat anxiety disorders is to expose patients to a fear-evoking stimulus within a safe environment before encouraging more positive stimulus-related thoughts. In the study reported here, we adapted these psychotherapeutic principles of exposure therapy to test the hypothesis that imagining a positive encounter with a member of a stigmatized group would be more likely to promote positive perceptions when it was preceded by an imagined negative encounter. The results of three experiments targeting a range of stigmatized groups (adults with schizophrenia, gay men, and British Muslims) supported this hypothesis. Compared with purely positive interventions, interventions in which a single negative encounter was imagined just prior to imagining a positive encounter resulted in significantly reduced prejudice. Furthermore, reduced anxiety uniquely derived from the mixed-valence imagery task statistically explained enhanced intentions to engage positively with the previously stigmatized group in the future.","Birtel, M D; Crisp, R J",2012.0,10.1177/0956797612443838,0,0,
5335,"FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm","ER DESIGNA randomized crossover study and a randomized crossover case-control study.PARTICIPANTSThe first study included 30 subjects with BEB. The second study included 26 subjects with BEB and 26 controls.METHODSFor the first study, subjects were randomized to wear either FL-41 or gray-tinted lenses for 2 weeks. After a 2-week washout period, the other lens was worn for 2 weeks. Questionnaires were completed at baseline, after the first lens, and after the second lens. In the second study, surface electromyography (EMG) was used to measure blink frequency, duration, and force while subjects read and wore FL-41, rose, or gray-tinted lenses.MAIN OUTCOME MEASURESQuestionnaires were used to assess perceptions of light sensitivity and the effect of light sensitivity on activities of daily living (ADL). EMG was used to measure blink frequency, duration, and force.RESULTSMost participants observed improvement while wearing both FL-41 and gray-tinted lenses. FL-41-tinted lenses provided superior improvement in the areas of reading, fluorescent light sensitivity, overall light sensitivity, blepharospasm frequency, and blepharospasm severity. FL-41 lenses reduced mean blink rate compared with both rose and gray-tinted lenses, and reduced eyelid contraction force compared with rose-tinted lenses.CONCLUSIONSFL-41 lenses provided both subjective and objective benefit to subjects with BEB. Physicians should consider recommending this noninvasive and inexpensive lens tint to patients with BEB.FINANCIAL DISCLOSURE(S)Proprietary or commercial disclosure may be found after the references.OBJECTIVEThe objective of these 2 studies was to assess the efficacy of FL-41-tinted lenses in the treatment of benign essential blepharospasm (BEB).","Blackburn, M K; Lamb, R D; Digre, K B; Smith, A G; Warner, J E; McClane, R W; Nandedkar, S D; Langeberg, W J; Holubkov, R; Katz, B J",2009.0,10.1016/j.ophtha.2008.12.031,0,0,
5336,Control versus abstinence in the treatment of pathological gambling: a two to nine year follow-up,"ER A structured gambling interview schedule, the Eysenck Personality Questionnaire, Spielberger's State-Trait Anxiety Inventory, Zuckerman's Sensation Seeking Scale and Beck Depression Inventory were administered to 63 out of 120 pathological gamblers who had 5 years previously completed a behavioural treatment for uncontrollable gambling behaviour. Results indicated that both abstinence and controlled gambling outcomes were associated with continued improvement in self-report and psychological indices of social functioning and psychopathology. Response to treatment was associated with a reduction in arousal levels, anxiety and depression. Uncontrolled gamblers failed to show post-treatment changes on parameters of improvement. It was concluded that abstinence is not the only possible therapeutic outcome in behavioural treatment and further, that controlled gambling is not a temporary response which is followed by a return to continued uncontrollable gambling.","Blaszczynski, A; McConaghy, N; Frankova, A",1991.0,,0,0,
5337,The effects of a telehealth coping skills intervention on outcomes in chronic obstructive pulmonary disease: primary results from the INSPIRE-II study,"ER METHODS: We conducted a dual-site, randomized clinical trial with assessments at baseline and after 16 weeks of treatment. The study population comprised 326 outpatients with COPD aged 38 to 81 years, randomized to coping skills training (CST) or to COPD education (COPD-ED). Patients completed a battery of QoL instruments, pulmonary function tests, and functional measures and were followed up for up to 4.4 years to assess medical outcomes.RESULTS: The CST group exhibited greater improvements in psychological QoL compared with controls (p = .001), including less depression (Cohen d = 0.22 [95% confidence interval, or CI = 0.08-0.36]) and anxiety (d = 0.17 [95% CI = 0.02-0.33]), and better overall mental health (d = 0.17 [95% CI = 0.03-0.32]), emotional role functioning (d = 0.29 [95% CI = 0.10-0.48]), vitality (d = 0.27 [95% CI = 0.11, 0.42]), and social functioning (d = 0.21 [95% CI = 0.03-0.38]). A significant baseline psychological QoL by treatment group interaction revealed that CST with lower QoL at baseline achieved even greater improvements in psychological QoL compared with COPD-ED. CST participants also exhibited greater improvements in somatic QoL (p = .042), including greater improvements in pulmonary QoL (d = 0.13 [95% CI = 0.01-0.24]), less fatigue (d = 0.34 [95% CI = 0.18-0.50]), and less shortness of breath (d = 0.11 [95% CI = -0.01 to 0.23]) and greater improvement in distance walked on the Six-Minute Walk test (d = 0.09 [95% CI = 0.01-0.16]). However, there was no significant difference in risk of time to COPD-related hospitalization or all-cause mortality between CST (34 events) and COPD-ED (32 events; p = 0.430).CONCLUSIONS: A telehealth CST intervention produced clinically meaningful improvements in QoL and functional capacity, but no overall improvement in risk of COPD-related hospitalization and all-cause mortality.TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00736268.OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is associated with increased morbidity and mortality and reduced quality of life (QoL). Novel interventions are needed to improve outcomes in COPD patients. The present study assessed the effects of a telephone-based coping skills intervention on psychological and somatic QoL and on the combined medical end point of COPD-related hospitalizations and all-cause mortality.","Blumenthal, J A; Emery, C F; Smith, P J; Keefe, F J; Welty-Wolf, K; Mabe, S; Martinu, T; Johnson, J J; Babyak, M A; O'Hayer, V F; Diaz, P T; Durheim, M; Baucom, D; Palmer, S M",2014.0,10.1097/PSY.0000000000000101,0,0,
5338,"Enhancing Cardiac Rehabilitation With Stress Management Training: a Randomized, Clinical Efficacy Trial","ER METHODS AND RESULTS: One hundred fifty-one outpatients with coronary heart disease who were 36 to 84 years of age were randomized to 12 weeks of comprehensive CR or comprehensive CR combined with SMT (CR+SMT), with assessments of stress and coronary heart disease biomarkers obtained before and after treatment. A matched sample of CR-eligible patients who did not receive CR made up the no-CR comparison group. All participants were followed up for up to 5.3 years (median, 3.2 years) for clinical events. Patients randomized to CR+SMT exhibited greater reductions in composite stress levels compared with those randomized to CR alone (P=0.022), an effect that was driven primarily by improvements in anxiety, distress, and perceived stress. Both CR groups achieved significant, and comparable, improvements in coronary heart disease biomarkers. Participants in the CR+SMT group exhibited lower rates of clinical events compared with those in the CR-alone group (18% versus 33%; hazard ratio=0.49; 95% confidence interval, 0.25-0.95; P=0.035), and both CR groups had lower event rates compared with the no-CR group (47%; hazard ratio=0.44; 95% confidence interval, 0.27-0.71; P<0.001).CONCLUSIONS: CR enhanced by SMT produced significant reductions in stress and greater improvements in medical outcomes compared with standard CR. Our findings indicate that SMT may provide incremental benefit when combined with comprehensive CR and suggest that SMT should be incorporated routinely into CR.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00981253.BACKGROUND: Cardiac rehabilitation (CR) is the standard of care for patients with coronary heart disease. Despite considerable epidemiological evidence that high stress is associated with worse health outcomes, stress management training (SMT) is not included routinely as a component of CR.","Blumenthal, J A; Sherwood, A; Smith, P J; Watkins, L; Mabe, S; Kraus, W E; Ingle, K; Miller, P; Hinderliter, A",2016.0,10.1161/CIRCULATIONAHA.115.018926,0,0,
5339,An automated telemedicine system improves patient-reported well-being,"ER METHODS: A total of 35 adult, insulin-treated patients with diabetes (type 1 and type 2) were enrolled in the present study (63.0 +/- 10 years of age, 63% female) and randomized to telemedicine monitoring (including cordless, remote glucose monitor, and transmitter, n = 17), or conventional follow-up (n = 18). Metabolic parameters were evaluated, and a quality of life questionnaire was administered both pre- and post-treatment.RESULTS: Groups were similar at baseline in terms of demographic, quality of life, and metabolic parameters. Significant differences in post-treatment metabolic parameters were not observed, although serum glucose was marginally elevated in the control group compared to the telemedicine group (214 +/- 65 mg/dL vs. 171 +/- 77 mg/dL, P = 0.09). On the other hand, being clinically symptom-free (71% vs. 11%, P = 0.003), having no hypoglycemic events (82% vs. 17%, P = 0.0001), and having no hyperglycemic events (65% vs. 17%, P = 0.004) were all significantly more frequently reported in the telemedicine group compared to the control group. Compared to the control group, the telemedicine group reported experiencing significantly less anxiety, treatment difficulty, depression, disease-associated life complications, and feelings of impotence or ineptitude and significantly greater improvement in personal control over glucose, weight, and overall diabetes.CONCLUSIONS: Though post-treatment metabolic differences were not observed between treatment groups, the telemedicine group reported significantly greater post-treatment experiences of improved quality of life and sense of control over the disease. Thus patient satisfaction can be enhanced through the use of telemedicine.BACKGROUND: Control of serum glucose levels is essential for the reduction of complications of diabetes. Telemedicine is one strategy through which serum glucose control can be improved.","Boaz, M; Hellman, K; Wainstein, J",2009.0,10.1089/dia.2008.0048,0,0,
5340,Beyond attentional bias: a perceptual bias in a dot-probe task,"ER Previous dot-probe studies indicate that threat-related face cues induce a bias in spatial attention. Independently of spatial attention, a recent psychophysical study suggests that a bilateral fearful face cue improves low spatial-frequency perception (LSF) and impairs high spatial-frequency perception (HSF). Here, we combine these separate lines of research within a single dot-probe paradigm. We found that a bilateral fearful face cue, compared with a bilateral neutral face cue, speeded up responses to LSF targets and slowed down responses to HSF targets. This finding is important, as it shows that emotional cues in dot-probe tasks not only bias where information is preferentially processed (i.e., an attentional bias in spatial location), but also bias what type of information is preferentially processed (i.e., a perceptual bias in spatial frequency).","Bocanegra, B R; Huijding, J; Zeelenberg, R",2012.0,10.1037/a0028415,0,0,
5341,Manual treatment for cervicogenic headache and active trigger point in the sternocleidomastoid muscle: a pilot randomized clinical trial,"ER OBJECTIVE: The purpose of this preliminary study was to determine feasibility of a clinical trial to measure the effects of manual therapy on sternocleidomastoid active trigger points (TrPs) in patients with cervicogenic headache (CeH).METHODS: Twenty patients, 7 males and 13 females (mean ± SD age, 39 ± 13 years), with a clinical diagnosis of CeH and active TrPs in the sternocleidomastoid muscle were randomly divided into 2 groups. One group received TrP therapy (manual pressure applied to taut bands and passive stretching), and the other group received simulated TrP therapy (after TrP localization no additional pressure was added, and inclusion of longitudinal stroking but no additional stretching). The primary outcome was headache intensity (numeric pain scale) based on the headaches experienced in the preceding week. Secondary outcomes included neck pain intensity, cervical range of motion (CROM), pressure pain thresholds (PPT) over the upper cervical spine joints and deep cervical flexors motor performance. Outcomes were captured at baseline and 1 week after the treatment.RESULTS: Patients receiving TrP therapy showed greater reduction in headache and neck pain intensity than those receiving the simulation (P 0.84).CONCLUSION: This study provides preliminary evidence that a trial of this nature is feasible. The preliminary findings show that manual therapy targeted to active TrPs in the sternocleidomastoid muscle may be effective for reducing headache and neck pain intensity and increasing motor performance of the deep cervical flexors, PPT, and active CROM in individuals with CeH showing active TrPs in this muscle. Studies including greater sample sizes and examining long-term effects are needed.","Bodes-Pardo, G; Pecos-Martín, D; Gallego-Izquierdo, T; Salom-Moreno, J; Fernández-de-Las-Peñas, C; Ortega-Santiago, R",2013.0,10.1016/j.jmpt.2013.05.022,0,0,
5342,The ACTH (4-9) analog ORG 2766 in panic disorder: a preliminary study,,"Boer, J A; Westenberg, H G; Mastenbroek, B; Ree, J M",1989.0,,0,0,
5343,Internet-based self-help treatment for depression in multiple sclerosis: study protocol of a randomized controlled trial,"ER BACKGROUND: Depression in MS patients is frequent but often not treated adequately. An important underlying factor may be physical limitations that preclude face-to-face contact. Internet-based treatment showed to be effective for depressive symptoms in general and could thus be a promising tool for treatment in MS.METHODS/DESIGN: Here, we present a study protocol to investigate the effectiveness of a 5 week Internet-based self-help problem solving treatment (PST) for depressive symptoms in MS patients in a randomized controlled trial. We aim to include 166 MS patients with moderate to severe depressive symptoms who will be randomly assigned to an Internet-based intervention (with or without supportive text-messages) or waiting list control group. The primary outcome is the change in depressive symptoms defined by a change in the sum score on the Beck Depression Inventory (BDI-II). Secondary outcomes will include measures of anxiety, fatigue, cognitive functioning, physical and psychological impact of MS, quality of life, problem solving skills, social support, mastery, satisfaction and compliance rate. Assessments will take place at baseline (T0), within a week after the intervention (T1), at four months (T2) and at ten months follow-up (T3: only the intervention group). The control group will be measured at the same moments in time. Analysis will be based on the intention-to-treat principle.DISCUSSION: If shown to be effective, Internet-based PST will offer new possibilities to reach and treat MS patients with depressive symptoms and to improve the quality of care.TRIAL REGISTRATION: The Dutch Cochrane Center, NTR2772.","Boeschoten, R E; Dekker, J; Uitdehaag, B M; Polman, C H; Collette, E H; Cuijpers, P; Beekman, A T; Oppen, P",2012.0,10.1186/1471-244X-12-137,0,0,
5344,The efficacy of telephone counseling for health promotion in people with multiple sclerosis: a randomized controlled trial,"ER DESIGNRandomized controlled trial with wait-list controls and single-blinded outcome assessments conducted at baseline and at 12 weeks.SETTINGMS research and training center in the Pacific Northwest.PARTICIPANTSCommunity-residing persons (N=130) with physician confirmed MS aged 18 or older who were able to walk unassisted at least 90 m (300 ft).INTERVENTIONA single in-person motivational interview followed by 5 scheduled telephone counseling sessions to facilitate improvement in 1 of 6 health promotion areas: exercise, fatigue management, communication and/or social support, anxiety and/or stress management, and reducing alcohol or other drug use.MAIN OUTCOME MEASURESHealth Promotion Lifestyle Profile II plus fatigue impact, subjective health, and objective measures of strength, fitness, and cognition. Intent-to-treat analyses of change scores were analyzed using nonparametric tests.RESULTSSeventy persons were randomized to treatment and 60 to the control condition. The treatment group reported significantly greater improvement in health promotion activities, including physical activity, spiritual growth, and stress management as well as in fatigue impact and mental health compared with controls. In addition, the exerciser subgroup showed greater improvement than controls in self-selected walking speed.CONCLUSIONSA less intensive, more accessible approach to health promotion based on telephone counseling and motivational interviewing shows promise and merits further study.OBJECTIVETo determine if motivational interviewing-based telephone counseling increases health promotion activities and improves other health outcomes in people with multiple sclerosis (MS).","Bombardier, C H; Cunniffe, M; Wadhwani, R; Gibbons, L E; Blake, K D; Kraft, G H",2008.0,10.1016/j.apmr.2008.03.021,0,0,
5345,Improving physical fitness and emotional well-being in adolescents of low socioeconomic status in Chile: results of a school-based controlled trial,"ER Regular physical activity is associated with a reduced risk of all-cause mortality, and mortality due to cardiovascular disease and cancer. Among adolescents, physical activity is associated with benefits in the prevention and control of emotional distress, and improvement of self-esteem. Countries in transitional epidemiological scenarios, such as Chile, need to develop effective strategies to improve physical activity as a way to face the epidemic of chronic diseases. The objective of this study was to evaluate the effects of a school-based physical activity program on physical fitness and mental health status of adolescents living in a low socioeconomic status area in Santiago, Chile. A quasi-experimental design was used to evaluate the effects of the program over one academic year. The study included 198 students aged 15 years old. Two ninth grade classes were randomly selected as the intervention group, with two classes of the same grade as controls. A social planning approach was used to develop the intervention. The program was designed and implemented based on student preferences, teachers' expertise and local resources. Changes in physiological and mental health status were assessed. After the intervention, maximum oxygen capacity achieved a significant increase of 8.5% in the intervention versus 1.8% in the control group (p  0.01). Anxiety score decreased 13.7% in the intervention group versus 2.8% in the control group (p  0.01). Anxiety score decreased 13.7% in the intervention group versus 2.8% in the control group (p  80%. To conclude, a school-based program to improve physical activity in adolescents of low socioeconomic status, obtained a high level of participation and achieved significant benefits in terms of physical fitness and mental health status.","Bonhauser, M; Fernandez, G; Püschel, K; Yañez, F; Montero, J; Thompson, B; Coronado, G",2005.0,10.1093/heapro/dah603,0,0,
5346,Medical and psychosocial effects of early discharge after surgery for breast cancer: randomised trial,"ER DESIGNRandomised trial comparing discharge from hospital 4 days after surgery (with drain in situ) with discharge after drain removal (mean 9 days in hospital). Psychosocial measurements performed before surgery and 1 and 4 months after.SETTINGGeneral hospital and cancer clinic in Rotterdam with a socioeconomically diverse population.SUBJECTS125 women with operable breast cancer.MAIN OUTCOME MEASURESIncidence of complications after surgery for breast cancer, patient satisfaction with treatment, and psychosocial effects of short stay or long stay in hospital.RESULTSPatient satisfaction with the short stay in hospital was high; only 4% (2/56 at 1 month after surgery and 2/52 at 4 months after surgery) of patients indicated that they would have preferred a longer stay. There were no significant differences in duration of drainage from the axilla between the short stay and long stay groups (median 8 v 9 days respectively, P=0.45) or the incidence of wound complications (10 patients v 9 patients). The median number of seroma aspirations per patient was higher for the long stay group (1 v 3.5, P=0.04). Leakage along the drain occurred more frequently in short stay patients (21 v 10 patients, P=0.04). The two groups did not differ in scores for psychosocial problems (uncertainty, anxiety, loneliness, disturbed sleep, loss of control, threat to self esteem), physical or psychological complaints, or in the coping strategies used. Before surgery, short stay patients scored higher on scales of depression (P=0.03) and after surgery they were more likely to discuss their disease with their families (at 1 month P=0.004, at 4 months P=0.04).CONCLUSIONSEarly discharge from hospital after surgery for breast cancer is safe and is well received by patients. Early discharge seems to enhance the opportunity for social support within the family.OBJECTIVETo assess the medical and psychosocial effects of early hospital discharge after surgery for breast cancer on complication rate, patient satisfaction, and psychosocial outcomes.","Bonnema, J; Wersch, A M; Geel, A N; Pruyn, J F; Schmitz, P I; Paul, M A; Wiggers, T",1998.0,,0,0,
5347,Bromocriptine in the treatment of the alcohol-withdrawal syndrome,"ER A 10-day random double-blind study on the effect of bromocriptine versus placebo in severe alcohol-withdrawal symptoms was conducted in 60 alcoholics. The effect of bromocriptine--a dopamine agonist--was significantly better than placebo in ameliorating the following symptoms: anxiety, restlessness, depression, tremor, sweating and nausea as well as the total score of these symptoms. Also in the evaluation of specific symptoms according to a symptom check list of psychiatric, behavioural and social aspects, and in a global evaluation, bromocriptine was clearly superior to placebo. Serum prolactin studied on the first and tenth day of the survey showed a significant increase occurring in the placebo-treated patients. Side effects related to the use of bromocriptine were negligible. Our findings support recent experimental evidence that alcohol-withdrawal symptoms, at least in part, are related to a transient dopaminergic dysfunction in the brain.","Borg, V; Weinholdt, T",1982.0,,0,0,
5348,Comparing effects in regular practice of e-communication and Web-based self-management support among breast cancer patients: preliminary results from a randomized controlled trial,"ER OBJECTIVE: Our aim was to compare in regular care the effects of (1) an Internet-based patient provider communication service (IPPC), (2) WebChoice, a Web-based illness management system for breast cancer patients (IPPC included), and (3) usual care on symptom distress, anxiety, depression, (primary outcomes), and self-efficacy (secondary outcome). This study reports preliminary findings from 6 months' follow-up data in a 12-month trial.METHODS: We recruited 167 patients recently diagnosed with breast cancer and undergoing treatment from three Norwegian hospitals. The nurse-administered IPPC allowed patients to send secure e-messages to and receive e-messages from health care personnel at the hospital where they were treated. In addition to the IPPC, WebChoice contains components for symptom monitoring, tailored information and self-management support, a diary, and communication with other patients. A total of 20 care providers (11 nurses, 6 physicians, and 3 social workers) were trained to answer questions from patients. Outcomes were measured with questionnaires at study entry and at study months 2, 4, and 6. Linear mixed models for repeated measures were fitted to compare effects on outcomes over time.RESULTS: Patients were randomly assigned to the WebChoice group (n=64), the IPPC group (n=45), or the usual care group (n=58). Response rates to questionnaires were 73.7% (123/167) at 2 months, 65.9 (110/167) at 4 months, and 62.3% (104/167) at 6 months. Attrition was similar in all study groups. Among those with access to WebChoice, 64% (41/64) logged on more than once and 39% (25/64) sent e-messages to care providers. In the IPPC group, 40% (18/45) sent e-messages. Linear mixed models analyses revealed that the WebChoice group reported significantly lower symptom distress (mean difference 0.16, 95% CI 0.06-0.25, P=.001), anxiety (mean difference 0.79, 95% CI 0.09-1.49, P=.03), and depression (mean difference 0.79, 95% CI 0.09-1.49, P=.03) compared with the usual care group. The IPPC group reported significant lower depression scores compared with the usual care group (mean difference 0.69, 95% CI 0.05-1.32, P=.03), but no differences were observed for symptom distress or anxiety. No significant differences in self-efficacy were found among the study groups.CONCLUSIONS: In spite of practice variations and moderate use of the interventions, our results suggest that offering Web support as part of regular care can be a powerful tool to help patients manage their illness. Our finding that a nurse-administered IPPC alone can significantly reduce depression is particularly promising. However, the multicomponent intervention WebChoice had additional positive effects.TRIAL REGISTRATION: Clinicaltrials.gov:NCT00971009; http://clinicaltrials.gov/show/NCT00971009 (Archived by WebCite at http://www.webcitation.org/6USKezP0Y).BACKGROUND: While Web-based interventions have been shown to assist a wide range of patients successfully in managing their illness, few studies have examined the relative contribution of different Web-based components to improve outcomes. Further efficacy trials are needed to test the effects of Web support when offered as a part of routine care.","B√∏r√∏sund, E; Cvancarova, M; Moore, S M; Ekstedt, M; Ruland, C M",2014.0,10.2196/jmir.3348,0,0,
5349,Joint crisis plans for people with borderline personality disorder: feasibility and outcomes in a randomised controlled trial,"ER BACKGROUND: People with borderline personality disorder frequently experience crises. To date, no randomised controlled trials (RCTs) of crisis interventions for this population have been published.AIMS: To examine the feasibility of recruiting and retaining adults with borderline personality disorder to a pilot RCT investigating the potential efficacy and cost-effectiveness of using a joint crisis plan.METHOD: An RCT of joint crisis plans for community-dwelling adults with borderline personality disorder (trial registration: ISRCTN12440268). The primary outcome measure was the occurrence of self-harming behaviour over the 6-month period following randomisation. Secondary outcomes included depression, anxiety, engagement and satisfaction with services, quality of life, well-being and cost-effectiveness.RESULTS: In total, 88 adults out of the 133 referred were eligible and were randomised to receive a joint crisis plan in addition to treatment as usual (TAU; n = 46) or TAU alone (n = 42). This represented approximately 75% of our target sample size and follow-up data were collected on 73 (83.0%) participants. Intention-to-treat analysis revealed no significant differences in the proportion of participants who reported self-harming (odds ratio (OR) = 1.9, 95% CI 0.53-6.5, P = 0.33) or the frequency of self-harming behaviour (rate ratio (RR) = 0.74, 95% CI 0.34-1.63, P = 0.46) between the two groups at follow-up. No significant differences were observed between the two groups on any of the secondary outcome measures or costs.CONCLUSIONS: It is feasible to recruit and retain people with borderline personality disorder to a trial of joint crisis plans and the intervention appears to have high face validity with this population. However, we found no evidence of clinical efficacy in this feasibility study.","Borschmann, R; Barrett, B; Hellier, J M; Byford, S; Henderson, C; Rose, D; Slade, M; Sutherby, K; Szmukler, G; Thornicroft, G; Hogg, J; Moran, P",2013.0,10.1192/bjp.bp.112.117762,0,0,
5350,Effects of counseling Ashkenazi Jewish women about breast cancer risk,"ER The goal of this study was to determine whether genetic counseling or psychosocial group counseling provided to Ashkenazi women can reduce breast cancer worry, cancer risk perception, and interest in having genetic testing. Women (N=211) were randomized to receive individual genetic risk counseling, to receive a group psychosocial group counseling, or to serve as a control group. The authors found that both counseling methods reduced cancer worry, lowered perceptions of breast cancer risk, and decreased interest in having genetic testing. Counseling can help women gain a more accurate perception of their risk, expose them to the benefits and limitations of genetic testing, and reduce their worry about cancer.","Bowen, D J; Burke, W; Culver, J O; Press, N; Crystal, S",2006.0,10.1037/1099-9809.12.1.45,0,0,
5351,Aftermath of a chemical spill: psychological and physiological sequelae,"ER Psychological, and psychophysiological sequelae were studied in a community which had experienced a railroad chemical spill of 19,000 gallons of the toxic pesticide metam sodium. Information was collected on 350 persons living in the area of the spill (spill residents) and 114 nonexposed controls, recruited using a randomized sampling strategy, from a nearby similar, but unexposed control town. Psychological measures used were the MMPI-2, POMS, IES Scale, Environmental Worry, Perceived Social Support and Perceived Control Scale. Physiological measurements were two measurements of blood pressure, pulse, and salivary cortisol level, taken both at the beginning and the conclusion of the study. Demographic and medical information was asked in a Questionnaire. Results indicate greater levels of depression, anxiety, and somatic symptoms in the spill residents in addition to greater environmental worry and lower perceived social support. Spill odor perception was related to increased psychological and physiological sequelae. The spill residents had higher blood pressure and less fluctuation of cortisol levels than the controls. Comparison of spill residents who were litigants and those who were not, indicates no differences for blood pressure, pulse, and cortisol, MMPI-2, Environmental Worry and the Control Scale. Litigants scored slightly higher on the IES, Intrusion and the POMS scales. No dose/response relationship between distance to the river and evacuation status was obtained. The chemical spills was associated with a wide variety of psychological and physiological reactions.","Bowler, R M; Mergler, D; Huel, G; Cone, J E",1994.0,,0,0,
5352,Changes in functional status related to health maintenance visits to family physicians,"ER METHODSWe used an observational prospective cohort study in an academic family practice office to investigate changes in patients' functional status associated with receiving recommendations to change behavior from family physicians. Patients 18 years and older presenting for health maintenance visits to family physicians completed a functional status instrument and a brief intake questionnaire by telephone before their visit. After the visit patients were randomized to a debriefing interview or an observation-only group. The interview included the Patient/Doctor Interaction Scale and an assessment of whether patients received a recommendation to change behavior.RESULTSOne hundred thirty-two patients were randomized to the debriefing group, and of those, 92% completed assessments at 3 months. Patients reporting recommendations to change behavior had lower scores at 1 and 3 months for mental health, social health, and self-esteem and higher anxiety and depression scores than patients not receiving these recommendations.CONCLUSIONSThere are declines in social and emotional functional status in patients presenting to family practice clinicians for health maintenance visits during which recommendations for behavioral change were made. Such declines may inhibit physicians from making recommendations for behavioral change or patients from accepting them.BACKGROUNDPhysicians do not provide preventive care at the level recommended by national organizations. This may be because of physicians' lack of training or low level of confidence or because of patients' fears, beliefs, and lack of health knowledge.","Bowman, M A; Dignan, M; Crandall, S; Baier, M",2000.0,,0,0,
5353,"A randomized controlled trial of cognitive behavior therapy, relaxation training, and routine clinical care for the irritable bowel syndrome","ER METHODSPatients (n = 105) with Rome I criteria for IBS were recruited from advertisement (n = 51) and outpatient clinics (n = 54); those patients with resistant IBS were not included. A randomized controlled trial with three arms (standard care for all groups plus either CBT or relaxation) for 8 wk was conducted, which applied blinded outcome assessments using validated measures with 1 yr of follow-up. The primary outcome for this study was bowel symptom severity.RESULTSOf 105 patients at the commencement of treatment, the mean bowel symptom frequency score for the whole sample was 21.1 and at the end of treatment had fallen to 18.1; this persisted at the 52-wk follow-up, with a significant linear trend for scores to change over time (F = 39.57 p < 0.001). However, there were no significant differences among the three treatment conditions. Significant changes over time were found for physical functioning (F = 4.37, p < 0.001), pain (F = 3.12, p < 0.05), general health (F = 2.71, p < 0.05), vitality (F = 2.94, p < 0.05), and the social functioning scales on the Medical Outcomes Study Short Form 36 (F = 4.08, p < 0.05); however, all three arms showed similar improvement. There were significant reductions in anxiety, depression, and locus of control scales, but no significant differences among the treatment groups were detected.CONCLUSIONCognitive behavior and relaxation therapy seem not to be superior to standard care alone in IBS.OBJECTIVESPsychological treatments are considered to be useful in the irritable bowel syndrome (IBS), although the evidence is based on small, often flawed trials. Although cognitive behavior therapy (CBT) and relaxation therapy have both been promising, we hypothesized that CBT would be superior to relaxation and standard care alone in IBS patients. The objective of this study was to test this assumption by comparing the effects of cognitive behavior therapy with relaxation therapy and routine clinical care alone in individuals with IBS.","Boyce, P M; Talley, N J; Balaam, B; Koloski, N A; Truman, G",2003.0,10.1111/j.1572-0241.2003.07716.x,0,0,
5354,rTMS in fibromyalgia: a randomized trial evaluating QoL and its brain metabolic substrate,"ER OBJECTIVE: This double-blind, randomized, placebo-controlled study investigated the impact of repetitive transcranial magnetic stimulation (rTMS) on quality of life (QoL) of patients with fibromyalgia, and its possible brain metabolic substrate.METHODS: Thirty-eight patients were randomly assigned to receive high-frequency rTMS (n = 19) or sham stimulation (n = 19), applied to left primary motor cortex in 14 sessions over 10 weeks. Primary clinical outcomes were QoL changes at the end of week 11, measured using the Fibromyalgia Impact Questionnaire (FIQ). Secondary clinical outcomes were mental and physical QoL component measured using the 36-Item Short Form Health Survey (SF-36), but also pain, mood, and anxiety. Resting-state [(18)F]-fluorodeoxyglucose-PET metabolism was assessed at baseline, week 2, and week 11. Whole-brain voxel-based analysis was performed to study between-group metabolic changes over time.RESULTS: At week 11, patients of the active rTMS group had greater QoL improvement in the FIQ (p = 0.032) and in the mental component of the SF-36 (p = 0.019) than the sham stimulation group. No significant impact was found for other clinical outcomes. Compared with the sham stimulation group, patients of the active rTMS group presented an increase in right medial temporal metabolism between baseline and week 11 (p < 0.001), which was correlated with FIQ and mental component SF-36 concomitant changes (r = -0.38, p = 0.043; r = 0.51, p = 0.009, respectively). QoL improvement involved mainly affective, emotional, and social dimensions.CONCLUSION: Our study shows that rTMS improves QoL of patients with fibromyalgia. This improvement is associated with a concomitant increase in right limbic metabolism, arguing for a neural substrate to the impact of rTMS on emotional dimensions involved in QoL.CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that rTMS compared with sham rTMS improves QoL in patients with fibromyalgia.","Boyer, L; Dousset, A; Roussel, P; Dossetto, N; Cammilleri, S; Piano, V; Khalfa, S; Mundler, O; Donnet, A; Guedj, E",2014.0,10.1212/WNL.0000000000000280,0,0,
5355,Does routine assessment and real-time feedback improve cancer patients' psychosocial well-being?,"ER This study examined the effectiveness of giving medical oncologists immediate feedback about cancer patients' self-reported psychosocial well-being in reducing those patients' levels of anxiety, depression, perceived needs and physical symptoms. Cancer patients attending one cancer centre for their first visit were allocated to intervention (n = 42) or control (n = 38) groups. All patients completed a computerized survey assessing their psychosocial well-being while waiting to see the oncologist. Intervention patients' responses were immediately scored and summary reports were placed in each patient's file for follow-up. A total of 48 participants (25 intervention and 23 control) completed the survey four times. Intervention patients who reported a debilitating physical symptom at visit 2 were significantly less likely to report a debilitating physical symptom at visit 3 compared with control patients (OR = 2.8, P = 0.04). Reductions in levels of anxiety, depression and perceived needs among intervention patients were not significantly different to control patients. Repeated collection and immediate feedback of patient-reported health information to oncologists has potential to improve patients' symptom control, but has little impact upon emotional well-being, including those at high risk. Future research should consider providing the feedback to other health professionals and patients, and monitor the impact on the process of individual patient care.","Boyes, A; Newell, S; Girgis, A; McElduff, P; Sanson-Fisher, R",2006.0,10.1111/j.1365-2354.2005.00633.x,0,0,
5356,Combined therapy with interpersonal psychotherapy adapted for borderline personality disorder: a two-years follow-up,"ER Few investigations evaluated the long-term effects of psychotherapies in borderline personality disorder (BPD). In a previous study, we compared efficacy of combination of fluoxetine and interpersonal psychotherapy adapted to BPD (IPT-BPD) versus single fluoxetine administered for 32 weeks. This study is aimed to investigate whether the results obtained with the addition of IPT-BPD persist during a follow-up period. Forty-four patients who completed the 32 weeks trial underwent 24 months of follow-up receiving fluoxetine 20-40 mg/day. Clinical Global Impression Severity (CGI-S), Hamilton Rating Scales for Depression and Anxiety (HDRS, HARS), Social and Occupational Functioning Assessment Scale (SOFAS), Satisfaction Profile (SAT-P), and Borderline Personality Disorder Severity Index (BPDSI) were repeated at 6, 12, and 24 months. Statistical analysis was performed with the general linear model. Results showed that most of the differences between combined therapy and single pharmacotherapy at the end of the 32 weeks trial were maintained after 24 months follow-up. The addition of IPT-BPD to medication produced greater effects on BPD symptoms (impulsivity and interpersonal relationships) and quality of life (perception of psychological and social functioning) that endured after termination of psychotherapy. On the contrary, different effects on anxiety symptoms and affective instability were lost after 6 months.","Bozzatello, P; Bellino, S",2016.0,10.1016/j.psychres.2016.04.014,0,0,
5357,Factors influencing outcome following mild traumatic brain injury in adults.,"This study aimed to investigate outcome in adults with mild traumatic brain injury (TBI) at 1 week and 3 months postinjury and to identify factors associated with persisting problems. A total of 84 adults with mild TBI were compared with 53 adults with other minor injuries as controls in terms of postconcussional symptomatology, behavior, and cognitive performance at 1 week and 3 months postinjury. At 1 week postinjury, adults with mild TBI were reporting symptoms, particularly headaches, dizziness, fatigue, visual disturbance, and memory difficulties. They exhibited slowing of information processing on neuropsychological measures, namely the WAIS-R Digit Symbol subtest and the Speed of Comprehension Test. By 3 months postinjury, the symptoms reported at 1 week had largely resolved, and no impairments were evident on neuropsychological measures. However, there was a subgroup of 24% of participants who were still suffering many symptoms, who were highly distressed, and whose lives were still significantly disrupted. These individuals did not have longer posttraumatic amnesia (PTA) duration. They were more likely to have a history of previous head injury, neurological or psychiatric problems, to be students, females, and to have been injured in a motor vehicle accident. The majority were showing significant levels of psychopathology. A range of factors, other than those directly reflecting the severity of injury, appear to be associated with outcome following mild TBI.",Ponsford J.; Willmott C.; Rothwell A.; Cameron P.; Kelly AM.; Nelms R.; Curran C.; Ng K.,2000.0,,0,0,
5358,Characterization of a 7% carbon dioxide (CO2) inhalation paradigm to evoke anxiety symptoms in healthy subjects,"The present study is aimed at characterizing the carbon dioxide (CO 2) procedure in healthy subjects to achieve reliable provocation of anxiety symptoms. Thirty healthy subjects inhaled in single-blind both compressed air and 7% CO2 mixture. Panic Symptom List (PSLIII-R), Visual Analogue Scale-Anxiety (VAS-A), State Anxiety Inventory (STAI-Y/1), respiratory parameters and skin conductance were measured. 'Responders' were classified depending on PSLIII-R scores after CO2. Twelve out of the 21 'responders' performed a second test to assess test-retest repeatability. In 21 subjects Δ%VAS-A (45.4 ± 32.1) and PSLIII-R (pre-test 2.3 ± 2.1, post-test 17.5 ± 8.2) but not STAI-Y/1, significantly increased during CO2 inhalation. Respiratory Rate, Minute Volume, end-Tidal CO2 and skin conductance rose in 'responders'. Repeatability was studied with Bland-Altman plots, revealing mean difference between tests close to 0 for both Δ%VAS-A and PSLIII-R. Among physiologic parameters, end-Tidal CO2 and Respiratory Rate showed good repeatability, with a within-subject CV of 9.2% and 6%, respectively. The challenge produced measurable response in healthy subjects. Good test-retest repeatability was observed in 'responders'. These data indicate that the test can be suitable for testing putative anti-panic or anxiolytic drugs in clinical studies using a within subject, crossover design. © 2005 British Association for Psychopharmacology.",Poma S.Z.; Milleri S.; Squassante L.; Nucci G.; Bani M.; Perini G.I.; Merlo-Pich E.,2005.0,10.1177/0269881105056533,0,0,
5359,Yohimbine premedication and 35% CO2 vulnerability in healthy volunteers,"A group of 20 healthy volunteers underwent a 35% carbon dioxide/65% oxygen air-placebo controlled challenge test twice, premedicated 1 h before with either 20 mg yohimbine or placebo, following a double-blind randomized crossover design. Contrary to expectation the anxiety response to carbon dioxide was not higher when premedicated with yohimbine compared to premedication with placebo. Possible implications of this finding are discussed, with reference to general chemical models of panic.",Pols H.; Griez E.; Verburg K.; Van der Werf D.,1994.0,10.1007/BF02193523,0,0,
5360,Effect of CCK-4 on a 35% carbon dioxide challenge in healthy volunteers,"ER 1. The purpose of this study was to determine whether a subthreshold dose of CCK-4 would enhance the vulnerability of healthy subjects to a 35% carbon dioxide challenge. 2. 27 subjects, with no prior or present psychiatric disorder and in good physical condition were challenged with a vital capacity breath of a 35% carbon dioxide mixture, immediately after an intravenous injection of 5 micrograms CCK-4 or placebo, according to a random order double blind crossover design. 3. Subjects reported significantly less panic symptoms upon carbon dioxide after premedication with CCK-4 than after placebo. 4. Both CCK-4 and carbon dioxide may act on the same neuronal pathways, but seem to inhibit rather than potentiate each other effects.","Pols, H; Griez, E; Bourin, M; Schruers, K",1999.0,,0,0,
5361,Dysfunctional beliefs in the process of change of cognitive treatment in obsessive compulsive checkers.,"Cognitive behaviour therapy (CBT) is considered to be effective in the reduction of obsessive compulsive symptoms. However, questions remain as to how CBT works. Cognitive-behavioural models postulate that negative appraisals of intrusive thoughts and dysfunctional beliefs that give rise to them underlie the development and maintenance of obsessive-compulsive disorder (OCD). The current study aimed to study this hypothesis by investigating the processes of change over the course of cognitive treatment for OCD. Furthermore, a new theoretical approach and method for studying processes of change was presented. The participants were seven patients suffering from OCD with predominantly checking symptoms. Process variables (beliefs, anxiety and compulsions) were measured using idiosyncratic diaries and were analysed on an intra- and inter-individual level using dynamic systems methods. Results showed significant decreases in credibility of dysfunctional beliefs in six out of the seven participants, which is in line with the cognitive-behavioural model. Associations between process variables were in general medium to high. However, the actual patterns of change showed important intra- and interpersonal differences. Results indicated that different paths can lead to clinical recovery, and it was concluded that process studies that focus on individual trajectories of change can contribute to our understanding of OCD and its treatment. Furthermore, dynamic systems methods provide insight into intra-individual processes and shed a new light on variability.",Polman A.; Bouman TK.; van Geert PL.; de Jong PJ.; den Boer JA.,,10.1002/cpp.707,0,0,
5362,Dysfunctional beliefs in the process of change of cognitive treatment in obsessive compulsive checkers,"ER Cognitive behaviour therapy (CBT) is considered to be effective in the reduction of obsessive compulsive symptoms. However, questions remain as to how CBT works. Cognitive-behavioural models postulate that negative appraisals of intrusive thoughts and dysfunctional beliefs that give rise to them underlie the development and maintenance of obsessive-compulsive disorder (OCD). The current study aimed to study this hypothesis by investigating the processes of change over the course of cognitive treatment for OCD. Furthermore, a new theoretical approach and method for studying processes of change was presented. The participants were seven patients suffering from OCD with predominantly checking symptoms. Process variables (beliefs, anxiety and compulsions) were measured using idiosyncratic diaries and were analysed on an intra- and inter-individual level using dynamic systems methods. Results showed significant decreases in credibility of dysfunctional beliefs in six out of the seven participants, which is in line with the cognitive-behavioural model. Associations between process variables were in general medium to high. However, the actual patterns of change showed important intra- and interpersonal differences. Results indicated that different paths can lead to clinical recovery, and it was concluded that process studies that focus on individual trajectories of change can contribute to our understanding of OCD and its treatment. Furthermore, dynamic systems methods provide insight into intra-individual processes and shed a new light on variability.","Polman, A; Bouman, T K; Geert, P L; Jong, P J; Boer, J A",2011.0,10.1002/cpp.707,0,0,
5363,Cognitive behavior therapy for treatment-refractory panic disorder.,"The purpose of this pilot study is to assess the efficacy of cognitive behavior therapy for the treatment of patients with panic disorder who experience an incomplete response to a trial of pharmacotherapy. Fifteen consecutive patients with a DSM-III-R diagnosis of panic disorder referred for further treatment because of an incomplete response to pharmacotherapy were treated with 12-weeks of group cognitive behavior therapy. Patients were evaluated at baseline, endpoint, and at a mean of 2-months' follow-up to assess changes in panic attack frequency and global outcome. Eight of the 15 patients were deemed to have received an inadequate prior trial of medication at baseline, mainly because of a desire to control their symptoms without medication or fear of withdrawal and/or addiction. Seven of the patients were symptomatic at baseline despite an adequate prior trial of medication. Overall, patients experienced a significant improvement in global function at the end of the cognitive behavior therapy intervention, as well as a decrease in panic attack frequency. Improvement was maintained at follow-up. This study is consistent with a growing body of evidence that many patients with panic disorder remain symptomatic over time and are receiving inadequate pharmacotherapeutic treatment. Further, we observed that patients with panic disorder who are incompletely responsive or resistant to pharmacotherapeutic management may benefit from the addition of cognitive behavior therapy.",Pollack MH.; Otto MW.; Kaspi SP.; Hammerness PG.; Rosenbaum JF.,1994.0,,0,0,
5364,Cognitive control of intentions for voluntary actions in individuals with a high level of autistic traits,"Impairments in cognitive control generating deviant adaptive cognition have been proposed to account for the strong preference for repetitive behavior in autism. We examined if this preference reflects intentional deficits rather than problems in task execution in the broader autism phenotype using the Autism-Spectrum Quotient (AQ). Participants chose between two tasks differing in their relative strength by indicating first their voluntary task choice and then responding to the subsequently presented stimulus. We observed a stronger repetition bias for the harder task in high AQ participants, with no other differences between the two groups. These findings indicate that the interference between competing tasks significantly contributes to repetitive behavior in autism by modulating the formation of task intentions when choosing tasks voluntarily. © 2012 The Author(s).",Poljac E.; Yeung N.,2012.0,10.1007/s10803-012-1509-9,0,0,
5365,Olfactory Training Using Heavy and Light Weight Molecule Odors.,"Background Repeated short-term exposure to odors is known to improve olfaction in patients with acquired olfactory dysfunction. The aim was to find out whether differences in molecular weight of odors used for olfactory training influences olfaction. We hypothesized a greater improvement following training with light weight molecule (LWM) odors. Methods A prospective study was performed in patients with posttraumatic (PTOL) and postviral olfactory loss (PVOL). Olfactory training was performed over a period of 5 months. One group ( n‚Äâ=‚Äâ48) used four odors containing heavy weight molecules (HWM; >150‚Äâg/mol) and another ( n‚Äâ=‚Äâ48) containing LWM (<150‚Äâg/mol). Olfaction was tested before and after the training using the Sniffin' Sticks test. Results Olfactory training was associated with olfactory improvement, with the improvement in PVOL patients being three times greater than that seen in the PTOL group. Compared with LWM training, HWM training was associated with a significantly greater improvement in Phenyl Ethyl Alcohol (PEA) threshold scores in PVOL patients; however, no such improvement could be shown for other subtests or in PTOL patients. Conclusion Overall, training was associated with olfactory improvement. With the exception of threshold scores in PVOL, there were no significant differences between LWM and HWM groups.",Poletti SC.; Michel E.; Hummel T.,,10.1177/0301006616672881,0,0,
5366,A modified dexamethasone suppression test for endogenous depression,"ER In order to simplify the dexamethasone suppression test (DST), we have administered a lower dosage of dexamethasone (DEX) and shortened the sampling time to a single morning blood sample. DEX (in dosage increments from 0.125 to 1.0 mg, p.o.) was administered at 2300 h to normal volunteers in a double-blind randomized fashion, and blood samples were taken at 0700 h the following morning. While significant cortisol suppression occurred after the 0.375 mg, 0.5 mg, and 1.0 mg doses of DEX, the 0.5 mg dose was the smallest that clearly suppressed cortisol in all eight subjects. This dose then was used to test the feedback sensitivity of the central nervous system (CNS)-pituitary-adrenal axis in endogenously depressed patients. Twenty endogenously depressed patients and 20 normal volunteers were given both the standard 1.0 mg DST, with post-DEX serum cortisol determined at 1500 h, and the simplified 0.5 mg DST, with post-DEX serum cortisol determined at 0700 h. Four patients (20%) and one control (5%) were nonsuppressors after the 1.0 mg DST, and nine patients (45%) and one control (5%) were nonsuppressors after the 0.5 mg DST. In addition, nine patients with major depression (nonendogenous subtype) and 15 patients with panic attacks also were studied using the 0.5 mg DST. Only 2 of these 24 patients (8%) were nonsuppressors. The results suggest that the single-sample 0.5 mg DST is more sensitive than the standard 1.0 mg DST, and the specificity of the modified test appears comparable to the standard form of the test.","Poland, R E; Rubin, R T; Lane, L A; Martin, D J; Rose, D E; Lesser, I M",1985.0,,0,0,
5367,Comparison of the effectiveness of trauma-focused cognitive behavioral therapy and paroxetine treatment in PTSD patients: design of a randomized controlled trial.,"The two most common interventions for Posttraumatic Stress Disorder (PTSD) are pharmacological treatment with SSRIs such as paroxetine and psychological treatment such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). International guidelines recommend trauma-focused psychological interventions for all PTSD patients as first-line treatment (NICE). However, no clear-cut evidence is available to support this recommendation. In order to compare pharmacological treatment (paroxetine) and psychological treatment (TF-CBT) in (cost-) effectiveness on the short and the long term, we will randomize 90 patients with chronic PTSD to either paroxetine (24 weeks) or TF-CBT (10-12 weeks). We will assess symptom severity and costs before and after the intervention with the Clinician Administered PTSD Scale (CAPS), the Clinical Global Impression Scale (CGI) and the Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness (TiC-P). This study is unique for its direct comparison of the most commonly used psychological intervention (TF-CBT) and pharmacological intervention (paroxetine) on (cost-) effectiveness on the short and the long term. The anticipated results will provide relevant evidence concerning long-term effects and relapse rates and will be beneficial in reducing societal costs. It may also provide information on who may benefit most from which type of intervention. Some methodological issues will be discussed. Dutch Trial registration: NTR2235.",Polak AR.; Witteveen AB.; Visser RS.; Opmeer BC.; Vulink N.; Figee M.; Denys D.; Olff M.,2012.0,10.1186/1471-244X-12-166,0,0,
5368,Lactate and isoproterenol infusions in bulimic patients.,"Compared the responses of 9 female bulimics, 17 female panic disorder patients, and 8 normal female controls during infusions of sodium lactate and isoproterenol in a double-blind, placebo-controlled study. Unlike placebo infusions, sodium lactate and isoproterenol infusions were associated with large increases in anxiety as measured by a panic description scale (PDS) in bulimics and panic disorder Ss. The sensitivity of bulimics to provocative infusions as measured by the PDS, together with a high rate of concurrent panic disorder, suggest that ""panic bulimia"" may be a significant subset of the bulimic population. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pohl, Robert; Yeragani, Vikram K; Balon, Richard; Lycaki, Helene",1989.0,,0,0,
5369,Isoproterenol-induced anxiety states,,"Pohl, R; Rainey, J; Ortiz, A; Balon, R; Singh, H; Berchou, R",1985.0,,0,0,
5370,Plasma MHPG levels in lactate and isoproterenol anxiety states,"ER It has been claimed that an increase in brain noradrenergic activity plays a role in panic disorder and that enhanced noradrenergic activity may be reflected by plasma levels of MHPG. We investigated plasma MHPG levels in panic disorder patients at baseline and during lactate- and isoproterenol-induced anxiety states. These infusions and 5% dextrose infusions were given to 10 panic disorder patients and 9 healthy control subjects. Each subject received all three infusions, double-blind, in random order, and at 1-week intervals. When compared to controls, plasma free MHPG levels in panic patients were not elevated at baseline, during lactate or isoproterenol infusions, at the point of panic, or up to 20 min after the onset of panic. MHPG values were also not elevated in subjects who panicked compared to those who did not. MHPG values were significantly lower in three patients who failed to panic with isoproterenol, but the patient panickers had MHPG values similar to those of controls. Significant correlations between MHPG levels and anxiety ratings were infrequent and could be accounted for by chance alone. These results did not support the noradrenergic model for panic anxiety states induced by lactate or isoproterenol.","Pohl, R; Ettedgui, E; Bridges, M; Lycaki, H; Jimerson, D; Kopin, I; Rainey, J M",1987.0,,0,0,
5371,Effects of ursodeoxycholic acid and taurine on serum liver enzymes and bile acids in chronic hepatitis,"ER Hydrophobic bile acids have been shown to be hepatotoxic, whereas treatment with ursodeoxycholic acid, a hydrophilic bile acid, has improved liver function indices in patients with chronic liver disease. Taurine administration has also been suggested to be useful for chronic hepatitis, taurine-conjugated bile acids being more hydrophilic than glycine-conjugated bile acids. To determine if taurine and ursodeoxycholic acid are beneficial and if their effects are additive, a double-blind, randomized trial was designed comparing the effects of ursodeoxycholic acid, taurine, and a combination of the two on indices of liver injury in 24 patients with chronic hepatitis. They were assigned at random to two of the four following treatments: ursodeoxycholic acid (600 mg/day), taurine (1.5 g/day), ursodeoxycholic acid plus taurine (600 mg + 1.5 g/day) or placebo, given in two successive cycles of 2 mo each, according to a balanced incomplete-block design. Ursodeoxycholic acid became the predominant biliary bile acid when administered alone or in combination with taurine, and taurine conjugate levels increased during taurine administration. Ursodeoxycholic acid reduced aspartate aminotransferase (35%), alanine aminotransferase (33%), and gamma-glutamyl transpeptidase (41%), whereas taurine alone did not. The addition of taurine to ursodeoxycholic acid produced only minor changes in the effects of ursodeoxycholic acid alone. Results were confirmed by the administration of ursodeoxycholic acid, in a successive open phase of the study, to the entire patient population, which was large enough for different subsets of patients to be compared. Serum bile acids were measured at entry and during the open phase: primary bile acids did not change, whereas ursodeoxycholic acid levels increased from trace amounts to very high levels, especially in patients with more severe histological disease. It is concluded that ursodeoxycholic acid, but not taurine, improves enzymatic indices of liver injury in chronic hepatitis.","Podda, M; Ghezzi, C; Battezzati, P M; Crosignani, A; Zuin, M; Roda, A",1990.0,,0,0,
5372,Evaluation of clomipramine as an adjunct to behavioural therapy in the treatment of separation-related problems in dogs.,"Forty-nine dogs showing signs of separation-related problems were randomly assigned to one of three groups: group A (15 dogs) received a placebo twice daily; group B (17 dogs) received clomipramine at 0.5 to 1.0 mg/kg twice daily; and group C (17 dogs) received clomipramine at 1.0 to 2.0 mg/kg twice daily. All the dogs also received behavioural therapy. Their owners were required to complete questionnaires about their dog's behaviour initially, and one, four and eight weeks after the treatment with clomipramine began. Bipolar ratings scales were used to monitor the frequencies of 'general', 'attachment-related' and 'separation-related' behaviours. Kruskal-Wallis tests and Kendall Rank correlations were used to determine any initial differences between the treatment groups, and the association between the initial scores and behavioural changes after one week of treatment with clomipramine. Extended Mantel-Haenszel statistics were used to evaluate the effects of clomipramine treatment versus the placebo, and Page's test was used to assess the effectiveness of behavioural therapy on its own. There were no significant differences in the demographic characteristics of the owners of the dogs assigned to the three groups. The dogs differed slightly in age between groups, and the dogs in the two clomipramine-treated groups were reported as showing problems at a significantly earlier age than those in the placebo group. Clomipramine treatment had a sustained suppressive effect on the dogs' general activity levels, and a more modest suppressive effect on their attachment-related tendency to want much physical contact with their owners. The typical signs of separation-related behaviour problems were not significantly affected by treatment with clomipramine, but behavioural therapy on its own was highly effective in reducing behavioural problems.",Podberscek AL.; Hsu Y.; Serpell JA.,1999.0,,0,0,
5373,Biofeedback as a placebo: anxiety reduction facilitated by training in either suppression or enhancement of alpha brainwaves.,,Plotkin WP.; Rice KM.,1981.0,,0,0,
5374,Correlates of human food neophobia [1],,Pliner P.; Lahteenmaki L.; Tuorila H.,1998.0,10.1006/appe.1997.0086,0,0,
5375,Development of measures of food neophobia in children,"ER In order to construct a behavioral neophobia measure for children, we had 5-, 8- and 11-year-olds choose from ten novel and ten familiar foods which ones they were willing to taste. Meanwhile, their parents indicated their own willingness to taste each of the foods, predicted the children's willingness, estimated the number of times they and their children had eaten the foods, and completed trait measures of food neophobia for themselves and the children. The children's levels of behavioral neophobia were significantly related to both their levels of trait neophobia and their parents' predictions of their willingness to eat the foods (r = 0.38 and 0.34, respectively; p < 0.001). In addition, children's and parents' behavioral and trait neophobia scores were significantly related (both r = 0.31; p < 0.001). Finally, parents but not children were more neophobic with respect to foods of animal (vs. vegetable) origin.","Pliner, P",1994.0,10.1006/appe.1994.1043,0,0,
5376,The effects of fear and hunger on food neophobia in humans,"We examined the effects of hunger and fear on food neophobia in humans. Subjects came to the experiment five or more hours food-deprived (high hunger) or two or less hours food-deprived (low hunger) and were assigned either to give a speech (high fear) or to listen to a speech (low fear). All subjects were then given the task of selecting for tasting one member of each of ten pairs of foods, each pair consisting of one novel and one familiar food. The number of novel foods chosen was the measure of food neophobia (with fewer choices indicative of greater neophobia). The results indicated that subjects were least neophobic in the low fear-low hunger condition and were tentatively interpreted in terms of Hull's theory of behavior. That is, it was assumed that fear and hunger summated to produce different levels of drive in the various conditions, which combined with responses of different habit strength (the tendency to approach novel stimuli and the tendency to approach familiar stimuli) to produce the results obtained.",Pliner P.,1995.0,10.1006/appe.1995.0042,0,0,
5377,Guided self-help versus pure self-help for perfectionism: a randomised controlled trial.,"Perfectionism is known to be a risk factor for the development and maintenance of obsessive-compulsive (OC) and depressive symptoms. The purpose of the present study was to test the effectiveness of a cognitive-behavioural self-help therapy for perfectionism, and to examine the effect of such treatment on OC and depressive symptomatology. The study compares the effectiveness of guided self-help (GSH, n=24) with pure self-help (PSH, n=25) therapy. Both GSH and PSH were found to be effective in reducing perfectionism, and also in reducing OC and depressive symptomatology. Overall, participants in the GSH condition experienced greater symptom improvement than participants in the PSH condition, and treatment gains for both groups were largely maintained at 3-month follow-up. Twenty percent of PSH participants experienced clinically significant increases in depressive symptoms over the treatment and follow-up period (compared to 0% in the GSH condition), suggesting that PSH may be a less suitable strategy than GSH in treating this population. Overall, the findings suggest that self-help for perfectionism is effective in reducing OC and depressive symptomatology in non-clinical individuals, with GSH being superior to PSH.",Pleva J.; Wade TD.,2007.0,10.1016/j.brat.2006.08.009,0,0,
5378,A randomized trial of a nursing intervention to promote the adjustment of children with chronic physical disorders,"ER METHODOLOGYA clinical trial was conducted in which 332 children and their families were randomly assigned either to receive this specialized nursing for a 1-year period, or to remain in the control condition. The children were all active outpatients in nine clinics at the Montreal Children's Hospital. Three measures of psychosocial functioning administered before and after the intervention were the basis for assessing its efficacy. The measures included the behavior problems profile of the Achenbach Child Behavior Checklist, the Personal Adjustment and Role Skills, completed by the parents, and two versions of the Self-Perception Profile (Harter) for children aged 4 to 7 years and 8 to 16 years.RESULTSDifferences between groups were examined both categorically and quantitatively. In the former, the percent of children with clinical scores (those above or below a cut-off indicative of maladjustment) at baseline and postintervention were compared. In the latter, the mean scores at the end of the trial were analyzed using analysis of covariance with the baseline scores as covariates. Statistically significant positive differences were found in the domain of anxiety/depression on the Personal Adjustment and Role Skills, and in the areas of scholastic competence, behavior, and global self-worth on the Harter.CONCLUSIONThe results indicate that this intervention helps children with chronic disorders by preventing or reducing maladjustment. Most university-prepared nurses already have the basic skills required to achieve these results; only a modest investment in reorientation may be needed. Thus, other pediatric centers should be able to replicate these findings and thereby take a major step toward improving the lives of children with chronic disorders.OBJECTIVEThis study was conducted to determine whether a specialized form of nursing could help prevent or reduce psychosocial maladjustment among children, aged 4 to 16 years, with chronic physical disorders. In contrast to other studies, nurses were chosen to provide the intervention based on their central role in health care and the appropriateness of their training for this task.","Pless, I B; Feeley, N; Gottlieb, L; Rowat, K; Dougherty, G; Willard, B",1994.0,,0,0,
5379,Breast cancer patients' experiences of nursing care with the focus on emotional support: the implementation of a nursing intervention,"ER Nursing care with the focus on emotional support, aimed at improving breast cancer patients' adjustment to everyday life, was implemented. The women were offered the opportunity to talk about illness-related thoughts and reactions, as well as to express feelings of anxiety, fear and anguish with a nurse who listened, consoled and answered questions. The organizational changes included extensive co-operation between the surgical ward and primary health care, shorter waiting times, and changed routines around information about the diagnosis. A total of 26 Swedish women, aged 35-69, with newly diagnosed breast cancer, described their experiences of the disease and nursing care in a semi-structured interview 6 months after the primary treatment. Data were coded by open coding; themes and categories were formulated. Findings showed that emotional support, as well as organizational changes of care, led to feelings of safety and security. Most of the women could plan for the future despite a demanding situation. The study indicates that the nursing intervention may improve women's sense of control, and also that further changes in care are needed to meet their psychosocial needs, such as adequate information about medical treatment and more 'confirming' relationships.","Pålsson, M B; Norberg, A",1995.0,,0,0,
5380,The cost-effectiveness of cognitive behavior therapy for borderline personality disorder: results from the BOSCOT trial,"ER Borderline personality disorder places a significant burden on healthcare providers and other agencies. This study evaluated the cost-effectiveness of cognitive behavior therapy plus treatment as usual compared to treatment as usual alone for patients with borderline personality disorder. The economic analysis was conducted alongside a multi-center, randomized controlled trial. The costs of primary and secondary healthcare utilization, alongside the wider economic costs, were estimated from medical records and patient self-report. The primary outcome measure used was the quality-adjusted life year (QALY), assessed using EuroQol. On average, total costs per patient in the cognitive behavior therapy group were lower than patients receiving usual care alone (-689 pounds sterling), although this group also reported a lower quality of life (-0.11 QALYs). These differences were small and did not approach conventional levels of statistical significance. The use of cognitive therapy for borderline personality disorder does not appear to demonstrate any significant cost-effective advantage based on the results of this study.","Palmer, S; Davidson, K; Tyrer, P; Gumley, A; Tata, P; Norrie, J; Murray, H; Seivewright, H",2006.0,10.1521/pedi.2006.20.5.466,0,0,
5381,[Surgical prevention of post-traumatic infection by immediate necrectomy of burn wounds].,"Sepsis is the commonest cause of death following burn injuries. The main source of the bacteria which cause the onset of sepsis is the burn wound itself. We evaluated the question of whether immediate necrectomy versus early necrectomy leads to a decrease in septic complications, as well as posttraumatic lethality. We evaluated 66 patients, 33 of whom underwent immediate necrectomy (i.e., within the first 3 days posttraumatically, group 1); the remaining 33 patients underwent necrectomy in the early posttraumatic phase (from the fourth posttraumatic day, group 2). Following immediate necrectomy (group 1), septic complications developed in 12.1%, as compared to 33.3% in group 2 (p < 0.01). Lathality was significantly reduced in group 1 with 9.1% compared to 21.2% in group 2 (p < 0.01). In this study it was demonstrated that immediate necrectomy versus early necrectomy in young patients leads to a significant decrease of septic complications and lethality following burn injury.",Pallua N.; Machens HG.; Becker M.; Berger A.,1996.0,,0,0,
5382,Is virtual reality always an effective stressors for exposure treatments? Some insights from a controlled trial.,"Several research studies investigating the effectiveness of the different treatments have demonstrated that exposure-based therapies are more suitable and effective than others for the treatment of anxiety disorders. Traditionally, exposure may be achieved in two manners: in vivo, with direct contact to the stimulus, or by imagery, in the person's imagination. However, despite its effectiveness, both types of exposure present some limitations that supported the use of Virtual Reality (VR). But is VR always an effective stressor? Are the technological breakdowns that may appear during such an experience a possible risk for its effectiveness? To answer these questions we compared changes following the exposure to an academic examination, one of the most universal examples of real-life stressors, in a sample of 39 undergraduate students. The same experience was offered using text (TX), audio (AU), video (VD), and VR. However, in the virtual environment we manipulated the experience introducing technological breakdowns. The Post Media Questionnaire (PMQ) and the Slater-Usoh-Steed Presence Questionnaire (SUS) were administered to each participant in order to evaluated self-report measures of anxiety and relaxation and the level of presence experience during media exposure. Electrocardiogram (ECG), Thoracic Respiration Signal (RSP) and Facial corrugator supercilii muscle Electromyography (EMG) were recorded in order to obtain objective measures of subjects' emotional state. Analyses conducted on PMQ showed a significant increase in anxiety scores and a mirror decrease in relax scores after all our emotional procedures, showing that all the condition were effective in inducing a negative emotional response. Psychometric scores and psychophysiological indexes showed that VR was less effective than other procedures in eliciting stress responses. Moreover, we did not observe significative difference in SUS scores: VR induced a sense of presence similar to that experienced during the exposition to other media. Technological breakdowns significantly reduce the possibility of VR eliciting emotions related to complex real-life stressors. Without a high sense of presence, the significant advantages offered by VR disappear and its emotional induction abilities are even lower than the ones provided by much cheaper media.  NCT01683617.",Pallavicini F.; Cipresso P.; Raspelli S.; Grassi A.; Serino S.; Vigna C.; Triberti S.; Villamira M.; Gaggioli A.; Riva G.,2013.0,10.1186/1471-244X-13-52,0,0,
5383,Response Acceleration With Mirtazapine Augmentation of Citalopram in Obsessive-Compulsive Disorder Patients Without Comorbid Depression: A Pilot Study.,"Background: Therapeutic action of selective serotonin reuptake inhibitors (SSRIs) is delayed from 8 to 12 weeks in patients with obsessive-compulsive disorder (OCD). Several different agents have been tested to reduce the SSRI therapeutic latency time. Mirtazapine, an antagonist at alpha2-adrenoceptors, does not enhance serotonin (5-HT) neurotransmission directly but disinhibits the norepinephrine activation of 5-HT neurons and thereby increases 5-HT neurotransmission by a mechanism that may not require a time-dependent desensitization of receptors. The present study was undertaken to determine whether the mirtazapine-citalopram combination could induce an earlier and/or greater effect on the 5-HT system in OCD subjects than citalopram alone. Method: Forty-nine patients with OCD (DSM-IV) without comorbid depression were randomly assigned to a 2-tailed, single-blind, 12-week clinical trial with citalopram (20-80 mg/day) plus placebo or citalopram plus mirtazapine (15-30 mg/day). Assessments were performed weekly with the Yale-Brown Obsessive Compulsive Scale (YBOCS), the Hamilton Rating Scale for Depression, and the Clinical Global Impressions scale. Data were collected from November 2001 to July 2003. Results: The citalopram plus mirtazapine group achieved a reduction of at least 35% in YBOCS score and a ""much improved"" or ""very much improved"" rating on the Clinical Global Impressions-Improvement scale from the fourth week, while the citalopram plus placebo group obtained these results only from the eighth week. The number of responders was higher in the citalopram plus mirtazapine group at the fourth week of treatment, while no difference between groups in the response rate was noted at the eighth and twelfth weeks of treatment. Conclusions: We found an earlier onset of response action in OCD symptoms and reduced undesired side effects when mirtazapine was added to citalopram. This augmentation strategy deserves clinical and research consideration through further double-blind, placebo-controlled studies. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Pallanti, Stefano; Quercioli, Leonardo; Bruscoli, Matteo; Basson, Bezchlibnyk-Butler, Blier, Carpenter, Carpenter, Guy, Farah, First, First, Goodman, Hamilton, Koran, Marek, McGahuey, Montgomery, Mundo, Nutt, Nutt, Pallanti, Pallanti, Pallanti, Pauls, Pedersen, Quitkin, Ruwe, Saxena, Szegedi, Thompson, Thomsen",2004.0,,0,0,
5384,Smooth-pursuit eye movement and saccadic intrusions in obsessive-compulsive disorder.,"Although several reports agree that smooth-pursuit eye movement (SPEM) is abnormal in some obsessive-compulsive disordered (OCD) patients, differences between treatments and lack of accuracy in control selection make the results controversial. Although reduced gain seems the most accepted abnormality, the characteristics of saccadic disruption of smooth pursuit are as yet unspecified. SPEMs in 21 OCD patients (DSM-III-R) and 21 healthy subjects recruited from the community were studied through a multiple target velocity task . The two groups were individually matched on age, gender, and level of education. None of the subjects had a history of substance dependence apart from the smokers who refrained from smoking in the 2 hours prior to the test. A significantly lower SPEM gain and increased number and frequency of anticipatory saccades (ASs) was found in OCD patients as compared with control subjects. No relationship emerged between eye movement abnormalities and clinical variables explored.",Pallanti S.; Grecu LM.; Gangemi PF.; Massi S.; Parigi A.; Arnetoli G.; Quercioli L.; Zaccara G.,1996.0,,0,0,
5385,Exploring pain processing differences in native americans,"Objective: Several chronic pain conditions are more prevalent in Native Americans than in any other group in the United States; however, little has been done to identify factors contributing to this disparity. The study presented here was designed to examine whether there were pain processing differences in Native Americans relative to non-Hispanic White controls. Methods: Participants were healthy, pain-free Native Americans (n 22, 8 females) and non-Hispanic Whites (n 20, 7 females). Pain processing was assessed from electric pain threshold/tolerance, ischemia pain threshold/tolerance, nociceptive flexion reflex threshold (NFR; an electrophysiological measure of spinal nociception), pain ratings of suprathreshold electric stimuli, and temporal summation of pain and NFR (an electrophysiological measure of spinal cord sensitization). The institutional review board approved all procedures. Results: Compared to non-Hispanic Whites, Native Americans had dampened pain perception (higher ischemia pain tolerance, higher electric pain threshold, lower ratings of electric stimuli). Additionally, temporal summation of NFR was reduced in Native Americans, suggesting sensitization was reduced at the spinal level. Conclusions: Findings suggest Native Americans have dampened pain and pain signaling, perhaps due to overactivation of descending pain inhibition mechanisms. Given research indicating that other ethnic groups at risk for chronic pain (e.g., African Americans) show enhanced pain and enhanced central sensitization on experimental pain measures, chronic pain risk could be different for Native Americans, thus emphasizing the need for different treatment interventions. © 2013 American Psychological Association.",Palit S.; Kerr K.L.; Kuhn B.L.; Terry E.L.; DelVentura J.L.; Bartley E.J.; Shadlow J.O.; Rhudy J.L.,2013.0,10.1037/a0031057,0,0,
5386,"Longitudinal examination of mood, coping with cancer and post-traumatic distress on sleep disturbance in breast and prostate cancer survivors","PURPOSE: Previous research has shown that cancer survivors are more likely to experience sleep disturbance than the general population. However, little is known about the natural progression and predictors of sleep disturbance associated with cancer and cancer treatment. The purpose of this study was to characterize and compare the sleep disturbance reported by Breast Cancer (BC) and Prostate Cancer (PC) survivors. METHODS: Participants completed the Profile of Mood States (POMS), the Mini Mental Adjustment to Cancer (MAC), the Impact of Events Scale (IES) and the Stanford Sleep Questionnaire between 6 and 24 months post treatment (T1) and again at 24-month follow-up (T2). RESULTS: BC (N= 353; mean age= 50) and PC (N = 315; mean age = 66) survivors recruited for two large, randomized controlled trials provided information on sleep disturbance at T1 and T2. BC survivors reported significantly higher levels of moderate to severe sleep disturbance (31.4%) compared to PC (11.4%) at T1 and the differences remained at T2 (all p<0.0001). There were significant changes in reported symptoms for both groups from T1 to T2 (p= .004); both groups reported improvement in levels of sleep symptoms. There were no significant differences between the two groups in rates of persistence and remission in sleep disturbance. Moderate to severe levels of sleep disturbance persisted in 41.8% of survivors from T1 to T2, with 58.2% going into remission. At T2, 9.9% of those who slept well at T1 developed significant sleep disturbance. Mood disturbance (POMS) and traumatic stress symptoms (IES) at baseline, but not coping with cancer (MAC), emerged as consistent and significant predictors of sleep disturbance at T2; these relationships were stronger in PC compared to BC. CONCLUSIONS: These data show that BC survivors have nearly 3 times more sleep disturbance compared to PC survivors and that these sleep difficulties persist for a significant proportion of BC and PC survivors. RESEARCH IMPLICATIONS: Further research is needed to understand the relationship between psychological sequelae of cancer-specific diagnoses and the development and progression of sleep disturbances. CLINICAL IMPLICATIONS: Clinicians need to be aware that cancer survivors have persistent sleep disturbances after their cancer treatment is over. Mood and stress rather than coping predict sleep disturbance in cancer survivors.",Palesh O.; Purnell J.; Peppone L.; Mustian K.; Janelsins M.; Mohile S.; Spiegel D.; Morrow G.,2010.0,10.1002/pon.1689,0,0,
5387,A phase III randomized prospective trial of the effect of psychotherapy on distress in 287 prostate cancer patients: A URCC CCOP Study,"Background: Cancer patients suffer from significant psychological distress, including mood and anxiety disorders. Psychiatric disorders are common in cancer and affect 22 to 43% of cancer patients. We previously showed that Supportive Expressive Group Therapy (SET) was effective in reducing distress in women with metastatic breast cancer. The current study expands our earlier research and examines the effect of SET on mood disturbance in prostate cancer patients. Methods: A sample of 318 cancer patients diagnosed with prostate cancer was assessed for mood disturbances by 9 geographically distinct URCC CCOP affiliates. The patients were randomly assigned to receive either 12 weeks of SET or education materials as a control. Patient-reported mood disturbance was assessed using the Profile of Mood States (POMS), a psychometrically valid and reliable measure of mood states, at baseline, 3, 6, 12, 18 and 24 months. Differences between treatment and control groups at follow-up were tested using a mixed-ANOVA model. The dependent variable was individual slopes on the POMS. Results: 287 patients (142 SET and 145 controls) provided complete data. No significant overall effect of intervention on mood was found (p=0.49) and the interaction between baseline mood scores and treatment arm was non-significant (p=0.075). There was a significant main effect for baseline mood (p<0.0001) suggesting that those who have the greatest mood disruption at baseline improve with time independently of treatment arm. Conclusions: This is the first large randomized clinical trial using group psychotherapy among men with prostate cancer. Results suggest that a brief SET intervention does not improve distress among men with prostate cancer. Future studies might consider recruiting patients with particular psychosymptomatology and tailoring interventions.",Palesh O.; Mustian K.; Heckler C.; Purnell J.; Peppone L.; Weiss M.; Atkins J.N.; Dakhil S.R.; Spiegel D.; Morrow G.,2009.0,,0,0,
5388,Problem-solving skills training for parents of children with chronic pain: a pilot randomized controlled trial,"ER This pilot randomized controlled trial aimed to determine the feasibility, acceptability, and preliminary efficacy of parental problem-solving skills training (PSST) compared with treatment as usual on improving parental mental health symptoms, physical health and well-being, and parenting behaviors. Effects of parent PSST on child outcomes (pain, emotional, and physical functioning) were also examined. Participants included 61 parents of children aged 10 to 17 years with chronic pain randomized to PSST (n 31) or treatment as usual (n 30) groups. Parents receiving PSST participated in 4 to 6 individual sessions of training in problem-solving skills. Outcomes were assessed at pretreatment, immediately after treatment, and at a 3-month follow-up. Feasibility was determined by therapy session attendance, therapist ratings, and parent treatment acceptability ratings. Feasibility of PSST delivery in this population was demonstrated by high compliance with therapy attendance, excellent retention, high therapist ratings of treatment engagement, and high parent ratings of treatment acceptability. PSST was associated with posttreatment improvements in parental depression (d -0.68), general mental health (d 0.64), and pain catastrophizing (d -0.48), as well as in child depression (d -0.49), child general anxiety (d -0.56), and child pain-specific anxiety (d -0.82). Several effects were maintained at the 3-month follow-up. Findings demonstrate that PSST is feasible and acceptable to parents of youths with chronic pain. Treatment outcome analyses show promising but mixed patterns of effects of PSST on parent and child mental health outcomes. Further rigorous trials of PSST are needed to extend these pilot results.","Palermo, T M; Law, E F; Bromberg, M; Fales, J; Eccleston, C; Wilson, A C",2016.0,10.1097/j.pain.0000000000000508,0,0,
5389,Designing a comparative study of escitalopram versus risperidone for the treatment of behavioral and psychological symptoms in Alzheimer's disease,"Objective: Dementia is a multidimensional disease characterized by progressive cognitive impairment, behavioral symptoms and decline in activities of daily living. The behavioral and psychological symptoms of dementia (BPSD) have an adverse impact on patients' quality of life and create severe stress for caregivers, complicating effective management and precluding the decision to institutionalize patients. Most patients with dementia ultimately require pharmacological interventions to manage BPSD. Agents used include: antipsychotics, anxiolytics, antidepressants, beta-blockers and anticonvulsants. Second generation antipsychotic (SGA) drugs are widely used to treat psychosis, aggression and agitation in patients with Alzheimer's disease, but their benefits are uncertain and adverse effects offset advantages in their efficacy. Recently, in response to a meta-analysis reflecting prospective data, the FDA issued a black-box warning stating that SGAs increase mortality among elderly patients due to increased risk of cerebrovascular events. We have thus devised a study to compare escitalopram and risperidone for the treatment of psychosis and agitation associated with dementia of the Alzheimer's type. Methods: A 6-week randomized, controlled trial of BPSD in patients with Alzheimer's disease hospitalized due to these behavioral symptoms was designed by the psychogeriatric department, Abarbanel Mental Health Center, Israel. Participants will be consecutively recruited if they had at least one moderate to severe target symptom (aggression, agitation, hostility, suspiciousness, hallucinations, delusions). Sample size calculation: In order to record at least a 25% improvement in Neuropsychiatric Inventory (NPI) total score a minimal number of 40 patients equally divided in two arms would give an 85% power with a standard deviation of 0.70. The primary outcome measure is the change in the NPI total score. Planned pre-post and mixed model analyses of the main outcome measures of MMSE at base line, NPI and side effects reporting at baseline and at weekly intervals will be carried out. Hypothesis: Our a-priori hypotheses was that risperidone would be more efficacious for psychosis and escitalopram for agitation and that these compounds will differ in tolerability.",Paleacu D.; Plopsky I.; Tadger S.; Barak Y.,2010.0,10.3109/13651501.2010.527734,0,0,
5390,Effect of music therapy on state anxiety in patients undergoing flexible sigmoidoscopy,"PURPOSE: Patient anxiety related to flexible sigmoidoscopy can negatively affect acceptability and compliance with screening protocol, complicate and prolong procedure time, and potentially result in prematurely aborted procedures. Music has been recognized through research as a safe, inexpensive, and effective nonpharmaceutical anxiolitic agent. METHODS: An experimental study was performed on 50 adults scheduled for outpatient sigmoidoscopy. The control group received standard sigmoidoscopy protocol. Subjects in the experimental group received the standard protocol with the addition of listening to music throughout the procedure. State-Trait Anxiety Inventory (STAI) measurements were performed on all subjects before and postsigmoidoscopy. Physiologic recordings of heart rate and mean arterial pressure were recorded before and during the procedure. RESULTS: Patients who listened to self-selected music tapes during the procedure had significantly decreased STAI scores (P < 0.002), heart rates (P < 0.03), and mean arterial pressures (P < 0.001) in comparison to the control subjects. CONCLUSION: The results of the study indicate that music is an effective anxiolitic adjunct to flexible sigmoidoscopy.",Palakanis K.C.; DeNobile J.W.; Sweeney W.B.; Blankenship C.L.,1994.0,,0,0,
5391,Developing a sociological framework for dually diagnosed women.,"Studied social stressors and the incidence of a comorbid diagnosis among women in a residential therapeutic community for substance abuse treatment. Women were assessed at the beginning of treatment and 6 mo after leaving the program. Baseline assessments were completed for 143 18-37 yr old women. Clinically significant scores on measures of antisocial and borderline personality were noted for 116 women, 68 of whom completed 6-mo posttreatment assessments. Assessments noted history of abuse, delinquent or criminal behavior, arrests, and number of drugs used. Outcome variables were whether patients were arrest-free, drug-free, and reunited with children. Women with histories of delinquent and/or criminal behavior were more likely to have used more types of drugs and multiple drugs. These women also tended to have a history of being abused emotionally (57.1%), physically (48.9%), or sexually (39.7%). This group was also less successful on all outcome measures at the 6-mo follow-up. These results are consistent with research that indicates abuse plays a central role in the development and chronic effect of personality disorders and, in particular, posttraumatic stress disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Palacios, Wilson R; Urmann, Catherine F; Newel, Richard; Hamilton, Nancy; Andersen, Boyd, Boyd, Boyd, Boyd, Briere, Brown, Brown, Cammaert, Carmen, Chatham, Chesney-Lind, Chodorow, Coletti, Courtois, DeLeon, Drake, Dunn, Eth, Evans, Gilligan, Goldberg, Hagan, Harley, Harris, Henderson, Herman, Hien, Howard, Hubbard, Janikowski, Lesswing, Lindberg, Lindemann, Lindenberg, McLellan, Mendelson, Miller, Millon, Minkoff, Ouimette, Pavkov, Pohl, Rosenbaum, Rosenberg, Rosenheck, Salzman, Schliebner, Senna, Southwick, Spitzer, Stephens, Teets, Terr, Van der Kolk, Zweben",1999.0,,0,0,
5392,Agreement between telerehabilitation and face-to-face clinical outcome assessments for low back pain in primary care,"ER STUDY DESIGN: A descriptive study of repeated measures using a crossover design.OBJECTIVE: To determine the level of agreement between assessments obtained via telerehabilitation and those obtained by traditional face-to-face method in a population of individuals with chronic low back pain (LBP) in a primary care setting.SUMMARY OF BACKGROUND DATA: Musculoskeletal assessment using telerehabilitation has shown adequate inter- and intrarater agreement and concordance with face-to-face clinical assessment in different diseases. There have been no published studies on the reliability of a telerehabilitation system to assess LBP.METHODS: Fifteen individuals (6 males; mean age, 37 yr) with chronic LBP attended a session for a clinical interview, followed by face-to-face and real-time online telerehabilitation evaluations. There was a 30-minute interval between the 2 assessments, the order of which was randomly selected for each patient. The telerehabilitation system used an Internet application conducted via Internet connection (17 kB/s) between 2 personal computers. Real-time video connection facilitated communication between the therapist and the subject. Outcome measures included lumbar spine mobility, Sorensen test, anterior straight leg raise test, Oswestry Disability Index, visual analogue scale for pain, 12-Item Short Form Health Survey questionnaire, and Tampa Kinesiophobia Scale.RESULTS: The ? reliability between face-to-face and telerehabilitation evaluations was more than 0.80 for 7 of the 9 outcome measures. Lowest reliability was for lateral flexion range of motion (?= 0.75). Very good inter- and intrarater intraclass correlation coefficients (?) were obtained (0.92-0.96).CONCLUSION: The findings of our pilot study suggest that this telerehabilitation system may be useful to assess individuals with chronic LBP, providing initial support for its implementation in primary care.LEVEL OF EVIDENCE: 2.","Palacín-Marín, F; Esteban-Moreno, B; Olea, N; Herrera-Viedma, E; Arroyo-Morales, M",2013.0,10.1097/BRS.0b013e318281a36c,0,0,
5393,Patients' resilience and distress over time: Is resilience a prognostic indicator of treatment?,"Resilience is a positive adaptation or the ability to maintain mental health despite experiencing difficulty. Many researchers are linking resilience with many aspects of life, most often with better mental health. Resilience can affect health status and symptoms, but conversely, it can also be affected by health status or symptoms. From the literature it appears that resilience can even be a predictor of psychiatric symptoms. Resilience can predict severity of symptoms, but the question is whether symptoms can also affect resilience over time when previous levels of resilience are controlled for. The aim of this study was to explore the relationship of resilience scores and the expression of distress in the context of treatment over time. Ninety-five patients diagnosed with affective and anxiety disorders from a clinical sample treated psychotherapeutically with (N=81) or without (N=14) a pharmacological treatment at a psychotherapy day center participated in the study. All the participants were assessed three times: at the beginning of the treatment, after treatment (after 6weeks), and after a follow-up interval of 6months after the end of therapy. The Resilience Scale for Adults and the Clinical Outcomes in Routine Evaluation Outcome Measure were used in the study. All distress indicators were expressed more before the treatment compared to right after the treatment or half a year after the treatment. Distress indicators were more stable from Time 1 to Time 2, while from Time 2 to Time 3 they were less stable. In this study, resilience increased during the treatment and stayed stable after the treatment. Looking at bidirectional relationships between distress indicators and resilience over time, the results of this study suggest that levels of resilience have a prognostic value for the reduction of symptoms over the course of treatment. However, decrease in distress does not predict increase in resilience. Levels of resilience measured by RSA scores seem to have a certain prognostic value for the reduction of symptoms over the course of treatment. Perception of self was the strongest predictor of lower levels of distress over time when distress and perception of self-stability are controlled for. Results suggest that decreased distress indicators are not directly related to increasing resilience over six weeks or over six months. Considering that resilience is rather stable over time and indicators are less stable, it is possible that resilience could be increased by personal or environmental factors, and a decrease in distress is not a contributing factor. In this study distress decreased over time, while resilience characteristics increased for the whole sample. Patients in this study underwent treatment, and decreases in global distress were a result of treatment. An increase in resilience over time supports the effectiveness of treatment. However, there were no significant differences between treatment types while evaluating models. Results suggest that treatments (psychotherapy or psychopharmacological with psychotherapy) were equally effective for the chosen patients.",Pakalniškienė V.; Viliūnienė R.; Hilbig J.,2016.0,10.1016/j.comppsych.2016.05.010,0,0,
5394,Efficacy of two versions of emotion-focused therapy for resolving child abuse trauma,"ER This study evaluated and compared emotion-focused therapy for trauma (EFTT) with imaginal confrontation (IC) of perpetrators (n=20) and EFTT with empathic exploration (EE) of trauma material (n=25). Clients were women and men with histories of different types of childhood maltreatment (emotional, physical, and sexual abuse; emotional neglect). Clients were randomly assigned to treatment condition. Outcome measures assessed symptom distress, self and interpersonal problems, and abuse resolution. Results indicated statistically and clinically significant improvements on eight measures at posttest, maintenance of gains at follow-up, and no statistically significant differences between conditions. There were higher rates of clinically significant change in IC and a lower attrition rate for EE (7% vs. 20%). More severe personality pathology negatively influenced some dimensions of outcome, particularly in EE.","Paivio, S C; Jarry, J L; Chagigiorgis, H; Hall, I; Ralston, M",2010.0,10.1080/10503300903505274,0,0,
5395,Efficacy of emotion focused therapy for adult survivors of child abuse: A preliminary study.,"Examined the effectiveness of Emotion Focused Therapy (EFT) with 32 adult survivors (mean age 36 yrs) of childhood abuse (emotional, physical, and sexual). EFT consisted of a 20-wk individual psychotherapy based on current emotion theory and experiential therapy theory and research. The study employed a quasi-experimental design in which clients, who met screening criteria, were assigned to therapy or a variably delayed therapy condition. Data were obtained from pre- and post-therapy posttraumatic stress disorder (PTSD) symptom severity measures. Results show that clients receiving EFT achieved significant improvements in multiple domains of disturbance. Clients in the delayed treatment condition showed minimal improvements over the wait interval but after EFT showed significant improvements comparable to the immediate therapy group. These effects were maintained at 9 mo (on average) follow-up. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Paivio, Sandra C; Nieuwenhuis, James A; Alexander, Battle, Benjamin, Bernstein, Bernstein, Beutler, Briere, Chrits-Christoph, Derogatis, Foa, Foa, Fridja, Gaston, Greenberg, Greenberg, Greenberg, Herman, Horowitz, Horowitz, Horvath, Jacobson, Lambert, Malan, Mitchell, Morgan, Paivio, Paivio, Paivio, Resick, Solomon, Wilson, Zlotnik",2001.0,,0,0,
5396,New method for the determination of bile acids in human plasma by liquid-phase microextraction using liquid chromatography-ion-trap-time-of-flight mass spectrometry,"ER Bile acids (BAs) are derived from cholesterol and produced in the liver. The most abundant bile acids in humans are usually conjugated with glycine and taurine and are divided into primary BAs such as cholic acid (CA) and chenodeoxycholic acid (CDCA) and secondary BAs like deoxycholic acid (DCA), lithocholic acid (LCA) and ursodeoxycholic acid (UDCA). The differences amongst individual bile acids (BAs) are significant in order to distinguish different pathological processes and exposure to chemical compounds. Hollow fiber based liquid-phase microextraction (HF-LPME) is a technique that combines sample cleansing, extraction and the concentration of analytes, where a hydrophobic porous capillary membrane is impregnated with an organic extraction solvent and the lumen is filled with microliters of a phase acceptor both organic by nature. The aim of this study was to develop a new method to extract bile acids from plasma through HF-LPME of two phases (octanol as the acceptor phase) using LCMS-IT-TOF. The optimized two-phased LPME procedure for the extraction of bile acids showed limits of detection 1.0 ?g L(-1) and limits of quantification of 5.0 ?g L(-1). The intra-assay precision ranged from 2.1 to 11.9%. The method developed was linear over the range of 5.0-200.0 ?g L(-1) for all analytes. The hollow-fiber liquid-phase microextraction method was applied to human plasma from workers exposed to organic and halogenated solvents and also to unexposed volunteers. The method is simple, low cost and it does not require large amounts of organic solvents, therefore it is quite suitable for the analysis of bile acids exposed to hepatotoxic compounds.","Paiva, M J; Menezes, H C; Silva, J C; Resende, R R; Cardeal, Zde L",2015.0,10.1016/j.chroma.2015.02.016,0,0,
5397,Cost-Effectiveness of Collaborative Care for Depression in HIV Clinics,"ER Objective: To examine the cost-effectiveness of the HIV Translating Initiatives for Depression Into Effective Solutions (HITIDES) intervention. Design: Randomized controlled effectiveness and implementation trial comparing depression collaborative care with enhanced usual care. Setting: Three Veterans Health Administration HIV clinics in the Southern United States. Subjects: Two hundred forty-nine HIV-infected patients completed the baseline interview; 123 were randomized to the intervention and 126 to usual care. Intervention: HITIDES consisted of an offsite HIV depression care team that delivered up to 12 months of collaborative care. The intervention used a stepped-care model for depression treatment, and specific recommendations were based on the Texas Medication Algorithm Project and the VA/Department of Defense Depression Treatment Guidelines. Main Outcome Measures: Quality-adjusted life years (QALYs) were calculated using the 12-Item Short Form Health Survey, the Quality of Well Being Scale, and by converting depression-free days to QALYs. The base case analysis used outpatient, pharmacy, patient, and intervention costs. Cost-effectiveness was calculated using incremental cost-effectiveness ratios (ICERs) and net health benefit. ICER distributions were generated using nonparametric bootstrap with replacement sampling. Results: The HITIDES intervention was more effective and cost saving compared with usual care in 78% of bootstrapped samples. The intervention net health benefit was positive and therefore deemed cost-effective using an ICER threshold of $50,000/QALY. Conclusions: In HIV clinic settings, this intervention was more effective and cost saving compared with usual care. Implementation of offsite depression collaborative care programs in specialty care settings may be a strategy that not only improves outcomes for patients but also maximizes the efficient use of limited health care resources.","Painter, J T; Fortney, J C; Gifford, A L; Rimland, D; Monson, T; Rodriguez-Barradas, M C; Pyne, J M",2015.0,10.1097/QAI.0000000000000732,0,0,
5398,Realignment surgery as alternative treatment of varus and valgus ankle osteoarthritis.,"In patients with asymmetric (varus or valgus) ankle osteoarthritis, realignment surgery is an alternative treatment to fusion or total ankle replacement in selected cases. To determine whether realignment surgery in asymmetric ankle osteoarthritis relieved pain and improved function, we clinically and radiographically followed 35 consecutive patients with posttraumatic ankle osteoarthritis treated with lower leg and hindfoot realignment surgery. We further questioned if outcome correlated with achieved alignment. The average patient age was 43 years (range, 26-68 years). We used a standardized clinical and radiographic protocol. Besides distal tibial osteotomies, additional bony and soft tissue procedures were performed in 32 patients (91%). At mean followup of 5 years (range, 3-10.5 years), pain decreased by an average of 4 points on a visual analog scale; range of ankle motion increased by an average of 5 degrees . Walking ability and the functional parts of the American Foot and Ankle Society score increased by an average of 10 and 21 points, respectively, and correlated with achieved reversal of tibiotalar tilt and the score of Takakura et al. Revision surgery was performed in 10 ankles (29%), of which three ankles (9%) were converted to total ankle replacement. We believe the data support realignment surgery for patients with asymmetric ankle osteoarthritis.",Pagenstert GI.; Hintermann B.; Barg A.; Leumann A.; Valderrabano V.,2007.0,10.1097/BLO.0b013e318124a462,0,0,
5399,Outcomes for Depressed and Anxious Inpatients Discharged Before or After Group Cognitive Behavior Therapy: A Naturalistic Comparison.,"Treatment outcomes for psychiatric inpatients with a primary diagnosis of a depressive or anxiety disorder who completed a cognitive behavior therapy (CBT) program while inpatients or when discharged were examined. Of 340 inpatients, 197 had been discharged to day patient status before the end of the CBT program, and 143 remained as inpatients. Data were collected before and after the CBT program and at 3-month follow-up. There was a significant improvement by posttreatment in self-esteem, locus of control, anxiety, depression, and stress, and these gains were maintained at 3-month follow-up. In addition, anxious, but not depressed, patients who completed CBT as day patients demonstrated greater improvements from after the CBT program to follow-up than those treated as inpatients. Possible reasons for the beneficial effects of completing the CBT as a day patient rather than an inpatient are discussed, and threats to the validity of this naturalistic study are considered. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Page, Andrew C; Hooke, Geoffrey R; Andrews, Andrews, Andrews, Bebbington, Beck, Bower, Craig, Creamer, Duff, Ellis, Foster, Hickie, Hooke, Kasarabada, Kazantzis, Lovibond, MacKenzie, Manning, Marshall, McGinn, Miller, Moos, Nathan, Page, Page, Rosenberg, Schulte, Sledge, Sledge, Smith, Wickizer, Wing",2003.0,,0,0,
5400,A cembranoid from tobacco prevents the expression of nicotine-induced withdrawal behavior in planarian worms,"Using an adaptation of published behavioral protocols, we determined that acute exposure to the cholinergic compounds nicotine and carbamylcholine decreased planarian motility in a concentration-dependent manner. A tobacco cembranoid (1S,2E,4R,6R,7E,11E)-cembra-2,7,11-triene-4,6-diol (4R-cembranoid), also decreased planarian motility. Experiments in the presence of 1 μM 4R-cembranoid did increase the IC50 for nicotine- but not carbamylcholine-induced decrease in planarian motility. When planarians were exposed for 24 h to either nicotine or carbamylcholine at concentrations near their respective IC50 values and then transferred to plain media, nicotine-exposed, but not carbamylcholine- or cembranoid-exposed worms displayed withdrawal-like distress behaviors. In experiments where planarians were pre-exposed to 100 μM nicotine for 24 h in the presence of 1 μM 4R-cembranoid, the withdrawal-like effects were significantly reduced. These results indicate that the 4R-cembranoid might have valuable applications for tobacco abuse research. This experimental approach using planarians is useful for the initial screening of compounds relevant to drug abuse and dependence. © 2009 Elsevier B.V. All rights reserved.",Pagán O.R.; Rowlands A.L.; Fattore A.L.; Coudron T.; Urban K.R.; Bidja A.H.; Eterović V.A.,2009.0,10.1016/j.ejphar.2009.05.022,0,0,
5401,Effects of EMDR psychotherapy on 99mTc-HMPAO distribution in occupation-related post-traumatic stress disorder.,"Post-traumatic stress disorder (PTSD) is a derangement of mood control with involuntary, emotionally fraught recollections that may follow deep psychological trauma in susceptible individuals. This condition is treated with pharmacological and/or cognitive therapies as well as psychotherapy with eye movement desensitization and reprocessing (EMDR). However, only a very limited number of studies have been published dealing with work-related PTSD, and investigations on the effect of treatment on cerebral blood flow represent an even smaller number. To investigate the short-term outcome of occupation-related PTSD after EMDR therapy by 99mTc-HMPAO SPECT. Fifteen patients, either train drivers suffering from PTSD after having been unintentionally responsible for a person-under-train accident or employees assaulted in the course of duty, were recruited for the study. 99mTc-HMPAO SPECT was performed on these patients both before and after EMDR therapy while they listened to a script portraying the traumatic event. Tracer distribution analysis was then carried out at volume of interest (VOI) level using a three-dimensional standardized brain atlas, and at voxel level by SPM. The CBF data of the 15 patients were compared before and after treatment as well as with those of a group of 27 controls who had been exposed to the same psychological traumas without developing PTSD. At VOI analysis significant CBF distribution differences were found between controls and patients before and after treatment (P=0.023 and P=0.0039, respectively). Eleven of the 15 patients responded to treatment, i.e., following EMDR they no longer fulfilled the DSM-IV criteria for PTSD. When comparing only the eleven responders with the controls, the significant group difference found before EMDR (P=0.019) disappeared after treatment. Responders and non-responders showed after therapy significant regional differences in frontal, parieto-occipital and visual cortex and in hippocampus. SPM analysis showed significant uptake differences between patients and controls in the orbitofrontal cortex (Brodmann 11) and the temporal pole (Brodmann 38) both before and after treatment. A significant tracer distribution difference present before treatment in the uncus (Brodmann 36) disappeared after treatment, while a significant difference appeared in the lateral temporal lobe (Brodmann 21). Significant 99mTc-HMPAO uptake regional differences were found, mainly in the peri-limbic cortex, between PTSD patients and controls exposed to trauma but not developing PTSD. Tracer uptake differences between responders and patients not responding to EMDR were found after treatment suggesting a trend towards normalization of tracer distribution after successful therapy. These findings in occupational related PTSD are consistent with previously described effects of psychotherapy on anxiety disorders.",Pagani M.; Högberg G.; Salmaso D.; Nardo D.; Sundin O.; Jonsson C.; Soares J.; Aberg-Wistedt A.; Jacobsson H.; Larsson SA.; Hällström T.,2007.0,10.1097/MNM.0b013e3282742035,0,0,
5402,Pregabalin augmentation of antidepressants in patients with accident-related posttraumatic stress disorder: An open label pilot study,"This study evaluated the efficacy of pregabalin augmentation of antidepressant treatment in patients with posttraumatic stress disorder (PTSD). Nine patients meeting Diagnostic and Statistical Manual, fourth edition criteria for PTSD who were on stable doses of antidepressants were treated open label with flexibly dosed pregabalin for 6 weeks. All patients were assessed with the Short PTSD Rating Interview, Montgomery-Asberg Depression Rating Scale, Patient Global Impression-severity, Visual Analog Scale-pain, and Sheehan Disability Scale at baseline and weeks 2, 4, and 6. Significant reductions were observed in all effectiveness measures from week 4 to the end of the study. In particular, the numerical improvement of the Visual Analog Scale-pain score was most robust (-53.4%, P =0.007). Pregabalin augmentation was effective and well tolerated during the study. Our findings warrant adequately powered, placebo-controlled clinical trials to confirm the usefulness of pregabalin augmentation of antidepressants in patients with PTSD.",Pae C.,2009.0,10.3109/13651500903375487,0,0,
5403,Predictors of anxiety and depression among people attending diabetes screening: a prospective cohort study embedded in the ADDITION (Cambridge) randomized control trial.,"This study aimed to identify factors predicting anxiety and depression among people who attend primary care-based diabetes screening. A prospective cohort study embedded in the ADDITION (Cambridge) randomized control trial. Participants (N= 3,240) at risk of diabetes were identified from 10 primary care practices and invited to a stepwise screening programme as part of the ADDITION (Cambridge) trial. Main outcome measures were anxiety and depression at 12 months post-screening assessed using the Hospital Anxiety and Depression Scale (HADS). Hierarchical linear regressions showed that demographic, clinical, and psychological variables collectively accounted for 52% of the variance in HADS anxiety scores and 53% of the variance in HADS depression scores 12 months after diabetes screening. Screening outcome (positive or negative for diabetes) was not related to differences in anxiety or depression at 12 months. Higher number of self-reported (diabetes) symptoms after first attendance was associated with higher anxiety and depression at 12-month follow-up, after controlling for anxiety and depression after first attendance. Participants in a diabetes screening programme showed low scores on anxiety and depression scales after first appointment and 1 year later. Diagnosis of diabetes was shown to have a limited psychological impact and may be less important than symptom perception in determining emotional outcomes after participation in diabetes screening.",Paddison CA.; Eborall HC.; French DP.; Kinmonth AL.; Prevost AT.; Griffin SJ.; Sutton S.,2011.0,10.1348/135910710X495366,0,0,
5404,Tracking explicit and implicit long-lasting traces of fearful memories in humans.,"Recent accounts of Posttraumatic Stress Disorder (PTSD) suggest that the encoding of an episode within a fearful context generates different implicit and explicit memory representations. Whilst implicit memory traces include the associated emotional states, explicit traces include a recoding into an abstract or gist-based structural context of the episode. Theoretically, the long-term preservation of implicit memory traces may facilitate the often untreatable memory intrusions in PTSD. Here, we tracked in two experiments how implicit and explicit memory traces for fearful episodes dissociate and evolve over time. Subjects (N=86) were presented with semantically-related word-lists in a contextual fear paradigm and tested for explicit memories either immediately (i.e., 30 min) or after a delay (i.e., 1 or 2 weeks) with a verbal recognition task. Skin Conductance Response (SCR) was used to assess implicit memory responses. Subjects showed high memory accuracy for words when tested immediately after encoding. At test, SCR was higher during the presentation of verbatim but not gist-based words encoded in a fearful context, and remained unchanged after 2 weeks, despite subjects being unaware of words' encoding context. We found no clear evidence of accurate explicit memory traces for the fearful or neutral contexts of words presented during encoding, either 30 min or 2 weeks afterwards. These findings indicate that the implicit, but not the explicit, memory trace of a fearful context of an episode can be detected at long-term through SCR and is dissociated from the gist-based memory. They may have implicationstowards the understanding of how the processing of fearful memoriescould lead to PTSD.",Packard PA.; Rodríguez-Fornells A.; Stein LM.; Nicolás B.; Fuentemilla L.,2014.0,10.1016/j.nlm.2014.09.004,0,0,
5405,Expressive writing for gay-related stress: psychosocial benefits and mechanisms underlying improvement,"ER METHODSeventy-seven gay male college students (mean age = 20.19 years, SD = 1.99) were randomly assigned to write for 20 min a day for 3 consecutive days about either (a) the most stressful or traumatic gay-related event in their lives or (b) a neutral topic. We tested an exposure-based hypothesis of written emotional expression by asking half of the participants who were assigned to write about gay-related stress to read their previous day's narrative before writing, whereas the other half did not. Posttest and 3-month follow-up outcomes were assessed with common measures of overall psychological distress, depression, physical health symptoms, and positive and negative affect. Gay-specific social functioning was assessed with measures of gay-related rejection sensitivity, gay-specific self-esteem, and items regarding openness and comfort with one's sexual orientation.RESULTSParticipants who wrote about gay-related stress, regardless of whether they read their previous day's writing, reported significantly greater openness with their sexual orientation 3 months following writing than participants who wrote about a neutral topic, F(1, 74) = 6.66, p < .05, eta(2) = .08. Additional analyses examined the impact of emotional engagement in the writing, severity of the expressed topic, previous disclosure of writing topic, tendency to conceal, and level of perceived social support on mental health outcomes.CONCLUSIONSThe findings suggest that an expressive writing task targeting gay-related stress can improve gay men's psychosocial functioning, especially openness with sexual orientation. The intervention seems to be particularly beneficial for those men who write about more severe topics and for those with lower levels of social support. The findings suggest future tests of expressive writing tasks for different aspects of stigma-related stress.OBJECTIVEThis study tested the effectiveness of an expressive writing intervention for gay men on outcomes related to psychosocial functioning.","Pachankis, J E; Goldfried, M R",2010.0,10.1037/a0017580,0,0,
5406,The impact of PTSD treatment on the cortisol awakening response.,"Posttraumatic stress disorder (PTSD) is associated with abnormal functioning of the hypothalamic-pituitary-adrenal (HPA) axis; however, limited research has examined whether cortisol levels change following successful PTSD treatment. The current study examined the impact of successful PTSD treatment on the cortisol awakening response (CAR). Twenty-nine adults participating in a treatment trial for chronic PTSD provided saliva samples (upon waking, and 30-, 45-, and 60 min postwaking) before and after receiving either prolonged exposure therapy or sertraline. PTSD responder status (i.e., loss or retention of a PTSD diagnosis) served as the predictor variable. Outcome measures included area under the curve with respect to ground and increase, reflecting total cortisol output and HPA axis reactivity, respectively. A series of hierarchical regressions revealed no significant main effects of PTSD responder status for either CAR outcome. However, a significant gender by treatment response interaction for cortisol reactivity revealed that female treatment nonresponders displayed higher cortisol reactivity following treatment than female responders, whereas cortisol reactivity did not change pre- to posttreatment for male responders. Findings remained after controlling for age, trauma history, baseline medication status, baseline PTSD, and baseline depressive symptoms. Loss of a PTSD diagnosis may contribute to decreased cortisol reactivity in females. Neuroendocrine changes following treatment may emerge only for specific subgroups, highlighting the importance of exploring treatment moderators.",Pacella ML.; Feeny N.; Zoellner L.; Delahanty DL.,2014.0,10.1002/da.22298,0,0,
5407,Evaluation of Narrative Exposure Therapy (NET) for Borderline Personality Disorder with comorbid Posttraumatic Stress Disorder.,"Objective: Frequently patients with borderline personality disorder (BPD) report a history of exposure to traumatic stressors and, as a consequence, symptoms of Posttraumatic Stress disorder (PTSD). BPD and PTSD combined exacerbate suffering beyond a simple additive effect. To assist these complex cases, we have tested the efficacy of Narrative Exposure Therapy (NET), an evidence-based treatment for survivors of different, multiple or continued traumatic stressors and compared the outcome with the one from a standard Treatment by Experts for Borderline Personality Disorder (TBE). Method: In both an inpatient and outpatient setting, patients with BPD and comorbid PTSD (N = 22) were assigned to NET or a TBE. They received either weekly sessions of NET (on average 17) or TBE (on average 14). Changes in symptoms were evaluated prior to therapy, at 6 months and 1 year post-therapy. Results: Both treatment forms reduced all of the symptoms (PTSD, borderline, depression and dissociation) substantially. The decrease continued throughout the 12 months follow-up period producing large effects. Greatest effect sizes with Hedge's g = 1.6; CI 0.6-2.5 was obtained for the reduction of PTSD symptoms by NET (g = 1.1; CI 0.2-2.0 for TBE) and depression (g = 1.4 for NET and g = 0.7 TBE). Conclusions: The results of this evaluation study showed a considerable reduction for the whole spectrum of symptoms in patient with BPD and PTSD and indicate that Narrative Exposure Therapy (NET) warrants further testing as an effective tool to assist borderline patients suffering from trauma symptoms in both, a hospital setting as well as on an outpatient basis. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Pabst, Astrid; Schauer, Maggie; Bernhardt, Kirstin; Ruf-Leuschner, Martina; Goder, Robert; Elbert, Thomas; Rosentraeger, Rotraudt; Robjant, Katy; Aldenhoff, Josef; Seeck-Hirschner, Mareen; Ball, Bernstein, Beutel, Bohus, Bohus, Bohus, Bohus, Bohus, Bohus, Clarke, Cloitre, Dyer, Ehlers, Foa, Foa, Freyberger, Fydrich, Golier, Grant, Hamilton, Hamilton, Harned, Harned, Hensel-Dittmann, Hesbacher, Jacob, Jongedijk, Linehan, Linehan, Maercker, McDonagh, Molnar, Neuner, Neuner, Pabst, Pabst, Paris, Parloff, Peleikis, Robjant, Schaal, Schauer, Schauer, Schauer, Sheehan, Stenmark, Winokur, Zanarini, Zanarini",2014.0,,0,0,
5408,Stress views in the radiography of scapholunate instability.,"On the suspected carpal instabilities stress views are recommended but not often used. The present study evaluates the reliability of the dorsal and volar stress radiographs on patients with posttraumatic wrist pain. Stress radiographs of the wrists were examined in 22 patients with chronic wrist pain and the results were compared with scaphoid shift test and standard and positional views. The stress examination consists of applying to the wrist dorsal and volar stresses on the hand. Static scapholunate instability was diagnosed in 4 patients in whom 3 of them had positive scaphoid shift test sign as well. There were, however, 18 patients with dynamic scapholunate instability in whom the standard films were normal but dorsal stress radiography showed gap greater than 3mm between the scaphoid and lunate. Stress tests may provide considerable information in the evaluation of a patient who has a painful wrist in whom routine and special views do not demonstrate scapholunate dissociation.",Ozçelik A.; Günal I.; Köse N.,2005.0,10.1016/j.ejrad.2005.06.011,0,0,
5409,"Effect of the menstrual cycle on pain experience associated with periodontal therapy: randomized, pilot study","ER MATERIALS AND METHODSTwenty women with moderate-to-advanced chronic periodontitis and regular menstrual cycles were asked to complete Corah's Dental Anxiety Scale (DAS) during the first debridement visit. Patients were randomly assigned to receive their first debridement visit during either their peri-menstrual or post-menstrual period. Debridement was performed in bilateral quadrants of patients during the periods. Pain levels for each quadrant were assessed with a Visual Analogue Scale (VAS), after each debridement visit.RESULTSThere was no significant correlation of order of treatment in the intensity of perceived pain during the periods (p<0.05). The median VAS scores were 22.0 and 15.2 mm in the peri-menstrual and the post-menstrual period, respectively. Increase in pain perception among females during their peri-menstrual period was significantly greater than their post-menstrual period (p<0.05).CONCLUSIONNo clinical conclusions can be drawn at this stage as this pilot study did not have a sufficiently broad population to generalize these observations to all female periodontal patients. Providing clinicians with information about patients' menstrual cycle during debridement can alter the pain experience.OBJECTIVESThe aim of this pilot cross-over study was to compare preliminarily the pain perception of female patients undergoing periodontal debridement during menstrual or pre-menstrual phases (peri-menstrual period) with that observed during mid-menstrual phase (post-menstrual period).","Ozçaka, O; Biçakçi, N; Köse, T",2005.0,10.1111/j.1600-051X.2005.00841.x,0,0,
5410,Evaluation of the making sense of brain tumor program: a randomized controlled trial of a home-based psychosocial intervention,"ER DESIGNA randomized controlled trial with a wait list conditionMETHODSFifty participants aged 17-82 years with brain tumor (54% benign) were randomly allocated to immediate treatment (n?=?27) or a waitlist (n?=?23). Measures included Montgomery-Asberg Depression Rating Scale (MADRS), McGill Quality of Life (MQOL) Questionnaire, Depression Anxiety Stress Scales (DASS) and Functional Assessment of Cancer Therapy-Brain (FACT-Br). The immediate treatment group received the 10-session MSoBT program, while the waitlist group received usual care for 10 weeks and were then re-assessed before receiving the MSoBT program. A 6-month post-intervention follow-up was conducted.RESULTSAnalysis of covariance adjusting for baseline functioning identified that the immediate treatment group reported significantly lower levels of depression on the MADRS (?(p)(2) ?=?.19) and higher levels of existential well-being on the MQOL (?(p)(2) ?=?.13) and functional well-being (?(p)(2) ?=?.21) and global quality of life on the FACT-Br (?(p)(2) ?=?.12) at post-assessment than the waitlist group. At 6-month follow-up participants reported significantly lower levels of depression and stress and higher existential well-being and quality of life relative to pre-intervention.CONCLUSIONSThe MSoBT program appears to have efficacy for enhancing psychological well-being and quality of life after brain tumor.OBJECTIVEDespite significant psychosocial morbidity, there are few controlled trials of psychological support for people with brain tumor. This study evaluated the efficacy of the Making Sense of Brain Tumor (MSoBT) program, a home-based psychosocial intervention.","Ownsworth, T; Chambers, S; Damborg, E; Casey, L; Walker, D G; Shum, D H",2015.0,10.1002/pon.3687,0,0,
5411,Perinatal problems and psychiatric comorbidity among children with ADHD,"ER Among two large, independent samples of girls with attention-deficit/hyperactivity disorder (ADHD), we examined associations between specific (maternal gestational smoking and drug use, early labor, low birth weight, and infant breathing problems at birth) and cumulative prenatal and perinatal risk factors and psychiatric comorbidity during childhood. Data from the (a) Multimodal Treatment Study of Children with ADHD, a randomized clinical trial with 579 children aged 7 to 9.9 years with combined-type ADHD, and the (b) Berkeley Girls ADHD Longitudinal Sample, a naturalistic study of 140 girls with ADHD (93 combined-type and 47 inattentive-type) who were first seen when they were 6 to 12 years old, were analyzed separately. In each sample, perinatal risk factors were assessed retrospectively by maternal report, and current childhood psychiatric comorbidity was assessed using maternal report on the Diagnostic Interview Schedule for Children. Consistent findings across these two studies show that infant breathing problems, early labor, and total perinatal problems predicted childhood comorbid depression but not comorbid anxiety or externalizing disorders. These associations remained significant, in both samples, with control of family socioeconomic status (SES) and maternal symptoms of ADHD and depression. Results attenuated slightly with control of the number of child comorbidities plus SES and maternal symptoms. Accumulating evidence suggests that perinatal risk factors are important precursors of childhood psychiatric comorbidity and that the association between these risk factors and detrimental psychiatric outcomes cannot be explained by maternal psychiatric symptoms or SES during childhood.","Owens, E B; Hinshaw, S P",2013.0,10.1080/15374416.2013.785359,0,0,
5412,The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial,"ER BACKGROUND: Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!') has been developed. This program includes specific therapeutic factors focused on emotion awareness and expression, increasing feelings of emotional security, teaching specific coping strategies, developing a trauma narrative, improving parent-child interaction and psycho-education. The main study aim is to evaluate the effectiveness of the specific therapeutic factors in the program. A secondary objective is to study mediating and moderating factors.METHODS/DESIGN: This study is a prospective multicenter randomized controlled trial across cities in the Netherlands. Participants (N = 140) are referred to the secondary preventive intervention program by police, social work, women shelters and youth (mental health) care. Children, aged 6-12 years, and their parents, who experienced interparental violence are randomly assigned to either the intervention program or the control program. The control program is comparable on nonspecific factors by offering positive attention, positive expectations, recreation, distraction, warmth and empathy of the therapist, and social support among group participants, in ways that are similar to the intervention program. Primary outcome measures are posttraumatic stress symptoms and emotional and behavioral problems of the child. Mediators tested are the ability to differentiate and express emotions, emotional security, coping strategies, feelings of guilt and parent-child interaction. Mental health of the parent, parenting stress, disturbances in parent-child attachment, duration and severity of the domestic violence and demographics are examined for their moderating effect. Data are collected one week before the program starts (T1), and one week (T2) and six months (T3) after finishing the program. Both intention-to-treat and completer analyses will be done.DISCUSSION: Adverse outcomes after witnessing interparental violence are highly diverse and may be explained by multiple risk factors. An important question for prevention programs is therefore to what extent a specific focus on potential psychotrauma is useful. This trial may point to several directions for optimizing public health response to children's exposure to interparental violence.","Overbeek, M M; Schipper, J C; Lamers-Winkelman, F; Schuengel, C",2012.0,10.1186/1745-6215-13-12,0,0,
5413,"Chronic pain and comorbid mental health conditions: independent associations of posttraumatic stress disorder and depression with pain, disability, and quality of life.","Both posttraumatic stress disorder (PTSD) and depression are highly comorbid with chronic pain and have deleterious effects on pain and treatment outcomes, but the nature of the relationships among chronic pain, PTSD, and depression has not been fully elucidated. This study examined 250 Veterans Affairs primary care patients with moderate to severe chronic musculoskeletal pain who participated in a randomized controlled pain treatment trial. Baseline data were analyzed to examine the independent associations of PTSD and major depression with multiple domains of pain, psychological status, quality of life, and disability. PTSD was strongly associated with these variables and in multivariate models, PTSD and major depression each had strong independent associations with these domains. PTSD demonstrated similar relationships as major depression with psychological, quality of life, and disability outcomes and significant but somewhat smaller associations with pain. Because PTSD and major depression have independent negative associations with pain, psychological status, quality of life, and disability, it is important for clinicians to recognize and treat both mental disorders in patients with chronic pain.",Outcalt SD.; Kroenke K.; Krebs EE.; Chumbler NR.; Wu J.; Yu Z.; Bair MJ.,2015.0,10.1007/s10865-015-9628-3,0,0,
5414,"A comparative evaluation of substance abuse treatment IV. The effect of comorbid psychiatric diagnoses on amount of treatment, continuing care, and 1-year outcomes.","Compared patients with substance abuse and psychotic, anxiety/depressive, or personality disorders with patients with only substance use disorders on treatment experiences and outcomes. Regardless of dual diagnosis status, Ss generally improved on both substance use and social functioning outcomes after substance abuse treatment. At the 1-yr follow-up, dually diagnosed Ss, and Ss with only substance use disorders, had comparable substance use outcomes. However, patients with major psychiatric disorders, specifically psychotic and anxiety/depressive disorders, fared worse on psychological symptoms and employment outcomes than did patients with personality disorders and only substance use disorders. Although there were some group differences on the amount of index treatment received and continuing care, the overall pattern of relationships between treatment variables and outcomes was comparable for the patient groups. In addition, there was no diagnostic group by treatment orientation matching effects, which indicated that the dual diagnosis patient groups improved as much in 12-Step as in cognitive-behavioral substance abuse programs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ouimette, Paige Crosby; Gima, Kristian; Moos, Rudolf H; Finney, John W",1999.0,,0,0,
5415,Posttraumatic stress disorder in substance abuse patients: Relationship to 1-year posttreatment outcomes.,"140 men with posttraumatic stress disorder (PTSD) and substance abuse (SA-PTSD) were compared with 1,166 men with only SA (SA-only) and 227 men with SA and Axis I psychiatric diagnoses other than PTSD (SA-PSY) on substance-related and psychosocial outcomes 1 yr after VA inpatient SA treatment. At follow-up, SA-PTSD patients reported more problems that directly resulted from SA, had more psychological distress, and reported less support from friends than both SA-only and SA-PSY patients. SA-PTSD patients were less likely to be employed and more likely to be readmitted for inpatient/residential treatment during the follow-up than SA-only patients. The effect of PTSD on 1-yr problems from SA was partially mediated by greater use of emotional discharge coping, having more positive expectancies regarding substance use, and expecting fewer benefits from quitting. Expecting fewer benefits from quitting partially explained the relationship between PTSD and 1-yr friend support. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ouimette, Paige Crosby; Ahrens, Courtney; Moos, Rudolf H; Finney, John W; Abueg, Abueg, Annis, Babor, Baron, Brady, Brief, Brown, Brown, Brown, Cooper, Cottler, Dansky, Derogatis, Donovan, Fairbank, Foa, Helzer, Helzer, Kessler, Kulka, Kushner, Lyons, Mackinnon, McLellan, Miller, Moos, Moos, Moos, Najavits, Nezu, Ouimette, Ouimette, Penk, Room, Root, Royse, Sobell, Solomon, Solomon, Stine, Wolfe",1997.0,,0,0,
5416,The OPTICC trial: a multi-institutional study of occult pneumothoraces in critical care.,"The management of pneumothoraces detected on CT but not on supine chest radiographs remains controversial, especially in those undergoing positive pressure ventilation (PPV) who are at risk for complications with both observation and treatment. Previous limited study yielded confusion regarding the need for routine drainage of these occult pneumothoraces (OPTXs). We conducted a pilot study at 2 trauma centers to address the feasibility and safety of randomizing traumatized patients undergoing PPV to drainage or observation. Stable mechanically ventilated (or en route to surgery) adults with OPTXs were identified at 2 centers (Calgary and Quebec). Patients were randomized to observation (unless drainage became clinically indicated) or to chest drainage. Episodes of respiratory distress (need for thoracostomy tube, acute/sustained increase in oxygen requirements, difficulty in achieving adequate ventilation and self-reported distress) and subsequent imaging abnormalities were recorded until discharge. From August 2006 to April 2008, 24 trauma patients were enrolled (17 Calgary and 7 Quebec), with 2 later exclusions (final CT found no OPTX). Thirteen patients (59%) were randomized to observation, 9 to drainage (41%). Four observed (31%) later had chest tubes placed nonurgently for worsening OPTXs/effusions; none with increased morbidity. Overall rates of respiratory distress (drainage: 33%, observation: 41%) and mortality (drainage: 22%, observation: 15%) were similar across groups, as were median intensive care unit (drainage: 3, observation: 4) and in-hospital days (drainage: 10, observation: 16). With no important differences in morbidity, the OPTICC pilot lays the foundation for a future definitive trial comparing drainage or observation in posttraumatic OPTXs requiring PPV.",Ouellet JF.; Trottier V.; Kmet L.; Rizoli S.; Laupland K.; Ball CG.; Sirois M.; Kirkpatrick AW.,2009.0,10.1016/j.amjsurg.2008.12.007,0,0,
5417,Dreaming without REM sleep,"To test whether mental activities collected from non-REM sleep are influenced by REM sleep, we suppressed REM sleep using clomipramine 50. mg (an antidepressant) or placebo in the evening, in a double blind cross-over design, in 11 healthy young men. Subjects were awakened every hour and asked about their mental activity. The marked (81%, range 39-98%) REM-sleep suppression induced by clomipramine did not substantially affect any aspects of dream recall (report length, complexity, bizarreness, pleasantness and self-perception of dream or thought-like mentation). Since long, complex and bizarre dreams persist even after suppressing REM sleep either partially or totally, it suggests that the generation of mental activity during sleep is independent of sleep stage. © 2012 Elsevier Inc.",Oudiette D.; Dealberto M.-J.; Uguccioni G.; Golmard J.-L.; Merino-Andreu M.; Tafti M.; Garma L.; Schwartz S.; Arnulf I.,2012.0,10.1016/j.concog.2012.04.010,0,0,
5418,Treatment of multiple risk issues in urban women: Results of an intervention for co-existing alcohol use disorders and sexual risk (Heart to Heart),"Purpose: Heart to Heart was a NIAAA-sponsored randomized clinical trial evaluating an intervention for both alcohol use and HIV sexual risk behaviors in women with alcohol use disorders. Methods: Participants were adult women referred for alcohol treatment. Inclusion criteria included unprotected sex in past 90 days and meeting SCID criteria for alcohol abuse or dependence. Participants completed measures and were randomly assigned to 10 1-on-1 sessions of either Alcohol + HIV treatment or Alcohol + Health Education treatment, using a CBI approach. Outcomes included alcohol and sex behaviors in past 3 months as measured on the TimeLine FollowBack (TLFB) at baseline, compared to 3-, 6-, 9-, and 12-month assessments post-treatment. Data analyses included generalized estimating equations (GEE) and individual growth curve modeling. Results: Of the 406 women screened, 149 completed baseline measures. Over 90% screened scored ‚â•7 on the AUDIT; 95.6% of participants (N = 148) met SCID criteria for alcohol dependence. Those screened also showed high rates of PTSD (PCLC-C) and drug use (DAST) issues. TLFB data show high rates of unprotected vaginal sex, occasions of sex after alcohol or drug use, and occasions of sex while drunk or high. We found no significant interactions by time and condition for any outcomes. For alcohol use outcomes, main effects for time occurred for maximum number of drinks per day (p =.000), number of heavy drinking days (4 or more) (p <.000), number of SD/month (p <.000), and multiple substance use days (p <.000); main effects for condition occurred for multiple substance use days (p <.000). For sexual risk outcomes, main effects for time occurred for number of sexual partners (p <.000), proportion of clients who had sex after drinking (p <.000) or using drugs (p <.000); main effects for condition occurred for number of vaginal sex occasions (p =.021). Degree of alcohol use issue severity predicted alcohol but not sexual outcomes. Drug use issue severity predicted both sexual and alcohol outcomes, and symptoms of PTSD predicted sexual but not alcohol outcomes. Individuals having more severe issues at baseline had less risk behavior change. Implications: The alcohol treatment appears to have been effective in reducing alcohol use in our sample; combining it with HIV counseling did not affect either alcohol or sexual outcomes in our sample. Reasons for this will be discussed, as well as implications of intervening on multiple risk issues with alcohol using populations.",Otto-Salaj L.L.; Zweben A.; Traxel N.; Rose S.J.; Brondino M.J.; Cisler R.A.; Weinhardt L.S.; Kalichman S.C.,2010.0,10.1111/j.1530-0277.2010.01211.x,0,0,
5419,Efficacy of d-cycloserine for enhancing response to cognitive-behavior therapy for panic disorder.,"Traditional combination strategies of cognitive-behavior therapy plus pharmacotherapy have met with disappointing results for anxiety disorders. Enhancement of cognitive-behavior therapy with d-cycloserine (DCS) pharmacotherapy represents a novel strategy for improving therapeutic learning from cognitive-behavior therapy that remains untested in panic disorder. This is a randomized, double-blind, placebo-controlled augmentation trial examining the addition of isolated doses of 50 mg d-cycloserine or pill placebo to brief exposure-based cognitive-behavior therapy. Randomized participants were 31 outpatients meeting DSM-IV criteria for panic disorder with or without agoraphobia, who were offered five sessions of manualized cognitive-behavior therapy emphasizing exposure to feared internal sensations (interoceptive exposure) but also including informational, cognitive, and situational exposure interventions. Doses of study drug were administered 1 hour before cognitive-behavior therapy sessions 3 to 5. The primary outcome measures were the Panic Disorder Severity Scale (PDSS) and Clinicians' Global Impressions of Severity. Results indicated large effect sizes for the additive benefit of d-cycloserine augmentation of cognitive-behavior therapy for panic disorder. At posttreatment and 1 month follow-up, participants who received d-cycloserine versus placebo had better outcomes on the PDSS and global severity of disorder and were significantly more likely to have achieved clinically significant change status (77% vs. 33%). There were no significant adverse effects associated with DCS administration. This pilot study extends support for the role of d-cycloserine in enhancing therapeutic learning from exposure-based cognitive-behavior therapy and is the first to do so in a protocol emphasizing exposure to feared internal sensations of anxiety in panic disorder.",Otto MW.; Tolin DF.; Simon NM.; Pearlson GD.; Basden S.; Meunier SA.; Hofmann SG.; Eisenmenger K.; Krystal JH.; Pollack MH.,2010.0,10.1016/j.biopsych.2009.07.036,0,0,
5420,Discontinuation of benzodiazepine treatment: efficacy of cognitive-behavioral therapy for patients with panic disorder.,"The primary disadvantage of high-potency benzodiazepine treatment for panic disorder is the difficulty of discontinuing the treatment. During treatment discontinuation, new symptoms may emerge and anxiety may return, preventing many patients from successfully discontinuing their treatment. In this controlled, randomized trial the authors investigated the efficacy of a cognitive-behavioral program for patients with panic disorder who were attempting to discontinue treatment with high-potency benzodiazepines. Outpatients treated for panic disorder with alprazolam or clonazepam for a minimum of 6 months and expressing a desire to stop taking the medication (N = 33) were randomly assigned to one of two taper conditions: a slow taper condition alone or a slow taper condition in conjunction with 10 weeks of group cognitive-behavioral therapy. The rate of successful discontinuation of benzodiazepine treatment was significantly higher for the patients receiving the cognitive-behavioral program (13 of 17; 76%) than for the patients receiving the slow taper program alone (four of 16; 25%). There was no difference in the likelihood of discontinuation success between the patients treated with alprazolam and those who received clonazepam. At the 3-month follow-up evaluation, 77% of the patients in the cognitive-behavioral program who successfully discontinued benzodiazepine treatment remained benzodiazepine free. These findings support the efficacy of cognitive-behavioral interventions in aiding benzodiazepine discontinuation for patients with panic disorder.",Otto MW.; Pollack MH.; Sachs GS.; Reiter SR.; Meltzer-Brody S.; Rosenbaum JF.,1993.0,10.1176/ajp.150.10.1485,0,0,
5421,A comparison of the efficacy of clonazepam and cognitive-behavioral group therapy for the treatment of social phobia,"ER There is a growing body of evidence that social phobia may be treated effectively by either pharmacologic or cognitive-behavioral interventions. but few studies have examined the relative benefits of these treatments. In this study, we examined the relative efficacy of pharmacotherapy with clonazepam and cognitive-behavioral group therapy (CBGT) for treating social phobia. In addition, we examined potential predictors of differential treatment response. Outpatients meeting Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised) criteria for social phobia were randomly assigned to treatment. Clinician-rated and patient-rated symptom severity was examined at baseline and after 4, 8, and 12 weeks of treatment. All clinician-rated assessments were completed by individuals blind to treatment condition. Patients in both conditions improved significantly, and differences between treatment conditions were absent, except for greater improvement on clonazepam on several measures at the 12-week assessment. Symptom severity was negatively associated with treatment success for both methods of treatment, and additional predictors-sex, comorbidity with other anxiety or mood disorders, fear of anxiety symptoms, and dysfunctional attitudes-failed to predict treatment outcome above and beyond severity measures. In summary, we found that patients randomized to clinical care with clonazepam or CBGT were equally likely to respond to acute treatment, and pretreatment measures of symptom severity provided no guidance for the selection of one treatment over another.","Otto, M W; Pollack, M H; Gould, R A; Worthington, J J; McArdle, E T; Rosenbaum, J F",2000.0,,0,0,
5422,A comparison of the efficacy of clonazepam and cognitive-behavioral group therapy for the treatment of social phobia.,"There is a growing body of evidence that social phobia may be treated effectively by either pharmacologic or cognitive-behavioral interventions. but few studies have examined the relative benefits of these treatments. In this study, we examined the relative efficacy of pharmacotherapy with clonazepam and cognitive-behavioral group therapy (CBGT) for treating social phobia. In addition, we examined potential predictors of differential treatment response. Outpatients meeting Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised) criteria for social phobia were randomly assigned to treatment. Clinician-rated and patient-rated symptom severity was examined at baseline and after 4, 8, and 12 weeks of treatment. All clinician-rated assessments were completed by individuals blind to treatment condition. Patients in both conditions improved significantly, and differences between treatment conditions were absent, except for greater improvement on clonazepam on several measures at the 12-week assessment. Symptom severity was negatively associated with treatment success for both methods of treatment, and additional predictors-sex, comorbidity with other anxiety or mood disorders, fear of anxiety symptoms, and dysfunctional attitudes-failed to predict treatment outcome above and beyond severity measures. In summary, we found that patients randomized to clinical care with clonazepam or CBGT were equally likely to respond to acute treatment, and pretreatment measures of symptom severity provided no guidance for the selection of one treatment over another.",Otto MW.; Pollack MH.; Gould RA.; Worthington JJ.; McArdle ET.; Rosenbaum JF.,,,0,0,5421
5423,One-Session treatment of specific phobias in youths: a randomized clinical trial,"ER Sixty children, ages 7-17 years, who fulfilled Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnosis for various specific phobias were randomized to (a) 1-session exposure treatment alone, (b) 1-session treatment with a parent present, or (c) wait-list control group for 4 weeks. After the waiting period, the wait-list patients were rerandomized to the active treatments. The patients' phobias were assessed with behavioral approach tests (approach behavior, experienced anxiety, and physiological reactions), whereas general anxiety, depression, phobic tendencies, and anxiety sensitivity were assessed with self-report inventories. Assessments were done pre-, post-, and 1-year following treatment. Results showed that both treatment conditions did significantly better than the control condition, whereas the treatment groups did equally well on most measures, and the effects were maintained at follow-up. The implications of these results are discussed.","Ost, L G; Svensson, L; Hellström, K; Lindwall, R",2001.0,,0,0,
5424,The effects of cognitive behavior therapy delivered by students in a psychologist training program: an effectiveness study.,"Relatively little is known about the efficacy of clinically inexperienced student therapists carrying out cognitive behavior therapy (CBT) under supervision during a professional, psychologist training program. The current study evaluated this by collecting pre- and posttreatment data on 591 consecutive patients receiving treatment at the Psychotherapy Clinic of the Department of Psychology, Stockholm University, Sweden, over an 8-year period. The patients had mainly anxiety disorders or depression with a mean duration of 15 years, and received individual CBT for a mean of 18 sessions. They improved significantly on both general measures (Beck Anxiety Inventory [BAI], Beck Depression Inventory [BDI], and Quality of Life Inventory [QOLI]) and disorder-specific self-report scales. The proportions of recovered patients on the BAI (63%) and the BDI (60%) were higher than those of a comparison effectiveness study. On the specific self-report scales the current sample improved as much as the samples in extant efficacy trials. We conclude that clinically inexperienced student therapists who receive supervision from experienced supervisors can achieve treatment effects that are on a par with those of experienced licensed psychotherapists.",Öst LG.; Karlstedt A.; Widén S.,2012.0,10.1016/j.beth.2011.05.001,0,0,
5425,Individual response patterns and the effects of different behavioral methods in the treatment of social phobia.,,Ost LG.; Jerremalm A.; Johansson J.,1981.0,,0,0,
5426,Individual response patterns and the effects of different behavioral methods in the treatment of agoraphobia.,,Ost LG.; Jerremalm A.; Jansson L.,1984.0,,0,0,
5427,Probability ratings in claustrophobic patients and normal controls.,"Forty-nine DSM-IV diagnosed claustrophobics and 49 sex- and age-matched community controls, without any current or past psychiatric disorder, were asked to estimate the probability that three types if events would occur if they were in the described situations. The events were claustrophobic, generally negative, and positive in nature. The results showed that claustrophobics significantly overestimated the probability of events they specifically feared, i.e. the claustrophobic events, while there was no difference between the groups regarding generally negative events and positive events. This finding remained when the higher scores for claustrophobics on the Claustrophobia scale and the Anxiety Sensitivity Index were covaried out. The conclusion that can be drawn is that claustrophobics' probability ratings are characterized by distortions that are specifically connected to anxiety-arousing events and not negative events in general. The hypothesis is proposed that this may be explained by an exaggerated use of simplified rules-of-thumb for probability estimations that build on availability in memory, simulation, and representativity.",Ost LG.; Csatlos P.,2000.0,,0,0,
5428,Behavioral treatment of social phobia in youth: does parent education training improve the outcome?,"ER Social phobia is one of the most common anxiety disorders in children and adolescents, and it runs a fairly chronic course if left untreated. The goals of the present study were to evaluate if a parent education course would improve the outcome for children with a primary diagnosis of social phobia and if comorbidity at the start of treatment would impair the outcome of the social phobia. A total of 55 children, 8-14 years old, were randomly assigned to one of three conditions: 1) Child is treated, 2) Child is treated and parent participates in the course, or 3) A wait-list for 12 weeks. The treatment consisted of individual exposure and group social skills training based on the Beidel, Turner, and Morris (2000) SET-C. Children and parents were assessed pre-, post-, and at one year follow-up with independent assessor ratings and self-report measures. Results showed that there was no significant difference between the two active treatments and both were better than the wait-list. The treatment effects were maintained or furthered at the follow-up. Comorbidity did not lead to worse outcome of social phobia. Comorbid disorders improved significantly from pre-to post-treatment and from post-to follow-up assessment without being targeted in therapy.","Öst, L G; Cederlund, R; Reuterskiöld, L",2015.0,10.1016/j.brat.2015.02.001,0,0,
5429,One-session group treatment of spider phobia.,"Forty-two patients with spider phobia, fulfilling the DSM-III-R criteria for simple phobia, were assessed with behavioral, physiological and self-report measures. They were randomly assigned to two group treatment conditions: (1) small groups of three to four patients, and (2) large groups of seven to eight patients. They received one 3-hr session consisting of exposure and modeling. The results showed that both conditions yielded significant improvements on almost all measures, and these were maintained or furthered at the 1-yr follow-up. With one exception, there was no difference between the conditions, but on most measures there was a trend for the small group condition to yield better effects. The proportions of clinically significantly improved patients at post-treatment were 82% in the small group and 70% in the large group. At follow-up the corresponding figures were 95% and 75%, respectively. The conclusion that can be drawn is that one-session group treatment is a feasible alternative to individual treatment, yielding almost as good effects.",Ost LG.,1996.0,,0,0,
5430,A clinical study of spider phobia: Prediction of outcome after self-help and therapist-directed treatments.,"Examined predictors of treatment success, attrition and extent of treatment needed to achieve clinically significant improvement in spider phobic patients. 103 female patients (aged 19-55 yrs) were included in the study after a detailed screening interview. There were 4 treatment conditions; self-help manual, video, group, and individual treatment, which the patients received in a hierarchical order providing they were not clinically significantly improved after the previous treatment. Pre and post each treatment the patients went through a behavioral approach test and filled in a number of self-report questionnaires. 38 patients dropped out during the manual treatment, and 59 fulfilled the treatments to become clinically improved. The patients achieving clinical improvement after the 2 self-help treatments were significantly predicted, as was the extent of treatment needed. The significant predictors were credibility of the manual treatment and motivation for psychotherapy in general. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ost, Lars-Goran; Stridh, Britt-Marie; Wolf, Martina",1998.0,,0,0,
5431,"Art therapy improves coping resources: a randomized, controlled study among women with breast cancer","ER METHODIn this article, we report some of the results from a study including 41 women, aged 37-69 years old, with nonmetastatic primary breast cancer, referred to the Department of Oncology at Umeå University Hospital in Sweden for postoperative radiotherapy. The women represented various socioeconomic backgrounds. They were randomized to a study group (n = 20) with individual art therapy for 1 h/week during postoperative radiotherapy or to a control group (n = 21). The article focuses on changes in coping resources, as measured by the Coping Resources Inventory (CRI) before and 2 and 6 months after the start of radiotherapy. The study protocol was approved by the Umeå University Ethical Committee at the Medical Faculty (archive number 99-386).RESULTSThere was an overall increase in coping resources among women with breast cancer after taking part in the art therapy intervention. Significant differences were seen between the study and control groups in the social domain on the second and third occasions. Significant differences were also observed in the total score on the second occasion.SIGNIFICANCE OF RESULTSThis study shows that individual art therapy provided by a trained art therapist in a clinical setting can give beneficial support to women with primary breast cancer undergoing radiotherapy, as it can improve their coping resources.OBJECTIVEWomen with breast cancer suffer from considerable stress related to the diagnosis, surgery, and medical treatment. It is important to develop strategies to strengthen coping resources among these women. Research in art therapy has shown outcomes such as an increase in self-esteem and cohesion, significant improvement in global health, and a decrease in anxiety and depression. The aim of the present article was to describe the effects of an art therapy intervention program on coping resources in women with primary breast cancer.","Oster, I; Svensk, A C; Magnusson, E; Thyme, K E; Sjõdin, M; Aström, S; Lindh, J",2006.0,,0,0,
5432,Behavioral-graded activity compared with usual care after first-time disk surgery: considerations of the design of a randomized clinical trial,"ER DESIGNRandomized clinical trial.PATIENTSPatients undergoing first-time lumbar disk surgery who still have low-back pain at the 6-week neurosurgical consultation.INTERVENTIONSA patient-tailored behavioral-graded activity program that is based on operant therapy. The key elements of this program are baseline measurements, goal-setting, and time-contingency. This program is compared with usual care in physiotherapy, which is pain-contingent.OUTCOME MEASURESPrimary measures are the patient's global impression of the effect and their functional status. Secondary measures are kinesiophobia, catastrophizing, pain, main complaint, range of motion, and relapses. The direct and indirect costs will also be assessed. The effect measures are rated before randomization and 3, 6, and 12 months later.DISCUSSIONSeveral trials have been conducted on the effectiveness of behavioral treatments. Subjects were always patients with chronic low-back pain. In this trial, we apply such a treatment in patients after first-time disk surgery in a primary care setting.OBJECTIVETo present the design of a trial on the effectiveness of a behavioral-graded activity model.","Ostelo, R W; Köke, A J; Beurskens, A J; Vet, H C; Kerckhoffs, M R; Vlaeyen, J W; Wolters, P M; Berfelo, M W; Brandt, P A",2000.0,,0,0,
5433,Una investigacion preliminar del uso de la Terapia de la Aceptacion y el Compromiso en un tratamiento del grupo para la fobia social.,"The present study examined the impact of a group treatment protocol based on Acceptance and Commitment Therapy (ACT) that was tailored toward the avoidant behaviors and life problems typical for socially anxious persons. Twenty-two participants enrolled in the group treatment, which consisted of 10 sessions. Twelve participants completed treatment. Post-treatment and follow-up data revealed significant decreases on the social phobia and experiential avoidance measures (follow-up effect sizes: 0.83 and 1.71, respectively). Completers' ratings of effectiveness in living, specifically pertaining to social relationships, significantly increased at follow-up. Symptoms decreased despite their not being a treatment target. This results suggests that symptom improvement may result from an increased willingness to both experience aversive emotions and engage in social behaviors that are consistent with what the participants valued, but previously avoided. Despite its exploratory nature and limitations, the study provides a basis for further application of ACT in this population. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ossman, Wendy A; Wilson, Kelly G; Storaasli, Ragnar D; McNeill, John W; Bach, Bandura, Barlow, Block, Bond, Bond, Borkovec, Bouton, Chiesa, Cohen, Coyne, Craske, Dahl, Davidson, Eng, Fedoroff, Feske, Foa, Fresco, Frisch, Gifford, Gould, Gutierrez, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Heimberg, Heimberg, Heimberg, Heimberg, Heimberg, Herbert, Jacobson, Kessler, Kohlenber, Levenson, Liebowitz, Linehan, Lochner, Luciano, Luciano, Magee, Martell, Mowrer, Olfson, Otto, Persons, Quilty, Safren, Segal, Stein, Turner, Turner, Wilson, Wilson, Wittchen, Zettle, Zettle",2006.0,,0,0,
5434,Stress reduction by technology? An experimental study into the effects of brainmachines on burnout and state anxiety.,"Stress and burnout are widely acknowledged as major causes of societal and individual problems in the Western world. In order to reduce material and immaterial expenses, increased efforts are made to enhance relaxation and stress reduction. Based on neuropsychological findings, alternative ways have been explored, one of them being the application of so-called brain wave synchronizers, which are said to induce a relaxation response by entraining alpha brain-wave activity (8-13 Hz) through audiovisual stimulation. A double blind, quasi-experiment was conducted among employees at a Dutch addiction care center to investigate the possible effects of two distinct brainmachine programs on burnout and anxiety. Subjects in both conditions showed a significant, immediate decrease in state anxiety as assessed by Spielberger's State-Trait Anxiety Inventory (STAI) and reported a range of subjective effects. However, a long-term effect on burnout, as measured with Maslach's Burnout Inventory (MBI-NL), could not be established. A long-term effect on anxiety (STAI), as investigated by interrupted time-series measurement, could not be established either. These and other findings suggest that the major claims with respect to these machines cannot hold over time, although pleasant short-term effects do occur. Individual differences in baseline responsivity, the stable character of burnout dimensions, or the ill-defined nature of relaxation, or a combination of these, may account for these results.",Ossebaard HC.,2000.0,,0,0,
5435,"Safety and immunogenicity of a recombinant live attenuated tetravalent dengue vaccine (DENVax) in flavivirus-naive healthy adults in Colombia: a randomised, placebo-controlled, phase 1 study","ER METHODS: We undertook a randomised, double-blind, phase 1, dose-escalation trial between Oct 11, 2011, and Nov 9, 2011, in the Rionegro, Antioquia, Colombia. The first cohort of participants (aged 18-45 years) were randomly assigned centrally, via block randomisation, to receive a low-dose formulation of DENvax, or placebo, by either subcutaneous or intradermal administration. After a safety assessment, participants were randomly assigned to receive a high-dose DENVax formulation, or placebo, by subcutaneous or intradermal administration. Group assignment was not masked from study pharmacists, but allocation was concealed from participants, nurses, and investigators. Primary endpoints were frequency and severity of injection-site and systemic reactions within 28 days of each vaccination. Secondary endpoints were the immunogenicity of DENVax against all four dengue virus serotypes, and the viraemia due to each of the four vaccine components after immunisation. Analysis was by intention to treat for safety and per protocol for immunogenicity. Because of the small sample size, no detailed comparison of adverse event rates were warranted. The trial is registered with ClinicalTrials.gov, number NCT01224639.FINDINGS: We randomly assigned 96 patients to one of the four study groups: 40 participants (42%) received low-dose vaccine and eight participants (8%) received placebo in the low-dose groups; 39 participants (41%) received high-dose vaccine, with nine (9%) participants assigned to receive placebo. Both formulations were well tolerated with mostly mild and transient local or systemic reactions. No clinically meaningful differences were recorded in the overall incidence of local and systemic adverse events between patients in the vaccine and placebo groups; 68 (86%) of 79 participants in the vaccine groups had solicited systemic adverse events compared with 13 (76%) of 17 of those in the placebo groups. By contrast, 67 participants (85%) in the vaccine group had local solicited reactions compared with five (29%) participants in the placebo group. Immunisation with either high-dose or low-dose DENVax formulations induced neutralising antibody responses to all four dengue virus serotypes; 30 days after the second dose, 47 (62%) of 76 participants given vaccine seroconverted to all four serotypes and 73 (96%) participants seroconverted to three or more dengue viruses. Infectious DENVax viruses were detected in only ten (25%) of 40 participants in the low-dose group and 13 (33%) of 39 participants in the high-dose group.INTERPRETATION: Our findings emphasise the acceptable tolerability and immunogenicity of the tetravalent DENVax formulations in healthy, flavivirus-naive adults. Further clinical testing of DENVax in different age groups and in dengue-endemic areas is warranted.FUNDING: Takeda Vaccines.BACKGROUND: Dengue virus is the most serious mosquito-borne viral threat to public health and no vaccines or antiviral therapies are approved for dengue fever. The tetravalent DENVax vaccine contains a molecularly characterised live attenuated dengue serotype-2 virus (DENVax-2) and three recombinant vaccine viruses expressing the prM and E structural genes for serotypes 1, 3, and 4 in the DENVax-2 genetic backbone. We aimed to assess the safety and immunogenicity of tetravalent DENVax formulations.","Osorio, J E; Velez, I D; Thomson, C; Lopez, L; Jimenez, A; Haller, A A; Silengo, S; Scott, J; Boroughs, K L; Stovall, J L; Luy, B E; Arguello, J; Beatty, M E; Santangelo, J; Gordon, G S; Huang, C Y; Stinchcomb, D T",2014.0,10.1016/S1473-3099(14)70811-4,0,0,
5436,Identifying trajectories of change to improve understanding of integrated health care outcomes on PTSD symptoms post disaster.,"Introduction: Addressing life stressors is an important function for integrated care, especially for health care homes located in disaster prone environments. This study evaluated trajectories of change for patients with postdisaster posttraumatic stress disorder (PTSD) who were seen in integrated care. In addition to describing the results, this article provides the methods of subgroup analyses as this may be useful for others working in real-world practice. Method: Patients (N = 340) receiving services at 5 rural health clinics self-reported PTSD symptoms as part of an ongoing evaluation to study the effectiveness of integrated health. Analysis of variance was used to assess differences overtime and trajectories were identified with cluster analyses. Disaster and trauma related factors associated with these trajectories were assessed using logistic regression. Results: Significant overall decreases in PTSD symptoms overtime were found; individual trajectories were identified and include stable low, steep declines, stable high symptoms, and increasing symptoms. Stress related to disaster and the number of other traumas patients experienced correctly classified trajectory membership. Discussion: Trajectories indicate that patients have differing treatment needs and cluster analysis as an evaluation technique may be useful in identifying what treatment works and for whom. The present study addresses a major concern for health care providers serving disaster prone communities and emphasizes the importance of identifying pre incident and disaster related risk vulnerabilities that contribute to mental health outcomes. Subgroup analyses are a useful tool for developing more targeted treatment within integrated care and may be an accessible research strategy for others working in such settings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Osofsky, Howard J; Weems, Carl F; Hansel, Tonya Cross; Speier, Anthony H; Osofsky, Joy D; Graham, Rebecca; King, Lucy; Craft, Timothy K; Baji, Briggs, Bryan, Buttke, Clatworthy, Cohen, Conybeare, Couch, Croghan, Croghan, Croze, Cui, Danielsson, Davidson, Drescher, Eggleston, Ellison, Etz, Foa, Fraley, Funderburk, Galea, Goldmann, Haldar, Hansel, Hodgins, Kessler, Malta, Many, Milligan, Mooi, Morris, Norris, Norris, Osofsky, Osofsky, Osofsky, Osofsky, Palinkas, Peck, Picou, Pynoos, Reeves, Rosellini, Summergrad, Twersky, Twisk, Van Dyke, van Ommeren, Weathers, Weems, Weems, Wills, Witters, Woltmann, Yun",2017.0,,0,0,
5437,Treatment effects from UPBEAT: a randomized trial of care management for behavioral health problems in hospitalized elderly patients.,"The purpose of this study was to examine the impact of the Unified Psychogeriatric Biopsychosocial Evaluation and Treatment (UPBEAT) Program, an interdisciplinary mental health care management program, on the behavioral health symptoms of elderly veterans. Participants, 60 years and older, included 2637 veterans recruited from medical/surgical units who screened positively for significant depressive or anxiety symptoms and/or at-risk alcohol drinking. Participants were randomized to UPBEAT or to usual care. Primary outcomes were measured at baseline and at 6, 12, and 24 months. Participant nonadherence to the protocol was common and is a major limitation. There were no differences between UPBEAT and usual care patients on symptom or functional outcomes at any follow-up point. Exploratory analyses suggested that among participants with more physical health problems, there were greater improvements in depressive symptoms in those assigned to UPBEAT care. Despite a theoretical and practically sound intervention, participation was low and treatment outcomes, while generally good, appeared unaffected by the addition of the program.",Oslin DW.; Thompson R.; Kallan MJ.; TenHave T.; Blow FC.; Bastani R.; Gould RL.; Maxwell AE.; Rosansky J.; Van Stone W.; Jarvik L.,2004.0,10.1177/0891988703262539,0,0,
5438,PRISM-E: comparison of integrated care and enhanced specialty referral in managing at-risk alcohol use.,"This study was part of the Primary Care Research in Substance Abuse and Mental Health for the Elderly study (PRISM-E) and determined the relative effectiveness of two different models of care for reducing at-risk alcohol use among primary care patients aged 65 and older. This multisite study was a randomized clinical trial comparing integrated care with enhanced specialty referral for older primary care patients screened and identified to have at-risk drinking. Before the study, the 560 participants consumed a mean of 17.9 drinks per week and had a mean of 21.1 binge episodes in the prior three months. At six months, both treatment groups reported lower levels of average weekly drinking (p<.001) and binge drinking (p<.001), despite low levels of treatment engagement. However, the declines did not differ significantly between treatment groups. These results suggest that older persons with at-risk drinking can substantially modify their drinking over time. Although no evidence suggested that the model of care was important in achieving this result, the magnitude of reduction in alcohol use was comparable with other intervention studies.",Oslin DW.; Grantham S.; Coakley E.; Maxwell J.; Miles K.; Ware J.; Blow FC.; Krahn DD.; Bartels SJ.; Zubritsky C.; Olsen E.; Kirchner JE.; Levkoff S.,2006.0,10.1176/ps.2006.57.7.954,0,0,
5439,Cognitive-behavioral therapy for bulimia: an initial outcome study,,"Ordman, A M; Kirschenbaum, D S",1985.0,,0,0,
5440,An assimilation analysis of clinician-assisted emotional disclosure therapy with survivors of intimate partner sexual assault.,"This study examined clinician-assisted emotional disclosure therapy among college women with a history of intimate partner sexual assault. Assimilation analysis, a method for tracking client movement in psychotherapy, was used to document changes in dominant and submissive voices during clients' disclosure of the trauma. Self-blame, traditional gender-role assumptions, and internalized rape myth ideology emerged as prominent themes in clients' formations of problem statements. The two case studies presented illustrate the difficulty in clearly formulating experiences of intimate partner sexual assault as problematic, integrating submissive and dominant voices and empowering adaptive voices that speak for the well-being and self-assertion of the individual. Implications for psychotherapy with survivors of intimate partner sexual assault are discussed.",Orchowski LM.; Uhlin BD.; Probst DR.; Edwards KM.; Anderson T.,2009.0,10.1080/10503300902810600,0,0,
5441,A randomised placebo-controlled trial of a self-help Internet-based intervention for test anxiety.,"Test anxiety is widespread and associated with poor performance in academic examinations. The Internet, not well-proven for the treatment of anxiety, should be able to deliver highly accessible Cognitive Behavior Therapy (CBT). This study sought to test the hypothesis that CBT, available on the Internet, could reduce test anxiety. Ninety university students were randomly allocated to CBT or a control program, both on the Internet. Before and after treatment, the participants completed the Test Anxiety Inventory (TAI), an Anxiety Hierarchy Questionnaire (AHQ), the Exam Problem-Solving Inventory (EPSI), the General Self-Efficacy Scale (GSES) and the Heim reasoning tests (AH) as a measure of test performance. Of the CBT and control groups 28% and 35%, respectively, withdrew. According to the TAI, 53% of the CBT group showed a reliable and clinically significant improvement with treatment but only 29% of the control group exhibited such a change. On the AHQ, 67% of the CBT group and 36% of the control group showed a clinically significant improvement, more than two standard deviations above the mean of the baseline, a change in favour of CBT. Both groups improved on the GSES, in state anxiety during exams retrospectively assessed, and on the AH tests. The improvement on the AH tests was probably a practice effect and not a reflection of a change in capacity for academic testing. This study thus supports use of CBT on the Internet for the treatment of test anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Orbach, Gili; Lindsay, Stan; Grey, Susan; Andersson, Barnett, Beck, Bloom, Briggs, Buglione, Cane, Carlbring, Carlbring, Carlbring, Cassady, Ergene, Fisher, Heim, Hembree, Heppner, Hong, Jacobson, Jacobson, Jones, Kaltenhaler, Kaltenhaler, Kenardy, Kirk, Kirkland, Klein, Klein, Lange, Margraf, Marks, Marteau, McDonald, Meichenbaum, Morris, Nielsen, Orbach, Richards, Richards, Sanders, Schneider, Seipp, Sherer, Spielberger, Spielberger, Strom, Vagg, Wachelka, Zeidner",2007.0,,0,0,
5442,Virtual environments in the treatment of impotence and premature ejaculation.,"Virtual environments have recently attracted much attention in clinical medicine. Given the new opportunities offered by this technology, some on-going research projects are now testing the possibility of using virtual reality (VR) for behavioral therapy, especially in the treatment of phobias. This paper describes a psychodynamic psychotherapy, integrating VR, used for the treatment of erection dysfunctions and premature ejaculation. The rationale of this approach is presented together with the results obtained on 2 different clinical samples: 50 patients (aged 22-75 yrs) who had been impotent for at least 6 mo and 16 patients (aged 21-44 yrs) affected by primary premature ejaculation. The treatment consisted of 12 hr-long sessions over a 25-wk period, including the use of a VR helmet, joystick, and miniature TV screens projecting specially designed CD-ROM programs on psychological development from childhood to adolescence and the beginning of interest in the opposite sex. Results show a total of 9 partial and 26 complete positive responders in the impotence group and 2 partial and 9 complete positive responders in the premature ejaculation group. Patients benefiting from therapy reported lasting improvement when contacted 6-mo after the last session. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Optale, Gabriele; Munari, Adriano; Nasta, Alberto; Pianon, Carlo; Verde, Jole Baldaro; Viggiano, Giuseppe",1998.0,,0,0,
5443,Reducing phobic symptomatology using subliminal stimulation.,"Discusses the therapeutic efficacy of the fading technique in remitting phobic symptomatology in a 24-yr-old female, a 25-yr-old female, and a 22-yr-old male in Romania. Findings show that the threatening potential of a phobic situation is diminished significantly if the subject is prevented from processing the situation consciously. It is maintained that the fading technique helps to avoid the anxiety states that are induced artificially by classical desensitization techniques. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Opre, Adrian; Mois, Veronica; Opre, Dana; Barlow, Bornstein, David, Ellis, Elmore, Klepac, Lee, Levin, Opre, Opre, Ost, Radu, Radu, Ross, Silverman, Silverman, Silverman, Tyrer, Wolman, Wolpe",2002.0,,0,0,
5444,Clinical efficacy of eye movement desensitization and reprocessing.,"Eye Movement Desensitization and Reprocessing (EMDR) has gained notoriety as a brief treatment for Posttraumatic Stress Disorder (PTSD). In EMDR, clients repeatedly bring up traumatic events in memory and visually track stimuli moving back and forth in front of them. Previous group studies of EMDR have had methodological problems, however. The present study attempted to (1) assess EMDR's effectiveness compared to an Eye Focus treatment controlling for eye movement; (2) compare both treatments to a wait-list control; and (3) rate therapist characteristics to check experimenter bias. Twenty participants suffering from PTSD were randomly assigned to either EMDR or Eye Focus (EF) treatments, and immediate treatment or wait-list conditions. After two 90-minute treatment sessions, outcomes were assessed on subjective measures of anxiety (SUDs) and cognitive beliefs (VOCs). The mean SUDs pre-post differences on matched pairs t-tests indicated significant reduction of disturbance for both the EMDR group, p < .001, and the Eye Focus group, p < .001. VOC ratings showed similar treatment gains. Two-factor analyses assessed changes across groups (2 administrations x 2 treatment groups) on two standardized measures, the Impact of Event Scale (IES) and the Modified PTSD Symptom Scale (MPSS). The IES showed a main effect for treatment F (2, 18) = 16.45, p < .001, while wait-list remained unchanged F (2, 18) = 1.09, p > .05. A significant interaction F (2, 18) = 6.69, p < .05 supported treatment efficacy. EMDR and EF participants improved equally on the IES, i.e., no differences for type of treatment, F (2, 18) = 0.54, p > .05. The MPSS also showed a main effect for treatment, F (2, 18) = 6.46, p < .05, with wait-list unchanged, F (2, 18) = 0.27, p > .05. This interaction was not significant, p =.10. Further, both EMDR and EF groups demonstrated improvement on the MPSS. Results suggest that (1) EMDR and Eye Focus are both effective in reducing some self-reported PT (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Opdyke, Daniel C",1996.0,,0,0,
5445,A cross-national study of posttraumatic stress disorder in Dutch-Australian immigrants,"Objective. Studying the rates of posttraumatic stress disorder (PTSD) in people who experienced World War II, but who have subsequently lived in different environments is a way of looking at the impact of recovery environment on PTSD. Immigrants had less support in terms of the social cohesion in their home country, but were not subjected to the same triggers of war-related intrusions. Method. Posttraumatic stress disorder was investigated in citizens from the Netherlands who emigrated to Australia in the post-World War II years (n = 251). Immigrants born between 1920 and 1930 (n = 171) were compared with a same-aged group living in Holland (n = 1461) for stressful war experiences and the extent of PTSD. Results. Those who had been exposed to the most severe war stress were over-represented in the immigrant group. Immigrants with current PTSD more often stated that motives for migration were threat of a third world war, disappointment with Dutch society and personal problems. We were unable to demonstrate specific effects of emigration on the prevalence of current PTSD. Conclusions. This study suggests that exposure to severe war stress promoted the need to emigrate. The comparable PTSD scores of the groups of war victims living in Australia and the Netherlands support the notion that extreme war stress may be considered the primary determining factor in the development of PTSD, and that actual post-war living circumstances are, in the long term, of subordinate importance.",Op den Velde W.; Hovens J.E.; Bramsen I.; McFarlane A.C.; Aarts P.G.H.; Falger P.R.J.; de Groen J.H.M.; van Duijn H.,2000.0,10.1046/j.1440-1614.2000.00842.x,0,0,
5446,Effectiveness of face-to-face versus telephone support in increasing physical activity and mental health among university employees,"ER METHODSUniversity employees were randomly assigned to a coaching program with 4 face-to-face (N = 33) or telephone-based (N = 33) support contacts. Both programs included an initial face-to-face intake session and an informational brochure. Physical activity, trait anxiety, self-efficacy, and social support were measured by self-report before and after the interventions that lasted 3 months.RESULTSBoth groups increased leisure-time physical activity, self-efficacy, and social support and decreased sitting time and trait anxiety. The only significant time by group interaction was found for active transportation. More specifically, participants in the face-to-face group reported a significant increase in their active transportation from pretest to posttest, whereas participants in the telephone group reported no significant change.CONCLUSIONSBoth face-to-face support and telephone support proved to be effective in increasing the physical activity level and mental health of university employees.BACKGROUNDFollow-up support increases the effectiveness of physical activity interventions. This study evaluates the effectiveness of 2 support modes on physical activity and mental health.","Opdenacker, J; Boen, F",2008.0,,0,0,
5447,Cost-effectiveness of a workplace intervention for sick-listed employees with common mental disorders: design of a randomized controlled trial,"ER METHODSThe study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are on sick leave for 2 to 8 weeks with common mental disorders. The workplace intervention will be compared with usual care. The workplace intervention is a stepwise approach that aims to reach consensus about a return-to-work plan by active participation and strong commitment of both the sick-listed employee and the supervisor. Outcomes will be assessed at baseline, 3, 6, 9 and 12 months. The primary outcome of this study is lasting return-to-work, which will be acquired from continuous registration systems of the companies after the follow-up. Secondary outcomes are total number of days of sick leave during the follow-up, severity of common mental disorders, coping style, job content, and attitude, social influence, and self-efficacy determinants. Cost-effectiveness will be evaluated from the societal perspective. A process evaluation will also be conducted.DISCUSSIONReturn-to-work is difficult to discuss in the workplace for sick-listed employees with mental disorders and their supervisors. Therefore, this intervention offers a unique opportunity for the sick-listed employee and the supervisor to discuss barriers for return-to-work. Results of this study will possibly contribute to improvement of disability management for sick-listed employees with common mental disorders. Results will become available in 2009.TRIAL REGISTRATIONISRCTN92307123.BACKGROUNDConsidering the high costs of sick leave and the consequences of sick leave for employees, an early return-to-work of employees with mental disorders is very important. Therefore, a workplace intervention is developed based on a successful return-to-work intervention for employees with low back pain. The objective of this paper is to present the design of a randomized controlled trial evaluating the cost-effectiveness of the workplace intervention compared with usual care for sick-listed employees with common mental disorders.","Oostrom, S H; Anema, J R; Terluin, B; Vet, H C; Knol, D L; Mechelen, W",2008.0,10.1186/1471-2458-8-12,0,0,
5448,"Collaborative stepped care v. care as usual for common mental disorders: 8-month, cluster randomised controlled trial.","Thus far collaborative stepped care (CSC) studies have not incorporated self-help as a first step. To evaluate the effectiveness of CSC in the treatment of common mental disorders. An 8-month cluster randomised controlled trial comparing CSC to care as usual (CAU) (Dutch Trial Register identifier NTR1224). The CSC consisted of a stepped care approach guided by a psychiatric nurse in primary care with the addition of antidepressants dependent on the severity of the disorder, followed by cognitive-behavioural therapy in mental healthcare. Twenty general practitioners (GPs) and 8 psychiatric nurses were randomised to provide CSC or CAU. The GPs recruited 163 patients of whom 85% completed the post-test measurements. At 4-month mid-test CSC was superior to CAU: 74.7% (n = 68) v. 50.8% (n = 31) responders (P = 0.003). At 8-month post-test and 12-month follow-up no significant differences were found as the patients in the CAU group improved as well. Treatment within a CSC model resulted in an earlier treatment response compared with CAU.",Oosterbaan DB.; Verbraak MJ.; Terluin B.; Hoogendoorn AW.; Peyrot WJ.; Muntingh A.; van Balkom AJ.,2013.0,10.1192/bjp.bp.112.125211,0,0,
5449,The influence on treatment gain of comorbid avoidant personality disorder in patients with social phobia.,,Oosterbaan DB.; van Balkom AJ.; Spinhoven P.; de Meij TG.; van Dyck R.,2002.0,,0,0,
5450,"Does brief, clinically based, intensive multimodal behavior therapy enhance the effects of methylphenidate in children with ADHD?","ER METHODFifty children with ADHD (ages 8-12) were randomized to treatment of methylphenidate or treatment with methylphenidate combined with 10 weeks of multimodal behavior therapy. The multimodal behavior therapy consisted of a child and parent behavioral therapy and a teacher behavioral training. Assessments included parent, teacher and child ratings of ADHD symptoms, oppositional and conduct behavior, social skills, parenting stress, anxiety and self-worth.RESULTSBoth treatment conditions yielded significant improvements on all outcome domains. No significant differences were found between both treatments.CONCLUSIONSNo evidence was found for the additive effect of multimodal behavior therapy next to optimally titrated methylphenidate.CLINICAL IMPLICATIONSThis study does not support the expectation that optimally dosed stimulant treated children with ADHD should routinely receive psychosocial treatment to further reduce ADHD- and related symptoms.OBJECTIVEThe additional value of a short-term, clinically based, intensive multimodal behavior therapy to optimally titrated methylphenidate in children with attention-deficit hyperactivity disorder (ADHD) was investigated.","Oord, S; Prins, P J; Oosterlaan, J; Emmelkamp, P M",2007.0,10.1007/s00787-006-0574-z,0,0,
5451,Deep brain stimulation for obsessive-compulsive disorders: long-term analysis of quality of life.,"To evaluate the long-term effects of deep brain stimulation (DBS) on quality of life (QOL) in therapy-refractory obsessive-compulsive disorder (OCD) patients. 16 patients who met Diagnostic and Statistical Manual of Mental Disorders (4th ed) (DSM-IV) criteria for OCD and were considered therapy-refractory were treated with DBS. Patients were assessed 1 month before device implantation (T0), at 8 months of active stimulation (T1) and at 3-5 years of active stimulation (T2). QOL was measured with the WHO Quality of Life Scale-Brief Version (WHOQOL-BREF) that covers physical, psychological, social and environmental domains. The study was conducted between April 2005 and January 2011 at the Academic Medical Center, Amsterdam, The Netherlands. At T1 and T2, we found significant improvement (p<0.05) in the general score and in the physical, psychological and environmental domains of WHOQOL-BREF. Between T1 and T2, the physical and psychological domains improved further (p<0.05). At T2, the general score improved by a total of 90%, the physical and psychological domains both improved by 39.5% and the environmental domain improved by 16%. The social domain did not change between baseline and follow-up assessments. In line with symptom improvement, patient's QOL improved in the general score and in three of the four WHOQOL-BREF domains. This suggests that the improvement caused by DBS is not limited to symptom reduction alone, but also has a positive influence on patients' perception of their physical, psychological, environmental and global QOL. http://isrctn.org identifier: ISRCTN23255677.",Ooms P.; Mantione M.; Figee M.; Schuurman PR.; van den Munckhof P.; Denys D.,2014.0,10.1136/jnnp-2012-302550,0,0,
5452,Caregiving and illness beliefs in the course of psychotic illness,"Objective: Informal caregivers play a central role in patient care, and caregiving can provide positive and negative experiences. Negative caregiving experiences are associated with distress. This study investigates associations between caregiving appraisals in psychosis, distress, and 3 key illness beliefs (consequences, cure-control, and timeline), and whether illness beliefs makes a contribution to the relation between negative caregiving appraisal and distress. Method: We employed a cross-sectional study design. Caregivers (n = 146), including Early Psychosis Services caregivers (n = 60), completed self-report measures of the impact of care and illness beliefs. Results: Negative caregiving appraisals and distress were strongly associated. Caregivers appraised caregiving negatively and reported greater distress when they perceived the illness as having severe consequences for themselves and the patient, and when they perceived it as a long-term illness. In contrast, they appraised caregiving positively when they perceived that both they and the patient could exert some control over the illness. Illness beliefs did not account for the strong relation between negative caregiving appraisals and distress. Caregivers of patients with longer illness histories reported higher levels of positive caregiving appraisals. Conclusion: Caregivers' cognitive representation of psychosis may play an important role in positive and negative appraisals about caregiving, even at an early stage of the illness. Implications for interventions with early psychosis caregivers are discussed.",Onwumere J.; Kuipers E.; Bebbington P.; Dunn G.; Fowler D.; Freeman D.; Watson P.; Garety P.,2008.0,,0,0,
5453,Identifying moderators and predictors of treatment outcome in caregivers. Results from the GET UP PIANO pragmatic cluster randomized controlled trial,"Background: Over the last decade, family interventions (FI) and cognitive behavioural therapy(CBT) have featured in psychosis treatment guidelines in different countries and alongside case management, form part of optimal packages of care in first episode psychosis (FEP) services. Robust evidence in support of their efficacy and acceptability to clinical groups is well established. However, data remains scarce and our understanding limited, on moderators of treatment outcome for carers in FEP services. This study investigated what carer and patient demographics and clinical profiles were associated with gains from psychosocial treatment interventions within FEP services. Methods: Data was collected as part of the GET UP (Genetics, Endophenotypes, Treatment: Understanding early Psychosis) PIANO (Psychosis: Early intervention and Assessment of Needs and Outcome) pragmatic cluster RCT that compared additional psychosocial intervention (CBT, FI case management) with treatment as usual for FEP cases in 126 mental health centres in Italy. Patients were assessed with a range of clinical assessments before treatment initiation and 9 month follow up. Results: Significant interactions were identified between psychosocial interventions, patient and carer factors and carer outcomes. The results suggested that psychosocial interventions, when compared to routine care alone, delivered greater reductions in carer distress particularly in patients reporting higher levels of carer EE and more negative accounts of early caregiving experiences and carers reporting greater caregiving hours. Further analyses are in progress. Conclusions: Current findings are encouraging and offer indications for future investigations. Further studies are required to replicate the findings and assess the contribution of local contexts.",Onwumere J.; Kuipers E.; Bebbington P.; Bonetto C.; Cristofalo D.; Cremonese C.; Miceli M.; Scarone S.; Meneghelli A.; De Girolamo G.; Ruggeri M.,2016.0,10.1111/eip.12395,0,0,
5454,The N-methyl-D-aspartate receptor co-agonist D-cycloserine facilitates declarative learning and hippocampal activity in humans.,"Background: The N-methyl-D-aspartate receptor (NMDAR) is critical for learning-related synaptic plasticity in amygdala and hippocampus. As a consequence, there is considerable interest in drugs targeting this receptor to help enhance amygdala- and hippocampus-dependent learning. A promising candidate in this respect is the NMDAR glycine-binding site partial agonist D-cycloserine (DCS). Accumulating clinical evidence indicates the efficacy of DCS in the facilitation of amygdala-dependent fear extinction learning in patients with phobic, social anxiety, panic, and obsessive-compulsive disorder. An important unresolved question though is whether the use of DCS can also facilitate hippocampus-dependent declarative learning in healthy people as opposed to being restricted to the fear memory domain. Methods: In the present study, we investigated whether or not DCS can facilitate hippocampus-dependent declarative learning. We have therefore combined functional magnetic resonance imaging with two different declarative learning tasks and cytoarchitectonic probabilistic mapping of the hippocampus and its major subdivisions in 40 healthy volunteers administered either a 250 mg single oral dose of DCS or a placebo. Results: We found that DCS facilitates declarative learning as well as blood-oxygen level dependent activity levels in the probabilistically defined cornu ammonis region of the hippocampus. The absence of activity changes in visual control areas underscores the specific action of DCS in the hippocampal cornu ammonis region. Conclusions: Our findings highlight NMDAR glycine-binding site partial agonism as a promising pharmacological mechanism for facilitating declarative learning in healthy people. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Onur, Oezguer A; Schlaepfer, Thomas E; Kukolja, Juraj; Bauer, Andreas; Jeung, Haang; Patin, Alexandra; Otte, David-Marian; Shah, N. Jon; Maier, Wolfgang; Kendrick, Keith M; Fink, Gereon R; Hurlemann, Rene; Amunts, Artola, Ashburner, Assini, Cansino, Collins, D'Souza, Davis, Eickhoff, Evans, Flood, Gomperts, Goossens, Grillon, Grunwald, Guastella, Hardingham, Hofmann, Holdiness, Holmes, Hurlemann, Hurlemann, Johnson, Kalisch, Kleckner, Kukolja, Kukolja, Kukolja, Kushner, Laake, Lashley, Ledgerwood, Lee, Li, Monahan, Nair, Norberg, Onur, Otto, Otto, Quartermain, Ressler, Rosenzweig, Strange, Strange, Thompson, Wilhelm",2010.0,,0,0,
5455,Some complications of common treatment schemes of thoracolumbar spine fractures can be predicted with magnetic resonance imaging: prospective study of 53 patients with 71 fractures.,"Prospective cohort study. To study the predictive value of magnetic resonance imaging (MRI) findings of thoracolumbar spine fractures concerning the radiologic and clinical outcome. Disagreement about the proper treatment of thoracolumbar spine fractures is caused by insufficiency of conventional imaging techniques. Previous studies have shown that MRI is capable of distinguishing injury to all structures of the fractured spine and thus may help develop schemes with higher predictive power. A total of 53 patients with 71 fractures were studied with MRI in a prospective fashion. A total of 24 patients with 39 fractures were treated conservatively and 29 patients with 32 fractures were treated operatively after a protocol concerning the treatment options. MRI scans were obtained within 1 week of injury and at the 2-year follow-up. Pain scores were obtained at the 2-year follow-up. Previously described MRI schemes concerning the trauma and post-trauma conditions were used. An unfavorable outcome in the conservative group was related to the progression of kyphosis, which in most cases was predictable with the use of trauma MRI findings concerning the endplate comminution and vertebral body involvement. In the operatively treated group, recurrence of the kyphotic deformity was predictable by the lesion of the posterior longitudinal ligamentary complex together with endplate comminution and vertebral body involvement as seen on trauma MRI. The authors recommend the use of MRI to develop reliable prognostic criteria for these injuries.",Oner FC.; van Gils AP.; Faber JA.; Dhert WJ.; Verbout AJ.,2002.0,,0,0,
5456,"PTSD, resilience, and quality of life in military veterans.","Objective: This prospective study aims to examine the relationship between PTSD symptoms and quality of life in trauma-exposed veterans and veterans with PTSD. The study also examined the extent to which resilience moderates the relationship between PTSD symptoms and domains of quality of life (mental and physical). Further, this study explored the relationship between specific symptom clusters of PTSD and mental and physical quality of life in trauma-exposed veterans and veterans diagnosed with PTSD. Method: This study used cross sectional data taken from initial assessments of 82 trauma-exposed veterans who were participating in a larger clinical trial treatment study at the Palo Alto Veteran's Affairs Health Care System and Stanford University. PTSD symptoms were assessed using the CAPS, resilience levels were assessed using the Connors-Davidson Resilience Scale (CD-RISC) and quality of life was assessed using the SF-36. A Hierarchical Multiple Regression (HMR) model was used to examine both main effects and interaction effects between PTSD, resilience and quality of life domains. Results: HMR analyses revealed that PTSD symptom severity significantly predicted mental quality of life (MQOL) and physical quality of life (PQOL) in trauma-exposed veterans but only MQOL in veterans diagnosed with PTSD. Resilience did not predict quality of life or moderate the relationship between PTSD and quality of life in either the overall trauma-exposed sample or the PTSD-diagnosed subsample. When looking at specific symptom clusters of PTSD, hyperarousal symptoms were shown to predict MQOL but not PQOL. In addition, resilience was only shown to moderate the relationship between re-experiencing symptom clusters and MQOL. Conclusions: Results suggest that increasing resilience in veterans with symptoms of PTSD is most helpful when working to minimize symptoms of re-experiencing, avoidance and numbing, but not necessarily symptoms of hyperarousal. In addition, it appears that focusing on reducing symptoms, rather than building resilience, may be more important for improving veterans' quality of life. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","O'Neill, Shawna Katherine",2015.0,,0,0,
5457,Effectiveness of a programme of exercise on physical function in survivors of critical illness following discharge from the ICU: study protocol for a randomised controlled trial (REVIVE),"ER BACKGROUND: Following discharge home from the ICU, patients often suffer from reduced physical function, exercise capacity, health-related quality of life and social functioning. There is usually no support to address these longer term problems, and there has been limited research carried out into interventions which could improve patient outcomes. The aim of this study is to investigate the effectiveness and cost-effectiveness of a 6-week programme of exercise on physical function in patients discharged from hospital following critical illness compared to standard care.METHODS/DESIGN: The study design is a multicentre prospective phase II, allocation-concealed, assessor-blinded, randomised controlled clinical trial. Participants randomised to the intervention group will complete three exercise sessions per week (two sessions of supervised exercise and one unsupervised session) for 6 weeks. Supervised sessions will take place in a hospital gymnasium or, if this is not possible, in the participants home and the unsupervised session will take place at home. Blinded outcome assessment will be conducted at baseline after hospital discharge, following the exercise intervention, and at 6 months following baseline assessment (or equivalent time points for the standard care group). The primary outcome measure is physical function as measured by the physical functioning subscale of the Short-Form-36 health survey following the exercise programme. Secondary outcomes are health-related quality of life, exercise capacity, anxiety and depression, self efficacy to exercise and healthcare resource use. In addition, semi-structured interviews will be conducted to explore participants' perceptions of the exercise programme, and the feasibility (safety, practicality and acceptability) of providing the exercise programme will be assessed. A within-trial cost-utility analysis to assess the cost-effectiveness of the intervention compared to standard care will also be conducted.DISCUSSION: If the exercise programme is found to be effective, this study will improve outcomes that are meaningful to patients and their families. It will inform the design of a future multicentre phase III clinical trial of exercise following recovery from critical illness. It will provide useful information which will help the development of services for patients after critical illness.TRIAL REGISTRATION: ClinicalTrials.gov NCT01463579.","O'Neill, B; McDowell, K; Bradley, J; Blackwood, B; Mullan, B; Lavery, G; Agus, A; Murphy, S; Gardner, E; McAuley, D F",2014.0,10.1186/1745-6215-15-146,0,0,
5458,Three modes of hierarchy presentation in systematic desensitization therapy.,,O'Neil DG.; Howell RJ.,1969.0,,0,0,
5459,Effect of religious cognitive-behavior therapy on religious content obsessive compulsive disorder and marital satisfaction,"Objective: Religious themes commonly feature in religious with Obsessive-compulsive disorder (OCD). OCD which includes cognitive, emotional, and behavioral components, is a debilitating chronic disorder and can affects on patient' marital satisfaction. The aim of us was to evaluate efficacy of Religious Cognitive- Behavior therapy (RCBT) on religious oriented Obsessive-Compulsive disorder and marital satisfaction. Method: This is a randomized controlled clinical trial. This study conducted on 90 OCD outpatients with 17 and more Yale Brown obsessive compulsive scale(Y-BOCS) and religious content OCD . Intervention consists of 10 weekly RCBT . We used Enrich scale for asses' marital satisfaction and Y-BOCS scale before and after treatment.Data were analyzed by ANCOVA/ANOVA repeated measure test using SPSS version ver.15. Result: In our study duration of OCD was 11.5 ± 8.6 years & 11.5 ± 8.8 years and duration of marriage was 16.88 ± 11.6 & 13.51± 10.9 years Yale Brown scores after intervention decreased with significant difference (p=0.001). There were significant difference between mean scores of two groups (p=0.001). Comparison of obsession subscale and compulsion subscale of Yale Brown scale showed decreasing trend in both of obsession subscale and compulsion either within or between group is statistically significant (p= 0.001).Also marital satisfaction significantly improved in case group (p= 0.001). Conclusion: In religious patients with religious contents, religious based interventions like religious CBT could significantly increase clinical responses. Also theses interventions could improve marital status . These results suggest that Religious Cognitive-Behavior Therapy can be effective for religious oriented OCD patients.",Omranifard V.; Akuchakian S.; Almasi A.; Maraci M.R.,2011.0,10.1016/S0924-9338(11)73446-0,0,0,
5460,Quality of life in treatment of mandibular fractures using closed reduction and maxillomandibular fixation in comparison with open reduction and internal fixation--a randomized prospective study,"ER Treatment of mandibular fractures by open reduction and internal fixation (ORIF) is often assumed to be superior to treatment by close reduction and maxillomandibular fixation (MMF) because patients managed by ORIF seem to be rehabilitated earlier according to functional and social aspects. This assumption is often from surgeon's perspective, not taking into account patient's view point. This study highlights a comparative assessment between ORIF and MMF from the patients' perspective. Fifty six patients with mandibular fractures within the tooth bearing areas of the mandible were prospectively studied in a randomized controlled pattern for postoperative Quality of Life (QoL) after ORIF versus MMF. Both groups were analyzed preoperatively, at 1 day, 6 and 8 weeks regarding their QoL using the General Oral Health Assessment Index questionnaire (GOHAI). No significant statistical difference was found between the groups regarding overall QoL. Patients managed by MMF were more affected by psychosocial and physical domains whereas patients managed by ORIF were more affected by the pain domain. The results demonstrate that the treatment affects the psychosocial, physical and pain domain differentially. When both treatments are possible the patient's should be enlightened on the advantages and disadvantages of both treatment modalities to guide their choice of treatment.","Omeje, K U; Rana, M; Adebola, A R; Efunkoya, A A; Olasoji, H O; Purcz, N; Gellrich, N C",2014.0,10.1016/j.jcms.2014.06.021,0,0,
5461,Netmums: a phase II randomized controlled trial of a guided Internet behavioural activation treatment for postpartum depression.,"Despite the high prevalence of postnatal depression (PND), few women seek help. Internet interventions may overcome many of the barriers to PND treatment use. We report a phase II evaluation of a 12-session, modular, guided Internet behavioural activation (BA) treatment modified to address postnatal-specific concerns [Netmums Helping With Depression (NetmumsHWD)]. To assess feasibility, we measured recruitment and attrition to the trial and examined telephone session support and treatment adherence. We investigated sociodemographic and psychological predictors of treatment adherence. Effectiveness outcomes were estimated with the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder-7, Work and Social Adjustment Scale, Postnatal Bonding Questionnaire, and Social Provisions Scale. A total of 249 women were recruited via a UK parenting site, Netmums.com. A total of 83 women meeting DSM-IV criteria for major depressive disorder were randomized to NetmumsHWD (n = 41) or treatment-as-usual (TAU; n = 42). Of the 83 women, 71 (86%) completed the EPDS at post-treatment, and 71% (59/83) at the 6-month follow-up. Women completed an average of eight out of 12 telephone support sessions and five out of 12 modules. Working women and those with less support completed fewer modules. There was a large effect size favouring women who received NetmumsHWD on depression, work and social impairment, and anxiety scores at post-treatment compared with women in the TAU group, and a large effect size on depression at 6 months post-treatment. There were small effect sizes for postnatal bonding and perceived social support. A supported, modular, Internet BA programme can be feasibly delivered to postpartum women, offering promise to improve depression, anxiety and functioning.",O'Mahen HA.; Richards DA.; Woodford J.; Wilkinson E.; McGinley J.; Taylor RS.; Warren FC.,2014.0,10.1017/S0033291713002092,0,0,
5462,The role of anxiety sensitivity in the relation between trait worry and smoking behavior.,"Introduction: Smoking and anxiety disorders frequently co-occur. Trait worry is a core symptom of anxiety disorders. While research suggests worry processes may be important to certain smoking behaviors, the mechanisms explicating these relations remain unknown. Method: The current study examined anxiety sensitivity (AS) as a potential mediator for the relation between trait worry and number of years being a daily smoker, latency to first cigarette of the day, smoking rate, heaviness of smoking, and nicotine dependence among treatment-seeking daily smokers (N = 376; 47% female; Mage = 37.76, SD = 13.46). Results: Consistent with prediction, AS significantly mediated the relations between trait worry and the studied smoking variables. Conclusion: The present findings suggest it may be useful to clinically address AS among worry-prone, treatment-seeking daily smokers in order to address smoking behavior. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Olvera, Hyaneyoung; Bakhshaie, Jafar; Garey, Lorra; Jardin, Charles; Schmidt, Norman B; Zvolensky, Michael J; Assayag, Babor, Battista, Behar, Bollen, Borkovec, Borkovec, Borkovec, Breslau, Brown, Brown, Brown, Brown, Comeau, Cougle, Cranford, Draper, Etter, Evatt, First, Floyd, Fresco, Fritz, Goodwin, Hayes, Hayes, Hayward, Heatherton, Johnson, Johnson, Johnson, Keough, Langdon, Lasser, Leyro, Maller, Marshall, McNally, Meyer, Newman, Peasley-Miklus, Perkins, Piper, Pomerleau, Preacher, Preacher, Preacher, Rapee, Reiss, Ruscio, Schmidt, Schmidt, Schmidt, Sheets, Shrout, Sobel, Taylor, Tofighi, Watson, Wong, Zvolensky, Zvolensky, Zvolensky, Zvolensky, Zvolensky",2015.0,,0,0,
5463,CBT for high anxiety sensitivity: alcohol outcomes.,High anxiety sensitivity (AS) has been associated with greater alcohol consumption and alcohol-related problems as well as greater sensitivity to the anxiety-reducing effects of alcohol and greater risky negative reinforcement motives for drinking. The present study reported on the alcohol-related outcomes of a telephone-delivered cognitive behavioral treatment (CBT) designed to reduce high AS. Eighty individuals with high AS (M age=36 years; 79% women; 76% Caucasian) seeking treatment for their AS-related concerns participated in the study and were randomly assigned to an eight week telephone CBT program or a waiting list control. Participants completed measures of drinking motives and problem drinking at pre- and post-treatment. Multilevel modeling showed that the treatment was successful in reducing AS. The treatment also resulted in specific reductions in drinking to cope with anxiety motives as well as physical alcohol-related problems. Mediated moderation analyses showed treatment-related changes in AS mediated changes in drinking to cope with anxiety motives. Changes in drinking to cope with anxiety motives mediated changes in physical alcohol-related problems. Results of the present study suggest that an AS-targeted intervention may have implications for reducing risky alcohol use cognitions and behaviors. Further research is needed in a sample of problem drinkers.,Olthuis JV.; Watt MC.; Mackinnon SP.; Stewart SH.,2015.0,10.1016/j.addbeh.2015.02.018,0,0,
5464,Telephone-delivered cognitive behavioral therapy for high anxiety sensitivity: a randomized controlled trial.,"High anxiety sensitivity (AS) is associated with the development and maintenance of anxiety and depressive symptoms and is theorized to be a mediator of treatment outcomes for anxiety and depression. The present study tested the efficacy of a telephone-delivered cognitive behavioral therapy (CBT) intervention in reducing high AS and its associated anxiety and depressive symptoms. Treatment-seeking participants with high AS were recruited from the community (N = 80; M age = 36 years; 79% women; 76% Caucasian) and were randomly assigned to an 8-week telephone-delivered CBT program or a waiting list control. Participants completed anxiety and depression symptom and diagnostic measures at pre- and posttreatment, after a subsequent 4 weeks of continued interoceptive exposure, and 8 weeks later. Multilevel modeling showed the treatment was successful in reducing AS, as well as panic, social phobia, posttraumatic stress symptoms, and number of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnoses per participant when compared to a waiting list control. These gains were maintained at follow-up. Generalized anxiety and depressive symptoms, however, did not improve as a result of treatment. Mediated moderation analyses suggested that treatment-related changes in AS may mediate anxiety symptom changes. RESULTS of the present study provide promising evidence for this transdiagnostic treatment approach. Reductions in anxiety symptoms across diagnostic categories stemming from this AS-targeted intervention may have implications for helping a broad array of clients with various anxiety disorders that share AS as a common risk or maintenance factor.",Olthuis JV.; Watt MC.; Mackinnon SP.; Stewart SH.,2014.0,10.1037/a0037027,0,0,
5465,Psychosocial screening effects on health-related outcomes in patients receiving radiotherapy. A cluster randomised controlled trial,"ER OBJECTIVE: This study examined the short-term and long-term effects of using a screening instrument on psychological distress and health-related quality of life (HRQoL) among cancer patients receiving radiotherapy. In addition, we investigated the effect of early psychosocial treatment on patients' overall health-related outcomes as previous research showed that patients in the screening condition were referred to a psychosocial caregiver at an earlier stage.METHODS: A cluster randomised controlled trial with a randomisation at the levels of 14 radiotherapists, 568 patients was conducted. Patients were asked to complete questionnaires at 3 and 12?months follow-up.RESULTS: Mixed models analyses showed no significant intervention effects on patients' overall extent of psychosocial distress and HRQoL, both on the short and long terms. Post-hoc analyses revealed significant interactions of the intervention with early referral and improved HRQoL and anxiety, suggesting that earlier referral might influence short-term HRQoL and experienced anxiety in patients.CONCLUSIONS: Our results suggest that the use of a psychosocial screening instrument among patients receiving radiotherapy in itself does not sufficiently improve patients' health-related outcome. The effective delivery of psychosocial care depends upon several components such as identification of distress and successful implementation of screening procedures. One of the challenges is to get insight in the effects of early referral of cancer patients for psychosocial support because early referral might have a favourable effect on some of the patients' health-related outcomes.","Braeken, A P; Kempen, G I; Eekers, D B; Houben, R M; Gils, F C; Ambergen, T; Lechner, L",2013.0,10.1002/pon.3340,0,0,
5466,The effectiveness of the Screening Inventory of Psychosocial Problems (SIPP) in cancer patients treated with radiotherapy: design of a cluster randomised controlled trial,"ER METHODS/DESIGNA CRCT is developed using a Solomon four-group design (two intervention and two control groups) to evaluate the effects of using the SIPP. Radiotherapists, instead of cancer patients, are randomly allocated to the experimental or control groups. Within these groups, all included cancer patients are randomised into two subgroups: with and without pre-measurement. Self-reported assessments are conducted at four times: a pre-test at baseline before the first consultation and a post-test directly following the first consultation, and three and 12 months after baseline measurement. The primary outcome measures are the number and types of referrals of cancer patients with psychosocial problems to relevant (psychosocial) caregivers. The secondary outcome measures are patients' satisfaction with the radiotherapist-patient communication, psychosocial distress and quality of life. Furthermore, a process evaluation will be carried out. Data of the effect-evaluation will be analysed according to the intention-to-treat principle and data regarding the types of referrals to health care providers and patient satisfaction about the with radiotherapists will be analysed by means of descriptive techniques. The process evaluation data will also be analysed by means of descriptive techniques.DISCUSSIONUsing the SIPP may prevent underdiagnosis of early symptoms reflecting psychosocial problems, should facilitate communication between physicians and patients about psychosocial distress and may contribute to adequate referral to relevant (psychosocial) caregivers.TRIAL REGISTRATIONNCT00859768.BACKGROUNDThe Screening Inventory of Psychosocial Problems (SIPP) is a short, validated self-reported questionnaire to identify psychosocial problems in Dutch cancer patients. The one-page 24-item questionnaire assesses physical complaints, psychological complaints and social and sexual problems. Very little is known about the effects of using the SIPP in consultation settings. Our study aims are to test the hypotheses that using the SIPP (a) may contribute to adequate referral to relevant psychosocial caregivers, (b) should facilitate communication between radiotherapists and cancer patients about psychosocial distress and (c) may prevent underdiagnosis of early symptoms reflecting psychosocial problems. This paper presents the design of a cluster randomised controlled trial (CRCT) evaluating the effectiveness of using the SIPP in cancer patients treated with radiotherapy.","Braeken, A P; Lechner, L; Gils, F C; Houben, R M; Eekers, D; Ambergen, T; Kempen, G",2009.0,10.1186/1471-2407-9-177,0,0,
5467,Long-term psychosocial outcomes of low-dose CT screening: results of the UK Lung Cancer Screening randomised controlled trial,"ER METHODS: A random sample of individuals aged 50-75?years was contacted via primary care. High-risk individuals who completed T0 questionnaires (baseline) were randomised to LDCT screening (intervention) or usual care (no screening control). T1 questionnaires were sent 2?weeks after baseline scan results or control assignment. T2 questionnaires were sent up to 2?years after recruitment. Measures included cancer distress, anxiety, depression and decision satisfaction.RESULTS: A total of 4037 high-risk individuals were randomised and they completed T0 questionnaires (n=2018 intervention, n=2019 control). Cancer distress was higher at T1 in intervention arm participants who received positive screening results (p?0.001), but not at T2 (p=0.04). T2 anxiety (p?0.001) and depression (p?0.01) were higher in the control arm, but the absolute differences were small and not clinically relevant. At both time points, fewer control than screened participants were satisfied with their decision to participate in UKLS (p?0.001). Regardless of trial allocation, cancer distress was higher in women (p?0.01), participants aged ?65?years (p?0.001), current smokers (p?0.001), those with lung cancer experience (p?0.001) and those recruited from the Liverpool area (p?0.001).CONCLUSION: Lung cancer screening using LDCT appears to have no clinically significant long-term psychosocial impact on high-risk participants. Strategies for engaging and supporting underserved groups are the key to implement routine lung cancer screening in the UK.TRIAL REGISTRATION NUMBER: ISRCTN 78513845; results.BACKGROUND: The UK Lung Cancer Screening (UKLS) trial is a randomised pilot trial of low-dose CT (LDCT) screening for individuals at high risk of lung cancer. We assessed the long-term psychosocial impact on individuals participating in the UKLS trial.","Brain, K; Lifford, K J; Carter, B; Burke, O; McRonald, F; Devaraj, A; Hansell, D M; Baldwin, D; Duffy, S W; Field, J K",2016.0,10.1136/thoraxjnl-2016-208283,0,0,
5468,"Impact of peer teaching on nursing students: perceptions of learning environment, self-efficacy, and knowledge","ER BACKGROUND: Peer teaching has been shown to enhance student learning and levels of self efficacy.OBJECTIVES: The purpose of the current study was to examine the impact of peer-teaching learning experiences on nursing students in roles of tutee and tutor in a clinical lab environment.SETTINGS: This study was conducted over a three-semester period at a South Central University that provides baccalaureate nursing education.PARTICIPANTS: Over three semesters, 179 first year nursing students and 51 third year nursing students participated in the study.METHODS: This mixed methods study, through concurrent use of a quantitative intervention design and qualitative survey data, examined differences during three semesters in perceptions of a clinical lab experience, self-efficacy beliefs, and clinical knowledge for two groups: those who received peer teaching-learning in addition to faculty instruction (intervention group) and those who received faculty instruction only (control group). Additionally, peer teachers' perceptions of the peer teaching learning experience were examined.RESULTS: Results indicated positive response from the peer tutors with no statistically significant differences for knowledge acquisition and self-efficacy beliefs between the tutee intervention and control groups. In contrast to previous research, students receiving peer tutoring in conjunction with faculty instruction were statistically more anxious about performing lab skills with their peer tutor than with their instructors. Additionally, some students found instructors' feedback moderately more helpful than their peers and increased gains in knowledge and responsibility for preparation and practice with instructors than with peer tutors.CONCLUSIONS: The findings in this study differ from previous research in that the use of peer tutors did not decrease anxiety in first year students, and no differences were found between the intervention and control groups related to self efficacy or cognitive improvement. These findings may indicate the need to better prepare peer tutors, and research should be conducted using more complex skills.","Brannagan, K B; Dellinger, A; Thomas, J; Mitchell, D; Lewis-Trabeaux, S; Dupre, S",2013.0,10.1016/j.nedt.2012.11.018,0,0,
5469,Square-edge polymethylmethacrylate intraocular lens design for reducing posterior capsule opacification following paediatric cataract surgery: initial experience,"ER DESIGNProspective, consecutive, interventional, comparative, randomized and cross-sectional study of 40 eyes of 32 children aged between 4 and 12 years who underwent phacoemulsification and posterior chamber IOL implantation.METHODSThe patients were randomized into two groups of 20 eyes each. Group 1 eyes received a square-edge hydrophobic acrylic IOL (Acrysof SA 60 AT, Alcon Surgical, Fort Worth, Texas), and Group 2 eyes received a square-edge single-piece PMMA lens (Aurolab SQ 3600 Aurolab IOL Division, Madurai, India) in the capsular bag. No eye underwent a primary posterior capsulotomy. The PCO density was evaluated on slitlamp retroillumination photographs by using POCOman software at 3, 6, 9 and 12 months post surgery.RESULTSThe average percentage PCO on POCOman analysis was 51.23 for Group 1 and 49.49 for Group 2 (P = 0.09), and the average PCO severity grade was 1.34 in Group 1 and 1.12 in Group 2 (P = 0.08). Visual axis remained clear in 14 of 20 eyes with the acrylic lens as compared with 13 of 20 eyes with the PMMA lens. (P = 0.32).CONCLUSIONSSquare-edge PMMA IOLs offer a significant cost advantage over acrylic lenses at similar rates of PCO formation following paediatric cataract surgery, which is of significant value in developing countries.PURPOSETo compare the incidence and severity of development of posterior capsule opacification (PCO) following implantation of square-edged polymethylmethacrylate (PMMA) or hydrophobic acrylic intraocular lenses (IOLs) following paediatric cataract surgery.","Brar, G S; Grewal, D S; Ram, J; Singla, M; Grewal, S P",2008.0,10.1111/j.1442-9071.2008.01818.x,0,0,
5470,Internet-based rehabilitation for individuals with chronic pain and burnout: a randomized trial,"ER This study investigates utilization of the Internet in the rehabilitation of people on long-term sick leave with chronic pain and/or burnout. Fifty-five people were randomly assigned to two groups: a treatment group (n = 27) that participated in a rehabilitation course over the Internet and a waiting list group (n = 28). The goals were to improve participants' health and increase quality of life, and, for those who were not on permanent disability pensions, to increase work capacity, if possible. A 20-week program, based on 19 films on different themes, was supplemented with written material and a Socratic dialogue over the Internet. Upon completion of the rehabilitation course, statistically significant improvements were observed in the treatment group in comparison to the waiting list group, for variables such as depression, pain, vitality, social function, performance problems involving work or other activities due to physical illness and the presence of stress symptoms. Thirteen of 23 individuals (57%) also increased their work capacity. The number needed to treat regarding recovering from anxiety and depression was 2. For increased work capacity, the number needed to treat was 3. Rehabilitation of people on long-term sick leave carried out over the Internet is a good complement to other rehabilitation programs.","Brattberg, G",2006.0,10.1097/01.mrr.0000210055.17291.f5,0,0,
5471,"Community knowledge, attitudes and media recall about AIDS, Sydney 1988 and 1989","ER A randomized telephone survey of Sydney residents aged 16-50 was conducted in 1988 (n = 651) and repeated in 1989 (n = 701) to assess changes in AIDS-related knowledge and attitudes and opinions about AIDS policies. The mean number of correct answers to 21 questions about AIDS was 18.6 (1988) and 18.1 (1989). Almost all respondents gave correct answers to fundamental questions about AIDS transmission and prevention. No statistically significant changes in AIDS knowledge were found between the two survey periods. There was widespread anxiety about AIDS: just over half the population was personally afraid of getting AIDS, 80 per cent had considered being tested for human immunodeficiency virus and over half supported 'compulsory testing' for all the population. Mass media messages about AIDS were almost universally recalled, with the Grim Reaper and news stories centring on particular individuals ranking highest. AIDS policy makers in public education should consider the wisdom of continuing to target messages to low-risk populations. These messages have raised fundamental knowledge about AIDS but may be unintentionally causing social divisiveness and widespread unnecessary anxiety.","Bray, F; Chapman, S",1991.0,,0,0,
5472,Multifamily group psychoeducation and cognitive remediation for first-episode psychosis: a randomized controlled trial,"ER METHODS/DESIGNForty individuals with first-episode psychosis and their caregiving relative will be recruited to participate in this study. Individuals with first-episode psychosis will be randomized to one of two conditions: (i) MFG with concurrent participation in cognitive remediation or (ii) MFG alone. The primary outcome for this study is relapse of psychotic symptoms. We will also examine secondary outcomes among both individuals with first-episode psychosis (i.e., social and vocational functioning, health-related quality of life, service utilization, independent living status, and cognitive functioning) and their caregiving relatives (i.e., caregiver burden, anxiety, and depression)DISCUSSIONCognitive remediation offers the possibility of ameliorating a specific deficit (i.e., deficits in cognitive functioning) that often accompanies psychotic symptoms and may restrict the magnitude of the clinical benefits derived from MFG.TRIAL REGISTRATIONClinicalTrials (NCT): NCT01196286.BACKGROUNDMultifamily group psychoeducation (MFG) has been shown to reduce relapse rates among individuals with first-episode psychosis. However, given the cognitive demands associated with participating in this intervention (e.g., learning and applying a structured problem-solving activity), the cognitive deficits that accompany psychotic disorders may limit the ability of certain individuals to benefit from this intervention. Thus, the goal of this study is to examine whether individuals with first-episode psychosis who participate simultaneously in MFG and cognitive remediation--an intervention shown to improve cognitive functioning among individuals with psychotic disorders--will be less likely to experience a relapse than individuals who participate in MFG alone.","Breitborde, N J; Moreno, F A; Mai-Dixon, N; Peterson, R; Durst, L; Bernstein, B; Byreddy, S; McFarlane, W R",2011.0,10.1186/1471-244X-11-9,0,0,
5473,A comparative study of polyacrylic acid (Viscotears) liquid gel versus polyvinylalcohol in the treatment of dry eyes,"ER We conducted a prospective, randomised, single-masked study comparing the safety and efficacy of polyacrylic acid 0.2% (PAA) and polyvinylalcohol 1.4% (PVA) in 85 patients (PAA 43, PVA 42) with dry eyes. The two groups were similar in patient demographics and study parameters at baseline. With treatment, the reduction in total symptoms (gritty or foreign body sensation, burning sensation, dry eye sensation, photophobia, others) and signs (conjunctival hyperaemia, ciliary injection, corneal and conjunctival epithelial staining) score on PAA was significantly greater than that on PVA at both two and four weeks. The daily frequency of instillation of PAA was significantly less than that of PVA on 16 of the 27 (59%) study days. For overall local tolerance there was a significant preference for PAA compared to PVA by both patients and doctors. Only one patient on each treatment had an adverse event and neither was serious. PAA (Viscotears) was as safe as, but better tolerated and more effective than PVA in the treatment of dry eye conditions.","Brodwall, J; Alme, G; Gedde-Dahl, S; Smith, J; Lilliedahl, N P; Kunz, P A; Sunderraj, P",1997.0,,0,0,
5474,Psychophysiological responses to stress after stress management training in patients with rheumatoid arthritis,"ER BACKGROUND: Stress management interventions may prove useful in preventing the detrimental effects of stress on health. This study assessed the effects of a stress management intervention on the psychophysiological response to stress in patients with rheumatoid arthritis (RA).METHODS: Seventy-four patients with RA, who were randomly assigned to either a control group or a group that received short-term stress management training, performed a standardized psychosocial stress task (Trier Social Stress Test; TSST) 1 week after the stress management training and at a 9-week follow-up. Psychological and physical functioning, and the acute psychophysiological response to the stress test were assessed.RESULTS: Patients in the intervention group showed significantly lower psychological distress levels of anxiety after the training than did the controls. While there were no between-group differences in stress-induced tension levels, and autonomic (?-amylase) or endocrine (cortisol) responses to the stress test 1 week after the intervention, levels of stress-induced tension and cortisol were significantly lower in the intervention group at the 9-week follow-up. Overall, the response to the intervention was particularly evident in a subgroup of patients with a psychological risk profile.CONCLUSION: A relatively short stress management intervention can improve psychological functioning and influences the psychophysiological response to stress in patients with RA, particularly those psychologically at risk. These findings might help understand how stress can affect health and the role of individual differences in stress responsiveness.TRIAL REGISTRATION: TrialRegister.nl NTR1193.","Brouwer, S J; Kraaimaat, F W; Sweep, F C; Donders, R T; Eijsbouts, A; Koulil, S; Riel, P L; Evers, A W",2011.0,10.1371/journal.pone.0027432,0,0,
5475,Improving child and parenting outcomes following paediatric acquired brain injury: a randomised controlled trial of Stepping Stones Triple P plus Acceptance and Commitment Therapy,"ER BACKGROUND: Persistent behavioural difficulties are common following paediatric acquired brain injury (ABI). Parents and families also experience heightened stress, psychological symptoms and burden, and there is evidence of a reciprocal relationship between parent and child functioning, which may be mediated by the adoption of maladaptive parenting practices. Despite this, there is currently a paucity of research in family interventions in this population. The aim of this study was to determine the efficacy of Stepping Stones Triple P: Positive Parenting Program (SSTP), with an Acceptance and Commitment Therapy (ACT) workshop, in improving child outcomes and parenting practices following paediatric ABI.METHODS: Fifty-nine parents of children (mean age 7 years, SD 3 years, 1 month; 35 males, 24 females) with ABI (Traumatic injuries 58%, Tumour 17%, Encephalitis or meningitis 15%, Cardiovascular accident 7%, Hypoxia 3%) who were evidencing at least mild behaviour problems were randomly assigned to treatment or care-as-usual conditions over 10 weeks. Mixed-model repeated-measures linear regression analyses were conducted to compare conditions from pre- to postintervention on child behavioural and emotional functioning (Eyberg Child Behavior Inventory, Strengths and Difficulties Questionnaire) and dysfunctional parenting style (Parenting Scale). Assessment of maintenance of change was conducted at a 6-month follow-up. The trial was registered on Australian New Zealand Clinical Trials Registry (ID: ACTRN12610001051033, www.anzctr.org.au).RESULTS: Significant time-by-condition interactions were identified on number and intensity of child behaviour problems, child emotional symptoms and parenting laxness and overreactivity, indicating significant improvements in the treatment condition, with medium-to-large effect sizes. Most improvements were maintained at 6 months.CONCLUSIONS: Group parenting interventions incorporating Triple P and ACT may be efficacious in improving child and parenting outcomes following paediatric ABI.","Brown, F L; Whittingham, K; Boyd, R N; McKinlay, L; Sofronoff, K",2014.0,10.1111/jcpp.12227,0,0,
5476,Psychosocial status of patients randomly assigned to medical or surgical therapy for chronic stable angina,"ER Aspects of social and psychologic functioning are compared for 51 patients randomly assigned to surgical or medical management of chronic stable angina. No differences were found between the two groups in work status, social activity, adequacy of family functioning, perceived health, life satisfaction, memory span, extent of anxiety, hypochondriasis and hysteria. However, surgically treated patients were significantly less depressed and more likely to report improvement in health and family functioning after the initiation of treatment. It is concluded that the psychologic and social outcomes appear slightly more favorable in patients treated surgically than in those treated medically.","Brown, J S; Rawlinson, M E",1979.0,,0,0,
5477,Will improvement in quality of life (QOL) impact fatigue in patients receiving radiation therapy for advanced cancer?,"ER METHODSPatients with newly diagnosed cancer were randomly assigned to an 8-session structured multidisciplinary intervention or a standard-care arm at the beginning of their course of radiotherapy (RT) designed to impact QOL. Ninety-minute sessions were led by either a psychiatrist or psychologist, collaborating with a nurse, physical therapist, chaplain, or social worker, depending on the session's theme. The fatigue assessments used in this trial included the Linear Analogue Self Assessment (LASA), the Profile of Mood States (POMS), Spielberger's State-Trait Anxiety Inventory (STAI), and the Symptom Distress Scale (SDS).RESULTSThere were 115 participants enrolled and the 2 randomization arms were well balanced in terms of baseline characteristics and treatment received except for increased commuting distance for the patients in the intervention arm (P = 0.042). Most of scores indicated less fatigue (higher score) in the standard treatment group, but there were no statistically significant differences found at baseline and weeks 4, 8, and 27 except for SDS at week 8 (P = 0.018) with less patients reporting significant fatigue in the standard treatment arm. For the entire participant population, fatigue levels initially worsened with radiotherapy, stabilized at week 8, and returned to baseline by week 27. Disease site, chemotherapy use, and radiotherapy dose did not have a significant impact on fatigue levels.CONCLUSIONSRadiotherapy initially caused a worsening of fatigue but with time fatigue levels returned to baseline. Clinically, this structured multidisciplinary intervention had no impact on fatigue, and there was the suggestion the multiple sessions may have contributed to worse fatigue during active cancer treatment.BACKGROUNDFatigue has a significant impact on the quality of life (QOL) of cancer patients. Recent research has suggested that physical activity can reduce fatigue in patients receiving active cancer treatment. In this project, we examined the impact that participation in a randomized controlled trial of a multidisciplinary intervention designed to impact overall QOL had on fatigue for advanced cancer patients actively receiving treatment.","Brown, P; Clark, M M; Atherton, P; Huschka, M; Sloan, J A; Gamble, G; Girardi, J; Frost, M H; Piderman, K; Rummans, T A",2006.0,10.1097/01.coc.0000190459.14841.55,0,0,
5478,Two brief interventions for acute pain,"ER This study evaluated two brief (3-5 min) interventions for controlling responses to acute pain. Eighty male subjects were randomly assigned to 1 of 2 intervention groups (Positive Emotion Induction (PEI) or Brief Relaxation (BR)) or to 1 of 2 control groups (No-instruction or Social Demand). The PEI focused on re-creating a pleasant memory, while the BR procedure involved decreasing respiration rate and positioning the body in a relaxed posture. All subjects underwent a 60-sec finger pressure pain trial. Analyses indicated that the PEI subjects reported lower ratings of pain, fear, and anxiety, and experienced greater finger temperature recovery than controls. The BR procedure resulted in greater blood pressure recovery, but did not alter ratings of pain or emotion relative to controls. Further research is needed to explore the clinical use of the PEI for acute pain management.","Bruehl, S; Carlson, C R; McCubbin, J A",1993.0,,0,0,
5479,Oxytocin influences avoidant reactions to social threat in adults with borderline personality disorder,"ER BACKGROUND: Borderline personality disorder (BPD) is characterized by interpersonal dysfunction, emotional instability, impulsivity, and risk-taking behavior. Recent research has focused on the role of oxytocin in BPD, with mixed results as regards the processing of social stimuli.METHODS: In a double-blind randomized placebo-controlled study, 13 BPD patients and 13 controls performed a dot probe task to examine attentional biases to happy and angry faces after intranasal application of oxytocin or placebo. Childhood trauma was examined using the childhood trauma questionnaire.RESULTS: In the placebo condition, patients with BPD (but not controls) showed an avoidant reaction to angry faces (but not happy faces). The strength of the avoidant reaction correlated with the severity of childhood trauma. This behavioral response (as well as the correlation) was abolished in the oxytocin condition.CONCLUSIONS: Adult patients with BPD show an avoidant response to social threat, a reaction that is linked with traumatic experiences during childhood. This response pattern is altered by oxytocin, possibly by reducing stress and inhibiting social withdrawal from distressing social stimuli.","Brüne, M; Ebert, A; Kolb, M; Tas, C; Edel, M A; Roser, P",2013.0,10.1002/hup.2343,0,0,
5480,Leucine dose response in the reduction of urea production from septic proteolysis and in the stimulation of acute-phase proteins,"ER The administration of branched-chain amino acids (BCAAs) has been proved useful in reducing both urea nitrogen production and muscle proteolysis in trauma patients with sepsis, but the optimum infusion rate to achieve these effects is still in question. In this prospective randomized study, a group of 16 posttrauma patients with sepsis received a branched chain-enriched (BCAA = 49.4%) amino acid mixture (8 patients; 120 observations) or a standard amino acid infusion (BCAAs = 15.5%; 8 patients; 227 observations). Total calories, percent lipid calories, and amino acid nitrogen administration were not different in the two groups. Each patient was studied at 8-hour intervals for the plasma levels of amino acids, six hepatic acute-phase proteins, albumin, and other metabolic parameters, including urinary urea nitrogen and 3-methylhistidine excretion. The total intake of each amino acid and its clearance were calculated and the dose of leucine during each 8-hour period was related to the leucine clearance, plasma acute-phase protein levels, and the urinary production of urea and 3-methylhistidine, as an indicator of proteolysis. The results show a significant (r2 = 0.691; p less than 0.0001) reduction of urea nitrogen production and proteolysis as a function of the increase in leucine dose. The identification of a critical mean rate of leucine infusion has been derived from the analysis of the significant linear correlation between leucine intake and leucine clearance (r2 = 0.594; p less than 0.0001). Significant positive correlations between the leucine intake dose and the platelet count (r2 = 0.402; p less than 0.0001), the plasma fibrinogen level (r2 = 0.218; p less than 0.0001), and the regression-derived sum of six acute-phase proteins plus albumin (r2 = 0.696; p less than 0.0001) were found. The increase in leucine clearance was progressively less marked above a mean daily leucine intake rate of 1.4 mumol/kg/min, which also appeared to be the dose level that maximized the acute-phase protein and coagulation effects and reduced proteolysis and urea nitrogen production, suggesting that this is a critical BCAA infusion rate at which an optimum leucine effect occurs. From these data a BCAA (leucine) dose nomogram has been derived.","Bruzzone, P; Siegel, J H; Chiarla, C; Wiles, C E; Placko, R; Goodarzi, S",1991.0,,0,0,
5481,Protocol of a multi-centre randomised controlled trial of a web-based information intervention with nurse-delivered telephone support for haematological cancer patients and their support persons,"ER METHODS/DESIGNA non-blinded, parallel-group, multi-centre randomised controlled trial will be conducted to compare the effectiveness of a web-based information tool and nurse-delivered telephone support with usual care. Participants will be recruited from the haematology inpatient wards of five hospitals in New South Wales, Australia. Patients diagnosed with acute myeloid leukaemia, acute lymphoblastic leukaemia, Burkitt's lymphoma, Lymphoblastic lymphoma (B or T cell), or Diffuse Large B-Cell lymphoma and their Support Persons will be eligible to participate. Patients and their Support Persons will be randomised as dyads. Participants allocated to the intervention will receive access to a tailored web-based tool that provides accurate, up-to-date and personalised information about: cancer and its causes; treatment options including treatment procedures information; complementary and alternative medicine; and available support. Patients and Support Persons will complete self-report measures of anxiety, depression and unmet needs at 2, 4, 8 and 12 weeks post-recruitment. Patient and Support Person outcomes will be assessed independently.DISCUSSIONThis study will assess whether providing information and support using web-based and telephone support address the major psychosocial challenges faced by haematological patients and their Support Persons. The approach, if found to be effective, has potential to improve psychosocial outcomes for haematological and other cancer patients, reduce the complexity and burden of meeting patients' psychosocial needs for health care providers with high potential for translation into clinical practice.TRIAL REGISTRATIONACTRN12612000720819.BACKGROUNDHigh rates of anxiety, depression and unmet needs are evident amongst haematological cancer patients undergoing treatment and their Support Persons. Psychosocial distress may be minimised by ensuring that patients are sufficiently involved in decision making, provided with tailored information and adequate preparation for potentially threatening procedures. To date, there are no published studies evaluating interventions designed to reduce psychosocial distress and unmet needs specifically in patients with haematological cancers and their Support Persons. This study will examine whether access to a web-based information tool and nurse-delivered telephone support reduces depression, anxiety and unmet information needs for haematological cancer patients and their Support Persons.","Bryant, J; Sanson-Fisher, R; Stevenson, W; Smits, R; Henskens, F; Wei, A; Tzelepis, F; D'Este, C; Paul, C; Carey, M",2015.0,10.1186/s12885-015-1314-x,0,0,
5482,Bioavailability and biological efficacy of a new oral formulation of salmon calcitonin in healthy volunteers,"ER Salmon calcitonin (SCT) is a well-tolerated peptide drug with a wide therapeutic margin and is administered parenterally for long-term treatments of bone diseases. Its clinical usefulness would be enhanced by the development of an orally active formulation. In this randomized crossover double-blinded phase I trial, controlled by both a placebo and a parenteral verum, we have tested a new oral formulation of SCT associated with a caprylic acid derivative as carrier. Eight healthy volunteers received single doses of 400, 800, and 1200 microg of SCT orally, a placebo, and a 10-microg (50 IU) SCT intravenous infusion. SCT was reliably absorbed from the oral formulation, with an absolute bioavailability of 0.5-1.4%, depending on the dose. It induced a marked, dose-dependent drop in blood and urine C-terminal telopeptide of type I collagen (CTX), a sensitive and specific bone resorption marker, with the effects of 1200 microg exceeding those of 10 microg intravenously. It also decreased blood calcium and phosphate, and increased the circulating levels of parathyroid hormone (PTH) and, transiently, the urinary excretion of calcium. It was well-tolerated, with some subjects presenting mild and transient nausea, abdominal cramps, diarrheic stools, and headaches. This study shows that oral delivery of SCT is feasible with reproducible absorption and systemic biological efficacy. Such an oral formulation could facilitate the use of SCT in the treatment of osteoporosis and other bone diseases.","Buclin, T; Cosma, Rochat M; Burckhardt, P; Azria, M; Attinger, M",2002.0,10.1359/jbmr.2002.17.8.1478,0,0,
5483,Reshaping the Macintosh blade using biomechanical modelling. A prospective comparative study in patients,"ER It has been demonstrated that during routine use of the Macintosh blade, great forces are exerted on the maxillary incisors. The aim of this study was, by using biomechanical modelling, to modify a standard Macintosh blade in order to reduce these forces. This resulted in a Macintosh blade with a reduced proximal flange. Five anaesthetists performed tracheal intubation in 46 patients using the modified (n = 24) or the standard blade (n = 22). The mean (SD) maximal forces exerted on the maxillary incisors were 12.7 (8.8) N in patients in the modified Macintosh group compared to 25.5 (17.8) N in the standard Macintosh group (p = 0.008). These results demonstrate that reducing the proximal step of the Macintosh laryngoscope results in a reduction of the forces exerted on the teeth and suggest that laryngoscope blades with a high proximal step might be more traumatic than blades in which the proximal step is reduced.","Bucx, M J; Snijders, C J; ven der, Vegt M H; Holstein, J D; Stijnen, T",1997.0,,0,0,
5484,Special-class EMR children mainstreamed: a study of an aptitude (learning potential) X treatment interaction,"ER Academic, personal, and social growth were compared for special-class EMR children who were assigned randomly to regular grades or retained in special classes at three time intervals: prior to the assignment, 2 month after assignment, and at the conclusion of the school year. There were no significant differences between the two groups prior to or 2 months after reintegration. After one school year, the reintegrated children were more internally controlled, had more positive attitudes toward school, and were more reflective in their behavior. The hypothesis that the more able students by the learning potential criterion would benefit more from regular than special-class placement was supported. These students expressed more positive feelings toward themselves as students, felt others perceived them as more competent, and behaved more reflectively when they were integrated than when assigned to special class. The high-able (learning potential) students performed more competently academically than the low-able (learning potential) students, regardless of placement.","Budoff, M; Gottlieb, J",1976.0,,0,0,
5485,Telephone support for pregnant women: outcome in late pregnancy,"ER METHODRandomised controlled trial. The study sample were women recruited from an antenatal clinic and general practice surgeries who were less than 20 weeks gestation and either single or in a relationship where the partner was unemployed. Women in the intervention group received weekly telephone calls throughout their pregnancy. All women were interviewed initially and at 34 weeks gestation. There were 66 women in the control group and 65 women in the intervention group.RESULTSThe intervention and control groups did not differ significantly on the psychosocial measures at baseline. Comparisons at 34 weeks were made by analysis of covariance using the baseline scores. The intervention group at 34 weeks had lower stress scores than the control group (means 16.5 vs 18.4, p = 0.02), lower trait anxiety (means 35.2 vs 39.4, p = 0.04) and less depressed mood (means 6.6 vs 8.1, p = 0.02). Self esteem was higher for the intervention group (means 34.9 vs 32.5, p = 0.008). The intervention failed to alter smoking but the intervention women did report more use of community resources (p = 0.02) and were less likely to skip meals (p = 0.03).CONCLUSIONA low cost health promotion program of telephone support during pregnancy can significantly improve a woman's psychosocial status during pregnancy.AIMThe aim of the study was to test the psychosocial benefits of a telephone support program for pregnant women.","Bullock, L F; Wells, J E; Duff, G B; Hornblow, A R",1995.0,,0,0,
5486,The effectiveness of a supervised physical training model tailored to the individual needs of patients with whiplash-associated disorders--a randomized controlled trial,"ER DESIGN: A randomized controlled trial with follow-up at three and nine months after randomization.SETTING: An interdisciplinary rehabilitation centre.SUBJECTS: Forty-seven patients with subacute disorders following a whiplash trauma.INTERVENTIONS: Patients were randomized to a supervised training group or a self-administered home training group.MAIN MEASURES: Primary outcome measures were the Self-Efficacy Scale, the Tampa Scale for Kinesiophobia and the Pain Disability Index. Secondary outcome measures were neck pain intensity, sensory and affective dimensions of pain, pain location and duration, muscle tenderness, grip strength, cervical mobility, sick leave and analgesic consumption.RESULTS: Forty patients (85%) completed the intervention period, and the drop-outs were followed up by intention-to-treat. The results showed that supervised training was significantly more favourable than home training, with a more rapid improvement in self-efficacy (P = 0.03), fear of movement/(re)injury (P = 0.03) and pain disability (P = 0.03) at three months. Further, supervised training significantly reduced the frequency of analgesic consumption (P = 0.03). The improvements were partly maintained at nine months, even though there was no amelioration in pain and physical disorders. Despite the favourable outcome, supervised intervention did not reduce sick leave.CONCLUSIONS: The findings indicate a treatment approach that is feasible in the rehabilitation of patients with subacute whiplash-associated disorders in the short term, but additional research is needed to extend these findings and elucidate treatment strategies that also are cost effective.OBJECTIVE: To evaluate the effects of a physical training programme which is supervised and tailored to meet the needs of patients with subacute whiplash-associated disorders.","Bunketorp, L; Lindh, M; Carlsson, J; Stener-Victorin, E",2006.0,10.1191/0269215506cr934oa,0,0,
5487,The perception of pain and pain-related cognitions in subacute whiplash-associated disorders: its influence on prolonged disability,"ER METHODThe data was obtained from an on-going randomised controlled trial (RCT) on 47 patients. The sensory dimension of pain was evaluated with a visual analogue scale (VAS) diary and a Painometer. The affective dimension was assessed using the Painometer. The Tampa Scale for Kinesiophobia (TSK) and the Self-Efficacy Scale (SES) were used as measures of pain-related cognitions. The Pain Disability Index (PDI) was used as the outcome measure.RESULTSForty patients (85%) completed the trial. The correlations between the sensory and affective dimensions of pain were non-significant, which indicates that they are two independent constructs that describe various dimensions of whiplash-related pain. High pain intensity and pain affect, more widespread pain, and high fear of movement/(re)injury corresponded to low self-efficacy. Multiple regression analyses showed that self-efficacy was the most important predictor of persistent disability contributing to 42% of the variation in the PDI score.CONCLUSIONThe treatment approach for patients with subacute WAD should incorporate the multidimensional nature of pain and to prevent disability special effort should be made to enhance the patient's self-efficacy beliefs.PURPOSETo clarify the relations between the sensory, affective and cognitive dimensions of pain and to analyse what influence these components have on persistent disability in patients with subacute whiplash-associated disorders (WAD).","Bunketorp, L; Lindh, M; Carlsson, J; Stener-Victorin, E",2006.0,10.1080/09638280500158323,0,0,
5488,Pilot randomized controlled trial of Chinese herbal treatment for HIV-associated symptoms,"ER We wished to determine the short-term safety and efficacy of a Chinese medicinal herb preparation in treating symptoms of human immunodeficiency virus (HIV) infection in a 12-week randomized, double-blind, placebo-controlled clinical trial in a University-affiliated acquired immunodeficiency syndrome (AIDS) clinic at a public general hospital. Thirty adults with symptomatic HIV infection, no previous AIDS-defining diagnosis, and CD4+ counts of 0.200-0.499 x 10(9)/L (200-499/mm3) received 28 tablets each day of either a standardized oral preparation of 31 Chinese herbs or a cellulose placebo. Primary outcome measures were changes in life satisfaction, perceived health, and number and severity of symptoms. Other outcomes included adherence, and changes in weight, CD4+ count, depression, anxiety, physical and social function, and mental health. Two placebo- and no herb-treated subjects had mild adverse events (AE). Subjects on both arms reported taking 94% of prescribed tablets. No differences between treatment groups reached the p < 0.05 level. Life satisfaction improved in herb-treated [+0.86, 95% confidence interval (CI): +0.29, +1.43] but not in placebo-treated subjects (+0.20, 95%","Burack, J H; Cohen, M R; Hahn, J A; Abrams, D I",1996.0,,0,0,
5489,"Repressed anger and patterns of cardiovascular, self-report and behavioral responses: effects of harassment","ER We hypothesized that anger repressors would show discrepancies between self-reported anger and cardiovascular and behavioral responses only during harassment. Subjects (N=102) were assigned randomly to condition. In the nonharassment condition, subjects told stories about eight Thematic Apperception Test cards without any harassment. In the harassment condition, subjects told four stories without harassment, and then told four more stories with harassment. Words connoting aggressive behavior and angry/hostile affect were coded from story content. Subjects were classified into low anger expressor, anger repressor, high anger expressor, and defensive anger expressor categories based on median splits of the Anger-Out Subscale and Marlowe-Crowne Social Desirability Scale. Results showed that harassed anger repressors reported anger comparable to that of low anger expressors but less than high expressors, whereas their heart rate (HR) reactivity was comparable to high expressors, but greater than low anger expressors. Increases in anger words did not distinguish repressors from other groups. Repressed anger may represent a distinct anger management style characterized by a discrepancy between acknowledged anger and cardiovascular reactivity--effects that become fully manifest only during interpersonal provocation.","Burns, J W; Evon, D; Strain-Saloum, C",1999.0,,0,0,
5490,"Psychological, situational, and gender predictors of cardiovascular reactivity to stress: a multivariate approach","ER This study examined whether relationships between anger expression, hostility, social evaluative anxiety, and a presumed mechanism for coronary heart disease development, cardiovascular reactivity (CVR) to stress, are moderated by stress situation and gender and whether such relationships are attenuated by inadequate assessments. Subjects (47 men, 47 women) were assigned randomly to either a Harassment or a Social Evaluation condition, under which they performed a reaction time task. SBP, DBP, and HR measures were recorded during baseline and task. Multiple regression analyses indicated that expressed anger was related to CVR only among men in the Harassment condition; that hostile men who express anger showed the most CVR across situations, and that the traits assessed here did not predict CVR among women. Results suggest that assessments of coronary-risk and interventions to reduce risk may need to take into account attitudes, styles of emotional expression, environmental factors, and gender.","Burns, J W; Katkin, E S",1993.0,,0,0,
5491,"Evaluating the effectiveness of psychosocial resilience training for heart health, and the added value of promoting physical activity: a cluster randomized trial of the READY program","ER METHODS/DESIGN: In a cluster randomized trial, 95 participants will be allocated to either a waitlist or one of two intervention conditions. Both intervention conditions will receive a 10 x 2.5 hour group resilience training program (READY) over 13 weeks. The program targets five protective factors identified from empirical evidence and analyzed as mediating variables: positive emotions, cognitive flexibility, social support, life meaning, and active coping. Resilience enhancement strategies reflect the six core Acceptance and Commitment Therapy processes (values, mindfulness, defusion, acceptance, self-as-context, committed action) and Cognitive Behavior Therapy strategies such as relaxation training and social support building skills. Sessions include psychoeducation, discussions, experiential exercises, and home assignments. One intervention condition will include an additional session and ongoing content promoting physical activity. Measurement will occur at baseline, two weeks post intervention, and at eight weeks follow-up, and will include questionnaires, pedometer step logs, and physical and hematological measures. Primary outcome measures will include self-reported indicators of psychosocial well-being and depression. Secondary outcome measures will include self-reported indicators of stress, anxiety and physical activity, and objective indicators of CHD risk (blood glucose, cholesterol [mmol.L-1], triglycerides, blood pressure). Process measures of attendance, engagement and fidelity will also be conducted. Linear analyses will be used to examine group differences in the outcome measures, and the product of coefficients method will be used to examine mediated effects.DISCUSSION: If successful, this program will provide an innovative means by which to promote psychosocial well-being for heart health in the general population. The program could also be adapted to promote well-being in other at risk population subgroups.TRIAL REGISTRATION: ACTRN12608000017325.BACKGROUND: Depression and poor social support are significant risk factors for coronary heart disease (CHD), and stress and anxiety can trigger coronary events. People experiencing such psychosocial difficulties are more likely to be physically inactive, which is also an independent risk factor for CHD. Resilience training can target these risk factors, but there is little research evaluating the effectiveness of such programs. This paper describes the design and measures of a study to evaluate a resilience training program (READY) to promote psychosocial well-being for heart health, and the added value of integrating physical activity promotion.","Burton, N W; Pakenham, K I; Brown, W J",2009.0,10.1186/1471-2458-9-427,0,0,
5492,Self management of arthritis in primary care: randomised controlled trial,"ER DESIGNRandomised controlled trial.SETTING74 general practices in the United Kingdom.PARTICIPANTS812 patients aged 50 and over with osteoarthritis of hips or knees (or both) and pain or disability (or both).INTERVENTIONParticipants were randomised to six sessions of self management of arthritis and an education booklet (intervention group) or the education booklet alone (control group).MAIN OUTCOME MEASURESPrimary outcome was quality of life, as assessed by the short form health survey (SF-36). Several other physical and psychosocial secondary outcomes were assessed. Data were collected at baseline, four months, and 12 months.RESULTSResponse rates were 80% and 76% at four and 12 months. The two groups showed significant differences at 12 months on the anxiety subscore of the hospital anxiety and depression scale (mean difference -0.62, 95% confidence interval -1.08 to -0.16), arthritis self efficacy scale for pain (0.98, 0.07 to 1.89), and self efficacy for other aspects of management (1.58, 0.25 to 2.90). Results were similar for intention to treat and per protocol analyses. No significant difference was seen in number of visits to the general practitioner at 12 months.CONCLUSIONSThe self management of arthritis programme reduced anxiety and improved participants' perceived self efficacy to manage symptoms, but it had no significant effect on pain, physical functioning, or contact with primary care.TRIAL REGISTRATIONCurrent Controlled Trials ISRCTN79115352 [controlled-trials.com].OBJECTIVETo evaluate clinical effectiveness of a self management programme for arthritis in patients in primary care with osteoarthritis.","Buszewicz, M; Rait, G; Griffin, M; Nazareth, I; Patel, A; Atkinson, A; Barlow, J; Haines, A",2006.0,10.1136/bmj.38965.375718.80,0,0,
5493,Adaptation to effects of an audience during acquisition of rotary pursuit skill,"ER This study investigated the anxiety effects of an evaluative audience on the acquisition of a simple motor skill. These effects, also known as ""stage fright,"" can be a major moderator of performance, so a better understanding of these variables can lead to improvements in motor skill development. 60 students completed 15 trials on a pursuit rotor. Participants completed the trials either alone (control) or in front of an audience (treatment). To test for differences in acquisition due to the timing of the introduction of the audience, some subjects completed all trials with an audience present, while others were allowed to practice 4 or 9 trials before the introduction of the audience. The performance curves exhibited by each group reached asymptote at approximately the same time but at different performance levels. Analyses of covariance indicated that, while the final performance of the treatment groups was not different, each treatment group performed significantly more poorly than the control group. Participants attempting to acquire a skill before an audience might not be able to adapt to the effects of the audience regardless of the timing of the introduction of the audience.","Butki, B D",1994.0,,0,0,
5494,Hypnosis reduces distress and duration of an invasive medical procedure for children,"ER METHODSForty-four children who were scheduled for an upcoming VCUG were randomized to receive hypnosis (n = 21) or routine care (n = 23) while undergoing the procedure. The sample consisted of 29 (66%) girls and 15 (34%) boys with a mean age of 7.6 years (SD: 2.5; range: 4-15 years). Ethnic/racial backgrounds were 72.7% white, 18.2% Asian, 4.5% Latino, 2.3% black, and 2.3% Filipino. The mean number of previous VCUGs was 2.95 (SD: 2.51; mode: 2; range: 1-15). Potential participants were identified through computerized hospital records of upcoming VCUGs. Parents were contacted by telephone and invited to participate if their child was eligible. To be eligible for the study, the child must have undergone at least 1 previous VCUG, been at least 4 years of age at that time, and experienced distress during that procedure, and both the child and the participating parent had to be English speaking. Each eligible child and parent met with the research assistant (RA) before the day of the scheduled procedure for an initial assessment. Children were queried regarding the degree of crying, fear, and pain that they had experienced during their most recent VCUG. Parents completed a series of parallel questions. Immediately after this assessment, those who were randomized to the hypnosis condition were given a 1-hour training session in self-hypnotic visual imagery by a trained therapist. Parents and children were instructed to practice using the imaginative self-hypnosis procedure several times a day in preparation for the upcoming procedure. The therapist was also present during the procedure to conduct similar exercises with the child. The majority (83%) of those who were randomized to the routine care control group chose to participate in a hospital-provided recreation therapy program (offered as part of routine care). The program includes demonstration of the procedure with dolls, relaxation and breath work training, and assistance during the procedure. On the day of the VCUG, the RA met the family at the clinic before the procedure, and both the child and the parent rated the child's present level of fearfulness. During the procedure, the RA recorded observational ratings of the child's emotional tone and behavior and timed the overall procedure and its phases. Immediately after the VCUG, the child was asked how much crying, fear, and pain he or she had experienced during the procedure; the parent rated the child's experience on the same dimensions and also how traumatic the procedure had been (both generally and compared with their previous one), and the medical staff rated the degree of procedural difficulty. Outcomes included child reports of distress during the procedure, parent reports of how traumatic the present VCUG was compared with the previous one, observer ratings of distress during the procedure, medical staff reports of the difficulty of the procedure overall, and total procedural time.RESULTSResults indicate significant benefits for the hypnosis group compared with the routine care group in the following 4 areas: (1) parents of children in the hypnosis group compared with those in the routine care group reported that the procedure was significantly less traumatic for their children compared with their previous VCUG procedure; (2) observational ratings of typical distress levels during the procedure were significantly lower for children in the hypnosis condition compared with those in the routine care condition; (3) medical staff reported a significant difference between groups in the overall difficulty of conducting the procedure, with less difficulty reported for the hypnosis group; and (4) total procedural time was significantly shorter-by almost 14 minutes-for the hypnosis group compared with the routine care group. Moderate to large effect sizes were obtained on each of these 4 outcomes.CONCLUSIONSHypnotic relaxation may provide a systematic method for improving the overall medical care of children with urinary tract abnormalities and may be beneficial for children who undergo other invasive medical procedures. Because the VCUG is an essential part of the evaluation of urinary tract infections and vesicoureteral reflux in children, lower distress during the procedure may improve patient and family compliance with initial as well as follow-up evaluations. These findings augment the accumulating literature demonstrating the benefits of using hypnosis to reduce distress in the pediatric setting. The present findings are noteworthy in that this study was a controlled, randomized trial conducted in a naturalistic medical setting. In this context, we achieved a convergence of subjective and objective outcomes with moderate to large effect sizes, including those that may have an impact on patient care and procedure cost, that were consistently supportive of the beneficial effects of hypnosis-a noninvasive intervention with minimal risk. The findings, therefore, have immediate implications for pediatric care. Limitations of this study include the lack of participant and staff blindness to the child's condition assignment, which could have introduced bias into reports. However, the objective procedural time differences between groups were consistent with the other, more subjective outcome findings. The sample was also small and primarily white in ethnic/racial makeup, which may have restricted our ability to detect some differences and may limit the generalizability of findings to more representative samples. In addition, the sample comprised children who had already undergone at least 1 VCUG during which they had had difficulty. Consequently, additional research is needed to determine whether hypnosis would be helpful to those who are undergoing their first VCUG. Additional limitations, clinical observations, and directions for future research are also discussed.OBJECTIVEVoiding cystourethrography (VCUG) is a commonly performed radiologic procedure in children that can be both painful and frightening. Given the distress that some children experience during the VCUG and the need for children to be alert and cooperative during the procedure, finding a psychological intervention that helps children to manage anxiety, distress, and pain is clearly desirable. This study was designed to examine whether relaxation and analgesia facilitated with hypnosis could reduce distress and procedure time for children who undergo this procedure.","Butler, L D; Symons, B K; Henderson, S L; Shortliffe, L D; Spiegel, D",2005.0,10.1542/peds.2004-0818,0,0,
5495,Az√∫car y nervios: explanatory models and treatment experiences of Hispanics with diabetes and depression,"ER This study examined the explanatory models of depression, perceived relationships between diabetes and depression, and depression treatment experiences of low-income, Spanish-speaking, Hispanics with diabetes and depression. A purposive sample (n=19) was selected from participants enrolled in a randomized controlled trial conducted in Los Angeles, California (United States) testing the effectiveness of a health services quality improvement intervention. Four focus groups followed by 10 in-depth semi-structured qualitative interviews were conducted. Data were analyzed using the methodology of coding, consensus, co-occurrence, and comparison, an analytical strategy rooted in grounded theory. Depression was perceived as a serious condition linked to the accumulation of social stressors. Somatic and anxiety-like symptoms and the cultural idiom of nervios were central themes in low-income Hispanics' explanatory models of depression. The perceived reciprocal relationships between diabetes and depression highlighted the multiple pathways by which these two illnesses impact each other and support the integration of diabetes and depression treatments. Concerns about depression treatments included fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking psychotropic medications. This study provides important insights about the cultural and social dynamics that shape low-income Hispanics' illness and treatment experiences and support the use of patient-centered approaches to reduce the morbidity and mortality associated with diabetes and depression.","Cabassa, L J; Hansen, M C; Palinkas, L A; Ell, K",2008.0,10.1016/j.socscimed.2008.01.054,0,0,
5496,Exercise and quality of life during and after treatment for breast cancer: results of two randomized controlled trials,"ER METHODSFifty newly diagnosed breast cancer survivors were recruited through a hospital-based tumor registry and randomized to a 6-month, home-based exercise program (n=25) or a usual care group (n=25). In a separate trial, 75 post-treatment survivors were randomized to a 6-month, supervised exercise intervention (n=37) or to usual care (n=38). Participants in both studies completed measures of happiness, depressive symptoms, anxiety, stress, self-esteem, and quality of life at baseline and 6 months.RESULTSForty-five participants completed the trial for newly diagnosed survivors and 67 completed the trial for post-treatment survivors. Good adherence was observed in both studies. Baseline quality of life was similar for both studies on most measures. Exercise was not associated with quality of life benefits in the full sample of either study; however exercise was associated with improved social functioning among post-treatment survivors who reported low social functioning at baseline (p<0.05).CONCLUSIONSExercise did not affect quality of life in either recently diagnosed or post-treatment breast cancer survivors; however this may be due in part to relatively high baseline functioning among participants in both studies. Strategies for future research include limiting enrollment to survivors who report reduced quality of life on screening questionnaires and targeting survivor subgroups known to be at particular risk for quality of life impairment.OBJECTIVETo determine the effect of exercise on quality of life in (a) a randomized controlled trial of exercise among recently diagnosed breast cancer survivors undergoing adjuvant therapy and (b) a similar trial among post-treatment survivors.","Cadmus, L A; Salovey, P; Yu, H; Chung, G; Kasl, S; Irwin, M L",2009.0,10.1002/pon.1525,0,0,
5497,The YouthMood Project: a cluster randomized controlled trial of an online cognitive behavioral program with adolescents,"ER The aim in the current study was to investigate the effectiveness of an online, self-directed cognitive-behavioral therapy program (MoodGYM) in preventing and reducing the symptoms of anxiety and depression in an adolescent school-based population. A cluster randomized controlled trial was conducted with 30 schools (N = 1,477) from across Australia, with each school randomly allocated to the intervention or wait-list control condition. At postintervention and 6-month follow-up, participants in the intervention condition had significantly lower levels of anxiety than did participants in the wait-list control condition (Cohen's d = 0.15-0.25). The effects of the MoodGYM program on depressive symptoms were less strong, with only male participants in the intervention condition exhibiting significant reductions in depressive symptoms at postintervention and 6-month follow-up (Cohen's d = 0.27-0.43). Although small to moderate, the effects obtained in the current study provide support for the utility of universal prevention programs in schools. The effectiveness of booster sessions should be explored in future research.","Calear, A L; Christensen, H; Mackinnon, A; Griffiths, K M; O'Kearney, R",2009.0,10.1037/a0017391,0,0,
5498,Pregnancy today. Randomized study of the emotional state of the woman and her partner,"ER METHODSThrough a questionnaire including some general data and a more specific section to evaluate psychic and emotional factors of the pregnant and her partner during pregnancy, we interviewed 100 pregnant women beginning from the 32nd pregnancy week; all women attended the psychoprophylactic lessons for childbirth, they were between 20 and 41 years old and the 87% was primipara and the 13% was multipara.RESULTS AND CONCLUSIONSThis study showed that even if pregnancy is more and more planned and desired, anxiety and fears follow the joy and the happiness of having child, both in man and in woman. Thus, pregnancy and birth, seem to be, also today, too much medicated to the detriment of the ""naturalness"" of the event: in fact, woman uptake more drugs and there is an increased need to have a good medical assistance not for real obstetrical problems but only to make up for intense anxiety.BACKGROUNDPregnancy is a remarkable ground for studying the biopsychosocial perspective of psychosomatics, because there is a close correlation between biological conditions, that quickly change in time, and emotional implications that are this result of women psychological structure, her psychosexual maturation degree and her social and environment past and present influences.","Calleri, L; Ceffa, C; Allegra, A M; Porcelli, A",1998.0,,0,0,
5499,Facilitating coping behavior in children prior to dental general anesthesia: a randomized controlled trial,"ER METHODA total of 198 children were allocated randomly to computer, cartoon or control groups. A Visual Analog Scale (VAS) and Modified Child Dental Anxiety Scale (MCDAS) were used to compare preoperative anxiety levels between the three study groups. Blinded observers then scored behavior at both anesthesia induction and upon recovery using a VAS for each (0 = coped/no distress and 10 = no coping/high distress).RESULTSThe children's median age was 5 (range 3-10) years, 57% were boys, a median of seven teeth were extracted (range 1-20). Preoperative anxiety was similar for all preparation groups; with 24% of all children categorized 'phobic' using MCDAS. The median induction (coping) VAS level for both the computer and the cartoon groups was '1' (range 0-10), compared with the control group level of '3' (range 0-10). The median recovery (coping) VAS levels were: computer group: 0 (range 0-10), cartoon group: 4 (range 0-10) and control group: 2.5 (range 0-10). The Mann-Whitney U-test showed that the computer group coped significantly better than the control group at induction (P = 0.014) and significantly better than the cartoon group upon recovery (P = 0.016). The statistical power for detecting differences between groups (computer/cartoon versus control) was calculated to be 90%, based on pilot study data.CONCLUSIONSThe computer preparation package facilitated coping behavior in children undergoing DGA induction.BACKGROUNDThe aim of this study was to establish the efficacy of two different preparation packages, a paper-based cartoon and an interactive computer, at facilitating coping behavior in children undergoing dental general anesthetic (DGA) tooth extraction.","Campbell, C; Hosey, M T; McHugh, S",2005.0,10.1111/j.1460-9592.2004.01565.x,0,0,
5500,"A new device for sutureless skin closure ""the zipper""","ER METHODS610 consecutive patients underwent surgery for abdominal thoracic endocrinologic and post traumatic pathologies. In 203 cases we used the zipper a new device for skin closure.RESULTS6/203 Morbility: in six cases it was necessary to substitute the zipper with sutures or leave the wound healing by second intention. The patients were operated for inguinal hernioplasty, axillary lymphadenectomy, appendicectomy and cholecystectomy. These patients developed complications after surgery as hematoma, lymphorrhea, wound infection and a reintervention. The correction has been done removing the zipper and positioning sutures or leaving the wound healing by second intention.CONCLUSIONSThe use of the zipper permits to achieve an efficient seal, a simple application, an aesthetic comfort; it can be applied in local anaesthesia and for its painless, application it is indicated in pediatric surgery.BACKGROUNDWe have done a prospective, controlled, randomized study to investigate the role of the ""zipper"", a new device for skin closure. We have also analysed morbility and advantages with the use of the ""zipper"" compared with sutures.","Carcoforo, P; Jorizzo, E F; Maestroni, U; Soliani, G; Navarra, G",2002.0,,0,0,
5501,Could home be an appropriate location for performing posturographic assessments in elderly subjects?,"ER INTRODUCTION: Posturographic measurements are often performed in hospital in the context of assessing fall risks in elderly subjects. These hospital visits may generate different kinds of stimuli that could influence test outcomes.STUDY AIM: The aim was to investigate whether posturographic measurements performed both at home and in hospital in a randomized order provide similar data.METHODS: Thirty-five healthy elderly subjects (average age 72.5 ± 3.7 years) were assigned to two postural evaluations performed in a random order: one at home and one at the hospital. Before the first evaluation, subject's levels of anxiety, depression and stress were assessed. Then, the area of body sway, velocity and medial-lateral and antero-posterior amplitudes were recorded twice, first with the subject's eyes opened and then with eyes closed.RESULTS AND DISCUSSION: The posturographic data obtained in hospital and at home were quite similar. However, when the group that was first evaluated in hospital was compared with the group first evaluated at home, the medio-lateral amplitude was observed to significantly decrease in the second evaluation compared with the data obtained in the first trial (P<0.05), and this decrease was significantly higher in the first group (P<0.05). For the eyes-opened condition, we found significant correlations between anxiety and the area of body sway, stress and the area of body sway, and anxiety and the medial-lateral amplitude.CONCLUSIONS: Psychological factors may influence some posturographic data, and carrying out posturographic evaluations at home for elderly subjects could be a reasonable strategy.","Carette, P; Kemoun, G; Thibaud, M; Breque, C; Dugué, B",2012.0,10.1016/j.neucli.2012.02.135,0,0,
5502,Role of interactions between psychological and clinical factors in determining 6-month mortality among patients with acute myocardial infarction. Application of recursive partitioning techniques to the GISSI-2 database. Gruppo Italiano per lo Studio della Sopravvivenza nell' Infarto Miocardico,"ER METHODS AND RESULTSIn the framework of the GISSI-2 trial, the impact of psychological factors on 6-month mortality and their interaction with clinical features was included as an ad hoc research project. Overall, 2449 patients were evaluated, 63 of whom died during the study period. All patients undertook a self-administered questionnaire (Cognitive Behavioural Assessment Hospital Form), investigating 16 psychological dimensions relative to three areas (state variables, vital exhaustion, trait variables). The impact of psychological variables on prognosis and their interaction with clinical variables were investigated by using a tree-growing technique (RECursive Partitioning and AMalgamation-RECPAM) applied to survival analysis. This statistical method allowed the identification of three separate classes, characterized by different prognoses: Class I (presence of vital exhaustion), Class II (concomitance of no vital exhaustion, depression and low levels of anxiety) and Class III (all other patients). After adjusting for the clinical variables, Class I was associated with an intermediate prognosis (hazard ratio [HR] = 2.2; 95% confidence intervals [CI], 1.2-4.0) and Class II to the worst (HR = 3.2; 95% CI = 1.6-6.2), as compared to Class III. High levels of neuroticism and extroversion were associated with a better prognosis. When clinical and psychological variables were simultaneously investigated by RECPAM, Type A behaviour was shown to be an important risk predictor among patients with better clinical conditions, i.e. those eligible for exercise test (HR = 2.6, 95% CI = 1.2-5.5). Finally, a striking difference in the impact of the most predictive clinical variables (exercise test ineligibility, late and early ventricular failure) was found among patients with and without vital exhaustion.CONCLUSIONSThis study shows that acute myocardial infarction survivors are heterogeneous with respect to 6-month mortality according to their psychological profile. More important, the impact of these variables appears comparable to that of very well known clinical risk predictors. The availability of a large study population, together with the use of innovative statistical techniques, allowed us to identify subgroups of patients for whom the joint action of clinical and psychological characteristics has been clearly documented. This suggests the need for incorporating psychological evaluation in the care of acute myocardial infarction patients.BACKGROUNDClinical and epidemiological studies support the hypothesis that ischaemic cardiovascular diseases are consistently associated with psychological, social and behavioural factors. Nevertheless, the joint effect of clinical characteristics and psychological variables in determining the prognosis of acute myocardial infarction survivors has been seldom investigated.","Carinci, F; Nicolucci, A; Ciampi, A; Labbrozzi, D; Bettinardi, O; Zotti, A M; Tognoni, G",1997.0,,0,0,
5503,A natural setting behavior management program for persons with acquired brain injury: a randomized controlled trial,"ER DESIGNThree-group randomized controlled trial.SETTINGHomes and other community settings.PARTICIPANTSThirty-seven persons with traumatic and other acquired brain injury and their caregivers.INTERVENTIONSNatural Setting Behavior Management (NSBM) involving education and individualized behavior modification program versus education only versus control group.MAIN OUTCOME MEASURESChanges in frequency of targeted problematic behaviors. Subscale in Questionnaire on Resources and Stress, Maslach Burnout Inventory, and the Neurobehavioral Functioning Inventory.RESULTSWhile no significant effects were detected at termination of education only (P<.075) or of NSBM (P<.56), significant treatment effects were found at the main outcome point 3 months after termination of services (P<.002). Rates of disruptive or aggressive behaviors declined significantly in the NSBM group. Differences in caregiver-rated stress, burden, and aggression were not statistically significant.CONCLUSIONSA program of caregiver education and individualized behavior management in natural settings can decrease the frequency of disruptive behavioral challenges. Larger studies are needed to clarify the duration and intensity of education and individualized treatment required to diminish behavioral challenges and to understand relationships with general stress and burden experienced by caregivers.OBJECTIVETo investigate the efficacy of a behavior management program delivered in the natural community setting for persons with brain injury and their caregivers.","Carnevale, G J; Anselmi, V; Johnston, M V; Busichio, K; Walsh, V",2006.0,10.1016/j.apmr.2006.06.010,0,0,
5504,The efficacy of habituation in decreasing subjective distress among high anxiety-sensitive college students,"ER While there is mounting evidence that the concept of anxiety sensitivity (AS) is linked to the expression of anxiety (specifically, panic), there has been little research comparing the efficacy of interoceptive exposure alone with interoceptive exposure coupled with cognitive restructuring among high AS participants. The present investigation addressed this issue in a sample of high anxiety-sensitive college students (scores above 29 on the Anxiety Sensitivity Index). Participants were randomly assigned to receive either five consecutive trials of voluntary hyperventilation or five consecutive trials of hyperventilation with cognitive restructuring instructions. It was expected that while repeated hyperventilation would be associated with a significant reduction in self-reported anxiety, catastrophic cognitions, and somatic sensations across trials, the greatest reduction in symptoms would occur with the addition of cognitive restructuring. These predictions were partially supported. As expected, high AS participants evidenced significant decreases in anxiety symptoms when habituation was accompanied by cognitive restructuring. Contrary to predictions, however, interoceptive exposure alone was not effective in reducing anxious symptoms. These results suggest that brief habituation alone may not be an effective strategy for high AS participants and are discussed as providing further support for a cognitive model of anxiety.","Carter, M M; Marin, N W; Murrell, K L",1999.0,,0,0,
5505,Efficacy of a multidisciplinary treatment program in patients with severe fibromyalgia,"ER The purpose of this study was to evaluate the efficacy of a multidisciplinary treatment program in patients severely affected by fibromyalgia. Thirty-four fibromyalgia patients were randomly divided into two groups. The control group: 17 women who continued their medical treatment and participated in four educational sessions and the experimental group that included 17 patients who besides the former medical treatment also underwent a weekly 1-h session program for 8 weeks including massage therapy, ischemic pressure on the 18 tender points, aerobic exercise and thermal therapy. At the beginning of the program, there were no significant differences between the two groups in any of the parameters. At the end of treatment, there was a significant improvement in the experimental group in the following items: vitality, social functioning, grip strength and the 6-min walk test. At 1 month after the end of treatment, the experimental group showed significant differences in overall health perception, social functioning, grip strength and the 6-min walk test. At that time, considering the threshold for clinical efficacy set at an improvement of 30% or above for the analyzed variables, 25% of the patients met the requirement for improvement of the following: number of symptoms: Visual Analogic Scale for fatigue, Fibromyalgia Impact Questionnaire and Beck Anxiety Inventory. In conclusion, patients with severe manifestations of fibromyalgia can obtain improvement with a short-term, low-cost and simple-delivery multidisciplinary program. However, additional studies including higher numbers of patients are needed to confirm the beneficial effect of this treatment program.","Casanueva-Fernández, B; Llorca, J; Rubió, J B; Rodero-Fernández, B; González-Gay, M A",2012.0,10.1007/s00296-011-2045-1,0,0,
5506,Minor head trauma in children: an intervention to decrease functional morbidity,"ER Minor head trauma is common among children and evokes strong parental reaction. Parents often rush the child to an emergency department or consult their pediatrician by telephone despite the minor nature of the injury. In a previous report we showed that children with minor head trauma appear to have limitations in their usual daily activities and a high rate of school absenteeism. This study was a prospective, randomized trial of an intervention designed to reduce this functional morbidity after head trauma. Parents in the control group (n = 168) received routine discharge instructions. Parents in the intervention group (n = 153) received a discharge interview during which the nurse gave more explicit and behaviorally oriented instructions. The nurse also called intervention parents the next day to reassure them and to urge that the children return to their usual routine. One month after the injury a questionnaire was administered by telephone to assess physical health status, social or functional limitations, and behavior problems. The majority of parents (85%) were anxious, and this was not alleviated by previous experience with head trauma. Triage nurses incorrectly rated one third of the parents as not anxious. Physical health status, role activity indices, and behavior problems, were similar for the intervention and control groups 1 month after the head injury. Subsequent morbidity was highly correlated with parental anxiety. In managing children with minor head trauma, pediatricians and emergency department physicians must focus their discharge instructions on the parent's anxiety, emphasize the minor severity of the injury, and urge that the children return to their usual routine.","Casey, R; Ludwig, S; McCormick, M C",1987.0,,0,0,
5507,Emotional aspects of chronic orofacial pain and surgical treatment,"ER METHODSWe evaluated 30 patients (15 with temporomandibular disorder and 15 with trigeminal neuralgia) of three groups: 10 were hospitalized for surgery, 10 were newly diagnosed, and 10 had been clinically treated. Data were collected using a semi-structured interview and the Hospital Anxiety Depression Scale.RESULTSEighty percent reported lack of family support, 90% had important limitations in daily activities, and social aspects were the most affected (34%). Patients who were hospitalized for surgery had the highest degree of anxiety and expectation (90%; p<0.05).CONCLUSIONSurgery for chronic pain generates great expectations especially because it is considered a hope of cure. Clinically treated patients also might understand the factors associated to surgery choices and participate at the process of choosing. In general, chronic treatment for facial pain needs psychological support to cope with it.OBJECTIVEThe aim of this pilot study was to investigate the psychological factors of chronic orofacial pain patients regarding hospitalization for surgical treatment.","Castro, A R; Siqueira, S R; Perissinotti, D M; Teixeira, M J; Siqueira, J T",2009.0,10.1016/j.ijsu.2009.02.002,0,0,
5508,The cognitive behavioral therapy causes an improvement in quality of life in patients with chronic musculoskeletal pain,"ER UNLABELLED: Chronic pain causes functional incapacity and compromises an individual's affective, social, and economic life.OBJECTIVE: To study the cognitive behavioral therapy (CBT) effectiveness in a group of patients with chronic pain.METHODS: A randomized clinical trial with two parallel groups comprising 93 patients with chronic pain was carried out. Forty-eight patients were submitted to CBT and 45 continued the standard treatment. The visual analogue, hospital anxiety and depression, and quality of life SF-36 scales were applied. Patients were evaluated before and after ten weeks of treatment.RESULTS: When the Control Group and CBT were compared, the latter presented reduction of depressive symptoms (p=0.031) and improvement in the domains 'physical limitations' (p=0.012), 'general state of health' (p=0.045), and 'limitations by emotional aspects' (p=0.025).CONCLUSIONS: The CBT was effective and it has caused an improvement in more domains of quality of life when compared to the Control Group, after ten weeks of treatment.","Castro, M M; Daltro, C; Kraychete, D C; Lopes, J",2012.0,,0,0,
5509,Kinesio Taping reduces disability and pain slightly in chronic non-specific low back pain: a randomised trial,"ER QUESTION: Does Kinesio Taping reduce disability, pain, and kinesiophobia in people with chronic non-specific low back pain?DESIGN: Randomised trial, with concealed allocation, assessor blinding, and intention-to-treat analysis.PARTICIPANTS: Sixty adults with chronic non-specific low back pain.INTERVENTION: The experimental intervention was Kinesio Taping over the lumbar spine for one week; the control intervention was sham taping.OUTCOME MEASURES: The following outcomes were measured at baseline, immediately after the week with the tape in situ, and four weeks later: Oswestry Disability Index, Roland- Morris Low Back Pain and Disability Questionnaire, pain on a 10-cm visual analogue scale, Tampa kinesiophobia scale, trunk flexion range of motion, and the McQuade test of trunk muscle endurance.RESULTS: At one week, the experimental group had significantly greater improvement in disability, by 4 points (95% CI 2 to 6) on the Oswestry score and by 1.2 points (95% CI 0.4 to 2.0) on the Roland-Morris score. However, these effects were not significant four weeks later. The experimental group also had a greater decrease in pain than the control group immediately after treatment (mean between-group difference 1.1cm, 95% CI 0.3 to 1.9), which was maintained four weeks later (1.0cm, 95% CI 0.2 to 1.7). Similarly trunk muscle endurance was significantly better at one week (by 23 sec, 95% CI 14 to 32) and four weeks later (by 18 sec, 95% CI 9 to 26). Other outcomes were not significantly affected.CONCLUSION: Kinesio Taping reduced disability and pain in people with chronic non-specific low back pain, but these effects may be too small to be clinically worthwhile. Trial registration: ACTRN12612000402842.","Castro-Sánchez, A M; Lara-Palomo, I C; Matarán-Peñarrocha, G A; Fernández-Sánchez, M; Sánchez-Labraca, N; Arroyo-Morales, M",2012.0,10.1016/S1836-9553(12)70088-7,0,0,
5510,Therapeutic relationships in vocational rehabilitation: predicting good relationships for people with psychosis,"ER Therapeutic relationships between clients and vocational rehabilitation workers have been shown to predict entering competitive employment. We aimed to determine predictors of good relationships, using data from an international randomized controlled trial of supported employment (n=312). Baseline predictors of early therapeutic relationships with vocational workers were assessed, along with the impact of vocational status and changing clinical and social functioning variables on relationship ratings over time. Associations between client and professional relationship ratings were also explored. Better early client-rated therapeutic relationship was predicted by better baseline relationship with the clinical keyworker, being in the Individual Placement and Support (IPS) service, the absence of work history and a greater proportion of care needs being met, whereas over time it was predicted by being in the IPS service. Professional-rated early relationship was predicted by social disability and remission, while over time it was predicted by being the same sex as the client, duration of the relationship and the client's increasing anxiety. Client and professional ratings were positively associated but clients' ratings were higher than professionals', particularly in the IPS service. Relationships were better where clients may have been more motivated to engage, including by their prior experience of a good therapeutic relationship with the clinical keyworker.","Catty, J; White, S; Koletsi, M; Becker, T; Fioritti, A; Kalkan, R; Lauber, C; Lissouba, P; Rössler, W; Tomov, T; Busschbach, J T; Wiersma, D; Burns, T",2011.0,10.1016/j.psychres.2010.10.018,0,0,
5511,Bimanual microphacoemulsification versus coaxial miniphacoemulsification: prospective study,"ER SETTINGInstitute of Ophthalmology, University of Modena, Modena, Italy.METHODSIn a controlled prospective clinical trial, 100 eyes of 50 patients with nuclear or corticonuclear cataract of grade 2 to 4 on the Lens Opacities Classification System III had phacoemulsification. Fifty eyes were randomized to have surgery by the bimanual technique and 50, by the coaxial technique. All surgeries were performed by the same surgeon using the same machine (Sovereign WhiteStar, American Medical Optics). In all cases, the incision was made superiorly in clear cornea and a hydrophobic acrylic flexible intraocular lens (Acri. Smart 48 S, Acri.Tec) was implanted. Intraoperative parameters were mean phacoemulsification time, total phacoemulsification percentage, effective phacoemulsification time (EPT), total volume of balanced salt solution (BSS) used, total surgical time, and final size of the corneal incision. Postoperative parameters were visual acuity, astigmatism changes by vector analysis, corneal thickness, endothelial cell count, and presence of flare and cells in the anterior chamber.RESULTSThe only statistically significant difference between the 2 groups was the total volume of the BSS used (P = .004) and total surgical time (P = .045).CONCLUSIONSBoth techniques were safe and effective for cataract surgery. With bimanual microphacoemulsification, significantly less BSS was used and the total surgical time was significantly shorter than with the coaxial method.PURPOSETo compare the outcomes of bimanual microphacoemulsification and coaxial miniphacoemulsification and assess the potential advantages of the former over the latter.","Cavallini, G M; Campi, L; Masini, C; Pelloni, S; Pupino, A",2007.0,10.1016/j.jcrs.2006.11.016,0,0,
5512,Beating the blues after cancer: randomised controlled trial of a tele-based psychological intervention for high distress patients and carers,"ER METHODS/DESIGN: 140 patients and 140 carers per condition (560 participants in total) will been recruited after being identified as high distress through caller screening at two community-based cancer helplines and randomised to 1) a single 30-minute telephone support and education session with a nurse counsellor with self management materials 2) a tele-based psychologist delivered five session individualised cognitive behavioural intervention. Session components will include stress reduction, problem-solving, cognitive challenging and enhancing relationship support and will be delivered weekly. Participants will be assessed at baseline and 3, 6 and 12 months after recruitment. Outcome measures include: anxiety and depression, cancer specific distress, unmet psychological supportive care needs, positive adjustment, overall Quality of life.DISCUSSION: The study will provide recommendations about the efficacy and potential economic value of minimal contact self management vs. tele-based psychologist delivered cognitive behavioural intervention to facilitate better psychosocial adjustment and mental health for people with cancer and their carers.TRIAL REGISTRATION: ACTRN12609000301268.BACKGROUND: The diagnosis and treatment of cancer is a major life stress such that approximately 35% of patients experience persistent clinically significant distress and carers often experience even higher distress than patients. This paper presents the design of a two arm randomised controlled trial with patients and carers who have elevated psychological distress comparing minimal contact self management vs. an individualised tele-based cognitive behavioural intervention.","Chambers, S K; Girgis, A; Occhipinti, S; Hutchison, S; Turner, J; Carter, R; Dunn, J",2009.0,10.1186/1471-2407-9-189,0,0,
5513,Befriending carers of people with dementia: randomised controlled trial,"ER DESIGNSingle blind randomised controlled trial.SETTINGCommunity settings in East Anglia and London.PARTICIPANTS236 family carers of people with primary progressive dementia.INTERVENTIONContact with a befriender facilitator and offer of match with a trained lay volunteer befriender compared with no befriender facilitator contact; all participants continued to receive ""usual care.""MAIN OUTCOME MEASURESCarers' mood (hospital anxiety and depression scale-depression) and health related quality of life (EuroQoL) at 15 months post-randomisation.RESULTSThe intention to treat analysis showed no benefit for the intervention ""access to a befriender facilitator"" on the primary outcome measure or on any of the secondary outcome measures.CONCLUSIONSIn common with many carers' services, befriending schemes are not taken up by all carers, and providing access to a befriending scheme is not effective in improving wellbeing. Trial registration Current CONTROLLED TRIALS: ISRCTN08130075.OBJECTIVETo evaluate the effectiveness of a voluntary sector based befriending scheme in improving psychological wellbeing and quality of life for family carers of people with dementia.","Charlesworth, G; Shepstone, L; Wilson, E; Reynolds, S; Mugford, M; Price, D; Harvey, I; Poland, F",2008.0,10.1136/bmj.39549.548831.AE,0,0,
5514,"Does befriending by trained lay workers improve psychological well-being and quality of life for carers of people with dementia, and at what cost? A randomised controlled trial","ER DESIGNThe Befriending and Costs of Caring (BECCA) trial was a cost-effectiveness randomised controlled trial. Data on well-being and resource use were collected through interviews with participants at baseline and at 6, 15 and 24 months.SETTINGThis research was carried out in the English counties of Norfolk and Suffolk, and the London Borough of Havering. It was a community-based study.PARTICIPANTSParticipants were family carers who were cohabiting with, or providing at least 20 hours' care per week for, a community-dwelling relative with a primary progressive dementia.INTERVENTIONSThe intervention was 'access to a befriender facilitator' (BF). BFs, based with charitable/voluntary-sector organisations, were responsible for local befriending schemes, including recruitment, screening, training and ongoing support of befriending volunteers, and for matching carers with befrienders. The role of befrienders was to provide emotional support for carers. The target duration for befriending relationships was 6 months or more.MAIN OUTCOME MEASURESDepression was measured by the Hospital Anxiety and Depression Scale (HADS) at 15 months postrandomisation. The health-related quality of life scale EQ-5D (EuroQol 5 Dimensions) was used to derive utilities for the calculation of quality-adjusted life-years (QALYs).RESULTSA total of 236 carers were randomised into the trial (116 intervention; 120 control). At final follow-up, 190 carers (93 intervention; 97 control) were still involved in the trial (19% attrition). There was no evidence of effectiveness or cost-effectiveness from the primary analyses on the intention-to-treat population. The mean incremental cost per incremental QALY gained was in excess of 100,000 pounds, with only a 42.2% probability of being below 30,000 pounds per QALY gained. Where care-recipient QALYs were included, mean incremental cost per incremental QALY gained was 26,848 pounds, with a 51.4% probability of being below 30,000 pounds per QALY gained. Only 60 carers (52%) took up the offer of being matched with a trained lay befriender, and of these only 37 (32%) were befriended for 6 months or more. A subgroup analysis of controls versus those befriended for 6 months or more found a reduction in HADS-depression scores that approached statistical significance (95%","Charlesworth, G; Shepstone, L; Wilson, E; Thalanany, M; Mugford, M; Poland, F",2008.0,,0,0,
5515,Genetic modulation of oxytocin sensitivity: a pharmacogenetic approach,"ER Intranasal administration of the neuropeptide oxytocin has been shown to influence a range of complex social cognitions and social behaviors, and it holds therapeutic potential for the treatment of mental disorders characterized by social functioning deficits such as autism, social phobia and borderline personality disorder. However, considerable variability exists in individual responses to oxytocin administration. Here, we undertook a study to investigate the role of genetic variation in sensitivity to exogenous oxytocin using a socioemotional task. In a randomized, double-blind, placebo-controlled experiment with a repeated-measures (crossover) design, we assessed the performance of 203 men on an emotion recognition task under oxytocin and placebo. We took a haplotype-based approach to investigate the association between oxytocin receptor gene variation and oxytocin sensitivity. We identified a six-marker haplotype block spanning the promoter region and intron 3 that was significantly associated with our measure of oxytocin sensitivity. Specifically, the TTCGGG haplotype comprising single-nucleotide polymorphisms rs237917-rs2268498-rs4564970-rs237897-rs2268495-rs53576 is associated with increased emotion recognition performance under oxytocin versus placebo, and the CCGAGA haplotype with the opposite pattern. These results on the genetic modulation of sensitivity to oxytocin document a significant source of individual differences with implications for personalized treatment approaches using oxytocin administration.","Chen, F S; Kumsta, R; Dvorak, F; Domes, G; Yim, O S; Ebstein, R P; Heinrichs, M",2015.0,10.1038/tp.2015.163,0,0,
5516,Religious participation as a predictor of mental health status and treatment outcomes in older persons,"ER METHODSA sample of older adults participating in a clinical study (PRISM-E) to treat their depression with or without co-morbid anxiety (n = 1610) were queried about their religious affiliation and the frequency of their participation in religious activities. The diagnoses of depressive and anxiety disorders were made based on the MINI-International Neuropsychiatric Interview. Severity of depressive disorders was assessed by emotional distress using the CES-D.RESULTSThose attending religious activities on a weekly, monthly, or occasional basis were significantly less likely to have suicidal ideation (p < 0.02) and emotional distress (p < 0.0001) than those who never participated or participated on a less frequent basis. Frequency of religious participation was not associated with mental health service utilization (p = 0.16), but it was predictive of a lower CES-D score at the end of the study intervention (p < 0.001).CONCLUSIONSReligious participation is positively associated with older adults' mental health status and treatment effects, but results regarding mental health service utilization were inconclusive.OBJECTIVESThis study focuses on examining the relations of religious participation and affiliation to mental health status among older primary care patients, and to the use and clinical outcomes of mental health services.","Chen, H; Cheal, K; McDonel, Herr E C; Zubritsky, C; Levkoff, S E",2007.0,10.1002/gps.1704,0,0,
5517,Intramedullary nailing of clavicular midshaft fractures in adults using titanium elastic nail,"ER OBJECTIVE: Studies showed elastic stable intramedullary nailing (ESIN) of displaced midclavicular fractures has excellent outcomes, as well as high complication rates and specific problems. The aim was to discuss ESIN of midshaft clavicular fractures. METHODS: Totally 60 eligible patients (aged 18-63 years) were randomized to either ESIN group or non-operative group between January 2007 and May 2008. Clavicular shortening was measured after trauma and osseous consolidation. Radiographic union and complications were assessed. Function analysis including Constant shoulder scores and disabilities of the arm, shoulder and hand (DASH) scores were performed after a 15-month follow-up. RESULTS: ESIN led to a signifcantly shorter time to union, especially for simple fractures. In ESIN group, all patients got fracture union, of which 5 cases had medial skin irritation and 1 patient needed revision surgery because of implant failure. In the nonoperative group, there were 3 nonunion cases and 2 symptomatic malunions developed requiring corrective osteotomy. At 15 months after intramedullary stabilization, patients in the ESIN group were more satisfied with the appearance of the shoulder and overall outcome, and they benefited a lot from the great improvement of post-traumatic clavicular shortening. Furthermore, DASH scores were lower and Constant scores were significantly higher in contrast to the non-operative group. CONCLUSION: ESIN is a safe minimally invasive surgical technique with lower complication rate, faster return to daily activities, excellent cosmetic and better functional results, restoration of clavicular length for treating mid-shaft clavicular fractures, resulting in high overall satisfaction, which can be regard as an alternative to plate fixation or nonoperative treatment of mid-shaft clavicular fractures.","Chen, Q Y; Kou, D Q; Cheng, X J; Zhang, W; Wang, W; Lin, Z Q; Cheng, S W; Shen, Y; Ying, X Z; Peng, L; Lv, C Z",2011.0,,0,0,
5518,"A randomized, controlled trial of a community-based support program for families of children with chronic illness: pediatric outcomes","ER OBJECTIVESTo develop, implement, and evaluate child outcomes of a 15-month, community-based, family-support intervention designed to reduce risk for poor adjustment and mental health problems in children with 1 of 4 chronic illnesses (diabetes mellitus, sickle cell anemia, cystic fibrosis, or moderate to severe asthma) and their mothers.DESIGNRandomized, controlled clinical trial design with multiple measures of mental health based on both child and parent reports taken 1 year apart.SETTINGCommunity-based intervention linked to subspecialty and general pediatric clinics and practices in Baltimore, Md.PARTICIPANTSOne hundred thirty-six mothers and children aged 7 to 11 years with diabetes mellitus, sickle cell anemia, cystic fibrosis, or moderate to severe asthma.INTERVENTIONThe program, provided by ""experienced mothers"" and child life specialists, included telephone contacts, face-to-face visits, and special family events.MAIN OUTCOME MEASURESOutcomes were measured using the following instruments: the Personal Adjustment and Role Skills Scale III, the Children's Depression Inventory, the Revised Children's Manifest Anxiety Scale, and the Self-Perception Profile for Children.RESULTSThe experimental group's mean adjustment score increased over the intervention period while the control group's mean adjustment score decreased. Analysis of variance demonstrated that the intervention had a significant main effect on postintervention adjustment controlling for baseline scores (P =.01). Using a cutoff score indicating maladjustment, the percentage of experimental group children in the maladjustment range fell from 19% at baseline to 10% after the intervention; the percentage of control group children in the maladjustment range rose from 15% at baseline to 21% after the intervention. The effect of the intervention was more pronounced for children who had low physical self-esteem than for those who had moderate to high physical self-esteem at the beginning of the program.CONCLUSIONSOur results demonstrate modest positive effects of a family support intervention in promoting the adjustment of children with selective chronic health conditions. Including child life specialists in a community-based intervention may be especially salient for children with chronic illnesses who have low physical self-esteem. The intervention had a similar outcome for all diagnostic groups, suggesting that it could be effective for children with any chronic illness and implemented in a variety of pediatric settings.BACKGROUNDChildren with chronic illnesses have a heightened risk for mental health problems.","Chernoff, R G; Ireys, H T; DeVet, K A; Kim, Y J",2002.0,,0,0,
5519,Randomised controlled trial of qigong in the treatment of mild essential hypertension,"ER Exercise and relaxation decrease blood pressure. Qigong is a traditional Chinese exercise consisting of breathing and gentle movements. We conducted a randomised controlled trial to study the effect of Guolin qigong on blood pressure. In all, 88 patients with mild essential hypertension were recruited from the community and randomised to Goulin qigong or conventional exercise for 16 weeks. The main outcome measurements were blood pressure, health status (SF-36 scores), Beck Anxiety and Depression Inventory scores. In the qigong group, blood pressure decreased significantly from 146.3+/-7.8/93.0+/-4.1 mmHg at baseline to 135.5+/-10.0/87.1+/-7.7 mmHg at week 16. In the exercise group, blood pressure also decreased significantly from 140.9+/-10.9/93.1+/-3.5 mmHg to 129.7+/-11.1/86.0+/-7.0 mmHg. Heart rate, weight, BMI, waist circumference, total cholesterol, renin and 24 h urinary albumin excretion significantly decreased in both groups after 16 weeks. General health, bodily pain, social functioning and depression also improved in both groups. No significant differences between qigong and conventional exercise were found. In conclusion, Guolin qigong and conventional exercise have similar effects on blood pressure in patients with mild hypertension. While no additional benefits were identified, it is nevertheless an alternative to conventional exercise in the nondrug treatment of hypertension.","Cheung, B M; Lo, J L; Fong, D Y; Chan, M Y; Wong, S H; Wong, V C; Lam, K S; Lau, C P; Karlberg, J P",2005.0,10.1038/sj.jhh.1001884,0,0,
5520,"The UP-TECH project, an intervention to support caregivers of Alzheimer's disease patients in Italy: study protocol for a randomized controlled trial","ER METHODS/DESIGN: A total of 450 dyads comprising AD patients and their caregivers in five health districts of the Marche region, Italy, will be randomized into three study arms. Participants in the first study arm will receive comprehensive care and support from a case manager (an ad hoc trained social worker) (UP group). Subjects in the second study arm will be similarly supported by a case manager, but in addition will receive a technological toolkit (UP-TECH group). Participants in the control arm will only receive brochures regarding available services. All subjects will be visited at home by a trained nurse who will assess them using a standardized questionnaire at enrollment (M0), 6 months (M6) and 12 months (M12). Follow-up telephone interviews are scheduled at 24 months (M24). The primary outcomes are: 1) caregiver burden, measured using the Caregiver Burden Inventory (CBI); and 2) the actual number of days spent at home during the study period, defined as the number of days free from institutionalizations, hospitalizations and stays in an observation unit of an emergency room.DISCUSSION: The UP-TECH project protocol integrates previous evidence on the effectiveness of strategies in dementia care, that is, the use of case management, new technologies, nurse home visits and efforts toward the integration of existing services in an ambitious holistic design. The analysis of different interventions is expected to provide sound evidence of the effectiveness and cost of programs supporting AD patients in the community.TRIAL REGISTRATION: ClinicalTrials.gov: NCT01700556.BACKGROUND: The epidemic of Alzheimer's disease (AD) represents a significant challenge for the health care and social service systems of many developed countries. AD affects both patients and family caregivers, on whom the main burden of care falls, putting them at higher risk of stress, anxiety, mortality and lower quality of life. Evidence remains controversial concerning the effectiveness of providing support to caregivers of AD patients, through case management, counseling, training, technological devices and the integration of existing care services. The main objectives of the UP-TECH project are: 1) to reduce the care burden of family caregivers of AD patients; and 2) to maintain AD patients at home.","Chiatti, C; Masera, F; Rimland, J M; Cherubini, A; Scarpino, O; Spazzafumo, L; Lattanzio, F",2013.0,10.1186/1745-6215-14-155,0,0,
5521,painACTION-back pain: a self-management website for people with chronic back pain,"ER DESIGNThe study utilized a pretest-posttest randomized controlled design comparing Website (painACTION-Back Pain) and control (text-based material) conditions at baseline and at 1-, 3, and 6-month follow-ups.PARTICIPANTSTwo hundred and nine people with chronic back pain were recruited through dissemination of study information online and at a pain treatment clinic. The 6-month follow-up rates for the Website and control groups were 73% and 84%, respectively.MEASUREMENTSMeasures were based on the recommendations of the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials and included measures of pain intensity, physical functioning, emotional functioning, coping, self-efficacy, fear-avoidance, perceived improvement with treatment, self-efficacy, and catastrophizing.RESULTSCompared with controls, painACTION-Back Pain participants reported significantly: 1) lower stress; 2) increased coping self-statements; and 3) greater use of social support. Comparisons between groups suggested clinically significant differences in current pain intensity, depression, anxiety, stress, and global ratings of improvement. Among participants recruited online, those using the Website reported significantly: 1) lower ""worst"" pain; 2) lower ""average"" pain; and 3) increased coping self-statements, compared with controls. Participants recruited through the pain clinic evidenced no such differences.CONCLUSIONSAn online self-management program for people with chronic back pain can lead to improvements in stress, coping, and social support, and produce clinically significant differences in pain, depression, anxiety, and global rates of improvement.OBJECTIVETo determine whether an interactive self-management Website for people with chronic back pain would significantly improve emotional management, coping, self-efficacy to manage pain, pain levels, and physical functioning compared with standard text-based materials.","Chiauzzi, E; Pujol, L A; Wood, M; Bond, K; Black, R; Yiu, E; Zacharoff, K",2010.0,10.1111/j.1526-4637.2010.00879.x,0,0,
5522,Psychosocial-spiritual correlates of death distress in patients with life-threatening medical conditions,"ER The purpose of this study was to identify demographic, disease, health care, and psychosocial-spiritual factors associated with death distress (death-related depression and anxiety). Cross-sectional baseline data from a randomized controlled trial were used. Outpatients (n=70) were recruited from an urban academic medical centre and proprietary hospital. All patients had life-threatening medical conditions, including cancer; pulmonary, cardiac, liver, or kidney disease; HIV/AIDS; or geriatric frailty. Measures of death distress, physical symptom severity, depression and anxiety symptoms, spiritual well-being, social support, patient-perceived physician communication, and patient-perceived quality of health care experiences were administered. In a hierarchical multiple regression model, higher death distress was significantly associated with living alone, greater physical symptom severity, more severe depression symptoms, lower spiritual well-being, and less physician communication as perceived by the patient. Death distress as a unique experiential construct was discriminable among younger patients with specific, diagnosable life-threatening conditions, but less so among geriatric frailty patients. The findings suggest that the experience of death distress among patients with life-threatening medical conditions is associated with the psychosocial-spiritual dimensions of the patient's life. Attention to these dimensions may buffer the negative affects of death distress.","Chibnall, J T; Videen, S D; Duckro, P N; Miller, D K",2002.0,10.1191/0269216302pm544oa,0,0,
5523,Party drug use in techno nights: a field survey among French-speaking Swiss attendees,"ER This study was designed to investigate the lifestyle and substance use habits of dance music event attendees together with their attitudes toward prevention of substance misuse, harm reduction measures and health-care resources. A total of 302 attendees aged 16-46 years (mean=22.70, S.D.=4.65) were randomly recruited as they entered dance music events. Rates for lifetime and current use (last 30 days) were particularly high for alcohol (95.3% and 86.6%, respectively), cannabis (68.8% and 53.8%, respectively), ecstasy (40.4% and 22.7%, respectively) and cocaine (35.9% and 20.7%, respectively). Several patterns of substance use could be identified: 52% were alcohol and/or cannabis only users, 42% were occasional poly-drug users and 6% were daily poly-drug users. No significant difference was observed between substance use patterns according to gender. Pure techno and open-air events attracted heavier drug users. Psychological problems (such as depressed mood, sleeping problems and anxiety attacks), social problems, dental disorders, accidents and emergency treatment episodes were strongly related to party drug use. Party drug users appeared to be particularly receptive to harm reduction measures, such as on-site emergency staff, pill testing and the availability of cool water, and to prevention of drug use provided via counseling. The greater the involvement in party drug use, the greater the need for prevention personnel to be available for counseling. General practitioners appeared to be key professionals for accessing health-care resources.","Chinet, L; Stephan, P; Zobel, F; Halfon, O",2007.0,,0,0,
5524,Chronic fatigue in general practice: economic evaluation of counselling versus cognitive behaviour therapy,"ER AIMTo compare the relative costs and outcomes of counselling versus cognitive behaviour therapy (CBT) provided in primary care settings for the treatment of fatigue.DESIGN OF STUDYA randomised controlled trial incorporating a cost-consequences analysis.SETTINGOne hundred and twenty-nine patients from 10 general practices across London and the South Thames region who had experienced symptoms of fatigue for at least three months.METHODAn economic analysis was performed to measure costs of therapy, other use of health services, informal care-giving, and lost employment. The principal outcome measure was the Fatigue Questionnaire; secondary measures were the Hospital Anxiety and Depression Scale and a social adjustment scale.RESULTSAlthough the mean cost of treatment was higher for the CBT group (164 Pounds, standard deviation = 67) than the counselling group (109 Pounds, SD = 49; 95% confidence interval = 35 to 76, P < 0.001), a comparison of change scores between baseline and six-month assessment revealed no statistically significant differences between the two groups in terms of aggregate health care costs, patient and family costs or incremental cost-effectiveness (cost per unit of improvement on the fatigue score).CONCLUSIONSCounselling and CBT both led to improvements in fatigue and related symptoms, while slightly reducing informal care and lost productivity costs. Counselling represents a less costly (and more widely available) intervention but no overall cost-effectiveness advantage was found for either form of therapy.BACKGROUNDThere is a paucity of evidence relating to the cost-effectiveness of alternative treatment responses to chronic fatigue.","Chisholm, D; Godfrey, E; Ridsdale, L; Chalder, T; King, M; Seed, P; Wallace, P; Wessely, S",2001.0,,0,0,
5525,Low- Versus High-Intensity Plyometric Exercise During Rehabilitation After Anterior Cruciate Ligament Reconstruction,"ER PURPOSE: To compare the immediate effect of low- and high-intensity plyometric exercise during rehabilitation after ACL reconstruction on knee function, articular cartilage metabolism, and other clinically relevant measures.STUDY DESIGN: Randomized controlled trial; Level of evidence, 2.METHODS: Twenty-four patients who underwent unilateral ACL reconstruction (mean, 14.3 weeks after surgery; range, 12.1-17.7 weeks) were assigned to 8 weeks (16 visits) of low- or high-intensity plyometric exercise consisting of running, jumping, and agility activities. Groups were distinguished by the expected magnitude of vertical ground-reaction forces. Testing was conducted before and after the intervention. Primary outcomes were self-reported knee function (International Knee Documentation Committee [IKDC] subjective knee form) and a biomarker of articular cartilage degradation (urine concentrations of crosslinked C-telopeptide fragments of type II collagen [uCTX-II]). Secondary outcomes included additional biomarkers of articular cartilage metabolism (urinary concentrations of the neoepitope of type II collagen cleavage at the C-terminal three-quarter-length fragment [uC2C], serum concentrations of the C-terminal propeptide of newly formed type II collagen [sCPII]) and inflammation (tumor necrosis factor-?), functional performance (maximal vertical jump and single-legged hop), knee impairments (anterior knee laxity, average knee pain intensity, normalized quadriceps strength, quadriceps symmetry index), and psychosocial status (kinesiophobia, knee activity self-efficacy, pain catastrophizing). The change in each measure was compared between groups. Values before and after the intervention were compared with the groups combined.RESULTS: The groups did not significantly differ in the change of any primary or secondary outcome measure. Of interest, sCPII concentrations tended to change in opposite directions (mean ± SD: low-intensity group, 28.7 ± 185.5 ng/mL; high-intensity group, -200.6 ± 255.0 ng/mL; P = .097; Cohen d = 1.03). Across groups, significant changes after the intervention were increased the IKDC score, vertical jump height, normalized quadriceps strength, quadriceps symmetry index, and knee activity self-efficacy and decreased average knee pain intensity.CONCLUSION: No significant differences were detected between the low- and high-intensity plyometric exercise groups. Across both groups, plyometric exercise induced positive changes in knee function, knee impairments, and psychosocial status that would support the return to sports participation after ACL reconstruction. The effect of plyometric exercise intensity on articular cartilage requires further evaluation.REGISTRATION NUMBER: Clinicaltrials.gov NCT01851655.BACKGROUND: Plyometric exercise is used during rehabilitation after anterior cruciate ligament (ACL) reconstruction to facilitate the return to sports participation. However, clinical outcomes have not been examined, and high loads on the lower extremity could be detrimental to knee articular cartilage.","Chmielewski, T L; George, S Z; Tillman, S M; Moser, M W; Lentz, T A; Indelicato, P A; Trumble, T N; Shuster, J J; Cicuttini, F M; Leeuwenburgh, C",2016.0,10.1177/0363546515620583,0,0,
5526,A feasibility study of a psychoeducational intervention program for gynecological cancer patients,"ER PURPOSE OF THE RESEARCH: This study aimed to test the feasibility of implementing a psychoeducational intervention program for gynecological cancer patients.METHODS AND SAMPLE: A single-blinded randomized controlled trial and mixed-method design were used. Study subjects were newly diagnosed gynecological cancer patients with surgery as the first-line treatment. They were randomly assigned to the intervention group, in which a psychoeducational intervention program based on a thematic counseling model was offered, or to the attention control group. Quantitative data on sexual functioning, quality of life, uncertainty, anxiety, depression and social support were collected at recruitment, post-operative and during the in-hospital period, and eight weeks after the operation. Participants in the intervention group and three nurses working in the clinical setting were invited to have semi-structured interviews.KEY RESULTS: Of the 30 eligible subjects, 26 were successfully recruited into the study. Following the psychoeducational intervention program, there was significant improvement in the level of inconsistent information about the illness within the category of uncertainty among participants in the intervention group. In addition, trends towards improvement were demonstrated in quality of life, uncertainty, depression and perceived social support with the provision of the interventions. Qualitative data indicated the interventions were desired and appreciated by the participants, as well as being feasible and practical to implement in Hong Kong clinical settings.CONCLUSIONS: The findings suggest that it is feasible to deliver the psychoeducational intervention program and it may have beneficial effects in gynecological cancer patients. A full-scale study is warranted to confirm the results.","Chow, K M; Chan, C W; Chan, J C; Choi, K K; Siu, K Y",2014.0,10.1016/j.ejon.2014.03.011,0,0,
5527,Separation distress call in the human neonate in the absence of maternal body contact,"ER Few studies have used the baby's cry as a means of evaluating the quality of neonatal care. In this randomized trial the newborn's cry was registered during the first 90 min after birth when infants were cared for either: (a) skin-to-skin with the mother; (b) in a cot; or (c) in a cot for the first 45 min of the 90-min observation period and then skin-to-skin with the mother. The results suggested that human infants recognize physical separation from their mothers and start to cry in pulses. Crying stops at reunion. The observed postnatal cry may be a human counterpart to the ""separation distress call"" which is a general phenomenon among several mammalian species, and serves to restore proximity to the mother. Our results suggest that in human newborns this cry is not dependent on earlier social experience and may be a genetically encoded reaction to separation. The findings are compatible with the opinion that the most appropriate position of the healthy full-term newborn baby after birth is in close body contact with the mother.","Christensson, K; Cabrera, T; Christensson, E; Uvnäs-Moberg, K; Winberg, J",1995.0,,0,0,
5528,The effects of concrete objective information and relaxation on maintaining usual activity during radiation therapy,"ER DESIGNThree-group randomized trial. Assignment was stratified by cancer site. Data collectors were blinded to group assignments.SETTINGUniversity medical center radiation therapy department serving both urban and rural communities in the southeastern United States.SAMPLE76 adults having radiation with curative intent for gynecologic, head and neck, or lung cancer. Most were Caucasian and had in situ to stage II disease. Mean age was 55 years.METHODSCOI and RI were delivered by tape recordings. Outcome measures were indicators of usual activities and emotions at treatment week 3 and two and four weeks post-treatment.MAIN RESEARCH VARIABLESIntervention group; social, household, and recreational activities; anxiety, depression, and anger; body awareness; and symptom uncertainty.FINDINGSParticipants receiving either intervention reported more social activity during treatment. Those given RI who were high in body awareness reported more household activity during treatment. No effects were found regarding emotion. Symptom uncertainty partially explained COI effects.CONCLUSIONSThe findings provide additional support for the effectiveness of COI in helping patients to maintain more of their usual activities during radiation therapy. Instruction in progressive muscle relaxation also may help in maintaining activities.IMPLICATIONS FOR NURSINGCOI helps patients to cope with treatment by reducing their uncertainty about symptoms. RI effects may vary by activity type and awareness of usual body sensations.PURPOSE/OBJECTIVESTo examine the effects of concrete objective information (COI) and relaxation instruction (RI) on patients undergoing radiation therapy, as well as the contribution of symptom uncertainty and body awareness to the intervention effects.","Christman, N J; Cain, L B",2004.0,10.1188/04.ONF.E39-E45,0,0,
5529,"""Partnering with Seniors for Better Health"": computer use and Internet health information retrieval among older adults in a low socioeconomic community","ER METHODSOne hundred thirty-seven participants, ages sixty-five and older, were randomized in a controlled, two-group, pre-post, repeated measures design. Participants in the intervention group received a two-hour training session, once a week for five weeks. The Computer Confidence Subscale and Computer Anxiety Subscale of the Computer Attitude Scale and the Computer Self-Efficacy Measure were administered to both groups at three time intervals: at baseline, completion of the five-week intervention, and six weeks after completion of the intervention. Data were analyzed using repeated measures analysis of variance.RESULTSFindings showed a reduction in computer anxiety and increases in computer confidence and computer self-efficacy in retrieving and evaluating online health information (P<0.001).DISCUSSIONThe study suggests an array of possibilities to engage older adults in the use of Internet health information resources to better contribute to their health, independence, safety, and wellness.PURPOSEThis health communication project measured the psychosocial influences of computer anxiety, computer confidence, and computer self-efficacy in older adults at six meal congregate sites. The adults completed a five-week education intervention, based on Bandura's self-efficacy model, designed to assist older adults in retrieving and evaluating health information resources on the Internet.","Chu, A; Huber, J; Mastel-Smith, B; Cesario, S",2009.0,10.3163/1536-5050.97.1.003,0,0,
5530,The effect of intrathecal bupivacaine with combined fentanyl in cesarean section,"ER METHODSSeventy five healthy pregnant women who sustained cesarean section under spinal anesthesia were assessed in a randomized fashion. The spinal anesthetic used was 0.5% hyperbaric bupivacaine. Patients were divided into 5 groups, 15 in each group. Fentanyl 0 (Group I), 7.5 (Group II), 10 (Group III), 12.5 (Group IV) and 15 (Group V) micrograms was respectively added to normal saline to make a total volume of 0.3 ml, which was then added to bupivacaine and administered to patients in a randomized fashion. The effect of analgesia, vital signs and side effects were observed every 5 min during operation and every 30 min after operation.RESULTSIt was disclosed that all patients in group V and IV had excellent analgesia intraoperatively, while only 33.3% patients in the control group had an analgesia which was qualified as excellent. Complete analgesia (time from injection to first report of pain) also lasted longer in group IV (201.3 +/- 16.4 min, mean +/- SEM) and group V (210.3 +/- 18.6 min) compared with group I (118.9 +/- 10.4 min). The duration of effective analgesia (time from injection to first parental opioid) was increased with the dose of intrathecal fentanyl above 12.5 micrograms (293 +/- 22.4 min). Both complete analgesia and effective analgesia were not significantly different between group IV and group V. Pruritus was the most common side effect. The incidence of shivering decreased significantly in group IV & V as compared with control group.CONCLUSIONSThe combination of bupivacaine with a dose of fentanyl as low as 7.5 micrograms did not produce actual clinical effects. As the dose of fentanyl was increased to 12.5 micrograms or 15 micrograms the quality of surgical analgesia was better and the postoperative analgesia lasted longer. It seemed that the clinical effect might reach its ceiling at the dose of 12.5 micrograms. Pruritus was the most common side effect, but it was mild.BACKGROUNDThe use of neuraxial opioids has gained popularity over the last few years; they may augment the analgesia produced by the local anesthetic through direct binding with the specific spinal receptors. Morphine, a lipophobic opioid, may not be optimal as an intrathecal drug for intraoperative analgesia because of its slow onset. The lipophilic opioid, fentanyl for instance, if administered intrathecally, its onset is fast and many of its merits by virtue of its lipophilic property may be seen intraoperatively.","Chu, C C; Shu, S S; Lin, S M; Chu, N W; Leu, Y K; Tsai, S K; Lee, T Y",1995.0,,0,0,
5531,Poststroke fatigue: does group education make a difference? A randomized pilot trial,"ER PURPOSE: Fatigue is common and contributes to poor stroke outcomes. Educational fatigue management reduces fatigue in other conditions (eg, cancer). There was no evidence for educational fatigue management in stroke patients. This trial evaluated an educational fatigue management intervention in stroke survivors.METHODS: Participants in this pilot trial were 19 individuals 3 to 18 months post incident stroke who experienced fatigue (Fatigue Severity Scale (FSS) ?3.9). Participants were allocated to a Fatigue Management Group (FMG) or General Stroke Education (GSE) control group. Assessment occurred pre and post intervention and at the 3-month follow-up. The primary outcome was FSS fatigue.RESULTS: Both groups had significantly reduced FSS fatigue from baseline to postintervention assessment. Though not significantly different (P ?.05), FSS decreased more in FMG participants than controls. Participant SF-36 social functioning and Hospital Anxiety Depression Scale depression scores improved significantly, but the groups did not differ significantly (P ?.05).CONCLUSIONS: The findings indicate that the FMG intervention is both feasible and should be the subject of a full trial.","Clarke, A; Barker-Collo, S L; Feigin, V L",2012.0,10.1310/tsr1901-32,0,0,
5532,Psychosexual distress in women with gynecologic cancer: a feasibility study of an online support group,"ER OBJECTIVES: The psychosexual concerns of gynecologic cancer patients are often unaddressed and there are limited resources available for women to deal with this highly sensitive topic. This feasibility study examines the participation rates and preliminary outcomes for an online support group designed specifically for women who are sexually distressed subsequent to gynecologic cancer treatmentMETHODS: A 12-week online intervention was developed to address the psychosexual impact of gynecologic cancer. This intervention included a professionally moderated, asynchronous discussion forum as well as the provision of psycho-educational materials addressing the psychosexual impact of gynecologic cancer. Each week, a new topic was introduced and relevant material was posted on the website. Women were encouraged to share their experiences related to the topic. Twenty-seven, sexually distressed, remitted gynecologic cancer patients were randomly assigned to immediate treatment or a waitlist control condition. Participants completed questionnaires at baseline, 4-month and 8-month follow-ups assessing sexual distress as the primary outcome as well as anxiety, depression, and illness intrusiveness.RESULTS: Participation rates differed between the two groups, with greater participation occurring in the second group. Exit interviews indicated that the majority of the participants were satisfied with the intervention. Intent-to-treat analyses suggest a small effect for reduction in sexual distressCONCLUSIONS: This feasibility study suggests that women find this intervention acceptable. Further research is required to determine efficacy.","Classen, C C; Chivers, M L; Urowitz, S; Barbera, L; Wiljer, D; O'Rinn, S; Ferguson, S E",2013.0,10.1002/pon.3058,0,0,
5533,Melatonin secretion is supersensitive to light in migraine,"ER The present study examined the sensitivity to light of melatonin (MLT) secretion in familial migraine during a headache-free interval. Twelve female patients and 12 healthy controls were included in the trial. All subjects were studied twice. In each session, light exposure (300 lx) or placebo was randomly administered for 30 min between 00.30 and 01.00 h. Blood was sampled hourly between 20.00 and 24.00 h, and 02.00 and 04.00 h and every 15 min between 00.30 and 01.30 h. Plasma MLT levels were determined by radioimmunoassay. MLT suppression was more marked in the migraine group than in the control group [difference of area under curve (DeltaAUC)=-53.8 +/- 16.2 vs. 18.5 +/- 12.7 pg/h/ml, P<0.005; maximum of MLT suppression (Delta)=-35.7 +/- 10.2 vs. - 6.7 +/- 5.8 pg/ml, P<0.05]. These findings show a clear hypersensitivity to light in young female migraineurs during the headache-free period.","Claustrat, B; Brun, J; Chiquet, C; Chazot, G; Borson-Chazot, F",2004.0,10.1111/j.1468-2982.2004.00645.x,0,0,
5534,The Citizenship Project part II: impact of a citizenship intervention on clinical and community outcomes for persons with mental illness and criminal justice involvement,"ER This study assessed the effectiveness of an intervention based on a theoretical framework of citizenship on reducing psychiatric symptoms, alcohol use, and drug use, and increasing quality of life for persons with serious mental illness (SMI) and criminal justice involvement. One-hundred fourteen adults with SMI and a history of criminal justice involvement participated in a 2 √ó 3 longitudinal randomized controlled trial of a four-month citizenship intervention versus usual services. Linear mixed model analyses were used to assess the intervention's impact on quality of life, symptoms, and substance use. After controlling for baseline covariates, participants in the experimental condition reported significantly increased quality of life, greater satisfaction with and amount of activity, higher satisfaction with work, and reduced alcohol and drug use over time. However, individuals in the experimental condition also reported increased anxiety/depression and agitation at 6 months (but not 12 months) and significantly increased negative symptoms at 12 months. Findings suggest that community-oriented, citizenship interventions for persons with SMI and criminal justice histories may facilitate improved clinical and community outcomes in some domains, but some negative clinical findings suggest the need for post-intervention support for intervention participants. Implications for practice and future research are discussed.","Clayton, A; O'Connell, M J; Bellamy, C; Benedict, P; Rowe, M",2013.0,10.1007/s10464-012-9549-z,0,0,
5535,"Efficacy of a self-directed behavioral health change program: weight, body composition, cardiovascular fitness, blood pressure, health risk, and psychosocial mediating variables","ER This study assessed the efficacy of a comprehensive behavioral health program designed to promote self-initiated change in overweight healthy middle-aged adults (M = 49 years). Three treatment groups (total n = 25) differing in type of social support provided (i.e., group plus professional versus group plus peer versus group only) received 13 treatment sessions and 6 maintenance sessions scheduled over a full year. A self-directed change intervention taught several cognitive-behavioral techniques as they applied to exercise adherence, weight reduction/maintenance, and stress management. Combined treatment groups (n = 25) improved significantly more than an assessment only control group (n = 9) in weight, percentage body fat, cardiovascular fitness, exercise adherence, health-risk appraisal, chronic tension (MBHI, scale A), and systolic and diastolic blood pressure at both post-treatment and 6-month follow-up assessments. Self-motivation, group treatment attendance, and health-risk appraisal significantly related (r's = .30-.56) to several posttreatment and follow-up measures of behavioral health change. No significant differences were found among the three treatment groups on any of the outcome measures.","Clifford, P A; Tan, S Y; Gorsuch, R L",1991.0,,0,0,
5536,Randomised double-blind trial of acyclovir and idoxuridine in dendritic corneal ulceration,"ER The results of a randomised double-blind clinical trial of 3% acyclovir and 0.5% idoxuridine (IDU) ophthalmic ointments in 60 patients with corneal dendritic ulceration are presented. Ulcers in all 30 patients treated with acyclovir healed compared with 22 (76%) of 29 patients treated with IDU (P < 0.01). Patients treated with acyclovir healed more rapidly (average 4.4 days) than those who received IDU (average 9.2 days) (P < 0.01). No serious side effects were observed, though transient stinging was recorded in 8 patients receiving acyclovir and in 2 patients receiving IDU. Other side effects in the IDU treated group were watering in 2 patients and superficial punctate erosions in 6 patients.","Collum, L M; Benedict-Smith, A; Hillary, I B",1980.0,,0,0,
5537,Efficacy of acupuncture and electroacupuncture in patients with nonspecific low back pain: study protocol for a randomized controlled trial,"ER METHODS/DESIGN: The study design is a randomized controlled trial. Patients with nonspecific chronic low back pain of more than three months duration are recruited at Rehabilitation Center of Taboao da Serra - SP (Brazil). After examination, sixty-six patients will be randomized into one of two groups: acupuncture group (AG) (n = 33) and electroacupuncture group (EG) (n = 33). Interventions will last one hour, and will happen twice a week for 6 weeks. The primary clinical outcomes will be pain intensity as measured and functional disability.SECONDARY OUTCOMES: quality of pain, quality of life. perception of the overall effect, depressive state, flexibility and kinesiophobia. All the outcomes will be assessed will be assessed at baseline, at treatment end, and three months after treatment end. Significance level will be determined at the 5 % level. Results of this trial will help clarify the value of acupuncture and electroacupuncture as a treatment for chronic low back pain and if they are different.DISCUSSION: Results of this trial will help clarify the value of acupuncture needling and electroacupuncture stimulation of specific points on the body as a treatment for chronic low back pain.TRIAL REGISTRATION: Clinicaltrials.gov: NCT02039037 . Register October 30, 2013.BACKGROUND: Previous studies have shown that acupuncture and electroacupuncture (EA) are effective in the treatment of patients with low back pain. However, there is little evidence to support the use of one intervention over the other. The aim of this study is to compare the effect of acupuncture and electroacupuncture in the treatment of pain and disability in patients with chronic nonspecific low back pain.","Comachio, J; Oliveira, Magalh√£es M; Nogueira, Burke T; Vidal, Ramos L A; Peixoto Le√£o, Almeida G; Silva, A P; Ferreira de, Meneses S R; Costa-Frutuoso, J R; Santos Miotto, Amorim C; Pasqual, Marques A",2015.0,10.1186/s13063-015-0850-7,0,0,
5538,The correlates of antenatal attachment in pregnant women,"ER Maternal-foetal attachment represents the earliest and most basic form of human intimacy, and has both theoretical and clinical significance. Utilizing a previously published self-report questionnaire to assess antenatal attachment, the present paper explores its correlates using 238 women in the third trimester of pregnancy. Extrapolating from studies of maternal-infant attachment, it was hypothesized that depression and a lack of social support would be detrimental to the development of maternal antenatal attachment. The findings confirmed these hypothesized effects. In particular, the subgroup of women having low attachment was characterized by high levels of depression and anxiety, low levels of social support (outside the partner relationship) and high levels of control, domination and criticism within the partner relationship. Antenatal attachment may be predictive for future maternal-infant attachment. The findings suggest that negative mood states and lack of social support during pregnancy may warrant greater attention than has previously been accorded them.","Condon, J T; Corkindale, C",1997.0,,0,0,
5539,Nursing postvention for spousal survivors of suicide,"ER There is a scarcity of information available with respect to postbereavement outcomes for survivors of the suicide of a loved one. Few studies have focused on postvention therapies for the bereaved, particularly the bereaved survivors of suicide. The major aim of this study as to compare the effects of two theoretically derived nursing postventions, Bereavement Group Postvention (BGP) and Social Group Postvention (SGP), among the widowed whose spouses died of suicide. The findings suggest that both groups experienced an overall reduction in depression and distress. Although participants in the SGP generally showed significant improvement in social adjustment, they tended to be less well adjusted with respect to their parental roles at the end of the 8-week postvention sessions. Comparison of the psychoemotional correlates of grief varied such that there were no significant differences between the postvention groups for social isolation, loss of control, somatization, or death anxiety. The BGP participants experienced significantly reduced levels of anger/hostility and guilt; however, feelings of anger/hostility actually increased for those receiving the SGP. There was a significant reduction in feelings of despair, rumination, and depersonalization for both groups. Although social isolation was not significantly reduced for participants in either group, those receiving the BGP tended to experience a reduction in social isolation and those receiving the SGP showed no changes.","Constantino, R E; Bricker, P L",1996.0,,0,0,
5540,Thirty-six month outcome data from a trial of counselling with chronically depressed patients in a general practice setting,"ER Counsellors have been employed in general practice with little evidence of effectiveness in this setting. This randomized controlled trial examined long-term effectiveness of short-term counselling in general practice for patients with chronic depression, either alone or combined with anxiety. Participants were 181 patients recruited from nine general practitioners' (GP) practices in Derbyshire by screening consecutive attenders using the Beck Depression Inventory. Both the experimental and control group received routine GP treatment but the experimental group were also referred to the practice counsellor. Depression and social adjustment were measured at baseline, 6, 12, and 36 months. There was an overall significant improvement in the actual scores over time, but there were no significant differences between the two groups on any of the measures at either 6, 12, or 36 months. Although fewer experimental group patients were still 'cases' on the BDI than controls at 6 and 12 months, this difference disappeared at 36 months. There was no evidence to demonstrate a long-term effect of improved outcomes in those referred to counselling.","Corney, R; Simpson, S",2005.0,10.1348/147608304X21365,0,0,
5541,Evaluation of a pilot service designed to provide support following stroke: a randomized cross-over design study,"ER DESIGN: A randomized cross-over study design was used, randomly allocating individuals to attend the service for six months followed by a period of no attendance for six months.SETTING: A day service pilot project was launched in Cardiff in July 1995 for people who were aged between 18 and 55 years and had a stroke. It met one day a week.SUBJECTS: Twenty-six participants were recruited to the study between June 1998 and February 2000. Their mean age was 48 years (SD = 7).INTERVENTIONS: The service aimed to offer participants the opportunity to identify and pursue meaningful and realistic opportunities within the community. A range of activities occurred at the service including creative activities and social outings.MAIN OUTCOME MEASURES: The Barthel ADL Index, Extended ADL Scale, Nottingham Leisure Questionnaire, Short Form 36, the Hospital Anxiety and Depression Scale, the Canadian Occupational Performance Measure, the Role Checklist and the Semantic Differential Self Concept Scale were used to assess the outcomes from the service.RESULTS: Attending the service increased occupational performance and satisfaction with performance but there was no evidence that depression and anxiety were reduced or that quality of life and self-concept were improved.CONCLUSION: Although there were some gains from attending the service there were also many unmet needs. Further research is required to continue to identify how best to meet the needs of individuals post stroke under retirement age.OBJECTIVE: To evaluate a day service for people aged 18-55 years who had a stroke.","Corr, S; Phillips, C J; Walker, M",2004.0,10.1191/0269215504cr703oa,0,0,
5542,The effectiveness of cognitive behavioral group therapy in treating bipolar disorder: a randomized controlled study,"ER OBJECTIVE: Recent studies suggest that, when combined with pharmacotherapy, structured psychotherapy may modify the course of bipolar disorder. However, there are few studies that have examined the effects of cognitive behavioral group therapy on the course of this disorder. The aim of the present study was to evaluate the effectiveness of 14 sessions of cognitive behavioral group therapy, combined with pharmacotherapy, on the treatment of patients with bipolar disorder, and to compare our results against those from the use of pharmacotherapy alone.METHOD: Forty-one patients with bipolar I and II disorder participated in the study and were randomly allocated to one of two treatment groups; thirty-seven patients remained in the study until its completion. Mood and anxiety symptoms were measured in all subjects. Statistical analysis was used to investigate if the groups differed with respect to demographic characteristics and the scores recorded in the pre- and post-treatment stages, as well as during treatment (intra/inter groups).RESULTS: Patients showed statistically similar population characteristics. The association of cognitive behavioral group therapy and pharmacological treatment proved to be effective. Patients who had undergone cognitive behavioral group therapy presented fewer symptoms of mania, depression and anxiety, as well as fewer and shorter mood change episodes.CONCLUSION: Cognitive behavioral group therapy sessions substantially contributed to the improvement of depression symptoms.","Costa, R T; Cheniaux, E; Rosaes, P A; Carvalho, M R; Freire, R C; Versiani, M; Rangé, B P; Nardi, A E",2011.0,,0,0,
5543,Effectiveness and cost-effectiveness of community singing on mental health-related quality of life of older people: randomised controlled trial,"ER Background As the population ages, older people account for a greater proportion of the health and social care budget. Whereas some research has been conducted on the use of music therapy for specific clinical populations, little rigorous research has been conducted looking at the value of community singing on the mental health-related quality of life of older people. Aims To evaluate the effectiveness and cost-effectiveness of community group singing for a population of older people in England. Method A pilot pragmatic individual randomised controlled trial comparing group singing with usual activities in those aged 60 years or more. Results A total of 258 participants were recruited across five centres in East Kent. At 6 months post-randomisation, significant differences were observed in terms of mental health-related quality of life measured using the SF12 (mean difference = 2.35; 95% CI = 0.06-4.76) in favour of group singing. In addition, the intervention was found to be marginally more cost-effective than usual activities. At 3 months, significant differences were observed for the mental health components of quality of life (mean difference = 4.77; 2.53-7.01), anxiety (mean difference =-1.78; -2.5 to -1.06) and depression (mean difference =-1.52; -2.13 to -0.92). Conclusions Community group singing appears to have a significant effect on mental health-related quality of life, anxiety and depression, and it may be a useful intervention to maintain and enhance the mental health of older people.","Coulton, S; Clift, S; Skingley, A; Rodriguez, J",2015.0,10.1192/bjp.bp.113.129908,0,0,
5544,The effects of exercise on ligamentous stiffness in the wrist,"ER The purpose of this study was to determine if exercise alters wrist joint laxity, as measured by the mechanical behavior of the scaphoid bone. The load-displacement behavior of the scaphoid was studied in the palmar-dorsal direction in both wrists of 7 healthy volunteers (n = 14) before and after 2 exercise protocols (grip and push-up). When compared to the rested values, both exercise protocols significantly increased the displacement at 40 N by 47% (grip) and by 34% (push-up). Accordingly, the stiffness decreased significantly by 36% (grip) and by 32% (push-up). Partial recovery was documented after 1 hour of rest and there were no differences between any of the groups after 24 hours of rest. The increase in laxity documented during these exercise protocols reduces the ligament loads at comparable wrist positions and may thereby reduce the likelihood of traumatic ligamentous injury during participation in strenuous activity or sports.","Crisco, J J; Chelikani, S; Brown, R K; Wolfe, S W",1997.0,10.1016/S0363-5023(05)80178-9,0,0,
5545,Endometrial resection versus vaginal hysterectomy for menorrhagia: long-term clinical and quality-of-life outcomes,"ER STUDY DESIGNMenorrhagic women < or = 50 years old with a mobile uterus smaller than a 12-week pregnancy were enrolled in a randomized trial to compare endometrial resection and vaginal hysterectomy. Two years after surgery the women were requested to rate the degree of satisfaction with the effect of the operation and to complete the Short Form 36 general health survey questionnaire, the Hospital Anxiety and Depression Scale, and the revised Sabbatsberg Sexual Rating Scale.RESULTSForty-one subjects underwent endometrial resection and 44 underwent vaginal hysterectomy without major complications. Of the 77 women attending the 2-year follow-up visit, 33 of 38 (86.8%) in the endometrial resection arm were very satisfied or satisfied with the treatment compared with 37 of 39 (94.8%) of those in the hysterectomy arm. According to the Short Form 36 questionnaire, social functioning and vitality scores were significantly better in the hysterectomy group than in the resection group. Significantly lower Hospital Anxiety and Depression Scale anxiety scores were observed in the former than in the latter subjects. The Sabbatsberg Sexual Rating Scale scores were similar in the two groups.CONCLUSIONSIn patients requiring surgical treatment for menorrhagia vaginal hysterectomy appeared slightly more satisfying and offered a better health-related quality of life than did endometrial resection at 2-year follow-up. Hysterectomy did not adversely affect psychologic status and sexual functioning.OBJECTIVEOur purpose was to compare patients' satisfaction with the effect of treatment, health-related quality of life, psychologic status, and sexual functioning 2 years after endometrial resection or vaginal hysterectomy for menorrhagia.","Crosignani, P G; Vercellini, P; Apolone, G; Giorgi, O; Cortesi, I; Meschia, M",1997.0,,0,0,
5546,Pre-arthroplasty rehabilitation is effective in reducing hospital stay,"ER METHOD: Clients (n = 133) with complex needs (comorbid conditions or limited social support) were randomly assigned to receive preoperative usual care (UC) or rehabilitation (R). Usual care clients received a single preoperative clinic visit. Rehabilitation clients were individually assessed and received multi disciplinary rehabilitation to optimize functional capacity, education about the in-hospital phase and early discharge planning. All rehabilitation subjects received interdisciplinary counseling/education focused on preparation for discharge home. The intervention for approximately half the rehabilitation clients was a single, cost-effective session, while others received physical conditioning.RESULTS: Clients receiving rehabilitation achieved discharge criteria earlier (R = 5.4, UC = 8 days) and had a shorter actual length of stay (R = 6.5, UC = 10.5 days).CLINICAL IMPLICATIONS: This preoperative, individually tailored, rehabilitation program reduced length of stay.BACKGROUND: The purpose of the trial was to evaluate the effect on length of stay of individually tailored rehabilitation for clients who were undergoing hip or knee arthroplasty.","Crowe, J; Henderson, J",2003.0,10.1177/000841740307000204,0,0,
5547,Reductions in salivary cortisol are associated with mood improvement during relaxation training among HIV-seropositive men,"ER This study examined salivary cortisol and mood during relaxation training in 30 symptomatic, HIV+ gay men participating in a 10-week, group-based cognitive-behavioral stress management intervention. Cortisol levels and mood were assessed within these sessions just before and after 45-min relaxation exercises given as part of each session. Participants also recorded their stress level and compliance with daily home relaxation practice. Presession cortisol levels decreased across the 10-week period and were related to decreases in global measures of total mood disturbance and anxious mood. Reductions in presession cortisol levels were also associated with decreases in self-reported stress level during home practice. Greater reductions in cortisol during the first three sessions were associated with more frequent relaxation practice at home. These findings suggest that salivary cortisol represents an objective neuroendocrine marker for changes in anxiety and distress observed during relaxation training in symptomatic, HIV-seropositive men.","Cruess, D G; Antoni, M H; Kumar, M; Schneiderman, N",2000.0,,0,0,
5548,Diurnal cortisol amplitude and fronto-limbic activity in response to stressful stimuli,"ER The development and exacerbation of many psychiatric and neurologic conditions are associated with dysregulation of the hypothalamic pituitary adrenal (HPA) axis as measured by aberrant levels of cortisol secretion. Here we report on the relationship between the amplitude of diurnal cortisol secretion, measured across 3 typical days in 18 healthy individuals, and blood oxygen level dependant (BOLD) response in limbic fear/stress circuits, elicited by in-scanner presentation of emotionally negative stimuli, specifically, images of the World Trade Center (WTC) attack. Results indicate that subjects who secrete a greater amplitude of cortisol diurnally demonstrate less brain activation in limbic regions, including the amygdala and hippocampus/parahippocampus, and hypothalamus during exposure to traumatic WTC-related images. Such initial findings can begin to link our understanding, in humans, of the relationship between the diurnal amplitude of a hormone integral to the stress response, and those neuroanatomical regions that are implicated as both modulating and being modulated by that response.","Cunningham-Bussel, A C; Root, J C; Butler, T; Tuescher, O; Pan, H; Epstein, J; Weisholtz, D S; Pavony, M; Silverman, M E; Goldstein, M S; Altemus, M; Cloitre, M; Ledoux, J; McEwen, B; Stern, E; Silbersweig, D",2009.0,10.1016/j.psyneuen.2008.11.011,0,0,
5549,The effect of values affirmation on psychological stress,"ER There is growing evidence for the efficacy of acceptance-based behavioral therapies, which aim to increase acceptance of internal experiences and values-consistent action. Further, experimental studies have demonstrated that acceptance decreases distress and increases willingness to engage in challenging tasks (e.g. Levitt, Brown, Orsillo, & Barlow, 2004). However, research demonstrating the positive effects of values articulation on psychological functioning is needed. The goal of the present study was to evaluate the efficacy of a brief intervention in reducing anxiety related to a stressful speech task. Contrary to predictions, engagement in values writing did not reduce anticipatory or posttask anxiety relative to engagement in a neutral writing task. However, self-esteem significantly predicted anxious response to the task. Experiential avoidance and valued living were also associated with anxious response to the task, although the contribution of these predictors was not statistically significant.","Czech, S J; Katz, A M; Orsillo, S M",2011.0,10.1080/16506073.2011.585347,0,0,
5550,"A group social skills training program with psychiatric patients: outcome, drop-out rate and prediction",,"Dam-Baggen, R; Kraaimaat, F",1986.0,,0,0,
5551,Influence of timed nutrient diet on depression and light sensitivity in seasonal affective disorder,"ER Seasonal Affective Disorder (SAD) patients crave and eat more carbohydrates (CHO) in fall-winter when depressed, especially in the evenings, and feel energetic thereafter. Evening CHO-rich meals can phase delay circadian rhythms, and glucose increases retinal response to light. We studied timed CHO- or protein-rich (PROT) diet as a putative therapy for SAD. Unmedicated, DSM-IV-diagnosed depressed women with SAD (n=22, 19-63 yrs) in the follicular phase of the menstrual cycle (present in 19) were randomized to nine days of eating approximately 1600 kcal of either CHO before 12:00 h (n=9), CHO after 18:00 h (n=6), or PROT after 18:00 h (n=7); only water was allowed for the rest of the day. Measurements included the depression questionnaire SIGH-SAD (with 21-item Hamilton depression subscale), Eating Behavior Questionnaire (DEBQ), percentage fat (by bioimpedancemetry), clinical biochemistry (glucose, cholesterol, triglycerides, TSH, T4, cortisol), and electroretinogram (ERG). No differential effects of diet were found on any of the studied parameters (except DEBQ). Clinically, participants improved slightly; the 21-HDRS score (mean+/-SD) decreased from 19.6+/-6.4 to 14.4+/-7.4 (p=.004). Percent change correlated significantly with menstrual day at diet onset (mood improved the first week after menstruation onset), change in available sunshine (more sunlight, better mood), and initial percentage fat (fatter patients improved more). Scotopic ERG amplitude was diminished after treatment (p=.025, three groups combined), probably due to greater exposure to sunshine in 14/22 subjects (partial correlation analysis significant). Keeping in mind the limitations of this ambulatory study (i.e., inability to control outdoor light exposure, small number of participants, and briefness of intervention), it is suggested that the 25% clinical improvement (of the order of magnitude of placebo) is not related to nutrient diet or its timing, but rather to natural changes during the menstrual cycle, available sunshine, and ease of dieting for fatter patients.","Danilenko, K V; Plisov, I L; Hébert, M; Kräuchi, K; Wirz-Justice, A",2008.0,10.1080/07420520801903976,0,0,
5552,Appraisals of pain from controlled stimuli: relevance to quantitative sensory testing,"ER DESIGNA prospective within subjects design was used.METHODSHeat, ischaemic, and delayed-onset muscle pain were induced in the upper extremity of 44 participants (47.7% women) during four experimental sessions.RESULTSThe threat of heat and ischaemic pain was higher than delayed-onset muscle pain (F(2,86) = 5.30, p<.01, eta(2) = .11). Threat, challenge, predictability, and controllability were related to heat pain most consistently. The affective-sensory ratios of ischaemic and delayed-onset muscle pain resembled those of clinical pain and were higher than heat pain (F(2,84) = 11.64, p<.01, eta(2) = .22). Delayed-onset muscle pain meaningfully affected daily activities, which correlated to delayed-onset muscle pain ratings (rs = .60-.68, ps <.001).CONCLUSIONSHeat stimuli may be well suited for instructional manipulations of appraisals to improve the clinical relevance of quantitative sensory testing and delayed-onset muscle pain's effects on daily activities are clinically relevant.OBJECTIVESensory testing has been advocated for the diagnosis, prognosis, and outcome evaluation of pain patients, but responses to controlled stimuli have not been well correlated to clinical pain. As an initial step for improving the clinical relevance of sensory testing, this investigation compared appraisals of and responses to controlled pain stimuli.","Dannecker, E A; Price, D D; O'Connor, P D; Robinson, M E",2008.0,10.1348/135910707X230985,0,0,
5553,"The importance of acuity, stereopsis, and contrast sensitivity for health-related quality of life in elderly women with cataracts","ER METHODSData were analyzed from a trial of first-eye cataract surgery. Visual parameters, general health, and social variables, and disease-specific (VF-14 Index of Visual Function), generic (Euroqol: EQ-5D, London Handicap Scale, Barthel), and intermediate (anxiety, depression, and activity) outcomes were measured at baseline and 6 months later, when approximately half the group had had surgery.RESULTSThree hundred six participants provided data at baseline, and 289 at 6 months. At baseline, acuity, stereopsis, and contrast sensitivity were all associated with quality of life. Acuity and stereopsis were most strongly and consistently associated. Change in VF-14 was associated with changes in stereopsis and contrast sensitivity, while change in handicap was associated with change in stereopsis.CONCLUSIONSAcuity, stereopsis, and contrast sensitivity each contributed to quality of life, across a range of measures, in elderly women with cataract. Acuity was marginally the most consistently and generally the most strongly associated, but in some analyses stereopsis was more important. Change in quality of life was associated with change in stereopsis and contrast sensitivity.PURPOSETo investigate the relative contribution of visual and other factors to quality of life among elderly women with bilateral cataract.","Datta, S; Foss, A J; Grainge, M J; Gregson, R M; Zaman, A; Masud, T; Osborn, F; Harwood, R H",2008.0,10.1167/iovs.06-1073,0,0,
5554,An integrative complexity analysis of cognitive behaviour therapy sessions for borderline personality disorder,"ER DESIGNTen patients who received CBT were categorized according to the outcome, good (N=5) and poor (N=5), using an algorithm that incorporated the number of suicide attempts and magnitude of change in severity of depression during therapy.METHODFor each patient and their therapist, an early and a late therapy session were transcribed and coded for integrative complexity (IC) (N=20 sessions transcribed). IC scores for patients and therapists were compared across early and late therapy sessions and for good and poor outcomes of therapy.RESULTSThe majority of discourse was at the lower levels of IC. Higher levels of IC at baseline were related to depression and anxiety. Good outcome was not associated with a change in the level of IC between earlier and later CBT sessions. Therapists, however, showed an increase in IC when patient's outcome was poor. In addition, an increase in patient's IC was associated with improvement in social functioning.CONCLUSIONSTherapists may overcompensate for patient's poor outcome by giving more complex explanations to patients. Higher complexity does not necessarily lead to better outcomes.OBJECTIVESIntegrative complexity (IC), a measure of cognitive style, was used to analyse discourse in Cognitive Behaviour Therapy (CBT) sessions from patients with borderline personality disorder treated in the BOSCOT trial. It was predicted that patients' level of integrative complexity would be positively associated with the outcome of therapy. That is, an increase in patients' level of integrative complexity would be associated with good outcome. We also predicted that therapists would also show an increase in the level of complexity associated with their patient's increase in integrative complexity and good outcome.","Davidson, K; Livingstone, S; McArthur, K; Dickson, L; Gumley, A",2007.0,10.1348/147608307X191535,0,0,
5555,Therapist competence and clinical outcome in the Prevention of Parasuicide by Manual Assisted Cognitive Behaviour Therapy trial: the POPMACT study,"ER METHODA random sample of 49 audiotapes of manual assisted cognitive therapy sessions delivered by 21 therapists involved in the Prevention of Parasuicide by Manual Assisted Cognitive Behaviour Therapy trial was rated to assess the level of therapist competence. Patient outcome was assessed using self and observer ratings of depressive and anxiety symptoms, social functioning, global functioning and number of episodes of deliberate self-harm.RESULTSAt 6-month follow-up, there was a statistically significant association between therapist level of competence and observer-rated depression only. At 12-month follow-up, significant associations were noted between therapist competence and all observer-rated clinical outcomes but not for self-rated outcome measures. However, there was no association between therapist competence and the number of self-harm episodes during follow-up.CONCLUSIONSWhen treated by therapists rated as more competent than other therapists who received equivalent brief training, patients with recurrent self-harm show significant clinical improvements. However, this benefit is not identified across all outcome measures and is not fully apparent until 12-month follow-up.BACKGROUNDTherapist competence may be an important factor in determining clinical outcome in psychological therapies. However, there are few published studies of therapist competence v. patient outcome from randomized controlled trials. We tested the hypothesis that higher levels of therapist competence would lead to better clinical outcomes in both patient- and observer-rated measures at 6- and 12-month follow-up.","Davidson, K; Scott, J; Schmidt, U; Tata, P; Thornton, S; Tyrer, P",2004.0,,0,0,
5556,Social facilitation and coping with stress,,"Davidson, P O; Kelley, W R",1973.0,,0,0,
5557,MOMS: formative evaluation and subsequent intervention for mothers living with HIV,"ER The Making Our Mothers Stronger (MOMS) Project is a randomized controlled behavioral trial, comparing a stress-reduction and social support intervention (Healthy MOMS) to a parenting skills intervention (Parenting Skills for MOMS) for mothers living with HIV. Outcomes include maternal mental and physical health, parenting behaviors, and children's behavior. To ensure that these interventions were tailored to the needs of HIV+ mothers, extensive formative work was conducted with members of the intended audience and relevant service providers. Findings from focus groups and semi-structured interviews highlighted the need for Healthy MOMS to: (1) include appropriate approaches to group discussion and problem solving; (2) address the stressors of being both a parent and a woman living with HIV; and (3) enhance social support. Six weekly group sessions focused on topics including coping with stress and anxiety; enhancing nutrition, exercise, and sexual health; improving medical adherence; improving communication with health care providers; and communicating health needs to family, friends, and co-workers. Initial anecdotal responses from participants suggest that the Healthy MOMS intervention addresses several salient issues for the growing population of HIV+ mothers who can benefit from long-term support in adapting to this chronic disease.","Davies, S L; Horton, T V; Williams, A G; Martin, M Y; Stewart, K E",2009.0,10.1080/09540120802301832,0,0,
5558,Diabetes-specific quality of life after a low-carbohydrate and low-fat dietary intervention,"ER PURPOSE: The purpose of the study was to examine the impact of a 12-month weight loss intervention with either a low-carbohydrate or a low-fat diet on quality of life (QOL) among obese patients with type 2 diabetes.METHODS: Participants were enrolled in a randomized trial comparing a low-carbohydrate to a low-fat diet in type 2 diabetes. QOL was assessed with the Diabetes-39 questionnaire, which measures QOL within 5 distinct scales: anxiety and worry, diabetes control, energy and mobility, social burden, and sexual functioning. Repeated measures ANOVA compared change in QOL scales at baseline and 6 and 12 months.RESULTS: Forty-six participants completed all measures. Following 12 months, there was a significant reduction in the scores related to sexual function and energy and mobility, suggesting improvement in QOL related to these domains. These changes were not significantly different between dietary arms. Changes in weight, A1C, and dietary composition were not significantly correlated with changes in QOL.CONCLUSIONS: Participants with diabetes have various options for weight loss. Dietary interventions with either low-carbohydrate or low-fat diets may lead to some improvements in QOL in patients with type 2 diabetes.","Davis, N J; Tomuta, N; Isasi, C R; Leung, V; Wylie-Rosett, J",2012.0,10.1177/0145721711436132,0,0,
5559,"Cardiac repolarization with Gabapentin enacarbil in a randomized, double-blind, placebo- and active-controlled, crossover thorough QT/QTc study in healthy adults","ER BACKGROUND: Gabapentin enacarbil (GEn) is a prodrug of gabapentin and is approved in the United States in adults for the management of postherpetic neuralgia and in the United States and Japan for the treatment of moderate-to-severe primary restless legs syndrome.OBJECTIVE: This study examined the lack of effect of GEn on cardiac repolarization in accordance with International Conference on Harmonisation E14 guidance.METHODS: This was a randomized, double-blind, double-dummy, placebo- and active- controlled, crossover study in healthy adults (age range, 18-50 years). Study participants received the following in randomized order with a minimum 7-day washout period between treatments: placebo at 0 hours and GEn 1200 mg at 2 hours (GEn 1200 mg group), placebo at 0 hours and GEn 6000 mg at 2 hours (GEn 6000 mg group), placebo at 0 and 2 hours (placebo group), moxifloxacin 400 mg (active control group) at 0 hours, and placebo at 2 hours (moxifloxacin group). Dose offsetting permitted moxifloxacin to be administered in the fasted state and GEn to be administered in the fed state. Assessments included continuous ECG monitoring, pharmacokinetic parameters, and safety and tolerability profiles. The primary end point was the change from baseline in the Fridericia corrected QT interval, at each time point, for the GEn 6000 mg and placebo groups.RESULTS: Of 52 adults enrolled (mean [SD] age, 30.8 [8.55] years; 50% women), 44 adults (85%) completed the study. Forty-nine adults received GEn 1200 mg, 47 received GEn 6000 mg, 48 received placebo, and 47 received moxifloxacin. The highest estimated (upper limit of the 95% CI) model-adjusted difference in mean change from baseline in the Fridericia corrected QT interval between GEn and placebo was 3.55 (5.66) msec for 1200 mg and 1.20 (3.32) msec for 6000 mg. Assay sensitivity was confirmed with moxifloxacin 400 mg. The geometric mean (%CV) Cmax (between-subject coefficient of variation) was 7.49 (21.2) ?g/mL for GEn 1200 mg, 32.46 (23.9) ?g/mL for GEn 6000 mg, and 2.08 (24.5) ?g/mL for moxifloxacin 400 mg. The most frequently reported adverse events with GEn 6000 mg were dizziness (30%), feeling drunk (26%), nausea (15%), headache (13%), and vomiting (13%).CONCLUSION: Single doses of GEn, up to 6000 mg, had no effect on cardiac repolarization in this thorough-QT study and are unlikely to cause clinically relevant QT prolongation in clinical use. Assay sensitivity was confirmed with moxifloxacin as an active control. ClinicalTrials.gov identifier: NCT01516372.","Davy, M; Upward, J; Arumugham, T; Twomey, C; Chen, C; Stier, B",2013.0,10.1016/j.clinthera.2013.10.011,0,0,
5560,Psychological well-being in medical students during exam stress-influence of short-term practice of mind sound technology,"ER INTRODUCTION: Medical education is perceived as stressful. As excessive stress hampers students' performance, stress management is required for medical students. This study was aimed to assess the effect of Mind Sound Technology (MST), an intelligence enhancing program, on psychological well-being of medical undergraduates during exam stress.MATERIALS AND METHODS: Forty-two medical students were recruited and Dukes Health Profile scoring was done at baseline and during Exam Stress (ES). After pre-intervention measurements, the students were randomized into two groups: non-practitioners and MST practitioners. Post-intervention measurement was done at the end of 6 weeks when the students had examination.RESULTS: Students showed a significant increase (P < 0.001) in negative health scores like perceived health scores, anxiety, and depression and a significant decrease (P < 0.001) in positive health scores like Self-Esteem, Mental Health Score, Social Health Score, and General Health Score during exam when compared with baseline. MST practice increased positive health scores (P < 0.001) and decreased perceived health score (P < 0.01), anxiety, depression, and anxiety-depression scores significantly (P < 0.001) when compared with ES score. Non practitioners did not show any significant change in any of the scores when compared with ES score. Six weeks of MST practice by medical students have improved the academic scores (P < 0.05) when compared with their non-practitioner counterpart.CONCLUSION: Thus, practice of MST has helped in coping up the stress that occurs during examination and improved academic performance in medical undergraduates.","Dayalan, H; Subramanian, S; Elango, T",2010.0,10.4103/0019-5359.102122,0,0,
5561,Structured self-management education maintained over two years in insufficiently controlled type 2 diabetes patients: the ERMIES randomised trial in Reunion Island,"ER BACKGROUND: Self-management education programs can reduce the complications and mortality in type 2 diabetes. The need to structure these programs for outpatient and community care with a vision for long-term maintenance has been recognised. In Reunion Island, an area affected by epidemiological and nutritional transition, diabetes affects 18% of the adult population over 30 years, with major social disparities, poor glycaemic control and frequent cardiovascular complications.METHODS/DESIGN: ERMIES is a randomised controlled trial designed to test the efficacy of a long-term (2 years) structured group self management educational intervention in improving blood glucose in non-recent, insufficiently controlled diabetes. After an initial structured educational cycle carried out blind for the intervention arm, patients will be randomised in two parallel group arms of 120 subjects: structured on-going group with educational intervention maintained over two years, versus only initial education. Education sessions are organised through a regional diabetes management network, and performed by trained registered nurses at close quarters. The educational approach is theoretically based (socio-constructivism, social contextualisation, empowerment, action planning) and reproducible, thanks to curricula and handouts for educators and learners. The subjects will be recruited from five hospital outpatient settings all over Reunion Island. The main eligibility criteria include: age ?18 years, type 2 diabetes treated for more than one year, HbA1c???7.5% for ?3 months, without any severe evolving complication (ischaemic or proliferative retinopathy, severe renal insufficiency, coronaropathy or evolving foot lesion), and absence of any major physical or cognitive handicap. The primary outcome measure is HbA1c evolution between inclusion and 2 years. The secondary outcome measures include anthropometric indicators, blood pressure, lipids, antidiabetic medications, level of physical activity, food ingestion, quality of life, social support, anxiety, depression levels and self-efficacy. An associated nested qualitative study will be conducted with 30 to 40 subjects in order to analyse the learning and adaptation processes during the education cycles, and throughout the study.CONCLUSIONS: This research will help to address the necessary but difficult issue of structuring therapeutic education in type 2 diabetes based on: efficacy and potential interest of organising on-going empowerment group-sessions, at close quarters, over the long term, in a heterogeneous socioeconomic environment.TRIAL REGISTRATION: ID_RCB number: 2011-A00046-35Clinicaltrials.gov number: NCT01425866.","Debussche, X; Collin, F; Fianu, A; Balcou-Debussche, M; Fouet-Rosiers, I; Koleck, M; Favier, F",2012.0,10.1186/1475-2840-11-91,0,0,
5562,Habit reversal versus supportive psychotherapy in Tourette's disorder: a randomized controlled trial and predictors of treatment response,"ER Tourette syndrome (TS) is characterized by chronic motor and vocal tics. Habit reversal therapy (HR) is a behavioral treatment for tics which has received recent empirical support. The present study compared the efficacy of HRT in reducing tics, improving life-satisfaction and psychosocial functioning in comparison with supportive psychotherapy (SP) in outpatients with TS. In addition, we investigated whether impairments in response inhibition in patients with TS predict response to HR treatment which specifically aims to inhibit tics. Thirty adult outpatients with DSM-IV TS were randomized to 14 individual sessions of HR (n = 15); or SP (n = 15). HR but not SP reduced tic severity over the course of the treatment. Both groups improved in life-satisfaction and psychosocial functioning during active treatment. Reductions in tic severity (HR) and improvements in life-satisfaction and psychosocial functioning (HR and SP) remained stable at the 6-month follow-up. The extent of pre-treatment response inhibition impairment in the HR group predicted reductions in tic-severity from pre- to post-treatment. Our results suggest that HR has specific tic-reducing effects although SP is effective in improving life-satisfaction and psychosocial functioning. Assessments of response inhibition may be of value for predicting treatment response to HR.","Deckersbach, T; Rauch, S; Buhlmann, U; Wilhelm, S",2006.0,10.1016/j.brat.2005.08.007,0,0,
5563,Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial,"ER DESIGNMultisite randomised controlled trial.SETTINGSeven health regions across Ontario, Canada.PARTICIPANTS701 women in the first two weeks postpartum identified as high risk for postnatal depression with the Edinburgh postnatal depression scale and randomised with an internet based randomisation service.INTERVENTIONProactive individualised telephone based peer (mother to mother) support, initiated within 48-72 hours of randomisation, provided by a volunteer recruited from the community who had previously experienced and recovered from self reported postnatal depression and attended a four hour training session.MAIN OUTCOME MEASURESEdinburgh postnatal depression scale, structured clinical interview-depression, state-trait anxiety inventory, UCLA loneliness scale, and use of health services.RESULTSAfter web based screening of 21 470 women, 701 (72%) eligible mothers were recruited. A blinded research nurse followed up more than 85% by telephone, including 613 at 12 weeks and 600 at 24 weeks postpartum. At 12 weeks, 14% (40/297) of women in the intervention group and 25% (78/315) in the control group had an Edinburgh postnatal depression scale score >12 (chi(2)=12.5, P<0.001; number need to treat 8.8, 95% confidence interval 5.9 to 19.6; relative risk reduction 0.46, 95% confidence interval 0.24 to 0.62). There was a positive trend in favour of the intervention group for maternal anxiety but not loneliness or use of health services. For ethical reasons, participants identified with clinical depression at 12 weeks were referred for treatment, resulting in no differences between groups at 24 weeks. Of the 221 women in the intervention group who received and evaluated their experience of peer support, over 80% were satisfied and would recommend this support to a friend.CONCLUSIONTelephone based peer support can be effective in preventing postnatal depression among women at high risk.TRIAL REGISTRATIONISRCTN 68337727.OBJECTIVETo evaluate the effectiveness of telephone based peer support in the prevention of postnatal depression.","Dennis, C L; Hodnett, E; Kenton, L; Weston, J; Zupancic, J; Stewart, D E; Kiss, A",2009.0,,0,0,
5564,Evaluation of a stroke family care worker: results of a randomised controlled trial,"ER DESIGNRandomised controlled trial with broad entry criteria and blinded outcome assessment six months after randomisation.SETTINGA well organised stroke service in an Edinburgh teaching hospital.SUBJECTS417 patients with an acute stroke in the previous 30 days randomly allocated to be contacted by a stroke family care worker (210) or to receive standard care (207). The patients represented 67% of all stroke patients assessed at the hospital during the study period.MAIN OUTCOME MEASURESPatient completed Barthel index, Frenchay activities index, general health questionnaire, hospital anxiety and depression scale, social adjustment scale, mental adjustment to stroke scale, and patient satisfaction questionnaire; carer completed Frenchay activities index, general health questionnaire, hospital anxiety and depression scale, social adjustment scale, caregiving bassles scale, and carer satisfaction questionnaire.RESULTSThe groups were balanced for all important baseline variables. There were no significant differences in physical outcomes in patients or carers, though patients in the treatment group were possibly more helpless less well adjusted socially, and more depressed, whereas carers in the treatment group were possibly less hassled and anxious. However, both patients and carers in the group contacted by the stroke family care worker expressed significantly greater satisfaction with certain aspects of their care, in particular those related to communication and support.CONCLUSIONSThe introduction of a stroke family care worker improved patients' and their carers' satisfaction with services and may have had some effect on psychological and social outcomes but did not improve measures of patients' physical wellbeing.OBJECTIVETo examine the effect of contact with a stroke family care worker on the physical, social, and psychological status of stroke patients and their carers.","Dennis, M; O'Rourke, S; Slattery, J; Staniforth, T; Warlow, C",1997.0,,0,0,
5565,"Sumatriptan-naproxen and butalbital: a double-blind, placebo-controlled crossover study","ER OBJECTIVES: The primary objective was to compare the efficacy of a sumatriptan and naproxen combination medication (SumaRT/Nap-85mg sumatriptan and 500mg naproxen sodium), a butalbital-containing combination medication (BCM-50mg butalbital, 325mg acetaminophen, 40mg caffeine), and placebo when used to treat moderate to severe migraine headache pain in subjects who used BCMs in the past.BACKGROUND: Despite the lack of Food and Drug Administration approval and the absence of placebo-controlled trials to demonstrate efficacy, butalbital-containing medications are among the most commonly prescribed acute migraine treatments in the United States. Butalbital-containing medications are associated with serious and undesirable side effects, and have been linked to the chronification of migraine and development of medication-overuse headaches. This study compares the relative efficacy, safety, and tolerability of a fixed dose SumaRT/Nap versus a BCM and placebo.METHODS: Enrolled subjects were required to have treated at least 1 migraine with a butalbital medication in the past. Enrolled subjects treated 3 moderate to severe migraines using each of the 3 study treatments once in a randomized sequence. The primary endpoint compared SumaRT/Nap versus BCM for sustained pain freedom at 2-24 hours without the use of any rescue medication. This study combines data from 2 identical outpatient, randomized, multicenter, double-blind, double-dummy, 3 attack crossover studies in adult migraineurs (International Classification of Headache Disorders, 2nd edition).RESULTS: A total of 442 subjects treated at least 1 attack with study medication. The majority of the treated subjects were female (88%) with a mean age 43 years, who reported that their migraines had a severe impact on their lives (78% with Headache Impact Test-6 of >59). At screening, 88% of subjects reported current butalbital use; 68% had used butalbital for more than 6 weeks; and 82% reported satisfaction with butalbital. Across treatment groups, 28-29% of subjects took study medication within 15 minutes of migraine onset, 34-37% of subjects took study medication >15 minutes to 2 hours after onset, and 32-36% of subjects took study medication more than 2 hours after onset. This study did not detect a difference at the nominal 0.05 level in percent sustained pain-free between SumaRT/Nap (8%), BCM (6%), and placebo (3%). SumaRT/Nap was superior to BCM for pain free at 2, 4, 6, 8, 24, 48 hours (P?.044); pain relief (mild or no pain) at 2, 4, 6, 8, 24, 48 hours (P?.01); sustained pain relief 2-24 hours (P<.001); migraine free (pain free with no nausea, photophobia, or phonophobia) at 4, 6, 8, 24, 48 hours (P?.046); and complete symptom free (migraine free with no neck/sinus pain) at 4, 6, 8, 48 hours (P?.031). Adverse event incidence was similar for all treatments (10%, 12%, and 9% for placebo, SumaRT/Nap, and BCM, respectively). Nausea was the most frequent adverse event (2%, 2%, and <1% for placebo, SumaRT/Nap, and BCM, respectively). Five serious adverse events were reported by 3 subjects: viral meningitis and colon neoplasm (placebo); chest pain and hypertension 17 days postdose (SumaRT/Nap); and breast cancer (BCM). Investigators judged no serious adverse events related to study medication.CONCLUSIONS: This study primarily included subjects whose migraines significantly impacted their lives. Before the study, these subjects used butalbital-containing medications as part of their current migraine treatment regimen and were satisfied with it, suggesting they were butalbital responders who had found a workable treatment strategy for themselves. When treated with SumaRT/Nap versus BCM in this study, however, a significant proportion of subjects reported better treatment outcomes for themselves for both migraine pain and associated symptoms. Use of SumaRT/Nap was also associated with less rescue medication use and a longer time before use of rescue medication compared with both BCM and placebo.","Derosier, F; Sheftell, F; Silberstein, S; Cady, R; Ruoff, G; Krishen, A; Peykamian, M",2012.0,10.1111/j.1526-4610.2011.02039.x,0,0,
5566,Utility of the questionnaire for quality of life EORTC-QLQ-C30 in psycho-oncological outcome research,"ER Aim of this paper is to examine the utility and validity of the questionnaire for quality of life EORTC-QLQ-C30 (European Organization for Research and Treatment of Cancer). Data were collected within the scope of a study for evaluation of individual psycho-oncological support for inpatients with colorectal cancer undergoing surgery. The study was sponsored by the German Cancer Aid. The design was a prospective randomized controlled trial. After informed consent, patients were randomized in one of two groups: patients in the experimental group received individualized psychotherapeutic support during the hospital stay; those in the control group received a daily program of classical music. All patients were assessed one day before surgical treatment, ten days and three months after surgery. Instruments were questionnaires for quality of life and state anxiety. 106 patients met the inclusion criteria. Results show insufficient discriminative power (high significant bivariate correlations between most EORTC scales, Kendalls tau-b) and insufficient construct validity (high and significant bivariate correlations between most EORTC scales and state anxiety, Kendalls tau-b) of the EORTC scales. The scores of ""cognitive functioning"" and some symptom scales show an insufficient scatter. The illustration of situational influences and therefore an insufficient illustration of effects of specific interventions are connected with a high sensitivity of the scales and a tendency to extreme sores. The psycho-oncological intervention shows a significant stress reducing effect on the specific EORTC-scale ""Emotional Functioning"" and on State Anxiety (STAI). The testing of utility and validity of the EORTC-Questionnaire shows that they are insufficient and therefore the benefit for evaluation of specific intervention procedures is restricted.","Determann, M M; Kollenbaum, V E; Henne-Bruns, D",2004.0,10.1055/s-2004-44873,0,0,
5567,A web-based program improves physical activity outcomes in a primary care angina population: randomized controlled trial,"ER OBJECTIVE: Our aim was to examine the effectiveness of a Web-based cardiac rehabilitation program for those with angina.METHODS: We conducted a randomized controlled trial, recruiting those diagnosed with angina from general practitioners (GPs) in primary care to an intervention or control group. Intervention group participants were offered a 6-week Web-based rehabilitation program (""ActivateYourHeart""). The program was introduced during a face-to-face appointment and then delivered via the Internet (no further face-to-face contact). The program contained information about the secondary prevention of coronary heart disease (CHD) and set each user goals around physical activity, diet, managing emotions, and smoking. Performance against goals was reviewed throughout the program and goals were then reset/modified. Participants completed an online exercise diary and communicated with rehabilitation specialists through an email link/synchronized chat room. Participants in the control group continued with GP treatment as usual, which consisted of being placed on a CHD register and attending an annual review. Outcomes were measured at 6-week and 6-month follow-ups during face-to-face assessments. The primary outcome measure was change in daily steps at 6 weeks, measured using an accelerometer. Secondary outcome measures were energy expenditure (EE), duration of sedentary activity (DSA), duration of moderate activity (DMA), weight, diastolic/systolic blood pressure, and body fat percentage. Self-assessed questionnaire outcomes included fat/fiber intake, anxiety/depression, self-efficacy, and quality of life (QOL).RESULTS: A total of 94 participants were recruited and randomized to the intervention (n=48) or the usual care (n=46) group; 84 and 73 participants completed the 6-week and 6-month follow-ups, respectively. The mean number of log-ins to the program was 18.68 (SD 13.13, range 1-51), an average of 3 log-ins per week per participant. Change in daily steps walked at the 6-week follow-up was +497 (SD 2171) in the intervention group and -861 (SD 2534) in the control group (95% CI 263-2451, P=.02). Significant intervention effects were observed at the 6-week follow-up in EE (+43.94 kcal, 95% CI 43.93-309.98, P=.01), DSA (-7.79 minutes, 95%","Devi, R; Powell, J; Singh, S",2014.0,10.2196/jmir.3340,0,0,
5568,Predialysis psychoeducational intervention and coping styles influence time to dialysis in chronic kidney disease,"ER METHODSWe used an inception-cohort, prospective, randomized, controlled trial with follow-up to evaluate an intervention that included an interactive 1-on-1 slide-supported educational session, a printed summary (booklet), and supportive telephone calls once every 3 weeks. Participants were sampled from 15 Canadian (tertiary care) nephrology units and included 297 patients with progressive chronic kidney disease (CKD) expected to require renal replacement therapy (RRT) within 6 to 18 months. The main outcome was time to dialysis therapy (censored at 18 months if still awaiting RRT).RESULTSTime to dialysis therapy was significantly longer (median, 17.0 months) for the PPI group than the usual-care control group (median, 14.2 months; Cox's proportional hazards analysis, controlling for general nonrenal health, P < 0.001). Coping by avoidance of threat-related information (called blunting) was associated with shorter times to dialysis therapy (P < 0.032). A group x blunting interaction (P < 0.069) indicated: (1) time to dialysis therapy was shortened in the usual-care group, especially when patients coped by blunting; but (2) time to dialysis therapy was extended with PPI, even among patients who coped by blunting. Knowledge acquisition predicted time to dialysis therapy (r = 0.14; P < 0.013). Time to dialysis therapy was unrelated to depression or social support.CONCLUSIONPPI extends time to dialysis therapy in patients with progressive CKD. The mechanism may involve the acquisition and implementation of illness-related knowledge. Routine follow-up also may be especially important when patients cope by avoiding threat-related information.BACKGROUNDConsensus endorses predialysis intervention before the onset of end-stage renal disease. In a previous study, predialysis psychoeducational intervention (PPI) extended time to dialysis therapy by a median of 6 months. We undertook to replicate and extend this finding by examining hypothesized mechanisms.","Devins, G M; Mendelssohn, D C; Barré, P E; Binik, Y M",2003.0,,0,0,
5569,Clinical study of Supranettes pads in the treatment of seasonal or perennial allergic conjunctivitis in children,"ER MATERIAL AND METHODSOur prospective study was done in children with a diagnosis of seasonal or perennial clinical ocular allergy. Every symptom was rated from 0 to 4 according to the intensity described by the children and their parents. Twenty children (range, 4-10 years) presenting an ocular allergy were included in the study. A topical antiallergic treatment membrane stabilizer or antihistamine and Supranettes pads were prescribed for ocular cleaning of one randomized selected eye four times a day. Patients were seen in consultation 1 month later to evaluate the treatment. The ocular comfort of each eye, one treated with Supranettes pads and the other not treated by Supranettes pads, was evaluated by the child helped by parents on a graduated self-evaluation scale (range, 0-10). The Mann-Whitney statistical test was used to differentiate the two groups.RESULTSOf the 20 patients, eleven presented seasonal conjunctivitis and nine perennial conjunctivitis. Six of them presented conjunctivitis with a slight to moderate superficial punctuate keratitis. At the consultation on day 28+/-3, patients who were first treated showed clear improvement of clinical signs with the prescribed treatment. The statistical comparison of the two groups confirmed a significant difference (p<0.05) to the advantage of the group using the Supranettes pads.DISCUSSIONOcular washing is essential in the treatment of allergic conjunctivitis. The new galenic form of ocular cleaning by physiological serum-impregnated pads is simple to use for children. An objective significant difference is difficult to observe in 1 month.CONCLUSIONThis study underlines the importance of the comfort of Supranettes pads evaluated in the treatment of children's conjunctivitis. It confirms the advantage of developing evaluation studies including patient satisfaction and quality of life in ophthalmology.PURPOSEOcular allergy is a common disease that is on the rise. Seasonal and perennial conjunctivitis are the most common forms of ocular allergy. Itching, hyperemia, foreign body sensation, irritation, blurred vision or ocular dryness sensations, tearing, and photophobia are the clinical signs observed in patients. A topical antiallergic treatment is prescribed associated with ocular cleaning to contribute to an antigen washing of the ocular surface. Our study aimed to evaluate the use of Supranettes pads as supplementation treatment in children for seasonal or perennial conjunctivitis.","Devogelaere, T; Beresniak, A; Raymaeckers, A; Naacke, H; Ssi Yan, Kai I; Brémond-Gignac, D",2006.0,,0,0,
5570,Preventive intervention for living donor psychosocial outcomes: feasibility and efficacy in a randomized controlled trial,"ER There are no evidence-based interventions to prevent adverse psychosocial consequences after living donation. We conducted a single-site randomized controlled trial to examine the postdonation impact of a preventive intervention utilizing motivational interviewing (MI) to target a major risk factor for poor psychosocial outcomes, residual ambivalence (i.e. lingering hesitation and uncertainty) about donating. Of 184 prospective kidney or liver donors, 131 screened positive for ambivalence; 113 were randomized to (a) the MI intervention, (b) an active comparison condition (health education) or (c) standard care only before donation. Ambivalence was reassessed postintervention (before donation). Primary trial outcomes-psychosocial variables in somatic, psychological and family interpersonal relationship domains-were assessed at 6 weeks and 3 months postdonation. MI subjects showed the greatest decline in ambivalence (p = 0.050). On somatic outcomes, by 3 months postdonation MI subjects reported fewer physical symptoms (p = 0.038), lower rates of fatigue (p = 0.021) and pain (p = 0.016), shorter recovery times (p = 0.041) and fewer unexpected medical problems (p = 0.023). Among psychological and interpersonal outcomes, they had a lower rate of anxiety symptoms (p = 0.046) and fewer unexpected family-related problems (p = 0.045). They did not differ on depression, feelings about donation or family relationship quality. The findings suggest that the intervention merits testing in a larger, multisite trial.","Dew, M A; DiMartini, A F; DeVito, Dabbs A J; Zuckoff, A; Tan, H P; McNulty, M L; Switzer, G E; Fox, K R; Greenhouse, J B; Humar, A",2013.0,10.1111/ajt.12393,0,0,
5571,Protocolized cognitive-behavioural group therapy for inflammatory bowel disease,"ER OBJECTIVEthe main goal of this study was to design, to put into practice, and to validate a protocolized psychological treatment program based on the coping model, and a psycho-educational methodology in which the following intervention modules were included- illness information, coping model, problem solving techniques, relaxation, social skill training, distraction, and cognitive restructuring techniques. All these techniques were adapted to the characteristic features of inflammatory bowel disease.METHODthe sample included 57 patients with inflammatory bowel disease from the Spanish Crohn s Disease and Ulcerative Colitis Association. The sample was randomly assigned to one of the two experimental groups -33 were assigned to the treatment group, and 24 were assigned to the waiting list control group.RESULTSthe results reflected a significant clinical and statistical improvement in anxiety (p < 0.001) and depression (p < 0.001) variables when compared to the waiting list control group. Likewise, improvement was sustained at 3, 6, and 12 months during follow-up.CONCLUSIONthe protocolized psychological treatment program, administered in group sessions, is effective in reducing emotional symptoms arising as a result of inflammatory bowel disease.INTRODUCTIONpatients affected by inflammatory bowel disease have a high rate of psychiatric disorders such as depression and anxiety.","Díaz, Sibaja M A; Comeche, Moreno M I; Mas, Hesse B",2007.0,,0,0,
5572,Aggressive adolescents benefit from massage therapy,"ER Seventeen aggressive adolescents were randomly assigned to a massage therapy group or a relaxation therapy group to receive 20-minute therapy sessions, twice a week for five weeks. The massaged adolescents had lower anxiety after the first and last sessions. By the end of the study, they also reported feeling less hostile and they were perceived by their parents as being less aggressive. Significant differences were not found for the adolescents who were assigned to the relaxation group.","Diego, M A; Field, T; Hernandez-Reif, M; Shaw, J A; Rothe, E M; Castellanos, D; Mesner, L",2002.0,,0,0,
5573,Family-based interpersonal psychotherapy for depressed preadolescents: examining efficacy and potential treatment mechanisms,"ER OBJECTIVE: To conduct a randomized controlled trial to evaluate the preliminary efficacy of family-based interpersonal psychotherapy (FB-IPT) for treating depression in preadolescents (aged 7-12 years) as compared to child-centered therapy (CCT), a supportive and nondirective treatment that closely approximates the standard of care for pediatric depression in community mental health.METHOD: Preadolescents with depression (N = 42) were randomly assigned FB-IPT or CCT. Pre- and posttreatment assessments included clinician-administered measures of depression, parent- and child-reported depression and anxiety symptoms, and parent-child conflict and interpersonal impairment with peers.RESULTS: Preadolescents receiving FB-IPT had higher rates of remission (66.0% versus 31%), a greater decrease in depressive symptoms from pre- to posttreatment, and lower depressive symptoms at posttreatment (R(2) = 0.35, ?R(2) = 0.22; B = -8.15, SE = 2.61, t[37] = -3.13, p = .002, F(2) = 0.28) than did preadolescents with depression receiving CCT. Furthermore, preadolescents in the FB-IPT condition reported significant reductions in anxiety and interpersonal impairment compared with preadolescents in the CCT condition. Changes in social and peer impairment from pre- to posttreatment were associated with preadolescents' posttreatment depressive symptoms. There was a significant indirect effect for decreased social impairment accounting for the association between the FB-IPT and preadolescents' posttreatment depressive symptoms.CONCLUSION: Findings indicate FB-IPT is an effective treatment for preadolescent depression and support further investigation of interpersonal mechanisms by which FB-IPT may reduce preadolescent depression. Clinical trial registration information-Phase II Study of Family Based Interpersonal Psychotherapy (FB-IPT) for Depressed Preadolescents; http://clinicaltrials.gov; NCT02054312.","Dietz, L J; Weinberg, R J; Brent, D A; Mufson, L",2015.0,10.1016/j.jaac.2014.12.011,0,0,
5574,Study on the clinical effect of the massage method of micro-regulating with vertical cross pressing lying on one side in treating cervicogenic headache,"ER OBJECTIVE: To evaluate the clinical effects of the massage method of micro-regulating with vertical cross pressing lying on one side in treating cervicogenic headache (CEH).METHODS: Total 136 patients with CEH were collected in the study from August 2012 to April 2014. They were divided randomly into two groups according to random digits table. Sixty-nine patients accepted the treatment of micro-regulating with vertical cross pressing lying on one side (pressing micro-regulating group), including 29 males and 40 females with an average age of (50.55 ± 11.38) years old; 67 patients received the treatment of traditional massage (traditional massage group), including 28 males and 39 females with an average age of (51.20 ± 11.90) years old. Clinical effect was observed according to the standard of curative effect of State Administration of Traditional Chinese Medicine; the function of cervical vertebra and all body status were evaluated according to NDI score. VAS score, frequency and time of headache were recorded and compared before and after treatment.RESULTS: No adverse reactions were found after treatment, all patients were followed up from 1 to 6 months with an average of 3.1 months. In pressing micro-regulating group, 25 cases got fully recover, 26 excellence, 14 effectiveness and 4 inefficiency; and in traditional massage group, the results were 12,21,22, 12;clinical effect of pressing micro-regulating group was better than that of traditional massage group (P<0.01). NDI score in pressing micro-regulating group decreased from preoperative 13.48 ± 4.83 to postoperative 6.23 ± 3.76; in traditional massage group also decreased from preoperative 13.82 ± 5.78 to postoperative 8.25 ± 4.75; the improvement of the pressing micro-regulating group was obviously better than that of traditional massage group (P < 0.01). VAS score in pressing micro-regulating group decreased from preoperative 4.75 ± 0.97 to postoperative 1.88 ± 1.78; and in traditional massage group decreased from pre-operative 4.78 ± 0.98 to postoperative 2.84 ± 1.94; pressing micro-regulating group was more notable than that of traditional massage group (P < 0.01). The frequency per week,the pain time in pressing micro-regulating group decreased from preoperative (5.38 ± 1.96) times and (6.87 ± 3.67) hours to postoperative (1.71 ± 2.04) times and (0.97 ± 1.74) hours,respectively,in traditional massage group the above parameters decreased from preoperative (5.22 ± 1.81) times and (6.90 ± 3.79) hours to postoperative (2.81 ± 2.42) times and (1.83 ± 2.21) hours;pressing micr-regulating group was more notable than that of traditional massage group (P < 0.01 or P < 0.05).CONCLUSION: Using the tuina method of micro-regulating with vertical cross pressing lying on one side to treat CEH can improve function of cervical vertebra and all body status, lessen the intensity, frequency, duration time of pain, and had advantage of higher security, simple operation, and evident effect.","Ding, H T; Tang, X Z",2015.0,,0,0,
5575,Acute stress increases circulating anandamide and other N-acylethanolamines in healthy humans,"ER Stress plays an important role in psychiatric disorders, and preclinical evidence indicates that the central endocannabinoid system modulates endocrine and neuronal responses to stress. This study aimed to investigate the effect of acute stress on circulating concentrations of endocannabinoids (eCBs) in healthy humans. A total of 71 adults participated in two sessions in which they were exposed to either a standardized psychosocial stress procedure (Trier Social Stress Test) or a control task. Blood samples for eCB and cortisol assays and cardiovascular and subjective measures were obtained before and at regular intervals after the tasks. Serum concentrations of the eCBs, N-arachidonylethanolamine (anandamide, AEA) and 2-arachidonoylglycerol (2-AG), as well as of the N-acylethanolamides (NAEs), N-palmitoylethanolamine (PEA) and N-oleoylethanolamine (OEA), and of the O-acylglycerol, 2-oleoylglycerol (2-OG), were determined. Compared with the control condition, stress increased serum concentrations of AEA and the other NAEs immediately after the stress period. Increases in PEA were positively correlated with increases in serum cortisol after stress. Furthermore, anxiety ratings at baseline were negatively correlated with baseline concentrations of AEA. The sex and menstrual cycle status of the subject affected the NAE responses to stress. Interestingly, subjects of Asian and African-American races exhibited different patterns of stress responses compared with the Caucasian subjects. These results indicate that stress increases circulating NAEs in healthy human volunteers. This finding supports a protective role for eCBs in anxiety. Further research is needed to elucidate the function of these lipid mediators, and to determine the mechanisms that regulate their appearance in the circulation.","Dlugos, A; Childs, E; Stuhr, K L; Hillard, C J; Wit, H",2012.0,10.1038/npp.2012.100,0,0,
5576,Urges to smoke during the first month of abstinence: relationship to relapse and predictors,"ER The urges to smoke reported by 215 former smokers were measured 1 day, 7 days, 14 days and 30 days after they quit to examine: (a) the time course of smoking urges, (b) the relationship of urges to relapse, and (c) predictors of urges to smoke. Urges to smoke were strongest 1 day after quitting, and decreased at each subsequent measurement point. Urges were a powerful predictor of relapse. At each of the four assessment points, abstinent subjects who reported stronger urges to smoke were more likely to relapse by the next measurement point. Urges to smoke at a given day (e.g., day 1) were consistently the best predictors of the persistence of urges at the next assessment (e.g., day 7). Greater negative emotion (e.g., anxiety, sadness, anger, and confusion) and psychosocial stress also predicted stronger urges to smoke. Nicotine gum significantly reduced urges during week 1 post-cessation. Clinical implications of the findings are discussed.","Doherty, K; Kinnunen, T; Militello, F S; Garvey, A J",1995.0,,0,0,
5577,The effectiveness of a psycho-educational group after early-stage breast cancer treatment: results of a randomized French study,"ER METHODSTwo hundred and three patients, recruited after primary treatment, were randomly assigned either to a treatment group (psycho-educational intervention) or to a waiting-list control group. The 8-week programme of 2 h sessions comprised of thematic discussions, information and training in stress management techniques. Evaluation at baseline, after 8 sessions, and 1 month after programme completion, included evaluations using the STAI, POMS, MAC, EORTC QLQ-C30 and EORTC QLQ-BR23 breast module scales.RESULTSWe observed a significant reduction in anxiety (STAI, POMS) among group participants, a reduction in anger, depression and fatigue (POMS), a significant improvement in vigor and interpersonal relationships (POMS), in emotional and role functioning, in health status and fatigue level (EORTC QLQ-C30). In contrast, coping strategies (MAC) were not significantly different between groups. No group-related negative effects were observed and the global satisfaction levels were very high.CONCLUSIONThis study demonstrates the feasibility and effectiveness of a psycho-educational intervention, which can accelerate the reduction of those negative affects which are present at the end of treatment. It represents an excellent complement or an alternative to individual psycho-oncologic therapeutic support, widely proposed in France, and should now be tested in groups with other types of cancer and at other disease phases.BACKGROUNDMany women with breast cancer need psychological help to cope more effectively after treatment. Cognitive and behavioural techniques are not yet well established in France. A multi-site randomized study was conducted to evaluate the effects of a psycho-educational group intervention in this population.","Dolbeault, S; Cayrou, S; Brédart, A; Viala, A L; Desclaux, B; Saltel, P; Gauvain-Piquard, A; Hardy, P; Dickes, P",2009.0,10.1002/pon.1440,0,0,
5578,Oxytocin attenuates amygdala responses to emotional faces regardless of valence,"ER METHODSIn a functional magnetic resonance imaging study using a double-blind, placebo-controlled within-subject design, we measured neural responses to fearful, angry, and happy facial expressions after intranasal application of 24 IU oxytocin compared with placebo.RESULTSOxytocin reduced right-sided amygdala responses to all three face categories even when the emotional content of the presented face was not evaluated explicitly. Exploratory whole brain analysis revealed modulatory effects in prefrontal and temporal areas as well as in the brainstem.CONCLUSIONSResults suggest a modulatory role of oxytocin on amygdala responses to facial expressions irrespective of their valence. Reduction of amygdala activity to positive and negative stimuli might reflect reduced uncertainty about the predictive value of a social stimulus and thereby facilitates social approach behavior.BACKGROUNDOxytocin is known to reduce anxiety and stress in social interactions as well as to modulate approach behavior. Recent studies suggest that the amygdala might be the primary neuronal basis for these effects.","Domes, G; Heinrichs, M; Gläscher, J; Büchel, C; Braus, D F; Herpertz, S C",2007.0,10.1016/j.biopsych.2007.03.025,0,0,
5579,An internet tool to normalize grief,"ER This research evaluated the efficacy of a psycho-educational Internet self-help tool to educate and support recently (1-6 months) bereaved individuals. The goal of the website was to help users normalize their grief to enhance their adaptive adjustment. A randomized controlled trial evaluated the gains in social cognitive theory constructs and state anxiety. Compared to the control group (N = 34), treatment participants (N = 33) reported significant multivariate gains (eta-square = .191). Significant program effects were obtained on all three outcome measures: attitude (eta-square = .177), self-efficacy (eta-square = .106), and state anxiety (eta-square = .083). These findings suggest the potential efficacy of an Internet-based grief support tool to enhance adaptive adjustment of the bereaved.","Dominick, S A; Irvine, A B; Beauchamp, N; Seeley, J R; Nolen-Hoeksema, S; Doka, K J; Bonanno, G A",2009.0,,0,0,
5580,Effectiveness of telephone counseling in managing psychological outcomes after spinal cord injury: a preliminary study,"ER OBJECTIVE: To determine whether an individualized counseling intervention delivered by telephone-telecounseling-feasibly improves the emotional adjustment of adults with a newly acquired spinal cord injury (SCI).DESIGN: Randomized controlled trial.SETTING: Spinal injuries unit of a rehabilitation center.PARTICIPANTS: Adults (N=40) aged 18 or older, who were recently discharged home from inpatient spinal rehabilitation, were randomly assigned to a telecounseling treatment or standard-care control group. All participants had recently received psychological treatment as inpatients in order to help assist them in adjusting to their disability. Referral to the inpatient psychology service was therefore a key indicator of participants' baseline distress levels and, consequently, their need for counseling support postdischarge.INTERVENTION: Seven telecounseling sessions were delivered over a 12-week period by a single psychologist (D.D.). Pre- and postintervention data, plus a 3-month follow-up assessment, were compared with that of an SCI control group who received standard care.MAIN OUTCOME MEASURES: Psychosocial outcome was measured using the following: Depression Anxiety Stress Scale-21; Mini International Neuropsychiatric Interview; Spinal Cord Lesion Emotional Wellbeing and Coping Strategies Questionnaires; and the Multidimensional Measure of Social Support. Cost-effectiveness and clinical feasibility were also evaluated.RESULTS: Telecounseling participants reported clinical improvements in depression and anxiety and aspects of SCI coping immediately postintervention. However, these treatment gains were not statistically significant. Additionally, treatment effects were minimal at 3-month follow-up. Delivery related outcomes, including participation rate and cost analyses, were all positive.CONCLUSIONS: The results suggest that continued psychological services for individuals reporting distress during their inpatient rehabilitation is important and that such services can be delivered by telephone cost-effectively and efficiently. However, the long-term benefits of telecounseling, once ceased, were not demonstrated.","Dorstyn, D; Mathias, J; Denson, L; Robertson, M",2012.0,10.1016/j.apmr.2012.06.002,0,0,
5581,Outcomes of coaxial microincision cataract surgery versus conventional coaxial cataract surgery,"ER SETTINGUniversity Eye Clinic, Geneva, Switzerland.METHODSIn a prospective study, 50 eyes of 50 patients with nuclear or corticonuclear cataract (grades 2 to 4 on the Lens Opacities Classification System III) were randomly selected to have cataract extraction through a temporal clear corneal incision using 1 of 2 techniques: coaxial MICS (25 eyes) or conventional coaxial cataract surgery (25 eyes). Coaxial MICS was performed through a 1.6 mm incision and conventional coaxial cataract surgery, through a 2.8 mm incision. In all cases, a flexible hydrophobic acrylic intraocular lens (Lentis L-303, WaveLight GmbH) was implanted. Intraoperative parameters were ultrasound time, surgical time, and total volume of balanced salt solution used. The best corrected visual acuity, corneal thickness, and endothelial cell count were evaluated preoperatively and postoperatively.RESULTSThere were no relevant clinical differences between groups or perioperative complications in either group. The only statistically significant differences between the 2 groups were ultrasound time (P = .0002) and surgical time (P = .005).CONCLUSIONSCoaxial microincision cataract surgery was a safe and effective technique. Although ultrasound and surgical time were significantly higher with coaxial MICS than with conventional coaxial cataract surgery, the postoperative results in the 2 techniques were comparable.PURPOSETo compare the outcomes of coaxial microincision cataract surgery (MICS) with those of conventional coaxial cataract surgery.","Dosso, A A; Cottet, L; Burgener, N D; Nardo, S",2008.0,10.1016/j.jcrs.2007.09.037,0,0,
5582,Chemical cross-linking between lysine groups in vimentin oligomers is dependent on local peptide conformations,"ER Previous studies have shown that cytoplasmic intermediate filaments, other than the keratins, are each constructed from a single type of polypeptide chain. Studies involving chemical crosslinking between lysine groups have shown that assembly of the filaments begins with the formation of dimers in which the peptide chains are parallel and in exact register, and that these dimers further associate in antiparallel patterns having specific degrees of overlap. In the present study, molecular modeling of the conformations of vimentin molecules indicated that lysine side chains in identical positions in regions of alpha-helix in parallel chains might be unable to be linked because they are on opposite sides of the coiled coil hydrophobic core. Examination of published data on chemical crosslinking of lysines in vimentin confirmed that there were no instances of linkage within dimers between the nine pairs of identical lysines that lie more than one position within alpha-helical regions in parallel chains. Even among linkages that apparently were between dimers, only one of the 11 linkage products identified involved lysines that were both within an alpha-helical region. In 10 of the 11 identified linkages between dimers, one or both of the linked lysines were in regions of random coil conformation. These results of molecular modeling indicate that relative motion between polypeptide chains in oligomers of intermediate filament proteins is not sufficient to overcome an orientation of lysine groups that is unfavorable for their chemical linkage. This finding supports the interpretations of keratin cross-linking data indicating that parallel homodimers are the basis for keratin intermediate filament assembly.","Downing, D T",1996.0,10.1002/(SICI)1097-0134(199606)25:2&lt,0,0,
5583,The psychological consequences of cardiopulmonary resuscitation training for family members of patients at risk for sudden death,"ER METHODSPatient-family pairs (n = 337) were randomized into one of four groups: control, CPR only, CPR with cardiac risk factor education, and CPR with a social support intervention. Only family members received CPR training. Data on emotional state and psychosocial adjustment to illness were collected at baseline, 2 weeks, and 3 and 6 months following CPR training.RESULTSThere were no significant differences in the emotional states of family members across the four groups. However, significant differences in psychosocial adjustment and emotional states occurred in patients across treatment groups following CPR training. Patients whose family members learned CPR with the social support intervention reported better psychosocial adjustment and less anxiety and hostility than patients in the other groups. Control patients reported better psychosocial adjustment and less emotional distress than patients in the CPR-only and CPR-education groups.CONCLUSIONSThese findings support tailoring family CPR training so that instruction does not result in negative psychological states in patients. The findings also illustrate the efficacy of a simple intervention that combines CPR training with social support.OBJECTIVESThe purpose of this study was to determine psychological consequences of teaching cardiopulmonary resuscitation (CPR) to family members of patients at risk for sudden death.","Dracup, K; Moser, D K; Taylor, S E; Guzy, P M",1997.0,,0,0,
5584,Predictors of outcome following brief psychodynamic-interpersonal therapy for deliberate self-poisoning,"ER METHOD: Patients presenting to an emergency department with deliberate self-poisoning were randomly assigned to brief psychodynamic-interpersonal therapy (PIT) or usual care. Severity of suicidal ideation 6 months post-treatment was used as the main outcome measure. Sociodemographic features and baseline psychological measures were used as predictor variables. Univariate and regression analyses were used to identify predictors of outcome for the whole group and for those who received psychotherapy.RESULTS: Principal predictors for the psychotherapy group were baseline severity of depression and a prior history of self-harm. For the group as a whole predictors were severity of suicidal ideation, anxiety and prior history of self-harm.CONCLUSIONS: Four session PIT for deliberate self-poisoning is effective in reducing suicidal ideation in patients with less severe depression, no prior history of self-harm, and who have not consumed alcohol with the overdose. Extended therapy may be indicated for those with more severe depression.BACKGROUND: We found that brief psychodynamic-interpersonal therapy was more helpful than usual care in deliberate self-poisoning patients, and resulted in reduced suicidal ideation and repetition of self-harm in the 6 months post-treatment. Here, we explore which baseline factors predicted outcome following treatment.","Guthrie, E; Kapur, N; Mackway-Jones, K; Chew-Graham, C; Moorey, J; Mendel, E; Francis, F M; Sanderson, S; Turpin, C; Boddy, G",2003.0,10.1046/j.1440-1614.2003.01197.x,0,0,
5585,A preliminary path analysis of expectancy and patient-provider encounter in an open-label randomized controlled trial of spinal manipulation for cervicogenic headache,"ER METHODSEighty participants with chronic cervicogenic headache (CGH) were randomized to 4 groups: 2 levels of treatment dose (8 or 16) and 2 levels of therapy from a chiropractor (spinal manipulation or light massage). Providers were instructed to have equal enthusiasm for all care. Structural equation modeling with standardized path coefficients (beta) was used in a path analysis to identify the effects of patient expectancy and the PPE on CGH pain. The model included monthly pain from baseline to 12 weeks. Expectancy and PPE were evaluated on Likert scales. The patient-provider encounter was measured as patient perception of chiropractor enthusiasm, confidence, and comfort with care.RESULTSBaseline patient expectancy was balanced across groups. The PPE measures were balanced across groups and consistent over the 8-week treatment period. Treatment and baseline pain had the strongest effects on pain outcomes (|beta| = .46-.59). Expectations had little effect on pain (abs value(beta) < .15). The patient-provider encounter had a weak effect on pain (abs value(beta)= .03-.27) and on subsequent confidence in treatment success (abs value(beta)= .09 and .12).CONCLUSIONSEncouraging equipoise in the PPE and balancing expectancy across treatment groups may protect against some confounding related to the absence of blinding in a randomized controlled trial of pain. In this trial, their effects were found to be small relative to the effects of treatment and baseline values.OBJECTIVEThe purpose of this article was to present a preliminary model to identify the effects of expectancy of treatment success and the patient-provider encounter (PPE) on outcomes in an open-label randomized trial.","Haas, M; Aickin, M; Vavrek, D",2010.0,10.1016/j.jmpt.2009.11.007,0,0,
5586,Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial,"ER PURPOSETo compare the efficacy of two doses of SMT and two doses of light massage (LM) for CGH.PATIENT SAMPLEEighty patients with chronic CGH.MAIN OUTCOME MEASURESModified Von Korff pain and disability scales for CGH and neck pain (minimum clinically important difference=10 on 100-point scale), number of headaches in the last 4 weeks, and medication use. Data were collected every 4 weeks for 24 weeks. The primary outcome was the CGH pain scale.METHODSParticipants were randomized to either 8 or 16 treatment sessions with either SMT or a minimal LM control. Patients were treated once or twice per week for 8 weeks. Adjusted mean differences (AMD) between groups were computed using generalized estimating equations for the longitudinal outcomes over all follow-up time points (profile) and using regression modeling for individual time points with baseline characteristics as covariates and with imputed missing data.RESULTSFor the CGH pain scale, comparisons of 8 and 16 treatment sessions yielded small dose effects: |AMD|</=5.6. There was an advantage for SMT over the control: AMD=-8.1 (95% confidence interval=-13.3 to -2.8) for the profile, -10.3 (-18.5 to -2.1) at 12 weeks, and -9.8 (-18.7 to -1.0) at 24 weeks. For the higher dose patients, the advantage was greater: AMD=-11.9 (-19.3 to -4.6) for the profile, -14.2 (-25.8 to -2.6) at 12 weeks, and -14.4 (-26.9 to -2.0) at 24 weeks. Patients receiving SMT were also more likely to achieve a 50% improvement in pain scale: adjusted odds ratio=3.6 (1.6 to 8.1) for the profile, 3.1 (0.9 to 9.8) at 12 weeks, and 3.1 (0.9 to 10.3) at 24 weeks. Secondary outcomes showed similar trends favoring SMT. For SMT patients, the mean number of CGH was reduced by half.CONCLUSIONSClinically important differences between SMT and a control intervention were observed favoring SMT. Dose effects tended to be small.BACKGROUND CONTEXTSystematic reviews of randomized controlled trials suggest that spinal manipulative therapy (SMT) is efficacious for care of cervicogenic headache (CGH). The effect of SMT dose on outcomes has not been studied.","Haas, M; Spegman, A; Peterson, D; Aickin, M; Vavrek, D",2010.0,10.1016/j.spinee.2009.09.002,0,0,
5587,Functional magnetic resonance imaging as experienced by stroke survivors,"ER Functional magnetic resonance imaging (fMRI), a noninvasive technique that measures brain activation, has been increasingly used in the past decade, particularly among older adults. Use of fMRI in research with stroke survivors in recent years has substantially contributed to researchers' understanding of the pathophysiology of stroke sequelae. However, despite the increasing popularity and use of fMRI, little is known about the patient experience of fMRI under research circumstances. The current research brief reports the findings of a pilot study undertaken to understand stroke survivors' experiences with fMRI under research circumstances. Nine ischemic stroke patients underwent two MRI sessions, each of which lasted 1.5 hours and included several fMRI tasks. Patients were asked about their experiences and to share any advice. All participants reported that they did not feel claustrophobic; in addition, the importance of educating participants about fMRI was a universal theme that emerged. Knowledge of participant experiences may help with enrollment strategies for fMRI studies and improve research outcomes related to the fMRI experience.","Hadidi, N N; Cullen, K R; Hall, L M; Lindquist, R; Buckwalter, K C; Mathews, E",2014.0,10.3928/19404921-20140820-01,0,0,
5588,Efficacy of a C1-C2 self-sustained natural apophyseal glide (SNAG) in the management of cervicogenic headache,"ER OBJECTIVESTo determine the effect of a C1-C2 self-sustained natural apophyseal glide (SNAG) on cervicogenic headache.BACKGROUNDCervicogenic headache is a common condition causing significant disability. Recent studies have shown a high incidence of C1-C2 dysfunction, evaluated by the flexion-rotation test (FRT), in subjects with cervicogenic headache. To manage this dysfunction, Mulligan has described a C1-C2 self-SNAG, though no studies have investigated the efficacy of this intervention approach.METHODSA sample of 32 subjects (mean _ SD age, 36 +/- 3 years) with cervicogenic headache and FRT limitation were randomized into a C1-C2 self-SNAG or placebo group. After an initial instruction and practice visit in the clinic, interventions consisted of exercises applied independently by the subject twice daily at home on a continual basis. FRT range was measured twice, before and immediately after the instruction and practice visit. Headache symptoms were determined by a headache index over time, assessed by questionnaire preintervention, at 4 weeks postintervention, and at 12 months postintervention.RESULTSNo differences were found in baseline measures between groups. Immediately after the initial instruction and practice visit performed with the supervision of the therapist, FRT range increased by 15 degrees (SD, 9) for the C1-C2 self-SNAG group (P < .001), which was significantly more than 5 degrees (SD, 5) for the placebo intervention (P < .001). There was also a significant interaction for the variable headache index between group and time (P < .001), indicating that group difference was dependent on time. There was no difference in headache index scores at baseline between groups. Headache index scores were substantially less in the C1-C2 self-SNAG group (mean +/- SD points at 4 weeks, 31 +/- 9; mean +/- SD points at 12 months, 24 +/- 9) compared to the placebo group (mean +/- SD points at 4 weeks, 51 +/- 15; mean +/- SD points at 12 months, 44 +/- 13) at 4 weeks (P < .001) and 12 months (P < .001), with an overall (+/-SD) reduction of 54% (+/-17%) for the individuals in the C1-C2 self-SNAG group.CONCLUSIONSThese results provide evidence for the efficacy of the C1-C2 self-SNAG technique in the management of individuals with cervicogenic headache.STUDY DESIGNRandomized, double-blind, placebo controlled trial.","Hall, T; Chan, H T; Christensen, L; Odenthal, B; Wells, C; Robinson, K",2007.0,10.2519/jospt.2007.2379,0,0,
5589,Adverse side effects of methylphenidate among mentally retarded children with ADHD,"ER The adverse side effects of methylphenidate were evaluated in 27 children with attention deficit hyperactivity disorder and IQs of 48 to 74 who participated in a double-blind study of two doses of methylphenidate and placebo. A checklist of 13 side effects, generated from the Physician's Desk Reference, was completed by teachers. Rates of irritability, anxiety, moodiness, and activity level decreased significantly when comparing the placebo with drug conditions. However, medication for six (22%) of the children was discontinued because of the appearance of motor tics (three children) and severe social withdrawal (two children), suggesting that mentally retarded children with attention deficit hyperactivity disorder may be at a greater risk for developing these side effects than the nonretarded population.","Handen, B L; Feldman, H; Gosling, A; Breaux, A M; McAuliffe, S",1991.0,10.1097/00004583-199103000-00012,0,0,
5590,"Detecting effects of the indicated prevention Programme for Externalizing Problem behaviour (PEP) on child symptoms, parenting, and parental quality of life in a randomized controlled trial","ER AIMSTo evaluate the effects of PEP on child problem behaviour, parenting practices, parent-child interactions, and parental quality of life.METHODParents and kindergarten teachers of 155 children were randomly assigned to an intervention group (n = 91) and a nontreated control group (n = 64). They rated children's problem behaviour before and after PEP training; parents also reported on their parenting practices and quality of life. Standardized play situations were video-taped and rated for parent-child interactions, e.g. parental warmth.RESULTSIn the intention to treat analysis, mothers of the intervention group described less disruptive child behaviour and better parenting strategies, and showed more parental warmth during a standardized parent-child interaction. Dosage analyses confirmed these results for parents who attended at least five training sessions. Children were also rated to show less behaviour problems by their kindergarten teachers.CONCLUSIONSTraining effects were especially positive for parents who attended at least half of the training sessions.ABBREVIATIONSCBCL: Child Behaviour Checklist; CII: Coder Impressions Inventory; DASS: Depression anxiety Stress Scale; HSQ: Home-situation Questionnaire; LSS: Life Satisfaction Scale; OBDT: observed behaviour during the test; PCL: Problem Checklist; PEP: prevention programme for externalizing problem behaviour; PPC: Parent Problem Checklist; PPS: Parent Practices Scale; PS: Parenting Scale; PSBC: Problem Setting and Behaviour checklist; QJPS: Questionnaire on Judging Parental Strains; SEFS: Self-Efficacy Scale; SSC: Social Support Scale; TRF: Caregiver-Teacher Report Form.BACKGROUNDBehavioural parent training is effective in improving child disruptive behavioural problems in preschool children by increasing parenting competence. The indicated Prevention Programme for Externalizing Problem behaviour (PEP) is a group training programme for parents and kindergarten teachers of children aged 3-6 years with externalizing behavioural problems.","Hanisch, C; Freund-Braier, I; Hautmann, C; Jänen, N; Plück, J; Brix, G; Eichelberger, I; Döpfner, M",2010.0,10.1017/S1352465809990440,0,0,
5591,"Neck exercises, physical and cognitive behavioural-graded activity as a treatment for adult whiplash patients with chronic neck pain: design of a randomised controlled trial","ER BACKGROUND: Many patients suffer from chronic neck pain following a whiplash injury. A combination of cognitive, behavioural therapy with physiotherapy interventions has been indicated to be effective in the management of patients with chronic whiplash-associated disorders. The objective is to present the design of a randomised controlled trial (RCT) aimed at evaluating the effectiveness of a combined individual physical and cognitive behavioural-graded activity program on self-reported general physical function, in addition to neck function, pain, disability and quality of life in patients with chronic neck pain following whiplash injury compared with a matched control group measured at baseline and 4 and 12 months after baseline.METHODS/DESIGN: The design is a two-centre, RCT-study with a parallel group design. Included are whiplash patients with chronic neck pain for more than 6 months, recruited from physiotherapy clinics and an out-patient hospital department in Denmark. Patients will be randomised to either a pain management (control) group or a combined pain management and training (intervention)group. The control group will receive four educational sessions on pain management, whereas the intervention group will receive the same educational sessions on pain management plus 8 individual training sessions for 4 months, including guidance in specific neck exercises and an aerobic training programme. Patients and physiotherapists are aware of the allocation and the treatment, while outcome assessors and data analysts are blinded. The primary outcome measures will be Medical Outcomes Study Short Form 36 (SF36), Physical Component Summary (PCS). Secondary outcomes will be Global Perceived Effect (-5 to +5), Neck Disability Index (0-50), Patient Specific Functioning Scale (0-10), numeric rating scale for pain bothersomeness (0-10), SF-36 Mental Component Summary (MCS), TAMPA scale of Kinesiophobia (17-68), Impact of Event Scale (0-45), EuroQol (0-1), craniocervical flexion test (22 mmHg - 30 mmHg), joint position error test and cervical range of movement. The SF36 scales are scored using norm-based methods with PCS and MCS having a mean score of 50 with a standard deviation of 10.DISCUSSION: The perspectives of this study are discussed, in addition to the strengths and weaknesses.TRIAL REGISTRATION: The study is registered in http://www.ClinicalTrials.gov identifier NCT01431261.","Hansen, I R; S√∏gaard, K; Christensen, R; Thomsen, B; Manniche, C; Juul-Kristensen, B",2011.0,10.1186/1471-2474-12-274,0,0,
5592,Tryptophan depletion decreases the recognition of fear in female volunteers,"ER OBJECTIVEThe present study investigated the effects of reducing serotonin function, using acute tryptophan depletion, on the recognition of basic facial expressions of emotions in healthy male and female volunteers.METHODSA double-blind between-groups design was used, with volunteers being randomly allocated to receive an amino acid drink specifically lacking tryptophan or a control mixture containing a balanced mixture of these amino acids. Participants were given a facial expression recognition task 5 h after drink administration. This task featured examples of six basic emotions (fear, anger, disgust, surprise, sadness and happiness) that had been morphed between each full emotion and neutral in 10% steps. As a control, volunteers were given a famous face classification task matched in terms of response selection and difficulty level.RESULTSTryptophan depletion significantly impaired the recognition of fearful facial expressions in female, but not male, volunteers. This was specific since recognition of other basic emotions was comparable in the two groups. There was also no effect of tryptophan depletion on the classification of famous faces or on subjective state ratings of mood or anxiety.CONCLUSIONSThese results confirm a role for serotonin in the processing of fear related cues, and in line with previous findings also suggest greater effects of tryptophan depletion in female volunteers. Although acute tryptophan depletion does not typically affect mood in healthy subjects, the present results suggest that subtle changes in the processing of emotional material may occur with this manipulation of serotonin function.RATIONALESerotonergic processes have been implicated in the modulation of fear conditioning in humans, postulated to occur at the level of the amygdala. The processing of other fear-relevant cues, such as facial expressions, has also been associated with amygdala function, but an effect of serotonin depletion on these processes has not been assessed.","Harmer, C J; Rogers, R D; Tunbridge, E; Cowen, P J; Goodwin, G M",2003.0,10.1007/s00213-003-1401-6,0,0,
5593,Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial,"ER METHODS306 women aged over 70, with cataract, were randomised to expedited (approximately 4 weeks) or routine (12 months wait) surgery. Falls were ascertained by diary, with follow up every 3 months. Health status was measured after 6 months.RESULTSVisual function improved in the operated group (corrected binocular acuity improved by 0.25 logMAR units; 8% had acuity worse than 6/12 compared with 37% of controls). Over 12 months of follow up, 76 (49%) operated participants fell at least once, and 28 (18%) fell more than once. 69 (45%) unoperated participants fell at least once, 38 (25%) fell more than once. Rate of falling was reduced by 34% in the operated group (rate ratio 0.66, 95% confidence interval 0.45 to 0.96, p = 0.03). Activity, anxiety, depression, confidence, visual disability, and handicap all improved in the operated group compared with the control group. Four participants in the operated group had fractures (3%), compared with 12 (8%) in the control group (p = 0.04).CONCLUSIONFirst eye cataract surgery reduces the rate of falling, and risk of fractures and improves visual function and general health status.BACKGROUND/AIMA third of elderly people fall each year. Poor vision is associated with increased risk of falls. The authors aimed to determine if first eye cataract surgery reduces the risk of falling, and to measure associated health gain.","Harwood, R H; Foss, A J; Osborn, F; Gregson, R M; Zaman, A; Masud, T",2005.0,10.1136/bjo.2004.049478,0,0,
5594,Te Ira Tangata: a Zelen randomised controlled trial of a treatment package including problem solving therapy compared to treatment as usual in Maori who present to hospital after self harm,"ER METHODSWe propose to use a double consent Zelen design where participants are randomised prior to giving consent to enrol a representative cohort of patients. The main outcome will be the number of Maori scoring below nine on the Beck Hopelessness Scale. Secondary outcomes will be hospital repetition at one year; self reported self harm; anxiety; depression; quality of life; social function; and hospital use at three months and one year.DISCUSSIONA strength of the study is that it is a pragmatic trial which aims to recruit Maori using a Maori clinical team and protocol. It does not exclude people if English is not their first language. A potential limitation is the analysis of the results which is complex and may underestimate any effect if a large number of people refuse their consent in the group randomised to problem solving therapy as they will effectively cross over to the treatment as usual group. This study is the first randomised control trial to explicitly use cultural assessment and management.TRIAL REGISTRATIONAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12609000952246.BACKGROUNDMaori, the indigenous people of New Zealand, who present to hospital after intentionally harming themselves, do so at a higher rate than non-Maori. There have been no previous treatment trials in Maori who self harm and previous reviews of interventions in other populations have been inconclusive as existing trials have been under powered and done on unrepresentative populations. These reviews have however indicated that problem solving therapy and sending regular postcards after the self harm attempt may be an effective treatment. There is also a small literature on sense of belonging in self harm and the importance of culture. This protocol describes a pragmatic trial of a package of measures which include problem solving therapy, postcards, patient support, cultural assessment, improved access to primary care and a risk management strategy in Maori who present to hospital after self harm using a novel design.","Hatcher, S; Coupe, N; Durie, M; Elder, H; Tapsell, R; Wikiriwhi, K; Parag, V",2011.0,10.1186/1745-6215-12-117,0,0,
5595,The ACCESS study a Zelen randomised controlled trial of a treatment package including problem solving therapy compared to treatment as usual in people who present to hospital after self-harm: study protocol for a randomised controlled trial,"ER METHODSWe propose to use a double consent Zelen design where participants are randomised prior to giving consent to enroll a large representative cohort of patients. The main outcome will be hospital attendance following repetition of self-harm, in the 12 months after recruitment with secondary outcomes of self reported self-harm, hopelessness, anxiety, depression, quality of life, social function and hospital use at three months and one year.DISCUSSIONA strength of the study is that it is a pragmatic trial which aims to recruit large numbers and does not exclude people if English is not their first language. A potential limitation is the analysis of the results which is complex and may underestimate any effect if a large number of people refuse their consent in the group randomised to problem solving therapy as they will effectively cross over to the treatment as usual group. However the primary analysis is a true intention to treat analysis of everyone randomised which includes both those who consent and do not consent to participate in the study. This provides information about how the intervention will work in practice in a representative population which is a major advance in this study compared to what has been done before.TRIAL REGISTRATIONAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12609000641291.BACKGROUNDPeople who present to hospital after intentionally harming themselves pose a common and important problem. Previous reviews of interventions have been inconclusive as existing trials have been under powered and done on unrepresentative populations. These reviews have however indicated that problem solving therapy and regular written communications after the self-harm attempt may be an effective treatment. This protocol describes a large pragmatic trial of a package of measures which include problem solving therapy, regular written communication, patient support, cultural assessment, improved access to primary care and a risk management strategy in people who present to hospital after self-harm using a novel design.","Hatcher, S; Sharon, C; House, A; Collings, S; Parag, V; Collins, N",2011.0,10.1186/1745-6215-12-135,0,0,
5596,What are the real problems for patients with functional dyspepsia?,"ER METHODOne hundred FD patients were assessed with regard to psychologic, medical, and social factors, before randomization, in a study of cognitive therapy. They were asked to list their main problem areas or 'target complaints'.RESULTSDyspepsia was the third most frequent target complaint (26 patients), and anxiety was the most frequent one (65 patients). Patients identifying dyspepsia as a target complaint differed from the other FD patients in several aspects. They had significantly more dyspeptic symptoms (p < 0.05) and scored significantly higher on multiple somatic complaints (p = 0.001), depression (p = 0.025), general psychopathology (p = 0.043), the global assessment scale (p = 0.001), and the General Health Questionnaire (p = 0.040). However, they did not have more somatic predisposing factors like consumption of alcohol and coffee or infection with Helicobacter pylori than the patients with other target complaints.CONCLUSIONSAnxiety and not dyspepsia was the most frequent target complaint, and patients who identified dyspepsia as a target complaint did not have more somatic predisposing factors.BACKGROUNDPatients with functional dyspepsia (FD) have more complaints than just the dyspepsia.","Haug, T T; Wilhelmsen, I; Ursin, H; Berstad, A",1995.0,,0,0,
5597,Combined enteral-parenteral nutrition versus total parenteral nutrition in brain-injured patients. A comparative study,"ER A comparative nutritional study in brain-injured patients (BIP) was performed to assess the influence of a combined enteral-parenteral nutrition (CN) and a total parenteral nutrition (TPN) on protein catabolism in the early posttraumatic period. 20 male BIP (Glasgow coma scale 5-7) were randomized to one of the two feeding regimes. Nutritional support was based on 150-175% basic energy expenditure. Amino acid intake was 1.4 g/kg/day in the TPN and 2.4 g/kg/day in the CN group. Negative nitrogen balance (NNB) averaged means = 11.3 g/m2/day (SEM = 3.06 g/m2/day) in the TPN group and means = 10.2 g/m2/day (SEM = 2.33 g/m2/day) in the CN group. Between both feeding regimes not statistically significant differences could be observed concerning mortality, N-balance, creatinine and 3-methylhistidine excretions. Protein concentration of the regurgitated gastric fluid was significantly higher in the CN than in the TPN study group. Data imply that both alimentary regimes are of similar value, but BIP with impaired gastric function, such as high tube reflux, are better treated by TPN.","Hausmann, D; Mosebach, K O; Caspari, R; Rommelsheim, K",1985.0,,0,0,
5598,Psychosocial mediators of a nurse intervention to increase skin self-examination in patients at high risk for melanoma,"ER This prospective study examines psychosocial mediators of an efficacious skin self-examination (SSE) intervention that includes provision of a whole-body digital photography book depicting the entire skin surface. Individuals (n = 100) with established risk factors for melanoma were recruited from the Memorial Sloan-Kettering Cancer Center Pigmented Lesion Clinic during their initial dermatologist visit and were randomized to receive a photobook immediately (n = 49) or 4 months after intervention delivery (n = 51). Potential mediators included self-efficacy and response efficacy drawn from Social Cognitive Theory, melanoma worry, and SSE anxiety drawn from Self-Regulation Theory, and skin cancer knowledge, and skin awareness. Only self-efficacy was a significant mediator, accounting for 8% of the total effect of photobook enhancement on SSE adherence at 4 months.","Hay, J L; Oliveria, S A; Dusza, S W; Phelan, D L; Ostroff, J S; Halpern, A C",2006.0,10.1158/1055-9965.EPI-04-0822,0,0,
5599,Posterior capsule opacification after implantation of a hydrogel intraocular lens,"ER METHODSNinety five patients underwent a hydrogel IOL implantation in one eye and an acrylic IOL implantation in the opposite eye. The PCO value of these patients was measured using the Scheimpflug videophotography system at 1, 6, 12, 18, and 24 months postoperatively. The rate of neodymium:YAG (Nd:YAG) laser posterior capsulotomy and visual acuity were also evaluated.RESULTSThe mean PCO value in the hydrogel group increased significantly (p<0.0001), while that in the acrylic group did not show significant change. The PCO value in the hydrogel group was significantly greater than that in the acrylic group throughout the follow up period. Kaplan-Meier survival analysis determined that the Nd:YAG capsulotomy rate in the hydrogel group was significantly higher than that in the acrylic group (p<0.0001). Mean visual acuity in the hydrogel group decreased significantly with time (p<0.0001), and became significantly worse than that in the acrylic group at 18 and 24 months postoperatively.CONCLUSIONPosterior capsule opacification in eyes with a hydrophilic hydrogel IOL is significantly more extensive than that in eyes with a hydrophobic acrylic IOL, and results in a significant impairment of visual acuity.AIMTo compare the degree of posterior capsule opacification (PCO) in eyes with a hydrophilic hydrogel intraocular lens (IOL) with that in eyes with a hydrophobic acrylic IOL.","Hayashi, K; Hayashi, H",2004.0,,0,0,
5600,Comparison of posterior capsule opacification between fellow eyes with two types of acrylic intraocular lens,"ER METHODSForty-five patients underwent bilateral phacoemulsification and implantation of an Alcon AcrySof IOL (MA60AC) in one eye and an AMO Sensar IOL (AR40e) in the fellow eye. The PCO density value was measured using the Scheimpflug videophotography system at 1, 6, 12, and 24 months after surgery. The incidence of eyes that required a neodymium:YAG (Nd:YAG) laser capsulotomy, visual acuity, and contrast sensitivity with and without a glare source were also examined.RESULTSThe mean PCO value did not show a significant increase in either the AcrySof MA60AC or Sensar AR40e IOL groups, and was similar between the two groups throughout the 24-month follow-up period. The incidence of Nd:YAG laser capsulotomy was also the same between the groups. No significant difference was found in mean visual acuity between the two IOL groups during the follow-up, and there was no significant difference in photopic or mesopic contrast visual acuity with and without a glare source at 1 and 24 months after surgery.CONCLUSIONThe degree of PCO in eyes with an AcrySof IOL are almost the same as that in eyes with a Sensar IOL, with the results that visual acuity and contrast sensitivity with and without glare are similar.PURPOSETo compare the degree of posterior capsule opacification (PCO) and visual function between fellow eyes that received two different types of hydrophobic acrylic intraocular lenses (IOLs).","Hayashi, K; Yoshida, M; Hayashi, H",2008.0,10.1038/sj.eye.6702496,0,0,
5601,Prenatal depression: a randomized controlled trial in the emotional health of primiparous women,"ER The prevalence of postnatal depression (10%-15%) renders it a major public health problem not only for the depressed mother but also for the infant, who may suffer from behavioral disturbances and cognitive delays in later years. This study aimed at evaluating an educational intervention to alleviate postnatal depression and at generally measuring the prenatal and postnatal mood of primiparous women. A prospective, randomized controlled trial of an education intervention to reduce postnatal depression was conducted at three sites in Australia enrolling a total of 184 primiparous women. The intervention consisted of an information booklet on postnatal depression and an audiotape of one woman's journey through clinical postnatal depression. Mood was assessed once prenatally (12-28 weeks) and twice postnatally (8-12 weeks and 16-24 weeks) using the Scale for Assessment of Depression and Schizophrenia modified for pregnant and postnatal women (SADS-M). Demographic and social support data were also collected at enrollment. Comparisons between the control group and the intervention group revealed no differences; the educational intervention did not show any effect when women's mood was measured by the SADS-M. Overall, a general, significant, steady decrease of depressive tendencies was observed when the two postnatal assessments were compared to the prenatal measurements. Women were less depressed postnatally than prenatally. This overall improvement of mood was significant in most SADS-M items. The exceptions were discouragement, anxiety, anger, and irritability, which did not reach significance. Additional multivariate analyses revealed no relevant influence of social support or demographic variables on the changes in mood. The main results that the education intervention had no effect and women, overall, were more depressed prenatally than postnatally contributes further evidence to the view that the prenatal period is a separate entity from the postnatal period, with distinctive psychoneuro-endocrine pathways and, thus, suggesting different profiles of women's experience. This evidence indicates the necessity to screen, refer, and manage prenatal maternal mood as an entity in its own right, rather than as a window on the postnatal period.","Hayes, B A; Muller, R",2004.0,,0,0,
5602,Generalization of treatment effects in training public speakers,,"Hayes, B J; Marshall, W L",1984.0,,0,0,
5603,Pain and quality of life following radical retropubic prostatectomy,"ER MATERIALS AND METHODSA total of 110 patients undergoing radical retropubic prostatectomy were randomly assigned to receive epidural and/or general anesthesia. Patients responded to a questionnaire mailed 3 and 6 months following surgery that assessed prostate symptoms, pain related to surgery, quality of life and mood.RESULTSNo long-term effects of anesthesia were observed. Of the 103 respondents (94%) at 3 months 49% had some pain related to surgery. Although pain was not related to anesthesic technique, patients who had it at 3 months used significantly more pain medication on postoperative day 3. Pain at 3 months was mild, averaging 1.5 on a scale of 0 to 10, and associated with poor perceptions of overall health (p <0.02), and reduced physical (p <0.01) and social (p <0.01) functioning. Pain at 3 months was associated with higher levels of preoperative anxiety (p <0.05). At 6 months 36 of 90 patients (35%) had some pain related to surgery and the impact was similar.CONCLUSIONSLong-term effects of intraoperative anesthesic technique were not apparent. Mild pain following radical retropubic prostatectomy was common and associated with reduced quality of life, particularly social functioning. Affective distress, particularly anxiety, before surgery and use of pain medications following surgery may be predictors of chronic pain following radical retropubic prostatectomy.PURPOSEWe assess pain and quality of life following radical retropubic prostatectomy and determine whether intraoperative anesthetic management has any long-term effects on outcomes.","Haythornthwaite, J A; Raja, S N; Fisher, B; Frank, S M; Brendler, C B; Shir, Y",1998.0,,0,0,
5604,Efficacy of a psychoeducative group program for caregivers of demented persons living at home: a randomized controlled trial,"ER METHODSThe study was a multicenter randomized controlled trial. Randomization was stratified according to sex and kinship. Participants randomized to the control group were referred to the traditional support groups. Participants in the study group had fifteen 2-hr weekly sessions focusing on stress appraisal and coping. Eligible participants (primary caregivers of community-dwelling persons with dementia) were blindly assessed before the randomization and after 16 weeks on the following measures: frequency and reactions to behavioral problems (primary outcome), burden, psychological distress, anxiety, perceived social support, and personal efficacy.RESULTSA total of 158 participants were randomized to the study (n = 79) and control (n = 79) groups in 12 successive waves. Results show that study participants presented a 14% decrease in their reactions to the behavioral problems of the care-receivers as opposed to a 5% decrease in the control group ( p =.04). The frequency of behavior problems also decreased ( p =.06), as did the cross-product frequency/reaction ( p =.02). There was no significant effect on the secondary outcome variables.DISCUSSIONThis is one of the first studies showing a significant effect of this type of support group program on the caregivers of participants with dementia.OBJECTIVESTo test the efficacy of a psychoeducative group program for informal caregivers of persons with dementia.","Hébert, R; Lévesque, L; Vézina, J; Lavoie, J P; Ducharme, F; Gendron, C; Préville, M; Voyer, L; Dubois, M F",2003.0,,0,0,
5605,"A randomized clinical trial of two telephone-delivered, mental health interventions for HIV-infected persons in rural areas of the United States","ER Through December 2003, more than 55,300 persons were living in small towns and rural areas of the United States at the time of their AIDS diagnosis. Many HIV-infected rural persons experience elevated levels of depression, suicidal ideation, and anxiety. This research tested if two telephone-delivered, mental health interventions could facilitate the adjustment efforts of persons living with HIV/AIDS in rural areas of the United States. Participants (N=299) were recruited through AIDS service organizations in 13 states and assigned to a Usual Care Condition (n=107), an 8-session Information Support Group Intervention (n=84), or an 8-session Coping Improvement Group Intervention (n=108). Participants completed self-administered surveys at pre-intervention, post-intervention, and 4- and 8-month follow-ups. ANCOVA revealed that no treatment condition produced reductions in the main outcome measures of depressive and psychological symptoms; however, Information Support participants received significantly more support from friends at 4- and 8-month follow-ups and reported fewer barriers to health care and social services at 4-month follow-up compared to participants in the other two conditions. Telephone-delivered, information-support groups have potential to increase perceptions of support and reduce barriers to health care and social services in this population, but the practical significance of these intervention-related changes is limited.","Heckman, T G; Carlson, B",2007.0,10.1007/s10461-006-9111-9,0,0,
5606,Mechanisms of action of plant sterols on inhibition of cholesterol absorption. Comparison of sitosterol and sitostanol,"ER The effects of two different plant sterols on intestinal cholesterol absorption were compared in normal volunteers by an intestinal perfusion study during a control period followed by high dose infusion of sitosterol or sitostanol (3.6 mumol/min), to which subjects were allocated in a randomized manner. Cholesterol absorption during the control period was similar in the two groups, averaging 0.88 +/- 0.48 mumol/min (32 +/- 11%) for group I (sitosterol) and 0.68 +/- 0.33 mumol/min (29 +/- 9%) for group II (sitostanol). The infusion of a high dose of sitosterol resulted in a significant reduction of cholesterol absorption to 0.47 mumol/min (16%). Following the same dose of sitostanol, cholesterol absorption diminished significantly to 0.15 +/- 0.11 mumol/min (5.1 +/- 2.9%). Overall cholesterol absorption declined during sitosterol infusion by almost 50%, whereas sitostanol infusion caused a reduction of cholesterol absorption by almost 85%. These findings of a more effective inhibition of cholesterol absorption by sitostanol might confirm the observation recorded by others that an increase in hydrophobicity of a plant sterol results in a higher affinity but lower capacity to mixed micells. This may cause an effective displacement of cholesterol from micellar binding and therefore diminished cholesterol absorption.","Heinemann, T; Kullak-Ublick, G A; Pietruck, B; Bergmann, K",1991.0,,0,0,
5607,"German adaptation of the Resources for Enhancing Alzheimer's Caregiver Health II: study protocol of a single-centred, randomised controlled trial","ER BACKGROUND: Caring for a family member with dementia is extremely stressful, and contributes to psychiatric and physical illness among caregivers. Therefore, a comprehensive programme called Resources for Enhancing Alzheimer's Caregiver Health II (REACH II) was developed in the United States to enhance the health of Alzheimer's caregivers. REACH II causes a clear reduction of the stress and burdens faced by informal caregivers at home. The aim of this protocol is to adapt, apply, and evaluate this proven intervention programme in a German-speaking area for the first time. This newly adapted intervention is called Deutsche Adaption der Resources for Enhancing Alzheimer's Caregiver Health (DeREACH).METHODS: A total of 138 informal caregivers at home are recruited in a single-centred, randomised controlled trial. The intervention (DeREACH) consists of nine home visits and three telephone contacts over six months, all of which focus on safety, psychological well-being and self-care, social support, problem behaviour and preventive health-related behaviours. A complex intervention assessment on effectiveness will be adopted when the primary outcome - namely, the reduction of caregiver burden - and other secondary outcomes, including changes with regard to anxiety and depression, somatisation, health-related quality of life, and perceived social support, are measured at baseline, as well as immediately and three months after the intervention. The change from baseline to post-intervention assessment with regard to the primary outcome will be compared between treatment and control group using t-tests for independent samples.DISCUSSION: It is anticipated that this study will show that DeREACH effectively reduces caregiver burden and therefore works under the conditions of a local German health-care system. If successful, this programme will provide an effective intervention programme in the German-speaking area to identify and develop the personal capabilities of informal caregivers to cope with the burdens of caring for people with dementia.","Heinrich, S; Berwig, M; Simon, A; Jänichen, J; Hallensleben, N; Nickel, W; Hinz, A; Brähler, E; Gertz, H J",2014.0,10.1186/1471-2318-14-21,0,0,
5608,Effects of suckling on hypothalamic-pituitary-adrenal axis responses to psychosocial stress in postpartum lactating women,"ER In several studies lactation has been shown to be associated with a hypothalamic-pituitary-adrenal axis hyporesponsiveness to physical and psychological stressors. As it is not known whether the marked blunting of endocrine stress reactivity in women can be ascribed to suckling as a short-term effect or to lactation in general, the acute effects of suckling on the hypothalamic-pituitary-adrenal axis and the sympathetic-adrenal-medullary system responses to mental stress were investigated in lactating women. Forty-three lactating women were randomly assigned either to breast-feed or to hold their infants for a 15-min period with the onset 30 min before they were exposed to a brief psychosocial stressor (Trier Social Stress Test). Both breast-feeding and holding the infant yielded significant decreases in ACTH, total plasma cortisol, and salivary free cortisol (all P < 0.01). There were no significant differences in baseline hormone levels between the groups 1 min before the stress test. In response to stress exposure, ACTH, total plasma cortisol, salivary free cortisol, norepinephrine, and epinephrine were significantly increased in all lactating women (all P < 0.001). However, total cortisol and free cortisol responses to stress were attenuated in breast-feeding women (P = 0.001 and P = 0.067, respectively), who also showed significantly decreasing PRL levels during the stress test (P = 0.005). In addition, there was no change in plasma oxytocin or vasopressin in response to the stressor. Breast-feeding as well as holding led to decreased anxiety (P < 0.05), whereas, in contrast, stress exposure worsened mood, calmness, and anxiety in the total group (all P < 0.001). From these data we conclude that lactation in women, in contrast to that in rats, does not result in a general restraint of the hypothalamic-pituitary-adrenal axis response to a psychosocial stressor. Rather, suckling is suggested to exert a short-term suppression of the cortisol response to mental stress.","Heinrichs, M; Meinlschmidt, G; Neumann, I; Wagner, S; Kirschbaum, C; Ehlert, U; Hellhammer, D H",2001.0,10.1210/jcem.86.10.7919,0,0,
5609,Sepulveda Epilepsy Education: the efficacy of a psychoeducational treatment program in treating medical and psychosocial aspects of epilepsy,"ER The present study evaluated the efficacy of the Sepulveda Epilepsy Education program (SEE), using a controlled outcome design. SEE is a 2-day psychoeducational treatment program designed to provide medical education and psychosocial therapy. Thirty-eight outpatients, matched according to seizure type and frequency, were randomly assigned to treatment (n = 20) or waiting-list control (n = 18) groups. The major outcome measures used were a 50-item true-false test specifically designed to evaluate the SEE program, the Washington Psychosocial Seizure Inventory, the Beck Depression Inventory, Lubin's Depression Adjective Checklist, the State-Trait Anxiety Inventory, the Acceptance of Disability Scale, and Sherer's Self-Efficacy Scale. Significant differences between the two groups were found on the three major subscales of the 50-item true-false test. The treatment group demonstrated a significant increase in overall understanding of epilepsy, a significant decrease in fear of seizures, and a significant decrease in hazardous medical self-management practices. In addition, an objective measure of blood levels of antiepileptic drugs (AEDs) showed the treatment group to have a significant increase in medication compliance.","Helgeson, D C; Mittan, R; Tan, S Y; Chayasirisobhon, S",1990.0,,0,0,
5610,Individual psychological support for cancer patients: utilisation and patient satisfaction,"ER A short-term, problem-focused Individual Psychological Support (IPS) intervention was evaluated. The IPS was one of the interventions in a study where 527 patients newly diagnosed with breast, colorectal, gastric or prostate cancer were randomised between IPS (n = 265) and a control condition (n = 262). The IPS made use of cognitive-behavioural techniques and aimed at reducing depression and anxiety, to increase the feeling of mastery of the situation and to facilitate active participation in medical treatments. Half of the patients receiving the IPS had more than 2 sessions. After termination of the IPS, the patients were mailed a questionnaire concerning satisfaction with and perceived benefit from the IPS. A majority of the responding patients stated that their problems were addressed to a great extent, that the number of contacts was adequate and that the IPS came at the right time. Patients reporting problems received more sessions and perceived more benefits than patients reporting no problems.","Hellbom, M; Brandberg, Y; Glimelius, B; Sjödén, P O",1998.0,,0,0,
5611,"Psychological distress in women with uterovaginal agenesis (Mayer-Rokitansky-Kuster-Hauser Syndrome, MRKH)","ER OBJECTIVEThe authors investigated the psychological impact of this disorder, about which very little is known.METHODA group of 66 women with MRKH were compared with 31 control-group women on a range of self-rating scales assessing psychological distress and self-esteem.RESULTSWomen with MRKH had significantly more pathological scores on some of the scales and subscales, such as phobic anxiety and psychoticism (interpersonal alienation), with a similar trend for subscales measuring depression and anxiety.CONCLUSIONMRKH has a lasting negative impact on affected women's level of psychological distress and self-esteem.BACKGROUNDUterovaginal agenesis (Mayer-Rokitansky-Küster-Hauser Syndrome; MRKH) is a congenital nonformation of the vagina and the uterus, but with normal ovaries.","Heller-Boersma, J G; Schmidt, U H; Edmonds, D K",2009.0,10.1176/appi.psy.50.3.277,0,0,
5612,Effects of soy lecithin phosphatidic acid and phosphatidylserine complex (PAS) on the endocrine and psychological responses to mental stress,"ER Phosphatidylserine, derived from cow brains, has been shown previously to dampen the ACTH and cortisol response to physical stress. Further research investigated the influence of soy lecithin phosphatidylserine supplementation on mood and heart rate when faced with an acute stressor. In this study, we investigated the effects of soy lecithin phosphatidic acid and phosphatidylserine complex (PAS) supplementation on pituitary adrenal reactivity (ACTH, cortisol) and on the psychological response (Spielberger State Anxiety Inventory stress subscale) to a mental and emotional stressor. Four groups of 20 subjects were treated for three weeks with daily dosages of either 400 mg PAS, 600 mg PAS, 800 mg PAS, or placebo before exposure to the Trier Social Stress Test (TSST). Treatment with 400 mg PAS resulted in a pronounced blunting of both serum ACTH and cortisol, and salivary cortisol responses to the TSST, but did not affect heart rate. The effect was not seen with larger doses of PAS. With regard to the psychological response, 400 mg PAS seemed to exert a specific positive effect on emotional responses to the TSST. While the placebo group showed the expected increase in distress after the test, the group treated with 400 mg PAS showed decreased distress. These data provide initial evidence for a selective stress dampening effect of PAS on the pituitary-adrenal axis, suggesting the potential of PAS in the treatment of stress related disorders.","Hellhammer, J; Fries, E; Buss, C; Engert, V; Tuch, A; Rutenberg, D; Hellhammer, D",2004.0,10.1080/10253890410001728379,0,0,
5613,"Effects of a homeopathic combination remedy on the acute stress response, well-being, and sleep: a double-blind, randomized clinical trial","ER OBJECTIVES: Stress impacts on health, causing stress-related illness. The aim of this study was to investigate stress dampening effects of the homeopathic combination remedy dysto-loges(®) S on physiological and psychological measures during acute stress. Additionally, effects of the substance on sleep and life quality were investigated.DESIGN: This randomized, double-blind, placebo-controlled single center study had a total duration of 15 days for each participant.SETTING/LOCATION: The study was performed by Daacro, Trier, Germany.SUBJECTS: We included 40 women aged 30-50 years that regularly experienced impaired well-being when feeling stressed.INTERVENTION: Participants took three tablets daily for 14 days. On the final study day, participants took three pills in the morning and upon arrival at the study site. Thereafter, the Trier Social Stress Test (TSST) was performed.OUTCOME MEASURES: Primary endpoints were saliva cortisol responses to the stress test. Secondary biological endpoints were plasma cortisol, adrenocorticotrophic hormone, epinephrine, and norepinephrine (NE) and heart rates. Psychological secondary endpoints were well-being, anxiety, stress, and insecurity during the stress test as well as sleep and quality of life.RESULTS: Stress-induced cortisol levels did not differ between groups, but verum-treated participants were characterized by lower NE levels. Two weeks of treatment with the homeopathic substance resulted in a better sleep quality. Sleep improvement was associated with a higher hormonal response to the TSST in both groups. In addition, individuals with impaired sleep in the placebo group had higher unstimulated NE levels.CONCLUSIONS: This study provides preliminary evidence for beneficial effects of dysto-loges S on sleep quality. Improvement of sleep quality was positively associated with a normalized neuroendocrine stress response during acute stress, whereas an altered hormonal response was observed in participants with impaired sleep. We hypothesize that the test product may possibly reduce NE release.","Hellhammer, J; Schubert, M",2013.0,10.1089/acm.2010.0636,0,0,
5614,Prognostic factors for perceived recovery or functional improvement in non-specific low back pain: secondary analyses of three randomized clinical trials,"ER The objective of this study was to report on secondary analyses of a merged trial dataset aimed at exploring the potential importance of patient factors associated with clinically relevant improvements in non-acute, non-specific low back pain (LBP). From 273 predominantly male army workers (mean age 39 +/- 10.5 years, range 20-56 years, 4 women) with LBP who were recruited in three randomized clinical trials, baseline individual patient factors, pain-related factors, work-related psychosocial factors, and psychological factors were evaluated as potential prognostic variables in a short-term (post-treatment) and a long-term logistic regression model (6 months after treatment). We found one dominant prognostic factor for improvement directly after treatment as well as 6 months later: baseline functional disability, expressed in Roland-Morris Disability Questionnaire scores. Baseline fear of movement, expressed in Tampa Scale for Kinesiophobia scores, had also significant prognostic value for long-term improvement. Less strongly associated with the outcome, but also included in our final models, were supervisor social support and duration of complaints (short-term model), and co-worker social support and pain radiation (long-term model). Information about initial levels of functional disability and fear-avoidance behaviour can be of value in the treatment of patient populations with characteristics comparable to the current army study population (e.g., predominantly male, physically active, working, moderate but chronic back problems). Individuals at risk for poor long-term LBP recovery, i.e., individuals with high initial level of disability and prominent fear-avoidance behaviour, can be distinguished that may need additional cognitive-behavioural treatment.","Helmhout, P H; Staal, J B; Heymans, M W; Harts, C C; Hendriks, E J; Bie, R A",2010.0,10.1007/s00586-009-1254-8,0,0,
5615,Determinants of pain and functioning in knee osteoarthritis: a one-year prospective study,"ER DESIGN: A one-year prospective analysis of determinants of pain and functioning in knee osteoarthritis.STUDY SETTING: Primary care providers in a medium-sized city.PATIENTS: A total of 111 patients aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2-4) of knee osteoarthritis who participated in a randomized controlled trial.MAIN MEASURES: The outcome measures were self-reported pain and function, which were recorded at 0, 3 and 12 months. Disease-specific pain and functioning were assessed using the pain and function subscales of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. Generic physical and mental functioning were assessed using the RAND-36 subscales for function, and physical and mental component summary scores. Possible baseline predictors for these outcomes were 1) demographic, socioeconomic and disease-related variables, and 2) psychological measures of resources, distress, fear of movement and catastrophizing.RESULTS: Multivariate linear mixed model analyses revealed that normal mood at baseline measured with the Beck Anxiety Inventory predicted significantly better results in all measures of pain (WOMAC P=0.02) and function (WOMAC P=0.002, RAND-36 P=0.002) during the one-year follow-up. Psychological resource factors (pain self-efficacy P=0.012, satisfaction with life P=0.002) predicted better function (RAND-36). Pain catastrophizing predicted higher WOMAC pain levels (P=0.013), whereas fear of movement (kinesiophobia) predicted poorer functioning (WOMAC P=0.046, RAND-36 P=0.024).CONCLUSIONS: Multiple psychological factors in people with knee osteoarthritis pain are associated with the development of disability and longer term worse pain.OBJECTIVE: To identify predictors of pain and disability in knee osteoarthritis.","Helminen, E E; Sinikallio, S H; Valjakka, A L; Väisänen-Rouvali, R H; Arokoski, J P",2016.0,10.1177/0269215515619660,0,0,
5616,"The good, the bad, and the healthy: impacts of emotional disclosure of trauma on resilient self-concept and psychological distress","ER This study examined the impact of disclosing traumas on resilient self-perceptions and psychological distress. Participants (N = 50) wrote about a traumatic life event or their plans for the next day and completed measures of resilience and distress before disclosing (pretest) and 3 months later (posttest). Results revealed that trauma participants increased in positive self-perceptions (mastery, personal growth, self-acceptance) and decreased in distress (depression, interpersonal sensitivity, anxiety, somatization) from pretest to posttest. Control participants showed no changes except for autonomy, on which they decreased. Results suggest that in addition to reducing psychological distress, disclosing traumas change self-perception, resulting in a more resilient self-concept.","Hemenover, S H",2003.0,10.1177/0146167203255228,0,0,
5617,The effects of mindfulness-based stress reduction on psychosocial outcomes and quality of life in early-stage breast cancer patients: a randomized trial,"ER The aim of this study was determine the effectiveness of a mindfulness-based stress-reduction (MBSR) program on quality of life (QOL) and psychosocial outcomes in women with early-stage breast cancer, using a three-arm randomized controlled clinical trial (RCT). This RCT consisting of 172 women, aged 20-65 with stage I or II breast cancer consisted of the 8-week MBSR, which was compared to a nutrition education program (NEP) and usual supportive care (UC). Follow-up was performed at three post-intervention points: 4 months, 1, and 2 years. Standardized, validated self-administered questionnaires were adopted to assess psychosocial variables. Statistical analysis included descriptive and regression analyses incorporating both intention-to-treat and post hoc multivariable approaches of the 163 women with complete data at baseline, those who were randomized to MBSR experienced a significant improvement in the primary measures of QOL and coping outcomes compared to the NEP, UC, or both, including the spirituality subscale of the FACT-B as well as dealing with illness scale increases in active behavioral coping and active cognitive coping. Secondary outcome improvements resulting in significant between-group contrasts favoring the MBSR group at 4 months included meaningfulness, depression, paranoid ideation, hostility, anxiety, unhappiness, and emotional control. Results tended to decline at 12 months and even more at 24 months, though at all times, they were as robust in women with lower expectation of effect as in those with higher expectation. The MBSR intervention appears to benefit psychosocial adjustment in cancer patients, over and above the effects of usual care or a credible control condition. The universality of effects across levels of expectation indicates a potential to utilize this stress reduction approach as complementary therapy in oncologic practice.","Henderson, V P; Clemow, L; Massion, A O; Hurley, T G; Druker, S; Hébert, J R",2012.0,10.1007/s10549-011-1738-1,0,0,
5618,Effectiveness of teacher modeling to encourage food acceptance in preschool children,"ER Although Social Cognitive Theory (Bandura, 1997) suggests that teacher modeling would be one of the most effective methods to encourage food acceptance by preschool children, opinions of experienced teachers have not yet been sampled, teacher modeling has rarely been examined experimentally, and it has produced inconsistent results. The present study considers opinions of teachers and conditions under which teacher modeling is effective. Study 1 was a questionnaire in which preschool teachers (N=58) were found to rate modeling as the most effective of five teacher actions to encourage children's food acceptance. Study 2 and Study 3 were quasi-experiments that found silent teacher modeling ineffective to encourage either familiar food acceptance (N=34; 18 boys, 16 girls) or new food acceptance (N=23; 13 boys, 10 girls). Children's new food acceptance was greatest in the first meal and then rapidly dropped, suggesting a ""novelty response"" rather than the expected neophobia. No gender differences were found in response to silent teacher modeling. Study 4 was a repeated-measures quasi-experiment that found enthusiastic teacher modeling (""Mmm! I love mangos!"") could maintain new food acceptance across five meals, again with no gender differences in response to teacher modeling (N=26; 12 boys, 14 girls). Study 5 found that with the addition of a competing peer model, however, even enthusiastic teacher modeling was no longer effective to encourage new food acceptance and gender differences appeared, with girls more responsive to the peer model (N=14; 6 boys, 8 girls). Thus, to encourage children's new food acceptance, present results suggest that teachers provide enthusiastic modeling rather than silent modeling, apply such enthusiastic modeling during the first five meals before children's ""novelty response"" to new foods drops, and avoid placing competing peer models at the same table with picky eaters, especially girls.","Hendy, H M; Raudenbush, B",2000.0,10.1006/appe.1999.0286,0,0,
5619,Evaluating the validity of computerized content analysis programs for identification of emotional expression in cancer narratives,"ER Psychological interventions provide linguistic data that are particularly useful for testing mechanisms of action and improving intervention methodologies. For this study, emotional expression in an Internet-based intervention for women with breast cancer (n = 63) was analyzed via rater coding and 2 computerized coding methods (Linguistic Inquiry and Word Count [LIWC] and Psychiatric Content Analysis and Diagnosis [PCAD]). Although the computerized coding methods captured most of the emotion identified by raters (LIWC sensitivity = .88; PCAD sensitivity = .83), both over-identified emotional expression (LIWC positive predictive value = .31; PCAD positive predictive value = .19). Correlational analyses suggested better convergent and discriminant validity for LIWC. The results highlight previously unrecognized deficiencies in commonly used computerized content-analysis programs and suggest potential modifications to both programs that could improve overall accuracy of automated identification of emotional expression. Although the authors recognize these limitations, they conclude that LIWC is superior to PCAD for rapid identification of emotional expression in text. (PsycINFO Database Record (c) 2009 APA, all rights reserved).","Bantum, E O; Owen, J E",2009.0,10.1037/a0014643,0,0,
5620,"Fish oil supplementation reduces cortisol basal levels and perceived stress: a randomized, placebo-controlled trial in abstinent alcoholics","ER Behavioral distress and dysfunctions of hypothalamic-pituitary-adrenocortical (HPA) axis play a central role in alcohol abuse. Omega-3 fatty acids are proposed as having antistress, regulatory effects on HPA responsiveness, but a possible protective role in ethanol addiction is unexplored.A randomized, doubleblind, placebo-controlled trial was performed in male alcoholics undergoing residential rehabilitation program, to evaluate the effects of 3-week supplementation with fish-oil providing eicosapentaenoic (60 mg/day) and docosahexaenoic acid (252 mg/day) on perceived stress/anxiety and HPA activity, assessed by measuring saliva basal cortisol levels at various daytimes (0730 h, 1130 h, 1600 h, 2000 h, and 2400 h) and the acute cortisol response to Trier Social Stress Test.Results showed that in supplemented subjects, before versus after decrease of stress/anxiety ratings was accompanied by reduction of cortisol basal levels throughout the day; no changes were observed in placebo group. At the end of intervention, amplitude, and duration of stress-evoked cortisol response did not differ between groups; however, the peak of cortisol response was temporally anticipated in supplemented subjects. In conclusion, an elevated omega-3 intake may reduce distress symptoms and basal cortisol secretion in abstinent alcoholics, thus providing a valid subsidiary measure to increase the efficacy of rehabilitation programs in ethanol addicts.","Barbadoro, P; Annino, I; Ponzio, E; Romanelli, R M; D'Errico, M M; Prospero, E; Minelli, A",2013.0,10.1002/mnfr.201200676,0,0,
5621,Educational level and the quality of life of heart failure patients: a longitudinal study,"ER METHODS AND RESULTSThis research is a substudy of the Coordinating study evaluating Outcomes of Advising and Counselling in Heart failure (COACH). QoL of 553 HF patients (mean age 69, 38% female, mean left ventricular ejection fraction 33%) was assessed during their hospitalization and at 4 follow-up measurements after discharge. In total 32% of the patients had very low, 24% low, 32% medium, and 12% high education. Patients with low educational levels reported the worst QoL. Significant differences between educational groups (P < .05) were only reported in physical functioning, social functioning, energy/fatigue, pain, and limitations in role functioning related to emotional problems. Longitudinal results show that a significantly higher proportion of high-educated patients improved in functional limitations related to emotional problems over time compared with lower-educated patients (P < .05).CONCLUSIONSPatients with low educational levels reported the worst physical and functional condition. High-educated patients improved more than the other patients in functional limitations related to emotional problems over time. Low-educated patients may require different levels of intervention to improve their physical and functional condition.BACKGROUNDLower education in heart failure (HF) patients is associated with high levels of anxiety, limited physical functioning, and an increased risk of hospitalization. We examined whether educational level is related to longitudinal differences in quality of life (QoL) in HF patients.","Barbareschi, G; Sanderman, R; Leegte, I L; Veldhuisen, D J; Jaarsma, T",2011.0,10.1016/j.cardfail.2010.08.005,0,0,
5622,The effectiveness of the Training and Support Program for parents of children with disabilities: a randomized controlled trial,"ER METHODSParents were trained in massage by suitably qualified therapists in eight weekly sessions, each lasting 1 h. The sample comprised 188 parents who were randomized to an intervention group (n=95), who attended the TSP with their children immediately, or a control group (n=93), who were offered the TSP after 4 months of follow-up. Data were collected by self-administered questionnaires at baseline and at 4-month follow-up.RESULTSThe majority of participants were mothers (88%), with a partner (88%), and White European (82%); 40% worked full-time or part-time, and 34% had health problems (e.g., chronic fatigue, cancer, and arthritis). The TSP demonstrated statistically significant positive effects on parental self-efficacy (PSE) for managing children's psychosocial well-being and depressed mood (0.004 and 0.007). There were trends toward improvement on parental satisfaction with life (P=.053), global health (P=.065), and parental ratings of children's sleeping (P=.074) and mobility (P=.012). Effect sizes were small (0.11-0.23). Levels of anxiety, depression, and perceived stress were all higher than published norms.CONCLUSIONThe TSP is an effective means of improving PSE and depressed mood. Additional means of supporting parents need to be investigated.OBJECTIVEThe Training and Support Program (TSP) was designed to equip parents of children with disabilities with a simple massage skill for use with their children in the home environment. The effectiveness of the TSP was examined in a randomized controlled trial with a wait-list control group.","Barlow, J H; Powell, L A; Gilchrist, M; Fotiadou, M",2008.0,10.1016/j.jpsychores.2007.06.006,0,0,
5623,Are pain-related fears mediators for reducing disability and pain in patients with complex regional pain syndrome type 1? An explorative analysis on pain exposure physical therapy,"ER OBJECTIVE: To investigate whether pain-related fears are mediators for reducing disability and pain in patients with Complex Regional Pain Syndrome type 1 when treating with Pain Exposure Physical Therapy.DESIGN: An explorative secondary analysis of a randomised controlled trial.PARTICIPANTS: Fifty-six patients with Complex Regional Pain Syndrome type 1.INTERVENTIONS: The experimental group received Pain Exposure Physical Therapy in a maximum of five treatment sessions; the control group received conventional treatment following the Dutch multidisciplinary guideline.OUTCOME MEASURES: Levels of disability, pain, and pain-related fears (fear-avoidance beliefs, pain catastrophizing, and kinesiophobia) were measured at baseline and after 3, 6, and 9 months follow-up.RESULTS: The experimental group had a significantly larger decrease in disability of 7.77 points (95% CI 1.09 to 14.45) and in pain of 1.83 points (95% CI 0.44 to 3.23) over nine months than the control group. The potential mediators pain-related fears decreased significantly in both groups, but there were no significant differences between groups, which indicated that there was no mediation.CONCLUSION: The reduction of pain-related fears was comparable in both groups. We found no indication that pain-related fears mediate the larger reduction of disability and pain in patients with Complex Regional Pain Syndrome type 1 treated with Pain Exposure Physical Therapy compared to conventional treatment.TRIAL REGISTRATION: International Clinical Trials Registry NCT00817128.","Barnhoorn, K J; Staal, J B; Dongen, R T; Frölke, J P; Klomp, F P; Meent, H; Samwel, H; Nijhuis-van der, Sanden M W",2014.0,10.1371/journal.pone.0123008,0,0,
5624,Music therapy CD creation for initial pediatric radiation therapy: a mixed methods analysis,"ER A mixed methods research design was used to investigate the effects of a music therapy CD (MTCD) creation intervention on pediatric oncology patients' distress and coping during their first radiation therapy treatment. The music therapy method involved children creating a music CD using interactive computer-based music software, which was ""remixed"" by the music therapist-researcher to extend the musical material. Eleven pediatric radiation therapy outpatients aged 6 to 13 years were randomly assigned to either an experimental group, in which they could create a music CD prior to their initial treatment to listen to during radiation therapy, or to a standard care group. Quantitative and qualitative analyses generated multiple perceptions from the pediatric patients, parents, radiation therapy staff, and music therapist-researcher. Ratings of distress during initial radiation therapy treatment were low for all children. The comparison between the two groups found that 67% of the children in the standard care group used social withdrawal as a coping strategy, compared to 0% of the children in the music therapy group; this trend approached significance (p = 0.076). MTCD creation was a fun, engaging, and developmentally appropriate intervention for pediatric patients, which offered a positive experience and aided their use of effective coping strategies to meet the demands of their initial radiation therapy treatment.","Barry, P; O'Callaghan, C; Wheeler, G; Grocke, D",2010.0,,0,0,
5625,A randomized trial of three psychosocial treatments for the symptoms of rheumatoid arthritis,"ER METHODS: RA patients were randomized to cognitive-behavior therapy (CBT), relaxation response training (RR), or arthritis education (AE). All treatment was conducted in groups. Follow-up occurred immediately after treatment and 6 and 12 months later. Pain, other RA symptoms, role impairment, and psychological distress were assessed with standardized self-report questionnaires. Arthritis severity and activity were assessed with a joint examination, erythrocyte sedimentation rate, grip strength, and walking time. An intent-to-treat analytic strategy was employed. Linear regression was used to establish treatment effect on pain and other RA symptoms, while adjusting for sociodemographic and clinical variables.RESULTS: One hundred sixty-eight patients were randomized. Pain improved significantly at 12 months in the RR and AE groups and showed a nonsignificant positive trend with CBT. Other RA symptoms improved significantly with CBT and AE and showed a nonsignificant trend with RR. There were no significant differences in the outcomes across the 3 treatment groups. When the results for all 3 groups were aggregated, significant benefits were found for pain, other RA symptoms, self-care activities, and social activities. Effect sizes ranged between 0.26 and 0.35.CONCLUSIONS: These 3 psychosocial treatments were beneficial, with treatment effect sizes in the small to moderate range. The effects appeared immediately after treatment and were generally sustained at long-term follow-up. These benefits were achieved over and above those resulting from medical management. These treatments constitute an effective augmentation to standard medical therapy for RA patients.OBJECTIVE: To assess and compare the benefits of 3 psychosocial treatments for rheumatoid arthritis (RA).","Barsky, A J; Ahern, D K; Orav, E J; Nestoriuc, Y; Liang, M H; Berman, I T; Kingsbury, J R; Sy, J T; Wilk, K G",2010.0,10.1016/j.semarthrit.2010.04.001,0,0,
5626,Treatment of borderline personality disorder with psychoanalytically oriented partial hospitalization: an 18-month follow-up,"ER METHODForty-four patients who participated in the original study were assessed every 3 months after completion of the treatment phase. Outcome measures included frequency of suicide attempts and acts of self-harm, number and duration of inpatient admissions, service utilization, and self-reported measures of depression, anxiety, general symptom distress, interpersonal functioning, and social adjustment.RESULTSPatients who completed the partial hospitalization program not only maintained their substantial gains but also showed a statistically significant continued improvement on most measures in contrast to the patients treated with standard psychiatric care, who showed only limited change during the same period.CONCLUSIONSThe superiority of psychoanalytically oriented partial hospitalization over standard psychiatric treatment found in a previous randomized, controlled trial was maintained over an 18-month follow-up period. Continued improvement in social and interpersonal functioning suggests that longer-term changes were stimulated.OBJECTIVEThe aim of this study was to determine whether the substantial gains made by patients with borderline personality disorder following completion of a psychoanalytically oriented partial hospitalization program, in comparison to patients treated with standard psychiatric care, were maintained over an 18-month follow-up period.","Bateman, A; Fonagy, P",2001.0,10.1176/appi.ajp.158.1.36,0,0,
5627,"A Phase II, Randomized, Safety and Immunogenicity Trial of a Re-Derived, Live-Attenuated Dengue Virus Vaccine in Healthy Children and Adults Living in Puerto Rico","ER This was a double-blind, randomized, controlled, phase II clinical trial, two dose study of re-derived, live-attenuated, tetravalent dengue virus (TDEN) vaccine (two formulations) or placebo in subjects 1-50 years of age. Among the 636 subjects enrolled, 331 (52%) were primed, that is, baseline seropositive to at least one dengue virus (DENV) type. Baseline seropositivity prevalence increased with age (10% [< 2 years], 26% [2-4 years], 60% [5-20 years], and 93% [21-50 years]). Safety profiles of TDEN vaccines were similar to placebo regardless of priming status. No vaccine-related serious adverse events (SAEs) were reported. Among unprimed subjects, immunogenicity (geometric mean antibody titers [GMT] and seropositivity rates) for each DENV increased substantially in both TDEN vaccine groups with at least 74.6% seropositive for four DENV types. The TDEN vaccine candidate showed an acceptable safety and immunogenicity profile in children and adults ranging from 1 to 50 years of age, regardless of priming status. ClinicalTrials.gov: NCT00468858.","Bauer, K; Esquilin, I O; Cornier, A S; Thomas, S J; Quintero Del, Rio A I; Bertran-Pasarell, J; Morales, Ramirez J O; Diaz, C; Carlo, S; Eckels, K H; Tournay, E; Toussaint, J F; Barrera, R; Fernandez, S; Lyons, A; Sun, W; Innis, B L",2015.0,10.4269/ajtmh.14-0625,0,0,
5628,Impact of an acceptance facilitating intervention on diabetes patients' acceptance of Internet-based interventions for depression: a randomized controlled trial,"ER AIMS: To (1) determine diabetes patients' acceptance of Internet-based interventions (IBIs) for depression, to (2) examine the effectiveness of an acceptance facilitating intervention (AFI) and to (3) explore subgroup specific effects.METHODS: 141 diabetes patients from two inpatient rehabilitation units and one outpatient clinic in Germany were randomly allocated to an intervention (IG) and a no-intervention control group (CG). The IG received an AFI consisting of a personal information session before filling-out a questionnaire on patients' acceptance of IBIs, predictors of acceptance (performance expectancy, effort expectancy, social influence, facilitating conditions, and Internet anxiety) as well as sociodemographic, depression-related and diabetes-related variables. The CG filled out the questionnaire immediately. Patients' acceptance of IBIs was measured with a four-item scale (sum-score ranging from 4 to 20).RESULTS: The CG showed a low (50.7%) to medium (40.8%) acceptance with only 8.5% of all diabetes patients reporting a high acceptance of IBIs for depression. The AFI had no significant effect on acceptance (IG: M=10.55, SD=4.69, n=70; KG: M=9.65, SD=4.27, n=71; d=0.20 [95%-CI: -0.13;0.53]) and the predictors of acceptance. Yet, subgroup analyses yielded a trend for depressed, diabetes-related distressed, female and younger (<59) participants and for those who do not frequently use the Internet to profit from the AFI.CONCLUSION: Diabetes patients show a rather low acceptance toward IBIs for depression. Findings indicate that the AFI is likely to be effective in the subgroup of depressed, diabetes-related distressed, female or younger diabetes patients, but not in the whole target population. Hence, AFIs might need to be tailored to the specific needs of subpopulations.","Baumeister, H; Nowoczin, L; Lin, J; Seifferth, H; Seufert, J; Laubner, K; Ebert, D D",2014.0,10.1016/j.diabres.2014.04.031,0,0,
5629,Impact of an Acceptance Facilitating Intervention on Patients' Acceptance of Internet-based Pain Interventions: a Randomized Controlled Trial,"ER METHODSA total of 104 patients with chronic pain from 2 pain units were randomly allocated to an intervention group (IG) and a no-intervention control group (CG). The IG was shown a short informational video about Internet-based psychological pain interventions before receiving a questionnaire on patients' acceptance of Internet-based psychological pain interventions and predictors of acceptance (performance expectancy, effort expectancy, social influence, facilitating conditions, Internet usage, and Internet anxiety). The CG filled out the questionnaire immediately. Patients' acceptance was measured with a 4-item scale (sum score ranging from 4 to 20).RESULTSBaseline acceptance of Internet-based interventions was reported as low (sum-score:4-9) by 53.8%, moderate (10 to 15) by 42.3%, and high (16 to 20) by 3.9% of the patients with chronic pain in the CG. The IG showed a significantly higher acceptance (M = 12.17, SD = 4.22) than the CG (M = 8.94, SD = 3.71) with a standardized mean difference of d = 0.81 (95% CI, 0.41, 1.21). All predictor variables were significantly improved in the IG compared with the CG, except for Internet usage.CONCLUSIONSPatients with chronic pain display a relatively low acceptance of Internet-based psychological pain interventions, which can be substantially increased by a short informational video.OBJECTIVEResults from clinical trials indicate that Internet-based psychological pain interventions are effective in treating chronic pain. However, little is known about patients' acceptance of these programs and how to positively influence patients' intention to engage in them. Therefore, the present study aimed (1) to assess patients' acceptance of Internet-based interventions, and (2) to examine whether patients' acceptance can be increased by an acceptance facilitating intervention.","Baumeister, H; Seifferth, H; Lin, J; Nowoczin, L; Lüking, M; Ebert, D",2015.0,10.1097/AJP.0000000000000118,0,0,
5630,Tilt and decentration of three-piece foldable high-refractive silicone and hydrophobic acrylic intraocular lenses with 6-mm optics in an intraindividual comparison,"ER DESIGNProspective randomized study.METHODSTwenty-five patients with senile cataract (group I) received a foldable silicone, sharp optic edge IOL in one eye and a silicone, rounded optic edge IOL in the other eye. Group II (n = 28) received the foldable silicone, sharp optic edge IOL in one eye and an acrylate, sharp optic edge IOL in the other eye. Scheimpflug photography was performed after the procedure with an anterior eye segment analysis system. Tilt and decentration of the IOL optic were measured 1 week, 6 months, and 12 months after the procedure.RESULTSIn group I, the foldable silicone, sharp optic edge IOL showed a mean optic tilt of 3.03 +/- 1.79 degrees and an optic decentration of 0.24 +/- 0.13 mm; the silicone, rounded optic edge IOL showed a tilt of 3.26 +/- 1.69 degrees and a decentration of 0.23 +/- 0.13 mm. In group II, the foldable silicone, sharp optic edge IOL showed an average tilt of 2.34 +/- 1.81 degrees and a decentration of 0.29 +/- 0.21 mm after 12 months; the acrylate, sharp optic edge IOL had a tilt of 2.32 +/- 1.41 degrees and a decentration of 0.24 +/- 0.10 mm. There were no significant differences in either group.CONCLUSIONThe examined IOLs showed a stable position regarding tilt and decentration in the first 12 postoperative months, independent of material and edge design. Slight deviations from the optical axis might affect the outcome in aspheric or multifocal IOLs.PURPOSEIntraindividual comparison of tilt and decentration of three-piece foldable intraocular lenses (IOLs) with 6-mm optics and different edge design and material.","Baumeister, M; Neidhardt, B; Strobel, J; Kohnen, T",2005.0,10.1016/j.ajo.2005.07.026,0,0,
5631,Prospective randomized open-label multicenter phase I/II dose escalation trial of visilizumab (HuM291) in severe steroid-refractory ulcerative colitis,"ER BACKGROUND: Visilizumab is a humanized IgG(2) monoclonal anti-CD3 antibody. We evaluated its safety and dose response in severe intravenous steroid-refractory ulcerative colitis (UC). METHODS: In all, 104 patients were treated. In Stage I, 73 patients were randomly assigned to receive intravenous visilizumab 5, 7.5, 10, or 12.5 microg/kg/day for 2 consecutive days. In Stage II, 33 patients received visilizumab at the optimal clinical dose (OCD) of 5 microg/kg/day for 2 days. Symptomatic response and remission were defined by the modified Truelove-Witts severity index. Clinical response and remission were defined by the Mayo score. RESULTS: The rates of symptomatic response at day 15 in the 5, 7.5, 10, or 12.5 microg/kg dose groups were 71%, 70%, 50%, and 61%, respectively, in Stage I and in 54% in Stage II. The symptomatic remission rates were 35%, 5%, 22%, and 11% in Stage I and 18% in Stage II. The rates of clinical response at day 30 in the 5, 7.5, 10, or 12.5 microg/kg dose groups were 71%, 65%, 50%, and 67%, respectively, in Stage I and 55% in Stage II. The clinical remission rates were 6%, 5%, 0%, and 11% in Stage I and 6% in Stage II. All patients experienced adverse events. Serious adverse events included abdominal abscess, cytomegalovirus infection, atrial fibrillation, herpes zoster, and esophageal candidiasis. CONCLUSIONS: Treatment with visilizumab induced symptomatic response and clinical response. Results with 5 microg/kg/day were similar to those observed with higher doses.","Baumgart, D C; Targan, S R; Dignass, A U; Mayer, L; Assche, G; Hommes, D W; Hanauer, S B; Mahadevan, U; Reinisch, W; Plevy, S E; Salzberg, B A; Buchman, A L; Mechkov, G M; Krastev, Z A; Lowder, J N; Frankel, M B; Sandborn, W J",2010.0,10.1002/ibd.21084,0,0,
5632,Oxytocin shapes the neural circuitry of trust and trust adaptation in humans,"ER Trust and betrayal of trust are ubiquitous in human societies. Recent behavioral evidence shows that the neuropeptide oxytocin increases trust among humans, thus offering a unique chance of gaining a deeper understanding of the neural mechanisms underlying trust and the adaptation to breach of trust. We examined the neural circuitry of trusting behavior by combining the intranasal, double-blind, administration of oxytocin with fMRI. We find that subjects in the oxytocin group show no change in their trusting behavior after they learned that their trust had been breached several times while subjects receiving placebo decrease their trust. This difference in trust adaptation is associated with a specific reduction in activation in the amygdala, the midbrain regions, and the dorsal striatum in subjects receiving oxytocin, suggesting that neural systems mediating fear processing (amygdala and midbrain regions) and behavioral adaptations to feedback information (dorsal striatum) modulate oxytocin's effect on trust. These findings may help to develop deeper insights into mental disorders such as social phobia and autism, which are characterized by persistent fear or avoidance of social interactions.","Baumgartner, T; Heinrichs, M; Vonlanthen, A; Fischbacher, U; Fehr, E",2008.0,10.1016/j.neuron.2008.04.009,0,0,
5633,Feasibility of an exercise-based rehabilitation programme for chronic hip pain,"ER BACKGROUND: Chronic hip pain is prevalent and disabling and has considerable consequences for the individual, and health and social care. Evidence-based guidelines recommend that patients with chronic hip pain benefit from exercise, but these guidelines are predominantly based on the efficacy of knee rehabilitation programmes. Studies investigating hip rehabilitation programmes suggest that these may not be feasible, citing issues with case identification. This study evaluated the feasibility of an exercise-based rehabilitation programme in a primary care hospital.METHODS: Forty-eight participants with chronic hip pain were randomly allocated to receive a five-week exercise and self-management programme or to continue under the management of their general practitioner (GP). Participants were assessed at baseline, six weeks and six months. Outcome measures included Western Ontario and McMaster Universities osteoarthritis index physical function subscale, pain, objective functional performance, self-efficacy, anxiety and depression.RESULTS: This programme was feasible, well tolerated and easily implemented into a primary healthcare facility. Adherence to the programme was high (81% attendance). Immediately following rehabilitation, all outcomes measures improved (effect sizes 0.2-0.4), although these improvements diminished at six months. There were no differences between the groups (all p?>?0.05).CONCLUSIONS: An exercise-based rehabilitation programme was found to be feasible and well tolerated by people with chronic hip pain. The moderate effects in all outcomes immediately following rehabilitation suggested that it warrants further investigation. Issues with diagnosis and adaptations to the programme were identified and will be addressed in a randomized controlled trial.","Bearne, L M; Walsh, N E; Jessep, S; Hurley, M V",2011.0,10.1002/msc.209,0,0,
5634,An exploratory randomized controlled trial comparing telephone and hospital follow-up after treatment for colorectal cancer,"ER AIM: Following treatment for colorectal cancer it is common practice for patients to attend hospital clinics at regular intervals for routine monitoring, although debate persists on the benefits of this approach. Nurse-led telephone follow-up is effective in meeting information and psycho-social needs in other patient groups. We explored the potential benefits of nurse-led telephone follow-up for colorectal cancer patients.METHOD: Sixty-five patients were randomized to either telephone or hospital follow-up in an exploratory randomized trial.RESULTS: The telephone intervention was deliverable in clinical practice and acceptable to patients and health professionals. Seventy-five per cent of eligible patients agreed to randomization. High levels of satisfaction were evident in both study groups. Appointments in the hospital group were shorter (median 14.0 min, range 2.3-58.0) than appointments in the telephone group (median 28.9 min, range 6.1-48.3). Patients in the telephone arm were more likely to raise concerns during consultations.CONCLUSION: Historical approaches to follow-up unsupported by evidence of effectiveness and efficiency are not sustainable. Telephone follow-up by specialist nurses may be a feasible option. A main trial comparing hospital and telephone follow-up is justified, although consideration needs to be given to trial design and practical issues related to the availability of specialist nurses at study locations.","Beaver, K; Campbell, M; Williamson, S; Procter, D; Sheridan, J; Heath, J; Susnerwala, S",2012.0,10.1111/j.1463-1318.2012.02936.x,0,0,
5635,Measurement of the quality of life as a element in assessing therapeutic effects in essential arterial hypertension. Methodologic aspects,"ER The quality of life has become an important element in assessment of medicinal treatment. As an independent expression, the quality of life covers the human disappointments which a medical disease may involve (""discomfort"") whereas the clinical dysfunction caused by the disease is covered by the expression ""disability"". In the treatment of essential arterial hypertension, the clinical symptoms of the disease are few or none (""asymptomatic hypertension""). In an investigation of 303 patients in general practice for arterial hypertension, the significance of the frequency of dosage of metoprolol (Seloken) was assessed by means of measurement of the quality of life by the General Health Questionnaire (GHQ), a questionnaire which contains components such as fatigue, sleep, anxiety and depression. No advantages in the quality of life were found in administering antihypertensive drugs once or twice daily. From the methological point of view, the following conditions were found which should be taken into consideration in future investigations in this field: The GHQ was found to be easy for the patients to employ. This is important as the quality of life is a personally experienced dimension. The questionnaire correlated adequately with the visual analogue scales. Approximately 1/3 of the patients had reduced quality of life at the commencement of the investigation as assessed by GHQ. A multiple regression analysis revealed that the reduced well-being was due to social, life events and side effects. It is therefore recommended that these aspects should be described when patients commence a course of medicinal treatment i.e. the social life events and side effects of the medicine in connection with the actual subjective dimension of quality of life.","Bech, P; Poulsen, D L; Garre, K; Rasmussen, K; Jensen, H E",1990.0,,0,0,
5636,"The prediction of pregnancy outcome: maternal preparation, anxiety and attitudinal sets",,"Beck, N C; Siegel, L J; Davidson, N P; Kormeier, S; Breitenstein, A; Hall, D G",1980.0,,0,0,
5637,Adverse baseline physiological and psychosocial profiles of women enrolled in a cardiac rehabilitation clinical trial,"ER METHODWomen were randomized to a women's-only motivational interviewing or traditional CR group. Physiological measures included lipid profiles, body mass index, functional capacity, and anthropomorphic measures. Psychosocial measures included optimism, hope, social support, anxiety, depression, quality of life, and health perceptions. The median age was used to split the sample to examine data on 92 younger (64 years) women.RESULTSWith a mean age of 63 years, 66.5% were white, 47% were retired, and 54% were married. Most women were physically inactive (83%), hypertensive (76%), and overweight (56%). Most women (71.4%) met the criteria for metabolic syndrome. Younger women demonstrated significantly worse psychosocial profiles than older women. More of the younger women (64%) had depressive symptoms than older women (37%). Younger women demonstrated a mean Center for Epidemiological Studies Depression Scale score of 20.8 +/- 12.4, whereas older women had a substantially lower mean score of 14.9 +/- 9.5 (P < .001). Younger participants also reported significantly more anxiety than older participants (38.8 +/- 13.4 vs 32.8 +/- 10.6, P < .001).CONCLUSIONYounger women enrolled in a CR clinical trial had adverse baseline risk factor profiles placing them at high risk for disease progression.PURPOSECoronary heart disease (CHD) remains the leading cause of death in women. Despite positive outcomes associated with cardiac rehabilitation (CR), investigations of women are sparse. This article presents the baseline physiological and psychosocial profiles of 182 women in the Women's-Only Cardiac Rehabilitation study.","Beckie, T M; Fletcher, G F; Beckstead, J W; Schocken, D D; Evans, M E",2008.0,10.1097/01.HCR.0000311510.16226.6e,0,0,
5638,The immunological and psychological effects of bereavement: does grief counseling really make a difference? A pilot study,"ER This study evaluates psychological and immunological functioning after bereavement and the influence of group counseling. Eighteen widows (bereaved within 3 months of enrolment) and a reference group of 10 married control subjects were asked to fill in self-report scales and to donate a blood sample (T1). After T1, half of the widows (the experimental group) were randomly assigned to grief counseling (13 sessions over 4 months), while the other subjects (the control group) received no treatment. Seven months after bereavement (T2) or, in the case of the experimental group, immediately after the intervention, a follow-up was conducted in the widowed subsample using the same measures. Blood samples were analyzed to determine the total number of white blood cells, number of lymphocyte subsets, natural killer cell activity (NKCA) and lymphocyte proliferative response to phytohemagglutinin (PHA), anti-CD3 and pokeweed mitogen (PWM). At T1, we found significant differences between widows and non-widows regarding both psychological and immunological measures. Widows felt more anxious, depressed, hostile and agoraphobic. At T1, widows had a lower number of the CD19+CD5+ B cell subpopulation. The cell function tests for T and B cells showed higher responses in widows (lymphocyte proliferation response to PHA, anti-CD3 and PWM). No significant difference in NKCA was found between widows and non-widows. At T2, there appeared to be no significant difference between widows and non-widows on the psychological measures. With respect to the immunological measures, widows and non-widows showed no significant differences for the total number of white blood cells, number of lymphocyte subsets and NKCA. Consistent with our findings at T1, the lymphocyte proliferation response to PHA, anti-CD3 and PWM at T2 appeared to be higher in widows than in non-widows. Comparing the experimental group (widows) and the control group (widows) with respect to psychological measures at T1, widows in the experimental group felt more insufficient and had more sleep disturbances. With respect to the immunological measures, no differences were found between those two groups. When the same two groups were again compared at T2, no differences were found in any of the psychological or immunological measures (lymphocyte sub-populations, proliferation tests and the NKCA).","Beem, E E; Hooijkaas, H; Cleiren, M H; Schut, H A; Garssen, B; Croon, M A; Jabaaij, L; Goodkin, K; Wind, H; Vries, M J",1999.0,,0,0,
5639,Evaluating communication training for paid carers of people with traumatic brain injury,"ER PRIMARY OBJECTIVE: To evaluate the effectiveness of a communication training programme for paid carers to improve their conversational interactions with people with TBI.RESEARCH DESIGN: Single blinded randomized controlled study.METHODS AND PROCEDURES: Ten paid carers were randomly selected from a post-acute residential rehabilitation programme and allocated to either a training or control group. Training comprised a 17-hour programme (across 8 weeks) with conversational interactions (i.e. structured and casual) between paid carers and people with TBI videotaped pre-training, post-training and at 6-months follow-up. Interactions were rated on the Adapted Measure of Support in Conversation (MSC), Adapted Measure of Participation in Conversation (MPC) and Global Impression Scales of conversation.MAIN OUTCOMES AND RESULTS: Trained paid carers were more able to acknowledge and reveal the competence of people with TBI. Conversations were perceived as more appropriate, interesting and rewarding compared to the control group. Improvements were confined to the structured conversation and were maintained for 6 months.CONCLUSIONS: Training paid carers has a positive effect on improving conversational interactions with people with TBI in a long-term care facility. These improvements can help to foster increased independence for the person with TBI in the home and community.","Behn, N; Togher, L; Power, E; Heard, R",2012.0,10.3109/02699052.2012.722258,0,0,
5640,"Efficacy and safety of the glycine transporter-1 inhibitor org 25935 for the prevention of relapse in alcohol-dependent patients: a randomized, double-blind, placebo-controlled trial","ER Background: Org 25935 is a glycine transporter inhibitor that increases extracellular glycine levels and attenuates alcohol-induced dopaminergic activity in the nucleus accumbens. In animal models, Org 25935 has dose-dependent effects on ethanol intake, preference, and relapse-like behavior without tolerance. The current study aimed to translate these animal findings to humans by examining whether Org 25935 prevents relapse in detoxified alcohol-dependent patients. Methods: This was a multicenter, randomized, double-blind, placebo-controlled clinical trial. Adult patients diagnosed with alcohol dependence were randomly assigned to receive Org 25935 12 mg twice a day or placebo for 84 days. The primary end point was percentage heavy drinking days (defined as >5 standard drinks per day for men and >4 for women). Secondary end points included other measures of relapse-related drinking behavior (e.g., drinks per day, time to relapse), as well as measures of global functioning, alcohol-related thoughts and cravings, and motivation. Results: A total of 140 subjects were included in the intent-to-treat analysis. The trial was stopped approximately midway after a futility analysis showing that the likelihood of detecting a signal at study term was <40%. There was no significant difference between Org 25935 and placebo on percentage heavy drinking days or any other measure of relapse-related drinking behavior. Org 25935 showed no safety issues and was fairly well tolerated, with fatigue, dizziness, and transient visual events as the most commonly occurring side effects. Conclusions: Org 25935 demonstrated no benefit over placebo in preventing alcohol relapse. Study limitations and implications are discussed.","Bejczy, A; Nations, K R; Szegedi, A; Schoemaker, J; Ruwe, F; Söderpalm, B",2014.0,10.1111/acer.12501,0,0,
5641,MF Afragil® in the treatment of 34 menopause symptoms: a pilot study,"ER METHODSTwo groups of women were compared in a registry study (33 treated with MF Afragil® and 32 with no treatment). The climacteric condition was determined by using the 34-symptom questionnaire MSSQ, which was filled out at inclusion in the trial and after 8 weeks of treatment. The MSSQ signs/symptoms scores (Common Symptoms, Changes and Pains) of the two groups were comparable at inclusion, whereas after 8 weeks a significant reduction of many variables was found in the group treated with MF Afragil® and in the control group.RESULTSFollowing the treatment with MF Afragil®, the total MSSQ score was reduced by more than 45%. There was a significant reduction in hot flashes, CNS symptoms (depression, anxiety and panic disorders), incontinence and joint pain, which are among the most frequent symptoms of climacteric status. Otsteoporosis was not analyzed due to the short period of treatment.CONCLUSIONMF Afragil® was found to be efficient in reducing climacteric symptoms following a short-term administration. More prolonged treatment and more cases are under analysis to also determine its effect on osteroporosis.AIMA combination of calcium, vitamin D3, lycopene , astaxantin and Citrus bioflavoid (MF Afragil®) was administered for a period of 8 weeks to 65 women to determine its effects in reducing signs/symptoms of climacteric status.","Belcaro, G; Cesarone, M R; Cornelli, U; Dugall, M",2010.0,,0,0,
5642,Elevation of plasma beta-endorphin levels of shy elderly in response to novel laboratory experiences,"ER Heightened psychophysiological reactivity to the novel or unfamiliar is a leading characteristic of sky or behaviorally inhibited individuals. To assess one aspect of the physiological stress response in shyness, the authors compared the morning plasma beta-endorphin levels of 15 extremely sky, healthy elderly individuals with beta-endorphin levels of 15 extremely outgoing persons on three pairs of 2 successive days. The primary finding was that sky participants exhibited significantly higher levels of beta-endorphin on the 1st days of each pair of days, compared with the 2nd days in the laboratory. No main effect for shyness or interaction between shyness and diet on endorphin levels was found. The findings are consistent with a peripheral opioid hyperreactivity to novelty in shy elderly persons. Shyness may constitute a risk factor for panic disorder in younger adults and for nasal allergies and certain cancers in older adults. Experimental design and interpretation of future studies of shy individuals' stress responses may need to consider novelty versus familiarity of the procedures and setting.","Bell, I R; Schwartz, G E; Bootzin, R R; Hau, V; Davis, T P",1997.0,,0,0,
5643,Combined treatment of major depression in patients with borderline personality disorder: a comparison with pharmacotherapy,"ER METHODS: There were 39 consecutive outpatients diagnosed with BPD who presented with a major depressive episode enrolled in this study. They were randomly assigned to 1 of 2 treatment groups: fluoxetine 20 mg to 40 mg daily or fluoxetine 20 mg to 40 mg daily plus IPT 1 session weekly. Owing to noncompliance, 7 patients dropped out. We assessed the 32 patients who completed the 24 weeks of treatment at baseline, Week 12, and Week 24, using a semistructured interview for clinical characteristics, the Clinical Global Impression Scale (CGI), the Hamilton Depression Rating Scale (HDRS), and the Hamilton Anxiety Rating Scale (HARS), and 2 self-report questionnaires, that is, the Satisfaction Profile (SAT-P) for quality of life and the 64-item Inventory for Interpersonal Problems (IIP-64). We performed statistical analysis, using univariate general linear models with 2 factors: duration and type of treatment.RESULTS: Changes in remission rates, CGI, and HARS score did not differ between treatments. According to changes in the HDRS scores; changes in psychological functioning and social functioning scores on the SAT-P; and changes in vindictive or self-centred, cold or distant, intrusive or needy, and socially inhibited scores on the IIP-64, combined therapy was superior to fluoxetine alone.CONCLUSIONS: Combined therapy with IPT is more effective than antidepressant therapy alone, both in treating symptoms of major depression and in improving dimensions of quality of life and interpersonal functioning.OBJECTIVE: Combined treatment with psychotherapy and antidepressants is more effective than monotherapies. Recent data show that combined therapy has better results in patients with depression and Axis II codiagnosis. The aim of this study was to compare combined treatment using interpersonal psychotherapy (IPT) with pharmacotherapy alone in patients with depression and borderline personality disorder (BPD).","Bellino, S; Zizza, M; Rinaldi, C; Bogetto, F",2006.0,10.1177/070674370605100707,0,0,
5644,"Rethinking butterflies: the affective, physiological, and performance effects of reappraising arousal during social evaluation","ER This study examined the effects of reappraising stress arousal on affective displays, physiological responses, and social performance during an evaluative situation. Participants were sampled from across the social anxiety spectrum and instructed to reappraise arousal as beneficial or received no instructions. Independent raters coded affective displays, nonverbal signaling, and speech performance. Saliva samples collected at baseline and after evaluation were assayed for salivary alpha-amylase (sAA), a protein that indexes sympathetic activation. Arousal reappraisal participants exhibited less shame and anxiety, less avoidant nonverbal signaling, and performed marginally better than no instruction controls. Reappraisal participants also exhibited increased levels of sAA and increased appraisals of coping resources compared with controls. Furthermore, stress appraisals mediated relationships between reappraisal and affective displays. This research indicates that reframing stress arousal can improve behavioral displays of affect during evaluative situations via altering cognitive appraisals.","Beltzer, M L; Nock, M K; Peters, B J; Jamieson, J P",2014.0,10.1037/a0036326,0,0,
5645,"Treatment of traumatic effusion in the elbow joint: a prospective, randomized study of 62 consecutive patients","ER Sixty-two patients with post-traumatic radiologically visualized effusion in the elbow joint, apparently without bony damage, were randomized to either 1 week of immobilization in a plaster or immediately instructed in active exercises without any immobilization. They were reexamined by an orthopaedic surgeon weekly until recovery. New radiographs were taken after 1 week. Reevaluation of the radiographs by a radiologist revealed seven 'false-positive' effusions, i.e. neither effusion nor fracture, and 21 missed fractures. All but five missed fractures, continued in the study. Thirty patients started immediate active exercises instructed by the surgeon and 27 were immobilized. The 'active exercise' group had a significantly shorter recovery time (one week vs two weeks, P < 0.05). The presence of missed fractures did not influence the result and all patients recovered fully. Also four of the excluded patients with missed fractures recovered fully. One patient with missed fracture dropped out from follow-up. We recommend that an apparently isolated post-traumatic effusion in the elbow joint is treated with immediate active exercises followed by a clinical reexamination after one week supplemented with new radiographs if there is unsatisfactory clinical progress.","Henriksen, B M; Gehrchen, P M; J√∏rgensen, M B; Gerner-Smidt, H",1995.0,,0,0,
5646,Evidence-based HIV/STD prevention intervention for black men who have sex with men,"ER This report summarizes published findings of a community-based organization in New York City that evaluated and demonstrated the efficacy of the Many Men, Many Voices (3MV) human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention intervention in reducing sexual risk behaviors and increasing protective behaviors among black men who have sex with men (MSM). The intervention addressed social determinants of health (e.g., stigma, discrimination, and homophobia) that can influence the health and well-being of black MSM at high risk for HIV infection. This report also highlights efforts by CDC to disseminate this evidence-based behavioral intervention throughout the United States. CDC's Office of Minority Health and Health Equity selected the intervention analysis and discussion to provide an example of a program that might be effective for reducing HIV infection- and STD-related disparities in the United States. 3MV uses small group education and interaction to increase knowledge and change attitudes and behaviors related to HIV/STD risk among black MSM. Since its dissemination by CDC in 2004, 3MV has been used in many settings, including health department- and community-based organization programs. The 3MV intervention is an important component of a comprehensive HIV and STD prevention portfolio for at-risk black MSM. As CDC continues to support HIV prevention programming consistent with the National HIV/AIDS Strategy and its high-impact HIV prevention approach, 3MV will remain an important tool for addressing the needs of black MSM at high risk for HIV infection and other STDs.","Herbst, J H; Painter, T M; Tomlinson, H L; Alvarez, M E",2014.0,,0,0,
5647,Four-week multidisciplinary cardiac rehabilitation produces similar improvements in exercise capacity and quality of life to a 10-week program,"ER METHODS AND RESULTSCardiac patients (n = 60) were randomly assigned to either a standard 10-week (30 sessions) or a 4-week (20 sessions) multifactorial rehabilitation program. Patients underwent exercise testing using the Bruce protocol before, immediately after, and then 6 months after CR. Patients also completed the SF-36 quality of life questionnaire and the Hospital Anxiety and Depression scale at each time point. Compared with pre-CR, exercise time and metabolic equivalents attained were significantly increased, and heart rate significantly decreased both immediately (P<.05) and 6 months after CR (P<.05) in both groups, with no between-group differences. Significant improvements (P<.05) in energy, pain, and general health were reported after CR, and in energy and emotional and social well-being at 6 months after CR. No differences were seen between the groups.CONCLUSIONSCardiac rehabilitation after MI and CABG significantly improved exercise capacity and general health and well-being. No significant differences were detected between groups undergoing a 10-week or 4-week course. These preliminary data suggest that shortened courses of CR may be beneficial to cardiac patients and such courses may also facilitate more widespread use of CR.BACKGROUNDCardiac rehabilitation (CR) is widely accepted as beneficial for patients with myocardial infarction (MI) and coronary artery bypass graft (CABG). A need exists to evaluate how different formats of delivery can best meet CR service demands.","Hevey, D; Brown, A; Cahill, A; Newton, H; Kierns, M; Horgan, J H",2003.0,,0,0,
5648,"Long-term exercise training in persons with spinal cord injury: effects on strength, arm ergometry performance and psychological well-being","ER OBJECTIVEThe purpose of this study was to examine the effects of 9 months of twice-weekly exercise training on strength, arm ergometry performance, and indices of psychological well-being and quality of life.SETTINGCentre for Health Promotion and Rehabilitation, McMaster University, Hamilton, Ontario, Canada.METHODSThirty-four men and women (aged 19-65 years) with traumatic spinal cord injury (C4-L1; ASIA A-D) of 1-24 years duration volunteered to participate, and were randomized into exercise (EX; n=21) and control (CON; n=13) groups. Twenty-three subjects (11 EX; 12 CON) successfully completed the 9-month study. Subjects were assessed for one repetition maximum (1RM) strength, arm ergometry performance, and several indices of quality of life and psychological well-being at baseline, 3, 6, and 9 months.RESULTSAt baseline, there were no significant differences between groups in age, submaximal arm ergometry performance, muscle strength, or psychological well-being. Following training, the EX group had significant increases in submaximal arm ergometry power output (81%; P<0.05), and significant increases in upper body muscle strength (19-34%; P<0.05); no significant changes occurred in CON. Participants in EX reported significantly less pain, stress and depression after training, and scored higher than CON in indices of satisfaction with physical function, level of perceived health and overall quality of life (P<0.05). Exercise adherence (per cent of prescribed sessions attended) in those subjects who completed the 9 months of training was 82.5%.CONCLUSIONSThese results demonstrate that long-term twice-weekly exercise training in this population is feasible, and results in significant gains in both physical and psychological well-being.STUDY DESIGNRandomized controlled trial of exercise training in persons with spinal cord injury.","Hicks, A L; Martin, K A; Ditor, D S; Latimer, A E; Craven, C; Bugaresti, J; McCartney, N",2003.0,10.1038/sj.sc.3101389,0,0,
5649,"Short-term effects of Mulligan mobilization with movement on pain, disability, and kinematic spinal movements in patients with nonspecific low back pain: a randomized placebo-controlled trial","ER OBJECTIVE: The purpose of this clinical study was to compare the immediate- and short-term effects of lumbar Mulligan sustained natural apophyseal glides (SNAGs) on patients with nonspecific low back pain with respect to 2 new kinematic algorithms (KA) for range of motion and speed as well as pain, functional disability, and kinesiophobia.METHODS: This was a 2-armed randomized placebo-controlled trial. Subjects, blinded to allocation, were randomized to either a real-SNAG group (n = 16) or a sham-SNAG group (n = 16). All patients were treated during a single session of real/sham SNAG (3 √ó 6 repetitions) to the lumbar spine from a sitting position in a flexion direction. Two new KA from a validated kinematic spine model were used and recorded with an optoelectronic device. Pain at rest and during flexion as well as functional disability and kinesiophobia was recorded by self-reported measures. These outcomes were blindly evaluated before, after treatment, and at 2-week follow-up in both groups.RESULTS: Of 6 variables, 4 demonstrated significant improvement with moderate-to-large effect sizes (ES) in favor of the real-SNAG group: KA-R (P = .014, between-groups ES Cliff ? = -.52), pain at rest and during flexion (visual analog scale, P < .001; ES = -.73/-.75), and functional-disability (Oswestry Disability Index, P = .003 and ES = -.61). Kinesiophobia was not considered to be significant (Tampa scale, P = .03) but presented moderate ES = -.46. Kinematic algorithms for speed was not significantly different between groups (P = .118) with a small ES = -.33. All 6 outcome measures were significantly different (P ? .008) during within-group analysis (before and after treatment) only in the real-SNAG group. No serious or moderate adverse events were reported.CONCLUSION: This study showed evidence that lumbar spine SNAGs had a short-term favorable effect on KA-R, pain, and function in patients with nonspecific low back pain.","Hidalgo, B; Pitance, L; Hall, T; Detrembleur, C; Nielens, H",2015.0,10.1016/j.jmpt.2015.06.013,0,0,
5650,Predictors of poor outcome in patients with neck pain treated by physical therapy,"ER METHODSThis study was a secondary analysis of data from a randomized controlled trial assessing physical therapy treatments for neck pain (n=346). A baseline questionnaire provided data on a number of potential risk factors of poor outcome at follow-up. Follow-up was conducted at 6 weeks and 6 months by postal questionnaire with outcome defined separately by perceived (global) change and minimal clinically important differences in the Northwick Park Neck Pain Questionnaire (MCID-NPQ). Therapists' perceptions of predictors for treatment outcome were captured using a separate questionnaire, and the ratings compared with ranks derived from the 6-month trial data.RESULTSBaseline characteristics accounted for a much greater proportion of explained variance for global change compared with MCID-NPQ at 6 months. Independent biopsychosocial characteristics included manual social class, catastrophizing, anxiety and depression, low treatment expectations, severity of baseline neck pain/disability, presence of comorbid back pain, and older age. Physical therapist ranks correlated highly with those derived from the trial data.CONCLUSIONSSignificant predictors of outcome were identified, particularly at 6 months, including psychosocial, functional, and demographic indicators. Our findings suggest that physical therapists are collectively aware of the relative importance of physical and psychosocial factors in predicting clinical outcome. However, a significant amount of variability in outcomes in our prognostic models remained largely unexplained, indicating that we need to explore further underlying factors to inform clinical decision-making.OBJECTIVESThis study evaluated predictors of poor outcome in patients with neck pain treated by physical therapy, and sought to compare the findings of empirical data with physical therapy practitioners' subjective perceptions about predictors of outcome.","Hill, J C; Lewis, M; Sim, J; Hay, E M; Dziedzic, K",2007.0,10.1097/AJP.0b013e3181468e67,0,0,
5651,Capsular bag stability and posterior capsule opacification of a plate-haptic design microincision cataract surgery intraocular lens: 3-year results of a randomised trial,"ER PURPOSE: To compare capsular bag stability and posterior capsule opacification (PCO) of a plate-haptic intraocular lens (IOL) and a standard three-piece open-loop-haptic IOL of the same acrylic material.METHODS: In this randomised bilateral patient-masked and examiner-masked study, each patient received a microincision cataract surgery IOL (MICS IOL; Acri.Smart 46S=CT SHERIS 209M) in one eye and a small incision cataract surgery IOL (SICS IOL; AcriLyc 53N =?CT 53N, both Carl Zeiss Meditec AG, Germany) as a control in the contralateral eye. Follow-up examinations were performed 1 h, 1 week, 1 month, 1 year and 3 years postoperatively. Anterior chamber depth (ACD) was measured and retroillumination images were performed at all postoperative follow-ups. Furthermore, uncorrected and corrected distance visual acuity, autorefraction and subjective refraction were assessed.RESULTS: In total, 50 eyes of 25 patients were included. The ACD difference between the MICS IOL and the SICS IOL was not significant at any time point (p>0.05). Distance-corrected visual acuity at the 3-year follow-up was similar and not significantly different between the groups (p=0.48). Mean AQUA score in the MICS IOL group and in the SICS IOL group at the 3-year follow-up was 2.3 (SD ±2.3) and 2.1 (SD ±2.2), respectively (p=0.79).CONCLUSIONS: The investigated hydrophilic acrylic plate-haptic MICS IOL with a hydrophobic surface showed comparable results concerning capsular bag stability and PCO rates up to 3 years compared with a SICS IOL of the same material.","Hirnschall, N; Nishi, Y; Crnej, A; Koshy, J; Gangwani, V; Maurino, V; Findl, O",2013.0,10.1136/bjophthalmol-2013-303710,0,0,
5652,Anxiety and gaze aversion in dyadic encounters,,"Hobson, G N; Strongman, K T; Bull, D; Craig, G",1973.0,,0,0,
5653,"Biobehavioral correlates of relocation in the frail elderly: salivary cortisol, affect, and cognitive function","ER DESIGNRandomized, controlled trial.SETTINGLong-term care facility located within the greater Philadelphia, Pennsylvania, community.PARTICIPANTSSeventy-seven nursing home residents, aged 65 and over.INTERVENTIONExperimental group residents were relocated to a newly built nursing home facility with a cluster design in the fall of 2001; control group residents were moved after study completion in the spring of 2002.MEASUREMENTSMini-Mental State Examination scores, Observed Affect Rating Scale scores, salivary cortisol, blood pressure, and pulse obtained 1 week before moving and 1 week and 4 weeks after moving.RESULTSRelocated nursing home residents demonstrated significant differences in salivary cortisol and mood from a randomly selected group of residents that had not yet moved. Relocation resulted in significantly higher cortisol levels 1 week after the move (P=.005), followed by a significant decline in afternoon cortisol at 4 weeks after the move (P=.03). Moreover, relocated residents had significantly lower depression and anxiety symptoms and pulse rates than residents who had not yet moved.CONCLUSIONThese findings have important implications for planning medical and social services for relocated elderly. Efforts should be made to prepare individuals for the initial stressors associated with relocation, but it also appears that the stress imposed by relocation is time limited and may begin to ease as early as 4 weeks postmove.OBJECTIVESTo examine affect and physiological stress in frail older adults in response to a voluntary nursing home relocation.","Hodgson, N; Freedman, V A; Granger, D A; Erno, A",2004.0,10.1111/j.1532-5415.2004.52505.x,0,0,
5654,A microdomain-structured synthetic high-flux hollow-fiber membrane for renal replacement therapy,"ER A prospective crossover clinical study evaluated solute removal and biocompatibility of a tailored, hydrophobic-hydrophilic microdomain structure produced from a blend of polyamide, polyarylethersulfone, and polyvinylpyrrolidone (Polyflux) compared with Fresenius Polysulfone in dialyzers of similar surface area. The clearance of small molecules (urea, creatinine, and phosphate) for both membranes was comparable. Plasma levels of beta2 microglobulin were reduced at the end of treatment with both membranes (49.8% of pretreatment values for Polyflux; 45.9%, Fresenius Polysulfone) and was associated with the recovery of 207 +/- 84 mg of beta2 microglobulin from the dialyzing fluid for Polyflux compared with 147 +/- 29 for Fresenius Polysulfone (p = 0.12). The dialyzing fluid also contained 7,758 mg of protein when using Polyflux compared with 7,793 mg using Fresenius Polysulfone (standard error of difference for any pair was 511 mg). No albumin was present in the dialysis fluid for either membrane. Neutropenia, platelet adhesion to the membrane, and complement activation characterized by C3a, C5a, and SC5b-9 generation were slight and independent of membrane type. Membrane thrombus generating potential measured by thrombin:antithrombin III were also similar. These results indicate that the tailored, hydrophobic-hydrophilic microdomain structure of the membrane results in a favorable biocompatibility profile and clinically acceptable solute removal similar to the widely used Fresenius Polysulfone membrane.","Hoenich, N A; Stamp, S; Roberts, S J",2000.0,,0,0,
5655,Segment transport employing intramedullary devices in tibial bone defects following trauma and infection,"ER DESIGNRandomized, prospective, nonblinded study.SETTINGLevel 1 trauma center.PATIENTSThirty patients with posttraumatic or postseptic defects of the tibial shaft were admitted at our center between January 1994 and December 1995. For study purposes, they were divided into two groups with fifteen patients in each.METHODSAll thirty patients underwent a standardized therapy protocol consisting of three phases: (a) eradication of infection, (b) restoration of soft tissue defects, and (c) bone segment transport. The first two phases were identical for both groups. The third phase was different: in Group A transport of the segment was performed with a combination of intramedullary nail and wire towrope; in Group B the intramedullary nail was combined with an external fixation device. We then evaluated both subjective data (patient comfort, restrictions in physiotherapy) and objective data (mobility of knee and ankle joint, transport time, reoperations, complications) to determine treatment success.RESULTSBoth methods are useful for segment transport in patients with tibial shaft defects following trauma and infection. The relative transport time was shorter in Group A than in Group B (12.2 versus 13.7 days/centimeter; p = 0.002). Group B also recorded a significantly higher complication rate than did Group A (septic complications, twenty-six versus six events; necessary recorticotomies, four versus zero events).CONCLUSIONSAn intramedullary nail and wire towrope proves to be a reliable combination for segment transport in tibial defects following trauma and infection and provides a relatively high patient comfort rate and a low complication rate.OBJECTIVESTo compare two different methods of segment transport in posttraumatic and postseptic tibial defects by employing intramedullary tibial nails as the fixation system and to evaluate differences in the complication rate between external fixation and wire towropes as the transport system.","Hofmann, G O; Gonschorek, O; Bühren, V",1999.0,,0,0,
5656,"Companionship to modify the clinical birth environment: effects on progress and perceptions of labour, and breastfeeding","ER DESIGN: Randomized controlled trial.SETTING: A community hospital familiar to most of the participants, with a conventional, clinically-orientated labour ward.SUBJECTS: Nulliparous women in uncomplicated labour.INTERVENTION: Supportive companionship from volunteers from the community with no medical nor nursing experience, concentrating on comfort, reassurance and praise.MAIN OUTCOME MEASURES: Duration of labour, use of analgesia, perceptions of labour and breastfeeding success.RESULTS: Companionship had no measurable effect on the progress of labour. Diastolic blood pressure and use of analgesia were modestly but significantly reduced. The support group were more likely to report that they felt that they had coped well during labour (60 vs 24%, P less than 0.00001). Their mean labour pain scores (26.0 vs 44.2, P less than 0.00001) and state anxiety scores (28.2 vs 37.8, P less than 0.00001) were lower than those of the control group. Compared with the control group (n = 75), at 6 weeks women in the support group (n = 74) were more likely to be breastfeeding exclusively (51 vs 29%, P less than 0.01); and to be feeding at flexible intervals (81 vs 47%, P less than 0.0001).CONCLUSIONS: Labour in a clinical environment may undermine women's feelings of competence, perceptions of labour, confidence in adapting to parenthood and initiation of successful breastfeeding. These effects may be reduced by the provision of additional companionship during labour aimed to promote self-esteem.OBJECTIVE: To measure the effects of supportive companionship on labour and various aspects of adaptation to parenthood, and thus by inference the adverse effects of a clinically orientated labour environment on these processes.","Hofmeyr, G J; Nikodem, V C; Wolman, W L; Chalmers, B E; Kramer, T",1991.0,,0,0,
5657,The Effectiveness of Group Assertiveness Training on Happiness in Rural Adolescent Females With Substance Abusing Parents,"ER BACKGROUND: Parental substance abuse confronts children with a variety of psychological, social, and behavioral problems. Children of substance abusing parents show higher levels of psychiatric disorders including anxiety and depression and exert lower levels of communication skills. Weak social skills in this group of adolescents put them at a higher risk for substance abuse. Many studies showed school based interventions such as life skill training can effective on future substance abusing in these high risk adolescences.MATERIALS AND METHODS: The participants consisted of 57 middles schools girls, all living in rural areas and having both parents with substance dependency. The participants were randomly assigned to intervention (n=28) and control (n=29) groups. The data were collected before and six weeks after training in both group. The intervention group received eight sessions of group assertiveness training. Participants were compared in terms of changes in scores on the Oxford Happiness Questionnaire and the Gambrills-Richey Assertion Inventory.RESULTS: The total score for happiness change from 43.68 ±17.62 to 51.57 ±16.35 and assertiveness score changed from 110.33±16.05 to 90.40±12.84. There was a significant difference in pretest-posttest change in scores for intervention (7.89±4.13) and control (-2.51±2.64) groups; t (55) =2.15, p = 0.049. These results suggest that intervention really does have an effect on happiness and assertiveness.CONCLUSION: Determining the effectiveness of these school based interventions on other life aspects such as substance abuse calls for further study on these rural adolescent girls.","Hojjat, S K; Golmakani, E; Norozi, Khalili M; Shakeri, Chenarani M; Hamidi, M; Akaberi, A; Rezaei, Ardani A",2015.0,10.5539/gjhs.v8n2p156,0,0,
5658,Patient Involvement in the Design of a Patient-Centered Clinical Trial to Promote Adherence to Supplemental Oxygen Therapy in COPD,"ER OBJECTIVE: The aim of this report was to describe the process and outcomes of involving patients in the design of a clinical trial to promote adherence to supplemental oxygen therapy among patients with chronic obstructive pulmonary disease.METHODS: In-person focus groups and individual discussions via telephone and email were used to elicit feedback to refine the intervention and clarify outcomes of highest importance to patients.RESULTS: A total of 25 patients and five caregivers provided feedback. Their feedback has informed decisions regarding the length of intervention sessions (20 min and in some cases longer was acceptable), the importance of including caregivers, and discussion topics (e.g., social discomfort about using oxygen in public, identifying personally relevant reasons to use oxygen, pulmonary rehabilitation). Multiple outcomes were rated as highly important to patients (physical function, fatigue, sleep, anxiety, depression, and ability to participate in social roles and activities), and the outcome that was ranked as most important varied by individual. Therefore, multiple patient-reported outcomes will be used as endpoints for the clinical trial.CONCLUSIONS: Patient involvement led to refinements of the intervention and clinical trial endpoints to better address the expressed needs and concerns of patients and caregivers.BACKGROUND: Patients are increasingly viewed as key stakeholders who can contribute in meaningful ways to clinical research and are emphasized in research funded by the Patient-Centered Outcomes Research Institute (PCORI). We are not aware of other peer-reviewed publications that report methods and outcomes of patient engagement to refine study design for a PCORI-sponsored clinical effectiveness trial.","Holm, K E; Casaburi, R; Cerreta, S; Gussin, H A; Husbands, J; Porszasz, J; Prieto-Centurion, V; Sandhaus, R A; Sullivan, J L; Walsh, L J; Krishnan, J A",2016.0,10.1007/s40271-015-0150-z,0,0,
5659,Short-term and long-term effects of a psycho-educational group intervention for family caregivers in palliative home care - results from a randomized control trial,"ER METHODS: The study design was a randomized control trial where family caregivers were allocated either to an intervention or control group. The intervention was delivered as a program including three sessions by health professionals (physician, nurse, and social worker/priest). Family caregivers from 10 specialized palliative home care settings were included. Questionnaires with validated instruments at baseline, upon completion, and 2 months following the intervention were used to measure effects of the intervention. The primary outcome was preparedness for caregiving in family caregivers.RESULTS: In total, 21 intervention programs were delivered, and 119 family caregivers completed all three measurements. The intervention group had significantly increased their preparedness for caregiving in both the short-term and long-term follow-up compared with the control group. The intervention group also reported significantly increased competence for caregiving in short-term but not long. No effects of the intervention were found on rewards for caregiving, caregiver burden, health, anxiety, or depression.CONCLUSIONS: The psycho-educational intervention has the potential to be used by health professionals to improve preparedness for caregiving among family caregivers in palliative care both in short and long terms. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.BACKGROUND: Family caregivers in cancer and palliative care often face heavy responsibilities and feel insufficiently prepared for the situation as caregivers. This study evaluates short-term and long-term effects of a psycho-educational group intervention aiming to increase preparedness for family caregiving in specialized palliative home care.","Holm, M; Årestedt, K; Carlander, I; Fürst, C J; Wengström, Y; Öhlen, J; Alvariza, A",2016.0,10.1002/pon.4004,0,0,
5660,Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: randomized trial,"ER OBJECTIVE: Major depression is the most common psychiatric disorder among breast cancer patients and is associated with substantial impairment. Although some research has explored the utility of psychotherapy with breast cancer patients, only 2 small trials have investigated the potential benefits of behavior therapy among patients with well-diagnosed depression.METHOD: In a primarily Caucasian, well-educated sample of women (age = 55.4 years, SD = 11.9) diagnosed with breast cancer and major depression (n = 80), this study was a randomized clinical trial testing the efficacy of 8 sessions of behavioral activation treatment for depression (BATD) compared to problem-solving therapy. Primary outcome measures assessed depression, environmental reward, anxiety, quality of life, social support, and medical outcomes.RESULTS: Across both treatments, results revealed strong treatment integrity, excellent patient satisfaction with treatment protocols, and low patient attrition (19%). Intent-to-treat analyses suggested both treatments were efficacious, with both evidencing significant pre-post treatment gains across all outcome measures. Across both treatments, gains were associated with strong effect sizes, and based on response and remission criteria, a reliable change index, and numbers-needed-to-treat analyses, approximately ¾ of patients exhibited clinically significant improvement. No significant group differences were found at posttreatment. Treatment gains were maintained at 12-month follow-up, with some support for stronger maintenance of gains in the BATD group.CONCLUSIONS: BATD and problem-solving interventions represent practical interventions that may improve psychological outcomes and quality of life among depressed breast cancer patients. Study limitations and future research directions are discussed.","Hopko, D R; Armento, M E; Robertson, S M; Ryba, M M; Carvalho, J P; Colman, L K; Mullane, C; Gawrysiak, M; Bell, J L; McNulty, J K; Lejuez, C W",2011.0,10.1037/a0025450,0,0,
5661,Behavior therapy for depressed breast cancer patients: predictors of treatment outcome,"ER METHODIn the context of a recent randomized trial of behavior activation and problem-solving therapy for depressed breast cancer patients (n = 80; Hopko et al., 2011), this study explored predictors of treatment outcome with selected demographic (age, education, marital status, occupational status), psychosocial (pretreatment depression and environmental reward, coexistent anxiety disorders, social support, history of psychotherapy) and cancer-related variables (cancer stage, duration of cancer diagnosis, and cancer treatment).RESULTSPositive treatment outcome as defined by Beck Depression Inventory-II (Beck et al., 1996) response and remission criteria was associated with being married, increased social support, not actively undergoing cancer treatment during psychotherapy, and having a history of psychotherapy.CONCLUSIONSThe efficacy of behavior therapy for depressed breast cancer patients may depend on several patient variables. Implications for the provision of behavior therapy for breast cancer patients are discussed.OBJECTIVEMajor depressive disorder (MDD) is the most common psychiatric disorder among breast cancer patients and is associated with substantial functional impairment. Although several outcome studies have explored the utility of psychotherapy for breast cancer patients with subsyndromal depression symptoms, only a few clinical trials have explored the efficacy of behavior therapy for patients with well-diagnosed MDD. An additional limitation of this research is that little is known about factors that best predict treatment outcome.","Hopko, D R; Cannity, K; McIndoo, C C; File, A A; Ryba, M M; Clark, C G; Bell, J L",2015.0,10.1037/a0037704,0,0,
5662,The effects of education and group discussion in the post myocardial infarction patient,"ER An education and group discussion program administered to a randomly selected group of post myocardial infarction subjects failed to produce any differences in a large number of behavioral and psychological measures. These included smoking behavior, health status, social and recreational status, family and marital life and vocational activities, as well as measures of anxiety, depression, and health locus of control. Treated subjects were slower to return to work than controls and were less likely to have returned to work by the end of the study. More individuals in the treatment group were receiving compensation and this may have been a factor in delaying return to work. Since the majority of our subjects had a very optimistic attitude toward their eventual recovery, there was limited room for improvement. We suggest that cardiac rehabilitation be directed only at those patients with ""negative"" attitudes, and with more than usual anxiety and depression.","Horlick, L; Cameron, R; Firor, W; Bhalerao, U; Baltzan, R",1984.0,,0,0,
5663,"Study protocol: a randomised controlled trial comparing the long term effects of isolated hip strengthening, quadriceps-based training and free physical activity for patellofemoral pain syndrome (anterior knee pain)","ER METHODS/DESIGN: An observer-blinded RCT will be performed. We intend to include 150 patients aged 16-40 years, referred from primary care practitioners to the department of Physical Medicine and Rehabilitation in Kristiansand, Norway for PFPS with more than three months duration. Patients meeting the inclusion criteria will be randomised using opaque sequentially numbered sealed envelopes to one of three groups: isolated hip strengthening, quadriceps based training, or a control group (free physical activity). All groups will receive standardized information about PFPS formulated with the intention to minimize fear avoidance and encourage self-mastery of symptoms. Standardized exercises will be performed under supervision of a study physiotherapist once per week in addition to home training two times per week for a total of six weeks. The primary outcome measure will be the Anterior Knee Pain Score (AKPS) at three and 12 months. Secondary outcome measures will include Visual analogue scale (VAS) for pain, hip abductor and quadriceps strength, the generic EuroQol (EQ-5D), Hopkins Symptom Checklist (HSCL), Knee self-efficacy score and Tampa score for Kinesiophobia.DISCUSSION: This trial will help to elucidate the role of hip and quadriceps strengthening in the treatment of PFPS. Information as to the role of anxiety and depression, kinesiophobia and self-efficacy will be collected, also as regards prognosis and response to exercise therapy.TRIAL REGISTRATION: ClinicalTrials.gov reference: NCT02114294.BACKGROUND: Patellofemoral pain syndrome (PFPS), also known as Anterior Knee Pain, is a common cause of recurrent or chronic knee pain. The etiology is considered to be multifactorial but is not completely understood. At the current time the leading theory is that pathomechanics in the patellofemoral joint leads to PFPS. Traditionally, conservative treatment has focused on improving strength and timing in the quadriceps muscles. In recent years, evidence has been accumulating to support the importance of hip control and strengthening in PFPS. Two recent studies have shown promising results for hip strengthening as an isolated treatment for PFPS. The aim of this randomised controlled trial (RCT) is to compare isolated hip strengthening to traditional quadriceps-based training and a control group with free physical activity.","Hott, A; Liavaag, S; Juel, N G; Brox, J I",2015.0,10.1186/s12891-015-0493-6,0,0,
5664,Psychological intervention for older hip fracture patients,"ER 1. Although there are sophisticated surgical procedures for hip fracture repair, a substantial proportion of patients never return to pre-fracture levels of physical function. Factors that influence the recovery of older hip fracture patients represent important areas to study in order to more precisely predict outcome. 2. Research findings suggest that elevated depressive symptoms and cognitive impairment may negatively affect recovery, while mental alertness, emotional stability, and social involvement positively affect recovery. Thus, hip fracture and its subsequent disability must be studied as a biopsychosocial phenomenon, rather than merely as a physiological event. 3. Older hip fracture patients may be at higher risk for psychological problems related to the traumatic nature of the injury. A comprehensive psychological assessment at admission can assist the nursing staff to determine which patients are at higher risk for emotional distress.","Houldin, A D; Hogan-Quigley, B",1995.0,,0,0,
5665,Visual exposure impacts on toddlers' willingness to taste fruits and vegetables,"ER This study explores the effects of exposure to pictures of fruits and vegetables on young children's willingness to taste the foods. The parents of 20 toddlers aged 21-24 months were asked to read a picture book about four foods with their child every day for two weeks. In a subsequent 'taste test' children displayed a neophobic pattern of behaviour towards foods to which they had not been exposed, but not towards exposed foods. Furthermore, while exposure served to decrease children's willingness to taste familiar vegetables, it increased their willingness to taste unfamiliar fruits.","Houston-Price, C; Butler, L; Shiba, P",2009.0,10.1016/j.appet.2009.08.012,0,0,
5666,"A repressive coping style and affective, facial and physiological responses to looking at emotional pictures","ER Previous studies have demonstrated increased physiological-emotional responses despite relatively low self-reported affect for individuals with a repressive coping style, as compared to control groups. The main question in the current study was whether such group differences could also be demonstrated by using the picture perception methodology of Lang. A second question was whether differences between these groups could be found in the habituation of physiological and emotional responses. Repressors (n=14), 'truly' low anxious participants (n=14), and moderately high anxious participants (n=13) were selected with the Marlowe-Crowne Social Desirability Scale and the Taylor Manifest Anxiety Scale. Two sets of 27 pictures with alternating neutral, threatening and sexual content were presented whilst valence and arousal ratings, skin conductance, heart rate and facial muscle responses were measured. No straightforward group differences were found. However, the results suggest that differential habituation, and not a repressive coping style, may contribute to differential self-reported, facial and physiological-emotional responses.","Houtveen, J H; Rietveld, S; Schoutrop, M; Spiering, M; Brosschot, J F",2001.0,,0,0,
5667,Transforaminal lumbar interbody fusion (TLIF) versus posterolateral instrumented fusion (PLF) in degenerative lumbar disorders: a randomized clinical trial with 2-year follow-up,"ER PURPOSE: The aim of the present study was to analyze outcome, with respect to functional disability, pain, fusion rate, and complications of patients treated with transforaminal lumbar interbody fusion (TLIF) in compared to instrumented poserolateral fusion (PLF) alone, in low back pain. Spinal fusion has become a major procedure worldwide. However, conflicting results exist. Theoretical circumferential fusion could improve functional outcome. However, the theoretical advantages lack scientific documentation.METHODS: Prospective randomized clinical study with a 2-year follow-up period. From November 2003 to November 2008 100 patients with severe low back pain and radicular pain were randomly selected for either posterolateral lumbar fusion [titanium TSRH (Medtronic)] or transforaminal lumbar interbody fusion [titanium TSRH (Medtronic)] with anterior intervertebral support by tantalum cage (Implex/Zimmer). The primary outcome scores were obtained using Dallas Pain Questionnaire (DPQ), Oswestry disability Index, SF-36, and low back pain Rating Scale. All measures assessed the endpoints at 2-year follow-up after surgery.RESULTS: The overall follow-up rate was 94 %. Sex ratio was 40/58. 51 patients had TLIF, 47 PLF. Mean age 49(TLIF)/45(PLF). No statistic difference in outcome between groups could be detected concerning daily activity, work leisure, anxiety/depression or social interest. We found no statistic difference concerning back pain or leg pain. In both the TLIF and the PLF groups the patients had significant improvement in functional outcome, back pain, and leg pain compared to preoperatively. Operation time and blood loss in the TLIF group were significantly higher than in the PLF group (p < 0.001). No statistic difference in fusion rates was detected.CONCLUSIONS: Transforaminal interbody fusion did not improve functional outcome in patients compared to posterolateral fusion. Both groups improved significantly in all categories compared to preoperatively. Operation time and blood loss were significantly higher in the TLIF group.","Høy, K; Bünger, C; Niederman, B; Helmig, P; Hansen, E S; Li, H; Andersen, T",2013.0,10.1007/s00586-013-2760-2,0,0,
5668,Motivational interviewing and cognitive behaviour therapy for anxiety following traumatic brain injury: a pilot randomised controlled trial,"ER Although cognitive-behavioural therapy (CBT) is the treatment of choice for anxiety, its delivery needs to be adapted for individuals with traumatic brain injury (TBI). It also requires clients' active engagement for maximum benefit. This study was a pilot randomised controlled trial involving an anxiety treatment programme adapted for people with TBI, based on CBT and motivational interviewing (MI). Twenty-seven participants with moderate/severe TBI (aged 21-73 years, 78% males) recruited from a brain injury rehabilitation hospital were randomly allocated to receive MI + CBT (n = 9), non-directive counselling (NDC) + CBT (n = 10) and treatment-as-usual (TAU) (n = 8). CBT and MI were manualised and delivered in 12 weekly individual sessions. Primary outcome was self-reported anxiety symptoms assessed at baseline, at the end of NDC/MI and immediately following CBT. Assessment was conducted by assessors blinded to group assignment. Intention-to-treat analyses showed that the two active treatment groups demonstrated significantly greater anxiety reduction than TAU. Participants receiving MI showed greater response to CBT, in terms of reduction in anxiety, stress and non-productive coping, compared to participants who received NDC. The results provided preliminary support for the adapted CBT programme, and the potential utility of MI as treatment prelude. Longer follow-up data are required to evaluate the maintenance of treatment effects.","Hsieh, M Y; Ponsford, J; Wong, D; Schönberger, M; Taffe, J; McKay, A",2012.0,10.1080/09602011.2012.678860,0,0,
5669,"Traditional Chinese medicine compound ShengJinRunZaoYangXue granules for treatment of primary Sjögren's syndrome: a randomized, double-blind, placebo-controlled clinical trial","ER BACKGROUND: Traditional Chinese medical treatment of primary Sjögren's syndrome has advantages over Western medicine in terms of fewer side effects and improved patient conditions. This study was a multicenter, randomized, double-blind, placebo-controlled clinical trial of the efficacy and safety of ShengJinRunZaoYangXue granules for the treatment of primary Sjögren's syndrome, including the symptoms of dry mouth and dry eye.METHODS: We undertook a 6-week, double-blind, randomized trial involving 240 patients with primary Sjögren's syndrome at five centers in East China. A computer-generated randomization schedule assigned patients at a 2:1 ratio to receive either ShengJinRunZaoYangXue granules or placebo once daily. Patients and investigators were blinded to treatment allocation. The primary endpoints were the salivary flow rate, Schirmer test results, and sugar test results. Intention-to-treat and per-protocol analyses were performed.RESULTS: All 240 patients were randomly allocated to either the treatment group (n = 160, ShengJinRunZaoYangXue granules) or placebo group (n = 80) and were included in the intention-to-treat analysis. After program violation and loss to follow-up, a total of 199 patients were included in the per-protocol analysis. At six week, intention-to-treat and per-protocol analyses of the left-eye Schirmer I test results showed an improved difference of 1.36 mm/5 min (95% CI: 0.03 to 2.69 mm/5 min) and 1.35 mm/5 min (95% CI: 0.04 to 2.73 mm/5 min), respectively, and those of the right-eye Schirmer I test results showed an improved difference of 1.12 mm/5 min (95% CI: 0.02 to 2.22 mm/5 min) and 1.12 mm/5 min (95% CI: -0.02 to 2.27 mm/5 min), respectively. There was no significant difference between the two groups before treatment. After treatment, the between-group and within-group before-and-after paired comparison results were statistically significant (P < 0.05). Intention-to-treat and per-protocol analyses showed an improved salivary flow rate by 0.04 ml/15 min (95% CI: -0.49 to 0.58 ml/15 min) and 0.04 ml/15 min (95% CI: -0.52 to 0.60 ml/15 min), respectively, but the differences were not significant. Intention-to-treat and per-protocol analyses showed that the sugar test results were improved by 1.77 minutes (95% CI: 0.11 to 3.44 minutes) and 1.84 minutes (95% CI: 0.12 to 3.55 minutes), respectively, but the differences were not significant. For the secondary endpoint, intention-to-treat and per-protocol analyses showed significant improvement in the integrated evaluation of treated patients with dry eye and dry mouth after six weeks of treatment. The incidence of adverse events was 15.6% in the treatment group and 10.0% in the placebo group. Most (94%) adverse events were mild to moderate in the two groups, and only two cases of serious adverse events occurred in the treatment group; both were caused by autoimmune liver disease.CONCLUSIONS: Six-week treatment with ShengJinRun ZaoYangXue granules for primary Sjögren's syndrome in this large-scale study improved the symptoms of dry mouth, dry eyes, and low tear flow rate with minimal adverse events.","Hu, W; Qian, X; Guo, F; Zhang, M; Lyu, C; Tao, J; Gao, Z; Zhou, Z",2014.0,,0,0,
5670,Observation on the expression of PS2 and platelet activating factor affected by Jianwei Yuyang granules and study its potential mechanisim against peptic ulcer,"ER METHODS76 gastric ulcer patients were final diagnosed by gastroscope. They were randomly devided into 3 groups, including JWYY group (36 cases), Ranitidine group (36 cases) and Normal group (12 cases). Detection on Biospy Specimens of gastric mucosa to obseve the change of PAF, PS2 and the contents of aninohexose and phosphatide in ulcerated gastric mucosa for Immunohischemical and Western blotting.RESULTSThe contents of aninohexose, phosphatide of PU patients increased in JWYY group. There was significant difference between JWYY group and Ranitidine group (P < 0.01). The Immunohischemical and Western blotting methods showed that there was a linear correlation between the the contents of phosphatide, anino-hexose and the expression of PAF, PS2 in PU patients (P < 0.01).CONCLUSIONJWYY granule can prevent the occurrence and relaps of ulcer and affect the hydrophobicity of gastic mucosa and strengthen the stability of myxo-gellayer by reducing the expression of PAF, elevating the expression of PS2 and effecting the contents of phosphatide and aninohexose, that may be one of the mechanisms of JWYY to heal ulcer quickly.OBJECTIVETo observe the influences of Jianwei Yuyang (JWYY) granules on expressions of PS2 and platelet activating factor (PAF), and analyze its potential mechanism.","Huang, G D; Huang, Y H; Li, J B; Huang, D F; Xiao, M Z; Tang, L J; Li, Q",2007.0,,0,0,
5671,Effect of volatile oil of amomum on expressions of platelet activating factor and mastocarcinoma-related peptide in the gastric membrane of chronic gastritis patients with helicobacter-pylori infection,"ER METHODSEighty patients with HPG were randomly assigned to two groups, 42 patients in the treated group treated with 0.5 mL VOA, thrice per day; and the 38 patients in the control group receiving Western tertiary medicinal treatment. Gastroscopic picture and helicobacter pylori (HP) infection (by quick urease and Warthin-Starry stain) of the gastro-membrane, expressions of PS2 and PAF (by immunohistochemical assay and Western blotting) as well as the contents of aminohexose and phospholipid (by Neuhaus method) in the gastric membrane of all patients were detected before treatment and 4 weeks after treatment. The clinical efficacy in the two groups was compared.RESULTSThe total effective rate in the treated group was 88.1%, which was significantly higher than that in the control group (78.9%, P0.05).CONCLUSIONThe mechanism of VOA for anti-gastritis might be related with its action in increasing the expression of PS2 and decreasing the expression of PAF, and thus regulating the hydrophobicity of the gastric membrane.OBJECTIVETo observe the effect of volatile oil of amomum (VOA) on the expressions of mastocarcinoma-related peptide (PS2) and platelet activating factor (PAF) in helicobacter pyloriassociated gastritis (HPG) and to analyze its potential mechanism.","Huang, G D; Huang, Y H; Xiao, M Z; Huang, D F; Liu, J; Li, J B",2008.0,10.1007/s11655-008-0023-6,0,0,
5672,Effects of an educational program on parents with febrile convulsive children,"ER The purpose of this study was to characterize the effects of an educational program on knowledge, attitude, concern, and first-aid measures among parents with febrile convulsive children. All parents completed a pretest questionnaire 3 weeks before the meeting. The parents were assigned randomly into experimental (n = 65) and control (n = 64) groups on the day they attended the program. The control group completed the identical questionnaire (posttest) before the program, whereas the experimental group completed the same posttest after the program. In pretest, most parents considered electroencephalogram or computed tomography necessary in evaluating their children, suggested that immunization be postponed, and rated the risk of subsequent epilepsy as high for their children. Most of them favored frequent body temperature measurement, were very anxious about further febrile convulsion episodes during the night, and were fever phobic. After education, although only a slight change in fever anxiety was found, the experimental group showed significant improvement in knowledge, attitude, concerns, and anticipatory practice of febrile convulsion compared with the control group. In conclusion the parents' poor knowledge, negative attitudes, anxiety, and inadequate first-aid measures toward febrile convulsion can be effectively improved by an educational intervention program.","Huang, M C; Liu, C C; Huang, C C",1998.0,,0,0,
5673,Less systemic cytokine response in patients following microendoscopic versus open lumbar discectomy,"ER The magnitude of the tissue damage from surgery impacts the trauma response. This response is proportional to the severity of surgical stress. Systemic cytokines are recognized as markers of postoperative tissue trauma. Microendoscopic discectomy (MED) recently has become popular for treating lumbar disc herniations, and is associated with favorable clinical outcomes compared with open discectomy (OD). This study postulates that MED is a less traumatic procedure, and therefore has a lower surgical stress response compared to OD. In this study, a quantitative comparison of the overall effects of surgical trauma resulting from MED and OD was performed through analyzing patient systemic cytokines response. From April, 2002 to June, 2003, 22 consecutive patients who had symptomatic lumbar disc herniations were prospectively randomized to undergo either intracanalicular MED (N=10) or OD (N=12). In this study, the Vertebroscope System (Zeppelin, Pullach, Germany) was used to perform the endoscopic discectomy procedure in all MED patients. Serum levels of tumor necrosis factor-alpha (TNF-alpha), Interleukin-1beta (IL-1beta), Interleukin-6 (IL-6), and Interleukin-8 (IL-8) were measured before surgery and at 1, 2, 4, 8 and 24h after surgery using an enzyme-linked immunosorbent assay. Serum C-reactive protein (CRP) was measured at the same time interval. The results showed the MED patients had shorter postoperative hospital stay (mean, 3.57+/-0.98 vs. 5.92+/-2.39 days, p=0.025) and less intraoperative blood loss (mean, 87.5+/-69.4 vs. 190+/-115 ml, p=0.042). The operating length, including the set-up time, was longer in the MED group (mean, 109+/-35.9 vs. 72.1+/-17.8 min, p=0.01). The mean size of skin incision made for the MED patients was 1.86+/-0.13 cm (range 1.7-2.0 cm); and 6.3+/-0.98 cm for the OD patients (range 5.5-8 cm), p=0.001. The patients' pain severity of the involved limbs on 10-point Visual Analog Scale before operation in MED group was 7.5+/-0.3 (range 6-9) and 8+/-0.2 (range 7-9) in OD group, p=0.17; and after surgery, 1.5+/-0.2 (range 1-2) in MED group and 1.4+/-0.1 (range 1-3) in OD group, p=0.91. CRP levels peaked at 24h in both groups, and OD patients displayed a significantly greater postoperative rise in serum CRP (mean, 27.78+/-15.02 vs. 13.84+/-6.25mg/l, p=0.026). Concentrations of TNF-alpha, IL-1beta, and IL-8 were detected only sporadically. Serum IL-6 increased less significantly following MED than after OD. In the MED group, IL-6 level peaked 8h after surgery, with the response statistically less than in the open group (mean, 6.27+/-5.96 vs. 17.18+/-11.60 pg/ml, p=0.025). A statistically significant correlation was identified between IL-6 and CRP values (r=0.79). Using the modified MacNab criteria, the clinical outcomes were 90% satisfactory (9/10) in MED patients and 91.6% satisfactory (11/12) in OD patients at a mean 18.9 months (range 10-25) follow-up. Based on the current data, surgical trauma, as reflected by systemic IL-6 and CRP response, was significantly less following MED than following OD. The difference in the systemic cytokine response may support that the MED procedure is less traumatic. Moreover, our MED patients had achieved satisfactory clinical outcomes as the OD patients at a mean 18.9 months follow-up after surgery.","Huang, T J; Hsu, R W; Li, Y Y; Cheng, C C",2005.0,10.1016/j.orthres.2004.08.010,0,0,
5674,Reinvestigation of the dysfunction in neck and shoulder girdle muscles as the reason of cervicogenic headache among office workers,"ER PURPOSE: Dysfunction of cervical and shoulder girdle muscles as reason of cervicogenic headache (CEH) was reinvestigated with clinical and neurophysiological studies.METHODS: Forty office workers were randomized into two groups to verify efficiency of supervised kinesiotherapy (N = 20) aimed with improvement of muscle's activity and headache symptoms releasing. Headache intensity was evaluated with visual analog scale (VAS), range of cervical movement (ROM) with goniometer, trigger points (TrPs) incidence with palpation and muscle's strength with Lovett's scale. Reaction of patients for muscle's elongation was also evaluated. Surface electromyographical recordings were bilaterally analyzed at rest (rEMG) and during maximal contraction (mcEMG).RESULTS: Deficits of cervical flexion and muscles strength were found in all patients. TrPs occurred predominantly in painful trapezius muscle. Incidence of trigger points coexisted with intensity of CEH. Results indicated on muscles dysfunction which improved only after supervised therapy. Positive correlations between increase in rEMG amplitudes and high VAS scores, high-amplitude rEMG recordings incidence and increased number of TrPs were found. Negative correlation was detected between amplitude in mcEMG and amplitude of rEMG recordings.CONCLUSIONS: Dysfunction of trapezius muscle was most responsible for CEH etiology. Proposed algorithm of kinesiotherapy was effective as complementary method of the CEH patients treatment.","Huber, J; Lisi?ski, P; Polowczyk, A",2013.0,10.3109/09638288.2012.709306,0,0,
5675,Reducing the psychological distress of family caregivers of home based palliative care patients: longer term effects from a randomised controlled trial,"ER Background: Palliative care incorporates comprehensive support of family caregivers because many of them experience burden and distress. However, evidence-based support initiatives are few. Purpose: We evaluated a one-to-one psychoeducational intervention aimed at mitigating the distress of caregivers of patients with advanced cancer receiving home-based palliative care. We hypothesised that caregivers would report decreased distress as assessed by the General Health Questionnaire (GHQ). Method: A randomised controlled trial comparing two versions of the delivery of the intervention (one face-to-face home visit plus telephone calls versus two visits) plus standard care to a control group (standard care only) across four sites in Australia. Results: Recruitment to the one visit condition was 57, the two visit condition 93, and the control 148. We previously reported non-signi fi cant changes in distress between times 1 (baseline) and 2 (1-week post-intervention) but signifi cant gains in competence and preparedness. We report here changes in distress between times 1 and 3 (8-week post-death). There was significantly less worsening in distress between times 1 and 3 in the one visit intervention group than in the control group; however, no significant difference was found between the two visit intervention and the control group. Conclusions: These results are consistent with the aim of the intervention, and they support existing evidence demonstrating that relatively short psychoeducational interventions can help family caregivers who are supporting a dying relative. The sustained benefit during the bereavement period may also have positive resource implications, which should be the subject of future inquiry.","Hudson, P; Trauer, T; Kelly, B; O'Connor, M; Thomas, K; Zordan, R; Summers, M",2015.0,10.1002/pon.3610,0,0,
5676,Comparison of dextranomer and streptokinase-streptodornase in the treatment of venous leg ulcers and other infected wounds,"ER The clinical efficacy of dextranomer (Debrisan) and streptokinase-streptodornase (Varidase) was compared in a controlled randomized in-patient study. There were two patient groups: Group A consisting of 28 patients with a total of 31 venous leg ulcers and Group B consisting of 56 patients with other infected wounds (posttraumatic and postoperative wounds, amputation stumps, burn wounds, arteriosclerotic ulcers, decubital ulcers, ulcers due to bone disease, rheumatic ulcers, ulcers due to erysipelas and wounds of mixed aetiology). Both agents have a good cleansing effect as well as a good effect on infection and wet necrosis. Dextranomer stimulates the formation of granulation tissue faster than streptokinase-streptodornase.","Hulkko, A; Holopainen, Y V; Orava, S; Kangas, J; Kuusisto, P; Hyvärinen, E; Ervasti, E; Silvennoinen, E",1981.0,,0,0,
5677,"Psychosocial and other characteristics of women complaining of menorrhagia, with and without actual increased menstrual blood loss","ER DESIGNCross-sectional comparative study of women referred for menorrhagia.SETTINGGynaecology departments of all five university teaching hospitals in Finland.SAMPLETwo hundred and twenty-six women aged 35-49 years complaining of menorrhagia.MAIN OUTCOME MEASURESSeveral psychosocial factors, seeking medical attention, menstrual blood loss.RESULTSTwenty-nine percent of the women had their menstrual blood loss in the normal range (menstrual blood loss <60 mL). By univariate analysis, unemployment, anxiety, perceived inconvenience, abdominal pain, haemoglobin level and serum ferritin concentration distinguished this group of women from those with true menorrhagia. Unemployment, perceived inconvenience, abdominal pain and serum ferritin remained significant variables by multivariate analysis.CONCLUSIONSA significant proportion of women with complaints of menorrhagia have their measured menstrual blood loss within the normal range. Psychosocial factors can have an impact on their seeking health care. Better understanding of the factors, which explain complaints of menorrhagia in women with normal bleeding could improve both medical outcomes and reduce the cost of treatment for menorrhagia.OBJECTIVETo discover whether psychosocial factors can explain why many women with normal menstrual blood loss seek care for menorrhagia.","Hurskainen, R; Aalto, A M; Teperi, J; Grenman, S; Kivelä, A; Kujansuu, E; Vuorma, S; Yliskoski, M; Paavonen, J",2001.0,,0,0,
5678,"Randomized controlled trial of yoga for chronic poststroke hemiparesis: motor function, mental health, and quality of life outcomes","ER PURPOSE: To assess the efficacy of yoga for motor function, mental health, and quality of life outcomes in persons with chronic poststroke hemiparesis.METHOD: Twenty-two individuals participated in a randomized controlled trial involving assessment of task-orientated function, balance, mobility, depression, anxiety, and quality of life domains before and after either a 10-week yoga intervention (n = 11) or no treatment (n = 11).RESULTS: The yoga intervention did not result in any significant improvements in objective motor function measures, however there was a significant improvement in quality of life associated with perceived motor function (P = .0001) and improvements in perceived recovery approached significance (P = .072). Memory-related quality of life scores significantly improved after yoga intervention (P = .022), and those participating in the intervention exhibited clinically relevant decreases in state and trait anxiety.CONCLUSIONS: Preliminary results offer promise for yoga as an intervention to address mental health and quality of life in persons with stroke-related activity limitations. There is a need to more rigorously evaluate these yoga benefits with a larger randomized controlled trial, which, based on this preliminary trial, is feasible.","Immink, M A; Hillier, S; Petkov, J",2014.0,10.1310/tsr2103-256,0,0,
5679,"Prophylactic use of a probiotic in the prevention of colic, regurgitation, and functional constipation: a randomized clinical trial","ER IMPORTANCE: Infantile colic, gastroesophageal reflux, and constipation are the most common functional gastrointestinal disorders that lead to referral to a pediatrician during the first 6 months of life and are often responsible for hospitalization, feeding changes, use of drugs, parental anxiety, and loss of parental working days with relevant social consequences.OBJECTIVE: To investigate whether oral supplementation with Lactobacillus reuteri DSM 17938 during the first 3 months of life can reduce the onset of colic, gastroesophageal reflux, and constipation in term newborns and thereby reduce the socioeconomic impact of these conditions.DESIGN: A prospective, multicenter, double-masked, placebo-controlled randomized clinical trial was performed on term newborns (age <1 week) born at 9 different neonatal units in Italy between September 1, 2010, and October 30, 2012.SETTING: Parents were asked to record in a structured diary the number of episodes of regurgitation, duration of inconsolable crying (minutes per day), number of evacuations per day, number of visits to pediatricians, feeding changes, hospitalizations, visits to a pediatric emergency department for a perceived health emergency, pharmacologic interventions, and loss of parental working days.PARTICIPANTS: In total, 589 infants were randomly allocated to receive L reuteri DSM 17938 or placebo daily for 90 days.INTERVENTIONS: Prophylactic use of probiotic.MAIN OUTCOMES AND MEASURES: Reduction of daily crying time, regurgitation, and constipation during the first 3 months of life. Cost-benefit analysis of the probiotic supplementation.RESULTS: At 3 months of age, the mean duration of crying time (38 vs 71 minutes; P?<?.01), the mean number of regurgitations per day (2.9 vs 4.6; P?<?.01), and the mean number of evacuations per day (4.2 vs 3.6; P?<?.01) for the L reuteri DSM 17938 and placebo groups, respectively, were significantly different. The use of L reuteri DSM 17938 resulted in an estimated mean savings per patient of ?88 (US $118.71) for the family and an additional ?104 (US $140.30) for the community.CONCLUSIONS AND RELEVANCE: Prophylactic use of L reuteri DSM 17938 during the first 3 months of life reduced the onset of functional gastrointestinal disorders and reduced private and public costs for the management of this condition.TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01235884.","Indrio, F; Mauro, A; Riezzo, G; Civardi, E; Intini, C; Corvaglia, L; Ballardini, E; Bisceglia, M; Cinquetti, M; Brazzoduro, E; Vecchio, A; Tafuri, S; Francavilla, R",2014.0,10.1001/jamapediatrics.2013.4367,0,0,
5680,Durable bonding to mechanically and/or chemically pre-treated dental zirconia,"ER OBJECTIVES: To evaluate the effect of mechanical and chemical surface pre-treatment on the bond durability of two composite cements to dental zirconia.METHODS: Fully sintered IPS e.max ZirCAD (Ivoclar-Vivadent) blocks were either subjected to tribochemical silica sandblasting (CoJet, 3M ESPE) or not mechanically pre-treated. Next, the zirconia samples were either additionally pre-treated using one of two silane/MDP-combined ceramic primers (Clearfil Ceramic Primer, Kuraray; Monobond Plus, Ivoclar-Vivadent), or not further chemically pre-treated. Finally, two identically pre-treated zirconia blocks were bonded together using either a conventional BisGMA-based (Clearfil Esthetic Cement, Kuraray) or an MDP-based (Panavia F2.0, Kuraray) 'self-etch' dual-cure composite cement. The specimens were trimmed at the interface to a cylindrical hour-glass shape and stored for 7 days in distilled water (37°C), after which they were randomly exposed to one of three ageing protocols: (1) immersed in 37°C water for 10 days (10d); (2) subjected to 10,000 thermo-cycles (TC); or (3) immersed in 37°C water for 6 months (6m). After storage, the micro-tensile bond strength (?TBS) was determined in MPa (n=15-21/group). Fractographic analysis was performed using SEM.RESULTS: Weibull analysis revealed the highest Weibull scale and shape parameters for the 'CoJet/Clearfil Ceramic Primer/Panavia F2.0/10d' combination. While the BisGMA-based composite cement Clearfil Esthetic Cement (Kuraray) bonded equally well to zirconia using either tribochemical silica sandblasting (CoJet, 3M ESPE) or not, sandblasting appeared indispensable for the MDP-based and more hydrophilic composite cement Panavia F2.0 (Kuraray).CONCLUSIONS: Combined mechanical and chemical pre-treatment can best be recommended to durably bond to zirconia.CLINICAL SIGNIFICANCE: As a standard procedure to durable bond zirconia to tooth tissue, both mechanical (tribochemical silica coating) and chemical (silane/MDP-combined ceramic primers) is clinically highly recommended.","Inokoshi, M; Kameyama, A; Munck, J; Minakuchi, S; Meerbeek, B",2013.0,10.1016/j.jdent.2012.10.017,0,0,
5681,Differences in the metabolism and disposition of ursodeoxycholic acid and of its taurine-conjugated species in patients with primary biliary cirrhosis,"ER The clinical effectiveness of ursodeoxycholate in the treatment of liver disease may be limited by its poor absorption and extensive biotransformation. Because in vitro and in vivo studies suggest that the more hydrophilic bile acid tauroursodeoxycholate has greater beneficial effects than ursodeoxycholate, we have compared for the first time the absorption, metabolism, and clinical responses to these bile acids in patients with primary biliary cirrhosis (PBC). Twelve female patients with PBC were sequentially administered tauroursodeoxycholate and ursodeoxycholate (750 mg/d for 2 months) in a randomized, cross-over study. Bile acids were measured in serum, duodenal bile, urine, and feces by gas chromatography-mass spectrometry (GC-MS). Biliary ursodeoxycholate enrichment was higher during tauroursodeoxycholate administration (32.6% vs. 29.2% during ursodeoxycholate; P <.05). Lithocholic acid concentration was consistently higher in all biological fluids during ursodeoxycholate administration. Fecal bile acid excretion was the major route of elimination of both bile acids; ursodeoxycholate accounted for 8% and 23% of the total fecal bile acids during tauroursodeoxycholate and ursodeoxycholate administration, respectively (P <.05). Tauroursodeoxycholate was better absorbed than ursodeoxycholate, and, although it was partially deconjugated and reconjugated with glycine, it underwent reduced biotransformation to more hydrophobic metabolites. This comparative study suggests that tauroursodeoxycholate has significant advantages over ursodeoxycholate that may be of benefit for long-term therapy in PBC.","Invernizzi, P; Setchell, K D; Crosignani, A; Battezzati, P M; Larghi, A; O'Connell, N C; Podda, M",1999.0,10.1002/hep.510290220,0,0,
5682,Maternal outcomes of a randomized controlled trial of a community-based support program for families of children with chronic illnesses,"ER OBJECTIVETo evaluate maternal outcomes of a support intervention for families of children with selected chronic illnesses.DESIGNA randomized controlled clinical trial design with repeated measures 1 year apart.SETTINGA community-based family support intervention linked to subspecialty and general pediatric clinics and practices in a metropolitan area.PARTICIPANTSA population-based sample of 193 mothers of children aged 7 to 11 years; the children were diagnosed as having diabetes, sickle cell anemia, cystic fibrosis, or moderate to severe asthma. About 15% of the persons contacted refused to participate in the research, and 14% of the families were lost to follow-up.INTERVENTIONThe 15-month intervention, the Family-to-Family Network, was designed to enhance mothers' mental health by linking mothers of school-aged children with selected chronic illnesses with mothers of older children with the same condition. The program included telephone contacts, face-to-face visits, and special family events.MAIN OUTCOME MEASURESBeck Depression Inventory score and the Psychiatric Symptom Index.RESULTSMaternal anxiety scores for participants in the experimental group decreased during the intervention period for all diagnostic groups and for the total group; scores for the control group increased (F = 5.07, P =.03). In multiple regression analyses, the intervention group was a significant predictor of posttest anxiety scores (P =.03). Effects were greater for mothers with high baseline anxiety (P<.001) and for those who were themselves in poor health (P<.01).CONCLUSIONSA family support intervention can have beneficial effects on the mental health status of mothers of children with chronic illnesses. This type of intervention can be implemented in diverse pediatric settings.BACKGROUNDParents of children with chronic illnesses are at high risk for secondary mental health problems, such as anxiety and depression.","Ireys, H T; Chernoff, R; DeVet, K A; Kim, Y",2001.0,,0,0,
5683,Silence is golden: effect of encouragement in motivating the weak link in an online exercise video game,"ER BACKGROUND: Despite the physical and mental health benefits, few adults meet US Department of Health and Human Services physical activity guidelines for exercise frequency, intensity, and duration. One strategy that may increase physical activity duration is exercising with an Internet partner (ie, someone who is virtually present, as in video chat). Internet partners help people overcome many barriers associated with face-to-face exercise groups (eg, time, coordinating schedules, social physique anxiety). Past research examining individual performance in groups suggests that an increase in effort occurs when performing a task conjunctively, ie, when a participant is (1) less capable than fellow group members, and (2) participants efforts are particularly indispensable for group success (ie, where the group's potential productivity is equal to the productivity of its least capable member). This boost in effort is more commonly known as the Köhler effect, named after the German psychologist who first observed the effect. While encouragement between group members is common practice in face-to-face group exercise, the effect of encouragement between partners exercising conjunctively across the Internet is unknown.OBJECTIVE: To examine the impact of exercising alone, compared to exercising conjunctively with an Internet partner, both with and without encouragement, on exercise persistence (primary outcomes) and secondary psychosocial outcomes (self-efficacy, enjoyment, exercise intention).METHODS: Participants were recruited online and face-to-face from the campus of Michigan State University. With the assistance of the experimenter, participants (n=115) played an exercise video game in a laboratory, performing a series of five abdominal plank exercises where they were asked to hold the plank for as long as possible (Time 1). They were then randomized to a condition (Individual, Partner-without-encouragement, or Partner-with-encouragement), where they performed the exercises again (Time 2). The impact of condition on the primary outcome measures and secondary outcome measures were evaluated using a 2 (Gender) x 3 (Condition) ANOVA on change scores (Time 2-Time 1).RESULTS: Those who exercised in online teams (n=80) exercised significantly longer (time=78.8s, P<.001) than those who worked individually (n=35). However, exercise duration was shorter when one's more capable partner gave verbal encouragement (n=55) than when s/he did not (n=25) (a mean difference of 31.14s). These increases in effort were not accompanied by altered task self-efficacy, enjoyment of the task, or intention to exercise in the future.CONCLUSIONS: Exercising conjunctively with an Internet partner can boost one's duration of exercise. However, encouragement from the stronger to the weaker member can mitigate these gains, especially if one perceives such comments being directed at someone other than themselves. To boost exercise duration, Internet-based physical activity interventions involving group interaction should make relative abilities of participants known and communication clear.","Irwin, B C; Feltz, D L; Kerr, N L",2013.0,10.2196/jmir.2551,0,0,
5684,A randomised controlled trial of cognitive behaviour therapy and motivational interviewing for people with Type 1 diabetes mellitus with persistent sub-optimal glycaemic control: a Diabetes and Psychological Therapies (ADaPT) study,"ER DESIGNA three-arm parallel randomised controlled trial as the gold standard design to test the effectiveness of psychological treatments.SETTINGThe recruiting centres were diabetes clinics in seven acute trusts in south-east London and Greater Manchester.PARTICIPANTSAdults (18-65 years) with a confirmed diagnosis of type 1 diabetes for a minimum duration of 2 years and a current glycated (or glycosylated) haemoglobin (HbA1c) value between 8.2% and 15.0%.INTERVENTIONSThe control arm consisted of usual diabetes care which varied between the hospitals, but constituted at least three monthly appointments to diabetes clinic. The two treatments arms consisted of usual care with MET and usual care with MET + CBT.MAIN OUTCOME MEASURESThe primary outcome was HbA1c at 12 months from randomisation. Secondary outcome measures were 1-year costs measured by the Client Service Receipt Inventory at baseline, 6 months and 12 months; quality of life-years [quality-adjusted life-years (QALYs)] measured by the SF-36 (Short Form-36 Health Survey Questionnaire) and EQ-5D (European Quality of Life-5 Dimensions) at baseline and 12 months.RESULTSOne thousand six hundred and fifty-nine people with type 1 diabetes were screened and 344 were randomised to MET + CBT (n = 106), MET (n = 117) and to usual care (n = 121). The 12-month follow-up rate for HbA1c was 88% (n = 305). The adjusted mean 12-month HbA1c was 0.45% lower in those treated with MET + CBT [95% confidence interval (CI) 0.16% to 0.79%, p = 0.008] than for usual care; 0.16% lower in those treated with MET (95% CI 0.20% to 0.51%, p = 0.38) than for usual care; and 0.30% lower with MET + CBT than with MET (95%","Ismail, K; Maissi, E; Thomas, S; Chalder, T; Schmidt, U; Bartlett, J; Patel, A; Dickens, C; Creed, F; Treasure, J",2010.0,10.3310/hta14220,0,0,
5685,Accelerating the development of emotion competence in Head Start children: effects on adaptive and maladaptive behavior,"ER Separate studies of rural and urban Head Start systems tested the hypothesis that an emotion-based prevention program (EBP) would accelerate the development of emotion and social competence and decrease agonistic behavior and potential precursors of psychopathology. In both studies, Head Start centers were randomly assigned to treatment and control/comparison group conditions. In Study 1 (rural community), results of hierarchical linear modeling analyses showed that compared to the control condition (Head Start as usual), EBP produced greater increases in emotion knowledge and emotion regulation and greater decreases in children's negative emotion expressions, aggression, anxious/depressed behavior, and negative peer and adult interactions. In Study 2 (inner city), compared to the established prevention program I Can Problem Solve, EBP led to greater increases in emotion knowledge, emotion regulation, positive emotion expression, and social competence. In Study 2, emotion knowledge mediated the effects of EBP on emotion regulation, and emotion competence (an aggregate of emotion knowledge and emotion regulation) mediated the effects of EBP on social competence.","Izard, C E; King, K A; Trentacosta, C J; Morgan, J K; Laurenceau, J P; Krauthamer-Ewing, E S; Finlon, K J",2008.0,10.1017/S0954579408000175,0,0,
5686,A randomised controlled trial of dietary improvement for adults with major depression (the 'SMILES' trial),"ER METHODS: 'SMILES' was a 12-week, parallel-group, single blind, randomised controlled trial of an adjunctive dietary intervention in the treatment of moderate to severe depression. The intervention consisted of seven individual nutritional consulting sessions delivered by a clinical dietician. The control condition comprised a social support protocol to the same visit schedule and length. Depression symptomatology was the primary endpoint, assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) at 12 weeks. Secondary outcomes included remission and change of symptoms, mood and anxiety. Analyses utilised a likelihood-based mixed-effects model repeated measures (MMRM) approach. The robustness of estimates was investigated through sensitivity analyses.RESULTS: We assessed 166 individuals for eligibility, of whom 67 were enrolled (diet intervention, n?=?33; control, n?=?34). Of these, 55 were utilising some form of therapy: 21 were using psychotherapy and pharmacotherapy combined; 9 were using exclusively psychotherapy; and 25 were using only pharmacotherapy. There were 31 in the diet support group and 25 in the social support control group who had complete data at 12 weeks. The dietary support group demonstrated significantly greater improvement between baseline and 12 weeks on the MADRS than the social support control group, t(60.7)?=?4.38, p?<?0.001, Cohen's d?=?-1.16. Remission, defined as a MADRS score <10, was achieved for 32.3% (n?=?10) and 8.0% (n?=?2) of the intervention and control groups, respectively (? (2) (1)?=?4.84, p?=?0.028); number needed to treat (NNT) based on remission scores was 4.1 (95% CI of NNT 2.3-27.8). A sensitivity analysis, testing departures from the missing at random (MAR) assumption for dropouts, indicated that the impact of the intervention was robust to violations of MAR assumptions.CONCLUSIONS: These results indicate that dietary improvement may provide an efficacious and accessible treatment strategy for the management of this highly prevalent mental disorder, the benefits of which could extend to the management of common co-morbidities.TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000251820 . Registered on 29 February 2012.BACKGROUND: The possible therapeutic impact of dietary changes on existing mental illness is largely unknown. Using a randomised controlled trial design, we aimed to investigate the efficacy of a dietary improvement program for the treatment of major depressive episodes.","Jacka, F N; O'Neil, A; Opie, R; Itsiopoulos, C; Cotton, S; Mohebbi, M; Castle, D; Dash, S; Mihalopoulos, C; Chatterton, M L; Brazionis, L; Dean, O M; Hodge, A M; Berk, M",2017.0,10.1186/s12916-017-0791-y,0,0,
5687,Abnormal cortisol dynamics after traumatic brain injury. Lack of utility in predicting agitation or therapeutic response to tricyclic antidepressants,"ER A period of significant agitation affects up to 30% of patients after traumatic brain injury. The severity and persistence of this agitation may be such as to require pharmacologic methods as part of the treatment plan. To define which subgroup of patients develop severe agitation warranting intervention and to utilize the information to predict therapeutic responsiveness to tricyclic antidepressants (TCA), we examined cortisol dynamics in 35 traumatically brain-injured (TBI) patients 2-10 months post-TBI. Fasting hypercortisolemia (cortisol greater than 20 micrograms/dl) and/or an absent diurnal variation (1600:0800 cortisol greater than 0.5) was noted in more than 70% of TBI subjects. These abnormalities in cortisol dynamics were not predictive of severe agitation (chi 2 = 0, df = 1, P = 0.99 for hypercortisolemia; chi 2 = 0.163, df = 1, P = 0.7 for absent diurnal variation) and did not differ significantly between TCA responders and nonresponders. The cortisol response to dexamethasone suppression was abnormal (postdexamethasone cortisol value at 0800 and 1600 greater than 5 micrograms/dl) in 34 of 35 subjects and was also not predictive of the presence of agitation. The 0800 cortisol was lower in TCA nonresponders in comparison with TCA responders (8.3 +/- 5 v 17.2 +/- 9). In summary, severe TBI warranting inpatient rehabilitation results in hypothalamic-pituitary-adrenal dysfunction. The extent of these abnormalities renders the assessment of cortisol secretion of limited value in making clinical judgments concerning the development of post-traumatic agitation or the management of that agitation by tricyclic therapy.","Jackson, R D; Mysiw, W J",1989.0,,0,0,
5688,Behavior of cancer patients: a randomized study of the effects of education and peer support groups,"ER Two prospective, controlled studies were conducted to determine if psychological and social functioning could be enhanced in patients with Hodgkin's disease by either education or participation in a peer support therapy group. Eighty-one patients were evaluated with the Cancer Patient Behavior Scale prior to and following intervention. Following education, patients experienced significant improvement in the frequency of Anxiety, Treatment Problems, Depression, and Life Disruption (p less than or equal to 0.1) compared to a control group. Following participation in peer support groups, patients showed no improvement in any of 10 areas of life functioning. Thus education represents an effective, efficient, and inexpensive means of improving psychological and social behavior in patients with Hodgkin's disease. Participation in this peer support therapy group did not result in significant behavior change.","Jacobs, C; Ross, R D; Walker, I M; Stockdale, F E",1983.0,,0,0,
5689,Are Stage of Change constructs relevant for subjective oral health in a vulnerable population?,"ER UNLABELLED: Stage of Change constructs may be proxy markers of psychosocial health which, in turn, are related to oral health.OBJECTIVE: To determine if Stage of Change constructs were associated with subjective oral health in a population at heightened risk of dental disease.METHODS: Stage of Change constructs were developed from a validated 18-item scale and categorised into 'Pre-contemplative', 'Contemplative' and 'Active'. A convenience sample of 446 Australian non-Aboriginal women pregnant by an Aboriginal male (age range 14-43 years) provided data to evaluate the outcome variables (self-rated oral health and oral health impairment), the Stage of Change constructs and socio-demographic, behavioural and access-related factors. Factors significant at the p < 0.05 level in bivariate analysis were entered into prevalence regression models.RESULTS: Approximately 54% of participants had fair/poor self-rated oral health and 34% had oral health impairment. Around 12% were 'Pre-contemplative', 46% 'Contemplative' and 42% 'Active'. Being either 'pre-contemplative' or 'contemplative' was associated with poor self-rated oral health after adjusting for socio-demographic factors. 'Pre-contemplative' ceased being significant after adjusting for dentate status and dental behaviour. 'Pre-contemplative' remained significant when adjusting for dental cost, but not 'Contemplative'. The Stages of Change constructs ceased being associated with self-rated oral health after adjusting for all confounders. Only 'Contemplative' (reference: 'Active') was a risk indicator in the null model for oral health impairment which persisted after adding dentate status, dental behaviour and dental cost variables, but not socio-demographics. When adjusting for all confounders, 'Contemplative' was not a risk indicator for oral health impairment.CONCLUSIONS: Both the 'Pre-contemplative' and 'Contemplative' Stage of Change constructs were associated with poor self-rated oral health and oral health impairment after adjusting for some, but not all, covariates. When considered as a proxy marker of psychosocial health, Stage of Change constructs may have some relevance for subjective oral health.","Jamieson, L M; Parker, E J; Broughton, J; Lawrence, H P; Armfield, J M",2015.0,,0,0,
5690,"Don't worry, be constructive: a randomized controlled feasibility study comparing behaviour therapy singly and combined with constructive worry for insomnia","ER OBJECTIVES: Based on the lack of research on interventions targeting intrusive and worrisome thinking for insomnia, the aim was to examine whether a constructive worry (CW) intervention adds to the effects of behaviour therapy (BT).DESIGN: A randomized, controlled design was used. The design included a 2-week baseline, a 4-week intervention phase (sleep restriction and stimulus control [BT] or sleep restriction and stimulus control plus constructive worry [BT + CW]), and a 2-week follow-up.METHODS: Twenty-two patients with primary insomnia participated. The primary outcome was the Anxiety and Preoccupation about Sleep Questionnaire (APSQ), and secondary endpoints were subjective sleep estimates, the Insomnia Severity Index (ISI), and the Work and Social Adjustment Scale (WSAS).RESULTS: Although both conditions produced significant improvements in subjective sleep estimates, no significant group differences over time were shown for total wake time (TWT) and total sleep time (TST). Both interventions resulted in reductions over time in insomnia severity, worry, and dysfunction. Compared to BT, BT + CW led to a larger decrease in insomnia severity at all three time points (controlled d= 1.10-1.68). In comparison with BT, BT + CW resulted in a larger reduction in worry at two of the time points (controlled d= 0.76-1.64). No significant differences between the two conditions were demonstrated for dysfunction. While more participants responded positively to treatment in the BT + CW (80-100%) than in the BT condition (18-27%), none of the participants remitted.CONCLUSIONS: The findings suggest that, compared to BT alone, CW might result in additional improvements in insomnia severity and worry. Given the small sample size and short follow-up, future studies are warranted.","Jansson-Fröjmark, M; Lind, M; Sunnhed, R",2012.0,10.1111/j.2044-8260.2011.02018.x,0,0,
5691,Satisfaction of healthy pregnant women receiving short message service via mobile phone for prenatal support: a randomized controlled trial,"ER DESIGNA randomized controlled trial.MATERIAL AND METHOD68 healthy pregnant women who attended the antenatal clinic and delivered at Siriraj Hospital, who met the inclusion criterias between May 2007 and October 2007, were enrolled and randomly allocated into two random groups. The study group received two SMS messages per week from 28 weeks of gestation until giving birth. The other group was pregnant women who did not receive SMS. Both groups had the same antenatal and perinatal care. The satisfaction, confidence and anxiety scores were evaluated using a questionnaire at the postpartum ward. The pregnancy outcomes were also compared in these two groups.RESULTSThe satisfaction levels of the women who received prenatal support in SMS messages, were significantly higher than those of who did not receive the messages both in the antenatal period (9.25 vs. 8.00, p < 0.001) and during labor (9.09 vs. 7.90, p = 0.007). In the SMS using group, the confidence level was'higher (8.91 vs. 7.79, p = 0.001) and the anxiety level was lower (2.78 vs. 4.93, p = 0.002) than the control group n the antenatal period, however no diference in pregnancy outcomes were found.CONCLUSIONThe present study shows the higher satisfaction level of pregnant women who received SMS via mobile phone during their antenatal service when compared with the general antenatal care group. The study also show the higher confidence level and lower anxiety level in the antenatal period but no difference in pregnancy outcomes.OBJECTIVEThe main objective was to compare the satisfaction levels of antenatal care between healthy pregnant women who received short message service (SMS) via mobile phone for prenatal support, and those who did not. The second objective was to compare the confidence, anxiety levels and also pregnancy outcomes.","Jareethum, R; Titapant, V; Chantra, T; Sommai, V; Chuenwattana, P; Jirawan, C",2008.0,,0,0,
5692,Mind magic: a pilot study of preventive mind-body-based stress reduction in behaviorally inhibited and activated children,"ER PURPOSE OF STUDY: The aim of this pilot study was to examine a mind-body-based preventive intervention program and to determine relationships between children's behavioral inhibition system (BIS) and behavioral activation system, stress, and stress reduction after the program.DESIGN OF STUDY: Children participated in the program (n=30) or in a control condition (n=24). They filled out questionnaires before and after the program and reported their levels of stress before and after each of the five sessions.METHOD: The program consisted of weekly sessions. Each session incorporated yoga postures, visualization, and social exercises. Breathing techniques were integrated.FINDINGS: Stress reductions were only seen in the intervention group and mainly in children with high BIS--irrespective of their behavioral activation system.CONCLUSION: The results demonstrate that children with high BIS may benefit from a mind-body-based stress reduction program.","Jellesma, F C; Cornelis, J",2012.0,10.1177/0898010111418117,0,0,
5693,Effect of otopoint-needle embedment on headache and plasma 5-HT content in migraine patients,"ER METHODSNinety-two migraine outpatients were equally randomized into acupuncture group and medication group. For patients of the acupuncture group, one sterilized intradermal needle was inserted into E (MA-AT)-point and advanced toward Nie (temple-point, MA-AT), then another inserted into Nie (Temple-point, MA-AT) and advanced toward Zhen (occipus-point, MA-AT), followed by fixing the needles with a piece of adhesive-tape respectively, combined with Wei (stomach-point, MA-IC), Jiaogan (sympathesis-point, MA-AH 7) for migraine patients with nausea and vomiting, and with Yan (eye-point, MA-L 1) for those with phengophobia. Plasma serotonin (5-HT) contents before and after the treatment were detected by fluorescence spectrophotometry.RESULTSIn comparison with the pre-treatment, the synthetic scores of two groups one month and 6 months after the treatment were decreased significantly (P < 0.01). The integrative sores of the acupuncture group one month and 6 months after the treatment were significantly lower than those of the medication group (P < 0.01). The total effective rates of recent efficacy and long-term efficacy of the acupuncture group were 82.61% (38/46) and 83.72% (36/43) respectively, being significantly higher than those [67.39% (31/46) and 57.14% (24/42)] of the medication group. After the treatment, plasma 5-HT content of the acupuncture group was remarkablely higher than that of the medication group (P < 0.05).CONCLUSIONOtopoint-needle implant can effectively relieve headache in migraine patients and upregulate plasma 5-HT level.OBJECTIVETo observe the effect of otopoint-needle embedment on migraine and to explore its underlying mechanism.","Jia, C S; Zheng, L Y; Shi, J; Ma, X S; Li, X F; Li, W L; Zhu, H J",2010.0,,0,0,
5694,The effect of psychosocial rehabilitation after acute myocardial infarction. A randomized controlled trial,"ER MATERIAL AND METHODSA randomised clinical trial was performed in the setting of a coronary unit at Herlev University Hospital. The study sample included 200 patients admitted to the unit with a diagnosis of acute myocardial infarction. All patients received usual care. Besides, the intervention group was offered two group based outpatient counselling sessions with focus on reduction of risk factors and psychosocial adjustment after myocardial infarction. Coping strategies, anxiety and depression, general health, physical function and number of readmissions were measured on the basis of the questionnaires HAD and mini-MAC. Participants completed questionnaires before discharge and again six weeks and four months after discharge.RESULTSThe intervention did not significantly affect coping strategies, general health or physical function. The readmission rate was significantly lower in the intervention group compared to the control group. The mortality rate in the intervention group was lower after four months, one year and four years.DISCUSSIONPossible explanations for the lack of effect in psychosocial parameters are the complex target group with no restrictions in gender and age and no intervention targeted the relatives. The lower mortality rate in the intervention group might be due to the intervention. However, it could also be due to variables not available in this study, such as the type of infarction and changes in lifestyle.INTRODUCTIONThe aim of the study was to examine the effect of group based psychosocial rehabilitation following discharge compared to usual care.","Johansen, S; Baumbach, L A; J√∏rgensen, T; Willaing, I",2003.0,,0,0,
5695,Clinic-based training in comparison to home-based training after first-time lumbar disc surgery: a randomised controlled trial,"ER The effectiveness of physiotherapy after first-time lumbar disc surgery is still largely unknown. Studies in this field are heterogeneous and behavioural treatment principles have only been evaluated in one earlier study. The aim of this randomised study was to compare clinic-based physiotherapy with a behavioural approach to a home-based training programme regarding back disability, activity level, behavioural aspects, pain and global health measures. A total of 59 lumbar disc patients without any previous spine surgery or comorbidity participated in the study. Clinic-based physiotherapy with a behavioural approach was compared to home-based training 3 and 12 months after surgery. Additionally, the home training group was followed up 3 months after surgery by a structured telephone interview evaluating adherence to the exercise programme. Outcome measures were: Oswestry Disability Index (ODI), physical activity level, kinesiophobia, coping, pain, quality of life and patient satisfaction. Treatment compliance was high in both groups. There were no differences between the two groups regarding back pain disability measured by ODI 3 and 12 months after surgery. However, back pain reduction and increase in quality of life were significantly higher in the home-based training group. The patients in the clinic-based training group had significantly higher activity levels 12 months after surgery and were significantly more satisfied with physiotherapy care 3 months after surgery compared to the home-based training group. Rehabilitation after first-time lumbar disc surgery can be based on home training as long as the patients receive both careful instructions from a physiotherapist and strategies for active pain coping, and have access to the physiotherapist if questions regarding training arise. This might be a convenient treatment arrangement for most patients.","Johansson, A C; Linton, S J; Bergkvist, L; Nilsson, O; Cornefjord, M",2009.0,10.1007/s00586-008-0826-3,0,0,
5696,Effect of a social script iPad application for children with autism going to imaging,ER This randomized controlled trial feasibility study tested the effectiveness of an iPad® application (app) social script intervention for children with autism spectrum disorder (ASD) going to imaging and their parent (n=32 parent/child dyads). Parents of the children exposed to the app (n=16) had lower state anxiety compared to the parents whose children were not exposed to the app (n=16) (effect size 0.33). Children exposed to the app had fewer externalized challenging behaviors than the control group (effect size 0.56). The results demonstrate feasibility and efficacy of the intervention. Further study of the iPad app is warranted.,"Johnson, N; Bree, O; Lalley, E E; Rettler, K; Grande, P; Gani, M O; Ahamed, S I",2014.0,10.1016/j.pedn.2014.04.007,0,0,
5697,The effectiveness of an Acceptance and Commitment Therapy self-help intervention for chronic pain,"ER METHODThis was a randomized 2 group study design. Over a 6-week period, 6 participants read the self-help book and completed exercises from it with weekly telephone support whereas 8 others formed a wait-list control group. Subsequently, 5 of the wait-list participants completed the intervention. Participants completed preintervention and postintervention questionnaires for acceptance, values illness, quality of life, satisfaction with life, depression, anxiety, and pain. Initial outcome data were collected for 8 control participants and 6 intervention participants. Including the wait-list controls, a total of 11 participants completed preintervention and postintervention measures. Whilst completing the self-help intervention, each week participants' rated the content of the book according to reading level and usefulness, and their comprehension of the content was also assessed.RESULTSCompared with controls, participants who completed the book showed improved quality of life and decreased anxiety. When data from all the treatment participants were pooled, those who completed the intervention showed statistically significant improvements (with large effect sizes) for acceptance, quality of life, satisfaction with life, and values illness. Medium effect sizes were found for improvements in pain ratings.CONCLUSIONSThese findings support the hypothesis that using the self-help book, with minimal therapist contact adds value to the lives of people who experience chronic pain.OBJECTIVETo evaluate the effectiveness of an Acceptance Commitment Therapy based self-help book for people with chronic pain.","Johnston, M; Foster, M; Shennan, J; Starkey, N J; Johnson, A",2010.0,10.1097/AJP.0b013e3181cf59ce,0,0,
5698,Evaluation of a standard provision versus an autonomy promotive exercise referral programme: rationale and study design,"ER METHODS/DESIGNDESIGNAn exploratory cluster randomised controlled trial comparing standard provision exercise on prescription with a Self Determination Theory-based (SDT) exercise on prescription intervention.PARTICIPANTS347 people referred to the Birmingham Exercise on Prescription scheme between November 2007 and July 2008. The 13 exercise on prescription sites in Birmingham were randomised to current practice (n = 7) or to the SDT-based intervention (n = 6).Outcomes measured at 3 and 6-months: Minutes of moderate or vigorous physical activity per week assessed using the 7-day Physical Activity Recall; physical health: blood pressure and weight; health status measured using the Dartmouth CO-OP charts; anxiety and depression measured by the Hospital Anxiety and Depression Scale and vitality measured by the subjective vitality score; motivation and processes of change: perceptions of autonomy support from the advisor, satisfaction of the needs for competence, autonomy, and relatedness via physical activity, and motivational regulations for exercise.DISCUSSIONThis trial will determine whether an exercise referral programme based on Self Determination Theory increases physical activity and other health outcomes compared to a standard programme and will test the underlying SDT-based process model (perceived autonomy support, need satisfaction, motivation regulations, outcomes) via structural equation modelling.TRIAL REGISTRATIONThe trial is registered as Current Controlled trials ISRCTN07682833.BACKGROUNDThe National Institute of Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the utility of a Self Determination Theory (SDT)-based exercise referral consultation.","Jolly, K; Duda, J L; Daley, A; Eves, F F; Mutrie, N; Ntoumanis, N; Rouse, P C; Lodhia, R; Williams, G C",2009.0,10.1186/1471-2458-9-176,0,0,
5699,Self-efficacy and distress in women with AIDS: the SMART/EST women's project,"ER Though African American and Hispanic women accounted for 14% of the female population in the USA, they represented 66% of the total HIV/AIDS diagnoses among women in 2007. Among men living with HIV, increased coping self-efficacy (SE) following a cognitive behavioral intervention has been related to decreased distress, anxiety, anger, and confusion, but comparable studies had not been carried out with HIV+ women. The purpose of this study was to examine the impact of changes in SE following a cognitive behavioral stress management plus expressive supportive therapy (CBSM+) intervention on depression and anxiety in low-income urban predominantly minority women living with AIDS. Women (n=451) were randomized to a group CBSM+ or individual informational intervention condition and completed baseline, post-intervention and long-term follow-up (12 months) assessments of depression, anxiety and SE. Women who were assigned to the CBSM+ group condition and increased their level of cognitive behavioral SE reported significant decreases in anxiety and depression at post-intervention and long-term follow-up in comparison with controls who did not improve. Results suggest that both cognitive behavioral skills and a concomitant increase in the perceived level of SE in the use of those skills are predictive of distress reduction.","Jones, D L; Ishii, Owens M; Lydston, D; Tobin, J N; Brondolo, E; Weiss, S M",2010.0,10.1080/09540121.2010.484454,0,0,
5700,Changing self-efficacy in individuals following a first time stroke: preliminary study of a novel self-management intervention,"ER DESIGNMultiple-participant two-phase (baseline followed by treatment) single subject design. The intervention was introduced at a randomly generated time-point.SETTINGCommunity.SUBJECTSSeven men and three women, with a mean age of 61.5 years (SD 8.15), on average 24.2 weeks (SD 18.29) following first stroke, all with residual restriction of activity and participation.INTERVENTIONAn individualized self-management workbook based on self-efficacy principles, incorporating sections to increase mastery, vicarious experience and feedback.MAIN MEASURESStroke Self-Efficacy Questionnaire, General Self-Efficacy Scale, Recovery Locus of Control Scale, Rivermead Mobility Index, Rivermead Activities of Daily Living Scale, Subjective Index of Physical and Social Outcome and the Hospital Anxiety and Depression Scale. Individual data were analysed with weighted mean trend test and two standard deviation band test. Group data were analysed with a randomization test.RESULTSVisual inspection of the data over the 14-week period showed steady improvement for all of the 10 participants on the majority of variables. A randomization test indicated a statistically significant change in Stroke Self-Efficacy Questionnaire scores and Recovery Locus of Control Scale scores which followed introduction of the intervention. Measures of activity, participation and mood scores did not show a statistically significant change.CONCLUSIONThere is preliminary evidence that the use of an individualized stroke self-management intervention is acceptable and can lead to a change in self-efficacy in this small sample.OBJECTIVETo examine the effects of a self-management workbook intervention designed for use with individuals disabled after first time stroke.","Jones, F; Mandy, A; Partridge, C",2009.0,10.1177/0269215508101749,0,0,
5701,Does counseling help hysterectomy patients?,,"Jones, J",1993.0,,0,0,
5702,A primary preventive approach to children's drug refusal behavior: the impact of rehearsal-plus,"ER The effectiveness of a short-term prevention program to increase drug refusal behavior in a school-age population was assessed. Forty-two third-grade children were randomly assigned to one of three groups: rehearsal-plus, traditional, or attention control. Children in the rehearsal-plus group were taught specific drug refusal techniques and appropriate social skills, and were provided a rationale for each response. This procedure included behavioral training and elaborative rehearsal. Training occurred in four socially validated situations corresponding to settings where children were likely to be offered drugs. The traditional procedure consisted of instructions derived from a ""Just Say No"" drug program. Assessment focused on specific refusal behaviors, procedural knowledge, and self-efficacy. Significant gains in desired functioning and appropriate behavioral and social skills were found. The effectiveness of the rehearsal-plus procedure as a method of increasing adaptive responding in dangerous and/or anxiety-arousing situations is discussed.","Jones, R T; McDonald, D W; Fiore, M F; Arrington, T; Randall, J",1990.0,,0,0,
5703,The effectiveness of a minimal psychological intervention on self-management beliefs and behaviors in depressed chronically ill elderly persons: a randomized trial,"ER BACKGROUND: Chronically ill patients often develop symptoms of depression. They run the risk of sliding into a downward spiral because of the interaction between depression and chronic illness. A minimal psychological intervention (MPI) has been developed to break through the spiral by applying principles of self-management and cognitive behavioral therapy. This study examines the effects of the MPI on self-efficacy, anxiety, daily functioning and social participation.METHODS: A randomized controlled trial compared the MPI with usual care in 361 primary care patients. Nurses visited patients at home over a period of three months. Patients were aged 60 years and older, had minor depression or mild to moderate major depression and either type 2 diabetes mellitus (DM) or chronic obstructive pulmonary disease (COPD). Outcomes were measured at baseline and at one week, three months, and nine months after the intervention period.RESULTS: At nine months after treatment, the MPI was associated with less anxiety (mean difference 2.5; 95% CI 0.7-4.2) and better self efficacy skills (mean difference 1.8; 95% CI 3.4-0.2), daily functioning (mean difference 1.7; 95% CI 0.6-2.7), and social participation (mean difference 1.3; 95% CI 0.4-2.2). Effect sizes for these outcomes were small to medium (0.29-0.40). Differences were primarily due to a stabilization of outcomes in the intervention group and deterioration in the control group. No major differences were observed between DM and COPD patients.CONCLUSIONS: The intervention appears to be reasonably effective in improving care for chronically ill elderly people. We recommend further evaluation of the MPI, including emphasis on detection and watchful waiting.","Jonkers, C C; Lamers, F; Bosma, H; Metsemakers, J F; Eijk, J T",2012.0,10.1017/S1041610211001748,0,0,
5704,Improved Strain and Psychosocial Outcomes for Caregivers of Individuals with Dementia: Findings from Project ANSWERS,"ER PURPOSE: This study examined the efficacy of a newly developed intervention, Acquiring New Skills While Enhancing Remaining Strengths (ANSWERS), for family caregivers of individuals with dementia. ANSWERS was designed for dyads comprised of an individual with dementia and his/her family caregiver. Using a strength-based approach, ANSWERS combined educational skills (traditionally used with caregivers) and cognitive rehabilitation skills training (traditionally used with individuals with dementia) into a single protocol for addressing the dyad's care issues and needs. Key domains addressed by the intervention included: education about dementia and memory loss; effective communication; managing memory; staying active; and recognizing emotions and behaviors. This analysis focused on outcomes for caregivers.DESIGN & METHODS: The Stress Process Model guided the study's hypotheses and design. Caregiving dyads were randomly assigned to the control or intervention conditions. Intervention dyads received 6-curriculum guided sessions with an intervention specialist. Data came from in-person baseline interviews with caregivers conducted prior to randomization and follow-up interviews conducted approximately 14.56 weekspost-baseline.RESULTS: Intervention caregivers, compared to controls, had decreased care-related strain as indicated by lower emotional health strain, dyadic relationship strain, role captivity, and higher caregiving mastery. Additionally, intervention caregivers had improved well-being as indicated by fewer symptoms of depression and anxiety.IMPLICATIONS: ANSWERS was efficacious in improving key strain and psychosocial outcomes for caregivers. Features essential to the success of ANSWERS included a strength-based approach for selecting, developing, and implementing care goals, as well as teaching caregivers educational and cognitive rehabilitation skills for addressing care needs.","Judge, K S; Yarry, S J; Looman, W J; Bass, D M",2013.0,10.1093/geront/gns076,0,0,
5705,Relationship between role-play measures of coping skills and alcoholism treatment outcome,"ER Alcoholic clients were given role-play tests, involving various social and drinking-related scenarios, before and after two types of aftercare treatment. The assessments were used both to evaluate the effects of treatment and to determine whether any dimensions of pretreatment role-play performance interact with treatment type to predict treatment outcome. Eighty-nine patients were randomly assigned to aftercare group treatment involving either interactional therapy or coping skills training. Clients in both treatments experienced declines in their urge to drink during the role-play scenes from pre- to posttreatment, and these declines were related to reductions in heavy drinking. Three pretreatment role-play variables interacted with type of treatment to predict outcome: observer-rated skill, observer-rated anxiety, and self-reported urge to drink. In general, those patients who did better in the role plays had better drinking outcomes following interactional therapy. Those who experienced more difficulty in the role plays fared best with coping skills training. The results suggest that role-play measures could be used for patient-treatment matching, although it remains to be determined whether they will be superior to more easily assessed patient characteristics.","Kadden, R M; Litt, M D; Cooney, N L; Busher, D A",1992.0,,0,0,
5706,Intraindividual comparison of surgical trauma after bimanual microincision and conventional small-incision coaxial phacoemulsification,"ER SETTINGDepartment of Ophthalmology, Medical University of Vienna, Vienna, Austria.METHODSA prospective investigator-masked case series comprised patients with bilateral cataract who had cataract surgery on the same day. Thirty-three patients (66 eyes) were randomized. Microincision cataract surgery (MICS) was performed through 2, 1.4 mm clear corneal incisions (CCIs) using bimanual sleeveless phacoemulsification (cool phaco) in 1 eye. Small-incision cataract surgery (SICS) was performed on the other eye through a 3.2 mm CCI. In all cases, an AcrySof SA60AT IOL was inserted, in the MICS group after the CCI was enlarged. Laser flare photometry, specular microscopy, corneal endothelial cell density, and pachymetry were evaluated preoperatively and postoperatively. Intraindividual comparison and statistical analyses were performed.RESULTSThere were no relevant clinical differences or perioperative complications in either group. There were no statistically significant differences between preoperative and postoperative anterior chamber flare or endothelial cell loss. On the first postoperative day, the MICS group had statistically significantly increased corneal swelling (P = .008). Postoperatively, the mean endothelial cell density loss was higher in the MICS group (6.2%) than in the SICS group (3.10%); however, the difference between groups was not significant (P = .08)CONCLUSIONSMicroincision cataract surgery was a safe and reproducible technique. The postoperative results in the MICS group were comparable to those in the SICS group.PURPOSETo compare the surgical trauma after microincision phacoemulsification and small-incision coaxial phacoemulsification after implantation of conventional, foldable, hydrophobic acrylic intraocular lenses (IOLs).","Kahraman, G; Amon, M; Franz, C; Prinz, A; Abela-Formanek, C",2007.0,10.1016/j.jcrs.2007.01.013,0,0,
5707,"Double-blind trial of pentigetide ophthalmic solution, 0.5%, compared with cromolyn sodium, 4%, ophthalmic solution for allergic conjunctivitis","ER Fifty patients (25 per group) with the signs and symptoms of allergic conjunctivitis confirmed by positive skin test enrolled in this randomized, double-blind, parallel group, 2-week comparison of pentigetide, 0.5%, ophthalmic solution (Pentyde) and cromolyn sodium, 4%, USP ophthalmic solution (Opticrom). The physician and the patient rated the patient's overall ocular condition on days 3, 8, and 15. On day 15 both the physician and the patients rated the pentigetide group as significantly (Chi-square, P less than .05) more improved than the cromolyn sodium group. The physician rated independently conjunctival symptoms and ocular signs at days 1, 3, 8, and 15. Improvement in signs and symptoms favored pentigetide in the majority of comparisons to cromolyn sodium (14 of 18). The pentigetide group showed significantly (ANOVA, P less than .05) greater improvement in hyperemia, edema, lacrimation, and blurred vision/photophobia. Patients completed daily diaries for seven symptoms. At the end of the study, comparisons to baseline between groups favored the pentigetide group for six of the seven symptoms; for itching, improvement favored significantly (ANOVA, P less than .05) the pentigetide group. The mean severity of all symptoms decreased by 64% in the pentigetide group as compared with a decrease of 46% in the cromolyn sodium group. Adverse experiences were minor and comparable in both groups. No clinically abnormal changes were noted for visual acuity, intraocular pressure, or common laboratory tests. This double-blind, active-controlled trial demonstrates that pentigetide, 0.5%, ophthalmic solution is safe and effective in the treatment of allergic conjunctivitis.","Kalpaxis, J G; Thayer, T O",1991.0,,0,0,
5708,Training carers of stroke patients: randomised controlled trial,"ER OBJECTIVETo evaluate the effectiveness of training care givers in reducing burden of stroke in patients and their care givers.DESIGNA single, blind, randomised controlled trial.SETTINGStroke rehabilitation unit.SUBJECTS300 stroke patients and their care givers.INTERVENTIONSTraining care givers in basic nursing and facilitation of personal care techniques.MAIN OUTCOME MEASURESCost to health and social services, caregiving burden, patients' and care givers' functional status (Barthel index, Frenchay activities index), psychological state (hospital anxiety and depression score), quality of life (EuroQol visual analogue scale) and patients' institutionalisation or mortality at one year.RESULTSPatients were comparable for age (median 76 years; interquartile range 70-82 years), sex (53% men), and severity of stroke (median Barthel index 8; interquartile range 4-12). The costs of care over one year for patients whose care givers had received training were significantly lower (10,133 pounds sterling v 13,794 pounds sterling (18,087 dollars v 24,619 dollars; 15,204 euros v 20,697 euros); P = 0.001). Trained care givers experienced less caregiving burden (care giver burden score 32 v 41; P = 0.0001), anxiety (anxiety score 3 v 4; P = 0.0001) or depression (depression score 2 v 3; P = 0.0001) and had a higher quality of life (EuroQol score 80 v 70; P = 0.001). Patients' mortality, institutionalisation, and disability were not influenced by caregiver training. However, patients reported less anxiety (3 v 4.5; P < 0.0001) and depression (3 v 4; P < 0.0001) and better quality of life (65 v 60; P = 0.009) in the caregiver training group.CONCLUSIONTraining care givers during patients' rehabilitation reduced costs and caregiver burden while improving psychosocial outcomes in care givers and patients at one year.BACKGROUNDInformal care givers support disabled stroke patients at home but receive little training for the caregiving role.","Kalra, L; Evans, A; Perez, I; Melbourn, A; Patel, A; Knapp, M; Donaldson, N",2004.0,10.1136/bmj.328.7448.1099,0,0,
5709,Changes in cue reactivity and attentional bias following experimental cue exposure and response prevention: a laboratory study of the effects of D-cycloserine in heavy drinkers,"ER OBJECTIVESThe objective of this study is to investigate the effect of DCS on exposure/response prevention in heavy drinkers.METHODSIn a randomised, double-blind, placebo-controlled study, heavy social drinkers recruited from the community received either DCS (125 mg; n?=?19) or placebo (n?=?17) 1 h prior to each of two sessions of exposure/response prevention. Cue reactivity and attentional bias were assessed during these two sessions and at a third follow-up session. Between-session drinking behaviour was recorded.RESULTSRobust cue reactivity and attentional bias to alcohol cues was evident, as expected of heavy drinkers. Within- and between-session habituation of cue reactivity, as well as a reduction in attentional bias to alcohol cues over time was found. However, there was no evidence of greater habituation in the DCS group. Subtle stimulant effects (increased subjective contentedness and euphoria) which were unrelated to exposure/response prevention were found following DCS.CONCLUSIONSDCS does not appear to enhance habituation of alcohol cue reactivity in heavy non-dependent drinkers. Its utility in enhancing treatments based on exposure/response prevention in dependent drinkers or drug users remains open.RATIONALEThe effects of D-cycloserine (DCS) in animal models of anxiety disorders and addiction indicate a role for N-methyl D-aspartate (NMDA) receptors in extinction learning. Exposure/response prevention treatments for anxiety disorders in humans are enhanced by DCS, suggesting a promising co-therapy regime, mediated by NMDA receptors. Exposure/response prevention may also be effective in problematic drinkers, and DCS might enhance habituation to cues in these individuals. Since heavy drinkers show ostensible conditioned responses to alcohol cues, habituation following exposure/response prevention should be evident in these drinkers, with DCS enhancing this effect.","Kamboj, S K; Massey-Chase, R; Rodney, L; Das, R; Almahdi, B; Curran, H V; Morgan, C J",2011.0,10.1007/s00213-011-2254-z,0,0,
5710,"Reactivity to alcohol-related cues: relationship among cue type, motivational processes, and personality","ER This study examined the relationship between personality traits implicated in the drinking literature (i.e., sensation seeking and anxiety) and reactivity to 2 different alcohol cues. The opportunity to consume alcohol was manipulated, and differences in urge and affective reactivity were assessed. Gray's (1987) model of impulsive sensation seeking and anxiety was adopted to investigate relationships between personality and responses to the appetitive (consumption) and aversive (no consumption, nonrewarding) alcohol cues in 40 regular social drinkers. The consumption cue produced increases in appetitive motivation and positive correlations with sensation-seeking traits. The no-consumption cue produced increases in aversive motivation and positive correlations with anxiety-related traits. It was concluded that Gray's model of impulsive sensation seeking and anxiety may provide a useful framework for examining the personality correlates of cue reactivity to different cues.","Kambouropoulos, N; Staiger, P K",2004.0,10.1037/0893-164X.18.3.275,0,0,
5711,"""Maybe I made up the whole thing"": placebos and patients' experiences in a randomized controlled trial","ER Patients in the placebo arms of randomized controlled trials (RCT) often experience positive changes from baseline. While multiple theories concerning such ""placebo effects"" exist, peculiarly, none has been informed by actual interviews of patients undergoing placebo treatment. Here, we report on a qualitative study (n = 27) embedded within a RCT (n = 262) in patients with irritable bowel syndrome. Besides identical placebo acupuncture treatment in the RCT, the qualitative study patients also received an additional set of interviews at the beginning, midpoint, and end of the trial. Interviews of the 12 qualitative subjects who underwent and completed placebo treatment were transcribed. We found that patients (1) were persistently concerned with whether they were receiving placebo or genuine treatment; (2) almost never endorsed ""expectation"" of improvement but spoke of ""hope"" instead and frequently reported despair; (3) almost all reported improvement ranging from dramatic psychosocial changes to unambiguous, progressive symptom improvement to tentative impressions of benefit; and (4) often worried whether their improvement was due to normal fluctuations or placebo effects. The placebo treatment was a problematic perturbation that provided an opportunity to reconstruct the experiences of the fluctuations of their illness and how it disrupted their everyday life. Immersion in this RCT was a co-mingling of enactment, embodiment and interpretation involving ritual performance and evocative symbols, shifts in bodily sensations, symptoms, mood, daily life behaviors, and social interactions, all accompanied by self-scrutiny and re-appraisal. The placebo effect involved a spectrum of factors and any single theory of placebo--e.g. expectancy, hope, conditioning, anxiety reduction, report bias, symbolic work, narrative and embodiment--provides an inadequate model to explain its salubrious benefits.","Kaptchuk, T J; Shaw, J; Kerr, C E; Conboy, L A; Kelley, J M; Csordas, T J; Lembo, A J; Jacobson, E E",2009.0,10.1007/s11013-009-9141-7,0,0,
5712,Individual outcome-oriented cardiologic rehabilitation treatment,"ER Cardiac rehabilitation and subsequent intensified aftercare is capable, of increasing the rate of occupational reintegration not only over the short-term, but also over a period of two years. In addition to improving physical performance, this enhances the patient's self-confidence, decreases anxiety and reduces depression. Since, two years after completion of cardiac rehabilitation and aftercare, the percentage of those lost to gainful employment and in need of an early pension is appreciably less in the interventional group as compared with controls, this program would appear to be of particular economic importance for social security/national insurance carriers. For this reason, the Westphalian Social Security Carrier has initiated the regular use of this concept in its cardiological hospitals.","Karoff, M",2000.0,,0,0,
5713,Software-based evaluation of toric IOL orientation in a multicenter clinical study,"ER PURPOSE: To evaluate the rotational stability of a new one-piece hydrophobic acrylic toric intraocular lens (IOL) using a custom-developed software for analysis of slit-lamp photographs.METHODS: In a prospective, multicenter study, 174 eyes were implanted with the TECNIS Toric IOL (Abbott Medical Optics, Inc., Santa Ana, CA). A custom-developed software was used to analyze high-resolution slit-lamp photographs of 156 eyes taken at day 1 (baseline) and 1, 3, and 6 months postoperatively. The software uses iris and sclera landmarks to align the baseline image and later images for comparison. Validation of software was performed through repeated analyses of protractor images rotated from 0.1° to 10.0° and randomly selected photographs of 20 eyes.RESULTS: Software validation showed precision (repeatability plus reproducibility variation) of 0.02° using protractor images and 2.22° using slit-lamp photographs. Good quality slit-lamp images and clear landmarks were necessary for precise measurements. At 6 months, 94.2% of eyes had 5° or less change in IOL orientation versus baseline; only 2 eyes (1.4%) had axis shift greater than 30°. Most eyes were within 5° or less of rotation between 1 and 3 months (92.9%) and 3 and 6 months (94.1%). Mean absolute axis change (± standard deviation) from 1 day to 6 months was 2.70° ± 5.51°.CONCLUSIONS: The new custom software was precise and quick in analyzing slit-lamp photographs to determine postoperative toric IOL rotation.","Kasthurirangan, S; Feuchter, L; Smith, P; Nixon, D",2014.0,10.3928/1081597X-20141117-01,0,0,
5714,Effects on school outcomes in low-income minority youth: preliminary findings from a community-partnered study of a school-based trauma intervention,"ER OBJECTIVE: To examine academic outcomes of a community-partnered school mental health intervention for students exposed to community violence.DESIGN: Randomized controlled trial.SETTING AND PARTICIPANTS: Sixth-grade students (N = 123) from 2 middle schools in Los Angeles during the 2001-2002 academic year who had exposure to violence and posttraumatic stress symptoms in the clinical range.INTERVENTION: Students were randomized to either receive a 10-session standardized school trauma intervention (Cognitive Behavioral Intervention for Trauma in Schools) soon after screening (early intervention) or after a delay following screening (delayed intervention), but within the same school year.MAIN OUTCOME MEASURES: 59 students in the early intervention group vs. 64 students in the delayed intervention group (screened in September or December) were compared on spring semester grades in math and language arts, controlling for the students' standardized state test scores from the previous academic year and other covariates.RESULTS: Students in the early intervention group had a significantly higher spring semester mean grade in math (2.0 vs 1.6) but not language arts (2.2 vs 1.9). Students in the early intervention group were more likely than students in the delayed intervention group to have a passing grade (C or higher) in language arts (80% vs 61%; P < .033) by spring semester; we also found a substantial difference in the number of students receiving a passing math grade (70% vs 55%; P = .053).CONCLUSION: Through a collaborative partnership between school staff and researchers, preliminary evidence suggests that receiving a school trauma intervention soon after screening compared to delaying treatment can result in better school grades.","Kataoka, S; Jaycox, L H; Wong, M; Nadeem, E; Langley, A; Tang, L; Stein, B D",2011.0,,0,0,
5715,Investigation of the effects of connective tissue mobilisation on quality of life and emotional status in healthy subjects,"ER AIM: This study was planned to investigate the effects of connective tissue mobilization (CTM) on quality of life and emotional status in healthy subjects. Design; Prospective trial, Setting; Treatment and Population. The study was conducted on 100 volunteers (students). Students in second class were in CTM group (20,49±1,37 years) and students (19,50±1,15 years) educating in class 1 were in control group.METHODS: Participants were assessed before and after CTM according to flexibility of trunk flexion, hamstring muscles, trunk hyperextension and lateral flexion. It was used The SF-36 Health-Related Quality of Life Inventory (SF-36) to assess general health status and Beck Depression Scale was used for assessing emotional status.RESULTS: It was observed a significant increase at lateral flexion to the right of trunk (p=0,03) in CTM group after application. It was found a significant difference (p=0,009) in emotional status between groups. It was found differences at general health level (p=0,001), limitations in emotional role (p=0,016) in SF-36. It was some differences in depression status and some subscales of SF-36 (general health, social status, emotional well-being, pain and energy levels) in favour of control group before application. It was no difference between groups after application.CONCLUSION: CTM could be used for minimizing depressive symptoms, improving quality of life in healthy young subjects.BACKGROUND: Connective Tissue Massage (CTM) or Manipulation is a bodywork technique which lies at the interface between alternative approaches. The autonomic balancing responses to CTM can be useful in the treatment of anxiety.","Kavlak, E; Büker, N; Altug, F; Kitis, A",2014.0,,0,0,
5716,Evaluating treatment efficacy by triangulation,"ER The project 'Efficacy of Support Groups for Mexican American Widows' was evaluated by triangulating results collected from different points of view. These included changes after one year in (1) measurement scores of standardized instruments, (2) assessment of adjustment to role of widow by the outsider and (3) evaluation by the widow herself. When subjects were categorized by their assignment to experimental or control groups, the scores on standardized instruments including the Beck Depression Inventory (BDI), the Center for Epidemiologic Study of Depression (CES-D), Anxiety State, Life Satisfaction and new scales measuring Somatic symptoms and Emotional symptoms had decreased from time 1 to time 5 for all widows. However, the widows participating in support groups showed significantly improved changes in these scores. The outsiders found the women who participated in the support groups to have a far better change to the role of widow than the control widows. The support group widows themselves described more positive changes in themselves than did control widows.","Kay, M; Guernsey de, Zapien J; Wilson, C A; Yoder, M",1993.0,,0,0,
5717,"Antidepressant effects, of magnetic seizure therapy and electroconvulsive therapy, in treatment-resistant depression","ER Major depression is a common mental health problem and associated with significant morbidity and mortality, including impaired social and physical functioning and increased risk for suicide. Electroconvulsive therapy (ECT) is highly efficacious in treatment-resistant depressive disorders, but cognitive side effects are frequently associated with the treatment. Magnetic seizure therapy (MST) is a form of convulsive therapy, using magnetic fields in order to induce therapeutic seizures. First studies suggested that cognitive side effects of MST, including postictal recovery time, are more benign than those resulting from ECT treatment. In this open-label study we tested the hypothesis that MST is associated with clinically significant antidepressant effects in treatment-resistant depression (TRD) as an add-on therapy to a controlled pharmacotherapy. Twenty patients suffering from TRD were randomly assigned to receive either MST or ECT starting from July 2006 until November 2008. Primary outcome measure was antidepressant response assessed by Montgomery √Ösberg Depression Scale. Secondary outcome measures included Hamilton Depression Rating Scale, Hamilton Anxiety Scale, Beck Depression Inventory and 90-Item Symptom Checklist. Antidepressant response (improvement of 50% in MADRS ratings) was statistically significant and of similar size in both treatment groups. Cognitive side effects were observed in neither group. Characteristics in MST- and ECT-induced seizures were comparable, especially regarding ictal activity and postictal suppression. Thus, MST may be a potential alternative to ECT if efficacy and safety are validated in larger clinical trials.","Kayser, S; Bewernick, B H; Grubert, C; Hadrysiewicz, B L; Axmacher, N; Schlaepfer, T E",2011.0,10.1016/j.jpsychires.2010.09.008,0,0,
5718,"In cognitive therapy for depression, early focus on maladaptive beliefs may be especially efficacious for patients with personality disorders","ER Objective: Patients with major depressive disorder (MDD) and a comorbid personality disorder (PD) have been found to exhibit relatively poor outcomes in cognitive therapy (CT) and other treatments. Adaptations of CT focusing heavily on patients' core beliefs have yielded promising findings in the treatment of PD. However, there have been no investigations that have specifically tested whether increased focus on maladaptive beliefs contributes to CT's efficacy for these patients. Method: CT technique use from an early CT session was assessed for 59 patients (33 without PD, 26 with PD-predominantly Cluster C) who participated in a randomized controlled trial for moderate to severe MDD. Scores were calculated for directive CT techniques (CT-Concrete) and a set of belief-focused items (CT-Belief) as rated by the Collaborative Study Process Rating Scale. Robust regressions were conducted to estimate relations between scores on each of these measures and change in depressive and PD symptoms. A PD status by CT-Belief use interaction tested the hypothesis that therapist use of CT-Belief techniques would exhibit a stronger association with symptom change in the PD group relative to the non-PD group. Results: As hypothesized, a significant interaction between PD status and use of CT-Belief techniques emerged in the prediction of depressive and PD symptom change. Among PD patients, higher early CT-Belief interventions were found to predict significantly greater improvement. CT-Belief use did not predict greater symptom change among those without PD. Conclusions: Early focus on CT-Belief interventions may facilitate changes in depression and PD symptoms for patients with MDD-PD comorbidity.","Keefe, J R; Webb, C A; DeRubeis, R J",2016.0,10.1037/ccp0000071,0,0,
5719,Contemplative/emotion training reduces negative emotional behavior and promotes prosocial responses,"ER Contemplative practices are believed to alleviate psychological problems, cultivate prosocial behavior and promote self-awareness. In addition, psychological science has developed tools and models for understanding the mind and promoting well-being. Additional effort is needed to combine frameworks and techniques from these traditions to improve emotional experience and socioemotional behavior. An 8-week intensive (42 hr) meditation/emotion regulation training intervention was designed by experts in contemplative traditions and emotion science to reduce ""destructive enactment of emotions"" and enhance prosocial responses. Participants were 82 healthy female schoolteachers who were randomly assigned to a training group or a wait-list control group, and assessed preassessment, postassessment, and 5 months after training completion. Assessments included self-reports and experimental tasks to capture changes in emotional behavior. The training group reported reduced trait negative affect, rumination, depression, and anxiety, and increased trait positive affect and mindfulness compared to the control group. On a series of behavioral tasks, the training increased recognition of emotions in others (Micro-Expression Training Tool), protected trainees from some of the psychophysiological effects of an experimental threat to self (Trier Social Stress Test; TSST), appeared to activate cognitive networks associated with compassion (lexical decision procedure), and affected hostile behavior in the Marital Interaction Task. Most effects at postassessment that were examined at follow-up were maintained (excluding positive affect, TSST rumination, and respiratory sinus arrhythmia recovery). Findings suggest that increased awareness of mental processes can influence emotional behavior, and they support the benefit of integrating contemplative theories/practices with psychological models and methods of emotion regulation.","Kemeny, M E; Foltz, C; Cavanagh, J F; Cullen, M; Giese-Davis, J; Jennings, P; Rosenberg, E L; Gillath, O; Shaver, P R; Wallace, B A; Ekman, P",2012.0,10.1037/a0026118,0,0,
5720,Cognitive behavioural therapy in addition to antispasmodic therapy for irritable bowel syndrome in primary care: randomised controlled trial,"ER DESIGNThis was a randomised controlled trial in primary care of the addition of CBT to standard general practice management of IBS, using the antispasmodic agent mebeverine hydrochloride. The study set out to compare the addition of a standardised package of IBS-specific CBT to treatment with mebeverine hydrochloride.SETTINGTen general practices, serving a population of around 45,000 patients, located principally in south London, with some patients resident in north London.PARTICIPANTSPatients identified as having IBS by their GPs, aged between 17 and 54 (mean 34) years and predominantly white; 82% were female and half had had IBS for more than 5 years.INTERVENTIONSPractice nurses delivered CBT in a randomised trial of the addition of CBT to mebeverine in patients who had IBS of moderate or greater severity after 2 weeks of GP care and 4 weeks of mebeverine. The Symptom Severity Scale (SSS) was used to identify patients with moderate or severe IBS. Patients who continued to report moderate or severe IBS after 4 weeks of mebeverine at a dose of 270 mg three times a day were randomised to receive six sessions of CBT in addition to mebeverine (72 patients) or mebeverine alone (77 patients). These patients were followed at 3, 6 and 12 months after treatment. As part of the baseline evaluation, blood tests for antiendomysial and antigliadin antibodies were carried out on 141 patients to determine the prevalence of coeliac disease in this population.MAIN OUTCOME MEASURESThe principal outcome measure was the SSS. Others included the Hospital Anxiety and Depression Scale, psychopathology, the Work and Social Adjustment Scale (WASA, disability), a modified version of the Illness Perception Questionnaire (illness perceptions), the Beliefs about Medicine Questionnaire (attitudes to medication), the Reported Adherence to Medication Scale (adherence to prescribed medication), the Client Service Receipt Inventory (economic analysis), the Cognitive Scale for Functional Bowel Disorders (illness cognitions) and the Behaviour Scale for IBS (IBS coping behaviour).RESULTSThe addition of CBT produced a significant benefit compared with the mebeverine-only group at 3 months after treatment on all outcome measures, except for the adherence to medication scales. The difference between the groups was 107.8 points on the SSS, 24.5 points on question 4 of the SSS and 6.3 points on the WASA, representing therapeutic gains of approximately 20%, 28% and 40%, respectively. However, there was also evidence that these improvements began to wane, so that at 6 and 12 months follow-up significant therapeutic benefit of the addition of CBT could only be detected on question 4 of the SSS and on the WASA. The behaviour scale for IBS detected significant, positive changes in coping behaviours at up to 6 months after treatment. Three factors predicting a poor outcome were identified: male gender, believing that IBS had serious consequences and belief in an external aetiology, all of which were associated with greater than average disability at follow-up. The addition of CBT to mebeverine did not reduce overall treatment or social costs. The nested study on testing for coeliac disease provides cautious support for the inclusion of antiendomysial and antigliadin antibody testing in the investigation of patients thought to have IBS.CONCLUSIONSSpecially trained practice nurses can provide effective CBT to primary care patients with a clinical diagnosis of IBS, which although effective does not reduce service or social costs. Using a variety of measures the beneficial therapeutic effects of the addition of CBT to antispasmodic therapy persist for up to 6 months. Future research might include studies of the long-term follow-up of IBS patients treated with CBT, cost-benefit analyses comparing CBT with other therapeutic approaches to IBS, and evaluating means of training both non-specialist health professionals and GPs to deliver CBT.OBJECTIVESTo determine whether cognitive behavioural therapy (CBT) in addition to antispasmodic treatment offers a cost-effective benefit to primary care patients with irritable bowel syndrome (IBS) and to identify predictors of outcome.","Kennedy, T M; Chalder, T; McCrone, P; Darnley, S; Knapp, M; Jones, R H; Wessely, S",2006.0,,0,0,
5721,Theory of mind in bulimia nervosa,"ER OBJECTIVE: This study aimed to investigate theory of mind (ToM) in individuals with bulimia nervosa (BN), an area neglected by empirical research despite social functioning difficulties in this disorder and evidence of ToM deficits in people with anorexia nervosa (AN).METHOD: ToM was assessed in 48 BN and 34 Eating Disorder Not Otherwise Specified BN-type (EDNOS-BN) outpatients and 57 healthy controls (HCs) using the Reading the Mind in the Eyes and the Reading the Mind in the Films (RMF), an ecologically valid task novel to BN research.RESULTS: Overall performance in BN and EDNOS-BN groups was equivalent to HCs on both tasks. Individuals with BN had enhanced negative emotion recognition on the RMF.DISCUSSION: Individuals with AN and BN have distinct socio-cognitive profiles. Further research into social cognition is required to establish the link between interpersonal difficulties and psychopathology in people with BN.","Kenyon, M; Samarawickrema, N; Dejong, H; Eynde, F; Startup, H; Lavender, A; Goodman-Smith, E; Schmidt, U",2012.0,10.1002/eat.20967,0,0,
5722,A New Zealand pilot randomized controlled trial of a web-based interactive self-management programme (MSInvigor8) with and without email support for the treatment of multiple sclerosis fatigue,"ER DESIGN: Randomized controlled trial using an independent randomization system built into the website and intention-to-treat analysis.SETTING: Participants were recruited through the local Multiple Sclerosis Society and hospital neurological services in New Zealand.SUBJECTS: A total of 39 people (aged 31-63?years), experiencing multiple sclerosis fatigue, able to walk with and without walking aids, were randomized to MSInvigor8-Only (n = 20) or to MSInvigor8-Plus (n = 19).INTERVENTIONS: MSInvigor8 is an eight-session programme based on cognitive behaviour therapy principles including psycho-education, self-monitoring, and changing unhelpful activity and thought patterns.MAIN MEASURES: Outcome measures included fatigue severity (Chalder Fatigue Scale) and impact (Modified Fatigue Impact Scale), and anxiety and depression (Hospital Anxiety and Depression Scale). Assessments were performed at baseline and at 10?weeks.RESULTS: The MSInvigor8-Plus condition resulted in significantly greater reductions in fatigue severity (F [1,36] = 9.09, p < 0.01) and impact (F [1,36] = 6.03, p < 0.02) compared with the MSInvigor8-Only condition. Large between-group effect sizes for fatigue severity (d = 0.99) and fatigue impact (d = 0.81) were obtained. No significant differences were found between the groups on changes in anxiety and depression.CONCLUSIONS: MSInvigor8 delivered with email-based support is a potentially promising, acceptable, and cost-effective approach to treating fatigue in people with multiple sclerosis in New Zealand.OBJECTIVE: To pilot and compare the efficacy of an internet-based cognitive behavioural therapy self-management programme with (MSInvigor8-Plus) and without (MSInvigor8-Only) the use of email support in reducing fatigue severity and impact (primary outcomes), and depressed and anxious mood (secondary outcomes).","Kessel, K; Wouldes, T; Moss-Morris, R",2016.0,10.1177/0269215515584800,0,0,
5723,Temperature during coronary artery bypass surgery affects quality of life,"ER METHODSA total of 209 patients randomly received normothermic (warm) or hypothermic (cold) conditions during coronary artery bypass surgery (CABS), and a number of physical, social, and psychologic measures were assessed before as well as 6 weeks and 6 months after CABS.RESULTSRepeated measures analyses of covariance revealed significant temperature group main effects for anxiety (p = 0.008) and depression (p = 0.039), with the normothermic group obtaining lower anxiety and depression levels than the hypothermic group at both 6 weeks and 6 months after surgery. Additionally, among patients who entered the study with higher depression levels, those in the hypothermic group tended to have higher depression scores at follow-up compared with patients in the normothermic condition (p = 0.012). No temperature group differences were observed on other quality of life indices.CONCLUSIONSThe results of the present study indicate that hypothermic conditions during CABS are associated with higher levels of emotional distress after CABS than normothermic conditions, particularly for patients with greater stress to begin with.BACKGROUNDThe objective of this study was to examine the effects of temperature on a variety of indices of psychologic adjustment and quality of life.","Khatri, P; Babyak, M; Croughwell, N D; Davis, R; White, W D; Newman, M F; Reves, J G; Mark, D B; Blumenthal, J A",2001.0,,0,0,
5724,Comparison of new motorized injector vs manual injector for implantation of foldable intraocular lenses on wound integrity: an ASOCT study,"ER PURPOSE: To compare intraocular lens implantation using a motorized injector vs standard manual injector through a 2.2-mm clear corneal incision.METHODS: Patients underwent standard phacoemulsification using a 2.2-mm clear corneal incision. Hydrophobic acrylic aspheric intraocular lens (Acrysof SN60WF intraocular lens (IOL)) was inserted using D cartridge with manual monarch injector or autosert motorized injector. IOL safety, final incision size and wound integrity in terms of anterior and posterior wound gape, and descemet's membrane detachment were compared between the two groups at post-operative day 1 and at 1 month using Anterior Segment Optical Coherence Tomography.RESULTS: The study recruited 32 patients in the group I (manual injector) and 30 patients in group II (motorized injector). In group I, the final incision after IOL insertion increased by 0.12?mm (95% CI: 0.134-0.106) (P<0.0001), which was seen in 100% of the patients. In group II, the incision enlarged by 0.01 (95% CI: 0.021-0.0.001) (P=0.07) and was seen in only 6.67% of the cases. IOL nicks were seen in 9.37% of the cases in group I only. Although the incidence of descemet's membrane detachment and anterior wound gape was similar for both groups, posterior wound gape was seen more often with the manual injector in the immediate post-operative period. (P=0.018) CONCLUSION: The motorized insertion system was gentle and safe for the IOLs with lesser incidence of IOL nicks. Regarding wound safety, it caused significantly less incision enlargement and better posterior wound integrity.","Khokhar, S; Sharma, R; Patil, B; Aron, N; Gupta, S",2014.0,10.1038/eye.2014.162,0,0,
5725,Accelerated rehabilitation after arthroscopic Bankart repair for selected cases: a prospective randomized clinical study,"ER TYPE OF STUDYProspective randomized clinical trial.METHODSWe performed an arthroscopic Bankart repair using suture anchors in 62 patients with traumatic recurrent anterior instability of the shoulder. Patients were randomized into 2 groups; group 1 (28 patients; mean age, 28 years) was managed with 3 weeks of immobilization using an abduction sling and conventional rehabilitation program, and group 2 (34 patients; mean age, 29 years) was managed with an accelerated rehabilitation program that consisted of staged range of motion and strengthening exercises from the immediate postoperative day. Selection criteria were nonathletes with recurrent anterior shoulder dislocation and a classic Bankart lesion with a robust labrum limited to 1 cm from the midglenoid notch. The patients were followed up for a mean of 31 months (range, 27 to 45 months; standard deviation, 9 months). Analysis of outcome included pain scores at 6 weeks and at final follow-up evaluation, range of motion, return to activity, recurrence rate, patient satisfaction with each rehabilitation program, and shoulder scores assessed by the American Shoulder and Elbow Surgeons Shoulder Index, the rating system of the University of California at Los Angeles, and another scoring system.RESULTSThe recurrence rate was not different between the 2 groups (P =.842). None of the groups developed recurrent dislocation. Two patients from each group were positive for anterior apprehension signs. Patients who underwent accelerated rehabilitation resumed functional range of motion faster (P .05).CONCLUSIONSEarly mobilization of the operated shoulder after arthroscopic Bankart repair does not increase the recurrence rate in a selected group of patients. Although the final outcomes are approximately the same for both groups, the accelerated rehabilitation program promotes functional recovery and reduces postoperative pain, which allows patients an early return to desired activities.PURPOSEIncreased stress within a certain limit enhances ligament healing and improves joint function. In this prospective randomized clinical trial, we compared the clinical results of early motion versus conventional immobilization after arthroscopic Bankart repair in a selected patient population.","Kim, S H; Ha, K I; Jung, M W; Lim, M S; Kim, Y M; Park, J H",2003.0,,0,0,
5726,Correlation of mental health problems with psychological constructs in adolescence: final results from a 2-year study,"ER In recent years, it has been widely witnessed that a surprising number of adolescents suffer emotional and mental health problems, and such turmoil is very often carried over into adulthood with serious implications for adjustment during the post-adolescent years. On this point, mental health problems in Korea are only now being considered crucial factors in the health status of adolescents and important public and social issues. It is also true that studies concerning the link between adolescents' mental health problems and their psychology are limited. The purposes of this study were to investigate mental health problems of Korean adolescents, to reveal factors affecting their negative mental health and to explore a possible relationship between mental health problems and psychological variables. 2052 Korean adolescents selected randomly from junior high and high schools in Seoul, Korea were surveyed. Korean Symptom Checklist, Health Locus of Control Scale, Self-efficacy Scale and Self-esteem Scale were used to identify mental health problems and psychological variables of adolescents. Results indicated that Korean adolescents showed high prevalence in interpersonal sensitivity, depression, anxiety and hostility. In addition, the findings revealed that there were significant differences in adolescents' mental health problems between gender and age. Furthermore, results revealed that the adolescents' mental health problems were statistically correlated with psychological variables. This study provides significant information for the relatively unstudied Korean adolescents and also has the potential to influence the development of better mental health programs for adolescents.","Kim, Y H",2003.0,,0,0,
5727,Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial,"ER SUMMARY BACKGROUND DATALADG has been beneficial in terms of pain, recovery, and morbidity when compared with open surgery with equal oncologic outcome. There has been no clinical study on QOL.METHODSFrom July 2003 to November 2005, 164 patients with newly diagnosed cT1N0M0 and cT1N1M0 distal gastric cancer were randomly assigned either to LADG or ODG. All patients were asked to complete the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-STO22 questionnaires preoperatively and postoperatively on regular follow-up visits.RESULTSStatistically significant differences were observed with a more favorable outcome noted in the LADG group with respect to intraoperative blood loss (P < 0.001), total amount of analgesics used (P = 0.019), the size of the wound (P < 0.0001), postoperative hospital stay (P < 0.0001), and QOL parameters of global health (P < 0.0001). Most of the scales on patient functioning including physical (P < 0.0005), role (P = 0.0011), emotional (P < 0.0001), social (P < 0.0001), and symptom scales such as fatigue (P < 0.0001), pain (P < 0.0001), appetite loss (P = 0.031), sleep disturbance (P = 0.003), dysphasia (P = 0.0024), gastro-esophageal reflux (P = 0.0127), dietary restriction (P = 0.0004), anxiety (P = 0.0036), dry mouth (P = 0.0007), and body image (P < 0.0001) were also significantly better in the LADG group compared with the ODG group.CONCLUSIONSComparison of LADG to ODG in patients with early gastric cancer resulted in improved QOL outcomes in the patients followed for up to 3 months in the LADG group.OBJECTIVEThe purpose of this study was to evaluate the quality of life (QOL) after laparoscopy-assisted distal gastrectomy (LADG) compared with open distal gastrectomy (ODG) in patients with early gastric cancer.","Kim, Y W; Baik, Y H; Yun, Y H; Nam, B H; Kim, D H; Choi, I J; Bae, J M",2008.0,10.1097/SLA.0b013e318185e62e,0,0,
5728,Nurse-led telephone follow-up and an educational group programme after breast cancer treatment: results of a 2 √ó 2 randomised controlled trial,"ER PATIENTS AND METHODSA multicentre pragmatic randomised controlled trial (RCT) with a 2√ó2 factorial design was performed among 320 breast cancer patients who were treated with curative intent. Participants were randomised to follow-up care as usual (3-monthly outpatient clinic visits), nurse-led telephone follow-up, or the former strategies combined with an educational group programme. The primary outcome for both interventions was HRQoL, measured by EORTC QLQ-C30. Secondary outcomes were role and emotional functioning and feelings of control and anxiety.RESULTSData of 299 patients were available for evaluation. There was no significant difference in HRQoL between nurse-led telephone and hospital follow-up at 12 months after treatment (p = 0.42; 95% confidence interval (CI) for difference: -1.93-4.64) and neither between follow-up with or without EGP (p = 0.86; 95% CI for difference: -3.59-3.00). Furthermore, no differences between the intervention groups and their corresponding control groups were found in role and emotional functioning, and feelings of control and anxiety (all p-values > 0.05).CONCLUSIONReplacement of most hospital follow-up visits in the first year after breast cancer treatment by nurse-led telephone follow-up does not impede patient outcomes. Hence, nurse-led telephone follow-up seems an appropriate way to reduce clinic visits and represents an accepted alternative strategy. An EGP does not unequivocally affect positive HRQoL outcomes.OBJECTIVETo investigate whether frequent hospital follow-up in the first year after breast cancer treatment might partly be replaced by nurse-led telephone follow-up without deteriorating health-related quality of life (HRQoL), and whether a short educational group programme (EGP) would enhance HRQoL.","Kimman, M L; Dirksen, C D; Voogd, A C; Falger, P; Gijsen, B C; Thuring, M; Lenssen, A; Ent, F; Verkeyn, J; Haekens, C; Hupperets, P; Nuytinck, J K; Riet, Y; Brenninkmeijer, S J; Scheijmans, L J; Kessels, A; Lambin, P; Boersma, L J",2011.0,10.1016/j.ejca.2010.12.003,0,0,
5729,Hydrophilic-coated sheaths increase the success rate of transradial coronary procedures and reduce patient discomfort but do not reduce the occlusion rate: randomized single-blind comparison of coated vs. non-coated sheaths,"ER BACKGROUNDMain complications of the transradial access include spasms, discomfort and occlusion of the radial artery (RA). Coated sheaths have been demonstrated to reduce spasms and discomfort but have not been previously investigated for their potential effect on the occlusion rate.METHODSA total of 200 consecutive patients were randomized into four groups of 50 patients each. Two study groups were examined with hydrophilic-coated sheaths featuring a caliber of five or six French depending on RA diameters as determined by ultrasound. Two control groups were examined with traditional non-coated sheaths. RA occlusion was the primary endpoint of the study. Secondary endpoints included RA alterations as determined by ultrasound after 4 weeks. Pain intensities during sheath withdrawal were rated on a visual analog scale.RESULTSPost-procedural occlusion was diagnosed in nine patients of both study groups (9%) and in six patients of both control groups (6%). This difference was not statistically significant (P = 0.42). The same was true of the secondary endpoints (3% Vs. 9%; P = 0.74). However, the pain intensity scores obtained immediately after sheath withdrawal were significantly lower in the patients treated with coated sheaths (1.4 Vs. 2.7; P < 0.0001).CONCLUSIONSHydrophilic-coated sheaths for transradial access will reduce patient discomfort but do not involve fewer cases of occlusion than traditional non-coated sheaths.OBJECTIVESTo examine the effect of hydrophilic-coated Vs. non-coated sheaths for coronary angiography by transradial access and to determine whether the rate of post-procedural vascular occlusion can be reduced if different sheath diameters are used in accordance with vessel diameters.","Kindel, M; Rüppel, R",2008.0,10.1007/s00392-008-0658-5,0,0,
5730,The effects of gratitude expression on neural activity,"ER Gratitude is a common aspect of social interaction, yet relatively little is known about the neural bases of gratitude expression, nor how gratitude expression may lead to longer-term effects on brain activity. To address these twin issues, we recruited subjects who coincidentally were entering psychotherapy for depression and/or anxiety. One group participated in a gratitude writing intervention, which required them to write letters expressing gratitude. The therapy-as-usual control group did not perform a writing intervention. After three months, subjects performed a ""Pay It Forward"" task in the fMRI scanner. In the task, subjects were repeatedly endowed with a monetary gift and then asked to pass it on to a charitable cause to the extent they felt grateful for the gift. Operationalizing gratitude as monetary gifts allowed us to engage the subjects and quantify the gratitude expression for subsequent analyses. We measured brain activity and found regions where activity correlated with self-reported gratitude experience during the task, even including related constructs such as guilt motivation and desire to help as statistical controls. These were mostly distinct from brain regions activated by empathy or theory of mind. Also, our between groups cross-sectional study found that a simple gratitude writing intervention was associated with significantly greater and lasting neural sensitivity to gratitude - subjects who participated in gratitude letter writing showed both behavioral increases in gratitude and significantly greater neural modulation by gratitude in the medial prefrontal cortex three months later.","Kini, P; Wong, J; McInnis, S; Gabana, N; Brown, J W",2016.0,10.1016/j.neuroimage.2015.12.040,0,0,
5731,Psychosocial benefits of three formats of a standardized behavioral stress management program,"ER METHODSOne hundred ninety-six participants screening positive for elevated psychosocial distress were randomized to either a waitlist control group or one of three intervention groups: the LifeSkills Workshop, the LifeSkills Video, or the LifeSkills Video and Workshop combined. Psychosocial risk factors were evaluated at baseline and at 10 days, 2 months, and 6 months after the training/wait period.RESULTSAt 10 days follow up, the workshop + video and video-only groups showed significant improvements over control subjects in trait anxiety and perceived stress. Moreover, the workshop + video group maintained benefit over control subjects throughout 6 months follow up in both of these measures, whereas the video-only group maintained benefit in trait anxiety.CONCLUSIONSBecause the psychosocial well-being of two of the treated groups improved over that of the control group, it appears that the Williams LifeSkills program accelerates and maintains a normal return to low distress after a stressful time. This is the first study to show that a commercially available, facilitator- or self-administered behavioral training product can have significant beneficial effects on psychosocial well-being in a healthy community sample.OBJECTIVEPsychosocial factors are associated with increased morbidity and mortality in healthy and clinical populations. Behavioral interventions are needed to train the large number of people in the community setting who are affected by stressors to use coping skills that will reduce these risk factors. The aim of the current study was to evaluate the efficacy of three forms of delivery of a standardized, behavioral intervention-the Williams LifeSkills program-designed to reduce levels of psychosocial risk factors in nonclinical populations.","Kirby, E D; Williams, V P; Hocking, M C; Lane, J D; Williams, R B",2006.0,10.1097/01.psy.0000238452.81926.d3,0,0,
5732,Randomised trial of a brief physiotherapy intervention compared with usual physiotherapy for neck pain patients: outcomes and patients' preference,"ER DESIGNNon-inferiority randomised controlled trial eliciting preferences independently of randomisation.SETTINGPhysiotherapy departments in a community setting in Yorkshire and north Lincolnshire.PARTICIPANTS268 patients (mean age 48 years) with subacute and chronic neck pain, who were referred by their general practitioner and randomly assigned to a brief physiotherapy intervention (one to three sessions) using cognitive behaviour principles to encourage self management and return to normal function or usual physiotherapy, at the discretion of the physiotherapist concerned.MAIN OUTCOME MEASURESThe Northwick Park neck pain questionnaire (NPQ), a specific measure of functional disability resulting from neck pain. Also, the short form 36 (SF-36) questionnaire, a generic, health related, quality of life measure; and the Tampa scale for kinesophobia, a measure of fear and avoidance of movement.RESULTSAt 12 months, patients allocated to usual physiotherapy had a small but significant improvement in NPQ scores compared with patients in the brief intervention group (mean difference 1.99, 95% confidence interval 0.45 to 3.52; P = 0.01). Although the result shows a significant inferiority of the intervention, the confidence interval shows that the effect could be in the non-inferiority range for the brief intervention (below 1.2 points of NPQ score). Patients who preferred the brief intervention and received this treatment had similar outcomes to patients receiving usual physiotherapy.CONCLUSIONSUsual physiotherapy may be only marginally better than a brief physiotherapy intervention for neck pain. Patients with a preference for the brief intervention may do at least as well with this approach. Additional training for the physiotherapists in cognitive behaviour techniques might improve this approach further.OBJECTIVESFirstly, to compare the effectiveness of a brief physiotherapy intervention with ""usual"" physiotherapy for patients with neck pain. Secondly, to evaluate the effect of patients' preferences on outcome.","Klaber, Moffett J A; Jackson, D A; Richmond, S; Hahn, S; Coulton, S; Farrin, A; Manca, A; Torgerson, D J",2005.0,10.1136/bmj.38286.493206.82,0,0,
5733,A complex nursing intervention of complementary and alternative medicine (CAM) to increase quality of life in patients with breast and gynecologic cancer undergoing chemotherapy: study protocol for a partially randomized patient preference trial,"ER METHODS/DESIGN: CONGO is a prospective partially randomized patient preference (PRPP) trial including adult women diagnosed with breast and gynecologic cancer starting a new chemotherapy regimen. Patients without strong preferences for CAM will be randomized to usual nursing care or complex nursing care; those patients with strong preferences will be allowed their choice. The intervention consists of three interacting and intertwined elements: CAM nursing intervention packet, counseling on CAM using a resource-oriented approach and evidence-based informational material on CAM. Primary outcome data on participants' HRQoL will be collected from baseline until the end of treatment and long-term follow-up using the EORTC-QLQ-C30. Secondary outcomes include nausea, fatigue, pain, anxiety/depression, social support, self-efficacy, patient competence, spiritual wellbeing, and satisfaction with care. Accompanying research on economic outcomes as well as a mixed-methods process evaluation will be conducted. A total of 590 patients (236 patients in the randomized part of the study and 354 patients in the observational part of the study) will be recruited in the two outpatient clinics. The first analysis step will be the intention-to-treat (ITT) analysis of the randomized part of the trial. A linear mixed model will be used to compare the continuous primary endpoint between the intervention and control arm of the randomized group. The observational part of the trial will be analyzed descriptively. External validity will be assessed by comparing randomized with nonrandomized patients.DISCUSSION: Cancer patients are increasingly using CAM as supportive cancer care, however, a patient-centered model of care that includes CAM for the patient during chemotherapy still needs to be evaluated. This protocol has been designed to test if the effects of the intervention go beyond potential benefits in quality-of-life outcomes.TRIAL REGISTRATION: German Clinical Trials Register (DRKS), DRKS00006056 (15 April 2014).BACKGROUND: Health-related quality of life (HRQoL) is most adversely affected in cancer patients between diagnosis and the end of chemotherapy. The aim of the Complementary Nursing in Gynecologic Oncology (CONGO) study is to assess the effectiveness of a complex nursing care intervention of CAM to increase HRQoL in cancer patients undergoing chemotherapy.","Klafke, N; Mahler, C; Hagens, C; Rochon, J; Schneeweiss, A; Müller, A; Salize, H J; Joos, S",2015.0,10.1186/s13063-014-0538-4,0,0,
5734,Late-life depression and functional disability: the role of goal-focused group psychotherapy,"ER This study compares the efficacy of two time-limited group psychotherapies for depression and functional disability in late life. Goal-focused group psychotherapy (GFGP) utilized focused psychoeducation and skills training to assist each patient in the achievement of individualized goals. Reminiscence therapy (RT) emphasized individual life review to facilitate discussion. Subjects (N = 13), ages 55 and above, with major depression were randomly assigned to one of the two groups. Most were receiving antidepressant treatment. All had failed to achieve full remission. Whereas both treatment groups improved in depressed mood and disability, GFGP subjects had a far greater change in depressive symptomatology and also improved in the areas of hope, hopelessness, anxiety and social functioning.","Klausner, E J; Clarkin, J F; Spielman, L; Pupo, C; Abrams, R; Alexopoulos, G S",1998.0,,0,0,
5735,A randomized controlled trial of targeted prefrontal cortex modulation with tDCS in patients with alcohol dependence,"ER Preliminary small studies have shown that transcranial direct current stimulation (tDCS) reduces craving in alcoholic subjects. It is unclear whether tDCS also leads to changes in clinically meaningful outcomes for alcohol dependence in a properly powered phase II randomized clinical trial. We aimed to investigate whether repetitive tDCS changes the risk of alcohol use relapse in severe alcoholics from outpatient services. Thirty-five subjects were randomized to receive active bilateral [left cathodal/right anodal over the dorsolateral prefrontal cortex (dlPFC)] repetitive (five consecutive days) tDCS (2 mA, 35 cm2, two times daily stimulation for 13 min with a 20-min interval) or sham-tDCS. There were two dropouts before treatment. From 33 alcoholic subjects, 17 (mean age 45.5±8.9 s.d., 16 males) were randomized to sham and 16 (44±7.8 s.d., 16 males) to real tDCS treatment. By the end of the six months of follow-up, two subjects treated with sham (11.8%) and eight treated with real tDCS (50%) were still alcohol-abstinent [p=0.02, Long-rank (Mantel-Cox) Test, HR=0.35 (95% CI, 0.14-0.85)]. No differences with regard to changes on scores of craving, frontal function, global mental status, depressive or anxiety symptoms were observed between groups. However, subjects from the tDCS group improved with regard to their overall perception of quality of life (p=0.02), and increased their scores in the environment domain (p=0.04) after treatment. Bilateral tDCS over dlPFC reduces relapse probability in severe alcoholic subjects and results in improved perception of quality of life.","Klauss, J; Penido, Pinheiro L C; Silva, Merlo B L; Almeida Correia, Santos G; Fregni, F; Nitsche, M A; Miyuki, Nakamura-Palacios E",2014.0,10.1017/S1461145714000984,0,0,
5736,Cost effectiveness of a manual based coping strategy programme in promoting the mental health of family carers of people with dementia (the START (STrAtegies for RelaTives) study): a pragmatic randomised controlled trial,"ER OBJECTIVE: To assess whether the START (STrAtegies for RelatTives) intervention added to treatment as usual is cost effective compared with usual treatment alone.DESIGN: Cost effectiveness analysis nested within a pragmatic randomised controlled trial.SETTING: Three mental health and one neurological outpatient dementia service in London and Essex, UK.PARTICIPANTS: Family carers of people with dementia.INTERVENTION: Eight session, manual based, coping intervention delivered by supervised psychology graduates to family carers of people with dementia added to usual treatment, compared with usual treatment alone.PRIMARY OUTCOME MEASURES: Costs measured from a health and social care perspective were analysed alongside the Hospital Anxiety and Depression Scale total score (HADS-T) of affective symptoms and quality adjusted life years (QALYs) in cost effectiveness analyses over eight months from baseline.RESULTS: Of the 260 participants recruited to the study, 173 were randomised to the START intervention, and 87 to usual treatment alone. Mean HADS-T scores were lower in the intervention group than the usual treatment group over the 8 month evaluation period (mean difference -1.79 (95%","Knapp, M; King, D; Romeo, R; Schehl, B; Barber, J; Griffin, M; Rapaport, P; Livingston, D; Mummery, C; Walker, Z; Hoe, J; Sampson, E L; Cooper, C; Livingston, G",2013.0,,0,0,
5737,Dealing with daily challenges in dementia (deal-id study): effectiveness of the experience sampling method intervention 'Partner in Sight' for spousal caregivers of people with dementia: design of a randomized controlled trial,"ER METHODS/DESIGN: A randomized controlled trial with 90 spousal caregivers of people with dementia will be conducted. Participants will be randomly assigned to the experimental (6-week ESM intervention including feedback), pseudo-experimental (6-week ESM intervention without feedback), or control group (care as usual). Assessments will be performed pre- and post-intervention and at 2-, and 6-month follow-up. Main outcomes will be sense of competence, perceived control, momentary positive affect, and psychological complaints (depressive symptoms, perceived stress, anxiety, momentary negative affect). In addition to the effect evaluation, a process and economic evaluation will be conducted to investigate the credibility and generalizability of the intervention, and its cost-effectiveness.DISCUSSION: The potential effects of the ESM intervention may help caregivers to endure their care responsibilities and prevent them from becoming overburdened. This is the first ESM intervention for caregivers of people with dementia. The results of this study, therefore, provide a valuable contribution to the growing knowledge on m-health interventions for dementia caregivers.TRIAL REGISTRATION: Dutch Trial Register NTR4847 ; date registered Oct 9, 2014.BACKGROUND: There is an urgent need for psychosocial interventions that effectively support dementia caregivers in daily life. The Experience Sampling Methodology (ESM) offers the possibility to provide a more dynamic view of caregiver functioning. ESM-derived feedback may help to redirect caregivers' behavior towards situations that elicit positive emotions and to increase their feelings of competence in the caretaking process. This paper presents the design of a study that evaluates the process characteristics and effects of the ESM-based intervention 'Partner in Sight'.","Knippenberg, R J; Vugt, M E; Ponds, R W; Myin-Germeys, I; Verhey, F R",2016.0,10.1186/s12888-016-0834-5,0,0,
5738,Optic edge design as long-term factor for posterior capsular opacification rates,"ER DESIGNOpen-label, prospective, randomized, multicenter clinical trial.PARTICIPANTSTwo hundred and eighty-eight patients with bilateral surgery for senile cataract operated in German university clinics, eye hospitals, and private ophthalmic surgical centers (Aachen, Ahaus, Bad Hersfeld, Frankfurt/Main, Jena, Rosenheim, and Sulzbach/Saar).INTERVENTIONSAt each center, a highly refractive index silicone IOL with a sharp optic edge (CeeOn) was intraindividually compared either with a high-refractive index silicone IOL with a round optic edge (PhacoFlex) in 108 patients or with an acrylic IOL with a sharp optic edge (AcrySof) in 139 patients. All patients received standard phacoemulsification with IOL implantation in the bag in both eyes from the same surgeon. A morphological evaluation of PCO was performed by the Evaluation of the Posterior Capsule Opacification (EPCO) system 1 to 2 weeks and 11 to 14 and 35 to 37 months after surgery. The blinded digital pictures were evaluated by an independent investigator. Posterior capsular opacification was statistically evaluated by paired comparisons of 3-year cumulative incidences of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser treatment and EPCO scores.MAIN OUTCOME MEASURESPosterior capsular opacification.RESULTSThe 3-year cumulative incidences of Nd:YAG laser capsulotomy were 2.1% (CeeOn), compared with 2.1% (AcrySof) (risk difference, 0%; 90% confidence interval, -3.4% to 3.4%), and 5.7% (CeeOn), compared with 17.0% (PhacoFlex) (risk difference, -11.4%; 90% confidence interval, -18.1% to -4.7%). In patients without Nd:YAG laser treatment, medians of the total area EPCO score were 0.0005 (CeeOn) versus 0.0440 (AcrySof) and 0 (CeeOn) versus 0.0700 (PhacoFlex) at 3 years. Functional results, safety, and handling did not significantly differ for the 3 lenses.CONCLUSIONSOur results suggest that modern foldable IOLs have a low incidence of PCO after 3 years. There is less PCO for sharp optic edge designs independent of IOL material.OBJECTIVETo compare the difference in posterior capsular opacification (PCO) between highly refractive silicone and hydrophobic acrylic foldable intraocular lenses (IOLs) with sharp and round edge designs 3 years after in-the-bag IOL implantation in subjects undergoing bilateral cataract surgery.","Kohnen, T; Fabian, E; Gerl, R; Hunold, W; Hütz, W; Strobel, J; Hoyer, H; Mester, U",2008.0,10.1016/j.ophtha.2008.01.002,0,0,
5739,Effect of intraocular lens asphericity on quality of vision after cataract removal: an intraindividual comparison,"ER DESIGNIntraindividual, prospective, randomized clinical trial.PARTICIPANTSTwenty-six cataract patients received 2, one-piece, blue-light-filtering hydrophobic acrylic IOLs each.METHODSOne eye was implanted with a spherical (SN60AT, Alcon) and the contralateral eye with an aspheric (SN60WF, Alcon) IOL with -0.2 mum spherical aberration (SA). All trial-specific measurements (corneal topography, wavefront sensing, high-contrast visual acuity [HCVA], contrast sensitivity [CS]) were performed 6 months after surgery. A paired Student t-test or Wilcoxon test was used to check intergroup differences.MAIN OUTCOME MEASURESAbsolute values and intraindividual differences (Delta(i)) of corneal and ocular higher order aberrations and best-corrected visual Strehl ratio based on the optical transfer function (BCVSOTF) values for virtual pupil diameters of 3, 4, 5, and 6 mm were computed. Photopic and mesopic HCVA, photopic, and high-mesopic CS as well as high-mesopic disability glare (DG) were measured using the Frankfurt-Freiburg Contrast and Acuity Test System.RESULTSNo intergroup difference of demographic data, pupillometry, and corneal aberrations were observed. Coma and trefoil root mean square and SA were significantly lower in the aspheric group resulting in higher BCVSOTF, mesopic HCVA, and photopic and high mesopic CS. All Delta(i) values with exception of photopic HCVA and DG indicated significantly better performance of the aspheric IOL.CONCLUSIONSAn aspheric IOL with -0.2 microm SA provide higher quality of vision than spherical IOL in terms of retinal image quality, mesopic HCVA and CS.FINANCIAL DISCLOSURE(S)Proprietary or commercial disclosures may be found after the references.PURPOSETo determine the effect of intraocular lens (IOL) asphericity on quality of vision after cataract removal.","Kohnen, T; Klaproth, O K; Bühren, J",2009.0,10.1016/j.ophtha.2009.03.052,0,0,
5740,Splanchnic and renal deterioration during and after laparoscopic cholecystectomy: a comparison of the carbon dioxide pneumoperitoneum and the abdominal wall lift method,"ER IMPLICATIONSA mechanical retractor method (gasless) was compared with conventional CO2 pneumoperitoneum for laparoscopic cholestectomy. The gasless method ensured stable hemodynamics, prevented respiratory acidosis, and provided protection against the renal and splanchnic ischemia seen with CO2 pneumoperitoneum.UNLABELLEDCarbon dioxide (CO2) pneumoperitoneum together with an increased intraabdominal pressure (IAP) induces a hemodynamic stress response, diminishes urine output, and may compromise splanchnic perfusion. A new retractor method may be less traumatic. Accordingly, 30 ASA physical status I or II patients undergoing laparoscopic cholecystectomy were randomly allocated to a CO2 pneumoperitoneum (IAP 12-13 mm Hg) (control) or to a gasless abdominal wall lift method (retractor) group. Anesthesia and intravascular fluids were standardized. Direct mean arterial pressure (MAP), urine output, urine-N-acetyl-beta-D-glucosaminidase (U-NAG), arterial blood gases, gastric mucosal PCO2, and intramucosal pH (pHi) were measured. Normoventilation was instituted in all patients. MAP increased (P < 0.001) only with CO2 pneumoperitoneum. Minute volume of ventilation had to be increased by 35% with CO2 insufflation. PaCO2 was significantly higher (P < 0.05) for 3 h postoperatively in the control group. Diuresis was less (P < 0.01) and U-NAG levels (P < 0.01) higher in the control group. The pHi decreased after induction of pneumoperitoneum up to three hours postoperatively and remained intact in the retractor group. We conclude that the retractor method for laparoscopic cholecystectomy ensures stable hemodynamics, prevents respiratory acidosis, and provides protection against biochemical effects, which reveal the renal and splanchic ischemia caused by CO2 insufflation.","Koivusalo, A M; Kellokumpu, I; Ristkari, S; Lindgren, L",1997.0,,0,0,
5741,Impact of omega-3 fatty acid enriched TPN on leukotriene synthesis by leukocytes after major surgery,"ER Major surgery leads to post-traumatic immune dysregulation which is driven by the activation of potent proinflammatory mediators including the leukotrienes (LTs). The LTs of the four-series derive from arachidonic acid (an omega-6 fatty acid). In contrast, LTs of the five-series are metabolic products of eicosapentaenoic acid (an omega-3 fatty acid) and exert less biological activities. Therapeutical strategies to attenuate proinflammatory signals include the provision of omega-3 fatty acids. Thirty patients with major elective abdominal surgery and an indication for total parenteral nutrition (TPN) were compared in a prospective, double blind, randomized study of two parallel groups. Group 1 (n=14) received an omega-3 fatty acid enriched 20% lipid emulsion (MCT:LCT:fish oil = 5:4:1, MLF541; Lipoplus) for 5 days postoperatively. Group 2 (n=16) received a standard 20% fat emulsion (LCT; Intralipid). The LT release from whole blood leukocytes stimulated with Ca-ionophore was analyzed preoperatively and on postoperative days 1, 6 and 8 by HPLC. There was a significant increase in the generation of LTB(5) (P=0.0035) and in the ratio of LTB(5)/LTB(4) (P=0.0017) the omega-3 group, but not in the reference group after 5 days infusion of the lipid emulsions. The omega-6/omega-3 fatty acid ratio 3:1 of the newly developed MLF541 lipid emulsion is appropriate to increase the synthesis of the biologically less active leukotrienes of the five-series. Nutritive enrichment with omega-3 fatty acids in a balanced ratio with omega-6 fatty acids is an important step to avoid hyperinflammatory situations in patients after major surgery.","Köller, M; Senkal, M; Kemen, M; König, W; Zumtobel, V; Muhr, G",2003.0,,0,0,
5742,Response rate and completeness of questionnaires: a randomized study of Internet versus paper-and-pencil versions,"ER OBJECTIVEWe used a randomized design to compare a paper-and-pencil questionnaire with an Internet version of the same questionnaire with respect to differences in response rate and completeness of data.METHODSWomen referred for mammography at a Danish public hospital from September 2004 to April 2005, aged less than 67 years and without a history of breast cancer, were eligible for the study. The women received the invitation to participate along with the usual letter from the Department of Radiology. A total of 533 women were invited to participate. They were randomized to receive either a paper questionnaire, with a prepaid return envelope, or a guideline on how to fill in the Internet-based version online. The questionnaire consisted of 17 pages with a total of 119 items, including the Short Form-36, Multidimensional Fatigue Inventory-20, Hospital Anxiety and Depression Scale, and questions regarding social status, education level, occupation, and access to the Internet. Nonrespondents received a postal reminder giving them the option of filling out the other version of the questionnaire.RESULTSThe response rate before the reminder was 17.9% for the Internet group compared to 73.2% for the paper-and-pencil group (risk difference 55.3%, P < .001). After the reminder, when the participant could chose between versions of the questionnaire, the total response rate for the Internet and paper-and-pencil group was 64.2% and 76.5%, respectively (risk difference 12.2%, P = .002). For the Internet version, 97.8% filled in a complete questionnaire without missing data, while 63.4% filled in a complete questionnaire for the paper-and-pencil version (risk difference 34.5%, P < .001).CONCLUSIONSThe Internet version of the questionnaire was superior with respect to completeness of data, but the response rate in this population of unselected patients was low. The general population has yet to become more familiar with the Internet before an online survey can be the first choice of researchers, although it is worthwhile considering within selected populations of patients as it saves resources and provides more complete answers. An Internet version may be combined with the traditional version of a questionnaire, and in follow-up studies of patients it may be more feasible to offer Internet versions.BACKGROUNDResearch in quality of life traditionally relies on paper-and-pencil questionnaires. Easy access to the Internet has inspired a number of studies that use the Internet to collect questionnaire data. However, Internet-based data collection may differ from traditional methods with respect to response rate and data quality as well as the validity and reliability of the involved scales.","Kongsved, S M; Basnov, M; Holm-Christensen, K; Hjollund, N H",2007.0,10.2196/jmir.9.3.e25,0,0,
5743,Psychological and sociologic requirements to prepare for anesthesia and surgery of patients with intracranial invasive processes,ER Response to anxiety has been analyzed in 195 patients operated because of intracranial expansive process and influence of standard and individualized preoperative preparations over it.,"Kopli?ski, A; Rudner, R",2001.0,,0,0,
5744,The effects of different types of hair shaving on the body image and surgical site infection in elective cranial surgery,"ER BACKGROUND: Hair shaving before cranial surgery is commonly performed in many countries. However, the impact of shaving on the patients' body image and surgical site infection is not, as yet, well investigated.DESIGN: A randomised-controlled design was used in this study.METHODS: The sample comprised 200 patients who underwent elective cranial surgery between March 2013-August 2014. The Center for Disease Control and Prevention criteria were applied for the preoperative preparation of patients and for the follow-up of surgical site infection. Wound swab cultures were obtained four times from all patients. The Social Appearance Anxiety Scale was used to assess changes in the body image of patients.FINDINGS: The rate of surgical site infection was 1% for each group and for all patients. There was no difference between the groups of surgical site infection. Coagulase-negative staphylococci and Staphylococcus epidermidis were mostly isolated in the swab cultures. The Social Appearance Anxiety Scale score decreased in patients who underwent strip shaving and increased in patients with regional shaving.CONCLUSION: There is no difference between strip shaving and regional shaving in the development of surgical site infection after cranial surgery. In addition, regional hair shaving negatively affects the patients' body image.RELEVANCE TO CLINICAL PRACTICE: Findings of this study provide useful evidence-based information for healthcare professionals. The development and implementation of effective interventions result in the prevention of surgical site infection and improvement of the patients' body image in elective cranial surgery.AIMS AND OBJECTIVES: To investigate the effects of different types of shaving on body image and surgical site infection in elective cranial surgery.","Kose, G; Tastan, S; Kutlay, M; Bedir, O",2016.0,10.1111/jocn.13149,0,0,
5745,Comparative effectiveness of detoxification hemosorption and electroconvulsive therapy in patients with endogenous depression resistant to tricyclic antidepressants,"ER In 79 patients with endogenous depressions (66 MDP and 13 circular schizophrenic patients) which received high doses of tricyclic antidepressants (amitriptyline in agitated forms and melipramine++ in inhibited ones) that remained ineffective for at least one month, hemosorption (HS; 39 patients) or ECT (40 patients) were randomly applied. The overall efficiency of HS and ECT was 53.8% and 60%, respectively. The efficiency of HS was substantially higher than that of ECT in the cases with dominant obsessive-phobic symptoms in depression. The reverse relation was observed in the cases with dominant anxious-delirious symptoms. In order to determine the predictors of the efficiency of the therapies, the stepwise discriminant analysis was used and the linear discriminant function equations were derived for HS and ECT involving 11 and 8 parameters, respectively. Correlation coefficients between predicted and de-facto therapeutic effects determined in an additional test group of 20 patients were 0.63 for HS and 0.88 for ECT. This is important in terms of directing a practitioner toward one or another technique with due respect for the individual differential therapeutic prediction of its result.","Kosov, N E; Mosolov, S N",1991.0,,0,0,
5746,"Effect of acute tryptophan depletion on behavioral, cardiovascular, and hormonal sensitivity to cholecystokinin-tetrapeptide challenge in healthy volunteers","ER Recent data suggest that serotonergic (5-HT) mechanisms may mediate the anxiogenic effects of cholecystokinin (CCK)-related peptides. Accordingly, we investigated the effect of lowering plasma tryptophan to the elicitation of behavioral, cardiovascular, and hormonal changes in healthy volunteers challenged with the tetrapeptide CCK agonist, CCK-4. Forty men without personal or family history of psychiatric disorders were randomly assigned to either a tryptophan-free amino acid mixture, which decreases central 5-HT concentrations, or a control mixture. Five hours after administration of the amino acid mixture, all subjects received a single intravenous injection of CCK-4. The main finding of the study was that acute depletion of tryptophan failed to modify the panicogenic and cardiovascular effects of CCK-4, although it did enhance CCK-4-mediated increases in ACTH/cortisol and prolactin secretion. While these findings suggest that at least part of the neuroendocrine action of CCK-4 is mediated through the 5-HT system, the locus of the 5-HT-CCK interaction and the specific 5-HT receptor subtype involved remains to be determined.","Koszycki, D; Zacharko, R M; Melledo, J M; Young, S N; Bradwejn, J",1996.0,,0,0,
5747,Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain,"ER SUBJECTSFifty-five patients with recurrent, nonspecific back pain (stabilization-enhanced exercise group: n=29, general exercise-only group: n=26) and no clinical signs suggesting spinal instability were recruited.METHODSBoth groups received an 8-week exercise intervention and written advice (The Back Book). Outcome was based on self-reported pain (Short-Form McGill Pain Questionnaire), disability (Roland-Morris Disability Questionnaire), and cognitive status (Pain Self-Efficacy Questionnaire, Tampa Scale of Kinesiophobia, Pain Locus of Control Scale) measured immediately before and after intervention and 3 months after the end of the intervention period.RESULTSOutcome measures for both groups improved. Furthermore, self-reported disability improved more in the general exercise-only group immediately after intervention but not at the 3-month follow-up. There were generally no differences between the 2 exercise approaches for any of the other outcomes.DISCUSSION AND CONCLUSIONA general exercise program reduced disability in the short term to a greater extent than a stabilization-enhanced exercise approach in patients with recurrent nonspecific low back pain. Stabilization exercises do not appear to provide additional benefit to patients with subacute or chronic low back pain who have no clinical signs suggesting the presence of spinal instability.BACKGROUND AND PURPOSEThe purpose of this randomized controlled trial was to examine the usefulness of the addition of specific stabilization exercises to a general back and abdominal muscle exercise approach for patients with subacute or chronic nonspecific back pain by comparing a specific muscle stabilization-enhanced general exercise approach with a general exercise-only approach.","Koumantakis, G A; Watson, P J; Oldham, J A",2005.0,,0,0,
5748,Cancer Health Empowerment for Living without Pain (Ca-HELP): study design and rationale for a tailored education and coaching intervention to enhance care of cancer-related pain,"ER METHODS/DESIGNThe Cancer Health Empowerment for Living without Pain (Ca-HELP) Study is an American Cancer Society sponsored randomized trial conducted in Sacramento, California. A total of 265 cancer patients with at least moderate pain severity (Worst Pain Numerical Analog Score > or =4 out of 10) or pain-related impairment (Likert score > or = 3 out of 5) were randomly assigned to receive tailored education and coaching (TEC) or educationally-enhanced usual care (EUC); 258 received at least one follow-up assessment. The TEC intervention is based on social-cognitive theory and consists of 6 components (assess, correct, teach, prepare, rehearse, portray). Both interventions were delivered over approximately 30 minutes just prior to a scheduled oncology visit. The majority of visits (56%) were audio-recorded for later communication coding. Follow-up data including outcomes related to pain severity and impairment, self-efficacy for pain control and for patient-physician communication, functional status and well-being, and anxiety were collected at 2, 6, and 12 weeks.DISCUSSIONBuilding on social cognitive theory and pilot work, this study aims to test the hypothesis that a brief, tailored patient activation intervention will promote better cancer pain care and outcomes. Analyses will focus on the effects of the experimental intervention on pain severity and impairment (primary outcomes); self-efficacy and quality of life (secondary outcomes); and relationships among processes and outcomes of cancer pain care. If this model of coaching by lay health educators proves successful, it could potentially be implemented widely at modest cost.TRIAL REGISTRATION[Clinical Trials Identifier: NCT00283166].BACKGROUNDCancer-related pain is common and under-treated. This article describes a study designed to test the effectiveness of a theory-driven, patient-centered coaching intervention to improve cancer pain processes and outcomes.","Kravitz, R L; Tancredi, D J; Street, R L; Kalauokalani, D; Grennan, T; Wun, T; Slee, C; Evans, Dean D; Lewis, L; Saito, N; Franks, P",2009.0,10.1186/1471-2407-9-319,0,0,
5749,Pedometer-based internet-mediated intervention for adults with chronic low back pain: randomized controlled trial,"ER OBJECTIVE: The objective of the study was to determine whether a pedometer-based, Internet-mediated intervention can reduce chronic back pain-related disability.METHODS: A parallel group randomized controlled trial was conducted with 1:1 allocation to the intervention or usual care group. 229 veterans with nonspecific chronic back pain were recruited from one Department of Veterans Affairs (VA) health care system. Participants randomized to the intervention received an uploading pedometer and had access to a website that provided automated walking goals, feedback, motivational messages, and social support through an e-community (n=111). Usual care participants (n=118) also received the uploading pedometer but did not receive the automated feedback or have access to the website. The primary outcome was measured using the Roland Morris Disability Questionnaire (RDQ) at 6 months (secondary) and 12 months (primary) with a difference in mean scores of at least 2 considered clinically meaningful. Both a complete case and all case analysis, using linear mixed effects models, were conducted to assess differences between study groups at both time points.RESULTS: Baseline mean RDQ scores were greater than 9 in both groups. Primary outcome data were provided by approximately 90% of intervention and usual care participants at both 6 and 12 months. At 6 months, average RDQ scores were 7.2 for intervention participants compared to 9.2 for usual care, an adjusted difference of 1.6 (95% CI 0.3-2.8, P=.02) for the complete case analysis and 1.2 (95%","Krein, S L; Kadri, R; Hughes, M; Kerr, E A; Piette, J D; Holleman, R; Kim, H M; Richardson, C R",2013.0,10.2196/jmir.2605,0,0,
5750,The effects of visual imagery on adjustment and quality in life of hemodialysis patients,"ER METHODThe present study examined the effect of a specific visual imagery technique on adjustment and quality of life in a sample of 153 hemodialysis patients. Control procedures included an active control and a no-treatment control. The former consisted of relaxation training and general imagery techniques. Outcome variables included beliefs about hemodialysis treatment, ways of evaluating life, emotional adjustment, and quality of life. The ESRF Beliefs Questionnaire, the Life Evaluation Questionnaire for Hemodialysis Patients, the Hospital Anxiety and Depression Scale, the Ladder Scale, and 2 SF-36 summary scales were used to measure these outcome variables.RESULTSThe findings show that the specific imagery intervention did not have an effect on emotional adjustment or quality of life, either post-treatment or at follow-up; however, the rate of patient compliance with the interventions was moderately high and patients reported that they were satisfied with the intervention procedures.CONCLUSIONThe present study is the first randomized controlled intervention study of the effects of relaxation and imagery on adjustment in hemodialysis patients. The findings are discussed in terms of their implications for future studies as well as their limitations.OBJECTIVERelaxation and imagery techniques have been widely used among patients with chronic physical illnesses other than end stage renal failure (ESRF). Case studies and some controlled studies suggest that relaxation and imagery techniques can be successfully used with hemodialysis patients to improve their adjustment. Nonetheless, randomized controlled studies are needed to systematically examine this effect.","Krespi, M R; Oakley, D; Bone, M; Ahmad, R; Salmon, P",2009.0,,0,0,
5751,Correction of cubitus varus by French or dome osteotomy: a comparative study,"ER METHODSA comparative randomized study was undertaken of 25 patients (average age 10 years) with an established posttraumatic cubitus varus deformity (mean time from injury to corrective osteotomy, 1.7 years). Patients were followed-up with for 1 year, and carrying angle, Baumann's angle, and internal rotation deformity were measured. Postoperative complications were assessed.RESULTSA significant (p < 0.01) correction of carrying angle and Baumann's angle was achieved with both techniques, with no statistically significant differences between them. Although internal rotation deformity was corrected by both techniques, the correction was significantly greater with the dome osteotomy (p < 0.01). However, the persistence of internal rotation did not seem to affect the final outcome. There was a higher incidence of postoperative complications in the dome osteotomy group, including infection (1), inadequate correction (1), nerve palsy (1), loss of motion (5), and circulatory compromise (1).CONCLUSIONThe dome osteotomy is technically more difficult than the French osteotomy and has a higher incidence of complications. We suggest that the French osteotomy be used for the correction of cubitus varus after supracondylar fractures of the elbow in children.BACKGROUNDThe purpose of this study was to compare the outcomes of two different techniques of supracondylar osteotomy, French osteotomy and dome osteotomy, for the correction of posttraumatic cubitus varus.","Kumar, K; Sharma, V K; Sharma, R; Maffulli, N",2000.0,,0,0,
5752,Benefits of a gluten-free diet for asymptomatic patients with serologic markers of celiac disease,"ER BACKGROUND & AIMS: We investigated whether screen-detected and apparently asymptomatic adults with endomysial antibodies (EmA) benefit from a gluten-free diet (GFD).METHODS: We performed a prospective trial of 3031 individuals at risk for celiac disease based on screens for EmA. Of 148 seropositive individuals, 40 fulfilled inclusion criteria and were assigned randomly to groups placed on a GFD or gluten-containing diets. We evaluated ratios of small-bowel mucosal villous height:crypt depth, serology and laboratory test results, gastrointestinal symptom scores, physiologic well-being, perception of health by a visual analog scale, bone mineral density, and body composition at baseline and after 1 year. Thereafter, the group on the gluten-containing diet started a GFD and was evaluated a third time; subjects in the GFD group remained on this diet.RESULTS: After 1 year on the GFD, the mean mucosal villous height:crypt depth values increased (P < .001), levels of celiac-associated antibodies decreased (P < .003), and gastrointestinal symptoms improved to a greater extent than in patients on gluten-containing diets (P = .003). The GFD group also had reduced indigestion (P = .006), reflux (P = .05), and anxiety (P = .025), and better health, based on the visual analog scale (P = .017), than the gluten-containing diet group. Only social function scores improved more in the gluten-containing diet group than in the GFD group (P = .031). There were no differences between groups in laboratory test results, bone mineral density, or body composition. Most measured parameters improved when patients in the gluten-containing diet group were placed on GFDs. No subjects considered their experience to be negative and most expected to remain on GFDs.CONCLUSIONS: GFDs benefit asymptomatic EmA-positive patients. The results support active screening of patients at risk for celiac disease. Clinicaltrials.gov no: NCT01116505.","Kurppa, K; Paavola, A; Collin, P; Sievänen, H; Laurila, K; Huhtala, H; Saavalainen, P; Mäki, M; Kaukinen, K",2014.0,10.1053/j.gastro.2014.05.003,0,0,
5753,Long-term effectiveness of a group program for caregivers of frail elderly veterans,"ER Long-term results of an evaluation of a multicomponent support-group program for spouses caring for frail elderly veterans indicated that participants experienced significant reductions in subjective burden. As compared to those of the control group, caregivers' perceptions of their husbands' health improved significantly from pretest to one year, while perceptions of their husbands' functioning on measures of instrumental daily activities showed significantly less deterioration in the period from pretest to posttest.","Labrecque, M S; Peak, T; Toseland, R W",1992.0,,0,0,
5754,Multicenter pilot treatment trial for psychogenic nonepileptic seizures: a randomized clinical trial,"ER Importance There is a paucity of controlled treatment trials for the treatment of conversion disorder, seizures type, also known as psychogenic nonepileptic seizures (PNES). Psychogenic nonepileptic seizures, the most common conversion disorder, are as disabling as epilepsy and are not adequately addressed or treated by mental health clinicians. Objective To evaluate different PNES treatments compared with standard medical care (treatment as usual). Design, Setting, and Participants Pilot randomized clinical trial at 3 academic medical centers with mental health clinicians trained to administer psychotherapy or psychopharmacology to outpatients with PNES. Thirty-eight participants were randomized in a blocked schedule among 3 sites to 1 of 4 treatment arms and were followed up for 16 weeks between September 2008 and February 2012; 34 were included in the analysis. Interventions Medication (flexible-dose sertraline hydrochloride) only, cognitive behavioral therapy informed psychotherapy (CBT-ip) only, CBT-ip with medication (sertraline), or treatment as usual. Main Outcomes and Measures Seizure frequencywas the primary outcome; psychosocial and functioning measures, including psychiatric symptoms, social interactions, quality of life, and global functioning, were secondary outcomes. Data were collected prospectively, weekly, and with baseline, week 2, midpoint (week 8), and exit (week 16) batteries. Within-group analyses for each arm were performed on primary (seizure frequency) and secondary outcomes from treatment-blinded raters using an intention-to-treat analysis. Results The psychotherapy (CBT-ip) arm showed a 51.4%seizure reduction (P = .01) and significant improvement from baseline in secondary measures including depression, anxiety, quality of life, and global functioning (P < .001). The combined arm (CBT-ip with sertraline) showed 59.3%seizure reduction (P = .008) and significant improvements in some secondary measures, including global functioning (P = .007). The sertraline-only arm did not show a reduction in seizures (P = .08). The treatment as usual group showed no significant seizure reduction or improvement in secondary outcome measures (P = .19). Conclusions and Relevance This pilot randomized clinical trial for PNES revealed significant seizure reduction and improved comorbid symptoms and global functioning with CBT-ip for PNES without and with sertraline. There were no improvements in the sertraline-only or treatment-as-usual arms. This study supports the use of manualized psychotherapy for PNES and successful training of mental health clinicians in the treatment. Future studies could assess larger-scale intervention dissemination. Trial Registration clinicaltrials.gov Identifier: NCT00835627.","LaFrance, W C; Baird, G L; Barry, J J; Blum, A S; Frank, Webb A; Keitner, G I; Machan, J T; Miller, I; Szaflarski, J P",2014.0,10.1001/jamapsychiatry.2014.817,0,0,
5755,Interdisciplinary collaboration in the use of a music-with-movement intervention to promote the wellbeing of people with dementia and their families: development of an evidence-based intervention protocol,"ER The music-with-movement intervention is particularly suitable for people with dementia because their gross motor ability is preserved until the later stage of dementia. This study examines the effect of music-with-movement on reducing anxiety, sleep disturbances, and improving the wellbeing of people with dementia. This paper reports the first stage of the study - developing the intervention protocol that staff can use to teach family caregivers. A registered music therapist developed a music-with-movement protocol and taught staff of two social service centers over five weekly 1.5 h sessions, with center-in-charges (social workers and occupational therapists) and our research team joining these sessions to provide comments from their professional perspective. Each discipline had different expectations about the content; therefore, numerous meetings and discussions were held to bridge these differences and fine-tune the protocol. Few healthcare professionals doubt the merits of interdisciplinary collaboration at all levels of health promotion. In practice, interdisciplinary collaboration is complex and requires commitment. Openness and persistence is required from all stakeholders to achieve a successful intervention for consumers.","Lai, C K; Lai, D L; Ho, J S; Wong, K K; Cheung, D S",2016.0,10.1111/nhs.12238,0,0,
5756,A pilot randomized controlled trial of the feasibility of a self-directed coping skills intervention for couples facing prostate cancer: rationale and design,"ER METHODS/DESIGN: In this double-blind, two-group, parallel, randomized controlled trial, 70 couples will be recruited within 4 months of a prostate cancer diagnosis through urology private practices and randomized to: 1) Coping-Together or 2) a minimal ethical care condition. Minimal ethical care condition couples will be mailed information booklets available at the Cancer Council New South Wales and a brochure for the Cancer Council Helpline. The primary outcome (anxiety) and additional secondary outcomes (distress, depression, dyadic adjustment, quality of life, illness or caregiving appraisal, self-efficacy, and dyadic and individual coping) will be assessed at baseline (before receiving study material) and 2 months post-baseline. Intention-to-treat and per protocol analysis will be conducted.DISCUSSION: As partners' distress rates exceed not only population norms, but also those reported by patients themselves, it is imperative that coping skills interventions target the couple as a unit and enhance both partners' ability to overcome cancer challenges. This pilot study will examine the feasibility and potential efficacy of Coping-Together in optimising couples' illness adjustment. This is one of the first feasibility studies to test this innovative coping intervention, which in turn will contribute to the larger literature advocating for psychosocial care of couples affected by prostate cancer.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12611000438954.BACKGROUND: Although it is known both patients' and partners' reactions to a prostate cancer diagnosis include fear, uncertainty, anxiety and depression with patients' partners' reactions mutually determining how they cope with and adjust to the illness, few psychosocial interventions target couples. Those that are available tend to be led by highly trained professionals, limiting their accessibility and long-term sustainability. In addition, it is recognised that patients who might benefit from conventional face-to-face psychosocial interventions do not access these, either by preference or because of geographical or mobility barriers. Self-directed interventions can overcome some of these limitations and have been shown to contribute to patient well-being. This study will examine the feasibility of a self-directed, coping skills intervention for couples affected by cancer, called Coping-Together, and begin to explore its potential impact on couples' illness adjustment. The pilot version of Coping-Together includes a series of four booklets, a DVD, and a relaxation audio CD.","Lambert, S D; Girgis, A; Turner, J; McElduff, P; Kayser, K; Vallentine, P",2012.0,10.1186/1477-7525-10-119,0,0,
5757,Risk factors for community violence exposure in adolescence,"ER Community violence is recognized a significant public health problem. However, only a paucity of research has examined risk factors for community violence exposure across domains relevant to adolescents or using longitudinal data. This study examined youth aggressive behavior in relation to community violence exposure among a community epidemiologically defined sample of 582 (45% female) urban adolescents. Internalizing behaviors, deviant peer affiliation, and parental monitoring were examined as moderators of the association between aggressive behavior and exposure to community violence. For males with aggressive behavior problems and deviant peer affiliation or low parental monitoring, co-occurring anxiety symptoms protected against subsequent witnessing community violence. In contrast, males with aggressive behavior problems and co-occurring depressive symptoms were at increased risk for witnessing community violence. Implications of the findings for preventive interventions and future research are discussed.","Lambert, S F; Ialongo, N S; Boyd, R C; Cooley, M R",2005.0,10.1007/s10464-005-6231-8,0,0,
5758,"Return to work of workers without a permanent employment contract, sick-listed due to a common mental disorder: design of a randomised controlled trial","ER METHODS/DESIGN: The cost-effectiveness of the participatory supportive return to work program will be examined in a randomised controlled trial with a follow-up of twelve months.The program strongly involves the sick-listed worker in the identification of obstacles for return to work and possible solutions, resulting in a consensus based action plan. This plan will be used as a starting point for the search of suitable competitive employment with support of a rehabilitation agency. During this process the insurance physician of the sick-listed worker contacts other caregivers to promote integrated care.Workers eligible to participate in this study have no permanent employment contract, have applied for a sickness benefit at the Dutch Social Security Agency and are sick-listed between two and fourteen weeks due to mental health problems.The primary outcome measure is the duration until first sustainable return to work in a competitive job. Outcomes are measured at baseline and after three, six, nine and twelve months.DISCUSSION: If the participatory supportive return to work program proves to be cost-effective, the social security system, the sick-listed worker and society as a whole will benefit. A cost-effective return to work program will lead to a reduction of costs related to sickness absence. For the sick-listed worker a cost-effective program results in earlier sustainable return to work, which can be associated with both social and health benefits.TRIAL REGISTRATION: The trial registration number and date is NTR3563, August 7, 2012.BACKGROUND: Workers without a permanent employment contract represent a vulnerable group within the working population. Mental disorders are a major cause of sickness absence within this group. Common mental disorders are stress-related, depressive and anxiety disorders. To date, little attention has been paid to effective return to work interventions for this type of sick-listed workers. Therefore, a participatory supportive return to work program has been developed. It combines elements of a participatory return to work program, integrated care and direct placement in a competitive job.The objective of this paper is to describe the design of a randomised controlled trial to evaluate the cost-effectiveness of this program compared to care as usual.","Lammerts, L; Vermeulen, S J; Schaafsma, F G; Mechelen, W; Anema, J R",2014.0,10.1186/1471-2458-14-594,0,0,
5759,Motivational support provided via email improves the effectiveness of internet-delivered self-help treatment for insomnia: a randomized trial,"ER Internet-delivered treatment is effective for insomnia, but little is known about the beneficial effects of support. The aim of the current study was to investigate the additional effects of low-intensity support to an internet-delivered treatment for insomnia. Two hundred and sixty-two participants were randomized to an internet-delivered intervention for insomnia with (n = 129) or without support (n = 133). All participants received an internet-delivered cognitive behavioral treatment for insomnia. In addition, the participants in the support condition received weekly emails. Assessments were at baseline, post-treatment, and 6-month follow-up. Both groups effectively ameliorated insomnia complaints. Adding support led to significantly higher effects on most sleep measures (d = 0.3-0.5; p < 0.05), self-reported insomnia severity (d = 0.4; p < 0.001), anxiety, and depressive symptoms (d = 0.4; p < 0.01). At the 6-month follow-up, these effects remained significant for sleep efficiency, sleep onset latency, insomnia symptoms, and depressive symptoms (d = 0.3-0.5; p < 0.05). Providing support significantly enhances the benefits of internet-delivered treatment for insomnia on several variables. It appears that motivational feedback increases the effect of the intervention and encourages more participants to complete the intervention, which in turn improves its effectiveness.","Lancee, J; Bout, J; Sorbi, M J; Straten, A",2013.0,10.1016/j.brat.2013.09.004,0,0,
5760,Cognitive-behavioral self-help treatment for nightmares: a randomized controlled trial,"ER METHODSParticipants were recruited through a Dutch nightmare website. After completion of the baseline questionnaires, 399 participants were randomly assigned to a condition, received a 6-week self-help treatment (or were placed on the waiting list), and filled out the post-treatment measurements 11 weeks after baseline.RESULTSCompared to the waiting list, IRT and exposure were effective in ameliorating nightmare frequency and distress, subjective sleep quality, anxiety (after imagery rehearsal), and depression (after exposure; ?d = 0.25-0.56). Compared to recording, IRT reduced nightmare frequency while exposure reduced nightmare distress (?d = 0.20-0.30; p < 0.05). The recording condition was more effective compared to the waiting list in ameliorating nightmare frequency, nightmare distress, and subjective sleep quality (?d = 0.19-0.28; p < 0.05). IRT had a more rapid reduction on the diary compared to exposure and recording.CONCLUSIONSIRT and exposure appear equally effective in ameliorating nightmare complaints. Exposure to nightmare imagery may function as the crucial therapeutic factor; however, cognitive restructuring may be a useful addition to increase immediate effects.BACKGROUNDSeveral cognitive-behavioral techniques are effective in reducing nightmare frequency, but the therapeutic factor (e.g. cognitive restructuring, systematic desensitization) remains unclear. The aim of this study was to compare the nightmare treatments imagery rehearsal therapy (IRT), exposure, and recording (keeping a diary)--in a self-help format--with a waiting list.","Lancee, J; Spoormaker, V I; Bout, J",2010.0,10.1159/000320894,0,0,
5761,Effects of written emotional expression: the role of positive expectancies,"ER DESIGNTwo studies were conducted to test this hypothesis. In both studies, participants wrote about either an upsetting event or trivial issues. After the writing period, participants rated their expectancies that the writing intervention would improve (or impair) their emotional well-being over time.MAIN OUTCOME MEASURESStudy 1 assessed the emotional impact of an upsetting event, whereas Study 2 assessed subjective reports of physical symptoms. In both studies, outcome variables were collected both before and 6 weeks after the writing intervention.RESULTSThe results showed that (a) writing about upsetting experiences induced higher positive expectancies than writing about trivial issues and (b) expectancies associated with written emotional expression were related to a reduction in the emotional impact of an upsetting event (Study 1) and to a reduction in physical symptoms (Study 2).CONCLUSIONSThere may be 2 alternative ways to render written emotional expression effective in reducing negative emotions: (a) by rendering an emotional experience more meaningful and (b) by inducing positive affect regulation expectancies.OBJECTIVEWriting in an emotional way about stressful or traumatic experiences has beneficial effects on emotional well-being and physical health. Yet the mechanisms that underlie these effects still need to be explored. Integrating research on the effects of positive expectancies, the authors suggest that positive effects of written emotional expression may, in part, depend on expectancies induced by writing about emotional experiences.","Langens, T A; Schüler, J",2007.0,10.1037/0278-6133.26.2.174,0,0,
5762,Verbal conditioning and therapeutic change,,"Lapuc, P S; Harmatz, M G",1970.0,,0,0,
5763,Short-term effects of interferential current electro-massage in adults with chronic non-specific low back pain: a randomized controlled trial,"ER OBJECTIVES: To analyse the effectiveness of a combined procedure of massage and electrotherapy with interferential current in individuals with chronic non-specific low back pain of mechanical aetiology.DESIGN: A single blinded randomized controlled trial.SETTING: Clinical setting.PARTICIPANTS: Sixty-two individuals with chronic non-specific low back pain were randomly assigned to an experimental or control group. For 10 weeks the experimental group underwent treatment comprising 20 sessions (twice a week) of massage with interferential current in the lumbar and dorsal-lumbar area, and the control group received superficial lower back massage (effleurage, superficial pressure and skin rolling).MAIN OUTCOME VARIABLES: Oswestry Disability Index, pain visual analogue scale, Tampa Scale for Kinesiophobia, Roland Morris Disability Questionnaire, McQuade Test, Side Bridge Test, quality of life scores and the range of trunk anteflexion motion, which were all assessed before the treatment and immediately after the last treatment session.RESULTS: The 2 × 2 mixed model ANOVA with repeated measurements showed statistically significant group * time interactions for the visual analogue scale (F = 12.839; P = 0.001), Oswestry Disability Index (F = 5.850; P = 0.019), Roland Morris Disability Questionnaire (F = 8.237; P = 0.006) and quality of life (physical function (F = 16.792; P = 0.001), physical role (F = 14.839; P = 0.001) and body pain (F = 11.247; P = 0.001)).CONCLUSIONS: In individuals with chronic non-specific low back pain, interferential current electro-massage achieved a significantly greater improvement in disability, pain and quality of life in comparison to superficial massage after 20 treatment sessions.","Lara-Palomo, I C; Aguilar-Ferrándiz, M E; Matarán-Peñarrocha, G A; Saavedra-Hernández, M; Granero-Molina, J; Fernández-Sola, C; Castro-Sánchez, A M",2013.0,10.1177/0269215512460780,0,0,
5764,Stress management interventions in the workplace improve stress reactivity: a randomised controlled trial,"ER METHODS174 lower or middle management employees (99% male) were randomly assigned to an intervention or a waiting control group. The programme comprised 24 × 45 min group sessions (2 full days followed by two 4 × 45 min sessions within the next 8 months) on individual work stress situations. The primary endpoint was perceived stress reactivity (Stress Reactivity Scale, SRS), while secondary endpoints were salivary cortisol and ?-amylase, anxiety and depression, and ERI. Assessments were repeated in 154 participants 1 year later.RESULTSSRS score decreased in both groups. A two-factor ANOVA with repeated measures showed a significant time × group effect (F=5.932; p=0.016) with the greater reduction in the intervention group. For SRS, the effect size (Cohen's d) after 1 year was d=0.416 in the intervention and d=0.166 in the control group. ?-Amylase as a measure of sympathetic nervous system activation, decreased more strongly in the intervention group (area under the daytime curve and daytime slope: time × group effect p=0.076 and p=0.075). No difference was observed for cortisol. For depression, anxiety and ERI, improvements were higher in the intervention group but did not reach statistical significance.CONCLUSIONSSMI based on work stress theory, is effective in reducing perceived stress reactivity and sympathetic activation in lower and middle management employees. Other mental health parameters and ERI show a tendency towards improvement. These beneficial effects are present 1 year later.OBJECTIVETo examine the long-term effects of a stress management intervention (SMI) based on the effort-reward imbalance (ERI) model, on psychological and biological reactions to work stress.","Limm, H; Gündel, H; Heinmüller, M; Marten-Mittag, B; Nater, U M; Siegrist, J; Angerer, P",2011.0,10.1136/oem.2009.054148,0,0,
5765,An 8-week stress management program in pathological gamblers: a pilot randomized controlled trial,"ER Stress plays a major role at the onset and relapse of pathological gambling (PG), but at the same time it can also be the aftermath of gambling behavior, thus revealing a reciprocal relationship. Although the role of stress has been well-documented, there is a paucity of studies investigating the effect of an adjunctive stress management program on PG. In this 8-week parallel randomized waitlist controlled trial pathological gamblers, already in the gamblers anonymous (GA) group, were assigned randomly in two groups, with the intervention group (n = 22) receiving an additional stress management program (consisting of education on diet and exercise, stress coping methods, relaxation breathing -RB- and progressive muscle relaxation -PMR). Self-reported measures were used in order to evaluate stress, depression, anxiety, sleep quality/disturbances, life-satisfaction and daily routine. The statistical analyses for the between group differences concerning the main psychosocial study outcomes revealed a statistically significant amelioration of stress, depression, anxiety symptoms and an increase of life-satisfaction and a better daily routine in participants of the intervention group. We hope that these will encourage researchers and clinicians to adopt stress management in their future work.","Linardatou, C; Parios, A; Varvogli, L; Chrousos, G; Darviri, C",2014.0,10.1016/j.jpsychires.2014.05.013,0,0,
5766,"A prospective, randomized, multicentered controlled trial to compare the annual glycemic and quality outcomes of patients with diabetes mellitus monitored with weekly fructosamine testing versus usual care","ER Fructosamine is an indicator of overall glycemic control for a 10-14-day time frame, medium-term marker, versus the 90-day average indicated by the hemoglobin A1c (A1C) test. The utility of the home fructosamine test for management of persons with diabetes remains undefined. The primary objectives of this study were (1) to compare the annual A1C results of subjects monitoring weekly fructosamine with those receiving usual care, (2) to identify the number of subjects achieving goal A1C, and (3) to determine if the addition of a weekly fructosamine test changed a subject's quality of life. This was a prospective, randomized, multicenter, controlled trial. Subjects were recruited from three sites and randomly assigned to collect weekly fructosamine in addition to daily glucose (Group 1) or to receive usual care of daily glucose collection (Group 2). Follow-up occurred at 3-month intervals for a year. Baseline and quarterly A1C tests were collected. Quality of life assessment was conducted at baseline and at the final study visit. Seventy-two subjects were randomized. Demographic and whole blood assessments were similar between the two groups at baseline. The mean percent change of A1C from baseline to final study visit in Group 1 (-0.52 +/- 1.5) was not statistically different than Group 2 (-0.86 +/- 1.4) (P = 0.320). Seven subjects in each group achieved A1C of less than 7% (P = 0.532). No change in quality of life between or within the two groups was observed (P > 0.05) for each area of concern. Blood glucose monitoring alone was shown to be superior to the additional fructosamine testing after 1 year of treatment; however, weekly fructosamine testing demonstrated a decrease in A1C earlier and more consistently throughout the study. Despite glycemic improvement, the number of subjects attaining American Diabetes Association-defined A1C goals was not different between the treatment groups. Quality of life did not change with the addition of a weekly fructosamine test.","Lindsey, C C; Carter, A W; Mangum, S; Greene, D; Richardson, A; Brown, S J; Essary, J L; McCandless, B",2004.0,10.1089/152091504774198070,0,0,
5767,Adjustment in parents of children undergoing stem cell transplantation,"ER Pediatric stem cell transplantation (SCT) is a demanding procedure for children and parents. Interventions to promote positive adjustment of parents in this setting are needed. A total of 171 patient-parent dyads from 4 sites received 1 of 3 interventions to reduce SCT-related distress: a child intervention with massage and humor therapy, an identical child intervention plus a parent intervention with massage and relaxation/imagery, or standard care. Parents completed weekly self-report measures of distress and positive affect during the acute phase of treatment (weeks -1 through +6); and measures of depression, posttraumatic stress (PTSD), and benefit finding at baseline and week +24. No significant differences across treatment arms were observed on repeated measures of parental distress. There was a marginally significant effect of the child intervention on parental positive affect. Over time, parental distress decreased significantly and positive affect increased significantly in all groups. Similarly, there were no significant intervention effects on the global adjustment outcomes of depression, PTSD, and benefit finding. However, reports of depression and PTSD decreased significantly and reports of benefit finding increased significantly from baseline to week +24 for all groups. Across all study arms, parent adjustment improved over time, suggesting that parents demonstrate a transient period of moderately elevated distress at the time of their child's admission for transplantation, followed by rapid improved to normative levels of adjustment. Similar to results previously reported for their children, these parents appear resilient to the challenges of transplantation.","Lindwall, J J; Russell, K; Huang, Q; Zhang, H; Vannatta, K; Barrera, M; Alderfer, M; Phipps, S",2014.0,10.1016/j.bbmt.2014.01.007,0,0,
5768,The effect of a job placement and support program for workers with musculoskeletal injuries: a randomized control trial (RCT) study,"ER METHODOLOGYA total of 66 injured workers were recruited and randomly assigned into the job placement and support group (PS group) or the self-placement group (SP group). A three-week job placement and support program was given to subjects in the PS group while subjects in the control group (SP group) were only given advice on job placement at a workers' health center. The PS program was comprised of an individual interview, vocational counseling, job preparation training, and assisted placement using the case management approach. The Chinese Lam Assessment of Stages of Employment Readiness (C-LASER), the Chinese State Trait and Anxiety Inventory (C-STAI), and the SF-36 were the outcome measures for the two groups before and after the training program to observe the changes in subjects' work readiness status, emotional status and their health related quality of life pre- and post-training program. The rate of return to work was measured for both groups of subjects after the training program.RESULTSThe results indicated that the rate of success in RTW (73%) was significantly higher in the job placement (PS) group than that of the self-placement (SP) group (51.6%) with P < 0.05. Significant differences were also found in C-STAI (P < 0.05), SF-36 (P < 0.05) and C-LASER scores on action (P < 0.05) between the two groups.CONCLUSIONThe job placement (PS) program appeared to have enhanced the employability of injured workers. Workers who participated in the program also showed higher levels of work readiness and emotional status in coping with their work injuries.BACKGROUNDThis is a randomized clinical trial (RCT) to investigate the efficacy of a job placement and support program designed for workers with musculoskeletal injuries and having difficulties in resuming the work role. The program was planned to help injured workers to successfully return to work (RTW) by overcoming the difficulties and problems during the process of job seeking and sustaining a job using a case management approach.","Li-Tsang, C W; Li, E J; Lam, C S; Hui, K Y; Chan, C C",2008.0,10.1007/s10926-008-9138-z,0,0,
5769,The psychological impact of a specialist referral and telephone intervention on male cancer patients: a randomised controlled trial,"ER METHODS571 newly diagnosed male CRC (N=182) and prostate (N=389) cancer patients were block-randomised into three arms. In the two intervention arms, the specialist actively referred men to a Cancer Helpline. In Active Referral--4 outcalls, men received calls from the Helpline within 1 week of diagnosis, and at 6 weeks, 3 months and 6 months post-diagnosis. In Active Referral--1 outcall, men received one call within 1 week of diagnosis. In the control arm, Passive Referral, patients were referred to the Helpline, with contact at their initiative. Participants completed scales measuring cancer-specific distress, anxiety and depression at study entry, then 4, 7 and 12 months post-diagnosis. Random effects regression models compared rates of change in these outcomes between study arms.RESULTSAt the first outcall, over 85% of participants in both intervention arms discussed treatment management and psychological/emotional issues. Among the Active Referral--4 outcalls arm, over 80% of participants discussed psychological/emotional issues at each call. Mean changes over time in cancer-specific distress, anxiety and depression were similar between study arms.CONCLUSIONAlthough men were willing to discuss psychosocial issues via the telephone, we found no psychological impact. Further research is required to determine whether the intervention is more effective for patients who do not have psychosocial support or have unmet information needs.OBJECTIVETo examine the psychological impact of a referral and telephone intervention, involving information and support, among men with colorectal cancer (CRC) and prostate cancer.","Livingston, P M; White, V M; Hayman, J; Maunsell, E; Dunn, S M; Hill, D",2010.0,10.1002/pon.1609,0,0,
5770,Promoting enhanced patient and family caregiver congruence on lung cancer symptom experiences,"ER DESIGNCounterbalanced.SETTINGThoracic oncology outpatient clinical setting in Canada.SAMPLE98 dyads consisting of patients with lung cancer and their family caregivers.METHODSData were collected on a one-time basis by employing an abbreviated version of the Memorial Symptom Assessment Scale targeting lack of energy and worrying. Caregivers were randomized to one of six counterbalanced conditions of perspective-taking instructions.MAIN RESEARCH VARIABLESCaregiver discrepancy scores, instructional sets (i.e., neutral, self-report, and imagine-self and imagine-patient perspective-taking), order effects, gender, caregivers' personal history with cancer, and caregiving relationship factors.FINDINGSNo order effects were found for the instructional sets. Instructions to imagine the patient's perspective over imagining how the caregiver would feel if he or she had cancer were most effective in enhancing the caregiver's ability to estimate the patient's lack of energy and worrying. Gender had no significant effects. The amount of patient-caregiver communication had a positive impact on the accuracy of caregivers' perspectives.CONCLUSIONSThe patient-oriented instructions had a limited impact on enhancing patient-caregiver congruence on patient symptoms. This likely is related to the study's convenience sample of caregivers who appear to naturally engage in empathic processes of patient-oriented perspective-taking when they assessed and reported on patient symptom conditions.IMPLICATIONS FOR NURSINGFurther exploratory work should identify interpersonal conditions that negatively hamper the effects of caregiver perspective-taking on their reasonable understanding of patient symptoms.PURPOSE/OBJECTIVESTo test the effects of different perspective-taking instructional sets, gender, caregivers' personal histories with cancer, and caregiving relationship factors on family caregiver and patient perceptual agreement of symptom experiences of patients with lung cancer.","Lobchuk, M M; Degner, L F; Chateau, D; Hewitt, D",2006.0,10.1188/06.ONF.273-282,0,0,
5771,Assessment of immune response during chrysotherapy. Comparison of gold sodium thiomalate vs. auranofin,"ER Auranofin (AF) differs significantly from gold sodium thiomalate (GST) in formulation, i.e., aurous gold is stabilized by dual sulfur and phosphorus ligands, has hydrophobic rather than hydrophilic characteristics, and lacks ionic charge. These attributes facilitate: oral absorption of AF, plasma membrane penetration, increase in intracellular lymphocyte gold concentration and perhaps thereby influence lymphocyte function. AF therapy was observed to affect primarily T rather than B lymphocyte function in 16 RA subjects receiving 6 mg of AF per day for an average of 45 weeks (range 20-74 weeks) compared with GST-treated RA subjects. Lymphocytes from AF-treated subjects manifested prompt and sharp declines in mitogen-induced lymphoproliferative response (LPR); suppressed response to skin testing with dinitrochlorobenzene (DNCB); and blebbing of lymphocyte membranes as shown by scanning electron microscopy. Suppression of LPR with AF was approximately 60% after the first week and 80% after 20 weeks of therapy, contrasting with 0% and 30% for the respective intervals in GST-treated subjects. DNCB skin testing of AF patients, indicated 11 of 14, failed to respond, whereas all GST patients responded. Local or systemic fungal, bacterial and/or opportunistic infections were not encountered. The effect of AF on B cell effector function, e.g., suppression of immunoglobulins and rheumatoid factor titer, was less marked when contrasted with GST therapy in RA subjects, as previously reported.","Lorber, A; Jackson, W H; Simon, T M",1981.0,,0,0,
5772,Singing teaching as a therapy for chronic respiratory disease--a randomised controlled trial and qualitative evaluation,"ER METHODS: To test this hypothesis we performed a randomised controlled trial, comparing a six week course of twice weekly singing classes to usual care, in 28 COPD patients. The experience of singing was assessed in a qualitative fashion, through interviews with a psychologist. In addition, we surveyed patients with chronic respiratory conditions who participated in a series of open singing workshops.RESULTS: In the RCT, the physical component score of the SF36 improved in the singers (n = 15) compared to the controls (n = 13); +7.5(14.6) vs. -3.8(8.4) p = 0.02. Singers also had a significant fall in HAD anxiety score; -1.1(2.7) vs. +0.8(1.7) p = 0.03. Singing did not improve single breath counting, breath hold time or shuttle walk distance. In the qualitative element, 8 patients from the singing group were interviewed. Positive effects on physical sensation, general well-being, community/social support and achievement/efficacy emerged as common themes. 150 participants in open workshops completed a questionnaire. 96% rated the workshops as ""very enjoyable"" and 98% thought the workshop had taught them something about breathing in a different way. 81% of attendees felt a ""marked physical difference"" after the workshop.CONCLUSION: Singing classes can improve quality of life measures and anxiety and are viewed as a very positive experience by patients with respiratory disease; no adverse consequences of participation were observed.TRIAL REGISTRATION: Current Controlled Trials--ISRCTN17544114.BACKGROUND: Despite optimal pharmacological therapy and pulmonary rehabilitation, patients with COPD continue to be breathless. There is a need to develop additional strategies to alleviate symptoms. Learning to sing requires control of breathing and posture and might have benefits that translate into daily life.","Lord, V M; Cave, P; Hume, V J; Flude, E J; Evans, A; Kelly, J L; Polkey, M I; Hopkinson, N S",2010.0,10.1186/1471-2466-10-41,0,0,
5773,Cognitive bias modification training in adolescents: effects on interpretation biases and mood,"ER METHODSEighty-two healthy adolescents (aged 13-17 years) were randomly allocated to either positive or negative CBM training. To assess training effects on interpretation bias, participants read ambiguous situations followed by test sentences with positive or negative interpretations of the situation. Participants rated the similarity of these sentences to the previously viewed ambiguous situations. Training effects on negative and positive affect were assessed using visual analogue scales before and after training.RESULTSAfter training, adolescents in the negative condition drew more negative and fewer positive interpretations of new ambiguous situations than adolescents in the positive condition. Within the positive condition, adolescents endorsed more positive than negative interpretations. In terms of mood changes, positive training resulted in a significant decrease in negative affect across participants, while the negative condition led to a significant decrease in positive affect among male participants only.CONCLUSIONThis is the first study to demonstrate the plasticity of interpretation bias in adolescents. The immediate training effects on mood suggest that it may be possible to train a more positive interpretation style in youth, potentially helping to protect against anxiety and depressive symptoms.BACKGROUNDNegative biases in the interpretation of ambiguous material have been linked to anxiety and mood problems. Accumulating data from adults show that positive and negative interpretation styles can be induced through cognitive bias modification (CBM) paradigms with accompanying changes in mood. Despite the therapeutic potential of positive training effects, training paradigms have not yet been explored in adolescents.","Lothmann, C; Holmes, E A; Chan, S W; Lau, J Y",2011.0,10.1111/j.1469-7610.2010.02286.x,0,0,
5774,Clinical observation on treatment of cervicogenic headache with turtle-probing needling at Tianzhu (BL 10),"ER METHODSSeventy cases were randomly divided into a treatment group (n=36) and a control group (n= 34). The treatment group were treated with turtle-probing needling at Tianzhu (BL 10) on the affected side, first perpendicularly needling the point and then penetration-needling homolateral Fengchi (GB 20), Fengfu (GV 16), below cervical Jiaji points (EX-B2), and occipital tuberosity in order. And the control group were treated with acupuncture at Fengchi (GB 20),Tianzhu (BL 10), Shuaigu (GB 8), Touwei (ST 8) and corresponding cervical Jiaji points (EX-B2), Houxi (SI 3), Ashi points at the affected side with routine needling manipulation. Treatment was given once each day, 6 sessions constituting one course.RESULTSThere was no significant difference between the two groups in therapeutic effect (P > 0.05), but the cured and markedly effective rates for analgesic effect in the observation group at the first three sessions were higher than those in the control group (P < 0.05).CONCLUSIONThe turtle-probing needling method and the routine needling have a similar therapeutic effect, but the turtle-probing needling method more rapidly produces the analgesic effect.OBJECTIVETo observe therapeutic effect of turtle-probing needling at Tianzhu (BL 10) on cervicogenic headache.","Lü, Y X; Shan, Q H",2006.0,,0,0,
5775,Comparison of the microbiological milieu of patients randomized to either hydrophilic or conventional PVC catheters for clean intermittent catheterization,"ER OBJECTIVE: The goal of the study was to compare the type and virulence of microorganisms recovered from the urine of patients that use either a hydrophilic or conventional polyvinyl chloride (PVC) catheter.METHODS: Fifty patients with an underlying diagnosis of myelomeningocele were recruited for a 12-month prospective, randomized, investigator-blinded study. Twenty-five patients were allocated to the hydrophilic catheter intervention, and 25 continued use of a PVC catheter. Cultures were performed on urine obtained by catheterization at enrollment, and 3, 6, and 12 months. Bacterial species were assigned a designation as either potentially pathogenic or non-pathogenic. Escherichia coli isolates were the most predominant and were serotyped to further stratify the pathogenicity of the strains. Lastly, patients were surveyed at enrollment, and at the two later time points evaluating their current catheter for satisfaction.RESULTS: A total of 232 different bacterial isolates were obtained from the 182 collected urine cultures. In addition, seven species were recovered from the two UTI reported during the study period. Bacterial growth was not detected in 29 of the samples (16%). Although not statistically significant, collectively there was a 40% decrease in the average number of potentially pathogenic species recovered from those patients using hydrophilic catheters (0.81 per urine sample) compared with PVC catheter use (1.24 per urine sample). Since E. coli species can be either pathogenic or non-pathogenic, we examined 14 of the most commonly implicated serotypes associated with uropathogenic E. coli (UPEC). We identified the serotype of 57% of E. coli strains recovered. There was a trend for the recovery of fewer UPEC serotypes from the hydrophilic group (54% hydrophilic verses 64% PVC), further suggesting that the catheter type may influence the microbiological milieu. Although no significant differences were reported in patient satisfaction, almost half of the patients from the hydrophilic catheter cohort continue use of this type of catheter.CONCLUSIONS: There was a trend for reduced recovery of potentially pathogenic bacteria with the use of hydrophilic catheters. The reduction in potentially pathogenic species will reduce antibiotic exposures and some patients may prefer the comfort hydrophilic catheters provide.INTRODUCTION: Control of bacteriuria is problematic in patients who perform clean intermittent catheterization for management of neurogenic bladder. This population is often burdened with multiple urinary tract infections (UTIs), placing them at increased risk of end-stage renal disease. Hydrophilic catheters are a potential way to improve smooth and clean insertion, reduce disruption of the urothelium, and reduce bacterial colonization.","Lucas, E J; Baxter, C; Singh, C; Mohamed, A Z; Li, B; Zhang, J; Jayanthi, V R; Koff, S A; VanderBrink, B; Justice, S S",2016.0,10.1016/j.jpurol.2015.12.012,0,0,
5776,Effectiveness of a psychoeducational treatment program implemented in general practice for fibromyalgia patients: a randomized controlled trial,"ER METHODSThis study was based on a randomized controlled trial. The 484 patients with FM included in a database of the Viladecans Hospital (Barcelona, Spain) were eligible for screening. Finally, 108 patients were randomly assigned to the intervention and 108 patients were assigned to usual care. The intervention comprised nine 2-hour sessions (5 sessions of education and 4 sessions of autogenic relaxation). The patients were assessed before and after the intervention with a battery of instruments (measuring sociodemographic data, medical comorbidities, functional status, trait anxiety, and social desirability).RESULTSThe posttreatment drop-out rate was 9.7% (intervention: 6.5%; control: 13%). The intention-to-treat analyses showed significant differences between the groups at posttreatment: the intervention group improved in physical impairment, days not feeling well, pain, general fatigue, morning fatigue, stiffness, anxiety, and depression (medium effect size in most cases). The patients who responded to the intervention reported less trait anxiety at baseline than nonresponders. The absolute risk reduction with the intervention was 36.1% (95% confidence interval: 23.3-48.8) and the number needed to treat was 3 (95% confidence interval: 2.0-4.3).DISCUSSIONA 2-month psychoeducational intervention improves the functional status of FM patients to a greater extent than usual care, at least in the short-term. The social desirability bias did not explain the reported outcomes. Trait anxiety was associated with response to treatment.OBJECTIVESA recent meta-analysis concluded that multicomponent treatments are effective for some fibromyalgia (FM) symptoms. The objective of this study was to examine whether a psychoeducational intervention implemented in primary care is more effective than usual care for improving the functional status of patients with FM.","Luciano, J V; Martínez, N; Peñarrubia-María, M T; Fernández-Vergel, R; García-Campayo, J; Verduras, C; Blanco, M E; Jiménez, M; Ruiz, J M; López del, Hoyo Y; Serrano-Blanco, A",2011.0,10.1097/AJP.0b013e31820b131c,0,0,
5777,Sustained outcomes of a peer-taught family education program on mental illness,"ER OBJECTIVE: This study examines 6-month follow-up data from participants in a randomized trial of a peer-driven 12-session family support and education program, called family-to-family (FTF) and offered by the US National Alliance on Mental Illness, to determine whether improvements in distress, family functioning, coping and empowerment were sustained.METHOD: Individuals randomized to the FTF condition were assessed after program completion and then 3 months later on measures of distress, family functioning, coping, and empowerment. We used a multilevel regression model (sas proc mixed) to test for significant changes over time (baseline, 3 and 9 months).RESULTS: All significant benefits that FTF participants gained between baseline and immediately post-FTF were sustained at 9 months including reduced anxiety, improved family problem-solving, increased positive coping, and increased knowledge. Greater class attendance was associated with larger increases in empowerment and reductions in depression and displeasure with ill relative.CONCLUSION: Evidence suggests that benefits of the FTF program were sustained for at least 6 months without any additional boosters or supports. Peer-based programs may produce sustained benefits for individuals seeking help in addressing challenges and stresses related to having a family member with a mental illness.","Lucksted, A; Medoff, D; Burland, J; Stewart, B; Fang, L J; Brown, C; Jones, A; Lehman, A; Dixon, L B",2013.0,10.1111/j.1600-0447.2012.01901.x,0,0,
5778,A lifestyle intervention as supplement to a physical activity programme in rehabilitation after stroke: a randomized controlled trial,"ER OBJECTIVE: To evaluate the effectiveness of lifestyle group intervention on well-being, occupation and social participation.DESIGN: A randomized controlled trial.SETTING: Senior centres in the community.SUBJECTS: Of 204 stroke survivors screened, 99 (49%) were randomized three months after stroke whereby 86 (87%) participants (mean (SD) age 77.0 (7.1) years) completed all assessments (39 in the intervention group and 47 in the control group).INTERVENTION: A lifestyle course in combination with physical activity (intervention group) compared with physical activity alone (control group). Both programmes were held once a week for nine months.MAIN OUTCOME MEASURE: The Short Form Questionnaire (SF-36), addressing well-being and social participation. Assessments were performed at baseline and at nine months follow-up.RESULTS: We found no statistically significant differences between the groups at the nine months follow-up in the SF-36. Adjusted mean differences in change scores in the eight subscales of SF-36 were; 'mental health' (+1.8, 95% confidence interval (CI) -4.0, +7.6), 'vitality' (-3.0, 95%","Lund, A; Michelet, M; Sandvik, L; Wyller, T; Sveen, U",2012.0,10.1177/0269215511429473,0,0,
5779,A controlled pilot study of stress management training of elderly patients with congestive heart failure,"ER The purpose of this study was to evaluate the effect of stress management training on quality of life, functional capacity, and heart rate variability in elderly patients with New York Heart Association class I-III congestive heart failure (CHF). While substantial research exists on stress management training for patients with coronary heart disease, there are few data on the value of psychosocial training on patients with CHF. Thirty-three multiethnic patients (mean age, 66+/-9 years) were assigned through incomplete randomization to one of two treatment groups or a wait-listed control group. The 14 participants who completed the treatment attended eight training sessions during a 10-week period. The training consisted of 75-minute sessions adapted from the Freeze-Frame stress management program developed by the Institute of HeartMath. Subjects were assessed at baseline and again at the completion of the training. Depression, stress management, optimism, anxiety, emotional distress, and functional capacity were evaluated, as well as heart rate variability. Significant improvements (p<0.05) were noted in perceived stress, emotional distress, 6-minute walk, and depression, and positive trends were noted in each of the other psychosocial measures. The 24-hour heart rate variability showed no significant changes in autonomic tone. The authors noted that CHF patients were willing study participants and their emotional coping and functional capacity were enhanced. This program offers a simple and cost-effective way to augment medical management of CHF. Given the incompleteness of CHF medical management and the exploding interest in complementary medical intervention, it seems imperative that further work in psychosocial treatment be undertaken.","Luskin, F; Reitz, M; Newell, K; Quinn, T; Haskell, W",2002.0,,0,0,
5780,Changes in cognitive coping strategies predict EBV-antibody titre change following a stressor disclosure induction,"ER Previous research has shown that emotional disclosure of traumatic or stressful events is associated with facilitating insight into the experience, improving mood, and modulating some aspects of the immune system. The current study examined how cognitive changes and experiential involvement during an emotional disclosure induction protocol relate to immune functioning, as measured by IgG antibody titres to the Epstein-Barr virus viral capsid antigen (EBV-VCA). Seventy-six college undergraduates were randomly assigned to either a disclosure induction or an assessment-only control condition. Experimental subjects met with an experimenter for three weekly 20-min individual sessions during which time they were asked to discuss a stressful or traumatic topic which they had previously discussed only minimally with others. Blood was drawn a week prior to the first session and at one week following the third session. Subjects completed the Impact of Event Scale (IES) after session 1 and at followup, and the extent of experiential involvement in disclosure during each session was assessed by means of the Experiencing Scale. Mood was assessed before and after each disclosure using the Nowlis Mood Adjective Checklist. Although the disclosure induction did not directly affect EBV-VCA antibody titres, individual differences in subjects' ability to involve themselves in the disclosure process and abandon their avoidance of the stressful tropic during the course of the 3-wk period were predictive of antibody decrements. These associations were more pronounced for individuals who disclosed older and more troublesome events.","Lutgendorf, S K; Antoni, M H; Kumar, M; Schneiderman, N",1994.0,,0,0,
5781,Effectiveness of mat Pilates or equipment-based Pilates in patients with chronic non-specific low back pain: a protocol of a randomised controlled trial,"ER BACKGROUND: Chronic low back pain is an expensive and difficult condition to treat. One of the interventions widely used by physiotherapists in the treatment of chronic non-specific low back pain is exercise therapy based upon the Pilates principles. Pilates exercises can be performed with or without specific equipment. These two types of Pilates exercises have never been compared on a high-quality randomised controlled trial.METHODS/DESIGN: This randomised controlled trial with a blinded assessor will evaluate eighty six patients of both genders with chronic low back pain, aged between 18 and 60 years, from one Brazilian private physiotherapy clinic. The patients will be randomly allocated into two groups: Mat Group will perform the exercises on the ground while the Equipment-based Group will perform the Pilates method exercises on the following equipment: Cadillac, Reformer, Ladder Barrel, and Step Chair. The general and specific disability of the patient, kinesiophobia, pain intensity and global perceived effect will be evaluated by a blinded assessor before randomisation and at six weeks and six months after randomisation. In addition, the expectation of the participants and their confidence with the treatment will be evaluated before randomisation and after the first treatment session, respectively.DISCUSSION: This will be the first study aiming to compare the effectiveness of Mat and Equipment-based Pilates exercises in patients with chronic non-specific low back pain. The results may help health-care professionals in clinical decision-making and could potentially reduce the treatment costs of this condition.TRIAL REGISTRATION: Brazilian Registry of Clinical Trials RBR-7tyg5j.","Luz, M A; Costa, L O; Fuhro, F F; Manzoni, A C; Oliveira, N T; Cabral, C M",2013.0,10.1186/1471-2474-14-16,0,0,
5782,Research aimed at improving both mood and weight (RAINBOW) in primary care: A type 1 hybrid design randomized controlled trial,"ER Effective interventions targeting comorbid obesity and depression are critical given the increasing prevalence and worsened outcomes for patients with both conditions. RAINBOW is a type 1 hybrid design randomized controlled trial. The objective is to evaluate the clinical and cost effectiveness and implementation potential of an integrated, technology-enhanced, collaborative care model for treating comorbid obesity and depression in primary care. Obese and depressed adults (n = 404) will be randomized to usual care enhanced with the provision of a pedometer and information about the health system's services for mood or weight management (control) or with the Integrated Coaching for Better Mood and Weight (I-CARE) program (intervention). The 12-month I-CARE program synergistically integrates two proven behavioral interventions: problem-solving therapy with as-needed intensification of pharmacotherapy for depression (PEARLS) and standardized behavioral treatment for obesity (Group Lifestyle Balance(?)). It utilizes traditional (e.g., office visits and phone consults) and emerging care delivery modalities (e.g., patient web portal and mobile applications). Follow-up assessments will occur at 6, 12, 18, and 24 months. We hypothesize that compared with controls, I-CARE participants will have greater improvements in weight and depression severity measured by the 20-item Depression Symptom Checklist at 12 months, which will be sustained at 24 months. We will also assess I-CARE's cost-effectiveness and use mixed methods to examine its potential for reach, adoption, implementation, and maintenance. This study offers the potential to change how obese and depressed adults are treated-through a new model of accessible and integrative lifestyle medicine and mental health expertise-in primary care.","Ma, J; Yank, V; Lv, N; Goldhaber-Fiebert, J D; Lewis, M A; Kramer, M K; Snowden, M B; Rosas, L G; Xiao, L; Blonstein, A C",2015.0,10.1016/j.cct.2015.06.010,0,0,
5783,"Do you ""like"" my photo? Facebook use maintains eating disorder risk","ER OBJECTIVE: Social media sites, such as Facebook, merge two factors that influence risk for eating disorders:media and peers. Previous work has identified cross-sectional and temporal associations between Facebook use and disordered eating. This study sought to replicate and extend these findings using an experimental design.METHOD: In Study 1, 960 women completed self-report surveys regarding Facebook use and disordered eating. In Study 2, 84 women were randomly assigned to use Facebook or to use an alternate internet site for 20 min.RESULTS: More frequent Facebook use was associated with greater disordered eating in a cross-sectional survey. Facebook use was associated with the maintenance of weight/shape concerns and state anxiety compared to an alternate internet activity.DISCUSSION: Facebook use may contribute to disordered eating by maintaining risk for eating pathology. As such, targeting Facebook use may be helpful in intervention and prevention programs.","Mabe, A G; Forney, K J; Keel, P K",2014.0,,0,0,
5784,Determining the impact of a surgical liaison nurse role in the paediatric operating room,"ER A two-group (N = 92) quasi-experimental pre-post test design was used to examine the effects of intra-operative communication by a surgical liaison nurse (SLN) on parental anxiety. Group I received in person progress reports from the SLN. Group II received routine perioperative care. The Speilberger's State-Trait Anxiety Inventory (STAI) Scale and investigator developed family rating scales were distributed to both groups and used as a quantitative as well as a qualitative approach to determine what was helpful for the family members during the operative period. Two hundred and eighty feedback forms were dispersed to various health care professionals including all anaesthetists, surgeons, nurses and other staff in the perioperative care team, including the operating room, day surgery unit and the post anaesthetic recovery room areas. Feedback forms were also circulated to staff from the intensive care unit and the surgical in-patient units. The results showed the anxiety levels were lower for the families who received in person progress reports but the difference by group was not statistically significant. Thematic written responses provided examples of improved care and effective time management behaviours on the part of the health care professionals. Written responses provided validation for the scale scores for both families and health care professionals and were an indication of the support for the role of the surgical liaison nurse. Qualitative findings implied that the surgical liaison nurse facilitated the transfer of necessary information between the perioperative care team and the family thus providing a support mechanism for families under stress.","MacDonald, K; Latimer, M; Drisdelle, N",2006.0,,0,0,
5785,Efficacy of graded activity versus supervised exercises in patients with chronic non-specific low back pain: protocol of a randomised controlled trial,"ER BACKGROUND: Low back pain is a relevant public health problem, being an important cause of work absenteeism worldwide, as well as affecting the quality of life of sufferers and their individual functional performances. Supervised active physical routines and of cognitive-behavioral therapies are recommended for the treatment of chronic Low back pain, although evidence to support the effectiveness of different techniques is missing. Accordingly, the aim of this study is to contrast the effectiveness of two types of exercises, graded activity or supervised, in decreasing symptoms of chronic low back pain.METHODS/DESIGN: Sample will consist of 66 patients, blindly allocated into one of two groups: 1) Graded activity which, based on an operant approach, will use time-contingent methods aiming to increase participants' activity levels; 2) Supervised exercise, where participants will be trained for strengthening, stretching, and motor control targeting different muscle groups. Interventions will last one hour, and will happen twice a week for 6 ?weeks. Outcomes (pain, disability, quality of life, global perceived effect, return to work, physical activity, physical capacity, and kinesiophobia) will be assessed at baseline, at treatment end, and three and six months after treatment end. Data collection will be conducted by an investigator blinded to treatment allocation.DISCUSSION: This project describes the randomisation method that will be used to compare the effectiveness of two different treatments for chronic low back pain: graded activity and supervised exercises. Since optimal approach for patients with chronic back pain have yet not been defined based on evidence, good quality studies on the subject are necessary.TRIAL REGISTRATION: NCT01719276.","Magalhaes, M O; França, F J; Burke, T N; Ramos, L A; Moura Campos Carvalho, e Silva A P; Almeida, G P; Yuan, S L; Marques, A P",2013.0,10.1186/1471-2474-14-36,0,0,
5786,The treatment of chronic coccydynia with intrarectal manipulation: a randomized controlled study,"ER OBJECTIVETo evaluate the efficacy of intrarectal manual treatment of chronic coccydynia; and to determine the factors predictive of a good outcome.SUMMARY OF BACKGROUND DATAIn 2 open uncontrolled studies, the success rate of intrarectal manipulation of the coccyx was around 25%.METHODSPatients were randomized into 2 groups of 51 patients each: 1 group received three sessions of coccygeal manipulation, and the other low-power external physiotherapy. The manual treatment was guided by the findings on stress radiographs. Patients were assessed, at 1 month and 6 months, using a VAS and (modified) McGill Pain, Paris (functional coccydynia impact), and (modified) Dallas Pain questionnaires.RESULTSAt baseline, the 2 groups were similar regarding all parameters. At 1 month, all the median VAS and questionnaire values were modified by -34.7%, -36.0%, -20.0%, and -33.8%, respectively, in the manipulation group, versus -19.1%, -7.7%, 20.0%, and -15.7%, respectively, in the control (physiotherapy) group (P = 0.09 [borderline], 0.03, 0.02, and 0.02, respectively). Good results were twice as frequent in the manipulation group compared with the control group, at 1 month (36% vs. 20%, P = 0.075) and at 6 months (22% vs. 12%, P = 0.18). The main predictors of a good outcome were stable coccyx, shorter duration, traumatic etiology, and lower score in the affective parts of the McGill and Dallas questionnaires.CONCLUSIONSWe found a mild effectiveness of intrarectal manipulation in chronic coccydynia.STUDY DESIGNRandomized open study.","Maigne, J Y; Chatellier, G; Faou, M L; Archambeau, M",2006.0,10.1097/01.brs.0000231895.72380.64,0,0,
5787,Hero/heroine modeling for Puerto Rican adolescents: a preventive mental health intervention,"ER Culturally sensitive treatments of the special mental health needs of high-risk Puerto Rican adolescents are lacking. The hero/heroine intervention was based on adult Puerto Rican role models to foster ethnic identity, self-concept, and adaptive coping behavior. 90 nonclinical Puerto Rican 8th and 9th graders were screened for presenting behavior problems in school and randomly assigned to an intervention and a control group. After 19 sessions, the intervention significantly increased adolescents' ethnic identity and self-concept and reduced anxiety. Treatment outcomes varied as a function of grade level, sex, and household composition. Self-concept was negatively affected among girls from intact families. The study supports the effectiveness of the culturally sensitive modality as a preventive mental health intervention for high-risk Puerto Rican adolescents, especially from single-parent families.","Malgady, R G; Rogler, L H; Costantino, G",1990.0,,0,0,
5788,Cervicogenic dizziness - musculoskeletal findings before and after treatment and long-term outcome,"ER METHODTwenty-two patients (20 women, 2 men; mean age 37 years) with suspected cervicogenic dizziness underwent a structured physical examination before and after physiotherapy guided by the musculoskeletal findings. Questionnaires were sent to the patients six months and two years after treatment.RESULTSDorsal neck muscle tenderness and tightness was found in a majority of the patients. Zygapophyseal joint tenderness was found at all cervical levels. Cervical range of motion was equal to or larger than expected age and gender matched values. The cervico-thoracic region was often hypomobile. Most patients had postural imbalance. Dynamic stabilization capacity was reduced. Suboccipital muscles tightness correlated with posture imbalance and poor neck stability. The treatment resulted in reduced tenderness in levator scapula, high and middle paraspinal and temporalis muscles and zygapophyseal joints at C4-C7 and increased cervico-thoracic mobility. Reduction of middle paraspinal muscle tenderness correlated with neck pain relief. Postural alignment improved, as did dynamic stabilization in trunk, neck and shoulders. After 6 months, 13 of the 17 patients had still no or less neck pain and 14 had no or less dizziness. After 2 years, 7 patients had no or less neck pain and 11 no or less dizziness.CONCLUSIONPatients with suspected cervicogenic dizziness have some musculoskeletal findings in common. Treatment based on these findings reduces neck pain as well as dizziness long-term but some patients might need a maintenance strategy.PURPOSETo explore musculoskeletal findings in patients with cervicogenic dizziness and how these findings relate to pain and dizziness. To study treatment effects and long-term symptom progress.","Malmström, E M; Karlberg, M; Melander, A; Magnusson, M; Moritz, U",2007.0,10.1080/09638280600948383,0,0,
5789,Effects of music therapy on health-related outcomes in cardiac rehabilitation: a randomized controlled trial,"ER This study tested effectiveness of music therapy in improving health-related outcomes of cardiac rehabilitation patients. Using a randomized, controlled trial with follow-up, the study was conducted in an outpatient cardiac rehabilitation program in Ohio. Sixty-eight of 103 recruited patients, 30 to 80 years of age, completed the protocol through posttreatment. Physiological and psychological outcomes were measured. Cardiac rehabilitation patients were randomly assigned to cardiac rehabilitation only or to music therapy plus cardiac rehabilitation. Music therapy included musical experiences, counseling, and Music-Assisted Relaxation and Imagery. The null hypothesis of no differences in health-related outcomes between cardiac rehabilitation patients who experienced cardiac rehabilitation with and without music therapy was rejected due to changes in systolic blood pressure pre to post-treatment. Interpretation of changes at 4 months posttreatment in anxiety, general health, and social functioning are limited, due to small sample sizes at follow-up. Pre to post-music therapy session improvements were also reported. Findings suggest that some health-related outcomes may be affected positively by participation in music therapy in addition to cardiac rehabilitation. Attrition contributed to limitations in statistical power.","Mandel, S E; Hanser, S B; Secic, M; Davis, B A",2007.0,,0,0,
5790,Couple-focused group intervention for women with early stage breast cancer,"ER This study examined the efficacy of a couple-focused group intervention on psychological adaptation of women with early stage breast cancer and evaluated whether perceived partner unsupportive behavior or patient functional impairment moderated intervention effects. Two hundred thirty-eight women were randomly assigned to receive either 6 sessions of a couple-focused group intervention or usual care. Intent-to-treat growth curve analyses indicated that participants assigned to the couples' group reported lower depressive symptoms. Women rating their partners as more unsupportive benefited more from the intervention than did women with less unsupportive partners, and women with more physical impairment benefited more from the intervention group than did women with less impairment. Subgroup analyses comparing women attending the couple-focused group intervention with women not attending groups and with usual care participants indicated that women attending sessions reported significantly less distress than did women receiving usual care and women who dropped out of the intervention.","Manne, S L; Ostroff, J S; Winkel, G; Fox, K; Grana, G; Miller, E; Ross, S; Frazier, T",2005.0,10.1037/0022-006X.73.4.634,0,0,
5791,A novel cognitive behaviour therapy for bipolar disorders (Think Effectively About Mood Swings or TEAMS): study protocol for a randomized controlled trial,"ER BACKGROUND: Existing psychological therapies for bipolar disorders have been found to have mixed results, with a consensus that they provide a significant, but modest, effect on clinical outcomes. Typically, these approaches have focused on promoting strategies to prevent future relapse. An alternative treatment approach, termed 'Think Effectively About Mood Swings' (TEAMS) addresses current symptoms, including subclinical hypomania, depression and anxiety, and promotes long-term recovery. Following the publication of a theoretical model, a range of research studies testing the model and a case series have demonstrated positive results. The current study reports the protocol of a feasibility randomized controlled trial to inform a future multi-centre trial.METHODS/DESIGN: A target number of 84 patients with a diagnosis of bipolar I or II disorder, or bipolar disorder not-otherwise-specified are screened, allocated to a baseline assessment and randomized to either 16 sessions of TEAMS therapy plus treatment-as-usual (TAU) or TAU. Patients complete self-report inventories of depression, anxiety, recovery status and bipolar cognitions targeted by TEAMS. Assessments of diagnosis, bipolar symptoms, medication, access to services and quality of life are conducted by assessors blind to treatment condition at 3, 6, 12 and 18 months post-randomization. The main aim is to evaluate recruitment and retention of participants into both arms of the study, as well as adherence to therapy, to determine feasibility and acceptability. It is predicted that TEAMS plus TAU will reduce self-reported depression in comparison to TAU alone at six months post-randomization. The secondary hypotheses are that TEAMS will reduce the severity of hypomanic symptoms and anxiety, reduce bipolar cognitions, improve social functioning and promote recovery compared to TAU alone at post-treatment and follow-up. The study also incorporates semi-structured interviews about the experiences of previous treatment and the experience of TEAMS therapy that will be subject to qualitative analyses to inform future developments of the approach.DISCUSSION: The design will provide preliminary evidence of efficacy, feasibility, acceptability, uptake, attrition and barriers to treatment to design a definitive trial of this novel intervention compared to treatment as usual.TRIAL REGISTRATION: This trial was registered with Current Controlled Trials (ISRCTN83928726) on registered 25 July 2014.","Mansell, W; Tai, S; Clark, A; Akgonul, S; Dunn, G; Davies, L; Law, H; Morriss, R; Tinning, N; Morrison, A P",2014.0,10.1186/1745-6215-15-405,0,0,
5792,Family support for stroke: a randomised controlled trial,"ER METHODSPatients with acute stroke admitted to hospitals in Oxford, UK, were assigned family support or normal care within 6 weeks of stroke. After 6 months, we assessed, for carers, knowledge about stroke, Frenchay activities index, general health questionnaire-28 scores, caregiver strain index, Dartmouth co-op charts, short form 36 (SF-36), and satisfaction scores, and, for patients, knowledge about stroke and use of services, Barthel index, Rivermead mobility index, Frenchay activities index, London handicap scale, hospital anxiety and depression scales, Dartmouth co-op charts, and satisfaction.FINDINGS323 patients and 267 carers were followed up. Carers in the intervention group had significantly better Frenchay activities indices (p=0.03), SF-36 scores (energy p=0.02, mental health p=0.004, pain p=0.03, physical function p=0.025, and general health perception p=0.02), quality of life on the Dartmouth co-op chart (p=0.01), and satisfaction with understanding of stroke (82 vs 71%, p=0.04) than those in the control group. Patients' knowledge about stroke, disability, handicap, quality of life, and satisfaction with services and understanding of stroke did not differ between groups. Fewer patients in the intervention group than in the control group saw a physiotherapist after discharge (44 vs 56%, p=0.04), but use of other services was similar.INTERPRETATIONFamily support significantly increased social activities and improved quality of life for carers, with no significant effects on patients.BACKGROUNDAttention is currently focused on family care of stroke survivors, but the effectiveness of support services is unclear. We did a single-blind, randomised, controlled trial to assess the impact of family support on stroke patients and their carers.","Mant, J; Carter, J; Wade, D T; Winner, S",2000.0,10.1016/S0140-6736(00)02655-6,0,0,
5793,Family support for stroke: one year follow up of a randomised controlled trial,"ER OBJECTIVETo extend the follow up of a single blind randomised controlled trial of family support for stroke patients and carers to one year to ascertain whether there were any late effects of the intervention.METHODSThe study was a randomised controlled trial. Patients admitted to hospital with acute stroke who had a close carer were assigned to receive family support or normal care. Families were visited at home by a researcher 12 months after the stroke, and a series of questionnaires was administered to patient and carer.RESULTSThe benefits to carers mostly persisted, though they were no longer statistically significant because some patients were lost to follow up. There was no evidence of any effects on patients.CONCLUSIONFamily support is effective for carers, but different approaches need to be considered to alleviate the psychosocial problems of stroke patients.BACKGROUNDThere is evidence that family support can benefit carers of stroke patients, but not the patients themselves.","Mant, J; Winner, S; Roche, J; Wade, D T",2005.0,10.1136/jnnp.2004.048991,0,0,
5794,"Evaluation by multidimensional instruments of health-related quality of life of elderly cancer patients undergoing three different ""psychosocial"" treatment approaches. A randomized clinical trial","ER Our study belongs to the clinical trials in which the health-related quality of life (HQL) evaluation constitutes the primary endpoint. It was carried out with the aim of comparing the impact of three different types of psychological intervention, namely a psychopharmacological treatment alone, the same treatment plus social support carried out by volunteers (SSV) and a third treatment modality including ""structured psychotherapy"" (autogenous training), on improving the HQL of elderly cancer patients undergoing antineoplastic therapy with symptoms of anxiety and/or depression related to their disease. The eight questionnaires used for HQL evaluation were generally self-rated and multidimensional but unidimensional models were also employed. Seventy-four patients aged over 65 years with either solid tumors in different sites or hematological malignancies, generally in advanced stages (III-IV), were enrolled in the study. Of these patients, 72 (42 men and 30 women, mean age 70.68 years, range 66-85) were evaluable. Our study highlighted the usefulness of the pharmacological therapy (alprazolam + sulpiride) and of other specific ancillary treatments in reducing the incidence of the main HQL-related side-effects of antineoplastic therapy and the superiority of an ""integrated"" strategy, based both on psychopharmacology and psychosocial interventions, such as SSV with or without structured psychotherapy. The one-way analysis of variance carried out by us did not allow us to draw definitive conclusions about which of the two integrated treatments was to be considered the treatment of choice, as they proved to be almost equally effective.","Mantovani, G; Astara, G; Lampis, B; Bianchi, A; Curreli, L; Orr√π, W; Carta, M G; Carpiniello, B; Contu, P; Rudas, N",1996.0,,0,0,
5795,Absence of mitochondrial progesterone receptor polymorphisms in women with spontaneous preterm birth,"ER METHODS: Secondary analysis of DNA from women enrolled in a multicenter, prospective, study of 17 alpha-hydroxyprogesterone caproate (17OHPC) versus placebo for the prevention of recurrent SPTB. DNA was extracted from stored saliva.RESULTS: The PR-M localization sequence was sequenced on 344 patients. Sequences were compared with the previously published 48 base-pair sequence, and all were identical.CONCLUSIONS: We did not detect genetic variation in the mitochondrial localization sequence of the truncated PR-M in a group of women at high risk for SPTB.OBJECTIVE: The truncated mitochondrial progesterone receptor (PR-M) is homologous to nuclear PRs with the exception of an amino terminus hydrophobic membrane localization sequence, which localizes PR-M to mitochondria. Given the matrilineal inheritance of both spontaneous preterm birth (SPTB) and the mitochondrial genome, we hypothesized that (a) PR-M is polymorphic and (b) PR-M localization sequence polymorphisms could result in variable progesterone-mitochondrial effects and variable responsiveness to progesterone prophylaxis.","Manuck, T A; Price, T M; Thom, E; Meis, P J; Dombrowski, M P; Sibai, B; Spong, C Y; Rouse, D J; Iams, J D; Simhan, H N; O'Sullivan, M J; Miodovnik, M; Leveno, K J; Conway, D; Wapner, R J; Carpenter, M; Mercer, B; Ramin, S M; Thorp, J M; Peaceman, A M",2010.0,10.1177/1933719110374365,0,0,
5796,Treatment of problem alcohol use in women of childbearing age: results of a brief intervention trial,"ER METHODSProject TrEAT was conducted in the offices of 64 primary care, community-based physicians from 10 Wisconsin counties. Of 5979 female patients ages 18 to 40 who were screened for problem drinking, 205 were randomized into an experimental group (n = 103) or control group (n = 102). The intervention consisted of two 15 min, physician-delivered counseling visits that included advice, education, and contracting by using a scripted workbook. A total of 174 subjects (85%) completed the 48 month follow-up procedures.RESULTSNo significant differences were found between the experimental and control groups at baseline for alcohol use, age, socioeconomic status, smoking, depression or anxiety, conduct disorder, lifetime drug use, or health care utilization. The trial found a significant treatment effect in reducing both 7 day alcohol use (p = 0.0039) and binge drinking episodes (p = 0.0021) over the 48 month follow-up period. Women in the experimental group who became pregnant during the follow-up period had the most dramatic decreases in alcohol use. A logistic regression model based on a 20% or greater reduction in drinking found an odds ratio of 1.93 (confidence interval 1.07-3.46) in the sample exposed to physician intervention. Age, smoking, depression, conduct disorder, antisocial personality disorder, and illicit drug use did not reduce drinking significantly. No significant differences were found in health care utilization and health status between groups.CONCLUSIONSThis trial provides the first direct evidence that brief intervention is associated with sustained reductions in alcohol consumption by women of childbearing age. The results have enormous implications for the U.S. health care system.BACKGROUNDStudies suggest that 14% of women age 18 to 40 drink alcohol above recommended limits. Of special concern is the increasing use of alcohol by women during pregnancy. This article reports 48 month follow-up data from a subanalysis of a trial for early alcohol treatment (Project TrEAT) focused on women of childbearing age.","Manwell, L B; Fleming, M F; Mundt, M P; Stauffacher, E A; Barry, K L",2000.0,,0,0,
5797,Effects of various food ingredients on gall bladder emptying,"ER BACKGROUND/OBJECTIVES: The emptying of the gall bladder in response to feeding is pivotal for the digestion of fat, but the role of various food ingredients in contracting the gall bladder postprandially is not well understood. We hypothesized that different food ingredients, when consumed, will have a different effect on stimulating gall bladder emptying. To investigate this we designed two randomized, investigator-blind, cross-over studies in healthy subjects using magnetic resonance imaging (MRI) to measure gall bladder volumes serially and non-invasively.SUBJECTS/METHODS: Study 1: exploratory study evaluating the effects of 10 different food ingredients on gall bladder emptying in eight healthy subjects. The choice of ingredients varied from common items like coffee, tea and milk to actives like curcumin and potato protease inhibitor. Study 2: mechanistic study investigating the cholecystokinin (CCK) dose response to the best performer ingredient from Study 1 in 21 healthy subjects four ways.RESULTS: The largest gall bladder volume change in Study 1 was observed with fat, which therefore became the dose-response ingredient in Study 2, where the maximum % gall bladder volume change correlated well with CCK.CONCLUSIONS: These serial test-retest studies showed that the fasted gall bladder volume varied remarkably between individuals and that individual day-to-day variability had wide coefficients of variation. Improved knowledge of how to stimulate bile release using food ingredients will be useful to improve in vitro-in vivo correlation of bioavailability testing of hydrophobic drugs. It could improve performance of cholesterol-lowering plant stanol and sterol products and possibly aid understanding of some cholesterol gallstone disease.","Marciani, L; Cox, E F; Hoad, C L; Totman, J J; Costigan, C; Singh, G; Shepherd, V; Chalkley, L; Robinson, M; Ison, R; Gowland, P A; Spiller, R C",2013.0,10.1038/ejcn.2013.168,0,0,
5798,Maintenance treatment of schizophrenia with risperidone or haloperidol: 2-year outcomes,"ER METHODThis was a 2-year, randomized, double-blind comparison of 6 mg of risperidone versus haloperidol in 63 patients with stabilized DSM-IV schizophrenia. Study patients also received 15 months of standard behavioral skills training or enhanced training with a case manager who promoted patients' use of their skills in the community.RESULTSThe risk of psychotic exacerbations and the risk of leaving the study were similar for both drug treatment groups. However, patients who received both risperidone and the enhanced community-based skills training were more likely to remain in the study than those in the other treatment groups. Patients demonstrated significant improvement in score on the Brief Psychiatric Rating Scale over time with both medications. There were no between-group differences in cluster scores for thought disturbance, hostile-suspiciousness, and withdrawal-retardation. A significant between-group difference favoring risperidone was found for the anxious-depression cluster. Risperidone resulted in significantly greater reductions in tremor and akathisia and greater improvements in most items on the SCL-90-R.CONCLUSIONSWhen compared with patients given a low dose of haloperidol, risperidone-treated patients experienced similar improvements in positive and negative symptoms and similar risks of psychotic exacerbations. However, risperidone-treated patients appeared to feel subjectively better, as indicated by less anxiety and depression and fewer extrapyramidal side effects.OBJECTIVEMost controlled studies comparing second-generation and conventional antipsychotics have focused on the acute treatment of schizophrenia. The authors compared symptom outcomes, side effects, and social adjustment in stable schizophrenia outpatients who received 2 years of maintenance treatment with risperidone or haloperidol.","Marder, S R; Glynn, S M; Wirshing, W C; Wirshing, D A; Ross, D; Widmark, C; Mintz, J; Liberman, R P; Blair, K E",2003.0,10.1176/appi.ajp.160.8.1405,0,0,
5799,Oxytocin modulates the link between adult attachment and cooperation through reduced betrayal aversion,"ER An experiment examined whether and how the relationship between individual differences in social attachment and cooperation is modulated by brain oxytocin, a neuropeptide implicated both in parent-child bonding, and in social approach. Healthy males completed a validated attachment style measure, received intranasal oxytocin or placebo, and privately chose between cooperation and non-cooperation in an incentivized social dilemma with an anonymous stranger. Attachment anxiety--the tendency to fear rejection by others--had few effects and was not modulated by oxytocin. However, oxytocin interacted with attachment avoidance--the tendency to fear dependency and closeness in interpersonal relations. Especially among participants high rather than low in attachment avoidance, oxytocin reduced betrayal aversion, and increased trust and cooperation compared to placebo. Effects of attachment avoidance and oxytocin on cooperation were mediated by betrayal aversion, and not by affiliation tendencies.","Dreu, C K",2012.0,10.1016/j.psyneuen.2011.10.003,0,0,
5800,Oxytocin promotes human ethnocentrism,"ER Human ethnocentrism--the tendency to view one's group as centrally important and superior to other groups--creates intergroup bias that fuels prejudice, xenophobia, and intergroup violence. Grounded in the idea that ethnocentrism also facilitates within-group trust, cooperation, and coordination, we conjecture that ethnocentrism may be modulated by brain oxytocin, a peptide shown to promote cooperation among in-group members. In double-blind, placebo-controlled designs, males self-administered oxytocin or placebo and privately performed computer-guided tasks to gauge different manifestations of ethnocentric in-group favoritism as well as out-group derogation. Experiments 1 and 2 used the Implicit Association Test to assess in-group favoritism and out-group derogation. Experiment 3 used the infrahumanization task to assess the extent to which humans ascribe secondary, uniquely human emotions to their in-group and to an out-group. Experiments 4 and 5 confronted participants with the option to save the life of a larger collective by sacrificing one individual, nominated as in-group or as out-group. Results show that oxytocin creates intergroup bias because oxytocin motivates in-group favoritism and, to a lesser extent, out-group derogation. These findings call into question the view of oxytocin as an indiscriminate ""love drug"" or ""cuddle chemical"" and suggest that oxytocin has a role in the emergence of intergroup conflict and violence.","Dreu, C K; Greer, L L; Kleef, G A; Shalvi, S; Handgraaf, M J",2011.0,10.1073/pnas.1015316108,0,0,
5801,Does waiting after peri-prostatic nerve block reduce pain during transrectal ultrasound-guided prostate biopsy? A randomized controlled trial,"ER METHODS: This was a prospective, randomized controlled trial. All patients who underwent TRUS-guided prostate biopsy between February and June 2014 were randomized into waiting or control groups. All biopsies were performed by senior registrars with the same PNB technique. Patients in the waiting group waited 5 min after PNB prior to biopsies. Those in the control group did not. Patients were then asked to complete a questionnaire regarding pain associated with different parts of the procedure and their degree of anxiety using a 10-cm, validated visual analogue scale. Mann-Whitney U tests were performed on the pain and anxiety scores and analysis of variance was conducted using the Statistical Package for the Social Sciences software.RESULTS: A total of 92 patients were randomized to 39 in the waiting group and 53 in the control group. Mean overall pain scores were 2.85 and 2.66 (P = 0.626) for the waiting and control groups, respectively. The mean pain scores from probe insertion, biopsy, before leaving the department and mean anxiety scores were similar between the two groups and did not reach statistical significance. Analysis of variance showed that irrespective of group and age, increasing anxiety is associated with an increase in overall pain score (P < 0.0005).CONCLUSION: Waiting 5 min after PNB did not reduce pain in men undergoing TRUS-guided prostate biopsy.BACKGROUND: To determine if a short, clinically sufficient and manageable time delay after peri-prostatic nerve block (PNB) reduces pain during transrectal ultrasound (TRUS)-guided prostate biopsy.","Du, J; Johnston, J; Studd, R",2017.0,10.1111/ans.13597,0,0,
5802,CHESS improves cancer caregivers' burden and mood: results of an eHealth RCT,"ER METHODS: A total of 285 informal caregivers of patients with advanced nonsmall cell lung cancer were randomly assigned to a comparison group that received Internet or a treatment group that received Internet and CHESS. Caregivers were provided a computer and Internet service if needed. Written surveys were completed at pretest and during the intervention period bimonthly for up to 24 months. Analyses of covariance (ANCOVAs) compared the intervention's effect on caregivers' disruptiveness and burden (CQOLI-C), and negative mood (combined Anxiety, Depression, and Anger scales of the POMS) at 6 months, controlling for blocking variables (site, caregiver's race, and relationship to patient) and the given outcome at pretest.RESULTS: Caregivers randomized to CHESS reported lower burden, t(84) = 2.36, p = .021, d = .39, and negative mood, t(86) = 2.82, p = .006, d = .44, than those in the Internet group. The effect on disruptiveness was not significant.CONCLUSIONS: Although caring for someone with a terminal illness will always exact a toll on caregivers, eHealth interventions like CHESS may improve caregivers' understanding and coping skills and, as a result, ease their burden and mood.OBJECTIVE: Informal caregivers (family and friends) of people with cancer are often unprepared for their caregiving role, leading to increased burden or distress. Comprehensive Health Enhancement Support System (CHESS) is a Web-based lung cancer information, communication, and coaching system for caregivers. This randomized trial reports the impact on caregiver burden, disruptiveness, and mood of providing caregivers access to CHESS versus the Internet with a list of recommended lung cancer websites.","DuBenske, L L; Gustafson, D H; Namkoong, K; Hawkins, R P; Atwood, A K; Brown, R L; Chih, M Y; McTavish, F; Carmack, C L; Buss, M K; Govindan, R; Cleary, J F",2014.0,10.1037/a0034216,0,0,
5803,Coping effectiveness training during acute rehabilitation of spinal cord injury/dysfunction: a randomized clinical trial,"ER RESEARCH METHODParticipants (N = 40) entering a hospital-based program were assigned to treatment condition using block randomization. Questionnaire mood measures were completed at program admission, program discharge, and 3-month postdischarge follow-up. Adjustment to disability was assessed at follow-up only. Analyses of variance tested for group differences in anxiety, depression, and adjustment to injury.RESULTSBoth groups reported reductions in mood symptoms with no differences between treatment conditions. However, similar reductions were obtained after fewer sessions of CET. Symptoms of depression increased in both groups following hospital discharge.CONCLUSIONSClinical and research implications, including innovative interventions during the period after discharge, are discussed.PURPOSETo compare coping effectiveness training (CET) with supportive group therapy (SGT) for anxiety, depression, and adjustment to injury in an acute spinal cord injury/dysfunction (SCI/D) rehabilitation population. CET was shown to result in decreased anxiety and depression symptoms when compared to historical no-treatment control groups (Kennedy, Duff, Evans, & Beedie, 2003; King & Kennedy, 1999). The present study sought to extend those findings with a comparison of CET to an alternative active therapy condition, SGT.","Duchnick, J J; Letsch, E A; Curtiss, G",2009.0,10.1037/a0015571,0,0,
5804,"""Balance of power"": a transactional analysis of control in mother-child dyads involving socially competent, aggressive, and anxious children","ER The authors compared mother-to-child and child-to-mother control exchanges in dyads involving socially competent, aggressive, and anxious children (aged 2.5-6.5 years) observed in a laboratory setting. Competent children and their mothers influenced each other positively and reciprocally, making prudent use of control exchanges and setting firm limits to coercive attempts. Aggressive children and their mothers were relatively positive, but children made regular use of coercive control and mothers responded indiscriminately and failed to oppose more extreme forms of coercion. Anxious children and their mothers were generally aversive: mothers attempted to control their children by being coercive and unresponsive, and children tried to manage their mothers by being resistant and coercive. Results show that young children are active agents who influence and are influenced by their relationship with their mother and who behave--across contexts and with different social partners--in ways that reflect this relationship.","Dumas, J E; LaFreniere, P J; Serketich, W J",1995.0,,0,0,
5805,Upper cervical and upper thoracic manipulation versus mobilization and exercise in patients with cervicogenic headache: a multi-center randomized clinical trial,"ER METHODS: One hundred and ten participants (n = 110) with CH were randomized to receive both cervical and thoracic manipulation (n = 58) or mobilization and exercise (n = 52). The primary outcome was headache intensity as measured by the Numeric Pain Rating Scale (NPRS). Secondary outcomes included headache frequency, headache duration, disability as measured by the Neck Disability Index (NDI), medication intake, and the Global Rating of Change (GRC). The treatment period was 4 weeks with follow-up assessment at 1 week, 4 weeks, and 3 months after initial treatment session. The primary aim was examined with a 2-way mixed-model analysis of variance (ANOVA), with treatment group (manipulation versus mobilization and exercise) as the between subjects variable and time (baseline, 1 week, 4 weeks and 3 months) as the within subjects variable.RESULTS: The 2X4 ANOVA demonstrated that individuals with CH who received both cervical and thoracic manipulation experienced significantly greater reductions in headache intensity (p < 0.001) and disability (p < 0.001) than those who received mobilization and exercise at a 3-month follow-up. Individuals in the upper cervical and upper thoracic manipulation group also experienced less frequent headaches and shorter duration of headaches at each follow-up period (p < 0.001 for all). Additionally, patient perceived improvement was significantly greater at 1 and 4-week follow-up periods in favor of the manipulation group (p < 0.001).CONCLUSIONS: Six to eight sessions of upper cervical and upper thoracic manipulation were shown to be more effective than mobilization and exercise in patients with CH, and the effects were maintained at 3 months.TRIAL REGISTRATION: NCT01580280 April 16, 2012.BACKGROUND: Although commonly utilized interventions, no studies have directly compared the effectiveness of cervical and thoracic manipulation to mobilization and exercise in individuals with cervicogenic headache (CH). The purpose of this study was to compare the effects of manipulation to mobilization and exercise in individuals with CH.","Dunning, J R; Butts, R; Mourad, F; Young, I; Fernandez-de-Las, Peñas C; Hagins, M; Stanislawski, T; Donley, J; Buck, D; Hooks, T R; Cleland, J A",2016.0,10.1186/s12891-016-0912-3,0,0,
5806,Establishing treatment fidelity in a web-based behavioral intervention study,"ER OBJECTIVE: The aim of this study was to describe a methodology for ensuring treatment fidelity in a Web-based cognitive behavioral stress management intervention.METHODS: The intervention Coping With Cancer Workbook, adapted for Web-based delivery from an in-person intervention, was tested in a randomized controlled trial with 123 breast cancer survivors. Strategies for ensuring treatment fidelity were implemented and assessed.RESULTS: The National Institutes of Health Behavior Change Consortium Treatment Fidelity Guidelines were relevant to establishing treatment fidelity for the Web-based intervention.DISCUSSION: Web-based delivery of behavioral interventions is both a strength and a threat to treatment fidelity. Investigators must be cognizant of the elements of treatment fidelity and implement strategies to monitor and improve the reliability and validity of Web-based interventions.BACKGROUND: Treatment fidelity pertains to the methodological strategies used to monitor and enhance the reliability and validity of behavioral interventions. Approaches to establishing treatment fidelity in Web-based interventions differ from those used in interventions that are delivered in person.","Eaton, L H; Doorenbos, A Z; Schmitz, K L; Carpenter, K M; McGregor, B A",2011.0,10.1097/NNR.0b013e31823386aa,0,0,
5807,"The Dartmouth COOP Charts: a simple, reliable, valid and responsive quality of life tool for chronic obstructive pulmonary disease","ER The negative impact of chronic obstructive pulmonary disease (COPD) on health-related quality of life (HRQL) is substantial. Measurement of HRQL is increasingly advocated in clinical practice; traditional outcome measures such as lung function are poorly responsive. However many HRQL tools are not user-friendly in the clinic setting. Hence HRQL is often neglected. The Dartmouth Cooperative Functional Assessment Charts (COOP) have the requisite attributes of a tool suitable for routine clinical practice: they are simple, reliable, quick and easy to perform and score and well accepted. We aimed to determine the reliability, validity and responsiveness of the COOP in patients with significant COPD. HRQL was assessed during a prospective, randomised, placebo-controlled, double-blind, 12 week cross-over interventional study of ambulatory oxygen in patients (n = 50) with COPD. Test-retest reliability of the COOP domains was only modest however it was measured over a 2 month period. Significant correlations ranging between 0.4 and 0.8 were observed between all comparable domains of the COOP and the Medical Outcomes Study 36-item Short-form Health Survey, Chronic Respiratory Questionnaire (CRQ) and Hospital Anxiety and Depression (HAD) scale. Following ambulatory oxygen significant improvements were noted in all CRQ and HAD domains. Several domains of the generic SF-36 (role emotional, social functioning, role-physical) showed significant improvements. Comparable domains of the COOP (social activities, feelings) also showed significant improvements. The COOP change in health domain improved very significantly. The COOP is a simple, reliable HRQL tool which proved valid and responsive in our study population of COPD patients and may have a valuable role in routine clinical practice.","Eaton, T; Young, P; Fergusson, W; Garrett, J E; Kolbe, J",2005.0,,0,0,
5808,The examination of fatty acid taste with edible strips,"ER The objective of this study was to determine whether humans could detect long-chain fatty acids when these lipid molecules are delivered to the oral cavity by edible taste strips. For suprathreshold studies, up to 1.7 ?mol of stearic acid or linoleic acid was incorporated into 0.03 mm thick, one-inch square taste strips. Normalized taste intensity values for stearic acid were in the barely detectable range, with values equal to, or slightly above control strips. One-third of test subjects described the taste quality as oily/fatty/waxy. Approximately 75% of test subjects could detect the presence of linoleic acid when this fatty acid was incorporated into dissolvable strips. Normalized taste intensity values for linoleic acid were in the weak to moderate range. The most commonly reported taste quality responses for linoleic acid were fatty/oily/waxy, or bitter. When nasal airflow was obstructed, the perceived taste intensity of linoleic acid decreased by approximately 40%. Taste intensity values and taste quality responses for linoleic acid were then compared among tasters and non-tasters of 6-n-propylthiouracil (PROP). Individuals who could detect the bitter taste of PROP reported higher taste intensity values for linoleic acid compared with PROP non-tasters. However, taste quality responses for linoleic acid were similar among both PROP tasters and PROP non-tasters. These results indicate that humans can detect long-chain fatty acids by both olfactory and non-olfactory pathways when these hydrophobic molecules are delivered to the oral cavity by means of edible taste strips. These studies further show that genetic variation in taste sensitivity to PROP affects chemosensory responses to the cis-unsaturated fatty acid (linoleic acid) in the oral cavity.","Ebba, S; Abarintos, R A; Kim, D G; Tiyouh, M; Stull, J C; Movalia, A; Smutzer, G",2012.0,10.1016/j.physbeh.2012.04.006,0,0,
5809,The tele-visit as a telemedical technique in daily clinical practice. First results for elbow joint arthrolysis,"ER Technologies in telecommunication and information are being increasingly applied in the public health system of the western world. Also responsible for this development is the cost factor in the field of financing and maintenance of such a system of superior medical supply, as well as the concurrent patient' demand for optimized medical ""24 h care and treatment"". Pioneers in the use of telematic projects have, up until now, been large states such as the USA, Canada, Norway or Australia. Such projects have been used to provide, guarantee and maintain medical care in geographically remote regions with few medical facilities. After breaking the obstacle of geographic distance, telemedical solutions in general, and especially the tele-visit, represent a new form of treatment for patient care after discharge from hospital. In the year 2002, a prospective randomized two-armed study was initiated including patients after surgical intervention by arthroplasty in posttraumatic contracture of the elbow. The system of the tele-visit was used for 6 weeks after discharge and the patients were controlled as outpatients after 6 months, including a physical examination. The functional outcome, duration of stay in hospital and the costs for treatment arising were determined. A standardized questionnaire was developed and the degree of satisfaction of the patients surveyed. A shorter stay in hospital was found together with lowered costs in medical treatment, while no differences in functional outcome could be found in comparison to the control group, although there was an additionally high grade of satisfaction with the new system.","Eberl, R; Kaminski, A; Reckwitz, N; Muhr, G; Clasbrummel, B",2006.0,10.1007/s00113-006-1062-0,0,0,
5810,Oxytocin facilitates the extinction of conditioned fear in humans,"ER METHODSKey among the endogenous inhibitors of amygdala activity in response to social fear signals is the hypothalamic peptide oxytocin. To address the question whether oxytocin can strengthen Pavlovian extinction beyond its role in controlling social fear, we conducted a functional magnetic resonance imaging experiment with 62 healthy male participants in a randomized, double-blind, parallel-group, placebo-controlled design. Specifically, subjects were exposed to a Pavlovian fear conditioning paradigm before receiving an intranasal dose (24 IU) of synthetic oxytocin or placebo.RESULTSOxytocin, when administered intranasally after Pavlovian fear conditioning, was found to increase electrodermal responses and prefrontal cortex signals to conditioned fear in the early phase of extinction and to enhance the decline of skin conductance responses in the late phase of extinction. Oxytocin also evoked an unspecific inhibition of amygdalar responses in both phases.CONCLUSIONSCollectively, our findings identify oxytocin as a differentially acting modulator of neural hubs involved in Pavlovian extinction. This specific profile of oxytocin action may open up new avenues for enhancing extinction-based therapies for anxiety disorders.BACKGROUNDCurrent neurocircuitry models of anxiety disorders posit a lack of inhibitory tone in the amygdala during acquisition of Pavlovian fear responses and deficient encoding of extinction responses in amygdala-medial prefrontal cortex circuits. Competition between these two responses often results in a return of fear, limiting control over anxiety. However, one hypothesis holds that a pharmacologic strategy aimed at reducing amygdala activity while simultaneously augmenting medial prefrontal cortex function could facilitate the extinction of conditioned fear.","Eckstein, M; Becker, B; Scheele, D; Scholz, C; Preckel, K; Schlaepfer, T E; Grinevich, V; Kendrick, K M; Maier, W; Hurlemann, R",2015.0,10.1016/j.biopsych.2014.10.015,0,0,
5811,"Informed consent for clinical trials: in search of the ""best"" method","ER DESIGNEight hundred and twelve articles were traced, in the process of conducting a systematic review of the ethics of clinical trials, by searching a number of sources: bibliographic databases (Medline, Psychlit and BIDS science and social science indices), hand searches, personal contacts, an original collection and a systematic follow-up of reference lists. Fourteen research reports were found which provided comparative data on different methods of obtaining informed consent. Eleven of these used a randomised design. Studies were classified according to three outcome measures (anxiety, consent rate and understanding).RESULTSThe results of the various studies suggest that giving people more information and more time to reflect tends to be associated with a lower consent rate. There seems to be an optimal level of information about side-effects such that patients are not overburdened by detail, while grasping the most important risks. More information in general is associated with greater awareness of the research nature of the trial, voluntariness of participation, right to withdraw and (available) alternative treatments. This result does not, however, extend to explanations of the concept of randomisation on which the literature is contradictory--sometimes more information is associated with increased understanding of the concept and sometimes it is not. Although divulging less information seems to be associated with less anxiety, there is evidence of an interaction with knowledge--high levels of knowledge are significantly associated with less anxiety, irrespective of consent method. The more that patients know before they are invited to participate in a trial, the better equipped they are to cope with the informed consent procedure.CONCLUSIONThere is some evidence to suggest that there is an optimal amount of information which enhances patient understanding and which might, in turn, reduce anxiety. However. the studies were not altogether conclusive. More work needs to be carried out, especially on public understanding of science and on how different ways of explaining scientific concepts affect that understanding.OBJECTIVETo review the literature on comparisons between different methods of obtaining informed consent for clinical trials.","Edwards, S J; Lilford, R J; Thornton, J; Hewison, J",1998.0,,0,0,
5812,Effects of treatment with deoxycholic acid and chenodeoxycholic acid on the hepatic synthesis of cholesterol and bile acids in healthy subjects,"ER The degradation of cholesterol to bile acids is regulated by a negative-feedback mechanism by the bile acids, especially the hydrophobic bile acids, returning to the liver via the portal vein. Chenodeoxycholic acid (CDCA) is a potent suppressor of the cholesterol 7alpha-hydroxylase, the rate-determining enzyme in bile acid formation. CDCA may also suppress hepatic 3-hydroxy-3-methyl glutaryl coenzyme A (HMG CoA) reductase, the rate-limiting enzyme in cholesterol synthesis. Conflicting reports have appeared regarding the suppression on bile acid synthesis by the most hydrophobic bile acid of human bile, deoxycholic acid (DCA). To study the suppressive effects of CDCA and DCA on hepatic cholesterol and bile acid synthesis in humans, 10 healthy subjects were treated with CDCA or DCA for 3 weeks in a randomized cross-over study with a washout period of 4 weeks in between. Serum levels of 7alpha-hydroxy-4-cholesten-3-one, reflecting cholesterol 7alpha-hydroxylase activity, and 7-dehydrocholesterol, reflecting HMG CoA reductase activity, and bile acids were repeatedly measured during the study periods. After 3 weeks of treatment with CDCA or DCA, CDCA constituted 70% and DCA 74% of the total serum bile acids, respectively. CDCA and DCA decreased the serum levels of 7alpha-hydroxy-4-cholesten-3-one by 80% and 75%, respectively. Negative correlations between the percentages of CDCA and DCA and the serum concentration of 7alpha-hydroxy-4-cholesten-3-one were obtained. CDCA reduced the serum level of 7-dehydrocholesterol by 29%, whereas treatment with DCA tended to increase the level of 7-dehydrocholesterol. Treatment of healthy subjects with CDCA and DCA reduces bile acid synthesis. CDCA also inhibits cholesterol synthesis, whereas DCA does not.","Einarsson, C; Hillebrant, C G; Axelson, M",2001.0,10.1053/jhep.2001.23790,0,0,
5813,Is impact of fatigue an independent factor associated with physical activity in patients with idiopathic Parkinson's disease?,"ER To investigate the longitudinal association between fatigue and physical activity in Parkinson's disease (PD) and determine whether this association is distorted by potential confounders. Data from baseline, 3, 6, and 12 week assessments in a single blind randomized clinical trial with cross-over design were used (N = 153). The Multidimensional Fatigue Inventory (MFI) was used to assess fatigue and an activity monitor to measure amount of physical activity (defined as % dynamic activity during each monitoring session). Time-independent and time-dependent factors were investigated for their possible univariate association with dynamic activity. Random coefficient analysis was applied. Candidate confounders were successively added to the longitudinal association model to determine if the association between dynamic activity and fatigue was distorted. A proportional change beyond 15% was considered to be significant. Fatigue was significantly associated with physical activity (beta = -0.099, SE = 0.032, P = 0.002). This association was not significantly distorted by type of intervention, age, gender, social support, disease duration, disease severity, motor impairment, cognition, anxiety, or medication intake. Depression caused proportional change of 22.2% in the regression coefficient of MFI. After controlling for depression, a significant association between MFI and dynamic activity remained (beta = -0.121, SE = 0.036, P = 0.000). The association found between fatigue and dynamic activity suggests that patients who experience higher levels of fatigue are less physically active. However, the total explained variance of dynamic activity by fatigue alone was small, suggesting that fatigue is only a minor factor in the complex of behavioral aspects that affect the amount of physical activity in patients with PD.","Elbers, R; Wegen, E E; Rochester, L; Hetherington, V; Nieuwboer, A; Willems, A M; Jones, D; Kwakkel, G",2009.0,10.1002/mds.22664,0,0,
5814,Effects of a health education programme with telephone follow-up during cardiac rehabilitation,"ER A health education and counselling programme was offered to myocardial infarction patients during and after hospitalization. A randomized pre-test-post-test control group design was used to evaluate the effects of the experimental intervention. During hospitalization the intervention consisted of two individual counselling sessions and two group health education sessions focusing on medication, healthy habits, anxiety and depression. On completion of these sessions, weekly telephone calls were made to patients for a period of six weeks after discharge from hospital. The intervention was offered to 30 myocardial infarction patients and their partners (the experimental group) in addition to standard medical care. Thirty control patients received standard medical care only. Two months after myocardial infarction, patients in the experimental condition reported a significantly greater increase in physical activity, and a significantly greater decrease in unhealthy eating habits. No effects were found regarding smoking cessation, anxiety and depression. Twelve months after discharge from hospital patients in the experimental condition reported a significantly greater decrease in unhealthy eating habits. No effects were found regarding smoking cessation, physical activity, anxiety and depression. In addition, two months after myocardial infarction, it was found that patients whose partners participated in the health education sessions showed a significantly greater decrease in smoking and unhealthy eating habits and a significantly greater increase in physical activity than patients with no partner participating. Twelve months after discharge the only significant result favouring the patients whose partner participated in the health education sessions concerned smoking cessation.","Elderen-van, Kemenade T; Maes, S; Broek, Y",1994.0,,0,0,
5815,Depression and diabetes among low-income Hispanics: design elements of a socioculturally adapted collaborative care model randomized controlled trial,"ER METHODS: The PHQ-9 depression scale was used to identify patients meeting criteria for major depressive disorder (1 cardinal depression symptom + a PHQ-9 score of > or = 10) from two community safety net clinics. Design elements included sociocultural adaptations in recruitment and efforts to reduce attrition and collaborative depression care management.RESULTS: Of 1,803 diabetes patients screened, 30.2% met criteria for major depressive disorder. Of 387 patients enrolled in the clinical trial, 98% had Type 2 diabetes, and 83% had glycated hemoglobin (HbA1c) levels > or = 7%. Study recruitment rates and baseline data analyses identified socioeconomic and clinical factors that support trial design and intervention adaptations. Depression severity was significantly associated with diabetes complications, medical comorbidity, greater anxiety, dysthymia, financial worries, social stress, and poorer quality-of-life.CONCLUSION: Low-income Hispanic patients with diabetes experience high prevalence of depressive disorder and depression severity is associated with socioeconomic stressors and clinical severity. Improving depression care management among Hispanic patients in public sector clinics should include intervention components that address self-care of diabetes and socioeconomic stressors.OBJECTIVE: This article describes design elements of the Multifaceted Depression and Diabetes Program (MDDP) randomized clinical trial. The MDDP trial hypothesizes that a socioculturally adapted collaborative care depression management intervention will reduce depressive symptoms and improve patient adherence to diabetes self-care regimens, glycemic control, and quality-of-life. In addition, baseline data of 387 low-income, 96% Hispanic, enrolled patients with major depression and diabetes are examined to identify study population characteristics consistent with trial design adaptations.","Ell, K; Katon, W; Cabassa, L J; Xie, B; Lee, P J; Kapetanovic, S; Guterman, J",2009.0,10.2190/PM.39.2.a,0,0,
5816,"A 7-year prospective, randomized, clinical, and radiographic study after arthroscopic Bankart reconstruction using 2 different types of absorbable tack","ER PURPOSEThe aim of this study was to compare the clinical and radiographic results after arthroscopic Bankart reconstruction using 2 different types of absorbable implants.STUDY DESIGNRandomized controlled trial; Level of evidence, 1.METHODSA randomized series of 40 patients who had recurrent shoulder instability underwent reconstruction involving either polygluconate-B polymer or self-reinforced poly-L-lactic acid polymer tack implants. The patients underwent radiographic and clinical assessments preoperatively and at 7 years. Blood levels of C-reactive protein were analyzed preoperatively and postoperatively.RESULTSThe radiographic visibility of the drill holes was significantly (P = .0001) greater in the poly-L-lactic acid polymer group than in the polygluconate-B polymer group. The failure rate in terms of stability was 5 of 36 (14%) after 7 years and, as previously reported by Magnusson et al, 2 of 40 (5%) after 2 years. Analyses preoperatively and postoperatively of C-reactive protein revealed no significant difference between the groups. No significant differences were found between the groups in terms of strength in abduction, range of motion, and Rowe or Constant scores.CONCLUSIONSeven years after Bankart repair using either implant, the overall clinical results were satisfactory. The visibility of the drill holes was significantly greater after using poly-L-lactic acid polymer implants.BACKGROUNDRecent studies have shown that techniques for arthroscopic Bankart reconstruction using suture anchors or tacks can equal the results after an open procedure in the treatment of posttraumatic, recurrent, unidirectional shoulder instability. Which kind of technique and which implants to be used still need further study.","Elmlund, A O; Kartus, J; Rostgård-Christensen, L; Sernert, N; Magnusson, L; Ejerhed, L",2009.0,10.1177/0363546509335197,0,0,
5817,Comparison of brief dynamic and cognitive-behavioural therapies in avoidant personality disorder,"ER AIMSTo compare the effectiveness of brief dynamic therapy and cognitive-behavioural therapy as out-patient treatment for people with avoidant personality disorder.METHODPatients who met the criteria for avoidant personality disorder (n=62) were randomly assigned to 20 weekly sessions of either brief dynamic therapy (n = 23) or cognitive-behavioural therapy (n=21), or they were assigned to the waiting-list control group (n = 18). After the waiting period, patients in the control group were randomly assigned to one of the two therapies.RESULTSPatients who received cognitive-behavioural therapy showed significantly more improvements on a number of measures in comparison with those who had brief dynamic psychotherapy or were in the waiting-list control group. Results were maintained at follow-up.CONCLUSIONSCognitive-behavioural therapy is more effective than waiting-list control and brief dynamic therapy. Brief dynamic therapy was no better than the waiting-list control condition.BACKGROUNDThere is a paucity of controlled trials examining the effectiveness of individual psychotherapy in personality disorders, especially in patients with cluster C disorders.","Emmelkamp, P M; Benner, A; Kuipers, A; Feiertag, G A; Koster, H C; Apeldoorn, F J",2006.0,10.1192/bjp.bp.105.012153,0,0,
5818,Treatment for Adolescents with Depression Study (TADS): safety results,"ER METHODSafety assessments included adverse events (AEs) collected by spontaneous report, as well as systematic measures for specific physical and psychiatric symptoms. Suicidal ideation and suicidal behavior were systematically assessed by self- and clinician reports. Suicidal events were also reanalyzed by the Columbia Group and expert raters using the Columbia-Classification Algorithm for Suicidal Assessment used in the U.S. Food and Drug Administration reclassification effort.RESULTSDepressed adolescents reported high rates of physical symptoms at baseline, which improved as depression improved. Sedation, insomnia, vomiting, and upper abdominal pain occurred in at least 2% of those treated with FLX and/or COMB and at twice the rate of placebo. The rate of psychiatric AEs was 11% in FLX, 5.6% in COMB, 4.5% in PBO, and 0.9% in CBT. Suicidal ideation improved overall, with greatest improvement in COMB. Twenty-four suicide-related events occurred during the 12-week period: 5 patients (4.7%) in COMB, 10 (9.2%) in FLX, 5 (4.5%) in CBT, and 3 (2.7%) in placebo. Statistically, only FLX had more suicide-related events than PBO (p =.0402, odds ratio (OR) = 3.7, 95% CI 1.00-63.7). Only five actual attempts occurred (2 COMB, 2 FLX, 1 CBT, 0 PBO). There were no suicide completions.CONCLUSIONSDifferent methods for eliciting AEs produce different results. In general, as depression improves, physical complaints and suicidal ideation decrease in proportion to treatment benefit. In this study, psychiatric AEs and suicide-related events are more common in FLX-treated patients. COMB treatment may offer a more favorable safety profile than medication alone in adolescent depression.OBJECTIVETo compare the rates of physical, psychiatric, and suicide-related events in adolescents with MDD treated with fluoxetine alone (FLX), cognitive-behavioral therapy (CBT), combination treatment (COMB), or placebo (PBO).","Emslie, G; Kratochvil, C; Vitiello, B; Silva, S; Mayes, T; McNulty, S; Weller, E; Waslick, B; Casat, C; Walkup, J; Pathak, S; Rohde, P; Posner, K; March, J",2006.0,10.1097/01.chi.0000240840.63737.1d,0,0,
5819,Stress hyperglycemia in minimally invasive surgery,"ER This study examined the selected hormonal responses to, and hormone-mediated glucose metabolism during minimally invasive surgery in, patients undergoing laparoscopic cholecystectomy for symptomatic gallstone disease. Thirty-two patients with symptomatic gallstone disease were included in this study and scheduled for open or laparoscopic procedure in a randomized trial. Results are expressed as mean and standard error of the mean. Statistical evaluations were performed with Mann-Whitney U and Wilcoxon signed-rank tests. Blood cortisol, glucagon, insulin, and glucose concentrations were measured immediately in the preoperative period and 6 h after surgery. Blood cortisol, glucagon, and glucose concentrations increased significantly after open and minimally invasive surgery, while insulin levels and the insulin:glucagon ratio remained unchanged. The rise of glucagon and cortisol values was found to be significantly higher in the postoperative period of the open procedure, than in the laparoscopic approach. However, in the patients who underwent open surgery, the increase in glucose concentrations was not significantly higher in the postoperative period. Surgery-induced hormonal effects on the islets increase glucagon and suppress insulin secretion. The glucagon-mediated increase in hepatic glucose production is excluded by the posttraumatic insulin levels from the insulin-sensitive tissues. A bihormonal setting favors a greater rate of hepatic glucose production in both open and laparoscopic surgery. Hormonal changes do reflect the degree of surgical stress, but their metabolic consequences are not parallel to the grade of surgical trauma in minimally invasive surgery.","Engin, A; Bozkurt, B S; Ersoy, E; Oguz, M; Gökçora, N",1998.0,,0,0,
5820,"A biopsychosocial primary care intervention (Back on Track) versus primary care as usual in a subgroup of people with chronic low back pain: protocol for a randomised, controlled trial","ER RESEARCH QUESTIONSThis study will investigate the difference in (cost) effectiveness between a biopsychosocial primary care intervention, Back on Track, and primary care physiotherapy as usual in a subgroup of adults with chronic low back pain.DESIGNDouble-blind, multicentre (n = 8), randomised, controlled trial.PARTICIPANTSEighty-six adults with chronic low back pain, aged 18 to 65 years, experiencing low to moderate levels of disability and in whom the contributing role of psychosocial factors to this disability is restricted.INTERVENTIONThe Back on Track intervention: four individual and eight group sessions, based on biopsychosocial approaches from multidisciplinary pain rehabilitation programs and provided by trained physiotherapists.CONTROLPrimary care physiotherapy as usual.MEASUREMENTSThe primary outcome is functional disability (Quebec Back Pain Disability Scale) at post treatment, and 3-month and 12-month follow-up. Secondary measures are: credibility and expectancy, anxiety and depression, catastrophising, pain intensity, kinesiophobia, self-efficacy, participant's global perceived effect, cost-effectiveness, and cost-utility estimated with cost diaries and quality-adjusted life years.ANALYSISLinear mixed models using an intention-to-treat principle. Incremental cost-effectiveness and cost-utility ratios will be calculated and plotted on a cost-effectiveness plane.DISCUSSIONThis study will provide useful information on a biopsychosocial intervention for chronic low back pain in primary care settings.INTRODUCTIONMultidisciplinary biopsychosocial interventions are effective at improving functional disability in people with chronic low back pain. However, these interventions are often expensive and have long waiting times before treatment starts. Therefore, implementing biopsychosocial interventions in primary care settings may be of interest. Because people with chronic low back pain show different biopsychosocial profiles, they might respond differently to specific interventions.","Erp, R M; Huijnen, I P; Verbunt, J A; Smeets, R J",2015.0,10.1016/j.jphys.2015.03.003,0,0,
5821,Supporting informed decision making for prostate specific antigen (PSA) testing on the web: an online randomized controlled trial,"ER OBJECTIVESThe aim of this study was to evaluate the effect of the Web-based PSA decision aid, Prosdex, on informed decision making.METHODSA Web-based randomized controlled trial was conducted in South Wales, United Kingdom. Men aged 50 to 75 who had not previously had a PSA test were randomly allocated to two intervention and two control groups. Participants in the intervention groups either viewed Prosdex or were given a paper version of the text. The main outcome measures were the three components of informed decision making: (1) knowledge of prostate cancer and PSA, (2) attitude toward PSA testing, (3) behavior using a proxy measure, intention to undergo PSA testing. Decisional conflict and anxiety were also measured as was uptake of the PSA test. Outcomes were measured by means of an online questionnaire for the Prosdex group, the paper version group, and one of two control groups. Six months later, PSA test uptake was ascertained from general practitioners' records, and the online questionnaire was repeated. Results are reported in terms of the Mann-Whitney U-statistic divided by the product of the two sample sizes (U/mm), line of no effect 0.50.RESULTSParticipants were 514 men. Compared with the control group that completed the initial online questionnaire, men in the Prosdex group had increased knowledge about the PSA test and prostate cancer (U/mn 0.70; 95% CI 0.62 - 0.76); less favourable attitudes to PSA testing (U/mn 0.39, 95% CI 0.31 - 0.47); were less likely to undergo PSA testing (U/mn 0.40, 95% CI 0.32 - 0.48); and had less decisional conflict (U/mn 0.32, 95% CI 0.25 - 0.40); while anxiety level did not differ (U/mn 0.50, 95% CI 0.42 - 0.58). For these outcomes there were no significant differences between men in the Prosdex group and the paper version group. However, in the Prosdex group, increased knowledge was associated with a less favourable attitude toward testing (Spearman rank correlation [rho] = -0.49, P < .001) and lower intention to undergo testing (rho = -0.27, P = .02). After six months, PSA test uptake was lower in the Prosdex group than in the paper version and the questionnaire control group (P = .014). Test uptake was also lower in the control group that did not complete a questionnaire than in the control group that did, suggesting a possible Hawthorne effect of the questionnaire in favour of PSA testing.CONCLUSIONSExposure to Prosdex was associated with improved knowledge about the PSA test and prostate cancer. Men who had a high level of knowledge had a less favourable attitude toward and were less likely to undergo PSA testing. Prosdex appears to promote informed decision making regarding the PSA test.TRIAL REGISTRATIONISRCTN48473735; http://www.controlled-trials.com/ISRCTN48473735 (Archived by WebCite at http://www.webcitation.org/5r1TLQ5nK).BACKGROUNDMen considering the prostate specific antigen (PSA) test for prostate cancer, an increasingly common male cancer, are encouraged to make informed decisions, as the test is limited in its accuracy and the natural history of the condition is poorly understood. The Web-based PSA decision aid, Prosdex, was developed as part of the UK Prostate Cancer Risk Management Programme in order to help men make such informed decisions.","Evans, R; Joseph-Williams, N; Edwards, A; Newcombe, R G; Wright, P; Kinnersley, P; Griffiths, J; Jones, M; Williams, J; Grol, R; Elwyn, G",2010.0,10.2196/jmir.1305,0,0,
5822,Demand characteristics of the research setting can influence indexes of negative affect-induced eating in obese individuals,"ER Measures of negative affect-induced eating (NAIE) are common in clinical research with obese individuals. However, previous studies suggest that measures of NAIE can be induced by social desirability tendencies or demand characteristics of the research setting. Using an experimental design, the present study tested the effects of demand characteristics of the research setting on self-report and behavioral indexes of NAIE. Obese and nonobese subjects (n=107) were randomly assigned to an experimental or control group. Experimental subjects received a lecture indicating an association between emotional eating and obesity; control subjects received no information. Outcome measures were indexes of NAIE from a questionnaire, food diaries, and food intake during a laboratory ""taste test."" We hypothesized that the association between relative body mass and NAIE would be stronger among subjects receiving the lecture manipulation than control subjects. Results indicated that NAIE indexes, particularly from food diaries, were influenced modestly by research demand characteristics. We conclude that demand characteristics of the research setting can affect indexes of NAIE among obese persons.","Faith, M S; Wong, F Y; Allison, D B",1998.0,,0,0,
5823,Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial,"ER DESIGNProspective, multicentre study capitalising on individual and motivational differences among patients and the different management policies among surgeons for treating patients with early breast cancer.SETTING12 District general hospitals, three London teaching hospitals, and four private hospitals.PATIENTS269 Women under 75 with a probable diagnosis of stage I or II breast cancer who were referred to 22 different surgeons.INTERVENTIONSSurgery and radiotherapy or adjuvant chemotherapy, or both, depending on the individual surgeon's stated preferences for managing early breast cancer.MAIN OUTCOME MEASURESAnxiety and depression as assessed by standard methods two weeks, three months, and 12 months after surgery.RESULTSOf the 269 women, 31 were treated by surgeons who favoured mastectomy, 120 by surgeons who favoured breast conservation, and 118 by surgeons who offered a choice of treatment. Sixty two of the women treated by surgeons who offered a choice were eligible to choose their surgery, and 43 of these chose breast conserving surgery. The incidences of anxiety, depression, and sexual dysfunction were high in all treatment groups. There were no significant differences in the incidences of anxiety and depression between women who underwent mastectomy and those who underwent lumpectomy. A significant effect of surgeon type on the incidence of depression was observed, with patients treated by surgeons who offered a choice showing less depression than those treated by other surgeons (p = 0.06). There was no significant difference in psychiatric morbidity between women treated by surgeons who offered a choice who were eligible to choose their treatment and those in the same group who were not able to choose. Most of the women (159/244) gave fear of cancer as their primary fear rather than fear of losing a breast. The overall incidences of psychiatric morbidity in women who underwent mastectomy and those who underwent lumpectomy were similar to those found in the Cancer Research Campaign breast conservation study. At 12 months 28% of women who underwent mastectomy in the present study were anxious compared with 26% in the earlier study, and 27% of women in the present study who underwent lumpectomy were anxious compared with 31% in the earlier study. In both the present and earlier study 21% of women who underwent mastectomy were depressed, and 19% of women who underwent lumpectomy in the present study were depressed compared with 27% in the earlier study.)CONCLUSIONSThere is still no evidence that women with early breast cancer who undergo breast conservation surgery have less psychiatric morbidity after treatment than those who undergo mastectomy. Women who surrender autonomy for decision making by agreeing to participate in randomised clinical trials do not experience any different psychological, sexual, or social problems from those women who are treated for breast cancer outside a clinical trial.OBJECTIVESTo assess outside a clinical trial the psychological outcome of different treatment policies in women with early breast cancer who underwent either mastectomy or breast conservation surgery depending on the surgeon's opinion or the patient's choice. To determine whether the extent of psychiatric morbidity reported in women who underwent breast conservation surgery was associated with their participation in a randomised clinical trial.","Fallowfield, L J; Hall, A; Maguire, G P; Baum, M",1990.0,,0,0,
5824,Is a specialist breathlessness service more effective and cost-effective for patients with advanced cancer and their carers than standard care? Findings of a mixed-method randomised controlled trial,"ER METHODS: A single-centre Phase III fast-track single-blind mixed-method randomised controlled trial (RCT) of BIS versus standard care was conducted. Participants were randomised to one of two groups (randomly permuted blocks). A total of 67 patients referred to BIS were randomised (intervention arm n = 35; control arm n = 32 received BIS after a two-week wait); 54 completed to the key outcome measurement. The primary outcome measure was a 0 to 10 numerical rating scale for patient distress due to breathlessness at two-weeks. Secondary outcomes were evaluated using the Chronic Respiratory Questionnaire, Hospital Anxiety and Depression Scale, Client Services Receipt Inventory, EQ-5D and topic-guided interviews.RESULTS: BIS reduced patient distress due to breathlessness (primary outcome: -1.29; 95%","Farquhar, M C; Prevost, A T; McCrone, P; Brafman-Price, B; Bentley, A; Higginson, I J; Todd, C; Booth, S",2014.0,10.1186/s12916-014-0194-2,0,0,
5825,Anger attacks in depressed outpatients and their response to fluoxetine,"ER ""Anger attacks"" are spells of anger that are inappropriate to the situation and have physical features resembling panic attacks. The Anger Attacks Questionnaire, designed to assess these attacks, was administered to 79 consecutive patients (25 men and 54 women, mean age 38.8 +/- 10.3 years) diagnosed as having major depression with the Structured Clinical Interview for DSM-III-R. Of these 79 depressed patients, 34 (13 men and 21 women) reported having anger attacks according to our criteria. The prevalence of anger attacks in a group of 31 younger depressed patients (48%) was significantly higher (p = .048) than that of 29 normal controls (21%) of similar age. Of the 79 depressed patients, 19 (7 men, 12 women) were treated openly with fluoxetine at 20 mg/day for at least 8 weeks. At pretreatment, 9 patients (47%) had reported anger attacks, only 3 (16%) continued to report them after treatment, and the difference was statistically significant (p less than .05).","Fava, M; Rosenbaum, J F; McCarthy, M; Pava, J; Steingard, R; Bless, E",1991.0,,0,0,
5826,"Hydrolytic degradation of the resin-dentine interface induced by the simulated pulpal pressure, direct and indirect water ageing","ER OBJECTIVES: The aim of this study was to compare the hydrolytic effects induced by simulated pulpal pressure, direct or indirect water exposure within the resin-dentine interfaces created with three ""simplified"" resin bonding systems (RBSs).METHODS: A two-step/self-etching (CSE: Clearfil SE Bond), one-step/self-etching (S3: Clearfil S3) and etch-and-rinse/self-priming (SB: Single-bond 2) adhesives were applied onto dentine and submitted to three different prolonged (6 or 12 months) ageing strategies: (i) Simulated Pulpal Pressure (SPP); (ii) Indirect Water Exposure (IWE: intact bonded-teeth); (iii) Direct Water Exposure (DWE: resin-dentine sticks). Control and aged specimens were submitted to microtensile bond strength (?TBS) and nanoleakage evaluation. Water sorption (WS) survey was also performed on resin disks. Results were analysed with two-way ANOVA and Tukey's test (p  0.05) and no evident change in nanoleakage. Conversely, SPP induced a clear formation of ""water-trees"" in CS3 and SB. WS outcomes were CS3 > SB = CSE.CONCLUSION: The hydrolytic degradation of resin-dentine interfaces depend upon the type of the in vitro ageing strategy employed in the experimental design. Direct water exposure remains the quickest method to age the resin-dentine bonds. However, the use of SPP may better simulate the in vivo scenario. However, the application of a separate hydrophobic solvent-free adhesive layer may reduce the hydrolytic degradation and increase the longevity of resin-dentine interfaces created with simplified adhesives.","Feitosa, V P; Leme, A A; Sauro, S; Correr-Sobrinho, L; Watson, T F; Sinhoreti, M A; Correr, A B",2012.0,10.1016/j.jdent.2012.09.011,0,0,
5827,Effects of Person-Centered Physical Therapy on Fatigue-Related Variables in Persons With Rheumatoid Arthritis: A Randomized Controlled Trial,"ER Objective To examine effects of person-centered physical therapy on fatigue and related variables in persons with rheumatoid arthritis (RA). Design Randomized controlled trial. Setting Hospital outpatient rheumatology clinic. Participants Persons with RA aged 20 to 65 years (N=70): intervention group (n=36) and reference group (n=34). Interventions The 12-week intervention, with 6-month follow-up, focused on partnership between participant and physical therapist and tailored health-enhancing physical activity and balancing life activities. The reference group continued with regular activities; both groups received usual health care. Main Outcome Measures Primary outcome was general fatigue (visual analog scale). Secondary outcomes included multidimensional fatigue (Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire) and fatigue-related variables (ie, disease, health, function). Results At posttest, general fatigue improved more in the intervention group than the reference group (P=.042). Improvement in median general fatigue reached minimal clinically important differences between and within groups at posttest and follow-up. Improvement was also observed for anxiety (P=.0099), and trends toward improvements were observed for most multidimensional aspects of fatigue (P=.023-.048), leg strength/endurance (P=.024), and physical activity (P=.023). Compared with the reference group at follow-up, the intervention group improvement was observed for leg strength/endurance (P=.001), and the trends toward improvements persisted for physical (P=.041) and living-related (P=.031) aspects of fatigue, physical activity (P=.019), anxiety (P=.015), self-rated health (P=.010), and self-efficacy (P=.046). Conclusions Person-centered physical therapy focused on health-enhancing physical activity and balancing life activities showed significant benefits on fatigue in persons with RA.","Feldthusen, C; Dean, E; Forsblad-d'Elia, H; Mannerkorpi, K",2016.0,10.1016/j.apmr.2015.09.022,0,0,
5828,Respiratory training as strategy to prevent cognitive decline in aging: a randomized controlled trial,"ER OBJECTIVE: To investigate the effect of aerobic physical exercises and respiratory training on the blood oxygenation, pulmonary functions, and cognition of the elderly.DESIGN: This was a randomized and controlled trial with three parallel groups. A total of 195 community-dwelling elderly were assessed for eligibility; only n=102 were included and allocated into the three groups, but after 6 months, n=68 were analyzed in the final sample. Participants were randomized into a social interaction group (the control group), an aerobic exercise group (the ""walking"" group), or a respiratory training group (the ""breathing"" group). The main outcome measures were the Wechsler Adult Intelligence Scale, Wechsler Memory Scale, Wisconsin Card Sorting Test, respiratory muscular strength, cirtometry (thoracic-abdominal circumference); oxygen saturation in arterial blood (SpO2), and hemogram.RESULTS: No differences were observed for any of the blood parameters. Aerobic exercise and respiratory training were effective in improving the pulmonary parameters. Better cognitive performance was observed for the breathing group as regards abstraction and mental flexibility. The walking group remained stable in the cognitive performance of most of the tests, except attention. The control group presented worst performance in mental manipulation of information, abstraction, mental flexibility, and attention.CONCLUSION: Our results showed that both the walking and breathing groups presented improvement of pulmonary function. However, only the breathing group showed improved cognitive function (abstraction, mental flexibility). The improvement in cognitive functions cannot be explained by blood parameters, such as SpO2, erythrocytes, hemoglobin, and hematocrit.BACKGROUND: Inadequate oxygenation may cause lesions and brain atrophy during aging. Studies show a positive association between pulmonary function and the cognitive performance of individuals from middle age on.","Ferreira, L; Tanaka, K; Santos-Galduróz, R F; Galduróz, J C",2015.0,10.2147/CIA.S79560,0,0,
5829,Does internet-based prevention reduce the risk of relapse for anorexia nervosa?,"ER Technological advancements allow new approaches to psychotherapy via electronic media. The eating disorder literature currently contains no studies on internet intervention in anorexia nervosa (AN). This study presents a RCT on an internet-based relapse prevention program (RP) over nine months after inpatient treatment for AN. The sample comprised 258 women, randomized to the RP or treatment as usual (TAU). Expert- and self-ratings were evaluated by intent-to-treat analyses. Concerning age, age at onset and comorbidity, both groups were comparable at randomization. During the RP, the intervention group gained weight while the TAU group had minimal weight loss. RP completers gained significantly more body weight than patients in the TAU condition. Group-by-time comparisons for eating-related cognitions and behaviors and general psychopathology showed a significantly more favorable course in the RP program for ""sexual anxieties"" and ""bulimic symptoms"" (interview), and ""maturity fears"" and ""social insecurity"" (EDI-2). General psychopathology showed no significant group-by-time interaction. Important factors for successful relapse prevention were adherence to the intervention protocol and increased spontaneity. Considering the unfavorable course and chronicity of anorexia nervosa (AN), internet-based relapse prevention in AN following inpatient treatment appears a promising approach. Future internet-based programs may be further improved and enhanced.","Fichter, M M; Quadflieg, N; Nisslmüller, K; Lindner, S; Osen, B; Huber, T; Wünsch-Leiteritz, W",2012.0,10.1016/j.brat.2011.12.003,0,0,
5830,Psychological aspects of genital human papillomavirus infection: a preliminary report,"ER Genital human papillomavirus (HPV) infection can lead to self-inflicted blame and hypochondriac fears as well as to problems with sexuality. The aim of this study was to assess the psychological and psychodynamic aspects of patients with widespread genital HPV infection entering into a clinical trial in which they were randomly assigned to three treatment groups: CO2 laser ablation, intramuscular interferon-alpha, CO2 laser ablation plus intramuscular interferon-alpha. Fifty-one patients were studied. Patients were asked to take a series of questionnaires which included a self-rating questionnaire for gathering information on sexuality, emotional relationship with the partner and social life. A visual analog scale was used to rate intensity of pain during sexual intercourse. Each patient went also through an in-depth interview with a clinical psychologist and filled out two personality tests to measure depression (CDQ = IPAT depression test) and anxiety (ASQ = IPAT anxiety test). Results indicated a high percentage of sexual impairments after therapy (28 cases), presence of fear of cancer (14 cases) and worsenings in the emotional relationship with the partner. No difference was found among groups of treatment.","Filiberti, A; Tamburini, M; Stefanon, B; Merola, M; Bandieramonte, G; Ventafridda, V; Palo, G",1993.0,,0,0,
5831,The association between body image and smoking cessation among individuals living with HIV/AIDS,"ER Lower smoking cessation rates are associated with body image concerns in the general population. This relationship is particularly important to study in individuals living with HIV/AIDS due to alarmingly high smoking rates and considerable bodily changes experienced with HIV disease progression and treatment. The association between body image and smoking cessation rates was examined among individuals living with HIV/AIDS participating in a smoking cessation intervention. Body image concerns were significantly associated with depression, anxiety, stress, and social support, all variables known to affect cessation rates. However, reduced quit rates were found among individuals reporting elevated and low levels of body image concerns at the end of treatment. These findings suggest a unique relationship between smoking and body image among individuals living with HIV/AIDS. Further research is needed to examine these effects and whether moderate levels of body image concerns in this population reflect realistic body perceptions associated with positive mental health.","Fingeret, M C; Vidrine, D J; Arduino, R C; Gritz, E R",2007.0,10.1016/j.bodyim.2007.01.005,0,0,
5832,Interpersonal psychotherapy and pharmacotherapy for post-stroke depression. Feasibility and effectiveness,"ER PATIENTS AND METHODSPost-stroke depression was found in 35% of 485 stroke patients examined. Seventy-four PSD patients were randomised to one of three treatment conditions. Severity of depression was measured by the Hamilton Depression Rating Scale and the Hospital Anxiety and Depression Scale. The Barthel Index and a questionnaire for health-related quality of life were used as measurements of rehabilitation outcome.RESULTSThere were no significant differences between the three groups in patient mood or rehabilitation outcome. Concerning the severity of depression, quality of life, and social support, all patients showed benefits from antidepressive treatment. In addition a correlation was found between rehabilitation outcome and depression.CONCLUSIONIn this feasibility study all antidepressive treatments were successfully implemented in the rehabilitation of post-stroke depressed patients. Combination therapy (interpersonal psychotherapy plus medication) was as effective as one of those elements alone. Because of the small sample size however, further randomized trials are required.BACKGROUNDOnly few studies investigated the effectiveness of psychotherapy in post-stroke depression (PSD). The aim of this feasibility study was to compare interpersonal psychotherapy, pharmacotherapy, and their combination regarding depression and rehabilitation outcome.","Finkenzeller, W; Zobel, I; Rietz, S; Schramm, E; Berger, M",2009.0,10.1007/s00115-008-2649-1,0,0,
5833,Randomized trial of light versus deep sedation on mental health after critical illness,,"Finkielman, J D",2010.0,10.1097/CCM.0b013e3181c30cbc,0,0,
5834,Neuropsychologic and clinical effects of protirelin tartrate in patients with stroke sequelae,"ER An ischemic cerebral lesion involves a progressive metabolic damage to neurons and neurotransmitter alterations. The consequent functional deficits give rise to the neurological and cognitive impairment seen in most stroke patients. As soon as neuronal loss brings synaptic activities to an end, a maximum release of neurotransmitters and peptides occurs, no longer balanced by effective synthesis activity. This unbalanced control of neurotransmitters causes the typical neurological and psychological disturbances of the post-stroke phase. In particular, the unbalance of the catecholaminergic and/or serotoninergic system seems to be related to emotional disturbances, whereas the cholinergic unbalance seems to be the cause of cognitive impairment (which is manifested in memory and learning capacity deficits). The recent demonstration that peptides also act as synaptic transmission modulators supplied the rationale to propose the use of neuropeptides as a substitutive therapy in many neurodegenerative pathologies and particularly in post-traumatic encephalopathies and stroke sequelae. Furthermore, one of these neuropeptides, protirelin, has been proved to have neurotransmitter and neuromodulator activities as well as being capable of inducing the functional maturity and regeneration of neurons and improving functional recovery and vigilance in cases of stroke sequelae. A double-blind multicenter trial versus placebo was therefore performed to evaluate the efficacy and tolerability of protirelin tartrate (TRH-T) in this pathology. The neuropsychological functions (attentiveness, learning capacity, memory) were evaluated in 136 patients with stroke sequelae, treated with TRH-T or with placebo.(ABSTRACT TRUNCATED AT 250 WORDS)","Fioravanti, M",1990.0,,0,0,
5835,Dantrolene sodium in traumatic muscle contracture: double-blind clinical and pharmacological trial,"ER Thirty athletes with muscular contractures were enrolled in a double-blind study of dantrolene sodium and placebo to evaluate the decontracture activity and tolerance of the drug after eight days of treatment. The efficacy of the drug was assessed by studying pain at rest, during movement, and during pressure, as well as muscular tension and functional recovery. Twenty-eight patients completed the study. At the end of treatment, a decrease in pain was observed at rest (71.4% of patients treated with dantrolene and 21.4% of placebo-treated patients), during movement (78.6% and 35.7%, respectively), and during compression. The most noticeable effects were seen in the reduction of muscular tension (100% in the patients treated with dantrolene sodium and 35.7% in the placebo-treated patients) and in functional recovery (100% and 28%, respectively). In addition to the clinical study, an evaluation of the effects of dantrolene and placebo on overall performance and on the action of the respiratory system was conducted with six healthy subjects by means of basal respiratory measurement and ergospirometry before and after single-dose treatment. This study showed that dantrolene sodium is useful in the treatment of traumatic contracture, and that it does not alter an individual's overall performance. Dantrolene sodium represents a valid treatment to accompany analgesic, anti-inflammatory, and rehabilitation therapy of posttraumatic lesions in athletes.","Flacco, L; Colozzi, A; Ripari, P; Pieralisi, G",1989.0,,0,0,
5836,Glutamine attenuates post-traumatic glutathione depletion in human muscle,"ER Glutathione is quantitatively the most important endogenous scavenger system. Glutathione depletion in skeletal muscle is pronounced following major trauma and sepsis in intensive care unit patients. Also, following elective surgery, glutathione depletion occurs in parallel with a progressive decline in muscle glutamine concentration. The present study was designed to test the hypothesis that glutamine supplementation may counteract glutathione depletion in a human trauma model. A homogeneous group of patients (n = 17) undergoing a standardized surgical procedure were prospectively randomly allocated to receive glutamine (0.56 g x day(-1) x kg(-1)) or placebo as part of isonitrogenous and isocaloric nutrition. Percutaneous muscle biopsies and blood samples were taken pre-operatively and at 24 and 72 h after surgery. The concentrations of muscle glutathione and related amino acids were determined in muscle tissue and plasma. In the control (unsupplemented) subjects, total muscle glutathione had decreased by 47+/-8% and 37+/-11% and reduced glutathione had decreased by 53+/-10% and 45+/-16% respectively at 24 and 72 h after surgery (P < 0.05). In contrast, in the glutamine-supplemented group, no significant post-operative decreases in total or reduced glutathione were seen following surgery. Muscle free glutamine had decreased at 72 h after surgery in both groups, by 41.4+/-14.8% (P < 0.05) in the glutamine-supplemented group and by 46.0+/-14.3% (P < 0.05) in the control group. In conclusion, the present study demonstrates that intravenous glutamine supplementation attenuates glutathione depletion in skeletal muscle in humans following standardized surgical trauma.","Fläring, U B; Rooyackers, O E; Wernerman, J; Hammarqvist, F",2003.0,10.1042/CS20020198,0,0,
5837,Mindfulness-based cognitive therapy for individuals whose lives have been affected by cancer: a randomized controlled trial,"ER METHODParticipants (N = 115) diagnosed with cancer, across site and stage, were randomly allocated to either the treatment or the wait-list condition. Treatment was conducted at 1 site, by a single therapist, and involved participation in 8 weekly 2-hr sessions that focused on mindfulness. Participants meditated for up to 1 hr daily and attended an additional full-day session during the course. Participants were assessed before treatment and 10 weeks later; this second assessment occurred immediately after completion of the program for the treatment condition. The treatment condition was also assessed at 3 months postintervention. All postinitial assessments were completed by assessors who were blind to treatment allocation.RESULTSThere were large and significant improvements in mindfulness (effect size [ES] = 0.55), depression (ES = 0.83), anxiety (ES = 0.59), and distress (ES = 0.53) as well as a trend for quality of life (ES = 0.30) for MBCT participants compared to those who had not received the training. The wait-list group was assessed before and after receiving the intervention and demonstrated similar change.CONCLUSIONSThese improvements represent clinically meaningful change and provide evidence for the provision of MBCT within oncology settings.OBJECTIVEThis study evaluated the effectiveness of mindfulness-based cognitive therapy (MBCT) for individuals with a diagnosis of cancer.","Foley, E; Baillie, A; Huxter, M; Price, M; Sinclair, E",2010.0,10.1037/a0017566,0,0,
5838,Group psychotherapy during radiotherapy: effects on emotional and physical distress,"ER METHODTwenty-four patients receiving radiotherapy were randomly selected for group psychotherapy (six patients per group, 90-minute weekly sessions for 10 weeks). Another 24 patients served as control subjects. Each patient was given the Schedule for Affective Disorders and Schizophrenia (SADS) at the onset of radiotherapy, midway through radiotherapy, at the end of radiotherapy, and 4 and 8 weeks after radiotherapy ended.RESULTSThe combined SADS items for depression, pessimism and hopelessness, somatic preoccupation and worry, social isolation and withdrawal, insomnia, and anxiety and agitation were used as a measure of emotional distress. The combined SADS items for anorexia, nausea and vomiting, and fatigue were used as a measure of physical distress. By 4 weeks after the end of radiotherapy, the patients who received group psychotherapy showed significant decreases in both emotional and physical symptoms, and the decreases were greater than those for the control patients. The subjects who initially seemed unaware of their cancer diagnoses had the lowest baseline levels of emotional and physical distress, but 4 weeks after the end of radiotherapy they had high distress levels.CONCLUSIONSGroup therapy may enhance quality of life for cancer patients undergoing radiotherapy by reducing their emotional and physical distress. The degree to which patients acknowledge the diagnosis of malignancy may be a factor in their initial distress level and their response to radiotherapy and group therapy.OBJECTIVEThe purpose of this study was to ascertain whether group psychotherapy during radiotherapy for cancer significantly decreases patients' emotional and physical distress.","Forester, B; Kornfeld, D S; Fleiss, J L; Thompson, S",1993.0,10.1176/ajp.150.11.1700,0,0,
5839,Response intensity in content-specific fear conditioning comparing 20% versus 13% CO2-enriched air as unconditioned stimuli,"ER This study examined the relation between the intensity of CO2-induced psychophysiological responses and content-specific fear conditioning. Sex-balanced groups of undergraduates (N = 96) were assigned to 1 of 3 conditioned stimuli (CSs) differing in fear-relevance, and within each CS, to either 20% or 13% CO2-enriched air (unconditioned stimuli [UCS]). Several psychophysiological measures were assessed before, during, and following conditioning phases. Consistent with expectation, electrodermal and cardiac conditioned responses were larger and more resistant to extinction when associated with fear-relevant compared with fear-irrelevant stimuli, and this overall effect of fear-relevance was more robust to the more intense UCS. Severity and frequency of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) panic symptoms also varied reliably with UCS intensity, and women reported more distress and symptoms than men. Overall, the findings suggest that content-specific fear conditioning is mediated, in part, by the intensity of the bodily response. The authors discuss clinical and theoretical implications for understanding fear onset in the absence of obvious environmental pain or trauma.","Forsyth, J P; Eifert, G H",1998.0,,0,0,
5840,Efficacy of the addition of interferential current to Pilates method in patients with low back pain: a protocol of a randomized controlled trial,"ER BACKGROUND: Chronic low back pain is one of the four most common diseases in the world with great socioeconomic impact. Supervised exercise therapy is one of the treatments suggested for this condition; however, the recommendation on the best type of exercise is still unclear. The Pilates method of exercise is effective in reducing pain and disability in these patients, as well as the analgesia promoted by interferential current. Currently, the literature lacks information on the efficacy of the association of these two techniques in the short- and medium-term than performing one of the techniques isolated. The objective of this study will be to evaluate the efficacy of adding interferential current to the Pilates method exercises for the treatment of patients with chronic nonspecific low back pain in the short- and medium-term.METHODS/DESIGN: This study will be a randomized controlled trial with two arms and blinded evaluator, conducted at an outpatient Physical Therapy Department in Brazil. Patients with nonspecific chronic low back pain and pain equal to or greater than 3 in the Pain Numerical Rating Scale (0/10) will be randomly assigned to one of two groups: Group with active interferential current?+?Pilates (n?=?74) will be submitted to the active interferential current associated to the modified Pilates exercises, and Group with sham interferential current?+?Pilates (n?=?74) will be submitted to the sham interferential current associated with the modified Pilates exercises during 18 sessions. The outcomes pain intensity, pressure pain threshold, general and specific disability, global perceived effect and kinesiophobia will be evaluated by a blinded assessor at baseline, six weeks and six months after randomization.DISCUSSION: Because of the study design, blinding of the participants and the therapists involved in the study will not be possible. The results of this study could contribute to the process of clinical decision- making for the improvement of pain and disability in participants with nonspecific chronic low back pain.TRIAL REGISTRATION: ClinicalTrials.gov NCT01919268.","Franco, Y R; Liebano, R E; Moura, K F; Oliveira, N T; Miyamoto, G C; Santos, M O; Cabral, C M",2014.0,10.1186/1471-2474-15-420,0,0,
5841,Accelerated nitrogen loss after traumatic injury is not attenuated by achievement of energy balance,"ER METHODS: Surgical intensive care unit of a level I trauma center in a university medical center. Trauma patients expected to be mechanically ventilated for at least 4 days were randomly assigned to one of three parenteral feeding groups: (1) nonprotein calorie group: dextrose and lipid intake equal to measured energy expenditure; (2) total calorie group: dextrose, lipid, and protein intake equal to measured energy expenditure; and (3) hypocaloric group: dextrose and lipid intake equal to 50% of measured energy expenditure. Target protein intake for all groups was 1.7 g/kg body wt. On day 4 of nutrition support, a 24-hour balance study was conducted. Urine urea and total nitrogen production, 3-methylhistidine excretion, energy expenditure, and substrate utilization were measured.RESULTS: Despite significant differences in nonprotein and total calorie balance among the groups, nitrogen loss, nitrogen balance, and catabolic rate were not significantly different. Nitrogen loss correlated with catabolic rate but not with energy expenditure or energy balance. Catabolic rate was associated with energy expenditure but not with energy balance. Nitrogen loss was positively correlated with the percentage of nonprotein energy expenditure met by nonprotein calorie intake.CONCLUSIONS: Achievement of energy balance (nonprotein or total energy) failed to decrease catabolic rate or nitrogen loss acutely in multiple trauma patients. Provision of caloric intake equal to energy expenditure does not seem necessary during the acute phase of posttraumatic catabolic illness.BACKGROUND: We wanted to determine if achievement of energy balance decreases myofibrillar protein catabolism and nitrogen loss during posttraumatic catabolic illness.","Frankenfield, D C; Smith, J S; Cooney, R N",1997.0,10.1177/0148607197021006324,0,0,
5842,Up-regulation of Glutamate in Painful Human Supraspinatus Tendon Tears,"ER BACKGROUND: Pain related to rotator cuff tendinopathy is a common problem, but little is known regarding the origin and cause of pain from the tendon substance. No study to date has looked at the association between tissue changes and patient outcomes.PURPOSE: To describe the peripheral neuronal phenotype in painful rotator cuff tears and to determine correlations between tissue changes and clinical outcome measures.STUDY DESIGN: Controlled laboratory study.METHODS: Tissue samples of the supraspinatus were taken from patients undergoing surgery to repair a rotator cuff tendon tear. Patients were classified as having small/medium or large/massive tears. Control tissue was obtained from patients undergoing surgery for posttraumatic shoulder instability. Immunohistochemical techniques were performed using antibodies to known nociceptive and neuronal markers as well as general tissue structural markers.RESULTS: There was no correlation between tissue changes and patient-reported outcomes. A significant increase in the expression of glutamate was seen in tendon tears. There were differences in the expression of metabotropic and ionotropic glutamate receptors. Expression changes were also observed for markers of the sensory and autonomic systems; however, no differences were found in neurotrophins.CONCLUSION: Glutamate and the glutaminergic system play a key role in painful human tendon tears; however, the exact role is still uncertain, as glutamate is highly involved in both pain and metabolic pathways.CLINICAL RELEVANCE: This study has identified a number of markers that could be potential therapeutic targets.","Franklin, S L; Dean, B J; Wheway, K; Watkins, B; Javaid, M K; Carr, A J",2014.0,10.1177/0363546514532754,0,0,
5843,Cognitive Behavior Therapy for Depression and Self-Care in Heart Failure Patients: A Randomized Clinical Trial,"ER IMPORTANCE: Depression and inadequate self-care are common and interrelated problems that increase the risks of hospitalization and mortality in patients with heart failure (HF).OBJECTIVE: To determine the efficacy of an integrative cognitive behavior therapy (CBT) intervention for depression and HF self-care.DESIGN, SETTING, AND PARTICIPANTS: Randomized clinical trial with single-blind outcome assessments. Eligible patients were enrolled at Washington University Medical Center in St Louis between January 4, 2010, and June 28, 2013. The primary data analyses were conducted in February 2015. The participants were 158 outpatients in New York Heart Association Class I, II, and III heart failure with comorbid major depression.INTERVENTIONS: Cognitive behavior therapy delivered by experienced therapists plus usual care (UC), or UC alone. Usual care was enhanced in both groups with a structured HF education program delivered by a cardiac nurse.MAIN OUTCOMES AND MEASURES: The primary outcome was severity of depression at 6 months as measured by the Beck Depression Inventory. The Self-Care of Heart Failure Index Confidence and Maintenance subscales were coprimary outcomes. Secondary outcomes included measures of anxiety, depression, physical functioning, fatigue, social roles and activities, and quality of life. Hospitalizations and deaths were exploratory outcomes.RESULTS: One hundred fifty-eight patients were randomized to UC (n = 79) or CBT (n = 79). Within each arm, 26 (33%) of the patients were taking an antidepressant at baseline. One hundred thirty-two (84%) of the participants completed the 6-month posttreatment assessments; 60 (76%) of the UC and 58 (73%) of the CBT participants completed every follow-up assessment (P =?.88). Six-month depression scores were lower in the CBT than the UC arm on the Beck Depression Inventory (BDI-II) (12.8 [10.6] vs 17.3 [10.7]; P =?.008). Remission rates differed on the BDI-II (46% vs 19%; number needed to treat [NNT] = 3.76; 95% CI, 3.62-3.90; P <?.001) and the Hamilton Depression Scale (51% vs 20%; NNT = 3.29; 95% CI, 3.15-3.43; P <?.001). The groups did not differ on the Self-Care Maintenance or Confidence subscales. The mean (SD) Beck Depression Inventory scores 6 months after randomization were lower in the CBT (12.8 [10.6]) than the UC arm (17.3 [10.7]), P =?.008. There were no statistically significant differences between the groups on the Self-Care Maintenance or Confidence subscale scores or on physical functioning measures. Anxiety and fatigue scores were lower and mental- and HF-related quality of life and social functioning scores were higher at 6 months in the CBT than the UC arm, and there were fewer hospitalizations in the intervention than the UC arm.CONCLUSIONS AND RELEVANCE: A CBT intervention that targets both depression and heart failure self-care is effective for depression but not for HF self-care or physical functioning relative to enhanced UC. Additional benefits include reduced anxiety and fatigue, improved social functioning, and better health-related quality of life.TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01028625.","Freedland, K E; Carney, R M; Rich, M W; Steinmeyer, B C; Rubin, E H",2015.0,10.1001/jamainternmed.2015.5220,0,0,
5844,Treatment of depression after coronary artery bypass surgery: a randomized controlled trial,"ER OBJECTIVE: To test the efficacy of 2 nonpharmacological interventions for depression after coronary artery bypass surgery compared with usual care.DESIGN: A 12-week, randomized, single-blind clinical trial with outcome evaluations at 3, 6, and 9 months.SETTING: Outpatient research clinic at Washington University School of Medicine, St Louis, Missouri.PATIENTS: One hundred twenty-three patients who met the DSM-IV criteria for major or minor depression within 1 year after surgery.INTERVENTION: Twelve weeks of cognitive behavior therapy or supportive stress management. Approximately half of the participants were taking nonstudy antidepressant medications.MAIN OUTCOME MEASURE: Remission of depression, defined as a score of less than 7 on the 17-item Hamilton Rating Scale for Depression.RESULTS: Remission of depression occurred by 3 months in a higher proportion of patients in the cognitive behavior therapy (71%) and supportive stress-management (57%) arms than in the usual care group (33%) (chi(2)(2) = 12.22, P = .002). Covariate-adjusted Hamilton scores were lower in the cognitive behavior therapy (mean [standard error], 5.5 [1.0]) and the supportive stress-management (7.8 [1.0]) arms than in the usual care arm (10.7 [1.0]) at 3 months. The differences narrowed at 6 months, but the remission rates differed again at 9 months (73%, 57%, and 35%, respectively; chi(2)(2) = 12.02, P = .003). Cognitive behavior therapy was superior to usual care at most points on secondary measures of depression, anxiety, hopelessness, stress, and quality of life. Supportive stress management was superior to usual care only on some of the measures.CONCLUSIONS: Both cognitive behavior therapy and supportive stress management are efficacious for treating depression after coronary artery bypass surgery, relative to usual care. Cognitive behavior therapy had greater and more durable effects than supportive stress management on depression and several secondary psychological outcomes.TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00042198.CONTEXT: There has been little research on the treatment of depression after coronary artery bypass surgery.","Freedland, K E; Skala, J A; Carney, R M; Rubin, E H; Lustman, P J; D√°vila-Rom√°n, V G; Steinmeyer, B C; Hogue, C W",2009.0,10.1001/archgenpsychiatry.2009.7,0,0,
5845,Understanding acute psychological distress following natural disaster,"ER A household probability sample of 229 adults was interviewed four to seven months after the Sierra Madre earthquake (June 28, 1991; Los Angeles County). The study predicted psychological distress from these variables: demographics, traumatic event history, low magnitude event history, earthquake related threat perceptions, and earthquake related resource loss. Based on the Conservation of Resources (COR) stress model, it was predicted that resource loss would be central in predicting psychological distress. Three major hypotheses were supported: (1) resource loss was positively associated with psychological distress; (2) resource loss predicted psychological distress when other predictors were statistically controlled; and (3) resource loss was associated with mild to moderate elevations in of psychological distress. The findings support COR stress theory. Theoretical and practical implications are discussed.","Freedy, J R; Saladin, M E; Kilpatrick, D G; Resnick, H S; Saunders, B E",1994.0,,0,0,
5846,Imagery intervention for recovering breast cancer patients: clinical trial of safety and efficacy,"ER In a phase I National Cancer Institute (NCI)-funded clinical trial, 34 breast cancer survivors, six weeks to one year post-treatment, were recruited to participate in a 6-class, 8-week long imagery stress reduction program entitled ""Envision the Rhythms of Life."" Patients practiced imagery during and between sessions. Outcomes for quality of life and cortisol rhythm were assessed pre- to post-intervention, in two subsets of survivors (intravenous [IV] chemotherapy, or no IV chemotherapy). Thirty survivors completed the 8-week program. Quality of life outcomes demonstrated statistically and clinically significant outcomes for the functional assessment of cancer therapy-general (FACT-G) global index (p<.001), representing improvements in survivor quality of life related to physical, social/family, emotional, and function well-being. Survivors also improved significantly on the breast cancer (p<.001) and spiritual subscales (p = .008.) Brief symptom inventory (BSI) assessment reported significant improvement for the global index (p<.001) which included the categories of depression, somatization and anxiety. At eight weeks, cortisol rhythm, a biochemical indicator of stress and likelihood of cancer recurrence, produced a trend toward improvement for the fifth time point of the day (p = .18). Likert-based stress scales showed highly significant reductions in stress (p<.0001) with subjects practicing imagery the most producing the best scores. Outcomes suggest the imagery program may significantly improve survivor quality of life and reduce stress.","Freeman, L; Cohen, L; Stewart, M; White, R; Link, J; Palmer, J L; Welton, D",2008.0,,0,0,
5847,Mood effects of alcohol and expectancies across the menstrual cycle,"ER To examine menstrual cycle phase variations in alcohol absorption and mood before and after drinking alcohol, 96 volunteers female heavy drinkers, unaware they were in a menstrual cycle study, were randomly assigned to 12 equal-sized groups with controls for the effects of alcohol, expectancy, and menstrual cycle phase. Alcohol subjects received sufficient alcohol to raise their blood alcohol level to .07 mg %. Mood, assessed with the Profile of Mood States, did not differ across menstrual cycle phases at baseline, failing to support the notion of menstrual phase-related moods. The only mood changes were a Beverage by Trials interaction on the Vigor and Confusion scales and a main effect for trials on the Tension-Anxiety and Vigor scales. Peak intoxication level did not differ across phases. The present findings of an absence of menstrual cycle phase-related differences in mood or alcohol absorption support social learning theory and suggest that phasic variations in mood are socially learned. They also suggest the need for systematic study of methodologic factors in this research area.","Freitag, W J; Adesso, V J",1993.0,,0,0,
5848,Randomised controlled assessment of non-directive psychotherapy versus routine general-practitioner care,"ER METHODSWe carried out a prospective, randomised, controlled trial of brief, non-directive psychotherapy and routine general-practice care. Therapists adhered to a non-directive Rogerian model of psychotherapy. Between one and 12 sessions of psychotherapy were given over 12 weeks in 14 general practices in north London, UK. Of 136 patients with emotional difficulties, mainly depression, 70 patients were randomly assigned to the therapist and 66 to the general practitioner. Depression, anxiety, other mental-disorder symptoms, and social adjustment were measured by self-report at baseline, 3 months, and 9 months. Patients' satisfaction was also measured by self-report at 3 and 9 months.FINDINGSAll patients improved significantly over time. There were no significant differences between the groups receiving brief psychotherapy and routine general-practitioner care. Patients assigned brief psychotherapy were more satisfied with the help they received than those assigned to the general practitioner at both 3 and 9 months' follow-up (mean scores on satisfaction scale 50.9 [SD 7.9] vs 44.4 [9.8] and 45.6 [9.4] vs 37.1 [11.2], respectively).INTERPRETATIONGeneral-practitioner care is as effective as brief psychotherapy for patients usually referred by doctors to practice-based psychotherapists. Patients with emotional difficulties prefer brief psychotherapy from a counsellor to care from their general practitioner.BACKGROUNDWe compared the efficacy of and patients' satisfaction with general-practice-based psychotherapists with those of general practitioners in providing treatment to people with emotional difficulties.","Friedli, K; King, M B; Lloyd, M; Horder, J",1997.0,,0,0,
5849,Proactive tobacco treatment and population-level cessation: a pragmatic randomized clinical trial,"ER IMPORTANCE: Current tobacco use treatment approaches require smokers to request treatment or depend on the provider to initiate smoking cessation care and are therefore reactive. Most smokers do not receive evidence-based treatments for tobacco use that include both behavioral counseling and pharmacotherapy.OBJECTIVE: To assess the effect of a proactive, population-based tobacco cessation care model on use of evidence-based tobacco cessation treatments and on population-level smoking cessation rates (ie, abstinence among all smokers including those who use and do not use treatment) compared with usual care among a diverse population of current smokers.DESIGN, SETTING, AND PARTICIPANTS: The Veterans Victory Over Tobacco Study, a pragmatic randomized clinical trial involving a population-based registry of current smokers aged 18 to 80 years. A total of 6400 current smokers, identified using the Department of Veterans Affairs (VA) electronic medical record, were randomized prior to contact to evaluate both the reach and effectiveness of the proactive care intervention.INTERVENTIONS: Current smokers were randomized to usual care or proactive care. Proactive care combined (1) proactive outreach and (2) offer of choice of smoking cessation services (telephone or in-person). Proactive outreach included mailed invitations followed by telephone outreach to motivate smokers to seek treatment with choice of services.MAIN OUTCOMES AND MEASURES: The primary outcome was 6-month prolonged smoking abstinence at 1 year and was assessed by a follow-up survey among all current smokers regardless of interest in quitting or treatment utilization.RESULTS: A total of 5123 participants were included in the primary analysis. The follow-up survey response rate was 66%. The population-level, 6-month prolonged smoking abstinence rate at 1 year was 13.5% for proactive care compared with 10.9% for usual care (P =?.02). Logistic regression mixed model analysis showed a significant effect of the proactive care intervention on 6-month prolonged abstinence (odds ratio [OR], 1.27 [95% CI, 1.03-1.57]). In analyses accounting for nonresponse using likelihood-based not-missing-at-random models, the effect of proactive care on 6-month prolonged abstinence persisted (OR, 1.33 [95% CI, 1.17-1.51]).CONCLUSIONS AND RELEVANCE: Proactive, population-based tobacco cessation care using proactive outreach to connect smokers to evidence-based telephone or in-person smoking cessation services is effective for increasing long-term population-level cessation rates.TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00608426.","Fu, S S; Ryn, M; Sherman, S E; Burgess, D J; Noorbaloochi, S; Clothier, B; Taylor, B C; Schlede, C M; Burke, R S; Joseph, A M",2014.0,10.1001/jamainternmed.2014.177,0,0,
5850,A psychosocial group intervention for Japanese women with primary breast carcinoma,"ER METHODSThe patient selection criteria were age younger than 65 years, lymph node metastasis positive and/or histologic or nuclear Grade 2-3, and surgery undergone within the previous 4-18 months as of the start of the study. We conducted a 6-week, structured, psychosocial group intervention. The intervention consisted of health education, coping skills training, stress management, and psychologic support. Subjects were assessed for psychologic distress and coping by administering the Profile of Mood States (POMS), Mental Adjustment to Cancer (MAC) scale, and Hospital Anxiety and Depression (HADS) scale at the baseline, at 6 weeks, and at 6 months.RESULTSFifty (33%) of the 151 patients participated and were randomized, and 46 (30%) completed the study. The experimental group had significantly lower scores than the controls for total mood disturbance and significantly higher scores for vigor on the POMS, and significantly higher scores for fighting spirit on the MAC at the end of the 6-week intervention. These improvements were sustained over 6 months of follow-up.CONCLUSIONSThe results of this study suggest that a short term psychosocial group intervention produces significant long term improvement in the quality of life of Japanese patients with primary breast carcinoma.BACKGROUNDTo the authors' knowledge, there had been no evidence for the efficacy of psychosocial intervention among Japanese cancer patients. The objective of this study was to determine the effect of a psychosocial group intervention in reducing psychologic distress and enhancing coping in this population in a randomized controlled trial.","Fukui, S; Kugaya, A; Okamura, H; Kamiya, M; Koike, M; Nakanishi, T; Imoto, S; Kanagawa, K; Uchitomi, Y",2000.0,,0,0,
5851,Intervention for aggressive victims of school bullying in Hong Kong: a longitudinal mixed-methods study,"ER The distinction between aggressive and passive victims of school bullying is well documented. Aggressive victims exhibit restlessness and hot-temperedness, are easily provoked, and take revenge when irritated, whereas passive victims are quiet and timid when attacked or insulted and withdraw rather than retaliate. To date, there has been no evidence-based evaluative study examining interventions designed specifically to reduce aggressive victimization, and neither has there been an inclusive assessment screening of high-risk aggressive victims prior to intervention. This study addressed these research gaps by employing multi-stage assessment procedures and a mixed-mode methodology in a one-year longitudinal design. Data were collected from student self-reports, parent and teacher rating scales, and individual structured interviews with students, parents and teachers. A total of 269 potential high-risk aggressive victims were identified from among 5,089 schoolchildren, 68 of whom were screened out and randomly assigned to 10 treatment groups, with 39 completing a one-year follow-up study. Multivariate analysis of variance identified significant improvements in physical and verbal victimization (F(2,47, 93.99) = 10.73, p < 0.01), verbal victimization (F(2.74, 104.14) = 12.80, p < 0.01) and social exclusion scores at the three follow-up assessments compared to the pre-treatment scores, and the qualitative results were consistent, showing participants' cognition, emotion, and behavior to have been positively reconstructed by the group intervention. The consistent quantitative and qualitative results confirm that the cognitive-behavioral group therapy program reported herein is effective in reducing aggressive victims' anxious and depressed emotions and reactive cognition.","Fung, A L",2012.0,10.1111/j.1467-9450.2012.00953.x,0,0,
5852,A randomized controlled trial of an educational programme to improve self-care in Brazilian patients following percutaneous coronary intervention,"ER AIMS: To test an educational programme with telephone follow-up to improve self-care in Brazilian patients who underwent percutaneous coronary intervention.BACKGROUND: Percutaneous coronary intervention has been established as a treatment for coronary disease. However, additional intervention is needed to improve self-care for individuals who undergo this procedure to reduce further disease. Telephone follow-up is one strategy that has been used to improve chronic disease self-care.DESIGN: Randomized controlled trial.TRIAL REGISTRATION: ClinicalTrials.gov, NCT01341093.METHODS: Sixty patients who were preparing for their first percutaneous coronary intervention between 2011-2012 were randomly allocated to an educational programme with telephone follow-up (N = 30) or a control group (N = 30). Perceived health status was assessed with the Medical Outcomes Study 36-Item Short Form. Self-efficacy, symptoms of anxiety and depression and medication adherence were also assessed. Measures were collected before intervention (baseline) and 6 months later.RESULTS: Both groups improved from baseline to 6 months in the 'Physical Component Summary' and in the domains of 'Physical Functioning', 'Role-Emotional' and 'Role-Physical'. The educational programme group showed a reduction in anxiety from baseline to 6-month follow-up, while the control group showed a slight increase. No differences in symptoms in depression and self-efficacy were found and both groups reported high levels of medication adherence.CONCLUSION: The educational programme with telephone follow-up is a promising intervention as it led to reduction in anxiety for those receiving the educational programme. Further improvements in timing and focus of the educational programme, such as targeting emotional and social lifestyle changes, might be warranted.","Furuya, R K; Arantes, E C; Dessotte, C A; Ciol, M A; Hoffman, J M; Schmidt, A; Dantas, R A; Rossi, L A",2015.0,10.1111/jan.12568,0,0,
5853,Randomized controlled trial of a lay-facilitated angina management programme,"ER BACKGROUND: Previously, a nurse-facilitated angina programme was shown to reduce angina while increasing physical activity, however most people with angina do not receive a cardiac rehabilitation or self-management programme. Lay people are increasingly being trained to facilitate self-management programmes.DESIGN: A randomized controlled trial comparing a lay-facilitated angina management programme with routine care from an angina nurse specialist.METHODS: Participants with new stable angina were randomized to the angina management programme (intervention: 70 participants) or advice from an angina nurse specialist (control: 72 participants). Primary outcome was angina frequency at 6 months; secondary outcomes at 3 and 6 months included: risk factors, physical functioning, anxiety, depression, angina misconceptions and cost utility. Follow-up was complete in March 2009. Analysis was by intention-to-treat; blind to group allocation.RESULTS: There was no important difference in angina frequency at 6 months. Secondary outcomes, assessed by either linear or logistic regression models, demonstrated important differences favouring the intervention group, at 3 months for: Anxiety, angina misconceptions and for exercise report; and at 6 months for: anxiety; depression; and angina misconceptions. The intervention was considered cost-effective.CONCLUSION: The angina management programme produced some superior benefits when compared to advice from a specialist nurse.AIMS: This article reports a randomized controlled trial of lay-facilitated angina management (registered trial acronym: LAMP).","Furze, G; Cox, H; Morton, V; Chuang, L H; Lewin, R J; Nelson, P; Carty, R; Norris, H; Patel, N; Elton, P",2012.0,10.1111/j.1365-2648.2011.05920.x,0,0,
5854,Pulsed radiofrequency therapy versus greater occipital nerve block in the management of refractory cervicogenic headache - a pilot study,"ER The aim of this pilot study was to compare the efficacy of pulsed radiofrequency to the greater occipital nerve versus a greater occipital nerve block with a mixture of local anaesthetic and steroid in the management of refractory cervicogenic headache. We enrolled 30 patients suffering from refractory cervicogenic headache. Patients were randomly allocated into two groups of fifteen. A greater occipital nerve block with steroid was utilised in group A, while a pulsed radiofrequency treatment was employed in group B. Success of both procedures was evaluated by comparing pre and post intervention Visual Analogue Scale of pain, Medication Quantification Scale - III. and Global Perceived Effect at three and 9 months after the procedures. At three months post therapy a significant decrease in Visual Analogue Scale (p<0.001) was identified (3.2 points in group A, 3.3 points in group B respectively). In group B pain remained reduced even after 9 months (p<0.001) when compared to pre treatment scores. The consumption of analgesic medication was reduced significantly in both groups at three months (p<0.001) and 9 months (p<0.01), respectively. No serious complication was noted. Greater occipital nerve block is a safe, efficient technique in the management of cervicogenic headaches. Despite the lack of high quality scientific evidence (level III or IV) in the literature, we have extensive experience with steroid application and pulsed radiofrequency to the greater occipital nerve and report the beneficial results in our study.","Gabrhelík, T; Michálek, P; Adamus, M",2011.0,,0,0,
5855,The effect of group aerobic exercise and t'ai chi on functional outcomes and quality of life for persons living with acquired immunodeficiency syndrome,"ER DESIGNThis was a randomized clinical trial investigating the effects of tai chi (TC) and aerobic exercise (EX) on functional outcomes and quality of life (QOL) in patients with AIDS.SETTINGTwo outpatient infectious disease clinics in a mid-atlantic state were the setting.SUBJECTS AND INTERVENTIONThirty-eight (38) subjects with advanced HIV (AIDS) were randomized to one of three groups: TC, EX, or control. Experimental groups exercised twice weekly for 8 weeks.OUTCOME MEASURESThe primary outcomes included QOL as measured by the Medical Outcomes Short Form (MOS-HIV) and Spirituality Well-Being Scale (SWB). Functional measures included the functional reach (FR) for balance, sit and reach (SR) for flexibility, and sit-up (SU) test for endurance. The physical performance test (PPT) was used to determine overall function, and the Profile of Mood States (POMS) was used to evaluate psychologic changes. To consider the patients' explanations for these measurements, qualitative data were collected from subjects' journals, focus groups, and nonparticipant observation.RESULTSThirty-eight (38) subjects were included in data analysis: 13 in the TC group, 13 in the EX group, and 12 in the control group. Results of analysis of covariance showed significant changes in the exercise groups in overall functional measures (p < 0.001). The MOS-HIV showed a significant difference on the subscale of overall health (p = 0.04). The POMS showed significant main effect for time in confusion-bewilderment (p = 0.000) and tension-anxiety (p = 0.005). Three dominant themes emerged from the qualitative data, including: positive physical changes, enhanced psychologic coping, and improved social interactions.CONCLUSIONSThis study shows that TC and EX improve physiologic parameters, functional outcomes, and QOL. Group intervention provides a socialization context for management of chronic HIV disease. This study supports the need for more research investigating the effect of other types of group exercise for this population. This study sets the stage for a larger randomized controlled trial to examine the potential short- and long-term effects of group exercise that may prove beneficial in the management of advanced HIV disease. Further research is warranted to evaluate additional exercise interventions that are accessible, safe, and cost-effective for the HIV population.OBJECTIVEThis study aimed to assess the usefulness of two interventions in a group rehabilitation medicine setting to determine strategies and exercise guidelines for long-term care of the HIV/AIDS population with human immunodeficiency virus (HIV) and/or acquired immunodeficiency syndrome (AIDS).","Galantino, M L; Shepard, K; Krafft, L; Laperriere, A; Ducette, J; Sorbello, A; Barnish, M; Condoluci, D; Farrar, J T",2005.0,10.1089/acm.2005.11.1085,0,0,
5856,Effects of a telephone counseling intervention on psychosocial adjustment in women following a cardiac event,"ER OBJECTIVE: The purpose of this study was to test the effect of a post-discharge telephone counseling intervention on women's psychosocial adjustment following a cardiac event. DESIGN: The study was a prospective, randomized, controlled trial. PATIENTS: Women (n = 196) were recruited from 4 hospitals in Sydney, Australia, who were hospitalized for coronary artery disease: myocardial infarction, coronary artery bypass grafts, coronary angioplasty, or stable angina. Women were randomized to usual care (n = 103) or telephone counseling (n = 93) and were 67 years of age (range 34-92). The majority had not completed high school (92%) and were not employed (84%). OUTCOMES: Psychosocial adjustment was measured by the Psychosocial Adjustment to Illness Scale and the Hospital Anxiety and Depression Scale the day before hospital discharge and 12 weeks postdischarge. INTERVENTION: Individualized information and support, was designed to promote self-managed recovery and psychosocial adjustment, and began with an evaluation during admission and was followed up by telephone counseling at 1, 2, 3, and 6 weeks after discharge. RESULTS: The intervention had no effect on psychosocial adjustment (F[1,182] = 0.06, P =.8), anxiety (F[1,182] = 0.15, P =.69) or depression (F[1,182] = 0.11, P =.74) at 12 weeks after discharge. Women made significant improvements during the 12 weeks on mean scores for psychosocial adjustment (F[1,182] = 58.37, P =.00), anxiety (F [1,182] = 74.58, P =.00) and depression (F[1,182] = 14.11, P =.00). The predictors of poor psychosocial outcomes for women included being less than 55 years of age, being unemployed or retired, having poor psychosocial adjustment to illness at baseline, having readmission, or experiencing a stressful, personal event during follow-up. CONCLUSIONS: Women at risk for poor outcomes following hospitalization for a cardiac event can be identified (ie, women less than 55 years of age, unemployed or retired, poorly adjusted to their cardiac illness, or readmitted to hospital within 12 weeks of a previous cardiac admission), but an effective intervention to enhance psychosocial outcomes remains to be established.","Gallagher, R; McKinley, S; Dracup, K",2003.0,10.1067/mhl.2003.19,0,0,
5857,A randomized trial of group interventions for hospital staff caring for persons with AIDS,"ER The purpose of this study was to develop an educational package for health care providers. Findings from a survey conducted by investigators were used to direct intervention content. All subjects received a 1 hour educational package. Since this type of intervention was not expected to be sufficient to modify attitudes and concerns, 75% of the subjects received an additional 1 hour group discussion intervention (n = 118). In a subgroup of those receiving group interventions, the discussion was preceded by the presence of a person with AIDS (PWA) (in person or on video) discussing his personal experience with the illness and health care workers. It was demonstrated that in order to modify change attitudes, concerns, and affective response, groups were necessary. Furthermore, fear of risk of contagion and homophobia required the presence of a PWA (in person or on video) in order for change to occur.","Gallop, R M; Taerk, G; Lancee, W J; Coates, R A; Fanning, M",1992.0,10.1080/09540129208253089,0,0,
5858,Biofeedback treatment for acute whiplash patients,"ER METHODS: Twelve patients with acute whiplash volunteered to participate in a quasi-experimental design and a control group.INCLUSION CRITERIA: Two months maximum after car accident, severity levels II and I.EXCLUSION CRITERIA: previous history of persistent pain or serious previous injury. The groups were randomly divided in two (treatment and waiting list groups). We used electromyographic measures of the trapezius muscles with psychometric tests: Beck Anxiety and Depression Inventory; Oswestry Pain Disability Questionnaire; Visual Analog Scale of Pain; TAMPA Scale for Kinesiophobia. The treatment consisted in electromyographic biofeedback after progressive muscular relaxation training.RESULTS: There were significant intra-group differences before and after treatment in muscular symmetry and subjective pain perception in the treatment group.CONCLUSIONS: We achieved a significant change (clinical and statistical) in subjective pain perception and muscular symmetry. This study highlights the importance of multidisciplinary work in acute pain patients and the effectiveness of clinical psychophysiological strategies with acute whiplash patients.BACKGROUND: The aim of this study is to evaluate the physiological and psychological effect after an electromyographic biofeedback treatment in combination with progressive muscular relaxation training in patients with acute whiplash.","Gálvez-Hernández, C L; Rodríguez-Ortiz, M D; Río-Portilla, Y",2016.0,,0,0,
5859,Posterior capsule opacification and capsular bag performance of a microincision intraocular lens,"ER PURPOSE: To assess the axial stability and posterior capsule opacification (PCO)-inhibiting efficacy of a microincision hydrophilic intraocular lens (IOL) (Idea 613 XC) and a standard hydrophobic open-loop acrylic IOL (Acrysof SA60AT).SETTING: Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.DESIGN: Clinical trial.METHODS: Patients with bilateral cataract received a microincision cataract surgery (MICS) IOL in 1 eye and a small-incision cataract surgery (SICS) IOL in the contralateral eye. Follow-up examinations were performed immediately after surgery and postoperatively at 1 week and 3 and 24 months. Posterior capsule opacification was assessed using retroillumination photography. Anterior chamber depth (ACD) was measured using partial coherence laser interferometry, and IOL tilt and decentration were measured using a Purkinje meter.RESULTS: Seventy eyes (35 patients) were enrolled. The mean ACD at 3 months was 4.91 mm ± 0.26 (SD) in the MICS group and 4.60 ± 0.23 mm in the SICS group. The anterior IOL shift over the first 3 months was slightly smaller with the MICS IOL (81 ?m) than with the SICS IOL (254 ?m). The mean ACD was 0.377 ± 178 ?m deeper with the MICS IOL (P<.01, paired t test). Two years postoperatively, the amount of regeneratory PCO was higher with the MICS IOL than with the SICS IOL (image analysis software score 2.6 versus 1.9; P=.005).CONCLUSIONS: Two years after surgery, the PCO rate was slightly higher with the MICS IOL. The 2 IOLs had similar performance in terms of axial stability, decentration, and tilt.FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.","Gangwani, V; Hirnschall, N; Koshy, J; Crnej, A; Nishi, Y; Maurino, V; Findl, O",2011.0,10.1016/j.jcrs.2011.05.035,0,0,
5860,Effect of Therapeutic Hypercapnia on Inflammatory Responses to One-lung Ventilation in Lobectomy Patients,"ER Background: One-lung ventilation (OLV) can result in local and systemic inflammation. This prospective, randomized trial was to evaluate the effect of therapeutic hypercapnia on lung injury after OLV. Method: Fifty patients aged 20 to 60 yr undergoing lobectomy were randomly provided with air or carbon dioxide (partial pressure of carbon dioxide: 35 to 45 mmHg or 60 to 70 mmHg). Peak pressure, plateau pressure, and lung compliance were recorded. Bronchoalveolar lavage fluid (BALF) and blood samples were collected. Adverse events were monitored. The primary outcome was the concentration of BALF tumor necrosis factor, and the secondary outcomes were serum cytokine concentrations. Results: The BALF tumor necrosis factor was lower in the carbon dioxide group than in the air group (median [range], 51.1 [42.8 to 76.6] vs. 71.2 [44.8 to 92.7]; P = 0.034). Patients in the carbon dioxide group had lower concentrations of serum and BALF interleukin (IL)-1, IL-6, and IL-8, but higher serum concentrations of IL-10, accompanied by reduced numbers of cells and neutrophils as well as lower concentrations of protein in the BALF. Also, patients in the carbon dioxide group had lower peak (mean +/- SD, 22.2 +/- 2.9 vs. 29.8 +/- 4.6) and plateau pressures (20.5 +/- 2.4 vs. 27.1 +/- 2.9), but higher dynamic compliance (46.6 +/- 5.8 vs. 38.9 +/- 6.5). Furthermore, patients in the carbon dioxide group had higher postoperation oxygenation index values. Ten patients experienced slightly increased blood pressure and heart rate during OLV in the carbon dioxide group. Conclusion: Under intravenous anesthesia, therapeutic hypercapnia inhibits local and systematic inflammation and improves respiratory function after OLV in lobectomy patients without severe complications.","Gao, W; Liu, D D; Li, D; Cui, G X",2015.0,10.1097/ALN.0000000000000627,0,0,
5861,Lead poisoning in the newborn and infants: an epidemiological study in an area of Northern Italy,"ER DESIGNThe study was carried out on a random sample of 55 mother-infant couples attending the Mauriziano Hospital in Turin. The cohort was divided into urban versus rural residence. In every subject attending the study lead, ALA-d and Zn-PP were measured on venous blood specimens in three different moments.RESULTSEven though our study refers to a small population our data were reassuring. The mean lead values found in the cohort in the three different stages were all below 10 mcgr/dl. ALA-d and Zn-PP resulted also in normal ranges. No statistical difference emerged between urban and rural coming subjects.CONCLUSIONSIn consideration of the results obtained we cannot confirm the necessity of a general screening programme for lead poisoning in our population. We assert the utility of a selective screening on the basis of a questionnaire as already experimented in some states of the U.S.A.OBJECTIVELead crosses the placenta and can cause permanent neurological impairment by prenatal poisoning. Blood lead levels higher than 10 mcgr/dl in children age 1 to 2 years may be toxic. In 1991 the CDC (Centers for Disease Control and Prevention) published ""Preventing Lead Poisoning in Young Children"" with the new guidelines defining the value of 10 mcgr/dl as the security limit. Since no blood lead levels in childhood have been collected in Italy this study reports blood lead levels in newborns and 4 month old infants in the Piemonte Region.","Garbo, G; Frigerio, M; Ivaldi, P A; Caroni, G; Ferrari, G; Giachino, G M",1998.0,,0,0,
5862,Efficacy of the McKenzie method in patients with chronic nonspecific low back pain: a protocol of randomized placebo-controlled trial,"ER BACKGROUND: The McKenzie method is widely used as an active intervention in the treatment of patients with nonspecific low back pain. Although the McKenzie method has been compared with several other interventions, it is not yet known whether this method is superior to placebo in patients with chronic low back pain.OBJECTIVE: The purpose of this trial is to assess the efficacy of the McKenzie method in patients with chronic nonspecific low back pain.DESIGN: An assessor-blinded, 2-arm, randomized placebo-controlled trial will be conducted.SETTING: This study will be conducted in physical therapy clinics in S√£o Paulo, Brazil.PARTICIPANTS: The participants will be 148 patients seeking care for chronic nonspecific low back pain.INTERVENTION: Participants will be randomly allocated to 1 of 2 treatment groups: (1) McKenzie method or (2) placebo therapy (detuned ultrasound and shortwave therapy). Each group will receive 10 sessions of 30 minutes each (2 sessions per week over 5 weeks).MEASUREMENTS: The clinical outcomes will be obtained at the completion of treatment (5 weeks) and at 3, 6, and 12 months after randomization. The primary outcomes will be pain intensity (measured with the Pain Numerical Rating Scale) and disability (measured with the Roland-Morris Disability Questionnaire) at the completion of treatment. The secondary outcomes will be pain intensity; disability and function; kinesiophobia and global perceived effect at 3, 6, and 12 months after randomization; and kinesiophobia and global perceived effect at completion of treatment. The data will be collected by a blinded assessor.LIMITATIONS: Therapists will not be blinded.CONCLUSIONS: This will be the first trial to compare the McKenzie method with placebo therapy in patients with chronic nonspecific low back pain. The results of this study will contribute to better management of this population.","Garcia, A N; Costa, Lda C; Hancock, M J; Almeida, M O; Souza, F S; Costa, L O",2015.0,10.2522/ptj.20140208,0,0,
5863,Effectiveness of the psychological and pharmacological treatment of catastrophization in patients with fibromyalgia: a randomized controlled trial,"ER METHOD/DESIGNDESIGNA multi-centre, randomized controlled trial involving three groups: the control group, consisting of usual treatment at primary care level, and two intervention groups, one consisting of cognitive-behaviour therapy, and the other consisting of the recommended pharmacological treatment for fibromyalgia.SETTING29 primary care health centres in the city of Zaragoza, Spain.SAMPLE180 patients, aged 18-65 years, able to understand and read Spanish, who fulfil criteria for primary fibromyalgia, with no previous psychological treatment, and no pharmacological treatment or their acceptance to discontinue it two weeks before the onset of the study.INTERVENTIONPsychological treatment is based on the manualized protocol developed by Prof. Escobar et al, from the University of New Jersey, for the treatment of somatoform disorders, which has been adapted by our group for the treatment of fibromyalgia. It includes 10 weekly sessions of cognitive-behaviour therapy. Pharmacological therapy consists of the recommended pharmacological treatment for fibromyalgia: pregabalin (300-600 mg/day), with duloxetine (60-120 mg/day) added where there is a comorbid depression).MEASUREMENTSThe following socio-demographic data will be collected: sex, age, marital status, education, occupation and social class. The diagnosis of psychiatric disorders will be made with the Structured Polyvalent Psychiatric Interview. Other instruments to be administered are the Pain Catastrophizing Scale, the Hamilton tests for Anxiety and for Depression, the Fibromyalgia Impact Questionnaire (FIQ), the EuroQuol-5 domains (EQ-5D), and the use of health and social services (CSRI). Assessments will be carried out at baseline, 1, 3, and 6 months. MAIN VARIABLE: Pain catastrophizing.ANALYSISThe analysis will be per intent to treat. We will use the general linear models of the SPSS version 15 statistical package, to analyse the effect of the treatment on the result variable (pain catastrophizing).DISCUSSIONIt is necessary to assess the effectiveness of pharmacological and psychological treatments for pain catastrophizing in fibromyalgia. This randomized clinical trial will determine whether both treatments are effective for this important prognostic variable in patients with fibromyalgia.TRIAL REGISTRATIONCurrent Controlled Trials ISRCTN10804772.BACKGROUNDFibromyalgia is a prevalent and disabling disorder characterized by widespread pain and other symptoms such as insomnia, fatigue or depression. Catastrophization is considered a key clinical symptom in fibromyalgia; however, there are no studies on the pharmacological or psychological treatment of catastrophizing. The general aim of this study is to assess the effectiveness of cognitive-behaviour therapy and recommended pharmacological treatment for fibromyalgia (pregabalin, with duloxetine added where there is a comorbid depression), compared with usual treatment at primary care level.","García-Campayo, J; Serrano-Blanco, A; Rodero, B; Magallón, R; Alda, M; Andrés, E; Luciano, J V; Hoyo, Y L",2009.0,10.1186/1745-6215-10-24,0,0,
5864,Psychological changes accompanying and mediating stress-management training for essential hypertension,"ER In a previous controlled study, 21 participants with essential hypertension were treated with a program based on education, relaxation and D'Zurilla problem-solving training, and another 21 participants were assigned to a waiting list control condition (García-Vera, Labrador, & Sanz, 1997). In this report, the pre-post-treatment psychological changes accompanying those conditions were examined with the Jenkins Activity Survey, the Rosenbaum Self-Control Schedule, the Spielberger State-Trait Anxiety Inventory, and the D'Zurilla-Nezu Social Problem-Solving Inventory. Treatment yielded significant psychological changes that included an increase of problem-solving abilities. Moreover, correlation and multiple regression analyses revealed that, when clinic blood pressure (BP) values were considered, increases in problem-solving abilities were correlated with systolic and diastolic BP reductions for participants in the stress-management condition, and they mediated partially the antihypertensive effects of stress-management training on BP. No significant correlations were found between psychological changes and self-measured systolic or diastolic BP reductions.","García-Vera, M P; Sanz, J; Labrador, F J",1998.0,,0,0,
5865,"Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations","ER Irritable bowel syndrome (IBS) is a prevalent functional disorder characterized by abdominal pain and hypervigilance to gastrointestinal sensations. We hypothesized that mindfulness training (MT), which promotes nonreactive awareness of emotional and sensory experience, may target underlying mechanisms of IBS including affective pain processing and catastrophic appraisals of gastrointestinal sensations. Seventy five female IBS patients were randomly assigned to participate in either 8 weeks of MT or a social support group. A theoretically grounded, multivariate path model tested therapeutic mediators of the effect of MT on IBS severity and quality of life. Results suggest that MT exerts significant therapeutic effects on IBS symptoms by promoting nonreactivity to gut-focused anxiety and catastrophic appraisals of the significance of abdominal sensations coupled with a refocusing of attention onto interoceptive data with less emotional interference. Hence, MT appears to target and ameliorate the underlying pathogenic mechanisms of IBS.","Garland, E L; Gaylord, S A; Palsson, O; Faurot, K; Douglas, Mann J; Whitehead, W E",2012.0,10.1007/s10865-011-9391-z,0,0,
5866,Mindfulness-oriented recovery enhancement reduces pain attentional bias in chronic pain patients,"ER BACKGROUND: Chronic pain involves hypervigilance for pain-related stimuli. Selective attention to pain-related stimuli, known as pain attentional bias (AB), can exacerbate chronic pain, prolong suffering, and undermine quality of life. The aim of this study was to determine if a multimodal mindfulness-oriented intervention could significantly reduce pain AB among chronic pain patients receiving opioid analgesics.METHODS: A total of 67 chronic pain patients were randomized to an 8-week Mindfulness-Oriented Recovery Enhancement (MORE) intervention or a social support group intervention and began treatment. A dot probe task was used to measure pain AB. Primary outcomes were pain AB scores for cues presented for 2,000 and 200 ms.RESULTS: Prior to intervention, participants exhibited a significant bias towards pain-related cues presented for 2,000 ms, but no bias for cues presented for 200 ms. A statistically significant time √ó intervention condition interaction was observed for 2,000 ms pain AB, such that participants in MORE evidenced significantly reduced posttreatment pain AB relative to pretreatment levels, whereas no significant pre-post treatment changes in pain AB were observed for support group participants. Decreases in pain AB were associated with increased perceived control over pain and attenuated reactivity to distressing thoughts and emotions.CONCLUSION: Study findings provide the first indication that a mindfulness-oriented intervention may reduce pain AB among adults suffering from chronic pain. Given the magnitude of chronic pain in postindustrial societies, coupled with the dramatic escalation in prescription opioid misuse, future studies should evaluate MORE as a nonpharmacological means of addressing factors linked with chronic pain.","Garland, E L; Howard, M O",2013.0,10.1159/000348868,0,0,
5867,Impact of self-administered relaxation and guided imagery techniques during final trimester and birth,"ER The objective of this study was to test if and how self-administered practice of relaxation techniques, positive affirmation and guided imagery, in the final part of pregnancy had an impact on giving birth. Further to see if the use of a simple method, a CD with a booklet, with no previous training or specific support of the participants (neither required nor delivered), affected the birth experience. Outcome measures were monitored both during and after delivery: During delivery, pain and anxiety were measured at different stages of birth. Post-delivery Wellbeing (Edmonton Scale 0-10, where 10 is the worst possible feeling of Wellbeing), pain, anxiety, Apgar score, duration of birth, complications and anesthesia/analgesic were recorded. Those in the CD-intervention group also reported how many times they had practiced the techniques. The study employed a randomized controlled trial. Results show that the CD-intervention group had a significantly better score on total Wellbeing, as measured by the ESAS (0-10) Edmonton Scale.","Gedde-Dahl, M; Fors, E A",2012.0,10.1016/j.ctcp.2011.08.008,0,0,
5868,Computerised therapy for depression with clinician vs. assistant and brief vs. extended phone support: study protocol for a randomised controlled trial,"ER METHODS/DESIGN: This is a two-by-two factorial RCT investigating the effectiveness, cost-effectiveness and acceptability of cCBT supplemented with 12 weekly phone support sessions are either brief (5-10 min) or extended (20-30 min) and are offered by either an expert clinician or an assistant with no clinical training. Adults with non-suicidal depression in primary care can self-refer into the study by completing and posting to the research team a standardised questionnaire. Following an assessment interview, eligible referrals have access to an 8-session cCBT programme called Beating the Blues and are randomised to one of four types of support: brief-assistant, extended-assistant, brief-clinician or extended-clinician.A sample size of 35 per group (total 140) is sufficient to detect a moderate effect size with 90% power on our primary outcome measure (Work and Social Adjustment Scale); assuming a 30% attrition rate, 200 patients will be randomised. Secondary outcome measures include the Beck Depression and Anxiety Inventories and the PHQ-9 and GAD-7. Data on clinical outcomes, treatment usage and patient experiences are collected in three ways: by post via self-report questionnaires at week 0 (randomisation) and at weeks 12 and 24 post-randomisation; electronically by the cCBT system every time patients log-in; by phone during assessments, support sessions and exit interviews.DISCUSSION: The study's factorial design increases its efficiency by allowing the concurrent investigation of two types of adjunct support for cCBT with a single sample of participants. Difficulties in recruitment, uptake and retention of participants are anticipated because of the nature of the targeted clinical problem (depression impairs motivation) and of the studied interventions (lack of face-to-face contact because referrals, assessments, interventions and data collection are completed by phone, computer or post).TRIAL REGISTRATION: Current Controlled Trials ISRCTN98677176.BACKGROUND: Computerised cognitive behaviour therapy (cCBT) involves standardised, automated, interactive self-help programmes delivered via a computer. Randomised controlled trials (RCTs) and observational studies have shown than cCBT reduces depressive symptoms as much as face-to-face therapy and more than waiting lists or treatment as usual. cCBT's efficacy and acceptability may be influenced by the ""human"" support offered as an adjunct to it, which can vary in duration and can be offered by people with different levels of training and expertise.","Gega, L; Swift, L; Barton, G; Todd, G; Reeve, N; Bird, K; Holland, R; Howe, A; Wilson, J; Molle, J",2012.0,10.1186/1745-6215-13-151,0,0,
5869,Psychophysiological reactivity and coping styles influence the effects of acute stress exposure on rapid eye movement sleep,"ER METHODSSixty-three healthy young adults slept in the laboratory after being randomized into CTL or EXP. Measures of psychophysiological reactivity (state anxiety, stress level, and mean arterial blood pressure) were collected before and immediately after randomization. All subjects completed the Neuroticism-Extroversion-Openness-Personality Inventory Revised and the Ways of Coping Checklist.RESULTSA significant stress exposure by REM period interaction was found, and average RCs in the last REM period were significantly lower in EXP compared with CTL subjects (p =.005). The global slope of increase in average RC across successive REM sleep periods was less steep in EXP compared with CTL subjects (p =.02). Late-night RC was mediated by changes in subjective stress level from baseline to task notification, whereas REM latency was predicted by changes in state anxiety. Neuroticism and coping style did not directly moderate the effects of acute stress exposure on REM sleep. Rather, social coping and avoidance moderated psychological reactivity.CONCLUSIONSThe findings suggest that attenuation of REM sleep phasic activity after stress exposure may reflect adaptive regulation of waking emotional arousal. Mediation and moderation models are more informative than traditional bivariate approaches to investigating the relation between stress exposure and sleep alterations.OBJECTIVEThe goal of the present study was to investigate the roles of situational (ie, psychophysiological reactivity to acute stress) and dispositional variables (ie, neuroticism, coping styles) in shaping the effects of acute stress exposure on REM sleep.","Germain, A; Buysse, D J; Ombao, H; Kupfer, D J; Hall, M",2003.0,,0,0,
5870,Treatment for insomnia in combat-exposed OEF/OIF/OND military veterans: preliminary randomized controlled trial,"ER CLINICALTRIALSGOV IDENTIFIER: NCT00840255.UNLABELLED: Chronic insomnia is highly prevalent among military personnel returning from Iraq and Afghanistan. We evaluated the effects of a military version of a brief behavioral treatment of insomnia (BBTI-MV) compared to an information only control (IC) condition in combat-exposed Veterans of Operations Enduring/Iraqi Freedom or Operation New Dawn (OEF/OIF/OND) on insomnia, sleep quality, and daytime symptoms of anxiety and depression. Forty OEF/OIF/OND Veterans (Mean age = 38.4 years old, s.d. = 11.69; 85% men; 77.5% white) were randomized to one of two conditions. BBTI-MV consisted of two in-person sessions and two telephone contacts delivered over four weeks, and included personalized recommendations to reduce insomnia. The IC condition also consisted of 2 in-person sessions two telephone contacts delivered over four weeks, and Veterans were encouraged to read written information about sleep-promoting behaviors. The Insomnia Severity Index, Pittsburgh Sleep Quality Index, PTSD Checklist, and Beck Depression and Anxiety Inventories were completed at baseline, post-treatment, and at the six-month follow-up. Both interventions were associated with clinically significant improvements in insomnia, although the magnitude of improvements in sleep and rates of treatment response and remission were greater for BBTI-MV compared to IC from pre- to post-treatment. Both BBTI-MV and the provision of information were associated with clinically significant improvements in insomnia among Veterans. Despite the preliminary nature of the findings and limitations inherent to small controlled trials, the findings suggest that both approaches may provide viable options in a stepped-care approach to the treatment of insomnia in retuning combat-exposed Veterans. Larger, confirmatory effectiveness trials are required.","Germain, A; Richardson, R; Stocker, R; Mammen, O; Hall, M; Bramoweth, A D; Begley, A; Rode, N; Frank, E; Haas, G; Buysse, D J",2014.0,10.1016/j.brat.2014.07.016,0,0,
5871,Medical students and psychiatry. A survey of students' opinion,"ER In the last years research on the didactics of Psychiatry and opinions of medical students on Psychiatry has gained great interest. The authors think that this research could be useful for the improvement of didactics, for better understanding the meanings of professional choice, the identity of psychiatrist and their relationship with colleagues in other medical field. The goal of this research work was a preliminary survey of Genoese University Medical Student's opinions about psychiatry didactics, and choice of specialization. A questionnaire was submitted to all the students who passed Clinical Psychiatry examination in the period from November 1987 to December 1988. The students were divided in two randomized groups: the first group of students (224) was submitted to the questionnaire immediately after Clinical Psychiatry examination; while to the second group of students (66) the questionnaire was mailed. The aim of the questions was to assess the student's opinions on psychiatry, psychoanalysis, psychotherapy, the career they wanted to take up, and the difficulties of studying psychiatry: 69% of the students of the first group and 42% of the students of the second group answered the questionnaire. Female students answered that they preferred psychiatric specialization more than their male colleagues did, but the difference has no statistical importance. In most cases, the students who answered that they have taken into account psychiatry as a choice of specialisation, are more interested in medical specialties (primary care, etc.) than in surgical specialties. Most of the medical students declare some emotional troubles (anxiety, sleeplessness, problem in social relations).(ABSTRACT TRUNCATED AT 250 WORDS)","Giberti, F; Corsini, G; Rovida, S",1994.0,,0,0,
5872,Emotional expression and diurnal cortisol slope in women with metastatic breast cancer in supportive-expressive group therapy: a preliminary study,"ER We examined coded emotional expression during an initial therapy session and its association with a known physiological risk factor for early death, aberrant diurnal cortisol slope, in women with metastatic breast cancer. Out of 64 women with metastatic breast cancer randomized to a multi-site clinical intervention trial of supportive-expressive group therapy (SET), a subsample of 29 met eligibility criteria for this study. We tested whether longer mean durations of primary negative affect (fear, sadness, and anger) expression were associated with steeper diurnal cortisol slopes after adjusting for speaking time, repressive-defensiveness, anxiety, and the interaction between repressive-defensiveness and anxiety. We found that steeper cortisol slopes were related to lower repressive-defensiveness and greater primary negative affect expression in line with a priori hypotheses. Additionally we explored whether coded positive affect, defensive/hostile affect, constrained anger, and the interaction between primary negative affect and repressive-defensiveness explained additional variance in diurnal cortisol patterns.","Giese-Davis, J; DiMiceli, S; Sephton, S; Spiegel, D",2006.0,10.1016/j.biopsycho.2006.04.003,0,0,
5873,Pretreatment of problem youths with clozapin in preparation for group psychotherapy,,"Giovannetti, A; Trombetta, N",1974.0,10.1055/s-0028-1094427,0,0,
5874,A community-integrated home based depression intervention for older African Americans: corrected description of the Beat the Blues randomized trial and intervention costs,"ER BACKGROUND: Primary care is the principle setting for depression treatment; yet many older African Americans in the United States fail to report depressive symptoms or receive the recommended standard of care. Older African Americans are at high risk for depression due to elevated rates of chronic illness, disability and socioeconomic distress. There is an urgent need to develop and test new depression treatments that resonate with minority populations that are hard-to-reach and underserved and to evaluate their cost and cost-effectiveness.METHODS/DESIGN: Beat the Blues (BTB) is a single-blind parallel randomized trial to assess efficacy of a non-pharmacological intervention to reduce depressive symptoms and improve quality of life in 208 African Americans 55+ years old. It involves a collaboration with a senior center whose care management staff screen for depressive symptoms (telephone or in-person) using the Patient Health Questionnaire (PHQ-9). Individuals screened positive (PHQ-9 ? 5) on two separate occasions over 2 weeks are referred to local mental health resources and BTB. Interested and eligible participants who consent receive a baseline home interview and then are randomly assigned to receive BTB immediately or 4 months later (wait-list control). All participants are interviewed at 4 (main study endpoint) and 8 months at home by assessors masked to study assignment. Licensed senior center social workers trained in BTB meet with participants at home for up to 10 sessions over 4 months to assess care needs, make referrals/linkages, provide depression education, instruct in stress reduction techniques, and use behavioral activation to identify goals and steps to achieve them. Key outcomes include reduced depressive symptoms (primary), reduced anxiety and functional disability, improved quality of life, and enhanced depression knowledge and behavioral activation (secondary). Fidelity is enhanced through procedure manuals and staff training and monitored by face-to-face supervision and review of taped sessions. Cost and cost effectiveness is being evaluated.DISCUSSION: BTB is designed to bridge gaps in mental health service access and treatments for older African Americans. Treatment components are tailored to specific care needs, depression knowledge, preference for stress reduction techniques, and personal activity goals. Total costs are $584.64/4 months; or $146.16 per participant/per month.TRIAL REGISTRATION: ClinicalTrials.gov #NCT00511680.","Gitlin, L N; Harris, L F; McCoy, M; Chernett, N L; Jutkowitz, E; Pizzi, L T",2012.0,10.1186/1471-2318-12-4,0,0,
5875,A home-based intervention to reduce depressive symptoms and improve quality of life in older African Americans: a randomized trial,"ER BACKGROUND: Effective care models for treating older African Americans with depressive symptoms are needed.OBJECTIVE: To determine whether a home-based intervention alleviates depressive symptoms and improves quality of life in older African Americans.DESIGN: Parallel, randomized trial stratified by recruitment site. Interviewers assessing outcomes were blinded to treatment assignment. (ClinicalTrials.gov: NCT00511680) SETTING: A senior center and participants' homes from 2008 to 2010.PATIENTS: African Americans aged 55 years or older with depressive symptoms.INTERVENTION: A multicomponent, home-based intervention delivered by social workers or a wait-list control group that received the intervention at 4 months.MEASUREMENTS: Self-reported depression severity at 4 months (primary outcome) and depression knowledge, quality of life, behavioral activation, anxiety, function, and remission at 4 and 8 months.RESULTS: Of 208 participants (106 and 102 in the intervention and wait-list groups, respectively), 182 (89 and 93, respectively) completed 4 months and 160 (79 and 81, respectively) completed 8 months. At 4 months, participants in the intervention group showed reduced depression severity (difference in mean change in Patient Health Questionnaire-9 score from baseline, -2.9 [95% CI, -4.6 to -1.2]; difference in mean change in Center for Epidemiologic Studies Depression Scale score from baseline, -3.7 [CI, -5.4 to -2.1]); improved depression knowledge, quality of life, behavioral activation, and anxiety (P < 0.001); and improved function (P = 0.014) compared with wait-list participants. More intervention than wait-list participants entered remission at 4 months (43.8% vs. 26.9%). After treatment, control participants showed benefits similar in magnitude to those of participants in the initial intervention group. Those in the initial intervention group maintained benefits at 8 months.LIMITATION: The study had a small sample, short duration, and differential withdrawal rate.CONCLUSION: A home-based intervention delivered by social workers could reduce depressive symptoms and enhance quality of life in most older African Americans.PRIMARY FUNDING SOURCE: National Institute of Mental Health.","Gitlin, L N; Harris, L F; McCoy, M C; Chernett, N L; Pizzi, L T; Jutkowitz, E; Hess, E; Hauck, W W",2013.0,10.7326/0003-4819-159-4-201308200-00005,0,0,
5876,Mediators of the impact of a home-based intervention (beat the blues) on depressive symptoms among older African Americans,"ER Older African Americans (N = 208) with depressive symptoms were randomly assigned to a home-based nonpharmacologic intervention (Beat the Blues, or BTB) or wait-list control group. BTB was delivered by licensed social workers and involved up to 10 home visits focused on care management, referral and linkage, depression knowledge and efficacy in symptom recognition, instruction in stress reduction techniques, and behavioral activation through identification of personal goals and action plans for achieving them. Structured interviews by assessors masked to study assignment were used to assess changes in depressive symptoms (main trial endpoint), behavioral activation, depression knowledge, formal care service utilization, and anxiety (mediators) at baseline and 4 months. At 4 months, the intervention had a positive effect on depressive symptoms and all mediators except formal care service utilization. Structural equation models indicated that increased activation, enhanced depression knowledge, and decreased anxiety each independently mediated a significant proportion of the intervention's impact on depressive symptoms as assessed with 2 different measures (PHQ-9 and CES-D). These 3 factors also jointly explained over 60% of the intervention's total effect on both indicators of depressive symptoms. Our findings suggest that most of the impact of BTB on depressive symptoms is driven by enhancing activation or becoming active, reducing anxiety, and improving depression knowledge/efficacy. The intervention components appear to work in concert and may be mutually necessary for maximal benefits from treatment to occur. Implications for designing tailored interventions to address depressive symptoms among older African Americans are discussed.","Gitlin, L N; Roth, D L; Huang, J",2014.0,10.1037/a0036784,0,0,
5877,Empirical examination of the interpersonal maintenance model of anorexia nervosa,"ER OBJECTIVE: A cognitive interpersonal maintenance model of anorexia nervosa (AN) was first proposed in 2006 and updated in 2013 (Schmidt and Treasure, J Br J Clin Psychol, 45, 343-366, 2006; Treasure and Schmidt, J Eat Disorders, in press.). The aim of this study was to test the interpersonal component of this model in people with AN requiring intensive hospital treatment (inpatient/day patient).METHOD: On admission to hospital women with AN or eating disorder not otherwise specified (AN subtype; n = 152; P) and their primary carers (n = 152; C) completed questionnaires on eating symptoms (P), depression and anxiety (P, C), accommodation and enabling (C), and psychological control (C). Structural equation modeling was used to examine relationships among these components.RESULTS: Carers' expressed emotion and level of psychological control were significantly related to carers' distress, which in turn, was related to patients' distress. This pathway significantly predicted eating symptoms in patients.DISCUSSION: The cognitive interpersonal maintenance model of eating disorders (EDs) was confirmed in part and suggests that interventions targeting interpersonal maintaining factors such as carer distress might impact on patient outcomes.","Goddard, E; Salerno, L; Hibbs, R; Raenker, S; Naumann, U; Arcelus, J; Ayton, A; Boughton, N; Connan, F; Goss, K; Lacey, H; Laszlo, B; Morgan, J; Moore, K; Robertson, D; Schreiber-Kounine, C; Sharma, S; Whitehead, L; Schmidt, U; Treasure, J",2013.0,10.1002/eat.22172,0,0,
5878,"""MOVE!"" Outcomes of a weight loss program modified for veterans with serious mental illness","ER METHODS: Between January 2007 and June 2009, overweight or obese veterans with serious mental illness were randomly assigned to a six-month trial of MOVE! (N=53), which includes both individual and group sessions, or to a control condition that offered basic information about diet and exercise every month (N=56). Weight and metabolic, attitudinal, behavioral, and functional variables were measured at baseline and six months, and weight was also measured monthly.RESULTS: Thirty participants in MOVE! and 41 participants in the control group completed the six-month assessment, and only seven lost 5% of their baseline weight; there was no effect of group assignment on weight loss. There were no significant group √ó time differences in any metabolic, dietary, physical activity, attitudinal, or functional measure.CONCLUSIONS: Despite the negative findings of this study, research is crucial to identify lifestyle interventions and related supports and services to help veterans with mental illness reduce overweight and obesity.OBJECTIVES: Veterans with serious mental illness are at increased risk of obesity, sedentary lifestyle, and a host of related chronic diseases. Although evidence suggests that lifestyle interventions can help mental health consumers achieve modest weight loss, several studies have failed to show a benefit and most have concluded that significant challenges remain in delivering effective interventions. In 2006, the Veterans Health Administration introduced MOVE!, a weight management program that includes behaviorally based dietary and physical activity self-management support. This article describes modifications used to manualize MOVE! for veterans with serious mental illness and reports findings from a randomized controlled trial of the new intervention.","Goldberg, R W; Reeves, G; Tapscott, S; Medoff, D; Dickerson, F; Goldberg, A P; Ryan, A S; Fang, L J; Dixon, L B",2013.0,10.1176/appi.ps.201200314,0,0,
5879,Sexual arousal and desire: interrelations and responses to three modalities of sexual stimuli,"ER INTRODUCTION: Traditionally, sexual desire is understood to occur spontaneously, but more recent models propose that desire responds to sexual stimuli.AIMS: To experimentally assess whether sexual stimuli increased sexual desire; to compare how sexual arousal and desire responded to three modalities of sexual stimuli: erotic story, unstructured fantasy, and the Imagined Social Situation Exercise (ISSE).METHODS: In an online study, participants (128 women, 98 men) were randomly assigned to one of four arousal conditions (ISSE, story, fantasy, or neutral), and then completed desire measures. In the ISSE, participants imagined and wrote about a positive sexual encounter with a self-defined attractive person.MAIN OUTCOME MEASURES: Sexual arousal (perceived genital, psychological, and perceived autonomic), anxiety, positive and negative affect, and state sexual desire via self-report measures pre- and post-condition; ""trait"" desire via the Sexual Desire Inventory post-condition.RESULTS: All three sexual conditions significantly increased sexual arousal and positive affect compared with the neutral condition, with trends for higher arousal to unstructured fantasy than the ISSE or story conditions. Sexual conditions significantly increased scores on state measures of sexual desire. In addition, sexual context influenced measurement of ""trait"" solitary sexual desire in women, such that women reported significantly higher trait desire after the neutral and ISSE conditions vs. fantasy.CONCLUSION: Results highlight the responsiveness of sexual desire, problems with measurement of desire as a long-term trait, trade-offs of using the ISSE and other stimuli in sexuality research, and the need to address context in discussions of women's and men's desire.","Goldey, K L; Anders, S M",2012.0,10.1111/j.1743-6109.2012.02845.x,0,0,
5880,A randomised controlled trial to evaluate a nurse-led programme of support and lifestyle management for patients awaiting cardiac surgery 'Fit for surgery: fit for life' study,"ER AIMTo evaluate our nurse-led programme in a randomised controlled trial with 188 patients.METHODSPatients listed for coronary artery bypass surgery with at least one poorly controlled risk factor were randomised to standard care or the intervention which provided lifestyle counselling and preparation for surgery at monthly intervals. Primary outcome measurements were anxiety, blood pressure, cholesterol, length of stay and body mass index. Costs of the intervention were also collected.RESULTSFor both groups blood pressure and total cholesterol improved (Blood pressure mm Hg (Control -9.11 (","Goodman, H; Parsons, A; Davison, J; Preedy, M; Peters, E; Shuldham, C; Pepper, J; Cowie, M R",2008.0,10.1016/j.ejcnurse.2007.11.001,0,0,
5881,Implications of the failure rates of bonded brackets and eyelets: a clinical study,"ER A clinical study of the rate of failure of bonded brackets and eyelets on primary molars was undertaken. Two groups of patients (one bonded contralaterally and the other at random) were studied for 12 to 17 months. The data support the hypothesis that one major cause of bond failure is the force of occlusion during mastication. On the basis of this finding, several clinical applications are suggested. These include rotation of second premolars, closure of extraction spaces, and the management of limited treatment of lower incisors in the presence of deep, traumatic overbite.","Gorelick, L; Geiger, A M; Gwinnett, A J",1984.0,,0,0,
5882,Effect of marijuana and placebo-marijuana smoking on psychological state and on psychophysiological cardiovascular functioning in anginal patients,"ER Ten male anginal patients with angiographically documented coronary artery disease, in a randomized double-blind crossover study, smoked one marijuana cigarette (containing 18 mg of delta-9-THC) on one morning and one placebo marijuana cigarette (containing 0.05 mg of delta-9-THC) on a successive morning. Significant increases occurred in average cognitive and intellectual impairment scores, derived from the objective content analysis of 5 min of speech, 30 mins after smoking the marijuana cigarette as compared to the placebo marijuana cigarette, and these scores decreased to near presmoking levels 60 min after smoking. No significant average changes occurred in anxiety or three hostility scale scores following smoking marijuana. Sizable individual differences were noted in the psychological responses to marijuana smoking due, presumably, to personality differences and/or differences in THC pharmacokinetics. Significant psychocardiovascular hemodynamic correlations, as measured by echocardiography, were observed during placebo-marijuana smoking between hostility inward scores and systolic blood pressure and ejection fraction, overt hostility outward scores and diastolic blood pressure, as well as between anxiety scores and stroke volume and left ventricular end-diastolic dimension and left ventricular diastolic volume. These significant psychophysiologic correlations were all eliminated during marijuana smoking. In view of associated findings that marijuana smoking decreased myocardial oxygen delivery, decreased exercise time until the onset of anginal pain, and increased myocardial oxygen demand in anginal patients, the use of marijuana by such patients is clearly inadvisable.","Gottschalk, L A; Aronow, W S; Prakash, R",1977.0,,0,0,
5883,Randomized controlled trial comparing stabilization of fresh close femoral shaft fractures in children with titanium elastic nail system versus stainless steel elastic nail system,"ER In vitro mechanical studies have demonstrated equal or superior fixation of pediatric femoral fractures with use of titanium elastic nails (TENS) as compared with stainless steel elastic nails (SSEN). SSEN are less expensive as compared to TENS. However, there are only two studies in the English literature which have compared the results of TENS and SSEN in paediatric femoral shaft fracture. The present study compares the clinical and radiological outcomes of femoral shaft fracture in patients 6-12 years of age, operatively stabilised either by TENS or SSEN. 35 children (6-12 years) with closed, post traumatic femoral shaft fractures were randomized into two treatment groups. Both groups underwent closed reduction internal fixation (CRIF) by either of the implants (TENS OR SSENS) as per randomization protocol and followed up for six months. Comparison of clinical and radiological outcomes in both the groups was done in terms of time to union of fracture and radiological angulations in coronal and sagittal plane. There was no significant difference in both groups with respect to fracture site tenderness and presence of bridging callus at fracture site at 3 weeks, 6 weeks and 6 months follow up (p-value = 1.000). There was no significant difference in radiological angulation rate in both groups in the sagittal (p-value = 0.661) as well as in the coronal plane (p-value = 0.219) at six month follow up. Both groups showed a similar rate of complication, most common being prominent hardware. TENS and SSENS are equally effective treatment modalities for paediatric femoral shaft fracture with similar rate of complications. However, SSENS is less costly as compared to TENS and can be considered as an alternative in a resource constrained setup.","Goyal, N; Aggarwal, A N; Mishra, P; Jain, A",2014.0,,0,0,
5884,A randomized controlled trial of a hospital at home service for the terminally ill,"ER This study evaluated the impact of a Cambridge hospital at home service (CHAH) on patients' quality of care, likelihood of remaining at home in their final 2 weeks of life and general practitioner (GP) visits. The design was a randomized controlled trial, comparing CHAH with standard care. The patient's district nurse, GP and informal carer were surveyed within 6 weeks of patient's death, and 225 district nurses, 194 GPs and 144 informal carers of 229 patients responded. There was no clear evidence that CHAH increased likelihood of remaining at home during the final 2 weeks of life. However, the service was associated with fewer GP out of hours visits. All respondent groups rated CHAH favourably compared to standard care but emphasized different aspects. District nurses rated CHAH as better than standard care in terms of adequacy of night care and support for the carer, GPs in terms of anxiety and depression, and informal carers in terms of control of pain and nausea. Thus whilst CHAH was not found to increase the likelihood of remaining at home, at appeared to be associated with better quality home care.","Grande, G E; Todd, C J; Barclay, S I; Farquhar, M C",2000.0,10.1191/026921600701536200,0,0,
5885,"Selective blockade of cholecystokinin type B receptors with L-365,260 does not impair gallbladder contraction in normal humans","ER METHODSL-365,260, a novel, nonpeptide cholecystokinin antagonist shown to be selective for type B cholecystokinin receptors, was administered every 6 h over a 5-7 day period. Plasma levels of L-365,260 were determined by high pressure liquid chromatography. Gallbladder contraction after a standardized fatty meal was measured by ultrasonography, and results were calculated by ellipsoid or sum of cylinders methods.RESULTSL-365,260 levels were comparable to levels in earlier studies demonstrating inhibition of pentagastrin-stimulated acid secretion in normal subjects and blockade of anxiogenic effects of cholecystokinin injections in patients with panic disorder. Regardless of the method used for estimating gallbladder size, none of the L-365,260 doses studied inhibited gallbladder contraction. Gallbladder size was most consistently estimated by the ellipsoid method using measurements normalized to individual values for minimum and maximum gallbladder dimensions.CONCLUSIONSMultiple oral doses of L-365,260 do not alter ultrasonographically assessed gallbladder contraction at doses shown to be clinically effective in earlier studies. Despite being more difficult to implement, the sum of cylinders method for estimating gall bladder size offers no advantage over the ellipsoid method.OBJECTIVESTo evaluate the effect of selective blockade of type B cholecystokinin receptors on gall bladder contraction in normal humans and to compare methods for quantitative analysis of gall bladder contraction.","Grasing, K; Freedholm, D; Murphy, M G; Swigar, M; Russer, T; Nosher, J; Lin, J; Frame, V; Clarke, L; Seibold, J R",1996.0,,0,0,
5886,Physiotherapy for patients with mobility problems more than 1 year after stroke: a randomised controlled trial,"ER METHODSWe screened 359 patients older than 50 years for a single-masked, randomised controlled trial to assess the effects of community physiotherapy. Assessments were made at baseline, 3, 6, and 9 months in 170 eligible patients assigned treatment or no intervention. The primary outcome measure was mobility measured by the Rivermead mobility index. Secondary outcome measures were gait speed, number of falls, daily activity (Barthel index scores), social activity (Frenchay activities index), hospital anxiety and depression scale, and emotional stress of carers (general health questionnaire 28). Analyses were by intention to treat.FINDINGSFollow-up was available for 146 patients (86%). Changes in scores on the Rivermead mobility index (score range 0-15) differed significantly between treatment and control groups at 3 months (p=0.018), but only by a median of 1 point (95% CI 0-1), with an interpolated value of 0.55 (0.08-1.04). Gait speed was 2.6 m/min (0.30-4.95) higher in the treatment group at 3 months. Neither treatment effect persisted at 6-months' and 9-months' follow-up. Treatment had no effect on patients' daily activity, social activity, anxiety, depression, and number of falls, or on emotional stress of carers.INTERPRETATIONCommunity physiotherapy treatment for patients with mobility problems 1 year after stroke leads to significant, but clinically small, improvements in mobility and gait speed that are not sustained after treatment ends.BACKGROUNDCommunity physiotherapy is often prescribed for stroke patients with long-term mobility problems. We aimed to assess the effectiveness of this treatment in patients who had mobility problems 1 year after stroke.","Green, J; Forster, A; Bogle, S; Young, J",2002.0,10.1016/S0140-6736(02)07443-3,0,0,
5887,Alcohol misuse and psychological resilience among U.S. Iraq and Afghanistan era veterans,"ER OBJECTIVE: The present study sought to investigate the longitudinal effects of psychological resilience against alcohol misuse adjusting for socio-demographic factors, trauma-related variables, and self-reported history of alcohol abuse.METHODOLOGY: Data were from the National Post-Deployment Adjustment Study (NPDAS) participants who completed both a baseline and one-year follow-up survey (N=1090). Survey questionnaires measured combat exposure, probable posttraumatic stress disorder (PTSD), psychological resilience, and alcohol misuse, all of which were measured at two discrete time periods (baseline and one-year follow-up). Baseline resilience and change in resilience (increased or decreased) were utilized as independent variables in separate models evaluating alcohol misuse at the one-year follow-up.RESULTS: Multiple linear regression analyses controlled for age, gender, level of educational attainment, combat exposure, PTSD symptom severity, and self-reported alcohol abuse. Accounting for these covariates, findings revealed that lower baseline resilience, younger age, male gender, and self-reported alcohol abuse were related to alcohol misuse at the one-year follow-up. A separate regression analysis, adjusting for the same covariates, revealed a relationship between change in resilience (from baseline to the one-year follow-up) and alcohol misuse at the one-year follow-up. The regression model evaluating these variables in a subset of the sample in which all the participants had been deployed to Iraq and/or Afghanistan was consistent with findings involving the overall era sample. Finally, logistic regression analyses of the one-year follow-up data yielded similar results to the baseline and resilience change models.CONCLUSIONS: These findings suggest that increased psychological resilience is inversely related to alcohol misuse and is protective against alcohol misuse over time. Additionally, it supports the conceptualization of resilience as a process which evolves over time. Moreover, our results underscore the importance of assessing resilience as part of alcohol use screening for preventing alcohol misuse in Iraq and Afghanistan era military veterans.","Green, K T; Beckham, J C; Youssef, N; Elbogen, E B",2014.0,10.1016/j.addbeh.2013.08.024,0,0,
5888,Group therapy for women with substance use disorders: results from the Women's Recovery Group Study,"ER METHOD: In this randomized clinical trial, participants were included if they were substance dependent and had used substances within the past 60 days (n=158). Women were randomized to WRG (n=52) or GDC (n=48); men were assigned to GDC (n=58). Substance use outcomes were assessed at months 1-6 and 9.RESULTS: Women in both the WRG and GDC had reductions in mean number of substance use days during treatment (12.7 vs 13.7 day reductions for WRG and GDC, respectively) and 6 months post-treatment (10.3 vs 12.7 day reductions); however, there were no significant differences between groups.CONCLUSIONS: The WRG demonstrated comparable effectiveness to standard mixed-gender treatment (i.e., GDC) and is feasibly delivered in an open-group format typical of community treatment. It provides a manual-based group therapy with women-focused content that can be implemented in a variety of clinical settings for women who are heterogeneous with respect to their substance of abuse, other co-occurring psychiatric disorders, and life-stage.BACKGROUND: This Stage II trial builds on a Stage I trial comparing the single-gender Women's Recovery Group (WRG) to mixed-gender Group Drug Counseling (GDC) that demonstrated preliminary support for the WRG in treating women with substance use disorders. The Stage II trial aims were to (1) investigate effectiveness of the WRG relative to GDC in a sample of women heterogeneous with respect to substance of abuse and co-occurring psychiatric disorders, and (2) demonstrate the feasibility of implementing WRG in an open-enrollment group format at two sites.","Greenfield, S F; Sugarman, D E; Freid, C M; Bailey, G L; Crisafulli, M A; Kaufman, J S; Wigderson, S; Connery, H S; Rodolico, J; Morgan-Lopez, A A; Fitzmaurice, G M",2014.0,10.1016/j.drugalcdep.2014.06.035,0,0,
5889,Control of body temperature during abdominal aortic surgery,"ER METHODSIn this clinical trial we evaluated the mean body temperature profile measured at five points in 40 patients divided into two groups: Group I was ventilated with a non-rebreathing circuit and Group II was ventilated with a circle system using low flow rates of fresh gases. All patients were treated with a hydrophobic heat moisture exchanger.RESULTSThe results point out a significantly (P < 0.01) lower decrease in mean body temperature 40 min after the start of mechanical ventilation with the use of low flow rate anesthesia.CONCLUSIONSThis study shows that anesthesia carried out using low fresh gas flow rates and heat moisture exchanger is able to reduce the fall in mean body temperature, when compared with anesthesia carried out using high fresh gas flow rates and heat moisture exchanger.BACKGROUNDCareful control of body temperature during anesthesia aims to prevent cardiocirculatory complications during the phase of recovery from anesthesia. Numerous studies have examined methods for warming the gases breathed by the patient, but the question of whether low flow anesthesia or heat and moisture exchanges can also influence the pattern of body temperature remains unresolved.","Gregorini, P; Cangini, D",1996.0,,0,0,
5890,Unexpected effect of repetition of imaged behavior,"ER In order to examine the efficiency of covert behavior rehearsal, 33 subjects, randomly assigned to three groups, were submitted to a task in a social condition. To reduce the stress-induced anxiety, the participants of the first group had been prepare by covert behavior rehearsal in a relaxed condition. Those of the second group received only relaxation and the third group had no preparation at all. The behavior rehearsal had no positive effect on the efficacy of the task execution. Moreover, a negative influence appeared. The results are discussed.","Griez, E; Callens, J",1983.0,,0,0,
5891,Qigong stress reduction in hospital staff,"ER METHODSSubjects were randomly assigned to a 6-week intervention of either qigong practice (n = 16) or a waiting list (n = 21). The primary measure of stress was the Perceived Stress Scale. Secondary measures included the Short Form 36 (SF-36) quality-of-life measure and a 100-mm analog pain scale.RESULTSThe qigong group demonstrated a statistically significant reduction of perceived stress compared to the control group (p = 0.02). On the Social Interaction subscale of the SF-36, the qigong group demonstrated greater improvement compared to controls (p = 0.04). Within-groups analyses demonstrated that the qigong group (p = 0.03), but not the control group, experienced a significant reduction of pain intensity. A regression analysis demonstrated an association between higher baseline stress levels and greater improvement within the qigong group (R(2) = 0.34; p = 0.02).CONCLUSIONSThese results suggest that short-term exposure to qigong was effective in reducing stress in hospital staff. Further studies are needed to evaluate the possible effectiveness of qigong in reducing pain and in improving quality of life.OBJECTIVEThe aim of this study was to investigate the effectiveness of a qigong training program in reducing stress in hospital staff.","Griffith, J M; Hasley, J P; Liu, H; Severn, D G; Conner, L H; Adler, L E",2008.0,10.1089/acm.2007.0814,0,0,
5892,Long-term effects of a nurse-led group and individual patient education programme for patients with chronic inflammatory polyarthritis - a randomised controlled trial,"ER AIMS AND OBJECTIVES: To investigate the long-term effect of a nurse-led hospital-based patient education programme combining group and individual education for patients with chronic inflammatory polyarthritis.BACKGROUND: Patient education interventions have shown short-term effects, but few studies have investigated whether the effects are sustained for a longer period.DESIGN: Randomised controlled trial.METHODS: Patients with rheumatoid arthritis, psoriatic arthritis and unspecified polyarthritis were randomised to the intervention group (n = 71) or a waiting list (n = 70). Primary outcomes were as follows: Global Well-Being and the Arthritis Self-Efficacy Other Symptoms Subscale. Secondary outcomes were as follows: patient activation, physical and psychological health status, patients' educational needs and a Disease Activity Score (DAS28-3).RESULTS: The intervention group had a statistically significant higher global well-being than the controls after 12 months, mean change score 8·2 (95% CI, 1·6-14·8; p-value = 0·015), but not in the Arthritis Self-Efficacy Other Symptoms Subscale, mean change score 2·6 (95% CI, -1·8 to 7·1; p-value = 0·245). Within each group, analyses showed a statistically significant improvement in DAS28-3, mean change -0·3 (95% CI, -0·5 to -0·1; p-value = 0·001), in the intervention group from baseline to 12 months, but not in the controls. The controls had a statistically significant deterioration in the Arthritis Self-Efficacy Other Symptoms Subscale, mean change -5·0 (95% CI, -8·6 to -1·3; p-value = 0·008), Arthritis Impact Measurement Scales - 2 Social, mean change 0·3 (95% CI, 0·1-0·5; p-value = 0·008), and Hospital Anxiety and Depression Scale total, mean change 1·4 (95% CI, 0·3-2·5; p-value = 0·013).CONCLUSION: A combination of group and individual patient education has a long-term effect on patients' global well-being.RELEVANCE TO CLINICAL PRACTICE: Nurses should consider whether a combination of group and individual patient education for patients with chronic inflammatory polyarthritis is an alternative in their clinical practice. This combination is less time-consuming for the patients, and it includes the benefit of group learning in addition to focusing on patient's individual educational needs.","Grønning, K; Rannestad, T; Skomsvoll, J F; Rygg, L Ø; Steinsbekk, A",2014.0,10.1111/jocn.12353,0,0,
5893,Impact of childhood trauma on the outcomes of a perinatal depression trial,"ER METHODS: Fifty-three pregnant low-income women were randomly assigned to IPT-B (n = 25) or UC (n = 28). Inclusion criteria included ? 18 years, >12 on the Edinburgh Postnatal Depression Scale, 10-32 weeks gestation, English speaking, and access to a phone. Participants were evaluated for childhood trauma, depressive symptoms/diagnoses, anxiety symptoms, social functioning, and interpersonal problems.RESULTS: Regression and mixed effects repeated measures analyses revealed that trauma exposure did not moderate changes in symptoms and functioning over time for women in UC versus IPT-B. Analyses of covariance showed that within the IPT-B group, women with more versus less trauma exposure had greater depression severity and poorer outcomes at 3-month postbaseline. At 6-month postpartum, they had outcomes indicating remission in depression and functioning, but also had more residual depressive symptoms than those with less trauma exposure.CONCLUSIONS: Childhood trauma did not predict poorer outcomes in the IPT-B group at 6-month postpartum, as it did at 3-month postbaseline, suggesting that IPT including maintenance sessions is a reasonable approach to treating depression in this population. Since women with more trauma exposure had more residual depressive symptoms at 6-month postpartum, they might require longer maintenance treatment to prevent depressive relapse.BACKGROUND: Childhood abuse and neglect have been linked with increased risks of adverse mental health outcomes in adulthood and may moderate or predict response to depression treatment. In a small randomized controlled trial treating depression in a diverse sample of nontreatment-seeking, pregnant, low-income women, we hypothesized that childhood trauma exposure would moderate changes in symptoms and functioning over time for women assigned to usual care (UC), but not to brief interpersonal psychotherapy (IPT-B) followed by maintenance IPT. Second, we predicted that trauma exposure would be negatively associated with treatment response over time and at the two follow-up time points for women within UC, but not for those within IPT-B who were expected to show remission in depression severity and other outcomes, regardless of trauma exposure.","Grote, N K; Spieker, S J; Lohr, M J; Geibel, S L; Swartz, H A; Frank, E; Houck, P R; Katon, W",2012.0,10.1002/da.21929,0,0,
5894,"A comparison of the effects of prednisolone and mianserin on ventilatory, exercise and psychometric parameters in patients with chronic obstructive pulmonary disease","ER There is controversy as to whether effects on mood play a role in mediating the response to corticosteroids in chronic obstructive pulmonary disease (COPD). If alterations in mood are important, it is conceivable that psychotropic drugs such as mianserin might produce similar responses to prednisolone in patients with COPD. Twelve patients age 62.5 y, with FEV1 29% of predicted and < 15% reversibility to salbutamol completed a randomised, double-blind crossover study. After an initial three week placebo run-in period patients received three weeks of prednisolone 40 mg daily or mianserin 60-90 mg daily with an intervening three week placebo washout period. Full respiratory function tests, bicycle ergometry and 6 minute walks were performed before and after the run-in and at the end of each period. Psychological and functional assessments were also made at each visit. Prednisolone significantly increased FVC, maximum ventilation (VEmax) and maximum heart rate (HRmax) compared with placebo, with mean for the difference of 0.25 l, 2.56 l.min-1 and 12 beats.min-1 respectively. FVC, maximum oxygen uptake (VO2max) and HRmax were also significantly increased with prednisolone compared with mianserin. Anxiety scores were significantly lower with prednisolone compared with placebo. In contrast, mianserin had no significant effects on lung function, exercise or psychological parameters compared with placebo. The improvements in ventilation, exercise and anxiety scores following treatment with prednisolone were not reproduced by mianserin, suggesting that the effects of prednisolone in COPD are unlikely to be due to alterations in mood.","Grove, A; Lipworth, B J; Ingram, C G; Clark, R A; Dhillon, D P",1995.0,,0,0,
5895,Routine follow up of breast cancer in primary care: randomised trial,"ER DESIGNRandomised controlled trial with 18 month follow up in which women received routine follow up either in hospital or in general practice.SUBJECTS AND SETTING296 women with breast cancer in remission receiving regular follow up care at district general hospitals in England.MAIN OUTCOME MEASURESTime between first presentation of symptoms to confirmation of recurrence; quality of life measured by specific dimensions of the SF-36 schedule, the EORTC symptom scale, and hospital anxiety and depression scale.RESULTSMost recurrences (18/26, 69%) presented as interval events, and almost half (7/16, 44%) of the recurrences in the hospital group presented first to general practice. The median time to hospital confirmation of recurrence was 21 days in the hospital group (range 1-376 days) and 22 days in the general practice group (range 4-64). The differences between groups in the change in SF-36 mean scores from baseline were small: -1.8 (95% confidence interval -7.2 to 3.5) for social functioning, 0.5 (-4.1 to 5.1) for mental health, and 0.6 (-3.6 to 4.8) for general health perception. The change from baseline in the mean depression score was higher in the general practice group at the mid-trial assessment (difference 0.6, 0.1 to 1.2) but there was no significant difference between groups in the anxiety score or the EORTC scales.CONCLUSIONGeneral practice follow up of women with breast cancer in remission is not associated with increase in time to diagnosis, increase in anxiety, or deterioration in health related quality of life. Most recurrences are detected by women as interval events and present to the general practitioner, irrespective of continuing hospital follow up.OBJECTIVETo assess the effect on time to diagnosis of recurrence and on quality of life of transferring primary responsibility for follow up of women with breast cancer in remission from hospital to general practice.","Grunfeld, E; Mant, D; Yudkin, P; Adewuyi-Dalton, R; Cole, D; Stewart, J; Fitzpatrick, R; Vessey, M",1996.0,,0,0,
5896,"A prospective, randomized clinical study of osteochondral autologous transplantation versus microfracture for the treatment of osteochondritis dissecans in the knee joint in children","ER TYPE OF STUDYProspective, randomized clinical study.METHODSBetween 2001 and 2005, a total of 50 children with a mean age of 14.3 years (12 to 18) and with symptomatic lesions of the OCD in the femoral condyle of the knee were randomized to undergo either the OAT or the MF procedure. Only those children with grade 3 or 4 (OCD) in the medial or lateral femoral condyle (according to International Cartilage Repair Society, ICRS) were included in the study. Forty-seven patients (94%) were available for follow-up. There were 25 patients in the OAT group and 22 patients in the MF group. The mean duration of symptoms was 23.54+/-4.24 months and the mean follow-up was 4.2 years (range from 3 to 6 y), and none of the children had prior surgical interventions to the affected knee. Children were evaluated using ICRS score, x-rays, magnetic resonance imaging, and second-look arthroscopies.RESULTSAfter 1 year, both groups had significant clinical improvement (P<0.05) and the ICRS functional and objective assessment showed that 23 of 25 (92%) patients had excellent or good results after OAT compared with 19 of 22 (86%) after MF (NS), but 19 of 23 (83%) after OAT and only 12 of 19 (63%) after MF procedure maintained excellent or good results after 4.2 years (range from 3 to 6 y). The MF group showed significant deterioration over the 4.2 years follow-up (P<0.05), but still had significant clinical improvement compared with pretreatment evaluation (P=0.004). There were 9 of 22 (41%) failures in the MF group, and none in the OAT group. Magnetic resonance imaging evaluation according to the ICRS evaluation system showed excellent or good repairs in 19 of 21 patients (91%) after OAT compared with 10 of 18 (56%) after MF.CONCLUSIONSAt an average of 4.2 years follow-up, our prospective, randomized, clinical study in children under the age of 18 years has shown significant superiority of the mosaic-type OAT over MF for the treatment of osteochondritis dissecans defects in the knee. However, our study has shown that both MF and OAT give encouraging clinical results for children under the age of 18 years.LEVEL OF EVIDENCELevel 1: randomized controlled trial, significant difference.PURPOSEThe aim of this study was to compare the outcomes of the arthroscopic mosaic-type osteochondral autologous transplantation (OAT) and microfracture (MF) procedures for the treatment of osteochondritis dissecans (OCD) defects of the femoral condyles of the knee joint in children under the age of 18 years.","Gudas, R; Simonaityte, R; Cekanauskas, E; Tamosi?nas, R",2009.0,10.1097/BPO.0b013e3181b8f6c7,0,0,
5897,Multidisciplinary intervention program for caregivers of patients in a home care program,"ER METHODSWe performed a randomized clinical trial in 79 main caregivers (39 control group and 40 intervention group) of patients in the home care program of a primary care health center between 2000 and 2001. Quality of life, anxiety and depression were measured by the COOP/WONCA and Goldberg questionnaires, respectively, at the beginning and at the end of the study. Interventions consisted of two medical visits to take a bio-psychosocial history of the caregiver and a nurse visit for health education. Two letters, adapted to each carer's needs, were sent and two telephone calls were made.RESULTSThe intervention group scored significantly better than the control group in relation to WONCA-feelings (p=0.03), WONCA-social activities (p=0.05), and WONCA-quality of life (p=0.02).CONCLUSIONSA short multidisciplinary intervention program adapted to routine consultations could prevent deterioration in caregivers' quality of life.OBJECTIVESTo improve quality of life, anxiety and depression in caregivers of patients in home care.","Guerrero, Caballero L; Ramos, Blanes R; Alcolado, Aranda A; López, Dolcet M J; Pons La, Laguna J L; Quesada, Sabaté M",2008.0,,0,0,
5898,Use of silicone hydrogel material for daily wear,"ER Silicone hydrogel contact lenses were initially developed to optimise oxygen transmissibility for extended wear use. The concerns with such contact lenses have been their higher elastomeric and hydrophobic characteristics associated with the incorporation of silicone type monomers. The use of silicone hydrogel has most recently been suggested for daily wear to eliminate all hypoxic related problems. The primary aim of the investigation was to test in vivo wetting performance and subjective acceptance of the first silicone hydrogel contact lens developed for daily wear, ACUVUE ADVANCE with HYDRACLEAR (galyfilcon A), compared to a conventional hydrogel contact lens for the same application SofLens 66 (alphafilcon A). The investigation was a randomised, subject masked bilateral cross over investigation testing of the two contact lens materials over their approved replacement periods (galyfilcon A 2 weeks and alphafilcon A 2 weeks (USA) and 4 weeks (Europe)). In all cases ReNu Multiplus lens care system was used. The investigation carried out on 24 contact lens wearers showed that: (i) in vivo wettability was superior for galyfilcon A which had a thicker lipid layer (thin layer incidence: galyfilcon A 54%; alphafilcon A 70-86%, p<0.05), a thicker aqueous layer (thick layer incidence: galyfilcon A 88%; alphafilcon A 35-64%, p<0.05) and a more stable tear film (galyfilcon A 7.8s; alphafilcon A 2 weeks 5.6s, p=0.022; 4 weeks 7.4s, p=0.276); (ii) for the intended replacement period, comfort was better with galyfilcon A (2 weeks) compared to alphafilcon A (4 weeks) at insertion (p=0.001) and, throughout the day (daytime and evening p=0.008). Contact lenses made from galyfilcon A and replaced two weekly achieved better in vivo wettability than contact lenses made from alphafilcon A and replaced either two and four weekly; the better wettability was associated with an overall better comfort for galyfilcon A.","Guillon, M; Maissa, C",2007.0,10.1016/j.clae.2006.09.008,0,0,
5899,Live attenuated chimeric yellow fever dengue type 2 (ChimeriVax-DEN2) vaccine: phase I clinical trial for safety and immunogenicity: effect of yellow fever pre-immunity in induction of cross neutralizing antibody responses to all 4 dengue serotypes,"ER A randomized double-blind Phase I Trial was conducted to evaluate safety, tolerability, and immunogenicity of a yellow fever (YF)-dengue 2 (DEN2) chimera (ChimeriVax-DEN2) in comparison to that of YF vaccine (YF-VAX). Forty-two healthy YF naïve adults randomly received a single dose of either ChimeriVax-DEN2 (high dose, 5 log plaque forming units [PFU] or low dose, 3 log PFU) or YF-VAX by the subcutaneous route (SC). To determine the effect of YF preimmunity on the ChimeriVax-DEN2 vaccine, 14 subjects previously vaccinated against YF received a high dose of ChimeriVax-DEN2 as an open-label vaccine. Most adverse events were similar to YF-VAX and of mild to moderate intensity, with no serious side-effects. One hundred percent and 92.3% of YF naïve subjects inoculated with 5.0 and 3.0 log10 PFU of ChimeriVax-DEN2, respectively, seroconverted to wt DEN2 (strain 16681); 92% of subjects inoculated with YF-VAX seroconverted to YF 17D virus but none of YF naïve subjects inoculated with ChimeriVax-DEN2 seroconverted to YF 17D virus. Low seroconversion rates to heterologous DEN serotypes 1, 3 and 4 were observed in YF naïve subjects inoculated with either ChimeriVax-DEN2 or YF-VAX. In contrast, 100% of YF immune subjects inoculated with ChimeriVax-DEN2 seroconverted to all 4 DEN serotypes. Surprisingly, levels of neutralizing antibodies to DEN 1, 2 and 3 viruses in YF immune subjects persisted after 1 year. These data demonstrated that (1) the safety and immunogenicity profile of the ChimeriVax-DEN2 vaccine is consistent with that of YF-VAX, and (2) preimmunity to YF virus does not interfere with ChimeriVax-DEN2 immunization, but induces a long lasting and cross neutralizing antibody response to all 4 DEN serotypes. The latter observation can have practical implications toward development of a dengue vaccine.","Guirakhoo, F; Kitchener, S; Morrison, D; Forrat, R; McCarthy, K; Nichols, R; Yoksan, S; Duan, X; Ermak, T H; Kanesa-Thasan, N; Bedford, P; Lang, J; Quentin-Millet, M J; Monath, T P",2006.0,,0,0,
5900,"Stress, affiliation, and emotional contagion","ER Female participants were exposed to high or low threat in the presence of another person believed to be facing either the same or a different situation. In Study 1, each dyad consisted of 2 actual participants, whereas in Study 2, each dyad consisted of 1 participant and 1 confederate, trained to convey either a calm or a nervous reaction to the situation. Affiliation patterns in both studies, defined in terms of the amount of time spent looking at the affiliate, were consistent with S. Schachter's (1959) ""emotional similarity hypothesis""; threat increased affiliation and did so particularly with affiliates believed to be facing the same situation. The authors also found evidence of behavioral mimicry, in terms of facial expressions, and emotional contagion, in terms of self-reported anxiety. The behavioral mimicry and emotional contagion results are considered from both primitive emotional contagion and social comparison theory perspectives.","Gump, B B; Kulik, J A",1997.0,,0,0,
5901,Thinking outside the black box: the importance of context in understanding the impact of a preoperative education nursing intervention among Chinese cardiac patients,"ER OBJECTIVE: In a randomized controlled trial of a preoperative education intervention conducted for Chinese cardiac patients, we observed a greater effect on symptoms of anxiety and depression than that reported with regard to similar interventions in western care settings. The objective of this qualitative study was to help explain the findings of the trial by exploring Chinese patients' experience of seeking and receiving information before cardiac surgery.METHODS: Semi-structured interviews were conducted with a purposive sample of 20 trial participants before discharge (ten from the preoperative education group; ten from the usual care control group). Data were analyzed using a thematic analysis approach.RESULTS: A total of five themes were generated: the role of reputation and hierarchy; gaining strength from knowledge; information as a low priority; being kept in the dark; and learning through peer support.CONCLUSION: In health care systems where service users are given relatively little information, interventions designed to inform patients about their treatment are likely to have a much greater impact on their psychological health.PRACTICE IMPLICATIONS: Providers of services for patients undergoing cardiac surgery in China should be encouraged to incorporate information giving into routine practice, tailored according to individual need.","Guo, P; East, L; Arthur, A",2014.0,10.1016/j.pec.2014.03.001,0,0,
5902,Applied relaxation in the treatment of long-lasting neck pain: a randomized controlled pilot study,"ER DESIGNRandomized controlled pilot study.SUBJECTSThirty-seven patients with long-lasting neck pain.METHODSThe patients were randomly assigned either to applied relaxation or treatment as usual. The applied relaxation group received 7 group sessions over a period of 7 weeks and the treatment as usual group an average of 11 individual sessions spread over 20 weeks following baseline. Twenty-nine participants completed the intervention and filled in a self-assessment questionnaire before treatment, and 7 and 20 weeks after baseline. The questionnaire comprised: Neck Disability Index, Coping Strategies Questionnaire, Hospital Anxiety and Depression Scale, Tampa Scale of Kinesiophobia, and questions regarding neck pain, analgesic use, sleep, sick-leave and utilization of healthcare.RESULTSThe applied relaxation group had better perceived control over pain at the 20 weeks follow-up compared with the treatment as usual group.CONCLUSIONThe design and methods of this pilot study were feasible and will be suitable for a larger randomized controlled study.OBJECTIVESTo evaluate the feasibility of study design and method for evaluating effects of interventions on patients with long-lasting neck pain and to compare treatment effects of: (i) a pain and stress management group intervention with applied relaxation, and (ii) individual physiotherapy treatment as usual.","Gustavsson, C; Koch, L",2006.0,10.1080/16501970510044025,0,0,
5903,Examining the effectiveness of home-based parent aide services to reduce risk for physical child abuse and neglect: six-month findings from a randomized clinical trial,"ER OBJECTIVE: This study set out to carry out a feasible, real-world, randomized clinical trial to examine the benefits of home-based paraprofessional parent aide services in reducing physical abuse and neglect risk in high-risk parents.METHODS: Families were randomly assigned to receive either parent aide plus case management services (n = 73) or case management services only (n = 65), collecting in-home data on physical child abuse and neglect and proximal risk and protective factors, just prior to service initiation, and again after six months of services.RESULTS: Mothers receiving parent aide and case management services reported significant improvements from baseline to six-month follow-up in self-reported indicators of physical child abuse risk, as well as improvements on parental stress, mastery, depression, and anxiety, whereas mothers receiving only case management services did not. The slopes of such observed changes across groups, however, were not found to be statistically significantly different. No discernable improvements were found with regard to indicators of risk for child neglect.CONCLUSIONS: As the first randomized clinical trial examining the effectiveness of parent aide services, this study provides the first controlled evidence examining the potential benefits of this service modality. This study suggests promising trends regarding the benefit of parent aide services with respect to physical child abuse risk reduction and related predictors, but evidence does not appear to suggest that such services, as they are presently delivered, reduce child neglect.PRACTICE IMPLICATIONS: These findings support the continued use of parent aide services in cases of physical child abuse and also suggest careful consideration of the ways such services may be better configured to extend their impact, particularly with respect to child neglect risk.","Guterman, N B; Tabone, J K; Bryan, G M; Taylor, C A; Napoleon-Hanger, C; Banman, A",2013.0,10.1016/j.chiabu.2013.03.006,0,0,
5904,Interprofessional stroke rehabilitation for stroke survivors using home care,"ER METHODSRandomized controlled trial of 101 community-living stroke survivors (<18 months post-stroke) using home care services. Subjects were randomized to intervention (n=52) or control (n=49) groups. The intervention was a 12-month specialized, evidence-based rehabilitation strategy involving an interprofessional team. The primary outcome was change in health-related quality of life and functioning (SF-36) from baseline to 12 months. Secondary outcomes were number of strokes during the 12-month follow-up, and changes in community reintegration (RNLI), perceived social support (PRQ85-Part 2), anxiety and depressive symptoms (Kessler-10), cognitive function (SPMSQ), and costs of use of health services from baseline to 12 months.RESULTSA total of 82 subjects completed the 12-month follow-up. Compared with the usual care group, stroke survivors in the intervention group showed clinically important (although not statistically significant) greater improvements from baseline in mean SF-36 physical functioning score (5.87, 95%","Markle-Reid, M; Orridge, C; Weir, R; Browne, G; Gafni, A; Lewis, M; Walsh, M; Levy, C; Daub, S; Brien, H; Roberts, J; Thabane, L",2011.0,,0,0,
5905,"Safety, efficacy, and cost-effectiveness of mechanical ventilation with humidifying filters changed every 48 hours: a prospective, randomized study","ER DESIGNProspective randomized clinical trial.PATIENTSSixty-one consecutive unselected mechanically ventilated intensive care unit patients.INTERVENTIONSPatients were randomly allocated to one of the three HMEs studied (Hygrobac-Dar from Mallinckrodt, n = 21; Humid-Vent from Gibeck, n = 20; and Clear-Thermal from Intersurgical, n = 20).MEASUREMENTS AND MAIN RESULTSHygrometric parameters were measured by psychrometry after 3, 24, and 48 hrs of use. Peak airway pressure was recorded every 6 hrs and averaged over 24 hrs. Bacterial colonization of both patients and circuits was studied. Patients in all three groups were similar in terms of age, indications for, and overall duration of mechanical ventilation. Tracheal tube occlusion never occurred. Hygrometric data included 371 measurements whereas bacteriologic data included >700 samples and cultures. The Hygrobac-Dar HMEs gave a significantly higher absolute humidity whatever the time of measurement (3, 24, or 48 hrs) than the other two HMEs (p < .001). The Clear-Thermal HMEs gave the poorest hygrometric parameters (p < .01); five of them were replaced prematurely (24 hrs) because the absolute humidity was <25 mg H2O/L. This did not occur for the other HMEs. Mean peak airway pressures were identical in the three groups. The bacterial colonizations of both patient and circuit were similar (and negligible for circuits) for all three groups.CONCLUSIONSome HMEs may be used safely for 48 hrs without change. However, this does not pertain to every brand of HME. Objective in vivo evaluation of their humidifying performances is decisive before extending their duration of use.OBJECTIVETo determine whether three hydrophobic and hygroscopic heat and moisture exchangers (HMEs) retain their heating and humidifying properties (assessed by psychrometric measurements of absolute humidity, relative humidity, and tracheal temperature) for 48 hrs without any drop in their bacteriologic efficiency.","Markowicz, P; Ricard, J D; Dreyfuss, D; Mier, L; Brun, P; Coste, F; Boussougant, Y; Djedaïni, K",2000.0,,0,0,
5906,A controlled trial of brief psychotherapy and mutual-help group treatment of conjugal bereavement,"ER Sixty-one women who sought treatment for unresolved grief reactions 4 months to 3 years after the death of their husbands were randomly assigned to either brief dynamic psychotherapy with experienced clinicians or mutual-help group treatment led by nonclinicians. Women in both groups experienced a reduction in stress-specific and general symptoms as well as improvement in social and work functioning. Women in the brief psychotherapy group showed a greater decline in one measure of general symptoms, and there was greater attrition in the group treatment condition. When two subgroups who had completed the majority of sessions were compared, treatments were found to be equally effective.","Marmar, C R; Horowitz, M J; Weiss, D S; Wilner, N R; Kaltreider, N B",1988.0,10.1176/ajp.145.2.203,0,0,
5907,"Effects of a self-regulation based physical activity program (the ""4-STEPS"") for unexplained chronic fatigue: a randomized controlled trial","ER BACKGROUND: This study aimed at assessing the effects of a self-regulation-based brief physical activity program for patients suffering from unexplained chronic fatigue, the ""4-STEPS to control your fatigue program"".METHOD: A 12-week randomized controlled trial was conducted. Adult patients meeting the CDC criteria for idiopathic chronic fatigue were randomized to either the control condition (standard care) or the intervention condition (4-STEPS). The 4-STEPS was based on self-regulation principles and consisted of motivational interviewing and self-regulation skills training. All patients were assessed at baseline and post-treatment (12 weeks) for fatigue severity (primary outcome) and impact, physical activity (leisure time physical activity, number of daily steps and personal activity goal progress), health-related quality of life, somatic distress and psychological distress (depression and anxiety).RESULTS: Ninety-one patients (45 intervention and 46 control patients) received the allocated intervention. At post-treatment, statistical analysis revealed a significant difference for subjective experience of fatigue (4.73 points; g = 0.51) in favour of the intervention group. Mixed design ANCOVAs showed a significant effect of the 4-STEPS on fatigue severity, leisure time physical activity, personal activity goal progress and health-related quality of life. No significant effects were found for number of daily steps and somatic and psychological distress.CONCLUSION: The 4-STEPS program has significant beneficial effects at post-treatment. This brief self-regulation-based intervention looks promising for the management of unexplained chronic fatigue.TRIAL REGISTRATION: ISRCTN70763996.","Marques, M; Gucht, V; Leal, I; Maes, S",2015.0,10.1007/s12529-014-9432-4,0,0,
5908,Treating young individuals at clinical high risk for psychosis,"ER BACKGROUND: Typically, studies investigating those at clinical high risk for psychosis have focused on predictors of conversion and treatments that might prevent conversion to full-blown psychosis. Few studies have followed those who do not go on to develop a psychotic illness.METHODS: Participants were 48 young people who were at risk for developing psychosis based on the Structured Interview for Prodromal Symptoms criteria and participated in a treatment programme where they were offered up to 6 months of psychosocial treatment and psychiatric management. Attenuated psychotic symptoms, negative symptoms, depression, anxiety, social functioning, alcohol and drug use, and meta-cognitive beliefs were assessed at baseline, 6, 12 and 18 months. Personality characteristics were assessed at baseline. Medication use was tracked and psychiatric visits were logged over the 18-month study period.RESULTS: On average, participants attended 12 sessions of psychosocial treatment and had one meeting with the psychiatrist every 6 months. Only 24% were ever prescribed any psychotropic medications, and antipsychotics were not used. Significant improvements were found over time in attenuated positive symptoms, negative symptoms, depression, anxiety, meta-cognitions and social functioning with most improvement occurring in the first 6 months. There was no change in the level of substance use. For personality assessment, participants generally scored high on neuroticism and openness and had low scores on extraversion, agreeableness and conscientiousness.CONCLUSION: With minimal treatment and no antipsychotics, young people who present as being at risk for developing a psychotic disorder demonstrate clinical improvement over time. However, a few continued to have the liability of ongoing attenuated psychotic symptoms.","Marshall, C; Addington, J; Epstein, I; Liu, L; Deighton, S; Zipursky, R B",2012.0,10.1111/j.1751-7893.2011.00299.x,0,0,
5909,"Promoting mental health in small-medium enterprises: an evaluation of the ""Business in Mind"" program","ER METHODS/DESIGN: The effectiveness of two versions of the program (self administered and telephone facilitated) will be assessed using a randomised trial with an active control condition (psychoeducation only). We aim to recruit a minimum of 249 managers and a sample of their employees. This design allows for 83 managers per group, as power analyses showed that this number would allow for attrition of 20% and still enable detection of an effect size of 0.5. The intervention will be implemented over a three month period and postal surveys will assess managers and employees in each group at baseline, intervention completion, and at 6 month follow up. The intervention groups (managers only) will also be assessed at 12 and 24 month follow-up to examine maintenance of effects. Primary outcomes are managers' levels of psychological capital (hope, resilience, self-efficacy and optimism), coping strategies, anxiety and depression symptoms, self-reported health, job satisfaction and job tension. Secondary outcomes are participating managers subordinates' perceptions of manager support, relational justice, emotional climate and job tension. In order to provide an economic evaluation of the intervention, both employees and manager rates of absenteeism and presenteeism will also be assessed.DISCUSSION: The intervention being trialled is expected to improve both primary and secondary outcomes. If proven efficacious, the intervention could be disseminated to reach a much larger proportion of the business community.BACKGROUND: Workplace mental health promotion (WMHP) aims to prevent and effectively manage the social and economic costs of common mental illnesses such as depression. The mental health of managers and employees within small-medium enterprises (SMEs) is a neglected sector in occupational health research and practice, despite the fact that this sector is the most common work setting in most economies. The availability and propensity of SME staff to attend face-to-face training/therapy or workshop style interventions often seen in corporate or public sector work settings is a widely recognised problem. The 'Business in Mind' program employs a DVD mode of delivery that is convenient for SME managers, particularly those operating in regional and remote areas where internet delivery may not be optimal. The objective of the intervention program is to improve the mental health of SME managers, and examine whether employees of managers' whose mental health improves, report positive change in their psychosocial work environment. The mechanisms via which we aim to improve managers' mental health are through the development of their psychological capital (a higher order construct comprised of hope, self efficacy, resilience and optimism) and their skills and capacities for coping with work stress.","Martin, A; Sanderson, K; Scott, J; Brough, P",2009.0,10.1186/1471-2458-9-239,0,0,
5910,Performance evaluation of three vaporizing humidifiers and two heat and moisture exchangers in patients with minute ventilation > 10 L/min,"ER DESIGNProspective, controlled, randomized, not blinded study.SETTINGICU of a university hospital.PATIENTSICU patients requiring controlled mechanical ventilation with minute ventilation > 10 L/min. Patients had to be sedated and paralyzed and had to require ventilation for more than four days.INTERVENTIONSFollowing a randomized order, the patients were ventilated for 24-h periods with three HHWSs (Bennett Cascade 2 humidifier, Fisher-Paykel MR 460 and MR 600) and two HMEs (Pall Ultipor and Hygrobac filter).MEASUREMENTS AND RESULTSIn each patient and for each 24-h period, absolute humidity, (AH), relative humidity (RH) of inspired gases, and tracheal temperature were obtained. Two HHWSs (Bennett and Fisher-Paykel MR 460) had a better thermal and humidification capacity than any other systems (p  25 mg H2O/L in any patient, it was not studied beyond the first measurement.CONCLUSIONSThe Hygrobac filter had a thermal and humidification capability closed to the two HHWSs (81 to 97 percent) but the capability declines over 24 h. The Pall filter had a poor capability (54 to 74 percent of that of HHWSs).STUDY OBJECTIVETo compare the thermal and humidification capacity of three heated hot water systems (HHWSs) and two heat and moisture exchangers (HMEs) in ICU patients submitted to minute ventilation > 10 L/min.","Martin, C; Papazian, L; Perrin, G; Bantz, P; Gouin, F",1992.0,,0,0,
5911,The effects of aerobic- versus strength-training on body image among young women with pre-existing body image concerns,"ER This experiment compared the effects of aerobic-training (AT) versus strength-training (ST) on body image among young women with pre-existing body image concerns. Theory-based correlates of body image change were also examined. Participants were 46 women (M age=21.5 years), randomly assigned to an 8-week AT or ST intervention consisting of supervised exercise 3 days/week. Multidimensional measures of body image were administered pre- and post-intervention, along with measures of physical fitness, perceived fitness, and exercise self-efficacy. Women in the AT condition reported greater reductions in social physique anxiety (p=.001) and tended to report greater improvements in appearance evaluation (p=.06) than women in the ST condition. Changes in perceived fatness, perceived aerobic endurance and aerobic self-efficacy were significantly correlated with body image change (ps<.003). Results provide direction for prescribing exercise to improve body image and advancing theory to account for the effects of exercise.","Martin, Ginis K A; Strong, H A; Arent, S M; Bray, S R; Bassett-Gunter, R L",2014.0,10.1016/j.bodyim.2014.02.004,0,0,
5912,Impact of interdisciplinary treatment on physical and psychosocial parameters in patients with fibromyalgia: results of a randomised trial,"ER METHODSA randomised controlled clinical trial carried out among 153 patients. The control group (CG) received standard pharmacological therapy. The experimental group (EG) received an interdisciplinary treatment. At baseline and 6 months after the intervention, participants completed assessment for impact of FM in the quality of life, anxiety, depression, coping with pain, social support and satisfaction with the treatment.RESULTSA total of 110 participants completed the trial. Six months after the intervention, statistically significant improvements in quality of life (p = 0.04), pain (p = 0.03), self-assertiveness (p = 0.01), mental self-control (p = 0.05), social support (p = 0.02) and satisfaction (p = 0.0001) were observed in the EG. Randomisation to the EG was identified as a predictor for improvement.CONCLUSIONAn interdisciplinary intervention may be appropriate for patients referred to a hospital pain management unit.AIMFibromyalgia (FM) is a persistent disorder that can have a devastating effect on patients' lives. The purpose of the study was to assess the effects of an interdisciplinary treatment for FM on patients' physical and psychosocial parameters.","Martín, J; Torre, F; Padierna, A; Aguirre, U; González, N; Matellanes, B; Quintana, J M",2014.0,,0,0,
5913,A randomized trial to assess the efficacy of a psychoeducational intervention on caregiver burden in schizophrenia,"ER Background: Patient's relatives usually care for patients with schizophrenia, and as informal caregivers they experience negative consequences. The aim of the EDUCA-III trial is to test the efficacy of a psychoeducational intervention program (PIP) versus standard care to reduce the caregiver burden at post-intervention (4 months), and at follow-up (8 months). Method: A two-arm, evaluator blind, multicentre, randomized controlled trial. The PIP group had 12 weekly group sessions. The control intervention group had the usual support and standard care. Primary outcomes were change scores since baseline on the Zarit Burden Interview (ZBI) and the Involvement Evaluation Questionnaire (IEQ). Results: One hundred and nine caregivers were randomized to PIP and 114 to control condition from 23 research sites. The decrease of ZBI scores was significantly higher on the PIP arm at 4 months (mean difference [MD] = -4.33; 95%","Martín-Carrasco, M; Fernández-Catalina, P; Domínguez-Panchón, A I; Gonçalves-Pereira, M; González-Fraile, E; Muñoz-Hermoso, P; Ballesteros, J",2016.0,10.1016/j.eurpsy.2016.01.003,0,0,
5914,Predictors of diagnosis of child psychiatric disorder in adult-infant social-communicative interaction at 12 months,"ER To establish which social interactive behaviours predict later psychiatric diagnosis, we examined 180 videos of a parent-infant interaction when children were aged one year, from within the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. Sixty of the videos involved infants who were later diagnosed with a psychiatric disorder at seven years, and 120 were a randomly selected sex-matched control group. Interactive behaviours for both the caregiver and the one year old infant were coded from the videos according to eight holistic categories of interpersonal engagement: Well-being, Contingent Responsiveness, Cooperativeness, Involvement, Activity, Playfulness, Fussiness, and Speech. Lower levels of adult activity and speech in interaction at one year significantly predicted overall diagnosis of child psychiatric disorder.","Marwick, H; Doolin, O; Allely, C S; McConnachie, A; Johnson, P; Puckering, C; Golding, J; Gillberg, C; Wilson, P",2013.0,10.1016/j.ridd.2012.09.007,0,0,
5915,Value of superoxide dismutase for prevention of multiple organ failure after multiple trauma,"ER In a prospective, randomized trial, recombinant human superoxide dismutase (rhSOD, 3000 mg/day, Grünenthal, Aachen, Germany) or placebo was given intravenously during 5 days after multiple injuries (Injury Severity Score [ISS] > or = 27; 24 patients). Manifestation of multiple organ failure (MOF) and posttraumatic inflammatory response were evaluated over 14 days. No side effects were noted by continuous infusion of rhSOD, which allowed high SOD plasma levels (24.77 +/- 9.43 mg/L) compared with controls (0.03 +/- 0.02 mg/L). Multiple organ failure was attenuated by rhSOD treatment in respect to cardiovascular and pulmonary functions. Additionally, intensive care therapy was shortened from 30 days (Q25: 15; Q75: 37) to 21 days (Q25: 12; Q75: 41). A secondary increase of inflammatory mediators (e.g., C-reactive protein, polymorphonuclear [PMN]-elastase, phospholipase A2), as observed at the end of the first week in the placebo group, was reduced by rhSOD therapy. The results reveal an attenuation of organ failure after trauma, most likely by decreasing the release of inflammatory mediators and reduction of leukocyte-mediated organ injury. These preliminary results, while promising, need to be confirmed in a larger number of patients.","Marzi, I; Bühren, V; Schüttler, A; Trentz, O",1993.0,,0,0,
5916,High-frequency binge eating predicts weight gain among veterans receiving behavioral weight loss treatments,"ER Objective To assess for the frequency of binge eating behavior and its association with weight loss in an overweight/obese sample of veterans. Methods This study is a secondary analysis of data from the ASPIRE study, a randomized effectiveness trial of weight loss among veterans. Of the 481 enrolled veterans with overweight/obesity, binge eating frequency was obtained by survey for 392 (82%). Results The majority (77.6%) reported binge eating, and 6.1% reported high-frequency binge eating. Those reporting any binge eating lost 1.4% of body weight, decreased waist circumference by 2.0 cm, and had significantly worse outcomes than those reporting never binge eating who lost about double the weight (2.7%) and reduced waist circumference by twice as much (4.2 cm). The high-frequency binge group gained 1.4% of body weight and increased waist circumference by 0.3 cm. Conclusions High rates of binge eating were observed in an overweight/obese sample of veterans enrolled in weight loss treatment. The presence of binge eating predicted poorer weight loss outcomes. Furthermore, high-frequency binge eating was associated with weight gain. These findings have operational and policy implications for developing effective strategies to address binge eating in the context of behavioral weight loss programs for veterans.","Masheb, R M; Lutes, L D; Kim, H M; Holleman, R G; Goodrich, D E; Janney, C A; Kirsh, S; Richardson, C R; Damschroder, L J",2015.0,10.1002/oby.20931,0,0,
5917,Efficacy of a multimodal treatment for disruptive behavior disorders in children and adolescents: focus on internalizing problems,"ER Disruptive Behavior Disorders (DBDs) are among the most common reasons for youth referrals to mental health clinics. Aim of this study is to compare short and medium term efficacy of a multimodal treatment program (MTP), compared to community care (treatment-as-usual, TAU). The sample included 135 youths with DBDs (113 males, age range 9-15 years, mean age 12±2.5 years) were assigned either to a MTP (n=64), or addressed to community care for a TAU (n=71). Outcome measures were the Child Behaviour Checklist (CBCL) and the Children's Global Assessment Scale (C-GAS). All subjects were assessed at the baseline (T0), after 1-year treatment (T1) and after a 2-year follow-up (T2). Compared with patients receiving TAU, youths in the MTP showed, both at T1 and T2, significantly lower scores on CBCL Externalizing Scale, Internalizing Scale, Anxious/Depressed, Social Problems, and Aggressive Behavior, and higher scores at the C-GAS. Improvement in Internalizing Scales was particularly evident, with a shift from the clinical to the non-clinical range. Rate of use of mental health services and scholastic failure were reduced in the MTP. It is suggested that the improvement of the Internalizing symptoms is a crucial component of the therapeutic process in this MTP.","Masi, G; Milone, A; Paciello, M; Lenzi, F; Muratori, P; Manfredi, A; Polidori, L; Ruglioni, L; Lochman, J E; Muratori, F",2014.0,10.1016/j.psychres.2014.05.048,0,0,
5918,Peripheral neurostimulation and specific motor training of deep abdominal muscles improve posturomotor control in chronic low back pain,"ER OBJECTIVES: Chronic low back pain (CLBP) is associated with an impaired control of transversus abdominis/internal oblique muscle (TrA/IO), volitionally and during anticipatory postural adjustment (delay) along with maladaptive reorganization of primary motor cortex (M1). Specific training of deep trunk muscles and repetitive peripheral magnetic stimulation (RPMS) improve motor control. We thus tested whether RPMS over TrA/IO combined with training could promote TrA/IO motor control and decrease pain beyond the gains already reached in CLBP.METHODS: Thirteen CLBP patients, randomly allocated to RPMS and sham groups and compared with 9 pain-free controls, were tested in 1 session before/after (stimulation alone) and after (stimulation+TrA/IO training) combination. TrA/IO motor patterns were recorded during ballistic shoulder flexion using surface electromyography. Transcranial magnetic stimulation tested M1 excitability and short-interval intracortical inhibition. A blinded physical therapist assessed pain, disability, and kinesiophobia.RESULTS: The missing short-interval intracortical inhibition in CLBP was restored by RPMS alone then reduced after combination of RPMS with training. This combination also normalized the (at-first delayed) anticipatory activation of iTrA/IO (ipsilateral to arm raised) and the (at-first shortened) TrA/IO coactivation duration. Sham did not influence. Pain was reduced in both groups but kinesiophobia was decreased only in RPMS 2 weeks later.CONCLUSIONS: This study supports that peripheral neurostimulation (adjuvant to training) could improve TrA/IO motor learning and pain in CLBP associated with motor impairment. Testing of enlarged samples over several sessions should question the long-term influence of this new approach in CLBP.","Massé-Alarie, H; Flamand, V H; Moffet, H; Schneider, C",2013.0,10.1097/AJP.0b013e318276a058,0,0,
5919,Health-related quality of life after fast-track treatment results from a randomized controlled clinical equivalence trial,"ER METHODSFour hundred and ten CABG patients were randomly assigned to undergo either short-stay intensive care treatment (SSIC, 8 h of intensive care stay) or control treatment (care as usual, overnight intensive care stay). HRQoL was measured at baseline and 1 month, and one year after surgery using the multidimensional index of life quality (MILQ), the EQ-5D, the Beck Depression Inventory and the State-Trait Anxiety Inventory.RESULTSAt one month after surgery, no statistically significant difference in overall HRQoL was found (MILQ-score P-value=.508, overall MILQ-index P-value=.543, EQ-5D VAS P-value=.593). The scores on the MILQ-domains, physical, and social functioning were significantly higher at one month postoperatively in the SSIC group compared to the control group (P-value=.049; 95%CI: 0.01-2.50 and P-value=.014, 95% CI: 0.24-2.06, respectively). However, these differences were no longer observed at long-term follow-up.CONCLUSIONSAccording to our definition of clinical equivalence, the HRQoL of SSIC patients is similar to patients receiving care as usual. Since safety and the financial benefits of this intervention were demonstrated in a previously reported analysis, SSIC can be considered as an adequate fast-track intensive care treatment option for low-risk CABG patients.PURPOSEThis randomized clinical equivalence trial was designed to evaluate health-related quality of life (HRQoL) after fast-track treatment for low-risk coronary artery bypass (CABG) patients.","Mastrigt, G A; Joore, M A; Nieman, F H; Severens, J L; Maessen, J G",2010.0,10.1007/s11136-010-9625-5,0,0,
5920,Resilience of the immune system in healthy young students to 30-hour sleep deprivation with psychological stress,"ER OBJECTIVE: Young adults often encounter sleep deprivation and stressful events. Both have been separately reported to modulate immunity, and occasionally they occur simultaneously. We assessed the combined effects of these conditions on immune competence in healthy students.METHODS: Twenty-three participants (mean age 24 years; SD 1.86; 14 females) were exposed to 30 h of sleep deprivation during which they conducted physiological, social and cognitive tasks. The control group consisted of 18 participants (mean age 23.67 years; SD 1.46; 11 females). All participants underwent cognitive and psychological evaluations at 10:00 AM, followed by blood and saliva collection, 3 days before sleep deprivation induction and on the morning following it. Immune/endocrine measures included blood counts of lymphocytes, granulocytes, monocytes and natural killer (NK) cells; levels of several cell surface markers; NK cytotoxicity; plasma levels of interleukin (IL)-6, IL-10, dehydroepiandrosterone and neuropeptide Y, and plasma and salivary cortisol levels.RESULTS: Although the experimental protocol significantly elevated state anxiety and psychological dissociation levels, no effects were evident in any of the immunological/endocrine indices. In contrast, expected sex differences in immune measures were found, including significantly higher NK cytotoxicity and monocyte counts in males, validating the integrity of the measurements.CONCLUSIONS: The findings suggest resilience of the immune system to a combined sleep deprivation and stressful exposure in young adults, while previous studies reported immune perturbations following either of these conditions separately. These apparent contradictions might reflect differences in the study design or in the methodology used for immunological assessments, including the time of sample collection, the combination of sleep deprivation with stress and our in vivo assessment of cytokine levels.","Matzner, P; Hazut, O; Naim, R; Shaashua, L; Sorski, L; Levi, B; Sadeh, A; Wald, I; Bar-Haim, Y; Ben-Eliyahu, S",2013.0,10.1159/000348698,0,0,
5921,Lyophilized collagen in the treatment of diabetic ulcers,"ER Diabetic foot ulcers are a significant clinical problem. Lyophilized type I collagen (LC) can stimulate wound healing by promoting platelet adhesion and aggregation and acting as a chemotactic factor for macrophages. The aim of the present study was to evaluate the efficacy of LC in the treatment of diabetic ulcers. Twenty patients (twelve males and eight females, age range 60-78 years) affected by non-insulin-dependent diabetes and ulcers (19 foot ulcers and 1 post-traumatic wrist ulcer) were, consecutively and at random, treated with LC or hyaluronic acid medicated gauze. The two groups were comparable in age, sex, size and etiopathogenesis of ulcers, metabolic state. The mean time for wound healing in the group treated with LC was 32.4 +/- 8.6 days, and in the group treated with hyaluronic acid medicated gauze was 49.0 +/- 11.0 days (p less than 0.001). The data suggest that LC significantly improves wound healing and is more active than medicated gauze in the treatment of diabetic ulcers.","Mauro, C; Ossino, A M; Trefiletti, M; Polosa, P; Beghè, F",1991.0,,0,0,
5922,Effects of a reality TV cosmetic surgery makeover program on eating disordered attitudes and behaviors,"ER METHODParticipants (N=147 women) completed baseline surveys and were subsequently randomly assigned to one of two conditions: one in which they watched a reality TV cosmetic surgery program (The Swan) and one in which they watched a reality TV home improvement program (Clean Sweep). Assessments were conducted immediately post-video and two weeks later.RESULTSWomen in the cosmetic surgery program group who reported higher internalization of the thin-ideal at baseline manifested lower self-esteem at posttesting. Among White women, those who watched the cosmetic surgery program reported greater perceptions of media pressures to be thin and stronger endorsement of their ability to control their body's appearance after watching the video. These differences persisted over a two-week follow-up period.DISCUSSIONReality TV cosmetic surgery makeover programs may contribute to eating disordered attitudes and behaviors among young women, particularly those who have internalized the thin body-ideal. These findings seem to be especially applicable for White women; however, they should be further investigated with more diverse and international samples.OBJECTIVETo evaluate the effects of a reality TV cosmetic surgery program on eating disordered attitudes, behaviors, mood, anxiety, and self-esteem.","Mazzeo, S E; Trace, S E; Mitchell, K S; Gow, R W",2007.0,10.1016/j.eatbeh.2006.11.016,0,0,
5923,"Impact of a healthy body image program among adolescent boys on body image, negative affect, and body change strategies","ER This study evaluated the effectiveness of a healthy body image program. In total, 421 adolescent boys completed a five-session intervention program or a wait list control group. There were no differences between the intervention and the control group at post-intervention or any of the follow-up times. Boys in the intervention group who were one standard deviation above the mean on body dissatisfaction at baseline, demonstrated a reduction in negative affect in the intervention group at post-test and 6 months follow-up. Prevention programs need to target boys who are at risk of adopting health risk behaviors, rather than being universally applied.","McCabe, M P; Ricciardelli, L A; Karantzas, G",2010.0,10.1016/j.bodyim.2009.10.007,0,0,
5924,An Advanced Practice Nurse Coordinated Multidisciplinary Intervention for Patients with Late-Stage Cancer: a Cluster Randomized Trial,"ER Background: Early palliative care provided through a palliative care consultative service is effective in enhancing patient outcomes. However, it is unknown whether the integration of palliative care as part of routine comprehensive cancer care improves patients' self-reported clinical outcomes. Objective: The objective of this study was to evaluate the effects of a multidisciplinary coordinated intervention by advanced practice nurses at the clinic level on outcomes with patients newly diagnosed with late-stage cancer. Methods: A clustered, randomized, controlled trial design was used. Four disease-specific multidisciplinary clinics were randomized to the 10-week intervention (gynecologic and lung clinics) or to enhanced usual care (head and neck and gastrointestinal clinics). Patient primary outcomes (symptoms, health distress, depression, functional status, self-reported health) were collected at baseline and one and three months, and secondary outcomes were collected one and three months postbaseline. General linear mixed model analyses with a covariance structure of within-subject correlation was used to examine the intervention's effect. Results: The sample included 146 patients with newly diagnosed late-stage cancers. We found no differences between the two groups on the primary patient-reported outcomes at one and three months postbaseline; however, physical and emotional symptoms remained stable or significantly improved from baseline for both groups. Overall, secondary outcomes remained stable within the groups. Conclusion: In this translational study, we demonstrated that if patients newly diagnosed with late-stage cancer were managed by disease-specific multidisciplinary teams who palliated their symptoms, providing whole-patient care, patient outcomes remained stable or improved.","McCorkle, R; Jeon, S; Ercolano, E; Lazenby, M; Reid, A; Davies, M; Viveiros, D; Gettinger, S",2015.0,10.1089/jpm.2015.0113,0,0,
5925,Effects of joint hospital admission and couples treatment for hospitalized alcoholics: a pilot study,,"McCrady, B S; Paolino, T J; longabough, R; Rossi, J",1979.0,,0,0,
5926,Determinants of caregiving burden and quality of life in caregivers of stroke patients,"ER METHODSData on patient, caregiver, and health and social support characteristics were collected prospectively over 1 year in 232 stroke survivors in a randomized trial of caregiver training. The contribution of these variables to caregiver burden score (CBS) and quality of life (QOL) measures at 3 months and 1 year was analyzed using regression models.RESULTSStroke patients had a mean age of 74+/-11 years, and 120 (52%) were men. The mean age of caregivers was 65.7+/-12.5 years, 149 (64%) were females, and 116 (50%) had received caregiver training. The mean CBS was 48+/-13 and 38+/-11 (score range of bad to good 88 to 22) and QOL score was 75+/-16 and 75+/-15 (score range of bad to good 0 to 100) at 3 months and 1 year, respectively. CBS and QOL correlated with each other and with patient (age, dependency, and mood), caregiver (age, gender, mood, and training), and support (social services and family networks) variables. Of these, only patient and caregiver emotional status, caregiver age and gender, and participation in caregiver training were independent predictors of either outcome at 3 months. Patient dependency and family support were additional independent predictors at 1 year. Social services support predicted institutionalization but not caregiver outcomes.CONCLUSIONSAdvancing age and anxiety in patients and caregivers, high dependency, and poor family support identify caregivers at risk of adverse outcomes, which may be reduced by caregiver training.BACKGROUND AND PURPOSEA large proportion of disabled stroke survivors live at home and are supported by informal caregivers. Identification of determinants of caregiver burden will help to target caregiver interventions.","McCullagh, E; Brigstocke, G; Donaldson, N; Kalra, L",2005.0,10.1161/01.STR.0000181755.23914.53,0,0,
5927,Acupressure as a non-pharmacological intervention for traumatic brain injury (TBI),"ER Acupressure is a complementary and alternative medicine (CAM) treatment using fingertips to stimulate acupoints on the skin. Although suggested to improve cognitive function, acupressure has not been previously investigated with a controlled design in traumatic brain injury (TBI) survivors, who could particularly benefit from a non-pharmacological intervention for cognitive impairment. A randomized, placebo-controlled, single-blind design assessed the effects of acupressure (eight treatments over 4 weeks) on cognitive impairment and state of being following TBI, including assessment of event-related potentials (ERPs) during Stroop and auditory oddball tasks. It was hypothesized that active acupressure treatments would confer greater cognitive improvement than placebo treatments, perhaps because of enhanced relaxation response induction and resulting stress reduction. Significant treatment effects were found comparing pre- to post-treatment change between groups. During the Stroop task, the active-treatment group showed greater reduction in both P300 latency (p?=?0.010, partial ?²?=?0.26) and amplitude (p?=?0.011, partial ?²?=?0.26), as well as a reduced Stroop effect on accuracy (p?=?0.008, partial ?²?=?0.21) than did the placebo group. Additionally, the active-treatment group improved more than did the placebo group on the digit span test (p?=?0.043, Cohen's d?=?0.68). Together, these results suggest an enhancement in working memory function associated with active treatments. Because acupressure emphasizes self-care and can be taught to novice individuals, it warrants further study as an adjunct treatment for TBI.","McFadden, K L; Healy, K M; Dettmann, M L; Kaye, J T; Ito, T A; Hernández, T D",2011.0,10.1089/neu.2010.1515,0,0,
5928,Maternal relationship security as a moderator of home visiting impacts on maternal psychosocial functioning,"ER There is variability in home visiting program impacts on the outcomes achieved by high risk families. An understanding of how effects vary among families is important for refining service targeting and content. The current study assessed whether and how maternal attributes, including relationship security, moderate short- and long-term home visiting impacts on maternal psychosocial functioning. In this multisite RCT of home visiting in a population-based, ethnically-diverse sample of families at risk for maltreatment of their newborns (n?=?643), families were randomly assigned to home visited (HV) and control groups. HV families were to receive intensive services by trained paraprofessionals from birth-3 years. Outcome data were collected when children were 1, 2, and 3 years old and 7, 8, and 9 years old. Overall, short- and long-term outcomes for HV and control mothers did not differ significantly. Demographic attributes, a general measure of overall maternal risk, and partner violence did not moderate program impact on psychosocial functioning outcomes. Maternal relationship security did moderate program impact. Mothers who scored high on relationship anxiety but not on relationship avoidance showed the greatest benefits, particularly at the long-term follow-up. Mothers scoring high for both relationship anxiety and avoidance experienced some adverse consequences of home visiting. Further research is needed to determine mediating pathways and to inform and test ways to improve the targeting of home visiting and the tailoring of home visit service models to extend positive home visiting impacts to targeted families not benefiting from current models.","McFarlane, E; Burrell, L; Crowne, S; Cluxton-Keller, F; Fuddy, L; Leaf, P J; Duggan, A",2013.0,10.1007/s11121-012-0297-y,0,0,
5929,The efficacy of group treatment in sexually abused girls,"ER The efficacy of the outpatient, once a week group treatment of sexually abused girls was examined using a pre-post, matched control/treatment design. The 30 girls were 9-12 years old, within 1 year of trauma, and were screened for psychosis. The Quay Revised Behavioral Problem Checklist (RBPC) and the Eyberg Child Behavior Inventory (ECBI) were used as dependent measures, and given 6 months apart. Depending on the scale, and excepting the RBPC's Psychotic Behavior Scale, 60-100% of the girls had abnormal scores pretreatment, with no significant differences between the two groups. Significant (p < .001) treatment effects were found. After treatment, 0-33% of the treated girls had abnormal scores, while 60-100% of the control group continued to have abnormal scores. Assuming generalization is possible, it appears that this and similar treatment programs are effective in reducing the girls' perceived problematical anxiety and misbehavior.","McGain, B; McKinzey, R K",1995.0,,0,0,
5930,Remote population-based intervention for disruptive behavior at age four: study protocol for a randomized trial of Internet-assisted parent training (Strongest Families Finland-Canada),"ER METHODS/DESIGN: This protocol paper describes an ongoing population-based randomized controlled trial (RCT) of high-risk 4 year-olds attending well-child clinics in Turku, Finland and environs to examine the effectiveness of the Strongest Families Smart Website intervention compared to an Education Control condition. Randomization consists of a 1:1 ratio for intervention versus the education group, stratified by the child's sex. The participants randomized to the intervention group receive access to the Strongest Families Smart Website and weekly telephone coaching sessions. The participants randomized to the Education Control condition receive access to a static website with parenting tips. Children are followed using parental and daycare teacher measures at 6 and 12 months after randomization.DISCUSSION: The Strongest Families Smart Website intervention is hypothesized to improve parenting skills, reduce child disruptive behaviour, reduce parental distress and improve family functioning. These results will likely inform subsequent investigations, public policy, and early treatment of childhood disruptive behaviour problems.TRIAL REGISTRATION: ClinicalTrials.gov # NCT01750996.BACKGROUND: Oppositional Defiant Disorder (ODD) is characterized by angry and noncompliant behaviour. It is the most common disruptive behaviour disorder (DBD), with prevalence estimates of 6-9% for preschoolers and is closely linked to several long-term difficulties, including disorders of conduct, mood, anxiety, impulse-control, and substance abuse. ODD in children is related to parental depression, family dysfunction, and impairments in parental work performance. Children displaying early DBDs exhibit more symptoms of greater severity, more frequent offences, and commit more serious crimes later in life. The goal of the Strongest Families Finland Canada (SFFC) Smart Website intervention research program is to develop and evaluate an affordable, accessible, effective secondary prevention parent training program for disruptive behaviour in preschoolers to prevent the negative sequelae of ODD. Strongest Families is an 11-session program with two booster sessions that focuses on teaching skills to: strengthen parent-child relationships; reinforce positive behaviour; reduce conflict; manage daily transitions; plan for potentially problematic situations; promote emotional regulation and pro-social behaviour and decrease antisocial behaviour.","McGrath, P J; Sourander, A; Lingley-Pottie, P; Ristkari, T; Cunningham, C; Huttunen, J; Filbert, K; Aromaa, M; Corkum, P; Hinkka-Yli-Salomäki, S; Kinnunen, M; Lampi, K; Penttinen, A; Sinokki, A; Unruh, A; Vuorio, J; Watters, C",2013.0,10.1186/1471-2458-13-985,0,0,
5931,Living with tics: reduced impairment and improved quality of life for youth with chronic tic disorders,"ER Pharmacological and behavioral interventions have focused on reducing tic severity to alleviate tic-related impairment for youth with chronic tic disorders (CTDs), with no existing intervention focused on the adverse psychosocial consequences of tics. This study examined the preliminary efficacy of a modularized cognitive behavioral intervention (""Living with Tics"", LWT) in reducing tic-related impairment and improving quality of life relative to a waitlist control of equal duration. Twenty-four youth (ages 7-17 years) with Tourette Disorder or Chronic Motor Tic Disorder and psychosocial impairment participated. A treatment-blind evaluator conducted all pre- and post-treatment clinician-rated measures. Youth were randomly assigned to receive the LWT intervention (n=12) or a 10-week waitlist (n=12). The LWT intervention consisted of up to 10 weekly sessions targeted at reducing tic-related impairment and developing skills to manage psychosocial consequences of tics. Youth in the LWT condition experienced significantly reduced clinician-rated tic-impairment, and improved child-rated quality of life. Ten youth (83%) in the LWT group were classified as treatment responders compared to four youth in the waitlist condition (33%). Treatment gains were maintained at one-month follow-up. Findings provide preliminary data that the LWT intervention reduces tic-related impairment and improves quality of life for youth with CTDs.","McGuire, J F; Arnold, E; Park, J M; Nadeau, J M; Lewin, A B; Murphy, T K; Storch, E A",2015.0,10.1016/j.psychres.2014.11.045,0,0,
5932,What do patients want from doctors? Content analysis of written patient agendas for the consultation,"ER AIMTo describe the expectations of a large group of patients who consulted with their GPs.METHODA GP and a social sciences graduate carried out a content analysis of written agenda forms completed by 819 patients who consulted 46 randomly selected GPs. Inter- and intra-rater reliabilities were confirmed.RESULTSA total of 756 (92%) agenda forms were returned. Inter-rater reliability was satisfactory (kappa > 0.6 for all but two main themes). Almost all patients had requests they wished to make of their doctor, 60% had their own ideas about what was wrong, and 38% had considered explanations about why they were unwell. Forty-two per cent and 24% of patients had consulted because they had reached the limit of their anxiety or tolerance respectively. Seven per cent, 4%, and 2% had comments, which were usually negative, to make about previous management, communication with doctors, or time in the consultation.CONCLUSIONThese data demonstrate that most patients come to the consultation with a particular agenda. Failure to address this agenda is likely to adversely affect the outcome of many consultations.BACKGROUNDAlthough much has been written about what patients want when they contact their general practitioner (GP), there are no published data from large cohort studies of what patients expect.","McKinley, R K; Middleton, J F",1999.0,,0,0,
5933,Delayed maturation in brain electrical activity partially explains the association between early environmental deprivation and symptoms of attention-deficit/hyperactivity disorder,"ER METHODSWe present data from a sample of children raised in institutions in Bucharest, Romania (n = 117) and an age- and sex-matched sample of community control subjects (n = 49). Electroencephalogram data were acquired following entry into the study at age 6 to 30 months, and a structured diagnostic interview of psychiatric disorders was completed at age 54 months.RESULTSChildren reared in institutions evidenced greater symptoms of attention-deficit/hyperactivity disorder, anxiety, depression, and disruptive behavior disorders than community controls. Electroencephalogram revealed significant reductions in alpha relative power and increases in theta relative power among children reared in institutions in frontal, temporal, and occipital regions, suggesting a delay in cortical maturation. This pattern of brain activity predicted symptoms of hyperactivity and impulsivity at age 54 months, and significantly mediated the association between institutionalization and attention-deficit/hyperactivity disorder symptoms. Electroencephalogram power was unrelated to depression, anxiety, or disruptive behaviors.CONCLUSIONSThese findings document a potential neurodevelopmental mechanism underlying the association between institutionalization and psychiatric morbidity. Deprivation in social and environmental conditions may perturb early patterns of neurodevelopment and manifest as psychiatric problems later in life.BACKGROUNDChildren raised in institutional settings are exposed to social and environmental circumstances that may deprive them of expected environmental inputs during sensitive periods of brain development that are necessary to foster healthy development. This deprivation is thought to underlie the abnormalities in neurodevelopment that have been found in previously institutionalized children. It is unknown whether deviations in neurodevelopment explain the high rates of developmental problems evident in previously institutionalized children, including psychiatric disorders.","McLaughlin, K A; Fox, N A; Zeanah, C H; Sheridan, M A; Marshall, P; Nelson, C A",2010.0,10.1016/j.biopsych.2010.04.005,0,0,
5934,Cognitive behavioural therapy group work with voice hearers. Part 2,"ER This is the second of two papers that present a small, randomized control trial of cognitive behavioural therapy (CBT) within a group setting for the treatment of auditory hallucinations. In the previous paper, a method was described for an eight-session CBT group. Assessments were undertaken measuring control, power, frequency, and symptoms of distress and anxiety on commencement and on completion of the group. This second paper details the experience of the group and reports on the outcomes of the assessment measures. The study concludes that group CBT was helpful in the treatment of auditory hallucinations.","McLeod, T; Morris, M; Birchwood, M; Dovey, A",2007.0,10.12968/bjon.2007.16.5.23005,0,0,
5935,Cognitive behavioural therapy group work with voice hearers. Part 1,"ER This study presents a small, randomised control trial of cognitive behavioural interventions within a group setting for the treatment of auditory hallucinations. In a sample of 20 voice hearers, 10 were randomly allocated to an eight-session cognitive behavioural therapy group, and 10 underwent psychiatric 'treatment as usual'. Baseline assessments were undertaken. Measures of control, power, frequency and symptoms of distress and anxiety, were recorded on assessment and on completion of the group. The groups achieved a significant reduction in frequency of auditory hallucinations and in the beliefs about the power of the voice. Satisfaction measures also suggested that the group participants valued the group and benefited from the structured sessions. Universality, the recognition that other people experience very similar problems, was one of the most beneficial factors of the intervention. This study suggests that group cognitive behavioural therapy was helpful in the treatment of auditory hallucinations.","McLeod, T; Morris, M; Birchwood, M; Dovey, A",2007.0,10.12968/bjon.2007.16.4.22995,0,0,
5936,Effect of oxytocin on craving and stress response in marijuana-dependent individuals: a pilot study,"ER RATIONALE: Stress has been shown to be a significant factor in the maintenance of marijuana use. Oxytocin is a hypothalamic neuropeptide that has been shown to moderate behavioral responding to stress as well as play a role in the neuroadaptations that occur as a consequence of long-term drug use. OBJECTIVES: The current study evaluated the impact of oxytocin pretreatment on craving, stress, and anxiety responses following a psychosocial stress task in marijuana-dependent individuals. METHODS: In a laboratory setting, baseline measurements of craving (assessed using the Marijuana Craving Questionnaire; MCQ), salivary cortisol and dehydroepiandrosterone (DHEA), stress, and anxiety were collected in 16 participants (age 19-40) meeting DSM-IV criteria for marijuana dependence. Participants were then administered either oxytocin 40 IU (n?=?8) or placebo (n?=?8) nasal spray prior to completion of the Trier Social Stress Task (TSST). Measurements were repeated pre-TSST, immediately post-TSST, and 5-, 35-, and 60-min post-TSST. RESULTS: Oxytocin reduced both MCQ total score and DHEA levels from before to after the TSST. It also decreased anxiety, but not subjective stress ratings. CONCLUSIONS: Although preliminary, these results suggest that oxytocin may play a role in the amelioration of stress-induced reactivity and craving in marijuana-dependent individuals.","McRae-Clark, A L; Baker, N L; Maria, M M; Brady, K T",2013.0,10.1007/s00213-013-3062-4,0,0,
5937,Pain physiology education improves pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial,"ER DESIGNDouble-blind randomized controlled trial.SETTINGSpecialized chronic fatigue clinic in university hospital.PARTICIPANTSA random sample of patients (N=48) with CFS patients (8 men, 40 women) experiencing chronic pain, randomly allocated to the control group (n=24) or experimental group (n=24). Two women in the experimental group did not complete the study because of practical issues (lack of time and restricted mobility).INTERVENTIONSOne individual pain physiology education session (experimental) or 1 pacing and self-management education session (control).MAIN OUTCOME MEASURESAlgometry, the Neurophysiology of Pain Test, and questionnaires evaluating pain cognitions-the Pain Coping Inventory, the Pain Catastrophizing Scale, and the Tampa Scale for Kinesiophobia-version CFS-were completed immediately before and immediately after the intervention.RESULTSAfter the intervention, the experimental group demonstrated a significantly better understanding of the neurophysiology of pain (P<.001) and a reduction of the Pain Catastrophizing Scale subscale ""ruminating"" (P=.009) compared with controls. For these variables, moderate to large Cohen d effect sizes were revealed (.79-2.53).CONCLUSIONSA 30-minute educational session on pain physiology imparts a better understanding of pain and brings about less rumination in the short term. Pain physiology education can be an important therapeutic modality in the approach of patients with CFS and chronic pain, given the clinical relevance of inappropriate pain cognitions.OBJECTIVETo examine whether pain physiology education was capable of changing pain cognitions and pain thresholds in patients with chronic fatigue syndrome (CFS) and chronic widespread pain.","Meeus, M; Nijs, J; Oosterwijck, J; Alsenoy, V; Truijen, S",2010.0,10.1016/j.apmr.2010.04.020,0,0,
5938,Hypnosis to facilitate uncomplicated birth,"ER Prior research by the author showed that psychosocial factors distinguished complicated from uncomplicated birth outcome. The purpose of this study was to determine if prenatal hypnosis could facilitate uncomplicated birth. Following a psychosocial assessment, 520 pregnant women in their first or second trimester of pregnancy were randomized to receiving prenatal hypnosis or attention-only groups. The author provided all of the hypnosis in a manner similar to that taught by David Cheek. The goal was to reduce fear of birth and parenthood; to reduce anxiety; to reduce stress; to identify specific fears that might complicate the labor process (addressing them whenever possible); and to prepare women for the experience of labor. The attention-only group was matched to a no-contact comparison group. Women receiving prenatal hypnosis had significantly better outcomes than women who did not. Further assessment suggested that hypnosis worked by preventing negative emotional factors from leading to an complicated birth outcome. Attention only was associated with minimal differences in outcome over the no-contact group. The routine prenatal use of hypnosis could improve obstetric outcome.","Mehl-Madrona, L E",2004.0,10.1080/00029157.2004.10403614,0,0,
5939,Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: a randomized trial,"ER OBJECTIVE: We examined whether a shortened form of dialectical behavior therapy, dialectical behavior therapy for adolescents (DBT-A) is more effective than enhanced usual care (EUC) to reduce self-harm in adolescents.METHOD: This was a randomized study of 77 adolescents with recent and repetitive self-harm treated at community child and adolescent psychiatric outpatient clinics who were randomly allocated to either DBT-A or EUC. Assessments of self-harm, suicidal ideation, depression, hopelessness, and symptoms of borderline personality disorder were made at baseline and after 9, 15, and 19 weeks (end of trial period), and frequency of hospitalizations and emergency department visits over the trial period were recorded.RESULTS: Treatment retention was generally good in both treatment conditions, and the use of emergency services was low. DBT-A was superior to EUC in reducing self-harm, suicidal ideation, and depressive symptoms. Effect sizes were large for treatment outcomes in patients who received DBT-A, whereas effect sizes were small for outcomes in patients receiving EUC. Total number of treatment contacts was found to be a partial mediator of the association between treatment and changes in the severity of suicidal ideation, whereas no mediation effects were found on the other outcomes or for total treatment time.CONCLUSION: DBT-A may be an effective intervention to reduce self-harm, suicidal ideation, and depression in adolescents with repetitive self-harming behavior. Clinical trial registration information-Treatment for Adolescents With Deliberate Self Harm; http://ClinicalTrials.gov/; NCT00675129.","Mehlum, L; Tørmoen, A J; Ramberg, M; Haga, E; Diep, L M; Laberg, S; Larsson, B S; Stanley, B H; Miller, A L; Sund, A M; Grøholt, B",2014.0,10.1016/j.jaac.2014.07.003,0,0,
5940,"Effects of a physical exercise rehabilitation group program on anxiety, depression, body image, and health-related quality of life among breast cancer patients","ER PATIENTS AND METHODS: Women with primary nonmetastatic breast cancer after a minimum 4-week period post chemotherapy and/or radiotherapy completion were randomly assigned to one of 2 groups: intervention group (IG) (n = 30) and waiting group (WG) (n = 28). The 10-week twice weekly exercise group program consisted of gymnastics, movement games, relaxation, walking, and jogging. Anxiety, depression, body image, and quality of life were measured using standardized questionnaires. Maximal oxygen uptake (VO(2)max/kg) was assessed as a measure of physical fitness.RESULTS: Patients in the IG improved significantly over time with regard to anxiety (p = 0.03, d = 0.45), depression (p = 0.05, d = 0.43), individual body image (p = 0.006, d = 0.44), and VO(2)max/kg (p < 0.001, d = 0.50), whereas no improvements were observed in the WG. However, this randomized controlled trial failed to demonstrate significant intervention effects in quality of life and social body image.CONCLUSIONS: This prospective study provided evidence for the effectiveness of a 10-week physical exercise intervention to significantly improve psychosocial wellbeing, individual body image, and physical fitness.BACKGROUND: Since physical exercise programs have the potential to help cancer patients regain physical fitness and may exert a range of positive consequences for recovery and psychological well-being, the impact of a physical exercise program was investigated in this prospective study.","Mehnert, A; Veers, S; Howaldt, D; Braumann, K M; Koch, U; Schulz, K H",2011.0,10.1159/000327813,0,0,
5941,Group insight versus group desensitization in treating speech anxiety,,"Meichenbaum, D H; Gilmore, J B; Fedoravicius, A",1971.0,,0,0,
5942,"Cost-effectiveness of multidisciplinary treatment in sick-listed patients with upper extremity musculoskeletal disorders: a randomized, controlled trial with one-year follow-up","ER METHODSA randomized controlled trial with a 1-year follow-up was carried out. Thirty-eight subjects were allocated to multidisciplinary treatment (intervention, n=23), or to usual care provided by occupational health services (n=15). The intervention consisted of psychological and physical sessions provided by a medical specialist, a psychologist, a physiotherapist and an occupational therapist. It aims at reconditioning, ""de-medicalizing"", unrestrained moving and return-to-work. The intervention process was evaluated on compliance to the protocol and the effectiveness of its components. The individual outcome variable was the severity of complaints. The societal outcomes included return-to-work and costs. Measurements were performed at baseline and after 2, 6 and 12 months. Mixed model analyses were used for analysis.RESULTSThe intervention achieves its aims: physical disabilities (P=0.039), kinesiophobia (P<0.001) and physical functioning (P=0.016) improved significantly as compared to usual care. In addition, the intervention was significantly more effective in reducing the severity of complaints than usual care. The intervention was equally effective compared to usual care in terms of return-to-work (86% in the intervention group vs. 73% in the usual care group). The extra total costs and the extra gains in terms of return-to-work were not significantly higher for the intervention as compared to usual care after 12 months.CONCLUSIONMultidisciplinary treatment affects individuals positively, but shows no significant difference in (cost-) effectiveness on the societal level as compared to usual care.OBJECTIVETo determine the effectiveness and cost-effectiveness of a return-to-work outpatient multidisciplinary treatment programme for sick-listed workers with non-specific upper extremity musculoskeletal complaints.","Meijer, E M; Sluiter, J K; Heyma, A; Sadiraj, K; Frings-Dresen, M H",2006.0,10.1007/s00420-006-0098-3,0,0,
5943,Evaluation of nedocromil sodium 2% ophthalmic solution for the treatment of seasonal allergic conjunctivitis,"ER During peak ragweed season, 86 patients with seasonal allergic conjunctivitis participated in a 9-week, multicenter, double-masked, placebo-controlled, group-comparative study testing the efficacy and safety of bid nedocromil sodium, 2% ophthalmic solution. The clinical effectiveness of nedocromil sodium was measured by analyzing the means of patient daily symptom scores and eye examinations after 1, 3, 5, and 8 weeks of treatment. The use of nedocromil sodium during peak ragweed pollen season reduced symptom scores with statistically significant treatment differences as compared with the placebo for itchy eyes, tearing, overall eye condition, and symptom summary score. Clinician assessments also favored the use of nedocromil sodium as indicated by significant improvements in tearing, conjunctival injection, and conjunctival edema. No significant side effects were reported by the patients, allergists, or ophthalmologists. We conclude that nedocromil sodium, 2% ophthalmic solution, administered bid is more effective in the relief of symptoms of seasonal allergic conjunctivitis than placebo and causes no major side effects.","Melamed, J; Schwartz, R H; Hirsch, S R; Cohen, S H",1994.0,,0,0,
5944,Testing the theoretical framework of the COPE program for mothers of critically ill children: an integrative model of young children's post-hospital adjustment behaviors,"ER METHODSMothers (n = 143) and their 2-7-year-old children, unexpectedly hospitalized in two pediatric intensive care units, were randomized to COPE or control conditions. Maternal measures included parental beliefs, anxiety, negative mood, and child adjustment 3 months post discharge. Observers rated maternal support of their children during hospitalization.RESULTSStructural equation modeling suggested that the model tested provided a reasonable fit to the data [chi2 (97 df) = 129.43; p = .016; root mean square error of approximation = .048; comparative fit index = .95]. COPE effects on children's post-hospital externalizing behaviors were indirect, via associations with parental beliefs and maternal negative mood state. Furthermore, COPE participation was associated with more maternal support of their children, which was also associated with less internalizing and externalizing behaviors 3 months post discharge.CONCLUSIONImplementing COPE may help avert future mental health problems in this high risk population. Understanding the processes by which an already empirically validated program relates to child outcomes is likely to aid clinicians and administrators in the widespread uptake of the COPE program.OBJECTIVETo test a theoretical model examining processes through which a parent-focused educational-behavioral intervention [Creating Opportunities for Parent Empowerment (COPE)] relates to children's post-hospital adjustment problems.","Melnyk, B M; Crean, H F; Feinstein, N F; Fairbanks, E; Alpert-Gillis, L J",2007.0,10.1093/jpepsy/jsl033,0,0,
5945,Promoting healthy lifestyles in high school adolescents: a randomized controlled trial,"ER BACKGROUND: Although obesity and mental health disorders are two major public health problems in adolescents that affect academic performance, few rigorously designed experimental studies have been conducted in high schools.PURPOSE: The goal of the study was to test the efficacy of the COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, Nutrition) Program, versus an attention control program (Healthy Teens) on: healthy lifestyle behaviors, BMI, mental health, social skills, and academic performance of high school adolescents immediately after and at 6 months post-intervention.DESIGN: A cluster RCT was conducted. Data were collected from January 2010 to May of 2012 and analyzed in 2012-2013.SETTING/PARTICIPANTS: A total of 779 culturally diverse adolescents in the U.S. Southwest participated in the trial.INTERVENTION: COPE was a cognitive-behavioral skills-building intervention with 20 minutes of physical activity integrated into a health course, taught by teachers once a week for 15 weeks. The attention control program was a 15-session, 15-week program that covered common health topics.MAIN OUTCOME MEASURES: Primary outcomes assessed immediately after and 6 months post-intervention were healthy lifestyle behaviors and BMI. Secondary outcomes included mental health, alcohol and drug use, social skills, and academic performance.RESULTS: Post-intervention, COPE teens had a greater number of steps per day (p=0.03) and a lower BMI (p=0.01) than did those in Healthy Teens, and higher average scores on all Social Skills Rating System subscales (p-values <0.05). Teens in the COPE group with extremely elevated depression scores at pre-intervention had significantly lower depression scores than the Healthy Teens group (p=0.02). Alcohol use was 12.96% in the COPE group and 19.94% in the Healthy Teens group (p=0.04). COPE teens had higher health course grades than did control teens. At 6 months post-intervention, COPE teens had a lower mean BMI than teens in Healthy Teens (COPE=24.72, Healthy Teens=25.05, adjusted M=-0.34, 95% CI=-0.56, -0.11). The proportion of those overweight was significantly different from pre-intervention to 6-month follow-up (chi-square=4.69, p=0.03), with COPE decreasing the proportion of overweight teens, versus an increase in overweight in control adolescents. There also was a trend for COPE Teens to report less alcohol use at 6 months (p=0.06).CONCLUSIONS: COPE can improve short- and more long-term outcomes in high school teens.TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT01704768.","Melnyk, B M; Jacobson, D; Kelly, S; Belyea, M; Shaibi, G; Small, L; O'Haver, J; Marsiglia, F F",2013.0,10.1016/j.amepre.2013.05.013,0,0,
5946,Moderators of remission with interpersonal counselling or drug treatment in primary care patients with depression: randomised controlled trial,"ER Background: Despite depressive disorders being very common there has been little research to guide primary care physicians on the choice of treatment for patients with mild to moderate depression. Aims: To evaluate the efficacy of interpersonal counselling compared with selective serotonin reuptake inhibitors (SSRIs), in primary care attenders with major depression and to identify moderators of treatment outcome. Method: A randomised controlled trial in nine centres (DEPICS, Australian New Zealand Clinical Trials Registry number: ACTRN12608000479303). The primary outcome was remission of the depressive episode (defined as a Hamilton Rating Scale for Depression score <7 at 2 months). Daily functioning was assessed using the Work and Social Adjustment Scale. Logistic regression models were used to identify moderators of treatment outcome. Results: The percentage of patients who achieved remission at 2 months was significantly higher in the interpersonal counselling group compared with the SSRI group (58.7% v. 45.1%, P = 0.021). Five moderators of treatment outcome were found: depression severity, functional impairment, anxiety comorbidity, previous depressive episodes and smoking habit. Conclusions: We identified some patient characteristics predicting a differential outcome with pharmacological and psychological interventions. Should our results be confirmed in future studies, these characteristics will help clinicians to define criteria for first-line treatment of depression targeted to patients' characteristics.","Menchetti, M; Rucci, P; Bortolotti, B; Bombi, A; Scocco, P; Kraemer, H C; Berardi, D",2014.0,10.1192/bjp.bp.112.122663,0,0,
5947,Breastfeeding and prolactin levels in lactating women with a family history of alcoholism,"ER METHODS: This was a 2-day experimental study that used within-subject alcohol or control beverage consumption and between-subject family history of alcoholism factors. The participants were non-alcohol-dependent lactating women; 7 were family history-positive (FHP) for alcohol dependence, and 21 were family history-negative (FHN). Consumption of 0.4 g/kg alcohol or nonalcoholic beverage occurred in separate randomized sessions, followed by use of a breast pump. Basal and suckling-induced prolactin, blood alcohol concentrations, milk yield, self-reported drug effects, neophobia, and breastfeeding patterning were measured.RESULTS: Although no group differences in alcohol pharmacokinetics were detected, FHP women exhibited blunted prolactin to breast stimulation after drinking the control and alcohol beverage and felt more of the stimulant-like effects of alcohol than did FHN women. FHP women reported more frequent daily breastfeeding than did FHN women.CONCLUSIONS: This is the first evidence that family history of alcoholism is associated with a blunted magnitude, rapidity, and duration of the prolactin response to breast stimulation and an alcohol challenge in lactating women. More frequent breastfeeding by FHP women suggests behavioral compensation for perceived and/or actual poor lactation. Alcohol did not enhance lactational performance, further disputing the lore that alcohol is a galactagogue.OBJECTIVE: Many motivated new mothers fail to reach public health goals for breastfeeding, highlighting the need to identify risk factors. Because having a family history of alcoholism is associated with blunted prolactin responses to an alcohol challenge in nonlactating individuals, this study aimed to identify associations in family history of alcoholism, prolactin, and breastfeeding behaviors in lactating women.","Mennella, J A; Pepino, M Y",2010.0,10.1542/peds.2009-3040,0,0,
5948,Self-presentation origins of choking: evidence from separate pressure manipulations,"ER Whether self-presentation is involved in the choking process remains unknown. The purpose of the current study was to determine the role of self-presentation concerns on the frequency of choking within the context of a recently proposed self-presentation model. Experienced field hockey players (N = 45) were randomly assigned to one of five groups (i.e., performance-contingent monetary incentive, video camera placebo, video camera self-presentation, audience, or combined pressure), before taking penalty strokes in low- and high-pressure phases. Results indicated that groups exposed to self-presentation manipulations experienced choking, whereas those receiving motivational pressure treatments decreased anxiety and increased performance under pressure. Furthermore, cognitive state anxiety mediated the relationship between the self-presentation group and performance. These findings provide quantitative support for the proposed self-presentation model of choking, while also holding implications for anxiety manipulations in future sport psychology research.","Mesagno, C; Harvey, J T; Janelle, C M",2011.0,,0,0,
5949,"Sinusitis in long-term intubated, intensive care patients: nasal versus oral intubation","ER METHODSIn a prospective study, we followed 44 patients who required mechanical ventilation (greater than 24 h) in the ICU because of prolonged recovery from abdominal, thoracic, or posttraumatic surgery. Twenty patients were intubated nasotracheally and 24 orotracheally. Assignment to the groups was random. All were provided with a nasogastric tube and initially treated with systemic antibiotics. They received local antimicrobial prophylaxis of the nose, oropharynx, and stomach. Daily a-scan examinations of the maxillary sinuses were performed from the day of admission to the ICU until extubation, tracheotomy, death, or transfer. The average observation period was 6.9 days in the oral group and 7.1 days in the nasal group. In the case of a pathologic finding, aspiration of the antral sinus was carried out. In this study sinusitis indicated a sonographic finding; it did not necessarily imply a bacterial infection.RESULTSAt the beginning of the observation period, 6 patients in the oral group and 4 in the nasal group already had a pathologic maxillary sinus finding. At the end, in 15 of 24 in the oral group and 19 of 20 in the nasal group unilateral or bilateral sinusitis could be demonstrated. Development of bilateral sinusitis (13/20 in the nasotracheal group, 8/24 in the orotracheal group) was mainly observed after the appearance of unilateral sinusitis. The site corresponded to the site of the nasal tube in 65%. Unilateral paranasal infection was observed in nasotracheally and orotracheally intubated patients after an average of 2.8 and 2.6 days, respectively, whereas bilateral sinusitis had an average time delay of 4.5 and 5.7 days. Aspiration of the maxillary sinus was performed in 22 of 34 cases with sinusitis. Pathogenic organisms could be demonstrated in 7 of 13 nasotracheally intubated patients but only 2 of 9 with orotracheal tubes.CONCLUSIONWe found that patients intubated orotracheally developed significantly less sinusitis than those intubated nasotracheally. Edema, local infection of the nasal mucosa, or mechanical obstruction of sinus drainage pathways by the tube are possible explanations. The fact that 63% of orally intubated patients had a pathologic maxillary sinus finding as well suggests that in addition to other reasons, an increased central venous pressure, positive pressure ventilation, and the supine position must be regarded as predisposing factors that increase the incidence of sinusitis. We conclude that the conditions of critically ill patients predispose to the development of sinusitis. Nasotracheal intubation is to be regarded as an additional risk, and therefore oral intubation should be preferred.UNLABELLEDDiscussion of paranasal sinusitis as a nosocomial infection in the mechanically ventilated intensive care (ICU) patient has recently been intensified. Some authors have emphasized nasotracheal intubation as a possible pathogenetic pathway. The aim of this study was to investigate the impact of nasotracheal or orotracheal intubation on the development of sinusitis in ICU patients.","Michelson, A; Kamp, H D; Schuster, B",1991.0,,0,0,
5950,A pilot study of yoga as self-care for arthritis in minority communities,"ER METHODS/DESIGN: In this ongoing pilot study, a convenience sample of 20 minority adults diagnosed with either osteoarthritis or rheumatoid arthritis undergo an 8-week program of yoga classes. It is believed that by attending yoga classes designed for patients with arthritis, with racially concordant instructors; acceptability of yoga as an adjunct to standard arthritis treatment and self-care will be enhanced. Self-care is defined as adopting behaviors that improve physical and mental well-being. This concept is quantified through collecting patient-reported outcome measures related to spiritual growth, health responsibility, interpersonal relations, and stress management. Additional measures collected during this study include: physical function, anxiety/depression, fatigue, sleep disturbance, social roles, and pain; as well as baseline demographic and clinical data. Field notes, quantitative and qualitative data regarding feasibility and acceptability are also collected. Acceptability is determined by response/retention rates, positive qualitative data, and continuing yoga practice after three months.DISCUSSION: There are a number of challenges in recruiting and retaining participants from a community clinic serving minority populations. Adopting behaviors that improve well-being and quality of life include those that integrate mental health (mind) and physical health (body). Few studies have examined offering integrative modalities to this population. This pilot was undertaken to quantify measures of feasibility and acceptability that will be useful when evaluating future plans for expanding the study of yoga in urban, minority populations with arthritis.TRIAL REGISTRATION: ClinicalTrials.gov: NCT01617421.BACKGROUND: While arthritis is the most common cause of disability, non-Hispanic blacks and Hispanics experience worse arthritis impact despite having the same or lower prevalence of arthritis compared to non-Hispanic whites. People with arthritis who exercise regularly have less pain, more energy, and improved sleep, yet arthritis is one of the most common reasons for limiting physical activity. Mind-body interventions, such as yoga, that teach stress management along with physical activity may be well suited for investigation in both osteoarthritis and rheumatoid arthritis. Yoga users are predominantly white, female, and college educated. There are few studies that examine yoga in minority populations; none address arthritis. This paper presents a study protocol examining the feasibility and acceptability of providing yoga to an urban, minority population with arthritis.","Middleton, K R; Ward, M M; Haaz, S; Velummylum, S; Fike, A; Acevedo, A T; Tataw-Ayuketah, G; Dietz, L; Mittleman, B B; Wallen, G R",2013.0,10.1186/1477-7525-11-55,0,0,
5951,A randomized controlled trial of psychological interventions for postnatal depression,"ER DESIGNThe study involved 192 depressed women drawn from a large community screening programme in Melbourne, Australia and allocated to cognitive behaviour therapy, counselling, or routine primary care. Baseline and post-intervention measures of depression and anxiety were collected in the form of validated self-report inventories.METHODWomen were screened in the community and diagnosis of depression confirmed with a standardized psychiatric interview. Interventions were of 12 weeks duration, including three partner sessions, and adhered to a structured manual.RESULTSPsychological intervention per se was superior to routine care in terms of reductions in both depression and anxiety following intervention.CONCLUSIONSFor those women with PND, psychological intervention is a better option than routine care, leading to clinically significant reduction of symptoms. Counselling may be as effective as group cognitive behaviour therapy. The benefits of psychological intervention may be maximized by being delivered on a one-to-one basis.OBJECTIVESFirst, to establish the efficacy of psychological interventions versus routine primary care for the management of postnatal depression (PND). Secondly, to provide a direct comparison of cognitive-behavioural therapy (CBT) versus counselling and, finally, to compare the relative value of group and individual delivery formats.","Milgrom, J; Negri, L M; Gemmill, A W; McNeil, M; Martin, P R",2005.0,10.1348/014466505X34200,0,0,
5952,The positive outlook study- a randomised controlled trial evaluating the effectiveness of an online self-management program targeting psychosocial issues for men living with HIV: a study protocol,"ER BACKGROUND: The emergence of HIV as a chronic condition means that people living with HIV are required to take more responsibility for the self-management of their condition, including making physical, emotional and social adjustments. This paper describes the design and evaluation of Positive Outlook, an online program aiming to enhance the self-management skills of gay men living with HIV.METHODS/DESIGN: This study is designed as a randomised controlled trial in which men living with HIV in Australia will be assigned to either an intervention group or usual care control group. The intervention group will participate in the online group program 'Positive Outlook'. The program is based on self-efficacy theory and uses a self-management approach to enhance skills, confidence and abilities to manage the psychosocial issues associated with HIV in daily life. Participants will access the program for a minimum of 90 minutes per week over seven weeks. Primary outcomes are domain specific self-efficacy, HIV related quality of life, and outcomes of health education. Secondary outcomes include: depression, anxiety and stress; general health and quality of life; adjustment to HIV; and social support. Data collection will take place at baseline, completion of the intervention (or eight weeks post randomisation) and at 12 week follow-up.DISCUSSION: Results of the Positive Outlook study will provide information regarding the effectiveness of online group programs improving health related outcomes for men living with HIV.TRIAL REGISTRATION: ACTRN12612000642886.","Millard, T; Elliott, J; Slavin, S; McDonald, K; Rowell, S; Girdler, S",2014.0,10.1186/1471-2458-14-106,0,0,
5953,Chronic pain self-management support with pain science education and exercise (COMMENCE): study protocol for a randomized controlled trial,"ER METHODS/DESIGN: This study will be an unblinded, randomized controlled trial with 110 participants comparing a 6-week program that includes self-management support, pain science education and exercise to a wait-list control. The primary outcome will be function measured by the Short Musculoskeletal Function Assessment - Dysfunction Index. Secondary outcomes will include pain intensity measured by a numeric pain rating scale, pain interference measured by the eight-item PROMIS pain interference item-bank, how much patients are bothered by functional problems measured by the Short Musculoskeletal Function Assessment - Bother Index, catastrophic thinking measured by the Pain Catastrophizing Scale, fear of movement/re-injury measured by the 11-item Tampa Scale of Kinesiophobia, sense of perceived injustice measured by the Injustice Experience Questionnaire, self-efficacy measured by the Pain Self-Efficacy Questionnaire, pain sensitivity measured by pressure pain threshold and cold sensitivity testing, fatigue measured by a numeric fatigue rating scale, pain neurophysiology knowledge measured by the Neurophysiology of Pain Questionnaire, healthcare utilization measured by number of visits to a healthcare provider, and work status. Assessments will be completed at baseline, 7 and 18 weeks. After the 18-week assessment, the groups will crossover; however, we anticipate carry-over effects with the treatment. Therefore, data from after the crossover will be used to estimate within-group changes and to determine predictors of response that are not for direct between-group comparisons. Mixed effects modelling will be used to determine between-group differences for all primary and secondary outcomes. A series of multiple regression models will be used to determine predictors of treatment response.DISCUSSION: This study has the potential to inform future self-management programming through evaluation of a self-management program that aims to improve function as the primary outcome.TRIAL REGISTRATION: ClinicalTrials.gov NCT02422459 , registered on 13 April 2015.BACKGROUND: Previous research suggests that self-management programs for people with chronic pain improve knowledge and self-efficacy but result in negligible effects on function. This study will investigate the effectiveness self-management support with pain science education and exercise on improving function for people with chronic pain in comparison to a wait-list control. A secondary objective is to determine which variables help to predict response to the intervention.","Miller, J; MacDermid, J C; Walton, D M; Richardson, J",2015.0,10.1186/s13063-015-0994-5,0,0,
5954,"Oxytocin treatment in children with Prader-Willi syndrome: a double-blind, placebo-controlled, crossover study","ER Prader-Willi syndrome (PWS) is a rare, complex multisystem genetic disorder which includes hypothalamic dysfunction, hyperphagia, cognitive and behavioral problems, increased anxiety, and compulsive behaviors. Individuals with PWS have a deficit of oxytocin producing neurons in the paraventricular nucleus of the hypothalamus. Oxytocin plays a role in regulation of feeding behaviors, social interactions, and emotional reactivity, which are all issues that significantly affect the quality of life for individuals with this syndrome. We performed a double-blind, placebo-controlled, crossover study in 24 children with PWS at three academic institutions using 5 days of intranasal oxytocin (IN-OT) or 5 days of intranasal placebo spray, followed by a 4 week washout period, and then patients returned for 5 days of treatment with the alternate source. Questionnaires, including the Aberrant Behavior Checklist, Social Responsiveness Scale, Repetitive Behavior Scale - Revised, and the Hyperphagia Questionnaire, as well as Clinical Global Impression scales were administered. Blood testing for sodium, potassium, and glucose levels on days 2, 4, and 6, and a 24?hr diet recall. All scales factor improvement from Day 3 to Day 6 favored oxytocin over placebo. No single factor showed a statistically significant difference (P?<?0.05) between groups at Day 6. The drug effect appeared to be diminished at Day 14. There was no evidence of a difference between oxytocin and placebo in safety lab parameters, 60?min post dose vital signs, weight, or diet parameters. The results from this study suggest that low dose intranasal oxytocin is safe for individuals with PWS and may result in reduction in appetite drive, and improvements in socialization, anxiety, and repetitive behaviors. Further, long-term studies with a larger population of participants are necessary to confirm these findings. The results of this study are encouraging that oxytocin may be a safe and effective treatment for many of the issues that negatively impact individuals with PWS.","Miller, J L; Tamura, R; Butler, M G; Kimonis, V; Sulsona, C; Gold, J A; Driscoll, D J",2017.0,10.1002/ajmg.a.38160,0,0,
5955,Effects of a combined aerobic and resistance exercise program in breast cancer survivors: a randomized controlled trial,"ER Few randomized controlled trials have examined the effects of combined aerobic and resistance training in breast cancer survivors soon after completing adjuvant therapy. Breast cancer survivors (N=58) within 2 years of completing adjuvant therapy were randomly assigned to an immediate exercise group (IEG; n=29) or a delayed exercise group (DEG; n=29). The IEG completed 12 weeks of supervised aerobic and resistance exercise, three times per week. The DEG completed the program during the next 12 weeks. Participants completed patient-rated outcomes at baseline, 6, 12, 18 and 24 weeks. The primary endpoint was overall quality of life (QoL) measured by the Functional Assessment of Cancer Therapy-Breast scale. Secondary endpoints were fatigue, social physique anxiety, and physical fitness. Follow-up data was obtained on 97% of participants and exercise adherence was 61.3%. Repeated measures analyses of variance revealed a significant group by time interaction for overall QoL (P<0.001). Specifically, QoL increased in the IEG from baseline to 12 weeks by 20.8 points compared to a decrease in the DEG of 5.3 points (mean group difference=26.1; 95% CI=18.3-32.7; P<0.001). From 12 to 24 weeks, QoL increased in the DEG by 29.5 points compared to an increase of 6.5 points in the IEG (mean group difference=23.0; 95% CI=16.3-29.1; P<0.001). Similar results were obtained for the secondary endpoints. Combined aerobic and resistance exercise soon after the completion of breast cancer therapy produces large and rapid improvements in health-related outcomes.","Milne, H M; Wallman, K E; Gordon, S; Courneya, K S",2008.0,10.1007/s10549-007-9602-z,0,0,
5956,Exercise maintenance of persons with arthritis after participation in a class experience,"ER This study investigated factors related to an initial exercise experience to explain exercise maintenance in 120 adults with rheumatoid arthritis or osteoarthritis. Integral secondary analysis was used to incorporate data from a prospective, controlled trial of exercise (Minor et al.: Arthritis Rheum 32:1396, 1989) with data collected at 18 months follow-up. The dependent variable was self-directed exercise (min/wk) reported at 3, 9, and 18 or more months after exercise class participation. Predictor variables included physical, psychosocial, disease, and programmatic factors. The all possible regressions search procedure resulted in three explanatory models (p = .0001). At 3 months the model (R2 = .45) included initial aerobic capacity, depression, and anxiety; and changes in depression and social activity. The 9-month model (R2 = .35) consisted of initial anxiety and physical activity, change in depression, support of friends for exercise, and exercise behavior at prior assessment. At 18 or more months (R2 = .42), model variables were initial aerobic capacity, change in pain, and exercise behavior at the two prior assessments. Neither disease nor program factors appeared as significant. This limited study indicates that factors associated with exercise behavior in this sample are similar to those in the general population; explanatory factors change over time, and changes ascribed to a trial behavior may influence subsequent decision making.","Minor, M A; Brown, J D",1993.0,,0,0,
5957,"Lymphocyte subpopulations, oxidative burst and apoptosis in peripheral blood cells of patients with multiple sclerosis-effect of interferon-beta","ER At present, the most efficient therapeutical treatment of multiple sclerosis (MS) is achieved by IFN-beta. However, its in vivo effects remain incompletely understood. If applied parenterally, the hydrophobic IFN-beta acts primarily on blood cells with probable selectivity for functionally different lymphocyte subpopulations, monocytes and granulocytes. We have investigated the expression of the activation marker interleukin-2 receptor-alpha (CD25) on CD3+ T cells, CD19+ B cells, foetal-type gamma(delta)+CD3+ T cells and foetal-type CD5+CD19+ B cells of the peripheral blood. In addition, the oxidative burst activity and apoptosis have been determined in mononuclear and polymorphonuclear blood cells, respectively. The study accompanied a phase III trial with IFN-beta1b (BETAFERON, Schering). Two groups of MS patients with relapsing-remitting course of the disease have been investigated at 8 time points (days 0, 5, 15, 31, 60, 90, 180 and 270 after starting therapy): (1) verum group (n = 8) with application of 8 Mill. units IFN-beta1 b every other day, and (2) placebo group (n = 4) with application of placebo for 3 months and therapy as in (1) from day 90 onward. The main results were: (1) Activated T cells decreased until day 180 in the verum group and return thereafter to pre-treatment values, whereas in the placebo group the values remained relatively stable over the whole observation period. (2) Activated B cells increased between days 90 and 270 in both groups, i.e. after verum application in both groups. (3) Foetal-type B cells were more activated than total B and T cells with increase over time in both groups. (4) Foetal-type T cells exerted relatively stable intra-individual levels with generally low CD25 expression, but punctual CD25 peaks in both groups. (5) The spontaneous oxidative burst was higher in lymphocytes, more variable in monocytes and faster increasing in granulocytes in the verum group than in the placebo group. (6) Apoptosis of mononuclear cells and granulocytes showed similar variations in the verum and placebo groups with the exception of a selective increase over time of the proportion of granulocytes undergoing induced apoptosis in the verum group. It is concluded that IFN-beta has the following main effects on the immune system of MS patients: (1) the T cell immunity is systemically and reversibly suppressed, (2) the foetal-type lymphocytes, which are responsible for the first line of defence of infections, are stimulated in the long range, (3) the oxidative burst activity is increased in lymphocytes and granulocytes and instable in monocytes, and (4) the inducibility of apoptosis in granulocytes is increased. Re-examination of the altered blood cell parameters after long-term IFN-beta therapy is warranted.","Mix, E; Stefan, K; Höppner, J; Klauer, T; Zettl, U K; Strauss, U; Meyer-Rienecker, H J; Rolfs, A",2003.0,,0,0,
5958,Efficacy of the addition of modified Pilates exercises to a minimal intervention in patients with chronic low back pain: a randomized controlled trial,"ER BACKGROUND: The Pilates method has been used to improve function and reduce pain in patients with chronic nonspecific low back pain, although there is little scientific evidence that describes its efficacy.OBJECTIVE: The purpose of this study was to investigate the effectiveness of the addition of modified Pilates exercises to minimal intervention in patients with chronic low back pain.DESIGN: A randomized controlled trial was conducted.SETTING: The study was done in an outpatient physical therapy department in Brazil.PATIENTS: Eighty-six patients with chronic nonspecific low back pain participated in the study.INTERVENTION: All participants received an education booklet containing information about low back pain and were randomly allocated to receive 12 sessions, over 6 weeks, of exercises based upon Pilates principles (n=43) or of education alone (n=43).MEASUREMENTS: Primary outcomes were pain intensity and disability measured at 6 weeks and 6 months. Secondary outcomes were patient-specific functional disability, global impression of recovery, and kinesiophobia measured at 6 weeks and 6 months. All outcomes were measured by a blinded assessor in all time points.RESULTS: There was no loss to follow-up at any of the time points. Improvements were observed in pain (mean difference=2.2 points, 95% confidence interval [CI]=1.1 to 3.2), disability (mean difference=2.7 points, 95% CI=1.0 to 4.4), and global impression of recovery (mean difference=-1.5 points, 95% CI=-2.6 to -0.4) in favor of the Pilates group after intervention, but these differences were no longer statistically significant at 6 months.LIMITATIONS: Treatment provider and participants could not be blinded to the interventions.CONCLUSIONS: The addition of modified Pilates exercises to an educational booklet provides small benefits compared with education alone in patients with chronic nonspecific low back pain; however, these effects were not sustained over time.","Miyamoto, G C; Costa, L O; Galvanin, T; Cabral, C M",2013.0,10.2522/ptj.20120190,0,0,
5959,Effectiveness and Cost-Effectiveness of Different Weekly Frequencies of Pilates for Chronic Low Back Pain: randomized Controlled Trial,"ER OBJECTIVE: The aim of this study will be to investigate the effectiveness and cost-effectiveness of the Pilates method with different weekly frequencies in the treatment of patients with nonspecific low back pain.DESIGN: This is a randomized controlled trial with blinded assessor.SETTING: This study will be conducted at a physical therapy clinic in S√£o Paulo, Brazil.PARTICIPANTS: Two hundred ninety-six patients with nonspecific low back pain between the ages of 18 and 80 years will be assessed and randomly allocated to 4 groups (n=74 patients per group).INTERVENTION: All groups will receive an educational booklet. The booklet group will not receive additional exercises. Pilates group 1 will follow a Pilates-based program once a week, Pilates group 2 will follow the same program twice a week, and Pilates group 3 will follow the same program 3 times a week. The intervention will last 6 weeks.MEASUREMENTS: A blinded assessor will evaluate pain, quality-adjusted life-years, general and specific disability, kinesiophobia, pain catastrophizing, and global perceived effect 6 weeks, 6 months, and 12 months after randomization.LIMITATIONS: Therapists and patients will not be blinded.CONCLUSIONS: This will be the first study to investigate different weekly frequencies of treatment sessions for nonspecific low back pain. The results of this study will contribute to a better definition of treatment programs for this population.BACKGROUND: The Pilates method has been recommended to patients with low back pain, but the evidence on effectiveness is inconclusive. In addition, there is still no evidence for the cost-effectiveness of this method or for the ideal number of sessions to achieve the highest effectiveness.","Miyamoto, G C; Moura, K F; Franco, Y R; Oliveira, N T; Amaral, D D; Branco, A N; Silva, M L; Lin, C; Cabral, C M",2016.0,10.2522/ptj.20150404,0,0,
5960,The effect of Boswellia Serrata on neurorecovery following diffuse axonal injury,"ER OBJECTIVES: This pilot trial was conducted to establish whether Boswellia Serrata (BS), a traditional herbal medicine, could improve the outcome of patients who have diffuse axonal injury (DAI).METHODS: In total, 38 patients with pure DAI were enrolled in this 12-week, double-blind, randomized, cross-over study. The patients were randomly assigned to receive either placebo (group A, n?=?20) or BS capsules (group B, n?=?18) for 6 weeks and then switched to the other intervention for another 6 weeks. The disability rating scale (DRS) was used to assess the outcome at 2-, 6- and 12-weeks post-trauma.RESULTS: A non-significant trend for improvement of DRS total scores was observed after the use of BS. Regarding the DRS sub-scores, however, there was significant improvement in 'cognitive ability to self-care' during the second 6 weeks in group A on BS compared to an insignificant spontaneous recovery in group B during the same period on placebo. Moreover, both groups experienced a close-to-significant increase in the cognitive function-related items of the DRS during the periods they were on BS. The reported adverse events were all of mild quality and had similar frequency between the groups.CONCLUSION: These results suggest that BS resin does not significantly affect general outcome, but may enhance the cognitive outcome of patients with DAI.","Moein, P; Abbasi, Fard S; Asnaashari, A; Baratian, H; Barekatain, M; Tavakoli, N; Moein, H",2013.0,10.3109/02699052.2013.825009,0,0,
5961,Randomized trial of two physiotherapy interventions for primary care neck and back pain patients: 'McKenzie' vs brief physiotherapy pain management,"ER METHODSEligible patients referred by GPs to physiotherapy departments with neck or back pain lasting at least 2 weeks were randomized to McK (n= 161) or to SFA (n= 154). They were further randomized to receive an educational booklet or not. The primary outcome was the Tampa Scale of Kinesiophobia (TSK) (Activity-Avoidance scale used as a proxy for coping) at 6 weeks, and 6 and 12 months.RESULTSOf 649 patients assessed for eligibility, 315 were recruited (219 with back pain, 96 with neck pain). There were no statistically significant differences in outcomes between the groups, except that at any time point SFA patients supported by a booklet reported less reliance on health professionals (Multidimensional Health Locus of Control Powerful Others Scale), while at 6 months McK patients showed slightly more improvement on activity-avoidance (TSK). At 6 weeks, patient satisfaction was greater for McK (median 90% compared with 70% for SFA). Both interventions resulted in modest but clinically important improvements over time on the Roland Disability Questionnaire Scores and Northwick Park Neck Pain Scores.CONCLUSIONSThe McK approach resulted in higher patient satisfaction overall but the SFA could be more cost-effective, as fewer (three vs four) sessions were needed.OBJECTIVESInterventions that take psychosocial factors into account are recommended for patients with persistent back or neck pain. We compared the effectiveness of a brief physiotherapy pain management approach using cognitive-behavioural principles (Solution-Finding Approach-SFA) with a commonly used method of physical therapy (McKenzie Approach-McK).","Moffett, J K; Jackson, D A; Gardiner, E D; Torgerson, D J; Coulton, S; Eaton, S; Mooney, M P; Pickering, C; Green, A J; Walker, L G; May, S; Young, S",2006.0,10.1093/rheumatology/kel339,0,0,
5962,A Peer-Support and Mindfulness Program to Improve the Mental Health of Medical Students,"ER INTERVENTION: Medical students elected peer leaders who underwent training and then provided the intervention. The peer leaders provided support to students in the intervention group, as well as offering teaching in mindfulness meditation.CONTEXT: An exploratory study was conducted with 2nd- and 3rd-year medical students at 1 medical school in New Zealand randomized into 2 groups. In addition to existing mental health resources, intervention participants received a program including peer support and peer-taught mindfulness practice. Study participants not offered the intervention participants could use existing mental health resources. Primary measures included depression (PHQ-9) and anxiety (GAD-7) scores. Secondary measures were quality of life, resilience (15-item resilience scale), academic self-concept, and motivation to learn, assessed at baseline and 6 months.OUTCOME: Of the 402 students eligible, 275 (68%) participated and 232 (58%) completed the study. At baseline, 53% were female and mean age was 21 years (SD = 3)-PHQ-9 score (M = 5.2, SD = 3.7) and GAD-7 score (M = 4.5, SD = 3.4). Twelve peer leaders were elected. There was good participation in the intervention. One fourth of intervention students used the face-to-face peer support and more than 50% attended a peer social event and/or participated in the mindfulness program. Although improvements in mental health were seen in the intervention group, the difference between the intervention and nonintervention groups did not reach statistical significance.LESSONS LEARNED: Although evidence exists for effectiveness of peer support and mindfulness in other contexts, this exploratory study was not able to show a statistically significant effect. Future studies could consider using a longer training period for the peer leaders, as well as targeting the study population to those most likely to benefit such as those with poorer mental health, or using a more intensive intervention or larger sample size. A cluster randomized study design would also reduce the risk of contamination.PROBLEM: There is evidence that peer-support programs can improve mental health indices and help-seeking behavior among students in some secondary school and university settings and that mindfulness can improve mental health in medical students. Peer-led programs have not been formally assessed in a medical student population, where psychological issues exist and where it has been shown that students approach peers for help in preference to staff members or professional services.","Moir, F; Henning, M; Hassed, C; Moyes, S A; Elley, C R",2016.0,10.1080/10401334.2016.1153475,0,0,
5963,Acupuncture for cancer-related fatigue in patients with breast cancer: a pragmatic randomized controlled trial,"ER PURPOSE: We aimed to assess the effectiveness of acupuncture for cancer-related fatigue (CRF) in patients with breast cancer.PATIENTS AND METHODS: We conducted a pragmatic, randomized controlled trial comparing acupuncture with enhanced usual care. Three hundred two outpatients with breast cancer participated. We randomly assigned 75 patients to usual care and 227 patients to acupuncture plus usual care (random assignment of 1:3 respectively) with minimization controlling for baseline general fatigue and maintenance treatment. Treatment was delivered by acupuncturists once a week for 6 weeks through needling three pairs of acupoints. The usual care group received a booklet with information about fatigue and its management. Primary outcome was general fatigue at 6 weeks, measured with the Multidimensional Fatigue Inventory (MFI). Other measurements included the Hospital Anxiety and Depression Scale, Functional Assessment of Cancer Therapy-General quality-of-life scale, and expectation of acupuncture effect. Analyses were by intention to treat.RESULTS: Two hundred forty-six of 302 patients randomly assigned provided complete data at 6 weeks. The difference in the mean General Fatigue score, between those who received the intervention and those who did not, was -3.11 (95% CI, -3.97 to -2.25; P < .001). The intervention also improved all other fatigue aspects measured by MFI, including Physical Fatigue and Mental Fatigue (acupuncture effect, -2.36 and -1.94, respectively; both at P < .001), anxiety and depression (acupuncture effect, -1.83 and -2.13, respectively; both at P < .001), and quality of life (Physical Well-Being effect, 3.30; Functional Well-Being effect, 3.57; both at P < .001; Emotional Well-Being effect, 1.93; P = .001; and Social Functioning Well-Being effect, 1.05; P < .05).CONCLUSION: Acupuncture is an effective intervention for managing the symptom of CRF and improving patients' quality of life.","Molassiotis, A; Bardy, J; Finnegan-John, J; Mackereth, P; Ryder, D W; Filshie, J; Ream, E; Richardson, A",2012.0,10.1200/JCO.2012.41.6222,0,0,
5964,A pilot study of the effects of cognitive-behavioral group therapy and peer support/counseling in decreasing psychologic distress and improving quality of life in Chinese patients with symptomatic HIV disease,"ER Forty-six Chinese patients with symptomatic human immunodeficiency virus (HIV) participated in a comparative study assessing the effectiveness of cognitive-behavioral group therapy (CBT) and peer support/counseling group therapy (PSC) in relation to improving mood and quality of life and decreasing uncertainty in illness as compared to a group receiving routine treatment with no formal psychosocial intervention. The CBT group consisted of 10 subjects, the PSC group of 10 subjects, and the comparison group of 26 subjects. There was a 24% attrition rate. The intervention groups received 12 weekly sessions of therapy over 3 months. Assessment of mood states was carried out before randomization (baseline data), immediately postintervention (3-month time point) and followed-up 3 months later (6-month time point). Assessment of quality of life and uncertainty in illness was carried out before randomization and at the 6-month follow-up time point. Results indicated that the mood of the participants in the CBT group improved in terms of anger, tension-anxiety, depression, confusion, and overall mood. The quality of life in this group was significantly improved compared to the other two groups, as was uncertainty in illness. In the PSC group a worsening of psychologic functioning was observed immediately postintervention, but this picture dramatically improved at the follow-up assessment with improvements of up to 34%. Quality of life also improved over time in this group by almost 5%, but results did not reach statistical significance. This study demonstrated that psychologic interventions could decrease psychologic distress and improve quality of life in symptomatic HIV patients, indicating their use should be incorporated in the management of care of people living with HIV/AIDS.","Molassiotis, A; Callaghan, P; Twinn, S F; Lam, S W; Chung, W Y; Li, C K",2002.0,10.1089/10872910252806135,0,0,
5965,Music Therapy Increases Comfort and Reduces Pain in Patients Recovering From Spine Surgery,"ER The treatment of pain continues to gain in saliency as a component of defining best practice in medical care. Music therapy is an integrative treatment modality that impacts patient outcomes in the treatment of spinal pain. At Mount Sinai Beth Israel, we conducted a mixed-methods study addressing the effects of music therapy interventions on the recovery of patients after spine surgery. The study combined standard medical approaches and integrative music therapy. Sixty patients (35 female, 25 male) ranging in age from 40 to 55 years underwent anterior, posterior, or anterior-posterior spinal fusion and were randomly assigned to either music therapy plus standard care (medical and nursing care with scheduled pharmacologic pain intervention) or standard care only. Measurements for both groups were completed before and after the intervention. Music therapy involved the use of patient-preferred live music that supported tension release/relaxation through incentive-based clinical improvisation, singing, and/or rhythmic drumming or through active visualization supported by live music that encompasses tension resolution. The control and music groups showed significant differences in degree and direction of change in the visual analog scale (VAS) pain ratings from before to after intervention (P = .01). VAS pain levels increased slightly in the control group (to 5.87 from 5.20) but decreased by more than 1 point in the music group (to 5.09 from 6.20). The control and music therapy groups did not differ in the rate of change in scores on Hospital Anxiety and Depression Scale (HADS) Anxiety (P = .62), HADS Depression (P = .85), or Tampa Scale for Kinesiophobia (P = .93). Both groups had slight increases in HADS Anxiety, comparable decreases in HADS Depression, and minimal changes in fear-related movement (Tampa scale).","Mondanaro, J F; Homel, P; Lonner, B; Shepp, J; Lichtensztein, M; Loewy, J V",2017.0,,0,0,
5966,Testosterone administration modulates moral judgments depending on second-to-fourth digit ratio,"ER Moral judgment involves the interplay of emotions and social cognitions. The male sex-hormone testosterone might play a role in moral reasoning as males are more utilitarian than females in their moral decisions, and high salivary testosterone levels also are associated with utilitarian moral decisions. However, there is no direct evidence for a role of testosterone in moral reasoning. Recent testosterone administration studies show effects on cognitive empathy and social cooperation, which depend on right-hand's second-to-fourth (2D:4D) digit ratio, a proxy for prenatal sex-hormone (testosterone-versus-estradiol) priming. Here, in a placebo-controlled within-subjects design using 20 young females we show that 2D:4D predicts 44% of the variance in the effects of testosterone administration on moral judgment. Subjects who show an increase in utilitarian judgments following testosterone administration have significantly higher than average 2D:4D (relatively high prenatal estradiol priming), while subjects showing more deontological judgments following testosterone administration have near-significantly lower 2D:4D (relatively high prenatal testosterone priming). We argue that prenatally-organized differences in aromatase, i.e. conversion from testosterone to estradiol in the brain, might underlie these effects. Our findings suggest that early neurodevelopmental effects of sex steroids play a crucial role in the activational effects of hormones on moral reasoning later in life.","Montoya, E R; Terburg, D; Bos, P A; Will, G J; Buskens, V; Raub, W; Honk, J",2013.0,10.1016/j.psyneuen.2012.12.001,0,0,
5967,Supporting stress management for women undergoing the early stages of fertility treatment: a cluster-randomized controlled trial,"ER METHODSWe randomly assigned seven institutions into an experimental group (four institutions, n = 96) and a control group (three institutions, n = 44) using cluster randomization. The women in the experimental group were asked to continue stress management homework for 3 months. A nurse provided feedback on the homework every month. Those in the control group were given only the booklet. The primary outcomes were the risk ratios of ""depression"" and ""anxiety"" according to the Hospital Anxiety and Depression Scale. The secondary outcomes were ""health status"" from the Medical Outcomes Study Short-Form 36-item Health Survey (SF-36) v2 and ""satisfaction"" from the Visual Analogue Scale. We excluded 15 women who became pregnant and performed an intention-to-treat analysis of 125 women.RESULTSThere were no differences in the incidence of depression and anxiety between the experimental and control groups. There were significant interaction effects between the program and time in the scores of the two subscales of SF-36 and the summary. There was no difference in satisfaction. The use of ovulation-enhancing agents showed that the scores of ""role functioning physical"" and ""physical component summary"" in the non-use subgroup were higher at 2 and 3 months in the experimental group, compared to the control group.CONCLUSIONSPositive effects of the support program were observed on two subscales of the SF-36 in the subgroup that did not use ovulation-enhancing agents.AIMThe purpose of this study was to determine the effects of a support program for the stress management of women undergoing fertility treatment to reduce stress related to infertility and treatment.","Mori, A",2009.0,10.1111/j.1742-7924.2009.00119.x,0,0,
5968,Enhancement of Fat Oxidation by Licorice Flavonoid Oil in Healthy Humans during Light Exercise,"ER Licorice flavonoid oil (LFO) is a new functional food ingredient consisting of hydrophobic licorice polyphenols in medium-chain triglycerides. Recent studies reported that LFO prevented and ameliorated diet-induced obesity via the regulation of lipid metabolism-related gene expression in the livers of mice and rats, while it reduced body weight in overweight human subjects by reducing total body fat. However, the direct effects of LFO on energy metabolism have not been studied in human subjects. Therefore, we investigated the effects of ingestion of LFO on energy metabolism, including fat oxidation, by measuring body surface temperature under resting conditions and respiratory gas analysis under exercise conditions in healthy humans. We showed that ingestion of a single 600 mg dose of LFO elevated body trunk skin temperature when measured in a slightly cooled air-conditioned room, and increased oxygen consumption and decreased the respiratory exchange ratio as measured by respiratory gas analysis during 40% Vo2max exercise with a cycle ergometer. Furthermore, repeated ingestion of 300 mg of LFO for 8 d decreased respiratory exchange during the recovery period following 40 min of 30% Vo2max exercise on a treadmill. These results suggest that LFO enhances fat oxidation in humans during light exercise.","Mori, N; Nakanishi, S; Shiomi, S; Kiyokawa, S; Kakimoto, S; Nakagawa, K; Hosoe, K; Minami, K; Nadamoto, T",2015.0,10.3177/jnsv.61.406,0,0,
5969,Cognitive therapy for people with schizophrenia spectrum disorders not taking antipsychotic drugs: a single-blind randomised controlled trial,"ER BACKGROUND: Antipsychotic drugs are usually the first line of treatment for schizophrenia; however, many patients refuse or discontinue their pharmacological treatment. We aimed to establish whether cognitive therapy was effective in reducing psychiatric symptoms in people with schizophrenia spectrum disorders who had chosen not to take antipsychotic drugs.METHODS: We did a single-blind randomised controlled trial at two UK centres between Feb 15, 2010, and May 30, 2013. Participants aged 16-65 years with schizophrenia spectrum disorders, who had chosen not to take antipsychotic drugs for psychosis, were randomly assigned (1:1), by a computerised system with permuted block sizes of four or six, to receive cognitive therapy plus treatment as usual, or treatment as usual alone. Randomisation was stratified by study site. Outcome assessors were masked to group allocation. Our primary outcome was total score on the positive and negative syndrome scale (PANSS), which we assessed at baseline, and at months 3, 6, 9, 12, 15, and 18. Analysis was by intention to treat, with an ANCOVA model adjusted for site, age, sex, and baseline symptoms. This study is registered as an International Standard Randomised Controlled Trial, number 29607432.FINDINGS: 74 individuals were randomly assigned to receive either cognitive therapy plus treatment as usual (n=37), or treatment as usual alone (n=37). Mean PANSS total scores were consistently lower in the cognitive therapy group than in the treatment as usual group, with an estimated between-group effect size of -6.52 (95%","Morrison, A P; Turkington, D; Pyle, M; Spencer, H; Brabban, A; Dunn, G; Christodoulides, T; Dudley, R; Chapman, N; Callcott, P; Grace, T; Lumley, V; Drage, L; Tully, S; Irving, K; Cummings, A; Byrne, R; Davies, L M; Hutton, P",2014.0,10.1016/S0140-6736(13)62246-1,0,0,
5970,Foot massage and physiological stress in people with dementia: a randomized controlled trial,"ER METHODS: This randomized controlled trial aimed to compare the effect of foot massage (FM) versus a control activity (quiet presence, QP) on physiological stress response (i.e., blood pressure [BP] and heart rate [HR]) in people living with moderate-to-severe dementia in long-term-care settings.RESULTS: Fifty-three residents were randomized to intervention (10-minute FM) or control group (QP). While the FM group experienced a greater reduction in HR than the control group, these reductions were not significantly different between groups (p=0.83; see Table 1 ), or across time (p=0.46). Both groups experienced a reduction in systolic BP and diastolic BP, while the mean reduction in systolic BP was greater for those in the FM group.CONCLUSIONS: While the findings do not provide strong support for FM, the finding that both conditions allowed the person with dementia to rest in the presence of another human being is of importance in the care of people with dementia. The close presence of another person may in fact promote relaxation and therefore improve BP and HR measures.BACKGROUND: The anxiety associated with unfamiliar surroundings, the disorientation and mental confusion, and the social isolation that accompanies dementia can often create increased stress for people living in long-term care settings. Such a response is thought to affect the autonomic nervous system and result in emotional and physical symptoms of distress that may be manifested as agitation. There is the potential for such distress to influence the physiological response and in particular Blood Pressure and Heart Rate. A relaxation intervention such as massage may influence the physiological stress response.","Moyle, W; Cooke, M L; Beattie, E; Shum, D H; O'Dwyer, S T; Barrett, S; Sung, B",2014.0,10.1089/acm.2013.0177,0,0,
5971,Evaluation of adjuvant psychological therapy in patients with testicular cancer: randomised controlled trial,"ER DESIGNNewly diagnosed patients were asked to participate in a randomised trial of psychological support compared with standard medical care. Participants and non-participants completed self assessment questionnaires at baseline and at 2, 4 and 12 months.SETTINGTesticular Tumour Unit of the Royal Marsden Hospital.SUBJECTS73 of 184 (40%) eligible patients agreed to enter the randomised trial (participants) and 81 (44%) declined to participate but agreed to complete further assessments (non-participants). 30 patients wanted no further contact with the researchers.OUTCOME MEASURESHospital anxiety and depression scale, psychosocial adjustment to illness scale, Rotterdam symptom checklist, mental adjustment to cancer scale. Only scores on the hospital anxiety and depression scale are reported for evaluating treatment efficacy.RESULTS111 of 184 (60%) eligible men declined to participate in the trial. Patients with stage I disease were most likely to refuse to participate. A patient was less likely to participate if he had low volume disease and was receiving no further treatment. Likelihood of participation was associated with stage of disease and with type of primary treatment (P < 0.001 for heterogeneity). Patients with early stage disease (P < 0.001) and fewer physical symptoms (P < 0.001) were less likely to participate. Psychosocial factors associated with participation included anxious preoccupation regarding disease (P = 0.01). There were no differences in outcome between participants and non-participants during follow up. Patients seemed to gain little benefit from adjuvant psychological therapy. At 2 months change from baseline favoured the treated group in the anxiety subscale (mean difference between groups -1.41 (95% confidence interval -2.86 to 0.03)). This was not sustained when adjusted for factors related to the disease. By 12 months change from baseline seemed to favour the control group (mean difference between groups 1.66 (-0.18 to 3.50)).CONCLUSIONSPatients with testicular cancer seem to have considerable coping abilities. Those who declined to participate in the trial differed from those who participated. Those who agreed to participate may comprise the clinical group who perceive a need for psychological support. No evidence was found to indicate a need for routinely offering adjuvant psychological therapy.OBJECTIVETo determine the efficacy of adjuvant psychological therapy in patients with testicular cancer and to compare the characteristics and psychosocial outcomes of men who agreed to participate with those who declined to participate in a randomised trial of psychological intervention.","Moynihan, C; Bliss, J M; Davidson, J; Burchell, L; Horwich, A",1998.0,,0,0,
5972,Adverse effects of prolonged hyperventilation in patients with severe head injury: a randomized clinical trial,"ER There is still controversy over whether or not patients should be hyperventilated after traumatic brain injury, and a randomized trial has never been conducted. The theoretical advantages of hyperventilation are cerebral vasoconstriction for intracranial pressure (ICP) control and reversal of brain and cerebrospinal fluid (CSF) acidosis. Possible disadvantages include cerebral vasoconstriction to such an extent that cerebral ischemia ensues, and only a short-lived effect on CSF pH with a loss of HCO3-buffer from CSF. The latter disadvantage might be overcome by the addition of the buffer tromethamine (THAM), which has shown some promise in experimental and clinical use. Accordingly, a trial was performed with patients randomly assigned to receive normal ventilation (PaCO2 35 +/- 2 mm Hg (mean +/- standard deviation): control group), hyperventilation (PaCO2 25 +/- 2 mm Hg: HV group), or hyperventilation plus THAM (PaCO2 25 +/- 2 mm Hg: HV + THAM group). Stratification into subgroups of patients with motor scores of 1-3 and 4-5 took place. Outcome was assessed according to the Glasgow Outcome Scale at 3, 6, and 12 months. There were 41 patients in the control group, 36 in the HV group, and 36 in the HV + THAM group. The mean Glasgow Coma Scale score for each group was 5.7 +/- 1.7, 5.6 +/- 1.7, and 5.9 +/- 1.7, respectively; this score and other indicators of severity of injury were not significantly different. A 100% follow-up review was obtained. At 3 and 6 months after injury the number of patients with a favorable outcome (good or moderately disabled) was significantly (p less than 0.05) lower in the hyperventilated patients than in the control and HV + THAM groups. This occurred only in patients with a motor score of 4-5. At 12 months posttrauma this difference was not significant (p = 0.13). Biochemical data indicated that hyperventilation could not sustain alkalinization in the CSF, although THAM could. Accordingly, cerebral blood flow (CBF) was lower in the HV + THAM group than in the control and HV groups, but neither CBF nor arteriovenous difference of oxygen data indicated the occurrence of cerebral ischemia in any of the three groups. Although mean ICP could be kept well below 25 mm Hg in all three groups, the course of ICP was most stable in the HV + THAM group. It is concluded that prophylactic hyperventilation is deleterious in head-injured patients with motor scores of 4-5.(ABSTRACT TRUNCATED AT 400 WORDS)","Muizelaar, J P; Marmarou, A; Ward, J D; Kontos, H A; Choi, S C; Becker, D P; Gruemer, H; Young, H F",1991.0,10.3171/jns.1991.75.5.0731,0,0,
5973,Randomized controlled comparison of two cognitive behavioral therapies for obese children: mother versus mother-child cognitive behavioral therapy,"ER METHODFifty-six obese children and their families were randomly assigned to a 16-session cognitive behavioral therapy (CBT) for the parents only or for a combined treatment of parents and children. Children's percent overweight, the body mass index of their mothers, and behavioral and psychological problems of children and mothers were assessed.RESULTSBoth treatments reduced children's percent overweight significantly and equally by 6-month follow-up. Also both treatments provided similar results in reducing general behavior problems (externalizing and internalizing behavior problems), global and social anxiety, and depression.CONCLUSIONSOur results point to a comparable efficacy of the two treatments. Further, psychological well-being of both mothers and children can be improved in a CBT for obese children and their parents. Future studies should focus on finding ways to improve the adherence of families to long-term treatment of obesity in childhood.BACKGROUNDParent-child treatments have been shown to be superior to child-focused treatments of childhood obesity. Yet until now, the comparative effectiveness of parent-only and parent-child approaches has been little studied.","Munsch, S; Roth, B; Michael, T; Meyer, A H; Biedert, E; Roth, S; Speck, V; Zumsteg, U; Isler, E; Margraf, J",2008.0,10.1159/000129659,0,0,
5974,Children affected by maternal HIV/AIDS: feasibility and acceptability trial of the Children United with Buddies (CUB) intervention,"ER Past research has shown that young children affected by maternal HIV present with elevated stress/anxiety and negative well-being. This pilot intervention for children aged 7-14 affected by maternal HIV targeted improving positive child-mother communication, improving HIV/AIDS knowledge and reducing anxiety (especially related to transmission), and lessening feelings of stigma. Each of the three child intervention sessions included behavioral skills training and a themed craft exercise; mothers attended an open discussion group while the children attended their sessions. Study participants were 37 child-mother pairs. The study design was a randomized two-group pretest-posttest experimental design. The intervention sessions were audiotaped for transcription. Results showed significant decreases in anxiety and worry for children in the intervention group, and increases in happiness and knowledge regarding HIV/AIDS transmission. Intervention group mothers reported greater social support. Qualitative findings for the intervention group children and mothers also support these findings. Early intervention reduces child stress, and may affect longer-term outcomes.","Murphy, D A; Marelich, W D; Graham, J; Payne, D L",2015.0,10.1177/1359104513499357,0,0,
5975,A pragmatic randomised controlled trial of the Welsh National Exercise Referral Scheme: protocol for trial and integrated economic and process evaluation,"ER METHODS/DESIGN: The randomised controlled trial, with nested economic and process evaluations, recruited 2,104 inactive men and women aged 16+ with coronary heart disease (CHD) risk factors and/or mild to moderate depression, anxiety or stress. Participants were recruited from 12 local health boards in Wales and referred directly by health professionals working in a range of health care settings. Consenting participants were randomised to either a 16 week tailored exercise programme run by qualified exercise professionals at community sports centres (intervention), or received an information booklet on physical activity (control). A range of validated measures assessing physical activity, mental health, psycho-social processes and health economics were administered at 6 and 12 months, with the primary 12 month outcome measure being 7 day Physical Activity Recall. The process evaluation explored factors determining the effectiveness or otherwise of the scheme, whilst the economic evaluation determined the relative cost-effectiveness of the scheme in terms of public spending.DISCUSSION: Evaluation of such a large scale national public health intervention presents methodological challenges in terms of trial design and implementation. This study was facilitated by early collaboration with social research and policy colleagues to develop a rigorous design which included an innovative approach to patient referral and trial recruitment, a comprehensive process evaluation examining intervention delivery and an integrated economic evaluation. This will allow a unique insight into the feasibility, effectiveness and cost effectiveness of a national exercise referral scheme for participants with CHD risk factors or mild to moderate anxiety, depression, or stress and provides a potential model for future policy evaluations.TRIAL REGISTRATION: Current Controlled Trials ISRCTN47680448.BACKGROUND: The benefits to health of a physically active lifestyle are well established and there is evidence that a sedentary lifestyle plays a significant role in the onset and progression of chronic disease. Despite a recognised need for effective public health interventions encouraging sedentary people with a medical condition to become more active, there are few rigorous evaluations of their effectiveness. Following NICE guidance, the Welsh national exercise referral scheme was implemented within the context of a pragmatic randomised controlled trial.","Murphy, S; Raisanen, L; Moore, G; Edwards, R T; Linck, P; Williams, N; Ud, Din N; Hale, J; Roberts, C; McNaish, E; Moore, L",2010.0,10.1186/1471-2458-10-352,0,0,
5976,Videotape self-confrontation among chronic schizophrenics,,"Muzekari, L H",1974.0,,0,0,
5977,Effect of a single-piece and a three-piece acrylic sharp-edged IOL on posterior capsule opacification,"ER BACKGROUND: To compare the intensity of posterior capsule opacification (PCO) between two intraocular lenses (IOLs) of the same optic material, but with different haptic design (1-piece vs. 3-piece).METHODS: This prospective intraindividual controlled cohort study comprised eighty eyes of 40 patients with bilateral age-related cataract. Each patient received a Polylens Y10 (Polytech, Germany) 1-piece IOL in 1 eye and a Polylens Y30 (Polytech, Germany) 3-piece IOL in the contralateral eye. The IOL type in the first operated eye was randomly assigned before patient recruitment. Digital slitlamp photographs were taken 1 year postoperatively using a standardized photographic technique for regeneratory PCO. The amount of PCO was assessed subjectively at the slitlamp and objectively using automated image-analysis software.RESULTS: The Polylens Y10 (1-piece) group showed significantly higher regeneratory and fibrotic PCO scores 1 year after surgery in subjective slitlamp evaluation, however not with objective evaluation using automated image-analysis software. Subjective PCO assessment resulted in a mean PCO score (scale = 0-10) of 1.6 in the Polylens Y10 group and 0.6 in the Polylens Y30 group at 1 year (p < 0.05). The mean automated image-analysis software PCO score was 1.5 in the Polylens Y10 group and 0.9 in the Polylens Y30 group (p = 0.6).CONCLUSION: Both investigated IOLs showed good clinical performance regarding PCO, BCVA and IOL-centration. The Polylens Y10 IOL showed slightly more regeneratory PCO than the 3-piece acrylic IOL 1 year after surgery.","Mylonas, G; Prskavec, M; Baradaran-Dilmaghani, R; Karnik, N; Buehl, W; Wirtitsch, M",2013.0,10.3109/02713683.2012.717242,0,0,
5978,Smoke your troubles away: exploring the effects of death cognitions on cannabis craving and consumption,"ER Two studies informed by the terror management health model were conducted to examine the question of how death cognition affects cannabis craving and whether actual cannabis smoking alleviates death cognitions. The first study examined whether priming thoughts of death are associated with subjective cannabis craving among 42 frequent cannabis users randomly assigned to either a mortality salience or control task. When reminded of their death, participants craved cannabis, even though there was no change in their conscious negative mood. The second study examined the effect of cannabis smoking on death cognitions in an exploratory field setting. Fifty frequent cannabis users were randomly assigned to either mortality reminders or control task and completed death-related words accessibility measures before and after smoking cannabis. Results indicate that cannabis served as a buffer and prevented death-related thoughts from entering consciousness, thus acting as a defense mechanism against death anxiety. These findings indicate that death-related concerns may play a hitherto unsuspected role in cannabis craving and consumption. Also discussed are the implications of a terror management perspective in communication of negative health consequences of recreational cannabis smoking and in the use of cannabis for medical purposes among people with terminal illness.","Nagar, M; Rabinovitz, S",2015.0,10.1080/02791072.2015.1029654,0,0,
5979,Responsiveness of hypochondriacal patients with chronic low-back pain to cognitive-behavioral therapy,"ER BACKGROUND: Evidence has suggested that cognitive-behavioral therapy (CBT) is effective in reducing hypochondriacal symptoms, and another line of evidence has suggested that CBT is also effective in reducing pain and the psychological conditions associated with chronic low-back pain (CLBP). The purpose of this study was to examine the effectiveness of CBT among hypochondriacal patients with and without CLBP.METHODS: A total of 182 hypochondriacal patients were randomly assigned to a CBT or control group. The Somatic Symptom Inventory was used to define CLBP, and the Symptom Checklist 90R (SCL90R) was used to assess psychological symptoms. The outcome measures for hypochondriasis, the Whiteley Index (WI) and the Health Anxiety Inventory (HAI) were administered before the intervention and at 6 and 12 months after completion of the intervention.RESULTS: In the total sample, both WI and HAI scores were significantly decreased after treatment in the CBT group compared with the control group. Ninety-three (51%) patients had CLBP; the SCL90R scores for somatization, depression, phobic anxiety, paranoid ideation, and general severity were significantly higher in CLBP(+) group than in the CLBP(-) group at baseline. Although the WI and HAI scores were significantly decreased after treatment in the CLBP(-) group, such significant pre- to post-changes were not found in the CLBP(+) group.CONCLUSIONS: CBT was certainly effective among hypochondriacal patients without CLBP, but it appeared to be insufficient for hypochondriacal patients with CLBP. The core psychopathology of hypochondriacal CLBP should be clarified to contribute to the adequate management of hypochondriacal symptoms in CLBP patients.","Nakao, M; Shinozaki, Y; Nolido, N; Ahern, D K; Barsky, A J",2012.0,10.1016/j.psym.2011.09.006,0,0,
5980,Effect of intraocular lens asphericity on posterior capsule opacification between two intraocular lenses with same acrylic material: a fellow-eye study,"ER PURPOSE: To evaluate intra-individual differences in posterior capsule opacification (PCO) and visual performance between spherical AcrySof SN60AT and an aspheric AcrySof SN60WF intraocular lens (IOL) with a posterior aspheric surface, both of which are made of same hydrophobic acrylic material.SETTING: Ophthalmology Department, St Thomas' Hospital, London, UK.METHODS: In this prospective randomized, fellow-eye comparison, an aspheric IOL, which is 9% thinner in comparison with the spherical IOL, was randomized to the first eye of 47 patients and fellow-eye surgery was performed within 3 weeks. Follow-up was at 1, 3, 6, 12 and 24 months. Corrected logMAR visual acuity (CDVA) was measured at 100% and 9% contrast. After pupil dilation, digital retroillumination photographs were taken and the mean PCO percentage was calculated using poco software at each follow-up visit.RESULTS: At 1, 3, 6, 12 and 24 months, 47 (94 eyes), 44 (88 eyes), 42 (84 eyes) and 41 (82 eyes) patients were followed-up respectively. Hundred per cent and 9% of LogMAR CDVA was not significantly different between the two IOLs (p = NS at all time-points). Percentage area PCO scores (mean ± SD) at 1, 3, 6, 12 and 24 months with the spherical IOL was 5.82 ± 9.89, 7.76 ± 16.83, 7.21 ± 12.46, 9.29 ± 18.25 and 14.39 ± 25.42, respectively, and with an aspheric IOL was 8.91 ± 12.79, 5.97 ± 10.32, 5.15 ± 7.92, 7.68 ± 11.18 and 12.18 ± 20.10, respectively (p = NS at all time-points).CONCLUSIONS: Posterior capsule opacification was not significantly different between the spheric and aspheric IOLs in this fellow-eye, randomized comparison. Additional asphericity on the existing model of IOL does not influence PCO performance.","Nanavaty, M A; Spalton, D J; Gala, K B; Dhital, A; Boyce, J",2012.0,10.1111/j.1755-3768.2011.02286.x,0,0,
5981,Ex vivo analysis of cholesterol deposition for commercially available silicone hydrogel contact lenses using a fluorometric enzymatic assay,"ER OBJECTIVE: Lipid deposition on silicone hydrogel (SiHy) lenses, which are believed to be caused by their hydrophobic surface, can lead to discomfort, reduced vision, and inflammatory reactions. This study used a highly specific and sensitive fluorometric enzymatic assay for ex vivo cholesterol analysis of seven types of SiHy lenses: balafilcon A, comfilcon A, enfilcon A, enhanced-lotrafilcon A, enhanced-lotrafilcon B, galyfilcon A, and senofilcon A.METHODS: Cholesterol sorption was assessed in 140 previously worn SiHy lenses from 8 clinical trials conducted in the United States and Australia between 2006 and 2008. Patients wore the lenses for 2 to 4 weeks. Unworn negative control lenses for each lens material were obtained directly from the manufacturer. Lipids were isolated from the lenses using a two-step chloroform: methanol extraction method, and total cholesterol was quantified using a fluorometric enzymatic assay. Nonparametric Mann Whitney statistical analysis was performed to determine the differences in total cholesterol sorption between lens-specific data sets.RESULTS: Enhanced-lotrafilcon A and enhanced-lotrafilcon B contact lenses showed significantly lower median total cholesterol sorption (median±quartile, 0.30±0.2 ?g/lens and 0.09±0.1 ?g/lens, respectively) than all other types of lenses that were tested (P<0.0001). By contrast, enfilcon A (3.96±0.8 ?g/lens) and galyfilcon A (3.75±1.1 ?g/lens) showed the highest median total cholesterol sorption of all tested lenses.CONCLUSIONS: Cholesterol deposition in SiHy contact lenses seems to be lens polymer dependent. Enhanced-lotrafilcon A and enhanced-lotrafilcon B both sorbed the lowest amount of cholesterol compared with the other five types of SiHy lenses that were tested in this study.","Nash, W L; Gabriel, M M",2014.0,10.1097/ICL.0000000000000052,0,0,
5982,Evaluation of a randomized controlled trial in the management of chronic lower back pain in a French automotive industry: an observational study,"ER DESIGNRandomized controlled trial.SETTINGOn site at the workplace of a French automotive manufacturer.PARTICIPANTSSubjects (N=75 volunteers) were recruited on site and randomly assigned to either an experimental group (n=37) or a control group (n=38).INTERVENTIONThe experimental group followed a supervised 60-minute session, 3 times per week, of muscle strengthening, flexibility, and endurance training during 2 months. The control group received no direct intervention. Evaluation took place at baseline, 2 months, and 6 months.MAIN OUTCOME MEASURESPain related parameters were evaluated using validated questionnaires and scales translated into French (Quebec Back Pain Disability Scale, Rolan Morris Disability Questionnaire, Dallas Pain Questionnaire, and the Tampa Scale for Kinesiophobia). Perceived pain intensity was evaluated using the numerical rating scale, and physical outcome measures were evaluated using specific indicators (flexibility, Biering-Sorensen Test, Shirado test). The multivariate analysis of variance, t test, and Wilcoxon signed-rank test were used for statistical analysis.RESULTSWe observed a significant beneficial effect (P<.025) for the experimental group at 2 and 6 months in pain parameters, specific flexibility, and in back functions, and a significant improvement at 6 months in the control group for the perceived pain intensity, anterior flexion, flexibility of quadriceps, and Dallas Pain Questionnaire's work recreational score. An increase in the practice of physical activity outside the workplace was noted in both groups at 2 months but persisted at 6 months for the experimental group.CONCLUSIONSThis study reinforces the multiple health benefits of physical activity and physical therapy modalities in the workplace by assisting individuals at risk who have chronic LBP.OBJECTIVETo evaluate a specific workplace intervention for the management of chronic lower back pain among employees working in assembly positions in the automotive industry.","Nassif, H; Brosset, N; Guillaume, M; Delore-Milles, E; Tafflet, M; Buchholz, F; Toussaint, J F",2011.0,10.1016/j.apmr.2011.06.029,0,0,
5983,Attention training reduces intrusive thoughts cued by a narrative of stressful life events: a controlled study,"ER OBJECTIVES: Intrusive thoughts are common distressing symptoms that occur after exposure to stressful life events. This study tested the idea, based on metacognitive theory, that such intrusions may be ameliorated by the Attention Training Technique (ATT; Wells,). METHOD: Participants who reported distressing intrusions were randomly allocated to two sessions of ATT (plus homework) or a filler task and were exposed to a narrative recording of their traumatic experience before and after the intervention. Frequencies of intrusions occurring during the narrative were measured. A measure of self-reported attention flexibility was also examined. RESULTS: Participants in the ATT condition showed a significant reduction in intrusion frequency and an increase in attention flexibility compared with the control group. ATT was associated with a 3.4 times greater reduction in the incidence of intrusions. CONCLUSIONS: ATT may be an effective technique for reducing symptoms of stress exposure, reducing the incidence of intrusions when exposed to stimuli associated with stressful events.","Nassif, Y; Wells, A",2014.0,10.1002/jclp.22047,0,0,
5984,Prospective intrapatient comparison of 6.0-millimeter optic single-piece and 3-piece hydrophobic acrylic foldable intraocular lenses,"ER DESIGNProspective, randomized, self-controlled trial.PARTICIPANTSEighty eyes of 40 patients with bilateral senile cataracts.INTERVENTIONPhacoemulsification and IOL implantation were performed. One eye of a patient was randomly assigned to the SA60AT single-piece IOL, and the contralateral eye was allocated to the MA60AC 3-piece IOL.MAIN OUTCOME MEASURESBest-corrected visual acuity (BCVA), spherical equivalent, aqueous flare intensity, anterior chamber depth, amount of IOL decentration and tilt, area of anterior capsule opening, and degree of posterior capsule opacification (PCO) were measured 2 days, 1 week, and 1, 3, 6, and 12 months after surgery. Specular microscopy was performed at 12 months postoperatively.RESULTSIn the SA60AT group, the anterior chamber depth did not show significant changes after surgery (P>0.05; paired t test), and the refraction remained highly stable throughout the 1-year study period. The MA60AC group showed significant shallowing of the anterior chamber (P0.05) in BCVA, aqueous flare intensity, the amount of IOL decentration, IOL tilt, area of anterior capsule opening, and degree of PCO throughout the 12-month follow-up period.CONCLUSIONSBoth the SA60AT single-piece and MA60AC 3-piece lenses showed a minimum amount of decentration, tilt, anterior capsule contraction, and PCO. Although the MA60AC showed significant forward shift and myopic refractive changes after surgery, the SA60AT displayed little axial movement associated with highly stable refraction after surgery. This feature of the SA60AT should facilitate earlier spectacle prescription and quicker visual/social rehabilitation of patients after cataract surgery.PURPOSETo compare postoperative performance and stability of 6.0-mm optic single- and 3-piece acrylic foldable intraocular lenses (IOLs).","Nejima, R; Miyai, T; Kataoka, Y; Miyata, K; Honbou, M; Tokunaga, T; Kawana, K; Kiuchi, T; Oshika, T",2006.0,10.1016/j.ophtha.2005.10.064,0,0,
5985,Influence of a double blind pharmacological trial on two domains of well-being in subjects with age associated memory impairment,"ER This random double-blind trial compares psychological well-being and perceived quality of life in 60 subjects (18 M, 42 F), mean age 61 years, with age-associated memory impairment (AAMI), who were administered a standardised ginseng-containing vitamin complex or placebo for 9 months. We evaluated psychological well-being, in terms of affective status and memory functioning using the Symptom Rating Test [SRT] (depression, anxiety, somatisation, inadequacy) and Randt Memory Test [RMT] (memory index [MI]), respectively, and the quality of life, using the Life Satisfaction in the Elderly Scale [LSES]. At final evaluation, SRT did not differ in the drug and placebo groups, whereas MI and LSES were significantly higher in the drug-treated group. Moreover, the negative correlation between the affective (SRT) and cognitive (MI) component of psychological well-being waned in the drug-treated but not placebo group. In the drug-treated group, a positive correlation emerged between the cognitive index and social contacts, mood and self-concept factors of the LSES. In both groups, the initial negative correlations between quality of life (LSES) and affection (SRT) persisted at the end of the study. Drug-treated AAMI subjects differ from controls in part by improved scores on objective cognitive tests but even more so by modifications of the correlations among indexes of psychological well-being and quality of life.","Neri, M; Andermarcher, E; Pradelli, J M; Salvioli, G",1995.0,,0,0,
5986,Correlates of quality of life in rural patients with heart failure,"ER BACKGROUND: There is abundant research indicating poor physical, psychological, and social functioning of patients with chronic heart failure (HF), a reality that can lead to poor health-related quality of life (QoL). Little is known about the experience of rural patients with HF.METHODS AND RESULTS: This study was part of a randomized clinical trial titled Rural Education to Improve Outcomes in Heart Failure (REMOTE-HF) designed to test an education and counseling intervention to improve self-care in patients with HF. We evaluated 612 rural patients. Multiple validated questionnaires were administered to assess patient perceptions of health and health literacy. Baseline factors were collected and compared with baseline QoL measures only. Patients' health-related QoL was assessed using the Minnesota Living with Heart Failure scale. The data were analyzed using a general linear model to test the association of various patient characteristics with QoL in rural patients with HF. Patients were 65.8 (+12.9) years of age. The majority were men (58.7%), married (56.4%), and had completed a high-school education (80.9%). Factors associated with reduced QoL among this population include geographic location, younger age, male sex, higher New York Heart Association class, worse HF knowledge, poorer perceived control, and symptoms of depression or anxiety. The data provided no evidence of an association between left ventricular ejection fraction and QoL.CONCLUSIONS: This study of rural patients with HF confirms previously identified factors associated with perceptions of QoL. However, further study is warranted with an urban control group.CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00415545.","Nesbitt, T; Doctorvaladan, S; Southard, J A; Singh, S; Fekete, A; Marie, K; Moser, D K; Pelter, M M; Robinson, S; Wilson, M D; Cooper, L; Dracup, K",2014.0,10.1161/CIRCHEARTFAILURE.113.000577,0,0,
5987,Gender specific effects of a mild stressor on alcohol cue reactivity in heavy social drinkers,"ER AIMThe present study set out to examine the effects of stress on feelings of desire for alcohol, skin conductance response and alcohol consumption in the presence of alcohol-related cues in relation to gender. Participants were heavy non-dependent alcohol drinkers.METHODSThirty-two (16 males) participants drinking more than 21 units of alcohol per week were randomly allocated to undergo the experimental stress (based on the 'Trier Social Stress' Test) or the non-stress procedure before the alcohol cue exposure procedure, during which participants handled and smelled their preferred drink. Mood and saliva cortisol level changes were used as indices of the stress effects, while alcohol craving, skin conductance and alcohol consumption were the cue reactivity measures.RESULTSSelf ratings of anxiety and tension increased and cortisol levels remained high in the stress compared to the non-stress condition; no gender differences were found. Stress induced gender-specific effects with regard to skin conductance response and alcohol consumption measurements. Stressed females did not show an increase from baseline in the skin conductance response during the alcohol cue-exposure session, which was observed in the non-stressed females; they also consumed less alcohol than males under stress.CONCLUSIONFemale participants respond less to alcohol-related cues when in a negative mood state. Such a finding suggests that females when in a negative mood may be less sensitive to positive incentive processes mediating cue reactivity compared to males.RATIONALEStress plays an important role in the development and maintenance of alcohol-abuse. Some of the effects of stress on alcohol-related behaviours, however, appear to be gender-dependent.","Nesic, J; Duka, T",2006.0,10.1016/j.pbb.2006.02.006,0,0,
5988,Interactions during feeding with mothers and their infants with symptoms of gastroesophageal reflux,"ER OBJECTIVES: To examine whether maternal-child interaction during feedings was suboptimal in dyads in which the infant had gastroesophageal reflux disease (GERD) and to compare massage therapy to a nonmassage therapy sham treatment in improving the mother-child interaction in these dyads.DESIGN: In this randomized, controlled pilot study, infants received massage therapy (n=18) or a nonmassage touch/holding sham treatment (n=18). Mothers, data collectors, and the investigator who scored the feeding observations were blinded to group assignment.SETTINGS/LOCATION: Dyads were recruited from pediatric care providers in the Denver metropolitan area and online advertisements at the University of Colorado. Treatments were given in the home of the dyad.PARTICIPANTS: Healthy infants, born at 38-42 weeks gestational age, were 5-10 weeks of age at enrollment; had a score of at least 16 on the Infant Gastroesophageal Reflux Questionnaire-Revised; and were diagnosed with GERD by their pediatric provider. Mothers were English speaking and at least 18 years of age.INTERVENTIONS: Treatments were given for 30 minutes twice weekly for 6 weeks. A certified infant massage therapist administered massage, and a registered nurse or physical therapist experienced with infants administered the control treatment.OUTCOME MEASURES: Maternal and infant scores on the Nursing Child Assessment of Feeding Scale (NCAFS).RESULTS: NCAFS scores were significantly lower than national norms. Small to moderately sized effects showing improvement in the massage group relative to the nonmassage group were seen for Sensitivity to Cues, Social-Emotional Growth Fostering, Cognitive Growth Fostering, and Clarity of Cues (Cohen d) and ranged from 0.24 to 0.56.CONCLUSIONS: Mothers and infants with GERD experience significantly worse interactions than those without GERD. Massage given twice weekly by a professional trended toward improved interaction during feeding. Daily maternal administration of massage may have a positive effect on the relationship.","Neu, M; Schmiege, S J; Pan, Z; Fehringer, K; Workman, R; Marcheggianni-Howard, C; Furuta, G T",2014.0,10.1089/acm.2013.0223,0,0,
5989,Evaluation of a self-help leaflet in treatment of social difficulties following facial disfigurement,"ER Psychological difficulty, particularly in social situations, is widely reported by disfigured people, but many receive no formal psychological treatment. This study randomly allocated 106 facially disfigured people either to receive a self-help leaflet offering cognitive-behavioural guidance or not. Participants were assessed pre-treatment and at 3 month follow-up. The untreated group then received the leaflet. Participants in the leaflet group fared better than controls on 3 of the 9 scales employed (Social Leisure [SAQ] (t=2.31, p=0.012), HADS anxiety (t=2.22, p=0.015), HADS depression (t=1.83, p=0.036). There is support for a cognitive-behavioural approach and the usefulness of self-help instructions in addressing the social difficulties of facially disfigured people. The approach merits further development and investigation.","Newell, R; Clarke, M",2000.0,,0,0,
5990,Outcomes for youths from racial-ethnic minority groups in a quality improvement intervention for depression treatment,"ER METHODS: A randomized controlled trial comparing quality improvement and usual care for youths from diverse racial-ethnic groups from five health care organizations, including managed care, the public sector, and academic center clinics, was conducted. Depressed youths (N=325), who self-identified as black (N=59), Latino (N=224), and white (N=42), aged 13-21 years, were included in these analyses. To evaluate intervention effects within racial-ethnic groups, regression models were constructed, which adjusted for baseline and study site variation in depression symptoms, mental health status, satisfaction with mental health care, and mental health service utilization.RESULTS: Differential intervention effects were found across racial-ethnic groups. Black youths in the intervention group experienced significant reductions in depression symptoms and had higher rates of use of specialty mental health care at the six-month follow-up. Among Latino youths, the intervention was associated with significantly greater satisfaction with care. Intervention effects were weak among white youths.CONCLUSIONS: Quality improvement interventions may help to reduce disparities in mental health care for youths from racial-ethnic minority groups. (OBJECTIVE: This study examined racial-ethnic differences in the impact of the Youth Partners in Care quality improvement intervention. The intervention was designed to improve access to evidence-based depression care, primarily cognitive-behavioral therapy and medication, through primary care. Previous analyses have shown that the quality improvement intervention was associated with improved depression and quality-of-life outcomes at the end of the six-month intervention period.","Ngo, V K; Asarnow, J R; Lange, J; Jaycox, L H; Rea, M M; Landon, C; Tang, L; Miranda, J",2009.0,10.1176/ps.2009.60.10.1357,0,0,
5991,Family group psychotherapy to support the disclosure of HIV status to children and adolescents,"ER Disclosure of the HIV status to infected children is often delayed due to psychosocial problems in their families. We aimed at improving the quality of life in families of HIV-infected children, thus promoting disclosure of the HIV status to children by parents. Parents of 17 HIV-infected children (4.2-18 years) followed at our Center for pediatric HIV, unaware of their HIV status, were randomly assigned to the intervention group (8 monthly sessions of family group psychotherapy, FGP) or to the control group not receiving psychotherapy. Changes in the Psychological General Well-Being Index (PGWB-I) and in the Short-Form State-Trait Anxiety Inventory (Sf-STAI), as well as the HIV status disclosure to children by parents, were measured. Ten parents were assigned to the FGP group, while 7 parents to the controls. Psychological well-being increased in 70% of the FGP parents and none of the control group (p=0.017), while anxiety decreased in the FGP group but not in controls (60% vs. 0%, p=0.03). HIV disclosure took place for 6/10 children of the intervention group and for 1/7 of controls. Family group psychotherapy had a positive impact on the environment of HIV-infected children, promoting psychological well-being and the disclosure of the HIV status to children.","Nicastro, E; Continisio, G I; Storace, C; Bruzzese, E; Mango, C; Liguoro, I; Guarino, A; Officioso, A",2013.0,10.1089/apc.2012.0465,0,0,
5992,Hyperbaric oxygen in the treatment of acute ischemic stroke. A double-blind pilot study,"ER METHODSPatients who experienced middle cerebral artery occlusion and were seen within 24 hours of onset were randomized to receive either active (HBO) or sham (air) treatment. The HBO patients were exposed daily to 40 minutes at 1.5 atmospheres absolute for a total of 10 dives. We used the Orgogozo scale to establish a pretreatment functional level. Changes in the Orgogozo scale score at 6 months and 1 year after therapy were used to assess the therapeutic efficacy of HBO. In addition, we used the Rankin scale and our own 10-point scale to assess long term-disability at 6 months and 1 year. Two sample t tests and 95% confidence intervals were used to compare the mean differences between the two treatment groups. Student's two-tailed test was used to compare the differences between pretherapeutic and posttherapeutic scores at 6 months and 1 year in the two treatment groups.RESULTSOver the 3 years of study enrollment, 34 patients were randomized, 17 to hyperbaric treatment with air and 17 to hyperbaric treatment with 100% oxygen. There was no significant difference at inclusion between groups regarding age, time from stroke onset to randomization, and Orgogozo scale scores. Neurological deterioration occurred during the first week in 4 patients in the sham group, 3 of whom died; this worsening was clearly related to the ischemic damage. Treatment was also discontinued for 3 patients in the HBO group who experienced myocardial infarction, a worsening related to the ischemic process, and claustrophobia. Therefore, 27 patients (13 in the sham group and 14 in the HBO group) completed a full course of therapy. The mean score of the HBO group was significantly better on the Orgogozo scale at 1 year (P < .02). However, the difference at 1 year between pretherapeutic and posttherapeutic scores was not significantly different in the two groups (P < .16). Moreover, no statistically significant improvement was observed in the HBO group at 6 months and 1 year according to Rankin score (P < .78) and our own 10-point scale (P < .50).CONCLUSIONSAlthough the small number of patients in each group precludes any conclusion regarding the potential deleterious effect of HBO, we did not observe the major side effects usually related to HBO. Accordingly, it can be assumed that hyperbaric oxygen might be safe. We hypothesize that HBO might improve outcome after stroke, as we detected an outcome trend favoring HBO therapy. A large randomized trial might be required to address the efficacy of this therapy.BACKGROUND AND PURPOSEThe effects of hyperbaric oxygen (HBO) therapy on humans are uncertain. Our study aims first to outline the practical aspects and the safety of HBO treatment and then to evaluate the effect of HBO on long-term disability.","Nighoghossian, N; Trouillas, P; Adeleine, P; Salord, F",1995.0,,0,0,
5993,Implementing CBT for traumatized children and adolescents after september 11: lessons learned from the Child and Adolescent Trauma Treatments and Services (CATS) Project,"ER The Child and Adolescent Trauma Treatments and Services Consortium (CATS) was the largest youth trauma project associated with the September 11 World Trade Center disaster. CATS was created as a collaborative project involving New York State policymakers; academic scientists; clinical treatment developers; and routine practicing clinicians, supervisors, and administrators. The CATS project was established to deliver evidence-based cognitive-behavioral trauma treatments for children and adolescents affected by the September 11 terrorist attack in New York City and to examine implementation processes and outcomes associated with delivery of these treatments. Referrals were obtained on 1,764 children and adolescents; of these, 1,387 were subsequently assessed with a standardized clinical battery and 704 found to be eligible for services. Ultimately 700 youth participated in the project. Treatments were delivered in either school or clinic settings by clinicians employed in 9 provider organizations in New York City. All participating clinicians were trained on the cognitive behavioral therapy models by the treatment developers and received case consultation for 18 months by expert clinician consultants and the treatment developers. The challenges of mounting a large trauma treatment project within routine clinical practices in the aftermath of a disaster and simultaneously evaluating the project have been significant. We outline the major challenges, describe strategies we employed to address them, and make recommendations based on critical lessons learned.",,2007.0,10.1080/15374410701662725,0,0,
5994,Fast track randomized controlled trial to prevent externalizing psychiatric disorders: findings from grades 3 to 9,"ER METHODSchools within four sites (Durham, NC; Nashville, TN; Seattle, WA; and rural central Pennsylvania) were selected as high-risk institutions based on neighborhood crime and poverty levels. After screening 9,594 kindergarteners in these schools, 891 highest risk and moderate-risk children (69% male and 51% African American) were randomly assigned by matched sets of schools to intervention or control conditions. The 10-year intervention (begun in 1991 with three yearly cohorts) included parent behavior-management training, child social-cognitive skills training, reading tutoring, home visiting, mentoring, and a universal classroom curriculum. Outcomes included criterion counts and psychiatric diagnoses after grades 3, 6, and 9 for conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder, any externalizing disorder, and self-reported antisocial behavior. Grade 9 outcomes were assessed between 2000 and 2003, depending upon cohort.RESULTSSignificant interaction effects between intervention and initial risk level were found at each age but most strongly after grade 9. Assignment to intervention had a significant positive effect in lowering criterion count scores and diagnoses for conduct disorder, attention-deficit/hyperactivity disorder, and any externalizing disorder, and lowering antisocial behavior scores, but only among those at highest risk initially.CONCLUSIONSPrevention of serious antisocial behavior can be efficacious across sex, ethnicity, and urban/rural residence, but screening is essential.OBJECTIVEThis study tests the efficacy of the Fast Track Program in preventing antisocial behavior and psychiatric disorders among groups varying in initial risk.",,2007.0,10.1097/chi.0b013e31813e5d39,0,0,
5995,The Treatment for Adolescents With Depression Study (TADS): demographic and clinical characteristics,"ER METHODParticipants are 439 adolescents, aged 12-17 years inclusively, with a primary DSM-IV diagnosis of current major depressive disorder. Baseline data are summarized and compared with those from national samples and previous trials.RESULTSThe sample composition is 54.4% girls, 73.8% white, 12.5% African American, and 8.9% Hispanic. The mean Child Depression Rating Scale-Revised total score is 60.1 (SD = 10.4, range 45-98) with 86.0% experiencing their first major depressive episode. The most common concurrent diagnoses are generalized anxiety disorder (15.3%), attention-deficit/hyperactivity disorder (13.7%), oppositional defiant disorder (13.2%), social phobia (10.7%), and dysthymia (10.5%). Demographic results are consistent with data from national samples and large psychopharmacology trials involving depressed adolescents.CONCLUSIONSThe Treatment for Adolescents With Depression Study provides a large, diverse, and representative sample of depressed adolescents that highlights the complexity of major depressive disorder in adolescents and provides a rich source for explicating the effects of moderator and mediator variables on baseline psychopathology and treatment outcome.OBJECTIVEThe Treatment for Adolescents With Depression Study is a multicenter, randomized clinical trial sponsored by the NIMH. This study is designed to evaluate the short- and long-term effectiveness of four treatments for adolescents with major depressive disorder: fluoxetine, cognitive-behavioral therapy, their combination, and, acutely, pill placebo. This report describes the demographic and clinical characteristics of the sample and addresses external validity.",,2005.0,,0,0,
5996,"Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: the Pediatric OCD Treatment Study (POTS) randomized controlled trial","ER OBJECTIVETo evaluate the efficacy of CBT alone and medical management with the selective serotonin reuptake inhibitor sertraline alone, or CBT and sertraline combined, as initial treatment for children and adolescents with OCD.DESIGN, SETTING, AND PARTICIPANTSThe Pediatric OCD Treatment Study, a balanced, masked randomized controlled trial conducted in 3 academic centers in the United States and enrolling a volunteer outpatient sample of 112 patients aged 7 through 17 years with a primary Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of OCD and a Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) score of 16 or higher. Patients were recruited between September 1997 and December 2002.INTERVENTIONSParticipants were randomly assigned to receive CBT alone, sertraline alone, combined CBT and sertraline, or pill placebo for 12 weeks.MAIN OUTCOME MEASURESChange in CY-BOCS score over 12 weeks as rated by an independent evaluator masked to treatment status; rate of clinical remission defined as a CY-BOCS score less than or equal to 10.RESULTSNinety-seven of 112 patients (87%) completed the full 12 weeks of treatment. Intent-to-treat random regression analyses indicated a statistically significant advantage for CBT alone (P = .003), sertraline alone (P = .007), and combined treatment (P = .001) compared with placebo. Combined treatment also proved superior to CBT alone (P = .008) and to sertraline alone (P = .006), which did not differ from each other. Site differences emerged for CBT and sertraline but not for combined treatment, suggesting that combined treatment is less susceptible to setting-specific variations. The rate of clinical remission for combined treatment was 53.6% (95% confidence interval [CI], 36%-70%); for CBT alone, 39.3% (95% CI, 24%-58%); for sertraline alone, 21.4% (95% CI, 10%-40%); and for placebo, 3.6% (95% CI, 0%-19%). The remission rate for combined treatment did not differ from that for CBT alone (P = .42) but did differ from sertraline alone (P = .03) and from placebo (P<.001). CBT alone did not differ from sertraline alone (P = .24) but did differ from placebo (P = .002), whereas sertraline alone did not (P = .10). The 3 active treatments proved acceptable and well tolerated, with no evidence of treatment-emergent harm to self or to others.CONCLUSIONChildren and adolescents with OCD should begin treatment with the combination of CBT plus a selective serotonin reuptake inhibitor or CBT alone.CONTEXTThe empirical literature on treatment of obsessive-compulsive disorder (OCD) in children and adolescents supports the efficacy of short-term OCD-specific cognitive-behavior therapy (CBT) or medical management with selective serotonin reuptake inhibitors. However, little is known about their relative and combined efficacy.",,2004.0,10.1001/jama.292.16.1969,0,0,
5997,Not All Sounds Have Negative Effects on Children Undergoing Cardiac Surgery,"ER DESIGN: Prospective, randomized, double-blind, controlled clinical trial.SETTING: Children's university hospital.PARTICIPANTS: Fifty children aged 4 to 12 years undergoing repair of congenital heart disease.INTERVENTIONS: Patients were randomized into 2 equal groups (control group and music group); in the control group, patients listened to a blank CD, and in the music group, patients listened to a recorded CD of music and songs preferred by the child. Demographic data, clinical data, and preoperative vital signs were recorded. Baseline stress markers (blood glucose and cortisol levels) were sampled. Patients were assessed intraoperatively until extubation for vital signs and stress markers and after extubation for pain and sedation scales. An interview was conducted within the first postoperative week with the patients and their parents for assessment of post-traumatic stress disorder and negative postoperative behavior changes.MEASUREMENTS AND MAIN RESULTS: There were no significant differences in demographic characteristics, clinical data, vital signs, preoperative and at-extubation blood glucose levels, and preoperative blood cortisol levels between groups. Significant differences were found between groups in blood glucose levels and cortisol levels at all intraoperative times, but only in cortisol blood levels at extubation. Significant differences were found in pain score, sedation score, occurrence of child post-traumatic stress disorder, and occurrence of negative postoperative behavior.CONCLUSION: Listening to favorable music by children undergoing repair for congenital heart disease resulted in less stress and more relaxation.OBJECTIVE: This study was designed to evaluate the role of music therapy on the level of stress in children undergoing repair of congenital heart disease.","Abd-Elshafy, S K; Khalaf, G S; Abo-Kerisha, M Z; Ahmed, N T; Abd, El-Aziz M A; Mohamed, M A",2015.0,10.1053/j.jvca.2015.01.005,0,0,
5998,Evaluation of quality of life therapy for parents of children with obsessive-compulsive disorders in Iran,"ER Previous research has provided evidence on the effectiveness of CBT in the symptomatic improvement of children with obsessive-compulsive disorders. There is also increasing recognition of the importance of involving parents and families in treatment. The aim of this study was to evaluate the short-term effectiveness of such an intervention that promoted family strengths [(quality of life therapy (QoLT)] for mothers of children with obsessive-compulsive disorders (OCD). The sample consisted of 40 children with OCD and their mothers, who had been referred to clinics in Esfahan city in Iran. Mothers were randomly allocated to an experimental (QoLT) and waiting list control group. Mothers participated in eight QoLT group sessions over 4 weeks. QoLT incorporated CBT techniques in managing OCD symptoms. Measures were completed pre- and post-intervention by both groups. Children completed the Yale-Brown obsession compulsion scale for Children, the Revised children's manifest anxiety scale, and the brief multidimensional student's life satisfaction scale; mothers completed the quality of life inventory (QoLI). QoLT was associated with decrease in OCD and anxiety symptoms and increase in children's satisfaction in the global, family and environment domains, as well as with increased QoLI scores in their mothers. Parenting interventions like QoLT can complement individual modalities such as CBT in the presence of family-related difficulties. This can be particularly applicable in countries and settings with limited resources and high stigma of child mental health problems.","Abedi, M R; Vostanis, P",2010.0,10.1007/s00787-010-0098-4,0,0,
5999,Brief cognitive intervention can modulate neuroendocrine stress responses to the Trier Social Stress Test: buffering effects of a compassionate goal orientation,"ER BACKGROUND: The hypothalamic-pituitary-adrenal (HPA) axis is a critical mediator linking stress to health. Understanding how to modulate its reactivity could potentially help reduce the detrimental health effects of HPA axis activation. Social evaluative threat is a potent activator of this system. Access to control and coping responses can reduce its reactivity to pharmacological activation. Compassionate or affiliative behaviors may also moderate stress reactivity. Impact of these moderators on social evaluative threat is unknown. Here, we tested the hypotheses that interventions to increase control, coping, or compassionate (versus competitive) goals could reduce HPA-axis response to social evaluative threat. METHODS: Healthy participants (n=54) were exposed to social evaluative threat using the Trier Social Stress Test (TSST). They were randomly assigned to receive one of four different instructions prior to the stressor: Standard TSST instructions (SI), standard instructions with access to ""control"" (SI Control), or one of two cognitive interventions (CI) that (1) increased familiarity and helped participants prepare coping strategies (CI Coping), or (2) shifted goal orientation from self-promotion to helping others (CI Compassionate Goals). ACTH and cortisol were obtained before and after stress exposure via intravenous catheter. RESULTS: Control alone had no effect. CI Compassionate Goals significantly reduced ACTH and cortisol responses to the TSST; CI Coping raised baseline levels. Compassionate Goals reduced hormonal responses without reducing subjective anxiety, stress or fear, while increasing expression of pro-social intentions and focus on helping others. CONCLUSIONS: Brief intervention to shift focus from competitive self-promotion to a goal orientation of helping-others can reduce HPA-axis activation to a potent psychosocial stressor. This supports the potential for developing brief interventions as inoculation tools to reduce the impact of predictable stressors and lends support to growing evidence that compassion and altruistic goals can moderate the effects of stress.","Abelson, J L; Erickson, T M; Mayer, S E; Crocker, J; Briggs, H; Lopez-Duran, N L; Liberzon, I",2014.0,10.1016/j.psyneuen.2014.02.016,0,0,
6000,Use of receiver-operator characteristic (ROC) curve analysis to evaluate predictors of response to clomipramine therapy,"ER We used receiver-operator characteristic (ROC) curve analysis to evaluate predictors of response to clomipramine in obsessive-compulsive disorder (OCD). Previously, we identified response predictors among 230 OCD patients who received clomipramine in a placebo-controlled, multicenter clinical trail. We found that at baseline a later age of OCD onset, low scores on the Hamilton Depression scale, and high scores on items 3 and 8 of the Yale-Brown Obsessive Compulsive Scale predicted good response. Certain early side effects also predicted outcome. We fitted a logistic regression model containing baseline information and then calculated each patient's estimated response probability by substituting individuals' values in the regression equation. Next we compared the estimated response risks with each patient's known outcome. Finally, we produced a ROC curve by plotting the true positive and false positive rates for various cutoff points of the risk scores. The same steps were followed for Weeks 1 through 4, adding information about early side effects and weekly response. We found that baseline information predicted outcome better than chance, and predictive ability increased with data on side effects and early response.","Ackerman, D L; Greenland, S; Bystritsky, A",1996.0,,0,0,
6001,Effectiveness of treatment in day hospital versus inpatient ward evaluated by patients' psychopathological symptoms and subjective quality of life (QoL) analysis,"ER METHOD238 patients admitted to the Psychiatric Hospital in Wroc?aw were randomly assigned to treatment in either day hospital (n=l15) or inpatient ward (n=123). Patients were interviewed at 4 time-points comprising their stay in hospital. Differences between settings in terms of dynamics of psychopathological symptoms and subjective QoL were expressed in mean scores of BPRS subscales and MANSA. Two parameters of effectiveness were considered: the static--the score on the scale at a given time-point and average score level, and the dynamic--describing dynamics of changes (gradients). Statistical methods included ANOVA and ANCOVA with co-variables.RESULTSIn terms of manic and excitement symptoms inpatient wards proved to be more effective as measured at discharge, no differences in dynamics between settings were found. Day hospital was superior in alleviating negative symptoms during treatment but improvement in that respect was quicker in the inpatient ward. In terms of alleviating positive symptoms, the inpatient ward was more effective only at the beginning of the treatment. Day hospital was more effective in handling symptoms of depression and anxiety but only at the beginning of treatment. Dynamics of subsiding of the symptoms at the beginning of hospitalization was better for the inpatient ward. No differences in QoL in both settings were found.CONCLUSIONSTaking into consideration the static and the dynamic parameters of effectiveness of treatment, the superiority of inpatient treatment over day hospital has not been, therefore, definitely proven.AIMThe authors analyzed patients' psychopathological symptoms and subjective quality of life (QoL) for evaluating the effectiveness of treatment in day hospital versus inpatient wards. Analyses concerned patients from Wroc?aw and recruited within the framework of an EU funded multi-centre study EDEN.","Adamowski, T; Hadry?, T; Rymaszewska, J; Kiejna, A",2005.0,,0,0,
6002,A randomized controlled trial of cognitive behavioral therapy for individuals at clinical high risk of psychosis,"ER METHODFifty-one individuals at clinical high risk of developing psychosis were randomized to CBT or a supportive therapy for up to 6 months. The sample was assessed at 6, 12 and 18 months post baseline on attenuated positive symptoms, negative symptoms, depression, anxiety and social functioning.RESULTSConversions to psychosis only occurred in the group who received supportive therapy although the difference was not significant. Both groups improved in attenuated positive symptoms, depression and anxiety and neither improved in social functioning and negative symptoms. There were no differences between the two treatment groups. However, the improvement in attenuated positive symptoms was more rapid for the CBT group.CONCLUSIONSThere are limitations of this trial and potential explanations for the lack of differences. However, both the results of this study and the possible explanations have significant implications for early detection and intervention in the pre-psychotic phase and for designing future treatments.BACKGROUNDThere has been increasing interest in early detection during the prodromal phase of a psychotic disorder. To date a few treatment studies have been published with some promising results for both pharmacological treatments, using second generation antipsychotics, and psychological interventions, mainly cognitive behavioral therapy. The purpose of this study was to determine first if cognitive behavioral therapy (CBT) was more effective in reducing the rates of conversion compared to a supportive therapy and secondly whether those who received CBT had improved symptoms compared to those who received supportive therapy.","Addington, J; Epstein, I; Liu, L; French, P; Boydell, K M; Zipursky, R B",2011.0,10.1016/j.schres.2010.10.015,0,0,
6003,Baclofen efficacy in reducing alcohol craving and intake: a preliminary double-blind randomized controlled study,"ER METHODSA total of 39 alcohol-dependent patients were consecutively enrolled in the study. After 12-24 h of abstinence from alcohol, patients were randomly divided into two groups. Twenty patients were treated with baclofen and 19 with placebo. Drug and placebo were orally administered for 30 consecutive days. Baclofen was administered at the dose of 15 mg/day for the first 3 days and 30 mg/day for the subsequent 27 days, divided into three daily doses. Patients were monitored as out-patients on a weekly basis. At each visit alcohol intake, abstinence from alcohol, alcohol craving and changes in affective disorders were evaluated.RESULTSA higher percentage of subjects totally abstinent from alcohol and a higher number of cumulative abstinence days throughout the study period were found in the baclofen, compared to the placebo, group. A decrease in the obsessive and compulsive components of craving was found in the baclofen compared to the placebo group; likewise, alcohol intake was reduced in the baclofen group. A decrease in state anxiety was found in the baclofen compared to the placebo group. No significant difference was found between the two groups in terms of current depressive symptoms. Baclofen proved to be easily manageable and no patient discontinued treatment due to the presence of side-effects. No patient was affected by craving for the drug and/or drug abuse.CONCLUSIONSBaclofen proved to be effective in inducing abstinence from alcohol and reducing alcohol craving and consumption in alcoholics. With the limits posed by the small number of subjects involved, the results of this preliminary double-blind study suggest that baclofen may represent a potentially useful drug in the treatment of alcohol-dependent patients and thus merits further investigations.AIMSThe gamma-aminobutyric acid (GABA(B)) receptor agonist, baclofen, has recently been shown to reduce alcohol intake in alcohol-preferring rats and alcohol consumption and craving for alcohol in an open study in humans. The present study was aimed at providing a first evaluation of the efficacy of baclofen in inducing and maintaining abstinence and reducing craving for alcohol in alcohol-dependent patients in a double-blind placebo-controlled design.","Addolorato, G; Caputo, F; Capristo, E; Domenicali, M; Bernardi, M; Janiri, L; Agabio, R; Colombo, G; Gessa, G L; Gasbarrini, G",2002.0,,0,0,
6004,Does acupuncture influence the cardiac autonomic nervous system in patients with minor depression or anxiety disorders?,"ER We undertook this study to evaluate the effects of needle acupuncture on cardiac autonomic nervous system (ANS) function in patients with minor depression or anxiety disorder. Patients (n = 36) were randomly distributed into a verum acupuncture (VA) group (needles were applied at classical acupuncture points, e. g. He7, Pe6, Du20, Bl62, Ex6) or a placebo (PL) group (needles were applied only epidermal at non-acupuncture points). Both groups underwent standardized measurements of the 5-minute resting heart rate variability (HRV), which were performed before the first and after the 9th acupuncture session of an acupuncture series, and also three times (before the start and 5, respectively, 15 minutes after needle application) during the third acupuncture session. Demographic data between the VA and PL group did not differ. Before the start of acupuncture there were also no significant differences in HRV data between these groups. Compared to PL the VA group showed a significant decrease of the mean resting heart rate both, 5 and 15 minutes after needle application, combined with a trend towards an increase of the high frequency (HF; 0.15 - 0.4 Hz) and a decrease of the low frequency (LF; 0.04 - 0.15 Hz) spectral power. The latter effects resulted in an overall significant decrease of the mean LF/HF ratio in VA compared to PL treated patients. This pattern of findings suggests that in patients with minor depression or anxiety only verum acupuncture 1.) leads to a relative increase of cardiovagal modulation of heart rate and 2.) facilitates the physiological regulatory ANS function in response to alterations of external or internal environment. Clinical implications of these findings are discussed.","Agelink, M W; Sanner, D; Eich, H; Pach, J; Bertling, R; Lemmer, W; Klieser, E; Lehmann, E",2003.0,10.1055/s-2003-37756,0,0,
6005,Comparison of 2 family therapies for adolescent anorexia nervosa: a randomized parallel trial,"ER IMPORTANCE: Anorexia nervosa (AN) is a serious disorder with high rates of morbidity and mortality. Family-based treatment (FBT) is an evidence-based therapy for adolescent AN, but less than half of those who receive this approach recover. Hence, it is important to identify other approaches to prevent the development of the chronic form of AN for which there is no known evidence-based treatment.OBJECTIVE: To compare FBT with systemic family therapy (SyFT) for the treatment of adolescent-onset AN.DESIGN, SETTING, AND PARTICIPANTS: Research in Anorexia Nervosa (RIAN) is a 2-group (FBT and SyFT) randomized trial conducted between September 2005 and April 2012. Interviewers were blinded to the treatment condition. A total of 564 adolescents receiving care at 6 outpatient clinics experienced in the treatment of AN were screened. Of these, 262 adolescents did not meet the inclusion criteria and 138 declined to participate; hence, 164 adolescents (aged 12-18 years) of both sexes meeting the criteria for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, AN (except for amenorrhea) were enrolled. Three participants were withdrawn from FBT and 7 were withdrawn from SyFT after serious adverse events occurred.INTERVENTIONS: Two manualized family therapies with 16 one-hour sessions during 9 months. Family-based therapy focuses on the facilitation of weight gain, whereas SyFT addresses general family processes.MAIN OUTCOMES AND MEASURES: The primary outcomes were percentage of ideal body weight (IBW) and remission (?95% of IBW). The a priori hypothesis was that FBT would result in faster weight gain early in treatment and at the end of treatment (EOT).RESULTS: There were no statistically significant differences between treatment groups for the primary outcome, for eating disorder symptoms or comorbid psychiatric disorders at the EOT or follow-up. Remission rates included FBT, 33.1% at the EOT and 40.7% at follow-up and SyFT, 25.3% and 39.0%, respectively. Family-based therapy led to significantly faster weight gain early in treatment, significantly fewer days in the hospital, and lower treatment costs per patient in remission at the EOT (FBT, $8963; SyFT, $18?005). An exploratory moderator analysis found that SyFT led to greater weight gain than did FBT for participants with more severe obsessive-compulsive symptoms.CONCLUSIONS AND RELEVANCE: The findings of this study suggest that FBT is the preferred treatment for adolescent AN because it is not significantly different from SyFT and leads to similar outcomes at a lower cost than SyFT. Adolescents with more severe obsessive-compulsive symptoms may receive more benefits with SyFT.TRIAL REGISTRATION: clinicaltrials.gov Identifier NCT00610753.","Agras, W S; Lock, J; Brandt, H; Bryson, S W; Dodge, E; Halmi, K A; Jo, B; Johnson, C; Kaye, W; Wilfley, D; Woodside, B",2014.0,10.1001/jamapsychiatry.2014.1025,0,0,
6006,EMDR treatment for children with PTSD: results of a randomized controlled trial,"ER The objective of the study was to examine the efficacy of EMDR treatment for children with post-traumatic stress disorder (PTSD) compared with untreated children in a waiting list control group (WLC) participating in a randomized controlled superiority trial (RCT). Thirty-three 6-16-year-old children with a DSM-IV diagnosis of PTSD were randomly assigned to eight weekly EMDR sessions or the WLC group. The Posttraumatic Stress Symptom Scale for Children (PTSS-C scale) was used in interviews with children to evaluate their symptoms and outcome. Post-treatment scores of the EMDR group were significantly lower than the WLC indicating improvement in total PTSS-C scores, PTSD-related symptom scale, and the subscales re-experiencing and avoidance among subjects in the EMDR group, while untreated children improved in PTSD-non-related symptom scale. The improvement in re-experiencing symptoms proved to be the most significant between-group difference over time. The results of the present exploratory study including a limited number of children with PTSD are encouraging and warrant further controlled studies of larger samples of children suffering from PTSD.","Ahmad, A; Larsson, B; Sundelin-Wahlsten, V",2007.0,10.1080/08039480701643464,0,0,
6007,Applying EMDR on children with PTSD,"ER METHODChild-adjusted modification were made in the original adult-based protocol, and within-session measurements, when EMDR was used in a randomized controlled trial (RCT) on thirty-three 6-16-year-old children with post-traumatic stress disorder (PTSD).RESULTSEMDR was applicable after certain modifications adjusted to the age and developmental level of the child. The average treatment effect size was largest on re-experiencing, and smallest on hyperarousal scale. The age of the child yielded no significant effects on the dependent variables in the study.CONCLUSIONSA child-adjusted protocol for EMDR is suggested after being applied in a RCT for PTSD among traumatized and psychosocially exposed children.OBJECTIVETo find out child-adjusted protocol for eye movement desensitization and reprocessing (EMDR).","Ahmad, A; Sundelin-Wahlsten, V",2008.0,10.1007/s00787-007-0646-8,0,0,
6008,Psychological predictors of glycemic change with relaxation training in non-insulin-dependent diabetes mellitus,"ER METHODSSubjects with NIDDM were randomized to relaxation training (6 sessions of progressive muscle relaxation and imagery, n = 12) or control treatment (routine medical care, n = 10). Physiological measures were total glycosylated hemoglobin (GHb) and area under the 2-hour oral-glucose-tolerance curve (AUC). Psychological measures of generalized distress, anxiety and daily stress were also administered. All subjects were assessed before and after the 8-week intervention, and again at 16 weeks of long-term follow-up.RESULTSThere were no postintervention group differences in physiological variables. Highly distressed subjects and those who rated their glucose as more stress responsive tended to practice relaxation less between sessions. Within the treated group only, lower preintervention stress responsivity was associated with greater improvement in GHb, and lower anxiety and distress levels predicted long-term improvement in AUC.CONCLUSIONSIt remains unclear whether relaxation training produces glycemic benefits in NIDDM. Perhaps the least anxious and stress-responsive patients only benefit from group-based relaxation training, whereas anxious individuals require intensive individually administered interventions.BACKGROUNDPrevious findings are unclear regarding the possible glycemic benefits of applying behavioral relaxation training in non-insulin-dependent diabetes mellitus (NIDDM).","Aikens, J E; Kiolbasa, T A; Sobel, R",1997.0,,0,0,
6009,Comparison of limbal-conjunctival autograft and intraoperative 0.02% mitomycin-C for treatment of primary pterygium,"ER MATERIAL AND METHODOne hundred and twelve eyes of eighty patients with primary pterygia were randomly treated either by intraoperative 0.02% MMC for 5 min or LCAG. Recurrence (defined as fibrovascular tissue invading the cornea >1.5 mm) and complications were evaluated.RESULTSFifty-two eyes were included in the MMC group and sixty in the LCAG group. Recurrence occurred in three eyes (5.76%) in the MMC group and in two eyes (3.33%) in the LCAG group. This difference between recurrence in the two groups was not statistically significant (P > 0.05). Incidence of complications such as conjunctival cysts, symblephara, conjunctival hyperemia, and subconjunctival hemorrhage was similar in both groups (P > 0.05) whereas corneal epithelial defects (CED), irritation, lacrimation, and photophobia were more common in the MMC group (P < 0.05).CONCLUSIONSimple excision then intraoperative use of 0.02% (MMC) for 5 min or LCAG are similarly successful in the treatment of primary pterygia. Some complications, for example irritation, lacrimation, photophobia, and CED are more common when simple excision is followed by MMC.PURPOSETo compare the outcomes of use of intraoperative 0.02% mitomycin-C (MMC) and limbal-conjunctival autograft (LCAG) for treatment of primary pterygia.","Akinci, A; Zilelioglu, O",2007.0,10.1007/s10792-007-9034-0,0,0,
6010,Evaluation of a patient-centred approach in generalized musculoskeletal chronic pain/fibromyalgia patients in primary care,"ER The aim of this paper is to assess whether patient-centred consultations are more effective than the usual style of consultations used by general practitioners with patients suffering from benign chronic musculoskeletal pain and fibromyalgia. It also seeks to evaluate the differential characteristics of these two clinical groups of symptoms. The study was designed as a cluster randomised and simple blind trial. Twenty general practitioners took part and 110 patients were recruited. Compared with patients who received the usual treatment from their family physician, those who received a patient-centred approach showed greater improvement after 1 year in terms of psychological distress (anxiety) and number of tender points, as well as showing positive trends in some important outcomes such as pain intensity. Significantly better results were observed in those patients suffering chronic pain than in those with fibromyalgia, particularly as regards associated symptoms, self-rated pain and physical mobility as measured by the Nottingham health profile.","Alamo, M M; Moral, R R; Pérula de, Torres L A",2002.0,,0,0,
6011,"The effects of multimodal intervention for the primary prevention of cardiovascular diseases on depression, anxiety, and Type-D pattern: initial results of the randomized controlled PreFord trial","ER Depression, anxiety, and Type-D pattern are associated with the earlier development and faster progression of cardiovascular disease (CVD). The aim of the randomized controlled PreFord trial was to improve multiple biological and psychosocial risk factors in the primary prevention of CVD. A total of 447 women and men with an ESC risk score >5% were randomly assigned to either multimodal or routine care groups. Somatic and psychosocial variables (HADS, DS-14) were assessed before and after the intervention, and annually for 2 years thereafter. The intervention showed no significant effects on the symptoms of depression, anxiety, and type D personality, either in the whole sample or in those with elevated scores at baseline. Thus, our study did not provide evidence that symptoms of depression, anxiety, or Type D personality can be effectively treated by multimodal behavioral interventions for the primary prevention of CVD.","Albus, C; Bjarnson-Wehrens, B; Gysan, D B; Herold, G; Schneider, C A; zu, Eulenburg C; Predel, H G; PräFord-Studiengruppe",2012.0,10.1007/s00059-011-3542-4,0,0,
6012,Anxiogenic properties of yohimbine. II. Influence of experimental set and setting,"ER To study the pharmacological induction of stress along with psychological stress and their possible interaction, 20 mg yohimbine and placebo orally were administered to 8 panic patients on placebo treatment, 7 panic patients on alprazolam treatment and 12 controls in a double-blind crossover design. Two structured situations which can be considered as 'neutral' stressors were included: a mental arithmetic task and a continuous performance task. Mental arithmetic induced robust increases in ratings of panicky, anxiety, nervousness, heart rate and electrodermal activity, while the continuous performance task induced increases exclusively in skin conductance reaction. Patients responded to these tasks less than controls with regard to subjective ratings and electrodermal activity. Yohimbine did not potentiate the response to the tasks in the patients. In controls, heart rate during the mental arithmetic task, but not during rest, was increased after yohimbine. In contrast to other yohimbine challenge studies no panic attacks were observed. It is hypothesized that the experimental design together with an instructional set that reduces expectancy factors and the inclusion of structured and time-limited tasks in a challenge paradigm is able to reduce the anxiogenic effects of yohimbine.","Albus, M; Zahn, T P; Breier, A",1992.0,,0,0,
6013,"Anxiogenic properties of yohimbine. I. Behavioral, physiological and biochemical measures","ER The anxiogenic effects of yohimbine, a specific alpha-2-receptor antagonist were examined by administering 20 mg yohimbine orally to 8 panic patients on placebo treatment, 7 panic patients on alprazolam treatment and 12 controls using a double-blind randomized design, instructions that minimized the expectancy of experiencing a panic attack and two additional structured situations. Yohimbine induced more pronounced increases in anxiety and panicky ratings, norepinephrine secretion, maximum heart rate and high heart rate variability and decreases in skin temperature in panic patients compared with controls. However, possibly owing to an instructional set and experimental design that distracted patients from unpleasant bodily sensations no panic attacks were observed.","Albus, M; Zahn, T P; Breier, A",1992.0,,0,0,
6014,Mediators and moderators of outcome in the behavioral treatment of childhood social phobia,ER METHOD: Participants were 88 youths participating in one of two randomized controlled treatment trials of Social Effectiveness Therapy for Children. Potential mediators included changes in observer-rated social skill and child-reported loneliness after 12 weeks of Social Effectiveness Therapy for Children. Age and depressive symptoms were examined as potential moderators.RESULTS: Loneliness scores and social effectiveness during a role-play task predicted changes in social anxiety and overall functioning at posttreatment. Changes in social anxiety were mediated by child-reported loneliness. Outcomes were not moderated by age or depressive symptoms.CONCLUSIONS: Findings support the role of loneliness as an important mechanism of change during treatment for childhood social phobia.OBJECTIVE: The current study examined mediators and moderators of treatment response among children and adolescents (ages 7-17 years) with a primary diagnosis of social phobia.,"Alfano, C A; Pina, A A; Villalta, I K; Beidel, D C; Ammerman, R T; Crosby, L E",2009.0,10.1097/CHI.0b013e3181af8216,0,0,
6015,"Long-term effects of and physiological responses to nitrous oxide gas treatment during alcohol withdrawal: a double-blind, placebo-controlled trial","ER METHODSA total of 105 inpatients who had AWS and were admitted to the A-Clinic detoxification center were included in the study. The subjects were randomly assigned to one of the following three treatments: (1) N2O/oxygen (from 30 to 70% in oxygen), (2) air/oxygen (30%/70%), and (3) medical (normal) air. During the single 45-min treatment period, end-tidal N2O, carbon dioxide, and oxygen concentrations were measured. The physiologic responses were studied by measuring heart rate, blood pressure, pulse oximetric saturation, frontal muscle electromyographic activity, and plethysmographic pulse amplitude. Long-term effects were studied by measuring craving with the Obsessive-Compulsive Drinking Scale; severity of dependency with Severity of Alcohol Dependence Data; and liver enzymes with aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltransferase 3 and 6 months after the treatment.RESULTSPatients in the N2O group demonstrated significantly higher facial muscle electromyographic activity and higher pulse amplitude than the air-treated subjects. Self-reported side effects between the gas treatments, however, did not differ between the groups. Regarding long-term effects of the treatments, there were no differences between the groups.CONCLUSIONSContrary to previously published data, N2O treatment did not decrease craving or liver enzymes during the 6-month follow-up. At the concentration used, N2O treatment produced signs of arousal instead of strong sedation.BACKGROUNDNitrous oxide gas (N2O) has been proposed to be effective in the treatment of the alcohol withdrawal syndrome (AWS). This has not been proved, however, in studies performed according to good clinical practice guidelines. Moreover, previous studies have not measured end tidal N2O concentrations or physiologic responses during N2O treatment. We have recently reported that in a double-blind, randomized, controlled setting, N2O was not superior to placebo in relieving AWS symptoms. In this previous study, we did not find significant differences between the treatments either in the Clinical Institute Withdrawal Assessment of Alcohol scores or in the total use of benzodiazepines (diazepam and temazepam). The aim of the present study was to characterize other effects and side effects of the N2O treatment using several objective measures and to study the possible long-term efficacy of the treatment.","Alho, H; Methuen, T; Paloheimo, M; Strid, N; Seppä, K; Tiainen, J; Salaspuro, M; Roine, R",2002.0,10.1097/01.ALC.0000042151.96124.52,0,0,
6016,Effect of psychoeducational intervention on anxiety among Egyptian bladder cancer patients,"ER This study examined the effect of psychoeducational preparation 1-2 days prior to surgery on postoperative state anxiety among Egyptian bladder cancer patients with urinary diversion. The theoretical rationale was based upon the Betty Neuman Health-Care Systems Model. State anxiety was measured by the A-state form of the State Trait Anxiety Inventory. A total of 30 patients were assigned randomly to experimental and control groups. Fifteen patients were included in each category. Preoperatively, the total sample was interviewed about their ""worries"" at that time, and data from this qualitative part were categorized into three subconcepts. Results revealed that their main anxieties are related to stress associated with being cancer patients followed by stress related to the impact of surgery on their bodies and on their social and marital life. Results from the quantitative part of the study showed that psychoeducational preparation lowered significantly state anxiety on the third day postoperatively and before discharge for those patients who had the intervention.","Ali, N S; Khalil, H Z",1989.0,,0,0,
6017,Anxiety and depression in an older research population and their impact on clinical outcomes in a randomised controlled trial,"ER SUBJECTS AND METHODSA total of 729 people were recruited. Participants completed the hospital anxiety and depression scale (HADS) and EuroQol EQ-5D quality of life questionnaire immediately before receiving vaccination and every two months for the next six months after this. Side effects three days after vaccination and Barthel score at baseline were also recorded.RESULTSAt baseline the prevalence of ""definite"" anxiety in this sample (HADS score > or =11) was 4% and 1.2% of individuals had definite depression (HADS score > or =11). Individuals with anxiety or depression (HADS score > or =8) were more likely to complain of systemic side effects after vaccination and have a lower Barthel index score (p or =8 on both scales).CONCLUSIONAlthough the prevalence of anxiety and depression in this sample was low, people with anxiety or depression were more likely to suffer from perceived side effects after influenza vaccine and have a lower Barthel and EQ-5D visual analogue score. In future studies the effect of anxiety and depression on older participants should be remembered and care taken to ensure that they do not affect results more than the intervention under study.INTRODUCTIONAnxiety and depression are common in older people living in the community. The aim of the study was to investigate their impact on clinical outcomes during a randomised controlled trial investigating the cost benefits of influenza vaccination in fit and healthy, independent living 65-74 year olds.","Allsup, S J; Gosney, M A",2002.0,,0,0,
6018,A supported psychoeducational intervention to improve family mental health following discharge from paediatric intensive care: feasibility and pilot randomised controlled trial,"ER OBJECTIVE: To assess feasibility and pilot a supported psychoeducational tool to improve parent and child mental health following discharge from a paediatric intensive care unit (PICU), in preparation for a large randomised controlled trial (RCT).DESIGN: Feasibility assessment and single-centre, parallel group, pilot RCT. A concealed computer generated list was used to randomise participants, with an allocation of 2:1 in favour of the intervention.SETTING: A PICU in an acute care hospital in London, UK.PARTICIPANTS: 31 parents of children aged 4-16 years-old admitted to PICU.INTERVENTION: Parents received a psychoeducational tool supported by a telephone call. The psychoeducational tool outlined the possible psychological reactions in children and parents alongside management advice. The telephone call addressed each family's postdischarge experience, reinforced the psychoeducational material and encouraged parents to put into practice the advice given.MAIN OUTCOME MEASURES: The primary outcome was the number of feasibility criteria successfully met (linked to the intervention and the study design). Secondary outcomes were questionnaire data collected at 3-6-month follow-up assessing mental health in parents and children.RESULTS: 31 parents were randomised (intervention n=22; treatment as usual, TAU n=9). 23 parents were included in the analysis of secondary outcomes (intervention n=17; TAU n=6). 3 (of 6) intervention and 1 (of 6) study design feasibility criteria were fully met. All unmet criteria could be addressed with minor or significant modifications to the protocol. At follow-up there was a tendency for parents who received the intervention to report lower post-traumatic stress symptoms in themselves and fewer emotional and behavioural difficulties in their children than TAU parents. This needs to be explored in a fully powered trial.CONCLUSIONS: This feasibility and pilot RCT provided valuable information on the intervention and trial design for a full RCT.TRIALS REGISTRATION NUMBER: NCT01737021; Results.","Als, L C; Nadel, S; Cooper, M; Vickers, B; Garralda, M E",2015.0,10.1136/bmjopen-2015-009581,0,0,
6019,Investigation of the pathophysiological mechanisms of migraine attacks induced by pituitary adenylate cyclase-activating polypeptide-38,"ER Pituitary adenylate cyclase-activating polypeptide-38 (PACAP38) and vasoactive intestinal polypeptide are structurally and functionally closely related but show differences in migraine-inducing properties. Mechanisms responsible for the difference in migraine induction are unknown. Here, for the first time, we present a head-to-head comparison study of the immediate and long-lasting observations of the migraine-inducing, arterial, physiological and biochemical responses comparing PACAP38 and vasoactive intestinal polypeptide. In a double-blind crossover study 24 female migraine patients without aura were randomly allocated to intravenous infusion of PACAP38 (10 pmol/kg/min) or vasoactive intestinal polypeptide (8 pmol/kg/min) over 20 min. We recorded incidence of migraine during and after infusion (0-24 h). Magnetic resonance angiography of selected extra- and intracranial arteries, blood samples (plasma PACAP38 and vasoactive intestinal polypeptide and serum tryptase), and vital signs (blood pressure, heart rate, respiratory frequency, and end-tidal pressure of CO2) was recorded before and up to 5 h after infusion. Twenty-two patients [mean age 24 years (range 19-36)] completed the study on both days. Sixteen patients (73%) reported migraine-like attacks after PACAP38 and four after vasoactive intestinal polypeptide (18%) infusion (P = 0.002). Three of four patients, who reported migraine-like attacks after vasoactive intestinal polypeptide, also reported attacks after PACAP38. Both peptides induced marked dilatation of the extracranial (P  0.05). PACAP38-induced vasodilatation was longer lasting (>2 h), whereas vasoactive intestinal polypeptide-induced dilatation was normalized after 2 h. We recorded elevated plasma PACAP38 at 1 h after the start of PACAP38 infusion only in those patients who later reported migraine attacks. Blood levels of vasoactive intestinal polypeptide and tryptase were unchanged after PACAP38 infusion. In conclusion, PACAP38-induced migraine was associated with sustained dilatation of extracranial arteries and elevated plasma PACAP38 before onset of migraine-like attacks. PACAP38 has a much higher affinity for the PAC1 receptor and we therefore suggest that migraine induction by PACAP38 may be because of activation of the PAC1 receptor, which may be a future anti-migraine drug target.","Amin, F M; Hougaard, A; Schytz, H W; Asghar, M S; Lundholm, E; Parvaiz, A I; Koning, P J; Andersen, M R; Larsson, H B; Fahrenkrug, J; Olesen, J; Ashina, M",2014.0,10.1093/brain/awt369,0,0,
6020,Changes in the autonomic status in vegetovascular dystonia syndrome during exposure to permanent magnetic field,"ER Permanent magnetic field was applied by placing two magnetic discs (induction 60 mT) in the projection of great arteries on both sides symmetrically. The treatment was given to hypertensive patients with vegetovascular asthenia. A course of such magnetic treatment affects pathogenetic mechanisms of vegetative disorders due to the ability of permanent magnetic field to restore vegetative homeostasis, normalize sympathicotony and vegetative regulation.","Anan'in, N N; Levitski?, E F; Klemenkov, S V; Kolesnikova, I V",2001.0,,0,0,
6021,Efficacy of 'Tailored Physical Activity' on reducing sickness absence among health care workers: a 3-months randomised controlled trial,"ER Aim: The aim was to evaluate efficacy of ""Tailored Physical Activity"" (TPA) versus a reference group (REF) in reducing the number of self-reported days of sickness absence for health care workers in the Sonderborg Municipality. Methods: In this randomised controlled trial, all participants (n = 54) received health guidance for 1.5 h and were randomised to TPA or REF. The primary aim was to make a comparison of participants' self-reported sickness absence due to musculoskeletal troubles measured three months after baseline. Secondary outcomes included anthropometric, health-related and physical capacity measures. Results: A TPA intervention was not significantly more effective than REF in reducing sickness absence caused by musculoskeletal troubles. However, there were significant improvements for TPA participants compared to REF in reducing pain intensity from 47.9 mm to 21.8 mm (p < .01), increasing work ability from 7.3 to 8.1 (p = .04) and decreasing kinesiophobia from 26.7 to 22.5 (p < .01). A trend towards a significant improvement was seen for aerobic capacity while no effect of the intervention was found on productivity, BMI or grip strength. Conclusion: This physical activity intervention is a promising initiative for health care workers since participants achieved a substantial effect on their experience of pain, on their work ability and on their fear of physical movement relating to pain. Moreover, a difference in aerobic capacity was apparent between the sample groups. TPA however, had no significant effect in reducing sickness absence days.","Andersen, L N; Juul-Kristensen, B; Roessler, K K; Herborg, L G; S√∏rensen, T L; S√∏gaard, K",2015.0,10.1016/j.math.2015.04.017,0,0,
6022,Anxiety but not social stressors predict 12-month depression and pain severity,"ER METHODS: We analyzed data from the Stepped Care for Affective Disorders and Musculoskeletal Pain study, a randomized clinical trial of a combined medication-behavioral intervention for primary care patients with chronic musculoskeletal pain and depression. Using multivariable linear regression modeling, we examined the independent association of baseline anxiety and social stressors with depression and pain severity at 12 months. In addition, we modeled whether changes in anxiety and social stressors predicted 12-month depression and pain severity.RESULTS: Overall, the sample (N=250) was 52.8% women with a mean age of 55.5 years, and a racial distribution of 60.4% white, 36.4% black, and 3.2% other. Depression and pain were moderately severe at baseline (mean SCL-20 depression=1.9 and Brief Pain Inventory pain severity=6.15) and similar across intervention and usual care arms. Baseline anxiety symptoms predicted both depression (t score=2.13, P=0.034) and pain severity (t score=2.75, P=0.007) at 12 months. Also, early change in anxiety predicted 12-month depression (t score=-2.47, P=0.014), but not pain. Neither baseline nor early change in social stressors predicted depression or pain severity.CONCLUSIONS: Anxiety, but not social stressors predict 12-month depression and pain severity. The presence of comorbid anxiety should be considered in the assessment and treatment of patients with musculoskeletal pain and depression, particularly as a factor that may adversely affect treatment response.OBJECTIVES: To determine whether baseline anxiety and social stressors as well their early change (first 3 months) predict 12-month depression and pain severity.","Bair, M J; Poleshuck, E L; Wu, J; Krebs, E K; Damush, T M; Tu, W; Kroenke, K",2013.0,10.1097/AJP.0b013e3182652ee9,0,0,
6023,Emotion potentiated startle in fragile X syndrome,"ER Social avoidance and anxiety are prevalent in fragile X syndrome (FXS) and are potentially mediated by the amygdala, a brain region critical for social behavior. Unfortunately, functional brain resonance imaging investigation of the amygdala in FXS is limited by the difficulties experienced by intellectually impaired and anxious participants. We investigated the relationship between social avoidance and emotion-potentiated startle, a probe of amygdala activation, in children and adolescents with FXS, developmental disability without FXS (DD), and typical development. Individuals with FXS or DD demonstrated significantly reduced potentiation to fearful faces than a typically developing control group (p < .05). However, among individuals with FXS, social avoidance correlated positively with fearful-face potentiation (p < .05). This suggests that general intellectual disability blunts amygdalar response, but differential amygdala responsiveness to social stimuli contributes to phenotypic variability among individuals with FXS.","Ballinger, E C; Cordeiro, L; Chavez, A D; Hagerman, R J; Hessl, D",2014.0,10.1007/s10803-014-2125-7,0,0,
6024,Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders,"ER Objective: The authors compared the effectiveness of 50 sessions of schema therapy with clarification-oriented psychotherapy and with treatment as usual among patients with cluster C, paranoid, histrionic, or narcissistic personality disorder. Method: A multicenter randomized controlled trial, with a single-blind parallel design, was conducted between 2006 and 2011 in 12 Dutch mental health institutes. A total of 323 patients with personality disorders were randomly assigned (schema therapy, N=147; treatment as usual,N=135; clarification-oriented psychotherapy, N=41). There were two cohorts of schema therapy therapists, with the first trained primarily with lectures and the second primarily with exercises. The primary outcome was recovery from personality disorder 3 years after treatment started (assessed by blinded interviewers). Secondary outcomes were dropout rates and measures of personality disorder traits, depressive and anxiety disorders, general psychological complaints, general and social functioning, self-ideal discrepancy, and quality of life. Results: A significantly greater proportion of patients recovered in schema therapy compared with treatment as usual and clarification-oriented psychotherapy. Second-cohort schema therapists had better results than first-cohort therapists. Clarification-oriented psychotherapy and treatment as usual did not differ. Findings did not vary with specific personality disorder diagnosis. Dropout was lower in the schema therapy and clarification-oriented psychotherapy conditions. All treatments showed improvements on secondary outcomes. Schema therapy patients had less depressive disorder and higher general and social functioning at follow-up. While interview-based measures demonstrated significant differences between treatments, differences were not found with self-report measures. Conclusions: Schema therapy was superior to treatment as usual on recovery, other interview-based outcomes, and dropout. Exercise-based schema therapy training was superior to lecturebased training.","Bamelis, L L; Evers, S M; Spinhoven, P; Arntz, A",2014.0,10.1176/appi.ajp.2013.12040518,0,0,
6025,Posttraumatic growth in adolescent survivors of cancer and their mothers and fathers,"ER METHODAdolescent survivors of cancer (N = 150, ages 11-19), at least 1 year after treatment, and their mothers (N = 146) and fathers (N = 107) completed self-report measures of perceived treatment intensity and PTSS and a semistructured interview designed to identify posttraumatic responses and indicators of PTG including perceived positive changes for self, relationships, and life goals.RESULTSA majority of adolescents and their mothers and fathers reported PTG. Greater perceived treatment severity and life threat, but not objective disease severity, was associated with PTG. PTG and PTSS were positively associated for the adolescent cancer survivors. Diagnosis after age 5 resulted in more perceived benefit and greater PTSS for adolescent survivors.CONCLUSIONClarification of the concept and measurement of PTG after childhood cancer is warranted, as are prospective studies of the association of PTG and PTSS and the role of demographic variables and illness-specific appraisals.OBJECTIVETo describe posttraumatic growth (PTG) following childhood cancer survival and its association with demographic and disease/treatment variables, perceived treatment severity and life threat, and posttraumatic stress symptoms (PTSS).","Barakat, L P; Alderfer, M A; Kazak, A E",2006.0,10.1093/jpepsy/jsj058,0,0,
6026,The effects of music interventions on anxiety in the patient after coronary artery bypass grafting,"ER DESIGNProspective, repeated measures, quasiexperimental, random assignment.SETTINGThe cardiovascular intensive care and progressive care units of a midwestern community hospital were used as the setting for this study.PATIENTSNinety-six patients who underwent elective, heart bypass surgery; the mean age of the subjects was 67 years, with an age range of 37 to 84 years. Most subjects were men (n = 65, 68%).OUTCOME MEASURESPhysiologic measures of anxiety and mood include blood pressure and heart rate. Additional measures included the use of Spielberger's state-trait anxiety inventory (STAI) and patient verbal ratings of both mood and anxiety with use of a numeric rating scale (NRS).INTERVENTIONPatients were randomly assigned to one of three groups: (1) music therapy, (2) music-video therapy, or (3) scheduled rest group. Subjects in the groups received their assigned 30-minute intervention at two episodes on postoperative days 2 and 3. Subjects had physiologic measures of blood pressure and heart rate measured immediately before the intervention and at 10-minute intervals throughout the intervention. Mood and anxiety were evaluated by having subjects use a NRS (i.e., 0 to 10) to give rating of mood and anxiety immediately before and after each session. Anxiety was further measured with the STAI. A baseline measure of STAI was taken before surgery; patients also completed the ""state"" anxiety tool before the intervention session on postoperative day 2 and on completion of the session on postoperative day 3.RESULTSWith use of an analysis of covariance (ANCOVA), subjects' mood ratings showed significant improvement in mood among subjects in the ""music intervention"" group after the second intervention when controlling for the preintervention rating of mood, F(2, 87) = 4.33, p = 0.016. However, no significant differences were reported for anxiety ratings as measured by the NRS and state anxiety instruments. With use of repeated measures analysis of variance (ANOVA), there were no significant interactions between the intervention groups and time for any of the physiologic variables. However, there were significant main effects over time for heart rate and systolic and diastolic blood pressure, which indicated a generalized physiologic relaxation response.CONCLUSIONSAlthough none of the three interventions was overwhelmingly superior, the overall response by all intervention groups demonstrated a generalized relaxation response. It is also important to note that there was reduced anxiety and improved mood within all three groups.OBJECTIVETo examine the influence during the early postoperative period of selected nursing interventions on mood and anxiety of patients undergoing heart surgery.","Barnason, S; Zimmerman, L; Nieveen, J",1995.0,,0,0,
6027,Professional and non-professional intervention for highly anxious primiparous mothers,"ER Primiparous women (n = 627) were screened on state and trait anxiety measures in the post-partum period; sub-groups of highly anxious (n = 89), moderately anxious (n = 29), and minimally anxious (n = 29) mothers were derived and subsequently interviewed. The high-anxiety mothers were randomly assigned to a professional intervention, to a non-professional intervention, and to a control group, and their progress was reviewed over the following 12 months. Compliance, both in responding to progressive assessments and in accepting therapeutic intervention, was extremely high. Changes in anxiety levels for mothers not receiving an intervention were minimal over the study. In the high-anxiety sub-groups, there was a 19% reduction in state anxiety levels for those receiving a professional intervention, a 12% reduction for those receiving a non-professional intervention, and a 3% reduction in the controls. A planned contrast analysis determined that only professional intervention had a significant effect, intervention successfully lowering state anxiety levels to a value comparable with the moderately anxious mothers.","Barnett, B; Parker, G",1985.0,,0,0,
6028,Maternal anxiety: a 5-year review of an intervention study,"ER Primiparous women were divided into groups according to their post-partum trait anxiety scores. Professional or non-professional support for the first 12 months was offered to two subgroups of high trait anxiety subjects. At the 5-year follow-up the high-anxiety mothers (n = 57) manifested more psychological and social pathology than moderate- and low-anxiety mothers (n = 43), and their children also showed signs of poorer adaptation. There was evidence of improved outcome for mothers in the professional intervention group, but not for their children. Child psychopathology was predicted best by maternal psychosocial variables, and to a lesser extent by child temperament variables. The relation of infant attachment and temperament measures to subsequent psychopathology is discussed.","Barnett, B; Schaafsma, M F; Guzman, A M; Parker, G B",1991.0,,0,0,
6029,Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: a controlled trial,"ER METHODThis study, conducted at a university clinic in Brisbane, Australia, involved 77 children and adolescents with OCD who were randomized to individual CBFT, group CBFT, or a 4- to 6-week waitlist control condition. Children were assessed before and after treatment and at 3 months and 6 months following the completion of treatment using diagnostic interviews, symptom severity interviews, and self-report measures. Parental distress, family functioning, sibling distress, and levels of accommodation to OCD demands were also assessed. Active treatment involved a manualized 14-week cognitive-behavioral protocol, with parental and sibling components.RESULTSBy an evaluable patient analysis, statistically and clinically significant pretreatment-to-posttreatment change occurred in OCD diagnostic status and severity across both individual and group CBFT, with no significant differences in improvement ratings between these conditions. There were no significant changes across measures for the waitlist condition. Treatment gains were maintained up to 6 months of follow-up.CONCLUSIONSContrary to previous findings and expectations, group CBFT is as effective in reducing OCD symptoms for children and adolescents as individual treatment. Findings support the efficacy and durability of CBFT in treating childhood OCD.OBJECTIVETo evaluate the relative efficacy of (1) individual cognitive-behavioral family-based therapy (CBFT); (2) group CBFT; and (3) a waitlist control group in the treatment of childhood obsessive-compulsive disorder (OCD).","Barrett, P; Healy-Farrell, L; March, J S",2004.0,10.1097/00004583-200401000-00014,0,0,
6030,Prevention of anxiety symptoms in primary school children: preliminary results from a universal school-based trial,"ER Preliminary data are presented on the effectiveness of a universal school-based intervention for the prevention of anxiety symptoms in primary school children. A sample of 489 children (aged 10-12 years) were assigned to one of three intervention conditions: a psychologist-led preventive intervention, a teacher-led preventive intervention, or a usual care (standard curriculum) with monitoring condition. The intervention offered was the Friends for Children programme, a 12-session cognitive-behavioural intervention, originally based upon Kendall's (1994) Coping Cat programme. Participants in both intervention conditions reported fewer symptoms of anxiety at post-intervention than participants in the usual care condition. These preliminary results suggest that universal programmes for childhood anxiety are promising intervention strategies that can be successfully delivered to a school-based population and integrated into the classroom curriculum.","Barrett, P; Turner, C",2001.0,,0,0,
6031,Evaluation of cognitive-behavioral group treatments for childhood anxiety disorders,"ER Undertook an evaluation of a cognitive-behavioral group family-based intervention for childhood anxiety disorders in Brisbane, Australia. The treatment aimed to provide children and their families with skills in the management of anxiety and avoidance, problem solving, and mutual family support. Children (n = 60) ranging from 7 to 14 years old who fulfilled diagnostic criteria for separation anxiety, overanxious disorder, or social phobia were randomly allocated to 3 treatment conditions: group cognitive-behavioral therapy (GROUP-CBT), group cognitive-behavioral therapy plus family management (GROUP-FAM), and wait list (WL). The effectiveness of the interventions was evaluated at posttreatment and 12-month follow-up. Results indicated that across treatment conditions, 64.8% of children no longer fulfilled diagnostic criteria for an anxiety disorder in comparison with 25.2% of children on the wait list. At 12-month FU, 64.5% of children in the GROUP-CBT group and 84.8% of children in the GROUP-FAM group were diagnosis free. Comparisons of children receiving GROUP-CBT with those receiving GROUP-FAM on self-report measures and clinician ratings indicated marginal added benefits from GROUP-FAM treatment. Results show that CBT interventions for childhood anxiety disorders can be effectively administered in a group format.","Barrett, P M",1998.0,10.1207/s15374424jccp2704_10,0,0,
6032,Family treatment of childhood anxiety: a controlled trial,"ER A family-based treatment for childhood anxiety was evaluated. Children (n = 79) aged 7 to 14 who fulfilled diagnostic criteria for separation anxiety, overanxious disorder, or social phobia were randomly allocated to 3 treatment conditions: cognitive-behavioral therapy (CBT), CBT plus family management (CBT + FAM), and waiting list. The effectiveness of the interventions was evaluated at posttreatment and at 6 and 12 months follow-up. The results indicated that across treatment conditions, 69.8% of the children no longer fulfilled diagnostic criteria for an anxiety disorder, compared with 26% of the waiting-list children. At the 12-month follow-up, 70.3% of the children in the CBT group and 95.6% of the children in the CBT + FAM group did not meet criteria. Comparisons of children receiving CBT with those receiving CBT + FAM on self-report measures and clinician ratings indicated added benefits from CBT + FAM treatment. Age and gender interacted with treatment condition, with younger children and female participants responding better to the CBT + FAM condition.","Barrett, P M; Dadds, M R; Rapee, R M",1996.0,,0,0,
6033,Long-term outcomes of an Australian universal prevention trial of anxiety and depression symptoms in children and youth: an evaluation of the friends program,"ER This study evaluated the long-term effectiveness of the FRIENDS Program in reducing anxiety and depression in a sample of children from Grade 6 and Grade 9 in comparison to a control condition. Longitudinal data for Lock and Barrett's (2003) universal prevention trial is presented, along with data from 12-month follow-up to 24- and 36-month follow-up. Results of this study indicate that intervention reductions in anxiety reported in Lock and Barrett were maintained for students in Grade 6, with the intervention group reporting significantly lower ratings of anxiety at long-term follow-up. A significant Time x Intervention Group x Gender Effect on Anxiety was found, with girls in the intervention group reporting significantly lower anxiety at 12-month and 24-month follow-up but not at 36-month follow-up in comparison to the control condition. Results demonstrated a prevention effect with significantly fewer high-risk students at 36-month follow-up in the intervention condition than in the control condition. Results are discussed within the context of prevention research.","Barrett, P M; Farrell, L J; Ollendick, T H; Dadds, M",2006.0,10.1207/s15374424jccp3503_5,0,0,
6034,Cognitive behavior therapy for hypochondriasis: a randomized controlled trial,"ER OBJECTIVETo assess the efficacy of a cognitive behavior therapy (CBT) for hypochondriasis.DESIGNA randomized, usual care control group design, conducted between September 1997 and November 2001. The individual primary care physician was the unit of randomization, and all patients clustered within each physician's practice were assigned to the experimental treatment (individual CBT and a consultation letter to the primary care physician) or to the control condition. Subjects were assessed immediately before and 6 and 12 months after the completion of treatment.SETTING AND PARTICIPANTSParticipants were 80 patients from primary care practices and 107 volunteers responding to public announcements, all of whom exceeded a predetermined cutoff score on a hypochondriasis self-report questionnaire on 2 successive occasions.INTERVENTIONA scripted, 6-session, individual CBT intervention was compared with medical care as usual. The CBT was accompanied by a consultation letter sent to the patient's primary care physician.MAIN OUTCOME MEASURESHypochondriacal beliefs, fears, attitudes, and somatic symptoms; role function and impairment.RESULTSA total of 102 individuals were assigned to CBT and 85 were assigned to medical care as usual. The sociodemographic and clinical characteristics of the 2 groups were similar at baseline. Using an intent-to-treat analytic strategy, a consistent pattern of statistically and clinically significant treatment effects was found at both 6- and 12-month follow-up, adjusting for baseline covariates that included educational level, generalized psychiatric distress, and participant status (patient vs volunteer). At 12-month follow-up, CBT patients had significantly lower levels of hypochondriacal symptoms, beliefs, and attitudes (P<.001) and health-related anxiety (P =.009). They also had significantly less impairment of social role functioning (P =.05) and intermediate activities of daily living (P<.001). Hypochondriacal somatic symptoms were not improved significantly by treatment.CONCLUSIONThis brief, individual CBT intervention, developed specifically to alter hypochondriacal thinking and restructure hypochondriacal beliefs, appears to have significant beneficial long-term effects on the symptoms of hypochondriasis.CONTEXTHypochondriasis is a chronic, distressing, and disabling condition that is prevalent in ambulatory medical practice. Until recently, no specific treatment has been clearly demonstrated to be effective.","Barsky, A J; Ahern, D K",2004.0,10.1001/jama.291.12.1464,0,0,
6035,Clinical effects of supplemental enteral nutrition solution in severe polytrauma,"ER Previous studies in critically ill patients have shown the beneficial effects of early enteral nutrition supplemented with arginine, omega-3 fatty acids and nucleotides (Impact) on immunological response, infection rate and length of stay in hospital. No specific data exist for patients with severe multiple injury, who represent a high risk group for systemic inflammatory response syndrome (SIRS), septic complications and multiple organ failure (MOF). In this prospective, randomized, double-blind controlled clinical study on patients after severe trauma (ISS ca. 40) the primary study endpoints were incidence of SIRS and MOF [definitions according to Am Soc Crit Care Med (5) and Goris (23), Sauaia (43)]. Thirty-two patients enrolled in the study, and 29 were eligible for analysis: test (Impact) (n = 16), control (n = 13). Both groups were comparable according to age, body mass index and severity of trauma (PTS-test: 38.8 +/- 12.5, PTS-control: 40.8 +/- 15.5, ISS-test: 39.6 +/- 11.4, ISS-control: 40.5 +/- 9.2). Patients were randomized to receive either Impact (test) or an isonitrogenous isocaloric diet (control). Feeding was started on the 2nd day after trauma via endoscopically placed nasoduodenal or jejunal feeding tubes. The experimental diet was safe and well tolerated. During the 1st week the enteral feeding amount was about 2000 ml without significant difference. Test-fed patients developed SIRS significantly less frequently between day 1 and day 28 (8 vs 13.3; P < 0.05) and especially between day 8 and day 14 (3 vs 6.2; P < 0.001). In the control group the Goris score was significantly worse (P < 0.05) on days 3, 4, 6, 7, 10, 11, 16 and 17 and the Sauaia score on days 8, 9, 10 and 11 (P < 0.05; P < 0.01). Mortality rate did not significantly differ (test 2/16, control 4/13), nor did length of ICU or hospital stay. With regard to the acute-phase response, C-reactive protein was significantly lower on day 4 in the test group (test: 131 +/- 67 mg/l, control: 221 +/- 110 mg/l) as was fibrinogen on day 12 (6.6 +/- 1.4 vs 7.5 +/- 1.4 g/l) and day 14 (7.1 +/- 1.3 vs 7.8 +/- 0.8 g/l). No significant difference could be observed for CD4/CD8 ratio, CD45 isotope on activated T-cells and lymphocytic interleukin (II)-2-receptor- and II-6 level. However, HLA-DR antigen presentation on peripheral monocytes was significantly elevated on day 7 in the test group (P < 0.05). According to the results, arginine, omega-3 fatty acids and nucleotides-enriched diet during early enteral feeding leads to reduction of SIRS after severe multiple injury. There is evidence for improvement of post-traumatic immunological response which helps to overcome the immunological depression after trauma.","Bastian, L; Weimann, A; Bischoff, W; Meier, P N; Grotz, M; Stan, C; Regel, G",1998.0,,0,0,
6036,Topiramate treatment of alcohol use disorder in veterans with posttraumatic stress disorder: a randomized controlled pilot trial,"ER BACKGROUND: The course of posttraumatic stress disorder (PTSD) is frequently and severely complicated by co-occurring alcohol use disorder (AUD), yet there are few reports of pharmacologic treatments for these comorbid conditions. The objective of this pilot study was to obtain a preliminary assessment of the efficacy and safety of topiramate in reducing alcohol use and PTSD symptoms in veterans with both disorders.METHODS: This was a prospective 12-week, randomized, double-blind, placebo-controlled pilot trial of flexible-dose topiramate up to 300 mg/d in 30 veterans with PTSD and AUD. The primary outcome measure was frequency of drinking. Secondary outcomes consisted of other measures of alcohol use and PTSD symptom severity.RESULTS: Within-group analyses showed that topiramate treatment was associated with significant reductions in frequency and amount of alcohol use and alcohol craving from baseline through week 12. Between-group analyses showed that topiramate reduced frequency of alcohol use and alcohol craving significantly more than placebo and tended to reduce drinking amount. Topiramate treatment was also associated with decreased PTSD symptom severity and tended to reduce hyperarousal symptoms compared with placebo. Topiramate transiently impaired learning and memory, with significant recovery by the end of treatment.CONCLUSIONS: These preliminary results indicate that in veterans with co-occurring PTSD and AUD, topiramate may be effective in reducing alcohol consumption, alcohol craving, and PTSD symptom severity-particularly hyperarousal symptoms. Topiramate was associated with transient cognitive impairment but was otherwise well tolerated.","Batki, S L; Pennington, D L; Lasher, B; Neylan, T C; Metzler, T; Waldrop, A; Delucchi, K; Herbst, E",2014.0,10.1111/acer.12496,0,0,
6037,Children of treatment-seeking depressed mothers: a comparison with the sequenced treatment alternatives to relieve depression (STAR*D) child study,"ER OBJECTIVE: To estimate the prevalence of current psychiatric disorders among children and adolescents (collectively called children) of mothers entering treatment for depression; to examine maternal predictors of child psychopathology among children of depressed mothers; and to determine consistency of findings with a similar child study ancillary to Sequenced Treatment Alternatives to Reduce Depression (STAR?D) from seven United States sites (STAR?D-Child).METHOD: Mothers (N = 82) with major depressive disorder (MDD) enrolled in a treatment study in Ottawa (Ontario, Canada) or New York City, and their eligible children (N = 145) (aged 7 through 17 years) were assessed independently when the mother enrolled.RESULTS: Among the children of depressed mothers, 42% had at least one current psychiatric diagnosis, including affective (15%), anxiety (19%), behavioral (23%), and/or substance use (2%) disorders. In all, 40% of the children were rated as impaired by clinical assessors. Mothers' comorbid anxiety disorders predicted the highest rates of current disorders in the child in both studies. The severity of the mother's depression predicted behavioral problems in the child. The current and lifetime rates of psychiatric disorders in the children of depressed mothers were compared to rates found in STAR?D Child and findings were consistent. Both studies used similar diagnostic assessments.CONCLUSION: Given the high prevalence of offspring psychiatric disorders, inquiring about the mental health of the children when a depressed mother comes for treatment, and referring children for treatment when appropriate, are important.","Batten, L A; Hernandez, M; Pilowsky, D J; Stewart, J W; Blier, P; Flament, M F; Poh, E; Wickramaratne, P; Weissman, M M",2012.0,10.1016/j.jaac.2012.08.020,0,0,
6038,"A randomised controlled trial of the Flinders Program? of chronic condition management in Vietnam veterans with co-morbid alcohol misuse, and psychiatric and medical conditions","ER Objective: To evaluate the efficacy of the Flinders Program? of chronic condition management on alcohol use, psychosocial well-being and quality of life in Vietnam veterans with alcohol misuse. Method: This 9-month wait-list, randomised controlled trial used the Alcohol Use Disorders Identification Test (AUDIT) score ? 8 as the entry criterion. Intervention veterans received the Flinders Program plus usual care and controls received usual care. The primary outcome measure was AUDIT score at baseline, 3, 6 and 9 months. Secondary measures included quality of life, alcohol dependence (DSM-IV), anxiety and depression. All measures were repeated at variable trial end dates between 9 and 18 months in the intervention group. Results: Randomisation resulted in 46 intervention and 31 control participants. Intent-to-treat analyses showed AUDIT scores improved significantly from baseline to 9-month follow-up (p = 0.039) in the intervention group compared to control group. The control group had 1.46 times the risk of alcohol dependence than the intervention group at 9 months (p = 0.027). There were no significant differences between groups for secondary measures. Within-group analyses showed that both groups significantly improved in AUDIT (p < 0.001), anxiety and depression (p < 0.01), anger (p < 0.001), and post-traumatic stress (p < 0.01). Improvements in AUDIT (p < 0.001) and alcohol dependence were maintained in the intervention group to 18 months. Conclusions: Use of the Flinders Program in addition to usual care resulted in reduced alcohol use, reduced alcohol dependence, and global clinical improvement in Vietnam veterans with risky alcohol behaviours and chronic mental health problems. The findings demonstrate that the Flinders Program provides a structured framework for delivering self-management support, case management and coordinated care for people with chronic conditions. This clinical approach has the potential to bridge the gap between physical and mental illness service delivery for people with long-term conditions in Australia.","Battersby, M W; Beattie, J; Pols, R G; Smith, D P; Condon, J; Blunden, S",2013.0,10.1177/0004867412471977,0,0,
6039,Development and testing of two lifestyle interventions for persons with chronic mild-to-moderate traumatic brain injury: acceptability and feasibility,"ER This clinical methods discursive highlights the development, piloting, and evaluation of two group interventions designed for persons who experienced chronic traumatic brain injury (TBI). Intervention science for this population is limited and lacking in rigor. Our innovative approach to customize existing interventions and develop parallel delivery methods guided by Allostatic Load theory is presented and preliminary results described. Overall, parallel group interventions delivered by trained leaders with mental health expertise were acceptable and feasible for persons who reported being depressed, stressed, and symptomatic. They reported being satisfied with the overall programs and mostly satisfied with the individual classes. Attendance was over the anticipated 70% expected rate and changes in daily living habits were reported by participants. These two group interventions show promise in helping persons to self manage their chronic stress and symptomatology.","Bay, E; Ribbens-Grimm, C; Chan, R R",2016.0,10.1016/j.apnr.2015.11.003,0,0,
6040,The Cool Little Kids randomised controlled trial: population-level early prevention for anxiety disorders,"ER METHODS/DESIGNThis randomised trial will be conducted within the preschool service system, attended by more than 95% of Australian children in the year before starting school. In early 2011, preschool services in four local government areas in Melbourne, Australia, will distribute the screening tool. The ?16% (n?500) with temperamental inhibition will enter the trial. Intervention parents will be offered Cool Little Kids, a 6-session group program in the local community, focusing on ways to develop their child's bravery skills by reducing overprotective parenting interactions. Outcomes one and two years post-baseline will comprise child internalising diagnoses and symptoms, parenting interactions, and parent wellbeing. An economic evaluation (cost-consequences framework) will compare incremental differences in costs of the intervention versus control children to incremental differences in outcomes, from a societal perspective. Analyses will use the intention-to-treat principle, using logistic and linear regression models (binary and continuous outcomes respectively) to compare outcomes between the trial arms.DISCUSSIONThis trial addresses gaps for internalising problems identified in the 2004 World Health Organization Prevention of Mental Disorders report. If effective and cost-effective, the intervention could readily be applied at a population level. Governments consider mental health to be a priority, enhancing the likelihood that an effective early prevention program would be adopted in Australia and internationally. RCH HUMAN RESEARCH ETHICS APPROVAL: 30105A.BACKGROUNDThe World Health Organization predicts that by 2030 internalising problems (e.g. depression and anxiety) will be second only to HIV/AIDS in international burden of disease. Internalising problems affect 1 in 7 school aged children, impacting on peer relations, school engagement, and later mental health, relationships and employment. The development of early childhood prevention for internalising problems is in its infancy. The current study follows two successful 'efficacy' trials of a parenting group intervention to reduce internalising disorders in temperamentally inhibited preschool children. Cool Little Kids is a population-level randomised trial to determine the impacts of systematically screening preschoolers for inhibition then offering a parenting group intervention, on child internalising problems and economic costs at school entry.","Bayer, J K; Rapee, R M; Hiscock, H; Ukoumunne, O C; Mihalopoulos, C; Clifford, S; Wake, M",2011.0,10.1186/1471-2458-11-11,0,0,
6041,Comparison of preventive interventions for families with parental affective disorder,"ER Twenty families participated in a random assignment trial of two cognitive psychoeducational preventive interventions for families with parental affective disorder. Twelve families were assigned to a clinician-based intervention and eight to a lecture-based intervention, with assessment prior to intervention and an average of 18 weeks following intervention. Both groups were satisfied and believed they received help from the intervention. The clinician-based group was significantly more satisfied overall, and reported significantly more changes in both behaviors and attitudes about their illness from pre- to postintervention. Both groups showed significant decrease in degree of upset over issues of concern from pre- to postintervention. The clinician-based group reported receiving significantly more help with their primary concern. The implications of these findings are discussed.","Beardslee, W R; Salt, P; Porterfield, K; Rothberg, P C; Velde, P; Swatling, S; Hoke, L; Moilanen, D L; Wheelock, I",1993.0,10.1097/00004583-199303000-00004,0,0,
6042,Negative social preference in relation to internalizing symptoms among children with ADHD predominantly inattentive type: girls fare worse than boys,"ER Despite distinct peer difficulties, less is known about the peer functioning of children with attention-deficit/hyperactivity disorder (ADHD) predominantly inattentive type (ADHD-I) in comparison to the peer functioning of children with ADHD combined type. Our purpose was to examine whether child sex moderated the relations between negative social preference and internalizing/externalizing problems in children with ADHD-I. Participants included 188 children diagnosed with ADHD-I (110 boys; ages 7-11; 54% Caucasian). Teacher ratings of the proportion of classmates who ""like/accept"" and ""dislike/reject"" the participating child were used to calculate negative social preference scores. Children, parents, and teachers provided ratings of anxious and depressive symptoms, and parents and teachers provided ratings of externalizing problems. Boys and girls did not differ on teachers' negative social preference scores. As hypothesized, however, the relation between negative social preference and internalizing symptoms was moderated by sex such that negative social preference was consistently and more strongly associated with internalizing symptoms among girls than in boys. In terms of externalizing problems, negative social preference was associated with teacher (but not parent) ratings, yet no moderation by child sex was found. Negative social preference is associated with teacher-report of externalizing problems for both boys and girls with ADHD-I, whereas negative social preference is consistently associated with girls' internalizing symptoms across child, parent, and teacher ratings. Implications for future research and interventions are discussed.","Becker, S P; McBurnett, K; Hinshaw, S P; Pfiffner, L J",2013.0,10.1080/15374416.2013.828298,0,0,
6043,Reactivity to a 35% CO2 challenge in healthy first-degree relatives of patients with panic disorder,"ER METHODSOne single inhalation of a 35% CO2/65% O2 challenge was administered to 50 first-degree relatives of panic disorder patients and 50 control subjects.RESULTSThe first-degree relatives were more reactive to the 35% CO2 challenge than the control subjects.CONCLUSIONSThese findings indicate that being a member of a family with a panic disorder patient is, in itself an important factor in CO2 hypersensitivity among subjects who have never experienced a panic attack. Both panic disorder patients and their first-degree relatives have a tendency to be more reactive to the CO2 challenge.BACKGROUNDThe effects of a 35% CO2 challenge were examined in healthy first-degree relatives of panic disorder patients and in healthy control subjects matched for age and gender.","Beek, N; Griez, E",2000.0,,0,0,
6044,Behavioral treatment of childhood social phobia,"ER Sixty-seven children (ages 8 and 12) with social phobia were randomized to either a behavioral treatment program designed to enhance social skills and decrease social anxiety (Social Effectiveness Therapy for Children, SET-C) or an active, but nonspecific intervention (Testbusters). Children treated with SET-C were significantly more improved across multiple dimensions, including enhanced social skill, reduced social fear and anxiety, decreased associated psychopathology, and increased social interaction. Furthermore, 67% of the SET-C group participants did not meet diagnostic criteria for social phobia at posttreatment compared with 5% of those in the Testbusters group. Treatment gains were maintained at 6-month follow-up. The results are discussed in terms of treatment of preadolescent children with social phobia and the durability of treatment effects.","Beidel, D C; Turner, S M; Morris, T L",2000.0,,0,0,
6045,Continuous lateral rotational therapy and systemic inflammatory response in posttraumatic acute lung injury: results from a prospective randomised study,"ER BACKGROUND: The incidence of posttraumatic acute lung injury is high and may result in increased mortality. Changes in the body position are additional measures to improve pulmonary gas exchange and to prevent pulmonary complications. We investigated the effect of a continuous lateral rotational therapy (CLRT) on the inflammatory response in patients with posttraumatic lung failure.METHODS: After admission to the intensive care unit (ICU) and after randomisation, 13 patients were placed in a special motor-driven bed and CLRT was performed for 5 days. In the control group (n=14), patients were positioned conventionally. Samples from blood and from broncho-alveolar lavage fluid (BAL) were collected in both groups before study began and on day 5. The levels of cytokines (Tumour Necrosis Factor, Interleukin 6, Interleukin 8 or Intercellular Adhesion Molecule-1) were assessed and haemodynamic, pulmonary, and laboratory values were documented.RESULTS: On day 5, no significant differences were found in cytokine levels between groups, but a significant decrease in IL-8 (p<0.01) and TNF-? (p<0.05) serum levels and an increase in IL-8 BAL levels was found in the CLRT-group, but not for conventionally managed patients. In general cytokine BAL levels tended to be increased in both groups, but more pronounced during CLRT. Daily assessment of the severity of disease (SAPS-II, SOFA) was significantly reduced in the study group on days 2-4 (p<0.05) in comparison to control group.CONCLUSIONS: CLRT may attenuate the inflammatory response to posttraumatic acute lung injury. The exact mechanism of such an effect is unknown.","Bein, T; Zimmermann, M; Schiewe-Langgartner, F; Strobel, R; Hackner, K; Schlitt, H J; Nerlich, M N; Zeman, F; Graf, B M; Gruber, M",2012.0,10.1016/j.injury.2011.08.034,0,0,
6046,A home-based walking study to ameliorate perceived stress and depressive symptoms in people with a traumatic brain injury,"ER UNLABELLED: Abstract Objective: To determine whether a 12-week home-based walking programme can decrease perceived stress and depressive symptoms in persons with a traumatic brain injury (TBI).SETTING: Community- and home-based.PARTICIPANTS: Sixty-nine participants with a TBI.DESIGN: Comparative effectiveness cross-over design with random assignment to treatment sequence and blinded post-hoc assessment of outcome where participants completed a 12-week walking intervention and a nutrition education module. The walking intervention utilized pedometers to track the amount of steps each participant walked daily. With the assistance of an assigned coach, weekly goals were given with the intent of increasing the amount of walking that the participant was initially completing. The nutrition control group was created to offset the impact of the coaching calls.MAIN MEASURES: Measurement of perceived stress and depressive symptoms was completed through the use of the Perceived Stress Scale (PSS) and Center for Epidemiological Studies-Depression (CES-D). These measures were collected at three time points: baseline and following each 12-week intervention.RESULTS: RESULTS indicated that both perceived stress and depression symptoms significantly improved following the walking intervention.CONCLUSIONS: While limitations existed with the study, it is evident that walking can be used as an efficient and cost-effective tool to manage perceived stress and depressive symptoms in persons who have sustained a TBI.","Bellon, K; Kolakowsky-Hayner, S; Wright, J; Huie, H; Toda, K; Bushnik, T; Englander, J",2015.0,10.3109/02699052.2014.974670,0,0,
6047,"Manual Therapy, Therapeutic Patient Education, and Therapeutic Exercise, an Effective Multimodal Treatment of Nonspecific Chronic Neck Pain: A Randomized Controlled Trial","ER OBJECTIVE: The aim of this study was to determine the effectiveness of a multimodal treatment in the short and medium term for disability in nonspecific chronic neck pain.DESIGN: The design of this study is a single-blinded randomized controlled trial carried out in a university research laboratory. Forty-five patients between 18 and 65 yrs with nonspecific chronic neck pain were included in this study. Each patient was treated eight times over a 4-wk period. The sample was divided into three groups: control group, subjected to a protocol of manual therapy; experimental group 1, subjected to a protocol of manual therapy and therapeutic patient education; and experimental group 2, subjected to manual therapy, therapeutic patient education, and a therapeutic exercise protocol. Assessments were performed at baseline and at 4, 8, and 16 wks using the following measurements: the Neck Disability Index, the 11-item Tampa Scale of Kinesiophobia, the Fear Avoidance Beliefs Questionnaire, the Neck Flexor Muscle Endurance Test, and the Visual Analog Fatigue Scale.RESULTS: The nonparametric Kruskal-Wallis test for the Neck Disability Index showed statistically significant differences between baseline outcomes and all follow-up periods (P < 0.01). In the Kruskal-Wallis test, differences were found for the Visual Analog Fatigue Scale and the Neck Flexor Muscle Endurance Test in the follow-ups at 8 and 16 wks (P < 0.05). Analysis of variance for group × time interaction showed statistically significant changes (Tampa Scale of Kinesiophobia, F = 3.613, P = 0.005; Fear Avoidance Beliefs Questionnaire, F = 2.803, P = 0.022). Minimal detectable changes were obtained in both experimental groups for the 11-item Tampa Scale of Kinesiophobia but not in the control group.CONCLUSION: Differences between experimental groups and the control group were found in the short and medium term. A multimodal treatment is a good method for reducing disability in patients with nonspecific chronic neck pain in the short and medium term.","Beltran-Alacreu, H; López-de-Uralde-Villanueva, I; Fernández-Carnero, J; Touche, R",2015.0,10.1097/PHM.0000000000000293,0,0,
6048,Psychiatric symptoms and psychosocial functioning among hospital personnel during the Gaza War: a repeated cross-sectional study,"ER Studies of mental health among hospital personnel during armed conflict are scarce and usually include single time point investigations without a comparison group. The authors compared the psychiatric symptoms and psychosocial functioning of exposed and unexposed hospital personnel at two time points. The research was conducted during 2009 and included a survey of two random samples of hospital personnel (physicians and nurses), one collected during the Gaza War and the other 6 months later. Each sample included hospital personnel who were exposed to war-related stress and others who were not (Study 1: n=67 and 74 for exposed and unexposed, respectively; Study 2: n=57 and 50 for exposed and unexposed, respectively). Levels of psychiatric symptoms and psychosocial functioning were measured. Compared to unexposed hospital personnel, exposed hospital personnel had a significantly higher level of post-traumatic symptoms during the Gaza War and 6 months later. In addition, during the Gaza War, exposed hospital personnel had a significantly higher level of depressive symptoms. However, in the second study, depressive symptoms were similar to those found in the unexposed group. These findings may suggest that war-related stress is associated with post-traumatic symptoms among hospital personnel even 6 months after exposure.","Ben-Ezra, M; Palgi, Y; Wolf, J J; Shrira, A",2011.0,10.1016/j.psychres.2011.02.004,0,0,
6049,Anxiety and related outcomes in young adults 7 to 19 years after receiving treatment for child anxiety,"ER METHOD: Participants were a sample of 66 youths (ages 7-14 years at time of treatment, ages 18-32 years at present follow-up) who had been diagnosed with an anxiety disorder and randomized to treatment in a randomized clinical trial on average 16.24 (SD = 3.56, range = 6.72-19.17) years prior. The present follow-up included self-report measures and a diagnostic interview to assess anxiety, depression, and substance misuse.RESULTS: Compared with those who responded successfully to CBT for an anxiety disorder in childhood, those who were less responsive had higher rates of panic disorder, alcohol dependence, and drug abuse in adulthood. Relative to a normative comparison group, those who were less responsive to CBT in childhood had higher rates of several anxiety disorders and substance misuse problems in adulthood. Participants remained at particularly increased risk, relative to the normative group, for generalized anxiety disorder and nicotine dependence regardless of initial treatment outcome.CONCLUSIONS: The present study is the first to assess the long-term follow-up effects of CBT treatment for an anxiety disorder in youth on anxiety, depression, and substance abuse through the period of young adulthood when these disorders are often seen. Results support the presence of important long-term benefits of successful early CBT for anxiety.OBJECTIVE: This study evaluated follow-up outcomes associated with cognitive behavioral therapy (CBT) for childhood anxiety by comparing successfully and unsuccessfully treated participants 6.72 to 19.17 years after treatment.","Benjamin, C L; Harrison, J P; Settipani, C A; Brodman, D M; Kendall, P C",2013.0,10.1037/a0033048,0,0,
6050,Patterns and predictors of subjective units of distress in anxious youth,"ER AIMS: The present study examined patterns and predictors of SUDS in a sample of anxiety-disordered youth.METHOD: Youth (N = 99) aged 7 to 14 (M = 10.4, SD = 1.8) were treated with CBT for social phobia (SP), generalized anxiety disorder (GAD), and/or separation anxiety disorder (SAD). Analyses were conducted using hierarchical linear modeling.RESULTS: Child's peak SUDS and magnitude of change in SUDS significantly increased between sessions. Higher child self-reported pretreatment total Multidimensional Anxiety Scale for Children (MASC) score predicted greater change in SUDS within the first exposure session. Primary GAD diagnosis predicted less increase in change in SUDS between sessions.CONCLUSIONS: Results suggest that higher pretreatment total MASC scores are associated with increased first exposure within-session habituation. Additionally, youth with a principal diagnosis of GAD experienced less between-session habituation, perhaps because they may have required more imaginal than in-vivo exposures.BACKGROUND: Subjective Units of Distress Scale (SUDS) ratings are commonly used during exposure tasks in cognitive behavioral treatment (CBT) for anxiety.","Benjamin, C L; O'Neil, K A; Crawley, S A; Beidas, R S; Coles, M; Kendall, P C",2010.0,10.1017/S1352465810000287,0,0,
6051,Synchrony-desynchrony in the tripartite model of fear: predicting treatment outcome in clinically phobic children,"ER The tripartite model of fear posits that the fear response entails three loosely coupled components: subjective distress, behavioral avoidance, and physiological arousal. The concept of synchrony vs. desynchrony describes the degree to which changes in the activation of these components vary together (synchrony), independently, or inversely (both forms of desynchrony) over time. The present study assessed synchrony-desynchrony and its relationship to treatment outcome in a sample of 98 children with specific phobias both prior to and 1 week after receiving one-session treatment, a 3 h cognitive-behavioral intervention. The results suggest an overall pattern of desynchronous change whereby youth improved on behavioral avoidance and subjective distress following treatment, but their level of cardiovascular reactivity remained stable. However, we found evidence that synchronous change on the behavioral avoidance and subjective distress components was related to better treatment outcome, whereas desynchronous change on these components was related to poorer treatment outcome. These findings suggest that a fuller understanding of the three response systems and their interrelations in phobic youth may assist us in the assessment and treatment of these disorders, potentially leading to a more person-centered approach and eventually to enhanced treatment outcomes.","Benoit, Allen K; Allen, B; Austin, K E; Waldron, J C; Ollendick, T H",2015.0,10.1016/j.brat.2015.05.009,0,0,
6052,School-based intervention for the treatment of tsunami-related distress in children: a quasi-randomized controlled trial,"ER METHODSIn a quasi-randomized controlled trial 166 elementary school students (ages 9-15) with significant levels of tsunami exposure and previous traumatic background were randomly assigned to a 12-session structured program 'ERASE Stress Sri Lanka' (ES-SL) or to a waiting list (WL) religious class control group. Students were assessed 1 week prior and 3 months after the intervention on measures of posttraumatic symptomatology [including posttraumatic stress disorder (PTSD) and severity of posttraumatic symptomatology], depression, functional problems, somatic problems and hope.RESULTSThis study shows a significant reduction on all outcome variables. PTSD severity, functional problems, somatic complaints, depression and hope scores were all significantly improved in the ES-SL group compared to the WL group. No new cases of PTSD were observed in the experimental group.CONCLUSIONThis study adds to the growing body of evidence suggesting the efficacy of school-based universal approaches in helping children in regions touched by war, terror and disaster and suggests the need to adopt a two-stage approach toward dealing with trauma-exposed students, namely, starting with a universal intervention followed by targeted specialized interventions for those still suffering from posttraumatic distress.BACKGROUNDOn December 26, 2004, a tsunami hit the southern coast of Sri Lanka, leaving thousands dead and injured. Previous research has found significant mental health problems among children exposed to major disasters. School-based universal interventions have shown promise in alleviating distress and posttraumatic symptomatology in children and adolescents. This study evaluated the efficacy of a school-based intervention in reducing stress-related symptomatology among Sri Lankan children exposed to the tsunami.","Berger, R; Gelkopf, M",2009.0,10.1159/000235976,0,0,
6053,A teacher-delivered intervention for adolescents exposed to ongoing and intense traumatic war-related stress: a quasi-randomized controlled study,"ER PURPOSE: For the past 8 years, the residents of Sderot-a town in southern Israel-have been exposed to ongoing and intense war-related threat due to daily rocket attacks and mortar shelling from the adjacent Gaza region. This study first evaluates the prevalence of posttraumatic symptomatology in a sample of seventh- and eighth-grade students, and then assesses the efficacy of a universal teacher-delivered skill-oriented and present-focused intervention in preventing and reducing adolescents' posttraumatic stress-related symptoms.METHOD: In a quasi-randomized controlled trial, 154 seventh- and eighth-grade students with significant levels of war-related exposure were assigned to participate in either a manualized active 16-session intervention (Extended Enhancing Resiliency Amongst Students Experiencing Stress, ERASE-Stress) or a waiting-list control group. They were assessed using self-report measures before and after the intervention on posttraumatic stress-related symptoms, somatic complaints, functional impairment, and anxiety.RESULTS: At baseline, 43.5% were found to have a likely diagnosis of posttraumatic stress disorder. A month after the intervention ended, students in the active intervention showed statistically significant reduction on all outcome measures compared with those in the waiting-list control group.CONCLUSIONS: Extended ERASE-Stress-a universal teacher-delivered skill-oriented program not targeting traumatic memories and involving trained and supervised homeroom teachers-may help students suffering from significant war-related posttraumatic symptoms reduce their level of symptomatology and can serve as an important and effective component of a community mental health policy for communities affected by chronic trauma, such as war and terrorism.","Berger, R; Gelkopf, M; Heineberg, Y",2012.0,10.1016/j.jadohealth.2012.02.011,0,0,
6054,School-based intervention for prevention and treatment of elementary-students' terror-related distress in Israel: a quasi-randomized controlled trial,"ER A school-based intervention for preventing and reducing children's posttraumatic stress-related symptoms, somatic complaints, functional impairment, and anxiety due to exposure to terrorism was evaluated. In a quasi-randomized controlled trial, elementary school students were randomly assigned to an eight-session structured program, ""Overshadowing the Threat of Terrorism"" or to a waiting list control comparison group. Two months postintervention, the study group reported significant improvement on all measures. The authors conclude that a school-based universal intervention may significantly reduce posttraumatic stress disorder- (PTSD-) related symptoms in children repeatedly exposed to terrorist attacks and propose that it serve as a component of a public mental health approach dealing with children exposed to ongoing terrorism in a country ravaged by war and terrorism.","Berger, R; Pat-Horenczyk, R; Gelkopf, M",2007.0,10.1002/jts.20225,0,0,
6055,Integrated Behavior Therapy for Selective Mutism: a randomized controlled pilot study,"ER OBJECTIVE: To evaluate the feasibility, acceptability, and preliminary efficacy of a novel behavioral intervention for reducing symptoms of selective mutism and increasing functional speech.METHOD: A total of 21 children ages 4 to 8 with primary selective mutism were randomized to 24 weeks of Integrated Behavior Therapy for Selective Mutism (IBTSM) or a 12-week Waitlist control. Clinical outcomes were assessed using blind independent evaluators, parent-, and teacher-report, and an objective behavioral measure. Treatment recipients completed a three-month follow-up to assess durability of treatment gains.RESULTS: Data indicated increased functional speaking behavior post-treatment as rated by parents and teachers, with a high rate of treatment responders as rated by blind independent evaluators (75%). Conversely, children in the Waitlist comparison group did not experience significant improvements in speaking behaviors. Children who received IBTSM also demonstrated significant improvements in number of words spoken at school compared to baseline, however, significant group differences did not emerge. Treatment recipients also experienced significant reductions in social anxiety per parent, but not teacher, report. Clinical gains were maintained over 3 month follow-up.CONCLUSION: IBTSM appears to be a promising new intervention that is efficacious in increasing functional speaking behaviors, feasible, and acceptable to parents and teachers.","Bergman, R L; Gonzalez, A; Piacentini, J; Keller, M L",2013.0,10.1016/j.brat.2013.07.003,0,0,
6056,Supportive telephone outreach as an interventional strategy for elderly patients in a period of crisis,"ER During the Gulf War in 1991 a telephone-based support system was established for elderly patients living at home in Israel. The study population involved 93 elderly patients (mean age 74), who had recently been discharged from hospital and were chosen for supervision by the Home-Care Unit of the Tel Aviv Sourasky Medical Center, Israel. Two different teams were involved with the telephone support calls: secretarial staff (nonprofessional team) and social workers (professional team). The research examined the characteristics of the study population and also included a comparison between the two groups of patients receiving the psycho-social support. The latter indicated that better results of outcome indices were achieved by the professional team. Further, this study demonstrated the feasibility of telephone-support outreach as an interventional strategy for psycho-social support for elderly patients at a time of crisis.","Berkman, P; Heinik, J; Rosenthal, M; Burke, M",1999.0,10.1300/J010v28n04_05,0,0,
6057,The Child and Family Traumatic Stress Intervention: secondary prevention for youth at risk of developing PTSD,"ER METHODOne-hundred seventy-six 7 to 17-year-old youth were recruited through telephone screening based on report of one new distressing posttraumatic stress symptom after a PTE. Of those, 106 youth were randomly assigned to the Intervention (n = 53) or a four-session supportive Comparison condition (N = 53). Group differences in symptom severity were assessed using repeated measures with mixed effects models of intervention group, time, and the interaction of intervention and time. Logistic regression analyses were performed to assess treatment condition and any subsequent traumas experienced as predictors for full and partial PTSD diagnosis at 3-month follow-up. An exploratory chi-square analysis was performed to examine the differences in PTSD symptom criteria B, C, and D at follow-up.RESULTSAt baseline, youth in both groups had similar demographics, past trauma exposures and symptom severity. At follow-up, the Intervention group demonstrated significantly fewer full and partial PTSD diagnoses than the Comparison group on a standardized diagnostic measure of PTSD. Also, there was a significant group by time interaction for Trauma Symptom Checklist for Children's Posttraumatic Stress and Anxiety Indices as the CFTSI group had significantly lower posttraumatic and anxiety scores than the Comparison group.CONCLUSIONSThe results suggest that a caregiver-youth, brief preventative early intervention for youth exposed to a PTE is a promising approach to preventing chronic PTSD.OBJECTIVEThis pilot study evaluated the effectiveness of a four-session, caregiver-child Intervention, the Child and Family Traumatic Stress Intervention (CFTSI), to prevent the development of chronic posttraumatic stress disorder (PTSD) provided within 30 days of exposure to a potentially traumatic event (PTE).","Berkowitz, S J; Stover, C S; Marans, S R",2011.0,10.1111/j.1469-7610.2010.02321.x,0,0,
6058,Income and recurrent events after a coronary event in women,"ER Strong evidence supports the existence of a social gradient in poor prognosis in patients with coronary heart disease (CHD). However, knowledge regarding what factors may explain this relationship is limited. We aimed to analyze in women CHD patients the association between personal income and recurrent events and to determine whether lifestyle, biological and psychosocial factors contribute to the explanation of this relationship. Altogether 188 women hospitalized for a cardiac event were assessed for personal income, demographic factors, lipids, inflammatory markers, cortisol, creatinine, lifestyle and psychosocial factors, i.e. alcohol consumption, smoking habits, body-mass index, depressive symptoms, anxiety, vital exhaustion, availability of social interaction, hostility and anger-related characteristics and were followed for cardiovascular death and recurrent acute myocardial infarction (AMI). During the 6-year follow-up 18 patients deceased and 31 experienced cardiovascular death or non-fatal AMI. After adjustment for confounders, patients with medium and high income had lower risk for recurrent events relative to those with low income (HR (95% CI): 0.38 (0.15-0.97) and 0.39 (0.17-0.93), respectively). Controlling for smoking reduced by 12.8% the risk for recurrent events associated with high versus low income, while adjusting for depression decreased the risk for middle versus low income by 13.5%. Anger symptoms explained 16.7% of the risk for recurrent events associated with middle versus low income and 10.2% of the risk for high versus low income. We suggest that in women with CHD low income is associated with recurrent events and that smoking, depressive symptomatology and anger symptoms may contribute to the explanation of this relationship.","László, K D; Janszky, I; Ahnve, S",2008.0,10.1007/s10654-008-9285-8,0,0,
6059,Investigating the effects of physical discomfort on laboratory-induced mood states,"ER In order to investigate the effects of physical discomfort (i.e., pain) on the induction of mood, 139 participants were randomly assigned to one of four conditions: sad, sad with physical discomfort, happy, and happy with physical discomfort. Consistent with our hypotheses, the addition of physical discomfort resulted in a significantly stronger induction of self-reported depression, with these findings showing temporal specificity and persisting even after statistically controlling for stable response biases. However, other self-reported affective states, as well as cognitive and behavioral measures, were not significantly affected by physical discomfort. Findings are discussed with regard to making the laboratory induction of sad affect more consistent with the multifaceted experience of depression.","Lecci, L; Wirth, R J",2000.0,,0,0,
6060,"Subtyping pathological gamblers based on impulsivity, depression, and anxiety","ER This study examined putative subtypes of pathological gamblers (PGs) based on the Pathways model, and it also evaluated whether the subtypes would benefit differentially from treatment. Treatment-seeking PGs (N = 229) were categorized into Pathways subtypes based on scores from questionnaires assessing anxiety, depression, and impulsivity. The Addiction Severity Index-Gambling assessed severity of gambling problems at baseline, posttreatment, and 12-month follow-up. Compared with behaviorally conditioned (BC) gamblers, emotionally vulnerable (EV) gamblers had higher psychiatric and gambling severity, and were more likely to have a parent with a psychiatric history. Antisocial impulsive (AI) gamblers also had elevated gambling and psychiatric severity relative to BC gamblers. They were more likely to have antisocial personality disorder and had the highest legal and family/social severity scores. They were also most likely to have a history of substance abuse treatment, history of inpatient psychiatric treatment, and a parent with a substance use or gambling problem. AI and EV gamblers experienced greater gambling severity throughout treatment than BC gamblers, but all three subtypes demonstrated similar patterns of treatment response. Thus, the three Pathways subtypes differ on some baseline characteristics, but subtyping did not predict treatment outcomes beyond a simple association with problem gambling severity.","Ledgerwood, D M; Petry, N M",2010.0,10.1037/a0019906,0,0,
6061,Applying cerebral hypothermia and brain oxygen monitoring in treating severe traumatic brain injury,"ER MATERIALS AND METHODSForty-five patients with severe TBI whose Glasgow Coma Scale (GCS) score ranged between 4 and 8 during September 2006 and August 2007 were enrolled in China Medical University Hospital, Taichung, Taiwan. One patient with a GCS score of 3 was excluded for poor outcome. These patients were randomized into three groups. Group A (16 patients) was intracranial pressure/cerebral perfusion pressure (ICP/CPP)-guided management only, Group B (15 patients) was ICP/CPP guided with mild hypothermia, and Group C (14 patients) was combined mild hypothermia and P(ti)o(2) guided with CPP management on patients with severe TBI. All patients were treated with ICP/CPP management (ICP 60 mm Hg). However, the group with P(ti)o(2) monitoring was required to raise the P(ti)o(2) above 20 mm Hg. Length of intensive care unit stay, ICP, P(ti)o(2), Glasgow Outcome Scale (GOS) score, mortality, and complications were analyzed.RESULTSThe ICP values progressively increased in the first 3 days but showed smaller changes in hypothermia groups (Groups B and C) and were significantly lower than those of the normothermia group (Group A) at the same time point. We also found out that the averaged ICP were significantly related to days and the daily variations [measured as (daily observation - daily group mean)(2)] of ICP were shown to the significantly different among three treatment groups after the third posttraumatic day. The values of P(ti)o(2) in Group C tended to rise when the ICP decreased were also observed. A favorable outcome is divided by the result of GOS scores. The percentage of favorable neurologic outcome was 50% in the normothermia group, 60% in the hypothermia-only group, and 71.4% in the P(ti)o(2) group, with statistical significance. The percentage of mortality was 12.5% in the normothermia group, 6.7% in the hypothermia-only group, and 8.5% in the P(ti)o(2) group, without statistical significance in three groups. Complications included pulmonary infections, peptic ulcer, and leukocytopenia (43.8% in the normothermia group, 55.6% in the hypothermia-only group, and 50% in the P(ti)o(2) group).CONCLUSIONSTherapeutic mild hypothermia combined with P(ti)o(2)-guided CPP/ICP management allows reducing elevated ICP before 24 hours after injury, and daily variations of ICP were shown to be significantly different among the three treatment groups after the third posttraumatic day. It means that the hypothermia groups may reduce the ICP earlier and inhibit the elicitation of acute inflammation after cerebral contusion. Our data also provided evidence that early treatment that lowers P(ti)o(2) may improve the outcome and seems the best medical treatment method in these three groups. We concluded that therapeutic mild hypothermia combined with P(ti)o(2)-guided CPP/ICP management provides beneficial effects when treating TBI, and a multicenter randomized trial needs to be undertaken.BACKGROUNDSevere traumatic brain injury (TBI) was to be one of the major health problems encountered in modern medicine and had an incalculable socioeconomic impact. The initial cerebral damage after acute brain injury is often exacerbated by postischemic hyperthermia and worsens the outcome. Hypothermia is one of the current therapies designed to combat this deleterious effect. The brain tissue oxygen (P(ti)o(2))-guided cerebral perfusion pressure (CPP) management was successfully reduced because of cerebral hypoxic episodes following TBI.","Lee, H C; Chuang, H C; Cho, D Y; Cheng, K F; Lin, P H; Chen, C C",2010.0,10.1016/j.wneu.2010.06.019,0,0,
6062,Mastectomy or conservation for early breast cancer: psychological morbidity,"ER A consecutive series of 197 women under 70 years of age with operable breast cancer, randomised to treatment by a conservation technique in comparison to mastectomy, were assessed using structured interviews. The prevalence of cases of anxiety and depression was high before treatment commenced, there were fewer cases in the conservation group but no significant difference at 3 or 12 months in the number of new cases, social adjustment, or capacity to return to work. Attitudes to treatment showed significant differences between the groups, more women in the conservation group were able to wear their usual clothes and most women rated the cosmetic result highly. Patients were more likely to stop sexual intercourse completely after mastectomy. An effective conservation technique should be an attractive treatment choice available to selected women with early breast cancer.","Lee, M S; Love, S B; Mitchell, J B; Parker, E M; Rubens, R D; Watson, J P; Fentiman, I S; Hayward, J L",1992.0,,0,0,
6063,A randomized trial of dyadic peer support intervention for newly diagnosed breast cancer patients in Korea,"ER BACKGROUND: At the time of diagnosis, patients with cancer are highly exposed to the risk of psychological morbidity. The effects of psychosocial intervention for newly diagnosed cancer patients have not been extensively studied.OBJECTIVE: The objective of this study was to test the effects of a dyadic peer support intervention on self-efficacy, anxiety, depression, and mental adjustment among newly diagnosed breast cancer patients in Korea.METHODS: This study used a randomized controlled trial design. One hundred twenty-nine patients were recruited within 1 month of diagnosis with breast cancer in the National Cancer Center in Korea. The study participants were randomly assigned to either experimental (n = 64) or control (n = 65) group. The experimental group underwent dyadic peer support intervention during the 6 weeks after surgery. The control group received the usual care.RESULTS: There was a significant difference in changes in self-efficacy for self-management of breast cancer between the experimental and control groups; however, no significant changes were observed in anxiety, depression, and mental adjustment between the 2 groups.CONCLUSIONS: A 6-week dyadic peer support intervention was feasible and effective for increasing self-efficacy for self-management among newly diagnosed breast cancer patients in Korea. However, this intervention did not improve other psychological outcomes.IMPLICATIONS FOR PRACTICE: Oncology nurses are optimally positioned to promote adjustment in patients with cancer. Trained peer support partners, supervised by skilled nurses, may be useful in improving self-efficacy of patients newly diagnosed with breast cancer.","Lee, R; Lee, K S; Oh, E G; Kim, S H",2013.0,10.1097/NCC.0b013e3182642d7c,0,0,
6064,Influence of ambient temperature and minute ventilation on passive and active heat and moisture exchangers,"ER OBJECTIVE: During invasive mechanical ventilation, inspired gases must be humidified. We previously showed that high ambient temperature greatly impaired the hygrometric performance of heated wire-heated humidifiers. The aim of this bench and clinical study was to assess the humidification performance of passive and active heat and moisture exchangers (HMEs) and the impact of ambient temperature and ventilator settings.METHODS: We first tested on the bench a device with passive and active humidification properties (Humid-Heat, Teleflex), and 2 passive hydrophobic/hygroscopic HMEs (Hygrobac and Hygrobac S, Tyco Healthcare). The devices were tested at 3 different ambient temperatures (from 22 to 30 °C), and at 2 minute ventilation settings (10 and 20 L/min). Inspired gas hygrometry was measured at the Y-piece with the psychrometric method. In addition to the bench study, we measured the hygrometry of inspired gases in 2 different clinical studies. In 15 mechanically ventilated patients, we evaluated Humid-Heat at different settings. Additionally, we evaluated Humid-Heat and compared it with Hygrobac in a crossover study in 10 patients.RESULTS: On the bench, with the Hygrobac and Hygrobac S the inspired absolute humidity was ? 30 mg H2O/L, and with the Humid-Heat, slightly < 35 mg H2O/L. Ambient temperature and minute ventilation did not have a clinically important difference on the performance of the tested devices. During the clinical evaluation, Humid-Heat provided inspired humidity in a range from 28.5 to 42.0 mg H2O/L, depending on settings, and was only weakly influenced by the patient's body temperature.CONCLUSIONS: In this study both passive and active HMEs had stable humidification performance with negligible influence of ambient temperature and minute ventilation. This contrasts with previous findings with heated wire-heated humidifiers. Although there are no clear data demonstrating that higher humidification impacts outcomes, it is worth noting that humidity was significantly higher with the active HME.","Lellouche, F; Qader, S; Taillé, S; Lyazidi, A; Brochard, L",2014.0,10.4187/respcare.02523,0,0,
6065,Psychosocial service utilization by patients with bipolar disorders: data from the first 500 participants in the Systematic Treatment Enhancement Program,"ER METHODWe investigated psychosocial service utilization among the first 500 patients admitted to the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).RESULTSIn the 3 months prior to enrollment in STEP-BD, a majority of the patients (54%) were engaged in at least one psychosocial service modality in addition to pharmacotherapy. In order of decreasing frequency, these were therapy with a psychologist, self-help group, therapy with a social worker, and therapy with another type of provider. Bipolar patients with personality disorders (80% vs 20%, p = 0.0002), alcohol/drug abuse disorders (76% vs 24%, p = 0.0022), and anxiety disorders (60% vs 40%, p = 0.0043) received more psychosocial services than those without. Poorer global functioning also increased the likelihood of receiving services, whereas being married decreased service utilization.CONCLUSIONPsychosocial service utilization by outpatients with bipolar disorder is strongly linked to greater severity/complexity of illness. Potential moderators, such as insurance status and availability of care, should be examined in future studies.OBJECTIVEAlthough patients with bipolar disorder have been shown to benefit from psychosocial interventions, the proportion that utilizes these interventions is unknown. We set out to clarify the determinants of psychosocial service utilization in adults with bipolar disorder.","Lembke, A; Miklowitz, D J; Otto, M W; Zhang, H; Wisniewski, S R; Sachs, G S; Thase, M E; Ketter, T A",2004.0,,0,0,
6066,Association between alcohol-cue modulated startle reactions and drinking behaviour in alcohol dependent patients - results of the PREDICT study,"ER Previous research on alcohol dependent patients has shown that variations in eyeblink startle response can be used as an indicator of their emotional responses to alcohol-related stimuli. Postulating that reactions on substance associated stimuli are controlled by either a negative or a positive affective processing system, we expect that abstinent alcoholics react differently (within-group) in the emotional evaluation of alcohol cues. Furthermore, we assumed the startle response to covary with medication response to acamprosate and naltrexone.We measured 74 detoxified inpatients' acoustic startle responses while they were being presented with alcohol-related images as well as affectively negative, neutral, and positive pictures before they were randomized to pharmacotherapy.Group-mean startle peak amplitudes were lowest for alcohol-related cues. The relative startle response (alcohol cues set in relation to the other stimulus categories) did not correlate with craving for alcohol (OCDS) or alcohol cue induced self-ratings of arousal, valence and craving. Patients with a lower percentage of abstinent days in the 90. days prior to the last drinking day showed a lower (""more appetitive"") startle response to alcohol cues. A survival analysis using the time to first heavy drinking day as the survival criterion revealed a significant interaction between alcohol-cue startle responses and medication type.The results indicate that the psycho-physiological measure of emotional evaluation of alcohol cues includes unconscious processing not reflected by conscious self-ratings. Furthermore, our result of a differential medication effect may encourage further studies to use biological characteristics to stratify patients as a step towards individualized treatment for alcohol dependence.","Leménager, T; Hill, H; Reinhard, I; Hoffmann, S; Zimmermann, U S; Hermann, D; Smolka, M N; Kiefer, F; Vollstädt-Klein, S; Heinz, A; Mann, K",2014.0,10.1016/j.ijpsycho.2014.09.009,0,0,
6067,Economic analysis of psychosocial group therapy in women with metastatic breast cancer,"ER METHODSData on health care system resources utilization were collected as part of a Canadian multicenter randomized controlled trial of a supportive-expressive group support in metastatic breast cancer. Costs were obtained from one tertiary care hospital in Toronto. A cost minimization analysis was conducted since there was no survival difference; the primary endpoint of the study. Cost-effectiveness analyses were conducted for mood and pain.RESULTSTotal health care utilization costs (including costs of the group therapy intervention) for the intervention and control groups were $31,715 and $28,189, respectively per patient. The difference in total costs between groups ($3,526) was not statistically significant (P = 0.53). The cost-effectiveness analysis for mood showed the intervention group to have an increased cost of $5,550 per patient for an effect size of 0.5 on the POMS scale. The corresponding cost for pain was $4,309. An exploratory analysis on patients who were more distressed at baseline showed a non-significant decrease in cost in favor of the intervention arm (difference of $3,911 P = 0.66).CONCLUSIONPsychosocial intervention, in the form of supportive-expressive group support for metastatic breast cancer, does not lower health care system resource utilization.PURPOSEMetastatic breast cancer is associated with psychological distress in one-third of patients. We examined the impact of group psychosocial support on health care costs in metastatic breast cancer. Psychosocial interventions have been shown to reduce psychological distress in these patients. In other diseases, depression and anxiety have been associated with higher health care system resource utilization.","Lemieux, J; Topp, A; Chappell, H; Ennis, M; Goodwin, P J",2006.0,10.1007/s10549-006-9249-1,0,0,
6068,Cardiac rehabilitation adapted to transient ischaemic attack and stroke (CRAFTS): a randomised controlled trial,"ER METHODSA single blind randomised controlled trial is proposed to examine a primary care cardiac rehabilitation programme for adults post transient ischemic attack (TIA) and stroke in effecting a positive change in the primary outcome measures of cardiac risk scores derived from Blood Pressure, lipid profile, smoking and diabetic status and lifestyle factors of habitual smoking, exercise and healthy eating participation. Secondary outcomes of interest include health related quality of life as measured by the Hospital Anxiety and Depression Scale, the Stroke Specific Quality of Life scale and WONCA COOP Functional Health Status charts and cardiovascular fitness as measured by a sub-maximal fitness test.A total of 144 patients, over 18 years of age with confirmed diagnosis of ischaemic stroke or TIA, will be recruited from Dublin community stroke services and two tertiary T.I.A clinics. Exclusion criteria will include oxygen dependence, unstable cardiac conditions, uncontrolled diabetes, major medical conditions, claudication, febrile illness, pregnancy or cognitive impairment. Participants will be block-statified, randomly allocated to one of two groups using a pre-prepared computer generated randomisation schedule. Both groups will receive a two hour education class on risk reduction post stroke. The intervention group will receive a 10 week programme of supervised aerobic exercises (twice weekly) and individually tailored brief intervention lifestyle counselling. Both groups will be tested on week one and week ten of the programme. Follow-up at 1 year will assess longer term benefits. Analysis will test for significant changes in the key variables indicated.DISCUSSIONApplication of the Cardiac Rehabilitation paradigm to patients with ischaemic stroke or TIA has not been explored despite the obvious overlap in aetiology. It is hoped the anticipated improvement in vascular risk factors and fitness resulting from such a programme will enhance health and social gain in this population.TRIAL REGISTRATIONCurrent Controlled Trials ISCTRN90272638.BACKGROUNDCoronary Heart Disease and Cerebrovascular Disease share many predisposing, modifiable risk factors (hypertension, abnormal blood lipids and lipoproteins, cigarette smoking, physical inactivity, obesity and diabetes mellitus). Lifestyle interventions and pharmacological therapy are recognised as the cornerstones of secondary prevention. Cochrane review has proven the benefits of programmes incorporating exercise and lifestyle counselling in the cardiac disease population. A Cochrane review highlighted as priority, the need to establish feasibility and efficacy of exercise based interventions for Cerebrovascular Disease.","Lennon, O; Blake, C",2009.0,10.1186/1471-2377-9-9,0,0,
6069,Psychologic functioning and needs of indigent patients with facial injury: a prospective controlled study,"ER MATERIALS AND METHODSProspective, case-control study of patients treated at a public hospital in Los Angeles, CA. A total of 336 subjects with mandible fractures and 119 subjects undergoing elective removal of their third molars participated in structured, repeated follow-up assessments (10 days, 6 months, and 12 months after their surgical procedures). Multiple imputation was used to manage incomplete data, and propensity score analysis was used to correct for covariate imbalances between the injury and the control cohort. A series of ANOVAs, chi(2) analyses, and odds ratios was conducted.RESULTSThe injury patients continue to experience significant psychologic distress for up to 12 months following the traumatic event. Orofacial injury patients also tend to report more lifetime and current mental health and social service needs than the sociodemographically similar elective-surgery cohort.CONCLUSIONThe management of facial injuries in disadvantaged individuals should integrate case management that addresses psychosocial sequelae and service needs of patients.PURPOSEThis study sought to examine 1) temporal changes in psychologic functioning over 12 months and 2) baseline differences in mental health and social service needs between orofacial injury patients and sociodemographically comparable controls undergoing elective oral surgery.","Lento, J; Glynn, S; Shetty, V; Asarnow, J; Wang, J; Belin, T R",2004.0,,0,0,
6070,Effect size as a measure of symptom-specific drug change in clinical trials,"ER A data-analytic strategy is proposed for identifying the symptom-specific effects of each medication in a clinical trial. The within-group effect size is a standardized ratio of the pre-post change relative to the stability of change for each treatment group. Advantages of using this descriptive approach are illustrated by examining antidepressant effects of alprazolam, imipramine, and placebo in a clinical trial for patients meeting criteria for both panic disorder and depression. There was a significant difference between active medication and placebo on the Hamilton Rating Scale for Depression (HAM-D) total, but no difference between the anti-depressant effects of the active medications despite their diverse psychopharmacologic properties. Examination of effect sizes for each HAM-D item revealed distinct symptom-specific effects of each active medication in this study sample. Although these descriptive findings cannot be used for inferential conclusions, they can be used to guide the design of future trials.","Leon, A C; Shear, M K; Portera, L; Klerman, G L",1993.0,,0,0,
6071,Fat embolism in severely injured patients,"ER Forty-five patients with severe blunt injuries were examined during eight posttraumatic days. At random, 14 patients were given three doses of methylprednisolone intravenously; 10 mg/kg at 8-hour intervals. Fat embolism syndrome was diagnosed in 13/45 patients, only one of whom had received corticosteroid (p = 0.03). Shock, acidosis and elevated plasma catecholamines showed no correlation with the occurrence of fat embolism syndrome. Platelet counts immediately after trauma were significantly lower in the fat embolism patients than in the other trauma patients, indicative of early platelet aggregation. Prophylactically administered methylprednisolone in pharmacological doses appeared to inhibit the emergence of fat embolism syndrome.","Lepistö, P; Avikainen, V; Alho, A; Jäättelä, A; Karaharju, E; Kataja, J; Lahdensuu, M; Rokkanen, P; Tervo, T",1975.0,,0,0,
6072,"Effects of set, setting, and sedatives, on reaction time","ER The effects of sessions, individual characteristics, group behavior, sedative medications, and pharmacological anticipation, on simple visual and auditory reaction time were evaluated with a randomized block design. The project involved 4 separate small groups of 5 to 9 healthy young adults who met 4 times for 9 hr. over 4 mo. and received 4 drug regimens under controlled conditions. Attitudes toward the experiment, which were mainly related to an early fear of potent drugs and late feelings of weariness, markedly affected reaction time. This effect decreased the test-retest reliability of the instrument, hence its sensitivity. Group behavior, subjective feelings attributable to the medications, and pharmacological anticipation, on the other hand, did not seem to have affected psychomotor performance. The effects of sedatives were much more marked and consistent with reaction time than with subjective responses, which primarily represented the influence of anticipation. This dissociation between objective and subjective behavior indicates that the subjects acted according to the drugs which they had taken but felt according to what they believed they had received.","Levine, H D; Sicé, J",1976.0,10.2466/pms.1976.42.2.403,0,0,
6073,Psychogenic panic after zidovudine therapy: the therapeutic benefit of an N of 1 trial,,"Levitt, A J; Lippert, G P",1990.0,,0,0,
6074,Validation of the Cardiovascular Limitations and Symptoms Profile (CLASP) in chronic stable angina,"ER METHODSAfter 226 patients with angina had been recruited, they were randomly allocated to one of three groups: a 10-week hospital-based angina management program (n = 75; men = 56; age = 60 +/- 8 years), routine care (n = 74; men = 52; age = 61 +/- 7 years), and exercise therapy (n = 77; men = 60; age = 60 +/- 7 years). All the patients were assessed with CLASP on two occasions: at baseline and at 10 weeks. The Sickness Impact Profile (SIP), the Hospital Anxiety and Depression Scale (HADS), and the Sleep Problems Questionnaire (SPQ) also were administered at the same time.RESULTSSignificant positive correlations between the actual number of angina episodes and the CLASP angina subscale scores (r =.60, P <.001) were observed. The CLASP subscale scores for shortness of breath (r = -.36; P <.001) and ankle swelling (r = -.24; P <.001) were significantly correlated with the total treadmill time. The CLASP tiredness subscale score showed a significant positive correlation with the SPQ score (r =.48; P <.001). The CLASP subscale scores were significantly correlated with their corresponding SIP subscale scores: the tiredness score with the sleep and rest score (r =.49; P <.001), the social and leisure score with the recreation and pastimes score (r =.41; P <.001), the home score with the home management score (r =.45; P <.001), and the mobility score with the mobility (r =.37; P <.001) and total treadmill time scores (r = -.49; P <.001).CONCLUSIONSThe findings show CLASP to be a reliable, valid, sensitive measure of health-related quality of life in patients with chronic stable angina. Before it can be recommended for all patients with heart disorders, similar data will be required from other diagnostic groups such as patients with heart failure or those who have sustained an acute myocardial infarction.PURPOSEThis study aimed to establish the reliability, validity, and sensitivity of the Cardiovascular Limitations and Symptoms Profile (CLASP) in a group of patients with chronic stable angina.","Lewin, R J; Thompson, D R; Martin, C R; Stuckey, N; Devlen, J; Michaelson, S; Maguire, P",2002.0,,0,0,
6075,The Enhancing Connections Program: a six-state randomized clinical trial of a cancer parenting program,"ER Objective: The purpose of this study was to test the efficacy of a cancer parenting program for child rearing mothers with breast cancer, the Enhancing Connections Program. Primary goals were to decrease maternal depressed mood and anxiety, improve parenting quality, parenting skills and confidence, and enhance the child's behavioral-emotional adjustment to maternal breast cancer. Method: A total of 176 mothers diagnosed within 6 months with Stage 0 to Stage III breast cancer and their 8- to 12-year-old child were recruited from medical providers in 6 states: Washington, California, Pennsylvania, Minnesota, Arizona, and Indiana. After consenting and obtaining baseline measures, study participants were randomized into experimental or control groups. Experimental mothers received 5, 1-hr educational counseling sessions at 2-week intervals; controls received a booklet and phone call on communicating and supporting their child about the mother's cancer. Outcomes were assessed at 2 and 12 months. Results: Compared to controls, at 2 months experimental mothers significantly improved on depressed mood and parenting skills; experimental children improved on behavioral-emotional adjustment: total behavior problems, externalizing problems, and anxiety/depressed mood significantly declined. At 1 year, experimental children remained significantly less depressed than controls on both mother- and child-reported measures. The intervention failed to significantly affect parenting self-efficacy or maternal anxiety. Conclusions: The Enhancing Connections Program benefitted mothers and children in specific areas and warrants refinement and further testing.","Lewis, F M; Brandt, P A; Cochrane, B B; Griffith, K A; Grant, M; Haase, J E; Houldin, A D; Post-White, J; Zahlis, E H; Shands, M E",2015.0,10.1037/a0038219,0,0,
6076,Validation of the timeline follow-back in the assessment of adolescent smoking,"ER The timeline follow-back instrument (TLFB) is a valid and reliable method of quantifying alcohol use patterns. The use of this instrument has been expanded to assess other behaviors, such as drug use, sexual behavior, binge eating, and panic attacks. Some evidence for the validity and reliability of this assessment instrument has emerged in the area of adult smoking. However, to date, there is no published evidence of its reliability and validity in the assessment of adolescent smoking. The purpose of this study is to present early evidence of the utility of the TLFB to collect information on adolescent smoking behavior. Through secondary data analysis of four studies on adolescent smokers, we examined the associations between the TLFB and measures of dependence, smoking history, respiratory symptoms, and saliva cotinine. Moreover, we examined the stability of the TLFB data across two 15-day time periods. Results provide preliminary evidence of the validity and reliability of the TLFB in the assessment of adolescent smoking. In particular, the TLFB instrument offered important data on the heterogeneity of adolescent smoking patterns beyond a global measure of cigarettes per day, and the reduction of digit bias. Implications of these findings for the assessment of adolescent smoking are discussed.","Lewis-Esquerre, J M; Colby, S M; Tevyaw, T O; Eaton, C A; Kahler, C W; Monti, P M",2005.0,10.1016/j.drugalcdep.2004.12.007,0,0,
6077,Efficacy of Williams LifeSkills training for improving psychological health: a pilot comparison study of Chinese medical students,"ER INTRODUCTION: High stress levels and mental health problems are common among medical students. Behavioral interventions aimed at preventing mental health problems among medical students have been recommended in managing stress during their study period. The aim of the study was to evaluate the efficacy of Williams LifeSkills training (WLST) for improving psychological health of Chinese medical students.METHODS: Sixty medical students were chosen as the study group (n = 30) and the control group (n = 30). The study group completed the 8-week WLST, while the controls did not take any training course. All subjects were assessed before and after the 8-week training period using the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Trait Coping Style Questionnaire (TCSQ), Interpersonal Support Evaluation List (ISEL) and Self-Esteem Scale (SES). The data of 29 students in the study group and 26 students in the control group were qualified for statistical analysis in the current study.RESULTS: Group-time interactions were significant for the ISEL total (P = 0.008), ISEL appraisal (P = 0.002), SES (P = 0.002), SAS (P = 0.005) and SDS (P = 0.032). Post-hoc paired Student's t-tests showed that all these measures improved significantly (P < 0.05) in the study group but were unchanged in the control group.DISCUSSION: In our study, a behavioral intervention -","Li, C; Chu, F; Wang, H; Wang, X P",2014.0,10.1111/appy.12084,0,0,
6078,The effective evaluation on symptoms and quality of life of chronic obstructive pulmonary disease patients treated by comprehensive therapy based on traditional Chinese medicine patterns,"ER OBJECTIVE: To evaluate the efficacy of comprehensive interventions based on the three TCM patterns on symptoms and quality of life of COPD patients.DESIGN: An open-label, randomized, controlled trial.SETTING: Four hospitals in China.INTERVENTION: 352 patients were randomly divided into two groups. Patients in the trial group were given conventional Western medicine and Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules and Yi-Qi Zi-Shen granules respectively; patients in the control group were given conventional Western medicine. Data collection was performed at baseline, in the 3rd and 6th month during the treatment period, and the 12th month during the follow-up period.OUTCOMES: Symptoms, including cough, sputum, pant, chest tightness, short of breath, lassitude, cyanosis and symptom total score; quality of life, measured by the WHOQOL-BREF questionnaire and adult COPD quality of life questionnaire (COPD-QOL).RESULTS: Of the 352 patients, 306 fully completed the study. After treatment and follow-up, there were significant differences between two groups in the following: cough, sputum, pant, chest tightness, shortness of breath, lassitude score and symptom total score (P<.05); physical, psychological, social and environment domain (P<.05) of the WHOQOL-BREF; daily living ability, social activity, depression symptoms and anxiety symptoms domain (P<.05) of the COPD-QOL. There were no differences between two groups in cyanosis and adverse events.CONCLUSION: Based on the TCM patterns, Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules and Yi-Qi Zi-Shen granules have beneficial effects on symptoms and quality of life of COPD patients.","Li, J S; Li, S Y; Xie, Y; Yu, X Q; Wang, M H; Sun, Z K; Ma, L J; Jia, X H; Zhang, H L; Xu, J P; Hou, C X",2013.0,10.1016/j.ctim.2013.09.006,0,0,
6079,Propafenone versus disopyramide: a double-blind randomized crossover trial in patients presenting chronic ventricular arrhythmias,"ER In vitro and in vivo electrophysiological studies have shown that propafenone could be classified as a class I antiarrhythmic agent. The aim of this study was to investigate the short-term antiarrhythmic efficacy and safety of propafenone in 10 patients compared to disopyramide in a double-blind randomized protocol. Included patients suffered from ventricular arrhythmias with at least 60 ventricular premature beats (VPB) per hour refractory to at least two other antiarrhythmic agents. At the end of the control period and of the two treatment periods during which patients received either propafenone (300 mg three times a day) or disopyramide (200 mg three times a day), clinical examination, Holter recordings, electrocardiogram, and clinical laboratory tests were performed. The PR interval and the QRS interval were significantly increased with propafenone, but not with disopyramide. The cQT interval was not significantly changed by either propafenone or disopyramide. Heart rate was decreased with propafenone (p less than 0.05) with no change in the diurnal/nocturnal circadian ratio variation. Heart rate was significantly decreased with disopyramide only during the day. Five of nine patients in the propafenone group and two of nine patients in the disopyramide group showed a reduction in ventricular premature beats greater than 80%. Total resolution of severe arrhythmias (repetitive events) was seen in 5 of 8 patients with propafenone; 2 of 8 with disopyramide. Adverse events, when they occurred, were mild (visual disturbances, epigastric discomfort, changes in taste perception, transient atrioventricular block with propafenone, and photophobia with disopyramide), and did not require reduction or discontinuation of study drug.(ABSTRACT TRUNCATED AT 250 WORDS)","Libersa, C; Caron, J; Pladys, A; Beuscart, R; Kacet, S; Wajman, A; Connell, C; Dupuis, B; Lekieffre, J",1987.0,,0,0,
6080,Preventive intervention and outcome with anxiously attached dyads,"ER Anxiously attached 12-month-olds and their mothers as assessed in the Strange Situation were randomly assigned to an intervention and a control group to test the hypothesis that infant-parent psychotherapy can improve quality of attachment and social-emotional functioning. Securely attached dyads comprised a second control group. Intervention lasted 1 year and ended when the child was 24 months. ANOVAs were used to compare the research groups at outcome. Intervention group toddlers were significantly lower than anxious controls in avoidance, resistance, and anger. They were significantly higher than anxious controls in partnership with mother. Intervention mothers had higher scores than anxious controls in empathy and interactiveness with their children. There were no differences on the outcome measures between the intervention and the secure control groups. The groups did not differ in maternal child-rearing attitudes. Within the intervention group, level of therapeutic process was positively correlated with adaptive scores in child and mother outcome measures.","Lieberman, A F; Weston, D R; Pawl, J H",1991.0,,0,0,
6081,A randomized controlled trial examining the effectiveness of a STOMA psychosocial intervention programme on the outcomes of colorectal patients with a stoma: study protocol,"ER BACKGROUNDWith the loss of a significant body function and distorted body image, stoma patients experience physical, psychological and social challenges. Nurses have an important role in helping patients' make a smooth transition to living with their stoma. Limited studies have examined the effects of psychosocial interventions on improving stoma-related health outcomes.DESIGNA randomized controlled trial is planned.METHODSEighty-four patients with newly formed stoma in a tertiary hospital in Singapore (Research Ethics Committee approval obtained in January 2013) will be recruited. Participants will be randomly assigned to either a control group who receive routine care or an intervention group who receive STOMA psychosocial intervention besides routine care. Outcome variables include stoma care self-efficacy, days to stoma proficiency, length of hospital stay, acceptance of stoma, anxiety and depression and quality of life. Data will be collected at four time points: before randomization and intervention (baseline), on the day of discharge (mid-intervention), at 4 weeks after discharge (postintervention 1) and at 4 months after discharge (postintervention 2).DISCUSSIONThis study will develop a psychosocial intervention programme, which may improve patients' stoma-related outcomes. The findings will provide direction to health professionals about education and the type of support that could be offered to patients concerning stoma care in the hospital setting, which will eventually improve their quality of life.AIMSTo report a study protocol that evaluates the effects of a psychosocial intervention on patients with a newly formed stoma.","Lim, S H; Chan, S W; Lai, J H; He, H G",2015.0,10.1111/jan.12595,0,0,
6082,Relaxation therapy in patients with anxiety and somatoform disorders in primary care,"ER DESIGNAn experimental prospective study, controlled through random assignation, using evaluation scales.SETTINGMn. Jaume Soler Health Centre, Cornellà (Barcelona).PATIENTS31 patients (8 men and 23 women), diagnosed with anxiety or previously untreated somatoform disorders, for whom combined anti-depressive and relaxation therapy over a 5-month period was established. The results were compared with those of a control group (n = 17) with identical diagnoses, which only received antidepressive medication.MEASUREMENTS AND MAIN RESULTSThe STAI tests and two pain scales were administered at 0, 15, 30, 45, 60 and 150 days and the HRS and SCL-90-R at 0 and 150 days. The possible impact of the psychiatric diagnosis, age, gender, married status, existence of concomitant physical illness, SRE, present employment status and the presence of children or not were all considered. The results pointed to a significant improvement over the period in the analogue-visual scale of pain (p = .009) and in the HRS (p = .046) for the group comprised of those complying with the relaxation therapy independently of the psychiatric diagnosis.CONCLUSIONSThe benefit of relaxation in anxious and somatoform patients, when pain--and not anxiety--is the principal symptom, was confirmed. Depression improved when antidepressants were administered simultaneously, whereas anxiety varied little, at least during the time the trial lasted.OBJECTIVETo study the effect of relaxation therapy on the symptomology of patients with anxiety and somatoform disorders.","Bernal, i. Cercós A; Fusté, i. Vallverdú R; Urbieta, Solana R; Montesinos, Molina I",1995.0,,0,0,
6083,The effects of hatha yoga exercises on stress and anxiety levels in mastectomized women,"ER This article seeks to evaluate the effects of hatha yoga on stress and anxiety levels in mastectomized women. It also investigates the relationship between these levels with the following variables: age; marital status; religion; instruction; profession; smoke addiction; elitism; staging of the disease; and treatment phase. This involved controlled random clinical trial sampling of 45 mastectomized women treated at the Ilza Bianco outpatient service of Santa Rita de Cássia Hospital in the Brazilian state of Espírito Santo from March to November 2010. The experimental group participated in 6 individually-applied sessions with incentive for ongoing home practice and was re-evaluated after the period, whereas the control group was re-evaluated after a proportional period. For the study of the variables, the interview and recording on a form technique was used, along with the Anxiety Trait and State Test, and the Stress Symptoms and Signs Test. For statistical treatment, the Statistical Pack for Social Sciences was used. The data are statistically significant and have shown that hatha yoga exercises decrease stress and anxiety in the experimental group. No connection between confounding variables and anxiety and stress levels was found.","Bernardi, M L; Amorim, M H; Zandonade, E; Santaella, D F; Barbosa, Jde A",2013.0,,0,0,
6084,Homophobia and physical aggression toward homosexual and heterosexual individuals,"ER This study examined the relationship between homophobia (defined as self-reported negative affect, avoidance, and aggression toward homosexuals) and homosexual aggression. Self-identified heterosexual college men were assigned to homophobic (n = 26) and nonhomophobic (n = 26) groups on the basis of their scores on the Homophobia Scale (HS; L. W. Wright, H. E. Adams, & J. A. Bernat, 1999). Physical aggression was examined by having participants administer shocks to a fictitious opponent during a competitive reaction time (RT) task under the impression that the study was examining the relationship between sexually explicit material and RT. Participants were exposed to a male homosexual erotic videotape, their affective reactions were assessed, and they then competed in the RT task against either a heterosexual or a homosexual opponent. The homophobic group reported significantly more negative affect, anxiety, and anger-hostility after watching the homosexual erotic videotape than did the nonhomophobic group. Additionally, the homophobic group was significantly more aggressive toward the homosexual opponent, but the groups did not differ in aggression toward the heterosexual opponent.","Bernat, J A; Calhoun, K S; Adams, H E; Zeichner, A",2001.0,,0,0,
6085,Psychotherapy of irritable colon,"ER 16 patients with an irritable colon were examined psychologically and independent of the result of the diagnostics of neuroses additionally distributed to two groups of treatment. One group was treated symptomatically, the other additionally psychotherapeutically (above all with autogenous training). Two thirds of the patients showed a neurosis. Psychotherapy was very useful only in those patients with a neurosis, measured as the result of the treatment one year after the beginning of the therapy. When an obstinate irritable colon is present, a diagnostics of neuroses is indicated. If a neurosis is proved, an individual psychotherapy is indicated, in which case the autogenous training as basis therapy apparently stood the test.","Berndt, H; Maercker, W",1985.0,,0,0,
6086,"School-based interventions for anxious children: 3-, 6-, and 12-month follow-ups","ER METHODParent, child, and clinician report measures of child anxiety were completed at 3, 6, and 12 months posttreatment. Semistructured diagnostic interviews were administered at 6- and 12-month follow-ups. For initial analyses, the group CBT and group CBT plus parent training conditions were collapsed into one group and compared to control. When significant results were found, each active treatment group was compared to control.RESULTSAcross several measures, the collapsed CBT group sustained significant improvement in anxiety severity and impairment across a 12-month period compared to control. There were no significant differences between the three groups on remission of baseline anxiety disorders or incidence of new anxiety disorders during the follow-up. Several parent-report measures at 3 and 6 months posttreatment suggested that group CBT for children plus parent training provided additional benefit over the group CBT for children when each was compared to the control group.CONCLUSIONSSchool-based CBT appears effective in decreasing anxiety symptoms up to 12 months posttreatment for anxious children.OBJECTIVETo follow 61 participants (7-11 years old) from a study that compared three school-based interventions for anxious children: group cognitive-behavioral therapy (CBT) for children, group CBT for children plus parent training, and no-treatment control to determine whether posttreatment benefits are sustained longitudinally.","Bernstein, G A; Bernat, D H; Victor, A M; Layne, A E",2008.0,10.1097/CHI.ob013e31817eecco,0,0,
6087,School-based interventions for anxious children,"ER METHODStudents (7-11 years old) in three elementary schools (N = 453) were screened using the Multidimensional Anxiety Scale for Children and teacher nomination. Subsequently, 101 identified children and their parents completed the Anxiety Disorders Interview Schedule for DSM-IV, Child Version. Children with features or DSM-IV diagnoses of separation anxiety disorder, generalized anxiety disorder, and/or social phobia (n = 61) were randomized by school to one of three conditions. Active treatments were nine weekly sessions of either group CBT or group CBT plus concurrent parent training.RESULTSClinician-report, child-report, and parent-report measures of child anxiety demonstrated significant benefits of CBT treatments over the no-treatment control group. Effect size was 0.58 for change in composite clinician severity rating, the primary outcome measure, favoring collapsed CBT conditions compared with control. In addition, several instruments showed significantly greater improvement in child anxiety for group CBT plus parent training over group CBT alone.CONCLUSIONSBoth active CBT treatments were more effective than the no-treatment control condition in decreasing child anxiety symptoms and associated impairment. When parent training was combined with child group CBT, there were some additional benefits for the children.OBJECTIVETo compare the effectiveness of three school-based interventions for anxious children: group cognitive-behavioral therapy (CBT) for children, group CBT for children plus parent training group, and no-treatment control.","Bernstein, G A; Layne, A E; Egan, E A; Tennison, D M",2005.0,10.1097/01.chi.0000177323.40005.a1,0,0,
6088,Comparison of the outcome of implantation of hydrophobic acrylic versus silicone intraocular lenses in pediatric cataract: prospective randomized study,"ER DESIGNProspective randomized study.PARTICIPANTSForty-one eyes of 41 children (age 1 month to 8 years) with congenital or developmental cataract.METHODSChildren were randomly divided into 2 groups. All participants underwent phacoaspiration, primary posterior capsulotomy, and anterior vitrectomy. Group A (n = 21) eyes were implanted with acrylic hydrophobic AcrySof SA60AT intraocular lenses (IOLs), and those of Group B (n = 20) were implanted with silicone Tecnis Z9000 IOLs. The children were evaluated for anterior chamber reaction, IOL position, posterior capsular opacification PCO), intraocular pressure, best-corrected visual acuity (BCVA), corneal status, and refractive errors.RESULTSPostoperatively, 2 eyes in each group had significant anterior chamber reaction with fibrin membrane formation. IOLs were in the capsular bag in all but 1 eye in both groups. Seven eyes in the acrylic group and 6 eyes in the silicone group achieved visual acuity of 20/40 or better. None of the eyes showed glaucoma. BCVA at 1 year was similar in both groups. In the acrylic hydrophobic group, 14 eyes needed hypermetropic correction and 7 eyes were myopic, and in the silicone group 10 eyes had myopia and 10 eyes had hypermetropia at 1 year postoperatively. PCO at 1 year follow-up was more common in eyes implanted with acrylic hydrophobic IOLs (5 eyes) than silicone IOLs (2 eyes).CONCLUSIONSBoth square-edge hydrophobic acrylic and silicone IOLs were found to be compatible and safe for use in pediatric cataract surgery with similar visual axis clarity and postoperative outcome.OBJECTIVETo compare the postoperative performance of hydrophobic acrylic and silicone square-edge intraocular lenses in pediatric cataract.","Bhusal, S; Ram, J; Sukhija, J; Pandav, S S; Kaushik, S",2010.0,10.3129/i10-045,0,0,
6089,Migraine with aura versus migraine without aura: pain intensity and associated symptom intensities after placebo,"ER BACKGROUNDStudies that evaluate drugs used in the acute treatment of migraine ideally should include a placebo arm. The International Headache Society also recommends stratification according to age and sex but not by the presence versus absence of aura.METHODSThe study was conducted as part of a placebo controlled randomized survey comparing four active drugs against placebo in the acute treatment of migraine. Patients were blinded as to treatment received. Placebo consisted of 10 mL of normal saline (0.9%) intravenously. Pain intensity was evaluated by a 10-point analogical-verbal scale. Nausea, photophobia, and phonophobia were evaluated by a four-point analogical-verbal scale. For statistical analysis, unpaired t-test with Welch correction was used.RESULTSAfter placebo administration, reduction of symptom intensity (pain, nausea, photophobia, and phonophobia) in patients with migraine without aura was significantly greater than that observed in patients with migraine with aura.CONCLUSIONSOur findings suggest that studies comparing placebo against an active drug should use stratification according to the presence versus absence of aura.OBJECTIVETo compare the intensity of pain and associated symptoms after placebo administration in patients with migraine with aura and migraine without aura.","Bigal, M E; Bordini, C A; Sheftell, F D; Speciali, J G; Bigal, J O",2002.0,,0,0,
6090,"The effect of massage on cellular immunity, endocrine and psychological factors in women with breast cancer -- a randomized controlled clinical trial","ER DESIGNA single centre, prospective, randomized, controlled trial.SETTINGS/LOCATIONThe study was conducted in a radiation department, in a hospital in south-western Sweden.SUBJECTSTwenty-two women (mean age=62) with breast cancer undergoing radiation were included in this study.INTERVENTIONSThe patients were randomly assigned to effleurage massage therapy (20 min of effleurage on ten occasions) or to control visits (ten 20-minute visits).OUTCOME MEASURESBlood samples were collected before the first and last massage/control visit for analysis of peripheral blood NK, T cells and oxytocin. Saliva was analysed for cortisol. In addition, the patients completed the Hospital Anxiety and Depression Scale, Life Satisfaction Questionnaire and Spielbergers State Trait Anxiety Inventory prior to the first and last massage/control visit.RESULTSEffleurage massage treatment had no significant effect on the number, frequencies or activation state of NK cells or CD4+ or CD8+ T cells. Furthermore, no significant changes between groups were detected on cortisol and oxytocin concentrations, anxiety, depression or quality of life.CONCLUSIONSSignificant effect of effleurage massage on cellular immunity, cortisol, oxytocin, anxiety, depression or quality of life could not be demonstrated in this study. Several possible explanations to the results of this study are discussed.OBJECTIVESThe purpose of this study was to examine the effect of repeated effleurage massage treatments compared with a visit control group on circulating lymphocytes by studying the number and activity of peripheral blood NK cells, CD4+ and CD8+ T cells in women with breast cancer. Furthermore, the effect of repeated effleurage massage treatments on the levels of cortisol in saliva and oxytocin in plasma as well as degree anxiety, depression and quality of life was studied.","Billhult, A; Lindholm, C; Gunnarsson, R; Stener-Victorin, E",2008.0,10.1016/j.autneu.2008.03.006,0,0,
6091,"Treatment of elective mutism with fluoxetine: a double-blind, placebo-controlled study","ER METHODSixteen subjects with elective mutism were treated with placebo (single-blind) for 2 weeks. Fifteen placebo nonresponders were then randomly assigned to double-blind treatment with fluoxetine at a dose of 0.6 mg/kg/day (N = 6) or continued placebo (N = 9) for an additional 12 weeks. Outcome ratings were completed by the treating psychiatrist, parents, and teachers.RESULTSSignificant improvements over time on ratings of elective mutism, anxiety, and social anxiety, rated by clinician, parents, and teachers, were demonstrated in both fluoxetine- and placebo-treated subjects. Subjects treated with fluoxetine were significantly more improved than placebo-treated subjects on parent's ratings of mutism change and global change. Clinician and teacher ratings did not reveal significant differences between treatment groups. Although improved, most subjects in both treatment groups remained very symptomatic at the end of the study period. Side effects were minimal.CONCLUSIONFluoxetine may be beneficial and safe in the treatment of children with elective mutism. Longer periods of treatment may yield more substantial therapeutic benefits. Further study is indicated.OBJECTIVETo evaluate the efficacy of treatment with fluoxetine in reducing symptoms associated with elective mutism.","Black, B; Uhde, T W",1994.0,10.1097/00004583-199409000-00010,0,0,
6092,A double-blind comparison of fluvoxamine versus placebo in the treatment of compulsive buying disorder,"ER Nondepressed outpatients with a compulsive buying disorder were recruited by advertisement and word of mouth for inclusion in a controlled treatment trial. Following a 1-week single-blind placebo washout, subjects were randomly assigned to fluvoxamine (n = 12) or placebo (n = 11). Subjects received fluvoxamine (up to 300 mg daily) or placebo for 9 weeks. There were few dropouts. Outcome measures included the Yale-Brown Obsessive-Compulsive Scale--Shopping Version (YBOCS-SV), three Clinical Global Impressions (CGI) ratings, the Hamilton Rating Scale for Depression (HRSD), and the Maudsley Obsessive-compulsive Inventory (MOI). At the conclusion of the trial, 50% of fluvoxamine recipients and 63.6% of placebo recipients achieved CGI ratings of ""much"" or ""very much"" improvement, while 33% of fluvoxamine recipients were ""very much"" improved compared with 18% of placebo recipients (by endpoint analysis). Subjects in both treatment cells showed improvement as early as the second week of the trial, and for most, improvement continued during the 9-week study. There were no significant differences between fluvoxamine- and placebo-treated subjects on any of the outcome measures, with the exception that fluvoxamine recipients achieved greater improvement than placebo recipients on the MOI (p = .02). Adverse experiences were more frequent in the group receiving fluvoxamine, particularly nausea, insomnia, decreased motivation, and sedation. We conclude that in a short-term treatment trial of compulsive buying, subjects receiving fluvoxamine or placebo respond similarly.","Black, D W; Gabel, J; Hansen, J; Schlosser, S",2000.0,,0,0,
6093,Effects of exercise intensity and self-efficacy on state anxiety with breast cancer survivors,"ER DESIGNRepeated-measures, experimental pilot.SETTINGUniversity laboratory.SAMPLEBreast cancer survivors (n = 25) and age-matched women without a cancer diagnosis (n = 25).METHODSCycling for 20 minutes at light and moderate intensities on two separate occasions. State anxiety and self-efficacy measures were completed before, immediately following, and 10 minutes after exercise.MAIN RESEARCH VARIABLESState anxiety, self-efficacy, and light and moderate exercise.FINDINGS2 (sample) x 2 (intensity condition) x 3 (time) repeated-measure analyses of variance revealed a main effect for time (p < 0.01, eta2 = 0.37, F[2, 86] = 24.687), but between-sample and exercise intensity interaction effects were not significant. Autoregressive path analysis using ordinary least squares multiple regression revealed significant reciprocation for self-efficacy and anxiety pre-exercise (light intensity beta = 0.49, p < 0.05; moderate intensity beta = -0.37, p < 0.05) and post-exercise (moderate intensity beta = -0.31, -0.23, p < 0.05).CONCLUSIONSAcute exercise at light and moderate intensity decreases state anxiety for breast cancer survivors and those without a diagnosis. Additional research is warranted.IMPLICATIONS FOR NURSINGLight- and moderate-intensity exercise may be a valuable alternative anxiolytic tool that also allows for the acquisition of myriad additional known health benefits associated with exercise.PURPOSE/OBJECTIVESTo determine whether acute exercise reduces state anxiety and whether this reduction is moderated by the sample (i.e., breast cancer survivors versus those without a cancer diagnosis), exercise intensity (i.e., moderate versus light), and the potential sample times intensity interactions; and to explore whether changes in self-efficacy and state anxiety reciprocally predict each other as suggested by social cognitive theory.","Blacklock, R; Rhodes, R; Blanchard, C; Gaul, C",2010.0,10.1188/10.ONF.206-212,0,0,
6094,Telephone-based coping skills training for patients awaiting lung transplantation,"ER Impaired quality of life is associated with increased mortality in patients with advanced lung disease. Using a randomized controlled trial with allocation concealment and blinded outcome assessment at 2 tertiary care teaching hospitals, the authors randomly assigned 328 patients with end-stage lung disease awaiting lung transplantation to 12 weeks of telephone-based coping skills training (CST) or to usual medical care (UMC). Patients completed a battery of quality of life instruments and were followed for up to 3.4 years to assess all-cause mortality. Compared with UMC, CST produced lower scores on perceived stress, anxiety, depressive symptoms, and negative affect and improved scores on mental health functioning, optimism, vitality, and perceived social support. There were 29 deaths (9%) over a mean follow-up period of 1.1 year. Survival analyses revealed that there was no difference in survival between the 2 groups. The authors conclude that a telephone-based CST intervention can be effectively delivered to patients awaiting lung transplantation. Despite the severity of pulmonary disease in this patient population, significant improvements in quality of life, but not somatic measures or survival to transplant, were achieved.","Blumenthal, J A; Babyak, M A; Keefe, F J; Davis, R D; Lacaille, R A; Carney, R M; Freedland, K E; Trulock, E; Palmer, S M",2006.0,10.1037/0022-006X.74.3.535,0,0,
6095,Child versus family cognitive-behavioral therapy in clinically anxious youth: an efficacy and partial effectiveness study,"ER METHODClinically referred children with anxiety disorders (N = 128) and their parents were randomly assigned to child or family CBT and evaluated at pretreatment, posttreatment, and 3-month follow-up. Twenty-five families were measured before and after a 2- to 3-month waitlist period.RESULTSNone of the waitlisted children recovered from their anxiety disorders. In contrast, 41% of the treated children no longer met criteria for any anxiety disorder after CBT, and 52% demonstrated continued improvement at the 3-month follow-up. Significantly more children were free of anxiety disorders (53%) in the child CBT condition compared with family CBT condition (28%) at posttreatment, whereas at 3-month follow-up, the superior effect of child CBT was no longer significant. Similar results were obtained from the questionnaire measures. Both child and family CBT were less effective if parents had an anxiety disorder themselves. On some of the measures, child CBT was superior if parents had anxiety disorders themselves, whereas family CBT was superior if parents had no anxiety disorders. Finally, younger children had better outcomes than older children, regardless of the treatment condition.CONCLUSIONSOverall, child CBT seems slightly more beneficial than family CBT. Because this study was conducted in a clinical setting with clinically referred children, results indicate partial effectiveness for child CBT.OBJECTIVEThe efficacy and partial effectiveness of child-focused versus family-focused cognitive-behavioral therapy (CBT) for clinically anxious youths was evaluated, in particular in relation to parental anxiety disorders and child's age.","Bodden, D H; Bögels, S M; Nauta, M H; Haan, E; Ringrose, J; Appelboom, C; Brinkman, A G; Appelboom-Geerts, K C",2008.0,10.1097/CHI.0b013e318189148e,0,0,
6096,Societal burden of clinically anxious youth referred for treatment: a cost-of-illness study,"ER A prevalence-based cost-of-illness study using a societal perspective was conducted to investigate the cost-of-illness in clinically anxious youth aged 8-18 in The Netherlands. Discriminant validity of the cost diary used was obtained by comparing costs of families with an anxious child (n = 118) to costs of families from the general population (n = 41). To examine the convergent validity, bottom-up acquired costs derived from cost diaries were compared to top-down acquired costs obtained from national registrations. Bottom-up acquired costs measured by means of cost diaries amounted to Euro 2,748 per family of a clinically referred anxious child per annum. Societal costs of families with clinically anxious children were almost 21 times as high compared to families from the general population. With respect to convergent validity, total health care costs using the bottom-up approach from clinically anxious children were quite comparable to those of top-down data of anxious children, although costs within the subcategories differed considerably. Clinical anxiety disorders in childhood cost the Dutch society more than 20 million euros a year. Based on results of discriminate and convergent validity, the cost diary seems a valid method in establishing cost-of-illness in childhood anxiety disorders.","Bodden, D H; Dirksen, C D; Bögels, S M",2008.0,10.1007/s10802-007-9194-4,0,0,
6097,Costs and cost-effectiveness of family CBT versus individual CBT in clinically anxious children,"ER The objective of this study was to investigate the cost-effectiveness of family cognitive-behavioral therapy (CBT) compared with individual CBT in children with anxiety disorders. Clinically anxious children (aged 8-18 years) referred for treatment were randomly assigned to family or individual CBT and were assessed pre-treatment, post treatment, and at 3 months and 1 year after treatment. Cost-effectiveness ratios were calculated expressing the incremental costs per anxiety-free child and the incremental costs per Quality Adjusted Life Year (QALY) for the referred child. Neither societal costs nor effectiveness were significantly different between individual and family CBT. However, the point estimates of the cost-effectiveness ratios resulted in dominance for individual CBT, indicating that individual CBT is more effective and less costly than family CBT. These results were confirmed by bootstrap analyses and cost-effectiveness acceptability curves. Several secondary and sensitivity analyses showed that the results were robust. It can be concluded that family CBT is not a cost-effective treatment for clinically anxious children, compared with individual CBT.","Bodden, D H; Dirksen, C D; Bögels, S M; Nauta, M H; Haan, E; Ringrose, J; Appelboom, C; Brinkman, A G; Appelboom-Geerts, K C",2008.0,10.1177/1359104508090602,0,0,
6098,The effect of prayer on depression and anxiety: maintenance of positive influence one year after prayer intervention,"ER DESIGN, SETTING, AND PARTICIPANTS: One-year follow-up of subjects with depression and anxiety who had undergone prayer intervention consisting of six weekly 1-hour prayer sessions conducted in an office setting. Subjects (44 women) completed Hamilton Rating Scales for Depression and Anxiety, Life Orientation Test, and Daily Spiritual Experiences Scale after finishing a series of six prayer sessions and then again a month later in an initial study. The current study reassessed those subjects with the same measures 1 year later. One-way repeated measures ANOVAs were used to compare findings pre-prayer, immediately following the six prayer sessions, and 1 month and again 1 year following prayer interventions.RESULTS: Evaluations post-prayer at 1 month and 1 year showed significantly less depression and anxiety, more optimism, and greater levels of spiritual experience than did the baseline (pre-prayer) measures (p < 0.01 in all cases).CONCLUSIONS: Subjects maintained significant improvements for a duration of at least 1 year after the final prayer session. Direct person-to-person prayer may be useful as an adjunct to standard medical care for patients with depression and anxiety. Further research in this area is indicated.OBJECTIVE: To investigate whether the effect of direct contact person-to-person prayer on depression, anxiety, and positive emotions is maintained after 1 year.","Boelens, P A; Reeves, R R; Replogle, W H; Koenig, H G",2012.0,10.2190/PM.43.1.f,0,0,
6099,Serotonin function in panic disorder: a double blind placebo controlled study with fluvoxamine and ritanserin,"ER In order to evaluate serotonin (5-HT) function in panic disorder, a double blind placebo controlled study was conducted with ritanserin, a specific 5-HT2 receptor antagonist, and fluvoxamine, a selective 5-HT reuptake inhibitor, in 60 patients with panic disorder. Patients were treated for 8 weeks with 150 mg fluvoxamine, 20 mg ritanserin or placebo; these dose levels were reached after 1 week. In addition, as an index of 5-HT function in panic disorder, plasma concentration of beta-endorphin, cortisol and 5-hydroxyindolacetic-acid (5-HIAA) were measured. Furthermore, 5-HT uptake in blood platelets was assessed. Noradrenergic function was assessed by measuring plasma MHPG concentration. In addition, plasma melatonin concentration was measured. Treatment with fluvoxamine resulted in a profound reduction in the number of panic attacks, followed by a decrease in avoidance behavior. Treatment with ritanserin appeared to be ineffective. During treatment no significant changes were observed in plasma concentrations of beta-endorphin, cortisol, 5-HIAA and MHPG. With respect to 5-HT kinetics in blood platelets, a substantial increase in Km was observed after treatment with fluvoxamine, whereas Vmax decreased. After treatment with fluvoxamine, plasma concentration of melatonin was significantly increased, which suggests that melatonin synthesis is in part under serotonergic control. The findings of the present study do not support the hypothesis that 5-HT2 receptors are supersensitive in patients suffering from panic disorder, but allow no conclusions about the involvement of other 5-HT receptor subtypes.","Boer, J A; Westenberg, H G",1990.0,,0,0,
6100,"The effects of alcohol, expectancy, and alcohol beliefs on anxiety and self-disclosure in women: do beliefs moderate alcohol effects?","ER This study investigates the effects of alcohol, expectancy, and alcohol-related beliefs on self-reported anxiety and self-disclosure behavior in a social interaction situation. Seventy-two female social drinkers were assigned to eight conditions in a 2 x 2 x 2 factorial balanced-placebo design, controlling for drink content, expectancy, and beliefs. Results show that alcohol expectancy resulted in an anxiety reduction in subjects who believed that alcohol has a positive influence on social behavior, whereas expectancy had no effect in subjects with negative alcohol beliefs. Furthermore, subjects who expected alcohol were less anxious when they had positive alcohol beliefs than when they had negative beliefs, whereas beliefs made no difference in subjects who expected tonic. Our results suggest that the effect of alcohol expectancy on social anxiety in women is moderated by differences in the content of their alcohol-related beliefs. We conclude that the inconsistency in previous results about the effect of alcohol expectancy on social behavior might be explained by differences in subjects' alcohol beliefs. Finally, as neither of the three factors had any effect on self-disclosure behavior, we suggest that this behavioral measure is unrelated to self-reported anxiety.","Boer, M C; Schippers, G M; Staak, C P",1994.0,,0,0,
6101,Evaluation of exposure with response-prevention for obsessive compulsive disorder in childhood and adolescence,"ER The present study was undertaken to estimate the effect of exposure plus response-prevention (E/RP), delivered alone intensively over 5-weeks and without concomitant pharmacotherapy, for children and adolescents with OCD. Twenty children and adolescents with OCD, not receiving medication for this condition, were randomized to E/RP or a wait-list condition. Statistically and clinically significant symptomatic improvement was found in the E/RP group compared with controls, with improvement maintained at follow-up an average of 14 weeks later. Effect size in the main intention-to-treat analysis was 1.23 and in the secondary per protocol analysis was 1.64. This study lends further support to the view that E/RP is an effective treatment for childhood OCD.","Bolton, D; Perrin, S",2008.0,10.1016/j.jbtep.2006.11.002,0,0,
6102,Randomized controlled trial of full and brief cognitive-behaviour therapy and wait-list for paediatric obsessive-compulsive disorder,"ER BACKGROUND: Reviews and practice guidelines for paediatric obsessive-compulsive disorder (OCD) recommend cognitive-behaviour therapy (CBT) as the psychological treatment of choice, but note that it has not been sufficiently evaluated for children and adolescents and that more randomized controlled trials are needed. The aim of this trial was to evaluate effectiveness and optimal delivery of CBT, emphasizing cognitive interventions.METHODS: A total of 96 children and adolescents with OCD were randomly allocated to the three conditions each of approximately 12 weeks duration: full CBT (average therapist contact: 12 sessions) and brief CBT (average contact: 5 sessions, with use of therapist-guided workbooks), and wait-list/delayed treatment. The primary outcome measure was the child version of the semi-structured interviewer-based Yale-Brown Obsessive Compulsive Scale. Clinical Trial registration: http://www.controlled-trials.com/ISRCTN/; unique identifier: ISRCTN29092580.RESULTS: There was statistically significant symptomatic improvement in both treatment groups compared with the wait-list group, with no significant differences in outcomes between the two treatment groups. Controlled treatment effect sizes in intention-to-treat analyses were 2.2 for full CBT and 1.6 for brief CBT. Improvements were maintained at follow-up an average of 14 weeks later.CONCLUSIONS: The findings demonstrate the benefits of CBT emphasizing cognitive interventions for children and adolescents with OCD and suggest that relatively lower therapist intensity delivery with use of therapist-guided workbooks is an efficient mode of delivery.","Bolton, D; Williams, T; Perrin, S; Atkinson, L; Gallop, C; Waite, P; Salkovskis, P",2011.0,10.1111/j.1469-7610.2011.02419.x,0,0,
6103,"Is youth victimization related to trauma symptoms and depression after controlling for prior symptoms and family relationships? A longitudinal, prospective study","ER The common finding linking symptoms such as posttraumatic stress disorder (PTSD) and depression with youth victimization (e.g., sexual abuse) might well be artifactual if preexisting psychopathology or disturbed family relationships create a common risk for both later victimization and later symptoms. This study used a longitudinal, prospective design to examine this issue. In a national random sample telephone survey, children 10 to 16 years old were interviewed and then reinterviewed approximately 15 months later about psychological problems, family relationships and victimization experiences that had occurred in the interim. Victimization in the interim was associated with PTSD-related symptoms and depression measured at Time 2, even after controlling for these symptoms and the quality of the parent-child relationship at Time 1. The association was particularly strong for sexual abuse, parental assault, and kidnapping experiences. However, these data also suggest that some of the apparent association found in cross-sectional studies between victimization and psychopathology may be due to prior psychopathology (but not parent-child relationship problems), which puts children at risk for both victimization and later symptoms.","Boney-McCoy, S; Finkelhor, D",1996.0,,0,0,
6104,"A randomized, double-blind, placebo-controlled study of classical homeopathy in generalized anxiety disorder","ER METHODForty-four patients with DSM-IV generalized anxiety disorder participated in a randomized, double-blind, placebo-controlled 10-week trial of individually tailored homeopathic remedy. Homeopathic therapy was administered by an expert who followed the traditional routines of homeopathic diagnosis and prescription. Thirty-nine subjects completed the study (20 in the active treatment group and 19 in the placebo group). Subjects' symptoms were rated before treatment and after 5 and 10 weeks of treatment, with the Hamilton Rating Scale for Anxiety (HAM-A) as main outcome measure. Additional measures of outcome included the Brief Symptom Inventory, the Psychological General Well-Being Index, the Hamilton Rating Scale for Depression, the Beck Depression Inventory, Spielberger's State-Trait Anxiety Inventory, and a Visual Analogue Scale of subjective distress.RESULTSSignificant (p <.05) improvement in most measures, including the HAM-A, was observed in both the active treatment and placebo groups, yet no group effect was observed.CONCLUSIONThe effect of homeopathic treatment on mental symptoms of patients with generalized anxiety disorder did not differ from that of placebo. The improvement in both conditions was substantial. Improvement of such magnitude may account for the current belief in the efficacy of homeopathy and the current increase in the use of this practice.BACKGROUNDHomeopathy is commonly used for the treatment of medical and psychological conditions. Such prevalent use, however, is not supported by robust, methodologically sound research. This study evaluates the effect of homeopathic treatment in generalized anxiety disorder, a prevalent mental disorder characterized by an enduring pattern of excessive apprehension and distress and by mental and bodily complaints.","Bonne, O; Shemer, Y; Gorali, Y; Katz, M; Shalev, A Y",2003.0,,0,0,
6105,Motor/vocal tics and compulsive behaviors on stimulant drugs: is there a common vulnerability?,"ER The occurrence of abnormal movements or perserverative/compulsive behaviors was noted in 34 (76%) of a group of 45 hyperactive boys during a double-blind crossover treatment trial of methylphenidate and dextroamphetamine given in a wide range of doses. These adverse effects were often subtle and transient, and they usually occurred only on one drug. There was only one case where treatment was discontinued due to the severity of the tic the subject developed during his initial treatment phase. Dextroamphetamine tended to produce more compulsive behaviors, which were also more likely to resemble clinical obsessive-compulsive disorder (OCD), than did methylphenidate. Abnormal movements and compulsive behaviors tended to co-occur on methylphenidate only; no general ""Tourette-OCD diathesis"" was found for this population.","Borcherding, B G; Keysor, C S; Rapoport, J L; Elia, J; Amass, J",1990.0,,0,0,
6106,Spiritual Care Training for Mothers of Children with Cancer: effects on Quality of Care and Mental Health of Caregivers,"ER MATERIALS AND METHODS: This study was a quasi-experimental study with pretest and posttest design consisting of a sample of 42 mothers of children diagnosed as having cancer. Participants were randomly assigned to either an experimental or a control group. The training package consisted of seven group training sessions offered in a children's hospital in Tehran. All mothers completed the Spirituality and Spiritual Care Rating Scale (SSCRS) and the Depression, Anxiety and Stress Scale (DASS-21) at pre and post test and after a three month follow up.RESULTS: There was significant difference between anxiety and spiritual, religious, Personalized care and total scores spiritual care between the intervention and control groups at follow-up (P<0.001).There was no statistically significant difference in stress and depression scores between the intervention and the control groups at follow-up.CONCLUSIONS: Findings show that spiritual care training program promotes spirituality, personalized care, religiosity and spiritual care as well as decreasing anxiety in mothers of children with cancer and decreases anxiety. It may be concluded that spiritual care training could be used effectively in reducing distressful spiritual challenges in mothers of children with cancer.BACKGROUND: The purpose of this study was to explore the effectiveness of a spiritual care training package in maternal caregivers of children with cancer.","Borjalilu, S; Shahidi, S; Mazaheri, M A; Emami, A H",2016.0,,0,0,
6107,Testosterone administration modulates neural responses to crying infants in young females,"ER Parental responsiveness to infant vocalizations is an essential mechanism to ensure parental care, and its importance is reflected in a specific neural substrate, the thalamocingulate circuit, which evolved through mammalian evolution subserving this responsiveness. Recent studies using functional Magnetic Resonance Imaging (fMRI) provide compelling evidence for a comparable mechanism in humans by showing thalamocingulate responses to infant crying. Furthermore, possibly acting on this common neural substrate, steroid hormones such as estradiol and testosterone, seem to mediate parental behavior both in humans and other animals. Estradiol unmistakably increases parental care, while data for testosterone are less unequivocal. In humans and several other animals, testosterone levels decrease both in mothers and fathers during parenthood. However, exogenous testosterone in mice seems to increase parenting, and infant crying leads to heightened testosterone levels in human males. Not only is the way in which testosterone is implicated in parental responsiveness unresolved, but the underlying mechanisms are fully unknown. Accordingly, using fMRI, we measured neural responses of 16 young women who were listening to crying infants in a double blind, placebo-controlled, counterbalanced, testosterone administration experiment. Crucially, heightened activation in the testosterone condition compared to placebo was shown in the thalamocingulate region, insula, and the cerebellum in response to crying. Our results by controlled hormonal manipulation confirm a role of the thalamocingulate circuit in infant cry perception. Furthermore, the data also suggest that exogenous testosterone, by itself or by way of its metabolite estradiol, in our group of young women acted on this thalamocinculate circuit to, provisionally, upregulate parental care.","Bos, P A; Hermans, E J; Montoya, E R; Ramsey, N F; Honk, J",2010.0,10.1016/j.psyneuen.2009.09.013,0,0,
6108,Multicenter randomized controlled trial of an outreach nursing support program for recently discharged stroke patients,"ER METHODSIn a multicenter trial, 536 stroke patients were randomized at discharge to standard care (n=273) or standard care plus outreach care (n=263). The outreach care consisted of 3 telephone calls and 1 home visit within 5 months after discharge by 1 of 13 stroke nurses. Patients were masked for the trial objectives. Six months after discharge, they assessed the 2 primary outcomes: quality of life (Short Form 36 [SF-36]) and dissatisfaction with care. Secondary measures of outcome were disability, handicap, depression, anxiety, and use of health care services and secondary prevention drugs. Informal carers assessed strain, and social support. Analysis was by intention to treat.RESULTSTwelve patients died before follow-up, 38 declined outcome assessment, and 486 completed the primary outcome assessments. Outreach care patients had better scores on the SF-36 domain ""Role Emotional"" than controls (mean difference 7.9 [95% confidence limit, 0.1 to 15.7]). No statistically significant differences were found on the other primary outcome measures. For secondary outcomes, no statistically significant differences were found, except that intervention patients used fewer rehabilitation services (relative risk, 0.66 [0.44 to 1.00]) and had lower anxiety scores (median difference 1 [0.19 to 2.79]).CONCLUSIONSThis outreach nursing stroke care was not effective in improving quality of life and dissatisfaction with care of recently discharged patients.BACKGROUND AND PURPOSEMany stroke patients and informal carers experience a decreased quality of life after discharge home and are dissatisfied with the care received. We assessed the effectiveness of an outreach nursing care program.","Boter, H",2004.0,10.1161/01.STR.0000147717.57531.e5,0,0,
6109,Prevention of alcohol misuse through the development of personal and social competence: a pilot study,"ER Seventh graders (N = 239) from two New York City junior high schools were involved in a 9-month study testing the efficacy of a broad-spectrum approach to prevention of alcohol misuse. The two schools were randomly assigned to experimental and control conditions. The seventh graders in the treatment school received a 20-session program targeted at the major cognitive, attitudinal, social and personality factors believed to promote the early stages of alcohol misuse. The program contained material on decision making, coping with anxiety, general social skills and assertiveness (including techniques for resisting peer pressure to drink) as well as information about the short- and long-term consequences of alcohol misuse. Complete pretest, posttest 1 and posttest 2 data were collected from 167 students (89 women). A significantly greater proportion of the students in the experimental group reported less frequent drinking (p less than .02), less drinking per occasion (p less than .04), and less frequent episodes of drunkenness (p less than .01) than the students in the control group.","Botvin, G J; Baker, E; Botvin, E M; Filazzola, A D; Millman, R B",1984.0,,0,0,
6110,Catamnesis of neuroses after 11 years of treatment with 3 different therapeutic programs,"ER A total of 266 of 331 neurotics included to controlled comparison of further course and outcome of three therapeutic and preventive programmes of different duration of the contact with therapeutic environment (full inpatient, day center and walk-in clinic treatment) was reexamined 11 years after inclusion to the core (N = 239) and verification (N = 92) study. Results of multivariate analysis of relations between the characteristic of the episode of inclusion and seven criteria of further course and outcome follow-up confirmed the previous (6 and 12 months' follow-up) statements of no relationship neither between the type of the programme, the patient has been randomly assigned to, nor between the duration of the contacts with the therapeutic environment and with further course and outcome of the neurosis. Personality characteristics seem to be more important that the actual neurotic symptomatology and potential predictor of course and outcome. Only hysterical and psychiasthenic syndrome proved to be related to the level of subjective worries and life dissatisfaction at time of the 11 years follow-up, but even these syndromes are usually claimed to be rather relatively stable pattern of personality reactions. Prevailing positive evaluation of the former programme by the followed-up patients provided the clinical workers with an unexpected satisfaction.","Bouchal, M; Skoda, C",1991.0,,0,0,
6111,Evaluation of a primary prevention program for anxiety disorders using story books with children aged 9-12 years,"ER UNLABELLED: This article reports the results of a study evaluating a book-supported primary prevention program ""Dominique's Handy Tricks"" for anxiety disorders in children aged 9-12 years. This cognitive-behavioural program is delivered using a combination of storybooks and workshop sessions. The originality of the program comes from the use of storybooks that were not developed specifically for anxiety management. Every session is based on a story describing characters facing common stressors and how they manage to cope with their daily problems. In our randomized control trial with 46 children, participation in the program led to a significant improvement in coping skills, perceived self-efficacy, anxiety sensitivity, as well as in symptoms of anxiety and fear. The theoretical and practical elements underlying the delivery of this primary prevention program are described.CONCLUSION: It is suggested that such an approach, without any labelling specific to anxiety disorders, can be useful in primary prevention programs.","Bouchard, S; Gervais, J; Gagnier, N; Loranger, C",2013.0,10.1007/s10935-013-0317-0,0,0,
6112,Attentional biases to pain and social threat in children with recurrent abdominal pain,"ER METHODSParticipants were 59 children with RAP who completed a computer-based attentional bias task. Participants and their parents also completed questionnaires measuring pain, somatic complaints, anxiety/depression, and body vigilance.RESULTSChildren with RAP showed attentional biases toward subliminal pain-related words and attentional biases away from supraliminal pain-related words. Participants' attentional biases to social threat-related words were marginally significant and also reflected subliminal attention and supraliminal avoidance. Attentional biases were related to parent and child reports of pain, body vigilance, and anxiety/depression.CONCLUSIONSChildren with RAP show nonconscious attention to and conscious avoidance of threat-related words. Their attentional biases relate to individual differences in symptom severity. Implications for models of pediatric pain and future studies are discussed.OBJECTIVESTo test whether children with recurrent abdominal pain (RAP) exhibit subliminal (nonconscious) and supraliminal (conscious) attentional biases to pain-related words, and to determine correlates of these biases. Previous research indicates that individuals attend to disorder-relevant threat words, and in this study, attentional biases to disorder-relevant threat (pain), alternative threat (social threat), and neutral words were compared.","Boyer, M C; Compas, B E; Stanger, C; Colletti, R B; Konik, B S; Morrow, S B; Thomsen, A H",2006.0,10.1093/jpepsy/jsj015,0,0,
6113,Microtensile dentin bond strength of self-etching resins: effect of a hydrophobic layer,"ER In this study, the microtensile bond strength of resin composites to dentin was determined when hydrophilic self-etching resins were used with and without an additional layer of a more hydrophobic adhesive. Included were three single-step self-etching adhesives, Adper Prompt L-Pop (3M ESPE), iBond GI (Heraeus Kulzer, Inc) and Xeno III (Caulk/Dentsply), and as a negative control, UniFil Bond (GC America), a self-etching primer with a separate adhesive. Each product was evaluated using a hybrid resin composite from its respective manufacturer, and each was used as directed and then used with an added layer of a more hydrophobic resin from its respective manufacturer. Testing was performed after 72 hours using a ""non-trimming"" microtensile test at a crosshead speed of 0.6 mm/minute. When the products were used according to manufacturers' directions, iBond had a significantly higher bond strength to dentin than the other three products (p<0.001), which were not significantly different from each other. For the three self-etching adhesive systems, the addition of a layer of a more hydrophobic resin produced significantly higher bond strengths to dentin (p<0.001), while no significant effect was found for the self-etching primer (p=0.40). A significant interaction was found between the variables product and adhesive treatment. The TEM evaluation of Prompt L-Pop and iBond demonstrated reduced nanoleakage with the additional resin layer.","Brackett, W W; Ito, S; Tay, F R; Haisch, L D; Pashley, D H",2005.0,,0,0,
6114,Effects of psychological therapy on pain behavior of rheumatoid arthritis patients. Treatment outcome and six-month followup,"ER A randomized clinical trial was performed to evaluate a psychological treatment intervention and a social support program, compared with a control program in which no adjunct treatment was rendered, and their effects upon pain behavior, affect, and disease activity of 53 patients with rheumatoid arthritis. The psychological intervention produced significant reductions in patients' pain behavior and disease activity at posttreatment. Significant reductions were also observed in trait anxiety at posttreatment and 6-month followup. Relaxation training may have been the most important component of the psychological intervention. The social support program produced a significant reduction in trait anxiety only at posttreatment. This is the first well-controlled study to demonstrate reduced pain behavior, disease activity, and trait anxiety following psychological treatment.","Bradley, L A; Young, L D; Anderson, K O; Turner, R A; Agudelo, C A; McDaniel, L K; Pisko, E J; Semble, E L; Morgan, T M",1987.0,,0,0,
6115,Group therapy for incarcerated women who experienced interpersonal violence: a pilot study,"ER This study evaluated effectiveness of group therapy for incarcerated women with histories of childhood sexual and/or physical abuse. The intervention was based on a two-stage model of trauma treatment and included Dialectical Behavior Therapy skills and writing assignments. We randomly assigned 24 participants to group treatment (13 completed) and 25 to a no-contact comparison condition (18 completed). We evaluated treatment effects, using the Beck Depression Inventory, Inventory of Interpersonal Problems, and Trauma Symptom Inventory. The data demonstrate significant reductions in PTSD, mood, and interpersonal symptoms in the treatment group.","Bradley, R G; Follingstad, D R",2003.0,10.1023/A:1024409817437,0,0,
6116,Enhanced sensitivity to cholecystokinin tetrapeptide in panic disorder. Clinical and behavioral findings,"ER We studied the action of cholecystokinin tetrapeptide (CCK-4) in patients with panic disorder and normal controls. Subjects received, in random order, one injection of CCK-4 and one injection of placebo (saline) on two separate days in a double-blind crossover design. Two doses of CCK-4, 50 and 25 micrograms, were administered to two different samples of subjects. The panic rate with 50 micrograms of CCK-4 was 100% (12/12) for patients and 47% (7/15) for controls. The panic rate with 25 micrograms of CCK-4 was 91% (10/11) for patients and 17% (2/12) for controls. Nine percent of patients compared with 0% of controls panicked with placebo. These findings concur with previous reports of a panicogenic effect of CCK-4 and suggest that patients with panic disorder are more sensitive to the panicogenic effect of the peptide than are normal controls.","Bradwejn, J; Koszycki, D; Shriqui, C",1991.0,,0,0,
6117,Anxiety and adherence to breast self-examination in women with a family history of breast cancer,"ER METHODSA sample of at-risk women (N=833) completed a questionnaire regarding BSE frequency, general anxiety, breast cancer worries, perceived risk of breast cancer, and family history of breast cancer. Women who self-examined infrequently (N=211), appropriately (N=462), or excessively (N=156) were compared on these variables.RESULTSStatistical analyses indicated that general anxiety differentiated only between excessive self-examiners and less frequent self-examiners, with excessive self-examiners reporting significantly higher general anxiety. Breast cancer worries differentiated between all three groups in a linear fashion, with increasing cancer worries associated with higher levels of BSE.CONCLUSIONSIn some at-risk women, high cancer anxiety may lead to high general anxiety and precipitate hypervigilant breast self-examination rather than avoidance. These findings are discussed in relation to psychoeducational interventions and genetic counseling services for women with a family history of breast cancer.OBJECTIVEPrevious research has indicated low rates of adherence to monthly breast self-examination (BSE) in women with a family history of breast cancer, and anxiety has been identified as a major factor that may interfere with regular self-examination. However, the direction of the relationship between anxiety and BSE frequency remains unclear, with some studies indicating that high anxiety promotes adherence and others indicating that it leads to avoidance. The aim of the present study was to clarify the relationship between anxiety and adherence to breast self-examination by comparing the impact of general anxiety with that of cancer-specific anxiety on BSE frequency.","Brain, K; Norman, P; Gray, J; Mansel, R",1999.0,,0,0,
6118,Influence of biased clinician statements on patient report of referred pain,"ER METHODSForty subjects with pain and who met specific inclusion criteria were randomly assigned to 1 of 2 experimental groups. One group was subjected to a standardized biasing statement, while the other group was not. Tender points in the masseter muscle were then stimulated with a pressure algometer to the pressure-pain threshold. Subjects then recorded the presence or absence, location, intensity, and unpleasantness of any referred pain. State-trait anxiety and social desirability were also assessed to explore the possibility that anxiety levels or subjects' desires to please the experimenter influenced results.RESULTSThe biased group reported increased presence (P  0.05).CONCLUSIONThese data suggest that patient reports of pain referral may be subject to clinician bias, and recommendations to control this bias are offered.AIMSThe purpose of this study was to examine the influence of clinician bias on patients' reports of referred pain. Diagnosis of temporomandibular disorders is dependent on subjective reports of pain and referred pain upon manual muscle palpation. The influence of biased clinician statements in such subjective reports has not been previously investigated.","Branch, M A; Carlson, C R; Okeson, J P",2000.0,,0,0,
6119,Core symptoms of posttraumatic stress disorder unimproved by alprazolam treatment,"ER The authors report a random-assignment, double-blind crossover trial comparing alprazolam and placebo in posttraumatic stress disorder (PTSD). Ten patients fulfilling DSM-III criteria for PTSD completed 5 weeks of treatment on each agent. Improvement in anxiety symptoms was significantly greater during alprazolam treatment but modest in extent. Symptoms specific to PTSD were not significantly altered. The impact of nonspecific symptomatic effects on the outcome of drug trials in PTSD is considered.","Braun, P; Greenberg, D; Dasberg, H; Lerer, B",1990.0,,0,0,
6120,Positron emission tomography measurement of cerebral metabolic correlates of yohimbine administration in combat-related posttraumatic stress disorder,"ER BACKGROUND: We have previously reported an increase in symptoms of anxiety in patients with posttraumatic stress disorder (PTSD) following administration of the beta 2-antagonist yohimbine, which stimulates brain norepinephrine release. Preclinical studies show decreased metabolism in the neocortex and the caudate nucleus with high-dose yohimbine-induced norepinephrine release, but low levels of norepinephrine release result in an increase in metabolism in these areas. METHODS: We used positron emission tomography and fludeoxyglucose F 18 to measure brain metabolism in Vietnam combat veterans with PTSD (n = 10) and healthy age-matched control subjects (n = 10), following administration of yohimbine (0.4 mg/kg) or placebo in a randomized, double-blind fashion. RESULTS: Yohimbine resulted in a significant increase in anxiety in the patients with PTSD, but not in healthy subjects. There was a significant difference in brain metabolic response to yohimbine in patients with PTSD compared with healthy subjects in prefrontal, temporal, parietal, and orbitofrontal cortexes. Metabolism tended to decrease in patients with PTSD and increase in healthy subjects following administration of yohimbine. CONCLUSION: These findings are consistent with our previous hypothesis of enhanced norepinephrine release in the brain with yohimbine in patients with PTSD.","Bremner, J D; Innis, R B; Ng, C K; Staib, L H; Salomon, R M; Bronen, R A; Duncan, J; Southwick, S M; Krystal, J H; Rich, D; Zubal, G; Dey, H; Soufer, R; Charney, D S",1997.0,,0,0,
6121,The role of intelligence in posttraumatic stress disorder: does it vary by trauma severity?,"ER BACKGROUND: Only a small minority of trauma victims develops post-traumatic stress disorder (PTSD), suggesting that victims vary in their predispositions to the PTSD response to stressors. It is assumed that the role of predispositions in PTSD varies by trauma severity: when stressors are less severe, predispositions play a bigger role. In this study, we test whether the role of intelligence in PTSD varies by trauma severity. Specifically, does low intelligence plays a bigger part among victims of lower magnitude stressors than among victims of extreme stressors?METHODS: Data come from a longitudinal study of randomly selected sample in Southeast Michigan (n?=?713). IQ was measured at age 6. PTSD was measured at age 17, using the NIMH-DIS for DSM-IV. Stressors were classified as extreme if they involved assaultive violence (e.g. rape, sexual assault, threatened with a weapon); other stressors in the list (e.g. disaster, accidents) were classified as lower magnitude. Assaultive violence victims had experienced assaultive violence plus other event types or only assaultive violence. Victims of other stressors were participants who had never experienced assaultive violence. We compared the influence of age 6 IQ on PTSD among persons exposed to assaultive violence vs. other stressors, using multinomial logistic regression.RESULTS: Relative risk ratio (RRR) for PTSD associated with a one point drop in age 6 IQ among victims of assaultive violence was 1.04 (95% CI 1.01, 1.06); among victims of other stressors, it was 1.03 (95% CI 0.99, 1.06). A comparison of the two RRRs indicates no significant difference between the two estimates (p?=?0.652). IQ does not play a bigger role in PTSD among victims of other stressors than it does among victims of assaultive violence.CONCLUSIONS: Lower IQ exerts an adverse PTSD effect on trauma victims, with no evidence of variability by the severity of trauma they have experienced.","Breslau, N; Chen, Q; Luo, Z",2013.0,10.1371/journal.pone.0065391,0,0,
6122,Long-term effects of very low-carbohydrate and high-carbohydrate weight-loss diets on psychological health in obese adults with type 2 diabetes: randomized controlled trial,"ER METHODS: One hundred and fifteen obese adults [age: 58.5 ± 7.1 years; body mass index: 34.6 ± 4.3 kg m(-2) ; HbA1c : 7.3 ± 1.1%] with T2DM were randomized to consume either an energy-restricted (~6 to 7 MJ), planned isocaloric LC or high-carbohydrate, low-fat (HC) diet, combined with a supervised exercise programme (3 days week(-1) ) for 1 year. Body weight, psychological mood state and well-being [Profile of Mood States (POMS), Beck Depression Inventory (BDI) and Spielberger State Anxiety Inventory (SAI)] and diabetes-specific emotional distress [Problem Areas in Diabetes (PAID) Questionnaire] and quality of life [QoL Diabetes-39 (D-39)] were assessed.RESULTS: Overall weight loss was 9.5 ± 0.5 kg (mean ± SE), with no difference between groups (P = 0.91 time × diet). Significant improvements occurred in BDI, POMS (total mood disturbance and the six subscales of anger-hostility, confusion-bewilderment, depression-dejection, fatigue-inertia, vigour-activity and tension-anxiety), PAID (total score) and the D-39 dimensions of diabetes control, anxiety and worry, sexual functioning and energy and mobility, P < 0.05 time. SAI and the D-39 dimension of social burden remained unchanged (P ? 0.08 time). Diet composition had no effect on the responses for the outcomes assessed (P ? 0.22 time × diet).CONCLUSION: In obese adults with T2DM, both diets achieved substantial weight loss and comparable improvements in QoL, mood state and affect. These results suggest that either an LC or HC diet within a lifestyle modification programme that includes exercise training improves psychological well-being.BACKGROUND/OBJECTIVE: Very low-carbohydrate, high-fat (LC) diets are used for type 2 diabetes (T2DM) management, but their effects on psychological health remain largely unknown. This study examined the long-term effects of an LC diet on psychological health.","Brinkworth, G D; Luscombe-Marsh, N D; Thompson, C H; Noakes, M; Buckley, J D; Wittert, G; Wilson, C J",2016.0,10.1111/joim.12501,0,0,
6123,Training-associated changes and stability of attention bias in youth: implications for Attention Bias Modification Treatment for pediatric anxiety,"ER Attention Bias Modification Treatment (ABMT), an emerging treatment for anxiety disorders, is thought to modify underlying, stable patterns of attention. Therefore, ABMT research should take into account the impact of attention bias stability on attention training response, especially in pediatric populations. ABMT research typically relies on the dot-probe task, where individuals detect a probe following an emotional-neutral stimulus pair. The current research presents two dot-probe experiments relevant to ABMT and attention-bias stability. In Experiment 1, anxious youth receiving 8-weeks of cognitive-behavioral therapy (CBT) were randomly assigned to ABMT that trains attention towards happy faces (n=18) or placebo (n=18). Two additional comparison groups, anxious youth receiving only CBT (n=17) and healthy comparison youth (n=16), were studied. Active attention training towards happy faces did not augment clinician-rated response to CBT; however, individuals receiving training exhibited reductions on self-report measures of anxiety earlier than individuals receiving CBT only. In Experiment 2, healthy youth (n=12) completed a dot-probe task twice while undergoing functional magnetic resonance imaging. Intra-class correlation demonstrated stability of neural activation in response to attention bias in the ventrolateral prefrontal cortex and amygdala. Together, these two studies investigate the ways in which attention-bias stability may impact future work on ABMT.","Britton, J C; Bar-Haim, Y; Clementi, M A; Sankin, L S; Chen, G; Shechner, T; Norcross, M A; Spiro, C N; Lindstrom, K M; Pine, D S",2013.0,10.1016/j.dcn.2012.11.001,0,0,
6124,"Relationship of service members' deployment trauma, PTSD symptoms, and experiential avoidance to postdeployment family reengagement","ER This research examined whether military service members' deployment-related trauma exposure, posttraumatic stress disorder (PTSD) symptoms, and experiential avoidance are associated with their observed levels of positive social engagement, social withdrawal, reactivity-coercion, and distress avoidance during postdeployment family interaction. Self reports of deployment related trauma, postdeployment PTSD symptoms, and experiential avoidance were collected from 184 men who were deployed to the Middle East conflicts, were partnered, and had a child between 4 and 13 years of age. Video samples of parent-child and partner problem solving and conversations about deployment issues were collected, and were rated by trained observers to assess service members' positive engagement, social withdrawal, reactivity-coercion, and distress avoidance, as well as spouse and child negative affect and behavior. Service members' experiential avoidance was reliably associated with less observed positive engagement and more observed withdrawal and distress avoidance after controlling for spouse and child negative affect and behavior during ongoing interaction. Service members' experiential avoidance also diminished significant associations between service members' PTSD symptoms and their observed behavior. The results are discussed in terms of how service members' psychological acceptance promotes family resilience and adaption to the multiple contextual challenges and role transitions associated with military deployment. Implications for parenting and marital interventions are described.","Brockman, C; Snyder, J; Gewirtz, A; Gird, S R; Quattlebaum, J; Schmidt, N; Pauldine, M R; Elish, K; Schrepferman, L; Hayes, C; Zettle, R; DeGarmo, D",2016.0,10.1037/fam0000152,0,0,
6125,Effects of a Single Bout of Aerobic Exercise Versus Resistance Training on Cognitive Vulnerabilities for Anxiety Disorders,"ER The purpose of this study was to compare the relative effects of a single bout of aerobic exercise versus resistance training on cognitive vulnerabilities for anxiety disorders. Seventy-seven participants (60% female; 84% Caucasian) were randomized to complete 20 min of moderate-intensity aerobic exercise, resistance training, or rest, followed by a 35% CO2/65% O2 inhalation challenge task. Results indicated that aerobic exercise and resistance training were significantly and equally effective in reducing anxiety sensitivity (AS) compared with rest ((?(2)(p ) = 52), though only aerobic exercise significantly attenuated reactivity to the CO2 challenge task. Neither form of exercise generated observable effects on distress tolerance, discomfort intolerance, or state anxiety (all ps >.10). The results of this study are discussed with regard to their implications for the use of exercise interventions for anxiety and related forms of psychopathology, and potential directions for future research are discussed.","Broman-Fulks, J J; Kelso, K; Zawilinski, L",2015.0,10.1080/16506073.2015.1020448,0,0,
6126,Effectiveness of an intervention to reduce sickness absence in patients with emotional distress or minor mental disorders: a randomized controlled effectiveness trial,"ER METHODIn a 1.5-year randomized controlled trial, 194 patients with minor mental disorders received either an experimental intervention by social workers or general practitioners' usual care. The intervention focused on understanding causes, developing and implementing problem-solving strategies and promoting early work resumption. Outcome measures were sick leave duration, mental health and physical health (questionnaires included the Hospital Anxiety and Depression Scale, the Four-Dimensional Symptom Questionnaire and SF-36), all measured at baseline at and 3, 6 and 18 months later. Multilevel analyses were used to evaluate differences between groups.RESULTSThe groups did not differ significantly on any of the outcome measures, except that the experimental group reported higher satisfaction with treatment.CONCLUSIONAlthough the intervention has benefits, it was not successful at its primary goal (i.e., to reduce sick leave duration in patients with emotional distress or minor mental disorders). Programs aimed at the reduction of sick leave duration may yield better results if targeted at patients with more severe emotional problems than at those with exclusively emotional distress or minor mental disorders, or if delivered by caregivers who are closer to the work environment than are social workers, such as occupational physicians.OBJECTIVEThe purpose of this study was to evaluate the effectiveness of an activating intervention designed to reduce sick leave duration in patients with emotional distress or minor mental disorders.","Brouwers, E P; Tiemens, B G; Terluin, B; Verhaak, P F",2006.0,10.1016/j.genhosppsych.2006.02.005,0,0,
6127,Factors associated with symptomatic improvement and recovery from major depression in primary care patients,"ER This article describes a post-hoc analysis of clinical and psychosocial factors and beliefs about health associated with treatment outcome in a sample of depressed primary care patients (N=181) randomly assigned to a standardized treatment or physician's usual care (UC). Different factors were found to predict clinical outcomes for treatment modality [UC vs. interpersonal psychotherapy (IPT) or nortriptyline (NT)] and the type of outcome evaluated (i.e., depressive symptoms at 8 months or symptomatic and functional recovery at 8 months). Factors associated with treatment-specific outcomes are also described. Consistent with prior studies, lower depressive symptom severity at 8 months was associated with higher baseline functioning, minimal medical co-morbidity, race, and standardized pharmacologic or psychotherapeutic treatment. Additionally, an interaction between treatment modality and health locus of control indicated that individuals perceiving more self-control of their health and who received a standardized treatment experienced greater depressive symptom reduction at 8 months. Factors associated with symptomatic and functional recovery from the depressive episode were also examined. Patients who received a standardized treatment (IPT or NT) perceived greater control of their health and lacked a lifetime generalized anxiety disorder or panic disorder were more likely to recover by month 8 than those who received usual care. While clinical severity and treatment adequacy play an important role in both symptomatic improvement and full recovery from a depressive episode, other key factors such as health beliefs and non-depressive psychopathology also influence recovery.","Brown, C; Schulberg, H C; Prigerson, H G",2000.0,,0,0,
6128,Impact of childhood abuse on the course of bipolar disorder: a replication study in U.S. veterans,"ER METHODSAs part of the VA Cooperative Study 430, ""Reducing the Efficacy-Effectiveness Gap in Bipolar Disorder,"" 330 veterans (91% male) with bipolar I or II disorder who were enrolled in a 3-year prospective study were examined for baseline data obtained at study entry. Diagnoses were determined by the use of the SCID. A semistructured interview designed to elicit data about exposure to childhood physical, sexual, or combined abuse was conducted as part of baseline demographic and clinical information. Other reports from this data set have not addressed the issues of childhood adversity.RESULTSChildhood abuse was reported by 48.3% of the subjects (47.3% of men). Any abuse (AA) was reported by 48.3%; sexual abuse without physical abuse (SA) was reported by 8%, physical abuse without sexual abuse (PA) by 20.7%, and both types of abuse (combined abuse, CA) by 18.7% of the male subjects. Female veterans reported more SA (27%) and less PA (6.7%). AA subjects were more likely to have current PTSD and lifetime diagnoses of panic disorder and alcohol use disorders. CA was associated with lower SF-36 Mental scores, higher likelihood of current PTSD and lifetime diagnoses of alcohol use disorders, as well as more lifetime episodes of major depression and higher likelihood of at least one suicide attempt. Younger age at study entry was associated with AA and PA.LIMITATIONSPotential limitations include generalizability beyond the male, veteran population of patients with bipolar disorder and the methodology used to elicit abuse histories.CONCLUSIONSSimilar to studies of predominantly female nonveteran samples, this study extends the finding that a history of childhood abuse acts as a disease course modifier in male veterans with bipolar disorder. Clinicians should routinely seek information regarding abuse and be aware that these patients may be more difficult to treat than bipolar patients who have no abuse histories.BACKGROUNDThe association between early childhood abuse and the course of illness, including psychiatric comorbidities, in adults with bipolar disorder has not been examined in a predominantly male or veteran population.","Brown, G R; McBride, L; Bauer, M S; Williford, W O",2005.0,10.1016/j.jad.2005.06.012,0,0,
6129,Assessing adolescent mindfulness: validation of an adapted Mindful Attention Awareness Scale in adolescent normative and psychiatric populations,"ER Interest in mindfulness-based interventions for children and adolescents is burgeoning, bringing with it the need for validated instruments to assess mindfulness in youths. The present studies were designed to validate among adolescents a measure of mindfulness previously validated for adults (e.g., Brown & Ryan, 2003), which we herein call the Mindful Attention Awareness Scale-Adolescent (MAAS-A). In 2 large samples of healthy 14- to 18-year-olds (N = 595), Study 1 supported a single-factor MAAS-A structure, along with acceptably high internal consistency, test-retest reliability, and both concurrent and incremental validity. In Study 2, with a sample of 102 psychiatric outpatient adolescents age 14-18 years, participants randomized to a mindfulness-based stress reduction intervention showed significant increases in MAAS-A scores from baseline to 3-month follow-up, relative to nonsignificant score changes among treatment-as-usual participants. Increases in MAAS-A scores among mindfulness-based stress reduction participants were significantly related to beneficial changes in numerous mental health indicators. The findings support the reliability and validity of the MAAS-A in normative and mixed psychiatric adolescent populations and suggest that the MAAS-A has utility in mindfulness intervention research.","Brown, K W; West, A M; Loverich, T M; Biegel, G M",2011.0,10.1037/a0021338,0,0,
6130,Childhood maltreatment and response to cognitive behavioral therapy among individuals with social anxiety disorder,"ER BACKGROUND: The association between childhood maltreatment-particularly emotional maltreatment-and social anxiety disorder (SAD) has been established by research. Only recently have researchers begun to look at the impact of childhood maltreatment on treatment outcomes, and findings have been mixed. Because prior studies have focused on pharmacotherapy outcomes, or used global measures of childhood adversity or abuse, it is not clear how specific types of maltreatment impact outcomes in cognitive-behavioral therapy (CBT) for SAD. The current study reports on how specific types of childhood maltreatment such as physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect impact response to CBT in adults with SAD.METHODS: Sixty-eight individuals with a primary diagnosis of SAD completed the childhood trauma questionnaire, along with measures of social anxiety, disability, and life satisfaction.RESULTS: Childhood maltreatment did not affect the rate of response to CBT, but there is evidence for its negative impact. Patients with histories of emotional abuse and emotional neglect reported greater social anxiety, less satisfaction, and greater disability over the course of treatment. Sexual abuse also predicted greater social anxiety.CONCLUSIONS: Childhood abuse and/or neglect did not result in differential rates of improvement during CBT; however, those reporting histories of emotional and sexual forms of maltreatment evidenced greater symptoms and/or impairment at pre- and posttreatment. Additional attention to the role of traumatic experiences within CBT for SAD may be warranted.","Bruce, L C; Heimberg, R G; Goldin, P R; Gross, J J",2013.0,10.1002/da.22112,0,0,
6131,Effectiveness of wraparound versus case management for children and adolescents: results of a randomized study,"ER In this study, we compared service experiences and outcomes for youths with serious emotional disorder (SED) randomly assigned to care coordination via a defined wraparound process (n = 47) versus more traditional intensive case management (ICM; n = 46) The wraparound group received more mean hours of care management and services; however, there ultimately were no group differences in restrictiveness of residential placement, emotional and behavioral symptoms, or functioning. Wraparound implementation fidelity was found to be poor. Organizational culture and climate, and worker morale, were poorer for the wraparound providers than the ICM group. Results suggest that, for less-impaired youths with SED, less intensive options such as ICM may be equally effective to poor-quality wraparound delivered in the absence of wraparound implementation supports and favorable system conditions.","Bruns, E J; Pullmann, M D; Sather, A; Denby, Brinson R; Ramey, M",2015.0,10.1007/s10488-014-0571-3,0,0,
6132,An experimental test of the effects of parental modeling on panic-relevant escape and avoidance among early adolescents,"ER Escape and avoidance behaviors play a prominent role in the maintenance and possibly development of panic disorder, yet the literature regarding the etiology of these emotion-regulation strategies is relatively underdeveloped. The current study experimentally tests hypotheses that parental modeling of escape during a well-established panic-relevant biological challenge increases panic-relevant escape and avoidance among offspring. Fifty physically and psychologically healthy early adolescents (28 females; Mage=11.58; 86% Caucasian), stratified by gender, were randomly assigned to observe one of their parents (39 females; Mage=40.04): either (a) model completing a 3-min voluntary hyperventilation exercise (no escape modeling group) or (b) model premature termination of a similar procedure (escape modeling group). Offspring in the escape modeling group demonstrated a stronger escape response by discontinuing their own challenge sooner than those in the no-escape modeling group (r=.70). No group differences emerged in terms of avoidance responding, as indexed by nearly identical responding in terms of delay time before initiating the challenge, respiration rate, and self-reported willingness to engage in a second proposed challenge. Results suggest that parental behaviors may play an important role in the development of some forms of panic-relevant responding. These preliminary findings may have important implications for future prevention programs targeting parents and at-risk youth.","Bunaciu, L; Leen-Feldner, E W; Blumenthal, H; Knapp, A A; Badour, C L; Feldner, M T",2014.0,10.1016/j.beth.2014.02.011,0,0,
6133,Predictors of health-care utilization of patients with Crohn's disease: results of a prospective randomized multicenter trial,"ER PATIENTS AND METHODSTherefore, data of 499 patients was collected over a 2-year period. A sample of 87 patients was taken and analyzed. Health-care utilization was measured as work disability days and hospital bed days. Sociodemographic, mental as well as somatic variables were used as possible predictors of health-care utilization.RESULTSIn a linear regression model with work disability days, the variables gender (b = 43.01; p = 0.032) and depressiveness (b = 2.949; p = 0.014) turned out to be significant (R(2) = 0.189). In a linear regression model with hospital bed days, the variables gender (b = 19.863; p = 0.006) and age (b = 0.785; p = 0.029) proved to be significant (R(2) = 0.114). No significant result was found for somatic variables such as severity of disease.CONCLUSIONPsychosocial variables such as depressiveness, gender and age have, therefore, a low but measurable impact on health-care utilization of patients with Crohn's disease. Increased consideration of these variables in clinical practice would not only improve the quality of life of these patients but also reduce health-care utilization.PURPOSEThe objective of the study was to identify predictors of health-care utilization in Crohn's disease.","Burgdorf, F; Schreyögg, J; Keller, W; Wietersheim, J; Deter, H C",2007.0,10.1007/s00063-007-1115-3,0,0,
6134,"Interactive effects of traits, states, and gender on cardiovascular reactivity during different situations","ER Interactive effects of anger and anxiety traits, negative affect state, different situations, and gender on cardiovascular reactivity (CVR) to stress were examined. Subjects (91 men, 92 women) performed a reaction time task under either a Social Evaluation, a Harassment, or a Control condition; SBP, DBP, and HR were recorded continuously. Hierarchical multiple regressions revealed intricate interactions. The interaction of anger expression style and anger experience was significant only among men, such that anger suppressors with high trait anger showed the largest CVR of any group during Harassment; anger expressors exhibited generally high CVR across conditions. However, anger expression style and state negative affect interacted to affect CVR in both men and women. Finally, the fear of negative evaluation predicted elevated DBP responses only among men in the Social Evaluation condition. Results imply that the extent to which traits of anger and anxiety contribute to coronary risk may depend on interactions with other traits, gender, and the environment.","Burns, J W",1995.0,,0,0,
6135,The Clinical Global Impressions scale: errors in understanding and use,"ER METHODForty-five principal investigators provided CGI-S and CGI-I ratings of narratives of patients with major depressive disorder or generalized anxiety disorder. Investigators were blindly randomized to receive narratives that either did (experimental) or did not (control) contain indication-unrelated medical or psychiatric adverse events. Investigators then completed a survey assessing CGI-S and CGI-I rating patterns.RESULTSCGI-S and CGI-I ratings were significantly more severe and less improved when the narratives contained medical and psychiatric adverse events unrelated to the diseases under study (major depressive disorder and generalized anxiety disorder) than when the narratives did not (Ps < .04). In response to the survey, 46% and 56% of investigators reported that a psychiatric adverse event unrelated to the disease under study would not affect their CGI-S and CGI-I ratings, respectively. Although 87% of investigators reported that their CGI-S and CGI-I ratings would not be affected by a medical adverse event, actual CGI-S ratings were significantly more severe when an unrelated medical adverse event was described as occurring than when it was not (P < .03).CONCLUSIONClinical trials investigators' inclusion of indication-irrelevant adverse events threatens the validity of the CGI as an efficacy measure and may contribute to failure to detect efficacy signals in psychopharmacology clinical trials.OBJECTIVEThe Clinical Global Impressions Severity and Improvement scales (CGI-S and CGI-I) are widely included as efficacy data in psychopharmacology new drug application submissions. This study was conducted to determine the extent to which clinical trials investigators included information unrelated to efficacy in their CGI ratings.","Busner, J; Targum, S D; Miller, D S",2009.0,10.1016/j.comppsych.2008.08.005,0,0,
6136,Associations between increases in plasma n-3 polyunsaturated fatty acids following supplementation and decreases in anger and anxiety in substance abusers,"ER METHODSubstance abusers (n=22) were assigned to either 3 g of n-3 PUFAs, mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) or soybean oil in identically looking capsules. The trial was double-blind, randomized and lasted 3 months. Anger and anxiety scales were administered at baseline and once a month thereafter. Blood samples were collected at baseline and at the end of the trial.RESULTSPatients' dietary intakes of n-3 PUFAs fell below recommended levels. Assignment to n-3 PUFA treatment was accompanied by significant decreases in anger and anxiety scores compared to placebo assignment. These changes were associated with increases in plasma levels of both EPA and DHA but an increase in EPA was more robustly correlated with low end-of-trial anxiety scores and an increase in DHA was more robustly correlated with low end-of-trial anger scores.CONCLUSIONThese pilot data indicate that ensuring adequate n-3 PUFA intake via supplementation benefits substance abusers by reducing their anger and anxiety levels. The strong correlations between an increase in plasma EPA and lower anxiety scores and between an increase in plasma DHA and lower anger scores suggests a need for the further exploration of the differential responses to these two n-3 PUFAs in different psychiatric conditions.OBJECTIVEMounting evidence indicates that low levels of n-3 polyunsaturated fatty acids (PUFAs) play a role in the pathophysiology of a large number of psychiatric disorders. In light of the suboptimal n-3 PUFAs intake due to poor dietary habits among substance abusers and the strong associations between aggression, anxiety and substance use disorders we examined if insurance of adequate intakes of n-3 PUFAs with supplementation would decrease their anger and anxiety scores.","Buydens-Branchey, L; Branchey, M; Hibbeln, J R",2008.0,10.1016/j.pnpbp.2007.10.020,0,0,
6137,Prazosin versus quetiapine for nighttime posttraumatic stress disorder symptoms in veterans: an assessment of long-term comparative effectiveness and safety,"ER Posttraumatic stress disorder (PTSD) is an anxiety disorder experienced by combat veterans. Nighttime symptoms are often unrelieved by selective serotonin reuptake inhibitor therapy, and increased use of prazosin or quetiapine for treatment is seen. The purpose of this study was to determine the short- and long-term effectiveness and safety of prazosin versus quetiapine for treating nighttime symptoms in veteran PTSD patients. This is a historical prospective cohort study using retrospective chart review. Three hundred twenty-four patients with a diagnosis of PTSD, based on International Classification of Diseases, Ninth Revision coding, who were initially prescribed prazosin or quetiapine for nighttime symptoms were screened for inclusion. Short-term effectiveness was determined by documentation of symptomatic improvement within 6 months, and long-term effectiveness if patients continued therapy to study end date. Safety was assessed by comparing incidence of adverse drug effects causing discontinuation of either study drug. This study included 237 patients: 62 received prazosin, and 175 received quetiapine. Short-term effectiveness was similar for prazosin (61.3%) and quetiapine (61.7%; P = 0.54). However, patients prescribed prazosin were significantly more likely to continue their therapy to study end date compared with quetiapine (48.4% vs 24%; P < 0.001; odds ratio, 3.0; 95% confidence interval, 1.62-5.45), thus achieving long-term effectiveness. Alternatively, patients in the quetiapine group were more likely to discontinue therapy because of adverse effects compared with the prazosin group (34.9% vs 17.7%; P = 0.008). Because of similar rate of short-term effectiveness, superior long-term effectiveness, and lower incidence of events leading to discontinuation, compared with quetiapine, prazosin should be used first-line for treating nighttime PTSD symptoms in a veteran population.","Byers, M G; Allison, K M; Wendel, C S; Lee, J K",2010.0,10.1097/JCP.0b013e3181dac52f,0,0,
6138,Use of complementary and alternative medicine in a large sample of anxiety patients,"ER OBJECTIVE: To examine a large sample of patients with anxiety and the association between types of complementary and alternative treatments that were used, demographic variables, diagnostic categories, and treatment outcomes.METHOD: Cross-sectional and longitudinal survey during the Coordinated Anxiety Learning and Management (CALM) study that assessed this intervention against the Usual Care in a sample of patients with anxiety recruited from primary care. Interviewer-administered questionnaires via a centralized telephone survey by blinded assessment raters. The interviews were done at baseline, 6, 12, and 18 months of the study. A total of 1004 adults ages 18-75 who met DSM-IV criteria for Generalized Anxiety Disorder (GAD), Panic Disorder, Social Anxiety Disorder, or Post-Traumatic Stress Disorder. We assessed medication/herbal use, the use of any alternative therapies, and combined Complementary and Alternative Medicine (CAM) use.RESULTS: We found an extensive (43%) use of a variety of CAM treatments that is consistent with previous study results in populations with anxiety. Only a few significant demographic or interventional characteristics of CAM users were found. Users most often had a diagnosis of GAD, were older, more educated, and had two or more chronic medical conditions. CAM users who had a 50% or more drop in anxiety scores over 18 months were less likely to report continued use of alternative therapies.CONCLUSIONS: The study confirms the importance of awareness of CAM use in this population for possible interference with traditional first-line treatments of these disorders, but also for finding the best integrative use for patients who require multiple treatment modalities.","Bystritsky, A; Hovav, S; Sherbourne, C; Stein, M B; Rose, R D; Campbell-Sills, L; Golinelli, D; Sullivan, G; Craske, M G; Roy-Byrne, P P",2012.0,10.1016/j.psym.2011.11.009,0,0,
6139,The 35% CO2 challenge test in patients with social phobia,"ER Panic disorder (PD) and social phobia (SP) share many clinical, demographic and biological characteristics. To investigate the relationships between the two disorders, the responses to inhalation of a 35% carbon-dioxide (CO2) and 65% oxygen (O2) gas mixture were assessed. Sixteen patients with PD, 16 patients with SP, 13 patients with both SP and PD, seven patients with SP who experienced sporadic unexpected panic attacks and 16 healthy control subjects inhaled one vital capacity of 35% CO2 or compressed air. A double-blind, randomized, crossover design was used. PD patients and SP patients showed similar anxiogenic reactions to 35% CO2, both stronger than seen in control subjects. Patients with both disorders and SP patients with sporadic unexpected panic attacks reacted similarly to subjects with PD or SP alone. These results suggest that PD and SP share a common hypersensitivity to CO2 and thus might belong to the same spectrum of vulnerability.","Caldirola, D; Perna, G; Arancio, C; Bertani, A; Bellodi, L",1997.0,,0,0,
6140,Cluster randomised controlled trial of the e-couch Anxiety and Worry program in schools,"ER METHODSA three-arm cluster stratified randomised controlled trial was conducted with 30 Australian schools. Each school was randomly assigned to receive: (1) externally-supported intervention, (2) teacher-supported intervention, or (3) wait-list control. All consenting students (N=1767) were invited to complete pre-intervention, post-intervention, 6- and 12-month follow-up questionnaires measuring generalised anxiety, social anxiety, anxiety sensitivity, depressive symptoms and mental wellbeing. Intervention participants completed the e-couch Anxiety and Worry program over 6 weeks.RESULTSAt post-intervention, 6- and 12-month follow-up no significant differences were observed between the intervention and control conditions for generalised anxiety (Cohen's d=-0.14 to 0.15), social anxiety (d=0.04-0.23), anxiety sensitivity (d=-0.07 to 0.07), depressive symptoms (d=-0.05 to 0.04) or mental wellbeing (d=-0.06 to -0.30).LIMITATIONSThe current study only included self-report measures that may have been influenced by situational factors or biases.CONCLUSIONSThe e-couch Anxiety and Worry program did not have a significant positive effect on participant mental health or wellbeing. The addition of a mental health education officer to support classroom teachers in the delivery of the program also had no effect on intervention outcomes. Future prevention research should look to develop briefer and more interactive interventions that are more engaging for youth.BACKGROUNDAnxiety is a common mental health problem in youth. The current study aimed to test the effectiveness of an online self-directed anxiety prevention program in a school-based sample and to compare two methods of implementing an anxiety program in schools.","Calear, A L; Batterham, P J; Poyser, C T; Mackinnon, A J; Griffiths, K M; Christensen, H",2016.0,10.1016/j.jad.2016.02.049,0,0,
6141,Adherence to the MoodGYM program: outcomes and predictors for an adolescent school-based population,"ER BACKGROUND: Program adherence has been associated with improved intervention outcomes for mental and physical conditions. The aim of the current study is to investigate adolescent adherence to an Internet-based depression prevention program in schools to identify the effect of adherence on outcomes and to ascertain the predictors of program adherence.METHODS: Data for the current study (N=1477) was drawn from the YouthMood Project, which was conducted to test the effectiveness of the MoodGYM program in reducing and preventing symptoms of anxiety and depression in an adolescent school-based population. The current study compares intervention effects across three sub-groups: high adherers, low adherers and the wait-list control condition.RESULTS: When compared to the control condition, participants in the high adherence intervention group reported stronger intervention effects at post-intervention and 6-month follow-up than participants in the low adherence group for anxiety (d=0.34-0.39 vs. 0.11-0.22), and male (d=0.43-0.59 vs. 0.26-0.35) and female depression (d=0.13-0.20 vs. 0.02-0.04). No significant intervention effects were identified between the high and low adherence groups. Being in Year 9, living in a rural location and having higher pre-intervention levels of depressive symptoms or self-esteem were predictive of greater adherence to the MoodGYM program.LIMITATIONS: The program trialled is Internet-based and therefore the predictors of adherence identified may not generalise to face-to-face interventions.CONCLUSIONS: The current study provides preliminary support for the positive relationship between program adherence and outcomes in a school environment. The identification of significant predictors of adherence will assist in identifying the type of user who will engage most with an online depression prevention program.","Calear, A L; Christensen, H; Mackinnon, A; Griffiths, K M",2013.0,10.1016/j.jad.2012.11.036,0,0,
6142,An assessment of radiotelemetry in the monitoring of labour,"ER Conventional and telemetric monitoring of labour were compared in a randomized study of 200 patients to assess the effect on the pattern of labour, outcome and attitude of the patients. All the telemetry patients had the option of mobility, but only 45% elected to get out of bed, and then often only for short periods. No clear physical benefits accrued from voluntary mobility. Ambulant patients who had spontaneous deliveries had a longer second stage and more of their babies were slow to establish regular respiration. Quantitative subjective assessments of pain, anxiety and comfort were made. Primigravidae with telemetric monitoring who chose to get out of bed had higher pain scores than primigravidae monitored conventionally, but anxiety scores were highest among primigravidae with telemetry who elected to stay in bed. There was a significant bias towards increased anxiety in the lower social classes. Primigravidae gained more reassurance from monitoring than did multigravidae, but there were no differences resulting from whether or not the recording apparatus was within the patients' view. Multigravidae who had experienced both forms of monitoring preferred telemetry because they felt less restricted and less anxious.","Calvert, J P; Newcombe, R G; Hibbard, B M",1982.0,,0,0,
6143,Impact of desipramine or carbamazepine on patient retention in outpatient cocaine treatment: preliminary findings,"ER This is a preliminary report of a double-blind comparison of desipramine or carbamazepine to placebo among subjects participating in an outpatient cocaine treatment program. Sixty-five subjects were randomly assigned to one of the active drugs or placebo and followed until treatment completion or drop-out to determine if either drug enhanced retention in treatment and/or increased cocaine abstinence. There was no significant difference between carbamazepine or desipramine and placebo on either outcome measure in this preliminary analysis. While this is a preliminary report and does not take into account the heterogeneity of the patients in cocaine treatment, the results are consistent with those of other investigators and suggest that use of desipramine or carbamazepine may not offer any advantage in retaining cocaine-dependent patients in treatment.","Campbell, J L; Thomas, H M; Gabrielli, W; Liskow, B I; Powell, B J",1994.0,,0,0,
6144,Social competence promotion with inner-city and suburban young adolescents: effects on social adjustment and alcohol use,"ER This study assessed the impact of school-based social competence training on skills, social adjustment, and self-reported substance use of 282 sixth and seventh graders. Training emphasized broad-based competence promotion in conjunction with domain-specific application to substance abuse prevention. The 20-session program comprised six units: stress management, self-esteem, problem solving, substances and health information, assertiveness, and social networks. Findings indicated positive training effects on Ss' skills in handling interpersonal problems and coping with anxiety. Teacher ratings revealed improvements in Ss' constructive conflict resolution with peers, impulse control, and popularity. Self-report ratings indicated gains in problem-solving efficacy. Results suggest some preventive impact on self-reported substance use intentions and excessive alcohol use. In general, the program was found to be beneficial for both inner-city and suburban students.","Caplan, M; Weissberg, R P; Grober, J S; Sivo, P J; Grady, K; Jacoby, C",1992.0,,0,0,
6145,Defining treatment response and remission in child anxiety: signal detection analysis using the pediatric anxiety rating scale,"ER METHOD: Data were from a subset of youth (N = 438; 7-17 years of age) who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS), a multi-site, randomized controlled trial that examined the relative efficacy of cognitive-behavioral therapy (CBT; Coping Cat), medication (sertraline [SRT]), their combination, and pill placebo for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. The clinician-rated PARS was administered pre- and posttreatment (delivered over 12 weeks). Quality receiver operating characteristic methods assessed the performance of various PARS percent reductions and absolute cut-off scores in predicting treatment response and remission, as determined by posttreatment ratings on the Clinical Global Impression scales and the Anxiety Disorders Interview Schedule for DSM-IV. Corresponding change in impairment was evaluated using the Child Anxiety Impact Scale.RESULTS: Reductions of 35% and 50% on the six-item PARS optimally predicted treatment response and remission, respectively. Post-treatment PARS raw scores of 8 to 10 optimally predicted remission. Anxiety improved as a function of PARS-defined treatment response and remission.CONCLUSIONS: Results serve as guidelines for operationalizing treatment response and remission in future research and in making cross-study comparisons. These guidelines can facilitate translation of research findings into clinical practice.OBJECTIVE: To determine optimal Pediatric Anxiety Rating Scale (PARS) percent reduction and raw score cut-offs for predicting treatment response and remission among children and adolescents with anxiety disorders.","Caporino, N E; Brodman, D M; Kendall, P C; Albano, A M; Sherrill, J; Piacentini, J; Sakolsky, D; Birmaher, B; Compton, S N; Ginsburg, G; Rynn, M; McCracken, J; Gosch, E; Keeton, C; March, J; Walkup, J T",2013.0,10.1016/j.jaac.2012.10.006,0,0,
6146,A randomized controlled trial to test an HIV-prevention intervention for Latino gay and bisexual men: lessons learned,"ER At the time of this writing, no randomized controlled trial (RCT) of an intervention to reduce unsafe sex among Latino gay and bisexual men (LGBM) had been published. We report the results of an RCT conducted in New York City in which 180 LGBM were assigned either to an intervention developed specifically for this population or to a wait-list control group. The intervention was based on empowerment theory and used factors identified in prior research as determinants of unsafe sex. By eligibility criteria, all men had engaged in unprotected anal intercourse (UAI) within two months of the baseline assessment. At first (two months) and second (six months later) follow-up assessments, approximately half of the men in the experimental group reported no UAI. Yet, a similar proportion of the control group also reported no UAI. Baseline data indicate that although the men had been the subject of social oppression and sexual prejudice (homophobia), they did not feel disempowered, externally controlled or fatalistic, and they reported self-efficacy and intentionality to enact safer sex. Lessons learned are discussed, as well as notes of caution for future research employing a similar conceptual framework.","Carballo-Diéguez, A; Dolezal, C; Leu, C S; Nieves, L; Díaz, F; Decena, C; Balan, I",2005.0,10.1080/09540120512331314303,0,0,
6147,Osmophobia in migraine classification: a multicentre study in juvenile patients,"ER METHODSWe analysed 1020 patients presenting at 10 Italian juvenile headache centres, 622 affected by migraine (M) and 328 by tension-type headache (TTH); 70 were affected by headache not elsewhere classified (NEC) in ICHD-II. By using a semi-structured questionnaire, the prevalence of osmophobia was 26.9%, significantly higher in M than TTH patients (34.6% vs 14.3%).RESULTSOsmophobia was correlated with: (i) family history of M and osmophobia; and (ii) other accompanying symptoms of M. By applying these 'new' criteria, we found an agreement with the current criteria for the diagnosis of migraine without aura (MO) in 96.2% of cases; 54.3% of previously unclassifiable patients received a 'new' diagnosis.CONCLUSIONSIn conclusion, this study demonstrates that this new approach, proposed in the Appendix (A1.1), appears easy to apply and should improve the diagnostic standard of ICHD-II in young patients too.AIMSThis study was planned to investigate the diagnostic utility of osmophobia as criterion for migraine without aura (MO) as proposed in the Appendix (A1.1) of the International Classification of Headache Disorders (ICHD-II, 2004).","Carlo, D; Dal, Zotto L; Perissinotto, E; Gallo, L; Gatta, M; Balottin, U; Mazzotta, G; Moscato, D; Raieli, V; Rossi, L N; Sangermani, R; Soriani, S; Termine, C; Tozzi, E; Vecchio, A; Zanchin, G; Battistella, P A",2010.0,10.1177/0333102410362928,0,0,
6148,Changes in ratings of caregiver burden following a community-based behavior management program for persons with traumatic brain injury,"ER DESIGNA control group was compared with an education only and education plus behavior management group with random assignment to conditions.PARTICIPANTSTotal number of participants was 27 persons with brain injury and their caregivers.MAIN OUTCOME MEASURESDependent measures were subscales of the Questionnaire on Resources and Stress (QRS) and an adapted version of the Maslach Burnout Inventory (MBI).RESULTSAn analysis of covariance adjusting for baseline burden and stress ratings showed no significant change in these measures associated with treatment.CONCLUSIONSThe results are discussed in terms of the potential modifiability of caregiver burden, the small sample size, and the sensitivity of current measures of caregiver stress and burden to detect clinically meaningful change.OBJECTIVEThis study examines the use of a community-delivered behavior management program for persons with traumatic brain injury and their caregivers and its effect on reduction of ratings of caregiver burden.","Carnevale, G J; Anselmi, V; Busichio, K; Millis, S R",2002.0,,0,0,
6149,Effects of an exercise programme on anxiety in adults with intellectual disabilities,"ER Although high anxiety is common in people with intellectual disabilities (ID) and the anxiolytic effects of exercise have been systematically recognised in clinical and non-clinical populations, research is scant concerning the role played by exercise on anxiety in people with ID. The purpose of this study was to investigate the effects of a 12-week exercise programme on anxiety states in a group of adults with ID. Twenty-seven individuals with mild to moderate ID were randomly assigned to an exercise group or a control group. The Zung Self-Rating Anxiety Scale adapted for individuals with ID and the State-Trait Anxiety Inventory form Y were used to assess trait and state anxiety. In comparison with the control group, the anxiety scores of people in the exercise group decreased significantly over time.","Carraro, A; Gobbi, E",2012.0,10.1016/j.ridd.2012.02.014,0,0,
6150,Cue-centered treatment for youth exposed to interpersonal violence: a randomized controlled trial,"ER This study provides preliminary evidence of the feasibility and efficacy of the Stanford cue-centered treatment for reducing posttraumatic stress, depression, and anxiety in children chronically exposed to violence. Sixty-five youth aged 8?17 years were recruited from 13 schools. Participants were randomly assigned to cue-centered treatment or a waitlist control group. Assessments were conducted at 4 discrete time points. Self-report measures assessed youth symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression.Self-report ratings of caregiver anxiety and depression as well as caregiver report of child PTSD were also obtained. Therapists evaluated participants? overall symptom improvement across treatment sessions. Hierarchal linear modeling analyses showed that compared to the waitlist group, the cue-centered treatment group had greater reductions in PTSD symptoms both by caregiver and child report, as well as caregiver anxiety. Cue-centered treatment, a hybrid trauma intervention merging diverse theoretical approaches, demonstrated feasibility,adherence, and efficacy in treating youth with a history of interpersonal violence.","Carrion, V G; Kletter, H; Weems, C F; Berry, R R; Rettger, J P",2013.0,,0,0,
6151,A new parenting-based group intervention for young anxious children: results of a randomized controlled trial,"ER METHODFamilies of 74 anxious children (aged 9 years or less) took part in a randomized controlled trial, which compared the new 10-session, group-format intervention with a wait-list control condition. Outcome measures included blinded diagnostic interview and self-reports from parents and children.RESULTSIntention-to-treat analyses indicated that children whose parent(s) received the intervention were significantly less anxious at the end of the study than those in the control condition. Specifically, 57% of those receiving the new intervention were free of their primary disorder, compared with 15% in the control condition. Moreover, 32% of treated children were free of any anxiety diagnosis at the end of the treatment period, compared with 6% of those in the control group. Treatment gains were maintained at 12-month follow-up.CONCLUSIONSThis new parenting-based intervention may represent an advance in the treatment of this previously neglected group.OBJECTIVEDespite recent advances, there are still no interventions that have been developed for the specific treatment of young children who have anxiety disorders. This study examined the impact of a new, cognitive-behaviorally based parenting intervention on anxiety symptoms.","Cartwright-Hatton, S; McNally, D; Field, A P; Rust, S; Laskey, B; Dixon, C; Gallagher, B; Harrington, R; Miller, C; Pemberton, K; Symes, W; White, C; Woodham, A",2011.0,10.1016/j.jaac.2010.12.015,0,0,
6152,Use of a preanesthetic video for facilitation of parental education and anxiolysis before pediatric ambulatory surgery,"ER IMPLICATIONSIn this study, we demonstrated the benefits of viewing an educational videotape about pediatric anesthesia on measures of parental knowledge of anesthesia and preoperative anxiety using a randomized, controlled design. We found that videotape viewing facilitated preoperative preparation and lessened preoperative anxiety.UNLABELLEDIn this study, we evaluated the effects of viewing an educational videotape about pediatric anesthesia on measures of parental knowledge of anesthesia and preoperative anxiety using a randomized, controlled design. During their routine preoperative visit, 85 parents of children scheduled to undergo ambulatory surgical procedures under general anesthesia were randomized to view either the experimental videotape about pediatric anesthesia or a control videotape with no medical content. Before and immediately after viewing the assigned videotape, parents completed measures of situational anxiety (State-Trait Anxiety Inventory-State), preoperative anxiety and need for information (Amsterdam Preoperative Anxiety and Information Scale), and anesthesia knowledge (Standard Anesthesia Learning Test). Repeated-measures analyses of variance showed that parents who viewed the experimental videotape showed a significant increase in anesthesia knowledge (P < 0.022) and a significant reduction in their state of anxiety (P < 0.031), anesthesia-specific anxiety, and need for information (P < 0.0001) compared with the control group. These results demonstrated that viewing a preoperative educational videotape about pediatric anesthesia can provide immediate educational and anxiolytic benefits for parents of children undergoing ambulatory surgery. The duration of these benefits remains to be determined.","Cassady, J F; Wysocki, T T; Miller, K M; Cancel, D D; Izenberg, N",1999.0,,0,0,
6153,The influence of maternal infant feeding practices and beliefs on the expression of food neophobia in toddlers,"ER Food neophobia is a highly heritable trait characterized by the rejection of foods that are novel or unknown and potentially limits dietary variety, with lower intake and preference particularly for fruits and vegetables. Understanding non-genetic (environmental) factors that may influence the expression of food neophobia is essential to improving children's consumption of fruits and vegetables and encouraging the adoption of healthier diets. The aim of this study was to examine whether maternal infant feeding beliefs (at 4 months) were associated with the expression of food neophobia in toddlers and whether controlling feeding practices mediated this relationship. Participants were 244 first-time mothers (M=30.4, SD=5.1 years) allocated to the control group of the NOURISH randomized controlled trial. The relationships between infant feeding beliefs (Infant Feeding Questionnaire) at 4 months and controlling child feeding practices (Child Feeding Questionnaire) and food neophobia (Child Food Neophobia Scale) at 24 months were tested using correlational and multiple linear regression models (adjusted for significant covariates). Higher maternal Concern about infant under-eating and becoming underweight at 4 months was associated with higher child food neophobia at 2 years. Similarly, lower Awareness of infant hunger and satiety cues was associated with higher child food neophobia. Both associations were significantly mediated by mothers' use of Pressure to eat. Intervening early to promote positive feeding practices to mothers may help reduce the use of controlling practices as children develop. Further research that can further elucidate the bi-directional nature of the mother-child feeding relationship is still required.","Cassells, E L; Magarey, A M; Daniels, L A; Mallan, K M",2014.0,10.1016/j.appet.2014.07.001,0,0,
6154,Benefits of Craniosacral Therapy in Patients with Chronic Low Back Pain: a Randomized Controlled Trial,"ER DESIGN: A single-blinded randomized controlled trial.PATIENTS: Sixty-four patients with chronic nonspecific low back pain (mean age?±?SD, 50?±?12 years; 66% female) who were referred for physical therapy at a clinical unit of the Health Science School of the University of Almeria (Spain).INTERVENTIONS: Participants were randomly assigned to an experimental group (10 sessions of craniosacral therapy) or a control group (10 sessions of classic massage).OUTCOME MEASURES: Disability (Roland Morris Disability Questionnaire [RMQ, primary outcome] and Oswestry Disability Index), pain intensity (10-point numeric pain rating scale), kinesiophobia (Tampa Scale of Kinesiophobia), isometric endurance of trunk flexor muscles (McQuade test), lumbar mobility in flexion, hemoglobin oxygen saturation, systolic blood pressure, diastolic blood pressure, hemodynamic measures (cardiac index), and biochemical estimation of interstitial fluid. These outcomes were registered at baseline, after treatment, and 1-month follow-up.RESULTS: No statistically significant differences were seen between groups for the main outcome of the study, the RMQ (p?=?0.060). However, patients receiving craniosacral therapy experienced greater improvement in pain intensity (p???0.008), hemoglobin oxygen saturation (p???0.028), and systolic blood pressure (p???0.029) at immediate- and medium-term and serum potassium (p?=?0.023) level and magnesium (p?=?0.012) at short-term than those receiving classic massage.CONCLUSIONS: Ten sessions of craniosacral therapy resulted in a statistically greater improvement in pain intensity, hemoglobin oxygen saturation, systolic blood pressure, serum potassium, and magnesium level than did 10 sessions of classic massage in patients with low back pain.OBJECTIVES: To evaluate the effects of craniosacral therapy on disability, pain intensity, quality of life, and mobility in patients with low back pain.","Castro-Sánchez, A M; Lara-Palomo, I C; Matarán-Peñarrocha, G A; Saavedra-Hernández, M; Pérez-Mármol, J M; Aguilar-Ferrándiz, M E",2016.0,10.1089/acm.2016.0068,0,0,
6155,Treating children traumatized by war and Tsunami: a comparison between exposure therapy and meditation-relaxation in North-East Sri Lanka,"ER METHODS: A randomized treatment comparison was implemented in a refugee camp in a severely affected community. 31 children who presented with a preliminary diagnosis of PTSD were randomly assigned either to six sessions Narrative Exposure Therapy for children (KIDNET) or six sessions of meditation-relaxation (MED-RELAX). Outcome measures included severity of PTSD symptoms, level of functioning and physical health.RESULTS: In both treatment conditions, PTSD symptoms and impairment in functioning were significantly reduced at one month post-test and remained stable over time. At 6 months follow-up, recovery rates were 81% for the children in the KIDNET group and 71% for those in the MED-RELAX group. There was no significant difference between the two therapy groups in any outcome measure.CONCLUSION: As recovery rates in the treatment groups exceeded the expected rates of natural recovery, the study provides preliminary evidence for the effectiveness of NET as well as meditation-relaxation techniques when carried out by trained local counselors for the treatment of PTSD in children in the direct aftermath of mass disasters.TRIAL REGISTRATION: ClinicalTrials.gov Identifier:NCT00820391.BACKGROUND: The North-Eastern part of Sri Lanka had already been affected by civil war when the 2004 Tsunami wave hit the region, leading to high rates of posttraumatic stress disorder (PTSD) in children. In the acute aftermath of the Tsunami we tested the efficacy of two pragmatic short-term interventions when applied by trained local counselors.","Catani, C; Kohiladevy, M; Ruf, M; Schauer, E; Elbert, T; Neuner, F",2009.0,10.1186/1471-244X-9-22,0,0,
6156,Treatment of traumagenic beliefs among sexually abused girls and their mothers: an evaluation study,"ER The objective of this study was to evaluate and compare the efficacy of two short-term individual therapy interventions for sexually abused girls and their nonoffending female caretakers. Thirty-two girls, ages 8 to 13, and their caretakers from primarily low-income, African-American families were randomly assigned to a theoretically based, structured experimental treatment program or to a relatively unstructured comparison intervention. Measures of child outcome were completed before and after the treatment program by each parent and child, and by a clinician blind to treatment condition. Pre- and postmeasures of maternal outcome were completed by the caretaker and a clinician not involved in the treatment. Both treatment programs yielded decreases in children's posttraumatic stress disorder symptoms and traumagenic beliefs reflecting self-blame and powerlessness, and increases in children's overall psychosocial functioning. The experimental intervention was more effective than the comparison program in increasing abuse-related caretaker support of the child and in decreasing caretaker self-blame and expectations of undue negative impact of the abuse on the child. Clinical implications of these findings include the development of interventions targeting sexually abused children's traumagenic beliefs and nonoffending parents' support of their victimized children.","Celano, M; Hazzard, A; Webb, C; McCall, C",1996.0,,0,0,
6157,Measuring disability in patients with chronic fatigue syndrome: reliability and validity of the Work and Social Adjustment Scale,"ER METHODSData from two samples of patients were used, one from a multicenter randomized controlled clinical trial of treatments for CFS (n =639) and the other from a clinic that specializes in CFS (n=384). All patients completed the WSAS as well as other measures.RESULTSInternal consistency and the Spearman-Brown split-half coefficient values indicated that the scale is reliable. CFS patients who had comorbid diagnoses of depression, anxiety or fibromyalgia had higher WSAS scores. High levels of disability were associated with high number of physical symptoms, severe fatigue, depression, anxiety, poor sleep quality and poor physical fitness, with correlation coefficients ranging between 0.41 and 0.11. Lower scores on the WSAS were modestly associated with better physical functioning as well as higher levels of physical capacity as assessed by a walking test. Sensitivity to change was evaluated in a subgroup of patients who had undergone a course of cognitive behavioral therapy. Disability significantly decreased after therapy and remained stable at follow-ups.CONCLUSIONThe WSAS is a reliable and valid assessment tool for disability in patients with CFS.BACKGROUNDDisability is a defining feature of chronic conditions, and it is an increasingly used measure of therapy effectiveness. The Work and Social Adjustment Scale (WSAS) is a simple and clear measure of disability. Although the scale is widely used, no study has yet investigated its psychometric properties in patients with chronic fatigue syndrome (CFS).","Cella, M; Sharpe, M; Chalder, T",2011.0,10.1016/j.jpsychores.2011.02.009,0,0,
6158,"Guided self-help as intervention for traumatic stress in parents of children with cancer: conceptualization, intervention strategies, and a case study","ER Being a parent of a child diagnosed with cancer poses an enormous stressor. Indeed, several parents have difficulties adjusting to such a situation and react with symptoms of traumatic stress, depression, and reduced quality of life. However, there is little conceptual work on behavioral mechanisms that contribute to suboptimal adaptation in these parents. The authors present a conceptualization in which experiential avoidance and rumination are suggested to contribute to increased levels of traumatic stress and suboptimal adaption. Based on this conceptualization, a recently developed intervention for parents of children with cancer, in the form of guided self-help, is presented. Finally, the authors present a successful case study as an example of the application of this intervention. Clinical implications and suggestions for future research are discussed.","Cernvall, M; Carlbring, P; Ljungman, G; Essen, L",2013.0,10.1080/07347332.2012.741095,0,0,
6159,Internet-based guided self-help for parents of children on cancer treatment: a randomized controlled trial,"ER METHODS: Parents of children on cancer treatment, who fulfilled the modified symptom criteria on the PTSD Checklist, were randomly allocated to the intervention or to a wait-list control condition. The intervention group accessed a 10-week guided self-help program via the Internet based on principles from cognitve behavior therapy. The primary outcome PTSS and the secondary outcomes depression and anxiety were assessed by self-report preintervention and postintervention.RESULTS: Seven hundred forty-seven parents were approached and informed about the study, 92 were assessed for eligibility, and 58 were included and randomized to the intervention (n?=?31) or wait list (n?=?27). Eightteen participants completed the intervention. Intention-to-treat analyses indicated a significant effect of the intervention on PTSS with a large between-group effect size at postassessment (Cohen's d?=?0.88). The intervention group reported reductions in PTSS with a large within-group effect size (d?=?1.62) compared with a minimal reduction in the wait-list group (d?=?0.09). There was a significant intervention effect on depression and anxiety and reductions in the intervention group with large within-group effect sizes (d?=?0.85-1.09).CONCLUSIONS: Findings indicate a low enrollment rate and considerable attrition but also that Internet-based guided self-help shows promise for parents of children on cancer treatment who report a high level of PTSS and would like to take part in an Internet-based intervention.OBJECTIVE: The aim of the study was to investigate the feasibility and preliminary efficacy of an Internet-based guided self-help intervention for posttraumatic stress symptoms (PTSS) and related symptoms in parents of children on cancer treatment.","Cernvall, M; Carlbring, P; Ljungman, L; Ljungman, G; Essen, L",2015.0,10.1002/pon.3788,0,0,
6160,"The effect of stress level, amino acid formula, and nitrogen dose on nitrogen retention in traumatic and septic stress","ER Eighty-seven patients were entered into a randomized, prospective, double-blind, six-center study to evaluate the effect of amino acid loading and a formula that was branched chain enriched (50%) on nitrogen retention in metabolic stress. The patients had varying levels of metabolic stress (0-3) after major surgery, polytrauma, or surgical sepsis. The study was isocaloric and isonitrogenous and lasted for 7 days. The patients received either a standard amino acid formula (SAA) (Travasol) or a 50% branched chain enriched formula that was equimolar, leucine, isoleucine, and valine (MAA) (Travasol + Branchamin concentrate) at a dose of 1.0-2.0 g/kg/day in a fixed ratio with 114 glucose calories per gram of nitrogen administered. The nitrogen retention was proportionate to the nitrogen (and, therefore, caloric) load in both groups. The MAA group, however, had better nitrogen retention, reached nitrogen equilibrium at a lower dose of amino acids, and had less urinary nitrogen excretion per gram of nitrogen administered. Since the groups were isonitrogenous and the calorie to nitrogen ratios were fixed, it appears that nitrogen equilibrium in surgical stress is proportionate to the amino acid load over a range of 0.05-0.4 g/kg/day of nitrogen; and that MAA are more efficient at inducing nitrogen retention and a reduction in urea excretion. These effects on nitrogen retention were more significant at level 2 stress or greater. At these higher stress levels, a dose of 2 +/- 0.2 g/kg/day of MAA seemed most efficient in promoting nitrogen retention.","Cerra, F; Blackburn, G; Hirsch, J; Mullen, K; Luther, W",1987.0,,0,0,
6161,Short-term effect of motivational interviewing on clinical and psychological outcomes and health-related quality of life in cardiac rehabilitation patients with poor motivation in Hong Kong: a randomized controlled trial,"ER BACKGROUND: Motivational interviewing (MI) is effective in promoting behavioural changes in patients with substance abuse and smoking. However, its effectiveness on health outcomes in cardiac rehabilitation patients is unclear.DESIGN: A randomized controlled trial.METHOD: A total of 146 patients assessed as having poor motivation attended a cardiac rehabilitation programme from February 2008 to June 2010. Patients (n?=?73) in the control group received usual care while those in the experimental group (n?=?73) received usual care plus four sessions of MI, each lasting 30-45?min. Clinical and psychological outcomes and health-related quality of life were measured at baseline and 3 months after entering the programme. Descriptive statistics, independent t-test, Pearson Chi-squared test, and generalized estimating equations models were used to analyse the data.RESULTS: There was no significant difference between the two groups on clinical outcomes (all p-values >0.05). Patients in the experimental group had higher increases in health-related quality of life (SF-36) scores in the aspects of general health (4.74, 95% CI 0.04-9.44; p?=?0.048) and role limitation due to emotional problems (8.80, 95% CI 1.16-16.43; p?=?0.024). However, they reported significantly higher increases in anxiety levels (Hospital Anxiety and Depression Scale) than those in the control group (0.96, 95% CI 0.09-1.83; p?=?0.030).CONCLUSION: The short-term effectiveness of MI on clinical outcomes and health-related quality of life in poorly motivated cardiac rehabilitation patients is limited. MI, however, was shown to increase anxiety levels of patients during the study period (3 months). More evidence is needed to better understand this phenomenon in the future studies.","Chair, S Y; Chan, S W; Thompson, D R; Leung, K P; Ng, S K; Choi, K C",2012.0,10.1177/1741826711425428,0,0,
6162,Treating anxiety disorders in children with high functioning autism spectrum disorders: a controlled trial,"ER A family-based, cognitive behavioural treatment for anxiety in 47 children with comorbid anxiety disorders and High Functioning Autism Spectrum Disorder (HFA) was evaluated. Treatment involved 12 weekly group sessions and was compared with a waiting list condition. Changes between pre- and post-treatment were examined using clinical interviews as well as child-, parent- and teacher-report measures. Following treatment, 71.4% of the treated participants no longer fulfilled diagnostic criteria for an anxiety disorder. Comparisons between the two conditions indicated significant reductions in anxiety symptoms as measured by self-report, parent report and teacher report. Discussion focuses on the implications for the use of cognitive behaviour therapy with HFA children, for theory of mind research and for further research on the treatment components.","Chalfant, A M; Rapee, R; Carroll, L",2007.0,10.1007/s10803-006-0318-4,0,0,
6163,Effectiveness of psychosocial group intervention for reducing anxiety in women undergoing in vitro fertilization: a randomized controlled study,"ER DESIGNRandomized controlled study.SETTINGTertiary assisted reproduction unit.PARTICIPANT(S)Two hundred twenty-seven women undergoing their first cycle of IVF treatment.INTERVENTION(S)The intervention group (n = 69) received four sessions of EBMS group counseling, while the control group (n = 115) did not receive any intervention.MAIN OUTCOME MEASURE(S)State-Trait Anxiety Inventory.RESULT(S)Compared with the control group, the intervention group had a significant drop in State Anxiety mean score following intervention. A comparable number of embryos were transferred for each group, but there was a nonsignificant trend of a higher pregnancy rate in the intervention group.CONCLUSION(S)The Eastern Body-Mind-Spirit group intervention approach effectively reduces the anxiety level of women undergoing IVF treatment.OBJECTIVETo evaluate the effect of the Eastern Body-Mind-Spirit (EBMS) group intervention on anxiety-reduction of Chinese women undergoing IVF.","Chan, C H; Ng, E H; Chan, C L; Ho, null; Chan, T H",2006.0,10.1016/j.fertnstert.2005.07.1310,0,0,
6164,Enhanced Psychosocial Support for Caregiver Burden for Patients With Chronic Kidney Failure Choosing Not to Be Treated by Dialysis or Transplantation: A Pilot Randomized Controlled Trial,"ER Background Family caregivers of patients with chronic kidney failure have increased burden, as reflected by their high frequency of physical and mental disturbances. The impact of enhanced psychosocial support to caregivers of patients with chronic kidney failure remains unclear. Study Design Open-label randomized controlled trial. Setting & Participants All new patients referred to the renal palliative clinic were screened. Caregivers of patients who met the following criteria were recruited: (1) chronic kidney failure as defined by creatinine clearance < 15 mL/min, (2) opted for conservative management by nephrology team or patient, (3) never treated with dialysis or transplantation, and (4) able to provide informed consent. Interventions Random assignment to treatment with enhanced psychosocial support or standard renal care (control). Enhanced psychosocial support included counseling and psychosocial interventions by an on-site palliative care nurse and designated social worker. Each caregiver was followed up at 2- to 4-week intervals for up to 6 months. Outcomes Zarit Burden Inventory (ZBI) and Hospital Anxiety and Depression Scale (HADS) in caregivers and McGill Quality of Life scores in patients of both groups were compared. Results 29 pairs of family caregivers/patients with chronic kidney failure were randomly assigned (intervention, n = 14; control, n = 15). Mean ages of patients and caregivers were 81.6 +/- 5.1 and 59.8 +/- 14.2 (SD) years, respectively. The intervention group showed significantly lower ZBI scores than the control group at 1 and 3 months (22.0 +/- 5.3 vs 31.6 +/- 9.5 and 21.3 +/- 6.6 vs 33.4 +/- 7.2; P = 0.006 and P = 0.009, respectively). HADS anxiety scores of caregivers who received the intervention were significantly lower than those of controls at 1 and 3 months (7.1 +/- 3.2 vs 10.1 +/- 2.2 and 6.5 +/- 4.5 vs 11.0 +/- 3.1; P = 0.01 and P = 0.03, respectively). Insignificant reductions in ZBI and HADS scores were found at 6 months. 19 patients died (intervention, n = 10; control, n = 9) during the study period. Limitations The study is limited by a relatively small sample size and short duration. Conclusions Enhanced psychosocial support program in patients with chronic kidney failure and caregivers resulted in an early significant reduction in caregiver burden and anxiety.","Chan, K Y; Yip, T; Yap, D Y; Sham, M K; Wong, Y C; Lau, V W; Li, C W; Cheng, B H; Lo, W K; Chan, T M",2016.0,10.1053/j.ajkd.2015.09.021,0,0,
6165,Comparison of posterior capsule opacification and glistenings with 2 hydrophobic acrylic intraocular lenses: 5- to 7-year follow-up,"ER PURPOSE: To compare posterior capsule opacification (PCO) and glistenings 5 to 7 years after cataract surgery with implantation of 2 hydrophobic acrylic intraocular lenses (IOLs) and evaluate the effects on corrected distance visual acuity (CDVA) and contrast sensitivity.SETTING: St. Erik Eye Hospital, Stockholm, Sweden.DESIGN: Randomized clinical trial.METHODS: Cataract surgery with standard phacoemulsification was performed in 1 eye of patients. The patients were randomized to an Acrysof SA60AT (1-piece IOL group) or a Sensar AR40e (3-piece IOL group), both hydrophobic acrylic IOLs with a sharp-edged design. Five to 7 years postoperatively, retroillumination images were obtained and the PCO area and severity (area affected within the capsulorhexis and severity) were evaluated using computer software. High-contrast (100%) and low-contrast (2.5%) CDVAs were measured. The neodymium:YAG laser capsulotomy rates were recorded. Scheimpflug images were obtained to evaluate glistenings, which were graded subjectively at the slitlamp and quantified objectively by digital image analysis using computer software.RESULTS: The study enrolled 80 patients. There were no significant differences in PCO between the 2 groups. The 3-piece IOL group had significantly fewer glistenings (P<.001). There was good correlation between the subjective grading of glistenings and objective computer-processed image grading. The glistenings were not correlated with IOL power, CDVA, or contrast sensitivity.CONCLUSIONS: There were no significant differences in PCO between the 2 acrylic hydrophobic IOLs 5 to 7 years postoperatively. The 1-piece IOL group developed more glistenings than the 3-piece IOL group.","Chang, A; Behndig, A; R√∏nbeck, M; Kugelberg, M",2013.0,10.1016/j.jcrs.2012.11.032,0,0,
6166,Posterior capsule opacification 9 years after phacoemulsification with a hydrophobic and a hydrophilic intraocular lens,"ER METHODS: One of 3 experienced cataract surgeons performed standard phacoemulsification in one eye of 120 patients with cataract. The patients were randomized to implantation of either a hydrophobic acrylic IOL or a hydrophilic acrylic IOL. Both IOLs had sharp posterior edges. Retroillumination images of PCO were obtained with a fundus camera 9 years postoperatively and analyzed semiobjectively using POCOman computer software.RESULTS: Seventy-eight of the 120 patients completed the 9-year follow-up examination. Patients implanted with the hydrophilic IOL had significantly (p<0.001) more and denser PCO. The survival rate without Nd:YAG capsulotomy was significantly higher (p<0.001) in eyes with the hydrophobic IOL.CONCLUSIONS: After 9 years, more and denser PCO developed in eyes with the hydrophilic IOL than the hydrophobic IOL. The survival rate without the need for capsulotomy was higher in eyes with the hydrophobic IOL.PURPOSE: To compare the development of posterior capsule opacification (PCO) and survival rate without capsulotomy after implantation of a hydrophobic or hydrophilic acrylic intraocular lens (IOL) at the 9-year postoperative follow-up.","Chang, A; Kugelberg, M",2017.0,10.5301/ejo.5000831,0,0,
6167,Glistenings 9 years after phacoemulsification in hydrophobic and hydrophilic acrylic intraocular lenses,"ER SETTINGSt. Erik Eye Hospital, Stockholm, Sweden.DESIGNProspective randomized clinical trial.METHODSOne of 3 experienced cataract surgeons performed standard phacoemulsification in 1 eye of each patient. The patients were randomized to implantation of a hydrophobic acrylic IOL or a hydrophilic acrylic IOL. Both IOLs had sharp posterior edges. The CDVA and contrast sensitivity were measured 9 years postoperatively. Scheimpflug images of the IOLs were obtained to analyze glistenings, which were graded subjectively at the slitlamp and quantified objectively with digital image analysis using computer software.RESULTSSeventy-eight of the 120 patients were available for the 9-year follow-up examination. Patients with the hydrophilic IOL had statistically significantly fewer glistenings (P < .001). The development of glistenings was not correlated with IOL power, CDVA, or contrast sensitivity.CONCLUSIONSAfter 9 years, the hydrophobic IOL developed more glistenings than the hydrophilic IOL. Glistenings did not affect CDVA or contrast sensitivity.FINANCIAL DISCLOSURENeither author has a financial or proprietary interest in any material or method mentioned.PURPOSETo compare the development of glistenings after implantation of a hydrophobic acrylic intraocular lens (IOL) (AcrySof SA60AT) and a hydrophilic IOL (BL27) and evaluate the effect on corrected distance visual acuity (CDVA) and contrast sensitivity 9 years postoperatively.","Chang, A; Kugelberg, M",2015.0,10.1016/j.jcrs.2014.09.038,0,0,
6168,Decomposing the Relationship Between Anxiety Sensitivity and Alcohol Use,"ER METHOD: The sample consisted of 329 participants selected from a larger sample of individuals in a brief smoking-cessation intervention. Latent factor models were used to determine the effects of the bifactor model of AS on alcohol use behavior.RESULTS: The general AS factor was significantly associated with alcohol use problems but not alcohol consumption. The AS subfactors of cognitive, physical, and social concerns were not significantly related to either alcohol variable.CONCLUSIONS: The findings are inconsistent with previous research that has found associations between the AS subfactors and alcohol-related outcomes. The use of a bifactor model of AS allowed the variance associated with AS to be parceled out of the subfactors, indicating that general AS accounts for the relationship between AS and alcohol misuse.OBJECTIVE: The misuse of alcohol is related to numerous detrimental health effects. Research has determined anxiety sensitivity (AS) to be a risk factor for problematic alcohol use. To date, no studies have investigated this relationship using a bifactor model of AS. This study used a bifactor model to determine the effects of the general AS factor and the cognitive, physical, and social concerns subfactors on alcohol-related outcomes.","Chavarria, J; Allan, N P; Boffa, J W; Albanese, B J; Schmidt, N B; Zvolensky, M J",2015.0,,0,0,
6169,Feasibility of two modes of treatment delivery for child anxiety in primary care,"ER In this study, we examine the feasibility of cognitive behavior therapy (CBT) for children with anxiety in primary care, using two modes of treatment delivery. A total of 48 parents and youth (8-13) with anxiety disorders were randomly assigned to receive 10-sessions of CBT either delivered by a child anxiety specialist in the primary care clinic or implemented by the parent with therapist support by telephone (i.e., face-to-face or therapist-supported bibliotherapy). Feasibility outcomes including satisfaction, barriers to treatment participation, safety, and dropout were assessed. Independent evaluators, blind to treatment condition, administered the Anxiety Disorders Interview Schedule for Children (ADIS) and the Clinical Global Impression of Improvement (CGI-I) at baseline, post-treatment and 3-month follow-up; clinical self-report questionnaires were also administered. Findings revealed high satisfaction, low endorsement of barriers, low drop out rates, and no adverse events across the two modalities. According to the CGI-I, 58.3%-75% of participants were considered responders (i.e., much or very much improved) at the various time points. Similar patterns were found for remission from ""primary anxiety disorder"" and ""all anxiety disorders"" as defined by the ADIS. Clinically significant improvement was seen on the various parent and child self-report measures of anxiety. Findings suggest that both therapy modalities are feasible and associated with significant treatment gains in the primary care setting. (clinicaltrials.gov unique identifier: NCT00769925).","Chavira, D A; Drahota, A; Garland, A F; Roesch, S; Garcia, M; Stein, M B",2014.0,10.1016/j.brat.2014.06.010,0,0,
6170,Brief treatment for elementary school children with disaster-related posttraumatic stress disorder: a field study,"ER Effective psychological intervention is needed to help children recover from disaster-related posttraumatic stress disorder (PTSD). This controlled study evaluated the effectiveness of a brief intervention for disaster-related PTSD. At one-year follow-up of a prior intervention for disaster-related symptoms, some previously treated children were still suffering significant trauma symptoms. Using a randomized lagged-groups design, we provided three sessions of Eye Movement Desensitization and Reprocessing (EMDR) treatment to 32 of these children who met clinical criteria for PTSD. The Children's Reaction Inventory (CRI) was the primary measure of the treatment's effect on PTSD symptoms. Associated symptoms were measured using the Revised Children's Manifest Anxiety Scale (RCMAS) and the Children's Depression Inventory (CDI). Treatment resulted in substantial reductions in both groups' CRI scores and in significant, though more modest, reductions in RCMAS and CDI scores. Gains were maintained at six-month follow-up. Health visits to the school nurse were significantly reduced following treatment. Psychosocial intervention appears useful for children suffering disaster-related PTSD. Conducting controlled studies of children's treatment in the postdisaster environment appears feasible.","Chemtob, C M; Nakashima, J; Carlson, J G",2002.0,,0,0,
6171,Psychosocial intervention for postdisaster trauma symptoms in elementary school children: a controlled community field study,"ER OBJECTIVETo evaluate the efficacy of a public health--inspired intervention combining school-based screening and psychosocial treatment to identify and treat children with persistent disaster-related trauma symptoms.DESIGNTo identify children with continued high levels of trauma-related symptoms 2 years after a major disaster, we conducted a community-wide school-based screening of disaster-exposed public elementary school children. Children with the highest levels of trauma-related symptoms were randomly assigned to 1 of 3 consecutively treated cohorts. Children in the cohorts awaiting treatment served as wait-list controls. Within each cohort, children were randomly assigned to either individual or group treatment to allow comparison of the efficacy of the 2 treatment modalities.SETTINGAll 10 public elementary schools on the island of Kauai (one of the Hawaiian Islands) 2 years after Hurricane Iniki.PARTICIPANTSAll 4258 children in second through sixth grade were screened. The 248 children with the highest levels of psychological trauma symptoms were selected for treatment.INTERVENTIONChildren were randomly assigned to either individual or group treatment provided by specially trained school-based counselors. Treatment comprised 4 sessions.MAIN OUTCOME MEASURESThe Kauai Reaction Inventory, a self-report measure of trauma symptoms, and the Child Reaction Inventory, a semistructured clinical interview for posttraumatic stress disorder symptoms.RESULTSAfter treatment, children reported significant reductions in self-reported trauma-related symptoms. This symptom reduction was maintained at the 1-year follow-up. Clinical interviews also indicated that treated children had fewer trauma symptoms compared with untreated children.CONCLUSIONSSchool-based community-wide screening followed by psychosocial intervention seems to effectively identify and reduce children's disaster-related trauma symptoms and may facilitate psychological recovery. While group and individual treatments did not differ in efficacy, fewer children dropped out of the group treatment. This approach may be applicable to screening and treating children exposed to a variety of large-scale disasters.CONTEXTNatural disasters negatively affect children's emotional and behavioral adjustment. Although treatments to reduce psychological morbidity following disasters are needed, it has been difficult to conduct treatment research in postdisaster environments because of the sensitivity of victims to perceived intrusiveness and exploitation.","Chemtob, C M; Nakashima, J P; Hamada, R S",2002.0,,0,0,
6172,"Randomised controlled trial on the effectiveness of home-based walking exercise on anxiety, depression and cancer-related symptoms in patients with lung cancer","ER Background:Although exercise has been addressed as an adjuvant treatment for anxiety, depression and cancer-related symptoms, limited studies have evaluated the effectiveness of exercise in patients with lung cancer.Methods:We recruited 116 patients from a medical centre in northern Taiwan, and randomly assigned them to either a walking-exercise group (n=58) or a usual-care group (n=58). We conducted a 12-week exercise programme that comprised home-based, moderate-intensity walking for 40 min per day, 3 days per week, and weekly exercise counselling. The outcome measures included the Hospital Anxiety and Depression Scale and the Taiwanese version of the MD Anderson Symptom Inventory.Results:We analysed the effects of the exercise programme on anxiety, depression and cancer-related symptoms by using a generalised estimating equation method. The exercise group patients exhibited significant improvements in their anxiety levels over time (P=0.009 and 0.006 in the third and sixth months, respectively) and depression (P=0.00006 and 0.004 in the third and sixth months, respectively) than did the usual-care group patients.Conclusions:The home-based walking exercise programme is a feasible and effective intervention method for managing anxiety and depression in lung cancer survivors and can be considered as an essential component of lung cancer rehabilitation.","Chen, H M; Tsai, C M; Wu, Y C; Lin, K C; Lin, C C",2015.0,10.1038/bjc.2014.612,0,0,
6173,The effects of different postoperative analgesic procedure on stress response,,"Chen, S Y; Zhang, Y M; Luo, L",2002.0,,0,0,
6174,Effectiveness of medical hypnosis for pain reduction and faster wound healing in pediatric acute burn injury: study protocol for a randomized controlled trial,"ER METHODS/DESIGN: This is a single-center, superiority, parallel-group, prospective randomized controlled trial. Children (4 to 16 years, inclusive) with acute burn injuries presenting for their first dressing application or change are randomly assigned to either the (1) intervention group (medical hypnosis) or (2) control group (standard care). A minimum of 33 participants are recruited for each treatment group. Repeated measures of pain, anxiety, stress, and wound healing are taken at every dressing change until ?95 % wound re-epithelialization. Further data collection assesses impact on posttraumatic stress symptomatology, speed of wound healing, and parent perception of how easy the dressing change is for their child.DISCUSSION: Study results will elucidate whether the disease process can be changed by using medical hypnosis with children to decrease pain, anxiety, and stress in the context of acute burn wounds.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12615000419561.BACKGROUND: Burns and the associated wound care procedures can be extremely painful and anxiety-provoking for children. Burn injured children and adolescents are therefore at greater risk of experiencing a range of psychological reactions, in particular posttraumatic stress disorder, which can persist for months to years after the injury. Non-pharmacological intervention is critical for comprehensive pain and anxiety management and is used alongside pharmacological analgesia and anxiolysis. However, effective non-pharmacological pain and anxiety management during pediatric burn procedures is an area still needing improvement. Medical hypnosis has received support as a technique for effectively decreasing pain and anxiety levels in adults undergoing burn wound care and in children during a variety of painful medical procedures (e.g., bone marrow aspirations, lumbar punctures, voiding cystourethrograms, and post-surgical pain). Pain reduction during burn wound care procedures is linked with improved wound healing rates. To date, no randomized controlled trials have investigated the use of medical hypnosis in pediatric burn populations. Therefore this study aims to determine if medical hypnosis decreases pain, anxiety, and biological stress markers during wound care procedures; improves wound healing times; and decreases rates of traumatic stress reactions in pediatric burn patients.","Chester, S J; Stockton, K; Young, A; Kipping, B; Tyack, Z; Griffin, B; Chester, R L; Kimble, R M",2016.0,10.1186/s13063-016-1346-9,0,0,
6175,The effect of progressive muscle relaxation training on anxiety and quality of life after stoma surgery in colorectal cancer patients,"ER The aim of the study was to evaluate the effects of the use of progressive muscle relaxation training (PMRT) on anxiety and quality of life in colorectal cancer patients after stoma surgery. A randomised controlled trial was used with repeated measures assessment over 10 weeks post-stoma surgery. Fifty-nine patients participated in the study and were randomised to a control group receiving routine care (n=30) and an experimental group receiving routine care and PMRT through two teaching sessions and practice at home for the first 10 weeks. The State-Trait Anxiety Inventory and two Quality of Life Scales were used to collect the data of interest in three occasions, namely during hospitalisation, at week 5 and at week 10 post-surgery. The use of PMRT significantly decreased state anxiety and improved generic quality of life in the experimental group (P<0.05), especially in the domains of physical health, psychological health, social concerns and environment. Social relationships decreased in both groups. In relation to the disease-specific quality of life measure, differences were observed only in the 10-week assessment, with the experimental group reporting better quality of life at 10 weeks, but not over time as compared to the control group. The use of PMRT should be incorporated in the long-term care of colorectal cancer patients, as it can improve their psychological health and quality of life. This may be a cost-effective intervention that needs minimal training and could easily be offered to those patients that they would like to use it as part of the specialist care provided to stoma patients.","Cheung, Y L; Molassiotis, A; Chang, A M",2003.0,10.1002/pon.638,0,0,
6176,The relationship between plasma taurine and other amino acid levels in human sepsis,"ER Although reports of decreased plasma taurine in trauma, sepsis and critical illness are available, very little is known about the relationships among changes in plasma taurine, other amino acid levels and metabolic variables. We analyzed a large series of plasma amino acid profiles obtained in trauma patients with sepsis who were undergoing total parenteral nutrition. The correlations between plasma taurine, other amino acid levels, parenteral substrate doses and metabolic and cardiorespiratory variables were assessed by regression analysis. Post-traumatic hypotaurinemia was followed by partial recovery toward less abnormal values when sepsis developed. Levels of taurine were directly and significantly related to levels of glutamate, aspartate, beta-alanine and phosphoethanolamine (and unrelated to other amino acids). Levels of these amino acids increased simultaneously with increasing doses of leucine, isoleucine and valine in total parenteral nutrition. Decreasing taurine was associated with increasing lactate, arteriovenous O(2) concentration difference and respiratory index, and with decreasing cholesterol and cardiac index. These results characterize the relationships between plasma taurine and other amino acid levels in sepsis, provide evidence of amino acid interactions that may support taurine availability and show more severe decreases in plasma taurine with the worsening of metabolic and cardiorespiratory patterns.","Chiarla, C; Giovannini, I; Siegel, J H; Boldrini, G; Castagneto, M",2000.0,,0,0,
6177,Inhibition of post-traumatic septic proteolysis and ureagenesis and stimulation of hepatic acute-phase protein production by branched-chain amino acid TPN,"ER Previous studies have shown that severe sepsis after major trauma results in the reprioritization of release of hepatic acute-phase proteins (APP). They suggest competition for leucine for nutritional utilization may be responsible. To test this hypothesis, a branched-chain enriched (46.6%) amino acid mixture (BCAA) was administered on a prospective randomized basis with standard TPN therapy to 16 septic post-trauma patients. After sepsis was diagnosed, a randomized therapy (control-TPN or BCAA-TPN) was given for 12 days, or until death occurred. Total calories and amino acid nitrogen (N) administered were not different in the two groups (t-test) and q 8 h (347 study periods) amino acid clearances, urinary urea nitrogen excretion, muscle proteolysis from 3-methyl-histidine (3-MH) excretion, and standard indices of sepsis severity and hepatic function were measured, as well as platelets (PLAT), leucocytes (WBC), albumin (ALB), and six acute-phase proteins: C-reactive protein (CRP), alpha-1-antitrypsin (A1TRIP), fibrinogen (FIBRIN), alpha-2-macroglobulin (AMACRO), ceruloplasmin (CERUL), and transferrin (TRANS). Using Scheffé analysis of all contrasts the data showed: BCAA resulted in a fall in 24-hour urea N excretion (24.0 to 20.0 gm/24 hr) and in proteolysis (138 to 126 gm/24 hr) (p less than 0.0001). Prestudy CRP levels were all elevated, but compared to control where APP reprioritization occurred, over the initial 10 days of therapy BCAA patients had a more rapid fall in CRP with a more rapid rise in FIBRIN, TRANS, CERUL, ALBUMIN, AMACRO, and A1TRIP (all p less than 0.0001) relative to CRP. Also, the sepsis-reduced clearances of glutamine and glutamate, alanine, and proline were increased (p less than 0.0001) during BCAA even though urea nitrogen production was reduced (p less than 0.0001). The increase in leucine clearance with BCAA-enriched TPN was positively correlated (r2 = 0.601; p less than 0.0001) with the increase in the sum of all APP and ALB and was also associated with an increase both in FIBRIN and in platelets (p less than 0.0001). The BCAA-related increase in FIBRIN (9.1 to 11.9 mg/ml) occurred at the same time as a fall in prothrombin time (p less than 0.0001). BCAA-enriched TPN reduced proteolysis and amino acid catabolism and appeared to increase the levels of the more rapidly appearing anti-inflammatory and nutritional hepatic APP and formed coagulation elements in post-traumatic sepsis.","Chiarla, C; Siegel, J H; Kidd, S; Coleman, B; Mora, R; Tacchino, R; Placko, R; Gum, M; Wiles, C E; Belzberg, H",1988.0,,0,0,
6178,Changes in illness-related cognitions rather than distress mediate improvements in irritable bowel syndrome (IBS) symptoms and disability following a brief cognitive behavioural therapy intervention,"ER OBJECTIVE: A previous randomised controlled trial demonstrated that a cognitive behavioural therapy (CBT) self-management intervention significantly improved irritable bowel syndrome (IBS) symptoms and disability compared to treatment as usual (TAU). The current study analysed additional data to establish whether; 1) cognitive, behavioural and emotional factors hypothesized to perpetuate IBS symptoms and disability changed following CBT and, 2) ascertain if changes in these factors over the intervention period mediated treatment effects 6-months later.METHOD: IBS patients (CBT = 31, TAU = 33) completed measures pre-and-post intervention including: Brief Illness Perception Questionnaire, Hospital Anxiety & Depression Scale and Cognitive and Behavioural Responses to Symptoms Questionnaire. Path models were evaluated to determine whether changes in cognitive and behavioural factors over the treatment period mediated treatment effects.RESULTS: Compared to TAU, CBT patients showed significant positive changes on several cognitive variables but not anxiety and depression following intervention. Positive change in illness perceptions following intervention mediated the treatment effect on improved IBS symptom severity and social adjustment six months later. Changes in damaging beliefs mediated the effect on social adjustment.CONCLUSIONS: Change in cognition rather than mood mediated treatment related improvements. Changing negative perceptions of IBS appears to be a particularly important treatment mechanism.","Chilcot, J; Moss-Morris, R",2013.0,10.1016/j.brat.2013.07.007,0,0,
6179,Effectiveness of modular CBT for child anxiety in elementary schools,"ER Most randomized controlled trials of cognitive-behavioral therapy (CBT) for children with anxiety disorders have evaluated treatment efficacy using recruited samples treated in research settings. Clinical trials in school settings are needed to determine if CBT can be effective when delivered in real world settings. This study evaluated a modular CBT program for childhood anxiety disorders in two elementary schools. Forty children (5-12 years old) with anxiety disorders, referred by teachers and school staff, were randomly assigned to modular CBT or a 3-month waitlist. Clinicians worked with individual families as well as teachers and school staff. Evaluators blind to treatment condition conducted structured diagnostic interviews and caregivers and children completed symptom checklists at pre- and posttreatment. The primary study outcome, the Clinical Global Impressions-Improvement scale, yielded a positive treatment response at posttreatment for 95.0% of CBT participants, as compared with only 16.7% of the waitlist participants. CBT also outperformed the waitlist on diagnostic outcomes and caregiver-report measures of anxiety. Treatment effects did not extend beyond anxiety diagnoses and symptoms. Results suggest that modular CBT delivered within the elementary school setting may be effective for the treatment of child anxiety disorders. A replication of the study results with a larger sample is indicated.","Chiu, A W; Langer, D A; McLeod, B D; Har, K; Drahota, A; Galla, B M; Jacobs, J; Ifekwunigwe, M; Wood, J J",2013.0,10.1037/spq0000017,0,0,
6180,Patterns of anxiety in critically ill patients receiving mechanical ventilatory support,"ER OBJECTIVESAlthough mechanical ventilation and critical illness induce great anxiety and distress in hospitalized patients, little is known about anxiety ratings over the course of ventilatory support. Knowledge of anxiety ratings over time is needed to implement effective symptom management interventions. The purposes of this study were to describe anxiety ratings for a subgroup of mechanically ventilated patients over the duration of enrollment in a multisite clinical trial, to discern any pattern of change in anxiety ratings, to determine if anxiety decreases over time, and to explore the influence of sedative exposure on anxiety ratings.METHODSParticipants were 57 mechanically ventilated patients who were randomly assigned to the usual care group of a randomized controlled trial designed to assess the efficacy of music interventions on anxiety of mechanically ventilated patients in intensive care units. Anxiety ratings were obtained at study entry and daily for up to 30 days. A 100-mm visual analog scale was used to measure anxiety. Visual Analog Scale-Anxiety scores were plotted as a function of study time in days for each participant to discern possible patterns of change. A mixed-models analysis was performed to assess the nature and magnitude of change over time (slope) using 251 observations on 57 patients.RESULTSResults of the unconditional means model indicated that further modeling was appropriate. An autoregressive covariance structure with a random component for participant was chosen as the most appropriate covariance structure for modeling. An unconditional growth model indicated that the Visual Analog Scale-Anxiety ratings declined slowly over time: -.53 points per day (p = .09).DISCUSSIONAnxiety is an individual patient experience that requires ongoing management with appropriate assessment and intervention over the duration of mechanical ventilatory support.BACKGROUNDMechanical ventilation is one of the most frequently used technological treatments in critical care units and induces great anxiety in patients.","Chlan, L; Savik, K",2011.0,10.1097/NNR.0b013e318216009c,0,0,
6181,Comparative effects of emotion management training and social skills training in Korean children with ADHD,"ER OBJECTIVE: ADHD is associated with social and emotional impairment that goes beyond the core symptoms of hyperactivity, impulsivity, and attention deficits. This study evaluates the comparative efficacy of emotional management training (EMT) with social skills training (SST) and no treatment in children with ADHD.METHOD: A randomized, controlled treatment outcome study was conducted with 32 boys and 40 girls (aged 10-12 years). The Child Behavior Checklist, Emotion Expression Scale for Children, Child Depression Inventory, and State-Trait Anxiety Inventory for children were completed before and after the intervention.RESULTS: The EMT group exhibited a significant improvement in emotion recognition and expressive reluctance. Therefore, focusing on emotion identification and expression in social cognitive processes (i.e., EMT), instead of merely focusing on social skills (SST), enhances treatment efficacy.CONCLUSION: These results support the hypothesis that focusing on the identification and expression of emotional information processes, instead of merely focusing on social skills (SST) enhances treatment efficacy.","Choi, E S; Lee, W K",2015.0,10.1177/1087054713496460,0,0,
6182,"The effect of music and progressive muscle relaxation on anxiety, fatigue, and quality of life in family caregivers of hospice patients","ER The purpose of this study was to examine the effects of music, progressive muscle relaxation (PMR), and music combined with progressive muscle relaxation on the reduction of anxiety, fatigue, and improvement of quality of life in family hospice caregivers. Subjects (N = 32) were divided randomly into 4 groups: control, music only, progressive muscle relaxation only, and music combined with progressive muscle relaxation and were tested twice a week for a duration of 2 weeks. A pre and posttest measuring anxiety and fatigue was administered each session. Quality of life was measured only on the first and last session. Results of three-way mixed design ANOVA indicated no significant main effect for group. However, results revealed a significant main effect for pretest and posttest on anxiety F(1, 28) = 51.82, p < .01 and fatigue, F(1, 28) = 32.86, p < .01. Significant difference on time effect were found for both anxiety F(3, 84) = 3.53, p < .05 and fatigue F(3, 84) = 5.21, p < .01. Follow-up paired t tests used for posthoc testing were conducted to compare pre and posttest difference scores for each group separately. Statistical results indicated a significant difference in quality of life when comparing the subject sample as a whole across the four days of treatment period, F(1, 28) = 14.21, p < .01. Follow-up paired sample t test indicated that the control and PMR group exhibited a significant difference in pre and posttest quality of life scores. There was a significant correlation between anxiety and quality of life (r(32) = .75, p < .01), anxiety and fatigue (r(32) = .55, p < .01), and fatigue and quality of life (r(32) = -.53, p < .01).","Choi, Y K",2010.0,,0,0,
6183,Long-term outcomes for the Child STEPs randomized effectiveness trial: a comparison of modular and standard treatment designs with usual care,"ER OBJECTIVE: This article reports outcomes from the Child STEPs randomized effectiveness trial conducted over a 2-year period to gauge the longer term impact of protocol design on the effectiveness of evidence-based treatment procedures.METHOD: An ethnoracially diverse sample of 174 youths ages 7- 13 (N = 121 boys) whose primary clinical concerns involved diagnoses or clinical elevations related to anxiety, depression, or disruptive behavior were treated by community therapists randomly assigned to 1 of 3 conditions: (a) standard, which involved the use of 1 or more of 3 manualized evidence-based treatments, (b) modular, which involved a single modular protocol (Modular Approach to Treatment of Children With Anxiety, Depression, or Conduct Problems; MATCH) having clinical procedures similar to the standard condition but flexibly selected and sequenced using a guiding clinical algorithm, and (c) usual care.RESULTS: As measured with combined Child Behavior Checklist and Youth Self-Report Total Problems, Internalizing, and Externalizing scales, the rate of improvement for youths in the modular condition was significantly better than for those in usual care. On a measure of functional impairment (Brief Impairment Scale), no significant differences were found among the 3 conditions. Analysis of service utilization also showed no significant differences among conditions, with almost half of youths receiving some additional services in the 1st year after beginning treatment, and roughly one third of youths in the 2nd year.CONCLUSIONS: Overall, these results extend prior findings, supporting incremental benefits of MATCH over usual care over a 2-year period.","Chorpita, B F; Weisz, J R; Daleiden, E L; Schoenwald, S K; Palinkas, L A; Miranda, J; Higa-McMillan, C K; Nakamura, B J; Austin, A A; Borntrager, C F; Ward, A; Wells, K C; Gibbons, R D",2013.0,10.1037/a0034200,0,0,
6184,"The Effect of Chronic Alprazolam Intake on Memory, Attention, and Psychomotor Performance in Healthy Human Male Volunteers","ER Alprazolam is used as an anxiolytic drug for generalized anxiety disorder and it has been reported to produce sedation and anterograde amnesia. In the current study, we randomly divided 26 healthy male volunteers into two groups: one group taking alprazolam 0.5?mg and the other taking placebo daily for two weeks. We utilized the Cambridge Neuropsychological Test Automated Battery (CANTAB) software to assess the chronic effect of alprazolam. We selected Paired Associates Learning (PAL) and Delayed Matching to Sample (DMS) tests for memory, Rapid Visual Information Processing (RVP) for attention, and Choice Reaction Time (CRT) for psychomotor performance twice: before starting the treatment and after the completion of the treatment. We found statistically significant impairment of visual memory in one parameter of PAL and three parameters of DMS in alprazolam group. The PAL mean trial to success and total correct matching in 0-second delay, 4-second delay, and all delay situation of DMS were impaired in alprazolam group. RVP total hits after two weeks of alprazolam treatment were improved in alprazolam group. But such differences were not observed in placebo group. In our study, we found that chronic administration of alprazolam affects memory but attentive and psychomotor performance remained unaffected.","Chowdhury, Z S; Morshed, M M; Shahriar, M; Bhuiyan, M A; Islam, S M; Bin, Sayeed M S",2016.0,10.1155/2016/3730940,0,0,
6185,Effect of verbal self-disclosure on natural killer cell activity: moderating influence of cynical hostility,"ER One objective of the present research was to examine the immunological effects of self-disclosing personal information regarding a traumatic or stressful experience. A second objective was to examine the hypothesis that the effect of self-disclosure on immune function is moderated by individual differences in cynical hostility. Forty-three male college undergraduates, classified as high or low on the Cook-Medley Hostility scale were randomly assigned to either a verbal self-disclosure or a nondisclosure discussion condition. Task-induced change in natural killer (NK) cell activity (i.e., cytotoxicity) served as the dependent variable. As predicted, a significant interaction between discussion condition and hostility was obtained. Among subjects in the self-disclosure condition, high hostility subjects exhibited a significantly greater increase in NK cell cytotoxicity than low hostility subjects. The effect of self-disclosure on NK cell activity is moderated by an individual's level of cynical hostility. The greater short term enhancement in NK cell activity observed for hostile persons is a likely correlate of a more pronounced acute arousal response elicited by the self-disclosure task.","Christensen, A J; Edwards, D L; Wiebe, J S; Benotsch, E G; McKelvey, L; Andrews, M; Lubaroff, D M",1996.0,,0,0,
6186,"A placebo-controlled, double-blind crossover study of fluoxetine in trichotillomania","ER METHODTwenty-one adult chronic hair pullers were recruited into an 18-week placebo-controlled, double-blind crossover study of fluoxetine, in doses up to 80 mg/day. The fluoxetine and placebo treatment phases consisted of 6-week trials of each agent separated by a 5-week washout period. Fifteen subjects (14 female and one male) completed the study; an additional female subject dropped out at 16 weeks after developing a drug reaction.RESULTSNo significant Drug by Period interactions were found in weekly subject ratings of hair pulling, weekly subject ratings of the urge to pull hair, weekly assessments of the number of hair-pulling episodes, or the estimated amount of hair pulled per week.CONCLUSIONSThe short-term efficacy of fluoxetine in the treatment of trichotillomania was not demonstrated in this study.OBJECTIVEIt has been proposed by some investigators that trichotillomania, a disorder of chronic hair pulling, is a variant of obsessive-compulsive disorder, and some studies have suggested that the antiobessional agents clomipramine and fluoxetine are useful in treating this disorder. The authors investigated the efficacy of fluoxetine in the treatment of trichotillomania.","Christenson, G A; Mackenzie, T B; Mitchell, J E; Callies, A L",1991.0,10.1176/ajp.148.11.1566,0,0,
6187,Preliminary evaluation of a multimodal early intervention program for behaviorally inhibited preschoolers,"ER Objective: Approximately 15%-20% of young children can be classified as having a behaviorally inhibited (BI) temperament. Stable BI predicts the development of later anxiety disorders (particularly social anxiety), but not all inhibited children develop anxiety. Parenting characterized by inappropriate warmth/sensitivity and/or intrusive control predicts the stability of BI and moderates risk for anxiety among high-BI children. For these reasons, we developed and examined the preliminary efficacy of the Turtle Program: a multimodal early intervention for inhibited preschool-age children. Method: Forty inhibited children between the ages of 42-60 months and their parent(s) were randomized to either the Turtle Program (n = 18) or a waitlist control (WLC; n = 22) condition. Participants randomized to the Turtle Program condition received 8 weeks of concurrent parent and child group treatment. Participants were assessed at baseline and posttreatment with multisource assessments, including parent and teacher report measures of child anxiety, diagnostic interviews, and observations of parenting behavior. Results: The Turtle Program resulted in significant beneficial effects relative to the WLC condition on maternal-reported anxiety symptoms of medium to large magnitude; large effects on parent-reported BI; medium to large effects on teacher-rated school anxiety symptoms; and medium effects on observed maternal positive affect/sensitivity. Conclusions: This study provides encouraging preliminary support for the Turtle Program for young behaviorally inhibited children. Effects of the Turtle Program generalized to the school setting. Future studies should examine whether this early intervention program improves long-term developmental outcomes for this at-risk group.","Chronis-Tuscano, A; Rubin, K H; O'Brien, K A; Coplan, R J; Thomas, S R; Dougherty, L R; Cheah, C S; Watts, K; Heverly-Fitt, S; Huggins, S L; Menzer, M; Begle, A S; Wimsatt, M",2015.0,10.1037/a0039043,0,0,
6188,Transdiagnostic group behavioral activation and exposure therapy for youth anxiety and depression: initial randomized controlled trial,"ER Anxiety and depression are debilitating and commonly co-occurring in young adolescents, yet few interventions are designed to treat both disorder classes together. Initial efficacy is presented of a school-based transdiagnostic group behavioral activation therapy (GBAT) that emphasizes anti-avoidance in vivo exposure. Youth (N = 35; ages 12-14; 50.9% male) were randomly assigned to either GBAT (n = 21) or WL (n = 14) after completing a double-gated screening process. Multi-reporter, multi-domain outcomes were assessed at pretreatment, posttreatment, and four-month follow-up (FU). GBAT was associated with greater posttreatment remission rates than WL in principal diagnosis (57.1% vs. 28.6%; X12 = 2.76, p = .09) and secondary diagnosis (70.6% vs. 10%; X12 = 9.26, p = .003), and greater improvement in Clinical Global Impairment - Severity ratings, B = -1.10 (0.42), p = .01. Symptom outcomes were not significantly different at posttreatment. GBAT produced greater posttreatment behavioral activation (large effect size) and fewer negative thoughts (medium effect), two transdiagnostic processes, both at the trend level. Most outcomes showed linear improvement from pretreatment to FU that did not differ depending on initial condition assignment. Sample size was small, but GBAT is a promising transdiagnostic intervention for youth anxiety and unipolar mood disorders that can feasibly and acceptably be applied in school settings.","Chu, B C; Crocco, S T; Esseling, P; Areizaga, M J; Lindner, A M; Skriner, L C",2016.0,10.1016/j.brat.2015.11.005,0,0,
6189,Therapist responsiveness to child engagement: flexibility within manual-based CBT for anxious youth,"ER Therapy process research helps delineate common and specific elements essential to positive outcomes as well as develop best practice training protocols. Child involvement and therapist flexibility were rated in 63 anxious youth (ages 8-14) who received cognitive-behavioral therapy. Therapist flexibility, defined as therapist attempts to adapt treatment to a child's needs, was hypothesized to act as an engagement strategy that serves to increase child involvement during therapy. Flexibility was significantly related to increases in later child engagement, which subsequently predicted improvement in posttreatment diagnosis and impairment. Therapist flexibility was not associated with earlier measures of child engagement, so a mediation model could not be supported. It was also hypothesized that the impact of flexibility would be greatest for cases who began treatment highly disengaged (i.e., early involvement would moderate the effect of flexibility). Basic descriptive data supported this model, but formal analyses failed to confirm. Further descriptive analyses suggest therapists employ a range of adaptations and a profile of flexible applications within a manual-based treatment is provided. Treatment, measurement, and dissemination issues are discussed.","Chu, B C; Kendall, P C",2009.0,10.1002/jclp.20582,0,0,
6190,Positive association of child involvement and treatment outcome within a manual-based cognitive-behavioral treatment for children with anxiety,"ER Ratings of child involvement in manual-based cognitive-behavioral treatment for anxiety were associated with the absence of primary anxiety diagnosis and reductions in impairment ratings at posttreatment for 59 children with anxiety (ages 8-14 years). Good-to-excellent interrater reliability was established for the independent ratings of 237 therapy sessions, and strong psychometrics were established for the involvement measure. Child involvement at midtreatment, just prior to in vivo exposures, was positively associated with treatment gains but earlier involvement was not. Increased involvement during therapy (positive involvement shifts) may provide a useful index of change and may also predict outcomes. Involvement was not associated with client demographics or diagnostic category. Implications for treatment and measurement of psychotherapy process within manual-based treatments are discussed.","Chu, B C; Kendall, P C",2004.0,10.1037/0022-006X.72.5.821,0,0,
6191,Triple acupuncture method at cervical Jiaji (EX-B 2) for cervicogenic headache: a randomized controlled trial,"ER OBJECTIVE: To compare the efficacy difference between triple acupuncture method at cervical Jiaji (EX-B 2) and conventional acupuncture for cervicogenic headache. METHODS: A total of 66 patients were randomly divided into a triple acupuncture group and a conventional acupuncture group, 33 cases in each one. The acupoints selected in the two groups were identical, including C1 to C7 of cervical Jiaji (EX-B 2) as well as Baihui (GV 20), Qiangjian (GV 18), Naokong (GB 19), Fengchi (GB 20), Fengfu (GV 16), Tianzhu (BL 10), etc. The conven- tional acupuncture was performed at acupoints on the head in the two groups; triple acupuncture was performed at cervical Jiaji (EX-B 2) in the triple acupuncture group while perpendicular acupuncture was performed with a depth of 25 to 40 mm in the conventional acupuncture group. The treatment was given once a day. Five treatments were considered as one session and totally two sessions were required. The changes of simplified McGill scale before and after acupuncture were observed in the two groups, and the efficacy of the two groups was compared. RESULTS: After acupuncture, the simplified McGill scale was both reduced in the two groups (both P  0.05). The cured and markedly effective rate was 75.8% (25/33) and the total effective rate was 93.9% (31/33) in the triple acupuncture group, which were superior to 57.6% (19/33, P < 0.01) and 84.8% (28/33, P < 0.05) in the conventional acupuncture group respectively. CONCLUSION: The efficacy of triple acupuncture method at cervical Jiaji (EX-B 2) is superior to that of conventional acupuncture for cervicogenic headache.","Chu, H; Hu, B",2016.0,,0,0,
6192,Efficacy and tolerability of mirtazapine and sertraline in Korean veterans with posttraumatic stress disorder: a randomized open label trial,"ER METHODSEfficacy was evaluated by the clinician administered PTSD scale (CAPS-2), the Hamilton rating scale for depression (HAMD-17) and the clinical global impression scale (CGI), at baseline and at weeks 1, 2 and 6. A response was defined as a > or = 30 % decrease in CAPS-2 total severity, a > or = 50 % decrease in total HAMD-17 score, and a CGI-I score < 3.RESULTS51 patients on mirtazapine (mean age/duration of illness: 59.1/33.5 years) and 49 on sertraline (mean age/duration of illness: 60.6/35.6 years) completed the study. The mean daily dosage was 34.1 mg for mirtazapine and 101.5 mg for sertraline. On the CAPS-2 total score more patients responded in the mirtazapine group at week 1 (13 vs 2 %) and week 2 (51 vs 31 %). At week 6 this difference was statistically significant (88 % vs 69 %, p = 0.039) on the CAPS-2 total score. The HAMD-17 total score and CGI-I score decreased in both groups, with no significant differences between th groups on all time points. The main side effects for the mirtazapine group were: dry mouth (19.6 %), constipation (19.6 %), somnolence (15.7 %) and weight gain (1.96 %); and for the sertraline group: indigestion (14.3 %), palpitation (6.1 %), agitation (2.0 %), epigastric soreness (2.0 %), insomnia (2.0 %) and sexual dysfunction (2.0 %).CONCLUSIONMirtazapine appeared to be an effective and well-tolerated treatment for PTSD in Korean veterans.BACKGROUNDThe aim of this study was to investigate the potential use of mirtazapine in Korean veterans diagnosed with PTSD, by comparing it with sertraline, a drug approved for use in PTSD in the USA.","Chung, M Y; Min, K H; Jun, Y J; Kim, S S; Kim, W C; Jun, E M",2004.0,10.1002/hup.615,0,0,
6193,"Reductions in pain, depression, and anxiety symptoms after PTSD remediation in veterans","ER A randomized controlled trial of veterans with clinical levels of PTSD symptoms found significant improvements after Emotional Freedom Techniques (EFT). Although pain, depression, and anxiety were not the primary targets of treatment, significant improvements in these conditions were noted. Subjects (N = 59) received six sessions of EFT coaching supplementary to primary care. They were assessed using the SA-45, which measures nine mental health symptom domains and also has two general scales measuring the breadth and depth of psychological distress. Anxiety and depression both reduced significantly, as did the breadth and depth of psychological symptoms. Pain decreased significantly during the intervention period (-41%, p < .0001). Subjects were followed up at three and six months, revealing significant relationships between PTSD, depression, and anxiety at several assessment points. At follow-up, pain remained significantly lower than at pretest. The results of this study are consistent with other reports showing that, as PTSD symptoms are reduced, general mental health improves, and pain levels drop. The ability of EFT to produce reliable and long-term gains after relatively brief interventions indicates its utility in reducing the estimated trillion-dollar cost of treating veteran mental health disorders in the coming years.","Church, D",2014.0,10.1016/j.explore.2014.02.005,0,0,
6194,Fostering secure attachment in infants in maltreating families through preventive interventions,"ER The malleability of insecure and disorganized attachment among infants from maltreating families was investigated through a randomized preventive intervention trial. Findings from research on the effects of maltreatment on infant attachment were incorporated into the design and evaluation of the intervention. One-year-old infants from maltreating families (N = 137) and their mothers were randomly assigned to one of three intervention conditions: (a) infant-parent psychotherapy (IPP), (b) psychoeducational parenting intervention (PPI), and (c) community standard (CS) controls. A fourth group of infants from nonmaltreating families (N = 52) and their mothers served as an additional low-income normative comparison (NC) group. At baseline, mothers in the maltreatment group, relative to the nonmaltreatment group mothers, reported greater abuse and neglect in their own childhoods, more insecure relationships with their own mothers, more maladaptive parenting attitudes, more parenting stress, and lower family support, and they were observed to evince lower maternal sensitivity. Infants in the maltreatment groups had significantly higher rates of disorganized attachment than infants in the NC group. At postintervention follow-up at age 26 months, children in the IPP and PPI groups demonstrated substantial increases in secure attachment, whereas increases in secure attachment were not found for the CS and NC groups. Moreover, disorganized attachment continued to predominate in the CS group. These results were maintained when intent to treat analyses were conducted. The findings are discussed in terms of the utility of translating basic research into the design and evaluation of clinical trials, as well as the importance of preventive interventions for altering attachment organization and promoting an adaptive developmental course for infants in maltreating families.","Cicchetti, D; Rogosch, F A; Toth, S L",2006.0,,0,0,
6195,The effect of hyperbaric oxygen on persistent postconcussion symptoms,"ER BACKGROUND: The high incidence of persistent postconcussion symptoms in service members with combat-related mild traumatic brain injury has prompted research in the use of hyperbaric oxygen (HBO2) for management.OBJECTIVE: The effects of HBO2 on persistent postconcussion symptoms in 60 military service members with at least 1 combat-related mild traumatic brain injury were examined in a single-center, double-blind, randomized, sham-controlled, prospective trial at the Naval Medicine Operational Training Center at Naval Air Station Pensacola.METHODS: Over a 10-week period, subjects received a series of 40, once-daily, hyperbaric chamber compressions at 2.0 atmospheres absolute (ATA). During each session, subjects breathed 1 of 3 preassigned oxygen fractions (10.5%, 75%, or 100%) for 60 minutes, resulting in an oxygen exposure equivalent to breathing surface air, 100% oxygen at 1.5 ATA, or 100% oxygen at 2.0 ATA, respectively. Individual, subscale and total item responses on the Rivermead Postconcussion Symptom Questionnaire and individual and total Posttraumatic Disorder Checklist-Military Version were measured just prior to intervention and immediately postintervention.RESULTS: Between-group testing of pre- and postintervention means revealed no significant differences on individual or total scores on the Posttraumatic Disorder Checklist-Military Version or Rivermead Postconcussion Symptom Questionnaire, demonstrating a successful randomization and no significant main effect for HBO2 at 1.5 or 2.0 ATA equivalent compared with the sham compression. Within-group testing of pre- and postintervention means revealed significant differences on several individual items for each group and difference in the Posttraumatic Disorder Checklist-Military Version total score for the 2.0 ATA HBO2 group.DISCUSSION: The primary analyses of between group differences found no evidence of efficacy for HBO2. The scattered within group differences are threatened by Type 2 errors and could be explained by nonspecific effects.CONCLUSION: This study demonstrated that HBO2 at either 1.5 or 2.0 ATA equivalent had no effect on postconcussion symptoms after mild traumatic brain injury when compared with sham compression.","Cifu, D X; Hart, B B; West, S L; Walker, W; Carne, W",2014.0,10.1097/HTR.0b013e3182a6aaf0,0,0,
6196,Neuropeptide Y stimulation as primary target for preventive measures of maladaptative cardiovascular reactions in occupational chronic stress exposure,"ER UNLABELLED: Chronic stress may produce a decrease in central NPY expression and subjects exposed to it may prove hypersensitivity to a novel stressor with dysfunctions in the NPY system and cardiovascular maladaptation to stress, even hypertension. Upregulation of NPY expression may contribute to successful behavioral adaptation to stress by reducing cardiovascular tone and suppressing anxious behaviors. Adaptogens, a new class of metabolic regulators stimulate NPY expression and release. The aim of this study is to increase tolerance and adaptation to stress of hypersensitive to novel stressor, occupational chronic stress exposed subjects with cardiovascular maladaptation to mild new stressor using adaptogens as part of prevention protocol.MATERIAL AND METHODS: 40 military personnel with known cardiostressor reactional mode and occupational chronic stress exposure were exposed to mild novel stressor: occupational medicine routine evaluation and clinically assessed for maladaptative cardiovascular response prior and before application of 30 day prevention protocol. Employees were randomly split in two groups, one receiving standard prevention protocol (lifestyle counseling) plus adaptogens in multiple dose administration, twice daily and the other receiving only standard prevention protocol.RESULTS: We found significant statistic differences in all cardiovascular parameters in adaptogen group and only in diastolic blood pressure in control group.CONCLUSIONS: Adaptogens could be an important factor in successful prevention protocols of chronic occupational stress dysfunctions involving NPY systems.","Ciuma?u-Rîmbu, M; Popa, L; Vulpoi, C",2012.0,,0,0,
6197,A randomized controlled trial of an education and counselling intervention for families after stroke,"ER DESIGN: Two-group randomized controlled trial. Data were collected on admission to and discharge from rehabilitation, and again six months later.SETTING: Rehabilitation units at Repatriation General Hospital and Griffith Hospital, in Adelaide, South Australia.PARTICIPANTS: Sixty-two stroke patients and their spouses, 32 in the intervention group and 30 in the control group.INTERVENTION: Stroke information package and three visits from a social worker trained in family counselling.OUTCOME MEASURES: Family functioning: McMaster Family Assessment Device (FAD); functional status: Barthel Index (BI); social recovery: Adelaide Activities Profile (AAP); depression: Geriatric Depression Scale (GDS); anxiety: Hospital Anxiety and Depression Scale (HADS); mastery: Mastery Scale (MS); health status: SF-36.RESULTS: At six months the intervention group had better family functioning for both patients (mean FAD difference 0.19) and spouses (mean difference 0.09). A modest benefit in functional status for intervention patients (mean BI difference 1.3) was related to improved family functioning. Intervention patients reported better social recovery (mean AAP differences: domestic chores 5.7, household maintenance 4.6, social activities 11.5), but there were no significant effects on depression, anxiety, mastery or health status.CONCLUSIONS: An education and counselling intervention maintained family functioning, and in turn led to improved functional and social patient outcomes. This approach helps patients and their spouses to make the optimal adjustment to living with stroke.OBJECTIVES: To determine whether education and counselling after stroke leads to improved family functioning and psychosocial outcomes for stroke patients and their spouses, and better functional and social outcomes for patients.","Clark, M S; Rubenach, S; Winsor, A",2003.0,10.1191/0269215503cr681oa,0,0,
6198,Thyrotropin-releasing hormone: a potential comparator for the panicogenic effects of pentagastrin and CCK?,,"Coupland, N; Malizia, A; Bailey, J; Nutt, D",1996.0,,0,0,
6199,A randomized controlled trial of a web-based early intervention for children and their parents following unintentional injury,"ER METHODParticipants were randomly assigned to an intervention (n = 29) or a control group (n = 27) following baseline measurements. Further assessment was taken at 4-6 weeks and 6 months post-trauma event.RESULTSAnalyses revealed that children within the intervention group reported improved anxiety, in comparison to a worsening of symptoms for children in the control group. Furthermore, children who had higher baseline trauma scores reported the intervention to be helpful.CONCLUSIONSThe intervention showed promising results in its ability to aid child recovery.OBJECTIVEThe aim of this article was to evaluate the effectiveness of an information provision web-based early intervention via a randomized controlled trial for children and their parents following pediatric unintentional injury.","Cox, C M; Kenardy, J A; Hendrikz, J K",2010.0,10.1093/jpepsy/jsp095,0,0,
6200,Senior peer counseling by telephone for psychosocial support after breast cancer surgery: effects at six months,"ER PURPOSE/OBJECTIVES: To evaluate the efficacy of senior peer counseling by telephone for supplemental psychosocial support of older women after breast cancer surgery.DESIGN: Experimental, randomized block, longitudinal.SETTING: A community-based senior service agency and a community hospital-based breast surgical oncology practice in an urban area of California.SAMPLE: 142 women newly diagnosed and scheduled for surgery for stage 0-III breast cancer (X age = 61.8, range = 50-94).METHODS: Participants were stratified by age and randomized to receive telephone calls from a peer counselor (a) once per week for five weeks beginning within 72 hours postsurgery, (b) once weekly for five weeks beginning six weeks postsurgery, and (c) by request. Assessments were conducted before surgery, postintervention, and six months after surgery. Questionnaires included the Hospital Anxiety and Depression Scale, the Interpersonal Relationship Inventory, and the Brief COPE.MAIN RESEARCH VARIABLES: Anxious mood, social support, and coping by seeking instrumental support.FINDINGS: At six months, significant main effects of age were noted for social support, fear of recurrence, and resource use. Significant independent effects of age and intervention were noted for coping by seeking instrumental support. After controlling for age, a significant interaction effect of intervention and time was observed for coping by seeking instrumental support.CONCLUSIONS: Peer counseling may affect instrumental support seeking and appears to be differentially received by age group. Additional study is needed to better understand who benefits most and how from peer counseling.IMPLICATIONS FOR NURSING: Trained senior peer counselor volunteers, supervised by a skilled clinical team, may be a useful adjunct in addressing psychosocial needs of women after breast cancer surgery.","Crane-Okada, R; Freeman, E; Kiger, H; Ross, M; Elashoff, D; Deacon, L; Giuliano, A E",2012.0,10.1188/12.ONF.78-89,0,0,
6201,Does psychological treatment help only those patients with severe irritable bowel syndrome who also have a concurrent psychiatric disorder?,"ER METHOD: Two hundred and fifty-seven patients with severe IBS entering a psychological treatment trial were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. At entry to the trial and 15 months later, patients were also assessed using the Hamilton Depression Rating Scale, Symptom Cheecklist-90 (SCL-90) and Short Form-36 (SF36) physical component summary score as the main outcome measure. Partial correlation was used to compare changes in SF36 score and changes in psychological scores while controlling for possible confounders, treatment group and baseline scores. Multiple regression analysis was used to examine whether changes in psychological scores, changes in pain and a history of abuse could account for most of the variance of change in SF36 physical component score.RESULTS: Of 257 patients with severe IBS, 107 (42%) had a depressive, panic or generalized anxiety disorder at trial entry. There were moderate but significant correlations (0.21-0.47) between change in the psychological scores and the change in SF36 physical component scores. The correlation coefficients were similar in the groups with and without psychiatric disorder. The superiority of psychotherapy and antidepressant groups over treatment as usual was similar in those with and without psychiatric disorder. Multiple regression found significant independent effects of change in depression, anxiety, somatization and abdominal pain but there was still variance explained by treatment group.CONCLUSIONS: In severe IBS improvement in health-related quality of life following psychotherapy or antidepressants is correlated with, but not explained fully by reduction of psychological scores. A more complete understanding of how these treatments help patients with medically unexplained symptoms will enable us to refine them further.OBJECTIVE: We have previously reported improved health-related quality of life in patients with severe irritable bowel syndrome (IBS) following psychological treatments. In this paper, we examine whether this improvement was associated with improvement in psychological symptoms and was confined to those patients who had concurrent psychiatric disorder.","Creed, F; Guthrie, E; Ratcliffe, J; Fernandes, L; Rigby, C; Tomenson, B; Read, N; Thompson, D G",2005.0,10.1080/j.1440-1614.2005.01686.x,0,0,
6202,Treatment of childhood anxiety disorder in the context of maternal anxiety disorder: a randomised controlled trial and economic analysis,"ER BACKGROUND: Cognitive-behavioural therapy (CBT) for childhood anxiety disorders is associated with modest outcomes in the context of parental anxiety disorder. OBJECTIVES: This study evaluated whether or not the outcome of CBT for children with anxiety disorders in the context of maternal anxiety disorders is improved by the addition of (i) treatment of maternal anxiety disorders, or (ii) treatment focused on maternal responses. The incremental cost-effectiveness of the additional treatments was also evaluated. DESIGN: Participants were randomised to receive (i) child cognitive-behavioural therapy (CCBT); (ii) CCBT with CBT to target maternal anxiety disorders [CCBT?+?maternal cognitive-behavioural therapy (MCBT)]; or (iii) CCBT with an intervention to target mother-child interactions (MCIs) (CCBT?+?MCI). SETTING: A NHS university clinic in Berkshire, UK. PARTICIPANTS: Two hundred and eleven children with a primary anxiety disorder, whose mothers also had an anxiety disorder. INTERVENTIONS: All families received eight sessions of individual CCBT. Mothers in the CCBT?+?MCBT arm also received eight sessions of CBT targeting their own anxiety disorders. Mothers in the MCI arm received 10 sessions targeting maternal parenting cognitions and behaviours. Non-specific interventions were delivered to balance groups for therapist contact. MAIN OUTCOME MEASURES: Primary clinical outcomes were the child's primary anxiety disorder status and degree of improvement at the end of treatment. Follow-up assessments were conducted at 6 and 12 months. Outcomes in the economic analyses were identified and measured using estimated quality-adjusted life-years (QALYs). QALYS were combined with treatment, health and social care costs and presented within an incremental cost-utility analysis framework with associated uncertainty. RESULTS: MCBT was associated with significant short-term improvement in maternal anxiety; however, after children had received CCBT, group differences were no longer apparent. CCBT?+?MCI was associated with a reduction in maternal overinvolvement and more confident expectations of the child. However, neither CCBT?+?MCBT nor CCBT?+?MCI conferred a significant post-treatment benefit over CCBT in terms of child anxiety disorder diagnoses [adjusted risk ratio (RR) 1.18, 95% confidence interval (CI) 0.87 to 1.62, p?=?0.29; adjusted RR CCBT?+?MCI vs. control: adjusted RR 1.22, 95% CI 0.90 to 1.67, p?=?0.20, respectively] or global improvement ratings (adjusted RR 1.25, 95% CI 1.00 to 1.59, p?=?0.05; adjusted RR 1.20, 95% CI 0.95 to 1.53, p?=?0.13). CCBT?+?MCI outperformed CCBT on some secondary outcome measures. Furthermore, primary economic analyses suggested that, at commonly accepted thresholds of cost-effectiveness, the probability that CCBT?+?MCI will be cost-effective in comparison with CCBT (plus non-specific interventions) is about 75%. CONCLUSIONS: Good outcomes were achieved for children and their mothers across treatment conditions. There was no evidence of a benefit to child outcome of supplementing CCBT with either intervention focusing on maternal anxiety disorder or maternal cognitions and behaviours. However, supplementing CCBT with treatment that targeted maternal cognitions and behaviours represented a cost-effective use of resources, although the high percentage of missing data on some economic variables is a shortcoming. Future work should consider whether or not effects of the adjunct interventions are enhanced in particular contexts. The economic findings highlight the utility of considering the use of a broad range of services when evaluating interventions with this client group. TRIAL REGISTRATION: Current Controlled Trials ISRCTN19762288. FUNDING: This trial was funded by the Medical Research Council (MRC) and Berkshire Healthcare Foundation Trust and managed by the National Institute for Health Research (NIHR) on behalf of the MRC-NIHR partnership (09/800/17) and will be published in full in Health Technology Assessment; Vol. 19, No. 38.","Creswell, C; Cruddace, S; Gerry, S; Gitau, R; McIntosh, E; Mollison, J; Murray, L; Shafran, R; Stein, A; Violato, M; Voysey, M; Willetts, L; Williams, N; Yu, L M; Cooper, P J",2015.0,10.3310/hta19380,0,0,
6203,Brief mindfulness meditation training alters psychological and neuroendocrine responses to social evaluative stress,"ER OBJECTIVE: To test whether a brief mindfulness meditation training intervention buffers self-reported psychological and neuroendocrine responses to the Trier Social Stress Test (TSST) in young adult volunteers. A second objective evaluates whether pre-existing levels of dispositional mindfulness moderate the effects of brief mindfulness meditation training on stress reactivity. METHODS: Sixty-six (N=66) participants were randomly assigned to either a brief 3-day (25-min per day) mindfulness meditation training or an analytic cognitive training control program. All participants completed a standardized laboratory social-evaluative stress challenge task (the TSST) following the third mindfulness meditation or cognitive training session. Measures of psychological (stress perceptions) and biological (salivary cortisol, blood pressure) stress reactivity were collected during the social evaluative stress-challenge session. RESULTS: Brief mindfulness meditation training reduced self-reported psychological stress reactivity but increased salivary cortisol reactivity to the TSST, relative to the cognitive training comparison program. Participants who were low in pre-existing levels of dispositional mindfulness and then received mindfulness meditation training had the greatest cortisol reactivity to the TSST. No significant main or interactive effects were observed for systolic or diastolic blood pressure reactivity to the TSST. CONCLUSIONS: The present study provides an initial indication that brief mindfulness meditation training buffers self-reported psychological stress reactivity, but also increases cortisol reactivity to social evaluative stress. This pattern may indicate that initially brief mindfulness meditation training fosters greater active coping efforts, resulting in reduced psychological stress appraisals and greater cortisol reactivity during social evaluative stressors.","Creswell, J D; Pacilio, L E; Lindsay, E K; Brown, K W",2014.0,10.1016/j.psyneuen.2014.02.007,0,0,
6204,Quality of life in patients with chronic obstructive pulmonary disease and comorbid anxiety or depression,"ER The authors examined 179 veterans with chronic obstructive pulmonary disease (COPD) to determine the relative contribution of clinical depression and/or anxiety (Beck Depression and Beck Anxiety Inventories) to their quality of life (Chronic Respiratory Questionnaire and Medical Outcomes Survey Short Form). Multiple-regression procedures found that both depression and anxiety were significantly related to negative quality-of-life outcomes (anxiety with both mental and physical health quality-of-life outcomes, and depression primarily with mental health). When comorbid with COPD, mental health symptoms of depression and anxiety are some of the most salient factors associated with quality-of-life outcomes.","Cully, J A; Graham, D P; Stanley, M A; Ferguson, C J; Sharafkhaneh, A; Souchek, J; Kunik, M E",2006.0,10.1176/appi.psy.47.4.312,0,0,
6205,Yoga to Reduce Trauma-Related Distress and Emotional and Behavioral Difficulties Among Children Living in Orphanages in Haiti: a Pilot Study,"ER DESIGNCase comparison with random assignment to YI or aerobic dance control (DC) plus a nonrandomized wait-list control (WLC) group.SETTINGTwo orphanages for children in Haiti.PARTICIPANTS76 children age 7 to 17 years.INTERVENTIONThe YI included yoga postures, breathing exercises, and meditation. The DC group learned a series of dance routines. The WLC group received services as usual in the institutional setting. After completion of data collection, the WLC group received both yoga and dance classes for 8 weeks.OUTCOME MEASURESThe UCLA PTSD Reaction Index and the Strengths and Difficulties Questionnaire were used to indicate trauma-related symptoms and EBD, respectively. A within-subject analysis was conducted to compare pre- and post-treatment scores. A post-treatment yoga experience questionnaire evaluated acceptability of the YI.RESULTSAnalyses of variance revealed a significant effect (F[2,28]=3.30; p=0.05) of the YI on the trauma-related symptom scores. Regression analyses showed that participation in either 8 weeks of yoga or dance classes suggested a reduction in trauma-related symptoms and EBD, although this finding was not statistically significant (p>0.05). Respondents reported satisfaction with the yoga program and improved well-being.CONCLUSIONSChildren with trauma-related distress showed improvements in symptoms after participation in an 8-week yoga program compared to controls. Yoga is a feasible and acceptable activity with self-reported benefits to child mental and physical health. Additional research is needed to further evaluate the effect of yoga to relieve trauma-related distress and promote well-being among children.OBJECTIVESTo measure trauma-related distress and evaluate the feasibility, acceptability, and preliminary efficacy of an 8-week yoga intervention (YI) in reducing trauma-related symptoms and emotional and behavioral difficulties (EBD) among children living in orphanages in Haiti.","Culver, K A; Whetten, K; Boyd, D L; O'Donnell, K",2015.0,10.1089/acm.2015.0017,0,0,
6206,Anxiety in children with mood disorders: a treatment help or hindrance?,"ER This study examined the role of comorbid anxiety in treatment outcome for children with mood disorders (N?=?165; age 8-11) participating in Multi-Family Psychoeducational Psychotherapy (MF-PEP). Assessments occurred at baseline, 6, 12, and 18 months for two randomly assigned groups: immediate treatment and 1-year wait-list. Most children (69%) had comorbid anxiety disorders. Baseline comorbid anxiety, as reported on the Children's Interview for Psychiatric Syndromes (ChIPS), was associated with higher Children's Depression Rating Scale- Revised (CDRS-R) scores but not Young Mania Rating Scale (YMRS) scores. Higher levels of anxiety symptoms were associated with lower Children's Global Assessment Scale (C-GAS) scores. Participation in MF-PEP did not significantly reduce anxiety symptoms (p?=?0.62). However, presence of comorbid anxiety did not impede reduction in depressive (CDRS-R, p?=?0.74) or manic (YMRS scores, p?=?0.94) symptoms following MF-PEP. More baseline anxiety symptoms were associated with greater improvement in C-GAS scores post-treatment (p?=?0.02). Implications are discussed.","Cummings, C M; Fristad, M A",2012.0,10.1007/s10802-011-9568-5,0,0,
6207,Treating depressive symptoms in schoolchildren: a pilot study,"ER Although studies on sub-threshold depression in childhood and adolescence have demonstrated an at risk profile that merits further attention, only few investigators examined the impact of therapy with these children. In this study, twenty elementary schoolchildren (aged 10-12) with moderate depressive symptoms were randomly assigned to an eighteen-session cognitive-behavioural treatment programme or to a waiting list (WL) control group (= Study 1). The key components of the programme ""Taking Action"" used in the study were: affective education, problem-solving, cognitive restructuring and engaging in enjoyable activities. Child self-reports and parent reports were used to evaluate the outcome. Paired t-tests comparing the 4-months follow-up results with baseline measurements, revealed a significant improvement on the Children Depression Inventory and on the Self-Perception Profile for Children, but only in the treatment group. Afterwards, the WL control group was treated as well. All children were followed in a long-term follow-up study (= Study 2). Analyses at the 12 month stage of the follow-up study showed a further improvement of the scores on the Self-Perception Profile. Moreover, a significant decrease was found on the Children Depression Inventory, the State-Trait Anxiety Inventory and the Child Behaviour Checklist parent measure. It was concluded that the protocol is suitable for European children. The most remarkable findings in this pilot study are discussed.","Cuyper, S; Timbremont, B; Braet, C; Backer, V; Wullaert, T",2004.0,10.1007/s00787-004-0366-2,0,0,
6208,Emotional and cardiovascular reactivity to a child-focused interpersonal stressor among depressed mothers of psychiatrically ill children,"ER METHODSThe current feasibility study evaluated mothers' emotional and cardiovascular reactivity in response to an acute, child-focused stress task. Twenty-two depressed mothers of psychiatrically ill children were recruited from a larger clinical trial; half were randomly assigned to receive an adapted form of interpersonal psychotherapy (IPT-MOMS), while the other half received treatment as usual (TAU). For comparison purposes, a matched sample of 22 nondepressed mothers of psychiatrically healthy children was also evaluated.RESULTSDepressed mothers receiving minimal-treatment TAU displayed the greatest increases in depressed mood, heart rate, and diastolic blood pressure in response to the child-focused stress task, and significantly differed from the relatively low levels of reactivity observed among nondepressed mothers of healthy children. In contrast, depressed mothers receiving IPT-MOMS displayed patterns of reactivity that fell between these extreme groups. Maternal stress reactivity was associated not only with maternal psychiatric symptoms, but also with levels of chronic parental stress and maternal history of childhood emotional abuse.CONCLUSIONSFuture, more definitive research is needed to evaluate depressed mothers' interpersonal stress reactivity, its amenability to treatment, and its long-term impact on child psychiatric outcomes.BACKGROUNDImpairment in maternal interpersonal function represents a risk factor for poor psychiatric outcomes among children of depressed mothers. However, the mechanisms by which this effect occurs have yet to be fully elucidated. Elevated levels of emotional or physiological reactivity to interpersonal stress may impact depressed mothers' ability to effectively negotiate child-focused conflicts. This effect may become particularly pronounced when depressed mothers are parenting a psychiatrically ill child.","Cyranowski, J M; Swartz, H A; Hofkens, T L; Frank, E",2009.0,10.1002/da.20515,0,0,
6209,Pre-emptive effect of pre-incisional versus post-incisional infiltration of local anaesthesia on children undergoing hernioplasty,"ER METHODSFifty children aged 2-10 years scheduled for hernioplasty were randomly assigned into two groups. Group 1 (n = 28) was infiltrated before surgery with bupivacaine 2.5mg/ml, 1mg/kg after induction of general anaesthesia. After surgery they were infiltrated with the same volume of 0.9% saline. Group 2 (n = 22) was infiltrated with 0.9% saline before surgery and bupivacaine 2.5 mg/ml, 1mg/kg after surgery. The study was performed double-blindly. In both groups anaesthesia was induced with thiopenthone and maintained with nitrous oxide and halothane, adjusted to keep haemodynamic measurements stable. All children were given paracetamol 15-20 mg/kg rectally when admitted to the recovery ward. Painscore (OPS) and analgesic requirements were registered postoperatively. After 48 h the parents completed a standardised questionnaire and they were interviewed by telephone after one week.RESULTSThe pre-incisional group needed significantly less halothane during the procedure compared with the post-incisional group (P < 0.05). The pre-incisional group also had a tendency towards faster awakening after the end of anaesthesia and a significantly lower OPS-pain score 30 min after the operation (P < 0.03). There were no differences between the two groups regarding need for additional analgesia: meperidine i.v. during the first 5 h postoperatively, and paracetamol thereafter. There were no differences between the groups regarding activity level, appetite and quality of sleep in the first week. In both groups the need for opioid analgesics was low: 54% in the pre-incisional group and 45% in the post-incisional group did not receive any opioid analgesic treatment. The children were virtually fully recovered after the first 24 h.CONCLUSIONPerioperative infiltration with a local anaesthetic in children undergoing hernioplasty results in a smooth recovery with little need for opioids postoperatively. Apart from a lower anaesthetic requirement and a reduced postoperative pain level after 30 min in the pre-incisional bupivacaine group, there was no difference between infiltration before (pre-emptive) or after surgery.BACKGROUNDAlthough promising in experimental studies of post-traumatic pain, the concept of pre-emptive analgesia is still controversial in a clinical setting. Thus, we wanted to compare the clinical efficacy of wound infiltration with local anaesthesia before surgery with wound infiltration after hernioplasty in children.","Dahl, V; Raeder, J C; Ern√∏, P E; Kovdal, A",1996.0,,0,0,
6210,Diclofenac-K (50 and 100 mg) and placebo in the acute treatment of migraine,"ER The aim of the present study was to assess the efficacy and tolerability of single oral doses of 50 mg and 100 mg of diclofenac-K compared to placebo in migraine sufferers during three attacks. The study was conducted in a double-blind, randomized, placebo-controlled, three-period, within-patient comparative trial; 72 migraine patients were treated with diclofenac-K (50 mg or 100 mg) or placebo at six centres (1 in Sweden and 5 in Finland). The primary efficacy end-point was the change in pain intensity assessed on a 100 mm Visual Analogue Scale (VAS) at 120 min after taking the study medication. We found that 50 mg and 100 mg of diclofenac-K reduced the pain intensity significantly better than placebo (p = 0.003 and p = 0.001, respectively), without difference between the doses; 100 mg diclofenac-K was significantly better than placebo in improving phonophobia, photophobia, working ability and need for rescue medication. Diclofenac-K 50 mg or 100 mg is an effective and well-tolerated acute treatment for migraine headache and its associated symptoms. The higher dose of diclofenac-K was only marginally more effective than the lower dose.","Dahlöf, C; Björkman, R",1993.0,10.1046/j.1468-2982.1993.1302117.x,0,0,
6211,Within-patient consistency of response of rizatriptan for treating migraine,"ER METHODSPost hoc analysis was performed on data from a randomized, double-blind, placebo-controlled clinical trial. Four hundred seventy-three patients with migraine diagnosed according to the criteria of the International Headache Society were randomly assigned to one of five sequence groups in which each patient was scheduled to treat four separate moderate or severe migraine attacks. Patients in four groups received 10 mg of rizatriptan for three of four attacks and placebo for the remaining attack; patients in the fifth group received 10 mg of rizatriptan for all four attacks. Headache severity, functional disability, and associated migraine symptoms were measured immediately before dosing and at regular intervals up to 4 hours after the dose. The analysis was based on efficacy at 2 hours after dosing, the last time point before escape medications were allowed. The percentages of patients who responded in a specified number of attacks after treatment with rizatriptan were calculated. The analysis was descriptive, and no formal statistical testing was performed.RESULTSOf the evaluable patients who treated three migraine attacks with 10 mg of rizatriptan (with an additional interspersed placebo-treated attack in most patients), 216 of 252 (86%) had pain relief (reduction of pain to mild or none), 122 of 252 (48%) were pain free, 211 of 250 (84%) had no nausea, 163 of 251 (65%) had no photophobia, 182 of 252 (72%) had no phonophobia, 136 of 249 (55%) had no functional disability, and 233 of 252 (92%) had no need for escape medications at 2 hours after dosing in at least two of three attacks.CONCLUSIONThe response to 10 mg of oral rizatriptan within individual patients was consistent over three attacks on a range of measures.OBJECTIVETo determine the within-patient consistency of response for rizatriptan, a 5-HT(1B/1D) receptor agonist for the acute treatment of migraine.","Dahlöf, C G; Lipton, R B; McCarroll, K A; Kramer, M S; Lines, C R; Ferrari, M D",2000.0,,0,0,
6212,Trauma-focused cognitive behaviour therapy versus treatment as usual for post traumatic stress disorder (PTSD) in young children aged 3 to 8 years: study protocol for a randomised controlled trial,"ER BACKGROUND: Following horrific or life-threatening events approximately 10 to 15% of young children develop post traumatic stress disorder (PTSD). The symptoms of this disorder are distressing - nightmares, flashbacks, anger outbursts and disturbed play. These symptoms cause major disruption to a child's functioning and, if left untreated, can persist for many years. As yet, there are no established empirically-validated treatments for PTSD in young children. Trauma-focused cognitive behaviour therapy (TF-CBT) is a psychological intervention that is effective in treating the disorder in older children (8 to 12 years), adolescents and adults. This study examines TF-CBT adapted for children aged between 3 and 8 years.METHODS/DESIGN: This protocol describes a two-arm exploratory randomised controlled trial comparing TF-CBT to treatment as usual (TAU) in children aged 3 to 8 years with a principal diagnosis of PTSD following a single-event discrete trauma. Using a half-crossover design, 44 participants will be randomly allocated to receive the intervention or to receive TAU. Those allocated to TAU will be offered TF-CBT at the end of the 'treatment' period (approximately 12 weeks) if still indicated. The primary outcome is PTSD diagnosis according to DSM-5 criteria for children 6 years and younger at post-treatment. Secondary outcomes include effects on co-morbid diagnoses and changes in emotion and trauma symptoms at each of the follow-up points (post-treatment, 3-months, 12-months). Additionally, broader efficacy will be considered with regard to treatment feasibility, acceptability and service utilisation. The key targets of the intervention are trauma memory, the interpretation of the meaning of the event, and the management of symptoms.DISCUSSION: This is the first European trial to examine the efficacy of TF-CBT in alleviating PTSD in very young children. As well as providing much-needed data on the utility of the intervention, this exploratory trial will also allow us to gather important information about the feasibility of delivering the treatment in UK National Health Service (NHS) settings, and its acceptability to the children and their families. This study will highlight aspects of the intervention that need improvement or modification in preparation for a full-scale evaluation in a larger sample.TRIAL REGISTRATION: ISRCTN35018680 , registered on 18 November 2013.","Dalgleish, T; Goodall, B; Chadwick, I; Werner-Seidler, A; McKinnon, A; Morant, N; Schweizer, S; Panesar, I; Humphrey, A; Watson, P; Lafortune, L; Smith, P; Meiser-Stedman, R",2015.0,10.1186/s13063-015-0632-2,0,0,
6213,"Topiramate versus fluvoxamine in the treatment of pathological gambling: a randomized, blind-rater comparison study","ER Pathologic gambling (PG) is a highly prevalent and disabling impulse control disorder. Recent studies have demonstrated that PG patients respond well to treatment with SSRIs, mood stabilizers, and opioid antagonists. These findings support the idea that PG and other disorders of impulse control may be conceptualized as part of the obsessive-compulsive spectrum disorders. Pilot studies have shown topiramate to be effective in the treatment of specific disorders of impulse control. The aim of the study is to compare the effectiveness of topiramate versus fluvoxamine in the treatment of PG. Thirty-one male PGs were assigned in a randomized fashion to receive either topiramate (15/31) or fluvoxamine (16/31) pharmacotherapy for 12 weeks. A comprehensive psychiatric diagnostic evaluation was performed on all patients, and all patients were evaluated for symptoms of gambling, depression, and anxiety using the South Oaks Gambling Screen, the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Yale-Brown Obsessive Compulsive Symptoms Scale, and the Clinical Global Impression-Improvement Scale. The rating scales were administered at baseline and at the 12-week endpoint. In addition, the patients completed self-report questionnaires about their demographic status. Twelve of the 15 patients from the topiramate group completed the 12-week treatment. Nine of the 12 topiramate completers reported full remission of gambling behavior, and 3 completers had a partial remission. The CGI-improvement score was significantly better for the topiramate group at the 12-week visit as compared with baseline (F = 10.5, P < 0.01, df = 2.31). In the fluvoxamine treatment group 8/16 patients completed the study, and 6/8 fluvoxamine completers reported a full remission, and the remaining 2/8 fluvoxamine completers reported a partial remission. The fluvoxamine group showed improvement in the CGI-improvement score at week 12, although this difference was not significant (F = 3.7, P < 0.08, df = 2.31). Topiramate and fluvoxamine monotherapy may be effective in the treatment of pathologic gambling.","Dannon, P N; Lowengrub, K; Gonopolski, Y; Musin, E; Kotler, M",2005.0,,0,0,
6214,Personality factors moderate the associations between apolipoprotein genotype and cognitive function as well as late onset Alzheimer disease,"ER DESIGN: Primary analyses of existing randomized clinical trial data.SAMPLE: Six-hundred two older adults (mean age of 78 years at baseline).MEASUREMENTS: APOE genotype, the NEO-Five Factor Inventory, the Alzheimer's Disease Assessment Scale-Cognitive: measured every 6 months for 6.5 years) and relevant covariates.RESULTS: Fully adjusted multivariate analyses showed that the association between the presence of APOE [Latin Small Letter Open E]-4 allele(s) and both outcomes was evident among individuals with high levels of neuroticism and extraversion but not among persons with low levels of these traits.CONCLUSIONS: Phenotypic personality dimensions, primarily neuroticism and extraversion, moderate the relationship between APOE [Latin Small Letter Open E]-4 genotype and cognitive outcomes among older adults. Future research is needed to elucidate the physiological processes involved in these particular phenotype-genotype interactions.OBJECTIVES: We tested the hypothesis that neuroticism moderates the association between APOE (apolipoprotein E) genotype and two major outcomes, cognitive function and Alzheimer disease. We also explored whether other personality dimensions (extraversion, openness to experience, agreeableness, and conscientiousness) moderate the associations of APOE with these outcomes.","Dar-Nimrod, I; Chapman, B P; Franks, P; Robbins, J; Porsteinsson, A; Mapstone, M; Duberstein, P R",2012.0,10.1097/JGP.0b013e318267016b,0,0,
6215,Genetic variability in glutamic acid decarboxylase genes: associations with post-traumatic seizures after severe TBI,"ER Post traumatic seizures (PTS) occur frequently after traumatic brain injury (TBI). Since gamma-amino butyric acid (GABA) neurotransmission is central to excitotoxicity and seizure development across multiple models, we investigated how genetic variability for glutamic acid decarboxylase (GAD) influences risk for PTS. Using both a tagging and functional single nucleotide polymorphism (SNP) approach, we genotyped the GAD1 and GAD2 genes and linked them with PTS data, regarding time to first seizure, obtained for 257 adult subjects with severe TBI. No significant associations were found for GAD2. In the GAD1 gene, the tagging SNP (tSNP) rs3828275 was associated with an increased risk for PTS occurring <1 wk. The tSNP rs769391 and the functional SNP rs3791878 in the GAD1 gene were associated with increased PTS risk occurring 1 wk-6 mo post-injury. Both risk variants conferred an increased susceptibility to PTS compared to subjects with 0-1 risk variant. Also, those with haplotypes having both risk variants had a higher PTS risk 1 wk-6 mo post-injury than those without these haplotypes. Similarly, diplotype analysis showed those with 2 copies of the haplotype containing both risk alleles were at the highest PTS risk. These results implicate genetic variability within the GABA system in modulating the development of PTS.","Darrah, S D; Miller, M A; Ren, D; Hoh, N Z; Scanlon, J M; Conley, Y P; Wagner, A K",2013.0,10.1016/j.eplepsyres.2012.07.006,0,0,
6216,Treatment of posttraumatic stress disorder with amitriptyline and placebo,"ER Amitriptyline hydrochloride was compared with placebo in 46 veterans with chronic posttraumatic stress disorder. Treatment continued up to 8 weeks, and efficacy was measured by five observer and two self-rated scales. Percent recovery rates were higher for amitriptyline than placebo on two measures. In patients who completed 4 weeks (n = 40), better outcome with amitriptyline was noted on the Hamilton depression scale only. In the group completing 8 weeks of treatment (n = 33), the drug was superior to placebo on Hamilton depression, Hamilton anxiety, Clinical Global Impression severity, and Impact of Event scales. There was no evidence for drug effects on the structured interview for posttraumatic stress disorder. Drug-placebo differences were greater in the presence of comorbidity in general, although recovery rates were uniformly low in the presence of major depression, panic disorder, and alcoholism. At the end of treatment, 64% of the amitriptyline and 72% of the placebo samples still met diagnostic criteria for posttraumatic stress disorder.","Davidson, J; Kudler, H; Smith, R; Mahorney, S L; Lipper, S; Hammett, E; Saunders, W B; Cavenar, J O",1990.0,,0,0,
6217,"Efficacy of sertraline in preventing relapse of posttraumatic stress disorder: results of a 28-week double-blind, placebo-controlled study","ER METHODNinety-six patients were randomly assigned, in a double-blind design, to 28 weeks of maintenance treatment with sertraline (50-200 mg, N=46; 78% were women) or placebo (N=50; 62% were women). Measures used in biweekly assessments included the Clinician-Administered PTSD Scale, the Impact of Event Scale, and the Clinical Global Impression severity and improvement ratings. Kaplan-Meier analyses were used to estimate time to discontinuation from the study due to relapse, relapse or study discontinuation due to clinical deterioration, and acute exacerbation.RESULTSContinued treatment with sertraline yielded lower PTSD relapse rates than placebo (5% versus 26%). Patients who received placebo were 6.4 times as likely to experience relapse as were patients who received sertraline. Kaplan-Meier analyses confirmed the protective effect of sertraline in significantly extending time in remission. The ability of sertraline to sustain improvement was comparable across the three core PTSD symptom clusters (reexperiencing/intrusion, avoidance/numbing, and hyperarousal). A regression analysis found early response during acute treatment to be associated with a more than 16-fold reduced risk of relapse after placebo substitution. Sertraline, at a mean endpoint dose of 137 mg, was well tolerated, with no sertraline-related adverse events observed at a rate of 10% or higher.CONCLUSIONSThe results provide evidence for the ability of sertraline both to sustain improvement in PTSD symptoms and to provide prophylactic protection against relapse.OBJECTIVEThe study examined the efficacy of sertraline, compared with placebo, in sustaining improvement and preventing relapse over 28 weeks in patients with posttraumatic stress disorder (PTSD) who had completed a 12-week double-blind, placebo-controlled acute treatment study and a subsequent 24-week open-label study of continuation treatment with sertraline.","Davidson, J; Pearlstein, T; Londborg, P; Brady, K T; Rothbaum, B; Bell, J; Maddock, R; Hegel, M T; Farfel, G",2001.0,10.1176/appi.ajp.158.12.1974,0,0,
6218,Maintenance therapy with fluoxetine in posttraumatic stress disorder: a placebo-controlled discontinuation study,"ER The effect of fluoxetine (FLU) in posttraumatic stress disorder was studied in a one-year trial. Subjects received open-label treatment for 6 months, followed by double-blind randomized treatment with FLU or placebo (PBO) for 6 months. Rates of relapse were compared using the Clinical Global Impressions of Improvement. One hundred twenty-three subjects entered open-label treatment, of whom 114 returned at least once. Sixty-two subjects were randomized to receive FLU or PBO, of whom 57 returned at least once and were analyzed. The dose of FLU ranged from 10 to 60 mg/d; at randomization, mean doses were 48.6 and 42.1 mg for FLU and PBO groups. Rates of relapse were 22% for FLU versus 50% for PBO (P = 0.02), and time to relapse on FLU was longer than for PBO (P = 0.02, log-rank statistic). The odds ratio for relapse on PBO relative to FLU was 3.50. No significant differences were found on other measures. Fluoxetine was well tolerated during double-blind treatment.","Davidson, J R; Connor, K M; Hertzberg, M A; Weisler, R H; Wilson, W H; Payne, V M",2005.0,,0,0,
6219,Characterizing the effects of sertraline in post-traumatic stress disorder,"ER METHODThe study examined the effects of sertraline on the individual symptoms of PTSD. It also examined whether early changes in anger explained drug-induced change in other symptoms over time. Mixed models analysis was applied to datasets from two 12-week placebo-controlled trials of sertraline. A validated self-rating scale (DTS) was used to assess treatment efficacy.RESULTSSertraline was superior to placebo on 15 of 17 symptoms, especially in the numbing and hyperarousal clusters. A strong effect was found on anger from week 1, which partly explained the subsequent effects of sertraline on other symptoms, some of which began to show significantly greater response to drug than to placebo at week 6 (emotional upset at reminders, anhedonia, detachment, numbness, hypervigilance) and week 10 (avoidance of activities, foreshortened future).CONCLUSIONSSertraline exercises a broad spectrum effect in PTSD. Effects are more apparent on the psychological rather than somatic symptoms of PTSD, with an early modulation of anger and, perhaps, other affects, preceding improvement in other symptoms.BACKGROUNDSertraline has a proved efficacy in post-traumatic stress disorder (PTSD), but it is unknown which symptoms respond or in what sequence this occurs. Such information might be useful clinically and heuristically.","Davidson, J R; Landerman, L R; Farfel, G M; Clary, C M",2002.0,,0,0,
6220,The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial,"ER The outcome of a randomized controlled trial of cognitive behavior therapy in addition to treatment as usual (CBT plus TAU) compared with TAU alone (TAU) in one hundred and six participants meeting diagnostic criteria for borderline personality disorder is described. We anticipated that CBT plus TAU would decrease the number of participants with in-patient psychiatric hospitalizations or accident and emergency room contact or suicidal acts over twelve months treatment and twelve months follow-up, compared with TAU. We also anticipated that CBT plus TAU would lead to improvement in a range of secondary outcomes of mental health and social functioning compared to TAU. Of the 106 participants randomized, follow-up data on 102 (96%) was obtained at two years. Those randomized to CBT were offered an average of 27 sessions over 12 months and attended on average 16 (range 0 to 35). We found that the global odds ratio of a participant in the CBT plus TAU group compared with the TAU alone group having any of the outcomes of a suicidal act, in-patient hospitalization, or accident and emergency contact in the 24 months following randomization was 0.86 (95% confidence interval [CI] 0.45 to 1.66, p = 0.66). The corresponding global odds ratio, excluding accident and emergency room contact, was 0.75 (95% CI 0.37 to 1.54, p = 0.44). In terms of the number of suicidal acts, there was a significant reduction over the two years in favor of CBT plus TAU over TAU, with a mean difference of -0.91 (95%","Davidson, K; Norrie, J; Tyrer, P; Gumley, A; Tata, P; Murray, H; Palmer, S",2006.0,10.1521/pedi.2006.20.5.450,0,0,
6221,Involuntary memories after a positive film are dampened by a visuospatial task: unhelpful in depression but helpful in mania?,"ER Spontaneous negative mental images have been extensively researched due to the crucial role they play in conditions such as post-traumatic stress disorder. However, people can also experience spontaneous positive mental images, and these are little understood. Positive images may play a role in promoting healthy positive mood and may be lacking in conditions such as depression. However, they may also occur in problematic states of elevated mood, such as in bipolar disorder. Can we apply an understanding of spontaneous imagery gained by the study of spontaneous negative images to spontaneous positive images? In an analogue of the trauma film studies, 69 volunteers viewed an explicitly positive (rather than traumatic) film. Participants were randomly allocated post-film either to perform a visuospatial task (the computer game 'Tetris') or to a no-task control condition. Viewing the film enhanced positive mood and immediately post-film increased goal setting on a questionnaire measure. The film was successful in generating involuntary memories of specific scenes over the following week. As predicted, compared with the control condition, participants in the visuospatial task condition reported significantly fewer involuntary memories from the film in a diary over the subsequent week. Furthermore, scores on a recognition memory test at 1 week indicated an impairment in voluntary recall of the film in the visuospatial task condition. Clinical implications regarding the modulation of positive imagery after a positive emotional experience are discussed. Generally, boosting positive imagery may be a useful strategy for the recovery of depressed mood.","Davies, C; Malik, A; Pictet, A; Blackwell, S E; Holmes, E A",2012.0,10.1002/cpp.1800,0,0,
6222,Prolonged use of heat and moisture exchangers does not affect device efficiency or frequency rate of nosocomial pneumonia,"ER DESIGNProspective, controlled, randomized, unblinded study.SETTINGSurgical intensive care unit at a university teaching hospital.PATIENTSA total of 220 consecutive patients requiring mechanical ventilation for >48 hrs.INTERVENTIONSPatients were randomized to one of three groups: a) hygroscopic HME (Aqua+) changed every 24 hrs (HHME-24); b) hydrophobic HME (Duration HME) changed every 120 hrs (HME-120); and c) hygroscopic HME (Aqua+) changed every 120 hrs (HHME-120). Devices in all groups could be changed at the discretion of the staff when signs of occlusion or increased resistance were identified.MEASUREMENTS AND MAIN RESULTSDaily measurements of inspired gas temperature, inspired relative humidity, and device resistance were made. Additionally, daily cultures of the patient side of the device were accomplished. The frequency rate of nosocomial pneumonia was made by using clinical criteria. Ventilatory support variables, airway care, device costs, and clinical indicators of humidification efficiency (sputum volume, sputum efficiency) were also recorded. Prolonged use of both hygroscopic and hydrophobic devices did not diminish efficiency or increase resistance. There was no difference in the number of colony-forming units from device cultures over the 5-day period and no difference between colony-forming units in devices changed every 24 hrs compared with devices changed after 120 hrs. The average duration of use was 23+/-4 hrs in the HHME-24 group, 73+/-13 hrs in the HME-120 group, and 74+/-9 hrs in the HHME-120 group. Mean absolute humidity was greater for the hygroscopic devices (30.4+/-1.1 mg of H2O/L) compared with the hydrophobic devices (27.8+/-1.3 mg of H2O/L). The frequency rate of nosocomial pneumonia was 8% (8:100) in the HHME-24 group, 8.3% (5:60) in the HME-120 group, and 6.6% (4:60) in the HHME-120 group. Pneumonia rates per 1000 ventilatory support days were 20:1000 in the HHME-24 group, 20.8:1000 in the HME-120 group, and 16.6:1000 in the HHME-120 group. Costs per day were $3.24 for the HHME-24 group, $2.98 for the HME-120 group, and $1.65 for the HHME-120 group.CONCLUSIONSChanging the hydrophobic or hygroscopic HME after 3 days does not diminish efficiency, increase resistance, or alter bacterial colonization. The frequency rate of nosocomial pneumonia was also unchanged. Use of HMEs for >24 hrs, up to 72 hrs, is safe and cost effective.OBJECTIVETo determine whether use of a single heat and moisture exchanger (HME) for < or =120 hrs affects efficiency, resistance, level of bacterial colonization, frequency rate of nosocomial pneumonia, and cost compared with changing the HME every 24 hrs.","Davis, K; Evans, S L; Campbell, R S; Johannigman, J A; Luchette, F A; Porembka, D T; Branson, R D",2000.0,,0,0,
6223,Substance use disorder comorbidity in major depressive disorder: a confirmatory analysis of the STAR*D cohort,"ER The demographics and clinical features were compared between those with (29.4%) and without concurrent substance use disorder (SUD) in 2541 outpatients with major depression (MDD) enrolled in the Sequenced Treatment Alternatives to Relieve Depression study. Compared to those without SUD, MDD patients with concurrent SUD were more likely to be younger, male, divorced or never married, and at greater current suicide risk, and have an earlier age of onset of depression, greater depressive symptomatology, more previous suicide attempts, more frequent concurrent anxiety disorders, and greater functional impairment (p = 0.048 to <0.0001). They were also less likely to be Hispanic and endorse general medical comorbidities (p = 0.006 and 0.002, respectively).","Davis, L L; Frazier, E; Husain, M M; Warden, D; Trivedi, M; Fava, M; Cassano, P; McGrath, P J; Balasubramani, G K; Wisniewski, S R; Rush, A J",2006.0,10.1080/10550490600754317,0,0,
6224,A placebo-controlled study of nefazodone for the treatment of chronic posttraumatic stress disorder: a preliminary study,"ER Nefazodone is a unique serotonergic antidepressant that acts as both a presynaptic serotonin reuptake inhibitor and a postsynaptic 5-hydroxytryptamine 2A receptor antagonist. Based on the positive results of open-label trials of nefazodone, including one from our group, we tested nefazodone's efficacy in the treatment of posttraumatic stress disorder (PTSD) under placebo-controlled conditions. Forty-one patients with chronic PTSD, predominantly male combat veterans, were enrolled in a randomized, double-blind, placebo-controlled 12-week trial of nefazodone. The primary outcome measure was the Clinician-Administered PTSD Scale. Fifteen patients were randomized to placebo and 26 were randomized to nefazodone. In a repeated-measures analysis of variance with last observation carried forward, patients on nefazodone showed a significant improvement in the percentage change of Clinician-Administered PTSD Scale Total score from baseline compared with those on placebo (P = 0.04; effect size = 0.6). Sample size was not powered to test group differences in the Clinician-Administered PTSD Scale criterion B, C, or D subscale. However, the criterion D subscale showed significant improvement in patients treated with nefazodone compared with those treated with placebo (P = 0.007). In addition, the Hamilton Rating Scale for Depression showed significant improvement compared with placebo (P = 0.008). The nefazodone group also reported an improvement on the PTSD Checklist (self-report scale; P = 0.08) and the Clinician-Administered Dissociative States Scale (P = 0.06). This pilot study supports the efficacy of nefazodone for the treatment of PTSD. However, larger placebo-controlled studies in more diverse patient population are warranted.","Davis, L L; Jewell, M E; Ambrose, S; Farley, J; English, B; Bartolucci, A; Petty, F",2004.0,,0,0,
6225,Effects of social support on children's eyewitness reports: a test of the underlying mechanism,"ER Research on children's eyewitness testimony demonstrates that interviewer-provided social support given during a mock forensic interview helps children resist an interviewer's misleading suggestions about past events. We proposed and tested 1 potential mechanism underlying support effects: ""Resistance Efficacy,"" or children's perceived self-efficacy for resisting an interviewer's suggestions. Eighty-one 6- and 7-year-old children experienced a play event, then were interviewed about the event with misleading and specific questions. Consistent with prior research, children interviewed by a supportive person were more resistant to misleading suggestions than were those interviewed by a nonsupportive person. Although Resistance Efficacy did not mediate the effects of interviewer support in the full sample, additional analyses revealed that Resistance Efficacy may be a mediator for older, but not younger, children. Contrary to predictions, children's preexisting social support reserves were not related to children's interview accuracy nor to perceived Resistance Efficacy. Implications for psychological theory are discussed, as well as implications for understanding and improving children's eyewitness reports.","Davis, S L; Bottoms, B L",2002.0,,0,0,
6226,Trauma-focused cognitive behavioral therapy for children: impact of the trauma narrative and treatment length,"ER METHODSTwo hundred and ten children (aged 4-11 years) referred for CSA and posttraumatic stress disorder symptoms were randomly assigned to one of the four treatment conditions: 8 sessions with no TN, 8 sessions with TN, 16 sessions with no TN, and 16 sessions with TN.RESULTSMixed-model ANCOVAs demonstrated that significant posttreatment improvements had occurred with respect to 14 outcome measures across all conditions. Significant main and interactive effect differences were found across conditions with respect to specific outcomes.CONCLUSIONSTF-CBT, regardless of the number of sessions or the inclusion of a TN component, was effective in improving participant symptomatology as well as parenting skills and the children's personal safety skills. The eight session condition that included the TN component seemed to be the most effective and efficient means of ameliorating parents' abuse-specific distress as well as children's abuse-related fear and general anxiety. On the other hand, parents assigned to the 16 session, no narrative condition reported greater increases in effective parenting practices and fewer externalizing child behavioral problems at posttreatment.BACKGROUNDChild sexual abuse (CSA) is associated with the development of a variety of mental health disorders, and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an established treatment for children who have experienced CSA. However, there are questions about how many TF-CBT sessions should be delivered to achieve clinical efficacy and whether a trauma narrative (TN) component is essential. This study examined the differential effects of TF-CBT with or without the TN component in 8 versus 16 sessions.","Deblinger, E; Mannarino, A P; Cohen, J A; Runyon, M K; Steer, R A",2011.0,10.1002/da.20744,0,0,
6227,"A follow-up study of a multisite, randomized, controlled trial for children with sexual abuse-related PTSD symptoms","ER METHOD: A total of 183 children 8 to 14 years old and their primary caregivers were assessed 6 and 12 months after their posttreatment evaluations.RESULTS: Mixed-model repeated analyses of covariance found that children treated with TF-CBT had significantly fewer symptoms of PTSD and described less shame than the children who had been treated with CCT at both 6 and 12 months. The caregivers who had been treated with TF-CBT also continued to report less severe abuse-specific distress during the follow-up period than those who had been treated with CCT. Multiple traumas and higher levels of depression at pretreatment were positively related to the total number of PTSD symptoms at posttreatment for children assigned to the CCT condition only.CONCLUSIONS: Children and caregivers assigned to TF-CBT continued to have fewer symptoms of PTSD, feelings of shame, and abuse-specific parental distress at 6- and 12-month assessments as compared to participants assigned to CCT.OBJECTIVE: To ascertain whether the differential responses that previously have been found between trauma-focused, cognitive-behavioral therapy (TF-CBT), and child-centered therapy (CCT) for treating posttraumatic stress disorder (PTSD) and related problems in children who had been sexually abused would persist following treatment and to examine potential predictors of treatment outcome.","Deblinger, E; Mannarino, A P; Cohen, J A; Steer, R A",2006.0,10.1097/01.chi.0000240839.56114.bb,0,0,
6228,Two-year follow-up study of cognitive behavioral therapy for sexually abused children suffering post-traumatic stress symptoms,"ER METHODThese sexually abused children, along with their nonoffending mothers, had been randomly assigned to one of three cognitive-behavioral treatment conditions, child only, mother only, or mother and child, or a community comparison condition, and were followed for 3 months, 6 months, 1 year, and 2 years after treatment.RESULTSA series of repeated MANCOVAs, controlling for the pre-test scores, indicated that for the three measures of psychopathology that had significantly decreased in the original study (i.e., externalizing behavior problems, depression, and PTSD symptoms), these measures at 3 months, 6 months, 1 year, and 2 years were comparable to the posttest scores.CONCLUSIONSThese findings suggest that the pre- to post-treatment improvements held across the 2-year follow-up period. The clinical and research implications of these findings are discussed.OBJECTIVEThe present study sought to determine whether the 12-session pre- to posttest therapeutic gains that had been found by Deblinger, Lippmann. and Steer (1996) for an initial sample of 100 sexually abused children suffering posttraumatic stress disorder (PTSD) symptoms would be sustained 2 years after treatment.","Deblinger, E; Steer, R A; Lippmann, J",1999.0,,0,0,
6229,Randomized controlled trial of trigeminal nerve stimulation for drug-resistant epilepsy,"ER METHODS: This is a double-blind randomized active-control trial in DRE. Fifty subjects with 2 or more partial onset seizures per month (complex partial or tonic-clonic) entered a 6-week baseline period, and then were evaluated at 6, 12, and 18 weeks during the acute treatment period. Subjects were randomized to treatment (eTNS 120 Hz) or control (eTNS 2 Hz) parameters.RESULTS: At entry, subjects were highly drug-resistant, averaging 8.7 seizures per month (treatment group) and 4.8 seizures per month (active controls). On average, subjects failed 3.35 antiepileptic drugs prior to enrollment, with an average duration of epilepsy of 21.5 years (treatment group) and 23.7 years (active control group), respectively. eTNS was well-tolerated. Side effects included anxiety (4%), headache (4%), and skin irritation (14%). The responder rate, defined as >50% reduction in seizure frequency, was 30.2% for the treatment group vs 21.1% for the active control group for the 18-week treatment period (not significant, p = 0.31, generalized estimating equation [GEE] model). The treatment group experienced a significant within-group improvement in responder rate over the 18-week treatment period (from 17.8% at 6 weeks to 40.5% at 18 weeks, p = 0.01, GEE). Subjects in the treatment group were more likely to respond than patients randomized to control (odds ratio 1.73, confidence interval 0.59-0.51). eTNS was associated with reductions in seizure frequency as measured by the response ratio (p = 0.04, analysis of variance [ANOVA]), and improvements in mood on the Beck Depression Inventory (p = 0.02, ANOVA).CONCLUSIONS: This study provides preliminary evidence that eTNS is safe and may be effective in subjects with DRE. Side effects were primarily limited to anxiety, headache, and skin irritation. These results will serve as a basis to inform and power a larger multicenter phase III clinical trial.CLASSIFICATION OF EVIDENCE: This phase II study provides Class II evidence that trigeminal nerve stimulation may be safe and effective in reducing seizures in people with DRE.OBJECTIVE: To explore the safety and efficacy of external trigeminal nerve stimulation (eTNS) in patients with drug-resistant epilepsy (DRE) using a double-blind randomized controlled trial design, and to test the suitability of treatment and control parameters in preparation for a phase III multicenter clinical trial.","DeGiorgio, C M; Soss, J; Cook, I A; Markovic, D; Gornbein, J; Murray, D; Oviedo, S; Gordon, S; Corralle-Leyva, G; Kealey, C P; Heck, C N",2013.0,10.1212/WNL.0b013e318285c11a,0,0,
6230,"Effect of a non-pharmacological intervention, Voix d'Or(®), on behavior disturbances in Alzheimer disease and associated disorders","ER An innovative non-pharmacological intervention called Voix d'Or(®) (Golden Voice) was proposed in the Cognitive behavioral unit (CBU) of the Memory center at the Hospices civils in Lyon. Voix d'Or(®) offers eight sound activities disseminated via an audio device based on different approaches sociotherapeutic (music therapy, reminiscence, relaxation, reorientation in reality). The aim of this study was to test the effects of the Voix d'Or(®) program on behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer's disease hospitalized in the CBU. Twenty four patients with agitation and/or apathy and/or anxiety and/or depression were included. Patients were randomly selected in the intervention group exposed to Voix d'Or versus a control group exposed to usual occupational activities. Patients were assessed before (T0) and after (T1) the intervention period. Several variables were measured: frequency and severity of behavioral disorders, anxiety, depression, agitation and apathy. A significant improvement of anxiety level between T0 and T1was observed in the group with Voix d'Or(®) compared to the control group. This study suggests that this non-pharmacological intervention may be beneficial on anxiety in patients with Alzheimer's disease.","Delphin-Combe, F; Rouch, I; Martin-Gaujard, G; Relland, S; Krolak-Salmon, P",2013.0,10.1684/pnv.2013.0421,0,0,
6231,Influence of Fuzheng Huayu Tablet on mental state and social function of patients with post-hepatitis B liver cirrhosis,"ER OBJECTIVE: To observe the influence of Fuzheng Huayu Tablet on mental state and social activity of patients with post-hepatitis B liver cirrhosis (LC-HB).METHODS: Adopting grouped randomized double-blinded control method, 180 LC-HB patients in 3 research centers were distributed to 2 groups, the treated group and the control group, 90 in each group. Patients in the treated group were administered with FZHYT; while those in the control group treated with conventional therapy combined with placebo, the course for all patients were 6 months. Their mental state and social activity were evaluated before treatment, after 3 months' treatment and at terminal of the 6-month therapeutic course by estimating with Zung self-rating anxiety scale (SAS), self-rating depression scale (SDS) and social deficit screening scale (SDSS). Additionally, the basic demographic materials, liver function, cirrhosis index, hepatic and splenic images, blood coagulation function, etc. in the patients were tested and compared as well.RESULTS: As compared with before treatment, the normal rate of SAS and SDS scores increased and the social deficit rate decreased in the treated group significantly after treatment, showing statistical significance (P<0.05 or P<0.01); while in the control group, change was only shown in the social deficit (P<0.01), inter-group comparisons after treatment showed significant differences in all the three indexes (P<0.05 or P<0.01). Additionally, after treatment, levels of liver function, cirrhosis, blood coagulation function and splenomegaly in the treated group were all improved significantly P<0.05 or P<0.01), and the improvements were better than those in the control group (P<0.01) in levels of total bilirubin (TBIL), albumin (ALB), type IV collagen (IV-C), prothrombin time (PT), prothrombin activity (PTA).CONCLUSION: Most patients of LC-HB have mental disturbance and social activity deficit, which could definitely be improved by intervention with Chinese FZHYT.","Deng, X; Liang, J; Wu, F S; Li, Y B; Zhang, Y P; Tang, Y F",2012.0,10.1007/s11655-012-1112-0,0,0,
6232,Effect of hygrophobic filter or heated humidifier on peroperative hypothermia,"ER A study was carried out to find out whether the use of a hygrophobic filter (Pall, Ultipor) or of a heated humidifier (Dräger, Aquapor) during surgery had any effect on a patient's intraoperative core temperature and thermal balance. Seventy-five ASA I or II patients scheduled for gynaecological surgery were randomly assigned to three groups: group A (n = 25), where no warming device was used; and two groups (n = 25 for each) where inhaled gases were humidified and heated with either a hygrophobic filter set up between the endotracheal tube and the Y-piece (group B) or a heated humidifier set to 100% saturation at a temperature of 41.5 degrees C (group C). The patients were all anaesthetised with the same technique (thiopentone 5 mg.kg-1, dextromoramide 0.03 mg.kg-1 and 0.1 mg.kg-1 of either pancuronium or vecuronium, followed by enflurane with nitrous oxide in oxygen); the perfused fluids were not heated. Room, tympanic, rectal, oesophageal and four skin (thorax, arm, leg, thigh) temperatures were measured with calibrated Exacon thermistances, on arrival in the operating theatre, during induction, every ten minutes for two hours, and then every twenty minutes for two hours more. Ramanathan's and Burton's formulae were used to calculate mean skin temperature and heat loss respectively. In the recovery room, patients were warmed up with an electric blanket. Shivering was ranked from ""0"" to ""+ +"". There were no differences between groups as far as age, drug doses, perfusion volumes and room temperature were concerned.(ABSTRACT TRUNCATED AT 250 WORDS)","Deriaz, H; Fiez, N; Lienhart, A",1992.0,,0,0,
6233,Building relationships and combating bullying: effectiveness of a school-based social skills group intervention,"ER This study tested the efficacy of a generic social skills intervention, Social Skills GRoup INtervention (S.S.GRIN), for children experiencing peer dislike, bullying, or social anxiety. Third-grade children were randomly assigned to treatment (n = 187) or no-treatment control (CO; n = 194) groups. Examination of the direction and magnitude of change in functioning revealed that S.S.GRIN increased peer liking, enhanced self-esteem and self-efficacy, and decreased social anxiety compared to controls. S.S.GRIN was equally efficacious for all subtypes of peer problems targeted. Particular benefits were found for aggressive children who showed greater declines in aggression and bullying behavior and fewer antisocial affiliations than aggressive control participants. Discussion focuses on the benefits of heterogeneous versus homogeneous groups of participants and the potential value of utilizing generic social skills training protocols.","DeRosier, M E",2004.0,10.1207/S15374424JCCP3301_18,0,0,
6234,Building friendships and combating bullying: effectiveness of S.S.GRIN at one-year follow-up,"ER This study tested the long-term effectiveness of a social-skills program for peer-rejected, victimized, and socially anxious children. Third-grade children with peer problems were randomly assigned to treatment (TX; n=187) or no-treatment control (CO; n=194) groups. One year after the intervention, the pattern of findings was similar to that at postintervention; however, several new group differences emerged. Additional positive treatment effects were found, including higher social acceptance and self-esteem and lower depression and anxiety. Lower aggressive behavior was found, particularly for initially more aggressive children. Several gender differences emerged where treatment effects were present for girls but not boys. The demonstrated value of teaching social skills to children experiencing peer problems is discussed and suggestions for future research are offered.","DeRosier, M E; Marcus, S R",2005.0,10.1207/s15374424jccp3401_13,0,0,
6235,"Horticultural therapy: a pilot study on modulating cortisol levels and indices of substance craving, posttraumatic stress disorder, depression, and quality of life in veterans","ER CONTEXT: Horticultural therapy (HT) is a subgroup of occupational therapy (OT). Both HT and OT have been successful as adjunctive treatment modalities in substance abuse treatment. Studies have indicated that gardening promotes neuroendocrine and affective restoration from stress.OBJECTIVES: The study intended to assess the effect of HT versus nonhorticultural OT on cortisol levels, depression, symptoms of posttraumatic stress disorder (PTSD), alcohol cravings, and quality of life.METHODS: The research team designed a randomized pilot study.SETTING: The study was open for participation from July 2012-October 2012. It took place during multiple occurrences of a 28-d treatment programs for substance use disorder at a Veterans Affairs medical center. Participants ? Participants were 49 veterans, averaging 46.4 y old (SD = 11.9); the dropout rate was 37%.INTERVENTION: Participants were randomly assigned to the HT or the OT group. They attended supervised HT and OT groups 5 h/d for 3 wk. Outcome Measures ? Pre- and posttreatment, participants completed the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF), the Alcohol Craving Questionnaire (ACQ-NOW), the Posttraumatic Stress Disorder Checklist Civilian Version (PCLC), and the Center for Epidemiologic Studies Depression Scale (CES-D). Salivary cortisol samples were taken at wk 1, 2, and 3.RESULTS: A repeated measures analysis of variance (ANOVA) (F2,20 = 0.878) revealed that the HT performed was associated with a 12% reduction in salivary cortisol levels from wk 1 to wk 3, but the difference was not statistically significant (P = .43). Separate 1-way analyses of covariance (ANCOVAs) revealed no statistically significant differences in the self-administered tests, although both the Q-LES-Q-SF and CES-D showed a trend toward improving quality of life and depressive symptoms in the HT group compared with the OT group. Additional analysis of the nonbiologic tests suggests that most participants in the HT and OT had some benefit from the programmed activities.CONCLUSIONS: The trends suggest that HT may modulate stress in veterans, as evidenced by decreased cortisol levels and depressive symptoms, and may improve quality of life more than the programs in which the OT group participated. Further investigation with larger samples, including a nontreatment control group, is needed to determine whether the observed trends are treatment effects or due to abstinence.","Detweiler, M B; Self, J A; Lane, S; Spencer, L; Lutgens, B; Kim, D Y; Halling, M H; Rudder, T C; Lehmann, L P",2015.0,,0,0,
6236,Predicting children's quality of life in an asthma clinical trial: what do children's reports tell us?,"ER STUDY DESIGNThree hundred thirty-nine children participated at 4 of 8 Childhood Asthma Management Program clinical centers. Included in the analyses were 2 weeks of asthma symptom data, child-reported health status, and QOL scores from the Pediatric Asthma Quality of Life Questionnaire. Data were obtained 12 months after randomization into the Childhood Asthma Management Program.RESULTSChildren were rated at baseline as having ""moderate"" asthma (63%) and ""mild"" asthma (37%). QOL scores were correlated with the child-reported anxiety measures. Factor analysis of the QOL measure resulted in 2 factors. Stepwise multiple regression indicated that the strongest independent predictors of QOL were the child's anxiety level, age, sex, and a measure of the child's tendency to minimize or exaggerate symptoms.CONCLUSIONSChildren had few asthma symptoms in the 2 weeks before their 12-month follow-up clinic visit and a generally positive QOL, suggesting that mild-to-moderate asthma does not significantly impair QOL. A child's QOL was predicted primarily by their level of anxiety.OBJECTIVETo define predictors of disease-specific quality of life (QOL) and the relationship between asthma symptoms and disease-specific QOL.","Annett, R D; Bender, B G; Lapidus, J; Duhamel, T R; Lincoln, A",2001.0,10.1067/mpd.2001.119444,0,0,
6237,"Depression, anxiety and quality of life scores in seniors after an endurance exercise program","ER METHODSThe study involved 46 sedentary seniors aged 60-75 (66.97 +/- 4.80) who were randomly allocated to two groups: 1) Control group, which was neither asked to vary their everyday activities nor to join a regular physical fitness program; and 2) Experimental group, whose members took part in an aerobic fitness program consisting of ergometer cycle sessions 3 times a week on alternate days for six months working at a heart rate corresponding to ventilatory threshold (VT-1) intensity. Subjects were submitted to a basal evaluation using the geriatric depression screening scale--GDS, STAI trait/state (anxiety scale) and SF-36 (quality of life scale).RESULTSComparing the groups after the study period, we found a significant decrease in depressive and anxiety scores and an improvement in the quality of life in the experimental group, but no significant changes in the control group.CONCLUSIONThe data suggest that an aerobic exercise program at VT-1 intensity suffices to promote favorable modifications in depressive and anxiety scores to improve the quality of life in seniors.OBJECTIVEMood disorders are a frequent problem in old age, and their symptoms constitute an important public health issue. These alterations affect the quality of life mainly by restricting social life. The participation in a regular exercise program is an effective way of reducing or preventing the functional decline associated with aging. The aim of the present study was to examine the effects of fitness-endurance activity (at the intensity of Ventilatory Threshold 1 (VT-1)) in depression, anxiety and quality of life scores in seniors.","Antunes, H K; Stella, S G; Santos, R F; Bueno, O F; Mello, M T",2005.0,,0,0,
6238,Branched-chain amino acids may improve recovery from a vegetative or minimally conscious state in patients with traumatic brain injury: a pilot study,"ER DESIGNPatients were randomly assigned to 15 days of intravenous BCAA supplementation (n=22; 19.6g/d) or an isonitrogenous placebo (n=19).SETTINGTertiary care rehabilitation setting.PARTICIPANTSPatients (N=41; 29 men, 12 women; mean age, 49.5+/-21 y) with a posttraumatic vegetative or minimally conscious state, 47+/-24 days after the index traumatic event.INTERVENTIONSupplementation with BCAAs.MAIN OUTCOME MEASUREDisability Rating Scale (DRS) as log(10)DRS.RESULTSFifteen days after admission to the rehabilitation department, the log(10)DRS score improved significantly only in patients who had received BCAAs (log(10)DRS score, 1.365+/-0.08 to 1.294+/-0.05; P<.001), while the log(10)DRS score in the placebo recipients remained virtually unchanged (log(10)DRS score, 1.373+/-0.03 to 1.37+/-0.03; P not significant). The difference in improvement of log(10)DRS score between the 2 groups was highly significant (P<.000). Moreover, 68.2% (n=15) of treated patients achieved a log(10)DRS point score of .477 or higher (3 as geometric mean) that allowed them to exit the vegetative or minimally conscious state.CONCLUSIONSSupplemented BCAAs may improve the recovery from a vegetative or minimally conscious state in patients with posttraumatic vegetative or minimally conscious state.OBJECTIVETo investigate whether supplementation with branched-chain amino acids (BCAAs) may improve recovery of patients with a posttraumatic vegetative or minimally conscious state.","Aquilani, R; Boselli, M; Boschi, F; Viglio, S; Iadarola, P; Dossena, M; Pastoris, O; Verri, M",2008.0,10.1016/j.apmr.2008.02.023,0,0,
6239,"Self-compassion training modulates alpha-amylase, heart rate variability, and subjective responses to social evaluative threat in women","ER A growing body of research has revealed that social evaluative stressors trigger biological and psychological responses that in chronic forms have been linked to aging and disease. Recent research suggests that self-compassion may protect the self from typical defensive responses to evaluation. We investigated whether brief training in self-compassion moderated biopsychological responses to the Trier Social Stress Test (TSST) in women. Compared to attention (placebo) and no-training control conditions, brief self-compassion training diminished sympathetic (salivary alpha-amylase), cardiac parasympathetic, and subjective anxiety responses, though not HPA-axis (salivary cortisol) responses to the TSST. Self-compassion training also led to greater self-compassion under threat relative to the control groups. In that social stress pervades modern life, self-compassion represents a promising approach to diminishing its potentially negative psychological and biological effects.","Arch, J J; Brown, K W; Dean, D J; Landy, L N; Brown, K D; Laudenslager, M L",2014.0,10.1016/j.psyneuen.2013.12.018,0,0,
6240,"Relationships between locus of control, trait anxiety, and state anxiety: an interactionist perspective","ER This study examined the relationships among generalized expectancy for internal or external control, situational expectancy of control over aversive stimuli, trait anxiety level, and state anxiety reactivity. Seventy-two male subjects, selected from the upper and lower halves of the distributions of scores from the I-E and STAI A-Trait Scales, were randomly assigned to one of three conditions of expectancy of control over electric shock. Repeated measures of state anxiety were taken at three points in the experiment, and subjects were asked to rate the degree of control they expected to have in avoiding shocks. Results, based upon analyses of variance, were interpreted as strongly supportive of the use of the interactionist model in understanding the manner in which personality trait and situational variables interact in the determination of subject expectancies of control and anxiety reactivity.","Archer, R P",1979.0,,0,0,
6241,"Effects of aerobic exercise program and relaxation techniques on anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia: a randomized controlled trial","ER PATIENTS AND METHODAn experimental study was performed with a placebo control group. Fifty-six fibromyalgia patients were randomly assigned to intervention (aerobic exercises+progressive relaxation techniques) and placebo (sham treatment with disconnected magnet therapy device) groups. Outcome measures were anxiety (STAI- State Trait Anxiety Inventory), quality of sleep (Pittsburgh sleep quality index), depression (Beck depression inventory) and quality of life (questionnaire SF-36). Measures were performed at baseline and after 10-weeks treatment.RESULTSAfter 10 weeks of treatment, the intervention group showed significant reduction (p<0.05) in sleep duration, trait anxiety and quality of life.CONCLUSIONSThe combination of aerobic exercise program and progressive relaxation techniques contribute to improve night rest, trait anxiety and quality of life in patients with fibromyalgia.BACKGROUND AND OBJECTIVEFibromyalgia is considered as a combination of physical, psychological and social disabilities. The purpose of the present study was to determine the benefits of aerobic exercise program and progressive relaxation techniques on anxiety, quality of sleep, depression and quality of life in patients with fibromyalgia.","Arcos-Carmona, I M; Castro-Sánchez, A M; Matarán-Peñarrocha, G A; Gutiérrez-Rubio, A B; Ramos-González, E; Moreno-Lorenzo, C",2011.0,10.1016/j.medcli.2010.09.045,0,0,
6242,Homework Adherence and Cognitive Behaviour Treatment Outcome for Children and Adolescents with Anxiety Disorders,"ER AIMSThe study examined the association between homework adherence and treatment outcome following a generic group cognitive behaviour treatment program (Cool Kids) for anxiety disordered youths and their parents.METHODThe treatment program was completed by 98 children and adolescents (ages 7-16). Homework adherence was measured as time spent doing homework assignments between each session, reported by youths as well as parents. Outcome criteria consisted of youth-reported anxiety symptoms and clinician rated severity of primary anxiety diagnosis at posttreatment and 3-month follow-up.RESULTSResults did not support an association between homework adherence and treatment outcome when controlling for pretreatment severity.CONCLUSIONSThe study found no convincing evidence that homework adherence predicted outcome of cognitive behavioural therapy for youths with anxiety disorders. Reasons for divergent findings on homework adherence in cognitive behavioural therapy for youths compared to adults are discussed.BACKGROUNDHomework assignments are considered an essential component for a successful outcome of cognitive behavioural therapy for youths with anxiety disorders. However, only two studies have examined the association between homework adherence and outcome of cognitive behavioural therapy for youths with anxiety disorders.","Arendt, K; Thastum, M; Hougaard, E",2016.0,10.1017/S1352465815000429,0,0,
6243,EMDR and psychopharmacological therapy in the treatment of the post-traumatic stress disorder,"ER AIM: This study evaluates the efficacy of two different treatment for post-traumatic stress disorder (PTSD): the psychopharmacological therapy, with a SSRI drug, and EMDR. METHOD: Two indipendent groups have been administered two different treatments: the treatment with sertraline to the group for psychopharmacological therapy; the treatment with one-week sessions of EMDR to the other group. For the evaluation of the symptoms of PTSD has been used the Clinician-Administered PTSD Scale (CAPS). The inclusion of the subjects in the two groups has been absolutely random. RESULTS: The results confirm previous studies available in literature, pointing out the efficacy of EMDR and of sertraline in improving the post-traumatic symptomatology and the levels of subjective sufference. But the number of subjects which at the end of the study didn't satisfy any more the criteria for PTSD has been absolutely greater in the group treated with EMDR. CONCLUSIONS: The study confirms the hypothesis of EMDR as a more efficacious treatment for PTSD compared to psychopharmacological therapy. This result could be a stimolous for further research with greater groups to investigate also the long term efficacy.","Arnone, R; Orrico, A; D'aquino, G; Munzio, W",2012.0,10.1708/1071.11732,0,0,
6244,Effectiveness of individual and dyadic training protocols: the influence of trainee interaction anxiety,"ER The present study focuses on the consequences of the social dynamics that are created whenever two or more individuals are brought together for the purpose of training. An investigation of the role of individual differences in interaction anxiety on training outcomes demonstrated that the comparative effectiveness of dyadic versus individual protocols for computer-based training is moderate by trainees' level of interaction anxiety. Specifically, assignment to a dyadic protocol adversely affected the performance of high-interaction-anxiety participants but appeared to be advantageous for low-interaction-anxiety participants. Implications are discussed for changing the design and implementation of computer-based protocols for training groups and individuals in military and industrial training centers.","Arthur, W; Young, B; Jordan, J A; Shebilske, W L",1996.0,10.1518/001872096778940732,0,0,
6245,An emergency department intervention for linking pediatric suicidal patients to follow-up mental health treatment,"ER METHODS: In a randomized controlled trial, suicidal youths at two emergency departments (N=181; ages ten to 18) were individually assigned between April 2003 and August 2005 to one of two conditions: an enhanced mental health intervention involving a family-based cognitive-behavioral therapy session designed to increase motivation for follow-up treatment and safety, supplemented by care linkage telephone contacts after emergency department discharge, or usual emergency department care enhanced by provider education. Assessments were conducted at baseline and approximately two months after discharge from the emergency department or hospital. The primary outcome measure was rates of outpatient mental health treatment after discharge.RESULTS: Intervention patients were significantly more likely than usual care patients to attend outpatient treatment (92% versus 76%; p=.004). The intervention group also had significantly higher rates of psychotherapy (76% versus 49%; p=.001), combined psychotherapy and medication (58% versus 37%; p=.003), and psychotherapy visits (mean 5.3 versus 3.1; p=.003). Neither the emergency department intervention nor community outpatient treatment (in exploratory analyses) was significantly associated with improved clinical or functioning outcomes.CONCLUSIONS: Results support efficacy of the enhanced emergency department intervention for improving linkage to outpatient mental health treatment but underscore the need for improved community outpatient treatment to prevent suicide, suicide attempts, and poor clinical and functioning outcomes for suicidal youths treated in emergency departments.OBJECTIVE: Suicide is the third leading cause of death among adolescents. Many suicidal youths treated in emergency departments do not receive follow-up treatment as advocated by the National Strategy for Suicide Prevention. Two strategies for improving rates of follow-up treatment were compared.","Asarnow, J R; Baraff, L J; Berk, M; Grob, C S; Devich-Navarro, M; Suddath, R; Piacentini, J C; Rotheram-Borus, M J; Cohen, D; Tang, L",2011.0,10.1176/ps.62.11.pss6211_1303,0,0,
6246,Group cognitive-behavioral therapy versus sertraline for the treatment of children and adolescents with obsessive-compulsive disorder,"ER METHODBetween 2000 and 2002, 40 subjects between 9 and 17 years old were randomized to receive GCBT (n = 20) or sertraline (n = 20). GCBT consisted of a manual-based 12-week cognitive-behavioral protocol adapted for groups, and treatment with sertraline involved medication intake for 12 weeks. Subjects were assessed before, during, and after treatment (at 1, 3, 6, and 9 months after treatment conclusion). Primary outcome measure was the Children's Yale-Brown Obsessive-Compulsive Scale. Repeated-measures analyses of variance were done.RESULTSBoth GCBT and sertraline conditions had significant improvement in obsessive-compulsive disorder symptoms as measured by the Children's Yale-Brown Obsessive-Compulsive Scale after 12 weeks of treatment. After the 9-month follow-up period, subjects in the GCBT condition had a significantly lower rate of symptom relapse than those in the sertraline group.CONCLUSIONSThe treatment with GCBT may be effective in decreasing obsessive-compulsive symptoms in childhood obsessive-compulsive disorder and should be considered as an alternative to either individual cognitive-behavioral therapy or a medication, such as sertraline. Results support the effectiveness and the maintenance of gains of GCBT in the treatment of youngsters with obsessive-compulsive disorder.OBJECTIVETo compare the effectiveness of group cognitive-behavioral therapy (GCBT) and of sertraline in treatment-naïve children and adolescents with obsessive-compulsive disorder.","Asbahr, F R; Castillo, A R; Ito, L M; Latorre, M R; Moreira, M N; Lotufo-Neto, F",2005.0,10.1097/01.chi.0000177324.40005.6f,0,0,
6247,Group support to improve psychosocial well-being and primary-care demands among women with cardiac syndrome X,"ER METHODSForty-nine women with cardiac syndrome X (mean?±?standard deviation 61.8?±?8 years) were randomized to 12 monthly support group meetings or usual care control. The Health Anxiety Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS), SF-36, York Angina Beliefs scale, ENRICHD Social Support Instrument (ESSI) and a demographic information scale, along with hospital admissions, general practitioner (GP) or cardiologist appointments were measured at baseline, 6 months and 12 months.RESULTSSupport group participants maintained higher levels of social support than controls (ESSI score, 17.18?±?5.35 vs. 14.45?±?6.98, p?=?0.008). Near significant improvements in health beliefs total score (p?=?0.068) and threat perception (p?=?0.062) were found among the support group compared to the control; 29% of support patients had made one or more GP visits over the duration of the study, compared with 54% of the control group (p?=?0.06).CONCLUSIONSupport group participation maintains social support and may reduce health-care demands and misconceived health beliefs among patients with cardiac syndrome X.BACKGROUNDWomen with angina pectoris, a positive exercise electrocardiogram (ECG) for myocardial ischemia and angiographically smooth coronary arteries (cardiac syndrome X), are often characterized by unresolved symptomatology and a poor quality of life. Psychological morbidity and quality of life appear to be related to social support and social isolation. An investigation of group support as an aid to treatment for cardiac syndrome X was therefore undertaken.","Asbury, E A; Webb, C M; Collins, P",2011.0,10.3109/13697137.2010.499181,0,0,
6248,The effect of perceived child anxiety status on parental latency to intervene with anxious and nonanxious youth,"ER OBJECTIVE: We examined the effect of perceived child anxiety status on parental latency to intervene with anxious and nonanxious youth.METHOD: Parents (68) of anxiety-disordered (PAD) and nonanxiety-disordered (PNAD; 56) children participated. Participants listened and responded to an audio vignette of a parent-child interaction: Half were told the child was anxious, and half were given a neutral description. Participants completed measures of anxiety and emotional responding before and after the audio vignette and signaled when the mother on the vignette should accommodate the child.RESULTS: Whereas PNAD responded significantly faster when provided with neutral information about the child than when told the child was anxious, PAD did not differ in response latency. However, PAD exhibited a significant increase in state anxiety and negative affect and a decrease in positive affect after the vignette, whereas PNAD did not.CONCLUSIONS: Results suggest that PNAD are more flexible and adaptable in their parenting behavior than PAD and that the greater anxiety and emotional lability of PAD may influence their parenting. Suggestions for research are discussed.","Aschenbrand, S G; Kendall, P C",2012.0,10.1037/a0027230,0,0,
6249,Comparison of cognitive behavioral therapy and supportive psychotherapy for the treatment of depression following traumatic brain injury: a randomized controlled trial,"ER OBJECTIVE: To determine the efficacy of 2 different interventions (cognitive behavioral therapy [CBT] and supportive psychotherapy [SPT]) to treat post-traumatic brain injury (TBI) depression.PARTICIPANTS: A sample of 77 community-dwelling individuals with a TBI, and a diagnosis of depression. Participants were randomized into treatment conditions either CBT or SPT and received up to 16 sessions of individual psychotherapy.MEASURES: Participants completed the Structured Clinical Interview for DSM-IV and self-report measures of depression (Beck Depression Inventory-Second Edition), anxiety (State-Trait Anxiety Inventory), perceived social support (Interpersonal Support Evaluation List), stressful life events (Life Experiences Survey), and quality of life (QOL) before beginning and immediately following treatment.RESULTS: No significant differences were found at baseline between CBT and SPT groups on demographic factors (sex, age, education, race, and time since injury) or baseline measures of depression, anxiety, participation, perceived social support, stressful life events, or QOL. Analyses of variance revealed significant time effects for the Beck Depression Inventory-Second Edition, State-Trait Anxiety Inventory, and QOL outcome measures but no group effects. Intention-to-treat mixed effects analyses did not find any significant difference in patterns of scores of the outcome measures between the CBT and SPT intervention groups.CONCLUSIONS: Both forms of psychotherapy were efficacious in improving diagnoses of depression and anxiety and reducing depressive symptoms. These findings suggest that in this sample of individuals with TBI, CBT was not more effective in treating depression than SPT, though further research is needed with larger sample sizes to identify different components of these interventions that may be effective with different TBI populations. ClinicalTrials.gov Identifier: NCT00211835.","Ashman, T; Cantor, J B; Tsaousides, T; Spielman, L; Gordon, W",2014.0,10.1097/HTR.0000000000000098,0,0,
6250,The effectiveness of the combined use of energomonitor antioxidant and cognitive psychotherapy in the treatment of generalized periodontitis in elderly patients,"ER The aim of the study was to evaluate the effect of combined use of Cytoflavin and cognitive therapy on the dynamics of psychosomatic status and effectiveness of the treatment of generalized periodontitis in elderly patients. The results of treatment of 103 patients aged 60 and older were analyzed. All patients received standard therapy for 10-14 days depending on the severity of the process. In addition, the patients of the main group (51 patients) received Cytoflavin: 2 tabs. 2 times a day with an interval between doses of 8-10 hours for 25 days, and cognitive therapy aimed at training alternative realistic way of life perception. Treatment results were monitored by PMA, Russell periodontal index (PI), Green-Vermillion hygienic index. Psychosomatic dynamics was assessed by means of Spielberger anxiety scale and SUN"" methods of before and after a month of treatment. The inclusion in the treatment regimen of Cytoflavin and cognitive therapy had a positive impact: reduction of PMA by 61.8%, PI by 45.3% and Green-Vermillion index by 39.8%. The psychosomatic tests proved anxiety level decrease by 28.7% in terms of ""reactive"" anxiety and 31.5% in terms of ""personal"" anxiety, emotional status (21.2%), activity (21.7%) and mood (21.8%) improvement.","Ashour, A Z; Belov, V G; Parfyonov, U A; Parfyonov, S A; Ershov, E V; Tuchin, I A; Kovalenko, A L; Talikova, E V",2016.0,,0,0,
6251,"Functional interrelationship of serotonin and norepinephrine: cortisol response to MCPP and DMI in patients with panic disorder, patients with depression, and normal control subjects","ER The relationship between norepinephrine (NE) and serotonin (5-hydroxytryptamine; 5HT) functioning was explored in a neuroendocrine challenge paradigm. Ten normal control subjects, 17 patients with major depression, and 22 patients with panic disorder volunteered to participate in this study. Each subject received a challenge with meta-chlorophenylpiperazine (MCPP; 0.25 mg/kg, p.o.), a 5HT agonist, and desmethylimipramine (DMI; 75 mg, i.m.), an indirect NE agonist, in randomized order. The peak-minus-baseline cortisol response to MCPP was used as an indicator of 5HT function, and cortisol response at 75 minutes-minus-baseline to DMI was used as an indicator of NE function. The cortisol responses to DMI and MCPP were found to be highly negatively correlated in the total sample, in particular in the patients with major depression and panic disorder. This finding suggests that the functions (or dysfunctions) of the NE and 5HT systems may not be separate as is usually believed, and that the NE and 5HT disturbances observed in major depression and panic disorder may not be independent. Rather, there may be a joint disturbance of NE-5HT in these disorders.","Asnis, G M; Wetzler, S; Sanderson, W C; Kahn, R S; Praag, H M",1992.0,,0,0,
6252,Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial,"ER AIMS: To assess the therapeutic potential of dietary elimination based on the presence of IgG antibodies to food.PATIENTS: A total of 150 outpatients with IBS were randomised to receive, for three months, either a diet excluding all foods to which they had raised IgG antibodies (enzyme linked immunosorbant assay test) or a sham diet excluding the same number of foods but not those to which they had antibodies.METHODS: Primary outcome measures were change in IBS symptom severity and global rating scores. Non-colonic symptomatology, quality of life, and anxiety/depression were secondary outcomes. Intention to treat analysis was undertaken using a generalised linear model.RESULTS: After 12 weeks, the true diet resulted in a 10% greater reduction in symptom score than the sham diet (mean difference 39 (95% confidence intervals (CI) 5-72); p = 0.024) with this value increasing to 26% in fully compliant patients (difference 98 (95% CI 52-144); p<0.001). Global rating also significantly improved in the true diet group as a whole (p = 0.048, NNT = 9) and even more in compliant patients (p = 0.006, NNT = 2.5). All other outcomes showed trends favouring the true diet. Relaxing the diet led to a 24% greater deterioration in symptoms in those on the true diet (difference 52 (95% CI 18-88); p = 0.003).CONCLUSION: Food elimination based on IgG antibodies may be effective in reducing IBS symptoms and is worthy of further biomedical research.BACKGROUND: Patients with irritable bowel syndrome (IBS) often feel they have some form of dietary intolerance and frequently try exclusion diets. Tests attempting to predict food sensitivity in IBS have been disappointing but none has utilised IgG antibodies.","Atkinson, W; Sheldon, T A; Shaath, N; Whorwell, P J",2004.0,10.1136/gut.2003.037697,0,0,
6253,Universal-based prevention of syndromal and subsyndromal social anxiety: a randomized controlled study,"ER This article reports results from a universal preventive program aimed at (a) reducing social anxiety and (b) preventing the development of syndromal social anxiety among a population-based sample of older children and young adolescents during a 1-year period. Pupils (N = 1,748) from 2 counties were cluster randomized to either an intervention or a control condition. In the intervention condition, the Norwegian Universal Preventive Program for Social Anxiety (NUPP-SA)-which educates pupils, parents/guardians, teachers/school staff, and county health workers-was administered. The results indicate that NUPP-SA had a significant specific intervention effect for reducing social anxiety in the total sample as well as among the syndromal subjects. Further, significantly fewer subjects from the intervention county developed syndromal social anxiety during the 1-year period, thus showing a prevention effect. The results demonstrate the value of an intervention specifically aimed at reducing social anxiety and preventing the development of syndromal social anxiety among young people.","Aune, T; Stiles, T C",2009.0,10.1037/a0015813,0,0,
6254,Pars plana vitrectomy with or without silicone oil endotamponade in post-traumatic endophthalmitis,"ER METHODSA prospective randomized controlled study of 24 consecutive cases of post-traumatic endophthalmitis was conducted. Patients were randomized into two groups in the absence of clinical improvement after primary tap and treatment with intravitreal vancomycin and amikacin: group 1 consisted of patients who underwent core vitrectomy alone, group 2 of patients who underwent complete vitrectomy with silicone oil endotamponade. All patients included in the study received intravenous antibiotics and underwent lensectomy. Patients were followed up 1, 2, 4 and 12 weeks postoperatively. In all patients of group 2, silicone oil was removed 6 weeks after primary surgery. The mean duration of follow-up was 112+/-55 days.RESULTSVision of 20/400 or better was obtained in 58.33% of cases (14/24). Visual acuity of only one patient in group 1 was >or=20/200, compared with that of 58.3% of patients (7/12) in group 2 ( P=0.02). Intra-operative retinal breaks were found in 50% (6/12) of the patients belonging to group 1, but did not affect the final visual outcome. In group 1, 33.33% (4/12) developed rhegmatogenous retinal detachment in the immediate post-operative period. Only one of these patients had useful final visual outcome after resurgery.CONCLUSIONComplete vitrectomy with primary silicone oil endotamponade is a useful treatment modality which improves the anatomical and functional results in post-traumatic endophthalmitis.BACKGROUNDResults of core vitrectomy in post-traumatic endophthalmitis are poor. Our initial results of complete vitrectomy with primary silicone oil endotamponade were promising. A comparative study of this procedure with conventional core vitrectomy was therefore carried out.","Azad, R; Ravi, K; Talwar, D; Rajpal, null; Kumar, N",2003.0,10.1007/s00417-003-0670-4,0,0,
6255,Prevention of posttraumatic hypoxaemia in isolated lower limb long bone fractures with a minimal prophylactic dose of corticosteroids,"ER The efficacy of a minimum dose of methylprednisolone for the prevention of posttraumatic hypoxaemia and fat embolism syndrome (FES) was prospectively studied in 87 patients with isolated, closed or grade I open, femoral and tibial fractures. On admission, the patients were randomly allocated either to a control group given placebo (40 patients) or to a methylprednisolone-treated group (47 patients). A total dose of 6 mg/kg BW methylprednisolone (SoluMedrol, Upjohn) was administered intravenously, divided in six equal doses at 8 h intervals. Six patients (12.8%) in the control group and one patient (2.5%) in the trial group developed FES (P = 0.079) but the difference is not statistically significant. Twenty-four hours after admission, the steroid-treated patients displayed statistically significant higher p(O2) values compared to the control group (P = 0.035) and this difference persisted on the second and the third post-admission day as well (P = 0.008). No corticosteroid-related side-effects were noticed in any of the patients during hospitalisation. Our results support the prophylactic administration of methylprednisolone in small dosage to prevent posttraumatic hypoxaemia and probably FES in patients with isolated lower limb long bone fractures, especially when early fracture stabilisation is not possible.","Babalis, G A; Yiannakopoulos, C K; Karliaftis, K; Antonogiannakis, E",2004.0,,0,0,
6256,An experimental investigation of the effects of acute sleep deprivation on panic-relevant biological challenge responding,"ER Prospective research indicates sleep deprivation potentiates anxiety development, yet relatively little research has examined the effects of sleep deprivation in terms of specific types of anxiety. The current study tested the association between acute sleep deprivation and panic-relevant biological challenge responding among nonclinical participants. One hundred and two participants were randomly assigned to either an experimental (acute sleep deprivation) or control (no sleep deprivation) group. The day prior to and following the experimental (sleep) manipulation, participants completed a 5-minute 10% carbon dioxide-enriched air laboratory-based biological challenge. As predicted, sleep deprivation increased anxious and fearful responding to the challenge. Findings suggest sleep deprivation may be an important factor to consider in models of panic development. There are several areas in this general domain that warrant additional investigation.","Babson, K A; Feldner, M T; Trainor, C D; Smith, R C",2009.0,10.1016/j.beth.2008.06.001,0,0,
6257,Depression and anxiety in women with breast cancer and their partners,"ER OBJECTIVETo test the hypotheses that telephone-delivered psychosocial interventions decrease depression and anxiety in women with breast cancer and their partners.METHODSThe design of the study was a three-wave repeated measures with a between-subjects factor (treatment group). Ninety-six women and their 96 partners were assigned randomly to participate in one of three different 6-week programs: (a) telephone interpersonal counseling (TIP-C); (b) self-managed exercise; or (c) attention control (AC).RESULTSThe mixed-model analysis of variance for symptoms of depression among women with breast cancer revealed women's depressive symptom scores decreased over time in all groups. For anxiety, women's symptoms of anxiety decreased in the TIP-C and exercise groups over time, but not in the AC group. A parallel set of analyses was conducted on partners' depression and anxiety data. Symptoms of depression and anxiety among the partners decreased substantially over the course of the investigation. Similar to the women, partners' symptoms of anxiety decreased significantly in the TIP-C and exercise groups, but not in the AC group.DISCUSSIONFindings from this study support that these telephone-delivered psychosocial interventions were effective for decreasing symptoms of depression and anxiety to improve psychological quality of life when compared to an AC group.BACKGROUNDPsychosocial interventions can improve psychological quality of life (symptoms of depression and anxiety) of both women with breast cancer and their partners, but are not offered routinely to women and their partners.","Badger, T; Segrin, C; Dorros, S M; Meek, P; Lopez, A M",2007.0,,0,0,
6258,An examination of stress in college students over the course of a semester,"ER The purpose of this study was to determine whether differing stress reduction interventions could alter stress levels experienced by male and female college students from the beginning to the end of a semester. Components of stress examined included overall perceived stress, test anxiety, and personal burnout. Participants (N = 531) were part of courses that during the course of a 16-week semester focused specifically on cognitive-behavioral stress management, cardiovascular fitness, generalized physical activity, or a control with no intervention. In addition to gender differences, both the stress management and physical activity groups had significantly lower levels of perceived stress, test anxiety, and personal burnout at the end of the semester. The fitness group scored significantly lower on perceived stress and personal burnout, but there was no difference in scores for test anxiety. The important ramifications of reducing stress in college students are discussed, including the pros and cons of implementing differing physical and psychological intervention modalities.","Baghurst, T; Kelley, B C",2014.0,10.1177/1524839913510316,0,0,
6259,"Correlation between blood cAMP, cGMP levels and traumatic severity in the patients with acute trauma and its clinical significance","ER In order to investigate the correlation between traumatic servity and blood cAMP and cGMP levels in the patients with acute trauma and its clinical significance, 120 cases of trauma were randomly selected and divided into 4 groups (n = 30 in each group): mildly traumatic group (ISS  25). The cAMP and cGMP levels were assayed in sera, leucocytes and platelets respectively in 6 h and 24 h after trauma. The results showed that cAMP and cGMP levels were elevated significantly in sera and platelets (P < 0.05 or P < 0.01), meanwhile cGMP levels in leucocytes (P < 0.05). It was concluded that cAMP and cGMP might play an important role in traumatic stress, participate in the cellular signal transducation and promote the immune function of leucocytes and the coagulation founction of platelets. Serum cAMP and cGMP levels were upregulated correspondingly as ISS increased, and positively correlated to the traumatic severity.","Bai, X; Wang, H; Li, Z; Liu, K",2004.0,,0,0,
6260,Preoperative patient education for open-heart patients: a source of anxiety?,"ER METHODSThis quasi-experimental study was conducted at a large hospital in Beirut, which is a university hospital. All patients who were admitted to the cardiac surgery unit and who met the inclusion criteria were randomly assigned to as experimental or a control group. The patients in the experimental group (n = 57) received a special educational session on their admission day and had a tour of the cardiac surgery unit. The control group (n = 53) followed the routine hospital protocol, which encompassed almost no preoperative education or a tour. Anxiety was assessed using the Beck Anxiety Inventory while recovery was measured by physiological outcomes, days of hospital stay, and presence of complications. A Multivariate Analysis of Covariance (MANCOVA) was performed with adjustment for potential confounding variables.RESULTSBorderline statistical significance was noted for the experimental group in terms of preoperative and postoperative anxiety. The experimental group had a shorter time from awakening to extubation.CONCLUSIONUnlike most studies published previously, which noted the benefits of preoperative patient education, this study with the Lebanese clients, failed to support earlier findings.PRACTICE IMPLICATIONSThe results suggest that patient education should not be initiated before assessing the patient's cultural and social background.OBJECTIVEThe purpose of this study was to assess the impact of preoperative patient education on anxiety and recovery of the Lebanese patients undergoing open-heart surgery.","Deyirmenjian, M; Karam, N; Salameh, P",2006.0,10.1016/j.pec.2005.06.014,0,0,
6261,Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing: what works in children with posttraumatic stress symptoms? A randomized controlled trial,"ER To prevent adverse long-term effects, children who suffer from posttraumatic stress symptoms (PTSS) need treatment. Trauma-focused cognitive behavioral therapy (TF-CBT) is an established treatment for children with PTSS. However, alternatives are important for non-responders or if TF-CBT trained therapists are unavailable. Eye movement desensitization and reprocessing (EMDR) is a promising treatment for which sound comparative evidence is lacking. The current randomized controlled trial investigates the effectiveness and efficiency of both treatments. Forty-eight children (8-18 years) were randomly assigned to eight sessions of TF-CBT or EMDR. The primary outcome was PTSS as measured with the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). Secondary outcomes included parental report of child PTSD diagnosis status and questionnaires on comorbid problems. The Children's Revised Impact of Event Scale was administered during the course of treatment. TF-CBT and EMDR showed large reductions from pre- to post-treatment on the CAPS-CA (-20.2; 95%","Diehle, J; Opmeer, B C; Boer, F; Mannarino, A P; Lindauer, R J",2015.0,10.1007/s00787-014-0572-5,0,0,
6262,Effects of a combined physical and psychosocial intervention program for childhood cancer patients on quality of life and psychosocial functioning: results of the QLIM randomized clinical trial,"ER METHODS: In this multicenter randomized controlled trial, cancer patients (aged 8-18 years) and their parents filled in questionnaires on HrQoL, depressive symptoms, behavioral problems, and self-esteem. Measurements were conducted at baseline, shortly after the 12-week intervention period and 12 months after baseline. Generalized estimating equations analyses were performed to assess short-term and long-term psychosocial effects.RESULTS: Of the 174 eligible patients, 68 (39.1%) participated. The intervention group consisted of 30 participants at baseline [mean age 13.0 (SD 3.0) years; 53% male], 26 at short-term and 22 at long-term follow-up. The 'care as usual' control group consisted of 38 participants at baseline [mean age 12.6 (SD 3.1) years; 53% male], 33 at short-term and 31 at long-term follow-up. Overall, the intervention did not improve psychosocial functioning and HrQoL. According to parent-proxy reports, the intervention leads to a greater improvement on pain-related HrQoL on both the short (??=?13.4; 95% CI: 3.0; 23.8) and long term (??=?13.0; 95% CI: 1.6; 24.4) and to greater improvement on procedural anxiety immediately after the intervention (??=?12.6; 95% CI: 1.9; 23.3).CONCLUSION: A combined physical and psychosocial training for children with cancer did not have effects on HrQoL or psychosocial functioning, with exception of modest positive effects on parent-reported pain and procedural anxiety Copyright © 2015 John Wiley & Sons, Ltd.OBJECTIVE: Although survival rates in childhood cancer have improved, prevention and reduction of late effects remain important. This study evaluates the effects of a combined physical exercise and psychosocial intervention on health-related quality of life (HrQoL) and psychosocial functioning in childhood cancer patients.","Dijk-Lokkart, E M; Braam, K I; Dulmen-den, Broeder E; Kaspers, G J; Takken, T; Grootenhuis, M A; Streng, I C; Bierings, M; Merks, J H; Heuvel-Eibrink, M M; Veening, M A; Huisman, J",2016.0,10.1002/pon.4016,0,0,
6263,Neuropsychological effects of valproate in traumatic brain injury: a randomized trial,"ER METHODSIn a randomized, double-masked, parallel group clinical trial, we compared the seizure prevention and neuropsychological effects of 1 or 6 months of VPA to 1 week of phenytoin. We studied 279 adult subjects who were randomized within 24 hours of injury and examined with a battery of neuropsychological measures at 1, 6, and 12 months after injury. We examined drug effects cross-sectionally at 1, 6, and 12 months and longitudinally by examining differential change from 1 to 6 months and from 6 to 12 months as a function of protocol-dictated changes in treatment.RESULTSNo significant adverse or beneficial neuropsychological effects of VPA were detected.CONCLUSIONSValproate (VPA) appears to have a benign neuropsychological side effects profile, making it a cognitively safe antiepileptic drug to use for controlling established seizures or stabilizing mood. However, based on this study, VPA should not be used for prophylaxis of posttraumatic seizures because it does not prevent posttraumatic seizures, there was a trend toward more deaths in the VPA groups, and it did not have positive effects on cognition.OBJECTIVESTo examine the neuropsychological side effects of valproate (VPA) given to prevent posttraumatic seizures.","Dikmen, S S; Machamer, J E; Winn, H R; Anderson, G D; Temkin, N R",2000.0,,0,0,
6264,Neurobehavioral effects of phenytoin prophylaxis of posttraumatic seizures,"ER In order to determine potential negative neurobehavioral effects of phenytoin given to prevent the development of posttraumatic seizures, 244 subjects were randomized to phenytoin or placebo. They received neurobehavioral assessments at 1 and 12 months postinjury while receiving their assigned drug and at 24 months while receiving no drugs. In the severely injured, phenytoin significantly impaired performance at 1 month. No significant differences were found as a function of phenytoin in the moderately injured patients at 1 month or in either severity group at 1 year. Patients who stopped receiving phenytoin according to protocol between 1 and 2 years improved more than corresponding placebo cases on several measures. We conclude that phenytoin has negative cognitive effects. This, combined with lack of evidence for its effectiveness in preventing posttraumatic seizures beyond the first week, raises questions regarding its use for long-term prophylaxis. Our findings do not negate phenytoin's proven efficacy in controlling established seizures nor do they indicate that its cognitive effects are worse than other anticonvulsant drugs.","Dikmen, S S; Temkin, N R; Miller, B; Machamer, J; Winn, H R",1991.0,,0,0,
6265,Anxious and depressive symptoms and children's judgements of their own and others' interpretation of ambiguous social scenarios,"ER This study investigated associations between anxious and depressive symptoms in 7- and 9-year-olds and their judgements of intention. It asked children to judge how a protagonist (other judgement) and they themselves (self-judgement) would interpret the intention of a second character, where this intention was ambiguously negative or benign. The results showed that levels of self-report depressive symptoms predicted an increase in the number of negative interpretations for self (but not for other) judgements. In comparison, increased levels of parent-report anxiety symptoms predicted an increase in number of negative interpretations for other (but not for self) judgements.","Dineen, K A; Hadwin, J A",2004.0,10.1016/S0887-6185(03)00030-6,0,0,
6266,"Risperidone in the treatment of tourette syndrome: a double-blind, placebo-controlled trial","ER A double-blind, placebo-controlled trial was performed to determine the efficacy and tolerability of 8 weeks of treatment with risperidone in the management of 48 adolescent and adult patients with Tourette syndrome. Twenty-four patients were randomly assigned to treatment with risperidone in doses of 0.5 to 6.0 mg/day, and 24 were assigned to placebo. The dosage of medication was increased in fixed increments during the first week of double-blind treatment and thereafter in a flexible dose regimen according to clinical response. Risperidone, at a median dose of 2.5 mg/day (range, 1 to 6 mg/day), was found to be significantly ( p < 0.05) superior to placebo on the Global Severity Rating of the Tourette Syndrome Severity Scale. The proportion of patients who improved by at least one point on this seven-point scale was 60.8% in the risperidone group and 26.1% in the placebo group. Treatment with risperidone was accompanied by an improvement in global functioning in patients with average to above-average impairment at baseline as measured by the Global Assessment of Functioning scale. With respect to extrapyramidal symptom scores measured on the Extrapyramidal Symptom Rating Scale, hypokinesia and tremor increased in the risperidone group, but the effect on tremor was largely confined to subjects with higher baseline tremor scores. There were no significant differences in dystonic reactions, dyskinetic movements, subjective parkinsonism, or akathisia. Risperidone did not increase obsessive-compulsive symptoms. Fatigue and somnolence were the most common adverse events associated with risperidone.","Dion, Y; Annable, L; Sandor, P; Chouinard, G",2002.0,,0,0,
6267,Social contagion of vasovagal reactions in the blood collection clinic: a possible example of mass psychogenic illness,"ER OBJECTIVE: Observing or hearing about illness in another person can lead to reports of similar symptoms. Reports can occasionally be widespread. However, it has been difficult to document whether this is the result of genuine illness or the expression of anxiety with physical terminology. This study examined the effects of being able to see another blood donor experience vasovagal symptoms.METHODS: Data were collected in mobile university blood collection clinics. Bedside research assistants coded whether the donor was able or not able to see another donor being treated for vasovagal symptoms. Dependent variables included subjective vasovagal symptoms indicated on the Blood Donation Reactions Inventory (BDRI) and the need for treatment oneself. Given the population of inexperienced donors, many (26% of the 1,209 participants) were able to see another donor treated for symptoms.RESULTS: Being able to see another donor treated was associated with higher scores on the BDRI and an increased likelihood of treatment for vasovagal symptoms oneself. However, this was limited to non-first-time blood donors, perhaps because of higher levels in first-time donors (ceiling effects) or greater attention to the environment in less ""overwhelmed"" repeat donors. In general, donors who were able to see another react rated themselves as less relaxed and had smaller increases in heart rate. During the 2-year follow-up, first-time donors who were able to see another react were slower to return to give blood again.CONCLUSIONS: Seeing another donor being treated for symptoms contributed to the vasovagal process in many donors. This environment provides a useful context to study social influences on symptoms and illness.","Ditto, B; Byrne, N; Holly, C; Balegh, S",2014.0,10.1037/hea0000053,0,0,
6268,Adult attachment and social support interact to reduce psychological but not cortisol responses to stress,"ER METHODSSixty-three healthy men who were married or cohabiting were randomly assigned to receive either instructed social support from their partner or no social support before being exposed to a standardized psychosocial stressor (Trier Social Stress Test). Attachment was determined using the Experiences in Close Relationships-Revised questionnaire. State anxiety, mood, and salivary cortisol levels were repeatedly assessed before and after stress.RESULTSSecure attachment was associated with stronger decreases in state anxiety levels following stress exposure. More importantly, the combination of social support and secure attachment exhibited the lowest anxiety levels after stress (interaction effect). Social support alone reduced cortisol responses to stress, whereas secure attachment did not influence cortisol concentrations.CONCLUSIONThis first study on the interaction of adult attachment and social support in terms of psychological and endocrine stress responses concurs with previous studies suggesting an important protective role of attachment for psychological stress responsiveness. However, attachment did not directly moderate cortisol responses to acute stress.OBJECTIVEAdult attachment has been suggested to mediate the effect of social support on stress protection. The purpose of this study was to investigate the effects of adult attachment and social support on psychological and endocrine responses to psychosocial stress.","Ditzen, B; Schmidt, S; Strauss, B; Nater, U M; Ehlert, U; Heinrichs, M",2008.0,10.1016/j.jpsychores.2007.11.011,0,0,
6269,The affective dimension of dyspnea improves in a dyspnea self-management program with exercise training,"ER Context The perception of dyspnea includes both sensory and affective dimensions that are shaped by emotions and psychological, social, and environmental experiences. Previous investigators have studied either measurement or strategies to decrease the affective dimension with laboratory-induced dyspnea. Few have reported the effect of a therapeutic clinical intervention on the affective dimension of dyspnea. Objectives 1) To evaluate the effects of three different versions of a dyspnea self-management program (DM) on the affective dimension of dyspnea, measured by dyspnea-related anxiety (DA) and dyspnea-related distress (DD); and 2) to determine the stability of DA and DD over two baseline incremental treadmill tests (ITTs). Methods Participants with chronic obstructive pulmonary disease were randomly assigned to three 12 month DMs with varying doses of supervised exercise (DM, DM-Exposure, and DM-Training). The measurements of the affective dimension, DA and DD, were rated during ITTs on two baseline days and at two, six, and 12 months. Changes over time in DA and DD were analyzed using linear mixed-effects models. Results Participants in the DM-Training group who received 24 nurse-coached exercise sessions had significantly greater reductions in DA and DD compared with those who had four exercise sessions (DM-Exposure) or only received a home-walking program (DM). Reductions in DA and DD in the DM-Training group were only maintained through six months. There were no significant differences in ratings of DA and DD at end between the two baseline ITTs. Conclusion These findings provide initial support for the positive impact of a self-management program with nurse-coached exercise on the affective dimension of dyspnea. Further investigation of interventions that target the affective dimension in addition to the sensory dimension of dyspnea should be encouraged.","Donesky, D; Nguyen, H Q; Paul, S M; Carrieri-Kohlman, V",2014.0,10.1016/j.jpainsymman.2013.05.019,0,0,
6270,Online CBT for preschool anxiety disorders: a randomised control trial,"ER UNLABELLED: The aim of this study was to investigate the efficacy of an internet-based, therapist assisted, parent-focussed, CBT program for preschoolers with anxiety disorders. Fifty-two children aged 3-6 years were randomly allocated into internet treatment (NET) and waitlist control (WLC) groups. Parents completed diagnostic interviews and online questionnaires at pre-treatment, post-treatment and 6-month follow-up. Results at post-treatment showed a significantly greater reduction in clinical severity, anxiety symptoms and internalising behaviour, as well as a greater increase in overall functioning for children in the NET compared to the WLC condition. However, group differences were not evident from pre- to post-treatment on the percentages of children who lost their primary anxiety diagnosis or who lost all anxiety diagnoses. At post-treatment for the completer sample, 39.1% of the NET children compared to 25.9% of the WLC were free of their primary diagnosis. At 6-month follow-up, treatment gains were maintained in the case of overall functioning and further improved upon with respect to clinical severity, anxiety symptoms and internalising behaviour. By 6-month follow-up for the completer sample, 70.6% of children were free of their primary diagnosis. The results suggest that an internet program for preschool anxiety is feasible, efficacious and well received by parents.AUSTRALIAN CLINICAL TRIAL REGISTRATION NUMBER: ACTRN12612000139875.","Donovan, C L; March, S",2014.0,10.1016/j.brat.2014.05.001,0,0,
6271,Engaging foster parents in treatment: a randomized trial of supplementing trauma-focused cognitive behavioral therapy with evidence-based engagement strategies,"ER The goal of this study was to examine the impact of supplementing Trauma-focused Cognitive Behavioral Therapy (TF-CBT; Cohen et al., 2006) with evidence-based engagement strategies on foster parent and foster youth engagement in treatment, given challenges engaging foster parents in treatment. A randomized controlled trial of TF-CBT standard delivery compared to TF-CBT plus evidence-based engagement strategies was conducted with 47 children and adolescents in foster care and one of their foster parents. Attendance, engagement, and clinical outcomes were assessed 1 month into treatment, end of treatment, and 3 months post-treatment. Youth and foster parents who received TF-CBT plus evidence-based engagement strategies were more likely to be retained in treatment through four sessions and were less likely to drop out of treatment prematurely. The engagement strategies did not appear to have an effect on the number of canceled or no-show sessions or on treatment satisfaction. Clinical outcomes did not differ by study condition, but exploratory analyses suggest that youth had significant improvements with treatment. Strategies that specifically target engagement may hold promise for increasing access to evidence-based treatments and for increasing likelihood of treatment completion.","Dorsey, S; Pullmann, M D; Berliner, L; Koschmann, E; McKay, M; Deblinger, E",2014.0,10.1016/j.chiabu.2014.03.020,0,0,
6272,Study protocol for a randomized controlled trial of telephone-delivered cognitive behavior therapy compared with befriending for treating depression and anxiety in older adults with COPD,"ER BACKGROUND: COPD is an umbrella term to describe chronic lung diseases that cause limitations in lung airflow, including emphysema and chronic bronchitis. The prevalence of depression and anxiety in people with COPD is high, although these comorbidities are often undiagnosed, untreated, or undertreated. There is a need to identify efficacious treatments for depression and anxiety in people with COPD. Cognitive behavior therapy (CBT) for the treatment of anxiety and depression has a strong evidence base. There has been some success delivering this treatment over the telephone in limited studies. The aim of this study is to evaluate the efficacy of both telephone-administered CBT and befriending on outcomes for patients with diagnosed COPD who have at least mild levels of depression and/or anxiety.METHODS: The protocol described in this paper is of a pragmatic randomized controlled trial comparing eight sessions of telephone CBT to an active social control, referred to as befriending. Primary outcome measures will include depression and anxiety symptoms, and secondary outcome measures will include quality of life, self-efficacy, and COPD symptom severity. Participants' satisfaction with the intervention and therapeutic alliance will also be assessed. Measures will be taken pre- and postdelivery of the intervention and again at 8 weeks following the intervention.CONCLUSION: People with COPD often have limitations to their mobility because of their breathlessness. They are often already attending many medical appointments and could be reluctant to attend for face-to-face psychological treatment. The results of this study should identify the relative efficacy of CBT delivered over the telephone to this population, which, if successful, may be a cost-effective and more palatable alternative to face-to-face treatment of depression or anxiety for this population.","Doyle, C; Dunt, D; Ames, D; Fearn, M; You, E C; Bhar, S",2016.0,10.2147/COPD.S100859,0,0,
6273,A controlled trial of cardiopulmonary resuscitation training for ethnically diverse parents of infants at high risk for cardiopulmonary arrest,"ER DESIGN, SETTING, AND SUBJECTSIn this prospective, multisite clinical trial, 335 parents and other caretakers of infants hospitalized in the neonatal intensive care unit were followed for 1 yr. Participants were 69% female, 49% Latino/Latina, with a mean age of 30 +/- 8 yrs.INTERVENTIONSubjects initially were randomized to one of four CPR training protocols: a video-only class, an instructor-taught class, an instructor-taught class combined with a social support intervention, and a control group. The social support intervention involved a group discussion after CPR training with regular telephone follow-up over the next 6 months by a nurse.MEASUREMENTS AND MAIN RESULTSData on psychosocial adjustment to illness, anxiety, and depression were collected at baseline, 2 wks, and 3 and 6 months. There were significant differences among the groups over time in anxiety (p = .007) and psychosocial adjustment to illness (p = .001). Parents in the CPR-video protocol had significantly less early anxiety and better postdischarge psychosocial adjustment compared with parents in the social support intervention at 2 wks after hospital discharge. Patterns of change over time, however, supported the efficacy of the CPR-social support intervention or the CPR-instructor protocols when compared with the CPR-video protocol.CONCLUSIONThe results confirm that parents have difficulty adjusting after an infant's discharge from the neonatal intensive care unit and support the positive psychosocial effects of helping parents prepare for a home emergency by teaching CPR. The additional staff resources required to provide parents with social support along with CPR training are not justified based on the findings of the current study.OBJECTIVEParents of infants hospitalized in the neonatal intensive care unit are routinely taught cardiopulmonary resuscitation (CPR) as part of the preparation for transition to home. A variety of methods are used to teach CPR knowledge and skills. The purpose of this study was to compare the psychosocial consequences of three different methods of CPR training for parents of infants at high risk for cardiopulmonary arrest.","Dracup, K; Moser, D K; Doering, L V; Guzy, P M; Juarbe, T",2000.0,,0,0,
6274,Effects of cognitive behavioral therapy on daily living skills in children with high-functioning autism and concurrent anxiety disorders,"ER CBT is a promising treatment for children with autism spectrum disorders (ASD) and focuses, in part, on children's independence and self-help skills. In a trial of CBT for anxiety in ASD (Wood et al. in J Child Psychol Psychiatry 50:224-234, 2009), children's daily living skills and related parental intrusiveness were assessed. Forty children with ASD (7-11 years) and their primary caregiver were randomly assigned to an immediate treatment (IT; n = 17) or 3-month waitlist (WL; n = 23) condition. In comparison to WL, IT parents reported increases in children's total and personal daily living skills, and reduced involvement in their children's private daily routines. Reductions correlated with reduced anxiety severity. These results provide preliminary evidence that CBT may yield increased independence and daily living skills among children with ASD.","Drahota, A; Wood, J J; Sze, K M; Dyke, M",2011.0,10.1007/s10803-010-1037-4,0,0,
6275,Personality disorders do not influence the results of cognitive and behavior therapy for obsessive compulsive disorder,"ER This study examined whether categorical or dimensional personality disorder variables affected treatment outcome in a sample of 52 patients with obsessive compulsive disorder who followed a standardized cognitive behavior therapy program. Treatment consisted of 12 weekly sessions and was completed by 43 patients. The Structured Clinical Interview for DSM-III-R personality disorders (SCID-II) was taken before the start of treatment by an independent rater. The treatment outcome measures included questionnaires and a Behavioral Assessment Test. Measurements were taken before and after treatment, and at 1 and 6 month follow-up tests. After the first follow-up test, further treatment was provided if clinically indicated. Neither categorical, nor dimensional personality disorder variables affected treatment outcome significantly. The inclusion of drop-outs in the analyses, did not change these results. Therefore, patients with obsessive compulsive disorder and concomitant personality disorder pathology should not be excluded from cognitive or behavior therapy for their obsessive compulsive complaints. Attributing therapy failure to concomitant Axis II pathology should be approached with caution.","Dreessen, L; Hoekstra, R; Arntz, A",1997.0,,0,0,
6276,"Effect of massage therapy on pain, anxiety, relaxation, and tension after colorectal surgery: a randomized study","ER The purpose of this randomized controlled trial was to evaluate the effect of postoperative massage in patients undergoing abdominal colorectal surgery. One hundred twenty-seven patients were randomized to receive a 20-min massage (n = 61) or social visit and relaxation session (no massage; n = 66) on postoperative days 2 and 3. Vital signs and psychological well-being (pain, tension, anxiety, satisfaction with care, relaxation) were assessed before and after each intervention. The study results indicated that postoperative massage significantly improved the patients' perception of pain, tension, and anxiety, but overall satisfaction was unchanged. In conclusion, massage may be beneficial during postoperative recovery for patients undergoing abdominal colorectal surgery. Further studies are warranted to optimize timing and duration and to determine other benefits in this clinical setting.","Dreyer, N E; Cutshall, S M; Huebner, M; Foss, D M; Lovely, J K; Bauer, B A; Cima, R R",2015.0,10.1016/j.ctcp.2015.06.004,0,0,
6277,"The fear-factor stress test: an ethical, non-invasive laboratory method that produces consistent and sustained cortisol responding in men and women","ER We describe a method to administer a controlled, effective stressor to humans in the laboratory. The method combines the Trier Social Stress Test (TSST) and the Cold Pressor Test into a single, believable procedure called the Fear-Factor Stress Test (FFST). In the procedure, participants imagine auditioning for the reality television show Fear Factor. They stand before a video recorder and a panel of judges while (a) delivering a motivational speech, (b) performing a verbal arithmetic task, and (c) placing one hand into a bucket of ice water for up to 2 min. We measured subjective anxiety, heart rate, and salivary cortisol in three groups of young adults (n?=?30 each, equal numbers of men and women): FFST, TSST, and Control (a placebo version of the FFST). Although the FFST and TSST groups were not distinguishable at the cortisol measure taken 5 min post-manipulation, at 35 min postmanipulation average cortisol levels in the TSST group had returned to baseline, whereas those in the FFST group continued to rise. The proportion of individual cortisol responders (? 2 nmol/l increase over baseline) in the TSST and FFST groups did not differ at the 5-min measure, but at the 35-min measure the FFST group contained significantly more responders. The findings indicate that the FFST induces a more robust and sustained cortisol response (which we assume is a marker of an HPA-axis response) than the TSST, and that it does so without increasing participant discomfort or incurring appreciably greater resource and time costs.","du, Plooy C; Thomas, K G; Henry, M; Human, R; Jacobs, W J",2014.0,10.1007/s11011-014-9484-9,0,0,
6278,Treatment of child extensive anxiety disorder with catgut implantation of point plus western medicine,"ER METHODSSeventy cases were randomly divided into a treatment group and a control group, 35 cases in each group. The treatment group were treated with catgut implantation of points, once 2 weeks, 3 sessions constituting one course, with the 3 groups of points, (1) Ganshu (BL 18) and Danzhong (CV 17), (2) Dazhui (CV 14) and Zhongwan (CV 12), (3) Shenshu (BL 23) and Zhangmen (LR 13) alternated, in combination with oral administration of Wenlafaxin. The control group were treated with simple oral administration of Wenlafax-cin. All of them were treated for 6 weeks.RESULTSThe cured and markedly effective rate was 74.3% in the treatment group and 60.0% in the control group, with a significant difference between the two groups (P < 0.05). After treatment for 6 weeks, the HAMD score was significantly lower than that before treatment in the two groups. The following survey showed that the long-term therapeutic effect in the treatment group was better, with smaller dose and less adverse effects.CONCLUSIONCatgut implantation of point plus small dose of Wenlafaxin is a more ideal therapy for child extensive anxiety disorder.OBJECTIVETo compare therapeutic effects and adverse effects between catgut implantation of point plus Wenlafaxin and simple Wenlafaxin on child extensive anxiety disorder.","Duan, Y E",2007.0,,0,0,
6279,"Comparative study of enamel adhesion between RelyX? Unicem® (3M), a self-adhesive bonding agent, and the combination of MIP® (3M), a hydrophilic adhesive, and Transbond Supreme Low Viscosity® (3M), a traditional hydrophobic adhesive","ER UNLABELLED: Although the bond strength of self-adhesive bonding agents is inferior to that of other families of adhesives, it is still adequate for orthodontic purposes provided prior enamel etching is performed.AIM: To determine the efficacy of RelyX? Unicem(®) (3M) self-adhesive cement both in vitro and in vivo and to compare it with the combination of MIP(®) (3M), a moisture-insensitive primer, with a traditional hydrophobic adhesive, Transbond Supreme Low Viscosity(®) (3M).IN VITRO: Comparison of bonding results on 23 trial dentures using RelyX? Unicem(®) (3M) with bonding results on 29 trial dentures using a combination of MIP(®) and Transbond Supreme Low Viscosity(®) (3M), by means of a multipurpose Instron(®) 4444 testing machine.RESULTS: the breaking force of MIP(®)/Transbond Supreme Low Viscosity(®) (3M) (mean: 144±37.5 Newtons) was significantly higher than that of RelyX? Unicem(®) (3M) (mean=110±26 Newtons) (P=0.001).IN VIVO: A 12-month prospective, randomized, monocentric, single-blind clinical study in order to investigate the failure rate of orthodontic attachments according to the type of adhesive used, and the precise site of the debonding. Bracket bonding was performed on 16 patients with randomized allocation of the two adhesives to each of the semi-arches.RESULTS: The failure rates were: 15.3% for the MIP(®)/Transbond Supreme Low Viscosity(®) (3M) combination and 8.2% for the RelyX? Unicem(®) (3M), with a significant difference (P=0.039). The more posterior the bonded teeth, the greater the superiority of RelyX? Unicem(®) (3M). The in vivo results did not concord with those obtained in vitro. RelyX? Unicem(®) (3M) exhibited lower adhesion values in vitro and yet it presented a debonding rate almost half that of the MIP(®)/Transbond Supreme Low Viscosity(®) (3M). The viscosity of RelyX? Unicem(®) (3M) and its moisture tolerance would appear to account for these results.CONCLUSION: With prior etching, RelyX? Unicem(®) (3M), a self-adhesive, self-etching bonding agent is compatible with use in the orthodontic indirect bonding technique. The MIP(®)/Transbond Supreme Low Viscosity(®) (3M) combination, though very effective, still remains sensitive and requires special care during usage.","Dubernard, C; Raynal, P; Tramini, P",2013.0,10.1016/j.ortho.2013.06.009,0,0,
6280,Parental mental health moderates the efficacy of exercise training on health-related quality of life in adolescents with congenital heart disease,"ER To evaluate the moderating influence of parental variables on changes in health-related quality of life (HRQoL) in adolescents with Tetralogy of Fallot (ToF) or a Fontan circulation after participation in standardized exercise training. A multicenter randomized controlled trail in which 56 patients, aged 10-15, were randomly allocated (stratified by age, gender, and congenital heart disease) to a 12-week period with either: (a) 3 times per week standardized exercise training or (b) care-as-usual (randomization ratio 2:1). Adolescents and their parents filled in online questionnaires at baseline and at 12-week follow-up. In this randomized controlled trail, primary analyses involved influence of parental mental health and parental social support for exercise on changes in the TNO/AZL Child Quality of Life Questionnaire Child Form at followup. Secondary analyses concerned comparing levels of parental characteristics with normative data. Compared with controls, adolescents in the exercise group reported a decrease in social functioning when their parents had more anxiety/insomnia or severe depression themselves. Adolescents also reported a decrease in social functioning when their parents showed poorer overall mental health themselves. Parents reported comparable or even better mental health compared with normative data. The effect of a standardized exercise program on HRQoL changes in adolescents with ToF or a Fontan circulation is moderated by parental mental health, more specifically by parental anxiety/insomnia and severe depression. The trial registration number of this article is NTR2731 (www.trialregister.nl).","Dulfer, K; Duppen, N; Dijk, A P; Kuipers, I M; Domburg, R T; Verhulst, F C; Ende, J; Helbing, W A; Utens, E M",2015.0,10.1007/s00246-014-0961-z,0,0,
6281,Social technology restriction alters state-anxiety but not autonomic activity in humans,"ER Social technology is extensively used by young adults throughout the world, and it has been suggested that interrupting access to this technology induces anxiety. However, the influence of social technology restriction on anxiety and autonomic activity in young adults has not been formally examined. Therefore, we hypothesized that restriction of social technology would increase state-anxiety and alter neural cardiovascular regulation of arterial blood pressure. Twenty-one college students (age 18-23 yr) were examined during two consecutive weeks in which social technology use was normal or restricted (randomized crossover design). Mean arterial pressure (MAP), heart rate, and muscle sympathetic nerve activity (MSNA) were measured at rest and during several classic autonomic stressors, including isometric handgrip, postexercise muscle ischemia, cold pressor test, and mental stress. Tertile analysis revealed that restriction of social technology was associated with increases (12 ± 2 au; range 5 to 21; n = 7), decreases (-6 ± 2 au; range -2 to -11; n = 6), or no change (0 ± 0 au; range -1 to 3; n = 8) in state-anxiety. Social technology restriction did not alter MAP (74 ± 1 vs. 73 ± 1 mmHg), heart rate (62 ± 2 vs. 61 ± 2 beats/min), or MSNA (9 ± 1 vs. 9 ± 1 bursts/min) at rest, and it did not alter neural or cardiovascular responses to acute stressors. In conclusion, social technology restriction appears to have an interindividual influence on anxiety, but not autonomic activity. It remains unclear how repeated bouts, or chronic restriction of social technology, influence long-term psychological and cardiovascular health.","Durocher, J J; Lufkin, K M; King, M E; Carter, J R",2011.0,10.1152/ajpregu.00418.2011,0,0,
6282,The effect of moisture on the shear bond strength of gold alloy rods bonded to enamel with a self-adhesive and a hydrophobic resin cement,"ER The aim of this in vitro study was to investigate the influence of enamel moisture on the shear bond strength (SBS) of a hydrophobic resin cement, Maximum Cure (MC), and a self-adhesive resin cement, Multilink Sprint (MLS), after etching of the enamel. Forty cylindrical gold alloy rods were used to simulate the Incognito lingual bracket system. They were bonded to the enamel of 40 human teeth embedded in self-cured acrylic resin. Twenty were bonded with MC (10 on dry and 10 on wet enamel) and 20 with MLS (10 on dry and 10 on wet enamel). The SBS of MC and MLS was determined in a universal testing machine and the site of bond failure was defined by the adhesive remnant index (ARI). A Kruskal-Wallis test was performed followed by Games-Howell post hoc pairwise comparison tests on the SBS results (P < 0.05) and a chi-square test was used for the analysis of ARI scores (P < 0.05). On dry enamel, no significant differences between MC (58 +/- 5 MPa) and MLS (64 +/- 13 MPa) were noted. On wet enamel, the adherence of MC (6 +/- 8 MPa) and MLS (37 +/- 13 MPa) significantly decreased but to a lesser extent for MLS. The ARI scores corroborated these results. In conclusion, MC did not tolerate moisture. MLS was also affected but maintained sufficient adherence.","Dursun, E; Wiechmann, D; Attal, J P",2010.0,10.1093/ejo/cjp102,0,0,
6283,Children and mothers in war: an outcome study of a psychosocial intervention program,"ER The present study was designed to evaluate the effects on children (age: M = 5.5 years) in war-torn Bosnia and Herzegovina of a psychosocial intervention program consisting of weekly group meetings for mothers for 5 months. An additional aim was to investigate the children's psychosocial functioning and the mental health of their mothers. Internally displaced mother-child dyads were randomly assigned to an intervention group receiving psychosocial support and basic medical care (n = 42) or to a control group receiving medical care only (n = 45). Participants took part in interviews and tests to provide information about war exposure, mental health, psychosocial functioning, intellectual abilities, and physical health. Results showed that although all participants were exposed to severe trauma, their manifestations of distress varied considerably. The intervention program had a positive effect on mothers' mental health, children's weight gain, and several measures of children's psychosocial functioning and mental health, whereas there was no difference between the two groups on other measures. The findings have implications for policy.","Dybdahl, R",2001.0,,0,0,
6284,For whom does it work? moderators of outcome on the effect of a transdiagnostic internet-based maintenance treatment after inpatient psychotherapy: randomized controlled trial,"ER BACKGROUND: Recent studies provide evidence for the effectiveness of Internet-based maintenance treatments for mental disorders. However, it is still unclear which participants might or might not profit from this particular kind of treatment delivery.OBJECTIVE: The study aimed to identify moderators of treatment outcome in a transdiagnostic Internet-based maintenance treatment (TIMT) offered to patients after inpatient psychotherapy for mental disorders in routine care.METHODS: Using data from a randomized controlled trial (N=400) designed to test the effectiveness of TIMT, we performed secondary analyses to identify factors moderating the effects of TIMT (intervention) when compared with those of a treatment-as-usual control condition. TIMT involved an online self-management module, asynchronous patient-therapist communication, a peer support group, and online-based progress monitoring. Participants in the control condition had unstructured access to outpatient psychotherapy, standardized outpatient face-to-face continuation treatment, and psychotropic management. Self-reports of psychopathological symptoms and potential moderators were assessed at the start of inpatient treatment (T1), at discharge from inpatient treatment/start of TIMT (T2), and at 3-month (T3) and 12-month follow-up (T4).RESULTS: Education level, positive outcome expectations, and diagnoses significantly moderated intervention versus control differences regarding changes in outcomes between T2 and T3. Only education level moderated change differences between T2 and T4. The effectiveness of the intervention (vs control) was more pronounced among participants with a low (vs high) education level (T2-T3: B=-0.32, SE 0.16, P=.049; T2-T4: B=-0.42, SE 0.21, P=.049), participants with high (vs low) positive outcome expectations (T2-T3: B=-0.12, SE 0.05, P=.02) and participants with anxiety disorder (vs mood disorder) (T2-T3: B=-0.43, SE 0.21, P=.04). Simple slope analyses revealed that despite some subgroups benefiting less from the intervention than others, all subgroups still benefited significantly.CONCLUSIONS: This transdiagnostic Internet-based maintenance treatment might be suitable for a wide range of participants differing in various clinical, motivational, and demographic characteristics. The treatment is especially effective for participants with low education levels. These findings may generalize to other Internet-based maintenance treatments.","Ebert, D D; Gollwitzer, M; Riper, H; Cuijpers, P; Baumeister, H; Berking, M",2013.0,10.2196/jmir.2511,0,0,
6285,Psychological impact of screening for type 2 diabetes: controlled trial and comparative study embedded in the ADDITION (Cambridge) randomised controlled trial,"ER DESIGNControlled trial and comparative study embedded in a randomised controlled trial.SETTING15 practices (10 screening, five control) in the ADDITION (Cambridge) trial in the east of England.PARTICIPANTS7380 adults (aged 40-69) in the top fourth for risk of having undiagnosed type 2 diabetes (6416 invited for screening, 964 controls).INTERVENTIONSInvited for screening for type 2 diabetes or not invited (controls), incorporating a comparative study of subgroups of screening attenders. Attenders completed questionnaires after a random blood glucose test and at 3-6 months and 12-15 months later. Controls were sent questionnaires at corresponding time points. Non-attenders were sent questionnaires at 3-6 months and 12-15 months.MAIN OUTCOME MEASURESState anxiety (Spielberger state anxiety inventory), anxiety and depression (hospital anxiety and depression scale), worry about diabetes, and self rated health.RESULTSNo significant differences were found between the screening and control participants at any time-for example, difference in means (95% confidence intervals) for state anxiety after the initial blood glucose test was -0.53, -2.60 to 1.54, at 3-6 months was 1.51 (-0.17 to 3.20), and at 12-15 months was 0.57, -1.11 to 2.24. After the initial test, compared with participants who screened negative, those who screened positive reported significantly poorer general health (difference in means -0.19, -0.25 to -0.13), higher state anxiety (0.93, -0.02 to 1.88), higher depression (0.32, 0.08 to 0.56), and higher worry about diabetes (0.25, 0.09 to 0.41), although effect sizes were small. Small but significant trends were found for self rated health across the screening subgroups at 3-6 months (P=0.047) and for worry about diabetes across the screen negative groups at 3-6 months and 12-15 months (P=0.001).CONCLUSIONSScreening for type 2 diabetes has limited psychological impact on patients. Implementing a national screening programme based on the stepwise screening procedure used in the ADDITION (Cambridge) trial is unlikely to have significant consequences for patients' psychological health.TRIAL REGISTRATIONCurrent Controlled Trials ISRCTN99175498 [controlled-trials.com].OBJECTIVETo quantify the psychological impact of primary care based stepwise screening for type 2 diabetes.","Eborall, H C; Griffin, S J; Prevost, A T; Kinmonth, A L; French, D P; Sutton, S",2007.0,10.1136/bmj.39303.723449.55,0,0,
6286,"Cognitive behavior therapy for chronic subjective dizziness: a randomized, controlled trial","ER PURPOSE: The aim of this study was to evaluate the effects of a brief cognitive behavior therapy (CBT) intervention on the physical symptoms, illness-related disability, and psychologic distress of patients with chronic subjective dizziness.MATERIALS AND METHODS: Forty-one patients with chronic subjective dizziness referred by a neurootologic clinic were randomly assigned to immediate treatment or a wait-list control. Three weekly treatment sessions based on the CBT model of panic disorder, adapted for patients with dizziness, were administered by a clinical psychologist. Treatment included psychoeducation, behavioral experiments, exposure to feared stimuli, and attentional refocusing. Outcomes were measured on the Dizziness Handicap Inventory and the Depression, Anxiety and Stress Scales. Two further measures developed for this study; the Dizziness Symptoms Inventory and the Safety Behaviours Inventory were used to measure physical symptoms and safety behaviors.RESULTS: The intervention was associated with significant reductions in disability on the Dizziness Handicap Inventory, reduced dizziness and related physical symptoms on the Dizziness Symptoms Inventory, and reduced avoidance and safety behaviors as measured by the Safety Behaviours Inventory. Pre- to posteffect sizes ranged from 0.98 to 1.15. There was no change in psychologic outcomes measured on the Depression, Anxiety and Stress Scales.CONCLUSIONS: A 3-session psychologic intervention based on the CBT model can produce significant improvements in dizziness-related symptoms, disability, and functional impairment among patients with chronic subjective dizziness. This suggests that treatment of this condition may be reasonably simple and cost-effective for most of the patients.","Edelman, S; Mahoney, A E; Cremer, P D",2012.0,10.1016/j.amjoto.2011.10.009,0,0,
6287,Assessing the long-term effects of EMDR: results from an 18-month follow-up study with adult female survivors of CSA,"ER This 18-month follow-up study builds on the findings of a randomized experimental evaluation that found qualified support for the short-term effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in reducing trauma symptoms among adult female survivors of childhood sexual abuse (CSA). The current study provides preliminary evidence that the therapeutic benefits of EMDR for adult female survivors of CSA can be maintained over an 18-month period. Furthermore, there is some support for the suggestion that EMDR did so more efficiently and provided a greater sense of trauma resolution than did routine individual therapy.","Edmond, T; Rubin, A",2004.0,10.1300/J070v13n01_04,0,0,
6288,Acupuncture in patients with minor depressive episodes and generalized anxiety. Results of an experimental study,"ER In a placebo-controlled, randomized, modified double-blind study we investigated the effects of body needle acupuncture (n = 10) in 43 patients with minor depression (ICD 10 F32.0, F32.1) and 13 patients with generalized anxiety disorders (ICD10 F41.1). The severity of the disease was assessed by the Clinical Global Impression Scale (CGI). Treatment response was defined as a significant improvement in CGI. An intent-to-treat analysis was performed to compare treatment responses between verum- and placebo acupuncture. After completing an total of 10 acupuncture sessions the verum acupuncture group (n = 28) showed a significantly larger clinical improvement compared to the placebo group (Mann-Whitney test, p < 0.05). There were significantly more responders in the verum-compared to the placebo group (60.7% vs. 21.4%; chi-square test, p < 0.01). In contrast, no differences in the response rates were evident just after 5 acupuncture sessions. A multivariate analysis with the independent factor acupuncture (verum vs. placebo) and the results of the results of the additional rating scales (total score of HAMA, HAMD, Bf-S, BL) as dependent variables (ANOVA, 1:54 D.F.) revealed a clear trend towards lower HAMA scores in the verum group after completing 10 acupunctures (F3.29, p = 0.075). This corresponds well to the high response rate of 85.7% in patients with generalized anxiety disorders, in whom verum acupuncture was applied. Our results indicate that needle acupuncture (Du.20, Ex.6, He.7, Pe.6, Bl.62) leads to a significant clinical improvement as well as to a remarkable reduction in anxiety symptoms in patients with minor depression or with generalized anxiety disorders. The total sum of acupuncture sessions and the specific location of acupuncture needle insertions might be important factors for bringing about therapeutic success.","Eich, H; Agelink, M W; Lehmann, E; Lemmer, W; Klieser, E",2000.0,10.1055/s-2000-11624,0,0,
6289,A double-blind randomized controlled trial of oxytocin nasal spray in Prader Willi syndrome,"ER Individuals with Prader-Willi syndrome (PWS) have a significant reduction in the number of oxytocin-producing neurons (42%) in the hypothalamic paraventricular nucleus. A number of animal studies and observations of humans show that lesions in this region can produce PWS-like symptoms. Given the evidence for potential oxytocin deficiency, we tested the effects of a course of intranasal oxytocin on PWS symptoms. Thirty individuals with PWS aged 12-30 years participated in an 18-week randomized double-blind placebo-controlled crossover trial. Participants received 8 weeks of oxytocin and 8 weeks of placebo with a minimum 2-week washout period. The first 11 participants received the following oxytocin doses: 24 IU (twice daily) B.I.D for participants 16 years and over and 18 IU B.I.D for participants 13-15 years. The dose was increased for the remaining 18 participants to 40 IU B.I.D for participants 16 years and over and 32 IU B.I.D for 13-15 years. Measures used to assess changes were standardized well-accepted measures, including the Developmental Behavior Checklist-Monitor, Parent, Teacher, and Adult; The Yale-Brown Obsessive Compulsive Scale; The Dykens Hyperphagia questionnaire; Reading The Mind in the Eyes Test; Epworth Sleepiness Scale and the Movie Stills. Oxytocin had little impact on any measure. The only significant difference found between the baseline, oxytocin, and placebo measures was an increase in temper outbursts (P = 0.023) with higher dose oxytocin. The lack of effect of oxytocin nasal spray may reflect the importance of endogenous release of oxytocin in response to exogenous oxytocin.","Einfeld, S L; Smith, E; McGregor, I S; Steinbeck, K; Taffe, J; Rice, L J; Horstead, S K; Rogers, N; Hodge, M A; Guastella, A J",2014.0,10.1002/ajmg.a.36653,0,0,
6290,"The influence of long-term awareness of hyperlipidemia and of 3 years of dietary counseling on depression, anxiety, and quality of life","ER METHODSHigh-risk subjects (n=563) with hyperlipidemia from the Oslo Diet and Antismoking Study (1972-1977) were reexamined after 25 years and randomly assigned to a new 3-year prospective 2x2 factorial placebo-controlled study in 1997 of n-3 polyunsaturated fatty acids and/or dietary counseling. Hospital Anxiety and Depression Scale (HADS), Life Satisfaction Index (LSI), and a new questionnaire on health concerns and behavior in response to risk information were collected at the 25-year follow-up. Hospital Anxiety and Depression Scale and LSI were evaluated at the end of the 3-year Diet and Omega-3 Intervention Trial on atherosclerosis (DOIT) in 505 subjects.RESULTSTwenty-five years after the screening program, HADS-anxiety was similar to the Norwegian norms (3.3 vs. 3.5), while HADS-depression was significantly lower (3.6 vs. 4.1, P<.01). Patients reported that 25 years of awareness of hyperlipidemia had influenced health concerns through a moderate change in diet habits, some restriction in life conduct, but an improvement of the total life situation. After a novel 3-year intervention in DOIT, there was no difference between the dietary counseling and control group with regard to anxiety, depression, or life satisfaction, but HADS-anxiety increased significantly (4.0 vs. 3.3, P<.001) in both groups.CONCLUSIONCompared to the general population, screening-positive subjects did not have increased mental distress 25 years after screening, and beneficial health behavior persisted. Dietary counseling did not affect psychosocial outcomes.OBJECTIVEThe purpose of this study is to investigate the long-term effects of participation in a cardiovascular screening program and of dietary counseling on self-reported psychosocial outcomes and health concerns.","Einvik, G; Ekeberg, O; Lavik, J G; Ellingsen, I; Klemsdal, T O; Hjerkinn, E M",2010.0,10.1016/j.jpsychores.2009.11.004,0,0,
6291,"A hybrid effectiveness-implementation cluster randomized trial of group CBT for anxiety in urban schools: rationale, design, and methods","ER METHODS/DESIGN: The aim of this 5-year study is to evaluate both the effectiveness of CATS for urban public schools compared to the original FRIENDS as well as compare the implementation strategies (train-the-trainer vs. train-the-trainer + ongoing consultation) by conducting a three-arm, parallel group, type 2 hybrid effectiveness-implementation trial in 18 K-8 urban public schools. We will also assess the cost-effectiveness and the mediators and moderators of fidelity. Ninety therapists, 18 agency supervisors, and 360 children will participate. The interactive systems framework for dissemination and implementation guides the training and support procedures for therapists and supervisors.DISCUSSION: This study has the potential to demonstrate that agency therapists and supervisors who have had little to no prior exposure to evidence-based practices (EBPs) can implement an anxiety disorder EBP with fidelity. Comparisons of the implementation strategies would provide large urban mental health systems with data to make decisions about the adoption of EBPs.TRIAL REGISTRATION: ClinicalTrials.gov, NCT02651402.BACKGROUND: Schools present a context with great potential for the implementation of psychosocial evidence-based practices. Cognitive behavioral therapy (CBT) is an evidence-based practice that has been found to be very effective in treating anxiety in various community settings, including schools. Friends for Life (FRIENDS) is an efficacious group CBT protocol for anxiety. Unfortunately, evidence-based practices for anxiety are seldom employed in under-resourced urban schools, because many treatment protocols are not a good fit for the urban school context or the population, existing behavioral health staff do not receive adequate training or support to allow them to implement the treatment with fidelity, or school districts do not have the resources to contract with external consultants. In our prior work, we adapted FRIENDS to create a more culturally sensitive, focused, and feasible CBT protocol for anxiety disorders (CBT for Anxiety Treatment in Schools (CATS)).","Eiraldi, R; Khanna, M S; Jawad, A F; Fishman, J; Glick, H A; Schwartz, B S; Cacia, J; Wandersman, A; Beidas, R",2016.0,10.1186/s13012-016-0453-z,0,0,
6292,A cluster randomized trial to evaluate external support for the implementation of positive behavioral interventions and supports by school personnel,"ER BACKGROUND: Urban schools lag behind non-urban schools in attending to the behavioral health needs of their students. This is especially evident with regard to the level of use of evidence-based interventions with school children. Increased used of evidence-based interventions in urban schools would contribute to reducing mental health services disparities in low-income communities. School-wide positive behavioral interventions and supports (SWPBIS) is a service delivery framework that can be used to deliver universal preventive interventions and evidence-based behavioral health treatments, such as group cognitive behavioral therapy. In this article, we describe our ongoing research on creating internal capacity for program implementation. We also examine the cost-effectiveness and resulting school climate when two different levels of external support are provided to personnel as they implement a two-tier SWPBIS program.METHODS/DESIGN: The study follows six K - 8 schools in the School District of Philadelphia randomly assigned to consultation support or consultation-plus-coaching support. Participants are: approximately 48 leadership team members, 180 school staff and 3,900 students in Tier 1, and 12 counselors, and 306 child participants in Tier 2. Children who meet inclusion criteria for Tier 2 will participate in group cognitive behavioral therapy for externalizing or anxiety disorders. The study has three phases, baseline/training, implementation, and sustainability. We will measure implementation outcomes, service outcomes, child outcomes, and cost.DISCUSSION: Findings from this study will provide evidence as to the appropriateness of school-wide prevention and treatment service delivery models for addressing services disparities in schools. The effectiveness and cost-effectiveness analyses of the two levels of training and consultation should help urban school districts and policymakers with the planning and deployment of cost-effective strategies for the implementation of evidence-based interventions for some of the most common behavioral health problems in school children.TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01941069.","Eiraldi, R; McCurdy, B; Khanna, M; Mautone, J; Jawad, A F; Power, T; Cidav, Z; Cacia, J; Sugai, G",2014.0,10.1186/1748-5908-9-12,0,0,
6293,Magnetopuncture therapy in the combined corrective treatment of clinical manifestations of non-specific distress syndrome,"ER The efficiency of a combined approach to the correction of clinical manifestations of non-specific distress syndrome was evaluated in patients with psychovegetative syndrome by comparing effects of phytoaeroionotherapy, graduated physical exercises, and soft tissue manual therapy in different combinations with simultaneous magnetopuncture therapy and without it. It was shown that above therapeutic modalities combined with magnetotherapy decreased the degree of asymmetry of both right and left heart meridians (by 60.5%) and interhemisphere asymmetry of blood flow in the system of internal carotid arteries (by 74.19%), reduced the tone of cerebral arterioles and veins (by 40.7% and 8.6% respectively), improved symptomes of depression and asthenia (by 23.2% and 63.9% respectively), increased mental performance quotient and activity indices (by 34.7% and 28.7% respectively). These changes were far less significant in the absence of by magnetopuncture therapy.","El'chininov, N V",2009.0,,0,0,
6294,Attention bias modification treatment for pediatric anxiety disorders: a randomized controlled trial,"ER METHODFrom a target sample of 186 treatment-seeking children at a hospital-based child anxiety clinic, 40 patients with an ongoing anxiety disorder who met all inclusion criteria were enrolled in the study. Children were randomly assigned to one of three conditions: ABM designed to shift attention away from threat; placebo attention training using stimuli identical to those in the ABM condition; and placebo attention training using only neutral stimuli. All participants completed four weekly 480-trial sessions (1,920 total trials). Before and after the attention training sessions, children's clinical status was determined via semistructured interviews and questionnaires. Reduction in the number of anxiety symptoms and their severity was compared across the three groups.RESULTSChange in the number of anxiety symptoms and their severity differed across the three conditions. This reflected significant reductions in the number of anxiety symptoms and symptom severity in the ABM condition but not in the placebo attention training or placebo-neutral condition.CONCLUSIONSABM, compared with two control conditions, reduces pediatric anxiety symptoms and severity. Further study of efficacy and underlying mechanisms is warranted.OBJECTIVEWhile attention bias modification (ABM) is a promising novel treatment for anxiety disorders, clinical trial data remain restricted to adults. The authors examined whether ABM induces greater reductions in pediatric anxiety symptoms and symptom severity than multiple control training interventions.","Eldar, S; Apter, A; Lotan, D; Edgar, K P; Naim, R; Fox, N A; Pine, D S; Bar-Haim, Y",2012.0,10.1176/appi.ajp.2011.11060886,0,0,
6295,Optical coherence tomography of intraocular lens implants and their relationship to the posterior capsule: a pilot study comparing a hydrophobic acrylic to a plate-haptic silicone type,"ER OBJECTIVESTo use OCT to examine two of the IOLs and some of the features related to the development of posterior capsular opacification (PCO).METHODSThis is a pilot study of a prospective (n = 12) and a retrospective (n = 14) series of patients who had uneventful phacoemulsification and IOL implantation of either hydrophobic acrylic (Acrysof; Alcon) or plate-haptic (PH) silicone (C11UB; Chiron, Bausch & Lomb) IOLs. The outcome of interest was the ability of OCT to clearly delineate the outline of the IOL optics and their appositional relationship to the posterior capsule.RESULTSOCT showed that hydrophobic acrylic IOLs had a better defined outline than PH silicone IOLs. It also showed close apposition between hydrophobic acrylic optics and the mid-peripheral part of the posterior capsule and the absence thereof with PH silicone IOLs.CONCLUSIONSHydrophobic acrylic implants have better definition on the OCT scans than PH silicone and they develop close apposition to the posterior capsule. The latter feature is consistent with the 'no space, no cell, no PCO' concept and what is known about the effect of the implant material and design on the rate of PCO.BACKGROUNDOptical coherence tomography (OCT) has been used to examine the anterior as well as the posterior segment and can be used to examine the intraocular lens (IOL) and their relationship to the posterior capsule in vivo.","Elgohary, M A; Chauhan, D S; Dowler, J G",2006.0,10.1159/000090532,0,0,
6296,Anterior segment optical coherence tomography evaluation of corneal epithelium healing time after 2 different surface ablation methods,"ER Objectives: To compare epithelial healing time following laser epithelial keratomileusis (LASEK) and photorefractive keratectomy (PRK) with anterior segment optic coherence tomography (AS-OCT). Methods: This prospective interventional case series study comprised 56 eyes of 28 patients that underwent laser refractive surgery in the Department of Ophthalmology, Medipol University Medical Faculty, Istanbul, Turkey, between March 2014 and May 2014. Each patient was randomized to have one eye operated on with PRK, and the other with LASEK. Patients were examined daily for 5 days, and epithelial healing time was assessed by using AS-OCT without removing therapeutic contact lens (TCL). Average discomfort scores were calculated from ratings obtained from questions regarding pain, photophobia, and lacrimation according to a scale of 0 (none) to 5.Results: The mean re-epithelialization time assessed with AS-OCT was 3.07+/-0.64 days in the PRK group, 3.55+/-0.54 days in the LASEK group, and the difference was statistically significant (p=0.03). Mean subjective discomfort score was 4.42+/-0.50 in the PRK eyes, and 2.85+/-0.44 in the LASEK eyes on the first exam day (p=0.001). The score obtained on the second (p=0.024), and third day (p=0.03) were also statistically significant. The fourth (p=0.069), and fifth days scores (p=0.1) showed no statistically significant difference between groups.Conclusion: The PRK showed a statistically significant shorter epithelial healing time, but had a statistically significant higher discomfort score until the postoperative fourth day compared with LASEK.","Eliaçik, M; Bayramlar, H; Erdur, S K; Karabela, Y; Demirci, G; Gulkilik, I G; Ozsutcu, M",2015.0,10.15537/smj.2015.1.9983,0,0,
6297,Prevalence and correlates of a lifetime cannabis use disorder among pregnant former tobacco smokers,"ER Background: Following tobacco and alcohol, cannabis is the most commonly used substance during pregnancy. Given the high prevalence of concurrent cannabis and tobacco use as well as the health consequences associated with prenatal substance use, we sought to document the relative contributions of psychosocial and psychiatric factors commonly associated with cannabis use in predicting a lifetime cannabis use disorder (CUD) among women who had quit smoking tobacco as a result of pregnancy. Methods: Pregnant former tobacco smokers (n= 273) enrolled in a larger randomized controlled trial for postpartum tobacco relapse prevention completed semi-structured psychiatric interviews and self-reported demographic, pregnancy, health, psychosocial, and tobacco use factors during their third trimester of pregnancy. Results: In total, 14% (n= 38) of women met criteria for a lifetime CUD. The strongest predictors of a lifetime CUD were a history of having multiple psychiatric disorders (OR= 36.44; 95% CI= 5.03-264.27; p< 0.001) followed by a lifetime alcohol use disorder (OR= 3.54; 95% CI= 1.27-9.87; p< 0.05). In addition, more frequent attempts to quit smoking tobacco (OR= 1.12; 95% CI= 1.01-1.25; p< 0.05) and lower self-efficacy about weight management after quitting smoking tobacco (OR= 0.78; 95% CI= 0.62-0.97; p< 0.05) also were significantly associated with a lifetime CUD. Conclusions: Women with a history of both cannabis and tobacco dependence may represent a subset of women who need more specialized treatment during the perinatal period to improve substance use outcomes.","Emery, R L; Gregory, M P; Grace, J L; Levine, M D",2016.0,10.1016/j.addbeh.2015.12.008,0,0,
6298,Alleviating social avoidance: effects of single dose testosterone administration on approach-avoidance action,"ER Testosterone is an important regulator of social-motivational behavior and is known for its dominance-enhancing and social-anxiolytic properties. However, to date no studies have systematically investigated the causal effect of testosterone on actual social approach-avoidance behavior in humans. The present study sets out to test the effects of testosterone administration in healthy female volunteers using an objective implicit measure of social motivational behavior: the social Approach-Avoidance Task, a reaction time task requiring participants to approach or avoid visually presented emotional (happy, angry, and neutral) faces. Participants showed significantly diminished avoidance tendencies to angry faces after testosterone administration. Testosterone did not affect approach-avoidance tendencies to social affiliation (happy) faces. Thus, a single dose testosterone administration reduces automatic avoidance of social threat and promotes relative increase of threat approach tendencies in healthy females. These findings further the understanding of the neuroendocrine regulation of social motivational behavior and may have direct treatment implications for social anxiety, characterized by persistent social avoidance.","Enter, D; Spinhoven, P; Roelofs, K",2014.0,10.1016/j.yhbeh.2014.02.001,0,0,
6299,"A double-blind, randomized trial of deep repetitive transcranial magnetic stimulation (rTMS) for autism spectrum disorder","ER BACKGROUND: Biomedical treatment options for autism spectrum disorder (ASD) are extremely limited. Repetitive transcranial magnetic stimulation (rTMS) is a safe and efficacious technique when targeting specific areas of cortical dysfunction in major depressive disorder, and a similar approach could yield therapeutic benefits in ASD, if applied to relevant cortical regions.OBJECTIVE: The aim of this study was to examine whether deep rTMS to bilateral dorsomedial prefrontal cortex improves social relating in ASD.METHODS: 28 adults diagnosed with either autistic disorder (high-functioning) or Asperger's disorder completed a prospective, double-blind, randomized, placebo-controlled design with 2 weeks of daily weekday treatment. This involved deep rTMS to bilateral dorsomedial prefrontal cortex (5 Hz, 10-s train duration, 20-s inter-train interval) for 15 min (1500 pulses per session) using a HAUT-Coil. The sham rTMS coil was encased in the same helmet of the active deep rTMS coil, but no effective field was delivered into the brain. Assessments were conducted before, after, and one month following treatment.RESULTS: Participants in the active condition showed a near significant reduction in self-reported social relating symptoms from pre-treatment to one month follow-up, and a significant reduction in social relating symptoms (relative to sham participants) for both post-treatment assessments. Those in the active condition also showed a reduction in self-oriented anxiety during difficult and emotional social situations from pre-treatment to one month follow-up. There were no changes for those in the sham condition.CONCLUSION: Deep rTMS to bilateral dorsomedial prefrontal cortex yielded a reduction in social relating impairment and socially-related anxiety. Further research in this area should employ extended rTMS protocols that approximate those used in depression in an attempt to replicate and amplify the clinical response.","Enticott, P G; Fitzgibbon, B M; Kennedy, H A; Arnold, S L; Elliot, D; Peachey, A; Zangen, A; Fitzgerald, P B",2014.0,10.1016/j.brs.2013.10.004,0,0,
6300,Effect of kinetic therapy on the course of treatment of patients with post-traumatic lung failure,"ER This study was conducted to investigate the effects of intermittent prone positioning of patients with post-traumatic respiratory failure (paO2/FiO2 < 280 mm Hg) in comparison with conventional therapy in a supine position. Although the severity of injury of the prone-positioned patients was much higher (ISS 35.8 vs 24.5), the ventilation time (32 vs 31 days) and ICU stay (39 vs 36 days) were similar to patients treated in the supine position. Besides the beneficial effect of prone positioning on oxygenation, for the first time we have evidence that prone positioning improves the outcome of patients with post-traumatic respiratory failure.","Erhard, J; Waydhas, C; Ruchholtz, S; Schmidbauer, S; Nast-Kolb, D; Duswald, K H; Schweiberer, L",1998.0,,0,0,
6301,The serotonin reuptake inhibitor paroxetin is superior to the noradrenaline reuptake inhibitor maprotiline in the treatment of premenstrual syndrome,"ER Recent studies indicate that antidepressant drugs with potent serotonin reuptake inhibiting properties are effective in reducing the symptoms of premenstrual syndrome (PMS). In order to elucidate whether all antidepressant drugs are equally effective in the treatment of PMS or whether potent serotonin reuptake inhibition is a prerequisite for reducing premenstrual complaints, women suffering from severe PMS were treated daily for three menstrual cycles with a selective serotonin reuptake inhibitor, paroxetine (n = 22), or with a selective noradrenaline reuptake inhibitor, maprotiline (n = 21); in addition, a placebo group was included (n = 22). Six symptoms (irritability, depressed mood, tension/anxiety, increased appetite/craving for carbohydrates, bloating, and breast tenderness) were rated by the participants daily throughout the study. With respect to all outcome measurements, the symptom reduction obtained with paroxetine was significantly superior to that obtained with placebo; with respect to irritability, increased appetite/carbohydrate craving, bloating, and breast tenderness, as well as global self-rating, paroxetine was significantly superior also to maprotiline. The clear-cut superiority of paroxetine over maprotiline indicates that not all antidepressant drugs are equally effective in the treatment of PMS; rather, like panic disorder and obsessive compulsive disorder, but in contrast to depression, PMS apparently responds better to serotonin reuptake inhibitors than to antidepressants with a noradrenergic profile.","Eriksson, E; Hedberg, M A; Andersch, B; Sundblad, C",1995.0,10.1016/0893-133X(94)00076-C,0,0,
6302,Effects of 24 h working on-call on psychoneuroendocrine and oculomotor function: a randomized cross-over trial,"ER OBJECTIVES: On-call duty (OCD) is frequently associated with health and safety risks for both physicians and patients. The lack of studies conducted in clinical care environments and the ongoing public dialogue concerning OCD led to a detailed investigation of a working schedule including sleep fragmentation and extended work hours.DESIGN: Within-person randomized cross-over trial.SETTING: Comparison of a 24h on-call shift (OCD) compared to a routine working-day (non on call, NOC) in hospital.PARTICIPANTS: 30 residents and senior physicians of the Department of Internal Medicine, Neurology and Otorhinolaryngology at the University Hospital Innsbruck.MAIN OUTCOME MEASURES: Sleep variables, cognitive performance (Concentration-Endurance d2 test), emotional status (Eigenschaftswoerterliste 60S), serum-cortisol, urinary cortisol and noradrenaline, heart-rate variability, and saccadic eye movements were determined before and after OCD and NOC respectively.RESULTS: Concentration-endurance performance was significantly reduced after OCD as compared to NOC by 16.4% (p<0.001). Changes in emotional status consisted in a reduction of subjective concentration and performance related activation after OCD by 17.4% (p<0.001) and 16.0% (p<0.001) respectively together with a 21.8% increase of general deactivation (p<0.001) and a 29.2% rise of fatigue (p<0.001). On the contrary, subjective activation and raised mood showed an 18.3% and 21.7% increase after OCD (p<0.01). Urinary noradrenaline excretion (46 ?g/24 h, 19-97) was greater during OCD when compared to NOC (36 ?g/24 h, 10-54, p<0.01). Sympathetic activity measured by heart rate variability was significantly higher during OCD in contrast to NOC (p<0.05). Serum-cortisol was lower in the morning after (132 ng/l, 60-273) than the morning before OCD (p<0.01). Finally, the number of short saccadic latencies was reduced after OCD (p<0.05) compared to NOC.CONCLUSIONS: 24 h OCD alters both, the sympathetic-adrenomedullary system as well as the hypothalamic pituitary-adrenocortical axis. Moreover, physicians' emotional state, cognitive and oculomotor performance seems to be influenced independently from sleep interruptions. The discrepancy between subjective feeling and objective cognitive impairments pose a risk for performing complex manual and cognitive tasks. Hence, our findings argue against an oversimplified interpretation of alterations in the physicians' psychoneuroendocrine structure in terms of impaired mood and neurocognitive deterioration combined with up-/dysregulated stress axes associated with OCD as a consequence of sleep deprivation.","Ernst, F; Rauchenzauner, M; Zoller, H; Griesmacher, A; Hammerer-Lercher, A; Carpenter, R; Schuessler, G; Joannidis, M",2014.0,10.1016/j.psyneuen.2014.05.019,0,0,
6303,Community-implemented trauma therapy for former child soldiers in Northern Uganda: a randomized controlled trial,"ER OBJECTIVETo assess the efficacy of a community-based intervention targeting symptoms of posttraumatic stress disorder (PTSD) in formerly abducted individuals.DESIGN, SETTING, AND PARTICIPANTSRandomized controlled trial recruiting 85 former child soldiers with PTSD from a population-based survey of 1113 Northern Ugandans aged 12 to 25 years, conducted between November 2007 and October 2009 in camps for internally displaced persons. Participants were randomized to 1 of 3 groups: narrative exposure therapy (n = 29), an academic catch-up program with elements of supportive counseling (n = 28), or a waiting list (n = 28). Symptoms of PTSD and trauma-related feelings of guilt were measured using the Clinician-Administered PTSD Scale. The respective sections of the Mini International Neuropsychiatric Interview were used to assess depression and suicide risk, and a locally adapted scale was used to measure perceived stigmatization. Symptoms of PTSD, depression, and related impairment were assessed before treatment and at 3 months, 6 months, and 12 months postintervention.INTERVENTIONTreatments were carried out in 8 sessions by trained local lay therapists, directly in the communities.MAIN OUTCOME MEASURESChange in PTSD severity, assessed over a 1-year period after treatment. Secondary outcome measures were depression symptoms, severity of suicidal ideation, feelings of guilt, and perceived stigmatization.RESULTSPTSD symptom severity (range, 0-148) was significantly more improved in the narrative exposure therapy group than in the academic catch-up (mean change difference, -14.06 [95% confidence interval, -27.19 to -0.92]) and waiting-list (mean change difference, -13.04 [95% confidence interval, -26.79 to 0.72]) groups. Contrast analyses of the time √ó treatment interaction of the mixed-effects model on PTSD symptom change over time revealed a superiority of narrative exposure therapy compared with academic catch-up (F(1,234.1) = 5.21, P = .02) and wait-listing (F(1,228.3) = 5.28, P = .02). Narrative exposure therapy produced a larger within-treatment effect size (Cohen d = 1.80) than academic catch-up (d = 0.83) and wait-listing (d = 0.81).CONCLUSIONAmong former Ugandan child soldiers, short-term trauma-focused treatment compared either with an academic catch-up program including supportive counseling or with wait-listing resulted in greater reduction of PTSD symptoms.TRIAL REGISTRATIONclinicaltrials.gov Identifier: NCT00552006.CONTEXTThe psychological rehabilitation of former child soldiers and their successful reintegration into postconflict society present challenges. Despite high rates of impairment, there have been no randomized controlled trials examining the feasibility and efficacy of mental health interventions for former child soldiers.","Ertl, V; Pfeiffer, A; Schauer, E; Elbert, T; Neuner, F",2011.0,10.1001/jama.2011.1060,0,0,
6304,"Reliability and validity of an assessment instrument for anxiety, depression, and mood among individuals with mental retardation","ER A review of the literature revealed that there was no adequate assessment instrument available that screens comprehensively for anxiety and depression in persons with mental retardation. The purpose of this research was to develop the Anxiety, Depression, and Mood Scale (ADAMS), an instrument intended to fill this gap. We developed a preliminary rating scale that included 55 symptom items. We examined the factor structure of these items by an exploratory factor analysis of behavior ratings on 265 individuals. A five-factor solution emerged that was both statistically sound and clinically meaningful. These factors were labeled ""Manic/Hyperactive Behavior,"" ""Depressed Mood,"" ""Social Avoidance,"" ""General Anxiety"" and ""Compulsive Behavior."" We validated this solution by conducting a confirmatory factor analysis on ratings of 268 additional individuals. Model fit was acceptable. Internal consistency of the subscales and retest reliability for both the total scale and the subscales was high. Interrater reliability was satisfactory. The validity of the ADAMS was assessed with a clinical sample of 129 individuals with mental retardation who were seen in a psychiatric clinic; this provided additional support for the subscales. The ADAMS appears to be a psychometrically sound instrument for screening anxiety, depression and mood disorders among individuals with mental retardation.","Esbensen, A J; Rojahn, J; Aman, M G; Ruedrich, S",2003.0,,0,0,
6305,Parental changes after involvement in their anxious child's cognitive behavior therapy,"ER OBJECTIVE: Specific parental behaviors and cognitions are associated with child anxiety. Studies informing us of the directionality of the associations are lacking. We investigated the effect of parental involvement in children's anxiety treatment on parental behaviors and cognitions.METHOD: Children (N=54, 7-12 years) and parents were randomly allocated to different treatment groups (involved, not involved). Observed behavior, self-reported behavior and cognitions were assessed separately for mothers and fathers at pre-, posttreatment and follow-up.RESULTS: There were no differences over time for self-reported parental efficacy and observed negativity, but self-reported autonomy granting increased for both groups over time. Differential effects were found between groups for observed paternal over-involvement (fathers involved in treatment showed a more rapid decrease) and self-reported maternal autonomy-granting (non-involved mothers showed a greater increase).CONCLUSION: Our findings suggest that child anxiety significantly influences parental behaviors and cognitions. Child therapy may successfully change the family system.","Esbj√∏rn, B H; S√∏mhovd, M J; Nielsen, S K; Normann, N; Leth, I; Reinholdt-Dunne, M L",2014.0,10.1016/j.janxdis.2014.07.008,0,0,
6306,"The impact of a middle school program to reduce aggression, victimization, and sexual violence","ER PURPOSE: To evaluate the impact of the Second Step: Student Success Through Prevention (SS-SSTP) Middle School Program on reducing youth violence including peer aggression, peer victimization, homophobic name calling, and sexual violence perpetration and victimization among middle school sixth-grade students.METHODS: The study design was a nested cohort (sixth graders) longitudinal study. We randomly assigned 18 matched pairs of 36 middle schools to the SS-SSTP or control condition. Teachers implemented 15 weekly lessons of the sixth-grade curriculum that focused on social emotional learning skills, including empathy, communication, bully prevention, and problem-solving skills. All sixth graders (n = 3,616) in intervention and control conditions completed self-report measures assessing verbal/relational bullying, physical aggression, homophobic name calling, and sexual violence victimization and perpetration before and after the implementation of the sixth-grade curriculum.RESULTS: Multilevel analyses revealed significant intervention effects with regard to physical aggression. The adjusted odds ratio indicated that the intervention effect was substantial; individuals in intervention schools were 42% less likely to self-report physical aggression than students in control schools. We found no significant intervention effects for verbal/relational bully perpetration, peer victimization, homophobic teasing, and sexual violence.CONCLUSIONS: Within a 1-year period, we noted significant reductions in self-reported physical aggression in the intervention schools. Results suggest that SS-SSTP holds promise as an efficacious prevention program to reduce physical aggression in adolescent youth.","Espelage, D L; Low, S; Polanin, J R; Brown, E C",2013.0,10.1016/j.jadohealth.2013.02.021,0,0,
6307,Effect of manual therapy techniques on headache disability in patients with tension-type headache. Randomized controlled trial,"ER BACKGROUND: Tension-type headache (TTH) is the most common type of primary headache however there is no clear evidence as to which specific treatment is most effective or whether combined treatment is more effective than individual treatments.AIM: To assess the effectiveness of manual therapy techniques, applied to the suboccipital region, on aspects of disability in a sample of patients with tension-type headache.DESIGN: Randomized Controlled Trial.SETTING: Specialized centre for headache treatment.POPULATION: Seventy-six (62 women) patients (age: 39.9 ± 10.9 years) with episodic chronic TTH.METHODS: Patients were randomly divided into four treatment groups: 1) suboccipital soft tissue inhibition; 2) occiput-atlas-axis manipulation; 3) combined treatment of both techniques; 4) control. Four sessions were applied over 4 weeks and disability was assessed before and after treatment using the Headache Disability Inventory (HDI). Headache frequency, severity and the functional and emotional subscales of the questionnaire were assessed. Photophobia, phonophobia and pericranial tenderness were also monitored.RESULTS: Headache frequency was significantly reduced with the manipulative and combined treatment (P<0.05), and the severity and functional subscale of the HDI changed in all three treatment groups (P<0.05). Manipulation treatment also reduced the score on the emotional subscale of the HDI (P<0.05). The combined intervention showed a greater effect at reducing the overall HDI score compared to the group that received suboccipital soft tissue inhibition and to the control group (both P<0.05). In addition, photophobia, phonophobia and pericranial tenderness only improved in the group receiving combined therapy (P<0.05).CONCLUSION: When given individually, suboccipital soft tissue inhibition and occiput-atlas-axis manipulation resulted in changes in different parameters related to the disability caused by TTH. However, when the two treatments were combined, effectiveness was noted for all aspects of disability and other symptoms including photophobia, phonophobia and pericranial tenderness.CLINICAL REHABILITATION IMPACT: Although individual manual therapy treatments showed a positive change in headache features, measures of photophobia, photophobia and pericranial tenderness only improved in the group that received the combined treatment suggesting that combined treatment is the most appropriate for symptomatic relief of TTH.","Espí-López, G V; Rodríguez-Blanco, C; Oliva-Pascual-Vaca, A; Benítez-Martínez, J C; Lluch, E; Falla, D",2014.0,,0,0,
6308,Acute exercise reduces the effects of a 35% CO2 challenge in patients with panic disorder,"ER METHODSEighteen PD patients performed either moderate/hard exercise or very-light exercise before a 35% CO2 challenge in a randomized, between-group design. The reactivity to CO2 was assessed with the Visual Analogue Anxiety Scale and the DSM-IV Panic Symptom List.RESULTSPanic reactions to CO2 were smaller in patients that performed moderate/hard exercise in contrast to those that performed very-light exercise. Increments in both measurements and panic rates were consistently reduced by intense exercise.LIMITATIONSSince this study focuses on the acute effects of exercise on CO2 sensitivity in patients with PD, the results of repetitive exercise sessions on the rate of spontaneous panic attacks and overall symptoms are warranted. The small sample size and other limitations are addressed.CONCLUSIONSExercise reduced the panicogenic effects of a CO2 challenge. In addition to its therapeutic potential, exercise may also be useful as a laboratory maneuver with heuristic value in experimental research into the mechanisms of antipanic treatment.BACKGROUNDChronic exercise has been shown to have therapeutic effects in panic disorder (PD). The mechanism of these effects is unknown. Acute exercise reduces the effect of a panic challenge in healthy volunteers. Such an effect has not yet been demonstrated in PD patients. The present study aimed at exploring the antipanic effects of acute exercise on a 35% CO2 panic provocation in treatment-naïve PD patients to further elucidate the mechanisms of the beneficial effects of exercise on panic.","Esquivel, G; Díaz-Galvis, J; Schruers, K; Berlanga, C; Lara-Muñoz, C; Griez, E",2008.0,10.1016/j.jad.2007.07.022,0,0,
6309,Frequency and comorbidity of social anxiety and social phobia in adolescents. Results of a Bremen adolescent study,"ER Using data from the Bremen Adolescent Study, this report presents findings on the frequency, comorbidity and psychosocial impairment of social phobia and social fears among 1035 German adolescents of 12-17 years of age. The adolescents were randomly selected from 36 schools in the city and provincial government area of Bremen, Germany. Social phobia and other psychiatric disorders were coded based on DSM-IV criteria using the computerized personal interview of the Munich version of the Composite International Diagnostic Interview. Seventeen (1.6%) of the adolescents had met the DSM-IV criteria for social phobia at some time in their life. More girls than boys were diagnosed as suffering from social phobia. The incidence of the disorder increased with age. The lifetime frequency of social fears is much higher. The most common types of feared social situations were fear of doing something in front of other people, followed by public speaking. Social phobia very often co-occurred with depressive disorders, somatoform disorders and disorders caused by excessive or inappropriate consumption of substances. Over 94% of those with social phobia and 54.4% with any social fears were severely impaired in their daily life during the worst episode. Despite the high level of psychosocial impairment, only a small portion of the cases received professional help.","Essau, C A; Conradt, J; Petermann, F",1998.0,10.1055/s-2007-995294,0,0,
6310,Comparison of brief group therapies for depressed cancer patients receiving radiation treatment,"ER Although many studies have documented patterns of emotional distress in persons undergoing radiation treatment for cancer, there have been few controlled evaluations of counseling or psychotherapy outcomes with these persons. In this research, the effects of cognitive-behavioral and socially supportive group therapy were evaluated. A total of 72 depressed cancer patients were randomly assigned to one of three conditions--cognitive-behavioral treatment, social support, or a no-treatment control condition. Before and after intervention and at 6-month followup, study participants were individually assessed by using measures of symptom distress. Relative to the comparison group, both the cognitive-behavioral and social support therapies resulted in less depression, hostility, and somatization. The social support intervention also resulted in fewer psychiatric symptoms and reduced maladaptive interpersonal sensitivity and anxiety. It was concluded that both group therapies can reduce symptoms of distress for depressed persons undergoing radiation treatment for cancer. Both forms of therapy resulted in improvements in psychosocial function (compared with no treatment at all), but social support groups demonstrated more changes that were evident at 6-month followup. Further research is needed to evaluate the differential effectiveness of mental health services provided to cancer patients undergoing radiation.","Evans, R L; Connis, R T",1995.0,,0,0,
6311,Association between neuroticism and amygdala responsivity emerges under stressful conditions,"ER Increased amygdala reactivity in response to salient stimuli is seen in patients with affective disorders, in healthy subjects at risk for these disorders, and in stressed individuals, making it a prime target for mechanistic studies into the pathophysiology of affective disorders. However, whereas individual differences in neuroticism are thought to modulate the effect of stress on mental health, the mechanistic link between stress, neuroticism and amygdala responsivity is unknown. Thus, we studied the relationship between experimentally induced stress, individual differences in neuroticism, and amygdala responsivity. To this end, fearful and happy faces were presented to a large cohort of young, healthy males (n. = 120) in two separate functional MRI sessions (stress versus control) in a randomized, controlled cross-over design. We revealed that amygdala reactivity was modulated by an interaction between the factors of stress, neuroticism, and the emotional valence of the facial stimuli. Follow-up analysis showed that neuroticism selectively enhanced amygdala responses to fearful faces in the stress condition. Thus, we show that stress unmasks an association between neuroticism and amygdala responsivity to potentially threatening stimuli. This effect constitutes a possible mechanistic link within the complex pathophysiology of affective disorders, and our novel approach appears suitable for further studies targeting the underlying mechanisms.","Everaerd, D; Klumpers, F; Wingen, G; Tendolkar, I; Fern√°ndez, G",2015.0,10.1016/j.neuroimage.2015.03.014,0,0,
6312,The Potential Efficacy of Psychological First Aid on Self-Reported Anxiety and Mood: A Pilot Study,"ER The authors explored the efficacy of a randomized controlled trial to assess the potential benefits of psychological first aid (PFA) compared with a social acknowledgement condition in a sample of 42 participants who spoke about a stressful life event. Demographics and standardized questionnaires, including the state version of the State Trait Anxiety Inventory Scale and the Brief Profile of Mood States, assessed anxiety and mood state. Those in the PFA group evidenced significantly lower anxiety scores at 30-minute postdisclosure than at baseline and, although not significant, showed lowered distressed mood compared with baseline at 30-minute postdisclosure. Those in the social acknowledgment condition evidenced increases in anxiety and distressed mood scores, albeit not significantly, at 30 minutes post disclosure compared with their baseline scores. These results provide preliminary empirical evidence for the efficacy of PFA, and implications for intervention and additional assessment are suggested.","Everly, G S; Lating, J M; Sherman, M F; Goncher, I",2016.0,10.1097/NMD.0000000000000429,0,0,
6313,Drowsiness sedation levels in anxious neurotic outpatients,,"Fabre, L F; Johnson, P A; Greenblatt, D J",1984.0,,0,0,
6314,Impacts of acupuncture and moxibustion on outcome indeices of depression patients' subjective reports,"ER OBJECTIVE: To assess the clinical efficacy of acupuncture and moxibustion on depression in view of the outcome indicators of the patient subjective reports.METHODS: One hundred and sixty-three cases of depression being in compliance with the inclusive standards were randomized into a soothing-liver and regulating-mind group, an acupoint-shallow-puncturing group and a non-acupoint-shallow-puncturing group. In the soothing-liver and regulating-mind group, the conventional acupuncture was applied to the four-gate points [Hegu (LI 4) and Taichong (LR 3)], Baihui (GV 20) and Yintang (EX-HN 3), the direct moxibustion with moxa cone was applied to the four-flower points [Geshu (BL 17), Danshu (BL 19)]. Finally, the intradermal needling was used at Xinshu (BL 15) and Ganshu (BL 18). In the acupoint-shallow-puncturing group, the acupoints selected were same as those in the soothing-liver and regulating-mind group. But the needle insertion was shallower and the time of moxibustion was shorter. In the non-acupoint-shallow-puncturing group, the spots that were 10 mm lateral to those acupoints in the soothing-liver and regulating-mind group were selected. The operation was same as that in the acupoint-shallow-puncturing group. The treatment was given twice a week in three groups. Totally, 12 weeks of treatment were required. The score of symptom checklist 90 (SCL-90), the self-report symptom inventory was observed before treatment, 1 month and 3 months after treatment separately so as to assess the corresponding short-term, mid-term and long-term efficacies of the program of acupuncture and moxibustion for soothing the liver and regulating the mind.RESULTS: In each time-point after treatment, for the scores of somatization, obsessive-compulsive symptom, interpersonal sensitivity, depression, anxiety, hostility, paranoid ideation, psychoticism and the other 8 dimensionalities, in comparison between the soothing-liver and regulating-mind group and the non-acupoint-shallow-puncturing group, the differences were significant statistically (all P < 0.05). For the scores of depression, anxiety and hostility, in comparison between the soothing-liver and regulating-mind group and the acupoint-shallow-puncturing group, the differences were significant statistically (all P < 0.05).CONCLUSION: Acupuncture and moxibustion can improve the scores of SCL-90 scale for the patients with depression. The outcome indicators of the patient subjective reports can accurately assess the clinical efficacy.","Fan, L; Fu, W B; Xu, N G; Liu, J H; Ou, A H",2012.0,,0,0,
6315,Is psychotherapy a reliable alternative to pharmacotherapy to promote the mental health of infertile women? A randomized clinical trial,"ER STUDY DESIGNIn a randomized controlled clinical trial, 89 depressed infertile women that they were recruited and divided into three groups in three groups: cognitive behavior therapy (CBT), antidepressant therapy, and a control group. Twenty-nine participants in the CBT method received 10 sessions on relaxation training, restructuring, and eliminating negative automatic thoughts and dysfunctional attitudes to infertility. Thirty participants in the pharmacotherapic group took 20mg fluoxetine daily for 90 days. Thirty control subjects did not receive any intervention. All participants completed the Beck Depression Inventory (BDI) and the General Health Questionnaire (GHQ) at the beginning and end of the study. Paired t-test, ANOVA, chi(2), and McNemar tests were used to analyze the data.RESULTSFluoxetine significantly reduced the mean of three subscale scores of the GHQ anxiety (7.3+/-4.1 vs. 5.1+/-3.2), social function (7+/-2.8 vs. 4.3+/-2), and depression (7.8+/-5.2 vs. 4.4+/-2.2) but could not significantly change the mean score of psychosomatic signs. The CBT method effectively reduced the mean of all four GHQ subscales: anxiety (8+/-4 vs. 3.2+/-2), social function (7.2+/-2.6 vs. 4.7+/-2.5), depression (7.7+/-4.2 vs. 3.6+/-2.7), and psychosomatic signs (7.5+/-3.2 vs. 5.5+/-3.2). Also, both methods significantly reduced the total GHQ scores. Successful treatment of depression in three groups was fluoxetine group 50%, CBT 79.3%, and control 10%. The mean Beck scores among the groups at the beginning and end of study were, respectively: fluoxetine 23.2+/-8.6 versus 14.3+/-8.5 (p<0.001), CBT 20+/-7.9 versus 7.7+/-4.8 (p<0.001), and control 19.8+/-8.5 versus 19.7+/-8.4 (p=0.9). Although both fluoxetine and CBT significantly decreased the mean BDI scores more than the control group, the decrease in the CBT group was significantly greater than the fluoxetine group.CONCLUSIONPsychotherapy, such as group CBT, was superior to or at least as effective as pharmacotherapy to promote the well being of depressed infertile women.OBJECTIVEWomen with fertility problems experience a higher prevalence of negative emotions than women without fertility problems. The goal of this study was to compare the effects of psychological intervention with psychotropic medication on the mental health improvement of depressed infertile women.","Faramarzi, M; Kheirkhah, F; Esmaelzadeh, S; Alipour, A; Hjiahmadi, M; Rahnama, J",2008.0,10.1016/j.ejogrb.2008.07.012,0,0,
6316,Difficult-to-treat pediatric obsessive-compulsive disorder: feasibility and preliminary results of a randomized pilot trial of D-cycloserine-augmented behavior therapy,"ER BACKGROUND: This study examined the feasibility and preliminary effectiveness of d-cycloserine (DCS)-augmented cognitive behavioral therapy (CBT) for children and adolescents with difficult-to-treat Obsessive Compulsive Disorder, in a double-blind randomized controlled pilot trial (RCT).METHODS: Seventeen children and adolescents (aged 8-18 years) with a primary diagnosis of OCD, which was deemed difficult-to-treat, were randomly assigned to either nine sessions of CBT including five sessions of DCS-augmented exposure and response prevention (ERP) [ERP + DCS] or nine sessions of CBT including five sessions of placebo-augmented ERP [ERP + PBO]. Weight-dependent DCS or placebo doses (25 or 50 mg) were taken 1 hour before ERP sessions.RESULTS: At posttreatment, both groups showed significant improvements with 94% of the entire sample classified as responders. However, a greater improvement in the ERP + DCS relative to the ERP + PBO condition was observed at 1-month follow-up on clinician-rated obsessional severity and diagnostic severity, and parent ratings of OCD severity. There were no changes across time or condition from 1- to 3-month follow-up.CONCLUSIONS: In this preliminary study, DCS-augmented ERP produced significant improvements in OCD severity from posttreatment to 1-month follow-up, relative to a placebo control condition, in severe and difficult-to-treat pediatric OCD. The significant effect on obsessional severity suggests that DCS augmentation might be associated with enhanced modification of obsessional thoughts during ERP, and warrants further investigation.","Farrell, L J; Waters, A M; Boschen, M J; Hattingh, L; McConnell, H; Milliner, E L; Collings, N; Zimmer-Gembeck, M; Shelton, D; Ollendick, T H; Testa, C; Storch, E A",2013.0,10.1002/da.22132,0,0,
6317,The role of distress intolerance for panic and nicotine withdrawal symptoms during a biological challenge,"ER METHODSmokers (n = 54; 40.7% panic disorder) were recruited for an experimental study; half were randomly assigned to 12-hour nicotine deprivation and half smoked as usual. The current investigation consisted of secondary, exploratory analyses from this larger experimental study. Four distress intolerance indices were examined as predictors of anxious responding to an emotional elicitation task (10% carbon dioxide (CO2)-enriched air challenge); anxious responding was in turn examined as a predictor of post-challenge panic and nicotine withdrawal symptoms.RESULTSThe Distress Tolerance Scale (DTS) was significantly negatively associated with anxious responding to the challenge (? = -0.41, p = 0.017). The DTS was negatively associated with post-challenge increases nicotine withdrawal symptoms indirectly through the effect of anxious responding to the challenge (b = -0.485, CI95% (-1.095, -0.033)). This same indirect effect was found for post-challenge severity of panic symptoms (b = -0.515, CI95% (-0.888, -0.208)). The DTS was directly predictive of post-challenge increases nicotine withdrawal symptoms, in the opposite direction (? = 0.37, p = 0.009), but not panic symptom severity.CONCLUSIONSAnxious responding in response to stressful experiences may explain the impact of perceived distress intolerance on panic and nicotine withdrawal symptom expression.BACKGROUNDDistress intolerance is linked to the maintenance of panic disorder and cigarette smoking, and may underlie both problems.","Farris, S G; Zvolensky, M J; Otto, M W; Leyro, T M",2015.0,10.1177/0269881115575536,0,0,
6318,A randomized controlled trial to assess the effect of self-paced walking on task-specific anxiety in cardiac rehabilitation patients,"ER PURPOSE: Cardiac rehabilitation can reduce overall anxiety. However, task-specific anxiety is yet to be investigated in the cardiac patient. This study investigates the effect of an outdoor walking intervention (WI) in alleviating the high degree of task-specific anxiety in cardiac patients.METHODS: Participants (N = 22, mean age ± SD = 62.0 ± 10.8 years, 9 women), who had experienced a cardiac event and exhibited a moderate to high level of anxiety for outdoor walking (anxiety score ? 7 on a modified version of the Hospital Anxiety and Depression Scale), were initially assessed during an incremental shuttle walk test and a self-paced 1-mile walk. Heart rate and the ratings of perceived exertion were monitored during both tests. Participants also completed an exercise self-efficacy (ESE) questionnaire. Following this, participants were randomized to either a 3 sessions per week, 4 weeks, self-paced WI on a predetermined variable topographic course, or to a control group (CG; 30-minute stationary cycling, 3 sessions per week for 4 weeks). Identical assessments (Incremental Shuttle Walk Test, Self-Paced 1-Mile Walk, Hospital Anxiety and Depression Scale, ESE) were used postintervention. The 2 groups were compared for anxiety, ESE, and fitness by analysis of variance.RESULT: The WI group exhibited a significantly greater decrease in task-specific anxiety (51%; P < .01), increased self-efficacy (6.6%; P < .001) and improved fitness (P < .05) in comparison with CG.CONCLUSION: This study demonstrated that task familiarization reduced the task-specific anxiety associated with outdoor walking in cardiac patients and, as such, may help in changing exercise behavior patterns in patients undergoing cardiac rehabilitation.","Faulkner, J; Westrupp, N; Rousseau, J; Lark, S",2013.0,10.1097/HCR.0b013e3182a0295c,0,0,
6319,Emotional avoidance: an experimental test of individual differences and response suppression using biological challenge,"ER The present study examined the affective consequences of response inhibition during a state of anxiety-related physical stress. Forty-eight non-clinical participants were selected on the basis of pre-experimental differences in emotional avoidance (high versus low) and subjected to four inhalations of 20% carbon dioxide-enriched air. Half of the participants were instructed to inhibit the challenge-induced aversive emotional state, whereas the other half was instructed to simply observe their emotional response. Participants high in emotional avoidance compared to those low in emotional avoidance responded with greater levels of anxiety and affective distress but not physiological arousal. Individuals high in emotional avoidance also reported greater levels of anxiety relative to the low emotional avoidance group when suppressing compared to observing bodily sensations. These findings are discussed in terms of the significance of emotional avoidance processes during physical stress, with implications for better understanding the nature of panic disorder.","Feldner, M T; Zvolensky, M J; Eifert, G H; Spira, A P",2003.0,,0,0,
6320,A quasi randomized-controlled trial to evaluate the effectiveness of clowntherapy on children's anxiety and pain levels in emergency department,"ER CONCLUSION: The presence of clowns in the ED before and during painful procedures was effective in reducing children's anxiety.WHAT IS KNOWN: ? Anxiety and fear caused by medical procedures exacerbate children's pain and may interfere with the procedure. ? To reduce anxiety, fear, and pain and to facilitate patient's evaluation, different non-pharmacological approaches have been proposed and positive effects of laughter and humor have been reported. What is New: ? The presence of clowns in the waiting room and in the ED during medical evaluation and painful procedures helps to reduce children's anxiety.UNLABELLED: The aim of the study is to investigate if the presence of medical clowns during painful procedures in the emergency department (ED) affects children's anxiety and pain. Forty children (4-11 years) admitted to the ED with the need of painful procedures were prospectively enrolled. They were randomly assigned to the clown group, where children interacted with clowns or to the control group in which they were entertained by parents and ED nurses. The children's anxiety was assessed by the Children's Anxiety and Pain Scales; pain was evaluated with the Numerical Rating Scale and Wong-Backer Scale, according to the children's age. Staff and clown's opinions were evaluated by means of dedicated questionnaires. Children's anxiety levels in the clown group were significantly lower than those compared with the control group, while children's pain levels did not change between the two groups.","Felluga, M; Rabach, I; Minute, M; Montico, M; Giorgi, R; Lonciari, I; Taddio, A; Barbi, E",2016.0,10.1007/s00431-015-2688-0,0,0,
6321,Randomised controlled trial of a collaborative care model with psychiatric consultation for persistent medically unexplained symptoms in general practice,"ER METHODRandomised controlled trial. Cluster randomisation at GP practices and multilevel analysis were performed. A total of 81 patients from 36 general practices completed the study. A collaborative care model of training and psychiatric consultation in general practice in the presence of the GP was compared with training plus care as usual by the GP. Outcome assessment on the patients' well-being, functioning and utilisation of health care services was performed 6 weeks and 6 months later.RESULTSAll the patients had somatoform disorders (Whitely Index 7.46), and 86% had comorbid psychiatric disorders. In the intervention group, the severity of the main medically unexplained symptoms decreased by 58%. The patients' social functioning improved. The utilization of health care was lower than in the care as usual group.CONCLUSIONSA collaborative care model combining training with psychiatric consultation in the general practice setting is an effective intervention in the treatment of persistent medically unexplained symptoms. Anxiety and depressive disorders are highly comorbid in this group. The findings warrant a larger study.BACKGROUNDPatients with persistent medically unexplained symptoms often exhibit general dysfunction and psychiatric comorbidity and frequently resist psychiatric referral. The aim of this study was to evaluate the efficacy of a collaborative care model including training for general practitioners (GPs) and a psychiatric consultation model for patients with persistent medically unexplained symptoms in general practice.","Feltz-Cornelis, C M; Oppen, P; Adèr, H J; Dyck, R",2006.0,10.1159/000093949,0,0,
6322,Clinical study on treatment of obsessive compulsive neurosis by acupoint stimulating control,"ER METHODSThe comparative study was conducted in 65 patients with obsessive compulsive neurosis, they were divided into two groups, the 33 patients in the control group treated with chlorimipramine and the 32 in the tested group treated with ASC. The therapeutic efficacy and adverse reaction were assessed according to the standard for clinical efficacy evaluation by Yale-Brown scale for obsession (Y-BOCS)and adverse reaction scale.RESULTSThe curative rate and markedly effective rate in the control group was 24.2% (8/33) and 27.3% (19/33), which in the tested group was 37.5% (12/32) and 34.4% (11/32) respectively. Significant difference was shown in comparison of Y-BOCS score between the two groups from the end of the 4th week of treatment (P < 0.05), indicating the efficacy in the tested group was better than that in the control group. Moreover, the occurrence of adverse reaction was higher in the control group than that in the tested group.CONCLUSIONASC is a treatment with good effect, less adverse reaction and favourable safety superior to the treatment by chlorimipramine.OBJECTIVETo study the clinical effect of acupoint stimulating control (ASC) in treating obsessive compulsive neurosis.","Feng, B; Liu, L Y; Xu, F Z; Chen, J; Wang, P; Chen, W; Yu, E",2005.0,,0,0,
6323,Cognitive inhibition in individuals prone to homophobia,"ER Individuals scoring either High, Medium, or Low on the Homosexism Short-Form scale (Hansen, 1982) made speeded decisions to neutral (N), mildly provocative (MP), or very provocative (VP) statements regarding issues relating to homophobia. These three groups did not differ on age, education, reading rate, or vocabulary ability. It was predicted that individuals High in homophobia would produce faster reaction times to the VP sentences than those individuals scoring Medium or Low in homophobia. Results indicated the opposite pattern. Individuals scoring High in homophobia actually had slower reaction times to VP sentences than did either the Medium or Low homophobia individuals. Results are discussed within an inhibitory framework related to the High homophobia individuals' overall homophobia schema.","Ferraro, F R; Dukart, A",1998.0,,0,0,
6324,"Temperament and parenting predicting anxiety change in cognitive behavioral therapy: the role of mothers, fathers, and children","ER OBJECTIVE: A considerable amount of children with anxiety disorders do not benefit sufficiently from cognitive behavioral treatment. The present study examines the predictive role of child temperament, parent temperament and parenting style in the context of treatment outcome.METHOD: Participants were 145 children and adolescents (ages 8-18) with DSM-IV-TR anxiety disorders who received a 12-session CBT program and were assessed at pretreatment, posttreatment and three months follow-up. Multiple-regression analyses were used to evaluate the following pretreatment and posttreatment variables as potential predictors of treatment response at follow-up: baseline level of anxiety symptoms, child reported maternal and paternal rearing style (emotional warmth, rejection, and overprotection), parent reported child temperament traits (negative affect, effortful control, and extraversion), and mothers' and fathers' self-report temperament traits.RESULTS: More maternal negative affect and less emotional warmth as perceived by the child before treatment were related to less favorable treatment outcome (accounting for 29% of the variance in anxiety at follow-up). Furthermore, maternal negative affect and children's extraversion measured after treatment also predicted anxiety at follow-up (together accounting for 19% of the variance). Paternal temperament and parenting style were unrelated to treatment outcome, as were children's pretreatment temperament traits.CONCLUSION: The results suggest that tailoring intervention to include strategies to reduce maternal negative affect and promote an emotional warm rearing style may improve treatment outcome.","Festen, H; Hartman, C A; Hogendoorn, S; Haan, E; Prins, P J; Reichart, C G; Moorlag, H; Nauta, M H",2013.0,10.1016/j.janxdis.2013.03.001,0,0,
6325,Who's afraid of the big bad wolf: a prospective paradigm to test Rachman's indirect pathways in children,"ER Rachman's theory [The conditioning theory of fear insition: a critical examination. Behav. Res. Ther. 15 (1977) 375-387] of fear acquisition suggests that fears and phobias can be acquired through three pathways: direct conditioning, vicarious learning and information/instruction. Although retrospective studies have provided some evidence for these pathways in the development of phobias during childhood [see King, Gullone, & Ollendick, Etiology of childhood phobias: current status of Rachman's three pathway's theory. Behav. Res. Ther. 36 (1998) 297-309 for a review], these studies have relied on long-term past memories of adult phobics or their parents. The current study was aimed towards developing a paradigm in which the plausibility of Rachman's indirect pathways could be investigated prospectively. In Experiment 1, children aged between 7 and 9 were presented with two types of information about novel stimuli (two monsters): video information and verbal information in the form of a story. Fear-related beliefs about the monsters changed significantly as a result of verbal information but not video information. Having established an operational paradigm, Experiment 2 looked at whether the source of verbal information had an effect on changes in fear-beliefs. Using the same paradigm, information about the monsters was provided by either a teacher, an adult stranger or a peer, or no information was given. Again, verbal information significantly changed fear-beliefs, but only when the information came from an adult. The role of information in the acquisition of fear and maintenance of avoidant behaviour is discussed with reference to modern conditioning theories of fear acquisition.","Field, A P; Argyris, N G; Knowles, K A",2001.0,,0,0,
6326,The verbal information pathway to fear and heart rate changes in children,"ER METHODSAn experiment is reported in which children (N = 26) aged between 6 and 9 were given threat, positive or no information about three novel animals and then asked to place their hands into boxes that they believed to contain each of these animals. Their average heart rate during each approach task was measured.RESULTSOne-way analysis of variance revealed significant differences in the average heart rate when approaching the three boxes: heart rates were significantly higher when approaching the box containing the animal associated with threat information compared to when approaching the control animal.CONCLUSIONSThese findings suggest that fear information acts not only upon cognitive and behavioural aspects of the fear emotion, but also on the physiological component.BACKGROUNDAlthough many studies have now demonstrated that threat information is sufficient to change children's beliefs and behaviours towards novel animals, there is no evidence to suggest that it influences the physiological component of the fear emotion.","Field, A P; Schorah, H",2007.0,10.1111/j.1469-7610.2007.01772.x,0,0,
6327,"Yoga and social support reduce prenatal depression, anxiety and cortisol","ER The purpose of this study was to compare the effects of yoga (physical activity) versus social support (verbal activity) on prenatal and postpartum depression. Ninety-two prenatally depressed women were randomly assigned to a yoga or a social support control group at 22 weeks gestation. The yoga group participated in a 20-min group session (only physical poses) once per week for 12 weeks. The social support group (a leaderless discussion group) met on the same schedule. At the end of the first and last sessions the yoga group reported less depression, anxiety, anger, back and leg pain as compared to the social support group. At the end of the last session the yoga group and the support group did not differ. They both had lower depression (CES-D), anxiety (STAI), and anger (STAXI) scores and improved relationship scores. In addition, cortisol levels decreased for both groups following each session. Estriol and progesterone levels decreased after the last session. At the postpartum follow-up assessment depression and anxiety levels were lower for both groups.","Field, T; Diego, M; Delgado, J; Medina, L",2013.0,10.1016/j.jbmt.2013.03.010,0,0,
6328,Cortisol decreases and serotonin and dopamine increase following massage therapy,"ER In this article the positive effects of massage therapy on biochemistry are reviewed including decreased levels of cortisol and increased levels of serotonin and dopamine. The research reviewed includes studies on depression (including sex abuse and eating disorder studies), pain syndrome studies, research on auto-immune conditions (including asthma and chronic fatigue), immune studies (including HIV and breast cancer), and studies on the reduction of stress on the job, the stress of aging, and pregnancy stress. In studies in which cortisol was assayed either in saliva or in urine, significant decreases were noted in cortisol levels (averaging decreases 31%). In studies in which the activating neurotransmitters (serotonin and dopamine) were assayed in urine, an average increase of 28% was noted for serotonin and an average increase of 31% was noted for dopamine. These studies combined suggest the stress-alleviating effects (decreased cortisol) and the activating effects (increased serotonin and dopamine) of massage therapy on a variety of medical conditions and stressful experiences.","Field, T; Hernandez-Reif, M; Diego, M; Schanberg, S; Kuhn, C",2005.0,10.1080/00207450590956459,0,0,
6329,"High-dose pyridoxine and magnesium administration in children with autistic disorder: an absence of salutary effects in a double-blind, placebo-controlled study","ER Several reports have described salutary effects such as decreased physical aggression and improved social responsiveness being associated with the administration of high doses of pyridoxine and magnesium (HDPM) in open-labeled and controlled studies of patients with autism. Despite this fact, this intervention remains controversial. A 10-week double-blind, placebo-controlled trial was undertaken to examine both the efficacy and safety of HDPM in autism. Twelve patients were enrolled, and 10 patients (mean age 6 years 3 months) were able to complete the study. HDPM at an average dose of 638.9 mg of pyridoxine and 216.3 mg of magnesium oxide was ineffective in ameliorating autistic behaviors as assessed by the Children's Psychiatric Rating Scale (CPRS), the Clinical Global Impression Scale, and the NIMH Global Obsessive Compulsive Scale. Furthermore, no clinically significant side effects were noted during HDPM administration. A trend for a transient change on the CPRS was found that was possibly due to a placebo response. This study raises doubts about the clinical effectiveness of HDPM in autistic disorder.","Findling, R L; Maxwell, K; Scotese-Wojtila, L; Huang, J; Yamashita, T; Wiznitzer, M",1997.0,,0,0,
6330,Research on the treatment of sexually abused children: a review and recommendations,"ER RESULTSThe studies overall document improvements in sexually abused children consistent with the belief that therapy facilitates recovery, but only five of them marshal evidence that the recovery is not simply due to the passage of time or some factor outside therapy. There has yet to be a true large-scale, randomized trial of treatment versus control. The studies suggest that certain problems, such as aggressiveness and sexualized behavior, are particularly resistant to change and that some children do not improve. A number of considerations that merit special attention in future sexual abuse therapy outcome research are identified, including (1) the diversity of sexually abused children, (2) the problem of children with no symptoms, (3) the possible existence of serious ""sleeper"" effects, (4) the importance of family context on recovery, (5) the utility of abuse-focused therapy and targeted interventions, (6) the optimal length of treatment, (7) the problem of treatment dropouts, and (8) the development and use of abuse-specific outcome measures.CONCLUSIONSThe need for more treatment outcome research is highlighted by the rising demand for accountability in the health care system that will increasingly require professionals in the field of sexual abuse treatment to justify their efforts and their methods.OBJECTIVETo review findings and conclusions from 29 studies that evaluated with quantitative outcome measures the effectiveness of treatments for sexually abused children.","Finkelhor, D; Berliner, L",1995.0,10.1097/00004583-199511000-00007,0,0,
6331,Factor structure and validity of the therapy process observational coding system for child psychotherapy-alliance scale,"ER The aim of this study was to examine the factor structure and psychometric properties of an observer-rated youth alliance measure, the Therapy Process Observational Coding System for Child Psychotherapy-Alliance scale (TPOCS-A). The sample was 52 youth diagnosed with anxiety disorders (M age = 12.43, SD = 2.23, range = 8-15; 56% boys; 98% Caucasian) drawn from a randomized controlled trial. Participants received a manualized individual cognitive behavioral treatment, the FRIENDS for life program, in public community clinics in Norway. Diagnostic status, treatment motivation, and perceived treatment credibility were assessed at pretreatment. Using the TPOCS-A, independent observers rated child-therapist alliance from the third therapy session. Child- and therapist-reported alliance measures were collected from the same session. An exploratory factor analysis supported a one-factor solution, which is consistent with previous studies of self- and observer-rated youth alliance scales. Psychometric analyses supported the interrater reliability, internal consistency, and convergent/divergent validity of the TPOCS-A. Accumulating psychometric evidence indicate that the TPOCS-A has the potential to fill a measurement gap in the youth psychotherapy field. In youth psychotherapy, alliance may be unidimensional, so establishing a strong bond and engaging the child in therapeutic activities may both be instrumental to establishing good alliance early in treatment. However, it is important to be cautious when interpreting the factor analytic findings, because the sample size may have been too small to identify additional factors. Future research can build upon these findings by examining the factor structure of youth alliance measures with larger, more diverse samples.","Fjermestad, K W; McLeod, B D; Heiervang, E R; Havik, O E; Ost, L G; Haugland, B S",2012.0,10.1080/15374416.2012.651999,0,0,
6332,"Does cognitive behaviour therapy for insomnia reduce clinical levels of fatigue, anxiety and depression in cancer patients?","ER OBJECTIVES: This secondary analysis of data from a randomised controlled trial explores associations between common symptom clusters and evaluates pre-treatment to post-treatment changes in clinical levels of these symptoms following cognitive behaviour therapy for insomnia (CBT-I).METHODS: Baseline data from 113 participants with insomnia were explored to establish rates of and associations between clinical levels of fatigue, anxiety and depression across the sample. Effects of CBT-I on this symptom cluster were also explored by examining changes in pre-treatment to post-treatment levels of fatigue, anxiety and depression.RESULTS: At baseline, the most common symptom presentation was insomnia?+?fatigue, and 30% of the sample reported at least three co-morbid symptoms. Post-CBT, the number of those experiencing clinical insomnia and clinical fatigue decreased. There were no changes in anxiety rates from baseline to post-treatment in the CBT group and modest reductions in rates of those with clinical depression. Seven individuals (9.6%) from the CBT group were completely symptom free at post-treatment compared with 0% from the treatment as usual condition. Chi-square analysis revealed a significant relationship between group allocation and changes in symptoms of insomnia and fatigue. No such relationship was found between group allocation and mood variables.CONCLUSIONS: These findings confirm the high rate of symptom co-morbidities among cancer patients and highlight strong associations between sleep and fatigue. CBT-I appears to offer generalised benefit to the symptom cluster as a whole and, specifically, is effective in reducing fatigue, which exceeded clinical cut-offs prior to implementation of the intervention. This has implications for the diagnosis/management of common symptoms in cancer patients.","Fleming, L; Randell, K; Harvey, C J; Espie, C A",2014.0,10.1002/pon.3468,0,0,
6333,The impact of neuropsychological functioning on treatment outcome in pediatric obsessive-compulsive disorder,"ER METHODSA total of 63 youths were included in this study and asked to complete the Rey-Osterrieth Complex Figure (ROCF) and specific subtests of the Wechsler Intelligence Scale for Children, Third Edition (WISC-III).RESULTSAnalyses suggest that 5 min recall accuracy (raw score) and percent recall from the ROCF, assessed before treatment may be predictors of treatment response among children with OCD. What is more, exploratory post hoc analyses indicated that performance on these ROCF tasks is particularly relevant among youths receiving cognitive-behavior therapy (CBT) alone. These results may be driven by executive functioning ability. Additional analyses suggest a relationship between age, symptom severity, and NP functioning on select tasks from both the ROCF and WISC-III.CONCLUSIONSAlthough alternative explanations exist, these findings suggest that poorer performance on the ROCF and, in turn, poorer response to treatment, particularly among those youths receiving CBT alone, may be due to executive functioning difficulties. Clinicians and researchers should be sensitive to this fact and may warrant modification(s) to existing treatment protocols. Limitations to this study, however, suggest the need for replication and extension of these findings in the future.BACKGROUNDScant research has examined the effect of neuropsychological (NP) functioning on treatment outcome in pediatric obsessive-compulsive disorder (OCD). This study sought to address this gap in existing research.","Flessner, C A; Allgair, A; Garcia, A; Freeman, J; Sapyta, J; Franklin, M E; Foa, E; March, J",2010.0,10.1002/da.20626,0,0,
6334,"A Single-blinded, Randomized Clinical Trial of How to Implement an Evidence-based Treatment for Generalized Anxiety Disorder IMPLEMENT--Effects of Three Different Strategies of Implementation","ER Background: Despite long-standing calls to disseminate evidence-based treatments for generalized anxiety (GAD), modest progress has been made in the study of how such treatments should be implemented. The primary objective of this study was to test three competing strategies on how to implement a cognitive behavioral treatment (CBT) for out-patients with GAD (i.e., comparison of one compensation vs. two capitalization models). Methods: For our three-arm, single-blinded, randomized controlled trial (implementation of CBT for GAD [IMPLEMENT]), we recruited adults with GAD using advertisements in high-circulation newspapers to participate in a 14-session cognitive behavioral treatment (Mastery of your Anxiety and Worry, MAW-packet). We randomly assigned eligible patients using a full randomization procedure (1:1:1) to three different conditions of implementation: adherence priming (compensation model), which had a systematized focus on patients' individual GAD symptoms and how to compensate for these symptoms within the MAW-packet, and resource priming and supportive resource priming (capitalization model), which had systematized focuses on patients' strengths and abilities and how these strengths can be capitalized within the same packet. In the intention-to-treat population an outcome composite of primary and secondary symptoms-related self-report questionnaires was analyzed based on a hierarchical linear growth model from intake to 6-month follow-up assessment. This trial is registered at ClinicalTrials.gov (identifier: NCT02039193) and is closed to new participants. Findings: From June 2012 to Nov. 2014, from 411 participants that were screened, 57 eligible participants were recruited and randomly assigned to three conditions. Forty-nine patients (86%) provided outcome data at post-assessment (14% dropout rate). All three conditions showed a highly significant reduction of symptoms over time. However, compared with the adherence priming condition, both resource priming conditions indicated faster symptom reduction. The observer ratings of a sub-sample of recorded videos (n = 100) showed that the therapists in the resource priming conditions conducted more strength-oriented interventions in comparison with the adherence priming condition. No patients died or attempted suicide. Interpretation: To our knowledge, this is the first trial that focuses on capitalization and compensation models during the implementation of one prescriptive treatment packet for GAD. We have shown that GAD related symptoms were significantly faster reduced by the resource priming conditions, although the limitations of our study included a well-educated population. If replicated, our results suggest that therapists who implement a mental health treatment for GAD might profit from a systematized focus on capitalization models. Funding: Swiss Science National Foundation (SNSF-Nr. PZ00P1_136937/1) awarded to CF.","Flückiger, C; Forrer, L; Schnider, B; Bättig, I; Bodenmann, G; Zinbarg, R E",2016.0,10.1016/j.ebiom.2015.11.049,0,0,
6335,Are venotonic drugs effective for decreasing acute posttraumatic oedema following ankle sprain? A prospective randomized clinical trial,"ER PATIENTS AND METHODSEighty-one patients with type II and III ankle sprain were screened and randomly assigned for receiving standard conservative treatment alone (control group, 39 patients) or with oral intake of a venotonic drug (micronized purified flavonoid fraction, Daflon 1,000 mg × 3) for 20 days (study group, 42 patients). Measurement of the circumference of ankle region in two different locations and assessment of pain intensity with the Visual Analogue Score were performed at the time of patients' admission and during the 7th and 20th posttraumatic day.RESULTSPatients demographics were comparable in both groups. There were no significant differences between the two groups regarding the values of perimeter of ankle joint or pain intensity at all the examined time points.CONCLUSIONSVenotonic drugs seem not to decrease the posttraumatic oedema or pain in patients who suffer from moderate or severe ankle sprain.OBJECTIVELower leg oedema after trauma may cause various degrees of pain, disability and delay in patient recovery. In this prospective randomized study, we hypothesized that venotonic drugs had no effect in clinical outcome of patients with ankle sprain.","Fotiadis, E; Kenanidis, E; Samoladas, E; Chytas, A; Lyrtzis, C; Koimtzis, M; Chalidis, B",2011.0,10.1007/s00402-011-1266-9,0,0,
6336,A randomized clinical trial of phenelzine and imipramine for posttraumatic stress disorder,"ER In a double-blind, randomized clinical trial, the efficacy of imipramine and of phenelzine was compared with that of placebo in 34 male veterans with posttraumatic stress disorder (PTSD). Both medications reduced PTSD symptoms.","Frank, J B; Kosten, T R; Giller, E L; Dan, E",1988.0,10.1176/ajp.145.10.1289,0,0,
6337,Cognitive behavior therapy augmentation of pharmacotherapy in pediatric obsessive-compulsive disorder: the Pediatric OCD Treatment Study II (POTS II) randomized controlled trial,"ER OBJECTIVE: To examine the effects of augmenting SRIs with CBT or a brief form of CBT, instructions in CBT delivered in the context of medication management.DESIGN, SETTING, AND PARTICIPANTS: A 12-week randomized controlled trial conducted at 3 academic medical centers between 2004 and 2009, involving 124 pediatric outpatients between the ages of 7 and 17 years with OCD as a primary diagnosis and a Children's Yale-Brown Obsessive Compulsive Scale score of 16 or higher despite an adequate SRI trial.INTERVENTIONS: Participants were randomly assigned to 1 of 3 treatment strategies that included 7 sessions over 12 weeks: 42 in the medication management only, 42 in the medication management plus instructions in CBT, and 42 in the medication management plus CBT; the last included 14 concurrent CBT sessions.MAIN OUTCOME MEASURES: Whether patients responded positively to treatment by improving their baseline obsessive-compulsive scale score by 30% or more and demonstrating a change in their continuous scores over 12 weeks.RESULTS: The medication management plus CBT strategy was superior to the other 2 strategies on all outcome measures. In the primary intention-to-treat analysis, 68.6% (95% CI, 53.9%-83.3%) in the plus CBT group were considered responders, which was significantly better than the 34.0% (95% CI, 18.0%-50.0%) in the plus instructions in CBT group, and 30.0% (95% CI, 14.9%-45.1%) in the medication management only group. The results were similar in pairwise comparisons with the plus CBT strategy being superior to the other 2 strategies (P < .01 for both). The plus instructions in CBT strategy was not statistically superior to medication management only (P = .72). The number needed-to-treat analysis with the plus CBT vs medication management only in order to see 1 additional patient at week 12, on average, was estimated as 3; for the plus CBT vs the plus instructions in CBT strategy, the number needed to treat was also estimated as 3; for the plus instructions in CBT vs medication management only the number needed to treat was estimated as 25.CONCLUSIONS: Among patients aged 7 to 17 years with OCD and partial response to SRI use, the addition of CBT to medication management compared with medication management alone resulted in a significantly greater response rate, whereas augmentation of medication management with the addition of instructions in CBT did not.TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00074815.CONTEXT: The extant literature on the treatment of pediatric obsessive-compulsive disorder (OCD) indicates that partial response to serotonin reuptake inhibitors (SRIs) is the norm and that augmentation with short-term OCD-specific cognitive behavior therapy (CBT) may provide additional benefit.","Franklin, M E; Sapyta, J; Freeman, J B; Khanna, M; Compton, S; Almirall, D; Moore, P; Choate-Summers, M; Garcia, A; Edson, A L; Foa, E B; March, J S",2011.0,10.1001/jama.2011.1344,0,0,
6338,"Long-term survival differences among low-anxious, high-anxious and repressive copers enrolled in the Montreal heart attack readjustment trial","ER METHODSThree subgroups were defined using median splits on the State Anxiety Inventory and Marlowe-Crowne Scale administered at baseline: truly low anxious, repressors, and high anxious. Quebec medicare data were used to track survival through 5 years.RESULTSThe trend toward worse prognosis in women in the treatment group and no evidence of treatment impact in men that were seen during the program year were maintained during the follow-up. Analysis of results in terms of coping styles showed a significant long-term survival benefit of treatment in highly anxious men, for whom reductions in somatic symptoms of depression mediated program impact. However, the program was also associated with significantly worse survival in repressors of both sexes. By the end of the program, repressors in the treatment group were more likely to be prescribed benzodiazepines and to have visited emergency rooms without being readmitted than those in the control group, suggesting that the program may have increased distress in repressors.CONCLUSIONSPatients' coping style is important in determining outcomes of psychosocial treatments and should be taken into account when tailoring interventions.OBJECTIVEThis study reports 5-year outcomes from the Montreal Heart Attack Readjustment Trial, a randomized, controlled trial of monthly telephone monitoring of psychological distress and home nursing visits in a sample of 1376 patients. It focuses on differences in long-term program impact associated with patients' sex and baseline anxiety/repressor coping styles. The potential mediating roles of medications, medical care utilization, and changes in negative emotions over the program are also explored.","Frasure-Smith, N; Lespérance, F; Gravel, G; Masson, A; Juneau, M; Bourassa, M G",2002.0,,0,0,
6339,An early Phase II randomised controlled trial testing the effect on persecutory delusions of using CBT to reduce negative cognitions about the self: the potential benefits of enhancing self confidence,"ER Background: Research has shown that paranoia may directly build on negative ideas about the self. Feeling inferior can lead to ideas of vulnerability. The clinical prediction is that decreasing negative self cognitions will reduce paranoia. Method: Thirty patients with persistent persecutory delusions were randomised to receive brief CBT in addition to standard care or to standard care (ISRCTN06118265). The six session intervention was designed to decrease negative, and increase positive, self cognitions. Assessments at baseline, 8. weeks (posttreatment) and 12. weeks were carried out by a rater blind to allocation. The primary outcomes were posttreatment scores for negative self beliefs and paranoia. Secondary outcomes were psychological well-being, positive beliefs about the self, persecutory delusions, social comparison, self-esteem, anxiety, and depression. Results: Trial recruitment and retention were feasible and the intervention highly acceptable to the patients. All patients provided follow-up data. Posttreatment there was a small reduction in negative self beliefs (Cohen's d=0.24) and a moderate reduction in paranoia (d=0.59), but these were not statistically significant. There were statistically significant improvements in psychological well-being (d=1.16), positive beliefs about the self (d=1.00), negative social comparison (d=0.88), self-esteem (d=0.62), and depression (d=0.68). No improvements were maintained. No adverse events were associated with the intervention. Conclusions: The intervention produced short-term gains consistent with the prediction that improving cognitions about the self will reduce persecutory delusions. The improvement in psychological well-being is important in its own right. We recommend that the different elements of the intervention are tested separately and that the treatment is lengthened.","Freeman, D; Pugh, K; Dunn, G; Evans, N; Sheaves, B; Waite, F; Cernis, E; Lister, R; Fowler, D",2014.0,10.1016/j.schres.2014.10.038,0,0,
6340,The Children's Yale-Brown Obsessive Compulsive Scale: reliability and validity for use among 5 to 8 year olds with obsessive-compulsive disorder,"ER The Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) is the instrument of choice for assessing symptom severity in older children (i.e., 8-18 years) diagnosed with obsessive-compulsive disorder (OCD). The reliability and validity of this measure for use among younger children (i.e., 5-8 years of age), however, has never been examined. The primary aim of this study was to examine this scale's use among those presenting with early childhood OCD. Forty-two children with OCD between the ages of 4 and 8 years of age were recruited as part of a larger treatment outcome study, and the reliability and validity of the CY-BOCS was examined. Results revealed questionable reliability for the measure's 5-item Obsessions subscale but good reliability (i.e., internal consistency, temporal stability) for the 5-item Compulsions subscale and 10-item total scale. Results also revealed that the CY-BOCS total scale demonstrated mixed discriminant validity but strong convergent validity and sensitive to change. Collectively, the 10-item, CY-BOCS total score yields a reliable and valid scale for the assessment of symptom severity in early childhood OCD. However, we urge caution in use of the Obsessions subscale in isolation for either clinical or research purposes. Limitations and future areas of research are discussed including the potential benefit of developing a measure of OCD-related symptom severity specifically for younger children with greater attention to developmental differences among children within this population.","Freeman, J; Flessner, C A; Garcia, A",2011.0,10.1007/s10802-011-9494-6,0,0,
6341,Family-based treatment of early childhood obsessive-compulsive disorder: the Pediatric Obsessive-Compulsive Disorder Treatment Study for Young Children (POTS Jr)--a randomized clinical trial,"ER OBJECTIVE: To examine the relative efficacy of family-based CBT (FB-CBT) involving exposure plus response prevention vs an FB relaxation treatment (FB-RT) control condition for children 5 to 8 years of age.DESIGN, SETTING, AND PARTICIPANTS: A 14-week randomized clinical trial (Pediatric Obsessive-Compulsive Disorder Treatment Study for Young Children [POTS Jr]) conducted at 3 academic medical centers between 2006 and 2011, involving 127 pediatric outpatients 5 to 8 years of age who received a primary diagnosis of OCD and a Children's Yale-Brown Obsessive Compulsive Scale total score of 16 or higher.INTERVENTIONS: Participants were randomly assigned to 14 weeks of (1) FB-CBT, including exposure plus response prevention, or (2) FB-RT.MAIN OUTCOMES AND MEASURES: Responder status defined as an independent evaluator-rated Clinical Global Impression-Improvement scale score of 1 (very much improved) or 2 (much improved) and change in independent evaluator-rated continuous Children's Yale-Brown Obsessive Compulsive Scale total score. RESULTS Family-based CBT was superior to FB-RT on both primary outcome measures. The percentages of children who were rated as 1 (very much improved) or 2 (much improved) on the Clinical Global Impression-Improvement scale at 14 weeks were 72% for FB-CBT and 41% for FB-RT. The effect size difference between FB-CBT and FB-RT on the Clinical Global Impression-Improvement scale was 0.31 (95% CI, 0.17-0.45). The number needed to treat (NNT) with FB-CBT vs FB-RT was estimated as 3.2 (95% CI, 2.2-5.8). The effect size difference between FB-CBT and FB-RT on the Children's Yale-Brown Obsessive Compulsive Scale at week 14 was 0.84 (95% CI, 0.62-1.06).CONCLUSIONS AND RELEVANCE: A comprehensive FB-CBT program was superior to a relaxation program with a similar format in reducing OCD symptoms and functional impairment in young children (5-8 years of age) with OCD.TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00533806.IMPORTANCE: Cognitive behavior therapy (CBT) has been established as efficacious for obsessive-compulsive disorder (OCD) among older children and adolescents, yet its effect on young children has not been evaluated sufficiently.","Freeman, J; Sapyta, J; Garcia, A; Compton, S; Khanna, M; Flessner, C; FitzGerald, D; Mauro, C; Dingfelder, R; Benito, K; Harrison, J; Curry, J; Foa, E; March, J; Moore, P; Franklin, M",2014.0,10.1001/jamapsychiatry.2014.170,0,0,
6342,Early childhood OCD: preliminary findings from a family-based cognitive-behavioral approach,"ER METHODForty-two young children with primary OCD were randomized to receive 12 sessions of family-based CBT or family-based RT. Assessments were conducted before and after treatment by independent raters blind to treatment assignment. Primary outcomes included scores on the Children's Yale-Brown Obsessive Compulsive Scale and Clinical Global Impressions-Improvement.RESULTSFor the intent-to-treat sample, CBT was associated with a moderate treatment effect (d = 0.53), although there was not a significant difference between the groups at conventional levels. For the completer sample, CBT had a large effect (d = 0.85), and there was a significant group difference favoring CBT. In the intent-to-treat sample, 50% of children in the CBT group achieved remission as compared to 20% in the RT group. In the completer sample, 69% of children in the CBT group achieved a clinical remission compared to 20% in the RT group.CONCLUSIONSResults indicate that children with early-onset OCD benefit from a treatment approach tailored to their developmental needs and family context. CBT was effective in reducing OCD symptoms and in helping a large number of children achieve a clinical remission.OBJECTIVETo examine the relative efficacy of family-based cognitive-behavioral therapy (CBT) versus family-based relaxation treatment (RT) for young children ages 5 to 8 years with obsessive-compulsive disorder (OCD).","Freeman, J B; Garcia, A M; Coyne, L; Ale, C; Przeworski, A; Himle, M; Compton, S; Leonard, H L",2008.0,10.1097/CHI.0b013e31816765f9,0,0,
6343,"The group-based social skills training SOSTA-FRA in children and adolescents with high functioning autism spectrum disorder--study protocol of the randomised, multi-centre controlled SOSTA--net trial","ER BACKGROUND: Group-based social skills training (SST) has repeatedly been recommended as treatment of choice in high-functioning autism spectrum disorder (HFASD). To date, no sufficiently powered randomised controlled trial has been performed to establish efficacy and safety of SST in children and adolescents with HFASD. In this randomised, multi-centre, controlled trial with 220 children and adolescents with HFASD it is hypothesized, that add-on group-based SST using the 12 weeks manualised SOSTA-FRA program will result in improved social responsiveness (measured by the parent rated social responsiveness scale, SRS) compared to treatment as usual (TAU). It is further expected, that parent and self reported anxiety and depressive symptoms will decline and pro-social behaviour will increase in the treatment group. A neurophysiological study in the Frankfurt HFASD subgroup will be performed pre- and post treatment to assess changes in neural function induced by SST versus TAU.METHODS/DESIGN: The","Freitag, C M; Cholemkery, H; Elsuni, L; Kroeger, A K; Bender, S; Kunz, C U; Kieser, M",2013.0,10.1186/1745-6215-14-6,0,0,
6344,Adult sexual abuse is associated with elevated neurohormone levels among women with PTSD due to childhood sexual abuse,"ER Posttraumatic stress disorder (PTSD) has been associated with reduced, similar, or increased urinary cortisol levels. The authors identified a factor that might contribute to such variability when they obtained 24-hour urinary neurohormone profiles on 69 women with PTSD due to childhood sexual abuse. Half (n = 35) had subsequently experienced adult sexual abuse (ASA) while the other half (n = 34) had not. The ASA group had significantly elevated urinary cortisol, norepinephrine and dopamine levels in comparison to the non-ASA group. Neither a history of childhood or adult physical abuse nor other variables contributed to this finding. The results suggest that the psychobiological consequences of exposure to the same traumatic event may differ as a result of an interaction between age and the composite history of trauma exposure.","Friedman, M J; Jalowiec, J; McHugo, G; Wang, S; McDonagh, A",2007.0,10.1002/jts.20221,0,0,
6345,Colour contrast sensitivity with different intraocular lens materials in the right and left eyes in same day surgery,"ER METHODSCentral colour contrast sensitivity was measured with a computer graphics system along the protan, deutan and tritan axes. Thirty-four patients with cataract were studied. The patients were randomized to one of three groups: group 1 received a Clariflex (silicone) lens in one eye and an Akreos Fit (hydrophilic acrylic) lens in the other; group 2 received an Akreos lens in one eye and a Sensar AR40e (hydrophobic acrylic) lens in the other, and group 3 received a Clariflex lens in one eye and an AR40e lens in the other. Surgery was performed in both eyes on the same day. A postoperative questionnaire was distributed, asking the patients to describe any differences experienced between their two eyes.RESULTSThere were no significant differences between the three different IOLs in any colour axis. There were no complications of importance during surgery. Thirty-two of the 34 patients answered the questionnaire. Twenty-one patients experienced some difference between their two eyes in distance vision and 23 noticed differences in near vision. For distance vision, nine reported better vision in the eye with the Akreos IOL, eight in the eye with the Clariflex IOL lens and four in the eye with the AR40e IOL. For near vision, 12 preferred the Akreos lens, eight the Clariflex lens and three the AR40e lens.CONCLUSIONThere were no significant differences between the three different IOLs in any colour axis.PURPOSETo study possible differences in colour contrast sensitivity between different intraocular lens (IOL) materials with consecutive same day cataract surgery performed in the right and left eyes.","Friström, B; Lundh, B L",2005.0,10.1111/j.1395-3907.2005.00510.x,0,0,
6346,Physical symptom attributions: a defining characteristic of somatoform disorders?,"ER OBJECTIVES: We examined whether primary care patients were more likely to perceive a current health problem as 'physical illness only' as opposed to entailing psychological difficulties if they had a comorbid somatoform disorder compared to patients who had (a) both comorbid somatoform disorder and anxiety/depression or (b) comorbid anxiety and/or depression, and a reference group of (c) patients with well-defined physical disease. We examined whether attributions predicted future health expenditures.METHODS: A total of 1209 of 1785 patients completed questions on patient-perceived illness. The physicians diagnosed the current health problem. A stratified subsample was interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. Health expenditure was obtained from registers for a 2-year period.RESULTS: The belief that the current health problem was only physical was endorsed by 86% of patients presenting physical disease, 58% of patients with somatoform disorders, 29% of patients with both somatoform disorders and anxiety/depression and 24% of patients with anxiety or depressive disorders (?2=269.2, df=3, P<.0001). In a multiple regression model, a 'physical illness only' perception predicted lower health expenditures [? = -0.31, 95% confidence interval (-0.55; -0.07), P=.013].CONCLUSIONS: The prevalent assumption that physical symptom attributions are a central aspect in somatoform disorders is not supported by the current study.","Frostholm, L; √òrnb√∏l, E; Fink, P K",2015.0,10.1016/j.genhosppsych.2015.01.002,0,0,
6347,Reducing negative interpretations in adolescents with anxiety disorders: a preliminary study investigating the effects of a single session of cognitive bias modification training,"ER Anxiety disorders are globally prevalent, debilitating and onset in early life. Cognitive bias modification of interpretations (CBM-I) training has emerged as a targeted intervention for early emerging anxiety problems. While CBM-I can alter interpretational styles in unselected and clinical-analogue samples of adolescents, no studies have assessed its capacity to change biases in clinical samples. Here, we assessed training efficacy in ameliorating interpretation biases and anxious mood in adolescents with anxiety disorders. Twenty-eight Chinese adolescents meeting criteria for a current anxiety disorder were randomly assigned to receive positive or neutral CBM-I training. Training involved completing a word-fragment to resolve the outcomes of sixty ambiguous scenarios. During positive training, scenarios ended with benign/positive resolutions, but during neutral training, half of the scenarios were resolved positively and half negatively. Positively trained patients interpreted new ambiguous scenarios less negatively than the neutral training group although training effects were not observed on a questionnaire measure of interpretation bias. Training effects on mood were also absent. Before the clinical implications of CBM-I can be considered in adolescents, research needs to establish optimal training parameters for symptom-changes to occur.","Fu, X; Du, Y; Au, S; Lau, J Y",2013.0,10.1016/j.dcn.2012.11.003,0,0,
6348,"A link between serotonin-related gene polymorphisms, amygdala activity, and placebo-induced relief from social anxiety","ER Placebo may yield beneficial effects that are indistinguishable from those of active medication, but the factors underlying proneness to respond to placebo are widely unknown. Here, we used functional neuroimaging to examine neural correlates of anxiety reduction resulting from sustained placebo treatment under randomized double-blind conditions, in patients with social anxiety disorder. Brain activity was assessed during a stressful public speaking task by means of positron emission tomography before and after an 8 week treatment period. Patients were genotyped with respect to the serotonin transporter-linked polymorphic region (5-HTTLPR) and the G-703T polymorphism in the tryptophan hydroxylase-2 (TPH2) gene promoter. Results showed that placebo response was accompanied by reduced stress-related activity in the amygdala, a brain region crucial for emotional processing. However, attenuated amygdala activity was demonstrable only in subjects who were homozygous for the long allele of the 5-HTTLPR or the G variant of the TPH2 G-703T polymorphism, and not in carriers of short or T alleles. Moreover, the TPH2 polymorphism was a significant predictor of clinical placebo response, homozygosity for the G allele being associated with greater improvement in anxiety symptoms. Path analysis supported that the genetic effect on symptomatic improvement with placebo is mediated by its effect on amygdala activity. Hence, our study shows, for the first time, evidence of a link between genetically controlled serotonergic modulation of amygdala activity and placebo-induced anxiety relief.","Furmark, T; Appel, L; Henningsson, S; Ahs, F; Faria, V; Linnman, C; Pissiota, A; Frans, O; Bani, M; Bettica, P; Pich, E M; Jacobsson, E; Wahlstedt, K; Oreland, L; Långström, B; Eriksson, E; Fredrikson, M",2008.0,10.1523/JNEUROSCI.2534-08.2008,0,0,
6349,Cognitive and behavioral findings in children taking theophylline,"ER In a prior pilot study involving six children, we noted improved memory and concentration and improved behavior when these children were switched from theophylline to cromolyn sodium therapy. We now report the findings in 29 children (24 boys and five girls), aged 7 to 12 years. In this study, a double-blind, double-dummy randomized design was used so that half the subjects continued to receive theophylline and the other half was actually switched from theophylline to cromolyn sodium therapy. Assessment again consisted of the revised Wechsler Intelligence Scale for Children, the Selective Reminding test, the Benton Visual Retention test, Stroop tests I and II, and the Child Behavior Checklist. The group receiving placebo theophylline/active cromolyn sodium therapy demonstrated greater improvement on all tests of memory and concentration, with greatest significance for the Stroop test (p less than 0.03 by analysis of covariance). There were also significant correlations between length of time theophylline was taken and scores on the depression (p less than 0.03) and the obsessive-compulsive (p less than 0.04) subscales of the Child Behavior Checklist. These results support the findings of the previous pilot study but, in addition, raise concern about depression and anxiety as possible long-term side effects of long-term theophylline therapy.","Furukawa, C T; DuHamel, T R; Weimer, L; Shapiro, G G; Pierson, W E; Bierman, C W",1988.0,,0,0,
6350,"A double-blind, placebo-controlled trial of ?-3 fatty acids in Tourette's disorder","ER OBJECTIVE: Clinical observations have suggested therapeutic effects for ?-3 fatty acids (O3FA) in Tourette's disorder (TD), but no randomized, controlled trials have been reported. In a placebo-controlled trial, we examined the efficacy of O3FA in children and adolescents with TD.METHODS: Thirty-three children and adolescents (ages 6-18) with TD were randomly assigned, double-blind, to O3FA or placebo for 20 weeks. O3FA consisted of combined eicosapentaenoic acid and docosahexaenoic acid. Placebo was olive oil. Groups were compared by using (1) intent-to-treat design, with the last-observation-carried-forward controlling for baseline measures and attention-deficit/hyperactivity disorder via (a) logistic regression, comparing percentage of responders on the primary Yale Global Tic Severity Scale (YGTSS)-Tic and secondary (YGTSS-Global and YGTSS-Impairment) outcome measures and (b) analysis of covariance; and (2) longitudinal mixed-effects models.RESULTS: At end point, subjects treated with O3FA did not have significantly higher response rates or lower mean scores on the YGTSS-Tic (53% vs 38%; 15.6 ± 1.6 vs 17.1 ± 1.6, P > .1). However, significantly more subjects on O3FA were considered responders on the YGTSS-Global measure (53% vs 31%, P = .05) and YGTSS-Impairment measure (59% vs 25%, P < .05), and mean YGTSS-Global scores were significantly lower in the O3FA-treated group than in the placebo group (31.7 ± 2.9 vs 40.9 ± 3.0, P = .04). Obsessive-compulsive, anxiety, and depressive symptoms were not significantly affected by O3FA. Longitudinal analysis did not yield group differences on any of the measures.CONCLUSIONS: O3FA did not reduce tic scores, but it may be beneficial in reduction of tic-related impairment for some children and adolescents with TD. Limitations include the small sample and the possible therapeutic effects of olive oil.","Gabbay, V; Babb, J S; Klein, R G; Panzer, A M; Katz, Y; Alonso, C M; Petkova, E; Wang, J; Coffey, B J",2012.0,10.1542/peds.2011-3384,0,0,
6351,One year follow-up to modular cognitive behavioral therapy for the treatment of pediatric anxiety disorders in an elementary school setting,"ER The current study sought to evaluate the relative long-term efficacy of a modularized cognitive behavioral therapy (CBT) program for children with anxiety disorders. Twenty four children (5-12 years old) randomly assigned to modular CBT or a 3-month waitlist participated in a 1-year follow-up assessment. Independent evaluators blind to treatment condition conducted structured diagnostic interviews, and caregivers and children completed symptom checklists at pre- and post-, and 1 year follow-up assessments. Analyses revealed that 71.4% of children who received CBT demonstrated a positive treatment response 1 year following treatment, and 83.3% were free of any anxiety diagnosis at 1 year follow-up. Analyses further revealed robust effects of intervention on diagnostic outcomes, caregiver- and child-report measures of anxiety at 1 year follow-up. Results provide evidence of an ongoing advantage on anxiety-specific outcomes for this modularized school-based CBT program 1 year post-treatment.","Galla, B M; Wood, J J; Chiu, A W; Langer, D A; Jacobs, J; Ifekwunigwe, M; Larkins, C",2012.0,10.1007/s10578-011-0258-x,0,0,
6352,A brief group cognitive-behavioral intervention for social phobia in childhood,"ER Twenty-three preadolescent children (ages 8-11) meeting criteria for social phobia were randomly assigned to either a 3-week cognitive-behavioral group intervention or a wait-list control group. The intervention consisted of psychoeducation, cognitive strategies, and behavioral exposure. Outcome measures included diagnostic interview as well as parent and child report measures of anxiety and depression. Improvements were observed at posttest, with results stronger for parent report and interviewer ratings than for child self-report. At 3-week follow-up, children receiving the intervention demonstrated significant improvements on the majority of child, parent, and interviewer reports of social anxiety and related symptoms relative to wait-list participants. Preliminary support is provided for the utility of a brief intervention for preadolescent children with social phobia. Limitations and implications for future research are discussed.","Gallagher, H M; Rabian, B A; McCloskey, M S",2004.0,10.1016/S0887-6185(03)00027-6,0,0,
6353,Gender Differences in Service Utilization among OEF/OIF Veterans with Posttraumatic Stress Disorder after a Brief Cognitive-Behavioral Intervention to Increase Treatment Engagement: A Mixed Methods Study,"ER PURPOSE: Women veterans who served in Iraq and Afghanistan (Operation Enduring Freedom and Operation Iraqi Freedom [OEF/OIF]) have a moderately higher risk of developing posttraumatic stress disorder (PTSD) than male veterans. However, gender disparities in treatment engagement may prevent women veterans from initiating the care they need. Understanding gender differences in predictors of and barriers to treatment is essential to improving engagement and mental health outcomes. The purpose of this study was to examine gender differences in treatment utilization after a brief, cognitive-behavioral therapy (CBT) intervention among male and female OEF/OIF veterans.METHODS: Participants were assigned randomly to either the intervention or control conditions. Intervention participants received the telephone-based CBT intervention. Participants were 35 female and 238 male OEF/OIF veterans who screened positive for PTSD and had never initiated PTSD treatment. Participants were asked about treatment utilization, beliefs about PTSD treatment, and symptoms at months 1, 3, and 6 months subsequent to the baseline telephone assessment. The PTSD Checklist-Military Version was used to assess PTSD and the Patient's Health Questionnaire was used to assess symptoms of depression.FINDINGS: Female veterans who received an intervention were significantly more likely to have attended treatment over the 6-month follow-up period than male veterans who received an intervention (?(2) = 7.91; df = 3; odds ratio, 3.93; p = .04).CONCLUSIONS: The CBT intervention may be a critical mechanism to engage female veterans in treatment. Further research is needed to understand how to engage male veterans with PTSD in treatment.","Gallegos, A M; Wolff, K B; Streltzov, N A; Adams, L B; Carpenter-Song, E; Nicholson, J; Stecker, T",2015.0,10.1016/j.whi.2015.04.008,0,0,
6354,The impact of an 8-day intensive treatment for adolescent panic disorder and agoraphobia on comorbid diagnoses,"ER Previous research findings have shown positive effects of cognitive-behavioral therapy for primary anxiety disorders as well as for nonprimary, co-occurring anxiety disorders. In this study, we analyzed data from an existing randomized controlled trial of intensive treatment for panic disorder with or without agoraphobia (PDA) to examine the effects of the treatment on comorbid psychiatric diagnoses. The overall frequency and severity of aggregated comorbid diagnoses decreased in a group of adolescents who received an 8-day treatment for PDA. Results suggest that an 8-day treatment for PDA can alleviate the symptoms of some specific comorbid clinical diagnoses; in particular specific phobias, generalized anxiety disorder, and social phobia. These findings suggest that an intensive treatment for PDA is associated with reductions in comorbid symptoms even though disorders other than PDA are not specific treatment targets.","Gallo, K P; Chan, P T; Buzzella, B A; Whitton, S W; Pincus, D B",2012.0,10.1016/j.beth.2011.05.002,0,0,
6355,Trajectories of change across outcomes in intensive treatment for adolescent panic disorder and agoraphobia,"ER Much remains to be learned about typical and individual growth trajectories across treatment for adolescent panic disorder with and without agoraphobia and about critical treatment points associated with key changes. The present study examined the rate and shape of change across an 8-day intensive cognitive behavioral therapy for adolescent panic disorder with and without agoraphobia (N = 56). Participants ranged in age from 12 to 17 (M = 15.14, SD = 1.70; 58.9% female, 78.6% Caucasian). Multilevel modeling evaluated within-treatment linear and nonlinear changes across three treatment outcomes: panic severity, fear, and avoidance. Overall panic severity showed linear change, decreasing throughout treatment. In contrast, fear and avoidance ratings both showed cubic change, peaking slightly at the first session of treatment, starting to decrease at the second session of treatment, and with large gains continuing then plateauing at the fourth session. Findings are considered with regard to the extent to which they may elucidate critical treatment components and sessions for adolescents with panic disorder with and without agoraphobia.","Gallo, K P; Cooper-Vince, C E; Hardway, C L; Pincus, D B; Comer, J S",2014.0,10.1080/15374416.2013.794701,0,0,
6356,3D micro-CT analysis of the interface voids associated with Thermafil root fillings used with AH Plus or a flowable MTA sealer,"ER AIM: To investigate nondestructively the percentage of 3D voids and marginal gaps in a pre-defined interface volume of interest (VOI) within root fillings produced by Thermafil Obturators with either a hydrophobic epoxy-resin-based sealer (AH Plus) or a hydrophilic flowable calcium-silicate sealer [mineral trioxide aggregate (MTA) Flow].METHODOLOGY: Sixteen single root canals from extracted premolar teeth were prepared with ProTaper rotary instruments, randomly allocated into two groups (n = 8) and filled with size 30 Thermafil Obturators in association with AH Plus or MTA Flow sealers. The filled roots were stored at 37 °C in 5 mL of Hank's balanced salt solution (HBSS) used to represent body fluids and scanned after 7 days and 6 months using a high-resolution micro-CT. From each root, images of 3000 sections were analysed in 3D and binarized using a high-resolution micro-CT (4-? resolution). The 3D distribution of voids (porosity and marginal gaps) at the gutta-percha-sealer-dentine interface was detected through a threshold grey level and expressed as percentage of the 40-?-thick pre-defined interface VOI (20 ? of interface dentine and 20 ? of gutta-percha/sealer). A method of analysis based on the root canal segmentation was used, and coronal, middle and apical thirds considered separately. The percentage of 3D void volume was compared statistically using one-way anova (significance for P < 0.05). Environmental Scanning Electron Microscope with Energy Dispersive X-ray (ESEM-EDX) analysis was performed on the surface of both sealers after soaking in HBSS.RESULTS: Micro-CT detected gaps at the dentine-sealer interface in both groups. Void volumes wider than 10.21 ?m(3) with 1.35 ?m diameter were detected. Cul-de-sac-type voids (blind pores) and through-and-through voids (continuous pores) were discriminated. The apical thirds had a significantly lower 3D void volume (P < 0.05) than the middle and coronal thirds. The 3D void volume reduced significantly (P < 0.05) over time. ESEM-EDX analysis revealed that MTA Flow sealer created a dense apatite layer after 7 days of immersion in HBSS, whilst only sparse calcium phosphate deposits were detected on AH Plus even after 28 days.CONCLUSIONS: Micro-CT proved to be a powerful nondestructive 3D analysis tool for visualizing the porous internal microstructure of dental/endodontic materials at the interface with dentine. The proportion of voids was least in the apical third of root canals. Voids reduced over time in the presence of simulated body fluid.","Gandolfi, M G; Parrilli, A P; Fini, M; Prati, C; Dummer, P M",2013.0,10.1111/j.1365-2591.2012.02124.x,0,0,
6357,Effects of problem solving therapy on mental health outcomes in family caregivers of persons with a new diagnosis of mild cognitive impairment or early dementia: a randomized controlled trial,"ER METHOD: Seventy-three (43 MCI and 30 early dementia) family caregivers were randomly assigned to receive PST or a comparison condition (nutritional education). Depression, anxiety, and problem-solving orientation were assessed at baseline and at 1, 3, 6, and 12 months post intervention.RESULTS: In general, the PST caregiver intervention was feasible and acceptable to family caregivers of older adults with a new cognitive diagnosis. Relative to nutritional education, PST led to significantly reduced depression symptoms, particularly among early dementia caregivers. PST also lowered caregivers' anxiety levels, and led to lessening of negative problem orientation.DISCUSSION: Enhanced problem-solving skills, learned early after a loved one's cognitive diagnosis (especially dementia), results in positive mental health outcomes among new family caregivers.OBJECTIVE: Interventions directed at the mental health of family dementia caregivers may have limited impact when focused on caregivers who have provided care for years and report high burden levels. We sought to evaluate the mental health effects of problem-solving therapy (PST), designed for caregivers of individuals with a recent diagnosis of Mild Cognitive Impairment (MCI) or early dementia.","Garand, L; Rinaldo, D E; Alberth, M M; Delany, J; Beasock, S L; Lopez, O L; Reynolds, C F; Dew, M A",2014.0,10.1016/j.jagp.2013.07.007,0,0,
6358,Predictors and moderators of treatment outcome in the Pediatric Obsessive Compulsive Treatment Study (POTS I),"ER METHODPotential baseline predictors and moderators were identified by literature review. The outcome measure was an adjusted week 12 predicted score for the Children's Yale Brown Obsessive Compulsive Scale (CY-BOCS). Main and interactive effects of treatment condition and each candidate predictor or moderator variable were examined using a general linear model on the adjusted predicted week 12 CY-BOCS scores.RESULTSYouth with lower obsessive-compulsive disorder (OCD) severity, less OCD-related functional impairment, greater insight, fewer comorbid externalizing symptoms, and lower levels of family accommodation showed greater improvement across treatment conditions than their counterparts after acute POTS treatment. Those with a family history of OCD had more than a sixfold decrease in effect size in CBT monotherapy relative to their counterparts in CBT without a family history of OCD.CONCLUSIONSGreater attention is needed to build optimized intervention strategies for more complex youth with OCD. Youth with a family history of OCD are not likely to benefit from CBT unless offered in combination with an SSRI.CLINICAL TRIALS REGISTRATION INFORMATIONTreatment of Obsessive Compulsive Disorder (OCD) in Children, http://www.clinicaltrials.gov, NCT00000384.OBJECTIVETo identify predictors and moderators of outcome in the first Pediatric OCD Treatment Study (POTS I) among youth (N = 112) randomly assigned to sertraline, cognitive behavioral therapy (CBT), both sertraline and CBT (COMB), or a pill placebo.","Garcia, A M; Sapyta, J J; Moore, P S; Freeman, J B; Franklin, M E; March, J S; Foa, E B",2010.0,10.1016/j.jaac.2010.06.013,0,0,
6359,Psychological aspects of rheumatoid arthritis,"ER This study had 3 aims: to determine whether rheumatoid arthritics had certain personality traits; to examine the relationship between psychological factors and the presence of rheumatoid factor in blood serum; and to explore the prognostic significance of psychological factors in the management of rheumatoid arthritis. Within a few days of discharge, 129 in-patient rheumatoid arthritics were clinically and psychologically assessed and allocated at random to 1 of 3 forms of follow-up care. The psychological assessment included measures of personality, non-psychotic psychiatric disturbance, and attitudes and beliefs. A year later all patients were reassessed. It was found that rheumatoid arthritics were more neurotic in personality, more likely to give socially desirable responses, and more prone to psychiatric disturbance, than the general population. Seropositive patients were less susceptible to psychiatric disturbance than seronegative patients. None of the psychological variables predicted disease activity, but those patients who rated themselves as 'slow, dependent, and weak' lost more time off work in the subsequent year.","Gardiner, B M",1980.0,,0,0,
6360,"Effect of a cognitive behavioral self-help intervention on depression, anxiety, and coping self-efficacy in people with rheumatic disease","ER OBJECTIVE: The aim of this study was to investigate whether a new cognitive-behavioral self-help program with minimal coaching could improve psychological well-being (depression, anxiety, and coping self-efficacy) in people with rheumatic disease and depressive symptoms.METHODS: In total, 82 persons with a rheumatic disease enrolled in a randomized controlled trial were allocated to either a group receiving the self-help program or a waiting list control condition group. For both groups, measurements were done at baseline, posttest, and followup. The outcome measures were the depression and anxiety scales of the Hospital Anxiety and Depression Scale and an adaptation of the Generalized Self-Efficacy Scale. Repeated-measures analyses of covariance were performed to evaluate changes in outcome measures from pretest to posttest and from posttest to followup.RESULTS: The results showed that the self-help program was effective in reducing symptoms of depression and anxiety and in strengthening coping self-efficacy. The positive effects remained after a followup period of 2 months.CONCLUSION: This cost-effective program could very well be used as a first step in a stepped care approach or as one of the treatment possibilities in a matched care approach.","Garnefski, N; Kraaij, V; Benoist, M; Bout, Z; Karels, E; Smit, A",2013.0,10.1002/acr.21936,0,0,
6361,An experimental investigation of thought suppression and anxiety in children,"ER DESIGNParticipants were allocated to conditions in a between-groups experimental design devised on the basis of thought suppression methodologies reported in the adult literature.METHODSOne-hundred and twelve participants were recruited from local primary schools and randomly allocated to four experimental conditions. Children in all conditions monitored the occurrence of a target thought (either neutral or anxiety-provoking) by tapping their hand on a table each time the thought came to mind during two consecutive experimental periods. During the first period, half the children were asked not to think about the target thought, while the remaining half were asked to think about anything. During the second period, all children were instructed to think about anything.RESULTSNo evidence was found for either an immediate or a delayed increase in frequency of target thoughts as a consequence of suppression attempts. State and trait anxiety were, however, found to influence children's performance during these experimental tasks and were associated with increased intrusions under certain conditions.CONCLUSIONSThe results of this study suggest that the experimental thought suppression paradigm is workable with 7-11-year-old children. The methodological, theoretical and clinical implications of these findings are discussed.OBJECTIVESThis study aimed to explore the effects of thought suppression in children--in particular, whether trying to suppress a thought leads to an immediate and/or delayed increase in its occurrence. The influence of anxiety on children's performance in the experimental paradigm was also examined.","Gaskell, S L; Wells, A; Calam, R",2001.0,,0,0,
6362,Aqueous flare induced by heparin-surface-modified poly(methyl methacrylate) and acrylic lenses implanted through the same-size incision in patients with diabetes,"ER SETTINGDepartment of Ophthalmology, University of Paris XIII, Bobigny, France.METHODSIn a prospective study, 44 eyes of 31 diabetic patients with or without mild to moderate diabetic retinopathy were randomly assigned to receive an HSM PMMA IOL (22 eyes) or a soft hydrophobic acrylic IOL (22 eyes) after standardized phacoemulsification surgery. Both types of IOLs had a 6.0 mm optic, were inserted unfolded, and were placed in the bag through a calibrated 6.0 mm superior scleral incision. Anterior chamber flare was measured preoperatively and 1, 7, 30, and 240 days postoperatively using the Kowa 500 laser flare meter.RESULTSThe mean flare value was higher on the first postoperative day in both groups. There were no statistically significant between-group differences in flare scores or clinical parameters preoperatively or at any postoperative visit.CONCLUSIONSNo significant difference was observed in inflammation between eyes having HSM PMMA IOL implantation or those having soft hydrophobic acrylic IOL implantation through the same-size incision. This indicates that hydrophobic acrylic and HSM PMMA materials induce the same degree of BAB breakdown after phacoemulsification in eyes of diabetic patients.PURPOSETo compare the degree of blood-aqueous barrier (BAB) breakdown in eyes of diabetic patients after phacoemulsification and implantation of heparin-surface-modified poly(methyl methacrylate) (PMMA) or soft hydrophobic acrylic intraocular lenses (IOLs) performed using the same technique with the same incision size to determine the influence of the IOLs on postoperative inflammation independent of other surgical factors.","Gatinel, D; Lebrun, T; Toumelin, P; Chaine, G",2001.0,,0,0,
6363,Distress related to dental extraction for children under general anaesthesia and their parents,"ER DESIGNa randomized comparative trial. Setting University Dental Hospital of Manchester.SUBJECTS AND METHODSTwo hundred and one children, together with their parents took part in this study. Immediately before GA, the Modified Child Smiley Faces Scales (MCSFS) and Modified Adult Smiley Faces Scales (MASFS) were completed by a trained observer for children and accompanying parents respectively, and again on recovery from anaesthesia and 15 minutes postoperatively.RESULTSThere were generalised increases in mean distress scores for children when comparing the pre-operative with the postoperative scores. However, mean distress scores for parents reduced at recovery and 15 minutes postoperatively and were less than the mean distress scores for children. There was no correlation between the child and parent distress scores preoperatively, postoperatively and 15 minutes postoperatively. There were significant increase in median distress scores for younger children compared to the older children at recovery and 15 minutes postoperatively (P0.05). Children who had 8 - 14 teeth extracted demonstrated higher levels of distress than those who had 1 - 7 teeth extracted (P0.05).CONCLUSIONExtraction of teeth under general anaesthesia does produce distress in children and their parents. Child and parental distress were not related. Both age and number of teeth extracted appear to influence the level of distress in children.AIMThe aims of this study were to observe levels of distress in children and their parents before and after extractions under general anaesthesia (GA) and to assess the effect of age, gender and the number of extractions on distress.","Gazal, G; Mackie, I C",2007.0,,0,0,
6364,Youth Early-intervention Study (YES) - group interventions targeting social participation and physical well-being as an adjunct to treatment as usual: study protocol for a randomized controlled trial,"ER METHODS/DESIGN: The design is a 2-arm, parallel group cross-over, randomized clinical trial (RCT) that examines the efficacy of this adjunctive youth early intervention program (called ""YES"") for improving social, vocational, mental and physical health functioning in a trans-diagnostic sample of 120 young persons aged 14-25 years who are currently receiving a range of ""usual treatments"" for clinically diagnosed anxiety, affective and/or psychotic disorders. Individuals who provide written informed consent are offered 2 group therapy modules (each comprising 4 hours per week for 8 weeks) with a 3-week ""pause"" between modules. Randomization determines whether individuals commence with module A or module B. The sample will be assessed pre-randomization, and at week 1 and week 8 (after completion of the first module), and at week 11 (commencement of second module) and week 19 (completion of second module). Final follow-up is 1-year post trial entry.DISCUSSION: If the findings of this exploratory trial demonstrate benefits in the target domains, then it will be important to extend the research by undertaking: (a) a comparison of the YES program to a control intervention in a randomized controlled trial, (b) an explanatory study of putative mediators of change, and (c) a multi-center trial with a number of trained therapists offering the group modules combined with a longer follow-up period.TRIAL REGISTRATION: Australian New Zealand Controlled Trial Registration: ACTRN1262400175673 , Date: 16 July 2015.BACKGROUND: It is increasingly acknowledged that clinical interventions for young persons with mental disorders need to optimize social, vocational and physical functioning, and take into account developmental needs, rather than focusing only on the traditional target of psychiatric symptom change. However, few interventions for youth presenting to mental health services offer a coherent rationale for multi-faceted approaches that efficiently address all these targets. This trial uses two facilitated group therapy modules (social and physical activity) as a vehicle for promoting clinical, cognitive, social and vocational change. The modules are an adjunct to usual treatments offered to youth attending mental health services in Sydney, Australia.","Gehue, L J; Scott, E; Hermens, D F; Scott, J; Hickie, I",2015.0,10.1186/s13063-015-0834-7,0,0,
6365,Effect of inositol on bulimia nervosa and binge eating,"ER METHODA double-blind crossover trial using 18 g inositol versus placebo was performed in 12 patients for 6 weeks in each arm.RESULTSInositol was significantly better than placebo on the Global Clinical Impression, the Visual Analogue Scale, and the Eating Disorders Inventory.DISCUSSIONInositol is as therapeutic in patients with bulimia nervosa and binge eating as it is in patients with depression and panic and obsessive-compulsive disorders. This increases its parallelism with serotonin selective reuptake inhibitors.OBJECTIVESThis study aimed to determine whether inositol has therapeutic value in patients with bulimia nervosa and binge eating.","Gelber, D; Levine, J; Belmaker, R H",2001.0,,0,0,
6366,Effects of alcohol on the processing of social threat-related stimuli in socially phobic women,"ER PROCEDUREThirty-two women with social phobia (DSM-IV) and 32 female controls performed an emotional Stroop test either after drinking alcohol resulting in a blood alcohol levels (BAL) of 0.6%. or after drinking a non-alcoholic beverage. The emotional Stroop test contained social anxiety-related and neutral stimuli. Implicit memory for the words presented was tested with a word-stem completion test.RESULTSWithout alcohol, both controls and socially-phobic participants took longer to name the colour of socially-threatening stimuli than of neutral stimuli. Alcohol levelled response latencies to the two stimulus categories only in controls. Socially-phobic participants responded more slowly to social anxiety-related stimuli than to neutral stimuli, irrespective of their BAL. In contrast to controls, social phobics showed an implicit memory bias for social threat words. This bias was attenuated by alcohol.DISCUSSIONAlcohol disrupts appraisal of social anxiety-related stimuli in controls but not in social phobics; in these it hinders the consolidation of memory. This also suggests that social phobics experience similar anxiety with and without alcohol, but remember this experienced anxiety less precisely. This effect might act as a reinforcer for the use of alcohol for the purpose of self-medication in future situations.BACKGROUNDSocial phobics are at a higher risk of developing alcohol problems. The mechanism promoting this association is not clear. According to Sayette (1993b), alcohol attenuates anxiety responses by disrupting initial appraisal of threatening stimuli. We used the emotional Stroop test and an implicit memory test to investigate whether alcohol hinders appraisal of social threat words in patients diagnosed with social phobia.","Gerlach, A L; Schiller, A; Wild, C; Rist, F",2006.0,,0,0,
6367,"Depression, anxiety and suicidal behaviour in children and adolescents with Haemophilia","ER It was aimed to study the prevalence of major depressive disorder, separation anxiety disorder and suicidal behaviour in the children and adolescents with haemophilia. A total of 83 children and adolescents with haemophilia A or B aged 5-19 years old were randomly selected using systematic random sampling method. They were interviewed using the Farsi (Persian) version of Kiddie Schedule for Affective Disorders and Schizophrenia by face-to-face interview with the subjects and their primary caregivers, according to the DSM-IV diagnostic criteria. Major depressive disorder, separation anxiety disorder and suicidal behaviour were surveyed. The rate of major depressive disorder was 6.0%. Approximately 2.4% of the patients were suffering from at least five symptoms of major depression, and 4.8% were suffering from more than five symptoms of major depressive disorder. One-third of the children and adolescents were suffering from irritability. Approximately 36% of the subjects wished to die at least once during the last 6 months. Also, 6% of the subjects had thought about suicidal attempt. Approximately 4.8% of them met the criteria of separation anxiety disorder. The incidences of major depressive disorder and separation anxiety disorder were comparable to that prevalent in the thalassaemic patients. The proportion of patients with death wish was very high. The proportion of patients with suicidal thought and attempt was much lower than that in the children and adolescents with thalassaemia. Therefore, psychiatric consultation needs to be included in the management of these children.","Ghanizadeh, A; Baligh-Jahromi, P",2009.0,10.1111/j.1365-2516.2008.01971.x,0,0,
6368,Traumatic and stressful events in early childhood: can treatment help those at highest risk?,"ER METHODS: Participants comprised 75 preschool-aged children and their mothers referred to treatment following the child's exposure to domestic violence. Dyads were randomly assigned to CPP or to a comparison group that received monthly case management plus referrals to community services and were assessed at intake, posttest, and 6-month follow-up. Treatment effectiveness was examined by level of child TSE risk exposure (<4 risks versus 4+ TSEs).RESULTS: For children in the 4+ risk group, those who received CPP showed significantly greater improvements in PTSD and depression symptoms, PTSD diagnosis, number of co-occurring diagnoses, and behavior problems compared to those in the comparison group. CPP children with <4 risks showed greater improvements in symptoms of PTSD than those in the comparison group. Mothers of children with 4+ TSEs in the CPP group showed greater reductions in symptoms of PTSD and depression than those randomized to the comparison condition. Analyses of 6-month follow-up data suggest improvements were maintained for the high risk group.CONCLUSIONS: The data provide evidence that CPP is effective in improving outcomes for children who experienced four or more TSEs and had positive effects for their mothers as well.PRACTICE IMPLICATIONS: Numerous studies show that exposure to childhood trauma and adversity has negative consequences for later physical and mental health, but few interventions have been specifically evaluated to determine their effectiveness for children who experienced multiple TSEs. The findings suggest that including the parent as an integral participant in the child's treatment may be particularly effective in the treatment of young children exposed to multiple risks.OBJECTIVE: This study involves a reanalysis of data from a randomized controlled trial to examine whether child-parent psychotherapy (CPP), an empirically based treatment focusing on the parent-child relationship as the vehicle for child improvement, is efficacious for children who experienced multiple traumatic and stressful life events (TSEs).","Ghosh, Ippen C; Harris, W W; Horn, P; Lieberman, A F",2011.0,10.1016/j.chiabu.2011.03.009,0,0,
6369,"Effect of lysine supplementation on health and morbidity in subjects belonging to poor peri-urban households in Accra, Ghana","ER OBJECTIVEThe objective was to investigate the effects of lysine supplementation on morbidity, growth, and anxiety in children and adults of peri-urban areas of Accra, Ghana.DESIGNIn a double-blind randomized trial, the effect of lysine supplementation (1 g lysine/d) compared with that of placebo was examined in 2 groups of men, women, and children (n = 271). Primary outcomes included diarrheal and respiratory morbidity, growth, and anxiety and complement C3, C-reactive protein, serum cortisol, transferrin, and ferritin values. Independent-sample t tests, odds ratios, generalized estimating equations, 4-parameter sinusoid regression, and generalized linear models were used.RESULTSThirty percent of men, 50% of women, and 15% of children were at risk of lysine inadequacy. Supplementation in children reduced diarrheal episodes [19 lysine, 35 placebo; odds ratio (OR): 0.52; 95% CI: 0.29, 0.92; P = 0.046] and the total number of days ill (21 lysine, 47 placebo; OR: 0.44; 95% CI: 0.26, 0.74; P = 0.034). Mean days ill per child per week (0.058 ± 0.039 lysine, 0.132 ± 0.063 placebo; P = 0.017) were negatively associated with weight gain with control for baseline weight and study group (P = 0.04). Men had fewer coryza episodes (23 lysine, 39 placebo; OR: 0.60; 95% CI: 0.36, 1.01; P = 0.05), total number of days ill (lysine: 130; placebo: 266; OR: 0.51; 95% CI: 0.28, 0.93; P = 0.03), and mean days ill per person per week (lysine: 0.21 ± 0.23; placebo: 0.41 ± 0.35; P = 0.04). Serum ferritin (P = 0.045) and C-reactive protein (P = 0.018) decreased in lysine-supplemented women but increased in placebo-supplemented women.CONCLUSIONLysine supplementation reduced diarrheal morbidity in children and respiratory morbidity in men in Ghana.BACKGROUNDLysine affects diarrhea and anxiety via effects on serotonin receptors, enhanced intestinal repair, and sodium chloride-dependent opioid peptide transport.","Ghosh, S; Smriga, M; Vuvor, F; Suri, D; Mohammed, H; Armah, S M; Scrimshaw, N S",2010.0,10.3945/ajcn.2009.28834,0,0,
6370,Results of an Italian school-based expressive writing intervention trial focused on peer problems,"ER This study investigated the effectiveness of an expressive writing intervention in a sample of Italian early adolescents on internalizing and post-traumatic stress symptoms and coping strategies. Participants were 153 Italian adolescents (48% male), attending 7th grade (M=12.24 yrs, SD=0.47). Youth were randomly assigned either to write about personal emotional events related to problems they recently experienced with peers, or trivial topics. Data were collected before and 2 months following the intervention. Analyses revealed no overall intervention effects on symptoms. However, level of peer victimization moderated the effects of the intervention on coping strategies, such that victimized youth in the intervention showed increases in cognitive restructuring and avoidance coping, relative to other groups. Thus, expressive writing affected coping strategies but not internalizing problems in our early adolescent sample.","Giannotta, F; Settanni, M; Kliewer, W; Ciairano, S",2009.0,10.1016/j.adolescence.2009.07.001,0,0,
6371,Relaxation to reduce dyspnea and anxiety in COPD patients,"ER The purpose of this study was to test the effectiveness of a taped relaxation message in reducing dyspnea and anxiety in chronic obstructive pulmonary disease (COPD) patients. Twenty-six adult COPD patients with dyspnea were randomly assigned to two groups. The treatment group was taught relaxation using a prerecorded tape while the control group was instructed to sit quietly. Skin temperature, heart rate, and respiratory rate were recorded for all subjects during a total of four weekly sessions. Anxiety, dyspnea, and airway obstruction were measured at the beginning and end of the study. The relaxation group achieved the preset relaxation criteria. Dyspnea, anxiety, and airway obstruction were reduced in the relaxation group while the control group remained the same or became worse.","Gift, A G; Moore, T; Soeken, K",1992.0,,0,0,
6372,The vasovagal response during confrontation with blood-injury-injection stimuli: the role of perceived control,"ER The vasovagal response (VVR) is a common medical problem, complicating and deterring people from various procedures. It is an unusual stress response given the widespread decreases in physiological activity. Nevertheless, VVR involves processes similar to those observed during episodes of strong emotions and pain. We hypothesized that heightened perceived control would reduce symptoms of VVR. Eighty-two young adults were randomly assigned to perceived control or no perceived control conditions during exposure to a stimulus video of a mitral valve surgery, known to trigger VVR in non-medical personnel. Perceived control was manipulated by allowing some participants to specify a break time, though all received equivalent breaks. Outcomes included subjective symptoms of VVR, anxiety, blood pressure, heart rate, and other measures derived from impedance cardiography. Compared to participants with perceived control, participants with no perceived control reported significantly more vasovagal symptoms and anxiety, and experienced lower stroke volume, cardiac output, and diastolic blood pressure. Participants who were more fearful of blood were more likely to benefit from perceived control in several measures. Perceived control appears to reduce vasovagal symptoms. Results are discussed in terms of cognition and emotion in VVR.","Gilchrist, P T; McGovern, G E; Bekkouche, N; Bacon, S L; Ditto, B",2015.0,10.1016/j.janxdis.2015.01.009,0,0,
6373,Individual differences in resting heart rate variability moderate thought suppression success,"ER Individual differences in heart rate variability (HRV) at rest are thought to represent an individual's capacity for self-regulation, but it remains unclear whether HRV predicts control over unwanted thoughts. The current study used a thought suppression paradigm in which participants recorded occurrences of a personally relevant intrusive thought over three monitoring periods. Among those instructed to suppress, higher levels of HRV were associated with greater declines in intrusions across the monitoring periods; no such relationship was found among those assigned to a control condition. Resting HRV also interacted with spontaneous thought suppression effort to predict intrusive thought frequency. In both cases, these HRV-related differences in thought suppression success predicted the generalized distress symptoms common to depression and anxiety. These findings enhance understanding of the relationships between HRV and cognitive control and highlight how individual differences in self-regulatory capacity impact thought suppression success and emotion regulation.","Gillie, B L; Vasey, M W; Thayer, J F",2015.0,10.1111/psyp.12443,0,0,
6374,The Child Anxiety Prevention Study: intervention model and primary outcomes,"ER The article presents the intervention model and primary outcomes of a preventive intervention designed to reduce anxiety symptoms and prevent the onset of anxiety disorders in the offspring of parents with anxiety disorders. Participants were 40 volunteer children (mean age = 8.94 years; 45% girls; 90% Caucasian) whose parents met criteria for a broad range of anxiety disorders. Families were randomly assigned to an 8-week cognitive-behavioral intervention, the Coping and Promoting Strength program (CAPS; n = 20) or a wait list control condition (WL; n = 20). Independent evaluators (IEs) conducted diagnostic interviews, and children and parents completed measures of anxiety symptoms. Assessments were conducted pre- and postintervention and 6 and 12 months after the postintervention assessment. On the basis of intent to treat analyses, 30% of the children in the WL group developed an anxiety disorder by the 1-year follow-up compared with 0% in the CAPS group. IE and parent-reported (but not child-reported) levels of anxiety showed significant decreases from the preintervention assessment to the 1-year follow-up assessment in the CAPS but not the WL group. Parental satisfaction with the intervention was high. Findings suggest that a family-based intervention may prevent the onset of anxiety disorders in the offspring of parents with anxiety disorders.","Ginsburg, G S",2009.0,10.1037/a0014486,0,0,
6375,Preventing Onset of Anxiety Disorders in Offspring of Anxious Parents: A Randomized Controlled Trial of a Family-Based Intervention,"ER Objective: The authors examined the efficacy of a familybased intervention to prevent the onset of anxiety disorders in offspring of anxious parents. Method: Participants were 136 families with a parent meeting DSM-IV criteria for an anxiety disorder and one child 6 13 years of age without an anxiety disorder. Families were randomly assigned to the family-based intervention (N=70) or to an information-monitoring control condition (N=66). All families were expected to complete assessments, administered by blind interviewers, at baseline, at the end of the intervention (or 8weeks after randomization) and at 6- and 12-month follow-ups. Onset of any anxiety disorder and anxiety symptom severity (assessed using the Anxiety Disorders Interview Schedule for Children) at 12 months were the primary and secondary outcome measures, respectively. Results: The incidence of child anxiety disorders was 31% in the control group and 5% in the intervention group (odds ratio=8.54, 95% CI=2.27, 32.06). At the 1-year follow-up, youths in the control group also had higher anxiety symptoms ratings than those in the intervention group. Effect sizes weremediumto large (0.81 at6monthsand0.57 at 12months for anxiety symptoms), and the number needed to treat was 3.9 at 12 months. Significant moderators included baseline levels of child anxiety; significant mediators were parental distress and modeling of anxiety. Child maladaptive cognitions and parental anxiety did not mediate outcomes. Conclusions: A brief psychosocial prevention program holds promise for reducing the 1-year incidence of anxiety disorders among offspring of anxious parents.","Ginsburg, G S; Drake, K L; Tein, J Y; Teetsel, R; Riddle, M A",2015.0,10.1176/appi.ajp.2015.14091178,0,0,
6376,Individual versus group family-focused cognitive-behaviour therapy for childhood anxiety: pilot randomized controlled trial,"ER METHODTwenty-nine clinically anxious children aged between 7 and 12 years were randomly allocated to either individual cognitive-behaviour therapy (ICBT) or group cognitive-behaviour therapy (GCBT).RESULTSAt post-treatment assessment 57% of children in the ICBT condition no longer met criteria for any anxiety disorder, compared to 47% of children in the GCBT condition. At 3 month follow up these improvements were retained with some weakening. By the 6 month follow up 50% of children in the ICBT compared to 53% of children in the GCBT condition were anxiety diagnosis free. In terms of questionnaire data, no significant differences were detected between the ICBT and GCBT conditions at any of the follow-up points. However, a significant treatment effect for time was found, with both self-reports and parent reports indicating a significant reduction over time in anxiety symptoms.CONCLUSIONOverall, results suggest that children with anxiety disorders appear to improve following a family-focused cognitive behavioural intervention, regardless of individual or group administration. The interpretation and potential clinical implications of these findings are discussed, together with the limitations of this study and suggestions for future research.OBJECTIVEThe aim of the present study was to compare the relative effectiveness of group and individual formats of a family-focused cognitive-behavioural intervention, for the treatment of childhood anxiety disorders.","Groot, J; Cobham, V; Leong, J; McDermott, B",2007.0,10.1080/00048670701689436,0,0,
6377,Preventing postsurgical dissatisfaction syndrome after rhinoplasty with propranolol: a pilot study,"ER METHODSThe authors theorized that the syndrome is analogous to the persistence of negative emotional memories seen in posttraumatic stress disorder. In trauma-exposed patients, the beta-adrenergic blocker propranolol, when given within a few hours of the traumatic event, may reduce the subsequent emotional strength of the traumatic memory. The authors hypothesized that giving propranolol to postrhinoplasty patients with the above early symptomatology would reduce the likelihood of postsurgical dissatisfaction syndrome.RESULTSA retrospective review of 1000 consecutive rhinoplasty patients identified 11 with early symptomatology. Of these 11 (not taking propranolol), nine (82 percent) developed postsurgical dissatisfaction syndrome. In addition, a prospective study was performed of nine additional patients with the same early symptomatology who were immediately treated with propranolol. In contrast, only three developed postsurgical dissatisfaction syndrome (p < 0.04). Results of a randomized, double-blind, placebo-controlled study of 50 additional postrhinoplasty patients suggests that propranolol's effect is not due to anxiolysis.CONCLUSIONSPropranolol given immediately after splint removal in anxious, unhappy cosmetic surgery patients may prevent postsurgical dissatisfaction syndrome. A double-blind study appears warranted.BACKGROUNDRhinoplasty patients are commonly anxious about their result when the splint is removed. A small group of them, however, are overtly unhappy with their appearance despite objectively satisfactory early results, cannot be reassured about their favorable long-term prognosis, and remain dissatisfied despite objectively satisfactory end results. The authors have termed this symptom complex ""postsurgical dissatisfaction syndrome."" In these patients, it seems that persistence of the original negative image of their appearance at the time of splint removal fails to yield to an improved self-image as healing progresses.","Gruber, R P; Roberts, C; Schooler, W; Pitman, R K",2009.0,10.1097/PRS.0b013e318199f63f,0,0,
6378,"Acute threat to the social self: shame, social self-esteem, and cortisol activity","ER METHODSPre- and poststressor emotion, self-esteem, heart rate, blood pressure, and salivary cortisol were compared in 81 participants randomly assigned to complete speech and mental arithmetic stress tasks with social evaluation present (n = 41) or absent (n = 40).RESULTSAs hypothesized, participants in the social evaluation condition exhibited greater increases in shame and greater decrements in social self-esteem. Other psychological states (eg, anxiety, performance self-esteem) did not show differential changes as a function of the social context. Salivary cortisol increased in social evaluation condition participants but did not increase in participants who performed the same tasks in the absence of social evaluation. Cortisol increases were greater in participants who experienced greater increases in shame and greater decreases in social self-esteem under social-self threat.CONCLUSIONThreat to the social self is an important elicitor of shame experience, decreases in social self-esteem and cortisol increases under demanding performance conditions. Cortisol changes may be specifically tied to the experience of emotions and cognitions reflecting low self-worth in this context.OBJECTIVEOur Social Self Preservation Theory asserts that situations which threaten the ""social self"" (ie, one's social value or standing) elicit increased feelings of low social worth (eg, shame), decrements in social self-esteem, and increases in cortisol, a hormone released by the hypothalamic-pituitary-adrenal axis. To test our theoretical premise, cognitive, emotional, and physiological responses to the performance of laboratory stressor tasks were compared in participants who performed these tasks in the presence or absence of social-self threat.","Gruenewald, T L; Kemeny, M E; Aziz, N; Fahey, J L",2004.0,10.1097/01.psy.0000143639.61693.ef,0,0,
6379,Working memory training improves cognitive function in VLBW preschoolers,"ER BACKGROUND AND OBJECTIVE: Preterm born children perform poorer than term peers on tests of attention and executive functions including working memory tests. Our aim was to evaluate if preterm born preschoolers with very low birth weight (VLBW) would benefit from a computerized working memory training program and if the training would have a generalizing effect on memory, learning, attention, behavior, and anxiety.METHODS: A prospective intervention study with a stepped wedge design where 20 VLBW preschoolers aged 5 to 6 years participated. The children trained with the Cogmed JM program for 10 to 15 minutes a day, 5 days a week over a 5-week period. Extensive neuropsychological assessment and parental questionnaires regarding behavior and anxiety were performed before and 4 weeks after intervention.RESULTS: The children improved significantly on trained (mean Start Index 42.1 [SD 6.3]), mean Max Index 60.6 [SD 5.7]), and nontrained working memory tasks (Spatial Span backward; 2.3 [before] to 3.6 [after training] [confidence interval {CI} -2.2 to -0.4] and Spatial Span total score; 6.4-8.3 [","Grunewaldt, K H; L√∏haugen, G C; Austeng, D; Brubakk, A M; Skranes, J",2013.0,10.1542/peds.2012-1965,0,0,
6380,The effect of educational interventions with siblings of hospitalized children,"ER METHODSA pretest-posttest experimental design was used with 50 subjects, ages 6-17 years, recruited from a children's hospital within a university medical center. Subjects were matched according to age, sex, and race, with 25 siblings each in the experimental and control groups. Siblings assigned to the experimental group received interventions from a standardized educational intervention protocol developed by the researcher. Interventions focused on teaching the sibling about hospitalization, illness or injury, and treatment for the patient, based on cognitive stages of development. All interventions were conducted by child life specialists on staff at the hospital with extensive training and experience in preparation and procedural teaching.RESULTSResults shows that siblings who received educational interventions had significantly lower anxiety levels after interventions, compared to siblings who did not receive interventions.CONCLUSIONThese findings have significant impact on children's health care and supporting family needs when a child is hospitalized.OBJECTIVEResearch has demonstrated that siblings of chronically ill children can experience significant emotional and behavior changes; however, few studies have looked at the specific impact of pediatric hospitalization on the nonhospitalized child. Studies also indicate that children who receive age-appropriate information are better equipped to handle the stress and anxiety often associated with hospitalization.This study explored whether siblings of hospitalized children who received educational interventions had lower anxiety levels compared to siblings who did not receive interventions.","Gursky, B",2007.0,10.1097/DBP.0b013e318113203e,0,0,
6381,imProving Outcomes after STroke clinical pilot trial protocol,"ER DESIGNA single-centre randomised, double-blind, pilot trial to prevent depression in patients with a recent (within 8 weeks) stroke presenting to hospital. Patients will be enrolled over 12 months and randomised to receive three trial-specific assessments (baseline, 3- and 6-month assessments of mood, HRQoL and social functioning), or three trial-specific assessments plus a postcard sent centrally in a sealed envelope at 1, 2, 3, 4 and 5 months after discharge from hospital. Blinded follow-up telephone assessments will be conducted for both groups. STUDY OUTCOMES AND SAMPLE SIZE: For the primary end-point the POST trial will have 80% power to detect a relative risk of 0.4 given an incidence of depression of 30%. For the secondary aims POST has 90% power to detect a difference of 3 points on the HADS depression subscale (assuming a standard deviation of 6 points) between randomised groups. This includes an inflation factor of 15% to account for patients lost to follow-up.DISCUSSIONEvidence of efficacy will determine whether a multi-centre, international trial is warranted.RATIONALEOne in three patients experience depression after stroke and this risk is consistent over time. A strategy to prevent depression that could be economically delivered to most stroke patients and ideally which also has a low likelihood of adverse events needs to be developed and evaluated. Aims POST aims to determine whether a simple intervention (postcards) prevents depression (Hospital Anxiety and Depression rating Scale, HADS depression subscale score > or =8) in patients with a recent stroke. Secondary end-points include reduced anxiety (HADS anxiety subscale score > or =8) and improved health-related quality of life in patients with a recent stroke.","Hackett, M L; Carter, G; Crimmins, D; Clarke, T; Maddock, K; Sturm, J W",2010.0,10.1111/j.1747-4949.2009.00388.x,0,0,
6382,Effects of interdisciplinary functional restoration treatment with cognitive behavior therapy in patients with chronic back pain: healthcare research in the context of selective contracts,"ER INTRODUCTION: The efficacy of functional restoration programs for the treatment of chronic back pain is well documented. Nevertheless, there are only a few such centres in Germany and few trials have been conducted in German-speaking regions to demonstrate that implementing such programs in everyday clinical settings with large numbers of patients is just as effective as in a research setting. The present study examined whether the positive effects of such programs can also be observed in the clinically relevant context of a standardized day clinic treatment regimen.MATERIAL AND METHODS: A total of 681 back pain patients in 2 German cities were examined at 4 measurement points (before and immediately after the program, as well as 6 and 12 months after treatment) using a comprehensive questionnaire on perceived pain and symptoms of anxiety and depression, as well as the work situation.RESULTS: In both cities significant and long-term improvements in back pain, pain-related impairment and degree of chronification were observed, as well as a high return-to-work rate after treatment. Hence, the quality of such programs was also confirmed for a large patient population.","Hafenbrack, K; Heinrich, M; Müller, G; Marnitz, U; Mallwitz, J; Klinger, R",2013.0,10.1007/s00482-013-1377-z,0,0,
6383,"Repetitive Transcranial Magnetic Stimulation (rTMS) improves symptoms and reduces clinical illness in patients suffering from OCD--Results from a single-blind, randomized clinical trial with sham cross-over condition","ER Objectives: Both psychotherapeutic and psychopharmacological methods are used in the treatment of patients suffering from obsessive-compulsive disorders (OCD), and both with encouraging but also mixed results. Here, we tested the hypothesis that repetitive Transcranial Magnetic Stimulation (rTMS) improves symptoms and reduces illness severity in patients suffering from treatment-resistant OCD. Methods: A total of 21 patients (57% females; mean age: M=35.8 years) suffering from treatment-resistant OCD were randomly assigned either to an rTMS-first-sham-second, or a sham-first-rTMS-second condition. Treatment sessions lasted for 4 weeks with five sessions per week, each of about 50min duration. Symptoms were assessed via both self- and expert-ratings. Results: Both self- and expert-reported symptom severity reduced in the rTMS condition as compared to the sham condition. Full- and partial responses were observed in the rTMS-condition, but not in the sham-condition. Conclusions: The pattern of results from this single-blind, sham- and cross-over design suggests that rTMS is a successful intervention for patients suffering from treatment-resistant OCD.","Haghighi, M; Shayganfard, M; Jahangard, L; Ahmadpanah, M; Bajoghli, H; Pirdehghan, A; Holsboer-Trachsler, E; Brand, S",2015.0,10.1016/j.jpsychires.2015.06.020,0,0,
6384,Dialogical Exposure with Traumatically Bereaved Bosnian Women: findings from a Controlled Trial,"ER METHODSOne-hundred and nineteen women whose husbands were either killed or registered as missing during the war in Bosnia and Herzegovina were quasi-randomized to seven sessions of group treatment with dialogical exposure or to an active control condition.RESULTSBoth interventions resulted in significant improvement from baseline to post-treatment for both kinds of loss, in terms of post-traumatic symptoms, general mental health and grief reactions, with the exception of depression and traumatic grief in the control condition. Regarding mean effect sizes (Cohen's d), pre-treatment to post-treatment improvements were moderate (d?=?0.56) for the dialogical exposure group and small (d?=?0.34) for the supportive group. Treatment gains were maintained at least until the 1-year follow-up. In controlled comparisons, dialogical exposure was superior concerning traumatic grief (Cohen's d?=?0.37) and post-traumatic avoidance (d?=?0.73) at post-treatment.CONCLUSIONSResults show that short-term dialogical exposure group treatment was moderately effective in treating traumatically bereaved women.KEY PRACTITIONER MESSAGEResearch attests to high levels of symptoms among post-war civil populations, in particular, when a loved one was killed, which can lead not only to trauma reactions but also to severe separation distress. Grieving the loss of a loved one is hampered if the death remains unconfirmed. Unconfirmed loss could be conceptualized as unfinished business in terms of Gestalt therapy, which offers empty-chair dialogue for resolving unfinished business and grief. Dialogical exposure therapy (DET) supports the client in gaining awareness of and expressing his or her inner dialogues concerning the traumatic event, using Gestalt empty-chair method. Short-term DET was effective in treating traumatically bereaved women but showed little additional effects in comparison with a supportive group treatment, so further research is warranted.OBJECTIVEIn this trial, we compared the relative efficacy of dialogical exposure group treatment using Gestalt empty-chair method with a supportive group in the treatment of symptoms stemming from traumatic loss in a post-war society.","Hagl, M; Powell, S; Rosner, R; Butollo, W",2015.0,10.1002/cpp.1921,0,0,
6385,Conscientiousness is modified by genetic variation in catechol-O-methyltransferase to reduce symptom complaints in IBS patients,"ER BACKGROUND: Attention to and perception of physical sensations and somatic states can significantly influence reporting of complaints and symptoms in the context of clinical care and randomized trials. Although anxiety and high neuroticism are known to increase the frequency and severity of complaints, it is not known if other personality dimensions or genes associated with cognitive function or sympathetic tone can influence complaints. Genetic variation in catechol-O-methyltransferase (COMT) is associated with anxiety, personality, pain, and response to placebo treatment. We hypothesized that the association of complaint reporting with personality might be modified by variation in the COMT val158met genotype.METHODS: We administered a standard 25-item complaint survey weekly over 3-weeks to a convenience sample of 187 irritable bowel syndrome patients enrolled in a placebo intervention trial and conducted a repeated measures analysis.RESULTS: We found that complaint severity rating, our primary outcome, was negatively associated with the personality measures of conscientiousness (? = -0.31 SE 0.11, P = 0.003) and agreeableness (? = -0.38 SE 0.12, P = 0.002) and was positively associated with neuroticism (? = 0.24 SE 0.09, P = 0.005) and anxiety (? = 0.48 SE 0.09, P < 0.0001). We also found a significant interaction effect of COMT met alleles (? = -32.5 SE 14.1, P = 0.021). in patients genotyped for COMT val158met (N  = 87) specifically COMT × conscientiousness (? = 0.73 SE 0.26, P = 0.0042) and COMT × anxiety (? = -0.42 SE 0.16, P = 0.0078) interaction effects.CONCLUSION: These findings potentially broaden our understanding of the factors underlying clinical complaints to include the personality dimension of conscientiousness and its modification by COMT.","Hall, K T; Tolkin, B R; Chinn, G M; Kirsch, I; Kelley, J M; Lembo, A J; Kaptchuk, T J; Kokkotou, E; Davis, R B; Conboy, L A",2015.0,10.1002/brb3.294,0,0,
6386,"Long-term outcomes of brief, intensive CBT for specific phobias: the negative impact of ADHD symptoms","ER METHODEighty-three children (ages 6-15, 47% female, 89% White) with a SP were randomly assigned to receive OST or EST. Follow up assessments occurred at 1 week, 6 months, 1 year, and 4 years. Hierarchical linear growth modeling (HLGM) was used to explore the association of parent-reported ADHD symptoms, the 2 treatment conditions (i.e., OST vs. EST), and the trajectory of change in the severity of the SP from pretreatment to the 4-year follow-up. Age, conduct problems and learning problems were controlled for in all analyses.RESULTSA greater immediate reduction in severity rating of the SP was observed in the OST compared to EST, whereas the trajectory of long-term outcomes was similar across conditions over time. Higher levels of ADHD symptoms predicted poor immediate and long-term treatment outcomes across treatment conditions. ADHD symptoms, however, did not moderate the relationship between treatment condition and immediate or long-term treatment outcomes.CONCLUSIONSThe results of the study need to be interpreted in light of several study limitations. However, if confirmed, the findings suggest that anxious youth with comorbid ADHD symptoms are less likely to benefit from brief, intensive psychotherapy and may require either longer, standard CBT treatment or adjunctive pharmacotherapy.OBJECTIVESThe objectives were twofold: (a) examine long-term treatment effects in youth receiving 1-session treatment (OST) or educational support (EST) for a specific phobia (SP) and (b) examine the differential predictive and moderation effects of attention-deficit/hyperactivity disorder (ADHD) symptoms on immediate and long-term outcomes following the interventions.","Halldorsdottir, T; Ollendick, T H",2016.0,10.1037/ccp0000088,0,0,
6387,"Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder: a Randomized, Double-Blind, Controlled Trial","ER Objective: In this study, we aimed to determine if stellate ganglion block (SGB) could reduce symptoms of posttraumatic stress disorder (PTSD) in comparison with sham therapy in military service members. Methods: In a randomized trial in which both participants and assessors were blind, participants with PTSD received either an SGB or a sham procedure. Posttraumatic stress disorder symptoms were measured using the CAPS (Clinician-Administered PTSD Scale) and self-report measures of PTSD, depression, anxiety, and pain. Subjects underwent assessment before the procedure and at 1 week, 1 month, and 3 months after the procedure. Patients receiving sham injections were allowed to cross over to the treatment group, and participants who maintained criteria for PTSD were allowed to receive a second SGB treatment. Results: Posttraumatic stress disorder, anxiety, and depression scores all showed improvement across time, but there was no statistically or clinically relevant difference in outcomes between the active and control groups. Individuals who crossed over from sham treatment to SGB similarly showed no greater improvement with the SGB treatment. Improvement in CAPS was greater with a second SGB treatment than after the first treatment. Conclusions: Although previous case series have suggested that SGB offers an effective intervention for PTSD, this study did not demonstrate any appreciable difference between SGB and sham treatment on psychological or pain outcomes. Future studies should examine if differences in treatment methods or patient population could allow individuals with PTSD to benefit from SGB, but current evidence does not support widespread or indiscriminant clinical use of the procedure for PTSD.","Hanling, S R; Hickey, A; Lesnik, I; Hackworth, R J; Stedje-Larsen, E; Drastal, C A; McLay, R N",2016.0,10.1097/AAP.0000000000000402,0,0,
6388,"Influence of co-morbid generalized anxiety disorder, panic disorder and personality disorders on the outcome of cognitive behavioural treatment of obsessive-compulsive disorder","ER This study examined co-morbid generalized anxiety disorder and/or panic disorder and personality disorders as predictors of treatment outcomes in adult outpatients with obsessive-compulsive disorder. The patients received exposure with response prevention (ERP) treatment with the addition of either elements of cognitive therapy (ERP+CT) or relaxation training (ERP+REL). It was hypothesized that the addition of cognitive interventions would yield better treatment outcomes for patients with co-morbid generalized anxiety disorder and/or panic disorder. It was also hypothesized that patients with any personality disorder would show less treatment gains in both conditions. Using intention-to-treat criteria, patients with generalized anxiety disorder and/or panic disorder co-morbidity showed less treatment gains at post-treatment across both treatment conditions. This group showed significantly more treatment gains in the ERP+CT condition at the post-treatment and the 12-month follow-up assessments compared with patients in the ERP+REL condition. However, this was not significant when comparing treatment completers. Patients with a co-morbid Cluster A or B personality disorder showed significantly less treatment gains in both treatment conditions at the 12-month follow-up assessment. Among treatment completers, patients with a Cluster C personality disorder showed significantly better outcomes at the post-treatment assessment in the ERP+REL treatment condition. These results, clinical implications, and the importance of further investigations are discussed.","Hansen, B; Vogel, P A; Stiles, T C; Götestam, K G",2007.0,10.1080/16506070701259374,0,0,
6389,Variability of clinical features in attacks of migraine with aura,"ER METHODSPatients with migraine (n?=?267) with typical visual aura in more than 30% of their attacks were enrolled from 16 centers for a clinical trial. Upon enrollment, patients provided a detailed retrospective description of the clinical features of their attacks of migraine. During the trial, clinical symptoms in migraine attacks starting with aura were recorded prospectively in 861 attacks.RESULTSRetrospectively reported visual aura symptoms were variable and often overlapping; the most common symptoms were dots or flashing lights, wavy or jagged lines, blind spots, and tunnel vision. Multiple patients reported more than one visual phenomenon. Approximately half of the patients reported nonvisual aura symptoms, the most common were numbness and tingling, followed by difficulty in recalling or speaking words. A significant percentage of patients also reported a change in olfaction. There were several inconsistencies between the features of prospectively recorded and retrospectively reported attacks. Headache, nausea, photophobia, and phonophobia were all less common in prospectively recorded attacks as compared with retrospective reporting. Nausea was prospectively recorded in only 51% of attacks and mostly with mild intensity. The occurrence and severity of nausea was reduced with advancing patient age. Phonophobia was not consistently recorded in conjunction with photophobia.CONCLUSIONThese findings are consistent with variable involvement of different brain regions during a migraine attack. The variable occurrence of nausea, and phonophobia in conjunction with photophobia, both defining features of migraine, may be an important consideration in designing clinical studies of migraine in which prospectively recorded attacks are diagnosed based on these clinical features.BACKGROUNDThere is significant variability in the clinical presentation of migraine, both among patients, and between attacks in an individual patient. We examined clinical features of migraine with aura in a large group of patients enrolled in a clinical trial, and compared retrospective migraine attack characteristics reported upon enrollment in the trial with those recorded prospectively in the trial.","Hansen, J M; Goadsby, P J; Charles, A C",2016.0,10.1177/0333102415584601,0,0,
6390,Social support attenuates presyncopal reactions to blood donation,"ER STUDY DESIGN AND METHODSA final sample of 65 men and women with fewer than three prior donations was randomly assigned to either donate blood as usual or donate with a supportive research assistant. Donors in the support condition were accompanied throughout the donation process by a female research assistant who provided encouragement, made reassuring remarks, and engaged in small talk. Donors in both conditions completed a series of questions to assess anxiety, experience of prefaint reactions, and willingness to provide a future donation.RESULTSCompared to standard donation controls, donors in the social support condition reported fewer prefaint reactions (F(1,61) = 9.15, p = 0.004, eta(2)= 0.13) and greater likelihood of donating again within the next year (Z =-1.70, p < 0.05, one-tailed).CONCLUSIONRelatively novice donors report reduced reactions to blood donation when accompanied by a supportive individual, suggesting that social support may be a simple strategy to enhance the donation experience and possibly increase donor retention.BACKGROUNDThe experience of unpleasant blood donation reactions (e.g., dizziness, nausea, and fainting) has been linked to negative attitudes about donation and decreased likelihood of repeat donation. Consequently, interventions to reduce the adverse effects of blood donation are important and likely to increase donor retention. Based on laboratory studies suggesting that social support attenuates both physical and psychological responses to stress, the present study hypothesized that the presence of a supportive person during the donation process may help reduce reactions.","Hanson, S A; France, C R",2009.0,10.1111/j.1537-2995.2008.02057.x,0,0,
6391,Attenuation of posttraumatic muscle catabolism and osteopenia by long-term growth hormone therapy,"ER SUMMARY BACKGROUND DATAThe hypermetabolic response to severe burn is associated with increased energy expenditure, insulin resistance, immunodeficiency, and whole body catabolism that persists for months after injury. Growth hormone is a potent anabolic agent and salutary modulator of posttraumatic metabolic responses.METHODSSeventy-two severely burned children were enrolled in a placebo-controlled double-blind trial investigating the effects of growth hormone (0.05 mg/kg per day) on muscle accretion and bone growth. Drug or placebo treatment began on discharge from the intensive care unit and continued for 1 year after burn. Total body weight, height, dual-energy x-ray absorptiometry, indirect calorimetry, and hormone values were measured at discharge, then at 6 months, 9 months, and 12 months after burn. Results were compared between groups.RESULTSGrowth hormone subjects gained more weight than placebo subjects at the 9-month study point; this disparity in weight gain continued to expand throughout the remainder of the study. Height also increased in the growth hormone group compared with controls at 12 months. Change in lean body mass was greater in those treated with growth hormone at 6, 9, and 12 months. Bone mineral content was increased at 9 and 12 months; this was associated with higher parathormone levels.CONCLUSIONSLow-dose recombinant human growth hormone successfully abates muscle catabolism and osteopenia induced by severe burn.OBJECTIVETo determine whether the beneficial effects of growth hormone persist throughout the prolonged hypermetabolic and hypercatabolic response to severe burn.","Hart, D W; Herndon, D N; Klein, G; Lee, S B; Celis, M; Mohan, S; Chinkes, D L; Wolf, S E",2001.0,,0,0,
6392,Anger self-management in chronic traumatic brain injury: protocol for a psycho-educational treatment with a structurally equivalent control and an evaluation of treatment enactment,"ER Anger and irritability are important and persistent clinical problems following traumatic brain injury (TBI). Treatment options include medications, behavioral modification, and psychotherapies, but some are impractical and none have proven efficacy with this population. We describe a randomized multi-center clinical trial testing a novel, one-on-one, 8-session psychoeducational treatment program, Anger Self-Management Training (ASMT), designed specifically for people with TBI who have significant cognitive impairment. The trial is notable for its use of a structurally equivalent comparison treatment, called Personal Readjustment and Education (PRE), which was created for the study and is intended to maximize equipoise for both participants and treaters. Fidelity assessment is conducted in real time and used in therapist supervision sessions. The primary outcome is change in self-reported anger on validated measures from pre-treatment to 1. week after the final session. Secondary outcomes include participant anger as reported by a significant other; emotional distress in domains other than anger/irritability; behavioral functioning; and quality of life. An interim assessment after the 4th session will allow examination of the trajectory of any observed treatment effects, and a follow-up assessment 2. months after the end of intervention will allow examination of persistence of effects. A treatment enactment phase, in which participants are interviewed several months after the last therapy session, is designed to provide qualitative data on whether and to what extent the principles and techniques learned in treatment are still carried out in daily life.","Hart, T; Brockway, J A; Fann, J R; Maiuro, R D; Vaccaro, M J",2015.0,10.1016/j.cct.2014.12.005,0,0,
6393,Randomized controlled trial of a telephone intervention by nurses to provide information and support to patients and their partners after elective coronary artery bypass graft surgery: effects of anxiety,"ER DESIGNThe study is a randomized controlled trial. Intervention began at discharge; 6 telephone calls were made to patients and partners over 7 weeks. Primary outcome was Beck Anxiety Inventory measured at baseline in hospital, at home on day 3, week 4, and week 8.SAMPLEThe subjects were 131 patients who have undergone elective coronary artery bypass graft surgery and their partners.RESULTSPatients' anxiety was moderate to severe the day before discharge. It was significantly lower in the treatment group than in the control group at day 2 at home. Partners always had lower anxiety than patients. A more sustained decrease in anxiety in the partner treatment group was found at both day 2 and week 4.CONCLUSIONIntervention effect is in the early period after discharge-- the time most affected by reduced lengths of stay.OBJECTIVEThe purpose of this study was to determine the effectiveness of an information and support telephone intervention for reducing anxiety in patients who have undergone coronary artery bypass graft surgery and their partners.","Hartford, K; Wong, C; Zakaria, D",2002.0,,0,0,
6394,"Physical activity, bodyweight, health and fear of negative evaluation in primary school children","ER Fear of negative evaluation (FNE) is regarded as being the core feature of social anxiety. The present study examined how FNE is associated with physical activity (PA), body mass index (BMI) and perceived physical health (PPH) in children. Data were collected in a sample of 502 primary school children in first and fifth grades taking part in a randomized-controlled trial (""Kinder-Sportstudie KISS"") aimed at increasing PA and health. PA was assessed by accelerometry over 7 days, PPH by the Child Health Questionnaire and FNE by the Social Anxiety Scale for Children--Revised. BMI z-scores were calculated based on Swiss norms. Cross-sectional analyses indicated that children high in FNE exercised less, reported lower levels of PPH and had higher BMI z-scores (P<0.01). Using mixed linear models, the school-based PA intervention did not manage to reduce FNE scores. Overweight children demonstrated a greater increase in FNE (P<0.05) indicating that enhanced weight may be a risk factor for FNE. In conclusion, the associations among high FNE, low PA and increased BMI should be considered when promoting an active lifestyle in children.","Hartmann, T; Zahner, L; Pühse, U; Schneider, S; Puder, J J; Kriemler, S",2010.0,10.1111/j.1600-0838.2009.00888.x,0,0,
6395,Can ambient orange fragrance reduce patient anxiety during surgical removal of impacted mandibular third molars?,"ER PURPOSE: To investigate whether ambient orange fragrance, compared with no fragrance, can reduce patient anxiety before and during surgical removal of an impacted mandibular third molar.MATERIALS AND METHODS: In the present randomized clinical trial, the patients who required extraction of an impacted mandibular third molar and fulfilled the predetermined criteria were included. A dental anxiety scale (DAS) questionnaire was used to determine the anxiety level of the patients before surgery. Only patients with moderate and high anxiety levels (DAS scale ? 9 to ? 14) were included. The predictor variable was fragrance exposure. The fragrance group was exposed to orange fragrance, and the control group was exposed to no fragrance. The outcome variables were physiologic measures related to anxiety, including the mean blood pressure, respiratory rate, and pulse rate. The physiologic vital changes were determined before and during the surgical procedure. The data were analyzed using the independent t test, ?(2) test, and Mann-Whitney U test (Statistical Package for Social Sciences, version 16; ? = 0.05).RESULTS: A total of 56 patients fulfilled the inclusion criteria (fragrance group, 19 males and 9 females; no-fragrance group, 12 males and 16 females). Before entering the waiting room, the patients' vital signs were recorded twice. No significant differences were found between the 2 groups. The mean blood pressure, pulse rate, and respiratory rate were significantly lower in the fragrance group during surgery (from sitting in the dental chair to the end of surgery; P < .05).CONCLUSIONS: The results of our study have shown that orange fragrance is effective in reducing the anxiety related to surgical removal of an impacted mandibular third molar.","Hasheminia, D; Kalantar, Motamedi M R; Karimi, Ahmadabadi F; Hashemzehi, H; Haghighat, A",2014.0,10.1016/j.joms.2014.03.031,0,0,
6396,Social identification moderates cognitive health and well-being following story- and song-based reminiscence,"ER OBJECTIVES: Reminiscence is a popular intervention for seniors, but, with mixed evidence supporting its efficacy, questions have been raised about the mechanisms underlying improvement. The present paper addresses this question by investigating the degree to which health effects depend on the development of a shared sense of group identification. This is examined in the context of traditional story-based reminiscence as well as novel forms of song-based reminiscence.METHOD: As the focus of a manualized intervention, 40 participants were randomly assigned to secular song (n=13), religious song (n=13), or standard story reminiscence (n=14) groups. These were run over six weeks with cognitive performance, anxiety, and life satisfaction measured before and after the intervention. Measures of group fit were included to examine whether social identification contributed to outcomes.RESULTS: No evidence of change emerged over time as a function of intervention form alone, but analysis of identification data revealed significant interactions with the type of reminiscence group. Specifically, initial fit with the story reminiscence group was associated with enhanced cognitive outcomes and greater life satisfaction, while fit with the religious song reminiscence group was associated with greater life satisfaction and less anxiety.CONCLUSION: These findings show that group identification is a key moderator through which reminiscence promotes health outcomes. Implications for theory and practice highlight an inherent limitation in randomized controlled trials insofar as they may compromise participants' group identification.","Haslam, C; Haslam, S A; Ysseldyk, R; McCloskey, L G; Pfisterer, K; Brown, S G",2014.0,10.1080/13607863.2013.845871,0,0,
6397,"Exercise for health: a randomized, controlled trial evaluating the impact of a pragmatic, translational exercise intervention on the quality of life, function and treatment-related side effects following breast cancer","ER Exercise for Health was a randomized, controlled trial designed to evaluate two modes of delivering (face-to-face [FtF] and over-the-telephone [Tel]) an 8-month translational exercise intervention, commencing 6-weeks post-breast cancer surgery (PS). Outcomes included quality of life (QoL), function (fitness and upper body) and treatment-related side effects (fatigue, lymphoedema, body mass index, menopausal symptoms, anxiety, depression and pain). Generalised estimating equation modelling determined time (baseline [5 weeks PS], mid-intervention [6 months PS], post-intervention [12 months PS]), group (FtF, Tel, Usual Care [UC]) and time-by-group effects. 194 women representative of the breast cancer population were randomised to the FtF (n = 67), Tel (n = 67) and UC (n = 60) groups. There were significant (p < 0.05) interaction effects on QoL, fitness and fatigue with differences being observed between the treatment groups and the UC group. Trends observed for the treatment groups were similar. The treatment groups reported improved QoL, fitness and fatigue over time and changes observed between baseline and post-intervention were clinically relevant. In contrast, the UC group experienced no change, or worsening QoL, fitness and fatigue, mid-intervention. Although improvements in the UC group occurred by 12-months post-surgery, the change did not meet the clinically relevant threshold. There were no differences in other treatment-related side effects between groups. This translational intervention trial, delivered either FtF or Tel, supports exercise as a form of adjuvant breast cancer therapy that can prevent declines in fitness and function during treatment and optimise recovery post-treatment.","Hayes, S C; Rye, S; Disipio, T; Yates, P; Bashford, J; Pyke, C; Saunders, C; Battistutta, D; Eakin, E",2013.0,10.1007/s10549-012-2331-y,0,0,
6398,Effect of intensive acupuncture on pain-related social and psychological variables for women with chronic neck and shoulder pain--an RCT with six month and three year follow up,"ER METHODSTwenty-four female office workers (47 +/- 9 years old, mean +/- SD) who had had neck and shoulder pain for 12 +/- 9 years, were randomly assigned to a test group or a control group. Acupuncture was applied 10 times during three to four weeks either at presumed acupuncture points for pain (test group) or at sham points (control group). In addition, acupressure was given to patients between treatments, at either real or sham points. Questionnaires for social and psychological variables were completed before each treatment, just after the course, and six months and three years later.RESULTSThe pain-related activity impairment at work was significantly less in the test group than the controls by the end of treatment (P < 0.04). Also there were significant differences between the groups for quality of sleep, anxiety, depression and satisfaction with life (P < 0.05). At six months and three years follow ups the acupuncture group showed further improvements in most variables and was again significantly different from the control group.CONCLUSIONIntensive acupuncture treatment may improve activity at work and several relevant social and psychological variables for women with chronic pain in the neck and shoulders. The effect may last for at least three years.OBJECTIVESThis study examines whether intensive acupuncture treatment can improve several social and psychological variables for women with chronic pain in the neck and shoulders, and whether possible effects are long-lasting. The effects on pain have been reported elsewhere.","He, D; H√∏stmark, A T; Veiersted, K B; Medb√∏, J I",2005.0,,0,0,
6399,Sudden gains in internet-based cognitive behaviour therapy for severe health anxiety,"ER OBJECTIVE: A sudden gain is defined as a large and stable individual improvement occurring between two consecutive treatment sessions. Sudden gains have been shown to predict better long-term improvement in several treatment studies, including cognitive behavioural therapy for depression and anxiety disorders, but have not been studied in the treatment of health anxiety or any form of internet-based cognitive behavioural therapy. The aim of this study was to investigate the role of sudden gains in internet-based cognitive behavioural therapy for severe health anxiety.METHOD: We examined the occurrence and significance of sudden gains in measures of health anxiety in 81 participants receiving internet-based cognitive behavioural therapy. We compared patients with sudden gains, patients without sudden gains, and patients with gradual gains.RESULTS: Thirteen participants (16%) experienced one sudden gain in health anxiety with individual sudden gains distributed across the treatment. As expected, patients with a sudden gain showed larger improvements than patients without a sudden gain at post-treatment (d = 1.04) and at one-year follow-up (d = 0.91) on measures of health anxiety.CONCLUSIONS: Consistent with previous studies, sudden gains in internet-based cognitive behavioural therapy are associated with significantly larger and stable treatment effects up to one-year follow-up.","Hedman, E; Lekander, M; Ljótsson, B; Lindefors, N; Rück, C; Hofmann, S G; Andersson, E; Andersson, G; Schulz, S M",2014.0,10.1016/j.brat.2013.12.007,0,0,
6400,Study protocol for a multi-component kindergarten-based intervention to promote healthy diets in toddlers: a cluster randomized trial,"ER METHODS: This is an ongoing, cluster randomized trial. The intervention finished in 2014, but follow-up data collection is not yet complete. Eighteen randomly selected kindergartens located in two counties in Norway with enrolled children born in 2012 participated in the intervention. The kindergartens were matched into pairs based on background information, and randomly assigned to the intervention or control groups. A 9-week multi-component intervention was implemented, with four main elements: 1) kindergarten staff implemented a pedagogical tool (Sapere method) in daily sessions to promote willingness to try new food; 2) kindergarten staff prepared and served the toddlers a cooked lunch from a menu corresponding to the pedagogical sessions; 3) kindergarten staff were encouraged to follow 10 meal principles on modeling, responsive feeding, repeated exposure, and enjoyable meals; and 4) parents were encouraged to read information and apply relevant feeding practices at home. The control group continued their usual practices. Preference taste tests were conducted to evaluate behavioral food neophobia, and children's height and weight were measured. Parents and staff completed questionnaires before and after the intervention. Data have not yet been analyzed.DISCUSSION: This study provides new knowledge about whether or not a Sapere-sensory education and healthy meal intervention targeting children, kindergarten staff, and parents will: reduce levels of food neophobia in toddlers; improve parental and kindergarten feeding practices; improve children's dietary variety; and reduce childhood overweight and obesity.TRIAL REGISTRATION: ISRCTN74823448 DOI 10.1186/ISRCTN74823448.BACKGROUND: There is concern about the lack of diversity in children's diets, particularly low intakes of fruit and vegetables and high intakes of unhealthy processed food. This may be a factor in the rising prevalence of obesity. A reason for the lack of diversity in children's diets may be food neophobia. This study aimed to promote a healthy and varied diet among toddlers in kindergarten. The primary objectives were to reduce food neophobia in toddlers, and promote healthy feeding practices among kindergarten staff and parents. Secondary objectives were to increase food variety in toddlers' diets and reduce future overweight and obesity in these children.","Helland, S H; Bere, E; √òverby, N C",2016.0,10.1186/s12889-016-2952-x,0,0,
6401,Comparison of a high-intensity and a low-intensity lumbar extensor training program as minimal intervention treatment in low back pain: a randomized trial,"ER In a randomized, observer-blinded trial, the effectiveness of 3-month high-intensity training (HIT) of the isolated lumbar extensors was compared to low-intensity training (LIT). Eighty-one workers with nonspecific low back pain longer than 12 weeks were randomly assigned to either of the two training programs. Training sessions were performed on a modified training device that isolated the lower back extensors. Total intervention time was limited to 5-10 min (one or two training sessions) per week. Training effects were assessed in terms of changes in self-rated degree of back complaints, functional disability, and general, physical and mental health. Secondary outcomes in this study were muscle strength and fear of moving the back (kinesiophobia). Outcomes were evaluated at 1,2, 3, 6, and 9 months after randomization. The results showed that the two treatment programs led to comparable improvements in all outcome measures, except for mean isometric strength at 1, 2, 3, 6, and 9 months and kinesiophobia score at 2 and 9 months of follow-up. The high-intensity training group showed a higher strength gain (24 to 48 Nm) but a smaller decline in kinesiophobia (2.5 and 3.4 points, respectively), compared to the low-intensity training group. It can be concluded that high-intensity training of the isolated back extensors was not superior to a non-progressive, low-intensity variant in restoring back function in nonspecific (chronic) low back pain. In further research, emphasis should be put on identifying subgroups of patients that will have the highest success rate with either of these training approaches.","Helmhout, P H; Harts, C C; Staal, J B; Candel, M J; Bie, R A",2004.0,10.1007/s00586-004-0671-y,0,0,
6402,Yohimbine and the model anxiety state,"ER Ten subjects were treated with 30 and 60 mg oral doses of yohimbine hydrochloride or placebo under controlled clinical conditions to determine if such doses would create a ""model anxiety state."" Some evidence of anxiety was found on various rating scales, especially after the 60 mg dose. However, maximum anxiety produced by this dose of the drug exceeded that which occurred during placebo testing in only 5 of the 10 subjects. The 60 mg dose produced substantial increases in systolic blood pressure and less increase in diastolic blood pressure and pulse rate. It was concluded that yohimbine does not produce a very good model of anxiety.","Henauer, S A; Gillespie, H K; Hollister, L E",1984.0,,0,0,
6403,Cognitive behavior therapy for generalized social anxiety disorder in adolescents: a randomized controlled trial,"ER Early identification and treatment of social anxiety disorder (SAD) is critical to prevent development of a chronic course of symptoms, persistent functional impairment, and progressive psychiatric comorbidity. A small but growing literature supports the effectiveness of cognitive behavior therapy (CBT) for anxiety disorders, including SAD, in adolescence. The present randomized controlled trial evaluated the efficacy of group vs. individual CBT for adolescents with generalized SAD in relation to an educational/supportive psychotherapy that did not contain specific CBT elements. All three treatments were associated with significant reductions in symptoms and functional impairment, and in improved social skills. No differences between treatments emerged on measures of symptoms, but the CBT conditions demonstrated greater gains on behavioral measures. The implications of the findings are discussed.","Herbert, J D; Gaudiano, B A; Rheingold, A A; Moitra, E; Myers, V H; Dalrymple, K L; Brandsma, L L",2009.0,10.1016/j.janxdis.2008.06.004,0,0,
6404,Reduced intra-individual reaction time variability during a Go-NoGo task in detoxified alcohol-dependent patients after one right-sided dorsolateral prefrontal HF-rTMS session,"ER AIMS: As alcohol dependency is characterized by severe executive function deficits, we examined the influence of high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) applied to the right dorsolateral prefrontal cortex (DLPFC) on executive functioning in recently detoxified alcohol-dependent patients.METHODS: In this randomized, single blind, sham (placebo)-controlled, crossover study, we included 50 detoxified alcohol-dependent patients. We examined the effect of a single right DLPFC HF-rTMS session on commission errors, mean reaction times (RTs) and intra-individual reaction time variability (IIRTV) during a Go-NoGo task (50% Go/50% NoGo condition) in 29 alcohol-dependent patients. Patients completed this cognitive task immediately before and immediately after the stimulation session. In order to avoid carry-over effects between stimulation sessions, a 1-week inter-session interval was respected. Because rTMS treatment has been shown to affect subjective craving, all patients were also assessed with the Obsessive Compulsive Drinking Scale (OCDS).RESULTS: After both stimulation conditions, we observed a significant decrease of commission errors, without differences between active and sham HF-rTMS stimulation. No significant difference was observed between active and sham stimulation on mean RT. However, only active stimulation resulted in a significant decrease in IIRTV. No effects of stimulation were found for the craving measurements.CONCLUSION: Our findings suggest that in recently detoxified alcohol-dependent patients, one right-sided HF-rTMS session stabilizes cognitive performance during executive control tasks, implying that active stimulation reduces patients' proneness to attentional lapses.","Herremans, S C; Vanderhasselt, M A; Raedt, R; Baeken, C",2013.0,10.1093/alcalc/agt054,0,0,
6405,The combined predictive effect of patient characteristics and alliance on long-term dynamic and interpersonal functioning after dynamic psychotherapy,"ER On the basis of the well-established association between early alliance and outcome, this exploratory study investigated the associations between the therapeutic alliance and long-term outcome, 3 years after treatment termination. In addition to the early alliance, pre-treatment patient characteristics and expectancies that were significantly related to early alliance were included in the statistical analyses. The data are from the First Experimental Study of Transference, a dismantling randomized clinical trial with long-term follow-up. One hundred out-patients who sought psychotherapy due to depression, anxiety and personality disorders were treated. Alliance was measured with Working Alliance Inventory after session 7. Change was determined using linear mixed model analyses. The alliance alone had a significant impact on long-term outcome of the predetermined primary outcome variables of the study: Psychodynamic Functioning Scales and Inventory of Interpersonal Problems. Contrary to common clinical wisdom, when the pre-treatment patient variables were included, more personality disorder pathology was the strongest predictor of favourable outcome, over and above the effect of the alliance, which was no longer significant. Clinical implications are discussed.","Hersoug, A G; H√∏glend, P; Gabbard, G O; Lorentzen, S",2013.0,10.1002/cpp.1770,0,0,
6406,Effectiveness of cognitive behavioural therapy (CBT) interventions for anxiety in patients with chronic obstructive pulmonary disease (COPD) undertaken by respiratory nurses: the COPD CBT CARE study: (ISRCTN55206395),"ER BACKGROUND: Anxiety and depression are common co-morbidities in patients with chronic obstructive pulmonary disease (COPD). Serious implications can result from psychological difficulties in COPD including reduced survival, lower quality of life, and reduced physical and social functioning, increased use of health care resources and are associated with unhealthy behaviours such as smoking. Cognitive behavioural therapy (CBT) is a psychological intervention which is recommended for the treatment of many mental health problems including anxiety and depression. Unfortunately access to trained CBT therapists is limited. The aim of this study is to test the hypothesis that CBT delivered by respiratory nurses is effective in the COPD population. In this paper the design of the Newcastle Chronic Obstructive Pulmonary Disease Cognitive Behavioural Therapy Study (Newcastle COPD CBT Care Study) is described.METHODS/DESIGN: This is a prospective open randomised controlled trial comparing CBT with self-help leaflets. The primary outcome measure is the Hospital Anxiety & Depression Scale (HADS) - anxiety subscale. Secondary outcome measures include disease specific quality of life COPD Assessment Tool (CAT), generic quality of life (EQ5D) and HADS-depression subscale. Patients will be followed up at three, six and 12 months following randomisation.DISCUSSION: This is the first randomised controlled trial to evaluate the use of cognitive behavioural therapy undertaken by respiratory nurses. Recruitment has commenced and should be complete by February 2014.TRIAL REGISTRATION: Current Controlled Trials, ISRCTN55206395.","Heslop, K; Newton, J; Baker, C; Burns, G; Carrick-Sen, D; Soyza, A",2013.0,10.1186/1471-2466-13-62,0,0,
6407,A validity study of the SSAGA--a comparison with the SCAN,"ER METHODSubjects included 38 men and 42 women volunteers from another study and from an outpatient psychiatry clinic. Selected sections of both the SSAGA and the SCAN interviews were administered to all subjects, approximately 1 week apart, in a randomized order. Because the SCAN does not assess Antisocial Personality Disorder (ASPD), the ASPD section of the Structured Clinical Interview for DSM-III-R (SCID) was substituted for this comparison.RESULTSThe Kappa statistic was used to measure concordance between the two instruments. Kappa for alcohol dependence was in the acceptable range (0.63). Kappas were lower for sedative dependence (0.48) and for cannabis dependence (0.53), but higher for cocaine and stimulant dependence (0.85) and for opioid dependence (0.73). Kappa for major depression and the ASPD diagnoses were high (0.71 and 0.70), but slightly lower agreement was found for panic disorder (0.62). Kappa for social phobia was 0.47.CONCLUSIONThese data, combined with results from two previous studies which examined reliability, indicate that the SSAGA is a highly reliable and valid instrument for use in studies of a variety of psychiatric disorders, including alcohol and drug dependence.OBJECTIVEThis study examined the concurrent diagnostic validity of the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) across alcohol and drug dependencies, major depression, anxiety disorders and ASPD. The Schedule for Clinical Assessment in Neuropsychiatry (SCAN) was selected as the comparison instrument because it arises from a different tradition and uses a different format for its administration. The SCAN has been shown to be valid and applicable cross-culturally.","Hesselbrock, M; Easton, C; Bucholz, K K; Schuckit, M; Hesselbrock, V",1999.0,,0,0,
6408,Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders: a preliminary randomized controlled trial,"ER Although adults with autism spectrum disorder are an increasingly identified patient population, few treatment options are available. This preliminary randomized controlled open trial with a parallel design developed two group interventions for adults with autism spectrum disorders and intelligence within the normal range: cognitive behavioural therapy and recreational activity. Both interventions comprised 36 weekly 3-h sessions led by two therapists in groups of 6-8 patients. A total of 68 psychiatric patients with autism spectrum disorders participated in the study. Outcome measures were Quality of Life Inventory, Sense of Coherence Scale, Rosenberg Self-Esteem Scale and an exploratory analysis on measures of psychiatric health. Participants in both treatment conditions reported an increased quality of life at post-treatment (d = 0.39, p < 0.001), with no difference between interventions. No amelioration of psychiatric symptoms was observed. The dropout rate was lower with cognitive behavioural therapy than with recreational activity, and participants in cognitive behavioural therapy rated themselves as more generally improved, as well as more improved regarding expression of needs and understanding of difficulties. Both interventions appear to be promising treatment options for adults with autism spectrum disorder. The interventions' similar efficacy may be due to the common elements, structure and group setting. Cognitive behavioural therapy may be additionally beneficial in terms of increasing specific skills and minimizing dropout.","Hesselmark, E; Plenty, S; Bejerot, S",2014.0,10.1177/1362361313493681,0,0,
6409,Psychological and physical activity training for older persons: who does not attend?,"ER OBJECTIVETo identify demographic, physical and psychological determinants of attendance of older subjects following multifaceted psychological training - aimed at promoting active social participation - and physical activity training and to compare the variation of these determinants between the two training programs.METHOD118 subjects aged 65-92 years were randomized over psychological and physical activity training. Determinants of attendance were obtained at pretest with questionnaires and performance-based tests.RESULTSMean attendance was 62%. Attendance was not related to type of program. Having chronic diseases facilitated attendance in the psychological training group and limited attendance in the physical activity training group. Low and high levels of Activities of Daily Living performance (ADLs) and walking endurance were related to a high attendance in the psychological training group. A low level of activities of daily living (ADL) and a low walking endurance were related to a low attendance in the physical activity training group. For both training groups, persons living with a partner had higher attendance rates than persons living alone, and persons with a low level of anxiety had higher attendance rates than persons with a moderate or a high level of anxiety.CONCLUSIONPsychological training may be more suitable for frail older persons with chronic diseases, low ADL levels and low walking endurance than physical activity training, and may help to prepare such persons for physical activity.BACKGROUNDInterventions to promote successful aging include psychological and physical activity programs. Identification of determinants of attendance of older persons may be useful to develop strategies to improve attendance. For physical activity programs determinants of attendance have been investigated extensively. For psychological programs hardly any knowledge is available. Determinants of attendance at psychological and physical activity programs have never been investigated simultaneously.","Heuvelen, M J; Hochstenbach, J B; Brouwer, W H; Greef, M H; Scherder, E",2006.0,10.1159/000094986,0,0,
6410,The effectiveness of high-intensity versus low-intensity back schools in an occupational setting: a pragmatic randomized controlled trial,"ER OBJECTIVESTo compare high- and low-intensity back schools with usual care in occupational health care.SUMMARY OF BACKGROUND DATAThe content and intensity of back schools vary widely and the methodologic quality of randomized controlled trials is generally weak. Until now, no back school has proven to be superior for workers sick-listed because of subacute nonspecific low back pain.METHODSWorkers (n = 299) sick-listed for a period of 3 to 6 weeks because of nonspecific low back pain were recruited by the occupational physician and randomly assigned to a high-intensity back school, a low-intensity back school, or care as usual. Outcome measures were days until return to work, total days of sick-leave, pain, functional status, kinesiophobia, and perceived recovery and were assessed at baseline and at 3 and 6 months of follow-up. Principal analyses were performed according to the intention-to-treat principle.RESULTSWe randomly allocated 299 workers. Workers in the low-intensity back school returned to work faster compared with usual care and the high-intensity back school, with hazard ratios of 1.4 (P = 0.06) and 1.3 (P = 0.09), respectively. The comparison between high-intensity back school and usual care resulted in a hazard ratio of 1.0 (P = 0.83). The median number of sick-leave days was 68, 75, and 85 in the low-intensity back school, usual care, and high-intensity back school, respectively. Beneficial effects on functional status and kinesiophobia were found at 3 months in favor of the low-intensity back school. No substantial differences on pain and perceived recovery were found between groups.CONCLUSIONSThe low-intensity back school was most effective in reducing work absence, functional disability, and kinesiophobia, and more workers in this group scored a higher perceived recovery during the 6-month follow-up.STUDY DESIGNRandomized controlled trial.","Heymans, M W; Vet, H C; Bongers, P M; Knol, D L; Koes, B W; Mechelen, W",2006.0,10.1097/01.brs.0000216443.46783.4d,0,0,
6411,Evaluation of child therapy and caregiver training in the treatment of school refusal,"ER METHODSixty-one school-refusing children (aged 7-14 years) from throughout Melbourne, Australia, were randomized to a child therapy program, a parent and teacher training program, or a combination of the two. Children were assessed before and after treatment, and at 4.5-month follow-up, by means of attendance records, self-report of emotional distress and self-efficacy, parent and teacher reports of emotional distress, and clinician ratings of overall functioning.RESULTSStatistically and clinically significant pretreatment-posttreatment change occurred for each group. Immediately posttreatment, child therapy appeared to be the least effective in increasing attendance. By follow-up, the attendance and adjustment of those in the child therapy group equalled that of children whose parents and teachers were involved in treatment, whether on their own (parent/teacher training) or together with their children (combined child therapy and parent/teacher training).CONCLUSIONContrary to expectations, combined child therapy and parent/teacher training did not produce better outcomes at posttreatment or follow-up.OBJECTIVETo evaluate the relative efficacy of (1) child therapy, (2) parent/teacher training, and (3) the combination of child therapy and parent/teacher training in the treatment of anxiety-based school refusal.","Heyne, D; King, N J; Tonge, B J; Rollings, S; Young, D; Pritchard, M; Ollendick, T H",2002.0,10.1097/00004583-200206000-00008,0,0,
6412,Attitudes toward aging as a function of in-service training and practitioner age,"ER Age differences in attitudes toward aging were investigated as a function of a 3-hour training program with 322 women (18-74 years) from various geriatric health care and social service contexts. Using a quasi-experimental pre- and posttest design, sites were randomly divided into initial experimental and control groups, with all control participants receiving training following the research program. Results indicated few instances of unfavorable attitudes toward aging in any age group, with younger women evidencing less cynicism toward aging, less social distance from the aged, and slightly less stereotyping. Training appeared to result in less cynicism, stronger endorsements of family and public responsibility, and slightly greater anxiety. No Age X Pretest/Posttest interactions were found. The results are discussed in terms of their implications for service provider-client interaction, the correspondence of attitudinal and behavioral change, and appropriate instruments for assessing program impact.","Hickey, T; Rakowski, W; Hultsch, D F; Fatula, B J",1976.0,,0,0,
6413,Effects of anxiety arousal on the consumption of alcohol by alcoholics and social drinkers,,"Higgins, R L; Marlatt, G A",1973.0,,0,0,
6414,"Therapeutic alliance, negative mood regulation, and treatment outcome in child abuse-related posttraumatic stress disorder","ER This study examined the related contributions of the therapeutic alliance and negative mood regulation to the outcome of a 2-phase treatment for childhood abuse-related posttraumatic stress disorder (PTSD). Phase 1 focused on stabilization and preparatory skills building, whereas Phase 2 was comprised primarily of imaginal exposure to traumatic memories. Hierarchical regression analyses indicated the strength of the therapeutic alliance established early in treatment reliably predicted improvement in PTSD symptoms at posttreatment. Furthermore, this relationship was mediated by participants' improved capacity to regulate negative mood states in the context of Phase 2 exposure therapy. In the treatment of childhood abuse-related PTSD, the therapeutic alliance and the mediating influence of emotion regulation capacity appear to have significant roles in successful outcome.","Cloitre, M; Stovall-McClough, K C; Miranda, R; Chemtob, C M",2004.0,10.1037/0022-006X.72.3.411,0,0,
6415,Do anxiety-disordered children need to come into the clinic for efficacious treatment?,"ER OBJECTIVE: This study compared 3 experimental conditions: wait-list, therapist-supported bibliotherapy, and individual therapy, in the treatment of child anxiety.METHOD: Participants were 55 children (25 girls and 30 boys), aged 7 to 14 years diagnosed with an anxiety disorder, and their parents. Families were assigned using a modified random assignment process to 1 of the 3 conditions. The intervention evaluated in the 2 active treatment conditions was a family-focused, cognitive-behavioral program.RESULTS: At posttreatment, participants in both treatment conditions had improved significantly on both diagnostic and questionnaire outcome measures compared with participants in the wait-list condition, with no differences demonstrated between the treatment conditions. Thus, at posttreatment, 0% of children in the wait-list condition were anxiety diagnosis free, compared with 95% in the therapist-supported bibliotherapy condition and 78.3% in the individual therapy condition. There was no significant difference between diagnostic status at posttreatment between the 2 treatment conditions. Participants assigned to a treatment condition were reassessed at 3-month and 6-month follow-up. Treatment gains were maintained in both conditions across the follow-up period.CONCLUSION: In light of the fact that more than 80% of anxiety-disordered children never receive treatment, these data suggest that therapist-supported bibliotherapy represents a cost-effective means of reaching a greater number of anxious children.","Cobham, V E",2012.0,10.1037/a0028205,0,0,
6416,The role of parental anxiety in the treatment of childhood anxiety,"ER Sixty-seven children aged 7 to 14 who met diagnostic criteria for an anxiety disorder were assigned to conditions according to parental anxiety level. Within these conditions, children were randomly assigned to 1 of 2 treatments: child-focused cognitive-behavioral therapy (CBT) or child-focused CBT plus parental anxiety management (CBT + PAM). At posttreatment, results indicated that within the child-anxiety-only condition, 82% of the children in the CBT condition no longer met criteria for an anxiety disorder compared with 80% in the CBT + PAM condition. Within the child + parental anxiety condition, 39% in the CBT condition no longer met criteria compared with 77% in the CBT + PAM condition. At follow-up, these differences were maintained, with some weakening over time. Results were not consistent across outcome measures. The interpretation and potential clinical implications of these findings are discussed.","Cobham, V E; Dadds, M R; Spence, S H",1998.0,,0,0,
6417,Parental anxiety in the treatment of childhood anxiety: a different story three years later,"ER This study reports on the results of a long-term follow-up of 60 (29 girls and 31 boys, all of Caucasian ethnicity) children and adolescents diagnosed with an anxiety disorder and treated 3 years earlier with child-focused cognitive behavior therapy (CBT) or child-focused CBT plus parental anxiety management (PAM). Sixty-seven children aged 7 to --14 years were assigned to either the ""child anxiety only"" or the ""child + parental anxiety"" condition based on parents' trait anxiety scores. Within conditions, participants were randomly assigned to one of the two treatment conditions. Results indicated that at follow-up, parental anxiety did not represent a risk factor for children's treatment outcome. In addition at follow-up, children who received the combined CBT + PAM intervention (regardless of parental anxiety status) were significantly more likely to be anxiety diagnosis free compared with children who received the child-focused CBT intervention only.","Cobham, V E; Dadds, M R; Spence, S H; McDermott, B",2010.0,10.1080/15374411003691719,0,0,
6418,Treatment of childhood traumatic grief: contributing to a newly emerging condition in the wake of community trauma,,"Cohen, J; Goodman, R F; Brown, E J; Mannarino, A",2004.0,10.1080/10673220490509543,0,0,
6419,"A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms","ER METHODTwo hundred twenty-nine 8- to 14-year-old children and their primary caretakers were randomly assigned to the above alternative treatments. These children had significant symptoms of PTSD, with 89% meeting full DSM-IV PTSD diagnostic criteria. More than 90% of these children had experienced traumatic events in addition to sexual abuse.RESULTSA series analyses of covariance indicated that children assigned to TF-CBT, compared to those assigned to child-centered therapy, demonstrated significantly more improvement with regard to PTSD, depression, behavior problems, shame, and abuse-related attributions. Similarly, parents assigned to TF-CBT showed greater improvement with respect to their own self-reported levels of depression, abuse-specific distress, support of the child, and effective parenting practices.CONCLUSIONSThis study adds to the growing evidence supporting the efficacy of TF-CBT with children suffering PTSD as a result of sexual abuse and suggests the efficacy of this treatment for children who have experienced multiple traumas.OBJECTIVETo examine the differential efficacy of trauma-focused cognitive-behavioral therapy (TF-CBT) and child-centered therapy for treating posttraumatic stress disorder (PTSD) and related emotional and behavioral problems in children who have suffered sexual abuse.","Cohen, J A; Deblinger, E; Mannarino, A P; Steer, R A",2004.0,10.1097/00004583-200404000-00005,0,0,
6420,Community treatment of posttraumatic stress disorder for children exposed to intimate partner violence: a randomized controlled trial,"ER DESIGNRandomized controlled trial conducted using blinded evaluators.SETTINGRecruitment, screening, and treatment were conducted at a community IPV center between September 1, 2004, and June 30, 2009.PARTICIPANTSOf 140 consecutively referred 7- to 14-year-old children, 124 participated.INTERVENTIONSChildren and mothers were randomly assigned to receive 8 sessions of TF-CBT or usual care (child-centered therapy).MAIN OUTCOME MEASURESTotal child PTSD symptoms assessed using child and parent structured interview (Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version [K-SADS-PL]) and self-report (University of California at Los Angeles PTSD Reaction Index [RI]). Secondary child outcomes were scores on the K-SADS-PL (PTSD symptom clusters), Screen for Child Anxiety Related Emotional Disorders (SCARED) (anxiety), Children's Depression Inventory (depression), Kaufman Brief Intelligence Test (cognitive functioning), and Child Behavior Checklist (total behavior problems).RESULTSIntent-to-treat analysis using last observation carried forward showed superior outcomes for TF-CBT on the total K-SADS-PL (mean difference, 1.63; 95% confidence interval [CI], 0.44-2.82), RI (mean difference, 5.5; 95% CI, 1.37-9.63), K-SADS-PL hyperarousal (mean difference, 0.71; 95% CI, 0.22-1.20), K-SADS-PL avoidance (0.55; 0.07-1.03), and SCARED (mean difference, 5.13; 95% CI, 1.31-8.96). Multiple imputation analyses confirmed most of these findings. The TF-CBT completers experienced significantly greater PTSD diagnostic remission (?(2) = 4.67, P = .03) and had significantly fewer serious adverse events.CONCLUSIONSCommunity TF-CBT effectively improves children's IPV-related PTSD and anxiety.TRIAL REGISTRATIONclinicaltrials.gov Identifier: NCT00183326.OBJECTIVETo evaluate community-provided trauma-focused cognitive behavior therapy (TF-CBT) compared with usual community treatment for children with intimate partner violence (IPV)-related posttraumatic stress disorder (PTSD) symptoms.","Cohen, J A; Mannarino, A P; Iyengar, S",2011.0,10.1001/archpediatrics.2010.247,0,0,
6421,Treating sexually abused children: 1 year follow-up of a randomized controlled trial,"ER METHODEighty-two sexually abused children ages 8-15 years old and their primary caretakers were randomly assigned to trauma-focused cognitive-behavioral therapy (TF-CBT) or non-directive supportive therapy (NST) delivered over 12 sessions; this study examines symptomatology during 12 months posttreatment.DATA ANALYSISIntent-to-treat and treatment completer repeated measures analyses were conducted.RESULTSIntent-to-treat indicated significant group x time effects in favor of TF-CBT on measures of depression, anxiety, and sexual problems. Among treatment completers, the TF-CBT group evidenced significantly greater improvement in anxiety, depression, sexual problems and dissociation at the 6-month follow-up and in PTSD and dissociation at the 12-month follow-up.CONCLUSIONThis study provides additional support for the durability of TF-CBT effectiveness.OBJECTIVETo measure the durability of improvement in response to two alternative treatments for sexually abused children.","Cohen, J A; Mannarino, A P; Knudsen, K",2005.0,10.1016/j.chiabu.2004.12.005,0,0,
6422,A pilot randomized controlled trial of combined trauma-focused CBT and sertraline for childhood PTSD symptoms,"ER METHODTwenty-four 10- to 17-year-old female children and adolescents and their primary caretakers were randomly assigned to receive TF-CBT + sertraline or TF-CBT + placebo for 12 weeks.RESULTSBoth groups experienced significant improvement in posttraumatic stress disorder and other clinical outcomes from pre- to posttreatment with no significant group x time differences between groups except in Child Global Assessment Scale ratings, which favored the TF-CBT + sertraline group.CONCLUSIONSOnly minimal evidence suggests a benefit to adding sertraline to TF-CBT. A drawback of adding sertraline was determining whether TF-CBT or sertraline caused clinical improvement for children with comorbid depression. Current evidence therefore supports an initial trial of TF-CBT or other evidence-supported psychotherapy for most children with PTSD symptoms before adding medication.OBJECTIVETo examine the potential benefits of adding a selective serotonin reuptake inhibitor, sertraline, versus placebo, to trauma-focused cognitive-behavioral therapy (TF-CBT) for improving posttraumatic stress disorder and related psychological symptoms in children who have experienced sexual abuse.","Cohen, J A; Mannarino, A P; Perel, J M; Staron, V",2007.0,10.1097/chi.0b013e3180547105,0,0,
6423,Survey of eating disorder symptoms among women in treatment for substance abuse,"ER A strong association between substance use disorders (SUDs) and eating disorders (EDs) in women has been established. Yet, little is known about the rates and impact of ED symptoms in women presenting to addiction treatment. The current investigation assessed the prevalence of ED symptoms and their effect on treatment outcomes in a sample of substance abusing women with co-occurring posttraumatic stress disorder (PTSD) enrolled in outpatient substance use programs. Participants were 122 women who participated in a multisite clinical trial comparing two behavioral treatments for co-occurring SUD and PTSD. The Eating Disorder Examination-self report, and measures of PTSD and SUD symptoms were administered at baseline, during treatment and at four follow-up points. Two subgroups emerged; those reporting binge eating in the 28 days prior to baseline (Binge group; n = 35) and those who reported no binge eating episodes (No Binge group; n = 87). Women in the Binge group endorsed significantly higher ED, PTSD, and depression symptoms at baseline than those in the No Binge group. Although all participants showed significant reductions in PTSD symptoms and improvements in abstinence rates during the study period, the improvements for the Binge group were significantly lower. These findings suggest that a subgroup of women with co-occurring PTSD and SUDs, who endorsed binge ED symptoms, responded differently to SUD/PTSD group treatment. Identification of ED symptoms among treatment-seeking women with SUDs may be an important element in tailoring interventions and enhancing treatment outcomes.","Cohen, L R; Greenfield, S F; Gordon, S; Killeen, T; Jiang, H; Zhang, Y; Hien, D",2010.0,10.1111/j.1521-0391.2010.00038.x,0,0,
6424,Developing and assessing effectiveness of a time-limited therapy group for incarcerated women survivors of childhood sexual abuse,"ER A thorough search of the literature has revealed little empirical research on the effects of trauma therapy with incarcerated women with histories of CSA. Psychotherapy, when available in a correctional setting, seems more related to resolving immediate crises that interfere with smooth management of the corrections environment rather than dealing with underlying problems such as CSA. The purpose of this preliminary investigation therefore was to implement and evaluate the efficacy of a time-limited, trauma-focused group intervention with a group of recently-incarcerated women volunteers who had experienced CSA. Five women completed the group plus pre- and post-test measures; a wait-list control group completed measures at the same intervals. Results were mixed in regard to the effectiveness of treatment: decreases were found in the mean Trauma Content (TC/R) scores of the Rorschach Inkblot Method (RIM), but scores on the TSI and the SCL-90-R did not vary greatly. However, women in the control group showed consistent declines in scores during the wait-list period, suggesting the intervention may have helped newly incarcerated women adjust with less symptomatology.","Cole, K L; Sarlund-Heinrich, P; Brown, L",2007.0,10.1300/J229v08n02_07,0,0,
6425,Do parents benefit from the offer of a follow-up appointment after their child's admission to intensive care?: an exploratory randomised controlled trial,"ER DESIGNExploratory randomised controlled trial. Families were allocated to intervention (follow-up clinic appointment two months after discharge) or control (no appointment) condition.SETTINGAn eight-bed Paediatric Intensive Care Unit (PICU) in an inner city teaching hospital.MEASUREMENTSParents' baseline stress was assessed using the Parental Stressor Scale: PICU. Post-traumatic stress, anxiety and depression were assessed at five months using the Impact of Event Scale and the Hospital Anxiety and Depression Scale.RESULTSOnly 18/72 families (25%) in the intervention group chose to attend the clinic. Outcome data were provided by 55/82 parents in the intervention group and 50/72 in the control group. Although no significant differences were found between the groups as a whole, parents with higher baseline stress reported lower rates of post-traumatic stress (n=8/32(25%) vs. n=13/23(57%), p=0.018) and depression (n=6/32(19%) vs. n=12/23(52%), p=0.009) at five months if they had been offered an appointment than if they had not.CONCLUSIONSWhilst these results do not justify routine follow-up for all, they suggest that, for the most traumatised parents, rates of long-term distress could be reduced by this intervention.OBJECTIVEThe study aim was to evaluate the psychological impact on parents of the provision of a paediatric intensive care follow-up clinic.","Colville, G A; Cream, P R; Kerry, S M",2010.0,10.1016/j.iccn.2010.02.005,0,0,
6426,Parents' state and trait anxiety: relationships with anxiety severity and treatment response in adolescents with autism spectrum disorders,"ER Comorbid anxiety is common among children with Autism Spectrum Disorder (ASD), and parents of children with ASD are more likely to have anxiety disorders. This study investigated the relationship between parents' state and trait anxiety and parent-reported internalizing and externalizing symptoms among adolescents (n = 30) with ASD, as well as the relationship of parents' anxiety symptoms and adolescent treatment response in the context of a randomized controlled trial. Parental state anxiety correlated with severity of adolescent anxiety, and trait anxiety in parents correlated with parent-reported adolescent internalizing and externalizing symptoms. Also, parents of adolescent treatment responders experienced a decrease in their own trait anxiety. Findings highlight the importance of considering parental anxiety when targeting anxiety among youth with ASD.","Conner, C M; Maddox, B B; White, S W",2013.0,10.1007/s10803-012-1728-0,0,0,
6427,"Randomized, controlled trial of telcagepant for the acute treatment of migraine","ER METHODSAdults with migraine with or without aura (International Headache Society criteria) treated a moderate or severe attack with oral telcagepant 50 mg (n = 177), 150 mg (n = 381), 300 mg (n = 371), or placebo (n = 365) in a randomized, double-blind trial. The 5 co-primary endpoints were pain freedom, pain relief, and absence of photophobia, absence of phonophobia, and absence of nausea, all at 2 hours postdose. The key secondary endpoint was 2-24 hour sustained pain freedom. The prespecified primary efficacy analyses evaluated the 150 mg and 300 mg groups; the 50-mg group was included on an exploratory basis to further characterize the dose response but was not prespecified for analysis. Tolerability was assessed by adverse experience reports.RESULTSTelcagepant 300 mg was more effective (p <or= 0.001) than placebo on all primary endpoints and the key secondary endpoint, as was telcagepant 150 mg (p <or= 0.05). Telcagepant 300 mg showed a slight numeric advantage over telcagepant 150 mg on most measures. Telcagepant 50 mg values were numerically intermediate between placebo and telcagepant 150 mg and 300 mg. The percentages of patients with adverse experiences were 32.2% for telcagepant 50 mg, 32.0% for telcagepant 150 mg, 36.2% for telcagepant 300 mg, and 32.2% for placebo.CONCLUSIONSThis study confirmed previous findings that telcagepant 300 mg was effective at relieving pain and other migraine symptoms at 2 hours and providing sustained pain freedom up to 24 hours. In this study, telcagepant 150 mg was also effective. Telcagepant was generally well tolerated.BACKGROUNDThe neuropeptide calcitonin gene-related peptide (CGRP) plays a key role in migraine pathophysiology. In this large phase 3 clinical trial, we sought to confirm the efficacy of telcagepant, the first orally bioavailable CGRP receptor antagonist.","Connor, K M; Shapiro, R E; Diener, H C; Lucas, S; Kost, J; Fan, X; Fei, K; Assaid, C; Lines, C; Ho, T W",2009.0,10.1212/WNL.0b013e3181b87942,0,0,
6428,The role of anxiety sensitivity in subjective and physiological responses to social and physical stressors,"ER This study examined the specificity of the relationship between anxiety sensitivity (AS), a measure of catastrophizing about arousal-related sensations, and pain responses, by examining the effect of AS on responses to stressors of a physical and social nature. Healthy men and women (n = 129) between the ages of 18 and 25 years were recruited from the community to participate in a study examining subjective, cognitive and behavioural responses to different types of stressors. Participants were randomly assigned to one of 3 groups: (i) a neutral condition in which they sat quietly and read a popular magazine; (ii) a social stress condition in which they anticipated having to give a self-disclosing speech; and (iii) a physical stress condition in which they were presented with 3 countdown to shock trials where a mild electrical shock was administered on the non-dominant arm. Subjective ratings and physiological responses were recorded in anticipation of the stressor and immediately after stress exposure. Results indicated that AS was indirectly related to pain ratings via its effect on anticipatory anxiety ratings. AS was associated with anticipatory anxiety ratings, regardless of whether the stressor was of a physical or social nature. Furthermore, AS was not shown to be directly associated with exaggerated subjective or physiological reactions to the physical stressor. These results indicate that the role of AS in pain responses may be mediated through a global effect on anxiety, and limited to the anticipatory stage of the pain experience. If future studies yield similar findings in pain patients, then they would suggest that interventions for helping individuals high in AS should focus on catastrophic thinking in anticipation of stressors in general, rather than on pain-specific stressors.","Conrod, P J",2006.0,10.1080/16506070600898587,0,0,
6429,Comparing Online with Face-to-Face HELPP Intervention in Women Experiencing Intimate Partner Violence,"ER Intimate partner violence (IPV) is a public health problem. The purpose of this study was to compare the effectiveness of the HELPP (Health, Education on Safety, and Legal Support and Resources in IPV Participant Preferred) intervention among IPV survivors. A sequential, transformative mixed-methods design was used. Participants were randomly assigned to one of three study groups: Online (ONL), Face-to-Face (FTF), and Waitlist Control (WLC). The HELPP intervention was offered to 32 adult female participants who were 45.2% Asian, 32.3% White, and 22.5% Black. Outcome measures were anxiety, depression, anger, personal, and social support. In total, 64% (n  =  20) of the participants reported having experienced IPV before the age of 18. The anger mean score pre-test to post-test difference was significant for ONL (p < 0.001) and WLC (p  =  0.01). The personal and social support pre-test to post-test mean score differences were significant for ONL (p < 0.001; p < 0.001) and WLC (p  =  0.01; p  =  0.006), respectively. The HELPP intervention (1) decreased anxiety, depression, anger, and (2) increased personal and social support in the ONL group. The HELPP information and intervention was shown to be feasible, acceptable, and effective among IPV survivors compared with participants in the WLC group. The WLC participants displayed (1) increased levels of anxiety, depression, and anger and (2) decreased levels of personal and social support, post-intervention. Further research could be conducted to determine if e-mail alone or e-mail plus mobile devices are more useful modes of delivering interventions.","Constantino, R E; Braxter, B; Ren, D; Burroughs, J D; Doswell, W M; Wu, L; Hwang, J G; Klem, M L; Joshi, J B; Greene, W B",2015.0,,0,0,
6430,"Guided, internet-based, rumination-focused cognitive behavioural therapy (i-RFCBT) versus a no-intervention control to prevent depression in high-ruminating young adults, along with an adjunct assessment of the feasibility of unguided i-RFCBT, in the REducing Stress and Preventing Depression trial (RESPOND): study protocol for a phase III randomised controlled trial","ER METHODS/DESIGN: A phase III randomised controlled trial following the Medical Research Council (MRC) Complex Interventions Framework will extend a Dutch trial to the United Kingdom, with the addition of diagnostic interviews, primarily to test whether guided internet-RFCBT reduces the onset of depression relative to a no-intervention control. High-risk young adults (aged 18 to 24 years), selected with elevated worry/rumination and recruited through university and internet advertisement, will be randomised to receive either guided internet-RFCBT, supported by clinical psychologists or mental health paraprofessionals, or a no-intervention control. As an adjunct arm, participants are also randomised to unguided internet-RFCBT self-help to provide an initial test of the feasibility and effect size of this intervention. While participants are also randomised to unguided internet-RFCBT, the trial was designed and powered as a phase III trial comparing guided internet-RFCBT versus a no-intervention control. In the comparison between these two arms, the primary outcomes are as follows: a) onset of major depressive episode over a 12-month period, assessed with a Structured Clinical Interview for Diagnosis at 3 months (post-intervention), 6 months and 15 months after randomisation. The following secondary outcomes will be recorded: the incidence of generalized anxiety disorder, symptoms of depression and anxiety, and levels of worry and rumination, measured at baseline and at the same follow-up intervals. In relation to the pilot investigation of unguided internet-RFCBT (the adjunct intervention arm), we will assess the feasibility and acceptability of the data-collection procedures, levels of attrition, effect size and acceptability of the unguided internet-RFCBT intervention.DISCUSSION: Widespread implementation is necessary for effective prevention, suggesting that the internet may be a valuable mode of delivery. Previous research suggests that guided internet-RFCBT reduces incidence rates relative to controls. We are also interested in developing and evaluating an unguided version to potentially increase the availability and reduce the costs.TRIAL REGISTRATION: Current Controlled Trials ISRCTN12683436 . Date of registration: 27 October 2014.BACKGROUND: Depression is a global health challenge. Prevention is highlighted as a priority to reduce its prevalence. Although effective preventive interventions exist, the efficacy and coverage can be improved. One proposed means to increase efficacy is by using interventions to target specific risk factors, such as rumination. Rumination-focused CBT (RFCBT) was developed to specifically target depressive rumination and reduces acute depressive symptoms and relapse for patients with residual depression in a randomised controlled trial. Preliminary findings from a Dutch randomised prevention trial in 251 high-risk 15- to 22-year-old subjects selected with elevated worry and rumination found that both supported internet-RFBCT and group-delivered RFCBT equally reduced depressive symptoms and the onset of depressive cases over a period of 1 year, relative to the no-intervention control.","Cook, L; Watkins, E",2016.0,10.1186/s13063-015-1128-9,0,0,
6431,Naturopathic care for anxiety: a randomized controlled trial ISRCTN78958974,"ER METHODS: Employees with moderate to severe anxiety of longer than 6 weeks duration were randomized based on age and gender to receive naturopathic care (NC) (n = 41) or standardized psychotherapy intervention (PT) (n = 40) over a period of 12 weeks. Blinding of investigators and participants during randomization and allocation was maintained. Participants in the NC group received dietary counseling, deep breathing relaxation techniques, a standard multi-vitamin, and the herbal medicine, ashwagandha (Withania somnifera) (300 mg b.i.d. standardized to 1.5% with anolides, prepared from root). The PT intervention received psychotherapy, and matched deep breathing relaxation techniques, and placebo. The primary outcome measure was the Beck Anxiety Inventory (BAI) and secondary outcome measures included the Short Form 36 (SF-36), Fatigue Symptom Inventory (FSI), and Measure Yourself Medical Outcomes Profile (MY-MOP) to measure anxiety, mental health, and quality of life respectively. Participants were blinded to the placebo-controlled intervention.RESULTS: Seventy-five participants (93%) were followed for 8 or more weeks on the trial. Final BAI scores decreased by 56.5% (p<0.0001) in the NC group and 30.5% (p<0.0001) in the PT group. BAI group scores were significantly decreased in the NC group compared to PT group (p = 0.003). Significant differences between groups were also observed in mental health, concentration, fatigue, social functioning, vitality, and overall quality of life with the NC group exhibiting greater clinical benefit. No serious adverse reactions were observed in either group.RELEVANCE: Many patients seek alternatives and/or complementary care to conventional anxiety treatments. To date, no study has evaluated the potential of a naturopathic treatment protocol to effectively treat anxiety. Knowledge of the efficacy, safety or risk of natural health products, and naturopathic treatments is important for physicians and the public in order to make informed decisions.INTERPRETATION: Both NC and PT led to significant improvements in patients' anxiety. Group comparison demonstrated a significant decrease in anxiety levels in the NC group over the PT group. Significant improvements in secondary quality of life measures were also observed in the NC group as compared to PT. The whole system of naturopathic care for anxiety needs to be investigated further including a closer examination of the individual components within the context of their additive effect.TRIAL REGISTRATION: Controlled-Trials.com ISRCTN78958974.BACKGROUND: Anxiety is a serious personal health condition and represents a substantial burden to overall quality of life. Additionally anxiety disorders represent a significant cost to the health care system as well as employers through benefits coverage and days missed due to incapacity. This study sought to explore the effectiveness of naturopathic care on anxiety symptoms using a randomized trial.","Cooley, K; Szczurko, O; Perri, D; Mills, E J; Bernhardt, B; Zhou, Q; Seely, D",2009.0,10.1371/journal.pone.0006628,0,0,
6432,Urban African American youth exposed to community violence: a school-based anxiety preventive intervention efficacy study,"ER This study evaluated the efficacy of a school-based anxiety prevention program among urban children exposed to community violence. Students who attended Title 1 public elementary schools were screened. Ninety-eight 3rd-5th-grade students (ages 8-12; 48% female; 92% African American) were randomized into preventive intervention versus wait list comparison groups. Students attended 13 biweekly one-hour group sessions of a modified version of FRIENDS, a cognitive-behavioral anxiety intervention program. Results indicated that both intervention and control groups manifested significant reductions in anxiety symptomatology and total exposure to community violence, along with improved standardized reading achievement scores. Additional gains observed only in the intervention group were increased standardized mathematics achievement scores, decreased life stressors, and reduced victimization by community violence. The intervention was equally efficacious for both genders and for children exposed to higher, compared to lower, levels of community violence. Implications for comprehensive, culturally and contextually relevant prevention programs and research are discussed.","Cooley-Strickland, M R; Griffin, R S; Darney, D; Otte, K; Ko, J",2011.0,10.1080/10852352.2011.556573,0,0,
6433,"A randomized, controlled, phase 2 study of AMG 317, an IL-4Ralpha antagonist, in patients with asthma","ER OBJECTIVESTo evaluate efficacy and safety of AMG 317 in patients with moderate to severe asthma.METHODSIn this phase 2, randomized, double-blind, placebo-controlled study, patients received weekly subcutaneous injections of placebo or AMG 317 (75-300 mg) for 12 weeks, followed by a 4-week follow-up period. The primary endpoint was change from baseline at Week 12 in Asthma Control Questionnaire (ACQ) symptom score.MEASUREMENTS AND MAIN RESULTSMean ACQ change (SE) was -0.49 (0.09) in placebo (n = 74), and -0.43 (0.11), -0.58 (0.12), and -0.70 (0.09) in the AMG 317 75 mg (n = 73), 150 mg (n = 73), and 300 mg (n = 74) groups, respectively (treatment effect P = 0.25). No statistically significant differences were observed in the secondary endpoints. Numerical decreases in number of and time to exacerbations were noted in patients receiving AMG 317 150 mg and 300 mg. Preplanned analyses by tertile of baseline ACQ revealed that patients with higher baseline ACQ scores (>or=2.86) were more likely to respond to AMG 317. Serious adverse events were reported in three patients, each noted as not related to study drug.CONCLUSIONSAMG 317 did not demonstrate clinical efficacy across the overall group of patients. Clinically significant improvements were observed in several outcome measures in patients with higher baseline ACQ scores. AMG 317 was safe and well tolerated in this study population. Clinical trial registered with www.clinicaltrials.gov (NCT 00436670).RATIONALEIL-4 and IL-13 share many biological functions important in the development of allergic airway inflammation and are implicated in the pathogenesis of asthma. AMG 317 is a fully human monoclonal antibody to IL-4Ralpha that blocks both IL-4 and IL-13 pathways.","Corren, J; Busse, W; Meltzer, E O; Mansfield, L; Bensch, G; Fahrenholz, J; Wenzel, S E; Chon, Y; Dunn, M; Weng, H H; Lin, S L",2010.0,10.1164/rccm.200909-1448OC,0,0,
6434,Predictors of treatment outcomes among depressed women with childhood sexual abuse histories,"ER METHOD: Seventy women with major depressive disorder and CSA histories in a CMHC were randomly assigned to interpersonal psychotherapy (n = 37) or usual care (n = 33). Using generalized estimating equations, we examined four pretreatment predictor domains (i.e. sociodemographic characteristics, clinical features, social and physical functioning, and trauma features) potentially related to depression treatment outcomes.RESULTS: Among sociodemographic characteristics, Black race/ethnicity, public assistance income, and unemployment were associated with less depressive symptom reduction over the course of treatment. Two clinical features, chronic depression and borderline personality disorder, were also related to less reduction in depressive symptoms across the treatment period.CONCLUSION: Our results demonstrate the clinical relevance of attending to predictors of depressed women with CSA histories being treated in public sector mental health centers. Particular sociodemographic characteristics and clinical features among these women may be significant indicators of risk for relatively poorer treatment outcomes.BACKGROUND: A notable portion (21%) of female patients receiving treatment for depression in community mental health centers (CMHC) has childhood sexual abuse (CSA) histories. Treatment outcomes in this population are heterogeneous; identifying factors associated with differential outcomes could inform treatment development. This exploratory study begins to address the gap in what is known about predictors of treatment outcomes among depressed women with sexual abuse histories.","Cort, N A; Gamble, S A; Smith, P N; Chaudron, L H; Lu, N; He, H; Talbot, N L",2012.0,10.1002/da.21942,0,0,
6435,Social competence and social skills training and intervention for children with Autism Spectrum Disorders,"ER This study examined the effectiveness of a 30 week social competence and social skills group intervention program with children, ages 7-11, diagnosed with Autism Spectrum Disorders (ASD). Eighteen children with ASD were assessed with pretreatment and posttreatment measures on the Walker-McConnell Scale (WMS) and the MGH YouthCare Social Competence Development Scale. Each received the 30-week intervention program. For comparison, a matched sample of ten non-ASD children was also assessed, but received no treatment. The findings indicated that each ASD intervention group demonstrated significant gains on the WMS and significant improvement in the areas of anxiety management, joint attention, and flexibility/transitions. Results suggest that this approach can be effective in improving core social deficits in individuals with ASD.","Cotugno, A J",2009.0,10.1007/s10803-009-0741-4,0,0,
6436,Sensory evaluation of a novel vegetable in school age children,"ER A behavioural sensory task was undertaken to further understanding into whether children's sensory evaluation of a new vegetable is associated with tasting and food neophobia scores. A sample of ninety-five children, aged 7-11 years, was recruited from a primary school in inner city Birmingham, UK. They were asked to rate the sight, smell and feel of a familiar vegetable (carrot) and an unfamiliar vegetable (celeriac) in a randomised order to control for order effects. They were then asked to try the each vegetable, and rate its taste. It was found that children rated the sensory characteristics of the familiar vegetable more positively than the novel vegetable across all sensory domains (p < 0.05). Refusing to try the novel vegetable was associated with food neophobia scores and olfactory ratings. The ratings of the taste of the novel vegetable were associated with olfactory and tactile ratings. In addition there was a clear developmental shift in the sample with younger children being more likely to rate the novel vegetable as 'looking strange' and older children rating the novel vegetable as 'smelling strange'. This research strengthens the idea that sensory information is important in children deciding to try, and their hedonic evaluation of the taste of a new vegetable.","Coulthard, H; Palfreyman, Z; Morizet, D",2016.0,10.1016/j.appet.2016.01.030,0,0,
6437,"When too much is not enough: obsessive-compulsive disorder as a pathology of stopping, rather than starting","ER METHOD: In two experiments, 70 patients with OCD (57 with washing compulsions, 13 with checking compulsions) and 72 controls were exposed to contamination cues--immersing a hand in wet diapers--and later allowed to wash their hands, first limited to 30 s and then for as long as desired. The intensity of activation of security motivation was measured objectively by change in respiratory sinus arrythmia. Subjective ratings (e.g., contamination) and behavioral measures (e.g., duration of hand washing) were also collected.RESULTS: Compared to controls, OCD patients with washing compulsions did not differ significantly in their levels of initial activation to the threat of contamination; however, they were significantly less able to reduce this activation by engaging in the corrective behavior of hand-washing. Further, the deactivating effect of hand-washing in OCD patients with checking compulsions was similar to that for controls, indicating that the dysfunction of termination in OCD is specific to the patient's symptom profile.CONCLUSIONS: These results are the first to show that OCD is characterized by a reduced ability of security-related behavior to terminate motivation evoked by potential danger, rather than a heightened initial sensitivity to potential threat. They lend support to the security-motivation theory of OCD (Szechtman & Woody, 2004) and have important implications both for research into the biological mechanisms underlying OCD and for the development of new treatment approaches.BACKGROUND: In obsessive-compulsive disorder (OCD), individuals feel compelled to repeatedly perform security-related behaviors, even though these behaviours seem excessive and unwarranted to them. The present research investigated two alternative ways of explaining such behavior: (1) a dysfunction of activation--a starting problem--in which the level of excitation in response to stimuli suggesting potential danger is abnormally strong; versus (2) a dysfunction of termination--a stopping problem--in which the satiety-like process for shutting down security-related thoughts and actions is abnormally weak.","Hinds, A L; Woody, E Z; Ameringen, M; Schmidt, L A; Szechtman, H",2012.0,10.1371/journal.pone.0030586,0,0,
6438,CCK-4: psychophysiological conditioning elicits features of spontaneous panic attacks,"ER METHODS20 healthy male subjects were randomly and double-blindedly assigned in two groups (dose groups), each of which was investigated three times once with placebo and twice with 25 ?g or 50 ?g CCK-4 respectively. Subjects of each group were randomly assigned in two different balanced orders of investigations: CCK-CCK-Placebo vs. Placebo-CCK-CCK. Facial muscle and hypothalamo-pituitary-adrenocortical (HPA)-axis activity were recorded.RESULTSCCK-4 led dose-dependently to an increase of panic anxiety, an activation of fear relevant facial muscles and a rise of stress hormones. Whereas placebo administration before CCK-4 revealed no significant panic and stress response, during placebo following CCK-4 stimulations a psychophysiological conditioning effect could be observed without rise in HPA-axis activity.DISCUSSIONOur findings indicate the possibility to measure different intensities of panic anxiety and conditioning effects with a facial EMG method. Dissociation of HPA-activity and fear relevant facial muscle activity is in accordance with former results about spontaneous panic attacks.INTRODUCTIONCholecystokinin-tetrapeptide (CCK-4) is an established model to generate subjective panic anxiety. CCK-4 injection also results in consistent and dose-dependent rise of stress hormones. Effects other than upon subjective panic and stress hormone activity have barely been examined. The purpose of the study was to investigate CCK-4 effects on emotional facial expression and especially on fear relevant facial muscles establishing therewith a more objective method to measure subjective panic anxiety.","Hinkelmann, K; Yassouridis, A; Mass, R; Tenge, H; Kellner, M; Jahn, H; Wiedemann, K; Wolf, K",2010.0,10.1016/j.jpsychires.2010.04.004,0,0,
6439,The effect of telecare on the quality of life and psychological well-being of elderly recipients of social care over a 12-month period: the Whole Systems Demonstrator cluster randomised trial,"ER BACKGROUND: home-based telecare (TC) is utilised to manage risks of independent living and provide prompt emergency responses. This study examined the effect of TC on health-related quality of life (HRQoL), anxiety and depressive symptoms over 12 months in patients receiving social care.DESIGN: a study of participant-reported outcomes [the Whole Systems Demonstrator (WSD) Telecare Questionnaire Study; baseline n = 1,189] was nested in a pragmatic cluster-randomised trial of TC (the WSD Telecare trial), held across three English Local Authorities. General practice (GP) was the unit of randomisation and TC was compared with usual care (UC).METHODS: participant-reported outcome measures were collected at baseline, short-term (4 months) and long-term (12 months) follow-up, assessing generic HRQoL, anxiety and depressive symptoms. Primary intention-to-treat analyses tested treatment effectiveness and were conducted using multilevel models to control for GP clustering and covariates for participants who completed questionnaire measures at baseline assessment plus at least one other assessment (n = 873).RESULTS: analyses found significant differences between TC and UC on Short Form-12 mental component scores (P < 0.05), with parameter estimates indicating being a member of the TC trial-arm increases mental component scores (UC-adjusted mean = 40.52; TC-adjusted mean = 43.69). Additional significant analyses revealed, time effects on EQ5D (decreasing over time) and depressive symptoms (increasing over time).CONCLUSIONS: TC potentially contributes to the amelioration in the decline in users' mental HRQoL over a 12-month period. TC may not transform the lives of its users, but it may afford small relative benefits on some psychological and HRQOL outcomes relative to users who only receive UC. International Standard Randomised Controlled Trial Number Register: ISRCTN 43002091.","Hirani, S P; Beynon, M; Cartwright, M; Rixon, L; Doll, H; Henderson, C; Bardsley, M; Steventon, A; Knapp, M; Rogers, A; Bower, P; Sanders, C; Fitzpatrick, R; Hendy, J; Newman, S P",2014.0,10.1093/ageing/aft185,0,0,
6440,Cognitive behavioral therapy for 4- to 7-year-old children with anxiety disorders: a randomized clinical trial,"ER METHODDESIGNRandomized wait-list controlled trial. Conduct: Sixty-four children (53% female, mean age 5.4 years, 80% European American) with anxiety disorders were randomized to a parent-child CBT intervention (n = 34) or a 6-month wait-list condition (n = 30). Children were assessed by interviewers blind to treatment assignment, using structured diagnostic interviews with parents, laboratory assessments of behavioral inhibition, and parent questionnaires.ANALYSISChi-square analyses of outcome rates and linear and ordinal regression of repeated measures, examining time by intervention interactions.RESULTSThe response rate (much or very much improved on the Clinical Global Impression Scale for Anxiety) among 57 completers was 69% versus 32% (CBT vs. controls), p < .01; intent-to-treat: 59% vs. 30%, p = .016. Treated children showed a significantly greater decrease in anxiety disorders (effect size [ES] = .55) and increase in parent-rated coping (ES = .69) than controls, as well as significantly better CGI improvement on social phobia/avoidant disorder (ES = .95), separation anxiety disorder (ES = .82), and specific phobia (ES = .78), but not on generalized anxiety disorder. Results on the Child Behavior Checklist Internalizing scale were not significant and were limited by low return rates. Treatment response was unrelated to age or parental anxiety but was negatively predicted by behavioral inhibition. Gains were maintained at 1-year follow-up.CONCLUSIONSResults suggest that developmentally modified parent-child CBT may show promise in 4- to 7-year-old children.OBJECTIVETo examine the efficacy of a developmentally appropriate parent-child cognitive behavioral therapy (CBT) protocol for anxiety disorders in children ages 4-7 years.","Hirshfeld-Becker, D R; Masek, B; Henin, A; Blakely, L R; Pollock-Wurman, R A; McQuade, J; DePetrillo, L; Briesch, J; Ollendick, T H; Rosenbaum, J F; Biederman, J",2010.0,10.1037/a0019055,0,0,
6441,"The effects of acupressure on depression, anxiety and stress in patients with hemodialysis: a randomized controlled trial","ER BACKGROUND: Patients with end stage renal disease on hemodialysis are affected by physiological and psychological stressors, which contribute to poor quality of life and negative clinical outcomes. Depression, anxiety, and stress are highly prevalent in this population. Effective interventional strategies are required to manage these psychological symptoms. Acupressure has been believed to be one of the complementary therapies that could promote psychological wellbeing.OBJECTIVE: The aim of this study was to evaluate the effects of acupressure on depression, anxiety, stress, and general psychological distress in patients with hemodialysis.DESIGN: Open-label randomized controlled trial.SETTING: Three hemodialysis centers.PARTICIPANTS: A total of 108 patients with hemodialysis were randomly recruited into the acupressure group (n=54) and the control group (n=54).METHOD: The intervention was carried out from January to March 2014. The acupressure group received routine hemodialysis treatment plus 15 min acupressure applied three times a week for four weeks. The control group received only usual care with routine hemodialysis treatment. The outcome measurements were the Depression, Anxiety Stress Scales (DASS-21), and general psychological distress using the General Health Questionnaire (GHQ-28). Statistical analysis was performed using Wilcoxon signed-rank test to compare DASS scales and GHQ-28 scores before and after acupressure intervention.RESULTS: The acupressure group had significantly lower DASS scores and GHQ scores compared to the control group, signifying improvements in depression, anxiety, stress and general psychological distress. The sub-score of the GHQ-28 for social dysfunction, however, were similar in both groups.CONCLUSION: Findings from this study indicates that acupressure therapy delivered three times a week for four weeks was able to significantly reduce depression, anxiety, stress, and general psychological distress in patients with hemodialysis. This positive finding suggests that acupressure may have a role in promoting psychological wellbeing of patients. Promoting psychological wellness will improve patients' quality of life, and reduce negative outcomes associated with psychological illnesses and distress experienced by patients with hemodialysis.","Hmwe, N T; Subramanian, P; Tan, L P; Chong, W K",2015.0,10.1016/j.ijnurstu.2014.11.002,0,0,
6442,The clinical significance of disordered renal excretion of xanthurenic acid in depressive patients,"ER Xanthurenic acid is a metabolite of L-tryptophanicotinic acid ribonucleotide biosynthesis. The excretion of xanthurenic acid from urine 24 h after ingestion of 5 g L-tryptophan is increased in depressive patients, and 17-hydroxycorticosteroids are considered of primary importance to this disorder. However, in this study, the excretion of xanthurenic acid and 17-hydroxycorticosteroids did not correlate with the scores of the Raskin depression scale, Hamilton depression scale, Zung depression scale, or the Zung anxiety scale in depressive patients. The patients were treated with either pyridoxine plus L-tryptophan, a presumably serotonin-enhancing treatment (n = 10) or maprotiline, a noradrenaline-enhancing drug (n = 10). Repeated measurements showed no differences between treatments after 2 or 4 weeks of treatment. The improvement in xanthurenic acid excretion precedes clinical improvements in depression. The excretion of xanthurenic acid only at 2 weeks correlated significantly with the anxiety and depression scores at 4 weeks, making prediction of clinical improvement possible. The neurobiological mode of action on noradrenergic or serotonergic neurons of antidepressant medication is of questionable significance to their therapeutic effect.","Hoes, M J; Sijben, N",1981.0,,0,0,
6443,Personality traits among panic disorder with agoraphobia patients before and after symptom-focused treatment,"ER The first aim of this study was to examine the relationship between change of the agoraphobic state during treatment and personality change. The second aim was to examine the potential effect of PD traits on symptom change during and after treatment. Patients (N = 46) suffering from panic disorder with moderate or severe agoraphobia and considering agoraphobia as their main problem were randomly assigned to receive either cognitive therapy or guided mastery therapy in a 6-week inpatient group program. From before to 1 year after the end of treatment, the number of avoidant and dependent traits decreased significantly. Among changes during treatment on various symptom and cognitive variables, only change in catastrophic beliefs was significantly related to reduction in avoidant and dependent traits. Number of dependent traits at pretreatment was related to less improvement from pretreatment to 1-year follow-up on the symptom and cognitive scales.","Hoffart, A; Hedley, L M",1997.0,,0,0,
6444,"Effectiveness of hospital-based video interaction guidance on parental interactive behavior, bonding, and stress after preterm birth: a randomized controlled trial","ER METHODVIG is a preventive video-feedback intervention to support the parent-infant relationship. One hundred fifty families (150 infants, 150 mothers, 144 fathers) participated in a pragmatic randomized controlled trial to evaluate the effects of VIG as adjunct to standard hospital care. Primary outcome was parental interactive behavior (sensitivity, intrusiveness, and withdrawal) as observed in videotaped dyadic parent-infant interaction. Secondary outcomes comprised parental bonding, stress responses, and psychological well-being based on self-report. The intervention effects were assessed at baseline, mid-intervention, 3-week, 3-month, and 6-month follow-ups. Data were analyzed on an intention-to-treat basis, using multilevel modeling and analyses of covariance.RESULTSVIG proved to be effective in enhancing sensitive behavior and diminishing withdrawn behavior in mothers (Cohen's d range = .24-.44) and in fathers (d range: .54-.60). The positive effects of VIG were particularly found in mothers who experienced the preterm birth as very traumatic (d range = .80-1.04). The intervention, however, did not change parents' intrusive behavior. Analyses additionally revealed positive effects on parental bonding, especially for fathers, yet no significant effects on stress and well-being were detected.CONCLUSIONSThe results indicate that VIG is a useful addition to standard hospital care, reducing the possible negative impact of preterm birth on the parent-infant relationship. VIG appeared particularly beneficial for fathers, and for mothers with traumatic birth experiences. High levels of parental intrusiveness, however, need complementary intervention. (PsycINFO Database RecordOBJECTIVEThis study examined the effectiveness of hospital-based Video Interaction Guidance (VIG; Eliëns, 2010; Kennedy, Landor, & Todd, 2011) for mothers and fathers of infants born preterm (25-37 weeks of gestation).","Hoffenkamp, H N; Tooten, A; Hall, R A; Braeken, J; Eliëns, M P; Vingerhoets, A J; Bakel, H J",2015.0,10.1037/a0038401,0,0,
6445,Thin-film optical notch filter spectacle coatings for the treatment of migraine and photophobia,"ER Previous evidence suggests optical treatments hold promise for treating migraine and photophobia. We designed an optical notch filter, centered at 480 nm to reduce direct stimulation of intrinsically photosensitive retinal ganglion cells. We used thin-film technology to integrate the filter into spectacle lenses. Our objective was to determine if an optical notch filter, designed to attenuate activity of intrinsically photosensitive retinal ganglion cells, could reduce headache impact in chronic migraine subjects. For this randomized, double-masked study, our primary endpoint was the Headache Impact Test (HIT-6; GlaxoSmithKline, Brentford, Middlesex, UK). We developed two filters: the therapeutic filter blocked visible light at 480 nm; a 620 nm filter was designed as a sham. Participants were asked to wear lenses with one of the filters for 2 weeks; after 2 weeks when no lenses were worn, they wore lenses with the other filter for 2 weeks. Of 48 subjects, 37 completed the study. Wearing either the 480 or 620 nm lenses resulted in clinically and statistically significant HIT-6 reductions. However, there was no significant difference when comparing overall effect of the 480 and 620 nm lenses. Although the 620 nm filter was designed as a sham intervention, research published following the trial indicated that melanopsin, the photopigment in intrinsically photosensitive retinal ganglion cells, is bi-stable. This molecular property may explain the unexpected efficacy of the 620 nm filter. These preliminary findings indicate that lenses outfitted with a thin-film optical notch filter may be useful in treating chronic migraine.","Hoggan, R N; Subhash, A; Blair, S; Digre, K B; Baggaley, S K; Gordon, J; Brennan, K C; Warner, J E; Crum, A V; Katz, B J",2016.0,10.1016/j.jocn.2015.09.024,0,0,
6446,Noradrenergic function in obsessive-compulsive disorder: behavioral and neuroendocrine responses to clonidine and comparison to healthy controls,"ER To evaluate noradrenergic (NE) function in obsessive-compulsive disorder (OCD), behavioral, physiological, and neuroendocrine responses to the alpha 2-adrenergic agonist clonidine were examined in 18 patients with OCD and 10 healthy subjects. Subjects received single i.v. doses of 2 micrograms/kg of clonidine administered under double-blind, placebo-controlled, random-assignment conditions. Following clonidine, but not following placebo, patients transiently experienced a significant reduction of obsessions and compulsions. Significant drowsiness and a reduction in anxiety were also noted, but the antiobsessional effect appeared independent of the soporific and antianxiety effects. Growth hormone (GH), cortisol, and 3-methoxy-4-hydroxyphenylglycol responses to clonidine did not differentiate patients from healthy controls. Blood pressure and pulse in response to clonidine did not differ between groups. Improvement in OCD symptoms after clonidine significantly correlated with GH response to clonidine, suggesting specific noradrenergic mediation. This finding lends only partial support for a primary defect of noradrenergic function in OCD.","Hollander, E; DeCaria, C; Nitescu, A; Cooper, T; Stover, B; Gully, R; Klein, D F; Liebowitz, M R",1991.0,,0,0,
6447,Divalproex in the treatment of impulsive aggression: efficacy in cluster B personality disorders,"ER Impulsive aggressive behavior is common in psychiatric disorders and accounts for significant morbidity and mortality. However, little systematic treatment data exist from placebo-controlled trials for this symptom domain. This was a multicenter, randomized, double-blind, placebo-controlled study in which outpatients with a score of > or =15 on the Aggression scale of the Overt Aggression Scale-Modified (OAS-M) and who fulfilled DSM-IV criteria for Cluster B personality disorder (n=96), intermittent explosive disorder (n=116), or post-traumatic stress disorder (n=34) were randomized to divalproex sodium or placebo for 12 weeks duration. Based on average OAS-M Aggression scores over the last 4 weeks of treatment, a treatment effect was not observed in the intent-to-treat data set (combined across the three psychiatric disorders), but was observed in both intent-to-treat and evaluable data sets for patients with Cluster B personality disorders. In the Cluster B evaluable data set, statistically significant treatment differences favoring divalproex were also observed for component items of the OAS-M Aggression score, including verbal assault and assault against objects, as well as OAS-M Irritability score, and Clinical Global Impression (CGI)-Severity at multiple time points throughout the study. No treatment group difference was noted for overall premature discontinuation rate; however, across psychiatric diagnoses, 21 (17%) patients in the divalproex group prematurely discontinued because of an adverse event, as compared to 4 (3%) patients in the placebo group (p <0.001). While a treatment effect was not observed when all diagnostic groups were combined, in a large subgroup of patients with Cluster B disorders, divalproex was superior to placebo in the treatment of impulsive aggression, irritability, and global severity.","Hollander, E; Tracy, K A; Swann, A C; Coccaro, E F; McElroy, S L; Wozniak, P; Sommerville, K W; Nemeroff, C B",2003.0,10.1038/sj.npp.1300153,0,0,
6448,"The efficacy of a group-based, disorder-specific treatment program for childhood GAD--a randomized controlled trial","ER The aim of this study was to provide a preliminary examination of a disorder-specific treatment program for children with generalised anxiety disorder (GAD) that employed strategies targeting underlying cognitive factors. Forty-two children with a primary diagnosis of GAD, aged between 7 and 12 years, were randomly assigned to either a treatment (TX) or waitlist (WLC) condition. Clinical diagnostic interviews as well as parent and child questionnaires were completed at pre- and post-assessment for both conditions, and at 3-month follow-up for the TX group. For the completer analyses at post-treatment, 52.9 % of children in the TX group (0% in the WLC group) were free of their primary GAD diagnosis. By 3-month follow-up, 100% of children in the TX group were free of their GAD diagnosis, 50% were free of all diagnoses. Overall, there is preliminary evidence that a disorder-specific treatment program for children with GAD is effective in treating this chronic and disabling disorder.","Holmes, M C; Donovan, C L; Farrell, L J; March, S",2014.0,10.1016/j.brat.2014.08.002,0,0,
6449,Meclofenamate sodium in the treatment of post-traumatic edema. Report of a controlled double-blind study,"ER 130 patients with edema as the sequel of a traumatic incident were selected for this study, 43 patients were treated with 300 mg N-(2,6-dichloro-m-tolyl)anthranilic acid, sodium salt (meclofenamate sodium, Meclomen) per day for one week, 44 patients received 600 mg oxyphenbutazone per day and 43 patients received placebo. Medication could be terminated if edema and pain disappeared or if deterioration or intolerance occurred. Extent of edema and degree of pain were assessed at entry into the study and on days 3, 5 and 8. Efficacy was assessed by the number of days elapsed before definite reduction and/or complete disappearance of edema and by the decrease and disappearance of pain. Meclofenamate sodium proved to be significantly superior to placebo in the treatment of patients with post-traumatic edema and post-traumatic pain. Reduction and disappearance of edema and cessation of pain occurred significantly more promptly in patients receiving meclofenamate sodium than in those receiving placebo. Although no statistically significant differences were observed between meclofenamate sodium and oxyphenbutazone, the results suggested that meclofenamate sodium might be clinically superior. Meclofenamate sodium was well tolerated.","Honorato, Pérez J; Martí, Massó R; Imizcoz, Barriola J L",1983.0,,0,0,
6450,Serotonin regulation of the human stress response,"ER Acute tryptophan depletion (ATD) is a technique that has been used to evaluate the effects on humans of acutely reducing serotonin neurotransmission. We have developed a model using a single breath of 35% CO(2) that activates the hormonal axis and produces autonomic and behavioural arousal, thus modelling a stress response. This study combines ATD and single breath 35% CO(2) inhalation to study stress responses in volunteers. A randomised, double-blinded, placebo-controlled, cross-over trial involving 14 healthy adult volunteers aged between 18 and 65 years was undertaken. Subjects underwent double-blind tryptophan depletion over 2 days and were then crossed over 1 week later. During each study day, at the time of peak depletion, participants were single blinded to receive a single breath of 35% CO(2) or air. This was followed 40 min later by the other gas. Psychological outcomes were assessed with the Spielberger State Anxiety Inventory (SSAI), Visual Analogue Scales (VAS), Panic Inventory (PI), Panic and Agoraphobia Scale (PSI) and Beck Depression Inventory (BDI). Physiological outcome was measured by serial plasma cortisol, prolactin and tryptophan levels, pulse and blood pressure. Tryptophan depletion did not exacerbate 35% CO(2) inhalation effects on anxiety symptoms. Single breath CO(2) robustly increased plasma cortisol levels in comparison to an air inhalation; this was less certain for prolactin levels. ATD influenced the HPA axis (associated with higher cortisol levels), apparently independent of CO(2) or air inhalation stressors. ATD and 35% CO(2) inhalation both induced a pressor response and bradycardia in these normal volunteers. Thirty-five percent CO(2) inhalation and ATD independently activate the human stress response, but do not appear to produce synergistic effects when combined, at least for the conditions produced in this study.","Hood, S D; Hince, D A; Robinson, H; Cirillo, M; Christmas, D; Kaye, J M",2006.0,10.1016/j.psyneuen.2006.07.001,0,0,
6451,Behavioral parent training as an adjunct to routine care in children with attention-deficit/hyperactivity disorder: moderators of treatment response,"ER METHODSWe randomly assigned 94 referred children (4-12 years) with attention-deficit/hyperactivity disorder (ADHD) to BPT plus RCC or RCC alone. Outcome was based on parent-reported behavioral problems and ADHD symptoms. Predictor/moderator variables included children's IQ, age, and comorbidity profile, and maternal ADHD, depression, and parenting self-efficacy.RESULTSSuperior BPT treatment effects on behavioral problems and ADHD symptoms were present in children with no or single-type comorbidity-anxiety/depression or oppositional defiant disorder (ODD)/conduct disorder (CD)-and when mothers had high parenting self-efficacy, but absent in children with broad comorbidity (anxiety/depression and ODD/CD) and when mothers had low parenting self-efficacy. In older children ADHD symptoms tended to decrease more through BPT than in younger children.CONCLUSIONSAdjunctive BPT is most useful when mothers have high parenting self-efficacy and in children with no or single-type comorbidity.OBJECTIVETo investigate predictors and moderators of outcome of behavioral parent training (BPT) as adjunct to ongoing routine clinical care (RCC), versus RCC alone.","Hoofdakker, B J; Nauta, M H; Veen-Mulders, L; Sytema, S; Emmelkamp, P M; Minderaa, R B; Hoekstra, P J",2010.0,10.1093/jpepsy/jsp060,0,0,
6452,Risk factors for depression and anxiety in survivors of acute respiratory distress syndrome,"ER METHODRisk factors for depression and anxiety at 1 and 2 years were assessed using stepwise multiple regression analyses, with and without 1-year outcomes.RESULTSARDS survivors had depression (16% and 23%) and anxiety (24% and 23%) at 1 and 2 years, respectively. Predictors of depression at 1 year were alcohol dependence, female gender and younger age (P=.006). Predictors of anxiety were ratio of arterial oxygen tension to inspired oxygen fraction and duration of mechanical ventilation (P<.005). Predictors of depression at 2 years were depression at 1 year and the presence of cognitive sequelae (P<.0001). Predictors of anxiety at 2 years was anxiety at 1 year (P<.0001).CONCLUSIONSMedical variables that predicted depression or anxiety at 1 year no longer predicted depression and anxiety at 2 years. Medical variables appear to have a short-term effect on psychiatric outcomes. At 2 years lifestyle behaviors including history of smoking along with cognitive sequelae, depression and anxiety at 1 year predict depression and anxiety.OBJECTIVEDepression and anxiety are common morbidities of critical illness. We assessed risk factors of depression and anxiety in Acute Respiratory Distress Syndrome (ARDS) survivors at 1 and 2 years post-hospital discharge.","Hopkins, R O; Key, C W; Suchyta, M R; Weaver, L K; Orme, J F",2010.0,10.1016/j.genhosppsych.2009.11.003,0,0,
6453,Pretreatment depression severity in breast cancer patients and its relation to treatment response to behavior therapy,"ER OBJECTIVE: Major depressive disorder is prevalent in breast cancer patients. There is a paucity of research on variables associated with depression severity and the link between depression severity and response to psychotherapy. To provide optimal mental health services to breast cancer patients, examining correlates of depression severity and its relation to treatment response is critical.METHOD: In the context of a randomized trial of behavior activation and problem-solving therapy for depressed breast cancer patients, this study evaluated demographic (marital status, age, education), psychosocial (social support, environmental reward, anxiety, number of coexistent anxiety disorders), and cancer-related (bodily pain, length of diagnosis, cancer stage) variables associated with pretreatment depression severity. Second, the relation of pretreatment depression severity with posttreatment and 12-month response and remission was assessed.RESULTS: For pretreatment depression severity, the overall regression model accounted for 40% of the variance, F(5, 74) = 9.87, p < .001. Less environmental reward and greater somatic anxiety were significantly and uniquely associated with depression severity. Depression severity was unrelated to treatment remission but was a significant moderator of treatment response at posttreatment and 12-month follow-up; individuals with higher depression severity were more responsive to therapy. For patients treated with behavior activation, environmental reward significantly mediated the relationship between pre- and posttreatment depression.CONCLUSIONS: Consistent with behavioral models of depression, less environmental reward and greater anxiety might influence depression severity in breast cancer patients. Data support the efficacy of behavior therapy for breast cancer patients, particularly those with more severe depression.","Hopko, D R; Clark, C G; Cannity, K; Bell, J L",2016.0,10.1037/hea0000252,0,0,
6454,Repetitive transcranial magnetic stimulation (rTMS) for treatment of alcohol dependence,"ER OBJECTIVES: Neuroimaging studies have found that alcohol dependent patients display dopaminergic dysfunction in the ventral striatum, which is associated with alcohol craving. Repetitive transcranial magnetic stimulation (rTMS) was introduced as a promising new treatment option for depression, and among other neurobiological mechanisms, it is able to stimulate the striatal dopaminergic system. The aim of our study was to investigate the effect of high frequency rTMS of the left dorsolateral prefrontal cortex compared to sham stimulation on craving and mood in alcohol dependent women. Furthermore, the impact on an attentional blink (AB) paradigm to pictures with neutral, emotional and alcohol-related contents was proofed.METHODS: Nineteen female detoxified patients were randomized either to a high frequency rTMS (20 Hz) over the left DLPFC (n = 10) or a sham stimulations (n = 9) at 10 days. Alcohol craving was determined with the Obsessive Compulsive Drinking Scale, depressive symptoms were registered by means of Hamilton Depression Rating Scale and Beck' Depression Inventory. For the AB paradigm an age-matched control group was investigated.RESULTS: There were no significantly differences between both groups regarding alcohol craving or mood. In the AB paradigm, real stimulated patients detected alcohol related T2 targets incorrectly in comparison to the sham stimulated and control subjects.SUMMARY: Although there were no differences in clinical parameters such as craving or mood after real high frequency rTMS compared to sham stimulation, we found an interesting difference between the real and the sham stimulated group and controls in the AB paradigm indicating an increase of the AB effect to alcohol-related pictures after real stimulation. Further studies are needed to replicate these findings and correlate them to clinical and neurophysiological data.","Höppner, J; Broese, T; Wendler, L; Berger, C; Thome, J",2011.0,10.3109/15622975.2011.598383,0,0,
6455,"Effects of 7 days of treatment with the cannabinoid type 1 receptor antagonist, rimonabant, on emotional processing","ER Rimonabant is a cannabinoid type 1 receptor (CB1) antagonist formerly used to treat obesity, but which was withdrawn from the market in late 2008 because of its association with psychiatric adverse effects such as depression and anxiety. Previously, we showed that a single dose of rimonabant produced a negative bias on an emotional word memory task, in the absence of subjective mood effects. The present study investigated whether a similar effect on emotional processing could be seen after 7 days' daily treatment with rimonabant 20 mg, using a randomized, placebo-controlled, between-subjects design in healthy volunteers (final n = 21). In comparison with placebo, rimonabant induced a negative bias on a memory recognition task without producing a change in subjective mood. This raises the possibility that the depressogenic effects of rimonabant may be linked to emotional memory biases, and that such biases may be detectable in the absence of subjective mood changes. Investigating such effects could be useful in detecting adverse psychiatric effects of novel treatments.","Horder, J; Browning, M; Simplicio, M; Cowen, P J; Harmer, C J",2012.0,10.1177/0269881111400649,0,0,
6456,Effects of a third party observer and anxiety on tests of executive function,"ER For the past 10 years, research on the effects of observer presence on test performance has expanded in the neuropsychological literature. Previous studies have shown that the presence of a third party observer is associated with poorer performance on tests of effort, attention, concentration, learning, and memory. The present study was designed to investigate whether performance on tests of executive function is similarly impaired by the presence of a third party observer. The study also sought to examine associations among examinee anxiety, observer presence, and performance. Seventy-nine college undergraduates were recruited for the study, and 70 were included in the final analyses. Participants were randomly assigned to either the observation or control condition, and were administered verbal fluency tests, the Trail Making Test (parts A and B), and the Tactual Performance Test, as well as the Fear of Negative Evaluation scale and State-Trait Anxiety Inventory. Multivariate analyses of variance revealed that performance on the combined dependent variables was significantly associated with observer presence. A significant observation condition by trait anxiety interaction was also found. Univariate analyses revealed that performances on semantic fluency and TPT-localization were most strongly associated with observation and trait anxiety, with performance being poorer in the presence of a third party observer. Additionally, effects of trait anxiety on performance in the presence of an observer appear to vary depending on task characteristics. Implications and suggestions for further research are discussed.","Horwitz, J E; McCaffrey, R J",2008.0,10.1016/j.acn.2008.02.002,0,0,
6457,"Toddlers' food preferences. The impact of novel food exposure, maternal preferences and food neophobia","ER Food preferences have been identified as a key determinant of children's food acceptance and consumption. The aim of this study was to identify factors that influence children's liking for fruits, vegetables and non-core foods. Participants were Australian mothers (median age at delivery=31years, 18-46years) and their two-year-old children (M=24months, SD=1month; 52% female) allocated to the control group (N=245) of the NOURISH RCT. The effects of repeated exposure to new foods, maternal food preferences and child food neophobia on toddlers' liking of vegetables, fruits and non-core foods and the proportion never tried were examined via hierarchical regression models; adjusting for key maternal (age, BMI, education) and child covariates (birth weight Z-score, gender), duration of breastfeeding and age of introduction to solids. Maternal preferences corresponded with child preferences. Food neophobia among toddlers was associated with liking fewer vegetables and fruits, and trying fewer vegetables. Number of repeated exposures to new food was not significantly associated with food liking at this age. Results highlight the need to: (i) encourage parents to offer a wide range of foods, regardless of their own food preferences, and (ii) provide parents with guidance on managing food neophobia.","Howard, A J; Mallan, K M; Byrne, R; Magarey, A; Daniels, L A",2012.0,10.1016/j.appet.2012.08.022,0,0,
6458,Protein-source tryptophan as an efficacious treatment for social anxiety disorder: a pilot study,"ER Until recently, intact protein that is rich in tryptophan was not seen as an alternative to pharmaceutical-grade tryptophan because protein also contains large neutral amino acids (LNAAs) that compete for transport sites across the blood-brain barrier. Recent evidence indicates that when deoiled gourd seed (a rich source of tryptophan with approximately 22 mg/g protein) is combined with glucose (a carbohydrate that reduces serum levels of competing LNAAs) a clinical effect similar to that of pharmaceutical-grade tryptophan is achieved. Objective and subjective measures of anxiety in those suffering from social phobia (also known as social anxiety disorder) were employed to measure changes in anxiety in response to a stimulus as part of a double-blind, placebo-controlled, crossover study with a wash-out period of 1 week between study sessions. Subjects were randomly assigned to start with either (i) protein-source tryptophan (deoiled gourd seed) in combination with carbohydrate or (ii) carbohydrate alone. One week after the initial session, subjects returned for a follow-up session and received the opposite treatment of that received at the first session. All 7 subjects who began the study completed the 2-week protocol. Protein-source tryptophan with carbohydrate, but not carbohydrate alone, resulted in significant improvement on an objective measure of anxiety. Protein-source tryptophan combined with a high glycemic carbohydrate is a potential anxiolytic to those suffering from social phobia.","Hudson, C; Hudson, S; MacKenzie, J",2007.0,10.1139/Y07-082,0,0,
6459,Improving distress in dialysis (iDiD): a feasibility two-arm parallel randomised controlled trial of an online cognitive behavioural therapy intervention with and without therapist-led telephone support for psychological distress in patients undergoing haemodialysis,"ER METHODS: Patients will be screened for depression and anxiety while attending for their haemodialysis treatments. We aim to recruit 60 adult patients undergoing haemodialysis who meet criteria for mild to moderately severe symptoms of depression and/or anxiety. Patients will be randomised individually (using a 1:1 computerised sequence ratio) to either online CBT with therapist telephone support (intervention arm), or online CBT with no therapist (control arm). Outcomes include feasibility and acceptability descriptive data on rates of recruitment, randomisation, retention and treatment adherence. Self-report outcomes include measures of depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), quality of life (Euro-QoL), service use (client service receipt inventory) and illness cognitions (brief illness perception questionnaire). A qualitative process evaluation will also be conducted. The statistician will be blinded to treatment allocation.ETHICS AND DISSEMINATION: A National Health Service (NHS) research ethics committee approved the study. Data from this study will provide essential information for the design and testing of further interventions to ameliorate distress in patients undergoing dialysis. Any amendments to the protocol will be submitted to the NHS committee and study sponsor.TRIAL REGISTRATION NUMBER: NCT023528702; Pre-results.INTRODUCTION: Psychological distress is common in end-stage kidney disease (ESKD) and is associated with poorer health outcomes. Cognitive behavioural therapy (CBT) is recommended in UK clinical guidelines for the management of depression in people with long-term conditions. Access to skilled therapists competent in managing the competing mental and physical health demands of ESKD is limited. Online CBT treatments tailored to the needs of the ESKD population offers a pragmatic solution for under-resourced services. This study examines the feasibility and acceptability of implementing a two-arm parallel randomised controlled trial of online CBT with (intervention arm) and without (control arm) therapist support to improve psychological distress in patients undergoing haemodialysis.","Hudson, J L; Moss-Morris, R; Game, D; Carroll, A; McCrone, P; Hotopf, M; Yardley, L; Chilcot, J",2016.0,10.1136/bmjopen-2016-011286,0,0,
6460,The impact of brief parental anxiety management on child anxiety treatment outcomes: a controlled trial,"ER Parental anxiety is a risk to optimal treatment outcomes for childhood anxiety disorders. The current trial examined whether the addition of a brief parental anxiety management (BPAM) program to family cognitive behavioral therapy (CBT) was more efficacious than family CBT-only in treating childhood anxiety disorders. Two hundred nine children (aged 6-13 years, 104 female, 90% Caucasian) with a principal anxiety disorder were randomly allocated to family CBT with a five-session program of BPAM (n = 109) or family CBT-only (n = 100). Family CBT comprised the Cool Kids program, a structured 12-week program that included both mothers and fathers. Overall, results revealed that the addition of BPAM did not significantly improve outcomes for the child or the parent compared to the CBT-only group at posttreatment or 6-month follow-up. Overall, however, children with nonanxious parents were more likely to be diagnosis free for any anxiety disorder compared to children with anxious parents at posttreatment and 6-month follow-up. BPAM did not produce greater reductions in parental anxiety. The results support previous findings that parent anxiety confers poorer treatment outcomes for childhood anxiety disorders. Nevertheless the addition of BPAM anxiety management for parents in its current format did not lead to additional improvements when used as an adjunct to family CBT in the treatment of the child's anxiety disorder. Future benefits may come from more powerful methods of reducing parents' anxiety.","Hudson, J L; Newall, C; Rapee, R M; Lyneham, H J; Schniering, C C; Wuthrich, V M; Schneider, S; Seeley-Wait, E; Edwards, S; Gar, N S",2014.0,10.1080/15374416.2013.807734,0,0,
6461,Cognitive-behavioral treatment versus an active control for children and adolescents with anxiety disorders: a randomized trial,"ER OBJECTIVE: The current trial examined whether a specific cognitive-behavioral treatment package was more efficacious in treating childhood anxiety disorders than a nonspecific support package. METHOD: One hundred twelve children (aged 7-16 years) with a principal anxiety disorder were randomly allocated to either a group cognitive-behavioral treatment (CBT) program or a control condition (group support and attention [GSA]). RESULTS: Overall, results showed that CBT was significantly more efficacious compared with the GSA condition: 68.6% of children in the CBT condition did not meet diagnostic criteria for their principal anxiety diagnosis at 6-month follow-up compared with 45.5% of the children in the GSA condition. The results of the child- and parent-completed measures indicated that, although mothers of CBT children reported significantly greater treatment gains than mothers of GSA children, children reported similar improvements across conditions. CONCLUSIONS: Specific delivery of cognitive-behavioral skills is more efficacious in the treatment of childhood anxiety than a treatment that includes only nonspecific therapy factors.","Hudson, J L; Rapee, R M; Deveney, C; Schniering, C A; Lyneham, H J; Bovopoulos, N",2009.0,10.1097/CHI.0b013e31819c2401,0,0,
6462,Callous-unemotional traits and anxiety in a community sample of 7-year-olds,"ER In forensic samples of adults and adolescents, there is evidence to suggest that there may be distinct variants of psychopathy marked by the presence/absence of significant levels of anxiety. Callous-unemotional (CU) traits can be used to characterize children who share behavioural and neurocognitive features with adult psychopaths. The aims of this paper are to (a) investigate the genetic and environmental influences on CU traits with/without anxiety and (b) explore differences in terms of concurrent and early parenting and adjustment. Discrete groups were formed on the basis of scores in the top 10% of the sample on CU and anxiety scales at age 7. Estimates of group heritability were calculated using a Defries-Fulker (DF) extremes regression model. Follow back analyses of early parenting and adjustment were conducted using multivariate analyses of covariance. There was high group heritability for CU traits with/without anxiety. Children with both high CU and anxiety showed greater levels of adjustment problems than those with CU only at age 7. The two groups did not differ in parenting characteristics. In this general population sample, evidence did not support differences in etiology for the two groups high on CU traits differing in level of anxiety.","Humayun, S; Kahn, R E; Frick, P J; Viding, E",2014.0,10.1080/15374416.2013.814539,0,0,
6463,"Effects of institutional rearing and foster care on psychopathology at age 12 years in Romania: follow-up of an open, randomised controlled trial","ER Background: Early social deprivation can negatively affect domains of functioning. We examined psychopathology at age 12 years in a cohort of Romanian children who had been abandoned at birth and placed into institutional care, then assigned either to be placed in foster care or to care as usual. Methods: We used follow-up data from the Bucharest Early Intervention Project (BEIP), a randomised controlled trial of abandoned children in all six institutions for young children in Bucharest, Romania. In the initial trial, 136 children, enrolled between ages 6-31 months, were randomly assigned to either care as usual or placement in foster care. In this study we followed up these children at age 12 years to assess psychiatric symptoms using the Diagnostic Interview Schedule for Children (4th edition; DISC-IV). We also recruited Romanian children who had never been placed in an institution from paediatric clinics and schools in Bucharest as a comparator group who had never been placed in an institution. The primary outcome measure was symptom counts assessed through DISC-IV scores for three domains of psychopathology: internalising symptoms, externalising symptoms, and attention-deficit hyperactivity disorder (ADHD). We compared mean DISC-IV scores between trial participants and comparators who had never been placed in an institution, and those assigned to care as usual or foster care. Analyses were done by modified intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00747396. Findings: We followed up 110 children from the BEIP trial between Jan 27, 2011, and April 11, 2014, and 49 children as comparators who had never been placed in an institution. The 110 children who had ever been placed in an institution had higher symptom counts for internalising disorders (mean 093 [SD 168] vs 045 [084], difference 048 [95% CI 014-082]; p=00127), externalising disorders (231 [286] vs 065 [133], difference 166 [106-225]; p<00001), and ADHD (400 [501] vs 071 [185], difference 329 [95% CI 239-418]; p<00001) than did children who had never been placed in an institution. Compared with 55 children randomly assigned to receive care as usual, the 55 children in the foster-care group had fewer externalising symptoms (mean 289 [SD 300] for care as usual vs 173 [261] for foster care, difference 116 [95% CI 011 to 222]; p=00255), but symptom counts for internalising disorders (mean 100 [159] for care as usual vs 085 [178] for foster care, difference 015 [-035 to 065]; p=05681) and ADHD (mean 376 [461] for care as usual vs 424 [541] for foster care, difference -047 [-215 to 120; p=05790) did not differ. In further analyses, symptom scores substantially differed by stability of foster-care placement. Interpretation: Early foster care slightly reduced the risk of psychopathology in children who had been living in institutions, but long-term stability of foster-care placements is an important predictor of psychopathology in early adolescence. Funding: National Institute of Mental Health and the John D and Catherine T MacArthur Foundation.","Humphreys, K L; Gleason, M M; Drury, S S; Miron, D; Nelson, C A; Fox, N A; Zeanah, C H",2015.0,10.1016/S2215-0366(15)00095-4,0,0,
6464,Randomized controlled trial of an early intervention programme for adolescent anxiety disorders,"ER METHODA total of 260 students in their first year of high school with self-reported anxiety symptoms >1 SD above the mean score of a normative sample were randomly allocated on the basis of their school to an intervention condition led by school staff or to a monitoring condition.RESULTSThere was little difference between conditions at the 2 year and 4 year follow up on self-reported symptoms, and no difference on diagnosis or health-care use.CONCLUSIONSOutcomes associated with indicated prevention programmes led by school staff may not be as strong as those produced by specialist mental health staff. More work is needed to delineate models by which evidence-based treatments can be effectively used in schools.OBJECTIVETo assess the effectiveness of an indicated early intervention and prevention programme for anxiety disorders when conducted by school staff.","Hunt, C; Andrews, G; Crino, R; Erskine, A; Sakashita, C",2009.0,10.1080/00048670902721152,0,0,
6465,Psychological and physiological response of students to different types of stress management programs,"ER PURPOSE: To design, implement, and examine the psychoneuroendocrine responses of three different types of stress management programs.DESIGN: Randomly assigned. A pre/post experimental design comparing variables between three different programs and a control group. The first program included training in deep breathing, relaxation response, meditation, and guided imagery techniques (RRGI). The second program included training in cognitive behavioral techniques (CB). The third program included both RRGI and CB (RRGICB).SETTING: The study was conducted at Buenos Aires University.SUBJECTS: Participants (N ?= 52) were undergraduate students.MEASURES: Anxiety, anger, hopelessness, neuroticism, respiration rate, and salivary cortisol levels were assessed.ANALYSIS: Wilcoxon signed rank test was used to investigate differences in pre and post variables.RESULTS: Subjects in the RRGI group showed significantly lower levels of anxiety (p < .011), anger (p < .012), neuroticism (p < .01), respiratory rate (p < .002), hopelessness (p < .01), and salivary cortisol (p < .002) after the treatment. Subjects in the CB group showed significantly lower levels of anxiety (p < .018), anger (p < .037), and neuroticism (p < .03) after the treatment. Subjects in the RRGICB group showed significantly lower levels of anxiety (p < .001), anger (p < .001), neuroticism (p < .008), hopelessness (p < .01), respiratory rate (p < .001), and salivary cortisol (p < .002) after the treatment. Subjects in the control group showed only one variable modification, a significant increase in cortisol levels (p < .004).CONCLUSIONS: The combination of deep breathing, relaxation response, meditation, and guided imagery techniques with CB seems to be effective at helping people to deal with stress.","Iglesias, S L; Azzara, S; Argibay, J C; Arnaiz, M L; Valle, Carpineta M; Granchetti, H; Lagomarsino, E",2012.0,10.4278/ajhp.110516-QUAL-199,0,0,
6466,Dietary weight loss and exercise interventions effects on quality of life in overweight/obese postmenopausal women: a randomized controlled trial,"ER METHODS: This study was a randomized controlled trial. Overweight/obese postmenopausal women were randomly assigned to 12 months of dietary weight loss (n = 118), moderate-to-vigorous aerobic exercise (225 minutes/week, n = 117), combined diet and exercise (n = 117), or control (n = 87). Demographic, health and anthropometric information, aerobic fitness, HRQOL (SF-36), stress (Perceived Stress Scale), depression [Brief Symptom Inventory (BSI)-18], anxiety (BSI-18) and social support (Medical Outcome Study Social Support Survey) were assessed at baseline and 12 months. The 12-month changes in HRQOL and psychosocial factors were compared using analysis of covariance, adjusting for baseline scores. Multiple regression was used to assess predictors of changes in HRQOL.RESULTS: Twelve-month changes in HRQOL and psychosocial factors differed by intervention group. The combined diet + exercise group improved 4 aspects of HRQOL (physical functioning, role-physical, vitality, and mental health), and stress (p ? 0.01 vs. controls). The diet group increased vitality score (p < 0.01 vs. control), while HRQOL did not change differently in the exercise group compared with controls. However, regardless of intervention group, weight loss predicted increased physical functioning, role-physical, vitality, and mental health, while increased aerobic fitness predicted improved physical functioning. Positive changes in depression, stress, and social support were independently associated with increased HRQOL, after adjusting for changes in weight and aerobic fitness.CONCLUSIONS: A combined diet and exercise intervention has positive effects on HRQOL and psychological health, which may be greater than that from exercise or diet alone. Improvements in weight, aerobic fitness and psychosocial factors may mediate intervention effects on HRQOL.BACKGROUND: Although lifestyle interventions targeting multiple lifestyle behaviors are more effective in preventing unhealthy weight gain and chronic diseases than intervening on a single behavior, few studies have compared individual and combined effects of diet and/or exercise interventions on health-related quality of life (HRQOL). In addition, the mechanisms of how these lifestyle interventions affect HRQOL are unknown. The primary aim of this study was to examine the individual and combined effects of dietary weight loss and/or exercise interventions on HRQOL and psychosocial factors (depression, anxiety, stress, social support). The secondary aim was to investigate predictors of changes in HRQOL.","Imayama, I; Alfano, C M; Kong, A; Foster-Schubert, K E; Bain, C E; Xiao, L; Duggan, C; Wang, C Y; Campbell, K L; Blackburn, G L; McTiernan, A",2011.0,10.1186/1479-5868-8-118,0,0,
6467,A randomized controlled trial of an audio-based treatment program for child anxiety disorders,"ER The aim of this study was to investigate the efficacy of an audio-based cognitive-behavioural therapy (CBT) program for child anxiety disorders. Twenty-four children aged 5-11 years were randomly allocated into either the audio-based CBT program condition (Audio, n = 12) or a waitlist control (WL; n = 12) group. Outcome measures included a clinical diagnostic interview, clinician-rated global assessment of functioning, and parent and child self-report ratings of anxiety and internalisation. Assessments were conducted prior to treatment, 12 weeks following treatment, and at 3-month follow-up. Results indicated that at post-assessment, 58.3% of children receiving treatment compared to 16.7% of waitlist children were free of their primary diagnosis, with this figure rising to 66.67% at the 3-month follow-up time point. Additionally, at post-assessment, 25.0% of children in the treatment condition compared to .0% of the waitlist condition were free of all anxiety diagnoses, with this figure rising to 41.67% for the treatment group at 3-month follow-up. Overall, the findings suggest that the audio program tested in this study has the potential to be an efficacious treatment alternative for anxious children.","Infantino, A; Donovan, C L; March, S",2016.0,10.1016/j.brat.2016.02.007,0,0,
6468,"A randomized controlled trial of individual cognitive therapy, group cognitive behaviour therapy and attentional placebo for adolescent social phobia","ER BACKGROUND: Very few studies have investigated the effects of individual disorder-specific treatment of social phobia (SP) in adolescents. The objective of this study was to compare the effects of individual cognitive therapy for SP, group cognitive behavioural therapy (CBTG) and attentional placebo (AP) among adolescents with a primary diagnosis of SP.METHODS: A randomized controlled design was used, and a total of 279 adolescents were assessed. Fifty-seven adolescents, between 13 and 16 years old, were allocated to individual cognitive therapy, CBTG or AP. The participants were assessed before treatment, at the end of treatment and at a 12-month follow-up using both self-report and a semi-structured interview.RESULTS: The individual cognitive therapy showed significant reductions in symptoms, impairment and diagnostic criteria both at the end of treatment and at the 12-month follow-up. Compared with CBTG and AP, the individual cognitive therapy group demonstrated significantly greater effects on both symptom reduction and impairment. There were no significant differences between CBTG and AP.CONCLUSIONS: In a direct comparison between the most commonly used treatments for adolescent SP, we found that individual therapy was the most effective, yielding better effects than both CBTG and AP.","Ingul, J M; Aune, T; Nordahl, H M",2014.0,10.1159/000354672,0,0,
6469,Problem solving and maternal distress at the time of a child's diagnosis of cancer in two-parent versus lone-parent households,ER METHODSNegative affectivity and problem-solving strategies were assessed for 464 mothers (87 lone and 377 married/partnered) within 2-16 weeks of their child's diagnosis with cancer.RESULTSThe two groups of mothers did not differ significantly on measures of perceived posttraumatic stress or problem-solving; lone mothers reported significantly more symptoms of depression. This difference was no longer significant when maternal education was taken into account.CONCLUSIONSNegative affectivity and problem-solving abilities were similar for lone mothers and those that are married/partnered shortly after their child has been diagnosed with cancer. Findings are discussed within the context of contemporary strategies to assess marital status as proxy variable for various underlying constructs.OBJECTIVETo examine negative affectivity and problem-solving abilities for lone mothers and those who are married/partnered subsequent to a child's diagnosis with cancer.,"Iobst, E A; Alderfer, M A; Sahler, O J; Askins, M A; Fairclough, D L; Katz, E R; Butler, R W; Dolgin, M J; Noll, R B",2009.0,10.1093/jpepsy/jsn140,0,0,
6470,An item response analysis of the pediatric PROMIS anxiety and depressive symptoms scales,"ER METHODS: Participants (n = 1,529) were recruited in public school settings, hospital-based outpatient and subspecialty pediatrics clinics. The anxiety (k = 18) and depressive symptoms (k = 21) items were split between two test administration forms. Hierarchical confirmatory factor-analytic models (CFA) were conducted to evaluate scale dimensionality and local dependence. IRT analyses were then used to finalize item banks and short forms.RESULTS: CFA results confirmed that anxiety and depressive symptoms are separate constructs and indicative of negative affect. Items with local dependence and DIF were removed resulting in 15 anxiety and 14 depressive symptoms items. The psychometric differences between short forms and simulated computer adaptive tests are presented.CONCLUSIONS: PROMIS pediatric item banks were developed to provide efficient assessment of health-related quality of life domains. This sample provides initial calibrations of anxiety and depressive symptoms item banks and creates PROMIS pediatric instruments, version 1.0.PURPOSE: The Patient-Reported Outcomes Measurement Information System (PROMIS) aims to develop self-reported item banks for clinical research. The PROMIS pediatrics (aged 8-17) project focuses on the development of item banks across several health domains (physical function, pain, fatigue, emotional distress, social role relationships, and asthma symptoms). The psychometric properties of the anxiety and depressive symptom item banks are described.","Irwin, D E; Stucky, B; Langer, M M; Thissen, D; Dewitt, E M; Lai, J S; Varni, J W; Yeatts, K; DeWalt, D A",2010.0,10.1007/s11136-010-9619-3,0,0,
6471,An association study between a transcriptional polymorphism in the serotonin transporter gene and panic disorder in a Japanese population,"ER A polymorphism in the 5' region of the serotonin transporter gene modulates its transcription efficiency. Its short allele has been reported to be associated with neurotic traits. The serotonin transporter is the action site of selective serotonin re-uptake inhibitors, widely used in the treatment of panic disorder. We examined an association between the polymorphism and panic disorder in a case-control study consisting of 66 Japanese patients and 150 controls. The short allele was significantly more frequent in the Japanese than in Caucasians. The patients and the controls had similar allele frequencies, indicating no association between the polymorphism and panic disorder in most Japanese patients.","Ishiguro, H; Arinami, T; Yamada, K; Otsuka, Y; Toru, M; Shibuya, H",1997.0,,0,0,
6472,Hydrophobic versus double-square-edged hydrophilic foldable acrylic intraocular lens: effect on posterior capsule opacification,"ER SETTINGToyama Prefectural Central Hospital, Toyama, Japan.DESIGNCase-control study.METHODSPatients with bilateral senile cataract were prospectively randomized to receive a hydrophobic IOL (Acrysof SA60AT) in 1 eye and a hydrophilic IOL (Meridian HP60M) in the other eye. The PCO density value, degree of IOL decentration and tilt, and anterior chamber depth (ACD) were measured using Scheimpflug videophotography 1, 6, 12, 18, and 24 months after surgery. Visual acuity and the number of eyes requiring neodymium:YAG laser capsulotomy were also assessed.RESULTSThe study evaluated 16 eyes (63 patients). The PCO value in the hydrophilic group increased significantly with time and was statistically significantly greater than in the hydrophobic group 18 and 24 months postoperatively (both P  .05), and there were no statistically significant postoperative differences in these parameters between the 2 IOL groups (P > .05).CONCLUSIONTwo years after surgery, the hydrophobic IOL group had less PCO, a lower capsulotomy rate, and better visual acuity than the hydrophilic IOL group.FINANCIAL DISCLOSURENo author has a financial or proprietary interest in any material or method mentioned.PURPOSETo evaluate posterior capsule opacification (PCO) 2 years after cataract surgery with implantation of a hydrophobic acrylic or single-piece sharp-edged hydrophilic acrylic intraocular lens (IOL).","Iwase, T; Nishi, Y; Oveson, B C; Jo, Y J",2011.0,10.1016/j.jcrs.2010.12.059,0,0,
6473,Effects of bilateral breast reduction on anxiety and depression: results of a prospective randomised trial,"ER We assessed the effects of bilateral breast reduction on anxiety and depression in women with mammary hypertrophy (macromastia). Seventy-three consecutive women referred for consideration for breast reduction were recruited. They were randomised to have either early operation (within six weeks of initial assessment) or delayed operation (within six months of recruitment). The Hospital Anxiety and Depression Score was given before randomisation and four months later. All 73 patients completed the study. The mean (SD) age was 39 (12) years. The groups were matched for age, smoking, social class, and educational achievement. There were highly significant improvements (p<0.001) in symptoms of anxiety and depression. Reduction mammaplasty significantly improved symptoms of clinical depression in women with macromastia.","Iwuagwu, O C; Stanley, P W; Platt, A J; Drew, P J; Walker, L G",2006.0,10.1080/02844310500415335,0,0,
6474,Method of recruitment and the scores of self-report measures: the example of worry in the elderly,"ER Due to the difficulties in recruiting elderly people for psychological studies, a wide range of recruitment methods has been used. The underlying assumption that the recruitment method does not seriously affect the results has to be tested. Results in different worry measures are compared between three samples which were recruited with different strategies: (i) randomization sampling from the census of an urban area (random sample; n=97); (ii) people involved in leisure activities in senior centers (convenience sample; n=142); and (iii) people from the close environment of psychology students (snowball sample; n=60). People from those samples, aged 65 and more, completed the Penn State Worry Questionnaire (trait-worry), and the Worry Scale (contents of worry). Differences were found for several demographic characteristics. There were marked differences between samples in the percentage of individuals endorsing cut-score criteria for generalized anxiety disorder (GAD), with a very high percentage for the snowball sample. For all of the worry measures, analyzes of variance revealed significantly higher total scores for the non-randomly selected samples (p<0.01). Comparing the latter samples, higher trait worry (p<0.01) and more worrying about health and personal competencies (p<0.01) was found in the snowball sample. These results suggest that the sample recruitment method can specifically and seriously affect the outcomes of studies with elderly people, thus limiting the generalization of their results.","Izal, M; Nuevo, R; Montorio, I; Pérez-Rojo, G",2009.0,10.1016/j.archger.2007.09.009,0,0,
6475,Experimental evidence of welfare reform impact on clinical anxiety and depression levels among poor women,"ER In this paper, we employ a classical experiment to determine if welfare reform causes poor women to experience increased levels of clinical anxiety and depression. We organize our analyses around the insights provided by lifestyle change and ecosocial theories of illness. Our data come from the New Jersey Family Development Program (FDP), one of the most highly publicized welfare experiments in the U.S. A sample of 8393 women was randomly assigned into two groups, one which stressed welfare-to-work and the other which offered traditional welfare benefits. These women were followed from 1992 through 1996 and information on clinical diagnoses was collected quarterly from physician treatment claims to the government Medicaid program. Our intention-to-treat estimates show that for short-term welfare recipients FDP decreased the prevalence of anxiety by 40% and increased depression by 8%. For black women both anxiety and depression diagnoses declined while Hispanic women experienced a 68% increase in depression. We discuss several public policy implications which arise from our work.","Jagannathan, R; Camasso, M J; Sambamoorthi, U",2010.0,10.1016/j.socscimed.2010.02.044,0,0,
6476,Providing emotional stability through relaxation training,"ER To determine the effects of integrative relaxation training (IRT) on emotional stability, we exposed 32 patients diagnosed with anxiety disorder to a pre-test (16PF) and to 12 sessions of group psychoeducation training. Patients were randomly assigned to 2 groups (study 17 and control 15 patients). The study group received 12 weekly group sessions of IRT. Level of anxiety was evaluated in a post-test using a questionnaire and the State-Trait Anxiety Inventory (STAI). Emotional stability and level of anxiety were significantly reduced in the study group: there was a marked increase in scores for emotionally s and venturesome and a decrease in scores for apprehensive and tense. The STAI score was statistically significantly lower in the study group.","Janbozorgi, M; Zahirodin, A; Norri, N; Ghafarsamar, R; Shams, J",2009.0,,0,0,
6477,Isometric hip muscle strength in posttraumatic below-knee amputees,"ER METHODSForty below-knee amputees (after war wounding), average age 35.6 +/- 10.6 years, that were included in primary rehabilitation program with prosthetics, were examined. Objective parameters were used to evaluate therapeutical effects. Isometric muscle strength of hip flexors, extensors, abductors and adductors was measured by dynamometer and expressed in Newton (N) at admission, control and discharge for each patient. Average length of the treatment was 51 +/- 34.1 days.RESULTSFor isometric hip flexors (t = -1.99346, p < 0.05), extensors (t = -4.629073, p < 0.001), abductors (t = -4.9408, p < 0.001) and adductors (t = -2.00228, p < 0.05), muscle strength was significantly less on the amputated than on nonamputated side. The highest differences in muscle strength between amputated and nonamputated limbs were noted for hip abductors (26.6%) and extensors (23.3%). There was significant improvement of mean values of strength for all examined hip muscles after rehabilitation and prosthetics for both legs in comparison to beginning of the therapy. The hip abductor on the amputated side was for 19.4% weaker after rehabilitation in comparison to the non-amputated limb.CONCLUSIONDecreases of isometric muscle strength in all examined hip muscles were observed, more in the amputated limb. Rehabilitation with prosthetics is a successful method for improving isometric hip muscle strength on the both, amputated and non-amputated limbs in war wounded below-knee amputees.BACKGROUND/AIMTraumas and war injuries, next to chronic occlusive artery disease and diabetes mellitus-derived complications, are the most frequent cause of the lower limbs amputation. They affect mostly younger population that need a higher level of activities as compared with the elderly. Medical rehabilitation is very significant for the muscle performance improvement in this population providing their social reintegration. The aim of this study was to investigate the effect of below-knee amputation on the hip isometric muscle strength and effect of rehabilitation on improvement of hip muscle strength in below-knee amputees, secondary to war wounding.","Jandri?, S",2007.0,,0,0,
6478,Using new technologies to promote weight management: a randomised controlled trial study protocol,"ER METHODS/DESIGN: This project will be conducted as a 3-arm randomised controlled trial. One hundred and twenty participants will be recruited from the Perth community, and will be randomly assigned to one of the following three groups: the Facebook group, the pamphlet group, or a control group. The Facebook Group will receive the weight management program delivered via a closed group in Facebook, the Pamphlet Group will be given the same weight management program presented in a booklet, and the Control Group will follow the Australian Dietary Guidelines and the National Physical Activity Guidelines for Adults as usual care. Change in weight, body composition and waist circumference will be initial indicators of adherence to the program. Secondary outcome measures will be blood glucose, insulin, blood pressure, arterial stiffness, physical activity, eating behaviour, mental well-being (stress, anxiety, and depression), social support, self-control, self-efficacy, Facebook activity, and program evaluation.DISCUSSION: It is expected that this trial will support the use of social media - a source of social support and information sharing - as a delivery method for weight management programs, enhancing the reduction in weight expected from dietary and physical activity changes. Facebook is a popular, easy to access and cost-effective online platform that can be used to assist the formation of social groups, and could be translated into health promotion practice relatively easily. It is anticipated in the context of the predicted findings that social media will provide an invaluable resource for health professionals and patients alike.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Register (ANZCTR): ACTRN12614000536662. Date registered: 21 May 2014.BACKGROUND: Over the last three decades, overweight and obesity and the associated health consequences have become global public health priorities. Methods that have been tried to address this problem have not had the desired impact, suggesting that other approaches need to be considered. One of the lessons learned throughout these attempts is that permanent weight loss requires sustained dietary and lifestyle changes, yet adherence to weight management programs has often been noted as one of the biggest challenges. This trial aims to address this issue by examining whether social media, as a potential health promotion tool, will improve adherence to a weight management program. To test the effectiveness of this measure, the designated program will be delivered via the popular social networking site Facebook, and compared to a standard delivery method that provides exactly the same content but which is communicated through a pamphlet. The trial will be conducted over a period of twelve weeks, with a twelve week follow-up. Although weight loss is expected, this study will specifically investigate the effectiveness of social media as a program delivery method. The program utilised will be one that has already been proven to achieve weight loss, namely The CSIRO Total Wellbeing Diet.","Jane, M; Foster, J; Hagger, M; Pal, S",2015.0,10.1186/s12889-015-1849-4,0,0,
6479,Methylphenidate hydrochloride effects on psychological tests in acute schizophrenic and nonpsychotic patients,"ER Actively psychotic schizophrenic and nonpsychotic psychiatric inpatients received intravenous methylphenidate hydrochlroide (0.5 mg/kg). Each patient was rated for level of psychosis and talkativeness, and each received the Holtzman projective ink blot tests and the Kent-Rosanoff word-association tests before, during, and after methylphenidate infusion. Minnesota Multiphasic Personality Inventory Goldberg Index scores were also obtained as a general measure of psychosis. For the entire patient group, methylphenidate infusion was followed by a significant increase in talkativeness and psychosis ratings and in pathological responses to the Holtzman ink blot test. There was a significant decrease in common word associations. Since neither of the psychological tests allow more than one response per item, it appears that methylphenidate truly effects pathological thought processes and decreases common word associations as such, rather than merely making these processes more evident by increasing verbalization.","Janowsky, D S; Huey, L; Storms, L; Judd, L L",1977.0,,0,0,
6480,Effectiveness of a cognitive-behavioral therapy (CBT) manualized program for clinically anxious children: study protocol of a randomized controlled trial,"ER BACKGROUND: In the Netherlands, the prevalence of anxiety disorders is 20%; and children with anxiety are at increased risk for psychopathology throughout adulthood. Recently, a revised version of a cognitive behavioral therapy manualized program called 'Thinking + Doing = Daring' (TDD) was developed for children between 8 and 12 years old with an anxiety disorder. The main aim of this project is to conduct a Randomized Controlled Trial (RCT) to evaluate the effectiveness of TDD. METHODS/DESIGN: The CBT program will be tested with a RCT with 120 clinically anxious children (8-12 years old) referred to one of three mental health care agencies. Children will be randomly assigned to the experimental (N = 60, TDD) or to the control condition (N = 60, treatment as usual). The primary outcome measure will be the child's anxiety symptoms level. Secondary outcome measures will be externalizing (e.g. aggression) and internalizing problems (e.g. depression). Two potential mediators of change will be examined in the current study: therapeutic alliance and parenting. Mother and child in both the experimental and control condition will be surveyed at baseline, post treatment and after 6 and 12 months (follow-up). It is hypothesized that children in the experimental condition will show a stronger decrease in anxiety symptoms compared to children that receive treatment as usual. Moreover, we expect that a strong therapeutic alliance and decreases in parental control and rejection will contribute to treatment success. DISCUSSION: Early treatment for anxiety problems has the potential to not only result in anxiety reductions, but also to prevent future problems such as substance abuse and psychopathology throughout adulthood. Our results will be immediately relevant to practice, since we are partnering with 'real world' community agencies. If the CBT program proves more effective than treatment as usual, it could be implemented in community mental health care agencies across the Netherlands and beyond. Moreover, it has the potential to make treatment in these community settings shorter, more efficient and therefore cost-effective. Trial registration: Nederlands Trial Register NTR2967.","Jansen, M; Doorn, M M; Lichtwarck-Aschoff, A; Kuijpers, R C; Theunissen, H; Korte, M; Rossum, J; Wauben, A; Granic, I",2012.0,10.1186/1471-244X-12-16,0,0,
6481,Treatment of comorbid attention-deficit/hyperactivity disorder and anxiety in children: a multiple baseline design analysis,"ER OBJECTIVE: The present study evaluated a 10-week psychosocial treatment designed specifically for children with attention-deficit/hyperactivity disorder (ADHD) and a comorbid anxiety disorder.METHOD: Using a nonconcurrent multiple baseline design, the authors treated 8 children ages 8-12 with ADHD, combined type, and at least 1 of 3 major anxiety disorders (separation anxiety disorder, generalized anxiety disorder, social phobia). The integrated treatment protocol involved parent management training for ADHD and family-based cognitive-behavioral therapy for anxiety. Pretreatment assessments included semistructured diagnostic interviews and other standardized measures to determine study eligibility. Children were randomized to 1 of 3 baseline control conditions (i.e., 2, 3, or 4 weeks) and subsequently treated in a university-based psychosocial treatment clinic. Weekly assessments of ADHD and anxiety disorder symptoms occurred throughout treatment and comprehensive assessments were obtained at pretreatment, 1-week posttreatment, and 6-months posttreatment.RESULTS: Single-case results supported greater success in the treatment phase relative to the baseline phase for both ADHD and anxiety symptoms, and ADHD and anxiety symptoms appeared to change concurrently. Pre-post group analyses revealed significant and clinically meaningful improvements in ADHD and anxiety symptoms at 1-week posttreatment, but only anxiety symptoms moved into the subclinical range. At 6-months follow-up, treatment effects were maintained with new movement into the subclinical range for ADHD.CONCLUSIONS: The present study provides initial data on an integrated treatment protocol for ADHD and anxiety. Further replication and evaluation are needed. Implications of the findings are discussed.","Jarrett, M A; Ollendick, T H",2012.0,10.1037/a0027123,0,0,
6482,Children's mental health care following Hurricane Katrina: a field trial of trauma-focused psychotherapies,"ER New Orleans school children participated in an assessment and field trial of two interventions 15 months after Hurricane Katrina. Children (N = 195) reported on hurricane exposure, lifetime trauma exposure, peer and parent support, posttraumatic stress disorder (PTSD), and depressive symptoms. Teachers reported on behavior. At baseline, 60.5% screened positive for PTSD symptoms and were offered a group intervention at school or individual treatment at a mental health clinic. Uptake of the mental health care was uneven across intervention groups, with 98% beginning the school intervention, compared to 37% beginning at the clinic. Both treatments led to significant symptom reduction of PTSD symptoms, but many still had elevated PTSD symptoms at posttreatment. Implications for future postdisaster mental health work are discussed.","Jaycox, L H; Cohen, J A; Mannarino, A P; Walker, D W; Langley, A K; Gegenheimer, K L; Scott, M; Schonlau, M",2010.0,10.1002/jts.20518,0,0,
6483,Hypertonic saline infusion induces panic in patients with panic disorder,,"Jensen, C F; Peskind, E R; Veith, R C; Hughes, J; Cowley, D S; Roy-Byrne, P; Raskind, M A",1991.0,,0,0,
6484,"Test-retest reliability of the Diagnostic Interview Schedule for Children (DISC 2.1). Parent, child, and combined algorithms","ER METHODSThe DISC was separately administered to children and parents, and diagnoses were derived from computer algorithms keyed to DSM-III-R criteria. Three sets of diagnoses were obtained, based on parent information only (DISC-P), child information only (DISC-C), and information from either or both (DISC-PC).RESULTSTest-retest reliabilities of the DISC-PC ranged from moderate to substantial for diagnoses in the clinical sample. Test-retest kappa coefficients were higher for the clinical sample than for the community sample. The DISC-PC algorithm generally had higher reliabilities than the algorithms that relied on single informants. Unreliability was primarily due to diagnostic attenuation at time 2. Attenuation was greatest among child informants and less severe cases and in the community sample.CONCLUSIONSTest-retest reliability findings were consistent with or superior to those reported in previous studies. Results support the usefulness of the DISC in further clinical and epidemiologic research; however, closely spaced or repeated DISC interviews may result in significant diagnostic attenuation on retest. Further studies of the test-retest attenuation phenomena are needed, including careful examination of the child, family, and illness characteristics of diagnostic stability.BACKGROUNDPrevious research has not compared the psychometric properties of diagnostic interviews of community samples and clinically referred subjects within a single study. As part of a multisite cooperative agreement study funded by the National Institute of Mental Health, 97 families with clinically referred children and 278 families identified through community sampling procedures participated in a test-retest study of version 2.1 of the Diagnostic Interview Schedule for Children (DISC 2.1).","Jensen, P; Roper, M; Fisher, P; Piacentini, J; Canino, G; Richters, J; Rubio-Stipec, M; Dulcan, M; Goodman, S; Davies, M",1995.0,,0,0,
6485,Findings from the NIMH Multimodal Treatment Study of ADHD (MTA): implications and applications for primary care providers,"ER In 1992, the National Institute of Mental Health and 6 teams of investigators began a multisite clinical trial, the Multimodal Treatment of Attention-Deficit Hyperactivity Disorder (MTA) study. Five hundred seventy-nine children were randomly assigned to either routine community care (CC) or one of three study-delivered treatments, all lasting 14 months. The three MTA treatments-monthly medication management (usually methylphenidate) following weekly titration (MedMgt), intensive behavioral treatment (Beh), and the combination (Comb)-were designed to reflect known best practices within each treatment approach. Children were assessed at four time points in multiple outcome. Results indicated that Comb and MedMgt interventions were substantially superior to Beh and CC interventions for attention-deficit hyperactivity disorder symptoms. For other functioning domains (social skills, academics, parent-child relations, oppositional behavior, anxiety/depression), results suggested slight advantages of Comb over single treatments (MedMgt, Beh) and community care. High quality medication treatment characterized by careful yet adequate dosing, three times daily methylphenidate administration, monthly follow-up visits, and communication with schools conveyed substantial benefits to those children that received it. In contrast to the overall study findings that showed the largest benefits for high quality medication management (regardless of whether given in the MedMgt or Comb group), secondary analyses revealed that Comb had a significant incremental effect over MedMgt (with a small effect size for this comparison) when categorical indicators of excellent response and when composite outcome measures were used. In addition, children with parent-defined comorbid anxiety disorders, particularly those with overlapping disruptive disorder comorbidities, showed preferential benefits to the Beh and Comb interventions. Parental attitudes and disciplinary practices appeared to mediate improved response to the Beh and Comb interventions.","Jensen, P S; Hinshaw, S P; Swanson, J M; Greenhill, L L; Conners, C K; Arnold, L E; Abikoff, H B; Elliott, G; Hechtman, L; Hoza, B; March, J S; Newcorn, J H; Severe, J B; Vitiello, B; Wells, K; Wigal, T",2001.0,,0,0,
6486,A randomized effectiveness study comparing trauma-focused cognitive behavioral therapy with therapy as usual for youth,"ER The efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) has been shown in several randomized controlled trials. However, few trials have been conducted in community clinics, few have used therapy as usual (TAU) as a comparison group, and none have been conducted outside of the United States. The objective of this study was to evaluate the effectiveness of TF-CBT in regular community settings compared with TAU. One hundred fifty-six traumatized youth (M age = 15.1 years, range = 10-18; 79.5% girls) were randomly assigned to TF-CBT or TAU. Intent-to-treat analysis using mixed effects models showed that youth receiving TF-CBT reported significantly lower levels of posttraumatic stress symptoms (est. = 5.78, d = 0.51), 95% CI [2.32, 9.23]; depression (est. = 7.00, d = 0.54), 95% CI [2.04, 11.96]; and general mental health symptoms (est. = 2.54, d = 0.45), 95% CI [0.50, 4.58], compared with youth in the TAU group. Youth assigned to TF-CBT showed significantly greater improvements in functional impairment (est. = -1.05, d = -0.55), 95% CI [-1.67, -0.42]. Although the same trend was found for anxiety reduction, this difference was not statistically significant (est. = 4.34, d = 0.30), 95% CI [-1.50, 10.19]. Significantly fewer youths in the TF-CBT condition were diagnosed with posttraumatic stress disorder compared to youths in the TAU condition, ?(2)(1, N = 116) = 4.61, p = .031, Phi = .20). Findings indicate that TF-CBT is effective in treating traumatized youth in community mental health clinics and that the program may also be successfully implemented in countries outside the United States.","Jensen, T K; Holt, T; Ormhaug, S M; Egeland, K; Granly, L; Hoaas, L C; Hukkelberg, S S; Indregard, T; Stormyren, S D; Wentzel-Larsen, T",2014.0,10.1080/15374416.2013.822307,0,0,
6487,Effect of long-term mild hypothermia or short-term mild hypothermia on outcome of patients with severe traumatic brain injury,"ER To compare the effect of long-term mild hypothermia versus short-term mild hypothermia on the outcome of 215 severe traumatic brain injured patients with cerebral contusion and intracranial hypertension. At three medical centers, 215 patients aged 18 to 45 years old with an admission Glasgow Coma Scale 1 cm confirmed on computed tomographic scan. Glasgow Outcome Scale at 6-month follow-up, 47 cases had favorable outcome (43.5%), and other 61 cases had unfavorable outcome (56.5%) in the long-term mild hypothermia group. However, only 31 cases had favorable outcome (29.0%), and other 76 cases had unfavorable outcome (71.0%) in the short-term mild hypothermia group (P 1 cm confirmed on computed tomographic scan. Glasgow Outcome Scale at 6-month follow-up, 47 cases had favorable outcome (43.5%), and other 61 cases had unfavorable outcome (56.5%) in the long-term mild hypothermia group. However, only 31 cases had favorable outcome (29.0%), and other 76 cases had unfavorable outcome (71.0%) in the short-term mild hypothermia group (P  0.05). Compared with short-term mild hypothermia, long-term mild hypothermia significantly improves the outcome of severe traumatic brain injured patients with cerebral contusion and intracranial hypertension without significant complications. Our data suggest that 5 days of long-term cooling is more efficacious than 2 days of short-term cooling when mild hypothermia is used to control refractory intracranial hypertension in patients with severe traumatic brain injury.","Jiang, J Y; Xu, W; Li, W P; Gao, G Y; Bao, Y H; Liang, Y M; Luo, Q Z",2006.0,10.1038/sj.jcbfm.9600253,0,0,
6488,Family composition and symptom severity among Veterans with comorbid PTSD and substance use disorders,"ER Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) frequently co-occur and affect a substantial proportion of military Veterans. Although the impact of parental PTSD and SUD on child development is well-documented, little is known about the influence of family composition on PTSD/SUD symptom severity. The present study investigated children in the home as an independent risk factor for symptom severity in a sample of treatment-seeking Veterans (N = 94; 92% male) with comorbid PTSD/SUD. Twenty-seven percent of the sample had minor children (age 18 or younger) living in the home. Veterans with children in the home evidenced significantly higher PTSD symptomatology as measured by the Clinical Administered PTSD Scale (CAPS; M = 82.65 vs. M = 72.17; t = -2.18; p < .05), and reported using marijuana more frequently than Veterans without children in the home (34% vs. 13% of past 60 days; t = -2.35, p < .05). In a multivariate model, having children in the home accounted for unique variance (?R(2) = .07) in PTSD severity after accounting for a range of covariates; however, having children in the home did not account for unique variance in substance use. Directions for future research as well as potential clinical implications for parents seeking treatment for PTSD/SUD are discussed.","Jobe-Shields, L; Flanagan, J C; Killeen, T; Back, S E",2015.0,10.1016/j.addbeh.2015.06.019,0,0,
6489,Mindfulness-based stress reduction (MBSR) improves long-term mental fatigue after stroke or traumatic brain injury,"ER OBJECTIVE: Patients who suffer from mental fatigue after a stroke or traumatic brain injury (TBI) have a drastically reduced capacity for work and for participating in social activities. Since no effective therapy exists, the aim was to implement a novel, non-pharmacological strategy aimed at improving the condition of these patients.METHODS: This study tested a treatment with mindfulness-based stress reduction (MBSR). The results of the programme were evaluated using a self-assessment scale for mental fatigue and neuropsychological tests. Eighteen participants with stroke and 11 with TBI were included. All the subjects were well rehabilitated physically with no gross impairment to cognitive functions other than the symptom mental fatigue. Fifteen participants were randomized for inclusion in the MBSR programme for 8 weeks, while the other 14 served as controls and received no active treatment. Those who received no active treatment were offered MBSR during the next 8 weeks.RESULTS: Statistically significant improvements were achieved in the primary end-point--the self-assessment for mental fatigue--and in the secondary end-point--neuropsychological tests; Digit Symbol-Coding and Trail Making Test.CONCLUSION: The results from the present study show that MBSR may be a promising non-pharmacological treatment for mental fatigue after a stroke or TBI.","Johansson, B; Bjuhr, H; Rönnbäck, L",2012.0,10.3109/02699052.2012.700082,0,0,
6490,Refining Clinical Judgment of Treatment Response and Symptom Remission Identification in Childhood Anxiety Using a Signal Detection Analysis on the Pediatric Anxiety Rating Scale,"ER Objective: The purpose of this study was to determine guidelines for delineating treatment response and symptom remission for children with anxiety disorder based on the five item and Pediatric Anxiety Rating Scale (PARS5), and replicate guidelines using the six item PARS (PARS6). Methods: Participants were 73 children 7-13 years of age with a primary anxiety disorder who received computer-assisted cognitive behavioral therapy for anxiety. Signal detection analyses utilizing receiver operating curve procedures were used to determine optimal guidelines for defining treatment response and symptom remission for youth with anxiety disorders on the PARS5 and PARS6. The percent reduction in anxiety severity was used to predict treatment responder status. The percent reduction in symptoms and posttreatment raw score were used to predict remission status. Results: Optimal prediction of treatment response based on gold standard criteria was achieved at 15-20% reduction in symptoms on the PARS5 (with 20% reduction achieving marginally higher accuracy), and 20% reduction on the PARS6. A 25% reduction in symptoms on the PARS5 or a posttreatment raw score cutoff of 9 optimally predicted remission status. For the PARS6, a cutoff of 35% reduction or a posttreatment score of 11, was considered optimal for determining remission in clinical settings, whereas a 30% reduction or score of 12 was considered optimal for research settings. Conclusions: With different scoring options available for the PARS, these results provide guidelines for determining response and remission based on the PARS5 and PARS6 scores. Guidelines have implications for use in clinical trials, as well as for assessment of change in clinical practice.","Johnco, C J; Salloum, A; Lewin, A B; Storch, E A",2015.0,10.1089/cap.2015.0102,0,0,
6491,Improvement of physical health and quality of life of alcohol-dependent individuals with topiramate treatment: US multisite randomized controlled trial,"ER METHODSIn a 17-site, 14-week, double-blind, randomized controlled trial, we compared the effects of topiramate (up to 300 mg/d) vs placebo on physical health, obsessional thoughts and compulsions about using alcohol, and psychosocial well-being among 371 alcohol-dependent subjects who received weekly adherence enhancement therapy.RESULTSTopiramate was more efficacious than placebo in reducing body mass index (calculated as weight in kilograms divided by height in meters squared) (mean difference, 1.08; 95% confidence interval [CI], 0.81-1.34; P < .001), all liver enzyme levels (P < .01 for all comparisons), plasma cholesterol level (mean difference, 13.30 mg/dL; 95% CI, 5.09-21.44 mg/dL; P = .002), and systolic (mean difference, 9.70 mm Hg; 95% CI, 6.81-12.60 mm Hg; P < .001) and diastolic (mean difference, 6.74 mm Hg; 95% CI, 4.57-8.90 mm Hg; P < .001) blood pressure to about prehypertension levels-effects that might lower the risk of fatty liver degeneration and cirrhosis as well as cardiovascular disease. Topiramate compared with placebo significantly (P < .05 for all comparisons) decreased obsessional thoughts and compulsions about using alcohol, increased subjects' psychosocial well-being, and improved some aspects of quality of life, thereby diminishing the risk of relapse and longer-term negative outcomes. Paresthesia, taste perversion, anorexia, and difficulty with concentration were reported more frequently for topiramate than for placebo.CONCLUSIONTopiramate appears to be generally effective at improving the drinking outcomes and physical and psychosocial well-being of alcoholic subjects.BACKGROUNDTopiramate can improve drinking outcomes via a hypothesized mechanism of facilitating gamma-aminobutyric acid function and inhibiting glutaminergic pathways in the corticomesolimbic system. We sought to determine whether topiramate's antidrinking effects are bolstered by improvements in physical and psychosocial well-being.","Johnson, B A; Rosenthal, N; Capece, J A; Wiegand, F; Mao, L; Beyers, K; McKay, A; Ait-Daoud, N; Addolorato, G; Anton, R F; Ciraulo, D A; Kranzler, H R; Mann, K; O'Malley, S S; Swift, R M",2008.0,10.1001/archinte.168.11.1188,0,0,
6492,Human papillomavirus infection and anxiety: analyses in women with low-grade cervical cytological abnormalities unaware of their infection status,"ER METHODSThis study was nested within a randomised controlled trial of management of women with abnormal cervical cytology conducted in the United Kingdom with recruitment between 1999 and 2002. At baseline, prior to having a sample taken for HPV testing, the results of which were not disclosed, women were assessed for anxiety using the Hospital Anxiety and Depression Scale and asked about fears of developing cervical cancer (""cancer worries""); this assessment was repeated at 12, 18, 24, and 30 months of follow-up. Logistic regression and generalized estimating equations were used for the cross-sectional (baseline) and longitudinal analyses, respectively.RESULTSAmong the 2842 participants, there was no association between HPV status and anxiety among white women. Among non-white women, however, anxiety was less common among HPV-positive than HPV-negative women (adjusted odds ratio 0.41, 95% confidence interval 0.22 to 0.77). Among non-smokers, cancer worry was more common in HPV-positive than HPV-negative women; the opposite association was observed among ex-smokers.CONCLUSIONSAssociations between HPV status and anxiety may be explained by factors other than learning of test results and may vary by ethnicity and lifestyle factors.BACKGROUNDWomen testing positive for human papillomavirus (HPV) infection experience increased levels of anxiety that have been attributed to fears of stigmatization and developing cervical cancer. The objective of this study was to investigate the association between HPV infection and anxiety in women who were unaware they had been tested specifically for HPV, to determine if any anxiety experienced by HPV-positive women could be due to causes other than learning of test results.","Johnson, C Y; Sharp, L; Cotton, S C; Harris, C A; Gray, N M; Little, J",2011.0,10.1371/journal.pone.0021046,0,0,
6493,Dual imputation model for incomplete longitudinal data,"ER Missing values are a practical issue in the analysis of longitudinal data. Multiple imputation (MI) is a well-known likelihood-based method that has optimal properties in terms of efficiency and consistency if the imputation model is correctly specified. Doubly robust (DR) weighing-based methods protect against misspecification bias if one of the models, but not necessarily both, for the data or the mechanism leading to missing data is correct. We propose a new imputation method that captures the simplicity of MI and protection from the DR method. This method integrates MI and DR to protect against misspecification of the imputation model under a missing at random assumption. Our method avoids analytical complications of missing data particularly in multivariate settings, and is easy to implement in standard statistical packages. Moreover, the proposed method works very well with an intermittent pattern of missingness when other DR methods can not be used. Simulation experiments show that the proposed approach achieves improved performance when one of the models is correct. The method is applied to data from the fireworks disaster study, a randomized clinical trial comparing therapies in disaster-exposed children. We conclude that the new method increases the robustness of imputations.","Jolani, S; Frank, L E; Buuren, S",2014.0,10.1111/bmsp.12021,0,0,
6494,The cost-effectiveness of a family meetings intervention to prevent depression and anxiety in family caregivers of patients with dementia: a randomized trial,"ER METHODS: The economic evaluation was conducted from a societal perspective alongside a randomized trial of 192 primary caregivers with community-dwelling dementia patients. Outcome measures included the Quality Adjusted Life-Years (QALY) of caregivers and patients and the incidence of depression and anxiety disorders in caregivers. Missing cost and effect data were imputed using multiple imputations. Bootstrapping was used to estimate uncertainty around the cost-differences and the incremental cost-effectiveness ratio (ICER). The bootstrapped cost-effect pairs were plotted on a cost-effectiveness plane and used to estimate cost-effectiveness curves.RESULTS: No significant differences in costs and effects between the groups were found. At 12 months, total costs per patient and primary caregiver dyad were substantial: ?77,832 for the intervention group and ?75,201 for the usual care group (adjusted mean difference per dyad ?4,149, 95%","Joling, K J; Bosmans, J E; Marwijk, H W; Horst, H E; Scheltens, P; MacNeil, Vroomen J L; Hout, H P",2013.0,10.1186/1745-6215-14-305,0,0,
6495,(Cost)-effectiveness of family meetings on indicated prevention of anxiety and depressive symptoms and disorders of primary family caregivers of patients with dementia: design of a randomized controlled trial,"ER METHODS/DESIGNIn this randomized controlled trial effectiveness as well as cost-effectiveness of family meetings is evaluated. The intervention group receives four family meetings with family and close friends of the primary family caregiver of a community dwelling patient with a clinical diagnosis of dementia. Dyads of patients and their primary caregiver are followed up to one year after baseline assessment. The main outcome measures are the incidence of anxiety and depressive disorders assessed with the Mini-International Neuropsychiatric Interview (MINI) and the severity of anxiety and depressive symptoms in caregivers is measured by validated self report instruments: the Centre for Epidemiologic Studies Depression Scale (CES-D) for depression and the anxiety scales of the Hospital Anxiety and Depression scales (HADS) for anxiety. The economic evaluation is performed from a societal perspective.DISCUSSIONBy evaluating the effectiveness of only structured family meetings organized in the Netherlands, this study will contribute to the existing literature about the value of psychosocial interventions for dementia caregivers.TRIAL REGISTRATIONDutch Trial Registry ISRCTN90163486.BACKGROUNDDementia is a major public health problem with enormous costs to society and major consequences for both patients and their relatives. Family members of persons with dementia provide much of the care for older adults with dementia in the community. Caring for a demented relative is not easy and fraught with emotional strain, distress, and physical exhaustion. Family caregivers of dementia patients have an extremely high risk developing affective disorders such as major depression and anxiety disorder. Family meetings appear to be among the most powerful psychosocial interventions to reduce depression in caregivers. An American landmark study reported substantial beneficial effects of a multifaceted intervention where family meetings had a central place on depression in family caregivers as well as on delay of institutionalization of patients. These effects were not replicated in other countries yet. We perform the first trial comparing only structured family meetings with significant others versus usual care among primary family caregivers of community dwelling demented patients and measure the effectiveness on both depression and anxiety in the primary caregiver, both on disorder and symptom levels.","Joling, K J; Hout, H P; Scheltens, P; Vernooij-Dassen, M; Berg, B; Bosmans, J; Gillissen, F; Mittelman, M; Marwijk, H W",2008.0,10.1186/1471-2318-8-2,0,0,
6496,Does a family meetings intervention prevent depression and anxiety in family caregivers of dementia patients? A randomized trial,"ER BACKGROUND: Family caregivers of dementia patients are at increased risk of developing depression or anxiety. A multi-component program designed to mobilize support of family networks demonstrated effectiveness in decreasing depressive symptoms in caregivers. However, the impact of an intervention consisting solely of family meetings on depression and anxiety has not yet been evaluated. This study examines the preventive effects of family meetings for primary caregivers of community-dwelling dementia patients.METHODS: A randomized multicenter trial was conducted among 192 primary caregivers of community dwelling dementia patients. Caregivers did not meet the diagnostic criteria for depressive or anxiety disorder at baseline. Participants were randomized to the family meetings intervention (n?=?96) or usual care (n?=?96) condition. The intervention consisted of two individual sessions and four family meetings which occurred once every 2 to 3 months for a year. Outcome measures after 12 months were the incidence of a clinical depressive or anxiety disorder and change in depressive and anxiety symptoms (primary outcomes), caregiver burden and quality of life (secondary outcomes). Intention-to-treat as well as per protocol analyses were performed.RESULTS: A substantial number of caregivers (72/192) developed a depressive or anxiety disorder within 12 months. The intervention was not superior to usual care either in reducing the risk of disorder onset (adjusted IRR 0.98; 95% CI 0.69 to 1.38) or in reducing depressive (randomization-by-time interaction coefficient?=?-1.40; 95%","Joling, K J; Marwijk, H W; Smit, F; Horst, H E; Scheltens, P; Ven, P M; Mittelman, M S; Hout, H P",2012.0,10.1371/journal.pone.0030936,0,0,
6497,"Effect of different forms of information produced for cancer patients on their use of the information, social support, and anxiety: randomised trial","ER DESIGNRandomised trial with eight groups (three factors, 2x2x2). Data collected at recruitment and three month follow-up.PARTICIPANTS400 patients starting radiotherapy, of whom 325 with breast or prostate cancer and complete anxiety and depression data were included in the analysis.INTERVENTIONSPrinted booklets: half had only general information from CancerBACUP about each patient's cancer and half had personalised information from the patient's medical record plus selected general information; half were composed of information chosen interactively by the patient and half were produced automatically with a larger volume of material; and half had additional advice on anxiety management and half did not.MAIN OUTCOME MEASURESPatients' views of the information, use of their booklets with others; change in reported social support; change in anxiety and depression.RESULTSThe larger booklets produced automatically were more likely to be found useful and to tell patients something new and less likely to be seen as too limited than the booklets produced interactively, but they were also more likely to overwhelm some patients. Personalised booklets were more likely than general booklets to tell patients something new. There was no difference in patients' perceived understanding of their cancer by any of the intervention factors. Patients with personalised information were more likely to show their booklets to others and to think it helped in discussing their cancer or its treatment. There were no major differences in social support, anxiety, or depression by any intervention factors.CONCLUSIONSPatients were more likely to show personalised information to their confidants than general information. Further research is needed into the effects of sharing information on patients' social support and anxiety. Trial registration US Government Clinical Trials Database NCT00127465.OBJECTIVETo explore the hypothesis that different methods of selecting and printing information for cancer patients could improve emotional support by affecting interaction with others, and so lead to improved psychological wellbeing.","Jones, R B; Pearson, J; Cawsey, A J; Bental, D; Barrett, A; White, J; White, C A; Gilmour, W H",2006.0,10.1136/bmj.38807.571042.68,0,0,
6498,A randomised controlled trial of time limited CBT informed psychological therapy for anxiety in bipolar disorder,"ER BACKGROUND: Anxiety comorbidity is common in bipolar disorder and is associated with worse treatment outcomes, greater risk of self harm, suicide and substance misuse. To date however there have been no psychological interventions specifically designed to address this problem. The primary objective of this trial is to establish the acceptability and feasibility of a new integrated intervention for anxiety in bipolar disorder designed in collaboration with individuals with personal experience of both problems.METHODS AND DESIGN: Single blind randomised controlled trials to assess the feasibility and acceptability of a time limited CBT informed psychological intervention for anxiety in bipolar disorder (AIBD) compared with treatment as usual. Participants will be recruited from across the North West of England from specialist mental health services and through primary care and self referral. The primary outcome of the study is the feasibility and acceptability of AIBD assessed by recruitment to target and retention to follow-up, as well as absence of untoward incidents associated with AIBD. We will also estimate the effect size of the impact of the intervention on anxiety and mood outcomes, as well as calculate preliminary estimates of cost-effectiveness and investigate potential mechanisms for this (stigma, self appraisal and stability of social rhythms).DISCUSSION: This is the first trial of an integrated intervention for anxiety in bipolar disorder. It is of interest to researchers involved in the development of new therapies for bipolar disorder as well as indicating the wider potential for evaluating approaches to the treatment of comorbidity in severe mental illness.","Jones, S; McGrath, E; Hampshire, K; Owen, R; Riste, L; Roberts, C; Davies, L; Mayes, D",2013.0,10.1186/1471-244X-13-54,0,0,
6499,An intensive social cognitive program (can do treatment) in people with relapsing remitting multiple sclerosis and low disability: a randomized controlled trial protocol,"ER METHODS/DESIGN: CDT is a sociologically oriented approach, its goal is to uncover and promote existing capabilities, and the notion ""stressor"" is the central concept. CDT's components are plenary group sessions, small group sessions, consultations, a theatre evening, and start of the day with a joint activity. The small group sessions form the actual training. Depending on their individual goals the participants join the training groups 'Body', 'Feeling' or 'Life', to work out their aims and to reduce their stressors. The multidisciplinary team includes a psychiatrist, psychiatric nurse, neurologist, specialized MS nurse, physiotherapist, dance therapist, and a person with MS. To evaluate the (cost)effectiveness of CDT in persons with relapsing remitting MS and low disability we perform a single-centre, randomized controlled trial in 140 patients, with or without support partners. The primary outcome is self-efficacy control. The secondary outcomes are self-efficacy function, health-related quality of life, autonomy and participation, anxiety, depression, cost effectiveness and cost utility. The tertiary outcome is care-related strain to support partners. Outcomes are assessed at baseline and at 1, 3 and 6 months after CDT.DISCUSSION: This randomized controlled trial will adequately evaluate the clinical and cost effectiveness of a 3-day intensive social cognitive program in people with relapsing remitting MS and low disability, with self-efficacy control as primary outcome.DUTCH TRIAL REGISTRY: Application number: 22444.BACKGROUND: In people with multiple sclerosis (MS) disabilities and limitations may negatively affect self-efficacy. Lowered self-efficacy has been associated with decreases in health-related quality of life, physical activity and cognitive performance. In an explorative observational study we found that a 3-day intensive social cognitive program (Can Do Treatment [CDT]) with the participation of support partners was followed by substantial increases in self-efficacy control and health-related quality of life 6 months after treatment in those people with MS who had relapsing remitting disease and low disability.","Jongen, P J; Heerings, M; Ruimschotel, R; Hussaarts, A; Evers, S; Duyverman, L; Valkenburg-Vissers, J; Cornelissen, J; Bos, M; Droffelaar, M; Lemmens, W A; Donders, R; Zande, A; Visser, L H",2016.0,10.1186/s12883-016-0593-4,0,0,
6500,The effectiveness of Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) for young children with severe behavioral disturbances: study protocol for a randomized controlled trial,"ER METHODS: This is a randomized controlled trial, wherein we expect to include 80 child-foster carer dyads. Forty dyads will be assigned to Multidimensional Treatment Foster Care for Preschoolers and 40 to treatment as usual, following pre-randomization. Data to be gathered concern problem behavior, symptoms of attachment disorder, post-traumatic stress symptoms, quality of life, hypothalamic-adrenal-pituitary axis functioning, parental stress and autonomic reactivity, to be collected via questionnaires, observations, interviews, saliva and recording at six time-points over 24 months. To compare treatment outcomes, Fisher's exact tests and repeated measures (mixed models) and independent t-tests will be used. All analyses will be performed following the intention-to-treat principle.DISCUSSION: Examining the generalizability of previous findings in the US and extending these previous findings is a step towards improving knowledge about treatment of young foster children with severe behavioral, emotional and attachment problems.TRIAL REGISTRATION: NTR1747.BACKGROUND: Among children placed out of home, behavioral and relationship functioning is often problematic. When placed in foster care, problems tend to persist or even worsen and increase the risk of placement breakdown. Multidimensional Treatment Foster Care for Preschoolers is an intensive behavior-focused program for young foster children (3 to 7 years) aiming to provide children with a positive and stimulating foster family setting and individually tailored behavioral interventions. This study will be the first to examine the effectiveness of Multidimensional Treatment Foster Care for Preschoolers outside the US and to examine the effectiveness across a broader range of problems related to foster care.","Jonkman, C S; Schuengel, C; Lindeboom, R; Oosterman, M; Boer, F; Lindauer, R J",2013.0,10.1186/1745-6215-14-197,0,0,
6501,Metacognitive therapy versus cognitive behavioural therapy for depression: a randomized pilot study,"ER OBJECTIVE: Metacognitive therapy (MCT) is one of the newer developments within cognitive therapy. This randomized controlled pilot study compared independently applied MCT with cognitive behavioural therapy (CBT) in outpatients with depression to explore the relative speed and efficacy of MCT, ahead of a planned randomized controlled trial.METHOD: A total of 48 participants referred for outpatient therapy were randomized to up to 12 weeks of MCT or CBT. Key outcomes were reduction in depressive symptoms at week 4 and week 12, measured using the independent-clinician-rated Quick Inventory of Depressive Symptomatology16. Intention-to-treat and completer analyses as well as additional methods of reporting outcome of depression are presented.RESULTS: Both therapies were effective in producing clinically significant change in depressive symptoms, with moderate-to-large effect sizes obtained. No differences were detected between therapies in overall outcome or early change on clinician-rated or self-reported measures. Post-hoc analyses suggest that MCT may have been adversely affected by greater comorbidity.CONCLUSIONS: In this large pilot study conducted independently of MCT's developers, MCT was an effective treatment for outpatients with depression, with similar results overall to CBT. Insufficient power and imbalanced comorbidity limit conclusions regarding comparative efficacy so further studies of MCT and CBT are required.","Jordan, J; Carter, J D; McIntosh, V V; Fernando, K; Frampton, C M; Porter, R J; Mulder, R T; Lacey, C; Joyce, P R",2014.0,10.1177/0004867414533015,0,0,
6502,Evaluation of a classroom-based psychosocial intervention in conflict-affected Nepal: a cluster randomized controlled trial,"ER METHODSA cluster randomized controlled trial was used to evaluate changes on a range of indicators, including psychiatric symptoms (depression, anxiety, posttraumatic stress disorder), psychological difficulties, resilience indicators (hope, prosocial behavior) and function impairment. Children (n = 325) (mean age = 12.7, SD = 1.04, range 11-14 years) with elevated psychosocial distress were allocated to a treatment or waitlist group.RESULTSComparisons of crude change scores showed significant between-group differences on several outcome indicators, with moderate effect sizes (Cohen d = .41 to .58). After correcting for nested variance within schools, no evidence for treatment effects was found on any outcome variable. Additional analyses showed gender effects for treatment on prosocial behavior (mean change difference: 2.70; 95% CI, .97 to 4.44), psychological difficulties (-2.19; 95% CI, -3.82 to -.56), and aggression (-4.42; 95% CI, -6.16 to -2.67). An age effect for treatment was found for hope (.90; 95% CI, -1.54 to -.26).CONCLUSIONSA school-based psychosocial intervention demonstrated moderate short-term beneficial effects for improving social-behavioral and resilience indicators among subgroups of children exposed to armed conflict. The intervention reduced psychological difficulties and aggression among boys, increased prosocial behavior among girls, and increased hope for older children. The intervention did not result in reduction of psychiatric symptoms.BACKGROUNDIn situations of ongoing violence, childhood psychosocial and mental health problems require care. However, resources and evidence for adequate interventions are scarce for children in low- and middle-income countries. This study evaluated a school-based psychosocial intervention in conflict-affected, rural Nepal.","Jordans, M J; Komproe, I H; Tol, W A; Kohrt, B A; Luitel, N P; Macy, R D; Jong, J T",2010.0,10.1111/j.1469-7610.2010.02209.x,0,0,
6503,"A randomised controlled trial among cleaners--effects on strength, balance and kinesiophobia","ER BACKGROUND: Cleaners constitute a job group with poor health and low socioeconomic resources. Therefore, there is a great need for scientifically documented health promoting initiatives for cleaners. However, both workplace initiatives and high quality intervention studies are lacking. The aim of this study was to evaluate the effects of a 3-month workplace trial with interventions to improve physical or cognitive behavioural resources among cleaners.METHODS: A cluster randomised controlled trial was conducted among 294 female cleaners from 9 workplaces. The participants were allocated to three groups: Physical coordination training (PCT, n = 95), Cognitive behavioural theory-based training (CBTr, n = 99) and Reference group (REF, n = 100). Interventions were conducted during work hours for an average of 1 hour/week. Muscle strength was measured by maximal voluntary contractions in trunk/extension, and shoulder abduction/elevation. Postural balance was measured on a force platform. Kinesiophobia was measured with Tampa Scale for Kinesiophobia. Test and questionnaires were completed at baseline and at 3-month follow-up and analyses followed the intention-to-treat (ITT) principle with last observation carried forward in case of missing data at follow-up. Reports and analyses are given on true observations as well.RESULTS: ITT-analyses revealed that PCT improved strength of the trunk (p < .05) and postural balance (p < .05) compared to CBTr and REF. Based on true observations the strength and balance improvements corresponded to ~20% and ~16%, respectively. ITT-analyses showed that CBTr reduced kinesiophobia compared to PCT and REF (p < .05). Based on true observations, the improvement corresponded to a ~16% improvement.CONCLUSION: This workplace-based intervention study including PCT and CBTr among cleaners improved strength and postural balance from PCT, and kinesiophobia from CBTr. The improved strength, postural balance and kinesiophobia may improve the cleaners' tolerance for high physical work demands. Future studies should investigate the potential in the combination of PCT and CBTr in a workplace intervention.TRIAL REGISTRATION: Current controlled trials ISRCTN96241850.","J√∏rgensen, M B; Ektor-Andersen, J; Sj√∏gaard, G; Holtermann, A; S√∏gaard, K",2011.0,10.1186/1471-2458-11-776,0,0,
6504,Reducing conduct problems among children exposed to intimate partner violence: a randomized clinical trial examining effects of Project Support,"ER This study was a randomized clinical trial of Project Support, an intervention designed to reduce conduct problems among children exposed to intimate partner violence. Participants were 66 families (mothers and children) with at least 1 child exhibiting clinical levels of conduct problems. Families were recruited from domestic violence shelters. The Project Support intervention involves (a) teaching mothers child management skills and (b) providing instrumental and emotional support to mothers. Families were randomly assigned to the Project Support intervention condition or to an existing services comparison condition. They were assessed on 6 occasions over 20 months, following their departure from the shelter. Children in families in the Project Support condition, compared with those in the comparison condition, exhibited greater reductions in conduct problems. Mothers in the Project Support condition, compared with those in the comparison condition, displayed greater reductions in inconsistent and harsh parenting behaviors and psychiatric symptoms. Changes in mothers' parenting and psychiatric symptoms accounted for a sizable proportion of Project Support's effects on child conduct problems at the end of treatment. Clinical and policy implications are discussed.","Jouriles, E N; McDonald, R; Rosenfield, D; Stephens, N; Corbitt-Shindler, D; Miller, P C",2009.0,10.1037/a0015994,0,0,
6505,Cortisol suppression by dexamethasone reduces exaggerated fear responses in posttraumatic stress disorder,"ER PTSD symptoms are associated with heightened fear responses in laboratory fear conditioning paradigms. This study examined the effects of dexamethasone administration on hypothalamic-pituitary-adrenal (HPA) function and fear-potentiated startle (FPS) in trauma-exposed individuals with and without PTSD. We used an established fear discrimination procedure, in which one visual stimulus (CS+, danger cue) was paired with aversive airblasts to the throat (unconditioned stimulus, US), and another stimulus (CS-, safety cue) was presented without airblasts. In addition to FPS, the dexamethasone suppression test (DST) was performed. The study sample (N=100) was recruited from a highly traumatized civilian population in Atlanta, GA. Half of the subjects (n=54, 16 PTSD, 38 controls) underwent conditioning at baseline and the other half (n=46, 17 PTSD, 29 controls) after DST, in a cross-sectional design. We found a significant interaction effect of diagnostic group and dexamethasone treatment. Under baseline conditions, subjects with PTSD showed more than twice as much fear-potentiated startle to the danger cue compared to traumatized controls, F(1,53)=8.08, p=0.006. However, there was no group difference in subjects tested after dexamethasone suppression. Furthermore, there was a significant treatment effect in PTSD subjects but not in controls, with dexamethasone reducing fear-potentiated startle to the CS+, F(1,32)=4.00, p=0.05. There was also a positive correlation between PTSD subjects' FPS and cortisol levels, r=0.46, p=0.01. These results suggest that transient suppression of HPA function via dexamethasone suppression may reduce exaggerated fear in patients with PTSD.","Jovanovic, T; Phifer, J E; Sicking, K; Weiss, T; Norrholm, S D; Bradley, B; Ressler, K J",2011.0,10.1016/j.psyneuen.2011.04.008,0,0,
6506,"The effect of lithium carbonate on affect, mood, and personality of normal subjects","ER Data reflecting affect, mood, and personality attributes of 23 normal men were compared after two weeks of placebo administration and two weeks of therapeutic serum lithium levels (mean, 0.91 mEq/liter). The study was a placebo-controlled, split-half crossover, double-blind design. Affect and mood were measured by three self-rating instruments, independent rater observation, and by the subjects' ""significant others."" Two personality inventories were administered. Substantial affect and mood changes are induced by lithium carbonate. Lethargy, dysphoria, a loss of interest in interacting with others and the environment, and a state of increased mental confusion were reported. No generalized effects were found in the responses to ther personality inventories.","Judd, L L; Hubbard, B; Janowsky, D S; Huey, L Y; Attewell, P A",1977.0,,0,0,
6507,Feasibility and preliminary outcomes from a pilot study of coping skills training for adolescent--young adult survivors of childhood cancer and their parents,"ER Uncertainty is a central feature of long-term childhood cancer survivorship during which time it principally has to do with late effects. Therefore, the purposes of this article are (a) to assess feasibility of a randomized clinical trial of a telephone-delivered coping skills training (CST) intervention in terms of recruitment, retention, and timeline, as well as the performance of the study measures; and (b) to demonstrate trends in change on outcomes within the context of a small pilot study. The results of this pilot study suggest that HEROS PLUS CST has clinical relevance and that in-person long-term follow-up plus telephone-delivered psychosocial care is a practical way to deliver integrated care to adolescent-young adult childhood cancer survivors and their parents.","Judge, Santacroce S; Asmus, K; Kadan-Lottick, N; Grey, M",2010.0,10.1177/1043454209340325,0,0,
6508,A randomized controlled trial on cognitive restructuring and imagery modification to reduce the feeling of being contaminated in adult survivors of childhood sexual abuse suffering from posttraumatic stress disorder,"ER BACKGROUND: The feeling of being contaminated (FBC) is a common phenomenon in survivors of childhood sexual abuse (CSA) suffering from posttraumatic stress disorder (PTSD). Thus far, this symptom has been neglected in research and therapy. For this reason, we developed Cognitive Restructuring and Imagery Modification (CRIM), a two-session treatment (lasting 90 and 50 min) that specifically targets the FBC. The present study examined the efficacy of the treatment.METHODS: Thirty-four women with CSA-related PTSD (mean age = 37 years) were randomized to either the CRIM group or a waitlist control group. Primary outcomes were intensity, vividness, and uncontrollability of the FBC, associated distress, and PTSD symptoms, which were assessed using the Clinician-Administered PTSD Scale and the Posttraumatic Diagnostic Scale. Outcomes were measured pre- and posttreatment, and at the 4-week follow-up. (M)ANOVAs were used to compare improvements across conditions.RESULTS: All FBC scores yielded a greater reduction in the CRIM group than the waitlist control (WL) group. Between-group effect sizes at follow-up were large and highly significant (intensity: d = 1.52, p < 0.001; vividness: d = 1.28, p < 0.001; uncontrollability: d = 1.77, p < 0.001; distress: d = 1.80, p < 0.001). PTSD symptoms also yielded a greater reduction in the CRIM group than the WL group, with large between-group effect sizes (Clinician-Administered PTSD Scale: d = 0.93, p < 0.001).CONCLUSIONS: Our findings support the efficacy of the newly developed CRIM in reducing the FBC and PTSD symptoms in adult survivors of CSA.","Jung, K; Steil, R",2013.0,10.1159/000348450,0,0,
6509,Resuscitation of traumatic hemorrhagic shock patients with hypertonic saline-without dextran-inhibits neutrophil and endothelial cell activation,"ER Posttraumatic inflammation and excessive neutrophil activation cause multiple organ dysfunction syndrome (MODS), a major cause of death among hemorrhagic shock patients. Traditional resuscitation strategies may exacerbate inflammation; thus, novel fluid treatments are needed to reduce such posttraumatic complications. Hypertonic resuscitation fluids inhibit inflammation and reduce MODS in animal models. Here we studied the anti-inflammatory efficacy of hypertonic fluids in a controlled clinical trial. Trauma patients in hypovolemic shock were resuscitated in a prehospital setting with 250 mL of either 7.5% hypertonic saline (HS; n = 9), 7.5% hypertonic saline + 6% dextran 70 (HSD; n = 8), or 0.9% normal saline (NS; n = 17). Blood samples were collected on hospital admission and 12 and 24 h after resuscitation. Multicolor flow cytometry was used to quantify neutrophil expression of cell-surface activation/adhesion (CD11b, CD62L, CD64) and degranulation (CD63, CD66b, CD35) markers as well as oxidative burst activity. Circulating concentrations of soluble intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVACM-1), P- and E-selectins, myeloperoxidase (MPO), and matrix metalloproteinase 9 (MMP-9) were assessed by immunoassay. Multiple organ dysfunction syndrome, leukocytosis, and mortality were lower in the HS and HSD groups than in the NS group. However, these differences were not statistically significant. Hypertonic saline prevented priming and activation and neutrophil oxidative burst and CD11b and CD66b expression. Hypertonic saline also reduced circulating markers of neutrophil degranulation (MPO and MMP-9) and endothelial cell activation (sICAM-1, sVCAM-1, soluble E-selectin, and soluble P-selectin). Hypertonic saline + 6% dextran 70 was less capable than HS of suppressing the upregulation of most of these activation markers. This study demonstrates that initial resuscitation with HS, but neither NS nor HSD, can attenuate posttraumatic neutrophil and endothelial cell activation in hemorrhagic shock patients. These data suggest that hypertonic resuscitation without dextran may inhibit posttraumatic inflammation. However, despite this effect, neither HS nor HSD reduced MODS in trauma patients with hemorrhagic shock.","Junger, W G; Rhind, S G; Rizoli, S B; Cuschieri, J; Shiu, M Y; Baker, A J; Li, L; Shek, P N; Hoyt, D B; Bulger, E M",2012.0,10.1097/SHK.0b013e3182635aca,0,0,
6510,Cognitive behaviour therapy for hyperacusis: a randomized controlled trial,"ER Hyperacusis, defined as unusual intolerance to ordinary environmental sounds, is a common problem for which there are no controlled trials on psychological treatment. Given the avoidance strategies present in hyperacusis, and similarities with problems such as tinnitus and chronic pain, cognitive behaviour therapy (CBT) is hypothesized to be helpful for patients with hyperacusis. In this randomized controlled study of 60 patients with hyperacusis, CBT was compared with a waiting list control group using the Loudness Discomfort Level test (LDL), the Hyperacusis Questionnaire, the Hospital Anxiety and Depression Scales, the Quality of Life Inventory and an adapted version of the Tampa Scale of Kinesiophobia. There were significant between-group effects in favour of the CBT group on all measures except for the HADS anxiety scale. Between-group effect sizes were moderate to high, with Cohen's d = 0.67 and 0.69 per ear, respectively, for the primary measure LDL, and ranging from d = 0.32 to 1.36 for the secondary measures. The differences between groups ceased to exist when the waiting list group was treated later with CBT, and the treatment results were largely maintained after 12 months. In conclusion, CBT is a promising treatment for hyperacusis, although more research is necessary.","Jüris, L; Andersson, G; Larsen, H C; Ekselius, L",2014.0,10.1016/j.brat.2014.01.001,0,0,
6511,The clinico-epidemiological characteristics of burn trauma,"ER Analysis of medical and sociopsychological factors in 231 burn victims was provided during 4-year randomized study. Groups of burn-prone (working class males, alcohol abusers, burned drunk, violating safety measures, with concomitant somatic and brain disorders and maladjustment) and non-prone individuals were elucidated. Shifts in Spielberger's state and trait anxiety scores depend on the damage of their somatic and nervous ""underground"". Beck's depression and trait anxiety high scores in all subgroups were found.","Kachalov, P V; Gel'fand, V B; Astasheva, N G",1992.0,,0,0,
6512,Intraindividual comparative analysis of capsule opacification after implantation of 2 single-piece hydrophobic acrylic intraocular lenses models: Three-year follow-up,"ER PURPOSE: To compare the 3-year postoperative anterior (ACO) and posterior (PCO) capsule opacification and the level of anterior capsule retraction after implantation of 2 single-piece hydrophobic acrylic intraocular lens (IOL) models.SETTING: Hospital of St. John of God, Vienna, Austria.DESIGN: Comparative randomized controlled double-blind clinical trial.METHODS: Eyes with bilateral cataract were evaluated. Each patient had an Acrysof SA60AT (interrupted optic edge) IOL implanted in 1 eye (Group A) and a Tecnis ZCB00 (continuous optic edge) IOL implanted in the fellow eye (Group B). One and 3 years postoperatively, PCO was evaluated using Evaluation of Posterior Capsule Opacification software and the ACO level and capsule-retraction level were evaluated and graded subjectively.RESULTS: The study evaluated 100 eyes of 50 patients ranging from 61 to 80 years. Postoperatively, there were no statistically significant differences in PCO between Group A and Group B at 1 year (0.06 ± 0.12 [SD] and 0.07 ± 0.13, respectively; P = 4.35) or 3 years (0.23 ± 0.36 and 0.22 ± 0.32, respectively; P = .66). In Group A and Group B, ACO was present in 18.0% of eyes and 2.7% of eyes, respectively, at 1 year (P = .03) and in 92.0% and 24.0%, respectively, at 3 years (P < .01). Capsule phimosis (18.0% at 1 year; 30.0% at 3 years) and glistenings (66.0% at 1 year; 86.0% at 3 years) were observed in Group A only.CONCLUSION: Both IOLs had similarly low PCO rates 3 years postoperatively, although more ACO and capsule retraction were observed in eyes with the interrupted optic edge IOL.","Kahraman, G; Amon, M; Ferdinaro, C; Nigl, K; Walch, M",2015.0,10.1016/j.jcrs.2014.07.041,0,0,
6513,Parental presence during induction of anesthesia: physiological effects on parents,"ER METHODSChildren and their parents (N = 80) were randomly assigned to one of three groups: (1) PPIA; (2) PPIA plus 0.5 mg/kg oral midazolam; and (3) control (no PPIA or midazolam). The effect of the group assignment on parental heart rate (HR), parental blood pressure, and parental skin conductance level (SCL) were assessed. Both parental HR and parental SCL were monitored continually. Anxiety of the parent and child was also assessed.RESULTSParental HR increased from baseline until the induction of anesthesia (P = 0.001). A group-by-time effect ( P= 0.005) was also found. That is, throughout the induction period there were several time points at which parents in the two PPIA groups had a significantly higher HR than did parents in the control group (P < 0.05). Similarly, SCL was found to increase in all parents from baseline until induction of anesthesia (P = 0.001). Significant group differences in SCL changes over time were found as well (P = 0.009). State anxiety and blood pressure following induction of anesthesia did not differ significantly between groups ( P= nonsignificant). Examination of parental Holter data revealed no rhythm abnormalities and no electrocardiogram changes indicating ischemia.CONCLUSIONSThe authors found that PPIA is associated with increased parental HR and SCL. However, no increased incidence of electrocardiogram abnormalities were found in parents present during induction of anesthesia.BACKGROUNDThe authors conducted a randomized controlled trial to determine whether parental presence during induction of anesthesia (PPIA) is associated with parental physiologic and behavioral manifestations of stress.","Kain, Z N; Caldwell-Andrews, A A; Mayes, L C; Wang, S M; Krivutza, D M; LoDolce, M E",2003.0,,0,0,
6514,Modafinil ameliorates excessive daytime sleepiness after traumatic brain injury,"ER METHODSWe conducted a prospective, double-blind, randomized, placebo-controlled pilot study in 20 patients with TBI who had fatigue or EDS or both. After baseline examinations (questionnaires including the Epworth Sleepiness Scale to assess EDS and the Fatigue Severity Scale to assess fatigue, actigraphy, polysomnography, maintenance of wakefulness test, and psychomotor vigilance test), 10 patients received 100 to 200 mg modafinil every morning, and 10 patients were treated with placebo. After a 6-week treatment period, all examinations were repeated.RESULTSEDS improved significantly in patients with TBI who were treated with modafinil, compared with the placebo group. Similarly, the ability to stay awake on the maintenance of wakefulness test improved only in the modafinil group. Modafinil, however, had no impact on posttraumatic fatigue. Clinically relevant side effects were not observed.CONCLUSIONThis study indicates that modafinil is effective and well tolerated in the treatment of posttraumatic EDS but not of fatigue.CLASSIFICATION OF EVIDENCEThis study provides Class I evidence that modafinil (100-200 mg daily) improves posttraumatic EDS compared with placebo. This study provides Class I evidence that modafinil (100-200 mg daily) does not improve posttraumatic fatigue compared with placebo.BACKGROUNDExcessive daytime sleepiness (EDS) and fatigue are common symptoms after traumatic brain injury (TBI), but there is no specific treatment for affected patients. With this pilot study, we aimed at studying the effect of daily modafinil on posttraumatic EDS and fatigue.","Kaiser, P R; Valko, P O; Werth, E; Thomann, J; Meier, J; Stocker, R; Bassetti, C L; Baumann, C R",2010.0,10.1212/WNL.0b013e3181fd62a2,0,0,
6515,Alcohol use biomarkers predicting cognitive performance: a secondary analysis in veterans with alcohol dependence and posttraumatic stress disorder,"ER METHODS: Two regression models were estimated and tested for each neurocognitive measure (dependent measure). The first model included the alcohol use biomarker alone as the predictor. The second model included the alcohol use biomarker along with the following 3 additional predictors: Beck Depression Inventory, Clinician-Administered PTSD Scale, and receiving medications.RESULTS: In both models, the indirect biomarkers, such as GGT and AST, significantly predicted performance on the Hopkins Verbal Learning Test-Revised %Retention. GGT alone significantly predicted performance on the Trail Making Test part A.CONCLUSIONS: Indirect alcohol use biomarkers may have a specific role in identifying those veterans with alcohol dependence and PTSD who have impaired cognitive performance. However, direct alcohol use biomarkers may not share such a role.OBJECTIVE: We conducted a secondary analysis of baseline data from a recently completed pharmacological pilot clinical trial among 30 veterans with alcohol dependence and posttraumatic stress disorder (PTSD). This trial included baseline measures of alcohol use biomarkers, both indirect (carbohydrate-deficient transferrin, GGT [?-glutamyltransferase], mean corpuscular volume, AST [aspartate aminotransferase], alanine aminotransferase) and direct (ethyl glucuronide, ethyl sulfate), as well as neurocognitive measures (Trail Making Test parts A and B, Hopkins Verbal Learning Test-Revised, Balloon Analogue Risk Task, Delay Discounting Task).","Kalapatapu, R K; Delucchi, K L; Lasher, B A; Vinogradov, S; Batki, S L",2013.0,10.7205/MILMED-D-13-00097,0,0,
6516,Comparison of posterior capsular opacification in heparin-surface-modified hydrophilic acrylic and hydrophobic acrylic intraocular lenses,"ER METHODSSeventy-eight patients with simple cataract were randomized to receive either the BioVue 3 HSM hydrophilic acrylic IOL (Ophthalmic Innovations International, Ontario, CA, USA) (n = 38) or the Sensar AR40e hydrophobic acrylic IOL (AMO, Santa Ana, CA, USA) (n = 40). Another 99 patients with complicated cataract received either the BioVue 3 (n = 49) or the Sensar AR40e IOL (n = 50). Twelve months after surgery, POCOman software was used to analyze digital retroillumination photographs of the PCO.RESULTSIn the simple cataract group, the respective PCO areas, expressed as a percentage and PCO severity scores at 12 months were 6.12% and 0.081 in the BioVue 3 group and 5.91% and 0.075 in the Sensar AR40e group. There was no statistically significant difference in the PCO area or the PCO severity score between the two IOLs (P = 0.631, P = 0.495, respectively). In the complicated cataract group, the respective PCO areas and PCO severity scores were 35.80% and 0.181 in the BioVue 3 group and 27.17% and 0.110 in the Sensar AR40e group. There was no statistically significant difference between the two IOLs (P = 0.147, P = 0.162).CONCLUSIONThere was no difference in the degree or severity of PCO between the HSM hydrophilic acrylic IOL and the hydrophobic acrylic IOL groups.PURPOSETo compare posterior capsular opacification (PCO) in a heparin-surface-modified (HSM) hydrophilic acrylic intraocular lens (IOL) and a hydrophobic acrylic IOL.","Kang, S; Choi, J A; Joo, C K",2009.0,10.1007/s10384-008-0646-3,0,0,
6517,Comparison of clinical results between heparin surface modified hydrophilic acrylic and hydrophobic acrylic intraocular lens,"ER METHODSOne hundred patients with cataract were randomized to receive one of acrylic foldable IOLs after phacoemulsification: HSM hydrophilic acrylic IOL (n=50) BioVue3 (BioVue, OII, Ontario, CA, USA) and hydrophobic acrylic IOL (n=50) Sensar (AR40e, AMO, Santa Ana, CA, USA). Bestcorrected visual acuity and refractive error were measured at 1 week, 2 months, 6 months and 12 months after surgery in both IOL groups. To assess posterior capsular opacification (PCO), digital retroillumination image of posterior capsule was analyzed at 12 months using POCOman software.RESULTSBest-corrected visual acuity (log MAR) was 0.032+/-0.082 in BioVue3 group and 0.034+/-0.077 in Sensar group at 12 months. There was no statistically significant difference between the two groups (p=0.554). Refractive error was -0.247+/-0.821 diopter in BioVue3 group and -0.264+/-0.808 diopter in Sensar group at 12 months. There was no statistically significant difference of refractive error between the two groups (p=0.909). At 12 months, BioVue3 IOL group had a lower percentage area and severity of PCO than Sensar group. However, it was not statistically significant (p=0.349, p=0.288). No Nd:YAG capsulotomy was performed in BioVue3 group while it was required in two eyes (4.0%) in Sensar group.CONCLUSIONSThere was no statistically significant difference of postoperative visual acuity, refractive error and degree of PCO between HSM hydrophilic acrylic IOL and hydrophobic acrylic IOL.PURPOSETo compare the clinical results of heparin surface modified (HSM) hydrophilic acrylic intraocular lens (IOL) with those of hydrophobic acrylic IOL.","Kang, S; Kim, M J; Park, S H; Joo, C K",2008.0,,0,0,
6518,Narrative exposure therapy for immigrant children traumatized by war: study protocol for a randomized controlled trial of effectiveness and mechanisms of change,"ER METHODS/DESIGN: We are conducting a multicentre, pragmatic RCT in a usual care setting. Up to 80 9-17-year-old immigrant children who have experienced war and suffer from PTSD symptoms will be randomized into intervention (NET) and control (treatment as usual, TAU) groups of equal sizes. The effectiveness of NET treatment will be compared to both a waiting list and the parallel TAU positive control group, on the primary outcomes of PTSD and depressive symptoms, psychological distress, resilience, and level of cognitive performance. The effects of the intervention on traumatic memories and posttraumatic cognitions will be studied as potential mechanisms of change mediating overall treatment effectiveness. The possible moderating effects of peritraumatic dissociation, level of cognitive performance, and gender on treatment effectiveness will also be considered. We hypothesize that NET will be more effective than a waitlist condition or TAU in reducing PTSD and other symptoms and improving resilience, and that these effects will be mediated by changes in traumatic memories and posttraumatic cognitions.DISCUSSION: The results of this trial will provide evidence for the effectiveness of NET in treating trauma-related symptoms in immigrant children affected by war. The trial will also generate insights into the complex relationships between PTSD, memory functions, posttraumatic cognitions and cognitive performance in children, and help guide the future development and implementation of therapeutic interventions for PTSD in children.TRIAL REGISTRATION: ClinicalTrials.gov NCT02425280 . Registered 15 April 2015.BACKGROUND: Millions of children worldwide suffer from posttraumatic stress disorder (PTSD) symptoms and other mental health problems due to repeated exposure to war or organized violence. Forms of cognitive-behavioral therapy (CBT) are the most commonly used treatment for PTSD and appear to be effective for children as well, but little is known about the mechanisms of change through which they achieve their effectiveness. Here we present the study protocol of a randomized controlled trial (RCT) studying the effectiveness and mechanisms of change of Narrative Exposure Therapy (NET), a CBT-based, manualized, short-term intervention for PTSD symptoms resulting from repeated traumatization, in immigrant children traumatized by war.","Kangaslampi, S; Garoff, F; Peltonen, K",2015.0,10.1186/s12888-015-0520-z,0,0,
6519,Inositol treatment of post-traumatic stress disorder,,"Kaplan, Z; Amir, M; Swartz, M; Levine, J",1996.0,10.1002/(SICI)1522-7154(1996)2:1<51::AID-ANXI8>3.0.CO,0,0,
6520,Clinically significant symptom change in children with attention-deficit/hyperactivity disorder: does it correspond with reliable improvement in functioning?,"ER This study examined the relation between clinically significant (CS) change in symptoms of attention-deficit/hyperactivity disorder (ADHD) and of oppositional defiant disorder (ODD), and reliable change in multiple domains of functioning in children who participated in the Multimodal Treatment Study of Children with ADHD. Children with CS change in symptoms were significantly more likely than children without CS change to have reliable change across five domains of functioning. Interestingly, however, depending on the measure of functioning, 14 to 52% of children who did not achieve CS change in symptoms showed reliable improvement in functional domains. The results have implications for the definition and measurement of CS change in child treatment-outcome studies.","Karpenko, V; Owens, J S; Evangelista, N M; Dodds, C",2009.0,10.1002/jclp.20549,0,0,
6521,A pilot randomized controlled trial assessing secondary prevention of traumatic stress integrated into pediatric trauma care,"ER Medical settings provide opportunities for secondary prevention of traumatic stress and other sequelae of pediatric injury. This pilot randomized trial evaluated the delivery and effectiveness of a targeted preventive intervention based on best practice recommendations and integrated within acute medical care. Hospitalized injured children were screened for risk of developing posttraumatic stress disorder (PTSD). Those at risk (N = 85) were randomized to the intervention (n = 46) or usual care (n = 39). The preventive intervention did not reduce PTSD or depression severity or increase health-related quality of life, compared to usual care. Both groups improved over time, but 6 months postinjury approximately 10% of each group still met criteria for PTSD, suggesting room for improvement in comprehensive pediatric injury care.","Kassam-Adams, N; García-España, J F; Marsac, M L; Kohser, K L; Baxt, C; Nance, M; Winston, F",2011.0,10.1002/jts.20640,0,0,
6522,Pilot Randomized Controlled Trial of a Novel Web-Based Intervention to Prevent Posttraumatic Stress in Children Following Medical Events,"ER METHODS: Children aged 8-12 years with a recent acute medical event were randomized to the intervention (N = 36) or a 12-week wait list (N = 36). Posttraumatic stress, health-related quality of life, appraisals, and coping were assessed at baseline, 6, 12, and 18 weeks.RESULTS: Most children used the intervention; half completed it. Medium between-group effect sizes were observed for change in posttraumatic stress severity from baseline to 6 weeks (d = -.68) or 12 weeks (d = -.55). Exploratory analyses suggest greatest impact for at-risk children, and a small effect for intervention initiated after 12 weeks. Analysis of covariance did not indicate statistically significant group differences in 12-week outcomes.CONCLUSIONS: This pilot randomized controlled trial provides preliminary evidence that a self-directed online preventive intervention is feasible to deliver, and could have an effect in preventing persistent posttraumatic stress.OBJECTIVE: To assess feasibility and estimate effect size of a self-directed online intervention designed to prevent persistent posttraumatic stress after acute trauma.","Kassam-Adams, N; Marsac, M L; Kohser, K L; Kenardy, J; March, S; Winston, F K",2016.0,10.1093/jpepsy/jsv057,0,0,
6523,Anxiety and depression screening for youth in a primary care population,"ER METHODSIn a sample of 1375 youth aged 11 to 17 (779 with asthma, 596 randomly selected controls) enrolled in a health maintenance organization, the psychometric properties (optimum cutoffs on receiver operator characteristic (ROC) curves, sensitivity, specificity, positive and negative predictive values) of 2 brief anxiety and depression screens were compared with a gold standard-structured psychiatric interview.RESULTSBoth the MFQ-SF and ASI performed well on ROC analysis for screening youth for 1 or more Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) anxiety or depressive disorders. The MFQ-SF performed better on ROC analysis than the ASI for youth with major depression (area under the curve of 0.84 vs 0.77). For screening youth with anxiety disorders, ROC curves showed that both the MFQ-SF and ASI only performed in the fair range (area under the curve of 0.76).CONCLUSIONThe MFQ-SF and ASI are 2 relatively brief questionnaires that performed well for screening youth for 1 or more DSM-IV anxiety or depressive disorders. The MFQ-SF performed better than the ASI for screening youth with major depression. Use of these instruments could increase the accuracy of identification of mental health disorders in youth by primary care physicians.OBJECTIVEPrior studies have shown a low rate of accurate identification by primary care physicians of mental health disorders in youth. This study tested the psychometric properties of 2 brief mental health screening questionnaires, the Mood and Feelings Questionnaire, short form, (MFQ-SF) and Childhood Anxiety Sensitivity Index (ASI), in a large sample of youth.","Katon, W; Russo, J; Richardson, L; McCauley, E; Lozano, P",2008.0,10.1016/j.ambp.2008.01.003,0,0,
6524,The iTreAD project: a study protocol for a randomised controlled clinical trial of online treatment and social networking for binge drinking and depression in young people,"ER BACKGROUND: Depression and binge drinking behaviours are common clinical problems, which cause substantial functional, economic and health impacts. These conditions peak in young adulthood, and commonly co-occur. Comorbid depression and binge drinking are undertreated in young people, who are reluctant to seek help via traditional pathways to care. The iTreAD project (internet Treatment for Alcohol and Depression) aims to provide and evaluate internet-delivered monitoring and treatment programs for young people with depression and binge drinking concerns.METHODS: Three hundred sixty nine participants will be recruited to the trial, and will be aged 18-30 years will be eligible for the study if they report current symptoms of depression (score 5 or more on the depression subscale of the Depression Anxiety Stress Scale) and concurrent binge drinking practices (5 or more standard drinks at least twice in the prior month). Following screening and online baseline assessment, participants are randomised to: (a) online monthly self-assessments, (b) online monthly self-assessments?+?12-months of access to a 4 week online automated cognitive behaviour therapy program for binge drinking and depression (DEAL); or (c) online monthly assessment?+?DEAL?+?12-months of access to a social networking site (Breathing Space). Independent, blind follow-up assessments occur at 26, 39, 52 and 64-weeks post-baseline.DISCUSSION: The iTreAD project is the first randomised controlled trial combining online cognitive behaviour therapy, social networking and online monitoring for young people reporting concerns with depression and binge drinking. These treatments represent low-cost, wide-reach youth-appropriate treatment, which will have significantly public health implications for service design, delivery and health policy for this important age group.TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12614000310662. Date registered 24 March 2014.","Kay-Lambkin, F J; Baker, A L; Geddes, J; Hunt, S A; Woodcock, K L; Teesson, M; Oldmeadow, C; Lewin, T J; Bewick, B M; Brady, K; Spring, B; Deady, M; Barrett, E; Thornton, L",2015.0,10.1186/s12889-015-2365-2,0,0,
6525,The influence of panic attacks on response to phenelzine and amitriptyline in depressed outpatients,"ER A total of 169 depressed outpatients completed a 6-week double-blind study designed to compare the relative efficacy of a tricyclic antidepressant (amitriptyline) with a monoamine oxidase inhibitor (phenelzine). Various ""target"" symptoms reported to predict preferential response to monoamine oxidase inhibitors were assessed. The major finding within the whole patient sample, based on results from serial self-report and interviewer-rated scales, was that phenelzine-treated patients showed greater improvements in anxiety symptoms than did patients treated with amitriptyline. Because of the heterogeneity of the sample, patients were classified into homogeneous subgroups of clinical interest. Data analyses of these subgroups detected important drug treatment differences not discernible by analysis of data from the overall sample. Panic attacks and corresponding anxiety symptoms were reported by about one third of the patients, more often by patients with major depression than with minor depression. Patients who reported ""spells of terror or panic"" responded preferentially to phenelzine on several measures, particularly on items measuring anxiety. Results suggest that phenelzine may be a preferred drug for treating depressed patients with panic attacks.","Kayser, A; Robinson, D S; Yingling, K; Howard, D B; Corcella, J; Laux, D",1988.0,,0,0,
6526,Treatment of posttraumatic stress symptoms in adolescent survivors of childhood cancer and their families: a randomized clinical trial,"ER Posttraumatic stress symptoms (PTSS), particularly intrusive thoughts, avoidance, and arousal, are among the most common psychological aftereffects of childhood cancer for survivors and their mothers and fathers. We conducted a randomized wait-list control trial of a newly developed 4-session, 1-day intervention aimed at reducing PTSS that integrates cognitive-behavioral and family therapy approaches--the Surviving Cancer Competently Intervention Program (SCCIP). Participants were 150 adolescent survivors and their mothers, fathers, and adolescent siblings. Significant reductions in intrusive thoughts among fathers and in arousal among survivors were found in the treatment group. A multiple imputations approach was used to address nonrandom missing data and indicated that treatment effects would likely have been stronger had more distressed families been retained. The data are supportive of brief interventions to reduce PTSS in this population and provide additional support for the importance of intervention for multiple members of the family.","Kazak, A E; Alderfer, M A; Streisand, R; Simms, S; Rourke, M T; Barakat, L P; Gallagher, P; Cnaan, A",2004.0,10.1037/0893-3200.18.3.493,0,0,
6527,Feasibility and preliminary outcomes from a pilot study of a brief psychological intervention for families of children newly diagnosed with cancer,"ER METHODNineteen families (38 caregivers) were randomly assigned to SCCIP-ND or treatment as usual subsequent to learning of their child's illness. The study design included pre- and 2-month postintervention assessments, with state anxiety and posttraumatic stress symptoms as outcomes. Feasibility was based on therapist feedback and supervision, program evaluations, and data from study-tracking procedures.RESULTSSCCIP-ND appears to be an acceptable intervention that can be used successfully with caregivers over the first few months after diagnosis. Recruitment and retention data document feasibility but also highlight challenges. Preliminary outcome data show changes in the desired direction [e.g., reduced anxiety and parental posttraumatic stress symptoms (PTSS)].CONCLUSIONSThe pilot data are supportive of the value and challenges of developing evidence-based family interventions in pediatric psychology.OBJECTIVETo report initial feasibility and outcome from a pilot study of a new three-session intervention for caregivers of children newly diagnosed with cancer, Surviving Cancer Competently Intervention Program-Newly Diagnosed (SCCIP-ND).","Kazak, A E; Simms, S; Alderfer, M A; Rourke, M T; Crump, T; McClure, K; Jones, P; Rodriguez, A; Boeving, A; Hwang, W T; Reilly, A",2005.0,10.1093/jpepsy/jsi051,0,0,
6528,Surviving cancer competently intervention program (SCCIP): a cognitive-behavioral and family therapy intervention for adolescent survivors of childhood cancer and their families,"ER Psychological reactions to having had childhood cancer often continue after treatment ends, for survivors and their parents. Based on our previous research, we developed an intervention program for adolescent survivors of childhood cancer, their parents, and siblings. Surviving Cancer Competently: An Intervention Program--SCCIP--is a one-day family group intervention that combines cognitive-behavioral and family therapy approaches. The goals of SCCIP are to reduce symptoms of distress and to improve family functioning and development. SCCIP is described and data from a pilot study of 19 families are presented. Program evaluation data indicated that all family members found SCCIP helpful. Standardized measures administered before the intervention and again at 6 months after SCCIP showed that symptoms of posttraumatic stress and anxiety decreased. Changes in family functioning were more difficult to discern. Overall, the results were promising with regard to the feasibility of the program and its potential for reducing symptoms of distress for all family members.","Kazak, A E; Simms, S; Barakat, L; Hobbie, W; Foley, B; Golomb, V; Best, M",1999.0,,0,0,
6529,Benefits of child-focused anxiety treatments for parents and family functioning,"ER METHODS: Participants were 488 youth ages 7-17 years (50% female; mean age 10.7 years) who met DSM-IV-TR criteria for social phobia, separation anxiety, and/or generalized anxiety disorder, and their parents. Youth were randomly assigned to 12 weeks of ""Coping Cat"" individual cognitive-behavioral therapy (CBT), medication management with sertraline (SRT), their combination (COMB), or medication management with pill placebo (PBO) within the multisite Child/Adolescent Anxiety Multimodal Study (CAMS). At pre- and posttreatment, parents completed measures of trait anxiety, psychological distress, family functioning, and burden of child illness; children completed a measure of family functioning. Blinded independent evaluators rated child's response to treatment using the Clinical Global Impression-Improvement Scale at posttreatment.RESULTS: Analyses of covariance revealed that parental psychological distress and trait anxiety, and parent-reported family dysfunction improved only for parents of children who were rated as treatment responders, and these changes were unrelated to treatment condition. Family burden and child-reported family dysfunction improved significantly from pre- to posttreatment regardless of treatment condition or response.CONCLUSIONS: Findings suggest that child-focused anxiety treatments, regardless of intervention condition, can result in improvements in nontargeted parent symptoms and family functioning particularly when children respond successfully to the treatment.BACKGROUND: To examine (1) changes in parent (global psychological distress, trait anxiety) and family (dysfunction, burden) functioning following 12 weeks of child-focused anxiety treatment, and (2) whether changes in these parent and family factors were associated with child's treatment condition and response.","Keeton, C P; Ginsburg, G S; Drake, K L; Sakolsky, D; Kendall, P C; Birmaher, B; Albano, A M; March, J S; Rynn, M; Piacentini, J; Walkup, J T",2013.0,10.1002/da.22055,0,0,
6530,"Bilateral globus pallidus stimulation for severe Tourette's syndrome: a double-blind, randomised crossover trial","ER Background: Deep brain stimulation (DBS) has been proposed as a treatment option for severe Tourette's syndrome on the basis of findings from open-label series and small double-blind trials. We aimed to further assess the safety and efficacy of bilateral globus pallidus internus (GPi) DBS in patient's with severe Tourette's syndrome. Methods: In a randomised, double-blind, crossover trial, we recruited eligible patients (severe medically refractory Tourette's syndrome, age >20 years) from two clinics for tertiary movement disorders in the UK. Enrolled patients received surgery for GPi DBS and then were randomly assigned in a 1:1 ratio (computer-generated pairwise randomisation according to order of enrolment) to receive either stimulation on-first or stimulation off-first for 3 months, followed by a switch to the opposite condition for a further 3 month period. Patients and rating clinicians were masked to treatment allocation; an unmasked clinician was responsible for programming the stimulation. The primary endpoint was difference in Yale Global Tic Severity Scale (YGTSS) total score between the two blinded conditions, assessed with repeated measures ANOVA, in all patients who completed assessments during both blinded periods. After the end of the blinded crossover phase, all patients were offered continued DBS and continued to have open-label stimulation adjustments and objective assessments of tic severity until database lock 1 month after the final patient's final trial-related visit. This trial is registered with ClinicalTrials.gov, number NCT01647269. Findings: Between Nov 5, 2009, and Oct 16, 2013, we enrolled 15 patients (11 men, four women; mean age 347 years [SD 100]). 14 patients were randomly assigned and 13 completed assessments in both blinded periods (seven in the on-first group, six in the off-first group). Mean YGTSS total score in these 13 patients was 879 (SD 92) at baseline, 807 (SD 120) for the off-stimulation period, and 683 (SD 186) for the on-stimulation period. Pairwise comparisons in YGTSS total scores after Bonferroni correction were significantly lower at the end of the on-stimulation period compared with the off-stimulation period, with a mean improvement of 124 points (95% CI 01-247, p=0048), equivalent to a difference of 153% (95% CI 53-253). All 15 patients received stimulation in the open-label phase. Overall, three serious adverse events occurred (two infections in DBS hardware at 2 and 7 weeks postoperatively, and one episode of deep-brain-stimulation-induced hypomania during the blinded on-stimulation period); all three resolved with treatment. Interpretation: GPi stimulation led to a significant improvement in tic severity, with an overall acceptable safety profile. Future research should concentrate on identifying the most effective target for DBS to control both tics and associated comorbidities, and further clarify factors that predict individual patient response. Funding: UK National Health Service.","Kefalopoulou, Z; Zrinzo, L; Jahanshahi, M; Candelario, J; Milabo, C; Beigi, M; Akram, H; Hyam, J; Clayton, J; Kass-Iliyya, L; Silverdale, M; Evans, J; Limousin, P; Hariz, M; Joyce, E; Foltynie, T",2015.0,10.1016/S1474-4422(15)00008-3,0,0,
6531,Possible role of atrial natriuretic hormone in pituitary-adrenocortical unresponsiveness in lactate-induced panic,"ER METHODSodium lactate and placebo infusions were administered to 10 patients with panic disorder and to 10 healthy comparison subjects, and the atrial natriuretic hormone responses of the two groups were compared.RESULTSDuring lactate infusion both the seven patients who had panic attacks and the eight comparison subjects who did not responded with increased plasma concentrations of atrial natriuretic hormone, but the patients had more pronounced surges of the hormone.CONCLUSIONSBecause atrial natriuretic hormone suppresses both pituitary ACTH and adrenal cortisol release, the authors suggest that the immediate rise of atrial natriuretic hormone explains the reported lack of pituitary-adrenocortical activation during lactate-induced panic.OBJECTIVEThis study investigated whether lactate-induced panic attacks in patients with panic disorder would activate atrial natriuretic hormone, which could explain the missing ACTH and cortisol response found in this kind of experimentally induced panic.","Kellner, M; Herzog, L; Yassouridis, A; Holsboer, F; Wiedemann, K",1995.0,10.1176/ajp.152.9.1365,0,0,
6532,"Outcome of cognitive-behavioral and support group brief therapies for depressed, HIV-infected persons","ER METHODSixty-eight depressed men with HIV infection were randomly assigned to one of three conditions: eight-session cognitive-behavioral groups, eight-session social support groups, or a comparison condition. Before and after intervention and at 3-month follow-up, all participants were individually assessed by using measures of symptoms of distress as well as substance use and sexual practices.RESULTSRelative to the comparison group, both the cognitive-behavioral and social support group therapies produced reductions in depression, hostility, and somatization. The social support intervention also produced reductions in overall psychiatric symptoms and tended to reduce maladaptive interpersonal sensitivity, anxiety, and frequency of unprotected receptive anal intercourse, while the cognitive-behavioral intervention resulted in less frequent illicit drug use during the follow-up period. Tests for clinical significance of change particularly underscored benefits of the social support group intervention both at postintervention and at long-term follow-up.CONCLUSIONSBrief group therapy for depressed persons with HIV infection produced reductions in symptoms of distress. The two forms of therapy resulted in shared and unique improvements in functioning, although social support groups focused on emotional coping presented greater evidence of clinically significant change. As more persons contract HIV infection and live longer with HIV disease, further research is needed to evaluate outcomes of mental health services with these individuals.OBJECTIVEAlthough many studies have documented patterns of emotional distress in persons with HIV disease, there have been few controlled evaluations of therapy outcomes with these individuals. This research evaluated the effects of brief cognitive-behavioral or social support group therapy with this population.","Kelly, J A; Murphy, D A; Bahr, G R; Kalichman, S C; Morgan, M G; Stevenson, L Y; Koob, J J; Brasfield, T L; Bernstein, B M",1993.0,10.1176/ajp.150.11.1679,0,0,
6533,Protocol for a randomised controlled trial of risk screening and early intervention comparing child- and family-focused cognitive-behavioural therapy for PTSD in children following accidental injury,"ER METHODS/DESIGNThe principal clinical question under investigation is the efficacy of an early, trauma-focused cognitive-behavioural intervention for the treatment of PTSD in children following accidental injury. Specifically, we compare the efficacy of two active treatments (child-focused and family-focused CBT) and a waitlist control (no therapy) to determine which is associated with greater reductions in psychological and health-related outcome measures over time. The primary outcome will be a reduction in trauma symptoms on a diagnostic interview in the active treatments compared to the waitlist control and greater reductions in the family-compared to the child-focused condition. In doing so, this project will also trial a method of stepped screening and assessment to determine those children requiring early intervention for PTSD following accidental injury.DISCUSSIONThe present trial will be one of the first controlled trials to examine a trauma-focused CBT, early intervention for children experiencing PTSD following accidental injury (as opposed to other types of traumatic events) and the first within a stepped care approach. In addition, it will provide the first evidence comparing the efficacy of child and family-focused interventions for this target group. Given the significant number of children and adolescents exposed to accidental injury, the successful implementation of this protocol has considerable implications. If efficacious, this early intervention will assist in reducing symptoms of traumatic stress as well as preventing chronic disorder and disability in children experiencing acute PTSD following accidental injury.TRIAL REGISTRATIONControlled-trials.com: ISRCTN79049138.BACKGROUNDAccidental injury represents the most common type of traumatic event to which a child or adolescent may be exposed, with a significant number of these children going on to experience posttraumatic stress disorder (PTSD). However, very little research has examined potential interventions for the treatment of PTSD in these children. The present trial aims to evaluate and compare child- and family-focused versions of a cognitive-behavioural early intervention for PTSD following accidental injury.","Kenardy, J; Cobham, V; Nixon, R D; McDermott, B; March, S",2010.0,10.1186/1471-244X-10-92,0,0,
6534,Information-provision intervention for children and their parents following pediatric accidental injury,"ER METHODInformation booklets provided to participants within 72 h of the initial trauma detailed common responses to trauma, the common time course of symptoms, and suggestions for minimizing any post-trauma distress. Following admission for traumatic injuries sustained in motor vehicle accidents, falls and sporting injuries a total of 103 children (aged 7-15) and their parents were evaluated at pre-intervention, 1 month, and 6 months post-trauma. The intervention (N = 33) was delivered to one of two hospitals, the second hospital was the control (N = 70).RESULTSAnalyses indicated that the intervention reduced child anxiety symptoms at 1-month follow-up and parental posttraumatic intrusion symptoms and overall posttraumatic symptoms at the 6-month follow-up. No other differences between the intervention and control groups were found.CONCLUSIONOverall, the information-based early intervention is simple, cost-effective method of reducing child and parent distress post-trauma.OBJECTIVEThis study evaluated an early intervention for children and their parents following pediatric accidental injury.","Kenardy, J; Thompson, K; Brocque, R; Olsson, K",2008.0,10.1007/s00787-007-0673-5,0,0,
6535,A Web-Based Early Intervention Can Prevent Long-Term PTS Reactions in Children With High Initial Distress Following Accidental Injury,"ER The present study explored the targeting of a preventative information provision intervention delivered to children following accidental injury by assessing the impact of initial traumatic distress on response to treatment. Analyses were based on baseline and 6-month outcome of child traumatic stress in a control (n = 28) and an intervention group (n = 31). Moderation of treatment outcome by initial levels of child traumatic stress was assessed through multiple hierarchical regression analyses. Results indicated the interaction between treatment provision and initial level of posttraumatic stress significantly predicted 6-month outcome (? = -.42, p = .019). When initial distress was high, children in the control group demonstrated an increase in trauma symptoms, and had significantly higher trauma symptoms at follow-up than those in the treatment group (d = 0.94, p = .008). When initial distress was not elevated, no significant differences were noted between the groups. These results indicate that a preventative early intervention may be best targeted at children presenting with the specific risk factor of high initial distress.","Kenardy, J A; Cox, C M; Brown, F L",2015.0,10.1002/jts.22025,0,0,
6536,Treating anxiety disorders in children: results of a randomized clinical trial,"ER In this study a psychosocial treatment for 47 Ss (aged 9-13 years) with anxiety disorders was investigated. A 16-session cognitive-behavioral treatment was compared with a wait-list condition. Outcome was evaluated using child self-report, parent report, teacher report, cognitive assessment, and behavioral observations. Pretreatment-posttreatment changes and maintenance of gains at 1-year follow-up were examined. Results revealed that many treated Ss were found to be without a diagnosis at posttest and at follow-up and to be within normal limits on many measures. The child's perception of the therapeutic relationship and the therapist's perception of parental involvement were measured but were not related to outcome. Discussion focuses on characteristics of effective child therapy and the need for further research on treatment components and alternative treatment methods.","Kendall, P C",1994.0,,0,0,
6537,Comorbidity in childhood anxiety disorders and treatment outcome,"ER METHODParticipants were 173 children between the ages of 8 and 13 years who met primary DSM-III-R/DSM-IV diagnoses of separation anxiety disorder, overanxious disorder/generalized anxiety disorder, or avoidant disorder/social phobia assessed by the Anxiety Disorders Interview Schedule for Children (ADIS-C). The majority (79%) had at least one comorbid diagnosis. Participants were randomly assigned to cognitive-behavioral therapy or waitlist. Group differences in ADIS-C diagnoses were compared after treatment. Multiple parent and child self-report measures were used to measure symptoms as well.RESULTSPretreatment comorbidity was not associated with differences in treatment outcome: 68.4% of noncomorbid participants and 70.6% of comorbid participants were free of their primary diagnosis after treatment. Regarding parent and child self-report symptoms, multivariate analyses of variance revealed significant time (treatment) main effects, but no significant main effect for group (comorbid status) or time/group interaction.CONCLUSIONSThe cognitive-behavioral treatment program was similarly effective in anxious children with and without comorbid disorders; both groups showed clinically significant reductions in pretreatment diagnoses and symptoms.OBJECTIVEPsychiatric comorbidity is common in anxious children. The purpose of this study was to investigate the impact of comorbidity on treatment outcome in anxious children.","Kendall, P C; Brady, E U; Verduin, T L",2001.0,10.1097/00004583-200107000-00013,0,0,
6538,In-session exposure tasks and therapeutic alliance across the treatment of childhood anxiety disorders,"ER The study examined the shape of therapeutic alliance using latent growth curve modeling and data from multiple informants (therapist, child, mother, father). Children (n = 86) with anxiety disorders were randomized to family-based cognitive-behavioral treatment (FCBT; N = 47) with exposure tasks or to family education, support, and attention (FESA; N = 39). Children in FCBT engaged in exposure tasks in Sessions 9-16, whereas FESA participants did not. Alliance growth curves of FCBT and FESA youths were compared to examine the impact of exposure tasks on the shape of the alliance (between-subjects). Within FCBT, the shape of alliance prior to exposure tasks was compared with the shape of alliance following exposure tasks (within-subjects). Therapist, child, mother, and father alliance ratings indicated significant growth in the alliance across treatment sessions. Initial alliance growth was steep and subsequently slowed over time, regardless of the use of exposure tasks. Data did not indicate a rupture in the therapeutic alliance following the introduction of in-session exposures. Results are discussed in relation to the processes, mediators, and ingredients of efficacious interventions as well as in terms of the dissemination of empirically supported treatments.","Kendall, P C; Comer, J S; Marker, C D; Creed, T A; Puliafico, A C; Hughes, A A; Martin, E D; Suveg, C; Hudson, J",2009.0,10.1037/a0013686,0,0,
6539,Therapy for youths with anxiety disorders: a second randomized clinical trial,"ER Ninety-four children (aged 9-13 years) with anxiety disorders were randomly assigned to cognitive behavioral treatment or waiting-list control. Outcomes were evaluated using diagnostic status, child self-reports, parent and teacher reports, cognitive assessment and behavioral observation: maintenance was examined using 1-year follow-up data. Analyses of dependent measures indicated significant improvements over time, with the majority indicating greater gains for those receiving treatment. Treatment gains returned cases to within nondeviant limits (i.e., normative comparisons) and were maintained at 1-year follow-up. Client age and comorbid status did not moderate outcomes. A preliminary examination of treatment segments suggested that the enactive exposure (when it follows cognitive-educational training) was an active force in beneficial change. Discussion includes suggestions for future research.","Kendall, P C; Flannery-Schroeder, E; Panichelli-Mindel, S M; Southam-Gerow, M; Henin, A; Warman, M",1997.0,,0,0,
6540,Cognitive-behavioral therapy for anxiety disordered youth: a randomized clinical trial evaluating child and family modalities,"ER This randomized clinical trial compared the relative efficacy of individual (child) cognitive-behavioral therapy (ICBT), family cognitive-behavioral therapy (FCBT), and a family-based education/support/ attention (FESA) active control for treating anxiety disordered youth ages 7-14 years (M = 10.27). Youth (N = 161; 44% female; 85% Caucasian, 9% African American, 3% Hispanic, 3% other/mixed) with a principal diagnosis of separation anxiety disorder, social phobia, or generalized anxiety disorder and their parents participated. Outcome analyses were conducted using hierarchical linear models on the intent-to-treat sample at posttreatment and 1-year follow-up using diagnostic severity, child self-reports, parent reports, and teacher reports. Chi-square analyses were also conducted on diagnostic status at post and 1-year follow-up. Children evidenced treatment gains in all conditions, although FCBT and ICBT were superior to FESA in reducing the presence and principality of the principal anxiety disorder, and ICBT outperformed FCBT and FESA on teacher reports of child anxiety. Treatment gains, when found, were maintained at 1-year follow-up. FCBT outperformed ICBT when both parents had an anxiety disorder. Implications for treatment and suggestions for research are discussed.","Kendall, P C; Hudson, J L; Gosch, E; Flannery-Schroeder, E; Suveg, C",2008.0,10.1037/0022-006X.76.2.282,0,0,
6541,Child anxiety treatment: outcomes in adolescence and impact on substance use and depression at 7.4-year follow-up,"ER Research suggests that the sequelae of childhood anxiety disorders, if left untreated, can include chronic anxiety, depression, and substance abuse. The current study evaluated the maintenance of outcomes of children who received a 16-week cognitive-behavioral treatment for primary anxiety disorders (generalized, separation, and social anxiety disorders) an average of 7.4 years earlier. The 86 participants (ages 15 to 22 years; 91% of the original sample) and their parents completed diagnostic interviews and self- and parent-report measures. According to the diagnostic interviews, a meaningful percentage of participants maintained significant improvements in anxiety at long-term follow-up. With regard to sequelae, positive responders to anxiety treatment, as compared with less positive responders, had a reduced amount of substance use involvement and related problems at long-term follow-up. The findings are discussed with regard to child anxiety and some of its sequelae.","Kendall, P C; Safford, S; Flannery-Schroeder, E; Webb, A",2004.0,10.1037/0022-006X.72.2.276,0,0,
6542,The role of self-statements as a mediator in treatment for youth with anxiety disorders,"ER The authors investigated features of self-statements as predictors of anxiety in children with and without anxiety disorder (AD) and as a mediator of treatment of ADs in children. Children (N = 145) between the ages of 9 and 13 years participated (71 AD youth, 84 controls). Self-statements were classified by valence and content. Results indicated that children's anxious, but not positive or depressed, self-statements significantly predicted anxiety in children with and without AD. For children with AD, changes in anxious self-statements mediated treatment gains, replicating a previously reported finding. A states of mind ratio mediated only 1 outcome measure, and positive and depressive cognitions served no mediating role. The impact of anxious self-talk on children's adjustment and implications for cognitive theory of anxiety in children are discussed.","Kendall, P C; Treadwell, K R",2007.0,10.1037/0022-006X.75.3.380,0,0,
6543,"A trial of problem-solving by community mental health nurses for anxiety, depression and life difficulties among general practice patients. The CPN-GP study","ER DESIGNA pragmatic, randomised controlled trial with three arms: CMHN problem-solving, generic CMHN care and usual GP care.SETTINGGeneral practices in two southern English counties were included in the study. CMHNs were employed by local NHS trusts providing community mental health services.PARTICIPANTSParticipants were GP patients aged 18--65 years with a new episode of anxiety, depression or reaction to life difficulties and had to score at least 3 points on the General Health Questionnaire-12 screening tool. Symptoms had to be present for a minimum of 4 weeks but no longer than 6 months.INTERVENTIONSPatients were randomised to one of three groups: (1) CMHN problem-solving treatment, (2) generic CMHN treatment, or (3) usual GP care. All three groups of patients remained free to consult their GPs throughout the course of the study, and could be prescribed psychotropic drug treatments.MAIN OUTCOME MEASURESPatients were assessed at baseline, and 8 weeks and 26 weeks after randomisation. The primary outcome measure was psychological symptoms measured on the Clinical Interview Schedule -- Revised. Other measures included social functioning, health-related quality of life, problem severity and satisfaction. The economic outcomes were evaluated with a cost--utility analysis.RESULTSTwenty-four CMHNs were trained to provide problem-solving under supervision, and another 29 were referred patients for generic support. In total, 247 patients were randomised to the three arms of the study, referred by 98 GPs in 62 practices. All three groups of patients were greatly improved by the 8-week follow-up. No significant differences were found between the groups at 8 weeks or 26 weeks in symptoms, social functioning or quality of life. Greater satisfaction with treatment was found in the CMHN groups. CMHN care represented a significant additional health service cost and there were no savings in sickness absence.CONCLUSIONSThe study found that specialist mental health nurse support is no better than support from GPs for patients with anxiety, depression and reactions to life difficulties. The results suggest that healthcare providers could consider adopting policies of restricting referrals of unselected patients with common mental disorders to specialist CMHNs, although there may be other roles in primary care that CMHNs could play effectively. Further research should address the predictors of chronicity in common mental disorders and target extra treatment. More research is also needed into the effectiveness and cost-effectiveness of problem-solving treatment for other disorders, of facilitated self-help treatments for common mental disorders and of CMHN care for people with severe and enduring mental illnesses, as well as the prevention of mental disorders.OBJECTIVESTo compare the effectiveness of community mental health nurse (CMHN) problem-solving and generic CMHN care, against usual general practitioner (GP) care in reducing symptoms, alleviating problems, and improving social functioning and quality of life for people living in the community with common mental disorders; and to undertake a cost comparison of each CMHN treatment compared with usual GP care.","Kendrick, T; Simons, L; Mynors-Wallis, L; Gray, A; Lathlean, J; Pickering, R; Harris, S; Rivero-Arias, O; Gerard, K; Thompson, C",2005.0,,0,0,
6544,A selective intervention program for inhibited preschool-aged children of parents with an anxiety disorder: effects on current anxiety disorders and temperament,"ER METHODSeventy-one 3- to 4-year-old children were selected based on demonstrating high levels of inhibition and having a parent with a current anxiety disorder. They were randomly allocated to an eight-session parent intervention or waitlist.RESULTSAt baseline, all of the children met criteria for one or more anxiety disorders. At 6-month follow-up, the intervention group showed a significantly greater reduction in anxiety disorders and less interference from their anxiety than the waitlist. In addition, children in the intervention condition showed greater reductions in parent and laboratory observed measures of behavioral inhibition.CONCLUSIONSThe results suggest that a brief early intervention delivered through parents can reduce current anxiety and associated risk and may have the potential to alter the developmental trajectory of anxiety in a high-risk group of young children.OBJECTIVEThe current study evaluated the efficacy of early intervention for preschool-aged children selected on the basis of risk who also met diagnostic criteria for anxiety disorders.","Kennedy, S J; Rapee, R M; Edwards, S L",2009.0,10.1097/CHI.0b013e31819f6fa9,0,0,
6545,Cognitive behaviour therapy in addition to antispasmodic treatment for irritable bowel syndrome in primary care: randomised controlled trial,"ER DESIGNRandomised controlled trial.SETTING10 general practices in London.PARTICIPANTS149 patients with moderate or severe irritable bowel syndrome resistant to the antispasmodic mebeverine.INTERVENTIONSCognitive behaviour therapy delivered by trained primary care nurses plus 270 mg mebeverine taken thrice daily compared with mebeverine treatment alone.MAIN OUTCOME MEASURESPrimary measures were patients' scores on the irritable bowel syndrome symptom severity scale. Secondary measures were scores on the work and social adjustment scale and the hospital anxiety and depression scale.RESULTSOf 334 referred patients, 72 were randomised to mebeverine plus cognitive behaviour therapy and 77 to mebeverine alone. Cognitive behaviour therapy had considerable initial benefit on symptom severity compared with mebeverine alone, with a mean reduction in score of 68 points (95% confidence interval 103 to 33), with the benefit persisting at three months and six months after therapy (mean reductions 71 points (109 to 32) and 11 points (20 to 3)) but not later. Cognitive behaviour therapy also showed significant benefit on the work and social adjustment scale that was still present 12 months after therapy (mean reduction 2.8 points (5.2 to 0.4)), but had an inconsistent effect on the hospital anxiety and depression scale.CONCLUSIONCognitive behaviour therapy delivered by primary care nurses offered additional benefit over mebeverine alone up to six months, although the effect had waned by 12 months. Such therapy may be useful for certain patients with irritable bowel syndrome in primary care.OBJECTIVETo assess the efficacy of cognitive behaviour therapy delivered in primary care for treating irritable bowel syndrome.","Kennedy, T; Jones, R; Darnley, S; Seed, P; Wessely, S; Chalder, T",2005.0,10.1136/bmj.38545.505764.06,0,0,
6546,Cognitive behavioral therapy for youth with social anxiety: differential short and long-term treatment outcomes,"ER This study examined social anxiety symptoms and/or diagnosis as a predictor of differential short- and long-term cognitive-behavioral treatment (CBT) outcomes. Ninety-one anxiety-disordered youth participated in a randomized clinical trial of CBT. Semi-structured interviews provided dimensional clinical severity ratings (CSRs) for children's principal anxiety disorder at pretreatment, posttreatment, 1-year and 7.4-year follow-up assessments for youth with versus without pretreatment social anxiety. Thirty-nine youth presented with either principal (n=17), secondary (n=11), or tertiary social phobia diagnoses (n=7) or subclinical social anxiety symptoms (n=4). Hierarchal linear modeling (HLM) indicated that youth made similar gains from pretreatment to posttreatment and 1-year follow-up regardless of their social anxiety symptoms or diagnosis; however, youth with social anxiety symptoms or diagnosis were significantly less improved at 7.4-year follow-up. This pattern was distinct from that of youth with the most severe (CSR=4) principal anxiety disorders at pretreatment. Though initially responsive to CBT, children who present with social anxiety diagnoses or symptoms may require an enhanced or extended treatment to maintain their gains into young adulthood whether or not social anxiety is considered their principal childhood difficulty.","Kerns, C M; Read, K L; Klugman, J; Kendall, P C",2013.0,10.1016/j.janxdis.2013.01.009,0,0,
6547,Associations of housing mobility interventions for children in high-poverty neighborhoods with subsequent mental disorders during adolescence,"ER OBJECTIVE: To perform an exploratory analysis of associations between housing mobility interventions for children in high-poverty neighborhoods and subsequent mental disorders during adolescence.DESIGN, SETTING, AND PARTICIPANTS: The Moving to Opportunity Demonstration from 1994 to 1998 randomized 4604 volunteer public housing families with 3689 children in high-poverty neighborhoods into 1 of 2 housing mobility intervention groups (a low-poverty voucher group vs a traditional voucher group) or a control group. The low-poverty voucher group (n=1430) received vouchers to move to low-poverty neighborhoods with enhanced mobility counseling. The traditional voucher group (n=1081) received geographically unrestricted vouchers. Controls (n=1178) received no intervention. Follow-up evaluation was performed 10 to 15 years later (June 2008-April 2010) with participants aged 13 to 19 years (0-8 years at randomization). Response rates were 86.9% to 92.9%.MAIN OUTCOMES AND MEASURES: Presence of mental disorders from the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) within the past 12 months, including major depressive disorder, panic disorder, posttraumatic stress disorder (PTSD), oppositional-defiant disorder, intermittent explosive disorder, and conduct disorder, as assessed post hoc with a validated diagnostic interview.RESULTS: Of the 3689 adolescents randomized, 2872 were interviewed (1407 boys and 1465 girls). Compared with the control group, boys in the low-poverty voucher group had significantly increased rates of major depression (7.1% vs 3.5%; odds ratio (OR), 2.2 [95% CI, 1.2-3.9]), PTSD (6.2% vs 1.9%; OR, 3.4 [95% CI, 1.6-7.4]), and conduct disorder (6.4% vs 2.1%; OR, 3.1 [95% CI, 1.7-5.8]). Boys in the traditional voucher group had increased rates of PTSD compared with the control group (4.9% vs 1.9%, OR, 2.7 [95% CI, 1.2-5.8]). However, compared with the control group, girls in the traditional voucher group had decreased rates of major depression (6.5% vs 10.9%; OR, 0.6 [95% CI, 0.3-0.9]) and conduct disorder (0.3% vs 2.9%; OR, 0.1 [95% CI, 0.0-0.4]).CONCLUSIONS AND RELEVANCE: Interventions to encourage moving out of high-poverty neighborhoods were associated with increased rates of depression, PTSD, and conduct disorder among boys and reduced rates of depression and conduct disorder among girls. Better understanding of interactions among individual, family, and neighborhood risk factors is needed to guide future public housing policy changes.IMPORTANCE: Youth in high-poverty neighborhoods have high rates of emotional problems. Understanding neighborhood influences on mental health is crucial for designing neighborhood-level interventions.","Kessler, R C; Duncan, G J; Gennetian, L A; Katz, L F; Kling, J R; Sampson, N A; Sanbonmatsu, L; Zaslavsky, A M; Ludwig, J",2014.0,10.1001/jama.2014.607,0,0,
6548,Patients with needle phobia? Try stress-reducing medical devices,,"Kettwich, S C; Sibbett, W L; Kettwich, L G; Palmer, C J; Draeger, H T; Bankhurst, A D",2006.0,,0,0,
6549,Computer-assisted cognitive behavioral therapy for child anxiety: results of a randomized clinical trial,"ER METHODChildren (49; 33 males) ages 7-13 (M = 10.1 ± 1.6; 83.7% Caucasian, 14.2% African American, 2% Hispanic) with a principal anxiety disorder were randomly assigned to (a) CCAL, (b) individual CBT (ICBT), or (c) a computer-assisted education, support, and attention (CESA) condition. All therapists were from the community (school or counseling psychologists, clinical psychologist) or were PsyD or PhD trainees with no experience or training in CBT for child anxiety. Independent diagnostic interviews and self-report measures were completed at pre- and posttreatment and 3-month follow-up.RESULTSAt posttreatment, ICBT or CCAL children showed significantly better gains than CESA children; 70%, 81%, and 19%, respectively, no longer met criteria for their principal anxiety diagnosis. Gains were maintained at follow-up, with no significant differences between ICBT and CCAL. Parents and children rated all treatments acceptable, with CCAL and ICBT children rating higher satisfaction than CESA children.CONCLUSIONSFindings support the feasibility, acceptability and beneficial effects of CCAL for anxious youth. Discussion considers the potential of computer-assisted treatments in the dissemination of empirically supported treatments.OBJECTIVEThis study examined the feasibility, acceptability, and effects of Camp Cope-A-Lot (CCAL), a computer-assisted cognitive behavioral therapy (CBT) for anxiety in youth.","Khanna, M S; Kendall, P C",2010.0,10.1037/a0019739,0,0,
6550,Exploring the role of parent training in the treatment of childhood anxiety,"ER Data from a randomized clinical trial comparing the relative efficacy of individual cognitive-behavioral therapy (ICBT), family CBT (FCBT), and a family-based education/support/attention control (FESA) condition were used to examine associations between in-session therapeutic techniques related to parent training (PT) and treatment outcomes. This study explored the extent to which therapists' use of PT techniques, specifically (a) parental anxiety management, (b) transfer of control from therapist to parent to child over child's coping, (c) communication skills training, and (d) contingency management training, contributed to treatment outcome in family-based CBT. Children (N = 53; 31 males; 7.8-13.8 years of age; M = 10.1 years, SD = 2.3; 85% Caucasian, 9% African American, 4% Asian, 2% ""other"" background) with a principal anxiety disorder completed 16 sessions of CBT with their parents. The relative contributions of PT components on treatment outcome were evaluated. As hypothesized, both transfer-of-control and parental anxiety management techniques significantly contributed to improvement on clinician and parent ratings of child global functioning within FCBT. PT did not significantly contribute to improvement on measures of child anxiety. These preliminary findings suggest that when FCBT is conducted for child anxiety, PT (i.e., transfer-of-control and parental anxiety management techniques) may contribute to improvements in the child's global functioning.","Khanna, M S; Kendall, P C",2009.0,10.1037/a0016920,0,0,
6551,Validation of two anxiety scales in a university primary care clinic,"ER Psychometric scales for the assessment of anxiety disorders have not been validated in primary care settings. We undertook a study to validate two brief, self-administered anxiety scales, Sheehan's Patient-Rated Anxiety Scale and Beck's Cognition Checklist, in a university primary care clinic. The two scales were compared with a diagnostic standard, the Structured Clinical Interview for the revised third edition of the Diagnostic and Statistical Manual (SCID). Of 87 randomly selected patients, 25 had an anxiety disorder by the SCID. Anxious patients scored statistically higher on both scales than nonanxious persons on both the Beck and Sheehan scales. Based on receiver operating characteristics curve analysis, we found that these two scales correctly classified 72% to 77% of anxious patients. Of the two scales, the Sheehan scale performed better, with a specificity of 94% and positive predictive value of 75%. Our results suggest that these instruments may be useful in the assessment of the anxiety disorders in medical populations.","Kick, S D; Bell, J A; Norris, J M; Steiner, J F",1994.0,,0,0,
6552,Effects of D-cycloserine on extinction of mesolimbic cue reactivity in alcoholism: a randomized placebo-controlled trial,"ER OBJECTIVESIn this study, we assessed the efficacy of CET treatment supplemented with the partial NMDA-receptor agonist D-cycloserine (DCS) at reducing mesolimbic cue reactivity (CR), craving, and relapse risk in alcoholism.METHODSIn a randomized, placebo-controlled, double-blind study, we recruited 76 recently detoxified abstinent alcohol-dependent patients. Thirty-two (16 DCS, 16 placebo) patients showed cue-induced ventral-striatal activation measured with functional magnetic resonance imaging (fMRI) prior to treatment and were thus included in the efficacy analyses. After inpatient detoxification, patients underwent nine sessions of CET spaced over 3 weeks, receiving either 50 mg DCS or placebo 1 h prior to each CET session. FMRI was conducted before treatment and 3 weeks after treatment onset.RESULTSFollowing treatment with CET plus DCS, cue-induced brain activation in the ventral and dorsal striatum was decreased compared to treatment with CET plus placebo. Elevated posttreatment ventral striatal CR and increased craving (assessed using the Obsessive Compulsive Drinking Scale) were associated with increased relapse risk.CONCLUSIONSDCS was shown to augment the effect of CET for alcohol-dependent subjects. The interaction between craving and ventral-striatal CR on treatment outcome suggests that CET might be especially effective in patients exhibiting both high craving and elevated CR.RATIONALEMesocorticolimbic reactivity to alcohol-associated cues has been shown to be associated with relapse to renewed drinking and to be decreased by cue-exposure-based extinction training (CET). Evidence from preclinical studies suggests that the extinction of conditioned alcohol-seeking behavior might be facilitated by drugs increasing N-methyl-D-aspartate (NMDA) receptor-associated memory consolidation.","Kiefer, F; Kirsch, M; Bach, P; Hoffmann, S; Reinhard, I; Jorde, A; Goltz, C; Spanagel, R; Mann, K; Loeber, S; Vollstädt-Klein, S",2015.0,10.1007/s00213-015-3882-5,0,0,
6553,Some aspects of energy and nutrition in rehabilitation: Assessment by dual-energy X-ray absorptiometry (DEXA),"Background. Dual-energy X-ray absorptiometry (DEXA) measures three main chemical components of the body: fat free mass (FFM), fat (BF) and bone mineral content (BMC), the gold standard for the in vivo study of body composition. Methods. Body composition was determined in 733 healthy independent subjects (M: 155; F: 578), aged 20-95 yrs, grouped according to gender and age (from <40 yrs to >90 yrs). From each gender-decade class, further subgroups of subjects with the same BMI (kg/h2=23.8) were extrapolated in order to compare subjects of the same age and BMI, but of different gender. The reduction in energy requirements, as calculated by the Harris-Benedict equations, in female and elderly subjects was correlated to the metabolically active FFM instead of body weight. Results. In men, the FFM values were always 30% higher than those in the age-matched women, with a loss of 11.6 kg (20-95 yrs) and a total decrement of 23.3%, which was most pronounced over 60 yrs, with a loss per decade of ~5%. Women had 18% to 42% more body fat than men, a finding which may be explained by a caloric excess of ~5 kcal/FFM kg, as compared to men. In women, the FFM values were more stable with aging, with a weight reduction of 4.8 kg (20 - >90 yrs) and a total decrement of 12.8% and -2% over 60 yrs. It is likely that this finding was related to a smaller reduction in the daily physical activity with aging (housework). The authors underline the risk of malnutrition in pathologies of rehabilitative interest (stroke, post-traumatic sequelae), and the importance of monitoring patients' nutritional status so as to optimize functional recovery. Conclusion. Lastly, the longitudinal assessment the body composition in a head-injured patient (M: 84 yrs) is described.",Cannone M.; Megna G.,1997.0,,0,0,
6554,No evidence for opioid-mediated analgesia induced by phobic fear,"The influence of anxiety on acute pain sensation was investigated, studying the relative contribution of endogenous opioids and attentional mechanisms. Thirty-six spider phobics received mildly painful electrical stimulation, while anxiety and focus of attention were manipulated within subjects. The opioid antagonist naloxone or placebo was administered between subjects to examine an analgesia owing to anxiety-induced endorphinergic activity. In contrast to earlier findings, attention towards pain failed to increase pain as opposed to distraction from pain, probably owing to a less effective attention manipulation. Furthermore, despite high levels of anxiety, subjective pain ratings were not influenced by anxiety, although heart rate responses were slightly inhibited. Accordingly, there was no increase in subjective or physiological pain responses as a result of naloxone, nor did beta-endorphin plasma levels rise during anxiety. The results suggest that phobic anxiety does not induce an opioid-mediated analgesia. Curiously, naloxone itself effected a dose-dependent analgesia compared to placebo during both high and low anxiety, which is compatible with the assumption of agonist properties of naloxone in the absence of opioid activity.",Janssen S.A.; Arntz A.,1997.0,10.1016/S0005-7967(97)00046-6,0,0,
6555,"Trait anxiety, negative emotions and the mothers' adaptation to an infant born subsequent to late pregnancy loss: A case-control study","Women with (n = 27) a history of late pregnancy loss (≤ 20 weeks) due to congenital anomalies who had completed the subsequent pregnancy with a live-birth were compared with a group of mothers with newborns without such a history (n = 29) at 4 and 16 weeks post-partum. The following aspects were assessed: depression, anxiety, psychological distress, and mother-infant adaptation. The women with a previous pregnancy loss showed significantly more negative emotions than the women without such a history. In addition, they considered that their healthy baby experienced more problems with sleeping, crying, eating, and acquiring a regular pattern of this behaviour than the average baby. They also perceived their baby as being less ideal than the women without a previous pregnancy loss. These problems were particularly present 4 weeks post-partum and were significantly positively related to trait anxiety. The implications of this study are that in women with a history of late pregnancy loss, family physicians and welfare officers should be made aware of possible problems in the mother and in mother-infant adaptation shortly after a normal live-birth, particularly in those with high trait anxiety. They will then be able to arrange psychological support at an early stage.",Hunfeld J.A.M.; Taselaar-Kloos A.K.G.; Agterberg G.; Wladimiroff J.W.; Passchier J.,1997.0,10.1002/(SICI)1097-0223(199709)17:9<843::AID-PD147>3.0.CO;2-Q,0,0,
6556,Lesopitron Dihydrochloride,,,1997.0,,0,0,
6557,Ritanserin facilitates anxiety in a simulated public-speaking paradigm,"The effects of ritanserin, a 5-HT(2A/2C) (5-hydroxytryptamine) antagonist, have been investigated in simulated public speaking with healthy volunteers. The aim was to investigate the role of 5-HT in subjective experimental anxiety. There were three experimental groups each comprising four or five males and 11 females. Subjects received placebo, ritanserin 2.5 or 10 mg, p.o. They rated themselves using the Spielberger State-Trait Anxiety Inventory and visual analogue scales factored into anxiety, sedation and discontentment scores. Autonomic measures included skin conductance and heart rate. Subjects were told, 75 min after drug or placebo ingestion, without prior warning, to prepare a 4-min speech. Measures were taken before, during and after the speech. Ritanserin prolonged the anxiety induced by the procedure on the subjective ratings but had minimal effect on autonomic responses to the procedure. The result contrasts with an anxiolytic-like effect of ritanserin on aversively conditioned autonomic responses. The present finding is compatible with animal behavioural evidence that 5-HT has distinct and opposing roles in modulating conditioned and unconditioned anxiety.",Guimar√£es F.S.; Mbaya P.S.; Deakin J.F.W.,1997.0,10.1177/026988119701100305,0,0,
6558,Speech disturbances and gaze behavior during public speaking in subtypes of social phobia,"Twenty-four social phobics with public speaking anxiety and 25 nonphobic individuals (controls) gave a speech in front of two people. Subjective anxiety, gaze behavior, and speech disturbunces were assessed. Based on subjects' fear ratings of social situations, phobics and controls were divided into the generalized and nongeneralized subtype. Results showed that generalized phobics reported the most, and nongeneralized controls the least anxiety during public speaking. All subjects had longer and more frequent eye contact when delivering a speech than when talking with an experimenter or sitting in front of an audience. Phobics showed more filled pauses, had longer silent pauses, paused more frequently, and spent more time pausing than controls when giving a speech. Generalized phobics spent more time pausing during their speech than the other subgroups (nongeneralized controls, generalized controls, and nongeneralized phobics). These results suggest that generalized phobics tended to shift attentional resources from speech production to other cognitive tasks.",Hofmann S.G.; Gerlach A.L.; Wender A.; Roth W.T.,1997.0,10.1016/S0887-6185(97)00040-6,0,0,
6559,No evidence for physiological coupling between melatonin and glucocorticoids,"Much has been speculated about the existence of a physiological coupling between melatonin and glucocorticoid secretion and about a possible anti-stress action of melatonin. We examined the relationship between melatonin and glucocorticoid secretion under close-to-physiological conditions, when the plasma concentration of either melatonin or glucocorticoids was elevated acutely or chronically in both rats and humans. Tryptophan administration caused a massive rise of plasma melatonin, but had no effect on corticosterone levels in rats or on cortisol levels in humans. The acute and long-lasting exposure of rats to uncontrollable stress resulted in a significant rise of adrenal corticosterone secretion, but had no effect on circulating melatonin levels. Orchectomy caused an initial increase in circulating corticosterone (when melatonin was unaffected) and a delayed rise in circulating melatonin (when corticosterone levels were normalized). In humans, no correlation was found between the nocturnal urinary excretion of melatonin and cortisol, either among healthy subjects, or among patients suffering from panic disorder (with an increased urinary excretion of cortisol) or among insomnia patients (with a high incidence of low melatonin secretion). Furthermore, no evidence was found for a suppressive action of melatonin on dexamethasone-mediated thymus regression in rats and on dexamethasone-mediated suppression of lymphocyle proliferation in vitro. Taken together, the results of this study provide no evidence for the existence of mutual influences between melatonin and glucocorticoid secretion, nor do they support the proposed attenuation of glucocorticoid-mediated effects on target cells or tissues by melatonin under physiological conditions.",Hajak G.; Rodenbeck A.; Ehrenthal H.-D.; Leonard S.; Wedekind D.; Sengos G.; Zhou D.; Huether G.,1997.0,10.1007/s002130050408,0,0,
6560,Combat veterans with posttraumatic stress disorder exhibit decreased habituation of the P1 midlatency auditory evoked potential,"The current study used a paired stimulus paradigm to investigate the P1 midlatency auditory evoked potential in Vietnam combat veterans with posttraumatic stress disorder (PTSD) and three comparison groups: alcohol dependents, combat-exposed normals, and combat-unexposed normals. Compared to each comparison group, PTSD subjects exhibited significantly diminished habituation of the P1 potential. P1 potential habituation within the PTSD group, correlated significantly with intensity of PTSD reexperiencing symptoms, such as trauma-related nightmares and flashbacks. These findings are discussed as consistent with a sensory gating defect at the brainstem level in PTSD, and are further discussed in the context of other psychophysiological measures in PTSD and of P1 potential findings in psychiatric disorders other than PTSD.",Gillette G.M.; Skinner R.D.; Rasco L.M.; Fielstein E.M.; Davis D.H.; Pawelak J.E.; Freeman T.W.; Karson C.N.; Boop F.A.; Garcia-Rill E.,1997.0,10.1016/S0024-3205(97)00688-7,0,0,
6561,Habituation of cognitive and physiological arousal and social anxiety,"This study examined differences in habituation between high and low socially anxious Ss. Participants gave three impromptu speeches, each separated by a brief rest interval. Skin conductance and heart rate were monitored during the speeches. Following each speech participants completed self-ratings of nervousness, heart rate, and palmar sweat activity as well as a modified Social Interaction Self Statement Test. Low anxious controls showed significant reduction of negative expectations and self-reported nervousness, heart rate, and sweat activity across the three trials. Actual heart rate of low-anxious subjects also decreased significantly across trials. In contrast, high anxious subjects did not evidence significant decreases in any of the above measures of anxiety and stress across the three trials. Skin conductance measures increased across trials for both groups, but increased more for the high anxious group than low-anxious controls. Results indicate that high anxiety participants are slow to decrease cognitive and autonomic responsiveness to stressful social situations.",Eckman P.S.; Shean G.D.,1997.0,10.1016/S0005-7967(97)10005-5,0,0,
6562,Don't worry and beware of white bears: Thought suppression in anxiety patients,"The ability to suppress unwanted thoughts was investigated in patients with Generalized Anxiety Disorder (GAD; n = 29), Speech Phobics (n = 25), and nonanxious controls (n = 28). All participants spent 5 minutes thinking aloud about anything that came to mind while trying not to think of white bears. In another task, they thought aloud for 5 minutes while trying not to think of their main worry. Intrusions of unwanted thoughts were signaled by button presses and recorded on tape. In accordance with the disorder's definition and complaints of the GAD patients, they showed more intrusions of their main worry than of white bears. The opposite was true for other participants. Compared to a baseline measure, all participant groups were unable to reduce duration of main worry thoughts when trying to suppress them.",Becker E.S.; Rinck M.; Roth W.T.; Margraf J.,1998.0,10.1016/S0887-6185(97)00048-0,0,0,
6563,Psychological predictors of CCK4-induced panic-like symptoms,"The present study investigated whether psychosomatic reaction to panicogenic CCK4 administration can be predicted based on basal and pre-administration psychological traits and characteristics. Sixteen healthy volunteers participated in a double-blind, placebo-controlled cross-over experiment in which they were subjected to CCK4 and placebo challenge. One week prior to experimentation, they completed a battery of self-administered psychological inventories, including the trait form of State-Trait Anxiety Inventory (STAI-T), Chambless Anxious Cognitions Inventory (CACI), Beck Depression Inventory (BDI) and the Symptom Checklist 90 (SCL-90). The state form of STAI (STAI-S) was administered before and after the injections of CCK4 (25 μg i.v.) and placebo. Various elements of the panic-like experience (latency and duration of symptoms, number and intensity of symptoms, fear of symptoms, and post-administration state anxiety) were recorded after both injections. The results of multiple regression analyses suggest that basal STAI-S, STAI-T and BDI are very good predictors of the number and intensity of CCK4-induced symptoms, the fear reaction to panic symptoms and post-injection state-anxiety. The SCL-90 scores were retained as the best predictor of placebo-induced panic-like symptoms. We conclude that substantial portions of variability in CCK4 and placebo-induced panic-like reaction can be explained by basal psychological characteristics.",Jerabek I.; Boulenger J.-P.; Lavallée Y.-J.; Jolicoeur F.B.,1998.0,10.1002/(SICI)1099-1077(199801)13:1<35::AID-HUP948>3.0.CO;2-G,0,0,
6564,Cognitive inhibition in phobia,"Objectives. The purpose of this study was to investigate whether cognitive bias for threat in anxious individuals may be attributed to a defective inhibition. Design. It was investigated whether phobics and not non-phobics would show a defective inhibition of threat words as compared to neutral words. Method. Inhibition was measured by a negative priming task, which was administered to spider phobic participants (N = 29) and non-phobic controls (N = 31). Results. The phobics did not show less negative priming of threatening information. Instead, they showed a general delay on all probe displays that were presented after threatening primes. Conclusion. Anxiety is related to defective inhibition of threat, in the sense that this inhibition consumes extra cognitive resources.",Kindt M.; Brosschot J.F.,1998.0,,0,0,
6565,What is the scientific meaning of empirically supported therapy?,"It is important to define precisely what is and is not meant by 'empirically supported treatments,' rigorously based on what is actually known about the nature of experimental therapy research. The criteria for empirically supported treatments merely allow conclusions about whether treatments cause any change beyond the causative effect of such factors as placebo or the passage of time. Applied implications are limited, due to external validity and to the fact that applied decisions are influenced by cost-benefit analyses. Creating increasingly effective therapies through between-group designs is best done by controlled trials specifically aimed at basic questions about the nature of psychological problems and the nature of therapeutic change mechanisms. Naturalistic research is important for external validity but is valuable only if it uses scientifically valid methods to address basic knowledge questions.",Borkovec T.D.; Castonguay L.G.,1998.0,10.1037/0022-006X.66.1.136,0,0,
6566,Effects of tryptophan depletion on anxiety and on panic provoked by carbon dioxide challenge,"Results of several studies suggest that anxiety is under serotonergic control. We studied the influence of tryptophan depletion on generalized anxiety and on the response to a 35% carbon dioxide (CO2) challenge. Fifteen healthy male volunteers received both a mixture of amine acids without tryptophan and a placebo mixture under double-blind conditions. The tryptophan-free mixture led to an 80% decrease in blood tryptophan levels compared to the placebo. There was a significant increase in anxiety on the Spielberger Anxiety Inventory and a trend towards more tension on the Profile of Mood States-'tension' items, both of which were interpreted as increased nervousness. Furthermore, a significant increase in neurovegetative panic symptoms occurred after the CO2 challenge. We conclude that the serotonergic system is causally involved in anxiety-related mechanisms and that it may be worth pursuing the role of tryptophan depletion on CO2-induced panic in patients with anxiety disorders.",Klaassen T.; Klumperbeek J.; Deutz N.E.P.; Van Praag H.M.; Griez E.,1998.0,10.1016/S0165-1781(98)00004-3,0,0,
6567,Effects of cholecystokinin tetrapeptide on respiratory function in healthy volunteers,Objective: The authors evaluated respiratory response to cholecystokinin tetrapeptide (CCK-4) in healthy volunteers. Method: Subjects were randomly assigned to either a CCK-4 (N=15) or placebo (N=15) challenge under double- blind conditions. Results: Dyspnea was reported by all of the subjects who received CCK-4 but only one subject who received placebo. CCK-4 caused a significant increase in tidal volume and minute ventilation but had no effect on breathing frequency. Placebo had no effect on any of the respiratory measures. Conclusions: These data indicate that the behavioral effects of CCK-4 are accompanied by changes in respiration in healthy volunteers.,Bradwejn J.; LeGrand J.-M.; Koszycki D.; Bates J.H.T.; Bourin M.,1998.0,,0,0,
6568,Anxiety and autonomic flexibility: A cardiovascular approach,"Autonomic characteristics of panickers, blood phobics, and nonanxious controls were compared with a variety of cardiovascular measures, including spectral analysis of the cardiac inter-beat interval time series (derived from the electrocardiogram). Responses to laboratory stressors (shock avoidance and cold face stress) of 16 participants who reported recent occurrences of frequent severe panic attacks, 15 participants who reported strong somatic reactions and fainting to the sight of blood, and 15 controls, were recorded. Results suggested distinct autonomic patterns among the three groups. Across conditions, panickers displayed the highest heart rates (HR) coupled with the least HR variability, which indicates low levels of cardiac vagal tone. Blood phobics showed more vagally mediated HR variability than panickers, with a significant association between cardiac rate and mean arterial pressure. Controls generally showed the most HR variability and 'spectral reserve' (a quality that indicates flexible responsivity). Results are discussed in the context of traditional models of anxiety and autonomic activity in contrast to contemporary notions of stability and change in biological systems.",Friedman B.H.; Thayer J.F.,1998.0,10.1016/S0301-0511(97)00027-6,0,0,
6569,Modelling ordinal responses from co-twin control studies,"The co-twin control design has been widely used in studying the effects of environmental factors on the development of diseases. For binary outcomes that arise from co-twin control studies, the conditional likelihood method is commonly used. This approach, however, does not readily extend to ordinal response data because the standard conditional likelihood does not exist for cumulative legit or proportional odds models. In this paper, we investigate the applicability of the random-effects and GEE approaches in analysing ordinal response data from co-twin control studies. Using both approaches, we re-analyse data from a co-twin control study of the impact of military services during the Vietnam era on post-traumatic stress disorders (PTSD). The ordinal models have considerably increased power in detecting the effects of exposure when compared to the analyses using a dichotomized response. We discuss the interpretation of the estimates from GEE and random-effects models in the context of the twin data.",Hu F.B.; Goldberg J.; Hedeker D.; Henderson W.G.,1998.0,10.1002/(SICI)1097-0258(19980515)17:9<957::AID-SIM791>3.0.CO;2-O,0,0,
6570,Thought suppression produces a rebound effect with analogue post-traumatic intrusions,"Attempts to suppress traumatic material may be involved in the development and maintenance of post-traumatic stress disorder (PTSD). In order to investigate this possibility, analogue post-traumatic intrusions were induced in normal participants by means of a distressing film. For comparison, a second film was used to induce intrusions about polar bears. It was hypothesized that the suppression of these intrusions would produce an immediate decrease but a delayed increase ('rebound effect') in their frequency. It was also predicted that the rebound effect would be larger for the analogue traumatic intrusions. Each film was followed by two consecutive time periods during which participants' thoughts were recorded. During the first period, the suppression group was instructed to suppress thoughts about the film whilst the control group merely recorded their thoughts. During the second period, both groups merely recorded their thoughts. The results supported the immediate decrease hypothesis for both types of intrusion. As predicted, there was a rebound effect for analogue traumatic intrusions although not for polar bear thoughts. Several methodological issues relating to the findings are highlighted. The possible implications of a rebound effect with trauma-relevant intrusions are discussed with reference to PTSD.",Davies M.I.; Clark D.M.,1998.0,10.1016/S0005-7967(98)00051-5,0,0,
6571,Brain correlates of an unexpected panic attack: A human positron emission tomographic study,"Previous brain imaging studies on symptom provocation in panic anxiety have used either drug-infusions or sensory related stimulation to induce panic attacks. We here report positron emission tomographic measurements of regional cerebral blood flow (rCBF) during an unexpected panic attack in a healthy female volunteer participating in a fear conditioning study. During a first but not a second run with electric shock presentations the woman unexpectedly experienced a panic attack that fulfilled the DSM-IV criteria. Panic was associated with decreased rCBF in the right orbitofrontal (Brodmann area 11), prelimbic (area 25), anterior cingulate (area 32) and anterior temporal cortices (area 15). These findings suggest that neural activity in brain regions previously associated with symptom provocation in specific phobics and subjects with posttraumatic stress disorder also are involved during panic in healthy individuals.",Fischer H.; Andersson J.L.R.; Furmark T.; Fredrikson M.,1998.0,10.1016/S0304-3940(98)00503-5,0,0,
6572,"Self-reported sleep quality, job stress, and daytime autonomic activities assessed in terms of short-term heart rate variability among male white-collar workers","To investigate the relationships among the amount of job stressors, self-reported sleep quality, and daytime autonomic activities, a questionnaire survey was conducted for 223 healthy male white-collar workers, and their short-term heart rate variability (HRV) was also examined. Half of the subjects complained of nightly poor sleep quality. Self-reported poor sleep quality was associated with a qualitative aspect of job stressors characterized by high amounts of 'job difficulty', less amounts of 'achievement in job', and less amounts of 'support by colleagues', and also with high amounts of personal distress and difficulty in changing their mood. Those who complained of poor sleep quality exhibited sympathetic predominance and reduced heartbeat intervals at standing rest, although job stressors was not correlated to HRV. These results suggest that their job stress disrupts nightly sleep, and also that their insufficient sleep at night causes daytime sympathetic Predominance. However, the amount of job stressors was not directly associated with HRV. Further studies should focus on the relationships among chronic job stress, the satisfaction of sleep demands, and the daily and long-term variation in cardiac autonomic activities.",Kageyama T.; Nishikido N.; Kobayashi T.; Kurokawa Y.; Kaneko T.; Kabuto M.,1998.0,,0,0,
6573,The role of the β-noradrenergic system in cholecystokinin- tetrapeptide-induced panic symptoms,"Background: The authors determined whether effective β- adrenergic blockade could attenuate the panicogenic effects of cholecystokinin-tetrapeptide (CCK-4) in healthy volunteers. Methods: Subjects were randomly assigned to either a propranolol (n = 14) or placebo (n = 16) infusion. Ten minutes after completion of the infusion subjects received a bolus injection of CCK-4 (50 μg). Results: Acute pretreatment with propranolol was more effective than placebo in decreasing behavioral and cardiovascular sensitivity to CCK-4. Conclusions: These preliminary results suggest that the panicogenic effects of CCK-4 are mediated, in part, through the β-adrenergic system.",Le Mellédo J.-M.; Bradwejn J.; Koszycki D.; Bichet D.G.; Bellavance F.,1998.0,10.1016/S0006-3223(97)00536-2,0,0,
6574,Functional anatomy of calorie fear in anorexia nervosa,,Ellison Z.R.; Foong J.; Howard R.; Bullmore E.; Williams S.; Treasure J.,1998.0,,0,0,
6575,Low serum dopamine-β-hydroxylase activity in patients with panic disorder,Decreased serum dopamine-β-hydroxylase activity in a group of patients with panic disorder was found as compared with the groups of patients with generalised anxiety disorder and healthy controls.,Landowski J.; Lysiak-Szydlowska W.,1998.0,,0,0,
6576,"Gender influences on performance, mood and recovery sleep in fatigued aviators","Female aviators now are able to serve in combat roles, but few studies have addressed potential differences between the ability of males and females to withstand combat stressors. This study examined responses of men and women to one operational stressor, sleep deprivation. Pilots were tested on flight performance and mood during 40-h periods of sustained wakefulness. Baseline and recovery sleep also were examined. Gender produced no operationally-significant effects on flight performance or recovery sleep. Although mood tests showed that women felt less tense and more energetic than men, there were no interactions between sleep deprivation and gender on either flight performance or psychological mood.",Caldwell Jr. J.A.; LeDuc P.A.,1998.0,,0,0,
6577,Serotonergic and noradrenergic markers of post-traumatic stress disorder with and without major depression,"Some studies have suggested that disorders in the peripheral and central metabolism of serotonin (5-HT) and noradrenaline (NE) may play roles in the pathophysiology of post-traumatic stress disorder (PTSD). This study examines (1) the availability of plasma total tryptophan, the precursor of 5-HT, and tyrosine, the precursor of NE; and (2) the platelet 5-HT transporter and α2-adrenoceptor (α2-AR) binding sites in patients with PTSD and healthy volunteers. High-performance liquid chromatography (HPLC) was employed to measure plasma tryptophan and tyrosine as well as amino acids known to compete with the same cerebral transport system; that is, valine, leucine, phenylalanine, and isoleucine. The maximum number of binding sites (B(max)) and their affinity (Kd) for binding to [3H]-paroxetine and [3H]-rauwolscine, a selective α2-AR antagonist, were determined. [3H]-paroxetine and [3H]-rauwolscine binding Kd values were significantly higher in patients with PTSD than in healthy volunteers. [3H]-rauwolscine binding Kd values were significantly higher in patients with PTSD and concurrent major depression (MD) than in PTSD patients without MD and healthy volunteers. Plasma tyrosine concentrations and the ratio of tyrosine/valine + leucine + isoleucine + phenylalanine + tryptophan were significantly higher in PTSD patients with MD than in those without MD and healthy volunteers. The results show that PTSD is accompanied by lower affinity of paroxetine binding sites and that PTSD with concurrent MD is accompanied by lower affinity of α2-ARs and increased plasma tyrosine availability to the brain. The results suggest that (1) serotonergic mechanisms, such as defects in the 5-HT transporter system, may play a role in the pathophysiology of PTSD; and (2) that catecholaminergic mechanisms, such as increased precursor availability and lowered affinity of α2-ARs, may play a role in the pathophysiology of PTSD with concurrent MD. Copyright (C) 1999 American College of Neuropsychopharmacology.",Maes M.; Lin A.-H.; Verkerk R.; Delmeire L.; Van Gastel A.; Van der Planken M.; Scharpé S.,1999.0,10.1016/S0893-133X(98)00058-X,0,0,
6578,The absence of relation between anxiety sensitivity and fear conditioning using 20% versus 13% CO2-enriched air as unconditioned stimuli,"Anxiety sensitivity has been implicated as a risk factor in the development and maintenance of anxiety and fear-related disorders. Indeed, persons who score high on the anxiety sensitivity index (ASI) are generally more responsive to biological challenge procedures such as CO2-inhalation that directly evoke the feared bodily events. One would expect, therefore, that persons high on anxiety sensitivity should be more conditionable and hence more likely to acquire fears, than persons low on anxiety sensitivity when CO2-enriched air is used as an unconditioned stimulus (UCS). Undergraduates (N=96), scoring high, medium and low on the ASI received 8 repeated 20-s inhalations of either 20 or 13% CO2-enriched air (UCSs) paired with one of three CSs differing in fear-relevance (snake, heart and flowers). Several autonomic and self-report measures were assessed. Contrary to expectation, electrodermal and cardiac conditioned responses failed to discriminate between ASI groups. Yet, SUDS and severity and frequency of DSM-IV panic symptoms varied reliably as a function of anxiety sensitivity. Overall, the findings suggest that anxiety sensitivity is related to subjective fear-related complaints, but not autonomic responding and conditionability. We discuss clinical and theoretical implications for understanding the place of anxiety sensitivity in fear onset. Copyright (C) 1998 Elsevier Science Ltd.",Forsyth J.P.; Palav A.; Duff K.,1999.0,10.1016/S0005-7967(98)00113-2,0,0,
6579,"Adrenergic receptor function in panic disorder. I. Platelet α2 receptors G(i) protein coupling, Effects of imipramine, and relationship to treatment outcome","Various studies suggest α2-adrenergic receptor (α2AR) dysregulation in panic disorder (PD). Platelet α2-AR exist in high- and low-conformational states as a function of their coupling to G(i) protein. α2AR coupling is important in signal transduction and is modulated by antidepressants. α2AR density in the high- and low-conformational states, agonist affinity, and coupling efficiency were investigated in 21 healthy controls, 21 drug-free PD patients, and eight imipramine-treated patients using norepinephrine displacement of 3H-yohimbine binding. Percentage of receptors in the high-conformational state (%R(H)) and the ratio of the agonist dissociation constant to the receptor in the low-/high-conformational state (K(L)/K(H)), calculated from displacement experiments, were used as coupling indices. Patients had high α2AR density in both conformational states. %R(H) and K(L)/K(H) ratio were significantly different, particularly in patients with Hamilton scale for depression (HAMD) scores ≥15. Imipramine treatment (29 weeks) had no effect on α2AR density or coupling, despite improvement in anxiety ratings. High pretreatment α2AR density and coupling predicted low severity of anxiety after treatment. Increased α2AR density and abnormal coupling may represent an adaptive mechanism or trait marker in PD. Copyright (C) 1999 American College of Neuropsychopharmacology.",Gurguis G.N.M.; Antai-Otong D.; Vo S.P.; Blakeley J.E.; Orsulak P.J.; Petty F.; Rush A.J.,1999.0,10.1016/S0893-133X(98)00062-1,0,0,
6580,Acute and chronic role of 5-HT3 neuronal system on behavioral and neuroendocrine changes induced by intravenous cholecystokinin tetrapeptide administration in humans,"The influence of single and multiple oral doses of ondansetron, a selective 5-HT3 receptor antagonist, was evaluated against placebo on cholecystokinin tetrapeptide (CCK-4)-induced behavioral and neuroendocrine changes in humans. As compared to placebo, subjects receiving acute ondansetron treatment showed a significant decrease in the sum intensity of CCK-4-induced-panic symptoms (iPSS). Pre-CCK-4 neuropeptide Y (NPY) plasma levels were significantly higher and maximal changes in cortisol, growth hormone, and prolactin secretion from baseline (Δ(max)) were significantly lower in the ondansetron group. After ondansetron and placebo chronic administration, there were no statistical differences in the iPSS between groups. Pre-CCK-4 NPY plasma levels were significantly higher; whereas, Δ(max) for NPY significantly lower in the ondansetron group as compared to placebo. These results suggest a role for the 5-HT3 receptor in the neurobiology of panic disorder through a possible interaction with CCK and NPY systems. Ondansetron chronic effect on CCK-4-induced behavioral changes needs further exploration. Copyright (C) 1999 American College of Neuropsychopharmacology.",Dépôt M.; Caillé G.; Mukherjee J.; Katzman M.A.; Cadieux A.; Bradwejn J.,1999.0,10.1016/S0893-133X(98)00074-8,0,0,
6581,Self-esteem differences as a function of race and weight preoccupation: Findings and implications,,Jones S.L.; Moulton M.A.; Moulton P.; Roach S.,1999.0,10.1016/S1049-3867(98)00025-5,0,0,
6582,Plasma anti-serotonin and serotonin anti-idiotypic antibodies are elevated in panic disorder,"The psychoneuroimmunology of panic disorder is relatively unexplored. Alterations within brain stress systems that secondarily influence the immune system have been documented. A recent report indicated elevations of serotonin (5-HT) and ganglioside antibodies in patients with primary fibromyalgia, a condition with documented associations with panic disorder. In line with our interest in dysregulated 5-HT systems in panic disorder (PD), we wished to assess if antibodies directed at the 5-HT system were elevated in patients with PD in comparison to healthy volunteers. Sixty-three patients with panic disorder and 26 healthy volunteers were diagnosed by the SCID. Employing ELISA, we measured anti-5-HT and 5-HT anti-idiotypic antibodies (which are directed at 5-HT receptors). To include all subjects in one experiment, three different batches were run during the ELISA. Plasma serotonin anti-idiotypic antibodies: there was a signficiant group effect [patients > controls (p = .007)] and batch effect but no interaction. The mean effect size for the three batches was .76. Following Z-score transformation of each separate batch and then combining all scores, patients demonstrated significantly elevated levels of plasma serotonin anti-idiotypic antibodies. Neither sex nor age as covariates affected the significance of the results. There was a strong correlation between anti-serotonin antibody and serotonin anti-idiotypic antibody measures. Plasma anti-serotonin antibodies: there was a signficiant diagnosis effect [patients > controls (p = .037)]. Mean effect size for the three batches was .52. Upon Z-score transformation, there was a diagnosis effect with antibody elevations in patients. Covaried for sex and age, the result falls below significance to trend levels. The data raise the possibility that psycho-immune dysfunction, specifically related to the 5-HT system, may be present in PD. Potential interruption of 5-HT neurotransmission through autoimmune mechanisms may be of pathophysiologic significance in certain patients with panic disorder. It remains to be demonstrated if the peripheral autoimmunity is representative of CNS 5-HT neuronal alterations. Replication appears warranted. Copyright (C) 1999 American College of Neuropsychopharmacology.",M.d. J.D.C.; Tamir H.; Calaprice D.; Dejesus M.; De La Nuez M.; Pine D.; Papp L.A.; Klein D.F.; Gorman J.M.,1999.0,10.1016/S0893-133X(98)00130-4,0,0,
6583,Manipulating self-efficacy in the exercise environment in women: Influences on affective responses,"Self-efficacy was experimentally manipulated in an exercise context, and its effect on affective responses was examined. College women (N = 46) were randomly assigned to a high- or low-efficacy condition, and efficacy expectations were manipulated by means of bogus feedback and graphs depicting contrived normative data. The manipulation successfully influenced affective responses, with participants in the high-efficacy group reporting more positive and less negative affect than did the low-efficacy group. Efficacy was significantly related to feeling-state responses during and after activity but only in the high-efficacy condition. The results suggest that self-efficacy can be manipulated and that these changes are related to the affective experience associated with exercise. Such findings may have important implications for the roles played by self-efficacy and affect in exercise adherence.",McAuley E.; Talbot H.-M.; Martinez S.,1999.0,10.1037/0278-6133.18.3.288,0,0,
6584,Physiological hyperarousal: Construct validity of a central aspect of the tripartite model of depression and anxiety,"Physiological hyperarousal (PH) is an understudied component of the tripartite model of depression and anxiety. This study contributes to the literature on PH, the tripartite model, and anxiety and its disorders, using data from psychotherapy outpatients (n = 2,448), air force cadets (n = 1,335), and undergraduates (n = 284). Psychometrics and exploratory and confirmatory factor analyses showed that PH is a reliable, cohesive, discriminable, and valid construct. Compared with subjective anxiety, PH was more associated to panic versus mood disordered status, and to panic versus generalized anxiety disordered status. As hypothesized, an aspect of anxiety sensitivity (i.e., fear of body sensations) was particularly related to subjective anxiety in the presence of PH. Results support the PH construct as replicable, valid, and clinically important and support the utility of the tripartite and related models for understanding the relation of depressive and anxious syndromes.",Joiner Jr. T.E.; Beck A.T.; Rudd M.D.; Steer R.A.; Schmidt N.B.; Catanzaro S.J.,1999.0,10.1037/0021-843X.108.2.290,0,0,
6585,Contrast-enhanced MR angiography of the supra-aortic vessels in 24 seconds: A feasibility study,"A contrast-enhanced, gradient-echo 3D pulse sequence providing angiographic information in 24 s was tested in five healthy subjects and used prospectively in 21 patients for the investigation of the cervical arteries. Indications included suspected stenosis of the carotid (in 13), or vertebral arteries (in 1), carotid dissection (3), variants of the branches of the aortic arch (2) and extracranial carotid aneurysms (2). The results in all patients were compared with those of intra-arterial digital subtraction angiography (DSA). In patients with carotid stenosis, they were also compared with high-resolution 3D time-of-flight (TOF) MR angiography (MRA). Good quality MR angiograms of the neck vessels were obtained with the fast 3D sequence in 20 of the 21 patients. One claustrophobic patient was unable to cooperate. The degree of internal carotid artery (ICA) stenosis was graded correctly (compared to DSA) in 21 of 24 cases (87.5%). Two mild stenoses were overestimated as moderate using the fast MR sequence and one high-grade stenosis was misdiagnosed as a complete occlusion. Carotid dissection was confirmed in one case and correctly excluded in two. Four extracranial ICA aneurysms in two patients, arterial variants and stenosis of the origin of the vertebral artery were correctly diagnosed using the contrast-enhanced MR angiogram. Three-dimensional TOF MRA was unsuccessful due to motion artefacts in half of the cases of ICA stenosis.",Kollias S.S.; Binkert C.A.; Ruesch S.; Valavanis A.,1999.0,10.1007/s002340050772,0,0,
6586,"Consequences of anxiety in older persons: Its effect on disability, well-being and use of health services","Background. Although anxiety is quite prevalent in late life, its impact on disability, well-being, and health care utilization of older persons has not been studied. Older persons are a highly relevant age group for studying the consequences of anxiety, since their increasing numbers put an extra strain on already limited health care resources. Methods. Data of a large community-based random probability sample (N = 659) of older subjects (55-85 year) in the Netherlands were used to select three groups: subjects with a diagnosed anxiety disorder, subjects with merely anxiety symptoms and a reference group without anxiety. These groups were compared with regard to their functioning, subjective well-being, and use of health care services, while controlling for potentially confounding variables. Results. Anxiety was associated with increased disability and diminished well-being. Older persons with a diagnosed anxiety disorder were equally affected in their functioning as those with merely anxiety symptoms. Although use of health services was increased in anxiety sufferers, their use of appropriate care was generally low. Conclusions. Anxiety has a clear negative impact on the functioning and well-being of older subjects. The similarity of participants with an anxiety disorder and those having merely anxiety symptoms regarding quality of life variables and health care use was quite striking. Finally, in spite of its grave consequences for the quality of life, appropriate care for anxiety is seldom received. Efforts to improve recognition, disseminate effective treatments in primary care, and referring to specialized care may have positive effects on the management of anxiety in late life.",De Beurs E.; Beekman A.T.F.; Van Balkom A.J.L.M.; Deeg D.J.H.; Van Dyck R.; Van Tilburg W.,1999.0,10.1017/S0033291799008351,0,0,
6587,The harvard group scale of hypnotic susceptibility and related instruments: Individual and group administrations,"The Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A); Tellegen's Absorption Scale (TAS); Dissociative Experiences Scale (DES); and Phenomenology of Consciousness Inventory (PCI) were administered either individually or in groups. Eighty students from undergraduate Introduction to Psychology classes were randomly assigned to 1 of the 2 administration conditions with 40 students each. Although there was a general trend of differential item difficulty levels across the 2 administration conditions, a variety of results (descriptive characteristics, reliability, and validity) point to the similarity of behavioral and subjective responses to hypnosis in the 2 conditions. The TAS, DES, and PCI also produced similar results across both conditions of administration.",Angelini F.J.; Kumar V.K.; Chandler L.,1999.0,,0,0,
6588,Cognitive-behavioral stress management buffers decreases in dehydroepiandrosterone sulfate (DHEA-S) and increases in the cortisol/DHEA-S ratio and reduces mood disturbance and perceived stress among HIV- seropositive men,"This study examined the effects of a 10-week cognitive-behavioral stress management (CBSM) intervention on dehydroepiandrosterone sulfate (DHEA-S) levels and the ratio of cortisol to DHEA-S (cortisol/DHEA-S), potential surrogate adrenal markers of HIV disease progression, in relation to alterations in mood and distress. HIV-seropositive men were randomized to either a group-based CBSM intervention (n = 43) or to a wait-list control group (n= 24), with both hormonal and distress measures assessed just prior to and immediately following the 10-week period. Results showed that CBSM buffers decreases in DHEA-S and increases in the cortisol/DHEA-S ratio. Further examination also revealed that changes in the cortisol/DHEA-S ratio were significantly and positively related to changes in total mood disturbance and perceived stress over time. These findings demonstrate that a short-term CBSM intervention can buffer against decrements in DHEA-S and increments in the cortisol/DHEA-S ratio among symptomatic, HIV-positive men, and that alterations in the cortisol/DHEA-S ratio move in concert with changes in mood and distress observed during CBSM.",Cruess D.G.; Antoni M.H.; Kumar M.; Ironson G.; McCabe P.; Fernandez J.B.; Fletcher M.; Schneiderman N.,1999.0,10.1016/S0306-4530(99)00010-4,0,0,
6589,The video-recorded Stroop Color-Word Test as a new model of experimentally-induced anxiety,"The use of the Stroop Color-Word Test as a model of experimentally induced anxiety was evaluated. First, the authors examined the influence of trait anxiety and the type of instructions on the anxiety state level. Subjects with high trait anxiety (above 50 on State-Trait Anxiety Scale STAI) showed a significant increase in anxiety state only with limited time (2 minutes) and error signal (with a ringing bell) procedures. This increase was blocked by diazepam (DZP) 5.0 mg p.o. both on pre- and post-test measures, but it was not changed by placebo administration. The public performance simulation (with a video-camera) was effective to raise the anxiety state on normal volunteers with mean trait anxiety (between 30 and 50 on STAI). This raise was prevented with diazepam 5.0 mg p.o. but it was not prevented with placebo administration. As a whole, these data suggest that the Video- recorded Stroop Color-Word Test is an effective anxiety provoking test, able to detect the effect of standard anxiolytic drug and stressed the importance of trait anxiety level and the instructions on tests that induced anxiety experimentally.",Leite J.R.; Seabra M.D.L.V.; Sartori V.A.; Andreatini R.,1999.0,10.1016/S0278-5846(99)00042-1,0,0,
6590,Prevalence of dysthymic disorder in primary care,"Background: Dysthymic disorder is characterised as a chronic state of depressed mood which is not otherwise attributable to physical, psychological or social events. While it can occur alone, there is increasing evidence that the majority of individuals who meet criteria for dysthymic disorder also experience more severe episodic mood disorders throughout their lifetime, and there is also an aggregation of mood disorders within their family members. Patients with dysthymic disorder are most often seen in primary care. Some researchers suggest that the majority of these individuals are never diagnosed or are not diagnosed until a more severe episodic mood disorder develops. The objective of this study was to determine the 12-month prevalence of Axis I psychiatric disorders, and in particular dysthymic disorder, in a primary care Health Service Organization in Ontario, Canada. Methods: Eligible and consenting adults registered with a primary care Health Service Organization were screened using the modified form of the University of Michigan Composite International Diagnostic Interview. Results: Of the 6280 eligible subjects, 4327 (69%) consented to screening. Two hundred and twenty-two (5.1%) subjects screened positive for dysthymic disorder. In addition, 90% of those who screened positive for dysthymic disorder also screened positive for other Axis I disorders including major depressive disorder, panic, simple phobia, and generalized anxiety disorder. Conclusions: There is much potential for the primary care physician to play a pivotal role in the recognition and treatment of dysthymic disorder and associated Axis I disorders. A focus on the family as a unit for care may be especially important given the reported aggregation of dysthymic disorder within families. Copyright (C) 1999 Elsevier Science B.V.",Browne G.; Steiner M.; Roberts J.; Gafni A.; Byrne C.; Bell B.; Mills M.; Chalklin L.; Wallik D.; Kraemer J.; Dunn E.,1999.0,10.1016/S0165-0327(98)00189-X,0,0,
6591,Factors mediating the effects of a depression intervention on functional disability in older African Americans,"ER Objectives To determine factors mediating the effects of a depression intervention for older African Americans on functional disability and, secondarily, whether functional improvements mediate intervention effects on depressive symptoms. Design Structural equation modeling to examine mediators in a secondary analysis of a randomized trial with 4-month follow-up. Setting Philadelphia region. Participants Community-dwelling African Americans (>55) with depressive symptoms living in an urban area (N = 208). Intervention Up to 10 one-hour sessions over 4 months conducted by licensed social workers who provided care management, referrals and linkages, stress reduction techniques, depression knowledge and symptom recognition, and behavioral activation techniques. Measurements Main outcome was self-reported functional difficulty level for 18 basic activities. Mediators included depression severity (Patient Health Questionnaire), depression knowledge and symptom recognition, behavioral activation, and anxiety. Results At 4 months, the intervention had positive effects on functional difficulty and all mediators (P <.001). Separate structural equation models indicated that two factors (reduced depressive symptoms (23.5% mediated) and improved depression knowledge and symptom recognition (52.9% mediated)) significantly mediated the intervention's effect on functional disability. Enhancing behavioral activation and decreasing anxiety were not found to mediate improvements in functional disability. The two significant mediators jointly explained 62.5% of the intervention's total effect on functional disability. Functional improvement was not found to mediate the intervention's effect on depressive symptoms. Conclusion This multicomponent depression intervention for African Americans has an effect on functional disability that is driven primarily by enhancing symptom recognition and decreasing depressive symptoms. Reduction of functional difficulties did not account for improvements in depressive symptoms. Nonpharmacological treatments for depressive symptoms that enhance symptom recognition in older African Americans can also reduce their functional difficulties with daily living activities.","Gitlin, L N; Szanton, S L; Huang, J; Roth, D L",2014.0,10.1111/jgs.13156,0,0,
6592,The effect of glucose on hippocampal-dependent contextual fear conditioning,"ER BACKGROUND: The metabolic challenge of trauma disrupts hippocampal functioning, which is necessary for processing the complex co-occurring elements comprising the traumatic context. Poor contextual memory of trauma may subsequently contribute to intrusive memories and overgeneralization of fear. Glucose consumption following trauma may be a means to protect hippocampal functioning and contextual fear learning. This study experimentally examined the effect of glucose on hippocampal-dependent contextual learning versus cued fear learning in humans.METHODS: Forty-two male participants underwent cued conditioning with an unconditional stimulus (US) (shock) paired with a discrete conditional stimulus (geometric shape) and context conditioning (requiring hippocampal processing) with a US unpredictably paired with a background context (picture of room). Participants were then blindly randomized to consume either a 25 g glucose or sweet-tasting placebo drink and returned for a test phase 24 hours later. Measures included acoustic startle response, US expectancy, blood glucose levels, and arousal ratings.RESULTS: The glucose group showed superior retention of hippocampal-dependent contextual learning at test relative to the placebo group, as demonstrated by acoustic startle response and US expectancy ratings. Glucose and placebo groups did not differ on any measure of cued fear learning at test.CONCLUSIONS: This study provides experimental evidence that in mildly stressed humans postconditioning glucose consumption improves retention of hippocampal-dependent contextual learning but not cued learning. Ultimately, glucose consumption following trauma may be a means of improving learning about the traumatic context, thereby preventing subsequent development of symptoms of posttraumatic stress.","Glenn, D E; Minor, T R; Vervliet, B; Craske, M G",2014.0,10.1016/j.biopsych.2013.09.022,0,0,
6593,Seizure prevention using carbamazepine following severe brain injuries,"ER In this article the efficacy of carbamazepine for seizure prophylaxis in severe head injuries is tested. In addition, conditions with high risk of seizures requiring prophylactic regimen, were defined. One hundred and thirty-nine patients above 15 years of age with severe head injuries were included in the study. They were randomly divided into two groups--carbamazepine versus placebo. Prophylaxis was started immediately after the accident and was continued for one and a half to two years. Carbamazepine dosage was adjusted individually to provide serum levels within therapeutic range. In case of a seizure all the necessary clinical management was initiated. Patients on carbamazepine showed a lower probability of post-traumatic seizures than those on placebo (p less than 0.05). This difference was statistically significant with regard to early seizures within the first week and with regard to the follow-up time in total, but not regarding late seizures per se. Brain lesions with a high risk of post-traumatic seizures were situated in the parietal and temporal areas and included acute subdural haematomas in all locations, temporal lobe contusions, parietal epidural haematomas accompanied by other lesions and the deep stages of coma. Brain stem contusions were accompanied by a rather low probability of seizures. The above mentioned types and locations of brain lesions with the exception of brain stem contusions justify antiepileptic prophylaxis. The regimen consists of oral carbamazepine 100 mg three times daily by gastric tube during the first two days increasing to about 200 mg three times daily on the third day corresponding to the serum level. If oral medication is not possible within the initial twelve hours, phenytoin in a dose of 750 mg Phenhydan-Infusion Konzentrate is given on the first day, followed by an intravenous dose of 250-500 mg on the second day or until oral carbamazepine administration is tolerated. Treatment should be continued for one year.","Glötzner, F L; Haubitz, I; Miltner, F; Kapp, G; Pflughaupt, K W",1983.0,10.1055/s-2008-1053615,0,0,
6594,"Efficacy of phenazone in the treatment of acute migraine attacks: a double-blind, placebo-controlled, randomized study","ER In this study we compared the efficacy of 1000 mg phenazone with that of placebo in the treatment of acute migraine attacks in a randomized double-blind, placebo-controlled study of 208 patients. The main target criterion was the number of patients with a pain reduction from severe or moderate to slight or no pain 2 h after taking the pain medication. The percentage of patients satisfying the main target criterion was 48.6% for phenazone and 27.2% (P < 0.05) for placebo. Freedom from pain after 2 h was reported by 27.6% with phenazone treatment and 13.6% (P < 0.05) with placebo. Compared with placebo, the phenazone treatment also resulted in a significant improvement in the associated migraine symptoms of nausea, phonophobia and photophobia. Of patients treated with phenazone 11.4%, and 5.8% of those treated with placebo reported adverse events. There was no significant difference between the groups with regard to numbers of patients with adverse events. No serious adverse events occurred. The results show that phenazone at a dosage of 1000 mg is effective and well tolerated in the treatment of acute migraine attacks.","Göbel, H; Heinze, A; Niederberger, U; Witt, T; Zumbroich, V",2004.0,10.1111/j.1468-2982.2004.00764.x,0,0,
6595,Stress pulls us apart: anxiety leads to differences in competitive confidence under stress,"ER Social competition is a fundamental mechanism of evolution and plays a central role in structuring individual interactions and communities. Little is known about the factors that affect individuals' competitive success, particularly in humans. Key factors might include stress, a major evolutionary pressure that can affect the establishment of social hierarchies in animals, and individuals' trait anxiety, which largely determines susceptibility to stress and constitutes an important determinant of differences in competitive outcomes. Using an economic-choice experiment to assess competitive self-confidence in 229 human subjects we found that, whereas competitive self-confidence is unaffected by an individual's anxiety level in control conditions, exposure to the Trier social stress test for groups drives the behavior of individuals apart: low-anxiety individuals become overconfident, and high-anxiety individuals become underconfident. Cortisol responses to stress were found to relate to self-confidence, with the direction of the effects depending on trait anxiety. Our findings identify stress as a major regulator of individuals' competitiveness, affecting self-confidence in opposite directions in high and low anxious individuals. Therefore, our findings imply that stress may provide a new channel for generating social and economic inequality and, thus, not only be a consequence, but also a cause of inequality through its impact on competitive self-confidence and decision making in financially-relevant situations.","Goette, L; Bendahan, S; Thoresen, J; Hollis, F; Sandi, C",2015.0,10.1016/j.psyneuen.2015.01.019,0,0,
6596,Surface hydrophobicity of gastric mucosa in Helicobacter pylori infection: effect of clearance and eradication,"ER Surface hydrophobicity of the gastric mucosa is reduced in peptic ulcer disease and Helicobacter pylori infection. This abnormality may be caused by H. pylori or may be an inherent defect. The aim of the present study was to clarify the relationship between H. pylori infection and mucosal hydrophobicity by examining the effect of eradication of the organism. H. pylori-positive patients with (n = 42) or without (n = 42) duodenal ulcer were randomized to receive ranitidine, bismuth, or bismuth plus antibiotics. Surface hydrophobicity of gastric mucosa was assessed by measurement of plateau-advancing contact angle. Measurements were performed at presentation, end of treatment, and 1 month later. Contact angle was unchanged after ranitidine (55 degrees vs. 56 degrees) but increased with bismuth (57 degrees-62 degrees; P < 0.05) and bismuth plus antibiotics (56 degrees-67 degrees; P < 0.0001). One month after treatment ended, contact angles in patients in whom H. pylori was not eradicated were not different from those before treatment (56 degrees vs. 56 degrees) but increased to a value similar to H. pylori-negative controls in patients in whom H. pylori was eradicated (56 degrees-69 degrees; P < 0.0001). It is concluded that reduced mucosal hydrophobicity in peptic ulcer disease is secondary to H. pylori infection and that this impaired mucosal defense provides a possible mechanism whereby H. pylori infection predisposes to acid/peptic digestion.","Goggin, P M; Marrero, J M; Spychal, R T; Jackson, P A; Corbishley, C M; Northfield, T C",1992.0,,0,0,
6597,Higher Beck depression scores predict delayed epinephrine recovery after acute psychological stress independent of baseline levels of stress and mood,"ER Depressive symptoms in the non-clinical range have been linked to increased health risks. Recent theorizing raises the possibility that heightened physiologic responses to acute stress and/or slowed stress recovery in individuals with depressive symptoms may contribute to increased risk. We investigated stress-induced catecholamine responses and recovery patterns using a modified version of the Trier Social Stress Test (15 min) with a sample of 52 healthy women and compared subgroups with high normal versus low scores on the Beck Depression Inventory (BDI, median split) to 29 women randomly assigned to a non-stressed control group. The BDI-high normal and BDI-low groups showed similar acute increases in epinephrine immediately post stressor, but only the BDI-high normal group remained significantly elevated above control group levels during the recovery period. No differences were found in norepinephrine responses. Elevations in BDI scores within the normal range may selectively predict slower physiological recovery following acute stress.","Gold, S M; Zakowski, S G; Valdimarsdottir, H B; Bovbjerg, D H",2004.0,10.1016/j.biopsycho.2003.12.001,0,0,
6598,A randomized controlled trial of multimodal music therapy for children with anxiety disorders,"ER BACKGROUND: Music therapy has been shown to be effective for children with psychopathology, providing an alternative nonverbal approach to the treatment of children with anxiety disorders.OBJECTIVE: This pilot study investigates the efficacy of Multimodal Music Therapy (MMT), a combination of music therapy and cognitive-behavioral therapy, compared to treatment as usual (TAU).METHODS: Thirty-six children aged 8-12 years with a primary diagnosis of an anxiety disorder were randomly assigned to 15 sessions of MMT or to TAU. Diagnostic status and dimensional outcome variables were assessed at the end of treatment and 4 months later.RESULTS: MMT was superior compared to TAU according to the remission rates after treatment (MMT 67%; TAU 33%; chi2 = 4.0; p = 0.046) and remissions persisted until four months post-treatment. Dimensional measures showed equivalent improvement after either MMT or TAU.CONCLUSIONS: The results regarding the efficacy of MMT are promising for children with anxiety disorders. Further evaluation with larger samples and comparisons to pure CBT are recommended.","Goldbeck, L; Ellerkamp, T",2012.0,,0,0,
6599,Effectiveness of Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents: a Randomized Controlled Trial in Eight German Mental Health Clinics,"ER AIMS: To determine whether Tf-CBT is superior to waiting list (WL), and to investigate the predictors of treatment response.METHOD: We conducted a single-blind parallel-group randomized controlled trial in eight German outpatient clinics with the main inclusion criteria of age 7-17 years, symptom score ?35 on the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA), and caregiver participation. Patients were randomly assigned to 12 sessions of Tf-CBT (n = 76) or a WL (n = 83). The primary outcome was the CAPS-CA symptom score assessed at 4 months by blinded evaluators. The secondary measures were diagnostic status, the Children's Global Assessment Scale (CGAS), self-reported and caregiver-reported PTSS (UCLA-PTSD Reaction Index), the Child Posttraumatic Cognitions Inventory (CPTCI), the Children's Depression Inventory (CDI), the Screen for Child Anxiety- Related Emotional Disorders (SCARED), the Child Behavior Checklist (CBCL/4-18), and the Quality of Life Inventory for Children.RESULTS: Intention-to-treat analyses showed that Tf-CBT was significantly superior to WL on the CAPS-CA (Tf-CBT: baseline = 58.51 ± 17.41; 4 months = 32.16 ± 26.02; WL: baseline = 57.39 ± 16.05; 4 months = 43.29 ± 25.2; F1, 157 = 12.3; p = 0.001; d = 0.50), in terms of secondary measures of the CGAS, UCLA-PTSD-RI, CPTCI, CDI, SCARED, and CBCL/4-18, but not in terms of quality of life. Age and comorbidity significantly predicted treatment response.CONCLUSIONS: Tf-CBT is effective for children and adolescents with heterogeneous trauma types in German service settings. Younger patients with fewer comorbid disorders show most improvement.BACKGROUND: Trauma-focused cognitive behavioral therapy (Tf-CBT) is efficacious for children and adolescents with posttraumatic stress symptoms (PTSS). Its effectiveness in clinical practice has still to be investigated.","Goldbeck, L; Muche, R; Sachser, C; Tutus, D; Rosner, R",2016.0,10.1159/000442824,0,0,
6600,"Treatment of severe, disabling migraine attacks in an over-the-counter population of migraine sufferers: results from three randomized, placebo-controlled studies of the combination of acetaminophen, aspirin, and caffeine","ER BACKGROUND: Subjects (n = 1220) who met the International Headache Society criteria for migraine with or without aura were included in three independent clinical studies.DESIGN/METHODS: Post-hoc analysis of 172 subjects who met the criteria for severe, disabling migraine reported a history of migraine attacks characterized by at least severe pain and severe disability, and treated attacks with severe pain and at least severe disability. Subjects who usually vomited with 20% or more of their migraine attacks, and those with incapacitating disability (subjects who required bed rest for more than 50% of their attacks) were not eligible for enrollment.RESULTS: From 1 h and continuing through 6 h postdose, the proportion of responders was significantly greater (p< or =0.01) for AAC than placebo. The pain intensity difference from baseline was significantly greater (p< or =0.05) for AAC than placebo from 0.5 h through 6 h. The proportion of subjects reporting improvement in functional disability, photophobia, and phonophobia was significantly greater for AAC than placebo from 2 h through 6 h postdose.CONCLUSIONS: The nonprescription combination of AAC was well tolerated and effective.OBJECTIVE: To examine the benefits of acetaminophen, aspirin, and caffeine (AAC) in the treatment of severe, disabling migraine attacks, in a population of migraine sufferers for whom over-the-counter (OTC) medications are appropriate.","Goldstein, J; Hoffman, H D; Armellino, J J; Battikha, J P; Hamelsky, S W; Couch, J; Blumenthal, H; Lipton, R B",1999.0,10.1046/j.1468-2982.1999.019007684.x,0,0,
6601,"A randomized, double-blind, placebo-controlled, crossover trial of mifepristone in Gulf War veterans with chronic multisymptom illness","ER No pharmacological treatments have been demonstrated to effectively treat chronic multisymptom illness (CMI) in Gulf War veterans (GWV). This study assessed the effect of the glucocorticoid receptor antagonist mifepristone in GWV with CMI. A randomized, double-blind, cross-over trial of mifepristone, with two six-week treatment phases separated by a one-month washout period, was conducted at a Veterans Affairs (VA) hospital between 2008 and 2011. Participants were randomized to receive either 200mg of mifepristone per day or matched placebo first. The primary clinical outcome measure was change in self-reported physical health. Neurocognitive functioning and self-reported measures of depression, PTSD, and fatigue were secondary outcomes. Sixty-five participants enrolled, of whom 36 were randomized and 32 (mean age, 49.1 (7.2) years) completed the study. Physical and mental health status and neurocognitive functioning were poor at baseline. Mifepristone treatment was not associated with improvement in self-reported physical health (p=0.838) or in other self-reported measures of mental health. Mifepristone treatment was significantly associated with improvements in verbal learning (p=0.008, d=0.508), in the absence of improvement in other cognitive measures (working memory (p=0.914), visual learning (p=0.643) and a global composite measure (p=0.937). Baseline morning cortisol levels and lysozyme IC50-DEX, a measure of peripheral glucocorticoid sensitivity, displayed a significant relationship with endpoint verbal learning scores (p=0.012 and p=0.007, respectively). The magnitude of cortisol change during treatment mediated the improvement in verbal learning. This study was negative for the primary and secondary clinical outcomes. However, the data suggest a moderate dose of mifepristone may have circumscribed cognitive-enhancing effects in CMI. Further study is warranted to determine whether and through which mechanisms mifepristone treatment can yield clinically meaningful improvement in cognitive function in CMI or other neuropsychiatric conditions associated with HPA axis dysregulation.","Golier, J A; Caramanica, K; Michaelides, A C; Makotkine, I; Schmeidler, J; Harvey, P D; Yehuda, R",2016.0,10.1016/j.psyneuen.2015.11.001,0,0,
6602,Effects of therapy goal oriented cognitive behavioural aftercare measures on therapy transfer following inpatient psychosomatic rehabilitation,"ER METHODThe evaluation was carried out as a field experiment. Patients were matched into pairs and then allocated randomly to either a control or an experimental condition. The experimental group, which had participated in specific aftercare measures after inpatient therapy, was compared to the control group at ""discharge from clinic"" and ""twelve weeks post-discharge"" relative to a number of variables relevant in therapy outcome.RESULTSTwelve weeks post-discharge patients who had participated in aftercare measures show significantly better progress relative to their physical and psychological complaints than patients in the control group. Also, they are more capable of coping with psychosocial demands of their everyday life. They experience better control of their symptoms and they are more successful in attaining the goals they have set for themselves for the time after discharge.CONCLUSIONSThe findings show that supplementing psychosomatic inpatient rehabilitation with specific aftercare measures will lead to better transfer and to increased effectiveness of psychosomatic rehabilitation. Also on account of our results, outpatient rehab aftercare programmes have in the meantime become a regular component of inpatient psychosomatic rehabilitation in Germany.OBJECTIVEAfter discharge from inpatient psychosomatic rehabilitation patients often face problems to transfer and stabilize the modifications they have achieved in the clinic. Using targeted outpatient aftercare interventions up to eight weeks after discharge from the inpatient programme we tried to support this transfer, thus enhancing treatment effectiveness.","Gönner, S; Bischoff, C; Ehrhardt, M; Limbacher, K",2006.0,10.1055/s-2006-932614,0,0,
6603,Letting the story unfold: a case study of client-centered therapy for childhood traumatic grief,"ER There has been increasing interest in the newly identified condition of childhood traumatic grief (CTG) since the 2001 attack on the World Trade Center. The case presented here is one of an adolescent girl who was diagnosed with CTG following the death of her father, a firefighter killed in the line of duty on September 11, 2001. Literature on CTG, its treatment, and adolescent development will be discussed. The application of client-centered treatment to CTG will be highlighted by the case description and diagnostic findings prior to, during, and following treatment.","Goodman, R F; Morgan, A V; Juriga, S; Brown, E J",2004.0,10.1080/10673220490509534,0,0,
6604,A double-blind comparison of clomipramine and desipramine in the treatment of developmental stuttering,"ER METHODSeventeen psychiatrically normal subjects, aged 14-61 years, with developmental stuttering completed a 10-week double-blind crossover trial of clomipramine and desipramine after a 2-week single-blind placebo phase.RESULTSClomipramine was superior to desipramine (two-tailed, p < .05) for 5 of 10 self-report ratings including stuttering severity on two scales, degree of preoccupation with stuttering and resistance to stuttering on a visual analog scale, and ""expectancy"" of stuttering on the Perceptions of Stuttering Inventory.CONCLUSIONClomipramine may be clinically useful for some patients with developmental stuttering. Biological links between developmental stuttering and other repetitive motor patterns that are selectively responsive to serotonergic agents should be explored.BACKGROUNDClomipramine, a serotonin reuptake blocker that has been shown to be effective in treating obsessive-compulsive disorder and other unwanted repetitive, ritualized behaviors, was hypothesized to be superior to desipramine, a tricyclic antidepressant with selective noradrenergic effects, for developmental stuttering.","Gordon, C T; Cotelingam, G M; Stager, S; Ludlow, C L; Hamburger, S D; Rapoport, J L",1995.0,,0,0,
6605,Differential response of seven subjects with autistic disorder to clomipramine and desipramine,"ER METHODSeven subjects, ages 6-18 years, with autistic disorder completed a 10-week double-blind, crossover trial of clomipramine and desipramine following a 2-week single-blind, placebo phase.RESULTSClomipramine was superior to desipramine and placebo, as indicated by standardized ratings of autism and anger as well as ratings of repetitive and compulsive behaviors. Clomipramine and desipramine were equally superior to placebo for ratings of hyperactivity. Parents of all seven subjects elected to have their children continue to take clomipramine after the study.CONCLUSIONSClomipramine and desipramine are differentially effective in treating the obsessive-compulsive and core symptoms in autistic disorder. Biological links between compulsions and stereotyped, repetitive behaviors in autistic disorder should be explored.OBJECTIVEClomipramine, a serotonin reuptake blocker that has unique antiobsessional properties, was hypothesized to have a different effect from that of desipramine, a tricyclic antidepressant with selective adrenergic effects, for the stereotyped, repetitive behaviors in autism.","Gordon, C T; Rapoport, J L; Hamburger, S D; State, R C; Mannheim, G B",1992.0,10.1176/ajp.149.3.363,0,0,
6606,"Anxiety Disorders in Caucasian and African American Children: a Comparison of Clinical Characteristics, Treatment Process Variables, and Treatment Outcomes","ER This study examined racial differences in anxious youth using data from the Child/Adolescent Anxiety Multimodal Study (CAMS) [1]. Specifically, the study aims addressed whether African American (n = 44) versus Caucasian (n = 359) children varied on (1) baseline clinical characteristics, (2) treatment process variables, and (3) treatment outcomes. Participants were ages 7-17 and met DSM-IV-TR criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder. Baseline data, as well as outcome data at 12 and 24 weeks, were obtained by independent evaluators. Weekly treatment process variables were collected by therapists. Results indicated no racial differences on baseline clinical characteristics. However, African American participants attended fewer psychotherapy and pharmacotherapy sessions, and were rated by therapists as less involved and compliant, in addition to showing lower mastery of CBT. Once these and other demographic factors were accounted for, race was not a significant predictor of response, remission, or relapse. Implications of these findings suggest African American and Caucasian youth are more similar than different with respect to the manifestations of anxiety and differences in outcomes are likely due to treatment barriers to session attendance and therapist engagement.","Gordon-Hollingsworth, A T; Becker, E M; Ginsburg, G S; Keeton, C; Compton, S N; Birmaher, B B; Sakolsky, D J; Piacentini, J; Albano, A M; Kendall, P C; Suveg, C M; March, J S",2015.0,10.1007/s10578-014-0507-x,0,0,
6607,Child-focused treatment of pediatric OCD affects parental behavior and family environment,"ER This study aimed to investigate the impact of child-focused pediatric OCD treatment on parental anxiety, family accommodation and family environment. Forty-three parents (72.1% female, mean age+/-. SD=43.1+/-5.6 years) were evaluated at baseline and after their children's (n=33, 54.5% female, mean age+/-. SD=12.9+/-2.7 years) randomized treatment with Group Cognitive-Behavioral Therapy or fluoxetine for 14 weeks. Validated instruments were administered by trained clinicians. Parents were assessed with the State-Trait Anxiety Inventory (STAI), the Family Accommodation Scale (FAS) and the Family Environment Scale (FES). The Yale-Brown Obsessive-Compulsive Scale was administered to children. Significant findings after the children's treatment include decreased family accommodation levels (participation, modification and distress/consequences domains); increased cohesion and active-recreational components of the family environment. In addition, changes in the FAS distress/consequences and the FES cohesion subscores were correlated with the children's clinical improvement. These results suggest that child-focused OCD treatment may have a positive impact on family accommodation and family environment. Future studies should further clarify the reciprocal influences of pediatric OCD treatment and family factors.","Gorenstein, G; Gorenstein, C; Oliveira, M C; Asbahr, F R; Shavitt, R G",2015.0,10.1016/j.psychres.2015.07.050,0,0,
6608,Brief psychotherapy versus general practice management--on the efficacy of treatment and patient satisfaction,,"Götzmann, L",1998.0,,0,0,
6609,"Examining the utility of using genotype and functional biology in a clinical pharmacology trial: pilot testing dopamine ?-hydroxylase, norepinephrine, and post-traumatic stress disorder",,"Graham, D P; Nielsen, D A; Kosten, T R; Davis, L L; Hamner, M B; Makotkine, I; Yehuda, R",2014.0,10.1097/YPG.0000000000000039,0,0,2087
6610,Randomized controlled trial of cognitive behavioral social skills training for older consumers with schizophrenia: defeatist performance attitudes and functional outcome,"ER OBJECTIVES: To determine whether Cognitive Behavioral Social Skills Training (CBSST) is an effective psychosocial intervention to improve functioning in older consumers with schizophrenia, and whether defeatist performance attitudes are associated with change in functioning in CBSST.DESIGN: An 18-month, single-blind, randomized controlled trial.SETTING: Outpatient clinic at a university-affiliated Veterans Affairs hospital.PARTICIPANTS: Veteran and non-veteran consumers with schizophrenia or schizoaffective disorder (N = 79) age 45-78.INTERVENTIONS: CBSST was a 36-session, weekly group therapy that combined cognitive behavior therapy with social skills training and problem-solving training to improve functioning. The comparison intervention, goal-focused supportive contact (GFSC), was supportive group therapy focused on achieving functioning goals.MEASUREMENTS: Blind raters assessed functioning (primary outcome: Independent Living Skills Survey), CBSST skill mastery, positive and negative symptoms, depression, anxiety, defeatist attitudes, self-esteem, and life satisfaction.RESULTS: Functioning trajectories over time were significantly more positive in CBSST than in GFSC, especially for participants with more severe defeatist performance attitudes. Greater improvement in defeatist attitudes was also associated with better functioning in CBSST, but not GFSC. Both treatments showed comparable significant improvements in amotivation, depression, anxiety, positive self-esteem, and life satisfaction.CONCLUSIONS: CBSST is an effective treatment to improve functioning in older consumers with schizophrenia, and both CBSST and other supportive goal-focused interventions can reduce symptom distress, increase motivation and self-esteem, and improve life satisfaction. Participants with more severe defeatist performance attitudes may benefit most from cognitive behavioral interventions that target functioning.TRIAL REGISTRY: ClinicalTrials.Gov #NCT00237796 (http://clinicaltrials. gov/show/NCT00237796).","Granholm, E; Holden, J; Link, P C; McQuaid, J R; Jeste, D V",2013.0,10.1097/JGP.0b013e31823e2f70,0,0,
6611,A randomised controlled trial and economic evaluation of a referrals facilitator between primary care and the voluntary sector,"ER DESIGNRandomised controlled trial with follow up at one and four months.SETTING26 general practices in Avon.PARTICIPANTS161 patients identified by their general practitioner as having psychosocial problems.MAIN OUTCOME MEASURESPrimary outcomes were psychological wellbeing (assessed with the hospital anxiety and depression scale) and social support (assessed using the Duke-UNC functional social support questionnaire). Secondary outcomes were quality of life measures (the Dartmouth COOP/WONCA functional health assessment charts and the delighted-terrible faces scale), cost of contacts with the primary healthcare team and Amalthea Project, cost of prescribing in primary care, and cost of referrals to other agencies, over four months.RESULTSThe Amalthea group showed significantly greater improvements in anxiety (average difference between groups after adjustment for baseline -1.9, 95% confidence interval -3.0 to -0.7), other emotional feelings (average adjusted difference -0.5, -0.8 to -0.2), ability to carry out everyday activities (-0.5, -0.8 to -0.2), feelings about general health (-0.4, -0.7 to -0.1), and quality of life (-0.5, -0.9 to -0.1). No difference was detected in depression or perceived social support. The mean cost was significantly greater in the Amalthea arm than the general practitioner care arm ( pound153 v pound133, P=0. 025).CONCLUSIONReferral to the Amalthea Project and subsequent contact with the voluntary sector results in clinically important benefits compared with usual general practitioner care in managing psychosocial problems, but at a higher cost.OBJECTIVESTo compare outcome and resource utilisation among patients referred to the Amalthea Project, a liaison organisation that facilitates contact between voluntary organisations and patients in primary care, with patients receiving routine general practitioner care.","Grant, C; Goodenough, T; Harvey, I; Hine, C",2000.0,,0,0,
6612,"Analysis and comparative evaluations of the costs of supports and treatments of schizophrenia, affective psychosis, paranoia and neurosis","ER SETTINGMental Health Department and CSM ""Scalo"" (NHS Mental Centre), AUSL ""Città di Bologna"", Emilia-Romagna Region.DESIGNYearly direct costs were calculated for a sample (n = 75) of all patients (N = 745) who during 365 days had more than four contacts with CSM and also for four randomised diagnostic groups (n = 30 per group).MAIN OUTCOME MEASURESWe calculated unit costs of 15 types of services provided by CSM, selected according to the yearly number of services provided and the time spent by each health professional, and the in patient-cost per all days spent in a public or private sector hospital for psychiatric care.RESULTSThe statistic analysis, performed with the help of the Kruskal-Wallis test, showed significantly higher overall costs for the schizophrenic patients than the sample-group and the neurotic disorders-group; besides a significant difference in the item costs for rehabilitation facilities was found between the schizophrenic group and the paranoia, neurotic disorders groups and the sample one, whereas no significant differences in costs of inpatients services and drugs administration were tested between the groups.CONCLUSIONSThe results of our study allow to demonstrate that there are cost differences between the diagnosis (direct costs are highest for schizophrenic patients and lowest for those with neurotic disorders) and that the costs evaluation can be used to ensure appropriate provisions to Mental Health Department for support and treatment of a wide range of psychiatric disorders.OBJECTIVEThe aim of the study was to show, trough the calculation of the direct costs of supports and treatments actually provided by a NHS Mental Health Department, the presence of associations between four diagnostic groups (schizophrenia, affective psychosis, paranoia and neurotic disorders) and their overall and items (community care, rehabilitation facilities and in-patients services) costs.","Grassi, A; Bruni, R; Pileggi, F; Chiappelli, M; Boldrini, M; Franceschi, E; Scarafoni, D",2001.0,,0,0,
6613,The green valley: the use of mobile narratives for reducing stress in commuters,"ER New technologies have influenced communication and interaction among people, enabling them to overcome face-to-face limitations and eliminating the need for persons in a communicative relationship to be in the same place at the same time. This project aimed to test the effectiveness of mobile phone usage applied to emotion induction. The authors wanted to check whether or not mobile narratives supported by multimedia mobile phones can enhance relaxation and reduce anxiety in a sample of commuters. The project sample consisted of 120 commuters, college students aged 20 to 25 years. The sample was randomly assigned into four conditions: the Vidnar group experienced the mobile narrative on a mobile phone during their daily train trip; the Nonar group experienced only video content proposed on a mobile phone; the MP3 group experienced only the audio content proposed on an MP3 player; and the Control group provided a no-intervention condition. The study measured participants' emotional state (State-Trait Anxiety Inventory [STAI] State questionnaire), trait (STAI Trait questionnaire, Generalized Self-Efficacy Scale), and sense of presence (Slater-Usoh-Steed Questionnaire [UCL-SUS] and the International Test Commission-Sense of Presence Inventory [ITC-SOPI]) before and after the experience. The main results showed a significant decrease in anxiety level (p < 0.05, assessed by STAI State questionnaire) and an increase in relaxation level (p < 0.001) assessed by the Visual Analog Scale (VAS). No significant differences were found in other conditions.","Grassi, A; Gaggioli, A; Riva, G",2009.0,10.1089/cpb.2008.0156,0,0,
6614,Randomized controlled trial of a psychosocial telephone counseling intervention in BRCA1 and BRCA2 mutation carriers,"ER METHODSThis prospective randomized clinical trial included 90 BRCA1/2 mutation carriers. We measured anxiety, depression, and genetic testing distress outcomes at intervention baseline and 6 and 12 months following disclosure. We evaluated the effects of SGC versus SGC plus PTC on psychological outcomes using intention-to-treat analyses through generalized estimating equations.RESULTSAt 6 months, PTC reduced depressive symptoms (Z = -2.25, P = 0.02) and genetic testing distress (Z = 2.18, P = 0.02) compared with SGC. Furthermore, women in the intervention condition reported less clinically significant anxiety at 6 months (chi(2)(1) = 4.11, P = 0.04) than women who received SGC. We found no differences in outcomes between the intervention groups at the 12-month follow-up.CONCLUSIONSAs an adjunct to SGC, PTC delivered following disclosure of positive BRCA1/2 test results seems to offer modest short-term benefits for distress and anxiety. These results build upon a growing literature of psychosocial interventions for BRCA1/2 carriers and, given the potential impact of affect on risk management decision making, suggest that some carriers may derive benefits from adjuncts to traditional genetic counseling.BACKGROUNDResponses following BRCA1/2 genetic testing are relevant for the comprehension of risk status and may play a role in risk management decision making. The objective of this study was to evaluate a psychosocial telephone counseling (PTC) intervention delivered to BRCA1/2 mutation carriers following standard genetic counseling (SGC). We examined the effect of the intervention on distress and the concerns related to genetic testing.","Graves, K D; Wenzel, L; Schwartz, M D; Luta, G; Wileyto, P; Narod, S; Peshkin, B N; Marcus, A; Cella, D; Emsbo, S P; Barnes, D; Halbert, C H",2010.0,10.1158/1055-9965.EPI-09-0548,0,0,
6615,Impact of preoperative patient education on postoperative pain in consideration of the individual coping style,"ER METHODSthe study is based on a 2×2 factorial experimental design with the experimental factor ""treatment"" (education vs control condition) and the factor ""negative coping style"" (high vs low). After informed consent 96 patients undergoing abdominal or vascular surgery were enrolled in the study. Outcomes were pain intensity, pain quality and psychic state. They were assessed by using numerical rating scales and psychometric methods of self-assessment. The data were collected preoperatively and on the first to third postoperative day.RESULTSpatients who received preoperative education experience a greater reduction in postoperative pain than patients without preoperative education do (ES=0.48). The risk for stronger pain (NRS>3) on the third postoperative day is decreased (2.1 vs 14.6%). The influence of negative coping style is altogether minimal.CONCLUSIONSpreoperative patient information has positive effects on the postoperative development of pain. Patient information is a valuable addition to the drug pain treatment. The application can be recommended regardless of the level of the patients' negative coping style.OBJECTIVEthe German guideline for the treatment of acute perioperative and post-traumatic pain (S3-Leitlinie zur Behandlung akuter perioperativer und posttraumatischer Schmerzen) recommends giving preoperative information about postoperative pain and how to influence it. It is expected that the effect of preoperative information is modified by psychological characteristics of the patient. One of these psychological characteristics is the individual coping style. The purpose of the study is to evaluate whether or not patients benefit from preoperative education in relation to their level of negative coping style.","Gräwe, J S; Mirow, L; Bouchard, R; Lindig, M; Hüppe, M",2010.0,10.1007/s00482-010-0994-z,0,0,
6616,A controlled therapeutic study of the irritable-bowel syndrome: effect of diphenylhydantoin,,"Greenbaum, D S; Ferguson, R K; Kater, L A; Kuiper, D H; Rosen, L W",1973.0,10.1056/NEJM197301042880103,0,0,
6617,Psychological defense in anticipation of anxiety: eliminating the potential for anxiety eliminates the effect of mortality salience on worldview defense,"ER A large body of research has shown that when people are reminded of their mortality, their defense of their cultural worldview intensifies. Although some psychological defenses seem to be instigated by negative affective responses to threat, mortality salience does not appear to arouse such affect. Terror management theory posits that the potential to experience anxiety, rather than the actual experience of anxiety, underlies these effects of mortality salience. If this is correct, then mortality-salience effects should be reduced when participants believe they are not capable of reacting to the reminder of mortality with anxiety. In a test of this hypothesis, participants consumed a placebo purported to either block anxiety or enhance memory. Then we manipulated mortality salience, and participants evaluated pro- and anti-American essays as a measure of worldview defense. Although mortality salience intensified worldview defense in the memory-enhancer condition, this effect was completely eliminated in the anxiety-blocker condition. The results suggest that some psychological defenses serve to avert the experience of anxiety rather than to ameliorate actually experienced anxiety.","Greenberg, J; Martens, A; Jonas, E; Eisenstadt, D; Pyszczynski, T; Solomon, S",2003.0,10.1111/1467-9280.03454,0,0,
6618,Carbon dioxide inhalation induces dose-dependent and age-related negative affectivity,"ER METHODOLOGY/PRINCIPAL FINDINGSSixty-four healthy subjects underwent a double inhalation of four mixtures containing respectively 0, 9, 17.5 and 35% CO(2) in compressed air, following a double blind, cross-over, randomized design. Affective responses were assessed according to DSM IV criteria for panic, using an Electronic Visual Analogue Scale and the Panic Symptom List. It was demonstrated that carbon dioxide challenges induced a dose dependent negative affect (p<0.0001). This affect was semantically identical to the DSM IV definition of panic. Older individuals were subjectively less sensitive to Carbon Dioxide (p<0.05).CONCLUSIONS/SIGNIFICANCECO(2) induced affectivity may lay on a continuum with pathological panic attacks. Consistent with earlier suggestions that panic is a false biological alarm, the affective response to CO(2) may be part of a protective system triggered by suffocation and acute metabolic distress.BACKGROUNDCarbon dioxide inhalation is known to induce an emotion similar to spontaneous panic in Panic Disorder patients. The affective response to carbon dioxide in healthy subjects was not clearly characterized yet.","Griez, E J; Colasanti, A; Diest, R; Salamon, E; Schruers, K",2007.0,10.1371/journal.pone.0000987,0,0,
6619,"Reduction of chronic posttraumatic hand edema: a comparison of high voltage pulsed current, intermittent pneumatic compression, and placebo treatments","ER The purpose of this study was to compare the efficacy of intermittent pneumatic compression (IPC) and high voltage pulsed current (HVPC) in reducing chronic posttraumatic hand edema. Thirty patients with posttraumatic hand edema were randomly assigned to IPC, HVPC, or placebo-HVPC groups (10 patients in each group). Patients received a single application of the respective treatment for 30 minutes. Measurements were made before and after a 10-minute rest period and after the 30-minute treatment. A volumetric method was used to quantify edema reduction. Reduction in hand edema was significant between the IPC and placebo-HVPC groups (p = .01). Differences in edema reduction between the HVPC and placebo-HVPC groups did not reach statistical significance (p = .04), but were considered clinically significant. There was no significant difference between the IPC and HVPC groups. A single 30-minute administration of IPC produced a significant reduction in hand edema. Additional clinical studies are needed to delineate maximally effective treatment protocols for reduction of chronic posttraumatic hand edema. [Griffin JW, Newsome LS, Stralka SW, et al: Reduction of chronic posttraumatic hand edema: A comparison of high voltage pulsed current, intermittent pneumatic compression, and placebo treatments.","Griffin, J W; Newsome, L S; Stralka, S W; Wright, P E",1990.0,,0,0,
6620,The Responsive Classroom approach and fifth grade students' math and science anxiety and self-efficacy,"ER Self-efficacy forecasts student persistence and achievement in challenging subjects. Thus, it is important to understand factors that contribute to students' self-efficacy, a key factor in their success in math and science. The current cross-sectional study examined the contribution of students' gender and math and science anxiety as well as schools' use of Social and Emotional Learning (SEL) practices to students' math and science self-efficacy. Fifth graders (n = 1,561) completed questionnaires regarding their feelings about math and science. Approximately half of the students attended schools implementing the Responsive Classroom® (RC) approach, an SEL intervention, as part of a randomized controlled trial. Results suggested no difference in math and science self-efficacy between boys and girls. Students who self-reported higher math and science anxiety also reported less self-efficacy toward these subjects. However, the negative association between students' anxiety and self-efficacy was attenuated in schools using more RC practices compared with those using fewer RC practices. RC practices were associated with higher science self-efficacy. Results highlight anxiety as contributing to poor self-efficacy in math and science and suggest that RC practices create classroom conditions in which students' anxiety is less strongly associated with negative beliefs about their ability to be successful in math and science.","Griggs, M S; Rimm-Kaufman, S E; Merritt, E G; Patton, C L",2013.0,10.1037/spq0000026,0,0,
6621,Group music therapy for severe mental illness: a randomized embedded-experimental mixed methods study,"ER OBJECTIVE: Music therapy is an innovative approach to support people with severe mental illness (SMI). The aim of the study was to determine whether group music therapy (GMT) positively impacted on quality of life (QoL), social enrichment, self-esteem, spirituality and psychiatric symptoms of participants with SMI and how they experienced the intervention.METHOD: The primary outcome was QoL; secondary measures assessed social enrichment, self-esteem, spirituality and psychiatric symptoms. The 13-week intervention comprised singing familiar songs and composing original songs recorded in a professional studio. Qualitative data were generated from focus group interviews and song lyric analysis.RESULTS: Ninety-nine adults (57 female) were recruited, with an initial cohort (n = 75) randomized to either: weekly GMT followed by standard care (SC) or SC followed by GMT. Crossover occurred after 13 weeks. Measures were conducted at baseline, 13, 26 and 39 weeks. A second cohort (n = 24) could not be randomized and were assigned to GMT followed by SC. Intention-to-treat analysis showed a significant difference between GMT and SC on QoL and spirituality. This was robust to different assumptions about missing data (listwise deletion, last observation carried forward or multiple imputation). Per-protocol analysis suggested greater benefit for those receiving more sessions. Focus group interview and song lyric analyses suggested that GMT was enjoyable; self-esteem was enhanced; participants appreciated therapists and peers; and although challenges were experienced, the programme was recommended to others.CONCLUSION: Group music therapy may enhance QoL and spirituality of persons with SMI.","Grocke, D; Bloch, S; Castle, D; Thompson, G; Newton, R; Stewart, S; Gold, C",2014.0,10.1111/acps.12224,0,0,
6622,Astereopsis caused by traumatic brain injury,"Impaired depth perception (astereopsis) has been observed in a variety of cerebral pathologies affecting the posterior parietal lobe. In the current study of 93 consecutive head trauma admissions, 24% had complete astereopsis and 41% performed more than 2 SDs below the orthopedic control group mean. Degree of impairment was related to Glascow Coma Scale score, length of posttraumatic amnesia, reduced visuospatial and memory abilities, and the presence of intracranial pathology of the parietal lobes. Impairment was also related to trauma severity in patients without any visualized intracranial pathology, presumably due to diffuse axonal shearing. Clinically meaningful impairment was observed in 25% of this group; 10% had complete astereopsis. Stereoacuity screening requires 1 to 2 minutes. Undetected astereopsis may increase risk for subsequent motor vehicle accidents or falls. Copyright (C) 1999 National Academy of Neuropsychology.",Miller L.J.; Mittenberg W.; Carey V.M.; McMorrow M.A.; Kushner T.E.; Weinstein J.M.,1999.0,10.1016/S0887-6177(98)00048-1,0,0,
6623,Effects of prepulses and d-amphetamine on performance and event-related potential measures on an auditory discrimination task,"Rationale: Prepulse inhibition (PPI) of the startle reflex is a measure of sensorimotor gating, that is the processing of the startle stimulus (S2) is inhibited by the interfering processing of a closely preceding prepulse (S1). It has been demonstrated that PPI is disrupted in a variety of mental disorders and that several neurotransmitter systems, including dopamine, participate in the modulation of sensorimotor gating. Previous studies have also shown that a task-relevant S1 enhances PPI in healthy subjects but not in schizophrenic patients. These findings indicate an influence of attentional processes on sensorimotor gating and an impairment of this modulation in schizophrenia. Objective: Assuming a dopamine-mediated suppression of S1 processing as a mechanism of resource management and selective attention, which might be impaired in certain mental disorders, the present study investigated the effects of the indirect dopaminergic agonist d-amphetamine on prepulse-altered S2 discrimination and event related potentials (ERPs). Methods: Twelve healthy volunteers were tested in a double-blind, placebo-controlled experimental design. Here, S2 is the target in a difficult Go/NoGo auditory discrimination task. Results: Confirming our previous results, S2 processing is 'accentuated' by a weak acoustic prepulse in healthy subjects, thus leading to a lower rate of errors of omission but also to more false alarms (i.e. a liberal response bias). This performance change correlated with a prepulse-induced increase in the amplitude of the P3 ERP towards non-targets ('prepulse-induced non-target positivity'; PINTP). In addition, the results of the present study show that under prepulse conditions amphetamine disrupts 'S2 accentuation' associated with a dose- related reduction of the P2 component of the S1 response and a plasma level related reduction of PINTP. Conclusions: These data suggest an involuntary attentional shift towards S1 processing with increasing dopamine-release similar to that observed in patients with schizophrenia or OCD. It is concluded that sensory gating alters selective attention via dopaminergic modulation.",Kröner S.; Schall U.; Ward P.B.; Sticht G.; Banger M.; Haffner H.-T.; Catts S.V.,1999.0,10.1007/s002130051040,0,0,
6624,High-level cognition in phobics: Abstract anticipatory memory is associated with the attenuation of physiological reactivity to threat,"The extent to which anxious people benefit from exposure-based treatments seems to depend on the degree to which they activate their fear network during exposure. This study was designed to investigate whether the cognitive processing of threat in anxious individuals is dominated by abstract anticipatory memory, and whether this abstract memory mode is related to the incomplete activation of the fear network. Activation of the fear network was assessed during phobic exposure, as evidenced by the initial autonomic reaction. Spider phobics and controls were presented with a threatening imagery script. Half of them were exposed to a real-life spider. Spider phobics memorized relatively more abstract anticipatory descriptions than concrete sensory descriptions when compared with the control subjects. Only in phobic subjects, higher recognition of abstract anticipatory descriptions was inversely related to heart rate reactivity during exposure. A preferential memory mode for abstract information was related to an attenuated heart rate reactivity to threat in spider phobics. It is suggested that the preferential memory mode for abstract information may inhibit the activation of the subcortical affective memory system, which is crucial for the complete activation of the fear network. The absence of complete fear network activation may play a role in the persistence of anxiety disorders by hindering anxious individuals to learn that the stimuli they fear are not as dangerous as they assumed. Copyright (C) 1999 Elsevier Science Ltd.",Kindt M.; Brosschot J.F.; Boiten F.,1999.0,10.1016/S0887-6185(99)00016-X,0,0,
6625,Skin conductance responses of spider phobics to backwardly masked phobic cues,"The present study was carried out to test Ohman's (1994) hypothesis that a pre-attentive analysis of phobic stimuli is sufficient for a fear response to occur. Spider phobic (n = 47) and nonphobic (n = 41) subjects were exposed to phobic slides (spiders) and nonphobic slides (flowers, mushrooms, and snakes) that were presented for 30 ms, 20 ms, or 15 ms. Slides were backwardly masked for 100 ms. This technique was used to prevent conscious identification. During each trial, SCRs were measured. Following each trial, subjects indicated what they had seen (forced choice awareness check). Awareness check data revealed that only 15 ms stimuli remained genuinely subliminal. No convincing evidence was found to suggest that masked spider pictures elicit stronger SCRs in spider phobics than neutral control pictures. All in all, the present data fail to provide straightforward support for the idea that subliminal phobic cues elicit differential autonomic reactions in phobics.",Mayer B.; Merckelbach H.; De Jong P.J.; Leeuw I.,1999.0,,0,0,
6626,Alcohol consumption and psychological distress in recently widowed older men,"Objective: The relationship between severe adverse life events and subsequent health-related behaviour is not well established for older people. To address this issue, we studied self-reported alcohol consumption in recently widowed older men and matched married men. Method: We carried out a double cohort study in community-residing men aged 65 years and over. Recently widowed men (n = 57; mean age = 74.5 years) were identified from the death records of their wives and assessed at 6 weeks, 6 months and 13 months post-bereavement. Matched married men (n = 57; mean age = 75.4 years) were identified from the electoral roll and assessed at similar intervals. Self-report measures of alcohol consumption, grief and state anxiety were employed. Results: Similar proportions of older widowers and married men reported that they consumed some alcohol, although recently widowed older men reported significantly greater frequency (χ2 = 4.64, df = 1, p = 0.031) and quantity (χ2 = 7.75, df = 1, p = 0.005) of alcohol consumption than matched married men. A significant minority of subjects reported hazardous levels of alcohol consumption with 18.9% of widowers and 8.3% of married men reporting that they drank five or more standard drinks per drinking day. However, among widowers, self-reported alcohol consumption was not significantly correlated with levels of either self-reported grief or state anxiety. Conclusions: Hazardous alcohol consumption occurs commonly among recently widowed older men, but is not related to their levels of self-reported grief or psychological distress. Loss of spousal care and control may be an alternative explanation for this drinking behaviour. Older widowers should be regarded as a high-risk group for hazardous alcohol consumption and would be a suitable target group for preventive interventions.",Byrne G.J.A.; Raphael B.; Arnold E.,1999.0,10.1046/j.1440-1614.1999.00614.x,0,0,
6627,Dose response of adrenocorticotropin and cortisol to the CCK-B agonist pentagastrin,"Cholecystokinin (CCK) is an abundant neurotransmitter in brain. Its functional significance in humans is incompletely understood, but it may modulate activity in the hypothalamic-pituitary-adrenal (HPA) axis. To explore this hypothesis, we examined the effects of varying doses (0 to 0.8 μg/kg) of the CCK-B agonist pentagastrin on adrenocorticotropin (ACTH) and cortisol release in healthy human subjects. We also examined anxiety, heart rate (HR), and blood pressure (BP) responses. Pentagastrin induced large (up to 520 % increase over baseline), significant and very rapid, dose-dependent elevations in ACTH and cortisol levels. Significant elevations in HR and BP were seen at all doses, without clear dose-response relationships. Anxious distress and symptom responses were also somewhat dose dependent; but hormonal responses were more robustly linked to pentagastrin dose than to these subjective measures. The HPA axis response to the CCK-B agonist pentagastrin may be a direct pharmacological effect. Further work is needed to determine the mechanisms and the physiological significance of CCK-mediated modulation of the human neuroendocrine stress axis. Copyright (C) 1999 American College of Neuropsychopharmacology.",Abelson J.L.; Liberzon I.,1999.0,10.1016/S0893-133X(98)00124-9,0,0,
6628,Fear of blushing: Fearful preoccupation irrespective of facial coloration,"Women, with high (n=29) and low (n=28) fear of blushing, were exposed to a mild social stressor (watching a television test card in the presence of two male confederates) and to an intense social stressor (watching their own prerecorded 'sing' video, in the presence of two male confederates). Facial coloration and facial temperature were measured and participants rated their own blush intensity. No differences in actual blushing emerged between both groups. Meanwhile, high fearful individuals' self-reported blush intensity was significantly higher than that of low fearful individuals. Thus, fear of blushing seems to reflect a fearful preoccupation, irrespective of differential facial coloration. The present findings concord with cognitive models of social phobia. Copyright (C) 1999 Elsevier Science Ltd.",Mulkens S.; De Jong P.J.; Dobbelaar A.; Bögels S.M.,1999.0,10.1016/S0005-7967(98)00198-3,0,0,
6629,Effects of anxiolytics on memory,"Drugs used in the treatment of anxiety disorders can produce impairments of cognitive functions. This article provides an overview and summary of research on the effects of anxiolytics upon human memory. Research with the benzodiazepines has shown that they produce a differential pattern of memory deficits whereby episodic memory is dose-dependently impaired but other memory systems are preserved relatively intact. Other anti-anxiety drugs have received relatively little research attention in terms of their memory effects. Recent studies imply that beta-blockers may produce poor memory particularly for emotionally valent information and that, at higher doses, buspirone may have detrimental effects on verbal recall. Studies with anxious patients suggest that tolerance does not fully develop to the amnestic effects of benzodiazepines over repeated use. Further, residual memory impairments appear to persist for a time beyond cessation of use of these drugs. The importance is stressed of assessing the effects of novel anxiolytics on a wide range of memory functions in clinical populations as well as in healthy volunteers.",Curran H.V.,1999.0,10.1002/(SICI)1099-1077(199908)14:1+<S72::AID-HUP120>3.0.CO;2-0,0,0,
6630,Learning history in fear of blushing,"Two studies, investigating the learning history (i.e. traumatic conditioning experiences, vicarious learning, informational learning) of individuals with and without fear of blushing, are presented. In study 1, individuals high (n=61) and low (n=59) in fear of blushing completed the (revised) Phobic Origin Questionnaire [POQ; Ost, L. G., and Hugdahl, K. (1981). Acquisition of phobias and anxiety response patterns in clinical patients. Behavior Research and Therapy, 19, 439-447]. In study 2, individuals who applied for treatment for fear of blushing (n=31) and a nonfearful, matched control group (n=31) were interviewed with the same instrument, taking into account only specific memories. High fearful individuals reported more negative learning experiences in connection with blushing than low fearful individuals, irrespective of the type of questioning. Meanwhile, study 1 (written POQ) produced higher percentages of negative learning experiences for both high and low fearful individuals than study 2 (interview). It is concluded that the POQ interview showed a more realistic picture than the written POQ. The possible role of learning history in the acquisition of fear of blushing is discussed. Copyright (C) 1999 Elsevier Science Ltd.",Mulkens S.; Bögels S.M.,1999.0,10.1016/S0005-7967(99)00022-4,0,0,
6631,Effects of alcohol on baseline startle and prepulse inhibition in young men at risk for alcoholism and/or anxiety disorders,"Objective: This study examined the hypothesis that a decreased reaction to alcohol and a deficit in prepulse inhibition (PPI) of the startle reflex are characteristics of male offspring of alcoholics without comorbid anxiety disorder. Method: Male offspring (N = 51) with a parental history of (1) alcoholism only, (2) anxiety disorder only, (3) alcoholism and anxiety disorder, and (4) no psychiatric disorder participated in an experiment examining the effects of alcohol on the acoustic startle reflex and on PPI. The experiment was carried out in two sessions in which subjects received an alcoholic beverage and placebo beverage on alternate days. Results: The magnitude of startle was reduced by alcohol in each group. However, the degree of reduction was less in the offspring of alcoholics only compared to the other groups. In addition, PPI was reduced in the offspring of alcoholics only compared to the offspring of parents with no psychiatric disorder. Conclusions: A reduced reactivity to the effect of alcohol and a deficit in PPI might constitute vulnerability markers for alcoholism, but only in offspring of alcoholics without comorbid anxiety disorder.",Grillon C.; Sinha R.; Ameli R.; O'Malley S.S.,2000.0,,0,0,
6632,Alcohol expectancies and social deficits relating to problem drinking among college students,"Standardized questionnaires were administered to 116 male and female undergraduates to examine how social deficits and alcohol expectancies relate to alcohol use. Participants were classified as either problem or nonproblem drinkers based on the Rutgers Collegiate Substance Abuse Screening Test. Problem drinkers reported experiencing social anxiety, shyness, and lower self-esteem to a greater extent than nonproblem drinkers. Problem drinkers also held more positive alcohol expectancies than nonproblem drinkers. Contrary to our hypotheses, however, particular types of alcohol expectancies did not interact with specific areas of social functioning to influence problem drinking. Overall, these findings suggest that problem drinkers have positive expectations about the immediate effects of alcohol consumption even though drinking is linked to long-term impairment in social functioning. Copyright (C) 2000 Elsevier Science Ltd.",Lewis B.A.; O'Neill H.K.,2000.0,10.1016/S0306-4603(99)00063-5,0,0,
6633,Preventing psychological trauma in soldiers: The role of operational stress training and psychological debriefing,"Armed conflict is associated with significant long-term psychiatric morbidity. Interventions to reduce the incidence of psychiatric disorder following psychological trauma may be classified into three categories. Primary prevention includes the selection, preparation and training of individuals likely to be exposed to potentially traumatizing events. Secondary prevention comprises a variety of brief psychological techniques immediately or shortly after traumatizing life events, the best known of which is Psychological Debriefing. Tertiary interventions comprise the treatment of established PTSD and others. Psychiatric morbidity was studied in 106 British soldiers returning from UN peacekeeping duties in the former Republic of Yugoslavia. All 106 soldiers received an Operational Stress Training Package prior to their deployment and a randomly selected group also received a post-operational PD. Very low rates of PTSD and other psychopathology were found overall and the Operational Stress Training Package may have contributed to this. Elevated CAGE scores suggestive of significant alcohol misuse were observed in both groups and chemical avoidance behaviours arising from this may have masked psychopathology. CAGE scores diminished significantly in the debriefed group by the end of the follow-up period suggesting that PD may have been of benefit despite the apparent absence of PTSD. This study also demonstrates that a high incidence of psychiatric morbidity is not an inevitable consequence of military conflict.",Deahl M.; Srinivasan M.; Jones N.; Thomas J.; Neblett C.; Jolly A.,2000.0,,0,0,
6634,Loudness dependence of auditory evoked potentials in obsessive-compulsive disorder: A pilot study,"In recent years it has been suggested that a serotonergic dysfunction is involved in the pathogenesis of obsessive-compulsive disorder (OCD). The loudness dependence of auditory evoked potentials (AEPs) is one of the best validated indicators of the activity of the serotonin system in humans. To explore the validity of the hypothesis of a serotonergic dysfunction in OCD, the loudness dependence of AEPs of 22 medication-free OCD patients were compared with those of 22 age- and gender-matched healthy subjects. Auditory evoked N1/P2 activity to tones of increasing intensity was studied using dipole source analysis. Contrary to the hypothesis, OCD patients and healthy controls did not differ in their LDAEPs of the tangential dipole in particular, located in the primary auditory cortex and closely related to central serotonergic activity. Furthermore, no significant correlation was found between the severity of obsessive-compulsive or depressive symptoms and the loudness dependence of AEPs. These findings do not support the hypothesis of a serotonergic dysfunction in OCD patients. Copyright (C) 2000 Elsevier Science Ireland Ltd.",Carrillo-De-La-Peña M.T.; Mavrogiorgou P.; Juckel G.; Hauke W.; Gallinat J.; Frodl T.; Zaudig M.; Hegerl U.,2000.0,10.1016/S0165-1781(00)00106-2,0,0,
6635,Emotional processing in combat-related posttraumatic stress disorder: A comparison with traumatized and normal controls,"Emotional numbing (EN) symptoms are an important but poorly understood component of the response to trauma. To try to demonstrate EN, this laboratory study examined subjective and psychophysiological emotion responses to standardized visual stimuli in combat veterans with posttraumatic stress disorder (PTSD), combat veterans without PTSD, and nontraumatized controls. PTSD subjects showed no evidence of generalized reduction in subjective or psychophysiological emotion responses. In response to a subset of more evocative stimuli, PTSD subjects reported less experience of Positive Emotions, and more experience of Negative Emotions than controls. For controls, valence and arousal were uncorrelated, while they were negatively correlated for PTSD subjects. Verbal and nonverbal subjective emotion measures were positively correlated for all subject groups, but there was little correlation between subjective emotion measures and psychophysiological indices. Viewing time was positively correlated with Positive Emotions for PTSD subjects, and with Negative Emotions for combat controls.All rights reserved. Copyright (C) 2000.",Amdur R.L.; Larsen R.; Liberzon I.,2000.0,10.1016/S0887-6185(99)00035-3,0,0,
6636,Comparative kinetics and response to the benzodiazepine agonists triazolam and zolpidem: Evaluation of sex-dependent differences,"Eighteen healthy volunteers (10 men and 8 women) participated in a single-dose, double-blind, three-way crossover pharmacokinetic and pharmacodynamic study. Treatment conditions were 0.25 mg of triazolam, a full-agonist benzodiazepine ligand; 10 mg of zolpidem, an imidazopyridine having relative selectivity for the type 1 benzodiazepine receptor subtype; and placebo. Weight-normalized clearance of triazolam was higher in women than in men (8.7 versus 5.5 ml/min/kg), but the difference was not significant. In contrast, zolpidem clearance was lower in women than in men (3.5 versus 6.7 ml/min/kg, P < .06). Compared to placebo, both active medications produced significant benzodiazepine agonist-like pharmacodynamic effects: sedation, impaired psychomotor performance, impaired information recall, and increased electroencephalographic β-amplitude. Effects of triazolam and zolpidem in general were comparable and less than 8 h in duration. There was no evidence of a substantial or consistent sex difference in pharmacodynamic effects or in the kinetic-dynamic relationship, although subtle differences could not be ruled out due to low statistical power. The complete dependence of triazolam clearance on CYP3A activity, as opposed to the mixed CYP participation in zolpidem clearance, may explain the differing sex effects on clearance of the two compounds.",Greenblatt D.J.; Harmatz J.S.; Von Moltke L.L.; Wright C.E.; Durol A.L.B.; Harrel-Joseph L.M.; Shader R.I.,2000.0,,0,0,
6637,False-positive findings in mammography screening induces short-term distress - Breast cancer-specific concern prevails longer,"The aim of this study was to examine psychological distress in a mammography screening process as a consequence of screening after adjusting for background, personality and prescreening distress. Subjects, aged 50 years, were invitees at their first screening. There were three groups; normal findings (n=1407), false-positive findings (n=492) and referents from outside the screening programme (n=1718, age 48-49 years). Distress was measured as illness worry, anxiety, depression, cancer beliefs and early detection behaviour. Measurements were one month before screening invitation with follow-ups at 2 and 12 months postscreening. At 2 months, there was a moderate multivariate effect of group on distress; and intrusive thinking and worry about breast cancer, in particular, were most frequent amongst the false positives. Intrusive thinking still prevailed at 12 months, in addition to a higher perceived breast cancer risk and susceptibility. Distress related to screening and false-positive findings seems to be moderate, but prevailing cancer-specific concerns call for improvements in screening programmes. Copyright (C) 2000 Elsevier Science Ltd.",Aro A.R.; Pilvikki Absetz S.; Van Elderen T.M.; Van Der Ploeg E.; Van Der Kamp L.J.T.,2000.0,10.1016/S0959-8049(00)00065-4,0,0,
6638,Evoking analogue subtypes of panic attacks in a nonclinical population using carbon dioxide-enriched air,"The increasing recognition that panic attacks are heterogeneous phenomena necessitates better and more objective criteria to define and examine what constitutes a panic attack. The central aim of the present study was to classify subtypes of panic attacks (i.e. prototypic, cognitive, and non-fearful) in a nonclinical sample (N=96) based on the concordance/discordance between subjective and physiological responding to multiple inhalations of 20 and 13% CO2-enriched air. Results show that a substantial proportion of this nonclinical sample (55.2%) responded to the CO2 challenge in a manner consistent with clinical and research definitions of different subtypes of panic attacks. The implications of this dimensional approach for discriminating subtypes of panic in the laboratory are discussed as a means to better understand the phenomenology and nature of panic attacks. Copyright (C) 2000 Elsevier Science Ltd.",Forsyth J.P.; Eifert G.H.; Canna M.A.,2000.0,10.1016/S0005-7967(99)00074-1,0,0,
6639,Clinical methodology for testing of anxiolytic drugs,"Diagnostic criteria and classification are changing. It is no longer acceptable to include patients with a general diagnosis of any anxiety, or neurotic anxiety. Regardless of the reference system used, DSM IV or ICD 10, anxiety disorders are now detailed in separate entities. General anxiety disorder, GAD, which is pivotal for the evaluation of new products, can only be claimed after the elimination of all the others, and is relatively rare. The inclusion of such outpatients is further complicated, as comorbidity is frequently associated with",Bourin M.,2000.0,,0,0,
6640,Self-reported sensitivity to chemical exposures in five clinical populations and healthy controls,"Two hundred and twenty-five subjects, including normal volunteers and patients with previously documented seasonal affective disorder (SAD), chronic fatigue syndrome (CFS), Cushing's syndrome, Addison's disease and obsessive-compulsive disorder (OCD), completed a self-rated inventory of reported sensitivity to various chemical exposures. Patients with CFS, Addison's disease and SAD self-reported more sensitivity to chemical exposures than normal controls. In addition, women reported more sensitivity than men. This report suggests that chemical sensitivity may be a relevant area to explore in certain medical and psychiatric populations. A possible relationship between reported chemical sensitivity and hypothalamic-pituitary-adrenal (HPA)-axis functioning is discussed. Copyright (C) 2000 Elsevier Science Ireland Ltd.",Nawab S.S.; Miller C.S.; Dale J.K.; Greenberg B.D.; Friedman T.C.; Chrousos G.P.; Straus S.E.; Rosenthal N.E.,2000.0,10.1016/S0165-1781(00)00148-7,0,0,
6641,Neurohormonal responses to cholecystokinin tetrapeptide: A comparison of younger and older healthy subjects,"We recently found that, compared with younger healthy subjects, older healthy subjects had less symptomatic and cardiovascular response to the panicogenic agent cholecystokinin tetrapeptide (CCK-4). As an exploratory part of that study, we also evaluated the effect of aging on neurohormonal responses to CCK-4. These hormonal data are the focus of this article. Forty healthy volunteers aged 20-35 years and 40 healthy volunteers aged 65-81 years, divided equally between men and women, were compared on their hormonal responses (maximum change from baseline in growth hormone [GH], prolactin, adrenocorticotropic hormone [ACTH], and cortisol) to the intravenous administration of 50 μg of CCK-4 or placebo. Blood samples for serum hormone determination were collected at 2 minutes prior to the intravenous challenge (baseline) and at 2, 5, and 10 minutes after the challenge. In both age groups, maximum increase in prolactin, ACTH and cortisol was significantly greater with CCK-4 than with placebo. Following administration of CCK-4, younger and older groups did not significantly differ in maximum increase in prolactin, ACTH, or cortisol. Older subjects had a statistically significant smaller increase in GH compared with younger subjects but the magnitude of the difference was small and of doubtful clinical relevance. Older subjects who had a panic attack had significantly greater elevations of all hormones compared with those who did not panic and younger panickers had a significantly greater elevation of GH compared with young nonpanickers. For the most part, maximum changes in hormonal levels were not correlated with symptom severity, suggesting that other factors may have contributed to the differential effect of panic on the HPA axis. Copyright (C) 2000 Elsevier Science Ltd.",Flint A.J.; Koszycki D.; Bradwejn J.; Vaccarino F.J.,2000.0,10.1016/S0306-4530(00)00015-9,0,0,
6642,Mental health in medical students. A case control study using the 60 item general health questionnaire,"This paper describes a cross-sectional case control study to measure the prevalence of psychological morbidity in first year medical students and compare it to the prevalence in a randomly selected control group of other first year students at Edinburgh University. The study was conducted anonymously using the 60 item General Health Questionnaire. Participation rates were over 90% in both subjects and controls. A total of 17% of medical students had symptoms of psychological morbidity which may benefit from treatment and a further 29% of medical students had symptoms of psychological distress which would be expected to remit spontaneously. A similar rate was found in the control group of students. This suggests that if medical students or doctors, later in their careers, fare badly in terms of mental health then this may well be related to aspects of their lives and is not an intrinsic characteristic.",Carson A.J.; Dias S.; Johnston A.; McLoughlin M.A.; O'Connor M.; Robinson B.L.; Sellar R.S.; Trewavas J.J.C.; Wojcik W.,2000.0,,0,0,
6643,Ambulatory blood pressure and marital distress in employed women,"In this investigation, the relationship between marital distress and blood pressure during daily life in a sample of married employed women was examined. It was hypothesized that greater marital distress would be associated with elevated blood pressure in the home environment, but not in the workplace. Participants were 50 married employed women, aged 25 to 45 years. Participants underwent ambulatory blood pressure monitoring on a typical workday. The women with higher levels of marital distress exhibited greater negative emotions and higher levels of blood pressure at home. These results suggest that the physiological concomitants of stress and emotional upset associated with marital distress are manifest in elevated blood pressure that is most pronounced in the home environment.",Carels R.A.; Sherwood A.; Szczepanski R.; Blumenthal J.A.,2000.0,,0,0,
6644,Effect of pre- or post-traumatically applied i.v. lidocaine on primary and secondary hyperalgesia after experimental heat trauma in humans,"Hyperalgesia on intradermal capsaicin application can be attenuated by systemic application of local anesthetics. We tested whether low doses of local anesthetics applied pre- or post-traumatically can reduce heat trauma-induced primary and secondary hyperalgesia in humans. Six healthy volunteers consented to the randomized, double-blind, and cross-over designed study. In each subject, a first-degree burn injury was induced three times (corresponding to a pre-traumatic, post-traumatic and control group) at an interval of at least 3 weeks. Heat was applied by a computer-controlled Peltier thermode (47°C, 5 min). In the pre-traumatic group, lidocaine infusion was commenced 30 min prior to heat trauma, and in the post-traumatic group immediately after heat trauma for a total infusion time of 60 min each. Volunteers rated pain on a visual analogue scale (VAS) between threshold and tolerance maximum (0-100% VAS). Primary hyperalgesia was quantified by determining mechanical (von Frey hairs) and thermal (Peltier thermode) pain thresholds. Secondary hyperalgesia was quantified by determining the area in which normally unpleasant von Frey hairs evoked pain or tenderness. Baseline thermal and mechanical pain thresholds did not differ between groups. Heat application always resulted in a first-degree burn injury including both primary and secondary hyperalgesia. The former remained by and large stable for about 4 h whereas the latter continuously increased within the first 2 h. Lidocaine did not affect primary hyperalgesia, irrespective of pre- or post-traumatic application, but substantially reduced the development of secondary hyperalgesia on pre-traumatic, and for tendency on post-traumatic infusion (treatment groups did not differ significantly). Burn injury-induced erythema was smallest in the pre-traumatic group and largest in the control group; however, the level of significance was not reached. Plasma concentrations of lidocaine were always higher than 1.5 μg/ml 30 min after bolus application of lidocaine and reached a peak of 2-3 μg/ml after about 1 h. Thus, local anesthetics at concentrations that do not block nerve conduction substantially affect ongoing central changes in pain processing that are induced by a real tissue trauma. A significant preemptive effect could not be demonstrated. The anti-hyperalgesic effect of lidocaine is likely based on action of central (spinal) sites, but peripheral sites may also be addressed. Copyright (C) 2000 International Association for the Study of Pain.",Holthusen H.; Irsfeld S.; Lipfert P.,2000.0,10.1016/S0304-3959(00)00338-9,0,0,
6645,Lifetime prevalence of trauma among homeless people in Sydney,"Objective. The experience of lifetime trauma among homeless women in the USA is well documented. Less information is available concerning homeless men. There are no prevalence studies concerning lifetime trauma among homeless people in Australia. Our aim was to assess the lifetime prevalence of trauma as reported by homeless men and women in Sydney. Method. We interviewed 119 men and 38 women who were visiting or residing at the seven largest refuges for homeless people in inner Sydney, using the lifetime trauma section of the Composite International Diagnostic Interview. Results. All women and over 90% of men reported at least one event of trauma in their life. Fifty-eight per cent suffered serious physical assault and 55% witnessed someone being badly injured or killed. Half the women and 10% of men reported that they had been raped. Conclusion. The experience of at least one lifetime event of trauma is almost universal among homeless people in Sydney and is considerably higher than for the USA general population. Reasons for such high prevalence rates are discussed. Depression and posttraumatic stress disorder are associated with a history of trauma. Health professionals need to be aware of past events of trauma among individuals who are homeless.",Buhrich N.; Hodder T.; Teesson M.,2000.0,10.1046/j.1440-1614.2000.00835.x,0,0,
6646,Medical-care costs associated with posttraumatic stress disorder in Vietnam veterans,"Objective. This study examined the relationship between medical-care costs of Vietnam veterans and predictor factors, including posttraumatic stress disorder (PTSD). Method. We merged medical-care cost data from the Department of Veterans' Affairs and the Health Insurance Commission with data from an epidemiological study of 641 Australian Vietnam veterans. Posttraumatic stress disorder and other factors were examined as predictors of medical-care cost using regression analysis. Results. We found that a diagnosis of PTSD was associated with medical costs 60% higher than average. Those costs appeared to be partly associated with higher treatment costs for physical conditions in those with PTSD and also related mental health comorbidities. Major predictors of medical-care cost were age ($137 per year for each 5-year increase in age) and number of diagnoses reported ($81 to $112 per year for each diagnosis). Mental health factors such as depression ($14 per year for each symptom reported) and anxiety ($27 per year for each symptom reported) were also important predictors. Conclusions. The findings indicate that, however they are incurred, high health-care and, presumably, also economic and personal costs are associated with PTSD. There is an important social obligation as well as substantial economic reasons to deal with these problems. From both perspectives, continued efforts to identify and implement effective prevention and treatment programs are warranted.",Marshall R.P.; Jorm A.F.; Grayson D.A.; O'Toole B.I.,2000.0,10.1046/j.1440-1614.2000.00831.x,0,0,
6647,Dose response of arginine vasopressin to the CCK-B agonist pentagastrin,"Cholecystokinin (CCK) is a peptide neurotransmitter that modulates hypothalamic-pituitary-adrenal (HPA) axis activity and may be involved in fear or anxiety states. Arginine vasopressin (AVP) also modulates HPA axis activity and may play a role in fear conditioning. Few human studies have examined interactions between CCK and AVP systems. To explore relationships between CCK-B receptor activation, the HPA axis response, and AVP release, a dose-response study using the CCK-B receptor agonist pentagastrin was conducted. Adrenocorticotropin (ACTH) and cortisol results have been previously reported and AVP data is presented here. Thirty-five healthy subjects were randomly assigned to receive placebo, or 0.2, 0.4, 0.6, or 0.8 μg/kg doses of pentagastrin. AVP release appeared to increase with increasing doses of the CCK-B agonist. However, this may have been due to a greater percentage of subjects releasing AVP in the higher dose groups, rather than a direct effect of dose on magnitude of response. AVP and ACTH responses were correlated, but AVP response alone could not account for the magnitude of the ACTH response. AVP release was significantly correlated with anxiety symptom responses. These findings suggest a possible role for the CCK-B receptor in AVP release, which may be at least partially separate from its role in modulation of the HPA axis. Further work is needed to determine whether these are physiologically meaningful interactions and to determine their functional implications. Copyright (C) 2000 American College of Neuropsychopharmacology.",Abelson J.L.; Le Mellédo J.-M.; Bichet D.G.,2001.0,10.1016/S0893-133X(00)00182-2,0,0,
6648,Startle reactivity and PTSD symptoms in a community sample of women,"Exaggerated startle and PTSD symptoms have been investigated primarily in relation to acute or Type I stressors. The present study examined PTSD symptoms and startle eyeblink response in relation to chronic or Type II stressors. Type II stressors were operationally defined as high levels of childhood corporal punishment and high levels of current partner aggression. This study recruited a sample of 52 women from a metropolitan community and administered several questionnaires assessing experience of corporal punishment in childhood, current intimate partner aggression and level of PTSD symptoms. Following questionnaires, women were presented with eight auditory startle probes (white noise). Results showed that both childhood corporal punishment and intimate partner aggression were associated with women's PTSD symptom scores. However, only PTSD symptom scores were associated with reduced startle. Results are discussed in light of Type I and Type II stressors, and recent suggestions in the PTSD literature that a subgroup of individuals may experience physiological suppression rather than heightened physiological reactivity. © 2001 Elsevier Science Ireland Ltd.",Medina A.M.; Mejia V.Y.; Schell A.M.; Dawson M.E.; Margolin G.,2001.0,10.1016/S0165-1781(01)00221-9,0,0,
6649,Prevalence of concern about physical appearance in the general population,"Using information gathered in the introductory sections of the Derriford Appearance Scales (DAS24 and DAS59), the prevalence and epidemiological characteristics of concern about physical appearance have been determined for a carefully constructed sample of the general population of southwest Devon (rural and urban). In all, 2108 usable replies were received from a postal survey of a targeted population of 5400 men and women, aged 18 and over and randomly selected with constraints for age, sex and socio-economic status. The prevalence of concern about physical appearance was highest among women through to age 60 and younger men. There was no association with socio-economic status or living status. Concerns about the nose, weight and skin disorders were reported most frequently by both men and women and additionally concerns about breasts and abdomen were reported by women and premature balding by men. The mean DAS24 and DAS59 full-scale scores of 19% of male and 25% of female responders who were concerned about appearance exceeded the mean scores of preoperative patients undergoing reconstructive and cosmetic plastic surgery. Concern about appearance is widespread in the general population. More often than not, concern, is about one feature only, which runs counter to the hypothesis that concern about appearance reflects a neurotic trait. The high levels of measured psychological distress and dysfunction found in a substantial minority of those in the general population who are concerned about appearance highlight the need for appropriate services. © 2001 The British Association of Plastic Surgeons.",Harris D.L.; Carr A.T.,2001.0,10.1054/bjps.2001.3550,0,0,
6650,The relationship of sociotropy and autonomy to symptoms of depression and anxiety,"Beck (1983) hypothesized that excessive interpersonal (sociotropy) and achievement (autonomy) concerns represent vulnerabilities to depression when congruent negative life events occur and that these personality constructs relate differentially to specific depressive symptoms. Recent research suggests that sociotropy relates to both depression and anxiety symptoms while autonomy may be specifically related to depression symptoms. This study employed a longitudinal, prospective design with a sample of 78 undergraduates to test aspects of Beck's (1983) hypotheses. Sociotropy correlated with anxiety symptoms while autonomy correlated with depression symptoms. Additionally, sociotropy moderated the relationship of life stress to depression symptoms for both negative interpersonal and achievement stress while autonomy moderated the relationship of life stress to depression symptoms for negative interpersonal events only. Finally, sociotropy and autonomy also moderated the relationship between life stress and anxiety symptoms in a pattern that was different from the pattern with depression symptoms. Findings from the present study add to a growing body of empirical evidence that sociotropy and autonomy relate to depression and introduce evidence indicating how these constructs may relate to anxiety.",Fresco D.M.; Sampson W.S.; Craighead L.W.; Koons A.N.,2001.0,,0,0,
6651,Quantitative analysis of spinal CSF dynamics using magnetic resonance imaging: Experimental and clinical studies,"Purpose: Measurement of the oscillating CSF flow in the spinal canal (SC) of healthy volunteers and in patients with post-traumatic syringomyelia (PTS) using an optimized MRI protocol as well as to determine whether stenosis induced velocity changes are detectable using MRI. Methods: In 68 healthy volunteers quantitative studies of CSF flow in the cervical, thoracic, and lumbar regions were performed. First, an optimized sequence was developed and tested in 19 volunteers using four different flow-encoding velocities (4, 8, 12, 16 cm/s). Secondly, the optimized sequence was employed in 49 volunteers to measure the different CSF patterns in the cervical, thoracic, and lumbar spinal canals (CSC, TSC, LSC). Part three of the study, in which patients with PTS are being examined is still underway. We measured the maximum velocity (cm/s), the pixel area (mm2), and the stroke volume (ml/s). Using a flow model the velocities prior to and after compression with 5 different power levels were measured at the stenosis and at a distance of 70 cm. Results: A total of 226 dynamic measurements have been performed - so far 76 in the first part (62 = 81.5% evaluable) and 150 in the second part - using the optimized sequence and optimal flow velocities. A flow-encoding sequence of 12 cm/s was found best in the CSC and one of 6 cm/s in the TSC and LSC. The maximum velocity in the CSC was 0.95 cm/s with the flow being directed caudal and 0.38 cm/s with the flow being directed cranial. In the TSC the values were 4.7 cm/s and 1.65 cm/s and in the LSC 0.96 cm/s and 0.59 cm/s. The highest velocities were found at the TSC, which has the smallest diameter compared to the CSC and LSC. In the 4 patients with PTS, the maximum velocities were between 0.09 cm/s and 0.97 cm/s with the flow being directed cranial and between 0.04 cm/s and 1.03 cm/s with the flow being directed caudal. The stroke volumina in the CSC were between 0.1 and 1.23 ml/s (mean: 0.48 ml/s) and 0.2 and 2.45 ml/s (mean: 0.66 ml/s) in the TSC and in the LSC 0.08 ml/s and 0.67 ml/s (mean: 0.29 ml/s). The results of the flow model studies showed an increase of velocity between 2.06 and 4.94 cm/s (mean: 3.31 cm/s) at the stenosis and 1.1 and 1.33 cm/s (mean: 1.23 cm/s) at a distance of 70 cm. Conclusion: Quantitative measurement of the oscillating CSF flow in the entire spinal canal (SC) is possible using an optimized MRI protocol as well as to detect stenosis induced velocity changes. Due to the high interindividual variability in the data of spinal CSF dynamics, further studies are necessary to collect normal data. The detection of movement of CSF in a post-traumatic spinal cord lesion may alter the therapeutic management.",Freund M.; Adwan M.; Kooijman H.; Heiland S.; Thomsen M.; Hähnel S.; Jensen K.; Gerner H.J.; Sartor K.,2001.0,10.1055/s-2001-12463,0,0,
6652,Cognitive bias in panic disorder: A process dissociation approach to automaticity,"We applied a variant of Jacoby's (1991) process dissociation procedure to parse the relative contributions of automatic and controlled processes to word-stem completion performance involving threatening, positive, and neutral material in patients with panic disorder and healthy control participants. Contrary to prediction, processing of threatening (relative to nonthreatening) information in panic disorder was not disproportionately influenced by automatic processing. We found limited evidence, however, that panic patients exhibit a baseline bias for completing stems relevant to threat relative to nonthreat stems, perhaps indicating a proneness to engage in self-generated priming of threat material.",McNally R.J.; Otto M.W.; Hornig C.D.; Deckersbach T.,2001.0,10.1023/A:1010740617762,0,0,
6653,Clinical research in palliative care: Choice of trial design,,Mazzocato C.; Sweeney C.; Bruera E.,2001.0,10.1191/026921601678576275,0,0,
6654,Response to pentagastrin after acute phenylalanine and tyrosine depletion in healthy men: A pilot study,"Objective: To assess the effects of the acute depletion of the catecholamine precursors phenylalanine and tyrosine on mood and pentagastrin-induced anxiety. Design: Randomized, double-blind controlled multiple crossover study. Setting: University department of psychiatry. Participants: 6 healthy male volunteers. Interventions: 3 treatments were compared: pretreatment with a nutritionally balanced amino acid mixture, followed 5 hours later by a bolus injection of normal saline placebo; pretreatment with a balanced amino acid mixture, followed by a bolus injection of pentagastrin (0.6 μg/kg); and pretreatment with an amino acid mixture without the catecholamine precursors phenylalanine or tyrosine, followed by pentagastrin (0.6 μg/kg). Outcome measures: Scores on the panic symptom scale, a visual analogue scale for anxiety, the Borg scale of respiratory exertion and the Profile of Mood States Elation-Depression Scale. Results: Pentagastrin produced the expected increases in anxiety symptoms, but there was no significant or discernible influence of acute phenylalanine and tyrosine depletion on anxiety or mood. Conclusions: These pilot data do not support further study using the same design in healthy men. Under these study conditions, phenylalanine and tyrosine depletion may have larger effects on dopamine than noradrenaline. Alternative protocols to assess the role of catecholamines in mood and anxiety are proposed.",Coupland N.; Zedkova L.; Sanghera G.; Leyton M.; Le Mellédo J.-M.,2001.0,,0,0,
6655,Worry: Daily self-report in clinical and non-clinical populations,"The present study establishes an ecologically-valid point of reference for generalized anxiety disorder (GAD) treatment outcome studies. Although worry is the main diagnostic criterion for GAD, it is also a common and everyday cognition. Few studies have investigated the normal manifestation of worry in a non-clinical population. For this research, time spent worrying and the tendency to worry were measured in a non-clinical sample (n=36), where GAD was screened-out, and results were compared to those obtained from a GAD sample (n=60). Participants recorded the time spent worrying in self-monitoring notebooks for two consecutive weeks and completed the French version of the Penn State Worry Questionnaire (PSWQ). It was found that the non-GAD group reported less time spent worrying on a daily basis as well as a lower tendency to worry than the GAD group. Results are discussed in terms of treatment implications. Copyright © 2001 Elsevier Science Ltd.",Dupuy J.-B.; Beaudoin S.; Rhéaume J.; Ladouceur R.; Dugas M.J.,2001.0,10.1016/S0005-7967(01)00011-0,0,0,
6656,Normative studies with the Scale for Interpersonal Behaviour (SIB): II. US students. A cross-cultural comparison with Dutch data,"The Scale for Interpersonal Behaviour (SIB), a multidimensional, self-report measure of state assertiveness, was administered to a nationwide sample of 2375 undergraduates enrolled at 11 colleges and universities across the USA. The SIB was developed in the Netherlands for the independent assessment of both distress associated with self-assertion in a variety of social situations and the likelihood of engaging in a specific assertive response. This is done with four factorially-derived, first-order dimensions: (i) Display of negative feelings (Negative assertion); (ii) Expression of and dealing with personal limitations; (iii) Initiating assertiveness; and (iv) Praising others and the ability to deal with compliments/praise of others (Positive assertion). The present study was designed to determine the cross-national invariance of the original Dutch factors and the construct validity of the corresponding dimensions. It also set out to develop norms for a nationwide sample of US students. The results provide further support for the reliability, factorial and construct validity of the SIB. Compared to their Dutch equivalents, US students had meaningfully higher distress in assertiveness scores on all SIB scales (medium to large effect sizes), whereas differences on the performance scales reflected small effect sizes. The cross-national differences in distress scores were hypothesized to have originated from the American culture being more socially demanding with respect to interpersonal competence than the Dutch, and from the perceived threats and related cognitive appraisals that are associated with such demands. Copyright © 2001 Elsevier Science Ltd.",Arrindell W.A.; Bridges K.Robert; Van der Ende J.; St. Lawrence J.S.; Gray-Shellberg L.; Harnish R.; Rogers R.; Sanderman R.,2001.0,10.1016/S0005-7967(01)00009-2,0,0,
6657,Effect of public speaking on gastric myoelectrical reactivity and parasympathetic cardiac control,"Gastrointestinal reactivity is a central concept in several psychosomatic approaches to peptic ulcer disease and irritable bowel disease. One potential limitation of many laboratory studies of gastrointestinal reactivity is their reliance on non-ecological tasks lacking components of social stressors which may better relate to day to day stress. Otherwise, the public speaking task is a well known stressful procedure and has a high degree of ecological validity. Stress reactions induced by preparation for public speaking are the result of both the cognitive demand of preparing a speech and social anxiety. The aim of this study was to observe the effect of the public speaking test on the electrogastric activity and the relationship between gastric myoelectrical activity and cardiac activity prior to and after the task. In particular, we hypothesized that public speaking would reduce the amplitude of the normal 3 c.p.m. band and that this decrease would be positively correlated with a reduction in respiratory sinus arrhythmia. As expected, the anticipation of public speaking triggered a decrease in respiratory sinus arrhythmia, an increase in heart rate, and higher skin conductance level compared to baseline. On the other hand, our measure of gastric myoelectrical activity was not affected by the public speaking task. Copyright © 2001 John Wiley & Sons, Ltd.",Codispoti M.; Mazzetti M.; Baldaro B.; Tuozzi G.; Trombini G.,2001.0,10.1002/smi.911,0,0,
6658,Adaptive and maladaptive perfectionism in medical students: A longitudinal investigation,"Objectives: The personality of medical students may have an important impact on both their academic performance and emotional adjustment during medical school. There has been little systematic study of the impact of perfectionism on medical students. The present study sought to compare the perfectionism profile of medical students with that of a general arts student group and to examine the relationship among perfectionism, distress symptoms and academic expectations and satisfaction. Design: Medical students (n = 96) and arts students (n = 289) completed a baseline assessment including two multidimensional perfectionism scales. The medical students also completed measures of distress symptoms, personality (neuroticism, conscientiousness) and questions about their perceptions of their academic performance. Of the medical students, 58 completed a second set of questionnaires 6 months later (time 2). Subjects: First-, second- and third year medical students and first-year arts students. Results: In comparison with arts students, the perfectionism profile of medical students showed higher personal standards, lower doubts about actions and lower maladaptive perfectionism scores. In the medical students adaptive perfectionism (achievement striving) was significantly correlated with baseline academic performance expectations and conscientiousness and was predictive of dissatisfaction with academic performance at time 2. Maladaptive perfectionism (excessive evaluative concerns) was significantly correlated with baseline distress symptoms and neuroticism and was predictive of symptoms of depression and hopelessness at time 2. Conclusions: Perfectionism in medical students differs systematically from perfectionism in general arts students. Distinguishing adaptive and maladaptive aspects of perfectionism is important in understanding the cross-sectional and longitudinal implications of perfectionism for medical students.",Enns M.W.; Cox B.J.; Sareen J.; Freeman P.,2001.0,10.1046/j.1365-2923.2001.01044.x,0,0,
6659,Clomipramine- Beyond separation anxiety,,Landsberg G.M.,2001.0,,0,0,
6660,Snake fear and the pictorial emotional stroop paradigm,"The purpose of this study was to test a novel pictorial emotional Stroop paradigm that required participants to name the colors of filtered images on a computer screen. High (n = 20) and low (n = 20) snake-fearful participants color-named filters covering images of snakes (threat), cows (neutral), bunnies (positive), and blank screens. Each image appeared as if viewed through tinted sunglasses. The results revealed that both groups took longer to name the colors of filters covering bunnies as well as snakes relative to filters covering cows. Intensely snake-fearful individuals (n = 5), however, exhibited additional interference for snake pictures beyond that evoked by bunny pictures. Thus, pictorial cues having positive as well as negative emotional valence disproportionately captured attention. This paradigm shows promise as a nonlexical, ecologically valid approach to evaluating selective processing of emotional cues.",Constantine R.; McNally R.J.; Hornig C.D.,2001.0,10.1023/A:1012923507617,0,0,
6661,A randomized controlled trial of cognitive therapy versus intensive behavior therapy in obsessive compulsive disorder,"Background: The study was designed to compare cognitive therapy (CT) with intensive behavior therapy (BT) in obsessive-compulsive disorder (OCD) and to study their change process. Methods: Sixty-five outpatients with DSM-4 OCD were randomized into 2 groups for 16 weeks of individual treatment in 3 centers. Group 1 received 20 sessions of CT. Group 2 received a BT program of 20 h in two phases: 4 weeks of intensive treatment (16 h), and 12 weeks of maintenance sessions (4 h). No medication was prescribed. Results: Sixty-two patients were evaluated at week 4, 60 at week 16 (post-test), 53 at week 26 and 48 at week 52 (follow-up). The response rate was similar in the 2 groups. The Beck Depression Inventory (BDI) was significantly more improved by CT (p = 0.001) at week 16. The baseline BDI and Obsessive Thoughts Checklist scores predicted a therapeutic response in CT, while the baseline BDI score predicted a response in BT. At week 16, only the changes in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and a scale measuring the interpretation of intrusive thoughts correlated in CT, while the changes in Y-BOCS, BDI, and interpretation of intrusive thoughts correlated in BT. Improvement was retained at follow-up without a between-group difference. The intent-to-treat analysis (last observation carried forward) found no between-group differences on obsessions, rituals and depression. Conclusions: CT and BT were equally effective on OCD, but at post-test CT had specific effects on depression which were stronger than those of BT. Pathways to improvement may be different in CT and BT. The outcomes are discussed in the light of an effect size analysis. Copyright © 2001 S. Karger AG, Basel.",Cottraux J.; Note I.; Yao S.N.; Lafont S.; Note B.; Mollard E.; Bouvard M.; Sauteraud A.; Bourgeois M.; Dartigues J.-F.,2001.0,10.1159/000056269,0,0,
6662,Carols in the wind,"Aim: To compare mood and emotional responses to music played on pipe organs and pipeless (digital) organs. Design: A two-organ (pipe v. digital) crossover study. Setting: St Theodore's Anglican Church, Adelaide. Subjects: 43 non-musician volunteers. Main outcome measures: Changes in mood and emotions measured by the Profile of Mood States. Results: Both instruments produced significant reductions in the emotions commonly experienced during the Christmas season: tension-anxiety, depression-rejection, anger-hostility and fatigue. There were no significant changes for vigour or confusion-bewilderment, and no significant differences between the mood-altering effects of the two instruments. Conclusions: Pipeless organs are as effective as pipe organs in inducing beneficial mood changes.",Marley J.E.; Searle P.; Chamberlain N.L.; Turnbull D.R.; Leahy C.M.,2001.0,,0,0,
6663,Alternative splicing and neuritic mRNA translocation under long-term neuronal hypersensitivity,"To explore neuronal mechanisms underlying long-term consequences of stress, we studied stress-induced changes in the neuritic translocation of acetylcholinesterase (AChE) splice variants. Under normal conditions, we found the synaptic AChE-S mRNA and protein in neurites. Corticosterone, anticholinesterases, and forced swim, each facilitated a rapid (minutes), yet long-lasting (weeks), shift from AChE-S to the normally rare AChE-R mRNA, promoted AChE-R mRNA translocation into neurites, and induced enzyme secretion. Weeks after stress, electrophysiological measurements in hippocampus slices displayed apparently normal evoked synaptic responses but extreme hypersensitivity to both anticholinesterases and atropine. Our findings suggest that neuronal hypersensitivity under stress involves neuritic replacement of AChE-S with AChE-R.",Meshorer E.; Erb C.; Gazit R.; Pavlovsky L.; Kaufer D.; Friedman A.; Glick D.; Ben-Arie N.; Soreq H.,2002.0,10.1126/science.1066752,0,0,
6664,Senior house officers' experience of a six month post in a hospice,"Background: Hospices provide care for patients with a terminal prognosis - a very small number of hospices employ Senior House Officers. Method: A survey was carried out to determine the experiences of SHOs working in hospices and their perceptions of the learning opportunities available. Perceived stress was measured by a Visual Analogue scale and psychological distress by the GHQ 12. Results: Of the 38 posts identified 23 SHOs (60%) responded and the majority had qualified during the last five years. Formal teaching was limited, but experiential teaching was very positively described. Many SHOs described their posts as stressful and cited staff conflict and caring for young patients as particularly stressful. Median stress scores as measured on the VAS was 55 mm (range 0-98 mm). Five respondents 22% scored for identifiable psychological distress on the GHQ 12. Conclusion: Conclusions include the need to acknowledge the important learning opportunities provided within hospices but also the need for consultant staff to be aware of the sources of stress for SHOs and their need for support.",Lloyd-Williams M.,2002.0,10.1046/j.1365-2923.2002.01103.x,0,0,
6665,Increased thymidylate synthase mRNA concentration in blood leukocytes following an experimental stressor,"Background: While it is well documented that immune responses, e.g. proliferative responses, can be influenced by psychosocial factors, e.g. stress, less is known about the biological mechanisms mediating such influences. The aim of the present investigation was to study the effect of an experimental stressor on mRNA levels in peripheral blood leukocytes of thymidylate synthase (TS), a gene necessary for cell division, while investigating possible individual differences in stress reactivity. Methods: Fifteen healthy subjects were investigated under three experimental conditions: (1) exposure to a computerized mental stressor; (2) relaxation, and (3) control. Measurements included TS mRNA levels, total leukocyte number, leukocyte subtypes, and serum cortisol before (baseline), immediately after, and 1 h after each experimental condition. Results: While no significant differences were found between experimental conditions at baseline in cortisol (p = 0.9) or TS mRNA levels (p = 0.1), significantly higher TS mRNA expression was found immediately after stress compared to pre-treatment levels (p < 0.02). Changes in cortisol levels indicated an effect of the experimental stressor, with higher cortisol levels seen immediately after stress as compared to both relaxation (p < 0.01) and control (p < 0.01). Subjects who scored above the median on the Tellegen Absorption Scale showed significantly (p < 0.05) greater increases in cortisol and percentage of lymphocytes and significantly greater decreases in percentage of neutrophil cells after stress. Conclusion: The results suggest that TS mRNA levels in peripheral leukocytes may be sensitive to mental stress and confirm previous findings indicating that subjects scoring high on the personality trait of absorption exhibit greater physiological stress reactivity. Copyright © 2002 S. Karger AG, Basel.",Ehrnrooth E.; Zacharia R.; Svendsen G.; Jørgensen M.M.; Yishay M.; Sørensen B.S.; Hjelm Poulsen J.; Von Der Maase H.,2002.0,10.1159/000049352,0,0,
6666,"Eleutherococcus senticosus reduces cardiovascular stress response in healthy subjects: A randomized, placebo-controlled trial","The number of studies devoted to the scientific evaluation of phytotherapy is rapidly increasing since Western patients seem more oriented towards so-called 'alternative medicine'. Bearing such arguments in mind we decided to address attention to Eleutherococcus senticosus, a root of the Ginseng family known for thousands of years in China as a remedy for psychological distress. Forty-five paid, healthy volunteers (20 males, 25 females) were recruited. Entry criteria were: good health, age 18-30 years, student and a Symptoms Rating Test score <10. At screening evaluation subjects were randomized to receive orally either placebo (Pl group) or Eleutherococcus senticosus (Es group) for 30 days, in a double-blind design. Subjects were submitted to a stressful cognitive task, the Stroop Colour-Word test (Stroop CW), both before and after treatment. Stroop CW increased heart rate (HR) and systolic BP in every subject. In females there was a greater response than in males in terms of both systolic and diastolic BP. For both genders, the HR response to Stroop CW was reduced by Es treatment while no changes were found after Pl. In females, systolic BP was also reduced in Es group while it remained unchanged in Pl group. This study demonstrated that treatment with Eleutherococcus senticosus is able to reduce cardiovascular responses to stress in healthy young volunteers, while placebo was ineffective. Eleutherococcus senticosus is confirmed to be helpful for stress adaptation. Copyright © 2002 John Wiley & Sons, Ltd.",Facchinetti F.; Neri I.; Tarabusi M.,2002.0,10.1002/smi.914,0,0,
6667,Behavioural effects of acute phenylalanine and tyrosine depletion in healthy male volunteers,"Acute phenylalanine and tyrosine depletion (APTD) studies have been used to assess the role of the cathecholaminergic system in various aspects of human behaviour. In this study we conducted a randomized, double-blind, controlled and cross-over comparison to evaluate the effects of APTD on memory, attention and mood in normal subjects. Twelve healthy male volunteers were included in this study. The subjects ingested a nutritionally balanced mixture (B) or a similar mixture deficient in phenylalanine and tyrosine (PT-). Before and 5 h after ingestion of the drink, volunteers underwent tests on mood, memory and attention. Results of the memory tests-showed that PT- mixture impaired word recall as measured in Rey's test (p = 0.016). The assessment of changes in mood showed that the balanced mixture improved scores of as alertness (VAMS factor I, p = 0.037) and the PT- mixture induces an opposite effect, increased scores of anxiety (Profiles of Mental State composed-anxious dimension, p = 0.022). These results suggest that tyrosine plasma levels and cathecholamines may be important factors in regulating mood and memory.",Grevet E.H.; Tietzmann M.R.; Shansis F.M.; Hastenflug C.; Santana L.C.; Forster L.; Kapczinski F.; Izquierdo I.,2002.0,,0,0,
6668,"Gender differences in anxiety: An investigation of the symptoms, cognitions, and sensitivity towards anxiety in a nonclinical population","Past research has demonstrated that anxiety disorders represent a significant mental health concern. A review of the literature in the area indicates that there is limited information regarding gender differences on the basis of cognitions in clinical or nonclinical samples. The current investigation sought to determine whether any observable gender differences existed in the expression of symptoms, cognitions, and anxiety sensitivity for a nonclinical sample of 48 males and 49 females. Multivariate analyses of variance revealed support for gender differences in the expression of physiological hyperarousal, catastrophic cognitions and a general level of anxiety sensitivity in a nonclinical population. The strengths, limitations, and directions for future research are discussed.",Armstrong K.A.; Khawaja N.G.,2002.0,10.1017/S1352465802002114,0,0,
6669,Conscious mechanisms of memory control,,,2002.0,10.1177/1073858402008003002,0,0,
6670,S-Enantiomer of citalopram launched,,,2002.0,,0,0,
6671,Perceived control over anxiety-related events as a predictor of pain behaviors in a cold pressor task,"The extent to which perceived control over anxiety-related events contributes to the experience of pain was investigated. It was hypothesized that perceived control over anxiety-related events would predict pain behaviors induced via a cold pressor task because perceived control may alter the meaning of a pain-inducing stimulus. Eighty undergraduate students completed the Anxiety Control Questionnaire, Pain Anxiety Symptoms Scale, State-Trait Anxiety Inventory, and Penn State Worry Questionnaire. Heart rate was assessed prior to hand immersion. Participants then immersed their dominant hand in ice water and rated pain intensity at their pain threshold and tolerance times. Results indicate that perceived control over anxiety-related events predicts pain tolerance and endurance (i.e., overt pain response) but not pain intensity, threshold, or heart rate. It appears that the psychological process variable of perceived control over anxiety-related events uniquely influences participants' ability to cope with the experience of pain by altering the perceived threat of the acute pain induced via a cold pressor task. © 2002 Elsevier Science Ltd. All rights reserved.",Feldner M.T.; Hekmat H.,2002.0,10.1016/S0005-7916(01)00034-9,0,0,
6672,Positive and negative schizotypy in a student sample: Neurocognitive and clinical correlates,"Positive and negative schizotypy may represent discrete factors or dimensions. To determine if distinct neurocognitive profiles are associated with these dimensions or factors, we classified university students on the basis of positive and negative schizotypal symptoms and conducted separate analyses. Following prior work in the neuropsychiatric literature, we predicted that subtle prefrontal deficits would be selectively associated with negative schizotypal personality features in a nonclinical student sample. We also investigated the relationship between positive/negative schizotypy and associated clinical states or personality dimensions including antisocial personality disorder, obsessive-compulsive personality traits, generalized and social anxiety, empathy, and impulsivity. Classification of subjects into positive and negative schizotypy groups revealed distinct neurocognitive and clinical profiles. We observed a positive relation between measures of temporolimbic dysfunction, impulsivity, antisocial behavior, and positive schizotypal phenomena. Negative schizotypy was associated with subtle performance deficits on measures of frontal executive function, increased social anxiety, and obsessive-compulsive phenomena. Findings are consistent with the contention that positive and negative schizotypy represent discrete factors. © 2002 Elsevier Science B.V. All rights reserved.",Dinn W.M.; Harris C.L.; Aycicegi A.; Greene P.; Andover M.S.,2002.0,10.1016/S0920-9964(01)00230-4,0,0,
6673,The effects of alcohol and anxiousness on physiological and subjective responses to a social stressor in women,"Several studies have examined the validity of the tension reduction hypothesis as an explanatory model for the development of alcohol problems, but support has been inconsistent. In recent years, researchers have begun to examine how various individual differences variables moderate the relationship between alcohol consumption and reduction of anxiety. The present study examined how 40 women, either moderate or low in anxiety sensitivity (AS), responded to a social stressor (giving a body image speech) after consuming either a low dose of alcohol (0.4 ml/kg of body weight) or a placebo. Results indicated that of the participants reporting moderate AS, participants consuming alcohol reported more stress dampening as measured by heart rate in anticipation to the stressor than participants not consuming alcohol. Furthermore, of the participants consuming alcohol, those reporting high social anxiety reported more of an increase in heart rate than participants not consuming alcohol. Findings are discussed in terms of considering individual differences factors when examining predictions made from the tension reduction hypothesis. © 2002 Elsevier Science Ltd. All rights reserved.",Lewis B.A.; Vogeltanz-Holm N.D.,2002.0,10.1016/S0306-4603(01)00190-3,0,0,
6674,Microscopic localization of active gelatinases in equine osteochondritis dissecans (OCD) cartilage,"Objective: To investigate the relationship between matrix metalloproteinase (MMP) activity and osteochondritis dissecans (OCD) in the equine joint. Methods: Equine articular cartilage was obtained from normal (N=8) and osteochondrotic (OCD) (N=6) femoropatellar joints from horses at necropsy. The activity of gelatinase MMPs was determined in sections of cartilage by in situ gelatin zymography. Results: Gelatinase activity was markedly increased A articular cartilage obtained from OCD samples and was particularly prominent in the deep cartilage zone. Activity was only seen in the pericellular area of chondrocytes. In addition, in OCD cartilage there were vertical lines of activity starting from the deep zone and radiating towards the articular surface. In contrast, normal cartilage showed only a very small amount of gelatinolytic activity, which was not restricted to specific cartilage zones. Gelatin zymography of culture supernatants from isolated chondrocytes demonstrated increased production of MMP-2 and MMP-9 from OCD chondrocytes. ConclusiOns: Sections of articular cartilage from OCD lesions revealed MMP activity, especially in the deep zone adjacent to the calcified subchondral bone. This MMP activity could account for the loss of cartilage integrity in the deep cartilage zone and the vertical lines of activity could represent areas of mechanical weakness, likely to result in fissures and the release of cartilage fragments into the joint space. © 2002 OsteoArthritis Research Society International. Published by Elsevier Science Ltd All rights reserved.",Al-Hizab F.; Clegg P.D.; Thompson C.C.; Carter S.D.,2002.0,10.1053/joca.2002.0811,0,0,
6675,Acute cholecystokinin effects on event-related potentials in healthy volunteers,"This study investigated the effects of a continuous slow infusion of cholecystokinin tetrapeptide (CCK-4), a neuropeptide with panicogenic properties, on brain event-related potentials (ERPs) in healthy adults. Twenty-four volunteers, 15 females and 9 males, were assigned to infusion with either placebo or CCK-4 in a randomized, double-blind, parallel group design. ERPs, elicited within a standard auditory odd-ball paradigm requiring the counting of rare (20%) occurring 'deviant' tones interspersed among more frequent (80%) occurring 'standard' tones, were assessed once before infusion, and at 10 min and 40 min after the onset of infusion. Compared with the placebo, CCK-4 delayed the latencies of N100 and P200 components elicited by 'deviant' stimuli. No significant treatment differences were observed with respect to N200, P300b, mood or adverse symptoms. These preliminary findings suggest that CCK-4 may interfere with information processing relating to the selection of significant stimulating and as such, may be of relevance to mechanisms underlying panic disorder. Copyright © 2002 John Wiley & Sons, Ltd.",Knott V.J.; Mahoney C.; Gunnarsson T.; Bradwejn J.; Shlik J.,2002.0,10.1002/hup.417,0,0,
6676,"Anxiety sensitivity, cognitive biases, and the experience of pain","It is becoming increasingly apparent that the tendency to be fearful of anxiety-related sensations, known as anxiety sensitivity, is closely associated with pain experiences. The aim of the current study was to determine the mechanisms by which such a relationship exists. Selective attentional and interpretative biases for negative material were compared as potential mediators of the anxiety sensitivity-pain relationship. With the cold pressor task, the current study found that high anxiety sensitivity participants exhibited a greater interpretative bias and reported more negative pain experiences than those low in anxiety sensitivity. A negative interpretative bias was also related to higher affective pain experiences. Most important, however, was that the tendency to misinterpret innocuous bodily sensations related to panic was found to mediate the association between anxiety sensitivity and affective pain experiences. These findings not only confirm that anxiety sensitivity plays an important role in the perception of experimental pain but also identify a potential cognitive mechanism by which this relationship exists. © 2002 by the American Pain Society.",Keogh E.; Cochrane M.,2002.0,10.1054/jpai.2002.125182,0,0,
6677,Improved cosmesis in varicose vein surgery,,Badvie S.; Fearn S.J.; Nott D.M.,2002.0,,0,0,
6678,Carbon dioxide test in respiratory panic disorder subtype [4],,Nardi A.E.; Valença A.M.; Nascimento I.; Zin W.A.; Versiani M.,2002.0,,0,0,
6679,Different mechanisms of development and maintenance of experimental incision-induced hyperalgesia in human skin,"Background: To determine the mechanisms of postoperative pain, the effects of local anesthesia on development and maintenance of surgical incision-induced hyperalgesia were evaluated in a crossover, double-blinded, placebo-controlled human study using 17 subjects. Methods: An experimental 4-mm-long incision through skin, fascia, and muscle was made in the volar forearm of each subject. In experiment 1, 1% lidocaine or saline in a volume of 0.2 ml was subcutaneously injected into the incision site pretraumatically and posttraumatically. In experiment 2, a 5-cm-long strip of skin was subcutaneously injected with 0.2 ml of 1% lidocaine near the incision site pretraumatically and posttraumatically. Flare, spontaneous pain, and primary and secondary hyperalgesia to punctate mechanical stimuli were assessed after the incision had been made. Results: Pretraumatic lidocaine injection prevented the occurrence of spontaneous pain and development of flare formation that was found surrounding the incision site immediately (1 min) after the incision had been made. The lidocaine suppressed primary hyperalgesia more effectively than did posttraumatic block, but only for the first 4 h after the incision. The preincision block prevented development of secondary hyperalgesia, whereas posttraumatic block did not significantly affect the fully developed secondary hyperalgesia. The area of flare formation and the area of secondary hyperalgesia did not extend over the strip of the skin that had been pretraumatically anesthetized, whereas the posttraumatic block did not significantly reduce the area of fully developed secondary hyperalgesia. Conclusions: Pretraumatic injection of lidocaine reduces primary hyperalgesia more effectively than does posttraumatic injection, but only for a short period after incision. The spread of secondary hyperalgesia is mediated via peripheral nerve fibers, but when secondary hyperalgesia has fully developed, it becomes less dependent on or even independent of peripheral neural activity originating from the injured site.",Kawamata M.; Watanabe H.; Nishikawa K.; Takahashi T.; Kozuka Y.; Kawamata T.; Omote K.; Namiki A.,2002.0,10.1097/00000542-200209000-00006,0,0,
6680,"Work characteristics, learning-related outcomes, and strain: A test of competing direct effects, mediated, and moderated models","Direct effect, mediated, and moderated models of the relationship among work characteristics (job control, job demands), learning-related outcomes (skill utilization, self-efficacy), and strain (anxiety, depression) were compared. Three independent samples of call center employees were used, 2 cross-sectional (Ns = 427 and 203) and 1 longitudinal (N = 144). Initial analysis of the cross-sectional samples using structural equation modeling revealed that mediated models provided the best fit to the data. Skill utilization mediated the effect of control on depression, and depression partially mediated the effect of control on skill utilization. Longitudinal hierarchical regression analysis confirmed these findings. Results indicate that, in this occupational context, learning reduces strain, strain inhibits learning, and job control is an important precursor of both these relationships. Copyright 2002 by the Educational Publishing Foundation.",Holman D.J.; Wall T.D.,2002.0,10.1037/1076-8998.7.4.283,0,0,
6681,Secondary traumatic stress and vicarious trauma: A validational study,"Vicarious trauma (VT) and secondary traumatic stress (STS) or compassion fatigue both describe effects of working with traumatized persons on therapists. Despite conceptual similarities, their emphases differ: cognitive schemas vs. posttraumatic symptoms and burnout, respectively. The TSI Belief Scale (TSI-BSL) measures VT; the Compassion Fatigue Self-Test (CFST) for Psychotherapists measures STS. Neither has substantial psychometric evidence yet, nor has their association been studied. Results for 99 sexual assault and domestic violence counselors show concurrent validity between TSI-BSL and CFST, moderate convergence with burnout but useful discrimination, and strong convergence with general distress, but adequate independent shared variance. Counselors with interpersonal trauma histories scored higher on CFST, but not TSI-BSL or burnout, consistent with the CFST's emphasis on trauma symptomatology.",Jenkins S.R.; Baird S.,2002.0,10.1023/A:1020193526843,0,0,
6682,Experimental incision-induced pain in human skin: Effects of systemic lidocaine on flare formation and hyperalgesia,"In order to try to gain a better understanding of the mechanisms of post-operative pain, this study was designed to psychophysically determine physiological and pharmacological characteristics of experimental pain induced by a 4-mm-long incision through the skin, fascia and muscle in the volar forearm of humans. In experiment 1, the subjects (n=8) were administered lidocaine systemically (a bolus injection of 2mg/kg for a period of 5min followed by an intravenous infusion of 2mg/kg/h for another 40min), and then the incision was made. In experiment 2, cumulative doses of lidocaine (0.5-2mg/kg) were systemically injected in the subjects (n=8) 30min after the incision had been made, when primary and secondary hyperalgesia had fully developed. Spontaneous pain was assessed using the visual analog scale (VAS). Primary hyperalgesia was defined as mechanical pain thresholds to von Frey hair stimuli (from 7 to 151mN) in the injured area. The area of secondary hyperalgesia to punctate mechanical stimuli was assessed using a rigid von Frey hair (151mN). Flare formation was assessed in the first experiment using a laser doppler imager (LDI). Pain perception was maximal when the incision was made and then rapidly disappeared within 30min after the incision had been made. Primary hyperalgesia was apparent at 15min after the incision had been made and remained for 2 days. The incision resulted in a relatively large area of flare formation immediately after the incision had been made. The area of flare began to shrink within 15min and was limited to a small area around the injured area at 30min after incision. Secondary hyperalgesia was apparent at 30min after incision and persisted for 3h after incision and then gradually disappeared over the next 3h. In experiment 1, pre-traumatic treatment with systemic lidocaine suppressed primary hyperalgesia only during the first 1h after the incision had been made. The lidocaine suppressed the development of flare formation without affecting the pain rating when the incision was made. The development of secondary hyperalgesia continued to be suppressed after completion of the lidocaine infusion. In experiment 2, post-traumatic treatment with lidocaine temporarily suppressed primary as well as secondary hyperalgesia that had fully developed; however, the primary and secondary hyperalgesia again became apparent after completion of the lidocaine administration. These findings suggest that pre-traumatic treatment with lidocaine reduces the excessive inputs from the injured peripheral nerves, thus suppressing development of flare formation and secondary hyperalgesia through peripheral and central mechanisms, respectively. Pre-traumatic treatment with lidocaine would temporarily stabilize the sensitized nerves in the injured area, but the nerves would be sensitized after completion of the administration. Post-traumatic treatment with lidocaine reduced primary and secondary hyperalgesia that had fully developed. However, the finding that the suppressive effect of lidocaine on secondary hyperalgesia was temporary suggests that the development and maintenance of secondary hyperalgesia are caused by different mechanisms. © 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.",Kawamata M.; Takahashi T.; Kozuka Y.; Nawa Y.; Nishikawa K.; Narimatsu E.; Watanabe H.; Namiki A.,2002.0,10.1016/S0304-3959(02)00233-6,0,0,
6683,"Level of threat and distress regarding ambiguous situations with respect to the level of intolerance to uncertainty, worry and obsessionability","The theoretical model proposed by Dugas, Freeston and Ladouceur (1994, 1997, 1998) to explain the generalized anxiety disorder (GAD) considers intolerance to uncertainty (IU) as the manifestation of a dysfunctional basic scheme that regulates information processing and contributes to the development of worry processes. In this study, 159 college students were assessed by means of questionnaires and scales in Worry, IU, anxiety/state, and obsessive thought variables. In addition, they were evaluated according to the level of both perceived threat and distress evoked by a group of positive and negative ambiguity situations. In general, the results obtained show a significant relationships among the level of threat and distress and the said variables, but only the worry variable shows significant relationships with the perception of negative ambiguity situations, while the IU variable shows significant relationships with some of them. These findings are discussed within the framework of the cognitive model, specifically in light of the critical role of both the IU and Worry processes.",González M.; Rovella A.; Peñate W.; Ibáñez I.; Díaz F.,2002.0,,0,0,
6684,Dextroamphetamine modulates the response of the human amygdala,"Amphetamine, a potent monoaminergic agonist, has pronounced effects on emotional behavior in humans, including the generation of fear and anxiety. Recent animal studies have demonstrated the importance of monoamines, especially dopamine, in modulating the response of the amygdala, a key brain region involved in the perception of fearful and threatening stimuli, and the generation of appropriate physiological and behavioral responses. We have explored the possibility that the anxiogenic effect of amphetamine in humans reflects the drug's influence on the activity of the amygdala. In a double-blind placebo controlled study, fMRI revealed that dextroamphetamine potentiated the response of the amygdala during the perceptual processing of angry and fearful facial expressions. Our results provide the first evidence of a specific neural substrate for the anxiogenic effects of amphetamine and are consistent with animal models of dopaminergic activation of the amygdala. © 2002 American College of Neuropsychopharmacology. Published by Elsevier Science Inc.",Hariri A.R.; Mattay V.S.; Tessitore A.; Fera F.; Smith W.G.; Weinberger D.R.,2002.0,10.1016/S0893-133X(02)00373-1,0,0,
6685,"Work, social, and family disabilities of subjects with anxiety and depression","Background. Functional impairment scales are increasingly used to evaluate subjects with a variety of mental disorders. Methods. We evaluated the work, social, and family disabilities of 228 subjects with 6 common anxiety and depressive disorders, as assessed by the Sheehan Disability Scale (major depression, panic disorder, generalized anxiety disorder, social phobia, obsessive-compulsive disorder, and mixed anxiety and depression). Results. Subjects in the 6 diagnostic groups had significantly higher work, social, and family disability scores than control subjects, with the exception of the social phobia and panic disorder subjects' scores for family disability. Those with depressive disorders tended to have significantly higher family disability scores than the anxiety disorder subjects. Conclusion. Subjects with both anxiety and depressive disorders from primary care clinics and from chronic psychiatric and medical populations need further evaluation and treatment of the disabilities to decrease the personal, family, and economic burdens of these disorders.",Kennedy B.L.; Lin Y.; Schwab J.J.,2002.0,,0,0,
6686,Human models as tools in the development of psychotropic drugs,"Despite the growing means devoted to research and development (R & D) and refinements in the preclinical stages, the efficiency of central nervous system (CNS) drug development is disappointing. Many drugs reach patient studies with an erroneous therapeutic indication and/or in incorrect doses. Apart from the first clinical studies, which are conducted in healthy volunteers and focus only on safety, tolerability, and pharmacokinetics, drug development mostly relies on patient studies. Psychiatric disorders are characterized by heterogeneity and a high rate of comorbidity. It is becoming increasingly difficult to recruit patients for clinical trials and there are many confounding factors in this population, for example, those related to treatments. In order to keep patient exposure and financial expenditure to a minimum, it is important to avoid ill-designed and inconclusive studies. This risk could be minimized by gathering pharmacodynamic data earlier in development and considering that the goal of a phase 1 plan is to reach patient studies with clear ideas about the compound's pharmacodynamic profile, its efficacy in the putative indication (proof of concept), and pharmacokinetic/pharmacodynamic relationships, in addition to safety, tolerability and pharmacokinetics. Human models in healthy volunteers may be useful tools for this purpose, but their use necessitates a global adaptation of the phase 1 scheme, favoring pharmacodynamic assessments without neglecting safety. We are engaged in an R & D program aimed to adapt existing models and develop new paradigms suitable for early proof of concept substantiation.",Gilles C.; Schunck T.; Erb G.; Namer I.J.; Hodé Y.; Nedelec J.-F.; Boeijinga P.; Luthringer R.; Macher J.-P.,2002.0,,0,0,
6687,Sentence completion test in combat veterans with and without PTSD: Preliminary findings,This study used a sentence completion task to assess semantic choice in combat veterans. Twenty-eight combat veterans with (n=14) and without (n=14) posttraumatic stress disorder (PTSD) filled in the final word for 33 incomplete sentences after receiving a combat prime. The veterans with PTSD completed sentences with significantly more trauma-relevant final words than those without PTSD. Findings are interpreted with respect to current language models and information-processing theories of PTSD. © 2002 Elsevier Science Ireland Ltd. All rights reserved.,Kimble M.O.; Kaufman M.L.; Leonard L.L.; Nestor P.G.; Riggs D.S.; Kaloupek D.G.; Bachrach P.,2002.0,10.1016/S0165-1781(02)00229-9,0,0,
6688,Bowel MR imaging with oral Gastrografin: An experimental study with healthy volunteers,"Our objective was to evaluate Gastrografin for MR bowel imaging. Twenty-three healthy volunteers in two randomised groups received 300 or 400 ml 50% Gastrografin, drunk continuously during 2 and 3 h, respectively. Images were applied during breath-hold in three orthogonal orientations. The balanced fast-field echo (BFFE) and balanced turbo field-echo (BTFE) sequences, with acquisition times from 13 to 25 s, were used before gadolinium (Gd) DTPA implying 1- to 2-mm-thick slices locally or 6-mm-thick slices through the entire gastrointestinal tract. The Gd-enhanced images were performed using a 3D T1-weighted FFE sequence with water selective excitation (Proset). Image quality, including bowel distention, homogeneity of opacification and wall conspicuity, were evaluated by two experienced reviewers, and the adverse reactions were recorded. Very good or excellent distention, homogeneity and wall conspicuity were achieved in the central segments from the ileum to the left colon flexure in 83-96% of cases, due to the adequate contrast media supply in these regions. Distention, homogeneity and delineation were good in the central segments of the remaining bowels. Diarrhoea was a major problem affecting all participants, followed by nausea. Provided that there is modern fast sequential technology, excellent MR imaging of the bowel can be achieved by the oral administration 50% diluted Gastrografin. Further studies are needed to refine the technique and optimise the quantity and concentration of Gastrografin in order to avoid or reduce adverse reaction.",Borthne A.S.; Dormagen J.B.; Gjesdal K.I.; Storaas T.; Lygren I.; Geitung J.T.,2003.0,,0,0,
6689,Buspirone decreases physiological reactivity to unconditioned and conditioned aversive stimuli,"Rationale: Serotonergic pathways are thought to be important in mediating the effects of aversive events. Objective: To investigate the effects of buspirone, a 5-HT1A partial agonist, on habituation and extinction in an aversive classical conditioning model. Methods: Forty healthy male volunteers were randomly assigned to a single dose of buspirone (10 mg) or placebo. They filled in questionnaires of anxiety and depression at baseline and visual analogue scales of tension and anxiety before and at 60, 120 and 150 min after drug administration. Their skin conductance responses to auditory stimuli were measured on the conditioning model 2 h after drug intake. Results: There were no differences between groups on depression or anxiety. Buspirone decreased the amplitude of the skin conductance response and the number of spontaneous fluctuations in both the habituation and extinction phases but had no effect on skin conductance level. Buspirone also attenuated the unconditioned response to the white noise and the response to the first tone. Visual analogue ratings of tension and anxiety decreased after buspirone. Conclusions: Buspirone decreased physiological reactivity in an aversive classical conditioning model. It had anxiolytic effects on both conditioned and unconditioned anxiety. This might be due to its multiple actions on 5-HT receptors.",Bond A.J.; Wingrove J.; Baylis M.; Dalton J.,2003.0,,0,0,
6690,Implicit memory bias and trait anxiety: A psychophysiological analysis,"The effect of threatening words and anxiety upon implicit memory performance was investigated. It was predicted that anxious individuals would show a bias to threat-related material. In addition, psychophysiological measures were obtained to assess the attentional and encoding processes that might underlie this cognitive bias. Forty participants were equally allocated to high and low trait anxious groups, according to pre-determined cut-offs. All participants were exposed to threat and non-threat words and following a filler task, were asked to complete primed and unprimed wordstems. Implicit memory performance was assessed in terms of accuracy and reaction time for completion. Heart rate and electrodermal responses were measured. Results demonstrated initial increased cardiac deceleration to threat stimuli, subsequent cardiac acceleration to non-threat stimuli, and an implicit memory bias to non-threat material by all participants. These findings are discussed in relation to the 'vigilance-avoidance' model of attention to threat stimuli. © 2002 Elsevier Science B.V. All rights reserved.",Harrison L.K.; Turpin G.,2003.0,10.1016/S0301-0511(02)00129-1,0,0,
6691,Timed bright-light exposure and complaints related to shift work among women,"Objectives. This field study measured whether repeated, brief exposures to bright light during night shifts improved subjective well-being during and after night work. A secondary objective was to investigate whether this response differed by season (summer or winter), seasonality, or age. Methods. Eighty-seven healthy female nurses were voluntarily exposed to brief periods (4 × 20 minutes) of bright (5000 lux) light at scheduled times during every night shift over a 2-week period. Each morning following a night shift the subjects filled out self-assessment questionnaires measuring subjective symptoms and distress caused by work at night. The questionnaires were also completed 2 weeks before and after the light intervention. The study had two phases, summer (May-June) and winter (November-December). Thirty-seven of the subjects participated during both periods. Results. Light significantly alleviated the subjective distress associated with nightshift work, both in summer and in winter, independent of the subject's age. The effect was stronger for those who reported routine seasonal changes in mood. Conclusions. Short pulses of timed bright-light exposure may enhance subjective adaptation to night work.",Leppämäki S.; Partonen T.; Piiroinen P.; Haukka J.; Lönnqvist J.,2003.0,,0,0,
6692,Effects of acute cholecystokinin infusion on hemispheric EEG asymmetry and coherence in healthy volunteers,"This study investigated the effects of continuous slow infusion of cholecystokinin tetrapeptide (CCK-4), a neuropeptide with panicogenic properties, on functional hemispheric differences, as indexed by quantitative electroencephalographic (EEG) asymmetry and coherence measures. Twenty-four adult volunteers (15 females and 9 males) were assigned to infusion with either placebo or CCK-4 in a randomized, double-blind, parallel-group design, with EEG being recorded before and during (10 and 40 min) a 60-min infusion period. No significant treatment differences were observed for absolute EEG power but, compared to placebo, CCK-4 infusion increased asymmetry and reduced coherence of slow-wave activity at midtemporal recording sites. These findings support the contention that functional imbalance of the temporal cortex, perhaps mediated by CCK-4, is involved in panic disorder (PD). © 2002 Elsevier Science Inc. All rights reserved.",Knott V.; Mahoney C.; Bradwejn J.; Shlik J.; Gunnarsson T.,2003.0,10.1016/S0278-5846(02)00350-0,0,0,
6693,Gender differences in the prevalence of symptom disorders and personality disorders among poly-substance abusers and pure alcoholics: Substance abusers treated in two counties in Norway,"Objective: Gender differences in the prevalence of Axis I and II disorders in poly-substance abusers and pure alcoholics and between these two groups are explored. Method: A consecutive sample (n=260) of in- and out-patients from two Norwegian counties were assessed by CIDI (Axis I disorders) and MCMI-II (Axis II disorders). Results: Major depression, post-traumatic stress disorder (PTSD), and eating disorders were significantly more prevalent in women than in men. A significantly higher prevalence of antisocial, passive-aggressive, and borderline personality disorders (PD) was observed among poly-substance abusers, whereas pure alcoholics were found to have dependent PDs more often. Female poly-substance abusers differed significantly from all other substance abusers by suffering more often from major depression, simple phobia, PTSD and borderline PD. Male poly-substance abusers more often presented antisocial PD and less often Cluster C disorders than all other substance abusers. Female pure alcoholics more often had major depression and Cluster C disorders than all other substance abusers. Male pure alcoholics presented less often with Axis I disorders, major depression, and PTSD, but more often with Cluster A disorders, in particular schizoid PD, than all other substance abusers. Conclusion: The pattern of comorbid disorders is clearly different between male and female poly-substance abusers and pure alcoholics. This implies that these four subgroups have important differences in their treatment needs. Copyright © 2003 S. Karger AG, Basel.",Landheim A.S.; Bakken K.; Vaglum P.,2003.0,10.1159/000067732,0,0,
6694,Coping strategies in civilians during air attacks,"Background. Coping strategies may influence the psychological outcome after a stressful event, both as coping at the time of the event and as strategies of dealing with its consequences after the event. The aim of the study was to investigate coping strategies used by civilians during the air attacks in Yugoslavia in 1999, and their association with the level of exposure, gender and psychological symptoms 1 year later. Method. The sample is a non-selective group of 139 medical students from the University of Belgrade, Yugoslavia. Open questions and content analysis were used to assess coping strategies. Symptoms of intrusion and avoidance were assessed, as well as general psychological symptoms. Results. Content analysis of answers to open questions revealed nine categories of coping strategies (sport and walks, leisure activities, talking and gathering, humor, avoidance, philosophical approach, getting information, work, and substance abuse). A cluster analysis identified three groups of students with different styles of coping. Students that used dominantly 'talking and gathering' had the highest, and the ones that mostly used 'leisure activities' the lowest scores on intrusion. There were significant gender differences in how coping strategies were associated with intrusive symptoms. Conclusion. The type of coping strategies used during the air attacks may contribute to the level of intrusive symptoms 1 year after the event. Different coping strategies might be effective in men and women to reduce intrusive symptoms. Longitudinal and prospective studies are needed to draw definite conclusions on causal relationships between coping strategies and levels of posttraumatic stress.",Gavrilovic J.; Lecic-Tosevski D.; Dimic S.; Pejovic-Milovancevic M.; Knezevic G.; Priebe S.,2003.0,10.1007/s00127-003-0612-9,0,0,
6695,Do ethnic identity and other-group orientation protect against discrimination for Asian Americans?,"Ethnic identity and other-group orientation were examined as possible moderators and mediators on the effects of personal ethnic discrimination and minority group discrimination in 2 studies of Asian Americans. Results demonstrated that discrimination, particularly when directed personally at an individual, correlated negatively with psychological well-being and correlated positively with distress. Ethnic identity and other-group orientation, however, correlated positively with psychological well-being. Contrary to the main hypothesis, ethnic identity did not moderate or mediate the effects of discrimination, although other-group orientation demonstrated a moderator effect on community well-being. More research on ethnic identity and other-group orientation as protective factors that enable Asian Americans to be resilient against discrimination is necessary to clarify the findings from these studies.",Lee R.M.,2003.0,10.1037/0022-0167.50.2.133,0,0,
6696,Biased cognitive processing of cancer-related information among women with family histories of breast cancer: Evidence from a cancer stroop task,"Stimuli associated with sources of stress have been shown to interfere with cognition. The authors hypothesized that women with the stress of having a family history of breast cancer (FH+) would exhibit greater interference on a task with cancer-related stimuli than women without cancer in the family (FH-). The authors developed a modified Stroop color-naming task to test this hypothesis in a sample of FH+ (n = 72) and FH- (n = 96) women. Consistent with the hypotheses, FH+ women had longer color-naming times and more errors (ps < .01) on a cancer word list relative to noncancer lists. This biased processing was not mediated by the significantly higher perceived risk, general distress, or cancer-specific distress in FH+ women. Maladaptive alterations in processing cancer stimuli may have important clinical implications, as these women must process complex cancer-related information critical to their health (e.g., options for chemoprevention, screening).",Erblich J.; Montgomery G.H.; Valdimarsdottir H.B.; Cloitre M.; Bovbjerg D.H.,2003.0,10.1037/0278-6133.22.3.235,0,0,
6697,Fear responses to mock magnetic resonance imaging among college students: Toward a prototype experiment,"Two hundred randomly selected student participants (139 females, 61 males) responded initially to questionnaires that quantified variables such as state and trait anxiety, anxiety sensitivity, claustrophobia, and panic/agoraphobia. Later they were informed that a mock magnetic resonance imaging (MRI) procedure was upcoming, and were prompted to provide self-efficacy ratings vis-à-vis completing the procedure. Finally, the participants' behavioral reactions to a mock MRI procedure were characterized; their heart beats were recorded and ratings of fearfulness were acquired. One purpose of the research was simply to tally numbers of participants who responded fearfully in various ways: 7 failed the procedure behaviorally, 7 others completed the procedure but did so fearfully, 17 others completed the procedure but manifested excessive heart-rate responsivity. A second purpose of the research was to ""predict"" subjects' fear-response categorization psychometrically and/or with self-efficacy ratings: psychometric data related to claustrophobia predicted subjects' fear-response categorization as did self-efficacy ratings. According to these results mock MRI assessment among college students provides a promising context for research on claustrophobia. © 2002 Elsevier Science Inc. All rights reserved.",McGlynn F.D.; Karg R.; Lawyer S.R.,2003.0,10.1016/S0887-6185(02)00204-9,0,0,
6698,Neural correlates of declarative memory for emotionally valenced words in women with posttraumatic stress disorder related to early childhood sexual abuse,"Background: Animal studies have shown that early stressors result in lasting changes in structure and function of brain areas involved in memory, including hippocampus and frontal cortex. Patients with childhood abuse-related posttraumatic stress disorder (PTSD) have alterations in both declarative and nondeclarative memory function, and imaging studies in PTSD have demonstrated changes in function during stimulation of trauma-specific memories in hippocampus, medial prefrontal cortex, and cingulate. The purpose of this study was to assess neural correlates of emotionally valenced declarative memory in women with early childhood sexual abuse and PTSD. Methods: Women with early childhood sexual abuse-related PTSD (n = 10) and women without abuse or PTSD (n = 11) underwent positron emission tomographic (PET) measurement of cerebral blood flow during a control condition and during retrieval of neutral (e.g., ""metal-iron"") and emotionally valenced (e.g., ""rape-mutilate"") word pairs. Results: During retrieval of emotionally valenced word pairs, PTSD patients showed greater decreases in blood flow in an extensive area, which included orbitofrontal cortex, anterior cingulate, and medial prefrontal cortex (Brodmann's areas 25, 32, 9), left hippocampus, and fusiform gyrus/inferior temporal gyrus, with increased activation in posterior cingulate, left inferior parietal cortex, left middle frontal gyrus, and visual association and motor cortex. There were no differences in patterns of brain activation during retrieval of neutral word pairs between patients and control subjects. Conclusions: These findings are consistent with dysfunction of specific brain areas involved in memory and emotion in PTSD. Regions implicated in this study of emotionally valenced declarative memory are similar to those from prior imaging studies in PTSD using trauma-specific stimuli for symptom provocation, adding further supportive evidence for a dysfunctional network of brain areas involved in memory, including hippocampus, medial prefrontal cortex, and cingulate, in PTSD. © 2003 Society of Biological Psychiatry.",Bremner J.D.; Vythilingam M.; Vermetten E.; Southwick S.M.; McGlashan T.; Staib L.H.; Soufer R.; Charney D.S.,2003.0,10.1016/S0006-3223(02)01891-7,0,0,
6699,Geriatric performance on the Neurobehavioral Cognitive Status Examination (Cognistat): What is normal?,"The Neurobehavioral Cognitive Status Examination (Cognistat) is a widely used cognitive screening measure that has been utilized in several clinical studies with a geriatric population. However, there has been relatively little normative research since its original publication. The objective of this study was to develop age-corrected norms for Cognistat. One hundred and fifty healthy participants aged 60-85 were recruited, all of whom spoke English fluently. Twenty-seven peoples met at least one exclusionary criterion and were therefore excluded. The participants were administered Cognistat along with measures of IQ, depression, alcohol usage, and activity level. Data were not normally distributed; therefore, analysis of these data was completed using descriptive statistics and the nonparametric bootstrapping technique. Study results provide age-corrected profiles that differ significantly from and extend the originally published norms. © 2002 National Academy of Neuropsychology. Published by Elsevier Science Ltd. All rights reserved.",Macaulay C.; Battista M.; Lebby P.C.; Mueller J.,2003.0,10.1016/S0887-6177(02)00141-5,0,0,
6700,Are dysfunctional beliefs about illness unique to hypochondriasis?,"Objective: There is evidence that individuals high in hypochondriasis overestimate the likelihood of ambiguous symptoms being indicative of serious illness. However, it is not known whether this tendency is unique to hypochondriasis or whether it can be attributed to high negative affectivity or other anxiety symptoms often found to be comorbid with hypochondriasis. Method: College students (N=133) completed measures of hypochondriasis, depression, anxiety, worry, avoidance and estimated the likelihood of various symptoms indicating catastrophic and minor illnesses. Results: Even after entering the other self-report variables, hypochondriasis was the only variable to predict estimates of the likelihood of serious illness. Conversely, being female, high levels of negative affect, agoraphobic avoidance when accompanied by others and higher estimates about the likelihood of symptoms leading to catastrophic illnesses best predicted hypochondriasis scores. Conclusion: Dysfunctional beliefs about illness appear to be unique to hypochondriasis and to uniquely contribute to the prediction of hypochondriasis. © 2003 Elsevier Inc. All rights reserved.",Marcus D.K.; Church S.E.,2003.0,10.1016/S0022-3999(02)00526-3,0,0,
6701,Pharmacokinetics and QT interval pharmacodynamics of oral haloperidol in poor and extensive metabolizers of CYP2D6,"We studied the pharmacokinetics and QT interval pharmacodynamics of a single 10 mg dose of oral haloperidol in a randomized, double-blind, placebo-controlled, crossover trial of healthy poor (PMs) and extensive (EMs) metabolizers of CYP2D6. There was a statistically significant greater mean QTc on haloperidol (421.6 ± 20.1 ms) than on placebo (408.4 ± 18.5 ms, P = 0.0053) occurring 10 h post haloperidol/placebo administration. Men and women had similar ranges of QTc changes from placebo. Despite a statistically significant greater mean elimination half-life (19.1 ± 3.6 vs 12.9 ± 4.0 h, P = 0.04) and lower mean apparent oral clearance (12.8 ± 4.1 vs 27.0 ± 11.3 ml/min/kg, P = 0.02) of haloperidol in CYP2D6 PMs than in EMs, this exposure change did not translate into marked QTc changes from baseline that could be considered clinically important. Although the magnitude of the mean QTc prolongation on haloperidol relative to placebo is relatively small, it may assume significance in the presence of other risk factors for QT prolongation.",Desai M.; Tanus-Santos J.E.; Li L.; Gorski J.C.; Arefayene M.; Liu Y.; Desta Z.; Flockhart D.A.,2003.0,10.1038/sj.tpj.6500160,0,0,
6702,Personality disorders and self-perceived quality of life in an elderly psychiatric outpatient population,"The aim of this work was to assess the impact of personality disorder and traits on the subjective assessment of quality of life by a sample of elderly psychiatric outpatients (60 years or more). Sixty of the total number of subjects interviewed were included in the test sample since they met the Vragenlijst Klinishe Persoonlijkheid (VKP) criteria for personality disorder. A control sample was also formed, composed of 50 subjects without personality disorders or traits. Quality of life was assessed using the LEIPAD questionnaire. Personality disorder diagnoses were prevalently distributed in cluster C (25%) and in cluster A (20%). A total of 48.3% of patients (n = 29) had more than 1 personality disorder. Sixty percent of the sample (n = 36) presented with comorbid Axis I psychiatric disorders, in most cases depressive pathologies. Comparing the case and control groups, worse LEIPAD scores were achieved by subjects with personality disorders. Between clusters of personality disorders, the worst scores were observed in subjects with more than 1 personality disorder diagnosis. Elderly people who presented with a personality disorder were more vulnerable to late-life distress, especially those with more than one diagnosis. In keeping with linear regression analysis, widowhood, divorcehood and living with others appear to be variables able to negatively influence quality of life in this population. While the VKP needs to be adapted to the application in the elderly, it does seem to be a particularly useful screening instrument. Copyright © 2003 S. Karger AG, Basel.",Condello C.; Padoani W.; Uguzzoni U.; Caon F.; De Leo D.,2003.0,10.1159/000070362,0,0,
6703,Characterization of the high resolution ESR spectra of the methoxyl radical adducts of 5-(diethoxyphosphoryl)-5-methyl-1-pyrroline N-oxide (DEPMPO),"Spin-trapping investigators are largely limited by the instability of the radical adducts. Spin trap 5-(diethoxyphosphoryl)-5-methyl-1-pyrroline N-oxide (DEPMPO) forms very stable alkoxyl radical adducts. However, the presence of two chiral centers in the DEPMPO alkoxyl radical adduct results in two diastereomers with distinctive ESR spectra, which complicates the interpretation of the ESR spectra. We have analyzed the high resolution ESR spectra of the DEPMPO/•OCH3 radical adduct. DEPMPO/•OCH3 has been synthesized by the nucleophilic addition of alcohols to DEPMPO. The electron spin resonance (ESR) spectrum of DEPMPO/•OCH3 in oxygen-free methanol solution reveals superhyperfine structure with hyperfine coupling constants as small as 0.3 G. In order to simplify the analysis of the electron spin resonance (ESR) spectrum, we synthesized the DEPMPO/•OCD3 radical adduct. Computer simulation of the DEPMPO/•OCD3 ESR spectrum revealed two diastereomers. Hyperfine coupling constants of γ-protons and 17O from the -OCH3 group were also determined. ESR spectra of DEPMPO/•OCH3 in phosphate buffer have also been characterized. The presence of specific hyperfine couplings from the -OCH3 group can be used for the unambiguous identification of the DEPMPO/•OCH3 radical adducts. We suggest that the analysis of high resolution ESR spectra can be used for the unambiguous characterization of DEPMPO radical adducts.",Dikalov S.; Tordo P.; Motten A.; Mason R.P.,2003.0,10.1080/1071576031000097508,0,0,
6704,Implicit memory for negative and positive social information in individuals with and without social anxiety,"Studies of memory bias for threat-relevant information in individuals with social anxiety have produced mixed results. These discrepancies may be because investigators have studied different memory processes or have used different memory tasks. We employed a video clarity judgement task to investigate implicit (capacity-free, automatic, unconscious) memory and a recognition task to investigate explicit (effortful, strategic, conscious) memory for threat in socially anxious individuals and nonanxious controls. Implicit memory for ""old"" (i.e., seen before) videos was defined as rating ""old"" videos as more clear than ""new"" (i.e., never seen before) videos. We created brief video clips that involved an actor or actress approaching the camera and commenting on some aspect of the viewer's actions, physical appearance, or belongings. Twenty-four videos were positive (e.g., ""I really like your shoes""), and 24 were negative (e.g., ""That is a horrible haircut""). Results revealed that the video clarity test was an effective measure of implicit memory. Furthermore, socially anxious individuals showed a larger implicit memory index for negative videos than did nonanxious and dysphoric controls. No group differences emerged for implicit memory for positive videos. Similarly, groups did not differ in recognition of, or false alarms for, positive and negative videos. These results demonstrate the role of implicit memory in social anxiety implying that information about threat may be automatically primed in these individuals.",Amir N.; Bower E.; Briks J.; Freshman M.,2003.0,10.1080/02699930302300,0,0,
6705,Dissociations between implicit and explicit attitudes toward phobic stimuli,"The present study explored the presence of complaint-specific implicit associations in the domain of spider fear. Participants' implicit negative associations with spider cues were measured in highly fearful (n = 18) and explicitly nonfearful individuals (n = 19). To increase the reliability of the present study, two indices of implicit associations were used: a modified implicit association test (IAT), and an affective Simon paradigm (ASP). To test the stability of the IAT and the ASP, participants were tested twice. At the explicit level the attitude to spider cues was far more negative for high fear participants than for no fear participants. In contrast, high and low fear participants displayed very similar negative associations with spiders at the implicit level. Indicating their resistance to practice effects the ASP and IAT revealed similar results on both occasions. The dual attitude in low fear individuals suggests that the nonfearful individual is the one who can suppress the automatic negative spider stereotype, whereas the phobic individual is the one who does not attempt or is not able to control the negative associations with spider cues.",de Jong P.J.; van den Hout M.A.; Rietbroek H.; Huijding J.,2003.0,10.1080/02699930302305,0,0,
6706,The effects of acceptance versus control contexts on avoidance of panic-related symptoms,"The present study compared the effects of creating an acceptance versus a control treatment context on the avoidance of aversive interoceptive stimulation. Sixty high anxiety sensitive females were exposed to two 10-min periods of 10% carbon dioxide enriched air, an anxiogenic stimulus. Before each inhalation period, participants underwent a training procedure aimed at encouraging them either to mindfully observe (acceptance context) or to control symptoms via diaphragmatic breathing (control context). A third group was given no particular training or instructions. We hypothesized that an acceptance rather than control context would be more useful in the reduction of anxious avoidance. Compared to control context and no-instruction participants, acceptance context participants were less avoidant behaviorally and reported less intense fear and cognitive symptoms and fewer catastrophic thoughts during the CO2 inhalations. We discuss the implications of our findings for an acceptance-focused vs. control-focused context when conducting clinical interventions for panic and other anxiety disorders. © 2004 Elsevier Ltd. All rights reserved.",Eifert G.H.; Heffner M.,2003.0,10.1016/j.jbtep.2003.11.001,0,0,
6707,Access to information about harm and safety in spider fearful and nonfearful individuals: When they were good they were very very good but when they were bad they were horrid,"This study tests two alternative hypotheses about how phobic information is processed in spider fearful and nonfearful individuals: (1) the threat-related cognitive set hypothesis and (2) the dimensions hypothesis. Counter to the traditional cognitive model of fear, the dimensions hypothesis predicts that spider fearful individuals tend to prioritise the harm-safety dimension when evaluating animal stimuli, and the consequent stretching of that evaluative dimension will confer advantage to the accessing of harm information when confronted with phobic stimuli, but conversely safety information when encountering FI stimuli. Spider fearful and nonfearful participants generated lists of reasons why spiders, fear relevant (e.g. tigers, snakes) and fear irrelevant (e.g. rabbits, kittens) animals might be harmful and might be safe. The findings indicate that, in comparison to a nonfearful group, spider fearful participants have facilitated access to both harm and safety information which is context dependent: spider fearful participants were able to generate more reasons why spiders may be harmful and fewer why they might be safe than nonfearful participants, but conversely were able to generate more reasons why fear irrelevant animals might by safe and fewer reasons why they might be harmful than the nonfearful group. The implications of these findings for our understanding of the cognitive mechanisms underlying fears and phobias are discussed. © 2003 Elsevier Ltd. All rights reserved.",Cavanagh K.; Davey G.,2003.0,10.1016/j.jbtep.2003.10.003,0,0,
6708,Anticipatory processing in social anxiety: Two pilot studies,"Two studies investigating the cognitive processes associated with anticipatory social anxiety are reported. Study 1 used a semi-structured interview to compare high and low socially anxious individuals (n=20 per group) in terms of their reported mental processes during periods of anticipatory social anxiety. Study 2 investigated the anxiety inducing effects of the mental processes that were shown to be characteristic of high socially anxious individuals in Study 1. Prior to giving a speech, high and low socially anxious individuals (n=20 per group) either engaged in these processes or performed a distraction task. The results of Study 1 were broadly consistent with Clark and Wells' (In: R.G. Heimberg, M. Liebowitz, D.A. Hope, F.R. Schneier (Eds.), Social phobia: Diagnosis, Assessment and Treatment (pp. 69-93). New York: Guilford Press, 1995) hypotheses about the nature of anticipatory processing in social anxiety. Study 2 showed that, compared to distraction, engaging in the mental processes characteristic of high socially anxious individuals was associated with sustained elevations of anticipatory anxiety in both high and low socially anxious individuals, and led to higher levels of peak anxiety during the speech. The findings suggest that high and low socially anxious individuals show systematic differences in their mental processes prior to a stressful social event, and are consistent with the suggestion that these differences play an important role in sustaining anticipatory anxiety. © 2003 Elsevier Ltd. All rights reserved.",Hinrichsen H.; Clark D.M.,2003.0,10.1016/S0005-7916(03)00050-8,0,0,
6709,Social anxiety and social comparison: Differential links with restrictive and bulimic attitudes among nonclinical women,"This study investigated the relationship of two social psychological constructs (social anxiety and social comparison) with bulimic and restrictive eating attitudes among nonclinical women. Eighty young women completed a measure of social anxiety (the Fear of Negative Evaluation Scale, FNE), a measure of social comparison (the Iowa-Netherlands Comparison Orientation Measure, INCOM), the Beck Depression Inventory (BDI), and the Eating Disorders Inventory (EDI). The results indicate a differential link between the two different social processes and the nature of eating psychopathology. Specifically, heightened social anxiety predicted drive for thinness, while levels of social comparison predicted bulimic attitudes. The findings support a model where the two social processes are each associated with different patterns of eating pathology. © 2003 Elsevier Ltd. All rights reserved.",Gilbert N.; Meyer C.,2003.0,10.1016/S1471-0153(03)00026-6,0,0,
6710,Examining the locus of age effects on complex span tasks,"To investigate the locus of age effects on complex span tasks, the authors evaluated the contributions of working memory functions and processing speed. Age differences were found in measures of storage capacity, language processing speed, and lower level speed. Statistically controlling for each of these in hierarchical regressions substantially reduced, but did not eliminate, the complex span age effect. Accounting for lower level speed and storage, however, removed essentially the entire age effect, suggesting that both functions play important and independent roles. Additional evidence for the role of storage capacity was the absence of complex span age differences with span size calibrated to individual word span performance. Explanations for age differences based on inhibition and concurrent task performamce were not supported.",McCabe J.; Hartman M.,2003.0,10.1037/0882-7974.18.3.562,0,0,
6711,Social anxiety and interpersonal perception: A social relations model analysis,"Cognitive models of social phobia posit that an individual's negative beliefs about the way he or she is perceived by others (metaperceptions) are a core feature of the disorder. The social relations model (Kenny, 1994) Interpersonal perception: A social relations analysis. New York: Guildford) was used to analyze interpersonal perception data collected following unstructured social interactions in 62 socially anxious (SA) and 62 not socially anxious (NSA) individuals. Using this model, the interpersonal perceptions were analyzed to evaluate whether pathological levels of social anxiety are associated with self-perceptions, metaperceptions, and perceptions from others. SA participants saw themselves negatively and believed others saw them negatively. Although seen as more nervous by others, SA participants were not seen as less likeable. A mediational model demonstrated that the negative metaperceptions of SA individuals were more a function of their own self-perceptions than the negative perceptions of others. These findings were not attributable to depressive symptoms. Implications for theory and treatment of social phobia are discussed. © 2003 Elsevier Ltd. All rights reserved.",Christensen P.N.; Stein M.B.; Means-Christensen A.,2003.0,10.1016/S0005-7967(03)00064-0,0,0,
6712,Relationships of distinct affective dimensions to performance on an emotional stroop task,"Few studies have examined the nature of enhanced selective attention to threatening stimuli with regard to distinct affective dimensions in nonclinical samples. No study to date has explored the relationships of multiple anxiety-related dimensions to performance on an emotional Stroop task. An adult sample without history of spontaneous panic attacks (N = 138) participated in an emotional Stroop task, and performance was analyzed in light of several types of self-reported anxiety. Only anxiety sensitivity distinguished individuals who showed a pattern of interference to threat information from those who showed a pattern of facilitation. No anxiety type was associated with reaction time patterns to appetitive distractors. These results highlight the importance of deconstructing anxiety into separate dimensions such that unique relationships between anxiety types and cognitive processing can be examined.",Koven N.S.; Heller W.; Banich M.T.; Miller G.A.,2003.0,10.1023/A:1026303828675,0,0,
6713,The effects of anxious responding on mental arithmetic and lexical decision task performance,"Anxiety-related responding and skill deficits historically are associated with performance-based problems such as mathematics anxiety, yet the relative contribution of these variables to substandard performance remains poorly understood. Utilizing a 7% carbon dioxide (CO2) gas to induce anxiety, the present study examined the impact of anxious responding on two performance tasks, mental arithmetic and lexical decision. Independent variables included math anxiety group, gender, and gas condition. Dependent variables included task performance and physiological and self-report indices of anxiety. A total of 64 university undergraduate students participated. Physiological and verbal-report measures of anxiety supported the utility of 7% carbon dioxide-enriched air as an anxiety-inducing stimulus. Behavioral disruption on performance tasks, however, did not differ as a function of carbon dioxide inhalation. Performance did differ as a function of math anxiety. High math anxious individuals generally exhibited higher error rates on mathematical tasks, particularly on tasks designed to measure advanced math skill and those requiring working memory resources. These findings are discussed with reference to processing efficiency theory, discordance among anxiety response systems, and the intricacies associated with skill measurement. © 2002 Elsevier Inc. All rights reserved.",Hopko D.R.; McNeil D.W.; Lejuez C.W.; Ashcraft M.H.; Eifert G.H.; Riel J.,2003.0,10.1016/S0887-6185(02)00240-2,0,0,
6714,Aging and Repetition Effects: Separate Specific and Nonspecific Influences,"The research reported in this article focuses on processes that contribute to the repetition effect in 2-alternative forced-choice tasks and on how these processes change with age. An analytical approach is presented that allows researchers to discriminate between 2 components of performance. The results of Experiment 1 show that differences in the relative contributions of these 2 processes can produce differences in repetition effects between younger and older adults. Furthermore, as in the negative priming domain, increasing the contribution of 1 of these 2 components can eliminate this age difference. Together, the results argue against the practice of attributing age differences in repetition effects to deficits in any single cognitive process.",Marczinski C.A.; Milliken B.; Nelson S.,2003.0,10.1037/0882-7974.18.4.780,0,0,
6715,Metabolic and psychosocial effects of minimal invasive gastric banding for morbid obesity,"Obesity is considered a primary risk factor for cardiovascular disease and related mortality. The current study aimed to investigate the efficacy of minimal invasive gastric banding (GB) surgery for reducing caloric intake in morbid obesity, and to analyze the effects of weight loss on body composition and metabolic and psychosocial outcomes. Twenty-six adult severely obese patients (mean body mass index [BMI], 48.1 kg/m2; range, 42 to 56) underwent adjustable silicone laparoscopic GB. Nine additional obese patients who declined surgery were treated with metformin (2 g daily) and served as a small additional group (BMI, 50.5 kg/m2; range, 41 to 68). Presurgery and 17 ± 2.2 months postoperatively, body composition (fat mass [FM], lean body mass [LBM], body water) and serum parameters (lipids, glucose, thyrotropin-stimulating hormone [TSH]) were determined. Quality of life (QoL) was evaluated by a standardized self-rating questionnaire (Short Form-36 [SF-36]), and supplemented by measures of physical complaints and psychological distress. After GB, weight loss was 21 ± 14.9 kg (14%, P < .001). It was associated with a decrease in FM by 14 ± 8.6 kg (18%, P < .001), LBM by 4 ± 2.7 kg (5%, P < .001), body water by 4 ± 3.4 L (7%, P < .01), systolic blood pressure by 16 ± 26.3 mm Hg (10%, P < .05), total cholesterol by 0.69 ± 1.29 mmol/L (12%, P < .05), and low-density lipoprotein cholesterol (LDL-C) by 0.38 ± 0.39 mmol/L (10%, P < .05). Highly significant interactions between surgery and time were noted for weight (P < .005), BMI (P < .005), and FM (P < .007, analysis of variance [AIMOVA]). Preoperatively, 14 of 26 patients (54%) had high fasting blood sugar levels (type 2 diabetics) and 11 (42%) had impaired glucose tolerance, whereas postoperatively, for baseline glucose levels a trend to decrease was noted. Neither malabsorption nor anemia was observed. QoL improved after GB; in particular, physical functioning and well being increased (P < .01), and somatic complaints (eg, dyspnea and heart complaints, pain in legs and arms) markedly decreased (P = .008). In the metformin group, neither relevant weight loss nor a significant decrease of biochemical values was observed. Minimal invasive GB is a successful therapeutic tool for reducing FM in morbidly obese patients. Weight loss resulted in improved metabolic parameters, suggesting a lowered atherogenic risk. © 2003 Elsevier Inc. All rights reserved.",Dittmar M.; Heintz A.; Hardt J.; Egle U.T.; Kahaly G.J.,2003.0,10.1016/j.metabol.2003.07.008,0,0,
6716,Section I Posttest: Treating Depression and Anxiety to Remission. Section I: Current Perspectives in the Treatment of Depression,,,2003.0,,0,0,
6717,"Internet use, identity development and social anxiety among young adults","Contradictory evidence exists regarding the benefit of the Internet for social and personal wellbeing, with some studies indicating deleterious effects and others possible social enrichment. The potential for increased social isolation from 'over-involvement' in online activities or, conversely, the Internet's possibilities for enhancing social relationships, may be particularly salient during young adulthood and adolescence because of the special importance of the peer group during this developmental phase. This study was an investigation of the relationships between the levels of identity development, Internet use and social anxiety among a sample of 161 older adolescents/young adults aged between 18 and 25. Results indicated that, for mates only, higher levels of social anxiety and less mature identity statuses were associated with more frequent Internet use, specifically time spent in chatrooms, online browsing for personal use, and games. For females (who were in this sample less socially anxious, more identity-developed, and lower users of the Internet than males), social anxiety and identity status were not significantly associated with time spent online. Discussion centred around the potential roles of Internet use in reinforcing already-existing social anxiety or, alternatively, in supporting and maintaining social contacts in those with lower levels of social deficit.",Mazalin D.; Moore S.,2004.0,10.1375/bech.21.2.90.55425,0,0,
6718,Psychometric properties of the OCI-R in a college sample,"Two studies examined the psychometric properties of the Obsessive-Compulsive Inventory - Revised (OCI-R; Psychol. Assessment 14 (2002) 485) in a nonclinical student sample. In Study 1, we investigated the factor structure and internal consistency of the OCI-R using a sample of 395 undergraduate students. At a second testing session 1 month later, 178 students completed the OCI-R. Test-retest reliability was examined using data from 94 students who completed the OCI-R in both sessions. Convergent validity was also assessed with the Maudsley Obsessive-Compulsive Inventory (MOCI). In Study 2, we further investigated the convergent and divergent validity of the OCI-R using a new sample of 221 students who completed a battery of measures of obsessive-compulsive symptoms, worry, and depression. There was a significant order effect for both the OCI-R and the MOCI: means of each measure were significantly lower when presented second. Despite the order effect, statistical analyses indicated that the OCI-R has adequate test-retest reliability for the full scale and subscale scores, solid factor structure, and high internal consistency. Convergent validity with other measures of obsessive-compulsive symptoms was moderate to excellent, and divergent validity was good. The results indicate that the OCI-R is a short, psychometrically sound self-report measure of obsessive-compulsive symptoms. © 2003 Elsevier Ltd. All rights reserved.",Hajcak G.; Huppert J.D.; Simons R.F.; Foa E.B.,2004.0,10.1016/j.brat.2003.08.002,0,0,
6719,The influence of alcohol oral intake on the effects of 35% CO2 challenge. A study in healthy volunteers,"Objective: Alcohol use disorders and panic disorder co-occur at a rate that exceeds chance significantly. The underlying mechanism of alcoholism associated with anxiety has rarely been examined using experimental methodologies. The present study in healthy volunteers tested whether alcohol consumption reduces anxiety associated with a panic-challenge procedure (35% CO2 challenge). Methods: The study design was placebo-controlled, double-blind, randomized. Eight healthy volunteers were enrolled; all subjects had an alcohol and a placebo oral intake according to a crossover design. After each consumption the subjects underwent the 35% CO2 challenge and a series of anxiety symptom assessments. Results: After the alcohol intake, the subjects presented a significant reduction in the anxiety state associated with the challenge procedure. The Panic Symptom List score is significantly lower after alcohol intake (P = 0.032), as compared with the placebo, and the Visual Analogue Anxiety Scale shows a trend to be lower after alcohol intake (P = 0.111). Conclusions: Moderate doses of alcohol acutely decrease the response to a 35% CO2 challenge in healthy volunteers. These results lend support to the pharmacological anxiolytic effect of alcohol and suggest that this property may reinforce the drinking behaviour among those with high levels of anxiety.",Cosci F.; Schruers K.; Faravelli C.; Griez E.,2004.0,10.1111/j.0924-2708.2004.0077.x,0,0,
6720,Depression impairs the ability to ignore the emotional aspects of facial expressions: Evidence from the Garner task,"We assessed dysphoric and clinically distressed individuals' ability to ignore the emotional aspects of facial expressions using the Garner speeded-classification task. Garner's paradigm tests the ability to selectively focus on a single relevant dimension while ignoring variations on other, irrelevant, ones. In the present task, the stimuli were faces of men and women expressing happy, angry, and neutral emotions. In Experiments 1 and 2, dysphoric and nondysphoric participants performed the Garner task, focusing on gender and ignoring emotion (Experiment 1) and focusing on emotion and ignoring gender (Experiment 2). Results suggest that dysphoric individuals exhibited more difficulty ignoring the emotional dimension of social stimuli even under specific instructions to do so than nondysphoric individuals. In Experiments 3 and 4, we replicated these results in clinically distressed and nondistressed individuals. The results of Experiment 3 further suggested that depression was more closely associated with the inability to selectively ignore emotion than was social anxiety. Experiment 4 confirmed that this failure of selective attention was specific to processing emotional, and not gender features. The implications of these findings for cognitive and interpersonal theories of depression are discussed.",Gilboa-Schechtman E.; Ben-Artzi E.; Jeczemien P.; Marom S.; Hermesh H.,2004.0,,0,0,
6721,Blunted growth hormone response to clonidine in post-traumatic stress disorder,"Hyperactivity of the sympathetic and noradrenergic systems is thought to be a feature of post-traumatic stress disorder (PTSD). Assessment of noradrenergic receptor function can be undertaken by measuring the growth hormone (GH) response to the α2-agonist clonidine. The aim of this study was to examine whether subjects with combat-related PTSD (with or without co-morbid depression) have a blunted growth hormone response to clonidine, compared to a combat-exposed control group. Twenty-three Vietnam veterans suffering from PTSD alone, 27 suffering from PTSD and co-morbid depression, and 32 veteran controls with no psychiatric illness were administered 1.5 μg/kg clonidine i.v. Plasma growth hormone was measured every 20 min for 120 min. The growth hormone response to clonidine was significantly blunted in the non-depressed PTSD group compared to both the depressed PTSD group and the control group as measured by peak growth hormone, delta growth hormone and AUC growth hormone. Subjects with PTSD and no co-morbid depressive illness show a blunted growth hormone response to clonidine. This suggests that post-synaptic α2-receptors are subsensitive. This finding is consistent with other studies showing increased noradrenergic activity in PTSD. © 2003 Elsevier Ltd. All rights reserved.",Morris P.; Hopwood M.; Maguire K.; Norman T.; Schweitzer I.,2004.0,10.1016/S0306-4530(03)00027-1,0,0,
6722,"Sex differences in mating strategies: Mate guarding, infidelity and multiple concurrent sex partners","We investigated sex differences in post-copulatory mate guarding behaviors, jealous reactions to opposite- versus same-sex infidelity, and preferences for multiple concurrent sex partners. Results of a questionnaire administered to 448 college students showed that: (1) females were more likely to initiate the practice of sleeping with their partner after sexual intercourse; (2) males were more distressed by opposite-sex infidelity, whereas females were equally distressed by both opposite- and same-sex infidelity; and (3) males were more willing than females to engage in sex with multiple concurrent partners. Under hypothetical conditions, males preferred having concurrent sex with two female partners, while females showed a more varied preference for the sexes of the other participants. These findings are consistent with predictions derived from evolutionary theory based upon sex differences in genetic assurance, parental investment and reproductive potential. © 2004 Taylor & Francis Ltd.",Hughes S.M.; Harrison M.A.; Gallup Jr. G.G.,2004.0,10.1080/14616660410001733588,0,0,
6723,Factorial Structure and Invariance Across Gender of the Swedish Self-Consciousness Scale,"In this study, I tested different factor models and the factorial invariance across gender for the Self-Consciousness Scale (Fenigstein, Scheier, & Buss (1975) using confirmatory factor analyses. University students (251 women and 259 men) completed the Swedish version of the scale. A respecified (Item 15 loading on the factor Internal State Awareness [ISA] instead of on the factor Self-Reflection [SR]) 17-item, 4-factor model of Burnkrant and Page (1984) including the factors SR, ISA, Public Self-Consciousness, and Social Anxiety demonstrated the best fit for both men and women. Factor intercorrelations were overall stronger for women. The respecified model demonstrated factorial invariance across gender. I discuss the strengthening of scale reliability through the expansion of subscale items and invariance testing across groups.",Lindwall M.,2004.0,,0,0,
6724,Inhibitory control in Obsessive-Compulsive Disorder,"The clinical features of Obsessive-Compulsive Disorder (OCD) suggest that a fundamental deficit of inhibitory control is intrinsic to the disorder. In this preliminary study, we sought to examine cognitive disinhibition in OCD by using an established laboratory technique. The stop signal task was administered to a higher functioning, untreated group of individuals with OCD, and to healthy comparison participants. Surprisingly, the OCD participants exhibited more accurate performance, suggesting better inhibitory control on this task. This unexpected finding suggests that higher functioning individuals with OCD are capable of adequate inhibition in certain contexts. It was speculated, however, that emotional stimulation might negatively affect performance and that this might be studied in subsequent research. © 2004 Elsevier Inc. All rights reserved.",Krikorian R.; Zimmerman M.E.; Fleck D.E.,2004.0,10.1016/j.bandc.2004.02.038,0,0,
6725,Applying decision analysis to facilitate informed decision making about prenatal diagnosis for Down syndrome: A randomised controlled trial,"Objective: To evaluate decision analysis as a technique to facilitate women's decision-making about prenatal diagnosis for Down syndrome using measures of effective decision-making. Design: Randomised controlled trial in a UK hospital's prenatal diagnosis clinic. Intervention: Routine versus routine consultation structured by decision analysis. Participants: 117/132 women receiving a screen-positive maternal serum screening result participated (58 routine, 59 decision analysis). Methods: Consultations were audio tape-recorded, transcribed and coded; questionnaires were completed after the consultation and one month later after receipt of a diagnostic test and/or the 19-week scan result. Main measures: Test decision, subjective expected utilities, knowledge, informed decision-making, risk perception, decisional conflict, anxiety, perceived usefulness and directiveness of consultation information. Results: 48/59 in the decision-aided group and 47/58 in the routine group underwent prenatal diagnosis. Informed decision-making was higher, perceived risk more realistic and decisional conflict over time lower in the decision analysis group. Decision analysis had no impact on knowledge or SEU scores, and was no more or no less directive, useful or anxiety provoking than the routine care. Consultations were six minutes longer. Conclusions: Decision analysis consultations enable women to make more informed prenatal diagnosis decisions. Professionals will need training to use this technique effectively. Copyright © 2004 John Wiley & Sons, Ltd.",Bekker H.L.; Hewison J.; Thornton J.G.,2004.0,10.1002/pd.851,0,0,
6726,An investigation of the cognitive organization of body comparison sites in relation to physical appearance related anxiety and drive for thinness,"Modeling cognitive processes that link variables associated with maladaptive behavior has led to successful interventions, particularly for alcohol use. In the present study, Individual Differences Scaling (INDSCAL) was used to model the cognitive structure of appearance-related comparisons in relation to physical appearance related anxiety and drive for thinness (DT) among 635 college students. Results were consistent with previous work in finding two primary comparison dimensions. A weight/nonweight dimension was primarily emphasized by females and a muscle/nonmuscle dimension was primarily emphasized by males. These gender differences continued to be evident when females and males were matched on levels of appearance-related anxiety and DT. Gender-specific analyses indicated that females with higher levels of appearance-related anxiety and DT primarily emphasized the weight dimension while females with lower levels of these characteristics tended to emphasize a physical attractiveness dimension. Males with higher levels of appearance-related anxiety and DT also primarily emphasized the weight dimension while males with lower levels of these characteristics tended to emphasize a muscle-related dimension. Findings are discussed in terms of risk factors for disturbance, and as a means of improving assessment, treatment, and prevention strategies. © 2004 Elsevier Ltd. All rights reserved.",Gokee-LaRose J.; Dunn M.E.; Tantleff-Dunn S.,2004.0,10.1016/j.eatbeh.2004.01.003,0,0,
6727,Aversion to risk and guilt,"Much research has shown that cognitive processes are largely guided by individuals' states of mind (Mancini & Gangemi, 2002a, in press; Smeets, de Jong, & Mayer, 2000). In this paper, we specifically consider a state of mind characterized by guilt for having acted irresponsibly. This state is currently considered the breeding ground for the obsessive-compulsive disorder (Rachman, 2002; Salkovskis & Forrester, 2002). Our aim is to examine the impact of this state of mind on decision under risk. We hypothesize that individuals' choices (risk seeking/risk aversion) depend on how they evaluate themselves, as guilty or as victims of a wrong, and thus on moral values. People who evaluate them-selves as guilty are expected to show a risk-averse preference. People who evaluate themselves as victims are expected to show a risk-seeking preference. In two different experiments, we demonstrated that non-clinical participants' aversion to risky choices and preference for risky choices vary as a function of their moral role (guilty/victim). As predicted, in both the experiments, participants experienced intolerance for risk, making more riskless choices, in the context of guilt. Thus, aversion to risk-taking is actually affected by a mental state of guilt. Copyright © 2004 John Wiley & Sons, Ltd.",Mancini F.; Gangemi A.,2004.0,10.1002/cpp.418,0,0,
6728,"Treatment Counselor's Attitudes about Lesbian, Gay, Bisexual, and Transgendered Clients: Urban vs. Rural Settings","Treatment counselors' attitudes about lesbian, gay, bisexual, and transgendered (LGBT) clients can have important effects on these client's recovery. There is a common, but unexamined, perception that LGBT people are more accepted in urban areas (and thus urban treatment programs) and that urban counselors have greater knowledge of the needs of the LGBT community. This study examined the attitudes and knowledge of treatment counselors from two geographic regions: urban Chicago (n = 109) and rural Iowa (n = 242) in 2000. The instrument assessed demographic characteristics, knowledge, and experiences working with LGBT clients, and attitudes about LGBT clients (an adaptation of Herek's Attititudes about Lesbians and Gays rating scale). Only a few demographic differences between the urban and rural counselors were identified. Chicago counselors were more racially diverse and more likely to have grown up in an urban area than the Iowa counselors. The Iowa counselors had slightly higher levels of formal education. Although the Chicago providers reported having considerably more contact with LGBT clients and more formal and continuing education about LGBT people, they did not have more positive attitudes or report more knowledge of specific LGBT issues that might influence alcohol and drug treatment. Overall, both Chicago and Iowa counselors had very little formal education regarding the needs of LGBT clients, and nearly half reported negative or ambivalent attitudes. Many of the counselors lacked knowledge about legal issues such as domestic partnership and power of attorney, the concepts of domestic partnership and internalized homophobia, and issues related to family of origin and current family.",Eliason M.J.; Hughes T.,2004.0,10.1081/JA-120030063,0,0,
6729,Effect of repeat exposure on neuroendocrine and symptom responses to pentagastrin,"The cholecystokinin (CCK-B) agonist pentagastrin stimulates dose-dependent release of adrenocorticotropin (ACTH) and cortisol in humans, likely via direct pharmacological action at pituitary CCK-B receptors. Pentagastrin also produces side effects, however, which may be experienced as novel or anxiety arousing and could contribute to ACTH release. Available data suggest that pentagastrin's activation of the hypothalamic-pituitary-adrenal (HPA) axis is unrelated to anxiety symptoms themselves, but novelty effects have not been examined in this model and do strongly activate this system in animals. To further explore the impact of novelty and anxiety symptoms on HPA responses, pentagastrin was administered twice to 12 subjects (six male, six female) under single-blind conditions. Repeat pentagastrin injection was associated with a slight habituation in the magnitude of symptom and HPA axis responses, but robust HPA and symptom responses were seen following both injections. No relationships were found between anxiety symptoms and HPA activity and the modest symptomatic and neuroendocrine habituation appeared to occur independently. Pentagastrin may release ACTH and cortisol through direct pharmacological action, perhaps enhanced on first exposure by psychologically mediated novelty effects. Novelty, per se, is not likely the primary mediator of the HPA response. This model may be useful for further study of cognitive-emotional modulators of HPA axis activity. © 2004 Elsevier Ireland Ltd. All rights reserved.",Khan S.; Liberzon I.; Abelson J.L.,2004.0,10.1016/j.psychres.2004.01.009,0,0,
6730,Elucidating the mechanism of uncertainty and doubt in obsessive-compulsive checkers,"The article presents three studies that explore the scope and mechanism of reduced confidence in obsessive-compulsive (OC) checkers. In the first study OC checkers, but not panic disorder patients, reported less confidence in their answers to a general knowledge test compared to non-anxious (NA) participants. The second study replicated these findings, but contrary to our prediction, the reduced confidence in OC checkers was not reflected in a disconfirmation bias in this population when both types of evidence were available. The third study found that when the same questions were repeated three times, the confidence of OC checkers progressively decreased, while that of the NA participants progressively increased. © 2004 Elsevier Ltd. All rights reserved.",Dar R.,2004.0,10.1016/j.jbtep.2004.04.006,0,0,
6731,Analysis of psychologic health level and individual characteristics of basic science collegian,"Aim: To explore the individual characteristics and the psychologic health level of basic science(B. Sc.) collegian. Methods: The psychologic status and personality structure of 161 B. Sc. collegians were assessed by the symptom checklist (SCL-90) and Eysenck Personality Questionnaire (EPQ). They were assigned into study group(n = 161) and control group. The control group contained healthy elderly people group, which had no obvious mental-body disorders(n = 84), norm group(n = 1 388) and same age group(n = 176). Results: The psychologic health level of the B. Sc. collegian was significantly lower than that of elderly people group and norm group, mainly in compulsion (X2 = 70.75), interpersonal sensitivity (X2 = 68.87), psychoticism (X2 = 55.32), paranoid ideation(X2 = 54.61), anxiety(X2 = 43.89) and hostility (X2 = 70.75) etc. Their mental disease tendency, introversion and extroversion, as well as personal stablity scores(t = -1.69, -0.96, -1.13; P < 0.05 - 0.01) were higher than those of the control groups. Conclusion: The psychologic health level of B. Sc. collegian is lower comparatively. It requires high regards and psychological intervention.",Lu L.-P.; Huang J.-F.; Sun R.-F.; Fan W.-P.,2004.0,,0,0,
6732,Attachment and interpersonal impact perceptions of group members: A social relations model analysis of transference,"Graduate students (N = 76) in 12 training groups reported, at pretest, memories of emotional bonds with parents and adult attachment avoidance and anxiety. At the midpoint and termination phases, they provided Impact Message Inventory ratings of fellow group members. Social relations model (SRM) analyses were used to partition variance in these round-robin data into perceiver and target variance. Thus, aggregate ratings of fellow group members provided a standard against which discrepant perceptions of a given member could be assessed. These discrepancies, in the form of SRM perceiver variance, were interpreted as indicators of transference and were significantly associated with negative memories of parents and attachment avoidance. Target variance showed consensus in group members' ratings of dommance or affiliation for a given member and was significantly associated with negative memories of parents and attachment anxity. © 2004 Society for Psychotherapy Research.",Mallinckrodt B.; Chen E.C.,2004.0,,0,0,
6733,"The Arabic Scale of Death Anxiety (ASDA): Its development, validation, and results in three Arab countries","The Arabic Scale of Death Anxiety (ASDA) was constructed and validated in a sample of undergraduates (17-33 yrs) in 3 Arab countries, Egypt (n = 418), Kuwait (n = 509), and Syria (n = 709). In its final form, the ASDA consists of 20 statements. Each item is answered on a 5-point intensity scale anchored by 1: No, and 5: Very much. Alpha reliabilities ranged from .88 to .93, and item-remainder correlations ranged between .27 and .74; the 1-week test-retest reliability was .90 (Egyptians only), denoting high internal consistency and stability. The correlations between the ASDA and Templer's DAS ranged from .60 to .74 denoting high convergent validity of the ASDA against the DAS in the 3 Arab countries. Four factors were extracted in the Egyptian sample and labeled ""Fear of dead people and tombs"". ""Fear of postmortem events"", ""Fear of lethal disease"", and ""death preoccupation"". The first two factors were almost completely identical in the three countries. The item, ""I fear the torture of the grave"", had a very high mean score. There were significant correlations between the ASDA and death depression, death obsession, reasons for death fear, and general anxiety, depression, obsession-compulsion, neuroticism, and being a female. All female groups attained significantly higher mean ASDA scores than their male counterparts. Kuwaitis had higher mean ASDA total scores, in comparison with their Egyptian and Syrian counterparts, where as female Syrians attained the lowest mean ASDA total score in proportion to their female peers.",Abdel-Khalek A.M.,2004.0,10.1080/07481180490437572,0,0,
6734,The effect of 5-hydroxytryptophan on cholecystokinin-4-induced panic attacks in healthy volunteers,"Previous studies suggest a modulatory role of serotonin (5-HT) in experimentally-induced panic attacks. In the current study, we investigated the acute effects of 5-HT precursor l-5-hydroxytryptophan (5-HTP) on the response to panicogenic challenge with cholecystokinin-tetrapeptide (CCK-4) in healthy volunteers. Thirty-two subjects were randomized to receive either 200 mg of 5-HTP or placebo with the CCK-4 challenge following in 90 min in a double-blind, parallel-group design. The results showed a nonsignificant difference between the groups in panic rate (19% after 5-HTP and 44% after placebo, p = 0.13) with a trend for lower intensity of symptoms after 5-HTP (p = 0.08). Further analysis by gender revealed that females in the 5-HTP group had a significantly lower panic rate and intensity of cognitive symptoms whereas, in males, the effect of 5-HTP was limited to lowering the intensity of somatic panic symptoms. Thus, an increased availability of 5-HT may have a gender-dependent protective effect in CCK-4-induced panic.",Maron E.; Tõru I.; Vasar V.; Shlik J.,2004.0,10.1177/0269881104042619,0,0,
6735,Development decrease in REM sleep: The shift to kainate receptor regulation,"We found a shift in the responsiveness of pedunculopontine neurons from N -methyl-d-aspartic acid (NMDA) to kainic acid (KA) regulation around 15 days of age. While rapid eye movement (REM) sleep in humans decreases from 50 to 15% of sleep time between birth and the end of puberty, a similar decrease in the rat occurs from 10 to 30 days postnatally. Intracellularly recorded type II cholinergic PPN neurons, known to modulate waking and REM sleep, showed a gradual decrease in responsiveness to NMDA, and an increase in responsiveness to KA, during this period. Non-cholinergic PPN neurons did not show a developmental-dependent change in responsiveness. These results do not help explain if KA and NMDA control the developmental decrease in REM sleep, however, the data indicate that the shift at ∼15 days suggests that REM sleep becomes selectively modulated by KA receptors in the adult. Therefore, given development of appropriate compounds, KA receptor antagonism may become an effective treatment for disorders that manifest increased REM sleep drive and produce frequent nocturnal arousals and awakenings, e.g. schizophrenia, anxiety, insomnia, etc. © 2004 Elsevier Ltd. All rights reserved.",Kobayashi T.; Skinner R.D.; Garcia-Rill E.,2004.0,10.1016/j.tharel.2004.01.002,0,0,
6736,Time course of attentional bias for threat scenes: Testing the vigilance-avoidance hyporthesis,"The study tested the vigilance-avoidance hypothesis, which proposes that anxiety-related attentional biases vary over time (i.e., initial vigilance for high threat cues, followed by avoidance). To investigate this, pictorial stimuli, which included scenes of injury, violence, and death, were presented in a visual probe task for two exposure durations: 500 ms and 1500 ms. Results showed that, in comparison with low trait anxious participants, high trait anxious individuals were more vigilant for high threat scenes at the shorter exposure duration (500 ms), and showed no attentional bias at the longer duration. However, the results also indicated significant avoidance of high threat scenes at the longer exposure duration in participants with high levels of blood-injury fear. These findings are discussed in relation to recent research indicating that anxiety and fear may reflect two distinct aversive motivational systems, which may be characterised by different patterns of cognitive bias. © 2004 Psychology Press Ltd.",Mogg K.; Bradley B.P.; Miles F.; Dixon R.,2004.0,10.1080/02699930341000158,0,0,
6737,Impact of coaching on malingered posttraumatic stress symptoms on the M-FAST and the TSI,"Of the existing posttraumatic stress disorder dissimulation studies, relatively few have employed a coaching challenge using the Miller Forensic Assessment of Symptoms Test and/or Trauma Symptom Inventory. The current investigation employed a coaching procedure that included both symptom specific information and strategies for avoiding detection on psychological validity scales. Participants were 68 undergraduate psychology students from a major mid-Atlantic university. Participants in the control groups were instructed to answer all interview and self-report items honestly. Those who were instructed to malinger were provided with a scenario in which they were to feign psychological trauma symptoms in order to secure financial gain through civil litigation. Unlike previous research, those who were provided with symptoms and/or symptoms and strategies were found to be no more successful at malingering PTSD than were those who were not provided with this information. While only two-thirds of the simulators were detected as malingering using the M-FAST total score or TSI validity scales, nearly 90% were identified when these measures were utilized together. © 2004 by The Haworth Press, Inc. All rights reserved.",Guriel J.; Yãnez T.; Fremouw W.; Shreve-Neiger A.; Ware L.; Filcheck H.; Farr C.,2004.0,10.1300/J158v04n02_02,0,0,
6738,Design and feasibility of a new cognitive-behavioural therapy course using a longitudinal interactive format,"Objective: This report describes the design and feasibility of conducting a unique longitudinal supervision course incorporating both therapist and patient evaluation measures in teaching cognitive-behavioural therapy (CBT) to a group of mental health practitioners. Method: We designed a 10-session longitudinal supervision course to teach CBT by applying key continuing medical education (CME) principles. Each session consisted of 30 minutes of didactics and demonstrations followed by 90 minutes of group case supervision. Course participants were mental health practitioners who treated patients from their own practice; most of the patients suffered from a depressive and (or) anxiety disorder. We assessed therapists for CBT skill acquisition at the beginning and at the end of the course, using the Cognitive Therapy Scale (CTS). We assessed patients' symptoms weekly, using the Beck Depression Inventory, the Beck Anxiety Inventory, and the Clinical Global Impression scale. Results: A total of 34 participants enrolled in three 10-session courses. Most participants submitted audiotapes for rating at the beginning and end of the course, and most submitted patient symptom information. Conclusions: This course shows promise as an effective way to teach complex skills in CBT to mental health providers. In limited samples, the course showed clear improvement in therapist adherence to CBT and in patients' clinical outcomes. Future research is required to validate the potential benefit of this CME intervention for mental health practitioners treating patients with mood and anxiety disorders.",Lau M.A.; Dubord G.M.; Parikh S.V.,2004.0,,0,0,
6739,Preparing psychiatry residents for the certification exam: A survey of residency and exam experiences,"Objective: To determine which methods best prepare psychiatry residents for the certification exam, and ultimately for practice, to facilitate appropriate residency program curriculum changes. Method: We sent an anonymous survey to all final year (that is, PGY5) Canadian university-affiliated psychiatry residents, regarding frequency and diversity of observed interviews, form of feedback delivery, research and other training experiences, self-perception of preparedness and knowledge base, and management strategies for exam anxiety 6 months before and immediately after the certification exam. Results: There was a 52% response rate. Residents from across Canada identified the following factors as enabling successful exam completion: regular mock orals supervised by Royal College examiners, clinical experience with exposure to a wide spectrum of pathologies, individual and group study time, and appropriate anxiety management. Preparation for the oral exam involving sample case vignettes with presentation and formulation skills training was considered to be essential but was identified as an area of educational and experiential weakness in some programs. Conclusions: To prepare psychiatry residents for successful completion of their certification exam, programs should incorporate regular mock orals observed by Royal College examiners throughout residency training (not just in PGY2 and PGY5). Programs should also incorporate training in case vignettes, training in oral exam skills, and teaching of anxiety-management strategies.",Crockford D.; Holt-Seitz A.; Adams B.,2004.0,,0,0,
6740,Effect of stimulus type and worry on physiological response to fear,"The current study investigated whether the immediacy and concreteness of fear stimuli play an important role in the effects of trait worry on physiological response to fear. One hundred and eight participants were exposed to one of three fear-provoking stimuli: an actual spider (immediate and concrete), an opaque box which they were told contained a spider (immediate but abstract), or a recorded script (distant and abstract). Participants were yoked by levels of worry and gender. Heart rate, vagal tone, and skin conductance were recorded. The combination of high worry and an actual spider caused the largest decrease in vagal tone, but both the actual spider and opaque box increased skin conductance regardless of worry level. The results suggest that factors, such as the type of fear stimulus and the type of physiological measures used, are vital in understanding the reasons for and the limits of fear activation. © 2003 Elsevier Inc. All rights reserved.",Castaneda J.O.; Segerstrom S.C.,2004.0,10.1016/j.janxdis.2003.10.003,0,0,
6741,Music performance anxiety and occupational stress amongst opera chorus artists and their relationship with state and trait anxiety and perfectionism,"This study explored the inter-relationships among state and trait anxiety, occupational stress, perfectionism, aspiration, and music performance anxiety in a group of elite operatic chorus artists employed full-time by a national opera company. The chorus artists reported higher trait anxiety, higher occupational role concerns, and higher occupational personal strain than normative samples. Higher scores on personal resources were associated with the higher scores on trait anxiety. It appears that these resources were used adaptively to manage anxiety. High trait anxiety was also associated with high personal strain in the work environment. Anxiety was not related to occupational roles or issues related to the physical environment or working conditions. These results suggest that while trait anxiety and music performance anxiety were closely associated, occupational stress makes a separate contribution to the quality of working life experienced by elite choral artists. © 2003 Elsevier Inc. All rights reserved.",Kenny D.T.; Davis P.; Oates J.,2004.0,10.1016/j.janxdis.2003.09.004,0,0,
6742,The structure of obsessionality among young adults,"Although the phenomenology of obsessive-compulsive disorder (OCD) is well understood, less is known about the structure of obsessive symptoms in non-clinical populations. The present study examines the factorial structure of the Leyton Obsessional Inventory short form (LOI-SF) in a sample of 1,015 undergraduate college students. Four factors were extracted describing concerns about contamination (labeled the Contamination factor); repeating behaviors or uncomfortable thoughts or doubts (labeled the Doubts/Repeating factor); checking behaviors, too much attention to detail, honesty concerns, strict conscience and strict routine (labeled the Checking/Detail factor); and taking a long time to dress and to hang up and put away clothing, as well as belief in extremely unlucky numbers (labeled Worries/Just Right factor). Self-report measures of anxiety and ADHD symptoms were correlated positively with these factors, particularly with the checking/detail factor. The prevalence, symptom structure, and patterns of comorbidity seen in this sample of unselected college students are similar to the patterns seen in adolescents with OCD, suggesting that obsessional symptoms and OCD may exist along a continuum.",Mathews C.A.; Jang K.L.; Hami S.; Stein M.B.,2004.0,10.1002/da.20028,0,0,
6743,Do medical students with A-level mathematics have a better understanding of the principles behind evidence-based medicine?,"With the advent of evidence-based medicine, medical students, doctors and other healthcare professionals are required to be more skilled in the interpretation and manipulation of numerical data. The authors observed that undergraduate students without A-level mathematics expressed concern as to their ability to cope with an epidemiology and biostatistics course. It was hypothesized that these anxieties reflected differences in attitudes to numerical manipulation rather than any real lack of competence. Mean exam performance scores were compared for 498 first-year medical students between 2000 and 2002 depending on whether the students did or did not have A-level mathematics. The data revealed no difference in performance. Students without mathematics A-level scored marginally worse (-1.1%, 95%",Ben-Shlomo Y.; Fallon U.; Sterne J.; Brookes S.,2004.0,10.1080/01421590400016290,0,0,
6744,Fear and the amygdala: Manipulation of awareness generates differential cerebral responses to phobic and fear-relevant (but nonfeared) stimuli,"Rapid response to danger holds an evolutionary advantage. In this positron emission tomography study, phobics were exposed to masked visual stimuli with timings that either allowed awareness or not of either phobic, fear-relevant (e.g., spiders to snake phobics), or neutral images. When the timing did not permit awareness, the amygdala responded to both phobic and fear-relevant stimuli. With time for more elaborate processing, phobic stimuli resulted in an addition of an affective processing network to the amygdala activity, whereas no activity was found in response to fear-relevant stimuli. Also, right prefrontal areas appeared deactivated, comparing aware phobic and fear-relevant conditions. Thus, a shift from top-down control to an affectively driven system optimized for speed was observed in phobic relative to fear-relevant aware processing.",Carlsson K.; Petersson K.M.; Lundqvist D.; Karlsson A.; Ingvar M.; Öhman A.,2004.0,10.1037/1528-3542.4.4.340,0,0,
6745,Eye movements and behavioral responses to threatening and nonthreatening stimuli during visual search in phobic and nonphobic subjects,"Spider-phobic and nonphobic subjects searched for a feared/fear-relevant (spider) or neutral target (mushroom) presented in visual matrices of neutral objects (flowers). In half of the displays, the mushroom target was paired with a spider distractor, or a spider target was paired with a mushroom distractor. Although all subjects responded faster to the neutral target than to the feared/fear-relevant target, phobics were slower to respond than nonphobics when a mushroom target was presented with a spider distractor. Their eyes appeared to be drawn to the feared distractor before fixating neutral targets. A further experiment indicated no group differences when subjects merely judged the homogeneity of matrices. Thus, threat seems to capture the attention of phobics only when it is part of a background that subjects are explicitly instructed to ignore.",Miltner W.H.R.; Krieschel S.; Hecht H.; Trippe R.; Weiss T.,2004.0,10.1037/1528-3542.4.4.323,0,0,
6746,Relations between hypnotizability and psychopathology revisited,"Inspired by a first episode of schizophrenia following within a week of stage hypnosis, we examined relations between schizotypy and hypnotizability with the Harvard Group Scale of Hypnotic Susceptibility (HGSHS), showing positive associations with 15 items mostly consisting of positive aspects of schizotypy. Here this was re-examined in two further samples. First, with the more cognitively loaded Stanford Hypnotic Susceptibility Scale, Form C, administered individually to Italian, female psychology students. In the second the HGSHS was administered to British medical student volunteers in stress reduction studies. In the first replication 12 correlations were disclosed, all with positive features of schizotypy, nine consisting of unreality experiences, with six items relating to psychic experiences. In the second replication of the 13 positive associations, seven were negative items belonging to the withdrawn syndrome, with six belonging to the social anxiety subscale, a non-specific feature of schizotypy. Across the series of studies, all but one item was interpreted as consistent with associations between hypnotizability and positive schizotypy and social anxiety. Though the items mostly varied from study to study, and despite sampling and scale differences, the outcome clearly merits large scale studies to investigate further the relation between hypnotic susceptibility and psychopathology.",Gruzelier J.; De Pascalis V.; Jamieson G.; Laidlaw T.; Naito A.; Bennett B.; Dwivedi P.,2004.0,,0,0,
6747,Relation between trauma and psychopathology: Mediating roles of dissociation and fears about death and control,"We investigated mediational relations among trauma, dissociation, psychopathology (e.g., PTSD, borderline personality disorder, bulimic behaviors), and fears about death and lacking control in a sample of 325 non-treatment-seeking women. With the use of structural equation modeling, findings indicated that: (1) dissociation accounted for 27% of variance in the trauma-psychopathology relation (significant partial mediation), and (2) general ongoing fears about death and control accounted for an additional 20% of variance in the trauma-psychopathology relation beyond what was already accounted for by dissociation (total of 47% of variance explained in the trauma-psychopathology relation; significant partial mediation). Findings are discussed, and postulations about relations are proposed. © 2004 by The Haworth Press, Inc. All rights reserved.",Gershuny B.S.; Najavits L.M.; Wood P.K.; Heppner M.,2004.0,10.1300/J229v05n03_08,0,0,
6748,Neural correlates of speech anticipatory anxiety in generalized social phobia,"Patients with generalized social phobia fear embarrassment in most social situations. Little is known about its functional neuroanatomy. We studied BOLD-fMRI brain activity while generalized social phobics and healthy controls anticipated making public speeches. With anticipation minus rest, 8 phobics compared to 6 controls showed greater subcortical, limbic, and lateral paralimbic activity (pons, striatum, amygdala/uncus/anterior parahippocampus, insula, temporal pole) - regions important in automatic emotional processing - and less cortical activity (dorsal anterior cingulate/prefrontal cortex) - regions important in cognitive processing. Phobics may become so anxious, they cannot think clearly or vice versa. © 2004 Lippincott Williams & Wilkins.",Lorberbaum J.P.; Kose S.; Johnson M.R.; Arana G.W.; Sullivan L.K.; Hamner M.B.; Ballenger J.C.; Lydiard R.B.; Brodrick P.S.; Bohning D.E.; George M.S.,2004.0,,0,0,
6749,Inhibition of return in patients with obsessive-compulsive disorder,"The present study is aimed at replicating and extending previous results by Nelson et al. [Psychiatry Res. 49 (1993) 183], who found decreased inhibition of return (IOR) in patients with obsessive-compulsive disorder (OCD). Thirty OCD patients, 14 psychiatric, and 14 healthy controls participated in a visual cueing experiment. The task required detection of a target stimulus at one of two possible locations. Prior to the target, an uninformative cue appeared at one of these two locations. The Stimulus Onset Asynchrony (SOA) between the cue and the target was systematically varied. We were especially interested in whether severity of OCD symptoms would be negatively correlated with inhibition for previously occupied locations. In accordance with prior research on healthy participants all groups displayed a comparable response pattern: facilitation at the short SOA condition and increasing IOR for the longer SOA conditions. Medication, comorbid depression, and OCD severity did not consistently moderate these effects. © 2003 Elsevier Inc. All rights reserved.",Moritz S.; Von Mühlenen A.,2005.0,10.1016/j.janxdis.2003.11.003,0,0,
6750,"A mood-as-input account of perseverative checking: The relationship between stop rules, mood and confidence in having checked successfully","The present paper reports the results of two experiments designed to test predictions from the mood-as-input account of perseverative checking. Using an analogue checking task, both experiments showed that perseveration, as indicted by a range of measures relevant to compulsive checking, was affected by the configuration of the stop rule for the task and mood at the outset of checking. Perseveration was most significant in the condition that most closely resembled the characteristics of obsessive-compulsive checkers (negative mood combined with a stop rule that specifies that the task should be done as thoroughly as possible - namely, an 'as many as can' stop rule). The studies also indicated that confidence at having completed the checking task successfully was (1) significantly related to the use of 'as many as can' stop rules at the outset of checking, (2) mood ratings at the end of checking, and (3) checking perseveration generally. These findings provide support for a mood-as-input explanation of perseverative psychopathologies such as compulsive checking, and begin to cast some light on how anxiety-reduction and 'confidence' models of compulsive checking, might be explained within broader mechanisms of perseveration. © 2003 Elsevier Ltd. All rights reserved.",Benie MacDonald C.; Davey G.C.L.,2005.0,10.1016/j.brat.2003.11.003,0,0,
6751,"Cardiac Vagal Tone, defensiveness, and motivational style","Cardiac Vagal Tone has been proposed as a stable biological marker for the ability to sustain attention and regulate emotion [Porges, Monographs of the Society for Research in Child Development 59 (1994) 167-186]. Vagal tone is a physiological index of parasympathetic nervous system influence on the heart that has predicted a number of emotional behaviors and styles in infants, children, and adults. Little research, however, has sought to explore the link between vagal tone and established variables relating to personality and self-regulation. In this study, vagal tone was collected during 5-min baseline, stress, and recovery periods. Subjects (n=98) also completed a short form of the Marlowe-Crowne Social Desirability Scale, the Behavioral Activation and Behavioral Inhibition Scales, the Taylor Manifest Anxiety Scale, the Self-Consciousness Scale, and the Openness to Experience subscale of the Five Factor Personality Inventory. Poorer modulation for vagal tone was associated with greater social anxiety, while lower vagal tone across recording periods was associated with greater defensiveness and lower behavioral activation sensitivity. © 2004 Elsevier B.V. All rights reserved.",Movius H.L.; Allen J.J.B.,2005.0,10.1016/j.biopsycho.2004.03.019,0,0,
6752,Development of the body image concern inventory,"Development of the Body Image Concern Inventory (BICI), a measure designed to assess dysmorphic concern, is described. A panel of expert raters supported the construct validity of the measure, and four college student samples (Ns=184, 200, 56, 40) supported the internal consistency of the BICI. In addition, in studies 1 and 3, concurrent validity was established through comparison of the BICI to extant self-report and interview measures of dysmorphic symptomatology. Convergent validity patterns were assessed through comparison with measures of obsessive-compulsive and eating disorder symptomatology in studies 2 and 4. Finally, the results of study 4 supported that the BICI discriminated individuals with a diagnosis of Body Dysmorphic Disorder or bulimia (disorders that frequently involve high levels of dysmorphic concern) from those with subclinical symptoms. Results suggest that the BICI is a reliable, valid, and user-friendly tool for assessing dysmorphic concern, with utility in both research and clinical settings. © 2004 Elsevier Ltd. All rights reserved.",Littleton H.L.; Axsom D.; Pury C.L.S.,2005.0,10.1016/j.brat.2003.12.006,0,0,
6753,Not just right experiences and obsessive-compulsive features: Experimental and self-monitoring perspectives,"Individuals with obsessive-compulsive disorder (OCD) often report compulsions aimed at reducing feelings of something not being just right or sensations of incompleteness. Research using self-report questionnaires has demonstrated a link between not just right experiences (NJREs) and OCD symptoms (Behav. Res. Therapy 41 (2003) 681; Anxiety, 1 (1995) 208). Extending previous work, this paper presents experimental and self-monitoring data on NJREs in an undergraduate sample. NJREs produced distress and urges to change something, but feared consequences were rare. Stronger responses were found for naturally occurring self-monitored NJREs compared to NJREs elicited in the laboratory. Several significant relationships were found between features of NJREs and OC symptoms and constructs theoretically related to OCD (e.g., responsibility, incompleteness), but no significant relationships were found between features of NJREs and non-OCD-related constructs (worry, depressive symptoms, social anxiety). Further consideration of NJREs will be useful in improving our understanding of the phenomenology, neurobiological substrates, and treatment, of OCD. © 2004 Elsevier Ltd. All rights reserved.",Coles M.E.; Heimberg R.G.; Frost R.O.; Steketee G.,2005.0,10.1016/j.brat.2004.01.002,0,0,
6754,A double-blind study in healthy volunteers to assess the effects on sleep of pregabalin compared with alprazolam and placebo,"Study Objectives: To assess the effects of pregabalin compared with alprazolam and placebo on aspects of sleep in healthy volunteers. Design: Randomized, double-blind, placebo- and active-controlled, 3-way crossover. Setting: Single research center. Participants and Interventions: Healthy adult (12 men) volunteers (N = 24) received oral pregabalin 150 mg t.i.d., alprazolam 1 mg t.i.d., and placebo t.i.d. for 3 days. Measurements and Results: Objective sleep was measured by an 8-channel polysomnograph; subjective sleep was measured using the Leeds Sleep Evaluation Questionnaire. Compared with placebo, pregabalin significantly increased slow-wave sleep both as a proportion of the total sleep period and the duration of stage 4 sleep. Alprazolam significantly reduced slow-wave sleep. Pregabalin and alprazolam produced modest, but significant, reductions in sleep-onset latency compared with placebo. Rapid eye movement sleep latency after pregabalin was no different than placebo but was significantly shorter than that found with alprazolam. Although there were no differences between the active treatments, both pregabalin and alprazolam reduced rapid eye movement sleep as a proportion of the total sleep period compared with placebo. Pregabalin also significantly reduced the number of awakenings of more than 1 minute in duration. Leeds Sleep Evaluation Questionnaire ratings of the ease of getting to sleep and the perceived quality of sleep were significantly improved following both active treatments, and ratings of behavior following awakening were significantly impaired by both drug treatments. Conclusions: Pregabalin appears to have an effect on sleep and sleep architecture that distinguishes it from benzodiazepines. Enhancement of slow-wave sleep is intriguing, since reductions in slow-wave sleep have frequently been reported in fibromyalgia and general anxiety disorder.",Hindmarch I.; Dawson J.; Stanley N.,2005.0,,0,0,
6755,Relationship of parental rearing styles and the correlative factors with the mental health of medical students,"Background: Parental rearing styles has profound and long-range effects on the mental development of their children. Objective: To investigate the relationship between parental rearing styles and its correlative factors and the mental health of medical students. Design: A transactional survey study based on medical students. Setting: Department of psychology in a clinical medical college of a normal school. Participants: The study was conducted in the faculty of medicine of Hangzhou Normal School in December 2002. Totally 165 students of grade 2000 - 2002 including 106 college students, 59 undergraduates, and 98 males, 67 females were selected as subjects. The youngest was 19 years old and the oldest was 24 years old. Totally 161 students had both parents (97.60%), 4 students had single parent (2.40%), 53 students were the only child of their family (32.10%), and 112 students were not the only child of the family (67.90%). Methods: Egna minnen barndoms uppfostran (EMBU) and symptom checklist 90 (SCL-90) was introduced to evaluate the parental rearing styles and the mental health level in 165 medical students. SPSS 10.0 software was used for correlation analysis and multifactor stepwise regression analysis. Main outcome measures: Scores for 11 factors in EMBU including father's emotional warmth and understanding, father's punishment and stringency, father's excessive interference, father's favoritism, father's rejection of deny, father's excessive protection, mother's emotional warmth and understanding, mother's excessive interference, mother's excessive protection, mother's punishment and stringency, and mother's favoritism, and the selection status of the factors correlated with the parental rearing styles including the relationship between father and mother, family income, and family type, etc. Total mean and scores for 9 factors in SCL-90 including somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paraniod ideation and psychoticism. Results: Correlation analysis displayed that there was significant positive correlation between father's punishment and stringency and somatization, sensitive human relationship (r = 0.186, r = 0.162), between mother's punishment and stringency and sensitive human relationship (r = 0.185), between father's favoritism and obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paraniod ideation and psychoticism factor and total mean (r = 0.161, 0.243, 0.224, 0.182, 0.166, 0.193), between mother's favoritism and depression (r = 0.132), between father's excessive protection and depression, anxiety, and total mean (r = 0.177, 0.204, 0.162), and between mother's rejection of deny and sensitive human relationship (r = 0.162). There was significant negative correlation between father's emotional warmth and anxiety, hostile (r = - 0.187, - 0.241). As indicated by multifactor stepwise regression analysis for the impacts of parental rearing styles and its correlative factors on SCL-90 total mean, rearing styles including mother's education background and father's excessive protection entered into regression equation (β = - 0.269, P = 0.001; β = - 0.187, P = 0.016). Conclusion: Parents' punishment and stringency, parents' favoritism, father's excessive protection and mother's rejection of deny are not good for the mental health of medical students. Father's emotional warmth is good for the improvement of mental health in medical students. The impacts of father's excessive protection and mother's education background are even more important to the mental health of medical students. Hence, the improvement of mental health in students should extend to the instruction of parental rearing styles.",Ma W.-N.,2005.0,,0,0,
6756,Sympathoneural adrenomedullary functional effects of α2c- adrenoreceptor gene polymorphism in healthy humans,"Objectives: α2-Adrenoreceptors restrain sympathetic nervous outflows and inhibit release of noradrenaline from sympathetic nerves. In-frame deletion of the α2c-adrenoreceptor subtype (α2CDel322-325) increases the risk of congestive heart failure. Increased delivery of catecholamines to cardiovascular receptors might explain this increased risk. Methods: Twenty-nine healthy African-Americans genotyped for α2-adrenoreceptor subtype polymorphisms underwent 3H-noradrenaline and 3H-adrenaline intravenous infusion and arterial blood sampling for measurements of rates of entry of endogenous noradrenaline and adrenaline into arterial plasma (total body spillovers) by the tracer dilution technique. Eleven subjects were homozygotes for the α2CDel322-325 polymorphism, nine heterozygotes, and nine non-carriers. Subjects were studied during supine rest and during and after i.v. infusion of the α2-adrenoreceptor antagonist, yohimbine. Results: At rest, homozygotes for the α2cDel322-325 polymorphism had higher total body noradrenaline spillover than did heterozygotes (t=2.90, df=18, P=0.023) or non-carriers (t=3.22, df=18, P=0.010). Adrenaline spillover was higher in homozygotes than non-carriers (t=2.61, df=18, P=0.045). Administration of yohimbine produced larger, more sustained increments in noradrenaline spillover, heart rate, and anxiety in homozygotes than in the other groups. Conclusion: In healthy people, α 2cDel322-325 polymorphism is associated with increased sympathetic nervous and adrenomedullary hormonal activities, both during supine rest and during pharmacologically evoked catecholamine release. Polymorphisms of the α2c-adrenoreceptor may help explain individual differences in predisposition to a variety of disorders of catecholaminergic function, such as cardiovascular disorders, depression or anxiety disorders. © 2005 Lippincott Williams & Wilkins.",Neumeister A.; Charney D.S.; Belfer I.; Geraci M.; Holmes C.; Sharabi Y.; Alim T.; Bonne O.; Luckenbaugh D.A.; Manji H.; Goldman D.; Goldstein D.S.,2005.0,,0,0,
6757,Psychometric properties of the Revised Cheek and Buss Shyness Scale,"Although the Revised Cheek and Buss Shyness Scale (RGBS; Cheek, 1983) is widely used, its psychometric properties largely are unknown. In this investigation, we examined the normative data, factor structure, internal consistency, test-retest reliability, and convergent/discriminant validity of the RGBS using a sample of 261 university students. Results provided strong support for the stability of normative data over time, reliability of the measure, and its predicted associations with contemporary measures of shyness, social anxiety, and related constructs. Although support was obtained for a unifactorial conceptualization of shyness, an exploratory factor analysis revealed an alternative 3-factor solution that was supportive of a previously proposed meta-analytic model of shyness (Jones, Briggs, & Smith, 1986) and was consistent with other prominent shyness theories (Buss, 1980; Pilkonis, 1977a, 1977b; Zimbardo, 1977). This factor model was replicable on a holdout sample, and there were some data to support the discriminant validity of factors. Copyright © 2005, Lawrence Erlbaum Associates, Inc.",Hopko D.R.; Stowell J.; Jones W.H.; Armento M.E.A.; Cheek J.M.,2005.0,10.1207/s15327752jpa8402_08,0,0,
6758,"Stress-induced cortisol elevations are associated with impaired delayed, but not immediate recall","Glucocorticoids are known to modulate memory functions, with elevated cortisol levels being associated with impaired declarative memory. This specific effect has been shown in several studies using pharmacological doses of cortisol. The present study was designed to assess the effects of stress-induced cortisol elevations on (1) the type of memory processing (encoding, consolidation and retrieval), and (2) on the emotional valence of the material under study. Sixteen healthy females were presented neutral and emotional material (words and paragraphs) before and after a stress challenge. Declarative memory was tested immediately after presentation and 24 h later (delayed recall). Delayed, but not immediate recall of the information presented after the stress challenge was significantly reduced compared with delayed recall of information presented before the stress challenge. In line with this, strong negative correlations were found for delayed recall of words and spatial memory presented after the challenge with post-stress cortisol levels, whereas no significant correlations were found between cortisol levels and delayed recall at day 1. These results suggest that stress-induced cortisol specifically affects long-term consolidation of declarative memories. These findings may have implications for understanding the effects of traumatic stress on memory functioning in patients with stress-related psychiatric disorders. © 2005 Elsevier Ireland Ltd. All rights reserved.",Elzinga B.M.; Bakker A.; Bremner J.D.,2005.0,10.1016/j.psychres.2004.11.007,0,0,
6759,The influence of ethanol infusion on the effects of 35% CO2 challenge. A study in panic disorder patients and healthy volunteers,"Alcohol and panic disorders co-occur at a rate that exceeds chance significantly. Early experimental work suggests that alcoholic subjects, compared to non-alcoholics, are less sensitive to sodium lactate and that alcohol intake reduces the response to a 35% CO2 challenge in Panic Disorder patients. The present study documents the direct pharmacological effect of ethanol infusion on CO2 induced panic. Methods. - According to a placebo-controlled, double-blind, randomized, cross-over design 10 drug free panic disorder patients and 16 healthy volunteers underwent a 35% CO2 challenge after intravenous infusion of a moderate dose of ethanol on one test day and of placebo on another test day. Results. - Compared to the placebo condition, the effect of the CO2 challenge was significantly smaller after ethanol infusion (P = 0.041). Discussion. - A moderate dose of ethanol decreased the response to a 35% CO2 without inducing pre challenge sedation. Conclusion. - The results comfort earlier findings of a direct pharmacological effect of ethanol on panic. © 2004 Elsevier SAS. All rights reserved.",Cosci F.; De Gooyer T.; Schruers K.; Faravelli C.; Griez E.,2005.0,10.1016/j.eurpsy.2004.06.009,0,0,
6760,Studies in cognitive processing during worry,"Three experiments were conducted to examine the cognitive processing biases during worry or positive imagery. Participants were classified as worriers or non-worriers on the basis of normative data for the Penn State Worry Questionnaire (PSWQ). Experiment 1 was a directed forgetting task using threat and non-threat words. Experiment 2 was a Stroop task, and Experiment 3 was a dot-probe task, also using threat and non-threat words as targets. Across all three experiments, worriers exhibited lower cognitive bias during positive imagery compared to during worry, whereas non-worriers did not show a difference in memory or response latency for all three experiments. A fourth experiment was conducted to determine whether there was a differential rate of catastrophic thinking or positive imagery in association with worry level. It was found that worriers catastrophized more rapidly when instructed, and more slowly engaged in positive imagery. Collectively, these results suggest that positive imagery reduces cognitive bias among worriers, and additional research is warranted to determine how this may contribute to treatment of worry-based conditions. © 2005 Springer Science + Business Media, Inc.",McKay D.,2005.0,10.1007/s10608-005-4268-3,0,0,
6761,Compliance with dietary guidelines and relationship to psychosocial factors in low-income women in late postpartum,"Objectives: The goals were to evaluate compliance with the Dietary Guidelines among low-income women during late postpartum and to examine the relationship between psychosocial variables and dietary compliance. Subjects/setting: Participants were 146 triethnic, low-income women who were recruited 0 to 1 days after childbirth and who visited a clinic site at 1 year postpartum. Design: At 1 year postpartum, multiple psychosocial characteristics were measured, and food choices and nutrient intakes were assessed via a validated food frequency questionnaire. Dietary guidelines index scores and measures of adherence to dietary recommendations were computed. Statistical analyses performed: Descriptive statistics, analysis of variance with post-hoc Scheffe tests, χ2 with follow-up tests of independent proportions, and Pearson correlation coefficients were utilized. Results: For dietary compliance, 60% had adequate intakes of meat, but less than 30% met recommendations for grains, vegetables, fruits, dairy foods, total fat, and added sugar. Healthful weights (body mass index <25) were observed in 37% of women. Those in the highest tertile of dietary compliance had a more positive body image than those in the lowest tertile, and less neglect of self-care, weight-related distress, stress, depressive symptoms, and perceived barriers to weight loss (P<.05). Dietary compliance and psychosocial scale scores did not vary by ethnicity. Conclusions: Adherence to dietary guidelines was limited in the low-income, postpartum women. Psychosocial variables, such as neglect of self-care, weight-related distress, negative body image, stress, and depressive symptoms were associated with less healthful diets and lifestyle in late postpartum. Programs that target diet-related behavior change in low-income women might be improved by inclusion of psychosocial assessment and counseling components. Copyright © 2005 by the American Dietetic Association.",George G.C.; Milani T.J.; Hanss-Nuss H.; Freeland-Graves J.H.,2005.0,10.1016/j.jada.2005.03.009,0,0,
6762,Effects of Bromazepam in qEEG by typingwriting,"The efficiency with which an information is processed by the brain's neural circuitry can be altered by neuromodulators. The use of Bromazepam in the pharmacological treatment of anxiety disorders is due to its anxiolytic property. However, the effects of this benzodiazepine in motor learning tasks are not entirely understood. In this context, the goal of this study was to assess the effects of Bromazepam (6mg) on psychophysiological, behavioral, and electrophysiological variables, during the process of learning a motor task. The sample consisted of 26 healthy individuals, of both sexes, between 19 and 36 years of age. The control (placebo) and experimental (Bromazepam 6 mg) groups were submitted to a typewriting task, in a randomized, doble-blind design. The results did not reveal differences for phychophysiological and behavioral variables between the groups. Statistical tests pointed out to an interaction between condition and moment, and a hemisphere main effect, i.e. a reduction of relative power in the right hemisphere. This reduction suggests a specialization of the neural circuitry in the hemisphere contralateral to the finger used in the task. Such reduction is independent from the drug administration.",Machado D.; Bastos V.H.; Cunha M.; Furtado V.; Cagy M.; Piedade R.; Ribeiro P.,2005.0,,0,0,
6763,Electroencephalography measures in motor skill learning and effects of bromazepam,"Neuromodulators change brain's neural circuitry. Bromazepam is often been used in the pharmacological treatment of anxiety disorders. Few papers links this anxiolytic to motor tasks. The purpose of this study was to examine motor and electrophysiological changes produced by administration of bromazepam in diffrents doses (3 and 6 mg). The sample consisted of 39 healthy individuals, of both sexes, between 20 and 30 years of age. The control (placebo) and experimental (bromazepam 3mg and bromazepam 6 mg) groups were submitted to a typewriting task, in a randomized, double-blind design. The results did not reveal differences on score and time of the attention test. In the comportamental analysis was noticed blocks as main effect to behavioral variables (time and mistakes in the task). Electrophysiological data showed significants interactions to: laterally/condition/moment; laterally/condition; laterally/moment; condition/moment; condition/site.",Bastos V.H.; Machado D.; Cunha M.; Portella C.E.; Cagy M.; Furtado V.; Piedade R.; Ribeiro P.,2005.0,,0,0,
6764,"Psychiatric genetics: A survey of psychiatrists' knowledge, opinions, and practice patterns","Objective: Knowledge about the genetic basis of psychiatric illness is growing rapidly, and psychiatrists may be called upon to incorporate this information into clinical practice. The goal of this study was to assess psychiatrists' familiarity with and attitudes toward genetic information. Method: We surveyed 844 participants, the majority of whom were psychiatrists, attending a continuing medical education course in the fall of 2002 and measured knowledge, opinions, and current practice patterns in regard to psychiatric genetics. Results: Responses were received from 352 psychiatrists (54% of those surveyed). Most psychiatrists correctly answered fewer than half of survey items assessing general and psychiatric genetic knowledge. While 83% considered it their role to discuss genetic information with patients and families, fewer than 25% felt prepared or competent to do so. In response to hypothetical questions regarding genetic testing, a substantial proportion of psychiatrists indicated willingness to use such tests for diagnostic clarification, as well as presymptomatic and even prenatal risk prediction. The majority of respondents expressed interest in further genetics education. Conclusions: Our results suggest that psychiatrists view genetic information as clinically relevant, but have limitations in knowledge that may impact the incorporation of psychiatric genetics into clinical practice.",Finn C.T.; Wilcox M.A.; Korf B.R.; Blacker D.; Racette S.R.; Sklar P.; Smoller J.W.,2005.0,,0,0,
6765,Process and outcome of a non-guided self-help manual for anxiety and depression in primary care: A pilot study,"Self-help interventions in mental health are increasingly seen as one way of overcoming problems with access to psychological therapy, but there is insufficient evidence of effectiveness in routine care settings. This paper investigates the process and outcome of a non-guided self-help manual for anxiety and depression compared to a waiting list control in a primary care setting. Patients with mild to moderate mental health problems were recruited from routine GP referrals to the local Primary Care Mental Health Team. Thirty patients were randomly assigned to either non-guided self-help or a waiting list control group. Patients completed outcome measures at baseline, 6 weeks and 12 weeks. Intention to treat analysis found no significant differences between the two groups on measures of anxiety or depression at 12 weeks. Between 40% to 50% of patients in both groups were no longer clinical cases at the end of the trial. However, there was a high level of satisfaction with the self-help manual. Within the limitations of the small sample size, the study does not support the hypothesis that non-guided self-help is superior to waiting list control in the treatment of anxiety and/or depression in primary care. © 2005 British Association for Behavioural and Cognitive Psychotherapies.",Fletcher J.; Lovell K.; Bower P.; Campbell M.; Dickens C.,2005.0,10.1017/S1352465805002079,0,0,
6766,Holocaust child survivors and child sexual abuse,"This study utilized a qualitative analysis of child survivors of the Holocaust who were sexually abused during World War II. The research study aimed to give this specific group of survivors a voice and to explore the impact of multiple extreme traumas, the Holocaust and childhood sexual abuse, on the survivors. Twenty-two child survivors of the Holocaust who were sexually abused during the war completed open-ended interviews. The data was qualitatively analyzed according to Tutty, Rothery, and Grinnell's (1996) guidelines. Three major themes were found: issues relating to the sexual abuse trauma, survivors' perceptions of the abuse, and survivors' general perspectives towards life. The identity of the offenders, Jewish or non-Jewish, determined the survivors' feelings towards themselves, the perpetrators, and about the worth of life. copy; 2005 by The Haworth Press, Inc. All rights reserved.",Lev-Ẃiesel R.; Amir M.,2005.0,10.1300/J070v14n02_04,0,0,
6767,Cognitive-emotional distinctiveness: Separating emotions from non-emotions in the representation of a stressful memory,"Current theories on autobiographical memory and recent neurological evidence suggest that emotional and non-emotional features of a memory may be retrieved by separate systems. To test this notion, 207 participants who had experienced the break-up of a significant romantic relationship in the last 12 months completed a Multidimensional Scaling (MDS) procedure in relation to the previous relationship. The resulting MDS model revealed two dimensions: a valence and an emotional/non-emotional dimension. Further, participants who associated a high level of distress with their relationship break-up perceived less dissimilarity between emotional and non-emotional features than participants who associated a low level of distress with their relationship break-up. Theoretical and methodological implications for stress and memory are discussed. © 2005 Psychology Press Ltd.",Boals A.; Klein K.,2005.0,10.1080/09658210444000287,0,0,
6768,A new method to approach exact hemoperitoneum volume in a splenic trauma model using ultrasonography,"In the trauma setting, the Focused Assessment for the Sonographic examination of the Trauma patient (FAST) accurately detects hemoperitoneum. Currently, only an approximate evaluation of the volume of free intraperitoneal fluid (FIPF) can be done by imaging modalities such as ultrasound (US). The aim of this study was to correlate the thickness of FIPF measured by US in different sites of the peritoneal cavity with the total volume of an experimental post-traumatic hemoperitoneum. An intra-abdominal collection with ongoing bleeding was simulated in eight cadavers with no previous abdominal surgery. Between 200 and 2000 ml of saline solution was instilled into the left hypochondrium of eight non-embalmed cadavers. During the instillation, FIPF thickness was measured every 200 ml by US in six different declivous sites of the peritoneal cavity. The volume of FIPF instilled could be mathematically correlated with fluid thickness in all the sites through the linear equation Y=aX +b, where Y is the volume of FIPF in milliliters, is 33 (variability coefficient), X is the FIPF thickness in millimeters and b is 470 ml (minimum volume detectable by US). The best correlation between thickness and volume was obtained in the hepatorenal pouch (Morrison pouch). Evaluation of the impact of intraperitoneal hemorrhage on the hemodynamic state of spleen trauma patients is of paramount importance for the surgeon, who has to decide whether to perform a laparotomy for hemostasis or not, specially when intra- and extra-abdominal injuries conjointly exist. After clinical validation, this new method to calculate the exact volume of FIPF could be used in current clinical practice of abdominal trauma to assist in the decision-making regarding non-operative treatment of spleen trauma. © Springer-Verlag 2005.",Baqué P.; Iannelli A.; Dausse F.; de Peretti F.; Bourgeon A.,2005.0,10.1007/s00276-004-0307-2,0,0,
6769,Effects of biofeedback therapy on the intervention of examination-caused anxiety,"Aim: To verify whether the biofeedback therapy on the intervention of examination-caused anxiety has effects or not. Methods: 312 students from grade 3 of a certain Shanghai senior high school were selected as observation objects from February to April 2005. The universal test was performed on the level of examination-caused anxiety by symptom checklist (SCL). The SCL included somatization, compulsion, human relation, depression, anxiety, rivalry, fear, intolerance and mental disease etc. totally 9 factors, 90 items. This investigation only chose the content of somatization, anxiety and depressive factor to test. The somatization (0.89-1.85), anxiety (0.89-1.82) and depression (0.91-2.09) of normal model of SCL were taken as assessment standard. Seventy students were collected randomly from those whose score of anxiety factor> 2.81 (over 2 standard deviation of normal model) as the observation objects for this investigation,and were divided randomly into experimental group and control group with 35 in each group, including 16 males and 19 females in the experimental group; 17 males and 18 females in the control group. Those in the experimental group were treated the biofeedback treatment by anxiety therapy program of biofeedback meter and VBFB3000 biofeedback diagnosis system, totally 6 treatment, 30 minutes once, twice a week. After treatment the SCL was performed after therapy. The second test in the control group was performed at the 21 days after the first test. Results: In the universal test of the 312 people, the scores of somatization, anxiety and depressive factor were 2.210±0.580, 3.204±0.412, 2.125± 0.324, respectively. The proportions of the people who were over two standard deviation compared with normal models were 66.1%, 77.2% and 71.2%, respectively. The people whose score of anxiety factor over 2.81 were as high as 241. Seventy people were collected by the complete randomized method. They were a4 conducted the whole test and involved in the result analysis. After treatment in the experimental group, the levels of somatization, anxiety and depression significantly decreased (P=0.000), but the average anxiety level was still more than 1.82, and the average levels of somatization and depression were within the normality. There were insignificant changes of levels of anxiety, somatization and depression in the control group. The sex differences of the scores of 3 factors were insignificant in 2 group students before trial. The score of somatization factor of males in experimental group after trial was lower than that of the females, and with significant difference [(1.181±0.219), (1.357±0.195), t=-2.518, P < 0.05]. Conclusion: The biofeedback therapy can effectually reduce the levels of individual somatization and anxiety. Meanwhile, reduce the depressive level.",Dong W.; Bao F.,2005.0,,0,0,
6770,Psychological health state of divorced nurses,"Aim: To investigate the psychological state of divorced nurses in hospitals, so as to provide theoretical evidence for the draw up and carried out of the nursing personnel managerial policies or measures. Methods: The experiment was finished in the Nursing Department of Hebi College of Vocation and Technology between January and December 2004. Totally 159 nurses aged 50-23 years, who had divorced for 3 months to 15 years, were selected from different hospitals, including 95 cases (59.74%) divorced for their husbands having an affair, 54 cases (33.96%) for their husbands' gambling, excessive drinking and home violence, and 20 cases (12.57%) for other reasons of inferitility, terrible relationship between mother and daughter-in-law, and 105 divorced nurses lived with children alone. Their education background was higher than secondary vocational school. Meanwhile, 136 nurses with complete family, who were similar in age and education background with those in the observational group, were selected as the control group. The psychological health level of the subjects were assessed with the symptom checklist-90 (SCL-90), the 5-grade scoring system was used, 1, 2, 3, 4, and 5 points stood for none, mild, moderate, severe and extremely severe respectively, the higher the score, the more the psychiatric symptoms, and the worse the psychological health level. The depression and anxiety were assessed with the self-rating depression scale (SDS) and self-rating anxiety scale (SAS), scored by 4 grades (1-4 points), the highest total score was 80 points. The 1-4 points of SDS stood for none or occasionally, sometimes, usually, always respectively, < 50 points as normal, the index of depressive severity=the sum-up of all the item scores/80, the higher the score, the severer the depression. The 1-4 points of SAS stood for none, small part of time, great times, most of time or total time, the delimitation value was 50 points, the higher the score, the severer the anxiety. The 3 scales were booked as the questionnaires, and finished in the same time under the unified instruction, and then the results were statistically analyzed. Results: Totally 295 questionnaires were sent out, and all were valid and collected back, the effective rate was 100%. (1) The factor scores of SCL-90 were all very significantly higher in the observational group than in the control group (P < 0.001). The total standard scores of SDS and SAS were also significantly higher in the observational group than in the control group [(60.12±5.46, 34.91±5.46), (58.76±6.80, 31.98±3.43), t=23.97-24.15, P < 0.01]. Conclusion: Divorced nurses have more serious psychological and physical problems, and their psychological health level is worse. It is suggested that certain social support should be given to this special group by families, society and nursing managers of hospital.",Chang F.-Y.,2005.0,,0,0,
6771,"The concurrent validity of the ""Carers' Needs Assessment for Dementia"" (CNA-D)","Objectives: The ""Carers' Needs Assessment for Dementia"" (CNA-D) has been developed to investigate the needs of carers of dementia patients. The aim of the present study was to examine the concurrent validity of the CNA-D. Methods: Forty five relatives of dementia patients were enrolled for this study. To evaluate if plausible associations (i.e. indicators for concurrent validity) exist, two summary scores of the CNA-D were used: the number of moderate or serious problems among the carers and the number of interventions needed. Further the ""Camberwell Assessment of Needs for the Elderly"" (CANE) and the ""General Health Questionnaire"" (GHQ-12) were used. Results: The numbers of carers' problems (CNA-D) were positively associated with the number of symptoms indicating anxiety disorders or depression (GHQ 12), the living situation of the patient (private household vs. nursing home) and the amount of time spent with the patient. Negative correlations were found with the extent of support the patient received from the private social network or from professional services (CANE). Similar results were yielded for the number of interventions needed (CNA-D). Conclusions: Overall, these results indicate that the concurrent validity of the CNA-D is satisfactory. © 2005 Dustri-Verlag Dr. Karl Feistle.",Kaiser G.; Krautgartner M.; Alexandrowicz R.; Unger A.; Marquart B.; Weiss M.; Wancata J.,2005.0,,0,0,
6772,The effects of suppressing thoughts and images about worrisome stimuli,"Several investigations have examined the potential role of mentation suppression in various psychological disorders. Existing studies do not, however, differentiate between the effects of suppressing imagery- versus thought-based mentation. This distinction is an especially important one for worry, given the predominantly thought-based nature of the worry process. The present study sought to distinguish between the effects of suppressing thoughts versus images about worrisome versus neutrally valenced topics. Consistent with past studies of worry suppression, results failed to find a rebound effect regardless of valence (worrisome, neutral) or mentation content (thoughts, images). However, results did indicate that a decrease in worrisome mentation across two consecutive expression periods was more pronounced when the worrisome material was imagery-based rather than thought-based in nature. Implications of these findings as they pertain to the perpetuation of worrisome activity and to treatment of generalized anxiety disorder are discussed. © 2005 the Association for Advancement of Behavior Therapy. All rights reserved.",Behar E.; Vescio T.K.; Borkovec T.D.,2005.0,10.1016/S0005-7894(05)80077-2,0,0,
6773,Thought and imaginal activity during worry and trauma recall,"The present study examined the frequency with which participants experienced thoughts and images, as well as relaxed, anxious, and depressed affect, when worrying and when recalling past traumatic events. Unselected participants in Study 1, and participants selected on the basis of their GAD and past trauma status in Study 2, engaged in 5-minute counterbalanced worry and trauma recall inductions. Results indicated that while worry was experienced primarily as verbal thought, trauma recall was primarily experienced as imaginal. Furthermore, while both worry and trauma recall were associated with increased anxious and depressed affect, worry was particularly associated with anxious affect in the selected sample, and trauma recall was particularly associated with depressed affect in both unselected and selected samples. Finally, for individuals with both GAD and trauma symptoms, prior worrying was associated with decreased anxious and depressed affect during a subsequent trauma recall task. Theoretical and clinical implications of these findings are discussed. © 2005 the Association for Advancement of Behavior Therapy. All rights reserved.",Behar E.; Zuellig A.R.; Borkovec T.D.,2005.0,10.1016/S0005-7894(05)80064-4,0,0,
6774,"A transactional approach to social anxiety and the genesis of interpersonal closeness: Self, partner, and social context","It remains unclear whether social anxiety interferes with the generation of closeness during initial encounters. We addressed the question of whether perceived closeness between strangers differs as a function of dyad characteristics (i.e., self and partner levels of social anxiety) and social context. We conducted an experiment with 90 participants randomly assigned to either a 45-minute personal disclosure or small-talk dyadic conversation. Multilevel modeling results yielded a 3-way interaction, such that the effect of social anxiety on closeness generated during the interaction was moderated by social anxiety reported by interaction partners and social context. In the personal disclosure condition, perceived closeness was greatest when the most socially anxious individuals interacted with each other. In the small-talk condition, perceived closeness was greatest when the least socially anxious individuals interacted with each other. Across conditions, partners with substantial differences in social anxiety (i.e., mixed dyads) reported relatively less closeness than partners with similar levels of social anxiety. Social anxiety effects were not attributable to depressive symptoms or physical attraction to partners. These findings suggest that neglecting specific qualities of interaction partners and social situational factors may lead to spurious conclusions in understanding interpersonal outcomes related to social anxiety. © 2005 Association for Advancement of Behavior Therapy.",Kashdan T.B.; Wenzel A.,2005.0,10.1016/S0005-7894(05)80115-7,0,0,
6775,Psychosocial aspects of survivors of childhood cancer or leukemia,"The majority of childhood cancer patients can expect nowadays to be cured and the percentage is now between 70% and 80%. The number of long-term survivors, off-threatment for at least 5 years, is rising rapidly and is becoming a new population, which needs a special care. It is becoming increasingly important to know how to prevent and treat the physical late effects as well as the psychosocial ones. The oldest among these patients are now in their 40's. How will their old age be like? Are they really cured? The aim of this study is to present a detailed survey of the literature on this topic as well as the authors' personal experience. Several techniques of psychological investigation for this population are highlighted. The semistructured interviews are mostly used for mono-institutional research, while the narrative dialogues are useful for small groups of patients. Questionnaires are usually conducted by epidemiologists for large groups of survivors. Tests are used for specific items such as defense mechanisms, self-esteem, relationships within the family, fear, and panic. The evaluation of the post-traumatic stress disorder is considered and the most important literature data are reported. It is also stressed the need of prevention of any type of psychosocial distress. In conclusion, most of the survivors appear to lead normal adult lives, to have obtained high school degrees, good jobs, and several have families and children. Nevertheless, a small percentage show some psychological or social problems, such as anxiety, depression, fear over the future or over relapse, a second primary, or sterility. The most vulnerable among them are females, people in poor financial conditions, the unemployed and those with poor educations.",Massimo L.; Zarri D.; Caprino D.,2005.0,,0,0,
6776,Opposing breathing therapies for panic disorder: a randomized controlled trial of lowering vs raising end-tidal P(CO?),"ER BACKGROUND: Teaching anxious clients to stop hyperventilating is a popular therapeutic intervention for panic. However, evidence for the theory behind this approach is tenuous, and this theory is contradicted by an opposing theory of panic, the false-suffocation alarm theory, which can be interpreted to imply that the opposite would be helpful.OBJECTIVE: To test these opposing approaches by investigating whether either, both, or neither of the 2 breathing therapies is effective in treating patients with panic disorder.METHOD: We randomly assigned 74 consecutive patients with DSM-IV-diagnosed panic disorder (mean age at onset = 33.0 years) to 1 of 3 groups in the setting of an academic research clinic. One group was trained to raise its end-tidal P(CO?) (partial pressure of carbon dioxide, mm Hg) to counteract hyperventilation by using feedback from a hand-held capnometer, a second group was trained to lower its end-tidal P(CO?) in the same way, and a third group received 1 of these treatments after a delay (wait-list). We assessed patients physiologically and psychologically before treatment began and at 1 and 6 months after treatment. The study was conducted from September 2005 through November 2009.RESULTS: Using the Panic Disorder Severity Scale as a primary outcome measure, we found that both breathing training methods effectively reduced the severity of panic disorder 1 month after treatment and that treatment effects were maintained at 6-month follow-up (effect sizes at 1-month follow-up were 1.34 for the raise-CO(2) group and 1.53 for the lower-CO(2) group; P < .01). Physiologic measurements of respiration at follow-up showed that patients had learned to alter their P(CO?) levels and respiration rates as they had been taught in therapy.CONCLUSIONS: Clinical improvement must have depended on elements common to both breathing therapies rather than on the effect of the therapies themselves on CO(2) levels. These elements may have been changed beliefs and expectancies, exposure to ominous bodily sensations, and attention to regular and slow breathing.TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00183521.","Kim, S; Wollburg, E; Roth, W T",2012.0,10.4088/JCP.11m07068,0,0,
6777,PTSD symptom reduction with mindfulness-based stretching and deep breathing exercise: randomized controlled clinical trial of efficacy,"ER OBJECTIVE: The aim of the study was to determine whether mindfulness-based stretching and deep breathing exercise (MBX) normalizes cortisol levels and reduces PTSD symptom severity among individuals with subclinical features of PTSD.DESIGN AND SETTING: A randomized controlled trial was conducted at the University of New Mexico Health Sciences Center.PARTICIPANTS: Twenty-nine nurses (28 female) aged 45-66 years participated in the study.INTERVENTION: Sixty-minute MBX sessions were conducted semiweekly for 8 weeks.MAIN OUTCOME MEASURES: Serum cortisol was measured, and the PTSD Checklist-Civilian version (PCL-C) was performed at baseline and weeks 4, 8, and 16.RESULTS: Twenty-nine participants completed the study procedures, 22 (79%) with PTSD symptoms (MBX, n = 11; control, n = 11), and 7 (21%) without PTSD (BASE group). Eight-week outcomes for the MBX group were superior to those for the control group (mean difference for PCL-C scores, -13.6; 95% confidence interval [CI], -25.6, -1.6; P = .01; mean difference for serum cortisol, 5.8; 95% CI, 0.83, 10.8; P = .01). No significant differences were identified between groups in any other items. The changes in the MBX group were maintained at the 16-week follow-up (P = .85 for PCL-C; P = .21 for cortisol). Our data show that improved PTSD scores were associated with normalization of cortisol levels (P < .05).CONCLUSIONS: The results suggest that MBX appears to reduce the prevalence of PTSD-like symptoms in individuals exhibiting subclinical features of PTSD.CONTEXT: Abnormal cortisol levels are a key pathophysiological indicator of post-traumatic stress disorder (PTSD). Endogenous normalization of cortisol concentration through exercise may be associated with PTSD symptom reduction.","Kim, S H; Schneider, S M; Bevans, M; Kravitz, L; Mermier, C; Qualls, C; Burge, M R",2013.0,10.1210/jc.2012-3742,0,0,
6778,Treating sexually abused children with posttraumatic stress symptoms: a randomized clinical trial,"ER METHODThirty-six sexually abused children (aged 5-17 years) were randomly assigned to a child-alone cognitive-behavioral treatment condition, a family cognitive-behavioral treatment condition, or a waiting-list control condition.RESULTSCompared with controls, children who received treatment exhibited significant improvements in posttraumatic stress disorder symptoms and self-reports of fear and anxiety. Significant improvements also occurred in relation to parent-completed measures and clinician ratings of global functioning. In general, parental involvement did not improve the efficacy of cognitive-behavioral therapy. Maintenance of improvement was evident at a 12-week follow-up assessment.CONCLUSIONSCognitive-behavioral treatment was useful, but further research is required on caregiver involvement.OBJECTIVETo evaluate the efficacy of child and caregiver participation in the cognitive-behavioral treatment of sexually abused children with posttraumatic stress symptoms.","King, N J; Tonge, B J; Mullen, P; Myerson, N; Heyne, D; Rollings, S; Martin, R; Ollendick, T H",2000.0,10.1097/00004583-200011000-00008,0,0,
6779,Exposure and response prevention process predicts treatment outcome in youth with OCD,"ER Recent research on the treatment of adults with anxiety disorders suggests that aspects of the in-session exposure therapy process are relevant to clinical outcomes. However, few comprehensive studies have been conducted with children and adolescents. In the present study, 35 youth diagnosed with primary obsessive-compulsive disorder (OCD; M age = 12.9 years, 49% male, 63% Caucasian) completed 12 sessions of exposure and response prevention (ERP) in one of two treatment conditions as part of a pilot randomized controlled testing of a family focused intervention for OCD. Key exposure process variables, including youth self-reported distress during ERP and the quantity and quality of ERP completed, were computed. These variables were examined as predictors of treatment outcomes assessed at mid-treatment, post-treatment, and three-month follow-up, partialing treatment condition. In general, greater variability of distress during ERP and completing a greater proportion of combined exposures (i.e., exposures targeting more than one OC symptom at once) were predictive of better outcomes. Conversely, greater distress at the end of treatment was generally predictive of poorer outcomes. Finally, several variables, including within- and between-session decreases in distress during ERP, were not consistently predictive of outcomes. Findings signal potentially important facets of exposure for youth with OCD and have implications for treatment. A number of results also parallel recent findings in the adult literature, suggesting that there may be some continuity in exposure processes from child to adult development. Future work should examine additional measures of exposure process, such as psychophysiological arousal during exposure, in youth.","Kircanski, K; Peris, T S",2015.0,10.1007/s10802-014-9917-2,0,0,
6780,"Reduction of subjective distress in CBT for childhood OCD: nature of change, predictors, and relation to treatment outcome","ER Little research has investigated changes in subjective distress during cognitive-behavioral therapy (CBT) for anxiety disorders in youth. In the current study, 40 youth diagnosed with primary obsessive-compulsive disorder (OCD; M age = 11.9 years, 60% male, 80% Caucasian) and 36 parent informants completed separate weekly ratings of child distress for each OC symptom during a 12-session course of CBT. Between-session changes in distress were calculated at the start of, on average throughout, and at the end of treatment. On average throughout treatment, child- and parent-reported decreases in child distress were significant. Baseline OCD severity, functional impairment, and internalizing symptoms predicted degree of change in child distress. Additionally, greater decreases in child distress were predictive of more improved clinical outcomes. Findings advance our understanding of the strengths and limitations of this clinical tool. Future studies should examine youth distress change between and within CBT sessions across both subjective and psychophysiological levels of analysis.","Kircanski, K; Wu, M; Piacentini, J",2014.0,10.1016/j.janxdis.2013.05.004,0,0,
6781,A pilot randomized controlled trial of a tailored cognitive behavioural therapy based intervention for depressive symptoms in those newly diagnosed with multiple sclerosis,"ER METHODS: The current study presents a pilot, parallel group randomized controlled trial (RCT) with an allocation ratio of 1:1 conducted in a large research and teaching hospital in Melbourne, Australia. 30 individuals with a mean age of 36.93 years (SD?=?9.63) who were newly diagnosed with multiple sclerosis (MS) (X?=?24.87 months, SD?=?15.61) were randomized to the CBT intervention (n?=?15) or treatment as usual (TAU) (n?=?15). The primary outcome was level of depressive symptoms using the Beck Depression Inventory-II (BDI-II). Secondary outcomes were level of anxiety, fatigue and pain impact, sleep quality, coping, acceptance of MS illness, MS related quality of life, social support, and resilience. Tertiary outcomes were acceptability and adherence to the intervention.RESULTS: Large between group treatment effects were found for level of depressive symptoms at post and at 20 weeks follow-up (d?=?1.66-1.34). There were also small to large group treatment effects for level of anxiety, fatigue and pain impact, sleep quality, MS related quality of life, resilience, and social support at post and at 20 weeks follow-up (d?=?0.17-1.63). There were no drop-outs and participants completed all treatment modules. All participants reported the treatment as 'very useful', and most (73.4%) reported that the intervention had addressed their problems 'completely'.CONCLUSIONS: These data suggest that the tailored early intervention is appropriate and clinically effective for the treatment of depressive symptoms in those newly diagnosed with MS. A larger RCT comparing the CBT intervention with an active comparative treatment with longer term follow-up and cost effectiveness analyses is warranted. The pilot trial has been retrospectively registered on 28/04/2016 with the ISRCTN registry (trial ID ISRCTN10423371).BACKGROUND: To examine the effectiveness and acceptability of an 8-week individual tailored cognitive behavioural therapy (CBT) intervention for the treatment of depressive symptoms in those newly diagnosed with multiple sclerosis.","Kiropoulos, L A; Kilpatrick, T; Holmes, A; Threader, J",2016.0,10.1186/s12888-016-1152-7,0,0,
6782,Psycho-socio-biological correlates of moderate overweight in an industrial population,,"Kittel, F; Rustin, R M; Dramaix, M; Backer, G; Kornitzer, M",1978.0,,0,0,
6783,Treatment of severe fear of childbirth with haptotherapy: design of a multicenter randomized controlled trial,"ER BACKGROUND: About six percent of pregnant women suffer from severe fear of childbirth. These women are at increased risk of obstetric labour and delivery interventions and pre- and postpartum complications, e.g., preterm delivery, emergency caesarean section, caesarean section at maternal request, severe postpartum fear of childbirth and trauma anxiety. During the last decade, there is increasing clinical evidence suggesting that haptotherapy might be an effective intervention to reduce fear of childbirth in pregnant women. The present study has been designed to evaluate the effects of such intervention. METHODS/DESIGN: Included are singleton pregnant women with severe fear of childbirth, age > 18 year, randomised into three arms: (1) treatment with haptotherapy, (2) internet psycho-education or (3) care as usual. The main study outcome is fear of childbirth. Measurements are taken at baseline in gestation week 20-24, directly after the intervention is completed in gestation week 36, six weeks postpartum and six months postpartum. Secondary study outcomes are distress, general anxiety, depression, somatization, social support, mother-child bonding, pregnancy and delivery complications, traumatic anxiety symptoms, duration of delivery, birth weight, and care satisfaction. DISCUSSION: The treatment, a standard haptotherapeutical treatment for pregnant women with severe fear of childbirth, implies teaching a combination of skills in eight one hour sessions. The internet group follows an eight-week internet course containing information about pregnancy and childbirth comparable to childbirth classes. The control group has care as usual according to the standards of the Royal Dutch Organisation of Midwives and the Dutch Organization of Obstetrics and Gynaecology. TRIAL REGISTRATION: This trial was entered in the Dutch Trial Register and registered under number NTR3339 on March 4th, 2012.","Klabbers, G A; Wijma, K; Paarlberg, K M; Emons, W H; Vingerhoets, A J",2014.0,10.1186/1472-6882-14-385,0,0,
6784,Interpretation modification training reduces social anxiety in clinically anxious children,"ER The present study was designed to examine the effects of training in positive interpretations in clinically anxious children. A total of 87 children between 7 and 12 years of age were randomly assigned to either a positive cognitive bias modification training for interpretation (CMB-I) or a neutral training. Training included 15 sessions in a two-week period. Children with an interpretation bias prior to training in the positive training group showed a significant reduction in interpretation bias on the social threat scenarios after training, but not children in the neutral training group. No effects on interpretation biases were found for the general threat scenarios or the non-threat scenarios. Furthermore, children in the positive training did not self-report lower anxiety than children in the neutral training group. However, mothers and fathers reported a significant reduction in social anxiety in their children after positive training, but not after neutral training. This study demonstrated that clinically anxious children with a prior interpretation bias can be trained away from negative social interpretation biases and there is some evidence that this corresponds to reductions in social anxiety. This study also highlights the importance of using specific training stimuli.","Klein, A M; Rapee, R M; Hudson, J L; Schniering, C A; Wuthrich, V M; Kangas, M; Lyneham, H J; Souren, P M; Rinck, M",2015.0,10.1016/j.brat.2015.10.006,0,0,
6785,Duration effect on neuropsychological function and treatment response of OCD,"ER Because of inconsistency among previous reports that examined neuropsychological function and treatment response of OCD patients, we here consider the heterogeneity of OCD; for example: symptom-based clusters, degree of insight, age of onset, and comorbid diagnoses. In this study, we examined neuropsychological function and the treatment response of OCD patients. Thirty-two OCD patients participated in this study. We examined their clinical symptoms by Y-BOCS, MOCI and other scales, and examined their cognitive function with several neuropsychological tests including: WAIS-R, Stroop test, WCST, WMS-R and R-OCFT. We then randomly assigned them to three treatment packages including: behavior therapy, pharmacotherapy by fluvoxamine, and controlled therapy. The patients were divided into two groups by duration of illness: short to middle range group (Group S, n=17, 5.5+/-3.1 years), and long range group (Group L, n=15, 20.3+/-6.1 years). The mean age of Group L was higher than that of Group S (Group S: 30.6+/-9.7 years old, Group L: 36.1+/-6.2 years old). There was no significant group difference in sex ratio or number of years of education. The mean age of onset of Group L was significantly lower than that of Group S (Group S; 25.5+/-10.2 years old, Group L; 15.3+/-7.1 years old). The total Y-BOCS mean score and MOCI score showed no group differences. These two groups showed similar clinical characteristics such as the severity of OC symptom, OC subtypes, and comorbid depression. Group S, however, demonstrated significantly more obsession with the need for correction. Group L had significantly higher levels of anxiety and compulsion. There were also no group differences in the mean HDRS or STAI scores. As a result, compared to Group S, Group L showed significant attention deficit in the Stroop test and the WMS-R though other neuropsychological dysfunctions such as intellectual level, executive function, verbal memory, and nonverbal memory were found in this group. Concerning treatment response, Group L showed little improvement by pharmacotherapy. Behavior therapy brought significant improvement to all patients of both groups. Long duration of the illness might cause attention deficit and a lowered pharmaceutical response in OCD patients.","Nakao, T; Nakatani, E; Nabeyama, M; Yoshioka, K; Tomita, M; Nakagawa, A",2005.0,,0,0,
6786,The unintended effects of risk-refuting information on anxiety,"ER Researchers in the field of risk perception have been asking why people are more worried about risk today than in years past. This article explores one possible answer to this question, associative anxiety. The affect heuristic and the mental network models suggest that anxiety triggered by information regarding a particular risk can spread to other risks of the same category. Research to date, however, has not examined how information refuting the particular risk can also be generalized across other risks. The article presents two experimental studies addressing this issue. Study 1 showed that when participants were presented with information based on a real train collision, they experienced increased anxiety not only about train collisions but also about public transportation in general. In contrast, those who were informed about the train collision case as well as the preventative measures implemented after the accident experienced decreased anxiety about train collisions but not about public transportation more generally. Study 2 measured the changes in participant anxiety about a genetically modified organism (GMO) and compared the influence of information about either the existence or nonexistence of its risk. Similar to Study 1, associative anxiety rippled through the risk category. The results also suggest that the follow-up information refuting the GMO risk reduced the anxiety toward the hazard drastically, but did not fully alleviate the anxiety toward other hazards in the category. The implications and the limitations of these studies are also discussed.","Nakayachi, K",2013.0,10.1111/j.1539-6924.2012.01852.x,0,0,
6787,Fellow-eye comparison of posterior capsule opacification between 2 aspheric microincision intraocular lenses,"ER PURPOSE: To compare posterior capsule opacification (PCO) between 2 microincision hydrophilic intraocular lenses (IOLs) and with a conventional spherical hydrophobic IOL.SETTING: St. Thomas' Hospital, London, United Kingdom.DESIGN: Prospective randomized comparative study.METHODS: A microincision Acri.Smart 36A (negatively aspheric) or Akreos MI-60 (aspherically neutral) IOL was randomized to the first eye of patients with the alternative IOL implanted in the fellow eye within 3 weeks. Postoperatively, 100% and 9% logMAR corrected distance visual acuity (CDVA) were assessed. Retroillumination photographs were analyzed using the posterior capsule opacity software system. The data on PCO scores were compared with those of a conventional spherical hydrophobic IOL (Acrysof SN60AT).RESULTS: One hundred percent CDVA was significantly better at 12 months and 9% CDVA was better at 6, 12, and 24 months (P<.05) with the negatively aspheric IOL. One eye in each group with microincision IOLs developed capsule phimosis at 1 month. Neodymium:YAG capsulotomies were required by 2 years in 2 eyes with a negatively aspheric IOL and 8 eyes with an aspherically neutral IOL. At 24 months, the mean PCO score remained less than 10% with the conventional spherical IOL, whereas it increased with time in the negatively aspheric IOL (up to 16%) and the aspherically neutral IOL (up to 23%).CONCLUSIONS: The negatively aspheric IOL had a better PCO profile than the aspherically neutral IOL. This may be attributed to the difference in the edge design between the IOLs. The microincision IOLs had more PCO than the conventional 1-piece hydrophobic IOL.","Nanavaty, M A; Spalton, D J; Gala, K B; Dhital, A; Boyce, J",2013.0,10.1016/j.jcrs.2012.12.030,0,0,
6788,Breath-holding in anxiety disorders,,"Nardi, A E; Valença, A M; Lopes, F L; Nascimento, I; Mezzasalma, M A; Zin, W A",2003.0,10.1177/070674370304800718,0,0,
6789,Psychopathological profile of 35% CO2 challenge test-induced panic attacks: a comparison with spontaneous panic attacks,"ER Our aim was to describe the clinical features of 35% CO2-induced panic attacks in patients with panic disorder (PD) (Diagnostic and Statistical Manual and Mental Disorders, Fourth Edition) and compare them with the last spontaneous panic attack in patients with PD who had not had a panic attack after the 35% CO2 challenge test. We examined 91 patients with PD submitted to the CO2 challenge test. The test consisted of exhaling as fully as possible, took a fast vital capacity breath, held their breath for 8 seconds, exhaled, and then repeated the fast vital capacity breath, again holding for 8 seconds. The patients inhaled the 35% CO2/65% O2 mixture or atmospheric compressed air, randomly selected in a double-blind design. Scales were applied before and after the test. A total of 68.1% (n = 62) patients with PD had a panic attack (responders) after the CO2 test (chi2(1) = 25.87, P = .031). The last spontaneous panic attack and the symptom profile from the patients with PD who had not had a panic attack after the test (n = 29, 31.9%) were described to compare. The responders had more respiratory symptoms (chi2(1) = 19.21, P < .001), fulfilling the criteria for respiratory PD subtype (80.6%); the disorder started earlier (Mann-Whitney, P < .001), had a higher familial prevalence of PD (chi2(1) = 20.45, P = .028), and had more previous depressive episodes (chi2(1) = 27.98, P < .001). Our data suggest that there is an association between respiratory PD subtype and hyperreactivity to a CO2 respiratory challenge test. The responders may be a subgroup of respiratory PD subtype with future diagnostic and therapeutic implications.","Nardi, A E; Valença, A M; Lopes, F L; Nascimento, I; Veras, A B; Freire, R C; Mezzasalma, M A; de-Melo-Neto, V L; Zin, W A",2006.0,10.1016/j.comppsych.2005.07.007,0,0,
6790,"Threat and defense as goal regulation: from implicit goal conflict to anxious uncertainty, reactive approach motivation, and ideological extremism","ER Four studies investigated a goal regulation view of anxious uncertainty threat (Gray & McNaughton, 2000) and ideological defense. Participants (N = 444) were randomly assigned to have achievement or relationship goals implicitly primed. The implicit goal primes were followed by randomly assigned achievement or relationship threats that have reliably caused generalized, reactive approach motivation and ideological defense in past research. The threats caused anxious uncertainty (Study 1), reactive approach motivation (Studies 2 and 3), and reactive ideological conviction (Study 4) only when threat-relevant goals had first been primed, but not when threat-irrelevant goals had first been primed. Reactive ideological conviction (Study 4) was eliminated if participants were given an opportunity to attribute their anxiety to a mundane source. Results support a goal regulation view of anxious uncertainty, threat, and defense with potential for integrating theories of defensive compensation.","Nash, K; McGregor, I; Prentice, M",2011.0,10.1037/a0025944,0,0,
6791,"Repetitive transcranial magnetic stimulation over the orbitofrontal cortex for obsessive-compulsive disorder: a double-blind, crossover study","ER This pilot study was designed to assess the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) over the right orbitofrontal cortex (OFC) by means of a double-cone coil in patients suffering from obsessive-compulsive disorder. We hypothesized that low-frequency stimulation of the OFC would lead to a reduction in clinical symptoms, as measured on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). A randomized, double-blind, crossover design was implemented with two 1-week treatment periods (active stimulation versus sham stimulation) separated by a 1-month washout period. Concomitantly, a subgroup of patients underwent a positron emission tomography (PET) scan after each stimulation sequence. Statistical analyses compared the Y-BOCS scores at the end of each period. At day 7, we observed a significant decrease from baseline in the Y-BOCS scores, after both active (P<0.01) and sham stimulation (P=0.02). This decrease tended to be larger after active stimulation than after sham stimulation: -6 (-29, 0) points versus -2 (-20, 4) points (P=0.07). Active versus sham PET scan contrasts showed that stimulation was related to a bilateral decrease in the metabolism of the OFC. The OFC should definitely be regarded as a key neuroanatomical target for rTMS, as it is easier to reach than either the striatum or the subthalamic nucleus, structures favored in neurosurgical approaches.","Nauczyciel, C; Jeune, F; Naudet, F; Douabin, S; Esquevin, A; Vérin, M; Dondaine, T; Robert, G; Drapier, D; Millet, B",2014.0,10.1038/tp.2014.62,0,0,
6792,Preventing mood and anxiety disorders in youth: a multi-centre RCT in the high risk offspring of depressed and anxious patients,"ER METHOD/DESIGN: The current STERK-study (Screening and Training: Enhancing Resilience in Kids) is a randomized controlled clinical trial combining selected and indicated prevention: it is targeted at both high risk individuals without symptoms and at those with subsyndromal symptoms. Individuals without symptoms meet two of three criteria of the High Risk Index (HRI; female gender, both parents affected, history of a parental suicide (attempt). This index was developed in an earlier study and corresponds with elevated risk in offspring of depressed patients. Children aged 8-17 years (n?=?204) with subthreshold symptoms or meeting the criteria on the HRI are randomised to one of two treatment conditions, namely (a) 10 weekly individual child CBT sessions and 2 parent sessions or (b) minimal information. Assessments are held at pre-test, post-test and at 12 and 24 months follow-up. Primary outcome is the time to onset of a mood or anxiety disorder in the offspring. Secondary outcome measures include number of days with depression or anxiety, child and parent symptom levels, quality of life, and cost-effectiveness. Based on models of aetiology of mood and anxiety disorders as well as mechanisms of change during interventions, we selected potential mediators and moderators of treatment outcome, namely coping, parent-child interaction, self-associations, optimism/pessimism, temperament, and emotion processing.DISCUSSION: The current intervention trial aims to significantly reduce the risk of intergenerational transmission of mood and anxiety disorders with a short and well targeted intervention that is directed at strengthening the resilience in potentially vulnerable children. We plan to evaluate the effectiveness and cost-effectiveness of such an intervention and to identify mechanisms of change.TRIAL REGISTRATION: NTR2888.BACKGROUND: Anxiety and mood disorders are highly prevalent and pose a huge burden on patients. Their offspring is at increased risk of developing these disorders as well, indicating a clear need for prevention of psychopathology in this group. Given high comorbidity and non-specificity of intergenerational transmission of disorders, prevention programs should target both anxiety and depression. Further, while the indication for preventive interventions is often elevated symptoms, offspring with other high risk profiles may also benefit from resilience-based prevention programs.","Nauta, M H; Festen, H; Reichart, C G; Nolen, W A; Stant, A D; Bockting, C L; Wee, N J; Beekman, A; Doreleijers, T A; Hartman, C A; Jong, P J; Vries, S O",2012.0,10.1186/1471-244X-12-31,0,0,
6793,Cognitive-behavioral therapy for children with anxiety disorders in a clinical setting: no additional effect of a cognitive parent training,"ER METHODSeventy-nine children with an anxiety disorder (aged 7-18 years) were randomly assigned to a cognitive behavioral treatment condition or a wait-list control condition. Families in the active treatment condition were randomly assigned to an additional seven-session cognitive parent training program. Semistructured diagnostic interviews were conducted with parents and children separately, before and after treatment and at 3 months follow-up. Questionnaires included child self-reports on anxiety and depression and parent reports on child's anxiety and behavioral problems.RESULTSChildren with anxiety disorders showed more treatment gains from cognitive-behavioral therapy than from a wait-list control condition. These results were substantial and significant in parent measures and with regard to diagnostic status, but not in child self-reports. In the active treatment condition, children improved on self-reported anxiety and depression, as well as on parent reports on their child's anxiety problems. These results were equal for clinically referred and recruited children. Child self-reports decreased to the normal mean, whereas parents reported scores that were lower than before treatment but were still elevated from the normal means. No significant outcome differences were found between families with or without additional parent training.CONCLUSIONSChildren with anxiety disorders profited from cognitive-behavioral therapy. Children improved equally whether or not additional parent training was offered.OBJECTIVETo evaluate a 12-week cognitive-behavioral treatment program for children with anxiety disorders and the additional value of a seven-session cognitive parent training program.","Nauta, M H; Scholing, A; Emmelkamp, P M; Minderaa, R B",2003.0,10.1097/01.chi.0000085752.71002.93,0,0,
6794,Comparison of eye movement desensitization and reprocessing with citalopram in treatment of obsessive-compulsive disorder,"ER OBJECTIVE: Obsessive-compulsive disorder (OCD) is one of the chronic anxiety disorders that interfere with routine individual life, occupational and social functions. There is controversy about the first choice of treatment for OCD between medication and psychotherapy.AIM: the aim was to investigate the efficacy of eye movement desensitization and reprocessing (EMDR) compared with medication by citalopram in treatment of OCD.METHODS: This randomized controlled trial was carried out on 90 OCD patients that randomly were assigned into two groups. They either received therapeutic sessions of EMDR or citalopram during 12 weeks. Both groups blindly were evaluated by the Yale-Brown scale before and after the trial period.RESULTS: Pretreatment average Yale-Brown score of citalopram group was about 25.26 as well as 24.83 in EMDR group. The after treatment scores were 19.06 and 13.6, respectively. There was significant difference between the mean Yale-Brown scores of the two groups after treatment and EMDR was more effective than citalopram in improvement of OCD signs.CONCLUSION: It is concluded that although both therapeutic methods (EMDR and Citalopram) had significant effect in improving obsessive signs but it seems that in short term EMRD has better effect in improvement of final outcome of OCD.","Nazari, H; Momeni, N; Jariani, M; Tarrahi, M J",2011.0,10.3109/13651501.2011.590210,0,0,
6795,Myo-inositol has no beneficial effect on premenstrual dysphoric disorder,"ER Inositol, a simple isomer of glucose, which serves as a precursor in the phosphatidyl-inositol (PI) second messenger cycle, was shown to be effective in double-blind, placebo-controlled studies of depression, panic and obsessive compulsive disorders as well as in bulimia. The following study was designed to investigate whether inositol has beneficial effects in another disorder shown to be responsive to SSRIs: premenstrual dysphoric disorder (PMDD). Eleven female patients with PMDD diagnosed according to DSM-IV participated in a cross-over, double-blind, placebo-controlled trial. The active drug was myo-inositol, 12 g daily, whereas placebo was d-glucose administered at the same dose. Each drug was given during the luteal phase only (14 days prior to menses). For each patient treatment alternated between these two drugs for six menstrual cycles. No beneficial effect was demonstrated for inositol over placebo.","Nemets, B; Talesnick, B; Belmaker, R H; Levine, J",2002.0,,0,0,
6796,Obsessions and compulsions in the community,"ER A total of 810 adults were examined by psychiatrists in the second stage of the Eastern Baltimore Mental Health Survey. A semistructured examination, the Standard Psychiatric Examination, was used. The relationships between obsessions and compulsions and personal characteristics, childhood behaviors, family history, and other psychopathology were evaluated. The estimated prevalence of obsessions and compulsions in this population was 1.5%. Cases were significantly more likely to report having had childhood fears, learning disabilities and a family history of alcoholism and suicidal behavior. There were significant positive relationships between scores on compulsive, borderline and histrionic personality disorder scales and the probability of obsessions and compulsions. These exploratory analyses in an epidemiologic sample may identify factors of etiologic importance in this condition.","Nestadt, G; Samuels, J F; Romanoski, A J; Folstein, M F; McHugh, P R",1994.0,,0,0,
6797,Treatment of acute migraine attack: naproxen and placebo compared,"ER A double-blind, cross-over, randomized study of acute migraine attack compared treatment results of naproxen with that of placebo. Each treatment period continued for either three months or six migraine attacks, whichever occurred first. The initial dose of naproxen was 750 mg, with additional 250-500 mg doses taken if and when required, to a maximum of five 250 mg tablets within a period of 24 h in each migraine attack. Forty-one patients were enrolled in the study; they had all experienced at least two but not more than eight migraine attacks a month during the preceding year. Thirty-two patients completed the two treatment periods. Naproxen was statistically significantly superior to placebo in reducing the severity of head pain, nausea, and photophobia; in shortening the duration of head pain, nausea, vomiting, photophobia, and lightheadedness; in diminishing the frequency of vomiting; and in decreasing the need for escape medication. Both patient and physician treatment preferences significantly favoured naproxen. Nine side effects were experienced by seven patients while receiving placebo and seven by five patients during naproxen treatment. Mild gastrointestinal discomfort was the main complaint. Only one patient withdrew from treatment because of a side effect, which occurred while receiving placebo.","Nestvold, K; Kloster, R; Partinen, M; Sulkava, R",1985.0,10.1046/j.1468-2982.1985.0502115.x,0,0,
6798,Effects of different methods of treatment of primary enuresis on psychologic functioning in children,"ER Sixty-two children with primary nocturnal enuresis were assigned randomly to one of two groups. Group 1 was treated with imipramine hydrochloride, and group 2 received a course of treatment with the Mozes Detector. Seventeen children from group 1 and 18 from group 2 were tested with the age-appropriate form of the Cattell personality questionnaire on three occasions: at the time of entry into the study, 2 months later and at follow-up, an average of 16 months later. The patients in group 2, who were older, had a higher rate of cure than did the patients in group 1. They also had significantly higher levels of extroversion and significantly lower levels of neuroticism at follow-up than did those in group 1. These findings indicate that better results are seen with the Mozes Detector than with imipramine in older children with primary nocturnal enuresis.","Netley, C; Khanna, F; McKendry, J B; Lovering, J S",1984.0,,0,0,
6799,A randomized controlled trial of emotion recognition training after traumatic brain injury,"ER SETTINGPostacute rehabilitation facilities.PARTICIPANTSA total of 203 participants with moderate to severe traumatic brain injury were screened; 71 were eligible and randomized to the Faces (n = 24), Stories (n = 23), and Control interventions (n = 24). Participants were an average of 39.8 years of age and 10.3 years postinjury; 74% of participants were male.DESIGNRandomized controlled trial with immediate, 3-month, and 6-month follow-up posttests. Interventions were 9 hours of computer-based training with a therapist.MEASURESDiagnostic Assessment of Nonverbal Accuracy 2-Adult Faces; Emotional Inference From Stories Test; Empathy (Interpersonal Reactivity Index); and Irritability and Aggression (Neuropsychiatric Inventory).RESULTSThe Faces Intervention did significantly better than the Control Intervention on the Diagnostic Assessment of Nonverbal Accuracy 2-Adult Faces (P = .031) posttreatment; no time effect or group interaction was observed. No other significant differences were noted for the Faces Intervention. No significant differences were observed between the Stories and the Control Interventions; however, a significant time effect was found for the Emotional Inference From Stories Test.CONCLUSIONThe Faces Intervention effectively improved facial affect recognition in participants with chronic post-traumatic brain injury, and changes were maintained for 6 months. Future work should focus on generalizing this skill to functional behaviors.OBJECTIVETo examine the effectiveness of 2 affect recognition interventions (Faces and Stories) in people with a traumatic brain injury.","Neumann, D; Babbage, D R; Zupan, B; Willer, B",,10.1097/HTR.0000000000000054,0,0,
6800,A quality-of-life study in high-risk (thickness > = or 2 mm) cutaneous melanoma patients in a randomized trial of 1-cm versus 3-cm surgical excision margins,"ER A quality-of-life study was carried out to test the hypothesis that melanoma patients treated with a 3-cm margin of excision suffer greater impairment of their quality of life than those treated with a 1-cm margin. The secondary aim was to determine the predictors of a poor patient perception of their excision scar. A postal questionnaire study was carried out using Hospital Anxiety and Depression (HAD), Psychosocial Adjustment of Illness Scale-Self-Report (PAIS-SR), Medical Outcomes Survey-Short Form 36 (MOS-SF36), and the Cassileth Scar questionnaires. Data were collected from 426 of the 537 patients who were mailed the questionnaires (response rate 79%). Fourteen percent had clinically significant anxiety and 5% had significant depression. A poor attitude toward quality of health care was associated with youth. Patients treated with a 3-cm margin excision had significantly poorer mental and physical function 1 mo after surgery, which disappeared within 6 mo. The greater difficulties experienced by the 3-cm margin group were particularly in their domestic, sexual, and social roles. Women, younger patients, those with poor physical and mental function after surgery, and those treated by a 3-cm margin were more likely to report a poorer perception of their scar. The poorer scar perception of patients in the 3-cm group persisted throughout the study period. Use of a 3-cm margin of excision for melanoma is associated with significantly more morbidity than use of a 1-cm margin, but this effect disappears in 6 mo. Patients treated by 3-cm excision were more likely, however, to have a persistent poor view of their scar. Youth and being female were also predictors of poor perception of the scar.","Newton-Bishop, J A; Nolan, C; Turner, F; McCabe, M; Boxer, C; Thomas, J M; Coombes, G; A'Hern, R P; Barrett, J H",2004.0,10.1046/j.1087-0024.2003.09118.x,0,0,
6801,The effect of providing a warning about the lie scale in a personality inventory,,"Nias, D K",1972.0,,0,0,
6802,"The ADHD response-inhibition deficit as measured by the stop task: replication with DSM-IV combined type, extension, and qualification","ER Although response inhibition has been proposed as a core element of child attention-deficit hyperactivity disorder (ADHD), the literature is heavily reliant on studies using DSM-III-R diagnostic criteria, older methods of measuring response inhibition, samples of boys, and failing to control thoroughly for comorbid problems--both as diagnoses and as subclinical variation. The present study replicated a deficit in response inhibition in the ADHD combined type (DSM-IV, American Psychiatric Association, 1994) using samples matched on age and sex. The study replicated an effect size of approximately d = .6 in boys with ADHD, and observed an even larger effect size for girls, although the Sex x Group interaction was nonsignificant. Children with ADHD also had problems with response output, shown by variable responding. Excluding comorbid conduct disorder, reading disorder, generalized anxiety disorder, obsessive-compulsive disorder, major depression, and posttraumatic stress disorder from the sample did not alter the results. Correlations indicated that response inhibition was associated with both attentional problems and reading level. Covarying for reading problems did not eliminate the ADHD group effect, but the association of response inhibition with reading clearly requires further examination. Overall, the study supported the role of response inhibition in the DSM-IV ADHD combined type, but with key qualifications as to degree of specificity in reference both to comorbid problems and other executive functions.","Nigg, J T",1999.0,,0,0,
6803,Anxiety treatment improves physical functioning with oblique scoring of the SF-12 short form health survey,"ER OBJECTIVE: No studies have found a positive effect of anxiety treatment on physical functioning, but recent investigations of the 12-item Short Form Health Questionnaire (SF-12), which is frequently used to assess physical functioning, have suggested that orthogonal scoring of the summary measure may distort representations of physical health. The current study reanalyzes whether anxiety treatment improves physical functioning using oblique scoring in the Coordinated Anxiety Learning and Management (CALM) randomized clinical trial for the treatment of anxiety disorders. Replication was tested in reanalysis of data from the earlier Collaborative Care for Anxiety and Panic (CCAP) randomized clinical trial for the treatment of panic disorder.METHOD: The CALM study included 1004 primary care patients with panic, social anxiety, generalized anxiety or posttraumatic stress disorders. Patients received usual care (UC) or an evidence-based intervention (cognitive behavioral therapy, psychotropic medication or both; ITV). Physical functioning (SF-12v2) was assessed at baseline and at 6, 12 and 18 months. Oblique and orthogonal scoring methods for the physical functioning aggregate measure from SF-12 scale items were compared.RESULTS: In CALM, physical functioning improved to a greater degree in ITV than UC for oblique but not orthogonal scoring. Findings were replicated in the CCAP data.CONCLUSIONS: Evidence-based treatment for anxiety disorders in primary care improves physical functioning when measured using oblique scoring of the SF-12. Due to this scoring issue, effects of mental health treatment on physical functioning may have been understated.","Niles, A N; Sherbourne, C D; Roy-Byrne, P P; Stein, M B; Sullivan, G; Bystritsky, A; Craske, M G",2013.0,10.1016/j.genhosppsych.2012.12.004,0,0,
6804,Imagery rescripting of early memories in social anxiety disorder: an experimental study,"ER INTRODUCTION: Evidence suggests that negative self imagery plays an important role in social anxiety disorder (SAD) as a maintaining factor, and that early memories of traumatic experiences are linked to recurrent catastrophic images. Previous research has showed that cognitive restructuring combined with imagery rescripting of these memories may affect recurrent images resulting in less imagery distress and less anxiety in social situations. The present study replicated these effects using (a) a modified treatment with imagery rescripting without cognitive restructuring, and (b) an experimental between-groups design.METHOD: Patients with SAD (N = 14) were randomised either to imagery rescripting of early memories, or to a reading task.RESULTS: Follow-up after 1 week showed that the intervention led to significant improvements in memory and image distress, and reduced fears of negative evaluation and social interaction.DISCUSSION: The results indicate that imagery rescripting is effective even without cognitive restructuring and question the importance of the latter. However, the small sample limits the strength of the conclusions.CONCLUSION: Imagery rescripting of early distressful memories may be a powerful intervention in the treatment of SAD.","Nilsson, J E; Lundh, L G; Viborg, G",2012.0,10.1016/j.brat.2012.03.004,0,0,
6805,"The relationship between coping strategies, quality of life, and mood in patients with incurable cancer","ER METHODS: As part of a randomized trial of palliative care, this study assessed baseline QOL (Functional Assessment of Cancer Therapy-General), mood (Hospital Anxiety and Depression Scale), and coping (Brief COPE) in patients within 8 weeks of a diagnosis of incurable lung or gastrointestinal cancer and before randomization. To examine associations between coping strategies, QOL, and mood, we used linear regression, adjusting for patients' age, sex, marital status, and cancer type.RESULTS: There were 350 participants (mean age, 64.9 years), and the majority were male (54.0%), were married (70.0%), and had lung cancer (54.6%). Most reported high utilization of emotional support coping (77.0%), whereas fewer reported high utilization of acceptance (44.8%), self-blame (37.9%), and denial (28.2%). Emotional support (QOL: ? = 2.65, P < .01; depression: ? = -0.56, P = .02) and acceptance (QOL: ? = 1.55, P < .01; depression: ? = -0.37, P = .01; anxiety: ? = -0.34, P = .02) correlated with better QOL and mood. Denial (QOL: ? = -1.97, P < .01; depression: ? = 0.36, P = .01; anxiety: ? = 0.61, P < .01) and self-blame (QOL: ? = -2.31, P < .01; depression: ? = 0.58, P < .01; anxiety: ? = 0.66, P < .01) correlated with worse QOL and mood.CONCLUSIONS: Patients with newly diagnosed, incurable cancer use a variety of coping strategies. The use of emotional support and acceptance coping strategies correlated with better QOL and mood, whereas the use of denial and self-blame negatively correlated with these outcomes. Interventions to improve patients' QOL and mood should seek to cultivate the use of adaptive coping strategies. Cancer 2016;122:2110-6. © 2016 American Cancer Society.BACKGROUND: Patients with incurable cancer face many physical and emotional stressors, yet little is known about their coping strategies or the relationship between their coping strategies, quality of life (QOL), and mood.","Nipp, R D; El-Jawahri, A; Fishbein, J N; Eusebio, J; Stagl, J M; Gallagher, E R; Park, E R; Jackson, V A; Pirl, W F; Greer, J A; Temel, J S",2016.0,10.1002/cncr.30025,0,0,
6806,Glutamatergic system abnormalities in posttraumatic stress disorder,"ER RATIONALE: Accumulating evidence suggests involvement of the glutamatergic system in the biological mechanisms of posttraumatic stress disorder (PTSD), but few studies have demonstrated an association between glutamatergic system abnormalities and PTSD diagnosis or severity.OBJECTIVE: We aimed to examine whether abnormalities in serum glutamate and in the glutamine/glutamate ratio were associated with PTSD diagnosis and severity in severely injured patients at risk for PTSD and major depressive disorder (MDD).METHODS: This is a nested case-control study in TPOP (Tachikawa project for prevention of posttraumatic stress disorder with polyunsaturated fatty acid) trial. Diagnosis and severity of PTSD were assessed 3 months after the accidents using the Clinician-Administered PTSD Scale. The associations of glutamate levels and the glutamine/glutamate ratio with diagnosis and severity of PTSD and MDD were investigated by univariate and multiple linear regression analyses.RESULTS: Ninety-seven of 110 participants (88 %) completed assessments at 3 months. Serum glutamate levels were significantly higher for participants with full or partial PTSD than for participants without PTSD (p = 0.049) and for participants with MDD than for participants without MDD (p = 0.048). Multiple linear regression analyses showed serum glutamate levels were significantly positively associated with PTSD severity (p = 0.02) and MDD severity (p = 0.03). The glutamine/glutamate ratio was also significantly inversely associated with PTSD severity (p = 0.03), but not with MDD severity (p = 0.07).CONCLUSIONS: These findings suggest that the glutamatergic system may play a major role in the pathogenesis of PTSD and the need for new treatments targeting the glutamatergic system to be developed for PTSD.","Nishi, D; Hashimoto, K; Noguchi, H; Hamazaki, K; Hamazaki, T; Matsuoka, Y",2015.0,10.1007/s00213-015-4052-5,0,0,
6807,Adolescent daily and general maladjustment: is there reactivity to daily repeated measures methodologies?,"ER The present study examined whether repeated exposure to daily surveys about negative social experiences predicts changes in adolescents' daily and general maladjustment, and whether question content moderates these changes. Across a 2-week period, 6th-grade students (N = 215; mode age = 11) completed 5 daily reports tapping experienced or experienced and witnessed negative events, or they completed no daily reports. General maladjustment was measured in 2-week intervals before, at the end of, and 2 weeks after the daily report study. Daily maladjustment either decreased or did not change across the 5 daily report exposures. General maladjustment decreased across the three 2-week intervals. Combined, results indicate that short-term daily report studies do not place youth at risk for increased maladjustment.","Nishina, A",2012.0,10.1111/j.1467-8624.2011.01718.x,0,0,
6808,A randomized trial of cognitive behaviour therapy and cognitive therapy for children with posttraumatic stress disorder following single-incident trauma,"ER The present study compared the efficacy of trauma-focused cognitive behavior therapy (CBT) with trauma-focused cognitive therapy (without exposure; CT) for children and youth with posttraumatic stress disorder (PTSD). Children and youth who had experienced single-incident trauma (N?=?33; 7-17 years old) were randomly assigned to receive 9 weeks of either CBT or CT which was administered individually to children and their parents. Intent-to-treat analyses demonstrated that both interventions significantly reduced severity of PTSD, depression, and general anxiety. At posttreatment 65% of CBT and 56% of the CT group no longer met criteria for PTSD. Treatment completers showed a better response (CBT: 91%; CT: 90%), and gains were maintained at 6-month follow-up. Maternal depressive symptoms and unhelpful trauma beliefs moderated children's outcome. It is concluded that PTSD secondary to single-incident trauma can be successfully treated with trauma-focused cognitive behavioural methods and the use of exposure is not a prerequisite for good outcome.","Nixon, R D; Sterk, J; Pearce, A",2012.0,10.1007/s10802-011-9566-7,0,0,
6809,The treatment of phobic anxiety by zimelidine,"Seven patients who were diagnosed as suffering from phobic anxiety were treated with a new antidepressant which causes relatively selective inhibition of serotonin uptake. This compound, zimelidine, was given for five weeks in doses of up to 300 mg per day. One patient dropped out of the study. Of the remaining six patients all but one made an improvement, which in most cases is thought to have been a drug effect. One patient relapsed some months following treatment and responded again to treatment with zimelidine having failed to respond to other psychotropic drugs.",Evans L.; Moore G.,1981.0,,0,0,
6810,Psychiatric symptom patterns of chronic epileptics attending a neurological clinic: A controlled investigation,"The psychiatric morbidity of chronic epileptic out-patients unknown to psychiatric agencies was assessed using two questionnaire measures of psychopathology (GHQ and CCEI). Nearly half of the epileptics were classified as probable psychiatric cases Psychiatric morbidity was both more prevalent and more severe in this group than in a comparison group of chronic neurological out-patients. Depression, anxiety and hysterical symptomatology were the commonest characteristics of psychiatrically impaired epileptics. The type and severity of epilepsy were found to influence both the degree and pattern of psychiatric morbidity. Contrary to previous findings, age of onset had no relation to psychopathology.",Kogeorgos J.; Fonagy P.; Scott D.F.,1982.0,,0,0,
6811,Excess mortality in panic disorder. A comparison with primary unipolar depression,"We located 113 former inpatients with panic disorder 35 years after index admission. According to age- and sex-specific Iowa population figures, patients with panic disorder had significant excess mortality due to death by unnatural causes. Other studies suggest that secondary depression and alcoholism may have had a role in these deaths. Men with panic disorder also exhibited excess mortality due to circulatory system disease. In an age- and sex-matched patient group with primary unipolar depression, both men and women showed excess mortality. Suicide accounted for 20.0% and 16.2% of deaths in the panic disorder and primary depression groups, respectively. We conclude that panic disorder accounted for much of the excess mortality formerly noted in the 'neuroses.'",Coryell W.; Noyes R.; Clancy J.,1982.0,,0,0,
6812,Alprazolam in the treatment of generalized anxiety and panic disorders: A double-blind placebo-controlled study,"In a double-blind controlled study lasting 8 weeks, 50 anxious psychoneurotic outpatients with a primary diagnosis of generalized anxiety or panic disorder were randomly assigned to alprazolam (n = 30), a new benzodiazepine, or placebo (n = 20), after a washout period of 1 week. Alprazolam at dosages between 0.25 and 3 mg/day was found to be significantly better than placebo in the treatment of either disorder. The finding that alprazolam was effective in the treatment of panic disorder is of interest as this diagnostic category is usually treated with tricyclic antidepressants or MAO inhibitors.",Chouinard G.; Annable L.; Fontaine R.; Solyom L.,1982.0,10.1007/BF00464571,0,0,
6813,E.N.G. after head injury,"The E.N.G. findings in patients suffering from post-traumatic vertigo show that the culmination frequency of the caloric responses is elevated or 'disinhibited.' Such a disinhibition suggests a central vestibular disorder. Vertiginous symptoms after head injuries are most often produced by central lesions, involving mainly the brain-stem. The incidence of peripheral lesions causing post-traumatic vertigo is remarkably low (16 per cent); central vestibular lesions are almost three times as common (44 per cent). The sensori-neural deafness associated with head injury is commonly bilateral, involving mainly the higher frequencies, and it has an audiometric configuration similar to that of noise-induced hearing loss.",Kirtane M.V.; Medikeri S.B.; Karnik P.P.,1982.0,,0,0,
6814,Variations of plasmatic enzyme activities and proteins after severe head injury: Effect of nicergoline,"The effect of nicergoline after severe head injury was evaluated in a double-blind study on forty six patients (20 treated patients, 26 non treated). There was no significant modification of cellular release of biochemical constituents which were used for a biological post-traumatic survey. The α-blocking and anti-aggregating effect of this drug is not involved in the mechanism of this release, making it possible to obtain an early prognosis in terms of survival or death.",Bourguignat A.; Tulasne P.A.; Metais P.,1983.0,,0,0,
6815,The relative dose indicator: A novel tool for clinical narcotic research,"Previous studies with patient-controlled analgesia (PCA) have shown that a reliable relationship exists between pain and sedation scores. Thus we combined these rankings into a single index, the relative dose indicator (RDI). Two applications of the RDI are described: A case report in which a post-trauma patient used PCA followed by intramuscular (IM) therapy for pain relief, and a study of 33 postoperative patients randomized to either PCA or IM therapy. Standard analyses, in which sedation and pain rankings were scrutinized individually, are presented in addition to RDI evaluations. The two evaluative methods concurred, indicating that PCA provided significantly better analgesia than IM therapy. The RDI appears to be useful in the clinical evaluation of narcotic analgesics, placing sedation and pain relief onto a single continuum.",Graves D.A.; Baumann T.J.; Batenhorst R.L.; Foster T.S.,1984.0,,0,0,
6816,Biological aspects of panic disorder,,Ballenger J.C.,1986.0,,0,0,
6817,Effects of lactate-induced panic attacks on brain stem auditory evoked potentials,"As the clinical symptomatology of panic attacks may be conceivably related to abnormal brain stem activity, the present study examined the effect of lactate-precipitated panic on brain stem auditory evoked potentials (BSAEPs). The subjects were 27 patients who met DSM-III criteria for panic disorder (Pd), agoraphobia with panic attacks (AgPa) or agoraphobia (Ag). Following drug washout, patients were tested in two separate sessions, in a double-blind randomised controlled design in which each session involved two sequentially ordered BSAEP collection periods - a baseline period with no infusion followed by an intravenous infusion of 5% dextrose in water or 1.0 M sodium lactate (5 ml/kg in 5% dextrose/water) over a 20-min period. Of the 27 patients, 17 were clear responders, reporting panic attacks and self-report changes under lactate similar to those occurring during spontaneous panic. Of the remaining 10 patients, 6 were pseudo-responders, reporting panic symptoms under both dextrose and lactate, and 4 were non-responders. In the clear responders, lactate did not alter electrical events of the BSAEP, but further analysis within the clear responders, comparing AgPa patients with Pd patients, yielded a significant effect with lactate resulting in a prolonged III-V inter-peak interval in the AgPa group. It is suggested that the increased III-V interval in the AgPa group may be reflective of hyperactivity of brain stem noradrenergic nuclei.",Knott V.J.; Lapierre Y.D.,1986.0,,0,0,
6818,The 'fixateur interne' as a versatile implant for spine surgery,"The 'fixateur interne' is a new device for posterior spine surgery. It consists of long Schanz screws which are inserted from a posterior approach through the pedicles into the vertebral bodies, and of connecting threaded longitudinal rods, carrying mobile clamps which can be fixed in every position by nuts. The long leverarms of the Schanz screws facilitate manual reduction. They are removed at the end of operation. As the device is stable against flexion and rotation by itself, it does not act on the four-point bending principle. Thus, the fixation can be restricted to the immediately adjacent vertebrae of a lesion, leaving the rest of the spine mobile. In fracture treatment instrumentation is combined with a direct repair of the anterior loss of bone stock by a transpedicular bone grafting procedure from the same dorsal approach. This report presents and discusses 183 instrumentations in fresh fractures, posttraumatic deformities, degenerative diseases, tumors, and severe spondyloistheses. The main advantage is the short fixation area and the ease of after treatment.",Dick W.,1987.0,,0,0,
6819,"Acute alkalosis, but not acute hypocalcemia, increases panic behavior in an animal model","Non-pretrained, randomized adult rats were tested in a panic-inducing model of passive avoidance. Intravenous treatment with alkalinizing agents (sodium lactate 0.5 M, 0.5 ml/100 g b.wt., or NaHCO3, 0.5 mEq/100 g b.wt.), but not with a hypocalcemic dose of EDTA (75 mg/kg) 3 min before testing, significantly increased panic behavior. These data may support the hypothesis that panic attacks are due to alkalosis and not to lactate-induced hypocalcemia.",Di Lorenzo R.; Bernardi M.; Genedani S.; Zirilli E.; Grossi G.; Guaraldi G.P.; Bertolini A.,1987.0,10.1016/0031-9384(87)90401-X,0,0,
6820,Autonomic nervous blockade and phobic fear responses,"Six animal phobics and six subjects phobic of blood and mutilation were exposed to 20 phobogenic and 20 neutral slides (duration 8 sec with a mean intertrial interval of 30 sec ranging between 20 and 50 sec) during beta-adrenoceptor blockade (propranolol), cholinergic blockade (methyl scopolamine) and a no-drug condition. Interbeat interval (IBI), T-wave amplitude (TWA) of the electrocardiogram and skin-conductance (SCR) were measured. Phobic compared to neutral response slides elicited shorter IBIs and greater SCRs, whereas both types of slides failed to affect TWA. Beta-adrenoceptor blockade lengthened resting IBI both in animal and blood and mutilation phobics but comparatively more in the blood phobics. Cholinergic blockade had no effect on resting IBI. No effect of any blockade was observed on resting TWA. Both beta-adrenoceptor and cholinergic blockade failed to affect IBI-, and TWA-responses to phobic cues. SCRs habituated faster during cholinergic than during beta-adrenoceptor blockade or the no-drug condition. Thus, the tachycardia observed in phobics during exposure to phobic slides does not seem to be determined by the sympathetic branch of the autonomic nervous system only.",Fredrikson M.; Danielssons T.; Iremark H.; Sundin O.,1987.0,,0,0,
6821,Lactate- and isoproterenol-induced panic attacks in panic disorder patients and controls,"In a double-blind study using sodium lactate and isoproterenol infusions to provoke panic attacks, 73 of 86 panic disorder patients and 10 of 45 controls panicked with lactate, and 58 of 86 patients and 4 of 45 controls panicked with isoproterenol. We measured baseline and peak anxiety ratings in 10 controls with lactate-induced panic attacks, 31 controls who did not panic during lactate infusions, and 63 panic disorder patients who did panic during lactate infusions. The controls who panicked with lactate had robust increases in their anxiety ratings very similar to the increases experienced by patients who panicked with lactate.",Balon R.; Pohl R.; Yeragani V.K.; Rainey J.M.; Weinberg P.,1988.0,10.1016/0165-1781(88)90005-4,0,0,
6822,Post-traumatic glycogen depletion in type I and type II muscle fibres in man,"Muscle glycogen content is decreased following trauma. The present study was undertaken in order to investigate the pattern of muscle glycogen depletion in type I and type II muscle fibres following surgical trauma. Twenty-four otherwise healthy patients undergoing elective intra-abdominal surgery were studied. Muscle biopsies were taken prior to surgery and on the 2nd and 4th post-operative day and analysed for glycogen content as well as histochemical classification of fibre type. In nine patients the glycogen content in separate muscle fibres was estimated histochemically by using the periodic acid Schiff (PAS) reaction. Muscle glycogen content showed only minor changes on the 2nd post-operative day but decreased about 30% from pre-operative values on the 4th post-operative day. A positive correlation between the decrease in muscle glycogen content on the 4th post-operative day and the percentage type I fibres was found. Furthermore, the PAS-staining indicated a significantly more pronounced glycogen depletion in type I than in type II muscle fibres on the 4th post-operative day. This study confirms that muscle glycogen content is decreased post-operatively and demonstrates that glycogen depletion after abdominal surgery is delayed until the 2nd-4th post-operative day. The results also show that this post-traumatic glycogen depletion occurs to a greater extent in type I than in type II fibres. We think it likely that the decrease in muscle glycogen content is due to a persistent insulin resistance and not to the transient rise in plasma adrenaline pre- and post-operatively.",Eriksson L.I.; Wictorsson Y.; Hendriksson K.G.; Hakanson E.; Jorfeldt L.; Rutberg H.,1988.0,,0,0,
6823,Investigations on the application of fat emulsions in ICU-patients,"In a prospective controlled randomized study applicability and security of fat infusion in severly ill patients was investigated. Besides the aim to define precise criteria of indications and contraindications the group I patients received substrate support as carbohydrates, amino acids and fat in an amount with carbohydrates and fat covered the total energy expenditure which was calculated from measured oxygen consumption data. In group II carbohydrates alone covered the total energy expenditure and the same amount of fat given in group I was applied in addition. Our aim was to find out if the overload of 20% of applied substrate is tolerated or not. With the applied dosages of 1.2 g fat/kg B.W./day it is shown that homeostasis of the patient remains undisturbed even with the surplus if the indication for fat is given. Special interest focused on the interrelationship between carbohydrate and fat metabolism during the posttraumatic hormonally fixed metabolic situation.",Grunert A.; Wiedeck H.; Preiss F.,1988.0,,0,0,
6824,DSM-III-R anxiety classification: Impact on psychopharmacology clinical trials,,Liebowitz M.R.,1988.0,,0,0,
6825,Intraoperative electrical stimulation of the brain in patients with obsessive-compulsive neurosis,"Twenty patients with intractable obsessive-compulsive neurosis were operated under local anesthesia. Each patient had a lesion produced in 1 of the 4 brain targets: anterior internal capsule, rostral cingulum, middle cingulum, and genu of the corpus callosum. Before destructive permanent lesions were produced, the target area was stimulated electrically. Stimulation gave subjective or objective reactions in 30% of the patients: diminished anxiety, 3 patients; increased anxiety, 1 patient, and motor responses, 2 patients. None experienced an obsessive reaction to stimulation. The clinical effect of surgery was usually good.",Laitinen L.V.; Singounas E.,1988.0,,0,0,
6826,Psychological effects of running loss on consistent runners,,Chan C.S.; Grossman H.Y.,1988.0,,0,0,
6827,"Fractures of the atlas: classification, treatment and morbidity","Fractures of the atlas vertebra are generally considered to be innocuous injuries. A review of 35 patients with C1 fractures treated in the Acute Spinal Cord Injury Unit of Shaughnessy Hospital indicated that long-term morbidity is not as low as was previously thought. Thirteen of 23 patients (56%) followed up a minimum of 1 year posttrauma had significant symptoms of scalp dysesthesia, neck pain, and/or neck stiffness. A classification is presented, and the results of treatment modalities used are reviewed. Based on the findings, the simplest orthosis consistent with appropriate treatment of any of the often associated other spine fractures is recommended. Surgery is reserved for late instability or pain.",Landells C.D.; Van Peteghem P.K.,1988.0,,0,0,
6828,Systemic hormonal and physiological abnormalities in anxiety disorders,"Among the studies of systemic hormonal and physiological abnormalities associated with anxiety disorders, the most consistent and extensive findings suggest (a) peripheral adrenergic hyperactivity (including increases in norepinephrine but not epinephrine) and functional dysregulation, (b) increased incidence of mitral valve prolapse in panic patients, and (c) normal suppressibility of the hypothalamic-pituitary-adrenal cortical endocrine system with dexamethasone in panic patients. Other less-certain findings include (a) increased circulating concentrations of plasma ACTH and/or cortisol, and prolactin, in panic patients, (b) increased platelet oxidase activity in generalized anxiety and/or panic patients,(c) decreased gonadal axis activity in some anxious individuals, (d) decreased nighttime melatonin plasma concentrations in panic patients, and (e) peripheral α2-and β-adrenoreceptor down-regulation, with normal serotonin binding parameters. These findings, taken together, provide tentative support for dysfunction in adrenergic and GABAergic central nervous system mechanisms in people with anxiety disorders. Abnormal anxiety and normal stress both show evidence of adrenergic hyperactivity; however, there appear to be differences in hormonal profiles, especially the apparent lack of increase of epinephrine during panic attacks, as well as differences in the reactivity of the system, and in the 'trigger' mechanisms which determine when the response occurs.",Cameron O.G.; Nesse R.M.,1988.0,10.1016/0306-4530(88)90054-6,0,0,
6829,Posterior plating of the cervical spine. A biomechanical comparison of different posterior fusion techniques,"Posterior arthrodesis is a preferred treatment for posttraumatic instability of the cervical spine. While most surgical constructs yield predictably high rates of fusion in satisfactory alignment, certain injury patterns involving fractures of the lamina or spinous processes may preclude rigid immobilization by simple wiring techniques. Plate fixation of the posterolateral masses has been advocated for such injuries. The purpose of this biomechanical study was to test the relative stiffness provided by different posterior fusion constructs, including lateral mass plating. All testing was performed on fresh, unembalmed cadaveric spines divided into two vertebral segment units. Muscular tissue was stripped from the specimens, but all discal and ligamentous structures were preserved. Four different posterior fixation constructs were tested. These included 1) Rogers interspinous wiring, 2) Halifax laminar clamps, 3) bilateral 1/3 tubular plates on the lateral masses, using unicortical screws, and 4) bilateral 1/3 tubular plates on the lateral masses, using bicortical screws. Stiffness measurements were taken in both flexion and extension on all specimens. Yield strength and fatigue strength of the spines were not measured. It was found that 1/3 tubular plates secured with bicortical screws to the lateral masses provided the highest mean stiffness. Less stiffness was found in spines stabilized by Halifax clamps, interspinous wiring, and plates secured with unicortical screws. There was, however, no statistically significant difference in stiffness provided by these four implants. It was concluded that there is no advantage in plate fixation over standard fusion constructs in augmenting the stiffness of posterior fixation of the cervical spine.",Gill K.; Paschal S.; Corin J.; Ashman R.; Bucholz R.W.,1988.0,10.1097/00007632-198807000-00018,0,0,
6830,Hypothalamic-pituitary function in growth hormone-deficient patients with pituitary stalk transection,"We compared 1.5 T magnetic resonance (MR) image findings with hypothalamic-pituitary function in 11 patients with idiopathic pituitary dwarfism, each of whom had a history of perinatal abnormalities, and 1 patient with posttraumatic pituitary dwarfism. MR imaging revealed transection of the pituitary stalk in all patients and the formation of an ectopic posterior lobe at the proximal stump in 9 patients, none of whom had polydipsia or polyuria. Three patients without an ectopic posterior lobe had diabetes insipidus. The 5 patients who had small pituitary glands (<2 mm in height) had hypothyroidism with low serum TSH concentrations and low serum cortisol responses to insulin-induced hypoglycemia; however, 7 patients with normal-sized pituitary glands had normal thyroid and adrenal function. The serum GH response to GHRH did not correlate with the size of the pituitary gland. The patients with small pituitary glands had delayed or prolonged serum TSH responses to TRH and impaired serum LH and FSH responses to GnRH; 4 of the patients with normal-sized pituitary glands had normal serum TSH, LH and FSH responses. Only 2 patients had high basal serum PRL concentrations. The endocrinological data suggest that reestablishment of the hypothalamohypophyseal portal circulation, which cannot be seen by MR imaging, may occur. We suggest that the primary cause of idiopathic pituitary dwarfism in many patients is injury to the pituitary stalk at birth.",Kikuchi K.; Fujisawa I.; Momoi T.; Yamanaka C.; Kaji M.; Nakano Y.; Konishi J.; Mikawa H.; Sudo M.,1988.0,,0,0,
6831,Post-traumatic lumbar extra-arachnoid mass with radiculopathy responding to conservative therapy in a patient with bilateral laminar fractures,,Gupta K.L.; Kapila A.; Nasca R.J.; Duvall E.R.,1988.0,10.1097/00007632-198808000-00018,0,0,
6832,Electrodermal and cardiovascular responses to phobia-relevant stimuli in a trace conditioning paradigm: Effects of instructions,"The present study concerns itself with the hypothesis that the preparedness phenomenon demonstrated by Ohman and co-workers (1985) is non-cognitive in nature, i.e., is not dependent upon subjects deliberately focusing their attention on the contingency between a phobia-relevant conditioned stimulus (CS+) and shock. In order to test this hypothesis, a trace conditioning experiment was carried out in which one group of subjects saw a phobia-relevant CS+ and a second group saw a neutral CS+. During acquisition, the former group was confronted with the sequence phobia-relevant CS+ (slides of snakes or spiders)/shock/non-reinforced, neutral CS- (slides of mushrooms or flowers), while the latter group was confronted with the sequence neutral CS+/shock/phobia-relevant CS-. Within each group, half of the subjects received that stressd the CS+/shock contingency ('forward' instruction), while the other half was asked to pay special attention to the CS-, which always followed shock ('backward' instruction). The experiment consisted of 6 habituation, 12 acquisition, and 24 extinction trials. Both skin conductance responses (SCRs) and heart rate responses (HRRs) were measured. SCRs were found to extinguish more slowly in subjects who had received a 'forward' instruction than in subjects with a 'backward' instruction. however, there was no resistance to extinction of the conditioned SCRs in subjects who saw a phobia-relevant CS+ and received a 'backward' instruction. Thus, the delayed extinction of conditioned SCRs was not dependent upon the phobia relevance of the CS+, but rather upon the amount of attention that subjects were asked to pay to the CS+/shock contingency. For HRRs, a less comprehensive picture emerged, with phobia-relevant CS+s eliciting accelerative responding during habituation, a small deceleration during acquisition, and no significant changes from baseline during extinction. Results are related to other recent studies that have yielded contradictory evidence for the alleged non-cognitive nature of the preparedness phenomenon.",Merckelbach H.; Van den Hout M.A.,1988.0,,0,0,
6833,Provocation of panic with carbon dioxide inhalation in patients with premenstrual dysphoria,"The effects of double breath inhalation of a 35% CO2 mixture in oxygen and placebo air inhalation were compared in 14 women seeking treatment for marked premenstrual dysphoric changes who did not have panic disorder and 12 control women. The first exposure to CO2 inhalation induced a panic attack reaction (severe subjective anxiety with autonomic symptoms) in 9 of 14 women with premenstrual dysphoria but none of the controls. Neither patients nor controls panicked in response to the air inhalation. Control subjects experienced mild anxiety and/or somatic symptoms after CO2 inhalation, but these did not resemble panic attacks and were clearly different from the response of the patient group.",Harrison W.M.; Sandberg D.; Gorman J.M.; Fyer M.; Nee J.; Uy J.; Endicott J.,1989.0,10.1016/0165-1781(89)90133-9,0,0,
6834,Facial sensibility testing in the normal and posttraumatic population,"A reliable, reproducible, simple examination of facial sensibility is described. Evaluation of 60 healthy subjects established normal values, trends, and variations of facial sensibility. Comparison of these normal values with 20 posttraumatic patients revealed that postfacial fracture sensibility testing was abnormal. Abnormalities in pressure threshold testing was most consistently associated with functional sensory complaints. Twelve of the 20 patients had significant sensory complaints at one year following the trauma.",Kesarwani A.; Antonyshyn O.; Mackinnon S.E.; Gruss J.S.; Novak C.; Kelly L.,1989.0,10.1097/00000637-198905000-00006,0,0,
6835,"Anterior stabilization, instrumentation, and decompression for post-traumatic kyphosis","Thirty-seven patients underwent surgery for late post-traumatic kyphosis in the lumbar, thoracolumbar, or thoracic spine. Indications for surgery included: increasing deformity, pain, and persistent neurologic deficit with paraparesis in eight, and development of late spinal stenosis in a further nine patients. All patients underwent anterior correction with Kostuik-Harrington instrumentation. Seventeen patients with neurologic deficit underwent decompression over appropriate levels as well. No posterior fusions or instrumentation were carried out. Stable arthrodesis with correction of the deformity occurred in 36 of 37 patients with only one nonunion. Pain was reduced significantly in 78% of patients. Late neurologic improvement of a significant functional degree occurred in three of eight paraparetics. All patients with spinal stenosis had relief of their symptoms and signs.",Kostuik J.P.; Matsusaki H.,1989.0,10.1097/00007632-198904000-00006,0,0,
6836,"Obsessive-compulsive and other behavioural changes with bilateral basal ganglia lesions. A neuropsychological, magnetic resonance imaging and positron tomography study","Eight patients are reported who shared the combination of bilateral basal ganglia lesions and a frontal lobe-like syndrome. The main features were inertia and loss of drive, with preservation of intellectual function. Some patients showed stereotyped activities with compulsive and obsessive behaviour which were sometimes highly elaborate in pattern. Extrapyramidal clinical signs were absent or mild. Brain damage, related to anoxic or toxic encephalopathy, was demonstrated by CT scans and MRI. The lesions appeared to be confined to the lentiform nuclei, particularly affecting the pallidum, although there was generalized brain atrophy in 2 cases. Positron emission tomography (PET) in 7 patients revealed hypometabolism of the prefrontal cortex relative to other parts of the brain. The PET studies suggest dysfunction of the prefrontal cortex as a result of damage to the lentiform nuclei. These clinical, anatomical and functional observations emphasize the role of the circuits linking the prefrontal associative cortex and some specifics areas of the neostriatum, including the pallidum. The existence of distinct nonoverlapping circuits in the motor field or in the associative field can explain the fact that basal ganglia lesions may give rise to a clinical picture that is either purely motor, purely behavioural (as in some of our patients), or both. Similarities existed between some symptoms found in our patients and certain features of major psychiatric illnesses such as severe depression, catatonic schizophrenia, and obsessive-compulsive disorder. This raises the hypothesis that some aspects of these psychiatric disorders could be related to structural and physiological disturbances in the systems linking the frontal associative cortex and the basal ganglia.",Laplane D.; Levasseur M.; Pillon B.; Dubois B.; Baulac M.; Mazoyer B.; Dinh S.T.; Sette G.; Danze F.; Baron J.C.,1989.0,,0,0,
6837,Neuropsychology of posttraumatic stress disorder: A pilot study,,Everly G.S.; Horton Jr. A.M.,1989.0,,0,0,
6838,Sleep in patients with spontaneous panic attacks,"Twenty-four drug-free patients with a DSM-III diagnosis of panic disorders (and their age- and sex-matched normal controls) slept in the laboratory for 3 consecutive nights. Panic patients showed a slightly longer sleep latency and a lower sleep efficiency than their normal controls. They also had more overall movement time and more body movements during stage 2 sleep. Eight panic attacks were recorded arising out of sleep. Six of them occurred in the transition phase between stage 2 and stage 3 sleep. The nocturnal panic attacks of these patients are unique, different from stage 4 sleep terrors, and different from dream anxiety attacks.",Hauri P.J.; Friedman M.; Ravaris C.L.,1989.0,,0,0,
6839,Significance of acute posttraumatic bony encroachment of the neural canal,"Neurologic status (NS) of 80 consecutive patients with acute, traumatic thoracic, thoracolumbar, or lumbar fractures was correlated with the amount of neural canal impingement (NCI) demonstrated by computerized axial tomography (CT). Average NCI was significantly higher in the 34 patients with neurologic deficits, but the range of NCI was similar to that observed in the 46 patients with no deficits. Burst fractures and fractures in the lumbar spine had the highest average NCI but the lowest percentage of patients with neurologic deficits. The immediate, posttraumatic NS of the 80 patients studied did not directly correlate with the percent of NCI demonstrated on their CT scans.",Keene J.S.; Fischer S.P.; Vanderby Jr. R.; Drummond D.S.; Turski P.A.,1989.0,,0,0,
6840,Effects of m-chlorophenylpiperazine in normal subjects: A dose-response study,"m-Chlorophenylpiperazine (MCPP), a direct 5HT receptor agonist, was administered orally to 20 normal subjects in two doses (0.25 and 0.5 mg/kg) in a placebo-controlled design. Behavioral responses; ACTH, cortisol, prolactin and MCPP blood level; temperature and pulse rate were measured over a 210-min period after administration of tablets. Non-linear dose-response relationships between MCPP and ACTH, cortisol and prolactin response were found. On the higher dose, a significant increase in the number of physical symptoms was also noted and three subjects (15%) had a panic attack, while one subject (5%) had a panic attack on the lower dose. No effects on other behavioral variables, pulse rate and temperature were found using either dose. These findings attest to the usefulness of MCPP as a challenge agent to assess 5HT receptor hypersensitivity when given at a low oral dose (i.e. around 0.25 mg/kg), and to assess 5HT receptor hyposensitivity when given at higher oral doses (i.e. around 0.5 mg/kg).",Kahn R.S.; Wetzler S.; Asnis G.M.; Kling M.A.; Suckow R.F.; Van Praag H.M.,1990.0,,0,0,
6841,"Cathinone, a phenylpropylamine alkaolid from khat leaves that has amphetamine effects in humans",,Kalix P.; Geisshusler S.; Brenneisen R.; Koelbing U.; Fisch H.-U.,1990.0,,0,0,
6842,"ICI-118551, EN = 090697",,,1990.0,,0,0,
6843,Psychophysiological response patterns in panic disorder,"To determine whether panic disorder patients exhibit physiological hyperarousal during rest or during mild, non-panic-inducing stress, 18 patients who experienced frequent panic attacks were compared with nonanxious controls on a battery of physiological assessments. During baseline, patients with panic disorder exhibited higher forehead electromyographic activity, higher sytolic blood pressure and higher heart rates than nonanxious volunteers. During psychological stress, heart rate and systolic blood pressure rose more in patients with panic disorder than in nonaxious controls. The skin conductance response, however, was greater and more variable in the nonanxious controls. The results suggest that panic disorder patients with frequent panic attacks exhibit heightened cardiovascular arousal and decreased electrodermal flexibility than nonanxious people, even in nonthreatening situations.",Hoehn-Saric R.; McLeod D.R.; Zimmerli W.D.,1991.0,,0,0,
6844,Urine pH and panic disorder [20],,Balon R.; Pohl R.; Yeragani V.K.,1991.0,,0,0,
6845,Hyperventilation-induced panic attacks in panic disorder with agoraphobia,Eight minutes of hyperventilation to an end-tidal PCO2 of less than 20 mmHg led to a panic attack in 7 of 12 patients with panic disorder with agoraphobia and only 1 of 12 normal controls. Patients experienced greater increases in panic symptoms than controls during hyperventilation. Patients who reported more distress from somatic symptoms of hyperventilation during the preceding week were more likely to panic during hyperventilation. Patients who panicked during hyperventilation exhibited a delayed recovery of normocapnia following hyperventilation. Hyperventilation by this protocol is an effective means of inducing panic attacks in the laboratory. A hyperventilation challenge may identify a subgroup of patients for whom hyperventilation symptoms are frequently associated with panic.,Maddock R.J.; Carter C.S.,1991.0,10.1016/0006-3223(91)90051-M,0,0,
6846,Learning in post-traumatic amnesia following extremely severe closed head injury,"Verbal and spatial tests of learning were administered in five repeated sessions to nine subjects who were in post-traumatic amnesia (PTA) following extremely severe closed head injuries. PTA was operationally defined as having a score of 75 or less on the Galveston Orientation and Amnesia Test. Subjects showed no ability to learn verbal information (free recall and recognition of a word list) but showed some savings of spatial location information over the first three sessions. Results were interpreted as suggestive of a primarily passive mode of learning during PTA, regardless of the nature of the material to be learned.",Gasquoine P.G.,1991.0,,0,0,
6847,Panic attacks in healthy volunteers treated with a catecholamines synthesis inhibitor,,McCann U.D.; Penetar D.M.; Belenky G.,1991.0,10.1016/0006-3223(91)90299-2,0,0,
6848,Dose ranging study of the effects of cholecystokinin in healthy volunteers,,Bradwejn J.; Koszycki D.; Bourin M.,1991.0,,0,0,
6849,Panic disorder: Vascular evaluation with transcranial Doppler ultrasonography,Several recent studies have shown neurophysiologic and neuroanatomic abnormalities in panic disorder. This study aimed to assess by transcranial Doppler (TCD) ultrasonography the magnitude of the changes in blood flow during panic attacks induced by intravenous sodium lactate infusion. The subjects consisted of 30 patients with panic disorder (DSM-III-R) and 25 controls; all were between the ages of 18 and 40 years and were right-handed. The flow in the middle cerebral artery was recorded bilaterally before the infusion began (to provide baseline readings) and at 3-minute intervals during the infusion. The patients showed a more rapid acceleration of flow (p < 0.05) than the controls. Higher maximal velocity and higher variations in velocity (p < 0.05) were observed in the patients sensitive to lactate but only in the right middle cerebral artery. These results suggest that abnormalities of local cerebrovascular autoregulation occurred in the patients with panic disorder during attacks induced by sodium lactate.,Fontaine S.; Ontiveros A.; Fontaine R.; Elie R.,1991.0,,0,0,
6850,Academic medical center/industry collaboration,,DeVeaugh-Geiss J.,1991.0,,0,0,
6851,5-HT(1A) receptor-effector system responsivity in panic disorder,"To explore 5-HT(1A) receptor responsivity in panic disorder (PD), hypothermic, neuroendocrine and behavioral responses to the selective partial 5-HT(1A), receptor agonist ipsapirone (IPS) were investigated in patients with primary PD and healthy controls. Fourteen patients and matched controls received a single oral dose of 0.3 mg/kg IPS or placebo under double-blind, random-assignment conditions. IPS induced hypothermia and corticotropin (ACTH)/cortisol release but had only minimal effects on behavior. Compared with controls, the patients with PD exhibited significantly attenuated thermoregulatory and neuroendocrine responses to IPS. Although the healthy subjects reported increased drowsiness and the PD patients rated themselves more nervous and less calm following administration of IPS, no consistent changes in ratings of anxiety or panic symptoms were recorded. The impaired hypothermic and ACTH/cortisol responses following 5-HT(1A) receptor activation reflects subsensitivity of both the pre- and postsynaptic 5-HT(1A) receptor-effector system, thus supporting the hypothesis that a 5-HT(1A) receptor-related serotonergic dysfunction may be linked to the pathophysiology of PD. Future studies of 5-HT(1A) receptor-effector complex function in conjunction with assessment of the responsivity of other subtypes (e.g. 5-HT2, 5-HT3) should promote the evaluation of 5-HT system integrity in anxiety disorders and its involvement in anxiolytic drug effects.",Lesch K.P.; Wiesmann M.; Hoh A.; Muller T.; Disselkamp-Tietze J.; Osterheider M.; Schulte H.M.,1992.0,,0,0,
6852,A family study of obsessive-compulsive disorder,"First-degree relatives of probands with obsessive-compulsive disorder (OCD) (n = 32) and psychiatrically normal controls (n = 33) were blindly interviewed with the use of the Diagnostic Interview Schedule. The morbidity risk for anxiety disorders was increased among the relatives of obsessional subjects compared with that for the relatives of controls, but the risk for OCD was not. Risk for a more broadly defined OCD (including relatives with obsessions and compulsions not meeting criteria for OCD) was increased among the parents of obsessional subjects but not among the parents of controls (16% vs 3%). The findings suggest that an anxiety disorder diathesis is transmitted in families with OCD, but that its expression within these families is variable. The findings also support the current practice of classifying OCD as an anxiety disorder.",Black D.W.; Noyes Jr. R.; Goldstein R.B.; Blum N.,1992.0,,0,0,
6853,Ciprofloxacin-polyglycolic acid: A system for prolonged drug release in chronic posttraumatic osteitis,,Meffert R.; Teupe C.; Winckler S.; Ritzerfeld W.; Tormala P.; Brug E.,1992.0,,0,0,
6854,Effect of a single dose of des-glycinamide-[Arg8]vasopressin or oxytocin on cognitive processes in young healthy subjects,"A single dose of des-glycinamide-[Arg8]vasopressin (DGAVP, 2 mg intranasal) or oxytocin (OXT, 20 IU intranasal) was given to female and male volunteers, respectively, in a placebo-controlled double-blind trial. Memory, vigilance, attention, and mood were tested starting 10 minutes after treatment. The DGAVP dose improved delayed recognition of abstract words when measured 1 week after treatment and reduced the intercept of a memory comparison task (Sternberg paradigm). A trend was present for DGAVP and OXT to affect learning, i.e., storage processes of verbal memory in an opposite way; DGAVP improved, while OXT attenuated initial storage and the rate of storage. No treatment effects on visual memory and vigilance were found. Of the mood measures, vigor was reduced immediately after treatment with OXT.",Bruins J.; Hijman R.; Van Ree J.M.,1992.0,10.1016/0196-9781(92)90075-E,0,0,
6855,Ritanserin,,,1992.0,,0,0,
6856,The cholecystokinin hypothesis of panic and anxiety disorders A review,"It has been suggested that cholecystokinin, a neurotransmitter found in high density in mammalian brain, might be implicated in the neurobiology of panic and anxiety disorders. Cholecystokinin-tetrapeptide induces panic attacks analogous to spontaneous panic attacks in patients suffering from panic disorder and to a much lesser degree in healthy volunteers, suggesting an enhanced sensitivity to cholecystokinin-tetrapeptide in panic disorder. In animal models of anxiety, pre-treatment with cholecystokinin antagonists significantly decreases the anxiogenic effects of cholecystokinin agonists. This paper reviews clinical and basic studies supporting an involvement for cholecystokinin in panic and anxiety disorders.",Bradwejn J.; Koszyckil D.; Couetoux Du Tertre A.; Bourin M.; Palmour R.; Ervin F.,1992.0,,0,0,
6857,Selective attention toward physical threat in patients with panic disorder,"Recent research has indicated that panic disorder patients may exhibit a cognitive bias to attend selectively to stimuli that pertain to physical threat. The present study attempted to investigate this phenomenon using a direct assessment of attentive behaviour. Eighteen panic disorder patients and 18 control subjects were tested in a visual attention paradigm developed by MacLeod et al. This paradigm allowed for the assessment of the allocation of visual attention to words related either to physical or social threat, via the measurement of detection latencies for visual probes that appeared following presentations of specific threat cues. It was found that, compared to responses to social threat cues, patients had reduced detection latencies to probes presented when they were actively reading stimuli pertaining to physical threat. This effect was not observed among control subjects. These results are consistent with the view that panic patients maintain a cognitive set that biases attention towards the processing of physical threat.",Asmundson G.J.G.; Sandler L.S.; Wilson K.G.; Walker J.R.,1992.0,10.1016/0887-6185(92)90001-N,0,0,
6858,Buspirone induced prolactin responses in obsessive-compulsive disorder (OCD): Is OCD a 5-HT2 receptor disorder?,"Buspirone (BUSP) is a serotonergic (5-HT) agonist with activity at the 5-HT(1A) receptor. The BUSP induced prolactin (PRL) response was examined in 10 patients with a DSM IIIR diagnosis of obsessive-compulsive disorder (OCD). The results were compared with PRL responses to BUSP found in 10 age and sex matched healthy controls. The results suggest that the 5-HT(1A) receptor dysfunction may not be involved in the pathophysiology of OCD. The authors review the literature and consider the hypothesis that in OCD a complex interaction of other 5-HT receptor sub-types may be occurring, possibly with dysfunction primarily of the 5-HT2 receptors.",Lucey J.V.; Butcher G.; Clare A.W.; Dinan T.G.,1992.0,,0,0,
6859,War injury and post-traumatic morbidity [16],,Hume F.; Summerfield D.,1992.0,,0,0,
6860,Central nervous system effects of buspirone compared to diazepam in healthy volunteers and anxiety patients,"The central nervous system (CNS) effects of buspirone were evaluated in two separate double-blind, cross-over, placebo-controlled, quantitative pharmaco-EEG (QPEEG) studies. Single doses were used in healthy volunteers, and both single and multiple doses were evaluated in patients with generalized anxiety disorders (GAD). In healthy volunteers, statistically significant discrimination of CNS effects from placebo was observed even with the lowest single dose of buspirone (5 mg). In GAD patients, discrimination was observed only at the 10 mg buspirone level. Buspirone, in single or lower doses, produces CNS depressant effects. However, GAD patients who received 10 mg buspirone in single or multiple doses, exhibited CNS effects similar to diazepam and benzodiazepine anxiolytics. In addition, at both dose levels, and in at least one time period, buspirone also induced CNS effects similar to those of antidepressant drugs. This study indicates that although buspirone is different chemically and pharmacologically from diazepam and other benzodiazepine anxiolytics, at high and multiple doses it induces CNS effects similar to 'classic' anxiolytics in anxiety patients. Similar electrophysiological findings which correspond with similar clinical-therapeutic effects of buspirone and diazepam cannot be explained with the receptor binding. The discovery of the biochemical process which is responsible for producing 'anxiolytic' type CEEG alterations may be helpful in understanding the pathophysiology of anxiety disorder and its treatment.",Ferracuti S.; Itil K.Z.; Eralp E.; Ahmed I.; Lebars P.; Itil T.M.,1992.0,,0,0,
6861,Alcohol and social anxiety in women and men: Pharmacological and expectancy effects,"A replication study was conducted to determine pharmacological and expectancy effects of alcohol on self-reported anxiety in a social interaction situation. Thirty-two male and thirty-two female social drinkers were randomly assigned to four conditions in a 2 x 2 factorial balanced placebo design, controlling for drink content and expectations. Results show that in women alcohol expectancy reduced self-reported anxiety, whereas in men there was no significant effect of expectancy. Alcohol consumption reduced anxiety in both men and women. Controlling for beliefs increased some of the effects we found. We conclude that although cognitive factors do mediate the effects of alcohol on self-reported anxiety, this influence seems to be different for men and women and the role of pharmacological factors might be more crucial.",De Boer M.C.; Schippers G.M.; Van der Staak C.P.F.,1993.0,10.1016/0306-4603(93)90041-7,0,0,
6862,Treatment of post-traumatic stress syndrome,"This paper reviews different psychotherapeutic and drug treatments for Post Traumatic Stress Disorder (PTSD). Psychotherapeutic treatments have changed from the abreaction technique to more classical psychodynamic approaches and recently to cognitive and behavioral techniques. Many drugs have been used in the treatment of PTSD but most of the studies were not controlled and included very few patients. More recently, double blind controlled studies have been performed comparing imipramine, desipramine, amitriptyline, phenelzine and placebo. A global efficacy has been found but the improvement was more closely related to associated symptoms, namely anxiety and depression, than to the core symptoms of PTSD.",Lepine J.P.; Darves-Bornoz J.M.,1993.0,,0,0,
6863,Transient impairment in P50 auditory sensory gating induced by a cold-pressor test,"Diminished gating of the auditory evoked response to repeated stimuli is a psychophysiological defect associated with schizophrenia and several other psychiatric illnesses. The P50 wave of the auditory evoked response to the second of paired stimuli is decreased in most normal subjects, whereas many psychotic subjects show significantly less decrement. The aim of this experiment was to test whether the cold-pressor test, which causes transient distress and pain accompanied by increased sympathetic activity, also causes a transient impairment in P50 auditory sensory gating in normal control subjects. Ten normal control subjects with normal gating of the P50 response immersed their hands in an ice water bath for 2 min. This cold-pressor test diminished P50 auditory gating in nine of these subjects, although the degree of impairment was highly variable among subjects. The impairment in gating was transient, with partial resolution by 30 min. the cold-pressor test was subjectively viewed as painful and also caused blood pressure to increase. Thus, a transient stressor can impair P50 auditory gating in some subjects.",Johnson M.R.; Adler L.E.,1993.0,10.1016/0006-3223(93)90328-B,0,0,
6864,The health of women married to men in regular army service: Women who cannot afford to be ill,"The health, distress, and health services utilization of 44 women married to army men was compared to those of 53 women living in the same community. Army wives were found to have less access to health promoting and maintaining resources such as social support, employment, and the 'sense of coherence.' Although army wives' health is not significantly different from that of the controls, they visit the family physician with their children more often. It is suggested that women who are married to army men learn to cope with instability and with limited access to salutary factors, but the lay referral system is irreplaceable.",Anson O.; Rosenzweig A.; Shwarzmann P.,1993.0,,0,0,
6865,Endogenous event-related potentials in obsessive character,,Asahi K.; Ogura C.; Hirano K.; Nageishi Y.,1993.0,,0,0,
6866,"No effects of piroxicam on osteopenia and recovery after Colles' fracture. A randomized, double-blind, placebo-controlled, prospective trial","In a randomized double-blind study involving 42 postmenopausal women with a displaced Colles' fracture, we investigated whether piroxicam, a nonsteroid anti-inflammatory drug, can reduce posttraumatic osteopenia and improve the rate of recovery. In an earlier study we found a bone-sparing effect caused by piroxicam after external fixation of the rabbit hindleg. The patients were treated with a below-elbow paster slab for 4 weeks after the reduction. The bone mineral content of the forearm bones was measured with a single-photon absorptiometer 8 weeks after the fracture. There was a mean 7% bone mineral decrease in the radius and 5% in the ulna among the patients treated with piroxicam versus 10% in the radius and 7% in the ulna in the placebo group. However, this difference was not significant. Piroxicam did not decrease the rate of fracture healing. The patients who received piroxicam had significantly less pain during plaster treatment, but there was no difference in the rate of functional recovery between the groups.",Adolphson P.; Abbaszadegan H.; Jonsson U.; Dalen N.; Sjoberg H.E.; Kalen S.,1993.0,,0,0,
6867,Coping with distress and self harm: The impact of a primary prevention program among adolescents,"The effectiveness of a school-based primary prevention psychological program is assessed in the present study. The program was designed to (a) improve students' distress-coping, (b) prepare them as 'gatekeepers' with regard to self-destructive behavior of peers and (c) assess the program's face validity and social validity. The program was primarily based on cognitive-behavioral modification principles, procedures and techniques. Two hundred and thirty-seven students, drawn from six homeroom grade eight classes were randomly assigned to experimental and control (no intervention) conditions. The program consisted of seven units passed during twelve weekly one-hour sessions. Overall, the program had a positive effect on attitudes, emotions, knowledge and awareness of distress coping skills. In addition, it had some degree of face validity and social validity from the students' vantage point. These results lend support to the feasibility of a cognitive-behavioral, school-based prevention program for students' distress-coping enhancement.",Klingman A.; Hochdorf Z.,1993.0,10.1006/jado.1993.1012,0,0,
6868,Effects of the serotonin reuptake inhibitor fluvoxamine on yohimbine-induced anxiety in panic disorder,"To assess the effects of the selective serotonin reuptake blocker fluvoxamine on noradrenergic function in patients with panic disorder, an intravenous yohimbine challenge test was administered to eight patients with panic disorder before and after 8 weeks of fluvoxamine treatment and to a parallel group of eight patients treated with placebo. Fluvoxamine treatment reduced yohimbine-induced anxiety while placebo treatment had no effect on this variable. Both fluvoxamine and placebo treatment had little effect on biochemical or physiologic responses to yohimbine.",Goddard A.W.; Woods S.W.; Sholomskas D.E.; Goodman W.K.; Charney D.S.; Heninger G.R.,1993.0,10.1016/0165-1781(93)90036-G,0,0,
6869,Are covariation biases attributable to a priori expectancy biases?,"Illusory correlation experiments indicate that people overestimate the association between random presentations of snake slides and shock, but do not overestimate the association between random presentations of slides of damaged and exposed electric outlets (DEEOs) and shock. To investigate whether reports of covariation biases might be attributable to expectancy biases, we had Ss rate the a priori probabilities with which they would expect slides of snakes (or DEEOs), flowers, and mushrooms to be paired with shock, a tone, or nothing. In Study 1, Ss reported a pattern of a priori slide/outcome probability estimates that is nearly identical to that reported by Ss who have just undergone an illusory correlation procedure involving phylogenetic fear-relevant stimuli (e.g. snakes). Therefore, postexperimental estimates of covariation involving such stimuli appear at least partly attributable to pre-experimental expectancy biases rather than solely attributable to on-line processing biases. Study 2 revealed that Ss also display inflated a priori probability estimates for DEEO slides and shock, unlike Ss who have just undergone an illusory correlation procedure involving such stimuli. Taken together, these studies suggest that random slide/outcome pairings easily abolish pre-experimental expectancy biases for ontogenetic, but not phylogenetic, fear-relevant stimuli.",McNally R.J.; Heatherton T.F.,1993.0,10.1016/0005-7967(93)90118-E,0,0,
6870,Hyperventilation-induced cerebral ischemia in panic disorder [13],,Hesselink J.M.K.; Mathew R.J.; Gibbs D.M.,1993.0,,0,0,
6871,Bretazenil,,,1993.0,,0,0,
6872,The Zurich study: XXI. Sexual dysfunctions and disturbances in young adults. Data of a longitudinal epidemiological study,"In a cohort of young Swiss adults, sexual disturbances and dysfunctions were assessed by interview four times between ages 20 and 30 years. Over 10 years almost every second female and every third male subject reported disturbances. In females at age 30 years, the prevalence of orgasmic difficulties and of dyspareunia corresponded to non-clinical samples of other studies. Also, in accordance with the literature, impaired interest was much more prevalent in females. In males and females, sexual disturbances were to some extent associated with anxiety and depression; in addition, in women, they were also associated with social phobia and eating disorders. With regard to neuroticism, negative affect and reports of an unsatisfactory childhood, subjects with temporary disturbances resembled more strongly those with chronic problems than controls. Compared with the controls, women's sexual disturbances were more chronic and more strongly associated with minor psychiatric symptoms and personality deviance; this finding was less pronounced in men.",Ernst C.; Foldenyi M.; Angst J.,1993.0,10.1007/BF02190725,0,0,
6873,DAU-6215,,,1993.0,,0,0,
6874,Psychological aspects of parenting critically ill neonates,"This study was designed to objectively examine depression and distress levels in parents of ill versus parents of healthy neonates by utilizing two well-validated questionnaires, the Beck Depression Inventory (BDI) and Kellner Symptom Questionnaire (KSQ). In addition, morbidity of infants was assessed by the Minde-Whitelaw Neonatal Morbidity Scale, and parents completed a socioeconomic questionnaire. Analysis of mean BDI and KSQ scores revealed significant differences between parents of ill neonates and parents of healthy neonates in BDI, total KSQ scores, KSQ anxiety, and depression scale scores. Within these groups, respondents whose scores fell into moderate to severe ranges of distress on either questionnaire were referred for counseling. The BDI and KSQ can be tools for better understanding about distress levels in parents of ill and healthy neonates.",McGettigan M.C.; Greenspan J.S.; Antunes M.J.; Greenspan D.I.; Rubenstein S.D.,1994.0,,0,0,
6875,"Changes in the number of active sweat glands (palmar sweat index, PSI) during a distressing film","Changes of the number of active palmar sweat glands (palmar sweat index, PSI) as assessed by the plastic finger-print method were studied in two groups of female students (n = 21 each). In both samples experiments involved an initial adaptation period, several relaxation phases and an activation period (presentation of a movie). The film was shown 10 min earlier in Group 1, for which in turn follow-up was twice as long. Prints for determination of PSI were taken every 2.5 min from the forefinger and ring finger of the left hand, and recordings of SCL, SF (number of spontaneous fluctuations) and HR were made during the corresponding intervals. Both within- and between-groups comparisons showed an increase of PSI during the activation period and a decrease afterwards. Similar effects were observed for SCL, SF and affective and somatic arousal assessed by a state questionnaire. A decrease of PSI and parameters of electrodermal activity during the first measurements indicated an initial reaction to the assessment procedure itself. Both within-subject and between-subjects correlations between PSI from both fingers showed high parallel test reliabilities, while correlations with electrodermal variables indicated a common physiological basis.",Köhler T.; Schuschel I.,1994.0,10.1016/0301-0511(94)90027-2,0,0,
6876,A new procedure for determination of leg length and leg length discrepancy with the aid of ultrasound. I. Development and experimental investigations,"The precise measurement of leg length and leg length discrepancies (LLD) plays an important role in the examination of lumbar spine and lower extremities. Those real LLD which may be posttraumatic or idiopathic, can sometimes hardly be differentiated from LLD caused by spinal scoliosis or malposition. Although there is no final agreement, to which extent a LLD becomes clinically significant, most authors state that clinical assessment of LLD by tape measure or lengthening of the short leg with blocks of known thickness is highly unreliable. Radiological methods are necessary for precise detection of LLD less than 10 mm. Since previously reported non-invasive, ultrasound-supported leg-length measurement methods proved to be complicated and unhandy, a new method was developed. To avoid radiation exposure accuracy and precision were tested on human cadavers and were compared to clinical assessments by tape measurement. A measurement device was constructed consisting of a wire rope meter and a length millimeter digital display. Measurements were taken with the examined person in supine position. The device was placed beyond their feet and the end of the rope was hinged with a metal brace to a convenient transducer in exact middle position. Thus the middle of the ultrasound monitor concords with the end of the rope. The medial knee joint and ventral hip joint were used as standardised sonographic landmarks. Ten not pre-selected mortants were measured in this manner and additionally clinical LLD was obtained with a tape measure (medial ankle to anterior superior iliac spine). Afterwards all distances were anatomically prepared and measured with a meter stick. Precision was defined as the variance of consecutive measurements to the same cadaver, accuracy as the deviation of single measurement to the mean of corresponding anatomical measurements. The correlation coefficient according to Pearson was used to estimate the reliability of detecting LLD. In comparing precision there was no statistically significant difference between sonographic and anatomic measurements (p = 0.69). The precision of clinical measurements differed significantly from anatomic measurements (p < 0.0001). There was a good accuracy of sonographic measurements with only slight difference to anatomic measurements (0.4/1.72 mm lower limb length and -1.2 ± 2.85 mm leg length), while clinical measurements differed significantly from anatomic measurements (5.9 ± 6.28 mm, p < 0.01). In measuring LLD there was a highly significant correlation between sonographic and anatomic measurements (r = 0,962, p < 0.0001). Clinical measurements showed a low correlation with their corresponding anatomical measurements (r = 0.099, p = 0.494). According to our study this method is a precise and accurate alternative for analyzing leg length differences without radiation. Those good results recommend a clinical study on patients to evaluate practical usage of the method.",Krettek C.; Henzler D.; Hoffmann R.; Tscherne H.,1994.0,,0,0,
6877,Increased antipanic efficacy in combined treatment with clomipramine and dixyrazine,"A double-blind 12 week trial was undertaken to compare the effects of clomipramine + dixyrazine with clomipramine + placebo in the treatment of panic disorder with or without agoraphobia. Of 45 patients included (21 dixyrazine, 24 placebo), 16 dropped out (6 dixyrazine, 10 placebo). The number of panic attacks and the scores on the panic disorder subscale of the Hamilton Anxiety Rating Scale were significantly reduced in response to both treatment regimens, but the reduction was significantly greater in the dixyrazine group. The patients' daily functioning was significantly more improved with the dixyrazine combination. The serum concentration of desmethylclomipramine monotherapy was significantly higher and the side effects significantly lower in the combined treatment with dixyrazine than with clomipramine monotherapy. Clomipramine combined with dixyrazine seems superior to clomipramine in the treatment of panic disorder.",Feet P.O.; Gotestam K.G.,1994.0,,0,0,
6878,Effects of flumazenil on cholecystokinin-tetrapeptide-induced panic symptoms in healthy volunteers,"The neuropeptide cholecystokinin-tetrapeptide (CCK-4) has potent anxiogenic action in human and animal subjects. On the basis of prior work which demonstrated that benzodiazepine (BZD) receptor agonists antagonized CCK-induced excitation of rat hippocampal neurons we studied whether BZD receptors mediated the anxiogenic effect of CCK-4. To examine this possibility we determined whether the BZD receptor antagonist flumazenil could antagonize the effects of CCK-4 (50 μg) in healthy volunteers. Thirty subjects (10 females; 20 males) were pretreated with flumazenil (2 mg in saline) or placebo (0.9% NaCl in water) 15 min prior to CCK-4 challenge in a randomized double-blind crossover design. Flumazenil had no impact on the behavioral and cardiovascular effects of CCK-4, suggesting that BZD receptors do not mediate the anxiogenic action of CCK-4. The influence of GABA and non- GABA-related mechanisms on response to CCK-4 remains to be considered.",Bradwejn J.; Koszycki D.; Du Tertre A.C.; Paradis M.; Bourin M.,1994.0,10.1007/BF02244846,0,0,
6879,A principal component analysis of the DSM-III-R axis II personality disorders,"By means of the SCID Screen questionnaire, data concerning 76 reported criteria were collected from 176 controls and 388 patients. In a principal component analysis, 23 factors emerged that explained 62.7% of the variance. After regrouping, a pattern similar to the Clusters A, B, and C could be demonstrated. However, the criteria for Borderline Personality Disorder scattered in all three clusters. After rearrangement according to the loadings in components 1 and 2, two clear axes could be demonstrated. One axis went from overconscientiousness and inflexibility in one extreme, to unstable intense relationships in the other. The second axis went from avoiding social contacts in one extreme end, to uncomfortable if not in the center of attention in the other. When the separate personality disorders were arranged according to factor loadings in component 1 and 2, Borderline and Narcissistic Personality Disorders grouped together whereas Histrionic Personality Disorder formed a separate group. Schizotypal, Schizoid, and Paranoid Personality Disorders grouped together and so did Avoidant, Obsessive-Compulsive, and Dependent Personality Disorders; Passive-Aggressive Personality Disorder grouped together with the Cluster A disorders.",Ekselius L.; Lindstrom E.; Von Knorring L.; Bodlund O.; Kullgren G.,1994.0,,0,0,
6880,Response to Meta-Chlorophenylpiperazine in panic disorder patients and healthy subjects: Influence of reduction in intravenous dosage,"As a further test of the hypothesis of serotonin hypersensitivity in panic disorder (PD), the serotonin agonist meta-chlorophenylpiperazine (MCPP) was administered intravenously in a dose of 0.05 mg/kg to 27 PD patients and 22 normal control subjects. This is one-half the dose used in our previous study of PD patients, where the dose may have been too high to provide evidence of hypersensitivity to the agent. Responses of anxiety and nervousness were statistically indistinguishable by analysis of variance in the two groups, replicating our previous findings. Panic attack symptom score (PASS) ratings were significantly higher in the PD group, compared with a trend toward higher PASS ratings in the 0.1 mg/kg study. Cortisol, human growth hormone, and male prolactin responses showed no significant differences in the two groups by analysis of variance. Prolactin responses were significantly blunted in the female patients. The unexpected blunted prolactin response to MCPP in female PD patients may reflect a nonspecific blunting of prolactin response to stress. The PASS data provide some evidence of serotonergic hypersensitivity in PD.",Germine M.,1994.0,10.1016/0165-1781(94)90001-9,0,0,
6881,Quantitative sensory examination of epidural anaesthesia and analgesia in man: Effects of pre- and post-traumatic morphine on hyperalgesia,"The objectives of the study were: (1) comparison of hypoalgesic effects of pre- and post-traumatic epidural morphine (EM) on primary and secondary hyperalgesia, and (2) comparison of EM hypoalgesia in normal and injured skin. Burn injuries (25 x 50 mm rectangular thermode, 47°C, 7 min) were produced on the calves of healthy volunteers, at 2 different days at least 1 week apart. In randomized order, the subjects received 4 mg of EM administered via the L2-L3 intervertebral space on one day and no treatment on the other day. One calf was injured 30 min prior to and the other calf 2.5 h after administration of morphine. Hence, the calf injured prior to morphine administration was a model of postinjury treatment, and the calf injured after morphine administration, a model of pretraumatic treatment. The timing of injuries was identical on the morphine treatment and control days. The injuries induced decrease in heat pain detection and tolerance thresholds within the area of injury (area of primary hyperalgesia) as well as reduction of areas of allodynia for brush and pinprick surrounding the injury (area of secondary hyperalgesia). Both pre- and post-traumatic administration of EM increased heat pain detection and tolerance thresholds, and decreased by approximately 50% the areas of secondary hyperalgesia 2.5 h postinjury. The effects of morphine were naloxone (NAL)-reversible (0.1 mg/kg, i.v.). There was no significant difference between pre- and post-traumatic administration of morphine on the effect of either primary or secondary hyperalgesia. EM increased the heat pain detection threshold more within the injury than at a corresponding non-injured site. There was no significant difference in the effect of morphine on heat pain tolerance in injured and non-injured skin. Following NAL, the areas of secondary hyperalgesia expanded beyond control size. It is suggested that the major effect of EM on secondary hyperalgesia is inhibition of C fibre-mediated activity which maintains the altered response properties of central neurones responsible for secondary hyperalgesia. Possible mechanisms of action of NAL in enhancement of hyperalgesia are discussed.",Brennum J.; Dahl J.B.; Møiniche S.; Arendt-Nielsen L.,1994.0,10.1016/0304-3959(94)90079-5,0,0,
6882,BAP/SKB Young Psychopharmacologist Award: Towards a neuroendocrinology of obsessive-compulsive disorder,"Neuroendocrine research has made an important contribution to the understanding of psychiatric illness in vivo. This review is a summary of the recent neuroendocrine studies on obsessive-compulsive disorder (OCD) patients carried out at the Departments of Psychiatry at Trinity College Medical School and St. Patrick's Hospital, Dublin, Ireland. We found that both serotonergic and cholinergic abnormalities were present in OCD, while noradrenergic responsivity and hypothalmic-pituitary axis function were normal. The data suggests that OCD may have a unique neuroendocrinology.",Lucey J.V.,1994.0,,0,0,
6883,Startle potentiation during anticipation of a noxious stimulus: Active versus passive response sets,"The startle reflex response increases during aversive stimulus processing. This study examined whether differing response sets affected startle potentiation during anticipation of an aversive event. Two groups received a noxious noise blast following a 6-s warning cue. Subjects in the active group could press a switch to stop the noise; yoked passive subjects received the same noises with no control. Subjects in a yoked control group heard a soft tone following cue offset. Acoustic startle probes were presented during some of the warning periods and during some of the intertrial intervals. The major finding was that the active and passive groups did not differ in startle potentiation. In comparison with controls, startle reactions for both groups were larger and faster during the warning cue than between trials. The results suggest that the startle reflex indexes defensive response mobilization independently of specific task demands.",Patrick C.J.; Berthot B.D.,1995.0,,0,0,
6884,Recent developments in the psychopharmacology of social phobia,"The past 2 decades have witnessed an upsurge in the interest in anxiety disorders. Much research effort has been dedicated to panic disorder and obsessive - compulsive disorder. However, it is only very recently that we have begun to understand some of the basic principles about the psychopharmacology of social phobia. Drug classes thus far studied include beta-blockers, nonselective and irreversible monoamine oxidase inhibitors (MAOIs), and benzodiazepines. Beta blockers appear to be of use in specific social phobias, such as public speaking, whereas they are of little use in generalized social phobia. There is considerable evidence suggesting that MAOIs are effective in reducing both social anxiety as well as social avoidance in generalized social phobia. A disadvantage of the conventional irreversible MAOIs is their risk for hypertensive crises when combined with dietary tyramine. Thus far only a small number of studies with selective MAO-A inhibitors, such as moclobemide and brofaromine, have been conducted in social phobia, and the results indicate that both compounds are effective. Drugs exerting selective and specific actions on certain components of, for example, the serotonergic system, can now be studied, and it is hoped that the role of 5-hydroxytryptamine) and other neuronal systems in social phobia can be elucidated. In order to gain more information about selective serotonergic drugs, the first double-blind placebo-controlled study with fluvoxamine was recently published. Preliminary results indicate a reduction in social anxiety after a prolonged treatment period. Finally, the role of peptides in the treatment of social phobia is critically reviewed. The MSH/ACTH analog Org 2766 was investigated in patients suffering from social phobia. No anxiolytic effects of this peptide were observed.",Den Boer J.A.; van Vliet I.M.; Westenberg H.G.M.,1995.0,10.1007/BF02190409,0,0,
6885,Visual memory impairment in patients with obsessive-compulsive disorder: A controlled study,"Memory processes were compared in 26 patients presenting DSM-III-R obsessive-compulsive disorder (OCD) with 20 sex-, age- and education-matched normal controls. A significant between-group difference was found: visual memory was significantly lower in OCD, whereas no significant between memory group differences in verbal memory were observed, A subsample of 17 OCD were also compared with the 20 control subjects on an explicit-memory free-recall task and an implicit-memory completion task using neutral, obsessive and guilt-responsibility words to test the effects of an emotional verbal input on memory functioning. No between-group difference was found, suggesting that emotionally laden word processing did not modify implicit and explicit memory performances.",Dirson S.; Bouvard M.; Cottraux J.; Martin R.,1995.0,,0,0,
6886,Phase I safety assessment of intrathecal neostigmine methylsulfate in humans,"Background: In dogs, sheep, and rats, spinal neostigmine produces analgesia alone and enhances analgesia from α2-adrenergic agonists. This study assesses side effects and analgesia from intrathecal neostigmine in healthy volunteers. Methods: After institutional review board approval and informed consent, 28 healthy volunteers were studied. The first 14 volunteers received neostigmine (50-750 μg) through a 19.5 spinal needle followed by insertion of a spinal catheter. The remaining 14 volunteers received neostigmine through a 25 or 27 spinal needle without a catheter. Safety measurements included blood pressure, heart rate, oxyhemoglobin saturation, end-tidal carbon dioxide, neurologic evaluation, and computer tests of vigilance and memory. Analgesia in reSponse to ice Water immersion Was measured. Results: Neostigmine (50 μg) through the 19.5 needle did not affect any measured variable. Neostigmine (150 μg) caused mild nausea, and 500-750 μg caused severe nausea and vomiting. Neostigmine (150-750 μg) produced subjective leg weakness, decreased deep tendon reflexes, and sedation. The 750-μg dose was associated with anxiety, increased blood pressure and heart rate, and decreased end-tidal carbon dioxide. Neostigmine (100-200 μg) in saline, injected through a 25 or 27 needle, caused protracted, severe nausea, and vomiting. This did not occur when dextrose was added to neostigmine. Neostigmine by either method of administration reduced visual analog pain scores to immersion of the foot in ice water. Conclusions: The incidence and severity of these adverse events from intrathecal neostigmine appears to be affected by dose, method of administration, and baricity of solution. These effects in humans are consistent with studies in animals. Because no unexpected or dangerous side effects occurred, cautious examination of intrathecal neostigmine alone and in combination with other agents for analgesia is warranted.",Hood D.D.; Eisenach J.C.; Tuttle R.,1995.0,10.1097/00000542-199502000-00003,0,0,
6887,Selected psychophysiological stress responses in men with high and low body fatness,"Previous research on catecholamine (CA) response to exercise has linked heightened adiposity to a hypostress syndrome. In the present study a cognitive/psychomotor stressor was employed to determine whether this association exists during less metabolically challenging tasks. Moreover, because stress is manifested in a multidimensional manner, measures of behavior and perceived distress were analyzed in addition to the physiological response. Men were selectively recruited for two body fatness groups (low, 12 ± 4%, N = 9; high, 27 ± 2%, N = 10) while being matched on age, lean weight, and peak absolute oxygen consumption. All men performed a modified Stroop task for 12 min to induce a psychophysiological stress response. Physiological changes included significant increases in heart rate, venous plasma norepinephrine, and epinephrine. Cognitive/psychomotor responses indicated no change in reaction time during the task but significant cognitive fatigue as indicated by post-task anagram performance. Perceived distress was suggested by elevated state anxiety. The high and low adiposity groups were similar on all measures of the psychophysiological stress response. These findings suggest that elevated adiposity is not characterized by a hypostress state during the relatively low metabolic challenge of a cognitive/psychomotor stressor.",Sothmann M.S.; Hart B.A.; Horn T.S.,1995.0,,0,0,
6888,A comparison of augmenting central serotonin and noradrenaline function in healthy subjects: Implications for studies on the neurochemistry of anxiety,"Biochemical and psychophysiological effects of augmenting serotonergic and noradrenergic function were compared in 12 normal volunteers. Fluvoxamine (100 mg), a serotonin (5-HT) re-uptake inhibitor, maprotiline (75 mg), a noradrenaline re-uptake inhibitor, and placebo were given for 7 days each to each subject. Subjects were tested pre-drug on days 1, 4 and 8 of each treatment. Catecholamines in 24 h urine, 'platelet-rich' plasma 5-HT and hormones, EEG, auditory evoked response, skin conductance, and bodily and psychological responses were monitored. Augmentation of central 5-HT by fluvoxamine was demonstrated by the decrease of 5-HT plasma levels. Fluvoxamine also reduced urinary dopamine, indicating a decrease in dopamine metabolism in response to augmentation of 5-HT function. Decrease in pulse rate, loss of appetite and a mild arousing effect were also detected with administration of fluvoxamine. Thus, further investigations on the neurochemistry of anxiety disorders should include the study of mechanisms of interaction of neurotransmitters.",Dratcu L.; Keating J.W.; Sherwood R.; Lader M.,1995.0,,0,0,
6889,Sonographic signs of fresh rupture of the anterior cruciate ligament. Experimental and clinical trial,"In a prospective, controlled, monocentric clinical study 193 recently traumatized knee joints, suspicious of a ruptured anterior cruciate ligament, were examined sonographically. Three indirect signs of rupture were analyzed and compared to the results of the clinical tests of stability (Lachmann). Arthroscopy and arthrotomy were regarded as approved methods of reference. The sonographic pattern of an echo-free mass in the area of the femoral insertion of the anterior cruciate ligament proved to be more informative (sensitivity 0.91, specificity 0.78, effectivity 0.84) than the clinical signs of instabilily. A standardized sonographic examination of the knee joint should be a constant component of the posttraumatic examination. It is an inexpensive method, easy to learn and to perform, and is more reliable in the diagnosis of the ruptured anterior cruciate ligament than the clinical evaluation of instability.",Chylarecki C.; Hierholzer G.; Tabertshofer H.,1995.0,,0,0,
6890,Memory for actual and imagined events in OC checkers,"Information-processing theorists have suggested that obsessive-compulsive (OC) checking may be a function of either (1) an impaired memory of emotional events, (2) an attenuated ability to distinguish between real and imagined events or (3) a dissatisfaction with one's recall without actual memory impairment. These hypotheses were tested by having OC and control Ss engage in real and imagined actions. Some of the actions were designed to produce anxiety in the OC Ss while other events were designed to be emotionally neutral. No differences in reality-monitoring ability were found between OC and control Ss. Contrary to our prediction, OC Ss recall of their last actual behavior was superior to controls, but only for those actions that elicited anxiety. OC Ss, but not controls, reported that they desired higher levels of memory vividness than they were able to produce. The potential mechanism whereby dissatisfaction with memory vividness could contribute to repetitive checking is discussed.",Constans J.I.; Foa E.B.; Franklin M.E.; Mathews A.,1995.0,10.1016/0005-7967(94)00095-2,0,0,
6891,Functional neuroanatomy of CCK4-induced anxiety in normal healthy volunteers,"Objective: The authors tested the prediction of temporal cortex activation during experimentally induced anxiety by using positron emission tomography and the [15O]H2O bolus-subtraction method to determine regional cerebral blood flow (CBF) changes in normal volunteers challenged with a bolus injection of cholecystokinin tetrapeptide (CCK4). Method: Eight right- handed healthy subjects (five male, three female; mean age, 26.4 years) underwent four 60-second [15O]H2O scans separated by 15-minute intervals; each scan followed an intravenous bolus injection of either saline (placebo) or CCK4 (50 μg). Each subject received CCK4 once, as the first or second bolus, in a random-order, placebo-controlled, double-blind fashion. Two of the three placebo conditions were nominally identical, and the remaining placebo was used to control for anticipatory anxiety. Magnetic resonance imaging scans were obtained for subsequent anatomical correlation of blood flow changes. Results: CCK4, but not placebo, elicited a marked anxiogenic response, reflected by robust increases in subjective anxiety ratings and heart rate. CCK4-induced anxiety was associated with 1) robust and bilateral increases in extracerebral blood flow in the vicinity of the superficial temporal artery territory and 2) CBF increases in the anterior cingulate gyrus, the claustrum-insular-amygdala region, and the cerebellar vermis. Conclusions: Some of the temporopolar cortex CBF activation peaks previously reported in humans in association with drug- and non-drug-induced anxiety, as well as the increase in regional CBF in the claustrum-insular-amygdala region, may be of vascular and/or muscular origin.",Benkelfat C.; Bradwejn J.; Meyer E.; Ellenbogen M.; Milot S.; Gjedde A.; Evans A.,1995.0,,0,0,
6892,The etiology of acrophobia and its relationship to severity and individual response patterns,"The acquisition of acrophobia in a large clinical sample was investigated. 148 patients from a university-based height phobia clinic and 148 age and sex matched non-phobic controls served as Ss. Subjects were assessed with a battery of measures including the Acrophobia questionnaire, self-rating of severity, global rating of severity, origins questionnaire and a height avoidance test. Results obtained question the significance of simple associative-learning events in the acquisition of fear of heights. Only 11.5% of fearful Ss were classified as directly conditioned cases. Furthermore, no differences between groups were found in the proportion of Ss who knew other height-fearfuls, had experienced relevant associative-learning events, or the ages at which these events had occurred. Finally, no relationships between mode of acquisition and severity or individual response patterns were obtained. In general, the data were consistent with the non-associative, Darwinian accounts of fear acquisition that continue to attract theorists from a variety of backgrounds.",Menzies R.G.; Christopher Clarke J.,1995.0,10.1016/0005-7967(95)00023-Q,0,0,
6893,Control and attention influence snake phobics' arousal and fear during laboratory confrontations with a caged snake,Heart rates and skin-conductance levels were recorded among eight pairs of snake-fearful subjects who were exposed simultaneously to an approaching snake during eight 4-min trials. Retrospective ratings of fear were acquired from the 16 subjects after each of the eight exposure trials. Control over the distance between the subjects and the snake alternated between subjects over trials. On different trials both subjects were instructed either to attend closely to the features of the snake or to attend closely to their bodily fear reactions. Instructions to attend closely to the snake produced higher skin-conductance and heart-rate reactivity and marginally higher fear ratings during the early trials than did instructions to attend to one's bodily reactions. Controlling the presentation of the snake produced higher skin-conductance reactivity during the early trials than did not controlling its presentation. Accumulated findings of this sort can be used by clinicians and theorists who work with exposure approaches to behavioral fear therapy.,Rose M.P.; McGlynn F.D.; Lazarte A.,1995.0,10.1016/0887-6185(95)00010-L,0,0,
6894,Optic flow-induced sway in anxiety disorders associated with space and motion discomfort,"This study examined whether anxiety patients with space and motion discomfort (SMD; e.g., fear of heights), like patients with vestibular dysfunction, have increased body sway responses to motion in the visual field. Six patients with panic disorder, agoraphobia, or generalized anxiety disorder, all with symptoms of SMD, and seven asymptomatic nonanxious control subjects were examined. While standing on a force platform, subjects monocularly viewed optic flow (movement) stimuli projected on a screen in a 60° central visual field. The experiment consisted of (a) a baseline (no-flow) period involving three different visual conditions without flow, (b) an optic flow period involving five different conditions of moving visual stimuli, and (c) a postflow period during which the baseline conditions were repeated. Three of the five optic flow stimuli oscillated at a frequency of 3 cycles/10 s (0.3 Hz) in a manner designed to increase anterior-posterior sway. Postural sway measures were decomposed into powers at four frequency bands, one of which (centered at 0.3 Hz) reflected sway that occurred in tandem with the motion of the oscillating flow stimuli. Results indicated that compared with controls, sway in patients showed (a) greater overall levels; (b) greater flow effects, i.e., greater increases during oscillatory flow conditions compared to baseline; (c) a trend toward greater persistence effects, i.e.,greater increases from preflow to postflow periods. Four of the six patients showed sway levels exceeding that of normals by two standard deviations. The results indicate that SMD in patients with anxiety disorders is associated with increased reliance on visual cues for maintaining balance. The situation-specific symptoms of SMD may lead to avoidance behaviors and the development of phobia, such as height phobia or agoraphobia.",Jacob R.G.; Redfern M.S.; Furman J.M.,1995.0,10.1016/0887-6185(95)00021-F,0,0,
6895,The relation between obsessive-compulsive personality traits and subtypes of compulsive behavior,"The nature of the relationship between obsessive-compulsive personality disorder (OCPD) and obsessive-compulsive disorder (OCD) has been the subject of considerable debate. The current study examined the hypothesis of a differential association of compulsive checking and washing behaviors with obsessive-compulsive personality traits within a nonclinical sample utilizing the Checking and Washing subscales of the Maudsley Obsessive-Compulsive Inventory (MOCI). Since checking behavior and obsessive-compulsive personality traits share a common future orientation, it was expected that checking behavior would be more strongly related to OCPD traits than washing behavior. As hypothesized, checkers scored significantly higher than washers on several measures of obsessive-compulsive personality traits. In addition, the MOCI Checking subscale was more strongly associated with obsessive-compulsive personality measures than was the MOCI Washing subscale. The implications of these results in terms of etiology and treatment of OCD are discussed.",Gibbs N.A.; Oltmanns T.F.,1995.0,10.1016/0887-6185(95)00020-O,0,0,
6896,"Accuracy of heartbeat perception in panic disorder, social phobia, and nonanxious subjects","Recent research on psychosocial models of panic disorder has demonstrated that panic patients become anxious about, and tend to focus on, the physical sensations of panic (e.g., palpitations, dizziness, and breathlessness). To assess whether patients' hypervigilance for panic sensations is associated with heightened awareness of internal sensations, subjects with panic disorder, social phobia, and no mental disorder were asked to count heartbeats at rest and following a period of exercise, while actual heartbeats were recorded using a polygraph. The groups did not differ in heartbeat awareness at rest. Following exercise, all groups became more aware of cardiac sensations, again with no between-group differences. Despite a lack of group differences, several variables were positively related to accuracy of heartbeat perception, including self-reported anxiety over relevant sensations and subjects' confidence in their estimations. In addition, actual heart rate was negatively related to accuracy of heartbeat tracking. The implications of these results are discussed.",Antony M.M.; Brown T.A.; Craske M.G.; Barlow D.H.; Mitchell W.B.; Meadows E.A.,1995.0,10.1016/0887-6185(95)00017-I,0,0,
6897,"Comparison of the analgesic effects of β-cyclodextrin-piroxicam, sodium naproxen, and potassium diclofenac utilizing the dental pain model","The nociceptive threshold of the six upper front teeth (left and right central and lateral incisors, and canines) of twelve volunteers was determined by an electrical stimulus delivered by a pulp tester. A single dose of 20 mg β-cyclodextrin-piroxicam, 50 mg potassium diclofenac or 275 mg sodium naproxen was given orally according to a double-blind randomized design with a one week interval between each drug. The nociceptive threshold was recorded every 15 min for 4 h. The analgesic profile was similar for the three drugs. Significant effect was observed after 30 minutes, peak action was reached between 45 and 60 minutes and lasted up to 120 minutes and disappearance of the effect below the level of significance after 150 minutes. The rapid onset of analgesia is consistent with the rapid absorption of these three drugs characterized with a short t(max) of about 1 hour or less. The dental pain model explores essentially the central action of drugs on pain. It probably does not evaluate the effect of nonsteroidal antiinflammatory drugs on peripheral antiinflammatory and analgesic activities which account for their more protracted action in relevant clinical situations such as rheumatic, post-traumatic or post-surgical pain and inflammation. The central effect of these drugs on pain is of limited duration.",Bauduin H.; Famaey J.-P.,1995.0,,0,0,
6898,Effect of CI-988 on cholecystokinin tetrapeptide-induced panic symptoms in healthy volunteers,"A randomized, placebo-controlled double-blind, three-way crossover design was used to evaluate the effectiveness of single oral 100 mg doses of CI-988, a cholecystokinin B (CCK(B)) antagonist, in attenuating panic symptoms induced by intravenous injection of cholecystokinin-tetrapeptide (CCK-4). Thirty healthy men received the following treatments on three separate occasions: placebo capsules/placebo, placebo capsules/CCK-4, or CI-988 capsules/ CCK-4. There was no marked difference in the number, time to onset or duration of panic symptoms between CI-988/CCK-4 and placebo/CCK-4. There was, however, a 14% difference in sum intensity scores between these treatments that was statistically significant (p = 0.039). The symptoms most affected by CI-988 were cold chills/hot flushes, chest pain/discomfort, and anxiety/fear/apprehension. Panic attack frequency also decreased following CI-988 treatment (8/30 vs. 16/30; p = 0.035). This decrease, amid otherwise modest effects, could be explained by a p referential effect of CI-988 on the subjective experience of anxiety/fear/apprehension. Possible reasons for the relatively modest effects of CI-988 on CCK-4-induced panic symptoms are discussed.",Bradwejn J.; Koszycki D.; Paradis M.; Reece P.; Hinton J.; Sedman A.,1995.0,10.1016/0006-3223(95)00081-X,0,0,
6899,Thyrotropin-releasing hormone: A potential comparator for the panicogenic effects of pentagastrin and CCK? [1],,Coupland N.; Malizia A.; Bailey J.; Nutt D.,1996.0,10.1016/0006-3223(95)00526-9,0,0,
6900,Variable selection with neural networks,"In this paper, we present 3 different neural network-based methods to perform variable selection.",Cibas T.; Soulié F.F.; Gallinari P.; Raudys S.,1996.0,10.1016/0925-2312(95)00121-2,0,0,
6901,Fearful responding to repeated CO2 inhalation: A preliminary investigation,"In an effort to explore factors which maintain fear of physical sensations, repeated administration of 35% C02 was used with college students scoring high and low on the Anxiety Sensitivity Index. Half of each group was administered 12 CO2 trials, while the other half received 9 CO2 trials, followed by a dishabituation trial (Trial 10) and 2 more CO2 administrations (Trials 11 and 12). Measures included subjective anxiety, heart rate, skin conductance, and number of panic symptoms reported. Results indicated a nonsignificant trend for the High ASI group to show increased pre-inhalation anxiety across trials, while the Low ASI group showed a rapid reduction in pre-inhalation anxiety. Post-inhalation skin conductance mirrored this pattern, although rapid reduction in post-inhalation heart rate was observed. Overall, the High ASI participants showed a notable lack of fear reduction across trials. Results are discussed in light of sensitization as a factor contributing to anticipatory anxiety, with implications for understanding the etiology and maintenance of Panic Disorder.",Gayle Beck J.; Shipherd J.C.; Zebb B.J.,1996.0,10.1016/0005-7967(96)00039-3,0,0,
6902,"Anxiety sensitivity, suffocation fear, trait anxiety, and breath-holding duration as predictors of response to carbon dioxide challenge","We investigated predictors of response to carbon dioxide challenge (i.e. breathing deeply and rapidly into a paper bag for 5 min) in college students. Zero-order correlations indicated that scores on both the Anxiety Sensitivity Index (ASI: Reiss, Peterson, Gursky and McNally, 1986) and the Suffocation Fear Scale (SFS: Rachman and Taylor, 1994), predicted anxious response to challenge, whereas a behavioral measure of carbon dioxide sensitivity (i.e. maximum breath-holding duration) and scores on the State-Trait Anxiety Inventory-Trait form (STAI-T: Spielberger, Gorsuch, Lushene, Vagg and Jacobs, 1983) did not. Multiple regression revealed that all four variables remained in the model, entering in the following order: ASI, breath-holding duration, SFS, and STAI-T. These data suggest that psychological variables reflecting fears of bodily sensations are better predictors of response to challenge than either behavioral sensitivity to carbon dioxide or general trait anxiety.",Eke M.; McNally R.J.,1996.0,10.1016/0005-7967(96)00044-7,0,0,
6903,Anxiety and pain: Attentional and endorphinergic influences,"The role of attentional mechanisms and endogenous opioids in the influence of anxiety on acute pain sensation was investigated. Forty-five spider phobics received mildly painful electrical stimulation. The opioid antagonist naltrexone or placebo was administered between subjects to examine an analgesia due to anxiety-induced endorphinergic activity, while anxiety and focus of attention were manipulated within subjects. In accordance with previous research, pain ratings and skin conductance responses (SCRs) were not influenced by anxiety when focus of attention was controlled for. Attention towards pain led to an increase in subjective pain as opposed to distraction from pain. SCRs, however, were increased in the distraction conditions, probably due to heightened unexpectedness. Further, both high and low anxiety resulted in an analgesia compared to the pretest in the placebo condition, which was reversed by a low dose of naltrexone, but not by a high dose. Apart from possible agonist properties of high doses of naltrexone, this effect suggests an opioid-induced analgesia. It remains to Lie demonstrated whether this was due to endogenous opioids released during high anxiety.",Janssen S.A.; Arntz A.,1996.0,10.1016/0304-3959(96)03031-X,0,0,
6904,Design of novel cholecystokinin-B receptor ligands based on the 'double-ring system' approach,"A structurally novel series of cholecystokinin-B (CCK-B) receptor ligands has been designed and synthesized based on the 'double-ring system' theory of receptor recognition. Compounds 2b-cis and 2g-cis from this 1-amino-2-benzyltetralin series show modest CCK-B receptor affinity, with IC50 values of 48.5 nM and 39.0 nM, respectively. The results are discussed in the context of ongoing efforts to identify the CCK-B receptor binding site for nonpeptide ligands.",Lowe III J.A.; Qian W.; McLean S.; Bryce D.K.; Crawford R.T.; Olsson L.C.; Bordner J.,1996.0,10.1016/0167-0115(96)00066-3,0,0,
6905,Cognitive-behavioral group intervention for spousal caregivers: Findings and clinical considerations,"Caring for a family member who suffers from dementia represents an important source of stress for caregivers. Group interventions are increasingly being used as a means of relieving caregiver burden but it remains unclear which types of groups are most helpful. The object of this study was to evaluate the effectiveness of a skills training cognitive- behavioral group intervention which focused on assertion, problem-solving and cognitive restructuring. This intervention was compared to a support group which emphasized information-giving and social exchanges between participants. Thirty-five spousal caregivers were randomly assigned to one of two 8-week interventions. Using a covariance analysis, with pre-test scores as covariants, the two groups were found to differ significantly following the intervention on one measure of assertion and on two dimensions of marital adjustment. No significant differences were found on measures of psychological distress, negative thoughts coping styles and perceived burden. Findings suggest the need to evaluate the effect of specific components of a group intervention, such as Assertive Training and Cognitive Restructuring.",Gendron C.; Poitras L.; Dastoor D.P.; Pérodeau G.,1996.0,,0,0,
6906,Acute effects of β blockade and exercise on mood and anxiety,"Objective - To measure the previously reported p blocker induced adverse changes in mood state and anxiety measures, and to determine if prolonged aerobic exercise attenuates such mood modifications. Methods - After 4 days of drug treatment with comparable doses of propranolol (40 and 80 mg), metoprolol (50 and 100 mg), or placebo, mood (POMS) and anxiety states (STAI) were assessed in healthy volunteers, before and after 1 h of treadmill walking exercise at 50% maximum oxygen uptake. Results - Compared to placebo, resting 'tension', 'depression', and 'total mood disturbance' were significantly higher on propranolol 80 mg, but all were reduced with exercise. 'Fatigue' and 'confusion' were also higher on propranolol, and were unaffected by exercise. 'Fatigue' was also higher than placebo after exercise on metoprolol 100 mg. 'Anxiety' was unaffected by drug treatment or exercise. Conclusions - The evidence that β blockers, and particularly propranolol, have adverse effects on mood was confirmed. It would be preferable to prescribe a β blocker which does not adversely alter mood states. However, exercise significantly reduced the measures of 'tension' and 'depression' which were adversely increased by propranolol. Exercise prescription may therefore not only be compatible with β blockade, but a highly desirable adjuvant therapy.",Head A.,1996.0,,0,0,
6907,Effect of d-fenfluramine on human experimental anxiety,"To investigate the role of 5-HT in human anxiety, the 5-HT releaser and uptake blocker d-fenfluramine (FEN) was administered to healthy volunteers under two models of experimental anxiety. The first was a simulated public speaking (SPS) test consisting of talking in front of a video camera, anxiety being evaluated mainly by self-rating scales. The second was a conditioned fear test, in which the changes in skin electrical conductance caused by a tone associated once with an aversive white noise were measured. The doses of 15 and 30 mg FEN, PO, decreased anxiety induced by SPS in a dose-dependent way, as indicated by the anxiety factor of Norris Visual Analogue Mood Scale. In the conditioned fear test, however, the amplitude and level of skin conductance responses to the conditioned aversive stimulus were not significantly changed by FEN. The differential effects of FEN in these human experimental models of anxiety, together with similar results reported in rats, support the view that 5-HT exerts a dual action on brain mechanisms regulating anxiety, facilitating conditioned while inhibiting unconditioned fear. The presumed reduction in unconditioned fear caused by FEN may have implications for the treatment of panic disorder.",Hetem L.A.B.; De Souza C.J.; Guimaràes F.S.; Zuardi A.W.; Graeff F.G.,1996.0,10.1007/s002130050086,0,0,
6908,"Alexithymia, defensiveness and cardiovascular reactivity to stress","This article attempts to further our understanding of alexithymia by testing two conceptual questions about the construct: (a) Is alexithymia characterized by reduced autonomic activity? and (b) Can it be clearly distinguished from defensiveness? Eighty healthy university students completed a battery of personality scales including the Toronto Alexithymia Scale, measures of self-deception and impression management, depression, and anger-in. They also participated in three lab stress tasks: isometric handgrip; mental arithmetic; and a negative affect provocation task. Blood pressure and heart rate were monitored throughout the lab procedure. Analyses were conducted with tercile groups of low, medium, and high alexithymia scorers. The 'high alexithymia' tercile showed smaller heart rate responses to the stress tasks and more anger-in behavior. Blood pressure responses did not differentiate the low/medium/high alexithymia subgroups. Alexithymia scores were unrelated to defensiveness, that is, there was no relationship between alexithmia and impression management or self-deception, and alexithymia was unrelated to depression. We conclude that students defined as 'high alexithymia' on the Toronto Alexithymia Scale are not sell-deceptive nor do they try to leave a particular impression; they tend to be somewhat hypoaroused autonomically, and they report as many psychological distress symptoms as do subjects with lower TAS scores.",Linden W.; Lenz J.W.; Stossel C.,1996.0,10.1016/S0022-3999(96)00229-2,0,0,
6909,Calcium channel blockers for anxiety disorders?,"The role of calcium in the etiology of anxiety has been proposed for several decades. Calcium channel blockers profoundly influence calcium metabolism and the transport of calcium. Even though the evidence for the role of calcium remains weak, drugs affecting calcium might be useful in the treatment of anxiety disorders. One of these compounds, verapamil, has been used to treat mood disorders. Calcium channel blockers have also been tried in other indications such as premenstrual syndrome, irritable bowel syndrome, schizophrenia, tardive dyskinesia, and Tourette's syndrome. However, the number of articles on the use of calcium channel blockers in the treatment of anxiety disorders is low. Three reports (two open, one double-blind) described some success in the treatment of panic disorder with verapamil, diltiazem, or nimodipine and one open-label study described unsuccessful treatment of anxiety and phobia with nifedipine in patients with various anxiety disorders. Further double-blind placebo-controlled studies of calcium channel blockers in the treatment of anxiety disorders are warranted to determine a possible role of these compounds in the armamentarium of antianxiety drugs.",Balon R.; Ramesh C.,1996.0,,0,0,
6910,"β-Adrenoceptor coupling to G(s) protein in alcohol dependence, panic disorder, and patients with both conditions","Ethanol may down-regulate G-protein-coupled beta-adrenoceptors (βAR). βAR may also be dysregulated in panic disorder (PD). 61 clinical samples, many patients have comorbid alcohol dependence (AD) and PD. Therefore, we investigated βAR coupling in patients with these disorders. We harvested polymorphonuclear leukocytes from 24 healthy volunteers (Vs), and from 22 abstinent AD patients, 7 PD patients, and 9 patients with comorbid AD/ PD. βAR were assayed using saturation and agonist-displacement experiments. Group differences were tested using one-way analysis of variance (ANOVA). All βAR binding parameter were similar in AD patients and Vs. The ratio of the agonists' dissociation constant from the receptor in the low affinity state (K(L)) to that in the high affinity state (K(H)) was significantly higher in PD patients than in AD patients and Vs (930.97 ± 440.80 vs. 226.2 ± 94.47 vs. 197.05 ± 61.03, respectively, p <.01). This finding suggests that βAR are supercoupled to G(s) in patients with PD. There was a trend for higher total receptor density (R(T)) in AD/PD and PD patients (Vs = 39.06 ± 42.57 vs. AD = 27.93 ± 23.07 vs. AD/PD = 66.85 ± 79.02 vs. PD = 68.36 ± 49.20, p < .08). There were no differences between AD/PD and PD patients, who combined had a significantly higher R(T) than V(s) and AD patients (Vs = 38.95 ± 8.81 vs. AD = 29.63 ± 5.07 vs. AD/PD = 67.51 ± 17.00, fmol/mg protein, p < .04). Finally, AD/PD patients had a significantly higher receptor density in the low-affinity conformational state than Vs and AD patients, but not PD patients (25.96 ± 11.59 vs. 10.69 ± 1.53 vs. 7.62 ± 1.08 vs. 17.07 ± 5.26 fmol/mg protein, respectively, p < .005). βAR function in polymorphonuclear leukocytes is normal in abstinent alcoholics. The previously reported abnormal βAR regulation is alcoholism may be state dependent. The higher R(T) and K(L)/K(H) ratio in AD/PD and PD, but not in the AD patients, suggest that increased βAR function may be important in the pathophysiology of PD.",Gurguis G.N.M.; Turkka J.; George D.T.; Linnoila M.,1997.0,10.1016/S0893-133X(96)00161-3,0,0,
6911,Impaired color naming of food and body shape words: Weight phobia or distinct affective state?,"Objective: The current study investigated whether a concern with body shape and weight represents a distinct affective state, or whether it is better conceptualized as a highly specific form of anxiety. Method: The color-naming performance of women with a high Drive for Thinness score was examined under three experimental conditions: when a photograph of chocolate was present, when actual chocolate was present, and a control condition. High Drive for Thinness subjects demonstrated relatively impaired color naming of body shape words in the picture condition, but not in the food or control conditions. Results: Although there was a significant impairment in the color naming of food words, this was unaffected by condition or degree of Drive for Thinness. Discussion: The results are interpreted as supporting an analogy between weight/body shape concerns and subclinical phobic anxiety.",Green M.W.; Elliman N.A.; Rogers P.J.; Welch D.A.,1997.0,10.1002/(SICI)1098-108X(199701)21:1<77::AID-EAT9>3.0.CO;2-0,0,0,
6912,Emotional and cognitive factors connected with response to cholecystokinin tetrapeptide in healthy volunteers,"This article examines the effect of baseline anxiety, anxiety sensitivity and dysfunctional attitudes on the response to cholecystokinin tetrapeptide (CCK-4) in healthy volunteers. CCK-4 and placebo were administered to 14 subjects in a double-blind manner. Four volunteers experienced a panic attack after CCK-4 administration. Those subjects who panicked had significantly higher baseline scores on dysfunctional attitudes. Dysfunctional thought patterns appeared also to predict number of symptoms and experience of cognitive and affective symptoms during injection. Baseline anxiety as well as anxiety sensitivity predicted reactions to placebo but not panic responses to CCK-4. Results suggest that a general tendency towards erroneous interpretation of information has some role in mediating the panicogenic effects of CCK-4, and also interpersonal sensitivity may constitute a vulnerability factor for panic. Psychological factors that have been considered more specific to panic disorder, namely high state and trait anxiety as well as anxiety sensitivity, appeared mainly to determine general reactions to a threatening situation.",Aluoja A.; Shlik J.; Vasar V.; Kingisepp P.-H.; Jagomägi K.; Vasar E.; Bradwejn J.,1997.0,10.1016/S0165-1781(96)02948-4,0,0,
6913,Behavioral and neuroendocrine responses to m-chlorophenylpiperazine in subtypes of alcoholics and in healthy comparison subjects,"Objective: The purpose of this study was to explore central serotonergic functions in subgroups of alcoholics and in healthy comparison subjects. Method: The mixed serotonin (5-HT) agonist/antagonist m- chlorophenylpiperazine (m-CPP) was administered to male alcoholic patients who were classified according to the criteria of von Knorring et al. as type I alcoholics (late onset) (N= 16) or type II alcoholics (early onset with antisocial traits) (N=24) and to 22 healthy comparison subjects. Psychological, physiological, and neuroendocrine measures were obtained before and after the m-CPP infusion. Results: m-CPP elicited subtype-related differential effects among the alcoholics; the type I alcoholics reported more anger and anxiety, and the type II alcoholics reported increased euphoria and a greater likelihood of drinking. The healthy comparison subjects exhibited a greater increase in plasma ACTH response to the m-CPP infusion than the alcoholics regardless of subtype. Conclusions: Differences in certain 5-HT receptor functions may explain some of the clinical characteristics that differentiate the type II and type I subgroups of alcoholic patients. Furthermore, alcoholics may have reduced sensitivity of 5-HT(2C) receptors in comparison with healthy subjects.",George D.T.; Benkelfat C.; Rawlings R.R.; Eckardt M.J.; Phillips M.J.; Nutt D.J.; Wynne D.; Murphy D.L.; Linnoila M.,1997.0,,0,0,
6914,Impact of definition on prevalence of food cravings in a random sample of young women,"The objective of this study was to determine the characteristics of food cravings in a random sample of young women and to evaluate the impact of the definition used in food craving research. The Diagnostic interview for Genetic Studies and a questionnaire about food craving experiences were completed by 101 women aged between 18 and 45 years. Of this sample, 58% of respondents reported having ever experienced food cravings. Of these, 7% had experienced food cravings only during pregnancy. Fewer women met criteria for craving as the definition narrowed; 28% reported moderate to strong cravings with two features of intensity; 6% reported moderate to strong cravings with three features of intensity and 4% reported strong cravings with three features of intensity. Features of intensity or 'core features' were those that related to strength of craving and were difficulty resisting eating, feeling anxious when the craved food was unavailable and a change in speed of consumption. Of strong cravers, 86% experienced at least two core features, compared with 48% of moderate and 10% of mild cravers. These features may aid in defining the craving state and should be taken into consideration in studies on food cravings.",Gendall K.A.; Joyce P.R.; Sullivan P.F.,1997.0,10.1006/appe.1996.0060,0,0,
6915,"The role of blame, distress, and anger in the hypermasculine man","Research has demonstrated an association between the hypermasculine personality pattern and a history of sexually aggressive behavior. This study was conducted to examine emotions experienced by hypermasculine or macho men when prevented from attaining a goal relevant to their sense of attractiveness and sexuality by a woman. It was hypothesized that macho males would respond to high and moderate threats to their masculine identity with greater blame and anger than nonmacho males. Macho men's blame was hypothesized to mediate the transformation of negative emotions such as distress into anger. After screening with the Hypermasculinity Inventory, 34 high hypermasculine and 36 low hypermasculine men were assigned to one of three experimental conditions in which the feedback received from a female partner was either highly threatening, moderately threatening, or neutral in nature. Measures of emotion and blame were collected after the men received their feedback. Results of the study indicated that macho and nonmacho men differed only in the moderate threat condition. Macho men in this condition reported greater anger yet less blame than the nonmacho men. The pattern of results is most consistent with Berkowitz's cognitive-neoassociationistic model of emotion, which does not require blame for anger to occur, as does Lazarus's cognitive-motivational-relational theory of emotion. Results of the study suggest that anger in macho men is associated with the level of surprise in a situation.",Downs K.; Gold S.R.,1997.0,,0,0,
6916,Effects of fluoxetine administration on mood response to tryptophan depletion in healthy subjects,"Short-term reduction in plasma tryptophan (tryptophan depletion) produces a relapse of depressive symptoms in 60% of previously depressed patients recently recovered with serotonin reuptake inhibitor treatment. Tryptophan depletion does not consistently increase depressive symptoms in unmedicated depressed patients or in depressed patients whose symptoms are remitted with a norepinephrine reuptake inhibitor. These data suggest that serotonin reuptake inhibitor treatment itself may confer vulnerability to the development of depressive symptoms during tryptophan depletion. In order to further investigate this possibility, six healthy individuals underwent double-blind placebo-controlled tryptophan depletion before and following six weeks of treatment with fluoxetine 20 mg/day. No increased vulnerability to the mood-lowering effects of tryptophan depletion occurred as a result of fluoxetine treatment. Additionally, fluoxetine treatment itself was not associated with changes in mood or quality of life in these healthy volunteers. These data indicate that serotonin reuptake inhibitor treatment alone does not produce the depressive effects of tryptophan depletion that are observed in serotonin reuptake inhibitor-treated depressed and obsessive compulsive disorder patients.",Barr L.C.; Heninger G.R.; Goodman W.; Charney D.S.; Price L.H.,1997.0,10.1016/S0006-3223(96)00224-7,0,0,
6917,Setting new standards for the pharmacological treatment of panic disorder,"Three drugs are currently licensed for the treatment of panic disorder: the benzodiazepine, alprazolam; the tricyclic antidepressant, clomipramine; and, most recently, the selective serotonin reuptake inhibitor, paroxetine. Alprazolam and clomipramine are effective in the treatment of panic disorder, but are less than ideal agents due to their tolerability profiles. An extensive clinical trial programme has been undertaken to investigate the efficacy and tolerability of paroxetine treatment in panic disorder. This article reviews the clinical evidence for the short- and long-term efficacy and tolerability of paroxetine in panic disorder, and its effect on relapse prevention and on quality of life. The results from the short-term studies indicate that paroxetine is effective in treating panic disorder (with or without agoraphobia) either alone or in combination with cognitive-behavioural therapy. The minimum effective dose is 40 mg daily. Paroxetine was equally as effective as clomipramine in reducing the frequency of panic attacks but produced an earlier improvement in symptomatology. Continued treatment with paroxetine over periods of up to 9 months provided evidence that paroxetine maintained its anti-panic effect and prevented relapse. Paroxetine was well-tolerated during both the short- and long-term studies at doses of up to 60 mg per day.",Kumar R.,1997.0,10.1002/(SICI)1099-1077(199706)12:1+<S19::AID-HUP894>3.0.CO;2-X,0,0,
6918,Rhizosphere microbial populations in contaminated soils,"Rhizosphere microbial populations may increase bioremediation of soil contaminated with organic chemicals. A growth chamber study was conducted to evaluate rhizosphere microbial populations in contaminated and non-contaminated soil. Alfalfa (Medicago sativa L.) and alpine bluegrass (Poa alpina L.) were grown in soil containing a mixture of organic chemicals for 14 weeks. The equal millimolar mixture of hexadecane, (2,2-dimethylpropyl)benzene, cis-decahydronaphthalene (decalin), benzoic acid, phenanthrene, and pyrene was added at levels of 0 and 2000 mg/kg. Organic chemical degrader (OCD) populations were assessed by a Most-Probable-Number technique, and bacteria and fungi were enumerated by plate count methods. Different methods for expressing OCD rhizosphere populations were investigated to determine the effect it had on interpretation of the results. At 9 weeks, the OCD numbers were significantly higher in rhizosphere and contaminated soils than in bulk and non-contaminated soils, respectively. Alfalfa rhizosphere OCD levels were 4 x 107/g for contaminated and 6 x 106/g for non-contaminated soils. Bluegrass rhizosphere OCD levels were 1 x 107/g and 1 x 106/g in contaminated and non-contaminated soils, respectively. Selective enrichment of OCD populations was observed in contaminated rhizosphere soil. Higher numbers of OCD in contaminated rhizospheres suggest potential stimulation of bioremediation around plant roots.",Nichols T.D.; Wolf D.C.; Rogers H.B.; Beyrouty C.A.; Reynolds C.M.,1997.0,,0,0,
6919,The relationship of Homophobia to intimacy in heterosexual men,"Interpersonal intimacy is more difficult to achieve for American men than women. Research has shown that men disclose less, have fewer close friendships, and are viewed by their wives as low in intimacy. Among the barriers to intimacy among men, Tognoli (1980) suggested that homophobia is the most powerful. The present study tested this idea by asking men to disclose a personal secret to either a male confidant, a female confidante, or by writing the secret. It was expected that the presence of a male confidant would stimulate homophobic feelings and inhibit disclosure, while the other two conditions would result in more personal disclosure. A correlation between intimacy of disclosure and level of homophobia was also expected. Subjects were 75 heterosexual men, 31 to 50 years of age, randomly assigned to one of the three conditions. They also completed the Miller Social Intimacy Scale, the Jourard Self-Disclosure Questionnaire, the Index of Homophobia, and the Mar-lowe-Crowne Social Desirability Scale. Results showed that homophobia was inversely related to level of social intimacy. There was some indication that homophobia does relate to less intimate disclosure to other males. Thus this study found some support for the idea that homophobia is an obstacle to intimacy for men.",Monroe M.; Baker R.C.; Roll S.,1997.0,10.1300/J082v33n02_02,0,0,
6920,Thought suppression in spider phobia,"The current study examined the role of thought suppression in spider phobia. Spider phobic (n = 41) and non-phobic (n = 40) subjects were asked to monitor their thoughts for three 5 min periods. During the first period, all subjects were instructed to 'think about anything'. During the second period, half of the subjects received suppression instructions (i.e., subjects were explicitly asked 'not to think of spiders'), whereas the other half once again received instructions to 'think about anything'. During the third period, all subjects were instructed to 'think about anything'. Spider-related thoughts were monitored on-line. Also, subjects retrospectively estimated the amount of time they had spent thinking about spiders. Overall, spider phobics reported higher levels of spider-related thoughts than non-phobic subjects. Furthermore, phobic subjects tried harder to suppress spider-related thoughts than non-phobic subjects. Finally, although some evidence was found for the counterproductive effects of thought suppression, its contribution to the frequency of spider-related thoughts was minimal.",Muris P.; Merckelbach H.; Horselenberg R.; Sijsenaar M.; Leeuw I.,1997.0,10.1016/S0005-7967(97)00036-3,0,0,
6921,Correlation between psychometric and biological parameters in anorexic and bulimic patients during and after an intensive day hospital treatment,"This study describes: 1. The therapeutic effects on anorexia nervosa (AN) and bulimia nervosa (BN) patients of a psycho-nutritional intensive day-hospital program; 2. The possible correlation between the changes observed in the psychometric tests and the variations of a number of biological parameters. Forty-six female patients (24 AN and 22 BN) were assessed through a semi-structured clinical interview based on DSM-IV criteria for Eating Disorders (ED) and a number of psychometric tests (SCL-90R, BDI, EDI-2, EAT-40, BITE, BAT) at the beginning and at the end of treatment, and after a 6-month follow-up. At these three times, we also assessed the plasma level of leptin, cortisol, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and 17β-estradiol together with body mass index (BMI) and menstrual cycle. From beginning to discharge, the scores on all psychometric tests improved in the whole sample, except for the Perfectionism subscale of EDI-2 in both groups (AN and BN), the Anger-Hostility, Phobic Anxiety and Paranoid Ideation subscales of SCL-90 and the Interpersonal Distrust subscale of EDI-2 in the BN group. At follow-up, there was a worsening of the BITE scores and of a number of EDI-2 subscales, especially in the AN subgroup - with these changes correlating with the trend of BMI. In AN patients, plasma leptin levels changed from the beginning to the end of treatment and at follow-up according to BMI changes. The mean plasma leptin level in the BN subgroup was higher than in the AN one. We found a statistically significant correlation with the scores of BDI, SCL-90R Depression and Ineffectiveness subscales, EAT-40, BITE-Symptom subscale and the trend of menses dividing these patients into two subgroups (according to the plasma leptin concentration, higher or lower than the top leptin level in the anorexics). These data seem to confirm that leptin secretion doesn't correlate univocally to BMI. ©2005, Editrice Kurtis.",Manara F.; Manara A.; Todisco P.,2005.0,,0,0,
6922,Fear of pain is elevated in adults with Co-Occurring Trauma-Related stress and social anxiety symptoms,"The aim of this study was to determine whether fear of pain and related fear constructs are elevated in people with co-occurring trauma-related stress and social anxiety symptoms relative to people with 1 or neither of these conditions. Eighty students were selected from a larger sample and divided into 4 equal groups comprising those with both high trauma-related stress and social anxiety symptom scores (TRS/SAS), only high trauma-related stress symptom scores (TRS), only high social anxiety symptom scores (SAS), or neither (N). Results indicated that the TRS/SAS group had significantly higher scores on all fear of pain measures, anxiety sensitivity, and illness/injury sensitivity than any other group, even when level of current pain was included as a covariate. These findings suggest that people with co-occurring trauma-related and social anxiety symptoms are most likely to be fearful of pain and to thereby be at increased risk of developing chronic and disabling pain. Implications for future research and treatment are discussed. © 2005 Taylor & Francis.",Asmundson G.J.G.; Carleton R.N.,2005.0,10.1080/16506070510011557,0,0,
6923,The role of avoidance coping in the disclosure of trauma,"Little research has been undertaken to examine the empirical basis of commonly applied methods of posttrauma intervention. We propose that Pennebaker's work on structured disclosure of trauma provides a suitable analogue to explore questions of interest. The present study asks whether avoidance coping is likely to interfere with abbreviated disclosure of traumatic experiences. Subjects were 118 college students randomly allocated to either a one-session or four-session written trauma-disclosure condition. At 2 months postdisclosure, subjects with high avoidance coping within the one-session condition exhibited significantly more trauma-specific and physical symptoms than all other subjects. Avoidance coping significantly predicted trauma-specific symptoms at 2 months. These findings suggest that single session traumatic disclosure may not be useful for individuals with an avoidance style of coping.",Kenardy J.; Tan L.-J.,2006.0,10.1375/bech.23.1.42,0,0,
6924,Implicit associations between anxiety-related symptoms and catastrophic consequences in high anxiety sensitive individuals,"Anxiety sensitivity refers to the fear of anxiety-related physical sensations arising from beliefs that these sensations have harmful consequences (Reiss & McNally, 1985). The present study examined whether individuals with high (vs. low) anxiety sensitivity show stronger implicit associations in memory between anxiety-related symptoms, as opposed to neutral body parts, and harmful, as compared to harmless, consequences. A total of 22 undergraduate students (14 F, 8 M) completed the Extrinsic Affective Simon Task (EAST; De Houwer, 2003). Results indicated that high anxiety sensitive individuals (n = 10) tended to implicitly associate harmful consequences with anxiety-related symptoms. Their performance was significantly faster on trials where target words related to anxiety symptoms were mapped on to the same response key as harmful consequences. No significant difference in performance was found for low anxiety sensitive individuals (n = 12) or when target words were body parts unlikely related to diseases. Between-group differences persisted after controlling for trait anxiety and history of panic attacks, but not when illness-related beliefs were introduced as a covariate. Identifying this implicit association bias provides additional empirical support for the concept of anxiety sensitivity. © 2006 Psychology Press Ltd.",Lefaivre M.-J.; Watt M.C.; Stewart S.H.; Wright K.D.,2006.0,10.1080/02699930500336466,0,0,
6925,Stance-phase aggregate contact stress and contact stress gradient changes resulting from articular surface stepoffs in human cadaveric ankles,"Objective: Determine how stepoff incongruities of the distal tibia affect aggregate (whole-cycle) contact stresses and contact stress gradients for a complete motion cycle in human cadaveric ankles. Method: Ten human cadaveric ankles were subjected to quasiphysiologic forces during stance-phase range of motion. Each specimen was loaded intact, with anatomic reduction of the anterolateral quarter of the distal tibia, and with increasing stepoffs of the anterolateral fragment up to 4.0 mm. Transient contact stresses were measured using a custom-built, real-time stress transducer that sampled stresses at 132 Hz at 1472 separate foci (sensels). Aggregate stresses were calculated by summing the sequential transient stress values multiplied by the transient sampling duration for the complete motion cycle at each sensel. Transient contact stress gradients were calculated at each sensel using a central-differencing formula applied to adjacent transient stress measurements. Aggregate contact stress gradients were calculated by vector summation of sequential transient stress gradients multiplied by the sampling duration. Results: Compared to the intact configuration, anatomic reduction of the fragment caused minimal changes in aggregate contact stresses and stress gradients (30% increase compared to intact values). In contrast, stepoffs caused substantial increases (200% increase compared to intact values) in peak and mean whole-cycle stresses and gradients. Conclusions: Aggregate contact stresses and stress gradients quantify loading history for the complete motion cycle. Incongruity-associated changes in aggregate stresses and gradients are a surrogate for ""accumulated"" damage over a motion cycle in stepoff specimens. These loading abnormalities may be important determinants of posttraumatic arthritis. © 2005 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved.",McKinley T.O.; McKinley T.; Rudert M.J.; Koos D.C.; Pedersen D.R.; Baer T.E.; Tochigi Y.; Brown T.D.,2006.0,10.1016/j.joca.2005.09.010,0,0,
6926,A comparison of intolerance of uncertainty in analogue obsessive-compulsive disorder and generalized anxiety disorder,"Intolerance of uncertainty has been defined as the unwillingness to tolerate the possibility that negative events may occur in the future, no matter how low the probability [Personality Individual Differences 17 (1994), 791-802]. Previous research suggests that intolerance of uncertainty may be more specific to worry and generalized anxiety disorder (GAD) than to other anxiety disorders [e.g., Dugas, M. J., Buhr, K., & Ladouceur, R. (2004). The role of intolerance of uncertainty in the etiology and maintenance of generalized anxiety disorder. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 143-163). New York: Guilford Press]. However, Tolin et al. [J. Anxiety Disorders 17 (2003), 233-242] argued that intolerance of uncertainty may also play a central role in obsessive-compulsive disorder (OCD). Therefore, the current study compared intolerance of uncertainty in individuals with analogue GAD and/or OCD. Intolerance of uncertainty was strongly related to pathological worry, GAD symptoms, and OCD symptoms; however, neither worry nor GAD was found to be more strongly associated with intolerance of uncertainty than OCD. Further, individuals with analogue GAD or OCD reported more intolerance of uncertainty than controls, but they did not differ significantly from each other. These findings suggest that intolerance of uncertainty may be a central theme in a number of the anxiety disorders. © 2005 Elsevier Inc. All rights reserved.",Holaway R.M.; Heimberg R.G.; Coles M.E.,2006.0,10.1016/j.janxdis.2005.01.002,0,0,
6927,"Effects of electrical acupuncture on acupoint BL15 evaluated in terms of heart rate variability, pulse rate variability and skin conductance response","In this research, heart rate variability (HRV), pulse rate variability (PRV) and human skin conductance (SC) of all acupoints on Heart Meridian were used to evaluate the effects of electrical acupuncture (EA) on acupoint BL15 (Bladder Meridian). Ten healthy volunteers (aged 23 ± 6) were selected as the control group on the first day, and then used again as the experimental group on the second day. The control group received sham EA during the study, while subjects of the experimental group were stimulated by 2 Hz EA on acupoint BL15 for 10 minutes. Electrocardiogram (ECG), wrist blood pressure pulse meter and skin conductance response (SCR) device were used to measure and analyze HRV, PRV and SCR for the two groups before and after stimulation. From the spectrum analysis of ECG and pulse pressure graph, we found that the EA applied on BL15 could induce a significant increase in the normalized high frequency power (nHFP) component of HRV and PRV, as well as a significant decrease in the normalized low frequency power (nLFP) part (p < 0.05). Moreover, both the heart rate and pulse rate were reduced in the analysis of the time domain of ECG and PRV. Furthermore, most of the SCR values at acupoints were decreased after stimulation. These results also indicate that the stimulation of BL15 by EA could cause relaxation, calmness and reduce feeling of tension or distress. © 2006 World Scientific Publishing Company.",Hsu C.-C.; Weng C.-S.; Liu T.-S.; Tsai Y.-S.; Chang Y.-H.,2006.0,10.1142/S0192415X06003606,0,0,
6928,Does threatening imagery sensitize distress during contaminant exposure?,"Prominent models of fear focus on the role of cognition in the development and maintenance of maladaptive responses. Little research, however, has evaluated the impact of cognition on distress reduction. The current study uses an experimental design to examine the effect of different types of imagery (moving harm, static harm, and safety) on reduction of distress associated with a contaminating stimulus in a normal university sample. Results indicate that use of moving harm imagery sensitizes distress during a 30-min exposure, whereas static harm and safety imagery reduce distress. These findings demonstrate that cognitive factors can moderate affective response during exposure. Clinical implications for the treatment of anxiety disorders are discussed. © 2005 Elsevier Ltd. All rights reserved.",Dorfan N.M.; Woody S.R.,2006.0,10.1016/j.brat.2005.02.006,0,0,
6929,Unconscious responses to threatening pictures: Interactive effect of trait anxiety and social desirability on skin conductance responses,"The purpose of the present study was to examine the role of trait anxiety and social desirability on skin conductance responses (SCRs) following exposure to masked and unmasked pictures in a non-clinical sample. The most prominent results were found with regard to masked pictures (i.e. subliminal). Higher levels of social desirability were associated with a decrease in SCRs to masked threat pictures (relative to neutral), whereas elevated levels of trait anxiety were associated with an increase in SCRs. This latter effect, however, was mainly seen among participants who simultaneously scored low on social desirability. These results were discussed in terms of trait anxiety (combined with lower social desirability scores) being associated with (i) enhanced autonomic responses to threatening information most evident at a pre-attentive level, that (ii) may potentially be a vulnerability marker for anxiety disturbances. © 2006 Taylor & Francis.",Najström M.; Jansson B.,2006.0,10.1080/16506070510011566,0,0,
6930,Stress differentially modulates fear conditioning in healthy men and women,"Background: Stress and stress hormones modulate emotional learning in rats and might have similar effects in humans. Theoretic accounts of posttraumatic stress disorder (PTSD), for example, implicate the stress-induced modulation of fear conditioning in the development of intrusive emotional reactions. The present study examined the impact of acute stress and cortisol (CORT) on classically conditioned fear in men and women. Methods: Ninety-four healthy undergraduates were exposed to a mild stressor (or control condition) while subjective anxiety and glucocorticoid stress responses (salivary CORT) were measured. One hour later, all participants participated in a differential fear conditioning procedure while conditioned skin conductance responses (SCR) were recorded. Results: Exposure to the stressor increased subjective anxiety and elevated CORT levels. In men, stress exposure facilitated fear conditioning; whereas in women, stress appeared to inhibit fear conditioning. The impact of stress on differential conditioning in men was associated with increased CORT levels. Conclusions: Consistent with animal models, these results demonstrate that stress exposure can modulate classical conditioning in humans, possibly via hormonal mechanisms. The enhancing effects of stress on the formation of conditioned fear might provide a useful model for the formation of pathological emotional reactions, such as those found in PTSD. © 2005 Society of Biological Psychiatry.",Jackson E.D.; Payne J.D.; Nadel L.; Jacobs W.J.,2006.0,10.1016/j.biopsych.2005.08.002,0,0,
6931,Interpersonal correlates of generalized anxiety disorder: Self versus other perception,"The present investigation examined the interpersonal functioning of undergraduate students who met self-report criteria for generalized anxiety disorder (GAD), both as they perceive it and as perceived by their self-nominated friends. Forty-eight participants who met self-report criteria for GAD endorsed greater global severity of interpersonal problems on the 64-item version of the Inventory of Interpersonal Problems [Horowitz, L. M., Alden, L. E., Wiggins, J. S., Pincus, A. L. (2000). Inventory of Interpersonal Problems: Manual. San Antonio, TX: The Psychological Corporation] than 53 control participants. However, friends of GAD participants did not attribute significantly greater interpersonal problems to them than did friends of control participants. GAD participants reported less secure attachment to their parents than control participants but reported similar levels of attachment to peers and perceived social support. Furthermore, there were no significant differences between the friends of the GAD participants and friends of the control participants on ratings of their friendships quality. Findings are discussed in the context of their relevance to the etiology, maintenance, and treatment of GAD. © 2005 Elsevier Inc. All rights reserved.",Eng W.; Heimberg R.G.,2006.0,10.1016/j.janxdis.2005.02.005,0,0,
6932,Anxiety sensitivity among Cambodian refugees with panic disorder: A factor analytic investigation,"Among Cambodian refugees with panic disorder (N = 208), we performed two factor analyses, one with the ASI, another with an Augmented ASI (consisting of the 16-item ASI supplemented with a 9-item addendum that assesses additional Cambodian concerns about anxiety-related sensations). The principal component analysis of the ASI yielded a 3-factor solution (I, ""Weak Heart Concerns""; II, ""Social Concerns""; III, ""Control Concerns""); the Augmented ASI, a 4-factor solution: I, ""Wind Attack Concerns""; II, ""Weak Heart Concerns""; III, ""Social Concerns""; and IV, ""Control Concerns."" The item clustering within the factor solution of both the ASI and Augmented ASI illustrates the role of cultural syndromes in generating fear of mental and bodily events. © 2005 Elsevier Inc. All rights reserved.",Hinton D.E.; Pich V.; Safren S.A.; Pollack M.H.; McNally R.J.,2006.0,10.1016/j.janxdis.2005.02.006,0,0,
6933,Hypnotic trait and specific phobia: EEG and autonomic output during phobic stimulation,"In a previous study we showed that healthy highly hypnotizable subjects, during the suggestion of a moderately unpleasant situation administered in awake conditions, exhibited a sympathetic response greatly attenuated with respect to non-hypnotizable individuals. This was interpreted as a natural protection of hypnotizable subjects against the cardiovascular effects of cognitive stress. Aim of the present study was to investigate whether the hypnotic trait is able to modulate the autonomic and cerebral activities also in specific phobic awake hypnotizable (Highs) and non-hypnotizable (Lows) subjects. Electroencephalogram, electrooculogram, electromiogram of corrugator muscle, electrocardiogram, respirogram and tonic electrodermal activity were recorded during a guided mental imagery of an animal phobic object. Phobic stimulation induced in both groups the rise of heart and respiratory frequency and the lowering of skin resistance. These changes are less pronounced in Highs than in Lows and are sustained by a different modulation of the sympatho-vagal balance. During phobic stimulation both groups exhibited a similar significant increase of EEG gamma relative power. At variance, significant stimulation-related decrements of alpha1, theta1 and theta2 activities were found only in Highs that exhibited similar changes during the control and phobic stimulation. Results suggest that hypnotizability is able to modulate cerebral and autonomic responses also in specific phobic subjects. However, the presence of a specific phobia attenuates the effectiveness of hypnotizability as a protective factor against possible stress-related cardiac illness. © 2005 Elsevier Inc. All rights reserved.",Gemignani A.; Sebastiani L.; Simoni A.; Santarcangelo E.L.; Ghelarducci B.,2006.0,10.1016/j.brainresbull.2005.12.003,0,0,
6934,Anticipation of public speaking in virtual reality reveals a relationship between trait social anxiety and startle reactivity,"Background: Startle reflex modification has become valuable to the study of fear and anxiety, but few studies have explored startle reactivity in socially threatening situations. Methods: Healthy participants ranging in trait social anxiety entered virtual reality (VR) that simulates standing center-stage in front of an audience to anticipate giving a speech and count backward. We measured startle and autonomic reactivity during anticipation of both tasks inside VR after a single baseline recording outside VR. Results: Trait social anxiety, but not general trait anxiety, was positively correlated with startle before entering VR and most clearly during speech anticipation inside VR. Speech anticipation inside VR also elicited stronger physiologic responses relative to anticipation of counting. Conclusions: Under social-evaluative threat, startle reactivity showed robust relationships with fear of negative evaluation, a central aspect of social anxiety and clinical social phobia. Context-specific startle modification may be an endophenotype for subtypes of pathological anxiety. © 2005 Society of Biological Psychiatry.",Cornwell B.R.; Johnson L.; Berardi L.; Grillon C.,2006.0,10.1016/j.biopsych.2005.09.015,0,0,
6935,Effects of oral cannabis and dronabinol on driving capacity,"Two retrospective epidemiologic studies have shown that cannabis is the main psychoactive substance detected in the blood of drivers suspected of driving under the influence of psychotropic drugs. An oral administration double-blind crossover study was carried out with eight healthy male subjects, aged 22 to 30 years, all occasional cannabis smokers. Three treatments and one placebo were administered to all participants at a two week interval: 20 mg dronabinol, 16.5 mg D9-tétrahydrocannabinol (THC) and 45.7 mg THC as a cannabis milk decoction. Participants were asked to report the subjective drug effects and their willingness to drive under various circumstances on a visual analog scale. Clinical observations, a psychomotor test and a tracking test on a driving simulator were also carried out. Compared to cannabis smoking, THC, 11-OH-THC and THC-COOH blood concentrations remained low through the whole study (<13.1 ng THC/mL, <24.7 ng 11-OH-THC/mL and <99.9 ng THC-COOH/mL). Two subjects experienced deep anxiety symptoms suggesting that this unwanted side-effect may occur when driving under the influence of cannabis or when driving and smoking a joint. No clear association could be found between these adverse reactions and a susceptibility gene to propensity to anxiety and psychotic symptoms (genetic polymorphism of the catechol-O-methyltransferase). The questionnaires have shown that the willingness to drive was lower when the drivers were assigned an insignificant task and was higher when the mission was of crucial importance. The subjects were aware of the effects of cannabis and their performances on the road sign and tracking test were greatly impaired, especially after ingestion of the strongest dose. The Cannabis Influence Factor (CIF) which relies on the molar ratio of active and inactive cannabinoids in blood provided a good estimate of the fitness to drive. © Masson, 2006.",Giroud C.; Augsburger M.; Favrat B.; Menetrey A.; Pin M.-A.; Rothuizen L.-E.; Appenzeller M.; Buclin T.; Mathieu S.; Castella V.; Hazekamp A.; Mangin P.,2006.0,,0,0,
6936,Anxiety responses to CO2 inhalation in subjects at high-risk for panic disorder,"Background: A number of reports have shown that patients with panic disorder have greater anxiety responses to the inhalation of enhanced carbon dioxide mixtures than do well controls or patients with other psychiatric illnesses. Three earlier studies have shown that well individuals who have first-degree relatives with panic disorder also experience more anxiety following CO2 than do controls without such a family history. The following was undertaken to confirm and extend these findings. Methods: Well subjects at high risk for panic disorder (HR-P, n = 132) had a first-degree family member with treated panic disorder but no personal history of panic attacks. Low-risk subjects (LR-C, n = 85) had no such family history. All underwent a diagnostic interview with the SADS-LA and completed a battery of self-rating scales before undergoing two CO2 challenges. One involved a single vital capacity breath of air and then of 35% CO2 and the other 5 min of air and then 5 min of 5% CO2. Results: In comparison to the LR-C group, HR-P subjects had higher scores on various self-ratings of anxiety and depression and were more likely to have a lifetime diagnosis of MDD or of an anxiety disorder. NEO neuroticism and a history of MDD were the most important of these measures in separating the high-risk and low-risk groups. As predicted, the HR-P subjects experienced more anxiety following 35% CO2 exposure. The removal of individuals with lifetime diagnosis of MDD or of an anxiety disorder eliminated the relationship of neuroticism to CO2-induced anxiety and strengthened the relationship between the CO2 response and a family history of panic disorder. Five minutes of 5% CO2 produced much lower increases in anxiety than did the 35% exposure, but a dose by group interaction suggested that increasing exposure increased anxiety preferentially in the high-risk subjects. Conclusion: The results confirm earlier findings in indicating that a family history of panic disorder conveys a liability to experience anxiety with CO2 exposure. They also suggest that this anxiety may reflect several discrete diatheses of relevance to the heritability of panic disorder. © 2005 Elsevier B.V. All rights reserved.",Coryell W.; Pine D.; Fyer A.; Klein D.,2006.0,10.1016/j.jad.2005.12.045,0,0,
6937,When the heat is on: Romantic partner responses influence distress in socially anxious women,"This study provided a preliminary test of whether socially anxious women and their partners would show more negative social support behavior, especially among those with low relationship satisfaction, and whether this would increase the distress of the socially anxious women. Women with (n=22) and without (n=23) heightened social anxiety were observed interacting with their partners under a social-evaluative threat and support behaviors were coded. Unexpectedly, no differences were found between socially and non-socially anxious women and their partners. Although relationship satisfaction influenced this process, it was the more satisfied women who showed more negative behavior. Additionally, the more positive behaviors the partner exhibited, the greater was the distress reported by socially anxious women, particularly among women whose partners reported high relationship satisfaction. Implications for how these findings might expand theories on interpersonal processes in social anxiety are discussed. © 2005 Elsevier Ltd. All rights reserved.",Gayle Beck J.; Davila J.; Farrow S.; Grant D.,2006.0,10.1016/j.brat.2005.05.004,0,0,
6938,Attentional biases in social anxiety and dysphoria: Does comorbidity make a difference?,"This study examined whether comorbid symptoms influence the attentional biases associated with social anxiety and dysphoria using the Emotional Stroop Task (EST). Participants were recruited into three groups: a Social Anxiety group, a Dysphoric group, and a Social Anxiety/Dysphoric group. Four types of stimulus words were used: social anxiety threat, depressive threat, neutral words, and positive words. It was hypothesized that the Social Anxiety group would display an attentional bias to emotionally threatening stimuli whereas neither the dysphoric nor the Social Anxiety/Dysphoric group would display an attentional bias. Results found that the Social Anxiety group took longer to color name social threat and depressive words, whereas neither the Dysphoric nor the Comorbid group displayed an attentional bias. These results are discussed in light of their implications for cognitive theories of social anxiety and depression. © 2005 Elsevier Inc. All rights reserved.",Grant D.M.; Beck J.G.,2006.0,10.1016/j.janxdis.2005.05.003,0,0,
6939,"Clinical investigation of characteristics of emergency telephone counseling and medical service for outpatients in the Department of Psychiatry, Nara Medical University, in fiscal 2004","Characteristics of emergency telephone counseling and medical service for outpatients in the Psychiatric Service of Nara Medical University in fiscal 2004 were investigated, and those clinical features of emergency psychiatric service of the core general hospitals in Nara Prefecture were analyzed. The total of emergency telephone counseling was 1,049 cases/year and the details consisted of mild psychiatric deterioration (31.8%), questions concerning medication (15%), and distress (of patient or caregiver) (12.8%). The majority of our responses needed for telephone counseling was brief supportive counseling (87.2%). According to the diagnostic classification of ICD-10, F2 (schizophrenia, schizotypal and delusional disorder) were most frequent (35.6%), followed by F4 (neurotic, stress-related and somatoform disorder; 23.5%), F3 (mood disorder; 19.2%), and others. The total of emergency medical services was 846 cases/year and the details consisted of psychiatric deterioration (anxiety, agitation, etc.) (36.8%), complaints related to physical symptoms (21.3%), and suicide attempts (11.7%). About 22% patients were referred for psychiatric examination from other departments in our hospital. Complaints related to physical symptoms might be one of psychiatric symptoms, but additional physical examinations (blood test, brain CT, etc.) were needed according to the circumstances for differential diagnosis of physical disease. The rate of suicide attempts was 11.7%, which may reflect the feature of a general hospital with psychiatric service. Also the availability of psychiatric service in general hospitals (21.7%) is more useful for them and consultation-liaison psychiatry is much important for one another.",Nagauchi K.; Morikawa M.; Nagashima T.; Kimoto S.; Nakagawa K.; Ota T.; Toritsuka M.; Okada K.; Sawada M.; Yamauchi T.; Ichiiwa T.; Kiuchi K.; Kishino K.; Makinodan M.; Yoshino H.; Kou M.; Miyamoto T.; Negoro H.; Takahashi Y.; Inoue M.; Nakagawa Y.; Kishimoto T.,2006.0,,0,0,
6940,Cortisol and DHEA-S are associated with startle potentiation during aversive conditioning in humans,"Rationale: Fear conditioning reliably increases the startle reflex and stress hormones, yet very little is known about the effect of stress hormones on fear-potentiated startle. Cortisol and the sulfate ester of dehydroepiandrosterone (DHEA-S) are involved in stress and anxiety. Evidence suggests that low cortisol/DHEA-S ratio has a buffering effect on stress and anxiety in preclinical and clinical studies, suggesting that there may be a relationship between fear-potentiated startle and cortisol and DHEA-S activity. Objective: The aim of the study was to examine whether there is a relationship between cortisol/DHEA-S ratio and fear-potentiated startle. Methods: Thirty healthy subjects participated in a differential aversive conditioning experiment during which one of two stimuli (CS+) was paired with a shock, and the other was not (CS-). Conditioned responses were assessed with the startle reflex, defined as startle potentiation during CS+ compared to CS-. DHEA-S and cortisol levels were assayed from blood samples collected in both a baseline and an aversive conditioning session. Subjective state anxiety, arousal, and valence were assessed at various times during testing. Results: Fear-potentiated startle was larger in individuals with high compared to low cortisol/DHEA-S ratio. Multiple regression analyses revealed that fear-potentiated startle was positively associated with cortisol and negatively associated with DHEA-S. There was no significant correlation between DHEA-S and cortisol levels. Conclusion: These data suggest that cortisol and DHEA-S are involved in fear conditioning. © Springer-Verlag 2005.",Grillon C.; Pine D.S.; Baas J.M.P.; Lawley M.; Ellis V.; Charney D.S.,2006.0,10.1007/s00213-005-0124-2,0,0,
6941,An analogue study of intrusions,"According to cognitive theorists, intrusive trauma memories have their origin in how information during the event is processed. Two studies investigated functional cognitive strategies during medical crises that might protect against intrusions. In Study 1, interviews with health-care professionals were used to identify cognitive strategies judged to be effective in controlling emotions and dealing with medical crises. Study 2 systematically manipulated the use of those strategies in a trauma analogue film paradigm. Experimental participants reported fewer intrusions, and less fear and avoidance of film-related stimuli during the subsequent week than controls. The manipulation did not affect anxiety during the film or memory disorganization. Implications for cognitive theories of intrusion development are discussed. © 2005 Elsevier Ltd. All rights reserved.",Laposa J.M.; Alden L.E.,2006.0,10.1016/j.brat.2005.07.003,0,0,
6942,Cartilage-derived biomarkers and lipid mediators of inflammation in horses with osteochondritis dissecans of the distal intermediate ridge of the tibia,"Objective - To assess whether reported alterations in metabolism of cartilage matrix in young (0 to 24 months old) horses with osteochondritis dissecans (OCD) may also be found in older (24 to 48 months old) horses with clinical signs of OCD and to investigate the role of eicosanoids in initiating these clinical signs. Sample Population - Synovial fluid was collected from 38 tarsocrural joints of 24 warmblood horses with (22 joints of 16 horses) or without (16 joints of 8 horses) clinical signs and a radiographic diagnosis of OCD of the distal intermediate ridge of the tibia. Procedures - Turnover of type II collagen was investigated by use of specific immunoassays for synthesis (carboxypropeptide of type II) collagen [CPII]) and degradation (collagenase-cleaved fragments of type II collagen [C2C]) products. Furthermore, glycosaminoglycan (GAG), leukotriene (LT) B4, cysteinyl LTs, and prostaglandin (PG) E2 concentrations were determined, and concentrations in joints with OCD were compared with those in joints without OCD. Results - Concentrations of CPII, C2C, and GAG did not differ significantly between affected and nonaffected joints. Fluid from joints with OCD had significantly higher LTB4 and PGE2 concentrations than did fluids from nonaffected joints. Conclusions and Clinical Relevance - Altered collagen or proteoglycan turnover was not detected in 24- to 48-month-old horses at the time they developed clinical signs of OCD of the distal intermediate ridge of the tibia. However, increased concentrations of LTB4 and PGE2 in fluid of joints with OCD implicate these mediators in the initiation of clinical signs of OCD.",de Grauw J.C.; Brama P.A.; Wiemer P.; Brommer H.; van de Lest C.H.; van Weeren P.R.,2006.0,10.2460/ajvr.67.7.1156,0,0,
6943,Painful bladder syndrome/interstitial cystitis and sexual dysfunction in women,"Objectives: To assess the extent and nature of sexual dysfunction and feelings of distress in women suffering from painful bladder syndrome/interstitial cystitis (PBS/IC) in relation to age matched healthy controls. Methods: The 19 item self-administered Female Sexual Function Index (FSFI) was used to assess sexual function, with responses graded from 1 (almost never, never) to 5 (almost always, always). The 12 item Sexual Distress Scale was used to assess feelings of stress and frustration, with responses graded 1 (never) to 5 (always). Questionnaires were performed prior to therapy. 20 healthy women and 20 female patients, ranging from 18 to 65 years, from Austrian PBS/IC self help groups and the Department of Urology of Vienna Community Hospital Hietzing, were interviewed. Inclusion criteria for PBS/IC patients were at least 30 % reduction in bladder capacity under the modified 0.2 mol Potassium Chloride Test or a positive Potassium Sensitivity Test (PST-Parson's Test), negative urine cultures and the absence of Sexually Transmitted Diseases. Results: The symptoms most frequently reported were hypoactive sexual desire disorders (HSDD) (65 %), followed by sexual arousal disorder (SAD) (40 %) and dyspareunia (30 %). 45 % described a high extent of pain during or after sexual intercourse. Only 25 % reported orgasmic disorders (OD). 30 % of the women had not attempted sexual activities. 45 % were dissatisfied with their sex partners, 52 % of the patients were unhappy/disappointed about their sex life, and 70 % reported feelings of guilt. 50 % stated feelings of inadequacy and inferiority. Conclusions: Women with PBS/IC have a considerably higher prevalence of sexual function disorders compared to age matched healthy controls. HSDD and SAD were most frequently reported, with only 30 % of dyspareunia. Besides sexual dysfunction, IC also influences self esteem with 50 % reporting feelings of inferiority and 70 % feelings of guilt.",Lazar D.S.; Daha L.K.; Plas E.; Pflüger H.,2006.0,,0,0,
6944,Investigation into the mental health and personality of cadets in different love conditions under pressure environment,"Aim: To study the mental health and personality of cadets in love under the pressure environment. Methods: From November 2005 to January 2006, the students from Grade One to Four of some science military college were enrolled and 609 unmarried undergraduates of 17 teams were randomly selected from 62 teams. The mental health and personality of the cadets were tested with Symptom Check List 90 (SCL-90) and 16 Personality Factors Questionnaire (16PF) in batch. The SCL-90 had 90 items of 9 factorial scales such as somatization, obsession, interpersonal sensitivity, depression, anxiety, hostility, photic anxiety, paranoid ideation, and psychoticism. The SCL-90 adopted five-rank standard grading: nothing (1 score), mild (2 scores), moderate (3 scores), severe (4 scores) and very severe (5 scores). The 16PF concluded 187 questions, and every question had 3 ready-made answers. Except the answer of intelligence was 0 score for wrong and 1 score for correct, all answers of the rest 15 factors included 0, 1 and 2 scores. The general conditions included age, sex, grade, native place, length of military service, love condition, family background, state of study, life event and so on. Results: Among the 609 people joined the test, 565 ones were effectively measured with the efficiency rate of 92.8%. 1 There were 166 cadets in love condition, accounted for 29.4%, including 105 males (63.3%) and 61 females (36.7%); 399 students were not falling in love, accounted for 70.6%. 2 The scores of obsession, depression, anxiety, hostility, paranoid and psychoticism and number of positive items of the love condition cadets were significantly higher than those of not in love condition cadets, which had significant differences. 3 The scores of warmth, liveliness, social boldness, vigilance and apprehension of love condition cadets were higher than those not in love, but the scores of stability, rule-consciousness, openness to change, innovation were significantly lower than those not in love condition. Conclusion: Under pressure environment, love has more negative effects on mental health and personality of the cadets. The total mental health level of love condition cadets is worse than that of not in love ones. There are many differences in personality between the two groups, the cadets falling in love are more enthusiasm and brave, but more suspicious and anxiety, and the cadets not in love are more persevering, self-control, steady, and their creative ability and latent capacity are higher than cadets in love condition.",Ni W.-J.; Shi W.-H.,2006.0,,0,0,
6945,Path analysis on influential factors of mental health in 285 submariners,"Aim: To probe into the influential factors of mental health in submariners and the ways of interaction among them. Methods: Between July and August 2003, 285 subjects were randomly selected from male naval submariners of south China, and all of them joined the evaluation voluntarily. The personality characteristics were assessed with eysenck personality questionnaire (EPQ, composed of 88 declarative sentences. The dimensions of neuroticism, extraversion and psychoticism from EPQ were selected to analyze). The mental health status was assessed with symptom checklist (SCL-90, including 90 items and 9 factors of somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism, scored by 5 grades according to the severity, 1 as none, 2 as mild, 3 as moderate, 4 as a little severe,, 5 as severe). The mental health of subjects was evaluated with the total mean score and scores of each factor, and compared with Chinese army man norm. The coping styles were assessed with simplified coping style questionnaire (SCSQ, consisted of 20 items and divided into 2 factors of positive coping style and negative coping style, scored by 4 grades according to their frequency, 0 as none, 1 as once a while, 2 as sometimes, 3 as often). The scale was subdivided into two factors of positive coping and negative coping. The mental health status of naval submariners serving in south China was evaluated. The relationship between personality characteristics, coping style and mental health status as well as the path which personality characteristics and coping style influenced on mental health status were analyzed. Results: A total of 285 questionnaires were sent out, and 10 were excluded. 275 complete questionnaires were collected with an effective rate of 96.5%. 1 The scores of obsessive-compulsive, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism as well as the total mean score of SCL-90 were more in submariners than in Chinese army man norm (P < 0.01), and the score of interpersonal sensitivity was more than Chinese army man norm with a significant differences (P < 0.05). 2 Neuroticism and psychoticism dimension of EPQ was positively correlated with scores of all factors and the total mean score of SCL-90 (0.374 < r < 0.566), (0.189 < r < 0.290). The scores of positive coping dimension on SCSQ had a positive correlation with scores of obsessive-compulsive, interpersonal sensitivity, hostility, psychoticism and the total mean score of SCL-90 (0.127 < r < 0.160). The scores of negative coping dimension on SCSQ significantly had a positive correlation with scores of all factors and the total mean score of SCL-90(0.343 < r < 0.494). 3 Analysis of multiple stepwise regression showed that, the influencing factors of mental health were mainly neuroticism, negative coping style, and the standardized regression coefficients were 0.433 and 0.390 respectively. 4 Neuroticism was a disposition factor of mental health with direct action, the path coefficient of which was 0.390. Neuroticism indirectly influenced mental health by influencing negative coping style, the path coefficient of which was 0.455. Psychoticism indirectly influenced mental health by influencing negative coping style, the path coefficient of which was 0.455. Conclusion: The personality characteristics and coping style have significant influence on the mental health status in submariners serving in south China. As a dimension of personality, neuroticism is a disposition factor of mental health with direct and indirect action, psychoticism is a disposition factor of mental health with indirect action. The negative coping style is an intermediate link between personality and mental health.",Feng X.-G.; Zhang X.-Y.; Xie Y.-N.; Zhao J.-B.,2006.0,,0,0,
6946,Mental health conditions of 10 052 normal adults from three provinces and autonomous region in comparison with the norms in 1986,"Aim: To study the mental health conditions of Chinese normal adults to compare it with the norms in 1986 and evaluate the reliability of Symptom Checklist (SCL-90). Methods: With two-stage cluster sampling method, subjects of the study came from the survey on physiological and psychological constants of Chinese adults in 2002-2004, which was conducted in ten cities of Hebei province, Zhejiang province and Guangxi Zhuang Autonomous Region. Among these cities, 70 communities and countryside were sampled as cluster units and all available normal adults were regarded as the survey subjects. 10 052 normal adults from three provinces and autonomous region were interviewed with demographic questionnaire and SCL-90. Demographic questionnaire included age, sex, occupation, marital status and education. SCL-90 included 90 items of 1.0 dimensions: Somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, photic anxiety, paranoid ideation, psychoticism and additional items. Each item was scored with 5 grades. Total score, factor score and number of positive item (number of items with 2-5 scores) were recorded and calculated. The reliability of SCL-90 was evaluated with internal consistency and split-half reliability. Results: Among the 10 052 subjects, 9 107 valid questionnaires were retracted and the response rate was 90.599%. 1 The split-half reliability coefficients of 10 factors and total score were from 0.57-0.94 and Cronbach's α from 0.68-0.97. 2 Scores of 10 factors, total scores and number of positive item were significantly different among age groups. The factor score of somatization was highest at middle-aged group and other scores were negatively correlated with age. 3 There were not significant difference between sexes in the factor scores of obsessive-compulsive, interpersonal sensitivity, hostility and psychoticism. The scores of somatization, depression, anxiety, phobic anxiety and other factors, number of positive items and total scores of females were all higher than those of males, but the factor score of paranoid ideation of males was higher than that of females. 4 All scores were statistically different between urban and suburban subjects. Physical health conditions of urban adults were better than that of suburban ones, but they were susceptible to suffer from obsessive-compulsive, paranoid ideation and interpersonal sensitivity. 5 Most of the factor scores were significantly lower than those of the 1986's results, except for the factor of somatization. Conclusion: The somatization factor of the middle aged people are comparatively poor; mental health condition of females was inferior; somatization factor of urban adults is better than that of rural ones, but they are susceptible to suffer from obsessive-compulsive, paranoid ideation and interpersonal sensitivity; except for the factor of somatization, all the factor scores are significantly lower than those of the 1986's results, indicating great changes have happened in mental health conditions of Chinese normal adults.",Han S.-M.; Xu T.; Wang Y.; Zhu G.-J.,2006.0,,0,0,
6947,Hope and coping in family members of patients with obsessive-compulsive disorder,"Obsessive-compulsive disorder (OCD) affects approximately 2-4% of the adult population. Despite the practical and emotional demands of having a family member with OCD, few systematic attempts have been made to assess the coping strategies used by relatives of individuals with such diagnoses. In this study we examined the relationships between hope, coping strategies, and depressive symptoms in a heterogeneous sample of 67 spouses/primary caregivers of individuals with a history of OCD. In support of our hypotheses, hope was negatively related to depressive symptoms, symptom severity, and denial disengagement coping strategies, and positively related to active reframing and social support coping strategies. Active, Reframing, Social Support, and Religiosity were negatively related to depressive symptoms. Denial/Disengagement was positively associated with depressive symptoms. Coping mediated the relationship between hope and depressive symptoms. Given the importance of family members in treatment, clinical implications of these findings are discussed. © 2005 Elsevier Inc. All rights reserved.",Geffken G.R.; Storch E.A.; Duke D.C.; Monaco L.; Lewin A.B.; Goodman W.K.,2006.0,10.1016/j.janxdis.2005.07.001,0,0,
6948,"Three decades of antidepressant, anxiolytic and hypnotic use in a national population birth cohort","Background: Psychotropic medication use is common and increasing. Use of such drugs at the individual level over long periods has not been reported. Aims: To describe antidepressant, anxiolytic and hypnotic drug use, and associations between such medication use and common mental disorder, over a 22-year period. Method: Questions about psychotropic medication use and symptoms of common mental disorder were asked of more than 3000 members of the 1946 British birth cohort at multiple time points between ages 31 and 53 years. Results: Prevalence of any antidepressant, anxiolytic or hypnotic use increased significantly from 1977 (30.6 per 1000) to 1999 (59.1 per 1000) as the cohort aged. Less than 30% with mental disorder used antidepressants, anxiolytics or hypnotics. Previous use of antidepressant, anxiolytic or hypnotic was a strong predictor of future use during an episode of mental disorder (odds ratios 3.0-8.4); this association became weaker over time. Conclusions: Pharmacotherapy is infrequently used by individuals with common mental disorder in Britain; this has not changed in the past three decades.",Colman I.; Wadsworth M.E.J.; Croudace T.J.; Jones P.B.,2006.0,10.1192/bjp.bp.105.017434,0,0,
6949,The psychometric properties of the Brief Fear of Negative Evaluation Scale,"This study examined the psychometric properties of the Brief Fear of Negative Evaluation (BFNE) Scale in a nonclinical, nonstudent sample. Participants were administered the BFNE Scale, Beck Depression Inventory (BDI), and the UCLA Loneliness Scale. No differences were found across age, but women scored significantly higher on the BFNE Scale than men. Confirmatory factor analysis supported a two-factor solution corresponding to positive and reverse scored items. Internal consistency was excellent for the positive scored factor (α = .94), acceptable for the reverse scored factor (α = .73), and good for the full BFNE Scale (α = .80). BFNE scores were significantly correlated in the expected directions with the BDI and the UCLA Loneliness Scale. Implications of these findings for clinical practice and future research are discussed. © 2005 Elsevier Ltd. All rights reserved.",Duke D.; Krishnan M.; Faith M.; Storch E.A.,2006.0,10.1016/j.janxdis.2005.11.002,0,0,
6950,Altered coordination of the neuroendocrine response during psychosocial stress in subjects with high trait anxiety,"Contradicting data are available on stress responsiveness in subjects with high anxiety. In the present study we tested the hypothesis that high trait anxiety is associated with impaired coordination of the stress response, rather than global hypo- or hyper-responsiveness. The sample consisted of subjects with high (n = 15) and with low (n = 12) trait anxiety. Subjects with middle-range levels of anxiety were excluded from the study. After psychological characterization, the volunteers were exposed to a public speech procedure. A spectrum of neuroendocrine parameters was measured before, during and after the procedure and the results were analyzed by exploratory statistics. Psychological characterization of subjects revealed a lower preference for task-oriented but a higher one for emotion-oriented coping strategies as well as lower scores on hardiness in subjects with high trait anxiety. After the speech procedure, differences in selected mood and personality characteristics were observed, with the anxious group scoring significantly higher in scales for stress, tiredness, arousal, anxiety and depression. Factor analysis revealed that one common factor grouped blood pressure, catecholamine concentrations in blood and heart rate in non-anxious subjects, while three distinct factors separated these parameters in anxious subjects. Correlation analysis in anxious subjects showed that lower adrenocorticotropin (ACTH) and cortisol responses during stress were associated with exaggerated perception of stress and worse mental performance. Our findings indicate that subjects with high anxiety have different relationships between specific neuroendocrine parameters, subjective perception of stress and Stroop test performance. © 2006 Elsevier Inc. All rights reserved.",Duncko R.; Makatsori A.; Fickova E.; Selko D.; Jezova D.,2006.0,10.1016/j.pnpbp.2006.04.002,0,0,
6951,Intervention research on work organization and health: Research design and preliminary results on mental health,"This article presents the overall research design and preliminary results of an intervention study on work organization and health which integrates the 3 phases of intervention research: development, implementation, and effectiveness. The demand-latitude-support and effort-reward-imbalance models were used to assess adverse work organization factors. Psychological distress was measured using the Psychiatric Symptoms Index. The intervention development phase in a major department of a public organization revealed an excess of psychological demands, job strain, low reward, effort-reward imbalance, and psychological distress compared to reference populations, and allowed workers to identify 5 priorities for action. The implementation phase showed that changes that were put into effect were consistent with those priorities.",Brisson C.; Cantin V.; Larocque B.; Vézina M.; Vinet A.; Trudel L.; Bourbonnais R.,2006.0,,0,0,
6952,Greater vulnerability to the amnestic effects of ketamine in males,"Rationale: Gender differences both in response to ketamine in animals and general cognitive functioning in humans have been observed and suggested to be related to modulatory effects of sex hormones on N-methyl-d-aspartate receptor (NMDA-R) functioning. Objectives: The current study aimed to determine whether there were gender differences in response to ketamine in humans. Methods: Behavioral data including positive and negative symptoms (Brief Psychiatric Rating Scale), perceptual alterations (Clinician-Administered Dissociative States Scale, CADSS), and ""high"" and ""anxiety"" states (Visual Analog Scale) from 295 subjects who participated in a total of 11 placebo-controlled ketamine studies were analyzed. In a subset of subjects, memory (Hopkins Verbal Learning Task: HVLT, n=108) and attention (continuous performance task, n=177) data were also analyzed. Results: Male participants showed a greater performance decrement on the HVLT after ketamine administration compared to women. Men also reported a greater subjective sense of memory impairment on a CADSS subscale. No other gender differences in behavioral or cognitive measures were observed. Conclusions: Men showed a greater vulnerability to the amnestic effects of ketamine than women. Possible explanations of these findings are neuroanatomical and cognitive differences in processing of words in men and women and interactions between sex hormones and NMDA-R function. © Springer-Verlag 2006.",Morgan C.J.A.; Perry E.B.; Cho H.-S.; Krystal J.H.; D'Souza D.C.,2006.0,10.1007/s00213-006-0409-0,0,0,
6953,Incorporating social anxiety into a model of college problem drinking: Replication and extension,"Although research has found an association between social anxiety and alcohol use in noncollege samples, results have been mixed for college samples. College students face many novel social situations in which they may drink to reduce social anxiety. In the current study, the authors tested a model of college problem drinking, incorporating social anxiety and related psychosocial variables among 228 undergraduate volunteers. According to structural equation modeling (SEM) results, social anxiety was unrelated to alcohol use and was negatively related to drinking consequences. Perceived drinking norms mediated the social anxiety-alcohol use relation and was the variable most strongly associated with problem drinking. College students appear to be unique with respect to drinking and social anxiety. Although the notion of social anxiety alone as a risk factor for problem drinking was unsupported, additional research is necessary to determine whether there is a subset of socially anxious students who have high drinking norms and are in need of intervention. Copyright 2006 by the American Psychological Association.",Ham L.S.; Hope D.A.,2006.0,10.1037/0893-164X.20.3.348,0,0,
6954,Smooth pursuit and saccadic tests outcome in healthy persons in different age,"The study of eye movement presents a unique opportunity to investigate the integrity of central ocular-motor pathways and structures, involved in the generation and control of ocular-motor reflexes, which is important in the diagnosis of rate balance system in otoneurology. In psychiatry, oculography is useful for the evaluation of schizophrenia, obsessive-compulsive and affective disorders as well as the effectiveness of psychoactive drugs. Aim. The aim of the study was to investigate the results of smooth pursuit and saccadic tests in healthy persons in respect to age and stimulus paradigm. Method. Sixty seven subjects in different age: 16 - young (mean 29.8 years), 38 - middle-aged (mean 53.2 years) and 13 - elderly (mean 73.6 years) were enrolled in the study. Oculographic tests were performed on the computerized ENG system. The pursuit target was driven by a predictable sinusoidal task at various frequencies 30 Hz, 40 Hz, 50 Hz and amplitudes of 15°, 20° and 30°. In the saccades test the target moved abruptly 15° left and right of the centre. In all tests, several parameters and the 95% prediction interval (95 PI) were calculated. Results. In the smooth pursuit test gain decreased with ageing. The differences between age groups (younger - middle-age and younger - elderly) were statistically significant for each target velocity. In this study we found no significant evidence that age has an impact on the parameters of saccadic tests. Conclusion. These findings suggest that the results of oculomotor tests should be quantified by the age of the patient and the target task.",Józefowicz-Korczyńska M.; Pajor A.,2006.0,,0,0,
6955,Experienced disgust causes a negative interpretation bias: A causal role for disgust in anxious psychopathology,"This paper reports the results of an experiment investigating the effect of induced disgust on interpretational bias using the homophone spelling task. Four groups of participants experienced a disgust, anxiety, happy or neutral mood induction and then completed the homophone spelling task which requires the participant to interpret ambiguous words presented through headphones. Both the disgust and anxiety groups interpreted significantly more threat/neutral homophones as threat than both the happy and neutral groups; the disgust group also interpreted significantly fewer positive/neutral homophones as positive than the happy group. These findings are consistent with the view that induced disgust causes a negative interpretational bias which is similar to that reported for anxiety. The results could not be interpreted in terms of the disgust induction concurrently raising levels of self-reported anxiety, but could be interpreted in terms of disgust maintaining existing levels of anxiety. The effect of disgust was to facilitate negative interpretations rather than emotional interpretations regardless of valence. These findings provide the basis for a causal role for disgust in anxious psychopathology. Because the effect is a non-specific emotion-congruent one, elevated disgust levels will result in a predisposition to interpret information in a threatening way across a broad range of anxious- and threat-relevant domains. © 2005 Elsevier Ltd. All rights reserved.",Davey G.C.L.; Bickerstaffe S.; MacDonald B.A.,2006.0,10.1016/j.brat.2005.10.006,0,0,
6956,Correlates of exchanging sex for drugs or money among women who use crack cocaine,"This study examined the correlates of trading sex for drugs or money among women who use crack cocaine. Using baseline data (n = 669) from a woman-focused HIV intervention study among African American women who use crack cocaine, we conducted logistic regression analysis to examine the odds of trading sex associated with distal and proximal factors. The results indicate that heavier crack use, homelessness, and unemployment are associated with trading sex. In addition, childhood abuse is associated with trading sex and this relationship is, in part, mediated by psychological distress. This suggests that distal factors may underlie the relationship between current variables and sex trading. These findings underscore the importance for public health interventions to address both distal and proximal factors that contribute to and/or co-occur with women's drug use which, in turn, may affect their HIV risk and overall well-being. © 2006 The Guilford Press.",Edwards J.M.; Halpern C.T.; Wechsberg W.M.,2006.0,10.1521/aeap.2006.18.5.420,0,0,
6957,Sex differences in response to a panicogenic challenge procedure: An experimental evaluation of panic vulnerability in a non-clinical sample,"Epidemiological studies show that women are twice as likely as men to develop panic disorder (PD) during their lifetimes. Data from retrospective studies also suggest that women are more distressed by panic and other negative emotional states than men, and that this tendency may precede the development of PD. The present prospective study sought to expand this work by evaluating sex differences in the predisposition to panic in individuals without PD or other forms of psychopathology. Participants (N=96; 52 women) were exposed to 12 panicogenic inhalations of 20% CO2-enriched air while physiological (e.g., heart rate, electrodermal response, Frontalis EMG) and self-report (e.g., subject distress, fear, frequency and severity of DSM-IV panic symptoms) response domains were monitored. As expected, magnitude of autonomic responding failed to reliably discriminate between women and men. Yet, women reported more fear and panic immediately following the challenge procedure relative to men, and this sex difference persisted when assessed again 30 min post-challenge. Implications of these results are discussed broadly in the context of biopsychosocial accounts of sex differences in the clinical presentation of PD. © 2005 Elsevier Ltd. All rights reserved.",Kelly M.M.; Forsyth J.P.; Karekla M.,2006.0,10.1016/j.brat.2005.10.012,0,0,
6958,Randomized trial of the effect of research design and publication characteristics on physician change,"Background: The primary barrier to translation of research into practice relates to physician use of research. If we are to succeed at translating research into practice, we must understand to which research characteristics and publication formats practitioners attend. Objective: To determine which characteristics of research design (sample characteristics, study design) and publication (type of publication) are most influential on the acquisition of knowledge and change in behavior of family practitioners. Method: This randomized clinical trial was conducted in family practice offices on the 305 family physicians who scored lowest on a survey of knowledge about management of major depressive disorder (MDD), panic disorder, and generalized anxiety disorder (GAD). Subjects were randomly assigned to receive 1 of 3 MDD abstracts differing in study site, 1 of 3 panic disorder abstracts differing in study design, and 1 of 3 GAD communications differing in format. The main outcome measures (knowledge and management strategies) were assessed immediately following the intervention and again 6 months later. Data for the intervention survey were gathered in November 2002. Results: This study found significant increases in knowledge level and use of first-line agents with all interventions; however, knowledge declined again after 6 months for both panic disorder and GAD. The only statistically significant interoption difference was that the POEM (patient-oriented evidence that matters) was associated with better retention of knowledge of the treatment of GAD. Conclusion: In conclusion, all interventions were associated with immediate increases in knowledge and use of first-line treatments. However, such gains were not retained for panic disorder and GAD. Except for better knowledge retention associated with POEM use, no consistent differences between intervention options were noted. © Copyright 2006 Physicians Postgraduate Press, Inc.",Katerndahl D.A.; Ferrer R.L.,2006.0,,0,0,
6959,The influence of personality variable on Secondary Traumatic Stress,"Trauma has received a great deal of attention in the last years. One line of research in this field focuses on exploring the importance of personality variables in resistance and vulnerability in trauma (Beaton y Murphy, 1995; Dutton y Rubinstein, 1995; Figley, 1995). This empirical study explores the process of secondary traumatic stress among 175 sanitary professional, focusing on the contribution and the degree of relevance of personality variables, such as comprehensibility, challenge, sense of humor and empathy. Secondary traumatic stress was measured with the Secondary Traumatic Stress Measure (Moreno-Jiménez, Morante, Rodríguez and Garrosa, 2004). Results indicate these personality variables seem to have an important role in secondary traumatic stress's process. Finally, further implications of the findings are discussed.",Moreno Jiménez B.; Morante Benadero M.E.; Rodríguez Muñoz A.; Rodríguez Carvajal R.,2006.0,,0,0,
6960,Detection of the reliability and validity of Dissociative Experience Scale II,"Aim: To test the reliability and validity of Dissociative Experiences Scale II (DES-II). Methods: A total of 186 undergraduates selected from Sichuan University, Chengdu University of Traditional Chinese Medicine, Sichuan Normal College, Sichuan Education College, Sichuan Physical Education College and West-South Nationality College were interviewed from June 2003 to January 2004, who were selected by a senior attending physician according to the inclusion criteria and exclusion criteria. Inclusion criteria: 1 Undergraduates of Han ethnic. 2 Normal subjects without mental diseases, general medical diseases, chronic pain and psychoactive addiction in the past and at present, and have never been hypnotized. 3 Patients with the total score less than 2 points respectively in Psychiatry Screening Inventory and Neurosis Screening Inventory (Three items were added into the Neurosis Screening Inventory, including acute stress reaction, post-trauma stress disturbance and hypochondria, considering the differences in perceptibility of hypnosis between patients with stress disturbance and hypochondria and normal people). Exclusion criteria: 1 Patients with a score of either screening inventory equal to or above 2 points. All subjects filled in the DES-II and Tellegen Absorption Scale (TAS), and the Stanford Group Hypnotic Susceptibility Scale was used to assess the subjects. Six weeks later, 38 subjects were re-tested with DES-II. Results: A total of 155 subjects accomplished the whole hynotization with three valid questionnaires, whose test data were involved in the analysis of results. The Cronbach coefficient α was 0.93 in Chinese DES-II, and the split-half coefficient of Spearman-Brown was 0.88, which was 0.84 in the retest at 6 weeks later. Factor analysis showed that there were three main factors, which determined 32.16% of the total variance and respectively represented absorption and imaginative involvement, amnestic dissociation as well as the experiences of depersonalization and derealization respectively. After controlling factor of sex, the partial-correlation coefficient between DES-II and SGHSS:C was 0.25 (P < 0.05), and the partial-correlation coefficient between DES-II and TAS was 0.32(P < 0.05). Conclusion: DES-II has good reliability and validity, while further research should be done to provide the data for criterion validity of DES-II.",Fang L.; Liu X.-H.,2006.0,,0,0,
6961,Is this happiness i see? Biases in the identification of emotional facial expressions in depression and social phobia,"The present study was designed to examine the operation of depression-specific biases in the identification or labeling of facial expression of emotions. Participants diagnosed with major depression and social phobia and control participants were presented with faces that expressed increasing degrees of emotional intensity, slowly changing from a neutral to a full-intensity happy, sad, or angry expression. The authors assessed individual differences in the intensity of facial expression of emotion that was required for the participants to accurately identify the emotion being expressed. The depressed participants required significantly greater intensity of emotion than did the social phobic and the control participants to correctly identify happy expressions and less intensity to identify sad than angry expressions. In contrast, social phobic participants needed less intensity to correctly identify the angry expressions than did the depressed and control participants and less intensity to identify angry than sad expressions. Implications of these results for interpersonal functioning in depression and social phobia are discussed. © 2006 APA, all rights reserved.",Joormann J.; Gotlib I.H.,2006.0,10.1037/0021-843X.115.4.705,0,0,
6962,The role of responsibility and fear of guilt in hypothesis-testing,"Recent theories argue that both perceived responsibility and fear of guilt increase obsessive-like behaviours. We propose that hypothesis-testing might account for this effect. Both perceived responsibility and fear of guilt would influence subjects' hypothesis-testing, by inducing a prudential style. This style implies focusing on and confirming the worst hypothesis, and reiterating the testing process. In our experiment, we manipulated the responsibility and fear of guilt of 236 normal volunteers who executed a deductive task. The results show that perceived responsibility is the main factor that influenced individuals' hypothesis-testing. Fear of guilt has however a significant additive effect. Guilt-fearing participants preferred to carry on with the diagnostic process, even when faced with initial favourable evidence, whereas participants in the responsibility condition only did so when confronted with an unfavourable evidence. Implications for the understanding of obsessive-compulsive disorder (OCD) are discussed. © 2006 Elsevier Ltd. All rights reserved.",Mancini F.; Gangemi A.,2006.0,10.1016/j.jbtep.2006.03.004,0,0,
6963,Investigating peri-traumatic dissociation using hypnosis during a traumatic film,"We investigated the hypothesis that inducing a dissociative response (detachment) in healthy volunteers while they were watching a trauma film would lead to increased numbers of intrusive memories of the film during the following week. Hypnotized participants were given suggestions to dissociate during part of the film, and to watch the rest of the film normally from their own perspective. The order of these conditions, and the section of film watched under the two conditions, were counterbalanced. As predicted, watching the film under both conditions led to increases in dissociation. Explicit suggestions to dissociate were generally effective in inducing higher levels of dissociation. Contrary to prediction, there were no more intrusive memories of sections of the film for which participants had received dissociation suggestions. Implications of our results for views of the relationship between peri-traumatic dissociation and intrusive memories are discussed. Copyright © by The Haworth Press, Inc. All rights reserved.",Holmes E.A.; Oakley D.A.; Stuart A.D.P.; Brewin C.R.,2006.0,10.1300/J229v07n04_06,0,0,
6964,Roles of brain-derived neurotrophic factor in spinal cord injury,"Currently it is accepted that in mammals, neurons or axons possess regenerative potentials after spinal cord injury (SCI). However, it largely depends on participation of neurotrophic factors (NTFs). Brain-derived neurotrophic factor (BDNF) is one of the NTFs members, which is secreted by three major cell types in the spinal cord, namely, neurons, astrocytes and oligodendrocytes. BDNF can not only protect neurons, but also promote cell regeneration and differentiation. Further investigation on the roles that BDNF play in the SCI and the time-dependent pattern at the different posttraumatic intervals in SCI may offer a new way for the clinical treatment of SCI and the medico-legal wound age determination.",Liu Y.; Wang Y.-Y.,2006.0,,0,0,
6965,Motion sickness preceded by unstable displacements of the center of pressure,"We exposed standing participants to optic flow in a moving room. Motion sickness was induced by motion that simulated the amplitude and frequency of standing sway. We identified instabilities in displacements of the center of pressure among participants who became sick; these instabilities occurred before the onset of subjective motion sickness symptoms. Postural differences between Sick and Well participants were observed before exposure to the nauseogenic stimulus. During exposure to the nauseogenic stimulus, sway increased for participants who became sick but also for those who did not. However, at every point during exposure sway was greater for participants who became motion sick. The results reveal that motion sickness is preceded by instabilities in displacements of the center of pressure. © 2006 Elsevier B.V. All rights reserved.",Bonnet C.T.; Faugloire E.; Riley M.A.; Bardy B.G.; Stoffregen T.A.,2006.0,10.1016/j.humov.2006.03.001,0,0,
6966,Quality of life and subthreshold obsessive-compulsive disorder,"Objective: This study investigates the relationship between subthreshold obsessive-compulsive disorder (OCD) and quality of life (QoL) in a sample from the Italian general population. Methods: A sample of 202 psychiatrically healthy (defined as absence of current axis I and axis II disorders) subjects was recruited by word of mouth from the residential population in the Siena, Salerno and Milano municipalities (Italy). All study subjects completed the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Questionnaire for Obsessive-Compulsive Spectrum (OBS-SR), which explore a wide array of threshold and subthreshold OCD symptoms, behaviours and traits. A diagnostic assessment was conducted to exclude the presence of DSM-IV axis I and axis II disorders using the Mini International Neuropsychiatric Interview and the Structured Clinical Interview for DSM-III-R personality disorders, respectively. Results: A statistically significant correlation was found between the OBS-SR total score and the Q-LES-Q domains of physical health, subjective feelings, work, school, social relationships and general activities. There was also a statistically significant correlation between several Q-LES-Q and OBS-SR domains. Conclusions: The presence of subthreshold OCD is correlated with poorer QoL. More research is needed to evaluate if specific therapeutic interventions targeting subthreshold obsessive-compulsive symptoms can lead to a significant improvement in the QoL of the affected individuals. © 2007 Blackwell Munksgaard.",Goracci A.; Martinucci M.; Kaperoni A.; Fagiolini A.; Sbaragli C.; Corsi E.; Castrogiovanni P.,2007.0,10.1111/j.1601-5215.2007.00257.x,0,0,
6967,Induced amnesia for distressing information in a nonclinical sample,"Dissociative reactions during and subsequent to traumatic events are theorised to result in memory deficits for trauma-related information. This study investigated the interaction between induced amnesia and dissociative reactions. Participants (N = 29) were presented with a word list, a series of disfigured or neutral faces and a second word list, followed by free recall and recognition tasks. Participants presented with disfigured faces recalled fewer words from the postimage list in the free recall task than those presented with neutral faces; however, there were no between-group differences for recognition. No relationship was observed between dissociative tendencies and memory performance. Trait dissociation was unrelated to induced amnesia effects. Findings are interpreted in terms of impaired consolidation of information following encoding of distressing information. Implications of the results for the clinical management of traumatized individuals are considered.",Moulds M.L.; Bryant R.A.,2007.0,10.1375/bech.24.1.7,0,0,
6968,Itch and motivation to scratch: An investigation of the central and peripheral correlates of allergen- and histamine-induced itch in humans,"Intense itch and urge to scratch are the major symptoms of many chronic skin ailments, which are increasingly common. Vicious itch-scratch cycles are readily established and may diminish quality of life for those afflicted. We investigated peripheral and central processing of two types of itch sensation elicited by skin-prick tests of histamine and allergen solutions. Itch-related skin blood flow changes were measured by laser Doppler in 14 subjects responsive to type I allergens and 14 nonatopic subjects. In addition, this study examined central processing of both types of itch using functional magnetic resonance imaging (fMRI). Itch perception and blood flow changes were significantly greater when itch was induced by allergens compared with histamine. Both types of itch correlated significantly with activity in the genual anterior cingulate, striatum, and thalamus. Moreover, itch elicited by allergens activated orbitofrontal, supplementary motor, and posterior parietal areas. Histamine-induced itch also significantly correlated with activation in the insula bilaterally. The identification of limbic and ventral prefrontal activation in two types of itch processing likely reflects the subjects' desire to relieve the itch sensation by scratching, and these regions have been repeatedly associated with motivation processing. A dysfunction of the striato-thalamo-orbitofrontal circuit is believed to underlie the failure to regulate motivational drive in disorders associated with strong urges, e.g., addiction and obsessive compulsive disorder. The patterns of itch-induced activation reported here may help explain why chronic itch sufferers frequently self-harm through uncontrollable itch-scratch cycles. Copyright © 2007 The American Physiological Society.",Leknes S.G.; Bantick S.; Willis C.M.; Wilkinson J.D.; Wise R.G.; Tracey I.,2007.0,10.1152/jn.00070.2006,0,0,
6969,Age effects on brain activity during repetition priming of targets and distracters,"The effects of age on repetition priming and how such differences were related to intentional learning and working memory status were examined. Fourteen older (age 65-75) and 14 younger (age 18-28) healthy adults performed a modified delayed match-to-sample task consisting of a target object held in mind followed by nine test objects. Sixty four-channel EEGs were recorded as participants indicated whether each test object was the same or different from the target object. Half of all target and distractor objects were intentionally studied prior to the task, and both target and distractor objects were repeatedly presented up to four times in each trial. Although both age groups showed repetition priming effects, speed increases due to repetition were more enhanced for elderly. ERP repetition effects for both younger and older adults were indexed via early (200-550) and late (550-850 ms) components. The early repetition effect was affected by whether a distractor was previously studied or not for younger but not for older adults. In contrast, the late repetition effect was not affected by prior intentional learning, and a marginal age effect suggested that repetitions of distractors likely affected older and younger adults differently. These findings suggest that at least two distinguishable repetition mechanisms differentially affect adult aging. © 2006 Elsevier Ltd. All rights reserved.",Lawson A.L.; Guo C.; Jiang Y.,2007.0,10.1016/j.neuropsychologia.2006.10.014,0,0,
6970,Intravenous levodopa administration in humans based on a two-compartment kinetic model,"Levodopa, when combined with a decarboxylase inhibitor, essentially delivers dopamine directly to the brain, with no net effect on brain blood vessels. For future neuroimaging studies of Parkinson disease and Tourette syndrome, we sought to rapidly produce a biologically relevant levodopa concentration in plasma and then maintain that concentration long enough to assess motor, cognitive, emotional, and neuroimaging responses, while minimizing side effects in levodopa-naive individuals. Based on available pharmacokinetic data and a two-compartment model, we designed a decreasing-exponential-rate infusion to meet these goals. This report gives results of double-blind levodopa and placebo infusions in six healthy subjects. Mean plasma levodopa concentrations were within 3% of their 1200 ng/mL target at 20 and 40 min into the infusion, and within 20% between ∼12 and 90 min. Levodopa significantly reduced serum prolactin and raised serum growth hormone concentrations. Volunteers had no significant side effects. © 2006 Elsevier B.V. All rights reserved.",Gordon M.; Markham J.; Hartlein J.M.; Koller J.M.; Loftin S.; Black K.J.,2007.0,10.1016/j.jneumeth.2006.07.010,0,0,
6971,Enhanced perceptual priming for neutral stimuli occurring in a traumatic context: Two experimental investigations,"Intrusive memories in posttraumatic stress disorder are often triggered by stimuli that are perceptually similar to those present shortly before or during the trauma. The present study aims to examine the possible role of perceptual priming in this phenomenon. It further investigates whether the degree of perceptual priming is associated with dissociation and whether both perceptual priming and intrusive memories can be reduced through elaboration. Two experiments measured perceptual priming for neutral stimuli that immediately preceded a ""traumatic"" event. Volunteers (N=46, 92) watched a series of ""traumatic"" and neutral picture stories, and completed a blurred object identification (perceptual priming) memory task, and a recognition memory task. Participants in Experiment 1 were selected to score either high or low on the Trait Dissociation Questionnaire [Murray, Ehlers, & Mayou (2002). Dissociation and posttraumatic stress disorder: Two prospective studies of motor vehicle accident survivors. British Journal of Psychiatry, 180, 363-368]. They also completed a state dissociation measure in the session. Experiment 2 randomly allocated participants to an experimental condition designed to increase elaboration or to a control condition. This experiment also included a measure of intrusive memories. Both experiments found enhanced perceptual priming for the stimuli that immediately preceded the ""traumatic"" stories compared to those preceding neutral stories. Participants with high trait dissociation showed relatively stronger perceptual perceptual priming. The degree of perceptual priming for stimuli from the ""traumatic"" stories also correlated with state dissociation (Experiment 1). Experimental manipulation of the elaboration of the stories showed that elaboration reduced the enhanced perceptual priming effect and the relative probability of reexperiencing symptoms (Experiment 2). The results support the role of perceptual priming in intrusions after traumatic events. © 2006 Elsevier Ltd. All rights reserved.",Michael T.; Ehlers A.,2007.0,10.1016/j.brat.2006.03.012,0,0,
6972,"Effects of suppression, acceptance and spontaneous coping on pain tolerance, pain intensity and distress","Wegner's Theory of Ironic Processes has been applied to study the effects of cognitive strategies to control pain. Research suggests that suppression contributes to a more distressing pain experience. Recently, the acceptance-based approach has been proposed as an alternative to cognitive control. This study assessed the tolerance time, the distress and the perceived pain intensity in three groups (suppression, acceptance and spontaneous coping groups) when the participants were exposed to a cold pressor procedure. Two hundred and nineteen undergraduates volunteered to participate. The suppression group showed the shortest tolerance time and the acceptance group showed the longest tolerance time. The acceptance group showed pain and distress immersion ratings that were significantly lower than in the other two groups, between which the differences were not significant. In the first recovery period, the suppression group showed pain and distress ratings that were higher than in the other two groups. In the second recovery period, although the acceptance group showed pain and distress ratings that were significantly lower than in the other two groups, the suppression and the spontaneous coping groups did not differ. The presence of a 'rebound' of physical discomfort and the effects of suppression on behavioural avoidance are discussed. These results support the acceptance approach in the management of pain. © 2006 Elsevier Ltd. All rights reserved.",Masedo A.I.; Rosa Esteve M.,2007.0,10.1016/j.brat.2006.02.006,0,0,
6973,Conducting extinction in multiple contexts does not necessarily attenuate the renewal of shock expectancy in a fear-conditioning procedure with humans,"The renewal of Pavlovian-conditioned responses may provide a model for the relapse of fear following extinction-based treatments for anxiety disorders. Renewal can be observed if conditional stimulus (CS) and unconditional stimulus (US) pairings are given in one context, extinction trials of CS presentations in a second context, prior to test trials of CS presentations in the original acquisition context (ABA renewal). We examined ABA renewal in humans by using a fear-conditioning procedure with an unpleasant shock US. A renewal of rated shock expectancy was demonstrated with this procedure. Conducting extinction treatment in multiple contexts was expected to attenuate the renewal effect. However, the renewal of shock expectancy persisted when extinction treatment was given across three or five different contexts. With the current renewal design, learning task, and measure of conditioned behaviour, extinction treatment does not appear to readily generalise to the test context. The use of multiple extinction treatments in a clinical setting may not necessarily reduce the likelihood of relapse via a renewal effect. © 2006 Elsevier Ltd. All rights reserved.",Neumann D.L.; Lipp O.V.; Cory S.E.,2007.0,10.1016/j.brat.2006.02.001,0,0,
6974,Reduction of trace but not delay eyeblink conditioning in panic disorder,"Objective: Individuals with panic disorder perceive panic attacks as unpredictable. Because predictability is fundamental to Pavlovian conditioning, failure to predict panic attacks could be due to a basic deficit in conditioning. The present study examined trace eyeblink conditioning in order to test the hypothesis that individuals with panic disorder are impaired in associative learning tasks that depend on declarative memory. Method: Delay and trace eyeblink conditioning were tested in separate experimental sessions in 19 individuals meeting DSM-IV criteria for panic disorder and 19 sex- and age-matched healthy comparison subjects. In the delay paradigm, a mild puff was delivered to the eye at the end of a 500-msec tone; in the trace paradigm, the puff was delivered after a 700-msec empty ""trace"" interval that followed the end of the tone. Results: Patients and comparison subjects showed similar rates of conditioned responses in the delay paradigm, but patients showed reduced rates of conditioned responses in the trace paradigm. Conclusions: These results suggest that individuals with panic disorder suffer from a deficit in declarative associative learning. Such a deficit points to impaired hippocampal function that may disrupt cognitive processing of internal and external cues predictive of a panic attack.",Grillon C.; Lissek S.; McDowell D.; Levenson J.; Pine D.S.,2007.0,10.1176/appi.ajp.164.2.283,0,0,
6975,Taxometric and factor analytic models of anxiety sensitivity: Integrating approaches to latent structural research,"This study represents an effort to better understand the latent structure of anxiety sensitivity (AS), as indexed by the 16-item Anxiety Sensitivity Index (ASI; S. Reiss, R. A. Peterson, M. Gursky, & R. J. McNally, 1986), by using taxometric and factor-analytic approaches in an integrative manner. Taxometric analyses indicated that AS has a taxonic latent class structure (i.e., a dichotomous latent class structure) in a large sample of North American adults (N = 2,515). As predicted, confirmatory factor analyses indicated that a multidimensional 3-factor model of AS provided a good fit for the AS complement class (normative or low-risk form) but not the AS taxon class (high-risk form). Exploratory factor analytic results suggested that the AS taxon may demonstrate a unique, unidimensional factor solution, though there are alternative indications that it may be characterized by a 2-factor solution. Findings suggest that the latent structural nature of AS can be conceptualized as a taxonic latent class structure composed of 2 types or forms of AS, each of these forms characterized by its own unique latent continuity and dimensional structure. © 2007 APA, all rights reserved.",Bernstein A.; Zvolensky M.J.; Norton P.J.; Schmidt N.B.; Taylor S.; Forsyth J.P.; Lewis S.F.; Feldner M.T.; Leen-Feldner E.W.; Stewart S.H.; Cox B.,2007.0,10.1037/1040-3590.19.1.74,0,0,
6976,Neuropsychiatric symptoms and past manganese exposure in a ferro-alloy plant,"Introduction: Psychiatric manifestations have been reported in cases of manganism, and mood disorders are often observed in manganese (Mn) exposed workers. We examined neuropsychiatric symptoms among formerly Mn-exposed workers 14 years after cessation of exposure. Materials and methods: A study was conducted in 1990 among workers from a ferro- and silico-Mn plant and unexposed working men referents from the same region in South-West Quebec. At follow-up in 2004, 77 former Mn-workers and 81 referents agreed to participate and responded to a neuropsychiatric symptom checklist, the Brief Symptom Inventory (BSI); scores were transformed into T-scores based on a normative population. Cumulated exposure indices (CEI) were computed for each former Mn-worker. Linear and logistic regression analyses were used. Results: Mean T-scores were significantly higher among former Mn-workers than referents on scales of Depression and Anxiety. Mean T-scores of psychological distress increased with the CEI tertiles, with significant associations for the scales Somatization, Depression, Anxiety and Hostility. Former Mn-workers in the two highest tertiles of CEI showed a higher risk for T-scores ≥63 for Hostility (OR, 7.5; 95% CI, 1.5-38.9), Depression (OR, 2.6; 95% CI, 1.1-8.4) and Anxiety (OR, 3.0; 95% CI, 1.1-8.4). Conclusion: These results suggest that past exposure to Mn may have lasting consequences on neuropsychiatric symptoms. © 2006.",Bouchard M.; Mergler D.; Baldwin M.; Panisset M.; Roels H.A.,2007.0,10.1016/j.neuro.2006.08.002,0,0,
6977,Beta-adrenergic modulation of cognitive flexibility during stress,"Stress-induced activation of the locus ceruleus-norepinephrine (LC-NE) system produces significant cognitive and behavioral effects, including enhanced arousal and attention. Improvements in discrimination task performance and memory have been attributed to this stress response. In contrast, for other cognitive functions that require cognitive flexibility, increased activity of the LC-NE system may produce deleterious effects. The aim of the present study was to determine the effect of pharmacological modulation of the LC-NE system on stress-induced impairments in cognitive flexibility performance in healthy individuals. Cognitive performance, plus psychological and physiological parameters for 16 adults without any history of anxiety disorders, was assessed during four test sessions: stress and no-stress, with each condition tested after administration of propranolol and placebo. The Trier Social Stress Test, a public-speaking and mental arithmetic stressor, was presented to participants for the stress sessions, whereas a similar, but nonstressful, control task (reading, counting) was utilized for the no-stress sessions. Tests of cognitive flexibility included lexical-semantic and associative problem-solving tasks (anagrams, Compound Remote Associates Test). Visuospatial memory and motor processing speed tests served as control tasks. Results indicate that (1) stress impaired performance on cognitive flexibility tasks, but not control tasks; (2) compared to placebo, cognitive flexibility improved during stress with propranolol. Therefore, psychological stress, such as public speaking, negatively impacts performance on tasks requiring cognitive flexibility in normal individuals, and this effect is reversed by beta-adrenergic antagonism. This may provide support for the hypothesis that stress-related impairments in cognitive flexibility are related to the noradrenergic system. © 2007 Massachusetts Institute of Technology.",Alexander J.K.; Hillier A.; Smith R.M.; Tivarus M.E.; Beversdorf D.Q.,2007.0,10.1162/jocn.2007.19.3.468,0,0,
6978,Slow habituation of arousal associated with psychosis proneness,"Background. Previous studies report skin conductance (SC) abnormalities in both patients with schizophrenia and psychosis-prone individuals. However, no studies have assessed SC abnormalities in relation to specific psychotic and emotional symptoms. The aim of the present study was to examine the relationship between SC orienting response and hallucination proneness, delusional ideation, anxiety and self-focused attention in non-clinical individuals. Method. Forty-three participants were recruited and divided into two groups depending upon the SC habituation profile. Normal habituators (n=28) and slow habituators (n=15) were compared on measures of psychosis proneness, anxiety and self-focused attention. Results. Slow habituators had significantly higher levels of delusional ideation and hallucination proneness than the normal habituators. SC habituation scores were particularly associated with the conviction of delusional ideas. Levels of anxiety or self-focused attention did not differ significantly between the groups. Conclusions. The study provides evidence of 'aetiological continuity'. Common mechanisms may contribute to psychotic experiences in non-clinical and clinical samples, consistent with the notion of a psychosis continuum. © 2007 Cambridge University Press.",Allen P.; Freeman D.; McGuire P.,2007.0,10.1017/S0033291706009615,0,0,
6979,Psychometric analyses of the Clinician-Administered PTSD Scale (CAPS) - Bosnian translation,"Methods for assessing psychological distress in culturally diverse populations are not firmly established. This study was designed to examine the psychometric properties of the Bosnian translation of the Clinician-Administered PTSD Scale (CAPS; D. D. Blake, F. W. Weathers, L. M. Nagy, D. Kaloupek, G. Klauminzer, D. Charney, et al., 1995) in a Bosnian refugee sample. The authors interviewed 115 help-seeking Bosnian refugees with the CAPS-Bosnian translation to examine its internal consistency and convergent validity, and to provide an assessment of its factor structure. This study demonstrated optimal fit with a 2-factor model of posttraumatic stress disorder (PTSD); the authors also found high reliability with a coefficient alpha of 0.92 and strong convergent validity with instruments measuring depression, anxiety, and levels of psychosocial functioning. Future directions for the assessment of PTSD in cross-cultural populations are discussed. © 2007 APA, all rights reserved.",Charney M.E.; Keane T.M.,2007.0,10.1037/1099-9809.13.2.161,0,0,
6980,Emotional Conflict and Neuroticism: Personality-Dependent Activation in the Amygdala and Subgenual Anterior Cingulate,"The amygdala and subgenual anterior cingulate (AC) have been associated with anxiety and mood disorders, for which trait neuroticism is a risk factor. Prior work has not related individual differences in amygdala or subgenual AC activation with neuroticism. Functional magnetic resonance imaging was used to investigate changes in blood oxygen level-dependent signal within the amygdala and subgenual AC associated with trait neuroticism in a nonclinical sample of 36 volunteers during an emotional conflict task. Neuroticism correlated positively with amygdala and subgenual AC activation during trials of high emotional conflict, compared with trials of low emotional conflict. The subscale of neuroticism that reflected the anxious form of neuroticism (N1) explained a greater proportion of variance within the observed clusters than the subscale of neuroticism that reflected the depressive form of neuroticism (N3). Using a task that is sensitive to individual differences in the detection of emotional conflict, the authors have provided a neural correlate of the link between neuroticism and anxiety and mood disorders. This effect was driven to a greater extent by the anxious relative to the depressive characteristics of neuroticism and may constitute vulnerability markers for anxiety-related disorders. © 2007 American Psychological Association.",Haas B.W.; Omura K.; Constable R.T.; Canli T.,2007.0,10.1037/0735-7044.121.2.249,0,0,
6981,Comparison of the stability of various internal fixators used in the treatment of osteochondritis dissecans - A mechanical model,"The purpose of this study was to determine what characteristics of fixation devices used in the treatment of osteochondritis dissecans (OCD) contribute to improved stability to resist shear loading. An OCD model was designed using rigid polyurethane foam. Each specimen consisted of two components, an osteochondral fragment and a corresponding defect. A total of 40 specimens were prepared and assigned to one of four groups: control (no extrinsic stabilizer); two 2-mm-diameter Kirschner wires (K-wires), 40 mm in length; one threaded washer and a 28-mm screw; and one threaded washer and a 38 mm screw. Each specimen was mounted onto an Iosipescu shear test fixture and subjected to shear loads at a pseudo-static displacement rate of 0.075 mm/s. All groups demonstrated some stability; controls were significantly less stable than all other groups. The group with the threaded washer and 38-mm screw demonstrated the greatest stability (p < 0.001), and no difference was noted between the K-wire and 28-mm screw groups. These results suggest that, in this OCD model, friction conferred some intrinsic stability to resist loads in shear. However, stability was improved with the use of long implants that compressed the fragments together. © 2007 Orthopaedic Research Society.",Morelli M.; Poitras P.; Grimes V.; Backman D.; Dervin G.,2007.0,10.1002/jor.20332,0,0,
6982,An evaluation of accuracy and repeatability of a novel gait analysis device,"Introduction: Restoration of gait is a particularly important patient-based functional outcome following lower extremity trauma. A new portable device which measures gait parameters, the IDEEA, may be particularly useful in evaluating post-traumatic gait parameters in the office setting, but the accuracy and repeatability of this device relative to standard gait laboratory footswitches are unknown. Material and methods: Twelve healthy subjects were tested simultaneously using the IDEEA device and standard gait laboratory footswitches, at slow, medium, and fast speeds. Parameters evaluated were single-limb support time (SLS), double-limb support time (DLS), swing phase duration (SPD), cycle duration, and cadence. Results: The repeatability between right and left measurements tended to be better for the IDEEA, and was at least as good as the foot switches. The absolute differences of the timed gait parameters between the two devices were all in the range of 0.03 s, which is within the data sampling resolution of the gait laboratory foot switches (0.04 s). Furthermore, assuming a 1-s gait cycle, these differences account for only 3% of the gait cycle, which is also well within the clinical parameters for evaluating and differentiating between treatments. Conclusion: This device is accurate and repeatable, and may facilitate the evaluation of gait function in post-traumatic patients in settings outside of the traditional gait laboratory. © Springer-Verlag 2006.",Gardner M.J.; Barker J.U.; Briggs S.M.; Backus S.I.; Helfet D.L.; Lane J.M.; Lorich D.G.,2007.0,10.1007/s00402-006-0279-2,0,0,
6983,The effects of sleep deprivation on symptoms of psychopathology in healthy adults,"Background: Sleep loss leads to temporary changes in mood and cognition, and is associated with reduced cerebral metabolism within the prefrontal cortex, similar to findings observed in some psychiatric disorders. However, the extent to which sleep deprivation may be associated with the emergence of clinical symptoms of psychopathology in healthy normal individuals is not clear. Methods: The Personality Assessment Inventory (PAI) was administered to 25 healthy adults at rested baseline and again after 56 h of continuous wakefulness. Results: Comparisons showed a significant global increase in PAI psychopathology scores from baseline to sleep-deprived sessions, particularly for somatic complaints, anxiety, depression, and paranoia. Mean elevations for the clinical scales remained within normal limits, however. In contrast, sleep loss was not associated with significant changes in anxiety-related disorders, manic symptoms, borderline, schizophrenic, or antisocial features. Conclusions: Two nights without sleep may lead to a sub-clinical increase in self-reported affective symptoms of psychopathology while having little effect on symptoms of thought disorder, psychotic processes, or behavioral dysregulation. These data suggest that sleep loss may be differentially disruptive to regions of the brain involved in affective regulation and may, therefore, serve as a model for understanding the brain dysfunction associated with affective psychopathology.",Kahn-Greene E.T.; Killgore D.B.; Kamimori G.H.; Balkin T.J.; Killgore W.D.S.,2007.0,10.1016/j.sleep.2006.08.007,0,0,
6984,Enrollment in a Brain Magnetic Resonance Study: Results From the Women's Health Initiative Memory Study Magnetic Resonance Imaging Study (WHIMS-MRI),"Rationale and Objectives: The rates of enrollment of volunteers for brain magnetic resonance imaging (MRI) studies vary by demographic and clinical characteristics. We use data from a large MRI study to identify factors associated with differential enrollment and to examine potential biases this may produce in study results. Materials and Methods: Results from recruitment of 1,431 women into the MRI substudy of the Women's Health Initiative Memory Study (WHIMS-MRI) are described. A sensitivity analysis was conducted to estimate the degree of bias associated with missing data on estimates of risk factor relationships. Results: Of 2,345 women contacted from an established cohort of women older than 70 years of age, 72% consented to undergo screening for WHIMS-MRI. Scanning was ultimately completed on 61%. Completion rates varied according to a range of sociodemographic, lifestyle, and clinical characteristics that may be related to study outcomes. Plausible levels of selective enrollment in magnetic resonance imaging studies may produce moderate biases (< ±20%) in characterizations of risk factor relationships. Adverse events, such as claustrophobia, occurred during 1.7% of the attempted scans and, in 0.8% of instances, led to lost data. Conclusions: Enrollment of older women into brain imaging studies is feasible, although selection biases may limit how well study cohorts reflect more general populations. © 2007 AUR.",Jaramillo S.A.; Felton D.; Andrews L.; Desiderio L.; Hallarn R.K.; Jackson S.D.; Coker L.H.; Robinson J.G.; Ockene J.K.; Espeland M.A.,2007.0,10.1016/j.acra.2007.02.001,0,0,
6985,The effect of music on the anxiety levels of patients undergoing hysterosalpingography,"Objectives: To determine the effect of music on the anxiety levels of patients undergoing a hysterosalpingography procedure. Patients and methods: One hundred hysterosalpingography referrals were randomly assigned to either the experimental or control group. Music chosen earlier by the patients was played during the hysterosalpingography procedure for the experimental group. The control group was studied without music. Certain physiological parameters and the State-Trait Anxiety Inventory were used to assess the patients' anxiety levels before and during the investigation. Patient's willingness to have a repeat procedure, should it become necessary, was also assessed in both groups as a measure of acceptability of the investigation. The z-test was used to analyze the results for any statistically significant differences between the experimental and the control groups. Results: The blood pressure (BP) monitored during the procedure was reduced in 31 (62%) of the patients in the experimental group compared to their pre-investigation values. Reduction in the pulse rate (PR) in 28 (56%) of the patients was also noted in the experimental group. On the other hand, the blood pressure of 37 (74%) of the patients and the pulse rate of 32 (64%) patients in the control group were increased from their pre-investigation values. The physiological parameters in the experimental group were significantly lower than the values in the control group during the investigation (p < 0.05). A comparison of the State-Trait Anxiety Inventory scores taken before and during the procedure shows significantly lower scores for the experimental group compared to those for the control group (p < 0.05). More patients, 41 (82%) in the experimental group were also willing to have a repeat procedure compared to 16 (32%) patients in the control. Conclusion: Music reduces the physiological and cognitive responses of anxiety in patients undergoing hysterosalpingography and can be harnessed for clinical use. The use of music therapy made the procedure to be more acceptable by the patients. © 2006 The College of Radiographers.",Agwu K.K.; Okoye I.J.,2007.0,10.1016/j.radi.2005.12.002,0,0,
6986,Observational fear conditioning in the acquisition and extinction of attentional bias for threat: An experimental evaluation,"Anxious persons show automatic and strategic attentional biases for threatening information. Yet, the mechanisms and processes that underlie such biases remain unclear. The central aim of the present study was to elucidate the relation between observational threat learning and the acquisition and extinction of biased threat processing by integrating emotional Stroop color naming tasks within an observational differential fear conditioning procedure. Forty-three healthy female participants underwent several consecutive observational fear conditioning phases. During acquisition, participants watched a confederate displaying mock panic attacks (UCS) paired with a verbal stimulus (CS+), but not with a second nonreinforced verbal stimulus (CS-). As expected, participants showed greater magnitude electrodermal and verbal-evaluative (e.g., distress, fear) conditioned responses to the CS+ over the CS- word. Participants also demonstrated slower color-naming latencies to CS+ compared to the CS- word following acquisition and showed attenuation of this preferential processing bias for threat following extinction. Findings are discussed broadly in the context of the interplay between fear learning and processing biases for threat as observed in persons suffering from anxiety disorders. © 2007 APA, all rights reserved.",Kelly M.M.; Forsyth J.P.,2007.0,10.1037/1528-3542.7.2.324,0,0,
6987,Social anxiety and romantic relationships: The costs and benefits of negative emotion expression are context-dependent,"In general, expressing emotions is beneficial and withholding emotions has personal and social costs. Yet, to serve social functions there are situations when emotions are withheld strategically. We examined whether social anxiety influenced when and how emotion expressiveness influences interpersonal closeness in existing romantic relationships. For people with greater social anxiety, withholding the expression of negative emotions was proposed to preserve romantic relationships and their benefits. We examined whether social anxiety and emotion expressiveness interacted to predict prospective changes in romantic relationship closeness over a 12-week period. For people with less social anxiety, relationship closeness was enhanced over time when negative emotions were openly expressed whereas relationship deterioration was found for those more likely to withhold emotions. The reverse pattern was found for people with greater social anxiety such that relationship closeness was enhanced over time for those more likely to withhold negative emotions. Related social anxiety findings were found for discrepancies between desired and actual feelings of closeness over time. Findings were not attributable to depressive symptoms. These results suggest that the costs and benefits of emotion expression are influenced by a person's degree of social anxiety. © 2006 Elsevier Ltd. All rights reserved.",Kashdan T.B.; Volkmann J.R.; Breen W.E.; Han S.,2007.0,10.1016/j.janxdis.2006.08.007,0,0,
6988,What ends a worry bout? An analysis of changes in mood and stop rule use across the catastrophising interview task,"This paper reports the results of two experiments designed to test predictions from the mood-as-input hypothesis about the factors that contribute to the ending of a worry bout. Experiment 1 looked at changes in self-reported mood across a catastrophising interview task. Experiment 2 investigated whether there were any changes in stop rule deployment between the beginning and end of a catastrophising interview task. Experiment 1 demonstrated that worriers tended to show increases in negative mood and decreases in positive mood over the course of catastrophising. In Experiment 2, participants exhibited a significant shift away from endorsing the use of 'as many as can' stop rules and a significant increasing tendency to endorse the use of 'feel like continuing' stop rules over the course of catastrophising. These results suggest that worriers exhibit increases in negative mood across the worry bout, but shift from the use of 'as many as can' to 'feel like continuing' stop rules. Mood-as-input hypothesis predicts that if high worriers ask the question ""do I feel like continuing?"" in the context of increasing negative mood, this will imply that the activity is no longer enjoyable or profitable and should be terminated. The results are discussed in the context of mood-as-input accounts of pathological worrying and the therapeutic implications of these findings are reviewed. © 2006 Elsevier Ltd. All rights reserved.",Davey G.C.L.; Eldridge F.; Drost J.; MacDonald B.A.,2007.0,10.1016/j.brat.2006.08.024,0,0,
6989,Attentional focus during repeated checking influences memory but not metamemory,"Compulsive checking may be associated with reduced memory confidence, which results from changes in encoding during the act of repeated checking. It was hypothesized that instructions to focus attention on one's surroundings as well as one's actions during a repeated checking task may attenuate decreases in memory confidence. Prior to a repeated checking task, 64 participants were instructed to focus not only on their actions but also on their surroundings (Peripheral condition), and 66 participants were instructed to focus only on their actions (Central condition). Contrary to expectations, compared with those in the central condition, participants in the peripheral condition did not report greater memory confidence, but did have a significantly more accurate memory. Furthermore, this effect was largest for participants scoring high on a measure of compulsive checking. Results are discussed in terms of cognitive models of obsessive compulsive disorder (OCD) and compulsive checking. © 2007 Springer Science+Business Media, LLC.",Ashbaugh A.R.; Radomsky A.S.,2007.0,10.1007/s10608-006-9087-9,0,0,
6990,"Cognitive bias in men's processing of negative social information: The role of social anxiety, toughness as a masculine role norm, and their interaction","Cognitive approaches to social anxiety focus on a person's tendency to make biased judgments for threat-relevant stimuli. This notion was tested relative to whether men's adherence to a toughness male role norm moderates the relation between social anxiety and biased judgments for negative interpersonal events. For negative interpersonal events not involving male role norms, results indicated that only social anxiety was related to probability estimates, while for cost estimates there was a unique association for social anxiety and a significant social anxiety by toughness interaction such that men who were high in both made greater cost estimates. For events involving explicit male role norms, social anxiety and toughness evidenced unique relationships with probability estimates. For cost estimates, in addition to unique associations for social anxiety and toughness, there was a significant interaction, which showed that men high in both characteristics gave the highest cost ratings. © 2006 Springer Science + Business Media, Inc.",Bruch M.A.,2007.0,10.1007/s10608-006-9001-5,0,0,
6991,"Interpretation biases in social anxiety: Response generation, response selection, and self-appraisals","Cognitive theories propose that the resolution of ambiguity is related to the maintenance of social anxiety. A sentence completion task was used to examine how individuals high (n=26) and low (n=23) in social anxiety resolve ambiguous social sentences. Individuals were asked to generate as many responses as came to mind for each sentence, and then to endorse the response that best completes the sentence. Total responses, first responses, and endorsed responses were examined separately. Results indicated that high anxious individuals had more negative and anxious responses and fewer positive and neutral responses than low anxious individuals on all sentence completion measures. In contrast, a self-report measure of interpretation bias indicated that more of negative and anxious appraisals were related to social anxiety, while positive and neutral appraisals were not. Results are discussed in terms of a multi-stage processing model of interpretation biases. © 2007 Elsevier Ltd. All rights reserved.",Huppert J.D.; Pasupuleti R.V.; Foa E.B.; Mathews A.,2007.0,10.1016/j.brat.2007.01.006,0,0,
6992,Personality traits and anxiety symptoms: The multilevel trait predictor model,"Investigation of relations between personality traits and mental disorders can inform key issues in psychopathology research. However, it has been hindered by extensive correlations among the traits. Building on studies of affect-psychopathology relations (e.g., the tripartite model), an organizational framework is proposed to solve this problem with respect to anxiety pathology. To test the resulting model, associations between four traits (negative emotionality, positive emotionality, anxiety sensitivity, and negative evaluation sensitivity) and four anxiety symptoms (chronic worry, obsessive-compulsive symptoms, panic, and social anxiety) were examined in an undergraduate sample (N=907). Confirmatory factor analyses supported operationalizations of the constructs in this study. Examination of the trait-symptom links using hierarchical multiple regression analyses supported most of the predicted relations. Specifically, negative emotionality emerged as a general predictor that was significantly related to all four symptom dimensions. In contrast, anxiety sensitivity was specific to panic and worry, whereas negative evaluation sensitivity was specific to social anxiety and worry. Finally, positive emotionality was uniquely related to social anxiety. The model accounted for a substantial amount of variance in the symptoms and almost all of the covariation among them. © 2006 Elsevier Ltd. All rights reserved.",Kotov R.; Watson D.; Robles J.P.; Schmidt N.B.,2007.0,10.1016/j.brat.2006.11.011,0,0,
6993,Cognitive aspects of nonclinical obsessive-compulsive hoarding,"Research on the cognitive variables associated with obsessive-compulsive hoarding is scarce. In this study, we investigated cognitive variables that may contribute to the maintenance and possibly etiology of hoarding. College students who characterized themselves as either ""packrats"" (nonclinical hoarders; n = 21) or not (control participants; n = 20) completed questionnaires assessing hoarding behavior and beliefs about hoarding, and completed a task requiring them to categorize diverse objects and trinkets of minimal value into groups. The results revealed that nonclinical hoarders, relative to control participants, rated the categorization task as significantly more stressful and difficult. Relative to control participants, hoarders took longer to complete the task and sorted objects into more categories. These findings suggest that underinclusiveness and indecisiveness, characteristic of clinical hoarders, are evident in nonclinical hoarders as well. © 2006 Elsevier Ltd. All rights reserved.",Luchian S.A.; McNally R.J.; Hooley J.M.,2007.0,10.1016/j.brat.2006.08.014,0,0,
6994,Blushing during social interactions in people with a fear of blushing,"Changes in facial blood flow were investigated during an introductory conversation, delivering a speech, and listening to the speech afterwards in 16 people with a fear of blushing and 16 controls. It was hypothesized that fear of blushing would be associated with high ratings of self-reported blushing intensity and embarrassment during the tasks, and with persistence of the blushing reaction between tasks. Embarrassment and self-reported blushing intensity were greater in the fear-of-blushing group than in controls throughout the experiment. Increases in facial blood flow were similar in the two groups during each of the tasks. However, blushing dissipated more slowly after each task in the fear-of-blushing group than in controls, resulting in an incremental increase in facial blood flow over the course of the experiment. The slow recovery after an episode of blushing might result in physiological or social cues that help to maintain a fear of blushing. © 2006 Elsevier Ltd. All rights reserved.",Drummond P.D.; Back K.; Harrison J.; Dogg Helgadottir F.; Lange B.; Lee C.; Leavy K.; Novatscou C.; Orner A.; Pham H.; Prance J.; Radford D.; Wheatley L.,2007.0,10.1016/j.brat.2006.06.012,0,0,
6995,Neural basis for priming of pop-out during visual search revealed with fMRI,"Maljkovic and Nakayama first showed that visual search efficiency can be influenced by priming effects. Even ""pop-out"" targets (defined by unique color) are judged quicker if they appear at the same location and/or in the same color as on the preceding trial, in an unpredictable sequence. Here, we studied the potential neural correlates of such priming in human visual search using functional magnetic resonance imaging (fMRI). We found that repeating either the location or the color of a singleton target led to repetition suppression of blood oxygen level-dependent (BOLD) activity in brain regions traditionally linked with attentional control, including bilateral intraparietal sulci. This indicates that the attention system of the human brain can be ""primed,"" in apparent analogy to repetition-suppression effects on activity in other neural systems. For repetition of target color but not location, we also found repetition suppression in inferior temporal areas that may be associated with color processing, whereas repetition of target location led to greater reduction of activation in contralateral inferior parietal and frontal areas, relative to color repetition. The frontal eye fields were also implicated, notably when both target properties (color and location) were repeated together, which also led to further BOLD decreases in anterior fusiform cortex not seen when either property was repeated alone. These findings reveal the neural correlates for priming of pop-out search, including commonalities, differences, and interactions between location and color repetition. fMRI repetition-suppression effects may arise in components of the attention network because these settle into a stable ""attractor state"" more readily when the same target property is repeated than when a different attentional state is required.",Kristj√°nsson A.; Vuilleumier P.; Schwartz S.; MacAluso E.; Driver J.,2007.0,10.1093/cercor/bhl072,0,0,
6996,Incidental and intentional flavor memory in young and older subjects,"Incidental and intentional learning and memory for 2 novel flavors were compared in young and elderly subjects. Incidental and intentional learning groups rated 2 new soups on acceptability for different occasions and were tested for memory the next day. On the first day, only the intentional group was asked to memorize the stimuli. With incidental learning, elderly and young were equally good, but the young performed better with intentional than with incidental learning, whereas the elderly did not. There were no age-related differences in perceptual discrimination. When comparing perceived flavor with the memory of it, the elderly tend to overrate intensities of remembered flavor attributes, whereas the young tend to underrate them. Memory was not related to flavor pleasantness or neophobia. Like memory for taste and texture, flavor memory seems to be mainly tuned at detecting changes and based on ""feelings of not knowing"" rather than on precise identification and recognition of previously encountered stimuli. © The Author 2007. Published by Oxford University Press. All rights reserved.",Møller P.; Mojet J.; Köster E.P.,2007.0,10.1093/chemse/bjm026,0,0,
6997,"The role of avoidance, pacing, and other activity patterns in chronic pain","The level and pattern of daily activities performed by persons with chronic pain are regarded as central determinants of their overall physical, social and emotional functioning. Within the chronic pain literature, various approaches to activity are typically considered, including activity avoidance, ""pacing"", and particular patterns of high rate activity, sometimes referred to as ""overuse"" or ""activity cycling"". Of these, activity avoidance has been most studied, while the others remain poorly understood. The purpose of this investigation was to examine distinct activity patterns of chronic pain sufferers, and to consider their relations with physical, social, and emotional functioning. Based on data from 276 individuals with chronic pain, four distinct activity patterns were identified with cluster analysis. Correlation and group comparison analyses confirmed that patients who avoid activity suffer greater physical disability and distress. Surprisingly, pacing activity was positively related to avoidance and disability. Patients who reported relatively high activity in conjunction with little avoidance demonstrated distinctly better physical and emotional functioning than other groups. Pain did not distinguish groups to a large extent but acceptance of pain did. Groups with the most avoidance and disability reported the lowest levels of acceptance of pain. These data suggest that activity patterns are complex and multidimensional, and that avoidance appears to be the overriding process with regard to daily functioning. Moreover, avoidance patterns may be subtle, sometimes resembling healthy coping, and sometimes presenting along side patterns of high activity. © 2006 International Association for the Study of Pain.",McCracken L.M.; Samuel V.M.,2007.0,10.1016/j.pain.2006.11.016,0,0,
6998,"Effect of mountain climbing on physical quality, psychological quality and psychological health of college students","Aim: To study the effect of mountain climbing affecting college student's physical quality, psychological quality and psychological health, explore health efficacy of mountain climbing and draw college's attention to mountain climbing activity. Methods: The trainer picked up 313 students from Heyuan Vocational Technical College at random, including 65 boys and 248 girls, were experimental subjects for this experiment from September 2003 to July 2004. 1 The climbing route was a road for local people's exercise around a mountain with 683 meters above sea level. There were 5 climbing routes, each was about 2.5 km long and stone road contained no less than 2 000 steps. Before climbing the mountain, the trainer stated the aim and requirement of mountain climbing to the trainees and let them do some preparing activities for 10 minutes. In order to enforce the psychological efficacy of mountain climbing, the trainees were requested to shout out and talk with the air after reaching the top. Exercise was organized for trainees 3 times a week, and they were required to record what they felt. 2 Constitution test included stature, weight, vital capadity, pulse, patience controlling running and so on. 3 Psychological quality was tested by adopting self-made measuring table, consisting of 4 factors (self-respect and self-confidence, attitude of interest, will quality and emotion controlling) in 5 ranks. The higher the marks were, the better the situation was. 4 Psychological quality test adopted SCL-90 questionnaire of 9 factors: somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paraniod ideation and psychoticism. Five degrees were adopted, the higher the marks were, the worse the situation was. Results: All 313 students completed the one-year mountain climbing and answered the questionnaire completely. All results were analyzed. 1 Change of physical quality: After one-year's mountain climbing exercise, there were significant differences in boy trainees' and girl trainees' pulse, vital capacity, patience controlling running and body mass index (t = -7.28 to 3.82, P < 0.01; t =-10.60 to 9.92, P < 0.01). 2 Change of psychological quality: After one-year's mountain climbing exercise, there were significant improvements about boy trainees' and girl trainees' self-respect and self-confidence, attitude of interest, will quality and emotion controlling (t =-4.37 to -2.84, P < 0.01). 3 Change of psychological health: After one-years mountain climbing exercise, there were positive changes about each factor in the SCL-90 for the trainees. There were significant differences about somatization, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety and psychoticism (t=2.06-4.92, P < 0.05 or 0.01). Conclusion: Mountain climbing exercise plays an important role to strengthen the college student's physical quality, psychological quality and psychological health. As for starching, wakening and developing the human thought, spirit and body, the health efficacy of mountain climbing is from the theorem of enjoyment-chastening and soul-regres.",Liu B.-Q.; Qiu Y.,2007.0,,0,0,
6999,"What's the Use of Being Happy? Mood States, Useful Objects, and Repetition Priming Effects","Two experiments involving 99 undergraduate participants sought to examine the influence of mood states on encoding speed within lexical decision and pronunciation tasks. Mood states were measured naturalistically in Experiment 1 and manipulated in Experiment 2. Stimuli consisted of nouns representing useful (e.g., food) and nonuseful (e.g., lint) objects. Mood states had no implications for initial encoding speed. However, when the same words were presented a 2nd time (i.e., repeated), happy individuals displayed a tendency to encode useful words faster than nonuseful ones. Thus, mood states influenced repetition priming on the basis of stimulus valence. The authors propose that happiness sensitizes individuals to useful or rewarding objects, which in turn creates a stronger memory trace for such stimuli in the future. © 2007 American Psychological Association.",Goetz M.C.; Goetz P.W.; Robinson M.D.,2007.0,10.1037/1528-3542.7.3.675,0,0,
7000,Does magical thinking produce neutralising behaviour? An experimental investigation,"Magical thinking is of relevance to obsessive compulsive disorder (OCD), and has been most widely investigated in relation to the cognitive bias known as thought-action fusion (TAF). This is seen as playing a role in the formation of fears about responsibility for harm. We suggest that magical thinking may also characterise some types of neutralising behaviour, which arise in response to those fears, and are a hallmark of the disorder. In an experimental study of 51 undergraduate students, we assessed whether the use of neutralising behaviours in response to an induction of fears of increasing likelihood for harm is related to a propensity for magical thinking. The 75.5% of participants demonstrated at least one form of neutralising behaviour in response to a TAF-induction task. Neutralising was associated with stronger and more persistent responses to the task, and with questionnaire measures of magical ideation. Those who neutralised did not report higher levels of OCD symptoms. It appears that neutralising is a common response in circumstances that provoke a sense of responsibility for harm. Its occurrence may be linked to magical thinking, however, the results from this experimental investigation suggested that this process may not be specific to OCD. © 2007 Elsevier Ltd. All rights reserved.",Bocci L.; Gordon P.K.,2007.0,10.1016/j.brat.2007.02.003,0,0,
7001,Sex Differences in Neural Responses to Disgusting Visual Stimuli: Implications for Disgust-Related Psychiatric Disorders,"Background: A majority of patients with disgust-related psychiatric disorders such as animal phobias and contamination-related obsessive-compulsive disorder are women. The aim of this functional magnetic resonance imaging (fMRI) study was to examine possible sex differences in neural responses to disgust-inducing stimuli that might help explain this female predominance. Methods: Thirty-four healthy adult volunteers (17 women, all right-handed) were scanned while viewing alternating blocks of disgusting and neutral pictures from the International Affective Picture System. Using a partially-silent fMRI sequence, the participants rated their level of discomfort after each block of pictures. Skin conductance responses (SCR) were measured throughout the experiment. All participants completed the Disgust Scale. Results: Both women and men reported greater subjective discomfort and showed more SCR fluctuations during the disgusting picture blocks than during the neutral picture blocks. Women and men also demonstrated a similar pattern of brain response to disgusting compared with neutral pictures, showing activation in the anterior insula, ventrolateral and dorsolateral prefrontal cortices, and visual regions. Compared with men, women had significantly higher disgust sensitivity scores, experienced more subjective discomfort, and demonstrated greater activity in left ventrolateral prefrontal regions. However, these differences were no longer significant when disgust sensitivity scores were controlled for. Conclusions: In healthy adult volunteers, there are significant sex-related differences in brain responses to disgusting stimuli that are irrevocably linked to greater disgust sensitivity scores in women. The implications for disgust-related psychiatric disorders are discussed. © 2007 Society of Biological Psychiatry.",Caseras X.; Mataix-Cols D.; An S.K.; Lawrence N.S.; Speckens A.; Giampietro V.; Brammer M.J.; Phillips M.L.,2007.0,10.1016/j.biopsych.2006.10.030,0,0,
7002,Recall of Fear Extinction in Humans Activates the Ventromedial Prefrontal Cortex and Hippocampus in Concert,"Background: Extinction of conditioned fear is thought to form a new safety memory that is expressed in the context in which the extinction learning took place. Rodent studies implicate the ventromedial prefrontal cortex (vmPFC) and hippocampus in extinction recall and its modulation by context, respectively. The aim of the present study is to investigate the mediating anatomy of extinction recall in healthy humans. Methods: We used event-related functional magnetic resonance imaging (fMRI) and a 2-day fear conditioning and extinction protocol with skin conductance response as the index of conditioned responses. Results: During extinction recall, we found significant activations in vmPFC and hippocampus in response to the extinguished versus an unextinguished stimulus. Activation in these brain regions was positively correlated with the magnitude of extinction memory. Functional connectivity analysis revealed significant positive correlation between vmPFC and hippocampal activation during extinction recall. Conclusions: These results support the involvement of the human hippocampus as well as vmPFC in the recall of extinction memory. Furthermore, this provides a paradigm for future investigations of fronto-temporal function during extinction recall in psychiatric disorders such as posttraumatic stress disorder. © 2007 Society of Biological Psychiatry.",Milad M.R.; Wright C.I.; Orr S.P.; Pitman R.K.; Quirk G.J.; Rauch S.L.,2007.0,10.1016/j.biopsych.2006.10.011,0,0,
7003,Structure analysis of the protein translocating channel TatA in membranes using a multi-construct approach,"The twin-arginine-translocase (Tat) can transport proteins in their folded state across bacterial or thylakoid membranes. In Bacillus subtilis the Tat-machinery consists of only two integral (inner) membrane proteins, TatA and TatC. Multiple copies of TatA are supposed to form the transmembrane channel, but little structural data is available on this 70-residue component. We used a multi-construct approach for expressing several characteristic fragments of TatAd, to determine their individual structures and to cross-validate them comprehensively within the architecture of the full-length protein. Here, we report the design, high-yield expression, detergent-aided purification and lipid-reconstitution of five constructs of TatAd, overcoming difficulties associated with the very different hydrophobicities and sizes of these membrane protein fragments. Circular dichroism (CD) and oriented CD (OCD) were used to determine their respective conformations and alignments in suitable, negatively charged phospholipid bilayers. CD spectroscopy showed an N-terminal α-helix, a central helical stretch, and an unstructured C-terminus, thus proving the existence of these secondary structures in TatAd for the first time. The OCD spectra demonstrated a transmembrane orientation of the N-terminal α-helix and a surface alignment of the central amphiphilic helix in lipid bilayers, thus supporting the postulated topology model and function of TatA as a transmembrane channel. © 2007 Elsevier B.V. All rights reserved.",Lange C.; Müller S.D.; Walther T.H.; Bürck J.; Ulrich A.S.,2007.0,10.1016/j.bbamem.2007.06.021,0,0,
7004,"Acculturative Stress, Social Support, and Coping: Relations to Psychological Adjustment Among Mexican American College Students","This study examined the relations between acculturative stress and psychological functioning, as well as the protective role of social support and coping style, in a sample of 148 Mexican American college students (67% female, 33% male; mean age = 23.05 years, SD = 3.33). In bivariate analyses, acculturative stress was associated with higher levels of anxiety and depressive symptoms. Moreover, active coping was associated with better adjustment (lower depression), whereas avoidant coping predicted poorer adjustment (higher levels of depression and anxiety). Tests of interaction effects indicated that parental support and active coping buffered the effects of high acculturative stress on anxiety symptoms and depressive symptoms. In addition, peer support moderated the relation between acculturative stress and anxiety symptoms. Implications for reducing the effects of acculturative stress among Mexican American college students are discussed. © 2007 American Psychological Association.",Crockett L.J.; Iturbide M.I.; Torres Stone R.A.; McGinley M.; Raffaelli M.; Carlo G.,2007.0,10.1037/1099-9809.13.4.347,0,0,
7005,Salivary cortisol levels and mood vary by lifetime trauma exposure in a sample of healthy women,"The authors examined the effects of lifetime trauma exposure on salivary cortisol and mood in a sample of women (N = 37) over 25 days before and after a stressful event. The sample excluded posttraumatic stress disorder (PTSD) and major depression and was divided into three groups: (a) no trauma, (b) prior trauma with no peritraumatic symptoms of acute distress, and (c) prior trauma with peritraumatic symptoms. Because results indicated no significant differences between groups one and two, they were combined for analysis. Women reporting prior trauma with symptoms had lower afternoon cortisol levels across time, with sustained negative mood relative to the comparison group. These data suggest the presence of long-term psychophysiological effects of trauma exposure in healthy women. © 2007 International Society for Traumatic Stress Studies.",Ganzel B.L.; Eckenrode J.J.; Kim P.; Wethington E.; Horowitz E.; Temple E.,2007.0,10.1002/jts.20287,0,0,
7006,Impulsive decision-making: Learning to gamble wisely?,"A decade ago, Bechara et al. [Bechara, A., Damasio, A. R., Damasio, H., & Anderson, S. W. (1994). Insensitivity to future consequences following damage to human prefrontal cortex. Cognition, 50, 7-15] published a paper in Cognition, introducing a Gambling Task which was designed to mimic everyday decision-making. Since then, the task has been computerized, its decision-making components have been scrutinized, and it has been employed in various patient groups, such as pathological gamblers, substance abusers, and so forth. Time and again it has been shown that while normal controls perform well on the task, it is the various target populations under scrutiny who exhibit poor performance. Yet, as we show in this paper, a total of 46% of normal individuals exhibited poor performance on the task, indicating a lack of learning. We argue that while so much importance has been placed on contrasting patients with controls, perhaps the real emphasis should lie in distinguishing among different individual profiles of performance on the task, irrespective of clinical classification. Our basic recommendation is to look at the individual data, pool when you can, and only then to contrast groups. © 2006 Elsevier B.V. All rights reserved.",Glicksohn J.; Naor-Ziv R.; Leshem R.,2007.0,10.1016/j.cognition.2006.08.003,0,0,
7007,Interoceptive fear conditioning as a learning model of panic disorder: An experimental evaluation using 20% CO2-enriched air in a non-clinical sample,"Despite the role afforded interoceptive fear conditioning in etiologic accounts of panic disorder, there are no good experimental demonstrations of such learning in humans. The aim of the present study was to evaluate the interoceptive conditioning account using 20% carbon dioxide (CO2)-enriched air as an interoceptive conditioned stimulus (CS) (i.e., physiologically inert 5-s exposures) and unconditioned stimulus (US) (i.e., physiologically prepotent 15-s exposures). Healthy participants (N=42) were randomly assigned to one of three conditions: a CS-only, contingent CS-US pairings, or unpaired/non-contingent CS and US presentations. Electrodermal and self-report (e.g., distress, fear) served as indices of conditioned emotional responding. Results showed greater magnitude electrodermal and evaluative fear conditioning in the paired relative to the CS-only condition. The explicitly unpaired condition showed even greater electrodermal and evaluative responding during acquisition, and marked resistance to extinction. The latter results are consistent with the possibility that the unpaired procedure constituted a partial reinforcement procedure in which CO2 onset was paired with more extended CO2 exposure on 50% of the trials. Overall, the findings are consistent with contemporary learning theory accounts of panic. © 2007 Elsevier Ltd. All rights reserved.",Acheson D.T.; Forsyth J.P.; Prenoveau J.M.; Bouton M.E.,2007.0,10.1016/j.brat.2007.04.008,0,0,
7008,"Prevalence and Correlates of Depression, Anxiety, and Suicidality Among University Students","Mental health among university students represents an important and growing public health concern for which epidemiological data are needed. A Web-based survey was administered to a random sample at a large public university with a demographic profile similar to the national student population. Depressive and anxiety disorders were assessed with the Patient Health Questionnaire (R. L. Spitzer, K. Kroenke, J. B. W. Williams, & the Patient Health Questionnaire Primary Care Study Group, 1999). Nonresponse weights were constructed with administrative data and a brief nonrespondent survey. The response rate was 56.6% (N = 2,843). The estimated prevalence of any depressive or anxiety disorder was 15.6% for undergraduates and 13.0% for graduate students. Suicidal ideation in the past 4 weeks was reported by 2% of students. Students reporting financial struggles were at higher risk for mental health problems (odds ratios = 1.6-9.0). These findings highlight the need to address mental health in young adult populations, particularly among those of lower socioeconomic status. Campus communities reach over half of young adults and thus represent unique opportunities to address mental health issues in this important age group. © 2007 American Psychological Association.",Eisenberg D.; Gollust S.E.; Golberstein E.; Hefner J.L.,2007.0,10.1037/0002-9432.77.4.534,0,0,
7009,Factors linked to distress in mothers of children disclosing sexual abuse,"The aim of the present study is to investigate the variability in clinical level of psychological distress experienced by mothers of sexually abused children by exploring the role of (a) abuse-related variables (length, severity, and identity of perpetrator), (b) a history of childhood sexual abuse and partner violence experienced in the past year, and (c) mothers' coping and feelings of empowerment. Data were collected through self-report measures completed by 149 French-speaking mothers of girls aged 4 to 12 years disclosing sexual abuse. Results revealed that more than half of the mothers reported clinical levels of psychological distress and experienced child sexual abuse, and 1 of 4 mothers experienced physical partner violence. Logistic regression analysis revealed that mother's sexual abuse and partner violence as well as avoidance coping and empowerment contributed to scores reaching clinical levels of psychological distress. In addition, mothers of child victims of intrafamilial sexual abuse are more likely to report clinical levels of distress. Results underscore the importance of evaluating for trauma history and taking coping strategies and empowerment into account in treatment interventions. © 2007 Lippincott Williams & Wilkins, Inc.",Hébert M.; Daigneault I.; Collin-Vézina D.; Cyr M.,2007.0,10.1097/NMD.0b013e3181568149,0,0,
7010,The role of drinking motives in social anxiety and alcohol use,"Although social anxiety and problem drinking commonly co-occur, the relationship between social anxiety and drinking among college students is not well understood. The current study examined the relationship between drinking motives, or reasons for drinking, and social anxiety in 239 volunteers. Contrary to hypotheses, high (n = 83), moderate (n = 90), and low (n = 66) social anxiety groups did not differ in endorsement of coping and conformity drinking motives. Further, social anxiety was negatively related to weekly alcohol use and unrelated to alcohol-related problems. Post hoc hierarchical multiple regression analyses conducted for each social anxiety group indicated that coping motives were related to greater alcohol use and problems for those in the high and moderate social anxiety groups, but not for the low social anxiety group. It appears that drinking motives, particularly coping motives, have promise in providing a greater understanding of the social anxiety-drinking relationship. Drinking motives could aid in identification of socially anxious students at risk for alcohol problems and inform intervention strategies. © 2007 Elsevier Ltd. All rights reserved.",Ham L.S.; Bonin M.; Hope D.A.,2007.0,10.1016/j.janxdis.2006.10.014,0,0,
7011,Subtypes of paranoia in a nonclinical sample,"Introduction. Previous research has proposed that there may be subtypes of paranoia with different patterns of performance on symptom and clinical measures. However, there has been little empirical examination of whether distinct subtypes actually exist. Recent research has suggested that paranoia can be found in normal individuals and exists on a continuum. Thus, it is possible that evidence for subtypes of paranoia can be derived from nonclinical samples. Methods. From a total of 723 participants, we identified 114 college students who showed elevated levels of paranoia as determined by two measures of paranoid ideation. The remaining sample of 609 persons served as the nonparanoid control group. All participants completed measures of depression, self-esteem, and social anxiety. Scores from the high subclinical group was subjected to cluster analysis to derive homogeneous subtypes. Participants also completed a measure of attributional style, the IPSAQ, which was used to validate the subtypes and was not used in the cluster analysis. Results. Based on the cluster analysis, three subtypes were derived. Each subtype showed a different pattern of scores on measures of depression, self-esteem, and anxiety. There were also additional differences on the externalising and personalising bias scores from the IPSAQ between the subtypes. Conclusions. We conclude that there is preliminary evidence for the presence of subtypes among nonclinical samples and discuss the patterns of performance in relation to previous research on subtypes of paranoia. The implications of these subtypes for the study of paranoia are discussed. © 2007 Psychology Press.",Combs D.R.; Penn D.L.; Chadwick P.; Trower P.; Michael C.O.; Basso M.R.,2007.0,10.1080/13546800701707306,0,0,
7012,Predictors of post-event rumination related to social anxiety,"Post-event processing is the cognitive rumination that follows social events in cognitive models of social anxiety. The aim of this study was to examine factors that may predict the extent to which individuals engage in post-event processing. Anxious rumination, social anxiety, anxiety sensitivity and post-event processing related to a recent anxiety-provoking social event were assessed in a college student sample (n = 439). Social anxiety and anxious rumination, but not anxiety sensitivity, significantly predicted the extent to which the participants engaged in post-event processing related to an anxiety-provoking social event. Factors that appear to impact on the post-event period include the nature of the social situation and the ethnicity of the participant. It appears that both general rumination over anxious symptoms, and specific rumination related to social events are relevant for cognitive models of social anxiety.",Kocovski N.L.; Rector N.A.,2007.0,10.1080/16506070701232090,0,0,
7013,Secondary traumatic stress: Personality and shattered assumptions,"Trauma has received a great deal of attention in recent years. One line of research in this field focuses on the importance of personality variables in the resistance and vulnerability to trauma (Figley, 1995) and on the consequences of trauma on emergency professionals (Stamm, 2002). The purpose of this study was to examine in a sample of 419 emergency professionals the role of several personality variables (empathy, comprehensibility, challenge and sense of humor) as moderators of the relationship between job demands (traumatic task and overload) with shattered assumptions (Janoff-Bulman, 1992). Secondary traumatic stress was measured with measured with Secondary Traumatic Stress Measure (Moreno et al., 2004). Results indicate these personality variables seem to have an important role in the change of assumptions process. Finally, further implications of the findings are discussed.",Moreno Jiménez B.; Morante Benadero M.E.; Stamm B.H.; Sanz Vergel A.I.,2007.0,,0,0,
7014,"Optimism, self-efficacy and information processing of threat- and well-being-related stimuli","The purpose of this study was to examine whether information bias associated with dispositional optimism and generalized self-efficacy can account for the link between general expectations and well-being. A modified Stroop task was used in this study. Our hypothesis was that individuals with high self-efficacy expectations or dispositional optimism would show greater bias towards well-being-related stimuli, whereas individuals with low self-efficacy or optimism would exhibit bias towards threat-related stimuli. A secondary hypothesis was that both self-efficacy and optimism would act as mediators of the latency, perceived distress relationship. One hundred and two undergraduate students participated in the study. After controlling for daily mood, the results showed that individuals high in optimism and self-efficacy showed greater informational bias towards well-being-related stimuli. The low self-efficacy group exhibited greater bias towards threat-related stimuli. Also, consistent with our hypothesis, optimism and self-efficacy mediated the relationship between the Stroop colour-naming latencies and perceived distress. These findings suggest that associations, which refer to automatic processes, may form an additional way through which expectations are related to functioning. Copyright © 2007 John Wiley & Sons, Ltd.",Karademas E.C.; Kafetsios K.; Sideridis G.D.,2007.0,10.1002/smi.1147,0,0,
7015,The relationship between past traumatic experience and sickness absence,"Background: Past traumatic experiences have been reported to lower stress tolerance, thereby increasing job strain. However, the relationship between past traumatic experiences and employee sickness absence is poorly understood. Aims: This study explores the relationship between sickness absence and past traumatic experience with regard to the amount of time lapsed after the experience, job strain and other mental health states such as depression and anxiety. Methods: A total of 3238 workers were assessed for levels of traumatic stress, depressive status, anxiety and job stress. Results: Odds ratios of the presence of traumatic experiences to sickness absence, adjusted for sex, age and depressive and anxiety states, were presented according to the length of time that had passed since the traumatic events. The odds ratio in the 0-1 Years Group was 1.75 (p < 0.05), and the odds ratio for the 19+ Years Group was 1.46 (p < 0.1). Conclusions: Past traumatic events are related to sickness absence. Sickness absence resulting from a past traumatic experience is important with respect to industrial health. © Sage Publications 2008.",Izutsu T.; Shibuya M.; Tsutsumi A.; Konishi T.; Kawamura N.,2008.0,10.1177/0020764007083874,0,0,
7016,Christian religious functioning and trauma outcomes,"While some trauma survivors find their faith helpful in recovery, others find it a source of distress, and still others abandon their faith. More complex conceptualizations of religious functioning are needed to explore its relationship with trauma. This study explores such relationships using measures of religious action and behaviors in a community sample of 327 church-going, self-identified trauma survivors. A principal components analysis of positive and negative religious coping, religious comforts and strains, and prayer functions identified two dimensions: Seeking Spiritual Support, which was positively related to posttraumatic growth, and Religious Strain, which was positively related to posttraumatic symptoms. © 2007 Wiley Periodicals, Inc.",Harris J.I.; Erbes C.R.; Engdahl B.E.; Olson R.H.A.; Winskowski A.M.; McMahill J.,2008.0,10.1002/jclp.20427,0,0,
7017,Fear of childbirth: Predictors and temporal changes among nulliparous women in the Danish National Birth Cohort,"Objectives: To describe the association between fear of childbirth and social, demographic and psychological factors in a cohort of 30 480 healthy nulliparous women with uncomplicated singleton pregnancies. Design: Nationwide population-based study. Setting: The Danish National Birth Cohort. Population: Healthy nulliparous women (n = 30 480) with singleton pregnancies. Methods: Data from computer-assisted telephone interviews twice in pregnancy linked with national health registers. Main outcome measures: Characteristics of women with fear of childbirth in early (mean, 16 weeks) and late pregnancy (mean, 32 weeks) and changes in fear of childbirth between 1997 and 2003. Results: Low educational level, lack of a social network, young age and unemployment were associated with fear of childbirth, as were being a smoker and having low self-rated health. The odds ratio for fear of childbirth among women with anxiety symptoms was 4.8 (4.1-5.7) after adjustment for socio-demographic, lifestyle, fertility and depression variables. During the study period, the prevalence of fear of childbirth was stable. Fear of childbirth was reported by 7.6% in early pregnancy and 7.4% in late pregnancy. Only 3.2% of the women expressed fear of childbirth in both interviews. Conclusions: The prevalence of fear of childbirth among healthy nulliparous women with singleton pregnancies did not increase during the study period. Fear of childbirth among nulliparous women was most often seen in individuals with few social and psychological resources. Testing the women twice, we found the same prevalence of fear in early and late pregnancy, but found that half the women who expressed fear during early pregnancy had no fear later in pregnancy, an effect that was counterbalanced by a similar number of women who became fearful between the two interviews. © 2008 The Authors.",Laursen M.; Hedegaard M.; Johansen C.,2008.0,10.1111/j.1471-0528.2007.01583.x,0,0,
7018,"Distress, coping, and blogging: Comparing new myspace users by their intention to blog","New Myspace.com users (N = 134, mean age 24.5 years) completed a questionnaire about their intent to blog and several psychosocial variables. Intending bloggers scored higher on psychological distress, self-blame, and venting and scored lower on social integration and satisfaction with number of online and face-to-face friends. Intending bloggers may view this activity as a potential mechanism for coping with distress in situations in which they feel inadequately linked with social supports. © 2008 Mary Ann Liebert, Inc.",Baker J.R.; Moore S.M.,2008.0,10.1089/cpb.2007.9930,0,0,
7019,The value of RCT evidence depends on the quality of statistical analysis,"The authors examined statistical practices in 193 randomized controlled trials (RCTs) of psychological therapies published in prominent psychology and psychiatry journals during 1999-2003. Statistical significance tests were used in 99% of RCTs, 84% discussed clinical significance, but only 46% considered-even minimally-statistical power, 31% interpreted effect size and only 2% interpreted confidence intervals. In a second study, 42 respondents to an email survey of the authors of RCTs analyzed in the first study indicated they consider it very important to know the magnitude and clinical importance of the effect, in addition to whether a treatment effect exists. The present authors conclude that published RCTs focus on statistical significance tests (""Is there an effect or difference?""), and neglect other important questions: ""How large is the effect?"" and ""Is the effect clinically important?"" They advocate improved statistical reporting of RCTs especially by reporting and interpreting clinical significance, effect sizes and confidence intervals. © 2007 Elsevier Ltd. All rights reserved.",Faulkner C.; Fidler F.; Cumming G.,2008.0,10.1016/j.brat.2007.12.001,0,0,
7020,"Effect of time of preparation on pentagastrin-induced symptom, endocrine and cardiovascular responses","Pentagastrin is a cholecystokinin (CCK)-B agonist and laboratory panicogenic agent that produces endocrine (ACTH and cortisol), symptom (anxiety, panic) and cardiovascular (heart rate) responses. Although in vitro data have supported its chemical stability, preliminary data suggested that increasing time between drug preparation and drug infusion could reduce the magnitude of endocrine and symptom responses. The current study examined this possibility. Twenty-one healthy subjects presented at the University of Michigan General Clinical Research Center (GCRC) and had an intravenous catheter inserted. Heart rate, cortisol levels and subjective anxiety were measured before and after pentagastrin and placebo injections. Pentagastrin was prepared either within 60 min of IV infusion (Normal Preparation group) or at least 3.5 h prior to infusion (Early Preparation group). Relative to the Normal Preparation group, Early Preparation subjects had similar heart rate responses but significantly smaller cortisol and subjective anxiety responses. Early preparation of pentagastrin thus appears to weaken endocrine and subjective anxiety responses, highlighting the importance of attending to often overlooked procedural variables (e.g., time between preparation and administration) in studies of this type. The sensitivity of cortisol and anxiety responses to preparation time, but insensitivity of heart rate, is consistent with previous studies suggesting different thresholds of activation for the three response modalities. These differential sensitivities may suggest different and separable CCK-B stimulated pathways for each response, which combine to produce panic, rather than a single, unified CCK-B mediated panicogenic response. © 2007 Elsevier Ireland Ltd. All rights reserved.",Khan S.; Briggs H.; Abelson J.L.,2008.0,10.1016/j.psychres.2007.10.020,0,0,
7021,Breast cancer and psychological distress: Mothers' and daughters' traumatic experiences,"Goal of work: The objective of this exploratory retrospective study was to assess the effects of breast cancer diagnosis upon the psychological distress of adult breast cancer patients and their mothers, particularly mothers who experienced past trauma. Materials and methods: Four groups of mother-daughter dyads were evaluated using self-reporting measures of psychological distress [Brief Symptom Inventory (BSI)], familial support (PFS), and adjustment to cancer (MAC, IES): breast cancer patients whose mothers were Holocaust survivors (group 1), breast cancer patients with non-traumatized mothers (group 2), healthy daughters of Holocaust survivor mothers (group 3), and a control group of healthy daughters with non-traumatized mothers (group 4). Main results: Distress levels of both mothers and daughters in group 1 were significantly higher than distress levels of mothers and daughters in the other three groups. Daughters' distress levels in all four groups were found to be significantly related to mothers' distress levels, with the highest correlation found in both groups of cancer patients. The factors of having a clinically distressed mother and being a second-generation daughter contributed the most to predicting the clinical distress of the daughter. Conclusions: The outcomes imply that the mother's traumatic past intensifies the distressing effect of cancer diagnosis upon both the patient and her mother. The findings concerning the impact of cancer diagnosis upon the patients' non-traumatized mothers were more ambiguous. The results support the idea that in the case of breast cancer patients, a complete psychological evaluation must include not only spouses and children but also the familial background of the patient and the history of the patients' mothers. © 2007 Springer-Verlag.",Baider L.; Goldzweig G.; Ever-Hadani P.; Peretz T.,2008.0,10.1007/s00520-007-0320-1,0,0,
7022,Gender differences in the mu rhythm of the human mirror-neuron system,"Background: Psychologically, females are usually thought to be superior in interpersonal sensitivity than males. The human mirror-neuron system is considered to provide the basic mechanism for social cognition. However, whether the human mirror-neuron system exhibits gender differences is not yet clear. Methodology/Principal Findings: We measured the electroencephalographic mu rhythm, as a reliable indicator of the human mirror-neuron system activity, when female (N=20) and male (N=20) participants watched either hand actions or a moving dot. The display of the hand actions included androgynous, male, and female characteristics. The results demonstrate that females displayed significantly stronger mu suppression than males when watching hand actions. Instead, mu suppression was similar across genders when participants observed the moving dot and between the perceived sex differences (same-sex vs. opposite-sex). In addition, the mu suppressions during the observation of hand actions positively correlated with the personal distress subscale of the interpersonal reactivity index and negatively correlated with the systemizing quotient. Conclusions/Significance: The present findings indirectly lend support to the extreme male brain theory put forward by Baron-Cohen (2005), and may cast some light on the mirror-neuron dysfunction in autism spectrum disorders. The mu rhythm in the human mirror-neuron system can be a potential biomarker of empathic mimicry. © 2008 Cheng et al.",Cheng Y.; Lee P.-L.; Yang C.-Y.; Lin C.-P.; Hung D.; Decety J.,2008.0,10.1371/journal.pone.0002113,0,0,
7023,Age-Related Differences in Switching Between Cognitive Tasks: Does Internal Control Ability Decline With Age?,"The present study tested the hypothesis that older adults establish a weaker task set than younger adults and therefore rely more on stimulus-triggered activation of task sets. This hypothesis predicts that older adults should have difficulty with task switches, especially when the stimuli-responses are associated with multiple, competing tasks. Weak task preparation, however, could actually benefit older adults when performing an unexpected task. The authors tested this prediction in Experiment 1 using a repeating AABB task sequence, with univalent and bivalent stimuli intermixed. On some univalent trials, participants received an unexpected task. Contrary to the authors' predictions, expectancy costs were not smaller for older adults. Similar findings were obtained in Experiments 2 and 3, in which the authors used a task-cueing paradigm to more strongly promote deliberate task preparation. The authors found no disproportionate age effects on switch costs but did find age effects on bivalence costs and mixing costs. The authors conclude that older adults do experience extra difficulty dealing with stimuli associated with 2 active tasks but found no evidence that the problem specifically stems from an increased reliance on bottom-up task activation rather than top-down task preparation. © 2008 American Psychological Association.",Lien M.-C.; Ruthruff E.; Kuhns D.,2008.0,10.1037/0882-7974.23.2.330,0,0,
7024,Decreased differential activity in the amygdala in response to fearful expressions in Type D personality,"Recent advances in functional brain imaging offer unique opportunities to explore the neurofunctional basis of tools used to assess personality differences which have proven their clinical usefulness. In this functional magnetic resonance imaging (fMRI) study, the focus was on the amygdala activation and we investigated whether individual differences in activity of the amygdala following presentation of emotional expressions in the face and the whole body may be systematically related to the presence of Type D (distressed) personality or to its constituting factors, Negative Affectivity (NA) and Social Inhibition (SI). Our results show that the observed difference in amygdala activity between fearful and neutral expressions was present in participants that did not meet the criteria for Type D personality, while this effect was absent in participants that could be classified as Type D personality. Our correlation analyses further showed that the activation in the left amygdala elicited by fearful versus neutral bodily expressions correlated negatively with the Negative Affectivity score. The same pattern was observed for the right amygdala for fearful facial and bodily expressions when contrasted with neutral facial and bodily expressions. © 2008 Elsevier Masson SAS. All rights reserved.",de Gelder B.; van de Riet W.A.C.; Grèzes J.; Denollet J.,2008.0,10.1016/j.neucli.2008.03.002,0,0,
7025,Effects of Acceptance-Oriented Versus Evaluative Emotional Processing on Heart Rate Recovery and Habituation,"The effects of emotional processing on stress response trajectories may depend on the nature of processing, as evaluative rumination about emotions can prolong distress. In contrast, observing negative emotions in an accepting manner may promote efficient recovery from stressful situations. The present study examined the effect of acceptance-oriented versus evaluative emotional processing on cardiovascular habituation and recovery. Across two experimental sessions, 81 participants were randomly assigned to write about an ongoing stressful experience while either (1) evaluating the appropriateness of their emotional response (EVAL), (2) attending to their emotions in an accepting way (ACC), or (3) describing the objective details of the experience (CTL). Heart rate was assessed continuously throughout baseline, writing, and recovery. Results suggest that writing about emotions in an evaluative way leads to less efficient heart rate habituation and recovery than processing emotions in an accepting manner. These findings highlight a potential mechanism of mindfulness- and acceptance-based interventions' effects on health outcomes and further suggest that habitually evaluating the appropriateness of one's emotional responses rather than accepting them as they unfold may have consequences for cardiovascular health. © 2008 American Psychological Association.",Low C.A.; Stanton A.L.; Bower J.E.,2008.0,10.1037/1528-3542.8.3.419,0,0,
7026,Attentional biases in social anxiety: An investigation using the inattentional blindness paradigm,"One line of research has examined attentional bias as a potential maintenance factor in social anxiety using cognitive experiment paradigms. The present study sought to examine the utility of the inattentional blindness (IB) paradigm for assessing attentional bias in social anxiety. Unlike other existing paradigms such as the emotional Stroop or dot-probe tasks, the IB paradigm has the advantage of eliminating the individual's expectation and intention to search for social cues, which would reduce strategic or effortful responses. Two independent experiments were conducted using college students scoring high or low on the Fear of Negative Evaluation Scale. In both Experiments 1 and 2, participants were randomized to one of three IB experiment conditions, in which a positive face, a negative face, or a neutral item was unexpectedly presented, in the presence/absence of a bogus-speech threat. The overall pattern of our data suggests the presence of hypervigilant attentional processing in social anxiety. The IB paradigm appears to be a useful addition to existing experiment paradigms for investigating attentional bias in social anxiety and perhaps other psychopathology. © 2008 Elsevier Ltd. All rights reserved.",Lee H.-J.; Telch M.J.,2008.0,10.1016/j.brat.2008.04.001,0,0,
7027,A preliminary look at loneliness as a moderator of the link between perfectionism and depressive and anxious symptoms in college students: Does being lonely make perfectionistic strivings more distressing?,"An integrative model involving perfectionism [Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456-470] and loneliness as predictors of depressive and anxious symptoms was proposed and tested in 383 college students. Beyond the expected additive influences of the two predictors in the prediction of symptoms, loneliness was also hypothesized to moderate the link between perfectionism and symptoms. Results indicated that other-oriented perfectionism predicted anxious symptoms, whereas socially prescribed perfectionism predicted both depressive and anxious symptoms. Loneliness was found to add incremental validity to these predictions. Moreover, the Perfectionism×Loneliness interaction was found to further augment the prediction of depressive and anxious symptoms. These findings are taken to offer support for a more contextual model of perfectionism. Some implications of the present findings are discussed. © 2008 Elsevier Ltd. All rights reserved.",Chang E.C.; Sanna L.J.; Chang R.; Bodem M.R.,2008.0,10.1016/j.brat.2008.03.012,0,0,
7028,"Inferential confusion, obsessive beliefs and obsessive-compulsive symptoms: A multidimensional investigation of cognitive domains","Generally, research into the relationship between cognitive domains and obsessive-compulsive symptoms involves the use of scales that are highly intercorrelated with each other. The current study investigates the relationship between cognitive constructs and obsessive-compulsive symptoms using the item set of the Obsessive Beliefs Questionnaire and the Inferential Confusion Questionnaire. In order to create constructs that would not be excessively correlated with each other, factor scores were used to investigate the relationship between cognitive domains and obsessive-compulsive symptoms. Factor analysis followed by oblique rotation resulted in four moderately correlated cognitive constructs (importance/control of thoughts, inferential confusion/threat estimation, perfectionism/certainty and responsibility for preventing harm). With the exception of responsibility for preventing harm, the cognitive constructs under investigation were quite strongly related to obsessive-compulsive symptoms. In particular, hierarchical regression revealed the construct inferential confusion/threat estimation to be a global and strong predictor of obsessive-compulsive symptoms, followed by the constructs of perfectionism/certainty and the construct importance/control. Responsibility for preventing harm acted to be a negative predictor of obsessive-compulsive symptoms. It is concluded that the construct of inferential confusion acts as a more powerful predictor of obsessive-compulsive symptoms than any specific obsessive belief. Copyright © 2008 John Wiley & Sons, Ltd.",Aardema F.; Radomsky A.S.; O'Connor K.P.; Julien D.,2008.0,10.1002/cpp.581,0,0,
7029,Implicit awareness of ambiguity: A role in the development of obsessive-compulsive disorder,"The cognitive-behavioral model of obsessive-compulsive disorder proposes that obsessional symptoms are the consequence of the manner in which intrusive cognitions are interpreted [e.g., Salkovskis, P. M. (1998). Cognitive-behavioral approach to understanding obsessional thinking. British Journal of Psychiatry, 173(35S), 53-63]. The present study suggests that this may be attributable to maladaptive implicit cognitive processing, a deficit that results in the explicit awareness of ambiguity in idiographic obsessive-compulsive disorder (OCD) stimuli. The present study examines decision-making responses of low and high OCD scorers in a non-clinical undergraduate sample. Via a computer console, participants were shown sentence statements for three levels of ambiguity. They were then presented with a propositional statement for which they had to indicate agreement or disagreement for sentences of varying ambiguity. After this, the participants indicated whether they were completely confident or unconfident as regards their previous agree-disagree decisions. Results indicate that the high compared to the low OCD scoring group had less agreement and subsequent less confidence in decisions made for sentences of varying ambiguity. Response latencies partially fitted the predicted hypotheses. Consequently, an addition to Salkovskis, Forester, and Richards' [1998. Cognitive-behavioral approach to understanding obsessional thinking. The British Journal of Psychiatry, 173(35S), 53-63] model of OCD is suggested: namely that an implicit ambiguity deficit mediates the likelihood of normally occurring intrusions developing into abnormal obsessions. Methodological limitations and future research are considered. © 2008 Elsevier Ltd. All rights reserved.",Harkin B.L.; Mayes G.M.,2008.0,10.1016/j.brat.2008.03.009,0,0,
7030,Polymorphisms in the FKBP5 gene region modulate recovery from psychosocial stress in healthy controls,"Mood and anxiety disorders are considered stress-related diseases characterized by an impaired function of mineralocorticoid and glucocorticoid receptors (MR and GR, respectively), the major regulatory elements of the hypothalamus-pituitary-adrenocortical (HPA) axis. A number of so-called chaperone proteins moderate the function of these receptors. Genetic variations in one of these chaperones, FKBP5, were associated with antidepressant treatment response in depression and with a major risk-factor for the development of posttraumatic stress disorder. To further investigate the effect of FKPB5 polymorphisms on corticosteroid receptor-mediated HPA axis regulation we conducted the Trier Social Stress test, a standardized procedure to evaluate psychosocial stress response, in 64 healthy volunteers. We genotyped rs4713916, rs1360780 and rs3800737, the three single nucleotide polymorphisms (SNPs) in the FKBP5 region which had shown the strongest effect in previous studies. In addition, we evaluated the effects of the GR polymorphisms Bcl1 and N363S as well as the MR polymorphism I180V. Subjects homozygous for any of the FKBP5 variants displayed an incomplete normalization of the stress-elicited cortisol secretion. This was also observed following a second test additionally accompanied by an increased self-reported anxiety. Regarding GR and MR, only carriers of the Bcl1 variant displayed an altered cortisol response in the prognosticated direction. While Bcl1 was predominantly associated with anticipatory cortisol, homozygous carriers of the FKBP5 minor allele showed insufficient cortisol recovery and increased self-reported anxiety after psychosocial stress. This reaction pattern suggests that subjects carrying these variants are at risk of displaying chronically elevated cortisol levels after repeated stress constituting a risk factor for stress-related diseases. © The Authors (2008).",Ising M.; Depping A.-M.; Siebertz A.; Lucae S.; Unschuld P.G.; Kloiber S.; Horstmann S.; Uhr M.; Müller-Myhsok B.; Holsboer F.,2008.0,10.1111/j.1460-9568.2008.06332.x,0,0,
7031,Anxiety in a socially high-risk sample of pregnant women in Canada,"Objective: To determine if an anxiety dimension in the Edinburgh Postnatal Depression Scale (EPDS) could be identified in a sample of pregnant women with high social risk factors. Method: Four hundred women attending prenatal outreach programs, most of whom were single, low-income, and Aboriginal, participated in a study of feelings in pregnancy. The primary outcome measure was the EPDS. Data were also collected on sociodemographic, obstetrical-biological, psychological, and behavioural variables. Results: Factor analysis of the EPDS revealed 3 factors: anxiety, depression, and self-harm. The anxiety factor accounted for the greatest variance in the overall EPDS score. Comparisons of different groups of women revealed significantly more anxiety in the women aged under 19 years, compared with those over 25 years (P < 0.01). Linear regression analysis showed anxiety was associated with age, stressors (that is, pregnancy, health of the baby, birth of the baby, money, and other), history of depression, and fluctuating moods. Conclusions: Anxiety symptoms were predominant in the emotional distress identified by the EPDS in this sample of socially high-risk pregnant women. Younger women appear to experience the highest levels of anxiety. Anxiety in pregnancy in socially high-risk women should not be normalized.",Bowen A.; Bowen R.; Maslany G.; Muhajarine N.,2008.0,,0,0,
7032,Affective primes suppress attention bias to threat in socially anxious individuals,"Anxious individuals show an attention bias towards threatening information. However, under conditions of sustained environmental threat this otherwise-present attention bias disappears. It remains unclear whether this suppression of attention bias can be caused by a transient activation of the fear system. In the present experiment, high socially anxious and low socially anxious individuals (HSA group, n=12; LSA group, n=12) performed a modified dot-probe task in which they were shown either a neutral or socially threatening prime word prior to each trial. EEG was collected and ERP components to the prime and faces displays were computed. HSA individuals showed an attention bias to threat after a neutral prime, but no attention bias after a threatening prime, demonstrating that suppression of attention bias can occur after a transient activation of the fear system. LSA individuals showed an opposite pattern: no evidence of a bias to threat with neutral primes but induction of an attention bias to threat following threatening primes. ERP results suggested differential processing of the prime and faces displays by HSA and LSA individuals. However, no group by prime interaction was found for any of ERP components. © 2008 Elsevier Ltd. All rights reserved.",Helfinstein S.M.; White L.K.; Bar-Haim Y.; Fox N.A.,2008.0,10.1016/j.brat.2008.03.011,0,0,
7033,"Effects of a standardized Bacopa monnieri extract on cognitive performance, anxiety, and depression in the elderly: A randomized, double-blind, placebo-controlled trial","Objectives: Study aims were to evaluate effects of Bacopa monnieri whole plant standardized dry extract on cognitive function and affect and its safety and tolerability in healthy elderly study participants. Design: The study was a randomized, double-blind, placebo-controlled clinical trial with a placebo run-in of 6 weeks and a treatment period of 12 weeks. Setting/location: Volunteers were recruited from the community to a clinic in Portland, Oregon by public notification. Subjects: Fifty-four (54) participants, 65 or older (mean 73.5 years), without clinical signs of dementia, were recruited and randomized to Bacopa or placebo. Forty-eight (48) completed the study with 24 in each group. Interventions: Standardized B. monnieri extract 300 mg/day or a similar placebo tablet orally for 12 weeks. Outcome measures: The primary outcome variable was the delayed recall score from the Rey Auditory Verbal Learning Test (AVLT). Other cognitive measures were the Stroop Task assessing the ability to ignore irrelevant information, the Divided Attention Task (DAT), and the Wechsler Adult Intelligence Scale (WAIS) letter-digit test of immediate working memory. Affective measures were the State-Trait Anxiety Inventory, Center for Epidemiologic Studies Depression scale (CESD)-10 depression scale, and the Profile of Mood States. Vital signs were also monitored. Results: Controlling for baseline cognitive deficit using the Blessed Orientation-Memory- Concentration test, Bacopa participants had enhanced AVLT delayed word recall memory scores relative to placebo. Stroop results were similarly significant, with the Bacopa group improving and the placebo group unchanged. CESD-10 depression scores, combined state plus trait anxiety scores, and heart rate decreased over time for the Bacopa group but increased for the placebo group. No effects were found on the DAT, WAIS digit task, mood, or blood pressure. The dose was well tolerated with few adverse events (Bacopa n = 9, placebo n = 10), primarily stomach upset. Conclusions: This study provides further evidence that B. monnieri has potential for safely enhancing cognitive performance in the aging. © 2008 Mary Ann Liebert, Inc.",Calabrese C.; Gregory W.L.; Leo M.; Kraemer D.; Bone K.; Oken B.,2008.0,10.1089/acm.2008.0018,0,0,
7034,Lack of analgesia by oral standardized cannabis extract on acute inflammatory pain and hyperalgesia in volunteers,"Background: Cannabinoid-induced analgesia was shown in animal studies of acute inflammatory and neuropathic pain. In humans, controlled clinical trials with Δ-tetrahydrocannabinol or other cannabinoids demonstrated analgesic efficacy in chronic pain syndromes, whereas the data in acute pain were less conclusive. Therefore, the aim of this study was to investigate the effects of oral cannabis extract in two different human models of acute inflammatory pain and hyperalgesia. Methods: The authors conducted a double-blind, crossover study in 18 healthy female volunteers. Capsules containing Δ- tetrahydrocannabinol-standardized cannabis extract or active placebo were orally administered. A circular sunburn spot was induced at one upper leg. Heat and electrical pain thresholds were determined at the erythema, the area of secondary hyperalgesia, and the contralateral leg. Intradermal capsaicin-evoked pain and areas of flare and secondary hyperalgesia were measured. Primary outcome parameters were heat pain thresholds in the sunburn erythema and the capsaicin-evoked area of secondary hyperalgesia. Secondary measures were electrical pain thresholds, sunburn-induced secondary hyperalgesia, and capsaicin-induced pain. Results: Cannabis extract did not affect heat pain thresholds in the sunburn model. Electrical thresholds (250 Hz) were significantly lower compared with baseline and placebo. In the capsaicin model, the area of secondary hyperalgesia, flare, and spontaneous pain were not altered. Conclusion: To conclude, no analgesic or antihyperalgesic activity of cannabis extract was found in the experiments. Moreover, the results even point to the development of a hyperalgesic state under cannabinoids. Together with previous data, the current results suggest that cannabinoids are not effective analgesics for the treatment of acute nociceptive pain in humans. Copyright © 2008 The American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc.",Kraft B.; Frickey N.A.; Kaufmann R.M.; Reif M.; Frey R.; Gustorff B.; Kress H.G.,2008.0,10.1097/ALN.0b013e31817881e1,0,0,
7035,Orbitofrontal dysfunction in patients with obsessive-compulsive disorder and their unaffected relatives,"Obsessive-compulsive disorder (OCD) is characterized by repetitive thoughts and behaviors associated with underlying dysregulation of frontostriatal circuitry. Central to neurobiological models of OCD is the orbitofrontal cortex, a neural region that facilitates behavioral flexibility after negative feedback (reversal learning). We identified abnormally reduced activation of several cortical regions, including the lateral orbitofrontal cortex, during reversal learning in OCD patients and their clinically unaffected close relatives, supporting the existence of an underlying previously undiscovered endophenotype for this disorder.",Chamberlain S.R.; Menzies L.; Hampshire A.; Suckling J.; Fineberg N.A.; Del Campo N.; Aitken M.; Craig K.; Owen A.M.; Bullmore E.T.; Robbins T.W.; Sahakian B.J.,2008.0,10.1126/science.1154433,0,0,
7036,A Longitudinal Investigation of Interpersonal Violence in Relation to Mental Health and Substance Use,"The authors examined longitudinally the mental health status of women as a function of different types and combinations of exposure to interpersonal violence. A structured telephone interview was administered to a household probability sample of 4,008 women (18-89 years of age), who were then recontacted for 1- and 2-year follow-up interviews. Interviews assessed lifetime violence history (i.e., sexual assault, physical assault, witnessed serious injury or violent death), past-year mental health functioning (i.e., posttraumatic stress disorder [PTSD], depression, and substance use problems), and new instances of violence occurring after the baseline interview. Results indicate that (a) lifetime violence exposure was associated with increased risk of PTSD, depression, and substance use problems; (b) odds of PTSD, depression, and substance use problems increased incrementally with the number of different types of violence experienced; (c) relations were fairly stable over a 2-year period; and (d) new incidents of violence between the baseline and follow-up interviews were associated with heightened risk of PTSD and substance use problems. Greater understanding of the cumulative impact of violence exposure will inform service provision for individuals at high risk. © 2008 American Psychological Association.",Hedtke K.A.; Ruggiero K.J.; Fitzgerald M.M.; Zinzow H.M.; Saunders B.E.; Resnick H.S.; Kilpatrick D.G.,2008.0,10.1037/0022-006X.76.4.633,0,0,
7037,Biomechanics of thoracolumbar junction vertebral fractures from various kinematic conditions,"Thoracolumbar spine fracture classifications are mainly based on a post-traumatic observation of fracture patterns, which is not sufficient to provide a full understanding of spinal fracture mechanisms. This study aimed to biomechanically analyze known fracture patterns and to study how they relate to fracture mechanisms. The instigation of each fracture type was computationally simulated to assess the fracture process. A refined finite element model of three vertebrae and intervertebral connective tissues was subjected to 51 different dynamic loading conditions divided into four categories: compression, shear, distraction and torsion. Fracture initiation and propagation were analyzed, and time and energy at fracture initiation were computed. To each fracture pattern described in the clinical literature were associated one or several of the simulated fracture patterns and corresponding loading conditions. When compared to each other, torsion resulted in low-energy fractures, compression and shear resulted in medium energy fractures, and distraction resulted in high-energy fractures. Increased velocity resulted in higher-energy fracture for similar loadings. The use of a finite element model provided quantitative characterization of fracture patterns occurrence complementary to clinical and experimental studies, allowing to fully understand spinal fracture biomechanics. © 2013 International Federation for Medical and Biological Engineering.",Fradet L.; Petit Y.; Wagnac E.; Aubin C.-E.; Arnoux P.-J.,2014.0,10.1007/s11517-013-1124-8,0,0,
7038,Increasing optimism abolishes pain-induced impairments in executive task performance,"Coping with the demands of pain diminishes self-regulatory capacity and causes self-regulatory fatigue, which then leads to deteriorated executive task performance. It has been suggested that optimism can counteract the depletion of self-regulatory capacity. This study employed a 2 (optimism/no optimism) × 2 (pain/no pain) between-subjects design to explore whether (1) experimentally induced pain (cold pressor task) deteriorates subsequent executive task performance, and (2) whether an optimism induction can counteract this sustained deteriorating effect of pain on executive task performance. Results indicated that although pain led to significantly worse performance on the executive functioning task in the no optimism condition, this sustained deteriorating effect of pain on task performance was abolished in the optimism condition. This finding is imperative because it suggests that optimism may be an important factor to implement in current psychological treatment approaches to diminish the negative impact of chronic pain on the ability to function in daily life. © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.",Boselie J.J.L.M.; Vancleef L.M.G.; Smeets T.; Peters M.L.,2014.0,10.1016/j.pain.2013.10.014,0,0,
7039,Don't look now! oculomotor avoidance as a conditioned disgust response,"Pavlovian conditioning paradigms have revealed fear learning tendencies that may be implicated in the etiology and maintenance of anxiety disorders. Given the prominence of disgust in certain anxiety disorders, it may be fruitful to study disgust learning in addition to fear learning. The present study utilized eye tracking to examine the effects of disgust conditioning on attentional bias, a phenomenon that characterizes anxiety disorders. Participants completed either a disgust condition, in which a face (conditioned stimulus; CS+) was paired with videos of individuals vomiting (unconditioned stimulus; US), or a negative condition in which a face was paired with videos of individuals being harmed in motor-vehicle accidents. Eye movements were used to measure attentional biases related to the USs and the CSs. In line with prior research, attentional avoidance was observed for the disgust CS+. However, this effect did not reach significance until after extinction and was linked to self-reported disgust postacquisition, yet decoupled from self-reported disgust postextinction. Attentional avoidance of the CS+ was not found in the negative condition, and postextinction differences in attentional bias for the CS+ between conditions were found to be mediated by differences in attentional bias for the US, as only the disgust US elicited attentional avoidance. Also, individual differences in disgust sensitivity were found to be associated with attentional avoidance of the disgust US, and this effect was mediated by self-reported disgust in response to the US. Further, disgust sensitivity was associated with attentional avoidance of the disgust CS+, and this effect was mediated by attentional avoidance of the disgust US. These findings provide new insight into a complex pattern of relations between disgust, evaluative learning, and attention that may have implications for the etiology and maintenance of certain anxiety Pavlovian conditioning paradigms have revealed fear learning tendencies that may be implicated in the etiology and maintenance of anxiety disorders. Given the prominence of disgust in certain anxiety disorders, it may be fruitful to study disgust learning in addition to fear learning. The present study utilized eye tracking to examine the effects of disgust conditioning on attentional bias, a phenomenon that characterizes anxiety disorders. Participants completed either a disgust condition, in which a face (conditioned stimulus; CS+) was paired with videos of individuals vomiting (unconditioned stimulus; US), or a negative condition in which a face was paired with videos of individuals being harmed in motor-vehicle accidents. Eye movements were used to measure attentional biases related to the USs and the CSs. In line with prior research, attentional avoidance was observed for the disgust CS+. However, this effect did not reach significance until after extinction and was linked to self-reported disgust postacquisition, yet decoupled from self-reported disgust postextinction. Attentional avoidance of the CS+ was not found in the negative condition, and postextinction differences in attentional bias for the CS+ between conditions were found to be mediated by differences in attentional bias for the US, as only the disgust US elicited attentional avoidance. Also, individual differences in disgust sensitivity were found to be associated with attentional avoidance of the disgust US, and this effect was mediated by self-reported disgust in response to the US. Further, disgust sensitivity was associated with attentional avoidance of the disgust CS+, and this effect was mediated by attentional avoidance of the disgust US. These findings provide new insight into a complex pattern of relations between disgust, evaluative learning, and attention that may have implications for the etiology and maintenance of certain anxiety disorders. © 2013 American Psychological Association.",Armstrong T.; McClenahan L.; Kittle J.; Olatunji B.O.,2014.0,10.1037/a0034558,0,0,
7040,Brief training of psychoneuroendocrino immunology-based meditation (PNEIMED) reduces stress symptom ratings and improves control on salivary cortisol secretion under basal and stimulated conditions,"Context Meditation is proposed as an anti-stress practice lowering allostatic load and promoting well-being, with brief formats providing some of the benefits of longer interventions. Objectives PsychoNeuroEndocrinoImmunology- based meditation (PNEIMED) combines the teaching of philosophy and practice of Buddhist meditation with a grounding in human physiology from a systemic and integrative perspective. We evaluated the effects of four-day PNEIMED training (30 h) on subjective and objective indices of stress in healthy adults. Design A non-randomized, controlled, before-and-after study was conducted. Participants (n = 125, mostly health practitioners) answered a questionnaire rating stress symptom before (T0) and after (Tf) a PNEIMED course. In an additional sample (n = 40; smokers, overweight persons, women taking contraceptives, and subjects with oral pathologies were excluded), divided into PNEIMED-attending (intervention, n = 21) and non-meditating (control, n = 19) groups, salivary cortisol was measured upon awakening and during a challenging mental task. Results Self-rated distress scores were highly reduced after the PNEIMED course. In the intervention group, improvement of psychological well-being was accompanied by decrease in cortisol levels at awakening. No T0-vs-Tf changes in distress scores and morning cortisol were found in controls. Based on baseline-to-peak increment of cortisol response at T0, 26 subjects (n = 13 for each group) were classified as task-responders. The amplitude and duration of the cortisol response decreased after PNEIMED, whereas no effects were found in controls. Conclusions Brief PNEIMED training yields immediate benefits, reducing distress symptoms and adrenocortical activity under basal and stimulated conditions. PNEIMED may represent an effective practice to manage stress and anxiety, particularly among subjects facing a multitude of job-related stressors, such as healthcare workers. © 2014 The Authors © 2014 187 Published by Elsevier Inc.",Bottaccioli F.; Carosella A.; Cardone R.; Mambelli M.; Cemin M.; D'Errico M.M.; Ponzio E.; Bottaccioli A.G.; Minelli A.,2014.0,10.1016/j.explore.2014.02.002,0,0,
7041,Whole body and local muscle vibration reduce artificially induced quadriceps arthrogenic inhibition,"Conclusions Quadriceps AMI is a common complication following knee pathology that produces quadriceps dysfunction and increases the risk of posttraumatic osteoarthritis. Quadriceps strengthening after knee pathology is often ineffective because of AMI. WBV and LMV improve quadriceps function equivocally after simulated knee pathology, effectively minimizing quadriceps AMI. Therefore, these stimuli may be used to enhance quadriceps strengthening, therefore improving the efficacy of rehabilitation and reducing the risk of osteoarthritis.",Blackburn J.T.; Pamukoff D.N.; Sakr M.; Vaughan A.J.; Berkoff D.J.,2014.0,10.1016/j.apmr.2014.07.393,0,0,
7042,The 5-HTTLPR genotype modulates heart rate variability and its adjustment by pharmacological panic challenge in healthy men,"Abnormal serotonin transporter (5-HTT) function and autonomic nervous system (ANS) dysregulation has been proposed in panic disorder. However, in contrast to hypothalamo-pituitary-adrenocortical (HPA) functioning, ANS reactivity during panic response has yet not been investigated in humans with respect to the 5-HTT genotype. The present study assessed the influence of challenging by cholecystokinin tetrapeptide (CCK-4) on heart rate variability (HRV) measures, to monitor autonomic reactivity and its relationship to 5-HTT-linked polymorphic region (5-HTTLPR) genotypes. We hypothesized substantial effects of the 5-HTTLPR genotype on autonomic reactivity. We studied 30 healthy young men, 15 of each with the long/long (l/l) or short/short (s/s) genotype for the 5-HTTLPR. All participants received an intravenous application of 50μg CCK-4. HRV measures were assessed in both groups at baseline and immediately after CCK-4 application. Our results indicated lower parasympathetic activity in s/s carriers during baseline, time and frequency domain measures. CCK-4 application significantly enhanced the sympathetic tone in both groups, leading to diminished group differences. A significant treatment by genotype effect indicated reduced autonomic reactivity to CCK-4 challenge in the s/s compared to l/l carriers. Our findings show enhanced sympathetic and/or diminished cardiac vagal activity under basal conditions and blunted autonomic reactivity in s/s vs. l/l carriers. Our study provides novel data supporting claims that the s/s genotype represents a genetic vulnerability factor associated with inadequate hyporeactivity to stress and extends current knowledge on the impact of the central serotonergic activity on the sympathoadrenal pathway. © 2013 Elsevier Ltd.",Agorastos A.; Kellner M.; Stiedl O.; Muhtz C.; Becktepe J.S.; Wiedemann K.; Demiralay C.,2014.0,10.1016/j.jpsychires.2013.11.013,0,0,
7043,Playing super mario induces structural brain plasticity: Gray matter changes resulting from training with a commercial video game,"Video gaming is a highly pervasive activity, providing a multitude of complex cognitive and motor demands. Gaming can be seen as an intense training of several skills. Associated cerebral structural plasticity induced has not been investigated so far. Comparing a control with a video gaming training group that was trained for 2 months for at least 30 min per day with a platformer game, we found significant gray matter (GM) increase in right hippocampal formation (HC), right dorsolateral prefrontal cortex (DLPFC) and bilateral cerebellum in the training group. The HC increase correlated with changes from egocentric to allocentric navigation strategy. GM increases in HC and DLPFC correlated with participants' desire for video gaming, evidence suggesting a predictive role of desire in volume change. Video game training augments GM in brain areas crucial for spatial navigation, strategic planning, working memory and motor performance going along with evidence for behavioral changes of navigation strategy. The presented video game training could therefore be used to counteract known risk factors for mental disease such as smaller hippocampus and prefrontal cortex volume in, for example, post-traumatic stress disorder, schizophrenia and neurodegenerative disease. © 2014 Macmillan Publishers Limited All rights reserved.",Kühn S.; Gleich T.; Lorenz R.C.; Lindenberger U.; Gallinat J.,2014.0,10.1038/mp.2013.120,0,0,
7044,Chronic effects of cannabis use on the auditory mismatch negativity,"Background Cannabis use is associated with the development of psychotic symptoms and increased risk for schizophrenia. The mismatch negativity (MMN) is a brain event-related potential marker of change detection thought to index glutamatergic N-methyl-D-aspartate receptor-mediated neurotransmission, which is known to be deficient in schizophrenia. This study examined auditory MMN in otherwise healthy chronic cannabis users compared with nonuser control subjects. Methods Forty-two chronic cannabis users and 44 nonuser healthy control subjects completed a multi-feature MMN paradigm, which included duration, frequency, and intensity deviants (deviants 6%; standards 82%). The MMN was compared between users and control subjects as well as between long- and short-term users and age- and gender-matched control subjects. Associations between MMN, cannabis use measures, and symptoms were examined. Results The MMN amplitude was significantly reduced to frequency but not duration or intensity deviants in overall cannabis users relative to control subjects. Frequency MMN was similarly attenuated in short- and long-term users relative to control subjects. Long-term users also exhibited reduced duration MMN relative to control subjects and short-term users and this was correlated with increased duration of exposure to cannabis and increased psychotic-like experiences during intoxication. In short-term users, a younger age of onset of regular cannabis use and greater frequency of use were associated with greater psychotic-like experiences and symptomatic distress. Conclusions These results suggest impaired sensory memory that might reflect N-methyl-D-aspartate receptor dysfunction in chronic cannabis users. The pattern of MMN alterations in cannabis users differed from that typically observed in patients with schizophrenia, indicating overlapping but distinct underlying pathology. © 2014 Society of Biological Psychiatry.",Greenwood L.-M.; Broyd S.J.; Croft R.; Todd J.; Michie P.T.; Johnstone S.; Murray R.; Solowij N.,2014.0,10.1016/j.biopsych.2013.05.035,0,0,
7045,Controlling social stress in virtual reality environments,"Virtual reality exposure therapy has been proposed as a viable alternative in the treatment of anxiety disorders, including social anxiety disorder. Therapists could benefit from extensive control of anxiety eliciting stimuli during virtual exposure. Two stimuli controls are studied in this study: the social dialogue situation, and the dialogue feedback responses (negative or positive) between a human and a virtual character. In the first study, 16 participants were exposed in three virtual reality scenarios: a neutral virtual world, blind date scenario, and job interview scenario. Results showed a significant difference between the three virtual scenarios in the level of self-reported anxiety and heart rate. In the second study, 24 participants were exposed to a job interview scenario in a virtual environment where the ratio between negative and positive dialogue feedback responses of a virtual character was systematically varied on-the-fly. Results yielded that within a dialogue the more positive dialogue feedback resulted in less self-reported anxiety, lower heart rate, and longer answers, while more negative dialogue feedback of the virtual character resulted in the opposite. The correlations between on the one hand the dialogue stressor ratio and on the other hand the means of SUD score, heart rate and audio length in the eight dialogue conditions showed a strong relationship: r(6) = 0.91, p = 0.002; r(6) = 0.76, p = 0.028 and r(6) = 20.94, p = 0.001 respectively. Furthermore, more anticipatory anxiety reported before exposure was found to coincide with more self-reported anxiety, and shorter answers during the virtual exposure. These results demonstrate that social dialogues in a virtual environment can be effectively manipulated for therapeutic purposes. © 2014 Hartanto et al.",Hartanto D.; Kampmann I.L.; Morina N.; Emmelkamp P.G.M.; Neerincx M.A.; Brinkman W.-P.,2014.0,10.1371/journal.pone.0092804,0,0,
7046,Enhanced visuomotor processing of phobic images in blood-injury-injection fear,"Numerous studies have identified attentional biases and processing enhancements for fear-relevant stimuli in individuals with specific phobias. However, this has not been conclusively shown in blood-injury-injection (BII) phobia, which has rarely been investigated even though it has features distinct from all other specific phobias. The present study aims to fill that gap and compares the time-course of visuomotor processing of phobic stimuli (i.e., pictures of small injuries) in BII-fearful (n= 19) and non-anxious control participants (n= 23) by using a response priming paradigm. In BII-fearful participants, phobic stimuli produced larger priming effects and lower response times compared to neutral stimuli, whereas non-anxious control participants showed no such differences. Because these effects are fully present in the fastest responses, they indicate an enhancement in early visuomotor processing of injury pictures in BII-fearful participants. These results are comparable to the enhanced processing of phobic stimuli in other specific phobias (i.e., spider phobia). © 2014 Elsevier Ltd.",Haberkamp A.; Schmidt T.,2014.0,10.1016/j.janxdis.2014.02.001,0,0,
7047,Stimulus collative properties and consumers' flavor preferences,"The present work investigated consumers' hedonic response to flavor stimuli in light of Berlyne's collative-motivational model of aesthetic preferences. According to this paradigm, sensory preferences are a function of a stimulus' arousal potential, which is determined by its collative properties. The relationship between overall arousal potential and hedonic response takes the shape of an inverted ""U"", reaching an optimum at a certain level of arousal potential. In three independent studies, using different sets of novel beers as stimuli, consumers reported their hedonic response and rated three collative properties: novelty, familiarity and complexity. Relationships between these collative properties and hedonic ratings were explored by polynomial regression. The results revealed patterns in line with Berlyne's predictions (curvilinear relationship) with regard to perceived novelty, whereas mixed results were obtained for familiarity and complexity. Additionally, in two of the studies, the moderating role of relevant consumer characteristics - product knowledge, food neophobia and variety seeking tendency - was investigated. A consumer's degree of product knowledge was found to significantly reduce perceived complexity and novelty, ostensibly reflecting the learning that occurs with previous exposures. © 2014 Elsevier Ltd.",Giacalone D.; Duerlund M.; Bøegh-Petersen J.; Bredie W.L.P.; Frøst M.B.,2014.0,10.1016/j.appet.2014.02.007,0,0,
7048,They are laughing at me: Cerebral mediation of cognitive biases in social anxiety,"The fear of embarrassment and humiliation is the central element of social anxiety. This frequent condition is associated with cognitive biases indicating increased sensitivity to signals of social threat, which are assumed to play a causal role in the maintenance of social anxiety. Here, we employed laughter, a potent medium for the expression of acceptance and rejection, as an experimental stimulus in participants selected for varying degrees of social anxiety to identify cerebral mediators of cognitive biases in social anxiety using functional magnetic resonance imaging in combination with mediation analysis. We directly demonstrated that cerebral activation patterns within the dorsal attention network including the left dorsolateral and dorsomedial prefrontal cortex mediate the influence of social anxiety on laughter perception. This mediation proved to be specific for social anxiety after correction for measures of general state and trait anxiety and occurred most prominently under bimodal audiovisual laughter presentation when compared with monomodal auditory or visual laughter cues. Considering the possibility to modulate cognitive biases and cerebral activity by neuropsychological trainings, non-invasive electrophysiological stimulation and psychotherapy, this study represents a starting point for a whole line of translational research projects and identifies promising targets for electrophysiological interventions aiming to alleviate cognitive biases and symptom severity in social anxiety. © 2014 Kreifelts et al.",Kreifelts B.; Brück C.; Ritter J.; Ethofer T.; Domin M.; Lotze M.; Jacob H.; Schlipf S.; Wildgruber D.,2014.0,10.1371/journal.pone.0099815,0,0,
7049,Is rumination after bereavement linked with loss avoidance? Evidence from eye-tracking,"Rumination is a risk factor in adjustment to bereavement. It is associated with and predicts psychopathology after loss. Yet, the function of rumination in bereavement remains unclear. In the past, researchers often assumed rumination to be a maladaptive confrontation process. However, based on cognitive avoidance theories of worry in generalised anxiety disorder (GAD) and rumination after post-traumatic stress disorder (PTSD), others have suggested that rumination may serve to avoid painful aspects of the loss, thereby contributing to complicated grief. To examine if rumination is linked with loss avoidance, an eye-tracking study was conducted with 54 bereaved individuals (27 high and 27 low ruminators). On 24 trials, participants looked for 10 seconds at a picture of the deceased and a picture of a stranger, randomly combined with negative, neutral or loss-related words. High ruminators were expected to show initial vigilance followed by subsequent disengagement for loss stimuli (i.e., picture deceased with a loss word) in the first 1500 ms. Additionally, we expected high ruminators to avoid these loss stimuli and to show attentional preference for non-loss-related negative stimuli (i.e., picture stranger with a negative word) on longer exposure durations (1500-10000 ms). Contrary to expectations, we found no evidence for an effect of rumination on vigilance and disengagement of loss stimuli in the first 1500 ms. However, in the 1500-10000 ms interval, high ruminators showed shorter gaze times for loss stimuli and longer gaze times for negative (and neutral) non-loss-related stimuli, even when controlling for depression and complicated grief symptom levels. Effects of rumination on average fixation times mirrored these findings. This suggests that rumination and loss avoidance are closely associated. A potential clinical implication is that rumination and grief complications after bereavement may be reduced through the use of exposure and acceptance-based therapeutic techniques. © 2014 Eisma et al.",Eisma M.C.; Schut H.A.W.; Stroebe M.S.; Van Den Bout J.; Stroebe W.; Boelen P.A.,2014.0,10.1371/journal.pone.0104980,0,0,
7050,Associations between exposure to stressful life events and alcohol use disorder in a longitudinal birth cohort studied to age 30,"Background: To examine associations between measures of stressful life events exposure and alcohol abuse/dependence (AAD) from ages 18 to 30 using data from a longitudinal birth cohort (n= 987 to 1011). Methods: Outcome measures included DSM-IV (American Psychiatric Association, 1994) AAD symptoms and AAD, at ages 20-21, 24-25, and 29-30 years. Exposure to a range of stressful life events was measured during the periods 18-21, 21-25, and 25-30 years using items adapted from the social readjustment rating scale (Holmes and Rahe, 1967). Data were analysed using Generalised Estimating Equation models, adjusted for non-observed sources of confounding using conditional fixed effects regression. Further analyses examined: gender. ×. life events exposure interactions, structural equation modelling of possible reciprocal causal pathways linking stressful life events and AAD symptoms, and an alternative conceptualization of the stressful life events measure. Results: After adjustment, those with the highest exposure to stressful life events had rates of AAD symptoms that were 2.24 (p<. .0001) times higher, and odds of AAD that were 2.24 times higher(p<. .01), than those at the lowest level of exposure. Associations between life events exposure and AAD symptoms were stronger for females than for males (p<. .05), with results consistent using a count measure of stressful life events. Structural equation modelling showed that the best-fitting model was one in which life events influenced AAD symptoms. Conclusions: The results suggest that there were persistent linkages between stressful life events and AAD, providing support for a stress-reduction model of alcohol consumption. © 2014 Elsevier Ireland Ltd.",Boden J.M.; Fergusson D.M.; Horwood L.J.,2014.0,10.1016/j.drugalcdep.2014.06.010,0,0,
7051,Effects of acute cortisol administration on perceptual priming of trauma-related material,"Intrusive memories are a hallmark symptom of posttraumatic stress disorder (PTSD). They reflect excessive and uncontrolled retrieval of the traumatic memory. Acute elevations of cortisol are known to impair the retrieval of already stored memory information. Thus, continuous cortisol administration might help in reducing intrusive memories in PTSD. Strong perceptual priming for neutral stimuli associated with a ""traumatic"" context has been shown to be one important learning mechanism that leads to intrusive memories. However, the memory modulating effects of cortisol have only been shown for explicit declarative memory processes. Thus, in our double blind, placebo controlled study we aimed to investigate whether cortisol influences perceptual priming of neutral stimuli that appeared in a ""traumatic"" context. Two groups of healthy volunteers (N = 160) watched either neutral or ""traumatic"" picture stories on a computer screen. Neutral objects were presented in between the pictures. Memory for these neutral objects was tested after 24 hours with a perceptual priming task and an explicit memory task. Prior to memory testing half of the participants in each group received 25 mg of cortisol, the other half received placebo. In the placebo group participants in the ""traumatic"" stories condition showed more perceptual priming for the neutral objects than participants in the neutral stories condition, indicating a strong perceptual priming effect for neutral stimuli presented in a ""traumatic"" context. In the cortisol group this effect was not present: Participants in the neutral stories and participants in the ""traumatic"" stories condition in the cortisol group showed comparable priming effects for the neutral objects. Our findings show that cortisol inhibits perceptual priming for neutral stimuli that appeared in a ""traumatic"" context. These findings indicate that cortisol influences PTSD-relevant memory processes and thus further support the idea that administration of cortisol might be an effective treatment strategy in reducing intrusive reexperiencing.",Holz E.; Lass-Hennemann J.; Streb M.; Pfaltz M.; Michael T.,2014.0,10.1371/journal.pone.0104864,0,0,
7052,Stability of low-frequency fluctuation amplitudes in prolonged resting-state fMRI,"The (fractional) amplitudes of low-frequency fluctuations (f)ALFF are popular measures for the magnitude of low-frequency oscillations in resting-state fMRI (R-fMRI) data. Both measures can be directly derived from the spectral power of R-fMRI time courses. Numerous studies suggest that ALFF and fALFF might be used as biomarkers for a variety of diseases including schizophrenia, major depressive disorder, and obsessive-compulsive disorder. However, the temporal stability of (f)ALFF values, which is of great importance for the application of (f)ALFF both as a biomarker and scaling parameter, has not been studied in detail yet.Here, we quantify the temporal stability, robustness and reproducibility of both ALFF and fALFF maps obtained from R-fMRI data by performing statistical analyses over 55 minute resting-state scans which included a period of NaCl infusion. We also examine the differences of using either raw or standardised (f)ALFF maps. Our analyses show that no significant changes of (f)ALFF values over the 55. minute period occur for both raw and standardised (f)ALFF maps. In addition, we demonstrate that raw (f)ALFF maps across subjects are correlated with head motion as quantified via frame-wise displacement, whereas no such correlation is present in standardised (f)ALFF maps. In conclusion, the results of our study show that both ALFF and fALFF qualify as potential biomarkers due to their high temporal stability.",Küblböck M.; Woletz M.; Höflich A.; Sladky R.; Kranz G.S.; Hoffmann A.; Lanzenberger R.; Windischberger C.,2014.0,10.1016/j.neuroimage.2014.09.038,0,0,
7053,Labeling exercise fat-burning increases post-exercise food consumption in self-imposed exercisers,"The goal of the study was to determine whether the label given to an exercise bout affects immediate post-exercise food intake. The authors hypothesized that explicitly labeling an exercise bout 'fat-burning' (vs. labeling an exercise bout 'endurance' exercise) would increase post-exercise food intake in individuals who self-impose physical activity, because they are more likely to see the label as signal of activated fat metabolism and license to reward oneself. No such effect was expected for individuals who do not self-impose physical activity but consider exercise enjoyable. Ninety-six participants took part in an experiment manipulating the label given to an exercise bout (fat-burning exercise or endurance exercise) between participants. They cycled on an ergometer for 20 minutes at a consistent work rate (55-65% of predicted VO2 max) and were offered ad libitum food (i.e., pretzel pieces) after the exercise bout. The results showed that self-imposed exercisers, that is, individuals with low behavioral regulation and individuals with high psychological distress, high fatigue levels, and low positive well-being when exercising, ate more food after exercise when the bout was labeled fat-burning exercise rather than endurance exercise. The results help develop health interventions, indicating that the tendency to compensate for energy expended following physical activity depends on both the label given to the exercise bout and the degree to which individuals self-impose physical activity. © 2014 Elsevier Ltd.",Fenzl N.; Bartsch K.; Koenigstorfer J.,2014.0,10.1016/j.appet.2014.05.030,0,0,
7054,Impact of viewing vs. Not viewing a real forest on physiological and psychological responses in the same setting,"We investigated the impact of viewing versus not viewing a real forest on human subjects’ physiological and psychological responses in the same setting. Fifteen healthy volunteers (11 males, four females, mean age 36 years) participated. Each participant was asked to view a forest while seated in a comfortable chair for 15 min (Forest condition) vs. sitting the same length of time with a curtain obscuring the forest view (Enclosed condition). Both conditions significantly decreased blood pressure (BP) variables, i.e., systolic BP, diastolic BP, and mean arterial pressure between pre and post experimental stimuli, but these reductions showed no difference between conditions. Interestingly, the Forest viewing reduced cerebral oxygenated hemoglobin (HbO2) assessed by near-infrared spectroscopy (NIRS) and improved the subjects’ Profile of Mood States (POMS) scores, whereas the Enclosed condition increased the HbO2 and did not affect the POMS scores. There were no significant differences in saliva amylase or heart rate variability (HRV) between the two conditions. Collectively, these results suggest that viewing a real forest may have a positive effect on cerebral activity and psychological responses. However, both viewing and not viewing the forest had similar effects on cardiovascular responses such as BP variables and HRV.",Horiuchi M.; Endo J.; Takayama N.; Murase K.; Nishiyama N.; Saito H.; Fujiwara A.,2014.0,10.3390/ijerph111010883,0,0,
7055,Towards virtual training of emotion regulation,"For professionals in military and law enforcement domains, learning to regulate one’s emotions under threatening circumstances is crucial. The STRESS project envisions a virtual reality-based system to enable such professionals to train their emotion regulation skills. To explore the possibilities for such a system, this article describes an experiment performed to investigate the impact of virtual training on participants’ experienced emotional responses in threatening situations. A set of 15 participants were asked to rate the subjective emotional intensity of a set of affective pictures at two different time points, separated by 6 h. The participants were divided into three groups: the first group performed a session of virtual training in between, in which they received a choice-reaction task; the second group performed a session of virtual training, in which they had to apply reappraisal strategies; and a control group, that did not have any training session. The results indicate that the reappraisal-based training caused the participants in that group to give significantly lower ratings for the emotional intensity of the negative pictures, whereas the content-based training resulted in significantly higher ratings compared to the group without training. Moreover, a second experiment, performed with the same participants 6 months later, indicated that these effects are fairly persistent over time, and that they transfer to different pictures with similar characteristics.",Bosse T.; Gerritsen C.; de Man J.; Treur J.,2014.0,10.1007/s40708-014-0004-9,0,0,
7056,Effect of clinical characteristics on cognitive performance in service members and veterans with histories of blast-related mild traumatic brain injury,"Objective: To examine the relationship between clinical characteristics and cognitive performance in service members and veterans with histories of blast-related mild traumatic brain injury (mTBI). Design: This study consisted of 40 Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) service members and veterans; 20 participants reported blast exposure and alteration of mental status consistent with mTBI and 20 participants denied blast exposure and had no history of traumatic brain injury (TBI), but could have experienced extra-cranial injuries. Measures of simple reaction time, processing speed, visual attention, working memory and mathematical processing were used to assess long-term effects of mTBI. Measures of post-traumatic stress symptom severity, pain intensity, sleep difficulty and subjective appraisal of cognition at time of testing were also obtained. Multivariate analyses were conducted with clinical characteristics and mTBI history as predictors of cognitive performance. Results: There was no evidence of an effect of mTBI history on cognitive performance in this sample. However, post-traumatic stress symptom severity was significantly related to two measures of cognitive performance. Conclusions: This study demonstrated the importance of considering the effects of current clinical symptoms (e.g. post-traumatic stress) as possibly having greater influence on current cognitive functioning than the effects of a remote history of mTBI.",Neipert L.; Pastorek N.J.; Troyanskaya M.; Scheibel R.S.; Petersen N.J.; Levin H.S.,2014.0,10.3109/02699052.2014.947623,0,0,
7057,Interference with the reconsolidation of trauma-related memories in adults,"Background Reactivated memories go through a process of reconsolidation, during which they are malleable and susceptible to modification. Strategies targeting the interruption of memory reconsolidation hold the promise of weakening fear memories that underlie traumatic stress disorders. Although many studies have examined the efficacy of reconsolidation interference strategies with fear memories developed in a laboratory, very few have examined this with trauma-related episodic memories. This study aims to examine whether new learning can interfere with the reconsolidation of trauma-related episodic memories, when the affective content of the new learning and memory match. Methods Boston-area young adults (n = 94) wrote about negative autobiographical memories; specifically, their personal memories of the Boston Marathon bombings. Following reactivation, participants were randomized to receive interference with a negative, positive, neutral, or no story. One week later, participants were tested for memory recall. Results Comparisons between conditions with relevant covariates revealed a significant interfering effect for a negative story, relative to no story, on recall (P <.05, 95% CI [-3.90, -0.04]), d = 0.62). In contrast, the neutral and positive story, relative to no story, resulted in smaller and nonsignificant effects. Conclusions These findings indicate that reconsolidation interference effects can be achieved for trauma-related episodic memories and the emotional valence of interference material may be an important contextual factor in achieving these effects. This study provides support for further research translating memory reconsolidation findings into treatments for traumatic stress disorders.",Kredlow M.A.; Otto M.W.,2015.0,10.1002/da.22343,0,0,
7058,Temporal estimation of threatening stimuli in social anxiety disorder: Investigation of the effects of state anxiety and fearfulness,Conclusions These results may be relevant for the understanding of the etiology and maintenance of SAD and potentially for the development of novel intervention methods.,Jusyte A.; Schneidt A.; Schönenberg M.,2015.0,10.1016/j.jbtep.2014.11.006,0,0,
7059,Lipase supplementation before a high-fat meal reduces perceptions of fullness in healthy subjects,"Background/Aims: Postprandial symptoms of fullness and abdominal discomfort are common after fatty meals. Gastric lipases hydrolyze 10% to 20% of dietary triglycerides during the stomach trituration period of digestion. The aim of this study was to evaluate the effects of acid-resistant lipase on upper gastrointestinal symptoms, including fullness and bloating, as well as on gastric myoelectrical activity after healthy subjects ingested a high-fat, liquid meal. Methods: This study utilized a double-blind, placebo-controlled, crossover design with 16 healthy volunteers who ingested either a capsule containing 280 mg of acid-resistant lipase or a placebo immediately before a fatty meal (355 calories, 55% fat). Participants rated their stomach fullness, bloating, and nausea before and at timed intervals for 60 minutes after the meal. Electrogastrograms were obtained to assess the gastric myoelectrical activity. Results: Stomach fullness, bloating, and nausea increased significantly 10 minutes after ingestion of the fatty meal (p<0.01), whereas normal gastric myoelectrical activity decreased and tachygastria increased (p<0.05). With lipase, reports of stomach fullness were significantly lower compared with placebo (p<0.05), but no effect on gastric myoelectrical activity or other upper gastrointestinal symptoms was observed. Conclusions: The high-fat meal induced transient fullness, bloating, nausea, and tachygastria in healthy individuals, consistent with postprandial distress syndrome. Acid-resistant lipase supplementation significantly decreased stomach fullness.",Levine M.E.; Koch S.Y.; Koch K.L.,2015.0,10.5009/gnl14005,0,0,
7060,Threat Interference Biases Predict Socially Anxious Behavior: The Role of Inhibitory Control and Minute of Stressor,"The current study brings together two typically distinct lines of research. First, social anxiety is inconsistently associated with behavioral deficits in social performance, and the factors accounting for these deficits remain poorly understood. Second, research on selective processing of threat cues, termed cognitive biases, suggests these biases typically predict negative outcomes, but may sometimes be adaptive, depending on the context. Integrating these research areas, the current study examined whether conscious and/or unconscious threat interference biases (indexed by the unmasked and masked emotional Stroop) can explain unique variance, beyond self-reported anxiety measures, in behavioral avoidance and observer-rated anxious behavior during a public speaking task. Minute of speech and general inhibitory control (indexed by the color-word Stroop) were examined as within-subject and between-subject moderators, respectively. Highly socially anxious participants (N=135) completed the emotional and color-word Stroop blocks prior to completing a 4-minute videotaped speech task, which was later coded for anxious behaviors (e.g., speech dysfluency). Mixed-effects regression analyses revealed that general inhibitory control moderated the relationship between both conscious and unconscious threat interference bias and anxious behavior (though not avoidance), such that lower threat interference predicted higher levels of anxious behavior, but only among those with relatively weaker (versus stronger) inhibitory control. Minute of speech further moderated this relationship for unconscious (but not conscious) social-threat interference, such that lower social-threat interference predicted a steeper increase in anxious behaviors over the course of the speech (but only among those with weaker inhibitory control). Thus, both trait and state differences in inhibitory control resources may influence the behavioral impact of threat biases in social anxiety.",Gorlin E.I.; Teachman B.A.,2015.0,10.1016/j.beth.2015.03.001,0,0,
7061,Stability indicating spectrofluorimetric method for determination of duloxetine hydrochloride in bulk and in dosage form,"Duloxetine (DLX), is a selective serotonin-norepinephrine reuptake inhibitor (SNRI) recommended for maintenance treatment of major depressive disorder, neuropathic pain especially diabetic polyneuropathy (first-line treatment), generalized anxiety disorder, stress urinary incontinence and fibromyalgia. The present investigation describes the validation of rapid, sensitive, cost effective and reproducible stability indicating spectrofluorometric methods based on the native fluorescence of duloxetine HCl in acidic medium for the estimation of duloxetine HCl in bulk and in formulations. The fluorescence intensity of duloxetine hydrochloride was measured at 336 nm after excitation at 290 nm. The methods were validated with respect to linearity, accuracy, precision and robustness. Linearity was observed in the concentration range of 0.3-30 μg/ml with an excellent correlation coefficients (r<sup>2</sup>) ranging from 0.9940-0.9996. The limits of assay detection values were found to range from 0.56-0.89 μg/ml and quantitation limits ranged from 1.69-2.42 μg/ml for the proposed methods. The proposed method was applicable to the determination of the drug in capsules and the percentage recovery was found to range from 99.53 ± 99.66%. The proposed methods were developed as stability indicating procedures by carrying out the analysis for duloxetine hydrochloride on stressed samples prepared under various forced degradation conditions.",Chadha R.; Bali A.,2015.0,,0,0,
7062,Intolerance of uncertainty predicts fear extinction in amygdala-ventromedial prefrontal cortical circuitry,"Background: Coordination of activity between the amygdala and ventromedial prefrontal cortex (vmPFC) is important for fear-extinction learning. Aberrant recruitment of this circuitry is associated with anxiety disorders. Here, we sought to determine if individual differences in future threat uncertainty sensitivity, a potential risk factor for anxiety disorders, underly compromised recruitment of fear extinction circuitry. Twenty-two healthy subjects completed a cued fear conditioning task with acquisition and extinction phases. During the task, pupil dilation, skin conductance response, and functional magnetic resonance imaging were acquired. We assessed the temporality of fear extinction learning by splitting the extinction phase into early and late extinction. Threat uncertainty sensitivity was measured using self-reported intolerance of uncertainty (IU). Results: During early extinction learning, we found low IU scores to be associated with larger skin conductance responses and right amygdala activity to learned threat vs. safety cues, whereas high IU scores were associated with no skin conductance discrimination and greater activity within the right amygdala to previously learned safety cues. In late extinction learning, low IU scores were associated with successful inhibition of previously learned threat, reflected in comparable skin conductance response and right amgydala activity to learned threat vs. safety cues, whilst high IU scores were associated with continued fear expression to learned threat, indexed by larger skin conductance and amygdala activity to threat vs. safety cues. In addition, high IU scores were associated with greater vmPFC activity to threat vs. safety cues in late extinction. Similar patterns of IU and extinction learning were found for pupil dilation. The results were specific for IU and did not generalize to self-reported trait anxiety. Conclusions: Overall, the neural and psychophysiological patterns observed here suggest high IU individuals to disproportionately generalize threat during times of uncertainty, which subsequently compromises fear extinction learning. More broadly, these findings highlight the potential of intolerance of uncertainty-based mechanisms to help understand pathological fear in anxiety disorders and inform potential treatment targets.",Morriss J.; Christakou A.; van Reekum C.M.,2015.0,10.1186/s13587-015-0019-8,0,0,
7063,Fluorescence analysis of NOM degradation by photocatalytic oxidation and its potential to mitigate membrane fouling in drinking water treatment,"This study examined the photocatalytic oxidation of natural organic matter (NOM) as a method to mitigate membrane fouling in drinking water treatment. ZnO and TiO2 photocatalysts were tested in concentrations ranging from 0.05gL-1 to 0.5gL-1. Fluorescence peaks were used as the primary method to characterize the degradation of three specific NOM components - fulvic acid-like humic substances, humic acid-like humic substances, and protein-like substances during photocatalytic oxidation. Fluorescence peaks and Liquid Chromatography-Organic Carbon Detection (LC-OCD) analysis indicated that higher NOM degradation was obtained by photocatalytic oxidation with ZnO than with TiO2. Treatment of the feed water by ZnO photocatalytic oxidation was successful in reducing considerably the extent of hydraulically reversible and irreversible membrane fouling during ultrafiltration (UF) compared to feed water treatment with TiO2. Fouling during UF of water subjected to photocatalytic oxidation appeared to be caused by low molecular weight constituents of NOM generated during photocatalytic oxidation.",Nerger B.A.; Peiris R.H.; Moresoli C.,2015.0,10.1016/j.chemosphere.2015.03.089,0,0,
7064,Trainee perspectives on manikin death during mock codes,"BACKGROUND: The acceptability of simulated death has been debated by experts, but there is scarce information regarding trainees' perspective. METHODS: Trainees in a large pediatric program were invited to perform mock codes, including pre and post questionnaires. Participants were exposed to 2 mock codes of neonates born pulseless. In the RESUSC scenario, the manikin responded to adequate resuscitation; in the DEATH scenario, the manikin remained pulseless. Mock codes were videotaped and evaluated by using the Neonatal Resuscitation Program score sheet. Debriefing was analyzed by using qualitative methodology. RESULTS: Fifty-nine of 62 trainees answered the questionnaire, and 42 performed a total of 84 mock codes. All trainees found mock codes beneficial and would appreciate being exposed to more. Most found them realistic and 78% agreed with the following statement: ""During mock codes the manikin improves when adequate resuscitation steps are provided."" The scenario or order of scenario did not affect performance (RESUSC versus DEATH). Only 1 trainee stopped resuscitation after 10 minutes of asystole; 31% had not ceased resuscitation efforts by 20 minutes. During debriefing and post questionnaire, trainees found the DEATH scenario more stressful than RESUSC. Trainees all answered the following question during debriefing: ""How did this go for you?"" Two themes were identified in their answers: (1) the manikin does not die; and (2) death equals inadequate resuscitation. CONCLUSIONS: The death of the manikin was stressful, but trainees thought this was acceptable and prepared them for their future. Trainees did not state that ""death disclosures"" were necessary before a simulated death.",Lizotte M.-H.; Latraverse V.; Moussa A.; Lachance C.; Barrington K.; Janvier A.,2015.0,10.1542/peds.2014-3910,0,0,
7065,Paths to tobacco abstinence: A repeated-measures latent class analysis,"Objective: Knowledge of smoking change processes may be enhanced by identifying pathways to stable abstinence. We sought to identify latent classes of smokers based on their day-to-day smoking status in the first weeks of a cessation attempt. We examined treatment effects on class membership and compared classes on baseline individual differences and 6-month abstinence rates. Method: In this secondary analysis of a double-blind randomized placebo-controlled clinical trial (N = 1,433) of 5 smoking cessation pharmacotherapies (nicotine patch, nicotine lozenge, bupropion SR, patch and lozenge, or bupropion SR and lozenge), we conducted repeated-measures latent class analysis of daily smoking status (any smoking vs. none) for the first 27 days of a quit attempt. Treatment and covariate relations with latent class membership were examined. Distal outcome analysis compared confirmed 6-month abstinence rates among the latent classes. Results: A 5-class solution was selected. Three-quarters of smokers were in stable smoking or abstinent classes, but 25% were in classes with unstable abstinence probabilities over time. Active treatment (compared to placebo), and particularly the patch and lozenge combination, promoted early quitting. Latent classes differed in 6-month abstinence rates and on several baseline variables, including nicotine dependence, quitting history, self-efficacy, sleep disturbance, and minority status. Conclusions: Repeated-measures latent class analysis identified latent classes of smoking change patterns affected by treatment, related to known risk factors, and predictive of distal outcomes. Tracking behavior early in a change attempt may identify prognostic patterns of change and facilitate adaptive treatment planning.",McCarthy D.E.; Ebssa L.; Witkiewitz K.; Shiffman S.,2015.0,10.1037/ccp0000017,0,0,
7066,Short-term pain for long-term gain: The role of experiential avoidance in the relation between anxiety sensitivity and emotional distress,"Research has provided evidence of an interactive effect between anxiety sensitivity (AS) and experiential avoidance (EA) in predicting both anxiety and posttraumatic stress (PTS) symptomatology. Additionally, theory suggests that EA alleviates distress in the short-term, but exacerbates it in the long-term. The present cross-sectional study was developed to replicate the noted findings and examine the interaction (EA. √ó. AS) in the context of an emotionally evocative task. It was predicted that, among high AS participants, high EA would (a) reduce the likelihood of experiencing short-term increases in negative affect following the task, and (b) increase the likelihood of anxiety and PTS symptomatology. Undergraduate participants (N= 199) completed a battery of self-report questionnaires and an emotionally evocative task. As predicted, positive associations were observed between AS and both anxiety and PTS symptoms, but only among high EA participants. Additionally, AS only predicted increases in negative affect following the emotionally evocative task for those with lower levels of EA, thus providing empirical evidence of the affect regulatory function of EA among those who fear anxiety-related bodily sensations. These findings help to elucidate the motives for the use of avoidance among those high in AS. Conceptual and clinical implications are discussed.",Bardeen J.R.,2015.0,10.1016/j.janxdis.2014.12.013,0,0,
7067,"Prevalence of mental distress and associated factors among undergraduate students of University of Gondar, Northwest Ethiopia: A cross-sectional institutional based study","Background Mental health problems affect society as a whole and no group is immune to mental disorders; however, students have significantly high level of mental distress than their community peers. Objectives The purpose of this study was to assess the prevalence and associated factors of mental distress among undergraduate students of University of Gondar, Northwest Ethiopia. Methods Institution based cross sectional study was conducted among 836 students from April 9-11/2014. Stratified multistage sampling technique was used to select the study participants. Data were collected using pretested and structured self-administered questionnaire. Bivariate and multivariate logistic regression model was fitted to identify factors associated with mental distress among students. An adjusted odds ratio with 95% confidence interval was computed to determine the level of significance. Results Prevalence of mental distress among students was found to be 40.9%. Female sex (AOR = 1.65; 95% CI 1.17-2.30), lack of interest towards their field of study (AOR = 2.28; 95% CI 1.49-3.50), not having close friends (AOR = 1.48; 95% CI 1.03-2.14), never attend religious programs (AOR = 1.58; 95% CI 1.02-2.46), conflict with friends (AOR = 1.93; 95% CI 1.41-2.65), having financial distress (AOR1.49 = 95% CI 1.05, 2.10), family history of mental illness (AOR = 2.12; 95% CI 1.31-3.45), Ever use of Khat (AOR = 1.71; 95% CI 1.12-2.59), lower grade than anticipated(AOR = 2.07; 95% CI 1.51-2.83), lack of vacation or break (AOR = 1.46; 95% CI 1.06-2.02), and low social support(AOR = 2.58; 95% CI 1.58- 4.22) were significantly associated with mental distress. Conclusion The overall prevalence of mental distress among students was found to be high. Therefore, it is recommended that mental distress needs due attention and remedial action from policy makers, college officials, non-governmental organizations, parents, students and other concerned bodies.",Dachew B.A.; Bisetegn T.A.; Gebremariam R.B.,2015.0,10.1371/journal.pone.0119464,0,0,
7068,Pain modulation in waking and hypnosis in women: Event-related potentials and sources of cortical activity,"Using a strict subject selection procedure, we tested in High and Low Hypnotizable subjects (HHs and LHs) whether treatments of hypoalgesia and hyperalgesia, as compared to a relaxation-control, differentially affected subjective pain ratings and somatosensory event-related potentials (SERPs) during painful electric stimulation. Treatments were administered in waking and hypnosis conditions. LHs showed little differentiation in pain and distress ratings between hypoalgesia and hyperalgesia treatments, whereas HHs showed a greater spread in the instructed direction. HHs had larger prefrontal N140 and P200 waves of the SERPs during hypnotic hyperalgesia as compared to relaxation-control treatment. Importantly, HHs showed significant smaller frontocentral N140 and frontotemporal P200 waves during hypnotic hypoalgesia. LHs did not show significant differences for these SERP waves among treatments in both waking and hypnosis conditions. Source localization (sLORETA) method revealed significant activations of the bilateral primary somatosensory (BA3), middle frontal gyrus (BA6) and anterior cingulate cortices (BA24). Activity of these contralateral regions significantly correlated with subjective numerical pain scores for control treatment in waking condition. Moreover, multivariate regression analyses distinguished the contralateral BA3 as the only region reflecting a stable pattern of pain coding changes across all treatments in waking and hypnosis conditions. More direct testing showed that hypnosis reduced the strength of the association of pain modulation and brain activity changes at BA3. sLORETA in HHs revealed, for the N140 wave, that during hypnotic hyperalgesia, there was an increased activity within medial, supramarginal and superior frontal gyri, and cingulated gyrus (BA32), while for the P200 wave, activity was increased in the superior (BA22), middle (BA37), inferior temporal (BA19) gyri and superior parietal lobule (BA7). Hypnotic hypoalgesia in HHs, for N140 wave, showed reduced activity within medial and superior frontal gyri (BA9,8), paraippocampal gyrus (BA34), and postcentral gyrus (BA1), while for the P200, activity was reduced within middle and superior frontal gyri (BA9 and BA10), anterior cingulate (BA33), cuneus (BA19) and sub-lobar insula (BA13). These findings demonstrate that hypnotic suggestions can exert a top-down modulatory effect on attention/preconscious brain processes involved in pain perception.",De Pascalis V.; Varriale V.; Cacace I.,2015.0,10.1371/journal.pone.0128474,0,0,
7069,Interoceptive exposure exercises for social anxiety,"Individuals with social anxiety disorder (SAD) commonly experience panic attacks and evidence increased anxiety sensitivity (AS) specific to noticeable anxiety sensations. Interoceptive exposure (IE) is an effective treatment for reducing AS, but few IE tasks target fears of blushing, sweating, or trembling, which are incorporated within AS social concerns and especially feared by individuals with SAD. The primary study aims were trifold: (1) identify novel IE tasks that produce blushing, sweating, and/or trembling; (2) assess the intensity of sensations and anxiety produced by a series of novel and validated IE tasks; and (3) evaluate the incremental validity of combining an IE task and a speech task. Individuals (N=55) with heightened fear of noticeably blushing, sweating, and/or trembling completed a control task and 8 IE tasks (e.g., hot sauce, hyperventilation). All tasks produced greater intensity of anxiety and sensations compared to the control task (ps<.001; range of η<inf>p</inf><sup>2</sup>=.20-.50). Responses to the combination of an IE task and social task compared to a social task alone did not differ significantly. Future directions for research and clinical implications of the findings are discussed.",Dixon L.J.; Kemp J.J.; Farrell N.R.; Blakey S.M.; Deacon B.J.,2015.0,10.1016/j.janxdis.2015.04.006,0,0,
7070,"Importance of virtual reality to virtual reality exposure therapy, study design of a randomized trial","Post Traumatic Stress Disorder (PTSD) can be a debilitating problem in service members who have served in Iraq or Afghanistan. Virtual Reality Exposure Therapy (VRET) is one of the few interventions demonstrated in randomized controlled trials to be effective for PTSD in this population. There are theoretical reasons to expect that Virtual Reality (VR) adds to the effectiveness of exposure therapy, but there is also added expense and difficulty in using VR. Described is a trial comparing outcomes from VRET and a control exposure therapy (CET) protocol in service members with PTSD.",Mclay R.N.; Baird A.; Murphy J.; Deal W.; Tran L.; Anson H.; Klam W.; Johnston S.,2015.0,,0,0,1362
7071,Accurately decoding visual information from fMRI data obtained in a realistic virtual environment,"Three-dimensional interactive virtual environments (VEs) are a powerful tool for brain-imaging based cognitive neuroscience that are presently under-utilized. This paper presents machine-learning based methods for identifying brain states induced by realistic VEs with improved accuracy as well as the capability for mapping their spatial topography on the neocortex. VEs provide the ability to study the brain under conditions closer to the environment in which humans evolved, and thus to probe deeper into the complexities of human cognition. As a test case, we designed a stimulus to reflect a military combat situation in the Middle East, motivated by the potential of using real-time functional magnetic resonance imaging (fMRI) in the treatment of post-traumatic stress disorder. Each subject experienced moving through the virtual town where they encountered 1-6 animated combatants at different locations, while fMRI data was collected. To analyze the data from what is, compared to most studies, more complex and less controlled stimuli, we employed statistical machine learning in the form of Multi-Voxel Pattern Analysis (MVPA) with special attention given to artificial Neural Networks (NN). Extensions to NN that exploit the block structure of the stimulus were developed to improve the accuracy of the classification, achieving performances from 58 to 93% (chance was 16.7%) with six subjects. This demonstrates that MVPA can decode a complex cognitive state, viewing a number of characters, in a dynamic virtual environment. To better understand the source of this information in the brain, a novel form of sensitivity analysis was developed to use NN to quantify the degree to which each voxel contributed to classification. Compared with maps produced by general linear models and the searchlight approach, these sensitivity maps revealed a more diverse pattern of information relevant to the classification of cognitive state.",Floren A.; Naylor B.; Miikkulainen R.; Ress D.,2015.0,10.3389/fnhum.2015.00327,0,0,
7072,Neural correlates of individual differences in fear learning,"Variability in fear conditionability is common, and clarity regarding the neural regions responsible for individual differences in fear conditionability could uncover brain-based biomarkers of resilience or vulnerability to trauma-based psychopathologies (e.g., post-traumatic stress disorder). In recent years, neuroimaging work has yielded a detailed understanding of the neural mechanisms underlying fear conditioning common across participants, however only a minority of studies have investigated the brain basis of inter-individual variation in fear learning. Moreover, the majority of these studies have employed small sample sizes (mean n=. 17; range n=. 5-27) and all have failed to meet the minimum recommended sample size for functional magnetic resonance imaging (fMRI) studies of individual differences. Here, using fMRI, we analyzed blood-oxygenation level dependent (BOLD) response recorded simultaneously with skin conductance response (SCR) and ratings of unconditioned stimulus (US) expectancy in 49 participants undergoing Pavlovian fear conditioning. On average, participants became conditioned to the conditioned stimulus (CS+; higher US expectancy ratings and SCR for the CS+ compared to the unpaired conditioned stimulus, CS-); the CS+ also robustly increased activation in the bilateral insula. Amygdala activation was revealed from a regression analysis that incorporated individual differences in fear conditionability (i.e., a between-subjects regressor of mean CS+. >. CS- SCR). By replicating results observed using much smaller sample sizes, the results confirm that variation in amygdala reactivity covaries with individual differences in fear conditionability. The link between behavior (SCR) and brain (amygdala reactivity) may be a putative endophenotype for the acquisition of fear memories.",MacNamara A.; Rabinak C.A.; Fitzgerald D.A.; Zhou X.J.; Shankman S.A.; Milad M.R.; Phan K.L.,2015.0,10.1016/j.bbr.2015.03.035,0,0,
7073,"Kirschner wiretransfixation of unstable ankle fractures: Indication, surgical technique and outcomes","PURPOSE OF THE STUDY: The aim of the study was to assess treatment outcomes in patients undergoing K-wire transfixation of unstable ankle fractures and compare the results with those of patients in whom it was possible to perform primary one-stage osteosynthesis. MATERIAL AND METHODS: Between 2009 and 2012, a total of 358 patients (191 women and 167 men) had surgery for unstable ankle fracture. At 1 -year follow-up, their subjective feelings, objective findings and ankle radiographs were evaluated. The fractures were categorised according to the Weber classification. A patient group treated by one-stage osteosynthesis, a group with definitive transfixation and a group of patients in whom temporary transfixation was converted to definitive osteosynthesis were assessed and compared. RESULTS: The group treated by one-stage osteosynthesis included 278 patients with an average age of 47 years; the group of 20 patients with definitive transfixation had an average age of 67 years, and the group of 60 patients who had temporary transfixation with subsequent conversion to internal osteosynthesis were 55 years on average. In the group with one-stage osteosynthesis, 223 (80%) ankle fractures on post-injury radiographs were associated with minor joint dislocations and 55 (20%) with major dislocations. On the other hand, the radiographs of the patients treated by temporary transfixation and delayed open reduction with internal fixation showed major dislocations in 38 (63%) and minor dislocations in the rest of the patients (37%); the difference between the two groups was statistically significant (p<0.001). Posterior malleolar fractures were most frequent in the group with temporary transfixation (60%) and least frequent in the group with primary osteosynthesis (44%); also this difference was statistically significant (p=0.032). At one-year follow-up, in the group with one-stage osteosynthesis, 220 patients (79%) had no radiographic signs of post-traumatic ankle osteoarthritis while, in the group with temporary transfixation, no radiographic evidence of ankle osteoarthritis was recorded in 25 (42%) patients. While tibiofibular synostosis was recorded in only few patients (9%) of the group with one-stage osteosynthesis, it showed a high occurrence in the group with temporary transfixation (35%). The patients with one-stage osteosynthesis (188/68%) had a higher proportion of excellent outcomes measured on the Olerund-Molander ankle scoring scale than the other two groups (temporary transfixation, 47%; definitive transfixation, 10%); in both cases the difference was significant (p < 0.001 and p = 0.003, respectively). DISCUSSION: In this study the morphological and clinical aspects of surgically treated ankle fractures were assessed. The patients with one-stage osteosynthesis were compared with those treated by temporary or definitive transfixation. The majority of patients undergoing temporary transfixation had a fractured posterior margin of the tibia and major ankle joint dislocation, which suggested serious injuries to bone and ligament structures. Generally, the use of only two K-wires inserted through the cal-caneus and talus into the distal tibia is recommended. Patients with K-wire transfixation usually require a longer hospital stay because of the serious nature of their injuries. CONCLUSIONS: The therapy of choice for unstable ankle fractures is one-stage osteosynthesis. Temporary transfixation is an effective method of primary management when an unstable fracture cannot be treated by definitive osteosynthesis at the early stage due to local or general health conditions of the patient. The temporary transfixation provides good alignment of the ankle joint necessary for successful healing of soft tissues. A higher occurrence of post-traumatic ankle osteoarthritis, ossification and distal tibiotalar synostosis found in the patients treated by temporary transfixation is more related to serious types of ankle fractures the patient had suffered than to the method itself.",Marvan J.; Džupa V.; Bartoška R.; Kachlík D.; Krbec M.; Báča V.,2015.0,,0,0,
7074,The foreign language effect on moral judgment: The role of emotions and norms,"We investigated whether and why the use of a foreign language influences moral judgment. We studied the trolley and footbridge dilemmas, which propose an action that involves killing one individual to save five. In line with prior work, the use of a foreign language increased the endorsement of such consequentialist actions for the footbridge dilemma, but not for the trolley dilemma. But contrary to recent theorizing, this effect was not driven by an attenuation of emotions. An attenuation of emotions was found in both dilemmas, and it did not mediate the foreign language effect on moral judgment. An examination of additional scenarios revealed that foreign language influenced moral judgment when the proposed action involved a social or moral norm violation.We propose that foreign language influences moral judgment by reducing access to normative knowledge.",Geipel J.; Hadjichristidis C.; Surian L.,2015.0,10.1371/journal.pone.0131529,0,0,
7075,Anxiogenic effects of m-CPP in patients with panic disorder: comparison to caffeine's anxiogenic effects,"ER The behavioral and neuroendocrine effects of meta-chlorophenylpiperazine (m-CPP), a serotonergic agonist, were compared with the effects of caffeine, an adenosine antagonist, in panic disorder patients. Patients with panic disorder were given single oral doses of 0.5 mg/kg m-CPP, 480 mg caffeine, and placebo on separate days under double-blind conditions. Both m-CPP and caffeine had significantly greater anxiogenic and panic-inducing effects than placebo, although caffeine produced nonsignificantly greater increases on all anxiety rating scales than m-CPP. Both m-CPP and caffeine produced significant equivalent increases in plasma cortisol concentrations, but only m-CPP produced plasma prolactin increases. These findings provide further evidence implicating both the serotonergic and adenosinergic receptor systems in the neurobiology of panic disorder.","Klein, E; Zohar, J; Geraci, M F; Murphy, D L; Uhde, T W",1991.0,,0,0,
7076,Effectiveness of a psychosocial counselling intervention for first-time IVF couples: a randomized controlled trial,"ER METHODSTwo hundred sixty-five couples admitted to an IVF treatment programme at the Erasmus MC were asked to participate in this study. Eighty-four couples agreed and were randomized according to a computer-generated random-numbers table into either a routine-care control group or an intervention group. The intervention consisted of three sessions with a social worker trained in Experiential Psychosocial Therapy: one before, one during and one after the first IVF cycle. Distress was measured daily during treatment by the Daily Record Keeping Chart. Depression and anxiety were measured before and after treatment by the Hospital Anxiety and Depression Scale.RESULTSNo significant group differences were found.CONCLUSIONSThe results of this study do not support the implementation of our counselling intervention for all first-time IVF couples. The low response rate suggests that there is little perceived need for psychosocial counselling among couples during a first IVF treatment cycle.BACKGROUNDThe objective of this study was to evaluate a psychosocial counselling intervention for first-time IVF couples. In this article the results on women's distress are presented.","Klerk, C; Hunfeld, J A; Duivenvoorden, H J; Outer, M A; Fauser, B C; Passchier, J; Macklon, N S",2005.0,10.1093/humrep/deh748,0,0,
7077,Effect of a Family-Maintained Progress Journal on anxiety of families of critically ill patients,"ER The purpose of this research was to determine the effect of a Family-Maintained Progress Journal on the anxiety of the family member of patients undergoing coronary artery bypass graft surgery. Ninety-one family members were assigned to either the group receiving the usual information or the group that also received a diary. Anxiety was significantly lower after 3 days although the reduction was not different by group. Trait anxiety had the most influence on anxiety reduction, followed by uncertainty. Content analysis revealed negative emotions with illness appearance of the patient, requests for regular communication, and concerns about reducing pain. Family members wrote that faith in God and support of others helped them. Nurses can affect uncertainty by adjusting the information provided according to family preferences and by supporting their faith practices. Further research on the role of faith in uncertainty and anxiety during critical illness is needed.","Kloos, J A; Daly, B J",2008.0,10.1097/01.CNQ.0000314469.41507.cb,0,0,
7078,Relaxation-induced EEG alterations in panic disorder patients,"ER Based on previous reports of relaxation-induced panic attacks in panic disorder patients, quantitative electroencephalographic (EEG) profiles and subjective anxiety ratings were assessed in panic disorder patients and normal controls listening to neutral and relaxation audiotapes. Regardless of tape condition, patients exhibited a greater frequency and severity of panic-related symptoms. Relaxation failed to alter panic-related symptom ratings or anxiety ratings in patients and controls. Theta and alpha increments were observed during relaxation, but only in normal controls. High frequency beta activity was less evident in patients, regardless of tape conditions. Results are discussed in relation to arousal and treatment issues in panic disorder.","Knott, V; Bakish, D; Lusk, S; Barkely, J",1997.0,,0,0,
7079,The relaxation exercise and social support trial-resst: study protocol for a randomized community based trial,"ER METHODS/DESIGNThis is a community-based intervention trial that aims to evaluate the impact of a psycho-social intervention on medically unexplained vaginal discharge (MUVD) in a group of married, low-income Lebanese women, aged 18-49, and suffering from low to moderate levels of anxiety and/or depression. The intervention consisted of 12 sessions of structured social support, problem solving techniques, group discussions and trainer-supervised relaxation exercises (twice per week over six weeks). Women were recruited from Hey el Selloum, a southern disadvantaged suburb of Beirut, Lebanon, during an open recruitment campaign. The primary outcome was self-reported MUVD, upon ruling out reproductive tract infections (RTIs), through lab analysis. Anxiety and/or depression symptoms were the secondary outcomes for this trial. These were assessed using an Arabic validated version of the Hopkins Symptoms Checklist-25 (HSCL-25). Assessments were done at baseline and six months using face-to face interviews, pelvic examinations and laboratory tests. Women were randomized into either intervention or control group. Intent to treat analysis will be used.DISCUSSIONThe results will indicate whether the proposed psychosocial intervention was effective in reducing MUVD (possibly mediated by common mental distress).TRIAL REGISTRATIONThe trial is registered at the Wellcome Trust Registry, ISRCTN assigned: ISRCTN: ISRCTN98441241.BACKGROUNDStudies suggests a possible link between vaginal discharge and common mental distress, as well as highlight the implications of the subjective burden of disease and its link with mental health.","Kobeissi, L; Araya, R; Kak, F; Ghantous, Z; Khawaja, M; Khoury, B; Mahfoud, Z; Nakkash, R; Peters, T J; Ramia, S; Zurayk, H",2011.0,10.1186/1471-244X-11-142,0,0,
7080,The Relaxation Exercise and Social Support Trial (RESST): a community-based randomized controlled trial to alleviate medically unexplained vaginal discharge symptoms,"ER METHODS: A community-based individually randomized controlled trial to assess the effectiveness of a relatively simple, culturally appropriate multi-component intervention on reducing reported MUVD, among women suffering from low-moderate levels of common mental distress. The setting was a socio-economically deprived, informal settlement in the southern suburbs of Beirut, Lebanon. The intervention comprised up to 12 group sessions implemented over a six-week period, each divided into a psychosocial and a relaxation exercise component. The primary outcome was self-reported MUVD, which was defined as a complaint of vaginal discharge upon ruling out reproductive tract infections (RTIs), through lab analysis. Anxiety and/or depression symptoms were the secondary outcomes for this trial. These were assessed using an Arabic validated version of the Hopkins Symptoms Checklist-25 (HSCL-25). Assessments were done at baseline and six months using face-to face interviews, pelvic examinations and laboratory tests. Women were randomized into either intervention or control group. Blinding on the intervention status was not possible for both logistic and ethical reasons, especially as knowledge of involvement in the intervention was integral to its delivery. Intent to treat analysis was used.RESULTS: Of 75 women randomized to the intervention, 48% reported MUVD at 6 months compared with 63% of 73 in the control group (difference of -15%, 95% confidence interval (CI) -31%, 0%, p=0.067). Adjustments for baseline imbalances and any factors relating to consent had no appreciable effect on these results. The risk of MUVD was reduced in absolute terms by 2.4% for each intervention session attended (95%","Kobeissi, L; Mahfoud, Z; Khoury, B; Kak, F; Ghantous, Z; Khawaja, M; Nakkash, R; Ramia, S; Zurayk, H; Araya, R; Peters, T J",2012.0,10.1186/1471-244X-12-195,0,0,
7081,Incision sizes before and after implantation of SN60WF intraocular lenses using the Monarch injector system with C and D cartridges,"ER SETTINGDepartment of Ophthalmology, Johann Wolfgang Goethe-University, Frankfurt, Germany.METHODSIn this prospective randomized trial of 100 cataract patients, hydrophobic acrylic IOLs (SN60WF) were implanted using 2 injector systems with 2 cartridges (Monarch II and Monarch III with C and D cartridges, respectively; Alcon) and 2 surgical techniques (direct implantation and wound-assisted docking implantation). Incision sizes were measured before and after phacoemulsification as well as before and after IOL implantation using a Tsuneoka microincision gauge. The Saphiro-Wilks test was performed to detect nonparametric distribution and the Kruskal-Wallis test, to test for significant differences between groups.RESULTSThe mean incision sizes (mm) at the 4 points of treatment with the Monarch III with the D cartridge were 1.98+/-0.07, 2.01+/-0.05, 2.42+/-0.07, and 2.51+/-0.05, respectively, with direct implantation and 1.92+/-0.06, 1.98+/-0.04, 2.02+/-0.11, and 2.09+/-0.11, respectively, with wound-assisted implantation. With the Monarch II with the C cartridge, the mean incision sizes were 2.17+/-0.06, 2.2+/-0.16, 2.77+/-0.11, and 2.86+/-0.11, respectively, with direct implantation and 2.12+/-0.10, 2.17+/-0.19, 2.19+/-0.09, and 2.28+/-0.08, respectively, with wound-assisted implantation. Postoperative incision sizes differed significantly from preoperative incision sizes and from each other (P<.05).CONCLUSIONWith new injector systems and an appropriate docking implantation technique, foldable hydrophobic acrylic IOLs can be implanted through 2.0 mm tunnel incisions.PURPOSETo evaluate incision sizes for 6.0 mm optic hydrophobic acrylic intraocular lenses (IOLs) implanted with different injector systems and surgical techniques.","Kohnen, T; Klaproth, O K",2008.0,10.1016/j.jcrs.2008.06.031,0,0,
7082,Fluoxetine in posttraumatic stress disorder,"ER METHOD64 subjects (22 women and 42 men; 31 veterans and 33 nonveterans) with PTSD entered a 5-week randomized double-blind trial comparing fluoxetine (N = 33) and placebo (N = 31).RESULTSBy Week 5 fluoxetine, but not placebo, significantly reduced overall PTSD symptomatology, as assessed by the Clinician-Administered PTSD Scale (CAPS) score. Changes were most marked in the arousal and numbing symptom subcategories. Non-VA patients responded much better than VA patients. Fluoxetine was an effective antidepressant independent of its effects on PTSD.CONCLUSIONFluoxetine is an effective pharmacotherapeutic agent for treating PTSD and its associated features, particularly in patients without chronic treatment histories.BACKGROUNDThis study was designed to establish the efficacy of the serotonin reuptake blocker fluoxetine in the treatment of posttraumatic stress disorder (PTSD).","Kolk, B A; Dreyfuss, D; Michaels, M; Shera, D; Berkowitz, R; Fisler, R; Saxe, G",1994.0,,0,0,
7083,"Endogenous opioids, stress induced analgesia, and posttraumatic stress disorder","ER The hypothesis that the animal model of inescapable shock (IES) is an appropriate model for posttraumatic stress disorder (PTSD) predicts that re-exposure to a traumatic stressor will precipitate opioid-mediated stress-induced analgesia in people with PTSD. Eight Vietnam veterans with PTSD and eight matched veterans without PTSD viewed a combat videotape under naloxone and placebo conditions in a randomized double-blind crossover design. In the placebo condition, but not after naloxone, the PTSD subjects reported a 30 percent decrease in pain intensity ratings of standardized heat stimuli after the combat videotape. Point biserial correlations revealed that change in pain perception was the most highly correlated with PTSD of all variables tested, including biochemical, physiological, and self-report. These results suggest that a centrally mediated opioid response to traumatic stimuli is an important feature of PTSD. Possible implications of this finding for the psychobiology of PTSD are discussed.","Kolk, B A; Greenberg, M S; Orr, S P; Pitman, R K",1989.0,,0,0,
7084,Methylphenidate and behavior modification in children with ADHD and comorbid ODD or CD: main and incremental effects across settings,"ER METHODSixteen of 22 children with ADHD and comorbid disruptive disorder completed a randomized, placebo-controlled study examining the separate and incremental effects of 2 doses of MPH and BMOD during a partial hospitalization program. Of the 6 who did not complete the study, 2 children developed significant side effects. For the 16 who did complete the study, effects were examined on measures of symptom ratings, behavioral frequencies, and stimulant side effects across program activities.RESULTSBased on alpha-adjusted analyses of variance, there were several main effects of MPH and BMOD on ADHD symptoms, oppositional behavior, and positive social behavior, with certain effects unique to each intervention and setting. One incremental effect each was found for MPH (positive mood/behavior) and BMOD (negative behavior). MPH and BMOD were associated with few side effects. Effect sizes for each intervention showed considerable variability in clinical response.CONCLUSIONSThat MPH and BMOD had certain unique main and incremental effects extends findings supporting their combination and suggests that integrated studies evaluate multiple dimensions of functioning and in novel settings (e.g., home, school). The incorporation of other intervention components in combined treatments may be warranted to enhance clinical efficacy.OBJECTIVEAlthough the combination of methylphenidate (MPH) and behavior modification (BMOD) has been advocated to enhance clinical outcome for children with attention-deficit hyperactivity disorder (ADHD) and comorbid disruptive disorders, few group studies have been conducted. This study evaluates the separate and incremental effects of these modalities on rating scale and observational measures in multiple settings.","Kolko, D J; Bukstein, O G; Barron, J",1999.0,10.1097/00004583-199905000-00020,0,0,
7085,Effectiveness of Trauma-Focused Cognitive Behavioral Therapy in a community-based program,"ER Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a widely used treatment model for trauma-exposed children and adolescents (Cohen, Mannarino, & Deblinger, 2006). The Healthy Coping Program (HCP) was a multi-site community based intervention carried out in a diverse Canadian city. A randomized, waitlist-control design was used to evaluate the effectiveness of TF-CBT with trauma-exposed school-aged children (Muller & DiPaolo, 2008). A total of 113 children referred for clinical services and their caregivers completed the Trauma Symptom Checklist for Children (Briere, 1996) and the Trauma Symptom Checklist for Young Children (Briere, 2005). Data were collected pre-waitlist, pre-assessment, pre-therapy, post-therapy, and six months after the completion of TF-CBT. The passage of time alone in the absence of clinical services was ineffective in reducing children's posttraumatic symptoms. In contrast, children and caregivers reported significant reductions in children's posttraumatic stress (PTS) following assessment and treatment. The reduction in PTS was maintained at six month follow-up. Findings of the current study support the use of the TF-CBT model in community-based settings in a diverse metropolis. Clinical implications are discussed.","Konanur, S; Muller, R T; Cinamon, J S; Thornback, K; Zorzella, K P",2015.0,10.1016/j.chiabu.2015.07.013,0,0,
7086,Interpersonal Subtypes and Therapy Response in Patients Treated for Posttraumatic Stress Disorder,"ER KEY PRACTITIONER MESSAGE: Interpersonal traits may contribute to psychotherapy outcome. Dividing the sample according to the quadrants of the interpersonal circumplex, as opposed to cluster analysis, yielded promising results. Patients higher in dominance fared better with cognitive processing therapy, while interpersonal style had no correlations with therapy success in dialogical exposure therapy.UNLABELLED: Interpersonal traits may influence psychotherapy success. One way of conceptualizing such traits is the interpersonal circumplex model. In this study, we analyse interpersonal circumplex data, assessed with the Inventory of Interpersonal Problems (Horowitz, Strauß, & Kordy, 1994) from a randomized study with 138 patients suffering from posttraumatic stress disorder after trauma in adulthood. The study compared cognitive processing therapy and dialogical exposure therapy, a Gestalt-based intervention. We divided the interpersonally heterogeneous sample according to the quadrants of the interpersonal circumplex. The division into quadrants yielded subgroups that did not differ in their general psychological distress, but the cold-submissive quadrant tended to exhibit higher posttraumatic stress disorder symptom severity and interpersonal distress than the other three. There was also a trend for patients in different quadrants to be affected differently by the treatments. Correlation analyses supported these results: in cognitive processing therapy, more dominant patients had more successful therapies, while in dialogical exposure therapy, success was not correlated with interpersonal style. Results indicate that especially patients with cold interpersonal styles profited differentially from the two treatments offered. Dividing samples according to the interpersonal circumplex quadrants seems promising.","König, J; Onnen, M; Karl, R; Rosner, R; Butollo, W",2016.0,10.1002/cpp.1946,0,0,
7087,The effectiveness of an augmented cognitive behavioural intervention for post-stroke depression with or without anxiety (PSDA): the Restore4Stroke-PSDA trial,"ER BACKGROUND: Post-Stroke Depression with or without Anxiety (PSDA) is a common disorder in the chronic phase of stroke. Neuropsychiatric problems, such as PSDA, have a negative impact on social reintegration and quality of life. Currently, there is no evidence-based treatment available for reducing PSDA symptoms. In the recent literature on depression in the general population it has been shown that depression complaints can diminish by cognitive behavioural therapy (CBT). In the current study, the effectiveness of augmented, activation-based and individually tailored CBT on the reduction of depression and anxiety will be investigated in patients with PSDA. Additionally, the effects on various secondary outcome measures, such as quality of life, goal attainment and societal participation will be evaluated. This study is embedded in a consortium of 4 interrelated studies on quality of life after stroke (Restore4Stroke).METHODS/DESIGN: A multi-centre, assessor-blind, randomized controlled trial is conducted. A sample of 106 PSDA patients, as assessed with the Hospital Anxiety and Depression Scale (HADS depression subscale >7), will be recruited and randomly allocated to either an experimental or a control group. The experimental intervention consists of an augmented CBT intervention. The intervention is based on CBT principles of recognizing, registering, and altering negative thoughts and cognitions so that mood, and emotional symptoms are improved. CBT is augmented with direct in-vivo activation offered by occupational or movement therapists. Patients in the control group will receive a computerized cognitive training intervention. Outcomes will be assessed at baseline, immediately post intervention, and at 6 and 12 months follow up.DISCUSSION: This study is the first randomized clinical trial that evaluates the (maintenance of) effects of augmented CBT on post-stroke depression with or without anxiety symptoms. Together with three other projects, the Restore4Stroke PSDA trial will provide novel information about the (treatment of) emotional problems and quality of life after stroke.TRIAL REGISTRATION: Trial registration number: Dutch Trial Register NTR2999.","Kootker, J A; Fasotti, L; Rasquin, S M; Heugten, C M; Geurts, A Ch",2012.0,10.1186/1471-2377-12-51,0,0,
7088,Telephone monitoring of distress in patients aged 65 years or older with advanced stage cancer: a cancer and leukemia group B study,"ER METHODSOne hundred ninety-two older patients with breast, prostate, and colorectal cancers who had advanced disease and currently were receiving treatment were randomized to receive either TM + EM or EM alone. One hundred thirty-one patients were evaluated by telephone interview for psychologic and physical distress and for social support at baseline and at 6 months using the Hospital Anxiety and Depression Scale (HADS), the European Organization for Research and Treatment of Cancer (EORTC)-QLQ-C30 quality-of-life questionnaire, and the Medical Outcomes Study (MOS) Social Support Survey. Patients who in the TM + EM group were called monthly for 6 months to monitor their distress using the HADS and EORTC physical symptom items and the MOS Social Support Survey items, with cutoff levels were established to indicate which patients were in greater distress. Those patients who scored above the cutoff levels were referred to their oncology nurse for referral to the appropriate professional. Patients in the EM group received written materials regarding cancer-related psychosocial issues and available resources.RESULTSAt 6 months, patients in the TM + EM group reported significantly less anxiety (HADS; P < .0001), depression (HADS; P = .0004), and overall distress (HADS; P < .0001) compared with patients in the EM group.CONCLUSIONSMonthly monitoring of older patients' distress with TM and EM along with referral for appropriate help was found to be an efficient means of reducing patients' anxiety and depression compared with patients who received only EM.BACKGROUNDSignificant barriers to cancer patients receiving mental health treatment for distress have been reported in the literature. The objective of the current study was to determine whether distress in older patients (aged 65 years and older) would be reduced with educational materials (EM) supplemented by monthly telephone monitoring (TM) (TM + EM) compared with the use of EM alone because of more timely referrals to appropriate health professionals.","Kornblith, A B; Dowell, J M; Herndon, J E; Engelman, B J; Bauer-Wu, S; Small, E J; Morrison, V A; Atkins, J; Cohen, H J; Holland, J C",2006.0,10.1002/cncr.22296,0,0,
7089,Acupuncture in the treatment of posttraumatic pain syndrome,"ER To test the hypothesis that classical Chinese acupuncture provides an additional benefit subjectively as well as objectively in patients suffering from reflex sympathetic dystrophy, a double-blind, placebo-controlled prospective trial was performed. Fourteen patients suffering clinically and scintigraphically from acute CRPS of the upper limb lasting of more than one but less than 6 months were studied. Patients were randomly assigned to either the classical acupuncture (group A) or sham acupuncture (group S), which was applied five times a week for three weeks and required 30 minutes. Both groups received the same defined standard treatment. The current state of pain was assessed by means of a visual analogue scale. Subjective success of treatment was rated by the patients by means of a rating scale. Each patient underwent a clinical examination and was investigated by 5-phase bone scan in order to confirm the diagnosis. The current state of pain as well as clinical parameters were almost identical in patients of group A and of group S at the beginning. During therapy clinical parameters as well as pain improved in both groups and reached nearly normal levels after 6 months. Owing to the small number of patients in our study, no differences between sham and treatment group could be recognized. For a definitive statement the treatment of further patients in both groups is planned. Determinations of the effect of acupuncture on clinical parameters, based on long-term follow-ups are projected.","Korpan, M I; Dezu, Y; Schneider, B; Leitha, T; Fialka-Moser, V",1999.0,,0,0,
7090,"Effects of cancer rehabilitation on problem-solving, anxiety and depression: a RCT comparing physical and cognitive-behavioural training versus physical training","ER We tested the effects on problem-solving, anxiety and depression of 12-week group-based self-management cancer rehabilitation, combining comprehensive physical training (PT) and cognitive-behavioural problem-solving training (CBT), compared with PT. We expected that PT + CBT would outperform PT in improvements in problem-solving (Social Problem-Solving Inventory-Revised (SPSI-R)), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), and that more anxious and/or depressed participants would benefit most from adding CBT to PT. Cancer survivors (aged 48.8 ± 10.9 years, all cancer types, medical treatment completed) were randomly assigned to PT + CBT (n = 76) or PT (n = 71). Measurement occasions were: before and post-rehabilitation (12 weeks), 3- and 9-month follow-up. A non-randomised usual care comparison group (UCC) (n = 62) was measured at baseline and after 12 weeks. Longitudinal intention-to-treat analyses showed no differential pattern in change between PT + CBT and PT. Post-rehabilitation, participants in PT and PT + CBT reported within-group improvements in problem-solving (negative problem orientation; p < 0.01), anxiety (p < 0.001) and depression (p < 0.001), which were maintained at 3- and 9-month follow-up (p < 0.05). Compared with UCC post-rehabilitation, PT and PT + CBT only improved in anxiety (p < 0.05). CBT did not add to the effects of PT and had no extra benefits for higher distressed participants. PT was feasible and sufficient for durably reducing cancer survivors' anxiety.","Korstjens, I; Mesters, I; May, A M; Weert, E; Hout, J H; Ros, W; Hoekstra-Weebers, J E; Schans, C P; Borne, B",2011.0,10.1080/08870441003611569,0,0,
7091,Life review in groups? An explorative analysis of social processes that facilitate or hinder the effectiveness of life review,"ER OBJECTIVES: Life review can be implemented within a group as well as on an individual level. There have been few discussions about which the format is most effective. This study investigates the social aspects of a life-review group intervention from the perspective of the client within the context of a large, randomized controlled trial.METHOD: This was an exploratory study using a qualitative methodology. We conducted semi-structured interviews to explore how participants felt about the benefits and barriers of receiving life review in a group. Transcripts of the interviews were analyzed using inductive analysis.RESULTS: The social processes of life review in a group included experiencing a sense of belonging, feeling accepted, finding good company, disclosing oneself, learning to express oneself, finding recognition, realizing that others have problems too, being more successful at coping than others, learning from others, and being able to help others. Negative processes were less often mentioned and included having difficulties with sharing in a group, finding no recognition, and anxiety caused by the prospect of finding no recognition. These social processes can be divided into three categories: first, having a good atmosphere in the group; second, disclosure to peers; and third, relating to others.CONCLUSION: Our results reveal a variety of social processes that may facilitate the effects of life-review therapy. Future research, however, is needed to further examine the importance of these social processes and their effects on depression.","Korte, J; Drossaert, C H; Westerhof, G J; Bohlmeijer, E T",2014.0,10.1080/13607863.2013.837140,0,0,
7092,Impact of relaxation training according to the Yoga In Daily Life® system on anxiety after breast cancer surgery,"ER The purpose of this pilot study was to gather information on the immediate and short-term effects of relaxation training according to the Yoga In Daily Life (YIDL) system on anxiety of breast cancer patients. The YIDL system is a holistic system being practised and taught worldwide and has been proven to be highly effective in the prevention and treatment of various diseases. The system aims to establish physical, mental, spiritual, and social health. Thirty-two patients at the Institute for Oncology Ljubljana were randomized to the experimental (n=16) and to the control groups (n=16). Both groups received the same standard physiotherapy for 1 week, while the experimental group additionally received 1-hour group relaxation training session according to the YIDL system per day. At discharge, the experimental group was issued with audiocassette recordings containing similar instructions for relaxation training to be practiced for 3 weeks individually at home. Anxiety measures were obtained by blinded assessors using standardized questionnaires. The results indicate that relaxation training according to the YIDL system could be a useful clinical physiotherapy intervention for breast cancer patients experiencing anxiety.","Kova?i?, T; Zagori?nik, M; Kova?i?, M",2013.0,10.1515/jcim-2012-0009,0,0,
7093,Depression and anxiety in adult congenital heart disease: predictors and prevalence,"ER METHODSIn this cross-sectional study, consecutive patients were recruited from two ACHD outpatient clinics. All patients completed self-report psychosocial measures and a subset was randomly selected to participate in structured clinical interviews. Linear regression models were used to predict symptoms of depression and anxiety.RESULTSA total of 280 patients (mean age=32 years; 52% female) completed self-report measures. Sixty percent had defects of moderate complexity and 31% had defects of great complexity. Significant predictors of depressive symptoms were loneliness (p<0.001), perceived health status (p<0.001), and fear of negative evaluation (p=0.02). Predictors of anxiety symptoms were loneliness (p<0.001) and fear of negative evaluation (p<0.001). Disease severity and functional class did not predict mood or anxiety symptoms. Fifty percent of interviewed patients (29/58) met diagnostic criteria for at least one lifetime mood or anxiety disorder, of whom 39% had never received any mental health treatment.CONCLUSIONSThe results confirm an increased risk and under-treatment of mood and anxiety disorders in ACHD patients. Social adjustment and patient-perceived health status were more predictive of depression and anxiety than medical variables. These factors are modifiable and therefore a potential focus of intervention.BACKGROUNDAdult congenital heart disease (ACHD) patients face unique medical and social challenges that may contribute to psychological difficulties. The goals of this study were to identify predictors of symptoms of depression and anxiety and evaluate the prevalence of mood and anxiety disorders among North American ACHD patients.","Kovacs, A H; Saidi, A S; Kuhl, E A; Sears, S F; Silversides, C; Harrison, J L; Ong, L; Colman, J; Oechslin, E; Nolan, R P",2009.0,10.1016/j.ijcard.2008.06.042,0,0,
7094,Evaluation of an early risk screener for PTSD in preschool children after accidental injury,"ER OBJECTIVES: To evaluate the effectiveness and most powerful selection of predictors of an early screening tool for posttraumatic stress disorder (PTSD) in a sample of 87 children ages 2 to 6 years after unintentional injury.METHODS: The examined screener was administered within 6 to 13 days post accident and consisted of an adapted version of the Pediatric Emotional Distress Scale (PEDS), the PEDS-ES (PEDS Early Screener), and questions on 5 additional risk factors (preexisting child behavioral problems, parental preexisting chronic mental or physical illness, pretraumatic life events in the family, parental feelings of guilt, parental posttraumatic stress). The PTSD Semi-structured Interview and Observational Record for Infants and Young Children served as criterion measure 6 months after the accident. A case was deemed positive when meeting criteria for full or partial PTSD.RESULTS: Use of the PEDS-ES without the additional risk factors performed best, with good sensitivity (85%) and moderate specificity (63%) for full or partial PTSD.CONCLUSIONS: The PEDS-ES allows for successful early screening of preschool-aged children after single accidental trauma. It may be used within a stepped-care model for early identification of individuals designated for possible secondary preventative interventions.","Kramer, D N; Hertli, M B; Landolt, M A",2013.0,10.1542/peds.2013-0713,0,0,
7095,The randomization problem in psychotherapy studies,"ER In a research project comparing inpatient and outpatient psychotherapeutic treatment for patients suffering from anxiety disorders, 132 subjects were allocated to both treatments by means of randomisation. Because of the patients' voluntary agreement or refusal of the proposed treatment, the subsamples are markedly affected in their homogeneity. It seems that more disturbed patients agreed to inpatient psychotherapy, whereas less disturbed patients refused that form of treatment. Bias toward or against a given form of treatment turned out to be the most potent predictor in multivariate analysis. The influence of this distortion of the samples is discussed with regard to the generalisation of the results. Proposed countermeasures have their shortcomings, and in the end it seems that randomisation should be avoided in psychotherapeutic research.","Krauthauser, H; Bassler, M",1997.0,,0,0,
7096,Inflammation after phacoemulsification in diabetic retinopathy. Foldable acrylic versus heparin-surface-modified poly(methyl methacrylate) intraocular lenses,"ER SETTINGDepartment of Ophthalmology, University of Vienna, Vienna, Austria.METHODSPatients with NPDR were randomized for implantation of an HSM PMMA IOL (811C, Pharmacia) through a 6.0 mm sclerocorneal incision (30 patients) or a foldable hydrophobic acrylic IOL (AcrySof, Alcon) through a 4.0 mm sclerocorneal incision (32 patients). Both IOLs had 6.0 mm optics. All patients were treated according to a standardized protocol. The degree of flare in the anterior chamber was measured with the Kowa 1000 laser flare-cell meter 1 day preoperatively and 1 day, 1 week, and 1 and 3 months postoperatively.RESULTSIn both IOL groups, flare was highest on the first postoperative day and decreased to preoperative levels by 3 months after surgery. There was no statistically significant difference in relative flare values between the 2 groups.CONCLUSIONThere was no difference in postoperative inflammation in eyes with a foldable hydrophobic acrylic IOL implanted through a small incision and those with a rigid HSM PMMA IOL. Postoperative inflammation results indicate that the lenses are equally suitable for the use in patients with diabetic retinopathy.PURPOSETo evaluate inflammation after cataract surgery in patients with nonproliferative diabetic retinopathy (NPDR) and compare results with 2 intraocular lenses (IOLs): a foldable hydrophobic acrylic and a heparin-surface-modified (HSM) poly(methyl methacrylate) (PMMA).","Krepler, K; Ries, E; Derbolav, A; Nepp, J; Wedrich, A",2001.0,,0,0,
7097,Heparin Surface-Modified Poly(methylmethacrylate) and Foldable Hydrophobic Acrylic Intraocular Lenses in Cataract Patients with Acquired Immune Deficiency Syndrome and CMV-Retinitis,"ER METHODSIn this randomised prospective clinical trial 18 patients received 7 HSM-IOLs through a self-sealing scleral tunnel and 11 foldable Acrysof-IOLs through a self-sealing limbal tunnel incision by the same surgeon. 7 of the 18 eyes were silicone oil-filled before cataract surgery, one eye received oil after the IOL implantation. Visual acuity, intraocular pressure, contrast sensitivity, intraocular inflammation and posterior capsule opacification were assessed. The follow-up period was 1 year.RESULTSEyes with Acrysof-IOLs were associated with lower, but not statistically significant, laser flare photometry values (photon counts/ms) than those with HSM-IOLs pre- (90.18 +/- 54.7 vs. 73.92 +/- 6.44) and 3 months post-surgery (69.06 +/- 8.27 vs. 55.03 +/- 7.75). 6 of the 7 eyes with HSM-IOL and 3 eyes of the Acrysof-group developed a dense posterior capsule opacification (PCO), 2 eyes had no and 6 eyes only a distinct PCO. YAG capsulotomy did not improve visual acuity in any case but retinal examination was again possible. Eyes with Acryl-IOL showed pre- and postoperatively a better visual acuity than eyes with HSM-IOL (""hand movement"" - 0.4 vs. ""no light perception"" - 0.1 pre- and 0.05 - 0.6 vs. ""no light perception"" - 0.1 3 months postoperatively. Contrast sensitivity testing (Vistech method) could be performed in the PMMA-group preoperatively only in 1 eye (A1), in the Acryl-group in 2 eyes (A4, B4, C2, D2) and revealed postoperatively ""no contrast vision"" - A1, B2, C1 vs. ""no contrast vision"" - A2, B2, C3, D1, E1. The intraocular pressure was preoperatively 13.86 mm Hg (PMMA) vs. 14.82 mm Hg (Acrysof) and 14.4 mm Hg vs. 12.89 mm Hg 3 months post surgery.CONCLUSIONIn the parameters we observed there was no statistical significant difference between heparin-surface modified (Pharmacia 811 C) and hydrophobic acrylic IOLs (Alcon Acrysof MA60BM) in patients with AIDS. As foldable Acrysof-IOLs can be implanted through a self-sealing bloodless tunnel incision and are associated with less posterior capsule opacification we prefer this IOL type in cataract surgery of AIDS patients.BACKGROUNDIn HIV-positive patients with necrotising retinitis, well-tolerated lens material as well as minimal invasive surgery to avoid postoperative complications are imperative. Heparin surface-modified PMMA-IOLs as well as acrylic IOLs are associated with less postoperative inflammation than conventional intraocular lenses.","Krieglsteiner, S; Gümbel, H O; Kohnen, T",2004.0,10.1055/s-2003-812636,0,0,
7098,The effects of lavender scent on dental patient anxiety levels: a cluster randomised-controlled trial,"ER METHODSIn a cluster randomized-controlled trial, patients' (N = 340) anxiety was assessed while waiting for a scheduled dental appointment, either under the odor of lavender or with no odor. Current anxiety, assessed by the brief State Trait Anxiety Indicator (STAI-6), and generalized dental anxiety, assessed by the Modified Dental Anxiety Scale (MDAS) were examined.RESULTSAnalyses of variance (anovas) showed that although both groups showed similar, moderate levels of generalized dental anxiety (MDAS F((1,338)) = 2.17, P > 0.05) the lavender group reported significantly lower current anxiety (STAI: F((1,338)) = 74.69, P < 0.001) than the control group.CONCLUSIONSAlthough anxiety about future dental visits seems to be unaffected, lavender scent reduces state anxiety in dental patients.OBJECTIVESTo review the effect of lavender scent on anticipatory anxiety in dental participants.","Kritsidima, M; Newton, T; Asimakopoulou, K",2010.0,10.1111/j.1600-0528.2009.00511.x,0,0,
7099,Selective attention for hyperventilatory sensations in panic disorder,"ER According to cognitive theories, panic patients are assumed to display selective attention for feared bodily sensations. To date there has only been indirect evidence for this based on performance on reaction time tasks such as the modified Stroop task and the dot probe detection task. In the present study a more direct attempt was made to investigate whether panic patients show selective attention for feared sensations, in particular hyperventilatory sensations. A group of patients with panic disorder and a group of normal controls were compared on their performance on a reaction time task in which tones of different length had to be discriminated. During the task subjects were asked either to hyperventilate, to overbreathe under isocapnic conditions, or to make a neutral movement. No evidence for selective attention for hyperventilatory sensations was found. The article also discusses whether lack of finding interference during hyperventilation might be due to methodological issues.","Kroeze, S; Hout, M A",2000.0,,0,0,
7100,Efficacy of psychodynamic short-term psychotherapy for children and adolescents with anxiety disorders,"ER Anxiety disorders can be regarded as one of the most prevalent disorders in children and adolescents. Although psychodynamic psychotherapies are frequently carried out in this field, the evaluation of its efficacy for anxiety disorders is still deficient. Therefore the aim of the study was to evaluate psychodynamic short-term psychotherapy (PSTP) comprising 25 therapy sessions for children and adolescents with anxiety disorders. In a controlled trial PSTP was compared to a waiting list control condition. 26 children and adolescents with anxiety disorders were included in the study. Treatment outcome was measured by the Impairment-Score for Children and Adolescents (IS-CA). Moreover, the Child Behavior Checklist (CBCL) and the Psychic and Social-Communicative Findings Sheet for Children and Adolescents (PSCFS-CA) were administered at the beginning and end of the treatment. The statistical and clinical significance of changes in these measures was evaluated. A significant advantage of the treatment group compared to the waiting control group for the IS-CA was shown. For the IS-CA total score, an effect size of 1.6 was found. Whereas 62% of the patients in the treatment group showed clinically significant and reliable improvement at the end of therapy, this was the case for only 8% of the subjects in the waiting list condition. Effect sizes comparable to the IS-CA were found for the PSCFS-CA. In the CBCL significant improvement could be shown for the treatment and control group. The findings support the evidence that psychodynamic short-term psychotherapy (PSTP) is an effective treatment for children and adolescents with anxiety disorders. However, some of the studied children and adolescents seem to be in need of more intensive treatment.","Kronmüller, K T; Postelnicu, I; Hartmann, M; Stefini, A; Geiser-Elze, A; Gerhold, M; Hildegard, H; Winkelmann, K",2005.0,,0,0,
7101,The administration of transcranial electric treatment for affective disturbances therapy in alcoholic patients,"ER In a double blind placebo-controlled investigation it was shown that transcranial electric treatment (TET), comprising the combination of a constant current with a pulse current of square impulses of 70-80 Hz is an effective method to correct affective disturbances (anxiety, depression) in alcoholic patients. The medical effects of TET are accompanied by changes in the metabolism of GABA and monoamines, but not of beta-endorphin, and also by a decrease in the latency of alpha-rhythm appearance after closing of the eyes.","Krupitsky, E M; Burakov, A M; Karandashova, G F; Katsnelson, JaS null; Lebedev, V P; Grinenko, A Ja null; Borodkin, JuS null",1991.0,,0,0,
7102,Sleep disturbance in chronic military-related PTSD: clinical impact and response to adjunctive risperidone in the Veterans Affairs cooperative study #504,"ER METHOD: This article reports secondary analyses of a 24-week multicenter randomized placebo-controlled trial of adjunctive risperidone in patients with chronic military-related PTSD symptoms (n = 267, 97% male) who were symptomatic despite treatment with antidepressants and other medications. The study was conducted between February 2007 and February 2010. DSM-IV PTSD diagnoses were made by using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Nonpatient Edition. Sleep disturbances were assessed principally by using the Pittsburgh Sleep Quality Index (PSQI) (primary outcome measure). Analyses were conducted using bivariate correlations and longitudinal mixed model regressions.RESULTS: Eighty-eight percent of the patients in this study had clinically significantly impaired sleep on the PSQI. Severity of sleep disturbances correlated with PTSD symptom severity as measured by the Clinician-Administered PTSD Scale (CAPS) and reductions in multiple measures of quality of life (Veterans RAND 36-item Health Survey [SF-36 V] subscales, Boston Life Satisfaction Index). Risperidone produced small but statistically significant effects on total PSQI scores (main effect of drug: F1,228 = 4.57, P = .034; drug-by-time interaction: F2,421 = 4.32, P = .014) and severity of nightmares as assessed by the CAPS (main effect of drug: F1,248 = 4.60, P = .033). The improvements in sleep quality produced by risperidone correlated with reductions in PTSD symptom severity and improvement in the mental health subscale of the SF-36 V.CONCLUSIONS: This study highlighted the near universality and significant negative impact of severe disturbances in sleep quality in veterans with chronic military-related PTSD who were partial responders to standard pharmacotherapies. The modest improvements in sleep quality produced by adjunctive risperidone were correlated with limited reductions in PTSD severity and improvements in quality of life.TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00099983.OBJECTIVE: Sleep disturbances are common among veterans with chronic military-related posttraumatic stress disorder (PTSD). This article reports the results of a multicenter clinical trial that explored the clinical correlates of reported sleep impairment in these veterans and tested the impact of the second-generation antipsychotic risperidone upon these symptoms.","Krystal, J H; Pietrzak, R H; Rosenheck, R A; Cramer, J A; Vessicchio, J; Jones, K M; Huang, G D; Vertrees, J E; Collins, J; Krystal, A D",2016.0,10.4088/JCP.14m09585,0,0,
7103,Effects of phase I cardiac rehabilitation on anxiety of patients hospitalized for coronary artery bypass graft in Taiwan,"ER DESIGNProspective, quasi-experimental, random assignment, repeated measurements.SETTINGThe Veterans General Hospital Taipei, Taiwan, Republic of China.PATIENTSSeventy patients were randomly assigned to (1) the phase I cardiac rehabilitation intervention (experimental) group and (2) the nonintervention (comparison) group. Ultimately, 60 subjects were included in the data analyses.OUTCOME MEASURESPsychological status was evaluated by the state of anxiety scores on the State-Trait Anxiety Inventory. Anxiety scores were measured 3 times: (1) after admission, before the patient underwent CABG surgery; (2) the day before the patient underwent CABG surgery; and (3) the day of discharge from the hospital.INTERVENTIONIndividual instruction in progressive exercises and daily activities according to the phase I cardiac rehabilitation program (Chinese manual) were used during hospitalization.RESULTSData analysis was performed with use of generalized estimating equations (GEE) to assess the between- and within-group variations. The mean anxiety for all subjects before undergoing CABG surgery was 42.6. The mean anxiety on the day before undergoing CABG surgery was 33.7 in the experimental group and 49.8 in the comparison group; there were statistical differences, with a P <.05 level of significance between these 2 groups. The mean anxiety on the day of discharge in the experimental group was 28.6 and in the comparison group was 38.4; there were statistical differences, with a P <.05 level of significance between these 2 groups.CONCLUSIONSThese results have been supported by similar studies. This finding suggests that application of phase I cardiac rehabilitation intervention can reduce the anxiety level during hospitalization of patients undergoing CABG surgery.OBJECTIVETo assess the effects of phase I cardiac rehabilitation intervention on anxiety of patients hospitalized for coronary artery bypass graft (CABG) surgery.","Ku, S L; Ku, C H; Ma, F C",2002.0,,0,0,
7104,Two-year follow-up of posterior capsule opacification after implantation of a hydrophilic or hydrophobic acrylic intraocular lens,"ER METHODSPhacoemulsification cataract surgery was performed in one eye of 120 patients with senile cataract in this prospective study. They were randomized to implantation of either a hydrophilic acrylic IOL (BL27; Bausch & Lomb, Rochester, NY, USA) or a hydrophobic acrylic IOL (AcrySof) SA60AT; Alcon Laboratories, Fort Worth, TX, USA). Two years after surgery, retroillumination images were obtained and PCO area and severity were evaluated using pocoman software. Best corrected visual acuity (VA) (both high-contrast [100%] and low-contrast [2.5%]), glare, laser flare and intraocular pressure were measured. Capsulotomy rates were recorded.RESULTSPatients implanted with the hydrophilic IOL had a greater percentage area and severity of PCO compared with patients with the hydrophobic IOL (p < 0.001). There was no difference in PCO between men and women in the hydrophilic group. However, in the hydrophobic group, women had significantly more PCO than men (p < 0.05). Patients with the hydrophobic acrylic IOL had better high- and low-contrast visual activity (VA) (p < 0.01) and less glare (p < 0.001) than those with a hydrophilic acrylic IOL. Of the patients with the hydrophilic IOL, 42% underwent capsulotomy, compared with 10% in the hydrophobic group (p < 0.001).CONCLUSIONSTwo years after surgery, patients with the SA60AT hydrophobic acrylic IOL had less PCO and better high- and low-contrast VA than patients with the BL27 hydrophilic acrylic IOL.PURPOSETo evaluate posterior capsule opacification (PCO) 2 years after cataract surgery following implantation of a hydrophilic or a hydrophobic single-piece acrylic intraocular lens (IOL) with a sharp edge.","Kugelberg, M; Wejde, G; Jayaram, H; Zetterström, C",2008.0,10.1111/j.1600-0420.2007.01094.x,0,0,
7105,Posterior capsule opacification after implantation of a hydrophilic or a hydrophobic acrylic intraocular lens: one-year follow-up,"ER SETTINGSt. Erik's Eye Hospital, Stockholm, Sweden.METHODSIn a prospective study, 120 patients having cataract surgery were randomized to implantation of a hydrophilic acrylic IOL (BL27, Bausch & Lomb) or a hydrophobic acrylic IOL (AcrySof SA60AT, Alcon). Surgery was performed according to a standardized protocol by 1 of 3 surgeons. Best corrected visual acuity, contrast sensitivity, glare, intraocular pressure, and flare were measured 1 week, 3 months, and 1 year after surgery. Posterior capsule opacification was assessed by digital retroillumination photography and analysis using POCOman software at 1 year. The rate of neodymium:YAG (Nd:YAG) capsulotomy for each IOL was also recorded.RESULTSAt 1 year, the hydrophilic acrylic IOL group had a significantly greater percentage area and severity of PCO than the hydrophobic acrylic IOL group (P.05). Contrast sensitivity was significantly better in the hydrophilic acrylic group at 3 months (P<.05); however, at 12 months no difference between the IOLs was observed. There was no significant difference in the other measured parameters.CONCLUSIONPatients with the hydrophilic acrylic BL27 IOL had a significantly greater percentage area and severity of PCO than those with the hydrophobic acrylic SA60AT IOL 1 year after surgery.PURPOSETo evaluate the effect of hydrophilic and hydrophobic single-piece acrylic intraocular lenses (IOLs) on posterior capsule opacification (PCO) after cataract surgery.","Kugelberg, M; Wejde, G; Jayaram, H; Zetterström, C",2006.0,10.1016/j.jcrs.2006.05.011,0,0,
7106,Social comparison and affiliation under threat: going beyond the affiliate-choice paradigm,"ER This study examined the emotional similarity hypothesis--a derivation from social comparison theory, which predicts that increasing fear should lead to greater affiliation with someone who is awaiting the same threat (and who therefore is of relatively similar emotional status) relative to someone who has already experienced the threat (and who therefore is of relatively dissimilar emotional status). The results failed to support the emotional similarity hypothesis and in so doing challenged the importance of emotional comparison as a determinant of verbal affiliation under threat. Cognitive clarity concerns instead seemed to account better for the observed effects on verbal affiliation. Supplementary analyses of nonverbal affiliation (facial glances) likewise ran counter to an emotional similarity prediction. Effects of affiliation on anxiety were also examined. Previous conclusions regarding the pattern and causes of affiliation under threat that have relied on the affiliate-choice paradigm are considered.","Kulik, J A; Mahler, H I; Earnest, A",1994.0,,0,0,
7107,A practical screening tool for anxiety and depression in patients with chronic breathing disorders,"ER Obstructive lung diseases are associated with high rates of depression and anxiety, yet many patients are never screened or treated. This study evaluated the five-question Depression and Anxiety modules of the Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Questionnaire as a telephone screen in 1,632 patients with chronic breathing disorders at a Veterans Affairs Medical Center in Houston, TX. Subsequent testing of 828 patients with the Beck Depression Inventory-II and the Beck Anxiety Inventory showed that the sensitivity and specificity, respectively, of the Depression and Anxiety modules of the PRIME-MD Patient Questionnaire screening were 94.6% and 49.5% (Depression); 93.7% and 32.2% (Anxiety); and 97.7%, and 36.0% (combined screen), with an overall accuracy of 80.7%. In such populations, these two modules of the PRIME-MD Patient Questionnaire may be a useful screening tool.","Kunik, M E; Azzam, P N; Souchek, J; Cully, J A; Wray, N P; Krishnan, L L; Nelson, H A; Stanley, M A",2007.0,10.1176/appi.psy.48.1.16,0,0,
7108,Treatment of acrophobia in a virtual environment,"ER Specific phobias are one of the most frequent mental health problems and can lead to years of personal suffering. The most effective treatment is exposure therapy. Our aim was to proof the feasibility and efficacy of virtual environments in treating acrophobia patients using a manually guided exposure therapy. Our pilot study was designed as a crossover intervention with a waiting list condition as a control group. After treatment, our results show that exposure in virtual environments is a feasible technique, can provoke anxiety, and leads to a therapeutic effect.","Kuntze, M F; Störmer, R; Mager, R; Müller-Spahn, F; Bullinger, A",2003.0,,0,0,
7109,A controlled trial of propoxyphene and naltrexone in patients with Tourette's syndrome,"ER To investigate the effect of drugs acting on the endogenous opioid system, we studied 10 adults with Tourette's syndrome who received propoxyphene hydrochloride (260 mg/day), naltrexone hydrochloride (50 mg/day), and placebo in a double-blinded, randomized clinical trial. Using a self-report scale (Tourette's Syndrome Symptom List), subjects noted a significant (p less than 0.04) lessening of tics after treatment with naltrexone when compared with placebo. An improvement in performance on the Trail Making B test, a measure of attention and visuomotor sequencing and planning, occurred after receiving naltrexone when compared with placebo (p less than 0.08) or propoxyphene (p less than 0.02). The Trail Making B test best discriminated the treatments (p less than 0.02, analysis of variance). No other treatment effects were observed for several other measures of tic severity, attentional ability, or obsessive-compulsive symptoms. Our findings indicate that pharmacological manipulation of the endogenous opioid system does influence symptoms of Tourette's syndrome.","Kurlan, R; Majumdar, L; Deeley, C; Mudholkar, G S; Plumb, S; Como, P G",1991.0,10.1002/ana.410300105,0,0,
7110,Capsular bag shrinkage after implantation of a capsular bending or capsular tension ring,"ER SETTINGDepartment of Ophthalmology, Johannes Gutenberg-University, and Department of Medical Biometry, Epidemiology and Informatics, University of Mainz, Mainz, Germany.METHODSIn 92 eyes of 92 patients, a capsular measuring ring (CMR) was implanted after phacoemulsification to measure capsular bag size in vivo. Patients were randomized into 3 groups: The first received a CMR and CBR, the second received a CMR and CTR, and the third received a CMR alone. Measurements were performed preoperatively, intraoperatively, during the first 3 postoperative days, and after 1 and 3 months. Preoperative biometric characteristics such as axial length (AL) and anterior chamber depth were determined. Primary clinical end points were capsular bag size and capsulorhexis diameter measured intraoperatively and by means of slitlamp biomicroscopy and retroillumination photography postoperatively.RESULTSThere were no clinically relevant group differences in AL, anterior chamber depth, or capsulorhexis diameter. Eyes implanted with the CBR showed shrinkage of the capsular bag from 10.6 to 10.4 mm after a median of 3 months (sign test; P = .023); eyes with a CTR showed comparable median capsular bag shrinkage from 10.5 to 10.2 mm (P<.001), whereas eyes without a CTR showed a median shrinkage from 10.5 to 10.0 mm (P<.001). Intraindividual shrinkage was of a similar, although significantly different, order among these groups (median shrinkage 0.15 versus 0.23 and 0.38 mm, respectively; all pairwise Wilcoxon test; P = .050, P = .020, P<.001, respectively).CONCLUSIONSCapsular shrinkage can be inhibited by a CBR and, to lesser extent, a CTR; the gain in shrinkage prevention is limited when compared with a CMR, however. This conclusion can be drawn only for the specific CBR or CTR and hydrophobic acrylic intraocular lens (IOL) used in this study. Reduction of capsular bag shrinkage after CTR implantation may reduce IOL dislocation and tilt and help to maintain postoperative visual acuity.PURPOSETo evaluate the influence of a capsular bending ring (CBR) or tension ring (CTR) on capsular bag shrinkage.","Kurz, S; Krummenauer, F; Hacker, P; Pfeiffer, N; Dick, H B",2005.0,10.1016/j.jcrs.2005.06.046,0,0,
7111,The effects of alcohol consumption on laboratory-induced panic and state anxiety,"ER METHODSSubjects with panic disorder were randomly assigned to consume either a moderate dose of alcohol or a nonalcoholic placebo. All subjects were told that they were drinking alcohol to control beverage expectancies. Following the beverage administration, subjects underwent a panic challenge (35% carbon dioxide) and a series of anxiety symptom assessments.RESULTSSubjects who consumed alcohol reported significantly less state anxiety both before and after the challenge. In response to the challenge, subjects who consumed alcohol experienced significantly fewer panic attacks when applying liberal panic criteria; however, this effect only approached significance when applying conservative panic criteria.CONCLUSIONSThese findings suggest that alcohol acts acutely to reduce both panic and the anxiety surrounding panic, and they lend support to the view that drinking behavior among those with panic disorder is reinforced by this effect. We suggest that this process may contribute to the high rate at which alcohol-use disorders co-occur with panic disorder.BACKGROUNDThis study tested whether alcohol consumption reduces anxiety and panic associated with a panic-challenge procedure.","Kushner, M G; Mackenzie, T B; Fiszdon, J; Valentiner, D P; Foa, E; Anderson, N; Wangensteen, D",1996.0,,0,0,
7112,Psychological characteristics of patients with infarction: results of the GISSI-2. Italian Group for the Study of Survival in Myocardial Infarction (GISSI),"ER POPULATION AND SETTINGA total of 2705 patients (12.5% females) admitted to 166 Italian Coronary Care Units.METHODSPatients were administered the CBA-H, a standardized questionnaire with dichotomous responses (true/false), for a total of 152-item grouped into 16 scales. For each scale, the frequency of scores above cut-off values was computed and compared to patients' clinical and sociodemographic profile.RESULTSOver one third of all patients scored above the clinical cut-off for anxiety and health-related fears, and 15% showed a depressive pattern. Forty percent of patients reported depressive mood and a diminished sense of well-being in the past three months preceding MI, and more than half perceived themselves as stressed. About one third of the sample overtly exhibited TAB traits and half reported neuroticism scores in the clinical range. One half of our sample could be identified as extrovert, and 14% as introverted. Feelings of guilt and social anxiety were registered respectively in 40% and 12% of the sample. A worse psychological profile was associated to female gender, older age, lower education, living alone and a worse cardiac asset.CONCLUSIONThe study has documented the association between clinical, sociodemographic and psychological variables in a large sample of patients with IMA. While the impact of psychological variables upon patients' clinical outcome is to be evaluated, these data may be helpful in promoting the comprehensive and effective care of IMA patients.OBJECTIVETo provide a thorough psychological examination of patients with documented myocardial infarction (MI) enrolled in a multicenter randomized clinical trial (GISSI-2). The psychosocial variables examined include: state variables (anxiety, health-related fears, depression), psychophysical well-being in the three months preceding the acute event (depressive mood, impaired sense of well-being, perceived stress) and trait variables (Type-A Behavior (TAB), neuroticism, introversion/extroversion, social anxiety and feelings of guilt in interpersonal relationships).","Labbrozzi, D; Carinci, F; Nicolucci, A; Bettinardi, O; Zotti, A M; Tognoni, G",1996.0,,0,0,
7113,Evaluation of two prevention programs 'Early Steps' and 'Faustlos' in daycare centers with children at risk: the study protocol of a cluster randomized controlled trial,"ER BACKGROUND: While early programs to prevent aggression and violence are widely used, only a few controlled trials of effectiveness of psychoanalytically based prevention programs for preschoolers have been evaluated. This study compares 'Faustlos' (a violence prevention program) and 'Early Steps' (a psychoanalytically based, whole daycare center intervention to prevent violence) in daycare centers in socioeconomically deprived neighborhoods.METHODS/DESIGN: Preschoolers in 14 daycare centers in Frankfurt, Germany, participate in a cluster randomized controlled trial (CRCT). The daycare centers were randomly chosen from a representative baseline survey of all Frankfurt's daycare centers carried out in 2003 (n = 5,300) with the following stratifying factors: children's aggressiveness, hyperactivity, anxiety and socioeconomic status. Additionally, the geographic identification of socioeconomically deprived neighborhoods regarding low-income children was taken from the Frankfurt Municipality Statistics. Children's attachment classification and children's aggressiveness, hyperactivity, anxiety and social competence are measured as outcome criteria before and after 2 years of intervention. The programs in the study aim to reach a high-risk population. Therefore, the combination of a random sampling of daycare centers out of a representative baseline survey in all daycare centers in Frankfurt and the application of official data on the local distribution of low-income children are unique features offered by the EVA study design. Data on preschooler's attachment representations are collected in socioeconomically deprived neighborhoods for the first time.TRIAL REGISTRATION DRKS-ID: DRKS00003500.","Laezer, K L; Leuzinger-Bohleber, M; Rüger, B; Fischmann, T",2013.0,10.1186/1745-6215-14-268,0,0,
7114,"Efficacy of functional relaxation and patient education in the treatment of somatoform heart disorders: a randomized, controlled clinical investigation","ER OBJECTIVEThe authors assessed a body-oriented approach to the somatic fixation frequently seen in these patients.METHODThey conducted a controlled study to assess the effect of functional relaxation in 22 patients with non-specific chest pain. The primary outcome measures were self-reported changes on the subscales Somatization and Anxiety of the Symptom Checklist of Derogatis, as well as the subscale Cardiovascular Complaints of the Giessen Inventory of Complaints.RESULTSSignificant improvements of the primary outcome measures were observed in patients treated with functional relaxation, whereas no significant improvements could be seen in the control group.CONCLUSIONFunctional relaxation appears to be a safe and effective, non-pharmacological approach in the treatment of non-specific chest pain.BACKGROUNDRecurrent heart problems and, especially, chest pain in the absence of somatic heart disease is a common finding, although challenging to treat.","Lahmann, C; Loew, T H; Tritt, K; Nickel, M",2008.0,10.1176/appi.psy.49.5.378,0,0,
7115,The preparation of patients for cardiac surgery,"ER This study examines the impact of a preadmission telephone intervention on anxiety, knowledge, and readiness for discharge for patients attending a preadmission teaching program prior to cardiac surgery. The primary goal of the telephone intervention was to provide support by giving additional information about individual concerns. The telephone intervention did not have an effect on anxiety and knowledge. A significantly higher level of anxiety was found in the experimental group on admission, but this difference became nonsignificant when baseline level and length of waiting time were entered as covariates. The more anxious group rated their perceived knowledge level lower, despite the fact that both groups had similar scores in actual knowledge. Given the potential barrier that anxiety can pose for patient learning, nurses need to adapt their interventions to deal with the patients' feelings of anxiety that accompany cardiac surgery to make the learning process effective.","Lamarche, D; Taddeo, R; Pepler, C",1998.0,10.1177/105477389800700406,0,0,
7116,The effects of experimenter gender on state social physique anxiety and strength in a testing environment,"ER Social influences can impact self-presentational concerns such as social physique anxiety (SPA), concerns over one's body being evaluated by others. In addition, social influences may also impact performance on a physical test. In a physical testing environment, one social factor that influences SPA and which may also influence the outcomes of a physical test is experimenter gender. The present study examined the influence of experimenter gender on SPA and actual muscle strength in an experimental testing environment. Male (n = 50) and female (n = 50) university students were randomly assigned to either a male or female experimenter. Before strength testing, state SPA (SPA-S) was assessed. Actual strength was represented by the score obtained during the maximum voluntary contraction (MVC) test. Two 2 × 2 (participant gender × gender of the experimenter) analyses of variance were conducted with SPA-S and strength as the dependent variables. For SPA-S, a significant main effect was found only for participant gender (F(1,95) = 14.08, p < 0.01, ?² = 0.13), with women scoring significantly higher than men. For MVC, there was a significant effect for participant gender (F(1,96) = 48.08, p < 0.001, ?² = 0.33), with men, as expected, having significantly higher strength values than women. Although the gender of the experimenter did not influence SPA-S or muscle strength, other forms of anxiety (e.g., fitness anxiety) may be relevant in this setting. Future research should also investigate other factors in the testing environment (e.g., type of task) that may be more influential on psychological or performance outcomes.","Lamarche, L; Gammage, K L; Gabriel, D A",2011.0,10.1519/JSC.0b013e3181c1f7b3,0,0,
7117,Writing assignments about stressful and/or traumatic events do not benefit patients with anxiety disorders,"ER AIMTo find out whether writing about stressful and/or traumatic events would also benefit patients with severe anxiety disorders.METHODOur sample consisted of 32 patients (24 women and 8 men) with anxiety disorders. They were randomly assigned to 2 groups, one being an experimental group, the other a control group. Eighteen patients were asked to write about the most stressful events they had experienced and 14 were asked to write about trivial topics. Each patient completed 4 writing sessions over a 2-week period. A follow-up writing session took place six weeks later. Anxiety symptoms and mood were measured by means of the Symptom Check List, the Penn State Worry Questionnaire, the Impact of Event Scale and the Profile of Mood State. The immediate effect of writing on mood was scored by means of a simple questionnaire.RESULTSThe mood of the patients in the experimental writing group deteriorated markedly during a short time. Multivariate analyses conducted on repeated measurements did not reveal any significant effects. The interaction between the experimental group and the test scores was not significant either. At follow-up psychic functioning and mood in the experimental group were no better that in the control group.CONCLUSIONWriting about stressful and/or traumatic events is a very taxing activity for patients (pain). This has often been demonstrated in the past. The results show that simply writing about stressful events is definitely not a successful way of reducing anxiety symptoms (no gain).BACKGROUNDSeveral studies have indicated that patients with mild anxiety symptoms may benefit from writing about life events that they have found stressful. However, there is very little research done into the effects of this technique.","Lammerts van, Bueren N",2007.0,,0,0,
7118,Training in iterative hypothesis testing as part of psychiatric education. A randomized study,"ER BACKGROUND: The improvement of medical education is at the center of efforts to reform the studies of medicine. Furthermore, an excellent teaching program for students is a quality feature of medical universities. Besides teaching of disease-specific contents, the acquisition of interpersonal and decision-making skills is important. However, the cognitive style of senior physicians leading to a diagnosis cannot easily be taught. Therefore, the following study aimed at examining whether specific training in iterative hypothesis testing (IHT) may improve the correctness of the diagnostic process.MATERIALS AND METHODS: Seventy-one medical students in their 9th-11th terms were randomized to medical teaching as usual or to IHT training for 4 weeks. The intervention group received specific training according to the method of IHT. All students were examined by a multiple choice (MC) exam and additionally by simulated patients (SP). The SPs were instructed to represent either a patient with depression and comorbid anxiety and substance use disorder (SP1) or to represent a patient with depression, obsessive-compulsive disorder and acute suicidal tendencies (SP2).RESULTS: All students identified the diagnosis of major depression in the SPs, but IHT-trained students recognized more diagnostic criteria. Furthermore, IHT-trained students recognized acute suicide tendencies in SP2 more often and identified more comorbid psychiatric disorders. The results of the MC exam were comparable in both groups. An analysis of the satisfaction with the different training programs revealed that the IHT training received a better appraisal.CONCLUSIONS: Our results point to the role of IHT in teaching diagnostic skills. However, the results of the MC exam were not influenced by IHT training. Furthermore, our results show that students are in need of training in practical clinical skills.","Lampen-Imkamp, S; Alte, C; Sipos, V; Kordon, A; Hohagen, F; Schweiger, U; Kahl, K G",2012.0,10.1007/s00115-011-3252-4,0,0,
7119,A function of form: terror management and structuring the social world,"ER Drawing on lay epistemology theory, the authors assessed a terror management analysis of the psychological function of structuring social information. Seven studies tested variations of the hypothesis that simple, benign interpretations of social information function, in part, to manage death-related anxiety. In Studies 1-4, mortality salience (MS) exaggerated primacy effects and reliance on representative information, decreased preference for a behaviorally inconsistent target among those high in personal need for structure (PNS), and increased high-PNS participants' preference for interpersonal balance. In Studies 5-7, MS increased high-PNS participants' preference for interpretations that suggest a just world and a benevolent causal order of events in the social world.","Landau, M J; Johns, M; Greenberg, J; Pyszczynski, T; Martens, A; Goldenberg, J L; Solomon, S",2004.0,10.1037/0022-3514.87.2.190,0,0,
7120,Parent-reported homework problems in the MTA study: evidence for sustained improvement with behavioral treatment,"ER Parent-report of child homework problems was examined as a treatment outcome variable in the MTA-Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (ADHD). Five hundred seventy-nine children ages 7.0 to 9.9 were randomly assigned to either medication management, behavioral treatment, combination treatment, or routine community care. Results showed that only participants who received behavioral treatment (behavioral and combined treatment) demonstrated sustained improvements in homework problems in comparison to routine community care. The magnitude of the sustained effect at the 10-month follow-up assessment was small to moderate for combined and behavioral treatment over routine community care (d = .37, .40, respectively). Parent ratings of initial ADHD symptom severity was the only variable found to moderate these effects.","Langberg, J M; Arnold, L E; Flowers, A M; Epstein, J N; Altaye, M; Hinshaw, S P; Swanson, J M; Kotkin, R; Simpson, S; Molina, B S; Jensen, P S; Abikoff, H; Pelham, W E; Vitiello, B; Wells, K C; Hechtman, L",2010.0,10.1080/15374410903532700,0,0,
7121,"Effects of psychosocial support during labour and childbirth on breastfeeding, medical interventions, and mothers' wellbeing in a Mexican public hospital: a randomised clinical trial","ER DESIGNThe effects of the intervention were assessed by means of a randomised clinical trial. Social support by a doula was provided to women in the intervention group, while women in the control arm received routine care.SETTINGA large social security hospital in Mexico City.PARTICIPANTSSeven hundred and twenty-four women with a single fetus, no previous vaginal delivery, < 6 cm of cervical dilatation, and no indications for an elective caesarean section were randomly assigned to be accompanied by a doula, or to receive routine care.OUTCOME MEASURESBreastfeeding practices, duration of labour, medical interventions, mother's emotional conditions, and newborn's health.METHODSBlinded interviewers obtained data from the clinical records, during encounters with women in the immediate postpartum period, and at their homes 40 days after birth. Relative risks and confidence intervals were estimated for all relevant outcomes.RESULTSThe frequency of exclusive breastfeeding one month after birth was significantly higher in the intervention group (RR 1.64; I-C: 1.01-2.64), as were the behaviours that promote breastfeeding. However, the programme did not achieve a significant effect on full breastfeeding. More women in the intervention group perceived a high degree of control over the delivery experience, and the duration of labour was shorter than in the control group (4.56 hours vs 5.58 hours; RR 1.07 CI (95%) = 1.52 to -0.51). There were no effects either on medical interventions, mothers' anxiety, self-esteem, perception of pain and satisfaction, or in newborns' conditions.CONCLUSIONSPsychosocial support by doulas had a positive effect on breastfeeding and duration of labour. It had a more limited impact on medical interventions, perhaps because of the strict routine in hospital procedures, the cultural background of the women, the short duration of the intervention, and the profile of the doulas. It is important to include psychosocial support as a component of breastfeeding promotion strategies.OBJECTTo evaluate the effects of psychosocial support during labour, delivery and the immediate postpartum period provided by a female companion (doula).","Langer, A; Campero, L; Garcia, C; Reynoso, S",1998.0,,0,0,
7122,The Latin American trial of psychosocial support during pregnancy: effects on mother's wellbeing and satisfaction. Latin American Network For Perinatal and Reproductive Research (LANPER),"ER A randomized controlled trial including 2235 women at high risk of low birthweight was conducted in four Latin American institutions. The objective of this trial was to evaluate a psychosocial support intervention during pregnancy aimed at improving perinatal health and mothers' psychosocial conditions. The core of the intervention was four to six home visits where emotional support, counseling and strengthening of the woman's social network was provided. Outcomes were measured at 36 weeks of pregnancy, post-partum and 40 days after delivery. The intervention was not successful in either altering women's perception of social support and satisfaction with the reproductive experience, as well as maternal and newborn's health care. It is concluded that although high levels of psychosocial distress during pregnancy may play an independent role in determining adverse pregnancy outcomes, this adverse effect does not appear to be ameliorated by psychosocial interventions conducted only during pregnancy, particularly those of a magnitude that can be realistically implemented (in content and frequency) at public care services in most developing countries.","Langer, A; Farnot, U; Garcia, C; Barros, F; Victora, C; Belizan, J M; Villar, J",1996.0,,0,0,
7123,Do treatment manuals undermine youth-therapist alliance in community clinical practice?,"ER METHODSeventy-six clinically referred youths (57% female, age 8-15 years, 34% Caucasian) were randomly assigned to receive nonmanualized usual care or manual-guided treatment to address anxiety or depressive disorders. Treatment was provided in community clinics by clinic therapists randomly assigned to treatment condition. Youth-therapist alliance was measured with the Therapy Process Observational Coding System--Alliance (TPOCS-A) scale at 4 points throughout treatment and with the youth report Therapeutic Alliance Scale for Children (TASC) at the end of treatment.RESULTSYouths who received manual-guided treatment had significantly higher observer-rated alliance than usual care youths early in treatment; the 2 groups converged over time, and mean observer-rated alliance did not differ by condition. Similarly, the manual-guided and usual care groups did not differ on youth report of alliance.CONCLUSIONSOur findings did not support the contention that using manuals to guide treatment harms the youth-therapist alliance. In fact, use of manuals was related to a stronger alliance in the early phase of treatment.OBJECTIVESome critics of treatment manuals have argued that their use may undermine the quality of the client-therapist alliance. This notion was tested in the context of youth psychotherapy delivered by therapists in community clinics.","Langer, D A; McLeod, B D; Weisz, J R",2011.0,10.1037/a0023821,0,0,
7124,Bounce back: effectiveness of an elementary school-based intervention for multicultural children exposed to traumatic events,"ER METHOD: Participants were 74 schoolchildren (Grades 1-5) and their primary caregivers. All participating students endorsed clinically significant posttraumatic stress symptoms. School clinicians were trained to deliver Bounce Back, a 10-session cognitive-behavioral group intervention. Children were randomized to immediate or delayed (3-month waitlist) intervention. Parent- and child-report of posttraumatic stress and depression, and child report of anxiety symptoms, were assessed at baseline, 3 months, and 6 months.RESULTS: Bounce Back was implemented with excellent clinician fidelity. Compared with children in the delayed condition, children who received Bounce Back immediately demonstrated significantly greater improvements in parent- and child-reported posttraumatic stress and child-reported anxiety symptoms over the 3-month intervention. Upon receipt of the intervention, the delayed intervention group demonstrated significant improvements in parent- and child-reported posttraumatic stress, depression, and anxiety symptoms. The immediate treatment group maintained or showed continued gains in all symptom domains over the 3-month follow-up period (6-month assessment).CONCLUSIONS: Findings support the feasibility, acceptability, and effectiveness of the Bounce Back intervention as delivered by school-based clinicians for children with traumatic stress. Implications are discussed.OBJECTIVE: To evaluate the feasibility and acceptability of a school-based intervention for diverse children exposed to a range of traumatic events, and to examine its effectiveness in improving symptoms of posttraumatic stress, depression, and anxiety.","Langley, A K; Gonzalez, A; Sugar, C A; Solis, D; Jaycox, L",2015.0,10.1037/ccp0000051,0,0,
7125,Pulmonary and systemic nitric oxide measurements during CCK-5-induced panic attacks,"ER Nitric oxide (NO) plays a major role in cardiopulmonary regulation as illustrated by the alterations of the NO system described in cardiopulmonary illnesses. Recent studies have found an association between panic disorder and cardiovascular death and illness, as well as pulmonary diseases. Our objective was to investigate whether pulmonary or systemic NO production was altered during induced panic attacks (PAs). We used a double-blind placebo-controlled crossover design with randomization of the order of an injection of placebo and pentagastrin, a cholecystokinin-B receptor agonist that induces PAs in healthy volunteers (HVs). A total of 17 HVs experienced a PA after pentagastrin challenge. Exhaled NO and NO metabolites were measured by chemiluminescence. During pentagastrin-induced PAs, HVs displayed significant decreases in plateau concentrations of NO exhaled, which were associated with proportional increases in minute ventilation. There were no significant changes in pulmonary or systemic NO production. These results suggest that the decrease in exhaled NO concentration observed during pentagastrin-induced PAs is related to the associated hyperventilation, rather than to any change in lung NO production. This study is the first to evaluate changes in NO measurements during acute anxiety.","Lara, N; Chrapko, W E; Archer, S L; Bellavance, F; Mayers, I; Mellédo, J M",2003.0,10.1038/sj.npp.1300241,0,0,
7126,Cognitive-behavioral treatment of school phobia,"ER METHODFifty-six children with school phobia were randomly assigned to 12 weeks of cognitive-behavioral therapy or an attention-placebo control condition. Pre- and posttreatment school attendance, self-reported anxiety and depression, and diagnostic status were compared.RESULTSBoth the experimental and control treatments were equally effective at returning children to school. Both treatments also were effective in reducing children's anxiety and depressive symptoms. Follow-up revealed no differences between groups when the children reentered school the next school year.CONCLUSIONSOverall, results suggest that psychosocial treatments are effective at returning school-phobic children to school and that the highly structured cognitive-behavioral approach may not be superior to more traditional educational and supportive treatment methods.OBJECTIVETo conduct a controlled group outcome investigation of the efficacy of cognitive-behavioral treatment for school phobia.","Last, C G; Hansen, C; Franco, N",1998.0,10.1097/00004583-199804000-00018,0,0,
7127,An examination of the mechanisms of exercise-induced change in psychological well-being among people with spinal cord injury,"ER For individuals with a spinal cord injury (SCI), regular exercise training leads to significant improvements in pain, stress, and depression. The mechanisms by which exercise effects change in these variables are poorly understood. To address this issue, we examined the mediated effects of exercise on the psychological well-being of individuals with SCI according to the relationships described in the Chronic Pain Process Model. Twenty-one individuals with traumatic SCI either participated in a 9-month, twice-weekly exercise program (n = 11), or participated as nonexercising controls (n = 10). Measures of pain, stress, and depression were administered at the baseline and 3, 6, and 9 months into the intervention. Change in pain mediated exercise-induced change in stress, F(4,17) = 7.72, p < 0.01. Change in stress mediated exercise-induced change in depression, F(4,17) = 7.68, p < 0.01. With the identification of these factors as mediators of exercise-related changes in pain and well-being, exercise interventions can be designed that specifically target these mediators and possibly maximize intervention efficacy.","Latimer, A E; Ginis, K A; Hicks, A L; McCartney, N",2004.0,,0,0,
7128,Effectiveness of group cognitive-behavioral treatment for childhood anxiety in community clinics,"ER This study evaluated the effectiveness of cognitive-behavioral treatment for childhood anxiety in a community clinic setting in Hong Kong, China. Forty-five clinically-referred children (age 6-11 years) were randomly assigned to either a cognitive-behavioral treatment program or a waitlist-control condition. Children in the treatment condition showed significant reduction in anxiety symptoms-both statistically and clinically-whereas children in the waitlist condition did not. After the waitlist period was over, the control group also received the treatment program and showed a similar reduction in symptoms. For the full sample of 45 children, the effectiveness of the intervention was significant immediately after treatment and in 3- and 6-month follow-ups. In addition, children's anxiety cognition and their ability to cope with anxiety-provoking situations fully mediated the treatment gains. These results offer empirical support for cognitive-behavioral treatment programs in a non-Western cultural context and plausible mediators for how cognitive-behavioral therapy works.","Lau, W Y; Chan, C K; Li, J C; Au, T K",2010.0,10.1016/j.brat.2010.07.007,0,0,
7129,A randomized control trial of a psychosocial intervention for caregivers of allogeneic hematopoietic stem cell transplant patients: effects on distress,"ER Caregivers of patients receiving allogeneic hematopoietic stem cell transplants (allo-HSCT) serve a pivotal role in patient care but experience high stress, anxiety and depression as a result. We theorized that stress management adapted for allo-HSCT caregivers would reduce distress compared with treatment as usual (TAU). Of 267 consecutive caregivers of allo-HSCT patients approached, 148 (mean=53.5 years, 75.7% female) were randomized to either psychosocial intervention (i=74) or TAU (n=74). Eight one-on-one stress management sessions delivered across the 100-day post-transplant period focused on understanding stress, changing role(s) as caregiver, cognitive behavioral stress management, pacing respiration and identifying social support. Primary outcomes included perceived stress (psychological) and salivary cortisol awakening response (CAR) (physiological). Randomized groups were not statistically different at baseline. Mixed models analysis of covariance (intent-to-treat) showed that intervention was associated with significantly lower caregiver stress 3 months post transplant (mean=20.0, 95% confidence interval (95% CI)=17.9-22.0) compared with TAU (mean=23.0, 95% CI=21.0-25.0) with an effect size (ES) of 0.39 (P=0.039). Secondary psychological outcomes, including depression and anxiety, were significantly reduced with ESs of 0.46 and 0.66, respectively. Caregiver CAR did not differ from non-caregiving controls at baseline and was unchanged by intervention. Despite significant caregiving burden, this psychosocial intervention significantly mitigated distress in allo-HSCT caregivers.","Laudenslager, M L; Simoneau, T L; Kilbourn, K; Natvig, C; Philips, S; Spradley, J; Benitez, P; McSweeney, P; Mikulich-Gilbertson, S K",2015.0,10.1038/bmt.2015.104,0,0,
7130,Stereotype threat and lift effects in motor task performance: the mediating role of somatic and cognitive anxiety,"ER The aim of this investigation was to replicate the stereotype threat and lift effects in a motor task in a neutral sex-typed activity, using somatic and cognitive anxiety as key mediators of these phenomena. It was hypothesized that an ingroup/outgroup social categorization based on gender would have distinctive effects for female and male participants. A total of 161 French physical education students were randomly assigned to three threat conditions--no threat, female threat, and male threat--thus leading to a 3 x 2 (threat by gender) design. The analyses revealed a stereotype lift effect on the performances for both male and female participants, as well as a stereotype threat effect only for female participants. They also indicated that somatic anxiety had a mediating effect on the performance of female participants targeted by a negative stereotype, but that it had a facilitating effect on their performance. The stereotype threat and lift effects on motor tasks were replicated in a neutral sex-typed activity and somatic anxiety seems to have a facilitating mediating effect of the relationships between the gender-conditions (control or female threat) interaction and free-throw performance. The model used to distinguish somatic and cognitive anxiety appeared to be a relevant means of explaining the stereotype threat and lift mechanisms.","Laurin, R",2013.0,10.1080/00224545.2013.821098,0,0,
7131,The relationship between challenging parenting behaviour and childhood anxiety disorders,"ER BACKGROUND: This research investigates the relationship between challenging parenting behaviour and childhood anxiety disorders proposed by Bögels and Phares (2008). Challenging parenting behaviour involves the playful encouragement of children to go beyond their own limits, and may decrease children's risk for anxiety (Bögels and Phares, 2008).METHOD: Parents (n=164 mothers and 144 fathers) of 164 children aged between 3.4 and 4.8 years participated in the current study. A multi-method, multi-informant assessment of anxiety was used, incorporating data from diagnostic interviews as well as questionnaire measures. Parents completed self-report measures of their parenting behaviour (n=147 mothers and 138 fathers) and anxiety (n=154 mothers and 143 fathers). Mothers reported on their child's anxiety via questionnaire as well as diagnostic interview (n=156 and 164 respectively). Of these children, 74 met criteria for an anxiety disorder and 90 did not.RESULTS: Fathers engaged in challenging parenting behaviour more often than mothers. Both mothers' and fathers' challenging parenting behaviour was associated with lower report of child anxiety symptoms. However, only mothers' challenging parenting behaviour was found to predict child clinical anxiety diagnosis.LIMITATIONS: Shared method variance from mothers confined the interpretation of these results. Moreover, due to study design, it is not possible to delineate cause and effect.CONCLUSIONS: The finding with respect to maternal challenging parenting behaviour was not anticipated, prompting replication of these results. Future research should investigate the role of challenging parenting behaviour by both caregivers as this may have implications for parenting interventions for anxious children.","Lazarus, R S; Dodd, H F; Majdand?i?, M; Vente, W; Morris, T; Byrow, Y; Bögels, S M; Hudson, J L",2016.0,10.1016/j.jad.2015.11.032,0,0,
7132,Perceptual consequences of an illness-concern induction and its relation to hypochondriacal tendencies,"ER This article examines the perceptual consequences of activating illness concern as a function of hypochondriacal tendencies. In 2 independent samples, hypochondriacal tendencies were associated with slower reaction times on a modified emotional Stroop task when the stimulus words were illness related, but only when illness concern was activated. Moreover, these findings emerged when hypochondriacal tendencies were defined as a sensitivity to bodily sensations. When defined as illness preoccupation and fear, hypochondriacal tendencies were associated with a generalized pattern of perseveration to all stimuli when health concern was activated. Finally, the results persisted even after statistically controlling for state anxiety. Findings are discussed within the context of an activation hypothesis and highlight the importance of the operational definition and assessment of hypochondriacal tendencies when examining perceptual biases.","Lecci, L; Cohen, D J",2002.0,,0,0,
7133,Cognitive and behavioral effects of lamotrigine and carbamazepine monotherapy in patients with newly diagnosed or untreated partial epilepsy,"ER METHODSThis was a multicenter, open-label, randomized study that compared monotherapy with LTG and CBZ in newly diagnosed or untreated patients with partial epilepsy. We employed an 8-week titration period and a 40-week maintenance period. Neuropsychological tests, Symptom Check List-90, and QOLIE-31 were assessed at baseline, 16 weeks, and 48 weeks after drug treatment. A group-by-time interaction was the primary outcome measure and was analyzed by use of the linear mixed model.RESULTSA total of 110 patients were eligible and 73 completed the 48-week study (LTG, n=39; CBZ, n=34). Among the cognitive tests, significant group-by-time interaction was identified only in phonemic fluency of Controlled Oral Word Association Task (p=0.0032) and Stroop Color-Word Interference (p=0.0283), with a significant better performance for LTG group. All other neuropsychological tests included did not show significant group-by-time interactions. Among the subscales of Symptom Check List-90, significant group-by-time interactions were identified in Obsessive-Compulsive (p=0.0005), Paranoid Ideation (p=0.0454), Global Severity Index (p=0.0194), and Positive Symptom Total (p=0.0197), with a significant improvement for CBZ group. QOLIE-31 did not show significant group-by-time interactions.CONCLUSIONOur data suggest that epilepsy patients on LTG have better performance on phonemic fluency and the task of Stroop Color-Word Interference than do patients on CBZ, whereas patients on CBZ had more favorable behavioral effects on two subscales and two global scores of Symptom Check List-90 than did patients on LTG.PURPOSEIn this prospective study, we compared the long-term cognitive and behavioral effects of lamotrigine (LTG) and carbamazepine (CBZ) in patients with newly diagnosed or untreated partial epilepsy.","Lee, S A; Lee, H W; Heo, K; Shin, D J; Song, H K; Kim, O J; Lee, S M; Kim, S O; Lee, B I",2011.0,10.1016/j.seizure.2010.10.006,0,0,
7134,School-Based Interventions for Anxious Children: long-Term Follow-Up,"ER This study examined the long-term outcomes of a nonclinical sample of anxious children (N = 61) who were randomized by school to 9 weeks of group cognitive-behavioral therapy (CBT) for children, group CBT for children plus parent training, or no-treatment control. Parents and children completed measures of anxiety symptoms at baseline, posttreatment, and at 3-, 6-, 12-month, 2-, and 3-year posttreatment follow-ups. Piecewise longitudinal growth curve analyses were applied to the data. When the two CBT groups were combined and compared with control, the combined treatment group showed significantly greater reduction in children's anxiety severity based on the parent ratings in the first longitudinal phase. However, on the parent Clinician Severity Rating, gains were maintained to 3 years. Child report revealed no significant differences between groups on anxiety reduction. This study maintained a small no-treatment control group during the entire follow-up period. From parental perspective only, school-based group CBT appeared to be beneficial in decreasing severity of anxiety symptoms and maintaining gains over time.","Lee, S S; Victor, A M; James, M G; Roach, L E; Bernstein, G A",2016.0,10.1007/s10578-015-0555-x,0,0,
7135,Stepped care cognitive behavioural therapy for children with anxiety disorders: a new treatment approach,"ER METHODSClinically anxious children (8-12 years, n = 133) and their parents participated in child focused CBT (10 sessions). If assessments indicated additional treatment was necessary, participants could step up to a second and possibly third treatment phase (each 5 sessions) including more parental involvement.RESULTSAfter the first treatment phase 45% of the Intention-To-Treat sample was free of any anxiety disorder; after the second and third phase an additional 17% and 11% respectively. In total, 74% of the children no longer met criteria for any anxiety disorder following treatment. Child and parent reported anxiety and depression symptoms of children improved significantly during all treatment phases, as well as child reported anxiety sensitivity and negative affect. Children participating in more treatment showed significant improvements during additional treatment phases, indicating that late change occurred for the subgroup that had not changed during the first phase.CONCLUSIONSStepped care offers a standardized, assessment based, yet tailored treatment approach for children with anxiety disorders. A more intensive treatment is offered when initial CBT is insufficient, providing children additional opportunities to reach the desired outcome.BACKGROUNDThe current nonrandomized clinical trial explored changes over time in children with an anxiety disorder during stepped care, manual-based cognitive behaviour therapy (CBT).","Leeden, A J; Widenfelt, B M; Leeden, R; Liber, J M; Utens, E M; Treffers, P D",2011.0,10.1017/S1352465810000500,0,0,
7136,Reinforced practice and reduction of different kinds of fears in adults and children,,"Leitenberg, H; Callahan, E J",1973.0,,0,0,
7137,Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer,"ER METHODSWe conducted a randomized controlled trial of 84 female BC survivors (Stages 0-III) recruited from the H. Lee Moffitt Cancer and Research Institute. All subjects were within 18 months of treatment completion with surgery and adjuvant radiation and/or chemotherapy. Subjects were randomly assigned to a 6-week Mindfulness-Based Stress Reduction (MBSR) program designed to self-regulate arousal to stressful circumstances or symptoms (n=41) or to usual care (n=43). Outcome measures compared at 6 weeks by random assignment included validated measures of psychological status (depression, anxiety, perceived stress, fear of recurrence, optimism, social support) and psychological and physical subscales of quality of life (SF-36).RESULTSCompared with usual care, subjects assigned to MBSR(BC) had significantly lower (two-sided p<0.05) adjusted mean levels of depression (6.3 vs 9.6), anxiety (28.3 vs 33.0), and fear of recurrence (9.3 vs 11.6) at 6 weeks, along with higher energy (53.5 vs 49.2), physical functioning (50.1 vs 47.0), and physical role functioning (49.1 vs 42.8). In stratified analyses, subjects more compliant with MBSR tended to experience greater improvements in measures of energy and physical functioning.CONCLUSIONSAmong BC survivors within 18 months of treatment completion, a 6-week MBSR(BC) program resulted in significant improvements in psychological status and quality of life compared with usual care.OBJECTIVESConsiderable morbidity persists among survivors of breast cancer (BC) including high levels of psychological stress, anxiety, depression, fear of recurrence, and physical symptoms including pain, fatigue, and sleep disturbances, and impaired quality of life. Effective interventions are needed during this difficult transitional period.","Lengacher, C A; Johnson-Mallard, V; Post-White, J; Moscoso, M S; Jacobsen, P B; Klein, T W; Widen, R H; Fitzgerald, S G; Shelton, M M; Barta, M; Goodman, M; Cox, C E; Kip, K E",2009.0,10.1002/pon.1529,0,0,
7138,"Comparison of the effect of alprazolam, imipramine and placebo in the treatment of panic disorders in Cali, Colombia","ER A comparison of safety, and efficiency of Alprazolam, Imipramine, and placebo in the treatment of panic disorder shows that both active drugs are significantly superior to placebo as regards therapeutic effectiveness. On a 77 patient sample, 62 completed an 8-week treatment, and 66 were considered as ""assessable"" for efficiency results after completing a 3-week treatment. Significantly, more placebo-treated patients than either Alprazolam, or Imipramine-treated patients dropped out trial, while the number of panic attacks was significantly reduced in both Alprazolam-, and Imipramine-treated groups. When trial was over, 96% of patients in Alprazolam group, and 95% of patients in Imipramine group were free from panic attacks, if compared to 65% in the placebo group. Generally speaking, drugs were well tolerated, and no serious adverse effects or life-threatening events were observed.","León, C A; Arango, M V; Arevalo, W; Calvo, A; Montoya, A; León, A",1990.0,,0,0,
7139,Comparing standard versus prosocial internet support groups for patients with breast cancer: a randomized controlled trial of the helper therapy principle,"ER Purpose: Internet support group (ISG) members benefit from receiving social support and, according to the helper therapy principle, by providing support to others. To test the mental health benefits of providing support to others, this trial compared the efficacy of a standard ISG (S-ISG) and an enhanced prosocial ISG (P-ISG). Methods: A two-armed randomized controlled trial with 1-month pretest and post-test assessments was conducted with women (N = 184) diagnosed in the past 36 months with nonmetastatic breast cancer who reported elevated anxiety or depression. Women were randomly assigned to either the S-ISG or P-ISG condition. Both conditions included six professionally facilitated live chat sessions (90-minute weekly sessions) and access to an asynchronous discussion board; P-ISG also included structured opportunities to help and encourage others. Results: Relative to the S-ISG, participants in the P-ISG condition exhibited more supportive behaviors (emotional, informational, and companionate support), posted more messages that were other-focused and fewer that were self-focused, and expressed less negative emotion (P <.05). Relative to the S-ISG, participants in the P-ISG condition had a higher level of depression and anxiety symptoms after the intervention (P <.05). Conclusion: Despite the successful manipulation of supportive behaviors, the P-ISG did not produce better mental health outcomes in distressed survivors of breast cancer relative to an S-ISG. The prosocial manipulation may have inadvertently constrained women from expressing their needs openly, and thus, they may not have had their needs fully met in the group. Helping others may not be beneficial as a treatment for distressed survivors of breast cancer.","Lepore, S J; Buzaglo, J S; Lieberman, M A; Golant, M; Greener, J R; Davey, A",2014.0,10.1200/JCO.2014.57.0093,0,0,
7140,A spiritual-hypnosis assisted treatment of children with PTSD after the 2002 Bali terrorist attack,"ER The aim of this study was to assess the effectiveness of a spiritual-hypnosis assisted therapy (SHAT) for treatment of posttraumatic stress disorder (PTSD) in children. All children, age 6-12 years (N=226; 52.7% females), who experienced the terrorist bomb blasts in Bali in 2002, and subsequently were diagnosed with PTSD were studied, through a longitudinal, quasi-experimental (pre-post test), single-blind, randomized control design. Of them, 48 received group SHAT (treatment group), and 178 did not receive any therapy (control group). Statistically significant results showed that SHAT produced a 77.1% improvement rate, at a two-year follow up, compared to 24% in the control group, while at the same time, the mean PTSD symptom score differences were significantly lower in the former group. We conclude that the method of spiritual-hypnosis is highly effective, economic, and easily implemented, and has a potential for therapy of PTSD in other cultures or other catastrophic life-threatening events.","Lesmana, C B; Suryani, L K; Jensen, G D; Tiliopoulos, N",2009.0,10.1080/00029157.2009.10401689,0,0,
7141,Impact of race on early treatment termination and outcomes in posttraumatic stress disorder treatment,"ER METHODIn each study, participants were randomized into 1 of 3 conditions. The first study compared cognitive processing therapy with prolonged exposure and a delayed treatment condition. In the second study, cognitive processing therapy was compared with its constituent components: cognitive therapy only and written accounts. Participants were assessed with the Clinician Administered PTSD Scale and the Structured Clinical Interview for DSM-IV, as well as through self-report measures of PTSD.RESULTSAnalyses revealed that African Americans were significantly less likely to complete treatment compared with Caucasians (45% vs. 73%, respectively, p < .001) and that the differences held even after controlling for education and income. Despite racial differences in treatment completion status, analyses with the intent-to-treat sample indicated no racial differences in outcomes on PTSD measures.CONCLUSIONSThe lack of difference in treatment outcomes despite racial differences in dropout may be explained by greater symptom improvement of African Americans who dropped out compared with Caucasians who dropped out. Implications of these findings and practical approaches to addressing sociocultural barriers to care are explored.OBJECTIVEThe present study investigated the influence of race on posttraumatic stress disorder (PTSD) treatment among 94 African American and 214 Caucasian female victims of interpersonal violence participating in 2 studies of cognitive-behavioral treatment for PTSD that were conducted sequentially and continuously.","Lester, K; Resick, P A; Young-Xu, Y; Artz, C",2010.0,10.1037/a0019551,0,0,
7142,Experimental modification of interpretation bias regarding social and animal fear in children,"ER Using an experimental bias modification task, an interpretation bias towards or away from threat was induced about animal or social situations in a sample of 103 children split into a young (7-10 years) and old age group (11-15 years). Children rapidly learned to select outcomes of ambiguous situations which were congruent with their assigned modification condition. Following positive modification, children's threat interpretation biases significantly decreased, while threat biases increased (non-significantly) after negative modification. Bias modification effects also varied as a function of age with children appearing particularly vulnerable to acquiring biases about stimuli that were congruent with the normative fears for their age group. Weak age-related modification-congruent effects on younger but not older children's anxiety vulnerability in response to a behavioral task were also observed. However, no consistent effects of bias modification on avoidance behavior were found.","Lester, K J; Field, A P; Muris, P",2011.0,10.1016/j.janxdis.2011.03.006,0,0,
7143,"Experimental modification of interpretation bias about animal fear in young children: effects on cognition, avoidance behavior, anxiety vulnerability, and physiological responding","ER This study investigated the effects of experimentally modifying interpretation biases for children's cognitions, avoidance behavior, anxiety vulnerability, and physiological responding. Sixty-seven children (6-11 years) were randomly assigned to receive a positive or negative interpretation bias modification procedure to induce interpretation biases toward or away from threat about ambiguous situations involving Australian marsupials. Children rapidly learned to select outcomes of ambiguous situations, which were congruent with their assigned condition. Furthermore, following positive modification, children's threat biases about novel ambiguous situations significantly decreased, whereas threat biases significantly increased after negative modification. In response to a stress-evoking behavioral avoidance test, positive modification attenuated behavioral avoidance compared to negative modification. However, no significant effects of bias modification on anxiety vulnerability or physiological responses to this stress-evoking Behavioral Avoidance Task were observed.","Lester, K J; Field, A P; Muris, P",2011.0,10.1080/15374416.2011.618449,0,0,
7144,Karaoke therapy in the rehabilitation of mental patients,"ER METHODSA double blind controlled trial was conducted over six weeks in a small sample of chronic schizophrenic patients matched in age, sex and duration of illness. The index group practised karaoke and the controlled group practised simple singing. Subjects were assessed in changes in mood and social interaction.RESULTSNo significant difference was detectable within the 2 groups. However, significant differences of anxiety and social interaction at the end of the third and sixth weeks respectively, were detectable between the 2 groups.CONCLUSIONKaraoke therapy may be more effective than simple singing in improving social interaction. There is preliminary evidence that it may be anxiety-provoking for unstable schizophrenic patients. More research is required for further elucidation of the characteristics of favourable candidates, optimal schedule and active components of the therapy.OBJECTIVESTo study the efficacy of karaoke singing and its implications in the rehabilitation of mental patients in Hong Kong Chinese.","Leung, C M; Lee, G; Cheung, B; Kwong, E; Wing, Y K; Kan, C S; Lau, J",1998.0,,0,0,
7145,Building psychosocial assets and wellbeing among adolescent girls: A randomized controlled trial,"ER We conducted a randomized controlled trial of a 5-month resilience-based program (Girls First Resilience Curriculum or RC) among 2308 rural adolescent girls at 57 government schools in Bihar, India. Local women with at least a 10th grade education served as group facilitators. Girls receiving RC improved more (vs. controls) on emotional resilience, self-efficacy, social-emotional assets, psychological wellbeing, and social wellbeing. Effects were not detected on depression. There was a small, statistically significant negative effect on anxiety (though not likely clinically significant). Results suggest psychosocial assets and wellbeing can be improved for girls in high-poverty, rural schools through a brief school-day program. To our knowledge, this is one of the largest developing country trials of a resilience-based school-day curriculum for adolescents.","Leventhal, K S; Gillham, J; DeMaria, L; Andrew, G; Peabody, J; Leventhal, S",2015.0,10.1016/j.adolescence.2015.09.011,0,0,
7146,Interpersonal predictors of early therapeutic alliance in a transdiagnostic cognitive-behavioral treatment for adolescents with anxiety and depression,"ER The importance of therapeutic alliance in predicting treatment success is well established, but less is known about client characteristics that predict alliance. This study examined alliance predictors in adolescents with anxiety and/or depressive disorders (n=31) who received a transdiagnostic cognitive-behavioral treatment, the Unified Protocol for the Treatment of Emotional Disorders in Youth (Ehrenreich, Buzzella, Trosper, Bennett, & Barlow, 2008) in the context of a larger randomized controlled trial. Alliance was assessed at session three by therapists, clients, and independent observers. Results indicated that alliance ratings across the three informant perspectives were significantly associated with one another, but that pretreatment interpersonal variables (e.g., social support, attachment security, and social functioning in current family and peer relationships) were differentially associated with varying informant perspectives. Adolescent and observer ratings of alliance were both predicted by adolescent self-reports on measures reflecting how they perceive their interpersonal relationships. In addition, adolescent-reported symptom severity at pretreatment predicted observer ratings of alliance such that adolescents who indicated greater anxiety and depressive symptoms were rated as having stronger early alliances by independent observers. Therapists perceived having weaker early alliances with adolescents evidencing clinically significant depression at intake as compared with adolescents diagnosed with anxiety disorders alone. Future research is needed to examine whether identification of relevant interpersonal factors at intake can help improve initial therapeutic engagement and resulting outcomes for the psychosocial treatment of adolescents with anxiety and depressive disorders.","Levin, L; Henderson, H A; Ehrenreich-May, J",2012.0,10.1037/a0028265,0,0,
7147,D-Cycloserine facilitation of exposure therapy improves weight regain in patients with anorexia nervosa: a pilot randomized controlled trial,"ER METHOD: Participants (N = 36) with anorexia nervosa (diagnosed via DSM-IV) were recruited from a partial hospitalization eating disorder clinic between February 2013 and November 2013. Participants were randomly assigned to receive exposure therapy plus D-cycloserine (n = 20) or placebo (n = 16). Participants completed psychoeducation and 4 sessions of exposure therapy, with medication (D-cycloserine vs placebo) given prior to the first 3 exposure sessions. They also completed a 1-month follow-up.RESULTS: As hypothesized, participants in the D-cycloserine group showed a significantly greater increase in BMI than those in the placebo group (Wilk ? = 0.86, F3,32 = 2.20, P = .043, ?p(2) = 0.12). D-Cycloserine participants gained 3 pounds relative to 0.5 pounds in the placebo group. Both groups experienced significantly decreased anxiety over the course of therapy (Wilk ? = 0.80, F3,32 = 3.32, P = .023, ?p(2) = 0.20).CONCLUSIONS: This study preliminarily demonstrates that D-cycloserine facilitates exposure therapy for anorexia nervosa, leading to increased weight gain. A potential mechanism is that participants who receive D-cycloserine may generalize learning from within-session exposures to food intake during other similar meals, resulting in sustained increases in BMI. Further research is needed to confirm these findings and test the putative mechanism that generalized learning from exposure therapy can increase BMI and stabilize a healthy weight.TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01996644.OBJECTIVE: Exposure therapy in anorexia nervosa has preliminarily been shown to be effective for increasing food intake. D-Cycloserine is a glutamatergic N-methyl-d-aspartate receptor agonist that has been shown to facilitate the benefits of exposure therapy for anxiety disorders by enhancing the emotional learning in the exposures; therefore, we examined D-cycloserine-facilitation of exposure therapy to increase body mass index (BMI) in patients with anorexia nervosa.","Levinson, C A; Rodebaugh, T L; Fewell, L; Kass, A E; Riley, E N; Stark, L; McCallum, K; Lenze, E J",2015.0,10.4088/JCP.14m09299,0,0,
7148,Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: a pilot randomized controlled trial,"ER METHODS: Thirty-one children ages 3-8 years (M = 5.8 years) with a primary diagnosis of OCD were randomized to E/RP or TAU. The E/RP condition received 12 sessions of family-based E/RP twice weekly over 6 weeks. Families were assessed at baseline, post-treatment, 1-month and 3-month follow up. The Children's Yale Brown Obsessive Compulsive Scale and Clinical Global Impression served as primary outcome measures.RESULTS: A large group effect emerged in favor of the E/RP group (d = 1.69). Sixty-five percent of the E/RP group was considered treatment responders as compared to 7% in the TAU group. Symptom remission was achieved in 35.2% of the E/RP group and 0% of the TAU group. There was no attrition and satisfaction was high; gains were maintained at 3 months.CONCLUSIONS: Even amongst children as young as 3 years, developmentally tailored E/RP is efficacious and well-tolerated in reducing OCD symptoms. Key adaptations for younger children include extensive parent involvement, targeting family accommodation, and frequent meetings while delivering a full course of E/RP.CLINICALTRIALSGOV IDENTIFIER: NCT01447966 http://clinicaltrials.gov/ct2/show/NCT01447966?term=ocd+and+st+petersburg&rank=1.AIMS: To examine the feasibility, acceptability and preliminary efficacy of family-based exposure/response prevention therapy (E/RP) versus treatment as usual (TAU) in a cohort of very young children with early onset obsessive-compulsive disorder (OCD).","Lewin, A B; Park, J M; Jones, A M; Crawford, E A; Nadai, A S; Menzel, J; Arnold, E B; Murphy, T K; Storch, E A",2014.0,10.1016/j.brat.2014.02.001,0,0,
7149,The role of treatment expectancy in youth receiving exposure-based CBT for obsessive compulsive disorder,"ER The purpose of this investigation was to examine correlates of parent, child, and therapist treatment expectations and their role in the exposure-based treatment of childhood obsessive compulsive disorder (OCD). Treatment expectations were assessed among 49 youth with primary OCD, their parents, and therapists as part of the baseline evaluation and post-treatment clinical outcomes were determined by blind evaluators. Baseline depressive symptoms, child/parent-rated functional impairment, externalizing behavior problems, number of comorbid psychiatric disorders, and a lower perception of control were associated with lower pre-treatment expectations. Parent expectation was associated with parental OCD symptoms, child depressive symptoms and child-reported impairment. Therapist expectations inversely correlated with child depressive symptoms, externalizing problems, and child-rated impairment. Pre-treatment OCD severity and prior treatment history were not linked to expectancy. Finally, higher treatment expectations were linked to better treatment response, lower attrition, better homework compliance, and reduced impairment.","Lewin, A B; Peris, T S; Lindsey, Bergman R; McCracken, J T; Piacentini, J",2011.0,10.1016/j.brat.2011.06.001,0,0,
7150,"Agreement between therapists, parents, patients, and independent evaluators on clinical improvement in pediatric obsessive-compulsive disorder","ER OBJECTIVE: Independent evaluators (IE) are used widely in clinical trials to make unbiased determinations of treatment response. By virtue of being kept blind to treatment condition, however, IEs are also kept unaware of many pertinent clinical details that are relevant for decisions about clinical improvement. In this study, agreement among raters (children, parents, therapists, and IEs) about treatment response over the course of a 14-week clinical trial for pediatric obsessive-compulsive disorder (OCD) was examined in order to determine the utility of nonblind clinician and patient ratings of treatment response.METHOD: Participants were 71 youth (mean age = 12.2 years; 63.4% female) with a primary diagnosis of OCD and their parents participating in a psychotherapy trial. IEs provided response ratings (Clinician's Global Impressions-Improvement Scale; CGI-I) at Weeks 4, 8, and 14, and therapists, children, and parents completed independent CGI-I ratings at Weeks 2, 4, 8, and 14.RESULTS: Nonlinear mixed models revealed differences in rating parties, with therapists and IEs slower to rate treatment improvement compared with children and parents, and growth curve models suggested that therapists and IEs produced generally consistent ratings. In addition, no evidence was found for an Evaluator √ó Treatment interaction, indicating that raters displayed these differences consistently across both active and placebo conditions.CONCLUSIONS: Youth and parents may be able to provide accurate ratings of global improvement; nonblinded treating clinicians (with training in research-oriented assessment) can offer global improvement ratings commensurate with blinded IEs. Findings suggest that alternatives (or additions) to the blinded-IE model may be appropriate for assessing global improvement, especially with the growing emphasis on dissemination and effectiveness trials.","Lewin, A B; Peris, T S; Nadai, A S; McCracken, J T; Piacentini, J",2012.0,10.1037/a0029991,0,0,
7151,Treating nighttime fears in young children with bibliotherapy: evaluating anxiety symptoms and monitoring behavior change,"ER Objective: Children's nighttime fears are a normal part of child development and are transient for most children, but result in considerable distress for others. The present study evaluated a 4-week bibliotherapy intervention designed to treat young children with persistent and interfering nighttime fears utilizing a multiple baseline design. Method: Nine children between 5 and 7 years of age with specific phobia diagnoses were randomized into one of three baseline control conditions (1, 2, or 3 weeks). The treatment protocol involved parents reading Uncle Lightfoot, Flip that Switch: Overcoming Fear of the Dark, Academic Version (Coffman, 2012) with their children over 4 weeks while engaging in activities prescribed in the book. Assessments took place at baseline, post treatment, and 1 month following treatment. Daily and weekly tracking of nighttime behaviors was also obtained. Results: Pre-post group analyses revealed that eight of the nine children demonstrated clinically significant change in anxiety severity. In addition, decreases in child-reported nighttime fears were observed, as were parent-reported decreases in separation anxiety and increases in the number of nights children slept in their own bed. Conclusions: The present study provides initial support for the use of bibliotherapy in the treatment of nighttime fears. Further replication and evaluation are needed to determine appropriate length of treatment and long-term effects. Implications of the findings are discussed.","Lewis, K M; Amatya, K; Coffman, M F; Ollendick, T H",2015.0,10.1016/j.janxdis.2014.12.004,0,0,
7152,Effects of Positive Action on the emotional health of urban youth: a cluster-randomized trial,"ER PURPOSE: We examined the effects of Positive Action (PA), a school-based social-emotional learning and health promotion program, on the emotional health of predominately low-income and ethnic minority urban youth.METHODS: The study was a matched-pair, cluster-randomized controlled trial involving 14 Chicago public schools. Outcomes were assessed over a 6-year period of program implementation for a cohort of youth in each school, followed from grades 3 to 8. Youth reported on their emotional health (positive affect, life satisfaction, depression, anxiety) and social-emotional and character development. Growth-curve and structural-equation modeling analyses assessed overall program effects on the emotional health outcomes as well as mediation of these effects via the program's impact on youths' social-emotional and character development.RESULTS: Students in PA schools, compared with those in control schools, had more favorable change over the course of the study in positive affect (standardized mean difference effect size [ES] = .17) and life satisfaction (ES = .13) as well as significantly lower depression (ES = -.14) and anxiety (ES = -.26) at study end point. Program effects for positive affect, depression, and anxiety were mediated by more favorable change over time in social-emotional and character development for students in PA schools.CONCLUSIONS: Results suggest that universal, school-based programs can benefit the emotional health of youth in low-income, urban settings. The modest magnitude of effects over an extended period of program implementation, however, reflects the challenges of both mounting interventions and offsetting formidable risks for mental health problems in such environments.","Lewis, K M; DuBois, D L; Bavarian, N; Acock, A; Silverthorn, N; Day, J; Ji, P; Vuchinich, S; Flay, B R",2013.0,10.1016/j.jadohealth.2013.06.012,0,0,
7153,Long-term effect of 1-piece and 3-piece hydrophobic acrylic intraocular lens on posterior capsule opacification: a randomized trial,"ER DESIGNRandomized, prospective, patient- and examiner-masked clinical trial with intraindividual comparison.PARTICIPANTSFifty-two patients with bilateral age-related cataract (104 eyes).METHODSEach study patient had cataract surgery in both eyes and received a 1-piece AcrySof IOL in 1 eye and a 3-piece AcrySof IOL in the other eye. Follow-up examinations were performed at 1 week, 1 month, 6 months, and 1, 2, and 5 years. Digital retroillumination images were obtained of each eye. The amount of posterior capsule opacification (score range, 0-10) was assessed subjectively at the slit lamp and objectively using automated image analysis software 1, 2, and 5 years after surgery.MAIN OUTCOME MEASUREPosterior capsule opacification score (scale, 0-10).RESULTSThere was no significant difference between the 1-piece and 3-piece AcrySof IOL in best-corrected visual acuity, overlap of rhexis and IOL, capsular folds, anterior capsule opacification, and posterior capsule opacification (1-piece AcrySof PCO score, 1.7+/-1.7; 3-piece AcrySof PCO score, 1.3+/-1.4; P = 0.30).CONCLUSIONSModification of the IOL haptic design of the sharp optic edged AcrySof IOL from a 3-piece to a 1-piece haptic design caused no significant change in PCO intensity and neodymium:yttrium-aluminium-garnet laser treatment rate 5 years after surgery.PURPOSETo compare the intensity of posterior capsule opacification (PCO) between the 1-piece and 3-piece haptic designs of the foldable hydrophobic acrylic AcrySof intraocular lens (IOL) over a 5-year period.","Leydolt, C; Davidovic, S; Sacu, S; Menapace, R; Neumayer, T; Prinz, A; Buehl, W; Findl, O",2007.0,10.1016/j.ophtha.2006.12.016,0,0,
7154,Posterior capsule opacification and neodymium:YAG rates with 2 single-piece hydrophobic acrylic intraocular lenses: three-year results,"ER PURPOSE: To compare the incidence and intensity of posterior capsule opacification (PCO) between 2 similar 1-piece foldable hydrophobic acrylic intraocular lenses (IOLs) over 3 years.SETTING: Department of Ophthalmology, Medical University Vienna, Vienna, Austria.DESIGN: Randomized prospective patient- and examiner-masked clinical trial with intraindividual comparison.METHODS: Patients with bilateral age-related cataract had cataract surgery and implantation of a Tecnis ZCB00 continuous-optic-edge IOL in 1 eye and an Acrysof SA60AT interrupted-optic-edge IOL in the other eye. Postoperative examinations were performed at 6 months and 3 years. Digital retroillumination images were taken of each eye. The amount of PCO (score 0 to 10) was assessed subjectively at the slitlamp and objectively using automated image-analysis software.RESULTS: The study comprised 54 patients (108 eyes). The mean objective PCO score was 1.3 ± 1.7 (SD) for the continuous-optic-edge IOLs and 0.9 ± 1.3 for the interrupted-optic-edge IOLs (P=.10). Three years postoperatively, a neodymium:YAG (Nd:YAG) capsulotomy was performed in 26.1% of eyes with the continuous-optic-edge IOL and 21.7% with the interrupted-optic-edge IOL (P=.56). There was no significant difference in corrected distance visual acuity, capsulorhexis?IOL overlap, capsule folds, or anterior capsule opacification 3 years after surgery.CONCLUSIONS: Both IOLs had comparable PCO and Nd:YAG rates 3 years postoperatively. The optimized barrier function of the continuous-optic-edge IOL and the material properties of the interrupted-optic-edge IOL seemingly outbalanced the effect on lens epithelial cell migration and proliferation beneath the optic.","Leydolt, C; Kriechbaum, K; Schriefl, S; Pachala, M; Menapace, R",2013.0,,0,0,
7155,Posterior capsule opacification with the iMics1 NY-60 and AcrySof SN60WF 1-piece hydrophobic acrylic intraocular lenses: 3-year results of a randomized trial,"ER PURPOSE: To compare the intensity of posterior capsule opacification (PCO) 3 years after implantation of 2 different 1-piece foldable hydrophobic acrylic intraocular lenses (IOLs).DESIGN: Randomized, prospective, patient- and examiner-masked clinical trial with intraindividual comparison.METHODS: One hundred patients with bilateral age-related cataract (200 eyes) had standard cataract surgery with implantation of an iMics1 NY-60 IOL (Hoya Corp) in one eye and an AcrySof SN60WF IOL (Alcon Laboratories) in the other eye. Follow-up examinations were performed at 1 week and 3 years. Digital retroillumination images were obtained of each eye. The main outcome measure was PCO score (scale, 0 to 10) assessed subjectively at the slit lamp and objectively using automated image analysis software (Automated Quantification of After-Cataract) 3 years after surgery.RESULTS: The objective PCO score (mean ± standard deviation) was 3.0 ± 2.0 for the iMics1 NY-60 IOL and 1.9 ± 1.4 for the AcrySof SN60WF IOL (P < .001). Three years after surgery, 35.6% of patients underwent a neodymium:yttrium-aluminum-garnet capsulotomy in the iMics1 NY-60 eye and 13.7% underwent a capsulotomy in the AcrySof SN60WF eye (P = .001). There was no statistically significant difference in best-corrected visual acuity, rhexis-IOL overlap, capsular folds, or anterior capsule opacification. Glistening formations were found in no iMics1 NY-60 IOLs, but in 97% of the AcrySof SN60WF IOLs.CONCLUSIONS: Comparison of 2 sharp-edged single-piece IOLs of similar design and hydrophobic acrylic material indicated a statistically significant difference in PCO and neodymium:yttrium-aluminum-garnet capsulotomy rate 3 years after surgery.","Leydolt, C; Schriefl, S; Stifter, E; Haszcz, A; Menapace, R",2013.0,10.1016/j.ajo.2013.04.007,0,0,
7156,Comparison of fondaparinux sodium and low molecular weight heparin in the treatment of hypercoagulability secondary to traumatic infection,"ER Purpose To compare the effects and side-effects of fondaparinux sodium and low molecular weight heparin in patients with hypercoagulability accompanied with traumatic infection. Methods Thirty-six patients with post-traumatic infections in our hospital intensive care center were diagnosed with hypercoagulability from February 2012 to February 2013. These patients were randomly divided into 2 groups. In group F (18 patients), the patients were treated with fondaparinux sodium, 2.5 mg, 1/d for 11 d. In group L (18 patients), the patients were treated with low molecular weight heparin, 4100 U, 1/12 h for 11 d. The incidence of deep vein thrombosis, bleeding events and multiple organ dysfunction syndrome (MODS) and mortality of two groups after anticoagulation therapy were analyzed. Fibrinogen, D-dimer level and activity of antithrombin III were measured by the coagulation analyzer. Results The incidence of deep vein thrombosis, MODS incidence and mortality were not significantly different between the two groups. The rate of bleeding evens in group F was lower than group L (p  0.05). D-dimer was significantly decreased after anticoagulant therapy for 5 d (p  0.05). D-dimer was significantly decreased after anticoagulant therapy for 5 d (p  0.05). Conclusion Fondaparinux sodium and low molecular weight heparin can effectively improve coagulopathy in patients with traumatic infection. Compared with low molecular weight heparin, fondaparinux sodium may reduce the risk of bleeding events in patients with hypercoagulability accompanied by traumatic infection.","Li, B; Wang, K; Zhao, X; Lin, C; Sun, H",2015.0,,0,0,
7157,"The effect of a ""training on work readiness"" program for workers with musculoskeletal injuries: a randomized control trial (RCT) study","ER METHODOLOGYA total of 64 injured workers were recruited and randomly assigned into the training (T) and control (C) groups. Observations were blinded between service providers and evaluators. A three-week intensive training on work readiness program was given to the T group while subjects in the C group were given advice on job placement by social workers in a community work health center. The training program was comprised of individual vocational counseling and group therapy using cognitive behavioral approach to alleviate symptoms of stress, pain and anxiety. The Chinese Lam Assessment of Stages of Employment Readiness (C-LASER), the Chinese State Trait and Anxiety Inventory (C-STAI) and the Short form of Health Survey (SF-36) were used to evaluate all subjects' psychological health status and behavioral changes on job readiness before and after the intervention.RESULTSSubjects in the T group showed significant improvement in their work readiness (p < 0.05), level of anxiety (p < 0.05) and their self perception of health status measured by SF-36 (p < 0.02) when compared with subjects in the C group. Control of chronic pain, negative motivation, and anxiety level were some of the key behavioral changes found from the study.CONCLUSIONThe TWR program appeared to improve injured workers' motivation and employment readiness. Further study on the employment outcomes of subjects is recommended.BACKGROUNDThis is a clinical randomized trail (RCT) to investigate the effects of a three-week training program on work readiness designed for musculoskeletal injured workers with long-term sick leave who had difficulties resuming their work role. The program was planned to help injured workers overcome the psychological and psychosocial problems and to facilitate their Work Readiness on Return to Work (RTW) based on the Employment readiness model.","Li, E J; Li-Tsang, C W; Lam, C S; Hui, K Y; Chan, C C",2006.0,10.1007/s10926-006-9034-3,0,0,
7158,Effect of hospice care on the quality of life and psychological state of aged mortal inpatients,"ER METHODSSeventy-six aged patients were randomly divided into 2 groups (n=38). The research group was treated with hospice care, while the control group was treated with conventional nursing. Before and after more than one month of the interference, the quality of life, social support, satisfied degree, anxiety, and depression mood were investigated.RESULTSAll the indexes, such as total scale of life quality, appetite, spirit, sleep, family comprehension and coordination, recognition of cancer, attitude to therapy, and facial expression of the mortal inpatients after the interference, were raised and higher than those of the controls (P<0.05 or P<0.01). Life satisfaction index and the total scale of social support and subjective support, utilization ratio of support were raised and higher than those of the controls (P<0.05 or P<0.01). The level of anxiety and depression was decreased and lower than the control (P<0.05 or P<0.01).CONCLUSIONHospice care can raise the life quality, subjective support, utilization ratio of support and life satisfaction of aged mortal inpatients. It could decrease the negative mood, such as anxiety and depression and improve the psychological state.OBJECTIVETo investigate the influence of hospice care on the life quality and psychological state of aged mortal inpatients.","Li, Y Q; Zhang, M X; Fu, G X; Zhao, L H; Li, W Y; Li, H; Zhang, C X; Fan, Y; Wang, Z H; Peng, L",2006.0,,0,0,
7159,"Examining the relation between the therapeutic alliance, treatment adherence, and outcome of cognitive behavioral therapy for children with anxiety disorders","ER Little is known about the contribution of technical and relational factors to child outcomes in cognitive behavioral therapy (CBT) for children with anxiety disorders. This study investigated the association between treatment adherence, the child-therapist alliance, and child clinical outcomes in manual-guided individual- and group-based CBT for youths diagnosed with anxiety disorders. Trained observers rated tapes of therapy sessions for treatment adherence and child-therapist alliance in a sample of 52 children (aged 8 to 12) with anxiety disorders. Self-reported child anxiety was assessed at pre-, mid-, and posttreatment; parent-reported child internalizing symptoms was assessed at pre- and posttreatment. The results showed high levels of treatment adherence and child-therapist alliance in both CBT programs. Neither treatment adherence nor child-therapist alliance predicted traditional measurements of child outcomes in the present study, but a relation between alliance and outcome was found using a more precise estimation of the true pre-post differences. Implications of these findings for expanding our understanding of how treatment processes relate to child outcome in CBT for children with anxiety disorders are discussed.","Liber, J M; McLeod, B D; Widenfelt, B M; Goedhart, A W; Leeden, A J; Utens, E M; Treffers, P D",2010.0,10.1016/j.beth.2009.02.003,0,0,
7160,The relation of severity and comorbidity to treatment outcome with Cognitive Behavioral Therapy for childhood anxiety disorders,"ER The present study investigated the impact of comorbidity over and above the impact of symptom severity on treatment outcome of Cognitive Behavioral Therapy for children with anxiety disorders. Children (aged 8-12, n = 124) diagnosed with an anxiety disorder were treated with a short-term CBT protocol. Severity was assessed with a composite measure of parent-reported behavior problems. Two approaches to comorbidity were examined; ""total comorbidity"" which differentiated anxiety disordered children with (n = 69) or without (n = 55) a co-occurring disorder and ""non-anxiety comorbidity' which differentiated anxious children with (n = 22) or without a non-anxiety comorbid disorder (n = 102). Treatment outcome was assessed in terms of Recovery, represented by post-treatment diagnostic status, and Reliable Change, a score reflecting changes in pre- to post-treatment symptom levels. Severity contributed to the prediction of (no) Recovery and (more) Reliable Change in parent-reported internalizing and externalizing symptoms and self-reported depressive symptoms. Total and non-anxiety comorbidity added to the prediction of diagnostic recovery. Non-anxiety comorbidity added to the prediction of Reliable Change in parent reported measures by acting as a suppressor variable. Non-anxiety comorbidity operated as a strong predictor that explained all of the variance associated with severity for self-reported depressive symptoms. The results support the need for further research on mechanisms by which treatment gains in children with higher symptom severity and non-anxiety comorbidity can be achieved.","Liber, J M; Widenfelt, B M; Leeden, A J; Goedhart, A W; Utens, E M; Treffers, P D",2010.0,10.1007/s10802-010-9394-1,0,0,
7161,No differences between group versus individual treatment of childhood anxiety disorders in a randomised clinical trial,"ER METHODAnalyses were conducted separately for the intent-to-treat sample and the sample of children who completed treatment. Analyses included chi-square comparisons and regression analyses with treatment format as a predictor.RESULTSForty-eight percent of the children in the individual versus 41% in the group treatment were free of any anxiety disorder at post-treatment; 62% versus 54% were free of their primary anxiety disorder. Regression analyses showed no significant difference in outcome between individual and group treatment.CONCLUSIONSChildren improved in both conditions. Choice between treatments could be based on pragmatic considerations such as therapeutic resources, referral rates, and the preference of the parents and the child.BACKGROUNDThe present study compares an individual versus a group format in the delivery of manualised cognitive-behavioural therapy (FRIENDS) for children with anxiety disorders. Clinically referred children (aged 8 to 12) diagnosed with Separation Anxiety Disorder (n = 52), Generalised Anxiety Disorder (n = 37), Social Phobia (n = 22) or Specific Phobia (n = 16) were randomly assigned to individual (n = 65) or group (n = 62) treatment.","Liber, J M; Widenfelt, B M; Utens, E M; Ferdinand, R F; Leeden, A J; Gastel, W; Treffers, P D",2008.0,10.1111/j.1469-7610.2008.01877.x,0,0,
7162,Effects of a home-based intervention program on anxiety and depression 6 months after coronary artery bypass grafting: a randomized controlled trial,"ER METHODSIn a prospective randomized controlled trial, 203 elective CABG patients were included. An HBIP structured for respondents in the intervention group was performed 2 and 4 weeks after surgery. Anxiety and depression symptoms were measured by the Hospital Anxiety and Depression Scale (HADS) in both patient groups before surgery, 6 weeks after surgery, and 6 months after surgery.RESULTSA total of 185 patients completed the study: 93 patients in the intervention group and 92 patients in the control group. On 6-week and 6-month follow-ups, significant improvements in anxiety and depression symptoms were found in both groups. These improvements did not differ significantly between the groups. However, in a predefined subgroup of patients with anxiety and/or depression symptoms at baseline (n=65), improvement was significantly larger in the intervention group (n=29) than in the control group (n=36) after 6 months (P<.05).CONCLUSIONSPatients experiencing high levels of psychological distress before CABG surgery benefited from a structured informational and psychological HBIP. Implementation of psychological screens of patients scheduled for CABG might serve to identify patients experiencing anxiety and/or depression. These patients could then be targeted to receive individualized HBIP.OBJECTIVEThe objective of this study was to evaluate the effects of a home-based intervention program (HBIP) on anxiety and depression 6 months after coronary artery bypass grafting (CABG).","Lie, I; Arnesen, H; Sandvik, L; Hamilton, G; Bunch, E H",2007.0,10.1016/j.jpsychores.2006.11.010,0,0,
7163,Child-parent psychotherapy: 6-month follow-up of a randomized controlled trial,"ER METHODSeventy-five multiethnic preschool-age child-mother dyads from diverse socioeconomic backgrounds were randomly assigned to (1) CPP or (2) case management plus community referral for individual treatment. Children were 3 to 5 years old. Follow-up assessments were conducted 6 months after the end of a 1-year treatment period. Mothers completed the Child Behavior Checklist and the Symptom Checklist Revised to assess child's and mother's symptoms.RESULTSFor treatment completers, general linear model (GLM) repeated-measures analyses support the durability of CPP with significant group x time interactions for children's total behavior problems and mothers' general distress. Intent-to-treat analyses revealed similar findings for children's behavior problems but were not significant for maternal symptoms.CONCLUSIONSThe findings provide additional evidence of the efficacy and durability of CPP with this population and highlight the importance of a relationship focus in the treatment of traumatized preschoolers.OBJECTIVETo examine the durability of improvement in child and maternal symptoms 6 months after termination of child-parent psychotherapy (CPP).","Lieberman, A F; Ghosh, Ippen C; Horn, P",2006.0,10.1097/01.chi.0000222784.03735.92,0,0,
7164,Toward evidence-based treatment: child-parent psychotherapy with preschoolers exposed to marital violence,"ER METHODSeventy-five multiethnic preschool mother dyads from diverse socioeconomic backgrounds were randomly assigned to (1) CPP or (2) case management plus community referral for individual treatment. CPP consisted of weekly parent-child sessions for 1 year monitored for integrity with the use of a treatment manual and intensive training and supervision. Parents completed the Child Behavior Checklist and participated in the Structured Clinical Interview for DC:0-3 to assess children's emotional and behavioral problems and posttraumatic stress disorder (PTSD) symptoms. Mothers completed the Symptom Checklist-90 and the Clinician Administered PTSD Scale interview to assess their general psychiatric and PTSD symptoms.RESULTSRepeated-measures analysis of variance demonstrated the efficacy of CPP with significant group x time interactions on children's total behavior problems, traumatic stress symptoms, and diagnostic status, and mothers' avoidance symptoms and trends toward significant group x time interactions on mothers' PTSD symptoms and general distress.CONCLUSIONSThe findings provide evidence of the efficacy of CPP with this population and highlight the importance of a relationship focus in the treatment of traumatized preschoolers.OBJECTIVETreatment outcome for preschool-age children exposed to marital violence was assessed, comparing the efficacy of Child-Parent Psychotherapy (CPP) with case management plus treatment as usual in the community.","Lieberman, A F; Horn, P; Ippen, C G",2005.0,10.1097/01.chi.0000181047.59702.58,0,0,
7165,Phenelzine v imipramine in atypical depression. A preliminary report,"ER Sixty patients meeting specific criteria for atypical depression completed six weeks of double-blind, randomly assigned treatment with phenelzine sulfate, imipramine hydrochloride, or placebo. The overall response rates were 67% with phenelzine, 43% with imipramine, and 29% with placebo. At week 6, phenelzine was superior to placebo on many measures, while the superiority of imipramine to placebo was confined to several variables. Phenelzine was superior to imipramine on the interpersonal sensitivity and paranoia factors of the 90-item Hopkins Symptom Checklist, with trends toward superiority on several other measures, while imipramine was not differentially superior on any measure. Atypical depressive patients with a history of spontaneous panic attacks and hysteroid dysphoric patients both showed extremely low rates of response to placebo and high rates of response to phenelzine. Conversely, those without panic or hysteroid dysphoric features responded equally to all three treatments. Responders to pheneizine also had greater platelet monoamine oxidase inhibition while receiving drug therapy than did nonresponders. Completion of the 120-patient sample will allow more detailed analyses.","Liebowitz, M R; Quitkin, F M; Stewart, J W; McGrath, P J; Harrison, W; Rabkin, J; Tricamo, E; Markowitz, J S; Klein, D F",1984.0,,0,0,
7166,Psychopharmacologic validation of atypical depression,"ER Sixty patients meeting specific criteria for atypical depression completed 6 weeks of double-blind, randomly assigned treatment with phenelzine, imipramine, or placebo. Patients who had a history of spontaneous panic attacks or hysteriod dysphoric features showed extremely low placebo-response rates, moderate responses to imipramine, and high rates of response to phenelzine. Conversely, patients without such features responded moderately well to all three treatments. Based on preliminary data, MAOI-specific atypical depression does appear to exist, although in more delimited forms than previously recognized.","Liebowitz, M R; Quitkin, F M; Stewart, J W; McGrath, P J; Harrison, W; Rabkin, J G; Tricamo, E; Markowitz, J S; Klein, D F",1984.0,,0,0,
7167,Factors that influence cancer patients' anxiety following a medical consultation: impact of a communication skills training programme for physicians,"ER PATIENTS AND METHODSPhysicians, after attending the BT, were randomly assigned to CW or to a waiting list. The control group was not a non-intervention group. Consultations with a cancer patient were recorded. Patients' anxiety was assessed with the State Trait Anxiety Inventory before and after a consultation. Communication skills were analysed according to the Cancer Research Campaign Workshop Evaluation Manual.RESULTSNo statistically significant change over time and between groups was observed. Mixed-effects modelling showed that a decrease in patients' anxiety was linked with screening questions (P = 0.045), physicians' satisfaction about support given (P = 0.004) and with patients' distress (P < 0.001). An increase in anxiety was linked with breaking bad news (P = 0.050) and with supportive skills (P = 0.013). No impact of the training programme was observed.CONCLUSIONSThis study shows the influence of some communication skills on the evolution of patients' anxiety. Physicians should be aware of these influences.BACKGROUNDNo study has yet assessed the impact of physicians' skills acquisition after a communication skills training programme on the evolution of patients' anxiety following a medical consultation. This study aimed to compare the impact, on patients' anxiety, of a basic communication skills training programme (BT) and the same programme consolidated by consolidation workshops (CW), and to investigate physicians' communication variables associated with patients' anxiety.","Liénard, A; Merckaert, I; Libert, Y; Delvaux, N; Marchal, S; Boniver, J; Etienne, A M; Klastersky, J; Reynaert, C; Scalliet, P; Slachmuylder, J L; Razavi, D",2006.0,10.1093/annonc/mdl142,0,0,
7168,The effects of dietary tryptophan on affective disorders,"ER Using a randomized crossover study design, 25 healthy young adults were examined for differences in anxiety, depression, and mood after consuming a high tryptophan and a low tryptophan diet for 4days each. There was a 2week washout between the diets. A within-subjects analysis of the participants' mood indicated significantly (p.05). Also, consuming more dietary tryptophan resulted in (p<.05) less depressive symptoms and decreased anxiety.","Lindseth, G; Helland, B; Caspers, J",2015.0,10.1016/j.apnu.2014.11.008,0,0,
7169,Women living with facial hair: the psychological and behavioral burden,"ER METHODSEighty-eight women (90% participation rate) completed a self-administered questionnaire concerning hair removal practices; the impact of facial hair on social and emotional domains; relationships and daily life; anxiety and depression (Hospital Anxiety and Depression Scale); self-esteem (Rosenberg Self-esteem Scale); and quality of life (WHOQOL-BREF).RESULTSWomen spent considerable time on the management of their facial hair (mean, 104 min/week). Two thirds (67%) reported continually checking in mirrors and 76% by touch. Forty percent felt uncomfortable in social situations. High levels of emotional distress and psychological morbidity were detected; 30% had levels of depression above the clinical cut off point, while 75% reported clinical levels of anxiety; 29% reported both. Although overall quality of life was good, scores were low in social and relationship domains--reflecting the impact of unwanted facial hair.CONCLUSIONUnwanted facial hair carries a high psychological burden for women and represents a significant intrusion into their daily lives. Psychological support is a neglected element of care for these women.OBJECTIVEWhile unwanted facial hair is clearly distressing for women, relatively little is known about its psychological impact. This study reports on the psychological and behavioral burden of facial hair in women with suspected polycystic ovary syndrome.","Lipton, M G; Sherr, L; Elford, J; Rustin, M H; Clayton, W J",2006.0,10.1016/j.jpsychores.2006.01.016,0,0,
7170,"Single-pulse transcranial magnetic stimulation for acute treatment of migraine with aura: a randomised, double-blind, parallel-group, sham-controlled trial","ER METHODSWe undertook a randomised, double-blind, parallel-group, two-phase, sham-controlled study at 18 centres in the USA. 267 adults aged 18-68 years were enrolled into phase one. All individuals had to meet international criteria for migraine with aura, with visual aura preceding at least 30% of migraines followed by moderate or severe headache in more than 90% of those attacks. 66 patients dropped out during phase one. In phase two, 201 individuals were randomly allocated by computer to either sham stimulation (n=99) or sTMS (n=102). We instructed participants to treat up to three attacks over 3 months while experiencing aura. The primary outcome was pain-free response 2 h after the first attack, and co-primary outcomes were non-inferiority at 2 h for nausea, photophobia, and phonophobia. Analyses were modified intention to treat and per protocol. This trial is registered with ClinicalTrials.gov, number NCT00449540.FINDINGS37 patients did not treat a migraine attack and were excluded from outcome analyses. 164 patients treated at least one attack with sTMS (n=82) or sham stimulation (n=82; modified intention-to-treat analysis set). Pain-free response rates after 2 h were significantly higher with sTMS (32/82 [39%]) than with sham stimulation (18/82 [22%]), for a therapeutic gain of 17% (95% CI 3-31%; p=0.0179). Sustained pain-free response rates significantly favoured sTMS at 24 h and 48 h post-treatment. Non-inferiority was shown for nausea, photophobia, and phonophobia. No device-related serious adverse events were recorded, and incidence and severity of adverse events were similar between sTMS and sham groups.INTERPRETATIONEarly treatment of migraine with aura by sTMS resulted in increased freedom from pain at 2 h compared with sham stimulation, and absence of pain was sustained 24 h and 48 h after treatment. sTMS could be a promising acute treatment for some patients with migraine with aura.FUNDINGNeuralieve.BACKGROUNDPreliminary work suggests that single-pulse transcranial magnetic stimulation (sTMS) could be effective as a treatment for migraine. We aimed to assess the efficacy and safety of a new portable sTMS device for acute treatment of migraine with aura.","Lipton, R B; Dodick, D W; Silberstein, S D; Saper, J R; Aurora, S K; Pearlman, S H; Fischell, R E; Ruppel, P L; Goadsby, P J",2010.0,10.1016/S1474-4422(10)70054-5,0,0,
7171,A prospective randomized clinical trial to investigate the effect of silicone gel sheeting (Cica-Care) on post-traumatic hypertrophic scar among the Chinese population,"ER METHOD AND MATERIALSA randomized clinical trial (RCT) was conducted on 45 Chinese patients with post-traumatic hypertrophic scars. Twenty-two subjects were placed in the experimental group with silicone gel sheeting (SGS) applied 24h per day for 6 months while all subjects were taught to massage the scar daily for 15 min serving as the control intervention. Scar assessments were conducted regularly to measure the changes in thickness, pigmentation, vascularity, pliability, itchiness and pain.RESULTSTwo-way repeated ANOVA showed a significant difference between MT group and SGS group on scar thickness. The post hoc comparison analysis showed that the difference was significant at the post-2-month (p=0.008) and post-6-month (p<0.001) intervention. The SGS group also showed changes in pigmentation which resembled normal skin but no statistical significance was found. Pain, itchiness and pliability were also improved after intervention.CONCLUSIONThis study indicated that silicone gel sheeting (Cica-Care) was effective to reduce thickness, pain, itchiness and pliability of the severe hypertrophic scar among the Chinese population. The moisturization effect of the tough and hard scar might contribute to the reduction of the skin thickness after 6 month's intervention.BACKGROUNDThis study aimed to determine the efficacy of silicone gel (Cica-Care) on severe post-traumatic hypertophic scars among the Chinese population.","Li-Tsang, C W; Lau, J C; Choi, J; Chan, C C; Jianan, L",2006.0,10.1016/j.burns.2006.01.016,0,0,
7172,A randomized clinical trial to study the effect of silicone gel dressing and pressure therapy on posttraumatic hypertrophic scars,"ER To investigate the effect of pressure therapy (PG), silicone gel sheeting (SGS), and combined therapy on the management of posttraumatic hypertrophic scar (HS) using a randomized controlled clinical trial. A total of 104 subjects with HS mostly resulting from burns and scald injuries (63 men and 41 women; average age: 21.8 +/- 18.7 years) were recruited from Jiangsu People's First Affiliated Hospital in Nanjing, China. The mean scar formation period was 14.9 +/- 30.8 months. All subjects were randomly allocated into four groups, namely the PG, SGS, combined PG and SGS groups, and single-blinded control group for the treatment of 6 months. Standardized scar assessments (pigmentation, vascularity, thickness, pain, and itchiness) were conducted before the intervention, 2, 4, and 6 months of the intervention, and 1 month after completion of the program, respectively, to observe the progress of the treatments. The results showed that the combined therapy seemed to be more effective in improving the thickness of scar after 2 months of intervention (P < .001). After 6 months of intervention, both the combined therapy group and the PG group showed significant improvement in scar thickness. The improvement in scar thickness was most significant in the combined therapy group. SGS was found to be more effective in alleviating the pain and pruritus rather than the scar thickness. This randomized clinical trial has demonstrated the evidence of the effect of combined PG and gel intervention on posttraumatic HS. The PG group showed an improvement in scar thickness too. Further studies are needed to investigate the biomechanical and physiological effect that PG and gel sheeting would exert on the scar tissues.","Li-Tsang, C W; Zheng, Y P; Lau, J C",2010.0,10.1097/BCR.0b013e3181db52a7,0,0,
7173,Network Support treatment for alcohol dependence: gender differences in treatment mechanisms and outcomes,"ER OBJECTIVE: Network Support treatment was intended to help alcohol dependent patients alter their close social support networks to be more supportive of sobriety and less supportive of drinking. The purpose of the present study was to examine the differential influences of Network Support treatment on men and women.METHODS: Alcohol dependent men (n=122) and women (n=88) recruited from the community were randomly assigned to 1 of 3 12-week outpatient treatment conditions: Network Support (NS), Network Support+Contingency Management (NS+CM), or Case Management (CaseM; a control condition). Patients were then followed for a period of 27 months. Multilevel modeling was used to evaluate Sex√óTreatment interaction effects on outcome variables over time. Tests of mediation were used to determine what factors might account for differential effectiveness for men or women in the NS conditions.RESULTS: Analyses of drinking-related outcome measures over the 27 months indicated that women fared less well overall, and particularly poorly in the Network Support conditions, relative to men. Tests of mediation indicated that self-efficacy change and change in the number of non-drinking close associates partially mediated the effect of NS treatments on outcome.CONCLUSIONS: It was concluded that the NS conditions failed to alter women's social networks, and may have had the effect of undermining women's self-efficacy. Network Support treatment might be applicable for women and more effective generally if particular attention is paid to understanding preexisting social support networks.","Litt, M D; Kadden, R M; Tennen, H",2015.0,10.1016/j.addbeh.2015.01.005,0,0,
7174,Brief screening instrument of posttraumatic stress disorder for children and adolescents 7-15 years of age,"ER The objective of this paper is to develop a brief screening instrument of posttraumatic stress disorder (PTSD) for young victims of natural disasters. Data were derived from flood victims in 1998 and 1999 in Hunan, China. A representative population sample of 6,852 subjects 7-15 years of age was selected. Among them, 6,073 (88.6%) were interviewed. Multistage sampling was used to select the subjects and PTSD was ascertained with Diagnostic and Statistical Manual of Mental Disorders: 4th Edition (DSM-IV). We randomly assigned 80% (4,851) of the study subjects to construct the screening instrument (construct model) and the remaining 20% (1,222) subjects to examine the model (validation model). Logistic regression analysis and receiver operating characteristics curves were utilized to select a subset of symptoms and cutoff point from the pre-structured questionnaires. A seven-symptom instrument for PTSD screening was selected. Scores of 3 or more on this instrument were employed to define positive cases of PTSD with a sensitivity of 96.9%, specificity 99.0%, positive predictive value (PPV) 82.6%, and negative predictive value (NPV) 99.8%. The brief screening instrument developed in this study is highly valid, reliable, and predictable.","Liu, A; Tan, H; Zhou, J; Li, S; Yang, T; Sun, Z; Wen, S W",2007.0,10.1007/s10578-007-0056-7,0,0,
7175,Effectiveness of audiovisual interventions on stress responses in adolescents with ENT surgery in hospital: randomized controlled trial protocol,"ER AIM: To investigate the circadian pattern of cortisol secretion and other stress indictors in association with audiovisual stimuli in adolescents having otorhinolaryngological surgery in hospital.BACKGROUND: Hospitalization for surgery is a major stressful life event for adolescents causing negative consequences, including anxiety. Recent studies suggest that entertaining and educational interventions might be effective at reducing such adversities, but little is known about the pattern of these responses and effects.DESIGN: Randomized controlled trial.METHODS: Adolescents with otorhinolaryngological surgery in hospital without any contraindictions for salivary cortisol enzyme immunoassays will be recruited and randomly allocated to experimental, placebo and control. Stress indicators will be collected regularly for 5 days. Standard audiovisual interventions will be displayed for experimental and placebo groups including a simultaneous video-recording of facial and behavioural changes on the second afternoon postadmission and stress indicators will be collected pre- and three times with 20-minute interval postintervention. Follow-up will be conducted to evaluate the longer term effects at 2 weeks, 1-month and 3 months postadmission, respectively. Descriptive and comparative analyses of stress indicators will be performed to examine group differences. Competitive funding was obtained from the Independent Innovation Foundation of Shandong University for interdisciplinary research in 2012.DISCUSSION: This study will help identify timeslots for interventions for integrating strength-building into stress response reduction in adolescents hospitalized for surgery.","Liu, C Y; Xu, L; Zang, Y L",2014.0,10.1111/jan.12295,0,0,
7176,Clinical intervention research on mental stress-induced myocardial ischemia,"ER OBJECTIVE: To observe the impact of Xinkeshu on top of standard medication on psychological stress-related emotional and biophysiological parameters in patients with mental stress-induced myocardial ischemia (MSIMI).METHODS: A randomized controlled clinical trial was conducted on 40 patients with MSIMI and patients were randomized into treatment group (n = 21) and control group (n = 19) by random number table method. Patients in the treatment group received Xinkeshu (12 capsules/d) on top of standard therapy, and the control group received placebo on top of standard therapy. Serum homocysteine (Hcy), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were compared between the groups at baseline and after 8 weeks therapy.RESULTS: (1) Baseline data were similar between the 2 groups (all P > 0.05). (2) After 8 weeks, LVFS was significantly increased (from (34.62 ± 5.76)% to (35.90 ± 4.99) %, P = 0.027) and serum Hcy (from (18.08 ± 1.81) µmol/L to (16.06 ± 10.10) µmol/L), PHQ-9 (from 8.14 ± 3.98 to 6.28 ± 2.87) and GAD-7 (from 9.52 ± 4.98 to 6.48 ± 3.84) were significantly reduced in treatment group (all P  0.05).CONCLUSION: Xinkeshu on the top of standard therapy can improve the emotional state and left ventricular systolic function in patients with MSIMI.","Liu, M",2015.0,,0,0,
7177,"Clinical effectiveness of a manual based coping strategy programme (START, STrAtegies for RelaTives) in promoting the mental health of carers of family members with dementia: pragmatic randomised controlled trial","ER DESIGN: Randomised, parallel group, superiority trial.SETTING: Three mental health community services and one neurological outpatient dementia service in London and Essex, UK.PARTICIPANTS: 260 carers of family members with dementia.INTERVENTION: A manual based coping intervention comprising eight sessions and delivered by supervised psychology graduates to carers of family members with dementia. The programme consisted of psychoeducation about dementia, carers' stress, and where to get emotional support; understanding behaviours of the family member being cared for, and behavioural management techniques; changing unhelpful thoughts; promoting acceptance; assertive communication; relaxation; planning for the future; increasing pleasant activities; and maintaining skills learnt. Carers practised these techniques at home, using the manual and relaxation CDs.MAIN OUTCOME MEASURES: Affective symptoms (hospital anxiety and depression total score) at four and eight months. Secondary outcomes were depression and anxiety caseness on the hospital anxiety and depression scale; quality of life of both the carer (health status questionnaire, mental health) and the recipient of care (quality of life-Alzheimer's disease); and potentially abusive behaviour by the carer towards the recipient of care (modified conflict tactics scale).RESULTS: 260 carers were recruited; 173 were randomised to the intervention and 87 to treatment as usual. Mean total scores on the hospital anxiety and depression scale were lower in the intervention group than in the treatment as usual group over the eight month evaluation period: adjusted difference in means -1.80 points (95% confidence interval -3.29 to -0.31; P=0.02) and absolute difference in means -2.0 points. Carers in the intervention group were less likely to have case level depression (odds ratio 0.24, 95% confidence interval 0.07 to 0.76) and there was a non-significant trend towards reduced case level anxiety (0.30, 0.08 to 1.05). Carers' quality of life was higher in the intervention group (difference in means 4.09, 95% confidence interval 0.34 to 7.83) but not for the recipient of care (difference in means 0.59, -0.72 to 1.89). Carers in the intervention group reported less abusive behaviour towards the recipient of care compared with those in the treatment as usual group (odds ratio 0.47, 95% confidence interval 0.18 to 1.23), although this was not significant.CONCLUSIONS: A manual based coping strategy was effective in reducing affective symptoms and case level depression in carers of family members with dementia. The carers' quality of life also improved.TRIAL REGISTRATION: Current Controlled Trials ISCTRN70017938.OBJECTIVE: To assess whether a manual based coping strategy compared with treatment as usual reduces depression and anxiety symptoms in carers of family members with dementia.","Livingston, G; Barber, J; Rapaport, P; Knapp, M; Griffin, M; King, D; Livingston, D; Mummery, C; Walker, Z; Hoe, J; Sampson, E L; Cooper, C",2013.0,,0,0,
7178,A pilot randomised controlled trial to reduce suffering and emotional distress in patients with advanced cancer,"ER INTRODUCTION: A pilot trial was carried out to determine if a focussed narrative interview could alleviate the components of suffering and anxiety and depression in advanced cancer patients.INTERVENTION: Patients recruited were invited to participate in a focussed narrative interview and reflect on their perspectives on their sense of ""meaning"", regarding suffering and their psychological, physical, social and spiritual well being - the emphasis was on allowing the patient to tell their story. Patients were encouraged to share what resources they themselves had utilised in addition to what professional care they may have received, to maintain a sense of well being.METHOD: Patients with advanced metastatic disease were recruited from hospices in the North West of England - the only exclusion criteria were not being able to understand written and spoken English and a non cancer diagnosis. At recruitment patients were asked to complete a numerical scale for suffering; the Brief Edinburgh Depression Scale, Edmonton Symptom Assessment Scale (ESAS), FACIT Spiritual well being questionnaire, Demographic information was collected and patients were randomised to either the intervention arm of the trial or the usual care arm of the study. Patients in both groups were invited to complete each measure at 2, 4 and 8 weeks.RESULTS: One hundred people were recruited into the study - 49 were randomised to intervention group and 51 to control group. The median age of patients was 66 years age range (31-89 years) and 68% of patients were female. At baseline the ECOG performance of 75% of patients recruited was 1 or 2. The median survival of all patients in the study was 169.5 days (range 10 days to still alive at end of study). There was no significant difference at any timepoint in scores on suffering measure between intervention group and control group. At each time point the intervention demonstrated mean improvement in scores for depression and anxiety on","Lloyd-Williams, M; Cobb, M; O'Connor, C; Dunn, L; Shiels, C",2013.0,10.1016/j.jad.2012.11.013,0,0,
7179,A comparison of short- and long-term family therapy for adolescent anorexia nervosa,"ER METHODEighty-six adolescents (12-18 years of age) diagnosed with anorexia nervosa were allocated at random to either a short-term (10 sessions over 6 months) or long-term treatment (20 sessions over 12 months) and evaluated at the end of 1 year using the Eating Disorder Examination (EDE) between 1999 and 2002.RESULTSAlthough adequately powered to detect differences between treatment groups, an intent-to-treat analysis found no significant differences between the short-term and long-term treatment groups. Although a nonsignificant finding does not prove the null hypothesis, in no instance does the confidence interval on the effect size on the difference between the groups approach a moderate .5 level. However, post hoc analyses suggest that subjects with severe eating-related obsessive-compulsive features or who come from nonintact families respond better to long-term treatment.CONCLUSIONSA short-term course of family therapy appears to be as effective as a long-term course for adolescents with short-duration anorexia nervosa. However, there is a suggestion that those with more severe eating-related obsessive-compulsive thinking and nonintact families benefit from longer treatment.OBJECTIVEResearch suggests that family treatment for adolescents with anorexia nervosa may be effective. This study was designed to determine the optimal length of such family therapy.","Lock, J; Agras, W S; Bryson, S; Kraemer, H C",2005.0,10.1097/01.chi.0000161647.82775.0a,0,0,
7180,Can adaptive treatment improve outcomes in family-based therapy for adolescents with anorexia nervosa? Feasibility and treatment effects of a multi-site treatment study,"ER Objective: Adolescents with Anorexia Nervosa (AN), treated with family-based treatment (FBT) who fail to gain 2.3 kg by the fourth week of treatment have a 40-50% lower chance of recovery than those who do. Because of the high risk of developing enduring AN, improving outcomes in this group of poor responders is essential. This study examines the feasibility and effects of a novel adaptive treatment (i.e., Intensive Parental Coaching-IPC) aimed at enhancing parental self-efficacy related to re-feeding skills in poor early responders to FBT. Method: 45 adolescents (12-18 years of age) meeting DSM TR IV criteria for AN were randomized in an unbalanced design (10 to standard FBT; 35 to the adaptive arm). Attrition, suitability, expectancy rates, weight change, and psychopathology were compared between groups. Outcomes: There were no differences in rates of attrition, suitability, expectancy ratings, or most clinical outcomes between randomized groups. However, the group of poor early responders that received IPC achieved full weight restoration (>95% of expected mean BMI) by EOT at similar rates as those who had responded early. Conclusions: The results of this study suggest that it is feasible to use an adaptive design to study the treatment effect of IPC for those who do not gain adequate weight by session 4 of FBT. The results also suggest that using IPC for poor early responders significantly improves weight recovery rates to levels comparable to those who respond early. A sufficiently powered study is needed to confirm these promising findings.","Lock, J; Grange, D; Agras, W S; Fitzpatrick, K K; Jo, B; Accurso, E; Forsberg, S; Anderson, K; Arnow, K; Stainer, M",2015.0,10.1016/j.brat.2015.07.015,0,0,
7181,Evaluation of an educational programme for family members of patients living with heart failure: a randomised controlled trial,"ER AIMS AND OBJECTIVES: To evaluate the effect of a group-based multi-professional educational programme for family members of patients with chronic heart failure with regard to quality of life, depression and anxiety. The secondary aim was to investigate the impact of social support and sense of coherence on changes in quality of life, anxiety and depression during the period of the study.BACKGROUND: When a person is diagnosed with heart failure, the daily life of the family members is also affected.DESIGN: Randomised controlled trial.METHODS: A total of 128 family members were randomly assigned to participate in a multi-professional educational programme or a control group. Analysis of variance and regression analysis were used.RESULTS: There were no significant differences in anxiety, depression or quality of life between the intervention group and control group. Adequacy of social network was the only independent variable that explained levels of anxiety and depression after 12 months beyond baseline levels of anxiety (p < 0·001, R(2) = 0·35) and depression (p = 0·021, R(2) = 0·37). Younger family members were found to have a higher quality of life (p < 0·01).CONCLUSION: Improved disease-related knowledge may need to be combined with other target variables to induce desired effects on depression, anxiety and quality of life of family members. Antecedents of depression and anxiety, such as sense of control, may need to be specifically targeted. Our results also suggest that intervention aimed at enhancing social support may be beneficial for family members.RELEVANCE TO CLINICAL PRACTICE: Anxiety and depression did not decrease nor did quality of life improve after the intervention. An educational programme for family members with a component specifically targeting anxiety, depression and quality of life warrants testing. Furthermore, it is important that health care providers understand the influence of social support on anxiety, depression and quality of life when interacting with family members.","Löfvenmark, C; Saboonchi, F; Edner, M; Billing, E; Mattiasson, A C",2013.0,10.1111/j.1365-2702.2012.04201.x,0,0,
7182,Double-blind crossover trial of progabide versus placebo in severe epilepsies,"ER In this double-blind, two-period, crossover trial with randomized treatment assignment, progabide (+/- 30 mg/kg/day) and placebo were compared as add-on to standard therapy in 20 ""therapy-resistant"" epileptic patients (11 males, nine females; age range, 7-47 years). The duration of each treatment period was 6 weeks. Crossover was performed gradually over 3-4 days. Twenty-four patients entered the study: three dropped out for reasons unrelated to progabide effects; one dropped out during the placebo period because of increased seizure frequency. Of the 20 patients who completed the study, 14 had partial, two partial plus secondary generalized, and four generalized seizures. Preexisting antiepileptic treatment consisted of one antiepileptic drug (AED) in three, two AEDs in eight, three AEDs in five, and four AEDs in four patients (mean, 2.5 AEDs/patient). The following parameters were recorded at biweekly intervals: (a) efficacy parameters--total seizure count, counts of each seizure type, and global clinical judgment; (b) safety parameters--adverse drug effects, brief clinical and neurological examinations, and laboratory tests; and (c) plasma concentrations of progabide and of the associated AEDs. Twelve patients were considered to be improved (p less than 0.01) with progabide by global clinical judgment compared with two patients improved with placebo. Nine patients of 20 had a 48-100% reduction of total seizure count in the verum period, leading to a significant reduction of total seizure number and of complex partial seizures in the verum period as compared with the placebo period (p less than 0.05). Adverse effects were reported or observed in 10 patients during the progabide period and in five patients in the placebo period. The side effects were generally mild and consisted of somnolence in four cases and of tremors, dry mouth, troubles of equilibrium, anorexia, euphoria, depression, and anxiety in individual patients; a 15-20% reduction of the progabide dose was required in two cases only. No treatment-related alterations in results of laboratory tests were observed.","Loiseau, P; Bossi, L; Guyot, M; Orofiamma, B; Morselli, P L",1983.0,,0,0,
7183,Interaction between the MTHFR C677T polymorphism and traumatic childhood events predicts depression,"ER Childhood trauma is associated with the onset and recurrence of major depressive disorder (MDD). The thermolabile T variant of the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism (rs1801133) is associated with a limited (oxidative) stress defense. Therefore, C677T MTHFR could be a potential predictor for depressive symptomatology and MDD recurrence in the context of traumatic stress during early life. We investigated the interaction between the C677T MTHFR variant and exposure to traumatic childhood events (TCEs) on MDD recurrence during a 5.5-year follow-up in a discovery sample of 124 patients with recurrent MDD and, in an independent replication sample, on depressive symptomatology in 665 healthy individuals from the general population. In the discovery sample, Cox regression analysis revealed a significant interaction between MTHFR genotype and TCEs on MDD recurrence (P=0.017). Over the 5.5-year follow-up period, median time to recurrence was 191 days for T-allele carrying patients who experienced TCEs (T+ and TCE+); 461 days for T- and TCE+ patients; 773 days for T+ and TCE- patients and 866 days for T- and TCE- patients. In the replication sample, a significant interaction was present between the MTHFR genotype and TCEs on depressive symptomatology (P=0.002). Our results show that the effects of TCEs on the prospectively assessed recurrence of MDD and self-reported depressive symptoms in the general population depend on the MTHFR genotype. In conclusion, T-allele carriers may be at an increased risk for depressive symptoms or MDD recurrence after exposure to childhood trauma.","Lok, A; Bockting, C L; Koeter, M W; Snieder, H; Assies, J; Mocking, R J; Vinkers, C H; Kahn, R S; Boks, M P; Schene, A H",2013.0,10.1038/tp.2013.60,0,0,
7184,Carbon dioxide-induced panic attacks and quantitative electroencephalogram in panic disorder patients,"ER The objective of the study was to investigate and compare the brain cortical activity, as indexed by quantitative electroencephalographic (qEEG) power, coherence and asymmetry measures, in panic disorder (PD) patients during an induced panic attack with a 35% CO(2) challenge test and also in a resting condition. Fifteen subjects with PD were randomly assigned to both 35% CO(2) mixture and atmospheric compressed air, in a double-blind study design, with EEG being recorded for a 20-min period. During induced panic attacks we found a reduced right-sided frontal orbital asymmetry in the beta band, a decreased occipital frontal intra-hemispheric coherence in the delta band at both right and left sides, a left-sided occipital delta inter-hemispheric asymmetry and an increased relative power in the beta wave at T4. Our data showed a disturbed frontal cortical processing, pointing to an imbalance of the frontal and occipital sites, common to both hemispheres, and an increased right posterior activity related to the high arousing panic attack condition. Those findings corroborate the Neuroanatomical hypothesis of PD.","Lopes, F L; Oliveira, M M; Freire, R C; Caldirola, D; Perna, G; Bellodi, L; Valença, A M; Nascimento, I; Piedade, R A; Ribeiro, P; Zin, W A; Nardi, A E",2010.0,10.3109/15622970903144012,0,0,
7185,Analysis of the efficacy of a psychotherapeutic program to improve the emotional status of caregivers of elderly dependent relatives,"ER METHODThe 86 participants, who lived with the older persons at home, were randomized into one of the two intervention formats. The individual treatment program was carried out during an 8-week interval. Measures of anxiety, depression, burden, coping, social support, and self-esteem were analyzed at pre- and post-treatment, and at 1-, 3-, 6-, and 12-month follow-ups.RESULTSSignificant effects were found in the expected direction in most of the measures analyzed. The participants in the intervention reduced significantly their levels of anxiety, depression, and burden, and they improved the levels of problem-focused coping, social support, and self-esteem. The two intervention formats had different evolutions, with better effects in the TWS format, especially at the first post-test measurements, but the differences tended to decrease over time.CONCLUSIONThese data suggest that individual psychotherapeutic interventions with caregivers are efficient to reduce their emotional problems, and that this effect is mediated by improvement both in their appraisal of the situation and in their personal resources.OBJECTIVESThis study examined the long-term impact of a psychotherapeutic cognitive-behavioral program with two intervention formats (traditional weekly sessions (TWS) and minimal therapist contact (MTC)) in caregivers who suffered from emotional problems due to caring for elderly dependent relatives.","López, J; Crespo, M",2008.0,10.1080/13607860802224292,0,0,
7186,Iron supplementation in infancy contributes to more adaptive behavior at 10 years of age,"ER Most studies of behavioral/developmental effects of iron deficiency anemia (IDA) or iron supplementation in infancy have found social-emotional differences. Differences could relate to behavioral inhibition or lack of positive affect and altered response to reward. To determine long-term behavioral effects, the study was a follow-up of a randomized controlled trial of behavioral/developmental effects of preventing IDA in infancy. Healthy Chilean infants free of IDA at age 6 mo were randomly assigned to iron supplementation or no added iron (formula with iron/powdered cow milk, vitamins with/without iron) from ages 6 to 12 mo. At age 10 y, 59% (666 of 1123) and 68% (366 of 534) of iron-supplemented and no-added-iron groups were assessed. Social-emotional outcomes included maternal-reported behavior problems, self-reported behavior, examiner ratings, and video coding of a social stress task and gamelike paradigms. Examiners rated the iron-supplemented group as more cooperative, confident, persistent after failure, coordinated, and direct and reality-oriented in speech and working harder after praise compared with the no-added-iron group. In a task designed to elicit positive affect, supplemented children spent more time laughing and smiling together with their mothers and started smiling more quickly. In the social stress task they smiled and laughed more and needed less prompting to complete the task. All P values were <0.05; effect sizes were 0.14-0.36. There were no differences in behaviors related to behavioral inhibition, such as anxiety/depression or social problems. In sum, iron supplementation in infancy was associated with more adaptive behavior at age 10 y, especially in affect and response to reward, which may improve performance at school and work, mental health, and personal relationships.","Lozoff, B; Castillo, M; Clark, K M; Smith, J B; Sturza, J",2014.0,10.3945/jn.113.182048,0,0,
7187,"Modular Approach to Therapy for Anxiety, Depression, Trauma, or Conduct Problems in outpatient child and adolescent mental health services in New Zealand: study protocol for a randomized controlled trial","ER METHODS: This is an assessor-blinded multi-site effectiveness randomized controlled trial. Randomization occurs at two levels: (1) clinicians (?60) are randomized to intervention or usual care; (2) youth participants (7-14 years old) accepted for treatment in child and adolescent mental health services (with a primary disorder that includes anxiety, depression, trauma-related symptoms, or disruptive behavior) are randomly allocated to receive MATCH-ADTC or usual care. Youth participants are recruited from 'mainstream', M?ori-specific, and Pacific-specific child and adolescent mental health services. We originally planned to recruit 400 youth participants, but this has been revised to 200 participants. Centralized computer randomization ensures allocation concealment. The primary outcome measures are: (i) the difference in trajectory of change of clinical severity between groups (using the parent-rated Brief Problem Monitor); (ii) clinicians' use of evidence-based treatment procedures during therapy sessions; (iii) total time spent by clinicians delivering therapy.DISCUSSION: If MATCH-ADTC demonstrates effectiveness it could offer a practical efficient method to increase access to evidence-based therapies, and improve outcomes for youth attending secondary care services.TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12614000297628 .BACKGROUND: Mental health disorders are common and disabling for young people because of the potential to disrupt key developmental tasks. Implementation of evidence-based psychosocial therapies in New Zealand is limited, owing to the inaccessibility, length, and cost of training in these therapies. Furthermore, most therapies address one problem area at a time, although comorbidity and changing clinical needs commonly occur in practice. A more flexible approach is needed. The Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems (MATCH-ADTC) is designed to overcome these challenges; it provides a range of treatment modules addressing different problems, within a single training program. A clinical trial of MATCH-ADTC in the USA showed that MATCH-ADTC outperformed usual care and standard evidence-based treatment on several clinical measures. We aim to replicate these findings and evaluate the impact of providing training and supervision in MATCH-ADTC to: (1) improve clinical outcomes for youth attending mental health services; (2) increase the amount of evidence-based therapy content; (3) increase the efficiency of service delivery.","Lucassen, M F; Stasiak, K; Crengle, S; Weisz, J R; Frampton, C M; Bearman, S K; Ugueto, A M; Herren, J; Cribb-Su'a, A; Faleafa, M; Kingi-'Ulu'ave, D; Loy, J; Scott, R M; Hartdegen, M; Merry, S N",2015.0,10.1186/s13063-015-0982-9,0,0,
7188,"No evidence for differential dose effects of hydrocortisone on intrusive memories in female patients with complex post-traumatic stress disorder--a randomized, double-blind, placebo-controlled, crossover study","ER METHODSAll participants were female and received various psychotropic medications. They were randomly assigned to one of two groups within a crossover design: they received either 1 week placebo followed by 1 week hydrocortisone 10/d, followed by 1 week placebo, followed by hydrocortisone 30 mg/d (15 participants) or 1 week hydrocortisone 30 mg/d, followed by 1 week placebo, followed by 1 week hydrocortisone 10 mg/d, followed by 1 week placebo (15 participants). The outcome measures were the frequency and the intensity of intrusions, the overall symptomatology of post-traumatic stress disorder and the general psychopathology.RESULTSWe did not find any differences in the frequency and the intensity of post-traumatic stress disorder-related intrusions between the 10 mg hydrocortisone, the 30 mg hydrocortisone and the placebo condition. All effect sizes for the hydrocortisone condition vs. placebo were very small. Additionally, the overall symptomatology of post-traumatic stress disorder and the general psychopathology did not differ between the hydrocortisone therapies and placebo.CONCLUSIONSOur results do not show any effect of the hydrocortisone administration on intrusions in complex post-traumatic stress disorder.BACKGROUNDPost-traumatic stress disorder is characterized by intrusive traumatic memories. Presently, a controversial debate is ongoing regarding whether reduced cortisol secretion in post-traumatic stress disorder promotes an automatic retrieval of trauma-associated memories. Hence, a pharmacological elevation of cortisol was proposed to decrease post-traumatic stress disorder symptoms, particularly intrusions. The present study investigated the impact of two different doses of hydrocortisone on automatic memory retrieval using a randomized, double-blind, placebo-controlled, crossover study in 30 inpatients with post-traumatic stress disorder.","Ludäscher, P; Schmahl, C; Feldmann, R E; Kleindienst, N; Schneider, M; Bohus, M",2015.0,10.1177/0269881115592339,0,0,
7189,Parents' difficulties as co-therapists in CBT among non-responding youths with anxiety disorders: parent and therapist experiences,"ER No increased effect has been associated with parent involvement in cognitive behavioral therapy (CBT) for youths with anxiety disorders. The purpose of this study was to explore parent and therapist experiences of CBT among non-responding youths with anxiety disorders, with a primary focus on parent involvement in therapy. Interpretative phenomenological analysis was applied to 24 sets of semi-structured interviews with families and therapists of anxiety-disordered youths who had not profited from CBT with parental inclusion. From the superordinate theme parents' difficulties acting as co-therapists, which emerged from the analyses, two master themes represented the perspectives of parents (difficulty working together with the youth and feeling unqualified, with limited resources), and two represented the perspectives of therapists (family dynamics stood in the way of progress and difficulty transferring control to parents). Parent and therapist experiences complemented each other, offering two different perspectives on parent difficulties as co-therapists. However, the two groups' views on their respective roles in therapy were in conflict. Parents wished to remain being ""just the parents"" and for the experts to take over, while therapists wished to act as facilitators transferring the control to parents. Clinical implications are drawn for parental involvement and enhancement of treatment outcomes for likely non-responders.","Lundkvist-Houndoumadi, I; Thastum, M; Nielsen, K",2016.0,10.1177/1359104515615641,0,0,
7190,"Clinical study on ""Jin's three-needling"" in treatment of generalized anxiety disorder","ER METHODSFifty-eight patients with generalized anxiety were randomly assigned to two groups equally, the medication group treated with anti-anxiety drugs and the acupuncture group with ""Jin's three-needling"". The treatment course was 6 weeks. The clinical effects were evaluated with Hamilton anxiety scale (HAMA), clinical global impression (CGI), and treatment emergent symptom scale (TESS) before treatment and at the end of 2nd, 4th, 6th week of the treatment course. The concentration of 5-hydroxytryptamine (5-HT) in platelet, and plasma levels of corticosterone (CS) and adrenocorticotropic hormone (ACTH) were measured with high performance liquid chromatography-electrochemical detection (HPLC-ED) method before and after treatment.RESULTSThe clinical effects in the two groups were equivalent, while the adverse reaction found in the acupuncture group was less than that in the medication group (P < 0.05). The platelet concentration of 5-HT and plasma ACTH level decreased significantly in both groups after treatment with insignificant difference between the group (P < 0.05). The plasma CS level had no obvious change in the two groups after treatment as compared with that before treatment respectively.CONCLUSION""Jin's three-needling"" shows similar curative effect on generalized anxiety to routine Western medicine but with less adverse reaction, which may be realized through regulating the platelet 5-HT concentration and plasma ACTH level.OBJECTIVETo study the clinical effect of ""Jin's three-needling"" in the treatment of generalized anxiety disorder.","Luo, W Z; Liu, H J; Mei, S Y",2007.0,,0,0,
7191,Changes in cognitive coping skills and social support during cognitive behavioral stress management intervention and distress outcomes in symptomatic human immunodeficiency virus (HIV)-seropositive gay men,"ER METHODSParticipants were randomized to a 10-week CBSM group intervention or to a wait-list control condition. Coping, social supports, and mood were measured before and after the intervention period.RESULTSMembers of the CBSM group (N = 22) showed significant improvement in cognitive coping strategies involving positive reframing and acceptance, and in social supports involving attachment, alliances, and guidance at the end of the 10-week CBSM program compared with controls (N = 18) who showed decrements in these coping abilities and no changes in social support. Improved cognitive coping, specifically acceptance of the HIV infection, was strongly related to lower dysphoria, anxiety, and total mood disturbance in both conditions. Changes in social support and in cognitive coping skills seem to mediate the effects of the experimental condition on the changes in distress noted during the intervention.CONCLUSIONSThese results suggest that cognitive coping and social support factors can be modified by psychosocial interventions and may be important determinants of the changes in psychological well-being and quality of life during symptomatic HIV infection that can be achieved through this form of intervention.OBJECTIVEWe have previously reported decreases in dysphoria, anxiety, and total mood disturbance in symptomatic HIV seropositive gay men after a 10-week cognitive behavioral stress management (CBSM) group intervention. This structured intervention was designed a) to increase cognitive and behavioral coping skills related to managing the distress of symptomatic HIV, and b) to increase social support among group members. Here we examine the relative contribution of changes in coping skills and social support during the intervention period to reductions in dysphoria, anxiety, and distress-related symptoms in this sample.","Lutgendorf, S K; Antoni, M H; Ironson, G; Starr, K; Costello, N; Zuckerman, M; Klimas, N; Fletcher, M A; Schneiderman, N",1998.0,,0,0,
7192,Effectiveness of mat Pilates or equipment-based Pilates exercises in patients with chronic nonspecific low back pain: a randomized controlled trial,"ER BACKGROUND: The Pilates method has been widely used to treat patients with chronic low back pain. Pilates exercises can be performed in 2 ways: by using specific equipment or without it (also known as mat Pilates). There are no studies, however, that have compared the effectiveness of mat Pilates with that of equipment-based Pilates.OBJECTIVE: The aim of this study was to compare the effectiveness of mat Pilates and equipment-based Pilates in patients with chronic nonspecific low back pain.DESIGN: A 2-arm randomized controlled trial with a blinded assessor was conducted.SETTING: The study was conducted at a private physical therapy clinic in Brazil.PATIENTS: Eighty-six patients with chronic nonspecific low back pain participated.INTERVENTION: The patients were randomly allocated to 1 of 2 groups: a mat Pilates group (n=43) and an equipment-based Pilates group (n=43). The participants in both groups attended 12 Pilates sessions over a period of 6 weeks.MEASUREMENTS: The primary outcomes were pain intensity and disability. The secondary outcomes were global perceived effect, patient's specific disability, and kinesiophobia. A blinded assessor evaluated the outcomes at baseline and 6 weeks and 6 months after randomization.RESULTS: After 6 months, there was a statistically significant difference for disability (mean difference=3.0 points, 95% confidence interval [CI]=0.6 to 5.4), specific disability (mean difference=-1.1 points, 95% CI=-2.0 to -0.1), and kinesiophobia (mean difference=4.9 points, 95% CI=1.6 to 8.2) in favor of equipment-based Pilates. No differences were found for the remaining outcomes.CONCLUSIONS: Equipment-based Pilates was superior to mat Pilates in the 6-month follow-up for the outcomes of disability and kinesiophobia. These benefits were not observed for pain intensity and global perceived effect in patients with chronic nonspecific low back pain.","Luz, M A; Costa, L O; Fuhro, F F; Manzoni, A C; Oliveira, N T; Cabral, C M",2014.0,10.2522/ptj.20130277,0,0,
7193,Evaluation of therapist-supported parent-implemented CBT for anxiety disorders in rural children,"ER Supplementing bibliotherapy with therapist-client communication has been shown to be an effective way of providing services to under-resourced and isolated communities. The current study examined the efficacy of supplementing bibliotherapy for child anxiety disorders with therapist-initiated telephone or email sessions, or with client-initiated contact in a randomised trial using a waitlist control. Participants were 100 anxiety-disordered children and their parents from rural and remote communities. All treatment conditions resulted in improvement on self-report measures and clinician rated severity. Telephone sessions produced superior outcomes with 79% of children being anxiety disorder free post-treatment compared with 33% of email and 31% of client-initiated participants. The results suggest that therapist supplemented bibliotherapy could provide an efficacious treatment option for families isolated from traditional treatment services.","Lyneham, H J; Rapee, R M",2006.0,10.1016/j.brat.2005.09.009,0,0,
7194,A randomized double-blinded sham-controlled trial of ? electroencephalogram-guided transcranial magnetic stimulation for obsessive-compulsive disorder,"ER BACKGROUND: Obsessive-compulsive disorder (OCD) is a highly prevalent and devastating psychiatric condition. Repetitive transcranial magnetic stimulation (rTMS) is a potential and non-invasive treatment for OCD. Diverse efficacies of rTMS have been reported in different locations or frequencies of the stimulation. The main objective of this study was to assess the treatment effect for OCD with alpha electroencephalogram (?EEG)-guided TMS over dorsal lateral prefrontal cortex bilaterally.METHODS: There were 25 OCD patients in the ?TMS treatment group and 21 OCD patients in the sham control group. Each subject received 10 daily treatment sessions (5 days a week). The ?TMS group had significant reduction in scores of Yale-Brown Obsessive Compulsive Scale and Hamilton Rating Scale for Anxiety (HAMA) compared with the control group at the end of 2-week treatment and 1-week follow-up. Analysis of variance with repeated measures was used to test the effects between the two groups.RESULTS: Significant difference in scores of obsession and HAMA were found between the two groups after treatment. No significant difference in scores of Hamilton Rating Scale for Depression was found between the two groups after the treatment, but statistical significance was shown at the end of 1-week follow-up.CONCLUSIONS: ?EEG-guided TMS may be an effective treatment for OCD and related anxiety. Delayed response to ?TMS in depression suggests that it might be secondary to the improvement of primary response in OCD and anxiety.","Ma, X; Huang, Y; Liao, L; Jin, Y",2014.0,,0,0,
7195,The roles of alcohol and alcohol expectancy in the dampening of responses to hyperventilation among high anxiety sensitive young adults,"ER Previous research suggests that high anxiety sensitivity (AS) young adults are particularly sensitive to alcohol's dampening effects on their responses to arousal-induction challenge [Alcohol.: Clin. Exp. Res. 24 (2000) 1656.]. This sensitivity to alcohol reward may place high AS individuals at increased risk for alcohol abuse. Over-and-above alcohol's pharmacological effects, tension-reduction expectancies might contribute to alcohol's reactivity-dampening effects in high-AS individuals. The present study examined the role of alcohol and alcohol expectancy factors by activating expectancies experimentally. Forty-eight high-AS young adults were randomly assigned to one of three beverage conditions: alcohol (pharmacology plus expectancy), placebo (expectancy only), and control (no pharmacology and no expectancy). Following beverage consumption and absorption, participants underwent a 3-min voluntary hyperventilation challenge. Replicating and extending previous findings, participants in the alcohol condition showed dampened affective and somatic responses to the challenge, and marginally dampened cognitive responses to the challenge, compared to both placebo and control participants. However, placebo participants did not display dampened responses to the challenge relative to control beverage condition participants. Additional analyses suggested that activation of tension-reduction expectancies might have contributed to an ""inverse placebo"" effect among high-AS participants administered placebo. Implications of the results for future research and for the prevention and treatment of alcohol problems among high-AS individuals are discussed.","MacDonald, A B; Stewart, S H; Hutson, R; Rhyno, E; Loughlin, H L",2001.0,,0,0,
7196,"Randomized, controlled trial of three levels of critical incident stress intervention","ER METHODSA randomized, controlled trial of three levels of critical stress intervention was conducted in the British Columbia Ambulance Service (BCAS), in British Columbia, Canada, among paramedics and emergency medical technicians (EMTs), reporting critical incident stress. Outcomes were measured at one week (Stanford Acute Stress Reaction Questionnaire (SASRQ), the Life Impact Score (LIS), and Schedule of Recent Events (SRE)), and at three months and six months following the intervention (Impact of Events (IE), Coping Mechanisms, LIS, and SRE).RESULTSFifty calls were received during the 26-month study period (<1 per 10,000 BCAS response calls): 23 were by third parties, but the involved EMT did not call; nine were placed by crew unwilling to participate in the study; 18 subjects enrolled, but six completed no forms. No correlation was found between severity of the incident and scores on the SASRQ, IE, or LIS, or between any of these scores. There was no consistent pattern in the stress scores over time.CONCLUSIONRequests for critical incident stress intervention were uncommon. The need for intervention may not be as great as generally is assumed. Further randomized trials, ideally multicenter studies, are indicated.BACKGROUNDStress debriefing following exposure to a critical incident is becoming more prevalent. Its aim is to prevent or minimize the development of excessive stress response symptoms that lead to loss of productivity or effectiveness in the workplace or at home. There is little evidence that any form of psychological debriefing is effective. This study evaluated the effectiveness of three intervention strategies, and attempted to correlate the symptoms with the severity of the incident and level of intervention.","Macnab, A; Sun, C; Lowe, J",2003.0,,0,0,
7197,Effects of an automated telephone support system on caregiver burden and anxiety: findings from the REACH for TLC intervention study,"ER DESIGN AND METHODSWe conducted a randomized controlled study of 100 caregivers, 51 in the usual care control group and 49 in the technology intervention group, who received yearlong access to an IVR-mediated system. The system provided caregiver stress monitoring and counseling information, personal voice-mail linkage to AD experts, a voice-mail telephone support group, and a distraction call for care recipients. We conducted analyses by using a repeated measures approach for longitudinal data and an intention-to-treat analytic approach. Outcomes included the caregiver's appraisal of the bothersome nature of caregiving, anxiety, depression, and mastery at baseline, 6, 12, and 18 months.RESULTSThere was a significant intervention effect as hypothesized for participants with lower mastery at baseline on all three outcomes: bother (p =.04), anxiety (p =.01), and depression (p =.007). Additionally, wives exhibited a significant intervention effect in the reduction of the bothersome nature of caregiving (p =.02).IMPLICATIONSWives who exhibited low mastery and high anxiety benefited the most from the automated telecare intervention. Findings suggest that, to optimize outcome effects, similar interventions should be tailored to match the users' characteristics and preferences.PURPOSEWe determine the main outcome effects of a 12-month computer-mediated automated interactive voice response (IVR) intervention designed to assist family caregivers managing persons with disruptive behaviors related to Alzheimer's disease (AD).","Mahoney, D F; Tarlow, B J; Jones, R N",2003.0,,0,0,
7198,Cooperative prospective study on posttraumatic epilepsy: risk factors and the effect of prophylactic anticonvulsant,,"Manaka, S",1992.0,,0,0,
7199,Group and individual cognitive-behavioral therapy for childhood anxiety disorders: a randomized trial,"ER METHODSeventy-eight children aged 8-12 years with diagnosed anxiety disorders were randomly assigned to a 12-week, manual-based program of group or individual CBT, both with parental involvement. Outcomes included child anxiety (child and parent report) and global functioning as estimated by clinicians. Repeated-measures analyses of variance (ANOVAs) were done. The sample was then dichotomized by self-reported social anxiety (high/low) and parent-reported hyperactivity (high/low) using median splits, and diagnostically by generalized anxiety disorder versus phobic disorders. ANOVAs were repeated.RESULTSChildren and parents reported significantly decreased anxiety and clinicians reported significantly improved global functioning regardless of treatment modality. Children reporting high social anxiety reported greater gains in individual treatment than in group treatment (p <.01). Parent reports of hyperactivity and diagnostic differences were not associated with differential treatment response by modality.CONCLUSIONSChildren with anxiety disorders appear to improve with CBT, whether administered in a group or individual format. A subgroup of children reporting high social anxiety may respond preferentially to individual treatment. Replication of these findings is indicated.OBJECTIVETo compare the efficacy of group and individual cognitive-behavioral therapy (CBT) in children with Axis I anxiety disorders. It was hypothesized that certain subgroups would respond preferentially to one modality.","Manassis, K; Mendlowitz, S L; Scapillato, D; Avery, D; Fiksenbaum, L; Freire, M; Monga, S; Owens, M",2002.0,10.1097/00004583-200212000-00013,0,0,
7200,The feelings club: randomized controlled evaluation of school-based CBT for anxious or depressive symptoms,"ER METHODSOne thousand one hundred and thirty-nine children from Grades 3-6 from a diverse sample of schools, were screened with the Multidimensional Anxiety Scale for Children and Children's Depression Inventory. Those with t>60 on either measure were offered participation in a randomized 12-week trial, school-based group CBT versus a structured after-school activity group of equal duration. We explored several therapeutic elements as potential predictors of change.RESULTSOne hundred and forty-eight children participated (84 boys, 64 girls; 78 CBT, 70 contrast; 57% Caucasian) and 145 completed the program. Self-reported anxious and depressive symptoms decreased significantly over time (?(2)=.15 and .133, respectively), with no group by time interaction. There was a trend toward fewer children meeting diagnostic criteria for an anxiety disorder on the Anxiety Disorders Interview Schedule at 1-year post-CBT than post-contrast (6/76 versus 12/69). Positive reinforcement of child behavior was associated with change in anxiety symptoms; checking homework was understood with change in depressive symptoms.CONCLUSIONSFindings suggest that children with internalizing symptoms may benefit from both school-based CBT and structured activity programs. Replication, longer follow-up, and further studies of therapeutic elements in child CBT are indicated. ISRCTN Registry identifier: ISRCTN88858028, url: http://www.controlled-trials.com/.BACKGROUNDChildren with anxious or depressive symptoms are at risk of developing internalizing disorders and their attendant morbidity. To prevent these outcomes, school-based cognitive-behavioral therapy (CBT) has been developed, but few studies include active control conditions. We evaluated a preventive CBT program targeting internalizing symptoms relative to an activity contrast condition post-intervention and at 1-year follow-up.","Manassis, K; Wilansky-Traynor, P; Farzan, N; Kleiman, V; Parker, K; Sanford, M",2010.0,10.1002/da.20724,0,0,
7201,Effect of PTSD diagnosis and contingency management procedures on cocaine use in dually cocaine- and opioid-dependent individuals maintained on LAAM: a retrospective analysis,"ER This randomized clinical trial retrospectively examined the effect of post-traumatic stress disorder (PTSD) and contingency management (CM) on cocaine use in opioid and cocaine dependent individuals maintained on high or low-dose LAAM randomly assigned to CM or a yoked-control condition. Cocaine-positive urines decreased more rapidly over time in those without PTSD versus those with PTSD in the noncontingency condition. In participants with PTSD, CM resulted in fewer cocaine-positive urines compared to the noncontingent condition. This suggests that CM may help improve the potentially worse outcomes in opioid- and cocaine-dependent individuals with PTSD compared to those without PTSD. (Am J Addict 2010;00:1-9).","Mancino, M J; McGaugh, J; Feldman, Z; Poling, J; Oliveto, A",2010.0,10.1111/j.1521-0391.2009.00025.x,0,0,
7202,"Does social exclusion motivate interpersonal reconnection? Resolving the ""porcupine problem""","ER Evidence from 6 experiments supports the social reconnection hypothesis, which posits that the experience of social exclusion increases the motivation to forge social bonds with new sources of potential affiliation. Threat of social exclusion led participants to express greater interest in making new friends, to increase their desire to work with others, to form more positive impressions of novel social targets, and to assign greater rewards to new interaction partners. Findings also suggest potential boundary conditions to the social reconnection hypothesis. Excluded individuals did not seem to seek reconnection with the specific perpetrators of exclusion or with novel partners with whom no face-to-face interaction was anticipated. Furthermore, fear of negative evaluation moderated responses to exclusion such that participants low in fear of negative evaluation responded to new interaction partners in an affiliative fashion, whereas participants high in fear of negative evaluation did not.","Maner, J K; DeWall, C N; Baumeister, R F; Schaller, M",2007.0,10.1037/0022-3514.92.1.42,0,0,
7203,Trauma-focused cognitive-behavioral therapy for children: sustained impact of treatment 6 and 12 months later,ER This study presents the findings from 6- and 12-month follow-up assessments of 158 children ages 4-11 years who had experienced sexual abuse and who had been treated with Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) with or without the inclusion of the trauma narrative (TN) treatment module and in 8 or 16 treatment sessions. Follow-up results indicated that the overall significant improvements across 14 outcome measures that had been reported at posttreatment were sustained 6 and 12 months after treatment and on two of these measures (child self-reported anxiety and parental emotional distress) there were additional improvements at the 12-month follow-up. Higher levels of child internalizing and depressive symptoms at pretreatment were predictive of the small minority of children who continued to meet full criteria for posttraumatic stress disorder at the 12-month follow-up. These results are discussed in the context of the extant TF-CBT treatment literature.,"Mannarino, A P; Cohen, J A; Deblinger, E; Runyon, M K; Steer, R A",2012.0,10.1177/1077559512451787,0,0,
7204,A randomized clinical trial of a parent-focused social-cognitive processing intervention for caregivers of children undergoing hematopoetic stem cell transplantation,"ER METHODTwo hundred eighteen caregivers were assigned either best-practice psychosocial care (BPC) or a parent social-cognitive intervention program (P-SCIP). The 5 session P-SCIP was delivered during the HSCT hospitalization. Caregivers completed measures of distress, optimism, coping, and fear appraisals preintervention, 1, 6 months, and 1 year.RESULTSP-SCIP reduced caregiver's distress significantly more than BPC between the pretransplant assessment (Time 1) and 1-month follow-up assessment (Time 2). P-SCIP had a stronger effect than BPC among caregivers who began the hospitalization reporting higher depression and anxiety, and among caregivers whose children developed graft-versus-host disease (GvHD). Long-term treatment effects of P-SCIP were seen in traumatic distress among caregivers who reported higher anxiety pretransplant as well as among caregivers whose children had GvHD at HSCT discharge.CONCLUSIONSScreening caregivers for elevations in pretransplant anxiety and targeting interventions specifically to these caregivers, as well as targeting caregivers to children who develop GvHD, may prove beneficial.OBJECTIVEProviding care to one's child during and after a hematopoietic stem cell transplant (HSCT) is a universally stressful experience, but few psychological interventions have been developed to reduce caregiver distress. The goal of this study was to test the efficacy of a brief cognitive-behavioral intervention delivered to primary caregivers.","Manne, S; Mee, L; Bartell, A; Sands, S; Kashy, D A",2016.0,10.1037/ccp0000087,0,0,
7205,Social-cognitive processes as moderators of a couple-focused group intervention for women with early stage breast cancer,"ER DESIGNParticipants (N = 238) were randomly assigned to 6 sessions of a couple-focused group versus usual care. Intent to treat growth curve modeling analyses indicated that emotional expression and emotional processing moderated CG effects on depression.MAIN OUTCOME MEASURESThe primary outcome measures for this study were psychological distress and psychological well-being.RESULTSTreatment attrition analyses separating out participants assigned to but not attending CG indicated that emotional expression, emotional processing, and protective buffering moderated the effects of CG among those who attended CG with the most consistent effects noted for emotional processing on indicators of distress and well-being.CONCLUSIONThe CG intervention may be more effective for patients who begin the group experience using emotional approach coping strategies to deal with cancer.OBJECTIVEThe purpose was to examine whether social-cognitive variables would moderate the efficacy of a couple-focused group intervention (CG) for women diagnosed with early stage breast cancer.","Manne, S; Ostroff, J S; Winkel, G",2007.0,10.1037/0278-6133.26.6.735,0,0,
7206,Anxiety as a predictor and outcome variable in the multimodal treatment study of children with ADHD (MTA),"ER Initial moderator analyses in the Multimodal Treatment Study of Children with ADHD (MTA) suggested that child anxiety ascertained by parent report on the Diagnostic Interview Schedule for Children 2.3 (DISC Anxiety) differentially moderated the outcome of treatment. Left unanswered were questions regarding the nature of DISC Anxiety, the impact of comorbid conduct problems on the moderating effect of DISC Anxiety, and the clinical significance of DISC Anxiety as a moderator of treatment outcome. Thirty-three percent of MTA subjects met DSM-III-R criteria for an anxiety disorder excluding simple phobias. Of these, two-thirds also met DSM-III-R criteria for comorbid oppositional-defiant or conduct disorder whereas one-third did not, yielding an odds ratio of approximately two for DISC Anxiety, given conduct problems. In this context, exploratory analyses of baseline data suggest that DISC Anxiety may reflect parental attributions regarding child negative affectivity and associated behavior problems (unlike fearfulness), particularly in the area of social interactions, another core component of anxiety that is more typically associated with phobic symptoms. Analyses using hierarchical linear modeling (HLM) indicate that the moderating effect of DISC Anxiety continues to favor the inclusion of psychosocial treatment for anxious ADHD children irrespective of the presence or absence of comorbid conduct problems. This effect, which is clinically meaningful, is confined primarily to parent-reported outcomes involving disruptive behavior, internalizing symptoms, and inattention; and is generally stronger for combined than unimodal treatment. Contravening earlier studies, no adverse effect of anxiety on medication response for core ADHD or other outcomes in anxious or nonanxious ADHD children was demonstrated. When treating ADHD, it is important to search for comorbid anxiety and negative affectivity and to adjust treatment strategies accordingly.","March, J S; Swanson, J M; Arnold, L E; Hoza, B; Conners, C K; Hinshaw, S P; Hechtman, L; Kraemer, H C; Greenhill, L L; Abikoff, H B; Elliott, L G; Jensen, P S; Newcorn, J H; Vitiello, B; Severe, J; Wells, K C; Pelham, W E",2000.0,,0,0,
7207,The efficacy of an internet-based cognitive-behavioral therapy intervention for child anxiety disorders,"ER METHODSSeventy-three children with anxiety disorders, aged 7-12 years, and their parents were randomly assigned to either an Internet-based CBT (NET) or wait-list (WL) condition. Clinical diagnostic assessment and parent and child questionnaires were completed before and after treatment. The NET condition was reassessed at 6-month follow-up.RESULTSAt posttreatment assessment, children in the NET condition showed small but significantly greater reductions in anxiety symptoms and increases in functioning than WL participants. These improvements were enhanced during the 6-month follow-up period, with 75% of NET children free of their primary diagnosis.CONCLUSIONSInternet delivery of CBT for child anxiety offers promise as a way of increasing access to treatment for this population. Future research is needed to examine ways to increase treatment compliance and further enhance the impact of treatment.OBJECTIVETo evaluate the efficacy of an Internet-based cognitive-behavioral therapy (CBT) approach to the treatment of child anxiety disorders.","March, S; Spence, S H; Donovan, C L",2009.0,10.1093/jpepsy/jsn099,0,0,
7208,Effect of different variables on the outcome of various cognitive-behavioral treatment modalities for panic disorder with agoraphobia,"ER The efficacy of cognitive-behavioral therapy (CBT) is clearly demonstrated in the treatment of panic-disorder with agoraphobia (PDA). Between 70% and 90% of people with PDA obtain an higher global functioning level after CBT, yet symptoms remain in 10 to 30% of participants after treatment termination. The goal of the present study is to find which variables have an effect on different CBT modalities (individual, group, self-help) for persons with moderate and high PDA. Eighty-four persons were randomly assigned to one of three treatment modalities. Evaluations were made before treatment, immediately after and one year later. Results show that sex, number of years with agoraphobia and anxiety level significantly predict outcome at post-test for the individual modality. However, only the number of years with agoraphobia is a strong predictor one year later for this treatment modality. For the self-help modality, no predictor is significant neither at post-test nor one year later. For the group modality, the agoraphobic avoidance predicts outcome at post-test whereas symptoms severity predicts outcome one year later.","Marchand, A; Germain, V",2004.0,,0,0,
7209,Modulatory effects of stress on reactivated emotional memories,"ER Previous studies have shown that stress, through secretion of stress hormones, increases the consolidation of memory while it exerts negative effects on memory retrieval. Other studies show that the process of memory retrieval serves as a reactivation mechanism whereby the memory trace that is reactivated during the retrieval process is once again sensitive to modifications by pharmacological or environmental manipulations. In this study, we assessed whether exposure to stress after retrieval of neutral and emotional information modulates the immediate and long-term recall of these reactivated memory traces. Three groups of participants (total N of 47) encoded on Day 1 a movie containing neutral and emotional information. Two days later (Day 2), one group was asked to retrieve (reactivate) the story before being exposed to a stressful condition (reactivation/stress group), while the second group was asked to retrieve the story and was not exposed to a stressful condition (reactivation/no stress group). A third group did not recall the story but was exposed to a stressful condition (no reactivation/stress group). All participants were asked to recall the story immediately after exposure to the stress/no stress condition (immediate recall) as well as 5 days later (delayed recall). Results show that immediate recall of emotional information was significantly increased in the reactivation/stress group when compared to the reactivation/no stress group while no effect of stress on reactivated neutral memories was found. Moreover, evidence suggests that the enhanced memory trace is maintained across time, suggesting a potential long-lasting effect of stress on reactivated memory traces. We also found that the enhanced emotional memory trace observed in the reactivation/stress group was not present in the no reactivation/stress group, showing that stress has the capacity to enhance memory only when the memory trace is acutely reactivated before exposure to stress. Altogether, these results suggest that stress differentially modulates reactivated emotional and neutral memory traces and that this effect is long-lasting. These results have important implications for the potential influence of acute stress on reactivated memories in individuals exposed to traumatic events.","Marin, M F; Pilgrim, K; Lupien, S J",2010.0,10.1016/j.psyneuen.2010.04.002,0,0,
7210,Preventing posttraumatic stress following pediatric injury: a randomized controlled trial of a web-based psycho-educational intervention for parents,"ER METHODS: 100 children with injuries requiring medical attention and their parents were randomly assigned to the intervention or usual care. Efficacy outcomes included parent knowledge and child and parent posttraumatic stress symptoms (PTSS).RESULTS: All parents in the intervention group completed the intervention (directed use of ATI) in the hospital. 56% reported using ATI online post-discharge, and 100% of these parents found it helpful. Parent knowledge increased immediately post-intervention, but there was no significant intervention impact on parent knowledge or PTSS at a 6-week follow-up. Relationships between knowledge and PTSS were identified.CONCLUSIONS: Brief web-based interventions introduced during child hospitalization are a feasible strategy to reach many parents following pediatric injury. Preventing psychological symptoms may require more than parental education alone.OBJECTIVE: The study objective is to evaluate the feasibility and efficacy of a web-based intervention for parents (AfterTheInjury.org [ATI]) in promoting emotional recovery following pediatric injury.","Marsac, M L; Hildenbrand, A K; Kohser, K L; Winston, F K; Li, Y; Kassam-Adams, N",2013.0,10.1093/jpepsy/jst053,0,0,
7211,A pilot trial of a stress management intervention for primary caregivers of children newly diagnosed with cancer: preliminary evidence that perceived social support moderates the psychosocial benefit of intervention,"ER OBJECTIVES: (1) To examine the acceptability and feasibility of a stress management intervention for caregivers of children recently diagnosed with cancer. (2) To explore whether caregivers with lower baseline perceived social support derive greater benefit from the intervention than those with higher perceived support.METHODS: 45 primary caregivers were randomly assigned to intervention or standard care. Of these, 37 completed measures of social support, depression, anxiety, and perceived stress at both pre-intervention (T1; mean = 24 days post-diagnosis) and post-intervention time points (T2; mean = 165 days post-diagnosis).RESULTS: Enrollment, retention, and satisfaction data support feasibility and acceptability of the intervention. There was no overall significant impact of participation in the intervention on levels of distress at T2. However, T1 social support moderated intervention response, with caregivers who perceived lower T1 support showing greater psychological benefit from the intervention.CONCLUSIONS: Primary caregivers with lower levels of perceived social support may benefit from preemptive stress management intervention.","Marsland, A L; Long, K A; Howe, C; Thompson, A L; Tersak, J; Ewing, L J",2013.0,10.1093/jpepsy/jss173,0,0,
7212,"Everyday eating experiences of chocolate and non-chocolate snacks impact postprandial anxiety, energy and emotional states","ER Social and psychological stressors are both a part of daily life and are increasingly recognized as contributors to individual susceptibility to develop diseases and metabolic disorders. The present study investigated how snacks differing in sensory properties and presentation can influence ratings of affect in consumers with different levels of dispositional anxiety. This study examines the relationships between a pre-disposition to anxiety and food using a repeated exposures design with three interspersed test days over a period of two weeks. The study was conducted on ninety free-living male (n = 28) and female (n = 62) Dutch participants aged between 18 and 35 years old, with a BMI between 18 and 25 kg/m(2) and different anxiety trait levels assessed using State-Trait Anxiety Inventory tests. The study was randomized by age, gender, anxiety trait score, and followed a parallel open design. Three test products: dark chocolate, a milk chocolate snack and crackers with cheese spread (control), which differed in composition, sensory properties and presentation, were evaluated. Changes in self-reported anxiety, emotion, and energetic states were assessed as a function of eating the snacks just after consumption and up to one hour. The repeated exposure design over a period of two weeks enabled the investigations of potential cumulative effects of regular consumption of the food products. The milk chocolate snack resulted in the decrease of anxiety in high anxiety trait subjects, whereas dark chocolate and cheese and crackers respectively improved the anxiety level and the energetic state of low anxiety trait participants. The mood effects were not altered with repeated exposure, and the magnitude of changes was similar on each test day, which illustrates the repeatability of the effects of the food on subjective measures of postprandial wellness.","Martin, F P; Antille, N; Rezzi, S; Kochhar, S",2012.0,10.3390/nu4060554,0,0,
7213,Interdisciplinary treatment of patients with fibromyalgia: improvement of their health-related quality of life,"ER Objective: To assess whether an interdisciplinary intervention is more effective than usual care for improving the health-related quality of life (HRQoL) among patients with fibromyalgia (FM), and to identify variables that were predictors of improvement in HRQoL. Methods: In a randomized controlled clinical trial carried out on an outpatient basis in a hospital pain management unit, 153 patients with FM were randomly allocated to an experimental group (EG) or a control group (CG). Participants completed the Fibromyalgia Impact Questionnaire (FIQ) at baseline and 6 months after the intervention. The EG received an interdisciplinary treatment (12 sessions for 6 weeks) which consisted of coordinated psychological, medical, educational, and physiotherapeutic interventions while the CG received standard-of-care pharmacologic treatment. Descriptive statistics, ANOVA, Chi square and Fisher tests and generalized linear models were used for data analysis. Results: Six months after the intervention, statistically significant improvements in HRQoL were observed in physical functioning (P = 0.01), pain (P = 0.03) and total FIQ score (P = 0.04) in the EG compared to the CG. The number of physical illnesses was identified as a predictor for improvement. Conclusions: This interdisciplinary intervention has shown effectiveness in improving the HRQoL of this sample of patients with FM. The number of physical illnesses was identified as a predictor of that improvement.","Martín, J; Torre, F; Padierna, A; Aguirre, U; González, N; Matellanes, B; Quintana, J M",2014.0,10.1111/papr.12134,0,0,
7214,Heart rate and respiratory response to doxapram in patients with panic disorder,"ER Panic disorder (PD) is characterized by anticipatory anxiety and panic, both causing physiological arousal. We investigated the differential responses between anticipatory anxiety and panic in PD and healthy controls (HC). Subjects (15 PD and 30 HC) received an injection of a respiratory stimulant, doxapram, with a high rate of producing panic attacks in PD patients, or an injection of saline. PD subjects had significantly higher scores in anxiety and panic symptoms during both conditions. Analysis of heart rate variability (HRV) indices showed higher sympathetic activity (LF) during anticipatory anxiety and panic states, an increase in the ratio of LF/HF during the anticipatory and panic states and a decrease in parasympathetic (HF) component in PD patients. During doxapram PD subjects increased their LF/HF ratio while HC had a reduction in LF/HF. Parasympathetic component of HRV was lower during anticipatory anxiety in PD. In general, PD showed greater sympathetic and psychological responses related to anxiety and sensations of dyspnea, reduced parasympathetic responses during anticipatory and panic states, but no differences in respiratory response. This confirms previous studies showing that PD patients do not have an intrinsic respiratory abnormality (either heightened or dysregulated) at the level of the brain stem but rather an exaggerated fear response.","Martinez, J M; Garakani, A; Aaronson, C J; Gorman, J M",2015.0,10.1016/j.psychres.2015.03.001,0,0,
7215,Self-reported quality of life and self-esteem in sad and anxious school children,"ER METHODS: Schoolchildren (n?=?915), aged 9-13, who considered themselves to be more anxious or sad than their peers, completed self-reports of anxiety (Multidimensional Anxiety Scale for children (MASC-C), depression (The Short Mood and Feelings Questionnaire; SMFQ), quality of life (Kinder Lebensqualität Fragebogen; KINDL) and self-esteem (Beck self-concept inventory for youth (BSCI-Y) at baseline of a randomized controlled indicative study. Using multivariate analyses, we examined the relationships between internalizing symptoms, quality of life and self-esteem in three at-risk symptom groups. We also examined gender and age differences.RESULTS: 52.1 % of the screened children scored above the defined at-risk level reporting elevated symptoms of either Anxiety and Depression (Combined group) (26.6 %), Depression only (15.4 %) or Anxiety only (10.2 %). One-way ANOVA analysis showed significant mean differences between the symptom groups on self-reported quality of life and self-esteem. Regression analysis predicting quality of life and self-esteem showed that in the Depression only group and the Combined group, symptom levels were significantly associated with lower self-reported scores on both functional domains. In the Combined group, older children reported lower quality of life and self-esteem than younger children. Internalizing symptoms explained more of the variance in quality of life than in self-esteem. Symptoms of depression explained more of the variance than anxious symptoms. Female gender was associated with higher levels of internalizing symptoms, but there was no gender difference in quality of life and self-esteem.CONCLUSION: Internalizing symptoms were associated with lower self-reported quality of life and self-esteem in children in the at-risk groups reporting depressive or depressive and anxious symptoms. A transdiagnostic approach targeting children with internalizing symptoms may be important as an early intervention to change a possible negative trajectory. Tailoring the strategies to the specific symptom pattern of the child will be important to improve self-esteem.TRIAL REGISTRATION: Trial registration in Clinical trials: NCT02340637 , June 12, 2014.BACKGROUND: Anxiety and depressive symptoms are common in childhood, however problems in need of intervention may not be identified. Children at risk for developing more severe problems can be identified based on elevated symptom levels. Quality of life and self-esteem are important functional domains and may provide additional valuable information.","Martinsen, K D; Neumer, S P; Holen, S; Waaktaar, T; Sund, A M; Kendall, P C",2016.0,10.1186/s40359-016-0153-0,0,0,
7216,"Effects of conceptions of ability on anxiety, self-efficacy, and learning in training","ER A field experiment of 76 employees studied the effects of induced conceptions of ability as either an acquirable skill or fixed entity on computer anxiety, computer efficacy beliefs, and the acquisition of declarative knowledge, drawing from social cognitive theory. The setting was an introductory microcomputer training course. The findings indicate that trainees in the acquirable skill condition experienced a significant decrease in computer anxiety between the pre- and posttraining assessments; however, trainees in the entity condition did not experience a significant change in computer anxiety. Also, trainees in the acquirable skill condition experienced a significant increase in computer efficacy beliefs, and trainees in the entity condition experienced a significant decrease in computer efficacy between the pre- and posttraining assessments. Contrary to expectations, the effects of the training intervention on the acquisition of declarative knowledge were not mediated by computer anxiety and computer efficacy beliefs. The significant results are consistent with deductions made from social cognitive theory.","Martocchio, J J",1994.0,,0,0,
7217,Lack of specific association between panicogenic properties of caffeine and HPA-axis activation. A placebo-controlled study of caffeine challenge in patients with panic disorder,"ER A subgroup of patients with Panic Disorder (PD) exhibits increased sensitivity to caffeine administration. However, the association between caffeine-induced panic attacks and post-caffeine hypothalamic-pituitary-adrenal (HPA)-axis activation in PD patients remains unclear. In a randomized, double-blind, cross-over experiment, 19 PD patients underwent a 400-mg caffeine-challenge and a placebo-challenge, both administered in the form of instant coffee. Plasma levels of adrenocorticotropic hormone (ACTH), cortisol and dehydroepiandrosterone sulfate (DHEAS) were assessed at both baseline and post-challenge. No patient panicked after placebo-challenge, while nine patients (47.3%) panicked after caffeine-challenge. Placebo administration did not result in any significant change in hormones' plasma levels. Overall, sample's patients demonstrated significant increases in ACTH, cortisol, and DHEAS plasma levels after caffeine administration. However, post-caffeine panickers and non-panickers did not differ with respect to the magnitude of the increases. Our results indicate that in PD patients, caffeine-induced panic attacks are not specifically associated with HPA-axis activation, as this is reflected in post-caffeine increases in ACTH, cortisol and DHEAS plasma levels, suggesting that caffeine-induced panic attacks in PD patients are not specifically mediated by the biological processes underlying fear or stress. More generally, our results add to the evidence that HPA-axis activation is not a specific characteristic of panic.","Masdrakis, V G; Markianos, M; Oulis, P",2015.0,10.1016/j.psychres.2015.07.069,0,0,
7218,Effect of an early perinatal depression intervention on long-term child development outcomes: follow-up of the Thinking Healthy Programme randomised controlled trial,"ER Background: Perinatal depression has been linked with deleterious child development outcomes, yet maternal depression interventions have not been shown to have lasting effects on child development, and evidence is not available from countries of low or middle income. In the Thinking Healthy Programme cluster-randomised controlled trial, a perinatal depression intervention was assessed in Pakistan in 2006-07. The intervention significantly reduced depression levels 12 months post partum compared with a control. We aimed to assess the effect of this same intervention on the cognitive, socioemotional, and physical development of children at around age 7 years. Methods: Mother-child dyads who participated in the Thinking Healthy Programme cluster-randomised controlled trial were interviewed when the index child was about 7 years old. A reference group of 300 mothers who did not have prenatal depression and, therefore, did not receive the original intervention, was enrolled with their children at the same time. The primary cognitive outcome was the score on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV); primary socioemotional outcomes included scores on the Strengths and Difficulties Questionnaire (SDQ) and the Spence Children's Anxiety Scale (SCAS); and primary physical outcomes were height-for-age, weight-for-age, and body-mass index (BMI)-for-age Z scores. Generalised linear modelling with random effects to account for clustering was the main method of analysis. Analyses were by intention to treat. The Thinking Healthy Programme cluster-randomised trial was registered at ISRCTN.com, number ISRCTN65316374. Findings: Of 705 participating mother-child dyads interviewed at the end of the Thinking Healthy Programme randomised controlled trial, 584 (83%) dyads were enrolled. 289 mothers had received the intervention and 295 had received a control consisting of enhanced usual care. The mean age of the children was 76 years (SD 01). Overall, cognitive, socioemotional, or physical development outcomes did not differ between children in the intervention or control groups whose mothers had prenatal depression. When compared with the reference group of children whose mothers did not have prenatal depression, the Thinking Healthy Programme trial children had worse socioemotional outcomes; mean scores were significantly higher on the SDQ for total difficulty (1134 vs 1035; mean difference 078, 95% CI 009-147; p=003) and on the SCAS for anxiety (2133 vs 1757; mean difference 293, 115-471; p=00013). Cognitive and physical outcomes did not differ. Interpretation: Our findings show that cognitive, socioemotional, and physical developmental outcomes of children at age 7 years whose mother had prenatal depression did not differ between those who received the Thinking Healthy Programme intervention and those who received the control. Further investigation is needed to understand what types of complex interventions or approaches are needed for long-term gains in maternal and child wellbeing. Prolonged, detailed, and frequent follow-up is warranted for all interventions. Funding: Grand Challenges Canada (Government of Canada), Saving Brains programme.","Maselko, J; Sikander, S; Bhalotra, S; Bangash, O; Ganga, N; Mukherjee, S; Egger, H; Franz, L; Bibi, A; Liaqat, R; Kanwal, M; Abbasi, T; Noor, M; Ameen, N; Rahman, A",2015.0,10.1016/S2215-0366(15)00109-1,0,0,
7219,"Prospective associations among approach coping, alcohol misuse and psychiatric symptoms among veterans receiving a brief alcohol intervention","ER Brief alcohol interventions (BAIs) target alcohol consumption and may exert secondary benefits including reduced depression and posttraumatic stress disorder (PTSD) symptoms among non-veteran and veteran populations. This study examined whether approach coping, alcohol misuse, and an interaction of these two factors prior to the administration of a BAI (i.e., baseline) would predict depression and PTSD symptoms 6-months post BAI (i.e., follow-up). Veterans (N=166) received a BAI after screening positive for alcohol misuse during a primary care visit and completed assessments of alcohol misuse, approach coping, and depression and PTSD symptoms at baseline and follow-up. Baseline substance misuse, but not approach coping, significantly predicted depression and PTSD symptoms at follow-up. Approach coping moderated associations between baseline alcohol misuse and psychiatric symptoms: Veterans reporting more alcohol misuse and more (relative to less) approach coping at baseline evidenced fewer psychiatric symptoms at follow-up after accounting for symptoms assessed at baseline.","Mason, A E; Boden, M T; Cucciare, M A",2014.0,10.1016/j.jsat.2014.01.006,0,0,
7220,Obsessive-compulsive symptom dimensions as predictors of compliance with and response to behaviour therapy: results from a controlled trial,"ER METHODSOne hundred and fifty-three OCD outpatients who participated in a multi-centre randomised controlled trial of computer- versus clinician-guided BT for OCD were included in the study. Logistic and multiple regression models tested for significant predictors of compliance with and response to BT and relaxation.RESULTSThe patients studied were phenomenologically comparable (including the presence of 'pure' obsessions and mental rituals) to those in previous serotonin reuptake inhibitor (SRI) trials and those in clinical epidemiology studies. High scorers on the 'hoarding' dimension were more likely to drop out prematurely from the study and tended to improve less. For those completing treatment, the strongest predictor of outcome was pre-treatment severity. Initial depression scores were unrelated to outcome. After controlling for symptom severity, higher scores on the 'sexual/religious obsessions' factor predicted poorer outcome with BT, especially when computer-guided.CONCLUSIONSBT is especially indicated for OCD patients with aggressive/checking, contamination/cleaning and symmetry/ordering symptoms. Previous accounts of unsuccessful BT in patients with hoarding symptoms may be due in part to their propensity to drop out earlier from treatment. Patients with sexual/religious obsessions, but not those with mental rituals, might respond less well to traditional BT techniques. Existing treatments need to be refined and/or new treatments developed to improve these patients' adherence and response to treatment.BACKGROUNDRecent factor-analytic studies in obsessive-compulsive disorder (OCD) identified consistent symptom dimensions. Support for the validity of these dimensions comes from studies of psychiatric comorbidity, functional brain imaging, genetic transmission, and treatment response to medications. This study examined whether previously identified OCD symptom dimensions are associated with treatment compliance and response to behaviour therapy (BT) for OCD.","Mataix-Cols, D; Marks, I M; Greist, J H; Kobak, K A; Baer, L",2002.0,,0,0,
7221,Induced emotional interpretation bias and anxiety,"ER Five experiments are reported showing that the interpretation of personally relevant emotional information can be modified by systematic exposure to congruent exemplars. Participants were induced to interpret ambiguous information in a relatively threatening or a benign way. Comparison with a baseline condition suggested that negative and positive induction had similar but opposing effects. Induction of an interpretative bias did not require active generation of personally relevant meanings, but such active processing was necessary before state anxiety changed in parallel with the induced interpretative bias. These findings provide evidence consistent with a causal link between the deployment of interpretative bias and anxiety and reveal something of the processes underlying this association.","Mathews, A; Mackintosh, B",2000.0,,0,0,
7222,The effect of omega-3 fatty acids on psychophysiological assessment for the secondary prevention of posttraumatic stress disorder: an open-label pilot study,"ER Our recent pilot study has shown that the supplementation of omega-3 fatty acids (fish oil) immediately after a traumatic event may be effective toward the secondary prevention of post-traumatic disorder (PTSD). To lay the groundwork for addressing the mechanism by which omega-3 fatty acids can prevent PTSD, we analyzed its psychophysiological data. The psychophysiological data included heart rate, skin conductance, and continuous blood pressure during patient subjection to startling tones and idiographic trauma-related cues. Of the 8 patients, 1 met the diagnostic criteria for PTSD. Compared to the seven patients without PTSD, one patient with PTSD showed relatively large reactivity to the startle tones. In contrast, this patient did not show large reactivity to the trauma-related cue during script-driven imagery. The combination of psychophysiological measurements in our randomized control trial should shed light on the underlying mechanisms by which omega-3 fatty acids can prevent PTSD.","Matsumura, K; Noguchi, H; Nishi, D; Matsuoka, Y",2011.0,10.5539/gjhs.v4n1p3,0,0,
7223,"Docosahexaenoic acid for selective prevention of posttraumatic stress disorder among severely injured patients: a randomized, placebo-controlled trial","ER METHOD: From December 2008 to August 2013, we conducted a randomized, double-blind, placebo-controlled trial of 110 accident-injured patients consecutively admitted to an intensive care unit of the National Disaster Medical Center in Tokyo, Japan. All patients were taught about their psychological reactions to accidental injury for 20 minutes and were randomly assigned to receive 1,470 mg/d of DHA plus 147 mg/d of eicosapentaenoic acid (EPA; n = 53) or placebo (n = 57) for 12 weeks. The primary outcome was total score on the Clinician-Administered PTSD Scale (CAPS) at 3-month follow-up. Secondary outcomes included PTSD diagnosis (full-blown or partial PTSD). Adherence to the interventions was assessed by erythrocyte fatty acid composition.RESULTS: At 3 months, the CAPS total score revealed no differences between the 2 groups (10.78 in the DHA group vs 9.22 in the placebo group; n = 100; P = .572). We found that 11.1% of the DHA group and 5.5% of the placebo group developed PTSD. The erythrocyte level of DHA and EPA in the DHA group was significantly elevated compared to the placebo group (P < .01).CONCLUSIONS: Docosahexaenoic acid supplementation was not superior to placebo for the secondary prevention of PTSD symptoms at 3 months after severe accidental injury. The efficacy of a different ratio of DHA and EPA and higher doses of omega-3 fatty acids as secondary prevention of PTSD remains to be determined.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00671099.OBJECTIVE: Docosahexaenoic acid (DHA) might help prevent or attenuate posttraumatic stress disorder (PTSD) symptoms. We examined the efficacy and safety of DHA for preventing PTSD (DSM-IV) after severe accidental injury.","Matsuoka, Y; Nishi, D; Hamazaki, K; Yonemoto, N; Matsumura, K; Noguchi, H; Hashimoto, K; Hamazaki, T",2015.0,10.4088/JCP.14m09260,0,0,
7224,Serum pro-BDNF/BDNF as a treatment biomarker for response to docosahexaenoic acid in traumatized people vulnerable to developing psychological distress: a randomized controlled trial,"ER Our open-label pilot study showed that supplementation with docosahexaenoic acid (DHA) increased serum brain-derived neurotrophic factor (BDNF) levels and that there might be an association between changes in serum BDNF levels and reduced psychological distress. Animal research has indicated that a DHA-enriched diet increases BDNF in the brain. In this randomized double-blind controlled trial of severely injured patients vulnerable to posttraumatic stress disorder (PTSD) and depression, we examined whether DHA increases serum BDNF levels and whether changes in BDNF levels are associated with subsequent symptoms of PTSD and depression. Patients received 1470 mg per day of DHA plus 147 mg per day of eicosapentaenoic acid (EPA; n = 53) or placebo (n = 57) for 12 weeks. Serum levels of mature BDNF and precursor pro-BDNF at baseline and 12-week follow-up were measured using enzyme-linked immunosorbent assay kits. At 12 weeks, we used the Clinician-Administered PTSD Scale to assess PTSD symptoms and depressive symptoms by the Montgomery-√Ösberg Depression Rating Scale. We found a significant increase in serum BDNF levels during the trial in the DHA and placebo groups with no interaction between time and group. Changes in BDNF levels were not associated with PTSD severity but negatively associated with depression severity (Spearman's ? = -0.257, P = 0.012). Changes in pro-BDNF were also negatively associated with depression severity (Spearman's ? = -0.253, P = 0.013). We found no specific effects of DHA on increased serum levels of BDNF and pro-BDNF; however, evidence in this study suggests that increased BDNF and pro-BDNF have a protective effect by minimizing depression severity.","Matsuoka, Y; Nishi, D; Tanima, Y; Itakura, M; Kojima, M; Hamazaki, K; Noguchi, H; Hamazaki, T",2015.0,10.1038/tp.2015.89,0,0,
7225,Tachikawa project for prevention of posttraumatic stress disorder with polyunsaturated fatty acid (TPOP): study protocol for a randomized controlled trial,"ER METHODS/DESIGN: The Tachikawa Project for Prevention of Posttraumatic Stress Disorder with Polyunsaturated Fatty Acid (TPOP) is a double-blinded, parallel group, randomized controlled trial to assess whether omega-3 fatty acid supplementation can prevent PTSD symptoms among accident-injured patients consecutively admitted to an intensive care unit. We plan to recruit accident-injured patients and follow them prospectively for 12 weeks. Enrolled patients will be randomized to either the omega-3 fatty acid supplement group (1,470 mg docosahexaenoic acid and 147 mg eicosapentaenoic acid daily) or placebo group. Primary outcome is score on the Clinician-Administered PTSD Scale (CAPS). We will need to randomize 140 injured patients to have 90% power to detect a 10-point difference in mean CAPS scores with omega-3 fatty acid supplementation compared with placebo. Secondary measures are diagnosis of PTSD and major depressive disorder, depressive symptoms, physiologic response in the experiment using script-driven imagery and acoustic stimulation, serum brain-derived neurotrophic factor, health-related quality of life, resilience, and aggression. Analyses will be by intent to treat. The trial was initiated on December 13 2008, with 104 subjects randomized by November 30 2012.DISCUSSION: This study promises to be the first trial to provide a novel prevention strategy for PTSD among traumatized people.TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT00671099.BACKGROUND: Preclinical and clinical studies suggest that supplementation with omega-3 fatty acids after trauma might reduce subsequent posttraumatic stress disorder (PTSD). To date, we have shown in an open trial that PTSD symptoms in critically injured patients can be reduced by taking omega-3 fatty acids, hypothesized to stimulate hippocampal neurogenesis. The primary aim of the present randomized controlled trial is to examine the efficacy of omega-3 fatty acid supplementation in the secondary prevention of PTSD following accidental injury, as compared with placebo. This paper describes the rationale and protocol of this trial.","Matsuoka, Y; Nishi, D; Yonemoto, N; Hamazaki, K; Matsumura, K; Noguchi, H; Hashimoto, K; Hamazaki, T",2013.0,10.1186/1471-244X-13-8,0,0,
7226,Anxiogenic effect of yohimbine in healthy subjects: comparison with caffeine and antagonism by clonidine and diazepam,"ER Three placebo-controlled double-blind and crossover trials were carried out to analyze the effects of oral yohimbine (YOH) 0.8 mg/kg on mood and performance in 16 healthy students. Subjective assessments (visual analogue scales, side-effects on questionnaire) and objective measurements (digit symbols, flicker fusion, tapping, heterophoria) were done at baseline, and post treatment. YOH shifted the healthy subjects' mood towards feeling panicked, elevated systolic blood pressure and plasma prolactin concentrations, reduced digit symbol substitution, and induced drowsiness and passiveness. Caffeine (CAF) 10 mg/kg raised plasma cortisol and rendered the subjects slightly panicked. Muzziness, clumsiness, tremor, chills and nausea were common after both YOH and CAF. Diazepam (DZ) 0.3 mg/kg given at 60 min antagonized some effects of CAF but failed to antagonize YOH. Clonidine (CLO) 100 micrograms counteracted YOH effects on blood pressure but less the subjective and hormonal effects. CLO 200 micrograms partly antagonized the pressor, sedative but not the hormonal responses of YOH. DZ counteracted YOH effects on plasma cortisol on panic but not on other subjective measures or plasma prolactin. Since CLO did not abolish YOH-induced prolactin increase, it is suggested that these effects of YOH are mediated not only via adrenergic alpha 2-receptors; other mechanisms made important contributions.","Mattila, M; Seppala, T; Mattila, M J",1988.0,,0,0,
7227,Evaluation of eye patching after cataract surgery in topical anesthesia,"ER PATIENTS AND METHODSIn this prospective and randomized study 133 patients received after cataract surgery either no covering of the eye (group1), a transparent eye shield for four hours (group 2), an eye pad for four hours (group 3) or an eye pad until the next morning (group 4). Clinical findings were noted and local symptoms, such as pain, foreign body sensation, tearing and photophobia were documented on a visual analogue scale (0 - 10). Furthermore, a questionnaire concerning the subjective opinion was handed out to the patient.RESULTSThe clinical findings revealed no significant differences between the groups. The mean values for local pain were 0.94 +/- 1.56, for the foreign body sensation 1.41 +/- 2.02, for tearing 0.99 +/- 1.8 and for photophobia 1.05 +/- 1.99. Comparing the groups there was significantly more pain and foreign body sensation reported by the patients in group 3, who received eye patching for 4 hours. 91 % of the unpatched patients had no discomfort, whereas 53 % of the patients wearing an eye pad until the next morning considered it as unnecessary.CONCLUSIONAfter cataract surgery in topical anesthesia only mild symptoms were noted. There were no significant differences between the groups in the objective clinical findings and the subjective feeling. These results indicate that after cataract surgery eye patching could be unnecessary.BACKGROUNDAlthough postoperative eye patching is a common practice its background is not well known. Therefore the necessity of eye patching after cataract surgery in topical anesthesia from the medical point of view and the patients' subjective opinion was studied.","Mayer, S; Wirbelauer, C; Häberle, H; Altmeyer, M; Pham, D T",2005.0,10.1055/s-2004-813826,0,0,
7228,Caffeine: use and effects in long-stay psychiatric patients,"ER In a double-blind crossover study of 26 long-stay schizophrenic patients, no correlation was found between caffeine consumption and levels of anxiety and depression. No significant changes in patients' behaviour or levels of anxiety and depression occurred when the wards changed to decaffeinated products. Serum caffeine levels confirmed compliance. No evidence was found to support a removal of caffeinated products from this group of patients.","Mayo, K M; Falkowski, W; Jones, C A",1993.0,,0,0,
7229,Impact of an educational program for parents of children with cancer on the increased knowledge of their children's disease and the decrease in anxiety,"ER PATIENTS AND METHODSA prospective randomized study was conducted on parents of children recently diagnosed with cancer and treated in the Hospital Luis Calvo Mackenna. After informed consent, parents were randomized in two groups: one receiving the educational program and another without intervention. Both groups completed a questionnaire on social risk, and three tests to assess the levels of knowledge and anxiety.RESULTSA total of 96 parents were enrolled (July 2010-November 2011). When comparing the number of correct responses on day 10, and day 90 after the intervention, a significant increase was observed in the level of parental knowledge in the group that received the educational program (P<.0001). No significant differences were observed in the levels of anxiety (P=.06) between both groups.CONCLUSIONSAn educational program provided by nurses to parents of children recently diagnosed with cancer, increased the knowledge of their children's disease. However there was no effect on the levels of anxiety. A feasible educational intervention is proposed that could be implemented at other cancer centers for children.PURPOSETo determine the impact of an educational program provided by a nurse to parents of children with cancer to improve the level of knowledge of the disease and to decrease the levels of anxiety.","Maza, L V; Fern√°ndez, C M; Concha, R L; Santolaya, D M E; Villarroel, C M; Castro, C M; Torres, T J P",,10.1016/j.rchipe.2015.04.027,0,0,
7230,Randomized Placebo-Controlled Trial of Methylphenidate or Galantamine for Persistent Emotional and Cognitive Symptoms Associated with PTSD and/or Traumatic Brain Injury,"ER We report findings from a 12-week randomized double-blinded placebo-controlled trial of methylphenidate or galantamine to treat emotional and cognitive complaints in individuals (n=32) with a history of PTSD, TBI, or both conditions. In this small pilot study, methylphenidate treatment was associated with clinically meaningful and statistically significant improvement compared with placebo on the primary outcome, a measure of cognitive complaints (Ruff Neurobehavioral Inventory-Postmorbid Cognitive Scale), as well as on the secondary outcomes reflecting post-concussive (Rivermead Post Concussive Symptom Questionnaire) and post-traumatic stress symptoms (Posttraumatic Stress Disorder Checklist). Treatment was well tolerated. These results suggest the need for a larger RCT to replicate and confirm these findings. Design considerations for such a trial should include the need for multiple sites to facilitate adequate recruitment and extension of the treatment and follow-up periods.","McAllister, T W; Zafonte, R; Jain, S; Flashman, L A; George, M S; Grant, G A; He, F; Lohr, J B; Andaluz, N; Summerall, L; Paulus, M P; Raman, R; Stein, M B",2016.0,10.1038/npp.2015.282,0,0,
7231,Psychological support for patients undergoing breast cancer surgery: a randomised study,"ER DESIGNProspective randomised study.SETTINGThree teaching hospitals in Glasgow with established breast clinics.SUBJECTS272 women aged less than 70 years undergoing surgery for breast cancer.INTERVENTIONSPatients were randomly allocated to receive routine care from ward staff, routine care plus support from breast care nurse, routine care plus support from voluntary organisation, or routine care plus support from nurse and organisation.MAIN OUTCOME MEASURESPrevalence of psychological morbidity as assessed by self rating scales: 28 item general health questionnaire and its subscales, and hospital anxiety and depression scale. Measurements were made at first postoperative clinic visit and at three, six, and 12 months after surgery.RESULTSOn each self rating scale, psychological morbidity tended to fall over the 12 month period. For each scale, scores were consistently lower in patients offered support from breast care nurse alone compared with the other groups, which were similar to each other. Differences were significant or nearly so: P values were 0.015 (28 item general health questionnaire), 0.027 (anxiety and insomnia), 0.072 (severe depression), 0.053 (somatic symptoms), 0.031 (social dysfunction), 0.093 (hospital anxiety), and 0.003 (hospital depression).CONCLUSIONSupport from breast care nurse can significantly reduce psychological morbidity, as measured by self rating scales, in women undergoing breast cancer surgery.OBJECTIVETo evaluate the effect of support from a nurse specialising in breast care and a voluntary support organisation on prevalence of psychological morbidity after surgery for breast cancer.","McArdle, J M; George, W D; McArdle, C S; Smith, D C; Moodie, A R; Hughson, A V; Murray, G D",1996.0,,0,0,
7232,"Physical activity and physique anxiety in older adults: fitness, and efficacy influences","ER Employing a randomized controlled trial, this study documents the effects of six months of physical activity and six month follow-up on reduction in social physique anxiety (SPA) in older adults. In addition, the role played by changes in behavioral, physiological, and psychological predictors of changes in SPA were examined. Participants (n = 174, mean age = 65 yrs) were randomly assigned to one of two activity groups and engaged in a six-month structured exercise program. Measures of physique anxiety were taken at baseline, six and twelve months. Latent growth curve analyses revealed significant reductions in SPA over the course of the 12-month period. Structural analyses controlling for treatment condition indicated that improvements in self-efficacy and fitness were significant predictors of changes in SPA but that changes in body fat and exercise frequency did not contribute to variation in SPA. Overall this model accounted for 19% of the variation in SPA changes. The extent to which changes in SPA may contribute to continued physical activity participation in older adults and how exercise programs might effectively influence predictors of SPA are discussed.","McAuley, E; Marquez, D X; Jerome, G J; Blissmer, B; Katula, J",2002.0,10.1080/13607860220142459,0,0,
7233,Improving outcomes for caregivers through treatment of young people affected by war: a randomized controlled trial in Sierra Leone,"ER Objective To measure the benefits to household caregivers of a psychotherapeutic intervention for adolescents and young adults living in a war-affected area. Methods Between July 2012 and July 2013, we carried out a randomized controlled trial of the Youth Readiness Intervention - a cognitive-behavioural intervention for war-affected young people who exhibit depressive and anxiety symptoms and conduct problems - in Freetown, Sierra Leone. Overall, 436 participants aged 15-24 years were randomized to receive the intervention (n = 222) or care as usual (n = 214). Household caregivers for the participants in the intervention arm (n = 101) or control arm (n = 103) were interviewed during a baseline survey and again, if available (n = 155), 12 weeks later in a follow-up survey. We used a burden assessment scale to evaluate the burden of care placed on caregivers in terms of emotional distress and functional impairment. The caregivers' mental health - i.e. internalizing, externalizing and prosocial behaviour - was evaluated using the Oxford Measure of Psychosocial Adjustment. Difference-in-differences multiple regression analyses were used, within an intention-to-treat framework, to estimate the treatment effects. Findings Compared with the caregivers of participants of the control group, the caregivers of participants of the intervention group reported greater reductions in emotional distress (scale difference: 0.252; 95% confidence interval, CI: 0.026-0.4782) and greater improvements in prosocial behaviour (scale difference: 0.249; 95% CI: 0.012-0.486) between the two surveys. Conclusion A psychotherapeutic intervention for war-affected young people can improve the mental health of their caregivers.","McBain, R K; Salhi, C; Hann, K; Kellie, J; Kamara, A; Salomon, J A; Kim, J J; Betancourt, T S",2015.0,10.2471/BLT.14.139105,0,0,
7234,Structure and validity of sluggish cognitive tempo using an expanded item pool in children with attention-deficit/hyperactivity disorder,"ER We evaluated the latent structure and validity of an expanded pool of Sluggish Cognitive Tempo (SCT) items. An experimental rating scale with 44 candidate SCT items was administered to parents and teachers of 165 children in grades 2-5 (ages 7-11) recruited for a randomized clinical trial of a psychosocial intervention for Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type. Exploratory factor analyses (EFA) were used to extract items with high loadings (>0.59) on primary factors of SCT and low cross-loadings (0.30 or lower) on other SCT factors and on the Inattention factor of ADHD. Items were required to meet these criteria for both informants. This procedure reduced the pool to 15 items. Generally, items representing slowness and low initiative failed these criteria. SCT factors (termed Daydreaming, Working Memory Problems, and Sleepy/Tired) showed good convergent and discriminant validity in EFA and in a confirmatory model with ADHD factors. Simultaneous regressions of impairment and comorbidity on SCT and ADHD factors found that Daydreams was associated with global impairment, and Sleepy/Tired was associated with organizational problems and depression ratings, across both informants. For teachers, Daydreams also predicted ODD (inversely); Sleepy/Tired also predicted poor academic behavior, low social skills, and problem social behavior; and Working Memory Problems predicted organizational problems and anxiety. When depression, rather than ADHD, was included among the predictors, the only SCT-related associations rendered insignificant were the teacher-reported associations of Daydreams with ODD; Working Memory Problems with anxiety, and Sleepy/Tired with poor social skills. SCT appears to be meaningfully associated with impairment, even when controlling for depression. Common behaviors resembling Working Memory problems may represent a previously undescribed factor of SCT.","McBurnett, K; Villodas, M; Burns, G L; Hinshaw, S P; Beaulieu, A; Pfiffner, L J",2014.0,10.1007/s10802-013-9801-5,0,0,
7235,Peptides and anxiety: a dose-response evaluation of pentagastrin in healthy volunteers,"ER A large body of data suggest that brain cholecystokinin (CCK) systems are involved in the regulation of anxiety, and numerous studies have demonstrated that CCK-4, a CCKB agonist, reliably induces panic attacks in patients with panic disorder. Recently, pentagastrin, a commercially available CCKB agonist, has been reported to have similar anxiogenic properties. To further explore the utility of pentagastrin as a challenge agent and to determine whether its effects are dose-related, a dose-response study was conducted in ten healthy volunteers. Pentagastrin (0.2 microgram/kg, 0.6 microgram/kg and 1.0 microgram/kg) and inactive placebo were infused over one minute on four separate challenge days in a double-blind fashion. Subjects received pentagastrin while participating in a structured social interaction task. Repeated measures of anxiety, blood pressure, pulse, ACTH, and cortisol were taken at baseline and postinfusion. Pentagastrin administration led to increases in anxiety, pulse, ACTH, cortisol and physical symptoms of panic, in a dose-related manner. Participation in the social interaction task led to increases in measures of anxiety as well as increases in pulse and blood pressure. Few differences were found between the 0.2 microgram/kg dose of pentagastrin and placebo, or between the 0.6 microgram/kg and the 1.0 microgram/kg doses of pentagastrin. These findings support the notion that CCK systems are involved in the regulation of anxiety, and suggest that the 0.6 microgram/kg dose may be optimal for increasing symptoms of anxiety while minimizing unpleasant side effects. The powerful anxiogenic effects of the social interaction task underscore the importance of contextual variables in challenge studies.","McCann, U D; Slate, S O; Geraci, M; Uhde, T W",1994.0,,0,0,
7236,A community-based group-guided self-help intervention for low mood and stress: study protocol for a randomized controlled trial,"ER METHODS/DESIGN: Participants with symptoms of low mood will be recruited from the community through newspaper adverts and also via the AOD website. Participants will receive either immediate or delayed access to guided CBT self-help classes - the eight session LLTTF course. The primary endpoint will be at 6 months at which point the delayed group will be offered the intervention. Levels of depression, anxiety and social functioning will be assessed and an economic analysis will be carried out.DISCUSSION: This RCT will test whether the LLTTF intervention is effective and/or cost-effective. If the LLTTF community-based classes are found to be cost effective, they may be helpful as both an intervention for those already seeking care in the health service, as well as those seeking help outside that setting, widening access to psychological therapy.TRIAL REGISTRATION: Current Controlled Trials ISRCTN86292664.BACKGROUND: Depression is a mental health condition which affects millions of people each year, with worldwide rates increasing. Cognitive behavioral therapy (CBT) is recommended in the National Institute for Health and Clinical Excellence (NICE) guidelines for the treatment of depression. However, waiting lists can cause delays for face-to-face therapy. Also a proportion of people decline to present for help through the health service - the so-called treatment gap. Self-referral to CBT using community-based group interventions delivered by a voluntary sector organization may serve to resolve this problem. The aim of this randomized controlled trial (RCT) is to determine the efficacy of such a guided CBT self-help course, the 'Living Life to the Full' (LLTTF) classes delivered by the charity Action on Depression (AOD). The primary outcome is level of depression at 6 months assessed using the patient health questionnaire-9 (PHQ9) depression scale. Secondary measures include levels of anxiety and social functioning.","McClay, C A; Morrison, J; McConnachie, A; Williams, C",2013.0,10.1186/1745-6215-14-392,0,0,
7237,Group therapy for anxiety in children with autism spectrum disorder,"ER Aim: To investigate the acceptability and feasibility of adapted group therapy for anxiety in children with autism spectrum disorder in a pilot randomised controlled trial. Method: A total of 32 children aged 9-13 years were randomised to immediate or delayed therapy using the 'Exploring Feelings' manual (Attwood, 2004). Child and parent groups were run in parallel, for seven weekly sessions, under the supervision of experienced psychologists. The primary blinded outcome measures addressed change in overall functioning and in severity of the primary anxiety diagnosis after 3 months. Results: Children met diagnostic criteria for 1-6 anxiety disorders (median 3). At end point, both parents and children in the immediate therapy group were more likely to report a reduction in anxiety symptoms. Fidelity of delivery of the group therapy was high, and attendance was 91%. Conclusions: This pilot trial established that children and families were willing to be recruited and randomised, the outcome measures were acceptable, the format and content of the groups were feasible within UK child and adolescent mental health services, the intervention was appreciated by families and attrition was very small.","McConachie, H; McLaughlin, E; Grahame, V; Taylor, H; Honey, E; Tavernor, L; Rodgers, J; Freeston, M; Hemm, C; Steen, N; Couteur, A",2014.0,10.1177/1362361313488839,0,0,
7238,"Social skills treatment for people with severe, chronic acquired brain injuries: a multicenter trial","ER OBJECTIVE: To determine whether social skills deficits including unskilled, inappropriate behavior, problems reading social cues (social perception), and mood disturbances (such as depression and anxiety) could be remediated after severe traumatic brain injuries. DESIGN: Randomized controlled trial comparing a social skills program with social activity alone or with waitlist control. Several participants were reassigned after randomization. SETTING: Hospital outpatient and community facilities. PARTICIPANTS: Fifty-one outpatients from 3 brain injury units in Sydney, Australia, with severe, chronic acquired brain injuries were recruited. A total of 39 people (13 in skills training, 13 in social activity, 13 in waitlist) completed all phases of the study. INTERVENTION: Twelve-week social skills treatment program encompassing weekly 3-hour group sessions focused on shaping social behavior and remediating social perception and 1-hour individual sessions to address psychologic issues with mood, self-esteem, etc. MAIN OUTCOME MEASURES: Primary outcomes were: (1) social behavior during encounters with a confederate as rated on the Behaviorally Referenced Rating System of Intermediary Social Skills-Revised (BRISS-R), (2) social perception as measured by The Awareness of Social Inference Test, and (3) depression and anxiety as measured by the Depression, Anxiety and Stress Scale. Secondary outcomes were: relative report on social behavior and participation using: the Katz Adjustment Scale-R1; the Social Performance Survey Schedule; the La Trobe Communication Questionnaire; and the Sydney Psychosocial Reintegration Scale (both relative and self-report). RESULTS: Repeated-measures analysis of variance indicated that social activity alone did not lead to improved performance relative to waitlist (placebo effect) on any outcome variable. On the other hand, the skills training group improved differentially on the Partner Directed Behavior Scale of the BRISS-R, specifically the self-centered behavior and partner involvement behavior subscales. No treatment effects were found for the remaining primary outcomes (social perception, emotional adjustment) or for secondary outcome variables (relative and self-report measures of social function). CONCLUSIONS: This study suggested that treatment effects after social skills training in people with severe, chronic brain injuries are modest and are limited to direct measures of social behavior.","McDonald, S; Tate, R; Togher, L; Bornhofen, C; Long, E; Gertler, P; Bowen, R",2008.0,10.1016/j.apmr.2008.02.029,0,0,
7239,"Armodafinil in binge eating disorder: a randomized, placebo-controlled trial","ER This study evaluated the efficacy, tolerability, and safety of armodafinil in the treatment of binge eating disorder (BED). Sixty participants with BED were randomized to receive armodafinil (150-250 mg/day) (N = 30) or placebo (N = 30) in a 10-week, prospective, parallel-group, double-blind, flexible-dose, single-center trial. In the primary longitudinal analysis, armodafinil and placebo produced similar rates of improvement in binge eating day frequency (the primary outcome measure); however, armodafinil was associated with a statistically significantly higher rate of decrease in binge eating episode frequency. In the secondary baseline-to-endpoint analyses, armodafinil was associated with statistically significant reductions in obsessive-compulsive features of binge eating and BMI. The mean (SD) armodafinil daily dose at endpoint evaluation was 216.7 (43.9) mg. There were no serious adverse events, although one armodafinil recipient developed markedly increased blood pressure that resolved upon drug discontinuation. The small sample size may have limited the detection of important drug-placebo differences. As some of the observed effect sizes appeared clinically meaningful, larger studies of armodafinil in the treatment of BED are warranted.","McElroy, S L; Guerdjikova, A I; Mori, N; Blom, T J; Williams, S; Casuto, L S; Keck, P E",2015.0,10.1097/YIC.0000000000000079,0,0,
7240,Efficacy of acupressure for non-pharmacological stress reduction in college students,"ER OBJECTIVES: Identifying a non-pharmacological intervention to reduce the stress response could be particularly beneficial to college students, a group prone to considerable stress. Acupressure has shown some efficacy in reducing stress in adults following stroke or traumatic brain injury (TBI), but multiple treatments were required. Results from single treatments in healthy populations have been mixed.DESIGN: The current study used a randomised, placebo-controlled, single-blind design to investigate the use of a single acupressure treatment for stress reduction in healthy college students (n=109) during a stressor.INTERVENTIONS: Participants were randomly assigned to one of three single, 40-min interventions: active acupressure, placebo acupressure, or a relaxation CD control. A math task stressor administered before and after the intervention assessed intervention effects on stressor responsivity.MAIN OUTCOME MEASURES: Stress responses were measured by physiological (heart rate (HR), heart rate variability (HRV), skin conductance response (SCR)) and subjective measures (State Anxiety Inventory, nine-item Psychological Stress Measure) of anxiety and stress.RESULTS: All interventions were associated with the following changes during the post-intervention stressor compared to the pre-intervention stressor: reduced HR (p<0.001), increased HRV (p<0.024), reduced SCR (p<0.001), reduced subjective stress scores (p<0.001), and increased correct answers (p<0.001). Although all groups demonstrated stress reduction, there were no significant group differences after a single treatment.CONCLUSIONS: All interventions significantly reduced the stress response, although not differently. The lack of active acupressure-associated treatment effects appears to be due to insufficient dosing.","McFadden, K L; Healy, K M; Hoversten, K P; Ito, T A; Hern√°ndez, T D",2012.0,10.1016/j.ctim.2011.12.003,0,0,
7241,Telephone-based mental health interventions for child disruptive behavior or anxiety disorders: randomized trials and overall analysis,"ER METHODIn three practical randomized controlled trials, 243 children (80 with oppositional-defiant, 72 with attention-deficit/hyperactivity, and 91 with anxiety disorders) were stratified by DSM-IV diagnoses and randomized to receive the Strongest Families intervention (treatment) or usual care (control). Assessments were blindly conducted and evaluated at 120, 240, and 365 days after randomization. The intervention consisted of evidence-based participant materials (handbooks and videos) and weekly telephone coach sessions. The main outcome was mental health diagnosis change.RESULTSIntention-to-treat analysis showed that for each diagnosis significant treatment effects were found at 240 and 365 days after randomization. Moreover, in the overall analysis significantly more children were not diagnosed as having disruptive behavior or anxiety disorders in the treatment group than the control group (120 days: ?(2)(1) = 13.05, p < .001, odds ratio 2.58, 95% confidence interval 1.54-4.33; 240 days: ?(2)(1) = 20.46, p < .001, odds ratio 3.44, 95% confidence interval 1.99-5.92; 365 days: ?(2)(1) = 13.94, p < .001, odds ratio 2.75, 95% confidence interval 1.61-4.71).CONCLUSIONSCompared with usual care, telephone-based treatments resulted in significant diagnosis decreases among children with disruptive behavior or anxiety. These interventions hold promise to increase access to mental health services.CLINICAL TRIAL REGISTRATION INFORMATIONStrongest Families: Pediatric Disruptive Behaviour Disorder, http://www.clinicaltrials.gov, NCT00267579; Strongest Families: Pediatric Attention-Deficit/Hyperactivity Disorder, http://www.clinicaltrials.gov, NCT00267605; and Strongest Families: Pediatric Anxiety, http://www.clinicaltrials.gov, NCT00267566.OBJECTIVEMost children with mental health disorders do not receive timely care because of access barriers. These initial trials aimed to determine whether distance interventions provided by nonprofessionals could significantly decrease the proportion of children diagnosed with disruptive behavior or anxiety disorders compared with usual care.","McGrath, P J; Lingley-Pottie, P; Thurston, C; MacLean, C; Cunningham, C; Waschbusch, D A; Watters, C; Stewart, S; Bagnell, A; Santor, D; Chaplin, W",2011.0,10.1016/j.jaac.2011.07.013,0,0,
7242,Web-based training in family advocacy,"ER PARTICIPANTS: A total of 201 individuals (control, n = 97; treatment, n = 104) providing support to a family member with traumatic brain injury.DESIGN: Randomized controlled study.MAIN MEASURES: Caregiver knowledge, skill application, behavioral intention, and overall life satisfaction.INTERVENTION: The Brain Injury Partners program, a Web site focused on advocacy, communication skills, and resources for families affected by brain injury.RESULTS: Univariate analyses revealed that compared with the control group, the Brain Injury Partners group reported statistically significant higher adjusted means for application, knowledge, and attitudes scales immediately postintervention and at follow-up. Satisfaction with life, assessed at follow-up but not posttest, was not significant.DISCUSSION: This study demonstrated the effectiveness of a Web-based intervention to teach effective skills to caregivers advocating for a family member with traumatic brain injury.OBJECTIVE: To examine the efficacy of an interactive multimedia intervention that teaches advocacy skills to people caring for a family member with traumatic brain injury.","McLaughlin, K A; Glang, A; Beaver, S V; Gau, J M; Keen, S",2013.0,10.1097/HTR.0b013e31824e1d43,0,0,
7243,Improving psychologic adjustment to chronic illness in cardiac patients. The role of depression and anxiety,"ER OBJECTIVETo evaluate the effectiveness of a telephone-based intervention for psychologic distress and functional impairment in cardiac illness.DESIGNRandomized, controlled trial.METHODSWe recruited survivors of acute coronary syndromes using the Hospital and Anxiety Depression Scale (HADS) with scores indicative of mood disturbances at 1-month postdischarge. Recruited patients were randomized to experimental or control status. Intervention patients received 6 30-minute telephone counseling sessions to identify and address illness-related fears and concerns. Control patients received usual care. Patients' responses to the HADS and the Workplace Social Adjustment Scale (WSAS) were collected at baseline, 2, 3, and 6 months using interactive voice recognition technology. At baseline, the PRIME-MD was used to establish diagnosis of depression. We used mixed effects regression to study changes in outcomes.RESULTSWe enrolled 100 patients. Mean age was 60; 67% of the patients were male. Findings confirmed that the intervention group had a 27% improvement in depression symptoms (P=.05), 27% in anxiety (P=.02), and a 38% improvement in home limitations (P=.04) compared with controls. Symptom improvement tracked those for WSAS measures of home function (P=.04) but not workplace function.CONCLUSIONSThe intervention had a moderate effect on patient's emotional and functional outcomes that were observed during a critical period in patients' lives. Patient convenience, ease of delivery, and the effectiveness of the intervention suggest that the counseling can help patients adjust to chronic illness.BACKGROUNDPoor mood adjustment to chronic medical illness is often accompanied by decrements in function.","McLaughlin, T J; Aupont, O; Bambauer, K Z; Stone, P; Mullan, M G; Colagiovanni, J; Polishuk, E; Johnstone, M; Locke, S E",2005.0,10.1111/j.1525-1497.2005.00256.x,0,0,
7244,Psychiatric disorders in sexually abused children,"ER METHODSTwenty-six sexually abused children and 23 non-sexually abused children referred for psychiatric outpatient evaluation at a medical school center were matched by age, sex, race, and socioeconomic status and compared to determine differences in prevalence of Axis I, DSM-III-R disorders. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version was used for systematic diagnosis.RESULTSGroups did not differ significantly in the number of diagnoses and, in both groups, attention-deficit hyperactivity disorder was the most frequent diagnosis. However, the prevalence of post-traumatic stress disorder among sexually abused children was significantly greater (p < .02), with 42.3% of sexually abused children and 8.7% of non-sexually abused children meeting full criteria. There were no significant differences between groups in other diagnostic categories.CONCLUSIONSThis study, using structured interviews and comparison groups, confirmed earlier findings suggesting that sexually abused children are at heightened risk for the development of post-traumatic stress disorder.OBJECTIVEThis study was designed to compare the prevalence of psychiatric disorders in a clinical sample of sexually abused children referred for outpatient evaluation. Two a priori hypotheses were tested: (1) the sexually abused group would have more post-traumatic stress disorder than the non-sexually abused group and (2) non-sexually abused children referred for evaluation would have more diagnoses than the sexually abused group.","McLeer, S V; Callaghan, M; Henry, D; Wallen, J",1994.0,10.1097/00004583-199403000-00003,0,0,
7245,"A double-blind trial of tetrabenazine, thiopropazate, and placebo in patients with chorea",,"McLellan, D L; Chalmers, R J; Johnson, R H",1974.0,,0,0,
7246,Effects of alprazolam and imipramine on parasympathetic cardiac control in patients with generalized anxiety disorder,"ER A noninvasive measure was used to assess the effects of alprazolam, imipramine and placebo on parasympathetic (vagal) cardiac control following 6-weeks of medication in patients with generalized anxiety disorder. Flexible dosage at therapeutic levels resulted in increased heart rate and blood pressure and in decreased cardiac vagal control in patients receiving imipramine but not alprazolam or placebo. About 50% of the variance in heart rate changes and changes in mean arterial blood pressure following treatment with imipramine could be accounted for by changes in cardiac vagal control. Decreased cardiac vagal control can now be added to the list of cardiovascular changes seen following several weeks of treatment with imipramine.","McLeod, D R; Hoehn-Saric, R; Porges, S W; Zimmerli, W D",1992.0,,0,0,
7247,INSPIRE (INvestigating Social and PractIcal suppoRts at the End of life): pilot randomised trial of a community social and practical support intervention for adults with life-limiting illness,"ER DESIGN: The INSPIRE study will be conducted within the Medical Research Council (MRC) Framework for the Evaluation of Complex Interventions (Phases 0-2) and includes an exploratory two-arm delayed intervention randomised controlled trial. Eighty patients and/or their carers will be randomly allocated to one of two groups: (I) Intervention: GNP in addition to standard care or (II) Control: Standard Care. Recipients of the GNP will be asked for their views on participating in both the study and the intervention. Quantitative and qualitative data will be gathered from both groups over eight weeks through face-to-face interviews which will be conducted before, during and after the intervention. The primary outcome is the effect of the intervention on social and practical need. Secondary outcomes are quality of life, loneliness, social support, social capital, unscheduled health service utilisation, caregiver burden, adverse impacts, and satisfaction with intervention. Volunteers engaged in the GNP will also be assessed in terms of their death anxiety, death self efficacy, self-reported knowledge and confidence with eleven skills considered necessary to be effective GNP volunteers.DISCUSSION: The INSPIRE study addresses an important knowledge gap, providing evidence on the efficacy, utility and acceptability of a unique model of social and practical support for people living at home, with advanced life-limiting illness. The findings will be important in informing the development (and evaluation) of similar service models and policy elsewhere both nationally and internationally.TRIAL REGISTRATION: ISRCTN18400594 18(th) February 2015.BACKGROUND: For most people, home is the preferred place of care and death. Despite the development of specialist palliative care and primary care models of community based service delivery, people who are dying, and their families/carers, can experience isolation, feel excluded from social circles and distanced from their communities. Loneliness and social isolation can have a detrimental impact on both health and quality of life. Internationally, models of social and practical support at the end of life are gaining momentum as a result of the Compassionate Communities movement. These models have not yet been subjected to rigorous evaluation. The aims of the study described in this protocol are: (1) to evaluate the feasibility, acceptability and potential effectiveness of The Good Neighbour Partnership (GNP), a new volunteer-led model of social and practical care/support for community dwelling adults in Ireland who are living with advanced life-limiting illness; and (2) to pilot the method for a Phase III Randomised Controlled Trial (RCT).","McLoughlin, K; Rhatigan, J; McGilloway, S; Kellehear, A; Lucey, M; Twomey, F; Conroy, M; Herrera-Molina, E; Kumar, S; Furlong, M; Callinan, J; Watson, M; Currow, D; Bailey, C",2015.0,10.1186/s12904-015-0060-9,0,0,
7248,"Posttraumatic lung syndrome. Definition, diagnosis, and therapy. Report of a double blind study",,"McMichan, J C; Rosengarten, D S; McNeur, J C; Philipp, E",1976.0,,0,0,
7249,Premedication of children with oral midazolam,"ER In a randomized, double-blind, placebo-controlled study, the safety, efficacy and feasibility of oral midazolam premedication in children were evaluated in an ambulatory surgery unit. Eighty unmedicated children (ASA PS I or II, ages 1-6 yr) were randomly assigned to one of four groups receiving midazolam 0.5, 0.75, or 1.0 mg.kg-1 or a placebo 30 min before separation from parents. Heart rate, systolic blood pressure, arterial oxygen saturation, respiratory rate, sedation and anxiolysis scores were recorded before premedication, every five minutes for 30 min and then during induction of anaesthesia and recovery. We found that heart rate, systolic blood pressure, arterial oxygen saturation and respiratory rate were unchanged during the study. Sedation and anxiolysis scores in the midazolam-treated groups were greater than those in the placebo group and that anxiolysis at the time of separation from the parents was judged excellent in 80-90% of the children who received midazolam. However, sedation and anxiolysis did not differ among the three midazolam groups. Mean times to discharge from hospital were similar for all four groups. The side effects, loss of balance and head control, blurred vision and dysphoric reactions were observed only in the 0.75 and 1.0 mg.kg-1 midazolam groups. We conclude that oral midazolam 0.5 mg.kg-1 is a safe and effective premedication and that 0.75 and 1 mg.kg-1 while offering no additional benefit, may cause more side effects.","McMillan, C O; Spahr-Schopfer, I A; Sikich, N; Hartley, E; Lerman, J",1992.0,10.1007/BF03008315,0,0,
7250,The Coping Cat program for children with anxiety and autism spectrum disorder: a pilot randomized controlled trial,ER The purpose of this pilot study was to evaluate whether a modified version of the Coping Cat program could be effective in reducing anxiety in children with autism spectrum disorder (ASD). Twenty-two children (ages 8-14; IQ ? 70) with ASD and clinically significant anxiety were randomly assigned to 16 sessions of the Coping Cat program (cognitive-behavioral therapy; CBT) or a 16-week waitlist. Children in the CBT condition evidenced significantly larger reductions in anxiety than those in the waitlist. Treatment gains were largely maintained at two-month follow-up. Results provide preliminary evidence that a modified version of the Coping Cat program may be a feasible and effective program for reducing clinically significant levels of anxiety in children with high-functioning ASD.,"McNally, Keehn R H; Lincoln, A J; Brown, M Z; Chavira, D A",2013.0,10.1007/s10803-012-1541-9,0,0,
7251,Low risk of late post-traumatic seizures following severe head injury: implications for clinical trials of prophylaxis,"ER A randomised, controlled, double-blind clinical trial designed to determine the effectiveness of phenytoin in preventing epilepsy in patients who had suffered a serious head injury is reported. One hundred and sixty-four patients were randomly assigned to treatment with phenytoin or placebo capsules for one year. Patients who had a fit within one week of injury were excluded. Drug levels were monitored throughout with appropriate dosage adjustment; however only 48% of the phenytoin group had plasma levels greater than 40 mumol/l. There were seven deaths during the study. Only 11 patients (six in the phenytoin group and five in the placebo group) developed post-traumatic epilepsy within one year; a further four patients developed seizures between 1 and 2 years after injury. This low incidence of post-traumatic epilepsy (7% (SE 2%) at one year and 10 (SE 2%) at two years) means that future clinical trials of prophylaxis will have to be much larger (at least six fold).","McQueen, J K; Blackwood, D H; Harris, P; Kalbag, R M; Johnson, A L",1983.0,,0,0,
7252,Differential therapeutic outcomes of community-based group interventions for women and children exposed to intimate partner violence,"ER Two community-based group therapies, emotion focused versus goal oriented, are compared among women exposed to intimate partner violence (n = 46) and their children ( n = 48) aged between 6 and 12 years. A series of repeated measures analyses are employed to evaluate the effects of time from baseline to postintervention following random assignment. Main and treatment effects for women provide support for the relative effectiveness in increasing quality of social support in the emotion-focused intervention and in the reduction of both family conflict and alcohol use for the goal-oriented intervention.","McWhirter, P T",2011.0,10.1177/0886260510383026,0,0,
7253,Mood as input and perseverative worrying following the induction of discrete negative moods,"ER Previous research has demonstrated that a combination of negative mood and rigorous ""as many as can"" stop rules can be used to help explain a range of perseverative psychopathologies such as pathological worrying, compulsive checking, and depressive rumination (known as the mood-as-input hypothesis). The aim of the present study was to extend this work and examine whether specific emotions of the same valence will have similar or differential effects on task perseveration. The study experimentally induced discrete moods and manipulated task stop rules in an analog population. Results showed that perseveration at a worry-based interview task conformed to standard mood-as-input predictions in which perseveration was significantly greater when an ""as many as can"" stop rule was paired with a negative mood or a ""feel like continuing"" stop rule was paired with a positively valenced mood. The pattern of results revealed no significant inherent differences in processing depending on the type of discrete negative mood being experienced. These findings support a view of mood-as-input effects where overall valency is the important factor in determining perseveration.","Meeten, F; Davey, G C",2012.0,10.1016/j.beth.2011.08.005,0,0,
7254,Feelings of betrayal by the United Nations High Commissioner for Refugees and emotionally distressed Sudanese refugees in Cairo,"ER Thousands of Sudanese refugees have fled to Cairo, Egypt in the wake of Sudanese civil conflicts. Sudanese refugees were evaluated with respect to symptoms of depression, post-traumatic stress disorder (PTSD) and social stress. Four respondents (22%) indicated that their interactions with the United Nations High Commissioner for Refugees (UNHCR) in Cairo, Egypt were the worst experiences since war-related atrocities. Fourteen participants (63.6%) felt 'extremely' betrayed by the UNHCR on a four point scale. Greater feelings of betrayal by the UNHCR were associated with greater avoidance and arousal symptoms of PTSD, symptoms of depression and trait anger. This is the first study of which we are aware that examines the relationship between sense of betrayal by the UNHCR and symptoms of PTSD, depression and anger among asylum seekers.","Meffert, S M; Musalo, K; Abdo, A O; Alla, O A; Elmakki, Y O; Omer, A A; Yousif, S; Metzler, T J; Marmar, C R",2010.0,10.1080/13623699.2010.491395,0,0,
7255,Pentagastrin induced panic attacks: enhanced sensitivity in panic disorder patients,"ER The effects of pentagastrin, a synthetic analogue of the cholecystokinin tetrapeptide (CCK4), were studied in 15 patients with panic disorder and 15 healthy controls. Three different intravenous dosages of pentagastrin (0.1, 0.3 and 0.6 microgram/kg) and saline were investigated. Subjects were randomly allocated to two of the four treatment groups and tested on two separate occasions, 1 week apart, using an unbalanced double-blind incomplete block design. The mean panic rate with pentagastrin was 55% (12/22) for patients and 5% (1/22) for controls. None of the subjects panicked with saline. The frequency of panic attacks between the three pentagastrin doses in patients was not different. One control subject had a panic-like attack at the highest dose of pentagastrin. These findings concur with previous studies on the panicogenic effect of CCK4 and pentagastrin and suggest a greater sensitivity for CCK receptor agonists in patients suffering from panic disorder than in healthy controls.","Megen, H J; Westenberg, H G; Boer, J A; Haigh, J R; Traub, M",1994.0,,0,0,
7256,Premenstrual dysphoric disorder and response to cholecystokinin-tetrapeptide,,"Melledo, J M; Bradwejn, J; Koszycki, D; Bichet, D",1995.0,,0,0,
7257,The role of the beta-noradrenergic system in cholecystokinin-tetrapeptide-induced panic symptoms,"ER METHODSSubjects were randomly assigned to either a propranolol (n = 14) or placebo (n = 16) infusion. Ten minutes after completion of the infusion subjects received a bolus injection of CCK-4 (50 micrograms).RESULTSAcute pretreatment with propranolol was more effective than placebo in decreasing behavioral and cardiovascular sensitivity.CONCLUSIONSThese preliminary results suggest that the panicogenic effects of CCK-4 are mediated, in part, through the beta-adrenergic system.BACKGROUNDThe authors determined whether effective beta-adrenergic blockade could attenuate the panicogenic effects of cholecystokinin-tetrapeptide (CCK-4) in healthy volunteers.","Mellédo, J M; Bradwejn, J; Koszycki, D; Bichet, D G; Bellavance, F",1998.0,,0,0,
7258,Creating opportunities for parent empowerment: program effects on the mental health/coping outcomes of critically ill young children and their mothers,"ER DESIGNA randomized, controlled trial with follow-up assessments 1, 3, 6, and 12 months after hospitalization was conducted with 174 mothers and their 2- to 7-year-old children who were unexpectedly hospitalized in the pediatric intensive care units (PICUs) of 2 children's hospitals. The final sample of 163 mothers ranged in age from 18 to 52 years, with a mean of 31.2 years. Among the mothers reporting race/ethnicity, the sample included 116 white (71.2%), 33 African American (20.3%), 3 Hispanic (1.8%), and 2 Indian (1.2%) mothers. The mean age of the hospitalized children was 50.3 months. Ninety-nine children (60.7%) were male and 64 (39.3%) were female. The major reasons for hospitalization were respiratory problems, accidental trauma, neurologic problems, and infections. Fifty-seven percent (n = 93) of the children had never been hospitalized overnight, and none had experienced a previous PICU hospitalization.INTERVENTIONSMothers in the experimental (COPE) group received a 3-phase educational-behavioral intervention program 1) 6 to 16 hours after PICU admission, 2) 2 to 16 hours after transfer to the general pediatric unit, and 3) 2 to 3 days after their children were discharged from the hospital. Control mothers received a structurally equivalent control program. The COPE intervention was based on self-regulation theory, control theory, and the emotional contagion hypothesis. The COPE program, which was delivered with audiotapes and matching written information, as well as a parent-child activity workbook that facilitated implementing the audiotaped information, focused on increasing 1) parents' knowledge and understanding of the range of behaviors and emotions that young children typically display during and after hospitalization and 2) direct parent participation in their children's emotional and physical care. The COPE workbook, which was provided to parents and children after transfer from the PICU to the general pediatric unit, contained 3 activities to be completed before discharge from the hospital, ie, 1) puppet play to encourage expression of emotions in a nonthreatening manner, 2) therapeutic medical play to assist children in obtaining some sense of mastery and control over the hospital experience, and 3) reading and discussing Jenny's Wish, a story about a young child who successfully copes with a stressful hospitalization.OUTCOME MEASURESPrimary outcomes included maternal anxiety, negative mood state, depression, maternal beliefs, parental stress, and parent participation in their children's care, as well as child adjustment, which was assessed with the Behavioral Assessment System for Children (parent form). RESn (parent form).RESULTSCOPE mothers reported significantly less parental stress and participated more in their children's physical and emotional care on the pediatric unit, compared with control mothers, as rated by nurses who were blinded with respect to study group. In comparison with control mothers, COPE mothers reported less negative mood state, less depression, and fewer PTSD symptoms at certain follow-up assessments after hospitalization. In addition, COPE mothers reported stronger beliefs regarding their children's likely responses to hospitalization and how they could enhance their children's adjustment, compared with control mothers. COPE children, in comparison with control children, exhibited significantly fewer withdrawal symptoms 6 months after discharge, as well as fewer negative behavioral symptoms and externalizing behaviors at 12 months. COPE mothers also reported less hyperactivity and greater adaptability among their children at 12 months, compared with control mothers. One year after discharge, a significantly higher percentage of control group children (25.9%) exhibited clinically significant behavioral symptoms, compared with COPE children (2.3%). In addition, 6 and 12 months after discharge, significantly higher percentages of control group children exhibited clinically significant externalizing symptoms (6 months, 14.3%; 12 months, 22.2%), compared with COPE children (6 months, 1.8%; 12 months, 4.5%).CONCLUSIONSThe findings of this study indicated that mothers who received the COPE program experienced improved maternal functional and emotional coping outcomes, which resulted in significantly fewer child adjustment problems, in comparison with the control group. With the increasing prevalence of attention-deficit/hyperactivity disorder and externalizing problems among children and the documented lack of mental health screening and early intervention services for children in this country, the COPE intervention could help protect this high-risk population of children from developing these troublesome problems. As a result, the mental health status of children after critical care hospitalization could be improved. With routine provision of the COPE program in PICUs throughout the country, family burdens and costs associated with the mental health treatment of these problems might be substantially reduced.OBJECTIVEIncreasing numbers of children in the United States (ie, approximately 200 children per 100,000 population) require intensive care annually, because of advances in pediatric therapeutic techniques and a changing spectrum of pediatric disease. These children are especially vulnerable to a multitude of short- and long-term negative emotional, behavioral, and academic outcomes, including a higher risk of posttraumatic stress disorder (PTSD) and a greater need for psychiatric treatment, compared with matched hospitalized children who do not require intensive care. In addition, the parents of these children are at risk for the development of PTSD, as well as other negative emotional outcomes (eg, depression and anxiety disorders). There has been little research conducted to systematically determine the effects of interventions aimed at improving psychosocial outcomes for critically ill children and their parents, despite recognition of the adverse effects of critical care hospitalization on the nonphysiologic well-being of patients and their families. The purpose of this study was to evaluate the effects of a preventive educational-behavioral intervention program, the Creating Opportunities for Parent Empowerment (COPE) program, initiated early in the intensive care unit hospitalization on the mental health/psychosocial outcomes of critically ill young children and their mothers.","Melnyk, B M; Alpert-Gillis, L; Feinstein, N F; Crean, H F; Johnson, J; Fairbanks, E; Small, L; Rubenstein, J; Slota, M; Corbo-Richert, B",2004.0,,0,0,
7259,Helping mothers cope with a critically ill child: a pilot test of the COPE intervention,ER The purpose of this study was to pilot test the effects of a theoretically driven intervention program (COPE = Creating Opportunities for Parent Empowerment) on the coping outcomes of critically ill children and their mothers. Thirty mothers of 1- to 6-year-old children in a pediatric intensive care unit (PICU) were randomly assigned to receive COPE or a comparison program. Mothers who received the COPE program: (a) provided more support to their children during intrusive procedures; (b) provided more emotional support to their children; (c) reported less negative mood state and less parental stress related to their children's emotions and behaviors; and (d) reported fewer post-traumatic stress symptoms and less parental role change four weeks following hospitalization. Results indicate the need to educate parents regarding their children's responses as they recover from critical illness and how they can assist their children in coping with the stressful experience.,"Melnyk, B M; Alpert-Gillis, L J; Hensel, P B; Cable-Beiling, R C; Rubenstein, J S",1997.0,,0,0,
7260,The COPE healthy lifestyles TEEN randomized controlled trial with culturally diverse high school adolescents: baseline characteristics and methods,"ER Obesity and mental health disorders remain significant public health problems in adolescents. Substantial health disparities exist with minority youth experiencing higher rates of these problems. Schools are an outstanding venue to provide teens with skills needed to improve their physical and mental health, and academic performance. In this paper, the authors describe the design, intervention, methods and baseline data for a randomized controlled trial with 779 culturally diverse high-school adolescents in the southwest United States. Aims for this prevention study include testing the efficacy of the COPE TEEN program versus an attention control program on the adolescents' healthy lifestyle behaviors, Body Mass Index (BMI) and BMI%, mental health, social skills and academic performance immediately following the intervention programs, and at six and 12 months post interventions. Baseline findings indicate that greater than 40% of the sample is either overweight (n = 148, 19.00%) or obese (n = 182, 23.36%). The predominant ethnicity represented is Hispanic (n = 526, 67.52%). At baseline, 15.79% (n = 123) of the students had above average scores on the Beck Youth Inventory Depression subscale indicating mildly (n = 52, 6.68%), moderately (n = 47, 6.03%), or extremely (n = 24, 3.08%) elevated scores (see Table 1). Anxiety scores were slightly higher with 21.56% (n = 168) reporting responses suggesting mildly (n = 81, 10.40%), moderately (n = 58, 7.45%) or extremely (n = 29, 3.72%) elevated scores. If the efficacy of the COPE TEEN program is supported, it will offer schools a curriculum that can be easily incorporated into high school health courses to improve adolescent healthy lifestyle behaviors, psychosocial outcomes and academic performance.","Melnyk, B M; Kelly, S; Jacobson, D; Belyea, M; Shaibi, G; Small, L; O'Haver, J; Marsiglia, F F",2013.0,10.1016/j.cct.2013.05.013,0,0,
7261,Cognitive-behavioral group treatments in childhood anxiety disorders: the role of parental involvement,"ER METHODParents and children (N = 62) were randomly assigned to one of three 12-week treatment conditions: parent and child intervention, child-only intervention, and parent-only intervention. Child anxiety, depression, and coping strategies were assessed before and after treatment.RESULTSAll treatment groups reported fewer symptoms of anxiety and depression posttreatment and changes in their use of coping strategies. Children in the parent and child intervention used more active coping strategies posttreatment compared with children in the other 2 treatment conditions. Parents in this treatment condition reported a significantly greater improvement in their children's emotional well-being than parents in the other treatment conditions.CONCLUSIONSCognitive-behavioral group interventions reduced symptoms of anxiety and depression in school-age children with anxiety disorders. Concurrent parental involvement enhanced the effect on coping strategies. Further investigation is needed to corroborate the effectiveness of such short-term interventions and the maintenance of treatment effects.OBJECTIVESThis study examined (1) the effect of a cognitive-behavioral group intervention on anxiety, depression, and coping strategies in school-age children (aged 7-12 years) with Axis I anxiety disorders; and (2) the effect of parental involvement on treatment outcomes.","Mendlowitz, S L; Manassis, K; Bradley, S; Scapillato, D; Miezitis, S; Shaw, B F",1999.0,,0,0,
7262,A comparison of in vivo and vicarious exposure in the treatment of childhood water phobia,"ER The effectiveness of in vivo exposure and vicarious exposure in reducing children's phobic anxiety and avoidance of water was investigated. Forty-eight water phobic children between the ages of 3 and 8 yr were randomly assigned to one of four groups: (1) in vivo exposure plus vicarious exposure (IVVE); (2) vicarious exposure (VE); (3) in vivo exposure (IVE); and (4) assessment only control. All subjects in the treatment groups received three individually administered treatment sessions. At the conclusion of treatment it was found that the IVE condition had produced statistically and clinically significant gains that had generalized to another situation involving water, and were largely maintained over a period of 3 months. In contrast, the VE condition did not lead to statistically greater treatment benefits than those observed in the control subjects. Furthermore, there was no significant difference between the IVVE condition and the IVE condition in their level of improvement from pre- to post-treatment. Hence, by post-treatment, vicarious exposure had not only failed to produce benefits when used on its own, but had also failed to enhance the benefits achieved through in vivo exposure. However, a tendency for the vicarious component to enhance the maintenance of treatment benefits was found at follow-up. The implications of these findings are discussed.","Menzies, R G; Clarke, J C",1993.0,,0,0,
7263,Vulnerability factors among children at risk for anxiety disorders,"ER METHODSThis paper reviews the methods of high-risk research and findings from previous high-risk studies of anxiety. The preliminary results of the 6-8 year follow-up of a high-risk study of 192 offspring of probands with anxiety disorders, substance abuse, and unaffected controls are presented. The key study measures include comprehensive diagnostic interviews, symptom ratings, indirect measures of brain functioning (neuropsychologic, neurologic and psychophysiologic function), developmental measures, and family functioning measures.RESULTSThe major findings reveal that there is specificity of familial aggregation of anxiety disorders among parents and children; children at high risk for anxiety have increased startle reflex, autonomic reactivity, and stress reactivity, higher verbal IQ, and deficits in paired associative learning as compared to other children.CONCLUSIONSThe finding that family environment and parenting do not differ between children at risk for anxiety disorders and other children, when taken together with the strong degree of specificity of transmission of anxiety disorders, suggests that there may be temperamental vulnerability factors for anxiety disorders in general that may already manifest in children prior to puberty.BACKGROUNDThe high-risk strategy is one of the most powerful approaches for identifying premorbid risk factors and reducing etiologic and phenotypic heterogeneity characteristic of the major psychiatric disorders.","Merikangas, K R; Avenevoli, S; Dierker, L; Grillon, C",1999.0,,0,0,
7264,Cognitive behavioral therapy plus motivational interviewing improves outcome for pediatric obsessive-compulsive disorder: a preliminary study,"ER Lack of motivation may negatively impact cognitive behavioral therapy (CBT) response for pediatric patients with obsessive-compulsive disorder (OCD). Motivational interviewing is a method for interacting with patients in order to decrease their ambivalence and support their self-efficacy in their efforts at behavior change. The authors present a preliminary randomized trial (N = 16) to evaluate the effectiveness of adding motivational interviewing (MI) as an adjunct to CBT. Patients aged 6 to 17 years who were participating in intensive family-based CBT for OCD were randomized to receive either CBT plus MI or CBT plus extra psychoeducation (PE) sessions. After four sessions, the mean Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) score for the CBT plus MI group was significantly lower than for the CBT plus psychoeducation group, t(14) = 2.51, p < .03, Cohen's d = 1.34. In addition, the degree of reduction in CY-BOCS scores was significantly greater, t(14) = 2.14, p = .05, Cohen's d = 1.02, for the CBT plus MI group (mean Delta = 16.75, SD = 9.66) than for the CBT plus psychoeducation group (mean Delta = 8.13, SD = 6.01). This effect decreased over time, and scores at posttreatment were not significantly different. However, participants in the MI group completed treatment on average three sessions earlier than those in the psychoeducation group, providing support for the utility of MI in facilitating rapid improvement and minimizing the burden of treatment for families.","Merlo, L J; Storch, E A; Lehmkuhl, H D; Jacob, M L; Murphy, T K; Goodman, W K; Geffken, G R",2010.0,10.1080/16506070902831773,0,0,
7265,"Effects of expressive writing on sexual dysfunction, depression, and PTSD in women with a history of childhood sexual abuse: results from a randomized clinical trial","ER AIM: We tested an expressive writing-based intervention for its effects on psychopathology, sexual function, satisfaction, and distress in women who have a history of CSA.METHODS: Seventy women with CSA histories completed five 30-minute sessions of expressive writing, either with a trauma focus or a sexual schema focus.MAIN OUTCOME MEASURES: Validated self-report measures of psychopathology and sexual function were conducted at posttreatment: 2 weeks, 1 month, and 6 months.RESULTS: Women in both writing interventions exhibited improved symptoms of depression and posttraumatic stress disorder (PTSD). Women who were instructed to write about the impact of the abuse on their sexual schema were significantly more likely to recover from sexual dysfunction.CONCLUSIONS: Expressive writing may improve depressive and PTSD symptoms in women with CSA histories. Sexual schema-focused expressive writing in particular appears to improve sexual problems, especially for depressed women with CSA histories. Both treatments are accessible, cost-effective, and acceptable to patients.INTRODUCTION: Women with a history of childhood sexual abuse (CSA) have high rates of depression, posttraumatic stress disorder, and sexual problems in adulthood.","Meston, C M; Lorenz, T A; Stephenson, K R",2013.0,10.1111/jsm.12247,0,0,
7266,"Effect of fall-related concerns on physical, mental, and social function in community-dwelling older adults: a prospective cohort study","ER Objectives To determine the effect of fall-related concerns on physical, mental, and social function. Design Community-based prospective cohort study (secondary analysis using control group data from a randomized controlled trial). Setting Two municipalities in the south of the Netherlands. Participants Community-dwelling older adults (N = 260). Measurements Two groups were created using Modified Falls Efficacy Scale scores (high and low levels of fall-related concerns). Five outcome measures representing physical, mental, and social function were included: activities of daily living (ADLs), symptoms of depression, feelings of anxiety, social participation, and social support interactions. Outcomes were measured at baseline and at 2, 8, and 14 months. Data were analyzed using analysis of covariance and mixed-effect regression models for longitudinal data, adjusting for age, sex, living status (alone or with another person), educational level, cognitive status, self-perceived health, and falls history at baseline. Results At baseline, significantly more limitations in ADLs and social participation were found for older persons with high levels of fall-related concerns than for those with low levels of concern. These differences persisted over 14 months of follow-up and were consistent over time. No significant differences were found for symptoms of depression, feelings of anxiety, or social support interactions, except for feelings of anxiety at 14 months. Conclusion Older persons with higher levels of fall-related concerns reported up to 14 months poorer ADL and social participation for up to 14 months than those with lower levels of fall-related concerns. From a clinical point of view, the clear relationship between fall-related concerns and ADL dysfunction and social participation may help to target groups who are at risk of developing adverse consequences of concerns about falls.","Meulen, E; Zijlstra, G A; Ambergen, T; Kempen, G I",2014.0,10.1111/jgs.13083,0,0,
7267,Feedback of end-tidal pCO2 as a therapeutic approach for panic disorder,"ER METHODSThirty-seven participants with PD with or without agoraphobia were randomly assigned to BRT or to a delayed-treatment control group. Clinical status, respiration rate, and end-tidal pCO(2) were assessed at baseline, post-treatment, 2-month and 12-month follow-up. Respiratory measures were also assessed during homework exercises using a portable capnometer as a feedback device.RESULTSSignificant improvements (in PD severity, agoraphobic avoidance, anxiety sensitivity, disability, and respiratory measures) were seen in treated, but not untreated patients, with moderate to large effect sizes. Improvements were maintained at follow-up. Treatment compliance was high for session attendance and homework exercises; dropouts were few.CONCLUSIONSThe data provide preliminary evidence that raising end-tidal pCO(2) by means of capnometry feedback is therapeutically beneficial for panic patients. Replication and extension will be needed to verify this new treatment's efficacy and determine its mechanisms.BACKGROUNDGiven growing evidence that respiratory dysregulation is a central feature of panic disorder (PD) interventions for panic that specifically target respiratory functions could prove clinically useful and scientifically informative. We tested the effectiveness of a new, brief, capnometry-assisted breathing therapy (BRT) on clinical and respiratory measures in PD.","Meuret, A E; Wilhelm, F H; Ritz, T; Roth, W T",2008.0,10.1016/j.jpsychires.2007.06.005,0,0,
7268,Medical Research Council's Treatment Trial for mild hypertension: an interim report,"ER The pilot phase of the British multicentre randomized controlled trial of treatment for mild hypertension has shown: (1) that unselected subjects, aged 35-64 years, with mild hypertension are willing to enter and remain in a long-term trial even though asymptomatic; (2) that the differences of mean systolic and mean diastolic pressure achieved between treated and control subjects is sufficient to produce the expected difference in terminating events with the 18000 patients calculated as needed for the full-scale trial; (3) that side effects with the two selected active primary regimens (bendrofluazide and propranolol) are common but mild (no serious side effects or toxic reactions have been reported); (4) that the work load imposed by the trial, though considerable during screening and the initiation of patients into the trial, can largely be taken by specially trained nursing staff, and when screening is completed the trial does not impose a heavy burden of follow-up examinations; (5) that there are no adverse psychological effects caused by alerting asymptomatic people to their raised pressure and enrolling them into a prolonged programme of clinical attendance; (6) that the total costs of carrying out a full-scale trial--estimated at about lb.2m ($U.S. 4m)--are commensurate with the potential annual savings in health service expenditure whether the trial shows treatment to be effective or unwarranted.","Miall, W E; Brennan, P J; Mann, A H",1976.0,,0,0,
7269,Targeted prevention of childhood anxiety: engaging parents in an underserved community,"ER Selective prevention programs hold the promise of alleviating child anxiety symptoms, decreasing the risk for emotional problems across the lifespan. Such programs have particular public health import for young children of poor, underserved communities. Identifying factors related to parent engagement, and methods to improve engagement, are paramount in the effort to develop anxiety-focused, community prevention programs. This feasibility study investigated the effect of an enhanced recruitment strategy to maximize parent engagement, as well as factors related to attendance in a single session focused on anxiety prevention. Participants were poor, ethnic minority parents of children aged 11-71 months (n = 256) who completed a survey that assessed anxiety risk according to trauma exposure, child anxiety, or parent anxiety, as well as preferences for preventive services (phase 1). Those meeting risk criteria (n = 101) were invited to a preventive group session (phase 2). Half of parents received enhanced recruitment (ER), which included personalized outreach, matching parent preferences, and community endorsement. Other parents were invited by mail. Chi square analyses indicated that ER was associated with planning to attend (49 vs. 6% of control). Parents receiving ER were 3.5 times more likely to attend. Higher sociodemographic risk was correlated with higher child anxiety symptoms but not attendance. Results highlight the need for improved strategies for engaging parents in preventive, community-based interventions.","Mian, N D; Eisenhower, A S; Carter, A S",2015.0,10.1007/s10464-014-9696-5,0,0,
7270,Effect of dexmedetomidine assisted with brachial plexus block on stress in acute trauma patients,,"Miao, W L; Zhang, Y X; Hou, S J; Tang, H P",2012.0,,0,0,
7271,"A randomized, controlled trial of the influence of prenatal parenting education on postpartum anxiety and marital adjustment","ER METHODSSeventy primiparous, low-risk couples enrolled in prenatal classes in a large urban hospital were randomized to experimental and control groups. An educational intervention consisting of two second-trimester classes was facilitated by two social workers. The classes were based on a previous assessment of the educational needs of postpartum couples and contained didactic sessions, role-playing sessions, and values clarification exercises. The Spielberger State-Trait Anxiety Inventory and the Dyadic Adjustment Scale were administered to both groups prenatally in the second trimester and at 6 weeks and 6 months postpartum. A modified version of the O'Hara Postpartum Adjustment Questionnaire was administered at 6 weeks and 6 months postpartum.RESULTSBoth groups scored comparably in the prenatal period. The experimental group scored significantly lower on anxiety and higher on dyadic adjustment at both postpartum time periods than the control group. The experimental group also indicated a higher degree of postpartum adjustment.CONCLUSIONPrenatal parenting communication classes had a significant impact on postpartum anxiety, postpartum marital satisfaction, and postpartum adjustment.OBJECTIVEThe aim of this study was to measure the impact of two middle-trimester parenting communication classes on postpartum anxiety, marital adjustment, and postpartum adjustment.","Midmer, D; Wilson, L; Cummings, S",1995.0,,0,0,
7272,"Towards parenthood: an antenatal intervention to reduce depression, anxiety and parenting difficulties","ER METHODSWe evaluated the effectiveness of an antenatal intervention which targeted risk factors for poor postnatal adjustment, with the dual aim of reducing both postnatal symptoms of depression/anxiety and parenting difficulties (a nine-unit self-guided workbook with weekly telephone support). Based on an initial feasibility study (n=200) which confirmed a low level of help-seeking among distressed women during pregnancy, an additional community networking component was developed aimed at increasing social support and access to health professionals to facilitate treatment of current antenatal depression/anxiety, if present. In the evaluation of a second version of the intervention, pregnant women (n=143) were randomly allocated to receive either the intervention or routine care.RESULTSFollowing the antenatal intervention there were significantly fewer cases scoring above threshold for mild-to-severe depression/anxiety symptoms postnatally compared to routine care, along with a trend towards reduced parenting stress. The community networking component appeared helpful and women with higher baseline depression scores showed higher levels of help-seeking in both intervention and routine care groups.LIMITATIONSIt was not possible to evaluate the efficacy of individual program components separately.CONCLUSIONSThe findings provide support for the effectiveness of the Towards Parenthood intervention both as a preparation for parenthood program and in reducing symptoms of postnatal depression/anxiety.BACKGROUNDThere have been few antenatal interventions aimed at preparing women for the transition to parenthood and previous attempts to intervene antenatally to prevent postnatal depression and anxiety have had limited impact.","Milgrom, J; Schembri, C; Ericksen, J; Ross, J; Gemmill, A W",2011.0,10.1016/j.jad.2010.10.045,0,0,
7273,Dextran as a modulator of immune and coagulation activities in trauma patients,"ER Low Mr dextran has been utilized as a prophylactic therapy in treatment of coagulopathy. There is evidence that monocyte dysfunctions are important contributors to hypercoagulability episodes, as well as to immunoincompetence post-trauma. Dextran is a known monocyte modulator. Consequently, we evaluated the efficacy of dextran infusion in moderating immune dysfunction, monocyte aberrations, and hypercoagulability episodes. Twenty-eight trauma patients were randomly divided into two groups. One group of 15 received dextran at 1 g/kg wt/24 hr for 5 days in addition to standard resuscitation and treatment. The control or nontreated patient group received only standard treatment. Trauma patients in the two groups were retrospectively matched by injury severity score (ISS) to ensure comparability. Blood samples were collected daily for some studies and at 3-day intervals for other assays. In vivo coagulation status was evaluated by assessing the changes in intravascular fibrinopeptide A (FPA). Immune reactivity to the mitogen phytohemagglutinin (PHA) was also evaluated. Both monocyte production of plasminogen activator (PA) and monocyte production of procoagulant activity (PCA) have been shown to correspond to and be augmented by monocyte-T lymphocyte interactions. Consequently, monocyte production of plasminogen activator and procoagulant activity were assessed as measures of monocyte immune activity as well as indicators of monocyte function in controlling the balance between fibrinolysis and coagulation. Only patients with ISS of greater than 25 experienced significant immune, coagulation, or monocyte aberrations. Of those having an injury severity score (ISS) score of 25-35, all of the control and two of the dextran patients had significant perturbations in their immune and monocyte functions.(ABSTRACT TRUNCATED AT 250 WORDS)","Miller, C L; Lim, R C",1985.0,,0,0,
7274,Effect of acute tryptophan depletion on CO2-induced anxiety in patients with panic disorder and normal volunteers,"ER AIMSTo investigate the effect of reducing brain serotonin function on anxiety at rest, and following 5% CO2 provocation in normal controls and patients with panic disorder.METHODTwenty drug-free patients with DSM-III-R panic disorder and 19 controls received a tryptophan-free amino acid drink on one occasion and a control drink on the other in a double-blind, balanced protocol. 5% CO2 was given as a panic challenge after 270 minutes.RESULTSPlasma tryptophan fell by more than 80% both patients and controls after the tryptophan-free drink. Tryptophan depletion did not alter resting anxiety. In patients alone, tryptophan depletion caused a greater anxiogenic response and an increased rate of panic attacks (9 v. 2, P < 0.05) after 5% CO2 challenge. No normal volunteers panicked.CONCLUSIONSSerotonin may directly modulate panic anxiety in patients with panic disorder. This may underlie the efficacy of serotonergic antidepressants in treating panic disorder.BACKGROUNDUncertainties remain about the role of serotonin in the aetiology and treatment of panic disorder.","Miller, H E; Deakin, J F; Anderson, I M",2000.0,,0,0,
7275,"Antazoline phosphate and naphazoline hydrochloride, singly and in combination for the treatment of allergic conjunctivitis-a controlled, double-blind clinical trial","ER A controlled, double-blind comparison of naphalzoline hydrochloride 0.05%, antazoline phosphate 0.5%, a combination of both components and a placebo was performed on 51 ragweed sensitive patients presenting allergic conjunctivitis. Evaluation of response at various times after instillation of medication for lacrimation, conjunctival inflammation, pruritus, photophobia and pain showed naphazoline hydrochloride, antazoline phosphate and the combination product superior to placebo. The combination product was statistically significantly superior for conjunctival inflammation and photophobia. The need for post-challenge treatment with epinephrine hydrochloride was significantly less in those eyes treated with the combination product. demonstrating prophylactic efficacy.","Miller, J; Wolf, E H",1975.0,,0,0,
7276,Psychological Outcomes After a Sexual Assault Video Intervention: A Randomized Trial,"ER Sexual assault survivors are at risk for a number of mental and physical health problems, including posttraumatic stress disorder and anxiety. Unfortunately, few seek physical or mental health services after a sexual assault (Price, Davidson, Ruggiero, Acierno, & Resnick, 2014). Mitigating the impact of sexual assault via early interventions is a growing and important area of research. This study adds to this literature by replicating and expanding previous studies (e.g., Resnick, Acierno, Amstadter, Self-Brown, & Kilpatrick, 2007) examining the efficacy of a brief video-based intervention that provides psychoeducation and modeling of coping strategies to survivors at the time of a sexual assault nurse examination. Female sexual assault survivors receiving forensic examinations were randomized to standard care or to the video intervention condition (N = 164). The participants completed mental health assessments 2 weeks (n = 69) and 2 months (n = 74) after the examination. Analyses of covariance revealed that women in the video condition had significantly fewer anxiety symptoms at the follow-up assessments. In addition, of those participants in the video condition, survivors reporting no previous sexual assault history reported significantly fewer posttraumatic stress symptoms 2 weeks after the examination than those with a prior assault history. Forensic nurses have the unique opportunity to intervene immediately after a sexual assault. This brief video intervention is a cost-effective tool to aid with that process.","Miller, K E; Cranston, C C; Davis, J L; Newman, E; Resnick, H",2015.0,10.1097/JFN.0000000000000080,0,0,
7277,Evaluation of a preventive intervention for child anxiety in two randomized attention-control school trials,"ER The present research examined the effectiveness of a cognitive-behavioral therapy (CBT) based intervention program, FRIENDS, for children from grades 4 to 6, using random assignment at the school-level and an attention-control design in two longitudinal studies. The first study targeted children with anxiety symptoms (N=191, mean age=10.1) as screened with self, parent, and teacher-reports; the second study took a universal approach with full classrooms of children participating (N=253, mean age=9.8). The results showed no intervention effect in both studies, with children's anxiety symptoms decreasing over time regardless of whether they were in the story-reading (attention control) or FRIENDS condition. The findings also indicated that girls reported a higher level of anxiety than boys and children in higher grades reported lower anxiety relative to younger children in both studies. In addition, similar patterns were found using a subgroup of children with high-anxiety symptoms from both studies.","Miller, L D; Laye-Gindhu, A; Liu, Y; March, J S; Thordarson, D S; Garland, E J",2011.0,10.1016/j.brat.2011.02.006,0,0,
7278,Hydrocortisone suppression of the fear-potentiated startle response and posttraumatic stress disorder,"ER This study examined the effects of oral administration of 20mg hydrocortisone on baseline and fear-potentiated startle in 63 male veterans with or without PTSD. The procedure was based on a two-session, within-subject design in which acoustic startle eyeblink responses were recorded during intervals of threat or no threat of electric shock. Results showed that the magnitude of the difference between startle responses recorded during anticipation of imminent shock compared to ""safe"" periods was reduced after hydrocortisone administration relative to placebo. This effect did not vary as a function of PTSD group nor were there were any significant group differences in other indices startle amplitude. Findings suggest that the acute elevations in systemic cortisol produced by hydrocortisone administration may have fear-inhibiting effects. This finding may have implications for understanding the role of hypothalamic-pituitary-adrenal (HPA)-axis function in vulnerability and resilience to traumatic stress.","Miller, M W; McKinney, A E; Kanter, F S; Korte, K J; Lovallo, W R",2011.0,10.1016/j.psyneuen.2010.12.009,0,0,
7279,An experimental investigation into the extent social evaluation anxiety impairs performance in simulation-based learning environments amongst final-year undergraduate nursing students,"ER METHODS: Final-year Bachelor of Science (Nursing) students (N=70) were randomly assigned to complete one of three clinically identical simulation-based scenarios designed to elicit varying levels of social evaluation anxiety by manipulating the number of other people present with the student during the simulation (1, 2 or 3 others). Rises in acute stress were measured via continuous heart-rate and salivary cortisol. Performance scores were derived from the average of two independent raters' using a structured clinical checklist (/16).RESULTS: Statistically different increases were found within the first minute of the simulation between those students with one versus three other people in the room (+4.13 vs. +14.01beats-per-minute respectively, p=0.01) and salivary cortisol measures suggested significantly different changes in anxiety between these groups (-0.05 vs. +0.11?g/dL respectively, p=0.02). Independent assessments suggested students with only one other person accompanying them in the simulation significantly outperformed those accompanied by three others (12.95 vs. 10.67 respectively, p=0.03).DISCUSSION: Students accompanied by greater numbers during simulations experienced measurably greater anxiety and measurably poorer performances. These results demonstrate the ability to manipulate social evaluation anxiety within high-fidelity simulation training of undergraduates in order to help students better acclimatise to stressful events prior to practising in real clinical settings.BACKGROUND: While numerous theoretical and conceptual models suggest social evaluation anxiety would likely influence performance in simulation-based learning environments, there has been surprisingly little research to investigate the extent to which this is true.","Mills, B; Carter, O; Rudd, C; Claxton, L; O'Brien, R",2016.0,10.1016/j.nedt.2016.06.006,0,0,
7280,Effects of three play conditions on separation anxiety in young children,,"Milos, M E; Reiss, S",1982.0,,0,0,
7281,Effect of treatment based on syndrome differentiation by Chinese medicine on post-traumatic elbow arthritis,"ER METHODSSeventy-six patients with PTEA requesting the conservative therapy were equally assigned to two groups randomly. The 38 patients in the treated group were administered with Chinese herbal medicines according to their syndrome typing for oral intake and external washing; while the other 38 patients in the control group were treated orally with glucosamine hydrochloride and Celecoxib, combined with intra-articular injection of sodium hyaluronate and peri-articular pain spot blocking with Triamcinolone Acetonaide Acetate injection. All were followed-up for six months with the therapeutic efficacy assessed by Japanese Orthopaedic Association (JOA) and the Hospital for Special Surgery (HSS) Scale scoring.RESULTSAll the 76 patients completed the trial. The JOA and HSS scores in the two groups were not significantly different before treatment (P>0.05), but they did show significant difference after treatment in terms of total score, joint pain, range of motion, and daily activity (P0.05).CONCLUSIONBoth the Chinese drug therapy according to syndrome differentiation and modern conservative therapy are effective in treating PTEA, but the former shows more superiority, and so it is worthy of clinical spreading.OBJECTIVETo compare the clinical efficacy of treatment based on syndrome differentiation of Chinese medicine and modern conservative therapeutic program on post-traumatic elbow arthritis (PTEA) in order to provide the guidance in clinical practice.","Min, Z H; Zhou, Y; Zhang, H M",2010.0,10.1007/s11655-010-0264-z,0,0,
7282,TEM characterization of a silorane composite bonded to enamel/dentin,"ER METHODSNon-demineralized/demineralized 70-90 nm sections were prepared following common TEM specimen processing procedures.RESULTSTEM revealed a typical twofold build-up of the adhesive resin, resulting in a total adhesive layer thickness of 10-20 microm. At bur-cut enamel, a tight interface without distinct dissolution of hydroxyapatite was observed. At bur-cut dentin, a relatively thin hybrid layer of maximum a few hundreds of nanometer was formed without clear surface demineralization. No clear resin tags were formed. At fractured dentin, the interaction appeared very superficial (100-200 nm). Distinct resin tags were formed due to the absence of smear plugs. Silver-nitrate infiltration showed a varying pattern of both spot- and cluster-like appearance of nano-leakage. Traces of Ag were typically detected along some part of the enamel-adhesive interface and/or between the two adhesive resin layers. Substantially more Ag-infiltration was observed along the dentin-adhesive interface of bur-cut dentin, as compared to that of fractured dentin.CONCLUSIONSThe nano-interaction of Silorane System Adhesive should be attributed to its relatively high pH of 2.7. The obtained tight interface at both enamel and dentin indicates that the two-step self-etch adhesive effectively bridged the hydrophilic tooth substrate with the hydrophobic silorane composite.OBJECTIVESThe low-shrinking composite composed of combined siloxane-oxirane technology (Filtek Silorane, 3M ESPE, Seefeld, Germany) required the development of a specific adhesive (Silorane System Adhesive, 3M ESPE), in particular because of the high hydrophobicity of the silorane composite. The purpose of this study was to characterize the interfacial ultra-structure at enamel and dentin using transmission electron microscopy (TEM).","Mine, A; Munck, J; Ende, A; Cardoso, M V; Kuboki, T; Yoshida, Y; Meerbeek, B",2010.0,10.1016/j.dental.2010.01.010,0,0,
7283,"Early Enteral Combined with Parenteral Nutrition Treatment for Severe Traumatic Brain Injury: effects on Immune Function, Nutritional Status and Outcomes(?)","ER Objective To compare the conjoint effect of enteral nutrition (EN) and parenteral nutrition (PN) with single EN or PN on immune function, nutritional status, complications and clinical outcomes of patients with severe traumatic brain injury (STBI). Methods A prospective randomized control trial was carried out from January 2009 to May 2012 in Neurological Intensive Care Unit (NICU). Patients of STBI who met the enrolment criteria (Glasgow Coma Scale score 6~8; Nutritional Risk Screening ?3) were randomly divided into 3 groups and were admi- nistrated EN, PN or EN+PN treatments respectively. The indexes of nutritional status, immune function, complications and clinical outcomes were examined and compared statistically. Results There were 120 patients enrolled in the study, with 40 pationts in each group. In EN+PN group, T lymthocyte subsets CD3+%, CD4+%, ratio of CD3+/CD25+, ratio of CD4+/CD8+, the plasma levels of IgA, IgM, and IgG at 20 days after nutritional treatment were significantly increased compared to the baseline(t=4.32-30.00, P<0.01), and they were significantly higher than those of PN group (t=2.44-14.70; P<0.05,or P<0.01) with exception of CD4+/CD8+, higher than those of EN group (t=2.49-13.31, P<0.05, or P<0.01) with exceptions of CD3+/CD25+, CD4+/CD8+, IgG and IgM. For the nutritional status, the serum total protein, albumin, prealbumin and hemoglobin were significantly higher in the EN (t=5.87-11.91; P<0.01) and EN+PN groups (t=6.12-13.12; P<0.01) than those in PN group after nutrition treatment. The serum prealbumin was higher in EN+PN group than that in EN group (t=2.08; P<0.05). Compared to the PN group, the complication occurrence rates of EN+PN group were significantly lower in stress ulcer (22.5% vs. 47.5%; ?(2)= 8.24, P<0.01), intracranial infection (12.5% vs 32.5%;?(2)= 6.88, P<0.01) and pyemia (25.0% vs. 47.5%; ?(2)= 6.57, P<0.05). Compared to the EN group, the complication occurrence rates of EN+PN group were significantly lower in aspirated pneumonia (27.5% vs. 50.0%; ?(2)= 6.39, P<0.05), hypoproteinemia (17.5% vs. 55.0%; ?(2)= 18.26, P<0.01) and diarrhea (20.0% vs. 60.0%; ?(2)= 20.00, P<0.01). The EN+PN group also had significant less length of stay in NICU (t=2.51, 4.82; P<0.05, P<0.01), number of patients receiving assisted mechanical ventilation (?(2)= 6.08, 12.88; P<0.05, P<0.01) and its durations (t=3.41, 9.08; P<0.05, P<0.01), and the death rate (?(2)=7.50, 16.37; P<0.05, P<0.01) than those of EN or PN group. Conclusion Early EN+PN treatment could promote the recovery of the immune function, enhance nutritional status, decrease complications and improve the clinical outcomes in patients with severe traumatic brain injury.","Ming-Chao, F; Qiao-Ling, W; Wei, F; Yun-Xia, J; Lian-di, L; Peng, S; Zhi-Hong, W",2016.0,,0,0,
7284,"A randomized, placebo-controlled trial of D-cycloserine for the enhancement of social skills training in autism spectrum disorders","ER METHODS: A 10-week, double-blind, placebo-controlled trial of DCS (50 mg) given 30 min prior to weekly group social skills training was conducted at two sites. Children with ASD were randomized to receive 10 weeks (10 doses) of DCS or placebo in a 1:1 ratio.RESULTS: No statistically significant difference attributable to drug treatment was observed in the change scores for the primary outcome measure, the Social Responsiveness Scale (SRS), total score (p?=?0.45), or on secondary outcome measures.CONCLUSIONS: The results of this trial demonstrated no drug-related short-term improvement on the primary outcome measure, or any of the secondary outcome measures. However, an overall significant improvement in SRS total raw score was observed from baseline to end of treatment for the entire group of children with ASD. This suggests a need to further study the efficacy of the social skills training protocol. Limitations to the current study and areas for future research are discussed.TRIAL REGISTRATION: ClinicalTrials.govNCT01086475.BACKGROUND: Researchers have demonstrated that d-cycloserine (DCS) can enhance the effects of behavioral interventions in adults with anxiety and enhances prosocial behavior in animal models of autism spectrum disorders (ASD). This study extended upon this background by combining DCS with behavioral social skills therapy in youth with ASD to assess its impact on the core social deficits of ASD. We hypothesized that DCS used in combination with social skills training would enhance the acquisition of social skills in children with ASD.","Minshawi, N F; Wink, L K; Shaffer, R; Plawecki, M H; Posey, D J; Liu, H; Hurwitz, S; McDougle, C J; Swiezy, N B; Erickson, C A",2016.0,10.1186/s13229-015-0062-8,0,0,
7285,The role of perfectionism in cognitive behaviour therapy outcomes for clinically anxious children,"ER The main aim of this study was to determine whether pre-treatment levels of child perfectionism impacted on anxiety treatment outcomes for school-aged children. In addition, it was investigated whether child perfectionism decreased following treatment for anxiety. Participants were sixty-seven clinically anxious children aged 6-13 years (female = 34; majority Caucasian) who were enrolled in a group-based cognitive behaviour therapy program, and their parents. They completed self-report questionnaires on anxiety and depressive symptoms and were administered a diagnostic interview to determine the type and clinician rated severity of anxiety and related disorders pre- and post-treatment and at 6-month follow-up. Self- and parent-rated perfectionism were also measured pre-treatment, while a subset of children completed perfectionism measures post-treatment as well. Self-Oriented Perfectionism, but not Socially Prescribed Perfectionism, predicted poorer self-reported treatment outcome (higher levels of anxiety symptoms) immediately following treatment and at 6-month follow-up when using a multi-informant approach. Additionally, both Self-Oriented and Socially Prescribed child perfectionism significantly reduced immediately following treatment. Despite reductions in child perfectionism following anxiety treatment, higher Self-Oriented Perfectionism may impact negatively on child anxiety treatment outcome.","Mitchell, J H; Newall, C; Broeren, S; Hudson, J L",2013.0,10.1016/j.brat.2013.05.015,0,0,
7286,The effect of jaw relaxation on pain anxiety during burn dressings: randomised clinical trial,"ER AIM: The purpose of this randomised clinical trial (RCT) was to determine the effect of jaw relaxation on pain anxiety related to dressing changes in burn injuries.INTRODUCTION: Patients hospitalised with burns experience high levels of anticipatory anxiety during dressing changes, which cannot be completely managed by anxiolytic drugs. Nurses as members of the burn care team contribute to pain management by using relaxation techniques as one of the most frequently used approaches to pain anxiety management. However, there is not enough information about the effects of these techniques on pain anxiety of patients with burns. The aim of this study was to determine the effect of jaw relaxation on pain anxiety related to dressing changes in burn injuries.METHODS: It was a randomised clinical trial with a control group. A total of 100 patients hospitalised in Shahid Motahari Burn Centre affiliated with Tehran University of Medical Sciences were recruited by convenience sampling and were randomly assigned to either experimental or control groups using minimisation. With institutional approval and written consent, the experimental group practiced jaw relaxation for 20 min before entering the dressing room. Data were collected by the Burn Specific Pain Anxiety Scale (BSPAS) during July-December 2009 and analysed using Statistical Package for the Social Sciences (SPSS)-PC (17).RESULTS: An independent t-test showed no significant difference between mean pain anxiety scores in the experimental and control group before intervention (p=0.787). A dependent t-test showed significantly less pain anxiety after intervention (before dressing) in the experimental group (p<0.05). Moreover, the independent t-test showed that the post-dressing pain anxiety of the experimental group was less than the control group (p<0.05). However, the dependent t-test showed no significant difference between before and after dressing pain anxiety (after intervention) in the experimental group (p=0.303).CONCLUSION: Nurses can independently decrease the pain anxiety of patients with burns and its subsequent physical and psychological burden by teaching the simple and inexpensive technique of jaw relaxation. Further research is needed to study the effect of this technique on pain anxiety of patients suffering from other painful procedures.","Mohammadi, Fakhar F; Rafii, F; Jamshidi, Orak R",2013.0,10.1016/j.burns.2012.03.005,0,0,
7287,Comparison of Lotrafilcon B and Balafilcon A silicone hydrogel bandage contact lenses in reducing pain and discomfort after photorefractive keratectomy: a contralateral eye study,"ER SETTINGFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.METHODSSixty patients (120 eyes) who had bilateral PRK were enrolled in this double blind clinical trial. Each patient was fitted with a Lotrafilcon B (Air Optix(®)AQUA, Ciba Vision, Duluth, GA, USA) lens in one eye and a Balafilcon A (PureVision? Bausch & Lomb, Rochester, NY, USA) lens in the fellow eye. Patients' responses to a subjective questionnaire in terms of pain, foreign body sensation, photophobia, blurred vision and epiphora were evaluated on the first and third postoperative days.RESULTSMean pain score for Lotrafilcon B and Balafilcon A contact lenses was 4.43±3.18 vs. 5.45±3.37 on the first postoperative day and 3.43±3.23 vs. 3.88±3.01 on the third postoperative day. However, the difference was only significant in the first 24h after surgery (P=0.032). Foreign body sensation was clinically higher with Balafilcon A contact lens (5.0±3.47 vs. 4.08±3.34 on day 1 and 4.98±3.52 vs. 3.55±3.20 on day 3) and the difference was statistically significant on the first and the third postoperative days (P=0.042 and 0.002, respectively). There was no statistically significant difference between two contact lenses in terms of photophobia, epiphora and blurred vision (P>0.05).CONCLUSIONThe Lotrafilcon B lens resulted in significantly less postoperative pain and discomfort after PRK, especially in the first 24h after PRK.PURPOSETo assess the effect of two silicone hydrogel contact lenses with high oxygen permeability in patients having photorefractive keratectomy (PRK).","Mohammadpour, M; Amouzegar, A; Hashemi, H; Jabbarvand, M; Kordbacheh, H; Rahimi, F; Hashemian, M N",2015.0,10.1016/j.clae.2015.01.014,0,0,
7288,Absence of mitral valve prolapse during panic attacks induced by sodium lactate,"ER The recent identification of a new type of anxiety state, panic attack, has drawn attention to common pathways between panic disorder and cardiac somatization, particularly mitral valve collapse. A double-blind study was set up, using doppler-echocardiography during a panic attack induced by sodium lactate infusion. The results showed that there was no relationship between panic attack and mitral valve collapse, and that the lactate infusion-anxiety rate was only 35 percent.","Moigne, E; Pichene, C; Hennequin, L; Hoffman, M; Lambert, H; Larcan, A",1993.0,,0,0,
7289,The effect of hypocapnia on extinction of conditioned fear responses,"ER Conditioning models have been very helpful in the understanding of the etiology and maintenance of anxiety. Such laboratory models, however, leave unexplained why in many cases of naturally occurring anxiety, as in the case of agoraphobia, the fear responses do not extinguish. Literature on experimental anxiety provocation suggests that a systemic alkalosis might play a role in the maintenance of phobic fear. It was hypothesized that a subject in a state of respiratory alkalosis would show delayed extinction to classical conditioned anxiety. In a differential classical conditioning paradigm, consisting of a habituation-, an acquisition-, and an extinction-phase, slides and electric shocks were used as conditioned stimuli (CS) and unconditioned stimuli (US) respectively. The skin conductance response was taken as (U)CR. Subjects were randomly assigned to two groups: hyperventilation or control. It was shown that the extinction was not delayed when subjects were hypocapnic during the extinction. These data support the view that a respiratory alkalosis per se is not a sufficient condition for the maintenance of neurotic fears. The data of the present study are discussed in the context of existing literature on a psychological interpretation of the maintenance of anxiety.","Molen, G M; Hout, M A; Merckelbach, H; Dieren, A C; Griez, E",1989.0,,0,0,
7290,"Serotonergic dysfunction across the eating disorders: relationship to eating behaviour, purging behaviour, nutritional status and general psychopathology","ER METHODSPlasma prolactin response to D-fenfluramine (30 mg p.o.) or placebo was measured in 58 drug-free female volunteers, comprising 15 underweight anorexic women, 18 bulimic women, 10 women with binge-eating disorder and 15 female healthy controls. Behavioural assessment included ratings of eating disorder symptoms, depression, aggression and food-related obsessions and compulsions.RESULTSA significantly decreased prolactin response to D-fenfluramine was found in underweight anorexic women and in bulimics with high frequency bingeing ( > 2 binge episodes/day), but not in patients with binge-eating disorder or in bulimics with low frequency bingeing (< I binge episode/day). In the whole bulimic group, a negative correlation emerged between frequency of bingeing and prolactin response. No significant correlation was found between physical or psychopathological measures and the hormonal response in any group.CONCLUSIONSThese results confirm our previous findings of an impaired serotonergic transmission in underweight anorexics and in bulimics with high frequency bingeing, but not in patients with less severe bulimia nervosa. Moreover, they show, for the first time, that the hypothalamic serotonergic system is not altered in women with binge-eating disorder.BACKGROUNDSeveral recent studies have pointed to a dysfunction of serotonin transmission in patients with eating disorders. Notwithstanding, it is not known whether serotonergic abnormalities are related primarily to eating and/or purging behaviour, nutritional status or general psychopathological dimensions. Therefore, by using a validated neuroendocrine strategy, we investigated central serotonergic function in patients with anorexia nervosa, bulimia nervosa or binge-eating disorder who differ on the above parameters.","Monteleone, P; Brambilla, F; Bortolotti, F; Maj, M",2000.0,,0,0,
7291,Preventing anxiety problems in children with Cool Little Kids Online: study protocol for a randomised controlled trial,"ER METHODS/DESIGN: Parents of young children who are 3-6 years old and who have an inhibited temperament will be recruited (n?=?385) and randomly assigned to either immediate access to Cool Little Kids Online or delayed access after a waiting period of 24 weeks. The online program contains eight modules that help parents address key issues in the development of anxiety problems in inhibited children, including children's avoidant coping styles, overprotective parenting behaviours, and parents' own fears and worries. Intervention participants will be offered clinician support when requested. The primary outcome will be change in parent-reported child anxiety symptoms. Secondary outcomes will be child internalising symptoms, child and family life interference due to anxiety, over-involved/protective parenting, plus child anxiety diagnoses assessed by using a new online diagnostic tool. Assessments will take place at baseline and 12 and 24 weeks after baseline.DISCUSSION: This trial expands upon previous research on the Cool Little Kids parenting group program and will evaluate the efficacy of online delivery. Online delivery of the program could result in an easily accessible evidence-based resource to help families with young children at temperamental risk for anxiety disorders.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry 12615000217505 (registered 5 March 2015).BACKGROUND: Anxiety disorders are the most common type of mental health problem and begin early in life. Early intervention to prevent anxiety problems in young children who are at risk has the potential for long-term impact. The 'Cool Little Kids' parenting group program was previously established to prevent anxiety disorders in young children at risk because of inhibited temperament. This group program was efficacious in two randomised controlled trials and has recently been adapted into an online format. 'Cool Little Kids Online' was developed to widen and facilitate access to the group program's preventive content. A pilot evaluation of the online program demonstrated its perceived utility and acceptability among parents. This study aims to evaluate the efficacy of Cool Little Kids Online in a large randomised controlled trial.","Morgan, A J; Rapee, R M; Tamir, E; Goharpey, N; Salim, A; McLellan, L F; Bayer, J K",2015.0,10.1186/s13063-015-1022-5,0,0,
7292,Yohimbine facilitated acoustic startle in combat veterans with post-traumatic stress disorder,"ER Preclinical and clinical studies have suggested that the acoustic startle reflex (ASR) is a useful model to investigate the neurochemical basis of anxiety and fear states. This work has revealed that the anxiogenic alpha-2 receptor antagonist, yohimbine, increases the amplitude of the ASR in laboratory animals and in healthy human controls. Because of the growing body of data that support the hypothesis that severe stress results in substantial alterations in noradrenergic neuronal reactivity, the present investigation evaluated the effects of yohimbine on the ASR of 18 patients with PTSD and 11 healthy combat controls. Subjects received IV yohimbine (0.4 mg/kg) or saline placebo on 2 separate days in a randomized double blind placebo control design. A trial of two tone frequencies with varied intensity (90, 96, 102, 108, 114 dB) white noise and instantaneous rise time, was delivered binaurally through headphones. Tones were delivered every 25-60 s, for a 40-ms duration. Startle testing was performed 80 min post-infusion and lasted 15-20 min. Yohimbine significantly increased the amplitude, magnitude and probability of the ASR in combat veterans with PTSD, but did not do so in combat controls. Overall startle was significantly larger in the PTSD subjects; however, this did not account for the differential effect of yohimbine, since yohimbine had no significant effect in the control group. This study demonstrates an excitatory effect of yohimbine on the amplitude, magnitude and probability of the ASR in PTSD patients that is not seen in combat controls.(ABSTRACT TRUNCATED AT 250 WORDS)","Morgan, C A; Grillon, C; Southwick, S M; Nagy, L M; Davis, M; Krystal, J H; Charney, D S",1995.0,,0,0,
7293,Home videoconferencing for patients with severe congential heart disease following discharge,"ER OBJECTIVEThis study aimed to assess the benefits of home monitoring by videoconferencing compared with contacting by telephone only, in terms of decreasing anxiety levels and clinical monitoring in the postdischarge period.METHODSWe performed a prospective, controlled study of children with a recent diagnosis of severe CHD and those recovering from palliative or corrective surgery for severe CHD. We used standardized anxiety scores to assess anxiety after discharge in families followed up by home videoconferencing or telephone calls and assessed the clinical information available through videoconferencing or telephone calls by structured questionnaires.RESULTSVideoconferencing decreased anxiety levels compared with telephone calls (P < .05). Improved clinical information was available in the videoconferencing group, resulting in more appropriate and timely hospital attendance.CONCLUSIONVideoconferencing is acceptable to parents and physicians and provides a more effective form of follow-up in terms of clinical observation and parental anxiety levels.BACKGROUNDCentralization of pediatric cardiology services into a small number of tertiary centers and the particular stress that accompanies diagnosis and surgical management of severe congenital heart disease (CHD) renders psychological support for families and clinical monitoring of patients following discharge increasingly important. Telemedicine has an increasing role in clinical and academic medicine. Improvements in quality and reliability of videoconferencing systems have allowed this to become a useful diagnostic tool.","Morgan, G J; Craig, B; Grant, B; Sands, A; Doherty, N; Casey, F",2008.0,10.1111/j.1747-0803.2008.00205.x,0,0,
7294,Indirect effects of 12-session seeking safety on substance use outcomes: overall and attendance class-specific effects,"ER OBJECTIVES: This study examined in- and post-treatment mediation effects of a 12-session dose of Seeking Safety (SS)-an integrative cognitive behavioral treatment for comorbid PTSD and SUDs-on alcohol and cocaine outcomes in comparison to Women's Health Education (WHE) in a seven-site randomized controlled effectiveness trial.METHODS: Women (n?=?353) enrolled in outpatient substance abuse treatment, who had experienced multiple traumas in childhood and/or adulthood and who had comorbid PTSD, were randomly assigned to receive SS or WHE delivered in open enrollment groups for 12 sessions in 6 weeks (unlike the full 25-topic SS protocol). Data were analyzed under two forms of longitudinal mediation analysis, each accounting for changes over time in group membership and group context, respectively.RESULTS: Women in SS, compared to WHE, showed significantly steeper decreases in PTSD frequency and severity, which in turn, showed significant impact in reducing both cocaine and alcohol use. This pattern was strongest for those who completed most of the treatment sessions, which was the majority of patients in the trial; these patterns only emerged during the in-treatment phase.CONCLUSIONS: Use of an integrated approach to PTSD/SUD such as SS can be helpful to more rapidly reduce PTSD, which consequently reduce SUD symptoms, particularly for those who attend most of the available treatment sessions.SCIENTIFIC SIGNIFICANCE: This is one of the first studies to illustrate such effects in treating comorbid PTSD and SUD in the context of a highly impaired population delivered by community-based providers. (Am J Addict 2014;23:218-225).","Morgan-Lopez, A A; Saavedra, L M; Hien, D A; Campbell, A N; Wu, E; Ruglass, L; Patock-Peckham, J A; Bainter, S C",2014.0,10.1111/j.1521-0391.2014.12100.x,0,0,
7295,Impact of chronic musculoskeletal pathology on older adults: a study of differences between knee OA and low back pain,"ER DESIGNSecondary data analysis.METHOD AND PATIENTSEighty-eight older adults with advanced knee OA and 200 with CLBP who had participated in separate randomized controlled trials were selected for this study.MEASURESInclusion criteria for both trials included age > or =65 and pain of at least moderate intensity that occurred daily or almost every day for at least the previous 3 months. Psychological constructs (catastrophizing, fear avoidance, self-efficacy, depression, affective distress) and physical measures (comorbid medical conditions, pain duration, pain severity, pain related interference, self-rated health) were obtained.RESULTSSubjects with CLBP had slower gait (0.88 m/s vs 0.96 m/s, P = 0.002) and more comorbid conditions than subjects with knee pain (mean 3.36 vs 1.97, P < 0.001). All the psychological measures were significantly worse in the CLBP group except the Multidimensional Pain Inventory-Affective Distress score. Self-efficacy, pain severity, and medical comorbidity burden were associated with slower gait regardless of the location of the pain.CONCLUSIONSOlder adults with chronic pain may have distinct psychological and physical profiles that differentially impact gait speed. These findings suggest that not all pain conditions are the same in their psychological and physical characteristics and may need to be taken into consideration when developing treatment plans.OBJECTIVESThe study aimed to compare the psychological and physical characteristics of older adults with knee osteoarthritis (OA) vs those of adults with chronic low back pain (CLBP) and to identify psychological and physical predictors of function as measured by gait speed.","Morone, N E; Karp, J F; Lynch, C S; Bost, J E; Khoudary, S R; Weiner, D K",2009.0,10.1111/j.1526-4637.2009.00565.x,0,0,
7296,Emotional reasoning and parent-based reasoning in normal children,"ER A previous study by Muris, Merckelbach, and Van Spauwen demonstrated that children display emotional reasoning irrespective of their anxiety levels. That is, when estimating whether a situation is dangerous, children not only rely on objective danger information but also on their own anxiety-response. The present study further examined emotional reasoning in children aged 7-13 years (N = 508). In addition, it was investigated whether children also show parent-based reasoning, which can be defined as the tendency to rely on anxiety-responses that can be observed in parents. Children completed self-report questionnaires of anxiety, depression, and emotional and parent-based reasoning. Evidence was found for both emotional and parent-based reasoning effects. More specifically, children's danger ratings were not only affected by objective danger information, but also by anxiety-response information in both objective danger and safety stories. High levels of anxiety and depression were significantly associated with the tendency to rely on anxiety-response information, but only in the case of safety scripts.","Morren, M; Muris, P; Kindt, M",2004.0,,0,0,
7297,"Effect of cardiopulmonary resuscitation training for parents of high-risk neonates on perceived anxiety, control, and burden","ER STUDY OBJECTIVES(1) To compare the effects of 3 methods of cardiopulmonary resuscitation (CPR) training for parents of infants at risk for cardiac or respiratory arrest on anxiety, perception of control, and sense of burden; and (2) to identify parents' attitudes about CPR training and willingness to perform CPR if needed.METHODSA longitudinal, controlled trial was conducted with parents and other caretakers of high-risk infants. Subjects were recruited from 5 level III neonatal intensive care units. We enrolled each of 578 subjects in 1 of 4 groups: (1) CPR-Video; (2) CPR-Didactic; (3) CPR-Social Support; or (4) control (no CPR training). Of these, 335 completed the entire study. Data were collected at baseline, and 2 weeks and 6 months after CPR training. The main outcomes measured were perceived anxiety, control, and burden related to caring for a high-risk infant and attitudes about responding to an emergency.RESULTSSubjects reported moderately high anxiety, sense of burden, and feelings of loss of control before CPR training. Within groups, subjects in all 3 treatment groups reported improvement in perceptions of anxiety, control, and burden 2 weeks after CPR training, with continued improvement evident 6 months after CPR training (P =.001). In contrast, perceptions were unchanged in the control group. Among groups, at 2 weeks there were significant differences in means between control and CPR-Didactic groups (P =.01), and at 6 months there were significant differences in means between control and CPR-Didactic groups (P =.01) and between control and CPR-Social Support groups (P =.01).CONCLUSIONCPR training is an important intervention for promoting a sense of control and reducing the anxiety and sense of burden experienced by parents of neonates at risk for cardiopulmonary arrest.OBJECTIVES","Moser, D K; Dracup, K; Doering, L V",1999.0,10.1053/hl.1999.v28.a101053,0,0,
7298,The impact on anxiety and perceived control of a short one-on-one nursing intervention designed to decrease treatment seeking delay in people with coronary heart disease,"ER BACKGROUND: Patient delay in seeking treatment for acute coronary syndrome symptoms remains a problem. Thus, it is vital to test interventions to improve this behavior, but at the same time it is essential that interventions not increase anxiety.PURPOSE: To determine the impact on anxiety and perceived control of an individual face-to-face education and counseling intervention designed to decrease patient delay in seeking treatment for acute coronary syndrome symptoms.METHODS: This was a multicenter randomized controlled trial of the intervention in which anxiety data were collected at baseline, 3-months and 12-months. A total of 3522 patients with confirmed coronary artery disease were enrolled; data from 2597 patients with anxiety data at all time points are included. The intervention was a 45 min education and counseling session, in which the social, cognitive and emotional responses to acute coronary syndrome symptoms were discussed as were barriers to early treatment seeking. Repeated measures analysis of covariance was used to compare anxiety and perceived control levels across time between the groups controlling for age, gender, ethnicity, education level, and comorbidities.RESULTS: There were significant differences in anxiety by group (p = 0.03). Anxiety level was stable in patients in the control group, but decreased across time in the intervention group. Perceived control increased across time in the intervention group and remained unchanged in the control group (p = 0.01).CONCLUSION: Interventions in which cardiac patients directly confront the possibility of an acute cardiac event do not cause anxiety if they provide patients with appropriate strategies for managing symptoms.","Moser, D K; McKinley, S; Riegel, B; Doering, L V; Meischke, H; Pelter, M; Davidson, P; Baker, H; Dracup, K",2012.0,10.1016/j.ejcnurse.2010.11.003,0,0,
7299,The effectiveness of a group-based acceptance and commitment additive therapy on rehabilitation of female outpatients with chronic headache: preliminary findings reducing 3 dimensions of headache impact,"ER OBJECTIVE: Examine whether acceptance and commitment additive therapy is effective in reducing the experience of sensory pain, disability, and affective distress because of chronic headache in a sample of outpatient Iranian females.BACKGROUND: Chronic headaches have a striking impact on sufferers in terms of pain, disability, and affective distress. Although several Acceptance and Commitment Therapy outcome studies for chronic pain have been conducted, their findings cannot be completely generalized to chronic headaches because headache-related treatment outcome studies have a different emphasis in both provision and outcomes. Moreover, the possible role of Iranian social and cultural contexts and of gender-consistent issues involved in Acceptance and Commitment Therapy outcomes deserve consideration.METHODS: This study used a randomized pretest-post-test control group design. The sample was selected from consecutive female outpatients with chronic headache, attending and/or referred to a headache clinic in a governmental hospital from April 2011 to June 2011. In total, 80 female outpatients were interviewed, and after implementing inclusion/exclusion criteria, thirty females were considered eligible to participate in the study. Half (n = 15) were randomly selected to participate in the treatment group. Four participants of this group failed to complete the treatment sessions (n = 11). The Acceptance and Commitment Therapy group received the medical treatment as usual and 8 sessions of Acceptance and Commitment Therapy. The other half (n = 15) served as the control group that received only medical treatment as usual. The short form of McGill pain questionnaire, the migraine disability assessment scale, and the trait subscale of the state-trait anxiety inventory were administered, which operationalized 3 dimensions of impact of chronic headache, sensory pain, disability, and emotional distress, respectively, to explore the impact of recurrent headache episodes. Pretest and post-test measures on these 3 dimensions of impact were the primary outcome measures of this study. Analyses of covariance with the pretreatment score used as a covariate were conducted on pain intensity, degree of disability, and level of affective distress before and after therapy to assess therapeutic intervention effectiveness.RESULTS: Chronic tension type of headache (63%) and chronic migraine without aura (37%) were the headache types reported by the participants. Data analyses indicated the significant reduction in disability (F[1,29] = 33.72, P < .0001) and affective distress (F[1,29] = 28.27, P < .0001), but not in reported sensory aspect of pain (F[1,29] = .81, P = .574), in the treatment group in comparison with the control group.CONCLUSIONS: The effectiveness of a brief acceptance and commitment additive therapy in the treatment of Iranian outpatient females with chronic headache represents a significant scientific finding and clinical progress, as it implies that this kind of treatment can be effectively delivered in a hospital setting.","Mo'tamedi, H; Rezaiemaram, P; Tavallaie, A",2012.0,10.1111/j.1526-4610.2012.02192.x,0,0,
7300,Observation on therapeutic effect of auricular acupuncture combined with body acupuncture for treatment of cardiac neurosis,"ER METHODSSeventy-two cases were randomly divided into an acupuncture group and a medication group, 36 cases in each group. The acupuncture group were treated with auricular acupuncture combined with body acupuncture, with auricular points Shenmen, Jiaogan (sympathesis), Xin (heart), etc. and body points Xinshu (BL 15), Shenmen (HT 7), Neiguan (PC 6), etc. selected; the medication group were treated with oral administration of Betaloc and Oryzanol. Their therapeutic effects were compared after treatment for 2 months.RESULTSThe cured rate was 77.8% in the acupuncture group and 52.8% in the medication group with very significant differences (P < 0.01), the former being better than the latter.CONCLUSIONAuricular acupuncture combined with body acupuncture is the best method for treatment of cardiac neurosis.OBJECTIVETo find an effective therapy for cardiac neurosis.","Mu, G M; Lu, Y Y",2008.0,,0,0,
7301,Cognitive-behavioral and experiential group psychotherapy for HIV-infected homosexual men: a comparative study,"ER The knowledge of being infected with the human immunodeficiency virus type 1 (HIV-1) brings about psychological distress and social problems including anxiety, depression, and social isolation. Participating in psychosocial intervention programs can help to reduce these problems. To date, however, very little is known about the efficacy of different intervention strategies. We implemented a study with a randomized experimental design to investigate the effectiveness of a cognitive-behavioral group psychotherapy (CBT) and an experiential group psychotherapy (ET) program for 39 asymptomatic HIV-infected homosexual men. Both therapies consisted of 17 sessions over a 15-week period. The major finding of this study was that psychosocial intervention, independent of the therapeutic orientation, decreased distress significantly, as compared with a waiting-list control group (WCG). There were no significant changes in the intervention groups as compared with the WCG in coping styles, social support, and emotional expression. Finally, CBT and ET did not differ in their effects on psychological distress or on the other psychosocial variables measured in this study.","Mulder, C L; Emmelkamp, P M; Antoni, M H; Mulder, J W; Sandfort, T G; Vries, M J",1994.0,,0,0,
7302,Fear of blushing: effects of task concentration training versus exposure in vivo on fear and physiology,"ER Patients with fear of blushing as the predominant complaint (N = 31) were randomly assigned to (1) exposure in vivo (EXP), or (2) task concentration training (TCT), in order to test the effect of redirecting attention above exposure only. In addition, it was investigated whether treatment reduced actual blush behavior; therefore, physiological parameters of blushing were measured during two behavioral tests. Half of the patients served as waiting-list controls first. Assessments were held before and after treatment, at 6-weeks, and at 1-year follow-up. Both treatments appeared to be effective in reducing fear of blushing and realizing cognitive change. Yet, at posttest, TCT tended to produce better results with respect to fear of blushing. At 6-weeks follow-up, TCT produced significantly more cognitive change. At 1-year follow-up, patients further improved, while differential effects had disappeared. The reduction in fear of blushing was not paralleled by a reduction in actual blush behavior during the behavioral assessments. Thus, it seems that fear of blushing reflects a fearful preoccupation, irrespective of actual facial coloration.","Mulken, S; Bögels, S M; Jong, P J; Louwers, J",2001.0,,0,0,
7303,"Mechanical massage and mental training programmes affect employees' anxiety, stress susceptibility and detachment-a randomised explorative pilot study","ER METHODS: Employees from four different workplaces were randomly assigned to one of the following groups: i) Massage and mental training (sitting in the armchair and receiving mechanical massage while listening to the mental training programmes, n=19), ii) Massage (sitting in the armchair and receiving mechanical massage only, n=19), iii) Mental training (sitting in the armchair and listening to the mental training programmes only, n=19), iv) Pause (sitting in the armchair but not receiving mechanical massage or listening to the mental training programmes, n=19), v) Control (not sitting in the armchair at all, n=17). In order to discover how the employees felt about their own health they were asked to respond to statements from the ""Swedish Scale of Personality"" (SSP), immediately before the randomisation, after four weeks and after eight weeks (end-of-study).RESULTS: There were no significant differences between the five study groups for any of the traits studied (""Somatic Trait Anxiety"", ""Psychic Trait Anxiety"", ""Stress Susceptibility"", ""Detachment"" and ""Social Desirability"") at any of the occasions. However, the massage group showed a significant decrease in the subscale ""Somatic Trait Anxiety"" (p=0.032), during the entire study period. Significant decreases in the same subscale were also observed in the pause group between start and week eight (p=0.040) as well as between week four and week eight (p=0.049) and also in the control group between the second and third data collection (p=0.014). The massage and mental training group showed a significant decrease in ""Stress Susceptibility"" between week four and week eight (p=0.022). The pause group showed a significant increase in the subscale ""Detachment"" (p=0.044).CONCLUSIONS: There were no significant differences between the five study groups for any of the traits studied. However, when looking at each individual group separately, positive effects in their levels of ""Anxiety"", ""Stress Susceptibility"" and ""Detachment"" could be seen. Although the results from this pilot study indicate some positive effects, mechanical chair massage and mental training programmes used in order to increase employee's ability to recover, needs to be evaluated further as tools to increase the employees ability to recover.AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY: ACTRN12615000020583 , Date of registration: 15/01/2015.BACKGROUND: Working people's reduced ability to recover has been proposed as a key factor behind the increase in stress-related health problems. One not yet evidence-based preventive method designed to help employees keep healthy and be less stressed is an armchair with built-in mechanical massage and mental training programmes, This study aimed to evaluate possible effects on employees' experience of levels of ""Anxiety"", ""Stress Susceptibility"", ""Detachment"" and ""Social Desirability"" when using mechanical massage and mental training programmes, both separately and in combination, during working hours.","Muller, J; Handlin, L; Harlén, M; Lindmark, U; Ekström, A",2015.0,10.1186/s12906-015-0753-x,0,0,
7304,Treatment of Tourette's syndrome with Delta 9-tetrahydrocannabinol (THC): a randomized crossover trial,"ER Anecdotal reports in Tourette's syndrome (TS) have suggested that marijuana (cannabis sativa) and delta-9-tetrahydrocannabinol (Delta(9)-THC), the major psychoactive ingredient of marijuana, reduce tics and associated behavioral disorders. We performed a randomized double-blind placebo-controlled crossover single-dose trial of Delta(9)-THC (5.0, 7.5 or 10.0 mg) in 12 adult TS patients. Tic severity was assessed using a self-rating scale (Tourette's syndrome Symptom List, TSSL) and examiner ratings (Shapiro Tourette's syndrome Severity Scale, Yale Global Tic Severity Scale, Tourette's syndrome Global Scale). Using the TSSL, patients also rated the severity of associated behavioral disorders. Clinical changes were correlated to maximum plasma levels of THC and its metabolites 11-hydroxy-Delta(9)-tetrahydrocannabinol (11-OH-THC) and 11-nor-Delta(9)-tetrahydrocannabinol-9-carboxylic acid (THC-COOH). Using the TSSL, there was a significant improvement of tics (p=0.015) and obsessive-compulsive behavior (OCB) (p = 0.041) after treatment with Delta(9)-THC compared to placebo. Examiner ratings demonstrated a significant difference for the subscore ""complex motor tics"" (p = 0.015) and a trend towards a significant improvement for the subscores ""motor tics"" (p = 0.065), ""simple motor tics"" (p = 0.093), and ""vocal tics"" (p = 0.093). No serious adverse reactions occurred. Five patients experienced mild, transient side effects. There was a significant correlation between tic improvement and maximum 11-OH-THC plasma concentration. Results obtained from this pilot study suggest that a single-dose treatment with Delta(9)-THC is effective and safe in treating tics and OCB in TS. It can be speculated that clinical effects may be caused by 11-OH-THC. A more long-term study is required to confirm these results.","Müller-Vahl, K R; Schneider, U; Koblenz, A; Jöbges, M; Kolbe, H; Daldrup, T; Emrich, H M",2002.0,10.1055/s-2002-25028,0,0,
7305,Selective processing of threat-related cues in day surgery patients and prediction of post-operative pain,"ER METHODSForty-seven women admitted for minor gynaecological surgical procedures completed a selective processing task (modified Stroop) and the State-Trait Anxiety Inventory immediately prior to surgery. Following surgery they completed the McGill Short-Form Pain Questionnaire. Intraoperative analgesia consumption was also recorded.RESULTSParticipants demonstrated significantly slower colour-naming times for physical threat cues than control cues. This was not due to an emotionality effect, as colour-naming times for neutral and positive cues were not significantly different. This bias was congruent with the participants' current concerns, as colour-naming times were significantly slower for physical threat words than for social threat words. This index of selective processing bias significantly predicted post-operative pain independently of self-reported state and trait anxiety.CONCLUSIONSThe advantages of measures of psychological constructs that are not reliant on self-reporting are discussed.OBJECTIVETo investigate the use of a measure of selective processing bias associated with anxiety as a predictor of post-operative pain independently of self-report measures of anxiety.","Munafò, M R; Stevenson, J",2003.0,10.1348/135910703770238293,0,0,
7306,Quality of life and symptoms in patients with chronic depression and anxiety after a self-management training: a randomised controlled trial,"ER AIMTo evaluate the effects that the program 'Rehabilitation through self-management' had on the life and symptoms of patients who had received this programme for six months in an outpatient mental health care setting.METHODAs part of a randomised controlled trial, patients were assigned to receive the programme (intervention group) or care as usual (control group). After six months we evaluated the change in the quality of life (World Health Organisation Quality of Life assessment, Brief version (WHOQOL-BREF)) and the change in anxiety symptoms (Beck Anxiety Inventory (BAI)) and depressive symptoms (Patient Health Questionnaire (PHQ-9)) using linear mixed models analysis.RESULTSWe included 141 patients from 12 participating mental health care institutions. We found no significant difference between the quality of life or symptoms of patients in the intervention group and those in the control groups. Differences in change scores on the WHOQOL-BREF, BAI and PHQ-9 were 0.74 (p=0.63), 0.39 (p=0.81) and -0.07 (p=0.95) respectively. Higher scores on the BAI and PHQ-9 had a negative influence on the effect of the intervention.CONCLUSIONAfter six months the programme had no significant effect on patients' quality of life or symptoms. These results reflect the chronicity of symptoms and the relation between symptoms and the quality of life in this patient population.BACKGROUNDEvidence-based interventions aimed at patient rehabilitation are not readily available in outpatient mental health care for patients with chronic anxiety and/or depression.","Muntingh, A; Laheij, M; Sinnema, H; Zoun, M; Balkom, A; Schene, A; Spijker, J",2016.0,,0,0,
7307,The revised version of the Screen for Child Anxiety Related Emotional Disorders (SCARED-R): treatment sensitivity in an early intervention trial for childhood anxiety disorders,"ER METHODSThirty-six children (aged 8-13 years) who fulfilled the criteria for generalized anxiety disorder, separation anxiety disorder, and/or social phobia received either group or individual cognitive-behavioural treatment. Children completed the SCARED-R and a traditional measure of childhood anxiety, the State-Trait Anxiety Inventory for Children (STAIC), at three points in time: (1) 6 months before treatment (i.e. baseline), (2) pre-treatment, and (3) post-treatment.RESULTSResults showed that children's SCARED-R and STAIC scores did not change from baseline to pre-treatment, but significantly declined from pre-treatment to post-treatment. An additional finding of the present study was that group and individual CBT were equally effective in reducing children's anxiety symptoms.CONCLUSIONSIt can be concluded that the SCARED-R reliably taps treatment effects and thus should be regarded as a useful self-report index of childhood anxiety in clinical and research settings. Furthermore, the data support the notion that CBT should be generally regarded as an efficacious intervention for anxiety disordered children.OBJECTIVESThe revised version of the Screen for Childhood Anxiety Related Emotional Disorders (SCARED-R) is a recently developed self-report questionnaire for measuring DSM-IV defined anxiety disorder symptoms in children. The current study examined the treatment sensitivity of the SCARED-R.","Muris, P; Mayer, B; Bartelds, E; Tierney, S; Bogie, N",2001.0,,0,0,
7308,Treating phobic children: effects of EMDR versus exposure,"ER This study examined the efficacy of eye movement desensitization and reprocessing (EMDR) and exposure in the treatment of a specific phobia. Twenty-six spider phobic children were treated during 2 treatment phases. During the first phase, which lasted 2.5 hr, children were randomly assigned to either (a) an EMDR group (n = 9), (b) an exposure in vivo group (n = 9), or (c) a computerized exposure (control) group (n = 8). During the 2nd phase, all groups received a 1.5-hr session of exposure in vivo. Therapy outcome measures (i.e., self-reported fear and behavioral avoidance) were obtained before treatment, after Treatment Phase 1, and after Treatment Phase 2. Results showed that the 2.5-hr exposure in vivo session produced significant improvement on all outcome measures. In contrast, EMDR yielded a significant improvement on only self-reported spider fear. Computerized exposure produced nonsignificant improvement. Furthermore, no evidence was found to suggest that EMDR potentiates the efficacy of a subsequent exposure in vivo treatment. Exposure in vivo remains the treatment of choice for childhood spider phobia.","Muris, P; Merckelbach, H; Holdrinet, I; Sijsenaar, M",1998.0,,0,0,
7309,Are poor health behaviours in anxious and depressed cardiac patients explained by sociodemographic factors?,"ER INTRODUCTION: While there is evidence of poor health behaviours in anxious and depressed cardiac patients, it is possible that sociodemographic factors explain these associations. Few previous studies have adequately controlled for confounders. The present study investigated health behaviours in anxious and depressed cardiac patients, while accounting for sociodemographic confounders.METHOD: A consecutive sample of 275 patients admitted to hospital after acute myocardial infarction (32%) or for coronary bypass surgery (40%) or percutaneous coronary intervention (28%) was interviewed six weeks after hospital discharge. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Smoking, physical activity, alcohol intake and dietary fat intake were assessed by self-report. Backward stepwise logistic regression was used to identify the factors independently associated with anxiety and depression.RESULTS: In total, 41 patients (15.2%) were 'depressed' (HADS-D ?8) while 68 (25.2%) were 'anxious' (HADS-A ?8). Depressed patients reported higher rates of smoking (?2)=?4.47, p?=?0.034), lower physical activity (F?=?8.63, p?<?0.004) and higher dietary fat intake (F?=?7.22, p?=?0.008) than non-depressed patients. Anxious patients reported higher smoking rates (?2)=?5.70, p?=?0.024) and dietary fat intake (F?=?7.71, p?=?0.006) than non-anxious patients. In multivariate analyses, an association with depression was retained for both diet and physical activity, and an association with anxiety was retained for diet. Low social support and younger age were significant confounders with depression and anxiety respectively.CONCLUSIONS: While the high smoking rates evidenced in anxious and depressed patients were explained by sociodemographic factors, their poor diet and low physical activity (depressed patients only) were independent of these factors. Given the impact of lifestyle modification on survival after a cardiac event, anxious and depressed patients should be a priority for cardiac rehabilitation and other secondary prevention programmes.","Murphy, B M; Grande, M R; Navaratnam, H S; Higgins, R O; Elliott, P C; Turner, A; Rogerson, M C; Worcester, M U; Goble, A J",2013.0,10.1177/2047487312449593,0,0,
7310,"The role of self-directed in vivo exposure in combination with cognitive therapy, relaxation training, or therapist-assisted exposure in the treatment of panic disorder with agoraphobia","ER The effects of self-directed in vivo exposure in the treatment of panic disorder with agoraphobia were examined. Seventy-four chronic and severe agoraphobic subjects were randomly assigned to Cognitive Therapy plus graded exposure. Relaxation Training plus graded exposure, or therapist-assisted graded exposure alone. Treatment consisted of 16 weekly 2.5-hour sessions. All subjects received programmed practice instructions for engaging in self-directed exposure as a concomitant strategy to their primary treatment. All subjects were instructed to keep systematic behavioral diary recordings of all self-directed exposure practice. The diary data were analyzed across and within treatments and assessment phases. Statistically significant findings were obtained across all diary measure domains with powerful repeated measures effects observed across all treatments. Significant between group effects and treatment x repeated measures interactions were obtained across the diary measure domains. Multiple linear regressions of in vivo anxiety levels and, to a lesser extent, frequency of self-directed exposure practice were found to be significantly associated with global assessment of severity at posttreatment and 3-month follow-up assessments. Furthermore, depression and marital satisfaction were significantly associated with in vivo anxiety. These and other findings are discussed with regard to their conceptual and clinical implications.","Murphy, M T; Michelson, L K; Marchione, K; Marchione, N; Testa, S",1998.0,,0,0,
7311,"A bereavement intervention for parents following the sudden, violent deaths of their 12-28-year-old children: description and applications to clinical practice","ER This report describes a randomized clinical trial with a longitudinal design involving parents bereaved by the violent deaths of their 12-28-year-old children, with a view to applying selected components of the study to clinical practice. Parents of children who died in the previous two to seven months by accident, homicide, or suicide were identified through the death certificates of the children. Of the 261 parents recruited and randomized to intervention and control conditions, 171 were mothers and 90 were fathers. Among the most important findings were: gender differences in both baseline distress and treatment response; and a very slow rate of reduction in distress over time, irrespective of participation in the intervention. Regardless of study group assignment and measurement period, mothers reported higher mental distress, more evidence of trauma, poorer loss accommodation, poorer physical health, and less marital satisfaction than did fathers. Among mothers, 85% met mental distress caseness criteria at baseline (2 to 7 months post-death), 81% met the criteria immediately following the treatment (5 to 10 months post-death), and 67% met the criteria six months later (11 to 16 months post-death). For fathers, 63% met mental distress caseness criteria at baseline, 71% met the criteria immediately post-treatment, and 69% met criteria six months later. Recommendations concern program planning, recruiting and retaining participants, screening and orientation of participants, program format, and evaluation.","Murphy, S A",1997.0,,0,0,
7312,"Effectiveness of Trauma-Focused Cognitive Behavioral Therapy Among Trauma-Affected Children in Lusaka, Zambia: A Randomized Clinical Trial","ER IMPORTANCE: Orphans and vulnerable children (OVC) are at high risk for experiencing trauma and related psychosocial problems. Despite this, no randomized clinical trials have studied evidence-based treatments for OVC in low-resource settings. OBJECTIVE: To evaluate the effectiveness of lay counselor-provided trauma-focused cognitive behavioral therapy (TF-CBT) to address trauma and stress-related symptoms among OVC in Lusaka, Zambia. DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial compared TF-CBT and treatment as usual (TAU) (varying by site) for children recruited from August 1, 2012, through July 31, 2013, and treated until December 31, 2013, for trauma-related symptoms from 5 community sites within Lusaka, Zambia. Children were aged 5 through 18 years and had experienced at least one traumatic event and reported significant trauma-related symptoms. Analysis was with intent to treat. INTERVENTIONS: The intervention group received 10 to 16 sessions of TF-CBT (n = 131). The TAU group (n = 126) received usual community services offered to OVC. MAIN OUTCOMES AND MEASURES: The primary outcome was mean item change in trauma and stress-related symptoms using a locally validated version of the UCLA Posttraumatic Stress Disorder Reaction Index (range, 0-4) and functional impairment using a locally developed measure (range, 0-4). Outcomes were measured at baseline and within 1 month after treatment completion or after a waiting period of approximately 4.5 months after baseline for TAU. RESULTS: At follow-up, the mean item change in trauma symptom score was -1.54 (95% CI, -1.81 to -1.27), a reduction of 81.9%, for the TF-CBT group and -0.37 (95% CI, -0.57 to -0.17), a reduction of 21.1%, for the TAU group. The mean item change for functioning was -0.76 (95% CI, -0.98 to -0.54), a reduction of 89.4%, and -0.54 (95% CI, -0.80 to -0.29), a reduction of 68.3%, for the TF-CBT and TAU groups, respectively. The difference in change between groups was statistically significant for both outcomes (P < .001). The effect size (Cohen d) was 2.39 for trauma symptoms and 0.34 for functioning. Lay counselors participated in supervision and assessed whether the intervention was provided with fidelity in all 5 community settings. CONCLUSIONS AND RELEVANCE: The TF-CBT adapted for Zambia substantially decreased trauma and stress-related symptoms and produced a smaller improvement in functional impairment among OVC having experienced high levels of trauma. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01624298.","Murray, L K; Skavenski, S; Kane, J C; Mayeya, J; Dorsey, S; Cohen, J A; Michalopoulos, L T; Imasiku, M; Bolton, P A",2015.0,10.1001/jamapediatrics.2015.0580,0,0,
7313,Brief culturally adapted CBT (CaCBT) for depression: a randomized controlled trial from Pakistan,"ER Objectives: To determine the efficacy of brief Culturally adapted CBT (CaCBT) for depression when added to Treatment As usual (TAU) - delivered by trained therapists using a manual compared with alone TAU. Methods: This was an assessor-blinded, randomised controlled clinical trial. Particpants with a diagnosis of depression, attending psychiatry departments of three teaching hospitals in Lahore, Pakistan, were included in the study. We screened a total of 280 patients and randomly allocated 137 of them to CaCBT plus Treatment As Usual (TAU) [Treatment group] or to TAU alone [Control group]. Assessments were completed at baseline, at 3 months and at 9 months after baseline. Reduction in depression score (Hospital Anxiety and Depression-Depression Subscale) at 3 months was primary outcome measure. The secondary outcome measures included anxiety scores (Hospital Anxiety and Depression-Anxiety Subscale), somatic symptoms (Bradford Somatic Inventory), disability (Brief Disability Questionnaire) and satisfaction with the treatment. Findings: A total of 69 participants were randomised to Treatment group and 68 to Control group. Participants in Treatment group showed statistically significant improvement in depression (p=0.000), anxiety (p=0.000), somatic symptoms (p=0.005) and disability (p=0.000). This effect was sustained at 9 months after baseline (Except for disability). Participants in Treatment group also reported higher satisfaction with treatment compared with those in Control group. Conclusion: Brief CaCBT can be effective in improving depressive symptoms, when compared with treatment as usual. This is the first report of a trial of Culturally adapted CBT from South Asia and further studies are needed to generalise these findings.","Naeem, F; Gul, M; Irfan, M; Munshi, T; Asif, A; Rashid, S; Khan, M N; Ghani, S; Malik, A; Aslam, M; Farooq, S; Husain, N; Ayub, M",2015.0,10.1016/j.jad.2015.02.012,0,0,
7314,Efficacy of nursing interventions in reducing social and occupational disabilities among patients with neurosis,"ER Individuals suffering from neurosis suffer from social and occupational disabilities similar to that of psychoses. Though understanding of disabilities in neurosis is essential in management of the clients, the relevant interventional studies are very limited. The present study attempted to evaluate the effect of nursing interventions in reducing social and occupational disabilities in neurotic patients. Sixty neurotic patients diagnosed as per ICD 9 criteria were randomly assigned to experimental and control groups followed by pre-assessment by Groningen social disability schedule. Of the 10 sessions of nursing intervention, 3 were individual sessions with clients, 5 with clients and family members and 2 with small group of clients with similar problems; nursing intervention group and non-nursing intervention group received the routine drug treatment at rural community mental health centre, NIMHANS, Bengaluru. The post-assessment was carried out first, second, and the third month followed by the nursing intervention. The findings revealed statistically significant reduction in social and occupational disabilities. A community-based psychosocial intervention led by community health nurses catering to the needs of neurotic patients is indicated by the results.","Nagarajaiah, null; Jothimani, G; Parthasarathi, R; Reddemma, K; Giri, A T",2012.0,,0,0,
7315,Clinical evaluation of the transparency of hydrophobic acrylic intraocular lens optics,"ER SETTINGDepartment of Ophthalmology, Dokkyo Medical University, Tochigi, Japan.DESIGNCase-control study.METHODSEyes having phacoemulsification were randomly assigned to have implantation of 1 of 3 hydrophobic acrylic IOL models. The IOLs were photographed at 0 degree and 90 degrees 1 week, 6 months, and 1 year after implantation using a Nidek EAS-1000 anterior chamber analyzer in slit mode. The images were used to determine the intensity of light scattering in the surface and middle regions of the IOL optic.RESULTSThe study comprised 65 eyes of 57 patients with a mean age of 72.5 years. The rate of increase in light-scattering intensity was similar in the middle and surface regions of the Tecnis ZA9003 aspheric IOL. The increase in light-scattering intensity in both regions of the AF-1 VA-60BB spherical IOL was greater than that in the aspheric IOL at all the measurement points. The intensity of light scattering was highest and tended to increase over time in both regions of the AcrySof SA60AT spherical IOL; the rate of increase in intensity was higher in the surface region than in the middle region, and the difference was significantly greater at 6 months and 1 year than at 1 week.CONCLUSIONOur results suggest that AcrySof SA60AT and AF-1 VA-60BB IOLs are likely to develop glistenings over time and that the former may develop whitening.PURPOSETo clinically evaluate postoperative changes in the transparency of hydrophobic acrylic intraocular lenses (IOLs).","Nagata, M; Matsushima, H; Mukai, K; Terauchi, W; Senoo, T; Wada, H; Yoshida, S",2010.0,10.1016/j.jcrs.2010.06.064,0,0,
7316,Safety and feasibility of repetitive transcranial magnetic stimulation in the treatment of anxious depression in pregnancy: a case report,"ER CASEWe report the case of a 36-year-old woman in her second trimester of pregnancy, whose depression (DSM-IV) and anxiety were successfully treated with rTMS. Further studies of rTMS in depressed pregnant women appear warranted.BACKGROUNDThe proper treatment of mood disorders occurring during pregnancy is a major therapeutic problem since no antidepressant medications have been established as safe for the developing fetus. Several double-blind placebo-controlled studies have explored the efficacy of repetitive transcranial magnetic stimulation (rTMS) in depression.","Nahas, Z; Bohning, D E; Molloy, M A; Oustz, J A; Risch, S C; George, M S",1999.0,,0,0,
7317,The Addiction Severity Index as a screen for trauma and posttraumatic stress disorder,"ER METHODAt the start of treatment cocaine dependent outpatients (N = 110, 65.5% male) were assessed on the ASI, the THQ and a PTSD symptom checklist as part of a multisite clinical trial.RESULTSSpecificity of the ASI questions was higher than sensitivity for both sexual trauma (specificity = .96, sensitivity = .46) and physical trauma (specificity = .71, sensitivity = .50), while for PTSD the sensitivity of the ASI (.91) was higher than its specificity (.43). Other findings indicated that patients were more likely to report trauma on the THQ than on the ASI (which may be due to the self-report format of the THQ); that the ASI was better at assessing sexual than assessing physical trauma; and that the higher the number of ASI trauma items endorsed, the more likely was the PTSD diagnosis. Finally, PTSD patients had greater severity than non-PTSD patients on other ASI items (e.g., psychological severity, need for treatment).CONCLUSIONSThe ASI trauma questions show stronger utility as a screen for PTSD than for trauma. Results of the study are discussed in light of ways to modify the ASI to screen more accurately for trauma, clinical implications, and limitations of the study method.OBJECTIVEThe Addiction Severity Index (ASI) includes items to assess patients' history of trauma (physical or sexual). The goal of this study was to assess the sensitivity and specificity of those questions in relation to the Trauma History Questionnaire (THQ), a more thorough measure of lifetime trauma and, in addition, to an actual posttraumatic stress disorder (PTSD) diagnosis.","Najavits, L M; Weiss, R D; Reif, S; Gastfriend, D R; Siqueland, L; Barber, J P; Butler, S F; Thase, M; Blaine, J",1998.0,,0,0,
7318,Individual trait anxiety levels characterizing the properties of Zen meditation,"Meditation is a specific consciousness state in which deep relaxation and increased internalized attention coexist. There have been various neurophysiological studies on meditation. However, the personal predispositions/traits that characterize the properties of meditation have not been adequately studied. We analyzed changes in neurophysiological parameters [EEG coherence and autonomic nervous activity using heart rate variability (HRV) as an index] during Zen meditation, and evaluated the results in association with trait anxiety (assessed by Spielberger's State-Trait Anxiety Inventory) in 22 healthy adults who had not previously practiced any form of meditation. During meditation, in terms of mean values in all subjects, an increase in slow alpha interhemispheric EEG coherence in the frontal region, an increase in high-frequency (HF) power (as a parasympathetic index of HRV), and a decrease in the ratio of lowfrequency to HF power (as a sympathetic index of HRV) were observed. Further evaluation of these changes in individuals showed a negative correlation between the percent change (with the control condition as the baseline) in slow alpha interhemispheric coherence reflecting internalized attention and the percent change in HF reflecting relaxation. The trait anxiety score was negatively correlated with the percent change in slow alpha interhemispheric coherence in the frontal region and was positively correlated with the percent change in HF. These results suggest that lower trait anxiety more readily induces meditation with a predominance of internalized attention, while higher trait anxiety more readily induces meditation with a predominance of relaxation. Copyright © 2004 S. Karger AG, Basel.",Murata T.; Takahashi T.; Hamada T.; Omori M.; Kosaka H.; Yoshida H.; Wada Y.,2004.0,10.1159/000079113,0,0,
7319,The reality of returning to work and training: Experiences from a long-term unemployment project,"A project called Pathway-to-Work was carried out in northern Finland between 1995 and 1998. In the course of this project, tailored return-to-work paths were planned for 140 long-term unemployed people with disabilities. The present study, based on that project, had three research objectives: (i) to describe how the participants experienced and defined their opportunities of employment and training at the beginning of the project and how the opportunities were eventually realized; (ii) to form a model of the issues that influenced the participants' decision making on the basis of their descriptions of their life situation; and (iii) to look for elements in the progression of the project that could explain the outcome in terms of the participants' situation in the labour market. The research design was composed of three parts: eight in-depth interviews, a register follow-up, and comparison with a matched control group. Comparative content analysis was used to process the in-depth interviews. The outcome was evaluated according to the following variables: (i) the changes in the participants' labour market situation during the 2-year follow-up; (ii) the changes in the participants' distress level, perceived competence, and sense of coherence during the intervention. We found that the participants had not decided whether to return to work but had left this decision to the professional working on the project. The way participants described their life situations and opportunities made it clear that they placed high expectations on the project. However, although they could realistically estimate their own potential, the labour-market situation was beyond their predictive vision. We conclude, that, when targeting services to groups such as described here, more attention should be paid to understanding the clients' behaviour and the social circumstances in which they live.",Juvonen-Posti P.; Piirainen K.; Kallanranta T.; Keinänen-Kiukaanniemi S.,2004.0,10.1097/00004356-200409000-00007,0,0,
7320,Effect of social support on the mental health of university students in physical cultures,"Aim: To study the influence of social support on the mental heath of undergraduates in physical cultures, so as to explore the probability of intervention. Methods: Investigations of mental heath status and social support conditions were conducted in 136 undergraduates from physical cultures by using symptom checklist (SCL-90) and social support questionnaire (SSQ), and the results were compared with the internal norm, and the correlation of each factor in the two questionnaires and the relationship between mental symptoms and social supports were analyzed. Results: In comparison of scores of SCL-90, the scores of compulsion (1.53 ± 0.64) and interpersonal relationship (1.49 ± 0.73) of the undergraduates from physical cultures were lower than those of internal normal youths (19 to 29 years old) (1.67 ± 0.60 and 1.70 ± 0.64) (P < 0.05). Among the 136 undergraduates, 20 cases (15%) had mental symptoms. The scores of subjective support (4.60 ± 1.20), utility of support (2.33 ± 1.02) were obviously lower in the undergraduates with symptoms than those without symptoms (3.24 ± 1.51 and 1.29 ± 0.67) (P < 0.05). Except for the scores of somatization and psychosis, the scores of other factors in SCL-90 were all negatively correlated with those of social support (P < 0.05). Conclusion: There are insignificant differences in the general mental health level of the undergraduates coming from physical cultures, partial students have mild or moderate mental symptoms, and social support has significant effect on the mental health of undergraduates.",Chen T.-X.,2004.0,,0,0,
7321,"Associations among pain intensity, sensory characteristics, affective qualities, and activity limitations in patients with chronic pain: A momentary, within-person perspective","The purpose of this article is to explore the multidimensionality of the pain experience for patients with chronic pain by using a within-person, longitudinal approach. An Ecological Momentary Assessment design with a patient electronic diary was used to collect random momentary pain assessments several times a day for 2 weeks. We examined the within-person relationships between pain intensity, sensory characteristics, affective qualities, and activities limited by pain. All 3 dimensions (sensory, affective, and activities) were significantly related to pain intensity in a monotonic, but nonlinear, manner. These results expand our understanding of the pain experience by showing that changes of pain over time are associated with changes in sensory symptoms, affective distress, and activity limitations. © 2004 by the American Pain Society.",Litcher-Kelly L.; Stone A.A.; Broderick J.E.; Schwartz J.E.,2004.0,10.1016/j.jpain.2004.07.005,0,0,
7322,The effects of sieving and spatial variability of estuarine sediment toxicity samples on sediment chemistry,"In 1998, we conducted a field-validation study of the chronic 28-day whole-sediment toxicity test with Leptocheirus plumulosus in Baltimore Harbor, MD, an area where this amphipod is indigenous. This study included an evaluation of the effect of sieving on sediment chemical concentrations and the use of field replicates, or separate grabs from the same site, which provided an estimation of within-site chemical and toxicologic variability. Six stations in Baltimore Harbor, MD, were included in this evaluation. Chemical analysis of two separate unsieved field replicates from the six sites indicated that, overall, the chemical concentrations of replicates within each site were similar, especially for metals. Organic contaminants particularly total PCBs, had the highest variability between replicates. Chemical variability did not appear to be related to differences in organic carbon content or grain size or to variability in toxicologic end points. Results supported the use of composite samples in sediment toxicity tests. In addition, in most cases, sieving had little effect on sediment chemistry. For the metals and trace elements, only selenium showed a substantial change after sieving, with some samples increasing after sieving and others decreasing. Concentrations of acid-volatile sulfide (AVS) increased 194.6% at one station after sieving, although in most other cases, AVS and simultaneously extracted metals remained relatively unchanged. As expected, concentrations of organics generally decreased after sieving, but in the majority of cases this decrease was small (i.e., coefficient of variation ≤25%). Total benzene hexachloride and total chlordanes had the greatest changes, whereas polychlorinated biphenyl concentrations decreased at only two stations after sieving. Concentrations of polyaromatic hydrocarbons showed little change after sieving. These changes in sediment chemistry due to sieving must be viewed in the larger context of the potentially confounding effects that indigenous organisms may have on the interpretation of test results from whole-sediment toxicity tests.",Fisher D.J.; McGee B.L.; Wright D.A.; Yonkos L.T.; Ziegler G.P.; Turley S.D.,2004.0,10.1007/s00244-003-0221-3,0,0,
7323,Examining the multi-process theory: An investigation of the effects of two relaxation techniques on state anxiety,"To test the multi-process theory (The psychobiology of relaxation and related states: a multi-process theory, in: D.E. Mostofsky (Ed.), Behavioural Control and Modification of Physiological Activity, Prentice-Hall, Englewood Cliffs, NJ, pp. 399-442.), the effects of Benson's relaxation method (The Relaxation Response, William Morrow and Company, New York.) and progressive relaxation (Progressive Relaxation, The University of Chicago Press, Chicago.) on state anxiety were measured in 76 undergraduate university students using a modified version of the Competitive State Anxiety Inventory-2 (Development and validation of the Competitive State Anxiety Inventory-2, in: R. Martens, R.S. Vealey, D. Burton. (Eds.), Competitive Anxiety in Sport, Human Kinetics, Champaign, IL, pp. 117-213). Results suggested that both relaxation techniques were effective in reducing cognitive and somatic anxiety, and elevating self-confidence. However, contrary to the predictions of the multi-process theory, there were no significant differences between the effects of either technique. The findings were discussed in light of the relaxation response (The Relaxation Response, William Morrow and Company, New York) and the cognitive-behavioural model (Meditation as psychotherapy: a new look at the evidence, in: M.A. West, (Ed.), Psychology of meditation, Oxford University Press, London, pp. 136-149; Relaxation Dynamics: A Cognitive-Behavioural Approach to Relaxation, Research Press, Champaign, IL; Cognitive-Behavioural Relaxation Training: A New System of Strategies for Treatment and Assessment, Springer, New York) as alternatives in predicting the effects of relaxation techniques on anxiety. © 2003 Elsevier Ltd. All rights reserved.",Gill S.; Kolt G.S.; Keating J.,2004.0,10.1016/j.jbmt.2003.11.002,0,0,
7324,The joint effect of noise exposure and job complexity on distress and injury risk among men and women: The cardiovascular occupational risk factors determination in Israel study,"We sought to explore the possibility that exposure to noise at work might interact with job complexity and gender to affect the incidence of occupational injury among industrial employees. In this study, we examined 4084 men and 1643 women from 21 industrial plants while controlling for a number of potent confounding variables, among them active safety hazards. Logistic regression results showed that the predictor variables interacted and that the highest injury risk (odds ratio - 2.72) was observed in women in high noise and high job complexity, compared with the referents scoring low on these predictors. The comparable injury risk in men was only 1.3. Parallel results were observed for three noise stress indicators: workload, noise annoyance and postwork irritability. We conclude that the joint exposure to noise and high job complexity is disruptive, resulting in higher distress and occupational injury risk, particularly among women.",Melamed S.; Fried Y.; Froom P.,2004.0,10.1097/01.jom.0000141661.66655.a5,0,0,
7325,Negative emotional arousal impairs associative memory performance for emotionally neutral content in healthy participants,"The effect of emotional arousal on memory presents a complex pattern with previous studies reporting conflicting results of both improved and reduced memory performance following arousal manipulations. In this study we further tested the effect of negative emotional arousal (NEA) on individual-item recognition and associative recognition of neutral stimuli in healthy participants, and hypothesized that NEA will particularly impair associative memory performance. The current study consists of two experiments; in both, participants studied a list of word-pairs and were then tested for items (items recognition test), and for associations (associative recognition test). In the first experiment, the arousal manipulation was induced by flashing emotionally-negative or neutral pictures between study-pairs while in the second experiment arousal was induced by presenting emotionally-negative or neutral pictures between lists. The results of the two experiments converged and supported an associative memory deficit observed under NEA conditions.We suggest that NEA is associated with an altered ability to bind one stimulus to another as a result of impaired recollection, resulting in poorer associative memory performance. The current study findings may contribute to the understanding of the mechanism underlying memory impairments reported in disorders associated with traumatic stress.",Guez J.; Saar-Ashkenazy R.; Mualem L.; Efrati M.; Keha E.,2015.0,10.1371/journal.pone.0132405,0,0,
7326,"Randomised clinical trial of the effects of prolonged-release melatonin, temazepam and zolpidem on slow-wave activity during sleep in healthy people","Current pharmacological treatments for insomnia include benzodiazepine and non-benzodiazepine hypnotics targeting γ-aminobutyric acid (GABA)A receptors, as well as agonists of the melatonin receptors MT1 and MT2. Melatonin, temazepam and zolpidem are thought to exert their effect through different mechanisms of action, but whether this leads to differential effects on electroencephalogram (EEG) power spectra during sleep in middle-aged people is currently not known. To establish whether the effects of prolonged-release melatonin (2 mg) on the nocturnal sleep EEG are different to those of temazepam (20 mg) and zolpidem (10 mg). Sixteen healthy men and women aged 55-64 years participated in a double-blind, placebo-controlled, four-way cross-over trial. Nocturnal sleep was assessed with polysomnography and spectral analysis of the EEG. The effects of single oral doses of prolonged-release melatonin, temazepam and zolpidem on EEG slow-wave activity (SWA, 0.75-4.5 Hz) and other frequencies during nocturnal non-rapid eye movement (NREM) sleep were compared. In an entire night analysis prolonged-release melatonin did not affect SWA, whereas temazepam and zolpidem significantly reduced SWA compared with placebo. Temazepam significantly reduced SWA compared with prolonged-release melatonin. Prolonged-release melatonin only reduced SWA during the first third of the night compared with placebo. These data show that the effects of prolonged-release melatonin on the nocturnal sleep EEG are minor and are different from those of temazepam and zolpidem; this is likely due to the different mechanisms of action of the medications.",Arbon E.L.; Knurowska M.; Dijk D.-J.,2015.0,10.1177/0269881115581963,0,0,
7327,Different genetic factors underlie Fear conditioning and episodic memory,"Objective: Fear conditioning seems to account for the acquisition of post-traumatic stress disorder, whereas conscious recall of events in aftermath of trauma reflects episodic memory. Studies show that both fear conditioning and episodic memory are heritable, but no study has evaluated whether they reflect common or separate genetic factors. To this end, we studied episodic memory and fear conditioning in 173 healthy twin pairs using visual stimuli predicting unconditioned electric shocks. Methods: Fear conditioning acquisition and extinction was determined using conditioned visual stimuli predicting unconditioned mild electric shocks, whereas electrodermal activity served as the fear learning index. Episodic memory was evaluated using cued recall of pictorial stimuli unrelated to conditioning. We used multivariate structural equation modeling to jointly analyze memory performance and acquisition as well as extinction of fear conditioning. Results: Best-fit twin models estimated moderate genetic loadings for conditioning and memory measures, with no genetic covariation between them. Conclusion: Individual differences in fear conditioning and episodic memory reflect distinct genetically influenced processes, suggesting that the genetic risk for learninginduced anxiety disorders includes at least two memoryrelated genetic factors. These findings are consistent with the facts that the two separate learning forms are distant in their evolutionary development, involve different brain mechanisms, and support that genetically independent memory systems are pivotal in the development and maintenance of syndromes related to fear learning.",Fredrikson M.; Annas P.; Hettema J.M.,2015.0,10.1097/YPG.0000000000000088,0,0,
7328,Estradiol levels modulate brain activity and negative responses to psychosocial stress across the menstrual cycle,"Although ovarian hormones are thought to have a potential role in the well-known sex difference in mood and anxiety disorders, the mechanisms through which ovarian hormone changes contribute to stress regulation are not well understood. One mechanism by which ovarian hormones might impact mood regulation is by mediating the effect of psychosocial stress, which often precedes depressive episodes and may have mood consequences that are particularly relevant in women. In the current study, brain activity and mood response to psychosocial stress was examined in healthy, normally cycling women at either the high or low estradiol phase of the menstrual cycle. Twenty eight women were exposed to the Montreal Imaging Stress Task (MIST), with brain activity determined through functional magnetic resonance imaging, and behavioral response assessed with subjective mood and stress measures. Brain activity responses to psychosocial stress differed between women in the low versus high estrogen phase of the menstrual cycle: women with high estradiol levels showed significantly less deactivation in limbic regions during psychosocial stress compared to women with low estradiol levels. Additionally, women with higher estradiol levels also had less subjective distress in response to the MIST than women with lower estradiol levels. The results of this study suggest that, in normally cycling premenopausal women, high estradiol levels attenuate the brain activation changes and negative mood response to psychosocial stress. Normal ovarian hormone fluctuations may alter the impact of psychosocially stressful events by presenting periods of increased vulnerability to psychosocial stress during low estradiol phases of the menstrual cycle. This menstrual cycle-related fluctuation in stress vulnerability may be relevant to the greater risk for affective disorder or post-traumatic stress disorder in women.",Albert K.; Pruessner J.; Newhouse P.,2015.0,10.1016/j.psyneuen.2015.04.022,0,0,
7329,Perceptual and conceptual similarities facilitate the generalization of instructed fear,"Background and objectives Learned fear can generalize to neutral events due their perceptual and conceptual similarity with threat relevant stimuli. This study simultaneously examined these forms of generalization to model the expansion of fear in anxiety disorders. Methods First, artificial categories involving sounds, nonsense words and animal-like objects were established. Next, the words from one category were paired with threatening information while the words from the other category were paired with safety information. Lastly, we examined if fear generalized to (i) the conceptually related animal-like objects and (ii) other animal like-objects that were perceptually similar. This was measured using behavioral avoidance, US expectancy ratings and self-reported stimulus valence. Results Animal-like objects conceptually connected to the aversive words evoked heightened fear. Perceptual variants of these animal-like objects also elicit fear. Limitations Future research would benefit from the use of online-US expectancy ratings and physiological measures of fear. Conclusions Investigating the role of both perceptual and conceptual fear generalization is important to better understand the etiology of anxiety disorders symptoms.",Bennett M.; Vervoort E.; Boddez Y.; Hermans D.; Baeyens F.,2015.0,10.1016/j.jbtep.2015.03.011,0,0,
7330,Attitudes and emotions towards pain and sensitivity to painful stimuli among people routinely engaging in masochistic behaviour,"Background People engaged in masochistic behaviour (MB) seek to experience pain and the pleasure it evokes in sadomasochistic (SandM) sessions. The sensitivity and attitude to pain in these individuals has hardly been tested. We evaluated pain perception among these individuals and tested whether their experiences and attitudes towards pain are context-related. Methods Thirty-four healthy subjects participated; 17 routinely engaged in MB and 17 controls. Pressure pain threshold (PPT) was measured in two body regions. A structured questionnaire on SandM activities and context-related pain experiences and emotions was completed, as well as the pain catastrophizing (CAT) and fear of pain (FOP) questionnaires. Results PPT was significantly higher among MB individuals and positively correlated with the frequency of SandM sessions. MB individuals also had lower levels of CAT, and FOP correlated negatively with the frequency of MB and the number of body regions involved. Pleasure evoked during SandM sessions correlated positively with pain intensity and number of body regions involved. Pain in everyday life correlated negatively with MB activities. However, the emotional attitude to everyday pain was ambivalent: MB individuals perceived pain intensity and unpleasantness similar to the controls, but simultaneously gained pleasure from the pain. Conclusions MB individuals exhibited pain hyposensitivity, presumably resulting from frequent engagement in MB. Alternatively, these subjects may have a predisposition which enables this engagement. Attitudes towards pain in MB individuals are complex. They appear to be context-related with pain experienced as pleasurable and rewarding during SandM sessions, and negative but still pleasurable in everyday life.",Defrin R.; Arad M.; Ben-Sasson M.P.; Ginzburg K.,2015.0,10.1002/ejp.662,0,0,
7331,Neural pathways of embarrassment and their modulation by social anxiety,"While being in the center of attention and exposed to other's evaluations humans are prone to experience embarrassment. To characterize the neural underpinnings of such aversive moments, we induced genuine experiences of embarrassment during person-group interactions in a functional neuroimaging study. Using a mock-up scenario with three confederates, we examined how the presence of an audience affected physiological and neural responses and the reported emotional experiences of failures and achievements. The results indicated that publicity induced activations in mentalizing areas and failures led to activations in arousal processing systems. Mentalizing activity as well as attention towards the audience were increased in socially anxious participants. The converging integration of information from mentalizing areas and arousal processing systems within the ventral anterior insula and amygdala forms the neural pathways of embarrassment. Targeting these neural markers of embarrassment in the (para-)limbic system provides new perspectives for developing treatment strategies for social anxiety disorders.",Müller-Pinzler L.; Gazzola V.; Keysers C.; Sommer J.; Jansen A.; Frässle S.; Einhäuser W.; Paulus F.M.; Krach S.,2015.0,10.1016/j.neuroimage.2015.06.036,0,0,
7332,High intelligence prevents the negative impact of anxiety on working memory,"Using a large sample and the confirmatory factor analysis, the study investigated the relationships between anxiety, working memory (WM) and (fluid) intelligence. The study showed that the negative impact of anxiety on WM functioning diminishes with increasing intelligence, and that anxiety can significantly affect WM only in people below average intelligence. This effect could not be fully explained by the sheer differences in WM capacity (WMC), suggesting the importance of higher-level cognition in coping with anxiety. Although intelligence moderated the impact of anxiety on WM, it was only weakly related to anxiety. In contrast to previous studies, anxiety explained the substantial amount of WMC variance (17.8%) in less intelligent participants, but none of the variance in more intelligent ones. These results can be explained in terms of either increased motivation of intelligent but anxious people to cope with a WM task, or their ability to compensate decrements in WM.",Chuderski A.,2015.0,10.1080/02699931.2014.969683,0,0,
7333,Relations of distinct psychopathic personality traits with anxiety and fear: Findings from offenders and non-offenders,"Early descriptions of psychopathy emphasise fearlessness and a lack of nervousness or anxiety as key characteristics of the disorder. However, conflicting evidence suggests that anxiety may be positively correlated with some aspects of the psychopathy construct. This position may seem somewhat paradoxical when considered alongside impaired processing of fear related stimuli in psychopathic personality. The aim of the current paper was to examine the distinct relations of callous, egocentric, and antisocial psychopathic traits with measures of anxiety and social anxiety in samples of non-offenders (Study 1) and violent offenders (Study 2). In Study 2 we also used an emotion recognition task to examine fearful face recognition. In Studies 1 and 2 we showed distinct and opposite significant relationships of egocentric and antisocial psychopathic traits with trait anxiety. Thus, while trait anxiety was negatively predicted by egocentric traits, it was predicted in a positive direction by antisocial traits in both samples. In Study 2 we found that callous traits were predictive of greater impairments in fearful face recognition. These findings suggest that anxiety and fear are distinguishable constructs in relation to psychopathic personality traits, and are discussed in terms of potentially separable mechanisms for these two constructs.",Gillespie S.M.; Mitchell I.J.; Satherley R.-M.; Beech A.R.; Rotshtein P.,2015.0,10.1371/journal.pone.0143120,0,0,
7334,Investigating the efficacy of attention bias modification in reducing high spider fear: The role of individual differences in initial bias,"Background and objectives Attention Bias Modification (ABM) targets attention bias (AB) towards threat and is a potential therapeutic intervention for anxiety. The current study investigated whether initial AB (towards or away from spider images) influenced the effectiveness of ABM in spider fear. Methods AB was assessed with an attentional probe task consisting of spider and neutral images presented simultaneously followed by a probe in spider congruent or spider incongruent locations. Response time (RT) differences between spider and neutral trials > 25 ms was considered 'Bias Toward' threat. RT difference < - 25 ms was considered 'Bias Away' from threat, and a difference between -25 ms and +25 ms was considered 'No Bias'. Participants were categorized into Initial Bias groups using pre-ABM AB scores calculated at the end of the study. 66 participants' (Bias Toward n = 27, Bias Away n = 18, No Bias n = 21) were randomly assigned to ABM-active training designed to reduce or eliminate a bias toward threat and 61 (Bias Toward n = 17, Bias Away n = 18, No Bias n = 26) to ABM-control. Results ABM-active had the largest impact on those demonstrating an initial Bias Towards spider images in terms of changing AB and reducing Spider Fear Vulnerability, with the Bias Away group experiencing least benefit from ABM. However, all Initial Bias groups benefited equally from active ABM in a Stress Task. Limitations Participants were high spider fearful but not formally diagnosed with a specific phobia. Therefore, results should be confirmed within a clinical population. Conclusions Individual differences in Initial Bias may be an important determinant of ABM efficacy.",Fox E.; Zougkou K.; Ashwin C.; Cahill S.,2015.0,10.1016/j.jbtep.2015.05.001,0,0,
7335,"""i Feel Contaminated in My Fake Hand"": Obsessive-Compulsive-Disorder like Disgust Sensations Arise from Dummy during Rubber Hand Illusion","Despite its theoretical and clinical interest, there are no experimental studies exploring obsessive-compulsive disorder (OCD)-like disgust sensations through using somatosensory illusions. Such illusions provide important clues to the nature and limits of multisensory integration and how the brain constructs body image; and may potentially inform novel therapies. One such effect is the rubber hand illusion (RHI) in which tactile sensations are referred to a rubber hand; if the experimenter simultaneously strokes a subject's occluded hand together with a visible fake hand, the subject starts experiencing the touch sensations as arising from the dummy. In this study, we explore whether OCD-like disgust may result from contamination of a dummy hand during the RHI; suggesting a possible integration of somatosensory and limbic inputs in the construction of body image.We predicted that participants would experience sensations of disgust, when placing a disgust stimulus (fake feces, vomit or blood) on the dummy hand after establishing the RHI.We found that 9 out of 11 participants experienced greater disgust during the synchronous condition (real hidden hand and fake hand are stroked in synchrony) compared to the asynchronous control condition (real hidden hand and fake hand are stroked in asynchrony); and on average such disgust was significantly greater during the synchronous condition compared to the asynchronous control condition, Z = 2.7, p = .008. These results argue against a strictly hierarchical modular approach to brain function and suggest that a four-way multisensory interaction occurs between vision, touch, proprioception on the one hand and primal emotions like disgust on the other. These findings may inform novel clinical approaches for OCD; that is, contaminating a dummy during the RHI could possibly be used as part of an in-vivo exposure-intervention for OCD.",Jalal B.; Krishnakumar D.; Ramachandran V.S.,2015.0,10.1371/journal.pone.0139159,0,0,
7336,Effects of cortisol on reconsolidation of reactivated fear memories,"The return of conditioned fear after successful extinction (eg, following exposure therapy) is a significant problem in the treatment of anxiety disorders and posttraumatic stress disorder (PTSD). Targeting the reconsolidation of fear memories may allow a more lasting effect as it intervenes with the original memory trace. Indeed, several pharmacological agents and behavioral interventions have been shown to alter (enhance, impair, or otherwise update) the reconsolidation of reactivated memories of different types. Cortisol is a stress hormone and a potent modulator of learning and memory, yet its effects on fear memory reconsolidation are unclear. To investigate whether cortisol intervenes with the reconsolidation of fear memories in healthy males and how specific this effect might be, we built a 3-day reconsolidation design with skin conductance response (SCR) as a measure of conditioned fear: Fear acquisition on day 1; reactivation/no-reactivation of one conditioned stimulus and pharmacological intervention on day 2; extinction learning followed by reinstatement and reinstatement test on day 3. The groups differed only in the experimental manipulation on day 2: Reactivation+Cortisol Group, Reactivation+Placebo Group, or No-reactivation+Cortisol Group. Our results revealed an enhancing effect of cortisol on reconsolidation of the reactivated memory. The effect was highly specific, strengthening only the memory of the reactivated conditioned stimulus and not the non-reactivated one. Our findings are in line with previous findings showing an enhancing effect of behavioral stress on the reconsolidation of other types of memories. These results have implications for the understanding and treatment of anxiety disorders and PTSD.",Meir Drexler S.; Merz C.J.; Hamacher-Dang T.C.; Tegenthoff M.; Wolf O.T.,2015.0,10.1038/npp.2015.160,0,0,
7337,Can doubt attenuate access to internal states? Implications for obsessive-compulsive disorder,"Background and objectives We have previously reported that obsessive-compulsive individuals perform more poorly on tasks that require accurate perception of internal states. As these individuals are also characterized by elevated levels of doubt regarding internal states, the causal relationship between doubt and accurate perception remained unclear. The presented study examines whether undermining participants' confidence in their ability to accurately produce a specific internal state would affect their performance on a task that requires accurate perception of this state. Methods Participants were trained to produce specific levels of forearm muscle tension and then required to produce various tension levels in four experimental phases. The first three alternated in terms of whether the participants viewed a biofeedback monitor while the fourth offered participants several times the choice to view the monitor. Prior to the task, half of the participants received instructions that undermined their confidence in their ability to accurately assess their own muscle tension. We measured participants' accuracy in producing the required muscle tension levels and the number of times they requested to view the monitor in the final phase. Results Undermined confidence participants were less accurate in producing the required muscle tension levels in the absence of biofeedback, and were also more likely to request the monitor in the final phase. Conclusions Doubt can affect performance on tasks that require perceiving and experiencing internal states. This finding supports the possibility that access to internal states in OCD is attenuated due to elevated levels of doubt regarding these states.",Lazarov A.; Cohen T.; Liberman N.; Dar R.,2015.0,10.1016/j.jbtep.2014.11.003,0,0,
7338,Experimental study on the effects of anxiety sensitivity and somatosensory amplification on the response to the 35% CO2 challenge in abstinent smokers,"The relationship between nicotine abstinence and panic onset is still not well understood and the role of catastrophic misinterpretation, as possible moderator or mediator of this relationship, is unknown. We tested whether nicotine abstinence influences the response to a CO2 panic challenge and whether catastrophic misinterpretation (measured via the Anxiety Sensitivity [ASI] and the SomatoSensory Amplification Scale [SSAS]) exerts a moderating or mediating effect on the relationship between nicotine abstinence and panic. Eighty regular smokers underwent a 35% CO2 challenge after the transdermal administration of nicotine or placebo. Physiological and psychological variables were measured at baseline, directly before and after the challenge. Fear reactivity to the challenge was similar in both conditions. ASI (post-Test Visual Analogous Scale of Fear: ΔR2 = 0.043, p < .05) and SSAS (post-Test Visual Analogous Scale of Anxiety: ΔR2 = 0.036, p < .05; post-Test Panic Symptom List: ΔR2 = 0.035, p < .05) influenced anxiety as response to the challenge. We found no support for the moderational and the mediational hypotheses. The findings regarding fear reactivity when group status is considered partly confirm the literature. The positive findings observed for ASI and SSAS as factors influencing the response to the challenge, together with the lack of evidence for a moderational and a mediational hypothesis, confirm that anxiety sensitivity and somatosensory amplification are independent constructs and suggest that they directly influence the response to the challenge.",Cosci F.; Hussein Ibrahim H.M.; Nannini A.; Schruers K.,2015.0,10.1037/pha0000048,0,0,
7339,The effect of existential therapy on divorced women's existential anxiety,"The aim of the present study is to investigate the effectiveness of existential therapy on divorced women's existential anxiety. The study is the result of a quasi-experimental research conducted at Babol Islamic Azad University. The sample size included 22 people assigned to experimental and control groups. To do the study, 22 female university students were selected and after carrying out a pretest were then randomly assigned to two groups, namely, experimental and control. Then, 12 (at maximum) therapy sessions were held for the experimental group. Finally, both the experimental and control groups were evaluated by a post-test. The data was analyzed by using the covariance test analysis (ANCOVA). The results showed that existential therapy decrease existential anxiety (p < 0/01). The post-test scores of existential anxiety for the subjects in the experimental group were significantly lower than the pre-test of the same group and the post-test of the control group. According to the results of the study it is predicted that existential therapy can be used as an effective method for treating the problems of divorcee women. The results of this study were in line with the findings about the treatment of cancer, diabetes and traumatic and post-traumatic stress disorder patients.",Aliesmaieli A.,2016.0,,0,0,
7340,Cognitive dissonance about thought-action fusion beliefs improves and maintains the effects of thought-action fusion-specific psychoeducation,"The effects of psychoeducation on thought-action fusion (TAF) beliefs are understudied. We tested whether adding mock electroencephalography (EEG)-based computer trials that induce cognitive dissonance about TAF beliefs, prior to TAF-specific psychoeducation, would enhance and maintain the reduction of TAF beliefs. An unselected sample of 140 Singaporean undergraduates (89 females, 51 males) was randomly assigned to a combined intervention, TAF-specific psychoeducation-only, or control group. Self-report measures of TAF beliefs and cognitive dissonance about TAF beliefs were administered 4 times in the initial session, and once at 1-month follow-up. Findings included the following: (a) greatest cognitive dissonance about TAF beliefs in the initial session with the combined intervention; (b) greater reduction in TAF beliefs in the initial session in both intervention groups, compared with the control group; and (c) incremental reduction in TAF beliefs in the initial session and maintenance at 1-month follow-up with the combined intervention. Cognitive dissonance should be investigated extensively in other aspects of cognitive behavioral therapy (CBT) procedures for TAF beliefs (e.g., behavioral experiments, exposure, and response prevention) to determine whether it contributes to therapeutic change with these techniques. Our combined intervention procedure should also be examined for relevant psychopathology (e.g., obsessive-compulsive symptoms).",Ching T.H.W.; Tang C.S.,2016.0,10.1891/0889-8391.30.4.235,0,0,
7341,The relationship between obsessive compulsive disorder and mental contamination (MC): Psychometric properties of vancouver obsessive compulsive inventory-MC scale and thought-action fusion-contamination scale,"Objective: Mental contamination is defined as feelings of internal dirtiness in absence of actual contact with a dirty physical object or a person. Mental contamination is considered to play an important role in maintenance and persistence of obsessive compulsive disorder (OCD). This study aimed to examine psychometric properties of the Turkish version of two objective measures of mental contamination: Vancouver Obsessive Compulsive Inventory-Mental Contamination Scale (VOCI-MC) and Thought-Action Fusion-Contamination Scale (TAF-CS). Method: The participants were 255 university students (183 females and 70 males) with the age range of 18-28 years. The participants were asked to fill out the questionnaire set consisted of VOCI-MC, TAF-CS, Thought-Action Fusion Scale (TAFS), Disgust Scale-Revised, Trait Anger Expression Inventory and Obsessive Compulsive Inventory-Revised (OCI-R). Results: Reliability analyses indicated that internal consistency of VOCI-MC and TAF-CS were 0.93 and 0.92, and test-retest reliabilities were 0.79 and 0.61, respectively. Consistent with the original study, the results of explanatory and confirmatory factor analysis indicated that both scales had one factor structure. Convergent and divergent validity analyses revealed that both scales were positively correlated with OCI-R total scores and its subscales as well as TAF total score and its subscales; but this relationship was significantly less strong for Trait Anger and Disgust Sensitivity. While VOCI-MC significantly predicted OCD symptomatology, TAF-CS had no predictive power in this regard. Conclusions: The results support that psychometric properties of the Turkish versions of the scales meet acceptable standards for validity and reliability, and therefore can be used among Turkish population.",Inozu M.; Bilekli I.; Ulukut F.O.,2016.0,10.5350/DAJPN2016290405,0,0,
7342,Genetic risk mechanisms of posttraumatic stress disorder in the human brain,"Posttraumatic stress disorder (PTSD) follows exposure to a traumatic event in susceptible individuals. Recently, genome-wide association studies have identified a number of genetic sequence variants that are associated with the risk of developing PTSD. To follow up on identifying the molecular mechanisms of these risk variants, we performed genotype to RNA sequencing-derived quantitative expression (whole gene, exon, and exon junction levels) analysis in the dorsolateral prefrontal cortex (DLPFC) of normal postmortem human brains. We further investigated genotype-gene expression associations within the amygdala in a smaller independent RNA sequencing (Genotype-Tissue Expression [GTEx]) dataset. Our DLPFC analyses identified significant expression quantitative trait loci (eQTL) associations for a ""candidate"" PTSD risk SNP rs363276 and the expression of two genes: SLC18A2 and PDZD8, where the PTSD risk/minor allele T was associated with significantly lower levels of gene expression for both genes, in the DLPFC. These eQTL associations were independently confirmed in the amygdala from the GTEx database. Rs363276 ""T"" carriers also showed significantly increased activity in the amygdala during an emotional face-matching task in healthy volunteers. Taken together, our preliminary findings in normal human brains represent a tractable approach to identify mechanisms by which genetic variants potentially increase an individual's risk for developing PTSD.",Bharadwaj R.A.; Jaffe A.E.; Chen Q.; Deep-Soboslay A.; Goldman A.L.; Mighdoll M.I.; Cotoia J.A.; Brandtjen A.C.; Shin J.; Hyde T.M.; Mattay V.S.; Weinberger D.R.; Kleinman J.E.,2016.0,10.1002/jnr.23957,0,0,
7343,Contributing factors in mobility-related participation restriction in traumatic brain injury (TBI): An Australian community patient perspective,"Objectives: A majority of persons with moderate-to-severe traumatic brain injury (TBI) return to independent ambulation following rehabilitation, yet experience long-term participation restrictions in the community due to difficulties in mobility. To improve participation outcomes, we sought to specify the contributing factors for this discrepancy from patient-perspectives. We sought to identify contributing factors for mobilityrelated participation restriction in persons with TBI in an Australian community cohort, through a qualitative analysis of focus groups and patient-interview transcriptions. Methods: For the validation of the International Classification of Functioning, Disability and Health (ICF) Core Sets for TBI, persons diagnosed with TBI (as evidenced by post-traumatic amnesia) and treated at the Royal Melbourne Hospital between 1 September 2009 and 30 August 2013, were invited to participate in focus groups. If attendance in person was difficult, phone interviews were allowed and pooled for grouped analysis for confidentiality. Groups were formed using maximum variation strategy. Ethics approval was granted by the Melbourne Health HREC (2013.224). Participant discussions were transcribed verbatim and linked to the ICF in the primary study. For this qualitative analysis, transcriptions were reexamined using the linked ICF concepts to identify contributing factors in mobility-related participation restriction from patient-perspectives. Results: A total of 21 (76.2% male) community-dwelling persons with TBI participated in five groups, with a mean age at injury of 55.2 years (range = 18-83); and a mean time since injury of 2.86 years (range = 0.78-5.33). Mobilityrelated participation restriction resulted from: increased cognitive effort or concentration required for walking; altered sensation for walking; difficulty with multi-tasking, crowds, objects or noise in the physical environment when walking or driving. Compared with empathy for concomitant orthopaedic injuries, societal attitudes towards the subtle mobility problems of TBI added to participation restriction. Community access was complicated by administrative delays for returning to driving or a new need to depend on supports and public transportation systems. Difficulties with time management, fatigue, healthcare systems and family or staff attitudes after TBI contributed to decreased return to recreational or professional sporting activities. Of note, severity of impairments or financial constraints were not patient-perceived contributing factors for participation restriction in this Australia cohort. However, this study did not involve validated measures of disability or clinician or carer perspectives. Conclusions: In this community dwelling cohort, participation restriction after TBI was only partially explained by the physical impairments, with many modifiable physical, social and attitudinal environmental factors identified. Further studies to specify and address the contributing factors may be beneficial in improving participation outcomes for persons with TBI.",Chung P.; Baguley I.; Williams G.; Galea M.; Judson R.; Khan F.,2016.0,10.3109/02699052.2016.1162060,0,0,
7344,Development of an anatomically accurate elbow finite element model for normal and pathologic simulations,"INTRODUCTION: Ulnar collateral ligament (UCL) tears are the most common throwing injury of the elbow joint. Several cadaveric studies have investigated static elbow joint mechanics after UCL disruption, but morphology makes evaluation of joint mechanics difficult under motion. Also, the long-term effects of UCL injury and surgical reconstruction on in vivo joint contact mechanics is still a question. Alterations in joint contact mechanics have been linked to the development of post-traumatic osteoarthritis (OA) in other joints, however, the degree to which UCL repair poses a risk for OA is not known. Validated computational models of the elbowjoint are few and limited to static posture [1]. Our goal was to develop a time-efficient anatomically accurate finite element (FE) model of the elbowjoint, which can be used to investigate in vivo normal, pathologic and repaired joint mechanics. METHODS: Computed tomography (CT) images were acquired from two cadaveric specimens (female age 66, male age 76) with the forearm in neutral orientation. A 10 cm region of each elbow was scanned in an XtremeCT scanner (Scanco, Switzerland) with 246 um isotropic voxel size, which included the distal humerus and proximal ulna and radius (up to the radial tuberosity for biceps insertion). The bones were segmented from the images using a fixed density threshold, and cartilage was created by expanding the articulating surface of the bones (1 mm average thickness). Bone and cartilage geometries were meshed using quadratic tetrahedral elements (3 mm and 2 mm average lengths, respectively, based on a previous convergence analysis). Bone was assigned an elastic inhomogeneous deformable material behavior using an established density-elasticity relationship [2], and cartilage was assigned a hyperelastic Neo-Hookean property. A finite sliding formulation was used to model contact between the radiocapitulum (RC) and ulnotrochlear (UT) articulations. An augmented Lagrange method was used to enforce the pressure-overclosure relationship (normal behavior) and frictionless interaction (tangential behavior) was defined between the surfaces in contact. The UCL (anterior, posterior, transverse bands), radial collateral, lateral collateral and annular ligaments were modeled as linear springs and were constrained to nodes on the bone surfaces based on anatomical insertion sites. Ligament stiffness values were acquired from literature [3] and scaled accordingly where unavailable (annular, lateral collateral, transverse UCL). The nodes of the transverse cross-section of the proximal humerus were fixed, and a combined biceps and brachialis force (total 80 N) together with triceps force (40 N) was applied at the insertion sites to simulate elbow flexion (Fig. 1 A). For model verification, we compared our results to a static analysis reported in literature which applied 80 N elbowjoint compression at 20° flexion [1]. All simulations were performed in Abaqus. Peak contact pressure and contact area from the RC and UT articulations, and maximum principal strain in the UCL were presently compared between 20-35° elbow flexion (30° important for graft tension in UCL repair). RESULTS SECTION: Figure 1B-E shows contact distribution on the radius and ulna articular surfaces from the different flexion angles. A predominantly medial contact was observed similar to literature [ 1]. Table 1 shows magnitude of RC and UT contact results. Peak contact pressure and area increased with increasing flexion. Our results at 35° flexion were in the reported range of the static posture analysis (20° flexion). Also, UCL strains typically increased with increasing flexion and tended to be higher after 30°, which is the start of the UCL working range of motion. DISCUSSION: UCL injuries, particularly amongst professional athletes, are a significant problem, and surgical reconstructions are frequently performed to restore elbow function. Though elbow use is regained, whether joint mechanics are restored to normal remains a question. This is important to assess long-term OA risk, which is related to abnormal mechanics. Developing tools to evaluate subject-specific in vivo elbowjoint mechanics have implications in reducing the future economic and functional burden of injuries and pathologies. FE simulations are useful, however, models need to be anatomically accurate and also time and computationally efficient. There is currently limited data on dynamic in vivo elbowjoint contact mechanics after UCL injury and the efficacy of surgical reconstruction. Here we developed an FE model of the elbowjoint including all soft tissue constraints and active motor stability. On average the models consisted of 246854 nodes and required 385 minutes to complete. We presently attempted to compare our analyses outcomes with simulations of static posture in literature, with promising results. Interestingly, we observed different contact behavior under active flexion forces and physiologic ligament constraints, versus simply compressing the joint under static alignment [1]. Some of the variations observed between our data and the reported data [1] could be due to the difference in analysis methods. We also observed significant between-specimen variation which further highlights the importance of subject-specific models. The next step is to validate our FE model with experimental joint contact data collected from cadaveric elbow specimens during dynamic flexion-extension motion. CT data allows for expedited model development however, approximated cartilage geometry is a limitation of the method. Rather than using idealized geometry, bone articular surfaces were used to create cartilage geometry, which together with modeling bone as a non-rigid deformable solid, has been shown to improve accuracy of joint contact results. The extent of error in contact mechanics prediction using approximated cartilage geometry will be assessed by comparison with experimental data. While data from two specimens is also a limitation, our preliminary results demonstrate the feasibility of an anatomically accurate elbow FE model. SIGNIFICANCE: We have developed an anatomically accurate finite element model of the elbow to evaluate joint biomechanics, which can be used to determine the effects of hard and soft tissue injuries/pathologies, surgical efficacy, and impact of alterations in ligament properties (joint laxity) due to aging and repetitive motion disorders.",Johnson J.E.; Hulburt T.C.; Magit D.; Troy K.L.,2016.0,10.1002/jor.23247,0,0,
7345,"Improving treatment engagement for returning operation enduring freedom and operation Iraqi freedom veterans with posttraumatic stress disorder, depression, and suicidal ideation","Posttraumatic stress disorder (PTSD) is associated with increased risk of suicidal ideation among veterans of Operation Enduring Freedom and Operation Iraqi Freedom. This report examined the effectiveness of a brief phonebased cognitive-behavioral intervention on treatment seeking among suicidal and nonsuicidal Operation Enduring Freedom and Operation Iraqi Freedom veteranswho screened positive for PTSD. Participantswere randomized to the intervention or control conditions.We found that suicidal participants, regardless of condition, were twice as likely to attend treatment as nonsuicidal participants. Participants assigned to the control condition who did not indicate suicidality at baseline were less likely to attend treatment at both the 1- And 6-month follow-up interviews. Qualitative findings of the suicidal participants indicated PTSD and depressive symptoms, low social support, and infrequent positive copingmechanisms. Our finding indicates the effectiveness of an intervention tomotivate veterans with PTSD to initiate and remain in treatment. The intervention might be particularly useful prior to experiencing a psychological crisis.",Gallegos A.M.; Streltzov N.A.; Stecker T.,2016.0,10.1097/NMD.0000000000000489,0,0,
7346,Oxytocin selectively modulates brain response to stimuli probing social synchrony,"The capacity to act collectively within groups has led to the survival and thriving of Homo sapiens. A central group collaboration mechanism is ""social synchrony,"" the coordination of behavior during joint action among affiliative members, which intensifies under threat. Here, we tested brain response to vignettes depicting social synchrony among combat veterans trained for coordinated action and following life-threatening group experience, versus controls, as modulated by oxytocin (OT), a neuropeptide supporting social synchrony. Using a randomized, double-blind, within-subject design, 40 combat-trained and control male veterans underwent magnetoencephalography (MEG) twice following OT/placebo administration while viewing two social vignettes rated as highly synchronous: pleasant male social gathering and coordinated unit during combat. Both vignettes activated a wide response across the social brain in the alpha band; the combat scene triggered stronger activations. Importantly, OT effects were modulated by prior experience. Among combat veterans, OT attenuated the increased response to combat stimuli in the posterior superior temporal sulcus (pSTS) - a hub of social perception, action observation, and mentalizing - and enhanced activation in the inferior parietal lobule (IPL) to the pleasant social scene. Among controls, OT enhanced inferior frontal gyrus (IFG) response to combat cues, demonstrating selective OT effects on mirror-neuron and mentalizing networks. OT-enhanced mirror network activity was dampened in veterans reporting higher posttraumatic symptoms. Results demonstrate that the social brain responds online, via modulation of alpha rhythms, to stimuli probing social synchrony, particularly those involving threat to survival, and OT's enhancing versus anxiolytic effects are sensitive to salient experiences within social groups.",Levy J.; Goldstein A.; Zagoory-Sharon O.; Weisman O.; Schneiderman I.; Eidelman-Rothman M.; Feldman R.,2016.0,10.1016/j.neuroimage.2015.09.066,0,0,
7347,Transcranial stimulation of the dorsolateral prefrontal cortex prevents stress-induced working memory deficits,"Stress isknownto impair workingmemoryperformance. This disruptive effect of stress on workingmemoryhas been linked to a decrease in the activity of the dorsolateral prefrontal cortex (dlPFC). In the present experiment, we tested whether transcranial direct current stimulation (tDCS) of the dlPFC can prevent stress-induced working memory impairments. We tested 120 healthy participants in a 2 d, sham-controlled, double-blind between-subjects design. Participants completed a test of their individual baseline working memory capacity on day 1. On day 2, participants were exposed to either a stressor or a control manipulation before they performed a visuospatial and a verbal working memory task. While participants completed the tasks, anodal, cathodal, or sham tDCS was applied over the right dlPFC. Stress impaired working memory performance in both tasks, albeit to a lesser extent in the verbal compared with the visuospatial workingmemorytask. This stress-induced workingmemoryimpairment was prevented by anodal, but not sham or cathodal, stimulation of the dlPFC. Compared with sham or cathodal stimulation, anodal tDCS led to significantly better working memory performance in both tasks after stress. Our findings indicate a causal role of the dlPFC in working memory impairments after acute stress and point to anodal tDCS as a promising tool to reduce cognitive deficits related to working memory in stress-related mental disorders, such as depression, schizophrenia, or post-traumatic stress disorder.",Bogdanov M.; Schwabe L.,2016.0,10.1523/JNEUROSCI.3687-15.2016,0,0,
7348,Impact of anionic ion exchange resins on NOM fractions: Effect on N-DBPs and C-DBPs precursors,"The formation potential of carbonaceous and nitrogenous disinfection by-products (C-DBPs, N-DBPs) after ion exchange treatment (IEX) of three different water types in multiple consecutive loading cycles was investigated. Liquid chromatography with organic carbon detector (LC-OCD) was employed to gauge the impact of IEX on different natural organic matter (NOM) fractions and data obtained were used to correlate these changes to DBPs Formation Potential (FP) under chlorination. Humic (-like) substances fractions of NOM were mainly targeted by ion exchange resins (40-67% removal), whereas hydrophilic, non-ionic fractions such as neutrals and building blocks were poorly removed during the treatment (12-33% removal). Application of ion exchange resins removed 13-20% of total carbonaceous DBPs FP and 3-50% of total nitrogenous DBPs FP. Effect of the inorganic nitrogen (i.e., Nitrate) presence on N-DBPs FP was insignificant while the presence of dissolved organic nitrogen (DON) was found to be a key parameter affecting the formation of N-DBPs. DON especially the portion affiliated with humic substances fraction, was reduced effectively (~77%) as a result of IEX treatment.",Bazri M.M.; Martijn B.; Kroesbergen J.; Mohseni M.,2016.0,10.1016/j.chemosphere.2015.10.086,0,0,
7349,Perineuronal Nets in the Adult Sensory Cortex Are Necessary for Fear Learning,"Lattice-like structures known as perineuronal nets (PNNs) are key components of the extracellular matrix (ECM). Once fully crystallized by adulthood, they are largely stable throughout life. Contrary to previous reports that PNNs inhibit processes involving plasticity, here we report that the dynamic regulation of PNN expression in the adult auditory cortex is vital for fear learning and consolidation in response to pure tones. Specifically, after first confirming the necessity of auditory cortical activity for fear learning and consolidation, we observed that mRNA levels of key proteoglycan components of PNNs were enhanced 4 hr after fear conditioning but were no longer different from the control groups 24 hr later. A similar pattern of regulation was observed in numbers of cells surrounded by PNNs and area occupied by them in the auditory cortex. Finally, the removal of auditory cortex PNNs resulted in a deficit in fear learning and consolidation. Banerjee et al., 2017 show that key components of the extracellular matrix, perineuronal nets (PNNs) in the auditory cortex of adult mice, are necessary for consolidation of fear learning in response to Pavlovian fear conditioning.",Banerjee S.B.; Gutzeit V.A.; Baman J.; Aoued H.S.; Doshi N.K.; Liu R.C.; Ressler K.J.,2017.0,10.1016/j.neuron.2017.06.007,0,0,
7350,Osteoclasts are recruited to the subchondral bone in naturally occurring post-traumatic equine carpal osteoarthritis and may contribute to cartilage degradation,"The role of osteoclasts in osteochondral degeneration in osteoarthritis (OA) has rarely been investigated in spontaneous disease or animal models of OA. Objective: The objectives of the current study were to investigate osteoclast density and location in post-traumatic OA (PTOA) and control specimens from racehorses. Method: Cores were harvested from a site in the equine third carpal bone, that undergoes repetitive, high intensity loading. Histological and immunohistochemical (Cathepsin K and Receptor-activator of Nuclear Factor kappa-β ligand (RANKL)) stained sections were scored (global and subregional) and the osteoclast density calculated. The cartilage histological scores were compared with osteoclast density and RANKL scores. Results: There was a greater density of osteoclasts in PTOA samples and they were preferentially located in the subchondral bone plate. RANKL scores positively correlated to the scores of cartilage degeneration and the osteoclast density. The relationship between hyaline articular cartilage RANKL score and osteoclast density was stronger than that of the subchondral bone RANKL score suggesting that cartilage RANKL may have a role in recruiting osteoclasts. The RANKL score in the articular calcified cartilage correlated with the number of microcracks also suggesting that osteoclasts recruited by RANKL may contribute to calcified cartilage degeneration in PTOA. Conclusion: Our results support the hypothesis that osteoclasts are recruited during the progression of spontaneous equine carpal PTOA by cartilage RANKL, contributing to calcified cartilage microcracks and focal subchondral bone loss.",Bertuglia A.; Lacourt M.; Girard C.; Beauchamp G.; Richard H.; Laverty S.,2016.0,10.1016/j.joca.2015.10.008,0,0,
7351,The value of armchairs in providing mechanical massage and mental relaxation programmes is not established for workplace health promotion,,London W.M.; Muller J.; Handlin L.; Harlén M.; Lindmark U.; Ekström A.,2016.0,10.1111/fct.12222,0,0,
7352,Effects of Compassion Meditation on a Psychological Model of Charitable Donation,"Compassion is critical for societal wellbeing. Yet, it remains unclear how specific thoughts and feelings motivate compassionate behavior, and we lack a scientific understanding of how to effectively cultivate compassion. Here, we conducted 2 studies designed to a) develop a psychological model predicting compassionate behavior, and b) test this model as a mediator of a Compassion Meditation (CM) intervention and identify the ""active ingredients"" of CM. In Study 1, we developed a model predicting compassionate behavior, operationalized as real-money charitable donation, from a linear combination of self-reported tenderness, personal distress, perceived blamelessness, and perceived instrumental value of helping with high cross-validated accuracy, r = .67, p < .0001. Perceived similarity to suffering others did not predict charitable donation when controlling for other feelings and attributions. In Study 2, a randomized controlled trial, we tested the Study 1 model as a mediator of CM and investigated active ingredients. We compared a smartphone-based CM program to 2 conditions-placebo oxytocin and a Familiarity intervention-to control for expectancy effects, demand characteristics, and familiarity effects. Relative to control conditions, CM increased charitable donations, and changes in the Study 1 model of feelings and attributions mediated this effect (pab = .002). The Familiarity intervention led to decreases in primary outcomes, while placebo oxytocin had no significant effects on primary outcomes. Overall, this work contributes a quantitative model of compassionate behavior, and informs our understanding of the change processes and intervention components of CM. (PsycINFO Database Record",Ashar Y.K.; Andrews-Hanna J.R.; Yarkoni T.; Sills J.; Halifax J.; Dimidjian S.; Wager T.D.,2016.0,10.1037/emo0000119,0,0,
7353,"Effects of 3,4-methylenedioxymethamphetamine on socioemotional feelings, authenticity, and autobiographical disclosure in healthy volunteers in a controlled setting","The drug 3,4-methylenedioxymethamphetamine (MDMA, ""ecstasy"", ""olly"") is a widely used illicit drug and experimental adjunct to psychotherapy. MDMA has unusual, poorly understood socioemotional effects, including feelings of interpersonal closeness and sociability. To better understand these effects, we conducted a small (n=12) within-subjects double-blind placebo controlled study of the effects of 1.5 mg/kg oral MDMA on social emotions and autobiographical disclosure in a controlled setting. MDMA displayed both sedative- and stimulant-like effects, including increased self-report anxiety. At the same time, MDMA positively altered evaluation of the self (i.e. increasing feelings of authenticity) while decreasing concerns about negative evaluation by others (i.e. decreasing social anxiety). Consistent with these feelings, MDMA increased how comfortable participants felt describing emotional memories. Overall, MDMA produced a prosocial syndrome that seemed to facilitate emotional disclosure and that appears consistent with the suggestion that it represents a novel pharmacological class.",Baggott M.J.; Coyle J.R.; Siegrist J.D.; Garrison K.J.; Galloway G.P.; Mendelson J.E.,2016.0,10.1177/0269881115626348,0,0,
7354,Trait attentional control influences the relationship between repetitive negative thinking and psychopathology symptoms,"Repetitive negative thinking (RNT) has been implicated in several disorders (e.g., Clark (2005)). However, little research has examined how RNT influences other risk factors of psychopathology, such as attentional control. This study used prospective methodology to determine if relationships among various RNT styles and symptoms of psychological disorders are indirectly influenced by facets of attentional control. The sample included 376 participants who completed measures of RNT (worry, rumination, anticipatory processing, obsessions, intrusive thoughts and panic cognitions), psychopathology (generalized anxiety disorder, depression, social anxiety, obsessive-compulsive disorder, posttraumatic stress disorder, and panic disorder), and attentional control at two time points. Several relationships between RNT forms and symptom levels were indirectly predicted by the focusing subscale of attentional control; however, the patterns of these relationships differed based on the disorder. The shifting subscale did not indirectly predict any relationship. Therefore, it appears that low focusing may be a particular risk factor for the development of later RNT and/or psychopathology symptoms.",Mills A.C.; Grant D.M.; Judah M.R.; White E.J.; Taylor D.L.; Frosio K.E.,2016.0,10.1016/j.psychres.2016.02.055,0,0,
7355,The impact of high trait social anxiety on neural processing of facial emotion expressions in females,"A cognitive model of social anxiety predicts that an early attentional bias leads to greater cognitive processing of social threat signals, whereas the vigilance-avoidance model predicts there will be subsequent reduction in cognitive processing. This study tests these models by examining neural responses to social threat stimuli using Event-related potentials (ERP). 19 women with high trait social anxiety and 19 women with low trait social anxiety viewed emotional expressions (angry, disgusted, happy and neutral) in a passive viewing task whilst ERP responses were recorded. The HSA group revealed greater automatic attention, or hypervigilance, to all facial expressions, as indexed by greater N1 amplitude compared to the LSA group. They also showed greater sustained attention and elaborative processing of all facial expressions, indexed by significantly increased P2 and P3 amplitudes compared to the LSA group. These results support cognitive models of social anxiety, but are not consistent with predictions of the vigilance-avoidance model.",Felmingham K.L.; Stewart L.F.; Kemp A.H.; Carr A.R.,2016.0,10.1016/j.biopsycho.2016.04.001,0,0,
7356,Post-operative follow-up practice of phyllodes tumour in the UK: Results from a national survey,"Introduction: Resected phyllodes tumours (PT) of the breast carry a small but significant risk of recurrence. Nevertheless, there are no national guidelines on the post-operative follow-up of these tumours potentially resulting in a wide variation in practice among breast surgeons in the UK. Methods: Aweb-based questionnaire was sent to NHS breast surgeons across the UK to assess individual follow-up practices including availability of local guidelines, methods of follow-up and influence of risk factors. Results: Only 38% from a total of 121 responses indicated the availability of local guidelines on PT follow-up. Modal follow-up duration for borderline and malignant disease was 5 years (53.7% and 79.3% of responses respectively), compared to 1 year for benign disease (43%) although 28% of respondents continue to review benign cases for 5 years. Less than 10% offered patient-directed follow-up for benign and borderline disease, mostly in NHS England. Within hospitals represented by more than one respondent in this survey, only 30% demonstrated consistent practices pertaining to length and frequency of post-operative PT follow-up. Around 25% of respondents from NHS England and NHS Northern Ireland reviewed patients clinically without routine imaging. Recurrent disease and margin status influenced the follow-up practice of 60% of respondents in our survey. Conclusion: This survey highlights the wide variation in post-operative follow-up for PT within the UK. This may affect the detection of disease relapse or, conversely, result in wasted clinical resources and unnecessary patient distress. Evidence-based national guidelines are necessary to resolve this issue and inform best follow-up practice.",Amer A.; McColl K.; Mathers H.,2016.0,10.1016/j.ejso.2016.02.058,0,0,
7357,Homophobia: An Impulsive Attraction to the Same Sex? Evidence From Eye-Tracking Data in a Picture-Viewing Task,"Introduction Some models suggest that homophobia can be explained as a denied attraction toward same-sex individuals. While it has been found that homophobic men have same-sex attraction, these results are not consistent. Aim This study drew on the dual-process models to test the assumption that sexual interest in homosexual cues among men high in homophobia will depend on their specific impulses toward homosexual-related stimuli. Methods Heterosexual men (N = 38) first completed a scale measuring their level of homonegativity. Then, they performed a manikin task to evaluate their impulsive approach tendencies toward homosexual stimuli (IAHS). Main outcomes measures A picture-viewing task was performed with simultaneous eye-tracking recording to assess participants’ viewing time of the visual area of interest (i.e., face and body). Results IAHS positively predicted the viewing time of homosexual photographs among men with a high score of homonegativity. Men with a high homonegativity score looked significantly longer at homosexual than at heterosexual photographs but only when they had a high IAHS. Conclusion These findings confirm the importance of considering the variability in impulsive processes to understand why some (but not all) men high in homophobia have homosexual interest. These findings reinforce the theoretical basis for elaborating a dual-process model for behaviors in the sexual context.",Cheval B.; Radel R.; Grob E.; Ghisletta P.; Bianchi-Demicheli F.; Chanal J.,2016.0,10.1016/j.jsxm.2016.02.165,0,0,
7358,Temporal changes in extracellular polymeric substances on hydrophobic and hydrophilic membrane surfaces in a submerged membrane bioreactor,"Membrane surface hydrophilic modification has always been considered to mitigating biofouling in membrane bioreactors (MBRs). Four hollow-fiber ultrafiltration membranes (pore sizes ~0.1 μm) differing only in hydrophobic or hydrophilic surface characteristics were operated at a permeate flux of 10 L/m2 h in the same lab-scale MBR fed with synthetic wastewater. In addition, identical membrane modules without permeate production (0 L/m2 h) were operated in the same lab-scale MBR. Membrane modules were autopsied after 1, 10, 20 and 30 days of MBR operation, and total extracellular polymeric substances (EPS) accumulated on the membranes were extracted and characterized in detail using several analytical tools, including conventional colorimetric tests (Lowry and Dubois), liquid chromatography with organic carbon detection (LC-OCD), fluorescence excitation - emission matrices (FEEM), fourier transform infrared (FTIR) and confocal laser scanning microscope (CLSM). The transmembrane pressure (TMP) quickly stabilized with higher values for the hydrophobic membranes than hydrophilic ones. The sulfonated polysulfone (SPSU) membrane had the highest negatively charged membrane surface, accumulated the least amount of foulants and displayed the lowest TMP. The same type of organic foulants developed with time on the four membranes and the composition of biopolymers shifted from protein dominance at early stages of filtration (day 1) towards polysaccharides dominance during later stages of MBR filtration. Nonmetric multidimensional scaling of LC-OCD data showed that biofilm samples clustered according to the sampling event (time) regardless of the membrane surface chemistry (hydrophobic or hydrophilic) or operating mode (with or without permeate flux). These results suggest that EPS composition may not be the dominant parameter for evaluating membrane performance and possibly other parameters such as biofilm thickness, porosity, compactness and structure should be considered in future studies for evaluating the development and impact of biofouling on membrane performance.",Matar G.; Gonzalez-Gil G.; Maab H.; Nunes S.; Le-Clech P.; Vrouwenvelder J.; Saikaly P.E.,2016.0,10.1016/j.watres.2016.02.064,0,0,
7359,Salsa dance and Zumba fitness: Acute responses during community-based classes,"Background: Research interest in both partnered Latin dance and non-partnered Latin-themed aerobic dance has increased in recent years, likely a result of the gaining popularity of these types of instructor-led group classes among the mainstream dance and fitness audiences; however, the efficacy of these activities for the purposes of health promotion currently remains unclear. The purpose of this study was to simultaneously assess the physiological responses and psychological experiences during salsa dance and Zumba fitness in a community sample of physically inactive women. Methods: Twenty-four participants, aged 22-56 years, visited the laboratory to perform a graded exercise test for determination of maximal oxygen uptake and maximal heart rate. The participants then attended 2 partnered salsa dance and 2 non-partnered Zumba fitness classes each in a counterbalanced order over a 2-week period. The 1-h classes were taught by certified instructors in established venues in the Royal Borough of Kingston and the surrounding communities of London, UK. Physiological data were collected using a wrist-worn ActiGraph wGT3X+ accelerometer with accompanying heart rate monitor and were processed using previously validated dance-specific techniques. Psychological experiences were measured via the Subjective Exercise Experiences Scale. Results: There was a significantly higher (p < 0.001) total time spent in moderate-to-vigorous physical activity (51.2 ± 3.1 vs. 32.6 ± 5.9 min), total energy expenditure (411 ± 66 vs. 210 ± 46 kcal), and total step count (6773 ± 556 vs. 4108 ± 781 steps) during Zumba fitness when compared to salsa dance. Significant pre- to post-class improvements in positive well-being (p < 0.01, partial η2 = 0.41) and psychological distress (p < 0.001, partial η2 = 0.72) were simultaneously observed for both salsa dance and Zumba fitness. Conclusion: The acute responses to classes of partnered Latin dance and non-partnered Latin-themed aerobic dance suggest that in physically inactive women participation is indeed efficacious in terms of community-based physical activity and psychosocial health promotion.",Domene P.A.; Moir H.J.; Pummell E.; Easton C.,2016.0,10.1016/j.jshs.2015.04.004,0,0,
7360,"Is the provision and management of peripheral and central venous catheters similar throughout France's CF centers? Access, choice and renewal frequency","Objectives: In 2014, during the French CF conference, a discussion between caregivers, patients and their family members revealed that the provision, choice and frequency of replacement of IV catheters [peripheral venous catheters (PVC), PICCs, Ports] varied widely between CF centers. We therefore sought to examine the disparities reported by patients. Methods: In December 2014, a 15 item questionnaire was sent to each CF center and was to be filled by a nurse/physician pair. By December 2015, 32 of 45 centers responded. Results: Only 53% of centers offered PICC placement. Frequency of CVP renewal varied from 3 days (6%) to 7 days (34%) or more (9%). Criteria for central line placement were: impaired peripheral access (94%); frequency of IV antibiotic courses (84%); comfort and safety (19%); continuous infusions (22%); home IV courses (9%); inexperienced homecare nurses (9%); drug toxicity (31%). The number of IV courses that justified a Port varied from 2 courses/year (6%) to 3-4 courses/year (34%). Indications for PICC vs PVC were: increased frequency of IV courses (34%); needle phobia (56%); continuous infusion (22%). Indications in favour of Ports vs PICCs are: reduced treatment initiation delay (44%); central vein protection (50%); decreased infection and thrombosis risk (31%); decreased risk of accidental displacement (37%); greater comfort when not in use (44%); patient acceptance (72%). Frequency of Port replacement varied from 3 years (3%) to 5 years (9%) or more (47%). Conclusion: Differences exist in the practice of CF centers. Multidisciplinary analysis of these differences could help harmonize practice and adopt evidence based practice guidelines.",Dupont C.; Panzo R.; Huber D.; Burnet E.; Honoré I.; Kanaan R.; Champreux J.; Burgel P.-R.; Colomb-Jung V.; Dusser D.; Duflos A.-S.,2016.0,,0,0,
7361,A possible link between supra-second open-ended timing sensitivity and obsessive-compulsive tendencies,"One of the main characteristics of obsessive-compulsive disorder (OCD) is the persistent feeling of uncertainty, affecting many domains of actions and feelings. It was recently hypothesized that OCD uncertainty is related to attenuated access to internal states. As supra-second timing is associated with bodily and interoceptive awareness, we examined whether supra-second timing would be associated with OC tendencies. We measured supra-second (9 s) and sub-second (450 ms) timing along with control non-temporal perceptual tasks in a group of 60 university students. Supra-second timing was measured either with fixed criterion tasks requiring to temporally discriminate between two predefined fixed interval durations (9 vs. 9.9 s), or with an open-ended task requiring to discriminate between 9 s and longer intervals which were of varying durations that were not a priori known to the participants. The open-ended task employed an adaptive Bayesian procedure that efficiently estimated the duration difference required to discriminate 9 s from longer intervals. We also assessed symptoms of OCD, depression, and anxiety. Open-ended supra-second temporal sensitivity was correlated with OC tendencies, as predicted (even after controlling for depression and anxiety), whereas the other tasks were not. Higher OC tendencies were associated with lower timing sensitivity to 9 s intervals such that participants with higher OC tendency scores required longer interval differences to discriminate 9 s from longer intervals. While these results need to be substantiated in future research, they suggest that open-ended timing tasks, as those encountered in real-life (e.g., estimating how long it would take to complete a task), might be adversely affected in OCD.",Gilaie-Dotan S.; Ashkenazi H.; Dar R.,2016.0,10.3389/fnbeh.2016.00127,0,0,
7362,The case for moderate-risk buyers: An empirical investigation,"Despite recent increase in research on compulsive buying and excessive buying, the category of buyers whose buying patterns are approaching the clinical level but still somewhat below it has rarely been recognized in the literature. In this paper, we propose the case for the category of moderate-risk buyers. Following Ridgway et al.'s (2008) findings, moderate-risk buyers were operationalized as scoring 21-24 on Compulsive Buying Index. We hypothesized that moderate-risk buyers would hold significantly higher materialistic values than non-compulsive buyers, while exhibiting significantly less depressive symptoms and covert narcissism than full-fledged compulsive buyers. An online survey of individuals who frequently engaged in buying lapses was used (N=809). We found that moderate-risk buyers were significantly different from both compulsive buyers and non-compulsive buyers in the frequency of buying lapses, hiding purchases and frequency of experiencing negative feelings leading to buying lapses. Furthermore, consistent with our hypothesis, moderate-risk buyers held significantly lower covert narcissism and depression than full-fledged compulsive buyers, but their materialism was not significantly different from each other. Our findings support the case for moderate-risk buyers as a separate group from full-fledged compulsive buyers.",Jung J.; Yi S.,2016.0,10.1016/j.psychres.2016.04.063,0,0,
7363,Predictors and moderators of biopsychological social stress responses following brief self-compassion meditation training,"Arch et al. (2014) demonstrated that brief self-compassion meditation training (SCT) dampened sympathetic (salivary alpha-amylase) and subjective anxiety responses to the Trier Social Stress Test (TSST), relative to attention and no-instruction control conditions. The present study examined baseline predictors and moderators of these SCT intervention effects. Baseline characteristics included two stress vulnerability traits (social anxiety and rumination) and two potential resiliency traits (non-attachment and self-compassion). We investigated how these traits moderated the effects of SCT on response to the TSST, relative to the control conditions. We also tested how these individual differences predicted TSST responses across conditions in order to uncover characteristics that confer increased vulnerability and resiliency to social stressors. Trait non-attachment, rumination (for sympathetic TSST response only), and social anxiety (for subjective TSST response only) interacted with training condition to moderate TSST responses such that following SCT, lower attachment and lower social anxiety predicted lower TSST stress responses, relative to those scoring higher on these traits. In contrast, trait self-compassion neither moderated nor predicted responses to the TSST. Thus, although SCT had robust effects on buffering stress across individuals with varying levels of trait self-compassion, other psychological traits enhanced or dampened the effect of SCT on TSST responses. These findings support the importance of examining the role of relevant baseline psychological traits to predict sympathetic and subjective responses to social evaluative threat, particularly in the context of resiliency training.",Arch J.J.; Landy L.N.; Brown K.W.,2016.0,10.1016/j.psyneuen.2016.03.009,0,0,
7364,Addiction to body modification,"Academy of Sciences, Saint-Petersburg State University Today it is obvious that the spectrum of addictive disorders consists of at least two groups: chemical (substance use) and behavior (or nonchemical) addictions. We have introduced the classification with five sections: 1) pathological gambling; 2) erotic addictions; 3) socially acceptable addictions; 4) technological addictions; 5) food addictions (Egorov, 2007; 2013; Egorov, Szabo, 2013). Body modification is the permanent or semi-permanent deliberate altering of the human body for non-medical reasons. In a 2010 study, 23% of Americans reported having at least one tattoo, and 8 percent reported sporting a piercing other than in the earlobe (Pew Research Center, 2010). Though the popularity of body modification is increasing, the psychosocial data about practitioners of body piercing and tattooing are few and controversial. In some cases the repeated body modification becomes uncontrollable and interferes negatively with life responsibilities, health and interpersonal relationships may be considered as a behavior addiction. Body modifications may be classified as Reversible: wearing unusual clothes and jewellery, colouring of the body (make-up, body art), manipulation with the hair, beard, moustaches and nails, weight change, and Irreversible: decorating skin with tattoos, scarification, implantation of foreign objects (mikrodermal and/ or transdermal implantation), piercing, operational modifications of the teeth, tongue, genitals, fingers and toes until the desire for amputation, suspension, repeated cosmetic surgery. The leading motive of body modifications is to get pleasure from the individually produced changes, which are partly connected with the sexual desire and relationship with partner. This gives satisfaction in their own eyes. This desire is moving closer to manifestations of sexual fetishism and primarily with fetishistic transvestism. Repeated body modification may be classified as a behavioural addiction (among socially acceptable addiction section up to our classification) because of obsessive-compulsive craving with inability to correct which is based not only on social circumstances but on personality characteristics. As in other addictions human behavior is not consistent with the concept of society about what is acceptable or unacceptable. Further investigations are needed to elucidate the definition of the body modification addiction.",Egorov A.Y.,2016.0,10.2340/00015555-2158,0,0,
7365,Physical and psychological effects of head treatment in the supine position using specialized ayurveda-based techniques,"Objective: To clarify the physical and psychological effects of head massage performed in the supine position using Ayurveda-based techniques (head treatment). Design: Twenty-four healthy female students were included in the study. Using a crossover study design, the same participants were enrolled in both the head treatment intervention group and control group. There was an interval of 1 week or more between measurements. Outcome measures: The physiologic indices measured included blood pressure and heart rate fluctuations (high frequency and low frequency/high frequency). The psychological markers measured included liveliness, depression, and boredom using the visual analogue scale method. State anxiety was measured using the State-Trait Anxiety Inventory method. Results: The parasympathetic nerve activity increased immediately after head treatment. Upon completion of head treatment, the parasympathetic nerve predominance tended to gradually ease. Head treatment boosted freshness and relieved anxiety. Conclusions: The results suggest that head treatment has a relaxing and refreshing effect and may be used to provide comfort.",Murota M.; Iwawaki Y.; Uebaba K.; Yamamoto Y.; Takishita Y.; Harada K.; Shibata A.; Narumoto J.; Fukui K.,2016.0,10.1089/acm.2015.0388,0,0,
7366,Stability and repeatability of the distress thermometer (DT) and the edmonton symptom assessment system-revised (ESASr) with parents of childhood cancer survivors,"Objective Parents report psychological distress in association with their child's cancer. Reliable tools are needed to screen parental distress over the cancer trajectory. This study aimed to estimate the stability and repeatability of the Distress Thermometer (DT) and the Depression and Anxiety items of the Edmonton Symptom Assessment System-revised (ESAS-r-D; -A) in parents of children diagnosed with cancer. Methods Fifty parents (28 mothers, median age = 44) of clinically stable survivors of childhood solid and brain tumours completed questionnaires about their own distress (DT, ESAS-r-D; -A, Brief Symptom Inventory-18: BSI-18, Patient Health Questionnaire-9: PHQ-9, Generalized Anxiety Disorder-7: GAD-7) and their children's quality of life (QoL; Peds Quality of Life: PedsQL) twice, with a month interval between the two assessments. At retest, parents also evaluated life events that occurred between the two time points. Hierarchical regressions explored moderators for the temporal stability of test measures. Results Stability estimates were ICC = .78 for the DT, .55 for the ESAS-r-D, and .47 for the ESAS-r-A. Caseness agreement between test and retest was substantial for the DT, fair for the ESAS-r-D, and slight for the ESAS-r-A. Repeatability analyses indicated that the error range for the DT was more than 2 pts below/above actual measurement, whereas it was more than 3 pts for the ESAS-r-A, and 2.5 for the ESAS-r-D. Instability of the DT could be explained by changes in children's physical QoL, but not by other components of QoL or life events. No moderators of stability could be identified for the ESAS-r items. Conclusions The DT appears to be a fairly stable measure when the respondent's condition is stable yet with a relatively wide error range. Fluctuations in distress-related constructs may affect the temporal stability of the DT. The lower stability of ESAS-r items may result from shorter time-lapse instructions resulting in a greater sensitivity to change. Findings support future research on the DT as a reliable instrument in caregivers.",Leclair T.; Carret A.-S.; Samson Y.; Sultan S.,2016.0,10.1371/journal.pone.0159773,0,0,
7367,Sense of coherence and mental health among seafarers in relation to physical activity,"Introduction Seafaring is a specific occupation due to long-term isolation from the society and the family. The aim of the study was to investigate the prevalence of psychological distress (PD), its extreme form posttraumatic stress disorder (PTSD) and sense of coherence (SOC) among seafarers in relation to occupational and leisure time physical activity (PhA). Methods 248 seafarers, attending the Maritime Medical Centre in Klaipeda for the mandatory health examination answered the General Health Questionnaire (GHQ-12), 169 seafarers answered the questionnaire on PTSD and 335 on SOC. The prevalence of PD, PTSD and SOC among seafarers was evaluated and the correlations with occupational PhA were calculated. The mean values of the 3 scales were compared to 4 groups of occupational and 3 groups of leisure time PhA. The differences in means were tested by significance level (p < 0.05). The statistical software SPSS 13.0 for Windows was used in the statistical analysis. Results The prevalence of PD among seafarers was 9.3%, PTSD 5.3%, weak SOC 24.2%. Spearman's correlation between SOC and PD was 0.211 (p < .01), between SOC and PTSD 0.211 (p < 0.01). PTSD was negatively correlated with occupational physical activity (Spearman's correlation -0.249 (p < 0.01), showing higher PTSD levels in low occupational physical activity groups. SOC was correlated with occupational (Spearman's correlation 0.108 (p < 0.05) and leisure time (Spearman's correlation 0.114 (p < 0.05) PhA. SOC was weaker in the heavy occupational PhA group and showed no difference between leisure time PhA groups. The mean values of the GHQ-12 scale showed no differences in the occupational and leisure time PhA groups. Conclusions Psychological distress was not more prevalent among seafarers as a compared to the investigations among other occupations. Posttraumatic stress disorder negatively correlated with occupational physical activity. Sense of coherence among the seafarers was weaker in the heavy occupational physical activity group.",Malinauskaite I.; Malinauskiene V.; Malinauskas M.,2016.0,10.1136/oemed-2016-103951.546,0,0,
7368,Habitual Use of High-Heeled Shoes Affects Isokinetic Soleus Strength More Than Gastrocnemius in Healthy Young Females,"Background: Habitual use of high-heeled shoes (HHS) has been reported to negatively impact different body structures. However, few studies have investigated its effect on plantarflexor performance. The aim of this study was to investigate the effect of habitual wear of HHS and knee joint position (to isolate the function of the gastrocnemius) on the isokinetic performance of the plantarflexors and ankle joint range of motion (ROM). Methods: A high-heel (HH) group included 12 women (25.4 ± 4.8 y) who have been wearing HHS for ≥40 hours/wk and for at least a year. A control group (CTRL) had 12 women (21.3 ± 0.5 y) who have occasionally been wearing HHS for <10 hours/wk. Participants performed isokinetic (60 degrees/s) plantarflexion movements through a range set between 15 degrees dorsiflexion and 30 degrees plantarflexion. Ankle joint ROM and average peak plantarflexion torque and power were recorded in 2 knee joint positions, extension and 90 degrees flexion. Results: Overall, torque was significantly affected by knee position (P =.04) and habitual use of HHS (P <.001), whereas power was impacted by knee position only (P <.001). Within each group, flexing the knee reduced isokinetic measurements. However, the reduction was greater for the HH group (torque: 54 Nm, power: 35.6 W) compared with the CTRL group (torque: 42 Nm, power: 32.5 W). Ankle joint ROM was significantly different between groups in knee flexion only. Conclusion: Flexing the knee limited the plantarflexor muscular performance and the limitation was more significant in habitual users of HHS compared to nonusers. Thus, it is concluded that habitual use of HHS impacts the contractile properties of soleus more than gastrocnemius. Clinical Relevance: The soleus is important for walking and anterior cruciate ligament protection. Thus, HHS users could be susceptible to injury and may need longer and more intensive posttraumatic rehabilitation. Therefore, clinicians should consider knee position when examining the plantarflexors of habitual HHS users.",Farrag A.; Elsayed W.,2016.0,10.1177/1071100716649172,0,0,
7369,"Psychological health and wellbeing in Australian gulf war veterans, 20 years after deployment","Background Ten years after the 1990-1991 Gulf War, Australian veterans were found to have significantly poorer psychological health and physical and mental wellbeing, compared to a military comparison group. Approximately 20 years after the Gulf War, the psychological health and wellbeing of the cohort was reassessed. Methods In a baseline study (2000-2002) and at follow up (2011-2012) the Composite International Diagnostic Interview (CIDI) was used to assess the presence of DSM-IV 12 month psychological disorders. Structured self-report instruments included the Short-Form 12 Health Survey, General Health Questionnaire-12, Patient Health Questionnaire-9, Posttraumatic Stress Disorder Checklist, Demoralisation Scale and Connor Davidson-Resilience Scale. Results The risk of PTSD and alcohol disorder in Gulf War veterans (veterans) at follow up was approximately twice that in the comparison group (PTSD adj relative risk (RR) 2.37; 95% CI: 1.37-4.09; alcohol adj RR 1.93; 1.10-3.38). Since baseline, the risk of 12 month PTSD in veterans had significantly increased (adj RR 1.96; 1.29-2.97), in contrast the risk in the comparison group had remained relatively stable, and there was no significant difference between groups. Veterans were not at significantly excess risk of major depression at follow up, although they reported more severe depressive symptoms. Other DSM-IV psychological disorders were infrequent in both study groups. Veterans reported significantly poorer physical and mental wellbeing than the comparison group, and had higher levels of demoralisation but were equally resilient. Conclusions Our findings highlight the 20 year longer-term psychological health and wellbeing of a Gulf War veteran cohort, indicating that psychological morbidity and poorer physical and mental wellbeing remain increased in veterans relative to a military comparison group. Effective strategies are needed to continue to identify and manage existing chronic conditions including psychological conditions and to prevent future cases.",Kelsall H.; Ikin J.; McKenzie D.; Gwini S.; Forbes A.; Wright B.; Sim M.,2016.0,10.1136/oemed-2016-103951.104,0,0,
7370,Understanding the early service leaver,"Introduction Previous studies have shown that Early Service Leavers (ESL) are at increased risk of adverse socio-economic outcomes such as unemployment, homelessness and crime, as well as poor mental health. The Scottish Veterans Health Study enabled exploration of long-term health outcomes in relation to length of service. This paper presents a comparison of the health of ESL with both longer-serving veterans and with non-veterans, and explores implications for transition. Methods Retrospective cohort study of 57,000 veterans and 173,000 people with no record of service, born between 1945 and 1985 who were resident in Scotland, matched for age, sex and geographical region, and stratified by length of service for veterans, followed up for up to 30 years. Health outcomes were compared using survival analysis methodology (Cox proportional hazards). Results The veteran cohort included 14,000 ESL, of whom 6,000 failed to complete initial training. People who were older at recruitment were more likely to become ESL. ESL were at higher risk of smoking-related disease than either longer-serving veterans or non-veterans. For alcohol-related outcomes, the risk was only increased in ESL who completed training. ESL were not at increased risk of drug misuse. The highest risk of PTSD was in ESL who did not complete training, whilst veterans with the longest service were at lower risk than non-veterans. Conclusion The Scottish Veterans Health Study has confirmed the poorer health outcomes of ESL reported in earlier studies. It is unlikely that military service is causal, and it is more likely that it represents a selection effect. The early weeks of training may act as a filter for those who are unsuited to military service, resulting in a 'less healthy leaver effect' which mirrors the 'healthy worker effect' in longer-serving people. Ensuring that ESL transition into new employment may help to minimise adverse outcomes.",Bergman B.; Mackay D.; Pell J.,2016.0,10.1136/oemed-2016-103951.268,0,0,
7371,CO2 exposure as translational cross-species experimental model for panic,"The current diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders are being challenged by the heterogeneity and the symptom overlap of psychiatric disorders. Therefore, a framework toward a more etiology-based classification has been initiated by the US National Institute of Mental Health, the research domain criteria project. The basic neurobiology of human psychiatric disorders is often studied in rodent models. However, the differences in outcome measurements hamper the translation of knowledge. Here, we aimed to present a translational panic model by using the same stimulus and by quantitatively comparing the same outcome measurements in rodents, healthy human subjects and panic disorder patients within one large project. We measured the behavioral-emotional and bodily response to CO2 exposure in all three samples, allowing for a reliable cross-species comparison. We show that CO2 exposure causes a robust fear response in terms of behavior in mice and panic symptom ratings in healthy volunteers and panic disorder patients. To improve comparability, we next assessed the respiratory and cardiovascular response to CO2, demonstrating corresponding respiratory and cardiovascular effects across both species. This project bridges the gap between basic and human research to improve the translation of knowledge between these disciplines. This will allow significant progress in unraveling the etiological basis of panic disorder and will be highly beneficial for refining the diagnostic categories as well as treatment strategies.",Leibold N.K.; Van Den Hove D.L.A.; Viechtbauer W.; Buchanan G.F.; Goossens L.; Lange I.; Knuts I.; Lesch K.P.; Steinbusch H.W.M.; Schruers K.R.J.,2016.0,10.1038/tp.2016.162,0,0,
7372,The role of alternating bilateral stimulation in establishing positive cognition in EMDR therapy: A multi-channel near-infrared spectroscopy study,"Eye movement desensitisation and reprocessing (EMDR) is a standard method for treating post-traumatic stress disorder. EMDR treatment consists of desensitisation and resource development and installation (RDI) stages. Both protocols provide a positive alternating bilateral stimulation (BLS). The effect of desensitisation with BLS has been elucidated. However, a role for BLS in RDI remains unknown. Therefore, it is important to measure feelings as subjective data and physiological indicators as objective data to clarify the role of BLS in RDI. RDI was administered to 15 healthy volunteer subjects who experienced pleasant memories. Their oxygenated haemoglobin concentration ([oxy-Hb]), a sensitive index of brain activity, was measured from the prefrontal cortex (PFC) to the temporal cortex using multi-channel near-infrared spectroscopy during recall of a pleasant memory with or without BLS. The BLS used was alternating bilateral tactile stimulation with a vibration machine. The psychological evaluation suggested that RDI was successful. The results showed that, compared with non-BLS conditions, accessibility was increased and subjects were more relaxed under BLS conditions. A significant increase in [oxy-Hb] was detected in the right superior temporal sulcus (STS), and a decrease in the wide bilateral areas of the PFC was observed in response to BLS. The significant BLS-induced activation observed in the right STS, which is closely related to memory representation, suggests that BLS may help the recall of more representative pleasant memories. Furthermore, the significant reduction in the PFC, which is related to emotion regulation, suggests that BLS induces relaxation and comfortable feelings. These results indicate an important neural mechanism of RDI that emotional processing occurred rather than higher cognitive processing during this stage. Considering the neuroscientific evidence to date, BLS in RDI may enhance comfortable feelings about pleasant memories. Based on the current findings, the use of BLS in RDI may be warranted in some clinical situations.",Amano T.; Toichi M.,2016.0,10.1371/journal.pone.0162735,0,0,
7373,"The role of genes encoding the transcription factors c-Fos, c-Jun and Ier5 in posttraumatic stress disorder","Background: Post-traumatic stress disorder (PTSD) is continuous psychological disorder, that may develop after exposure to exceptionally threatening or horrifying events (DSM-V code: 309.81). In this disorder, the patient is exposed to a traumatic event, which involves death or a threat of death, and the patient's responses to that event are very intense fear and distress. The patient shows serious disturbed behaviors and clinical disorder in his/her individual, social, and occupational performance, which would not occur before the trauma because the patient repeatedly recalls the traumatic experience. Therefore, development of prognostic strategies, novel efficient methods on early diagnostics and treatment of PTSD is currently considered as one of the most important healthcare problems worldwide. It is suggested that implication of both environmental and genetic factors are involved in pathomechanisms of PTSD. The importance of genetic influences on PTSD risk have been recognized for half a century, however, insufficient knowledge about genetic variations associated with PTSD is limiting a progress in elaboration of the efficient measures of its early diagnosis and treatment. Defects in synaptic plasticity, which has a direct connection with a cognitive function, play an important role in pathogenesis of PTSD. However, molecular pathomechanisms responsible for synaptic plasticity alterations in PTSD are not entirely clear. Transcription factors play an important role in regulation of synaptic plasticity. Variations in transcription factors encoding genes lead to alterations in synaptic plasticity. Among this type of transcriptional factors are c-Fos (proto-oncogene c-Fos), c-Jun (Fos-binding protein p39) and Ier5 (immediate early response 5). In the present study we evaluated the association of single nucleotide polymorphisms (SNPs) rs7101, rs1063169, rs11688 and rs6425663 of c-Fos, c-Jun and Ier5 encoding genes (FOS, JUN, and IER5, respectively) with PTSD. Methods: Study population includes 200 combat veterans with PTSD and an equal number of age- and sex-matched healthy controls. The experiments were performed using genomic DNA samples of study subjects. Methodological design was based on polymerase chain reaction with sequence-specific primers (PCRSSP). Data was evaluated using Hardy-Weinberg equilibrium, Pearson's Chi-square test, Bonferroni multiple correction approach. Results: According to the data obtained, the rs7101‚àóT allele of the FOS gene was more frequent in patients than in controls (pnominal = 2.02E-37). Also, the carriers of rs7101‚àóT minor allele were overrepresented in the group of patients compared to controls (pnominal = 6.57E-22). In contrast, the rs1063169‚àóT minor allele of the FOS gene was more frequent among controls compared to patients (pnominal = 7.48E-16). Also, the carriers of this allele were more in the group of controls compared to patients (pnominal = 8.51E-13). After Bonferroni correction, difference in allele frequency between the patient and control groups for these minor alleles remained significant. In case of other selected polymorphisms no significant association with PTSD was found (p>0.05). Conclusions: In conclusion, our results demonstrate association of PTSD with the polymorphisms of FOS rs7101 and rs1063169 gene. Furthermore, the data obtained suggests that FOS rs7101‚àóT allele might be nominated as risk factors, whereas the FOS rs1063169‚àóT allele might be protective against developing PTSD.",Avetyan D.; Mkrtchyan G.,2016.0,,0,0,
7374,Interaction effect of brooding rumination and interoceptive awareness on depression and anxiety symptoms,"Awareness of the body (i.e., interoceptive awareness) and self-referential thought represent two distinct, yet habitually integrated aspects of self. A recent neuroanatomical and processing model for depression and anxiety incorporates the connections between increased but low fidelity afferent interoceptive input with self-referential and belief-based states. A deeper understanding of how self-referential processes are integrated with interoceptive processes may ultimately aid in our understanding of altered, maladaptive views of the self – a shared experience of individuals with mood and anxiety disorders. Thus, the purpose of the current study was to examine how negative self-referential processing (i.e., brooding rumination) relates to interoception in the context of affective psychopathology. Undergraduate students (N = 82) completed an interoception task (heartbeat counting) in addition to self-reported measures of rumination and depression and anxiety symptoms. Results indicated an interaction effect of brooding rumination and interoceptive awareness on depression and anxiety-related distress. Specifically, high levels of brooding rumination coupled with low levels of interoceptive awareness were associated with the highest levels of depression and anxiety-related distress, whereas low levels of brooding rumination coupled with high levels of interoceptive awareness were associated with lower levels of depression and anxiety-related distress. The findings provide further support for the conceptualization of anxiety and depression as conditions involving the integration of interoceptive processes and negative self-referential processes.",Lackner R.J.; Fresco D.M.,2016.0,10.1016/j.brat.2016.08.007,0,0,
7375,"Devils, witches, and psychics: The role of thought-action fusion in the relationships between obsessive-compulsive features, religiosity, and paranormal beliefs","Research suggests that religiosity is related to obsessive-compulsive disorder (OCD). Moreover, one previous study found that paranormal beliefs are associated with OCD. It is currently unclear whether these relationships are independent of one another and what mechanisms may underlie them. The objectives of this study were to determine whether religiosity and paranormal beliefs are uniquely related to various features of OCD and whether moral thought action fusion (TAF-M) and/or likelihood thought-action fusion (TAF-L) mediate these relationships. A cross-sectional design was used in which 801 students completed measures of religiosity, paranormal beliefs, OCD, and thought-action fusion. Results indicated that religiosity and paranormal beliefs are uniquely related to OCD features. Further, TAF-M and TAF-L mediated most of the relationships between the two belief systems and OCD. Moreover, the results indicated that TAF-M accounts for more of the relationship between religious beliefs and OCD than does TAF-L. In contrast, TAF-L accounts for more of the relationship between paranormal beliefs and OCD than does TAF-M. This study helps elucidate the nature of the relationship between OCD and different belief systems, and the results suggest that therapeutically targeting TAF may represent a culturally sensitive means to severing the connection between these belief systems and OCD.",Mauzay D.; Spradlin A.; Cuttler C.,2016.0,10.1016/j.jocrd.2016.10.003,0,0,
7376,Building the Case for a Value-based Integrated Mental Health Services Access and Financial Model for a Comprehensive Cancer Center,"Background/Purpose: Although MDACC has an integrated, multidisciplinary delivery model of care, the value and impact of psychosocial service provision on patient outcomes is unknown. Using a phased approach, our goal is to develop and adopt a model of care that will ensure access to affordable, high-quality psychosocial services for our patients and families, as well as set the standard and benchmark the integration of psychosocial services into cancer care delivery. Methods: Phase I was accomplished by conducting an extensive literature review of the psychosocial cancer care landscape, reviewing current institutional policy and standard of practice regarding distress management, and evaluating stakeholder data from social work, nursing, psychiatry services, clinical operations, finance and sourcing and contract management. A summary of distress tool use and screening processes among our comprehensive cancer center counterparts was also compiled. Results: Phase I resulted in the development of a conceptual framework for gaps and barriers to treatment and their impact on sustaining value-based care for our targeted stakeholders. With the lack of evidence to quantify the value, impact, or benefit of psychosocial services on cancer patient outcomes (sustainability), the unsustainable growth in the cost of cancer care (coverage), a lack of infrastructure to support service needs (services), and the inconsistent use of distress screening processes and service resources (timeliness/workforce), our patient, family, provider and community needs will continue to go unmet. Conclusions: The conceptual framework supports the need for developing a value-based integrated mental health services access and financial model for a comprehensive cancer center.",Bell M.; Stepan K.; Meyer M.; Anderson J.; Calhoun J.; Guzman A.; Thomas J.; Rodriguez M.A.; Valentine A.,2016.0,10.1002/pon.4272,0,0,
7377,Sex differences in attention to disgust facial expressions,"Research demonstrates that women experience disgust more readily and with more intensity than men. The experience of disgust is associated with increased attention to disgust-related stimuli, but no prior study has examined sex differences in attention to disgust facial expressions. We hypothesised that women, compared to men, would demonstrate increased attention to disgust facial expressions. Participants (n = 172) completed an eye tracking task to measure visual attention to emotional facial expressions. Results indicated that women spent more time attending to disgust facial expressions compared to men. Unexpectedly, we found that men spent significantly more time attending to neutral faces compared to women. The findings indicate that women’s increased experience of emotional disgust also extends to attention to disgust facial stimuli. These findings may help to explain sex differences in the experience of disgust and in diagnoses of anxiety disorders in which disgust plays an important role.",Kraines M.A.; Kelberer L.J.A.; Wells T.T.,2016.0,10.1080/02699931.2016.1244044,0,0,
7378,No effects of psychosocial stress on memory retrieval in non-treated young students with Generalized Social Phobia,"Generalized Social Phobia (GSP) is a common anxiety disorder that produces clear social life disruptions. There is no consensus on the specific processes involved in its development, but the role of the hypothalamic-pituitary-adrenal (HPA) axis has been suggested. This study analyzed the effects of the cortisol response to the Trier Social Stress Test (TSST) on the memory retrieval of pictures with different emotional valences in 45 non-treated young students with GSP and 50 non-anxious (NA) subjects (mean = 19.35 years, SD = 0.18). No differences were found in the cortisol response of GSP and NA subjects to the TSST and control sessions. In addition, psychosocial stress impaired memory retrieval in both the GSP and NA groups, with no differences between them. Regarding the sex factor, no effects were found in the cortisol response to the TSST. However, during the encoding session, GSP men had higher cortisol levels than GSP women and NA subjects. There was also a significant interaction between sex and stress exposure on memory retrieval. Women recognized more unpleasant and neutral pictures than men; however, under stress, the women's advantage disappeared, and the men's performance improved. Sex also interacted with social phobia on positive mood, with GSP women exposed to the TSST showing the lowest positive mood. These results suggest that GSP subjects do not present an HPA axis sensitization to psychosocial stress, and they emphasize the importance of Sex in understanding stress effects on memory.",Espín L.; Marquina M.; Hidalgo V.; Salvador A.; Gómez-Amor J.,2016.0,10.1016/j.psyneuen.2016.07.211,0,0,
7379,Exploring the implementation of psychosocial care guidelines in a radiation oncology treatment centre,"Background: Uncertainty about treatment processes, side-effects and outcomes, contribute to the high rates of psychological distress among cancer patients receiving radiotherapy. To optimize supportive cancer care during radiotherapy, there is a need to explore and enhance uptake of guidelines for detecting and managing psychosocial issues, in radiation oncology treatment centers. Aims: (1) To assess radiation oncology treatment center staff awareness of, agreement with, adoption of, and adherence to, psychosocial care guidelines. (2) To develop, implement and test (based on staff and patient perceptions) a strategy for improving uptake of psychosocial care guidelines in radiation oncology settings. Methods: Design: Quasi-experimental pre-post test (without control group). Sample: Healthcare providers and patients attending a radiation oncology treatment center. Data collection: Phase 1 (and 3 if required): Radiation oncology department staff will complete an online survey assessing uptake of psychosocial guideline recommendations. Patient's perceptions of their psychosocial care will also be assessed. Phase 2: If required, a psychosocial guideline implementation enhancement package will be developed and implemented, targeting any gaps in psychosocial guideline uptake that are identified by staff and patients. Data analysis: Descriptive statistics will be used to inform development of the psychosocial guideline implementation enhancement package. Nonparametric statistics will be used to compare pre- and posttest staff-reported and patient-perceived psychosocial care. Results: A project update and preliminary findings will be presented at the 2016 Hunter Cancer Research Symposium. Conclusions: This study will progress translational research in psychooncology, in turn reducing psychosocial distress among radiation oncology patients. Translational research aspect: This project fits within the T3 research component of the HCRA Second Flagship (Implementation Research), as it is expected that the research team and site-based working party will develop an implementation strategy aimed at decreasing an evidence-practice gap in cancer care (the provision of guideline adherent psychosocial care for adults in oncology settings).",Mackenzie L.; Kelly M.; Waller A.; Grady A.; Leigh L.; Moylan R.; Kelly B.,2016.0,,0,0,
7380,Stop checking: Repeated checking and its effects on response inhibition and doubt,"Background Repeated checking is a common ritual in obsessive-compulsive disorder (OCD). van den Hout and Kindt (2003b) devised a task demonstrating paradoxical reductions in memory confidence following repeated checking. This effect was later found to be contingent upon response inhibition. The current study aims to (1) test an alternative interpretation, whereby repeated-checking effects are caused by viewing multiple exemplars, and (2) test whether repeated checking affects response inhibition. Method 132 students participated in two experiments (66 in Experiment 1 and 66 in Experiment 2). Participants were randomly allocated to a repeated-checking task or a simple-action task that featured similar multiple exemplars without the need for checking. Both tasks were followed by a stop-signal task, measuring response inhibition. Experiment 1 featured a stop-signal task with neutral go-signals while Experiment 2 incorporated familiar and unfamiliar stimuli from the previous task as go-signals. Results In both experiments, the repeated-checking group exhibited reduced memory confidence compared to the simple-action group. Groups did not differ in their response inhibition for neutral stimuli (Experiment 1), while familiar go-signals had a detrimental effect on response inhibition (Experiment 2). Limitations Our results examine the association between checking and response inhibition in healthy participants without attention deficit hyperactivity disorder and dyslexia. Replication with clinical samples awaits future studies. Conclusions Repeated checking impairs memory confidence. Increased familiarity of stimuli shortens the time it takes to respond to them while it impairs inhibition response to them. These effects possibly provide initial evidence for the hypothesized role of response inhibition in the maintenance of OCD.",Linkovski O.; Kalanthroff E.; Henik A.; Anholt G.E.,2016.0,10.1016/j.jbtep.2014.12.007,0,0,
7381,Quantitative models reveal dissociable effects of instructions and feedback on pain and aversive learning: Implications for placebo effects and clinical outcomes,"Background: Expectations-predictions about the future based on conscious beliefs and previous experience-play a central role in emotion, cognition, and well-being. Expectations shape perception across nearly all psychological domains, tuning responses even in the earliest stages of sensory processing. Expectations also directly influence clinical outcomes in the form of placebo effects (expectations about treatments). Despite their profound influence, we know little about the mechanisms by which expectancies actually modulate affective experience and clinical outcomes. In this talk, I will present a series of studies that used quantitative models to characterize the relationship between explicit beliefs, affective learning, and conscious pain experience. We asked whether expectations induced through verbal instruction have dissociable effects from those learned through experience, and how these in turn shape physiological, neural, and subjective responses to clinically relevant outcomes, such as pain. Methods: In our initial work (Study 1; Atlas et al, 2016, eLife) we measured the effects of instructions during aversive reversal learning. One group of participants was instructed about stimulus contingencies and reversals, while a second group learned from feedback alone. We introduced a new computational model that flexibly captures effects of instructions on feedback-driven learning, and fit this model to autonomic responses from both groups. Responses fit to the Uninstructed Group capture learning from feedbackalone, while responses fit to the Instructed Group isolate learning that updates with instructions. We then used these responses to isolate neural correlates of feedback-driven and instructed aversive learning. We have since extended this work to measure how these two factors influence subjective decisions about pain (Study 2; Atlas et al, In progress) by crossing this paradigm with a thermal pain task designed to measure expectancy effects on pain (adapted from Atlas et al, 2010, JNeurosci). Results: Study 1 revealed dissociable effects of instructions on the neural systems of aversive learning. The striatum and orbitofrontal cortex tracked aversive learning that updated with instructions, and correlated with the prefrontal cortex response to instructions. However, the amygdala learned from feedback irrespective of instruction. Study 2 reveals related dissociations between expectancy effects verbal decisions and autonomic responses. Specifically, verbal pain reports are biased toward initial learning, whereas autonomic responses update in response to contingency changes throughout the task. Finally, individual differences in anxiety moderate the effects of initial learning on autonomic responses, suggesting links between anxiety and dissociations in expectancy-based processing. Conclusions: Expectations have profound effects on subjective, neural, and autonomic outcomes. Quantitative models allow neuroscientists to isolate different factors that give rise to expectations and identify neural processes that support potential dissociations. The dissociations we observe are consistent with evolutionary theories of biological preparedness in the amygdala, and may be linked to the important role of experiential learning for successful treatment of anxiety disorders and PTSD. As placebo effects are thought to depend on the joint combination of explicit instruction and prior experience, this mechanistic approach holds promise to further isolate the mechanisms that underlie placebo effects and thereby harness them to improve clinical outcomes.",Atlas L.,2016.0,10.1038/npp.2016.239,0,0,
7382,Cognitive Bias Modification to Enhance Resilience to a Panic Challenge,"This study tested an intervention to enhance resilience among people at risk for developing panic disorder. Participants (N = 50) high in anxiety sensitivity (fear of anxiety symptoms) were randomly assigned to either four sessions of resilience-enhancing interpretation bias modification (CBM-I) or a control (Sham) condition. Following the intervention, participants engaged in a 7.5 % steady state carbon dioxide (CO2) breathing challenge, an established panic stressor. In line with hypotheses, CBM-I resulted in an increase in resilience-congruent interpretations (though no change for general panic interpretation bias) at post-training, and a trend for a greater reduction in anxiety sensitivity at 2-month follow-up. Additionally, CBM-I resulted in less intense cognitive symptoms of panic during the CO2 challenge, though not less intense physical or total panic symptoms. These results, though somewhat mixed, provide preliminary support for the value of training resilience using CBM-I.",Beadel J.R.; Mathews A.; Teachman B.A.,2016.0,10.1007/s10608-016-9791-z,0,0,
7383,Lack of predictive power of trait fear and anxiety for conditioned pain modulation (CPM),"In recent years the association of conditioned pain modulation (CPM) with trait fear and anxiety has become a hot topic in pain research due to the assumption that such variables may explain the low CPM efficiency in some individuals. However, empirical evidence concerning this association is still equivocal. Our study is the first to investigate the predictive power of fear and anxiety for CPM by using a well-established psycho-physiological measure of trait fear, i.e. startle potentiation, in addition to two self-report measures of pain-related trait anxiety. Forty healthy, pain-free participants (female: N = 20; age: M = 23.62 years) underwent two experimental blocks in counter-balanced order: (1) a startle paradigm with affective picture presentation and (2) a CPM procedure with hot water as conditioning stimulus (CS) and contact heat as test stimulus (TS). At the end of the experimental session, pain catastrophizing (PCS) and pain anxiety (PASS) were assessed. PCS score, PASS score and startle potentiation to threatening pictures were entered as predictors in a linear regression model with CPM magnitude as criterion. We were able to show an inhibitory CPM effect in our sample: pain ratings of the heat stimuli were significantly reduced during hot water immersion. However, CPM was neither predicted by self-report of pain-related anxiety nor by startle potentiation as psycho-physiological measure of trait fear. These results corroborate previous negative findings concerning the association between trait fear/anxiety and CPM efficiency and suggest that shifting the focus from trait to state measures might be promising.",Horn-Hofmann C.; Priebe J.A.; Schaller J.; Görlitz R.; Lautenbacher S.,2016.0,10.1007/s00221-016-4763-9,0,0,
7384,Rorschach Performance Assessment System (R-PAS) and vulnerability to stress: A preliminary study on electrodermal activity during stress,"This study investigated the predictive validity of the ten Rorschach Performance Assessment System (R-PAS) variables from the Stress and Distress domain, by testing whether they predicted increased sympathetic reactivity to a mild, laboratory-induced stress, occurred one week after Rorschach administration. A relatively small student sample (N=52) contributed to this research: During a first meeting (T1) participants were administered the Rorschach task according to R-PAS guidelines; about one week later (T2) their electrodermal activity (EDA) was recorded during exposure to a mild laboratory stress-inducing task. Based on literature indicating that exposure to stress tends to increase physiological vulnerability/reactivity to stressful situations, we anticipated that Stress and Distress R-PAS variables measured at T1 would positively correlate with increased sympathetic reactivity to stress at T2, as indicated by greater EDA changes from baseline to stress and recovery. Results partially confirmed our hypotheses: (a) the mean of and (b) the majority of the Stress and Distress R-PAS variables were significantly correlated, in the expected direction, with medium and medium to large effect sizes.",Giromini L.; Ando' A.; Morese R.; Salatino A.; Di Girolamo M.; Viglione D.J.; Zennaro A.,2016.0,10.1016/j.psychres.2016.09.036,0,0,
7385,One size doesn't fit all: Responders and non-responders to exercise interventions for cancer patients and survivors,"Introduction Research conducted in people without cancer demonstrates substantial inter-individual heterogeneity in response to exercise. Cancer introduces additional factors that may further influence the response. It is unclear which cancer patients do and don't respond to exercise or what factors influence the magnitude of response. Objectives Explore whether there is heterogeneity of effect among people with cancer in response to exercise. Methods 600 people with cancer (70% female, 30% male; age 61±12 years; BMI: 27 ±5 kg.m-2; 2.1±3.2 years since diagnosis) within 2 years of treatment participated in this investigation. Participants had been diagnosed with one of ∼40 different types of cancer, predominately breast (43%), prostate (13%) and bowel (9%). Participants self-enrolled in a 3-month community-based exercise program involving supervised moderate-intensity aerobic and re-sistance exercise. Assessment of physical function, fatigue, distress and quality of life (QOL) were conducted at baseline and post-intervention. Results Significant (p≤0.05) differences existed in the magnitude of change in all variables assessed (Table 1, Figure 1). Patients with the poorest baseline values had significantly greater change in all variables. The magnitude of change in all variables assessed did not vary between patients currently on vs. off treatment, <1-year vs. >1-year since diagnosis or common vs. rare cancer types (Figure 2).",Cormie P.; Lamb S.; Newton R.; Valentine L.; McKiernan S.; Nigel S.; Joseph D.; Taaffe D.; Galvao D.,2017.0,10.1007/s00520-017-3704-x,0,0,
7386,Occupational therapist delivered cognitive behavioral therapy for insomnia to post-9/11 veterans in college: A wait list control pilot study,"Introduction: The prevalence of chronic insomnia in post-9/11 Veterans is substantial, especially for those with service-connected injuries. Veterans' access to cognitive behavioral therapy for insomnia (CBT-I) is limited and expanding access to CBT-I is a critical need. Sleep is an area of concern for occupational therapists (OTs) and studies of OT-delivered CBT-I are warranted to ensure safe and effective care. Methods: Design: Wait list control pilot study. Sample: 6 treatment (1 female) and 8 wait list control (1 female) post-9/11 Veterans with service-connected injuries and chronic insomnia in college. Intervention: 7-weeks of multi-component CBT-I (i.e., sleep restriction, stimulus control, psycho-education, sleep hygiene, and mindfulness) delivered by OTs with advanced training in CBT-I using weekly 1-hour group meetings concurrent with weekly individual meetings. Outcomes: Insomnia Severity Index, Patient Health Questionnaire- Depression, Generalized Anxiety Disorder 7-item, Perceived Stress Scale, Dysfunctional Beliefs about Sleep, PROMIS-Satisfaction with Social Roles, Engagement in Meaningful Activities Survey. Sleep Onset Latency (SOL), Wake after Sleep Onset (WASO), Total Sleep Time (TST), and Sleep Efficiency (SE) were collected only in the treatment group. All data were collected using an internet-based interface. Analyses: 2X2 (condition X time) repeated measures ANOVA and paired t-test (SOL, WASO, TST, SE) with Generalized Eta-Squared (GES) effect sizes (.01 = small, .06 = medium, .14 = large). Results: The treatment group had reduced insomnia (p < .001; GES = .27), depression (p = .02; GES = .05), anxiety (p = .02; GES = .04), and stress (p = .01; GES = .07), fewer dysfunctional sleep beliefs (p < .001; GES = .39), trending greater social role satisfaction (p = .07; GES = .11) and meaningfulness in daily activities (p = .08; GES = .06); and reduced SOL (p = .03; GES = .48) and higher SE (p = .04; GES = .44) with non-significant changes found in WASO (p = .11) and TST (p = .20). There were no adverse events. Conclusion: It is feasible for OTs trained in multi-component CBT-I to safely and effectively deliver CBT-I to Veterans with service-connected injuries in college.",Eakman A.M.; Rolle N.R.; Henry K.L.,2017.0,,0,0,
7387,Lucid dreaming in veterans with PTSD: Nonnightmare dreams and nightmares,"Introduction: Lucid dreaming (LD) involves awareness, while dreaming, that one is dreaming and metacognitive monitoring of the ongoing dream. Estimates of LD in general population samples are 31-37% with rare (< one per month), and 20-30% with frequent (‚â• one per month), LD. The study of LD has important applications for examining the nature of consciousness during sleep and for understanding and treating dream disturbances including posttraumatic nightmares. LD can be assessed tri-dimensionally: dream awareness, dream content control, and control of waking from a dream. We have reported that a group of Veterans with PTSD and recurrent nightmares demonstrated a LD profile characterized by high dream awareness and low dream content control. Here we examined whether the LD profiles of Veterans with PTSD differed between LD in non-nightmare dreams and in nightmares. Methods: Thirty-two Veterans with current PTSD (mean age = 42, range = 24 - 60; 19% female) were recruited from the Crescenz VAMC Mental Health Clinic. They completed self-report questionnaires including the Nightmare Frequency Questionnaire, the LD subscale of the Iowa Sleep Experiences Scale, and the Lucidity and Consciousness in Dreams Scale. Lucidity in non-nightmare dreams and in nightmares was assessed. Results: Eighty-eight percent of participants reported at least one nightmare per week (mean = 4.7). Fifty-four percent had frequent awareness of non-nightmare dreams; only 22% had non-nightmare dream content control. Eighty-two percent had frequent awareness of nightmares; only 24% had nightmare content control. Conclusion: Compared to general population samples, Veterans with PTSD had a higher percentage of frequent lucid dreamers. For non-nightmare dreams, and more prominently for nightmares, they demonstrated a LD profile characterized by high dream awareness and low dream content control. The combination of high conscious awareness of dreaming and inability to control dream content may contribute to the distress of posttraumatic nightmares. These findings can be applied to the development of novel treatments for the nightmare disturbance in PTSD.",Harb G.C.; Greene J.L.; Dent K.M.; Ross R.J.,2017.0,,0,0,
7388,"Visual-vestibular and postural analysis of motion sickness, panic, and Acrophobia","Background: Visual-vestibular and postural interactions can act as cues that trigger motion sickness and can also have a role in some anxiety disorders. We explore a method to detect individual sensitivity to visual-vestibular unusual patterns, which can signal a vulnerability to develop motion sickness and possibly anxiety disorders such as a fear of heights and panic. Material/Methods: 65 undergraduate students were recruited for the purposes of this study as voluntary participants (44 females) average age 21.65 years (SD=2.84) with normal or corrected to normal vision, without vestibular or postural deficiencies. Panic was assessed with the Albany Panic and Phobia Questionnaire, Motion Sickness with the Motion Sickness Susceptibility Questionnaire and Acrophobia was assessed by means of the Acrophobia Questionnaire. The Sharpened Romberg Test was used to test participant’s postural balance. The Rod and Frame Test (RFT) measures the participant’s ability to align a rod to the vertical within a titled frame providing a measure of error in the perception of verticality by degrees. This test was changed to measure the error offered when a participant’s head was tilted, and to trace the error caused by manipulating the vestibular system input. Results: The main findings show only motion sickness to be correlated with significant errors while performing a visual-vestibular challenging situation, and fear of heights is the only anxiety disorder connected with postural stability, although all disorders (fear of heights, panic and motion sickness) are correlated between each other in the selfreport questionnaires. Conclusions: All disorders are correlated to each other in the surveys, and might have some common visual-vestibular origin, in theory. The rod and frame test was exclusively correlated with motion sickness whereas the postural stability test only displayed sensibility to acrophobia. Panic disorder was correlated to neither the RFT nor the Romberg. Although this method was initially employed to increase sensibility in order to detect anxiety disorders, it ended up showing its value in the detection of motion sickness.",Coelho C.M.; Silva J.; Pereira A.F.; Sousa E.; Taephant N.; Pisitsungkagarn K.; Santos J.A.,2017.0,,0,0,
7389,Caregivers' Perspectives on the Use of Long-Term Oxygen Therapy for the Treatment of Refractory Breathlessness: A Qualitative Study,"Context Despite limited clinical evidence, long-term oxygen therapy (LTOT) is used for the management of refractory breathlessness in people with life-limiting illnesses who are not necessarily hypoxemic. Objectives The aim of this study was to understand caregiver factors associated with caring for someone with LTOT from the perspectives and experiences of caregivers themselves. Methods The qualitative study used semistructured interviews. The study was conducted in two states in Australia. Participants (n = 20) were self-nominated caregivers of people receiving LTOT for refractory breathlessness in the palliative setting. Results Data analyses established one overarching theme titled: “Oxygen giveth (something to help caregivers relieve breathlessness) and oxygen taketh away (from patients who lose some autonomy).” The theme captured caregivers' feelings of extreme distress in response to witnessing refractory breathlessness, and oxygen fulfilling several critical and beneficial roles in this context. In parallel, caregivers also explicitly and implicitly articulated several downsides to the use of LTOT. Conclusion Caregivers find caring for someone with refractory breathlessness extremely distressing. The benefits of LTOT are often overestimated, whereas its potential harms are underestimated. As significant stakeholders of people receiving LTOT, caregivers should be provided with opportunities to collaborate with clinicians in evidence-based decision making, efforts should be made to provide them with information and education about the most effective pharmacological and nonpharmacological strategies to manage refractory breathlessness in a palliative care setting including the appropriate use of LTOT to enable them to do so.",Collier A.; Breaden K.; Phillips J.L.; Agar M.; Litster C.; Currow D.C.,2017.0,10.1016/j.jpainsymman.2016.06.007,0,0,
7390,Are media reports able to cause somatic symptoms attributed to WiFi radiation? An experimental test of the negative expectation hypothesis,"People suffering from idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) experience numerous non-specific symptoms that they attribute to EMF. The cause of this condition remains vague and evidence shows that psychological rather than bioelectromagnetic mechanisms are at work. We hypothesized a role of media reports in the etiology of IEI-EMF and investigated how somatosensory perception is affected. 65 healthy participants were instructed that EMF exposure can lead to enhanced somatosensory perception. Participants were randomly assigned to watch either a television report on adverse health effects of EMF or a neutral report. During the following experiment, participants rated stimulus intensities of tactile (electric) stimuli while being exposed to a sham WiFi signal in 50% of the trials. Sham WiFi exposure led to increased intensity ratings of tactile stimuli in the WiFi film group, especially in participants with higher levels of somatosensory amplification. Participants of the WiFi group reported more anxiety concerning WiFi exposure than the Control group and tended to perceive themselves as being more sensitive to EMF after the experiment compared to before. Sensational media reports can facilitate enhanced perception of tactile stimuli in healthy participants. People tending to perceive bodily symptoms as intense, disturbing, and noxious seem most vulnerable. Receiving sensational media reports might sensitize people to develop a nocebo effect and thereby contribute to the development of IEI-EMF. By promoting catastrophizing thoughts and increasing symptom-focused attention, perception might more readily be enhanced and misattributed to EMF.",Bräscher A.-K.; Raymaekers K.; Van den Bergh O.; Witthöft M.,2017.0,10.1016/j.envres.2017.03.040,0,0,
7391,A Brief Homophobia Scale in Medical Students From Two Universities: Results of A Refinement Process,"Background The process of evaluating measurement scales is an ongoing procedure that requires revisions and adaptations according to the characteristics of the participants. The Homophobia Scale of seven items (EHF-7) has showed acceptable performance in medical students attending to two universities in Colombia. However, performance of some items was poor and could be removed, with an improvement in the psychometric findings of items retained. Objective To review the psychometric functioning and refine the content of EHF-7 among medical students from two Colombian universities. Methods A group of 667 students from the first to tenth semester participated in the research. Theirs ages were between 18 and 34 (mean, 20.9 ± 2.7) years-old, and 60.6% were females. Cronbach alpha (α) and omega of McDonald (Ω) were calculated as indicators of reliability and to refine the scale, an exploratory (EFA) and confirmatory factor analysis (CFA) was performed. Results EHF-7 showed α = .793 and Ω = .796 and a main factor that explained 45.2% of the total variance. EFA and CFA suggested the suppression of three items. The four-item version (EHF-4) reached an α = .770 and Ω = .775, with a single factor that accounted for 59.7% of the total variance. CFA showed better indexes (χ2 = 3.622; df = 1; P = .057; Root-mean-square error of approximation (RMSEA) = .063, 90% CI, .000-.130; Comparative Fit Indices (CFI)=.998; Tucker-Lewis Index (TLI) = .991). Conclusions EHF-4 shows high internal consistency and a single dimension that explains more than 50% of the total variance. Further studies are needed to confirm these observations, that can be taken as preliminary.",Campo-Arias A.; Herazo E.; Oviedo H.C.,2017.0,10.1016/j.rcp.2016.03.005,0,0,
7392,Acquisition and inhibition of conditioned fear is modulated by individual stimulus fear-relevance,"Inhibitory learning is an important factor for decreasing fear expression. We investigated conditioned inhibition of learned fear responses using conditioned excitors and inhibitors differing in fear-relevance in a sample of 48 healthy female students. To study the effect of stimulus fear-relevance, we used the fear potentiated startle paradigm in an AX+/BX‚àí discrimination learning task with fear-relevant (spider) vs. fear-irrelevant (butterfly) pictures as CS+ (A) and CS‚àí (B), respectively. We found that, during acquisition, participants with elevated fear of spiders showed stronger fear potentiated startle to AX+ compared to BX‚àí when the inhibitor (B) was fear-irrelevant (butterfly) using both median split as well as correlational analyses. In contrast, when the excitor (A) was fear-irrelevant (butterfly), fear potentiated startle to AX+ compared to BX‚àí was reduced for participants with higher fear of spiders. Effects of conditioned inhibition were studied in a summation test, where excitor and inhibitor were presented in compound (AB) and compared to the last four excitor trials during prior acquisition. Conditioned inhibition was stronger for participants with a higher fear of spiders, when the butterfly acted as conditioned inhibitor (B). On the other hand, when the spider served as conditioned inhibitor, effects of conditioned inhibition were weaker for participants with higher fear of spiders. Hence, rather than to a general preparedness our data point to a specific impairment in safety learning for individually fear-relevant stimuli.",Neubert J.; Hillbrandt K.; Weymar M.; Hamm A.O.; Wendt J.,2017.0,10.1016/j.nlm.2016.11.015,0,0,
7393,Family factors related to major psychiatric disorders in Latina Americans nationwide,"Background: Despite a rapidly growing Latina/o American population, little is known about modifiable factors that could protect Latinas against major psychiatric disorders. Objective(s): The present study explored psychosocial risk (Negative Interaction) and protective factors (Family Cohesion, Social Support, Religious Involvement, Racial and Ethnic Identity) for major depressive disorder (MDD), general anxiety disorder (GAD), and suicidal ideation (SI) among Latinas participating in the first national mental health epidemiological survey of Latina Americans. Material/Methods: We conducted three sets of logistic regressions, predicting outcomes for 1,427 Latinas identified in the National Latino and Asian American Study (NLAAS), the first nationally representative, epidemiological study of Latino and Asian Americans living in the United States. These analyses followed preplanned steps: Model 1 used known predictors as controls and Model 2 added psychosocial risk and predictive factors beyond the known predictors. Results: For each outcome examined, psychosocial risk and protective factors produced a significantly better model fit in Model 2 than sociodemographic and acculturation variables known to predict mental health outcomes in Model 1 (x2mdd change = 14.62; df = 5; p < .05; x2gad change = 21.41; df = 5; p < .01; x2SI change = 18.97; df = 5; p < .01). Negative Interactions were associated with increased likelihood of GAD (OR = 1.5, 95% CI: 1.02,2.22, p < .05) and SI (OR = 2.30, 95% CI: 1.489,3.538, p < .0001), whereas Family Cohesion seemed to be protective against GAD (OR = 0.8, 95% CI:0.68,0.93, p < .01). No psychosocial factors predicted MDD. Conclusions: Differential protective and risk factors for major psychiatric disorders suggest that health care providers may need certain family dynamic related components in order to improve assessment and prevention for Latinas.",Ai A.; Deichen M.; Pappas C.,2017.0,10.1089/jwh.2017.29011.abstracts,0,0,
7394,Infrapatellar fat pad aggravates degeneration of acute traumatized cartilage: a possible role for interleukin-6,"Objectives The infrapatellar fat pad (IPFP), which is located underneath the patella, close to cartilage surfaces, functions in distributing mechanical load and has been shown to produce cytokines. This study aims to assess the involvement of the IPFP in the progression of post-traumatic osteoarthritis (OA) through investigating the crosstalk between the IPFP and injured cartilage in vitro. Methods A single blunt impact (36 MPa) on healthy bovine articular cartilage explants was used to generate traumatized cartilage. Conditioned media from IPFP and traumatized cartilage (FP-CM and TC-CM) were prepared separately. After culturing in FP-CM, the posttraumatic cartilage explants were analyzed for expression of cartilage degeneration associated genes and secretion of the interleukin (IL)-6, into the culture medium. The effect of traumatized cartilage on IPFP was studied by treating IPFP-derived adipocytes and IPFP adipose-derived stromal cells (ADSC) with TC-CM followed by analysis of cytokine expression. Results FP-CM aggravated glycosaminoglycan (GAG) release in traumatized cartilage, but did not significantly affect healthy cartilage. FP-CM raised gene expression of cyclooxygenase-2, inducible nitric oxide synthase, and IL-6 in traumatized cartilage explants, and lowered expression of tissue inhibitor of metalloproteinases-1, 2, 3, compared to non-conditioned medium. Of particular significance is that medium IL-6 levels increased substantially in both FP-CM and FP-CM treated traumatized cartilage cultures. Extrinsic IL-6 treatment of traumatized cartilage simulated part of the effects of FP-CM. TC-CM elevated levels of IL-6 expression in IPFP derived adipocytes and ADSCs. Conclusions IPFP aggravates post-traumatized cartilage degeneration, and IL-6 is a candidate tissue degeneration mediator.",He J.; Jiang Y.; Alexander P.G.; Ulici V.; Zhu Y.; Wu S.; Tuan R.S.,2017.0,10.1016/j.joca.2016.09.001,0,0,
7395,Characteristics and fate of natural organic matter during UV oxidation processes,"Advanced oxidation processes (AOPs) are widely used in water treatments. During oxidation processes, natural organic matter (NOM) is modified and broken down into smaller compounds that affect the characteristics of the oxidized NOM by AOPs. In this study, NOM was characterized and monitored in the UV/hydrogen peroxide (H2O2) and UV/persulfate (PS) processes using a liquid chromatography–organic carbon detector (LC-OCD) technique, and a combination of excitation–emission matrices (EEM) and parallel factor analysis (PARAFAC). The percentages of mineralization of NOM in the UV/H2O2 and UV/PS processes were 20.5 and 83.3%, respectively, with a 10 mM oxidant dose and a contact time of 174 s (UV dose: approximately 30,000 mJ). Low-pressure, Hg UV lamp (254 nm) was applied in this experiment. The steady-state concentration of SO4−[rad] was 38-fold higher than that of [rad]OH at an oxidant dose of 10 mM. With para-chlorobenzoic acid (pCBA) as a radical probe compound, we experimentally determined the rate constants of Suwannee River NOM (SRNOM) with [rad]OH (kOH/NOM = 3.3 × 108 M−1s−1) and SO4−[rad] (kSO4-/NOM = 4.55 × 106 M−1s−1). The hydroxyl radical and sulfate radical showed different mineralization pathways of NOM, which have been verified by the use of LC-OCD and EEM/PARAFAC. Consequently, higher steady-state concentrations of SO4−[rad], and different reaction preferences of [rad]OH and SO4−[rad] with the NOM constituent had an effect on the mineralization efficiency.",Ahn Y.; Lee D.; Kwon M.; Choi I.-H.; Nam S.-N.; Kang J.-W.,2017.0,10.1016/j.chemosphere.2017.06.079,0,0,
7396,Modeling the development of panic disorder with interoceptive conditioning,"Panic disorder is characterized by the paroxysmal occurrence and fear of bodily symptoms. In recent years it has been proposed that patients “learn” to fear cardiorespiratory sensations through interoceptive conditioning. This study sought to model the initial stage of this process in healthy volunteers (N=44) using mild cardiac sensations. An additional aim was to explore whether anxiety sensitivity – a known risk factor for panic disorder – modulates such interoceptive learning. Infusions of pentagastrin and saline were used to manipulate the presence versus absence of cardiac sensations, respectively, and served as conditioned stimuli in a differential interoceptive conditioning paradigm. Inhalation of 35% CO2-enriched air served as the panicogenic, unconditioned stimulus (UCS). In half of the participants (“prepared” condition), cardiac sensations caused by pentagastrin were followed by inhalation of CO2-enriched air (penta CS+), whereas the absence of such sensations (saline) was followed by room air (saline CS−). The reversed combination (“unprepared” condition) was used in the other half of the participants. Conditioning effects showed up for self-reported UCS-expectancy, but not for skin conductance and anxiety ratings. Only participants from the prepared group learned to expect the UCS, and differential learning was impaired with higher scores on anxiety sensitivity. Expectancy learning was more easily established towards the presence compared to the absence of cardiac sensations, whereas the reverse effect was observed for safety learning. Modeling impaired discriminatory learning and the moderating effect of anxiety sensitivity provides new insight in the development of panic disorder.",De Cort K.; Schroijen M.; Hurlemann R.; Claassen S.; Hoogenhout J.; Van den Bergh O.; Goossens L.; Van Diest I.; Schruers K.,2017.0,10.1016/j.euroneuro.2016.11.001,0,0,
7397,Value congruence and depressive symptoms among critical care clinicians: The mediating role of moral distress,"Clinicians working in intensive care units are often exposed to several job stressors that can negatively affect their mental health. Literature has acknowledged the role of value congruence and job control in determining clinicians' psychological well-being and depressive symptoms. However, potential mediators of this association have been scarcely examined. This study aimed to test the mediating role of moral distress in the relationship between value congruence and job control, on the one hand, and depression, on the other hand. A cross-sectional study involving physicians, nurses, and residents working in 7 intensive care units in the north of Italy was conducted. Clinicians were administered in the Italian Moral Distress Scale-Revised, the value and control subscales of the Areas of Worklife Scale, and the Beck Depression Inventory II. Structural equation modeling was used to test the mediation model. Analysis on 170 questionnaires (response rate 72%) found no relations between job control and moral distress. A total indirect effect of value congruence on depression through moral distress (β = -.12; p = .02) was found. Moral distress contributes to the development of depressive symptoms among critical care clinicians who perceive a value incongruence with their organization and therefore should be addressed.",Lamiani G.; Dordoni P.; Argentero P.,2017.0,10.1002/smi.2769,0,0,
7398,Dynamic brain connectivity is a better predictor of PTSD than static connectivity,"Using resting-state functional magnetic resonance imaging, we test the hypothesis that subjects with post-traumatic stress disorder (PTSD) are characterized by reduced temporal variability of brain connectivity compared to matched healthy controls. Specifically, we test whether PTSD is characterized by elevated static connectivity, coupled with decreased temporal variability of those connections, with the latter providing greater sensitivity toward the pathology than the former. Static functional connectivity (FC; nondirectional zero-lag correlation) and static effective connectivity (EC; directional time-lagged relationships) were obtained over the entire brain using conventional models. Dynamic FC and dynamic EC were estimated by letting the conventional models to vary as a function of time. Statistical separation and discriminability of these metrics between the groups and their ability to accurately predict the diagnostic label of a novel subject were ascertained using separate support vector machine classifiers. Our findings support our hypothesis that PTSD subjects have stronger static connectivity, but reduced temporal variability of connectivity. Further, machine learning classification accuracy obtained with dynamic FC and dynamic EC was significantly higher than that obtained with static FC and static EC, respectively. Furthermore, results also indicate that the ease with which brain regions engage or disengage with other regions may be more sensitive to underlying pathology than the strength with which they are engaged. Future studies must examine whether this is true only in the case of PTSD or is a general organizing principle in the human brain.",Jin C.; Jia H.; Lanka P.; Rangaprakash D.; Li L.; Liu T.; Hu X.; Deshpande G.,2017.0,10.1002/hbm.23676,0,0,
7399,Psychosocial influences on exercise-induced hypoalgesia,"Objective. The purpose of this study was to examine psychosocial influences on exercise-induced hypoalgesia (EIH). Design. Randomized controlled trial. Setting. Clinical research unit in a hospital. Subjects. Fifty-eight healthy men and women (mean age = 21 ± 3 years) participated in this study. Methods. Participants were first asked to complete a series of baseline demographic and psychological questionnaires including the Pain Catastrophizing Scale, the Fear of Pain Questionnaire, and the Family Environment Scale. Following this, they were familiarized with both temporal summation of heat pain and pressure pain testing protocols. During their next session, participants completed the Profile of Mood States, rated the intensity of heat pulses, and indicated their pressure pain thresholds and ratings before and after three minutes of submaximal, isometric exercise. Situational catastrophizing was assessed at the end of the experimental session. Results. Results indicated that experimental pain sensitivity was significantly reduced after exercise (P < 0.05). Men and women did not differ on any of the measured psychosocial variables (P > 0.05). Positive family environments predicted attenuated pain sensitivity and greater EIH, whereas negative and chronic pain-present family environments predicted worse pain and EIH outcomes. Situational catastrophizing and negative mood state also predicted worse pain and EIH outcomes and were additionally associated with increased ratings of perceived exertion and muscle pain during exercise. Conclusions. This study provides preliminary evidence that psychosocial variables, such as the family environment and mood states, can affect both pain sensitivity and the ability to modulate pain through exercise-induced hypoalgesia.",Brellenthin A.G.; Crombie K.M.; Cook D.B.; Sehgal N.; Koltyn K.F.,2017.0,10.1093/pm/pnw275,0,0,
7400,"Depressive, anxiety and post-traumatic stress disorders at six years after occupational injuries","The aim of this study is to determine the prevalence rates of depressive, anxiety and PTSDs, and the risk factors for psychological symptoms at 6 years after occupational injury. This longitudinal study followed workers who were occupationally injured in 2009. Psychological symptoms and return to work were assessed at 3 and 12 months after injury. Injured workers who had completed the initial questionnaire survey at 3 or 12 months after injury were recruited. A self-administered questionnaire was mailed to the participants. For workers with high Brief Symptom Rating Scale and Post-traumatic Symptom Checklist scores, an in-depth psychiatric evaluation was performed using the Mini-international Neuropsychiatric Interview. A total of 570 workers completed the questionnaire (response rate, 28.7%). Among them, 243 (42.6%) had high psychological symptom scores and were invited for a phone interview; 135 (55.6%) completed the interview. The estimated rates of major depression and post-traumatic stress disorder (PTSD)/partial PTSD were 9.2 and 7.2%, respectively, and both these rates were higher at 6 years after injury than at 12 months after injury (2.0 and 5.1%). After adjustment for family and social factors, the risk factors for high psychological scores were length of hospitalization immediately after injury, affected physical appearance, repeated occupational injuries, unemployment, and number of quit jobs after the injury. At 6 years after occupational injury, the re-emergence of psychiatric disorders was observed. Relevant factors for poor psychological health were severity of injury and instability of work. Periodic monitoring of psychological and physical health and economic stability are warranted.",Chin W.-S.; Shiao J.S.-C.; Liao S.-C.; Kuo C.-Y.; Chen C.-C.; Guo Y.L.,2017.0,10.1007/s00406-016-0762-x,0,0,
7401,Parkinson's disease patient preference and experience with various methods of DBS lead placement,"Introduction: Physiology-guided deep brain stimulation (DBS) surgery requires patients to be awake during a portion of the procedure, which may be poorly tolerated. Interventional MRI-guided (iMRI) DBS surgery was developed to use real-time image guidance, obviating the need for patients to be awake during lead placement. Methods: All English-speaking adults with PD who underwent iMRI DBS between 2010 and 2014 at our Center were invited to participate. Subjects completed a structured interview that explored perioperative preferences and experiences. We compared these responses to patients who underwent the physiology-guided method, matched for age and gender. Results: Eighty-nine people with PD completed the study. Of those, 40 underwent iMRI, 44 underwent physiology-guided implantation, and five underwent both methods. There were no significant differences in baseline characteristics between groups. The primary reason for choosing iMRI DBS was a preference to be asleep during implantation due to: 1) a history of claustrophobia; 2) concerns about the potential for discomfort during the awake physiology-guided procedure in those with an underlying pain syndrome or severe off-medication symptoms; or 3) non-specific fear about being awake during neurosurgery. Conclusion: Participants were satisfied with both DBS surgery methods. However, identification of the factors associated with a preference for iMRI DBS may allow for optimization of patient experience and satisfaction when choices of surgical methods for DBS implantation are available.",LaHue S.C.; Ostrem J.L.; Galifianakis N.B.; San Luciano M.; Ziman N.; Wang S.; Racine C.A.; Starr P.A.; Larson P.S.; Katz M.,2017.0,10.1016/j.parkreldis.2017.04.010,0,0,
7402,Copeptin – A potential endocrine surrogate marker of CCK-4-induced panic symptoms?,"Intravenous cholecystokinin-tetrapeptide (CCK-4) administration reliably and dose-dependently provokes panic anxiety in man, accompanied by adrenocorticotropic hormone (ACTH) and cortisol release. Preclinical findings suggest that behavioral and endocrine effects of CCK-4 are mediated via corticotropin-releasing hormone (CRH) release. Anxiogenic stimulation of the central CCK-receptors in man was shown to increase as well vasopressin (AVP), which acts synergistically with CRH as pituitary-adrenocortical axis stimulator during stress. Copeptin (CoP), the C-terminal part of pre-pro-AVP, is released in an equimolar ratio to AVP. It is more stable in the circulation and easier to determine than AVP and it was found to closely mirror the production of AVP. So far, CoP secretion has not been characterized during panic provocation. In 30 healthy male human subjects, we repeatedly measured CoP in plasma during a panic challenge and studied its correlation to Acute Panic Inventory (API) ratings and plasma ACTH and cortisol. CoP levels correlated positively with the increase in API ratings (r = 0.41, p = 0.03), while ACTH or cortisol did not (r = 0.08, p = 0.68 and r = 0.12, p = 0.53, respectively). CoP levels correlated also positively with ACTH (r = 0.48, p = 0.009) and cortisol (r = 0.48, p = 0.01) concentrations throughout the CCK-4 challenge. As expected, we found a positive correlation between plasma ACTH and cortisol levels (r = 0.57, p = 0.001). A vasopressinergic activation during CCK-4 induced panic was demonstrated, which was correlated positively to panic symptoms and pituitary-adrenocortical release. Our findings suggest a role of CoP as a potential surrogate marker of CCK-4 panic symptoms. Further studies are needed to replicate our results and to further clarify the role of CoP as a stress-sensitive hormone in different panic paradigms as well as in panic patients.",Demiralay C.; Agorastos A.; Yassouridis A.; Jahn H.; Wiedemann K.; Kellner M.,2017.0,10.1016/j.psyneuen.2016.11.006,0,0,
7403,Women recovering from social rejection: The effect of the person and the situation on a hormonal mechanism of affiliation,"Rejection can motivate either affiliation or withdrawal. In order to study how personality and situational variables influence whether women will be motivated to affiliate versus withdraw, we manipulate social feedback (rejection vs. acceptance) and opportunity for face-to-face interaction (blocked vs. face-to-face) and measure the individual difference variables rejection sensitivity and social anxiety. We test how these variables affect endogenous progesterone and cortisol concentrations, which are presumed to signal motivational responses to rejection. We find that three-way interactions involving social feedback, opportunity for face-to-face interactions, and either social anxiety or rejection sensitivity significantly predict progesterone change, but not cortisol change. Both interactions are driven by sharp progesterone decreases for women high in social anxiety/rejection sensitivity who have been rejected and who have no opportunity to reaffiliate in a face-to-face interaction. This progesterone change may be a physiological marker of motivation for social avoidance following rejection for women who cannot reaffiliate and who are particularly socially anxious or sensitive to rejection.",Duffy K.A.; Harris L.T.; Chartrand T.L.; Stanton S.J.,2017.0,10.1016/j.psyneuen.2016.11.017,0,0,
7404,Computerized analysis of the greater palatine foramen to gain the palatine neurovascular bundle during palatal surgery,"Objective: Investigation of the computerized dimensional anatomic location of the greater palatine foramen (GPF) and lesser palatine foramens (LPF) is important indicating site to collect palatal donor tissue, reconstructioning the orofacial area of the oncology patient and applying the greater palatine nerve block anesthesia. The aim of this study is to determine a patient-friendly landmark and to specify the precise location of the GPF in order to standardise certain anatomical marks of safe neurovascular bundle. Materials and methods: 120 bony palates were examined to detect the position of the GPF and the LPF related to adjacent anatomical landmarks using a computer software program. The GPF was assessed regarding the position, the diameter and the distances between each foramen and the midline maxillary suture (MMS), the inner border of alveolar ridge (AR), posterior palatal border (PBB), and incisive foramen (IF). Results: The GPF was identified as single in 81 %, double in 16 %, triple in 2 % and absent in 2 % of the specimens. The mean distances between the GPF and the MSS, the GPF and the AR, the GPF and the PPB, the GPF and the IF were 16, 4, 4, and 40 mm, respectively. In majority of the cases, the GPF was seen between the distal surfaces of the third maxillary molar (78 %). Single LPF was observed in 53.45 % of the skulls, two LPF were observed in 31 % of the skulls bilaterally and five LPF were rare in 2.1 % of the specimens. The LPF was most commonly at the junction of the palatine bone and the inner lamella of the pterygoid plate (71.9 %). Conclusions: This study made possible to investigate the variability of the GPF and the feasibility of the greater palatine neurovascular bundle, and to calculate the lengths of some parameters with the help of certain software. To collect the donor tissue of the neurovascular greater palatine network, each distance among the AR-GPF-PPB were equal to 4 mm. To estimate the possible length of the graft, the incision was made along the third and the second molar to the IF as 4 cm. The data we obtained within this study have been presented to help the surgeons avoid unexpected hemorrhage during the palatinal procedures such as posttraumatic dental reconstruction, maxillofacial tumor resections, palatal micro-implants, and dentofacial orthopedic surgery.",Cagimni P.; Govsa F.; Ozer M.A.; Kazak Z.,2017.0,10.1007/s00276-016-1691-0,0,0,
7405,An investigation into the jumping-to-conclusions bias in social anxiety,"‘Jumping-to-Conclusions’ (JTC) is a data-gathering bias characterised by hasty decision-making, and is typically seen in individuals with high levels of delusions or paranoia. JTC has also been found in people with high trait and state anxiety. The present study aimed to explore the relationship between JTC and trait social anxiety and state anxiety, given paranoia is common in both social anxiety and psychotic disorders. One-hundred-and-eighty-six undergraduate students were allocated to a manipulation or control condition, and classified as high or low socially anxious. All participants completed the ‘beads task’ to assess JTC, and the State-Trait Anxiety Inventory (state subscale) to assess state anxiety. Participants in the manipulation condition were given an anxiety-inducing situation. Although the manipulation was effective in inducing state anxiety, there was no significant correlation between JTC and trait or state social anxiety. High socially anxious individuals showed more conservative decision-making than controls over time, which was posited to be caused by inhibited working memory resulting from increased state anxiety.",Johnstone K.M.; Chen J.; Balzan R.P.,2017.0,10.1016/j.concog.2016.10.012,0,0,
7406,Reactive dissociative experiences in response to acute increases in shame feelings,"Studies have not examined if a direct causal relationship exists between shame and dissociation. The current research examined whether increases in dissociation were evident following exposure to acute shame feelings induced via narrative scripts of shame-evoking situations. Following Gilbert's (1998) differentiation between external and internal shame, participants heard shame-inducing or emotionally neutral stories in conditions designed to heighten (1) external shame, (2) internal shame or (3) general shame. In study 1, using a student sample (N = 78), dissociation as measured by the Modified Peritraumatic Dissociation Questionnaire was elevated during the shame script compared to the neutral script regardless of the type of shame participants were exposed to. A strong correlation was found between trait shame and trait dissociation. In study 2, using a treatment-attending sample (N = 33) and assessing intrusions in the two days following the script exposure, participants again demonstrated an increase in acute dissociative experiences during the shame script compared to the neutral script regardless of the type of shame evoked. Intrusions were present for the shame narrative with the distress they caused related to acute (peri-experimental) dissociation. Elevations in shame feelings produced a reactive response in dissociative experiences, which may heighten the distress associated with shame-filled intrusions.",Dorahy M.J.; McKendry H.; Scott A.; Yogeeswaran K.; Martens A.; Hanna D.,2017.0,10.1016/j.brat.2016.11.007,0,0,
7407,Application of coagulation-UF hybrid process for shale gas fracturing flowback water recycling: Performance and fouling analysis,"Shale gas fracturing flowback water (SGFFW) generated during shale gas extraction is of great concern and recycling for another fracking is the common disposal way. In this study, the feasibility of coagulation–UF hybrid process in assisting SGFFW reuse was systematically evaluated. Organics in SGFFW of Fuling were comparable with that reported in Marcellus. Poly aluminium chloride (PAC) dosage of 1500 mg/L may be preferred due to relatively low TOC (16.02 mg/L) and turbidity (3.03 NTU) in permeate and similar water flux (4.0×10−4 m/s) with that under the dosage of 2000 mg/L. With increase dosage of PAC, fouling mechanism changed from complete blocking to intermediate-blocking or cake standard. SEM-EDS indicated foulant was rich in carbon and oxygen with iron oxide and sulfate precipitates. According to volumetric integration method, overall rejection ratio for organics in different region in hybrid process decreased in the order of V (89.0%), IV 86.2%, III (80.3%), II (77.7%), I (55.2%) and VI (49.3%). LC-OCD illustrated coagulation mainly removed the organics with molecular weight of 20 kDa, while UF could remove a fraction of low molecular weight components (i.e., 200 Da). Fouling was reversible by backwashing and thus hybrid process without sedimentation can be potentially used for SGFFW treatment.",Kong F.-X.; Chen J.-F.; Wang H.-M.; Liu X.-N.; Wang X.-M.; Wen X.; Chen C.-M.; Xie Y.F.,2017.0,10.1016/j.memsci.2016.11.039,0,0,
7408,Distinct cortico-striatal connections with subthalamic nucleus underlie facets of compulsivity,"The capacity to flexibly respond to contextual changes is crucial to adapting to a dynamic environment. Compulsivity, or behavioural inflexibility, consists of heterogeneous subtypes with overlapping yet discrete neural substrates. The subthalamic nucleus (STN) mediates the switch from automatic to controlled processing to slow, break or stop behaviour when necessary. Rodent STN lesions or inactivation are linked with perseveration or repetitive, compulsive responding. However, there are few studies examining the role of latent STN-centric neural networks and compulsive behaviour in healthy individuals. We therefore aimed to characterize the relationship between measures of compulsivity (goal-directed and habit learning, perseveration, and self-reported obsessive – compulsive symptoms) and the intrinsic resting state network of the STN. We scanned 77 healthy controls using a multi-echo resting state functional MRI sequence analyzed using independent components analysis (ME-ICA) with enhanced signal-to-noise ratio to examine small subcortical structures. Goal directed model-based behaviour was associated with higher connectivity of STN with medial orbitofrontal cortex (mOFC) and ventral striatum (VS) and more habitual model-free learning was associated with STN connectivity with hippocampus and dorsal anterior cingulate cortex (ACC). Perseveration was associated with reduced connectivity between STN and premotor cortex and finally, higher obsessive –compulsive inventory scores were associated with reduced STN connectivity with dorsolateral prefrontal cortex (PF). We highlight unique contributions of diffuse cortico-striatal functional connections with STN in dissociable measures of compulsivity. These findings are relevant to the development of potential biomarkers of treatment response in neurosurgical procedures targeting the STN for neurological and psychiatric disorders.",Morris L.S.; Baek K.; Voon V.,2017.0,10.1016/j.cortex.2016.12.018,0,0,
7409,Genipin crosslinking decreases the mechanical wear and biochemical degradation of impacted cartilage in vitro,"High energy trauma to cartilage causes surface fissures and microstructural damage, but the degree to which this damage renders the tissue more susceptible to wear and contributes to the progression of post-traumatic osteoarthritis (PTOA) is unknown. Additionally, no treatments are currently available to strengthen cartilage after joint trauma and to protect the tissue from subsequent degradation and wear. The purposes of this study were to investigate the role of mechanical damage in the degradation and wear of cartilage, to evaluate the effects of impact and subsequent genipin crosslinking on the changes in the viscoelastic parameters of articular cartilage, and to test the hypothesis that genipin crosslinking is an effective treatment to enhance the resistance to biochemical degradation and mechanical wear. Results demonstrate that cartilage stiffness decreases after impact loading, likely due to the formation of fissures and microarchitectural damage, and is partially or fully restored by crosslinking. The wear resistance of impacted articular cartilage was diminished compared to undamaged cartilage, suggesting that mechanical damage that is directly induced by the impact may contribute to the progression of PTOA. However, the decrease in wear resistance was completely reversed by the crosslinking treatments. Additionally, the crosslinking treatments improved the resistance to collagenase digestion at the impact-damaged articular surface. These results highlight the potential therapeutic value of collagen crosslinking via genipin in the prevention of cartilage degeneration after traumatic injury. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:558–565, 2017.",Bonitsky C.M.; McGann M.E.; Selep M.J.; Ovaert T.C.; Trippel S.B.; Wagner D.R.,2017.0,10.1002/jor.23411,0,0,
7410,"Pain-Related Rumination, But Not Magnification or Helplessness, Mediates Race and Sex Differences in Experimental Pain","Compared with white individuals and men, black individuals and women show a lower tolerance for experimental pain stimuli. Previous studies suggest that pain catastrophizing is important in this context, but little is known about which components of catastrophizing contribute to these race and sex differences. The purpose of the current study was to examine the individual components of catastrophizing (rumination, magnification, and helplessness) as candidate mediators of race and sex differences in experimental pain tolerance. Healthy undergraduates (N = 172, 74% female, 43.2% black) participated in a cold pressor task and completed a situation-specific version of the Pain Catastrophizing Scale. Black and female participants showed a lower pain tolerance than white (P < .01, d = .70) and male (P < .01, d = .55) participants, respectively. Multiple mediation analyses indicated that these race and sex differences were mediated by the rumination component of catastrophizing (indirect effect = −7.13, 95% confidence interval (CI), −16.20 to −1.96, and 5.75, 95% CI, .81–15.57, respectively) but not by the magnification (95% CI, −2.91 to 3.65 and −1.54 to 1.85, respectively) or helplessness (95% CI, −5.53 to 3.31 and −.72 to 5.38, respectively) components. This study provides new information about race and sex differences in pain and suggests that treatments targeting the rumination component of catastrophizing may help mitigate pain-related disparities. Perspective This study suggests that differences in pain-related rumination, but not magnification or helplessness, are important contributors to race and sex differences in the pain experience. Interventions that target this maladaptive cognitive style may help reduce disparities in pain.",Meints S.M.; Stout M.; Abplanalp S.; Hirsh A.T.,2017.0,10.1016/j.jpain.2016.11.005,0,0,
7411,The impact of appraisals on intrusive memories,"Background and objectives Intrusive memories are a core feature of posttraumatic stress disorder (PTSD). Cognitive models posit that PTSD symptoms are stimulated by maladaptive appraisals about symptoms. This study aimed to test the causal pathway of maladaptive appraisals about the meaning of intrusions on subsequent intrusive memories. Methods Forty-five healthy participants were presented with a traumatic film, and were subsequently told either (a) intrusions are indicative of poor psychological functioning, (b) intrusions are not indicative of psychological functioning, or (c) no instructions. Participants subsequently completed a measure of cognitive performance to index potential interference by intrusions, as well as a scale of intrusive memories. Results Participants who were told that intrusions are indicative of negative psychological state subsequently reported more intrusive memories than those who were told that intrusions have no particular significance. Limitations Inferences are reduced by lack of group differences in appraisals reported by participants. A stronger index of intrusions would have been achieved through diary keeping in the period after the experimental session. Conclusions This finding provides initial causal evidence that appraising intrusions as maladaptive may directly enhance the occurrence of intrusions following encoding of an aversive event, and in this sense is supportive of cognitive models of PTSD.",Cheung J.; Bryant R.A.,2017.0,10.1016/j.jbtep.2016.07.005,0,0,
7412,Enantioselective analysis of fluoxetine in pharmaceutical formulations by capillary zone electrophoresis,"Fluoxetine is an antidepressant, a selective serotonin reuptake inhibitor (SSRI) used primarily in the treatment of major depression, panic disorder and obsessive compulsive disorder. Chiral separation of racemic fluoxetine is necessary due to its enantioselective metabolism. In order to develop a suitable method for chiral separation of fluoxetine, cyclodextrin (CD) modified capillary electrophoresis (CE) was employed. A large number of native and derivatized, neutral and ionized CD derivatives were screened to find the optimal chiral selector. As a result of this process, heptakis(2,3,6-tri-O-methyl)-β-CD (TRIMEB) was selected for enantiomeric discrimination. A factorial analysis study was performed by orthogonal experimental design in which several factors are varied at the same time to optimize the separation method. The optimized method (50 mM phosphate buffer, pH = 5.0, 10 mM TRIMEB, 15 °C, + 20 kV, 50 mbar/1 s, detection at 230 nm) was successful for baseline separation of fluoxetine enantiomers within 5 min. Our method was validated according to ICH guidelines and proved to be sensitive, linear, accurate and precise for the chiral separation of fluoxetine.",Cârcu-Dobrin M.; Budău M.; Hancu G.; Gagyi L.; Rusu A.; Kelemen H.,2017.0,10.1016/j.jsps.2016.09.007,0,0,
7413,Relative engagement of the anterior cruciate ligament and the surrounding soft tissue envelope,"INTRODUCTION: ACL graft failure rates remain suboptimal, especially in the younger population, which leaves these patients even more susceptible to increased risk of post-traumatic osteoarthritis and further compromises function and clinical outcome.1,2 In particular, a recent study has identified highgrade preoperative knee laxity, (i.e., laxity in the ACL-deficient condition) as a risk factor for graft failure.3 This indicates that one-size-fits-all treatment paradigms may not be appropriate for accommodating the wide range of laxity observed across a patient population. Thus, understanding the mechanisms for variations in preoperative knee laxity may lead to new surgical methods that mitigate the need for revision. In the intact and reconstructed knee, the native ACL or ACL graft carries force in concert with the surrounding soft tissue envelope (i.e., secondary stabilizers) as the knee translates and rotates through a range of motion. For example, during a Lachman exam, important secondary restraints to anterior translation of the tibia include the superficial medial collateral ligament (MCL) and medial meniscus.4,5 However, the relationship between anterior laxities in the ACL-intact vs. the ACL-sectioned condition and how these secondary stabilizers carry force through a range of motion is not well understood. We hypothesized that this relationship may be explained in part by where in the range of joint motion the surrounding soft tissues begin to bear appreciable force (i.e., engage) relative to the ACL. Therefore, we asked the following research questions: during a simulated Lachman, 1) are the anterior laxities of the ACL-intact and -sectioned knee associated; and 2) is the increase in laxity resulting from ACL rupture associated with the engagement point of the superficial MCL or medial meniscus relative to that of the ACL? METHODS: 16 fresh frozen human cadaveric knees were acquired for testing (mean age = 45 ± 13 years; range = 20-64 years; 11 male). Specimens were mounted to a robot equipped with a universal force-moment sensor. The robot passively flexed the knee to 30° and then increased anterior force on the tibia to 134 N in the following increments: 0, 10, 25, 50, 75, 100, and 134 N. The resulting kinematics were recorded with the ACL intact and sectioned, and then both sets of kinematics were repeated before and after serially sectioning the ACL, superficial MCL, and medial meniscus. In both ACL conditions, forces carried by each stabilizer were determined as a function of anterior tibial translation using the principle of superposition.6 The inflection points of the ligament force versus anterior tibial translation curves were identified with an objective algorithm7 and defined as engagement points, or the tibial positions at which stabilizers began to carry appreciable force. The relative engagement points of the superficial MCL and medial meniscus were determined by subtracting the engagement point of the ACL from that of each stabilizer. Univariate linear regressions were used to evaluate the association between ACLsectioned and -intact anterior laxity and between the increase in anterior laxity resulting from ACL sectioning and the relative engagement points of the superficial MCL and medial meniscus (p < 0.05). RESULTS: In response to a simulated Lachman, anterior laxity of the ACL-sectioned knee was unrelated to anterior laxity of the ACL-intact knee (r2 < 0.24, p = 0.056). Intact knees with greater anterior laxity were also more lax in the ACL-sectioned condition, but ACL-intact knees with less laxity exhibited variable laxity after the ACL was sectioned (Fig. 1, Table 1). The engagement point of the superficial MCL relative to the engagement point of the ACL was positively associated with the increase in anterior knee laxity resulting from sectioning the ACL (r2 = 0.73, p < 0.001), but the relative engagement point of the medial meniscus showed a weak association (r2 = 0.24, p = 0.052) (Table 1). DISCUSSION: Anterior laxity, as assessed by a simulated Lachman, is unrelated between the ACL-intact and -sectioned conditions. Thus, there is no consistent relationship between the stabilizing role of the ACL and that of the secondary soft tissues envelope as a whole. However, the increase in laxity resulting from ACL sectioning is positively associated with the engagement point of the superficial MCL relative to that of the ACL; that is, later engagement of the superficial MCL compared to the ACL is associated with a greater increase in laxity in the setting of ACL deficiency. These biomechanical findings are important in light of high-grade preoperative laxity being implicated as a risk factor for ACL graft failure.3 Specifically, they suggest that, in knees where the ACL engages well before the surrounding soft tissue envelope, a graft that is fixed with high tension or in flexion would engage before the surrounding soft tissues. Unaided by other passive stabilizers, the graft could be exposed to excessive loads. Conversely, stabilizers that engage along with the ACL graft would protect it. The latter scenario can be achieved surgically either by 1) implementing a looser graft that will engage late with a loose soft tissue envelope or 2) tightening or augmenting components of the soft tissue envelope such that it engages early with a tight graft. These findings challenge the current clinical paradigm of applying maximal pretension to grafts to obtain the tightest graft possible at the time of surgery. Randomized cohort studies have found no relationship between initial graft tension and clinical, functional, or patient-reported outcomes;8,9 however, tuning graft tension or that of the surrounding soft tissue envelope according to preoperative laxity might be an important consideration for more personalized treatment of ACL injury. These findings describing the engagement patterns of the secondary soft tissue envelope relative to that of the ACL provide a framework for developing more personalized surgical approaches that could ultimately lead to reduced rates of ACL graft failure. (Figure Presented).",Kent R.N.; Amirtharaj M.J.; Wickiewicz T.L.; Pearle A.D.; Imhauser C.W.,2017.0,,0,0,
7414,Preventing intrusive memories after trauma via a brief intervention involving Tetris computer game play in the emergency department: a proof-of-concept randomized controlled trial,"After psychological trauma, recurrent intrusive visual memories may be distressing and disruptive. Preventive interventions post trauma are lacking. Here we test a behavioural intervention after real-life trauma derived from cognitive neuroscience. We hypothesized that intrusive memories would be significantly reduced in number by an intervention involving a computer game with high visuospatial demands (Tetris), via disrupting consolidation of sensory elements of trauma memory. The Tetris-based intervention (trauma memory reminder cue plus c. 20‚Äâmin game play) vs attention-placebo control (written activity log for same duration) were both delivered in an emergency department within 6‚Äâh of a motor vehicle accident. The randomized controlled trial compared the impact on the number of intrusive trauma memories in the subsequent week (primary outcome). Results vindicated the efficacy of the Tetris-based intervention compared with the control condition: there were fewer intrusive memories overall, and time-series analyses showed that intrusion incidence declined more quickly. There were convergent findings on a measure of clinical post-trauma intrusion symptoms at 1 week, but not on other symptom clusters or at 1 month. Results of this proof-of-concept study suggest that a larger trial, powered to detect differences at 1 month, is warranted. Participants found the intervention easy, helpful and minimally distressing. By translating emerging neuroscientific insights and experimental research into the real world, we offer a promising new low-intensity psychiatric intervention that could prevent debilitating intrusive memories following trauma.Molecular Psychiatry advance online publication, 28 March 2017; doi:10.1038/mp.2017.23.",Iyadurai L.; Blackwell S.E.; Meiser-Stedman R.; Watson P.C.; Bonsall M.B.; Geddes J.R.; Nobre A.C.; Holmes E.A.,2017.0,10.1038/mp.2017.23,0,0,
7415,Within-session effect of repeated stress exposure on extinction circuitry function in social anxiety disorder,"Anxiety reduction following repeated exposure to stressful experiences is generally held to depend on neural processes involved in extinction of conditioned fear. We predicted that repeated exposure to stressful experiences would change activity throughout the circuitry serving extinction, including ventromedial prefrontal cortex (vmPFC), the hippocampus and the amygdala. To test this prediction, 36 participants diagnosed with SAD performed two successive speeches in front of an observing audience while regional cerebral blood flow (rCBF) was recorded using positron emission tomography. To control for non-anxiolytic effects of repeated exposure, rCBF was also measured during repeated presentations of neutral and angry facial expressions. Results showed that anxiety ratings and heart rate decreased from the first to the second speech, indicating an anxiolytic effect of repeated exposure. Exposure attenuated rCBF in the amygdala whereas no change in rCBF was observed in the vmPFC or hippocampus. The rCBF-reductions in the amygdala were greater following repetition of the speech task than repetition of face exposure indicating that they were specific to anxiety attenuation and not due to a reduced novelty. Our findings suggest that amygdala-related attenuation processes are key to understanding the working mechanisms of exposure therapy.",√Öhs F.; Gingnell M.; Furmark T.; Fredrikson M.,2017.0,10.1016/j.pscychresns.2017.01.009,0,0,
7416,Awareness of bullying in internal medicine residencies: Results of a national survey of internal medicine program directors,"BACKGROUND: Bullying in medical education has been described as a significant and ubiquitous problem in studies of residents and medical students. American and international studies cite upwards of 50% of trainees reporting experiencing bullying, most commonly in its verbal form. Being bullied creates psychological pressure which can lead to mental health consequences including depression, anxiety, and post-traumatic stress disorder. The authors conducted this study to describe perceptions of internal medicine (IM) program directors about the bullying of internal medicine residents. METHODS: The 2015 Association of Program Directors in Internal Medicine (APDIM) Annual survey was sent to 368 program directors (PDs) with APDIM membership, representing 92.9% of the IM residency programs. To understand internal medicine PDs' perspectives and awareness about bullying in their programs, several questions about bullying were included in the annual survey. Bivariate analyses were performed on PD characteristics and program characteristics with regard to their answer to the following specific question, “To the best of your knowledge, were one or more of your trainees bullied during the last academic year?” RESULTS: A total of 227/368 (61.6%) of PDs responded to the survey. Less than one third of respondents (71/227, 31%), reported being aware of bullying in their residency program during the previous year. There were no significant differences between those reporting bullying in their programs and those who did not when gender, tenure as PD, geographic location, or specialty of PD were considered in the analyses (all p > 0.05). Those who acknowledged bullying in their program were more likely to agree that bullying was a problem in graduate medical education (p < 0.0001), and that it had a significant negative impact on the learning environment (p < 0.0001). CONCLUSIONS: Most IM PDs believe that bullying does not occur in their training programs. Because bullying is thought to negatively affect the learning environment and threaten the well-being of trainees, program directors may wish to more proactively assess its actual prevalence.",Ayyala M.; Chaudhry S.; Windish D.; Dupras D.; Reddy S.; Wright S.,2017.0,,0,0,
7417,The effect of the social regulation of emotion on emotional long-term memory,"Memories for emotional events tend to be stronger than for neutral events, and weakening negative memories can be helpful to promote well-being. The present study examined whether the social regulation of emotion (in the form of handholding) altered the strength of emotional long-term memory. A sample of 219 undergraduate students viewed sets of negative, neutral, and positive images. Each participant held a stress ball while viewing half of the images and held someone's hand while viewing the other half. Participants returned 1 week later to complete a recognition task. Performance on the recognition task demonstrated that participants had lower memory accuracy for negative but not for positive pictures that were shown while they were holding someone's hand compared with when they were holding a stress ball. Although handholding altered the strength of negative emotional long-term memory, it did not down-regulate negative affective response as measured by self-report or facial expressivity. The present findings provide evidence that the social regulation of emotion can help weaken memory for negative information. Given the role of strong negative memories in different forms of psychopathology (e.g., depression, posttraumatic stress disorder), these findings may help better understand how close relationships protect against psychopathology.",Flores L.E.; Berenbaum H.,2017.0,10.1037/emo0000259,0,0,
7418,Physician trainees' experiences of moral distress regarding potentially futile treatments at the end of life in the United Kingdom: A qualitative study,"BACKGROUND: Moral distress, the inability to act in accordance with one's ethical beliefs due to hierarchical or institutional constraints, has been associated with burnout and poor well-being. Significant moral distress amongst American physician trainees might occur when they feel obligated to provide treatments at the end of life that they believe to be futile or harmful. In contrast to the US, policies in the United Kingdom permit physicians to make a decision to withhold or abort resuscitation that they believe would be inappropriate following discussions with the family. The aim of this study was to explore whether moral distress surrounding resuscitation at the end of life occurred in the UK, a country whose health policies surrounding end of life care are notably different than those in the US. METHODS: We conducted semi-structured in-depth interviews with 14 physician trainees in the UK regarding moral distress and attitudes surrounding donot- resuscitate (DNR) decision-making. Interviews, which were audio-taped and professionally transcribed, lasted an average of 60 min. Transcripts were analyzed and double coded using thematic analysis. Themes and patterns emerged from initial interviews and analysis, and were refined and validated in subsequent interviews through questions added to the interview guide and probing of key themes during the interviews. RESULTS: UK trainees infrequently experienced feelings of ethical conflict surrounding resuscitation, though some respondents did note one or two rare but notable cases of resuscitation they felt were inappropriate. Themes that arose included a feeling of shared attitudes around providing care that was in a patient's best interest. Please see Table 1 for example quotations of UK junior doctors. Distress instead appeared to arise from other areas such as insufficient resources or personnel to provide optimal care and a lack of control over the nature of theirwork. CONCLUSIONS: Along with the US data previously described in Dzeng, et al., 2016, we describe different degrees of moral distress surrounding potentially futile resuscitation at the end of life between US and UK trainees. We hypothesize that UK policies and culture allow physicians to withhold inappropriate or ineffective resuscitation, allowing physicians to act in ways that are in accordance with their ethical beliefs. Different policies surrounding resuscitation at the end of life in the US and UK might contribute to different degrees of moral distress amongst physician trainees regarding potentially futile treatments at the end of life.",Dzeng E.; Weiss R.; Vergnaud S.,2017.0,,0,0,
7419,Cortical and cardiovascular responses to acute stressors and their relations with psychological distress,"The purpose of this study was to assess the interrelation between cortical, cardiovascular, behavioural, and psychological responses to acute stressors in a large sample of healthy individuals. To date, there are only preliminary evidences for a significant association among these psychophysiological indexes during a stress task. 65 participants completed psychological questionnaires (Beck Depression Inventory and State-Trait Anxiety Inventory) and underwent a psychosocial math stress task, consisting of a control and an experimental (i.e. stressful) condition. Prefrontal and autonomic activities were recorded using respectively a 2-channel near-infrared spectroscopy (NIRS) device and a portable ECG monitoring system. Results evidenced an increased activation of both frontal areas assessed by NIRS, and a positive association between the right NIRS channel and heart rate changes from baseline, during both control and experimental conditions. Subjective stress increased during the procedure, reaching its maximum during the experimental condition. Behavioural performances during the task (e.g. response time) did not correlate with anxiety or depression. Autonomic data evidenced, as expected, an overall reduction of vagal tone during the experimental condition. Finally, severity of depressive and anxious symptoms predicted an increase in parasympathetic activity both at rest and during the task, even when controlling for respiration rate. Results support the hypothesis of an integration between right sectors of frontopolar or dorsolateral PFC and cardiac regulation. Trait anxiety and depression predicted an increase in vagal tone during the entire procedure. The implication of these findings is discussed.",Brugnera A.; Zarbo C.; Adorni R.; Tasca G.A.; Rabboni M.; Bondi E.; Compare A.; Sakatani K.,2017.0,10.1016/j.ijpsycho.2017.02.002,0,0,
7420,Facing two faces: Defense activation varies as a function of personal relevance,"It can be unsettling to be watched by a group of people, and when they express anger or hostility, this can prime defensive behavior. In contrast, when others smile at us, this may be comforting. This study tested to which degree the impact of facial expressions (happy, neutral, and angry) varies with the personal relevance of a social situation. Modelling a triadic situation, two faces looked either directly at the participant, faced each other, or they were back to back. Results confirmed that this variation constitutes a gradient of personal relevance (directed frontally > towards > away), as reflected by corresponding defensive startle modulation and autonomic nervous system activity. This gradient was particularly pronounced for angry faces and it was steeper in participants with higher levels of social anxiety. Thus, sender-recipient constellations modulate the processing of facial emotions in favor of adequate behavioral responding (e.g., avoidance) in group settings.",Bublatzky F.; Alpers G.W.,2017.0,10.1016/j.biopsycho.2017.03.001,0,0,
7421,Long-term oxytocin administration enhances the experience of attachment,"The neuropeptide ‘oxytocin’ (OT) is known to play a pivotal role in a variety of complex social behaviors by promoting a prosocial attitude and interpersonal bonding. Previous studies showed that a single-dose of exogenously administered OT can affect trust and feelings of attachment insecurity. With the present study, we explored the effects of two weeks of daily OT administration on measures of state and trait attachment using a double-blind between-subjects randomized placebo-controlled design. In 40 healthy young adult men state and trait attachment were assessed before and after two weeks of daily intranasal OT (24 IU) or placebo using the State Adult Attachment Scale and the Inventory of Parent and Peer Attachment. Mood, social responsiveness and quality of life were additionally assessed as secondary outcome measures. Reductions in attachment avoidance and increases in reports of attachment toward peers were reported after two weeks of OT treatment. Further, treatment-induced changes were most pronounced for participants with less secure attachment towards their peers. indicating that normal variance at baseline modulated treatment response. OT treatment was additionally associated with changes in mood, indicating decreases in feelings of tension and (tentatively) anger in the OT group, not in the placebo group. Further, at the end of the two-week trial, both treatment groups (OT, placebo) reported to experience an increase in social responsiveness and quality of life, but the effects were only specific to the OT-treatment in terms of reports on ‘social motivation’. In summary, the observed improvements on state and trait dimensions of attachment after a multiple-dose treatment with OT provide further evidence in support of a pivotal role of OT in promoting the experience of attachment.",Bernaerts S.; Prinsen J.; Berra E.; Bosmans G.; Steyaert J.; Alaerts K.,2017.0,10.1016/j.psyneuen.2017.01.010,0,0,
7422,The Damage Control Surgery in Austere Environments Research Group (DCSAERG): A dynamic program to facilitate real-time tele-mentoring/tele-diagnosis to address exsanguination in extreme and austere environments,"ABSTRACT: Hemorrhage is the most preventable cause of post-traumatic death. Many cases are potentially anatomically salvageable, yet remain lethal without logistics or trained personnel to deliver diagnosis or Resuscitative-surgery in austere-environments. Revolutions in technology for remote-mentoring of ultrasound and surgery may enhance capabilities to utilize the skill-sets of non-physicians. Thus, our Research-Collaborative explored remote-mentoring to empower non-physicians to address junctional and torso hemorrhage-control in Austere-environments. Major studies involved using remote-telementored ultrasound (RTMUS) to identify torso and junctional exsanguination, remotely mentoring resuscitative-surgery for torso hemorrhage-control, understanding and mitigating physiological stress during such tasks; and the technical practicalities of conducting Damage Control Surgery (DCS) in Austere Environments. Iterative projects involved: randomized guiding of Firefighters to identify torso (RCT) and junctional (pilot) hemorrhage using RTMUS; Randomized remote-mentoring of MedTechs conducting Resuscitative-surgery for torso exsanguination in an anatomically-realistic surgical trainer (“Cut-Suit”) including physiological monitoring; and trained surgeons conducting a comparative randomized study for torso hemorrhage-control in normal (1g) versus weightlessness (0g).This work demonstrated that Firefighters could be remotely mentored to perform just-in-time torso RTMUS on a simulator. Both Firefighters and mentors were confident in their abilities, the ultrasounds being 97% accurate. An ultrasound-naïve Firefighter in Memphis could also be remotely-mentored from Hawaii to identify and subsequently tamponade an arterial junctional hemorrhage using RTMUS in a live tissue model. Thereafter, (both mentored and unmentored MedTechs) and train-surgeons completed Resuscitative-surgery for Hemorrhage-control on the Cut-Suit, demonstrating practicality for all involved. While Remote-mentoring did not decrease blood loss among MedTechs it increased procedural confidence, and decreased physiologic stress. Therefore, remote-mentoring may increase the feasibility of non-physicians conducting a psychologically daunting task. Finally, DCS in weightlessness was feasible without fundamental differences from 1g. Overall, the collective evidence suggests that Remote-mentoring supports diagnosis, non-invasive therapy, and ultimately Resuscitative-surgery to potentially rescue those exsanguinating in Austere-environments and should be more rigorously studied.",Kirkpatrick A.W.; McKee J.; McBeth P.B.; Ball C.G.; LaPorta A.; Broderick T.; Leslie T.; King D.; Wright-Beatty H.; Keillor J.; Tien H.,2017.0,10.1097/TA.0000000000001483,0,0,
7423,Attitudes towards homosexuals in seven Caribbean countries: implications for an effective HIV response,"Between 2000 and 2015, the number of people newly infected with HIV in the Caribbean decreased by 76% and HIV-related deaths by 42%. The number of people living with HIV (PLHIV) on anti-retroviral therapy (ART) increased from near zero to 50% (44% to 57%) in 2015. In many Caribbean countries communities of men-who-have-sex-with-other-men (MSM) have higher incidence and prevalence of HIV. They are often stigmatized and subjected to both social and institutional discrimination. This study compared attitudes of the general public obtained through public opinion polls 2013–2014 towards homosexuals and willingness to socialize with them in seven Caribbean countries. Informants were asked if they “hate, tolerate or accept” homosexuals and if they would socialize with them. In St. Vincent 53% indicated they “hate” homosexuals, compared with 12% in Suriname; the converse was observed for those who “accept” homosexuals; 63% of St. Vincent informants would not socialize with homosexuals, compared with 25% in Suriname. Findings for the other 5 countries fell within these ranges. Women were more likely to accept and socialize with homosexuals, as were informants with a tertiary education and “passive” religious believers. These groups are less likely to adhere to a culture of “compulsory heterosexuality” or “hyper-masculinity” dominant among Caribbean men. The homophobic views expressed by these cultures result in stigma and discrimination by members of the “general” public towards MSM. This negatively affects the involvement of MSM in successful national HIV responses. Public messaging, communications campaigns and educational measures need to be employed to change the culture of “compulsory heterosexuality” or “hyper-masculinity” that result in stigma and discrimination of homosexuals to improve early access to services by MSM. Repeat use of well performed opinion polls is one method that can be employed to monitor progress over time in “key” and “general” populations.",Beck E.J.; Espinosa K.; Ash T.; Wickham P.; Barrow C.; Massiah E.; Alli B.; Nunez C.,2017.0,10.1080/09540121.2017.1316355,0,0,
7424,How does gaze direction affect facial processing in social anxiety? —An ERP study,"Previous behavioral studies have demonstrated an effect of eye gaze direction on the processing of emotional expressions in adults with social anxiety. However, specific brain responses to the interaction between gaze direction and facial expressions in social anxiety remain unclear. The present study aimed to explore the time course of such interaction using event-related potentials (ERPs) in participants with social anxiety. High socially anxious individuals and low socially anxious individuals were asked to identify the gender of angry or neutral faces with direct or averted gaze while their behavioral performance and electrophysiological data were monitored. We found that identification of angry faces with direct but not averted gaze elicited larger N2 amplitude in high socially anxious individuals compared to low socially anxious individuals, while identification of neutral faces did not produce any gaze modulation effect. Moreover, the N2 was correlated with increased anxiety severity upon exposure to angry faces with direct gaze. Therefore, our results suggest that gaze direction modulates the processing of threatening faces in social anxiety. The N2 component elicited by angry faces with direct gaze could be a state-dependent biomarker of social anxiety and may be an important reference biomarker for social anxiety diagnosis and intervention.",Li D.; Yu F.; Ye R.; Chen X.; Xie X.; Zhu C.; Wang K.,2017.0,10.1016/j.psychres.2017.02.018,0,0,
7425,Intolerance for approach of ambiguity in social anxiety disorder,"Previous research has utilised the approach–avoidance task (AAT) to measure approach and avoidance action tendencies in socially anxious individuals. “Neutral” social stimuli may be perceived as ambiguous and hence threatening to socially anxious individuals, however it is unclear whether this results in difficulty approaching ambiguous (“neutral”) versus unambiguous threat (e.g. disgust) faces (i.e. intolerance of ambiguity). Thirty participants with social anxiety disorder (SADs) and 29 non-anxious controls completed an implicit AAT in which they were instructed to approach or avoid neutral and disgust faces (i.e. pull or push a joystick) based on colour of the picture border. Results indicated that SADs demonstrated greater difficulty approaching neutral relative to disgust faces. Moreover, intolerance for approach of ambiguity predicted social anxiety severity while controlling for the effects of trait anxiety and depression. Our results provide further support for the role of intolerance of ambiguity in SAD.",Kuckertz J.M.; Strege M.V.; Amir N.,2017.0,10.1080/02699931.2016.1145105,0,0,
7426,Acute aerobic exercise helps overcome emotion regulation deficits,"Although colloquial wisdom and some studies suggest an association between regular aerobic exercise and emotional well-being, the nature of this link remains poorly understood. We hypothesised that aerobic exercise may change the way people respond to their emotions. Specifically, we tested whether individuals experiencing difficulties with emotion regulation would benefit from a previous session of exercise and show swifter recovery than their counterparts who did not exercise. Participants (N = 80) completed measures of emotion response tendencies, mood, and anxiety, and were randomly assigned to either stretch or jog for 30 minutes. All participants then underwent the same negative and positive mood inductions, and reported their emotional responses. Analyses showed that more perceived difficulty generating regulatory strategies and engaging in goal-directed behaviours after the negative mood induction predicted more intense and persistent negative affect in response to the stressor, as would be expected. Interactions revealed that aerobic exercise attenuated these effects. Moderate aerobic exercise may help attenuate negative emotions for participants initially experiencing regulatory difficulties. This study contributes to the literature on aerobic exercise’s therapeutic effects with experimental data, specifically in the realm of emotional processing.",Bernstein E.E.; McNally R.J.,2017.0,10.1080/02699931.2016.1168284,0,0,
7427,Potential Therapeutic Effects of Psilocybin,"Psilocybin and other 5-hydroxytryptamine2A agonist classic psychedelics have been used for centuries as sacraments within indigenous cultures. In the mid-twentieth century they were a focus within psychiatry as both probes of brain function and experimental therapeutics. By the late 1960s and early 1970s these scientific inquires fell out of favor because classic psychedelics were being used outside of medical research and in association with the emerging counter culture. However, in the twenty-first century, scientific interest in classic psychedelics has returned and grown as a result of several promising studies, validating earlier research. Here, we review therapeutic research on psilocybin, the classic psychedelic that has been the focus of most recent research. For mood and anxiety disorders, three controlled trials have suggested that psilocybin may decrease symptoms of depression and anxiety in the context of cancer-related psychiatric distress for at least 6 months following a single acute administration. A small, open-label study in patients with treatment-resistant depression showed reductions in depression and anxiety symptoms 3 months after two acute doses. For addiction, small, open-label pilot studies have shown promising success rates for both tobacco and alcohol addiction. Safety data from these various trials, which involve careful screening, preparation, monitoring, and follow-up, indicate the absence of severe drug-related adverse reactions. Modest drug-related adverse effects at the time of medication administration are readily managed. US federal funding has yet to support therapeutic psilocybin research, although such support will be important to thoroughly investigate efficacy, safety, and therapeutic mechanisms.",Johnson M.W.; Griffiths R.R.,2017.0,10.1007/s13311-017-0542-y,0,0,
7428,Can a virtual reality surgical simulation training provide a self-driven and mentor-free skills learning? Investigation of the practical influence of the performance metrics from the virtual reality robotic surgery simulator on the skill learning and associated cognitive workloads,"Background: While it is often claimed that virtual reality (VR) training system can offer self-directed and mentor-free skill learning using the system’s performance metrics (PM), no studies have yet provided evidence-based confirmation. This experimental study investigated what extent to which trainees achieved their self-learning with a current VR simulator and whether additional mentoring improved skill learning, skill transfer and cognitive workloads in robotic surgery simulation training. Methods: Thirty-two surgical trainees were randomly assigned to either the Control-Group (CG) or Experiment-Group (EG). While the CG participants reviewed the PM at their discretion, the EG participants had explanations about PM and instructions on how to improve scores. Each subject completed a 5-week training using four simulation tasks. Pre- and post-training data were collected using both a simulator and robot. Peri-training data were collected after each session. Skill learning, time spent on PM (TPM), and cognitive workloads were compared between groups. Results: After the simulation training, CG showed substantially lower simulation task scores (82.9 ± 6.0) compared with EG (93.2 ± 4.8). Both groups demonstrated improved physical model tasks performance with the actual robot, but the EG had a greater improvement in two tasks. The EG exhibited lower global mental workload/distress, higher engagement, and a better understanding regarding using PM to improve performance. The EG’s TPM was initially long but substantially shortened as the group became familiar with PM. Conclusion: Our study demonstrated that the current VR simulator offered limited self-skill learning and additional mentoring still played an important role in improving the robotic surgery simulation training.",Lee G.I.; Lee M.R.,2017.0,10.1007/s00464-017-5634-6,0,0,
7429,MDMA does not alter responses to the Trier Social Stress Test in humans,"Rationale: ±3,4-Methylenedioxymethamphetamine (MDMA, “ecstasy”) is a stimulant-psychedelic drug with unique social effects. It may dampen reactivity to negative social stimuli such as social threat and rejection. Perhaps because of these effects, MDMA has shown promise as a treatment for post-traumatic stress disorder (PTSD). However, the effect of single doses of MDMA on responses to an acute psychosocial stressor has not been tested. Objectives: In this study, we sought to test the effects of MDMA on responses to stress in healthy adults using a public speaking task. We hypothesized that the drug would reduce responses to the stressful task. Methods: Volunteers (N = 39) were randomly assigned to receive placebo (N = 13), 0.5 mg/kg MDMA (N = 13), or 1.0 mg/kg MDMA (N = 13) during a stress and a no-stress session. Dependent measures included subjective reports of drug effects and emotional responses to the task, as well as salivary cortisol, heart rate, and blood pressure. Results: The stress task produced its expected increase in physiological responses (cortisol, heart rate) and subjective ratings of stress in all three groups, and MDMA produced its expected subjective and physiological effects. MDMA alone increased ratings of subjective stress, heart rate, and saliva cortisol concentrations, but contrary to our hypothesis, it did not moderate responses to the Trier Social Stress Test. Conclusions: Despite its efficacy in PTSD and anxiety, MDMA did not reduce either the subjective or objective responses to stress in this controlled study. The conditions under which MDMA relieves responses to negative events or memories remain to be determined.",Bershad A.K.; Miller M.A.; de Wit H.,2017.0,10.1007/s00213-017-4621-x,0,0,
7430,Mindfulness meditation regulates anterior insula activity during empathy for social pain,"Mindfulness has been shown to reduce stress, promote health, and well-being, as well as to increase compassionate behavior toward others. It reduces distress to one's own painful experiences, going along with altered neural responses, by enhancing self-regulatory processes and decreasing emotional reactivity. In order to investigate if mindfulness similarly reduces distress and neural activations associated with empathy for others' socially painful experiences, which might in the following more strongly motivate prosocial behavior, the present study compared trait, and state effects of long-term mindfulness meditation (LTM) practice. To do so we acquired behavioral data and neural activity measures using functional magnetic resonance imaging (fMRI) during an empathy for social pain task while manipulating the meditation state between two groups of LTM practitioners that were matched with a control group. The results show increased activations of the anterior insula (AI) and anterior cingulate cortex (ACC) as well as the medial prefrontal cortex and temporal pole when sharing others' social suffering, both in LTM practitioners and controls. However, in LTM practitioners, who practiced mindfulness meditation just prior to observing others' social pain, left AI activation was lower and the strength of AI activation following the mindfulness meditation was negatively associated with trait compassion in LTM practitioners. The findings suggest that current mindfulness meditation could provide an adaptive mechanism in coping with distress due to the empathic sharing of others' suffering, thereby possibly enabling compassionate behavior. Hum Brain Mapp 38:4034–4046, 2017. © 2017 Wiley Periodicals, Inc.",Laneri D.; Krach S.; Paulus F.M.; Kanske P.; Schuster V.; Sommer J.; Müller-Pinzler L.,2017.0,10.1002/hbm.23646,0,0,
7431,"affron® a novel saffron extract (Crocus sativus L.) improves mood in healthy adults over 4 weeks in a double-blind, parallel, randomized, placebo-controlled clinical trial","Background In recent years phytotherapy has been explored as a source for alternative treatments for mood disorders. One potential candidate is saffron (Crocus sativus L.), whose main bioactive components are crocins and safranal. Objectives The aim of this study was to investigate the efficacy of affron®, a standardised stigmas extract from Crocus sativus L. for improving mood, stress, anxiety and sleep quality in healthy adults. Methods In this 3 arm study, 128 participants self-reporting low mood but not diagnosed with depression, were given affron® at 28 mg/day, 22 mg/day, or a placebo treatment in a randomized, double-blind, placebo-controlled trial for 4 weeks. Mood was measured at baseline and at the end of the study, using the POMS (primary outcome measure) and PANAS questionnaires, and the DASS-21 scale. Sleep was monitored using Sleep Quality Index (PSQI). Results Analysis indicated a significant decrease in negative mood and symptoms related to stress and anxiety at a 28 mg/day dose (with a significant difference between 28 mg/day and placebo on the POMS Total Mood Disturbance scale, p < 0.001, d = −1.10), but no treatment effect at the 22 mg/day dose. Limitations The main weaknesses of this investigation were found in the self-reporting nature of both the screening and the testing. Conclusions affron® increased mood, reduced anxiety and managed stress without side effects, offering a natural alternative to standard treatments.",Kell G.; Rao A.; Beccaria G.; Clayton P.; Inarejos-García A.M.; Prodanov M.,2017.0,10.1016/j.ctim.2017.06.001,0,0,
7432,The influence of mindfulness meditation on communication and anxiety: A case study of a person with aphasia,"Background: Anxiety goes largely undetected and undiagnosed in the aphasia population. Mindfulness programmes have been shown to be effective in reducing anxiety in populations with chronic disorders. These interventions have also shown effects on cognitive functioning including attention, executive function and working memory. Aims: To identify the impact of reduced anxiety using mindfulness meditation in a person with aphasia. Methods & Procedures: A 4-week one-on-one mindfulness programme was implemented with a participant who has post-stroke non-fluent aphasia. She completed three intervals of testing; one prior to intervention and two following the mindfulness intervention. Outcomes & Results: There was a clinical correlation between the mindfulness programme, a reduction in anxiety levels and improved language scores in this participant. The score on the Beck Anxiety Inventory reduced from a moderate level to a minimal score. Scores of confrontation naming, picture description and repetition improved, but no effect was seen in verbal fluency scores. Conclusion: Some aspect of a mindfulness programme appears to be effective in reducing anxiety scores in a person with aphasia, and improved language changes were evident in confrontation naming tasks. However, it is unclear exactly what the relationship is between the mindfulness intervention programme, reduced anxiety and improved language scores.",Dickinson J.; Friary P.; McCann C.M.,2017.0,10.1080/02687038.2016.1234582,0,0,
7433,"Clinical trial of a new drug, analog of chlordiazepoxide, for treatment of anxiety and tension.","57 moderately to severely psychoneurotic office patients, most of whom also had organic disorders, were treated with oxazepam. Anxiety and other symptoms were well controlled at dosage levels producing little sedation and no ataxia. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gilbert, Michael M",1965.0,,0,0,
7434,Systematic desensitization of snake-avoidance following three types of suggestion.,"Three groups of 8 Ss each received tape-recorded desensitization after having been exposed to different instructions regarding the anticipated outcome of the experiment. As compared to 7 untreated control Ss, each of the desensitization treatments led to behavioral improvements, while the differential instructions had no apparent impact. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","McGlynn, F. Dudley; Mapp, Russell H; Davison, Jacobson, Lang, Leitenuerg, Mcglynn, McGtynn, Oliveau, Wolpe, Wolpe",1970.0,,0,0,
7435,Effects of historically portrayed modeling and group treatment on self-observation: A comparison with agoraphobics.,"The effects of historically portrayed modeling and group treatment on self-observation were determined in a factorial design with agoraphobic patients. Group 1 saw a videofilm and was treated individually; group 2 saw the film and received group treatment; group 3 did not see the film and received individual treatment; and group 4 did not see the film and received group treatment. In the video recording improved 'ex-clients' related their experiences with the same treatment. Assessments were made at the beginning and at the end of treatment and at the follow-up 1 month later. Assessments were carried out by an independent observer (measurement in vivo, phobic anxiety and avoidance scales, anxious mood and panic), and by the client (phobic anxiety and avoidance scales, FSS, Social Anxiety Scale, SDS and I-E scale). Group treatment was just as effective as individual treatment. The videofilm did not increase the effect of the treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Emmelkamp, Paul M. G; Emmelkamp-Benner, Ank; Agras, Bandura, Emmelkamp, Emmelkamp, Emmelkamp, Everaerd, Hand, Rotter, Stern, Watson, Willems, Wolpe, Zung",1975.0,,0,0,
7436,A controlled trial of cognitive-behavioural and behavioural treatment of anorexia nervosa.,"Investigated whether a cognitive-behavioral treatment (CBT) procedure was superior to a standard behavioral treatment (SBT) in 24 outpatients with anorexia nervosa. Ss were assigned to 1 of 3 treatment groups: 8 (mean age 21.6 yrs) in the CBT, 8 (mean age 24.1 yrs) in the SBT, and 8 (mean age 25.7 yrs) in a control treatment. Changes in weight and clinical features (e.g., menstrual status) formed the basis of the outcome measures. Ss completed measures, including the Beck Depression Inventory, an obsessional-compulsive inventory, and self-reports of symptoms of eating disorders, and preferred weight. Ss showed significant improvement. CBT and SBT Ss showed significant differences on only a few of the outcome measures; however, CBT Ss attended more treatment sessions, suggesting that this treatment was more acceptable than the SBT. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Channon, Shelley; de Silva, Padmal; Hemsley, David; Perkins, Rachel E",1989.0,,0,0,
7437,"The Yale-Brown Obsessive Compulsive Scale: I. Development, use, and reliability.","In Study 1, 40 obsessive compulsive disorder (OCD) patients in placebo-controlled drug trials were rated with the Yale-Brown Obsessive Compulsive Scale (YBOCS) to assess the scale's reliability. In Study 2, psychometric properties of core YBOCS items were examined in pretreatment ratings from 42 OCD outpatients. Data confirmed the ability of the YBOCS to reliably rate the severity of symptoms in OCD patients. There was a high degree of internal consistency, and all items significantly correlated with the total YBOCS score. The primary use of the YBOCS is in rating the severity of OCD, with emphasis on its ability to reflect changes in severity during treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Goodman, Wayne K; Price, Lawrence H; Rasmussen, Steven A; Mazure, Carolyn; Fleischmann, Roberta L; Hill, Candy L; Heninger, George R; Charney, Dennis S",1989.0,,0,0,
7438,HPA axis disturbance in obsessive-compulsive disorder.,"Examined the relationship between hypothalamic-pituitary-adrenal axis disturbances and obsessive-compulsive disorder (OCD). 20 outpatients with OCD (mean age 37.4 yrs) entered a 10-wk placebo-controlled study of clomipramine and underwent a 1-mg dexamethasone suppression test (DST) at baseline; 11 Ss had a repeat DST at the end of treatment. Nonsuppression was rare. Compared with outpatients with panic disorder studied in a similar fashion in a previous report by W. Coryell et al (see record 1989-40085-001), OCD Ss had postdexamethasone cortisol values that were substantially lower and more stable over time. Results within the OCD Ss closely resembled those from a group of never-ill controls in a previous study by Coryell and M. Zimmerman (see record 1988-28956-001). (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Coryell, William H; Black, Donald W; Kelly, Michael W; Noyes, Russell",1989.0,,0,0,
7439,An open study comparing manual therapy with the use of cold packs in the treatment of post-traumatic headache.,"One year after head trauma, 23 patients with post-traumatic headache entered a prospective clinical controlled trial to find out if specific manual therapy on the neck could reduce the headache. The study was completed by 19 patients (83%). Ten patients were treated twice with manual therapy and nine patients were treated twice with cold packs on the neck. The pain index was calculated blindly. Two weeks after the last treatment the mean pain index was significantly reduced to 43% in the group treated with manual therapy compared with the pretreatment level. At follow-up five weeks later, the pain index was still lower in this group compared with the group treated with cold packs, but this difference was not statistically significant. The pain index for all 19 patients was significantly correlated to the use of analgesics as well as to the frequency of associated symptoms (number of days per week with dizziness, visual disturbances and ear symptoms). It is concluded that the type of manual therapy used in this study seems to have a specific effect in reducing post-traumatic headache. The result supports the hypothesis of a cervical mechanism causing post-traumatic headache and suggests that post-traumatic dizziness, visual disturbances and ear symptoms could be part of a cervical syndrome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Jensen, O. K; Nielsen, F. F; Vosmar, L; Almgren, Blume, Bogduk, Bogduk, Bourdillon, Cartlidge, Jansen, Jennet, Jensen, Jensen, Jensen, Kerr, Kerr, Kerr, Kerr, Lidvall, Pawl, Reicke, Schaerer, Sluijter, Stoddard",1990.0,,0,0,
7440,Effectiveness of exposure and ritual prevention for obsessive-compulsive disorder: Randomized compared with nonrandomized samples.,"The efficacy of exposure and ritual prevention (EX/RP) for reducing symptoms of obsessive-compulsive disorder (OCD) has been demonstrated in several randomized controlled trials (RCTs). However, procedures used in these studies to maximize experimental control may have limited their generalizability to typical clinical practice. Treatment outcome data from 110 clinical patients receiving EX/RP on an outpatient fee-for-service basis were compared with findings from 4 RCTs of EX/RP. Adult patients in the clinical sample were not excluded because of treatment history, concomitant pharmacotherapy, psychiatric comorbidity, age, or OCD severity. Clinical patients achieved substantial and clinically meaningful reductions in their OCD and depressive symptoms following EX/RP, which were comparable with those reported in the RCTs. Findings indicate that EX/RP is a potent treatment for OCD, and its benefits are not limited to select patient samples. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Franklin, Martin E; Abramowitz, Jonathan S; Kozak, Michael J; Levitt, Jill T; Foa, Edna B; Abramowitz, Abramowitz, Angst, Beck, Beck, Cohen, Fals-Stewart, Goodman, Goodman, Hamilton, Hedlund, Hiss, Jacobson, Karno, Kendall, Kendall, Kendall, Koran, Kozak, Kozak, Lindsay, Marks, Persons, Rachman, Rasmussen, Ray, Seligman, Steketee, Strosahl, van Balkom, Wade",2000.0,,0,0,
7441,Clinical usefulness of a simulated exposure treatment for fear of flying.,"Assessed the clinical usefulness of a computer assisted exposure treatment for fear of flying, which already proved to be effective in laboratory, controlled conditions. Two studies, one in Mallorca (S1, 12 Ss) and the other one in Germany (S2, 8 Ss), were conducted. Patients were recruited using advertisements in the airport (S1) or in local newspapers (S2), and they were individually treated. Data on fear of flying were collected before treatment, after computer assisted exposure, and after a post-treatment actual flight. Several results corroborated the clinical usefulness of the treatment: (a) Effective exposure time was quite similar in both studies; (b) 19 out of 20 patients completed treatment and took the actual flight; (c) the main fear reductions were found after computer exposure and before taking the flight; and (d) therapeutic changes were clinically significant in most cases: 91.7% of patients in S1 and 87.5% in S2 improved or recovered. It is concluded that the clear structure of the computer assisted program facilitates its application in very different settings. Moreover, therapists need only little training to use the program successfully. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bornas, Xavier; Tortella-Feliu, Miquel; Llabreas, Jordi; Muhlberger, Andreas; Pauli, Paul; Barcelo, Frencesca; Agras, Banos, Barlow, Berggren, Borkovec, Bornas, Bornas, Bornas, Botella, Botella, Botella, Burnett, Carlin, Chambless, Coldwell, Denholtz, DiNardo, Emmelkamp, Ghosh, Ghosh, Hamilton, Haug, Hester, Howard, Jacobson, Kazdin, Lange, Lange, Marks, Marks, McMinn, Moncher, Muhlberger, Nelissen, Newman, Newman, Newman, North, Osgood-Hynes, Persons, Riva, Roth, Rothbaum, Rothbaum, Rothbaum, Salkovskis, Seligman, Selmi, Solyom, Street, Strosahl, Taylor, Tortella-Feliu, Van Gerwen, Wiederhold, Wilhelm",2002.0,,0,0,
7442,Brief cognitive behavioral group therapy for social anxiety disorder.,"The growth of managed health care in the US has placed a high premium on the goal of efficiency in the treatment of psychopathology, but without sacrificing treatment efficacy in the process. A preliminary evaluation of a brief, 6-wk version of cognitive behavioral group therapy (CBGT) for generalized social anxiety disorder was conducted, with a sample of Ss aged 20-59 yrs. Various self-report and behavioral assessment measures were collected at pre- and post-treatment, and self-report assessments were again conducted at 6- and 12-wk follow-ups. The results suggest improvement during the acute 6-wk treatment phase, and further improvement during the 6 wks following treatment termination. These gains were maintained at the 3-mo follow-up assessment. Effect size comparisons with prior studies revealed that the present treatment produced comparable treatment gains at the 6-wk follow-up assessment to those produced by prior studies using the standard 12-wk CBGT protocol. Clinical and research implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Herbert, James D; Rheingold, Alyssa A; Goldstein, Suzanne G; Ballenger, Beck, Beck, Beidel, Beidel, Brown, Cox, Cox, Cox, Craske, Davidson, Davidson, Davidson, DiGiuseppe, Emmelkamp, Fava, Feske, First, Foa, Gelertner, Glass, Gould, Greist, Heimberg, Heimberg, Heimberg, Heimberg, Heimberg, Herbert, Herbert, Hofmann, Hope, Jerremalm, Lepine, Liebowitz, Liebowitz, Lydiard, Magee, Marks, Mattick, McNeil, Michelson, Norton, Oei, Ost, Ost, Rapee, Reich, Reich, Schneier, Stravynski, Taylor, Turner, Turner, Turner, Van Dam-Baggen, Van Zuuren, Walker, Wittchen, Wittchen, Wlazlo, Wolpe",2002.0,,0,0,
7443,Unconsummated marriages: A separate and different clinical entity.,"The authors discuss their experience in the treatment of unconsummated marriages (UM). They postulate that it is an independent clinical entity that should be differentiated from the individual etiology of a case (such as vaginismus, phobias, or impotence). They discuss the treatment of 199 couples with UM in their center in Buenos Aires. Their new approach to this problem is based on an intensive treatment session that lasts an entire day and a pledge to pay only if therapy succeeds. The treatment has been successful for 97% of couples (with coitus consummation). Long-term followup for couples that consummated has been done for 80 cases out of 135. The advantages of this treatment are its brevity and the lack of desertions. The authors postulate that UM cannot be approached with an individual perspective or with the usual psychotherapy techniques. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gindin, Leon Roberto; Resnicoff, Diana; Abraham, Abraham, Araoz, Bachmann, Barnes, Blazer, Davidson, Degun, Delmonte, Friedman, Gindin, Gindin, Grafeille, Granero, Granero, Groisman, Kaplan, Kinsey, Lo Piccolo, Malleson, Masters, Michel-Wolfromm, Ng, Ogden, Passini, Perry, Stallworthy, Sturgis",2002.0,,0,0,
7444,Goal conflicts and therapy motivation.,"Investigates the impact of goal conflicts on therapy motivation and treatment success. In a sample of 24 outpatients with anxiety disorders, goal conflict was assessed using the Striving Instrumentality Matrix, therapy motivation was measured with the BAV (D. Schulte and J. Michalak, in process), and treatment success with 8 different measurements of success. Depending on methodological issues, results are seen to provide considerable evidence that increased conflict scores are associated with deficits in therapy motivation and subjective outcome assessment. It is concluded that goal integration seems to be of high relevance for the therapy process. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Michalak, Johannes; Schulte, Dietmar; Austin, Brunstein, Derogatis, Ehlers, Emmons, Emmons, Emmons, Epstein, Freud, Grawe, Horney, Horowitz, Hovland, Hoyer, Jung, Kiresuk, Kuhl, Lauterbach, Lauterbach, Lecky, Lewin, Michalak, Michalak, Miller, Miller, Schulte, Schulte, Schulte, Schulte, Schulte, Sorembe, Vormbrock, Westmeyer, Westmeyer, Wittchen, Wolpe, Zielke",2002.0,,0,0,
7445,Two-year follow-up of self-examination therapy for generalized anxiety disorder.,"This study examined the stability of treatment gains after receiving self-examination therapy (SET) for generalized anxiety disorder. A 2-year follow-up of 16 participants from an earlier SET study by D. Bowman et al (1997) was conducted by comparing pre- and post-treatment measures with follow-up measures from the Hamilton Anxiety Rating Scale-Revised (HARS-R), the State-Trait Anxiety Inventory (STAI), and the SET quiz. Results indicated treatment gains from baseline to the 2-year follow-up period were maintained on all measures, and there was not a significant decline from post-treatment to follow-up on the HARS-R and STAI. These results suggest that SET for treatment of generalized anxiety disorder (GAD) may be effective in both the immediate and long-term reduction of GAD symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Floyd, Mark; McKendree-Smith, Nancy; Bailey, Elaine; Stump, Jamie; Scogin, Forrest; Bowman, Daniel; Barlow, Bowman, Bowman, Bowman, Bowman, Butler, Crosby, Curry, Derogatis, DiNardo, Dugas, Edelmann, Gould, Kessler, Marrs, Ohayon, Rapee, Riskind, Rokke, Speilberger, Weissman",2002.0,,0,0,
7446,Patient's subjective assessment of therapy outcome after in-patient psychotherapy for anxiety disorders.,"Attempted to identify factors influencing the subjective assessment of patients regarding the outcome of inpatient psychotherapy for anxiety disorders. A total of 231 patients were tested at admission, discharge and 1-year follow-up in a multi-center study. Subjective outcome assessment was measured with the revised German version of the Helping Alliance Questionnaire. The use of the term ""outcome satisfaction"" is discussed. Patient outcome assessment did not correlate with age, sex, or education, or with duration or severity of illness or duration of treatment. Outcome assessment was closely connected with therapy success. Reaching a low symptom level (""clinical significance"") had a higher impact than a high pre-post-difference (""statistical significance""). Anxiety patients give a generally positive assessment of their therapy outcome, which is most determined by symptom-related treatment success. The differentiation of ""clinical"" and ""statistical significance"" of success is of importance for the patient's subjective view of the therapy outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Geiser, F; Bassler, M; Bents, H; Carls, W; Joraschky, P; Michelitsch, B; Paar, G; Ullrich, J; Liedtke, R; Ankuta, Bassler, Bassler, Ehlers, Franke, Geiser, Greenfield, Gruyters, Hannover, Hautzinger, Kalmar, Laux, Leimkuhler, Luborsky, Lunnen, Margraf, Priebe, Schauenburg",2002.0,,0,0,
7447,Effects of psychoanalytically oriented and of behavioral long-term therapies: A comparative study.,"This prospective study compares 31 patients in behavior long-term-therapy (with an average of 63 sessions) with 31 patients in psychoanalytically-oriented long-term-therapy (with an average of 185 sessions) in a naturalistic design. Only patients with depression and anxiety problems were included in the study. Symptoms, interpersonal problems and goals (GAS) were examined at the beginning, after 1, 2.5 and 3.5 yrs. It was found that the characteristics of patients, who choose--or were referred to--psychoanalytically oriented or behavior long term therapy were different, even when their diagnoses were comparable, in a number of characteristics, such as education, access to psychotherapy (recommended by professionals versus patients introduce themselves), the taking of psychotropic medication, and the strain of symptoms. The results demonstrate how research comparing therapies using parallel samples do not meet reality in every case. Even if psychoanalysts and behavior therapists do treat equal disorders, the patients differ in many ways. Effect sizes and clinically significant results about changes of the symptomatic and of interpersonal problems are presented that prove the efficacy of the treatments. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Brockmann, Josef; Schluter, Thomas; Brodbeck, Dennis; Eckert, Jochen; Ambuhl, Blaser, Brahler, Brockmann, Buchkremer, Davies-Osterkamp, Eckert, Franke, Goldfried, Grawe, Grawe, Hartmann, Hedges, Hilsenroth, Horowitz, Howard, Howard, Jacobi, Janssen, Lambert, Linden, Linden, Luborsky, Luborsky, Lueger, McGaw, McPherson, Nissen, Orlinsky, Orlinsky, Orlinsky, Ruger, Saunders, Schauenburg, Schepank, Schepank, Schluter, Seligman, Smith, StrauB, Stuhr, Tingey, Torgerson, Wittchen, Wittmann, Wuchner, Zepf",2002.0,,0,0,
7448,Cost effectiveness and cost offset of a collaborative care intervention for primary care patients with panic disorder.,"To evaluate the incremental cost-effectiveness and potential cost offset of a collaborative care (CC) treatment program, 115 primary care patients with panic disorder were randomly assigned to a CC intervention that included systematic patient education and approximately 2 visits with an on-site consulting psychiatrist, compared with usual primary care. Telephone assessments of clinical outcomes were performed at 3, 6, 9, and 12 months. Use of health care services and costs were assessed using administrative data from the primary care clinics and self-report data. Patients receiving CC experienced a mean of 74.2 more anxiety-free days during the 12-month intervention. The incremental mental health cost of the CC intervention was $205, with the additional mental health costs of the intervention explained by expenditures for antidepressant medication and outpatient mental health visits. Total outpatient cost was $325 less for the CC than for the usual care group. The incremental cost-effectiveness ratio for total ambulatory cost was -$4 per anxiety-free day. Results of a bootstrap analysis suggested a 0.70 probability that the CC intervention was dominant (e. g., lower costs and greater effectiveness). (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Katon, Wayne J; Roy-Byrne, Peter; Russo, Joan; Cowley, Deborah; Barsky, Barsky, Blazer, Blough, Fogarty, Hazen, Katon, Katon, Katon, Katon, Katon, Katon, Klerman, Kouzis, Lave, Manning, Markowitz, Mendlowicz, Meredith, Miller, Otto, Peterson, Pollack, Roy-Byrne, Roy-Byrne, Roy-Byrne, Salvador-Carulla, Schoenbaum, Shear, Sherbourne, Simon, Simon, Simon, Simon, Spitzer, Stein, Stein, Von Korff, Walker, Wells, Wells, Wittchen, Wittchen",2002.0,,0,0,
7449,Davidson Trauma Scale (DTS): Normative scores in the general population and effect sizes in placebo-controlled SSRI trials.,"The Davidson Trauma Scale (DTS) was developed as a self-rating for use in diagnosing and measuring symptom severity and treatment outcome in posttraumatic stress disorder (PTSD); 630 Ss were identified by random digit dialing and evaluated for a history of trauma. Prevalence rates of PTSD and subthreshold PTSD with impairment were 2.2 and 4.1 %, respectively. In this general population sample, 438 Ss endorsed at least 1 trauma, and 4 groups were generated: A) threshold PTSD (n = 13), B) subthreshold PTSD with impairment (n = 26), C) subthreshold PTSD without impairment (n = 78), and D) no PTSD (n = 321). Ss mean age was 44.9 yrs. Differences were found in 4 of the 5 pairwise between-group contrasts. In a 2nd sample of 447 clinical trial participants from 3 SSRI vs. placebo studies, the authors assessed treatment effect size according to different measures. In all 3 clinical trials, effect size with the DTS was equal to, or better than, those found for the Impact of Event Scale (IES), Clinician Administered PTSD Scale (CAPS), and Structured Interview for PTSD (SIP). These results further affirm the utility of the DTS as a self rating measure of PTSD symptom severity and in evaluating treatment response. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Davidson, Jonathan R. T; Tharwani, Haresh M; Connor, Kathryn M; Blake, Brady, Chen, Cohen, Connor, Davidson, Davidson, Davidson, Escalona, Horowitz, Meltzer-Brody, Sheehan, Siegel, Stein",2002.0,,0,0,
7450,One session group treatment of spider phobia by direct or modelled exposure.,"Exposure therapy is the most effective treatment for specific phobias. The one-session procedure is a further development of the effectiveness of exposure therapy. The aims of this study were to determine whether a modelled version of exposure is also effective and what kind of efficiency gradient different procedures produce. A total of 38 patients (aged 19-52 yrs) with spider phobia participated in the study. They were assigned randomly to 3 different procedures: (1) direct exposure; (2) model exposure; or (3) video exposure. Diagnosis was established with Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) and the Fear Survey Schedule. Self-report questionnaires assessed cognitions, body sensation symptoms, self-efficacy and long-term effect evaluation. The results gave a significant time effect for cognitions, body sensations and self-efficacy. There was also a significant time effect and interaction for the evaluation of treatment and a time by group interaction for self-efficacy. Direct exposure seemed to produce the best long-term results. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gotestam, K. Gunnar; Bandura, Chambless, Emmelkamp, Gotestam, Gotestam, Gotestam, Merluzzi, Ost, Ost, Ost, Ost, Ost, Wolpe",2002.0,,0,0,
7451,Neurosurgery of treatment refractory obsessive-compulsive disorder. The first Hungarian clinical experiences at one year follow-up.,"Five patients with refractory obsessive-compulsive disorder (OCD) were operated by bilateral anterior capsulotomy. The authors conducted preoperative and follow-up assessment of OCD, depressive, and anxiety symptoms, as well as functional status in the patients. After the capsulotomy the patients were involved in a complex rehabilitation program including cognitive-behavior therapy and social skill training. Only a few adverse events were found after capsulotomy. At the 1-yr follow-up, the patients improved significantly in the OCD symptoms, but there were no symptom-free patients. Improvement in OCD symptoms was correlated with improvement in depressive and anxiety symptoms. Four of 5 patients improved significantly in mean functional status. The improvement of symptoms started 3-4 wks after operation. At the 1-yr follow-up a negative change in the personality of patients was not noticed. The authors conclude that the bilaterial anterior capsulotomy can be a useful treatment for severely incapacitated patients who have not responded to all other state-of-the-art pharmacological and behavioral treatments for OCD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Nemeth, Attila; Babal, B. Tamas; Pataki, Eva; Csigo, Katalin; Morotz, Kenez; Lukacs, Eszter; Borbely, Katalin; Babel, Ballantine, Ballantine, Biver, Goodman, Goodman, Guy, Kullberg, Lukacs, Mindus, Nemeth, Nemeth, Sachdev, Waziri",2002.0,,0,0,
7452,Pattern of change in prolonged exposure and cognitive-processing therapy for female rape victims with posttraumatic stress disorder.,"Curve estimation techniques were used to identify the pattern of therapeutic change in female rape victims with posttraumatic stress disorder (PTSD). Within-session data on the Posttraumatic Stres Disorder Symptom Scale were obtained, in alternate therapy sessions, on 171 women. The final sample of treatment completers included 54 prolonged exposure (PE) and 54 cognitive-processing therapy (CPT) completers. For both PE and CPT, a quadratic function provided the best fit for the total PTSD, reexperiencing, and arousal scores. However, a difference in the line of best fit was observed for the avoidance symptoms. Although a quadratic function still provided a better fit for the PE avoidance, a linear function was more parsimonious in explaining the CPT avoidance variance. Implications of the findings are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Nishith, Pallavi; Resick, Patricia A; Griffin, Michael G; Blake, Borkovec, Borkovec, Devilly, Foa, Foa, Foa, Foa, Norusis, Resick, Resick, Resick, Rothbaum, Tarrier, Tarrier",2002.0,,0,0,
7453,Cognitive-behavioural group therapy in obsessive-compulsive disorder: A clinical trial.,"Examined the effects of a cognitive-behavioral group therapy protocol on the reduction of obsessive compulsive disorder (OCD) symptoms. 32 adults (aged 18-65 yrs) diagnosed with OCD completed an intervention comprising 12 2-hr sessions of cognitive behavioral group therapy. Subjects (Ss) completed rating scales and interviews concerning OCD symptoms, anxiety, depression, and other neuropsychiatric symptoms during the treatment period and at 1-, 2-, and 3-mo follow-ups. Results show that OCD symptoms decreased in 78.1% of Ss following therapy to levels considered mild or subclinical. Significant reductions were observed in Ss' levels of anxiety by the end of the treatment, regardless of the use of anti-obsessive medications. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cordioli, Aristides V; Heldt, Elizeth; Bochi, Daniela B; Margis, Regina; de Sousa, Marcelo B; Tonello, Juliano F; Teruchkin, Betina; Kapczinski, Flavio; Abramowitz, Amorim, Araujo, Basoglu, Cohen, Eisen, Enright, Falls-Stewart, Foa, Freeston, Freeston, Ger, Goodman, Hamilton, Hamilton, Ito, Jenike, Kobak, Kobak, Kozak, Krone, March, Marks, Marks, McDougle, Neziroglu, Pato, Picinelli, Pigott, Salkovskis, Salkovskis, Sheehan, Simpsom, Spiegel, Van Noppen, Van Noppen, Van Oppen, Vinogradov",2002.0,,0,0,
7454,Evaluating an activity intervention with hemodialysis patients in Israel.,"As a life-threatening and potentially disabling disease, End Stage Renal Disease and its treatment cause stress as well as other psychosocial problems for patients and their families. This paper examines the results of an innovative activity-based intervention aimed at reducing some of the psychosocial repercussions of hemodialysis. A modified withdrawal/reversal design was employed to compare patients (mean age 54 yrs) participating in the intervention and those who did not, at 2 points in time. The findings confirmed that dialysis patients in general have relatively high levels of psychological distress, difficulty adhering to the treatment regimen and poor self-rated health. Patients participating in the group activity were more anxious and had lower levels of interdialytic weight gain than the non-participants. After the intervention was terminated, levels of psychological distress, hostility and phobic anxiety among patients in the treatment group dropped, while their weight gain continued to be less than that of non-participating patients. The implications of these findings as well as the methodological difficulties entailed in this type of study are examined. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Auslander, Gail K; Buchs, Adina; Agar, Bajwa, Boyer, Bremer, Cook, Corcoran, DeOreo, Derogatis, Epstein, Essink-Bot, Everett, Gudes, Heintz, Kimmel, Klang, Kutner, Lazarus, Lee, Levenson, Leventhal, Mapes, Peterson, Sno, Soskolne, Tripodi, Vourlekis, Wilson",2002.0,,0,0,
7455,Panic disorder and transcranial magnetic stimulation.,"Transcranial magnetic stimulation (TMS) has been tried with some anxiety disorders (obsessive-compulsive disorder and posttraumatic stress disorder) with differing results. This paper presents a pilot study including 3 panic disorder patients. The subjects (25, 30, and 57 yrs old) had a history of the disease for at least 1 yr and had been treated unsuccessfully with psychotherapy and pharmacological therapy. The patients received 10 sessions of TMS during 2 wks; each session consisted of 30 trains of 60 sec at a frequency of 1 Hz, on the right dorsolateral prefrontal cortex, at 110% of the motor threshold. All 3 patients experienced a modest and partial symptom improvement that did not seem to be clinically relevant. Two patients agreed to participate in a 2nd TMS phase, where the previous stimulation parameters were alternated with an application of 30 trains of 20 Hz during 2 sec on the left prefrontal cortex. This alternate application of high and low frequency TMS in each session also was well tolerated, but failed to produce additional improvement. In addition to presenting these 3 cases, the authors emphasize the neurobiological basis of anxiety disorders and connect them to the previously described TMS neurophysiological actions in order to justify further investigation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Garcia-Toro, M; Salva Coll, J; Crespi Font, M; Andres Tauler, J; Aguirre Orue, I; Bosch Calero, C; Alonso, Bartres-Faz, Brown, Davidson, Garcia-Toro, Garcia-Toro, Garcia-Toro, George, Greenberg, Kendler, Leon-Carrion, Manes, Modell, Reid, Shin, Wiedemann, Zuckerman",2002.0,,0,0,
7456,Groups for abused women: Treatment outcome.,"This study empirically investigated the outcome of a multi-phase group treatment program with a sample of 189 abused women, one of the largest samples to date. An exhaustive search of published articles demonstrated the need for research in this area. Repeated measures MANOVAs revealed a significant difference in pre-test vs. post-test scores across both phase groups for the dependent variables: self-esteem, depression, and post-traumatic stress. Participants who completed a phase group were clustered into high post-program and low post-program scores using the SPSS k-means clustering technique and a MANOVA revealed the greatest difference between groups were in the areas of depression and self-esteem. Repeated measures MANOVA on 18 women who completed both phases showed a significant pre-post difference for the first but not the second phase group; and while waiting for the second phase to begin the women's scores deteriorated. There were high drop-out rates in both phase I (51%) and phase II (32%) groups and a logistic regression indicated that unemployment and physical abuse were significant indicators of program drop-out. Extensive program revisions, directions for future research, and the limitations of the study are presented. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mcbride, Dawn Lorraine",2002.0,,0,0,
7457,Treatment of obsessive thoughts and cognitive rituals using exposure and response prevention: A case study.,"This case study describes the application of cognitive-behavioral therapy by exposure and response prevention (EX/RP) to a young man with obsessive-compulsive disorder (OCD) involving primarily obsessional thoughts and mental rituals. Although patients with primarily cognitive OCD symptoms have been previously considered treatment-resistant, novel approaches to EX/RP have been developed and validated. Successful treatment of such symptoms requires a thorough and informed assessment. The theoretical and empirical basis for these procedures is described, along with a cognitive-behavioral analysis of the problem. The course of treatment, use of assessment data, and recommendations to clinicians are also discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Abramowitz, Jonathan S; Abramowitz, Abramowitz, Amir, Angst, Baer, Barlow, Beck, Beck, Foa, Franklin, Freeston, Goodman, Goodman, Hartl, Jenike, Kozak, Kozak, Ladouceur, Newth, Rachman, Rachman, Rachman, Rachman, Rachman, Rasmussen, Salkovskis, Salkovskis, Shafran, Wegner, Wells",2002.0,,0,0,
7458,Changing process of a woman's belief with an anxiety neurosis: Application of techniques of both rational emotive behavior therapy and a solution-focused approach.,"Studied the effects of rational emotive behavior therapy and solution-focused approach techniques on a client's irrational beliefs. A female client with anxiety neurosis had the following irrational beliefs: (1) she must return to her hometown to be the caretaker of her parents as she has a brother with schizophrenia; (2) her husband should perfectly understand her situation; (3) her situation and life will be awful if she does not recover from neurosis; and (4) she must not take medicine out of concern for future pregnancies. Results show that a technique of performing tasks was mainly useful for the belief about her husband. Coping questions, compliments, goal maintenance, and disputing were useful for the belief about neurosis. Moreover, behind these beliefs, there was another belief that she had to do her best due to her brother's disease, which was eased after her brother's death. At the same time, beliefs about returning to her hometown and taking medicine were also eased. It is concluded that the use of both techniques was useful. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ando, Michiyo",2003.0,,0,0,
7459,Interapy: Treatment of post-traumatic stress via the Internet.,"This paper describes the theoretical background and procedures (including psycho-education, screening, treatment protocol and outcome measurement) involved in a protocol-driven internet treatment of post-traumatic stress and grief in a group of people who have suffered from mild to relatively severe trauma. The paper examines the results of 3 outcome and process studies, which were carried out initially in a student population and subsequently in the general population of highly traumatized people. In the latter study, participants in the experimental condition (n = 69) improved significantly more than participants in the waiting list control condition (n = 32), with respect to trauma-related symptoms and general psychopathology. The effect sizes were large. More than 50% of the participants treated showed reliable change and clinically significant improvement after treatment for avoidance and depression. Treatment proved most beneficial for participants who had suffered from intentional trauma and those who had not previously discussed the traumatic events with significant others. Content analysis of the publications indicates a remarkable increase in cognitive coping during treatment... (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lange, Alfred; van de Ven, Jean-Pierre; Schrieken, Bart; Arrindell, Barak, Botella, Brom, Carlbring, Celio, Cohen, Derogatis, Donnelly, Dunlop, Ehlers, Erdman, Esterling, Esterling, Foa, Hammer, Horowitz, Jacobson, Jaycox, Jaycox, Kamphuis, Kamphuis, King, King, Kleber, Klein, Klein, L'Abate, Lange, Lange, Lange, Lange, Lange, Lange, Lange, Lange, Lange, Lemmen, Lepore, Lepore, Lutgendorf, Marks, Miller, Murphy, Murray, Nijenhuis, Pennebaker, Postmes, Resick, Rime, Sampsom, Sarason, Sarason, Schoutrop, Schoutrop, Schoutrop, Shalev, Smith, Smyth, Smyth, Strom, Vaughan, Zuuren",2003.0,,0,0,
7460,Trauma-focused psychotherapy after a trial of medication for chronic PTSD: Pilot observations.,"Background: To date, all clinical trials using a single therapeutic modality (psychotherapy or pharmacotherapy) have found that even the best validated treatments for adults with chronic Posttraumatic Stress Disorder (PTSD) leave a substantial proportion of patients with disabling residual symptoms. Method: We reviewed the treatment course of three research patients with PTSD who received trauma-focused psychotherapy after experiencing a partial response to medication. Structured diagnostic interviews, validated symptom measures, and standardized treatment approaches were used to assess treatment response. Results: All patients partially benefited from medication treatment, and the degree of benefit varied substantially. Also, all patients experienced an additional reduction in PTSD symptoms after a time-limited course of prolonged exposure therapy (PE). This finding differs from anecdotal observations among U.S. War veterans and has never been documented systematically among civilian adults with chronic PTSD. Conclusion: Maximizing treatment outcome in adults with chronic PTSD may require additional psychotherapy after a partial medication response, and further study is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Marshall, Randall D; Carcamo, Jaime H; Blanco, Carlos; Liebowitz, Michael; Beck, Boudewyns, Brady, Connor, Cooper, Davidson, Davidson, Foa, Foa, Foa, Foa, Foa, Keane, Marks, Marshall, Marshall, Marshall, Marshall, Resick, Sheehan, Spielberger, Tarrier, Van der Kolk, Weathers",2003.0,,0,0,
7461,Efficacy of a virtual reality exposure treatment for acrophobia: A preliminary study.,"The goal of this study was to assess the effectiveness of virtual reality (VR) exposure for acrophobia in adults. The sample included five females and two males aged between 27 and 62 years, who were SCID-diagnosed to confirm the presence of acrophobia. The treatment consisted of five 90 minutes weekly sessions. The first one was to assess that all the participants met the inclusion and exclusion criteria of the study. The second session provided participants with the necessary information to successfully complete the program (informed consent, information about phobias and avoidance, etc.). The last four sessions consisted of VR exposure. The exposure was administered using a standardized treatment protocol. At pre-treatment, post-treatment and six-month follow-up, the participants completed a series of questionnaires: the Acrophobic Questionnaire, Fear Survey Schedule, Simulator Sickness Questionnaire, Presence Questionnaire, Immersion Tendencies Questionnaire, and Self-Efficacy Questionnaire. Results of pre and post measures results showed a statistically significant improvement, and results at the six-month follow-up demonstrated that gains were maintained over time. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bouchard, S; St-Jacques, J; Robillard, G; Cote, S; Renaud, P; Antony, Borkoveck, Cohen, First, Garcia-Palacio, Geer, Kennedy, Marchand, Nathan, Rachman, Witmer, Osr",2003.0,,0,0,
7462,Virtual reality therapy in social phobia: Preliminary study with 36 patients.,"The objective of this study was to assess the efficacy of a virtual reality treatment (VRT) compared to a group cognitive-behavioral treatment (CBT). The study population included patients with a social phobia according to DSM-IV diagnostic criteria (men and women, at least 18 years old and at most 65 years old, ambulatory, social phobics since at least two years and at most 25 years). We excluded patients with a mental disorder other than an anxious disorder, including patients with a current major depressive episode. 36 patients (17 men and 19 women) were included in this open study, 18 in the VRT group and 18 in the CBT group. The patients were assessed before and after the treatment for intensity of social phobia (Social Anxiety Scale), anxiety and depression, social contexts inducing anxiety, assertiveness, handicap, and clinical global impressions of change. The two treatment groups showed important clinical improvement. According to the principal criterion, the VRT patients, initially the most anxious, showed a more significant reduction of their social anxiety than the CBT patients. Clinically, the improvement was similar for the two groups with regard to the other psychometric criteria. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Legeron, P; Roy, S; Klinger, E; Chemin, I; Lauer, F; Andre, C; Macqueron, G; Nugues, P; Andre, Andre, Barlow, Beck, Emmhlkamp, Guy, Hhimbhrg, Klinger, Legeron, Legeron, Lepine, Liebowitz, North, North, Nugijes, Pelissolo, Pertaub, Pertaub, Rathus, Rothbaum, Roy, Roy, Servant, Sheehan, Slater, Zigmond",2003.0,,0,0,
7463,The Impact of Psychological Psychotherapy on Anxiety Provoking Dizziness in Panic Disorder with Agoraphobia.,"The present study examined the frequency and the influence of behavior therapy on anxiety provoking dizziness in patients with panic disorder with agoraphobia. 398 agoraphobics with panic disorder participated in the study. To analyze the impact of psychotherapy on dizziness, patients were classified into four groups depending on anxiety provoking dizziness (strong/weak) before or after treatment (pre/post). Results showed that fear of dizziness was the most frequent somatic complaint in these patients at the beginning of the treatment. According to different self-rating scales, all four groups improved considerably with treatment. However, the group that reported dizziness as very anxiety provoking before treatment but no longer anxiety provoking after treatment yielded the strongest overall therapy effect. The other three groups did not differ in their overall benefit from treatment. Similar effects were found if different somatic sensations such as heart palpitations or hard breathing were selected. It is discussed that the frequency of fear of dizziness emphasizes its relevance in this patient sample. It is therefore important that practitioners be informed about possible differential diagnoses that may include this fear. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Heinrichs, N; Hahlweg, K; Moschner, C; Wessel, K; Fiegenbaum, W; Brandt, Brandt, Chamblcss, Chambless, Cohen, Eckardt-Henn, Ehlers, Ehlers, Franke, Frommberger, Frommberger, Hautzinger, Huppert, Kapfhammer, Lilienfeld, Margraf, Mirabile, Oosterveld, Simon",2003.0,,0,0,
7464,Antisocial personality disorder (ASPD) and substance abuse treatment outcomes in a post-prison population.,"Antisocial personality disorder has been believed by many to overlap with substance abuse. Over the past several years there has been increasing attention directed to the dually diagnosed. The current managed health care system creates an environment in which social workers dealing with substance abusers need to provide or be able to refer clients to the most effective and cost efficient treatment service. The process shown in this study involves a pre-treatment assessment process, which attempts to match individuals with interventions that will probably work for them. It is program research which has explored for predictors of which men, out of a post-prison population, would be successful in avoiding relapse throughout a period of supervision, including group treatment. Specifically, the purpose of this study was to explore the effect of antisocial personality disorder on the outcomes of group treatment interventions with men who have problems with substance abuse. The study was conducted in the Southern District of the United States probation and parole office with a sample of 59 men who participated in a seven-week outpatient substance abuse treatment program. During 1997, using a newly instituted screening process, individuals under supervision who had profiles of chemical dependency were assigned to social group work treatment, while others were assigned to regular supervision by a federal parole worker. The sample was limited to males without other predetermined severe disorders. The study hypothesized that individuals who were assessed/diagnosed as chemically dependent and antisocial would be less successful in a substance abuse group treatment program compared with substance abusers who were not assessed with that disorder. The study did not support this hypothesis. However, the study did produce four significant non-hypothesized findings. The study found significant relationships between avoidance of relapse and number of friends, assessment to have disthymic or post-traumatic stress disorder (PTSD) and having higher severity scores in drug dependency. The PTSD finding is interesting. If the incarceration itself was the causal trauma, that could have numerous implications for societal responsibility and for post-prison rehabilitation. The findings of the study suggest a need for further study in the generalized area of group treatment for dual diagnosed persons and of the use of psychometric scales to identify predictor variables for success in substance abuse group treatment programs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mullaney, Donald K",2003.0,,0,0,
7465,Psychophysiological Analysis of Eye Movement Desensitisation and Reprocessing Treatment.,"Eye Movement Desensitisation and Reprocessing (EMDR) is a new controversial treatment that claims to resolve long-standing traumatic memories within few treatment sessions. Evidence based data indicate that EMDR markedly reduces anxiety associated with a traumatic memory already at the first session, and behavioural changes tend to be maintained. In spite of the positive results, critical reviews have outlined some methodological biases in the EMDR previous studies, such as the lacking of a pre and post treatment standardised assessments, lacking of standardised inclusion criteria, poor study design. In the present study we have examined three subjects with PTSD, before and after EMDR therapy. Clinical interviews, psychological tests and self-reports have been administered. Biofeedback measures of electromyographic muscle tension, body temperature, heart rate and skin potential reaction have been used as well. An independent investigator was responsible for the collection of final data. The results showed an interesting trend after treatment compared to baseline. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Guzzi, Roberto; Bossa, Rosella; Masaraki, Spiridione; Boucsein, Carlson, Foa, Kaloupek, Orr, Rothschield, Shapiro, van der Hart, Wilson",2003.0,,0,0,
7466,"The Albany treatment study: A randomized, controlled comparison of cognitive-behavioral therapy and SUPPORT in the treatment of chronic PTSD secondary to MVAs.","Examined the Albany Treatment Study: a randomized, controlled comparison of cognitive-behavioral therapy and support in the treatment of chronic PTSD, secondary to motor vehicle accidents (MVAs) in 98 persons. This chapter presents demographic information on the treatment by conditions, support, and dropouts. Results show that there were no significant differences among the three study groups on any of the tabulated variables. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Blanchard, Edward B; Hickling, Edward J; Blanchard, Edward B, Hickling, Edward J",2004.0,,0,0,
7467,Continuity and Intensity of Care Among Women Receiving Outpatient Care for PTSD.,"Continuity of care (COC) is often used as an indicator of treatment quality for patients with severe psychiatric or addictive disorders. However, few studies have examined the relationship between measures of COC and treatment outcomes. This study used standard regression models to examine the strength of the association between continuity of care measures and health outcomes for a sample of female veterans newly entering outpatient treatment for Posttraumatic Stress Disorder (PTSD). There were few consistently significant associations between COC and outcome measures. Four months following program entry only one measure of treatment process, commitment to treatment, was positively associated with one or more continuity of care measures and several COC measures were associated with poor outcomes. Eight months following program entry patients with greater COC during the first four months of treatment had greater declines in violent behavior and PTSD measurements and larger increases in global functioning. However, when a Bonferonni corrected alpha of P<.001 was used to adjust for multiple comparisons, none of the relationships remained statistically significant. Thus, this study provides only weak and inconsistent evidence of the clinical benefits of continuity of care. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Greenberg, Greg A; Fontana, Alan; Rosenheck, Robert A; Attkisson, Bachrach, Bachrach, Bice, Bindman, Brekke, Chinman, Cockburn, Desai, Druss, Endicott, Fontana, Fontana, Fontana, Greenberg, Greenberg, Horvath, Kulka, Lehman, Lehman, Magill, McLellan, Moos, Neale, Pugh, Rosenheck, Rosenheck, Smilkstein, Tessler, Wolfe",2004.0,,0,0,
7468,Mastery of Your Anxiety and Panic and brief therapist contact in the treatment of panic disorder.,"28 individuals with panic disorder were provided with a copy of Mastery of Your Anxiety and Panic II and received either four sessions of group cognitive-behavior therapy (Group) or one meeting with a therapist plus three telephone contacts (Telephone). Between group repeated measures analyses revealed significant improvement over the course of treatment and maintenance of gains over the follow-up period with few treatment by trials interactions. A higher percentage of participants in the Telephone condition achieved high end-state functioning status at posttreatment compared to those who participated in group CBT, but this difference disappeared at 6 months posttreatment. Participants with characteristics of either borderline, dependent, or depressive personality disorders were unlikely to achieve high end-state functioning status at posttreatment. Participants who met criteria for panic disorder with agoraphobia, and those with comorbid generalized anxiety disorder, were also less likely to achieve clinically significant outcome. Findings indicate that self-directed treatment with brief therapist contact is a viable option for many people with panic disorder. The study provides data suggesting that certain comorbid conditions negatively impact self-directed treatment outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hecker, Jeffrey E; Losee, Melinda C; Roberson-Nay, Roxann; Maki, Kristin; Barlow, Barlow, Beck, Beck, Black, Brown, Brown, Chambless, Chambless, Chambless, Clair, Clum, Cote, Craske, Curry, Dreesen, Febbraro, Ghosh, Gould, Gould, Hecker, Hecker, Hoffman, Jacobson, Keisjers, Lidren, Marks, Mavissakalian, McLean, McNamee, Millon, Peterson, Rathus, Roberge, Spielberger, Swinson, Telch, Westling, Wilkinson, Zhu",2004.0,,0,0,
7469,Does psychiatric comorbidity in alcohol-dependent patients affect treatment outcome?,"Comorbidity in alcohol research refers to the presence of alcohol dependency and another major psychiatric disorder. The existence of additional disorders may have consequences for treatment planning and success. The aims of this paper are therefore: 1) to give an overview on prevalence rates in studies with representative cohorts and hospital-based samples; 2) to report results on gender differences and 3) to determine the impact of comorbidity on treatment outcome. Comorbidity was examined with the Composite International Diagnostic Interview (CIDI) in N=118 (61 male and 57 female) alcohol-dependent patients who were socially well integrated. Results show that 65% of the female patients but only 28% of the male patients had a lifetime history of additional psychiatric disorders. Significantly more phobic/anxiety disorders, mood disorders occur in female patients. One year after inpatient treatment, overall 39% had suffered a relapse. More detailed analysis revealed that 55% of the non-comorbid but only 28% of the comorbid women suffered a relapse, thus contradicting our initial hypothesis that comorbid patients have a poorer prognosis with regard to their alcohol dependence. Male comorbid (40.9%) and non-comorbid (35.3%) patients showed no significant differences regarding relapse rates. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mann, Karl; Hintz, Thomas; Jung, Martin; Beck, Bowen, Brady, Bucholz, Chambless, Cohen, Cousineau, Davidson, DiNardo, Driessen, Endicott, Fichter, First, Folstein, Greenfield, Hasin, Haver, Heizer, Herz, Hesselbrock, House, Johannessen, Kessler, Kranzler, Kufner, Lejoyeux, Loosen, Mann, Mann, Meyer, Othmer, Penick, Powell, Regier, Reich, Robins, Ross, Ross, Rounsaville, Roy, Salize, Sallmen, Sarason, Schuckit, Schuckit, Schuckit, Schuckit, Schuckit, Schwarzer, Sheehan, Smail, Spitzer, Spitzer, Spitzer, Spitzer, Stetter, Stroebe, Teeson, Teilenbach, Tomasson, Waern, Weiss, Wittchen, Wittchen, Zerssen",2004.0,,0,0,
7470,Young people with heroin dependence: Findings from the Australian Treatment Outcome Study (ATOS).,"This paper examines the patterns and correlates of heroin use in a cohort of 210 young Australians aged between 18 and 24, who were participants in the Australian Treatment Outcome Study, a longitudinal study of treatment outcomes for heroin dependence. Of major importance were the high rates of psychiatric comorbidity found among this group (37% lifetime Post Traumatic Stress Disorder, 23% current Major Depression, 75% Anti-Social Personality Disorder, and 51% Borderline Personality Disorder). Seventeen percent had attempted suicide in the preceding year. Although both the young (aged 18-24 years) heroin users and their older counterparts (aged 25-56 years) initiated drug use at the same age, young heroin users progressed to heroin use, regular heroin use, and treatment for heroin use, twice as quickly as older heroin users. These findings suggest that there is a limited window of opportunity in which early interventions may be applied before young heroin users progress to problematic use. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mills, Katherine L; Teesson, Maree; Darke, Shane; Ross, Joanne; Lynskey, Michael; Andrews, Anthony, Bijl, Bland, Brienza, Brodsky, Brook, Carpenter, Darke, Darke, Darke, Darke, Degenhardt, Fergusson, Gerstley, Grant, Gupta, Henry, Hopfer, Inman, Johnston, Kessler, Labouvie, Lee, Lynskey, Lynskey, Mathers, Neaigus, Parker, Perez-Jimenez, Plant, Proudfoot, Pugatch, Ross, Schwartz, Shand, Smyth, Stein, Strang, Strang, Swift, Torres, Trull, Ware, Zanarini",2004.0,,0,0,
7471,The Short-Term Treatment of a Long-Term Interpersonal Avoidance.,"This case study presents the 21-session cognitive-behavioral treatment of a young adult female diagnosed with Generalized Social Phobia (GSP) and Avoidant Personality Disorder (APD). Therapy utilized Beck's modified cognitive therapy of personality disorders in addition to behavioral skills training. Therapist observation, client self-report, and objective measurements were used to assess behavioral change. Postintervention administrations of the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and Minnesota Multiphasic Inventory-2 (MMPI-2) evinced a clinically significant reduction of symptoms. The results indicate that a short-term cognitive-behavioral approach may prove efficacious when treating APD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hyman, Scott M; Schneider, Barry A; Beck, Beck, Beck, Beck, Beck, Beck, Ellis, Greene, Hathaway, Holt, Jacobson, Lazarus, Pretzer, Sperry, Stravynski, Van Velzen, Young",2004.0,,0,0,
7472,Quetiapine for treatment of alcohol dependence.,"Quetiapine is an atypical antipsychotic that has sedative effects. In this retrospective study, indices of alcohol use were compared for alcohol-dependent subjects who either were (n = 30) or were not (n = 20) treated with quetiapine (25 to 200 mg nightly) for disturbed sleep. Indices examined included total days of abstinence, number of hospitalizations for detoxification, and days to first relapse over 1 year of clinic treatment. Subjects were male veterans. All subjects had a diagnosis of alcohol dependence, and 90% of subjects in each group were also diagnosed with posttraumatic stress disorder. Both treatment groups contained a large number of subjects treated with psychiatric medications other than quetiapine. Significant differences were not found between the groups with respect to mean age, detoxifications undergone during the previous year, frequency of comorbid posttraumatic stress disorder or depression, or antidepressant use. The mean number of days abstinent was significantly greater, and the number of hospitalizations was significantly lower for the quetiapine than for the control group during the period studied. The mean number of days to relapse approached significance for the quetiapine as compared to the control group. This study has the usual limitations of a retrospective review, including the lack of standardized assessments of alcohol use. The results of this study are consistent with the hypothesis that the use of quetiapine to improve disturbed sleep may help alcohol-dependent patients maintain abstinence, although decreased drinking may also be a result of improving posttraumatic stress disorder symptoms or of a direct action of quetiapine to reduce alcohol use. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Monnelly, Edward P; Ciraulo, Domenic A; Knapp, Clifford; LoCastro, Joseph; Sepulveda, Isaias; Back, Bartzokis, Bremner, Drake, Green, Green, Hamner, Hutchison, Hutchison, Kasper, Landoli, Littrell, Monnelly, Nemeroff, Saltar, Stein, Weisman, Zimmet",2004.0,,0,0,
7473,Effects of CCK-Tetrapeptide in patients with social phobia and obsessive-compulsive disorder.,"Panicogenic sensitivity to CCK-tetrapeptide (CCK-4) is enhanced in panic disorder patients relative to normal controls (NC). We sought to determine whether CCK-4 sensitivity is augmented in patients with social phobia (SP) (n=12) and obsessive-compulsive disorder (OCD) (n = 8) versus NC (n=12). We also determined whether CCK-4 could elicit syndrome-specific symptoms in SP and OCD patients. The study employed a single-blind, placebo-controlled, within-subject design. Behavioral, cardiovascular and hormonal responses to a submaximal dose (20 microg) of CCK-4 were evaluated. Panic frequency after the placebo and CCK-4 challenge varied as a function of diagnosis. Differences in panic frequency between groups and between challenge agents within each group did not, however, reach statistical significance. Further, the number and intensity of panic symptoms, intensity of subjective anxiety, autonomic reactivity and hormonal release after CCK-4 administration did not distinguish the groups. Core symptoms of SP and OCD were unaffected by CCK-4. These data failed to detect significant differences between groups on behavioral, cardiovascular and hormonal response to CCK-4. The lack of effect of CCK-4 on SP and OCD symptoms suggests that this peptide does not play a salient role in the pathophysiology of these disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Katzman, Martin A; Koszycki, Diana; Bradwejn, Jacques; Abelson, Bradwejn, Bradwejn, Bradwejn, Bradwejn, Bradwejn, Brawman-Mintzer, de Leeuw, Denavit-Saubie, Flint, Flint, Harro, Javanmard, Kellner, Koszycki, Koszycki, Le Melledo, Liebowitz, McCann, Perna, Perna, Rasmussen, Shlik, Swain, Uhde, van Megen, van Megen, van Vliet",2004.0,,0,0,
7474,Increased Mastery Elements Associated With Imagery Rehearsal Treatment for Nightmares in Sexual Assault Survivors With PTSD.,"Exposure, abreaction, and mastery have been proposed as the therapeutic processes of nightmare (NM) reduction. Imagery rehearsal therapy (IRT) effectively reduces NMs but involves minimal exposure and abreaction. The authors investigated the use of mastery in the scripting of new dreams (NDs) elaborated during IRT. NM and ND reports were collected from 44 female sexual assault survivors with chronic NMs during their initial application of IRT. Mastery was assessed with a standardized dream coding system and a multidimensional mastery scale. NDs contained significantly fewer negative elements and more occurrences of positive elements and mastery than did NMs. NDs were not devoid of negative dream elements. An increase in mastery over negative dream elements is a core process involved in NM reduction. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Germain, Anne; Krakow, Barry; Faucher, Brigitte; Zadra, Antonio; Nielsen, Tore; Hollifield, Michael; Warner, Teddy D; Koss, Mary; Abromovitch, Brunelle, Bryant, Brylowsky, Burgess, Cium, Cohen, Domhoff, Eichelman, Forbes, Germain, Gillin, Hall, Halliday, Horowitz, Kellner, Kilpatrick, Koren, Krakow, Krakow, Krakow, Krakow, Krakow, Krakow, Krakow, Krakow, Krakow, Laor, MacFarlane, Marks, Marks, Mellman, Mikulincer, Miller, Neidhardt, Nishith, Taylor, Zadra",2004.0,,0,0,
7475,Who Benefits from Brief Psychodynamic Therapy for Generalized Anxiety Disorder?,"This study examined a broad range of predictors of the outcome of brief psychodynamically oriented treatment for generalized anxiety disorder (GAD). Outcome data from two studies of brief (16-session) supportive-expressive psychotherapy for GAD was pooled to explore whether demographic, diagnostic, interpersonal, expectation, or treatment process variables were associated with outcome (interview and self-report measures of anxiety symptoms, and worry symptoms). The results indicated that presence of an Axis II disorder, presence of a comorbid major depressive disorder, more interpersonal problems related to be overly nurturant, and negative expectation about psychotherapy compared to medication, were all associated with a relatively poorer outcome. However, in multiple regression analyses, only the interpersonal problem variable and expectations about psychotherapy versus medication remained statistically significant predictors of outcome. The results are discussed in terms of alternative treatment approaches that might improve success rates with GAD, including the use of longer-term psychoanalytic treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Crits-Christoph, Paul; Gibbons, Mary Beth Connolly; Losardo, Diane; Narducci, Julia; Schamberger, Megan; Gallop, Robert; Abel, Alden, Bachrach, Bachrach, Barlow, Barlow, Beck, Bordin, Borkovec, Borkovec, Borkovec, Borkovec, Breitholtz, Bruss, Butler, Butler, Cassidy, Cassidy, Castonguay, Chambless, Crits-Christoph, Crits-Christoph, Crits-Christoph, Crits-Christoph, Crits-Christoph, DiNardo, Ehrenberg, First, First, Gabbard, Gaston, Gelenberg, Goisman, Gould, Hamilton, Hamilton, Hoehn-Saric, Horowitz, Luborsky, Luborsky, Luborsky, MacLeod, Massion, Mathews, Meyer, Mogg, Newman, Reich, Reich, Rickels, Roemer, Rouillon, Spitzer, Spitzer, Stocci, Weber, Westen, Yonkers",2004.0,,0,0,
7476,Numerical Distraction Therapy: Initial Assessment of a Treatment for Posttraumatic Stress Disorder.,"The efficacy of a new therapy, numerical distraction therapy (NDT), in treating symptoms of posttraumatic stress disorder (PTSD) was investigated. It was hypothesized that the therapy would change the traumatic visual memories of PTSD patients and reduce the intensity of negative feelings associated with them. Both hypotheses were supported: 92% of patients reported post-treatment (positive) changes in their visual memories, and these same patients reported diminished levels of fear, shame, anxiety and other negative feelings. A subsample of patients reported stable treatment effects in follow-up surveys conducted two to four months later. The author also discusses possible mechanisms of NDT and suggests that NDT, eye movement desensitization and reprocessing (EMDR), and some forms of thought field therapy (TFT) might have ""dual attention"" as a common underlying mechanism. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Isaacs, John S; Baddeley, Baddeley, Bandler, Bergmann, Berndt, Bremner, Bremner, Callahan, Callahan, Callahan, Callahan, Carbonell, Carter, Commons, Craig, Dehaene, Diepold, Durlacher, Foa, Gallo, Gerbode, Isaacs, Johnson, Kavanaugh, Kotler, LeDoux, Lipke, Manos, Meltzer-Brody, Miller, Morgan, Morgan, Nicosia, Ochberg, Pignotti, Pitman, Rauch, Renfrey, Sakai, Schacter, Schiffer, Seligman, Shapiro, Shapiro, Shapiro, Shapiro, Stickgold, Van der Kolk, Van Etten, Wolpe",2004.0,,0,0,
7477,Effect of different variables on the outcome of various cognitive-behavioral treatment modalities for panic disorder with agoraphobia.,"The efficacy of cognitive-behavioral therapy (CBT) is clearly demonstrated in the treatment of panic disorder with agoraphobia (PDA). Between 70% and 90% of people with PDA obtain an higher global functioning level after CBT. Yet, symptoms remain in 10 to 30% of participants after treatment termination. The goal of the present study is to find which variables have an effect on different CBT modalities (individual, group, self-help) for persons with moderate and high PDA. Eighty-four persons were randomly assigned to one of three treatment modalities. Evaluations were made before treatment, immediately after and one year later. Results show that sex, number of years with agoraphobia and anxiety level significantly predict outcome at post-test for the individual modality. However, only the number of years with agoraphobia is a strong predictor one year later for this treatment modality. For the self-help modality, no predictor is significant neither at post-test nor one year later. For the group modality, the agoraphobic avoidance predicts outcome at post-test whereas symptoms severity predicts outcome one year later. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Marchand, A; Germain, V; Angst, Basoglu, Beck, Beck, Botella, Brown, Carlbring, Chambless, Chambless, Chambless, Craske, Craske, Dinardo, Faravelli, Fisher, Freeston, Gauthier, Germain, Gould, Hafner, Keijsers, Kessler, Lavallee, Lelliott, Lidren, Marchand, Mattick, Mavissakalian, Neron, Noyes, Otto, Otto, Penava, Reiss, Rijken, Roberge, Seivewrigh, Shear, Steketee, Stephenson, Stephenson, Stephenson, Stephenson, Wolfe",2004.0,,0,0,
7478,Intensive Cognitive Behavioural Group Treatment for Social Phobia: A Pilot Study.,"The aim of this pilot study was to examine the effectiveness of an intensive form of cognitive behavioural group treatment practised routinely in a psychiatric clinic. A total of 27 outpatients with social phobia of long duration were assigned to a 41-hour treatment administered over 2 periods of 3.5 and 4.5 days, 1 week apart. Four groups, each comprising 6-8 patients, participated in the study. All except 1 patient (26/27) completed the treatment and 20 patients participated in all follow-up sessions after 3, 6 and 12 months. Treatment significantly reduced fear and avoidance of social interaction and performance, anticipatory anxiety and symptoms' influence on daily life. Follow-up assessments indicated maintained or increased improvement from post-test to 1 year and large sensitivity to treatment at both post-test and 1 year. Of the patients in the study, 85% were taking a prescribed drug, and 70% had taken medication for at least 1 year before they entered the treatment. At 1-year follow-up 52% had discontinued medication. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mortberg, Ewa; Berglund, Gunilla; Sundin, Orjan; Andrews, Baker, Beck, Beck, Butler, Butler, Butler, Clark, Clark, Clark, Clark, Clark, Cohen, Fahlen, Fedoroff, Feske, Fresco, Furmark, Gould, Heimberg, Heimberg, Heimberg, Heimberg, Hunt, Juster, Jonsson, Liebowitz, Ogles, Scholing, Strangier, Taylor, Turk, van der Linden, Ost",2005.0,,0,0,
7479,The challenge of treating each and every depressed patient,"The implications of concomitant anxiety, severity, gender, age, and body mass index (BMI) need to be taken into account in selecting optimal antidepressant therapy. The presence of anxiety symptoms or comorbid anxiety disorders in depressed patients is very common and associated with lower rates of response to various antidepressants. Individuals with “anxious depression” display higher severity scores on depression rating scales, greater functional and psychosocial impairment, and higher suicide risk compared with “non-anxious” depressed patients. The anxiolytic effects of agomelatine observed in preclinical studies have been confirmed during treatment of anxious depression. Although there are various definitions of “severe depression”, predefined scores on depression rating scales provide the most accepted convention. Analysis of pooled data from 3 placebocontrolled studies on agomelatine demonstrated an increase in the magnitude of drug-placebo difference, with greater symptom severity at baseline, including in patients aged 60 or over. Pooled data from 3 placebo-controlled studies indicated a significant difference in HAM-D total score between agomelatine and placebo in subpopulations defined according to gender, age, body mass index, and concomitant anxiety: elderly patients (delta=4.50±2.11, P = 0.033), overweight patients (delta=3.22±0.85, P < 0.001), patients highly anxious at baseline and patients who did not use benzodiazepines (delta=2.46±0.67 P < 0.001), as well as both in men (delta= 3.83±1.01, P < 0.001) and women (delta= 2.46±0.7, P < 0.001). In summary, agomelatine appears to be the treatment of choice for a large spectrum of depressed populations defined on the basis of symptom profiles, severity, and age.",Kennedy S.,2008.0,,0,0,
7480,Addressing co-morbidities in insomnia,"As many as 80% of patients with insomnia report psychiatric symptoms (Stewart, 2006). Insomnia is known to be a risk factor for depression and anxiety, and patients with psychiatric conditions and insomnia use healthcare services more frequently than patients with insomnia alone. Recently presented clinical study results indicate that treating insomnia together with coexisting psychiatric conditions may result in increased benefits for the patient. Two placebo-controlled studies in patients with co-morbid insomnia and generalized anxiety disorder examined the effects of escitalopram coadministered with eszopiclone (Pollack, 2008) or with zolpidem (http://www.clinicalstudyresults.org/ documents/company-study-3110-0.pdf). In both studies, hypnotic/SSRI therapy was associated with early and sustained benefits on sleep onset, maintenance, and quality. In addition, the eszopiclone/escitalopram combination significantly improved the onset and duration of escitalopram's anxiolytic effects. The zolpidem/escitalopram combination was associated with an initial difference in anxiety score versus escitalopram alone, but this effect was not maintained beyond Week 1. A third placebo-controlled study, this time in patients with comorbid insomnia and major depressive disorder, has examined the effects of fluoxetine coadministered with eszopiclone (Fava, 2006). Again, rapid and sustained sleep benefits were observed following cotherapy. In addition, eszopiclone/fluoxetine cotherapy significantly improved the onset and magnitude of fluoxetine's antidepressant effects. Follow-up evaluations indicate that these improvements in sleep and depression symptoms were maintained for 2 weeks after discontinuation of eszopiclone, with no significant withdrawal or rebound effects. In summary, recent evidence suggests that patient recovery may be accelerated and enhanced by insomnia therapy prescribed in conjunction with treatment of the co-morbid psychiatric condition.",Krystal A.,2008.0,,0,0,
7481,"Pregabalin versus naltrexone in alcohol dependence: Results from a multicenter, rondomized, double-blind, comparison trial","Introduction: Pregabalin, a structural analogue of γ-aminobutyric acid, is a novel compound with broad-spectrum efficacy in the treatment of diverse medical conditions. In addition, evidence from different double-blind, placebo controlled studies suggests that Pregabalin may also have efficacy in general anxiety disorder (Feltner, 2003; Pande, 2003; Pohl, 2005; Rickels, 2004; Montgomery, 2006). Pregabalin selectively binds to the α2-δ subunit protein of voltage-gated calcium channels, as does gabapentin, although its binding is at least 3 times as potent as that of gabapentin In this multicenter, randomised, double-blind, comparison trial with naltrexone we aimed to investigate the efficacy of pregabalin on alcohol drinking indices. Craving and psychiatric symptoms improvements were the secondary endpoints. Methods: Seventy-one alcohol dependent subjects where detoxified and subsequently randomised into two groups, respectively receiving 50mg of naltrexone (NAL) and 150-450mg of Pregabalin (PRE). Withdrawal symptomatology was determined by the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar), whereas the level of craving for alcohol was evaluated by a 10-cm Visual Analogue Scale (VAS) and the Italian version of the Obsessive and Compulsive Drinking Scale (OCDS). Psychiatric symptomatology was evaluated by the Symptom Check List 90 Revised (SCL-90 R). Results: Alcohol drinking indices and craving scores were not significantly different between groups. The survival function showed that patients treated with pregabalin remained abstinent from any alcohol amount for a longer time with respect to those treated with naltrexone (Z = -2.27; P < 0.05). The SCL-90-R general index of “Positive Symptom Total” significantly reduced between times in the two groups considered (PRE: F= 3.33, p < 0.05; NAL: F = 5.30, p < 0.05), whereas the subscales for “phobic anxiety”, “hostility”, and “psychoticism” only reduced in the pregabaline treated subjects (F = 2.44, p < 0.05; F = 2.56, p < 0.05; F = 3.02, p < 0.05). The number of patients in dual diagnosis reporting a condition of total abstinence from alcohol at the end of the study was significantly higher (p < 0.01) in the PRE group (9/18; 50%) with respect to the NAL group (2/13; 15%). Discussion: To our knowledge, this is the first randomised, parallel group trial to evaluate the efficacy of pregabalin for alcohol dependence. Results from this study globally place pregabalin at the same range of efficacy of naltrexone, one of the approved drugs used in alcohol relapse prevention. Those significant points in favour of the employment of pregabalin were represented by the improvement of specific symptoms in the area of anxiety, hostility and psychoticism, a survival time remaining abstinent superior than naltrexone, and a better outcome in those patients reporting a comorbid psychiatric disorder. The mechanism involved in the efficacy of pregabalin in relapse prevention could be less related to craving for alcohol and more connected to the treatment of the comorbid psychiatric symptomatology, as rated by the SCL-90 R. If it could be confirmed in placebo-controlled trials that pregabalin is efficacious in decreasing alcohol use, lessening craving, and attenuating psychopathological symptom severity, we will have gained a valuable agent for the treatment of alcohol dependent subjects.",Martinotti G.; Di Nicola M.; Tedeschi D.; Guglielmo R.; Janiri L.,2008.0,,0,0,
7482,"""Perhaps you only imagined doing it"": Reality-monitoring in obsessive-compulsive checkers using semi-idiographic stimuli","Memory failures reported by obsessive-compulsive (OC) checkers often seem to be errors of ""reality-monitoring"", or misremembering whether one performed or imagined performing an action. To examine these memory processes in the context in which such errors are said to occur, an in-home reality-monitoring experiment involving bothersome and non-bothersome actions was conducted with 21 OC checkers and 24 non-clinical controls. OC checkers reported poorer confidence in memory, but both groups performed similarly on tests of immediate and delayed free and prompted recall. Among OC checkers (but not controls), accuracy in recall and confidence in memory were correlated. Theoretical implications are discussed. © 2007 Elsevier Ltd. All rights reserved.",Cougle J.R.; Salkovskis P.M.; Thorpe S.J.,2008.0,10.1016/j.jbtep.2007.08.001,0,0,
7483,Order-preserving dimension reduction procedure for the dominance of two mean curves with application to tidal volume curves,"The paper here presented was motivated by a case study involving high-dimensional and high-frequency tidal volume traces measured during induced panic attacks. The focus was to develop a procedure to determine the significance of whether a mean curve dominates another one. The key idea of the suggested method relies on preserving the order in mean while reducing the dimension of the data. The observed data matrix is projected onto a set of lower rank matrices with a positive constraint. A multivariate testing procedure is then applied in the lower dimension. We use simulated data to illustrate the statistical properties of the proposed testing procedure. Results on the case study confirm the preliminary hypothesis of the investigators and provide critical support to their overall goal of creating an experimental model of the clinical panic attack in normal subjects. © 2008, The International Biometric Society.",Lee S.H.; Lim J.; Vannucci M.; Petkova E.; Preter M.; Klein D.F.,2008.0,10.1111/j.1541-0420.2007.00959.x,0,0,
7484,The Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial and Hurricane Katrina: Lessons for managing clinical trials during and after a natural disaster,"Hurricane Katrina was one of the most catastrophic natural disasters to hit the United States. It had a major impact on health care in New Orleans, LA and the surrounding region, not only in relation to acute illness but also chronic disease. When Hurricane Katrina struck New Orleans on August 29, 2005, there were 193 participants being followed in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial at Tulane University Health Sciences Center. In the immediate aftermath of the storm, the Tulane University ACCORD Study site, in collaboration with the Study Coordinating Center and the Southeast Clinical Center Network office of the trial at Wake Forest University Health Sciences in North Carolina, took several actions in order to locate the participants, ensure their safety, and maintain the scientific integrity of the trial. We describe the actions taken and the relative success/failure of such actions.",McDuffie R.; Summerson J.; Reilly P.; Blackwell C.; Goff D.; Kimel A.R.; Crago L.; Fonseca V.,2008.0,10.1016/j.cct.2008.05.006,0,0,
7485,When moving faces activate the house area: An fMRI study of object-file retrieval,"Background: The visual cortex of the human brain contains specialized modules for processing different visual features of an object. Confronted with multiple objects, the system needs to attribute the correct features to each object (often referred to as 'the binding problem'). The brain is assumed to integrate the features of perceived objects into object files - pointers to the neural representations of these features, which outlive the event they represent in order to maintain stable percepts of objects over time. It has been hypothesized that a new encounter with one of the previously bound features will reactivate the other features in the associated object file according to a kind of pattern-completion process. Methods: Fourteen healthy volunteers participated in an fMRI experiment and performed a task designed to measure the aftereffects of binding visual features (houses, faces, motion direction). On each trial, participants viewed a particular combination of features (S1) before carrying out a speeded choice response to a second combination of features (S2). Repetition and alternation of all three features was varied orthogonally. Results: The behavioral results showed the standard partial repetition costs: a reaction time increase when one feature was repeated and the other feature alternated between S1 and S2, as compared to complete repetitions or alternations of these features. Importantly, the fMRI results provided evidence that repeating motion direction reactivated the object that previously moved in the same direction. More specifically, perceiving a face moving in the same direction as a just-perceived house increased activation in the parahippocampal place area (PPA). A similar reactivation effect was not observed for faces in the fusiform face area (FFA). Individual differences in the size of the reactivation effects in the PPA and FFA showed a positive correlation with the corresponding partial repetition costs. Conclusion: Our study provides the first neural evidence that features are bound together on a single presentation and that reviewing one feature automatically reactivates the features that previously accompanied it. © 2008 Keizer et al; licensee BioMed Central Ltd.",Keizer A.W.; Nieuwenhuis S.; Colzato L.S.; Teeuwisse W.; Rombouts S.A.R.B.; Hommel B.,2008.0,10.1186/1744-9081-4-50,0,0,
7486,Memory extinction entails the inhibition of the transcription factor NF-κB,"In contextual memories, an association between a positive or negative reinforcement and the contextual cues where the reinforcement occurs is formed. The re-exposure to the context without reinforcement can lead to memory extinction or reconsolidation, depending on the number of events or duration of a single event of context re-exposure. Extinction involves the temporary waning of the previously acquired conditioned response. The molecular processes underlying extinction and the mechanisms which determine if memory will reconsolidate or extinguish after retrieval are not well characterized, particularly the role of transcription factors and gene expression. Here we studied the participation of a transcription factor, NF-κB, in memory extinction. In the crab context-signal memory, the activation of NF-κB plays a critical role in consolidation and reconsolidation, memory processes that are well characterized in this model. The administration of a NF-κB inhibitor, sulfasalazine prior to extinction session impeded spontaneous recovery. Moreover, reinstatement experiments showed that the original memory was not affected and that NF-κB inhibition by sulfasalazine impaired spontaneous recovery strengthening the ongoing memory extinction process. Interestingly, in animals with fully consolidated memory, a brief re-exposure to the training context induced neuronal NF-κB activation and reconsolidation, while prolonged re-exposure induced NF-κB inhibition and memory extinction. These data constitutes a novel insight into the molecular mechanisms involved in the switch between memory reconsolidation and extinction. Moreover, we propose the inhibition of NF-κB as the engaged mechanism underlying extinction, supporting a novel approach for the pharmacological enhancement of this memory process. The accurate description of the molecular mechanisms that support memory extinction is potentially useful for developing new strategies and drug candidates for therapeutic treatments of the maladaptive memory disorders such as post-traumatic stress, phobias, and drug addiction. © 2008 Merlo, Romano.",Merlo E.; Romano A.,2008.0,10.1371/journal.pone.0003687,0,0,
7487,Trait dissociation predicts posttraumatic stress disorder symptoms in a prospective study of urban police officers,"The current study prospectively examines the predictive relationship of trait dissociation, assessed during academy training, to PTSD symptoms assessed at 12 months of active police duty in relatively young and healthy police academy recruits (N = 180). The roles of pre-academy trauma exposure, exposure to life-threatening critical incidents during police duty, and peritraumatic dissociation at the time of the officer's worst critical incident were also examined. Utilizing path analytic techniques, greater trait dissociation, assessed during academy training, was predictive of both peritraumatic dissociation, and PTSD symptoms assessed at 12 months of police service. Moreover, after accounting for trait dissociation and peritraumatic dissociation, the relationship of previous trauma to later PTSD symptoms was no longer significant, demonstrating that the effect of previous trauma on later vulnerability to PTSD symptoms in this sample may be mediated by both trait and peritraumatic dissociation. © 2008 by Lippincott Williams and Wilkins.",McCaslin S.E.; Inslicht S.S.; Metzler T.J.; Henn-Haase C.; Maguen S.; Neylan T.C.; Choucroun G.; Marmar C.R.,2008.0,10.1097/NMD.0b013e31818ec95d,0,0,
7488,Dimensional nosography of anxiety and mood disorders: The impact on quality of life,"Aim of the study: To explore the relation between quality of life and the perception of own well-being on one hand, and the psychopathological dimension of affectivity, on the other hand, in a spectrum perspective and in a transnosographical point of view. Materials and methods: We considered 918 healthy subjects, to which we administered Q-LES-Q and spectrum questionnaires MOODS-SR, OBS-SR, SHY-SR, PAS-SR. Results: We first considered subjects with a single specific spectrum symptomatology. In the ""Physical health/Activities"" domain we found lower scores in subjects with a social-phobic or depressive spectrum; in the ""Subjective sensations"" domain we found lower scores in subjects affected by the social-phobic spectrum; in the ""Work"" domain we found lower scores in subjects with social-phobic and obsessive-compulsive spectrum; in the ""School/ Scholastic activities"" and ""Spare time activities"" domains all the spectra did not show differences in comparison with the absence of spectrum symptomatology, except for the mania spectrum that was associated with satisfaction levels significantly higher; in the ""Social relationship"" and ""General activities"" domains we found lower scores in subjects with social-phobic spectrum. In all the Q-LES-Q domains we found lower scores in subjects affected by four spectra. We found several and significant negative correlations between quality of life and spectrum symptomatology, especially as regards mood and social-phobic spectra. Conclusions: Our results underline the importance for clinicians and researchers to focus the attention and to aim the therapeutic intervention not only at the categorial disorder but also at the psychopathological dimensions, that may significantly compromise quality of life independent of Axis I and II disorders.",Martinucci M.; Goracci A.; Scalcione U.; Castrogiovanni P.,2008.0,,0,0,
7489,Carbon dioxide-induced emotion and respiratory symptoms in healthy volunteers,"A number of evidences have established that panic and respiration are closely related. Clinical studies indicated that respiratory sensations constitute a discrete cluster of panic symptoms and play a major role in the pathophysiology of panic. The aim of the present study was to explore the phenomenology of an experimental model of panic in healthy volunteers based on the hypothesis that: (1) we can isolate discrete clusters of panic symptoms, (2) respiratory symptoms represent a distinct cluster of panic symptoms, and (3) respiratory symptoms are the best predictor of the subjective feeling of panic, as defined in the DSM IV criteria.Sixty-four healthy volunteers received a double inhalation of four mixtures containing 0, 9, 17.5 and 35% CO2, respectively, in a double-blind, cross-over, random design. An electronic visual analog scale and the Panic Symptom List (PSL) were used to assess subjective 'fear/discomfort' and panic symptoms, respectively. Statistical analyses consisted of Spearman's correlations, a principal component factor analysis of the 13 PSL symptoms, and linear regressions analyses.The factor analysis extracted three clusters of panic symptoms: respiratory, cognitive, and neurovegetative (r2=0.65). Respiratory symptoms were highly related to subjective feeling of fear/discomfort specifically in the CO 2-enriched condition. Moreover, the respiratory component was the most important predictor of the subjective feeling of 'fear/discomfort' (β=0.54).The discrete clusters of symptoms observed in this study were similar to those elicited in panic attacks naturally occurring in patients affected by panic disorder. Consistent with the idea that respiration plays a crucial role in the pathophysiology of panic, we found that respiratory symptoms were the best predictors the subjective state defined in the DSM IV criteria for panic. © 2008 Nature Publishing Group All rights reserved.",Colasanti A.; Salamon E.; Schruers K.; Van Diest R.; Van Duinen M.; Griez E.J.,2008.0,10.1038/npp.2008.31,0,0,
7490,Association testing of panic disorder candidate genes using CCK-4 challenge in healthy volunteers,"Despite continuing efforts to determine genetic vulnerability to panic disorder (PD), the studies of candidate genes in this disorder have produced inconsistent or negative, results. Laboratory panic induction may have a potential in testing genetic substrate of PD. In this study we aimed to explore the effects of several genetic polymorphisms previously implicated in PD on the susceptibility to cholecystokinin-tetrapeptide (CCK-4) challenge in healthy subjects. The study sample consisted of 110 healthy volunteers (47 males and 63 females, mean age 22.2 ± 5.2) who participated in CCK-4 challenge test. Nine gene-candidates, including 5-HTTLPR, MAO-A VNTR, TPH2 rs1386494, 5-HTR1 A -1019C-G, 5-HTR2A 102T-C, CCKR1 246G-A, CCK",Maron E.; Tõru I.; Tasa G.; Must A.; Toover E.; Lang A.; Vasar V.; Shlik J.,2008.0,10.1016/j.neulet.2008.09.052,0,0,
7491,Treatment of trichotillomania: Which therapy is the best?,"Background and Aim: Trichotillomania (TTM) is a disorder characterized by repetitive stereotypical hair pulling from different sites, resulting in noticeable hair loss (American psychiatric association, 1994). The lack of consensus about the drug of choice leads to the use of a wide range of treatments including antidepressants, neuroleptics, anticonvulsants, benzodiazepins and lithium. We describe four patients of TTM in which different treatment modalities were used. Material-Method. Case 1: A 25 year-old female had had TTM for 5 years. She met the DSM-IV-R criteria for bipolar disorder, Obsessive compulsive disorder (OCD), TTM, Eating disorder and B cluster Personality disorder. Risperidone 2 mg/day, Quetiapine 150 mg/day, Valproic acid 1500 mg/day were administered besides cognitive behavioural treatment for OCD and TTM symptoms. After six weeks of follow up her OCD symptoms eased and TTM symptoms were treated completely. Case 2: A 45-year-old female had had TTM for 4 years. She met the DSM-IV-R criteria for TTM, Depression, Anxiety disorder and OCD. She used Venlafaxine for several months with maximum dose 225 mg/day, but her symptoms were still persisting. Fluvoksamine was administered and the dose was increased to 200 mg/day within two weeks. Her symptoms were under the control after eight weeks of treatment with fluvoksamine. Case 3: A 20-year-old female had had TTM for several months. She met the DSM-IV-R criteria for TTM, Depression, Anxiety disorder. She used Sertraline for several weeks but there was no change in her symptoms. Duloxetine 60 mg/day and once a week and supportive psychotherapy were administered for 7 weeks. Her depression, anxiety disorder and TTM symptoms ceased. Case 4: An 18-year-old female had had TTM for one year. She met the DSM-IV-R criteria for TTM, Depression, Anxiety disorder. She used Venlafaxine 75 mg/day and she was asymptomatic in 3 months. She stopped her medication by herself and skin picking and TTM symptoms restarted in 6 months. There were no depression and anxiety symptoms accompanying dermatological symptoms during that time. Venlafaxine 75 mg/day was administered and evaluated for further progress. Results: TTM is currently classified as an impulse control disorder, but there is considerable controversy regarding its relationship with OCD or other disorders. TTM may be seen as a symptom observed in various psychiatric disorders including impulse control disorder, obsessive compulsive disorder, personality disorders such as histrionic or borderline personality disorders, mental retardation, schizophrenia, body dysmorphic disorder or mood disorder like depression or bipolar affective disorder. Treatment should be started after taking detailed history, psychiatric examination, dermatological examination and blood tests for differential diagnosis. No treatment approach has been established as effective in large controlled trials so far. Besides different pharmacological treatment methods, psychotherapy methods including behaviour therapy, insight oriented psychotherapy or supportive psychotherapy should be used in appropriate cases. Conclusions. We described comorbidities of TTM, paying attention to the available treatment modalities in pharmacotherapy and psychotherapy.",Mercan S.; Altunay I.,2009.0,,0,0,
7492,"Spontaneous improvement in randomised clinical trials: Meta-analysis of three-armed trials comparing no treatment, placebo and active intervention","Background. It can be challenging for patients and clinicians to properly interpret a change in the clinical condition after a treatment has been given. It is not known to which extent spontaneous improvement, effect of placebo and effect of active interventions contribute to the observed change from baseline, and we aimed at quantifying these contributions. Methods. Systematic review and meta-analysis, based on a Cochrane review of the effect of placebo interventions for all clinical conditions. We selected all trials that had randomised the patients to three arms: no treatment, placebo and active intervention, and that had used an outcome that was measured on a continuous scale or on a ranking scale. Clinical conditions that had been studied in less than three trials were excluded. Results. We analysed 37 trials (2900 patients) that covered 8 clinical conditions. The active interventions were psychological in 17 trials, physical in 15 trials, and pharmacological in 5 trials. Overall, across all conditions and interventions, there was a statistically significant change from baseline in all three arms. The standardized mean difference (SMD) for change from baseline was -0.24 (95% confidence interval -0.36 to -0.12) for no treatment, -0.44 (-0.61 to -0.28) for placebo, and -1.01 (-1.16 to -0.86) for active treatment. Thus, on average, the relative contributions of spontaneous improvement and of placebo to that of the active interventions were 24% and 20%, respectively, but with some uncertainty, as indicated by the confidence intervals for the three SMDs. The conditions that had the most pronounced spontaneous improvement were nausea (45%), smoking (40%), depression (35%), phobia (34%) and acute pain (25%). Conclusion. Spontaneous improvement and effect of placebo contributed importantly to the observed treatment effect in actively treated patients, but the relative importance of these factors differed according to clinical condition and intervention.",Krogsb√∏ll L.T.; Hr√°bjartsson A.; G√∏tzsche P.C.,2009.0,10.1186/1471-2288-9-1,0,0,
7493,Psychological impact of acne vulgaris and isotretinoin treatment,"Acne vulgaris is a common inflammatory dermatosis capable of producing psychological and physical scarring. It is common for patient to develop psychological problem as a consequence of the condition, such as those related to low self-esteem, social phobias, depression, anxiety, suicidal thoughts, and lowered quality of life. Self assessment of acne severity is often more severe than dermatological clinical evaluation what is important data in understanding the necessity of individual approachment to the patient. Isotretinoin is the drug which is indicated in the treatment of severe form of the disease, but in last period its application is suggested in moderate form of acne with prominent cicatricial liability or when the disease has strong psychological impact on patients life. Last 20 years some data of possible association with depression and suicidal tendency during treatment with isotretinoin appeared. In our clinic a prospective clinical trial has been terminated in which we used standardised psychometric questionnaires (APSEA, BDI, STAI, MPS) and psychological interview in order to evaluate the influence of isotretinoin on psychological status of patient during treatment of acne vulgaris. Conclusion: The overall results show that patients with acne suffer from psychosocial problems caused by their disease, but the impairment depends less on the objective severity of acne and more on the patient's perception of the condition. Isotretinoin group acne patients showed no more pronounced depression or suicidal ideation in comparison with acne patient who was not treated with isotretinoin.",Kotrulja L.; Vurnek M.; Sjerobabski-Masnec I.; Šitum M.; Vuletić G.,2009.0,,0,0,
7494,The significance of body dissatisfaction and overvaluation of shape in obesity and binge eating disorder,"This presentation will describe the nature and significance of body image dissatisfaction and overvaluation of shape and weight in obesity and eating disorders. The distinction between these two important clinical constructs for understanding obese patients with and without binge eating disorder will be highlighted. Although many may be dissatisfied with their physical appearance, only a portion of obese patients define their self-worth primarily on the basis of their shape/weight (i.e., overvaluation). Research demonstrating this distinction will be presented along with new findings showing that obese patients with binge eating disorder are significantly more likely to overvalue their shape than their obese peers who do not binge. Moreover, overvaluation of shape is associated with heightened eating disorder psychopathology and psychological distress. Lastly, the prognostic significance of overvaluation of shape will be discussed. Overvaluation of shape was found to significantly predict outcomes in secondary analyses of two recently completed NIH-funded randomized controlled trials with obese patients with binge eating disorder. Analyses from both controlled trials indicated that patients with overvaluation of shape had significantly lower remission rates than patients who do not overvalue their shape. Analyses from the second trial extended these findings to longer-term outcomes. Pre-treatment levels of overvaluation significantly predicted remission rates at follow-ups 12-months after completing and discontinuing both cognitive behavioural therapy (37% versus 72%) and behavioural weight loss treatment (21% versus 52%). The implications of these findings for nosology, clinical practice, and future research will be discussed.",Grilo C.M.,2009.0,,0,0,
7495,"Can playing the computer game ""Tetris"" reduce the build-up of flashbacks for trauma? A proposal from cognitive science","Background: Flashbacks are the hallmark symptom of Posttraumatic Stress Disorder (PTSD). Although we have successful treatments for full-blown PTSD, early interventions are lacking. We propose the utility of developing a 'cognitive vaccine' to prevent PTSD flashback development following exposure to trauma. Our theory is based on two key findings: 1) Cognitive science suggests that the brain has selective resources with limited capacity; 2) The neurobiology of memory suggests a 6-hr window to disrupt memory consolidation. The rationale for a 'cognitive vaccine' approach is as follows: Trauma flashbacks are sensor-perceptual. visuospatial mental images, Visuospatial cognitive tasks selectively compete for resources required to generate mental images. Thus, a visuospatial computer game (e.g. ""Tetris"") will interfere with flashback. Visuospatial tasks post-trauma, performed within the time window for memory consolidation, will reduce subsequent flashbacks. We predicted that playing ""Tetris"" half an hour after viewing trauma would reduce flashback fequency over 1-week. Methodoloyg/Principal Findings: The Trauma Film paradigm was used as a well-established experimental analog for Post-traumatic Stress. All participants viewed a traumatic film consisting of scenes of real injury and death followed by a 30-min structured break. Participants were then randomly allocated to either a no-task or visuospatial (""Tetris"") condition which they undertook for 10-min. Flashbacks were monitored for 1-week. Results indicated that compared to the no-task condition, the ""Tetris"" condition produced a significant reduction in flashback frequency over 1-week. Convergent results were found on a clinical measure of PTSD symptomatology at 1-week. Recognition memory between groups did not differ significantly. Conclusion/Significance: Playing ""Tetris"" after viewing traumatic material reduces unwanted, involuntary memory flashbacks to that traumatic film, leaving deliberate memory recall of the event intact. Pathological aspects of human memory in the aftermath trauma may be malleable using non-invasive, cognitive interventions. This has implications for a novel avenue of preventative treatment development, much-needed as a crisis intervention for the aftermath of traumatic events. © 2009 Holmes et al.",Holmes E.A.; James E.L.; Coode-Bate T.; Deeprose C.,2009.0,10.1371/journal.pone.0004153,0,0,
7496,Day surgery for breast cancer: A pilot randomised controlled trial,"Background: Over the past 10 years, surgical management of Breast Cancer has undergone a huge change. More patients are now treated by breast conserving surgery (BCS) and lesser axillary surgery. Therefore, great potential exists to carry out Breast Cancer surgery in day surgery (DS) setting. However, at present few centres in the United Kingdom are practicing this. The objectives of the present study were: (i) to review the evidence in literature, (ii) analyse current practice and (iii) conduct a pilot randomised controlled trial (RCT) comparing DS and inpatient surgery (IS) for patients undergoing BCS for Breast Cancer. Methods: (i) A systematic review of literature searching DS for breast cancer was performed using standard search tools. (ii) Age, treatment and length of stay information about all breast patients admitted at a tertiary centre from March, 07 to Jan, 08 was prospectively collected. (iii) Newly diagnosed breast cancer patients undergoing BCS with axillary sampling who had passed the DS preassessment were randomised to DS or IS. Physical and psychosocial outcomes were assessed using a Surgical Site Infection Form (Day 7 and Day30), FACT-B questionnaire (Baseline, Day7 and Day30) and a Patient Diary for the first post-operative week. Results: (i) No RCTs were found in the literature. Ten observational studies describing DS for breast cancer were included. Seven of these found DS to be safe with equivalent complications to IS and 3 highlighted its economic benefits. Only 1 study used a validated psychological distress scoring system and found results in favour of DS. (ii) Over the 10-month period there were 288 breast cancer operations. Of these, only 112 (38.9%) stayed in the hospital for > 23 hours. Hence, it would be ideal to consider breast cancer for DS. ((iii) There were 18 patients in the pilot RCT; 11 in the DS arm and 7 in the IS arm. Physical outcomes: There were no significant differences in pain, nausea or vomiting scores and infection rates. Patients in the DS group mobilised and stepped out of their house earlier (Day2 vs. Day4) after surgery and also more frequently (4 days vs. 3 days) in the first week than the IS group. FACT-B: Longitudinal differences in overall FACT B scores obtained on Day 7 and Day 30 compared to Baseline scores are detailed in Table1. A difference of > 5% was considered significant. (Table presented) Conclusions: Systematic review of literature showed DS to be safe for the patient but there is lack of evidence in the form of RCTs. This pilot RCT shows that DS patients mobilise earlier and have equivalent results for the other physical outcomes. FACT-B scores suggest better quality of life a week after surgery in the DS group.Larger RCTs are needed to support these results.",Marla S.; Proctor M.; Romics L.; Ogston K.; Cooke T.; Stallard S.,2009.0,10.1158/0008-5472.SABCS-5090,0,0,
7497,"Reduced heart rate variability and vagal tone in anxiety: Trait versus state, and the effects of autogenic training","This study investigated heart rate variability (HRV) in healthy volunteers that were selected for extreme scores of trait anxiety (TA), during two opposite psychophysiological conditions of mental stress, and relaxation induced by autogenic training. R-R intervals, HF and LF powers, and LF/HF ratios were derived from short-term electrocardiographic recordings made during mental stress and relaxation by autogenic training, with respiratory rate and skin conductance being controlled for in all the analyses. The main finding was that high TA was associated with reduced R-R intervals and HF power across conditions. In comparison to mental stress, autogenic training increased HRV and facilitated the vagal control of the heart. There were no significant effects of TA or the psychophysiological conditions on LF power, or LF/HF ratio. These results support the view that TA, which is an important risk factor for anxiety disorders and predictor of cardiovascular morbidity and mortality, is associated with autonomic dysfunction that seems likely to play a pathogenetic role in the long term. © 2008 Elsevier B.V. All rights reserved.",Miu A.C.; Heilman R.M.; Miclea M.,2009.0,10.1016/j.autneu.2008.11.010,0,0,
7498,Functional neuroanatomy of CCK-4-induced panic attacks in healthy volunteers,"Experimental panic induction with cholecystokinin tetrapeptide (CCK-4) is considered as a suitable model to investigate the pathophysiology of panic attacks. While only a few studies investigated the brain activation patterns following CCK-4, no data are available on the putative involvement of the amygdala in the CCK-4 elicited anxiety response. We studied the functional correlates of CCK-4-induced anxiety in healthy volunteers by means of functional magnetic resonance imaging (fMRI) and region of interest (ROI) analysis of the amygdala. Sixteen healthy volunteers underwent challenge with CCK-4 compared with placebo in a single-blind design. Functional brain activation patterns were determined for the CCK-4-challenge, the placebo response and anticipatory anxiety (AA). CCK-4-induced anxiety was accompanied by a strong and robust activation (random effects analysis, P < 0.00001, uncorrected for multiple testing) in the ventral anterior cingulate cortex (ACC), middle and superior frontal gyrus, precuneus, middle and superior temporal gyrus, occipital lobe, sublobar areas, cerebellum, and brainstem. In contrast, random effects group analysis for placebo and AA using the same level of significance generated no significant results. Using a more liberal level of significance, activations could be observed in some brain regions such as the dorsal part of the ACC during AA (random effects analysis, P < 0.005). Overall functional responses did not differ between panickers and nonpanickers. Only 5 of 11 subjects showed strong amygdala activation. However, ROI analysis pointed towards higher scores in fear items in these subjects. In conclusion, while overall brain activation patterns are not related to the subjective anxiety response to CCK-4, amygdala activation may be involved in the subjective perception of CCK-4-induced fear. © 2007 Wiley-Liss, Inc.",Eser D.; Leicht G.; Lutz J.; Wenninger S.; Kirsch V.; Schüle C.; Karch S.; Baghai T.; Pogarell O.; Born C.; Rupprecht R.; Mulert C.,2009.0,10.1002/hbm.20522,0,0,
7499,Thin stillage fractionation using ultrafiltration: Resistance in series model,"The corn based dry grind process is the most widely used method in the US for fuel ethanol production. Fermentation of corn to ethanol produces whole stillage after ethanol is removed by distillation. It is centrifuged to separate thin stillage from wet grains. Thin stillage contains 5-10% solids. To concentrate solids of thin stillage, it requires evaporation of large amounts of water and maintenance of evaporators. Evaporator maintenance requires excess evaporator capacity at the facility, increasing capital expenses, requiring plant slowdowns or shut downs and results in revenue losses. Membrane filtration is one method that could lead to improved value of thin stillage and may offer an alternative to evaporation. Fractionation of thin stillage using ultrafiltration was conducted to evaluate membranes as an alternative to evaporators in the ethanol industry. Two regenerated cellulose membranes with molecular weight cut offs of 10 and 100 kDa were evaluated. Total solids (suspended and soluble) contents recovered through membrane separation process were similar to those from commercial evaporators. Permeate flux decline of thin stillage using a resistance in series model was determined. Each of the four components of total resistance was evaluated experimentally. Effects of operating variables such as transmembrane pressure and temperature on permeate flux rate and resistances were determined and optimum conditions for maximum flux rates were evaluated. Model equations were developed to evaluate the resistance components that are responsible for fouling and to predict total flux decline with respect to time. Modeling results were in agreement with experimental results (R 2 > 0.98). © 2008 Springer-Verlag.",Arora A.; Dien B.S.; Belyea R.L.; Wang P.; Singh V.; Tumbleson M.E.; Rausch K.D.,2009.0,10.1007/s00449-008-0240-6,0,0,
7500,Processing of facial affect under social threat in socially anxious adults: Mood matters,"Background An important function of the human face is to communicate approval or disapproval toward others. Because socially anxious individuals are overly concerned about disapproval by others, it has been hypothesized that those individuals are faster at processing negative, specifically angry facial expressions than nonanxious individuals, especially under conditions of social threat. Method: To test this hypothesis, 25 socially anxious individuals and 24 nonanxious controls were asked to classify facial expressions associated with anger, sadness, fear, disgust, happiness, and surprise. Half of the participants performed this task while being confronted with social threat. Results: High socially anxious participants were faster than controls at classifying angry, sad, and fearful faces when confronted with social threat. No group difference was observed under the no-threat condition. Conclusions: The findings suggest that socially anxious individuals are more hypervigilant toward threat-related social cues, and that the processing of facial affect is dependent on the person's emotional state. Depression and Anxiety. © 2008 Wiley-Liss, Inc.",Leber S.; Heidenreich T.; Stangier U.; Hofmann S.G.,2009.0,10.1002/da.20525,0,0,
7501,Cognitions associated with anxiety in Ménière's disease,"Objectives: The purpose of this longitudinal study was to identify cognitions associated with anxiety and maintenance of anxiety in people with Ménière's disease. Method: At baseline, participants completed the Hospital Anxiety and Depression Scale (HADS), the Revised Illness Perception Questionnaire, the Dizziness Beliefs Scale, the Fear-Avoidance Beliefs Questionnaire, the Intolerance of Uncertainty Scale, and measures of demographic and illness characteristics. Participants were then randomized to a no-treatment group or to receive one of two self-help booklets, and completed the HADS again at 3-month follow-up. Results: After symptom severity had been controlled for, baseline anxiety was found to be associated with intolerance of uncertainty, fear-avoidance of physical activity, belief that dizziness would develop into a severe attack of vertigo, and several illness perception subscales (emotional representations, consequences, psychological causes, and perceived treatment effectiveness). Anxiety on follow-up was predicted by higher baseline levels of autonomic/somatic symptoms and intolerance of uncertainty, and by reporting less understanding of the illness. These longitudinal relationships were found in those who did and who did not receive self-help booklets. Conclusions: Our findings suggest that intolerance of uncertainty is associated with anxiety in Ménière's disease. A controlled trial is needed to see whether anxiety might be reduced in Ménière's disease by helping patients tolerate and cope with uncertainty. © 2009 Elsevier Inc. All rights reserved.",Kirby S.E.; Yardley L.,2009.0,10.1016/j.jpsychores.2008.05.027,0,0,
7502,Abstracts of the APOS 6th Annual Conference,"The proceedings contain 170 papers. The topics discussed include: impact of the livewell! life beyond cancer program on health-related quality of life among breast cancer survivors; a psychological intervention reduces inflammation by alleviating depressive symptoms: secondary analysis of a randomized controlled trial; increases in physical activity predict improvement in sleep quality following a combination exercise and relaxation intervention among breast cancer survivors; initial evaluation of APOS indicators of the quality of psychosocial care; feasibility of using touch screen technology for screening geriatric patients; making an impact: how to design, implement and evaluate effective programs in the cancer community; promoting excellence in pain management and palliative care for social workers; and a longitudinal investigation of post-traumatic growth in adult patients undergoing treatment for acute leukemia.",,2009.0,,0,0,
7503,Does oxytocin influence the early detection of angry and happy faces?,"Oxytocin has a crucial role in social behaviour, although its effects on social cognition are not fully understood. Past research shows that oxytocin enhances encoding and conceptual recognition of positive social stimuli over social-threat stimuli. In this study, we evaluated whether oxytocin modified responses to positive and threatening social stimuli at an earlier perceptual stage of processing using the visual search task. In a double-blind, randomized, placebo-controlled, between-subject design, oxytocin (24 IU) or a placebo was administered to 104 healthy volunteers. Participants returned to complete the visual search paradigm 45 min later. Results showed that angry faces were detected more efficiently than happy faces. Participants also gazed longer and more frequently toward angry faces. Oxytocin did not, however, influence response time, accuracy, or gaze toward angry or happy faces, even when participants were separated into high- and low-social anxiety. The results of this study suggest that oxytocin may not influence the detection of positive and threatening social stimuli at early perceptual levels of processing. Oxytocin may have greater influence in altering the cognitive processing of social valence at more conceptual and elaborate levels of processing. Crown Copyright © 2008.",Guastella A.J.; Carson D.S.; Dadds M.R.; Mitchell P.B.; Cox R.E.,2009.0,10.1016/j.psyneuen.2008.09.001,0,0,
7504,Using the Internet to provide cognitive behaviour therapy,"A new treatment form has emerged that merges cognitive behaviour therapy with the Internet. By delivering treatment components, mainly in the form of texts presented via web pages, and provide ongoing support using e-mail promising outcomes can be achieved. The literature on this novel form of treatment has grown rapidly over recent years with several controlled trials in the field of anxiety disorders, mood disorders and behavioural medicine. For some of the conditions for which Internet-delivered CBT has been tested, independent replications have shown large effect sizes, for example in the treatment of social anxiety disorder. In some studies, Internet-delivered treatment can achieve similar outcomes as in face-to-face CBT, but the literature thus far is restricted mainly to efficacy trials. This article provides a brief summary of the evidence, comments on the role of the therapist and for which patient and therapist this is suitable. Areas of future research and exploration are identified. © 2009 Elsevier Ltd. All rights reserved.",Andersson G.,2009.0,10.1016/j.brat.2009.01.010,0,0,
7505,Alterations of Auditory P50 Suppression in Human Fear Conditioning and Extinction,"Background: Auditory P50 suppression, assessed by using a paired auditory stimulus (S1 and S2) paradigm to record P50 mid-latency evoked potential, is assumed to reflect sensory gating. Recently, P50 suppression deficits were found in patients with anxiety disorders, including panic disorder, obsessive compulsive disorder, and posttraumatic stress disorder. The processes of fear conditioning are thought to play roles in pathophysiology of anxiety disorders. Our aim was to investigate whether sensory gating would be physiologically altered by fear conditioning. Methods: To clarify the relationship between classical fear conditioning and the sensory gating mechanism, we measured changes of P50 and N100 suppression of 21 healthy volunteers in control (baseline) phase, in fear acquisition phase, and in fear extinction phase. Results: The mean P50 S2/S1 ratio in fear acquisition phase was significantly elevated in comparison with that in control phase, and it recovered into basal level in extinction phase. In contrast, the mean N100 S2/S1 ratio showed no changes through all phases from fear acquisition to extinction. Conclusions: These results suggest that the P50 but not N100 sensory gating mechanism might be physiologically associated with fear acquisition and extinction. © 2009 Society of Biological Psychiatry.",Kurayama T.; Nakazawa K.; Matsuzawa D.; Yoshida S.; Nanbu M.; Suto C.; Shimizu E.,2009.0,10.1016/j.biopsych.2008.09.011,0,0,
7506,"A Multivariate Contextual Analysis of Torture and Cruel, Inhuman, and Degrading Treatments: Implications for an Evidence-Based Definition of Torture","Current thinking on what constitutes torture in a detention/interrogation setting focuses solely on particular procedures, without regard for contextual factors that mediate traumatic stress. The present study examined stressor interactions that determined severity and psychological impact of captivity stressors in 432 torture survivors in former Yugoslavia countries and Turkey. A principal components analysis of 46 captivity stressors measured by an Exposure to Torture Scale identified meaningful stressor clusters, which suggested that multiple detention procedures were used in combination to maximize their impact. Perceived torture severity related to 'cruel, inhuman, and degrading' treatments (CIDT) but not to physical torture. Posttraumatic stress disorder related to war-related captivity, deprivation of basic needs, sexual torture, and exposure to extreme temperatures, isolation, and forced stress positions but not to physical torture. CIDT increased posttraumatic stress disorder risk by 71%. Fear- and helplessness-inducing effects of captivity and CIDT appear to be the major determinants of perceived severity of torture and psychological damage in detainees. Considerations on what constitutes torture need to take into account the contextual processes in a captivity setting that mediate these effects. © 2009 American Psychological Association.",Başoĝlu M.,2009.0,10.1037/a0015681,0,0,
7507,"Effective treatment of idiopathic restless legs syndrome with Pregabalin: A twelve-week, double-blind, placebo-controlled study with clinical and polysomnographic assessment","Introduction: Pregabalin is an alpha-2 delta receptor agonist that has been approved for the treatment of disorders such as epilepsy, neuropathic pain, generalized anxiety and fibromyalgia. No controlled investigations have been performed so far in Restless Legs Syndrome (RLS), although an open study suggested therapeutic effects in neuropathic RLS. We report here on the first controlled study on the efficacy of pregabalin in idiopathic RLS. Methods: The study was designed as a double-blind, placebo-controlled, parallel treatment trial with pregabalin. Following a two-week placebo run-in, subjects with an improvement on the International RLS Severity Scale (IRLS) total score of more than 40% were excluded. Fifty eight patients diagnosed with idiopathic RLS were then randomized to receive either a 12-week flexible-dose treatment with pregabalin (n=30) or placebo (n=28). Polysomnographic studies were performed at baseline and at the end of treatment. Severity ratings and dose adjustments were performed every two weeks by means of the IRLSSG, CGI, RLS-6, and the MOS sleep subscale. Results: During the twelve-week treatment period with pregabalin, the IRLS score improved significantly compared with placebo (mean +SD: 19.8±4.2 to 7.4±6.9 versus 21.5±3.8 to 12.8±8.6, p=0.02). The mean effective dose of pregabalin at the end of treatment was 322.50±98.77 mg/day. Similarly, statistically significant improvements were observed on the CGI, the RLS-6 scale, and the MOS sleep subscale (all p<0.01). Treatment with pregabalin also resulted in an improvement in the mean (+SD) periodic leg movement index from 31.25±24.9 to 13.79±14.4, while in the placebo group it worsened from 33.1±36.3 to 40.98±47.15 (p>0.001). Pregabalin generally well tolerated. The main side effects reported were headache, dizziness, postural instability, dry mouth and daytime sleepiness (all <5%). Conclusion: These results suggest that pregabalin is effective for the treatment of idiopathic RLS and exerts significant therapeutic effects both on sensitive and motor symptoms. Pregabalin is a promising alternative to existing dopaminergic treatments for the long-term manage ment of RLS, as it is unlikely to cause RLS augmentation.",Garcia-Borreguero D.; Larrosa O.; Alvares J.; Pascual M.; Fernandez C.; Palacios C.,2009.0,,0,0,
7508,Attitudes to anatomy dissection in an Irish medical school,"Many studies around the world have looked at the stresses placed on medical students by cadaveric dissection. Although these studies have linked the use of cadavers in medical teaching to stress, some investigations have suggested an association with severe psychological stress and even post-traumatic stress disorder. This study assessed the attitudes of medical and biomedical sciences students in an Irish medical school towards cadaveric dissection by recording, through a questionnaire, their perceptions and experience before initial exposure to dissection and subsequently examining their attitudes after the first dissection and after 9 weeks. Student attitudes towards the dissecting room remained consistently positive for the duration of the study with only a minority of respondents reporting negative symptoms. Pre-existing attitudes to the idea of dissection were unaffected by exposure and subsequent continuous experience of dissection. The majority of students in this study did not find the dissecting room experience stressful, and considered time spent in the dissecting room valuable. However, the proportion of students with negative experiences in the dissecting room was higher than has been reported in previous studies. Many respondents felt they could be better prepared for the dissecting room experience, indicating an increasing requirement for effective preparatory programmes. Clin. Anat. 22:386-391, 2009. © 2009 Wiley-Liss, Inc.",Cahill K.C.; Ettarh R.R.,2009.0,10.1002/ca.20777,0,0,
7509,Stabilizing sleep and daily routine in veterans with comorbid PTSD and depression: Follow-up outcomes for cognitive behavioral social rhythm therapy,"Introduction: Cognitive Behavioral Social Rhythm Therapy (CBSRT) is a 12-week skills-based group therapy designed to improve sleep and increase the frequency and regularity of daily habitual behaviors in veterans with Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD). CBSRT is designed to facilitate readjustment after a traumatic event by stabilizing social rhythms and improving sleep. We report outcomes for a two-year open CBSRT trial to improve sleep and social rhythms. Methods: Twenty three veterans (M age = 55.25 years, SD = 9.84) with PTSD and MDD assessed by the Structured Clinical Interview for the DSM-IV have completed this pilot program. Pre- to post-treatment symptom scores were measured via actigraphy, Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Rating Scale (HDRS), and the Clinician Assessment of PTSD (CAPS). Results: Mixed linear modeling analyses indicated improvements in (a) sleep (global PSQI scores, γ10 = -.18, SE =.06, p =.005; PSQI-Addendum scores γ10 = -.13, SE =.07, p <.05; PSQI sleep onset latency (SOL), γ10 = -2.95, SE =.64, p <.001; actiwatch SOL, γ10 = -1.55, SE =.77, p <.05), (b) depression (HDRS γ10 = -.59, SE =.13, p <.001), and (c) PTSD (CAPS γ10 = -2.65, SE =.29, p <.001). There was rebound in all symptom scores at 3-month follow-up, although not to pre-treatment levels. Attrition rate was 17%, which is lower than seen in exposure therapies for PTSD (-30%). Conclusion: These data demonstrate that CBSRT is both feasible to administer and an effective treatment for sleep, depression, and PTSD symptoms. Regularization of daily routine may be particularly important for this population, as patients with PTSD/MDD have a tendency to avoid activities and isolate from others on a daily basis. A randomized controlled trial should be performed to confirm these findings.",Haynes P.; Kelly M.; Scheller V.; Quan S.F.; Bootzin R.R.,2009.0,,0,0,
7510,Chronic headache after traumatic brain injury,"The Centers for Disease Control estimates that 1.4 million individuals in the United States suffer from traumatic brain injuries (TBI) each year. The association of TBI with chronic pain was first described in 1915 in troops returning from World War I with “shell shock.” One study of veterans returning from Iraq and Afghanistan experiencing post-concussive syndrome found that post-traumatic stress disorder accounted for all symptoms except for pain. The objective of this study is to determine the prevalence of headache as an often overlooked consequence of traumatic brain injury (TBI). The Ovid/Medline database was searched for articles published between 1951 and February 2008 using any combination of the terms brain injury, pain, headache, blast injury, and combat. The PubMed, MD Consult, Cochrane Collaboration, National Institutes of Health Clinical Trials Database, Meta-Register of Current Controlled Trials, and CRISP databases were searched using the keyword brain injury. 1110 articles were identified for evaluation. 258 articles were reviewed and 15 met the inclusion criteria for calculating the prevalence of headache after TBI. Fifteen studies assessed headache (HA) pain in 1932 patients. Of these, 1081 complained of chronic HA, yielding a prevalence of 56.0% (95%CI, 53.9%-58.2%). We found evidence to suggest that there is an association between TBI and the development of chronic HA pain. Chronic pain from headache is a common complication of TBI and is common even with apparently minor injuries to the brain. The evidence suggests that this condition is independent of psychiatric disorders such as post-traumatic stress disorder and depression.",Nampiaparampil D.,2009.0,10.1016/j.jpain.2009.01.035,0,0,
7511,Neurotherapy for pain in veterans with trauma spectrum disorders,"Trauma spectrum disorders (e.g., TBI, PTSD) in veterans returning from the Afghanistan and Iraq wars are frequently complicated by complaints of bodily pain, including headache. Recent developments in neurotherapy suggest electromagnetic (EM) stimulation of brainwave (EEG) activity may be beneficial. The Flexyx Neurotherapy System (FNS) uses minute EM pulses to subliminally stimulate the EEG. As part of the outcome evaluation of a clinical trial of a novel adaptation of FNS for the treatment of OEF/OIF veterans with mixed TBI/PTSD symptom presentations, notable improvements in pain have been observed. Six female and male participants who have undergone up to 25 individual FNS sessions have completed, among other measures, 0-10 pain rating scales at the beginning of each session. Results indicate a highly statistically significant linear trend for decreased pain ratings (beta = -.30; R2 = .09, F[1,93] = 9.29, p = .003). For participants who indicated at the outset that headache was one of their most bothersome symptoms, improvement has typically occurred very early in the course of treatment. A larger sample within a randomized controlled clinical trial is needed to further substantiate these findings.",Nelson D.; Esty M.,2009.0,10.1016/j.jpain.2009.01.079,0,0,
7512,Adaptive designs for confirmatory clinical trials,"Adaptive designs play an increasingly important role in clinical drug development. Such designs use accumulating data of an ongoing trial to decide how to modify design aspects without undermining the validity and integrity of the trial. Adaptive designs thus allow for a number of possible adaptations at midterm: Early stopping either for futility or success, sample size reassessment, change of population, etc. A particularly appealing application is the use of adaptive designs in combined phase II/III studies with treatment selection at interim. The expectation has arisen that carefully planned and conducted studies based on adaptive designs increase the efficiency of the drug development process by making better use of the observed data, thus leading to a higher information value per patient. In this paper we focus on adaptive designs for confirmatory clinical trials. We review the adaptive design methodology for a single null hypothesis and how to perform adaptive designs with multiple hypotheses using closed test procedures. We report the results of an extensive simulation study to evaluate the operational characteristics of the various methods. A case study and related numerical examples are used to illustrate the key results. In addition we provide a detailed discussion of current methods to calculate point estimates and confidence intervals for relevant parameters. Copyright © 2009 John Wiley & Sons, Ltd.",Bretz F.; Koenig F.; Brannath W.; Glimm E.; Posch M.,2009.0,10.1002/sim.3538,0,0,
7513,Gamma ventral capsulotomy for obsessive compulsive-disorder: Updated results of a randomized controlled trial,"Background:Up to 40 % of Obsessive Compulsive Disorder (OCD) patients do not respond to conventional treatments. For this subgroup, an improved, stereotactic radiosurgery (Gamma ventral capsulotomy - GVC) is a treatment option which has been recently developed. We report the updated results from a pilot study with this new technique, as well as from a double-blind, randomized controlled trial (DB-RCT). Methods: Twenty one refractory DSM-IV OCD patients were selected. The first five patients were included in a pilot study. The other 16 subjects were randomly assigned to receive active (8 patients) or “sham” (6 patients) radiosurgery, as a DB-RCT. Two patients are still under blind condition. Periodical pre and postoperative follow-up assessments were provided, including psychopathological, global status, neuropsychological and personality scales, and magnetic resonance imaging scannings with voxel-based morphometry (VBM). Results: Three patients from the pilot study and three patients from the RCT active group became responders. As a whole, six out of thirteen (46 %) patients who had received active radiosurgery responded, 12 months or more after surgery. For the sham group, none responded for 12 months of followup. Manic episodes, delirium, episodic headaches, dizziness, nausea were few times observed. One patient presented a cyst. Improved simple visual attention (p=0.04), logical memory (p=0.04), and verbal/full IQs (p=0.04) were observed in the pilot patients. Post-operative VBM analysis (pilot patients) suggests increased gray matter volume in right inferior frontal gyri (BA47). Conclusions: Preliminary findings indicate that GVC for OCD shows some efficacy, with relatively few adverse effects.",Lopes A.C.; Taub A.; Batistuzzo M.; Cecconi J.P.; Canteras M.M.; D'Alcante C.C.; Gouvea F.S.; Hoexter M.Q.; Greenberg B.D.; Norén G.; Rasmussen S.A.; De Mathis M.E.; Duran F.L.S.; Fuentes D.; Castro C.C.; Leite C.; Busatto Filho G.; Miguel E.C.,2009.0,,0,0,
7514,What characterizes persons who do not report musculoskeletal pain? Results from a 4-year population-based longitudinal study (The Epifund Study),"Objective. To identify and characterize persons in the population who do not report musculoskeletal pain. Methods. This was a population-based 4-year prospective longitudinal study by postal questionnaire. Population sample recruited from general practice registers in North-West England followed up at 15 months and 4 years. Results. Of respondents, 17.4% [95% confidence interval (CI) 16.1%-19.7%] reported no pain in the previous month at all 3 measurement intervals over 4 years. They were characterized by low levels of psychological distress [relative risk (RR) low vs high levels of psychological distress 2.3; 95% CI 1.7-2.9], low levels of depression (2.7; 95% CI 2.0-3.6), low levels of anxiety (2.1; 95% CI 1.6-2.7), low health anxiety (1.6; 95% CI 1.2-2.1), and low illness behavior scores (5.8; 95% CI 4.0-8.3), good quality sleep (3.4; 95% CI 2.6-4.4), no somatic symptoms (RR 0 vs 3 or more, 3.1; 95% CI 1.6-6.3) and no adverse life events in the 6 months prior to baseline data collection (RR 0 vs 3 or more, 3.2; 95% CI 1.6-6.2). On multivariable analysis, good quality sleep, low illness behavior, low psychological distress, and absence of recent adverse life events remained statistically independent predictors of musculoskeletal health. In total, 46% of persons who had all 4 of these characteristics consistently reported being free of pain, compared to only 5% of those who had none. Conclusion. In a general population sample, over a period of 4 years, only around 1 in 6 persons do not report musculoskeletal pain. These persons report low levels of psychological distress and high quality sleep, both of which are potentially modifiable risk factors for the targeting of interventional or preventive strategies. Copyright © 2009. All rights reserved.",Jones E.A.; McBeth J.; Nicholl B.; Morriss R.K.; Dickens C.; Jones G.T.; Macfarlane G.J.,2009.0,10.3899/jrheum.080541,0,0,
7515,"An empirical test of the metacognitive model of obsessive-compulsive symptoms: Fusion beliefs, beliefs about rituals, and stop signals","The metacognitive model of obsessive-compulsive symptoms [Wells, A. (1997). Cognitive therapy of anxiety disorders: a practice manual and conceptual guide. Chichester, UK: Wiley] emphasizes three types of metacognitive knowledge in the etiology and maintenance of symptoms: thought fusion beliefs, beliefs about the need to perform rituals, and criteria that signal rituals can be stopped. We tested the model using a series of hierarchical regression analyses. Results showed that each metacognitive domain when entered in their hypothesized causal sequence explained incremental variance in two different measures of obsessive-compulsive symptoms, with worry controlled. These incremental relationships remained when non-metacognitive beliefs (e.g., responsibility and perfectionism) which have been linked to obsessive-compulsive symptoms in other theories were controlled. Results provide further support for the metacognitive model. © 2008 Elsevier Ltd. All rights reserved.",Myers S.G.; Fisher P.L.; Wells A.,2009.0,10.1016/j.janxdis.2008.08.007,0,0,
7516,The integrated self-discrepancy index: A reliable and valid measure of self-discrepancies,"In this article, we present the Integrated Self-Discrepancy Index (ISDI), a new method for measuring self-discrepancies (Higgins, 1987) that integrates idiographic and nomothetic methods to address important theoretical and methodological concerns in existing measures. In Study 1, 284 undergraduate participants completed the ISDI to measure ideal-own and ought-own self-discrepancies along with measures of dejection, agitation, cheerfulness, and quiescence. In Study 2, we used the ISDI to measure ideal and ought self-discrepancies from both own and other standpoints; 169 undergraduate participants completed measures of depressive symptoms and social anxiety approximately 1 week later. Data from both studies fully support the fundamental predictions of self-discrepancy theory: Ought self-discrepancies were uniquely related to agitation but not dejection, whereas ideal self-discrepancies were uniquely related to dejection but not agitation. In addition, comparisons to previously published data demonstrate that correlations between the ideal and ought self-discrepancies are significantly lower using the ISDI than using other measures of self-discrepancies, suggesting that the ISDI is better able to measure ideal and ought selves as distinct constructs. This measure may provide researchers with a simpler and more valid method to measure self-discrepancies, contributing to our understanding of the importance of self-discrepancies in many applied literatures.",Hardin E.E.; Lakin J.L.,2009.0,10.1080/00223890902794291,0,0,
7517,How checking breeds doubt: Reduced performance in a simple workingmemory task,"A paradox of memory research is that repeated checking results in a decrease in memory certainty, memory vividness and confidence [van den Hout, M. A., & Kindt, M. (2003a). Phenomenological validity of an OCD-memory model and the remember/know distinction. Behaviour Research and Therapy, 41, 369-378; van den Hout, M. A., & Kindt, M. (2003b). Repeated checking causes memory distrust. Behaviour Research and Therapy, 41, 301-316]. Although these findings have been mainly attributed to changes in episodic long-term memory, it has been suggested [Shimamura, A. P. (2000). Toward a cognitive neuroscience of metacognition. Consciousness and Cognition, 9, 313-323] that representations in working memory could already suffer from detrimental checking. In two experiments we set out to test this hypothesis by employing a delayed-match-to-sample working memory task. Letters had to be remembered in their correct locations, a task that was designed to engage the episodic short-term buffer of working memory [Baddeley, A. D. (2000). The episodic buffer: a new component in working memory? Trends in Cognitive Sciences, 4, 417-423]. Of most importance, we introduced an intermediate distractor question that was prone to induce frustrating and unnecessary checking on trials where no correct answer was possible. Reaction times and confidence ratings on the actual memory test of these trials confirmed the success of this manipulation. Most importantly, high checkers [cf. VOCI; Thordarson, D. S., Radomsky, A. S., Rachman, S., Shafran, R, Sawchuk, C. N., & Hakstian, A. R. (2004). The Vancouver obsessional compulsive inventory (VOCI). Behaviour Research and Therapy, 42(11), 1289-1314] were less accurate than low checkers when frustrating checking was induced, especially if the experimental context actually emphasized the irrelevance of the misleading question. The clinical relevance of this result was substantiated by means of an extreme groups comparison across the two studies. The findings are discussed in the context of detrimental checking and lack of distractor inhibition as a way of weakening fragile bindings within the episodic short-term buffer of Baddeley's (2000) model. Clinical implications, limitations and future research are considered. © 2009 Elsevier Ltd. All rights reserved.",Harkin B.; Kessler K.,2009.0,10.1016/j.brat.2009.03.002,0,0,
7518,Uncertainty about perception and dissociation after compulsive-like staring: Time course of effects,"Repeated and compulsive-like checking reduces confidence in memory for the last check. Obsessive-compulsive (OC) patients are not only uncertain about memory, but may also be uncertain about perception, while this perceptual uncertainty may be associated with prolonged visual fixation on the object of uncertainty. It was reported earlier that, among healthy participants, prolonged staring at light bulbs or gas rings induces OC-like uncertainty about perception and feelings of dissociation [van den Hout, M. A., Engelhard, I. M., de Boer, C., du Bois, A., & Dek, E. (2008). Perseverative and compulsive-like staring causes uncertainty about perception. Behaviour Research and Therapy, 46, 1300-1304]. In that study, staring continued for 10 min. For patients, however, staring intervals seem to be considerably shorter. To test the clinical credibility of the paradigm as a model of the maintenance of OC perceptual uncertainty, we investigated whether the effects of staring materialize long before 10 min. Five groups of 16 undergraduates participated: one group did not stare at a gas stove while the others stared for 7.5, 15, 30 or 300 s. In the absence of staring, no pre-to-post increase in dissociation/uncertainty was reported, but after staring it was. The larger part of the observed dissociation/uncertainty after 5 min had occurred within 30 s, and around 50% of this maximal increase was reported between 7.5 and 15 s. Thus, even relatively short intervals of staring induce uncertainty about perception and dissociative experiences. Perseverative looking at objects may be a counter-productive OC strategy, which increases uncertainty about perception and may serve to maintain the disorder. © 2009 Elsevier Ltd. All rights reserved.",den Hout M.A.v.; Engelhard I.M.; Smeets M.; Dek E.C.P.; Turksma K.; Saric R.,2009.0,10.1016/j.brat.2009.03.001,0,0,
7519,"Oganic mental disorders (other than memory disorders, Depression and psychosis) after temporal lobe epilepsy surgery","Objectives: To review the occurrence and type of organic mental disorders (OMDs) after temporal lobe epilepsy surgery (TLES) in the literature, and to outline the structure of a pilot questionnaire for use in the evaluation of these disorders in future prospective longitudinal controlled studies. Methods: The information for this study was extracted from a database search of the literature of the last 40 years and from a scrutiny of the reference lists of all the relevant papers. Follow-up descriptive, retrospective or prospective studies as well as case reports of adults, male or female, who underwent any resective temporal lobe procedures, with or without pre-surgical OMDs were included. No sample size restriction was applied but studies in French and English only were considered. The three main instruments used in psychiatry for the classification of OMDs (DSM-IV, ICD-10, and the Lindqvist-Malmgern scheme) and the traits identified by Bear and Fedio in patients with temporal lobe epilepsy were used to define these organic disorders. A total of 28 studies and two conference proceedings relevant to this study were obtained. [N. B. Depression, anxiety, psychosis and memory disturbances after TLES have been well documented and are therefore excluded from this study.] Results: The reported cases from the literature review can be divided into eight main categories: astheno-emotional and emotional motivational blunting disorder, interictal dysphoric disorder, mood disorders, obsessive-compulsive disorders, personality disorders, behavioural disorders, sexual disturbances, suicide and suicide attempts. A pilot questionnaire is proposed to identify the above mentioned categories in patients before and after TLES. It is intended to be administered by a psychiatrist in a face to face semi-structured interview of the patient. Each disorder will be scored separately before and after surgery. The results will then be compared within the same patient pre- and postoperatively, and in a non-operated control group based on serial prospective scores. The use of validated existing scales is referred to where necessary. Conclusion: OMDs are rarely assessed in the course of TLES and there is a surprising dearth of cases documented in the literature, in spite of their frequent occurrence and potential importance. For the first time, eight main categories of OMDs following TLES were outlined and a pilot questionnaire to be used in the diagnosis of these disorders designed.",Amarouche M.; Shorvon S.D.,2009.0,10.1007/s00415-009-5161-z,0,0,
7520,Personality disorders and the prediction of drinking outcomes: Dimensional versus categorical classification,"Aims: There has been much recent interest in shifting from a categorical to a dimensional classification of personality disorders (PDs), this study assessed which classification method best predicted drinking. Method: Participants were 102 women in a clinical trial comparing individual Cognitive Behavioral Therapy to Behavioral Couple Therapy for alcohol use disorders. The Structured Clinical Interview for DSM-IV (SCID-II) was used to assess PDs; the Timeline Follow-Back was used to assess drinking. Linear regressions were used to evaluate whether PD diagnosis or number of PD criteria met predicted percent days drinking (PDD), drinks per drinking day (DDD), or percent days heavy drinking (PDHD) over the course of a six month treatment, controlling for baseline drinking. One or zero participants provided drinking data and met criteria for Schizotypal, Schizoid, Histrionic PD or Antisocial PD, therefore regressions were not conducted for them. Results: (1) Number of Avoidant PD criteria met was a better predictor of PDD than diagnosis (p=.04 vs. p=.10). Neither diagnosis nor number of criteria predicted DDD or PDHD. (2) Borderline PD (BPD) diagnosis was a better predictor of DDD than criteria met (p=.01 vs. p=.07). Both BPD criteria met and diagnosis predicted PDD and PDHD (p <.01- p <.05). (3) Both Dependent PD diagnosis and criteria met significantly predicted DDD (p <.01); neither predicted PDD nor PDHD. (4) Depressive PD criteria met better predicted PDHD than did diagnosis (p=.03 vs. p=.16). Both diagnosis and criteria met predicted PDD (p <.01, p=.01); neither predicted DDD. (5) Neither Narcissistic PD criteria met nor diagnosis predicted any of the outcome variables. (6) Obsessive-compulsive PD criteria met better predicted PDD than did diagnosis (p <.01 v p=.12); criteria met was a slightly better predictor of PDHD than diagnosis (p=.04 v p=.07). Neither predicted DDD. (7) Passive-aggressive PD diagnosis better predicted PDD than criteria met (p=.01 v p=.13). Both diagnosis and criteria met significant predicted DDD; neither predicted PDHD. (8) Paranoid PD criteria met better predicted PDD than did ≤diagnosis (p=.02 v p=.99). Neither predicted DDD or PDHD. Conclusion: Of the eight PDs examined, criteria met were a better predictor of at least one drinking outcome variable for four PDs; diagnosis was a better predictor for two PDs. A dimensional approach may better predict drinking outcomes for some PDs, and should be utilized in future research.",Hunter-Reel D.; Epstein E.E.; McCrady B.S.; Cook S.,2009.0,10.1111/j.1530-0277.2009.00957.x,0,0,
7521,Cognitive behavioral therapy (CBT) and physical exercise for climacteric symptoms in breast cancer patients experiencing treatment-induced menopause,"BACKGROUND: Endocrine symptoms are common among women experiencing premature menopause as a result of adjuvant chemotherapy for breast cancer. The purpose of this clinical trial is to evaluate the efficacy of cognitive behavioural therapy (A), physical exercise (B), or the combination of these interventions (AB) in alleviating such symptoms, improving sexual functioning and enhancing quality of life. METHOD: In this multicenter study, 325 eligible women are being randomised to group A, B, AB or a 'waiting list' control group. For group A, the intervention consists of 6 weekly group CBT sessions of 1.5 hours and a booster session at 3 months. For group B, the intervention is an individually tailored, 12 week home-based physical exercise program of 2.5-3 hours per week. Group AB receives both the CBT and exercise program. Questionnaires assessing menopausal symptoms, sexuality, body- and self-image, psychological distress and quality of life are being completed at baseline, at 12 weeks and at 6 months follow-up. RESULTS: As of January 2009, 1880 women have been identified as being potentially eligible for study participation, of whom 1542 responded to a screening questionnaire (n=1075) or a postcard indicating they had no interest in the study (n=467). 427 of the screened women met eligibility criteria and received an extensive baseline questionnaire. To date, 297 women have returned this questionnaire and have been randomly allocated to the CBT group, (n=77), the physical exercise group (n=72), the combined intervention group (n=75), or the control group (n=73). Patient recruitment, intervention, and data collection will continue until mid-2010. CONCLUSIONS: In this presentation, the rationale for evaluating cognitive behavioral therapy and physical exercise, as well as the combination of both interventions, will be discussed. The content of both interventions, flow of participants throughout the trial so far, experiences of patients and therapists, reasons for (not) participating or withdrawal, and compliance will be described. RESEARCH IMPLICATIONS: Menopausal symptoms may be particularly severe in younger women with breast cancer who undergo treatment-induced menopause. This study will contribute to obtaining knowledge on effective and safe treatment options for these symptoms in breast cancer patients. CLINICAL IMPLICATIONS: If demonstrated to be effective, the availability of a structured supportive intervention program (A, B or AB) will be a welcome addition to regular medical care offered to breast cancer patients with treatment-induced menopause. It is anticipated that such a program will have direct benefit in terms of symptoms relief and the improvement of patients' health related quality of life.",Duijts S.; Oldenburg H.; Van Beurden M.; Gerritsma M.; Nagtegaal T.; Aaronson N.,2009.0,10.1002/pon.1594,0,0,
7522,Quality of life changes after treatment among individuals with psychotic spectrum disorders and alcohol dependence,"Background: Quality of life is an important measure of function in psychiatric research. Some research shows that individuals with a psychotic disorder have poorer quality of life scores than individuals with non psychotic disorders. Also, the use of substances such as alcohol can have significant impact on quality of life (poor treatment adherence, homelessness, increased psychiatric hospitalization, violence, relapse, strained interpersonal relationships, and employment status). The purpose of this project was to examine the impact of alcohol abstinence on quality of life between individuals diagnosed with psychotic spectrum disorders (PSD; schizophrenia, schizoaffective, or bipolar disorders) and individuals with non-psychotic spectrum disorders (non-PSD; depression, anxiety disorders). Method: Participants were 178 veterans who were enrolled in a 12 week, randomized clinical trial (disulfiram and naltrexone alone or in combination). All participants met DSM-IV criteria for alcohol dependence and another non-substance abuse Axis I diagnosis. Primary outcome measures included alcohol use (Timeline Follow-Back Interview) and quality of life (Quality of Life Scale [QLS]; total score and 4 subscales: interpersonal relations, instrumental role, intrapsychic foundations, common activities and objects). Results: QLS scores significantly improved in individuals that were abstinent from alcohol throughout the 12 weeks of treatment regardless of diagnostic condition (PSD vs non-PSD). However, there was a significant interaction between abstinence (abstinence vs no abstinence) and diagnostic condition (PSD vs non-PSD) for the interpersonal relationship subscale. For the non-PSD sample, significant improvement in interpersonal relationships was found for those who were abstinent while for participants with a PSD the significant improvement was for those who were drinking during treatment. Conclusions: Dual diagnosed veterans who abstained from using alcohol during treatment improved their quality of life over time. However, alcohol dependent veterans who also had a PSD and who drank during treatment had significant improvement in their social contacts compared to those who did not drink. Our results concur with findings from other studies who also found a relationship between drinking and social contact among individuals diagnosed with psychotic disorders.",McCarthy E.; Ralevski E.; Petrakis I.L.,2009.0,10.1111/j.1530-0277.2009.00957.x,0,0,
7523,The systematic treatment enhancement program for bipolar disorders (STEP-BD) database: Can it answer your research question?,"Introduction: The Systematic Treatment Enhancement Program for Bipolar Disorders (STEP-BD) was an NIMH-sponsored, long-term outpatient study that enrolled 4,360 participants from 22 sites over seven years (1998 to 2005). STEP-BD was designed to find out which treatments are most effective for treating or preventing episodes of depression and mania in people with bipolar disorder. Methods: STEP-BD inclusion criteria were broad. Participants completed independent intensive assessments at quarterly or semiannual intervals. Detailed information on clinical status, treatment, and side effects is also available for each clinical visit with the STEP-BD clinician. Smaller groups of participants were enrolled in clinical trials that assessed treatment for refractory depression, acute depression, adjunctive psychosocial interventions, polycystic ovarian syndrome, and the utility of omega 3 fatty acids for women planning pregnancy. Results: The STEP-BD database includes detailed information from each clinician visit, collected on the Clinical Monitoring Form (CMF). This includes detail on treatment, symptoms and side effects, and other assessments. In the main STEP-BD database, there are 50,987 CMFs on a total of 3720 persons who completed a range of 1-85 clinical visits while enrolled in STEPBD. Measures collected at intensive assessment visits include assessments of comorbidity (overall, ADHD, trauma, eating disorders, specific anxiety disorders), personality, hospitalization and utilization of other health resources, detailed symptom assessments (depression, anxiety, mania), and quality of life and function. Of the 4107 persons who completed baseline assessment, 1619 (39%) have partial or complete 12-month assessment packages. Retention at 2 years was 936, 3 years = 389, 4 years = 177. Complete lists of measures administered, completed, and limitations of data will be presented. Discussion: The NIMH has prepared all STEP-BD databases for public release. All data are de-identified, with no individual patient or site information retained. All dates, other than year of study entry, have also been removed. These databases are available for individual researchers to address appropriate questions of interest. The authors will educate interested investigators about opportunities using these data, and offer suggestions or opinions on the applicability of these data to specific research questions. Copyright © 2009 Blackwell Munksgaard.",Dennehy E.; Sachs G.,2009.0,10.1111/j.1399-5618.2009.00695.x,0,0,
7524,Pilot evaluation of a decision aid for chinese women considering breast cancer surgery for localized breast cancer,"BACKGROUND: We developed and piloted a decision aid (DA) booklet for Chinese women with localized breast cancer (BC) considering breast cancer surgery. This is probably the first DA designed specifically for non-Caucasian cancer patients. The current study tested the acceptability of the DA booklet to assist Chinese women facing breast cancer treatment decision-making (TDM). METHOD: Chinese women diagnosed with localized breast cancer were invited to evaluate the DA booklet. A total of 95 women received the DA booklet at the end of their initial diagnostic consultation. Questionnaires evaluating attitudes toward the DA booklet, patients' understanding of BC treatment and preference for decision involvement were completed four days after the initial consultation. The questionnaire was completed using a face-to-face interview. RESULTS: Most women (88%) had read/partly read the DA booklet; 73% found it useful in choosing BC surgery. Most found that the DA was easy to understand (89%), facilitated their understanding of information obtained from their surgeon (87%), and was not anxiety provoking (77%). Women found the DA eased TDM (84%). Women who read (mean 7.17) or partly read (mean 4.71) the DA had a better understanding of BC than those who did not read the booklet (mean 2.91, p<.001). Women preferring passive participation were less likely to read the booklet compared to those preferring active/shared decision making participation (p=.025). CONCLUSIONS: Our findings suggest that the DA booklet is acceptable to Chinese women deciding for breast cancer surgery. Consistent with previous studies, the DA booklet increased Chinese women's knowledge of BC and its treatment. RESEARCH IMPLICATIONS: The DA booklet has been revised to make it more parsimonious and enhance its clarity, particularly for sub-literate women. The revised DA booklet is being evaluated in a randomized controlled trial. CLINICAL IMPLICATIONS: Previous studies showed difficulties in treatment decision making (TDM) leads to persistent psychological distress among Chinese women with BC. If effective in improving health outcomes, the DA could be used in facilitate TDM, thereby minimizing subsequent psychological distress.",Lam W.W.T.; Chan M.; Kwong A.; Or A.; Suen D.; Butow P.N.; Fielding R.,2009.0,10.1002/pon.1594,0,0,
7525,CBT and venlafaxine for heavy drinkers with anxiety disorders: 12-month outcomes,"Anxiety and alcohol use disorders (AUDs) commonly co-occur, with rates of AUDs as high as 29-37% among the anxiety disorders (Petrakis, Gerardo, Gonzalez, Rosenheck, and Krystal, 2002). Those with panic disorder and generalized anxiety disorder (GAD) have the greatest likelihood of having an AUD (GAD; Grant et al. 2004), highlighting the importance of identifying treatments for these at-risk patients. To date, few randomized controlled trials have tested combined behavioral and pharmacological treatments for alcohol use disorders among patients evidencing anxiety disorders. In a randomized, controlled trial, 81 patients meeting criteria for alcohol use disorders (AUDs) and anxiety disorders (panic disorder with/without agoraphobia, social anxiety disorder or GAD) were randomly assigned to one of four treatment conditions: Cognitive Behavioral Therapy (CBT) plus venlafaxine (VEN), Progressive muscle relaxation (PMR) training plus VEN, CBT plus placebo (PLA), or PMR training plus PLA. Psychotherapy and pharmacotherapy were delivered concurrently over a 12-week period. The rigorous assessment methodology measured the dependent variables at post-treatment, 3-, 6-, 9-, and 12-months. We hypothesized that patients receiving combined active treatments (CBT-VEN) would demonstrate the highest rates of alcohol abstinence and lower levels of anxiety symptoms relative to patients receiving either mono-therapy (PMR-VEN or CBT-PLA). In addition, outcomes for patients receiving monotherapy would be superior to those in the PMR-PLA comparison condition. A series of repeated measures analyses of variance reveal time effects, such that all patients demonstrated decreased heavy drinking, increased percent days abstinent, and a reduction in anxiety symptoms during treatment. These changes were maintained through the one-year follow-up. No treatment condition differences were evident. Additional analyses are planned to examine the interaction between drinking and anxiety over the course of the study. The implications of this combined trial are discussed in the context of other trials to study the treatment of alcohol problems in patients with co-occurring anxiety disorders (e.g., Randall et al, 2001).",Gulliver S.B.; Ciraulo D.A.; Barlow D.H.; Morissette S.B.; Kamholz B.W.; Devine E.G.; Brown T.A.; Farchione T.; Eisenmenger K.; Brown B.C.,2009.0,10.1111/j.1530-0277.2009.00957.x,0,0,
7526,Quality of life: What has been learned from measuring Patient-Reported outcomes in clinical research of patients with myelodysplastic syndromes? A systematic review from 1980 to 2008,"Background. Patient-Reported Outcomes (PROs) are increasingly reported in hematological research and they can potentially provide valuable information to further support clinical decision-making. PROs include a number of parameters (e.g. quality of life and symptom burden) which all have in common the characteristic of being self-reported by the patient. Aims. Quality of life (QoL) and other key subjective health status domains, such as fatigue, are very important in the treatment of patients with myelodysplastic syndromes (MDS), but there is currently lack of data regarding the amount of research conducted in this area and the possible added value of using PROs in clinical research (including randomized controlled trials-RCTs) of patients with MDS. The purpose of this work was to systematically investigate traditional clinical and PROs in prospective studies of patients with MDS. Design and Methods. A systematic review was performed, broadly following the Cochrane methodology on all prospective studies (including RCTs) having PROs as an endpoint (either primary or secondary) published between January 1980 and July 2008. Candidate articles were identified mainly by PubMed and the Cochrane library. Two reviewers independently assessed all studies to consistently evaluate their methodological quality according to a previously developed protocol reviewer. This included a number of methodological and statistical quality criteria such as PRO missing data documentation, timing of assessment, discussion of outcomes in terms of clinical significance and questionnaire used. Both PROs and traditional clinical outcomes were also systematically analyzed to evaluate their relevance for supporting clinical decision-making. Results. Nine prospective studies were identified, four of which evaluated PROs in a RCT setting and interestingly, all the studies were published after the year 2001. Four studies used the EORTC QLQ-C30 to evaluate QoL while five used the FACT-An to also focus on fatigue related problems, in all RCT studies PROs were used as a secondary endpoint. Six out of the nine studies included less than 100 patients thus limiting the interpretation of PROs. In addition to small sample sizes, methodological drawbacks were mainly identified in terms amount of missing data over time and lack of reporting of important details about the design of the PRO assessment. Out of the four RCTs including PROs, important evidence emerged from two studies comparing azacitidine (AZA) and decitiabine versus supportive care. There is robust indication that AZA provide beneficial effects in terms of fatigue, physical functioning, dyspnea, positive affect and psychological distress. Another study also provided a preliminary indication that decitibaine could provide some benefit in terms of QoL compared to supportive care alone. Conclusions. The study revealed the paucity of research in this area and some methodological limitations when designing and reporting PROs. However, PROs have become more relevant only in recent years in clinical research of patients with MDS and there is strong evidence of the potential role in providing key outcomes to further support clinical decisionmaking. Investigators are encouraged to include PROs in future trials of patients with MDS.",Efficace F.; Caocci G.; Vignetti M.; Mandelli F.; Fazi P.; Cottone F.; La Nasa G.,2009.0,,0,0,
7527,Acamprosate in bipolar disorder: An open-label pilot study,"Introduction: Acamprosate is a calcium antagonist with a mixed NMDA receptor profile and hypothetically may have mood stabilising properties. We examined its effect as add-on treatment in bipolar disorder with or without co-morbid alcohol abuse. Methods: Bipolar patients participating were recruited from the Dutch and German SFBN outpatient clinics, having either an acute depressive (IDS > 15) or manic (YMRS score > 15) episode or a rapid cycling course. For manic and depressive patients the study period lasted 10 weeks, for rapid cycling patients 6 months. Acamprosate (1300-2000 mg) was added to the ongoing treatment. Ratings included the IDS, the YMRS, the CGI-BP, the prospective NIMH-Life Chart and the Obsessive Compulsive Drinking Scale (OCDS). Primary efficacy analyses were based on an intent-to-treat population which included all the patients with at least one post baseline efficacy evaluation (LOCF). Changes from baseline to endpoint were analyzed using non-parametric tests. Results: Of the 56 patients enrolled into the study, 15 had an acute manic episode, 20 acute depression and 21 rapid cycling. Manic patients: The mean YMRS score was 20.93 ± 10.46 at study entry and 10.07 ± 8.10 at study endpoint (p = 0.017) Dropout reasons included Psoriasis(n = 1), withdrawal of consent (n = 5) or noncompliance with the protocol (n = 4). Depressed patients: The mean IDS score was 28.67 ± 9.83 at baseline and 27.27 ± 13.97 at study endpoint (p = 0.453). Main reasons for early discontinuation were: worsening of mood state (n = 5), lack of improvement (n = 5) and side effects (n = 1). Rapid cycling patients: Of the 21 rapid cycling patients, 3 patients fulfilled the response criterion after 6 months. 4 patients terminated the study without improvement. 7 patients dropped out due to worsening of illness, 5 due to non-compliance and 2 patients due to side effects. Reported side effects included headache, nausea, diarrhea, stomach pain, constipation, feeling dull. Conclusion: This open pilot study suggests that acamprosate may have distinct antimanic properties warranting confirmation in controlled studies. Copyright © 2009 Blackwell Munksgaard.",Dittmann S.; Grunze H.C.; Kupka R.; Nolen W.; Bauer M.; Schärer L.; Walden J.; Post R.; Frye M.,2009.0,10.1111/j.1399-5618.2009.00695.x,0,0,
7528,Generalization of conditioned fear along a dimension of increasing fear intensity,"The present study investigated the extent to which fear generalization in humans is determined by the amount of fear intensity in nonconditioned stimuli relative to a perceptually similar conditioned stimulus. Stimuli consisted of graded emotionally expressive faces of the same identity morphed between neutral and fearful endpoints. Two experimental groups underwent discriminative fear conditioning between a face stimulus of 55% fear intensity (conditioned stimulus, CS+), reinforced with an electric shock, and a second stimulus that was unreinforced (CS-). In Experiment 1 the CS- was a relatively neutral face stimulus, while in Experiment 2 the CS- was the most fear-intense stimulus. Before and following fear conditioning, skin conductance responses (SCR) were recorded to different morph values along the neutral-to-fear dimension. Both experimental groups showed gradients of generalization following fear conditioning that increased with the fear intensity of the stimulus. In Experiment 1 a peak shift in SCRs extended to the most fear-intense stimulus. In contrast, generalization to the most fear-intense stimulus was reduced in Experiment 2, suggesting that discriminative fear learning procedures can attenuate fear generalization. Together, the findings indicate that fear generalization is broadly tuned and sensitive to the amount of fear intensity in nonconditioned stimuli, but that fear generalization can come under stimulus control. These results reveal a novel form of fear generalization in humans that is not merely based on physical similarity to a conditioned exemplar, and may have implications for understanding generalization processes in anxiety disorders characterized by heightened sensitivity to nonthreatening stimuli. © 2009 Cold Spring Harbor Laboratory Press.",Dunsmoor J.E.; Mitroff S.R.; LaBar K.S.,2009.0,10.1101/lm.1431609,0,0,
7529,"Pregabalin in restless legs syndrome: A double-blind, placebo-controlled study with clinical and polysomnographic assessment","OBJECTIVE: To investigate by means of a double-blind, placebo-controlled design the therapeutic efficacy of a 12 week treatment with pregabalin (PGB) or placebo (PBO) in idiopathic Restless Legs Syndrome. BACKGROUND: Pregabalin is a modulator of the alpha-2 delta receptor that has been approved for epilepsy, neuropathic pain, generalized anxiety and fibromyalgia. METHODSThe study was designed as a double-blind, placebo. controlled, parallel treatment with PGB and placebo (PBO). Following a two-week placebo run-in, fifty eight patients diagnosed with idiopathic RLS were randomized to a 12-week flexible-dose treatment with either PGB (n= 30) or PBO (n= 28) (range 150-600 mg/d). Severity ratings were performed periodically by means of IRLS-scale, CGI, RLS-6, and the MOS scale, while sleep studies were performed at baseline and at the end of treatment. RESULTSa) Change in IRLS-score was more pronounced under PGB (mean ± SD: 19.8 (4.2) to 6.8 (6.9) vs.21.5 (3.8) to 11.2 (8.6), p=0.02). Similar improvements were observed on other severity measurements. RLS symptom remission (final IRLS score < 7) was reached by 63.3% patients under PGB while 28.6% under PBO. b)The mean effective dose of PGB at the end of treatment was 337.50 (± 105.60) mg/day. c) Treatment with PGB resulted in an improvement of66% in the periodic leg movement index (PLMI) while PBO worsened it by 29% (p>.001). PGB improved sleep architecture with an increase in Slow Wave Sleep (p<.01) and decreased Stages 1 and 2 (p<.05). d) PGB was in general well tolerated. CONCLUSIONSa) Pregabalin is an effective treatment for RLS. Nearly two thirds of the patients achieve complete remission at a mean daily dose of 337 mg. b) Pregabalin improves sleep architecture and Periodic Leg Movements. c) Pregabalin is a promising alternative to current dopaminergic treatments due to its superior therapeutic effects on sleep architecture.",Garcia-Borreguero D.,2009.0,10.1212/WNL.0b013e3181af0778,0,0,
7530,Cognitive behavioral stress management among women at elevated risk for breast cancer,"Cognitive behavioral stress management (CBSM) has been shown to improve psychological and physiological functioning among HIV+ men and women with early stage breast cancer. The ability of CBSM intervention to affect psychological and physiological functioning in stressed but otherwise healthy individuals is unknown. To address this gap, we conducted a randomized clinical trial to test the efficacy of a 10-week CBSM intervention among stressed women at elevated risk for breast cancer because of family history. Women were randomly assigned to immediate CBSM intervention or a wait-list comparison group. Psychological measures included POMS Negative Affect, CESD, PSS, IES, and Breast Cancer Worry (BCW). Psychological distress was measured at baseline (T1) and immediately after the intervention (T2). Participants received Hepatitis A vaccination at T2. Distress and antibody response were measured one month later (T3), 6 months later at boost vaccine administration (T4), and one month after that (T5) for secondary antibody response. Preliminary repeated measures ANCOVA on 35 participants, (mean age 45 (9.2), 75% white), revealed a significant time (T1 to T2) by condition interaction between intervention and comparison participants for POMS Negative Affect (p <.01), CESD (p <.01), and PSS (p <.02), but not for IES (p =.25) or BCW (p =.71). Data regarding intervention effects on distress and antibody response to vaccine at T3 and T5 will be presented.",McGregor B.A.; Ceballos R.M.; Dolan E.D.; Medic S.T.; Albano D.V.,2009.0,10.1016/j.bbi.2009.06.092,0,0,
7531,Acute effects of alcohol on the development of intrusive memories,"Rationale: Post-traumatic stress disorder is characterised by repeated intrusive imagery of the traumatic event. Despite alcohol's impairing effect on memory and frequent involvement in real-life trauma, virtually nothing is known of the interaction between alcohol and trauma memory. Objective: We aimed to investigate the acute alcohol effects on spontaneous memories following a trauma film as well as explicit memory for the film. Methods: Utilising an independent-group double-blind design, 48 healthy volunteers were randomly allocated to receive alcohol of 0.4 or 0.8 g/kg or a matched placebo drink. A stressful film was viewed post-drink. Skin conductance was monitored throughout and mood and dissociative symptoms were indexed. Volunteers recorded their spontaneous memories of the film daily in an online diary over the following week. Their explicit memory for both gist and details of the film was tested on day 7. Results: Intriguingly, an inverted 'U' alcohol dose-response was observed on intrusive memories with a low dose of alcohol increasing memory intrusions while a high dose decreased intrusions. In contrast, explicit memory performance after 7 days showed a linear dose-response effect of alcohol with both recall and recognition decreasing as dose increased. Conclusions: These findings highlight a striking differential pattern of alcohol's effects on spontaneous memories as compared with explicit memories. Alcohol's effect on spontaneous memories may reflect a dose-dependent impairment of two separate memory systems integral to the processing of different aspects of a traumatic event. © 2009 Springer-Verlag.",Bisby J.A.; Brewin C.R.; Leitz J.R.; Valerie Curran H.,2009.0,10.1007/s00213-009-1496-5,0,0,
7532,Personality and health as predictors of income decrease in old age: Findings from the longitudinal SMILE study,"Background: There is much evidence for the influence of low socio-economic status on poor health. It is, however, also important to study the ways in which people attain and retain their socio-economic status and the factors that predict changes in socio-economic status, such as a decrease in income. Such mobility also occurs in older populations, in which financial and health-related changes are very common, especially after retirement. Methods: Three years of follow-up data from 1443 Dutch men and women aged 55 years and older who participated in the Study on Medical Information and Lifestyles Eindhoven (SMILE) were gathered. Logistic regression analyses were used to study the independent effects of physical and mental dysfunction and severity of chronic diseases and adverse personality factors on decrease in income. Results: Social anxiety (OR 1.62, 95 CI: 1.092.40), physical dysfunction (OR 1.71, 95 CI: 1.072.74) and severe diseases (OR 1.37, 95 CI: 1.051.78) were significant predictors of decrease in income. These contributions were independent of each other, and remained robust after controlling for other confounding factors, such as gender, age and educational level and change in employment status. Mental dysfunction and other personality characteristics, such as hostility and mastery, did not contribute to decrease in income. Conclusion: Social anxiety and poor physical health are relevant factors associated with decrease in income in old age. The findings suggest that these factors are important in retaining ones socio-economic status. Future longitudinal research is necessary to further disentangle the mechanisms and pathways related to socio-economic health inequalities along the life-course.",Groffen D.A.I.; Bosma H.; Van Den Akker M.; Kempen G.I.J.M.; Van Eijk J.T.M.,2009.0,10.1093/eurpub/ckp050,0,0,
7533,Safety behaviours preserve threat beliefs: Protection from extinction of human fear conditioning by an avoidance response,"A laboratory autonomic conditioning procedure was used to establish fear conditioning in human participants by pairing neutral stimuli with electric shock. Participants were also trained to make a button-press response to avoid shock. A target fear stimulus was then extinguished by presenting it without shock. The experimental group was given the opportunity to make the avoidance response during extinction whereas the control group was not. When the fear stimulus was tested without the response available, the control group showed normal extinction of both shock expectancy ratings and skin conductance responses, but the experimental group showed ""protection from extinction"": they continued to give high expectancy ratings and strong skin conductance responses. We interpret this effect as analogous to the role of within-situation safety behaviours in preserving threat beliefs during exposure therapy for anxiety disorders. The results support a cognitive account of learning and anxiety. The procedure provides a potential laboratory model for further examination of the cognitive and neural mechanisms underlying anxiety and its reduction. © 2009 Elsevier Ltd. All rights reserved.",Lovibond P.F.; Mitchell C.J.; Minard E.; Brady A.; Menzies R.G.,2009.0,10.1016/j.brat.2009.04.013,0,0,
7534,Effects vanish in the fog of multigene analysis,,Esch T.,2009.0,10.1159/000226618,0,0,
7535,"Transcranial magnetic stimulation for borderline personality disorder: Rationale, stimulation site and methods","Borderline personality disorder (BPD) is characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This disorder is associated with a significant rate of suicide attempts and completed suicides (4 to 10%), a major impairment in social functioning and an increased healthcare utilization cost. Treatments available include psychotherapy and pharmacotherapy. Research has shown some efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) on post-traumatic stress disorder and mood disorder which both share common biological or clinical features with BPD. It is then likely that rTMS might prove efficient on BPD symptoms. A review of the literature on neuroimaging and neuropsychology of BPD shows a hypoactivity of the dorsolateral prefrontal cortex which may be a potential target site for rTMS. We will conduct a pilot randomized sham-controlled trial on 30 BPD patients assessing the efficacy of a 10-day course of daily rTMS on neuropsychological tasks, BPD symptoms severity, risk taking behaviour, depression and general psychopathology.",Cailhol L.; Bui E.; Roussignol B.; Moncany A.-H.; Klein R.; Simonetta-Moreau M.; Thalamas C.; Birmes P.; Schmitt L.,2009.0,,0,0,
7536,Enhancing signal detection in clinical trials,"Dr. Leon will present the biostatistical considerations that contribute to a clinical trial design and the strategies to enhance signal detection. These include minimizing bias in the estimate of treatment effect while maintaining a nominal level of type I error (i.e., false positive results) and maintaining sufficient statistical power (i.e. reducing the likelihood of false negative results). Particular attention will be paid to reducing the problems of attrition and the hazards of multiplicity. Methods to examine moderators of the treatment effect will also be explored. Examples from psychopharmacologic and psychotherapy trials for the treatment of depression and panic disorder will be provided to illustrate these issues. Following the didactic session, the participants will be encouraged to bring forth their own questions regarding clinical trial design for a 45-minute interactive discussion with the presenters. The objectives of the workshop are to improve the participants' understanding of the goals of clinical trial design and methods to achieve those goals in order to improve their own research techniques, grantsmanship, and abilities to more accurately judge the results of studies presented in the literature.",Leon A.,2009.0,,0,0,
7537,Methodological approaches and evidence for effectiveness in clinical trials,"Recent publications by the Institute of Medicine have unearthed several fundamental flaws in clinical trial methodology that, if corrected by the next generation of clinical investigators, can transform the field of mental health intervention research. Using a clinician-friendly approach, Dr. Davis will succinctly review the essential elements of optimal design and implementation of a randomized controlled clinical study. These elements include the need for a hypothesis that has clinical relevance based on sound theoretical reasoning, reasonable and generalizable inclusion and exclusion criteria, feasibility of an enrollment goal and study timeline, and appropriate choice of a comparator intervention and primary outcome. Techniques to reduce the study's costs, risks, and participant burden will be described. Examples from psychopharmacologic, psychotherapy, and vocational rehabilitation trials for the treatment of posttraumatic stress disorder will be discussed. Following the didactic session by the two presenters, the participants will be encouraged to bring forth their own questions regarding clinical trial design for a 45-minute interactive discussion with the presenters. The objectives of the workshop are to improve the participants' understanding of the goals of clinical trial design and methods to achieve those goals in order to improve their own research techniques, grantsmanship, and abilities to more accurately judge the results of studies presented in the literature.",Davis L.,2009.0,,0,0,
7538,Reinventing the wheel in clinical trial design,"Recent publications by the Institute of Medicine have unearthed several fundamental flaws in clinical trial methodology that, if corrected by the next generation of clinical investigators, can transform the field of mental health intervention research. Using a clinician-friendly approach, this workshop will succinctly review the essential elements of optimal design and implementation of a randomized controlled clinical study and the strategies to enhance signal detection. These include minimizing bias in the estimate of treatment effect while maintaining a nominal level of type I error (i.e., false positive results) and maintaining sufficient statistical power (i.e. reducing the likelihood of false negative results). Particular attention will be paid to reducing the problems of attrition and the hazards of multiplicity. Methods to examine moderators of the treatment effect will also be explored. Examples from psychopharmacologic, psychotherapy, and vocational rehabilitation trials for the treatment of posttraumatic stress disorder, depression, and panic disorder will be provided to illustrate these issues. Techniques to reduce the study's costs, risks, and participant burden will be described. Following the didactic session, the participants are encouraged to bring forth their own questions regarding clinical trial design for a 45-minute interactive discussion with the presenters. The objectives of the workshop are to improve the participants' understanding of the goals of clinical trial design and methods to achieve those goals in order to improve their own research techniques, grantsmanship, and abilities to more accurately judge the results of studies presented in the literature.",Davis L.; Leon A.,2009.0,,0,0,
7539,Dialectical behavioral therapy for patients with borderline features and posttraumatic stress disorder after childhood sexual abuse (DBT-P),"Several randomised clinical trials (RCT) have demonstrated the efficacy of cognitive behavioral therapy in the treatment of Posttraumatic Stress Disorder (PTSD). However, the external validity of these studies is limited with regard to PTSD related to childhood sexual abuse which often results in severe and complex sympomatology accompanied by a variety of concurrent disorders or symptoms, for example self-mutilation, suicidal ideation, or severe dissociation. Nearly 30% of patients with PTSD have a co-occuring borderline personality disorder (BPD). The prevalence rates of PTSD in patients with BPD vary between 40% and 60%. Several RCTs have shown the efficacy of Dialectical Behavioral Therapy (DBT) in the treatment of borderline patients, who exaggerate severe behavioural dyscontrol. However specific treatment for co-occuring PTSD has been lucking. Clinical lore suggests that exposure to trauma-relevant memories can potentially aggravate dysfunctional behaviour in patients with BPD. Empirical research however reports discrepant results with two studies documenting deleterious effects of comorbid BPD on treatment outcome, whereas one study did not find an impact. DBT-P was specifically tailored to treat patients with PTSD after sexual abuse during childhood. DBT-P includes training in emotion regulation and mindfulness, cognitive interventions and exposure elements, usually in combination with the use of skills. To evaluate the efficacy of DBT-P as compared to a wait list control group a RCT is currently carried out. Preliminary data, which will be presented, revealed large between effect sizes for the primary outcome measures (PDS, CAPS).",Bohus M.; Priebe K.; Dyer A.; Steil R.,2009.0,,0,0,
7540,Efficacy and safety of pregabalin in the treatment of patients with generalised anxiety disorder and comorbid chronic pain conditions,"Background and Aims: Pregabalin is an alpha2-delta-ligand, with analgesic, anticonvulsant and anxiolytic activity. It has been shown to be effective and safe in the treatment of Generalised Anxiety Disorder (GAD) as well as of neuropathic pain in comprehensive clinical trial programs. We aimed to evaluate pregabalin in GAD patients under clinical practice conditions. Methods: In a 4-week open-label observational trial, 331 physicians (mainly psychiatrists) documented 578 consecutive adult patients with GAD. GAD severity was rated using Hospital Anxiety and Depression Scale (HADS-A) and a 100mm visual analogue scale (VAS anxiety). Pain and sleep were self-rated daily in patient diaries on VAS, and the treatment response by Patient Global Impression of Change (PGIC). Results: Most patients received an initial pregabalin dose of 150 mg/d, which was increased to 300 mg/d. 61 (10.5% of total population) patients reported concomitant chronic pain (CP) conditions. In these GAD/CP patients, mean HADS-A score decreased from 16.7 at baseline to 10.4 at final visit. Mean anxiety VAS score decreased in the GAD/CP patients from a baseline value of 58.4 by 71.6%, and pain VAS-score from 66.7 by 73.6%. An improvement of their global status in the PGIC was reported by 85% patients in this subgroup. Conclusions: In this difficult-to-treat subgroup with GAD and comorbid CP, pregabalin under real practice conditions was similarly effective as in the total cohort. Substantial effects on GAD, but also on pain and sleep, were observed within a short observation period.",Brasser M.,2009.0,10.1016/S1090-3801(09)60672-8,0,0,
7541,Benefit of decompressive craniectomy for refractory cranial hypertension in severe trauma brain injury,"OBJECTIVES: The management of malignant posttraumatic cerebral edema remains a frustrating endeavour for the neurosurgeon and the intensivist. Mortality and morbidity rates remain high despite refinements in medical and pharmacological means of controlling elevated intracranial pressure. Awaiting for results of new randomized -controlled trials, the use of decompressive craniectomy (DC)for refractory cranial hypertension in Severe Trauma Brain Injury continues being controversial . We present our experience in 14 patients with refractory cranial hypertension and DC after severe brain injury. METHODS: A retrospective review of prospectively collected data was performed on all patients admitted with Severe Trauma Brain Injury (GCS ≤ 8) from January of 2006 until December of the 2008. Thirty patients of a total of 79 with severe trauma brain injury, developed intracranial hypertension (ICP ≥ 25). Decompressive craniectomy (DC) was accomplished in 14 patients (G1:13 with frontotempoparietal craniectomy technique and 1 with bifrontal technique), 16 patients (G2: control group), received conventional approach. We analyze among others variables: age, injury severity score (ISS), abbreviated injury score (AIS); admission and discharge Glasgow coma score (GCS), extended Glasgow outcome score (GOSE), complications, ICU and hospital mortality. Differences between groups were tested with Students t test and Χ2 testing for statistical analysis. RESULTS: Fourteen patients with intracranial hypertension were treated with decompressive craniectomy. Compared with control group, patients with DC had a better GCS (9 ± 5 G1; 5 ± 4 G2 p = 0,004) and GOSE index not only at ICU discharge (4 ± 3 G1; 2 ± 2 G2 p = 0,008) but also at hospital discharge (4 ± 3 G1; 2 ± 2 G2 p = 0.03). The mortality rate was lower in the craniectomy group (G1: 14%, G2; 73% p = 0.05). CONCLUSION: In our Center, the use of DC for treat patients with severe TBI and refractory cranial hypertension (GCS ≤ 8 and PIC ≥ 25) improved outcome and mortality significantly compared with medical conventional approach.",Díaz Mendoza C.; Ugalde Jauregui L.; Coloma Valverde G.; Del Amo Nolasco B.; Sánchez Palacios M.,2009.0,,0,0,
7542,"ICU diaries reduce posttraumatic stress disorder after critical illness: A randomised, controlled trial","INTRODUCTION: We have previously showed that delusional memories from ICU were a major contributor to the development of post traumatic stress disorder (PTSD) [1]. We subsequently confirmed this in a European study, showing an average PTSD incidence of 10% [2], often precipitated by delusional recall. We now hypothesised that an ICU diary could be used as a form of cognitive behavioural therapy to help patients come to terms with their memories and so reduce the incidence of PTSD. METHODS: A prospective randomised, controlled study was performed in 12 ICUs across 6 European countries. Included criterion was ‚â•72 h stay in ICU. 1 week after ICU discharge the ICU Memory Tool [3] was used to identify recall for delusional memories and patients were screened for a history of previous psychological problems. 1 month post ICU discharge the level of PTSD related symptoms was assessed using the PTSS-14 [4] and the patients were randomised to receive their diary at this point or after the next interview 3 months post ICU discharge. At this point, the assessment of PTSD was repeated and a definitive diagnosis of PTSD was made using a diagnostic interview, the PDS [5]. After the final interview, the control patients also received their diaries. RESULTS: 352 patients were randomised, 322 (91.5%) completing the 3 month follow-up. 11 patients with undiagnosed, pre-existing PTSD were excluded from the final analysis. The incidence of new PTSD in the intervention group was 5% (8/154), and 13.4% (21/157) in the control group; this was statistically significant (Fisher's Exact test 6.15, df 1,P = 0.013). Patient feedback about the diaries was very positive with most of the intervention patients receiving the diary at the 1 month follow-up and reading it a median of 3 times (0-20 range). 148 (84%) patients said that others had read the diary, most commonly the family (100%), friends (36%), colleagues (5%) and health care staff (4%). Only 1 patient had not read the diary. CONCLUSION: This randomised, controlled trial confirms that the simple provision of an ICU Diary with appropriate photographs helps patients come to terms with psychological sequelae from their critical illness and significantly reduces the development of PTSD.",Jones C.; Backman C.; Capuzo M.; Egerod I.; Flaatten H.; Granja C.; Rylander C.; Griffiths R.D.,2009.0,,0,0,
7543,Attentional bias differences between fear and disgust: Implications for the role of disgust in disgust-related anxiety disorders,"Research demonstrates a relation between disgust and anxiety-related pathology; however, research has yet to reveal mechanisms by which disgust may contribute to anxiety. The current experiment examined attentional bias characteristics as one route by which disgust influences anxiety. Eighty undergraduate participants completed a rapid serial visual presentation attention task using fear, disgust, or neutral target stimuli. Task-relevance of the target's presentation was also manipulated. Results revealed that task-relevant disgust targets impaired attention among all participants, but task-irrelevant disgust targets impaired attention only in high disgust prone individuals. Difficulty in disengagement characterised both disgust and fear attentional biases, but the difficulty in disengagement was greater for disgust compared to fear attentional biases. High disgust prone individuals displayed exaggerated difficulty in disengaging attention from disgust targets compared to low disgust prone individuals. The results suggest that disgust attentional biases differ from fear attentional biases. The characteristics of disgust attentional biases are discussed as possible mechanisms by which disgust functions in certain anxiety disorders.",Cisler J.M.; Olatunji B.O.; Lohr J.M.; Williams N.L.,2009.0,10.1080/02699930802051599,0,0,
7544,Dog assisted interventions in a specialized centre and potential concerns for animal welfare,,Marinelli L.; Normando S.; Siliprandi C.; Salvadoretti M.; Mongillo P.,2009.0,10.1007/s11259-009-9256-x,0,0,
7545,From threat to fear: The neural organization of defensive fear systems in humans,"Post encounter and circa-strike defensive contexts represent two adaptive responses to potential and imminent danger. In the context of a predator, the post encounter reflects the initial detection of the potential threat, where as the circa-strike is associated with direct predatory attack. We used functional magnetic resonance imaging to investigate the neural organization of anticipation and avoidance of artificial predators with high or low probability of capturing the subject across analogous postencounter and circa-strike contexts of threat. Consistent with defense systems models, postencounter threat elicited activity in forebrain areas, including subgenual anterior cingulate cortex (sgACC), hippocampus, and amygdala. Conversely, active avoidance during circa-strike threat increased activity in mid-dorsal ACC and midbrain areas. During the circa-strike condition, subjects showed increased coupling between the midbrain and mid-dorsal ACC and decreased coupling with the sgACC, amygdala, and hippocampus. Greater activity was observed in the right pregenual ACC for high compared with low probability of capture during circa-strike threat. This region showed decreased coupling with the amygdala, insula, and ventromedial prefrontal cortex. Finally, we found that locomotor errors correlated with subjective reports of panic for the high compared with low probability of capture during the circa-strike threat, and these panic-related locomotor errors were correlated with midbrain activity. These findings support models suggesting that higher forebrain areas are involved in early-threat responses, including the assignment and control of fear, whereas imminent danger results in fast, likely ""hard-wired,"" defensive reactions mediated by the midbrain. Copyright © 2009 Society for Neuroscience.",Mobbs D.; Marchant J.L.; Hassabis D.; Seymour B.; Tan G.; Gray M.; Petrovic P.; Dolan R.J.; Frith C.D.,2009.0,10.1523/JNEUROSCI.2378-09.2009,0,0,
7546,Imagery rehearsal therapy (IRT) for recurrent nightmares in a post traumatic stress disorder (PTSD) patient - A case study,"Introduction: Nightmares are common in PTSD and reported by 5-8% of the general population. Few controlled studies exist in the literature addressing the treatment of chronic, debilitating nightmares. IRT has the most empirical support of all the techniques available to treat nightmares. IRT conceptualises nightmares as a learned sleep disorder and/or as a symptom of a faulty imagery system. It is based on the premise that we can alter the content of our dreams by cognitively rehearsing different content. Krakow and Zadra (2006)1 have documented a step-by-step account of IRT based on 4 √ó 2 hour group sessions. This was adapted by the authors of this present study and has been applied to the treatment of this patient who is being presented as a case study. Methods: Patient is a 37 yr old woman with PTSD, depression, hypersomnia, nightmare disorder and several other health issues including morbid obesity. She was referred by her psychiatrist to a sleep physician for assessment of her distressing recurrent nightmares and suspected sleep disordered breathing. Sleep study revealed moderate obstructive sleep apnoea, but no episodes of parasomnias were seen during polysomnography. CPAP implementation was undertaken (7 cm H2O) and she was also referred to a psychologist for specific management of nightmares using IRT. The simple steps of IRT are 1) selecting a nightmare, 2) changing the nightmare into a dream with no distressing elements, and 3) rehearsing the new dream. The patient has completed 7 sessions over a three-month period with a psychologist experienced in treating sleep disorders, with a plan for ongoing treatment. One-on-one sessions were conducted fortnightly. Results: Initial treatment has shown the patient to be CPAP compliant yet hypersomnia remains. The most significant nightmare has successfully been eradicated by IRT. 3 other recurrent nightmares remain and will be sequentially targeted and rehearsed. Discussion: Sixteen years of psychotherapy and a variety of drugs including prazosin, quetiapine and a broad range of anti-depressants have not altered this woman's nightmares yet IRT has had a significant and positive impact. Although it has been a difficult and challenging time for the patient in that her depression, at times, has worsened, the successful eradication of her most troubling nightmare after years of unsuccessful treatment has been very empowering for her. It is encouraging that the sessions outlined for groups in Krakow and Zadra (2006) have generalisability to working with individuals.",Junge M.; Cunnington D.,2009.0,10.1111/j.1479-8425.2009.00410-3.x,0,0,
7547,Dysfunction of attentional networks for non-emotional processing in negative affect,"It is unclear whether negative affect is associated with the impairment of attentional networks for non-emotional processing. Using the attention network test (ANT), which assesses the efficiency of alerting, orienting, and executive attention, we attempted to clarify which attentional networks were related to negative affect, i.e., anxiety, depression, and social anxiety. Forty-three participants completed the self-report questionnaires and the ANT. Negative affect was negatively correlated with orienting efficiency but not executive attention. Our results indicate that people with negative emotionality have an impaired orienting network for non-emotional stimuli. It is suggested that attentional bias for threatening stimuli in negative affect is due to the original impairment of the orienting network.",Moriya J.; Tanno Y.,2009.0,10.1080/02699930802335018,0,0,
7548,9th International Forum on Mood and Anxiety Disorders,"The proceedings contain 85 papers. The topics discussed include: diabetes mellitus and co-morbid depression: treatment with milnacipran results in significant improvement of both diseases; comorbidity of anxiety and depression with dermatological conditions; the effect of milnacipran on suicidality in patients with mild to moderate depressive disorder; vagus nerve stimulation in treatment-resistant depression: an Italian case-series; effects of duloxetine adjunctive to extended-release quetiapine treatment in bipolar I mixed - an open label study; early remission as predictor of good outcome in the prognosis of a mayor depressive episode: its neurobiological implications; differentiated information on antidepressants at hospital discharge: the GIPPOZ-study; and quetiapine in the treatment of bipolar depression: improvements in quality of life and functioning in four randomized, placebo-controlled trials.",,2009.0,,0,0,
7549,The development and pilot testing of a manualised Meaning and Purpose (MaP) psychotherapy for people with advanced cancer,Background: Previous work by the author indicated that the level of meaning in a person's life is predictive of adjustment. These results showed that cancer patients with less meaning in life expressed significantly higher psychological distress. The vital next step in this body of research was to translate these findings into the clinical setting. Methodology: Translating these outcomes into psychotherapy required the operationalising of the framework previously developed. A therapist manual for Meaning and Purpose (MaP) therapy was developed. Pilot testing involved a purposive sample of people with advanced cancer (n =6) to undertake the therapy. The aim of this was to ensure the flow and acceptability of the therapy in the clinical setting. Sessions underwent fidelity testing using an Integrity Coding Manual (ICM) developed to guide the quality and consistency of the therapy. A post therapy interview was conducted with each participant to gain further feedback. Outcomes: Participants found the therapy to be effective in re-focusing their thoughts and actions toward meaning and purpose resulting in a rebalancing of their emotions. Therapy sessions were consistent with the manualised therapy with 80% reliability. Pilot testing for acceptability has now been completed; fidelity testing for integrity and effectiveness will continue to be used in the larger trial. The efficacy of MaP therapy will now be studied using a randomized waitlist controlled trial.,Lethborg C.,2009.0,10.1111/j.1743-7563.2009.01252.x,0,0,
7550,Repeated Transcranial Magnetic Stimulation (RTMS) treatment for refractory obsessive-compulsive disorder,"Background: Recently there has been several attempts for using rTMS as a novel treatment in patients with obsessive-compulsive disorder (OCD) with various stimulation frequency. However the findings have not been consistent about the efficacy of rTMS in treating OCD. In the present study, we evaluated the clinical effect and safety of low frequency rTMS on the right dorsolateral prefrontal cortex in treatment of refractory OCD. Methods: Twenty-four patients with refractory OCD were applied-daily 20 minute low frequency rTMS (1Hz) to the right dorsolateral prefrontal cortex for 15 days with TMS with power of 100% of motor threshold. Treatment refractory OCD was defined as response failure of at least 2 kinds of antidepressant with full dose at least over 3 months. Clinical status has been evaluated with Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Anxiety Scale (HAMA) and Clinical Global Impression (CGI) at the baseline, the end of rTMS treatment (3 weeks) and 1 month after finishing rTMS treatment course. Results: With 3 weeks treatment of low frequency rTMS, Y-BOCS(baseline; 46.67¬°3/411.06, 3 weeks; 32.17 ¬°3/4 12.89, 1month follow-up finishing the rTMS treatment 29.29¬°3/414.65) was significantly improved (P<0.001). HAMA were also improved (baseline; 27.67¬°3/45.42, 3 weeks; 19.21¬°3/4 9.79, 1 month follow-up finishing the rTMS treatment, 15.83¬°3/4 5.43, P<0.001). CGI-S were also significantly decreased (baseline; 5.1¬°3/40.9, 3 weeks; 4.0¬°3/41.0, 1 month follow-up finishing the rTMS treatment; 3.5¬°3/41.0, P<0.001). At the timepoint at 1 month follow-up after finishing rTMS treatment course, 62.5% were clinically responded. Conclusions: The present study found that lowfrequency rTMS on the right prefrontal cortex for 3 weeks showed higher therapeutic effects in patients with OCD. It was suggested that rTMS would have beneficial effect on the treatment of OCD patients with diverse indices of application method such as frequency, stimulation intensity and location of stimulation. Further controlled trials are indicated to assess the efficacy of rTMS in OCD.",Chae J.; Lee S.; Jeong J.; Seo H.,2009.0,10.3109/13651500903375487,0,0,
7551,Sustained response with adjunctive extended release Quetiapine Fumarate (Quetiapine XR): Pooled Efficacy analysis in Major Depressive Disorder (MDD),"Background: Early improvements in symptoms of MDD are predictive of short-and long-term response; onset of response moves patients along a continuum between fully symptomatic and asymptomatic states (sustained response). This post hoc analysis evaluated sustained response with quetiapine fumarate (quetiapine XR) adjunct therapy in patients with MDD with inadequate response to ongoing antidepressant. Methods: Efficacy and tolerability data from two similar 6-week, multicentre, double-blind, randomised, placebo-controlled studies (D1448C00006 and D1448 C00007) have previously been reported; the present analysis was conducted using pooled data. Eligible patients (HAM-D total score > = 20; item 1 score > = 2) received quetiapine XR (150 or 300 mg/day) or placebo as adjunct to ongoing antidepressant. Study outcome: change in MADRS total scores at Weeks 1, 2, 4 and 6. Post hoc Cochran-Mantel-Haenszel analysis: sustained response rate (> = 50% reduction in MADRS total score at specific visit assessed and at all subsequent visits until Week 6). Results: Data from 919 patients were included: quetiapine XR 150 mg/day (309); quetiapine XR 300mg/day (307); placebo (303). MADRS total scores were significantly reduced with quetiapine XR 150 and 300 mg/day versus placebo (-7.8, -7.3 versus -5.1, respectively; both p<0.001) at Week 1 and to Week 6 (-14.5, -14.8 versus -12.0, respectively; both p<0.001). The proportion of patients at each visit achieving a response that was sustained at all subsequent visits until Week 6 was: 13.0% (p=0.050), 14.2% (p<0.05) versus 8.1% at Week 1; 32.7% (p<0.001), 34.9% (p<0.001) versus 17.5% at Week 2; and 43.4% (p<0.05), 48.5% (p<0.001) versus 35.0% at Week 4, for adjunctive quetiapine XR 150 mg/day and 300 mg/ day versus placebo, respectively. Conclusions: In patients with MDD who had an inadequate response to ongoing antidepressant treatment, adjunctive quetiapine XR (150 and 300 mg/ day) showed statistically significant reductions in MADRS total scores from Week 1. A greater proportion of patients receiving adjunctive quetiapine XR experienced a sustained response from Week 1 compared with patients receiving antidepressant alone. Funded by AstraZeneca.",Bauer M.; Vieta E.; Earley W.; Szamosi J.; Eriksson H.A.,2009.0,10.3109/13651500903375487,0,0,
7552,Optimal maintenance treatment for bipolar disorder,"Bipolar disorders are serious psychiatric diseases with a recurrent and/or chronic course in the majority of patients. Although bipolar disorder has traditionally been regarded as an illness with good prognosis and most patients returning to normal functioning when a mood episode is over, a growing body of longitudinal studies suggests that the long-term outcome is often much less favorable than previously thought. It has been recognized that full interepisodic recovery is not achieved in a significant proportion of patients and as a consequence bipolar disorder is one of the leading causes of disability. Despite the unquestionable advances in the pharmacological treatment of bipolar disorder achieved during the last four decades, even aggressive pharmacological treatment does not prevent relatively poor outcome in a substantial number of bipolar patients both in the acute and prophylactic treatment. Lithium has proved to be effective in acute and prophylactic treatment and is recommended firstline treatment in current guidelines. Unfortunately, in many patients prophylaxis with a single mood stabilizer agent is not sufficient to prevent mood episodes suggesting that clinicians may want to consider a double or even triple combination of lithium with another mood stabilizer, e.g. lamotrigine, valproate or carbamazepine or an atypical antipsychotic drug. Unfortunately, the evidence from controlled trials on the efficacy of such combination treatments is very limited to date, but the combination of two or even more mood stabilizers or combinations with atypical antipsychotics or thyroid hormone supplementation seems clinically reasonable and therefore worth recommending to effectively prevent depressive in bipolar disorder. Mood stability and other treatment outcomes may also be improved by combining prophylactic medication with psychoeducation and psychotherapy.",Bauer M.,2009.0,10.3109/13651500903375487,0,0,
7553,Pharmacological treatment of PTSD,"The first placebo-controlled double-blind trials of pharmacotherapy for PTSD were conducted in military veterans in the 1990s, and demonstrated modest efficacy for amitriptyline and imipramine but strong efficacy for phenelzine. Subsequently, the thrust of most trials has been to assess serotonin reuptake inhibitors, such as sertraline, paroxetine, fluoxetine, citalopram (SSRIs) and venlafaxine (SNRI). These 12-24 week studies have been carried out in mostly non-veteran populations on a worldwide basis and, while some have been negative, many have been positive, with effect sizes in the range of 0.2-0.4. Trials seem more likely to have a negative outcome (i) in veterans of combat, (ii) where the sample size was small, (iii) where a drug was used with only one primary mode of action, i.e. 5HT reuptake inhibition, (iv) with NE reuptake inhibitors (desipramine and bupropion), (v) with anticonvulsants and benzodiazepines and (vi) in the presence of comorbid alcohol use disorder. Relative to placebo, promising effects have been found for add-on therapy with antipsychotics and with unsystematically controlled use of prazosin (i.e. either as monotherapy or augmentation in nonrandomized manner). These therapies appear to be effective in veterans and non-veterans. Three of four placebo-controlled trials show that continuation and maintenance therapy over 12-18 months protects against relapse for fluoxetine, sertraline, but not paroxetine (where few relapsed in either group). There is a lack of information about whether combined pharmacotherapy and psychotherapy produces a better result than either treatment alone, or whether augmentation of one by the other is effective. For the latter, results are mixed and limited to small numbers. Similarly, there is no clear evidence that early use of medication following trauma protects high-risk subjects from developing PTSD, the results of studies with imipramine, fluoxetine, hydrocortisone, propranolol, gabapentin and benzodiazepines being contradictory, but largely negative. In the last few years, a number of treatment guidelines have appeared, but despite their authority, they give contradictory messages about the role and priority of pharmacotherapy, and even the strength of evidence, perhaps because they often start with different assumptions on what is acceptable evidence.",Davidson J.,2009.0,10.3109/13651500903375487,0,0,
7554,Nonverbal sensitivity in medical students: Implications for clinical interactions,"Background: Clinicians' accuracy in perceiving nonverbal cues has potentially important consequences, but has received insufficient research. Objective: To examine the relation of medical students' nonverbal sensitivity to their gender and personal traits, as well as to their communication and impressions made during a standardized patient (SP) visit. Design: Psychometric testing, questionnaire, and observation. Setting: One US medical school. Participants: Two-hundred seventy-five third-year medical students. Measurements: Nonverbal sensitivity and attitudes were measured using standard instruments. Communication during the SP visit was measured using trained coders and analogue patients who viewed the videotapes and rated the favorability of their impressions of the student. Results: Nonverbal sensitivity was higher in female than male students (P<0.001) and was positively correlated with self-reported patient-centered attitudes (P<0.01) and ability to name one's own emotions (P<0.05). It was also associated with less distressed (P<0.05), more dominant (P<0.001), and more engaged (P<0.01) behavior by the SP, and with more liking of the medical student (P<0.05) and higher ratings of compassion (P<0.05) by the analogue patients. Correlations between nonverbal sensitivity and other variables were generally stronger and different for male than female students, but nonverbal sensitivity predicted analogue patients' impressions similarly for male and female students. Conclusion: Medical students' nonverbal sensitivity was related to clinically relevant attitudes and behavioral style in a clinical simulation. © 2009 Society of General Internal Medicine.",Hall J.A.; Roter D.L.; Blanch D.C.; Frankel R.M.,2009.0,10.1007/s11606-009-1107-5,0,0,
7555,Long-term treatment of anxiety disorders,"Currently, evidence for efficacy of treatments for anxiety disorders (panic disorder, generalized anxiety disorder, and social phobia) comes from short-term randomized controlled studies (6-12 weeks), longterm RCTs (up to 2 years) and relapse-prevention studies, in which open treatment is followed by a relapse prevention period (26-52 weeks) with randomization of the responders to placebo or active treatment. In recent years, long-term and relapse prevention studies have been performed with most modern antianxiety medications, with positive results. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are first-line options for the treatment for anxiety disorders, according to the guidelines of World Federation of Societies of Biological Psychiatry for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders [1]. Tricyclic antidepressants (TCAs) are equally effective, but they are less well tolerated than firstline treatments. For short-term treatment or in treatment-resistant cases, benzodiazepines like alprazolam may be used when the patient does not have a history of dependency and tolerance. Recently, the atypical antipsychotic quetiapine was shown to be effective in GAD. According to preliminary data, agomelatine, an agonist at melatonin M1 and M2 receptors and an antagonist at 5-HT2C receptors, may be a future treatment option for patients with GAD. Combining drug treatment with cognitive behaviour therapy is the most successful strategy in anxiety disorders. No randomized controlled studies are available for the efficacy of drug treatment or psychotherapy beyond 2 years. Furthermore, it is a widespread opinion that psychotherapy has long-lasting effects, in contrast to drug treatment. However, there are no controlled data available to support this assumption, due to methodological problems of follow-up studies.",Bandelow B.,2009.0,10.3109/13651500903364234,0,0,
7556,Superstitious conditioning as a model of delusion formation following chronic but not acute ketamine in humans,"Background: Ketamine has previously been shown to induce delusion-like or referential beliefs, both acutely in healthy volunteers and naturalistically among nonintoxicated users of the drug. Delusions are theoretically underpinned by increased superstitious conditioning or the erroneous reinforcement of random events. Materials and methods: Using a novel and objectively measured superstitious conditioning task, experiment 1 assessed healthy volunteers before and during placebo (n=16), low-dose (n=15), and high-dose ketamine (n=16) under randomized and double-blind conditions. Experiment 2 used the same task to compare ketamine users (n=18), polydrug controls (n=19), and nondrug-using controls (n=17). Results: In experiment 1, ketamine produced dose-dependent psychotomimetic effects but did not cause changes in superstitious conditioning. Experiment 2 found increased levels of superstitious conditioning among ketamine users compared to polydrug and nondrug-using controls, respectively, as evidenced by both objective task responses and subjective beliefs following the task. Conclusions: Results indicate that chronic but not acute exposure to ketamine may increase the propensity to adopt superstitious conditioning. These findings are discussed in terms of acute and chronic ketamine models of delusion-like belief formation in schizophrenia. © 2009 Springer-Verlag.",Freeman T.P.; Morgan C.J.A.; Klaassen E.; Das R.K.; Stefanovic A.; Brandner B.; Curran H.V.,2009.0,10.1007/s00213-009-1564-x,0,0,
7557,Escitalopram versus SNRIs as second-line treatment,"Background/aims: A proportion of patients with major depressive disorder (MDD) fail antidepressant treatment due to poor tolerability or lack of efficacy. Pooled analyses of clinical trials in patients with MDD comparing escitalopram with venlafaxine or duloxetine demonstrated similar efficacy and better tolerability of escitalopram compared with venlafaxine and better efficacy and tolerability compared with duloxetine. However, these trials did not specifically focus on second-line patients, defined as patients that had failed treatment with an antidepressant within 6 months prior to study baseline. The objective of this analysis was to evaluate the efficacy and tolerability of escitalopram versus SNRIs in this subgroup of patients. Methods: Of the four head-to-head comparisons between escitalopram and SNRIs (venlafaxine and duloxetine) sponsored by Lundbeck or Forest Labs in MDD, three were eligible for analysis. MADRS total scores, response and remission at week 8 were compared between escitalopram and the SNRIs, adjusting for baseline severity and study using last observation carried forward (LOCF). Tolerability was assessed using withdrawal rates (total and due to adverse events). Results: 132 patients received escitalopram or an SNRI as second-line treatment (66 per group). At baseline, this subgroup had similar age, sex ratio and severity compared to the overall population (n =762). After 8 weeks, second-line escitalopram patients had a significantly lower mean MADRS total score compared with second-line patients treated with an SNRIs (difference =6.35, p =0.0001), with higher response (72.7% vs. 43.9%, p =0.0004) and remission (MADRS ≤12) rates (62.1% vs. 40.9%, p =0.0083). Lower rates of total withdrawals (9.1% vs. 22.7%, p=0.0322) and withdrawals due to adverse events (1.5% vs. 16.7%, p =0.0025) were observed for escitalopram versus SNRIs. Conclusions: Escitalopram has better efficacy and tolerability than SNRIs when used as second-line treatment for MDD. The findings are consistent for the two comparators, although no conclusions could be drawn due to the small sample size. These results should be confirmed in a randomized clinical trial with a pre-specified analysis of second-line patients. This study was funded by H Lundbeck A/S.",Lam R.W.; Lönn S.L.; Despiégel N.,2009.0,10.3109/13651500903375487,0,0,
7558,Milnacipran: A unique antidepressant,"Tricyclic antidepressants (TCAs) are effective antidepressants although their poor tolerance and toxicity in overdose make them difficult to use at effective doses. Extensive clinical trials and everyday experience have shown that while the selective serotonin reuptake inhibitors (SSRIs) are better tolerated than the TCAs, they have their own specific problems such as the aggravation of sexual dysfunction, interaction with other co-administered drugs and a withdrawal syndrome to a variable degree. In addition SSRIs appear, in general, to be less effective than TCAs especially in more severely depressed patients. Increasing preclinical and clinical evidence of the importance of noradrenaline in depression led to the development of a generation of antidepressants which inhibit the reuptake of both noradrenaline and serotonin, the serotonin and noradrenaline reuptake inhibitors (SNRI). Milnacipran (Ixel), one of the pioneer drugs of this class, was designed from theoretical considerations to be more effective than the SSRIs and better tolerated than the TCAs with an extremely simple pharmacokinetic profile. It has an almost identical potency for the inhibition of the reuptake of serotonin and noradrenaline (5-HT/NA selectivity ratio 1.6). Extensive clinical testing, as well as everyday clinical practice in countries across the world, has shown that this antidepressant has the properties predicted theoretically, that is an efficacy comparable to that of that of TCAs and superior to that of SSRIs in severe depression. In addition milnacipran is well tolerated with low potential for pharmacokinetic drug-drug interactions. It has been shown to be particularly effective in low-energy, slowed down patients and in patients with depression and comorbid disorders. Milnacipran is now considered a first-line therapy suitable for most depressed patients. In addition it is frequently successful when other treatments fail for reasons of efficacy or tolerance.",Kasper S.,2009.0,10.3109/13651500903375487,0,0,
7559,Are we too restrictive in licensing CNS drugs in Europe? No!,"Controlled, randomized, double-blind parallel-group clinical trials are still the gold standard to establish efficacy and safety of new medicinal products for psychiatric indications. In general at least two positive phase-III clinical trials in a well-defined patient population are necessary. Depending on the indication three-arm study designs including the new active substance, active control and placebo are preferred. In addition maintenance of efficacy has to be established in the European community before approval. Criteria for inclusion and exclusion of patients should assure homogeneous populations based on international classification systems as DSM-IV-TR or ICD-10, generalizability to everyday practice should be possible. For these patient populations validated rating instruments must be used to establish change in the predefined primary and secondary endpoints. Up to now no formal comparative efficacy or effectiveness studies are requested before approval in the EU.",Broich K.,2009.0,10.3109/13651500903375487,0,0,
7560,Finding solutions for late life depression,"Many reviews and meta-analyses of randomised controlled trials (RCTs) have established the efficacy of both antidepressants and psychotherapy in the short-term treatment of depressed elderly patients. However, following the first treatment intervention, remission is only achieved by one third of these patients, and response in less than half. As the majority of elderly patients require a more concerted approach to treatment in order to achieve remission, there is a need for more RCTs that examine patients that do not respond to their first treatment. Only a few RCTs have been published in this area, and their results will be discussed. Many frequently used treatment options have not been evaluated adequately in the elderly. These include the strategies of dose escalation and combining antidepressants. Further, psychotherapeutic treatment options in patients not responding to cognitive behavioural therapy (CBT) or interpersonal therapy (IPT) have also not been published. Promising results have, however, been published on sequential pharmacological treatment strategies, which have resulted in remission rates of 65-88%, although the lack of a control group in these studies limits their interpretation. These treatment strategies will be presented in more detail. Another option is to combine pharmacotherapy with psychotherapy and/or a collaborative care approach, as, for example, in the PROSPECT(1) intervention. A more recent focus in the literature is the interesting approach of using prediction models to derive decision trees for the treatment of late-life depression. Based on demographical and clinical data, treatment response can be predicted more accurately, and this may result in reductions in the numbers of patients who have to wait up to 8-12 weeks before non-response becomes apparent. Early improvement is the most important clinical variable. Assessment of this could be easily incorporated into clinical practice, but only after clinicians start using rating scales more often with their patients.",Kok R.M.,2009.0,10.3109/13651500903375487,0,0,
7561,Remission: Achieving and sustaining the optimal outcome,"Despite a growing awareness of the need to treat a depressive episode to remission, response is still considered as a “good enough” outcome by many clinicians. Although gaining a response with antidepressant treatment is a key determinant of longer-term positive outcomes, a significant challenge for the clinician is to ensure that patients continue to improve above and beyond this initial milestone. Further, for the many patients that show only a partial response, or no response, attaining the optimal outcome of remission becomes an even more difficult assignment. The Sequenced Treatment Alternatives to Relieve Depression (STAR∗D) Study is the largest prospective study of a sequential series of treatments for depression ever conducted. It confirms that about one-third of patients achieve remission with initial selective serotonin reuptake inhibitor (citalopram) treatment. Certain patient characteristics, namely female sex, Caucasian race, employment and higher educational and income levels were found to positively influence remission rates. With successive treatment failures, however, remission rates tended to decline. It is tempting to speculate on reasons behind these declining remission rates. One possibility is that the remaining patients were less responsive to antidepressants or cognitive behavioural therapy. An alternative hypothesis is that the portion of response associated with the non-specific effects of patient care - attention, reassurance and education (otherwise referred to as “placebo response”) - was also diminishing. Following two failed treatment trials each of 6 months duration, it would seem clinically feasible that any non-specific intervention would lose its effectiveness. The STAR∗D trial provides “benchmarks” in terms of the effectiveness of most of the available treatments for depression. Yet its relapse data are sobering. Consistent with earlier findings, relapse rates were as high as 83% in patients who showed an initial improvement, but then failed to progress to remission. It should be remembered that remission is a clinical judgment that cannot be replaced by rating scales. Increasingly, more focus is being shifted onto the functional aspects of patient recovery. Therefore, aiming for more a ambitious level of remission, for example, where no MADRS single item exceeds 1, needs be our ultimate goal. To achieve this, ideally with the first treatment schedule, it is necessary to consider the important differences that exist between the commonly used antidepressants. A pooled analysis of four randomised controlled trials revealed that antidepressants differ in terms of their likelihood to help patients reach a “symptom free” remission.",Barak Y.,2009.0,10.3109/13651500903375487,0,0,
7562,Evaluating the efficacy of a self-help workbook for women recently diagnosed with breast cancer,"Aim: Despite the psychological difficulties experienced after breast cancer diagnosis, evidence suggests that most women choose not to participate in psychological therapy. Innovative approaches are needed, and preliminary evidence shows that a workbook can be an effective method of delivering support. This study aimed to evaluate the effectiveness of a self-help workbook in facilitating psychosocial adjustment. Method: A randomised controlled trial compared the workbook (n = 25) with an information-control (n = 24). The workbook contained psychosocial information, cognitive and behavioural worksheets and survivors' stories. Participants were women with primary breast cancer diagnosed within the past month. Measures of coping, mood, and quality of life were administered at baseline, then 3 and 6 months later. Results were analysed using Linear Mixed Modelling. Results: After controlling for baseline levels, interactions at 3-month follow-up demonstrated that WB participants had significantly lower levels of helplessness/hopelessness [F(1,89) = 4.75, p = 0.03], cognitive avoidance [F(1,89) = 4.95, p = 0.03], and PTSD [F(1,89) = 7.01, p = 0.01] than controls. However, WB participants had significantly poorer body image than the controls [F(1,89) = 6.43, p = 0.01]. At 6 months, all interactions were no longer significant, with the exception of body image [F(1,93) = 7.44, p = 0.01]. Qualitative results showed that women felt supported by the workbook, and stated that it was 'great to have everything you need in one comprehensive resource'. Conclusions & Future Directions: These results suggest that a self-help workbook can be an effective, short-term intervention for improving coping and PTSD in women recently diagnosed with breast cancer. However issues related to body image need to be dealt with differently. The authors plan to expand on current findings by: (i) implementing the workbook across heterogeneous cancer populations, and (ii) increasing accessibility through transforming the workbook into a web-based resource.",Beatty L.; Koczwara B.; Rice J.; Wade T.D.,2009.0,10.1111/j.1743-7563.2009.01252.x,0,0,
7563,Review of Prolactin levels in patients taking duloxetine,"Background: Relatively little is known about the effects of antidepressants on prolactin levels. This study reviewed the effect of duloxetine on prolactin levels in major depressive disorder (MDD) studies and via spontaneous safety reports. Methods: This post hoc analysis used data from 4 studies of duloxetine in patients with MDD in which prolactin was collected (a placebo-controlled study in elderly, 2 venlafaxine comparator studies, and a relapse prevention study). Treatment-emergent abnormal prolactin values were assessed overall, by age (<55 and ‚â•55), and by gender. Moreover, duloxetine case reports were searched for elevated serum prolactin levels in a global patient safety database (August 2004-August 2007). Results: From the 4 studies (N =709), 54 (7.6%) duloxetine-treated patients had treatment-emergent abnormally high prolactin levels at any time during the study. The percentage of patients with abnormally high prolactin levels taking placebo versus duloxetine was 0% vs 2.1% (P =.306) in the elderly study and 8.5% vs 3.8% (P =.309) in the relapse prevention study after 12 weeks of open-label duloxetine treatment. No statistically significant differences occurred in abnormally high prolactin levels between venlafaxine and duloxetine overall (7.0% vs 8.9%, P =.376) or when analyzed by either gender or age. Only a few different adverse events were reported in study patients with elevated prolactin levels at any time. There were 36 spontaneous reports of hyperprolactinemia (21 reports provided a value: 22.7-182.5 ng/mL) out of nearly 10 million patient exposures to duloxetine. Conclusions: In clinical trials, abnormal prolactin levels were observed but did not significantly differ between patients taking placebo and duloxetine or between those taking venlafaxine and duloxetine. The number of spontaneously reported cases of elevated serum prolactin was very low. Limitations of these post hoc analyses include the limited available information and variety of study designs. Research funded by Eli Lilly and Company and Boehringer Ingelheim GmbH. Disclosure information: Drs Crucitti, Perahia, Mancini, Zhang, Wang, and Walker are employees and/or stockholders of Eli Lilly and Company. Dr Brecht is an employee of Boehringer Ingelheim GmbH.",Montejo A.L.; Crucitti A.; Perahia D.G.S.; Zhang Q.; Wang F.; Walker D.J.; Mancini M.; Brecht S.,2009.0,10.3109/13651500903375487,0,0,
7564,A comparative analysis between experts and novices interacting with a virtual patient with PTSD,"Virtual patients will provide a means to train the next generation of clinical residents. Interacting and engaging with virtual characters portraying standardized patients can have meaningful outcomes. As a cumulative set of data analysis, we investigate the comparison of how well novices, subjects without any clinical interviewing background, with experts, clinicians, or resident student clinicians with interviewing skills to assess if they could elicit the proper information from verbal interactions with a virtual character.",Kenny P.G.; Parsons T.D.; Rizzo A.,2009.0,,0,0,
7565,The Influence of Thought Suppression and Cognitive Load on Intrusions and Memory Processes Following an Analogue Stressor,"Ironic Process Theory and the role of thought suppression have been used in part to explain the phenomenon of intrusive memories in various disorders, including posttraumatic stress disorder. How thought suppression interacts with other cognitive processes believed to be instrumental in the development of traumatic intrusive memory is unclear. In an analogue study, thought suppression and cognitive processing was manipulated in 4 experimental groups after participants (n = 80) viewed a trauma film. The impact of suppression was examined in relation to self-reported intrusive experiences as well as via more objective methods (word stem and dot probe tasks) to assess potential preferential encoding of negative material. Cognitive load appeared to undermine thought suppression ability, with these participants experiencing more intrusions over the week relative to participants in all other conditions. This group also showed greater priming to negative film-related words, and both suppression groups demonstrated enhanced memory for film-related content on recognition testing. Thought suppression mediated the relationship between negative interpretations of initial intrusions and later intrusions experienced over the week. The findings are discussed in the context of ironic process theory and cognitive models of posttraumatic stress. © 2009.",Nixon R.D.V.; Cain N.; Nehmy T.; Seymour M.,2009.0,10.1016/j.beth.2008.10.004,0,0,
7566,Amygdala temporal dynamics: Temperamental differences in the timing of amygdala response to familiar and novel faces,"Background: Inhibited temperament - the predisposition to respond to new people, places or things with wariness or avoidance behaviors - is associated with increased risk for social anxiety disorder and major depression. Although the magnitude of the amygdala's response to novelty has been identified as a neural substrate of inhibited temperament, there may also be differences in temporal dynamics (latency, duration, and peak). We hypothesized that persons with inhibited temperament would have faster responses to novel relative to familiar neutral faces compared to persons with uninhibited temperament. We used event-related functional magnetic resonance imaging to measure the temporal dynamics of the blood oxygen level dependent (BOLD) response to both novel and familiar neutral faces in participants with inhibited or uninhibited temperament. Results: Inhibited participants had faster amygdala responses to novel compared with familiar faces, and both longer and greater amygdala response to all faces. There were no differences in peak response. Conclusion: Faster amygdala response to novelty may reflect a computational bias that leads to greater neophobic responses and represents a mechanism for the development of social anxiety. © 2009 Blackford et al; licensee BioMed Central Ltd.",Blackford J.U.; Avery S.N.; Shelton R.C.; Zald D.H.,2009.0,10.1186/1471-2202-10-145,0,0,
7567,Count out your intrusions: Effects of verbal encoding on intrusive memories,"Peri-traumatic information processing is thought to affect the development of intrusive trauma memories. This study aimed to replicate and improve the study by Holmes, Brewin, and Hennessy (2004, Exp. 3) on the role of peri-traumatic verbal processing in analogue traumatic intrusion development. Participants viewed an aversive film under one of three conditions: counting backwards in 3s (""verbal interference""), verbalising emotions and thoughts (""verbal enhancement""), or without an extra task. A dual-process account of PTSD would predict that verbal interference would increase intrusion frequency compared to no task, whereas verbal enhancement would lead to a decrease. In contrast, mainstream memory theory predicts a decrease in intrusion frequency from any concurrent task that diverts attention away from the trauma film. The main finding was that the verbal interference task led to a decrease in intrusive memories of the film compared to the other two conditions. This finding does not support a dual-process account of PTSD, but is in line with general theories of memory and attention.",Krans J.; Näring G.; Becker E.S.,2009.0,10.1080/09658210903130780,0,0,
7568,Mechanical but not painful electrical stimuli trigger TNF alpha release in human skin,"Pro-inflammatory cytokines-in particular tumor necrosis factor (TNF)-alpha-play an important role in pain and hyperalgesia. The stimuli inducing TNF-alpha release in humans and the time course of this release are largely unknown. We performed dermal microdialysis in healthy subjects (n = 36) during three experimental conditions: The first condition (control) was microdialysis without stimulation, the second condition was 30 min of electrical current stimulation (1 Hz, 20 mA, moderately painful), the third condition was 30 min of repetitive mechanical stimulation via an impact stimulator (bullet 0.5 g; velocity 11 m/s, minimally painful). TNF-alpha was quantified in the samples collected at the end of the baseline perfusion (about 1 h of saline perfusion), at the end of stimulation period (exactly 30 min after stimulation commenced) and at the end of the experiment (exactly 90 min after stimulation commenced) using a commercial enzyme-linked immunosorbent assay. The C-fiber-related flare was quantified with a laser-Doppler imager. ANOVA revealed that TNF-alpha levels increased during the eluate sampling period. At 90 min TNF-alpha in the eluate of the mechanical stimulation condition was significantly increased as compared to electrical current or control condition. Flare intensity was highest in the electrical current stimulation condition and only marginally different from control in mechanical stimulation. Our results show that minimal mechanical trauma is sufficient to induce significant TNF-alpha release in the skin. These results may be relevant to the treatment of posttraumatic pain disorders. © 2009 Elsevier Inc. All rights reserved.",Eberle T.; Doganci B.; Krämer H.; Fechir M.; Wagner I.; Sommer C.; Birklein F.,2010.0,10.1016/j.expneurol.2009.11.008,0,0,
7569,Investigating the impact of sex and cortisol on implicit fear conditioning with fMRI,"Fear conditioning is influenced by stress but opposing effects in males and females have often been reported. In a previous human functional magnetic resonance imaging (fMRI) study, we observed acute effects of the stress hormone cortisol on prefrontal structures. Men showed evidence for impaired fear conditioning after cortisol treatment, while the opposite pattern was found for women. In the current experiment, we tested whether similar sex-dependent effects would occur on the neural level if contingency awareness was prevented experimentally to investigate implicit learning processes. A differential fear conditioning experiment with transcutaneous electrical stimulation as unconditioned stimulus and geometric figures as conditioned stimuli (CS) was conducted. One figure was always paired (CS+), whereas the other (CS-) was never paired with the UCS. Thirty-nine (19 female) subjects participated in this fMRI study, receiving either placebo or 30 mg cortisol (hydrocortisone) before conditioning. Dependent variables were skin conductance responses (SCRs) and neural activity (BOLD signal). In line with prior findings in unaware participants, no differential learning could be observed for the SCRs. However, a sex × cortisol interaction was detected with a reduced mean response to the CS after cortisol treatment in men, while the opposite pattern was observed in women (enhanced mean SCR under cortisol). In the contrast CS+ minus CS-, neural activity showed a sex × cortisol interaction in the insula and further trends in the hippocampus and the thalamus. In these regions, cortisol reduced the CS+/CS- differentiation in men but enhanced it in women. In contrast to these sex specific effects, differential amygdala activation was found in the placebo group but not in the cortisol group, irrespective of sex. Further, differential neural activity in the amygdala and thalamus were positively correlated with the SCRs in the placebo group only. The present study in contingency unaware participants illustrates that cortisol has in some brain regions sex specific effects on neural correlates of emotional learning. These effects might translate into a different vulnerability of the two sexes for anxiety disorders. © 2009 Elsevier Ltd. All rights reserved.",Merz C.J.; Tabbert K.; Schweckendiek J.; Klucken T.; Vaitl D.; Stark R.; Wolf O.T.,2010.0,10.1016/j.psyneuen.2009.07.009,0,0,
7570,Repeated checking causes distrust in memory but not in attention and perception,"Repeated checking to reduce memory distrust seems to be counterproductive: it increases memory distrust. Obsessive-compulsive (OC) patients tend to be uncertain about other cognitive domains as well, like attention and perception. In an experiment with 70 healthy participants, we tested whether perseverative checking induces distrust not only in memory, but also in attention and perception. Participants were administered a computer task in which they had to activate, deactivate, and check threat-irrelevant stimuli, and rate their confidence in memory, attention, and perception in a pre-test and post-test. In between these tests, the relevant checking group performed 20 checks of the same stimuli used in the pre- and post-test. The irrelevant checking group performed 20 checks of different stimuli. Although memory accuracy improved in both groups, repeated checking reduced confidence in memory, vividness, and detail in the relevant checking group, but not in the irrelevant checking group. A trend was found towards a decline in attentional confidence in the relevant checking group only. Perception was not affected by repetitive checking. A replication study revealed similar results of relevant checking on meta-memory, however, the trend for attentional distrust was not confirmed. The results suggest that perseveration may be domain specific, i.e., only the cognitive processes that are subject to perseveration are affected. © 2010 Elsevier Ltd.",Dek E.C.P.; van den Hout M.A.; Giele C.L.; Engelhard I.M.,2010.0,10.1016/j.brat.2010.03.009,0,0,
7571,The relationship between religion and thought-action fusion: Use of an in vivo paradigm,"Research has demonstrated that higher levels of religiosity are positively correlated with thought-action fusion (TAF), a set of cognitive biases found to be associated with obsessive-compulsive symptoms. However, previous studies have exclusively relied on a nomothetic approach to measuring TAF using a single self-report instrument, the thought-action fusion scale. The current study examined the relationship between religiosity and TAF using an in vivo behaviorally-based assessment in which participants thought about and wrote down thoughts of negative events involving loved ones. Forty-three highly religious Protestant Christians were compared to 30 Atheists/Agnostics on their in vivo ratings of anxiety, estimates of likelihood, and moral wrongness related to the negative thoughts. Results indicated that compared to the non-religious participants, those who were highly religious believed that writing and thinking about the negative events was more morally wrong and increased the likelihood of the event. Results are discussed in terms of the potential relationship between certain religious teachings and TAF-related beliefs about the importance, significance, and influence of thoughts. © 2010 Elsevier Ltd.",Berman N.C.; Abramowitz J.S.; Pardue C.M.; Wheaton M.G.,2010.0,10.1016/j.brat.2010.03.021,0,0,
7572,A developmental-contextual approach to understanding mental health and well-being in early adulthood,"There is an increasing awareness of the social and economic burden of untreated mental illness. However, the question remains whether the individuals who are not identified as having a mental disorder are mentally healthy and socially functioning. This study aims to examine the sequence of Keyes's (Keyes, C. L. M. (2002). The mental health continuum: from languishing to flourishing in life. Journal of Health and Social Behavior, 43, 207-222.) mental health categories based on psychological status and well-being, and to identify qualitative differences in these categories by developmental-contextual factors and concurrent physical health status and social functioning. This study uses data from the UK 1958 National Child Development Study. Information was collected on the cohort members from childhood to age 33 years. Psychological distress (measured using the Malaise Inventory) and well-being (self-efficacy and appraisals of life circumstances) were assessed at age 33 years. Multinomial (polytomous) logistic regression models were used to examine the effects of individual characteristics and social contextual factors from childhood through adolescence on cross categorisations of psychological distress and well-being. Our findings suggest that there are similar early life predictors for both poor psychosocial functioning and mental ill-health. Our results also demonstrated a clear gradient of physical health and social functioning across mental health categories, even in the absence of mental disorder. Individual and social contextual factors in early life appear to offer clues as to why the absence of psychological distress does not always imply good mental health or social functioning. © 2009 Elsevier Ltd. All rights reserved.",Hatch S.L.; Harvey S.B.; Maughan B.,2010.0,10.1016/j.socscimed.2009.10.005,0,0,
7573,Neuroticism modulates amygdala-prefrontal connectivity in response to negative emotional facial expressions,"Neuroticism is associated with the experience of negative affect and the development of affective disorders. While evidence exists for a modulatory role of neuroticism on task induced brain activity, it is unknown how neuroticism affects brain connectivity, especially the crucial coupling between the amygdala and the prefrontal cortex. Here we investigate this relation between functional connectivity and personality in response to negative facial expressions. Sixty healthy control participants, from the Netherlands Study on Depression and Anxiety (NESDA), were scanned during an emotional faces gender decision task. Activity and functional amygdala connectivity (psycho-physiological interaction [PPI]) related to faces of negative emotional valence (angry, fearful and sad) was compared to neutral facial expressions, while neuroticism scores were entered as a regressor. Activity for fearful compared to neutral faces in the dorsomedial prefrontal (dmPFC) cortex was positively correlated with neuroticism scores. PPI analyses revealed that right amygdala-dmPFC connectivity for angry and fearful compared to neutral faces was positively correlated with neuroticism scores. In contrast, left amygdala-anterior cingulate cortex (ACC) connectivity for angry, fearful and sad compared to neutral faces was negatively related to neuroticism levels. DmPFC activity has frequently been associated with self-referential processing in social cognitive tasks. Our results therefore suggest that high neurotic participants display stronger self-referential processing in response to negative emotional faces. Second, in line with previous reports on ACC function, the negative correlation between amygdala-ACC connectivity and neuroticism scores might indicate that those high in neuroticism display diminished control function of the ACC over the amygdala. These connectivity patterns might be associated with vulnerability to developing affective disorders such as depression and anxiety. © 2009 Elsevier Inc. All rights reserved.",Cremers H.R.; Demenescu L.R.; Aleman A.; Renken R.; van Tol M.-J.; van der Wee N.J.A.; Veltman D.J.; Roelofs K.,2010.0,10.1016/j.neuroimage.2009.08.023,0,0,
7574,Components of attentional biases in contamination fear: Evidence for difficulty in disengagement,"Attentional bias for threat has been implicated in the contamination fear (CF) subtype of obsessive-compulsive disorder, but the components of the bias (facilitated attention versus difficulty in disengagement) and the stage of processing during which the bias occurs (early versus late stage of processing) remains unclear. Further, it is unclear whether attentional biases in CF are towards fear or disgust-related stimuli. The present study examined attentional biases in a group of individuals selected to have elevated CF (n = 23) and a control group (n = 28) using the spatial cueing task. Stimuli were neutral, disgusting, or frightening pictures presented for either 100 or 500 ms. Results revealed evidence for delayed disengagement from both fear and disgust stimuli in the CF group, but not in the control group. The effect appeared to be greater at 500 ms stimulus presentation, but did not appear to differ between fear and disgust stimuli. The CF group was associated with delayed disengagement from threat even when controlling for generic response slowing. Theoretical and clinical implications are discussed. © 2009 Elsevier Ltd. All rights reserved.",Cisler J.M.; Olatunji B.O.,2010.0,10.1016/j.brat.2009.09.003,0,0,
7575,Distress and metacognition in psychosis prone individuals: Comparing high schizotypy to the at-risk mental state,"Both schizotypy and at-risk mental states (ARMS: prodromal states) define individuals at risk for psychotic symptoms. However, the relationship between the 2 is unclear. ARMS individuals are, by definition, help-seeking and therefore at greater risk. We tested whether high schizotypes and ARMS exist along the same continuum by examining maladaptive metacognitions and distress. About 95 healthy volunteers (39% male; mean age, 22.8 years) completed the Schizotypal Personality Questionnaire, the Launay-Slade Hallucinations Scale, Metacognitions Questionnaire (MCQ), and the General Health Questionnaire, and 58 help seeking individuals with ARMS status (41% male; mean age, 22.2 years) completed the Metacognitions Questionnaire and General Health Questionnaire. With increasing expression of schizotypy and hallucinatory proneness healthy volunteers became difficult to differentiate from ARMS patients and showed similarities in distress and metacognitive abnormalities. Results suggest healthy volunteers who express both schizotypal trait and proneness to hallucinations have cognitive processes in common with ARMS patients. Copyright © 2010 by Lippincott Williams & Wilkins.",Barkus E.; Stirling J.; French P.; Morrison A.; Bentall R.; Lewis S.,2010.0,10.1097/NMD.0b013e3181cc418a,0,0,
7576,Successful peripheral field stimulation for thoracic radiculitis following brown-sequard syndrome,"Peripheral nerve stimulation (PNS) has been used in the management of refractory neuropathic pain conditions including post-traumatic and post-surgical neuropathy (1). Direct placement of electrodes along the target peripheral nerve during PNS may circumvent the difficulty of dorsal column stimulator lead placement in the post-surgical spine. Additionally, recent improvements in technique have made PNS less invasive through percutaneous electrode placement under fluoroscopic guidance. Case Report: A 57-year-old male with history of thoracic microdiscectomy resulting in Brown-Sequard syndrome who presented with chronic post-operative thoracic radicular pain radiating to the abdomen, refractory to conservative management. The patient underwent a series of three intercostal nerve blocks from T7 to T9 with transient symptomatic relief. The patients options were limited to chemomodulation, neuromodulation, or selective intercostal nerve surgical neurectomy. He subsequently underwent a PNS trial and reported >75% pain reduction. Permanent percutaneous PNS electrodes were implanted at the right T7 and T9 intercostal nerves and replicated the trial results. Conclusion: Chronic radicular pain may be difficult to manage in the post-surgical patient and often requires the use of multiple therapeutic modalities. We successfully utilized PNS in this case as it demonstrated greater technical feasibility when compared to spinal cord stimulation and repeat surgery; therefore, it may be considered for the management of post-surgical neuropathy. Further controlled studies are needed to evaluate the efficacy of this treatment option.",Desai M.J.; Jacob L.R.; Chai T.,2010.0,10.1111/j1526-4637.2009.00781.x,0,0,
7577,Initiating exercise therapy and LHRHa simultaneously to reduce toxicity induced declines in structure and function in men with prostate cancer,"Introduction: Androgen suppression therapy (AST) results in muscle loss, increased fat mass and decreased functional ability. Exercise has been demonstrated to alleviate these AST side effects however to date all such interventions have been initiated after the patient has been on therapy for some time. This study will determine the effectiveness of a 12-week exercise program initiated immediately following the first administration of LHRHa. Patients and methods: Randomized controlled trial in men initiating LHRHa (Lucrin®) for prostate cancer. One-hundred and twenty men will be randomly allocated to either immediate exercise (IE) or delayed exercise (DE). IE will immediately commence (within 1 week of first LHRHa treatment) a 12 week exercise program, prescribed and monitored by accredited exercise physiologists. After 12 weeks, the groups will cross over, and the DE group will receive the 12 week exercise interventio while the IE will no longer receive the exercise program. We will then assess all patients again at week 24. Study endpoints will include quality of life (QLQ-C30), physical function, waist circumference, blood biomarkers (PSA, testosterone, lipoprotein profile, glucose) and psychological distress (BSI-18). Results: This study will generate valuable information as to the initial effects of an exercise initiated immediately following the first administration of LHRHa. Conclusion: We expect dissemination of the knowledge gained from this project to reduce risk factors for the development of co-morbid diseases associated with AST such as cardiovascular disease, as well as improvements in physical ability and quality of life.",Newton R.U.; Taaffe D.R.; Spry N.; GalvãO D.A.,2010.0,10.1111/j.1464-410X.2010.09122.x,0,0,
7578,Outreach and screening following the 2005 London bombings: usage and outcomes,"BACKGROUND: Little is known about how to remedy the unmet mental health needs associated with major terrorist attacks, or what outcomes are achievable with evidence-based treatment. This article reports the usage, diagnoses and outcomes associated with the 2-year Trauma Response Programme (TRP) for those affected by the 2005 London bombings. METHOD: Following a systematic and coordinated programme of outreach, the contact details of 910 people were obtained by the TRP. Of these, 596 completed a screening instrument that included the Trauma Screening Questionnaire (TSQ) and items assessing other negative responses. Those scoring 6 on the TSQ, or endorsing other negative responses, received a detailed clinical assessment. Individuals judged to need treatment (n=217) received trauma-focused cognitive-behaviour therapy (TF-CBT) or eye movement desensitization and reprocessing (EMDR). Symptom levels were assessed pre- and post-treatment with validated self-report measures of post-traumatic stress disorder (PTSD) and depression, and 66 were followed up at 1 year. RESULTS: Case finding relied primarily on outreach rather than standard referral pathways such as primary care. The effect sizes achieved for treatment of DSM-IV PTSD exceeded those usually found in randomized controlled trials (RCTs) and gains were well maintained an average of 1 year later. CONCLUSIONS: Outreach with screening, linked to the provision of evidence-based treatment, seems to be a viable method of identifying and meeting mental health needs following a terrorist attack. Given the failure of normal care pathways, it is a potentially important approach that merits further evaluation.",Brewin C.R.; Fuchkan N.; Huntley Z.; Robertson M.; Thompson M.; Scragg P.; d'Ardenne P.; Ehlers A.,2010.0,10.1017/S0033291710000206,0,0,
7579,In vivo study of age-related changes in the optical properties of the skin,"The optical properties of the skin (absorption coefficient, scattering coefficient, refractive index) may serve to characterize the skin and are important for correct light dosimetry in many optical diagnostic procedures and laser treatments especially photodynamic therapy and laser therapy. We determined in vivo the optical properties of tissues near the wrist, elbow and knee in subjects of different ages using diffuse reflectance spectroscopy, having in view the establishment of laser system types for the laser treatment of posttraumatic lesions in subjects of different ages. Diffuse reflection of light from biological tissue is due to the variation in refractive index of tissular and cellular components and the surrounding medium and depends on the wavelength of the incident optical radiation. The diffuse reflectance spectrum of the tissues tested showed two maxima localized at λM1 ≈ 610 nm and λM2 ≈ 675 nm. Laser systems which emit radiation at these wavelengths are not efficient for the treatment of joints, regardless of the subject's age. The deep tissues have a strong absorption in the range 630-700 nm, which indicates that for treating posttraumatic lesions we can use laser systems such as the He-Ne laser, the GaAlAs laser, and the InGaAlAs laser. Using Kramers-Kronig analysis of the diffuse reflectance spectra, the optical parameters n(ω) and k(ω) were determined. The age-dependent changes in these optical parameters of tissue must be taken into consideration and the use of laser treatments or optical diagnosis methods must be based on a knowledge of these properties and of the optical radiation parameters. © Springer-Verlag London Ltd 2009.",Calin M.A.; Parasca S.V.,2010.0,10.1007/s10103-009-0725-9,0,0,
7580,Cognitive behavioral therapy and physical exercise for climacteric symptoms in breast cancer patients experiencing treatment-induced menopause,"Background: Premature menopause is a major concern of younger women undergoing adjuvant therapy for breast cancer. Hormone replacement therapy is contraindicated; non-hormonal medications show side-effects. There is growing evidence that cognitive behavioral therapy and physical exercise can have a positive impact on symptoms in naturally occurring menopause. The purpose of this clinical trial is to evaluate the efficacy of cognitive behavioural therapy (CBT) (A), physical exercise (B), or the combination of these interventions (AB) in alleviating menopausal symptoms, improving sexual functioning and enhancing quality of life. Material and Methods: In this multicenter study, a minimum of 325 eligible women are being randomised to group A, B, AB or a 'waiting list' control group. For group A, the intervention consists of 6 weekly group CBT sessions of 1.5 hours and a booster session. For group B, the intervention is an individually tailored, 12 week home-based physical exercise program of 2.5-3 hours per week. Group AB receives both the CBT and exercise program. Questionnaires assessing menopausal symptoms, sexuality, body- and self-image, psychological distress and quality of life are being completed at baseline, at 12 weeks and at 6 months follow-up. Results: As of November 2009, 2688 women have been identified as being potentially eligible for study participation, of whom 1514 completed a screening questionnaire and 662 a postcard indicating they had no interest in the study. 627 of the screened women met eligiblity criteria and received a baseline questionnaire. To date, 422 women have returned this questionnaire and have been been randomly allocated to the CBT group, (n= 109), the physical exercise group (n =104), the combined intervention group (n =106), or the control group (n = 103). Problems have been experienced in retaining patients in the trial, with dropouts occuring primarily between randomization and start of the intervention. The majority of those who actually participate in the interventions are able to comply with the program. Data collection will continue until mid-2010. Conclusions: Cognitive behavioral therapy and physical exercise are potentially useful treatments for women with breast cancer who experience treatment-induced, premature menopause. In this conference, the content of the interventions, flow of participants throughout the trial, reasons for dropout and initial experiences with the interventions will be presented.",Duijts S.; Oldenburg H.; Van Beurden M.; Aaronson N.,2010.0,10.1016/S1359-6349(10)70536-X,0,0,
7581,Recruitment of anxious older adults into an RCT of psychotherapy,"Introduction: Recruitment of participants into any clinical trial is an expensive and time consuming endeavor that is crucial to the success of the trial. The relative effectiveness, efficiency, and cost of different strategies for recruiting elderly anxious adults into a psychiatric clinical trial are presented. Methods: Data are from an RCT of cognitive-behavioral bibliotherapy and telephone therapy for the treatment of latelife anxiety. Participants had a diagnosis of Generalized Anxiety Disorder (GAD), Panic Disorder, or Anxiety Disorder NOS and were > 60 years. Six types of recruitment strategies were employed: 1) posting flyers in a senior health center and at 3 primary care practices; 2) advertisements in a senior newsletter; 3) advertisements in newspapers; 4) mass mailing of flyers; 5) screening patients in primary care and family medicine clinics; and 6) physician referral. Results: A total of 60 participants were randomized. Most had a diagnosis of GAD (90.0%); 40.0% had a diagnosis of Panic Disorder, and 3.3% had a diagnosis of Anxiety Disorder NOS. Participants ranged in age from 60 to 86, with a mean age of 69.3 years (SD = 7.0). The majority of the sample was women (83.3%), and half the sample was married (50.0%). Three quarters of the sample was white (74.6%), 15.3% was black, 8.5% was Native American, and 1.7% was Hispanic. There were a total of 351 responses to the recruitment strategies; 56 people were deemed ineligible based on the telephone screening; SCID interviews were conducted with 123 interested persons, and 60 were eligible and randomized into the study. Table 1 includes efficiency (number randomized/number screened with the SCID), total cost, and cost per randomized participant for each recruitment strategy. Conclusions: More than half of the sample was recruited though the use of mass mailing of flyers. There is conflicting evidence regarding the effectiveness of mass mailings for recruiting older adults into clinical trials. Our findings may reflect the fact that these participants were from greatly underserved communities and may have few mental health treatment options available to them. The most costly method of recruitment was screening in the primary care and family medicine clinics. Due to the confidentiality of patient information, research staff was unable to access information regarding the appointment dates and times for patients over the age of 60 years. Instead, research staff was located in the waiting rooms and spoke with each patient individually about participating in the study. This was very time consuming and yielded less than 10% of the sample. We recommend using a combination of strategies that balances yield, cost effectiveness, and efficiency. Mass mailings had the highest yield while advertising in a newspaper was the most efficient and cost-effective method. Combined, these 2 strategies also have the potential to reach the largest audience. (Table Presented).",Brenes G.A.; Miller M.E.; McCall V.; Knudson M.; Williamson J.; Stanley M.,2010.0,10.1097/01.JGP.0000369161.13792.ad,0,0,
7582,A randomized clinical trial of a cognitive orthotic with executive planning capability in individuals with cognitive dysfunction,"Objectives: Individuals with Brain Injury experience deficits across a number of functional domains. Cognitive deficits can be the most disabling since almost every aspect of the individual's life may be affected. Disease processes that affect the brain can also produce cognitive deficits similar to those observed following Brain Injury. While it is clear that cognitive orthotics can provide some benefit to individuals with memory and functional deficits, the ability to provide support for higher level executive function, such as flexibility in task scheduling, is lacking. One commercially available device, the Planning and Execution Assistant and Trainer (PEAT), was developed to serve as an executive function orthotic device. Therefore, this randomized controlled clinical trial examined whether individuals with cognitive impairments utilizing PEAT demonstrated better outcomes 3 and 6 months postimplementation than comparable individuals using current “community standard cognitive/memory strategies. Method: One hundred and twenty-five communitydwelling individuals at least one year post injury/ diagnosis with cognitive impairments were recruited prospectively from the community. The baseline assessment consisted of a demographic intake form. For those with TBI, etiology of injury, duration of post-traumatic amnesia, and time to follow commands was collected. The Repeatable Battery for the Assessment of Neuropsychological Status was administered to document cognitive impairment. The following measures were assessed serially at baseline, 3 and 6 months after study initiation: the Kohlman Evaluation of Living Skills (KELS), Disability Rating Scale (DRS), the Participation Index of the Mayo-Portland Adaptability Inventory - Version 4 (M2PI), Supervision Rating Scale (SRS), Craig Handicap Assessment Reporting Technique - Short Form (CHART-SF), and the Diener Satisfaction with Life Scale. After completion of the baseline assessment, each participant was randomly assigned to the PEAT (intervention) or community-standard (control) group. Each group received 11 hours of training in the implementation and use of the assigned cognitive aid. Participants used their cognitive aid outside of the training setting and were assessed at 3 and 6 months post-protocol initiation. Results: Both groups were comparable on all baseline measures. Drop-out rates were similar between the two groups and there were no significant differences between those who dropped out or completed the study. The PEAT group showed greater improvement than the control group in M2PI scores (F=5.70; p<0.001). However, all participants showed improved scores on the DRS, KELS, SRS, CHART Occupation and decreased scores on the BDI-II. Most improvements came 3 months into the study, with decreases in depression and need for supervision coming at 6 months also. Conclusions: There were select improvements in overall functioning for the PEAT group. Both groups demonstrated improvements across multiple dimensions suggesting that therapeutic interventions for the purpose of implementing cognitive aids can be beneficial even many years post diagnosis.",Bushnik T.; Englander J.; Oggins J.; Levinson R.; Halper D.,2010.0,10.3109/02699051003648227,0,0,
7583,Multi-wavelength spectroscopic and chromatography study on the photocatalytic oxidation of natural organic matter,"The effect of TiO2 photocatalytic oxidation on the natural organic matter (NOM) properties of two Australian surface waters were quantified using UV-vis spectroscopy, high performance size exclusion chromatography (HPSEC) with a multi-wavelength UV detector, liquid chromatography with organic carbon detector (LC-OCD), and trihalomethane formation potential (THMFP) analyses. Both the UV absorbance at wavelengths greater than 250nm and dissolved organic carbon (DOC) content decreased significantly with treatment, although complete mineralization of NOM could not be achieved. Multi-wavelength UV detection of HPSEC analysis was shown to be useful to display further changes to NOM composition and molecular weight profiles because the organic molecules was transformed into compounds that absorb weakly at the typical detection wavelength of 250-260nm. The multi-wavelength HPSEC results also revealed that photocatalytic oxidation yields by-products with a low aromaticity and low molecular weight. The LC-OCD chromatograms indicated that low molecular acids and neutral compounds remained after photocatalytic oxidation. Those groups of compounds did not seem to contribute significantly to the formation of trihalomethanes. © 2010 Elsevier Ltd.",Liu S.; Lim M.; Fabris R.; Chow C.W.K.; Drikas M.; Korshin G.; Amal R.,2010.0,10.1016/j.watres.2010.01.036,0,0,
7584,Comparison of MMPI-2 and PAI validity indicators to detect feigned depression and PTSD symptom reporting,"The purpose of this study was to compare the clinical utility of PAI and MMPI-2 validity indicators to detect exaggeration of psychological symptoms. Participants were 49 (75.5% female) Australian university students who completed the MMPI-2 and PAI under one of three conditions: Control [i.e., honest responding (n=20)], Feign Post Traumatic Stress Disorder [PTSD (n=15)], or Feign Depression (n=14). Participants instructed to feign depression or feign PTSD had significantly higher scores on the majority of MMPI-2 and PAI validity indicators compared with controls. The Meyers Validity Index, the Obvious-Subtle index, and the Response Bias Scale were the most accurate MMPI-2 validity indicators. Diagnostic-specific MMPI-2 validity indicators, such as the Infrequency-PSTD scales and Malingered Depression scale, were not effective at detecting participants instructed to feign those conditions. For the PAI, the most accurate validity indicator was the MAL index; however, the detection rate using this validity indicator was modest at best. The MMPI-2 validity indicators were clearly superior to those on the PAI at identifying feigned versus honest responding in this sample. © 2010.",Lange R.T.; Sullivan K.A.; Scott C.,2010.0,10.1016/j.psychres.2009.03.004,0,0,
7585,Blood injection injury phobia and severe vagal symptoms in patients with sleep syncope,"Objectives: to compare demographic and clinical data from patients with sleep syncope to that of patients with “classical” vasovagal syncope [VVS], collected over the last 8 years. Design: Retrospective case-controlled study Setting: Syncope unit. Patients and methods: 54 patients with a history suggestive of one or more episodes of sleep syncope (group SS) were matched for age and gender to 108 patients with VVS (control group). A syncope questionnaire was completed immediately before tilt-testing and included: frequency, age-of-onset and severity of episodes; situations, postures and perceived triggers; lifetime prevalence of specific phobias; and symptoms during syncope. Results: Group SS were mainly women (65%), mean age of 46 ± 2.1 years, with a mean lifetime total of 5.4 ± 0.83 episodes of sleep syncope. Compared to control, SS episodes were more likely to start in childhood, 26.9 versus 50% (p = 0.005) and more severe, score 2.40 ± 0.11 versus 2.81 ± 0.15 (p = 0.03). In group SS: syncope onset whilst lying down was more frequent, 4.6 versus 32.7% (p = 0.001); the lifelong prevalence of any specific phobia was higher, 32.4 versus 74.5% (p = 0.001), in particular blood injection injury (BII) phobia, 19.4 versus 57.4% (p = 0.001); and during attacks, distressing vagal symptoms were more frequent, eg abdominal discomfort, 13.9 versus 72.2% (p = 0.001). Conclusion: Sleep syncope is not rare and is characterised by life-long, intermittent but severe episodes of vasovagal syncope which may occur in the horizontal position, with distressing abdominal symptoms. BII phobia is strongly associated and may be a predisposing factor.",Busweiler L.; Jardine D.L.; Frampton C.M.; Wieling W.,2010.0,10.1007/s10286-010-0060-z,0,0,
7586,Changes in anxiety symptoms of ADHD adult patients with co-morbid refractory generalized anxiety disorder treated with mixed amphetamine salts (ADDERALL XR): An open label study,"Objectives: to examine the effectiveness of the mixed amphetamine salt adderall XR, in the treatment of adult Attention Deficit Hyperactivity Disorder (ADHD), with comorbid partially responsive generalized anxiety (GA). Method: consenting adult patients (n=32) with confirmed diagnosis of GA and comorbid ADHD participated in this open label study. All patients had significant comorbid anxiety symptoms (HAM-A >7), and failed to respond to 8 week trials of serotonin reuptake inhibitors (SSRIs) or Serotonin Norepinephrin reuptake inhibitors (SNRIs). All patients were treated with the mixed amphetamine salt adderall XR, as adjunctive to SSRIs or SNRIs and were followed for at least 12 weeks. The primary effectiveness measure was the Clinical Global Impression severity subscale (CGI-S). Other scales included the Hamilton anxiety scale (HAM-A), the adult ADHD self report scale (ASRS-v1.1) symptom checklist, and Sheehan's disability scale. Baseline measures prior to the treatment with adderall XR, were compared to those at 4, 8, and at 12 weeks of treatment. Results: There was significant resolution of symptoms of all effectiveness measures, including symptoms of anxiety, as shown by changes from baseline in HAM-A, ASRS-v1.1, and CGI at 8 weeks. Also there was significant reduction in the disability score at 12 weeks. Patients tolerated the adjunctive treatment and there were no significant cardiovascular changes at 12 weeks. Conclusion: Mixed mphetamine salts adderall XR, can be used in adult patients with ADHD, and co-morbid anxiety symptoms. Larger controlled studies are needed to examine the effectiveness of mixed amphetamine salts in patients with co-morbid anxiety symptoms.",Gabriel A.,2010.0,10.1016/j.jad.2010.02.070,0,0,
7587,Reliability and predictive validity of the Food Technology Neophobia Scale,"The recently developed Food Technology Neophobia Scale (FTNS) was further tested to assess scale reliability. On 2 occasions, 131 consumers responded to the FTNS, technologies descriptions and 'willingness to try' food technologies for 7 products. In the second session, they were offered foods to taste. 'Information seeking' was measured as a potential confounder of stability. The intra-class correlation was 0.86 and there was no difference between the FTNS scores (p > 0.05). Correlations with 'willingness to try' novel technologies were -0.39 to -0.58. The FTNS is confirmed as a reliable and predictive measure of responses to novel food technologies. Crown Copyright © 2009.",Evans G.; Kermarrec C.; Sable T.; Cox D.N.,2010.0,10.1016/j.appet.2009.11.014,0,0,
7588,The effect of duloxetine on cognition in patients with fibromyalgia,"Background: Cognitive difficulties are common complaints among patients with fibromyalgia and include perceived deficits in attention, concentration and memory. Cognitive testing was conducted in a subset of patients participating in a randomized, double-blind, placebo-controlled trial of duloxetine in fibromyalgia. Methods: At selected sites, patients eligible for the main study were asked if they would like to participate in the cognitive testing and provided separate informed consent for this testing. Patients were >=18 years of age, met ACR criteria for fibromyalgia, and >=4 score on the Brief Pain Inventory (BPI) 24-h average pain severity item. Patients who consented to cognitive testing were randomized to duloxetine (n=80) or placebo (n=76) for 24 weeks of double-blind treatment. The primary endpoint was at Week 12, after which placebo patients were switched to double-blind treatment with duloxetine. The results presented here are for the first 12 weeks. Verbal learning and memory was tested using the 15 word Verbal Learning and Recall Test (VLRT); speed of processing, visual attention and executive function were tested using the Symbol Digit Substitution Test (SDST), the Two Digit Cancellation Test (2DCT), and the Trailmaking Test (Trails A and B). Change from baseline to endpoint (last-observation-carriedforward) was analyzed by an analysis of covariance model, which included baseline, treatment, investigator and treatment-by-investigator interaction. Results: Most of the patients (N=156) were Caucasian (89%) women (92%), ranging in age from 21 to 88 years, 23% had comorbid major depressive disorder (MDD), and 8% had comorbid generalized anxiety disorder (GAD). Cognitive test scores at baseline were close to published scores1-4 for the general population indicating no impairment. Baseline-to-endpoint changes in cognitive scores did not differ significantly between treatment groups. Conclusion: Impairment in cognitive function in patients with fibromyalgia was not evident on VLRT, SDST, 2DCT, or Trails A and B. Overall, treatment with duloxetine did not have a positive or negative effect on cognition when measured with these tests.",Mease P.J.; Arnold L.; Wang F.; Ahl J.; Mohs R.; Gaynor P.; Wohlreich M.,2010.0,10.1002/art.27882,0,0,
7589,Is fear of pain related to placebo analgesia?,"Objective: Verbal information that a painkiller has been administered generates an expectation of pain relief which in turn decreases pain. This expectation-based pain reduction is termed placebo analgesia. We hypothesized that fear of pain would be related to higher stress and pain intensity and to reduced placebo analgesia. Methods: Sixty-three students (30 females) participated in a Two-Condition (placebo, natural history)×Five-Test (one pretest, four post-tests) within-subjects design. Heat pain was induced by a 30×30-mm contact thermode to the medial volar forearm. Each pain test lasted for 4 min at a temperature of 46°C. Stress, arousal, and pain intensity and pain unpleasantness were rated on 100-mm visual analogue scales. Results: Fear of pain was related to higher anticipatory stress and to higher stress and pain intensity during pain. Fear of pain was also related to reduced placebo analgesic responding. Conclusion: Fear of pain was positively related to stress both during pain and in the anticipation of pain, and negatively related to placebo analgesia. Previous research has indicated a role for increased stress in the nocebo response, and the present findings suggest that decreased stress may strengthen the placebo response. © 2010 Elsevier Inc.",Lyby P.S.; Aslaksen P.M.; Flaten M.A.,2010.0,10.1016/j.jpsychores.2009.10.009,0,0,
7590,Examining patient validity for clinical: A post-hoc analysis of placebo responders,"Background: It is well documented that placebo response rates for CNS studies conducted in the United States have gradually increased and that many clinical trials fail to achieve statistical significance. Numerous factors have been attributed to these failed clinical trials including misplaced site enrollment incentives, inflated entry scores, and the use of inappropriate or “professional” patients. Hence, it has been argued that some enrolled patients have not been truly valid treatment candidates for the study. Methods: We began a post-hoc analysis of unblinded data from 12 adult clinical trials conducted for different pharmaceutical sponsors between 2002 and 2009. All studies were conducted by CRIWW (Mount Laurel, New Jersey). Therapeutic areas included Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD), Bipolar Depression, and Schizophrenia. We examined the available data from all patients relative to demographic variables, baseline efficacy measures, psychopharmacologic treatment history, psychiatric history and co-morbid medical diagnoses, as well as their previous participation in clinical trials. Analysis of the data included general descriptive statistics and T-tests for equality of variance. Results: Data relative to the following questions will be presented: 1) Do any demographic variables predict placebo response? 2) Does a previous history of psychopharmacologic treatment affect placebo response? 3) Do co-morbid medical or psychiatric diagnoses affect placebo response? 4) Does previous participation in clinical trials affect placebo response? Discussion: In this preliminary analysis of a small sample of unblinded clinical trials, there was no relationship between treatment outcome in the current trial with patient demographic variables, co-morbid medical or psychiatric diagnoses, or previous participation in a clinical trial. Of note, it was difficult to obtain unblinded data from sponsors and fewer than 15% of studies conducted by CRIWW between 2002 and 2009 had available data for review. Prior to 2006, it was uncommon to collect systematic data about previous participation in clinical trials or detailed treatment response histories. CRIWW has beguna program to collect this data on all patients in all studies going forward. The analysis of unblinded treatment outcomes from CNS trials relative to patient demographic characteristics and past clinical trials experience can improve our understanding of patient selection variables and enhance the precision of patient selection for future trials.",Hassman H.A.; Haley S.,2010.0,10.1016/j.schres.2010.02.230,0,0,
7591,Telephone-delivered cognitive behavior therapy for chronic pain: Participant characteristics,"The purpose of this study was to examine baseline characteristics of 72 chronic pain patients enrolled in a clinical trial investigating the efficacy of telephonedelivered cognitive-behavior therapy (CBT) for chronic pain. Participants were all veterans, ages 55 and older, who were recruited from primary care clinics at a VA Medical Center and affiliated VA Community-based Outpatient Clinics. The sample consisted of 68 males and 4 females with a mean age of 67.7 years (SD=9.76). Over 75% of the participants were White and 14% were African-American. 37.5% were married, 29.2% were divorced, 19.4% were single, and 13.9% were widowed. 45.2% were unemployed and 41.1% were disabled/ unemployed. Mean duration of pain was 17.3 years (SD=15.43) and mean number of pain medications was 1.7 (SD=1.4). Their mean score on the Beck Depression Inventory (BDI) was 17.1 (SD=11.61). Age was inversely related to catastrophizing, use of pain medications, and perceived disability. Duration of pain was associated with more depressive symptoms (r = .24, p<.05) and perceived disability (r = .36, p<.002). Depression was positively associated with pain-related disability (r = .53, p<.001). After controlling for perceived disability, catastrophizing was positively associated with depression, (F = 6.89, df = 6,60, R squared = 0.41, p<.001). Participants with a history of PTSD (25% of the study sample) reported a greater level of disability (p<.05), less control over their pain (p<.01), and were more likely to acknowledge a relationship between stress and pain than participants with no history of PTSD (p<.001). Assessing changes in pain beliefs, cognitions, coping, and mood during the intervention will enhance our understanding of psychological factors mediating treatment outcome.",Carmody T.; Goldman A.; Reyes N.; Mozgai S.; Huggins J.; Solkowitz S.; Lee S.,2010.0,10.1016/j.jpain.2010.01.235,0,0,
7592,"Sodium oxybate improves function and quality of life in fibromyalgia - Results from a phase 3, randomized, controlled trial","Pain, fatigue, sleep disturbance, and psychological distress in fibromyalgia (FM) patients can greatly impair patient function and health related quality of life (HRQoL). The effects of sodium oxybate (SXB) on FM symptomatology were assessed in a 14 week double-blind, placebo-controlled trial using the Fibromyalgia Impact Questionnaire (FIQ) and the Short Form-36 Questionnaire (SF-36). SXB (4.5g/night or 6g/night) or placebo, dispensed in a 1:1:1 ratio, was given to 548 patients meeting the 1990 ACR classification criteria for FM. The primary outcome was the percent of patients reporting >=30% reduction in Pain VAS scores from baseline to Week14. Function and HRQoL were evaluated using the FIQ and SF-36. Other measures included: the percent of patients reporting >=30% reduction in total FIQ, FIQ subscales, SF-36 physical component summary (PCS), and SF-36 subscales from baseline to Week14. Both SXB doses resulted in significant improvements in both pain and function versus PBO (p<=0.002). Statistically significant improvements with both SXB doses were noted on FIQ subscales for “pain,” “stiffness,” “tired upon awakening,” “fatigue,” “difficulty with work,” and “did not feel good”. No significant differences were noted in “physical impairment,” “work missed,” “anxiety,” or “depression.” Both doses demonstrated improvements versus PBO in the SF-36 PCS (p<=0.003). Both doses demonstrated statistically significant improvements in SF-36 Role-Physical, Bodily Pain, and Vitality subscales; only SXB6g demonstrated significant improvement in Physical Functioning. The most common adverse events on SXB treatment, with incidences >=5% and twice the placebo rate, were headache, nausea, dizziness, vomiting, diarrhea, anxiety, and sinusitis. The most commonly reported AE was headache (23.1%, SXB6g). In summary, clinically relevant improvements in pain, stiffness, fatigue, overall function and well-being were seen in this Phase 3 study evaluating the safety and efficacy of SXB.",Jones K.; Bennett R.; Alvarez-Horine S.; Wang Y.; Guinta D.; Russell I.,2010.0,10.1016/j.jpain.2010.01.173,0,0,
7593,Opening Pandora's box: the potential benefit of the expanded FAST exam is partially confounded by the unknowns regarding the significance of the occult pneumothorax,"Introduction: Point of care (POC) ultrasound brings another powerful dimension to the physical examination of the critically ill. A contemporary challenge for all care providers, however, is how to best incorporate ultrasound into contemporary algorithms of care. When POC ultrasound corroborates pre-examination clinical suspicion, incorporation of the findings into decision-making is easier. When POC ultrasound generates new or unexpected findings, decision-making may be more difficult, especially with conditions that were previously not appreciated with older diagnostic technologies. Pneumothoraces (PTXs), previously seen only on computed tomography and not on supine chest radiographs known as occult pneumothoraces (OPTXs), which are now increasingly appreciated on POC ultrasound, are such an example. Methods: The relevant literature concerning POC ultrasound and PTXs was reviewed after an electronic search using PubMed supplemented by ongoing research by the Canadian Trauma Trials Collaborative of the Trauma Association of Canada. Results: OPTXs are frequently encountered in the critically injured who often require mechanical ventilation with positive pressure breathing (PPB). Standard recommendations for post-traumatic PTXs and the setting of PPB mandate chest drainage, recognizing a significant rate of complications related to this procedure itself. Whether these standard recommendations generated in response to obvious overt PTXs apply to these more subtle OPTXs is currently unknown, and evidence-based recommendations regarding appropriate therapy are impossible due to the lack of clinical studies. Conclusions: OPTXs are a condition that illustrates how incorporation of POC ultrasound findings brings further responsibilities to critically appraise the significance of these findings in terms of patient outcomes and overall care. Adequately powered and adequately followed-up clinical trials addressing the treatment are required. © 2010 Springer-Verlag.",Kirkpatrick A.W.; Gillman L.M.; Chun R.; Ball C.G.; Tiruta C.; Lall R.; Dunham M.,2010.0,10.1007/s13089-010-0024-5,0,0,
7594,Training Teachers to Deliver Mindfulness-Based Interventions: Learning from the UK Experience,"Several randomised controlled trials suggest that mindfulness-based approaches are helpful in preventing depressive relapse and recurrence, and the UK Government's National Institute for Health and Clinical Excellence has recommended these interventions for use in the National Health Service. There are good grounds to suggest that mindfulness-based approaches are also helpful with anxiety disorders and a range of chronic physical health problems, and there is much clinical and research interest in applying mindfulness approaches to other populations and problems such as people with personality disorders, substance abuse, and eating disorders. We review the UK context for developments in mindfulness-based approaches and set out criteria for mindfulness teacher competence and training steps, as well as some of the challenges and future directions that can be anticipated in ensuring that evidence-based mindfulness approaches are available in health care and other settings. © 2010 Springer Science+Business Media, LLC.",Crane R.S.; Kuyken W.; Hastings R.P.; Rothwell N.; Williams J.M.G.,2010.0,10.1007/s12671-010-0010-9,0,0,
7595,Effectiveness of a mindfulness-based cognitive therapy program as an adjunct to pharmacotherapy in patients with panic disorder,"Mindfulness-based cognitive therapy (MBCT) has been studied to treat patients with depressive or anxiety disorders. The aim of this study was to examine whether MBCT is effective as an adjunct to pharmacotherapy in the treatment of patients with panic disorder. Twenty-three patients with panic disorder were included in a MBCT program for a period of 8 weeks. The Hamilton Anxiety Rating Scale (HAM-A), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Anxiety Sensitivity Index-Revised (ASI-R), Albany Panic and Phobia Questionnaire (APPQ), and Panic Disorder Severity Scale (PDSS) were used to assess the patients during the MBCT program. Both HAM-A and PDSS scores were significantly decreased at the 2nd, 4th and 8th weeks compared to baseline in the patients with panic disorder (HAM-A, p < 0.01; PDSS, p < 0.01). Also, BAI, APPQ and ASI-R were improved significantly after MBCT program (BAI, p < 0.01; APPQ, p < 0.01; ASI-R, p < 0.01). In addition, all subscale scores of ASI-R decreased significantly. MBCT could be effective as an adjunct to pharmacotherapy in patients with panic disorder. However, randomized controlled trials are needed. © 2010 Elsevier Ltd. All rights reserved.",Kim B.; Lee S.-H.; Kim Y.W.; Choi T.K.; Yook K.; Suh S.Y.; Cho S.J.; Yook K.-H.,2010.0,10.1016/j.janxdis.2010.03.019,0,0,
7596,"CRH-stimulated cortisol release and food intake in healthy, non-obese adults","Background: There is considerable anecdotal and some scientific evidence that stress triggers eating behavior, but underlying physiological mechanisms remain uncertain. The hypothalamic-pituitary-adrenal (HPA) axis is a key mediator of physiological stress responses and may play a role in the link between stress and food intake. Cortisol responses to laboratory stressors predict consumption but it is unclear whether such responses mark a vulnerability to stress-related eating or whether cortisol directly stimulates eating in humans. Methods: We infused healthy adults with corticotropin-releasing hormone (CRH) at a dose that is subjectively undetectable but elicits a robust endogenous cortisol response, and measured subsequent intake of snack foods, allowing analysis of HPA reactivity effects on food intake without the complex psychological effects of a stress paradigm. Results: CRH elevated cortisol levels relative to placebo but did not impact subjective anxious distress. Subjects ate more following CRH than following placebo and peak cortisol response to CRH was strongly related to both caloric intake and total consumption. Conclusions: These data show that HPA axis reactivity to pharmacological stimulation predicts subsequent food intake and suggest that cortisol itself may directly stimulate food consumption in humans. Understanding the physiological mechanisms that underlie stress-related eating may prove useful in efforts to attack the public health crises created by obesity. © 2009 Elsevier Ltd.",George S.A.; Khan S.; Briggs H.; Abelson J.L.,2010.0,10.1016/j.psyneuen.2009.09.017,0,0,
7597,Screening is not enough: Theory-based practice change is needed to improve patient outcomes,"OBJECTIVES: Screening for distress and the use of standardized patient-reported outcomes (PRO) as part of routine clinical practice are proposed as a means to identify unmet needs, facilitate patientcentered communication, and monitor response to treatment. This assumption was examined in a recent systematic review as part of a psychosocial assessment guideline development initiative. We conducted a systematic review to examine the effectiveness of routine psychosocial assessment on psychosocial and supportive care outcomes. METHOD: A search of databases: CINAHL, EMBASE, HealthSTAR, MEDLINE, PsycINFO, Cochrane Database of Systematic Reviews, DARE, HTA (Health Technology Assessments), and CCTR (Cochrane Central Register of Controlled Trials) was conducted. Search terms: cancer, neoplasm, psychosocial aspects of illness, psychosocial factors, psychosocial support, psychological stress, symptom distress, psychosocial care, distress syndrome, psychosocial readjustment, assessment and screening. Eligible studies reviewed independently were: adult, cancer, English, systematic reviews, randomized trials, and cohort comparison studies. RESULTS: The search yielded 421 references: eight studies met inclusion criteria. A descriptive synthesis was completed since study heterogeneity precluded meta-analysis. Our findings were consistent with the IOM that there is little high quality evidence of the impact of routine PRO screening on patient outcomes. However, computerized screening is highly acceptable to patients. CONCLUSIONS: Screening alone does not automatically lead to improved outcomes unless followed by assessment and targeted interventions to address multi-causal determinants of distress. A theory-driven approach to practice change interventions is needed with explicit causal relationships specified between assessment, care processes and outcomes.",Howell D.; Currie S.; Mayo S.; Jones G.; Boyle M.; Hack T.; Green E.; Hoffman L.; Simpson J.; Collacutt V.; McLeod D.; Digout C.; Harrison M.,2010.0,10.1002/pon.1776,0,0,
7598,Formulation and evaluation of fast dispersible aceclofenac tablets: Effect of functionality of super disintegrants,"Aceclofenac, a non-steroidal anti-inflammatory drug, is used for posttraumatic pain and rheumatoid arthritis. Aceclofenac fast dispersible tablets have been prepared by direct compression method. Effect of superdisintegrants (such as crospovidone and sodium starch glycolate) on wetting time, disintegration time, drug content, in vitro release and stability parameters has been studied. Disintegration time and dissolution parameters were less in the tablets containing crospovidone than sodium starch glycolate. In vitro release studies were performed using USP XXII dissolution apparatus type II (Electro lab, Mumbai, India) paddle method in 900 ml of pH-7.4 at 75 rpm. Among all the formulation, F-2 shows 84.80% release at the end of 22 min. stability studies indicated that tablets containing superdisintegrants were sensitive to high humidity conditions. It is concluded that fast dispersible aceclofenac tablets could be prepared by direct compression method using superdisintegrants. The FT-IR study did not show any possibility of interaction between aceclofenac and superdisintegrants used in the fast dispersible tablets. © 2009, JGPT.",Malakar S.; Someshwara Rao B.; Ashok Kumar P.; Kulkarni S.V.,2010.0,,0,0,
7599,"Impact of a Mindfulness-Based Stress Reduction (MBSR) program on Posttraumatic Growth (PTG), spirituality, and mindfulness in cancer patients: A waitlist-controlled study","OBJECTIVES: Previous research suggests that Mindfulness Based Stress Reduction (MBSR), an 8-week group psychosocial intervention, may enhance spirituality and Posttraumatic Growth (PTG) in cancer patients. Enhanced spirituality and PTG may contribute to improvements in long term psychosocial adjustment. Mindfulness is posited as a key mechanism of action of MBSR however this hypothesis has not been adequately tested. This aim of this study is to assess the impact of MBSR on PTG, spirituality and mindfulness in cancer patients. METHOD: A longitudinal waitlist-controlled study was conducted to test the hypothesis that increased mindfulness would mediate the impact of MBSR on spirituality and PTG. One hundred and six patients (mostly female) with a diagnosis of cancer (mostly breast) were assessed pre-, mid-, and post-MBSR intervention (n = 62) or 8-week waiting period (n = 44). Five key aspects of mindfulness were measured using the Five Facet Mindfulness Questionnaire (FFMQ) subscales. RESULTS: Results indicated that MBSR participation compared to the waitlist condition was associated with increased spirituality (F = 10.67, p<0.001) and mindfulness (FFMQ-Observe: F = 15.70, p<0.001; FFMQ-Describe: F = 8.51, p<0.001; FFMQ-Act: F = 4.78, p<0.05; FFMQ-Nonjudge: F = 12.86, p<0.05; FFMQ-Nonreact: F = 16.87, p = 0.001) but not PTG. Changes in four measures of mindfulness partially mediated changes in spirituality (FFMQ-Observe: t = 4.44, p<0.001; FFMQ-Describe: t = 3.47, p<0.001; FFMQ-Act: t = 2.08, p<0.05, FFMQ-Nonreact: t = 2.59, p<0.05). CONCLUSIONS: This is the first controlled study to demonstrate an association between MBSR participation and enhanced spirituality in cancer patients. Findings suggest that spirituality may be enhanced through learning to maintain awareness of moment-to-moment experience in an accepting manner.",Lawlor-Savage L.; Labelle L.; Campbell T.; Carlson L.,2010.0,10.1002/pon.1776,0,0,
7600,Effects of intrathecal ketorolac on human experimental pain,"BACKGROUND: Nonsteroidal antiinflammatory drugs, the most commonly used analgesics, reduce pain not only by inhibiting cyclooxygenase at peripheral sites of inflammation but also by potentially inhibiting cyclooxygenase in the central nervous system, especially the spinal cord. Animal studies suggest that products of cyclooxygenase in the spinal cord do not alter pain responses to acute noxious stimuli but reduce pain and sensitization after peripheral inflammation. We used a spinal injection of small doses of the cyclooxygenase inhibitor ketorolac to survey the role of spinal cyclooxygenase in human experimental pain and hypersensitivity states. METHODS: After regulatory agency approval and informed consent, we examined the effect of 2.0 mg intrathecal ketorolac in 41 healthy volunteers to acute noxious thermal stimuli in normal skin and to mechanical stimuli in skin sensitized by topical capsaicin or ultraviolet burn. We also examined the effect of intravenous ketorolac. RESULTS: Intrathecal ketorolac reduced hypersensitivity when it was induced by a combination of ultraviolet burn plus intermittent heat and, according to one of the two analytical strategies, when it was induced by ultraviolet burn alone. CONCLUSIONS: These data suggest a more limited role for spinal cord cyclooxygenase in human pain states than predicted by studies in animals. Copyright © 2010, the American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins.",Eisenach J.C.; Curry R.; Tong C.; Houle T.T.; Yaksh T.L.,2010.0,10.1097/ALN.0b013e3181d94d8b,0,0,
7601,"Evaluation of psychosocial profiles in patients with fecal incontinence, constipation, and mixed symptoms; a controlled study","Background: Although previous studies have reported altered psychosocial profiles in patients with incontinence alone or constipation alone, there has been no comparative assessment of these features between patients with common defecation disorders, and also among subjects with mixed symptoms. Also, whether some features are more affected in one disease condition is unknown. Aims: To prospectively study the psychosocial profiles in subjects with fecal incontinence (>1 episode/week), chronic constipation (Rome III), and a mixed group - incontinence and constipation and to compare them between the three groups and with healthy controls. Methods: We surveyed 3 groups of patients and controls by asking them to complete a standard SCL90R questionnaire, a one week stool diary, and disease specific questionnaires. The impact on the psychosocial profiles was analyzed for 9 primary domains and 2 global indices. The data were compared using ANOVA, Dunnett's and Tukey Kramer adjusted probabilities. Results: We enrolled 522 subjects, of whom 156 had fecal incontinence (m/f=19/137, mean age=62), 286 had constipation (m/f=31/255 mean age=43), 26 had mixed symptoms (m/f=4/22, mean age=51), and 54 healthy controls (m/ f=12/42, mean age=35). All three groups showed significantly higher scores for most domains including global measures such as PSDI and GSI [Table, mean ± SEM∗= p<0.04 vs. controls] compared to controls. The mixed group showed more severe dysfunction for IS, DEP, ANX, HOS, PSY dimensions ($=p<0.05) compared to incontinent group and for DEP, IS, HOS dimensions (#=p≤0.03) compared to constipation. Subjects with increasing BMI had higher scores for SOM (p=0.046) and PAR (p=0.022) dimensions. Conclusions: We found significant and severe impairment of psychosocial profiles in fecal incontinence, chronic constipation, and those with mixed symptoms. Somatization, OCD, depression and anxiety were the predominant features. Subjects with Mixed disorder had greater psychological dysfunction as revealed by GSI than those with constipation or incontinence alone (Table presented).",Akhauri B.; Phillips C.; Day P.; Attaluri A.; Valestin J.; Brown C.K.; Rao S.S.,2010.0,,0,0,
7602,Biofeedback treatment for the prevention of vasovagal syncope,"Introduction: Biofeedback treatment, a behavioural training program that enables an individual to gain voluntary control over an autonomic bodily function, using feedback provided by a monitoring device, has been proposed for the treatment of patients (pts) with blood-injury phobia. The aim of this prospective, randomised, placebo-controlled study was to evaluate the efficacy of biofeedback treatment in pts with recurrent vasovagal syncope (VVS). Methods: We studied 20 consecutive pts (mean age 34±10 yrs, 65% females) with recurrent VVS (median 5.5 syncopal episodes), positive head-up tilt testing and no other comorbidities. Pts were randomised to biofeedback treatment (biofeedback-assisted heart rate stabilization using BIOFEEDBACK 2000 X-PERT version 1.0 - SCHUHFRIED GmbH) or to placebo (educational counselling) with one visit a week, for 5 weeks, and were followed up for at least 1 year. Results: Out of the 20 pts enrolled, ten pts were randomized in each arm of the study. No significant differences in baseline clinical characteristics and syncopal frequency were found between the two groups. The median follow-up was 13±1 months. The mean number of syncope during 12 months follow up reduced significantly in active group respect placebo group (0.1±0.31 in active group vs 0.5±0.52; p= 0.0008); no significant reduction in percentage of patient with at least one syncopal recurrence in active group vs placebo group, although there is a positive trend (40% vs 60%, p= ns). Conclusions: The results of this preliminary study suggest that the biofeedback treatment might be proposed as a nonpharmacological therapeutical approach in very symptomatic recurrent vasovagal fainters.",Madalosso M.; Giada F.; Di Natale A.; Buodo G.; Palomba D.; Raviele A.,2010.0,10.1016/j.hrthm.2010.03.031,0,0,
7603,Peer counseling improves quality of life for women with breast cancer: A randomized trial,"OBJECTIVES: In a community/research collaboration between WomenCARE in Santa Cruz and Stanford, we evaluated whether matching a woman newly diagnosed with breast cancer for 3 to 6 months after diagnosis with a trained (and supervised) volunteer who is herself a breast cancer survivor improves quality of life over the first year post-diagnosis. METHOD: We trained 36 peer counselors (Navigators) in training sessions emphasizing active listening skills and access to resources in the community for women with breast cancer. In addition 104 newly diagnosed women (within 2 months of dx) were randomized (52 receiving a match with a Navigator). We created slopes over baseline, and 3, 6, and 12 mo assessments and used multiple regressions to test whether group assignment affected outcome. RESULTS: We found women receiving a Navigator significantly increased on marital satisfaction (p = 0.02), and breast-cancer-specific quality of life (p = 0.01) while those in the control group decreased. Women receiving a Navigator who were highly distressed at study entry also experienced a significantly greater reduction in anxiety (p = 0.03), distress (p = 0.04). However, those not matched with a Navigator who were low on Post-Traumatic Growth at baseline significantly increased to a greater extent than did those matched. CONCLUSIONS: This first randomized clinical trial of an extensive peer counseling program demonstrates that being matched with a Peer Navigator appears to mitigate the distress newly diagnosed women often experience as they are undergoing treatment for breast cancer. It is also clear that not having a peer counselor may stimulate women to perhaps put more thought and energy into self-motivated growth post-diagnosis.",Giese-Davis J.; Bliss-Isberg C.; Wittenberg L.; Yutsis M.; Star P.; Cordova M.; Houston D.; Spiegel D.,2010.0,10.1002/pon.1776,0,0,
7604,Incidence of deep vein thrombosis in immobilised ALS patients,"Introduction: Amyotrophic Lateral Sclerosis (ALS) leads to progressive, high-grade pareses of the extremities and, as a rule, results in immobilisation. Immobilisation in the context of traumas or surgical interventions coincides with a higher incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE). In up to 20% of patients with ALS, sudden unexpected death (SUD) occurs. One possible cause of SUD is DVT in combination with PE. In ALS, the incidence of DVT as a risk factor for PE has as yet been widely unknown. Objective: To assess deep vein thrombosis in immobilised ALS patients by using duplex sonographic examination. Method: We conducted a prospective controlled study on duplex sonographic examinations of DVT in the lower extremities. Inclusive criteria were high-grade pareses of the legs (ALS Functional Scale - ALS-FRSr scoring <2 on the subscore for gait disturbances). Results: The duplex sonography revealed a complete and organised DVT in 3 out of 76 patients (3.9%). Discussion: The present study represents the first prospective, controlled study on the incidence of DVT in ALS. The DVT incidence of 3.9% ascertained herein is lower than that detected by other authors in a retrospective study in which the incidence of DVT was 5.7%. The mere presence of DVT cannot sufficiently substantiate the high incidence of SUD associated with ALS. Other underlying causes, including autonomic failure, must be considered as central events first and foremost. Our study demonstrates that the incidence of DVT in patients with ALS is higher compared with the normal population but lower compared with patients displaying posttraumatic or post-interventional symptoms. The low incidence of DVT in ALS could be due to the protracted development of lower extremities pareses and an adaptation of the coagulation system and the venous system. Therefore, it seems that a prophylactic administration of anticoagulation drugs to immobilised ALS patients is not required.",Borisow N.; Linke P.; Holm T.; Maier A.; Dullinger J.; Bahrke R.; Meyer T.,2010.0,10.3109/17482968.2010.519506,0,0,
7605,Is silexan an anxiolytic drug?,"Introduction: Preparations from lavender have been known for their relaxing and mood alleviating effects for centuries. Silexan1 is a novel defined preparation from Lavandula angustifolia for oral use that is being investigated for use as an anxiolytic drug. Methods: We review the results of 4 clinical trials investigating the efficacy of silexan in anxiety disorders and related conditions. All trials assessed the participants' anxiety levels using the Hamilton Anxiety Scale (HAMA) or the State Trait Anxiety Inventory (STAI) as well as measures of co-morbidity and clinical global impressions. Results: Across all trials 283 patients were exposed to silexan 80 mg/day, 37 were treated with lorazepam 0.5 mg/day and 193 received placebo for 6 or 10 weeks. Average within-group HAMA total scores at baseline ranged between 24.7 and 27.1 points. Patients treated with silexan showed average HAMA total score decreases of between 10.4 ± 7.1 and 12.0 ± 7.2 points at week 6 and of 9.5 ± 9.1 and 16.0 ± 8.3 points at week 10. In subthreshold generalized anxiety disorder (GAD) silexan was superior to placebo from treatment week 2 on, with a mean value difference of at least 4 points (lower bound of 95% confidence interval (CI)) after 10 weeks. In threshold GAD silexan and lorazepam showed comparable HAMA total score reductions (90% CI for mean value difference: -2.3; 2.8 points). The decrease of anxiety levels was accompanied by a reduction of restlessness and co-morbidity, and by improvements in general well-being. Conclusions: The results support the efficacy of silexan in subsyndromal anxiety disorder and in GAD. The novel drug may offer interesting perspectives as an anxiolytic particularly in subthreshold GAD.",Kasper S.; Klement S.,2010.0,10.3109/13651501.2010.527734,0,0,
7606,The efficacy of agomelatine in previously treated depressed patients,"Background: Agomelatine is a melatonergic (MT1/MT2) receptor agonist and a 5HT2C receptor antagonist whose antidepressant efficacy and safety as first-line treatment have been shown in several clinical studies either versus placebo or versus comparators [1]. Aim of the analysis: To evaluate the antidepressant efficacy of agomelatine in previously treated patients (defined as patients who had been treated with antidepressants at least once during the year before the inclusion) versus the general study population. Methods: Analysis of two 6-week randomized controlled trials were performed: study 1 [2], placebo-controlled and study 2, a randomized, double blind comparison with sertraline [3]. Results: 40% of the 235 enrolled patients in study 1 (n = 94), and 58% of the 307 enrolled patients in study 2 (n = 177) had been previously treated with SSRIs or other classes of antidepressants. Baseline characteristics of both the full analysis set (FAS) as well as the subgroup of previously treated patients (subFAS) were comparable in both studies. In study 1, after 6 weeks, the magnitude of the incremental HAM-D response rate in the subFAS was 31% (46.3% versus 15% an uncommon low placebo responder rate, p = 0.001), and in the FAS 19% (54.3% versus 35.3%, p = 0.003). The delta between treatment groups on HAMD score in the subFAS-population was 4.43 (p = 0.005) and 3.44 (p < 0.001) in the FAS. Response rates according to the CGI-I score were 55.6% in the agomelatine-group and 27.5% in the placebo group in the subFAS population. In study 2, after six weeks in the subFAS the overall HAM-D response rate with agomelatine was 67.5%, and 55.2% (p=0.096) with sertraline. The delta between treatment groups in the HAMD score was of 1.63 (p = 0.124) (In the FAS population the delta was 1.68, p = 0.03) in favour of agomelatine. Response rates in the subFAS population according to the CGI-I score were 80% in the agomelatinegroup and 75% in the sertraline-group. Agomelatine's tolerability was similar to that of placebo and better than that of sertraline. Conclusion: The data of the subset of previously treated depressed patients, which can be considered to be more difficult to treat, indicates that agomelatine is at least as effective as it is in the treatment of the general study population (FAS). Overall, due to its different mode of action and its favourable side effect profile, agomelatine - with proven benefits for first-line treatment - is an effective candidate for major depressive disorders who demonstrate less than adequate response to treatment.",Kasper S.; Hajak G.,2010.0,10.3109/13651501.2010.527734,0,0,
7607,How well do randomized controlled trial data generalize to real world clinical practice settings? Comparison of two generalized anxiety disorder (GAD) studies,"Background/Aims: It is uncertain how well results from placebo-controlled trials (RCTs) generalize to real world clinical practice settings. The objective of this post hoc analysis is to compare efficacy and safety results from two GAD studies: a placebo-controlled RCT and a study conducted in the clinical practice setting. Methods: In the clinical practice study (CPS) outpatients with GAD (N = 578) were treated with 4 weeks of pregabalin (PGB) in the dosing range of 150-600 mg/day. In the double-blind, placebo-controlled RCT, outpatients with GAD were randomized to 8-weeks of PGB (300-600 mg/d), or placebo (PBO; only the first 4 weeks are included in the current analysis). Efficacy was evaluated using the Hospital Anxiety and Depression Scale-Anxiety (HADS-A), a visual analogue anxiety scale (VAS-Anxiety), and the Medical Outcomes Study Sleep Scale (MOS-Sleep). Results: The CPS and RCT studies had similar anxiety severity at baseline (HADS-A, 15.4 vs. 14.0). In the RCT, treatment with pregabalin resulted in significantly greater change versus placebo by Week 4 in the HADS-A (-5.2 vs. -3.5; P < 0.01), the VAS-Anxiety (-24.0 vs. -13.3; P < 0.05), in the MOS-Sleep scale (-19.0 vs. -9.5; P<0.01), and in the HADS-D (-2.7 vs. -1.4; P < 0.05). The magnitude of Week 4 improvement on pregabalin in the CPS study versus the RCT study were comparable or larger on the HADS-A (-5.9), the VAS-Anxiety (-36.0), MOS-Sleep (-22.7) and the HADS-D (-5.1). However, dosing in the CPS was markedly less aggressive, with only 12.2% of patients taking a dose greater than 300 mg. In contrast, 66.1% of patients in the RCT took a maximum daily dose of either 450 mg or 600 mg. 1.2% of patients discontinued the CPS due to an adverse event compared to 12.3% in the RCT. Conclusions: These results suggest that in clinical practice patients with GAD may achieve comparable efficacy and superior tolerability on lower doses of PGB than tested in RCTs, despite having similar anxiety severity at baseline. Funded by Pfizer Inc.",Kasper S.; Brasser M.; Schweizer E.; Donevan S.; Lyndon G.; Prieto R.,2010.0,10.3109/13651501.2010.527734,0,0,
7608,"General hospital staff worries, perceived sufficiency of information and associated psychological distress during the A/H1N1 influenza pandemic","Background: Health care workers (HCWs) presented frequent concerns regarding their health and their families' health and high levels of psychological distress during previous disease outbreaks, such as the SARS outbreak, which was associated with social isolation and intentional absenteeism. We aimed to assess HCWs concerns and anxiety, perceived sufficiency of information, and intended behavior during the recent A/H1N1 influenza pandemic and their associations with psychological distress.Method: Between September 1st and 30th, 2009, 469 health-care workers (HCWs) of a tertiary teaching hospital completed a 20-item questionnaire regarding concerns and worries about the new A/H1N1 influenza pandemic, along with Cassileth's Information Styles Questionnaire (part-I) and the GHQ-28.Results: More than half of the present study's HCWs (56.7%) reported they were worried about the A/H1N1 influenza pandemic, their degree of anxiety being moderately high (median 6/9). The most frequent concern was infection of family and friends and the health consequences of the disease (54.9%). The perceived risk of being infected was considered moderately high (median 6/9). Few HCWs (6.6%) had restricted their social contacts and fewer (3.8%) felt isolated by their family members and friends because of their hospital work, while a low percentage (4.3%) indented to take a leave to avoid infection. However, worry and degree of worry were significantly associated with intended absenteeism (p < 0.0005), restriction of social contacts (p < 0.0005), and psychological distress (p = 0.036). Perceived sufficiency of information about several aspects of the A/H1N1 influenza was moderately high, and the overall information about the A/H1N1 influenza was considered clear (median 7.4/9). Also, perceived sufficiency of information for the prognosis of the infection was significantly independently associated with the degree of worry about the pandemic (p = 0.008).Conclusions: A significant proportion of HCWs experienced moderately high anxiety about the pandemic, and their degree of worry was an independent correlate of psychological distress. Since perceived sufficiency of information about the A/H1N1 influenza prognosis was associated with reduced degree of worry, hospital managers and consultation-liaison psychiatry services should try to provide for HCWs' need for information, in order to offer favourable working conditions in times of extreme distress, such as the current and future pandemics. © 2010 Goulia et al; licensee BioMed Central Ltd.",Goulia P.; Mantas C.; Dimitroula D.; Mantis D.; Hyphantis T.,2010.0,10.1186/1471-2334-10-322,0,0,
7609,Current concerns in involuntary and voluntary autobiographical memories,"Involuntary autobiographical memories are conscious memories of personal events that come to mind with no preceding attempts at retrieval. It is often assumed that such memories are closely related to current concerns - i.e., uncompleted personal goals. Here we examined involuntary versus voluntary (deliberately retrieved) autobiographical memories in relation to earlier registered current concerns measured by the Personal Concern Inventory (PCI; Cox & Klinger, 2000). We found no differences between involuntary and voluntary memories with regard to frequency or characteristics of current concern-related contents. However, memories related to current concerns were rated as more central to the person's identity, life story and expectations for the future than non-concern-related memories, irrespective of mode of recall. Depression and PTSD symptoms correlated positively with the proportion of current concern-related involuntary and voluntary memories. The findings support the view that involuntary and voluntary remembering is subject to similar motivational constraints. © 2010 Elsevier Inc.",Johannessen K.B.; Berntsen D.,2010.0,10.1016/j.concog.2010.01.009,0,0,
7610,Evaluation of non-invasive ventilation in management of acute severe asthma,"Objectives To study the role of non-invasive positive pressure ventilation (NIPPV) in management of acute severe asthma. Study design Open randomised controlled trial. Methods 50 patients of acute severe asthma having asthma for at least 1 year duration with exacerbation of less than 7 days duration, FEV1 <50% of predicted, respiratory rate of >25 breaths/min and pulse rate >110/min after half hour of 5 mg nebulised salbutamol were included in the study over 1 year. Patients with known COPD, history of smoking >10 years, HR >140/min, systolic BP <90 mm Hg, facial deformity, pulmonary oedema, pneumonia and pregnancy were excluded. Patients were divided into two groups A and B. All patients received nebulisation with salbutamol 5 mg and ipratropium bromide 0.5 mg and hydrocortisone 100 mg IV at zero hour and later 5 mg salbutamol with small volume oxygen driven nebuliser @ 6 l/min at 1, 2, 3, 5 h of the study. Group B patients were given NIV support in addition to medical therapy for 6 h. All patients received O2 at 6e8 l/min for 6 h. NIV and medical treatment were stopped after 6 h. Spirometry, ABG, respiratory rate (RR), accessory muscles of respiration (AMR) and Borg dyspnoea score were assessed at 0, 1, 3, 6 and 7th hour of study. Results: Out of 308 patients 246 were excluded because of nonfulfilment of inclusion criteria. Eight patients refused consent, three had pneumonia and claustrophobia to mask respectively. One patient deteriorated in Group A and was withdrawn. The use of accessory muscles of respiration (AMR) reduced significantly in group B at 3, 6 and 7 h (p<0.01), BORG dyspnoea score improved significantly (p<0.01) in group B after 1 h. There was no difference between two groups in terms of improvement in RR, HR, FEV1 and ABG. In group B, the mean IPAP and EPAP used was 14.3260.945 and 7.1660.472 cm of water, respectively. Conclusion: The use of NIPPV in patients with acute severe asthma though found to be useful in terms of faster resolution of dyspnoea and decrease in use of AMR but did not improve pulmonary functions significantly.",Chaudhry D.; Indora M.; Sangwan V.; Sehgal I.P.S.; Chaudhry A.,2010.0,10.1136/thx.2010.150938.19,0,0,
7611,Believe in yourself: Manipulating beliefs about memory causes checking,"One of the most common compulsions in obsessive-compulsive disorder (OCD) is repeated checking. Although individuals often report that they check to become more certain, checking has been shown to have the opposite effect - increased checking causes increased uncertainty. However, checking may also be thought of as beginning because of memory uncertainty. Beliefs about responsibility, over-estimation of threat, intolerance of uncertainty, perfectionism, and importance of and control of thoughts are already known to affect different aspects of OCD symptomatology. Beliefs about memory, however, are not currently considered to influence compulsive behaviour. In the current study, beliefs about memory were manipulated to test whether or not they affected urges to check. Ninety-one undergraduate participants received (positive or negative) false feedback about their performance on aspects of a standardized memory test, and then completed two additional memory tasks. Their urges to check following these tasks were assessed. Consistent with our hypotheses, individuals in the low memory confidence condition had greater urges to check following the memory tasks than those in the high memory confidence condition, demonstrating that manipulations of beliefs about memory can influence checking. Results and implications are discussed in terms of cognitive-behavioural models of and treatments for OCD. © 2010 Elsevier Ltd.",Alcolado G.M.; Radomsky A.S.,2011.0,10.1016/j.brat.2010.10.001,0,0,
7612,Assessed and distressed: White-coat effects on clinical balance performance,"Objectives: While balance in young and older adults is known to change with the threat of standing on elevated surfaces, the potential for social anxiety to influence emotional states and balance performance during a clinical assessment is currently unknown. Methods: Nineteen young and 19 older healthy female adults volunteered for the study. The effects of age and clinical assessment on balance performance were examined using a 2×2 between- and within-subjects factorial design. Balance performance measures were derived from forceplate recordings of three different postural tasks. Psychological measures included fear of negative evaluation, state anxiety, and fear related to the completed balance tasks. Results: There was a significant increase in state anxiety and fear when participants performed balance tasks while being assessed by an evaluator. Compared to the control condition, both age groups leaned significantly further forward during the functional reach task when being assessed. While being assessed, older adults had significantly larger amplitudes and frequencies of center of pressure (COP) displacement during two-legged stance with eyes closed (EC) and significantly less stance time during one-legged standing compared to the control condition. In contrast, balance performance in young adults during one-legged or two-legged stance tasks was unchanged by clinical assessment. Conclusions: Social anxiety associated with the clinical assessment of balance can have a negative influence on both emotional states and balance control. As a result, clinicians need to recognize and account or control for potential social anxiety effects on clinical balance performance in young and older adults in particular. © 2011 Elsevier Inc.",Geh C.L.M.; Beauchamp M.R.; Crocker P.R.E.; Carpenter M.G.,2011.0,10.1016/j.jpsychores.2010.09.008,0,0,
7613,Hematopoietic stem cell transplant: The young adult experience,"PURPOSE: Hematopoietic stem cell transplant (HSCT) is an intense, complex, uncertain and unique experience for patients, and has the potential to cause prolonged physical and psychological distress. Because of the diagnoses treated by HSCT, the age range is lower than most cancers and can include young adults. The purpose of this study is to describe the first year following transplantation for young adults (YA) using a developmental framework to highlight the unique experiences of this group. METHODS: This mixed-methods longitudinal clinical trial tested the effects of a standardized teaching intervention on quality of life outcomes for allogeneic HSCT patients at discharge, 3, 6, and 12 months post hos- pitalization. The sample consisted of 24 YA (10 from the experimental group and 14 from the control group) a subset of 282 allogeneic HSCT patients recruited from one large medical center on the Western Coast of the US. RESULTS: The mean age of this cohort of patients at transplant was 21.5, 11 were male and 13 were female; 13 were Hispanic. Most had a diagnosis of acute leukemia (83.5%) and had a sibling transplant (62.5%). Fifteen were in remission when transplanted. Readmission data and reasons for readmissions included infections, relapse, failure to thrive, and other complications. Content analysis was used to classify patient comments about the experience, using the four dimensions of quality of life as major categories (physical well being and functioning, psychological well being, social well being, and spiritual well being). Themes identified included sexuality/fertility, fatigue, depression/poor coping habits, adherence issues, use of technology, dependency issues, changes in roles/relationships, issues with school/education, financial issues, family problems/issues, fear of the future, uncertainty, death and life appreciation. Two cases studies will be presented to illustrate two of Erickson's Stages of Development: Identity vs. Role Confusion and Intimacy vs. Isolation. CONCLUSIONS: This study presents qualitative data on a unique young adult HSCT population. RESEARCH IMPLICATIONS: Implications: This descriptive research can provide the foundation for developing and testing interventions to support this vulnerable population. CLINICAL IMPLICATIONS: Clinical approaches may include supporting peer to peer connections, recognition of independence/dependency struggles, strategies based on developmental stage and awareness of the uniqueness of the YA population. FUNDING: Acknowledgement: NCI R01-CA107446, Structured Nursing Intervention Protocol for HCT Patients.",Cooke L.; Grant M.; Chung C.,2011.0,10.1111/j.1755-148X.2011.01915.x,0,0,
7614,"Agomelatine in the treatment of obsesive-compulsive-disorder: Potential for clinical effectiveness: An 4-week, multicenter, randomized, placebo-controlled trial","Objective: To evaluate the efficacy, safety, and tolerability of fixed-dose agomelatine 25 and 50 mg/d in the treatment of outpatients with obsesive-compulsive disorder (OCD) compared to placebo. Method: In this 8-week, multicenter, double-blind, parallel-group trial, patients with DSM-IVdefined OCD were randomly assigned (1:1:1) to receive a once-daily dose of agomelatine 25 mg, agomelatine 50 mg, or placebo. The primary efficacy measure was the change from baseline to week 8 in the clinician-rated 17-item Hamilton Depression Rating Scale (HDRS(17)); other efficacy measures were The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Clinical Global Impression scale. The study was conducted between December 2009 and January 2010. Results: Agomelatine 25 mg/d was more efficacious based on the HDRS(17) total score (P = .01) compared to placebo throughout the treatment period, whereas for agomelatine 50 mg/d, statistically significant reduction in HDRS(17) total score could be observed from weeks 2 to 6 but not at week 8 (P = .144). A higher proportion of patients receiving agomelatine 25 mg/d showed clinical response (P = .013), clinical remission (P = .07), and improvement according to the Clinical Global Impressions-Improvement scale (P = .065) compared to those receiving placebo. No statistically significant difference between patients receiving agomelatine 50 mg/d compared to placebo on clinical response. Both agomelatine doses were safe and well tolerated, although clinically notable aminotransferase elevations were observed transiently in the agomelatine 50 mg/d group. Conclusions: Agomelatine 50 mg/d provided evidence for its antidepressant efficacy until week 6 and was also safe and well tolerated.",Marqués Cabezas P.; Cabus Piñol G.; Coullaut-Valera García J.; Dominguez Martín C.; Villegas Martinez J.L.,2011.0,10.1016/S0924-9338(11)72679-7,0,0,
7615,Endoscopic treatment of GI tract post-surgical fistulas using an Over-The-Scope-Clip (OTSC) devices: Experience of two tertiary referral endoscopic centers,"Background and aim: GI perforations and post-surgical fistulas are dreaded complications that dramatically increase morbidity and mortality. A novel device namedOver The Scope Clip (OTSC) can be potentially useful for sealing the visceral wall. Aim of this study was to evaluate the clinical impact of OTSC on acute and chronic GI tract fistula management. Material and methods: From April 2008 to October 2010, 25 consecutive pts (13F/12M, mean age 64 yrs, range 31-86 yrs) with visceral perforations underwent OTSC application. Mean diameter of perforation was 10 mm (range 5-25 mm). OTSC of 11 and 12 mm were used in all cases according to diameter of the wall defect. All procedures were performed under conscious sedation. Results: Indications for treatment were as follows: 14 dehiscences of intraperitoneal or extraperitoneal colo-rectal anastomosis, 3 post-operative or post-traumatic recto-vaginal fistulas, 2 dehiscences of a gastro-jejunal anastomosis, 1 post-operative recto-urethral fistula, 1 duodenal perforation after failure of surgical treatment, 1 dehiscence after sleeve gastrectomy, 1 dehiscence of a gastro-jejunal anastomosis, 1 jejunal perforation secondary to a decubitus of a surgical drainage, 1 cecal post-traumatic perforation. In one case two OTSC were employed due to the large diameter on the orifice (25 mm). In a further case a second OTSC was applied 14 days after positioning of the first one, for persistence of a small orifice (8mm). In 4 patients OTSC failed to heal the defect, in other 3 patients needed to add self expandible metallic stent to obtain the complete healing of the leak. No OTSC-related complications occurred. Conclusions: Endoscopic closure of perforation and post surgical fistula with OTSC is a simple and safer technique. Controlled trials are needed to assess if the OTSC should be proposed as an alternative to surgery.",Manta R.; Arezzo A.; Bertani H.; Verra M.; Manno M.; Caruso A.; Pigò F.; Barbera C.; Mirante V.G.; Cravero F.; Morino M.; Conigliaro R.,2011.0,10.1016/S1590-8658(11)60347-2,0,0,
7616,Taxing working memory reduces vividness and emotional intensity of images about the Queen's Day tragedy,"Eye movements during exposure to distressing mental images reduce their vividness and emotional intensity, which may be due to both tasks competing for working memory (WM) resources. WM theory predicts an inverted U-shaped relationship between degree of taxing and beneficial effects: greater taxing of WM will more greatly reduce vividness/emotionality, but extremely taxing tasks prevent holding the image in mind, thereby reducing benefits. This study examined whether mental arithmetic (subtraction) tasks during visual imagery reduce image vividness/emotionality ratings, and taxing WM and reduced vividness/emotionality show the predicted quadratic relationship. A non-clinical sample retrieved a distressing image of the Queen's Day tragedy (which occurred 1-3 months earlier in the Netherlands), and rated it for vividness and emotionality. Participants were assigned to one of four conditions: exposure alone or exposure with concurrent 'simple' subtraction, 'intermediate' subtraction, or 'complex' subtraction. Afterwards, vividness and emotionality were rated again. A reaction time task showed that the subtraction tasks increasingly taxed WM. Consistent with WM theory, exposure with subtraction reduced image vividness and emotionality compared to exposure alone. The expected inverse U-curve relationship was found for emotionality, but not for vividness: simple or intermediate subtraction had more beneficial effects than no dual-task or complex subtraction. Clinical implications are discussed. © 2010 Elsevier Ltd. All rights reserved.",Engelhard I.M.; Van Den Hout M.A.; Smeets M.A.M.,2011.0,10.1016/j.jbtep.2010.09.004,0,0,
7617,Internet-based psychotherapeutic interventions for social phobia: How much and what kind of therapeutic contact is needed?,"Internet-based self-help for social phobia with minimal therapist support via email have shown efficacy in several controlled trials by independent research teams. The role and necessity of therapist guidance is, however, still largely unclear. The present study compared the benefits of a 10-week web-based unguided self-help treatment for social phobia with the same intervention complemented with minimal, although weekly, therapist support via email. Further, a third treatment arm was included, in which the level of support was flexibly stepped up, from no support to email or telephone contact, on demand of the participants. Eighty-one individuals meeting diagnostic criteria for social phobia were randomly assigned to one of the three conditions. Results showed significant symptom reductions in all three treatment groups with large effect sizes for primary social phobia measures (Cohen's d=1.47) and for secondary outcome measures (d=1.16). No substantial and significant between-groups effects were found on any of the measures (Cohen's d=.00-.36). Moreover, no difference between the three conditions was found regarding diagnosis-free status, clinically significant change, dropout rates, or adherence measures such as sessions or exercises completed.",Berger T.; Caspar F.,2011.0,10.1016/S0924-9338(11)73910-4,0,0,
7618,War psychic disorders treatment: Current perspectives,"Background: The confrontation with extreme events, such as a death threat, may release acute psychiatric troubles named “acute stress disorders” in the DSMIV-TR. Current operational context in Afghanistan is unpredictable and leads military surgeons to support soldiers facing major psychic suffering. Clinical practice confronts them with the difficulty to decrease the symptoms often strong, especially sleep disorders. Circadian rhythm disruption, lack of recovery may be at the origin of somatic and mental exhaustion. Methods: We propose a debate about the principles of a medico-psychological handling based on the current operational experiences of the French military psychiatry. Special operational circumstances led military psychiatrists to prescribe an antipsychotic, smalldose, in the evening. Results: Unexpected results are observed on some symptoms like sleep disorders (improvement of sleep disorders, less traumatic nightmares, sensation of restorative night) and hyperarousal. Conclusions: This clinical discovery leads to a reflection on physiopathological and pharmacological perspectives and to engage an observational study over 30 clinical cases and clinical trial project. Identifying, preventing, and treating operational stress at battlefront can provide the opportunity not only to improve operational performance, but also possibly to improve case by case the mental health.",Colas M.-D.; Calteau M.; Trousselard M.; Canini F.; De Montleau F.,2011.0,10.1016/S0924-9338(11)72771-7,0,0,
7619,Clinical characteristics and associated anxiety symptoms in anxious patients with dementia,"Introduction: Anxiety disorders such as generalized anxiety disorder (GAD) lowers quality of life, impairs activities of daily living, and is associated with earlier nursing home placement in patients with dementia. Given the impact of anxiety in dementia, accurate identification is important. However, the overlap of cognitive symptoms of dementia and similar anxiety symptoms (i.e. difficulty concentrating, fatigue, restlessness) contribute to inconsistent and complicated assessment of GAD. The objective of this study is to identify distinguishing characteristics and associated symptoms of those with and without GAD. Methods: To assess differences in dementia patients with and without coexistent GAD (defined as excessive worry and at least three associated anxiety symptoms for a minimum of 6-months) demographic characteristics, dementia severity, quality of life, depression and anxiety symptoms were compared. The associated anxiety symptoms that differentiated patients with and without GAD were also identified. All patients (N = 43) were recruited for a clinical trial studying the psychosocial treatment of anxiety in dementia and screened positive for anxiety on the neuropsychiatric inventory (NPI). The patients and their caregiver completed the Mini International Neuropsychiatric Interview (MINI) and the Clinical Dementia Rating scale (CDR). Results: Of 43 included patients, most were non-Hispanic Caucasians (65%), female (56%), and had Alzheimer's disease (61%). No differences between the GAD (n = 21) and non GAD (n = 22) subgroups were noted in age, race/ethnicity, or education level. However, those with GAD were more likely to be male (68% males vs. 33% females, p = .02) and have less severe dementia (.5 - 1 CDR, p = .05) relative to those without GAD. They also endorsed more depressive symptoms (Geriatric Depression Scale, p = .01), worry (Penn State Worry Questionnaire - Abbreviated, p = .05), and anxiety (Rating Anxiety in Dementia [RAID], p = .05) than patients without GAD. There were no differences in quality of life (Quality of life in Alzheimer's Disease) as assessed by either patients or caregivers between those with and without GAD. Associated anxiety symptom that differentiated those with GAD from those without included muscle tension (RAID: p = .01), feeling keyed up (MINI: p = .01) and being easily fatigued (MINI: p = .01). Conclusions: The study suggests that muscle tension, fatigue and feeling keyed up may be a key feature in distinguishing patients with GAD in dementia. It is possible that quality of life could be better accounted for by physical health, dementia or severity of anxiety/depressive symptoms rather than GAD status. Although the current study is limited by a small sample and all patients had at least minimal anxiety symptoms, it adds to the understanding and recognition of anxiety in dementia.",Calleo J.; Bush A.; Kraus-Schuman C.; Snow L.; Wilson N.; Kunik M.E.; Pauker A.; Stanley M.A.,2011.0,10.1097/01.JGP.0000395253.20665.35,0,0,
7620,Problem solving confidence and executive functioning in older adults with generalized anxiety disorder,"Introduction: Poor problem solving confidence or low self-ratings of problem solving ability are related to anxiety and depression. In younger adults, generalized anxiety disorder is associated with negative beliefs and poor problem solving confidence but not deficits in problem solving ability. Poor problem solving ability is associated with executive dysfunction or deficits in complex behavior needed for effective problem solving such as planning, initiating, sequencing and monitoring of goal directed behavior. However current research in late life anxiety suggests cognitive impairments are more frequent in older adults with chronic anxiety. Yet more information is needed identifying types of cognitive impairment and/or problem solving confidence deficits in older adults with GAD. Executive dysfunction is an important concern in older adults due to its association with decreased quality of life, impairments in driving ability, and inhibits treatment response for in antidepressant medications. This study examines the problem solving confidence and executive functioning in older adults with GAD. Methods: All participants were recruited from primary care clinics for an on-going cognitive behavior therapy clinical trial and were diagnosed with principal or co-principal GAD by completing the Structured Clinical Interview for DSMIV (SCID). To study executive functioning, the Trail Making Test B (TMT-B), a visual tracking and set shifting measure, was administered to participants. The participants with GAD completed assessments for problem-solving confidence (PSI-C), depression (PHQ-9; Patient Health Questionnaire-9), worry severity (PSWQ-A; Penn State Worry Questionnaire - Abbreviated), and anxiety (SIGH-A; Structured Interview Guide for Hamilton - Anxiety). Results: Currently, 64 participants have completed SCID and TMT-B. Of the 64, 25 are diagnosed with GAD and 39 without GAD. Of those without GAD, 6 have no diagnosis, 15 have principal anxiety disorder other than GAD, 16 have a principal depressive disorder and 2 have adjustment disorder. There were no differences in TMT-B time for participants with and without GAD (M = 115.5, SD = 59.0; M = 142.4, SD = 76.0, respectively, t = 1.45, p = .14), or with and without a depressive disorder (M = 141.4, SD = 80.9; M = 121.2, SD = 56.0, t = -1.14, p = .25). Next, we examined correlations within the GAD subgroup between measures of problem solving confidence, worry, anxiety, and executive functioning. Problem solving confidence (higher scores are indicative of poor problem solving confidence) and worry correlated significantly (r = .46, p = .05), but none of the other correlations were significant. Conclusions: The results are limited due but problem solving and cognitive functioning in late life anxiety is a new and important topic with implications for treatment. Recruitment for this study is on-going, and additional data will be available for presentation at the meeting.",Calleo J.S.; York M.; Bush A.; Wilson N.; Kraus-Schuman C.; Kunik M.E.; Stanley M.A.,2011.0,10.1097/01.JGP.0000395253.20665.35,0,0,
7621,Religious cognitive behavioral therapy in religiousoriented obsessive compulsive disorder,"Objective: Obsessive compulsive disorder (OCD) with religious contents is more prevalent among religious populations. The aim of this study was to evaluate efficacy of religious cognitive-behavioral therapy (RCBT) on OCD with religious content and co-morbidities. Design & method: This is a randomized controlled clinical trial. Our intervention consists of 10 weekly RCBT 90 minutes sessions supervised by both clergyman and psychiatrist. Randomly 50 patients with 17 and more Yale Brown scores and religious content obsessive symptoms were selected and divided into two intervention and control groups. Yale Brown, SCL-90, and Hamilton depression questionnaires were used in this study. Data were analyzed by ANOVA/ANCOVA repeated measure tests using SPSS ver. 13. Results: Mean age of patients was 32.9 ± 8.86 years. 94% (n=47) were female. Yale Brown scores in three stages (before intervention, after fifth and tenth session) in both groups decreased specially in intervention group but showed no significant difference (p=0.294). However there were significant difference between mean scores of two groups (p=0.047). Comparison of obsession subscale and compulsion subscale of Yale Brown scale showed decrease in three stages of the study. Decreasing trend in obsession subscale is not statistically significant (f (2, 42)= 0.94 , p-value =0.398), but decreasing trend in compulsive subscale is statistically significant (f(2,43)=36.008 , p value < 0.001). Conclusion: In obsessive compulsive disorder with religious contents, religious CBT not only could significantly increase clinical responses, especially in compulsive behavior but also improve co-morbid symptoms such as depression as well as global severity index and decrease symptoms.",Akouchekian S.; Jamshidian Z.; Maracy M.R.; Almasi A.; Davarpanah Jazi A.H.,2011.0,10.1016/S0924-9338(11)72667-0,0,0,
7622,Neural correlates of altered general emotion processing in social anxiety disorder,"Specific anxiety disorders are characterized by altered emotion processing of phobia-specific stimuli at the neurobiological level. Recent work has concentrated on specific anxiety-provoking stimuli; focusing on arousal- or fear-related brain areas such as the amygdala. We analyzed brain activation during the cued anticipation of unpleasant or uncertain emotional stimuli as a means of modeling an unspecific anxiety-laden situation. Sixteen patients with social anxiety disorder (SAD) and eighteen healthy control subjects completed a task during functional magnetic resonance imaging involving the anticipation of cued visual stimuli with prior known emotional valence (positive, negative, and neutral) or prior unknown/ambiguous emotional content. The anticipated stimuli had no social phobia specific content. During the anticipation of emotional stimuli of prior known negative and prior ambiguous emotional valence, brain activity in patients with SAD was increased in the upper midbrain/dorsal thalamus, the amygdala, and in temporo-occipital and parietal regions as compared to control subjects. Activity was decreased in SAD in left orbitofrontal cortex. Activations in the amygdala and in occipital regions correlated with trait anxiety and social anxiety measures. In conclusion, SAD was associated with enhanced activation in brain regions involved in emotional arousal as well as in attention and perception processing during the anticipation of non-specific, general emotional stimuli. Hence, our results suggest that patients with SAD not only have an altered processing of specific feared stimuli, but also a more generally disturbed emotion processing in basic neural pathways. These findings have implications for diagnostic models and the treatment of SAD. © 2010 Elsevier B.V. All rights reserved.",Brühl A.B.; Rufer M.; Delsignore A.; Kaffenberger T.; Jäncke L.; Herwig U.,2011.0,10.1016/j.brainres.2010.12.084,0,0,
7623,Short-term compassion training increases prosocial behavior in a newly developed prosocial game,"Compassion has been suggested to be a strong motivator for prosocial behavior. While research has demonstrated that compassion training has positive effects on mood and health, we do not know whether it also leads to increases in prosocial behavior. We addressed this question in two experiments. In Experiment 1, we introduce a new prosocial game, the Zurich Prosocial Game (ZPG), which allows for repeated, ecologically valid assessment of prosocial behavior and is sensitive to the influence of reciprocity, helping cost, and distress cues on helping behavior. Experiment 2 shows that helping behavior in the ZPG increased in participants who had received short-term compassion training, but not in participants who had received short-term memory training. Interindividual differences in practice duration were specifically related to changes in the amount of helping under no-reciprocity conditions. Our results provide first evidence for the positive impact of short-term compassion training on prosocial behavior towards strangers in a training-unrelated task. © 2011 Leiberg et al.",Leiberg S.; Klimecki O.; Singer T.,2011.0,10.1371/journal.pone.0017798,0,0,
7624,Population pharmacokinetics and pharmacodynamics of brief etomidate infusion in healthy volunteers,"This study established the pharmacokinetic and pharmacodynamic relationships of the bispectral index (BIS) and Observer's Assessment of Alertness/Sedation (OAA/S) scale with effect site drug concentrations during and after brief etomidate infusion. Eighteen American Society of Anesthesiologists status I or II volunteers received etomidate (0.2%) infusion at 5 mg/min until the loss of eyelash reflexes, and spontaneous recovery was allowed. Data for plasma etomidate concentrations, BIS, and OAA/S were collected every minute and analyzed by NONMEM. A 2-compartment pharmacokinetic model and a pharmacodynamic sigmoid Emax model fit the data best, with volumes of distribution at central and peripheral compartments of 4.45 and 74.90 L, respectively, and systemic and intercompartmental clearances of 0.63 and 3.16 L/min, respectively. t1/2ke0 was 1.550 min. EC50 values were 0.526 and 0.554 μg/mL, and gamma values were 2.25 and 6.24 for BIS and OAA/S, respectively. The prediction probability between OAA/S and BIS was 0.8. The slopes of the curves suggest that BIS is a better monitor of depth of sedation and hypnosis, whereas OAA/S may be more useful for monitoring sleep versus wakefulness. These results should be interpreted within the context of short-term etomidate infusion of less than 10 minutes. © 2011 The Author(s).",Kaneda K.; Yamashita S.; Woo S.; Han T.-H.,2011.0,10.1177/0091270010369242,0,0,
7625,The fear-avoidance model of musculoskeletal pain and low back pain subgrouping: Results of a cluster analysis,"The purpose of this secondary analysis was to evaluate established fear-avoidance model (FAM) measures to determine if developing subgroups based on psychological risk differs when using multiple or single measures. This sample consists of patients (n = 108) with acute or sub-acute LBP enrolled in a clinical trial comparing behavioral physical therapy interventions to standard physical therapy. Patients completed baseline questionnaires for pain catastrophizing (PCS), fear-avoidance beliefs (FABQ), and patient-specific fear (FDAQ). Clinical outcomes were pain intensity and disability measured at baseline, 4-weeks, and 6-months. A hierarchical agglomerative cluster analysis was performed to create distinct cluster profiles among FAM measures. Changes in clinical outcomes were investigated with repeated measures ANOVA. Differences in results based on cluster membership were compared to the FABQ subgrouping used in the original trial. Cluster analyses revealed three distinct subgroups: 1) low fear / catastrophizing; 2) high specific-fear; and 3) high fear / catastrophizing. Clusters differed on baseline pain intensity and disability (p's<.01) with the high fear /catastrophizing cluster reporting: 1) greater pain intensity than the low fear / catastrophizing cluster (p<.01) and 2) the greatest disability (p's<.01). There were interactions (time x subgroup) for both pain intensity and disability (p's<.05), with the high fear / catastrophizing cluster reporting greater changes in pain intensity and disability than other clusters (p's<.05). In contrast, FABQ subgroups were not associated with interactions for clinical outcomes. These data suggest that cluster membership based on multiple measures may provide additional information on clinical outcomes in comparison to determining subgroup status by FABQ alone. However, cluster membership was not associated with response to type of treatment, potentially explaining high fear subgroups not responding as favorable to behavioral interventions as expected. Subgrouping methods for patients with LBP should include multiple psychological factors to further explore if patients can be matched with appropriate interventions.",Beneciuk J.; George S.; Robinson M.,2011.0,10.1016/j.jpain.2011.02.046,0,0,
7626,Abstracts of Peer-Reviewed Presentations at the Australasian Cognitive Neurosciences Conference (20th Meeting of the Australasian Society for Psychophysiology),The proceedings contain 86 papers. The topics discussed include: fMRI based localization of V5 and motion-attention related IPS regions for neuronavigated TMS; the effects of enriched environment on the development of visual recognition memory and the influence of precocious tactile stimulation; global-shape after-effects have a local substrate; cortical auditory evoked potentials in response to alternating tone-burst stimuli; additivity of arousal effects of caffeine ingestion and opening the eyes; stimulus relevance as a determinant of multisensory facilitation; neurophysiological modification of cortical visual processing in young adults by omega-3 fatty acids: a randomized clinical trial; brief practice in the Go/Nogo task: behavioral and neural changes depend on task demands; perceptual processing asymmetry and hemispheric resource competition; and the role of fear and disgust in contamination based obsessive compulsive disorder.,,2011.0,,0,0,
7627,Visual and psychosocial feedback intervention for phantom limb pain: Participant characteristics,"Phantom limb pain (PLP), the experience of painful sensations in the missing appendage, is a prevalent (50%) and treatment-resistant complication of amputation. This report describes the research design and baseline characteristics of 43 participants. PLP participants enrolled in a randomized clinical trial assessing the efficacy of an 8-week, 12-hour intervention utilizing novel mirror visual feedback (MVF) supplemented with cognitive-behavioral therapy (CBT) compared to a Supportive Care condition (SC, Rogerian client-centered therapy) for reducing pain frequency and interference (Brief Pain Inventory) and improving life quality (Short Form 12). Included were individuals with weekly phantom pain, > 4/10) without psychotic disorders. The sample is predominantly male (86%), middle-aged (55.1 yrs), Caucasian (67%); and unmarried (61% single, widowed, divorced) with modest income of (67.4% annual income < $35,000). Participants had traumatic, surgical or diabetic amputations of upper (8%) or lower (92%) extremity, with a mean 7.4 years since amputation. PLP was intermittent in all cases, on average 4.8 days/week, and 38% had daily pain. Participants reported up to 20 pain episodes per day, lasting up to 20 hours per episode. Mean pain intensity was 6.4 on 0-10 (Numeric Rating Scale), 50% rated pain at least moderately with everyday function. Psychiatric assessment (Composite International Diagnostic Interview, CIDI 2.1) revealed high lifetime rates of major depression (32%), PTSD (16%) and substance use disorders (14%). Mirror visual feedback, if efficacious, might assist management of otherwise intractable phantom limb pain in a population of patients with high medical and psychiatric co-morbidity.",Mcquaid J.; Slater M.; Golish M.; Parkes K.; Chircop-Rollick T.; Rutledge T.; Cone R.; Peterzell D.; Atkinson J.; Nance P.,2011.0,10.1016/j.jpain.2011.02.309,0,0,
7628,Successful Peripheral Nerve Field Stimulation for Thoracic Radiculitis Following Brown-Sequard Syndrome,"Objective: The objective of this study is to present a novel approach to the treatment of thoracic radiculitis following Brown-Sequard syndrome with peripheral nerve field stimulation (PNFS). Furthermore, we endeavor to discuss the role of PNFS in the management of refractory neuropathic pain conditions including post-traumatic and post-surgical neuropathy particularly with regards to the post-surgical spine. Materials and Methods: Presented is a 57-year-old man with history of thoracic microdiscectomy resulting in Brown-Sequard syndrome presented with chronic post-operative thoracic radicular pain radiating to the abdomen, refractory to conservative management. The patient underwent three intercostal nerve blocks from T7 to T9 with transient symptomatic relief. The patient's options were limited to chemomodulation, neuromodulation, or selective intercostal nerve surgical neurectomy. He subsequently underwent a PNFS trial and reported >75% pain reduction. Permanent percutaneous PNFS electrodes were implanted subcutaneously over the right T7 and T9 intercostal nerves and replicated the trial results. Results: Neuromodulation produced pain relief with >90% improvement in pain compared with baseline both during the trial and following permanent implantation of the PNFS system. Conclusion: Chronic radicular pain may be difficult to manage in the post-surgical patient and often requires the use of multiple therapeutic modalities. In this case, we successfully utilized PNFS as it demonstrated greater technical feasibility when compared with dorsal column stimulation and repeat surgery; therefore, it may be considered for the management of post-surgical neuropathy. Further controlled studies are needed to evaluate the efficacy of PNFS as a treatment option. © 2011 International Neuromodulation Society.",Desai M.; Jacob L.; Leiphart J.,2011.0,10.1111/j.1525-1403.2011.00356.x,0,0,
7629,Using genetic loci to understand the relationship between adiposity and psychological distress: A Mendelian Randomization study in the Copenhagen General Population Study of 53221 adults,"Objective. We used genetic variants that are robustly associated with adiposity to examine the causal association of adiposity with psychological distress. Methods. We examined the association of adiposity with psychological distress in a large (N=53221) general population cohort of 20- to 99-year-old adults from Copenhagen, Denmark. Psychological distress was assessed using four questions that asked about: feeling stressed; not accomplishing very much; wanting to give up; and regular use of antidepressants/sedatives. We used the genetic loci FTO rs9939609 and MC4R rs17782313 as instrumental variables for adiposity quantified by body mass index (BMI) and waist to hip ratio (WHR). Results. In conventional multivariable analyses, BMI and WHR were positively associated with distress. For example, the odds ratio of reporting not accomplishing for each additional standard deviation increase for BMI was 1.11 (95% CI: 1.09, 1.13) and for WHR was 1.10 (95% CI: 1.08, 1.13) in the fully adjusted analyses. In contrast, instrumental variable analyses showed an inverse association of adiposity on distress; corresponding odds ratio in instrumental variable analyses was 0.64 (95% CI: 0.46, 0.89) for BMI and 0.49 (95% CI: 0.25, 0.94) for WHR (P-values for difference between the two approaches both= 0.001). Conclusion. The inverse associations of adiposity and psychological distress when genetic variants are used as instrumental variables could be explained by biological pathways linking adiposity and distress. The positive associations of adiposity with distress in multivariable analyses might be explained by residual confounding or reverse causality. © 2011 The Association for the Publication of the Journal of Internal Medicine.",Lawlor D.A.; Harbord R.M.; Tybjaerg-Hansen A.; Palmer T.M.; Zacho J.; Benn M.; Timpson N.J.; Davey Smith G.; Nordestgaard B.G.,2011.0,10.1111/j.1365-2796.2011.02343.x,0,0,
7630,Regional specificity of pre-frontal gray matter predicts differential treatment response to fluoxetine or cognitive-behavioral therapy in obsessive-compulsive disorder,"Background: Response rates to serotonin reuptake inhibitors and/or cognitivebehavioral therapy (CBT) vary immensely among individuals with obsessivecompulsive disorder (OCD). This study aimed to investigate structural brain predictors of response in treatment-naïve OCD patients randomized to treatment with either fluoxetine or CBT and to determine the relationship between pretreatment brain patterns and improvement of OCD symptoms according to these different treatments. Methods: Treatment-naïve patients with OCD underwent structural magnetic resonance imaging (MRI) scan before randomization to a 12-week clinical trial with either fluoxetine (n = 14) or group CBT (n = 15). Voxel-based morphometry was used to determine correlations between pretreatment regional gray matter (GM) volume and changes in the severity of OCD symptoms. Results: Smaller pretreatment GM volume within the right lateral orbitofrontal cortex (Talairach coordinates = 45, 48, -3; z score = 3.70) for fluoxetine-treated patients (figure, left) and larger pretreatment GM volume within the right ventromedial prefrontal cortex (Talairach coordinates = 7, 27, -6; z score = 3.45) for CBT-treated patients (figure, right) were significantly correlated with improvement in OCD symptoms. No significant correlations were found between OCD improvement and GM volumes within the territories predicted a priori when considering the entire sample (n=29). Conclusions: These findings suggest that pretreatment GM volumes of distinct brain regions within the prefrontal cortex predict treatment response to different interventions in OCD. (Figure presented).",Hoexter M.Q.; Dougherty D.; Shavitt R.; D'Alcante C.; Duran F.D.; Lopes A.; Diniz J.; Batistuzzo M.; Evans K.; Bressan R.; Busatto G.F.; Miguel E.C.,2011.0,10.1016/j.biopsych.2011.03.030,0,0,
7631,"In functional dyspepsia, are postprandial distress syndrome and epigastric pain syndrome different?","Background: Functional dyspepsia (FD) may be a heterogenous disorder with multiple pathophysiological mechanisms. Recently, the Rome III committee proposed a new classification of subgroups of FD, namely epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS), in an effort to create homogenous groups with similar mechanisms and clinical properties. However, the benefit of this classification of FD is not fully established. Aim: Our aim was to determine if PDS differed from EPS in regard to clinical features, psychopathological factors, and gastric physiology. Methods: The Functional Dyspepsia Treatment Trial (FDTT) is a multicenter randomized clinical trial evaluating the effect of antidepressants on relieving dyspepsia symptoms. This study used baseline data for the first 147 FD patients enrolled in the FDTT. These patients met Rome II criteria of FD with a negative upper GI endoscopy and no depression or major physical illness. Each subject completed a Bowel Disease Questionnaire (BDQ) and psychological profiles, and underwent gastric physiologic tests (gastric emptying and nutrient drink test). PDS was defined by more than one day per week of postprandial fullness and early satiety; EPS was defined by weekly or more frequent epigastric pain or burning. The association of the FD subgroups with clinical features (age, gender, somatic symptom checklist [SSC] score), psychopathological factors (global severity index [GSI] of SCL90-R, Hospital Anxiety and Depression [HAD] score), and gastric physiology (maximum tolerated volume during a nutrient drink test, gastric emptying at 2 hours by scintigraphy) was assessed using multiple variable logistic regression. Results: Among the 147 FD patients, PDS alone was reported in 31 (21%), EPS alone in 19 (13%), both PDS-EPS (overlap) in 74 (50%), and neither in 19 (13%). As shown in the table, numerically patients with both PDS-EPS showed the highest somatic symptom checklist score, highest global severity index on an SCL-90, lowest maximum tolerated volumes in a nutrient drink test, and worst sleep hygiene among the four groups. Higher SSC score was independently significantly associated with increased odds for EPS alone (vs. neither: OR=20.9 [2.2-202.0]), both PDS-EPS (vs. neither: OR=7.6 [1.3-45.5]), and EPS alone (vs. PDS alone: OR=7.7 [1.2, 50.8]). GSI (from SCL-90 R) was also significantly associated with a reduced odds for EPS alone (vs. neither, OR=0.9 [0.8-0.99]). However, no other statistically significant associations with the four groups were detected. Conclusions: Approximately half of the patients with FD have an overlap of PDS-EPS. Other than differences in SSC and GSI scores, no differences were detected among the groups. Overall this new classification did not appear to identify different patients groups. (Table presented).",Choung R.S.; Herrick L.M.; Locke G.R.; Bouras E.P.; Howden C.W.; Brenner D.M.; Lacy B.E.; DiBaise J.K.; Prather C.M.; Abraham B.P.; El-Serag H.; Zinsmeister A.R.; Talley N.J.,2011.0,10.1016/S0016-5085(11)63350-7,0,0,
7632,Right median nerve stimulation in post-traumatic coma,"Background: Reduced state of consciousness remains one of the major consequences of severe traumatic brain injury. To date, little progress has been made in its alleviation, even though a great deal of attention has been given to the issue. The question on every neurosurgeon's mind is what a physician can do to help coma patients and their families when lives are saved through intensive medical intervention. To investigate safe and efficient coma awakening strategies is among the targets of severe brain injury treatment. Methods: In this clinical trial, we applied the right median nerve stimulation (RMNS) technique in patients suffering from coma at the acute stage following primary brainstem injury. Eighty-seven patients were recruited into this multi-center clinical trial, and were randomly divided into treatment and control groups. In the treatment group, RMNS was used as the coma awakening method during the NICU period, and data including intracranial pressure, Glasgow Coma Scale score, and vital signs were taken daily for patients in both groups. Patients received RMNS treatment 8 h per day for 2 weeks, and were followed-up for 3 months. Results: The initiation of RMNS was at 9.2 ± 1.36 days in the treatment group. RMNS showed no significant relationship with changes in ICP values, regardless of variations in intracranial status. At the end of 2 weeks of treatment, the mean GCS scores of the treatment group were significantly higher compared with controls (p<0.01). Threemonth follow-up showed that more patients regained consciousness in the treatment group, and GOS scores were higher compared with controls (p<0.05). Conclusions: RMNS exhibits potential therapeutic value for patients with long-term coma and those in a vegetative state. The present study is the first to report the application of RMNS in patients with acute traumatic coma resulting from primary brainstem injury. Clinical data indicate that RMNS is a safe method to increase arousal of brain structures, even in patients who are still under NICU treatment, and the GCS and GOS data indicate that RMNS can hasten the recovery of decreased consciousness and improve prognosis, at least in those with primary brainstem injury.",Gao G.; Cooper E.; Jiang J.,2011.0,10.1089/neu.2011.9946,0,0,
7633,Visuospatial memory improvement after gamma ventral capsulotomy for obsessive-compulsive disorder,"Background: Visuospatial memory (VM) impairments have been consistently found in OCD patients. Treatment induced, symptom improvements may contribute to improved scores in VM, suggesting that this deficit could be state-dependent. For the present time, there are no reports of the impact of radiosurgery on VM of refractory OCD patients. Methods: An improved, stereotactic radiosurgery technique (Gamma ventral capsulotomy - GVC) was conducted, in a double-blind, randomized controlled trial. Sixteen refractory DSM-IV OCD patients randomly received active (8 patients) or “sham” (8 patients) radiosurgery. Pre-operative and median 12 months post-operative neuropsychological assessments were provided, including the Brief Visual Memory Test-revised (BVMT-R), and the Rey- Osterrieth Complex Figure (ROCF). Symptom improvement was assessed by the Yale-Brown Obsessive-Compulsive Scale (YBOCS). Results: As a whole, patients submitted to active GVC showed improved scores on VM tests, when compared to sham group patients. Statistically significant results were found on immediate and 25-minutes delayed recalls on BVMT-R, as well as on 30-minutes delayed recall of ROCF. Specifically, inter-group and interaction differences were observed on immediate BVMT-R scores (Wald non-parametric analysis of variance WQ=4.398, 1 df, p = 0.036, inter-group; WQ= 9.172, 1 df, p = 0.0025, interaction), long-term BVMT-R scores (WQ=1.337, 1 df, p=0.2475, inter-group; WQ= 3.985, 1 df, p=0.0459, interaction) and delayed-recall ROCF scores (WQ=22.902, 1 df, p<0.00001, inter-group; WQ= 11.648, 1 df, p = 0.0006, interaction). These results were not correlated to YBOCS scores. Conclusions: Improvements on visuospatial memory can be observed after a radiosurgical treatment in refractory OCD patients, regardless of symptom improvement.",Lopes A.C.; Batistuzzo M.C.; Taub A.; D'Alcante C.C.; Canteras M.M.; Joaquim M.; De Mathis M.E.; Hoexter M.Q.; Greenberg B.D.; Noren G.; Rasmussen S.A.; Shavitt R.G.; Miguel E.C.,2011.0,10.1016/j.biopsych.2011.03.032,0,0,
7634,Updated results of a randomized controlled trial of gamma ventral capsulotomy for obsessive-compulsive disorder,"Background: An improved, stereotactic radiosurgery (Gamma ventral capsulotomy - GVC) has been developed for treatment of refractory Obsessive Compulsive Disorder (OCD) patients. We report the updated results from a pilot study with this new technique, and from a double-blind, randomized controlled trial. Methods: Twenty one refractory DSM-IV OCD patients were selected. The first five patients were included in a pilot study. Other 16 subjects randomly received active (8 patients) or “sham” (8 patients) radiosurgery. Periodical pre and post-operative follow-up assessments were provided, including psychopathological, global status, neuropsychological and personality scales. Results: Three patients from the pilot study and three patients from the RCT active group became responders. As a whole, six out of thirteen (46 %) patients who had received active radiosurgery responded, 12 months or more after surgery. For the sham group, one patient transiently responded to the intervention. However, by 12 months of follow-up, no sham group patients were treatment responders. Groups were statistically different in terms of obsessive-compulsive scales scores (p=0.0179). Mania, delirium, episodic headaches, dizziness, nausea were few times observed. One patient presented a cyst and transient cognitive changes. Improved simple visual attention (p=0.04), logical memory (p=0.04), and verbal/full IQs (p = 0.04) were observed in the pilot patients. Interaction differences were observed on visuospatial memory tests between the active and sham groups (p=0.046). Patients submitted to active GVC showed improved scores on visual memory tests, when compared to sham group patients. Conclusions: Preliminary findings indicate that GVC for OCD shows some efficacy, with relatively few adverse effects.",Lopes A.C.; Batistuzzo M.C.; Canteras M.M.; De Mathis M.E.; Joaquim M.; D'Alcante C.C.; Taub A.; Duran F.F.L.S.; Hoexter M.Q.; Greenberg B.D.; Noren G.; Rasmussen S.A.; Shavitt R.G.; Miguel E.C.,2011.0,10.1016/j.biopsych.2011.03.032,0,0,
7635,Therapeutic impact of mindfulness meditation on Irritable Bowel Syndrome (IBS): Results of a randomized controlled trial,"Mindfulness meditation is a behavioral technique that involves attending intentionally to present-moment experience and nonjudgmental awareness of body sensations and emotions, as well as letting go of fixation on thoughts of past and future. Mindfulness training has been reported to improve symptoms in chronic medical conditions such as fibromyalgia and depression. Aim: To test the impact of this technique as therapy for IBS. Methods: Seventy-five female IBS patients (mean age 42.7 years, range 19-71) were randomly assigned to either a course of mindfulness training (MT) or a support group (SG). The mindfulness training was based on the Mindfulness-Based Stress Reduction Program of Kabat-Zinn and Santorelli (Kabat-Zinn, Full Catastrophe Living, 1990. NY: Delacorte Press), with adaptations to IBS symptoms and experiences. Intervention for both groups consisted of 8 weekly group sessions plus a half-day retreat. Participants completed the IBS Severity Scale (IBS-SS), the IBS-QOL, the Brief Symptom Inventory -18, the Visceral Sensitivity Index, a treatment credibility scale (adaptation of Borkovec & Nau, J Behav Therap & Exp Psychiat 1972; 3:257-260), and the Five-Facet Mindfulness Questionnaire (Baer et al, Assessment 2008; 15: 329-342) at pre- and post-treatment and at 3 month follow-up. Results: MT and SG subjects had equivalent pre-treatment IBS-SS (284.1 vs. 287.5) and IBS-QOL scores (64.8 vs. 67.2) and comparable demographic characteristics. Participants' ratings of the credibility of their assigned intervention as therapy for IBS symptoms, measured after the first group session, was not different between the two treatment groups. Sixty-six participants completed the intervention course (34 MT and 32 SG, 12% overall dropout). Intent-to-treat analysis using repeated measures ANOVAs showed significantly greater reduction in the MT group than SG in the primary outcome variable of overall IBS symptom severity after treatment (IBS-SS score change: 25.4% vs. 6.2%, p=0.006) and at 3 month follow-up (38.2% vs. 11.8%, p=0.001). Changes in quality-of-life impairment, visceral anxiety and psychological distress were not significantly different in the two groups at post-treatment assessment, but all were more improved in the MT group than SG at 3 month follow-up. Mindfulness scores increased significantly in the MT group after treatment, confirming effective learning of mindfulness skills, and remained elevated at 3 month follow-up. Conclusions: This first randomized controlled trial of mindfulness training as an intervention for IBS shows that such training has a substantial therapeutic effect on bowel symptom severity and also results in improved health-related quality of life and reduced psychological symptoms. The beneficial effects last at least 3 months after end of training.",Gaylord S.; Palsson O.S.; Garland E.; Faurot K.; Coble R.S.; Mann D.; Whitehead W.E.,2011.0,10.1016/S0016-5085(11)60203-5,0,0,
7636,The Perseverative Thinking Questionnaire (PTQ): Validation of a content-independent measure of repetitive negative thinking,"Repetitive negative thinking (RNT) has been found to be involved in the maintenance of several types of emotional problems and has therefore been suggested to be a transdiagnostic process. However, existing measures of RNT typically focus on a particular disorder-specific content. In this article, the preliminary validation of a content-independent self-report questionnaire of RNT is presented. The 15-item Perseverative Thinking Questionnaire was evaluated in two studies (total N = 1832), comprising non-clinical as well as clinical participants. Results of confirmatory factor analyses across samples supported a second-order model with one higher-order factor representing RNT in general and three lower-order factors representing (1) the core characteristics of RNT (repetitiveness, intrusiveness, difficulties with disengagement), (2) perceived unproductiveness of RNT and (3) RNT capturing mental capacity. High internal consistencies and high re-test reliability were found for the total scale and all three subscales. The validity of the Perseverative Thinking Questionnaire was supported by substantial correlations with existing measures of RNT and associations with symptom levels and clinical diagnoses of depression and anxiety. Results suggest the usefulness of the new measure for research into RNT as a transdiagnostic process. © 2010 Elsevier Ltd. All rights reserved.",Ehring T.; Zetsche U.; Weidacker K.; Wahl K.; Schönfeld S.; Ehlers A.,2011.0,10.1016/j.jbtep.2010.12.003,0,0,
7637,Effects of tryptophan depletion and tryptophan loading on the affective response to high-dose CO2 challenge in healthy volunteers,"Rationale It has been reported that in panic disorder (PD), tryptophan depletion enhances the vulnerability to experimentally induced panic, while the administration of serotonin precursors blunts the response to challenges. Objectives Using a high-dose carbon dioxide (CO2) challenge, we aimed to investigate the effects of acute tryptophan depletion (ATD) and acute tryptophan loading (ATL) on CO2-induced panic response in healthy volunteers. Methods Eighteen healthy volunteers participated in a randomized, double-blind placebo-controlled study. Each subject received ATD, ATL, and a balanced condition (BAL) in separate days, and a double-breath 35% CO 2 inhalation 4.5 h after treatment. Tryptophan (Trp) manipulations were obtained adding 0 g (ATD), 1.21 g (BAL), and 5.15 g (ATL) of l-tryptophan to a protein mixture lacking Trp. Assessments consisted of a visual analogue scale for affect (VAAS) and panic symptom list. A separate analysis on a sample of 55 subjects with a separate-group design has also been performed to study the relationship between plasma amino acid levels and subjective response to CO2. Results CO2-induced subjective distress and breathlessness were significantly lower after ATD compared to BAL and ATL (p<0.05). In the separate-group analysis, ΔVAAS scores were positively correlated to the ratio Trp:ΣLNAA after treatment (r=0.39; p<0.05). Conclusions The present results are in line with preclinical data indicating a role for the serotonergic system in promoting the aversive respiratory sensations to hypercapnic stimuli (Richerson, Nat Rev Neurosci 5(6):449-461, 2004). The differences observed in our study, compared to previous findings in PD patients, might depend on an altered serotonergic modulatory function in patients compared to healthy subjects. © 2011 The Author(s).",Colasanti A.; Esquivel G.; Den Boer E.; Horlings A.; Dandachi A.; Oostwegel J.L.; Van Donkelaar E.L.; Griez E.J.; Schruers K.,2011.0,10.1007/s00213-011-2177-8,0,0,
7638,Biodegradation behavior of natural organic matter (NOM) in a biological aerated filter (BAF) as a pretreatment for ultrafiltration (UF) of river water,"In this study, biodegradation of natural organic matter (NOM) in a biological aerated filter (BAF) as pretreatment of UF treating river water was investigated. Photometric measurement, three-dimensional excitation-emission matrix (EEM) fluorescence spectroscopy and liquid chromatography with online organic carbon detector (LC-OCD) were used to investigate the fate of NOM fractions in the BAF+UF process. Results showed that the BAF process could effectively remove particles and parts of dissolved organic matter, which led to a lower NOM loading in the UF system, but different NOM fractions showed different biodegradation potentials. Further biodegradation batch experiments confirmed this observation and identified that polysaccharides and proteins (quantified using photometric methods) contained a large proportion of readily biodegradable matter while humic substances were mainly composed of inert organic substances. According to EEM measurements, it is evident that protein-like substances were more readily eliminated by microorganisms than humic-like substances. LC-OCD data also supported the phenomena that the polysaccharides and large-size proteins were more degradable than humic substances. © 2011 Springer-Verlag.",Huang G.; Meng F.; Zheng X.; Wang Y.; Wang Z.; Liu H.; Jekel M.,2011.0,10.1007/s00253-011-3251-1,0,0,
7639,Replacement of meat by meat substitutes. A survey on person- and product-related factors in consumer acceptance,"What does it take to increase the consumption of meat substitutes and attract new consumers? We identified main barriers and drivers by a consumer survey (n= 553) in the U.K. and the Netherlands. Person-related factors (food neophobia and food choice motives) and product-related attitudes and beliefs towards meat and meat substitutes were compared between non-users (n= 324), light/medium-users (n= 133) and heavy-users of meat substitutes (n= 96). Consumer acceptance was largely determined by the attitudes and beliefs towards meat substitutes and food neophobia. Key barriers for non-users and light/medium-users were the unfamiliarity with meat substitutes and the lower sensory attractiveness compared to meat. In addition, non-users had a higher tendency to avoid new foods. Hence, the less consumers were using meat substitutes, the more they wanted these products to be similar to meat. Although non-users and light/medium-users did recognize the ethical and weight-control aspects of meat substitutes, this was obviously less relevant to them. Actually, only heavy-users had high motivations to choose ethical foods, which explains their choice for meat substitutes. In order to make meat substitutes more attractive to meat consumers, we would not recommend to focus on communication of ethical arguments, but to significantly improve the sensory quality and resemblance to meat. © 2011 Elsevier Ltd.",Hoek A.C.; Luning P.A.; Weijzen P.; Engels W.; Kok F.J.; de Graaf C.,2011.0,10.1016/j.appet.2011.02.001,0,0,
7640,Inhalation of 7.5% carbon dioxide increases threat processing in humans,"Inhalation of 7.5% CO2 increases anxiety and autonomic arousal in humans, and elicits fear behavior in animals. However, it is not known whether CO2 challenge in humans induces dysfunction in neurocognitive processes that characterize generalized anxiety, notably selective attention to environmental threat. Healthy volunteers completed an emotional antisaccade task in which they looked toward or away from (inhibited) negative and neutral stimuli during inhalation of 7.5% CO2 and air. CO2 inhalation increased anxiety, autonomic arousal, and erroneous eye movements toward threat on antisaccade trials. Autonomic response to CO2 correlated with hypervigilance to threat (speed to initiate prosaccades) and reduced threat inhibition (increased orienting toward and slower orienting away from threat on antisaccade trials) independent of change in mood. Findings extend evidence that CO2 triggers fear behavior in animals via direct innervation of a distributed fear network that mobilizes the detection of and allocation of processing resources toward environmental threat in humans. © 2011 American College of Neuropsychopharmacology. All rights reserved.",Garner M.; Attwood A.; Baldwin D.S.; James A.; Munafò M.R.,2011.0,10.1038/npp.2011.15,0,0,
7641,"Comparison of anxiety, depression, and post-traumatic stress symptoms in relatives of ICU patients in an American and an Indian public hospital","Context: An intensive care unit (ICU) admission of a patient causes considerable stress among relatives. Whether this impact differs among populations with differing sociocultural factors is unknown. Aims: The aim was to compare the psychological impact of an ICU admission on relatives of patients in an American and Indian public hospital. Settings and Design: A cross-sectional study was carried out in ICUs of two tertiary care hospitals, one each in major metropolitan cities in the USA and India. Materials and Methods: A total of 90 relatives visiting patients were verbally administered a questionnaire between 48 hours and 72 hours of ICU admission that included the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory-II (BDI-II) and Impact of Events Scale-Revised (IES-R) for post-traumatic stress response. Statistical Analysis: Statistical analysis was done using the Mann-Whitney and chi-square tests. Results: Relatives in the Indian ICU had more anxiety symptoms (median HADS-A score 11 [inter-quartile range 9-13] vs. 4 [1.5-6] in the American cohort; P<0.0001), more depression symptoms (BDI-II score 14 [8.5-19] vs. 6 [1.5-10.5], P<0.0001) but a comparable post-traumatic stress response (IES-R score>30). 55% of all relatives had an incongruous perception regarding ""change in the patient's condition"" compared to the objective change in severity of illness. ""Change in worry"" was incongruous compared to the ""perception of improvement of the patient's condition"" in 78% of relatives. Conclusions: Relatives of patients in the Indian ICU had greater anxiety and depression symptoms compared to those in the American cohort, and had significant differences in factors that may be associated with this psychological impact. Both groups showed substantial discordance between the perceived and objective change in severity of illness.",Kulkarni H.; Kulkarni K.; Mallampalli A.; Parkar S.; Karnad D.; Guntupalli K.,2011.0,10.4103/0972-5229.84891,0,0,
7642,The functional 5-HT1A receptor polymorphism affects response inhibition processes in a context-dependent manner,"Cognitive control processes may depend on contextual information, sometimes improving performance, but impairing performance if expectancies about forthcoming events induce pre-potent responses. The neurobiological bases of these effects are not understood. Here, we examine context-dependent variations of response control processes using the AX-CPT task with respect to the relevance of the functional serotonin 1A receptor polymorphism (5-HT1A C(-1019)G) in a sample of healthy subjects (N= 90) by means of event-related potentials (ERPs).The results show that, when context information is helpful to drive behavioural performance, carriers of the -1019G allele reveal compromised cognitive control. Yet, they show enhanced task performance when strong context representations would lead to declines in behavioural control. These findings are paralleled by modulations of the (Nogo)-P3 ERP-component. These results show for the first time that, even though the -1019G allele enhances the risk to develop anxiety disorders, it also confers an advantage to its carriers in terms of better cognitive control processes in conditions where contextual information compromises cognitive control. Effects of the 5-HT1A C(-1019)G polymorphism were further modulated by anxiety sensitivity. As the functional effect of the 5-HT1A C(-1019)G polymorphism has previously been shown to be rather specific for serotonergic 1A autoreceptors in the dorsal raphe nucleus (DRN), the results suggest that contextual modulations in cognitive control may be exerted by the DRN. © 2011 Elsevier Ltd.",Beste C.; Domschke K.; Radenz B.; Falkenstein M.; Konrad C.,2011.0,10.1016/j.neuropsychologia.2011.05.014,0,0,
7643,The effect of stress and anxiety associated with maternal prenatal diagnosis on feto-maternal attachment,"Background: A couple's decision to undergo an invasive test based on a screening test result is a process associated with anxiety. The aim of this study was to determine whether anxiety and prenatal attachment were affected by undergoing an invasive test compared to women in early pregnancy and after a reassuring anomaly scan.Methods: 200 women were recruited at booking, 14 women and 20 partners after an invasive test and 81 women following an anomaly scan. A questionnaire was completed using the Beck Anxiety Inventory and Maternal or Paternal Antenatal Attachment Scales.Results: Women who have had an invasive test have higher levels of anxiety compared to women at booking (P < 0.01) and after an anomaly scan (P = 0.002). Anxiety declines from booking to the time of an anomaly scan (P = 0.025), whilst attachment increases (P < 0.001). There is a positive correlation between anxiety and attachment in women who have had an invasive test (r = 0.479). Partners of women undergoing an invasive test experience lower levels of anxiety (P < 0.05).Conclusions: Women undergoing prenatal diagnostic procedures experience more psychological distress, which may be currently underestimated. Establishment of interdisciplinary treatment settings where access to psychological support is facilitated may be beneficial. © 2011 Allison et al; licensee BioMed Central Ltd.",Allison S.J.; Stafford J.; Anumba D.O.C.,2011.0,10.1186/1472-6874-11-33,0,0,
7644,The role of serotonin in the emotional and residual effects of MDMA,"Over 25 years ago, Nichols proposed that MDMA represented a novel class of psychoactive. Since then, many have anecdotally described seemingly unusual social-emotional MDMA effects. However, controlled studies are only beginning to examine these claims. We have conducted a series of controlled clinical experiments with MDMA to test anecdotal claims and characterize the drug's effects on self-report, perceptual, attentional, and autobiographical speech measures. We used coadministration of the SSRI citalopram to investigate the contributions of serotonergic mechanisms to these acute effects and to adverse residual effects. We find that MDMA increases sociability and decreases social anxiety while altering assessment of social images. MDMA also produces residual cognitive changes. Many of these effects have mechanisms that involve the serotonin transporter. These results may have implications for understanding the contributions of serotonin to positive and negative affect. MDMA may impair serotonergic modulation of harm sensitivity, yet the pattern of effects additionally suggests activation of biologicallybased attachment systems.",Baggott M.J.; Coyle J.R.; Galloway G.P.; Mendelson J.E.,2011.0,10.1097/01.fbp.0000399674.93315.4e,0,0,
7645,The neurobiology and psychopharmacology of GAD,"Neurobiological research in generalised anxiety disorder (GAD) has been hampered by uncertainties concerning the diagnostic independence of the disorder. During the past few years, research has identified several candidate genes, but their significance is still unclear. Neuroimaging studies have shown increased activity in the fear circuitry of the brain. When focusing on worrying as a central feature of GAD, studies using functional magnetic resonance imaging have shown that there is increased amygdala activity as a neural correlate of negative expectations of the future [1]. This may lead to support from neurobiological findings for theories of cognitive dysfunction in anxiety disorders. It might be argued that increased amygdala activity represents an enhanced anticipatory emotional response in GAD, and may explain why worrying is the core symptom of the disorder. Recent evidence-based guidelines for pharmacological management have recommended, as first-line treatment for GAD, the selective serotonin reuptake inhibitors escitalopram, paroxetine and sertraline,ª the serotonin-norepinephrine reuptake inhibitors venlafaxine and duloxetine and the calcium channel modulator pregabalin [2]. Efficacy has been observed with the atypical antipsychotic quetiapine,ª but these results must be seen as preliminary [2]. There is a paucity of studies in treatment-resistant (TR) GAD. In recent years, several clinical trials on adjunctive use of atypical antipsychotics for TR GAD have been published. Available evidence from controlled studies indicates significant reductions on HAM-A scales for risperidone and olanzapine in TR GAD. One placebo-controlled add-on study using augmentation with pregabalin in TR GAD has suggested good efficacy [3]. ªSertraline and quetiapine are not licensed for the treatment of GAD in Europe.",Den Boer J.A.,2011.0,10.1016/S0924-977X(11)71038-0,0,0,
7646,"Intolerance of uncertainty and decisions about delayed, probabilistic rewards","Worry is the inflated concern about potential future threats and is a hallmark feature of generalized anxiety disorder. Previous theoretical work has suggested that worry may be a consequence of intolerance of uncertainty (IU). The current study seeks to explore the behavioral consequences of IU. Specifically, we examine how IU might be associated with aspects of reward-based decision making. We utilized a simple laboratory gambling task in which participants chose between small, low-probability rewards available immediately at the beginning of each trial and large, high-probability rewards only available after some variable delay. Results demonstrate that higher levels of intolerance of uncertainty were associated with a tendency to select the immediately available, but less valuable and less probable rewards. IU also predicted decision-makers' sensitivity to outcomes. We discuss the cognitive and affective mechanisms that are likely to underlie the observed decision-making behavior and the implications for anxiety disorders. © 2011.",Luhmann C.C.; Ishida K.; Hajcak G.,2011.0,10.1016/j.beth.2010.09.002,0,0,
7647,Changes in cortical slow wave activity in healthy aging,"A number of studies have demonstrated enhanced slow wave activity associated with pathological brain function e. g. in stroke patients, schizophrenia, depression, Morbus Alzheimer, and post-traumatic stress disorder. However, the association between slow wave activity and healthy aging has remained largely unexplored. This study examined whether the frequency at which focal generators of delta waves appear in the healthy cerebral cortex changes with age and whether this measure relates to cognitive performance. We investigated 53 healthy individuals aged 18 to 89 years and assessed MEG during a resting condition. Generators of focal magnetic slow waves were localized. Results showed a significant influence of age: dipole density decreases with increasing age. The relationship between cognitive performance and delta dipole density was not significant. The results suggest that in healthy aging slow waves decrease with aging and emphasize the importance of age-matched control groups for further studies. Increased appearance of slow waves as a marker for pathological stages can only be detected in relation to a control group of the same age. © 2011 Springer Science+Business Media, LLC.",Leirer V.M.; Wienbruch C.; Kolassa S.; Schlee W.; Elbert T.; Kolassa I.-T.,2011.0,10.1007/s11682-011-9126-3,0,0,
7648,Obsessive-compulsive-like reasoning makes an unlikely catastrophe more credible,"When obsessive-compulsive (OC) patients are confronted with disorder-relevant situations, they tend to reason in chains of small steps between the current situation and a highly improbable catastrophe. It was hypothesized that this type of ""perseverative reasoning"" would increase the subjective likelihood of the feared catastrophe. In an experiment with 63 healthy undergraduates, we tested whether OC-like perseverative reasoning induces feelings of uncertainty about a harmful outcome and makes this outcome more credible. Furthermore, we explored whether making multiple series of events increases these effects. Participants were administered a neutral situation with a catastrophic improbable outcome. In a pre- and post-test, they rated the credibility of this outcome and feelings of uncertainty about the outcome. In between, two experimental groups were instructed to generate respectively one or five series of intermediate steps between the situation and the harmful outcome, while a control group carried out a filler task. Consistent with the predictions, perseverative reasoning enhanced the credibility of a negative, improbable outcome. However, there were no differences between the two experimental conditions (one or five reasoning chains), and perseverative reasoning did not increase uncertainty about the outcome. The OC-like generation of small steps between an innocuous situation and a negative outcome increases the credibility of a feared outcome, potentially serving to maintain obsessive-compulsive disorder (OCD) problems. © 2011 Elsevier Ltd. All rights reserved.",Giele C.L.; Van Den Hout M.A.; Engelhard I.M.; Dek E.C.P.; Hofmeijer F.K.,2011.0,10.1016/j.jbtep.2010.12.012,0,0,
7649,The challenge of subject selection in clinical trials,"Introduction: Clinical trial failure rates in several disease areas are approximately 50% even in trials powered at 80-90%. Expectation bias, therapeutic alliance, poor inter-rater reliability and the enrollment of inappropriate subjects by including subjects who are inaccurately diagnosed or insufficiently ill can lead to decreased signal detection. We present data from several studies examining the frequency of inappropriate subject enrollment based on inaccurate diagnosis or severity score and examine the use of blinded independent central raters in decreasing inappropriate subject enrollment. Methods: We present three studies in two different therapeutic areas in which subjects were assessed by both site raters and blinded independent central raters. In study 1, inter-rater reliability and internal consistency reliability were assessed in a study of major depressive disorder (MDD). 81 subjects with MDD participated in a study of placebo response. They were interviewed at three time points by both site and blinded independent central raters on the HAM-D. In study 2, two doses of an experimental compound were compared to placebo in a generalized anxiety disorder (GAD) study. 290 subjects with GAD were interviewed by both blinded independent clinicians and site raters with the HAM-A at four visits. In study 3, 341 subjects were interviewed on the HAM-A by both a site rater and a blinded independent central rater at baseline and week 6. Inter-rater reliability and placebo response were assessed Finally, in two studies, subjects referred by site personnel were diagnosed by blinded independent central raters using the SCID. Accuracy of diagnosis was examined. Results: In study 1, 35% (23/66) of the subjects included based on site ratings would have been excluded based on the ratings of blinded independent central raters. In study 2, subject ascertainment by blinded independent clinicians increased the drug effect size of the site ratings from 0.32 to 0.64. In study 3, blinded independent central raters would have excluded 52% of subjects enrolled by site raters. There was also statistically significantly greater placebo response in the group of subjects that site raters would have included but blinded independent central raters would have excluded. Analysis of diagnostic assessments by blinded independent clinicians using the SCID-CT revealed that diagnostic criteria were not met for 25-53% of site-referred study candidates. Conclusion: Subject ascertainment issues are pervasive and substantial. These studies suggest that 1/3 to 1/2 of the subjects enrolled in clinical trials may not meet protocol-specified inclusion/exclusion criteria and would be excluded by blinded independent clinicians' ratings of initial severity. Diagnosis is an additional source of potential error. 1/4 to 1/2 of subjects may not meet protocol-specified diagnostic criteria. Blinded independent clinicians may be beneficial for diagnosis and symptom severity assessment across several therapeutic areas. Accurate subject ascertainment may substantially increase effect size.",Detke M.; Williams J.B.W.; Kobak K.A.; Ellis A.; Giller E.; Brown B.; Reines S.; Kane J.; Popp D.,2011.0,10.1016/S0924-977X(11)71011-2,0,0,
7650,Cognitive-behaviour therapy interventions in PRS: Short-term and long-term outcomes,"In recent years, criteria based on sub-threshold levels of psychotic symptoms or self-perceived cognitive deficits have been found to predict psychosis onset within 12 months in 20-30% of the cases. These findings have provided the opportunity of indicated prevention efforts in order to reduce or prevent the devastating effects of schizophrenia. It has been argued that cognitive behaviour therapy (CBT) may have some advantages compared with antipsychotics (AN): (a) more acceptable, tolerable and less stigmatizing to (b) no risk of exposing false positives to pharmacological side effects, (c) effective treatment for false positives (depression, anxiety disorders). By the time of writing 5 randomised controlled trials (RCTs) have been (at least partially) published, which included CBT as an intervention arm. As regards short term outcomes (12 months), one trial reported advantages for CBT when combined with AN over supportive therapy (SC). In two trials the findings indicated superiority of CBT in comparison to monitoring or SC. One trial did not report statistical differences between CBT and SC. One trial did report no statistical differences between CBT, SC and AN. The differences between trial conditions were even smaller at longer term follow up (24 to 36 months). As a consequence the superiority of CBT over control conditions has to be judged as preliminary. Therefore there is a need for methodological sound collaborative large scale RCT involving CBT and AN as preventive strategies. Such trials are on the way at present.",Bechdolf A.,2011.0,10.1016/S0924-977X(11)70255-3,0,0,
7651,The effects of familiarity on thought-action fusion,"The present study examined whether beliefs about the importance of thoughts (i.e., thought-action fusion; TAF) are related to the target subject of the negative thought. One hundred and seven undergraduate students were randomly assigned to imagine either a beloved relative or a stranger being diagnosed with cancer and provided in vivo ratings of anxiety, likelihood, moral wrongness, urge to neutralize, and how upsetting the event would be if it occurred. Results indicated that thinking of a relative being diagnosed with cancer provoked more distress, urges to neutralize, and higher estimates of likelihood, as well greater use of mental neutralizing behaviors, compared to thinking of a stranger. Contrary to our prediction, the groups did not differ in their ratings of the moral wrongness. These findings broadly support the assertion that the more personally significant a negative intrusive thought, the more it will provoke distress and urges to neutralize. Results are discussed in terms of the cognitive model of obsessions and clinical implications are addressed. © 2011 Elsevier Ltd.",Berman N.C.; Wheaton M.G.; Fabricant L.E.; Jacobson S.R.; Abramowitz J.S.,2011.0,10.1016/j.brat.2011.07.010,0,0,
7652,Attentional control as a moderator of the relationship between posttraumatic stress symptoms and attentional threat bias,"Attentional threat bias (ATB) has been suggested as one factor leading to maintenance and exacerbation of posttraumatic stress symptoms (PTSS). In the present study, attentional processes (i.e., facilitated engagement, difficulty disengaging) underlying the association between ATB and PTSS were examined. Additionally, attentional control (AC) was examined as a moderator of this relationship. Participants (N= 97) completed a dot-probe task with two levels of stimulus-onset asynchrony (SOA: 150 and 500 ms). Higher PTSS were associated with ATB when SOA was longer (i.e., 500 ms), suggesting difficulty disengaging from threat stimuli. AC moderated the relationship between PTSS and ATB when SOA was shorter (i.e., 150 ms), with participants high in PTSS and high in AC having disengaged and shifted attention from threat stimuli using top-down AC when the emotional valence of threat stimuli was less salient (i.e., shorter presentation duration). Findings implicate AC as a buffering mechanism against prolonged attentional engagement with threat-related stimuli among those with high PTSS. Current PTSD interventions may benefit from incorporating attention-based components. © 2011 Elsevier Ltd.",Bardeen J.R.; Orcutt H.K.,2011.0,10.1016/j.janxdis.2011.06.009,0,0,
7653,Music in a serial repetition task: Is there perseverative behavior?,"Background: This paper revisits some of the processes that contribute to the study of perseveration. In particular it investigates whether the perseverative last step in an addition task (Brugger & Gardner, 1994) occurs in normal subjects with or without a systematic musical education. The classic mathematical addition task, which requires the repetitive change of the position of digits in a calculation (1000+40+1000+30+1000+20+ 1000+10) was applied to music, but with an exception in the change allowed in the last move. Material/Methods: The sample consisted of 40 healthy college students from northern Greece (19 men, 21 women, 18 to 27 years of age). Two music tasks were used. The first consisted of 7 measures of descending, morphologically similar note patterns, and the subjects were asked to anticipate the eighth measure. The second required the prediction of the sixth measure of a more complex, ascending and descending five-measure pattern. Results: For the majority of subjects and for all three tasks, regardless of the degree of creativity allowed by the instructions, there was a strong, incorrect imitative continuation of the way that subjects had previously responded to the tasks, i.e. an inappropriate maintenance of the pattern. Conclusions: Music has no specific response similar to the perseverative last step in the addition task, but the lack of a unique correct response does not prevent further study of this phenomenon.",Giannouli V.,2011.0,,0,0,
7654,A life course perspective on migration and mental health among Asian immigrants: The role of human agency,"The relationship between human agency and health is an important yet under-researched topic. This study uses a life course perspective to examine how human agency (measured by voluntariness, migratory reasons, and planning) and timing (measured by age at immigration) affect mental health outcomes among Asian immigrants in the United States. Data from the National Latino and Asian American Study showed that Asian immigrants (n = 1491) with multiple strong reasons to migrate were less likely to suffer from mental health problems (i.e., psychological distress and psychiatric disorders in the past 12 months) than those without clear goals. Moreover, Asian immigrants with adequate migratory planning had lower levels of distress and lower rates of 12-month psychiatric disorders than those with poorly planned migration. Compared with migrants of the youngest age category (six or younger), those who migrated during preteen and adolescent years without clear goals had higher levels of psychological distress, and those who migrated during adulthood (25 years or older) were less likely to suffer from recent depressive disorders (with the exception of those migrating for life-improving goals). Furthermore, we found that well-planned migration lowered acculturative stress, and multiple strong reasons for migration buffered the negative effect of acculturative stress upon mental health. Findings from this study advance research on immigrant health from the life course perspective by highlighting the effects of exercising human agency during the pre-migration stage upon post-migration mental health. © 2011 Elsevier Ltd.",Gong F.; Xu J.; Fujishiro K.; Takeuchi D.T.,2011.0,10.1016/j.socscimed.2011.09.014,0,0,
7655,The Small World of Psychopathology,"Background: Mental disorders are highly comorbid: people having one disorder are likely to have another as well. We explain empirical comorbidity patterns based on a network model of psychiatric symptoms, derived from an analysis of symptom overlap in the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Principal Findings: We show that a) half of the symptoms in the DSM-IV network are connected, b) the architecture of these connections conforms to a small world structure, featuring a high degree of clustering but a short average path length, and c) distances between disorders in this structure predict empirical comorbidity rates. Network simulations of Major Depressive Episode and Generalized Anxiety Disorder show that the model faithfully reproduces empirical population statistics for these disorders. Conclusions: In the network model, mental disorders are inherently complex. This explains the limited successes of genetic, neuroscientific, and etiological approaches to unravel their causes. We outline a psychosystems approach to investigate the structure and dynamics of mental disorders. © 2011 Borsboom et al.",Borsboom D.; Cramer A.O.J.; Schmittmann V.D.; Epskamp S.; Waldorp L.J.,2011.0,10.1371/journal.pone.0027407,0,0,
7656,Observational learning and pain-related fear: An experimental study with colored cold pressor tasks,"The primary aim of the current study was to experimentally test whether pain-related fear can be acquired through observational learning, whether extinction occurs after actual exposure to the aversive stimulus, and whether pain-related fear was associated with increased pain ratings. During an observation phase, female volunteers watched a video showing models performing cold pressor tasks (CPT), of which the color served as a conditioned stimulus (CS). In a differential fear conditioning paradigm, each of 2 colors were either paired with models' painful (CS+) or neutral (CS-) facial expressions. Exposure consisted of participants performing CPTs of both colors (10°C). Self-reported fear of pain and expected pain ratings were obtained after the observation period, while actual pain and avoidance measures were obtained during and after exposure. Results show that after observing another person performing the CPT associated with the painful faces, subjects report more fear of pain and expect more intense and unpleasant pain as compared with the CPT associated with the neutral faces. This effect of observational learning on pain-related fear persisted until after exposure. During and after exposure no stimulus-type effect for pain ratings was found. This study provides preliminary evidence for observational learning of pain-related fear in humans. Perspective: Fear of pain can be more disabling than pain itself, and is a risk factor for chronic pain. Knowledge about the acquisition of pain-related fear may help to develop novel pain management programs. This study is one of the first to demonstrate the effects of observational learning on pain-related fear. © 2011 by the American Pain Society.",Helsen K.; Goubert L.; Peters M.L.; Vlaeyen J.W.S.,2011.0,10.1016/j.jpain.2011.07.002,0,0,
7657,Influences of menstrual cycle position and sex hormone levels on spontaneous intrusive recollections following emotional stimuli,"Spontaneous intrusive recollections (SIRs) are known to follow emotional events in clinical and non-clinical populations. Previous work in our lab has found that women report more SIRs than men after exposure to emotional films, and that this effect is driven entirely by women in the luteal phase of the menstrual cycle. To replicate and extend this finding, participants viewed emotional films, provided saliva samples for sex hormone concentration analysis, and estimated SIR frequency following film viewing. Women in the luteal phase reported significantly more SIRs than did women in the follicular phase, and SIR frequency significantly correlated with salivary progesterone levels. The results are consistent with an emerging pattern in the literature suggesting that menstrual cycle position of female participants can potently influence findings in numerous cognitive domains. The potential implications of these results for disorders characterized by intrusions, such as post-traumatic stress disorder, are also discussed. © 2011 Elsevier Inc.",Ferree N.K.; Kamat R.; Cahill L.,2011.0,10.1016/j.concog.2011.02.003,0,0,
7658,Effect of d-cycloserine and valproic acid on the extinction of reinstated fear-conditioned responses and habituation of fear conditioning in healthy humans: A randomized controlled trial,"Rationale: Although the effects of d-cycloserine (DCS) and valproic acid (VPA) on the facilitation of the extinction of fear-conditioned memory have been elucidated in animals, these effects have not been clearly confirmed in humans. Objective: This study aimed to determine the effect of DCS (100 mg) and VPA (400 mg) on the facilitation of the extinction and acquisition of fear-conditioned memory in humans. Methods: We performed a randomized, blind, placebo-controlled, four-arm clinical trial in 60 healthy adults. Visual cues and electric shocks were used as the conditioned stimulus (CS) and unconditioned stimulus (US), respectively. Results: The extinction or acquisition effect was not observed in the simple recall after the extinction or acquisition of coupled CS-US; however, the extinction and habituation effects but not the acquisition effects were presented after the unexpected re-exposure of coupled CS-US (reinstatement stimuli). Extinction and habituation effects were facilitated by either a single dose of DCS or VPA or a combination of DCS and VPA. However, we did not observe the expected synergistic effect of the combined treatment on the extinction or habituation of fear conditioning. Conclusion: A single dose of DCS or VPA might enhance exposure-based cognitive therapy of anxiety disorders by reducing the vulnerability to reinstatement and preventing relapses of fear-conditioned responses. © 2011 Springer-Verlag.",Kuriyama K.; Honma M.; Soshi T.; Fujii T.; Kim Y.,2011.0,10.1007/s00213-011-2353-x,0,0,
7659,Individual differences in the ability to recognise facial identity are associated with social anxiety,"Previous research has been concerned with the relationship between social anxiety and the recognition of face expression but the question of whether there is a relationship between social anxiety and the recognition of face identity has been neglected. Here, we report the first evidence that social anxiety is associated with recognition of face identity, across the population range of individual differences in recognition abilities. Results showed poorer face identity recognition (on the Cambridge Face Memory Test) was correlated with a small but significant increase in social anxiety (Social Interaction Anxiety Scale) but not general anxiety (State-Trait Anxiety Inventory). The correlation was also independent of general visual memory (Cambridge Car Memory Test) and IQ. Theoretically, the correlation could arise because correct identification of people, typically achieved via faces, is important for successful social interactions, extending evidence that individuals with clinical-level deficits in face identity recognition (prosopagnosia) often report social stress due to their inability to recognise others. Equally, the relationship could arise if social anxiety causes reduced exposure or attention to people's faces, and thus to poor development of face recognition mechanisms. © 2011 Davis et al.",Davis J.M.; McKone E.; Dennett H.; O'Connor K.B.; O'Kearney R.; Palermo R.,2011.0,10.1371/journal.pone.0028800,0,0,
7660,Sex differences in emotional memory consolidation: The effect of stress-induced salivary alpha-amylase and cortisol,"This study examined sex differences in the emotional memory consolidation, and the impact of stress-induced cortisol and salivary alpha amylase responses on emotional memory recall. Following baseline salivary measures, 39 healthy women and 41 men viewed 20 neutral and 20 negative arousing images, and then underwent either a cold pressor stress test or control condition, followed by further salivary measures. Participants returned two days later for a free recall test. The stress condition induced greater cortisol response, and negative images were better recalled than neutral. Whereas women displayed greater recall of negative images under stress than men, they recalled fewer negative images in the control condition. Stress-induced cortisol predicted recall of negative images in women, and neutral images in men. This suggests there is an enhanced consolidation of negative images under stress in women that may be a potential mechanism for the greater female prevalence for developing anxiety disorders. © 2011 Elsevier B.V.",Felmingham K.L.; Tran T.P.; Fong W.C.; Bryant R.A.,2012.0,10.1016/j.biopsycho.2011.12.006,0,0,
7661,Neural correlates of blink suppression and the buildup of a natural bodily urge,"Neuroimaging studies have elucidated some of the underlying physiology of spontaneous and voluntary eye blinking; however, the neural networks involved in eye blink suppression remain poorly understood. Here we investigated blink suppression by analyzing fMRI data in a block design and event-related manner, and employed a novel hypothetical time-varying neural response model to detect brain activations associated with the buildup of urge. Blinks were found to activate visual cortices while our block design analysis revealed activations limited to the middle occipital gyri and deactivations in medial occipital, posterior cingulate and precuneus areas. Our model for urge, however, revealed a widespread network of activations including right greater than left insular cortex, right ventrolateral prefrontal cortex, middle cingulate cortex, and bilateral temporo-parietal cortices, primary and secondary face motor regions, and visual cortices. Subsequent inspection of BOLD time-series in an extensive ROI analysis showed that activity in the bilateral insular cortex, right ventrolateral prefrontal cortex, and bilateral STG and MTG showed strong correlations with our hypothetical model for urge suggesting these areas play a prominent role in the buildup of urge. The involvement of the insular cortex in particular, along with its function in interoceptive processing, helps support a key role for this structure in the buildup of urge during blink suppression. The right ventrolateral prefrontal cortex findings in conjunction with its known involvement in inhibitory control suggest a role for this structure in maintaining volitional suppression of an increasing sense of urge. The consistency of our urge model findings with prior studies investigating the suppression of blinking and other bodily urges, thoughts, and behaviors suggests that a similar investigative approach may have utility in fMRI studies of disorders associated with abnormal urge suppression such as Tourette syndrome and obsessive-compulsive disorder. © 2011 Elsevier Inc.",Berman B.D.; Horovitz S.G.; Morel B.; Hallett M.,2012.0,10.1016/j.neuroimage.2011.08.050,0,0,
7662,Effects of acute exercise on CO2-induced fear,"Background: Acute exercise has shown to reduce the effects of experimental panic provocation in healthy volunteers and in patients with panic disorder. Recent evidence suggests that when larger amounts of CO2 are inhaled, a large proportion of healthy subjects can also develop an affective response consistent with definitions of a panic attack. Our aim was to test whether exercise can show antipanic effects in healthy subjects when exposed to higher concentrations of CO2. Methods: Thirty-one healthy subjects, on four separate occasions in a randomized Latin square design, performed either moderate/hard or very-light exercise immediately followed by either a single or a double 35% CO2/65% O2 inhalation. Results: Compared to very-light exercise, when subjects performed moderate/hard exercise they reported a reduction in panic symptoms on the Panic Symptom List and the Visual Analogue Scale of Fear but no difference on the Visual Analogue Scale of Discomfort after a double CO2 inhalation. After a single CO 2 inhalation, reductions were only seen on the Panic Symptom List. Conclusions: After intense exercise, subjects had less panic symptoms when exposed 35% CO2, particularly after a double inhalation. © 2011 Wiley-Liss, Inc.",Esquivel G.; Dandachi A.; Knuts I.; Goossens L.; Griez E.; Schruers K.,2012.0,10.1002/da.20860,0,0,
7663,Interpretation of ambiguous social scenarios in social phobia and depression: Evidence from event-related brain potentials,"In the current study, event-related potentials (ERPs) and behavioral responses were measured in individuals meeting diagnostic criteria for social phobia, depression, their combination, or neither in order to examine the unique and combined effects of social phobia and depression on the interpretation of ambiguous social scenarios. ERPs revealed a lack of positive interpretation bias and some suggestion of a negative bias in the semantic expectancy N4 component across all clinical groups. Furthermore, socially phobic and comorbid individuals showed reductions in baseline attention allocation to the task, as indexed by P6 amplitude. RT and accuracy likewise revealed a lack of positive interpretation bias across disordered groups. When considered on a continuum across all samples, social phobia and depression symptoms were related to the N4 interpretation bias effect whereas P6 amplitude reduction and RT interpretation bias appeared uniquely associated with social phobia. © 2011 Elsevier B.V.",Moser J.S.; Huppert J.D.; Foa E.B.; Simons R.F.,2012.0,10.1016/j.biopsycho.2011.12.001,0,0,
7664,"The effect of group sandplay therapy on the social anxiety, loneliness and self-expression of migrant women in international marriages in South Korea","Recently, the number of international married couples in South Korea has been increasing and thus the related negative social phenomena, which have been observed in other multicultural societies, are also increasing. The purpose of this study was to implement group sandplay therapy on migrant women in international marriages in Korea and Verify that this intervention was effective in relieving the women's social anxiety and loneliness and improving the self-expression. The results indicated that using sandplay, women who immigrated to and live in Korea for marriage can reduce negative emotions related to anxiety and loneliness, and produce positive self-expressions, while making their own world. © 2011 Elsevier Inc.",Jang M.; Kim Y.-H.,2012.0,10.1016/j.aip.2011.11.008,0,0,
7665,"ADORA2A gene variation, caffeine, and emotional processing: A multi-level interaction on startle reflex","There is converging evidence for genetic, biochemical, and neuropsychological factors to increase the risk for anxiety and anxiety disorders. The pathogenesis of anxiety disorders is assumed to be influenced by a complex interaction of these individual risk factors on several levels, affecting intermediate phenotypes of anxiety such as the startle reflex. Thus, in the present double-blind, placebo-controlled study we attempted to paradigmatically investigate a multi-level pathogenetic model of anxiety by testing the effect of 300 mg caffeine citrate as an antagonist at the adenosine A2A receptor vs placebo on the emotion-potentiated (unpleasant, neutral, and pleasant International Affective Picture System pictures) startle reflex in 110 healthy individuals (male = 56, female = 54) stratified for the adenosine A2A receptor (ADORA2A) 1976T > C polymorphism (rs5751876). In addition to the expected main effect of picture category (highest startle amplitude for unpleasant, lowest for pleasant pictures) groups across all ADORA2A 1976T > C genotype and intervention (caffeine vs placebo) groups, an interaction effect of genotype, intervention, and picture category was discerned: In ADORA2A 1976TT risk genotype carriers, highest startle magnitudes were observed after caffeine administration in response to unpleasant pictures, with this effect arising particularly from the female subgroup. Our data point to a complex, multi-level, and potentially gender-specific pathogenetic model of anxiety, with genetic and biochemical factors interactively increasing the risk of maladaptive emotional processing and thereby possibly also anxiety disorders. The present findings may eventually aid in improving primary and secondary prevention by sharpening the risk profiles of anxiety-prone individuals. © 2012 American College of Neuropsychopharmacology. All rights reserved.",Domschke K.; Gajewska A.; Winter B.; Herrmann M.J.; Warrings B.; Mühlberger A.; Wosnitza K.; Glotzbach E.; Conzelmann A.; Dlugos A.; Fobker M.; Jacob C.; Arolt V.; Reif A.; Pauli P.; Zwanzger P.; Deckert J.,2012.0,10.1038/npp.2011.253,0,0,
7666,Biological sex and panic-relevant anxious reactivity to abrupt increases in bodily arousal as a function of biological challenge intensity,"An emerging pattern of results from panic-relevant biological challenge studies suggests women respond with greater subjective anxiety than men, but only to relatively abrupt and intense challenge procedures. The current investigation examined the relation between biological sex and self-reported anxious reactivity following biological challenges of varying durations and intensity. Participants were 285 (152 females; Mage = 21.38; SD = 5.92) nonclinical adults who completed one of three protocols: a 3-min voluntary hyperventilation challenge (VH), a 5-min 10% carbon dioxide-enriched air (CO2) challenge, or a 25-s 20% CO2 challenge. As predicted, results indicated that the 20% CO2 challenge elicited greater self-reported anxiety than the VH and 10% CO2 challenges. Moreover, women endorsed greater anxious reactivity than men, but only following the 20% CO2 challenge. Results are discussed in terms of processes likely to account for sex differences in anxious reactivity following relatively abrupt and intense biological challenges. © 2011 Elsevier Ltd. All rights reserved.",Bunaciu L.; Feldner M.T.; Babson K.A.; Zvolensky M.J.; Eifert G.H.,2012.0,10.1016/j.jbtep.2011.07.001,0,0,
7667,Interoceptive Fear Conditioning and Panic Disorder: The Role of Conditioned Stimulus-Unconditioned Stimulus Predictability,"Interoceptive fear conditioning is at the core of contemporary behavioral accounts of panic disorder. Yet, to date only one study has attempted to evaluate interoceptive fear conditioning in humans (see Acheson, Forsyth, Prenoveau, & Bouton, 2007). That study used brief (physiologically inert) and longer-duration (panicogenic) inhalations of 20% CO2-enriched air as an interoceptive conditioned (CS) and unconditioned (US) stimulus and evaluated fear learning in three conditions: CS only, CS-US paired, and CS-US unpaired. Results showed fear conditioning in the paired condition, and fearful responding and resistance to extinction in an unpaired condition. The authors speculated that such effects may be due to difficulty discriminating between the CS and the US. The aims of the present study are to (a) replicate and expand this line of work using an improved methodology, and (b) clarify the role of CS-US discrimination difficulties in either potentiating or depotentiating fear learning. Healthy participants (N=104) were randomly assigned to one of four conditions: (a) CS only, (b) contingent CS-US pairings, (c) unpaired CS and US presentations, or (d) an unpaired ""discrimination"" contingency, which included an exteroceptive discrimination cue concurrently with CS onset. Electrodermal and self-report ratings served as indices of conditioned responding. Consistent with expectation, the paired contingency and unpaired contingencies yielded elevated fearful responding to the CS alone. Moreover, adding a discrimination cue to the unpaired contingency effectively attenuated fearful responding. Overall, findings are consistent with modern learning theory accounts of panic and highlight the role of interoceptive conditioning and unpredictability in the etiology of panic disorder. © 2011.",Acheson D.T.; Forsyth J.P.; Moses E.,2012.0,10.1016/j.beth.2011.06.001,0,0,
7668,Linguistic Predictors of Post-Traumatic Stress Disorder Symptoms Following 11 September 2001,"Prior research has linked content analysis drawn from text narratives to psychopathology in trauma survivors. This study used a longitudinal design to determine whether linguistic elements of narrative memories of first hearing about the events of 11 September 2001 predict later post-traumatic stress disorder (PTSD). Narratives and self-report PTSD symptoms were collected within 1week and again 5months after 9/11 in 40 undergraduates. People who used more ""we"" words at Time 1 had fewer acute PTSD symptoms. Use of more cognitive mechanism words, more religion words, more first-person singular pronouns, and fewer anxiety words at Time 1 were related to more chronic PTSD symptoms. Linguistic characteristics accounted for variance in chronic PTSD symptoms above and beyond acute PTSD symptoms. This study provides evidence that lasting PTSD symptoms can be predicted through language in the immediate aftermath of the trauma. © 2011 John Wiley & Sons, Ltd.",D'Andrea W.; Chiu P.H.; Casas B.R.; Deldin P.,2012.0,10.1002/acp.1830,0,0,
7669,Obsessive-compulsive tendencies and undermined confidence are related to reliance on proxies for internal states in a false feedback paradigm,"Background and objectives: We have previously hypothesized that obsessive-compulsive (OC) tendencies are associated with a general lack of subjective conviction regarding internal states, which leads to compensatory seeking of and reliance on more discernible substitutes (proxies) for these states (Lazarov, A., Dar, R., Oded, Y., & Liberman, N. (2010). Behaviour Research and Therapy, 48, 516-523). This article presents two studies designed to provide further support to this hypothesis by using false biofeedback as a proxy for internal states. Methods: In Study 1 we presented high and low OC participants with pre-programmed false feedback showing either increasing or decreasing levels of muscle tension. In Study 2 we presented similar false feedback on level of relaxation to non-selected participants, half of which received instructions that undermined their confidence in their ability to assess their own level of relaxation. Results: In Study 1, high OC participants were more affected by false biofeedback when judging their own level of muscle tension than were low OC participants. In Study 2, undermined confidence participants were more affected by false biofeedback when judging their own level of relaxation as compared to control participants. Limitations: Our findings are based on a non-clinical, highly functioning, largely female student sample and their generalization to OCD requires replication with a sample of OCD patients. Conclusions: These results provide converging evidence for our hypothesis by replicating and extending our previous findings. We discuss the implication of our hypothesis for the understanding and treatment of OCD and outline directions for future research. © 2011 Elsevier Ltd. All rights reserved.",Lazarov A.; Dar R.; Liberman N.; Oded Y.,2012.0,10.1016/j.jbtep.2011.07.007,0,0,
7670,"The Role of ""Interoceptive"" Fear Conditioning in the Development of Panic Disorder","More than 20% of the general population experience a panic attack at least once in their lives; however, only a minority goes on to develop panic disorder (PD). Conditioning mechanisms have been proposed to explain this evolution in persons who are susceptible to developing panic disorder upon a ""traumatic"" panic attack. According to preparedness theory, some cues are more likely to condition than others, namely, those referring to internal, bodily signals of danger. The aim of the present study was to test this theory in a differential conditioning paradigm, making use of scripts referring to different internal, bodily sensations as conditioned stimulus (CS) and inhalation of 35% CO2 as unconditioned stimulus (UCS). Thirty-three healthy volunteers were assigned to three scripts conditions: ""suffocation,"" ""neutral,"" or ""urgency."" During acquisition, one of two versions of a particular script was always followed by an inhalation of 35% CO2 (CS+) and the other by room air (CS-). Acquisition was followed by a test phase, where only inhalations of room air were administered. In line with our hypothesis, only participants in the suffocation condition exhibited a selective conditioning effect. They were more fearful and showed a significantly higher increase in tidal volume than participants in the two control conditions. Results are discussed with relation to interoceptive conditioning, preparedness, and the possible role of tidal volume in PD. © 2011.",De Cort K.; Griez E.; Büchler M.; Schruers K.,2012.0,10.1016/j.beth.2011.06.005,0,0,
7671,The effects of 7.5% carbon dioxide inhalation on task performance in healthy volunteers,"Studies have shown that anxiety can positively or negatively affect performance with respect to focusing of attention or distractibility, subjective workload and effort (Humphreys and Revelle, 1984). The inhalation of carbon dioxide (CO2) is associated with physiological and psychological effects of anxiety (Bailey et al., 2005) but its effects on performance have rarely been reported. The studies reported here looked at the effects of CO2 inhalation on physiological and subjective measures and performance on two tasks. Eight healthy male participants completed a tracking task with a reaction time component, and 12 healthy participants (six male) completed a complex target identification task. Tasks were performed during 20-min inhalations of 7.5% CO2/21% O2/71.5% N2 mixture or medical air. Continuous heart rate and blood pressure measures were taken, in addition to subjective measures of mood and workload. In comparison with air, CO2 increased heart rate and blood pressure, increased subjective scores of panic, anxiety, fear, and tension, and reduced subjective scores of relaxation and happiness. Attention was focussed when inhaling CO2 during the simple task, and central demand was greater when inhaling CO2 during the complex task. Therefore, inhalation of 7.5% CO2 produces effects on task performance which are consistent with anxiety. © The Author(s) 2012.",Diaper A.; Nutt D.J.; Munafò M.R.; White J.L.; Farmer E.W.; Bailey J.E.,2012.0,10.1177/0269881111415729,0,0,
7672,P50 suppression in human discrimination fear conditioning paradigm using danger and safety signals,"Auditory P50 suppression, which is assessed using a paired auditory stimuli (S1 and S2) paradigm to record the P50 mid-latency evoked potential, is assumed to reflect sensory gating. Recently, P50 suppression deficits were observed in patients with anxiety disorders, including panic disorder, post-traumatic stress disorder and obsessive-compulsive disorder, as we previously reported. The processes of fear conditioning are thought to play a role in the pathophysiology of anxiety disorders. In addition, we found that the P50 sensory gating mechanism might be physiologically associated with fear conditioning and extinction in a simple human fear-conditioning paradigm that involved a light signal as a conditioned stimulus (CS. +). Our objective was to investigate the different patterns of P50 suppression in a discrimination fear-conditioning paradigm with both a CS. + (danger signal) and a CS. - (safety signal). Twenty healthy volunteers were recruited. We measured the auditory P50 suppression in the control (baseline) phase, in the fear-acquisition phase, and in the fear-extinction phase using a discrimination fear-conditioning paradigm. Two-way (CSs vs. phase) Analysis of variance with repeated measures demonstrated a significant interaction between the two factors. Post-hoc LSD analysis indicated that the P50 S2/S1 ratio in the CS. + acquisition phase was significantly higher than that in the CS. - acquisition phase. These results suggest that the auditory P50 sensory gating might differ according to the cognition of the properties (potentially dangerous or safe) of the perceived signal. © 2012 Elsevier B.V.",Kurayama T.; Matsuzawa D.; Komiya Z.; Nakazawa K.; Yoshida S.; Shimizu E.,2012.0,10.1016/j.ijpsycho.2012.01.004,0,0,
7673,High visual working memory capacity in trait social anxiety,"Working memory capacity is one of the most important cognitive functions influencing individual traits, such as attentional control, fluid intelligence, and also psychopathological traits. Previous research suggests that anxiety is associated with impaired cognitive function, and studies have shown low verbal working memory capacity in individuals with high trait anxiety. However, the relationship between trait anxiety and visual working memory capacity is still unclear. Considering that people allocate visual attention more widely to detect danger under threat, visual working memory capacity might be higher in anxious people. In the present study, we show that visual working memory capacity increases as trait social anxiety increases by using a change detection task. When the demand to inhibit distractors increased, however, high visual working memory capacity diminished in individuals with social anxiety, and instead, impaired filtering of distractors was predicted by trait social anxiety. State anxiety was not correlated with visual working memory capacity. These results indicate that socially anxious people could potentially hold a large amount of information in working memory. However, because of an impaired cognitive function, they could not inhibit goal-irrelevant distractors and their performance decreased under highly demanding conditions. © 2012 Moriya, Sugiura.",Moriya J.; Sugiura Y.,2012.0,10.1371/journal.pone.0034244,0,0,
7674,Negative emotional responses elicited by the anticipation of pain in others: Psychophysiological evidence,"Limited evidence is available about factors influencing observers' anticipatory emotional responses to another's pain. We investigated fear and distress towards the threat of pain in others, and the moderating role of observers' psychopathic traits and catastrophizing about their own or others' pain. Thirty-six dyads of healthy participants were randomly assigned to either the role of observer or observed participant. Both participants were instructed that 1 colored slide (blue or yellow) signalled that a pain stimulus could possibly be delivered to the observed participant (=pain signal), whereas no pain stimulus would be delivered when a differently colored slide was presented (=safety signal). Observers' self-reported fear, fear-potentiated startle, and corrugator electromyography activity during pain and safety signals were measured. Furthermore, observers rated the presence of pain after each trial allowing assessment of observers' perceptual sensitivity to others' pain. Results indicated that self-reported fear, fear-potentiated startle, and corrugator electromyography activity were augmented during pain signals compared to safety signals. Moreover, these negative emotional responses were heightened in observers highly catastrophizing about others' pain, but reduced in observers with heightened psychopathic traits. Psychopathic traits were also related with a diminished perceptual sensitivity to others' pain. The results are discussed in light of affective-motivational perspectives on pain. Perspective: This study investigated observers' negative emotional responses in anticipation of pain in another, and the moderating role of observers' psychopathic traits and pain catastrophizing. Knowledge about characteristics influencing observers' emotional response to others' pain may provide insight into why observers engage in particular behaviors when faced with another in pain. © 2012 by the American Pain Society.",Caes L.; Uzieblo K.; Crombez G.; De Ruddere L.; Vervoort T.; Goubert L.,2012.0,10.1016/j.jpain.2012.02.003,0,0,
7675,Expectancy bias in a selective conditioning procedure: Trait anxiety increases the threat value of a blocked stimulus,"Background and Objectives: In a blocking procedure, a single conditioned stimulus (CS) is paired with an unconditioned stimulus (US), such as electric shock, in the first stage. During the subsequent stage, the CS is presented together with a second CS and this compound is followed by the same US. Fear conditioning studies in non-human animals have demonstrated that fear responding to the added second CS typically remains low, despite its being paired with the US. Accordingly, the blocking procedure is well suited as a laboratory model for studying (deficits in) selective threat appraisal. The present study tested the relation between trait anxiety and blocking in human aversive conditioning. Methods: Healthy participants filled in a trait anxiety questionnaire and underwent blocking treatment in the human aversive conditioning paradigm. Threat appraisal was measured through shock expectancy ratings and skin conductance. Results: As hypothesized, trait anxiety was positively associated with shock expectancy ratings to the blocked stimulus. Limitations: In skin conductance responding, no significant effects of stimulus type could be detected during blocking training or testing. The current study does not allow strong claims to be made regarding the theoretical process underlying the expectancy bias we observed. Conclusions: The observed shock expectancy bias might be one of the mechanisms leading to non-specific fear in individuals at risk for developing anxiety disorders. A deficit in blocking, or a deficit in selective threat appraisal at the more general level, indeed results in fear becoming non-specific and disconnected from the most likely causes or predictors of danger. © 2011 Elsevier Ltd. All rights reserved.",Boddez Y.; Vervliet B.; Baeyens F.; Lauwers S.; Hermans D.; Beckers T.,2012.0,10.1016/j.jbtep.2011.11.005,0,0,
7676,Medial prefrontal cortex activity during the extinction of conditioned fear: An investigation using functional near-infrared spectroscopy,"The majority of fear conditioning studies in humans have focused on fear acquisition rather than fear extinction. For this reason only a few functional imaging studies on fear extinction are available. A large number of animal studies indicate the medial prefrontal cortex (mPFC) as neuronal substrate of extinction. We therefore determined mPFC contribution during extinction learning after a discriminative fear conditioning in 34 healthy human subjects by using functional near-infrared spectroscopy. During the extinction training, a previously conditioned neutral face (conditioned stimulus, CS+) no longer predicted an aversive scream (unconditioned stimulus, UCS). Considering differential valence and arousal ratings as well as skin conductance responses during the acquisition phase, we found a CS+ related increase in oxygenated haemoglobin concentration changes within the mPFC over the time course of extinction. Late CS+ trials further revealed higher activation than CS- trials in a cluster of probe set channels covering the mPFC. These results are in line with previous findings on extinction and further emphasize the mPFC as significant for associative learning processes. During extinction, the diminished fear association between a former CS+ and a UCS is inversely correlated with mPFC activity - a process presumably dysfunctional in anxiety disorders. Copyright © 2012 S. Karger AG.",Guhn A.; Dresler T.; Hahn T.; Mühlberger A.; Ströhle A.; Deckert J.; Herrmann M.J.,2012.0,10.1159/000337002,0,0,
7677,A cadaveric study on the anatomic variations of the musculocutaneous nerve in the infraclavicular part of the brachial plexus,"Backgroundand Objectives: The Musculocutaneousnervearises from the lateral cord of the brachial plexus, passes inferolaterally and then pierces through the coracobrachialis after supplying it, descends between the biceps and the brachialis, sending branches to both and continues as the lateral cutaneous nerve of the forearm. Variations in the origin, course, branching pattern, termination and the connections of the musculocutaneous nerve are not uncommon. These variations have clinical significance during surgical procedures, in the brachial plexus block and in diagnostic clinical neurophysiology. Methods: A detailed study was carried out on 50 upper limbs by using 25 embalmed cadavers. Dissection of the infraclavicular part of the brachial plexus was done. The variations in the origin, number and course, and their correlations to the coracobrachialis were noted. Results: Absence of the musculocutaneous nerve was noted in 6% of the limbs. The nerve was found to not pierce the coracobrachialis in 6% of the limbs. In 2% of the limbs, the nerve was found to rejoin the median nerve after piercing the coracobrachialis. Interpretation and Conclusion: The observations show that the musculocutaneous nerve has significant variations and that these variations have clinical significance in post traumatic evaluations and in the exploratory innervations of the arm for peripheral nerve repair.",Jamuna M.; Amudha G.,2012.0,,0,0,
7678,Effects of simulated distal radius malunion on contact biomechanics and range of motion,"Background A deepened articular cavity of the distal radius due to a metaphyseal comminution zone is associated with early osteoarthritis and reduced joint motion [Lutz et al., 2005; Medoff et al. 2005]. This deformity has not been investigated biomechanically and therefore the purpose of this study was to evaluate the effects of a deepened articular cavity on contact biomechanics and range of motion in a dynamic biomechanical setting. Methods Six fresh-frozen cadaver forearms were tested in a force controlled testbench during dynamic flexion and extension as previously described (Figure 1, [Erhart et al., 2011]). Intact contact biomechanics were evaluated with an ultrathin pressure sensor. Range of motion was monitored with an ultrasound based motion analysis system. Malunion was then simulated and intraarticular as well as motion data were obtained. Intact and malunion data were compared for the scaphoid and lunate facet and the total radial joint surface in maximum extension, maximum flexion and neutral position. Results Due to malunion simulation, cavity depth increased significantly. Motion decreased significantly to 54- 69% when compared to the intact state (Figure 2). Malunion simulation led to a significant decrease of contact area in maximum extension for all locations. In maximum flexion and neutral position, decrease in contact area was significant for the scaphoid fossa and the total radial joint surface. Contact pressure showed a significant increase in maximum extension in the scaphoid fossa. In maximum flexion and neutral position, contact pressure also increased after malunion simulation for all investigated locations, but without statistical significance. Discussion Already a small increase in cavity depth led to significant alterations in contact biomechanics of the radiocarpal joint and to a significant range of motion decrease. This could be the biomechanical cause for degenerative changes after the investigated type of malunion. We therefore recommend restoration of the normal distal radius shape to minimize osteoarthritis risk post trauma and to improve radiocarpal motion. (Figuer Presented).",Erhart S.; Schmoelz W.; Arora R.; Lutz M.,2012.0,,0,0,
7679,Guilt and compulsive washing: Experimental tests of interrelationships,"Recent evidence suggests a potentially important relationship between guilt and compulsive washing. The present studies sought to clarify this relationship. In Study 1, we examined whether washing reduced guilt. Following guilt induction, 132 non-clinical participants were randomized to one of three conditions: hand-wiping, straightening of clutter, or a control task. Contrary to predictions, analyses indicated no differences between conditions in post-task guilt. Moderator analyses indicated that among those in the straightening task, higher ordering symptoms were associated with greater increases in guilt. Study 2 examined whether guilt increased washing behavior. Sixty-one non-clinical participants were randomized to either a guilt induction or neutral condition. Afterwards, participants were timed as they cleansed their hands. Individuals in the guilt induction condition washed significantly longer than those in the neutral condition. These findings suggest that hand-washing does not lead to unique reductions in guilt, but guilt may prolong handwashing behavior. Theoretical and clinical implications are discussed. © Springer Science+Business Media, LLC 2011.",Cougle J.R.; Goetz A.R.; Hawkins K.A.; Fitch K.E.,2012.0,10.1007/s10608-011-9359-x,0,0,
7680,Differential effects to CCK-4-induced panic by dexamethasone and hydrocortisone,"Objectives. Peripheral administration of the cholecystokinin (CCK) receptor agonist CCK-4 generates panic and activates the hypothalamicpituitaryadrenal (HPA) axis. Direct effects at the pituitary and CCK-HPA interactions at higher regulatory sites have been suggested. According to preliminary data, ACTH response to CCK receptor agonists may differ from its response to exogenous CRH by its resistance to cortisol feedback inhibition. To further explore this resistance and to better characterize CCK-4 sites of action, the effects of different glucocorticoid pretreatments on CCK-4-induced panic were compared. Methods. Using a double-blind placebo-controlled design we pretreated healthy males with either dexamethasone (peripheral action) or hydrocortisone (central-peripheral action) each followed by a CCK-4 challenge. Blood levels of ACTH and cortisol were analyzed and panic symptoms were assessed. Results. We found a blunted response of ACTH release following CCK-4 injection only after hydrocortisone pretreatment. Dexamethasone however did not affect CCK-4-induced ACTH release relative to baseline. In contrast to dexamethasone, hydrocortisone reduced the severity of CCK-4-induced panic as measured by the Acute Panic Inventory on a trend level. Conclusions. Findings suggest that CCK-4-induced stress hormone release seems susceptible to cortisol-feedback inhibition and argues for a suprapituitary site of CCK action. Effects on panic anxiety were weak but congruent with studies showing that CCK-4-induced HPA axis inhibition is accompanied by a reduction of anxiety after CCK-4. © 2012 Informa Healthcare.",Demiralay C.; Jahn H.; Kellner M.; Yassouridis A.; Wiedemann K.,2012.0,10.3109/15622975.2011.604351,0,0,
7681,Early-life stress and recurrent psychological distress over the lifecourse predict divergent cortisol reactivity patterns in adulthood,"Early-life stress (ELS) is associated with substantially increased lifetime risk for recurrent psychological problems, with evidence indicating that dysregulation of the physiological stress reactivity system may be partly responsible. However, some ELS-exposed people remain psychologically resilient. Although two distinct patterns of hypothalamic-pituitary-adrenal axis (HPA) stress reactivity have been observed in ELS-exposed samples (hyper- and hypo-reactive), the hypothesis that these patterns may be associated with long-term history of psychological problems has not been explored. We used healthy Whitehall II study subjects (n= 543) who participated in the 2008 Heart Scan Study (HSS) to assess salivary cortisol responses to a cognitive stressor, ELS exposure, and other psychosocial factors. Mean age of the sample at the HSS was 63 years. HSS data were linked to nearly 20 years of participants' Whitehall data, including repeated measures of psychological distress (GHQ-28). Piecewise growth curve analyses revealed that ELS-exposed persons with a history of recurrent psychological distress in adulthood had significantly blunted cortisol reactivity compared to non-ELS-exposed participants, while ELS-exposed persons with little or no history of distress had significantly elevated baseline cortisol, prolonged responses, and greater total cortisol production. Our findings indicate that for ELS-exposed individuals, different trajectories in psychological health over their adult lifetimes predict different cortisol reactivity patterns. These findings have important implications for our understanding of ELS-related mental health risk and treatment of these disorders. © 2012 Elsevier Ltd.",Goldman-Mellor S.; Hamer M.; Steptoe A.,2012.0,10.1016/j.psyneuen.2012.03.010,0,0,
7682,Effects of massage on antibody responses after hepatitis B vaccination,"Objective: The aim of this study was to examine whether participation in a 4-week massage intervention is associated with reduced distress and enhanced antibody responses after hepatitis B vaccine in students embarking on academic examinations. Methods: Seventy medical student volunteers (36 women, 34 men) were randomly assigned to intervention or control groups. Baseline assessments were made of distress, health behaviors, and prevaccination antibodies to hepatitis B surface antigen. Intervention participants received weekly 45-minute massages before an examination period. At the end of the intervention and 1 week before commencing the examination period, all participants received an intramuscular hepatitis B vaccination and repeated the assessments completed at baseline. Serum antibody responses to hepatitis B surface antigen were measured at 2 and 6 weeks postvaccination. Results: Examinations were associated with increased distress in both the massage and the control groups: perceived stress (F(1,67) = 10.64, p = .002), anxiety (F(1,67) = 15.72, p < .001) and negative affect (F(1,66) = 5.80, p = .019); these increases did not differ between the massage and the control groups. Furthermore, massage was associated with lower levels of antibody to hepatitis B surface antigen after vaccination at both time points (F(1,63) = 6.29, p = .015). Conclusions: These findings indicate that a brief massage intervention did not attenuate emotional distress during an examination period but did result in lowered antibody responses to vaccination. Further research is required to establish whether these effects were attributable to the nature of intervention (i.e., duration and type of massage) and/or its limited relevance to a healthy population confronting a relatively acute stressor such as examinations. © 2012 by the American Psychosomatic Society.",Loft P.; Petrie K.J.; Booth R.J.; Thomas M.G.; Robinson E.; Vedhara K.,2012.0,10.1097/PSY.0b013e31826fb7d2,0,0,
7683,Reducing unwanted trauma memories by imaginal exposure or autobiographical memory elaboration: An analogue study of memory processes,"Unwanted memories of traumatic events are a core symptom of post-traumatic stress disorder. A range of interventions including imaginal exposure and elaboration of the trauma memory in its autobiographical context are effective in reducing such unwanted memories. This study explored whether priming for stimuli that occur in the context of trauma and evaluative conditioning may play a role in the therapeutic effects of these procedures. Healthy volunteers (N = 122) watched analogue traumatic and neutral picture stories. They were then randomly allocated to 20 min of either imaginal exposure, autobiographical memory elaboration, or a control condition designed to prevent further processing of the picture stories. A blurred picture identification task showed that neutral objects that preceded traumatic pictures in the stories were subsequently more readily identified than those that had preceded neutral stories, indicating enhanced priming. There was also an evaluative conditioning effect in that participants disliked neutral objects that had preceded traumatic pictures more. Autobiographical memory elaboration reduced the enhanced priming effect. Both interventions reduced the evaluative conditioning effect. Imaginal exposure and autobiographical memory elaboration both reduced the frequency of subsequent unwanted memories of the picture stories. © 2010 Elsevier Ltd. All rights reserved.",Ehlers A.; Mauchnik J.; Handley R.,2012.0,10.1016/j.jbtep.2010.12.009,0,0,
7684,Complex estimation of the psychotropic activity spectrum of pineal hormone melatonin in young healthy humans,"Effects of the pineal hormone melatonin (melaxen, 1.5 mg, 2 weeks) on a complex of psychophysiological indices have been studied on a group of healthy human volunteers in comparison to placebo. The drug improved the concentration of attention, improved its stability in the presence of visual hindrances, and increased the critical frequency of merging light flashes. The administration of melatonin also significantly increased the transient memory volume and reduced the levels of depression and anxiety. Shifts in the psychoemotional state were more pronounced than changes in the cognitive functions.",Arushanyan E.B.; Naumov S.S.; Fayans A.A.,2012.0,,0,0,
7685,Experimentally-induced dissociation impairs visual memory,"Dissociation is a phenomenon common in a number of psychological disorders and has been frequently suggested to impair memory for traumatic events. In this study we explored the effects of dissociation on visual memory. A dissociative state was induced experimentally using a mirror-gazing task and its short-term effects on memory performance were investigated. Sixty healthy individuals took part in the experiment. Induced dissociation impaired visual memory performance relative to a control condition; however, the degree of dissociation was not associated with lower memory scores in the experimental group. The results have theoretical and practical implications for individuals who experience frequent dissociative states such as patients with posttraumatic stress disorder (PTSD). © 2013 Elsevier Inc.",Brewin C.R.; Mersaditabari N.,2013.0,10.1016/j.concog.2013.07.007,0,0,
7686,An experimental manipulation of metacognition: A test of the metacognitive model of obsessive-compulsive symptoms,"The metacognitive model of obsessive-compulsive symptoms [Wells, A. (1997). Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. Chichester, UK: Wiley] assigns a necessary causal role to metacognitive beliefs in the development of symptoms. The current study tested the model by evaluating the effects of experimentally manipulating such beliefs. A 2 × 2 factorial design was used. Thirty-two students with high and 32 students with low obsessional symptoms were subject to an experimental (metacognitive belief induction) or control (no metacognitive belief induction) condition. All participants underwent fake EEG recordings and were informed that the EEG could sense hypothalamus activity caused by having thoughts related to drinking. Participants in the experimental condition were told that if such thoughts were detected they may be exposed to an aversive noise. Controls were told that they may hear an aversive noise but this would be unrelated to the thoughts they had. Results showed a significant interaction effect between level of obsessional symptoms and belief induction. Analysis of this effect demonstrated that in the high obsession group, participants in the experimental condition had significantly more intrusions about drinking, time spent thinking about these intrusions and discomfort from them, than controls. There were also significant main effects on some measures, such as effort to control intrusions about drinking, with higher scores in the experimental condition irrespective of levels of obsessional symptoms. Results support the metacognitive model. © 2013 Elsevier Ltd.",Myers S.G.; Wells A.,2013.0,10.1016/j.brat.2013.01.007,0,0,
7687,Conceptualizing and experiencing compassion,"Does compassion feel pleasant or unpleasant? Westerners tend to categorize compassion as a pleasant or positive emotion, but laboratory compassion inductions, which present another's suffering, may elicit unpleasant feelings. Across two studies, we examined whether prototypical conceptualizations of compassion (as pleasant) differ from experiences of compassion (as unpleasant). After laboratory-based neutral or compassion inductions, participants made abstract judgments about compassion relative to various emotion-related adjectives, thereby providing a prototypical conceptualization of compassion. Participants also rated their own affective states, thereby indicating experiences of compassion. Conceptualizations of compassion were pleasant across neutral and compassion inductions. After exposure to others' suffering, however, participants felt increased levels of compassion and unpleasant affect, but not pleasant affect. After neutral inductions, participants reported more pleasant than unpleasant affect, with moderate levels of compassion. Thus, prototypical conceptualizations of compassion are pleasant, but experiences of compassion can feel pleasant or unpleasant. The implications for emotion theory in general are discussed. © 2013 American Psychological Association.",Condon P.; Barrett L.F.,2013.0,10.1037/a0033747,0,0,
7688,The nucleus accumbens is involved in both the pursuit of social reward and the avoidance of social punishment,"Human social motivation is characterized by the pursuit of social reward and the avoidance of social punishment. The ventral striatum/nucleus accumbens (VS/Nacc), in particular, has been implicated in the reward component of social motivation, i.e., the 'wanting' of social incentives like approval. However, it is unclear to what extent the VS/Nacc is involved in avoiding social punishment like disapproval, an intrinsically pleasant outcome. Thus, we conducted an event-related functional magnetic resonance imaging (fMRI) study using a social incentive delay task with dynamic video stimuli instead of static pictures as social incentives in order to examine participants' motivation for social reward gain and social punishment avoidance. As predicted, the anticipation of avoidable social punishment (i.e., disapproval) recruited the VS/Nacc in a manner that was similar to VS/Nacc activation observed during the anticipation of social reward gain (i.e., approval). Stronger VS/Nacc activity was accompanied by faster reaction times of the participants to obtain those desired outcomes. This data support the assumption that dynamic social incentives elicit robust VS/Nacc activity, which likely reflects motivation to obtain social reward and to avoid social punishment. Clinical implications regarding the involvement of the VS/Nacc in social motivation dysfunction in autism and social phobia are discussed. © 2013 Elsevier Ltd.",Kohls G.; Perino M.T.; Taylor J.M.; Madva E.N.; Cayless S.J.; Troiani V.; Price E.; Faja S.; Herrington J.D.; Schultz R.T.,2013.0,10.1016/j.neuropsychologia.2013.07.020,0,0,
7689,Interpreting ambiguous social situations in social anxiety: Application of computerized task measuring interpretation bias,"Background and Aims: The interpretation bias which is an important factor in the pathology of social anxiety disorder, has been recently considered in therapeutic approaches. Given the importance of interpretation bias in the treatment of social anxiety, and despite the ambiguity in the relationship between social anxiety and interpretation bias, we compared the interpretation bias in individuals with social anxiety and without it. Methods: In this casual-comparative study, 60 volunteer students were selected from the Ferdowsi University of Mashhad. Data was collected using the fear of negative evaluation scale, Depression questionnaire, and computerized interpretation bias assessment task. Data were analyzed via SPSS-19 software. Results: Compared to the controls, individuals with social anxiety interpreted the ambiguous social information significantly more negatively and less positively, even after controlling for the effects of depression. Conclusions: Based on research findings, it can be concluded that individuals with social anxiety showed negative interpretation bias and lack of positive interpretation bias in the interpretation of ambiguous social information.",Khalili-Torghabeh S.; Salehi-Fadradi J.; Amin-Yazdi S.A.; Ansari Z.,2013.0,,0,0,
7690,Neural underpinnings of behavioural strategies that prioritize either cognitive task performance or pain,"We previously discovered that when faced with a challenging cognitive task in the context of pain, some people prioritize task performance, while in others, pain results in poorer performance. These behaviours, designated respectively as A- and P-types (for attention dominates vs pain dominates), may reflect pain coping strategies, resilience or vulnerabilities to develop chronic pain, or predict the efficacy of treatments such as cognitive behavioural therapy. Here, we used a cognitive interference task and pain stimulation in 80 subjects to interrogate psychophysical, psychological, brain structure and function that distinguish these behavioural strategies. During concurrent pain, the A group exhibited faster task reaction times (RTs) compared to nonpain trials, whereas the P group had slower RTs during pain compared to nonpain trials, with the A group being 143 ms faster than the P group. Brain imaging revealed structural and functional brain features that characterized these behavioural strategies. Compared to the performance-oriented A group, the P group had (1) more gray matter in regions implicated in pain and salience (anterior insula, anterior midcingulate cortex, supplementary motor area, orbitofrontal cortex, thalamus, caudate), (2) greater functional connectivity in sensorimotor and salience resting-state networks, (3) less white matter integrity in the internal and external capsule, anterior thalamic radiation and corticospinal tract, but (4) were indistinguishable based on sex, pain sensitivity, neuroticism, and pain catastrophizing. These data may represent neural underpinnings of how task performance vs pain is prioritized and provide a framework for developing personalized pain therapy approaches that are based on behaviour-structure-function organization. © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.",Erpelding N.; Davis K.D.,2013.0,10.1016/j.pain.2013.06.030,0,0,
7691,The effects of nicotine on intrusive memories in nonsmokers,"Correlational research suggests that smoking increases risk of posttraumatic stress disorder (PTSD), though such research by nature cannot rule out third variable explanations for this relationship. The present study used an analogue trauma film design to experimentally test the effects of nicotine on the occurrence of intrusive memories. Fifty-four healthy nonsmokers were randomly assigned to ingest either a nicotine or placebo lozenge before viewing a film depicting motor vehicle accidents. Participants recorded intrusive memories immediately after the film and for a week via diary. Participants in the nicotine condition reported significantly more intrusive memories immediately after watching the film, yet no group differences emerged on intrusions or intrusion-related distress reported during the following week. Among participants low in dispositional rumination, those who had ingested a nicotine lozenge reported more intrusions in the subsequent week than those in the placebo condition. These findings provide novel experimental evidence for the role of nicotine in increasing risk of PTSD and suggest that nicotine may contribute to trauma-related rumination but not heightened reactivity to trauma cues. © 2013 American Psychological Association.",Hawkins K.A.; Cougle J.R.,2013.0,10.1037/a0033966,0,0,
7692,Valproic acid but not D-cycloserine facilitates sleep-dependent offline learning of extinction and habituation of conditioned fear in humans,"The effectiveness of d-cycloserine (DCS), an N-methyl-d-aspartate glutamate receptor partial agonist, and valproic acid (VPA), a histone deacetylase inhibitor, in facilitating the extinction of fear-conditioned memory has been explored in humans and animals. Here, we confirmed whether DCS (100 mg) and VPA (400 mg) act in off-line learning processes during sleep or waking, for further clinical application to anxiety disorders and posttraumatic stress disorder (PTSD). We performed a randomized, blind, placebo-controlled clinical trial in 90 healthy adults. Visual cues and electric shocks were used as the conditioned stimulus (CS) and unconditioned stimulus (US), respectively. The extinction effect was observed not in simple recall after the extinction of coupled CS-US, but was observed in the post-re-exposure phase after unexpected re-exposure to reinstatement CS-US coupling. Newly acquired conditioned fear was also eliminated or habituated by DCS and VPA administration, in line with previous findings. Furthermore, VPA facilitated the off-line learning process of conditioned fear extinction and habituation during sleep, while DCS facilitated this process during waking. These novel findings suggest that DCS and VPA might enhance exposure-based cognitive therapy for anxiety disorders and PTSD by reducing the vulnerability to reinstatement and preventing relapses of fear-conditioned responses, and provide evidence for a peculiarity of the sleep-dependent off-line learning process for conditioned fear extinction. This article is part of a Special Issue entitled 'Cognitive Enhancers'. © 2012 Elsevier Ltd. All rights reserved.",Kuriyama K.; Honma M.; Yoshiike T.; Kim Y.,2013.0,10.1016/j.neuropharm.2012.07.045,0,0,
7693,Beliefs about control and the persistence of cleaning behaviour: An experimental analysis,"Background and objectives: Low perceived control (PC) and overestimations of controllability have each been related to obsessive compulsive (OC) symptoms and behaviour. OC beliefs and symptoms are also associated with a discrepancy between low perceived control (PC) and a high desire for control (DC). The present study sought to examine the influence of components of PC, low control-related self-efficacy (CSE) and high predicted controllability (PRC), on the persistence of cleaning behaviour and DC ratings. Methods: A cleaning task was used to observe cleaning time (in seconds) in undergraduate participants (n = 174) under two conditions of each of PRC (high versus low), and CSE (high versus low). DC ratings were taken prior to the cleaning task. Results: It was demonstrated that PRC and CSE manipulations had differential effects on cleaning times and DC ratings, where significantly longer cleaning times were observed in the high (versus low) PRC condition, and in association with higher DC ratings reported in the low (versus high) CSE condition. However, regression analyses demonstrated that DC, PRC and CSE each accounted for significant variance in observed cleaning times. Limitations: Teasing apart predictability from controllability is a methodological challenge in the manipulation of perceived control. Conclusions: Findings highlight the importance of considering components of PC along with DC in OC-phenomenology; these will be discussed in the context of current cognitive theories of and treatments for OCD. © 2012 Elsevier B.V. All rights reserved.",Gelfand L.A.; Radomsky A.S.,2013.0,10.1016/j.jbtep.2012.08.002,0,0,
7694,Vividness of general mental imagery is associated with the occurrence of intrusive memories,"Background and objectives: Intrusive memories of traumatic events constitute a core feature of post-traumatic stress disorder. However, the association of pre-traumatic factors with post-traumatic intrusive memories is still only poorly understood. The current study investigated the extent to which vividness of general mental imagery prior to an analogue stressor is positively associated with occurrence of intrusive images following such a stressor. Methods: Sixty-seven participants were exposed to video material depicting the aftermath of serious road traffic accidents. Additionally, participants filled in questionnaires on mental imagery, affect, peri-traumatic processing style, and intrusive memories. Results: Vividness of mental imagery before the analogue stressor correlated positively with the amount, vividness, and emotional distress due to intrusive images shortly after the analogue stressor and on the subsequently five days. Importantly, mental imagery assessed pre-stressor was associated with intrusive memories independently of trait anxiety and depression as well as participants' emotional response to the video. Peri-traumatic data-driven processing was also related to intrusive memories but not to the vividness of pre-stressor mental imagery. Limitations: An analogue design was used. Results need to be replicated in a prospective design with survivors of traumatic events according to DSM-IV criteria. Conclusions: The findings indicate that high levels of vividness of general mental imagery may contribute to the development of intrusive imaginal memories following exposure to traumatic events. © 2012 Elsevier Ltd. All rights reserved.",Morina N.; Leibold E.; Ehring T.,2013.0,10.1016/j.jbtep.2012.11.004,0,0,
7695,Unconscious thought reduces intrusion development: A replication and extension,"Background and Objectives: Intrusive images after a traumatic event, a hallmark feature of post-traumatic stress disorder, are suggested to develop because the trauma memory is disorganized and not integrated into autobiographical memory. Unconscious Thought Theory predicts that information can be conceptually organized after a period of unconscious thought (UT), more so than after conscious thought (CT). We aimed to test the hypothesis that UT decreases intrusions and increases conceptual organization in memory. Methods: Participants were shown a stressful film and were required to perform an UT task, a CT task, or a distraction task. Intrusions of the film, intrusion qualities, and sequence memory were measured afterwards. Results: We confirmed our hypothesis that UT (versus CT or mere distraction) leads to fewer intrusions, thereby replicating earlier research. Contrary to prediction, we found no difference between the conditions on sequence memory. In addition, conscious thought appeared to increase intrusion nowness and arousal. Limitations: The analogue design and healthy participant sample prevent from generalizing results to other populations. Intrusion frequency and qualities were assessed immediately after the film thereby prohibiting us from drawing conclusions about any long-term effects. Conclusions: Engaging in unconscious thought after a stressful film can reduce intrusion frequency. This has potential implications for clinical interventions to prevent initial stress symptoms. The underlying mechanism remains unclear for now and provides an avenue for future research. © 2012 Elsevier B.V. All rights reserved.",Krans J.; Janecko D.; Bos M.W.,2013.0,10.1016/j.jbtep.2012.08.004,0,0,
7696,"Bilateral saccadic eye movements and tactile stimulation, but not auditory stimulation, enhance memory retrieval","Recent research has shown superior memory retrieval when participants make a series of horizontal saccadic eye movements between the memory encoding phase and the retrieval phase compared to participants who do not move their eyes or move their eyes vertically. It has been hypothesized that the rapidly alternating activation of the two hemispheres that is associated with the series of left-right eye movements is critical in causing the enhanced retrieval. This hypothesis predicts a beneficial effect on retrieval of alternating left-right stimulation not only of the visuomotor system, but also of the somatosensory system, both of which have a strict contralateral organization. In contrast, this hypothesis does not predict an effect, or a weaker effect, on retrieval of alternating left-right stimulation of the auditory system, which has a much less lateralized organization. Consistent with these predictions, we replicated the horizontal saccade-induced retrieval enhancement (Experiment 1) and showed that a similar retrieval enhancement occurs after alternating left-right tactile stimulation (Experiment 2). Furthermore, retrieval was not enhanced after alternating left-right auditory stimulation compared to simultaneous bilateral auditory stimulation (Experiment 3). We discuss the possibility that alternating bilateral activation of the left and right hemispheres exerts its effects on memory by increasing the functional connectivity between the two hemispheres. We also discuss the findings in the context of clinical practice, in which bilateral eye movements (EMDR) and auditory stimulation are used in the treatment of post-traumatic stress disorder. © 2012 Elsevier Inc.",Nieuwenhuis S.; Elzinga B.M.; Ras P.H.; Berends F.; Duijs P.; Samara Z.; Slagter H.A.,2013.0,10.1016/j.bandc.2012.10.003,0,0,
7697,Aversive learning increases sensory detection sensitivity,"Increased sensitivity to specific cues in the environment is common in anxiety disorders. This increase in sensory processing can emerge through attention processes that enhance discrimination of a cue from other cues as well as through augmented senses that reduce the absolute intensity of sensory stimulation needed for detection. Whereas it has been established that aversive conditioning can enhance odor quality discrimination, it is not known whether it also changes the absolute threshold at which an odor can be detected. In two separate experiments, we paired one odor of an indistinguishable odor pair with an aversive outcome using a classical conditioning paradigm. Ability to discriminate and to detect the paired odor was assessed before and after conditioning. The results demonstrate that aversive conditioning increases absolute sensory sensitivity to a predictive odor cue in an odor-specific manner, rendering the conditioned odor detectable at a significantly lower (20%) absolute concentration. As animal research has found long-lasting change in behavior and neural signaling resulting from conditioning, absolute threshold was also tested eight weeks later. Detection threshold had returned to baseline level at the eight week follow-up session suggesting that the change in detection threshold was mediated by a transient reorganization. Taken together, we can for the first time demonstrate that increasing the biological salience of a stimulus augments the individual's absolute sensitivity in a stimulus-specific manner outside conscious awareness. These findings provide a unique framework for understanding sensory mechanisms in anxiety disorders as well as further our understanding of mechanisms underlying classical conditioning. © 2012 Elsevier B.V.",Åhs F.; Miller S.S.; Gordon A.R.; Lundström J.N.,2013.0,10.1016/j.biopsycho.2012.11.004,0,0,
7698,Migratory New World Blackbirds (Icterids) Are More Neophobic than Closely Related Resident Icterids,"Environments undergo short-term and long-term changes due to natural or human-induced events. Animals differ in their ability to cope with such changes which can be related to their ecology. Changes in the environment often elicit avoidance reactions (neophobia) which protect animals from dangerous situations but can also inhibit exploration and familiarization with novel situations and thus, learning about new resources. Studies investigating the relationship between a species' ecology and its neophobia have so far been restricted to comparing only a few species and mainly in captivity. The current study investigated neophobia reactions to experimentally-induced changes in the natural environment of six closely-related blackbird species (Icteridae), including two species represented by two distinct populations. For analyses, neophobic reactions (difference in number of birds feeding and time spent feeding with and without novel objects) were related to several measures of ecological plasticity and the migratory strategy (resident or migratory) of the population. Phylogenetic relationships were incorporated into the analysis. The degree of neophobia was related to migratory strategy with migrants expressing much higher neophobia (fewer birds feeding and for a shorter time with objects present) than residents. Furthermore, neophobia showed a relationship to diet breadth with fewer individuals of diet generalists than specialists returning when objects were present supporting the dangerous niche hypothesis. Residents may have evolved lower neophobia as costs of missing out on opportunities may be higher for residents than migrants as the former are restricted to a smaller area. Lower neophobia allows them approaching changes in the environment (e.g. novel objects) quickly, thereby securing access to resources. Additionally, residents have a greater familiarity with similar situations in the area than migrants and the latter may, therefore, initially stay behind resident species.",Mettke-Hofmann C.; Winkler H.; Hamel P.B.; Greenberg R.,2013.0,10.1371/journal.pone.0057565,0,0,
7699,Did I turn off the stove? Good inhibitory control can protect from influences of repeated checking,"Background and objectives: Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by compulsions aimed at reducing anxiety associated with intrusive cognitions. However, compulsive behaviors such as repeated checking were found to increase rather than decrease uncertainty related to obsessive thoughts (e.g.; whether the gas stove was turned off). Some recent studies illustrate that OCD patients and their family members have inhibitory deficits, often demonstrated by the stop-signal task. The current study aims to investigate relations between inhibitory control and effects of repeated checking. Methods: Fifty-five healthy participants carried out a stop-signal task followed by a repeated-checking task. Additionally, participants were asked to complete self-report questionnaires measuring OCD, anxiety and depression symptoms. Results: Confirming our hypothesis, participants with poor inhibitory capabilities demonstrated greater uncertainty and memory distrust as a consequence of repeated checking than participants with good inhibitory control. Limitations: Our findings concern an initial investigation on a sample of healthy participants and should be replicated and extended to clinical populations. Conclusions: These results suggest that deficits in inhibitory control may underlie cognitive vulnerability in OCD. An updated model integrating neuropsychological findings with current OCD models is suggested. © 2012 Elsevier Ltd. All rights reserved.",Linkovski O.; Kalanthroff E.; Henik A.; Anholt G.,2013.0,10.1016/j.jbtep.2012.07.002,0,0,
7700,Common mental disorders and long-term sickness absence in a general working population. The Hordaland Health Study,"Objective: To examine and compare the prospective effect of the common mental disorders (CMD) anxiety and depression on duration and recurrence of sickness absence (SA), and to investigate whether the effect of CMD on SA is detectable over time. Method: Information from a large epidemiological health study (N=13436) was linked with official records of SA episodes lasting ≥16days up to 6years after participation. Common mental disorders were assessed with the Hospital Anxiety and Depression Scale (HADS). Associations were analysed with Cox regression and multinomial logistic regression models controlling for potential covariates. Results: Comorbid anxiety and depression, and anxiety only were significant risk factors for SA after adjusting for covariates, whilst depression only was not. Anxiety and depression were stronger predictors for longer duration of SA episodes compared with shorter duration and associated with more frequent recurrence of SA. There was a general trend toward the effect of CMD on SA becoming weaker over time; however, the effect of anxiety only on SA remained stable throughout the follow-up. Conclusion: Common mental disorders are long-lasting predictors of onset, duration and recurrence of SA. Anxiety appears to be a more important contributor to long-term SA than previously described in the literature. © 2012 John Wiley & Sons A/S.",Knudsen A.K.; Harvey S.B.; Mykletun A.; Øverland S.,2013.0,10.1111/j.1600-0447.2012.01902.x,0,0,
7701,Assessing public speaking fear with the short form of the Personal Report of Confidence as a Speaker scale: Confirmatory factor analyses among a French-speaking community sample,"Background: The main aim of this study was to assess the reliability and structural validity of the French version of the 12-item version of the Personal Report of Confidence as Speaker (PRCS), one of the most promising measurements of public speaking fear. Methods: A total of 611 French-speaking volunteers were administered the French versions of the short PRCS, the Liebowitz Social Anxiety Scale, the Fear of Negative Evaluation scale, as well as the Trait version of the Spielberger State-Trait Anxiety Inventory and the Beck Depression Inventory-II, which assess the level of anxious and depressive symptoms, respectively. Results: Regarding its structural validity, confirmatory factor analyses indicated a single-factor solution, as implied by the original version. Good scale reliability (Cronbach's alpha=0.86) was observed. The item discrimination analysis suggested that all the items contribute to the overall scale score reliability. The French version of the short PRCS showed significant correlations with the Liebowitz Social Anxiety Scale (r=0.522), the Fear of Negative Evaluation scale (r=0.414), the Spielberger State-Trait Anxiety Inventory (r=0.516), and the Beck Depression Inventory-II (r=0.361). Conclusion: The French version of the short PRCS is a reliable and valid measure for the evaluation of the fear of public speaking among a French-speaking sample. These findings have critical consequences for the measurement of psychological and pharmacological treatment effectiveness in public speaking fear among a French-speaking sample. © 2013 Heeren et al, publisher and licensee Dove Medical Press Ltd.",Heeren A.; Ceschi G.; Valentiner D.P.; Dethier V.; Philippot P.,2013.0,10.2147/NDT.S43097,0,0,
7702,Context counts! social anxiety modulates the processing of fearful faces in the context of chemosensory anxiety signals,"During emotion perception, context is an important source of information. Whether contextual cues from modalities other than vision or audition influence the perception of social emotional information has not been investigated.Thus, the present study aimed at testing emotion perception and regulation in response to fearful facial expressions presented in the context of chemosensory stimuli derived from sweat of anxious individuals. In groups of high (HSA) and low socially anxious (LSA) participants we recorded the startle reflex (Experiment I), and analysed event-related potentials (ERPs; Experiment II) while they viewed anxious facial expressions in the context of chemosensory anxiety signals and chemosensory control stimuli. Results revealed that N1/P1 and N170 amplitudes were larger while Late Positive Potential (LPP) activity was smaller for facial expressions presented in the context of the anxiety and the chemosensory control stimulus as compared to facial expressions without a chemosensory context. Furthermore, HSA participants were highly sensitive to the contextual anxiety signals. They showed enhanced motivated attention allocation (LPP, Study II), as well aslarger startle responses towards faces in the context of chemosensory anxiety signals than did LSA participants (Study I). Chemosensory context had no effect on emotion regulation, and both LSA and HSA participants showed effective emotion regulation (Study I and II). In conclusion, both anxiety and chemosensory sport context stimuli enhanced early attention allocation and structural encoding, but diminished motivated attention allocation to the facial expressions. The current results show that visual and chemosensory information is integrated on virtually all levels of stimulus processing and that socially anxious individuals might be especially sensitive to chemosensory contextual social information.",Adolph D.; Meister L.; Pause B.M.,2013.0,10.3389/fnhum.2013.00283,0,0,
7703,Attentional bias in insomnia: The dot-probe task with pictorial stimuli depicting daytime fatigue/malaise,"The purpose of this study was to examine whether individuals with primary insomnia (PI) have an attentional bias towards insomnia-specific stimuli, relative to normal sleepers (NS). Also, the aim was to determine if the attentional bias was characterized by vigilance or disengagement. A between-groups, matched design was employed. Forty-two individuals completed the study (PI = 21; NS = 21). Participants completed a dot-probe task with stimuli comprising insomnia-specific (fatigue/malaise) and neutral pictures. It was hypothesized that individuals with PI would show greater attentional bias to insomnia-specific stimuli compared with NS. An overall bias effect was noted. This effect was however not due to vigilance; taking into account the reaction times on neutral trials, the PI group and the NS group did not display significantly different results in reaction times to insomnia-specific pictures. On the contrary, the results suggest that the overall bias effect was due to disengagement; the PI group had significantly longer reaction times than the NS group when shifting away from the insomnia-specific pictures, relative to neutral-neutral picture presentations. The findings suggest that individuals with insomnia are not more vigilant than normal sleepers to insomnia-specific stimuli, but instead have greater difficulties in shifting away from such stimuli. © 2012 Springer Science+Business Media, LLC.",Jansson-Fröjmark M.; Bermås M.; Kjellén A.,2013.0,10.1007/s10608-012-9486-z,0,0,
7704,Cartilage-on-cartilage versus metal-on-cartilage impact characteristics and responses,"A common in vitro model for studying acute mechanical damage in cartilage is to impact an isolated osteochondral or cartilage specimen with a metallic impactor. The mechanics of a cartilage-on-cartilage (COC) impact, as encountered in vivo, are likely different than those of a metal-on-cartilage (MOC) impact. The hypothesis of this study was that impacted in vitro COC and MOC specimens would differ in their impact behavior, mechanical properties, chondrocyte viability, cell metabolism, and histologic structural damage. Osteochondral specimens were impacted with either an osteochondral plug or a metallic cylinder at the same delivered impact energy per unit area, and processed after 14 days in culture. The COC impacts resulted in about half of the impact maximum stress and a quarter of the impact maximum stress rate of change, as compared to the MOC impacts. The impacted COC specimens had smaller changes in mechanical properties, smaller decreases in chondrocyte viability, higher total proteoglycan content, and less histologic structural damage, as compared to the impacted MOC specimens. If MOC impact conditions are to be used for modeling of articular injuries and post-traumatic osteoarthritis, the differences between COC and MOC impacts must be kept in mind. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.",Heiner A.D.; Smith A.D.; Goetz J.E.; Goreham-Voss C.M.; Judd K.T.; McKinley T.O.; Martin J.A.,2013.0,10.1002/jor.22311,0,0,
7705,The brain's error-detecting mechanism - A PET study,"The present study addresses the cerebral support for the mechanism of error detection (ED) operating during conscious execution of incorrect actions (deceptions) and in the resting state. Local cerebral blood flow was measured by positron emission tomography (PET), and demonstrated involvement of the anterior cingulate gyrus in processes associated with conscious deception. The data obtained here showed that ED operates in persistently executed errors - conscious control of ED was shown to be impossible. The hypothesis that failure of ED is an important factor in the formation of obsessive-compulsive disorder (OCD) was supported by analysis of PET data on the rate of glucose metabolism in the state of operative rest. Normative data from healthy subjects were compared with results obtained from patients with diagnoses of OCD and Tourette's syndrome. Patients showed decreases in glucose metabolism in the anterior cingulate gyrus, which can be regarded as a reflection of abnormal functioning of the cerebral ED system. © 2013 Springer Science+Business Media New York.",Kireev M.V.; Korotkov A.D.; Polyakov Yu.I.; Anichkov A.D.; Medvedev S.V.,2013.0,10.1007/s11055-013-9781-5,0,0,
7706,"Development and validation of the social exercise and anxiety measure (SEAM): Assessing fears, avoidance, and importance of social exercise","In two studies (N = 416; N = 118) examining responses from undergraduates, we developed the Social Exercise and Anxiety Measure (SEAM) and tested its factorial, convergent, and divergent validity. Our results demonstrate that the SEAM exhibits an excellent three factor structure consisting of the following subscales: Social Exercise Self-efficacy, Gym Avoidance, and Exercise Importance. In both studies, Social Exercise Self-efficacy correlated negatively, and Gym Avoidance correlated positively with social interaction anxiety, fear of scrutiny, and fear of negative evaluation. Exercise Importance correlated positively with frequency of exercise and frequency of public exercise. Implications for the mental and physical health of individuals with high levels of social anxiety are discussed. © 2012 Springer Science+Business Media New York.",Levinson C.A.; Rodebaugh T.L.; Menatti A.R.; Weeks J.W.,2013.0,10.1007/s10862-012-9326-1,0,0,
7707,Psychological factors predict local and referred experimental muscle pain: A cluster analysis in healthy adults,"Background: Recent studies suggest an underlying three- or four-factor structure explains the conceptual overlap and distinctiveness of several negative emotionality and pain-related constructs. However, the validity of these latent factors for predicting pain has not been examined. Methods: A cohort of 189 (99 female, 90 male) healthy volunteers completed eight self-report negative emotionality and pain-related measures (Eysenck Personality Questionnaire - Revised, Positive and Negative Affect Schedule, State-Trait Anxiety Inventory, Pain Catastrophizing Scale, Fear of Pain Questionnaire; Somatosensory Amplification Scale, Anxiety Sensitivity Index and Whiteley Index). Using principal axis factoring, three primary latent factors were extracted: general distress, catastrophic thinking and pain-related fear. Using these factors, individuals clustered into three subgroups of high, moderate and low negative emotionality responses. Experimental pain was induced via intramuscular acidic infusion into the anterior tibialis muscle, producing local (infusion site) and/or referred (anterior ankle) pain and hyperalgesia. Results: Pain outcomes differed between clusters (multivariate analysis of variance and multinomial regression), with individuals in the highest negative emotionality cluster reporting the greatest local pain (p = 0.05), mechanical hyperalgesia (pressure pain thresholds; p = 0.009) and greater odds (2.21 odds ratio) of experiencing referred pain when compared to the lowest negative emotionality cluster. Conclusion: Our results provide support for three latent psychological factors explaining the majority of the variance between several pain-related psychological measures, and that individuals in the high negative emotionality subgroup are at increased risk for (1) acute local muscle pain; (2) local hyperalgesia; and (3) referred pain using a standardized nociceptive input. © 2012 European Federation of International Association for the Study of Pain Chapters.",Lee J.E.; Watson D.; Frey-Law L.A.,2013.0,10.1002/j.1532-2149.2012.00249.x,0,0,
7708,Influence of stress on fear memory processes in an aversive differential conditioning paradigm in humans,"It is widely assumed that learning and memory processes play an important role in the pathogenesis, expression, maintenance and therapy of anxiety disorders, such as phobias or post-traumatic stress disorder (PTSD). Memory retrieval is involved in symptom expression and maintenance of these disorders, while memory extinction is believed to be the underlying mechanism of behavioral exposure therapy of anxiety disorders. There is abundant evidence that stress and stress hormones can reduce memory retrieval of emotional information, whereas they enhance memory consolidation of extinction training. In this study we aimed at investigating if stress affects these memory processes in a fear conditioning paradigm in healthy human subjects. On day 1, fear memory was acquired through a standard differential fear conditioning procedure. On day 2 (24. h after fear acquisition), participants either underwent a stressful cold pressor test (CPT) or a control condition, 20. min before memory retrieval testing and extinction training. Possible prolonged effects of the stress manipulation were investigated on day 3 (48. h after fear acquisition), when memory retrieval and extinction were tested again. On day 2, men in the stress group showed a robust cortisol response to stress and showed lower unconditioned stimulus (US) expectancy ratings than men in the control group. This reduction in fear memory retrieval was maintained on day 3. In women, who showed a significantly smaller cortisol response to stress than men, no stress effects on fear memory retrieval were observed. No group differences were observed with respect to extinction. In conclusion, the present study provides evidence that stress can reduce memory retrieval of conditioned fear in men. Our findings may contribute to the understanding of the effects of stress and glucocorticoids on fear symptoms in anxiety disorders and suggest that such effects may be sex-specific. © 2013 Elsevier Ltd.",Bentz D.; Michael T.; Wilhelm F.H.; Hartmann F.R.; Kunz S.; Von Rohr I.R.R.; de Quervain D.J.-F.,2013.0,10.1016/j.psyneuen.2012.12.018,0,0,
7709,The BclI polymorphism of the glucocorticoid receptor gene is associated with emotional memory performance in healthy individuals,"Glucocorticoids, stress hormones released from the adrenal cortex, are important players in the regulation of emotional memory. Specifically, in animals and in humans, glucocorticoids enhance memory consolidation of emotionally arousing experiences, but impair memory retrieval. These glucocorticoid actions are partly mediated by glucocorticoid receptors in the hippocampus, amygdala and prefrontal cortex, key brain regions for emotional memory. In a recent study in patients who underwent cardiac surgery, the BclI polymorphism of the glucocorticoid receptor gene (. NR3C1) was associated with traumatic memories and posttraumatic stress disorder symptoms after intensive care therapy. Based on this finding, we investigated if the BclI polymorphism is also associated with emotional memory in healthy young subjects (. N=. 841). We used a picture-learning task consisting of learning and recalling neutral and emotional photographs on two consecutive days. The BclI variant was associated with short-delay recall of emotional pictures on both days, with GG carriers showing increased emotional memory performance as compared to GC and CC carriers. We did not detect a genotype-dependent difference in recall performance for neutral pictures. These findings suggest that the Bcll polymorphism contributes to inter-individual differences in emotional memory also in healthy humans. © 2012 Elsevier Ltd.",Ackermann S.; Heck A.; Rasch B.; Papassotiropoulos A.; de Quervain D.J.-F.,2013.0,10.1016/j.psyneuen.2012.10.009,0,0,
7710,Once-weekly transdermal buprenorphine application results in sustained and consistent steady-state plasma levels,"Context: Transdermal formulations of buprenorphine offer controlled delivery of buprenorphine for sustained analgesic efficacy with reduced adverse events (AEs) compared with the other modes of administration. A buprenorphine transdermal system (BTDS) delivering 5, 10, or 20 mcg/hour for seven days is now marketed in the U.S. as Butrans® (Lohmann Therapie-System AG, Andernach Germany), a Schedule III single-entity opioid analgesic indicated for the management of moderate and chronic pain in patients requiring continuous around-the-clock analgesia for an extended period. Objectives: This was a randomized open-label study in healthy subjects to characterize the steady-state buprenorphine pharmacokinetics after the delivery of three consecutive seven-day BTDS applications. Methods: Thirty-seven subjects were randomized to receive three consecutive BTDS 10 mcg/hour (BTDS 10) patches applied to the deltoid or upper back for seven days each. Blood samples for buprenorphine concentration measurements were taken. Safety was assessed using recorded AEs, clinical laboratory test results, vital signs, pulse oximetry, physical examinations, and electrocardiograms. Patch adhesion assessments were taken. Results: Analysis of Cmin demonstrated that steady state was reached during the first BTDS 10 application. No significant difference in C min was observed across the three applications. Total and peak plasma buprenorphine exposures were similar after each of the seven-day administrations of BTDS. Conclusion: Three consecutive once-weekly applications of BTDS 10 provided consistent and sustained delivery of buprenorphine. Steady-state plasma concentrations were reached within 48 hours of the first application of BTDS 10. Patch adhesion analysis confirmed the appropriateness of the seven-day application period. Overall, BTDS 10 was safe and well tolerated. © 2013 U.S. Cancer Pain Relief Committee.Published by Elsevier Inc. All rights reserved.",Kapil R.P.; Cipriano A.; Friedman K.; Michels G.; Shet M.S.; Colucci S.V.; Apseloff G.; Kitzmiller J.; Harris S.C.,2013.0,10.1016/j.jpainsymman.2012.06.014,0,0,
7711,The role of sleep and sleep deprivation in consolidating fear memories,"Sleep, in particular REM sleep, has been shown to improve the consolidation of emotional memories. Here, we investigated the role of sleep and sleep deprivation on the consolidation of fear memories and underlying neuronal mechanisms. We employed a Pavlovian fear conditioning paradigm either followed by a night of polysomnographically monitored sleep, or wakefulness in forty healthy participants. Recall of learned fear was better after sleep, as indicated by stronger explicitly perceived anxiety and autonomous nervous responses. These effects were positively correlated with the preceding time spent in REM sleep and paralleled by activation of the basolateral amygdala. These findings suggest REM sleep-associated consolidation of fear memory in the human amygdala. In view of the critical participation of fear learning mechanisms in the etiology of anxiety and post-traumatic stress disorder, deprivation of REM sleep after exposure to distressing events is an interesting target for further investigation. © 2013 Elsevier Inc.",Menz M.M.; Rihm J.S.; Salari N.; Born J.; Kalisch R.; Pape H.C.; Marshall L.; Büchel C.,2013.0,10.1016/j.neuroimage.2013.03.001,0,0,
7712,Driving simulator performance of veterans from the Iraq and Afghanistan wars,"Driving simulator performance was examined in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/ OEF) Veterans to objectively evaluate driving abilities among this cohort who self-report poorer driving safety postdeployment. OIF/OEF Veterans (n = 25) and age- and education-matched civilian controls (n = 25) participated in a 30 min driving simulator assessment that measured the frequency of minor, moderate, and severe driving errors. Frequency of errors in specific content domains (speed regulation, positioning, and signaling) was also calculated. All participants answered questions about number of lifetime traffic ""warnings,"" moving violation tickets, and accidents. Veterans completed the Posttraumatic Stress Disorder (PTSD) Checklist-Military Version. On the driving simulator assessment, Veterans committed more minor, moderate, severe, and speeding errors and reported poorer lifetime driving records than the civilian control group. Exploratory analyses revealed an association between increasing errors on the driving simulator with increasing symptoms of PTSD, although statistically this correlation did not reach significance. These findings suggest that Veterans perform more poorly on an objective evaluation of driving safety and that the presence of PTSD could be associated with worse performance on this standardized driving simulator assessment.",Amick M.M.; Kraft M.; Mcglinchey R.,2013.0,10.1682/JRRD.2012.06.0108,0,0,
7713,Two weeks of pretreatment with escitalopram facilitates extinction learning in healthy individuals,"Objective We aimed to examine whether pretreatment with escitalopram would be associated with reduced fear acquisition and enhanced extinction learning in a fear conditioning paradigm, compared with placebo. Methods Healthy volunteers were randomized in double-blind fashion, to 14 days of escitalopram 10 mg/day (n = 18) or placebo (n = 20) prior to a classical fear conditioning paradigm. Results Although escitalopram was associated with a smaller skin conductance (SC) orienting response during habituation, no medication effects on fear acquisition were found. Escitalopram was associated with faster extinction of SC responses, compared with placebo, as revealed by a significant drug × conditioned stimulus × trial interaction for early extinction (F(3, 30) = 3.26, p = 0.035) and late extinction (F(3, 30) = 3.27, p = 0.035) trials. After adjustment for age, orienting response, and acquisition, results from linear contrast remained significant for early extinction (F(1, 29) = 5.43, p = 0.027). Conclusions Escitalopram administered for 14 days prior to a fear conditioning paradigm did not influence acquisition of a conditioned fear response but did facilitate extinction learning. Impairments in extinction learning have been identified as a key component of posttraumatic stress disorder; our preliminary findings suggest that additional experimental and clinical studies assessing the efficacy of selective serotonin reuptake inhibitors for posttraumatic stress disorder prevention are warranted. Copyright © 2013 John Wiley & Sons, Ltd.",Bui E.; Orr S.P.; Jacoby R.J.; Keshaviah A.; Leblanc N.J.; Milad M.R.; Pollack M.H.; Simon N.M.,2013.0,10.1002/hup.2330,0,0,
7714,The effect of intranasal oxytocin treatment on conditioned fear extinction and recall in a healthy human sample,"Rationale: To improve outcomes for patients undergoing extinction-based therapies (e.g.; exposure therapy) for anxiety disorders such as post-traumatic stress disorder (PTSD), there has been interest in identifying pharmaceutical compounds that might facilitate fear extinction learning and recall. Oxytocin (OT) is a mammalian neuropeptide that modulates activation of fear extinction-based neural circuits and fear responses. Little is known, however, about the effects of OT treatment on conditioned fear responding and extinction in humans. Objectives: The purpose of the present study was to assess the effects of OT in a fear-potentiated startle task of fear conditioning and extinction. Methods: A double-blind, placebo-controlled study of 44 healthy human participants was conducted. Participants underwent a conditioned fear acquisition procedure, after which they were randomized to treatment group and delivered OT (24 IU) or placebo via intranasal (IN) spray. Forty-five minutes after treatment, participants underwent extinction training. Twenty-four hours later, subjects were tested for extinction recall. Results: Relative to placebo, the OT group showed increased fear-potentiated startle responding during the earliest stage of extinction training relative to placebo; however, all treatment groups showed the same level of reduced responding by the end of extinction training. Twenty-four hours later, the OT group showed significantly higher recall of extinction relative to placebo. Conclusions: The current study provides preliminary evidence that OT may facilitate fear extinction recall in humans. These results support further study of OT as a potential adjunctive treatment for extinction-based therapies in fear-related disorders. © 2013 Springer-Verlag Berlin Heidelberg (outside the USA).",Acheson D.; Feifel D.; De Wilde S.; McKinney R.; Lohr J.; Risbrough V.,2013.0,10.1007/s00213-013-3099-4,0,0,
7715,The Role of Pain Catastrophizing in the Prediction of Acute and Chronic Postoperative Pain,"Background and Objectives: Despite the established association between greater pain catastrophizing and enhanced postoperative pain, it is still unclear: (i) what is the relative contribution of each of the pain catastrophizing scale (PCS) dimensions in the prediction of acute and chronic postoperative pain; and (ii) whether PCS scores mediate the association between acute and chronic postoperative pain intensity. Methods: The current prospective, observational study was conducted at Rambam Health Care Campus, Haifa, Israel. PCS was obtained in 48 pain-free patients a day before an elective thoracotomy in response to tonic heat pain. Acute postthoracotomy pain (APTP) was assessed during rest, including general pain (Restgeneral), and incision-related pain (Restincision), and in response to provoked physical activity, including hand elevation (Provokedhand) and cough (Provokedcough). Chronic postthoracotomy pain (CPTP) was assessed after 4.5±2.3 months. Results: Of the PCS subscales, only rumination: (i) was correlated with Restgeneral scores (r=0.337, P=0.027); and (ii) predicted chronic postthoracotomy pain in a regression analysis (P=0.001). General PCS and its subscales mediated the correlation between Restgeneral and chronic postthoracotomy pain intensity (Ps<0.006). Conclusions: Findings may elucidate the unique role of the rumination subscale in reflecting an individual's postoperative acute and chronic pain responsiveness. The transition from acute to chronic postoperative pain seems to be facilitated by enhanced pain catastrophizing. © Kremer et al.; Licensee Bentham Open.",Kremer R.; Granot M.; Yarnitsky D.; Crispel Y.; Fadel S.; Best L.A.; Nir R.-R.,2013.0,10.2174/1876386301306010176,0,0,
7716,Carbon dioxide inhalation as a human experimental model of panic: The relationship between emotions and cardiovascular physiology,"Inhaling carbon dioxide (CO2)-enriched air induces fear and panic symptoms resembling real-life panic attacks, the hallmark of panic disorder. The present study aimed to describe the emotional and cardiovascular effects evoked by inhaling CO2, taking shortcomings of previous studies into account. Healthy volunteers underwent a double inhalation of 0, 9, 17.5, and 35% CO2, according to a randomized, cross-over design. In addition to fear, discomfort, and panic symptom ratings, blood pressure and heart rate were continuously monitored. Results showed a dose-dependent increase in all self-reports. Systolic and diastolic blood pressure rose with increasing CO2 concentration, whereas heart rate results were less consistent. Diastolic blood pressure and heart rate variation correlated with fear and discomfort. Based on this relationship and the observation that the diastolic blood pressure most accurately mimicked the degree of self-reported emotions, it might serve as a putative biomarker to assess the CO2-reactivity in the future. © 2013 Elsevier B.V.",Leibold N.K.; Viechtbauer W.; Goossens L.; De Cort K.; Griez E.J.; Myin-Germeys I.; Steinbusch H.W.M.; van den Hove D.L.A.; Schruers K.R.J.,2013.0,10.1016/j.biopsycho.2013.06.004,0,0,
7717,Stress-induced negative mood moderates the relation between oxytocin administration and trust: Evidence for the tend-and-befriend response to stress?,"Introduction: Recent evidence suggests that oxytocin, a nonapeptide posited to underlie the affiliation-related ""tend-and-befriend"" behavioral response to stress (Taylor et al., 2000), may improve interpersonal functioning by facilitating the acquisition of social support during times of distress. The assertion, however, has not been explicitly tested in humans. Thus, we examined whether the effect of oxytocin on self-perceived trust is magnified in individuals who experienced higher ratings of negative mood following social rejection. Method: In a double-blind experiment, 100 students (50♀) were subject to a live social rejection paradigm following random assignment to either a 24. IU intranasal oxytocin or placebo administration. Mood and self-perceived trust were measured following social rejection. Results: Multiple regression and simple slope analysis revealed that oxytocin administration increased self-perceived trust relative to placebo in participants reporting a negative mood response following social rejection [. b= 4.245, t(96) = 3.10, p= .003], but not in those whose mood state was euthymic. Conclusion: These results demonstrate that oxytocin may promote the acquisition of social support in times of distress by increasing self-perceived trust. The findings provide empirical support that oxytocin promotes an affiliation-related behavioral response to stress, consistent with the tend-and-befriend theory. © 2013 Elsevier Ltd.",Cardoso C.; Ellenbogen M.A.; Serravalle L.; Linnen A.-M.,2013.0,10.1016/j.psyneuen.2013.05.006,0,0,
7718,TENS attenuates repetition-induced summation of activity-related pain following experimentally induced muscle soreness,"This study sought to determine whether repetition-induced summation of activity-related pain (RISP) could be demonstrated in healthy individuals in response to experimentally induced musculoskeletal pain. This study also assessed the effects of transcutaneous electrical nerve stimulation on RISP. The relation between the index of RISP and psychological factors such as catastrophizing and fear of pain was also explored. The sample consisted of 56 healthy (35 women, 21 men) participants who underwent 2 testing sessions, separated by 24 hours. In the first session, musculoskeletal pain was induced with a delayed-onset muscle soreness protocol. During the second session, participants were randomly assigned to the transcutaneous electrical nerve stimulation or placebo condition and were asked to rate their pain as they lifted a series of 18 weighted canisters. An index of RISP was derived as the change in pain ratings across repeated lifts. Approximately 25% of participants showed evidence of RISP. Results also revealed that transcutaneous electrical nerve stimulation attenuated the RISP effect. Psychological measures (fear of pain, catastrophizing) were not significantly correlated with the index of RISP, but the index of RISP was significantly correlated with a measure of physical tolerance. Discussion addresses the clinical implications of the findings as well as the potential mechanisms underlying RISP. Perspective This study showed that RISP could be demonstrated in healthy individuals in response to experimentally induced musculoskeletal pain with delayed-onset muscle soreness. Transcutaneous electrical nerve stimulation led to a significant reduction in RISP. © 2013 by the American Pain Society.",Mankovsky-Arnold T.; Wideman T.H.; Larivière C.; Sullivan M.J.L.,2013.0,10.1016/j.jpain.2013.07.019,0,0,
7719,Cone of direct gaze as a marker of social anxiety in males,"The fear of being scrutinised is a core feature of social anxiety disorder and socially anxious individuals overestimate being 'looked at'. A recent development in the vision sciences is a reliable psychophysical index of the range of eye gaze angles judged as being directed at oneself (Cone of Direct Gaze: CoDG). We tested the CoDG as a measure of ""being looked at"" in social anxiety. Participants were stratified into high/low social anxiety groups and asked to judge whether they were being 'looked at' by computerised male faces varying in eye gaze deviation and facial emotion. High socially anxious males had a wider CoDG than low socially anxious males; high and low socially anxious females did not differ. Fearful faces elicited narrower cones than neutral or angry faces; however, the effect size was small and not evident for the high socially anxious males. Measures of subjective reactions to the study, and to being looked at in general, indicated that the results may be in part due to males suffering more discomfort when being looked at. The results show that measures derived from psychophysics, in this case, the CoDG, have potential as clinical and research tools for measuring anxiety about being scrutinised. © 2013 Elsevier Ireland Ltd.",Jun Y.Y.; Mareschal I.; Clifford C.W.G.; Dadds M.R.,2013.0,10.1016/j.psychres.2013.05.020,0,0,
7720,Cognitive inflexibility and suicidal ideation: Mediating role of brooding and hopelessness,"Previous research suggests that cognitive inflexibility prospectively increases vulnerability to suicidal ideation, but the specific cognitive factors that may explain the relation have not been examined empirically. The present study examined the brooding subtype of rumination and hopelessness as potential mediators of the prospective relation between cognitive inflexibility and suicidal ideation. Fifty-six young adults who completed a measure of cognitive inflexibility and suicidal ideation at baseline were followed up 2-3 years later and completed measures of brooding, hopelessness, and suicidal ideation. Cognitive inflexibility at baseline predicted suicidal ideation at follow up, adjusting for baseline ideation. This relation was mediated by brooding but not by hopelessness. However, there was an indirect relation between perseverative errors and suicidal ideation through brooding, followed by hopelessness, such that brooding was associated with greater hopelessness and hopelessness, in turn, was associated with greater suicidal ideation. Cognitive inflexibility may increase vulnerability to suicidal thinking because it is associated with greater brooding rumination, while brooding, in turn, is associated with hopelessness. © 2013 Elsevier Ireland Ltd.",Miranda R.; Valderrama J.; Tsypes A.; Gadol E.; Gallagher M.,2013.0,10.1016/j.psychres.2013.02.033,0,0,
7721,Social anxiety is associated with general but not specific biases in emotion recognition,"Misreading facial expressions as signals of social disapproval, such as anger and disgust, may maintain social anxiety. If so, manipulating face processing could be therapeutic. It remains unclear, however, whether socially anxious individuals are in fact more sensitive to disapproving emotions. We assessed decoding of, and cost attributions to, emotional expressions in high and low socially anxious females (n=102) using five emotions (anger, disgust, fear, happiness, and sadness) expressed at 15 intensities (9-65%), providing 75 stimuli (see Supplementary Material). The decoding task briefly presented the stimuli and participants identified the emotion. The cost attribution task asked individuals to rate each stimulus for how costly it would be for them to interact with the person. Random effects regression indicated that social anxiety was not associated with overall decoding accuracy but was associated with a response bias. High socially anxious individuals had a lower threshold for decoding emotions but also more frequently classified low intensity emotions incorrectly. These effects were not emotion-specific. Socially anxious individuals also attributed excessive social cost to expressions of negative valence. Our results provide a novel conceptual framework for understanding emotion decoding in social anxiety, indicating the importance of considering both accuracy and response bias. © 2013 Elsevier Ireland Ltd.",Button K.; Lewis G.; Penton-Voak I.; Munafò M.,2013.0,10.1016/j.psychres.2013.06.005,0,0,
7722,Association between morningness-eveningness and the severity of compulsive internet use: The moderating role of gender and parenting style,"Background: Eveningness and Internet addiction are major concerns in adolescence and young adulthood. We investigated the relationship between morningness-eveningness and compulsive Internet use in young adults and explored the moderating effects of perceived parenting styles and family support on such relationships. Methods: The participants consisted of 2731 incoming college students (men, 52.4%; mean age, 19.4. ±. 3.6. years) from a National University in Taiwan. Each participant completed the questionnaires, which included the Morningness-Eveningness Scale (MES), the Yale-Brown Obsessive Compulsive Scale modified for Internet use (YBOCS-IU), the Parental Bonding Instrument for parenting style, the Family Adaptation, Partnership, Growth, Affection, and Resolve questionnaire (APGAR) for perceived family support, and the Adult Self-Report Inventory-4 (ASRI-4) for psychopathology. The morning (n=459), intermediate (n=1878), and evening (n=394) groups were operationally defined by the MES t scores. Results: The results showed that eveningness was associated with greater weekend sleep compensation, increased compulsive Internet use, more anxiety, poorer parenting styles, and less family support; additionally, the most associated variables for increased compulsive Internet use were the tendency of eveningness, male gender, more anxiety symptoms, less maternal affection/care, and a lower level of perceived family support. The negative association between the morning type and compulsive Internet use severity escalated with increased maternal affection/care and decreased with increased perceived family support. The positive association between the evening type and compulsive Internet use severity declined with increased maternal protection. However, the father's parenting style did not influence the relationship between morningness-eveningness and compulsive Internet use severity. Conclusions: Our findings imply that sleep schedule and the parental and family process should be part of specific measures for prevention and intervention of compulsive Internet use. © 2013 Elsevier B.V.",Lin Y.-H.; Gau S.S.F.,2013.0,10.1016/j.sleep.2013.06.015,0,0,
7723,"Perception and pain thresholds for cutaneous heat and cold, and rectal distension: Associations and disassociations","Background: Hypersensitivity to somatic or visceral pain has been reported in numerous clinical conditions such as fibromyalgia or the irritable bowel syndrome, and general hypersensitivity has been proposed to be the underlying mechanism. However, cross-modal relationships especially between somatic and visceral pain have rarely been investigated even in healthy volunteers. Furthermore, psychological influences on pain have rarely been characterized across modalities. Methods: Sixty-one healthy participants underwent testing of perception and pain thresholds for cutaneous thermode heat and cold, as well as for rectal balloon distension. Psychological testing for anxiety, depression, and pain experience (including catastrophizing and coping) as well as cardiac interoception was performed. Measurement quality and the correlations between the different modalities were examined. Key Results: Significant correlations existed between the perception thresholds for cold/heat (τB = -0.28, p = 0.002) and cold/distension (τB = -0.21, p = 0.03) and for the pain thresholds for cold/heat (r = -0.61, p < 0.001) and heat/distension (r = 0.33, p = 0.01). No association was found between pain thresholds and anxiety, depression, psychological experience with and processing of pain, or cardiac interoception. Retest reliabilities for pain measurements were satisfying after short intertrial intervals (all intraclass correlation coefficients >0.8), but less so after longer intervals. The individuals contributing to the respective correlations differ between measurements. Conclusions & inferences: Moderate associations were found for pain thresholds across modalities. The strength of the associations and their stability over time warrants further investigation and might serve to increase the understanding of conditions affecting multiple pain modalities. In healthy subjects, heat and cold pain thresholds were correlated with r = 0.61; heat and distension pain thresholds with r = 0.33; cold and distension pain thresholds were uncorrelated. Thresholds as well as correlations showed moderate to large retest reliability. © 2013 John Wiley & Sons Ltd.",Horing B.; Kugel H.; Brenner V.; Zipfel S.; Enck P.,2013.0,10.1111/nmo.12207,0,0,
7724,The EEG correlates of the TMS-induced EMG silent period in humans,"Application of magnetic or electrical stimulation to the motor cortex can result in a period of electromyography (EMG) silence in a tonically active peripheral muscle. This period of EMG silence is referred to as the silent period (SP). The duration of SP shows intersubject variability and reflects the integrity of cortical and corticospinal pathways. A non-invasive technique for assessing the duration of SP is the combination of Transcranial Magnetic Stimulation (TMS) with EMG. Utilizing TMS-EMG, several studies have reported on the shortening or lengthening of SP in neuropsychiatric disorders such as schizophrenia, bipolar disorder, depression, obsessive compulsive disorder, epilepsy, Parkinson's disease, and stroke. However, cortical, corticospinal and peripheral components are difficult to disentangle from EMG alone. Here, we use the multimodal neuroimaging technique of TMS-EMG combined with concurrent electroencephalography (EEG) recording to further examine the cortical origin of SP and the cortical oscillatory activity that underlies SP genesis. We demonstrate that the duration of SP is related to the temporal characteristics of the cortical reactivity and the power of delta to alpha oscillations in both local and remote areas ipsilateral and contralateral to the stimulation site, and beta oscillations locally. We illustrate that, compared to EMG, the EEG indices of the SP provide additional information about the brain dynamics and propose that the EEG measures of SP may be used in future clinical and research investigations to more precisely delineate the mechanisms underlying inhibitory impairments. © 2013 Elsevier Inc.",Farzan F.; Barr M.S.; Hoppenbrouwers S.S.; Fitzgerald P.B.; Chen R.; Pascual-Leone A.; Daskalakis Z.J.,2013.0,10.1016/j.neuroimage.2013.06.059,0,0,
7725,Socially anxious individuals with low working memory capacity could not inhibit the goal-irrelevant information,"Socially anxious individuals are interfered by distractors. Recent work has suggested that low working memory capacity and inappropriate temporary goal induce attention to distractors. We investigated the effects of working memory capacity and temporary goal on attention to distractors in social anxiety. Participants viewed a rapid serial visual presentation, in which participants reported the identity of a single target letter drawn in red. Distractors appeared before the target was presented. When the color of distractors was red (i.e., goal-relevant stimuli), low-capacity individuals were strongly interfered by the distractors compared to high-capacity individuals regardless of social anxiety. When the color of distractors was goal-irrelevant, low-capacity and high socially anxious individuals were strongly interfered by the distractors. These results suggest that socially anxious individuals with low working memory capacity could not inhibit the goal-irrelevant information and direct attention to distractors. © 2013 Moriya and Sugiura.",Moriya J.; Sugiura Y.,2013.0,10.3389/fnhum.2013.00840,0,0,
7726,The spontaneous decay and persistence of mental contamination: An experimental analysis,"Background and objectives It has recently been identified that feelings of contamination can arise in the absence of physical contact with a stimulus. This concept, known as 'mental contamination' has particular relevance to Obsessive Compulsive Disorder in which compulsive cleaning is a common symptom presentation. Experimental studies have begun to examine the psychopathology of mental contamination. The aims of the two experiments reported here were to explore the evocation and spontaneous decay of mental contamination. Methods In Experiment 1, a variant of the autobiographical memory task was used in which 40 non-clinical participants were asked to recall autobiographical memories associated with betrayal, harm, humiliation and violation of moral standards. In Experiment 2, 60 participants with moderate levels of mental contamination were asked to complete five short tasks designed to induce mental contamination, including recalling unwanted memories and images. Results In both experiments, participants reported significant increases in mental contamination, anxiety, urges to wash and actual washing behaviour. In experiment 1, the effect of the induction decayed spontaneously. Experiment 2 found that re-evoking contamination and repeated washing led to the persistence of mental contamination. Limitations The studies were conducted on non-clinical samples. Conclusions These findings demonstrated that repeated triggers may be causally connected to the maintenance of mental contamination fears in non-clinical samples. © 2013 Elsevier Ltd. All rights reserved.",Coughtrey A.E.; Shafran R.; Rachman S.J.,2014.0,10.1016/j.jbtep.2013.09.001,0,0,
7727,A pharmacogenetic survey of androgen receptor (CAG)n and (GGN)n polymorphisms in patients experiencing long term side effects after finasteride discontinuation,"Finasteride is a steroid 5-alpha-reductase inhibitor, approved for the treatment of androgenetic alopecia (AGA) and benign prostate hyperplasia. In some patients the treatment is associated with adverse side effects that could become persistent after therapy discontinuation, resulting in the so-called post-finasteride syndrome (PFS). A pharmacogenetic component in the response to finasteride treatment was previously demonstrated. Two polymorphisms (CAG) rs4045402 and (GGN) rs3138869 in the gene encoding for the androgen receptor (AR) have been hypothesized to play a role in finasteride sensitivity. We aimed to compare the rs4045402 and rs3138869 polymorphisms prevalence in a group of 69 selected subjects (AGA+PFS) that used finasteride to treat alopecia and developed persistent side effects, with that in a group of 91 untreated subjects with AGA (AGA), and a group of 76 untreated subjects without AGA (NO-AGA). The rs4045402 and rs3138869 polymorphisms extreme-lengths alleles were more frequent among AGA+PFS (odds ratio, 5.88; 95% CI, 1.87-18.52) and AGA subjects (odds ratio, 3.55; 95% CI, 1.13-11.21) than among NO-AGA subjects, probably reflecting the genetic predisposing factors for AGA development. In conclusion, we described a predictive effect of the less common repeats’ length CAG-rs4045402 and GGN-rs3138869 on AGA development. Prospective trials are required to confirm our findings also in other ethnicities, and to highlight possible further pharmacogenetic predictive markers of susceptibility to adverse effects.",Cecchin E.; De Mattia E.; Mazzon G.; Cauci S.; Trombetta C.; Toffoli G.,2014.0,10.5301/jbm.5000095,0,0,
7728,Pilot-scale investigation of drinking water ultrafiltration membrane fouling rates using advanced data analysis techniques,"A pilot-scale investigation of the performance of biofiltration as a pre-treatment to ultrafiltration for drinking water treatment was conducted between 2008 and 2010. The objective of this study was to further understand the fouling behaviour of ultrafiltration at pilot scale and assess the utility of different foulant monitoring tools. Various fractions of natural organic matter (NOM) and colloidal/particulate matter of raw water, biofilter effluents, and membrane permeate were characterized by employing two advanced NOM characterization techniques: liquid chromatography - organic carbon detection (LC-OCD) and fluorescence excitation-emission matrices (FEEM) combined with principal component analysis (PCA). A framework of fouling rate quantification and classification was also developed and utilized in this study. In cases such as the present one where raw water quality and therefore fouling potential vary substantially, such classification can be considered essential for proper data interpretation. The individual and combined contributions of various NOM fractions and colloidal/particulate matter to hydraulically reversible and irreversible fouling were investigated using various multivariate statistical analysis techniques. Protein-like substances and biopolymers were identified as major contributors to both reversible and irreversible fouling, whereas colloidal/particulate matter can alleviate the extent of irreversible fouling. Humic-like substances contributed little to either reversible or irreversible fouling at low level fouling rates. The complementary nature of FEEM-PCA and LC-OCD for assessing the fouling potential of complex water matrices was also illustrated by this pilot-scale study. © 2013 Elsevier Ltd.",Chen F.; Peldszus S.; Peiris R.H.; Ruhl A.S.; Mehrez R.; Jekel M.; Legge R.L.; Huck P.M.,2014.0,10.1016/j.watres.2013.10.007,0,0,
7729,Relationships between firefighters' postevent distress and growth at different times after distressing incidents,"As a consequence of exposure to distressing work-related incidents, firefighters may experience negative symptomatic responses, that is, postevent distress. As well as negative outcomes, empirical studies have documented the experience of growth, that is, positive psychological changes, among first responders after encountering distressing work-related incidents. Postevent distress and growth may evolve independently at different times following a distressing event yet are likely to influence each other. In the present study the impact of distressing work-related incidents on firefighters was investigated, examining the relationship (linear, quadratic, and cubic) between postevent distress and growth. To see what this relationship looked like in the immediate and in the more distant aftermath of distressing incidents, participants were split into 2 groups: those with more recent exposure (i.e., their distressing incident occurred within the past 12 months) and those with more distant exposure (i.e., their distressing incident occurred 13-24 months ago). A sample of 927 firefighters from 8 predominantly European countries completed the Impact of Event Scale-Revised and the Posttraumatic Growth Inventory-Short Form with reference to an incident they perceived to be most stressful. Time since this incident occurred was not significantly associated with growth, but was negatively associated with postevent distress. The relationship between postevent distress and growth at different times was first explored using the loess statistical method. Subsequent multivariate regression analyses produced evidence of both linear and curvilinear relationships between postevent distress and growth. Nevertheless, the cubic model appeared to be the best fit of the data for recent distressing incidents and the quadratic model for more distant distressing incidents. The regression results were consistent with the results of the loess smoothing. Implications for clinical practice are discussed.",Kehl D.; Knuth D.; Hulse L.; Holubov√° M.; Schmidt S.,2014.0,10.1037/h0099832,0,0,
7730,Examining sexual orientation disparities in alcohol misuse among women veterans,"Purpose To examine the role of civilian and military traumas and mental health symptoms (i.e., depression, post-traumatic stress disorder) in explaining sexual orientation disparities in alcohol misuse between sexual minority and heterosexual women veterans across the U.S.",Lehavot K.; Browne K.C.; Simpson T.L.,2014.0,10.1016/j.amepre.2014.07.002,0,0,
7731,Posttraumatic stress disorder and responses to couple conflict: Implications for cardiovascular risk,"Objective: Posttraumatic stress disorder (PTSD) is associated with increased risk of coronary heart disease (CHD) and difficulties in intimate relationships. Greater frequency and severity of couple conflict and greater cardiovascular reactivity to such conflict might contribute to CHD risk in those with PTSD, but affective and physiological responses to couple conflict have not been examined previously in this population. Method: In a preliminary test of this hypothesis, 32 male veterans of the Iraq and Afghanistan Wars with PTSD and their female partners, and 33 control male veterans without PTSD and their female partners completed relationship quality assessments and a conflict discussion task. PTSD diagnosis was confirmed through diagnostic interviews and questionnaires. State anger, state anxiety, and cardiovascular measures (i.e., blood pressure, heart rate) were recorded during baseline and the conflict discussion. Results: Compared with controls, PTSD couples reported greater couple conflict and less warmth, and displayed pronounced increases in anger and greater increases in systolic blood pressure in response to the conflict task (all ps < .05; range η<sup>2</sup>: .05-.24). Partners in the PTSD group exhibited similar, if not greater, responses as veterans. Conclusions: This was the first investigation to document emotional and cardiovascular responses to couple conflict in veterans with PTSD and their partners. PTSD was associated with greater frequency and severity of couple conflict, and greater anger and cardiovascular reactivity to conflict discussions. Anger and physiological responses to couple discord might contribute to CHD risk in veterans with PTSD, and perhaps their partners, as well.",Caska C.M.; Smith T.W.; Renshaw K.D.; Allen S.N.; Uchino B.N.; Birmingham W.; Carlisle M.,2014.0,10.1037/hea0000133,0,0,
7732,Comparing the roles of washing and non-washing behaviour in the reduction of mental contamination,"Background and objectives: Mental contamination is the experience of feelings of dirtiness without direct physical contact with a contaminant. Imagining a non-consensual kiss from an immoral man (Dirty Kiss task) can evoke feelings of mental contamination in non-clinical female participants. We investigated whether feelings of mental contamination evoked by the Dirty Kiss task are reduced by washing behaviours. Methods: Forty-eight female participants were split into two groups: washing ( n=24; asked to wash their hands and mouth after the Dirty Kiss task) and non-washing ( n=24; asked to wait without engaging in any behaviour after the Dirty Kiss task). Indices of mental contamination were administered before, immediately after, 5. min after, and 20. min after the task. Results: Mental contamination scores did not significantly differ between the groups at any point. However, in both groups, scores immediately after the Dirty Kiss task were significantly higher than those 5 or 20. min later. Limitations: The long-term effects of washing behaviour on mental contamination were not clarified. Conclusions: Mental contamination can be reduced by washing behaviour, although no more effectively than waiting without washing. © 2013 Elsevier Ltd.",Ishikawa R.; Kobori O.; Komuro H.; Shimizu E.,2014.0,10.1016/j.jocrd.2013.11.008,0,0,
7733,Neuropsychological characteristics of people living in squalor,"Background: Squalor is an epiphenomenon associated with a range of medical and psychiatric conditions. People living in squalor are not well described in the literature, and prior work has indicated that up to 50% do not have a psychiatric diagnosis. Squalor appears to be linked with neuropsychological deficits suggestive of the presence of impaired executive function. We present a case series of people living in squalor that examines their neuropsychological assessment and diagnosis. Methods: Clinicians from local health networks were invited to submit neuropsychological reports of patients living in squalor. These selected reports were screened to ensure the presence of squalor and a comprehensive examination of a set of core neuropsychological domains. Assessments were included if basic attention, visuospatial reasoning, information processing speed, memory function, and executive function were assessed. Results: Sixty-nine neuropsychological reports were included. Sixty-eight per cent of the group underwent neuropsychological assessments during an inpatient admission. For participants where it was available (52/69), the mean Mini-Mental State Examination score was 25.29 (SD = 3.96). Neuropsychological assessment showed a range of cognitive impairment with nearly all the participants (92.75%) found to have frontal executive dysfunction. One person had an unimpaired neuropsychological assessment. Results indicated that dorsolateral prefrontal rather than orbitofrontal functions were more likely to be impaired. Vascular etiology was the most common cause implicated by neuropsychologists. Conclusions: Frontal executive dysfunction was a prominent finding in the neuropsychological profiles of our sample of squalor patients, regardless of their underlying medical or psychiatric diagnoses. Our study highlights the importance of considering executive dysfunction when assessing patients who live in squalor.",Lee S.M.; Lewis M.; Leighton D.; Harris B.; Long B.; Macfarlane S.,2014.0,10.1017/S1041610213002640,0,0,
7734,Low-Intensity pulsed ultrasound promotes chondrogenic progenitor cell migration via focal adhesion kinase pathway,"Low-intensity pulsed ultrasound (LIPUS) has been studied frequently for its beneficial effects on the repair of injured articular cartilage. We hypothesized that these effects are due to stimulation of chondrogenic progenitor cell (CPC) migration toward injured areas of cartilage through focal adhesion kinase (FAK) activation. CPC chemotaxis in bluntly injured osteochondral explants was examined by confocal microscopy, and migratory activity of cultured CPCs was measured in transwell and monolayer scratch assays. FAK activation by LIPUS was analyzed in cultured CPCs by Western blot. LIPUS effects were compared with the effects of two known chemotactic factors: N-formyl-methionyl-leucyl-phenylalanine (fMLF) and high-mobility group box 1 (HMGB1) protein. LIPUS significantly enhanced CPC migration on explants and in cell culture assays. Phosphorylation of FAK at the kinase domain (Tyr 576/577) was maximized by 5min of exposure to LIPUS at a dose of 27.5mW/cm2 and frequency of 3.5MHz. Treatment with fMLF, but not HMBG1, enhanced FAK activation to a degree similar to that of LIPUS, but neither fMLF nor HMGB1 enhanced the LIPUS effect. LIPUS-induced CPC migration was blocked by suppressing FAK phosphorylation with a Src family kinase inhibitor that blocks FAK phosphorylation. Our results imply that LIPUS might be used to promote cartilage healing by inducing the migration of CPCs to injured sites, which could delay or prevent the onset of post-traumatic osteoarthritis. © 2014 World Federation for Ultrasound in Medicine & Biology.",Jang K.W.; Ding L.; Seol D.; Lim T.-H.; Buckwalter J.A.; Martin J.A.,2014.0,10.1016/j.ultrasmedbio.2013.12.007,0,0,
7735,Increased default mode network activity in socially anxious individuals during reward processing,"Background: Social anxiety has been associated with potentiated negative affect and, more recently, with diminished positive affect. It is unclear how these alterations in negative and positive affect are represented neurally in socially anxious individuals and, further, whether they generalize to non-social stimuli. To explore this, we used a monetary incentive paradigm to explore the association between social anxiety and both the anticipation and consumption of non-social incentives. Eighty-four individuals from a longitudinal community sample underwent functional magnetic resonance imaging (fMRI) while participating in a monetary incentive delay (MID) task. The MID task consisted of alternating cues indicating the potential to win or prevent losing varying amounts of money based on the speed of the participant's response. We examined whether self-reported levels of social anxiety, averaged across approximately 7 years of data, moderated brain activity when contrasting gain or loss cues with neutral cues during the anticipation and outcome phases of incentive processing. Whole brain analyses and analyses restricted to the ventral striatum for the anticipation phase and the medial prefrontal cortex for the outcome phase were conducted.Results: Social anxiety did not associate with differences in hit rates or reaction times when responding to cues. Further, socially anxious individuals did not exhibit decreased ventral striatum activity during anticipation of gains or decreased MPFC activity during the outcome of gain trials, contrary to expectations based on literature indicating blunted positive affect in social anxiety. Instead, social anxiety showed positive associations with extensive regions implicated in default mode network activity (for example, precuneus, posterior cingulate cortex, and parietal lobe) during anticipation and receipt of monetary gain. Social anxiety was further linked with decreased activity in the ventral striatum during anticipation of monetary loss.Conclusions: Socially anxious individuals may increase default mode network activity during reward processing, suggesting high self-focused attention even in relation to potentially rewarding stimuli lacking explicit social connotations. Additionally, social anxiety may relate to decreased ventral striatum reactivity when anticipating potential losses.",Maresh E.L.; Allen J.P.; Coan J.A.,2014.0,10.1186/2045-5380-4-7,0,0,
7736,Thought suppression across time: Change in frequency and duration of thought recurrence,"Some studies have found that trying to suppress thoughts increases their long-term recurrence, a phenomenon associated with psychopathology, particularly obsessive-compulsive disorder. However, effect sizes in thought suppression studies have often been small and inconsistent. The present study sought to improve thought suppression conceptualization and measurement by examining two distinct dimensions of thought recurrence - frequency and duration of a thought's return - and how they evolve over time. After a thought focus period, 100 adults were assigned to either suppress or monitor the recurrence of an unpleasant thought for 4. min. Then, during a second four-minute period, all participants were asked to monitor the thought's recurrence. Hierarchical linear modeling indicated that thought frequency declined across time and the rate of decline slowed as time went on. Initially, the extent of thought duration remained short and stable for those asked to suppress, and increased linearly over time for those asked to monitor. Later, this pattern reversed. Duration increased linearly for those initially asked to suppress but was short and stable for those who initially monitored. Accounting for change over time and means of measuring recurrence (frequency vs. duration) may help elucidate past mixed findings, and improve thought suppression research methodology. © 2013 Elsevier Ltd.",Lambert A.E.; Hu Y.; Magee J.C.; Beadel J.R.; Teachman B.A.,2014.0,10.1016/j.jocrd.2013.11.004,0,0,
7737,Investigating the 'placebo personality' outside the pain paradigm,"Aim: To identify personality traits related to placebo responding outside the context of pain. Methods: Sixty three healthy volunteers completed the study. Personality traits were measured online one week prior to a laboratory session in which two psychosocial stress tests were administered. Prior to the second test, the placebo group received an intranasal spray of 'serotonin' (placebo) with the suggestion that it would enhance recovery. Subjective stress, heart rate and heart rate variability were measured. Self reported and physiological responses to the placebo suggestion were assessed against personality variables. Results: Placebo effects were demonstrated in both self reported and physiological stress metrics. Lower optimism and less empathic concern predicted greater perceived benefits from the placebo treatment; and lower drive, fun, and sensation seeking were related to a greater physiological response to the manipulation. Multivariate analyses revealed lower optimism and behavioural drive to be predictive of responding to the placebo manipulation. Conclusion: Findings are in contrast with prior work in pain paradigms which found higher levels of the same traits to be related to greater placebo analgesic responses. A cluster of traits characterised by behavioural drive, extraversion, optimism and novelty or fun seeking appears to be germane to placebo responsiveness, but contextual stimuli may generate different patterns of responding. A new conceptualisation of placebo responsiveness may be useful. Rather than a 'placebo personality' it may be that responsiveness is better typified by a two faceted transactional model, in which different personality facets respond to different contextual contingencies. © 2014 Elsevier Inc.",Darragh M.; Booth R.J.; Consedine N.S.,2014.0,10.1016/j.jpsychores.2014.02.011,0,0,
7738,Paradoxical effects of compulsive perseveration: Sentence repetition causes semantic uncertainty,"Many patients with obsessive compulsive disorder (OCD) perform perseverative checking behavior to reduce uncertainty, but studies have shown that this ironically increases uncertainty. Some patients also tend to perseveratively repeat sentences. The aim of this study was to examine whether sentence repetitions leads to semantic uncertainty and how fast this effect occurs. We also explored if effects of repeating sentences are affected by simultaneously looking at the primary object in the repeated sentence (e.g., looking at a mug while saying ""the mug is clean""). Between a pre- and post-test, 165 students repeated short sentences only once (control conditions), or 5, 10 or 20 times (experimental conditions). In the pre- and post-test, they completed a questionnaire about feelings of uncertainty and dissociation. While repeating the sentence, participants looked at the object that was part of their perseveration (relevant) or looked at a white wall (irrelevant). Results showed that sentence repetition induces semantic uncertainty, which increased with more sentence repetitions, and was the largest after 20 repetitions. This effect was not qualified by looking at the object of perseveration. These and earlier findings suggest different types of OC-like perseveration have detrimental effects and may fruitfully be targeted in psychological treatments of OCD. © 2013 Elsevier Ltd.",Giele C.L.; van den Hout M.A.; Engelhard I.M.; Dek E.C.P.,2014.0,10.1016/j.jocrd.2013.11.007,0,0,
7739,Stress exposure prior to fear acquisition interacts with estradiol status to alter recall of fear extinction in humans,"Classical fear acquisition and extinction are important models for the etiology and treatment of anxiety disorders such as posttraumatic stress disorder (PTSD). Women are at a higher risk for PTSD than men. Levels of circulating 17-β estradiol (E2) in women have been linked to deficits in fear extinction and extinction recall. In PTSD, fear learning coincides with acute traumatic stress. However, little is known about the possible interaction between stress exposure and hormone status on fear acquisition and extinction learning. In a 2-day, 2. ×. 3 between-subjects design with healthy participants, we examined the effects of stress (psychosocial stressor vs. control, placed 45. min prior to conditioning) and natural E2-status on differential fear conditioning, covering fear acquisition, immediate extinction (Day 1), and 24. h-delayed extinction recall (Day 2). To operationalize E2-status, we compared women in the early follicular phase (EF) of their menstrual cycle (low E2, low progesterone plasma levels), women in the midcycle phase (MC, high E2, low progesterone), and men. Conditioning was indicated by differential skin conductance responses. We found an interaction between stress exposure and natural E2-status in women only: In MC-women, extinction recall on Day 2 (24. h after initial extinction training) was better when fear acquisition had been preceded by stress. In EF-women, the inverse was true. We show that extinction recall of conditioned fear acquired after stress depends on estrogen status in women. Therefore, extinction-based exposure therapy in free-cycling female anxiety patients should take cycle status into account.",Antov M.I.; Stockhorst U.,2014.0,10.1016/j.psyneuen.2014.06.022,0,0,
7740,Investigating the Structure of Craving Using Structural Equation Modeling in Analysis of the Obsessive-Compulsive Drinking Scale: A Multinational Study.,"Background: Currently, there is no agreement among researchers on the definition of craving and its underlying theoretical model. The Obsessive-Compulsive Drinking Scale (OCDS) seems to measure certain aspects of craving, but its theoretical basis remains unclear. The aim of this study was to investigate the structure of alcohol craving, using OCDS data. Methods: OCDS data from four studies were pooled to obtain a large and heterogeneous sample of 505 participants. All participants were treatment-seeking alcoholics meeting DSM-IV criteria for alcohol dependence. The factor structures of the OCDS previously found were evaluated using confirmatory factor analyses. The goodness of fit of these solutions was compared with those of alternative causal models: an obsessive-compulsive disorder model, an inhibition model, and a cognitive-behavioral model. These alternative models were based on modern theories about craving and were tested in the OCDS data, using structural equation modeling. In this way, the current study replaced simple correlational analysis by a more sophisticated causal way of analyzing the underlying structure of the OCDS items. The best fitting model was selected by comparing the mean discrepancy between the implied and observed matrices of the models. Results: The data showed that the previously reported factor structures had to be rejected. Also, the inhibition model and obsessive-compulsive disorder model did not fit the data. The cognitive-behavioral model showed encouraging fit. Optimizing strategies were applied to further improve the fit of this model, which resulted in a model with close fit to the data. Conclusions: The causal cognitive-behavioral model proved to be superior. It showed that the OCDS contains many items that do not represent the core concept of craving but instead are indicators for the consequences of craving. From this model, it seems that craving, in a narrow sense, can be reliably assessed with only five items of the OCDS. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","de Wildt, Wencke A. J. M; Lehert, Philippe; Schippers, Gerard M; Nakovics, Helmut; Mann, Karl; van den Brink, Wim; Annsseau, Anton, Anton, Bandura, Bohn, Bollen, de Wildt, Dimeff, Franzblau, Goldstein, Kranzler, Linhart, Mann, Marlatt, Marlatt, Marsh, Miller, Modell, Modell, Roberts, Satorra, Schippers, Schwarzer, Tiffany, Verheul, Volkow",2005.0,,0,0,
7741,"The Impact of an Exercise Program on Posttraumatic Stress Disorder, Anxiety, and Depression.","This preliminary study assessed the impact of a 12-session aerobic exercise program on symptoms of Posttraumatic Stress Disorder (PTSD), anxiety, and depression. Overall results show no symptom reduction during baseline phases but significant reductions in PTSD, anxiety, and depression following the exercise intervention. Reductions were maintained during a 1 month follow-up. Results suggest that exercise programs may be valuable resources for managing treatment-resistant participants with PTSD and may also have a beneficial effect on anxiety and depression. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Manger, Theresa A; Motta, Robert W; Altchiler, Beck, Biddle, Blake, Doyne, Foa, Foa, Foa, Folkins, Fremont, Green, Greist, Hays, Horowitz, Klein, Kulka, Leith, Mulcahy, Muran, Ochberg, Peterson, Petruzzello, Plante, Smith, Spielberger, Spitzer, Stein, Weathers, Weathers, Weathers, Wilkinson",2005.0,,0,0,
7742,Cognitive-Behavioral Therapy for PTSD in the Real World: Do Interpersonal Relationships Make a Real Difference?,"The goal of this effectiveness study was to investigate the role of pre-treatment interpersonal relationship functioning in two forms of group cognitive-behavioral treatment (CBT) for veterans with PTSD. Analysis of data from 45 veterans who completed either trauma- or skills-focused CBT indicated no overall differences between the two treatments in PTSD symptomatology, alcohol abuse, or violence perpetration at four months post-treatment. However, there was a stronger inverse relationship between intimate relationship functioning and violence outcomes in the trauma-focused group versus the skills-focused group. While no differences in violence outcomes were found between the treatments at poorer levels of pre-treatment intimate relationship functioning, those receiving trauma-focused treatment with better pre-treatment intimate relationships reported less violence. Extended relationship functioning and violence outcomes were less strongly associated in the trauma-focused group versus the skills-focused group. The theoretical implications of these results, as well as the clinical opportunities to improve CBT for PTSD by capitalizing on patients' relationships, are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Monson, Candice M; Rodriguez, Benjamin F; Warner, Reid; Aiken, Borkovec, Brewin, Byrne, Creamer, Foa, Foa, Foa, Fontana, Foy, Glynn, Hembree, Johnson, Keane, Kilpatrick, Kulka, Litz, Marks, McLellan, Monson, Monson, Persons, Resick, Riggs, Riggs, Rosenheck, Rothbaum, Tarrier, Tarrier, Taylor, Van Etten, Zayfert",2005.0,,0,0,
7743,An Investigation Into the Effectiveness of Bibliotherapy and Minimal Contact Interventions in the Treatment of Panic Attacks.,"The present study investigated the effectiveness of bibliotherapy and minimal therapist-contact interventions in the treatment of panic attacks. Individuals were randomly assigned to one of three conditions: (1) bibliotherapy alone (BT); (2) bibliotherapy plus phone contact (BT+PC); or (3) phone contact alone (PC). Assessment (pre- and post-treatment) and treatment (8 weeks in duration) were conducted via mail and phone. Individuals receiving BT and BT+PC exhibited significant reductions from pre- to post-treatment on panic cognitions and fear of having a panic attack. Individuals receiving BT+PC exhibited significant reductions from pre-to post-treatment on panic symptoms and avoidance. In addition, individuals in the BT and BT+PC groups were more likely to exhibit clinically significant improvement on most dependent measures relative to PC alone. On some measures, individuals in the BT+PC group did clinically better than individuals in the BT group. Results of the present study also suggest that diagnosis may play some role in outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Febbraro, Greg A. R; Adams, Barlow, Barlow, Borden, Borenstein, Brown, Chambless, Chambless, Clum, Clum, Clum, Febbraro, Ghosh, Gould, Gould, Gould, Hayes, Hecker, Jacobson, Lidren, Marrs, McNamee, Mullen, Mullen, Nelson, Newman, Newman, Parry, Paulsen, Reiss, Riordan, Roodman, Rosen, Rosen, Rosenthal, Starker, Warner, Wolfe, Wright",2005.0,,0,0,
7744,Treatment of depression and anxiety in Parkinson's Disease: A pilot study using group cognitive behavioural therapy.,"Depression and anxiety affect up to 50% of people with Parkinson's Disease (PD) (Marsh, 2000; Murray, 1996), however, few studies have examined the effectiveness of psychological treatment. This study examined the effectiveness of group cognitive behaviour therapy (GET) in treating depression and anxiety in PD. Four participants, aged between 56 and 81 years, who had been diagnosed with PD and suffering from depression and/or anxiety were included in the study. The results suggested that CBT was effective in treating depression and anxiety in PD. Furthermore, the results supported that the gains were maintained at 1-month follow-up. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Feeney, Farah; Egan, Sarah; Gasson, Natalie; Barlow, Beck, Beck, Bronstein, Burgess, Chambless, Comella, Craighead, Doherty, Dreisig, Elkin, Evans, Folstein, Goburdhun, Grant, Gupta, Hageman, Higginson, Hollon, Jacobson, Marsh, Menza, Moller, Murray, Nathan, Nathan, Playfer, Rabinstein, Schrag, Shaffer, Shea, Sheehan, Sheehan, Silver, Simons, Speilberger, Speilberger, Starkstein, Thompson, Troester, Walsh, White",2005.0,,0,0,
7745,Efficacy of an Intensive Outpatient Rehabilitation Program in Alcoholism: Predictors of Outcome 6 Months after Treatment.,"Treatment of alcohol-dependent patients was primarily focused on inpatient settings in the past decades. The efficacy of these treatment programs has been evaluated in several studies and proven to be sufficient. However, with regard to the increasing costs in public healthcare systems, questions about alternative treatment strategies have been raised. Meanwhile, there is growing evidence that outpatient treatment might be comparably effective as inpatient treatment, at least for subgroups of alcohol dependents. On that background, the present study aimed to evaluate the efficacy of a high-structured outpatient treatment program in 103 alcohol-dependent patients. 74 patients (72%) terminated the outpatient treatment regularly. At 6 months' follow-up, 95% patients were successfully located and personally re-interviewed. Analyses revealed that 65 patients (64%) were abstinent at the 6-month follow-up evaluation and 37 patients (36%) were judged to be non-abstinent. Pretreatment variables which were found to have a negative impact (non-abstinence) on the 6-month outcome after treatment were a higher severity of alcohol dependence measured by a longer duration of alcohol dependence, a higher number of prior treatments and a stronger alcohol craving (measured by the Obsessive Compulsive Drinking Scale). Further patients with a higher degree of psychopathology measured by the Beck Depression Inventory (depression) and State-Trait Anxiety Inventory (anxiety) relapsed more often. In summary, results of this study indicate a favorable outcome of socially stable alcohol-dependent patients and patients with a lower degree of depression, anxiety and craving in an intensive outpatient rehabilitation program. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bottlender, Miriam; Soyka, Michael; Anton, Battjes, Beck, Bell, Burtscheidt, Caddy, Elal-Lawrence, Emrick, Emrick, Feuerlein, Finney, Laux, Leune, Langle, Marlatt, Mattson, McLachlan, McLellan, McLellan, McLellan, Miller, Miller, Moos, Moos, Mundle, Nagy, Ouimette, Pfeiffer, Rounsaville, Soyka, Soyka, Soyka, Soyka",2005.0,,0,0,
7746,"Case Series Utilizing Exposure, Relaxation, and Rescripting Therapy: Impact on Nightmares, Sleep Quality, and Psychological Distress.","Experiencing a traumatic event may initiate or exacerbate the occurrence of nightmares. Nightmares may impact sleep quality and quantity, posttraumatic stress symptoms, and depression. Recently, imagery rehearsal has gained attention in the treatment of trauma-related nightmares and is reported to be promising in the reduction of nightmares. On the basis of the vast literature describing the therapeutic benefits of exposure techniques for anxiety-related problems, the treatment was modified to enhance the exposure component. This article presents a case series using this modified version of imagery rehearsal, Exposure, Relaxation, and Rescripting Therapy, with 1 male and 3 female participants. Overall, the participants treated reported a reduction in nightmare frequency and severity; 3 out of 4 participants also reported a reduction in posttraumatic stress and depression symptomotology and an increase in sleep quality and quantity. Clinical implications and future research directions are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Davis, Joanne L; Wright, David C; Beck, Buysse, Davis, Foa, Forbes, Krakow, Resick, Resnick, Schreuder, Spitzer, Thompson",2005.0,,0,0,
7747,Evaluation of aggression control therapy for violent forensic psychiatric patients.,"Aggression Control Therapy is meant for Dutch forensic psychiatric patients and consists of 15 weekly sessions and three follow-up sessions at 5-week intervals after completion. It includes the components: Anger Management, Social Skills, Moral Reasoning and Self-regulation Skills. It has been shown in various forensic psychiatric hospitals that Aggression Control Therapy can be given to both inpatients and outpatients. Inpatients had a 12% dropout rate and outpatients a 34% dropout rate. The self-report questionnaires showed a significant decrease in hostile and aggressive behaviour in both inpatients and outpatients. This decrease was maintained at the follow-up assessment. Follow-up research with a control condition and with more objective outcome measures is needed to confirm this improvement. No changes in socially competent behaviour were observed, probably because patients reported at the beginning of the therapy less social anxiety and more social skills than a norm group. The therapy turned out to be beneficial for patients who had a comparatively high level of anger as a personality characteristic. It is recommended that the Social Skills component of the therapy focuses on a decrease in ""limit-setting"" skills like giving criticism and more on an increase of ""approaching"" skills like giving a compliment. A design for a future controlled study is described briefly. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hornsveld, Ruud H. J; Buss, Costa, De Ruiter, Goldstein, Hare, Hoekstra, Hornsveld, Hornsveld, Hornsveld, Hornsveld, Hornsveld, Hornsveld, Hornsveld, Meesters, Novaco, Spielberger, Van Dam-Baggen, Van der Ploeg, Vertommen",2005.0,,0,0,
7748,The assessment of treatment strategy in cognitive-behavior therapy: Using the pivotal topic measure.,"A new method of how to assess treatment strategy is presented. In a controlled clinical trial of cognitive-behavioral therapy (CBT) for generalized anxiety disorder (GAD), 12 therapists and 30 patients were asked, after each of 25 sessions, to write down what they viewed to be the most important topic of that particular session. A content analytic scheme for the classification of answers was developed and has good interrater reliability. In the initial sessions therapists focused on building a working alliance and on behavior analysis. They then progressed to psychoeducation and cognitive restructuring and coping. This sequence is paralleled by pivotal topics reported by the patients. At the beginning of treatment, patients placed greatest importance on the opportunity to talk, then realized that gaining insight and coping with anxiety were the central foci of treatment, and finally found that it required changing thoughts and learning competencies and self-confidence. Therapist and patient answers reflect central features of CBT for GAD in both content and sequence. Because similar topics are first mentioned by therapists and at a later point by patients, the assumption that the therapists lead the treatment process is supported. The Pivotal Topic Measure can be seen as a new way of assessing treatment strategy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Linden, M; Staats, M; Bar, T; Zubragel, D; Barlow, Beck, Bergin, Brown, Cohen, Dolan, Friedman, Goldfried, Grawe, Hamilton, Hill, Jacobson, Kendall, Linden, Linden, Linden, Linden, Moncher, Pohl, Schulte, Staats, Waltz",2005.0,,0,0,
7749,Excessive social anxiety in clients with depressive disorders: Determinants of change in group treatment.,"Although more than 33% of depressed clients exhibit clinically impairing levels of social anxiety (SA), there are no data on the effects of SA on outcomes of treatment for depression. It was hypothesized that depressed clients with high SA would exhibit less favorable responses to group treatment for depression. The deleterious effects of high SA were proposed to be a function of excessive self-focused attention or distressing social experiences during the interpersonal format of group treatment. The present study investigated the effects of SA on treatment outcomes in depressed outpatients treated with a cognitive-behavioral group intervention. Potential mechanisms of change were stringently examined by addressing the temporal sequence of mediators and symptom changes in treatment. Clinically depressed clients reporting greater elevations in SA showed less self- and clinician-rated improvement in depressive symptoms at post-treatment. Using longitudinal growth curve modeling, high compared to low socially anxious clients improved at a substantially slower rate over the course of treatment. We found some support for self-focused attention early in treatment as a partial mediator of SA effects on subsequent changes in (a) self-reported depressive symptoms and (b) individual rate of symptom change trajectories for completers (i.e., those clients completing at least 50% of treatment sessions as well as the last group treatment or termination session). Findings remained after controlling for initial symptom severity and the number of treatment sessions attended. The quality and perceived closeness of relationships with therapists and other group members failed to account for SA effects on treatment outcome. These findings suggest that excessive self-focused attention plays a role in understanding the pernicious effects of SA on treatment outcome for depression. Given the high rate of excessive SA in individuals suffering from depression and the large portion of depressed clients who fail to recover at the end of treatment, understanding and addressing SA in treatment is of considerable clinical importance. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kashdan, Todd B",2005.0,,0,0,
7750,A comparison between acceptance-enhanced panic control treatment and panic control treatment for panic disorder.,"Panic Control Treatment has received wide spread research and clinical support for the treatment of panic disorder. Although PCT appears to be quite effective, it does not work for everyone, and relapse after treatment is common. PCT is cast within a framework directed toward assisting clients to become more adept at mastering and controlling anxiety and panic. More recently, alternative treatments set within the behavioral analytic framework have been proposed (e.g., Acceptance and Commitment Therapy). Unlike PCT, ACT focuses on acceptance and mastery of experiencing framework and conceptualizes psychopathology as resulting from patients' avoidance and faulty control strategies over unwanted thoughts and emotional responses. To date, no studies have evaluated whether notions of acceptance combined with PCT results in better outcome relative to PCT alone for persons with panic disorder. The present paper presents an Acceptance-enhanced version of PCT for treating panic disorder and describes data from a modest clinical trial designed to evaluate the relative efficacy of the integrated Acceptance-enhanced PCT approach vs. PCT as-usual for persons (n = 22; 17 female; ages 18-65) suffering from panic disorder. Study hypotheses were partially supported, as clinical improvements were found for both treatment conditions but no differences between the effectiveness of the two conditions were evident at either the post-treatment or six month follow-up. Although preliminary, the present data suggest that the Acceptance-enhanced treatment for PD is as equally effective as PCT and that the two treatments might achieve their therapeutic effects via different mechanisms of action. Recommendations for integrating acceptance notions within standard cognitive-behavioral treatments generally, and within specific available treatments for the anxiety-disorders, are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Karekla, Maria",2005.0,,0,0,
7751,Interpersonal Therapy for Social Phobia: Theoretical Model and Review of the Evidence.,"A general interpersonal theory based on Mead's (1934) theory of the self-image and Benjamin's (1993) Structural Analysis of Social Behavior is developed. Central concepts in this theory are relational schema, introjective schema, and self-perpetuating interactional cycles. Within this general theory, a specific interpersonal model of social phobia is formulated. In this model, it is assumed that social phobia is maintained by a critical-defective relational schema, which--when activated--tend to lead to negative self-perpetuating interactive cycles. In addition, an introjective self-critique is elicited concurrently, strengthening these cycles. A review of the evidence indicates that most relationships in the model are empirically supported. An inpatient interpersonal therapy program for social phobia is presented. This therapy appears to be as efficacious as cognitive therapy. With respect to the potential contributions of interpersonal therapy for social phobia, the SASB principles provides a systematic thinking about treatment goals and steps towards these goals. The SASB also includes guidelines for therapists' interventions and patients' constructive social behavior. It is further argued that interpersonal therapy may make better use of a group format than cognitive therapy, and that the notion of relational schemas may lead to techniques that may enhance the benefits of social exposure. If it is correct that the generalized and specific subtypes of social phobia are qualitatively distinct, and if the generalized subtype is more of an interpersonal nature, interpersonal therapy may be more beneficial for generalized social phobia than cognitive therapy. It is concluded that interpersonal therapy may be a promising option for social phobia, both as an alternative to and integrated with cognitive therapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hoffart, Asle; Alden, Arkin, Baldwin, Baldwin, Benjamin, Borge, Bowlby, Clark, Clark, Elkin, Higgins, Hoffart, Hook, Kessler, Kringlen, Lipsitz, Lipsitz, MacKenzie, Mead, Meleshko, Stangier, Strauman, Strupp, Taylor, Wallace, Wampold, Weissman, Wilfley; Abelian, M. E [Ed]",2005.0,,0,0,
7752,"Symptomatic and syndromal anxiety in chronic forms of major depression: Effect of nefazodone, Cogntive Behavioral Analysis System of Psychotherapy, and their combination.","Compared the efficacy of nefazodone (NEF) and Cognitive Behavioral Analysis System of Psychotherapy (CBASP), alone and in combination, in improving anxiety symptoms in patients with chronic major depression (MD). 681 patients with chronic MDD were subjects (Ss) in a 12 wk-study. 226 Ss received NEF, 228 received CBASP, and 227 a combination. Ss completed the Hamilton Rating Scale for Anxiety (HAM-A), the HAM-A psychic anxiety factor, and the anxiety/arousal subscale of the 30-item Inventory for Depressive Symptomatology-Self Report (IDS-SR-30). In the full sample combination therapy was superior to both monotherapies on all 3 anxiety measures both in the rate of change and at endpoint. When change in depressive symptoms was controlled for, there were no treatment differences in rate of change on any of the 3 anxiety measures. In Ss with a concurrent anxiety disorder the combination was superior to CBASP on the HAM-A and the IDS-SR-30. NEF alone and combination therapy were both superior to CBASP on the HAM-A psychic anxiety factor. For patients with chronic MD, combination therapy is superior to CBASP or NEF alone; NEF, either alone or with CBASP, improves anxiety among patients with a concurrent anxiety disorder, independent of depressive symptom reduction. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ninan, Philip T; Rush, A. John; Crits-Christoph, Paul; Kornstein, Susan G; Manber, Rachel; Thase, Michael E; Trivedi, Madhukar H; Rothbaum, Barbara O; Zajecka, John; Borian, Frances E; Keller, Martin B; Angst, Beck, Brown, Clark, Eison, Fava, Fawcett, Fawcett, Fawcett, Fawcett, Grunhaus, Grunhaus, Hamilton, Hays, Hecht, Hoehn-Saric, Howland, Joffe, Keller, Keller, Keller, Kessler, Klein, Klein, Kobak, Koesis, Koesis, Lydiard, McCullough, McCullough, Miller, Ninan, Pohl, Rudolph, Rush, Sanderson, Schapira, Schatzberg, Sogaard, Sonawalla, Spitzer, Thase, Tollefson, Weissman, Wells, Zajecka, Zimmerman, Zubenko",2002.0,,0,0,
7753,"A randomized, double-blind, placebo-controlled study of classical homeopathy in generalized anxiety disorder.","Evaluated the effect of homeopathic treatment in generalized anxiety disorder, a prevalent mental disorder characterized by an enduring pattern of excessive apprehension and distress and by mental and bodily complaints. 44 patients (aged 18-65 yrs) with DSM-IV generalized anxiety disorder participated in a randomized, double-blind, placebo-controlled 10-week trial of individually tailored homeopathic remedy. Homeopathic therapy was administered by an expert who followed the traditional routines of homeopathic diagnosis and prescription. 39 subjects completed the study (20 in the active treatment group and 19 in the placebo group). Subjects' symptoms were rated before treatment and after 5 and 10 weeks of treatment, with the Hamilton Rating Scale for Anxiety (HAM-A) as main outcome measure. Additional measures of outcome included the Brief Symptom Inventory, the Psychological General Well-Being Index, the Hamilton Rating Scale for Depression, the Beck Depression Inventory, Spielberger's State-Trait Anxiety Inventory, and a Visual Analogue Scale of subjective distress. Significant improvement in most measures, including the HAM-A, was observed in both the active treatment and placebo groups, yet no group effect was observed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bonne, Omer; Shemer, Yair; Gorali, Yonatan; Katz, Maor; Shalev, Arieh Y; Aifken, Alibeu, Ballenger, Beck, Davenas, Davidson, Davidson, Davidson, Derogatis, Dupuy, Eisenberg, Eisenberg, Ernst, First, Hamilton, Hamilton, Hirst, Jonas, Kitai, Kleijnen, Lamont, Linde, Linde, Peer, Rabkin, Rickels, Schweizer, Shapiro, Spielberger, Sukul, Sukul, Vitoulkas, Walach, Walach, Wiegant, Wong, Woods, Yakir",2003.0,,0,0,
7754,Evaluation of cognitive-analytic therapy (CAT) outcome: A 4-8 year follow up.,"Investigates the outcome of 121 patients (mean age 32.2 yrs) diagnosed with anxiety disorders, depressive disorders, comorbid in some cases with personality disorders, after being treated with cognitive-analytic therapy (CAT). The follow-up was of a period of 4-8 yrs. It was found that patients with a variety of psychiatric diagnoses show considerable improvement after receiving CAT and sustain the gains of the therapy for a long time. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Garyfallos, George; Adamopoulous, Aravela; Karastergious, Anastasia; Voikli, Maki; Zlatanos, Dimitris; Tsifida, Sophia; Adamopoulou, Alnaes, Auerbach, Aveline, Basham, Bergin, Beutler, Bosley, Brockman, Cartwright, Conte, Cowmeadow, Dahlstrom, Dunn, Elliot, Frank, Garfield, Garyfallos, Garyfallos, Garyfallos, Gleser, Graham, Kaplan, Kolotkin, Lambert, Leinman, Luborsky, Luborsky, Manos, Manos, Mohl, Patterson, Pillowski, Ryle, Ryle, Ryle, Skinner, Sloane, Smith, Strupp",2002.0,,0,0,
7755,Anxiety patients before and after hospitalization for psychotherapy - from a psychophysiological standpoint.,"Psychophysiological course studies are still the exception in AP hospitalized for psychotherapy. The aim of this study was to perform a more precise psychophysiological analysis of anxiety patients (AP) before and after hospital treatment. From a sample of 28 AP, 13 were psychophysiologically and psychodiagnostically examined and compared to controls (CG) at the beginning and end of in-patient psychotherapy and 4 months later. APs showed higher heart rate (HR) and electrodermal spontaneous fluctuations (SF) than control patients but did not differ in their resting systolic (SBP) and diastolic blood pressure (DBP). Under cognitive stress, the controls had a significantly stronger HR and SBP reaction, while the AP showed more SF during the tone sequence and while being asked about their subjectively experienced anxiety. Following inpatient psychotherapy, the two groups showed correlation in their vegetative reaction patterns. The study clearly demonstrates the effectiveness of the applied depth psychology-oriented multimodal therapy from a psychophysiological standpoint. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Deter, Von Hans-Christian; Luck, Heidrun; Balaban, Bassler, Birbaumer, Deter, Deter, Dilling, Fahrenberg, Fahrenberg, Freud, Hastrup, Hentschel, Johannes, Kelly, Kopp, Lacey, Lader, Lader, Lang, Larbig, Laux, Luck, Raskin, Schachter, Schandry, Strian, Thayer, Thayer, Wolf, Ost",2003.0,,0,0,
7756,Prospective long-term follow-up of 44 patients who received cingulotomy for treatment-refractory obsessive-compulsive disorder.,"Long-term outcome associated with cingulotomy for obsessive-compulsive disorder (OCD) was prospectively assessed. Findings are reported for 18 patients previously described in 1995 and for 26 new patients. An open preoperative and follow-up assessment was conducted at multiple time points for 44 patients undergoing one or more cingulotomies for treatment-refractory OCD. The patients were assessed by using the Structured Clinical Interview for DSM-III-R preoperatively and with the Yale-Brown Obsessive Compulsive Scale, the Beck Depression Inventory, and the Sickness Impact Profile both preoperatively and at all follow-up assessments. The patients completed clinical global improvement scales at all follow-up assessments. At mean follow-up of 32 mo after one or more cingulotomies, 14 patients (32%) met criteria for treatment response and 6 others (14%) were partial responders. Thus, 20 patients (45%) were at least partial responders at long-term follow-up after one or more cingulotomies. Few adverse effects were reported. It is concluded that 32% to 45% of patients previously unresponsive to medication and behavioral treatments for OCD were at least partly improved after cingulotomy. Cingulotomy remains a viable treatment option for patients with severe treatment-refractory OCD (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Dougherty, Darin D; Baer, Lee; Cosgrove, G. Rees; Cassem, Edwin H; Price, Bruce H; Nierenberg, Andrew A; Jenike, Michael A; Rauch, Scott L; Baer, Ballantine, Ballantine, Beck, Bergner, Bingley, Bingley, Cohen, Cohen, Corkin, Corkin, Cosgrove, de Bie, Ebert, Goodman, Jenike, Jenike, Jenike, Jenike, Karno, Levine, Rauch, Rauch, Rauch, Robins, Saxena, Spitzer",2002.0,,0,0,
7757,"Efficiency of psychosurgery in the treatment of obsessive-compulsive disorder: Preliminary results (September, 2002).","After a brief introduction to resistant obsessive-compulsive disorder, to history of psychosurgery and specifically to the anterior bilateral capsulotomy technique, the psychosurgical protocol at the Hospital Mutua de Terrassa is described below. The said protocol has been going on since 1998. Until September 2002, 38 requests have been assessed, of which 18 have led to psychosurgical intervention by means of termocoagulative anterior bilateral capsulotomy and to the corresponding 1 year long follow-up. The preliminary results are here reported by means of the following evaluation scales: The Yale-Brown Obsessive-Compulsive Scale, the Hamilton and Beck depression questionnaires, the STAI-state anxiety questionnaire and the Global Activity Evolution Scale of the V axis of DSM-IV, as well as the following basic set of psychological evolution scales: The Kohs cubes, the measure of immediate and midterm visual memory of the A and B trace tests. As the principle measure of response, the Y-BOCS score decreased from 29.4 basal to 19.1 one month later and to 17.3 after 1 year, with a mean recovery of 33% ot the basal score of the complete Y-BOCS per month. No worsening was measured by any of the neuropsychological scales. Only 3 patients underwent complications after the capsulotomy. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Gascon, Josep; Martin, Ma. Jose; Insa, Pere A. Soler; Alea, Elena; Aparicio, Alberto; Oliver, Bartolome; Aronowitz, Arranz Estevez, Binder, Bouckoms, Cosgrove, Cumming, Dougherty, Feldman, Galdensi, Gasto, Goodman, Goodman, Gross-Isseroff, Jenike, Kopell, Lippitz, Lucey, Malizia, Malizla, Marazzitti, Mindus, Mindus, Mindus, Mindus, Mindus, Mindus, Nyman, Okasha, Otto, Pifarre Paredero, Rasmussen, Rosenfeld, Rosenfeld, Sachdev, Sachdev, Soler Insa, Soler Insa, Talalrach",2002.0,,0,0,
7758,Pragmatic evaluation of computer-aided self-help for anxiety and depression.,"Evaluated a free primary-care clinic's use of 4 computer-aided cognitive-behavioral therapy (CBT) self-help systems as 'clinician extenders', which included brief advice from a therapist. Outcomes were examined of self-referrals who used 1 of the 4 CBT systems for depression, phobia/panic, general anxiety or obsessive-compulsive disorder. Measures included the Patient Global Impression of Improvement, Fear Questionnaire, Beck Depression Inventory, Hamilton Rating Scale for Depression, Beck Anxiety Inventory and Yale-Brown Obsessive-Compulsive Scale. The equivalent of 1 full-time clinician managed 355 referrals (mean age 38 yrs) over a year. Of 266 patients screened, 210 were suitable for treatment. Of these, 42 patients refused CBT and 60 dropped out. Results show that completers and non-completers had similar pre-treatment features, with chronic, moderately severe problems. Completers had a mean total of an hour's live therapist support over 12 wks. They improved significantly and clinically meaningfully with 3 of the 4 systems and felt 'fairly satisfied'. It is concluded that computer-aided CBT is a 'clinician extender' that greatly cuts per-patient therapist time without impairing improvement, and could reduce the per-patient cost of CBT. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Marks, Isaac M; Mataix-Cols, David; Kenwright, Mark; Cameron, Rachel; Hirsch, Steven; Gega, Lina; Beck, Beck, Burgess, Everitt, Everitt, Goodman, Greist, Guy, Hamilton, Hamilton, Kaltenthaler, Kenwright, Kenwright, Marks, Marks, Marks, Marks, McDonough, McKenzie, Mundt, Netten, Osgood-Hynes, Proudfoot, Yates",2003.0,,0,0,
7759,Obsessive-compulsive disorder in a multi-ethnic urban outpatient clinic: Initial presentation and treatment outcome with exposure and ritual prevention.,"There are no naturalistic treatment outcome studies in the literature investigating the effectiveness of exposure and ritual prevention across diverse ethnic groups for OCD. We present data on the naturalistic treatment of 62 outpatients with OCD who presented at an anxiety disorders clinic in an inner-city area. More of our African American and Caribbean American patients, compared to Caucasians with OCD, were female and were more likely to be initially diagnosed with panic disorder only. On initial assessment both groups were similar on psychometric measures as well as reporting similar types of obsessive-compulsive symptoms. Both groups showed moderate improvement with treatment, although significant residual symptoms remained. Our results are discussed within the need for further cross-cultural clinical research and outreach. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Friedman, Steven; Smith, Lisa C; Halpern, Beth; Levine, Carin; Paradis, Cheryl; Viswanathan, Ramaswamy; Trappler, Brian; Ackerman, Robert; Barlow, Beck, Brown, Chambless, Ellison, Fals-Stewart, Foa, Franklin, Friedman, Friedman, Friedman, Goodman, Goodman, Goodman, Griffith, Guarnaccia, Hatch, Hollingshead, Karno, Kozak, Lewis-Hall, Lindsay, Neal, Neighbors, Neighbors, Paradis, Paradis, Rasmussen, Robins, van Balkom, Williams",2003.0,,0,0,
7760,Magnitude of placebo response and drug-placebo differences across psychiatric disorders.,"Background: Placebo response, drug response, and drug-placebo differences appear to vary among psychiatric conditions. Method: We evaluated the Food and Drug Administration (FDA) Summary Basis of Approval (SBA) reports to compare the magnitude of placebo response, magnitude of psychotropic drug response, and drug-placebo differences among various diagnostic groups such as depression, anxiety, and psychotic disorders. Results: Six diagnostic groups (psychosis, obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), depression, post-traumatic stress disorder, panic) varied in response to both placebo and active drug treatments. Response to placebo was high among patients participating in GAD, depression, and panic disorder clinical trials. Conversely, patients participating in psychotic disorder and OCD trials experienced low response to placebo. Conclusion: Our findings indicate that the magnitude of placebo response and drug response were heterogeneous and were statistically significantly different among various psychiatric disorders. Although a noticeable degree of heterogeneity was detected in the drug-placebo ratio among various disorders, the differences did not reach statistical significance. This finding suggests that placebo use should be continued for newer agents being tested for all of the psychiatric disorders. These findings may help in the development of psychopharmacology trial designs and in the deliberations of ethics committees. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Khan, Arif; Kolts, Russell L; Rapaport, Mark H; Krishnan, K. Ranga Rama; Brodhead, Amy E; Brown, Walter A; Beecher, Frank, Hedges, Hollander, Khan, Khan, Lanctot, Parker, Rinne, Srisurapanont, Versiani, Walsh, Woods, Zimmerman",2005.0,,0,0,
7761,St John's wort versus placebo in obsessive-compulsive disorder: Results from a double-blind study.,"Although St John's wort (Hypericum perforatum) is one of the most widely used and studied herbal medicines for depression, less is known about its efficacy in anxiety disorders, in spite of the fact that patients with anxiety disorders are among the most likely to self-medicate using alternative treatments. Pharmacokinetic evidence for the serotonergic, dopaminergic and GABAminergic activity of hypericum, and a recent successful open-label study, suggests that it may be effective for obsessive-compulsive disorder (OCD). Sixty subjects were randomized to 12 weeks of treatment with St John's wort (L1160) or matching placebo. Subjects with Hamilton Depression Scale scores of 16 or above were excluded. A flexible-dose schedule was utilized (600-1800 mg/day). The mean change on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) with St John's wort (3.43) was not significantly different than the mean change found with placebo (3.60) (P=899). No significant differences were found on any of the Y-BOCS subscales. The percentage of patients rated as 'much' or 'very much' improved at endpoint was not significantly different between St John's wort (17.9%) and placebo (16.7%) (P= 0.905). Only one patient from each group discontinued due to adverse events [sinus infection (St John's wort); confusion (placebo)]. The results fail to support the efficacy of St John's wort for OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kobak, Kenneth A; Taylor, Leslie V. H; Bystritsky, Alexander; Kohlenberg, Cary J; Greist, John H; Tucker, Phebe; Warner, Gemma; Futterer, Rise; Vapnik, Tanya; Astin, Bhattacharya, Breen, Brevoort, Burstein, Chatterjee, Chatterjee, Cott, Davidson, Druss, Eisenberg, Eisenberg, Ernst, Foa, Goodman, Greist, Guy, Hafner, Hamilton, Hewlett, Hewlett, Huppert, Jacobs, Katon, Kessler, Khan, Khan, Kobak, Kobak, Kobak, McDonald, Muller, Muller, Nahrstedt, Perovic, Rasmussen, Reynolds, Rosenblatt, Taylor, Unutzer, Wonnemann",2005.0,,0,0,
7762,Botulinum toxin-A injections for spastic toe clawing.,"Spastic toe clawing describes extension at the metatarsophalangeal joints of the feet, flexion at the proximal interphalangeal joints and flexion at the distal interphalangeal joints that results from upper motor neuron lesions, such as stroke, intracranial hemorrhage, cervical myelopathy and brain tumors. Even though toe clawing is often asymptomatic, it can be painful. Previous studies have described the efficacy of injections of botulinum toxin type-A (BTX-A) to the long flexors of the toes, but this is often unsatisfactory as high dosages (up to 175 units) have been required, and patients often report significant residual toe clawing. We performed an open label, prospective study to assess the efficacy of BTX-A injections, targeting the long and short flexors of the toes, performed with electrical (motor point) stimulation under electromyographic guidance. Outcome measures, which included timed walking over 20 m, objective assessment of toe clawing (modified Ashworth scale and a visual analog scale rating) and patient assessment of functional disability, were assessed before injections and at six-weeks' follow-up. Seven patients (five male and two female) of mean age 51 (range 38-70) were recruited. Four had spasticity from underlying intracranial hemorrhage, the remaining three from cerebral infarct, astrocytoma and post-traumatic cervical myelopathy. The total dose of BTX-A injected for toe clawing ranged from 40 to 90 units. Improvements were observed in all outcome measures except timed walking. Injecting BTX-A to the long and short flexors of the toes, with electrical stimulation under electromyographic guidance, is well tolerated and efficacious in the treatment of toe clawing from spasticity, allowing for lower dosages to be used. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lim, Erle C. H; Ong, Benjamin K. C; Seet, Raymond C. S; Badlissi, Bernbach, Bohannon, Boulton, Childers, Critchfield, Cyphers, Delagi, Feeney, Fuhrmann, Gajiwala, Gelb, Gracies, Gracies, Gracies, Jankovic, Kinnett, Manoli, Mizel, Munchau, Myerson, Naumann, O'Brien, O'Brien, Pascual Pascual, Rivera-Dominguez, Rivest, Smith, Suputtitada, Teunissen, Truckenbrodt, Yelnik",2006.0,,0,0,
7763,One-session virtual reality exposure treatment for fear of flying: 1-year follow-up and graduation flight accompaniment effects.,"The efficacy of a brief 1-session virtual reality (VR) exposure treatment of fear of flying (FOF) was demonstrated in a prior study (Muhlberger, Wiedemann, & Pauli, 2003). The current study further evaluated the exposure's effects on a posttreatment graduation flight, with patients accompanied or not by their therapist, and its long-term efficacy (1-year follow-up). Flight-phobic participants completed a brief cognitive preparation and four VR exposure flights conducted in one individual session. Patients were randomly assigned to a graduation flight either alone or with the therapist and other patients. FOF was assessed before and after the treatment session, after the graduation flight, and 12 months later. Fear responses were assessed during VR and graduation flights. Treatment efficacy was reflected in significant FOF reductions, which were maintained over the 12-month follow-up period. Eighty-seven percent and 67% of the assigned patients completed graduation flights accompanied and alone, respectively, but this difference was not significant. However, completion of a graduation flight was a strong predictor for long-term treatment efficacy. A brief 1-session VR treatment effectively reduced FOF for up to one year. Completion of graduation flights may be important for long-term treatment efficacy, but an accompanying therapist presumably is less important. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Muhlberger, Andreas; Weik, Anne; Pauli, Paul; Wiedemann, Georg; Agras, Anderson, Bernstein, Borkovec, Bornas, Bortz, Cohen, Cohen, Derogatis, Franke, Fredrikson, Gursky, Hallam, Haug, Jacobson, Jacobson, Johnsen, Krijn, Maltby, Margraf, Muhlberger, Muhlberger, Muhlberger, Muhlberger, Muhlberger, Muhlberger, Nordlund, Rauscher, Reiss, Rothbaum, Rothbaum, Wiederhold, Wilhelm, Wittchen, Wolpe, Ost",2006.0,,0,0,
7764,Writing your Way to Health? The Effects of Disclosure of Past Stressful Events in German Students.,"In 1986 Pennebaker and Beall published their renowned study on the long-term beneficial health effects of disclosing traumatic events in 4 brief sequential writing sessions. Their results have been confirmed in various studies, but conflicting results have also been reported. The intent of our study was to replicate the experiments from Pennebaker and Beall (1986), Pennebaker et al. (1988), and Greenberg and Stone (1992) using a German student sample. Additionally, essay variables that point to the emotional processing of events (e.g., depth of self-exploration, number of negative/positive emotions, intensity of emotional expression) were examined as potential mechanisms of action. Trait measures of personality which could moderate the personal consequences of disclosure (alexithymia, self-concealment, worrying, social support) were also assessed. In a second study the experimental condition (disclosure) was varied by implementing ""coping"" vs. ""helping"" instructions as variations of the original condition. Under the coping condition participants were asked to elaborate on what they used to do, continue to do, or could do in the future to better cope with the event. Under the helping condition participants were asked to imagine themselves in the role of a adviser and elaborate on what they would recommend to persons also dealing with the trauma in order to better cope with the event. The expected beneficial effects of disclosure on long-term health (e.g., physician visits, physical symptoms, affectivity) could not be corroborated in either the first or the second study. None of the examined essay variables of emotional processing and only a single personality variable was able to explain significant variance in the health-related outcome variables influence. Nevertheless, substantial reductions in posttraumatic stress symptoms (e.g., intrusions, avoidance, arousal), were found in both experiments. These improvements were significantly related to essay variables of emotional expression and self-exploration and were particularly pronounced under the activation of a prosocial motivation (helping condition). Repeated, albeit brief, expressive writing about personally upsetting or traumatic events resulted in an immediate increase in negative mood but did not lead to long-term positive health consequences in a German student sample. It did, however, promote better processing of stressful or traumatic events, as evidenced by reductions in posttraumatic stress symptoms. The instruction to formulate recommendations for persons dealing with the same trauma seems more helpful than standard disclosure or focusing on one's own past, present, and future coping endeavours. Overall, expressive writing seems to be a successful method of improving trauma processing. Determining the appropriate setting (e.g., self-help vs. therapeutic context) for disclore can be seen as an objective of future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Morris, Lisette; Linkemann, Annedore; Kroner-Herwig, Birgit; Berking, Booth, Cameron, Catanzaro, Catanzaro, Cook, Donnelly, Eddins, Ehlers, Esterling, Fahrenberg, Foa, Francis, Fydrich, Gidron, Gillis, Greenberg, Greenberg, Henderson, Hitt, Horowitz, Horowitz, Kelley, Klapow, Klapow, Kloss, Kloss, Krantz, Larson, Linkemann, Lutgendorf, Marlo, McNair, Meyer, Midlarsky, Murray, Murray, Paez, Pennebaker, Pennebaker, Pennebaker, Pennebaker, Pennebaker, Pennebaker, Pennebaker, Pennebaker, Petrie, Reynolds, Richards, Rosenberg, Schilte, Schmidt-Atzert, Schoutrop, Smyth, Spera, Strobe, Tausch, Taylor, Traue, Tromp, Westbrook, Wilson, Zerssen; Abelian, M. E [Ed]",2006.0,,0,0,
7765,The Counting Method: Applying the Rule of Parsimony to the Treatment of Posttraumatic Stress Disorder.,"The authors contend that the primary therapeutic element in psychological treatments for posttraumatic stress disorder is imaginal exposure, and that differences among major approaches are determined more by secondary techniques designed to circumvent the client's avoidant defenses against exposure. A study is described comparing Prolonged Exposure, Eye Movement Desensitization and Reprocessing, and the Counting Method with 51 multiply-traumatized women. Measures of PTSD were significantly reduced by all three methods, but differences among the methods were negligible. Because the Counting Method utilizes only imaginal exposure as a therapeutic element, support is given to the more parsimonious conclusion that imaginal exposure may be both the necessary and sufficient factor in therapeutic effect, countering a trend in the field toward more complex, multi-faceted treatment packages. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Johnson, David Read; Lubin, Hadar; Beck, Blake, Boudewyns, Boudewyns, Carlson, Chemtob, Cooper, Derogatis, Edmond, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Hembree, Hembree, Johnson, Keane, Keane, Keane, Marcus, Ochberg, Ochberg, Pitman, Rothbaum, Rothbaum, Shapiro, Shapiro, Shapiro, Shapiro, Tarrier, Vaughn, Wilson, Wolpe, Zayfert",2006.0,,0,0,
7766,"The effects of eye movement desensitization and reprocessing (EMDR) therapy on posttraumatic stress disorder in survivors of the 1999 Marmara, Turkey, earthquake.","As part of a program of response to the 1999 Marmara, Turkey, earthquake, an estimated 1,500 trauma victims with posttraumatic stress disorder (PTSD) symptoms were treated in tent cities with eye movement desensitization and reprocessing (EMDR). A field study evaluating a representative group of 41 participants with diagnosed PTSD indicated that a mean of five 90-minute sessions was sufficient to eliminate symptoms in 92.7% of those treated, with reduction in symptoms in the remaining participants. Significant reductions occurred between the pre and posttreatment PTSD Symptom Scale Self-Report version (PSS-SR) total scores and all subscales. These gains were maintained at 6-month follow-up. The same pattern of recovery was observed regardless of the use or nonuse of psychotropic medication at the time of intake. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Konuk, Emre; Knipe, James; Eke, Ibrahim; Yuksek, Hakan; Yurtsever, Asena; Ostep, Sinem; Bisson, Bryant, Chambless, Chemtob, Chemtob, Fernandez, Foa, Foa, Foa, Foa, Foa, Grainger, Konuk, Litz, Marks, Maxfield, McFarlane, Shapiro, Shapiro, Shapiro, Sherman, Silver, Taylor, van der Kolk, van Emmerik, Van Etten, Walser, Wolpe, Yurtsever",2006.0,,0,0,
7767,Kava in generalized anxiety disorder: Three placebo-controlled trials.,"In this study, we evaluated the efficacy and safety of kava kava (Piper methysticum) in generalized anxiety disorder. Data were analyzed from three randomized, double-blind, placebo-controlled trials of kava, including one study with an active comparator (venlafaxine), in adult outpatients with DSM-IV generalized anxiety disorder. The pooled sample (n = 64) included the following number of participants: kava, n = 28; placebo, n = 30; and venlafaxine, n = 6. Given the comparability of the study designs, the data comparing kava and placebo were then pooled for further efficacy and safety analyses. No significant differences were observed between the treatment groups in any of the trials. In the pooled analyses, no effects were found for kava, while a significant effect in favor of placebo was observed in participants with higher anxiety at baseline. No evidence of hepatotoxicity was found with kava, and all of the treatments were well tolerated. Findings from these three controlled trials do not support the use of kava in DSM-IV generalized anxiety disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Connor, Kathryn M; Payne, Victoria; Davidson, Jonathan R. T; Boerner, Clouatre, Cohen, Connor, Connor, Cropley, Currie, Dragull, Eisenberg, Hamilton, Kinzler, Mathews, Moller, Montgomery, Nerurkar, Pittler, Russmann, Sheehan, Volz, Watkins, Whitton, Zigmond",2006.0,,0,0,
7768,Efficacy of a brief individual treatment program for the posttraumatic stress disorder in women victims of domestic violence.,"The objective of this work is to evaluate the effectiveness of a brief and standardized program of intervention for the treatment of the chronic posttraumatic stress disorder (PSD) in women victims of domestic violence. Twenty women victims of domestic violence participated in this study (10 in the experimental group and 10 in the control group); all they accomplished the criteria of DSM-IV-TR for the PSD diagnosis. The treatment program, evolved from Labrador and Rincon, individually applied, consists of eight sessions (2 months) and it includes psychoeducation, training for the control of the activation, cognitive therapy, and exposure therapy. A quasi-experimental design of two independent groups with repeated measures (at the pretreatment and at the post-treatment) has been used. The results in the post-treatment indicate that 100% of the women in the experimental group reduce the PSD. Also an improvement in all the concomitant evaluated measures, depression, self-esteem, social inadaptation and posttraumatic cognitions, was obtained. No significative differences were obtained according to the different application order of cognitive therapy and exposure therapy. The implications of this study for the clinical practice and future investigations are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Labrador, Francisco Javier; Fernandez-Velasco, M del Rocio; Rincon, Paulina P; Astin, Beck, Brewin, Brewin, Campbell, Dutton, Echeburua, Echeburua, Foa, Golding, Kubany, Kubany, Labrador, Labrador, Lorente, Montero, Ramos-Alvarez, Rincon, Rincon, Rincon, Rosenberg, Taylor, Varela, Vazquez, Walker",2006.0,,0,0,
7769,"Escitalopram for Comorbid Depression and Anxiety in Elderly Patients: A 12-Week, Open-Label, Flexible-Dose, Pilot Trial.","Background: Comorbid depression and anxiety may result in greater symptom severity and poorer treatment response than either condition alone. Selective serotonin reuptake inhibitors have been found to be effective in treating both depression and anxiety; however, pharmacodynamic and pharmacokinetic changes associated with aging warrant special attention in medication trials in older patients. Objective: The objective of this study was to assess the efficacy and tolerability of short-term (12-week) administration of escitalopram oxalate 10 to 20 mg/d for moderate to marked comorbid depression and anxiety in elderly patients. Methods: This open-label, flexible-dose (10-20 mg/d), pilot trial was conducted at the Psychiatry Service, Veterans Affairs Medical Center, Cincinnati, Ohio. Outpatients aged >=65 years were included if they met the criteria for comorbid major depressive disorder (MDD) and generalized anxiety disorder (GAD), as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, for >=4 weeks and had a baseline Montgomery-Asberg Depression Rating Scale (MADRS) score of >22 and a Hamilton Rating Scale for Anxiety (HAM-A) score of >=18. All patients received escitalopram 10 to 20 mg/d. The primary efficacy variables were the mean changes from baseline in total MADRS and HAM-A scores at 12 weeks (last observation carried forward). The secondary efficacy end point was the change from baseline in Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) 8 subscale scores. Adverse events were assessed at each visit (treatment weeks 1, 2, 3, 4, 6, 8, 10, and 12) with the use of open-ended questioning. Results: Twenty patients were enrolled (mean [SD] age, 73.0 [4.8] years; 6 [30%] women; race: 17 [85%] white, 2 [10%] black, and 1 [5%] ""other""). Seventeen (85%) of 20 patients completed the study; 3 (15%) withdrew: 1 (5%) due to lack of efficacy and 2 (10%) due to adverse events (dizziness and somnolence [1 (5%) patient each]). Statistically significant improvements from baseline to end point were found with escitalopram treatment (MADRS: t19 = 7.38, P < 0.001, effect size = 2.93; HAM-A: t19 = 4.19, P < 0.001, effect size = 1.83). Significant changes from baseline in scores on 4 (Social Functioning, Role Functioning-Emotional, Mental Health, and Energy/Fatigue) of the 8 subscales of the SF-36 were als of ound (all, P < 0.01). Conclusion: In this small study in elderly patients with comorbid MDD and GAD, treatment with escitalopram 10 to 20 mg/d for 12 weeks was associated with significant improvements in symptoms of depression and anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mohamed, Somaia; Osatuke, Katerine; Aslam, Muhammed; Kasckow, John; Alexopoulos, Alexopoulos, Allgulander, Asnis, Baillargeon, Bech, Brown, Bruce, Bruce, Buffett-Jerrott, Burke, Dada, Davidson, Davidson, First, Flint, Flint, Flint, Glass, Goodman, Gorman, Gorman, Gurian, Gurland, Hamilton, Hirschfeld, Kessler, Kessler, Knickman, Kroenke, Lenze, Lenze, Liebowitz, Maidment, McHorney, Montgomery, Montgomery, Olfson, Pagot, Pigott, Salzman, Schneider, Schoevers, Stahl, Stein, Uhlenhuth, Wade, Ware, Wittchen, Zimmerman",2006.0,,0,0,
7770,A Cognitive-Behavioral Treatment for Battered Women With PTSD in Shelters: Findings From a Pilot Study.,"Despite the high rates of posttraumatic stress disorder (PTSD) among battered women in shelters, virtually no treatments for these women have been developed or tested. This study evaluated the initial feasibility and efficacy of an individual, cognitive-behavioral treatment for battered women with PTSD or subthreshold PTSD in shelters. Eighteen women participated in an open-trial where they received a new treatment, Helping to Overcome PTSD with Empowerment (HOPE). Intent-to-treat analyses indicate that participants experienced significant decreases in PTSD symptoms, depressive symptoms, in their loss of resources and degree of social impairment; and significant increases in their effective use of community resources. These gains were maintained over time. Results should be interpreted with caution due to the small sample size and lack of a control group. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Johnson, Dawn M; Zlotnick, Caron; Beck, Blake, Bryant, Dutton, First, Foa, Herman, Hobfoll, Jones, Kubany, Mertin, Nguyen, Stein, Straus, Sullivan, Tjaden, Weathers, Weissman",2006.0,,0,0,
7771,Evaluation of a new Internet-based self-help guide for patients with bulimic symptoms in Sweden.,"The current study evaluated a new Internet-based self-help guide based on cognitive-behavioural therapy for patients with bulimic symptoms. Thirty-eight participants from a waiting list at an eating-disorder outpatient unit were assessed pre-treatment, post-treatment and at a 2-month follow-up using the Rating of Anorexia and Bulimia interview-revised version, an anamnesis questionnaire, the Eating Disorder Inventory-2 (EDI-2) and Symptom Check List-90-Revised (SCL-90R). The SCL-90R Global Severity Index and most EDI-2 subscales showed significant differences from pre- to post-treatment and the 2-month follow-up, apart from ineffectiveness, impulse regulation and social insecurity. Expert ratings revealed a significant reduction in vomiting, dietary restraints and weight phobia, with the exception of binge eating from pre-treatment to the 2-month follow-up. Exercise increased significantly, indicating that participants changed their method of compensation. An Internet-based self-help guide for bulimic symptoms is a promising new tool and can be used effectively as the first step in a stepped-care model. Further evaluations with randomized controlled trials are necessary. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Nevonen, Lauri; Mark, Mia; Levin, Birgitta; Lindstrom, Marianne; Paulson-Karlsson, Gunilla; Carrard, Cohen, Derogatis, Fairbum, Fairburn, Garner, Marrs, Nevonen, Nevonen, Norring, Palmer, Perkins, Walsh",2006.0,,0,0,
7772,A pilot study of oxcarbazepine versus acamprosate in alcohol-dependent patients.,"Objectives: This pilot study has been designed to collect preliminary data on the use of a new anti epileptic drug in the management of alcoholic patients. Oxcarbazepine (OXC) blocks voltage sensitive sodium channels. Its metabolite reduces high-voltage-activated calcium currents in striatal and cortical neurons, thus reducing glutamatergic transmission at corticostriatal synapses. This reduction is of interest in the treatment of alcohol dependence, as acamprosate (ACP) modulates NMDA receptors, resulting in an inhibition of glutamatergic transmission. Furthermore, OXC has revealed a mood-stabilizing effect in bipolar affective disorders. We have compared OXC with ACP in relapse prevention in recently withdrawn alcohol-dependent patients. Methods: We investigated the efficacy and safety of OXC (vs ACP) by conducting a 24-week randomized, parallel-group, open-label, clinical trial on 30 acutely detoxified alcoholic patients. Survival analyses (Kaplan-Meier) were performed to look for evidence of a longer ""survival"" of patients receiving OXC. We assessed time to first severe relapse and additional secondary endpoints. Results: After withdrawal, time to severe relapse and time to first consumption of any ethanol by OXC patients were not longer than for ACP patients. Abstinent patients in both study groups showed a significantly lower obsessive compulsive drinking scale--German version (OCDS-G) than relapsed patients. No undesired effects occurred when OXC patients consumed alcohol. Conclusion: Our findings indicate that it could be worthwhile to test relapse prevention using OXC in an adequate sample. While the current sample size clearly limits further conclusions from this pilot study, it is noteworthy that OXC is well tolerated, even when alcohol is on board. Thus, in medication-based relapse prevention, OXC could be a promising alternative for alcoholic patients unable to benefit from ACP or naltrexone or those who have affective liability. OXC certainly merits a larger placebo-controlled trial. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Croissant, Bernhard; Diehl, Alexander; Klein, Oliver; Zambrano, Sergio; Nakovics, Helmut; Heinz, Andreas; Mann, Karl; Ackermann, Anton, Anton, Bock, Croissant, Croissant, Dietrich, Freedman, Garbutt, Ghaemi, Glauser, Gonzalez, Hautzinger, Heatherton, Hermann, Johnson, Koob, Kranzler, Kuntze, Laberg, Laux, Lejoyeux, Littleton, Littleton, Mann, Mann, Mann, Metha, Miller, Mueller, Sass, Scherle, Skinner, Sobell, Spanagel, Spielberger, Swift, Wellington",2006.0,,0,0,
7773,Substance abuse treatment and psychiatric comorbidity: Do benefits spill over? Analysis of data from a prospective trial among cocaine-dependent homeless persons.,"Background: Comorbid psychiatric illness can undermine outcomes among homeless persons undergoing addiction treatment, and psychiatric specialty care is not always readily available. The prognosis for nonsubstance abuse psychiatric diagnoses among homeless persons receiving behaviorally-based addiction treatment, however, is little studied. Results: Data from an addiction treatment trial for 95 cocaine-dependent homeless persons (1996-1998) were used to profile psychiatric diagnoses at baseline and 6 months, including mood-related disorders (e.g. depression) and anxiety-related disorders (e.g. post-traumatic stress disorder). Treatment interventions, including systematic reinforcement for goal attainment, were behavioral in orientation. There was a 32% reduction in the prevalence of comorbid non-addiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32%) and anxiety-related disorders (-20%) (p = 0.12). Conclusion: Among cocaine-dependent homeless persons with psychiatric comorbidity undergoing behavioral addiction treatment, a reduction in comorbid psychiatric disorder prevalence was observed over 6 months. Not all participants improved, suggesting that even evidence-based addiction treatment will prove insufficient for a meaningful proportion of the dually diagnosed homeless population. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kertesz, Stefan G; Madan, Alok; Wallace, Dennis; Schumacher, Joseph E; Milby, Jesse B; Beck, Burt, Burt, Carroll, Derogatis, Drake, Eaton, Ekholm, Fairweather, Gawin, Grant, Grella, Hasin, Hasin, Helzer, Hudziak, Kertesz, Lukoff, McNamara, Milby, Milby, Milby, Minkoff, Moggi, Nuttbrock, Raudenbush, Robins, Rounsaville, Schuckit, Serdaru, Stahler, Tsemberis, Weddington, Zeger, Zeiss",2006.0,,0,0,
7774,Effects of a brief behavioral treatment for PTSD-related sleep disturbances: A pilot study.,"Objective: Sleep disturbances are a core feature of post-traumatic stress disorder (PTSD), and are often resistant to first-line pharmacological and psychological PTSD interventions. The goal of this pilot study was to explore the effects of a very brief intervention for PTSD-related nightmares and insomnia in victims of violent crimes with PTSD. Methods: Seven adult victims of violent crimes with a current diagnosis of PTSD received a single, 90-min intervention session that used cognitive-behavioral techniques aimed at reducing post-traumatic nightmares and insomnia. Sleep diary measures, and measures of sleep quality, PTSD severity, anxiety, and depression were completed at baseline and 6 weeks post-intervention. Results: Improvements in self-report and sleep diary measures of sleep quality and dream frequency were observed post-intervention. Clinically meaningful reductions in daytime PTSD symptom severity were also observed. Conclusions: A very brief behavioral intervention targeting post-traumatic nightmares and insomnia was associated with significant improvements in sleep and daytime PTSD symptom severity. Brief sleep-focused intervention may be helpful adjuncts to first-line PTSD treatments. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Germain, Anne; Shear, M. Katherine; Hall, Martica; Buysse, Daniel J; Blake, Bonnet, Bootzin, Buysse, Cassano, Clum, Cohen, Davidson, Dinges, Dunlap, Fagiolini, First, Foa, Forbes, Germain, Germain, Hall, Kilpatrick, Krakow, Krakow, Krakow, Monk, Neylan, Nishith, Ohayon, Perlis, Raskind, Spielman, Ursano, Zayfert",2007.0,,0,0,
7775,The impact of post-traumatic stress disorder on treatment outcomes for heroin dependence.,"Aims: To examine the impact of post-traumatic stress disorder (PTSD) on 2-year treatment outcomes for heroin dependence. Design: Prospective longitudinal study. Participants: Data were obtained from a predominantly treatment seeking sample of 615 dependent heroin users who were followed-up at 3, 12 and 24 months (follow-up rates: 89%, 81% and 76%, respectively). Measurements: Outcomes examined include treatment retention and exposure, substance use, general physical and mental health and employment. Findings: Despite improvements in substance use, PTSD was associated with continued physical (beta - 1.69, SE 0.61, P < 0.01) and mental disability (beta - 2.07, SE 0.66, P < 0.01), and reduced occupational functioning (OR 0.67, 95% CI: 0.48-0.93) throughout the 2-year follow-up. Conclusions: Although conventional treatment services are successful in producing improvements in substance use and associated disability, the disability associated with PTSD remains. An intervention targeting both heroin dependence and PTSD may help to improve the outcomes of those with PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mills, Katherine L; Teesson, Maree; Ross, Joanne; Darke, Shane; Andrews, Booth, Breslau, Brown, Brown, Brown, Brown, Clark, Cottler, Cottler, Creamer, Darke, Diggle, Helzer, Hien, Janca, Kessler, Kessler, Kessler, Loranger, Milby, Mills, Mills, Ouimette, Ouimette, Ouimette, Perry, Read, Ross, Villagomez, Ware, Wittchen, Wittchen, Zeger",2007.0,,0,0,
7776,The effect of nicotine and attention allocation on physiological and self-report measures of induced anxiety in PTSD: A double-blind placebo-controlled trial.,"Rates of smoking among populations with psychiatric disorders are more than twice as high as among the general population, yet there are few controlled studies of the mechanisms of this relationship. This trial examined the effect of nicotine by way of cigarette smoking on both self-report and autonomic parameters of anxiety among individuals with PTSD who were also heavy smokers. Half of the participants were randomized to an anxiety-eliciting condition, whereas the other half were assigned to a condition of neutral emotional content. Within each of these conditions, participants were randomized into a nicotine condition (high-yield nicotine cigarette) or a placebo condition (denicotinized cigarette). The final layer of randomization involved assigning participants to either an attention-demanding task or a no task condition. We examined the interactive effects of nicotine and attentional demand on parameters of anxious responding. Nicotine exerted an anxiolytic effect relative to placebo on self-report measures; however, nicotine did not interact with attentional demand in producing this effect. In contrast to the findings on the self-report measures of distress, nicotine enhanced autonomic reactivity to trauma cues, thereby suggesting a decoupling of self-reported anxiety and autonomic arousal associated with responding to trauma-relevant cues. The implications for understanding smoking and psychiatric comorbidity are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Buckley, Todd C; Holohan, Dana R; Mozley, Susannah L; Walsh, Kate; Kassel, Jon; Andreassi, Balfour, Beck, Beckham, Beckham, Berntson, Blake, Blanchard, Breslau, Brioni, Brody, Buckley, Buckley, Buckley, Callaway, Cheeta, Conklin, Copeland, Faraday, Fridlund, Genn, Gilbert, Grant, Haynes, Heatherton, Henningfield, Herbert, Ilan, Kassel, Kassel, Kassel, Kassel, Lasser, Lerman, Lykken, Nesbitt, Parrott, Parrott, Perkins, Picciotto, Pomerleau, Pomerleau, Rose, Sayette, Shiffman, Shiffman, Shiffman, Spielberger, Spielberger, Spring, Steele, Weathers",2007.0,,0,0,
7777,Characteristics and psychosocial needs of victims of violent crime identified at a public-sector hospital: Data from a large clinical trial.,"Objective: This study explores the feasibility of recruiting acutely injured public-sector crime victims into a research protocol and identifies baseline characteristics associated with posttraumatic distress in the enrolled sample (N=541). Method: Assertive research tracking methods were used to enroll participants, who completed baseline interviews. Descriptive statistics were used to define characteristics of the sample and prevalence of psychosocial problems and posttraumatic distress. Multiple regression analysis was performed to identify predictors of posttraumatic distress. Results: A high percentage (78%) of eligible victims completed baseline interviews within 1 month of victimization. The sample was largely male, ethnic minority, unemployed and living below the poverty level. Trauma symptoms were highly prevalent, with three quarters having significant posttraumatic distress. Female gender, preexisting psychiatric disorder, trauma history, case management needs and employment status were predictive of greater symptomatology. Stabbing victims had lower distress. Conclusions: Comprehensive mental health and case management services that proactively engage disadvantaged victims are needed to meet the complex problems of this population. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Boccellari, Alicia; Alvidrez, Jennifer; Shumway, Martha; Kelly, Vanessa; Merrill, Gregory; Gelb, Michael; Smart, Sharon; Okin, Robert L; Alegria, Amaya-Jackson, Baker, Ballenger, Boudreaux, Breslau, Brewin, Bryant, Creamer, Elklit, Feehan, Foa, Glynn, Greenspan, Hembree, Hobfoll, Holbrook, Jaycox, Jaycox, Kaukinen, Kessler, Kilpatrick, MacDonald, Magruder, McCaig, Miller, Mueser, New, Norris, Resnick, Resnick, Riggs, Roy-Byrne, Roy-Byrne, Shalev, Solomon, Spinazzola, Spitzer, Stein, Swartz, Switzer, Wagner, Weisaeth, Wells, Zatzick, Zatzick, Zayfert",2007.0,,0,0,
7778,Virtual reality exposure therapy for PTSD symptoms after a road accident: An uncontrolled case series.,"This report examined whether Virtual Reality Exposure Therapy (VRET) could be used in the treatment of posttraumatic stress disorder (PTSD) symptoms in the aftermath of a serious motor vehicle accident. Six individuals reporting either full or severe subsyndromal PTSD completed 10 sessions of VRET, which was conducted using software designed to create real-time driving scenarios. Results indicated significant reductions in posttrauma symptoms involving reexperiencing, avoidance, and emotional numbing, with effect sizes ranging from d=.79 to d=1.49. Indices of clinically significant and reliable change suggested that the magnitude of these changes was meaningful. Additionally, high levels of perceived reality (""presence"") within the virtual driving situation were reported, and patients reported satisfaction with treatment. Results are discussed in light of the possibility for VRET to be useful in guiding exposure in the treatment of PTSD following road accidents. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Beck, J. Gayle; Palyo, Sarah A; Winer, Eliot H; Schwagler, Brad E; Ang, Eu Jin; Ang, Beck, Beck, Beck, Beck, Beck, Bernstein, Blake, Blanchard, Blanchard, Blanchard, Botella, Creamer, Creamer, Emmelkamp, Foa, Foa, Foa, Foa, Folstein, Jacobson, Kennedy, Krijn, Kuch, Larsen, Maltby, Nishith, Rothbaum, Rothbaum, Sprinkle, Taylor, Wald, Weathers, Weiss, Whisman, Witmer",2007.0,,0,0,
7779,The impact of written exposure on worry: A preliminary investigation.,"The main goal of this study was to examine the effect of written exposure on generalized anxiety disorder (GAD)-related symptoms in high worriers. Thirty nonclinical high worriers were randomly assigned to either a written exposure condition or a control writing condition. Self-report measures were used to assess worry, GAD somatic symptoms, depression, and intolerance of uncertainty at four time points during the study. Using hierarchical linear modeling (HLM), the authors found that all symptoms (i.e., worry, GAD somatic symptoms, and depression) significantly decreased over time in the written exposure group (although GAD somatic symptoms also decreased in the control group). Moreover, consistent with previous findings that intolerance of uncertainty preceded changes in worry over the course of treatment, intolerance of uncertainty scores predicted subsequent scores on all symptom measures in the experimental group. In contrast, worry and depression scores predicted subsequent intolerance of uncertainty scores in the control group. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Goldman, Natalie; Dugas, Michel J; Sexton, Kathryn A; Gervais, Nicole J; Borkovec, Borkovec, Borkovec, Borkovec, Bouton, Bouton, Buhr, Butler, Choquette, Dugas, Dugas, Dugas, Dugas, Dugas, Dugas, Dugas, Dugas, Dugas, Dugas, Foa, Francis, Freeston, Gillis, Heinecke, Koerner, Ladouceur, Ladouceur, Lang, Mathews, Mennin, Meyer, Mineka, Molina, Pennebaker, Rachman, Radloff, Raudenbush, Schmidt, Sharpe, Sloan, Smyth, Southworth, Stober, Wells",2007.0,,0,0,
7780,Post-traumatic stress disorder in a person with a diagnosis of schizophrenia: Examining the efficacy of psychological intervention using single N methodology.,"Psychological intervention for post-traumatic stress disorder (PTSD) in a person with a diagnosis of schizophrenia is presented using single N methodology. Psychological formulation and intervention were informed by psychological models of PTSD symptom persistence that focus on dual maintaining factors of (a) disturbance in the form of trauma autobiographical memory and (b) problematic trauma-related appraisals. Baseline assessment of difficulties related to intrusive memories, problematic trauma-related appraisals (e.g., responsibility appraisals) and associated negative emotions (e.g., anger) was followed by two phases of intervention: (1) written elaboration of the trauma memory and (2) cognitive restructuring of problematic trauma-related appraisals. Treatment produced reduction in ratings of distress in all domains and there were clinically significant reductions in PTSD symptomatology and co-morbid depression on standardized self-report measures. There were, however, differential effects of treatment components as evidenced during the sequential introduction of treatment components. These are discussed and directions for future research in the treatment of PTSD in persons with severe mental health problems are highlighted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kevan, Ian Mark; Gumley, Andrew I; Coletta, Vicki; Beck, Birchwood, Breslau, Brewin, Callcott, Callcott, Crosbie, Dunmore, Ehlers, Foa, Foa, Foa, Foa, Good, Goodman, Gray, Grey, Gumley, Harris, Harvey, Hembree, Iqbal, Jacobsen, Janoff-Bulman, Kessler, Kingdon, Marks, Morley, Morley, Morley, Morrison, Mueser, Mueser, Mueser, Mueser, Nishith, Persons, Resick, Resnick, Salkovskis, Steil, Switzer",2007.0,,0,0,
7781,Efficacy of self-administered treatments for depression and anxiety.,"Self-administered treatments (SATs) are widely used by the general public and mental health professionals. Previous reviews of the efficacy of SATs have included under this category interventions for nonclinical problems, group interventions, and interventions involving significant amounts of therapist contact. The efficacy of SATs for clinical levels of depression and anxiety with minimal therapeutic contact was examined by meta-analyzing 24 studies. The results show large effects for SATs when compared with no-treatment control groups (d=1.00). However, unlike previous meta-analyses that found nonsignificant differences between SATs and therapist-administered treatments, in this sample SATs resulted in significantly poorer outcomes (d=-0.31). Some differences in effect size were observed between the clinical targets of depression and anxiety. However, there were high correlations between clinical target, methodological quality of the study, and amount of contact. This makes it impossible to determine whether the observed differences could be explained by the nature of the disorders, methodological quality, or the amount of contact with a member of the research team. The implications of the findings for the clinical use of SATs and for future research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Menchola, Marisa; Arkowitz, Hal S; Burke, Brian L; Ackerson, Al-Kubaisy, Balch, Beck, Beutler, Bohart, Bowman, Burns, Carlbring, Clum, Clum, Cuijpers, den Boer, Febbraro, Floyd, Floyd, Ghosh, Glass, Gould, Gould, Greenberger, Hamilton, Heather, Hecker, Hedges, Hellstrom, Hunter, Jacobson, Jamison, Kazdin, Landreville, Landreville, Lidren, Lipsey, Luborsky, Mahalik, Mains, Marrs, McKendree-Smith, Miller, Norcross, Norcross, Ogles, Parry, Rohen, Rosen, Rosen, Rosen, Salerno, Schelver, Schmidt, Scogin, Scogin, Scogin, Scogin, Scogin, Scogin, Scogin, Smith, Stanton, Starker, Van Lenkveld, Wampold, Westen, White, Wollersheim, Ost",2007.0,,0,0,
7782,"Temporal relationship between dysfunctional beliefs, self-efficacy and panic apprehension in the treatment of panic disorder with agoraphobia.","The aim of this study is to assess if changes in dysfunctional beliefs and self-efficacy precede changes in panic apprehension in the treatment of panic disorder with agoraphobia. Subjects participated in a larger study comparing the effectiveness of cognitive restructuring and exposure. Four variables were measured: (a) the strength of each subject's main belief toward the consequence of a panic attack; (b) perceived self-efficacy to control a panic attack in the presence of panicogenic body sensations; (c) perceived self-efficacy to control a panic attack in the presence of panicogenic thoughts; and (d) the level of panic apprehension of a panic attack. Variables were recorded daily on a ""0"" to ""100"" scale using category partitioning. Multivariate time series analysis and ""causality testing"" showed that, for all participants, cognitive changes preceded changes in the level of panic apprehension. Important individual differences were observed in the contribution of each variable to the prediction of change in panic apprehension. Changes in apprehension were preceded by changes in belief in three cases, by changes in self-efficacy in six cases, and by changes in both belief and self-efficacy in the remaining three cases. This pattern was observed in participants in the exposure condition as well as those in the cognitive restructuring condition. These results provide more empirical support to the hypothesis that cognitive changes precede improvement. They also underlie the importance of individual differences in the process of change. Finally, this study does not support the hypothesis that exposure and cognitive restructuring operate through different mechanisms, namely a behavioral one and a cognitive one. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bouchard, Stephane; Gauthier, Janel; Nouwen, Arie; Ivers, Hans; Vallieres, Annie; Simard, Sebastien; Fournier, Thomas; Anastasiades, Bandura, Barlow, Beck, Beck, Beck, Beck, Booth, Borden, Bouchard, Bouchard, Boudjellaba, Bouton, Bower, Box, Casey, Casey, Casey, Chambless, Clark, Clark, Clark, Davey, Ellermeier, Glass, Granger, Haynes, Haynes, Hilliard, Hoffart, Hoffart, Huitema, Jenkins, Jones, Junginger, Keeser, Kendall, Kirk, Laberge, Lazarus, Leahey, Liu, Lutkepohl, Lutkepohl, Margraf, Meichenbaum, Michelson, Mills, Moncher, Nurius, Pierce, Rachman, Rapee, Revenstorf, Rose, Salkovskis, Sanderson, Scheffe, Shafran, Shumway, Spitzer, Steptoe, Tiao, Tryon, Vallis, Wei, Wiener, Zane, Zinbarg",2007.0,,0,0,
7783,Efficacy of cognitive-behavioral therapy for comorbid panic disorder with agoraphobia and generalized anxiety disorder.,"The goal of this study was to evaluate the efficacy of cognitive-behavioral therapy for comorbid panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) by combining treatment strategies for both disorders. A single-case, multiple-baseline design across participants was used. Three participants with primary PDA and secondary GAD took part in the study. The efficacy of the treatment was assessed by means of a structured interview, self-administered questionnaires, and daily self-monitoring measures. After treatment, 2 of the 3 participants achieved high end-state functioning and maintained this level of functioning at 3-, 6-, and 12-month follow-ups. The third participant also improved but only reached high end-state functioning at 6-month follow-up. It therefore appears that the combined treatment is relatively effective for PDA-GAD comorbidity. Possible avenues for improving the treatment are suggested. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lebrecque, Joane; Marchand, Andre; Dugas, Michel J; Letarte, Andree; Baldwin, Barlow, Beck, Boivin, Borkovec, Bourque, Brawman-Mintzer, Brawman-Mintzer, Brown, Brown, Buhr, Chambless, Chambless, Craske, Curry, Di Nardo, Dugas, Dugas, Dugas, First, Freeston, Fyer, Gauthier, Goisman, Goldenberg, Gosselin, Jacobson, Keller, Kessler, Labrecque, Labrecque, Ladouceur, Ladouceur, Ladouceur, Lapalme, Marshall, McNally, Meyer, Noyes, Noyes, Provencher, Reiss, Roy-Byrne, Sanderson, Sanderson, Schweizer, Souetre, Spielberger, Starcevic, Steketee, Stephenson, Stephenson, Stephenson, Swinson, Tsao, Tsao, Tsao, Verreault",2007.0,,0,0,
7784,Empirical study on the healing nature of mandalas.,"Mandalas were first used in therapy by Carl Jung, who found that the act of drawing mandalas had a calming effect on patients while at the same time facilitating psychic integration. There is a scarcity of controlled empirical studies of the healing impact of mandalas on mental health. Based on the efficacy of James Pennebaker's written disclosure paradigm in promoting mental well-being (Pennebaker, 1997a, 1997b), the purpose of our study was to examine the benefits for those suffering from post traumatic stress disorder (PTSD) of processing traumatic events through the creation of mandalas. Benefits to participants were measured in terms of changes in the variables of PTSD symptoms, depressive symptoms, anxiety, spiritual meaning, and the frequency of physical symptoms and illness. Relative to those in the control condition, individuals assigned to the experimental mandala-creation group reported greater decreases in symptoms of trauma at the 1-month follow up. There were no other statistically significant outcome differences. Alternative modes of processing traumatic events (e.g., visually symbolically) may serve individuals who are either reluctant or unable to write about their experiences. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Henderson, Patti; Rosen, David; Mascaro, Nathan; Beck, Cohen, Cohen, Couch, Cox, Curry, Esterling, Foa, Foa, Gidron, Jung, King, Kloss, Mascaro, Mascaro, Mascaro, Park, Pennebaker, Pennebaker, Pennebaker, Pennebaker, Pennebaker, Pizarro, Slegelis, Sloan, Sloan, Smitherman-Brown, Smyth, Smyth, Spielberger, Stroebe",2007.0,,0,0,
7785,Cognitive-behavioral group treatment for pathological gambling: Analysis of effectiveness and predictors of therapy outcome.,"The authors sought to examine short- and mid-term effectiveness of a group cognitive-behavioral therapy (CBT) in pathological gambling (PG) and to analyze predictors of therapy outcome. Two hundred ninety PG patients participated in the current study, all diagnosed on the basis of Diagnostic and Statistical Manual of Mental Disorders (4th edition) criteria, and were given manualized outpatient group CBT (16 weekly sessions). Specific assessment before and after the therapy and at 1, 3, and 6 months follow-up was conducted. Logistic regression and survival analyses were applied. Outpatient group CBT was found to be effective, with abstinence rates of 76.1% by the end of therapy and 81.5% at 6 months follow-up. The dropout rate during treatment decreased significantly after the fifth treatment session. Psychopathological distress (p = .040) and obsessive-compulsive symptoms were identified as factors predicting relapse and dropout, respectively. These findings suggest that group CBT is effective for treating pathological gamblers. Several psychopathological and personality traits were identified as outcome predictors. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Jimenez-Murcia, Susana; Alvarez-Moya, Eva M; Granero, Roser; Aymami, M. Neus; Gomez-Pena, Monica; Jaurrieta, Nuria; Sans, Bibiana; Rodriguez-Marti, Jaume; Vallejo, Julio; Becona, Blaszczynski, Bulik, Cloninger, Cloninger, Cunningham-Williams, Derogatis, Derogatis, Echeburua, Echeburua, Echeburua, Eysenck, Farkas, First, Gonzalez de Rivera, Gutierrez, Gutierrez-Zotes, Hodgins, Hosmer, Jimenez-Murcia, Jimenez-Murcia, Ladouceur, Ladouceur, Ladouceur, Lesieur, Lopez Viets, Lynch, McConaghy, Milton, Oakley-Browne, Oakley-Browne, Pallesen, Petry, Petry, Raylu, Sharpe, Specker, Stinchfield, Sylvain, Toneatto, Toneatto, Toneatto, Vitaro, Westermeyer",2007.0,,0,0,
7786,Randomized trial of a meditation-based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder.,"Mindfulness-based stress reduction (MBSR) has been reported to reduce anxiety in a broad range of clinical populations. However, its efficacy in alleviating core symptoms of specific anxiety disorders is not well established. We conducted a randomized trial to evaluate how well MBSR compared to a first-line psychological intervention for social anxiety disorder (SAD). Fifty-three patients with DSM-IV generalized SAD were randomized to an 8-week course of MBSR or 12 weekly sessions of cognitive-behavioral group therapy (CBGT). Although patients in both treatment groups improved, patients receiving CBGT had significantly lower scores on clinician- and patient-rated measures of social anxiety. Response and remission rates were also significantly greater with CBGT. Both interventions were comparable in improving mood, functionality and quality of life. The results confirm that CBGT is the treatment of choice of generalized SAD and suggest that MBSR may have some benefit in the treatment of generalized SAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Koszycki, Diana; Benger, Melodie; Shlik, Jakov; Bradwejn, Jacques; Beck, Boyce, Clark, Cohen, Davidson, Erwin, Frisch, Frisch, Gelernter, Graham, Grossman, Guy, Hamilton, Heimberg, Heimberg, Heimberg, Kabat-Zinn, Kabat-Zinn, Kabat-Zinn, Kessler, Lau, Liebowitz, Linehan, Magee, Mattick, Mattick, Miller, Rapee, Schafer, Schneier, Sheehan, Stangier, Stein, Teasdale, Turner, Wagner, Walsh, Woody",2007.0,,0,0,
7787,Prognostic indices with brief and standard CBT for panic disorder: I. Predictors of outcome.,"Background: Although the effectiveness of cognitive behavioural therapy (CBT) in the management of panic disorder (PD) is now well established, there have been few studies of predictors of outcome with this patient group using clinical effectiveness trial data, a hypothesis-testing model, and a dependent measure of clinically significant change. Method: The data for this study came from a randomized controlled trial of three forms of CBT delivery for PD with and without agoraphobia (two 6-week CBT programmes, one of which was computer assisted, and one therapist-directed 12-week CBT programme), comprising a total of 186 patients across two sites. Based on previous related research, five hypothesized predictors of posttreatment and follow-up outcome were identified and examined, using a series of bivariate and multivariate analyses. Results: The results in general supported the hypotheses. Strength of blood/injury fears, age of initial onset of panic symptoms, co-morbid social anxieties and degree of agoraphobic avoidance were predictive of both measures of post-treatment outcome. Degree of residual social difficulties and the continued use of anxiolytics at post-treatment were also shown to predict poor outcome at the 6-month follow-up. However, strength of continuing dysfunctional agoraphobic cognitions by the end of active treatment did not predict outcome at follow-up for the sample as a whole. Conclusions: The identification of consistent predictors of outcome with CBT has many clinical and research benefits. As CBT, however, is being delivered increasingly in a variety of brief formats, further research is required to identify moderators of response to these 'non-standard' treatment formats. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dow, Michael G. T; Kenardy, Justin A; Johnston, Derek W; Newman, Michelle G; Taylor, C. Barr; Thomson, Aileen; Barlow, Basoglu, Beck, Brown, Chambless, Chambless, Clark, Clark, Clark, Clark, Conners, Craske, Dewey, Durham, Emmelkamp, Emmelkamp, Fava, Fava, Fischer, Foa, Foa, Green, Hackmann, Hafner, Katschnig, Keijsers, Kenardy, Kenardy, Lecrubier, Liebowitz, Marks, Marks, Mavissakalian, McCusker, Newman, Norton, O'Rourke, O'Sullivan, Oei, Otto, Otto, Ramnero, Reed, Ronalds, Salkovskis, Scheibe, Schmidt, Sharp, Sheehan, Shinoda, Spielberger, Steketee, Steketee, Van Balkom, Ware, Wells",2007.0,,0,0,
7788,Telepsychology and self-help: The treatment of fear of public speaking.,"This work presents a self-help, Internet-based telepsychology program for the treatment of public speaking fears. The system is comprised of 3 parts: The assessment protocol gives the patient information about his or her problem (i.e., amount of interference it creates in his or her life, severity, degree of fear and avoidance). The system also includes a structured treatment protocol, organized into separate blocks, reflecting the patient's progress. This ensures that the patient does not skip any steps in the treatment (something quite common in traditional self-help manuals), which provides more control over the process. The treatment protocol is a cognitive-behavioral program that provides exposure to the feared situation using videos of real audiences. Finally, the control protocol assesses treatment efficacy, not only at closure, but also at every intermediate step. Efficacy data from 12 social phobia patients are presented from pretreatment to posttreatment and at 1-month follow-up. These preliminary data support the efficacy of our telepsychology program for the treatment of fear of public speaking. This is a preliminary work in a promising research path that examines the possibility of using the Internet for the treatment of psychological disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Botella, Cristina; Guillen, Veronica; Garcia-Palacios, Azucena; Gallego, Maria J; Banos, Rosa M; Alcaniz, Mariano; Bachofen, Bados, Baer, Banshur, Barlow, Barlow, Barlow, Blackmon, Botella, Botella, Botella, Brown, Carlbring, Celio, Cho, Cho, Clark, Cote, DiNardo, Echeburua, Ermer, Glasgow, Glasgow, Gould, Gould, Gould, Graham, Harvey, Hecker, Heimberg, Heimberg, Heimberg, Jacobs, Kalucy, Kavanagh, Landau, Lange, Lange, Lidren, Magee, Marks, Marks, McCrone, Norcross, Pollard, Proudfoot, Przeworski, Robinson, Rosen, Schneier, Stein, Strom, Walker, Winzelberg, Wolpe, Woody, Zajtchuk",2007.0,,0,0,
7789,"Quetiapine adjunct to selective serotonin reuptake inhibitors or venlafaxine in patients with major depression, comorbid anxiety, and residual depressive symptoms: A randomized, placebo-controlled pilot study.","This double-blind, placebo-controlled study examined the efficacy and tolerability of quetiapine in combination with selective serotonin reuptake inhibitors (SSRIs)/venlafaxine in 58 patients with major depressive disorder, comorbid anxiety symptoms (HAM-A-14 score >=14), and residual depressive symptoms (HAM-D-17 score >=18, CGI-S score >=4). Patients had received an SSRI/venlafaxine (at a predefined therapeutic dose) for >=6 weeks. Overall, 62% (18/29) of quetiapine- and 55% (16/29) of placebo-treated patients completed the study. The mean change in HAM-D and HAM-A total scores from baseline to Week 8 (primary endpoint) was significantly greater with quetiapine (mean dose 182 mg/day) than placebo: -11.2 vs. -5.5 (P = .008) and -12.5 vs. -5.9 (P = .002), respectively. The onset of quetiapine efficacy (HAM-D/HAM-A/CGI-I) was rapid (by Week 1) and continued through to Week 8. Significant differences (P < .05) from baseline to Week 8 were observed between groups in 7/17 HAM-D (including feelings of guilt, suicide) and 6/14 HAM-A items (including tension, cardiovascular symptoms). Response (>=50% decrease in total score) was higher for quetiapine than placebo: HAM-D, 48% vs. 28% (not significant, NS); HAM-A, 62% vs. 28% (P = .02). Remission (total score <=7) was higher for quetiapine than placebo: HAM-D, 31% vs. 17% (NS); HAM-A, 41% vs. 17% (NS). CGI-S, CGI-I, and the Global Assessment Scale showed that quetiapine was significantly more effective than placebo. For quetiapine, adverse events (AEs) were similar to those previously observed; sedation/somnolence/lethargy was the most commonly reported. Here quetiapine was shown to be effective as augmentation of SSRI/venlafaxine therapy in patients with major depression, comorbid anxiety, and residual depressive symptoms, with no unexpected tolerability issues. Further studies are warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","McIntyre, Alexander; Gendron, Alain; McIntyre, Amanda; Adson, Barnett, Bauer, Brown, Calabrese, Denys, Dodd, Doree, Endicott, Fleck, Galynker, Goldstein, Gorman, Hamilton, Hamilton, Hamner, Hirschfeld, Hogan, Judd, Kennedy, Kessler, Lublin, Macfadden, Guy, O'Leary, Ostroff, Papakostas, Papakostas, Pathak, Pitchot, Rapaport, Schutters, Shelton, Sherbourne, Simon, Tohen, Worthington, Yargic",2007.0,,0,0,
7790,A naturalistic long-term comparison study of selective serotonin reuptake inhibitors in the treatment of panic disorder.,"Objectives: Selective serotonin reuptake inhibitors (SSRIs) are currently considered as the first drug of choice in the treatment of panic disorder (PD). The aim of this long-term, naturalistic comparison study was to compare 4 SSRIs with respect to tolerability and treatment outcome of PD. Outcome measures included relapse rates and adverse effects. Methods: Two hundred patients with PD were enrolled in our study. AH subjects met DSM-IV criteria for PD or PD with agoraphobia (PDA). All patients were assigned to receive SSRI monotherapy for 12 months with either citalopram (n = 50), fluoxetine (n = 50), fluvoxamine (n = 50), or paroxetine (n = 50) in a randomized, nonblinded fashion. Both the treating psychiatrist and the patients were not blind to the assigned treatment, but the clinician raters were blind to the study medication. The study design allowed for assignment of a particular SSRI as indicated according to the clinical judgment of the study psychiatrists. The Panic Self-Questionnaire, which is a self-report scale, was administered at baseline and then once per month during the duration of the 12-month study. The visual analog scale and the Clinical Global Impression Scale were administered at baseline and then once per month during the period of the study. Reports of sexual dysfunction were assessed using a nonstructured clinical interview at monthly visits. The body weight of study subjects was measured at baseline, and then at the 12th month visit end point. Results: Of 200 patients who entered the study, 127 patients (63.5%) completed the full 12-month protocol. Retention rates were highest for paroxetine (76% [38/50]), intermediate for citalopram (68% [34/50]) and fluvoxamine (60% [30/50]), and lowest for fluoxetine (50% [25/50]). Patients who completed the 12-month protocol responded favorably to the study treatment. The paroxetine and the citalopram groups had significantly lower rates of panic symptoms as measured at visits on weeks 4 and 8. At visits on months 3, 6, 9, and 12, however, there were no statistically significant differences between the 4 groups in relapse rates (defined as the occurrence of 1 or more panic attacks during the previous week of treatment) (F1,127 = 0.17; P= 0.13 [not statistically significant]). At the 12th month end point, patients in all 4 treatment groups had a statistically significant increase in body weight. Body weight among the study population increased by 6.1 + 4.9 kg from a mean weight of 72.4 + 7.3 kg at the onset of treatment. Reports of sexual adverse effects at the 12th month visit were similar in the citalopram, fluoxetine, and paroxetine groups, but the fluvoxamine patient group reported fewer sexual adverse effects at the 12th month visit. Conclusions: Most of our PD patients responded well to 12-month treatment with either citalopram, fluoxetine, fluvoxamine, or paroxetine, and the overall response rate was equal after the first 4 weeks of treatment. Although patients treated with paroxetine had the lowest dropout rates during the initiation phase, they had the highest rate of adverse effects as measured at the 12th month visit. Conversely, patients in the fluvoxamine group had the highest dropout rate (which was primarily caused by adverse effects in the initiation phase of treatment.); however, patients who were able to tolerate fluvoxamine throughout the full course of the study were observed to have lower rates of sexual dysfunction and weight gain compared with patients treated with the other agents. Overall, when measured at the 12th month visit, monotherapy with paroxetine and citalopram was associated with a higher rate of sexual adverse effects than was treatment with fluoxetine or fluvoxamine. In addition, monotherapy with paroxetine, citalopram, and fluoxetine seemed to cause more weight gain than did treatment with fluvoxamine. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dannon, Pinhas N; Iancu, Iulian; Lowengrub, Katherine; Gonopolsky, Yehudit; Musin, Ernest; Grunhaus, Leon; Kotler, Moshe; Asnis, Bakkar, Bakker, Ballenger, Ballenger, Barlow, Black, Clayton, Dannon, Dannon, Davidson, Dyckman, Emmanuel, Fyer, Guy, Hirschmann, Hofmann, Keltner, Kennedy, Kessler, Lecrubier, Leon, Lepola, Mavissakalian, Michelson, Michelson, Michelson, Oehrberg, Perna, Pollack, Salvador-Carulla, Sheehan, Wade, Weissman, Zajecka, Zeally",2007.0,,0,0,
7791,Effectiveness of a brief cognitive behavioural therapy for panic disorder with agoraphobia and the impact of partner involvement.,"A brief treatment for panic disorder with agoraphobia (PDA) supported by self-help materials may be an alternative choice to standard CBT: this type of program may also help to overcome some of the cost-benefit limitations of standard cognitive behavioural therapy. The aim of this study was to test the efficacy of a brief cognitive behaviour therapy (7 weeks) for PDA, with and without partner involvement, along with a self-study manual. A total of 77 participants meeting DSM-IV criteria of PDA were assigned to one of three treatment conditions: 1) a 14-session standard CBT (n = 26); 2) a 7-session brief cognitive behaviour therapy along with a self-study manual (n = 26); and 3) a 7-session brief cognitive behaviour therapy involving a partner along with a self-study manual (n = 25). Results show a statistically and clinically significant improvement on all outcome measures in the three treatment conditions. Gains were maintained up to 6 months. Both brief CBT conditions were as effective as the standard cognitive behavioural treatment. These results suggest that a brief program, supported by self-help materials, that shortens the time during which the patient suffers from this problem may be a good option for the treatment of panic disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Marchand, Andre; Todorov, Christo; Borgeat, Francois; Pelland, Marie-Eve; Addis, Barlow, Barlow, Barlow, Barlow, Botella, Cerny, Chambless, Chambless, Clark, Clark, Clark, Clum, Cobb, Craske, Craske, Cote, Cote, Daiuto, Deacon, Di Nardo, Emmelkamp, Emmelkamp, Emmelkamp, Febbraro, Fritzler, Gauthier, Ghosh, Goldstein, Gould, Gould, Gould, Gould, Grant, Hecker, Hecker, Holden, Jacobson, Jamison, Kenardy, Lavallee, Lidren, Marchand, Marchand, Marchand, Margraf, Mathews, Mavissakalian, McNamee, Michelson, Parry, Power, Scogin, Sharp, Smidt, Sorby, Spielberger, Stephenson, Stephenson, Stephenson, Swinson, Westling, White, Wright, Ost",2007.0,,0,0,
7792,Health-related quality of life (HRQOL) among patients with Generalised Anxiety Disorder: Evaluation conducted alongside an escitalopram relapse prevention trial.,"Background: Improving health-related quality of life (HRQoL) should be a treatment goal for patients with Generalised Anxiety Disorder (GAD). Objectives: To assess the impact of treatment with escitalopram on HRQoL as well as the effect of relapse on HRQoL and work productivity. Methods: This study was conducted alongside a double-blind, placebo-controlled, relapse prevention multinational clinical trial. Relapse was defined as a Hamilton Anxiety Scale (HAMA) >=15. Treatment responders (HAMA <=10) after 12 weeks of open-label treatment (10 mg/day escitalopram for Week 1 followed by 20 mg/day thereafter) were included. The study dataset comprised patients (n = 329) from French, Canadian, German and Swedish centres. HRQoL was assessed using the SF-36 scale, and data on sick leave and on-the-job productivity as measured by the Work Limitation Questionnaire and the work efficacy and work satisfaction visual analogue scales (VAS) scales were collected at baseline, randomization (Week 12), Weeks 36, 60 and at last assessment. For future health economic analysis, quality adjusted life years were calculated from the SF-36 results. Results: At baseline, GAD patients reported significantly impaired quality of life compared with the general population. During the 12-week open-label treatment period, treatment responders reported significant improvements in HRQoL on all dimensions of the SF-36 (p < 0.001) and on-the-job productivity (p < 0.001), whereas sick leave decreased but did not reach statistical significance. After randomization, relapsed patients reported significantly lower QoL than non-relapsed patients on all 4 SF-36 mental health dimensions (p < 0.001). Relapsed patients reported slightly lower on-the-job productivity than non-relapsed patients and scored lower on the work efficacy and work satisfaction VAS scales. Conclusion: GAD adversely affects patient functioning and daily life. Short-term treatment with escitalopram reverses this impairment to population norms. GAD relapse is associated with a deterioration of HRQoL and work productivity. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Allgulander, C; Jorgensen, T; Wade, A; Francois, C; Despiegel, N; Auquier, P; Toumi, M; Allgulander, Allgulander, Andrews, Baldwin, Blank, Brazier, Brazier, Davidson, Gambi, Gartlehner, Goodman, Heuzenroeder, Issakidis, Lamers, Lenox-Smith, Lerner, Lieb, Mattke, McHorney, Mohamed, Murray, Nutt, Perugi, Petrou, Pickard, Sassi, Ware, Wittchen",2007.0,,0,0,
7793,Psychotherapeutic treatment program for post-traumatic stress disorder: Prospective study of 70 war veterans.,"The aim of this study was to assess the effectiveness of the psychotherapeutic model of treatment of war veterans in Croatia with post-traumatic stress disorder (PTSD). The symptoms of PTSD are analysed and evaluated, together with associated neurotic symptoms, ways of coping with stress, and indicators of quality of life and depression. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Britvic, Dolores; Anticevic, Vesna; Urlic, Ivan; Dodig, Goran; Lapenda, Branka; Kekez, Vesna; Mustapic, Iva; Beck, Britvic, Cox, Crown, Crown, Elliot, Elsesser, Foa, Fontana, Golier, Gregurek, Gudmundsdottir, Hammarberg, Hudek-Knezevic, Johnson, Keane, Krizmanic, Lazarus, Loncar, Lubin, Mannar, Munley, Ragsdale, Schnurr, Scurfield, Shalev, Tocilj, Urlic, Urlic, Urlic, Weinberg, Willson",2007.0,,0,0,
7794,"Emotional disclosure in patients with amyotrophic lateral sclerosis: A randomized, controlled trial.","An emotional disclosure intervention, which involved either writing or speaking about a traumatic event, was tested in a population of 48 patients with Amyotrophic Lateral Sclerosis (ALS), a terminal and degenerative neurological disease, from six different states. Both control (N=23) and treatment participants (N= 25) completed self-report measures relating to physical and psychological health at study baseline, 3 months, and 6 months; treatment participants also completed an emotional disclosure exercise at study baseline. Subjects were contacted either in person or by phone and completed and returned study measures from their homes. There were no significant differences between treatment and control groups in terms of physical function or physical well-being. There was a significant group by time effect on psychological well-being at 3 and 6 months (p = .01), significant main effects for spirituality (p < .001), existential quality of life (p = .03), and posttraumatic growth (p = .007), and a significant interaction between baseline ambivalence regarding emotional expression and group (p = .02). Previous research on emotional disclosure has proposed that the intervention is most effective when it invokes a process of reordering thoughts relating to the traumatic event, or problem, being addressed in order to arrive upon a solution. The largely null findings for the current study suggest that the emotional disclosure intervention may not be well-suited for populations with terminal illness, as they are confronting a problem that cannot readily be solved. Patients with ALS may benefit most from information relating to their disease course and the support of their family, friends, and treatment team. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Averill, Alyssa Jane",2007.0,,0,0,
7795,A case study of trichotillomania with social phobia: Treatment and 4-year follow-up using cognitive-behaviour therapy.,"This article describes a case study that demonstrates an innovative combination of predominantly behavioural techniques in the treatment of trichotillomania (TTM) preceded by social phobia. Outcomes are reported to 4-year follow-up. A master's qualified cognitive-behavioural nurse therapist administered the course of treatment over 1 year and followed the client for 4 years. A combination of exposure and response prevention, habit reversal and serial photography for TTM urges, exposure for social phobia, cognitive restructuring and problem solving were utilised. These treatments were provided sequentially and concurrently. Pre and posttreatment and repeated outcome measures were applied in three domains. The client received a total of 23 treatment sessions over 1 year and follow-up over 4 years. During treatment, discharge and follow-up improved outcomes in TTM and social phobia were achieved and maintained at 4 years. Benefits accrued beyond the presenting conditions to have a major positive impact on the client's life. Theoretical implications for the classification of TTM are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Javidi, Zhila; Battersby, Malcolm; Forbes, Angus; Andrews, Andrews, Beck, Beck, Chamberlain, Clark, Clark, Diefenbach, Elliott, Fava, Feske, Fontenelle, Gershuny, Heimberg, Lochner, Marks, Marks, Mortberg, Mundt",2007.0,,0,0,
7796,Depressed mood and n-3 polyunsaturated fatty acid intake from fish: Non-linear or confounded association?,"There is increasing evidence of an association between low dietary intake of essential n-3 long chain polyunsaturated fatty acids (n-3 EFAs) and depressed mood. This study aimed to evaluate this association in a large population-based sample of UK individuals. N-3 EFA intake (intake from fish alone, and from all sources (fish and supplements)), depressed mood (assessed using the short-form Depression, Anxiety and Stress Scales) and demographic variables (sex, age, Index of Multiple Deprivation (IMD) based on postal code, and date of questionnaire completion) were obtained simultaneously by self-report questionnaire (N = 2982). Using polynomial regression, a non-linear relationship between depressed mood and n-3 EFA intake from fish was found, with the incremental decrease in depressed mood diminishing as n-3 EFA intake increased. However, this relationship was attenuated by adjustment for age and IMD. No relationship between depression and n-3 EFA intake from all sources was found. These findings suggest that higher levels of n-3 EFA intake from fish are associated with lower levels of depressed mood, but the association disappears after adjustment for age and social deprivation, and after inclusion of n-3 EFA intake from supplements. This study does have a number of limitations, but the findings available suggest that the apparent associations between depressed mood and n-3 EFA intake from fish may simply reflect a wider association between depressed mood and lifestyle. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Appleton, Katherine M; Peters, Tim J; Hayward, Robert C; Heatherley, Susan V; McNaughton, Sarah A; Rogers, Peter J; Gunnell, David; Ness, Andrew R; Kessler, David; Adams, Appleton, De Jong, Delion, Delion, Edwards, Finch, Greger, Gregory, Hallahan, Hibbeln, Kasen, Lewis, Lovibond, Maes, Peet, Salem, Shi, Silvers, Tanskanen, Timonen, Weich",2007.0,,0,0,
7797,Temperament and character dimensions in patients with social phobia: Patterns of change following treatments?,"The aim of this study was to examine Temperament and Character Inventory (TCI) profiles in patients with social phobia (DSM-IV) and to outline patterns of change following intensive group cognitive therapy (IGCT), individual cognitive therapy (ICT) and treatment as usual (TAU). One hundred patients recruited by advertisements in local papers were randomized to IGCT, ICT and TAU. Patients (n = 59) who completed diagnostic evaluation and TCI assessments at baseline and 1-year follow-up were examined in this study. Patients differed from healthy controls in novelty seeking (NS), harm avoidance (HA), self-directedness (SD), cooperativeness (C), and self-transcendence (ST). Treatments overall were associated with decrease in HA, while increase in SD was observed after psychotherapy only. Reduced social anxiety was correlated with decrease in HA and increase in SD. High HA at baseline was related to poor treatment outcome in all treatments. To conclude, patients with social phobia show a temperamental vulnerability for developing anxiety and character traits associated with personality disorders. Successful treatment is related to decrease in HA and increase in SD. High HA at baseline may suggest a need for extensive treatment in order to achieve remission. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mortberg, Ewa; Bejerot, Susanne; Wistedt, Anna Aberg; Abrams, Allgulander, Baker, Beck, Beck, Bejerot, Black, Blanco, Blanco, Bouwer, Bruce, Brandstrom, Chatterjee, Clark, Clark, Clark, Clark, Cloninger, Cloninger, Cloninger, Ekselius, Fahlen, First, Fossey, Fresco, Furmark, Hofmann, Hood, Kessler, Kim, Klump, Liebowitz, Lydiard, Lyoo, Marteinsdottir, Mattick, Mortberg, Mortberg, Mortberg, Pelissolo, Perna, Richman, Schneier, Soderstrom, Starcevic, Svrakic, Svrakic",2007.0,,0,0,
7798,Screening for posttraumatic stress disorder in VA primary care patients with depression symptoms.,"Background: Unrecognized posttraumatic stress disorder (PTSD) is common and may be an important factor in treatment-resistant depression. Brief screens for PTSD have not been evaluated for patients with depression. Objective: The objective was to evaluate a 4-item screen for PTSD in patients with depression. Design: Baseline data from a depression study were used to evaluate sensitivity, specificity, and likelihood ratios (LRs) using the PTSD checklist (PCL-17) as the reference standard. Subjects: Subjects are 398 depressed patients seen in Veterans Affairs (VA) primary care clinics. Measures: The Patient Health Questionnaire (PHQ) for depression, PCL-17, and 4-item screen for PTSD were used. Results: Patients had a mean PHQ score of 14.8 (SD 3.7). Using a conservative PCL-17 cut point ""(>50)"", the prevalence of PTSD was 37%. PCL-17 scores were strongly associated with PHQ scores (r = 0.59, P < 0.001). Among the 342 (86%) patients endorsing trauma, a score of 0 on the remaining 3 symptom items had a LR = 0.21, score of 1 a LR = .62, score of 2 a LR = 1.36, and score of 3 a LR = 4.38. Conclusions: Most depressed VA primary care patients report a history of trauma, and one third may have comorbid PTSD. Our 4-item screen has useful LRs for scores of 0 and 3. Modifying item rating options may improve screening characteristics. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gerrity, Martha S; Corson, Kathryn; Dobscha, Steven K; Blanchard, Bliese, Breslau, Campbell, Dobie, Dobscha, Forbes, Greenburg, Hoge, Hoge, Kang, Katzman, Kimerling, Kimerling, Kraemer, Kroenke, Lecrubier, Liebschutz, Magruder, Meltzer-Brody, Prins, Seal, Spiro, Spitzer, Weathers",2007.0,,0,0,
7799,Are depressed outpatients with and without a family history of substance use disorder different? A Baseline analysis of the STAR*D cohort.,"Objective: This report compares the baseline demographic and clinical characteristics of outpatients with nonpsychotic major depressive disorder (MDD) and a family history of substance use disorder (SUD) versus those with MDD and no family history of SUD. Method: Using data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, we grouped participants with MDD (DSM-IV criteria) according to presence or absence of family history of SUD based on participant report. Between-group comparisons were made of demographic and clinical characteristics, depressive symptoms, and psychiatric comorbidities. Patients were enrolled from July 2001 until August 2004. Results: Of 4010 participants, 46% had a positive family history of SUD. Those with a positive family history were less likely to be Hispanic (p = .0029) and more likely to be female (p = .0013). They were less educated (p = .0120), less likely to be married (p < .01), and more likely to be divorced (p < .01). They also reported an earlier age at onset of MDD, greater length of illness, and more major depressive episodes (all p < .001). They had an increased likelihood of recurrent MDD, more prior suicide attempts, and more concurrent psychiatric comorbidities, including posttraumatic stress disorder, SUD, and generalized anxiety disorder (all p < .0001). Conclusion: Depressed patients with a family history of SUD had a more severe previous course of depression, were more likely to have attempted suicide, and had a greater burden of psychiatric comorbid conditions than patients without such a family history. These findings represent important clinical features to be considered in the evaluation and treatment planning of patients with MDD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Davis, Lori L; Frazier, Elizabeth C; Gaynes, Bradley N; Trivedi, Madhukar H; Wisniewski, Stephen R; Fava, Maurizio; Barkin, Jennifer; Kashner, T. Michael; Shelton, Richard C; Alpert, Jonathan E; Rush, A. John; Andreasen, Cadoret, Coryell, Endicott, Fava, Grant, Hamilton, Hamilton, Jacob, Kendler, Kobak, Lin, McAvay, Merikangas, Mundt, Mundt, Nurnberger, Oquendo, Reich, Rush, Rush, Rush, Tanna, Tanna, Trivedi, Ware, Williams, Wilson, Winokur, Winokur, Zimmerman",2007.0,,0,0,
7800,Acceptance and commitment therapy for generalized social anxiety disorder: A pilot study.,"Despite the demonstrated efficacy of cognitive-behavior therapy (CBT) for social anxiety disorder (SAD), many individuals do not respond to treatment or demonstrate residual symptoms and impairment posttreatment. Preliminary evidence indicates that acceptance-based approaches (e.g., acceptance and commitment therapy; ACT) can be helpful for a variety of disorders and emphasize exposure-based strategies and processes. Nineteen individuals diagnosed with SAD participated in a 12-week program integrating exposure therapy and ACT. Results revealed no changes across a 4-week baseline control period. From pretreatment to follow-up, significant improvements occurred in social anxiety symptoms and quality of life, yielding large effect size gains. Significant changes also were found in ACT-consistent process measures, and earlier changes in experiential avoidance predicted later changes in symptom severity. Results suggest the acceptability and potential efficacy of ACT for SAD and highlight the need for future research examining both the efficacy and mechanisms of change of acceptance-based programs for SAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dalrymple, Kristy L; Herbert, James D; Baker, Barlow, Beidel, Beidel, Block, Block, Branstetter, Chambless, Clark, Clark, Davidson, Eifert, Eng, Eng, First, First, First, Fresco, Frisch, Frisch, Gould, Graham, Groom, Hayes, Hayes, Hayes, Heimberg, Heimberg, Heimberg, Herbert, Herbert, Herbert, Herbert, Herbert, Herbert, Herbert, Herbert, Herbert, Hill, Hofmann, Hope, Hope, Kabat-Zinn, Kashdan, Kashdan, Kessler, Leary, Leon, Leon, Liebowitz, Linehan, Lipsitz, Mattia, Mattick, Newman, O'Boyle, Orsillo, Rapee, Rapee, Rennenberg, Riskind, Saluck, Schneier, Skodol, Steketee, Teasdale, Turner, Twohig, Weeks, Williams, Wilson, Wolpe, Zaider, Zettle, Zettle, Zettle",2007.0,,0,0,
7801,"Cognitive-behavioural treatment of Obsessive-Compulsive Disorder: Results of an outcome naturalistic open study with 6, 12, 24 months follow-up.","Aim: According to international guidelines, pharmacological therapy and cognitive-behavioural therapy are the elective treatments for Obsessive-Compulsive Disorder (OCD). The aim of the present study is to verify the effectiveness of a protocol that combines evidence-based procedures and original interventions, emphasizing the issue of acceptance, that is acceptance of those cognitive and emotional states reported by several recent researches as being poorly tolerated by obsessive-compulsive patients. Furthermore the Authors meant to test the effectiveness of a treatment according to a naturalistic design, in an outpatient fee-for-service setting. Method: In the past three years, 59 patients affected by OCD have undergone our treatment. They were recruited solely because of their request of psychotherapy. Evaluation of outcomes has been carried out through the Y-BOCS. Results: Hitherto 39 patients completed treatment. Data show a decrease of symptomatology both in patients who concluded psychotherapy and in those still undergoing it. Repeated measures ANOVA performed on the variable-treatment on 3 levels (pre- post- follow) turns out to be very significant (p < .0001). A series of mixed ANOVA have been also performed (between factors: SEX/subtype of OCD/comorbidity/length of treatment/length of disorder; within factor: TREAMENT), and they show that the only significant factor is TREATMENT (3 levels). Post-hoc analyses on TREATMENT variable show that there are significant differences between pre-treatment and post-treatment follow-up. Discussion: Outcomes will be discussed, pointing limits and merits of the study out, as well as problems to be solved in future researches. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Mancini, Francesco; Barcaccia, Barbara; Capo, Rosario; Gangemi, Amelia; Gragnani, Andrea; Perdighe, Claudia; Rainone, Antonella; Romano, Giuseppe; Abramowitz, Amir, Andrews, Arntz, Cohen, Coles, Dottore, Fals-Stewart, Foa, Foa, Franklin, Franklin, Goodman, Koran, Kozak, Lindsay, Mancini, Mancini, Mancini, Mancini, Marks, Pato, Rachman, Ray, Salkovskis, Stein, van Balkom, van Oppen, Warren",2006.0,,0,0,
7802,Escitalopram prevents relapse of obsessive-compulsive disorder.,"To examine the efficacy and tolerability of escitalopram in the prevention of relapse in patients with OCD, 468 patients with OCD were treated with open label escitalopram (10 mg or 20 mg) for 16 weeks, after which the 320 responders (Y-BOCS total score decrease >=25%) were randomised to placebo or escitalopram (at the assigned dose) for 24 weeks double-blind treatment. The primary analysis (time to relapse) showed a significant advantage for escitalopram (p<0.001, log-rank test). The proportion of patients who relapsed was statistically significantly higher in the placebo group (52%) than in the escitalopram group (23%) (p<0.001, chi2-test). The risk of relapse was 2.74 times higher for placebo compared to escitalopram. Escitalopram was well tolerated and improvements in obsessive-compulsive symptoms reported during the open label period were sustained during the double-blind extension of treatment with active drug. These results demonstrate that escitalopram is effective for long-term treatment and relapse prevention in OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Fineberg, Naomi A; Tonnoir, Brigitte; Lemming, Ole; Stein, Dan J; Bailer, Baldwin, Cottraux, Eddy, Fineberg, Geller, Goodman, Greist, Guy, Hollander, Hollander, Insel, Katz, Kessler, Kessler, Koran, Maina, McLean, Montgomery, Montgomery, Pato, Robins, Romano, Sanchez, Simpson, Simpson, Skoog, Stein, Tollefson, van Oppen, Weissman",2007.0,,0,0,
7803,Fight fire with fireflies! Association splitting: A novel cognitive technique to reduce obsessive thoughts.,"Anovel cognitive technique, termed ""association splitting"", aimed at reducing obsessive thoughts, is introduced. Association splitting draws upon the so-called ""fan effect"" of associative priming. Transposing this principle to the treatment of obsessive-compulsive disorder (OCD), we hypothesize that the sprouting of new and the strengthening of existing neutral associations to core OCD cognitions will reduce their fear-evoking properties by depriving the chain of OCD-related cognitions of associative strength. To test the feasibility and efficacy of this approach, an internet intervention study was implemented. Initially, 38 subjects with OCD obsessions took part in a survey. After completion of the survey they were then sent a self-help manual. Three weeks later, participants were re-contacted. One-third of the participants responded to the treatment (at least 35% decline on the Y-BOCS scale). The completer analysis revealed a response rate of 42%. It is suggested that association splitting may lead to symptom relief in a subgroup of participants and may represent a useful addition to the tool box of cognitive-behavioural techniques. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Moritz, Steffen; Jelinek, Lena; Klinge, Ruth; Naber, Dieter; Anderson, Chinman, Meyerson, Moritz, Reisberg, Ritter",2007.0,,0,0,
7804,Mindfulness and task concentration training for social phobia: A pilot study.,"A new treatment for social phobia is evaluated: mindfulness training and task concentration training. The treatment consisted of nine sessions of 45-60 minutes and was administered individually. Nine severely socially phobic patients participated. No changes in complaints were observed during the waiting-list period. One patient withdrew during the treatment. Results show that treatment was well accepted and highly effective in reducing social phobia, and results were maintained at a 2-month follow-up. Effects of the treatment were most pronounced on Fear of Negative Evaluation and on the self-ideal discrepancy. Attention as well as cognitive changes may be responsible for the effectiveness. Explanations for the effects and clinical implications are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Bogels, Susan M; Sijbers, G. F. V. M; Voncken, Marisol; Arrindell, Bishop, Bogels, Bogels, Bogels, Bogels, Bogels, Bogels, Clark, Clark, Cohen, Derogatis, Fenigstein, First, First, Groenestijn, Hartman, Hope, Kabat Zinn, Kabat-Zinn, Leary, Miller, Miskimins, Mulkens, Mulkens, Rodebaugh, Segal, Turner, Voncken, Weertman, Wells, Wells, Zanarini",2006.0,,0,0,
7805,Social self-reappraisal therapy for social phobia: Preliminary findings.,"The recent psychopathology literature suggests that individuals with social phobia overestimate social standards and are deficient in setting and attaining social goals, have a negative perception of themselves as social objects, and show heightened self-focused attention when confronted with social threat. They further overestimate the potential cost of a social encounter, experience their anxiety as uncontrollable and visible to others, view their social skills as inadequate, rely on safety behaviors and avoidance strategies to control their anxiety, and engage in post-event rumination. Traditional cognitive-behavioral therapy does not adequately address all of these features of social phobia during treatment. We discuss here an enhanced version of cognitive-behavioral treatment for social phobia, which is expressly designed to address these factors. The results of an uncontrolled pilot study suggest that this new treatment may be more effective than traditional cognitive-behavioral therapy for social phobia. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Hofmann, Stefan G; Scepkowski, Lisa A; Alden, Alden, Alden, Alden, Barlow, Battersby, Beck, Brown, Bogels, Clark, Clark, Clark, DiNardo, Feske, Foa, Gelernter, Glasgow, Hackmann, Hackmann, Harvey, Hayes, Heckhausen, Heimberg, Heimberg, Heimberg, Heimberg, Heimberg, Heinrichs, Hiemisch, Hirsch, Hirsch, Hofmann, Hofmann, Hofmann, Hofmann, Hofmann, Hofmann, Kim, Leary, Leung, Lundh, Mansell, Mattick, McManus, Mellings, Morgan, Newman, Norton, Rachman, Rapee, Rapee, Rapee, Stangier, Stopa, Stravynski, Trower, Turner, Wallace, Wallace, Wells, Wells, Wells, Woody",2006.0,,0,0,
7806,Beyond brand names of psychotherapy: Identifying empirically supported change processes.,"There is considerable debate about which empirical research methods best advance clinical outcomes in psychotherapy. The prevailing tendency has been to test treatment packages using randomized, controlled clinical trials. Recently, focus has shifted to considering how studying the process of change in naturalistic treatments can be a useful complement to controlled trials. Clinicians self-identifying as psychodynamic treated 17 panic disorder patients in naturalistic psychotherapy for an average of 21 sessions. Patients achieved statistically significant reductions in symptoms across all domains. Rates of remission and clinically significant change as well as effect sizes were commensurate with those of empirically supported therapies for panic disorder. Treatment gains were maintained at 6-month follow-up. Intensive analysis of the process of the treatments revealed that integrative elements characterized the treatments: Adherence to cognitive-behavioral process was most characteristic, adherence to interpersonal and psychodynamic process, however, was most predictive of positive outcome. Specific process predictors of outcome were identified using the Psychotherapy Process Q-Set. These findings demonstrate how process research can be used to empirically validate change processes in naturalistic treatments as opposed to treatment packages in controlled trials. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Ablon, J. Stuart; Levy, Raymond A; Katzenstein, Tai; Abend, Ablon, Ablon, Ablon, Ablon, Barlow, Barlow, Barlow, Cohen, Craske, Crits-Christoph, Derogatis, Derogatis, Endicott, Endicott, Eudell-Simmons, Frieswyck, Gabbard, Garfield, Goldfried, Guy, Howard, Jacobson, Jones, Jones, Jones, Jones, Jones, Klein, Krupnick, Lambert, Markowitz, Markowitz, Milrod, Milrod, Milrod, Milrod, Orlinsky, Otto, Persons, Peterson, Reiss, Shear, Shear, Shear, Shear, Shear, Sifneos, Swenson, Westen, Wiborg",2006.0,,0,0,
7807,"Tryptophan hydroxylase and serotonin transporter gene polymorphism does not affect the diagnosis, clinical features and treatment outcome of panic disorder in the Korean population.","Panic disorder may be associated with defective serotonin (5-HT) neurotransmission. This study was to investigate the association between the tryptophan hydroxylase (TPH) gene and a serotonin transporter gene promoter polymorphism (5-HTTLPR), with panic disorder in a Korean population. 244 Korean patients with panic disorder and the 227 controls were genotyped by a polymerase chain reaction-based method. The severity of panic disorders was assessed by number of panic attacks during the previous 1 month, as well as scores for anticipatory anxiety, panic distress, and agoraphobic distress, as determined by a visual analogue scale (VAS). All the subjects completed the assessment measures including Spielberger State-Trait Anxiety Inventory-State (STAI-S), Spielberger State-Trait Anxiety Inventory-Trait (STAI-T), Beck Depression Inventory (BDI), Symptom Checklist-90-Revised (SCL-90-R), Revised Anxiety Sensitivity Index (ASI-R), Clinical Global Impression Scale - Severity of Illness (CGI-S), Panic Disorder Severity Scale (PDSS), and the Hamilton Depression Rating Scale (HAMD). Responder analyses were conducted based on changes in CGI-I scores after 10 weeks of treatment. We found no significant differences in the genotype and allele frequencies in TPH A218C and 5-HTTLPR polymorphisms between the panic patients and the control group. Subgroup analyses in terms of comorbidities, response, and other primary clinical variables, indicated no differences in these polymorphisms. Our findings suggest that the TPH A218C polymorphism and 5-HTTLPR play no significant roles in the pathogenesis and clinical symptomatologies, at least in a Korean population. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kim, Won; Choi, Young Hee; Yoon, Kyung-Sik; Cho, Dae-Yeon; Pae, Chi-Un; Woo, Jong-Min; Beck, Blondal, Breier, Brown, Cassano, Charney, Crowe, Deckert, Fehr, Greenberg, Hamilton, Hamilton, Heils, Heinz, Ishiguro, Kendler, Kim, Lesch, Lesch, Maron, Matsushita, Mazzanti, Nakamura, Noyes, Olesen, Patel, Perna, Perna, Reich, Rodonto, Sand, Scheibe, Serretti, Shear, Skre, Spielberger, Taylor, Torgerson, Vollrath, Walther, Weissman, Zanardi",2006.0,,0,0,
7808,The effect of doxapram on brain imaging in patients with panic disorder.,"Administration of doxapram hydrochloride, a respiratory stimulant, is experienced by panic disorder patients to be similar to panic attacks but has reduced emotional effect in normal volunteers, thus providing a laboratory model of panic for functional imaging. Six panic patients and seven normal control subjects underwent positron emission tomography with 18F-deoxyglucose imaging after a single-blinded administration of either doxapramor a placebo saline solution. Saline and doxapram were administered on separate days in counterbalanced order. Patients showed a greater heart rate increase on doxapram relative to saline than controls, indicating differential response. On the saline placebo day, patients had greater prefrontal relative activity than controls. In response to doxapram, patients tended to decrease prefrontal activity more than controls, and increased cingulate gyrus and amygdala activity more than controls. This suggests that panic disorder patients activate frontal inhibitory centers less than controls, a tendency that may lower the threshold for panic. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Garakani, Amir; Buchsbaum, Monte S; Newmark, Randall E; Goodman, Chelain; Aaronson, Cindy J; Martinez, Jose M; Torosjan, Yuliya; Chu, King-Wai; Gorman, Jack M; Abelson, Abelson, Abelson, Abelson, Anand, Armony, Bechara, Bisaga, Bob, Borg, Bourin, Burki, Cahill, Calverley, Choi, Davis, Dillon, Folgering, Fredrikson, Furmark, Gorman, Gorman, Graeff, Grove, Gutman, Guy, Hariri, Hazlett, Houtman, Kent, Lane, LeDoux, Lee, Liberzon, Maddock, Morris, Nordahl, Nordahl, Prasko, Rauch, Rosenkranz, Sakai, Sakai, Schaefer, Shear, Sullivan, Tabert, Whalen, Winnie, Woods",2007.0,,0,0,
7809,The use of in vivo desensitization for the treatment of a specific phobia of earthworms.,"Graduated in vivo desensitization was used to treat an intense fear of earthworms in a female college student. The participant reported intense physiological anxiety and avoidance behavior in situations where worms could be encountered. Treatment outcome was measured using a behavioral avoidance test (BAT) and the State-Trait Anxiety Inventory (STAI). Exposure therapy sessions required the client to confront a variety of anxiety-producing situations arranged in a hierarchy. Results indicated that at posttreatment the client was able to complete the BAT and was able to complete the fear hierarchy. State anxiety scores as measured by the STAI declined by 50% from pretreatment to posttreatment. In addition, the client reported little subjective anxiety and no avoidance of situations where worms might be present at posttreatment. The client maintained all posttreatment gains at 1-, 5-, and 8-month follow-ups. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Buchanan, Jeffrey A; Houlihan, Daniel; Ayers, Barlow, Burklow, Coldwell, Gasman, Gunnar, Hayes, Haynes, Jones, Menzies, Menzies, Narayana, Ost, Ost, Ost, Ost, Rent, Sanchez, Spielberger, Sturges, White, Wolpe",2008.0,,0,0,
7810,Drumming through trauma: Music therapy with post-traumatic soldiers.,"Combat stress reaction is common among soldiers and can develop to a post-traumatic stress disorder (PTSD). This distressing condition embraces symptoms such as feelings of loneliness and isolation from society, intrusive memories, outbursts of anger and generalized feelings of helplessness. Drumming has been receiving considerable attention in music therapy. Only few references relate to such activity among those who suffer from PTSD, and even fewer relate to combat induced post-traumatic syndrome, none of them empirical. The current study presents music therapy group work with six soldiers diagnosed as suffering from combat or terror related PTSD. Data were collected from digital cameras which filmed the sessions, open-ended in-depth interviews, and a self-report of the therapist. Some reduction in PTSD symptoms was observed following drumming, especially increased sense of openness, togetherness, belonging, sharing, closeness, connectedness and intimacy, as well as achieving a non-intimidating access to traumatic memories, facilitating an outlet for rage and regaining a sense of self-control. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bensimon, Moshe; Amir, Dorit; Wolf, Yuval; Aigen, Amir, Beattie, Behrens, Bensimon, Bernstein, Blades, Blake, Blake, Bodner, Brett, Brown, Burt, Campbell, Carrington, Denzin, Dey, Dixon, Edgerton, Erikson, Fetterman, Gardner, Gardner, Gerson-Kiwi, Guba, Hanna, Hart, Harvey, Herman, Hindley, Jaycox, Johnson, Juslin, Juslin, Kardiner, Kaser, Krumhansl, Kulka, Kvale, Lee, Lee, Lee, Lee, Lincoln, MacKenzie, Mikenas, Moore, Moustakas, Nordoff, Nordoff, Okoreaffia, Orth, Orth, Putilov, Reck, Reuer, Rhodes, Rogers, Rosen, Scherer, Scurfield, Sekeles, Sekeles, Sifneos, Slotoroff, Solomon, Solomon, Solomon, Solomon, Solomon, Solomon, Speed, Stark, Storr, Symonds, Van der Kolk, Van der Kolk, Van der Kolk, Volkman, Walker, Watson, Wigren, Winkelman, Yehuda, Zlotnick",2008.0,,0,0,
7811,Effects of trauma-related audiovisual stimulation on cerebrospinal fluid norepinephrine and corticotropin-releasing hormone concentrations in post-traumatic stress disorder.,"Background: Although elevated concentrations of both corticotropin-releasing hormone (CRH) and norepinephrine are present in the cerebrospinal fluid (CSF) of patients with post-traumatic stress disorder (PTSD), the effects of exposure to traumatic stimuli on these stress-related hormones in CSF are unknown. Methods: A randomized, within-subject, controlled, cross-over design was used, in which patients with war-related PTSD underwent 6-h continuous lumbar CSF withdrawal on two occasions per patient (6-9 weeks apart). During one session the patients watched a 1-h film containing combat footage (traumatic film) and in the other a 1-h film on how to oil paint (neutral film). At 10-min intervals, we quantified CRH and norepinephrine in CSF, and ACTH and cortisol in plasma, before, during, and after symptom provocation. Subjective anxiety and mood were monitored using 100-mm visual analog scales. Blood pressure and heart rate were obtained every 10min from a left leg monitor. Results: Eight of 10 patients completed two CSF withdrawal procedures each. A major drop in mood and increases in anxiety and blood pressure occurred during the traumatic relative to the neutral videotape. CSF norepinephrine rose during the traumatic film relative to the neutral videotape; this rise directly correlated with magnitude of mood drop. In contrast, CSF CRH concentrations declined during the trauma-related audiovisual stimulus, both absolutely and relative to the neutral stimulus; the magnitude of CRH decline correlated with degree of subjective worsening of anxiety level and mood. Plasma cortisol concentrations were lower and ACTH levels similar during the stress compared with the neutral videotape. Conclusions: CSF concentrations of the stress hormones norepinephrine and CRH differentially change after exposure to 1h of trauma-related audiovisual stimulation in chronic, combat-related PTSD. While the CSF norepinephrine increase was postulated, the decline in CSF CRH levels is surprising and could be due to audiovisual stress-induced increased uptake of CSF CRH into brain tissue, increased CRH utilization, increased CRH degradation, or to an acute stress-related inhibition or suppression of CRH secretion. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Geracioti, Thomas D Jr.; Baker, Dewleen G; Kasckow, John W; Strawn, Jeffrey R; Mulchahey, J. Jeffrey; Dashevsky, Boris A; Horn, Paul S; Ekhator, Nosakhare N; Abelson, Aitken, Baker, Baker, Blake, Bouwer, Brandstadter, Bremner, Bremner, Calogero, De Kloet, De Kloet, Dunn, Forray, Geracioti, Geracioti, Geracioti, Geracioti, Gesing, Gold, Hamilton, Hill, Jedema, Keane, Kolassa, Lavicky, Liberzon, Meewisse, Melia, O'Donnell, Olsen, Orr, Pacak, Pitman, Plotsky, Raskind, Raskind, Reyes, Sautter, Southwick, Spencer, Strawn, Strawn, Vaiva, Valentino, Vilming, Vythilingam, Westrin, Wheler, Wong, Yehuda, Yehuda, Zarkovic`, Ziegler, Zorrilla",2008.0,,0,0,
7812,EMDR treatment of distressful experiences that fail to meet the criteria for PTSD.,"Eye movement desensitization and reprocessing (EMDR) is thought to successfully treat not only posttraumatic stress disorder (PTSD) but also other psychiatric disorders and mental health problems inasmuch as these have experiential contributions. This randomized clinical trial investigated the effects of treatment of distressful experiences (or small ""t"" trauma) that fail to meet the criteria for PTSD. Three hours of a slightly adapted form of EMDR were compared to active listening (attentional placebo, also 3 hours) and wait list. Results with 90 participants showed that EMDR produced significantly lower scores on the Impact of Event Scale than active listening or wait list. EMDR also resulted in a significantly smaller increase on the State-Trait Anxiety Inventory (State subscale) after memory recall. Some limitations and implications of findings are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cvetek, Robert; Andrade, Bisson, Bohart, Chambless, Chemtob, Corcoran, Cvetek, Devilly, DiGiorgio, Dworkin, Gilligan, Gostecnik, Horowitz, Jensen, Kaslow, Kavanagh, Kompan-Erzar, Lamovec, Lee, Levin, Manfield, Marcus, Maxfield, Mol, Prochaska, Protinsky, Rauch, Repic, Rothbaum, Sack, Scheck, Seligman, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Sharpley, Shin, Smyth, Snyker, Spielberger, Sprang, Stickgold, Taylor, Van den Hout, Van der Kolk, Van der Kolk, Van der Kolk, Van der Kolk, Van der Kolk, Van der Kolk, Wachtel, Wilson, Wilson, Wilson, ZShapiro",2008.0,,0,0,
7813,Preliminary evidence for the efficacy of EMDR in treating generalized anxiety disorder.,"This preliminary study sought to evaluate the potential effectiveness of eye movement desensitization and reprocessing (EMDR) as a treatment modality for generalized anxiety disorder (GAD). Using a single-case design with multiple baselines across four subjects, the effectiveness of 15 EMDR sessions was evaluated. Results indicate that subsequent to targeting the experiential contributors to GAD and the current and anticipated situations that caused excessive worry, the scores of anxiety and of excessive worry dropped to levels below diagnostic threshold and in two cases to full remission of GAD symptoms. At both posttreatment and at 2 months follow-up, all four participants no longer presented with GAD diagnosis. In addition, time-series analyses (ARMA) indicate statistically significant improvement on both daily measures of worry and anxiety over the course of the EMDR treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gauvreau, Philippe; Bouchard, Stephane; Balcom, Bergmann, Bergmann, Bernstein-Carlson, Bisson, Borkovec, Borkovec, Borkovec, Bourque, Bouvard, Box, Bradley, Breinholtz, Brown, Bruce, Butler, Chorpita, Davidson, De Jongh, Deacon, Dugas, Dugas, Dugas, Dugas, Dugas, Dugas, Dugas, Dugas, Dupuy, First, First, Freeston, Gosselin, Gosselin, Gosselin, Grant, Grenier, Hudson, Kazdin, Kazdin, Korn, Korn, Laberge, Ladouceur, Ladouceur, Ladouceur, Ladouceur, Lytle, Manassis, Marcus, Marcus, Matyas, Maxfield, Maxfield, Mennin, Rapee, Rivard, Roemer, Roemer, Rothbaum, Rubin, Schneider, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Stanley, Stapleton, Stickgold, Van der Kolk, Van der Kolk, Van Etten, Wei, Western, Wilson, Wilson",2008.0,,0,0,
7814,The effectiveness of cognitive behavioral therapy for generalized anxiety disorder in a frontline service setting.,"The goal of the current study was to test the generalizability of cognitive behavioral therapy (CBT) for generalized anxiety disorder (GAD) in a frontline service setting. Twenty-nine patients who presented to treatment clinics with problematic worry were provided CBT for GAD. Among the intent-to-treat sample, there were no significant changes in worry or depression from pre- to posttreatment. Treatment completers showed significant pre- to posttreatment reductions on measures of worry and depression. The magnitude of change was smaller than has been reported in randomized control trials (RCTs). Although the frontline service setting differed from RCT settings in multiple ways, treatment completers nonetheless achieved moderate to large decreases in self-reported worry and depression. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kehle, Shannon M; Addis, Addis, Barlow, Beck, Beck, Behar, Borkovec, Borkovec, Borkovec, Borkovec, Brown, Butler, Chambless, Cohen, DeRubeis, Foa, Franklin, Goldfried, Hahlweg, Kopta, Lincoln, McFall, Meyer, Stuart, Wade, Westbrook, Westen, Wilson",2008.0,,0,0,
7815,Safety behaviour does not necessarily interfere with exposure therapy.,"There has been much recent controversy regarding whether or not the use of safety and other neutralizing behaviour interferes with exposure-based therapy. The aim of this study was to examine the role of safety behaviour in the treatment of specific phobia. Sixty-two snake-fearful participants were randomized to a 45-min exposure session with or without the use of safety gear, such as gloves and goggles. During the treatment, participants in the safety behaviour group were able to achieve a significantly closer initial distance of approach to the snake compared to controls. When tested post-treatment without any safety gear, both groups demonstrated comparable treatment gains involving significant reductions in fearful cognitions and subjective anxiety, as well as significant improvements in distance of approach. Results suggest that reliance on safety behaviour during exposure therapy for anxiety disorders may not interfere with treatment outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Milosevic, Irena; Radomsky, Adam S; Bandura, Barlow, Beck, Beck, Behar, Bouchard, Carter, Chambless, Choy, Clark, Craske, Craske, de Silva, Deacon, Foa, Foa, Hofmann, Johnstone, Kessler, Kim, Marks, Mowrer, Mowrer, Muris, Otto, Powers, Rachman, Rachman, Rachman, Radomsky, Salkovskis, Salkovskis, Salkovskis, Sartory, Schmidt, Sloan, Steer, Szymanski, Tang, Thwaites, Thyer, Tryon, Wolpe, Ost",2008.0,,0,0,
7816,A multi-session interpretation modification program: Changes in interpretation and social anxiety symptoms.,"Previous research suggests that socially anxious individuals interpret ambiguous social information in a more threatening manner compared to non-anxious individuals. Recently, studies have experimentally modified interpretation and shown that this subsequently affected anxiety in non-anxious individuals. If similar procedures can modify interpretation biases in socially anxious individuals, they may lead to a reduction in social anxiety symptoms. In the current study, we examined the effect of a computerized Interpretation Modification Program (IMP) on interpretation bias and social anxiety symptoms. Twenty seven socially anxious individuals were randomly assigned to the IMP or a control condition. Participants completed eight computer sessions over four weeks. The IMP modified interpretation by providing positive feedback when participants made benign interpretations and negative feedback in response to threat interpretations. The IMP successfully decreased threat interpretations, increased benign interpretations, and decreased social anxiety symptoms compared to the control condition. Moreover, changes in benign interpretation mediated IMP's effect on social anxiety. This initial trial suggests that interpretation modification may have clinical utility when applied as a multi-session intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Beard, Courtney; Amir, Nader; Amir, Beck, Clark, Constans, Cox, Franklin, Gillis, Grey, Hirsch, Hirsch, Hofmann, Holmes, Huppert, MacKinnon, MacKinnon, MacKinnon, Macleod, Mathews, Mathews, Murphy, Rapee, Roth, Salemink, Salemink, Sobel, Spielberger, Stopa, Turner, Turner, Voncken, Wilson, Yiend",2008.0,,0,0,
7817,Posttraumatic stress disorder and social support in female victims of sexual assault: The impact of spousal involvement on the efficacy of cognitive-behavioral therapy.,"The goal of this study is to enhance the efficacy of CBT with victims of sexual assault suffering from PTSD by getting the spouse involved. Thus, in addition to attempting to reduce PTSD symptoms, the therapy focuses on improving the support offered by the spouse and favors management of the impact of the traumatic event within the couple. A single-case, multiple-baseline across-subjects design is used. Three victims of sexual assault with a diagnosis of PTSD participated in the study. Results at posttreatment and at 3-month follow-up are promising. None of the participants presents a diagnosis of PTSD, and all report a significant improvement in their satisfaction with the support received from their spouses. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Billette, Valerie; Guay, Stephane; Marchand, Andre; Barker, Barlow, Beck, Bisson, Bradley, Breslau, Brewin, Brown, Byrne, Campbell, Coyne, Davis, Denkers, DeRubeis, Descutner, Falsetti, Filipas, First, Foa, Foa, Foa, Foa, Foa, Foa, Fontana, Foy, Guay, Guay, Guay, Guay, Halford, Horowitz, Jacobson, Jones, Joseph, Keane, Kessler, Ladouceur, Lawrance, Miller, Norris, Ozer, Primomo, Resick, Riggs, Riggs, Rothbaum, Solomon, St-Jean Trudel, Straus, Tarrier, Tarrier, Taylor, Ullman, Ullman, Ullman, Valentiner, Weiss, Winefield, Wirtz, Zoellner",2008.0,,0,0,
7818,The effect of telephone counselling on reducing posttraumatic symptoms after mild traumatic brain injury: A randomised trial.,"Background: Mild traumatic brain injury (MTBI) is a significant public health problem affecting approximately 1 million people annually in the USA. A total of 10-15% of individuals are estimated to have persistent posttraumatic symptoms. This study aimed to determine whether focused, scheduled telephone counseling during the first 3 months after MTBI decreases symptoms and improves functioning at 6 months. Methods: This was a two-group, parallel, randomised clinical trial with the outcome assessed by blinded examiner at 6 months after injury. 366 of 389 eligible subjects aged 16 years or older with MTBI were enrolled in the emergency department, with an 85% follow-up completion rate. Five telephone calls were completed, individualised for patient concerns and scripted to address education, reassurance and reactivation. Two composites were analysed, one relating to post-traumatic symptoms that developed or worsened after injury and their impact on functioning, the other related to general health status. Results: The telephone counseling group had a significantly better outcome for symptoms (6.6 difference in adjusted mean symptom score, 95% confidence interval (CI) 1.2 to 12.0), but no difference in general health outcome (1.5 difference in adjusted mean functional score, 95% CI 2.2 to 5.2). A smaller proportion of the treatment group had each individual symptom (except anxiety) at assessment. Similarly, fewer of the treatment group had daily functioning negatively impacted by symptoms with the largest differences in work, leisure activities, memory and concentration and financial independence. Conclusions: Telephone counseling, focusing on symptom management, was successful in reducing chronic symptoms after MTBI. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bell, K. R; Hoffman, J. M; Temkin, N. R; Powell, J. M; Fraser, R. T; Esselman, P. C; Barber, J. K; Dikmen, S; Alexander, Alves, Andersson, Bandura, Chen, Dunn, Finkelstein, Glueckauf, Gronwall, Jantzen, Levin, Liss, McAllister, McLean, Miller, Mittenberg, O'Brien, Paniak, Paniak, Patrick, Ponsford, Ponsford, Prochaska, Spitzer, Teasdale, Wade, Wade, Wallenstein, Ware",2008.0,,0,0,
7819,"Rationale, design, and baseline findings from a randomized trial of collaborative care for chronic musculoskeletal pain in primary care.","Objective: This article describes the rationale, design, and baseline findings from an ongoing study of collaborative care for chronic musculoskeletal pain and comorbid depression. Design: Cluster randomized clinical trial. Participants and Setting: Forty-two clinicians and 401 patients from five Veterans Affairs primary care clinics. Intervention: The intervention was based on the chronic care model, and included patient and provider activation and education, patient assessment, outcomes monitoring, and feedback to providers over 12 months. The intervention team consisted of a full-time psychologist care manager and a part-time physician internist. Approaches included goal setting emphasizing function, patient activation and educating about fear avoidance, and care management. Outcome Measures: Main outcomes are Roland-Morris Disability Questionnaire (RMDQ) score, depression severity (Patient Health Questionnaire-9), and pain severity (Chronic Pain Grade Severity subscale) at 6 and 12 months. Baseline Results: Fifteen percent of primary care patients mailed a study advertisement letter requested screening for the study. The mean age of enrolled patients was 62. Back and neck or joint pain diagnoses were present in 67% and 65% of patients, respectively. Mean pain duration was 15 years, and mean RMDQ score (range 0-24) was 14.7 (standard deviation = 4.4). Sixty-five percent of patients were receiving disability. Eighteen percent of patients met criteria for major depression, 17% for posttraumatic stress disorder, and 9% for alcohol misuse. Thirty-nine percent of patients felt strongly that experiencing pain was a sign of damage, and 60% reported strong avoidance of painful activities. Conclusions: These baseline data support the rationale to develop a multifaceted approach to treat chronic pain in primary care that includes detection and treatment of psychiatric comorbidity. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dobscha, Steven K; Corson, Kathryn; Leibowitz, Ruth Q; Sullivan, Mark D; Gerrity, Martha S; Adams, Adamson, Ahles, Bair, Bair, Balderson, Becker, Bodenheimer, Booker, Bradley, Brennan, Brooks, Brugha, Bush, Chabal, Chapman, Chelminski, Cherkin, Clark, Cleeland, Cocco, Cole, Crosby, DeAngelis, DeBattista, Diez-Rous, Dobscha, Dorr, Elliott, Epler, Farrar, Ferrell, Feunekes, Goldstein, Gureje, Haythornthwaite, Hegel, Holmes, Jensen, Katon, Katon, Katzman, Kerns, Kirsch, Knab, Kroenke, Kroenke, Kroenke, Lamers, Levin, Lin, Linzer, Luo, McCracken, McMurray, Ostelo, Patrick, Portenoy, Reid, Roland, Roland, Saint, Sales, Skinner, Sloan, Smith, Snijders, Spitzer, Spitzer, Sternbach, Sullivan, Sullivan, Tait, Tate, Trafton, Trout, Turner, Verhaak, Von Korff, Von Korff, Weathers, Weathers, Weingarten, Weinger, Wells, Williams, Williams, Wright",2008.0,,0,0,
7820,Patient Assisted Computerized Education for Recipients of Implantable Cardioverter Defibrillators (PACER): A randomized controlled trial of the PACER program.,"The implantable cardioverter defibrillator (ICD) is the treatment of choice for preventing and correcting potentially-lethal cardiac arrhythmias. Although its effectiveness is supported by data from several large-scale, randomized clinical trials, its psychological impact is less favorable, mostly because of the shock mechanism by which the device corrects arrhythmias. Patients with ICDs are vulnerable to depression and anxiety, including panic disorder and avoidance behaviors, as a result of device placement and experiencing an ICD shock. There are only a handful of randomized, controlled trials focused on enhancing the psychosocial functioning of ICD recipients. Computers are becoming an increasingly useful tool in providing psychological care due in part to their accessibility, convenience, anonymity, and cost effectiveness. There is ample support for using computerized interventions to successfully treat psychiatric dysfunction, including depression, panic disorder, generalized anxiety, and phobias. There are currently no computerized interventions in the literature aimed at the psychosocial fitness of ICD patients. Our study is a pilot study of a psychoeducational, computerized intervention for ICD recipients entitled Patient Assisted Computerized Education for Recipients of Implantable Cardioverter Defibrillators (PACER). We hypothesized that the PACER program would increase patient knowledge about their ICD, decrease anxiety, and increase device acceptance, as compared to usual care patients. PACER patients were also hypothesized to demonstrated equivalent scores of anxiety, device acceptance, and quality of life compared to patients from a similar, in-person intervention from a related study. Thirty patients were recruited, and half were randomized to the treatment condition. At one-month follow-up, there were no differences in scores between treatment and control patients on an ICD knowledge test. Increases in ICD knowledge were associated with increases in device acceptance, but only among treatment patients. There was no impact of the program on anxiety. Compared to participants from an in-person treatment, PACER patients demonstrated similar scores of mental quality of life and device acceptance, but worse scores of anxiety and physical quality of life. A user survey demonstrated overwhelming support of the PACER program by participants, suggesting the utility of future testing amongst a larger sample. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kuhl, Emily Ann",2008.0,,0,0,
7821,Internet-based self-management of generalised anxiety disorder: A preliminary study.,"Despite the continuing development of effective cognitive and behavioural interventions for Generalised Anxiety Disorder (GAD) less attention has been paid to the important issue of improving treatment accessibility and affordability. Self-management approaches that utilise the convenience of the Internet may provide a means by which more people can avail themselves of effective treatments. To date, studies examining the effectiveness of such approaches for GAD lag behind the work conducted with other clinical problems. This study describes the response of three individuals with a primary diagnosis of GAD to an Internet-based treatment completed at their own pace. The intervention ('What? Me Worry!?!; Saulsman, Nathan, Lim, and Correia, 2005) combines several cognitive and behavioural components with the inclusion of a significant metacognitive component. All participants achieved clinically significant improvement on measures of worry, GAD symptomatology, and metacognitions. Moreover, none of the participants met the diagnostic criteria for GAD at the completion of the study. A larger randomised controlled trial of this intervention is indicated. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Draper, Mark; Rees, Clare S; Nathan, Paula R; Andersson, Andrews, Barlow, Borkovec, Borkovec, Brown, Burhman, Butler, Carlbring, Carlbring, Carlbring, Cartwright-Hatton, Devilly, Durham, Emmelkamp, First, Fisher, Fisher, Gilroy, Gollings, Greist, Griffiths, Jacobson, Kaltenthaler, Katon, Kenardy, Klein, Ladouceur, Low, Meyer, Molina, Newman, Parslow, Richards, Roemer, Roemer, Roemer, Saulsman, Strom, Wagner, Walker, Wells, Wells, Wells, Wells, Wells, Wells, Wells, Wells, Zanarini",2008.0,,0,0,
7822,Cognitive behavioural treatment of perfectionism: A single case experimental design series.,"Perfectionism can maintain depression, anxiety and eating disorders, yet few studies have evaluated treatments for perfectionism. This study examined the effectiveness of individual cognitive behaviour therapy (CBT) in treating perfectionism in four adults with a diagnosis of either an anxiety disorder or depression. The study used an A-B single case experimental design series with follow-up, and a 3-week pre-and postbaseline phase. Treatment involved 8 sessions and a 2-week follow-up session. Visual inspection of data revealed downward trends in overall perfectionism and clinically significant decreases in perfectionism for two participants. No clinically significant reductions were observed in depressive or anxious symptomatology. CBT for perfectionism warrants further investigation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Egan, Sarah J; Hine, Paula; Barlow, Barrow, Beck, Beck, Beck, Beck, Beck, Beck, Beck, Bennett-Levy, Bieling, Blatt, Blatt, Burns, Derogatis, DiBartolo, DiBartolo, Egan, Fairburn, Fairburn, Fennell, Ferguson, Frost, Frost, Fydrich, Glover, Greenberger, Hageman, Hirsch, Jacobson, Pleva, Riley, Salkovskis, Shafran, Shafran, Shafran, Shafran, Sheehan, Sheehan, Steele",2008.0,,0,0,
7823,Treatment of post-traumatic stress disorder with eye movement desensitization and reprocessing: Outcome is stable in 35-month follow-up.,"Post-traumatic stress disorder (PTSD) is an anxiety disorder that may follow major psychological trauma. The disorder is longstanding, even chronic, and there is a need for effective treatment. The most effective short-term treatments are cognitive behavioural therapy and eye movement desensitization and reprocessing (EMDR). Twenty subjects with chronic PTSD following occupational health hazards from ""person under train"" accidents or assault at work were treated with five sessions of EMDR. They were assessed with psychometric scales and diagnostic interviews before treatment, directly after treatment, at 8 months, and at 35 months after the end of Therapy. The primary outcome variable was full diagnosis of PTSD according to the DSM-IV diagnostic criteria. Results from interview-based and self-evaluation psychometric scales were used as secondary outcome variables. Immediately following treatment, the patients were divided up into two groups, initial remitters (12 of 20) and non-remitters (8 of 20). There were no drop-outs during therapy, but three patients withdrew during follow-up. The initial result was maintained at the 35-month follow-up. The secondary outcome variables also showed a significant immediate change towards normality that was stable during the long-term follow-up. After 3 years of follow-up, 83% of the initial remitters had full working capacity. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hogberg, Goran; Pagani, Marco; Sundin, Orjan; Soares, Joaquim; Aberg-Wistedt, Anna; Tarnell, Berit; Hallstrom, Tore; Al-Saffar, Bech, Beck, Bisson, Blanchard, Blanchard, Bradley, Breslau, Burstein, Davidsson, Durham, First, Frans, Hamilton, Hamilton, Herman, Horowitz, Howgego, Hogberg, Jacobson, Janca, Kessler, Macklin, Ormel, Pagani, Pagani, Pitman, Power, Rosen, Shapiro, Tarrier, Tarrier, Van Etten, Wolpe",2008.0,,0,0,
7824,Comprehensive case management for substance abuse clients who have mood or anxiety disorders.,"Background: The Iowa Case Management Project (ICMP) was developed to evaluate the effectiveness of a comprehensive, solution-focused model of case management with rural clients in substance use disorder treatment. Aims: To evaluate the effectiveness of a strengths-based case management model to help clients with and without co-occurring psychiatric disorders reduce substance use and improve psychiatric functioning. Method: Clients admitted to residential or intensive outpatient substance use disorder treatment who volunteered (N = 518), were randomly assigned to one of four research conditions. In three conditions, participants received Iowa Case Management (ICM), while in the fourth condition participants received standard substance use disorder treatment services. Participants completed assessments at intake, three, six and 12 months. Results: A diagnosis of a psychiatric disorder did not impact the effect of case management on substance use, and client substance use decreased significantly in all four conditions, but was not different between groups. Participants without a co-occurring diagnosis had significantly better outcomes at follow-up points compared to those with a co-occurring diagnosis. Conclusion: The findings suggest that strengths-based case management is effective in improving psychiatric functioning among participants without a co-occurring disorder, but not among participants with a co-occurring disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hall, James A; Vaughan-Sarrazin, Mary; Reedy, Amanda R; Huber, Diane L; Aharonovich, Bateman, Bradizza, Bucholz, Bucholz, Derogatis, Dew, Dumaine, Essock, Grella, Hall, Hall, Hall, Hasin, Hillhouse, Hser, Huber, Huber, Hudson, Hwang, Klinkenberg, Kutchins, Lyons, Marcus, McLellan, McLellan, McLellan, Parry, Rapp, Reedy, Ridgely, Ross, Siegal, Slaymaker, Sorensen, Sullivan, Sun, Tiet, Vanderplasschen, Ziedonis",2008.0,,0,0,
7825,A randomised controlled trial of the effectiveness of writing as a self-help intervention for traumatic injury patients at risk of developing post-traumatic stress disorder.,"The study investigated the effects of writing and self-help information on severity of psychological symptoms in traumatic injury patients at risk for developing post-traumatic stress disorder (PTSD). Patients attending Accident and Emergency (A & E), were screened for Acute Stress Disorder and randomised to an information control group (n = 36) or a writing and information group (n = 31). Participants in both groups received an information booklet one-month post-injury. Participants in the writing group also wrote about emotional aspects of their trauma during three 20-min sessions, five to six weeks post-injury. Psychological assessments were completed within one month and at three and six months post-injury. There were significant improvements on measures of anxiety, depression and PTSD over time. Differences between groups on these measures were not statistically significant. However, subjective ratings of the usefulness of writing were high. In conclusion, the results do not currently support the use of writing as a targeted early intervention technique for traumatic injury patients at risk of developing PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bugg, Alison; Turpin, Graham; Mason, Suzanne; Scholes, Cathy; Batten, Bisson, Bisson, Bisson, Brown, Bryant, Bryant, Carlier, Downs, Ehlers, Ekers, Foa, Francis, Gidron, Greenberg, Grey, Hirai, Koopman, Lovell, McNally, Pennebaker, Pennebaker, Rogers, Scholes, Scogin, Sharsky, Sijbrandij, Small, Snaith, Turpin, Weisraeth",2009.0,,0,0,
7826,Sheehan Suicidality Tracking Scale (Sheehan-STS): Preliminary results from a multicenter clinical trial in generalized anxiety disorder.,"Objective: Accurate and prospective assessments of treatment-emergent suicidal thoughts and behaviors are essential to both clinical care and randomized clinical trials. The Sheehan Suicidality Tracking Scale is a prospective, patient self-report or clinician-administered rating scale that tracks both treatment-emergent suicidal ideation and behaviors. The Sheehan Suicidality Tracking Scale was incorporated into a multicenter, randomized, double-blind, placebo-controlled, and active comparator study examining the efficacy of an experimental corticotropin-releasing factor antagonist (BMS-562086) for the treatment of generalized anxiety disorder. Method: The Sheehan Suicidality Tracking Scale was administered to subjects at baseline, Week 2, Week 4, and Week 8 or early termination. Subjects completed the Sheehan Suicidality Tracking Scale by self report. The Sheehan Suicidality Tracking Scale was designated as an exploratory outcome measure in the study protocol, and post-hoc analyses were performed to examine the performance of the Sheehan Suicidality Tracking Scale. Results: A total of 82 subjects completed the Sheehan Suicidality Tracking Scale during the course of the study. Altogether, these subjects provided 297 completed Sheehan Suicidality Tracking Scale ratings across the study time points. Sixty-one subjects (n = 25 placebo, n = 24 BMS- 562086, and n = 12 escitalopram) had a baseline and at least one post-baseline Sheehan Suicidality Tracking Scale measurement. The mean change from baseline at Week 8 in the Sheehan Suicidality Tracking Scale total score was -0.10, -0.02, and -0.06 for escitalopram, placebo, and BMS-562086 groups, respectively. The sensitivity of the Sheehan Suicidality Tracking Scale and HAM-D Item #3 (suicide) for identifying subjects with suicidal thoughts or behaviors was 100 percent and 63 percent, respectively. Conclusions: The Sheehan Suicidality Tracking Scale may be a sensitive psychometric tool to prospectively assess for treatment-emergent suicidal thoughts and behaviors. Despite the small sample size and low occurrence of suicidal ideation during the course of this clinical trial, the self-reported Sheehan Suicidality Tracking Scale demonstrated increased sensitivity over the rater administered HAM-D Item #3 in identifying suicide related ideations and behaviors. Further research in larger study samples as well as in other psychiatric disorders are needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Coric, Vladimir; Stock, Elyse G; Pultz, Joseph; Marcus, Ronald; Sheehan, David V; Bridge, Coric, Erdman, Gibbons, Greist, Hamilton, Hammand, Kaplan, Posner, Sheehan",2009.0,,0,0,
7827,A direct comparison of effect sizes from the clinical global impression-improvement scale to effect sizes from other rating scales in controlled trials of adult social anxiety disorder.,"Objective: The clinical global impression-improvement scale (CGM) is used to monitor treatment outcome in mental disorders. To better understand the properties of the CGI-I scale in social anxiety disorder, effects sizes from the CGI-I scale were compared to comparably calculated effect sizes from other rating scales obtained from double-blind, placebo-controlled trials of selective-serotonin reuptake inhibitors in social anxiety disorder. From peer-reviewed, double-blind, placebo-controlled studies evaluating selective serotonin reuptake inhibitors in social anxiety disorder, we extracted CGI-I data and scores from other assessment scales of severity and function. Using calculations that enabled direct comparisons, effect sizes for the binarily reported CGI-I scores were compared to effect sizes from the quantitative scales. Results: Effect sizes for the binary CGI-I scale were statistically indistinguishable from effect sizes obtained from the other scales, with the exception of the social avoidance and distress scale. Conclusions: The CGI-I scale is an appropriate method of assessing clinical change in trials of social anxiety disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hedges, Dawson W; Brown, Bruce L; Shwalb, David A; Allgulander, Asakura, Baldwin, Beneke, Davidson, Davidson, Davidson, Furmark, Gattaz, Gorman, Guy, Guy, Hedges, Heimberg, Kasper, Kobak, Lader, Leon, Leon, la, Liebowitz, Liebowitz, Sheehan, Sheehan, Silva, Sprott, Stein, Stein, Stein, Steiner, Van Ameringen, Watson, Westenberg",2009.0,,0,0,
7828,Change processes in residential cognitive and interpersonal psychotherapy for social phobia: A process-outcome study.,"The purpose of this study was to test cognitive and interpersonal models for improving social phobia. Eighty patients with social phobia were randomized to 10-week residential cognitive (RCT) or residential interpersonal psychotherapy (RIPT). They completed process measures every Thursday and a sub-outcome measure every Monday. The ratings were analyzed with mixed models. Weekly changes in the process variables derived from the cognitive model (self-focus, estimated probability and estimated cost of negative social events, safety behaviors) predicted subsequent weekly changes in social anxiety. Changes in the interpersonal variable perceived acceptance by others also predicted subsequent changes in social anxiety. On the other hand, changes in social anxiety predicted changes in the four cognitive variables. There were no interactive effects of process with treatment. The cognitive variables decreased during treatment to a similar degree in both treatments. The results indicate that, to reduce social anxiety, therapy should target self-focus, estimated probability and cost of feared social events, safety behaviors, and perceived acceptance by others. The process of improvement may involve positive cycles in that a reduction of social anxiety, in turn, appeared to impact self-focus, probability, cost, and safety behaviors. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hoffart, Asle; Borge, Finn-Magnus; Sexton, Harold; Clark, David M; Alden, Borge, Brown, Clark, Clark, Clark, Clark, First, First, Fitzmaurice, Heimberg, Hofmann, Hofmann, Hofmann, Hofmann, Hollon, Kraemer, Lipsitz, Lipsitz, McManus, Moscovitch, Mortberg, Primakoff, Shrout, Smits, Stangier, Turner, Turner, Vallis, Weissman, Wells, Wells, Wilfley",2009.0,,0,0,
7829,The role of common factors in residential cognitive and interpersonal therapy for social phobia: A process-outcome study.,"This study examined the role of common factors in residential cognitive therapy (RCT) and residential interpersonal therapy (RIPT) for social phobia. Eighty social phobic patients were randomized to 10 weeks of RCT or RIPT. Patients and their individual therapists completed process and sub outcome measures weekly. The ratings were examined using linear mixed models. Most patient-rated process variables showed U-shaped (quadratic) patterns over the course of treatment. Therapist-rated alliance increased linearly. Therapist-rated first-week alliance and empathy predicted improvement in social role security over the course of therapy. The weekly fluctuations in common process predicted subsequent fluctuations in sub outcomes in seven of 10 possible cases, whereas sub outcomes predicted process in four cases. The results support the causal role of common factors. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hoffart, Asle; Borge, Finn-Magnus; Sexton, Harold; Clark, David M; Baldwin, Baron, Borcovec, Bordin, Borge, Burns, Clark, Clark, Clark, Feeley, First, First, Fitzmaurice, Fitzpatrick, Frank, Hoffart, Hollon, Holt, Horvath, Horvath, Joyce, Kirsch, Klein, Kraemer, Lipsitz, Meyer, Muran, Mollersen, Orlinsky, Raue, Rogers, Safran, Safren, Shrout, Tracey, Tschuschke, Turner, Vallis, Wampold, Wilfley, Wilson",2009.0,,0,0,
7830,High worry severity is associated with poorer acute and maintenance efficacy of antidepressants in late-life depression.,"Background: Co-morbid anxiety symptoms are common in late-life depression (LLD) and predict poorer treatment outcomes. No research has delineated the impact of different dimensions of anxiety (such as worry/anxious apprehension and panic/anxious arousal) on treatment response in LLD. We explored the impact of the dimensions of worry and panic on acute and maintenance treatment outcomes in LLD. Methods: We measured anxiety symptoms in 110 LLD subjects receiving protocolized treatment. Exploratory principal component analysis was used to delineate dimensions of anxiety symptoms. We defined subgroups based on factor scores. We used survival analysis to test the association of pretreatment anxiety dimensions with time to response and time to recurrence of LLD. Results: The principal component analysis found two factors: ""worry"" and ""panic."" Three sub-groups were defined: low panic-low worry, low panic-high worry, and high panic-high worry. The low panic-high worry and high panic-high worry sub-groups had longer time to response than the low panic-low worry sub-group. Time to recurrence was longer in low panic-low worry subjects randomized to drug. Among subjects with high worry, there was no difference between those with low versus high panic regarding both time to response and time to recurrence of LLD. Conclusion: High levels of worry were associated with longer time to response and earlier recurrence with pharmacotherapy for LLD. There was no additional effect of panic symptoms on treatment outcomes when accounting for the effects of excessive worry. These results suggest that worry symptoms should be a focus of strategies to improve acute and maintenance treatment response in LLD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Andreescu, Carmen; Lenze, Eric J; Mulsant, Benoit H; Wetherel, Julie Loebach; Begley, Amy E; Mazumdar, Sati; Reynolds, Charles F III; Alexopoulos, Alexopoulos, Alexopoulos, Andreescu, Bae, Beekman, Berkowitz, Bosworth, Clayton, Derogatis, Dew, Dombrovski, Dombrovski, Emmanuel, Faw cett, First, Flint, Flint, Folstein, Gould, Hamilton, Heller, Klerman, Larkin, Lenze, Lenze, Mobbs, Mulsant, Nitschke, Pae, Reynolds, Shafer, Shankman, Steffens, Wetherell",2009.0,,0,0,
7831,Impact of depression on treatment effectiveness and gains maintenance in social phobia: A naturalistic study of cognitive behavior group therapy.,"Background: The impact of depression on cognitive behavioral group therapy (CBGT) for social phobia (SP) in a naturalistic outpatient setting was examined after treatment termination and at 1-year follow-up. Methods: Consecutive SP outpatients (N= 219) were diagnosed using a structured interview. CBGT was provided in 18 1.5-hr weekly sessions. At pretreatment and posttreatment questionnaires and clinician ratings were administered. Self-report measures were obtained at 1-year follow-up. The main outcome measure was the Liebowitz Social Anxiety Scale. Results: CBGT was found to be effective in reducing both social anxiety (effect size = 1.23) as well as depression (effect size = 0.94). Individuals with generalized social phobia (GSP) and individuals with specific social phobia (SSP) differed in their presenting psychopathology and in their response to CBGT Among treatment completers, 44% GSPs and 31% SSPs achieved at least 50% improvement, and 44% GSPs and 81% SSPs reported distress and functioning within the normal range at the end of treatment. Among SPs diagnosed with major depressive disorder (MDD) at the onset of treatment, SP symptoms aggravated during the follow-up period, whereas SPs not diagnosed with MDD experienced a further alleviation ofSP symptoms during follow-up. CBGT provided in a public clinic to non-selected, mostly unmedicated and comorbid patients, is an effective treatment for the majority of SP sufferers. Conclusions: MDD at the onset of CBGT was not associated with poorer treatment response, but predicted exacerbation of SP symptoms following treatment termination. Depressed SPs may need additional intervention to maintain CBGT gains. SSPs may benefit from less intensive CBGT than GSPs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Marom, Sofi; Gilboa-Schechtman, Eva; Aderka, Idan M; Weizman, Abraham; Hermesh, Haggai; Baker, Blanco, Blanco, Blomhoff, Brown, Brown, Cameron, Chambless, Chartier, Clark, Clark, Clark, Dahlke, Davidson, Davidson, deWit, Erwin, Federoff, Feeny, Feske, Fresco, Furmark, Gartlehner, Gaston, Gould, Guy, Hambrick, Haug, Heimberg, Heimberg, Heimberg, Herbert, Hofmann, Hofmann, Hook, Hope, Iancu, Jacobson, Joormann, Kessler, Ledley, Leon, Levin, Liebowitz, Liebowitz, Lincoln, Montgomery, Montgomery, Moscovitch, Mortberg, Otto, Radomsky, Rosser, Scholing, Sheehan, Sheehan, Smits, Stangier, Turk, Turner, Von-Knorring",2009.0,,0,0,
7832,The Clinical Global Impressions scale: Errors in understanding and use.,"Objective: The Clinical Global Impressions Severity and Improvement scales (CGI-S and CGI-I) are widely included as efficacy data in psychopharmacology new drug application submissions. This study was conducted to determine the extent to which clinical trials investigators included information unrelated to efficacy in their CGI ratings. Method: Forty-five principal investigators provided CGI-S and CGI-I ratings of narratives of patients with major depressive disorder or generalized anxiety disorder. Investigators were blindly randomized to receive narratives that either did (experimental) or did not (control) contain indication-unrelated medical or psychiatric adverse events. Investigators then completed a survey assessing CGI-S and CGI-I rating patterns. Results: CGI-S and CGI-I ratings were significantly more severe and less improved when the narratives contained medical and psychiatric adverse events unrelated to the diseases under study (major depressive disorder and generalized anxiety disorder) than when the narratives did not (Ps < .04). In response to the survey, 46% and 56% of investigators reported that a psychiatric adverse event unrelated to the disease under study would not affect their CGI-S and CGI-I ratings, respectively. Although 87% of investigators reported that their CGI-S and CGI-I ratings would not be affected by a medical adverse event, actual CGI-S ratings were significantly more severe when an unrelated medical adverse event was described as occurring than when it was not (P < .03). Conclusion: Clinical trials investigators' inclusion of indication-irrelevant adverse events threatens the validity of the CGI as an efficacy measure and may contribute to failure to detect efficacy signals in psychopharmacology clinical trials. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Busner, Joan; Targum, Steven D; Miller, David S; Beneke, Fava, Green, Guy, Guy, Haro, Kadouri, Khan, Khan, Kinrys, Lieberman, Mallinckrodt, Rapoport, Schmidt, Spearing, Walsh",2009.0,,0,0,
7833,Anxiety and depression in mothers of preterm infants and psychological intervention during hospitalization in neonatal ICU.,"The objective of this study was to evaluate and compare symptoms of anxiety and depression before and after psychological intervention in mothers of babies born preterm with very low birth weight, hospitalized in the Neonatal Intensive Care Unit. Fifty nine mothers, without psychiatric antecedents, were distributed into two groups according to the type of psychological intervention received. Group Gl included 36 mothers who received routine psychological treatment associated with initial structured intake using support materials (video and guidance manual). Group G2 included 23 mothers who received routine psychological intervention without support material. The STAI and BDI, respectively, were used to evaluate maternal indicators of anxiety and depression. The results revealed that both groups showed a reduction in levels of state or trait anxiety and depression after psychological intervention and discharge of the baby from the hospital. In regard to the emotional symptoms at a clinical level, a statistically significant reduction in the level of state-anxiety was verified in G1. The findings confirmed the need for psychological support for mothers of preterm infants and the use of materials focusing on <<prematurity for reduction of the situational anxiety on a clinical level. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Carvalho, Ana Emilia Vita; Linhares, Maria Beatriz Martins; Padovani, Flavia Helena Pereira; Martinez, Francisco Eulogio; Ais, Bracht, Brans, Carvalho, Carvalho, Cockburn, Cunha, Davis, Del Ben, Dobbins, Doering, Gasparetto, Gorenstein, Grimstad, Holmgren, Klaus, Laucht, Levy-Shiff, Linhares, Linhares, Melnyk, Padovani, Pinelli, Poehlmann, Pridham, Scherman, Spielberger, Thurman, Zanardo",2009.0,,0,0,
7834,Preliminary investigation of intolerance of uncertainty treatment for anxiety disorders.,"Intolerance of uncertainty (IU) is the tendency to react negatively to uncertain situations or events, and it has been found to be an important maintaining factor in a number of different anxiety disorders. It is often included as a part of cognitive behavioural interventions for anxiety disorders but its specific contribution to treatment outcome has not been examined. The aim of the present study was to examine the effectiveness of a brief treatment specifically targeting IU in a 25-year-old man with comorbid diagnoses of social phobia, panic disorder, generalised anxiety disorder, major depressive disorder and dysthymia. A single case design series was utilised. Six sessions of individual therapy were provided with symptom measures administered weekly throughout the 3-week baseline, treatment and 1-month post-treatment phase. Clinically significant improvement occurred on measures of IU and social anxiety but not on a general measure of anxiety. The clinical implications of this finding and directions for future research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hewitt, Sarah N; Egan, Sarah; Rees, Clare; Barlow, Beck, Beck, Beck, Buhr, Butzer, Buunk, Corcoran, Cox, Creamer, Devilly, Di Nardo, Dugas, Dugas, Dugas, Dugas, Dugas, Dugas, Dugas, Dugas, Dugas, Freeston, Friend, Fydrich, Hedayati, Hewitt, Holaway, Jacobson, Krohne, Ladouceur, Ladouceur, Ladouceur, Langlois, Norton, Oei, Overton, Rassin, Salkovskis, Smith, Starcevic, Tolin, Watson, Weary",2009.0,,0,0,
7835,The efficacy of pregabalin and benzodiazepines in generalized anxiety disorder presenting with high levels of insomnia.,"The objective of this study was to assess the impact of high levels of insomnia on response to pregabalin (PGB) in patients with generalized anxiety disorder (GAD). Pooled data were analyzed from six double-blind, placebo-controlled, 4- to 6-week trials of outpatients who met the Diagnostic and Statistical Manual of Mental Disorders (fourth edition) criteria for GAD with a minimum Hamilton Rating Scale for Anxiety (HAM-A) score = 18. Response was evaluated for three fixed-dose PGB groups (150, 300-450, 600 mg/day), and for a benzodiazepine group (alprazolam or lorazepam). A 'high-insomnia' subgroup was defined by a baseline HAM for Depression (HAM-D) insomnia factor score greater than 3 (maximum = 6). At baseline, 1002 (54%) patients met the criteria for the high-insomnia subgroup, and 852 (46%) for the low-insomnia subgroup. Mean baseline HAM-A scores were 1-2 points higher in high-insomnia versus low-insomnia patients. In high-insomnia patients, PGB produced significantly greater improvement in HAM-A total scores at last observation carried forward endpoint on 300-450 mg (-13.1 +/- 0.6) and 600 mg (-11.2 +/- 0.5) dose groups compared with placebo (-8.3 +/- 0.5; P < 0.0001 for both comparisons); the improvement on PGB 150 mg was not significant (-9.9 +/- 0.7; P = 0.051). Improvement was significant in the benzodiazepine group (-11.0 +/- 0.6; P < 0.0001). In the high-insomnia subgroup, treatment with PGB significantly (P < 0.001) improved the HAM-D insomnia factor scores on both the 300-450 mg (-2.73) and 600 mg (-2.35) doses, and on benzodiazepines (-2.52) compared with placebo (-1.51); improvement on PGB 150 mg (-1.69) was not significant. Rates of treatment-emergent insomnia were lower on PGB compared with placebo in both the high- and low-insomnia subgroups. In conclusion, PGB was well tolerated, and improved overall anxiety symptoms, while specifically improving insomnia in patients with GAD presenting with high levels of concurrent insomnia. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Montgomery, Stuart A; Herman, Barry K; Schweizer, Edward; Mandel, Francine S; Andrews, Ansseau, Breslau, Dooley, Feltner, Hamilton, Hamilton, Herman, Hindmarch, Johnson, Kroenke, Lipman, Manber, Montgomery, Monti, Ohayon, Olfson, Ormel, Pande, Papadimitriou, Perlis, Perlis, Pohl, Raskin, Rasmussen, Rickels, Spitzer, Staner, Steiger, Taylor, Taylor, Weissman, Wilson, Wittchen, Zee",2009.0,,0,0,
7836,Inpatient treatment for adult survivors of childhood sexual abuse: A preliminary outcome study.,"The objective of this study was to examine the changes in psychiatric symptoms and interpersonal problems in 34 adults with a history of childhood sexual abuse and posttraumatic stress disorder who attended a 3-month inpatient treatment program. Levels of posttraumatic, depressive, and general psychiatric symptoms and interpersonal problems were assessed at pre-care evaluation, admission, discharge, and 1-year follow-up using the Impact of Event Scale, the Beck Depression Inventory, the Symptom Check List 90 Revised, and the Inventory of Interpersonal Problems. Work status was assessed at admission and at follow-up. Significant improvements were seen during treatment on the global scores of all instruments except the Beck Depression Inventory. At follow-up, patients had kept their gains on symptom measures and experienced further progress regarding interpersonal problems. At discharge, 3 of the previously 32 unemployed patients were able to return to work. Patients with comorbid somatization disorder tended to have higher levels of distress and less favorable treatment response. Future studies should include pre- and posttreatment assessment of dissociation to evaluate its association with outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Jepsen, Ellen K. K; Svagaard, Tron; Thelle, Mona I; McCullough, Leigh; Martinsen, Egil W; Allen, Beck, Bills, Browne, Callahan, Cohen, Courtois, Courtois, Derogatis, Ellason, Figueroa, Finestone, Haase, Herman, Herman, Horowitz, Lundqvist, Lundqvist, Mullen, Nelson, Neumann, Newman, Nijenhuis, Pedersen, Peleikis, Polusny, Sachsse, Sheehan, Spinazzola, Stalker, van der Hart, van der Kolk, Wright, Wright, Zlotnick",2009.0,,0,0,
7837,On the neural basis of EMDR therapy: Insights from qEEG studies.,"Eye movement desensitization and reprocessing (EMDR) therapy has been shown by empirical studies to be effective in relief from psychological traumas including posttraumatic stress disorder (PTSD). Several logical concepts regarding the origin of the EMDR effect have been presented, but no detailed neural explanation is available. This lack of a widely accepted scientific explanation for the EMDR effect has led to skepticism about the therapy by many therapists and potential clients. The authors present evidence based primarily on quantitative electroencephalogram studies that the neural basis for the EMDR effect is depotentiation of fear memory synapses in the amygdala during an evoked brain state similar to that of slow wave sleep. These studies suggest that brain stimulation during EMDR significantly increases the power of a naturally occurring low-frequency rhythm in memory areas of the brain, binding these areas together and causing receptors on the synapses of fear memory traces to be disabled. This mechanical change in the memory trace enables it to be incorporated into the normal memory system without the extreme emotions previously associated with it. EMDR is a medical procedure because it changes the physical structure of the brain to modify problematically stored memories. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Harper, Melvin L; Rasolkhani-Kalhorn, Tasha; Drozd, John F; Akirav, Axmacher, Barrowcliff, Bender, Bergmann, Bergmann, Bergmann, Born, Clemens, Corrigan, Dang-Vu, Devinsky, Earnshaw, Foa, Frankland, Gais, Gais, Hasselmo, Hendler, Huang, Holscher, Kalisch, Kattler, Keane, Klee, Konuk, Kopp, Lakatos, Lee, Lin, Lisman, Luo, MacCulloch, Malmivuo, Martin, Maxfield, McCoy, Murburg, Molle, Nader, Niedermeyer, Peigneux, Power, Propper, Rasch, Rasolkhani-Kalhorn, Ribeiro, Rigas, Rubin, Retey, Sah, Schiff, Shapiro, Shapiro, Shapiro, Shapiro, Solomon, Stickgold, Stickgold, Stickgold, Sondergaard, Takashima, Takehara-Nishiuchi, Tononi, Kolk, Kolk, Vyazovskiy, Williams, Wolansky, Wolpe, Wolpe",2009.0,,0,0,
7838,"Sociodemographic, clinical, and treatment characteristics associated with worsened depression during treatment with citalopram: Results of the NIMH STAR*D trial.","Context: Outcomes of antidepressant medication treatment for major depressive disorder include remission, response, and nonresponse. But nonresponse can include depression that worsened over the course of treatment, an outcome that has received scant attention. Objective: To describe baseline sociodemographic, clinical, and treatment characteristics associated with worsened depression during a trial of citalopram. Design, participants, and settings: Open-label clinical trial of 2,876 adult outpatients seen in 18 primary and 23 psychiatric-care settings. Intervention: Citalopram was delivered using measurement-based care and flexible dosing with the aim of achieving symptom remission. Symptom and side effect ratings were obtained at each treatment visit. Main outcome measures: Worsened depression was defined as an exit score >=3 points above the pretreatment (baseline) score on the 16-item QIDS-SR. Baseline sociodemographic, clinical, and treatment characteristics were examined for association with worsened depression. Results: Of 2,864 outpatients who returned for >=2 post baseline visits, 150 (5.2%) had worsened depression at study exit. Baseline characteristics independently associated with increased worsened depression included African-American race (OR = 2.02), having less than a college education (OR = 2.36), posttraumatic stress disorder (OR = 1.78), drug abuse (OR = 1.97), hypochondriasis (OR = 2.74). Participants with worsened depression spent less time in treatment; had fewer treatment visits; exited the study sooner; had more frequent, intense, and burdensome adverse effects; and were more intolerant of medication. Conclusions: The presence of certain baseline characteristics indicated a greater likelihood of worsened depression during antidepressant treatment. Patients with these characteristics should be monitored closely during treatment and may be candidates for more aggressive treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Friedman, Edward S; Wisniewski, Stephen R; Gilmer, William; Nierenberg, Andrew A; Rush, A. John; Fava, Maurizio; Zisook, Sidney; Balasubraman, G. K; Trivedi, Madhukar H; Adler, Brady, Brown, Cusin, Davidson, Fava, Fava, Fava, Fava, Foa, Foa, Hamilton, Hamilton, Isaacs, Judd, Kessler, Khan, Koran, Kranzler, Krueger, Linn, Lorant, Miller, Mrazek, Nierenberg, Novick, Paykel, Rush, Rush, Rush, Rush, Rush, Rush, Rush, Schraufnagel, Trivedi, Trivedi, Unutzer, Wisniewski, Wisniewski, Zimmerman, Zimmerman",2009.0,,0,0,
7839,A randomized pilot study of motivation enhancement therapy to increase utilization of cognitive-behavioral therapy for social anxiety.,"Despite the efficacy of cognitive-behavioral therapy (CBT), most socially anxious individuals do not seek treatment or seek treatment only after many years of suffering. This study evaluated the efficacy of a three-session motivation enhancement therapy (MET) designed to increase CBT utilization among socially anxious individuals. Twenty-seven non-treatment-seeking socially anxious individuals (92.6% met current DSM-IV criteria for social anxiety disorder) were randomly assigned to either MET for CBT (n = 12) or a control condition (n = 15). The primary outcome was attendance at first CBT appointment. Secondary outcomes included openness to therapist contact and willingness to schedule a CBT appointment. After the intervention, seven of the 12 (58.3%) participants in the MET condition attended a CBT appointment compared to two of 15 (13.3%) control participants. Eight of 11 (72.7%) participants in the MET condition indicated they would like a CBT therapist to contact them compared to four of 12 (33.3%) controls. Further, willingness to schedule a CBT appointment increased at a significantly greater rate in the MET condition. Results suggest MET for CBT may be a time-efficient means to increase CBT utilization among socially anxious individuals. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Buckner, Julia D; Schmidt, Norman B; Buckner, DiNardo, Dozois, Grant, Heimberg, Heimberg, Huppert, Kessler, Liebowitz, Maltby, Mattick, McConnaughy, Miller, Miller, Moyers, Moyers, Olejnik, Olfson, Pierson, Rickwood, Rodebaugh, Vogel, Westra, Westra, Westra",2009.0,,0,0,
7840,Computer-aided self-exposure therapy for phobia/panic disorder: A pilot economic evaluation.,"Phobia/panic disorder is common. It improves with exposure therapy, even when guided mainly by a computer self-help system such as FearFighter (FF), but such therapy must also demonstrate cost-effectiveness. This study compares the cost-effectiveness of FF with computed-aided relaxation and clinician-led exposure. Data were obtained on patients from a randomized controlled trial of FF. Economic analyses used pretreatment and 1-month follow-up self-ratings of the main problem and global phobia. Clinician costs were calculated using the number of therapist hours and the cost of FF. Incremental cost-effectiveness ratios were calculated and cost-effectiveness acceptability curves were produced. Data were available on 62 patients with main problem ratings and 60 with global phobia ratings. FF and clinician-led exposure were more effective than relaxation but more expensive. Compared with relaxation, producing an extra unit of improvement on the main problem scale cost 4 with FF and 00 with clinician-led exposure. FF appeared to be more cost-effective using the global phobia rating (12 per extra unit of improvement vs. 28 for clinician-led exposure). The cost-effectiveness of FF could be enhanced if users had less highly trained supporters. FF would be less cost-effective if face-to-face therapy was delivered by less qualified professionals. Caution is urged regarding these indicative findings given that these were secondary analyses. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","McCrone, Paul; Marks, Isaac M; Mataix-Cols, David; Kenwright, Mark; McDonough, Michael; Alkubaisy, Batelaan, Curtis, Everitt, Everitt, Fava, Ghosh, Ginsberg, Ginsberg, Heuzenroeder, Katon, Marks, Marks, Marks, Marks, Mavissakalian, McCrone, McCrone, McCrone, McKenzie, Newman, Schneider, Spek",2009.0,,0,0,
7841,A therapist-assisted Internet-based CBT intervention for posttraumatic stress disorder: Preliminary results.,"Posttraumatic stress disorder (PTSD) is a debilitating mental health condition frequently associated with psychiatric comorbidity and diminished quality of life, and it typically follows a chronic, often lifelong, course. Previous research has shown that trauma-related psychopathology (but not necessarily clinical PTSD) can be effectively treated via the Internet. This study is the first of its kind to report on the online treatment of patients with a Diagnostic and Statistical Manual of Mental Disorders (fourth edition) clinical diagnosis of PTSD with therapist support by e-mail only. Preliminary findings are presented of an open trial involving a 10-week Internet-based therapist-assisted cognitive behavioral treatment for PTSD (PTSD Online). Pre and posttreatment measures of PTSD and related symptomatology were compared for 16 participants with a variety of trauma experiences. Participants showed clinically significant reductions in PTSD severity and symptomatology, moderate tolerance of the program content, and high therapeutic alliance ratings. No significant change was found on measures of more general psychological symptoms. The results suggest that PTSD Online appears to be an effective and accessible clinical treatment for people with a confirmed PTSD diagnosis. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Klein, Britt; Mitchell, Joanna; Gilson, Kathryn; Shandley, Kerrie; Austin, David; Kiropoulos, Litza; Abbott, Jo; Cannard, Gwenda; Andersson, Barak, Bassler, Blake, Blake, Blanchard, Borkovec, Brown, Brown, Carlbring, Carlson, Christensen, Cohen, Cox, Davidson, Devilly, Devilly, Foa, Foa, Harvey, Henderson, Hirai, Horowitz, Jacobson, Kessler, Kiropoulos, Klein, Klein, Klein, Klein, Knaevelsrud, Lange, Lange, Lange, Lecrubier, Litz, Lovibond, Luborsky, McDonagh, Neal, Novaco, Norholm, Perini, Pier, Proudfoot, Richards, Ruggiero, Shandley, Sheehan, Spek, Weathers, Weathers, Wells",2009.0,,0,0,
7842,Treatment presentation and adherence of Iraq/Afghanistan era veterans in outpatient care for posttraumatic stress disorder.,"[Correction Notice: An erratum for this article was reported in Vol 7(3) of Psychological Services (see record 2010-17074-002). The copyright for the article was listed incorrectly. This article is in the Public Domain. The online version has been corrected.] The ongoing wars in Afghanistan (Operation Enduring Freedom or OEF) and Iraq (Operation Iraqi Freedom or OIF) make the development and application of effective postdeployment mental health treatment programs a high priority. There has been some concern that existing treatment programs for combat-related posttraumatic stress disorder (PTSD) may not fit well with OEF/OIF veterans confronted with acute mental health difficulties while reestablishing community, familial, and occupational connections after their deployment. This study utilized data gathered from a large outpatient Veterans Affairs Medical Center PTSD treatment clinic to examine differences in initial treatment presentation and treatment adherence (attendance and dropout) between a group of Vietnam era veterans (n = 54) and a group of OEF/OIF veterans (n = 106). OEF/OIF veterans reported lower levels of symptom distress on questionnaires assessing posttraumatic reexperiencing, avoidance, dissociation, and arousal symptoms but similar levels of anger and acting out behaviors and higher levels of alcohol problems. OEF/OIF veterans had significantly lower rates of session attendance and higher rates of treatment dropout than Vietnam veterans, and this difference was not accounted for by differences in treatment presentation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Erbes, Christopher R; Curry, Kyle T; Leskela, Jennie; Babor, Bradley, Briere, Briere, Elhai, Erbes, Erbes, Foa, Fontana, Hoge, Kessler, Kulka, McDevitt-Murphy, Miller, Milliken, Monson, Prigerson, Ramchand, Reis, Resick, Rosenheck, Runtz, Schnurr, Schnurr, Skevington, Weathers",2009.0,,0,0,
7843,Mechanisms of efficacy of CBT for Cambodian refugees with PTSD: Improvement in emotion regulation and orthostatic blood pressure response.,"Based on the results of a randomized controlled trial, we examined a model of the mechanisms of efficacy of culturally adapted cognitive-behavior therapy (CBT) for Cambodian refugees with pharmacology-resistant posttraumatic stress disorder (PTSD) and comordid orthostatic panic attacks (PAs). Twelve patients were in the initial treatment condition, 12 in the delayed treatment condition. The patients randomized to CBT had much greater improvement than patients in the waitlist condition on all psychometric measures and on one physiological measure the systolic blood pressure response to orthostasis (d = 1.31) as evaluated by repeated-measures MANOVA and planned contrasts. After receiving CBT, the Delayed Treatment Group improved on all measures, including the systolic blood pressure response to orthostasis. The CBT treatment's reduction of PTSD severity was significantly mediated by improvement in orthostatic panic and emotion regulation ability. The current study supports our model of the generation of PTSD in the Cambodian population, and suggests a key role of decreased vagal tone in the generation of orthostatic panic and PTSD in this population. It also suggests that vagal tone is involved in emotion regulation, and that both vagal tone and emotion regulation improve across treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hinton, Devon E; Hofmann, Stefan G; Pollack, Mark H; Otto, Michael W; Blechert, Casey, Coupland, Cysarz, First, Gratz, Hackmann, Hinton, Hinton, Hinton, Hinton, Hinton, Hinton, Hinton, Hinton, Hughes, Kiernan, Mennin, Mollica, Nickel, Orr, Otto, Peckerman, Porges, Rodriguez de la Torre, Rottenberg, Sack, Shear, Thayer, Tull, Den Berg, Weathers",2009.0,,0,0,
7844,The short- and long-term effect of duloxetine on painful physical symptoms in patients with generalized anxiety disorder: Results from three clinical trials.,"Generalized anxiety disorder (GAD) is associated with painful physical symptoms (PPS). These post hoc analyses of previous trial data assessed PPS and their response to duloxetine treatment in GAD patients. Studies 1 and 2 (n =840) were 9- to 10-week efficacy trials; study 3 (n =887) was a relapse prevention trial comprising a 26-week open-label treatment phase and a 26-week double-blind, placebo-controlled treatment continuation phase. Mean baseline visual analog scale scores (VAS, 0-100; n =1727) ranged from 26 to 37 for overall pain, headache, back pain, shoulder pain, interference with daily activities, and time in pain while awake. In studies 1 and 2, improvement on all VAS scores was greater in duloxetine-treated than in placebo-treated patients (p <=0.01). In study 3, pain symptoms worsened in responders switched to placebo compared with those maintained on duloxetine (p <=0.02). In conclusion, duloxetine was efficacious in the short- and long-term treatment of PPS, which are common in GAD patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Beesdo, Katja; Hartford, James; Russell, James; Spann, Melissa; Ball, Susan; Wittchen, Hans-Ulrich; Ansseau, Arnold, Arnold, Beesdo, Beesdo, Beesdo, Collins, Davidson, DeLoach, Demyttenaere, Farrar, Frohlich, Goldstein, Goldstein, Gureje, Guy, Hamilton, Hartford, Hartford, Hedges, Iyengar, Kessler, Koponen, Lieb, Lipman, McWilliams, McWilliams, Means-Christensen, Nicolini, Olfson, Olfson, Raskin, Raskin, Ruscio, Russell, Russell, Rynn, Sheehan, Stein, Turner, Von Korff, Wernicke, Wittchen, Wittchen, Wittchen, Wittchen, Wong, Zigmond",2009.0,,0,0,
7845,Improving access to psychological therapy: Initial evaluation of two UK demonstration sites.,"Recently the UK Government announced an unprecedented, large-scale initiative for Improving Access to Psychological Therapies (IAPT) for depression and anxiety disorders. Prior to this development, the Department of Health established two pilot projects that aimed to collect valuable information to inform the national roll-out. Doncaster and Newham received additional funds to rapidly increase the availability of CBT-related interventions and to deploy them in new clinical services, operating on stepped-care principles, when appropriate. This article reports an evaluation of the new services (termed 'demonstration sites') during their first thirteen months of operation. A session-by-session outcome monitoring system achieved unusually high levels of pre to post-treatment data completeness. Large numbers of patients were treated, with low-intensity interventions (such as guided self-help) being particularly helpful for achieving high throughput. Clinical outcomes were broadly in line with expectation. 55-56% of patients who had attended at least twice (including the assessment interview) were classified as recovered when they left the services and 5% had improved their employment status. Treatment gains were largely maintained at 10 month follow-up. Opening the services to self-referral appeared to facilitate access for some groups that tend to be underrepresented in general practice referrals. Outcomes were comparable for the different ethnic groups who access the services. Issues for the further development of IAPT are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Clark, David M; Layard, Richard; Smithies, Rachel; Richards, David A; Suckling, Rupert; Wright, Benjamin; Barkham, Catalan, Clark, Clark, Clark, Clark, Clark, Ehlers, Gillespie, Kendrick, Kroenke, Kroenke, Layard, Layard, Posternak, Richards, Richards, Spijker, Spitzer, Tennant",2009.0,,0,0,
7846,"A randomized, controlled clinical trial of standard, group and brief cognitive-behavioral therapy for panic disorder with agoraphobia: A two-year follow-up.","A randomized controlled clinical trial with a wait-list control group was conducted to examine the effectiveness of three modalities (brief, group, and standard) of cognitive-behavioral treatment (CBT) for panic disorder with agoraphobia. A total of 100 participants meeting DSM-IV criteria were randomly assigned to each treatment condition: a 14-session standard CBT (n = 33), a 14-session group CBT (n = 35) and a 7-session brief CBT (n = 32). Participants received a self-study manual and were assigned weekly readings and exercises. The results indicate that regardless of the treatment condition, CBT for moderate to severe PDA is beneficial in medium and long term. To this effect, all three-treatment conditions significantly reduced the intensity of symptoms, increased participants' quality of life, offered high effect sizes, superior maintenance of gains over time, and lower rates of relapse, compared to the wait-list control. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Marchand, Andre; Roberge, Pasquale; Primiano, Sandra; Germain, Vanessa; Austin, Baillie, Barlow, Barlow, Beck, Botella, Bower, Brown, Brown, Chambless, Chambless, Clark, Craske, Craske, Cote, Di Nardo, Duquette, Fava, Foldes-Busque, Galassi, Gauthier, Ghosh, Gould, Gould, Gould, Hafner, Hand, Hecker, Hecker, Heldt, Himadi, Hoffart, Kazdin, Laberge, Lavallee, Lehman, Lidren, Macdonald, Marchand, Marchand, Mattick, Mavissakalian, McCabe, Newman, Penava, Rathus, Reiss, Richter, Roberge, Roberge, Rosenberg, Shear, Stephenson, Stephenson, Stephenson, Swinson, Telch, Tsao, Walker, White",2009.0,,0,0,
7847,Construction and evaluation of a stress management group for patients with bipolar disorder.,"The present study assesses the efficacy of a therapeutic group for patients with bipolar disorder exhibiting a comorbid anxiety disorder. This ""Stress management"" group is conducted using psychoeducation (Bauer and Bride's program). It is based on cognitive behavioural techniques with an important relaxation component. Patients are assessed before with the mini-international neuropsychiatric interview (Mini), before and after with the Beck depression inventory, the Montgomery and Asberg's depression rating scale, the Beck and Rafaelsen's mania assessment scale, the Spielberger's state trait anxiety inventory, the Hamilton's anxiety rating scale, the Cohen and Williamson's perceived stress scale and the 29 items ways of coping checklist from Paulhan et Vitaliano. Results showed a decrease of perceived stress after therapy, development of coping skills focused on problem-solving (improvement in seeking social support, resolution of problems and positive re-evaluation of situations) and a trend of decrease in somatic symptoms of anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dusser, Isabelle; Romo, Lucia; Leboyer, Marion; Basco, Bauer, Beck, Beck, Bouvard, Graziani, Graziani, Guelfi, Hamilton, Hardy-Bayle, Henry, Lam, Lazarus, Lecrubier, Maurel, Mirabel-Sarron, Mirabel-Sarron, Mirabel-Sarron, Mirabel-Sarron, Montgomery, Newman, Paulhan, Rosner, Rouillon, Servant, Spielberger",2009.0,,0,0,
7848,"Randomized, double-blind, placebo-controlled trial of Cimicifuga racemosa (black cohosh) in women with anxiety disorder due to menopause.","Objective: We conducted a randomized, double-blind, placebo-controlled, parallel group trial of the efficacy and tolerability of Cimicifuga racemosa (black cohosh) extract for the treatment of anxiety disorder due to menopause. We hypothesized that black cohosh would be superior to placebo in reducing anxiety symptoms of menopause, with a comparable tolerability profile to placebo. Materials and Methods: Subjects were randomized to therapy with either pharmaceutical-grade black cohosh extract (n=15) or placebo (n=13) for up to 12 weeks. The primary outcome measure was changed over time in total Hamilton Anxiety Rating Scale (HAM-A) scores. Secondary outcomes included a change in scores on the Beck Anxiety Inventory, Green Climacteric Scale (GCS), and Psychological General Well-Being Index (PGWBI) and the proportion of patients with a change of 50% or higher in baseline HAM-A scores. Results: There was neither a significant group difference in change over time in total HAM-A scores (P=0.294) nor a group difference in the proportion of subjects with a reduction of 50% or higher in baseline HAM-A scores at study end point (P=0.79). There was a significantly greater reduction in the total GCS scores during placebo (vs black cohosh; P=0.035) but no group difference in change over time in the GCS subscale scores or in the PGWBI (P=0.140). One subject (3.6%) taking black cohosh discontinued treatment because of adverse events. Conclusions: We found no statistically significant anxiolytic effect of black cohosh (vs placebo). However, small sample size, choice of black cohosh preparation, and dosage used may have been limiting factors producing negative results. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Amsterdam, Jay D; Yao, Yubing; Mao, Jun James; Soeller, Irene; Rockwell, Kenneth; Shults, Justine; Amsterdam, Bair, Beck, Briese, Bukulmez, Burdette, Byrne, Conboy, Davidson, First, Frei-Kleiner, Givens, Givens, Greene, Grossi, Hamilton, Hay, Jacobson, Kronenberg, Li, Maartens, Mao, Maoz, Morelh, Nappi, Newton, O'Connor, Oktem, Osmers, Pagan, Pockaj, Rebbeck, Rickels, Rossouw, Shults, Stoll, Stratton, Tindle, Umland, Wiklund",2009.0,,0,0,
7849,Development of a patient-reported assessment to identify placebo responders in a generalized anxiety disorder trial.,"Placebo response is thought to be a primary contributor to uninformative (failed) trials in clinical drug development. This study describes the development of a patient-reported assessment to detect likely placebo responders. A novel scale, the Placebo Response Screening Scale (PRSS), was developed to assess domains expected to be associated with placebo response. The scale was administered during the screening visit of a 4-week, placebo-controlled study of alprazolam and an investigational compound in 211 patients with generalized anxiety disorder (GAD). Items that predicted placebo response were identified. Sensitivity and specificity of the instrument were used to determine a threshold score for use in screening likely placebo response. The PRSS was then evaluated by comparing active treatment and placebo groups and subsetting the groups based on subject PRSS scores. Twenty items were selected for being predictive of patient global improvement rating, clinician global improvement rating, or improvement on Hamilton Rating Scale for Anxiety (HAM-A) scores in placebo-arm patients. Receiver operating characteristic concordance values ranged from 0.77 to 0.96 for the different definitions of placebo responder. A cut-score of 50 on a scale of 0-100 was chosen to maximize sensitivity (range 0.67-0.79) and specificity (range 0.78-1.00). Fifty-six patients with scores of 50 or higher were flagged as potential placebo responders. Excluding these 56 patients from the analysis resulted in a greater separation of active treatment from placebo. The PRSS is a promising tool for predicting placebo response in clinical trials and requires further use and validation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Feltner, Douglas; Hill, Cheryl; Lenderking, William; Williams, Valerie; Morlock, Robert; Benedetti, Colloca, De Pacalis, Evans, Geers, Goebel, Green, Guy, Hamilton, Horvath, Hyland, Khan, Khan, Khan, Kirsch, Kirsch, Krell, Lecrubier, Lipman, McNair, Mundt, Pande, Pollo, Posternak, Price, Raskin, Schweizer, Shapiro, Stein, Stewart-Williams, Trivedi, Whalley, Zimbroff",2009.0,,0,0,
7850,"Feasibility, compliance and information content of an ecological momentary assessment approach in patients with panic disorder and agoraphobia.","Background: Ecological Momentary Assessment (EMA) describes an ambulatory assessment strategy for collecting information on psychological variables in an individual's natural environment. Although this research tool provides methodological advantages, clinical studies using EMA are relatively rare. Aims: Assessment of feasibility, reactivity, and information content of EMA compared to questionnaire measures. Method: 21 subjects with panic disorder and agoraphobia in a clinical trial on therapy preparation during a cognitive-behavioral therapy (CBT) waiting list were randomized to an intervention and a control group. Prior to and after waiting, all patients were assessed with disorder-specific questionnaires and participated in a 1 week EMA period. Results: Response rates (87 %) demonstrated high acceptance of EMA, but there was evidence for sample selection effects. Reactivity effects were rarely found. Data analyses showed a considerable information gain compared to questionnaire measures concerning descriptive data as well as group comparisons. Conclusion: Due to its feasibility and its ecological validity, EMA can be endorsed as an important tool for clinical research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Helbig, Sylvia; Lang, Thomas; Swendsen, Joel; Hoyer, Jurgen; Wittchen, Hans Ulrich; Barlow, Barrett, Baumann, Bolger, Broderick, Buhringer, Carels, Cruise, Dale, Ehlers, Fahrenberg, Fahrenberg, Gloster, Greeno, Hedges, Helbig, Hox, Hoyer, Hufford, Jamison, Johnson, Kamarck, Kraemer, Lopez, Margraf, Michel, Mussgay, Nisbett, Perrez, Piasecki, Ptacek, Raudenbush, Regier, Samo, Schwartz, Shear, Shiffman, Shiffman, Shiffman, Stein, Stone, Stone, Stone, Swendsen, Wittchen",2009.0,,0,0,
7851,Mechanism of action in CBT (MAC): Methods of a multi-center randomized controlled trial in 369 patients with panic disorder and agoraphobia.,"Cognitive behavioral therapy (CBT) is efficacious for panic disorder with agoraphobia (PD/A). Nevertheless, the active ingredients of treatment and the mechanisms through which CBT achieves its effects remain largely unknown. The mechanisms of action in CBT (MAC) study was established to investigate these questions in 369 patients diagnosed with PD/A. The MAC study utilized a multi-center, randomized controlled design, with two active treatment conditions in which the administration of exposure was varied, and a wait-list control group. The special feature of MAC is the way in which imbedded experimental, psychophysiological, and neurobiological paradigms were included to elucidate therapeutic and psychopathological processes. This paper describes the aims and goals of the MAC study and the methods utilized to achieve them. All aspects of the research design (e.g., assessments, treatment, experimental procedures) were implemented so as to facilitate the detection of active therapeutic components, and the mediators and moderators of therapeutic change. To this end, clinical, behavioral, physiological, experimental, and genetic data were collected and will be integrated. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gloster, A. T; Wittchen, H. U; Einsle, F; Hofler, M; Lang, T; Helbig-Lang, S; Fydrich, T; Fehm, L; Hamm, A. O; Richter, J; Alpers, G. W; Gerlach, A. L; Strohle, A; Kircher, T; Deckert, J; Zwanzger, P; Arolt, V; Alpers, Andor, Arch, Arch, Baker-Morrissette, Bandelow, Barlow, Beck, Blumel, Bond, Chambless, Chambless, Craig, Craske, Craske, Crawford, Davis, Deckert, Derogatis, Domschke, Domschke, Domschke, Gloster, Gloster, Gorman, Gorman, Guy, Hamilton, Hayes, Hofmann, Hueweler, Koch, Lang, Lonsdorf, McHugh, Melzig, Neudeck, Rabin, Radomsky, Reiss, Richard, Shadish, Shear, Sheehan, Wittchen, Wittchen",2009.0,,0,0,
7852,A validation study of the Alcohol Dependence Scale.,"Objective: The primary purpose of this study was to provide a comprehensive assessment of the underlying factor structure of the Alcohol Dependence Scale (ADS). Secondary goals included assessing concurrent validity of the total ADS and subscales derived from the factor analyses with variables related to alcohol dependence and further evaluating the validity of two proposed dichotomously scored, reduced-item ADS measures. Method: Responses to the ADS were obtained from participants who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for alcohol dependence in two large randomized clinical trials: COMBINE (Combining Medications and Behavioral Interventions Study; n = 1,335; 69% male) and Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity; n = 1,666; 75% male). Both exploratory and confirmatory factor analyses were conducted, and validity coefficients were obtained. Results: Across samples, analyses supported a correlated, three-factor solution representing loss of behavioral control and heavy drinking, obsessive-compulsive drinking style, and psychoperceptual and psychophysical withdrawal. The ADS was significantly related to other measures of severity of dependence, craving for and preoccupation with drinking, temptation to drink and confidence in the ability to not drink in high-risk relapse situations, heavy and sustained drinking patterns, concerns about negative alcohol-related consequences, and awareness of problematic drinking. Conclusions: These findings support a three-factor solution for the ADS and its ability to assess the construct of alcohol dependence in a reliable and valid manner. The 12-item reduced ADS measure (reflecting mostly dependence-related items), as opposed to the 9-item reduced ADS measure (generally excessive drinking items), provided validity coefficients comparable to the total, 25-item ADS. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Doyle, Suzanne R; Donovan, Dennis M; Allen, Anton, Anton, Babor, Babor, Babor, Bentler, Carbonari, Ciiantarujikapong, Connor, Connor, Connor, Connors, Craig, DiClemente, Donovan, Edwards, Edwards, Fabricar, First, Forcehimes, Gastfriend, Hayton, Hodgins, Horn, Horn, Horn, Horn, Bentler, Jennrich, Kahler, Kahler, Kivlahan, Sulesund, MacCallum, McConnaughy, McDonald, McDonald, Miller, Miller, Moak, Muthen, Muthen, Muthen, Muthen, Muthen, O'Connor, Ross, Saunders, Skinner, Skinner, Spitzer, Steiger, Sullivan, Tonigan, Tonigan, Tucker, Tucker, Turner, Velicer, Horn, Wanberg, Wrigley, Yu, Velicer",2009.0,,0,0,
7853,Prevalence and impact of co-occurring psychiatric disorders on outcomes from a private hospital drug and alcohol treatment program.,"Aim: This naturalistic study was designed to assess the prevalence and impact of co-occurring mental disorders in 104 adults (52% male) admitted to a private hospital drug and alcohol treatment program in Brisbane, Australia. Method: Psychiatric diagnoses made by the participants' admitting psychiatrists were collected by chart audit. Measures of substance use, dependence and mood were obtained by a program psychologist on participants' admission to the hospital, and during a follow-up interview conducted by the second researcher an average of 8.5 months after participants' discharge. Results: Ninety-two per cent of the sample was diagnosed with at least one mental disorder; most commonly Major Depressive Disorder (57%), Generalised Anxiety Disorder (20%) and Borderline Personality Disorder (16%). Having a concurrent mood, anxiety or personality disorder was not significantly related to either program attendance or outcomes on substance related self-report measures. Only depression symptoms at follow-up were associated with significantly fewer per cent days abstinent in the past 30 days. Conclusion: While co-occurring mental disorders are highly prevalent in this sample, the disorders conferred no significant disadvantage for patients undergoing treatment for substance abuse. However, depression symptoms should be addressed in the period after discharge in order to ensure positive longer-term outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dingle, Genevieve A; King, Pauline; Allen, Alonso, Beck, Beck, Bischof, Boyd Ritsher, Breslin, Burns, Burns, Carroll, Castel, Charney, Charney, Curran, Darke, Davidson, Dawe, DeMarce, Drake, Fals-Stewart, Gossop, Gossop, Greenfield, Greig, Havassy, Jane-Llopis, Joe, Johnson, Kessler, King, Kranzler, Lovibond, McGovern, McKay, Miller, Miller, RachBeisel, Regier, Ross, Saunders, Sellman, Sobell, Sobell, Stockwell, Ward, Westermeyer",2009.0,,0,0,
7854,Post-traumatic stress disorder nightmares and sleep disturbance in Iraq war veterans: A feasible and promising treatment combination.,"A substantial proportion of returnees from the Iraq war have significant psychological symptoms related to war zone exposure, including high rates of post-traumatic stress disorder (PTSD), nightmares, and sleep disturbances. This pilot investigation examined the feasibility and efficacy of a promising cognitive-behavioral treatment (CBT) for nightmares, Imagery Rehearsal, combined with CBT for insomnia. Seven veterans completed treatment and showed promising pre-post effects regarding nightmare frequency, sleep quality, and PTSD. This report further examined the content of participants' nightmares, changes made during treatment, and potentially important modifying variables of treatment outcome. Those with redeployment fears, guilt due to perpetration issues, or traumatic brain injuries may receive some but not full benefits of the treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Harb, Gerlinde C; Cook, Joan M; Gehrman, Philip R; Gamble, Geraldine M; Ross, Richard J; Blake, Buysse, Davis, Davis, DeViva, Forbes, Forbes, Friedman, Harvey, Hoge, Hoge, Hoge, Hoge, Krakow, Krakow, Krakow, Krakow, Mellman, Milliken, Moore, Morin, Neylan, Phelps, Pitman, Rothbaum, Schnurr, Seal, Stapleton, Stepanski, Weathers, Weathers, Zayfert",2009.0,,0,0,
7855,The effects of mindfulness-based cognitive therapy: A qualitative approach.,"Mindfulness-Based Cognitive Therapy (MBCT) is an 8-week group treatment program originally developed for the prevention of relapses in depression (Segal, Teasdale & Williams, 2003). In this article we present the qualitative aspects of an MBCT efficacy study in public Mental Health Units of Tenerife island (Canary Island, Spain) with anxious and depressive symptoms. Thirty-two participants in an MBCT efficacy study answered an open questionnaire at the end of the treatment and three months later. The text of their responses was analyzed using the content analysis technique. The results show that MBCT has a good level of acceptance, and that most of the patients noticed changes in their way of thinking, feeling and in their relations with others. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cebolla i Marti, Ausias; Barrachina, Maria Teresa Miro; Baer, Baer, Carson, Cebolla, Cebolla, Dumas, Finucane, Gilbert, Grossman, Hayes, Hayes, Kabat-Zinn, Kabat-Zinn, Kabat-Zinn, Kabat-Zinn, Linehan, Linehan, Lynn, Mason, Miro, Miro, Nolen-Hoeksema, Nolen-Hoeksema, Onwuegbuzie, Santamaria, Segal, Teasdale, Teasdale, Witkiewitz",2009.0,,0,0,
7856,A PET study of tiagabine treatment implicates ventral medial prefrontal cortex in generalized social anxiety disorder.,"Corticolimbic circuitry has been implicated in generalized social anxiety disorder (gSAD) by several neuroimaging symptom provocation studies. However, there are limited data regarding resting state or treatment effects on regional cerebral metabolic rate of glucose uptake (rCMRglu). Given evidence for anxiolytic effects conferred by tiagabine, a gamma-aminobutyric acid (GABA) reuptake inhibitor, the present [18F] fluorodeoxyglucose-positron emission tomography (18FDG-PET) study sought to (1) compare resting rCMRglu between healthy control (HC) and pretreatment gSAD cohorts, (2) examine pre- to post-tiagabine treatment rCMRglu changes in gSAD, and (3) determine rCMRglu predictors of tiagabine treatment response. Fifteen unmedicated individuals with gSAD and ten HCs underwent a baseline (pretreatment) resting-state 18FDG-PET scan. Twelve of the gSAD individuals completed an open, 6-week, flexible dose trial of tiagabine, and underwent a second (posttreatment) resting-state 18FDG-PET scan. Compared to the HC subjects, individuals with gSAD demonstrated less pretreatment rCMRglu within the anterior cingulate cortex and ventral medial prefrontal cortex (vmPFC) at baseline. Following tiagabine treatment, vmPFC rCMRglu increased significantly in the gSAD group. Further, the magnitude of treatment response was inversely correlated with pretreatment rCMRglu within vmPFC. Taken together the present findings converge with neuroimaging findings from studies of social cognition in healthy individuals and symptom provocation in gSAD to support a role for the vmPFC in the pathophysiology of gSAD. Given the pharmacological profile of tiagabine, these findings suggest that its therapeutic effects in gSAD may be mediated by GABAergic modulation within the vmPFC. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Evans, Karleyton C; Simon, Naomi M; Dougherty, Darin D; Hoge, Elizabeth A; Worthington, John J; Chow, Candice; Kaufman, Rebecca E; Gold, Andrea L; Fischman, Alan J; Pollack, Mark H; Rauch, Scott L; Adolphs, Akirav, Amaral, Amir, Benedetti, Borden, Breiter, Crane, Dunlop, Duvernoy, Etkin, Evans, Fink-Jensen, First, Friston, Frith, Furmark, Furmark, Geday, Harlow, Ipser, Kent, Kilts, Lanzenberger, Liebowitz, Lorberbaum, Lydiard, Mayberg, Milad, Milad, Mitchell, Ninan, Ongur, Phan, Phan, Phelps, Pollack, Quirk, Rosenthal, Santana, Schwartz, Serra, Shamay-Tsoory, Spielberger, Stein, Stein, Straube, Talairach, Tillfors, Tillfors, Van Ameringen",2009.0,,0,0,
7857,A pilot study of cranial electrotherapy stimulation for generalized anxiety disorder.,"Background: Cranial electrotherapy stimulation (CES) is a noninvasive procedure that has been used for decades in the United States to treat anxiety, depression, and insomnia in the general population. Whether CES is an effective treatment for patients with a DSM-IV diagnosis of generalized anxiety disorder (GAD) has not previously been explored. The goal of this study was to evaluate the efficacy of CES in alleviating anxiety in patients with DSM-IV-diagnosed GAD. Method: Twelve patients from 29 to 58 years of age with a DSM-IV diagnosis of GAD were enrolled from August 2005 to March 2006 through the University of California, Los Angeles (UCLA) Anxiety Disorders Program. Cranial electrotherapy stimulation treatment was administered for 6 weeks using the Alpha-Stim Stress Control System at 0.5-Hz frequency and 300-micro1 A intensity. The primary efficacy measures were the Hamilton Rating Scale for Anxiety (HAM-A) and the Clinical Global Impressions-Improvement (CGI-I) scale. Response to treatment was defined as a reduction of 50% or more on the HAM-A and a CGI-I score of 1 or 2 (""much improved"" or ""very much improved,"" respectively). Results: Cranial electrotherapy stimulation was associated with a significant decrease in HAM-A scores (t = 3.083, p = .01). At endpoint, 6 patients (50% of the intent-to-treat sample and 67% of completers) had a 50% decrease in HAM-A score and a CGI-I score of 1 or 2.'One additional patient significantly improved in anxiety scores but did not meet criteria for response. Adverse events were generally mild in severity, mostly consisting of headache and nausea. Conclusion: This preliminary study suggests that CES may reduce symptoms of anxiety in GAD. We hope that these preliminary results will encourage further research to explore the use of CES in clinical settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bystritsky, Alexander; Kerwin, Lauren; Feusner, Jamie; Anan, Andreatini, Boon, Brawman-Mintzer, Buchsbaum, Buckman, Bystritsky, Bystritsky, Bystritsky, Bystritsky, Carey, Ferdjallah, Flemenbaum, Flemenbaum, Guy, Guy, Hamilton, Hamilton, Hoehn-Sanc, Jarzembski, Jenkins, Kessler, Kessler, Kessler, Kirsch, Klawansky, Krupilsky, Laakmann, Long, Mandos, Matson, Moore, Muhlack, Okada, Paros, Philip, Pollack, Pollack, Regier, Rickels, Rickels, Rickels, Rickels, Rickels, Rickels, Rucci, Schmitt, Schmitt, Schroeder, Segal, Shealy, Shealy, Shealy, Sheehan, Smith, Solomon, Trexler, Wager, Watson, Wu",2008.0,,0,0,
7858,"Clinical correlates of patients with rapid-cycling bipolar disorder and a recent history of substance use disorder: A subtype comparison from baseline data of 2 randomized, placebo-controlled trials.","Objective: To compare clinical variables in patients with rapid-cycling bipolar I or II disorder and a recent history of substance use disorder (SUD). Method: Cross-sectional data from 2 studies of patients with rapid-cycling bipolar I disorder or rapid-cycling bipolar II disorder and a recent history of SUD were used to retrospectively assess the differences in clinical variables between the subtypes. The studies were conducted from November 1997 to February 2007 at University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio. Extensive clinical interview and the Mini-International Neuropsychiatric Interview were used to ascertain DSM-IV diagnoses of rapid-cycling bipolar disorder, SUDs, and other Axis I disorders and to collect clinical variables. The Addiction Seventy Index (ASI), Global Assessment Scale (GAS), and the Medical Outcomes Study 36-Item Short-Form Health Survey were used to measure the severity of impairment at the initial assessment. One-way analysis of variance or chi2 was used for significance tests. A Bonferroni adjustment was applied for multiple comparisons. Results: Of 245 patients with rapid-cycling bipolar disorder (rapid-cycling bipolar I disorder, N = 191; rapid-cycling bipolar II disorder, N = 54) and a recent history of SUD, the demographics were similar. A significantly higher rate of panic disorder was observed in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder (odds ratio = 3.72, 95% CI = 1.66 to 8.32, p = .008). A significantly higher psychiatric composite score on the ASI was also found in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder even after Bonferroni adjustment (p = .0007). There were no significant differences between the subtypes in the rates of previous hospitalization or suicide attempt, early childhood verbal, physical, or sexual abuse, lifetime substance abuse or dependence, the number of SUDs or mood episodes in the last 12 months, and total or other subscale scores on ASI and GAS. Conclusion: Except for the significantly higher rate of comorbid panic disorder and higher psychiatric composite scores on the ASI in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder, the other clinical variables were similar between the 2 groups. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gao, Keming; Verduin, Marcia L; Kemp, David E; Tolliver, Bryan K; Ganocy, Stephen J; Elhaj, Omar; Bilali, Sarah; Brady, Kathleen T; Findling, Robert L; Calabrese, Joseph R; Albert, Altshuler, Amsterdam, Back, Bauer, Birmaher, Bray, Chengappa, Endicott, Feske, First, Fiye, Frank, Gao, Goodwin, Grant, Heil, Joffe, Judd, Judd, Judd, Judd, Kessler, Levander, MacKinnon, MacKinnon, Maina, Masi, McElroy, McLellan, Mitchell, Parrott, Regier, Rotondo, Sachs, Salloum, Saunders, Sheehan, Simon, Simon, Suppes, Tondo, Ware",2008.0,,0,0,
7859,A preliminary study of transcranial direct current stimulation for the treatment of refractory chronic pelvic pain.,"Background: The modulatory effects of transcranial direct current stimulation (tDCS) appear beneficial for different chronic pain syndromes; however, it is unclear whether this method can be used to treat refractory chronic pelvic pain. Objective: The objective of this preliminary study was to determine the efficacy and safety of tDCS for the management of refractory chronic pelvic pain. Methods: Seven patients with chronic pelvic pain having failed standard medical or surgical therapy underwent a crossover, double-blind sham controlled tDCS treatment protocol consisting of 1 mA applied for 20 minutes on two consecutive days with 2 weeks of follow-up symptom recording. Symptoms were recorded using multiple scoring systems, including visual analog scales for different pains, as well as organ-specific symptom scales. Comparison between active and sham treatment was performed by using paired t tests. Results: Overall and pelvic pain scores were significantly lower after active compared with sham treatment, as were disability and traumatic stress scores. No patient discontinued the study because of side effects, which were infrequent. Conclusions: Active tDCS treatment induces a modest pain reduction in refractory chronic pelvic pain patients as compared with sham tDCS treatment. These results can guide the design and implementation of further studies investigating this method of neuromodulation for the treatment of refractory chronic pelvic pain. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fenton, Bradford W; Palmieri, Patrick A; Boggio, Paolo; Fanning, James; Fregni, Felipe; Abbott, Bolton, Drossman, Duffy, Fenton, Fenton, Fenton, Fenton, Flor, Foa, Fregni, Fregni, Gandiga, Garcia-Larrea, Goldberg, Howard, Johns, Mathias, Miller, Nitsche, Nitsche, Nitsche, O'Leary, Patrizi, Roizenblatt, Roland, Stones, Wolfe",2009.0,,0,0,
7860,"Online CBT II: A phase I trial of a standalone, online CBT treatment program for social anxiety in stuttering.","This paper introduces a novel approach to internet treatment for social anxiety. The goal of this treatment was to address key limitations of current standalone treatments (Helgadottir, Menzies, Onslow, Packman, & O'Brian, 2009). The 'computer psychologist' designed for this study used fully automated, prewritten individualized sample answers in order to simulate a human-human interaction through a human-computer interface. Two males who sought treatment for stuttering and met the diagnosis for social phobia according to the DSM-IV and ICD-10 criteria were selected for this study. After receiving the treatment, both users no longer met criteria for social phobia. Also, significant improvements were observed on other psychometric tests, including measures of unhelpful cognitions, behavioral avoidance, quality of life, and low mood. The quality of the interaction appeared to be similar to face-to-face therapy, indicating that the 'computer psychologist' established an effective therapeutic relationship, and the automated techniques used were sufficiently engaging to prompt users to log on regularly and complete the treatment program. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Helgadottir, Fjola Dogg; Menzies, Ross G; Onslow, Mark; Packman, Ann; O'Brian, Sue; Andersson, Antony, Beck, Berger, Blood, Blood, Brown, Carlbring, Carlbring, Clark, Craske, Crawford, Davis, Dozois, Durm, Endler, Endler, Endler, Garcia-Lopez, Guitar, Helgadottir, Helgadottir, Holmes, Hugh-Jones, Iverach, Lampe, Langevin, Lovibond, Lovibond, Menzies, Messenger, Osman, Spek, Spielberger, Spielberger, St Clare, Stopa, Titov, Titov, Turner, Turner, Watson, Wells, Yaruss",2009.0,,0,0,
7861,"Quetiapine addition to serotonin reuptake inhibitors in patients with severe obsessive-compulsive disorder: A double-blind, randomized, placebo-controlled study.","Objective: Although many patients with obsessive-compulsive disorder (OCD) benefit from treatment with serotonin reuptake inhibitors (SRIs), it is estimated that 40% to 60% of them do not respond. The objective of the present study was to evaluate the efficacy of quetiapine added to baseline treatment with SRIs for the treatment of OCD in severely ill adult subjects. Method: Forty patients (21 men, 19 women) with primary OCD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria participated in a 12-week, double-blind, placebo-controlled trial. They were randomly assigned to dosages of quetiapine titrated up to 400 mg/d (n = 20) or to placebo (n = 20) in addition to their SRI treatment. During the continuation phase (weeks 6-12), subjects received different dosages between 400 and 600 mg/d depending on clinical response. At entry, all patients were unresponsive to at least 1 course of at least 12 weeks of treatment with SRIs at defined doses. The total Yale-Brown Obsessive-Compulsive Scale score was the primary efficacy parameter. Results: Intention-to-treat, last-observation-carried-forward analysis demonstrated a mean +/- SD decrease in Yale-Brown Obsessive-Compulsive Scale score of 5.2 +/- 5.4 in the quetiapine group and 3.9 +/- 4.9 in the placebo group. The analysis of treatment effects between the 2 groups showed no significant difference. There were no significant group differences in any of the other self-rating scales or clinician-administered rating scales. Conclusions: In this study, augmentation of SRI treatment with quetiapine in severe OCD had no additional effect. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kordon, Andreas; Wahl, Karina; Koch, Nicole; Zurowski, Bartosz; Anlauf, Matthias; Vielhaber, Kirsten; Kahl, Kai G; Broocks, Andreas; Voderholzer, Ulrich; Hohagen, Fritz; Atmaca, Bloch, Bullinger, Carey, Denys, Denys, Denys, Fineberg, Fineberg, Goodman, Guy, Hamilton, Hautzinger, Leckmann, Misri, Mohr, Sevincok, Summerfeldt, Toren",2008.0,,0,0,
7862,Perfectionism and treatment outcome in obsessive-compulsive disorder.,"This study examined the relationship between perfectionism, as measured by the Multidimensional Perfectionism Scale (MPS; [R. O. Frost et al. (1990) Cognitive Therapy and Research, 14, 449-468], and treatment outcome in obsessive compulsive disorder (OCD). Patients (n = 118) participated in group [McLean et al. (2001) Journal of Consulting and Clinical Psychology, 69, 205-214] or individual [Whittal et al. (2005) Behaviour Research and Therapy, 43, 1559-1576] cognitive therapy (CT) or exposure and response prevention (ERP) for OCD. Doubts about Actions (DA), a subscale of the MPS, uniquely predicted worse treatment outcome in the Yale-Brown Obsessive-compulsive Scale (YBOCS; [Goodman et al. (1989) Archives of General Psychiatry, 40, 1006-1011]) total score and compulsions subscale. Interactions between Concern over Mistakes (CM; another MPS subscale) and DA, as well as DA alone, predicted poorer treatment outcome in patients who received ERP. Contrary to expectations, MPS total score was not related to treatment response. Moreover, levels of perfectionism did not change over the course of treatment, regardless of the type of treatment received. Implications for treatment in OCD are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Chik, Heather M; Whittal, Maureen L; O'Neill, Melanie L; Abramowitz, Antony, Beck, Beck, Blatt, Blatt, Calamari, Cohen, First, Foa, Foa, Frost, Frost, Frost, Goodman, Harvey, Mallinger, McFall, McLean, Purdon, Rachman, Rheaume, Rosser, Salzman, Sanvio, Shafran, Stumpf, Stober, Sutandar-Pinnock, Tabachnick, Taylor, Tolin, Vogel, Whittal, Whittal, Whittal, Whittal, Whittal, Wilhelm",2008.0,,0,0,
7863,Functional MRI study of brain activation alterations in patients with obsessive-compulsive disorder after symptom improvement.,"Dysfunction of the frontal-subcortical circuits has been the most common finding in the pathophysiology of obsessive-compulsive disorder (OCD), and recent neuropsychological studies have shown cognitive impairments in OCD. To clarify the pathophysiology of OCD without the confounding effects of medication, we investigated the alterations of brain function in OCD patients and changes after clinical improvement due solely to behavior therapy. The participants were 11 outpatients with OCD and 19 normal controls. The patients received 12 weeks of behavior therapy. We investigated the differences in the behavioral performance and functional magnetic resonance imaging results during the Stroop test in the patients and normal controls, and their changes after treatment in the patients. The patients showed less activation in the anterior cingulate gyrus and cerebellum than control subjects. Following significant improvement in OC symptoms, the cerebellum and parietal lobe showed increased activation, and the orbitofrontal cortex, middle frontal gyrus, and temporal regions showed decreased activation during the Stroop task, and performance of the task itself improved. Our findings suggest that dysfunction of the posterior brain regions, especially the cerebellum, is involved in the pathogenesis of OCD, and that normalization in function can occur with improvement of OC symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Nabeyama, Maiko; Nakagawa, Akiko; Yoshiura, Takashi; Nakao, Tomohiro; Nakatani, Eriko; Togao, Osamu; Yoshizato, Chika; Yoshioka, Kazuko; Tomita, Mayumi; Kanba, Shigenobu; Allen, Andreasen, Bannon, Baxter, Baxter, Baxter, Bench, Benkelfat, Botvinick, Brody, Busatto, Carter, Christensen, Clayton, Corbetta, Courchesne, Endicott, Enright, First, Gehring, Goodman, Goodman, Hamilton, Hamilton, Hodgson, Iikura, Jentsch, Kang, Kato, Kerns, Kim, Kuelz, Kwong, Le, MacDonald, Machlin, Martinot, Milham, Moritz, Nakao, Nakao, Nakatani, Nakatani, Nordahl, Oldfield, Pardo, Penades, Perani, Pujol, Rubin, Rubin, Savage, Saxena, Saxena, Saxena, Schmahmann, Schmahmann, Schmahmann, Schmahmann, Schmidtke, Schwartz, Spielberger, Spitzer, Stroop, Swedo, Swedo, Taylor, van den Heuvel, Vilensky, Wechsler, Zysset",2008.0,,0,0,
7864,Memantine augmentation in treatment-resistant obsessive-compulsive disorder: An open-label trial.,"Background: Data from the fields of genetics, neuroimaging, and animal studies, along with case reports and small clinical trials, point to a role for glutamatergic dysfunction in the pathophysiology of obsessive-compulsive disorder (OCD). We report on the first open-label study to test the hypothesis that memantine, a noncompetitive glutamate antagonist, will result in a clinically meaningful reduction in OCD symptoms in adults with treatment-resistant OCD. Methods: We recruited 15 adult subjects with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined OCD and a baseline Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) of 18 or higher, who had failed to respond to treatment with a serotonin reuptake inhibitor (SRI), given at an adequate and stable dose for at least 12 weeks. The duration of memantine treatment was 12 weeks, and the dose was gradually increased to a target of 20 mg/d. Response was denned .as a 25% or greater reduction in the Y-BOCS score at study end and a Clinical Global Impression-Improvement scale rating of ""much"" or ""very much"" improved. Results: Data from 14 subjects were analyzable. Mean baseline Y-BOCS score was 27.4 (SD, 5.0). Subjects had failed an average of 2.8 (SD, 1.8) SRI trials; 6 subjects had failed augmentation with atypical antipsychotics. At study end, 6 subjects (42.9%) were responders, and response was achieved by EOW4. Responders had significantly lower baseline Y-BOCS scores (2-tailed t tests, P <= 0.05, t = 2.2) and had failed fewer SRIs [P < 0.05, t = 2.2). Side effects to memantine were mild and transient, and no subject withdrew from the study for an adverse event. Summary: In this open-label augmentation trial of memantine in treatment-resistant OCD, almost half the subjects had a meaningful improvement in symptoms. Our study was limited by its small size, presence of comorbidities, 'and lack of control. Large double-blind placebo-controlled trials are needed to further test our findings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Aboujaoude, Elias; Barry, John I; Gomel, Nona; Arnold, Arnold, Bolton, Carlsson, Chakrabarty, Chipana, Cork, Dell'osso, Dell'Osso, Delorme, Dickel, Egashira, Fineberg, Goodman, Grant, Greenberg, Guy, Ichimaru, Koran, Koran, Lafleur, Lipton, McGrath, Montgomery, Moore, Murray, Nordstrom, Pasquini, Poyurovsky, Rosenberg, Rosenberg, Sheehan, Shinomiya, Zohar",2009.0,,0,0,
7865,A long-term trial of the effectiveness and safety of atypical antipsychotic agents in augmenting SSRI-refractory obsessive-compulsive disorder.,"Objective: Although atypical antipsychotic agents have been found effective in the augmentation of serotonin reuptake inhibitors (SRIs) for treatment-resistant obsessive-compulsive disorder (OCD) in short-term trials, there are few data on the effectiveness and safety of these agents in clinical settings over the long term. Method: Subjects (N = 46) who responded to selective SRIs (SSRIs) in an initial 12-week trial were continued on SSRI monotherapy plus cognitive-behavioral therapy (CBT) for 1 year. Subjects (N = 44) who failed to respond to SSRIs were randomly assigned to 1 of 3 atypical antipsychotics-olanzapine, quetiapine, or risperidone-and were consecutively treated using SSRI + atypical antipsychotics combined with CBT for 1 year. This study was conducted from January 2006 to November 2007 at Osaka City University Graduate School of Medicine Hospital, Japan. Results: Augmentation with atypical antipsychotics reduced mean +/- SD Yale-Brown Obsessive Compulsive Scale (YBOCS) total scores in SSRI-refractory OCD patients (at initial assessment = 29.3 +/- 9.9, after 1 year = 19.3 +/- 6.8). However, compared to SSRI responders (at initial assessment = 25.8 +/- 11.4, after 1 year = 13.7 +/- 4.6), total YBOCS scores in those who required atypical antipsychotic augmentation were initially higher, and they remained at higher levels than those of SRI responders after 1 year of the treatments. Conclusions: Our work does not sufficiently support the long-term effectiveness of the atypical antipsychotics in the augmentation of SSRIs for treatment-resistant OCD patients. Even though this approach seems useful for some types of OCD patients, such as those with symmetry/ordering and hoarding symptoms, these data emphasize the limitations of the current pharmacotherapeutic options in treatment-refractory OCD, and their chronic use raises a number of safety concerns. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Matsunaga, Hisato; Nagata, Toshihiko; Hayashida, Kazuhisa; Ohya, Kenzo; Kiriike, Nobuo; Stein, Dan J; Allison, Atmaca, Baer, Ball, Blin, Bogetto, Callaghan, Casey, D'Amico, De Luca, Denys, Denys, Denys, Fava, Fenton, First, Foa, Fukui, Goodman, Goodman, Hambree, Henderson, Hollander, Kampman, Koran, Maina, Malsui-Sakata, March, Mataix-Cols, Mataix-Cols, Matsunaga, McDougle, McDougle, Muller, Ninan, Pallanti, Saxena, Simpson, Spina, Stein, Stein, Tollefson, Umbricht, Wetterling",2009.0,,0,0,
7866,Predicting therapy outcome in patients with and early and late obsessive-compulsive disorder (EOCD and LOCD).,"Background: Increasing attention has been given to subtyping OCD with respect to different clinical profiles, response to drug treatments, comorbidity and age of onset. There are a number of studies looking at predictors of treatment outcome in OCD, but so far not for OCD subtypes. Method: Prediction of outcome after cognitive-behavioural therapy was evaluated in 63 inpatients with early obsessive-compulsive disorder (EOCD <= 12 years of age) and 191 patients with late obsessive-compulsive disorder (LOCD > 15 years of age). Results: For EOCD patients factors predicting a good outcome included high motivation and high initial Y-BOCS scores. Factors associated with a bad outcome were higher age at assessment, a longer duration of psychiatric inpatient treatment before assessment and a low level of social functioning (BSS). For LOCD patients living in a stable relationship, high motivation and completing treatment predicted a favourable therapy outcome, while a low level of psychological functioning (BSS) and a longer duration of inpatient psychiatric treatment before assessment were associated with an undesirable therapy outcome. Conclusions: Subtyping OCD patients according to age of onset seems to be a promising avenue towards improving and developing more specified treatment programs. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Langner, Judith; Laws, Manuela; Roper, Gisela; Zaudig, Michael; Hauke, Walter; Piesbergen, Christoph; Ackerman, Arrindel, Barrett, Basoglu, Beck, Black, Brickenkamp, Brahler, Buchanan, Busatto, Calamari, Castle, De Araujo, De Haan, Delorme, Do Rosario-Campos, Dressen, Erikson, Foa, Fontenelle, Geller, Goodman, Goodman, Hauke, Hauke, Hemmings, Hermesh, Hiss, Jaisoorya, Jansch, Kanfer, Kegan, Leckman, Leonard, Loevinger, McDougle, McDougle, Miller, Millet, Minichiello, Nestadt, Noam, Noshirvani, Pauls, Rachman, Rachman, Rasmussen, Rauch, Ravizza, Reinecker, Riddle, Roper, Schepank, Skoog, Sobin, Steketee, Steketee, Stewart, Summerfeldt, Treadwell",2009.0,,0,0,
7867,The Gambling Symptom Assessment Scale (G-SAS): A reliability and validity study.,"Two hundred seven patients with DSM-IV Pathological Gambling Disorder completed both the Gambling Symptom Assessment Scale (G-SAS) and the Yale-Brown Obsessive-Compulsive Scale-modified for Pathological Gambling (PG-YBOCS) at baseline visit and weekly or biweekly thereafter during the 12-week study period. The week 1 to week 2 visit data were used to assess test- retest reliability. Weekly or biweekly data were used for the G-SAS validity. The PG-YBOCS reliability and validity data have been published previously. We used the PG-YBOCS as the established scale and compared the G-SAS performance with the PG-YBOCS. Test-retest reliability was statistically significant. The correlations between the G-SAS and the PG-YBOCS and Clinical Global Impression rating were excellent. Findings suggest that the G-SAS is reliable and valid in assessing changes in symptoms during a drug treatment study. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kim, Suck Won; Grant, Jon E; Potenza, Marc N; Blanco, Carlos; Hollander, Eric; Bartko, Cooper, de Castro, Flannery, Goodman, Goodman, Grant, Kim, Kim, Kim, Kim, Landis, Lesieur, Pallanti, Petry, Raylu, Snedocor, Tukey, Winters",2009.0,,0,0,
7868,A randomized controlled study of sequentially applied repetitive transcranial magnetic stimulation in obsessive-compulsive disorder.,"Objective: The present study investigated possible therapeutic effects and safety of sequentially combined low-frequency repetitive transcranial magnetic stimulation (rTMS) to the right dorsolateral prefrontal cortex and supplementary motor area in patients with treatment-resistant obsessive-compulsive disorder. Method: Between February 2007 and January 2008, we carried out a study with a rater-blinded, sham-controlled design in which 20 patients with treatment-resistant obsessive-compulsive disorder, confirmed by a psychiatrist after use of the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinician Version, were randomly assigned to either active rTMS (n = 10) or sham treatment (n = 10). Over 10 days, rTMS of 1 Hz was given at 110% of the motor threshold for 20 minutes over the right dorsolateral prefrontal cortex and sequentially at 1 Hz at 100% of the motor threshold for 20 minutes over the supplementary motor area. The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (YBOCS) score. Results: For the between-group analyses, there were no significant differences over 4 weeks between the active and sham groups on the YBOCS (F = 0.01, P = .92) and the Montgomery-Asberg Depression Rating Scale (MADRS; F = 0.39, P = .54). In repeated-measures analyses on all subjects, there was a significant effect of time on the YBOCS (F = 5.48, P = .009) and the MADRS (F = 6.55, P = .004). There were no significant group-by-time interactions for the YBOCS (F = 0.03, P = .94) or the MADRS (F = 0.09,P = .67). Conclusions: These findings suggest that 10 sessions of sequential rTMS of the right dorsolateral prefrontal cortex and the supplementary motor area at low frequency had no therapeutic effect on obsessive compulsive symptoms. However, rTMS was a safe method of treatment, and there was no significant change in cognitive function after rTMS. Further controlled studies using a more sophisticated sham system in larger samples are required to confirm the effect of rTMS in obsessive-compulsive disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kang, Jee In; Kim, Chan-Hyung; Namkoong, Kee; Lee, Chang-il; Kim, Se Joo; Alano, Alonso, Beck, Bielski, Burt, Bystritsky, Egner, First, Fitzgerald, Giaybiel, Goodman, Goodman, Greenberg, Greenberg, Hamilton, Klein, Lisanby, Loo, Mantovam, Martin, Montgomery, Mostofsky, Oliven, Pallanti, Picard, Prasko, Rossi, Rossi, Rumi, Sachdev, Sachdev, Sachdev, Schruers, Schwartz, Simpson, Sommer, Spielberger, Swedo, van den Heuvel",2009.0,,0,0,
7869,Cognitive-behavior therapy for Japanese patients with panic disorder: Acute phase and one-year follow-up results.,"Aim: The aim of this paper is to report the outcomes and follow-up data of our cognitive behavioral therapy program for Japanese patients with panic disorder and to examine the baseline predictors of their outcomes. Methods: Seventy outpatients with panic disorder with or without agoraphobia were treated with manualized group cognitive behavioral therapy. Results: Fourteen patients (20%) did not complete the program. Among the completers, the average Panic Disorder Severity Scale score fell from 12.8 at baseline to 7.1 post-therapy (44.7% reduction). This effectiveness was sustained for 1 year. While controlling for the baseline severity, the duration of illness and the baseline social dysfunction emerged as significant predictors of the outcome. Conclusions: Our data suggest that group cognitive behavioral therapy for panic disorder can bring about as much symptom reduction among Japanese patients with panic disorder as among Western patients. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Nakano, Yumi; Lee, Kiyoe; Noda, Yumiko; Ogawa, Sei; Kinoshita, Yoshihiro; Funayama, Tadashi; Watanabe, Norio; Chen, Junwen; Noguchi, Yuka; Furukawa, Toshiaki A; Andrews, Barlow, Basoglu, Chambless, Chambless, Costa, Delgado, Derogaris, Eguchi, Ettigi, First, Furukawa, Furukawa, Hahlweg, Kessler, Marks, Marks, Marks, Martinsen, Michelson, Mundt, Perini, Robins, Salkovskis, Shear, Shimonaka, van Balkom, Wade, Wardle, Westra, Yamamoto, Yoshimura",2008.0,,0,0,
7870,Effect of medication and psychotherapy on heart rate variability in panic disorder.,"Background: Panic disorder (PD) patients have been shown to have reduced heart rate variability (HRV). Low HRV has been associated with elevated risk for cardiovascular disease. Our aim was to investigate the effects of treatment on heart rate (HR) in patients with PD through a hyperventilation challenge. Methods: We studied 54 participants, 43 with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) PD and 11 controls. Subjects lay supine with their heads in a plastic canopy chamber, resting for 15 min and then breathing at a rate of 30 breaths per minute for l0 min. HRV was sampled for spectral analysis. Clinical and behavioral measures of anxiety were assessed. Treatment was chosen by patients; either 12 weeks of CBT alone or CRT with sertraline. Results: All patients showed significant decrease on clinical measures from baseline and 31 were treatment responders, 8 dropped out of the study before completion of the 12-week treatment phase and 4 were deemed nonresponders after 12 weeks of treatment. Although both treatments led to significant clinical improvement, only CBT alone demonstrated a significant reduction in HR and increase in HRV. Conclusions: Our study replicated the finding that increased HR and decreased HRV occur in PD patients. Given the evidence of cardiac risk related to HRV, CBT appears to have additional benefits beyond symptom reduction. The mechanisms of this difference between CBT and sertraline are unclear and require further study. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Garakani, Amir; Martinez, Jose M; Aaronson, Cindy J; Voustianiouk, Andrei; Kaufmann, Horacio; Gorman, Jack M; Barlow, Barlow, Bigger, Bigger, Borg, Brosschot, Bruce, Carney, Chambless, Cohen, Coryell, Dillon, Dusseldorp, Evrengul, First, Goisman, Gomez-Caminero, Gorman, Guy, Guzik, Haines, Hamilton, Hamilton, Houtman, Kawachi, Kessler, Kleiger, Klein, Kohn, Lavoie, Liao, Lucini, Malliani, Martens, McCraty, Mitte, Molgaard, Pagani, Piccirillo, Rasmussen, Roose, Shapiro, Shear, Siepmann, Slaap, Sloan, Smoller, Sullivan, Tsuji, Tucker, Weissman, Yeragani, Yeragani, Yeragani, Yeragani, Yeragani",2009.0,,0,0,
7871,Family functioning predicts outcomes for veterans in treatment for chronic posttraumatic stress disorder.,"A longitudinal framework was used to examine the competing hypotheses of (a) whether family functioning predicts changes in posttraumatic stress disorder (PTSD) symptoms or (b) whether PTSD symptoms predict changes in family functioning. Veterans (N = 311) admitted to a treatment program completed a series of questionnaires at 3 time points: at intake, from intake to completion of a treatment program, and at the 6-month follow-up. Alcohol use and general mental health symptoms were also measured at intake. A cross-lagged panel model using structural equation modeling analyses indicated that family functioning was a moderate predictor of PTSD symptoms at posttreatment and at the 6-month follow-up. PTSD was not a significant predictor of family functioning across time and alcohol use, and general mental health symptoms did not affect the overall findings. Further analyses of PTSD symptom clusters indicated that the avoidance symptom cluster was most strongly related to family functioning. Targeting family relationships for treatment may be important in the future for veterans with PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Evans, Lynette; Cowlishaw, Sean; Hopwood, Malcolm; Anderson, Bandalos, Brewin, Cook, Coyne, Dirkzwager, Epstein, Evans, Figley, Fisher, Goldenberg, Graham, Hall, Hu, Kabacoff, Kline, Little, Lopez, MacDonald, Manne, Martens, Miller, Monson, Moos, Moos, Nelson Goff, Nelson Goff, Nelson Goff, Riggs, Saunders, Savarese, Schweitzer, Sherman, Weathers, Weathers, Westerlink, Westman, Whisman",2009.0,,0,0,
7872,Diagnostic comorbidity in adults with generalized anxiety disorder: Impact of comorbidity on psychotherapy outcome and impact of psychotherapy on comorbid diagnoses.,"The current study examined the impact of comorbidity on cognitive and behavioral therapies for generalized anxiety disorder (GAD) as well as the impact of these therapies on diagnoses comorbid to GAD. Seventy-six treatment-seeking adults with principal diagnoses of GAD received 14 sessions of therapy. Most (n =46; 60.5%) of the sample had at least one comorbid diagnosis. Although the presence of comorbid diagnoses was associated with greater severity of GAD symptoms at pretreatment, greater severity of comorbid major depression, simple phobia, and social phobia was associated with greater change in symptoms of GAD in response to treatment, with no effect on maintenance of gains during a 2-year follow-up. Further, psychotherapy for principal GAD led to a reduction in number of comorbid diagnoses and in severity of social phobia, simple phobia, and major depression at posttreatment. At 2-year follow-up severity of social and simple phobia remained below pretreatment levels, whereas severity of depression was no longer significantly below pretreatment levels. These results suggest that although people with comorbid disorders enter treatment with more severe GAD symptomatology, they demonstrate greater change, and therefore such comorbidity does not diminish the efficacy of cognitive and behavioral therapies for GAD. In addition, the impact of these treatments for GAD may generalize to reduced severity of simple phobia, social phobia, and major depression; however, gains in severity of major depression are not maintained. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Newman, Michelle G; Przeworski, Amy; Fisher, Aaron J; Borkovec, Thomas D; Austin, Barlow, Beck, Bernstein, Bland, Boden, Borkovec, Borkovec, Borkovec, Brown, Brown, Brown, Brown, Bruce, Bruce, Bruss, Butler, Butler, Clarke, Crits-Christoph, Di Nardo, Durham, Elston, Fisher, Garyfallos, Goisman, Goldfried, Hamilton, Hamilton, Hunt, Judd, Kazdin, Kessler, Kessler, Kessler, Kessler, Kobak, Maier, Maier, Marciniak, Mojtabai, Moras, Newman, Raudenbush, Riskind, Rogers, Rudd, Souetre, Spielberger, Steer, Tobin, Watkins, Wetherell, Whitehurst, Wittchen, Yonkers, Yonkers",2010.0,,0,0,
7873,Internet-based trials and the creation of health consumers.,"In this paper we document the experience of participating in novel randomised controlled trials for panic disorder-where face-to-face and Internet delivery of cognitive behavioural therapy are compared. Our analysis is based on 18 months of observation and in-depth interviews with 10 trial participants and 8 trialists in Victoria, Australia. We argue that the participants are positioned as active health consumers and approach the trial as they would other self-help practices. High levels of individual responsibility are assumed of participants in these trials, which they accept by approaching the trials reflexively and searching for information and strategies they can employ while building their health literacy on panic disorder. Although the researchers set the parameters of the treatment and interaction, increasingly the participants choose the extent to which they will comply with their defined role. For the participants the trial is one of the 'pick and mix' options of available treatment and we suggest it is a compelling example of contemporary health consumption. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Advocat, Jenny; Lindsay, Jo; Advocat, Babbie, Bauman, Beck, Birnbaum, Brown, Carlbring, Carlbring, Clarke, Crone, Epstein, Epstein, Fiegelson, Furedi, Gackenbach, Giddens, Griffiths, Healy, Healy, Henderson, Jerome, King, Klein, Lovibond, Lupton, Maguire, Maguire, Marks, McRobbie, Petersen, Reips, Rice, Richards, Rose, Ross, Shear, Zal, Zukin",2010.0,,0,0,
7874,Cognitive behavioral group therapy for patients with co-existing social anxiety disorder and substance use disorders: A pilot study.,"Social anxiety disorder (SAD) frequently co-occurs with substance use disorders (SUDs). Although the efficacy of separate cognitive behavioral treatments for each disorder has been widely documented, there is a dearth of studies investigating treatment outcome for patients with co-existing SAD and SUDs. This paper presents preliminary data from a pilot study that investigated whether cognitive behavioral group therapy-modified to explicitly address the link between social anxiety and substance use-could lead to reductions in social anxiety-related symptoms and improvements in affect and unrealistic alcohol expectancies in a sample of 59 patients diagnosed with co-existing SAD and SUDs. Results indicated significant reductions across treatment in social anxiety-related symptoms and negative affect, whereas no changes in positive affect or unrealistic alcohol expectancies were found. The results warrant a randomized controlled trial to explore the specificity of these effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Courbasson, Christine M; Nishikawa, Yasunori; Antony, Bruce, Bruch, Buckner, Cecilia, Cohen, Connor, Deacon, Driessen, Feske, First, Grant, Ham, Heimberg, Kashdan, Khantzian, Kushner, Myrick, Norton, Randall, Reiss, Safren, Stangier, Stark, Stewart, Stewart, Taylor, Taylor, Taylor, Thevos, Thomas, Thomasson, Thomasson, Tran, Watson, Wills",2010.0,,0,0,
7875,Efficacy of interpersonal therapy-group format adapted to post-traumatic stress disorder: An open-label add-on trial.,"Background: Post-traumatic stress disorder (PTSD) is a highly prevalent condition, yet available treatments demonstrate only modest efficacy. Exposure therapies, considered by many to be the ""gold-standard"" therapy for PTSD, are poorly tolerated by many patients and show high attrition. We evaluated interpersonal therapy, in a group format, adapted to PTSD (IPT-G PTSD), as an adjunctive treatment for patients who failed to respond to conventional psychopharmacological treatment. Methods: Research participants included 40 patients who sought treatment through a program on violence in the department of psychiatry of Federal University of Sao Paulo (UNIFESP). They had received conventional psychopharmacological treatment for at least 12 weeks and failed to have an adequate clinical response. After signing an informed consent, approved earlier by the UNIFESP Ethics Review Board, they received a semi-structured diagnostic interview (SCID-I), administered by a trained mental health worker, to confirm the presence of a PTSD diagnosis according to DSM-IV criteria. Other instruments were administered, and patients completed out self-report instruments at baseline, and endpoint to evaluate clinical outcomes. Results: Thirty-three patients completed the trial, but all had at least one second outcome evaluation. There were significant improvements on all measures, with large effect sizes. Conclusions: IPT-G PTSD was effective not only in decreasing symptoms of PTSD, but also in decreasing symptoms of anxiety and depression. It led to significant improvements in social adjustment and quality of life. It was well tolerated and there were few dropouts. Our results are very preliminary; they need further confirmation through randomized controlled clinical trials. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Campanini, Rosaly F. B; Schoedl, Aline F; Pupo, Mariana C; Costa, Ana Clara H; Krupnick, Janice L; Mello, Marcelo F; Arehart-Treichel, Beck, Beck, Blake, Bleiberg, Bosc, Breslau, Brewin, Brunner, First, Friedman, Kessler, Krupnick, McHomey, Mendes, Norris, Seedat, Spitzer, Weissman, Weissman, Wilfiey",2010.0,,0,0,
7876,Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder.,"Based on the theory that generalized anxiety disorder (GAD) is maintained through a reactive and fused relationship with one's internal experiences and a tendency towards experiential avoidance and behavioral restriction, an acceptance-based behavior therapy (ABBT) was developed to specifically target these elements. Since ABBT has been shown to be an efficacious treatment in previous studies, the current study focuses on proposed mechanisms of change over the course of therapy. Specifically, the current study focuses on session-by-session changes in two proposed mechanisms of change: acceptance of internal experiences and engagement in meaningful activities. Overall, clients receiving ABBT reported an increase in the amount of time spent accepting internal experiences and engaging in valued activities. Change in both acceptance and engagement in meaningful activities was related to responder status at post-treatment and change in these two proposed mechanisms predicted outcome above and beyond change in worry. In addition, change in acceptance was related to reported quality of life at post-treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hayes, Sarah A; Orsillo, Susan M; Roemer, Lizabeth; Borkovec, Borkovec, Brown, Brown, Cohen, DiNardo, Francis, Frisch, Hayes, Hayes, Hayes, Heimberg, Henning, Kessler, Lee, Linehan, Lovibond, Mennin, Meyer, Michelson, Molina, Muthen, Preacher, Roemer, Roemer, Roemer, Roemer, Salters-Pedneault, Segal, Treanor, Waters, Wells, Wilson, Wilson, Yonkers",2010.0,,0,0,
7877,A multifaith spiritually based intervention for generalized anxiety disorder: A pilot randomized trial.,"This pilot trial evaluated the efficacy of a multifaith spiritually based intervention (SBI) for generalized anxiety disorder (GAD). Patients meeting DSM-IV criteria for GAD of at least moderate severity were randomized to either 12 sessions of the SBI (n = 11) delivered by a spiritual care counselor or 12 sessions of psychologist-administered cognitive-behavioral therapy (CBT; n = 11). Outcome measures were completed at baseline, post-treatment, and 3-month and 6-month follow-ups. Primary efficacy measures included the Hamilton Anxiety Rating Scale, Beck Anxiety Inventory, and Penn State Worry Questionnaire. Data analysis was performed on the intent-to-treat sample using the Last Observation Carried Forward method. Eighteen patients (82%) completed the study. The SBI produced robust and clinically significant reductions from baseline in psychic and somatic symptoms of GAD and was comparable in efficacy to CBT. A reduction in depressive symptoms and improvement in social adjustment was also observed. Treatment response occurred in 63.6% of SBI-treated and 72.3% of CBT-treated patients. Gains were maintained at 3-month and 6-month follow-ups. These preliminary findings are encouraging and suggest that a multifaith SBI may be an effective treatment option for GAD. Further randomized controlled trials are needed to establish the efficacy of this intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Koszycki, Diana; Raab, Kelley; Aldosary, Fahad; Bradwejn, Jacques; Aten, Azhar, Baetz, Baetz, Beck, Beck, Bruce, Belanger, Carmody, Cohen, Craske, Dugas, Emmons, Evans, Farrell, First, Gould, Guy, Hamilton, Kessler, Koenig, Koenig, Koenig, Koenig, McCullough, Meyer, Montgomery, Pargament, Phillips, Pollack, Post, Razali, Rungreangkulkij, Smith, Walsh, Weissman, Zinbarg",2010.0,,0,0,
7878,Omega-3 fatty acids for secondary prevention of posttraumatic stress disorder after accidental injury: An open-label pilot study.,"Accidental injury is an important risk factor for posttraumatic stress disorder (PTSD). To examine whether omega-3 fatty acids attenuate PTSD symptoms in humans, we conducted a prospective, open label pilot trial of omega-3 fatty acid supplementation in accident-injured patients consecutively admitted to the intensive care unit (ICU) of the National Disaster Medical Center in Tokyo. All eligible patients received a psychological education session in the ICU by clinical psychologists. Patients received omega-3 fatty acid capsules containing 1470 mg DHA and 147 mg eicosapentaenoic acid daily for 12 weeks. There were significant differences in erythrocyte DHA concentrations between weeks 0 and 12. However, there was no significant difference in the mean levels of eicosapentaenoic acid between weeks 0 and 12 in 11 patients. Because of the open-label style of the design and the lack of controls, no definitive conclusion can be drawn, and we must wait for the results of adequately powered randomized controlled trials with larger samples. However, this pilot study has provided promising support for our hypothesis that omega-3 fatty acid supplementation started shortly after accidental injury may be efficacious in attenuating PTSD symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Matsuoka, Yutaka; Nishi, Daisuke; Yonemoto, Naohiro; Hamazaki, Kei; Hashimoto, Kenji; Hamazaki, Tomohito; Baker, Beltz, Blake, Bligh, Calderon, Feng, Kitamura, Matsuoka, Matsuoka, Ross, Squire, Wu",2010.0,,0,0,
7879,Predictors of outcome in residential cognitive and interpersonal treatment for social phobia: Do cognitive and social dysfunction moderate treatment outcome?,"Background: The predictors of residential cognitive (RCT) and residential interpersonal Treatment (RIPT) for social phobia were explored. (1) Sotsky et al. (1991) found differential effects of CT and IPT for depression, suggesting that the level of cognitive or social dysfunction predicted differential outcome. We examined whether an analogous effect could be demonstrated in 10 weeks of residential treatment of 80 social phobia subjects. (2) We also included expectations, age of onset, severity of illness, concurrent anxiety, mood, avoidant personality disorder, and body dysmorphic disorder as predictors in this exploratory study. Method: Main outcome was the social phobia subscale of Social Phobia and Anxiety Inventory (SPAI SP). DSM-IV axis I and II interviews were completed. Results: (1) Sotsky et al. (1991) findings were not reproduced. However, RIPT subjects with poor general functioning were less improved following treatment. Subjects with concurrent agoraphobia responded better with RCT than subjects without agoraphobia. (2) Age of onset and expectations were the most powerful predictors of post treatment outcome. Conclusion: Some patient characteristics appear to impact outcome with RIPT and RCT differentially. The findings are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Borge, Finn-Magnus; Hoffart, Asle; Sexton, Harold; Alden, Angst, Beck, Borge, Borge, Borkovec, Brown, Brown, Chambless, Chartier, Chen, Clark, Clark, Clark, Clark, Davidson, Delsignore, DeWit, Dreessen, Erwin, Fava, Feske, First, First, Heimberg, Hoffart, Hoffart, Hofmann, Hollon, Joyce, Kessler, Kessler, Kirsch, Kirsch, Kraemer, Lincoln, Lipsitz, Mersch, Meyer, Mortberg, Otto, Safren, Scholing, Sotsky, Stangier, Stopa, Szabo, Turner, Turner, Vallis, Van Ameringen, Van Velzen, Weinberger, Young",2010.0,,0,0,
7880,Comorbidity and the treatment of principal anxiety disorders in a naturalistic sample.,"This study examined the impact of comorbidity on treatment outcome and the effects of cognitive behavioral therapy (CBT) for anxiety and depressive disorders on comorbid disorders in a naturalistic sample of 150 patients presenting to an anxiety disorders clinic. The following results were observed across principal (i.e., most severe) diagnoses. Patients with comorbid anxiety and depressive disorders presented for treatment with higher severity of their principal disorder than patients without comorbidity. However, the presence of comorbidity did not predict dropout or poor treatment response, and patients demonstrated significant improvement in their principal disorders regardless of comorbidity. The frequency of clinically severe and subclinical (i.e., not severe enough to meet diagnostic criteria) comorbid conditions decreased significantly over the course of treatment. The implication of these findings for the classification and treatment of emotional disorders is discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Davis, Lissa; Barlow, David H; Smith, Lisa; Abramovitz, Allen, Allen, Barlow, Beck, Beck, Belzer, Borkovec, Brown, Brown, Brown, Brown, Brown, Chambless, Di Nardo, Di Nardo, Emmanuel, Erwin, Feinstein, Goisman, Goldenberg, Hafner, Lovibond, Mataix-Cols, McLean, Mennin, Mineka, Moscovitch, Mundt, Norton, Nutt, Pincus, Sanderson, Steketee, Tsao, Tsao, Tsao",2010.0,,0,0,
7881,A new hypnotic technique for treating combat-related posttraumatic stress disorder: A prospective open study.,"Many combat veterans with posttraumatic stress disorder (PTSD) have an olfactory component to their traumatic memories that might be utilized by a technique called hypnotherapeutic olfactory conditioning (HOC). Thirty-six outpatients with chronic PTSD, featuring resistant olfactory-induced flashbacks, were treated with six 1.5-hour sessions using hypnosis. The authors used the revised Impact of Events Scale (IES-R), Beck Depression Inventory, and Dissociative Experiences Scale as outcome measures. Significant reductions in symptomatology were recorded by the end of the 6-week treatment period for the IES-R, as well as for the Beck Depression Inventory and the Dissociative Experiences Scale; 21 (58%) of the subjects responded to treatment by a reduction of 50% or more on the IES-R. Improvement was maintained at 6-month and 1-year follow-ups. Use of medication was curtailed. HOC shows potential for providing benefit to individuals suffering from PTSD with olfactory components. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Abramowitz, Eitan G; Lichtenberg, Pesach; Abramowitz, Aviv, Bandler, Beck, Bernstein, Breuer, Brom, Bryant, Cardena, Cardena, Cole, Hagenaars, Harvey, Herz, Herz, Ijzendoorn, Janet, Kline, Laws, Lichtenberg, Lynn, Maylor, Otto, Rothbaum, Sareen, Solomon, Spiegel, Spiegel, Stimpson, Van der Velden, Vermetten, Vermetten, Weiss, Weitzenhoffer, Zald, Zhang",2010.0,,0,0,
7882,Do PTSD symptoms and course predict continued substance use for homeless individuals in contingency management for cocaine dependence?,"Homeless individuals (n =187) entering contingency management (CM) for cocaine dependence were assessed for PTSD diagnosis, and a subset of 102 participants reporting traumatic exposure also periodically completed a self-report measure of PTSD symptoms. Patients with PTSD in full remission at 6 months (end of active treatment) and 12 months (end of aftercare) used substances much less frequently during aftercare than those with no PTSD diagnosis. Those whose PTSD diagnosis improved to full remission status during active treatment, and remained in full remission at 12 months, also had superior substance use outcomes. Severity of PTSD symptoms at 6 months, but not baseline or 2 months, was associated with substance use across treatment phases. Substance use during aftercare, however, was better predicted by changes in PTSD symptom severity. Patients whose PTSD symptoms improved more during active treatment fared better during aftercare than those with less improvement. Findings suggest homeless individuals with comorbid PTSD entering CM for cocaine dependence are not necessarily at increased risk for substance use compared to those without the comorbidity. However, course of PTSD does predict substance use, with the potential for CM to be unusually effective for those who respond with substantial, lasting improvements in PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Burns, Michelle Nicole; Lehman, Kenneth A; Milby, Jesse B; Wallace, Dennis; Schumacher, Joseph E; Avants, Back, Back, Back, Ballenger, Benight, Bentler, Bentler, Brady, Brady, Brown, Brown, Browne, Cochrane, Coffey, Cohen, Crosby Ouimette, DeFulio, Derogatis, Derogatis, First, Fischer, Foa, Ford, Hien, Hien, Hien, Higgins, Ilgen, Khantzian, Khantzian, LaGory, Lavori, Lester, Luszczynska, McKinney, McNamara, Milby, Najavits, Najavits, Najavits, Najavits, Newcomb, North, Orwin, Ouimette, Ouimette, Ouimette, Ouimette, Ouimette, Ouimette, Peer, Petry, Preacher, Read, Rosnow, Somoza, Steiger, Stein, Stewart, Stitzer, Stump, Thompson, Thompson, Vuchinich, Wenzel, Widaman, Winer, Winick, Zlotnick",2010.0,,0,0,
7883,Treating cockroach phobia with augmented reality.,"In vivo exposure is the recommended treatment of choice for specific phobias; however, it demonstrates a high attrition rate and is not effective in all instances. The use of virtual reality (VR) has improved the acceptance of exposure treatments to some individuals. Augmented reality (AR) is a variation of VR wherein the user sees the real world augmented by virtual elements. The present study tests an AR system in the short (posttreatment) and long term (3, 6, and 12 months) for the treatment of cockroach phobia using a multiple baseline design across individuals (with 6 participants). The AR exposure therapy was applied using the ""one-session treatment"" guidelines developed by Ost, Salkovskis, and Hellstrom (1991). Results showed that AR was effective at treating cockroach phobia. All participants improved significantly in all outcome measures after treatment; furthermore, the treatment gains were maintained at 3, 6, and 12-month follow-up periods. This study discusses the advantages of AR as well as its potential applications. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Botella, Cristina; Breton-Lopez, Juani; Quero, Soledad; Banos, Rosa; Garcia-Palacios, Azucena; Agras, Arntz, Arvanitis, Azuma, Azuma, Botella, Botella, Botella, Botella, Botella, Boyd, Carlin, Choy, Cisler, De Buck, DiNardo, DiNardo, Essau, Garcia-Palacios, Garcia-Palacios, Garcia-Palacios, Gorman, Gotestam, Hersen, Juan, Juan, Kerawalla, Magee, Marks, Marks, Marks, McNally, Meng, Milgram, Mineka, Muris, Parsons, Powers, Riva, Riva, Rothbaum, Sandin, Shuhaiber, Squire, Squire, Szymanski, Tyron, Watson, Wolpe, Worn, Zlomke, Ost, Ost, Ost, Ost, Ost, Ost, Ost",2010.0,,0,0,
7884,Cost-effectiveness analysis of an occupational therapy-led lifestyle approach and routine general practitioner's care for panic disorder.,"Objective: To assess the cost-effectiveness of an occupational therapy-led lifestyle approach to treating panic disorder in primary care compared with routine general practitioner's (GP) care. The burden of mental health disorders is considerable. Cost-effective interventions are necessary to alleviate some of these burdens. Habitual lifestyle behaviours influence mood, although to date mainly single lifestyle factor trials have been conducted to examine the effects on anxiety. Methods: An economic evaluation was conducted alongside an unblinded pragmatic randomised controlled trial with assessment at 5 and 10 months. Costs and consequences, as measured by the Beck anxiety inventory (BAI) and quality adjusted life years (QALYs), were compared using incremental cost-effectiveness ratios (ICERs). Results: The occupational therapy-led lifestyle intervention was more costly than routine GP care at both 5 and 10 months. Significant outcome improvements were evident at 5 months when using the BAI, although these were not maintained at 10 months. Small differences in mean QALYs were found. The estimated ICER was 36 per BAI improvement for 5 months and 39 for 10 months, and 18,905 per QALY gained for 5 months and 8,283 for 10 months. Conclusions: If the maximum willingness to pay per additional QALY is 30,000, then there is an 86% chance that a lifestyle intervention may be considered to be value-for-money over 10 months. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lambert, Rodney A; Lorgelly, Paula; Harvey, Ian; Poland, Fiona; Alsene, Andrews, Asmundson, Barlow, Beck, Benton, Biber, Bower, Brazier, Briggs, Brooks, Brown, Callaghan, Clark, Davids, Dolan, Duncan, Falk Dahl, Frank, Glick, Gulpek, Hamilton, Heuzenroeder, Horwath, Isensee, Kaltenthaler, Kaltenthaler, Katon, Koh, Kumano, Lambert, Lambert, Manca, Mann, March, Marciniak, Matthews, Maunder, McCrone, McHugh, Mulder, Muller, Nadiga, Netten, Papakostas, Patel, Perna, Raftery, Roberge, Slattery, Smoller, van Hout, Weissman, Weissman, Yeragani",2010.0,,0,0,
7885,Comorbid anxiety disorders and treatment of depression in people with multiple sclerosis.,"Objective: Anxiety is highly comorbid with depression, but little is known about the impact of anxiety disorders on the effectiveness of empirically supported psychotherapies for depression. We examined such outcomes for people with Multiple Sclerosis (MS) and depression, with versus without comorbid anxiety disorders. Design: Participants with MS (N = 102) received 16 weeks of telephone-administered psychotherapy for depression and were followed for one year post-treatment. Results: Participants with comorbid anxiety disorders improved to a similar degree during treatment as those without anxiety disorders. Outcomes during follow-up were mixed, and thus we divided the anxiety diagnoses into distress and fear disorders. The distress disorder (GAD) was associated with elevated anxiety symptoms during and after treatment. In contrast, fear disorders (i.e., panic disorder, agoraphobia, social phobia, specific phobia) were linked to depression, specifically during follow-up, across 3 different measures. Conclusions: People with GAD receiving treatment for depression may benefit from additional services targeting anxiety more specifically, while those with comorbid fear disorders may benefit from services targeting maintenance of gains after treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Burns, Michelle Nicole; Siddique, Juned; Fokuo, J. Konadu; Mohr, David C; Allen, Barlow, Beck, Beiske, Brown, Clark, Cohen, Cohen, D'Alisa, Fairburn, Fava, Feinstein, First, Foley, Gibbons, Greenberg, Hamilton, Hatzakis, Kessler, Korostil, Kroencke, Lenze, Mineka, Miranda, Mohr, Mohr, Mohr, Mohr, Mohr, Mohr, Potts, Ruskin, Sadovnick, Scott, Sharrack, Simon, Taylor, Verdier-Taillefer, Watson, Watson, Zigmond",2010.0,,0,0,
7886,Dialectical behavior therapy as a precursor to PTSD treatment for suicidal and/or self-injuring women with borderline personality disorder.,"This study examined the efficacy of dialectical behavior therapy (DBT) in reducing behaviors commonly used as exclusion criteria for posttraumatic stress disorder (PTSD) treatment. The sample included 51 suicidal and/or self-injuring women with borderline personality disorder (BPD), 26 (51%) of whom met criteria for PTSD. BPD clients with and without PTSD were equally likely to eliminate the exclusionary behaviors during 1 year of DBT. By posttreatment, 50-68% of the BPD clients with PTSD would have been suitable candidates for PTSD treatment. Borderline personality disorder clients with PTSD who began treatment with a greater number of recent suicide attempts and more severe PTSD were significantly less likely to become eligible for PTSD treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Harned, Melanie S; Jackson, Safia C; Comtois, Katherine A; Linehan, Marsha M; Addis, Becker, Bernai, Bernstein, Bohus, Bolton, Bradley, Clarke, Cloitre, Cloitre, Feeny, First, First, Foa, Foa, Forbes, Harned, Harned, Harned, Keller, Kessler, Klonsky, Linehan, Linehan, Linehan, Linehan, Linehan, Loranger, Loranger, Lynch, McDonagh, Resick, Ross, Stirman, Taylor, van Minnen, Waller, Zanarini, Zanarini, Becker, DeViva, Zimmerman, Mattia, Shea",2010.0,,0,0,
7887,"Relationship between respiratory, endocrine, and cognitive-emotional factors in response to a pharmacological panicogen.","Background: The cholecystokinin agonist pentagastrin has been used to study panic attacks in the laboratory and to investigate hypothalamic-pituitary-adrenal axis activity. Its mechanism of panicogenesis remains unclear. Data from other models suggest that respiratory stimulation itself may induce panic, but pentagastrin's effects on respiration are not well established. Data from another model also suggest links between respiratory and HPA axis reactivity and cognitive modulation of both. To further explore these phenomena, we added respiratory measures to a study of cognitive modulation of HPA and anxiety responses to pentagastrin. Methods: Healthy subjects received pentagastrin and placebo injections, with measurement of cortisol and subjective responses, on two different laboratory visits. They were randomly assigned to receive standard instructions or one of two versions of previously studied cognitive interventions (to either facilitate coping or increase sense of control), given before each visit. Capnograph measures of heart rate (HR), respiratory rate (RR), and end-tidal pCO2 were obtained on 24 subjects. Results: Relative to placebo, pentagastrin induced a significant decline in pCO2 with no change in RR. Cortisol and HR increased, as expected. Cognitive intervention reduced the hyperventilatory response to pentagastrin. Conclusions: Pentagastrin stimulates respiration, likely via increases in tidal volume. Respiratory stimulation could play a role in its panicogenic potency, though perhaps indirectly. As with HPA axis responses, higher-level brain processes may be capable of modulating pentagastrin-induced hyperventilation. This model may be useful for further study of cortical/cognitive control of interacting emotional, respiratory, and neuroendocrine sensitivities, with potential relevance to panic pathophysiology. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lyubkin, Mark; Giardino, Nicholas D; Abelson, James L; Abelson, Abelson, Abelson, Abelson, Abelson, Abelson, Abelson, Abelson, Banzett, Banzett, Bradwejn, Bradwejn, Bradwejn, Craig, Critchley, Evans, Evans, Harper, Harro, Kamilaris, Khan, King, Klein, Koszycki, Kristensen, Lara, Lee, Ley, Mezey, Pfaltz, Pfaltz, Poe, Ritz, Schruers, von Leupoldt, Wilhelm",2010.0,,0,0,
7888,Internet-delivered physical activity intervention for college students with mental health disorders: A randomized pilot trial.,"The prevalence of mental health disorders among college students is rising and the increasing rates of anxiety and depression have important societal implications. Physical activity has been proposed as an adjuvant to traditional treatment approaches (i.e. psychotherapy or pharmacotherapy), and the internet is a potentially useful means of delivering physical activity information to the college-aged population. This randomized pilot trial examined the effects of an internet-based physical activity intervention on physical activity, self-efficacy, depression, and anxiety in college students (n = 47) receiving mental health counseling. Physical activity, depression, anxiety, exercise self-efficacy, and barriers self-efficacy were assessed at baseline and post-intervention. There was a significant time effect for physical activity, with both groups increasing their physical activity levels across the 10-week intervention but with a larger increase in the intervention condition (d = 0.68) than the control condition (d = 0.05). Exercise and barriers self-efficacy declined across the intervention, but more so in the control than intervention condition. Effects on depression and anxiety were nonsignificant. Finally, correlation analyses showed increases in physical activity were associated with increases in exercise self-efficacy (r = 0.62) and barriers self-efficacy (r = 0.63) and decreases in depression (r = -0.44) in the intervention condition, but not in the control condition. These results suggest that an internet-delivered physical activity intervention may be a promising approach to promoting physical activity among college students undergoing mental health counseling. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mailey, Emily L; Wojcicki, Thomas R; Motl, Robert W; Hu, Liang; Strauser, David R; Collins, Kimberly D; McAuley, Edward; Anderson, Andrews, Babyak, Bandura, Bandura, Baranowski, Beck, Beck, Benton, Biddle, Brent, Craft, Fombonne, Glasgow, Hughes, Klamm, Marquez, Mazure, McAuley, McAuley, McAuley, McAuley, McAuley, Moore, Nemeroff, Netz, Norman, Petruzzello, Rovniak, Singh, Spielberger, Steele, Vandelanotte, Vastag",2010.0,,0,0,
7889,The effects of group counseling on college students' obsessive-compulsive symptoms.,"Objective: To explore the accessibility and the effect of group counseling for improving college students' obsessive-compulsive symptoms. Methods: Chose 16 obsessive-compulsive symptoms students from Anhui Normal University as the experimental group, and another 16 students as the control group. Group counseling was given to the experimental group once a week for 8 weeks; the control group did not do any training. All the subjects were tested with. SCL-90, PI and PSCCS when the group counseling was started, finished, and had a period of three mondis after it was finished. Results: The experimental group and the control group had no difference in the total score of SCL-90 and the scores of obsessional factor in SCL-90, PI and PSCCS before group counseling. In the post-test and tracing-test, the total score of SCL-90 and the scores of obsessional factor in SCL-90, PI and PSCCS of experimental group were significantly lower than that before group counseling; whereas they had no significant difference in score from the control group. Conclusion: As a form of intervention, group counseling has great positive effect on improving the students' obsessive-compulsive symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fang, Shuang-Hu; Zheng, Kai; Falls-Stewart, Jenike, Muris, Wade",2010.0,,0,0,
7890,Benzodiazepine use among patients in heroin-assisted vs. methadone maintenance treatment: Findings of the German randomized controlled trial.,"Benzodiazepine (BZD) use has been found to be associated with poorer psychosocial adjustment, higher levels of polydrug use and more risk-taking behaviors among opioid dependent patients. The aim of this paper is to analyze the correlation between BZD use, BZD prescription and treatment outcome among participants in the German trial on heroin-assisted treatment. 1015 patients who participated in the study comparing heroin-assisted and methadone maintenance treatment (HAT & MMT) for 12 months were included in the analysis. Analyses were carried out to assess the association of treatment outcome with baseline BZD use, with ongoing BZD use and with different patterns of BZD prescription. Baseline BZD use correlated with lower retention rates but not with poorer outcome. Ongoing BZD use correlated with poorer outcomes. Significantly better outcomes were found in the course of phobic anxiety symptomatology for those with regular prescription of BZD. The percentage of BZD positive urine tests decreased more in HAT than in MMT. Poorer outcome for benzodiazepine users may be mediated by a higher severity of addiction. Cautious prescribing of benzodiazepines may be beneficial due to the reduction of overall illicit use. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Eiroa-Orosa, Francisco Jose; Haasen, Christian; Verthein, Uwe; Dilg, Christoph; Schafer, Ingo; Reimer, Jens; Backmund, Bammer, Batki, Blanken, Bleich, Bramness, Brands, Brunette, Busto, Darke, Darke, Derogatis, Devine, Eap, Gsellhofer, Haasen, Jaccard, Johnson, Kerr, Kokkevi, Lopez, March, McLellan, Meiler, Oviedo-Joekes, Perneger, Rehm, Seivewright, Sivam, Stitzer, van den Brink, Verthein, Weizman",2010.0,,0,0,
7891,Expressive writing as a therapeutic process for drug dependent women.,"Women with Substance Use Disorders (SUD) have high rates of trauma and PTSD, which is linked to greater physical and mental health problems and poorer SUD treatment outcomes. While research affirms trauma should be addressed during SUD treatment, the majority of addiction programs do not offer such services. One promising intervention is Pennebaker's expressive writing paradigm, which includes disclosure of traumatic/stressful experiences through 20-minute writing sessions over 3-5 consecutive days. While expressive writing has been linked to improvements in mental and physical health, the intervention has not been studied in persons with SUDs. The present study was a randomized clinical trial comparing expressive writing to control (neutral topic) writing. Conducted in a residential SUD program for women, the study: (1) compared psychological and physical health profiles in SUD women with and without co-morbid PTSD and/or trauma; (2) compared 2-week and 1-month outcomes for the experimental and control groups; and (3) examined immediate and more distal levels of psychological distress following expressive writing. Study participants were N=149 women randomized to either the expressive writing or control writing condition. All women completed 20-minute writing sessions daily for 4 consecutive days. As predicted, SUD women reported high rates of trauma and PTSD, and those with such co-morbidities had more severe psychological and physical health problems. At 2-week follow-up, expressive writing participants showed greater reductions in post-traumatic symptom severity and anxiety scores than control writing participants. While no group differences were found at 1-month follow-up, this was due largely to significant improvements for both groups over the course of residential treatment. Finally, expressive writing participants showed increased negative affect immediately after each writing session, but there were no differences in pre-writing negative affect scores between groups the following day. By the final writing session, participants were able to write about traumatic/stressful events without having a spike in negative affect. Study results suggest expressive writing may be a brief, cost effective, adjunct to SUD treatment. Furthermore, expressive writing, when implemented in a residential SUD setting, appears safe, and warrants further study as a strategy for addressing trauma and PTSD in tandem with SUD treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Meshberg-Cohen, Sarah",2010.0,,0,0,
7892,Narrative exposure therapy for posttraumatic stress disorder in tortured refugees: A preliminary uncontrolled trial.,"Torture has severe mental health effects, especially in terms of posttraumatic stress disorder (PTSD) and depression. However, there is still a lack of empirical treatment studies. The present paper presents data on 16 torture survivors receiving 10 sessions of narrative exposure therapy (NET). Symptoms of PTSD and depression, assessed by Clinician-Administered PTSD Scale (CAPS) and Hamilton Rating Scale for Depression (HRSD), decreased significantly from pre-treatment to 6-month follow-up, with Cohen's d effect sizes of 1.16 and 0.84, respectively. Although treatment gains were moderate, further research on evidence-based treatments for PTSD and depression in refugee torture survivors is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Halvorsen, Joar Overaas; Stenmark, Hakon; Asmundson, Basoglu, Basoglu, Basoglu, Basoglu, Basoglu, Bichescu, Birck, Blake, Blake, Bradley, Campbell, Carlsson, Cienfuegos, d'Ardenne, Dunlap, Foa, Foa, Furukawa, Gorst-Unsworth, Hamilton, Hinton, Holtz, Hougen, Jacobson, Kaminer, McGrath, Monson, Neuner, Neuner, Neuner, Nicholl, Paunovic, Petersen, Schauer, Schnurr, Schottenbauer, Schulz, Sheehan, Silove, Turner, Turner, Weathers, Weathers, Zimmerman",2010.0,,0,0,
7893,Effects of tryptophan depletion on responses to yohimbine in healthy human subjects.,"Explored the interactive role of 5-hydroxytryptamine (5-HT) and norepinephrine (NE) systems in the pathophysiology of panic anxiety by giving placebo-controlled challenge tests involving tryptophan depletion and the alpha-2-adrenergic antagonist yohimbine (YB) to 11 healthy adults. Five of 11 Ss reported a marked increase in feelings of nervousness (>= 25 mm on a 100 mm analog scale) following the combination test, while 1/11 had this response to YB alone. No Ss had an increase in nervousness during other control tests. The increase in nervousness after the tryptophan depletion-YB test was significant for the whole group, but there were no other unique changes in behavioral, physiologic, or biochemical variables with this test. The findings replicate those of D. S. Charney et al, (see record 1993-21858-001) and may have implications for theories about the pathophysiology of such anxiety disorders as panic disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Goddard, Andrew W; Charney, Dennis S; Germine, Mark; Woods, Scott W; Heninger, George R; Krystal, John H; Goodman, Wayne K; Price, Lawrence H",1995.0,,0,0,
7894,The 5-HT3 antagonist ondansetron reduces gastrointestinal side effects induced by a specific serotonin re-uptake inhibitor in man.,"Examined the effect of co-administration of ondansetron on the attenuation of fluvoxamine (FVX) induced gastrointestinal (GI) side effects in 14 healthy men (aged 20-37 yrs), in a double-blind, placebo controlled study. In Phase 1, 4 Ss used a visual analog rating scale to report nausea, GI symptoms, and other side effects after oral administration of FVX (100 mg). In Phase 2, 10 Ss rated their symptoms after co-administration of FVX and ondansetron or placebo. One dose of FVX produced nausea and other symptoms. Ondansetron attenuated GI side effects and total symptoms at the time of estimated peak plasma levels. FVX and other specific serotonin (5-hydroxytryptamine [5-HT]) re-uptake inhibitors (SSRIs) are effective treatments for depressive illness and panic disorder. If 5-HT3 antagonists such as ondansetron attenuate GI symptoms in patients taking SSRIs, their use may extend the advantages in tolerability which these drugs have over tricyclics. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bailey, Jayne E; Potokar, John; Coupland, Nick; Nutt, David J",1995.0,,0,0,
7895,Group vs individual cognitive behaviour therapy in panic disorder: An open clinical trial with a six month follow-up.,"Compared the efficacy of group (CBTgr) and individual cognitive behavior therapy (CBTi) in the treatment of panic disorder with and without agoraphobia, in a 6 mo followup. 20 patients (aged 18-65 yrs) with panic disorder with and without agoraphobia were assigned to CBTgr and CBTi with weekly sessions for 12 or 14 wks. The CBTgr Ss were given additional 2 individual 1 hr sessions with the protocol being identical for both treatment modalities. Ss were administered a battery of tests within 10 days prior to the beginning of the treatment, at midpoint, within 10 days following treatment and monthly thereafter for the follow-up. Results indicate that both CBTgr and CBTi significantly reduced panic frequency at treatment end. However, a differential effect favoring CBTi over CBTgr was observed at the end of the follow-up phase with regards to symptoms other than panic, like generalized anxiety and depressive symptoms. (French abstract) (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Neron, Sylvain; Lacroix, Denis; Chaput, Yves; Allgulander, Allgulander, Anderson, Ballenger, Barlow, Barlow, Beck, Beck, Beck, Beck, Beitman, Borkovec, Charney, Chignon, Clark, Clum, Coleman, Coryell, Coryell, Craske, Craske, Fifer, Johnson, Klosko, Lepine, Liebowitz, Lydiard, Markowitz, Mavissakalian, Michelson, Munjack, Nagy, Nagy, Noyes, Noyes, Neron, Pollack, Reich, Rickels, Rose, Rush, Salkovskis, Schneier, Schweizer, Shaffer, Shapiro, Sheehan, Siegel, Sokol, Thyer, Weissman, Wessler, Wilson, Zitrin, Ost, Ost, Ost",1995.0,,0,0,
7896,Dynamic change in psychotherapy: Mastery of interpersonal conflicts.,"This study investigated the relationship between the mastery of maladaptive interpersonal patterns (assessed from narratives told during psychotherapy) and outcome of psychotherapy. Transcripts from the psychodynamic psychotherapy of 41 patients were scored using a content analysis mastery scale. Changes in mastery level over the course of therapy were significantly related to changes in observer and therapist ratings. In addition, the patients' own judgments of changes in their symptoms and main problems paralleled changes in the mastery of interpersonal conflicts found in their narratives. These results are consistent with the proposition that symptoms abate with the mastery of core interpersonal conflicts. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Grenyer, Brin F. S; Luborsky, Lester; Battle, Derogatis, Freud, Freud, Gottschalk, Grenyer, Lambert, Liberman, Luborsky, Luborsky, Luborsky, Luborsky, Luborsky, Rice",1996.0,,0,0,
7897,Avoidant personality disorder as a predictor for treatment outcome among generalized social phobics.,"Examined the effect of comorbid avoidant personality disorder (APD) on response to exposure-based group therapy in 48 adult outpatients who met Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) diagnostic criteria for generalized social phobia. Ss completed self-report questionnaires, including measures of probability of assertion and associated discomfort, of negative self-image, and of social anxiety, at pretreatment, 1-wk posttreatment, and 3-mo follow-up. At pretest, Ss with APD were more severely impaired on all self-report measures and had a higher frequency of comorbid diagnoses than were Ss without the disorder. Although Ss with APD improved significantly with treatment, they continued to report more severe impairment on all outcome measures at posttest and 3-mo follow-up than did Ss without APD. Depression may in part explain the poorer rate of improvement during treatment of those with APD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Feske, Ulrike; Perry, Kevin J; Chambless, Dianne L; Renneberg, Babette; Goldstein, Alan J",1996.0,,0,0,
7898,Elimination of posttraumatic symptomatology by relaxation and visual-kinesthetic dissociation.,"Five male patients (aged 22-50 yrs) suffering from posttraumatic stress disorder (PTSD) and experiencing persistent intrusive imagery were treated with 2 sessions of relaxation training followed by 2 sessions of the visual-kinesthetic dissociation technique. Outcome was monitored using a multiple baseline design. Despite the briefness of the intervention, 3 of the patients showed an almost complete reduction in the frequency of their intrusive images and substantial changes on other measures of psychopathology. One patient showed partial improvement and one patient showed no improvement at all. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hossack, Alex; Bentall, Richard P",1996.0,,0,0,
7899,Causes and consequences of depression and its treatment: Three epidemiologic studies.,"Researchers have reported associations between panic disorder, depresslon and ischemic heart disease. The role of the drugs used to treat these conditions has not been evaluated. As part of a larger study on reducing cardiovascular disease in an entire community, we estimated the association between psychotropic drugs and ischemic heart disease in a large community-based population using a cohort study design. We defined exposure as current use of psychotropic medications at the time of the health interview. We determined ischemic heart disease by ICD9-CM codes and by an epidemiologic algorithm using clinical diagnostic criteria. An elevated risk for clinically significant ischemic cardiac events was associated with benzodiazepine use (relative risk (RR) = 2.0, 90 per cent CI = 1.1-3.9) and antidepressant use (RR = 5.7,90 per cent CI = 2.6-12.8), although the latter estimate was based on only six antidepressant users who had an ischemic event. Given that this is a highly prevalent disease and these are widely prescribed drugs, the trends shown in this exploratory study should be confirmed in other studies. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lapane, Kate Lynn",1996.0,,0,0,
7900,The efficacy of eye movement desensitization and reprocessing in the treatment of test anxiety.,"This study explores the efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of test anxiety. Thirty-five college students who scored above the 50th percentile on test anxiety were randomly assigned to either a treatment or wait-list control group. Subjects received two 1 hour sessions of EMDR. After posttesting, the control group also received EMDR treatment. The treatment group had a significant reduction in Test Anxiety Inventory total score, emotionality scale score, worry scale score, and state anxiety as compared to the control group. After treatment, the control group matched the experimental group for significant reductions on all dependent measures. The subject group as a whole had significant reductions in subjective units of distress during treatment as well as a significant increase in the validity of positive self-statements. Reductions in anxiety measures were maintained at one month follow-up. The differential effect of EMDR on subjects based on gender and pretreatment level of trait anxiety was also examined. Subjects with high trait anxiety had a greater reduction in total test anxiety, emotionality, and worry on posttesting as compared to subjects with lower trait anxiety. Males and females were found to respond equally to the treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Enright, Matthew Blaise",1996.0,,0,0,
7901,A treatment outcome study assessing the effectiveness of trauma focused and effect focused group psychotherapy for women who were sexually abused as children.,"Research indicates that depression and Post-traumatic Stress Disorder are the most commonly identified psychological disorders experienced by adult survivors of childhood sexual abuse. Results of controlled studies indicate different forms of group psychotherapy have been successful in ameliorating difficulties associated with these disorders. However, none of these investigations have assessed the effectiveness of theoretically based treatments. Theory and research regarding the treatment of Post-traumatic Stress Disorder indicate that exposure to imaginal stimuli related to sexual abuse trauma is necessary for the alleviation of difficulties. The present study attempted to compare an exposure based treatment (Trauma Focused Treatment or TFT) and a treatment similar to that offered in previous sexual abuse treatment studies which was designed to alleviate current problems associated with the abuse through group discussion (Effect Focused Treatment or EFT). Two psychotherapy groups that lasted for either 7 or 10 weeks were provided for each of the treatments. Twelve women received TFT and 10 women received EFT. Due to lack of statistically significant differences and methodological problems including a small sample size, it is not appropriate to draw firm conclusions regarding the data obtained in this study and not possible to make comparisons between the two types of treatment provided. However, descriptive findings suggest that the majority of subjects in the TFT and EFT experienced improvements in difficulties associated with the abuse. The most commonly identified changes included improvements in mood, self-esteem and ability to admit the abuse occurred. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dodds, Amy Kathryn",1996.0,,0,0,
7902,Direct therapeutic exposure and posttraumatic stress disorder: Predicting change scores.,"The purpose of this study was to identify predictors of change following direct therapeutic exposure in Vietnam veterans with post-traumatic stress disorder (PTSD). Fifty Vietnam veterans were assessed before ""flooding"" treatment and again seven months after treatment. The assessment included measurements of psychological functioning and social adjustment, as well as demographic and substance abuse information. A residual change score was used to determine PTSD symptom change. Predictors of change included social support, days of drinking alcohol and number of treatment sessions. Results suggest that number of days drinking was significantly related to the residual change score, but in a direction that was not predicted. Overall treatment effects from direct therapeutic exposure were insignificant for the group as a whole. This may have obscured possibilities of finding significant predictors of treatment response among social support, number of flooding sessions and substance use. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Leskin, Gregory Alan",1996.0,,0,0,
7903,Assessment of a new self-rating scale for post-traumatic stress disorder.,"Evaluated the test-retest reliability, internal consistency, and factorial, concurrent, convergent, discriminant and predictive validity of the Davidson Trauma Scale (DTS) among posttraumatic stress disorder (PTSD) patients. The DTS was administered to 78 rape victims (mean age 26.4 yrs), 110 war veterans (mean age 46.7 yrs), 53 Hurricane Andrew victims (mean age 40.8 yrs), and 102 Ss (mean age 44.7 yrs) in a multicenter clinical trial of an antidepressant drug in survivors of miscellaneous traumas. The DTS demonstrated good test-retest reliability and internal consistency. In PTSD diagnosed Ss, the factor structure more closely resembled the traditional grouping of symptoms. Concurrent validity was obtained against the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R). Good convergent and divergent validity was obtained. The DTS showed predictive validity against response to treatment, as well as sensitivity to treatment effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Davidson, Jonathan R. T; Book, S. W; Colket, J. T; Tupler, L. A; Roth, S; David, D; Hertzberg, M; Mellman, T; Beckham, J. C; Smith, R. D; Davison, R. M; Katz, R; Feldman, M. E",1997.0,,0,0,
7904,Clinical trial of a music generated vibrotactile therapeutic environment for musicians: Main effects and outcome differences between therapy subgroups.,"Investigated music-enhanced therapeutic regimes as compared to standard traditional verbal counseling and psychotherapy in order to evaluate a potentially attractive therapeutic option designed especially for musicians with career stress and performance anxiety. 54 22-55 yr old professional symphony orchestra musicians were first matched in a stratified fashion and then randomly assigned to 1 of 3 treatment interventions: traditional psychotherapeutic counseling, counseling supplemented with music, or counseling supplemented with music plus vibrotactile sensations. Treatment conditions were based on cognitive-behavioral techniques including relaxation training and imagery. The Somatron Acoustic Massage power recliner served as the therapeutic environment for all musicians. Results indicate that music-enhanced therapies were just as effective as traditional counseling. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Brodsky, Warren; Sloboda, John A",1997.0,,0,0,
7905,Predictors of response to cognitive-behavioral group therapy for social phobia.,"Response to cognitive-behavioral group therapy for social phobia was assessed at posttest and 6-month follow-up in a sample of 62 clients (41 generalized subtype, 21 nongeneralized). Predictors assessed were depression, expectancy, personality disorder traits, clinician-rated breadth and severity of impairment, and frequency of negative thoughts during social interactions. Outcome measures included self-report questionnaires and behavioral tests of dyadic interaction and a public speech. Although no predictor was related to outcome across all domains of measurement, higher depression, more avoidant personality traits, and lower treatment expectancy were each related to poorer treatment response on one or more outcome criteria. Cognitive change was consistently associated with change on self-report symptom measures, but, contrary to expectation, lower rates of negative thinking at posttest did not predict better maintenance of treatment gains at follow-up. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Chambless, Dianne L; Tran, Giao Q; Glass, Carol R",1997.0,,0,0,
7906,On predicting improvement and relapse in generalized anxiety disorder following psychotherapy.,"Reports an investigation of outcome predictors in a clinical trial of psychological therapies for 80 patients (aged 18-65 yrs) with generalized anxiety disorder. A variety of information of potential predictive value was obtained at 3 stages of patient contact: the initial referral, a screening interview and early sessions of therapy. Three measures of the clinical significance of change over a 12 mo follow-up period were used to construct a composite measure which categorized outcome in terms of sustained improvement, relapse and no consistent change. 71% of patients were correctly classified as improved or not from initial data with a significant increase in accuracy with information from the screening interview (77%) and early sessions (82%). Patients who relapsed or not were predicted with considerable accuracy from initial data (90%) and there was no significant increase in predictive power with additional information. The most powerful and robust predictors were: type of treatment received, marital status, marital tension and complexity of clinical presentation in terms of axis 1 co-morbidity. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Durham, Robert C; Allan, Therese; Hackett, Christine A",1997.0,,0,0,
7907,Systematic desensitization in the treatment of fear of flying.,"Presents preliminary results for the validation of a systematic desensitization program applied to 20 patients with fear of flying. The program is made up of 3 phases: (1) 4 sessions in relaxation and imagination training; (2) 3 sessions elaborating the phobic stimulus hierarchy (traveling by plane); and (3) 5-8 sessions focusing on the application of the systematic desensitization, together with stop thinking. Treatment success was evaluated with self-report scales, clinical interview, and psychophysiological variables in an analogous situation. Results support the validity of the systematic desensitization program. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Capafons, Jaun I; Sosa, Carmen D; Avero, Pedro",1997.0,,0,0,
7908,The effectivity of dynamic psychotherapy.,"Studied the effectiveness of psychodynamic therapies in a naturalistic prospective longitudinal study. 117 patients treated with psychodynamic therapy were compared with 116 untreated patients. Improvement of patients' general psychosocial impairment was of clinical relevance and significance. The effective magnitude of change was high. Untreated Ss showed on the average no remission of impaired well-being and symptoms 6 mo later. Analytically orientated short-term psychotherapy and dynamic psychotherapy seem to be effective in the treatment of many dysthymic and anxiety disorders and in the treatment of a number of personality disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Holm-Hadulla, Rainer; Kiefer, Lydia; Sessar, Wolfgang",1997.0,,0,0,
7909,The problem of randomisation in psychotherapeutic research.,"Observed problems with randomization in a study comparing inpatient and outpatient psychotherapeutic treatment for 132 patients suffering from anxiety disorders. Ss were randomly allocated to treatment type. Because of Ss' voluntary agreement or refusal of the proposed treatment, the subsamples were markedly affected in their homogeneity. More disturbed Ss agreed to inpatient psychotherapy, whereas less disturbed Ss refused that form of treatment. Bias toward or against a given form of treatment was the most potent predictor in multivariate analysis. The influence of this distortion of the samples is discussed with regard to the generalization of results. Data suggest that randomization should be avoided in psychotherapeutic research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Krauthauser, Helmut; Bassler, Markus",1997.0,,0,0,
7910,Cortisol response to d-fenfluramine in patients with obsessive-compulsive disorder and in healthy subjects: Evidence for a gender-related effect.,"To evaluate serotonergic function in obsessive-compulsive disorder (OCD), plasma cortisol response to d-fenfluramine (30 mg po) was examined in 20 drug-free obsessive-compulsive outpatients (aged 18-64 yrs), and in 20 age- and sex-matched healthy Ss, under double-blind, placebo-controlled conditions. The study found that (1) baseline plasma cortisol secretion was significantly increased in patients with OCD; (2) in healthy Ss, the cortisol response to d-fenfluramine was evident in women, but not in men; (3) plasma cortisol response to the serotonergic challenge did not differ between patients and controls, but it was significantly reduced in female patients as compared with healthy women. These results demonstrate a hyperactivity of the hypothalamo-pituitary-adrenal axis in obsessive-compulsive patients and suggest a dysfunction of 5-hydroxytryptamine (5-HT) transmission in female patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Monteleone, Palmiero; Catapano, Francesco; Tortorella, Alfonso; Maj, Mario",1997.0,,0,0,
7911,Danger ideation reduction therapy (DIRT): Preliminary findings with three obsessive-compulsive washers.,"Three obsessive compulsive patients (all females, aged 43, 51, and 37 yrs) received Danger Ideation Reduction Therapy (DIRT) in an initial treatment trial. All 3 Ss presented with contamination/washing concerns but refused to participate in exposure and response prevention. Components of DIRT include corrective information cognitive restructuring, filmed interviews, microbiological experiments, attentional focusing and R. Hoekstra's (1989) probability of catastrophe estimation task. Treatment consisted of between 6 and 10 1-hr weekly sessions. At post-treatment, substantial reductions in scores on the Padua Inventory, Maudsley Obsessional-Compulsive Inventory (R. J. Hodgson and S. Rachman, 1977) and 2 global rating scales were apparent for all Ss. These improvements were maintained at a 3-mo follow-up. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Jones, Mairwen K; Menzies, Ross G",1997.0,,0,0,
7912,"Employing Eye Movement, Desensitization/Reorientation.","The author presents a case study of a forty-two year-old white female, the victim of multiple sexual traumas resulting in Post-Traumatic Stress Disorder (PTSD). Eye Movement Desensitization/Reorientation (EMDR), a relatively new technique, is employed within the broader context of talk therapy to effect change. EMDR's therapeutic effectiveness is evaluated on a trauma-by-trauma basis through Subjective Units of Distress (SUD), pre- and post-treatment. The maintenance of sustained effected change in SUD ratings is monitored over time on a monthly basis throughout psychotherapy's duration. The patient's changes in overall level of functioning resulting from EMDR and talk therapy are evaluated through changes in MMPI and Rorschach scores. Patient progress is monitored three times through the assessment combination of these two measures: pre-, mid-, and post-treatment. This study addresses the following questions: Is Eye Movement Desensitization/Reorientation an effective technique in decreasing or eliminating symptomatology and psychopathology resulting from Post Traumatic Stress Disorder; and are any therapeutic benefits from its use maintained over a period of at least one year? Finally, what changes in the patient's overall level of functioning result from the combination of EMDR and talk therapy? The review of literature presents four models of Post-Traumatic Stress Disorder (PTSD): (a) the information processing model, (b) the psychological model, (c) the structural-developmental model (Fluid character pathology), and (d) the structural-developmental model (Dysregulation of impulse). These models offer a basis for conceptualizing PTSD as well as present the typical features of this pathology. The current diagnostic criteria for diagnosis as presented in Diagnostic and Statistical Manual of Mental Disorders (4th ed. (DSM-IV); American Psychiatric Association, 1994) also are included. Finally, a comprehensive review of the current literature available on Eye Mov (PsycINFO Database Record (c) 2016 APA, all rights reserved)","D'Anca, John Arthur",1997.0,,0,0,
7913,Appetite awareness training: A cognitive-behavioral intervention for binge eating disorder.,"The present study involves the development and evaluation of an intervention designed to treat women with Binge Eating Disorder. Appetite Awareness Training (AAT) is designed to increase eating in response to internal hunger and satiety cues and reduce eating in response to environmental and non-appetite internal cues such as negative affect and maladaptive dietary rules. AAT consists of an eight week cognitive-behavioral group intervention in which clients are taught strategies including problem solving, relapse prevention, and cognitive restructuring. The major innovation of the treatment is the self-monitoring of hunger and satiety on a form with a visual cue to prompt clients to keep both hunger and satiety at moderate levels; clients do not monitor food intake. Twenty women who met criteria for the proposed clinical diagnosis of Binge Eating Disorder were randomly assigned to either the group intervention or to a wait list control group. At pretest, subjects were administered self-report inventories in order to assess frequency of binges, levels of disordered eating behaviors and attitudes, and levels of associated psychological distress. At posttest, all subjects were readministered these questionnaires and re-evaluated to determine whether they still met diagnostic criteria for Binge Eating Disorder. Analyses indicated that women in the treatment group improved on measures of binge eating, associated symptomatology, depression, social anxiety, and urges to eat following treatment. Women in the control group did not improve on any measure. Relationships between the Record of Eating Episodes and other measures were also explored. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Allen, Heather Noel",1997.0,,0,0,
7914,Prediction of the outcome of cognitive-behavioral group therapy for social phobia.,"Pretreatment and early treatment variables were evaluated as predictors of outcome of Cognitive-Behavioral Group Treatment (CBGT) for social phobia. One hundred and one social phobics were assessed prior to treatment on measures of phobic severity, cognitive functioning, depression, fear of negative evaluation, age of onset of social phobia, diagnosis of avoidant personality disorder (APD), and subtype of social phobia. Subjects also indicated their reaction to the treatment rational and evaluated the credibility of CBGT at session 1. Less pretreatment phobic severity and more positive reaction to treatment predicted greater change in phobic severity by posttreatment assessment. Pretreatment severity, reaction to treatment, age of onset, and depression correctly classifed 82% of treatment completers as either responders or nonresponders, but misclassified the majority of treatment dropouts (83%) as nonresponders. Pretreatment-to-posttreatment change in phobic severity was significantly related to pretreatment-to-posttreatment change in cognitive functioning. More negative cognitive functioning prior to treatment and a composite social phobia subtype/diagnosis of APD predicted greater change from negative to positive cognitive functioning by posttreatment assessment. These results indicate that some baseline measures used to quantify or name important aspects of social phobia have utility in classifying posttreatment response status, but these variables may be less useful in predicting magnitude of change to CBGT. Implications of these findings are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mattia, Jill I",1997.0,,0,0,
7915,Factors that influence the impact of bone marrow transplantation for family caregivers of adult transplant recipients.,"The primary purposes of this descriptive repeated measures study were (a) to identify the influence of family-related characteristics of the caregiver, individual characteristics of the caregiver, uncertainty, and appraisal in predicting the impact of bone marrow transplant (BMT) on the family caregiver, and (b) to identify changes over time in uncertainty, appraisal, and the impact of BMT. Measures were taken at time of admission for transplant, the transplant infusion, and two weeks after the transplant infusion. Data were analyzed using descriptive statistics, correlations and multiple regression procedures. Results indicated that although the caregivers had high uncertainty scores, not all uncertainty factors were elevated. Unpredictability scores were lower than projected by the literature and previous research. Impact of event scores were not universally elevated, but the majority of the caregivers scored in the moderate to high range, indicating the presence of avoidance and intrusion symptomatology. Appraisal factor scores indicated caregivers use simultaneous danger and optimism appraisal of the situation, with both factors being high for this acute phase of BMT. Multiple regression findings indicated that unpredictability and gender were predictive of impact at the transplant infusion time point (F(7,80) = 4.54, p =.0003, R2 =.28 for avoidance and F(9,78) = 5.204, p =.0001, R2 =.38 for intrusion). At the second week after the transplant infusion the avoidance factor at time of the transplant infusion was the only significant predictor of avoidance (F(10.77) = 5.630, p =.0001, R2 =.42). Unpredictability at the second week after the transplant infusion and the intrusion factor score at time of the transplant infusion were predictive of intrusion at the second week time point (F(13,74) = 9.853, p.0001, R2 =.64). The findings indicate that although not all family caregivers are at risk of post-traumatic reactions secondary to BMT, transplant does have the potential to have an impact on family members. These results may help to increase the understanding of the impact, aid in the designing of future research studies, and facilitate identification of interventions to reduce the impact of BMT. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Eilers, June Gail Fechtner",1997.0,,0,0,
7916,Imagery rescripting and incest: Therapist dialogue and contextual unique change in women clients with post-traumatic stress.,"The prevalence of post-traumatic stress disorder (PTSD) among adult survivors of incest, in the context of a victimizing culture and health care reform in the United States, indicates a need for clinically effective and cost-effective therapeutic interventions. This study was designed to explore and evaluate one such treatment: Imagery Rescripting. Using content analysis of selected transcribed video-tapes of all therapy phases demonstrated a positive relationship between Imagery Rescripting and effective emotional processing of traumatic incest. Both quantitative and qualitative methods confirmed Imagery Rescripting's cost-effectiveness and clinical efficacy. Recommendations do include the suggestion for more specificity of client type and matching interventions, which can then produce even greater clinical and economic success. This study continued the social work legacy of evaluative practice and contextual client perspective in addressing serious social problems, such as incest. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Agbuis, Carmen Maria",1997.0,,0,0,
7917,A study of locus of control and the effectiveness of cognitive-behavioral group therapy in the treatment of persons with panic disorder.,"This study was undertaken to examine the impact of locus of control on the efficacy of cognitive-behavioral group therapy in the treatment of panic disorder. The study had a dual purpose: to determine if participation in an eight week program of cognitive-behavioral therapy would significantly reduce a person's level of anxiety and to assess the relationship of locus of control and the cognitive-behavioral therapy. The study hypothesized that the cognitive-behavioral therapy would be an effective treatment and that persons with an internal locus of control would benefit more fully from the therapy than persons with external locus of control. The study employed a quasi-experimental pretest-posttest research design with nonequivalent groups. Pretest and posttest data were collected from the experimental and the control groups through a self-administered questionnaire. The study questionnaire consisted of two standardized instruments with established reliability and validity: the Somatic, Cognitive, Behavioral Anxiety Inventory (Lehrer and Woolfolk, 1982) and the Locus of Control Orientation Scale (Rotter, 1966). A convenience sample of adult men and women diagnosed with panic disorder who voluntarily sought treatment participated in this study. The experimental group had 30 participants and the control group had 28 participants. The study results supported one of the two research hypotheses. Participants who received the cognitive-behavioral therapy demonstrated a significant reduction in the level anxiety while those in the control group did not. Locus of control, however, did not have any significant main or interaction effect upon the other variables. This lack of significance may be due to insufficient variability in participants' locus of control scores. This study contributed to social work knowledge development through exemplifying the concept of the research-practitioner. It contributed to clinical practice by demonstrating the application of cognitive-behav (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mitchell, Christopher Gerard",1997.0,,0,0,
7918,Past life and interlife reports of phobic people: Patterns and outcome.,"In a study of 37 participants with 81 phobias, hypnotically-facilitated ""past life"" and/or ""in-between lives"" (interlives) reports of people with simple and social phobias and agoraphobia were examined when they appeared to be phobia-related. In addition, earlier experiences in some participants' (present) lives that they believed had caused their phobias were examined with the participants in hypnosis. Two research questions guided the study: (1) were there any significantly phobia-differentiating patterns in the past life or interlife reports? and (2) was accessing these past life and/or interlife reports therapeutic? Both questions were examined. Two consistent patterns were found that differentiated simple (and possibly social) phobia from agoraphobia; these reach significance (p <.005) and may lead to questioning the statement ""past life and interlife reports are fantasies."" Additionally, the therapeutic effects, defined as the degree to which anxiety symptoms were reduced, were assessed by two self-rated pre- and post-treatment scales derived from the DSM-III-R (1987) diagnostic scale for phobia symptoms. Reduction in symptoms reached significance for those participants reporting past lives or interlives as causal of their phobias but did not reach significance for those reporting earlier-in-life experiences only as causal. A comparison of some elements of this study with Stevenson's findings about young children who consciously claim to remember prior lives is included, as is a discussion of the ways in which past life reports might fit within some theories of psychology, especially behaviorist, humanistic, and transpersonal psychologies. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Freedman, Thelma B",1997.0,,0,0,
7919,Group therapy for anxiety disorders using rationale emotive behaviour therapy.,"This paper reports a pilot study designed to investigate Rational Emotive Behaviour Therapy in the group treatment of selected clients suffering from anxiety disorders. A convenience sample of 17 clients who completed the treatment programme was selected for the study. Biographical information was sought and data were collected on S anxiety and depression. Intervention was targeted at identifying and correcting irrational beliefs via the application of a range of Rational Emotive Behaviour Therapy techniques. Pre- and post-intervention data were analysed by 2-tailed t-tests for paired samples and found to be significant. The results suggest that the treatment approach was successful in modifying irrational beliefs and anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cowan, Darrin; Brunero, Scott",1997.0,,0,0,
7920,Obsessive-compulsive disorder and ventromedial frontal lesions: Clinical and neuropsychological findings.,"Studied the long-term clinical and neuropsychological outcome of 16 patients with severe and refractory obsessive-compulsive disorder (OCD) who had undergone ventromedial frontal leukotomy during the 1970s. Special emphasis was given to the analysis of specific lesion sites. 6 Ss had ventromedial frontal lesions only, 5 Ss had ventromedial frontal and ventral striatum lesions, and 5 Ss had ventromedial frontal and dorsally extended lesions. Ss showed significant improvement in OCD symptoms; Ss with frontostriatal lesions tended to have improved most, however 8 Ss had developed substance dependence postoperatively. Intellectual functions were largely preserved in Ss with ventromedial frontal lesions only or frontostriatal lesions. However, all Ss showed subnormal performance on the Wisconsin Card Sorting Test. Ss with lesions of the dorsolateral frontal convexity also showed memory problems, attentional slowing, and lower performance IQ. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Irle, Eva; Exner, Cornelia; Thielen, Karsten; Weniger, Godehard; Ruther, Eckart",1998.0,,0,0,
7921,Effect of aging on cholecystokinin-induced panic.,"Epidemiologic surveys have found that the incidence and prevalence of panic disorder decline in later life. The goal of this study was to determine whether aging has an effect on healthy subjects' responses to the panicogenic agent cholecystokinin tetrapeptide (CCK-4). The study used a double-blind placebo-controlled design: 40 subjects 20-35 years old and 40 subjects 65 years old or older were randomly assigned to receive an intravenous bolus of either 50 microg of CCK-4 or normal saline. When given CCK-4, older subjects had significantly fewer and less intense symptoms of panic, shorter duration of symptoms, and less of an increase in heart rate than did younger subjects. The study found an age-related change in responsiveness to CCK-4. Further research to delineate the mechanism of this change is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Flint, Alastair J; Koszycki, Diana; Vaccarino, Franco J; Cadieux, Alain; Boulenger, Jean-Philippe; Bradwejn, Jacques",1998.0,,0,0,
7922,Repetitive transcranial magnetic stimulation for posttraumatic stress disorder.,"Presents 2 brief case histories (29-yr-old and 42-yr-old females) that illustrate the use of repetitive transcranial magnetic stimulation (RTMS) in the treatment of posttraumatic stress disorder (PTSD). RTMS involves placement of a water-cooled electromagnet with a figure-8 coil on the scalp and rapidly turning the magnetic flux on and off, thereby permitting noninvasive, relatively focal stimulation of the cerebral cortex. These initial case studies suggest the potential utility of low-frequency RTMS in normalizing right frontal and paralimbic metabolic activity associated with PTSD. It is noted that converging lines of evidence suggest a possible frequency-dependent effect of RTMS on brain metabolic function that might be usefully exploited in the treatment of disorders such as PTSD, where consistent alterations in regional brain metabolism have begun to be identified. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","McCann, Una D; Kimbrell, Timothy A; Morgan, Christina M; Anderson, Todd; Geraci, Marilla; Benson, Brenda E; Wassermann, Eric M; Willis, Mark W; Post, Robert M",1998.0,,0,0,
7923,Defense mechanism changes in successfully treated patients with obsessive-compulsive disorder.,"Changes in defense mechanisms after treatment of patients with obsessive-compulsive disorder (OCD) were measured by using an established rating scale. Before and after 7-wk group behavior therapy, 17 patients (average age 35 yrs) with OCD were assessed with the Defense Style Questionnaire, Yale-Brown Obsessive Compulsive Scale, and Beck Depression Inventory. After behavior therapy the patients evidenced significant decreases in Yale-Brown Obsessive Compulsive Scale scores and significant increases in the use of more adaptive defense mechanisms. There were no significant changes in 3 maladaptive defense mechanism categories. The improvement in adaptive defenses was independently linked to improvement both in OCD and in depression. Personality as defined by defense mechanisms may be more amenable to brief behavioral treatment than previously thought. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Albucher, Ronald C; Abelson, James L; Nesse, Randolph M",1998.0,,0,0,
7924,Stressful life events and personality styles: Relation to impairment and treatment outcome in patients with social phobia.,"Forty-five patients with social phobia and 15 individuals with no mental disorder were compared on number and type of life events experienced. Social phobia patients were further examined to evaluate the effect of negative life events and of the interaction between personality style and life events on severity of impairment and reactions to cognitive-behavioral group therapy. Ss with social phobia reported more negative life events than Ss with no mental disorder. Among Ss with social phobia, more frequent negative life events were associated with higher scores on measures of depression and general anxiety. Ss high on autonomy who reported more negative autonomous (i.e., achievement-oriented) life events also scored higher on measures of social anxiety and general anxiety. There were no significant interactions between sociotropy and the frequency of reported socially oriented negative life events. However, Ss high on sociotropy scored higher on measures of social anxiety, depression and general anxiety. Ss who had experienced more negative life events improved more after treatment on measures of social anxiety than did those who had experienced fewer negative life events. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Brown, Elissa J; Juster, Harlan R; Heimberg, Richard G; Winning, Cheryl D",1998.0,,0,0,
7925,A comparison of social phobia outcome measures in cognitive-behavioral group therapy.,"This article reports the effects of a cognitive-behavioral group therapy program for 25 socially phobic outpatients (mean age 33.8 yrs) on several psychometric measures. It is the first study to simultaneously examine 3 newer and promising social-phobia measures: the Social Phobia Scale (SPS) and accompanying Social Interaction Anxiety Scale (SIAS), the Social Phobia and Anxiety Inventory (SPAI), and the Liebowitz Social Anxiety Scale (LSAS). More traditional measures of social phobia were also included, along with measures of anxious and depressed mood. Among the newer scales, the SPAI and SPS/SIAS were found to have good sensitivity to treatment. There was limited support for the LSAS. Intercorrelations among all of the outcome measures are presented both before and after cognitive-behavioral therapy, Strengths and weaknesses of each of the newer social-phobia measures are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cox, Brian J; Ross, Leah; Swinson, Richard P; Direnfeld, David M",1998.0,,0,0,
7926,Successful interdisciplinary intervention with an initially treatment-resistant social phobic.,"Despite very successful treatments for social phobia, with many studies reporting as many as 75% of social phobics making clinically significant gains with 3 mo of treatment or less, some social phobics fail to respond to treatment. This case presents a 51-yr-old woman with social phobia who received several trials of treatment for severe public-speaking fears but failed to improve, as demonstrated by persistent reports of fear and avoidance equal to those before treatment. With the assistance of a speech language pathologist, this client received combined therapy that included cognitive-behavioral therapy to treat her public-speaking fear and avoidance and voice therapy to treat excessive muscle contractions in the respiratory and phonatory systems. Overall, the combined treatment was successful, with the client's self-reported levels of fear and avoidance of public speaking decreasing dramatically. Specific improvements during voice therapy and implications for the treatment of social phobia are also discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Laguna, Louis B; Healey, E. Charles; Hope, Debra A",1998.0,,0,0,
7927,Plasma prolactin response to {d}-fenfluramine is blunted in bulimic patients with frequent binge episodes.,"Abnormalities of brain serotonin (5-hydroxytryptamine [5-HT]) transmission have been implicated in the pathophysiology of bulimia nervosa (BN). The purpose of this study was to assess 5-HT transmission via the measurement of the prolactin (PRL) response to the specific 5-HT releasing agent {d}-fenfluramine ({d}-FEN) in 14 drug-free patients (aged 18-29 yrs) with BN and 14 matched controls using a double-blind placebo-controlled design. In both patients and controls, eating-related psychopathology, depressive and obsessive-compulsive symptoms, and aggressiveness were measured by rating scales. Results indicate that baseline plasma levels of PRL and 17beta-oestradiol were significantly reduced in bulimic patients, whereas basal plasma levels of cortisol did not significantly differ from healthy controls. PRL response to {d}-FEN was not different between patients and controls as groups, but it was significantly blunted in bulimics with high frequency bingeing as compared to both those with low frequency bingeing and controls. Results support the idea that serotonin transmission is impaired in bulimic patients with frequent binge episodes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Monteleone, P; Brambilla, F; Bortolotti, F; Ferraro, C; Maj, M",1998.0,,0,0,
7928,Treatments for depression and anxiety in the aged.,"Antidepressant medications, ECT, and selected psychosocial interventions have all been shown to be efficacious treatment approaches for depression in the elderly. Most studies have used drug and psychotherapy protocols specifically tailored for use with older patients. This chapter evaluates the efficacy evidence for these treatments, emphasizing randomized clinical trials with elderly samples in which depression or anxiety have been objectively characterized. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Niederehe, George; Schneider, Lon S; Nathan, Peter E [Ed], Gorman, Jack M [Ed]",1998.0,,0,0,
7929,"Psychosocial treatments for panic disorders, phobias, and generalized anxiety disorder.","In this chapter, we review systematically the current status of the evidence regarding the efficacious empirically supported treatments for panic disorder with and without agoraphobia, specific phobia, social phobia, and generalized anxiety disorder. The studies are evaluated along 2 axes, one that examines the treatments' efficacy and a second that examines the clinical utility of the treatments being researched. This is followed by a brief concluding section on future directions in treatment development and research for these disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Barlow, David H; Esler, Jeanne Lawton; Vitali, Amy E; Nathan, Peter E [Ed], Gorman, Jack M [Ed]",1998.0,,0,0,
7930,Cognitive-behavioral treatments for obsessive compulsive disorder.,"The symptoms that characterize what we now call obsessive compulsive disorder (OCD) have been recognized for centuries in many cultures. However, it was only in the last 3 decades that effective psychosocial and pharmacological therapies for OCD were developed and studied. We briefly discuss diagnostic and theoretical issues, then review the literature about available treatments. In this chapter, we focus primarily on the outcome of cognitive-behavioral therapy by exposure and ritual prevention because most experts consider it to be the treatment of choice for OCD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Franklin, Martin E; Foa, Edna B; Nathan, Peter E [Ed], Gorman, Jack M [Ed]",1998.0,,0,0,
7931,Psychological and behavioral treatments of post-traumatic stress disorder.,"This chapter discusses current psychological treatments of choice for posttraumatic stress disorder (PTSD) and examines the data supporting the use of exposure therapies, anxiety management therapies, their combinations, and eye-movement desensitization and reprocessing. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Keane, Terence M; Nathan, Peter E [Ed], Gorman, Jack M [Ed]",1998.0,,0,0,
7932,Psychosocial treatments for obsessive-compulsive disorder: Literature review.,"The last 30 years have brought much progress in the development of effective psychosocial treatments for obsessive-compulsive disorder (OCD). In this chapter, the authors first briefly review the early behavioral interventions that did not prove satisfactory. Next, they discuss the immediate and long-term efficacy of cognitive-behavioral therapy (CBT) involving exposure and ritual prevention (EX/RP), a program that emerged as quite effective in ameliorating OCD symptoms. The authors also describe what are thought to be the active ingredients in CBT. They then compare the relative efficacy of other treatments, including cognitive therapy, to EX/RP. Finally, they summarize the findings on the prediction of treatment outcome and point to topics for further study. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Foa, Edna B; Franklin, Martin E; Kozak, Michael J; Swinson, Richard P [Ed], Antony, Martin M [Ed], Rachman, S [Ed], Richter, Margaret A [Ed]",1998.0,,0,0,
7933,"Stress of life, stress of death: Anxiety in dentistry from the viewpoint of hypnotherapy.","This chapter studied the effectiveness of hypnosis in reducing dental anxiety. In the first experiment, 23 adults with moderate anxiety related to dental treatment were divided into 2 groups. The 15 Ss in the experimental group underwent a hypnotic treatment to reduce anxiety, while the 8 Ss in the control group received no special treatment. In the hypnotically calmed Ss, the frequency of spontaneous amnesia was not significantly decreased, the occurrence of spontaneous analgesia was significantly more frequent, and the frequency of spontaneous time distortion was not significantly increased compared to controls. In the second experiment, the effectiveness of hypnosis combined with local anesthesia was investigated in the dental treatment of 12 dental needle-phobic patients (aged 30-56 yrs) with needle-related collapse in the anamnesis. After hypnosis, a reduction of anxiety from the dental needle occurred. In 8 cases, no indisposition appeared; in 3 cases moderate indisposition appeared; and in only 1 case a collapse occurred. Even in this case, however, hypnosis had the significant advantage that the patient did not remember the indisposition or collapse. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fabian, T. K; Fabian, G; Csermely, Peter [Ed]",1998.0,,0,0,
7934,Obsessive-compulsive disorder: Cognitive behavioral treatment of older versus younger adults.,"Assessed the efficacy of an established behavioral treatment for obsessive compulsive disorder (OCD) administered to an elderly sample in a clinical setting. Ss were 11 elderly OCD inpatients (mean age 68.7 yrs) and 11 younger OCD inpatients (mean age 30.3 yrs) in a behavioral medicine unit. Ss underwent individualized treatment that featured exposure and response prevention. At discharge, Ss rated the extent of improvement they had experienced in each of the primary symptoms of OCD on an 11-point goal attainment scale. In addition, Ss were rated as responders of nonresponders. There was no significant difference in improvement ratings between the 2 groups at the time of discharge. Both mean ratings were in the range designated as significant improvement. 72% of the elderly Ss and 63% of the younger Ss were classified as treatment responders. Results indicate that older patients can benefit from cognitive behavioral treatment for OCD and that the level of improvement experienced may be comparable to that of younger adults. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Carmin, Cheryl N; Pollard, C. Alec; Ownby, Raymond L",1998.0,,0,0,
7935,"""Seeking safety"": Outcome of a new cognitive-behavioral psychotherapy for women with posttraumatic stress disorder and substance dependence.","Women with current posttraumatic stress disorder (PTSD) comprise 30-59% of substance abuse treatment samples and experience a more severe course than women with either disorder alone. As yet, no effective treatment for this population has been identified. This paper reports outcome results on 17 women who completed a new manual-based 24-session cognitive behavioral group therapy protocol treatment, based on assessments at pretreatment, during treatment, posttreatment, and at 3-month follow-up. Results showed significant improvements in substance use, trauma-related symptoms, suicide risk, suicidal thoughts, social adjustment, family functioning, problem solving, depression, cognitions about substance use, and didactic knowledge related to the treatment. Patients' treatment attendance, alliance, and satisfaction were also very strong. Treatment completers were more impaired than dropouts, yet more engaged in the treatment. Overall, our data suggest that women with PTSD and substance abuse can be helped when provided with a treatment designed for them. All results are clearly tentative, however, due to the lack of a control group, multiple comparisons, and absence of assessment of dropouts. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Najavits, Lisa M; Weiss, Roger D; Shaw, Sarah R; Muenz, Larry R",1998.0,,0,0,
7936,Predicting response to exposure treatment in PTSD: The role of mental defeat and alienation.,"Not all patients with posttraumatic stress disorder benefit from exposure treatment. The present paper describes two cognitive dimensions that are related to inferior response to exposure in rape victims. First, individuals whose memories during reliving of the trauma reflected mental defeat or the absence of mental planning showed little improvement. Second, inferior outcome was correlated with an overall feeling of alienation or permanent change following the trauma. These results are based on blind ratings of transcripts of exposure treatment sessions from 10 women with good outcome and 10 women with inferior outcome. Patients in the two groups were matched for initial symptom severity and were comparable in many aspects of the assault. Patients who experienced mental defeat, alienation, or permanent change may require cognitive restructuring in addition to exposure. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ehlers, Anke; Clark, David M; Dunmore, Emma; Jaycox, Lisa; Meadows, Elizabeth; Foa, Edna B",1998.0,,0,0,
7937,Long-term outcome of panic disorder and social phobia.,"Examined whether cognitive-behavior treatment delivered as a routine service in a specialist clinic is effective in the long term. Long-term outcome was assessed in terms of symptoms, course of the disorder, functioning and disablement, and change in personality traits. Of 124 consecutive patients completing treatment for panic disorder or social phobia, 93 were assessed 1-2 yrs following treatment. The Ss completed questionnaires at follow-up including the Symptom Checklist 90 Revised, the Eysenck Personality Questionnaire, the Locus of Control of Behaviour Scale, and the Composite International Diagnostic Interview Self-Report. The treatment produced significant improvement in measures of symptoms, avoidance, and disablement during treatment and further significant improvement during the follow-up. A quarter of participants no longer met diagnostic criteria, had not sought further treatment, and their anxiety had not troubled them since treatment. It is concluded that these findings, although not showing the large treatment effects reported from controlled outcome research, support the effectiveness of cognitive-behavioral interventions in routine care. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hunt, Caroline; Andrews, Gavin",1998.0,,0,0,
7938,Catastrophic cognitions and the clinical outcome: Two case studies.,"The present study used 2 single case studies (a 29- and a 48-yr-old female) to evaluate clinical improvement as a result of cognitive behavior therapy in panic disorder with or without agoraphobia (PDA). A special emphasis was placed on assessing the reduction in catastrophic cognitions, which are considered to be of prime importance in PDA. Multiple measures were employed, during pre and post treatment and at a 6 mo follow-up. Data from self-report questionnaires, physiological measures and cognitive sampling during in vivo exposure were used. Convergent results demonstrated clinical improvement and supported the importance of catastrophic cognitions in the process of change for treatment outcome of PDA. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Khawaja, Nigar G; Oei, Tian P. S",1998.0,,0,0,
7939,The impact of personality disorders on treatment outcome of anxiety disorders: Best-evidence synthesis.,"Reviews the literature on the impact of comorbid personality disorders on treatment outcome of anxiety disorders. The conclusions of this review are based on the best-evidence procedure. There were 2 selection criteria that studies had to meet to be included in the present review: the study design had to be prospective and a (semi)-structured interview had to be used for the assessment of personality disorders. 15 studies were selected. From these 15 studies it cannot be concluded that, in general, personality disorders affect treatment outcome for anxiety disorders negatively. The authors suggest that some personality disorders may have an adverse impact upon treatment outcome in anxiety disorders, and they should be investigated further. For the time being, in clinical practice one has to be cautious in relating personality disorders to less well treatment outcome in Axis I anxiety disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dreessen, Laura; Arntz, Arnoud",1998.0,,0,0,
7940,Pretreatment patient factors predicting attrition from a multicenter randomized controlled treatment study for panic disorder.,"Examined pretreatment factors associated with attrition from a clinical trial for panic disorder. The study group consisted of 162 patients who began 11-visit treatments. Six domains (demography, panic disorder severity, psychiatric comorbidity, illness/ treatment attributions, coping styles, and personality styles) with 52 variables were used to predict attrition. 122 patients completed and 40 dropped out from treatment. Final multivariate regression analyses showed that the following 2 variables were independently associated with attrition: lower household income and negative treatment attitudes; attributing the panic disorder to life stressors and greater age were independently associated with attrition at the trend level. Preliminary analyses suggested, in addition, associations between attrition and lower education, shorter length of prior treatment, higher anxiety sensitivity, lower agoraphobic avoidance, and a coping style of seeking social support that were not confirmed by best predictor analysis. Psychiatric comorbidity and personality styles were unrelated to attrition. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Grilo, Carlos M; Money, Roy; Barlow, David H; Goddard, Andrew W; Gorman, Jack M; Hofmann, Stefan G; Papp, Laszlo A; Shear, M. Katherine; Woods, Scott W",1998.0,,0,0,
7941,Provocation of a posttraumatic flashback by cholecystokinin tetrapeptide?,"Reports observation of a posttraumatic stress disorder (PTSD) patient to receive an intravenous bolus of 50 mg of the potent panicogen cholecystokinin tetrapeptide (CCK-4) in a double-blind, placebo-controlled randomized trial. The S, a 35-yr-old African American male, had been suffering from chronic PTSD with repetitive flashbacks for 4 yrs after being shot in the stomach point-blank. After placebo injection, no significant symptoms emerged. After CCK-4 injection, the S developed a full-blown panic attack with nausea and abdominal symptoms. Furthermore, the S reported (1) having seen himself, as in a video, back in the posttrauma emergency room; (2) having smelled blood; and (3) having felt a drainage in his stomach for about 45 sec, beginning approximately 1 min after CCK-4 injection.. The flashback occurring during CCK-4 induced panic attack could have been a drug effect mediated by the activation of brainstem CCK receptors. On the other hand, the abdominal symptoms produced by CCK-4 and the contingent memories of trauma could have acted as conditioned stimuli to trigger the flashback. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kellner, Michael; Levengood, Robert; Yehuda, Rachel; Wiedemann, Klaus",1998.0,,0,0,
7942,Multimodal treatment of women with mitral valve prolapse syndrome.,"Mitral valve prolapse is the most commonly occurring cardiac condition. It is a benign condition which affects as many as 10% of the population. Some patients have symptomatic mitral valve prolapse. This condition is referred to as mitral valve prolapse syndrome. Symptoms include: chest pain, tachycardia, palpitations, fatigue, dizziness, shortness of breath, headaches, low exercise tolerance, feelings of anxiety, panic attacks, and mood swings. These symptoms adversely effect the patient's quality of life. The purpose of this study was to investigate the response of patients with mitral valve prolapse syndrome to treatment that includes the accepted treatment for panic disorder, and to determine the roles of self-efficacy and of level of spousal support in enhancing the ability of identified patients to cope with mitral valve prolapse syndrome. Thirty-one subjects initially agreed to participate in this study. Of these subjects, fifteen left the study. The leading causes of dropout were lack of spousal support and multiple role stress. The remaining sixteen subjects completed the study. Subjects were randomly divided into three treatment conditions, individual multimodal therapy, couples multimodal therapy, and a waiting list/control group. Treatment consisted of attending a five session psychoeducational program and completing prescribed exercises at home between sessions. The first two sessions examined self-care lifestyle changes that patients could make to alleviate symptoms. The remaining three sessions focused on the over reactiveness of the autonomic nervous system for these patients and the efficacy of learned relaxation procedures. Dependent measures included a Symptom Checklist, Anxiety Sensitivity, Strength and Magnitude of Self-Efficacy and Strength and Magnitude of Interactive Efficacy. Data was analyzed in a two-step process. First, it was analyzed using a multiple single case design format. This was followed by a quantitative analysis of grouped data. In general, the multiple single case design complemented the quantitative analysis. Individual findings in the multiple single case design indicated issues for future research. Participation in treatment was found to aid in decreasing global physical symptoms, decreasing anxiety sensitivity symptoms, and increasing the subject's confidence in her ability to manage her symptoms. The increased level of self-confidence was related significantly to decreasing global physical symptoms. There was a weak, non-statistically significant correlation between increased confidence of self-efficacy and decreased anxiety sensitivity symptoms. Participation in couples multimodal treatment or any treatment was not significantly linked to increased interactive efficacy. Increased interactive efficacy was correlated with increased self-efficacy and decreased global physical symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Nevin, Doris Eileen Jacobs",1998.0,,0,0,
7943,Eye movement desensitization and reprocessing: Evaluating its effectiveness in reducing trauma symptoms in adult female survivors of childhood sexual abuse.,"The purpose of the study was to evaluate, through the use of a randomized experimental design, the effectiveness of EMDR in reducing trauma symptoms in adult female survivors of childhood sexual abuse. No EMDR research to date has been exclusively comprised of adult survivors of childhood sexual abuse, a historically difficult treatment population. Additionally, while numerous clinical accounts of treatment with sexual abuse survivors have been published, controlled treatment research has rarely been done. Of the studies found that examine treatment efficacy exclusively with this population, none involved the use of random assignment. A sample of sixty adult female sexual abuse survivors were selected and randomly assigned to one of three groups: (1) individual EMDR treatment; (2) individual eclectic treatment; or (3) delayed treatment control group. The participating survivors' trauma symptoms were measured in pretests and posttests on standardized as well as subjective instruments that measured anxiety, posttraumatic stress, depression, negative beliefs about the sexual abuse, emotional distress and desired positive self beliefs. The survivors' in the study assigned to the experimental or comparison treatment groups received six 90 minute individual sessions of either EMDR or eclectic therapy. The delayed treatment control group subjects were pretested, asked to delay treatment for six weeks, and after being post tested were assigned a therapist with which to work. Data analysis consisted primarily of multivariate and univariate analysis of variance. The posttest results indicated that EMDR was very effective in reducing the targeted trauma symptoms compared to the control group. Eclectic therapy at posttest was also found to be very effective, resulting in a lack of statistically significant differences between the experimental and comparison treatments. However, analysis conducted at the three month follow-up revealed that EMDR was significantly more effective than eclectic therapy at maintaining therapeutic gains. The results of this study suggest that while both EMDR and eclectic therapy, when applied as brief psychotherapy models of treatment for survivors, can produce significant alleviation of trauma symptoms, EMDR may provide more enduring resolution. These findings have important implications for both survivors and the service providers available to them. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Edmond, Tonya Elaine",1998.0,,0,0,
7944,Long-term outcome in anxiety disorders.,"The thesis addresses three main questions about the long-term outcome in panic disorder and social phobia: (i) whether cognitive behaviour treatment delivered as a routine service in a specialist clinic is effective in the long-term as measured by traditional outcome methods; (ii) whether this treatment is sufficiently effective, that is, whether patients show clinical improvement as well as statistical improvement; and (iii) whether long-term outcome can be predicted either by pre-treatment patient characteristics or from their short-term treatment response. A consecutive simple of patients with panic disorder or social phobia were assessed an average of 2 years following treatment. The treatment produced significant improvement in measures of symptoms, avoidance, and disablement during treatment and further improvement during the follow-up period. A quarter of subjects no longer met diagnostic criteria, had not sought further treatment, and their anxiety had not interfered with their lives or activities since treatment ended. The majority of the remaining subjects reported a reduction in the disability due to panic attacks or avoidance. These findings support the clinical significance of the outcome, that is, the treatment was sufficiently effective for a sizeable proportion of the patients. However few patients met conventional criteria for a clinically significant outcome. Conceptual and practical difficulties in the criteria for assessing clinical significance are discussed and an alternative approach is proposed. Patients who dropped out from, or who refused the offer of treatment, showed a poor long-term outcome whether or not they sought further care. It is concluded that effective treatment can be delivered in routine care but that these findings may be the exception. Success is related to the use of treatment protocols in specialist treatment settings, and attention should be paid to improving the efficacy of the non-specialist treatment of anxiety disorders. Severity, as measured by symptoms and disablement at the time of treatment, were the only variables found to predict symptoms and disablement at long-term follow-up. Our understanding of why not all patients response similarly to cognitive behaviour treatment is still lacking. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hunt, Caroline Jane",1998.0,,0,0,
7945,The impact of long-term group therapy on adult female survivors of childhood sexual abuse.,"Research about short-term and long-term group treatment for survivors of childhood sexual abuse has found that group treatment facilitates significant changes in self-esteem, locus of control and psychological distress. Difficulties with social intimacy, however, have shown no lasting improvement in short-term treatment, and no attempt has been made to assess the patterns of change over time. The study investigated patterns of change in self-esteem, locus of control, social intimacy and psychological distress among women who participated in one-year long group treatment and concurrent individual treatment. Client-perceived perceptions of progress in treatment and therapeutic factors were examined qualitatively. Fifty-seven women participated in therapy groups up to 55 weeks in duration, with measures and questionnaires describing progress in treatment administered every 11 weeks. Post-treatment interviews were conducted with nine participants. Demographic, abuse history and the dependent variables were examined in relationship to group completion, with the sample categorized into the no-treatment group, the 11-44 week treatment completers and the 55-week treatment completers. The dependent variables and the questionnaires were examined for improvement and patterns of change over time for the 55-week treatment completers. The 55-week treatment completers demonstrated marginally higher levels of somatization at assessment and a tendency to have also experienced physical abuse. The patterns of change revealed that sociability, self-esteem, assertiveness and overly nurturant behaviour showed early and continued improvement. Hostile dominance and psychological distress improved in the short-term with no further changes. Changes toward more internality in autonomous behaviour occurred after long-term treatment but a belief in the power of authority changed toward greater externality. No changes in intimacy, somatization, hostility, phobic anxiety, paranoid ideation and psychoticism occurred across the treatment period. The qualitative findings revealed that positive changes in self-esteem and interpersonal relationships occurred after 55 weeks but difficulties with abuse- related affect, anger and trust remained problematic. Results suggest the benefit of offering choice in terms of duration of group treatment as well as the need to determine which variables differentiate potential consumers of long-term treatment. For survivors who opt for long-term treatment, interventions should be focused specifically on issues which require longer periods of time to address. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bautz, Gabriele",1998.0,,0,0,
7946,Treating acute stress disorder: An evaluation of cognitive behavior therapy and supporting counseling techniques.,"Acute stress disorder (ASD) permits an early identification of trauma survivors who are at risk of developing chronic posttraumatic stress disorder (PTSD). This study assessed the relative efficacy of prolonged exposure and anxiety management in the treatment of ASD. 45 trauma survivors with ASD (aged 18-60 yrs) were given 5 sessions of prolonged exposure (N=14), combined prolonged exposure and anxiety management (N=15), or supportive counseling (N= 16) within 2 wks of trauma. Ss were assessed pretreatment, posttreatment, and at 6-mo follow-up. Fewer Ss with prolonged exposure (14%, N=2) and prolonged exposure plus anxiety management (20%, N=3) than supportive counseling (56%, N=9) met the criteria for PTSD after initial treatment. 15% in the prolonged exposure group and 23% in the prolonged exposure plus anxiety management group had PTSD at 6-mo follow-up, compared with 67% in the supportive counseling group. Chronic PTSD in the supportive counseling condition was characterized by greater avoidance behaviors than in the prolonged exposure alone or plus anxiety management conditions. Findings suggest that PTSD can be effectively prevented with an early provision of cognitive behavior therapy and that prolonged exposure may be the most critical component in the treatment of ASD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bryant, Richard A; Sackville, Tanya; Dang, Suzanne T; Moulds, Michelle; Guthrie, Rachel; Beck, Blake, Bryant, Bryant, Bryant, Bryant, Bryant, Bryant, Fleiss, Foa, Foa, Foa, Foa, Foa, Foa, Harvey, Harvey, Harvey, Horowitz, Jacobson, Jaycox, Kilpatrick, Resick, Shalev, Shalev, Spiegel, Spielberger, Van der Kolk",1999.0,,0,0,
7947,Obsessive-compulsive disorder and comorbidity: Results from a 12-month behavioral group therapy.,"Notes that behavior therapy with exposure and response prevention, and pharmacological treatment with selective serotonin reuptake inhibitors (SSRI), have been found effective in the treatment of obsessive-compulsive disorders. Data concerning the effectiveness and outcome of group therapy are rare and heterogeneous. The present authors developed a concept for a 12-mo outpatient group therapy (45 sessions) for 10 patients (8 females, 2 males, aged 28-52 yrs) addressing the reduction of obsessive-compulsive symptoms and other psychopathologic symptoms of comorbid disorders. The authors relate the findings of the study after 12 mos, specifying the comparative reduction of obsessive-compulsive disorders in almost all patients, and the psychometric instruments and inventories employed. The authors recognize the effects and limitations of their concept. The course of symptomatology during treatment and the patients' assessments concerning the importance of different treatment elements are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Grabe, Hans-Jorgen; Welter-Werner, E; Freyberger, H. J",1999.0,,0,0,
7948,Prediction of community integration and vocational outcome 2-5 years after traumatic brain injury rehabilitation in Australia.,"Examined the predictor variables of community integration and vocational outcomes of 209 patients (mean age 35.8 yrs) 2-5 yrs after traumatic brain injury. Data on predictor variables (demographic, injury severity, and functional) were retrieved from hospital records. Community integration and vocational outcome was assessed by self-administered questionnaire. Patients or carers completed and returned the questionnaires. Mean follow-up was 3.5 years. Results show that age, disability level, and cognition predicted community integration. Length of posttraumatic amnesia, cognition, disability levels, initial coma score, functional status, length of acute stay, and prior occupation discriminated those who returned to work. A total of 46.5% returned to work, with 74.5% of these working in the same or similar jobs. It is concluded that demographic, injury severity, and functional status variables can predict long-term outcomes in post-traumatic brain injury. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fleming, Jennifer; Tooth, Leigh; Hassell, Mary; Chan, Wilbur",1999.0,,0,0,
7949,Attentional focus and fear of blushing: A case study.,"A single-case method was used to test the effects of redirecting attention above exposure only on fear of blushing, avoidance, and idiosyncratic dysfunctional beliefs. A social phobic patient (21-yr-old female) with fear of blushing as the predominant complaint received sessions of Task Concentration Training (TCT) and Exposure in Vivo (EXP), alternately, after a steady baseline had been established. The treatment consisted of 14 individual sessions. Assessments were held before and after baseline, after treatment, at 4-wk follow-up, and at 1-yr follow-up. Continuous measurements were held throughout the treatment in order to measure the differential effects of TCT and EXP on fear, avoidance, and beliefs. TCT and EXP together turned out to be an effective treatment for fear of blushing: large effects were observed on all 3 outcome measurements. When differential effects are closely looked at, EXP seemed more effective in decreasing fear of blushing. However, the patient appeared to have used TCT strategies as well during the EXP weeks, which may have contributed to the favorable effects of EXP. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mulkens, Sandra; Bogels, Susan M; de Jong, Peter J",1999.0,,0,0,
7950,"Effect of comorbid anxiety, depressive, and personality disorders on treatment outcome of somatoform disorders.","Examined the effects of comorbidity of axis I and axis II Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) disorders on the treatment outcome of somatoform disorders (SDs) by comparing 3 types of comorbidity-(1) personality disorders (PDs), (2) major depression (MDD) and anxiety (ANX) disorders, and (3) PDS and MDD and ANX-among a final sample of 105 inpatients (aged 19-69 yrs). Ss completed a battery of self-rating scales to measure different aspects of the general symptomatology at least 4 wks before admission to treatment, upon admission, and again at discharge. Somatoform, hypochondriacal, and depressive symptomatology, dysfunctional cognitions about body and health, dysfunctional social relationships, and other clinical characteristics were measured using, among other measures, a modified version of the Screening for Somatoform Symptoms, the Whiteley Index, and the Beck Depression Inventory. Results suggest that a good therapy outcome in the cognitive-behavioral-oriented inpatient treatment of SDs may be attained. No major differences were found between somatoform patients with severe comorbidity of axis I (MDD and ANX) and patients with PD with respect to general psychopathology, dysfunction of social relations, and treatment outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Leibbrand, Rolf; Hiller, Wolfgang; Fichter, Manfred M",1999.0,,0,0,
7951,Treatment of social phobias: Efficacy of cognitive and behavioural group therapy.,"Studied the effectiveness of group cognitive-behavioral therapy for patients with social phobias. Human Ss: 55 male and female French adults (aged 19-49 yrs) (generalized social phobia, agoraphobia, generalized anxiety, major depression, dysthymia, bulimia, premature ejaculation, alcohol dependence, intermittent torticollis, and fetishism). Assertiveness training and cognitive-behavioral therapy were used in a 3-phase protocol: (1) preinclusion phase with 5 individual consultations, (2) 20 weekly 2-hr group sessions, and (3) a 6-mo follow-up group session and 6-mo and 12-mo follow-up assessment sessions. Tests used: The Rathus Assertiveness Schedule, the Brief Standard Self Rating for Phobic Patients (I. M. Marks and A. M. Mathews, 1979) and the Beck Depression Inventory. Treatments: 48 Ss were being treated with psychotropic drugs (mainly antidepressants) at their 1st consultation. (English abstract) (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fanget, F",1999.0,,0,0,
7952,Zolpidem for insomnia related to PTSD.,"Chronic sleep difficulties, including reduced total sleep time and nightmares, are often a chief complaint of combat veterans with posttraumatic stress disorder (PTSD). Trazodone, doxepin, and benzodiazepines can be used to treat insomnia in these patients. However, benzodiazepines have the disadvantage of potential addiction or tolerance. Trazodone and doxepin can cause a morning hangover feeling, and tolerance to their sedative properties may occur. Zolpidem is a nonbenzodiazepine imidazopyridine compound with unique characteristics that may confer advantages over conventional medications for sleep induction and maintenance in PTSD. This article presents 3 cases of 50-63 yr old male war veterans with PTSD who increased their total sleep time with zolpidem. It is suggested that controlled studies are needed to more fully elucidate the impact of zolpidem on insomnia, nightmares, and other symptoms of PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dieperink, Michael E; Drogemuller, Lisa",1999.0,,0,0,
7953,CCK4-induced panic in healthy subjects: I. Psychological and cardiovascular effects.,"Sixteen healthy subjects participated in a crossover, double blind, and placebo-controlled study, designed to assess simultaneously the psychological and cardiovascular effects of cholecystokinin tetrapeptide (CCK4). Following an iv injection of 25 microg of CCK4, 44% of subjects experienced symptoms that fulfilled the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for a panic attack while no one panicked with placebo. CCK4 induced a significantly greater number and higher intensity of panic-like symptoms than placebo. A significant increase in state anxiety was observed in the period after CCK4 injection; this increase was significantly larger than the non-specific anxious reaction to placebo. CCK4 also affected cardiovascular signs. Both heart rate and mean blood pressure significantly increased after administration of CCK4. Again, these increases were significantly higher than those seen after placebo injection. We conclude that, in healthy subjects, CCK4 induces panic-like reaction characterized by a number of somatic, cognitive and emotional symptoms, which are accompanied by increases in heart rate and blood pressure. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Jerabek, Ilona; Boulenger, Jean-Philippe; Bradwejn, Jacques; Lavallee, Yvon-Jacques; Jolicoeur, Francois B",1999.0,,0,0,
7954,CCK4-induced panic in healthy subjects: II. Neurochemical correlates.,"Cholecystokinin tetrapeptide (CCK4) induces symptoms similar to those of panic attack. The present study investigated the effects of CCK4 administration on catecholaminergic system. In this double blind, randomised, crossover experiment, 16 healthy subjects received injections of either 25 microg of CCK4 or placebo on two separate occasions. Platelet and plasma catecholamine concentrations were assessed before the administration and compared to post-injection values. The results clearly show that both plasma and platelet concentrations of catecholamines are significantly affected by CCK4. Plasma norepinephrine (NE) and epinephrine (EPI) raised significantly above baseline in the immediate post-CCK4 period, while in plasma dopamine (DA), the significant increases were delayed. In the platelets, significant post-CCK4 increases of NE and EPI concentrations were observed with a delay of several minutes. In summary, we have demonstrated that, in healthy subjects, CCK4 increases peripheral concentrations of catecholamines in both plasma and platelets, with the most consistent changes occurring in platelet NE and plasma EPI concentrations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Jerabek, Ilona; Boulenger, Jean-Philippe; Bradwejn, Jacques; Drumheller, Andrea; Lavallee, Yvon-Jacques; Jolicoeur, Francois B",1999.0,,0,0,
7955,The effects of a multimodal intervention program on performers: II. Training the butterflies to fly in formation.,"Examined the effects of a multimodal intervention on swimmers debilitated by anxiety. A staggered single-subject multiple-baseline across-subjects design was used over 10 competitive races for 4 swimmers. Baseline observations on cognitive and somatic anxiety ""direction"" (facilitative/debilitating) scores were collected for 3, 4, and 5 races for Participants 2, 3, and 4, respectively, prior to treatment. The intervention was designed based on qualitative data from S. Hanton and G. Jones's (see record 1999-10633-001) study and included the skills of goal setting, imagery, and self-talk. These psychological skills emerged as particularly important from Hanton and Jones's investigation as a means of maintaining facilitative interpretations of precompetition anxiety symptoms. Preintervention, all participants reported debilitating interpretations of cognitive and somatic anxiety symptoms. However, postintervention, the 3 participants who received treatment reported facilitative interpretations. Performance improvements were also evident for these swimmers. A postintervention follow-up showed that swimmers' interpretations were still facilitative. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hanton, Sheldon; Jones, Graham",1999.0,,0,0,
7956,"""The problem of randomisation in psychotherapeutic research"": Comment.","Comments on the article by H. Krauthauser and M. Bassler (see record 1997-35772-003) concerning observed problems with randomization when comparing treatment effectiveness between inpatients and outpatients with anxiety disorders. The authors describe sample inclusion and exclusion procedures that can be used without giving up the benefits of randomization, note that the questionnaire used in the original study was not appropriate for the sample, and assert that there appears to be no superior alternatives to the present methodologies for experimental research on treatment effectiveness and outcomes. Krauthauser and Bassler reply that they were careful in their research preparation and design and that randomization still deserves a professional review as to whether it always deserves to be the ""gold standard"" of research methodology. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Klingberg, Stefan; Buchkremer, Gerhard",1999.0,,0,0,
7957,Course of treatment during a cohort-based inpatient program for posttraumatic stress disorder.,"Examined 11 veterans with posttraumatic stress disorder (PTSD) over the course of a 4-mo inpatient treatment program to explore treatment process factors that may contribute to the generally poor outcome reported in previous studies (e.g., A. Fontana and R. Rosenheck, 1997). Group members made weekly ratings in the domains of PTSD symptoms, morale, interpersonal relationships, and physical problems. Despite an appearance of cohesion among group members, variation of scores on functional domains was explained largely by individual differences. Progress through the program showed a strongly linear pattern, with no phase effects. Somatic complaints did not increase during the phase when traumatic material was explored. Degree of improvement or worsening was best predicted by level of PTSD symptoms at admission, indicating that more symptomatic veterans did worse in the program. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Johnson, David Read; Lubin, Hadar; Corn, Barbara",1999.0,,0,0,
7958,Effects of psychological intervention on panic attack patients in the emergency department.,"For patients initially seen in the emergency department (ED) for panic attack, this study evaluated the effect of two brief psychological interventions in the ED on later utilization of emergency, psychiatric, and nonpsychiatric medical department services. Each of two intervention groups (N = 85) received usual ED care, a brochure on panic disorder, and a referral to treatment at the psychiatry department; one of the two groups (n = 32) also received 20-30 min of contact with a representative from the psychiatry department. Both intervention groups were compared with a historical control group (N = 269). The contact condition reduced ED use after the initial visit to the ED, although all three groups had more visits to the psychiatry department and to all nonpsychiatric departments. This decrease was statistically significant when compared with the brochure condition but not when compared with the historical control group. The decrease seen in ED use is an important therapeutic and economic finding. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dyckman, John M; Rosenbaum, Robert L; Hartmeyer, Rosarie J; Walter, Lawrence J",1999.0,,0,0,
7959,How I practice: Treating women golfers with eating disorders: Unique issues and concerns.,"Briefly outlines a clinical case report of the sporting-related pressures, obsessive-compulsive traits, and the treatment and subsequent recovery of an 18-yr-old female golfer in college who had struggled with bulimia since age 15. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Moore, Mary Ann",1999.0,,0,0,
7960,Paradoxical intention and recursive anxiety.,"Investigated the relationship between ""recursive anxiety"" and paradoxical intention. Ss were 20 professional employees (aged 23-53 yrs) with public speaking concerns, and for whom fear of fear or recursive anxiety clearly represented an important element, or was completely absent from the clinical profile. These Ss were offered a standard in vivo treatment program for public speaking phobia with inclusion or exclusion of paradoxical intention. A 2 x 2 factorial design was employed. Those Ss whose public speaking anxiety was complicated by recursive anxiety experienced greater improvement when paradoxical intention was included in the treatment program than when it was not employed. In contrast, Ss reporting simple public speaking phobia demonstrated greater success with a treatment program in which paradoxical intention was absent. D. M. Wegner's (e.g., 1994) hypothesis of ""ironic"" cognitive processing was used to explain the proposed relationship between paradoxical intention and fear of fear. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ascher, L. M; Schotte, David E",1999.0,,0,0,
7961,Treatment of anxiety disorders: Does specialty training help?,"Does specialized training in the treatment of anxiety disorders have an impact on clinical outcome and efficiency? The authors compared specialists in the cognitive-behavioral treatment of anxiety disorders with nonspecialists. The specialist group saw patients for a shorter average period of time (6.37 vs. 8.44) and reported less anxiety in their patients at termination. Patients were followed for 2 years to determine relapse rates. Only 19% of the patients treated by specialists returned for treatment, whereas 40% of those treated by nonspecialists did. Therapists who used cognitive-behavioral techniques were more effective than other clinicians in the treatment of anxiety disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Howard, Rodney C; Barlow, Barlow, Bologna, Burns, Christensen, Goldfried, Heimberg, Howard, Kendall, Kessler, Luborsky, Lyons, Parloff, Seligman, Smith, Strosahl, Wilson",1999.0,,0,0,
7962,A palmtop computer program for the treatment of generalized anxiety disorder.,"Describes a palmtop computer program developed to increase the efficiency and cost-effectiveness of cognitive behavioral therapy for generalized anxiety disorder (GAD). The computer program offers advantages to researchers, therapists, and clients. These advantages include continuous, unobtrusive collection of process data on treatment adherence as well as on the impact of cognitive behavioral therapy techniques in the client's natural setting. In addition, the computer extends treatment beyond the therapy hour and motivates clients to comply with homework assignments by prompting practice of cognitive behavioral strategies. The successful application of the palmtop computer program in therapy with 3 GAD patients (aged 31, 40, and 55 yrs) suggests a new line of research directed toward increasing the cost-effectiveness of GAD treatment as exemplified by T. D. Borkovec and E. Costello (1993). (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Newman, Michelle G; Consoli, Andres J; Taylor, C. Barr; Baer, Baer, Baer, Barlow, Beck, Beck, Beck, Bernstein, Biglan, Borkovec, Borkovec, Borkovec, Borkovec, Brown, Buglione, Carr, Chandler, Chandler, Ghosh, Ghosh, Goldfried, Heide, Kenardy, Leon, Meyer, Newman, Newman, Newman, Sheehan, Spielberger, Turner, Wilson",1999.0,,0,0,
7963,Two-year follow-up of behavioral treatment and maintenance for body dysmorphic disorder.,"Recent research has suggested that body dysmorphic disorder (BDD) is part of the obsessive-compulsive spectrum of disorders. As such, it has been hypothesized that these disorders respond in a similar manner to obsessive-compulsive disorder when behavioral interventions are used. A continuation of follow-up was conducted with a group of patients with BDD following treatment. 10 patients (aged 21-45 yrs) completed an intensive behavioral therapy program and either participated in a 6-mo maintenance program or served as controls. At 12-, 18-, and 24-mo follow-up assessments, patients participating in the maintenance program were more effective at managing limited symptom return and had significantly lower anxiety and depression. Both groups remained improved for acute symptomatology and behavioral avoidance. The results suggest that maintenance programs following behavioral treatment are effective in preventing symptom relapse and assist in patient self-management of lapses typically associated with BDD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","McKay, Dean; Beck, Beck, Emmelkamp, Goodman, Hollander, James, McKay, Neziroglu, Neziroglu, Ost, Rosen, Simeon, Spitzer, Steketee, Steketee, van Oppen",1999.0,,0,0,
7964,The contributions of eye movements to the efficacy of brief exposure treatment for reducing fear of public speaking.,"Attempted to isolate the effects of the eye-movement component of the Eye Movement Desensitization and Reprocessing (EMDR) procedure in the treatment of fear of public speaking. 71 female college students who responded in a fearful manner on the Fear Survey Schedule II and on a standardized, self-report measure of public speaking anxiety were randomly assigned to 1 of 4 groups. The 2 independent variables assessed were treatment condition (imagery plus eye movements vs imagery alone) and type of imagery (fear-relevant vs relaxing). Dependent variables assessed were self- reported and physiological anxiety during exposure and behavioral indices of anxiety while giving a speech. Although process measures indicated exposure to fear-relevant imagery increased anxiety during the procedure, no significant differences among groups were found on any of the outcome measures, except that Ss who received eye movements were less likely to give a speech posttreatment than Ss who did not receive eye movements. Addition of the eye movements to the experimental procedure did not result in enhancement of fear reduction. Findings suggest that the positive effects of the EMDR procedure may be largely due to exposure to conditioned stimuli. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Carrigan, Maureen H; Levis, Donald J",1999.0,,0,0,
7965,The relative efficacy and treatment distress of EMDR and a cognitive-behavior trauma treatment protocol in the amelioration of posttraumatic stress disorder.,"Compared Eye Movement Desensitization and Reprocessing (EMDR) and a Cognitive-Behavior Therapy (CBT) variant (Trauma Treatment Protocol; TTP) in the treatment of posttraumatic stress disorder (PTSD), via a controlled clinical study using therapists trained in both procedures. 23 Ss who had undergone a traumatic incident participated. It was found that TTP was both statistically and clinically more effective in reducing pathology related to PTSD and that this superiority was maintained and became more evident, by 3-mo follow-up. These results are discussed in terms of past research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Devilly, Grant J; Spence, Susan H",1999.0,,0,0,
7966,Lysine vasopressin in post-traumatic memory disorders: An uncontrolled pilot study.,"A pilot study explored effects of a 1-mo treatment with lysine-vasopressin delivered by nasal spray on memory and learning deficits in 26 severely head injured patients. Ss underwent neuropsychological assessment when first seen and at 1 mo posttreatment. No adverse effects were reported. Significant improvements were observed in learning and memory functions, independent of age, sex, severity of injury, severity of cognitive deficits, and time since injury. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Eames, Peter; Wood, Rodger Ll",1999.0,,0,0,
7967,Recovery rates in generalized anxiety disorder following psychological therapy: An analysis of clinically significant change in the STAI-T across outcome studies since 1990.,"Raw data on Spielberger State-Trait Anxiety Inventory (STAI-T) scores at pre-, post- and follow-up were obtained for 6 randomized controlled trials of psychological therapy with generalized anxiety disorder (GAD). N. S. Jacobson's methodology for defining clinically significant change was used to allocate each patient (aged 18-65 yrs) to one of four outcomes: worse, unchanged, improved and recovered. The proportion of patients in each category was calculated for treatment conditions in each study and also for aggregate data across types of treatment. A recovery rate of 40% was found for the sample as a whole with 12 of the 20 treatment conditions obtaining very modest recovery rates of 30% or less. Two treatment approaches-individual cognitive behavioral therapy and applied relaxation-do relatively well with overall recovery rates at 6-month follow-up of 50-60%. Jacobson methodology, in distinguishing between improvement and recovery on a standardized measure of general vulnerability to anxiety, provides a stringent but clinically more meaningful evaluation of the efficacy of psychological therapies with GAD than has been available hitherto. Systematic focus on either excessive worry or physiological arousal gives worthwhile results. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fisher, Peter L; Durham, Robert C; Barlow, Beck, Biswas, Borkovec, Borkovec, Borkovec, Brawman-Mintzer, Brown, Butler, Derogatis, Durham, Durham, Evans, Hoehn-Saric, Hunt, Jacobson, Jacobson, Lambert, Rachman, Rapee, Spielberger, Spielberger, Tyrer, Wells, White",1999.0,,0,0,
7968,"Treatment delivery variables, efficacy and return of fear.","Exposure techniques have been shown to be effective in the treatment of anxiety disorders. Further increase in treatment effectiveness may be possible with manipulations that increase long-term memory for other types of information. In experiment one, the effectiveness of massed treatment was compared to treatment delivered over an expanding spaced schedule. While the predicted long-term benefit of the expanding spaced schedule was not found in assessments immediately after treatment or one month later, there were interesting group differences during the treatment. In experiment two, exposure to a constant stimulus was compared to exposure to a varied stimulus. The hypothesis that varied exposure would lead to better long-term retention of treatment gains was supported. Considered together, these studies provide evidence for the usefulness of applying principles from the human learning and memory literature to cognitive-behavioral treatment of fear. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lang, Ariel Janna",1999.0,,0,0,
7969,The efficacy of a comprehensive cognitive-behavioral treatment program for anxiety disorders.,"In this study, the effectiveness of a comprehensive cognitive-behavioral treatment program for anxiety disorders was examined. Treatment comprised of a 15-week structured group therapy format with homework assignments including written and audiotape material. Twenty subjects were given four inventories (Beck Anxiety Inventory, State-Trait Anxiety Inventory, Fear Survey Schedule, and the Symptom Checklist-90-R) to complete before and after the program. Statistical analyses using a t-test design indicated that subjects' scores decreased significantly on all four inventories after the end of the program. Physiological symptoms of anxiety seemed to be the most affected. Results suggest that the Southeast Center for Stress' Anxiety: Learn to Take Control program is an effective means of reducing anxiety. The results also confirmed previous findings of the effectiveness of cognitive-behavioral group therapy with anxiety disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Nguyen, Kim Thi",1999.0,,0,0,
7970,"Eye movement desensitization and reprocessing in the treatment of posttraumatic stress disorder: An investigational study of the eye movement component using a within-subject design.(grief, anxiety).","Eye movement desensitization and reprocessing (EMDR) is a recently developed psychotherapy treatment procedure which combines imaginal exposure with eye movements and is reported to dramatically reduce negative symptoms associated with trauma related psychological disturbances and memories. The author reviewed and analyzed the current literature regarding EMDR, and conducted a within-subject design investigating the importance of the eye movement component in the EMDR treatment protocol by comparing the efficacy of an eye movement treatment condition, with two non-eye movement treatment conditions. The use of two different control conditions allowed comparisons of the eye movement condition (EMDR), which involved bilateral stimulation of the brain, with exposure to memory of the trauma without eye movements (Eye-Focus Desensitization), which served as a placebo, and exposure to memory of the trauma with a competing motor activity (Single Hand Tapping), which represented unilateral stimulation of the brain. This study also employed a delayed treatment condition to investigate the overall effectiveness of EMDR in treating posttraumatic stress disorder. The subject was a 53-year-old Caucasian female who met DSM IV criteria for Posttraumatic Stress Disorder. Dependent variables included a diagnostic instrument, which was the Structured Interview for Posttraumatic Stress Disorder (SI-PTSD); global instruments, which included the Beck Anxiety Inventory (BAI), Impact of Events Scale (IES), and Subjective Units of Distress scale (SUDs); process measures, which included the Subjective Units of Distress scale (SUDs) and Validity of Cognition (VOC) scale; and a self-report measure of overall improvement, which was the Image Desensitization Rating Scale (IDRS). Results demonstrated support for the superiority of an eye movement condition over that of both a no-eye movement condition (EFD), and a competing motor activity of single hand tapping (SHT) on process variables (SUDs and VOC), but not on weekly global measures (IES, BAI, and SUDs) in the single subject studied. Also, this study found support for the effectiveness of EMDR (delayed treatment phase) in reducing symptoms of anxiety, intrusiveness and avoidance, and subjective distress related to memory of trauma as measured by BAI, IES, and SUDs, and also in alleviating DSM-IV symptoms of Posttraumatic Stress Disorder for this subject. Experimental single-subject studies, as well as group designs, need to investigate possible neurological and theoretical explanations for the effectiveness of EMDR in future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Coleman, Gary Lee",1999.0,,0,0,
7971,"Overvalued ideation, habituation, and treatment outcome in obsessive-compulsive disorder: A case series.","Six 23-54 yr-old patients with obsessive compulsive disorder (OCD), 3 with poor insight into the senselessness of their OCD symptoms and 3 with good insight, received intensive cognitive-behavioral therapy by exposure and ritual prevention. Although all patients showed improvement in OCD and depressive symptoms, patients with poor insight improved less and failed to show habituation of anxiety between treatment sessions. The relationship between outcome and habituation of anxiety within and between treatment sessions is discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Abramowitz, Jonathan S",1999.0,,0,0,
7972,Attention fixation training: Training people to form cognitive maps helps to control symptoms of panic disorder with agoraphobia.,"Nine individuals (aged 27-39 yrs) diagnosed with panic with agoraphobia received 3 elements of Attentional Fixation Training (AFT): directed attention to the external environment, directed topographical synthesis, and directed orientation in space-time to control characteristics of panic. They then walked a standard 2.5 km route and practiced these elements upon entering 1 of the 5 panic-inducing situations: (1) walking alone near a busy street with the examiner following at 20 m, (2) walking alone near a busy street with the examiner out of client's visual field, (3) shopping with the examiner present, (4) traveling on a bus alone, and (5) shopping alone. Heart rate was monitored in each of these 5 situations. Except for the case of using public transport, heart rate activity decreased to a considerable extent during AFT practice, suggesting AFT elements provide a good way to control symptoms of panic in vivo. Results are discussed within the confines of a model suggesting that an attentional deficit, which produces a spatial disorientation disorder that maintains both panic and agoraphobia, can efficiently be overcome by means of all 3 AFT tools. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kallai, Janos; Kosztolanyi, Peter; Osvath, Aniko; Jacobs, W. Jake",1999.0,,0,0,
7973,Treatment outcome in Australian veterans with combat-related posttraumatic stress disorder: A cause for cautious optimism?,"This study investigated treatment outcome in combat-related posttraumatic stress disorder (PTSD). Participants were 419 male Australian Vietnam veterans (mean age 49.99 yrs) who completed a 12-wk hospital-based program. A comprehensive protocol assessed PTSD, comorbidity, and social functioning at admission and at 3 and 9 mo posttreatment. Overall, the group showed significant improvements in core PTSD symptoms, anxiety, depression, alcohol abuse, social dysfunction, and anger. Changes occurred mostly between admission and 3 mo posttreatment, with gains maintained at 9 mo. Ratings by patients and their partners indicated perceived improvement and strong satisfaction with treatment. Nevertheless, treatment gains were variable and, for most veterans, considerable pathology remained following the programs. The current study provides grounds for cautious optimism in the treatment of combat-related PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Creamer, Mark; Morris, Philip; Biddle, Dirk; Elliott, Peter",1999.0,,0,0,
7974,The treatment of claustrophobia with virtual reality: Changes in other phobic behaviors not specifically treated.,"Reports the effectiveness of a claustrophobia virtual reality (VR) treatment in the case of a female (aged 37 yrs) with a diagnosis of claustrophobia, storm phobia, and panic disorder with agoraphobia. In the 3-mo follow-up study, treatment consisted of 8 individual, VR-graded, exposure sessions designed specifically to treat claustrophobia. Questionnaire responses were obtained at pretreatment, posttreatment, and 3-mo follow-up. Results show significant changes in all measures after treatment completion. VR was found to be an effective procedure for the treatment of claustrophobia. There was a general improvement from claustrophobic situations to the other specific phobic and agoraphobic situations that were not treated. It is concluded that VR exposure was effective in reducing fear in closed spaces, in increasing self-efficacy in claustrophobic situations, and in improving other problems not specifically treated. These changes were maintained at 3-mo follow-up. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Botella, Cristina; Villa, H; Banos, R; Perpina, C; Garcia-Palacios, A",1999.0,,0,0,
7975,Does reducing safety behaviors improve treatment response in patients with social phobia?,"Assessed the efficacy of instructions to drop ""safety behaviors"" during exposure tasks in a cognitive-behavior therapy (CBT) group treatment program for social phobia. 14 subjects (mean age 34.07 yrs) with social phobia received a standardized CBT treatment program and were compared to 16 subjects (mean age 30.94 yrs) with social phobia who were given additional instructions to drop safety behaviors. Repeated measures of analysis of variance between groups on a specific social phobia measure (Social Phobia and Anxiety Inventory) demonstrated significant benefit when instructions to drop safety behaviors were added to the treatment program. Findings show that the addition of instruction to drop safety behaviors in exposure tasks in the course of CBT treatment for social phobia may be useful. This result supports the cognitive model of social phobia developed by D. M. Clark and A. Wells (1995), which postulates that anxiety and negative beliefs about social situations are in part maintained by engaging in safety behaviors. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Morgan, Hugh; Raffle, Catriona; Andrews, Bond, Butler, Butler, Butler, Clark, Clark, Cohen, Cohen, Derogatis, Emmelkamp, Hickie, Mattick, Mattick, McNeil, Montgomery, Salkovskis, Salkovskis, Streiner, Turner, Turner, Watson, Wells",1999.0,,0,0,
7976,Psychophysiological response of patients with anxiety disorders to inpatient treatment.,"Studied psychological response of patients with anxiety disorders during inpatient treatment. 31 patients with anxiety disorders (aged 22-71 yrs, 17 Ss with generalized anxiety disorder and 14 Ss with panic disorder) and 23 normal volunteers (aged 24-58 yrs) in Shanghai, China, were tested with the Multiple Physiological Recorder in rest condition and in mimic stress condition. A series of physical indexes were measured through dermoreaction, sphygmoscopy, spirogram, skin temperature, electrocardiogram, and electromyogram. Ss were assessed with the Eysenck Personality Questionnaire (EPQ), the SCL-90, the Hamilton Anxiety Scale (HAMA), and the State/Trait Anxiety Inventory-Form Y (STAI) during hospital admission and after 1 mo treatment. Patient Ss' data were compared before and after and with those of the normals; the correlations of patient Ss' psychological responses and physical status were analyzed. Patient Ss' higher heart rate and higher rate of low frequency peak of power spectrum had no significant change after the treatment. The negative correlation of Ss' baseline ratio of low frequency peak and high frequency peak of power spectrum in rest condition, the changes of blood flow area of sphygmoscopy in mimic stress condition and Ss' HAMA scores are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Li, Chunbo; Wu, Wenyuan; He, Kangmei; Liu, Meilan; Cui, Haisong; Li, Yushan",2000.0,,0,0,
7977,Use of percutaneous electrical nerve stimulation (PENS) in the short-term management of headaches.,"Evaluated the short-term effects of percutaneous electrical nerve stimulation (PENS) in the management of 3 types of chronic headache. 30 24-56 yr old patients with either tension headache, migraine, or posttraumatic headache symptoms of a least 6 mo duration were randomized to receive PENS (needles with electricity) or needles alone. All treatments were administered for 30 min, 3 times a wk for 2 consecutive wks with 1 wk off between treatments. For the PENS treatments, an alternating electrical stimulation frequency of 15 and 30 Hz was used. Pain, activity, and sleep scores were assessed using a visual analog scale. Compared with the needles alone, PENS was significantly more effective in decreasing the overall visual analog scale pain scores for tension-type headache, migraine and posttraumatic headache. Similarly, PENS produced greater improvement in the patients' physical activity and quality of sleep. However, there were no differences in the pattern of the response to PENS among the 3 headache groups. PENS appears to be a useful complementary therapy to algesic and antimigraine drugs for the short-term management of headache. The analgesic response to PENS therapy appears to be independent of the origin of the headache symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ahmed, Hesham E; White, Paul F; Craig, William F; Hamza, Mohamed A; Ghoname, El-sayed A; Gajraj, Noor M",2000.0,,0,0,
7978,An innovative approach to short-term group cognitive therapy in the combined treatment of anxiety and depression.,"Twenty-six adult outpatients completed a 12-session group cognitive therapy program specifically designed to conjointly treat individuals with comorbid depressive and anxiety symptoms. The program takes a content specificity approach, differentially treating depression and anxiety from a cognitive therapy perspective. Participants showed significant improvement on measures of depression, anxiety, and dysfunctional attitudes from pre- to posttest. Findings suggest clinical and practical utility for this intervention and support the use of combination therapeutics. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kush, Francis R; Fleming, Linda McRoberts; Abraham, Beck, Beck, Beck, Beck, Beck, Beck, Bednar, Brier, Castonguay, Clark, Clark, Dobson, Dyck, Hollon, Hope, Kelly, Kemp, Lekman, Nixon, Oliver, Rush, Segal, Shaw, Telch, Tingey, Watson, Weisman, Wessler, Woodruff",2000.0,,0,0,
7979,Functional outcome for African Americans and Hispanics treated at a traumatic brain injury model systems centre.,"Examined demographics, incidence, and functional outcome for African Americans and Hispanics treated for traumatic brain injury (TBI). In the retrospective study 87 African-American or Hispanic inpatients (mean age 34.5 yrs) with TBI completing rehabilitation programs were administered the Functional Independence Measure (K. M. Hall and M. V. Johnston, 1994) and the Disability Rating Scale (M. Rappaport et al, 1982). Other collected data included age, race, education, gender, and marital and employment status. Data were compared with National TBI Model Systems data. Results show that 48.8% of minority Ss were injured most often as a result of motor vehicle accidents. Males comprised 86.2% of the population. Average length of unconsciousness was 5.2 days, while average length of posttraumatic amnesia was 41.9 days. 88.5% returned to their original home. Only 7% of Ss had a history of prior TBI. 34.2% of minority Ss reported premorbid illicit drug use, but 50.5% met criteria for heavy or moderate alcohol use. 35.6% of patients reported a pre-morbid history of arrests. It is concluded that there are many more similarities than differences in comparing minority vs general patients with TBI. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Burnett, Derek M; Silver, Timothy M; Kolakowsky-Hayner, Stephanie A; Cifu, David X",2000.0,,0,0,
7980,Cognitive therapy by allocation versus cognitive therapy by preference in the treatment of panic disorder.,"Little is known about the influence of preference for a given therapy or preference against a modality of treatment on the outcome of that treatment. The primary aim of this study was to investigate possible differences in outcome between panic disorder patients treated with preferred cognitive therapy and patients treated by randomization with the same intervention. A 12-wk study compared 35 patients treated by allocation with 31 patients treated by preference. There were no differences at pretest between the 2 conditions on demographic or outcome measures. Outcome was assessed with measurements rating the panic frequency and severity of agoraphobia, general anxiety and depression. Both conditions improved significantly on nearly all ratings. There were no significant differences demonstrable between the 2 conditions on any of the outcome measures. Preference for a given therapy is not a powerful moderator of effect in the psychological treatment of panic disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bakker, Abraham; Spinhoven, Philip; van Balkom, Anton J. L. M; Vleugel, Liesbeth; van Dyck, Richard",2000.0,,0,0,
7981,Behavioral and endocrine response to cholecystokinin tetrapeptide in patients with posttraumatic stress disorder.,"Investigated the behavioral and endocrine response of posttraumatic stress disorder (PTSD) patients to the panicogen cholecystokinin tetrapeptide (CCK-4). Eight patients (aged 21-45 yrs) with PTSD received CCK-4 intravenously in a placebo-controlled, double-blind balanced design. Provocation of panic, anxiety, and flashbacks was assessed. Plasma adrenocorticotrophic hormone (ACTH) and cortisol levels were measured after CCK-4 and compared to matched healthy control subjects. Despite significant effect of CCK-4 on anxiety and panic systems, no significant provocation of flashbacks emerged. CCK-4-induced panic symptoms showed an inverse correlation to trait dissociation. The ACTH response after CCK-4 was significantly lower in PTSD patients than in controls. Cortisol was similarly increased in both groups after CCK-4, but PTSD patients showed a more rapid decrease of stimulated cortisol concentrations. Panic symptoms or heightened anxiety are not necessarily conditioned stimuli for the provocation of posttraumatic flashbacks. The hormone data provides further evidence for a coticotropin-releasing hormone overdrive and enhanced negative glucocorticoid feedback in PTSD patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kellner, Michael; Wiedemann, Klaus; Yassouridis, Alexander; Levengood, Robert; Guo, Ling Song; Holsboer, Florian; Yehuda, Rachel",2000.0,,0,0,
7982,Use of leukotomy for intractable anorexia nervosa: A long-term follow-up study.,"Studied the long-term outcomes of intractable anorexia nervosa treated with leukotomy and specialized psychotherapy over 20 yrs ago. All traceable Ss were interviewed using the Eating Disorders Examination (EDE) and the Structured Clinical Interview for DSM-III-R (SCID). Ss also completed questionnaires. Detailed histories were taken. Four of 5 female Ss were traced. Their cases had been severe, with failure of previous intensive psychotherapy and now with high risk of death from terminal inanition. One patient had committed suicide, whereas the others enjoyed a reasonable quality of life. Persistent core psychopathology was evident, but patients had not succumbed to weight loss. All suffered depression and anxiety-related disorders, but endorsed their treatment, which had allowed sustained weight gain by release of appetitive behavior, provision of a license to change, and alleviation of phobic anxiety, allowing psychotherapeutic engagement. The authors argue that these outcomes are relatively favorable and would not have been possible without this latter engagement in specialist psychotherapy to address burgeoning panic at unavoidable weight gain. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Morgan, John F; Crisp, Arthur H; Altschule, Beck, Carmody, Crisp, Crisp, Crisp, Crisp, Crisp, Crisp, Crisp, Drury, Fairburn, Garner, Glazebrook, Hemphill, Henderson, Kelly, Mallinson, Nielsen, Richardson, Sargant, Sifneos, Spitzer, Stonehill, Theander, Zamboni, Zilber",2000.0,,0,0,
7983,Outcomes in a referral cohort of patients with anxiety disorders.,"This study describes 6- and 12-month outcomes in a referral cohort with anxiety disorders and identifies treatment and prognostic factors related to these outcomes. Patients were recruited at three general hospital clinics, two psychologist-run clinics, and one psychiatric hospital clinic. Outcomes included severity of symptoms, physical and mental health status, and subjective global change in problem severity. Of 254 patients eligible for follow-up, 165 (65%) completed a follow-up questionnaire. Methods of treatment included consultation with return to the primary care physician (38.2%); or continued treatment at the clinic, with medications (16.4%), psychotherapy (22.4%), or both (23%). Both severity of symptoms and mental health status improved but remained abnormal at follow-up. In multiple logistic regression, subjective global improvement was related to a diagnosis of panic disorder only, treatment with psychotherapy, and type of referral. Change over time in symptom severity was related to clinic type, and change over time in mental health was related to clinic type and duration of previous treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","McCusker, Jane; Boulenger, Jean-Philippe; Bellavance, Francoise; Boyer, Richard; Miller, Jean-Marc",2000.0,,0,0,
7984,Five-year follow-up study of eye movement desensitization and reprocessing therapy for combat-related posttraumatic stress disorder.,"This study reports the results of a 5-year follow-up evaluation of 13 Vietnam combat veterans with chronic posttraumatic stress disorder (PTSD) who participated in a study of eye movement desensitization and reprocessing (EMDR) therapy previously reported in this journal. Pretreatment and follow-up psychometric outcome measures were compared with those of a demographically matched control group of 14 combat veterans with chronic PTSD who did not receive EMDR. Analysis of variance showed that the modest to moderate therapeutic benefits that were manifest immediately following EMDR were lost at the 5-year follow-up evaluation, and there was an overall worsening of PTSD symptomatology over the 5-year period in both EMDR-treated and non-treated control subjects. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Macklin, Michael; Metzger, Linda J; Lasko, Natasha B; Berry, Nancy J; Orr, Scott P; Pitman, Roger K",2000.0,,0,0,
7985,Vivid visualization in the experience of phobia in virtual environments: Preliminary results.,"Explored the effect of being able to form vivid mental images on the experience of phobia during exposure treatment in virtual environments. Nine Ss with acrophobia, specifically a fear of looking out of windows of tall buildings, received either exposure treatment in a real building or virtual exposure in a model of the same building, projected in a CAVE Virtual Environment. Measures were the Vividness of Visual Imagery Questionnaire and the Phenomenology of Consciousness Inventory as a measure of fear. Contrary to expectation, there was a negative correlation between vividness of visualization and amount of fear experienced during exposure. There was a positive correlation between fear and vividness of visualization during the exposure. Although these results are seen as preliminary due to the low number of Ss, they do indicate that vividness of visualization does affect fear experienced during exposure treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Huang, Milton P; Himle, Joseph; Alessi, Norman E; Beck, Beck, Crawford, Draper, First, Glantz, Huang, Huang, Huang, Huang, Kennedy, Kihlstrom, Marks, McKelvie, Nadon, O'Grady, Pekala, Richter, Rinaldo, Rothbaum, Tellegen",2000.0,,0,0,
7986,Objective validation of the effectiveness of virtual reality psychotherapy.,"Evaluated the effectiveness of virtual reality therapy (VRT) in patients with agoraphobia, using subjective measures of anxiety and fear, and objective measures of BP, respiration, and heart rate. A virtual environment tunnel scene with a traffic jam was created for the study. Ss were 7 patients diagnosed with panic disorder with agoraphobia. Results of the VRT procedure failed to support the efficacy of VRT on the objective measures. Most of the patients reported they were unable to become immersed in the virtual reality, and the planned objective, physiological evaluation of the VRT was incomplete. Improving the immersion process and the objective measures for evaluating the effectiveness of VRT for agoraphobics is suggested. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Jang, Dong P; Ku, Jeong H; Shin, Min B; Choi, Young H; Kim, Sun I; Gelder, Held, James, North, North, North, North, Rothbaum",2000.0,,0,0,
7987,A study of outcome in a clinical psychology service and preliminary evaluation of cognitive-behavioural therapy in real practice.,"Presents data collected as part of an ongoing audit and describes the clinical characteristics and treatment progress of a subgroup of 98 clients (mean age 36 yrs) presenting to a direct referral clinical psychology service. Cases were selected retrospectively from data spanning a 40-mo period on the following criteria: (1) Ss presenting with anxiety and/or depression as the primary problem, (2) audit data completed by client and therapist at both pre- and post-treatment time points, and (3) Ss attending at least 2 treatment sessions (typical length of treatment 4-18 sessions over 2-12 mo). All Ss were offered cognitive-behaviorally oriented therapy. Multiple measures of initial problem severity and outcome were utilized including standardized measures of symptomatology, therapist ratings of improvement, and therapist and client ratings of achievement of individualized therapeutic goals. The degree of correspondence between the different outcome measures was examined and possible predictors of outcome explored. Results tentatively suggest an encouraging level of improvement, with a high degree of correlation between outcome measures and 2 measures (self-reported duration of presenting problem and Global Assessment of Functioning) predicting outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hirsch, Colette; Jolley, Suzanne; Williams, Ruth",2000.0,,0,0,
7988,The determinants and correlates of outcome following traumatic brain injury: A prospective study.,"The determinants and correlates of outcome at one (Time 1) and four (Time 2) years posttraumatic brain injury (TBI) were investigated prospectively in patients (n = 92) recruited consecutively following admission to Canada's largest regional trauma centre. Friends and family members served as control subjects. Sixty-three percent of subjects who completed baseline testing completed follow-up interviews at Time 1. Of these, 72% completed neuropsychological testing. Fifty-three percent of subjects completed follow-up interviews and neuropsychological testing at Time 2. Demographic, injury-severity, acute imaging findings, and acute neuropsychological function (attention, orientation, memory) were investigated as determinants of outcome. Neuropsychological status (attention, memory, executive function) at Time 1 and 2, and psychological status (depression, locus of control, coping style) and social support at Time 2 were investigated as correlates of outcome. Outcomes evaluated at both time points included psychosocial outcome, and a measure of return to productivity (RTP) (work and/or school). At Time 2, quality of life (QOL) data were also reported. At both time points, TBI subjects reported considerable psychosocial distress relative to controls. At Time 1, 66% of TBI subjects had returned to productive activity, at Time 2, this increased to 78%. Determinants of outcome at Time 1 showed baseline memory status to be significantly associated with RTP (p le; 0.0007). Injury severity and measures of acute neuropsychological status showed a trend to be associated with psychosocial outcome and RTP (p le; 0.05). Determinants of outcome at Time 2 again showed acute memory status to be associated with RTP (p le; 0.003) and other measures of acute neuropsychological status to be associated with psychosocial status, RTP, and QOL at p le; 0.05. Psychological variables and social support were strongly correlated with psychosocial status, RTP, and QOL at Time 2. When included in hierarchical regression analyses with acute neuropsychological variables, they accounted for substantially more variance in each outcome. A small proportion of the neuropsychological test scores (measuring general slowing, memory and executive function) correlated with outcome at both time points. These data suggest that the influence of brain pathology on outcome is attenuated over time. Long-term outcome is explained by many factors: psychological factors and social support are particularly important. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dawson, Deirdre Rose",2000.0,,0,0,
7989,Eye Movement Desensitization and reprocessing treatment of adjustment disorder.,"The advent of Eye Movement Desensitization (EMDR) for treatment of post traumatic stress disorder (PTSD) has been classified by the American Psychological Association as probably efficacious (Chambless, et at., 1996). Actual practice descriptions and EMDR training material suggest that many clinicians are using the technique to treat other mental health issues as well. This study compares outcome measures for two sessions of EMDR and two sessions of exposure for participants with Adjustment Disorder (AD). A licensed, EMDR trained mental health professional provided treatment for this serial case study (n = 9) design. A control treatment condition of time-yoked imagined exposure to disturbing memories in participants was used to control for common treatment factors and exposure elements of the treatment protocol. Measures included the Impact of Events Scale-R (IES-R), and the Outcome Questionnaire 45.2 (OQ) and the Symptom Response Rating Scale (SRRS). At follow-up, seven of nine individuals clinically improved by demonstrating score changes that exceeded the RCI (Jacobson & clinically significant improvement for four of these six individuals from baseline to followup as defined by the OQ authors. Those with anxious or mixed features improved, while participants with depressive features and ongoing stressors showed no improvement. This study's hypothesis was that the effects of EMDR would show score improvements on the dependent measures beyond the effects of RUIC. This was not found from baseline to follow-up. After the first treatment phase, 75% of the cases receiving EMDR produced clinically significant improvement on IES Total scores, as opposed to 25% of the RUIC treated individuals in the same phase. Implications for the clinical use of EMDR and exposure for AD are discussed. It is suggested that clinical evaluation of symptom and personality features presented by a patient prior to treatment will aid in the appropriate selection of effective treatment methods. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mihelich, Mary Lynn",2000.0,,0,0,
7990,A retrospective study on improvements in nightmares and post-traumatic stress disorder following treatment for co-morbid sleep-disordered breathing.,"Assessed the impact of treatment for comorbid sleep-disordered breathing (SDB) on patients with nightmares and posttraumatic stress disorder (PTSD). 23 chronic nightmare sufferers (15 with PTSD) who also suffered comorbid SDB (16 with obstructive sleep apnea, OSA; 7 with upper airway resistance syndrome, UARS) completed a telephone interview, on average, 21 mos after having been offered treatment for SDB at a university sleep disorders clinic. At follow-up, 14 reported maintaining treatment (Treatment Group) and 9 reported discontinuing treatment (No-Treatment Group). More patients in the Treatment Group reported improvement in sleep (93% vs. 33%) and in daytime well-being (93% vs. 33%) compared with those in the No-Treatment group. The Treatment Group reported a median improvement in nightmares of 85% compared with a median 10% worsening in the No-Treatment Group. In the PTSD subset, 9 in the Treatment Group reported a median 75% improvement in PTSD symptoms whereas 6 in the No Treatment Group reported a median 43% worsening. In this small sample of patients, treatment of SDB was associated with improvements in nightmares and PTSD. Relationships between nightmares, PTSD and SDB are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Krakow, Barry; Lowry, Carmen; Germain, Anne; Gaddy, Lane; Hollifield, Michael; Koss, Mary; Tandberg, Dan; Johnston, Lisa; Melendrez, Dominic",2000.0,,0,0,
7991,Outcome in female patients with both substance use and post-traumatic stress disorders.,"The present study examines six-month treatment outcomes for substance use disordered (SUD) female patients (aged 19-55 yrs) with a comorbid diagnosis of posttraumatic stress disorder (PSTD). Patients completed a baseline assessment while receiving inpatient substance use treatment and were reinterviewed six-months post-treatment. Approximately one-half the women had relapsed on alcohol and/or drugs during the follow-up period. One-quarter had remitted from PSTD at follow-up. Logistic regressions showed that baseline severity of PSTD reexperiencing symptoms is a significant predictor of both alcohol/drug relapse and PSTD status (remitted/unremitted). No baseline measure of substance use emerged as a significant predictor of' PSTD remitted/unremitted status at follow-up. Results suggest that treatment targeting comorbid PSTD might result in improved outcomes for both disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Brown, Pamela J",2000.0,,0,0,
7992,Does major depressive disorder influence outcome of exposure and response prevention for OCD?,"Studies that have examined the effects of comorbid depression on response to treatment in obsessive-compulsive disorder (OCD) have yielded inconsistent results. The authors examined treatment outcome for 15 OCD patients with comorbid major depressive disorder (MDD) and 33 OCD patients without MDD. All patients received intensive cognitive-behavioral therapy by exposure and response (ritual) prevention. Improvement in OCD symptoms was observed in both patient groups, and treatment gains were maintained at follow-up. Whereas the presence of a comorbid MDD diagnosis in OCD was not related to treatment failure, nondepressed patients had significantly lower posttreatment and follow-up OCD severity scores. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Abramowitz, Jonathan S; Foa, Edna B",2000.0,,0,0,
7993,A controlled trial of cognitive behavioral treatment of panic in alcoholic inpatients with comorbid panic disorder.,"Patients entering a 4-wk inpatient alcoholism treatment program were screened for anxiety symptoms. Those with panic disorder with or without agoraphobia were randomly assigned to 2 groups. The treatment group received 12 hrs of cognitive-behavioral treatment for panic disorder in addition to the regular alcoholism treatment program; the control group received the regular program. Dropouts from the treatment group were also followed. Problem drinking and anxiety symptoms were measured at the start of the study, and at 3, 6, and 12 months posttreatment. Abstinence from drinking, and anxiety and mood symptoms improved after treatment in all of the groups; there were few differences in outcome between the groups. The authors conclude that this particular intervention had not been more effective than the regular alcohol treatment program in reducing problem drinking in those with panic disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bowen, Rudradeo C; D'Arcy, Carl; Keegan, David; Senthilselvan, A",2000.0,,0,0,
7994,Dual focus schema therapy for personality disorders and substance dependence: Case study results.,"This chapter reviews the theory, techniques, and development of a manual-guided individual psychotherapy for substance-dependent individuals diagnosed with personality disorders. Dual Focus Schema Therapy is a 24-wk therapy that integrates relapse prevention for substance dependence with targeted work on early maladaptive schemas (enduring negative beliefs about oneself, others, and events) and coping styles. The first 3 patients--one each from Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) Axis-II Cluster A, B, and C--treated during the pilot testing phase of the manual are summarized to illustrate differences in psychopathology, personality and interpersonal functioning, early maladaptive schemas, and coping styles, as well as treatment response. The 3 patients examined are a 41-yr-old female with schizotypal personality disorder, a 34-yr-old female with borderline personality disorder, and a 36-yr-old male with obsessive-compulsive personality disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ball, Samuel A; Young, Jeffrey E; Alden, Alden, Ball, Ball, Beck, Beck, Beck, Benjamin, Benjamin, Cacciola, Cappe, Carroll, Costa, Davidson, DeJong, Derogatis, First, Fisher, Freeman, Griggs, Horowitz, Horowitz, Kadden, Kadden, Kernberg, Kosten, Layden, Linehan, Linehan, Linehan, Lockwood, Longabaugh, Magnavita, Marlatt, Millon, Millon, Monti, Nace, Nace, Nelson-Gray, Perry, Pollack, Preston, Pretzer, Rounsaville, Rutherford, Ryle, Sanislow, Schmidt, Shea, Turkat, Van Velzen, Verheul, Winston, Yeomans, Young, Young, Zuckerman",2000.0,,0,0,
7995,Treatment of GAD: Targeting Intolerance of Uncertainty in Two Types of Worry.,"This study evaluates the efficacy of a cognitive-behavioral treatment for generalized anxiety disorder (GAD) that addresses two types of worries: (a) those about situations that are amenable to problem solving, and (b) those about situations that are not. The treatment's goal is to help patients become more tolerant of uncertainty by discriminating between both types of worry and applying the correct strategy to each type. A multiple baseline design was used and subjects were 4 adults with a primary diagnosis of GAD. Treatment outcome was assessed with daily self-monitoring, self-report questionnaires, and standardized clinician ratings. At posttest and 6-month follow-up, 3 of 4 subjects no longer met diagnostic criteria for GAD and had attained high end-state functioning. At 12-month follow-up, none of the subjects met GAD diagnostic criteria but end-state functioning was variable. The results also show that treatment outcome was highly related to change in intolerance of uncertainty. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dugas, Michel J; Ladouceur, Robert; Barlow, Barlow, Beck, Beck, Borkovec, Borkovec, Borkovec, Borkovec, Borkovec, Box, Brown, Butler, Butler, Chambless, Clark, Davey, Davey, Davey, Di Nardo, Dugas, Dugas, Ellermeier, Freeston, Hersen, Jacobson, Jacobson, Kraemer, Ladouceur, Ladouceur, Ladouceur, Ladouceur, MacLeod, Mathews, Meyer, Noyes, Roemer, Tallis",2000.0,,0,0,
7996,The Relative Effectiveness of EMDR Versus Relaxation Training with Battered Women Prisoners.,"Five women prisoners with a history of being battered and who met the DSM-IV criteria for post-traumatic stress disorder were assessed (A phase) and provided with structured relaxation training (RT) (B phase, or placebo treatment), followed by eye movement desensitization and reprocessing (EMDR) therapy (C phase). Using the Beck Anxiety Inventory and the Impact of Events Scale's avoidance behavior and intrusive thoughts subscales as outcome measures, RT alone did not result in any clinical improvements. The subsequent provision of EMDR did not improve upon this lack of success with 4 of the 5 participants; 1 did improve on anxiety and intrusive thoughts. The apparent ineffectiveness of EMDR with these participants may be attributed to several explanations. Foremost perhaps is the hypothesis that EMDR is not sufficient to ameliorate the effects of chronic abuse. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Colosetti, Sharman D; Thyer, Bruce A; Aciemo, Acierno, Austin, Bauman, Beck, Bernstein, Blake, Blake, Brannen, Cocco, Colosetti, Cox, Dunn, Dutton, Eoa, Gleason, Gosselin, Holiman, Horowitz, Hyer, Kemp, Kemp, Lohr, Mancoske, Marquis, Miller, Rubin, Sanderson, Saunders, Shapiro, Shapiro, Shapiro, Shapiro, Shapiro, Sharpley, Sharpley, Shepard, Spates, Tutty, Tutty, Vaughan, Walker, Wilson, Wolpe, Zilberg",2000.0,,0,0,
7997,The effectiveness of a multimodal brief group experiential psychotherapy approach.,"Assessed the effectiveness of a multimodal brief group experiential psychotherapy approach in reducing psychological symptoms, enhancing well-being, and in maintaining treatment outcomes at a 6-mo follow-up. Treatment outcomes were assessed in 41 Ss (aged 18-67 yrs) diagnosed with anxiety disorders, mood disorders, or adjustment disorders. Ss completed an 8-day, residential, group-therapy treatment program which involved 30 hr of intensive group experiential therapy, primarily using psychodrama. In addition, art therapy, music therapy, family sculpting, and Gestalt techniques were combined into an approach with philosophical and theoretical underpinnings in existential-humanistic psychology, developmental theory, and models of family therapy. Ss completed a battery of questionnaires at pretreatment, immediately following therapy, and between 4- and 6-mo posttreatment. Results show that the multimodal brief group experiential psychotherapy approach was effective in reducing negative psychological symptoms and in enhancing psychological well-being in the Ss. Future directions for research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Klontz, Bradley T; Wolf, Eve M; Bivens, Alex; Arn, Beck, Burnswick, Carpenter, Cohen, Cummings, D'Amato, Dayton, Derogatis, Elliot, Flomenhaft, Fogarty, Greenberg, Hattie, Hollon, Kaye, Kellermann, Kipper, Kipper, Lambert, Lambert, Loftus, Mahrer, Mann, Mehdi, Millon, Perrott, Ragsdale, Ray, Ray, Seligman, Shostrom, Stallone, Wegscheider-Cruse, Weiss, Yalom",2000.0,,0,0,
7998,Modulation by muscarinic antagonists of the response to carbon dioxide challenge in panic disorder.,"Investigated the roles of peripheral vs central muscarinic receptors in mediating the physiologic response to carbon dioxide inhalation in patients with panic disorder (PD). In a double-blind, random crossover design, 12 patients (aged 18-35 yrs) with PD received biperiden hydrochloride (a muscarinic antagonist that crosses the blood-brain barrier), pirenzepine hydrochloride (a muscarinic antagonist that does not cross the blood-brain barrier), or placebo 2 hrs before a 35% carbon dioxide-65% oxygen respiratory challenge (vs air as a placebo) on 3 separate days. Patients' self-ratings of subjective anxiety show that inhalation of the carbon dioxide/oxygen mixture provoked a significant and intense response after treatment with pirenzepine and placebo. After biperiden treatment, however, hypercapnia elicited a response profile similar to that elicited by air. Subjective anxiety remained similar to preinhalation levels. These results show that a centrally active muscarinic antagonist can block the response to carbon dioxide commonly observed in Ss with PD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Battaglia, Marco; Bertella, Silvana; Ogliari, Anna; Bellodi, Laura; Smeraldi, Enrico; Akiyama, Argyle, Aston-Jones, Battaglia, Battaglia, Battaglia, Bellodi, Bertani, Burton, Burton, Carmine, Coryell, Folgering, Fyer, Goddard, Gorman, Gozal, Griez, Grimaldi, Harrington, Heninger, Jensen, Kinney, Klein, Millhorn, Nattie, Nattie, Papp, Perna, Perna, Pine, Pols, Price, Robins, Roy-Byrne, Torvik, Wolpe, Yokogawa",2001.0,,0,0,
7999,How treating psychoanalysts respond to psychotherapy research constraints.,"Psychoanalysts who accept the value of research express concern that intrusions required by research protocols create significant distortions in the psychoanalytic process. The authors, all psychoanalysts, are studying the outcome of a brief (twenty-four-sess ion) psychodynamic treatment of panic disorder. They report their experiences and struggles with the intrusions of videotaping, working with a treatment manual, and time-limited treatment. This research process required them to question old beliefs and to confront feelings of disloyalty toward their analytic training and identity, particularly with regard to keeping a ""clean field"" and routinely performing long-term analysis of character. The therapists' psychoanalytic knowledge, however, emerged as crucial for them in managing specific research constraints. Despite concerns about providing inadequate treatment, therapists were found to engage patients with psychoanalytic tools and focus in vibrant and productive therapies that led to significant improvements in panic symptoms and associated quality of life. The authors suggest that psychoanalysts have been overestimating the potential damage of research constraints on psychoanalytic process and outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Busch, Fredric N; Milrod, Barbara L; Rudden, Marie; Shapiro, Theodore; Roiphe, Jean; Singer, Meriamne; Aronson, Andrew; Busch, Busch, Compton, Cooper, DiNardo, Freud, Freud, Freud, Greenacre, Home, Kandel, Markowitz, Marshall, Milrod, Milrod, O'Shaughnessy, Shear, Sheehan, Wallerstein",2001.0,,0,0,
8000,Outcome predictors in the treatment of fear of flying.,"Studied treatment outcome predictors in fear of flying. 31 males and females aged 20-68 yrs with fear of flying in Spain were treated with approximately 5 sessions of a computer-assisted exposure treatment. Demographic variables, clinical characteristics, and psychopathological variables were assessed with 2 Spanish-language questionnaires on fear of flying and with the Spanish versions of the Fear of Flying Scale (D. M. Gursky and S. Reiss, 1987), the Beck Depression Inventory, the Beck Anxiety Inventory (A. T. Beck et al, 1988), and the Anxiety Sensitivity Index. Multiple regression analysis was performed. The results show that fear of instability and fear of heights were associated with a poor treatment outcome and that the severity of the fear of instability was the best posttreatment outcome predictor. At 1-yr follow-up, the severity of posttreatment fear of flying was the best predictor of subsequent self-reported fear of flying. No predictors were found for flying vs not flying during the follow-up period. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fullana Rivas, Miquel Angel; Tortella-Feliu, Miquel; Beck, Beck, Beckham, Bornas, Bornas, Brown, Capafons, Capafons, Foa, Gursky, Hellstrom, Norton, Peterson, Rodriguez-Naranjo, Scholing, Shaw, Solyom, Sosa, Steketee, Traub, Walder",2001.0,,0,0,
8001,Predicting psychotherapeutic outcomes in patients with generalised anxiety disorder.,"Investigated the clinical characteristics of 30 male patients with generalised anxiety disorder (aged 25-40 yrs) and their relationship to the outcomes of cognitive and biofeedback therapies. The clinical characteristics included the severity of anxiety and depression, duration of illness, previous treatment, and locus of control. Measures were the Hamilton Anxiety Rating Scale, Beck Depression Inventory, a locus of control scale, and a case history schedule. No significant predictor was found for biofeedback therapy, but patients with a shorter illness duration and greater internal locus of control had good outcomes from cognitive therapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Biswas, Arpita; Chattopadhyay, P. K; Andrews, Andrews, Beck, Beck, Biswas, Borkovec, Borkovec, Budzynski, Butler, Butler, Butler, Clark, Garfield, Hamilton, Kendall, Mukhopadhyay, Mukhopadhyay",2001.0,,0,0,
8002,"Attentional bias, self-consciousness and perfectionism in social phobia before and after cognitive-behaviour therapy.","Attentional bias for threat words (as measured by the emotional Stroop task), self-consciousness and perfectionism was studied in 24 patients with social phobia before and after cognitive-behaviour treatment. A total of 18 (75%) of the patients were classified as treatment responders on the basis of reduced scores for social anxiety. The treatment responders showed a significant reduction in attentional bias for social threat words, in public self-consciousness and in perfectionism. The nonresponders showed an equal reduction in perfectionism; as they had a much higher level of perfectionism before treatment, however, their change only amounted to a lowering of their level of perfectionism to the level that characterized the treatment responders before treatment. The treatment responders, on the other hand, reduced their level of perfectionism to that of nonclinical samples. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lundh, Lars-Gunnar; Ost, Lars-Goran; Alden, Allen, Amir, Antony, Argyle, Beck, Bieling, Bogels, Clark, DiNardo, Fenigstein, Frost, Furmark, Heimberg, Hewitt, Hofmann, Holle, Hope, Hope, Hope, Hope, Jostes, Juster, Kessler, Liebowitz, Lundh, Maidenberg, Mattia, McNeil, Monfries, Nystedt, Rapee, Saboonchi, Saboonchi, Saboonchi, Sarason, Schlenker, Smari, Woody",2001.0,,0,0,
8003,"Right prefrontal repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: A double-blind, placebo-controlled study.","The efficacy of repetitive transcranial magnetic stimulation (rTMS) of the right prefrontal cortex for patients with obsessive-compulsive disorder (OCD) was studied under double-blind, placebo-controlled conditions. 18 patients (mean age 35.2 yrs) were randomly assigned to 18 sessions of real (N = 10) or sham (N = 8) rTMS. Treatments lasted 20 minutes, and the frequency was 1 Hz for both conditions, but the intensity was 110% of motor threshold for real rTMS and 20% for the sham condition. No significant changes in OCD were detected in either group after treatment. Two patients who received real rTMS, with checking compulsions, and 1 receiving sham treatment, with sexual/religious obsessions, were considered responders. Low-frequency rTMS of the right prefrontal cortex failed to produce significant improvement of OCD and was not significantly different from sham treatment. Further studies are indicated to assess the efficacy of rTMS in OCD and to clarify the optimal stimulation characteristics. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Alonso, Pino; Pujol, Jesus; Cardoner, Narcis; Benlloch, Luisa; Deus, Joan; Menchon, Jose M; Capdevila, Antoni; Vallejo, Julio; George, George, Goodman, Greenberg, Hamilton, Klein, Pascual-Leone, Reid",2001.0,,0,0,
8004,Impact of panic attacks on rehabilitation and quality of life among persons with severe psychiatric disorders.,"Evaluated data from 120 Ss with severe psychotic disorders to determine whether those with and without comorbid panic attacks (PAs) differed in rates of comorbidity of other psychiatric disorders, in quality of life (QoL), and in rehabilitation outcomes. Ss were assessed with the Center for Epidemiologic Studies-Depression scale, the Structured Clinical Interview for DSM-III-R, the General Health Questionnaire, the Global Assessment of Functioning scale, and several quality-of-life measures at baseline and 4.5 mo after they had participated in a social rehabilitation program. Statistical comparisons were made at baseline and follow-up scores between Ss with and without PAs. 18 (15%) of Ss who had severe psychotic disorders also had PAs. Ss with this type of comorbidity had significantly higher rates of major depressive disorder, specific phobia, sedative abuse, polysubstance abuse, other substance abuse, and anorexia nervosa than Ss without panic attacks. Ss who had panic attacks also had poorer rehabilitative outcomes and poorer QoL at baseline and at follow-up than Ss without PAs. PAs may be a valuable prognostic indicator among persons with psychotic disorders and may have implications for treatment and rehabilitation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Goodwin, Renee; Stayner, David A; Chinman, Matthew J; Davidson, Larry; Andrade, Arlow, Bermanzohn, Bodlund, Cassano, Cosoff, Cutler, Cutler, Davidson, Davidson, Endicott, Frank, Galynker, Goldberg, Hofmann, Husaini, Kessler, Kessler, Klerman, Lehman, Lehman, Markowitz, Radloff, Roy-Byrne, Spitzer, Williams",2001.0,,0,0,
8005,Long-term outcome of panic disorder with agoraphobia treated by exposure.,"Evaluated the long-term follow-up of patients with panic disorder with agoraphobia treated according to a standardized protocol. A series of 200 patients (mean age 34.5 yrs) with panic disorder with agoraphobia was treated in an outpatient clinic with behavioural methods based on exposure homework. 136 patients became panic free after 12 sessions of psychotherapy. 132 were available for follow-up. A 2- to 14-yr follow-up was performed. Survival analysis was employed to characterize the clinical course of patients. 31 of the 132 patients (23%) had a relapse of panic disorder at some time during follow-up. The estimated cumulative percentage of patients remaining in remission was 93.1 after 2 yrs, 82.4 after 5 yrs, 78.8 after 7 yrs and 62.1 after 10 yrs. Such probabilities increased with younger age, and in the absence of a personality disorder, of high pre-treatment levels of depressed mood, of residual agoraphobic avoidance after exposure, and of concurrent use of benzodiazepines and antidepressant drugs. The findings suggest that exposure treatment can provide lasting relief to the majority patients with panic disorder and agoraphobia. Disappearance of residual and subclinical agoraphobic avoidance, and not simply of panic attacks, should be the aim of exposure therapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fava, G. A; Rafanelli, C; Grandi, S; Conti, S; Ruini, C; Magelli, L; Belluardo, P; Bakker, Bakker, Barlow, Biondi, Breier, Brown, Bruce, Clair, Craske, de Beurs, Ehlers, Endicott, Evans, Fava, Fava, Fava, Fava, Fava, Fava, Fava, Fava, Fava, Goldthorpe, Gould, Keller, Kellner, Kilic, Lee, Margraf, Marks, Marks, Marks, Martinsen, Milrod, Noyes, Noyes, O'Sullivan, Oei, Otto, Paykel, Paykel, Rafanelli, Rief, Saviotti, Sonino, van Balkom, Vollrath",2001.0,,0,0,
8006,Long-term outcome of social phobia treated by exposure.,"Studied long-term follow-up of social phobia. A consecutive series of 70 patients with social phobia was treated in an outpatient clinic with behavioural methods based on exposure homework. 45 Ss (mean age 30.6 yrs) were judged to be remitted after 8 individual sessions of psychotherapy. A 2-12 year follow-up was performed. Survival analysis was selected to characterize the clinical course. Assessments were performed before treatment, at the end of therapy, after 1 year, and subsequently on a yearly basis, and utilized selected items of Paykel's Clinical Interview for Depression. Six of the 45 Ss (13%) had a relapse of social phobia at some time during follow-up. The estimated cumulative percentage of patients remaining in remission was 98 after 2 yrs, 85 after 5 yrs and 85 after 10 yrs. Such probabilities increased in the absence of a personality disorder, of residual social phobic avoidance after exposure, and of concurrent use of benzodiazepines. The findings suggest that, even though one patient out of three is unable to complete treatment or does not benefit sufficiently from it, exposure treatment can provide lasting effects to the majority of patients with social phobia. Disappearance of residual, subclinical social phobic avoidance appears to be the target of treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fava, G. A; Grandi, S; Rafanelli, C; Ruini, C; Conti, S; Belluardo, P; Antony, Brown, Bruce, Cottraux, den Boer, Ehlers, Endicott, Fava, Fava, Fava, Fava, Fava, Fava, Fava, Fava, Fava, Feske, Goldthorpe, Heimberg, Juster, Kellner, Lee, Marks, Marks, Marks, O'Sullivan, Otto, Otto, Paykel, Paykel, Rafanelli, Reich, Sonino, Stravynski, Van Balkom, Van Velzen, Wlazlo",2001.0,,0,0,
8007,An open-label trial of evidence-based cognitive behavior therapy for nightmares and insomnia in crime victims with PTSD.,"Insomnia and nightmares are perceived as secondary phenomena in posttraumatic stress disorder (PTSD). This study reports on an open-label trial of cognitive behavior therapy for insomnia and disturbing dreams in crime victims with PTSD. 62 Ss completed a 10-hr group treatment consisting of imagery rehearsal for nightmares and sleep hygiene, stimulus control, and sleep restriction for insomnia. Nightmare frequency, sleep quality, sleep impairment, and ratings for PTSD, anxiety, and depression symptoms were assessed at baseline and at the 3-mo follow-up. All measures demonstrated improvement that was roughly equivalent to changes in clinical severity from severe to moderate for sleep quality, sleep impairment, and nightmare frequency, from borderline severe to borderline moderate for PTSD symptoms, and from extremely severe to borderline severe for anxiety and depression symptoms. In this uncontrolled study, successful treatment for insomnia and nightmares in crime victims was associated with improvement in symptoms of PTSD, anxiety, and depression. Participants with clinical improvements in PTSD symptoms demonstrated significantly greater improvement in sleep quality and nightmare frequency than those whose PTSD symptoms did not improve. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Krakow, Barry; Johnston, Lisa; Melendrez, Dominic; Hollifield, Michael; Warner, Teddy D; Chavez-Kennedy, Debie; Herlan, Margaret J; Berlin, Blake, Buysse, Dashevsky, Foa, Halliday, Kellner, Kellner, Krakow, Krakow, Krakow, Krakow, Krakow, Krakow, Krakow, Kupfer, Morin, Morin, Morin, Neidhardt, Nowell, Reite, Sherman",2001.0,,0,0,
8008,Interapy. Treatment of posttraumatic stress through the Internet: A controlled trial.,"On-line therapy offers many advantages over face-to-face settings. Interapy includes psycho-education, screening, effect measures and protocol-driven treatment via the Internet for clients. The present paper reports the results of a controlled trial on the Interapy treatment of posttraumatic stress and grief in students (aged 18-37 yrs), gaining course credits. The participants in the experimental condition (n=13) improved significantly than the participants in the waiting-list control condition (n=12), on trauma-related symptoms and general psychopathology. The effect sizes were large. Eighty percent of the treated participants showed clinically significant improvement after treatment. The possibilities for future research with Interapy, including studies into moderating variables, are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lange, Alfred; van de Ven, Jean-Pierre; Schrieken, Bart; Emmelkamp, Paul M. G; Arrindell, Bedrosian, Bredeweg, Burnett, Carr, Chandler, Cohen, Davey, De Jong, Derogatis, Ehlers, Emmelkamp, Erdman, Esterling, Gelderen, Ghosh, Ghosh, Greenberg, Horowitz, Jacobson, Jaycox, Jaycox, King, Kleber, L'Abate, Lange, Lange, Lange, Lange, Lange, Lange, Marks, Miller, Moncher, Murphy, Newman, Nijenhuis, Pennebaker, Petrie, Postmes, Resick, Rime, Rime, Roemer, Sampson, Sarason, Schoutrop, Schoutrop, Selmi, Smyth, Smyth, Spera, Taylor, van Asselt, Wald, Zuuren",2001.0,,0,0,
8009,St. John's wort in generalized anxiety disorder: Three case reports.,"St. John's Wort (Hypericum perforatum) is now widely used to treat depression. Among its numerous mechanisms of action are some which might suggest potential benefit in anxiety disorders, including gamma-aminobutryic receptor activity; serotonin reuptake inhibition, and, in hyperforin-enriched preparations, serotonin receptor down-regulation. This article presents the results of an open-label study of St. John's Wort in obsessive-compulsive disorder for 3 female patients (aged 43-56 yrs). The findings suggest St. John's Wort may be used as a possible anxiolytic. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Davidson, Jonathan R. T; Connor, Kathryn M; Chatterjee, Cott, Derogatis, Hamilton, Hantsgen, Linde, Muller, Nahrstedt, Taylor, Williamson",2001.0,,0,0,
8010,The successful treatment of PTSD through overt cognitive behavioral therapy in non-responders to EMDR.,"This research investigated the efficacy of an operantly cognitive-behavioural trauma treatment protocol (TTP) in 2 cases that had previously been treated unsuccessfully with Eye Movement Desensitization and Reprocessing (EMDR). Ss were a 46-yr-old and a 25-yr-old female with posttraumatic stress disorder (PTSD). In line with previous research, both participants improved following TTP, to the extent where one of the participants was asymptomatic at post-treatment and 3 mo follow-up. These cases also demonstrate the ability of a cognitive-behavioural intervention to successfully treat childhood sexual abuse victims later in life. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Devilly, Grant J",2001.0,,0,0,
8011,A brief Internet-based treatment for panic disorder.,"This study investigated the effectiveness of an Internet-based intervention for people with panic disorder. Twenty-two participants met criteria for panic disorder and were randomly assigned to either the treatment or a self-monitoring control condition. The study took place over 3 weeks and consisted of one week of self-monitoring prior to the intervention group accessing the program for one week, followed by one week of post-intervention assessment. Participants were assessed on measures pertaining to panic, negative affect, body vigilance, anxiety sensitivity and self-efficacy in managing panic. The treatment condition was associated with significant reductions in all variables except anxiety sensitivity and depressive affect. This type of intervention for people with fearful panic attacks holds promise as an efficacious and economical method for treating spontaneous panic. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Klein, Britt; Richards, Jeffrey C",2001.0,,0,0,
8012,The psychophysiology of exposure therapy-a pilot therapy study with patients suffering from agoraphobia with panic disorder.,"Investigated individual response patterns in agoraphobic situations. Patients with an International Classification of Diseases and Related Health Problems (ICD--10) diagnosis of agoraphobia and panic disorder underwent ambulatory psychophysiologic monitoring in standardized agoraphobic situations before (n = 14) and after (n = 15) brief standardized cognitive behavioral treatment (pre as well as post values could be collected from 8 patients). Nine controls underwent the same monitoring procedure. The particular design of the ambulatory monitoring allowed very high control of the most important variables. Group means were in accordance with previous findings: in the agoraphobic situations slightly higher psychophysiologic activation for the patients than for the controls, and a reduction of that reaction after therapy. However, the large variance between subjects seems to favor individual response patterns. Examples of proto-typic responses-concordance, asynchrony, prolonged activation, and negative concordance-are presented. Only 1 of these responses is in accordance with the cognitive model of panic attacks and fits into the habituation model of exposure therapy. Hypotheses regarding the importance of the of the other patterns for therapy of agroaphobia and panic disorder are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ebner, Ulrich W; Angenendt, J; Wilmers, F",2001.0,,0,0,
8013,Cognitive strategies and the resolution of acute stress disorder.,"Thought control strategies were assessed in 45 civilian trauma survivors (mean age 34.7 yrs) with acute stress disorder prior to and following either cognitive behavior therapy or supportive counseling. Participants completed an acute stress disorder interview, depression inventory, a state trait anxiety inventory, an impact of event scale, and a thought control questionnaire within 2 wks of their trauma and 6 mo following treatment. Results show that receiving cognitive behavior therapy was associated with reductions in the use of punishment and worry, and increases in the use of reappraisal and social control strategies. Reduced posttraumatic stress symptoms were associated with increased use of social control strategies and reappraisal strategies, and decreased use of worry. Findings are discussed in terms of the cognitive strategies that may mediate acute posttraumatic stress. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bryant, Richard A; Moulds, Michelle; Guthrie, Rachel M; Amir, Beck, Blake, Borkovec, Bryant, Bryant, Bryant, Bryant, Bryant, Bryant, Harvey, Harvey, Horowitz, Litz, Solomon, Spielberger, Tarrier, Warda, Wells",2001.0,,0,0,
8014,Treatment of combat-related nightmares using imagery rehearsal: A pilot study.,"Examined the use of Imagery Rehearsal in treating combat-related nightmares of 12 male Vietnam veterans (aged 45-50 yrs) with posttraumatic stress disorder (PTSD). Three treatment groups, comprising 4 veterans in each, completed standardized treatment across 6 sessions. Treatment effects were investigated using nightmare diaries and established instruments. The data demonstrate significant reductions in nightmares targeted, and improvements in PTSD and comorbid symptomatology. It is recommended that, on the basis of the promising preliminary data, a randomized control trial be established to assess imagery ability and attitude toward nightmares. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Forbes, David; Phelps, Andrea; McHugh, Tony; Beck, Beck, Blake, Bryant, Celluci, Coalson, Creamer, Derogatis, Foa, Fontana, Halliday, Hartmann, Kellner, Krakow, Krakow, Krakow, Krakow, Krakow, Laor, Marks, Miller, Spiegel, Thompson, van der Kolk, Weiss, Wood",2001.0,,0,0,
8015,Effect of distraction and coping style on in vivo exposure for specific phobia of spiders.,"Hypothesized that the effect of distraction on treatment outcome might depend on coping style. Specifically, it was predicted that for blunters (i.e., individuals who tend to avoid threat-related information), distraction would interfere with the effects of exposure. However, it was predicted that distraction might benefit monitors (i.e., those who tend to seek out threat-related information). Measures were the Miller Behavioral Style Scale, and the Spider Questionnaire. 60 Ss (mean age 28.57 yrs) with a specific phobia of spiders underwent a single, two-hour session of exposure treatment. During the first hour, half of the Ss were distracted by listening to an audiotape and the other half underwent exposure without distraction. In the second hour, all Ss underwent focused exposure. Based on measures of heart rate, subjective fear, and behavioral testing, participants improved after one hour of treatment, and improved further during the second hour. However, neither distraction, coping style, nor their interaction had a significant effect on outcome. The present study provides support for the benefits of behavioral treatment for specific phobias. However, hypotheses regarding distraction and coping style were not confirmed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Antony, Martin M; McCabe, Randi E; Leeuw, Ina; Sano, Natasha; Swinson, Richard P; Antony, Antony, Antony, Arntz, Barlow, Bourdon, Craske, Craske, Curtis, Eaton, Efran, First, Foa, Gard, Grayson, Grayson, Haw, Kessler, Klorman, Lamping, Lang, Miller, Miller, Miller, Miller, Miller, Muris, Muris, Muris, Muris, Muris, Muris, Myers, Ost, Penfold, Phipps, Rachman, Rodriguez, Rodriguez, Sanderson, Sanderson, Skeptoe, Steketee",2001.0,,0,0,
8016,Obsessive-compulsive Disorder treatment outcome: The effect of comorbid DSM-IV personality disorders.,"Obsessive-compulsive Disorder (OCD) is a serious anxiety disorder that affects 2-3% of the American population at some point in their lifetime. Recent attention has focused on examining the comorbidity of OCD with personality disorders. Numerous studies have indicated that personality disorders are common in samples of anxiety disordered patients; in fact, approximately 50% of all anxiety disordered patients meet criteria for at least one personality disorder. Given the high comorbidity of OCD and personality disorders, it is important to examine how this relationship affects treatment outcome for OCD. The majority of studies have concluded that patients diagnosed with a personality disorder do not improve as much in treatment as those patients who do not carry a personality disorder diagnosis. An abundance of evidence has demonstrated that behavior therapy, primarily exposure with response prevention, is the treatment of choice for patients with OCD. Given this information, along with the knowledge that personality disorders may negatively affect treatment outcome in OCD patients, it is crucial to investigate the effects that personality disorders may have on behavioral treatments for OCD. The present study was designed to examine the effects of prospectively diagnosed personality disorders on treatment outcome in a sample of people seeking behavioral treatment for OCD. The patients were divided into three groups based on their personality disorder status: no personality disorders, one personality disorder, and more than one personality disorder. It was hypothesized that patients with comorbid personality disorder and obsessive-compulsive disorder would show less improvement from behavioral treatment than would patients with obsessive-compulsive disorder only. It was also hypothesized that patients with a personality disorder diagnosis would show more severe OCD symptoms on the Y-BOCS at pretreatment. An additional hypothesis was that the more severe the patient's personality functioning, the less effective treatment would be. (Abstract shortened by UMI.) (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Harap, Stephen Todd",2001.0,,0,0,
8017,The treatment of panic disorder: A comparative study between breathing retraining and cognitive behavioral therapy.,"Cognitive Behavioral Therapy (CBT) is a widely used and highly effective treatment for panic disorder. It consists of different components and breathing retraining (BR) is often included. It is not clear what mechanism of panic is affected when panic symptoms decrease. There has been an increase in studies over the past ten years looking at the respiratory component of panic. It is thought that BR may be effective in the treatment of panic if the respiratory aspect is a primary element in panic. Few studies have looked solely at breathing retraining in the treatment of panic. A treatment outcome study was conducted to assess if BR may be as effective as CBT in decreasing the frequency and severity of panic symptoms. Ten people with panic disorder were randomly assigned to CBT without BR and 11 were randomly assigned to a BR group. All participants kept a panic attack journal 4 weeks prior to starting treatment through 4 weeks after treatment. The BR group included six 30 to 60 minute sessions of breathing retraining. The CBT group followed a modified version of Craske, Barlow, and Meadows protocol (1994) which consisted of ten 45 to 90 minute sessions. Results show that BR appears as effective as CBT in the treatment of panic disorder. There were no significant pre to post differences in the severity or frequency of panic attacks between the two groups. It is felt that the respiratory component is more essential in panic than has been acknowledged in the past. Because breathing retraining can be taught more rapidly than cognitive behavioral therapy and therefore provide relief sooner, it can be a useful tool in the treatment of panic. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Berger, Beth Creager",2001.0,,0,0,
8018,Meta-analysis of Eye Movement Desensitization and Reprocessing efficacy studies in the treatment of PTSD.,"Eye Movement Desensitization and Reprocessing (EMDR) is a relatively new psychological therapy used in the treatment of Posttraumatic Stress Disorder (PTSD) and other disorders. EMDR is unique in that it combines sets of therapist-administered eye movements in conjunction with protocol-driven cognitive and affective processing related to past trauma. EMDR has become a controversial technique for reasons including a lack of explanation for why it works and stunning claims made for its efficacy in the literature. Despite a large amount of research over the past decade, EMDR has not before been studied meta-analytically in its own right. The present investigation used meta-analysis to examine the collection of EMDR PTSD studies available in the literature. The literature search resulted in a total of 21 studies, which met inclusion criteria. These primary studies in turn resulted in a collection of 118 effect sizes included in the analysis. Two separate analyses were conducted dependent on whether EMDR was compared to a no treatment control group or an alternative treatment control group. In addition to an overall estimate of the efficacy of EMDR in the treatment of PTSD represented through an effect size, five sub-hypotheses were investigated. First, it was hypothesized that RMDR would be more efficacious with a non-combat population than with combat-related PTSD. The second sub-hypothesis was that there would be significantly larger treatment effects associated with verbal report measures than with physiological outcome measures used in EMDR PTSD studies. Third, it was hypothesized that earlier EMDR studies would show larger treatment effects than more recent EMDR studies. The fourth sub-hypothesis concerned treatment dosage. It was hypothesized that there would not be significant differences based on the number of treatment sessions administered. Finally, it was hypothesized that the bilateral stimulation component of EMDR therapy would not contribute significantly to treatment effects. The analysis consisted of generating effect sizes in the form of standardized difference scores on the various outcome measures. Effect sizes were then grouped according to independent variable categories and averaged together. Before testing for between-group differences, homogeneity testing was completed. (Abstract shortened by UMI.) (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Alto, Caroline",2001.0,,0,0,
8019,"""Transcend"": Initial outcomes from a posttraumatic stress disorder/substance abuse treatment program.","This paper describes the development of a comprehensive treatment program for combat veterans diagnosed with posttraumatic stress disorder (PTSD) and substance abuse (SA). Outcome data are presented on 46 male patients (aged 44-55 yrs) who completed the 12-week partial hospitalization treatment program between 1996 and 1998. The treatment approach, defined by a detailed manual, integrates elements of cognitive-behavioral skills training, constructivist theory approaches, SA relapse prevention strategies, and peer social support into a group-focused program. The Clinician-Administered PTSD Scale (CAPS) and the Addiction Severity Index (ASI) were used to assess treatment effectiveness at discharge and 6- and 12-month follow-up. Significant symptom changes revealed on CAPS and ASI scores at discharge and follow-up are analyzed. Discussion focuses on hypotheses regarding treatment effectiveness, study limitations, and suggestions for further research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Donovan, Beverly; Padin-Rivera, Edgardo; Kowaliw, Sean; Abueg, Abueg, Abueg, Black, Blake, Blake, Boscarino, Boudewyns, Boudewyns, Boudewyns, Bowen, Brown, Brown, Clewell, Daniels, Davidson, Donovan, Donovan, Druley, Egendorf, Evans, Fontana, Fontana, Friedman, Friedman, Haley, Hammarberg, Haynes, Horowitz, Johnson, Johnson, Keane, Keane, Kofoed, Kosten, Kovach, Kubany, Kuhne, Kulka, Lyons, Marlatt, McCann, McFall, McFall, McLellan, McLellan, McWhirter, Miller, Monti, Nace, Najavits, Najavits, Padin-Rivera, Padin-Rivera, Peniston, Penk, Perconte, Pitman, Rogalski, Rosenheck, Schwarzwald, Scurfield, Shalev, Sherman, Shestatzky, Solomon, Starkey, Young",2001.0,,0,0,
8020,Controlled comparison of single-session treatments for spider phobia: Live graded exposure alone versus computer-aided vicarious exposure.,"The efficacy of prolonged single sessions of live graded exposure (LGE) vs computer-aided vicarious exposure (CAVE) for spider phobia was examined in a single-blind, controlled trial. 40 Ss (aged 18-61 yrs) diagnosed with specific phobia (spiders) received a prolonged single-session treatment of either therapist-aided LGE comprising exposure only or CAVE, or were assigned to a waiting list (control condition). Phobic symptomatology was measured at pre- and post-treatment and at 1-mo follow-up on a range of behavioral and subjective assessments including the Behavioral Assessment Test, the Subjective Units of Distress Scale, and the Spider Phobia Questionnaire. Results show that the single-session therapist-aided LGE was superior to both CAVE and the control conditions. In contrast with previous findings of comparability between LGE and CAVE and superiority of CAVE over placebo, the present study found no significant differences between the CAVE and waiting-list groups, with the exception of subjective units of distress, providing little support for single-session CAVE treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Heading, Katharine; Kirkby, Kenneth C; Martin, Frances; Daniels, Brett A; Gilroy, Lisa J; Menzies, Ross G; Andrews, Arntz, Bachofen, Baer, Borkovec, Botella, Carlin, Carr, Clark, Cohen, Crawford, Crawford, de Beurs, Fyer, Gelder, Gilroy, Greist, Harcourt, Hellstrom, Hodges, Hope, Kirkby, Marks, Marks, Marks, Marks, Marks, Nelson, O'Carroll, Ost, Ost, Ost, Ost, Ost, Ost, Ost, Ost, Regier, Rothbaum, Smith, Thorpe, Thorpe, Watson, Watts, Wittchen",2001.0,,0,0,
8021,Topiramate in posttraumatic stress disorder: Preliminary clinical observations.,"This article reviews the effects of the novel antiepileptic drug topiramate on 3 patients, a 40 yr old male, and two 33 and 45 year old females, meeting Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for chronic posttraumatic stress disorder (PTSD). In these previously treatment-refractory patients, topiramate had a marked effect: reducing and even eliminating trauma-related intrusive memories and nightmares and normalizing depressed mood. Adverse events were effectively controlled with careful drug titration and discontinuation of concomitant therapies. These findings, together with observations in more than 30 additional patients (reported elsewhere), suggest that further study of topiramate as a treatment for PTSD is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Berlant, Jeffrey L; Amano, Ben-Menachem, Biton, Breslau, Breslau, Chengappa, DeLorenzo, Elterman, Faught, Gibbs, Glauser, Keck, Kessler, McLean, Post, Post, Post, Post, Reife, Rosenfeld, Skradski, Taverna, Wauquier, White, White, Wu, Zhang, Zona",2001.0,,0,0,
8022,The requirement for an adequate clinical protocol for documenting the process and results of psychotherapeutic treatment in an institutional psychotherapy service: Preliminary results of a study.,"Studied the development of a protocol for evaluating psychotherapy process and treatment results for a mental health treatment unit in Italy. In a preliminary study, the protocol was used to evaluate 6 male and 14 female adults with mood, anxiety, psychotic, or dissociative disorders. The tests used include the SCL-90, the Interpersonal Problems Inventory (L. M. Horowitz et al, 1988), the Personality Organization Inventory (Clarkin, unpublished), the Health-Sickness Rating Scale (L. Luborsky, 1975), and the Defense Mechanisms Rating Scale (J. C. Perry and S. H. Cooper, 1989). The results were evaluated according to gender, marital status, education level, occupational status, diagnosis, relational patterns with self and others, and defense mechanisms. The preliminary results indicate that all patients desire to be loved by others, that relations with others are characterized by conflict in all patients, that relation to self in patients with psychosis is associated with delusions and depression, and in patients with mood and anxiety disorders, with impotence. Implications for using the protocol to evaluate psychotherapeutic results are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Freni, Salvatore; Azzone, Paolo; Bartocetti, Laura; Verga, Marina C; Vigano, Daniele; Alexander, Barber, Bond, Bucci, Cohen, Crits-Cristoph, Crits-Cristoph, Crits-Cristoph, Derogatis, Eckert, Elliot, Gabrielli, Greenberg, Horowitz, Luborsky, Luborsky, Luborsky, Luborsky, Luborsky, Luborsky, Luborsky, Mergenthaler, Mergenthaler, Orlinsky, Overall, Perry, Piper, Shrout, Thoma",2000.0,,0,0,
8023,Panic disorder: A five-year follow-up study in 52 patients.,"Clinical outcome was investigated in 52 Swedish patients who five years ago fulfilled the DSM-III criteria for Panic disorder on admission to a double-blind placebo-controlled, multi-center study for alprazolam and imipramine. A battery of rating scales was completed by patients and physicians during the 1st investigation as well as at follow-up. Significant improvement registered at the endpoint of the previous study had remained undiminished or become more accentuated five years later. Although 85% of the patients no longer fulfilled the DSM-III criteria for Panic disorder at follow-up, 62% had occasional anxiety attacks. Despite recurrent symptoms, the majority of patients reported satisfaction with their daily life functioning. Most patients had used psychopharmacological treatments continuously or as needed during the last five years. The results show that the long term course for the majority of PD patients is favourable. However, the illness is chronic and needs treatment (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Andersch, Sven; Hanson, Lennart; Hallstrom, Tore",1997.0,,0,0,
8024,An evaluation of outpatient clinic services for patients with panic disorder.,"The study is an evaluation of treatment services that are provided to patients with panic disorder at an outpatient mental health clinic. To provide information relevant to improving services at the clinic, the evaluation was intended to assess: (1) post-treatment level of functioning, (2) treatment components identified by patients as most useful, and (3) patient satisfaction with services received. A mail survey was used to contact 41 patients who had completed therapy at the clinic between January 1987 and October 1989. 21 Ss (mean age 36 yrs) completed the survey which included the General Health Questionnaire and an 18-item version of the Client Satisfaction Questionnaire. 14 of 21 Ss (66%) no longer met diagnostic criteria for panic disorder. However, even among these successfully treated patients, some continued to have occasional panic attacks, and others acknowledged a significant level of psychological distress. In general, patients expressed high levels of satisfaction with the clinic services, and they provided important feedback concerning the effectiveness of different treatment modalities. On the basis of these results, the authors discuss a number of suggestions for improving the operation of the clinic. (French abstract) (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Aubry, Tim D; Wilson, Keith G; Bilash, Ivan S",1992.0,,0,0,
8025,Cognitive therapy in the treatment of body dysmorphic disorder.,"The present investigation was the first to evaluate cognitive therapy alone to treat body dysmorphic disorder (BDD). Four BDD patients were treated with cognitive therapy based upon Beck's (1967) model. A single-subject multiple baseline design was used in which each subject served as his/her own control. Participants were randomly assigned to one of two conditions. Condition I involved 3 weeks of baseline data gathering, 7 weeks of cognitive therapy, and 5 weeks of follow-up assessment. Condition II involved 5 weeks of baseline, 7 weeks of cognitive therapy, and 3 weeks of follow-up. Dependent measures included the Body Dysmorphic Disorder Exam, the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder, the Body Satisfaction Scale, the Beck Depression Inventory, the Beck Anxiety Inventory, the Overvalued Ideas Scale, the Social Avoidance and Distress Scale, the Defect-Related Beliefs Test, and the Social Adjustment Scale-Self Report. Data were evaluated using a statistical technique for single-subject designs developed by Mueser, Yarnold, & Foy (1991). Three of the four subjects reported statistically significant reductions in depression, anxiety, and dissatisfaction with their body parts. Two subjects showed statistically significant decreases in body dysmorphic obsessions and compulsions. Though not statistically significant, one subject reported a 44 percent reduction in obsessions and a 34 percent reduction in compulsions. The remaining subject reported a 31 percent drop in obsessions and a 7 percent drop in compulsions. Two subjects reported statistically significant reductions in overvalued ideation and all reported feeling less distressed by their physical defects. Social avoidance and distress dropped by 50 to 93 percent for three subjects. The remaining subject showed no change in distress but a 33 percent reduction in social avoidance. Defect-related beliefs dropped by 32 to 40 percent for each subject. Based upon these results, it is suggested that BDD patients receive cognitive therapy. It is easily tolerated and appears to reduce depression, anxiety, dissatisfaction with body parts, maladaptive appearance-related beliefs, and obsessions and compulsions associated with the disorder. Further research is recommended to evaluate the effect of adding exposure plus response prevention exercises following a sufficient course of cognitive restructuring. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Geremia, Gina Marie",1998.0,,0,0,
8026,Applications of cognitive models of OCD in clinical practice.,"The results of 2 clinical trials for patients without overt compulsions are presented. The 1st was a controlled trial of cognitive-behavior therapy for obsessional thoughts only. Treatment consisted of exposure to the obsessional thought using tape-loop exposure and response prevention of all effortful coping strategies (neutralization). Cognitive restructuring was also used as need. For completers, 77% showed clinically significant gains on the Yale-Brown Obsessive-Compulsive Scale. There was some slippage at 6-mo follow-up to 59%. In the 2nd study, 6 patients without overt compulsions were treated in an intensive single case design using cognitive therapy without exposure or response prevention. The treatment targeted specific faulty appraisals of obsessional thoughts. We obtained clinically significant change for 5 Ss at posttest. So we have made some progress in the treatment of obsessional thoughts, both with a package that included exposure and response prevention with cognitive restructuring, and with cognitive restructuring alone. What does this partial success mean? Where do we go from here? Our position is that a fuller understanding of the role of neutralization will lead toward a truly process-oriented approach to therapy. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Freeston, Mark H; Ladouceur, Robert; Rheaume, Josee; Leger, Eliane; Sanavio, E [Ed]",1998.0,,0,0,
8027,Effect of fluoxetine on regional cerebral metabolism in autistic spectrum disorders: A pilot study.,"The regional metabolic effects of fluoxetine were examined in patients with autism spectrum disorders. Six adult patients with Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) and Autism Diagnostic Interview diagnoses of autism (n = 5) and Asperger's syndrome (n = 1), entered a 16-wk placebo-controlled cross-over trial of fluoxetine. The patients received 18F-deoxyglucose positron emission tomography with co-registered magnetic resonance imaging at baseline and at the end of the period of fluoxetine administration. After treatment, the patients showed significant improvement on the scores of the Yale-Brown Obsessive-Compulsive Scale-Obsessions subscale and the Hamilton Anxiety Scale; Clinical Global Impressions-Autism scores showed 3 of the patients much improved and 3 unchanged. Relative metabolic rates were significantly higher in the right frontal lobe following fluoxetine, especially in the anterior cingulate gyrus and the orbitofrontal cortex. Patients with higher metabolic rates in the medial frontal region and anterior cingulate when unmedicated were more likely to respond favourably to fluoxetine. These results are consistent with those in depression indicating that higher cingulate gyrus metabolic rates at baseline predict serotonin reuptake inhibitor response. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Buchsbaum, Monte S; Hollander, Eric; Haznedar, M. Mehmet; Tang, Cheuk; Spiegel-Cohen, Jacqueline; Wei, Tse-Chung; Solimando, Andrea; Buchsbaum, Bradley R; Robins, Diana; Bienstock, Carol; Cartwright, Charles; Mosovich, Serge; Buchsbaum, Buchsbaum, Chugani, Devinsky, Friston, Goodman, Gordon, Hamilton, Hamilton, Hamilton, Hazlett, Haznedar, Haznedar, Haznedar, Hollander, Hollander, Lord, Mayberg, McDougle, Mehlinger, Pascual, Poline, Shihabuddin, Siever, Steingard, Talairach, Wu",2001.0,,0,0,
8028,Cognitive-behavioral treatment of chronic posttraumatic stress disorder in battered women: A study.,"Studied the effectiveness of a cognitive-behavioral therapy program in the treatment of posttraumatic stress disorder (PTSD) in battered women. Human Ss: 62 female Spanish adults (aged 19-71 yrs) (victims of physical abuse or psychological abuse). A repeated-measures experimental design (pretreatment, posttreatment, and follow-up at 1 mo, 3 mo, 6 mo, and 12 mo) was used. Therapy consisted of emotional expression, cognitive restructuring, and training in specific coping skills. Tests used: The Semistructured Interview on Domestic Abuse (E. Echeburua et al, 1994), the PTSD Symptom Severity Scale (Echeburua et al, 1994), the State-Trait Anxiety Inventory, the Beck Depression Inventory, the Self-Esteem Scale (M. Rosenberg, 1965) and the Maladjustment Scale (Echeburua and P. de Corral, 1987). (English abstract) (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Echeburua, Enrique; de Corral, Paz; Sarasua, Belen; Zubizarreta, Irene",1996.0,,0,0,
8029,The effectiveness of 3-D video virtual reality for the treatment of fear of public speaking.,"Virtual reality (VR) has been utilized in conjunction with cognitive behavioural therapy (CBT) to decrease symptoms for people with specific phobias or anxiety disorders. Many studies investigating VR have employed complicated head-mounted displays with intricate software. This study investigates the effectiveness of presenting a 3-D video of a virtual audience to participants who experience the fear of public speaking. The VR environment was presented with a cost effective, standard CRT television using polarized shutter glasses. Results indicate that skin conductance and heart rate measures increased, which suggests that the VR 3-D video is effective in eliciting a fear response. Also, a decrease in anxiety and a decrease in negative self beliefs about public speaking ability suggest that VR 3-D video can provide an effective treatment. Future studies may combine this user-friendly technology with a therapeutic element, such as CBT, to treat anxiety disorders successfully and more cost effectively. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lister, Heather A; Piercey, C. Darren; Joordens, Chantele; Anderson, Barlow, Botella, Butler, Clark, Cornwell, Davidson, Emmelkamp, Garcia-Palacios, Geisel, Gilkinson, Harris, Hofmann, Hofmann, Kessler, Klinger, McCrosky, North, Paul, Pollack, Reger, Riva, Schneier, Spiegler, Spielberger, Stein, Stein, Tillfors, Wallach",2010.0,,0,0,
8030,"Identifying HAM-A cutoffs for mild, moderate, and severe generalized anxiety disorder.","The aim of the current study was to identify and evaluate cutoffs for mild, moderate, and severe ranges of Hamilton Anxiety Rating Scale (HAM-A) scores. Data were from a four-week randomized trial of treatment for generalized anxiety disorder. Measures included the HAM-A, SF-36, Hospital Anxiety and Depression Scale (HADS), and Clinical Global Impressions of Severity (CGI-S) scale. HAM-A cutoffs were identified based on literature review, expert panel input, and MANOVA models. The optimal cutoff set was evaluated based on association with clinician CGI-S ratings. The sample included 144 patients (56.3% female; 73.6% white; mean age = 35.7 years; mean baseline HAM-A score = 23.7). The optimal HAM-A score ranges were: mild anxiety = 8-14; moderate = 15-23; severe >= 24 (scores <= 7 were considered to represent no/minimal anxiety). Analysis of variance (ANOVA) models found statistically significant differences among these groups in the SF-36 and HADS. The HAM-A severity ranges closely corresponded to clinicians' CGI-S ratings. The study represents the first step towards developing severity ranges for the HAM-A. These cutoffs should be used with caution and validated in larger samples. If the proposed cutoffs are accepted for general use, they could make results more meaningful and interpretable for researchers, clinicians, and patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Matza, Louis S; Morlock, Robert; Sexton, Chris; Malley, Karen; Feltner, Douglas; Aben, Allgulander, Bagby, Bech, Belzer, Calabrese, Clark, Davidson, Debattista, Gulseren, Hamilton, Hamilton, Jensen, Kellner, Lenox-Smith, Lenze, Llorca, Maier, Marascuilo, Mathew, McHorney, Moller, Montgomery, Musselman, Naukkarinen, Paul, Pollack, Rickels, Rickels, Riskind, Serlin, Shear, Sheehan, Sheehan, Shelton, Smeraldi, Wan, Ware, Ware, Wellington, Zelman, Zelman, Zigmond, Zimmerman, Zimmerman",2010.0,,0,0,
8031,Effect of PTSD diagnosis and contingency management procedures on cocaine use in dually cocaine- and opioid-dependent individuals maintained on LAAM: A retrospective analysis.,"This randomized clinical trial retrospectively examined the effect of post-traumatic stress disorder (PTSD) and contingency management (CM) on cocaine use in opioid and cocaine dependent individuals maintained on high or low-dose LAAM randomly assigned to CM or a yoked-control condition. Cocaine-positive urines decreased more rapidly over time in those without PTSD versus those with PTSD in the noncontingency condition. In participants with PTSD, CM resulted in fewer cocaine-positive urines compared to the noncontingent condition. This suggests that CM may help improve the potentially worse outcomes in opioid- and cocaine-dependent individuals with PTSD compared to those without PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mancino, Michael J; McGaugh, Janette; Feldman, Zachary; Poling, James; Oliveto, Alison; Barry, Bryk, Cacciola, Cacciola, Charney, Clark, Compton, Creamer, Dansky, Davidson, Epstein, Ford, Fullilove, Gelkopf, Gibbons, Hedeker, Helzer, Hien, Higgins, Higgins, Higgins, Higgins, Kessler, Kessler, King, Kosten, Magura, Maremmani, McLellan, McLellan, Mertens, Milby, Mills, Najavits, Najavits, Oliveto, Oliveto, Ouimette, Preston, Rounsaville, Rounsaville, Saxon, Silverman, Stitzer, Trafton, Villagomez, Vocci, Weinstock, Weiss",2010.0,,0,0,
8032,Anxiety disorders among methamphetamine dependent adults: Association with post-treatment functioning.,"Although anxiety is one of the most prominent psychiatric complaints of methamphetamine (MA) users, little is known about the association between anxiety disorders and treatment outcomes in this population. Using data from 526 adults in the largest psychosocial clinical trial of MA users conducted to date, this study examined psychiatric, substance use, and functional outcomes of MA users with concomitant anxiety disorders 3 years after treatment. Anxiety disorders were associated with poorer alcohol and drug use outcomes, increased health service utilization, and higher levels of psychiatric symptomatology, including suicidality. Addressing anxiety symptoms and syndromes in MA users may be helpful as a means of optimizing treatment outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Glasner-Edwards, Suzette; Mooney, Larissa J; Marinelli-Casey, Patricia; Hillhouse, Maureen; Ang, Alfonso; Rawson, Richard; Methamphetamine Treatment Project Corporate Authors; Bourdon, Brown, Carroll, Conway, Cruickshank, Dalton, Darke, Diefenbach, Glasner-Edwards, Glasner-Edwards, Glasner-Edwards, Grant, Hall, Hillhouse, Kessler, McGregor, McKay, McKetin, McLellan, McNamara, Nurco, Rawson, Rawson, Ritsher, Rounsaville, Rounsaville, Sareen, Schneider, Sheehan, Tate, Verheul, Zweben",2010.0,,0,0,
8033,Independent predictors for lifetime and recent substance use disorders in patients with rapid-cycling bipolar disorder: Focus on anxiety disorders.,"We set out to study independent predictor(s) for lifetime and recent substance use disorders (SUDs) in patients with rapid-cycling bipolar disorder (RCBD). Extensive Clinical Interview and Mini-International Neuropsychiatric Interview were used to ascertain DSM-IV Axis I diagnoses of RCBD, anxiety disorders, and SUDs . Data from patients enrolling into four similar clinical trials were used. Where appropriate, univariate analyses with t-test or chi-square were applied. Stepwise logistic regression was used to examine the relationship among predictor variables and lifetime and recent SUDs. Univariate analysis showed that patients with co-occurring anxiety disorders (n = 261) had significantly increased rates of lifetime (odds ratio [OR] = 2.1) and recent (OR = 1.9) alcohol dependence as well as lifetime (OR = 3.4) and recent (OR = 2.5) marijuana dependence compared to those without co-occurring anxiety disorder (n = 303). In logistic regression analyses, generalized anxiety disorder (GAD) was associated with increased risk for lifetime SUDs (OR = 2.34), alcohol dependence (OR = 1.73), and marijuana dependence (OR = 3.36) and recent marijuana dependence (OR = 3.28). A history of physical abuse was associated with increased risk for lifetime SUDs (OR = 1.71) and recent marijuana dependence (OR = 3.47). Earlier onset of first mania/hypomania was associated with increased risk for lifetime SUDs (5% per year), and recent marijuana dependence (12% per year) and later treatment with a mood stabilizer were also associated with increased risk for recent SUDs (8% per year). Positive associations between GAD, later treatment with a mood stabilizer, and early childhood trauma and history of SUDs suggest that adequate treatment of comorbid anxiety, early treatment with a mood stabilizer, and prevention of childhood trauma may reduce the risk for the development of SUDs in patients with bipolar disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gao, Keming; Chan, Philip K; Verduin, Marcia L; Kemp, David E; Tolliver, Bryan K; Ganocy, Stephen J; Bilali, Sarah; Brady, Kathleen T; Findling, Robert L; Calabrese, Joseph R; Back, Bauer, Birmaher, Bolton, Buckner, Calabrese, Chen, Chen, Compton, Erb, First, Frye, Gao, Gao, Gao, Goldstein, Goodwin, Goodwin, Grant, Hyman, Karnik, Kemp, Kessing, Kessler, Kessler, Kolodziej, Kupka, Kushner, Levander, MacKinnon, MacKinnon, McIntyre, Merikangas, Merikangas, Miller, Miller, Mitchell, O'Brien, Perugi, Post, Regier, Roberts, Rotondo, Sareen, Saunders, Sheehan, Simon, Simon, Simon, Sussman, Waldrop, Wood, Zimmermann",2010.0,,0,0,
8034,Oxytocin attenuates amygdala reactivity to fear in generalized social anxiety disorder.,"Patients with generalized social anxiety disorder (GSAD) exhibit heightened activation of the amygdala in response to social cues conveying threat (eg, fearful/angry faces). The neuropeptide oxytocin (OXT) decreases anxiety and stress, facilitates social encounters, and attenuates amygdala reactivity to threatening faces in healthy subjects. The goal of this study was to examine the effects of OXT on fear-related amygdala reactivity in GSAD and matched healthy control (CON) subjects. In a functional magnetic resonance imaging study utilizing a double-blind placebo-controlled within-subjects design, we measured amygdala activation to an emotional face matching task of fearful, angry, and happy faces following acute intranasal administration of OXT (24 IU or 40.32 micro g) and placebo in 18 GSAD and 18 CON subjects. Both the CON and GSAD groups activated bilateral amygdala to all emotional faces during placebo, with the GSAD group exhibiting hyperactivity specifically to fearful faces in bilateral amygdala compared with the CON group. OXT had no effect on amygdala activity to emotional faces in the CON group, but attenuated the heightened amygdala reactivity to fearful faces in the GSAD group, such that the hyperactivity observed during the placebo session was no longer evident following OXT (ie, normalization). These findings suggest that OXT has a specific effect on fear-related amygdala activity, particularly when the amygdala is hyperactive, such as in GSAD, thereby providing a brain-based mechanism of the impact of OXT in modulating the exaggerated processing of social signals of threat in patients with pathological anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Labuschagne, Izelle; Phan, K. Luan; Wood, Amanda; Angstadt, Mike; Chua, Phyllis; Heinrichs, Markus; Stout, Julie C; Nathan, Pradeep J; Adolphs, Amir, Arce, Bale, Bartz, Baumgartner, Beck, Beck, Birbaumer, Blair, Blair, Blasi, Bogels, Bond, Born, Carver, Cassell, Champagne, Clark, Costafreda, De Vries, Di Simplicio, Domes, Domes, Ebner, Ehrlich, Etkin, Evans, Fischer-Shofty, Fitzgerald, Foa, Friston, Furmark, Fusar-Poli, Gamer, Garner, Gimpl, Goldin, Guastella, Guastella, Gur, Hariri, Hariri, Hariri, Harmer, Heinrichs, Heinrichs, Hoge, Holmes, Horley, Huber, Joormann, Killgore, Kirsch, Kosfeld, Kriegeskorte, Landgraf, Lee, Liebowitz, Lubin, Marsh, Mogg, Paulus, Petrovic, Phan, Phan, Phan, Poldrack, Poldrack, Rimmele, Savander, Savaskan, Shin, Spielberg, Spitzer, Stein, Straube, Straube, Tessitore, Unkelbach, Vaccari, Veit, Whalen, Williams, Yoon, Yoshimura, Zald",2010.0,,0,0,
8035,"Predicting outcome of treatment for severe, treatment resistant OCD in inpatient and community settings.","Treatment of OCD is effective, even for the most chronic and severe cases. It has been difficult to identify predictors of treatment outcome, with little work aimed at predicting treatment outcome in severe OCD. We examined the ability of a range of demographic and psychopathology variables to predict treatment outcome in a cohort of 52 inpatients and a second group of 62 community outpatients with severe, treatment-refractory OCD. Despite both cohorts showing significant improvement in OCD symptoms, reliable predictors were difficult to identify, and were different in the two cohorts. In the inpatient group, marital status was a significant predictor, with those who were married or cohabiting showing better outcome that those not currently in a relationship. This relationship was not observed in the community treatment group. Initial symptom severity was also found to be a significant predictor, but only in the community treatment group, where higher initial severity was associated with greater reduction in symptoms during treatment. Further research examining a wider range of predictors may assist in identifying those factors which predict outcome in severe OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Boschen, Mark J; Drummond, Lynne M; Pillay, Anusha; Morton, Katherine; Abramowitz, Beck, Beck, Beck, Borkovec, Boschen, Boschen, Boschen, Chambless, de Haan, Drummond, Drummond, Drummond, Drummond, Eddy, Ferrao, Fisher, Franklin, Goodman, Goodman, Hollander, Keeley, Keijsers, Leon, Mataix-Cols, Mataix-Cols, Merlo, Norberg, Pallanti, Ramos-Cerqueria, Riggs, Rosa-Alcazar, Rufer, Sanavio, Shetti, Somers, Stewart, Stewart, Storch, Taylor",2010.0,,0,0,
8036,Cognitive therapy for autogenous and reactive obsessions: Clinical and cognitive outcomes at post-treatment and 1-year follow-up.,"This study provides data about the differential effectiveness of cognitive therapy (CT) for obsessive-compulsive disorder (OCD) symptom presentation. Two OCD manifestations, autogenous and reactive, are considered. Seventy OCD patients started CT; 81.40% completed it and 72.85% were available 1 year later. Fifteen of the 57 treatment completers had autogenous obsessions, whereas 33 had reactive obsessions. Nine patients had both obsession modalities. Reactive patients were more severe, as they scored higher on thought suppression and on the dysfunctional beliefs of intolerance to uncertainty and perfectionism. Autogenous patients scored higher on the over-importance of thoughts beliefs. Although CT was effective in reducing OCD severity and the ascription to dysfunctional beliefs and neutralizing strategies in both the autogenous and the reactive patients, a significantly better outcome was observed for the autogenous patients, both at post-treatment (with 73.33% recovering versus 33.33% for reactives) and 1 year later. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Belloch, Amparo; Cabedo, Elena; Carrio, Carmen; Larsson, Christina; Abramowitz, Abramowitz, Alonso, Ball, Beck, Belloch, Belloch, Belloch, Belloch, Belloch, Besiroglu, Bloch, Calamari, Clark, Cottraux, Di Nardo, Eddy, Fisher, Foa, Freeston, Freeston, Freeston, Goodman, Goodman, Jacobson, Ladouceur, Ladouceur, Lee, Lee, Lee, Lee, Lee, Luciano, Mataix-Cols, Mataix-Cols, McLean, Meyer, Moulding, Rachman, Rachman, Rachman, Reynolds, Salkovskis, Salkovskis, Sandin, Sookman, Sookman, Summerfeldt, van Oppen, Vazquez, Wegner, Wells, Whittal, Wilhelm, Wilhelm",2010.0,,0,0,
8037,Extended-release fluvoxamine and improvements in quality of life in patients with obsessive-compulsive disorder.,"Objective: We hypothesized that subjects with obsessive-compulsive disorder (OCD) who received extended-release fluvoxamine (fluvoxamine ER) in a 12-week placebo-controlled trial would exhibit improvements in psychosocial domains of health-related quality of life (HRQOL) and that additional improvements would occur after a 40-week open-label extension trial. We also hypothesized that greater OCD symptom improvement in the first 12 weeks of treatment would be associated with greater HRQOL improvement after 52 weeks of treatment. Methods: In the 12-week placebo-controlled trial, subjects were randomized to receive placebo or 100 mg/d of fluvoxamine ER and then titrated in weekly 50 mg increments to a final dose of 100 to 300 mg/d. All subjects enrolled in the 40-week extension trial followed a similar titration, during which they were maintained on their highest well-tolerated dose. Results: After 12 weeks of treatment, fluvoxamine ER subjects experienced significantly greater decreases than placebo subjects in Yale-Brown Obsessive-Compulsive Scale scores (P = .001). Both the active drug and placebo groups exhibited significant improvements in psychosocial domains of HRQOL; further improvement occurred after 40 weeks of open-label treatment with active drug. The greater the improvement in OCD severity at 12 weeks, the greater the improvement at 52 weeks in the psychosocial domains (Social Functioning r = -0.39, P = .027; Emotional Problems r = -0.37, P = .037; Mental Health r = -0.49, P = .004). Conclusion: Improvement in Yale-Brown Obsessive-Compulsive Scale severity scores during treatment with fluvoxamine ER was associated with improvements in psychosocial aspects of HRQOL that increased over an extended period of treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Koran, Lorrin M; Bromberg, Daniel; Hornfeldt, Carl S; Shepski, John C; Wang, Shirley; Hollander, Eric; Besiroglu, Bobes, Calvocoressi, Goodman, Goodman, Gururaj, Hollander, Hollander, Hollander, Kamath, Karno, Koran, Koran, Koran, Leon, Magliano, Mancebo, Marks, Mawson, Moritz, Pallanti, Regier, Sorensen, Stein, Steketee, Stengler-Wenzke, Tenney, Torres, Torres, Ware",2010.0,,0,0,
8038,Acceptability of a cognitive behavior therapy intervention to implantable cardioverter defibrillator recipients.,"We aimed to assess cardiac patients, acceptance of cognitive behavior therapy (CBT); determine if gender was associated with treatment engagement (session attendance and utilization of intervention strategies); and relate engagement to outcome. Of 193 patients receiving an implantable cardioverter defibrillator (ICD) who agreed to participate in a randomized controlled trial, 96 were randomized to CBT. Measures of treatment acceptance indicated that most participants rated counseling as ""very to extremely helpful."" Gender was associated with only one treatment engagement index. Symptoms of depression and post-traumatic stress improved from baseline to 6- and 12-month follow-up. Number of counseling session attendance was not associated with outcome. Reported utilization of two of the six CBT strategies (modifying faulty thinking, correcting cognitive distortions) was associated with a better treatment outcome. In conclusion, a CBT intervention was well received by ICD patients. There was some indication that treatment engagement related to better treatment outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Irvine, Jane; Stanley, Jill; Ong, Lephuong; Cribbie, Robert; Ritvo, Paul; Katz, Joel; Dorian, Paul; O'Donnell, Suzan; Harris, Louise; Cameron, Doug; Hill, Ann; Newman, David; Johnson, Sabine N; Bilanovic, Ana; Sears, Samuel F Jr.; Albert, Alderman, Alter, Andrykowski, Beck, Berkman, Birtchnell, Bjelland, Burg, Burgess, Butler, Carroll, Chevalier, Clark, Conti, Cowan, Coyne, Creamer, Crown, Cupertino, Delsignore, Dunbar, Fiorentine, Frasure-Smith, Frasure-Smith, Frasure-Smith, Frizelle, Gaston, Grace, Greenberg, Haines, Herrmann, Herrmann, Irvine, Irvine, Irvine, Irvine, Irvine, Josephson, Kazantzis, Kelly, King, Kohn, Ladwig, Lavie, Leung, Lewin, Lidren, Linden, Marmar, Marmar, Meyer, Mohr, Pedersen, Pelletier, Pilote, Prochaska, Salkovskis, Schafer, Scogin, Sears, Sears, Snaith, Stefanek, Tabachnick, Ware, Weiss, Westra, Westra, Witt",2010.0,,0,0,
8039,Tailoring cognitive-behavioral therapy to treat anxiety comorbid with advanced cancer.,"Patients with advanced cancer often experience debilitating anxiety symptoms that interfere with quality of life and relate to worse medical outcomes. Although cognitive-behavioral therapy (CBT) is an empirically validated, first-line treatment for anxiety disorders, clinical trials of CBT for anxiety typically exclude patients with medical comorbidities in general, and those with terminal illnesses, such as advanced cancer, in particular. Moreover, CBT has generally targeted unrealistic fears and worries in otherwise healthy individuals with clinically significant anxiety symptoms. Consequently, traditional CBT does not sufficiently address the cognitive components of anxiety in patients with cancer, especially negative thought patterns that are rational but nonetheless intrusive and distressing, such as concerns about pain, disability, and death, as well as management of multiple stressors, changes in functional status, and burdensome medical treatments. In this article, we describe a treatment approach for tailoring CBT to the needs of this population. Three case examples of patients diagnosed with terminal lung cancer are presented to demonstrate the treatment methods along with outcome measures for anxiety and quality of life. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Greer, Joseph A; Park, Elyse R; Prigerson, Holly G; Safren, Steven A; Andrykowski, Baer, Barlow, Barlow, Barlow, Barsevick, Bausewein, Beck, Beck, Beck, Benson, Bruera, Butt, Cannon, Caudill, Cella, Coyne, Craske, Craske, D'Zurilla, Delgado-Guay, Felgoise, Given, Gosselink, Greer, Greer, Hamilton, Hamilton, Heron, Hill, Holland, Hopwood, Horner, Kadan-Lottick, Keefe, Kessler, Manne, Massie, Meyer, Miovic, Moorey, Mustian, Nesse, Newell, Nezu, Nield, O'Neill, Osborn, Otis, Otto, Prieto, Roth, Schofield, Schultz, Shear, Sheard, Sigal, Smith, Stark, Stark, Stark, Tanaka, Tanaka, Tatrow, Taylor, Tchekmedyian, Temel, Temel, Theobald, Turk, White",2010.0,,0,0,
8040,Catastrophic appraisal and perceived control as moderators of treatment response in panic disorder.,"The purpose of this study was to examine the moderating effects of cognitive risk factors in two mechanistically-distinct interventions. Forty-one patients with panic disorder and agoraphobia were randomly assigned to receive training aimed at altering respiration (Capnometry-assisted respiratory training, CART) or symptom appraisal (cognitive skill training, CT). Using a mixed effects regression model, we assessed whether reductions in panic symptom severity (PDSS) were moderated by the variables of interest. While improvement in PDSS did not differ among treatment modalities, moderating effects emerged. Individuals with greater initial levels of misappraisal showed smaller reduction in PDSS when receiving CT, but larger reduction when receiving CART. Greater lack of perceived control was predictive of worse outcome in CART, but better outcome in CT. Better homework compliance was related to greater reductions in PDSS irrespective of condition. The findings illustrate the complexity of moderating influences within and between distinct interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Meuret, Alicia E; Hofmann, Stefan G; Rosenfield, David; Aaronson, Aiken, Barlow, Barlow, Brown, Chambless, Chambless, Clark, Craske, Deacon, Dow, Edelman, Emmelkamp, Gibbons, Haby, Hamer, Hicks, Kazdin, Keijsers, Keller, Kessler, Klass, Klerman, Kraemer, Kraemer, Leon, Leung, Mass, McNally, Meuret, Meuret, Meuret, Meuret, Meuret, Meuret, Meuret, Milrod, Mineka, Mitte, Newman, Rapee, Rees, Reiss, Schmidt, Schneider, Shear, Shrout, Tabachnick, Westra, Westra, White, Woods",2010.0,,0,0,
8041,Estimating statistical power for open-enrollment group treatment trials.,"Modeling turnover in group membership has been identified as a key barrier contributing to a disconnect between the manner in which behavioral treatment is conducted (open-enrollment groups) and the designs of substance abuse treatment trials (closed-enrollment groups, individual therapy). Latent class pattern mixture models (LCPMMs) are emerging tools for modeling data from open-enrollment groups with membership turnover in recently proposed treatment trials. The current article illustrates an approach to conducting power analyses for open-enrollment designs based on the Monte Carlo simulation of LCPMM models using parameters derived from published data from a randomized controlled trial comparing Seeking Safety to a Community Care condition for women presenting with comorbid posttraumatic stress disorder and substance use disorders. The example addresses discrepancies between the analysis framework assumed in power analyses of many recently proposed open-enrollment trials and the proposed use of LCPMM for data analysis. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Morgan-Lopez, Antonio A; Saavedra, Lissette M; Hien, Denise A; Fals-Stewart, William; Asparouhov, Baldwin, Barcikowski, Barkham, Barkham, Bauer, Blalock, Carroll, Cohen, Collins, Demirtas, Duncan, Fals-Stewart, Feaster, Feingold, Hedeker, Hien, Hien, Hien, Hox, Kraemer, Lin, MacCallum, MacKinnon, MacKinnon, MacKinnon, Morgan-Lopez, Morgan-Lopez, Morgan-Lopez, Morgan-Lopez, Morgan-Lopez, Murray, Muthen, Muthen, Muthen, Najavits, Raudenbush, Rounsaville, Roy, Spybrook, Weiss, Weiss, Willett, Yuan",2011.0,,0,0,
8042,Aripiprazole: A clinical review of its use for the treatment of anxiety disorders and anxiety as a comorbidity in mental illness.,"Background: Although anxiety disorders are common, optimal treatment is elusive. More than half of anxiety patients treated with an adequate course of antidepressants fail to fully improve: treatment resistance, residual symptoms, and recurrence/relapse remain a challenge. Recently, atypical antipsychotics have been considered for treatment-resistant anxiety disorders. This review will explore the available data for the role of aripiprazole in the treatment of anxiety. Methods: PubMed and conference abstracts were searched for randomized, double-blind studies that investigated the efficacy of aripiprazole in anxiety; its efficacy in bipolar disorder and depression was also explored for comparison. Results: A number of studies have shown atypical antipsychotics to be effective in anxiety, and currently available data suggest that aripiprazole augmentation in patients with anxiety disorders is likely as effective as other atypical antipsychotic drugs. Although there have been no randomized, controlled trials, aripiprazole has been found to be effective in treating anxiety disorders in two open-label trials. This combined with the larger data base demonstrating its utility in bipolar disorder and depression, its safety profile and its unique mechanism of action, make aripiprazole for anxiety an intriguing avenue of exploration. Limitations: Data from large randomized, controlled trials on the use of atypical antipsychotics for anxiety in general, and aripiprazole in particular, are currently lacking. Conclusion: The results of open-label trials of aripiprazole in anxiety provide enough support to warrant its further study. This, combined with a larger data base demonstrating its utility in bipolar disorder and depression, its safety profile and its unique mechanism of action, make aripiprazole for anxiety an intriguing avenue of exploration. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Katzman, Martin A; Adson, Adson, Ananth, Baetz, Bandelow, Barbee, Barbee, Berman, Berman, Brawman-Mintzer, Brawman-Mintzer, Brown, Burris, Bystritsky, Carli, Casey, Chrzanowski, Chue, Clark, Devane, Dube, Dunn, Eaton, Fava, Fava, Feighner, Feltner, Fountoulakis, Freeman, Gidal, Goldberg, Goodnick, Harrigan, Haupt, Hellerstein, Henry, Hettema, Hettema, Hirose, Hirose, Hoge, Jordan, Judd, Kane, Katzman, Katzman, Keck, Keck, Keck, Keck, Kessler, Ketter, Kinrys, Kinrys, Leslie, Lieberman, Lipper, Luisi, Lum, Manning, Marcus, Marder, Massion, Matthews, Mazza, McElroy, McGavin, McIntyre, McQuade, McQuade, Menza, Muzina, Natesan, Nelson, Nelson, Ostroff, Pae, Pae, Papakostas, Papakostas, Papakostas, Patkar, Petty, Petty, Pohl, Pollack, Primeau, Quante, Rapaport, Rickels, Rush, Rutherford, Sachs, Sajatovic, Sajatovic, Sareen, Sheffrin, Shelton, Simon, Simon, Sokolski, Souetre, Sramek, Stahl, Stahl, Stern, Stock, Swinson, Thase, Thase, Thase, Tondo, Trivedi, Trivedi, Trivedi, Vieta, Vieta, Wisniewski, Wittchen, Wolf, Wood, Woodman, Worthington, Yonkers, Young",2011.0,,0,0,
8043,An evidence-based review of the effectiveness of cognitive behavioral therapy for psychosocial issues post-spinal cord injury.,"Study Design: Systematic review. Objective: To examine the evidence supporting the effectiveness of cognitive behavioral therapy (CBT) for improving psychosocial outcomes in individuals with spinal cord injury (SCI). Method: Electronic databases (MEDLINE, CINAHL, EMBASE, and PsycINFO) were searched for studies published between 1990 and October 2010. Randomized control trials (RCTs) and nonrandomized control trials (non-RCTs) utilizing a CBT intervention to improve psychosocial outcomes (depressive symptomatology, anxiety, coping, and adjustment to disability) in outpatient persons with SCI were included for review. Levels of evidence were assigned to each study using a modified Sackett scale. Effect size calculations for the interventions were provided where possible. Results: Nine studies met the inclusion criteria. The studies reviewed included two RCTs, six prospective controlled trials (PCTs) and one cohort study. All studies examined at least two groups. There is Level 1 and Level 2 evidence supporting the use of specialized CBT protocols in persons with SCI for improving outcomes related to depression, anxiety, adjustment, and coping. Conclusions: CBT holds promise as an effective approach for persons with SCI experiencing depression, anxiety, adjustment, and coping problems. As CBT may involve many different components, it is important in the future to determine which of these elements alone or in combination is most effective in treating the emotional consequences of SCI. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mehta, Swati; Orenczuk, Steven; Hansen, Kevin T; Aubut, Jo-Anne L; Hitzig, Sander L; Legassic, Matthew; Teasell, Robert W; Spinal Cord Injury Rehabilitation Evidence Research Team, Canada; Beck, Bombardier, Butler, Byford, Cohen, Craig, Craig, Craig, Dorstyn, Duchnick, Elliott, Elliott, Elliott, Elliott, Elliott, Eng, Foley, Galvin, Hancock, Hanson, Hayes, Hopko, Hufford, Kahan, Kalpakjian, Kemp, Kennedy, Kennedy, Kennedy, Kennedy, King, Kuptniratsaikul, Laurenceau, Lazarus, Mohr, Moseley, North, Pollard, Radnitz, Sakakibara, Schein, Schulz, Straus, Swett, Wade",2011.0,,0,0,
8044,Response to induced relaxation during pregnancy: Comparison of women with high versus low levels of anxiety.,"Relaxation exercises have become a standard intervention for individuals with anxiety disorders but little is known about their potential for anxiety relief during pregnancy. The purpose of this study was to examine psychoendocrine (i) baseline differences and (ii) changes after a standardized relaxation period in pregnant women with high versus low levels of anxiety. Thirty-nine third-trimester high and low anxious pregnant women performed active or passive relaxation while levels of anxiety, hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adrenal-medullary (SAM) system activity were assessed before and after the relaxation period. In women with high levels of trait anxiety, state anxiety (F(1,36) = 8.3, p = .007) and negative affect (F(1,36) = 7.99, p = .008) as well as ACTH (F(1,35) = 9.24, I = .002) remained elevated over the entire course of the experimental procedure, the last indicating increased HPA axis activity. In addition, norepinephrine showed a constricted decrease of relaxation reflecting lower response of the SAM-system (F(1,37) = 4.41, p = .043). Although relaxation exercises have become a standard intervention for individuals with anxiety, pregnant women with high levels of trait anxiety benefited less than women with low levels from a single standardized relaxation period. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Alder, Judith; Urech, Corinne; Fink, Nadine; Bitzer, Johannes; Hoesli, Irene; Alder, Andersson, Andersson, Aouizerate, Bastani, Bastani, Beddoe, Borri, de Weerth, DiPietro, Dressendorfer, Esler, Evans, Federenko, Field, Field, Field, Field, Field, Field, Gorman, Grant, Heron, Jacobi, Janke, Kringe, Kurki, Laux, Little, Manzoni, Marcus, Mathew, Misri, Narendran, Neumeister, Nickel, Obel, Odusola, Omer, Ross, Sandman, Sarkar, Schneid-Kofman, Spielberger, Strawn, Talge, Talley, Teixeira, Urech, Van den Bergh, Vieten, Vythilingum, Watson, Weisberg",2011.0,,0,0,
8045,Effectiveness randomized controlled trial of face to face versus Internet cognitive behaviour therapy for social phobia.,"Objective: To compare the effectiveness of Internet cognitive behaviour therapy (CBT) with face-to-face CBT in social phobia. Methods: Randomized controlled trial of 75 patients with social phobia referred to an anxiety disorders clinic. A total of 37 patients participated, and post-treatment data was obtained from 25 Subjects (Ss). An intention to treat analysis was used. The same therapist (M.D.) treated both groups. Results: Both groups made significant progress on symptoms and disability measures. There were no significant differences in outcome between the Internet and face-to-face groups. The total amount of therapist time required was 18 min per patient for the Internet group and 240 min per patient for the face-to-face group. Conclusions: Both forms of treatment were equally effective and this is consistent with previous findings in depression and panic disorder. The difference in clinician time required was substantial. If Internet CBT was offered as ""standard of care"" the staff time saved would permit a stepped care model in which in-depth therapy for the difficult to recover patients could be provided without an increase in staff. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Andrews, Gavin; Davies, Matthew; Titov, Nickolai; Andersson, Andrews, Andrews, Andrews, Carlbring, Cuijpers, Kay-Lambkin, Kiropoulos, Mattick, Selmi, Titov, Wright",2011.0,,0,0,
8046,Two sessions of sleep-focused mind-body bridging improve self-reported symptoms of sleep and PTSD in veterans: A pilot randomized controlled trial.,"Objective: Sleep disturbance is highly prevalent among veterans. As an alternative to sleep medications with their undesirable side effects, nonpharmacological mind-body interventions may be beneficial for sleep management in primary care. The aim of this pilot study was to investigate whether a novel mind-body intervention, mind-body bridging (MBB), focusing on sleep, could improve self-reported sleep disturbance and comorbid symptoms in veterans. Methods: This pilot study was a randomized controlled trial at the Veterans Affairs Salt Lake City Health Care System in which 63 veterans with self-reported sleep disturbance received MBB or an active sleep education control. Both interventions were conducted in two sessions, once per week. Patient-reported outcomes included the following: primary-Medical Outcomes Study (MOS) Sleep Survey, MOS Short Form-36V; secondary-Center for Epidemiological Studies-Depression, PTSD Check List-Military, Five-Factor Mindfulness Questionnaire. Results: At both Week 1 (1 week after the first session) and post-intervention assessments, while sleep disturbance decreased in both groups, MBB performed significantly better than did the control group. Furthermore, self-reported PTSD symptoms improved in MBB, while they remained unchanged in the control. Overall mindfulness increased in MBB, while it remained unchanged in the control. Conclusions: This study provides preliminary evidence that a brief sleep-focused MBB could be a promising intervention for sleep and potentially other comorbid symptoms (e.g., PTSD). MBB could help patients develop awareness skills to deal with sleep-related symptoms. Integration of MBB into primary care settings may enhance care of patients with sleep disturbance and co-morbid symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Nakamura, Yoshio; Lipschitz, David L; Landward, Richard; Kuhn, Renee; West, Gavin; Ang, Baer, Bastien, Begley, Block, Block, Britton, Britton, Buysse, Carlson, Carmody, Donaldson, Donaldson, Edinger, Edinger, Eisen, Germain, Germain, Harvey, Hays, Heidenreich, Johnson, Kabat-Zinn, Kazis, Keen, Lamarche, Lewis, Little, Marcks, Moinpour, Morin, Mustafa, Neylan, Ong, Ong, Peterson, Radloff, Riemann, Rosenberg, Ross, Shapiro, Shapiro, Swanson, Teasdale, Teasdale, Tollefson, Yook",2011.0,,0,0,
8047,Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: A randomized controlled non-inferiority trial.,"Background and Aims: Cognitive behavioral group therapy (CBGT) is an effective, well-established, but not widely available treatment for social anxiety disorder (SAD). Internet-based cognitive behavior therapy (ICBT) has the potential to increase availability and facilitate dissemination of therapeutic services for SAD. However, ICBT for SAD has not been directly compared with in-person treatments such as CBGT and few studies investigating ICBT have been conducted in clinical settings. Our aim was to investigate if ICBT is at least as effective as CBGT for SAD when treatments are delivered in a psychiatric setting. Methods: We conducted a randomized controlled non-inferiority trial with allocation to ICBT (n = 64) or CBGT (n = 62) with blinded assessment immediately following treatment and six months post-treatment. Participants were 126 individuals with SAD who received CBGT or ICBT for a duration of 15 weeks. The Liebowitz Social Anxiety Scale (LSAS) was the main outcome measure. The following non-inferiority margin was set: following treatment, the lower bound of the 95 % confidence interval (CI) of the mean difference between groups should be less than 10 LSAS-points. Results: Both groups made large improvements. At follow-up, 41 (64%) participants in the ICBT group were classified as responders (95% CI, 52%-76%). In the CBGT group, 28 participants (45%) responded to the treatment (95% CI, 33%-58%). At post-treatment and follow-up respectively, the 95 % CI of the LSAS mean difference was 0.68-17.66 (Cohen's d between group = 0.41) and -2.51-15.69 (Cohen's d between group = 0.36) favoring ICBT, which was well within the non-inferiority margin. Mixed effects models analyses showed no significant interaction effect for LSAS, indicating similar improvement across treatments (F = 1.58; df = 2, 219; p = .21). Conclusions: ICBT delivered in a psychiatric setting can be as effective as CBGT in the treatment of SAD and could be used to increase availability to CBT. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hedman, Erik; Andersson, Gerhard; Ljotsson, Brjann; Andersson, Erik; Ruck, Christian; Mortberg, Ewa; Lindefors, Nils; Andersson, Andersson, Attkisson, Baker, Barak, Beck, Berger, Berman, Blanco, Borkovec, Carlbring, Carlbring, Clark, Clark, Clark-Carter, Erwin, First, First, Fresco, Frisch, Furmark, Furmark, Gueorguieva, Guy, Hedman, Heimberg, Heimberg, Heimberg, Heimberg, Heimberg, Heimberg, Hofmann, Hunsley, Jacobson, Jorstad-Stein, Kessler, Ledley, Liebowitz, Maffei, Mattick, McAlister, Mortberg, Ponniah, Reich, Reiss, Ruscio, Saunders, Schneier, Shapiro, Sheehan, Soykan, Stangier, Svanborg, Tillfors, Titov, Titov, Yonkers, Zanarini",2011.0,,0,0,
8048,Elevated cortisol in older adults with generalized anxiety disorder is reduced by treatment: A placebo-controlled evaluation of escitalopram.,"Background: Generalized anxiety disorder (GAD) is a common disorder in older adults, which has been linked to hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis in this age group. The authors examined whether treatment of GAD in older adults with a selective serotonin reuptake inhibitor (SSRI) corrects this HPA axis hyperactivity. Methods: The authors examined adults aged 60 years and older with GAD in a 12-week randomized controlled trial comparing the SSRI escitalopram with placebo. The authors collected salivary cortisol at six daily time points for 2 consecutive days to assess peak and total (area under the curve) cortisol, both at baseline and posttreatment. Results: Compared with placebo-treated patients, SSRI-treated patients had a significantly greater reduction in both peak and total cortisol. This reduction in cortisol was limited to patients with elevated (above the median) baseline cortisol, in whom SSRI-treated patients showed substantially greater reduction in cortisol than did placebo-treated patients. Reductions in cortisol were associated with improvements in anxiety. Additionally, genetic variability at the serotonin transporter promoter predicted cortisol changes. Conclusions: SSRI treatment of GAD in older adults reduces HPA axis hyperactivity. Further research should determine whether these treatment-attributable changes are sustained and beneficial. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lenze, Eric J; Mantella, Rose C; Shi, Peichang; Goate, Alison M; Nowotny, Petra; Butters, Meryl A; Andreescu, Carmen; Thompson, Paul A; Rollman, Bruce L; Abelson, Alessandro, Andrews-Hanna, Beekman, Beluche, Bremmer, Bryant, Catania, Chaudieu, Chong, Comijs, Csernansky, Deuschle, Epel, Ferrari, First, Gallagher-Thompson, Gotlib, Gruenewald, Gunthert, Hamilton, Heinz, Ising, Kern, Kraemer, Lee, Lenze, Lupien, Lupien, Mantella, McCallum, McEwen, Meyer, Mohlman, O'Brien, O'Hara, O'Hara, Otte, Penninx, Pezawas, Pfefferbaum, Pruessner, Seeman, Stanley, Urry, Van Cauter, Wetherell, Young, Zalsman",2011.0,,0,0,
8049,Long-term effectiveness of collaborative depression care in older primary care patients with and without PTSD symptoms.,"Objective: Depressed patients with comorbid post-traumatic stress disorder (PTSD) are more functionally impaired and may take longer to respond to depression treatment than patients without PTSD. This study examined the long-term effects of PTSD on depression severity, treatment response, and health care costs among older adults. Methods: Patients were recruited from 18 primary care clinics in five states. A total of 1801 patients aged 60 years or older with major depression or dysthymia were randomized to Improving Mood Promoting Access to Collaborative Treatment (IMPACT) collaborative care or usual care. The study included 191 (10.6%) subjects who screened positive for PTSD. Depression severity, assessed by the Hopkins Depression Symptom Checklist, was used to estimate depression-free days (DFDs) over 24 months. Total health care costs included inpatient, outpatient, and pharmacy costs. Results: Depressed patients with PTSD had higher depression severity than patients without PTSD symptoms at baseline. Over 2 years, intervention patients with PTSD symptoms had relatively the same benefits from collaborative care (99 more DFDs than usual care patients) as patients without PTSD (108 more DFDs than usual care) (p = 0.85). Total health care costs did not differ significantly for depressed patients with and without PTSD symptoms. Conclusion: Depressed older adults with PTSD symptoms were more depressed at baseline, but collaborative care (compared to usual care) produced similar improvements in depression severity in both groups. This reduction of depression symptoms was observed for up to 12 months after the intervention ended, suggesting that long-term improvements in depression are possible with collaborative care in patients with and without PTSD symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Chan, Domin; Fan, Ming-Yu; Unutzer, Jurgen; Andreescu, Bruce, Campbell, Coyne, Derogatis, Felker, First, Gradus, Greenberg, Hankin, Harpole, Haverkamp, Hegel, Katon, Katon, Katon, Kramer, Lave, Lin, Linn, Liu, Lyness, Lyness, Magruder-Habib, Martell, Murray, Oishi, Oquendo, Prins, Rodriguez, Rubin, Samson, Schoenbaum, Schonfeld, Schulberg, Sheehan, Simon, Simon, Simon, Simon, Spiro, Stein, Unutzer, Unutzer, Unutzer, Vannoy, Von Korff, Wagner, Wagner, Wells, Williams, Zayfert",2011.0,,0,0,
8050,Intensive cognitive-behavioural treatment for women with postnatal obsessive-compulsive disorder: A consecutive case series.,"The postnatal period has been identified as a time of increased risk for the development of OCD. Obsessions and compulsions at this time frequently focus on accidental or deliberate harm coming to the infant and may impact on the sufferer's capacities as a parent. Given the similarities in presentation between OCD at this and other times, cognitive-behaviour therapy is likely to be effective, but there is little information on whether or how adaptations of CBT can be made to maximise effectiveness and acceptability for mothers. There are no data on the impact of successful treatment on parenting. Six consecutively referred cases of postnatal OCD were treated using cognitive-behavioural therapy (CBT) intensively delivered over a two week period. All mothers improved on self-report and clinician-rated measures which were sustained at 3-5 month follow-up. Mothers reported significant benefits in terms of their own symptoms and in parenting in general. The intensive mode of delivery appears to be effective and acceptable for this group. Future work should explore whether particular difficulties in terms of parenting are experienced by this group and whether these persist beyond the remission of the maternal disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Challacombe, Fiona L; Salkovskis, Paul M; Abramowitz, Abramowitz, Abramowitz, Abramowitz, Altemus, Alwan, Arnold, Beck, Beck, Bevan, Brandes, Challacombe, Chelmow, Christian, Diefenbach, Fairbrother, Fairbrother, First, Foa, Foa, Forray, Geller, Gezginc, Goodman, Halligan, Hay, Jennings, Leckman, Lovibond, Maina, Manassis, Matthey, Murray, Murray, Neziroglu, Noshirvani, Oberlander, Oldfield, Rasmussen, Salkovskis, Salkovskis, Salkovskis, Salkovskis, Stein, Storch, Torres, Uguz, Uguz, Uguz, Williams, Zambaldi",2011.0,,0,0,
8051,Exploring the efficacy of a residential treatment program incorporating cognitive processing therapy-cognitive for veterans with PTSD and traumatic brain injury.,"As the numbers of military personnel participating in the wars in Afghanistan and Iraq continue to grow, the percentage of individuals who return with both a traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) also increases. Although there appears to be significant overlap in the symptoms resulting from PTSD and TBI, the best course of treatment remains an area of controversy. The authors present initial findings from a Veterans Administration residential program for comorbid PTSD and TBI. Forty-two participants completed a program comprising psychoeducational groups and cognitive skill building that was augmented with a modification of standard cognitive processing therapy. The results suggest that residential programs that incorporate this form of cognitive therapy can anticipate meaningful participation from patients, and that it may be an effective approach to treat PTSD in individuals with a history of TBI. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Chard, Kathleen M; Schumm, Jeremiah A; McIlvain, Susan M; Bailey, Gregory W; Parkinson, R. Bruce; Al Sayegh, Beck, Belanger, Blake, Bryant, Chard, Chard, Fann, First, Hoge, Hoge, Kennedy, Monson, Resick, Resick, Resick, Stein, Tanielian, Twamley, Vanderploeg, Vasterling, Weathers",2011.0,,0,0,
8052,Feasibility and effectiveness of activity-scheduling as a guided self-help intervention for the prevention of depression and anxiety in residents in homes for the elderly: A pragmatic randomized controlled trial.,"Background: Elderly people living in residential homes are at high risk for developing major depressive and anxiety disorders, and therefore deserve attention in terms of preventive interventions. We evaluated the feasibility and effectiveness of a guided self-help intervention for the prevention of depression and anxiety in these residents. Methods: We conducted a pragmatic randomized controlled trial in two parallel groups comparing the intervention with usual care in 14 residential homes in and surrounding the city of Amsterdam in the Netherlands. A total of 129 residents with a score of 8 or more on the Centre for Epidemiologic Studies Depression Scale (CES-D) screening instrument, who did not meet the full diagnostic criteria for disorders, and were not suffering from cognitive impairment were recruited between April 2007 and December 2008. Participants were randomized to a guided self-help intervention (n = 67) or to usual care (n = 62). The main outcome measures were improvement in the level of symptoms of depression and anxiety. The secondary outcome was improvement in participation in organized activities in the residential homes. The study is registered in de Dutch Cochrane Centre, under number ISRCTN27540731. Results: Only 21% of the participants (mean age 84.0 years (SD 6.7), 72.1% suffering from two or more chronic illnesses) completed the intervention. Although we found some large positive effect sizes on the CES-D, none of these effects was statistically significant. Conclusion: Although guided self-help may be promising in the prevention of depression and anxiety, it proved to be difficult to apply in this very old and vulnerable group of people living in residential homes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dozeman, Els; van Schaik, Digna J. F; van Marwijk, Harm W. J; Stek, Max L; Beekman, Aartjan T. F; van der Horst, Henriette E; Beekman, Bisschop, Bjelland, Cohen, Cole, Cuijpers, Cuijpers, Cuijpers, Cuijpers, Dozeman, Dozeman, Dozeman, Folstein, Gellatly, Haringsma, Jacobson, Lipsey, Radloff, Roijen, Schellander, Sheehan, Smalbrugge, Smit, Spek, Spijker, Thakur, van Bilsen, van den Berg, van't Hof, Zigmond",2011.0,,0,0,
8053,Childhood trauma among individuals with co-morbid substance use and post-traumatic stress disorder.,"Little is known about the impact of childhood trauma (CT) on the clinical profile of individuals with co-occurring substance use disorder (SUD) and post-traumatic stress disorder (PTSD). The aim of this study was to compare the clinical characteristics of individuals with SUD + PTSD who have a history of CT, with SUD + PTSD individuals who have experienced trauma during adulthood only. Data were collected on 103 individuals as part of a randomised controlled trial examining the efficacy of an integrated psychosocial treatment for SUD + PTSD. Participants were recruited from substance use treatment services, community referrals and advertising. Data were collected on demographic characteristics, substance use and treatment histories, lifetime trauma exposure and current physical and mental health functioning. It was found that the vast majority (77%) of the sample had experienced at least one trauma before the age of 16, with 55% of those endorsing childhood sexual abuse. As expected, individuals with a CT history, as compared to without, evidenced significantly longer duration of PTSD. Those with a CT history also had more extensive lifetime trauma exposure, an earlier age of first intoxication and reported more severe substance use (e.g. a greater number of drug classes used in their lifetime, higher severity of dependence scores and greater number of drug treatment episodes). In conclusion, we found that individuals with co-morbid SUD + PTSD who had experienced CT presented with a more severe and chronic clinical profile in relation to a number of trauma and substance use characteristics, when compared to individuals with adulthood only trauma histories. It is, therefore, important for SUD + PTSD treatment planning that CT be carefully assessed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Farrugia, Philippa L; Mills, Katherine L; Barrett, Emma; Back, Sudie E; Teesson, Maree; Baker, Amanda; Sannibale, Claudia; Hopwood, Sally; Merz, Sabine; Rosenfeld, Julia; Brady, Kathleen T; Arata, Back, Bastiaens, Blake, Blanchard, Blanchard, Bonin, Brady, Breslau, Briere, Brown, Brown, Cloitre, Cloitre, Creamer, Desai, Dom, Donovan, Dragan, Evren, Farley, Ford, Gibson, Gil-Rivas, Gossop, Hidalgo, Hyman, Jankowski, Jarvis, Karadag, Kessler, Kessler, Kubiak, Loranger, Medrano, Messina, Messman, Mills, Mills, Mills, Mills, Mills, Najavits, Najavits, Ouimette, Plotzker, Read, Riggs, Roy, Schafer, Soloff, Spielberger, Tarrier, Triffleman, Triffleman, van den Bosch, van der Kolk, Waldrop, Ware, Widom, Widom, Wu, Zisook",2011.0,,0,0,
8054,Cost-effectiveness of Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: Results from a randomized controlled trial.,"Social anxiety disorder (SAD) is highly prevalent and associated with a substantial societal economic burden, primarily due to high costs of productivity loss. Cognitive behavior group therapy (CBGT) is an effective treatment for SAD and the most established in clinical practice. Internet-based cognitive behavior therapy (ICBT) has demonstrated efficacy in several trials in recent years. No study has however investigated the cost-effectiveness of ICBT compared to CBGT from a societal perspective, i.e. an analysis where both direct and indirect costs are included. The aim of the present study was to investigate the cost-effectiveness of ICBT compared to CBGT from a societal perspective using a prospective design. We conducted a randomized controlled trial where participants with SAD were randomized to ICBT (n = 64) or CBGT (n = 62). Economic data were assessed at pre-treatment, immediately following treatment and six months after treatment. Results showed that the gross total costs were significantly reduced at six-month follow-up, compared to pre-treatment in both treatment conditions. As both treatments were equivalent in reducing social anxiety and gross total costs, ICBT was more cost-effective due to lower intervention costs. We conclude that ICBT can be more cost-effective than CBGT in the treatment of SAD and that both treatments reduce societal costs for SAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hedman, Erik; Andersson, Erik; Ljotsson, Brjann; Andersson, Gerhard; Ruck, Christian; Lindefors, Nils; Acarturk, Andersson, Andersson, Barak, Berger, Blanco, Borkovec, Bravo Vergel, Carlbring, Chartier, Clark, Dolan, Drummond, Efron, Fehm, First, Furmark, Furmark, Gould, Hakkaart-van Roijen, Hedman, Heimberg, Heimberg, Heimberg, Heimberg, Heuzenroeder, Jacobson, Kessler, Layard, Ledley, Liebowitz, Little, Magee, Patel, Rabin, Ravens-Sieberer, Reich, Roberge, Shapiro, Sheehan, Smit, Soykan, Svanborg, Svanborg, Tillfors, Titov, Titov, Wittchen, Zanarini",2011.0,,0,0,
8055,The impact of motivational interviewing on resistance in cognitive behavioural therapy for generalized anxiety disorder.,"The present study simultaneously examined observed resistance and homework compliance in Cognitive Behavioural Therapy (CBT) between those with severe generalized anxiety disorder who did (n = 18) and did not (n = 17) receive Motivational Interviewing (MI) prior to CBT. Large effects for reduced resistance early in CBT were observed in the MI pretreatment group relative to the no-pretreatment group. Moreover, receiving four sessions of MI was associated with significantly lower levels of resistance, compared to receiving four sessions of CBT alone. Using path analysis, resistance, but not homework compliance, was found to strongly and directly mediate the relationship between treatment group and worry reduction. Findings suggest that MI improves treatment outcomes when added to CBT for generalized anxiety by reducing client resistance to, and increasing client engagement with treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Aviram, Adi; Westra, Henny Alice; Antony, Apodaca, Arbuckle, Arkowitz, Arkowitz, Beutler, Binder, Bischoff, Borkovec, Borkovec, Borkovec, Brown, Brown, Bryant, Burke, Chamberlain, Cohen, Deci, Dryden, Engle, Helbig, Hettema, Hu, Jungbluth, Kazantzis, Kazantzis, Kline, MacKinnon, Meyer, Miller, Miller, Miller, Moyers, Patterson, Pelletier, Primakoff, Sanderson, Shaw, Simpson, Taft, Tracey, Wachtel, Westra, Westra, Westra, Westra, Westra, Woody, Young",2011.0,,0,0,
8056,Efficacy of cognitive behavioral internet-based therapy in parents after the loss of a child during pregnancy: Pilot data from a randomized controlled trial.,"The loss of a child during pregnancy can be a traumatic event associated with long-lasting grief and psychological distress. This study examined the efficacy of an internet-based cognitive behavioral therapy program for mothers after pregnancy loss. In a randomized controlled trial with a waiting list control group, 83 participants who had lost a child during pregnancy were randomly allocated either to 5 weeks of internet therapy or to a 5-week waiting condition. Within a manualized cognitive behavioral treatment program, participants wrote ten essays on loss-specific topics. Posttraumatic stress, grief, and general psychopathology, especially depression, were assessed pretreatment, posttreatment, and at 3-month follow-up. Intention-to-treat analyses and completer analyses were performed. Relative to controls, participants in the treatment group showed significant improvements in posttraumatic stress, grief, depression, and overall mental health, but not in anxiety or somatization. Medium to large effect sizes were observed, and the improvement was maintained at 3-month follow-up. This internet-based cognitive behavioral therapy program represents an effective treatment approach with stable effects for women after pregnancy loss. Implementation of the program can thus help to improve the health care provision for mothers in this traumatic loss situation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kersting, Anette; Kroker, Kristin; Schlicht, Sarah; Baust, Katja; Wagner, Birgit; Andersson, Andersson, Badenhorst, Bergner, Berth, Boelen, Bradley, Brier, Brier, Buchner, Carter, Cohen, Cougle, Derogatis, Dunlap, Engelhard, First, Foa, Geller, Geller, Geller, Gold, Horowitz, Jacobson, Johnson, Kersting, Kersting, Kersting, Kersting, Kersting, Klier, Klier, Knaevelsrud, Korenromp, Korenromp, Kramer, Lange, Lange, Lange, Litz, Mansfield, Neal, Neugebauer, Neugebauer, Nijenhuis, Nikcevic, Prigerson, Puddifoot, Shear, Sundin, Swanson, Turton, van der Houwen, Vance, Wagner, Wagner, Wagner, Wagner, Wittouck",2011.0,,0,0,
8057,Feasibility of exercise training for the short-term treatment of generalized anxiety disorder: A randomized controlled trial.,"Background: Exercise training may be especially helpful for patients with generalized anxiety disorder (GAD). We conducted a randomized controlled trial to quantify the effects of 6 weeks of resistance (RET) or aerobic exercise training (AET) on remission and worry symptoms among sedentary patients with GAD. Methods: Thirty sedentary women aged 18-37 years, diagnosed by clinicians blinded to treatment allocation with a primary DSM-IV diagnosis of GAD and not engaged in any treatment other than pharmacotherapy, were randomly allocated to RET, AET, or a wait list (WL). RET involved 2 weekly sessions of lower-body weightlifting. AET involved 2 weekly sessions of leg cycling matched with RET for body region, positive work, time actively engaged in exercise, and load progression. Remission was measured by the number needed to treat (NNT). Worry symptoms were measured by the Penn State Worry Questionnaire. Results: There were no adverse events. Remission rates were 60%, 40%, and 30% for RET, AET, and WL, respectively. The NNT was 3 (95% CI 2 to 56) for RET and 10 (95%","Herring, Matthew P; Jacob, Marni L; Suveg, Cynthia; Dishman, Rodney K; O'Connor, Patrick J; Beck, Blair, Borg, Broocks, Brown, Brown, Brown, Chessick, Colcombe, Cook, Cook, Dishman, Goodwin, Gould, Hackett, Hedges, Herring, Heuzenroeder, Hofmann, Kendler, Martinsen, McCrone, Merom, Meyer, Puetz, Singh, Sylvia, Trivedi, Wittchen, Zimmerman",2011.0,,0,0,
8058,"The effects of web-based interactive emotional disclosure on stress and health: A randomized, controlled study.","The purpose of this study was to develop and assess the relative effectiveness of two novel alternatives to standard written emotional disclosure for coping with stressful traumatic experiences. In addition to standard emotional disclosure and time management writing control conditions, two guided feedback conditions were created with a goal of enhancing the disclosure paradigm by eliciting the most effective components of disclosure writing. All of the writing conditions in the study utilized the internet for both completion of the writing and receipt of feedback in the indicated conditions. The guided conditions included a feedback writing condition in which guidance was provided between writing sessions and an instant message condition in which guidance was provided in real-time during the writing session. It was hypothesized that all disclosure groups would exhibit improvements in symptoms as measured by the BSI Global Severity Index, the IES-R total score, the PHS total score, and a concurrent increase in PTGI overall scale ratings relative to the control writing condition. Furthermore, it was anticipated that participants in the instant message condition would exhibit the greatest amount of symptom reduction and posttraumatic growth on the selected outcome measures, followed by the feedback writing condition, the standard emotional disclosure condition, and that the control condition would exhibit minimal symptom change or growth. Participants (N=163) were undergraduate students enrolled in psychology courses. The participants were pre-screened to include only those who reported having experienced a trauma or stressor that continued to bother them and cause intrusive, avoidant, and hyperarousal symptoms. Invited participants who consented to involvement with the study completed baseline questionnaires and were randomized to experimental condition of either time management control, standard emotional disclosure, feedback, or instant message writing at their second laboratory visit. Participants completed three 30-minute writing sessions over the course of one week, and 151 participants returned to complete follow-up questionnaires six weeks after their initial writing session. The study hypotheses were not supported and the groups were found to be generally equivalent with regard to psychiatric and physical symptom reduction as well as posttraumatic growth. Each group exhibited reduction in symptoms on the BSI, IES-R, and PHS, and unexpected reductions in PTGI scores. Further analyses revealed that the experimental conditions were initially perceived as equally credible interventions, although at follow-up the feedback enhanced conditions were deemed most credible. The instant message condition performed differently than the other disclosure conditions in that it produced a less intense emotional reaction to the writing sessions, which may in part be a product of the relatively brief content produced relative to the to the other disclosure conditions. It was determined that future studies may benefit from selection of a more neutral control writing condition and possibly also sampling from a clinical population. Despite the lack of support for the study hypotheses, it is too early to dismiss the potential benefits of internet-based feedback-enhanced emotional disclosure interventions for patients who are unable or unwilling to access traditional PTSD treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Beyer, Jonathan A",2011.0,,0,0,
8059,Improving primary care outcomes for Hispanics with anxiety disorders: A randomized clinical trial evaluating the effectiveness of cognitive-behavioral therapy.,"The proportion of Hispanics in psychosocial treatment outcome research is limited. To our knowledge, no randomized clinical trials have investigated the effectiveness of cognitive-behavioral therapy in adult Hispanics with anxiety disorders. This is important because Hispanics are among the fastest growing minority group in the U.S., and as a group, they evidence pervasive and persistent anxiety disorders. The growth of the Hispanic population has taken place while social service systems are ill prepared to address the needs of these individuals. In this study, we addressed this gap in the literature by evaluating the difference in clinical effectiveness of cognitive behavioral therapy (CBT) for Hispanic relative to White adults with one or more of the four common anxiety disorders (panic disorder, post-traumatic stress disorder, generalized anxiety disorder, and social anxiety disorder). Participants ( N = 279) included treatment seeking patients (Hispanics = 53, Whites = 226) from 13 primary care clinics (each clinic linked to one of the 4 study sites: University of California, Los Angeles; University of California, San Diego; University of Washington; University of Arkansas for Medical Sciences). A particular interest of the present study was to examine differences in treatment response among Hispanics and Whites following CBT for anxiety disorders and to identify predictors of treatment response among Hispanics. A secondary aim was to investigate the relationship between acculturation and mental health in the Hispanic sample and whether this relationship was moderated by levels of social support. Assessed outcomes included symptom-based and physical and mental health functioning measures. Results showed that CBT improved symptom severity (i.e., ASI, BSI, PHQ-9) and mental health functioning (i.e., SF-12) in both samples. Data also suggested that marital dissatisfaction and lesser social support before receiving CBT treatment for anxiety predicted greater anxiety sensitivity and distress at the 6-month follow-up among Hispanics. Unexpectedly, a limited proportion of significant associations between acculturation and greater symptom severity were found in the Hispanic sample. Outcomes are discussed in terms of addressing the issue of whether empirically supported treatments (in this case, CBT for anxiety disorders) can be generalized for use with Hispanics in the U.S. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Barrios, Velma",2011.0,,0,0,
8060,Combined cognitive bias modification treatment for social anxiety disorder: A pilot trial.,"Background: Cognitive Bias Modification (CBM) is a promising treatment for Social Anxiety Disorder (SAD). However, previous randomized trials have not systematically examined the combination of CBM for attention (CBM-A) and interpretation (CBM-I) or the credibility and acceptability of these protocols. Methods: We conducted a randomized, double-blind placebo-controlled trial (N = 32) to examine the efficacy of a CBM treatment called Attention and Interpretation Modification (AIM) for SAD. AIM comprised eight, twice weekly computer sessions with no therapist contact. During AIM, participants (1) completed a dot probe task in which probes always followed neutral faces when paired with a disgust face, thereby directing attention away from threat and (2) completed a word-sentence association task in which they received positive feedback for making benign interpretations of word-sentence pairs and negative feedback for making negative interpretations. We also assessed participants' perceived credibility of and satisfaction with AIM. Results: Participants receiving AIM reported significantly reduced self-reported (Liebowitz Social Anxiety Scale) symptoms of social anxiety relative to the placebo. These gains were also evident on a behavioral measure (performance on an impromptu speech). AIM met our benchmarks for credibility and acceptability in this community sample, although credibility ratings were modest. Participants reported that CBM-I was more helpful than CBM-A. Conclusions: A combined CBM treatment produced medium-to-large effects on social anxiety. Participants rated AIM as moderately credibly and acceptable. Should these findings be replicated in larger samples, AIM has the potential to be a widely accessible and efficacious treatment for SAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Beard, Courtney; Weisberg, Risa B; Amir, Nader; Amir, Amir, Bar-Haim, Beard, Beard, Beard, Beard, Borkovec, Borkovec, Brosan, Chambless, Devilly, First, Fresco, Hakamata, Heimberg, Heimberg, Hofmann, Kazdin, Koster, Kraemer, Larsen, Liebowitz, Mennin, Nguyen, Rapee, Rozenman, Rytwinski, Schmidt, See",2011.0,,0,0,
8061,A transdiagnostic self-help guide for anxiety: Two preliminary controlled trials in subclinical student samples.,"Self-help therapies, such as bibliotherapy, are becoming increasingly more available to the general population as a treatment for psychological disorders, such as depression and anxiety. However, relatively few of these self-help books are properly evaluated to test their treatment efficacy. Two studies aimed to test a new self-help book to treat fears, phobias and anxiety in order to see if symptoms of anxiety and associated symptoms, such as functioning and coping, were improved compared to baseline scores and a waiting-list control group. Study 1 adopted a minimal guided approach (experimental group: n = 25; waiting-list control group: n = 29) whereas Study 2 adopted a non-guided approach (experimental group: n = 17; waiting-list control group: n = 16). In both studies, functioning and coping were improved and the current state of phobic symptoms was reduced. The main phobia improved only when adopting a guided approach and general psychological distress only reduced when adopting a non-guided approach. These studies provide preliminary support for a modest effect in a subclinical population. The results could have good implications for the treatment of anxiety and the use of self-help methods as an additional treatment aid or as a preventative treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dixon, Clare; Mansell, Warren; Rawlinson, Elizabeth; Gibson, Alisha; Bebbington, Clark, Clark, den Boer, Ehlers, Fletcher, Ghosh, Gilbert, Goldberg, Gould, Gould, Harvey, Hayes, Hayes, Hecker, Henry, Mansell, Mansell, Marks, Marks, Marrs, Newman, Quackenbush, Watkins, Wells, Whitfield",2011.0,,0,0,
8062,Predictors of persistence of comorbid generalized anxiety disorder among veterans with major depressive disorder.,"Objective: A limited number of randomized clinical trials show that efficacious pharmacologic treatments exist for comorbid major depressive disorder (MDD) and generalized anxiety disorder (GAD). The aims of this effectiveness study were to describe the impact of a depression care management intervention on the persistence of comorbid GAD symptoms in a sample of primary care patients with MDD and to identify risk factors for persistent GAD. Method: Data were collected from April 2003 to September 2005 for the Telemedicine-Enhanced Antidepressant Management (TEAM) study, a multisite, randomized effectiveness trial targeting US Department of Veterans Affairs (VA) primary care patients with depression. Veterans aged 26.59-88.36 years received either the TEAM intervention or usual care in small VA community-based outpatient clinics. The TEAM care management intervention focused on optimizing antidepressant therapy through patient education and activation, symptom monitoring, adherence promotion, and side-effect management. Veterans who screened positive for MDD using the Patient Health Questionnaire-9 (based on DSM-IV criteria) and who met the Mini-International Neuropsychiatric Interview criteria (maintaining consistency with DSM-IV-TR) for comorbid GAD at baseline were selected for the present study (N = 168). The primary outcome was persistence of GAD at 6 months and 12 months. All predictors available in the TEAM study data that were described in the literature to be associated with influencing GAD outcomes were examined. Results: Persistence of depression was the strongest predictor of persistence of comorbid GAD at both 6 months (OR = 5.75; 95% CI, 2.38-13.86; P < .05) and 12 months (OR = 15.56; 95% CI, 6.10-39.68; P < .05). Although the TEAM intervention significantly reduced depression symptom severity, it was not significantly associated with GAD persistence. Insomnia was a significant protective factor for persistence of GAD at 6 months (OR = 0.66; 95% CI, 0.44-0.99; P < .05). Conclusions: Early screening for presence of comorbid GAD among those with MDD may be valuable both for further research and for enhancing clinical management of GAD and MDD comorbidity. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mittal, Dinesh; Fortney, John C; Pyne, Jeffrey M; Wetherell, Julie L; Allgulander, Anton, Bakish, Baldwin, Berk, Brown, Brown, Browning, Bruce, Bystritsky, Coryell, Davidson, Derogatis, Derogatis, Edlund, Emmanuel, Fava, Fortney, Frasure-Smifh, Grant, Grunhaus, Johnson, Jones, Kapczinski, Kazis, Kazis, Kendler, Kendler, Kessler, Kessler, Kramer, Kroenke, Lecrubier, McClure, Mittal, Olatunji, Parkerson, Parkerson, Parkerson, Perugi, Pini, Pollack, Pollack, Pollack, Regier, Rickels, Rickels, Rost, Sanderson, Sheehan, Sherbourne, Sherbourne, Simon, Smith, Steffens, Stein, Stein, Van Ameringen, Van den Brink, Zimmerman",2011.0,,0,0,
8063,Attenuating posttraumatic distress with omega-3 polyunsaturated fatty acids among Disaster Medical Assistance Team members after the Great East Japan Earthquake: The APOP randomized controlled trial.,"Background: On March 11, 2011, a magnitude 9.0 earthquake, the most powerful ever recorded in Japan, and a massive tsunami struck off the coast of the Sanriku region. A Disaster Medical Assistance Team, a mobile medical team with specialized training that is deployed during the acute phase of a disaster, was dispatched to areas with large-scale destruction and multiple injured and sick casualties. Previous studies have reported critical incident stress (i.e. posttraumatic stress disorder symptoms and depressive symptoms) among rescue workers as well as the need for screening and prevention for posttraumatic stress disorder. So far we have shown in an open trial that posttraumatic stress disorder symptoms in critically injured patients can be reduced by taking omega-3 fatty acids intended to stimulate hippocampal neurogenesis. Method/Design: This study is designed to determine the effectiveness of attenuating posttraumatic distress with omega-3 polyunsaturated fatty acids among Disaster Medical Assistance Team members after the Great East Japan Earthquake, and is named the APOP randomized controlled trial which is currently ongoing. First, we will provide psycho-education on posttraumatic distress, which is common in responders to the Disaster Medical Assistance Team members deployed to the disaster area. Second, observational research will be conducted to evaluate critical incident stress following the completion of medical activities. Third, team members who provide consent to participate in the intervention research will be randomly divided into a group given an omega-3 fatty acid supplement and a group not given the supplements. Outcome will be evaluated at 12 weeks after the supplements are shipped to the team members. Discussion: Measures that address critical incident stress in disaster responders are important, but there is no substantial evidence that links such measures with prevention of posttraumatic stress disorder. Thus, any confirmation through this study that the intake of omega-3 fatty acid supplements serves as a simple preventative measure for critical incident stress will be of great significance. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Matsuoka, Yutaka; Nishi, Daisuke; Nakaya, Naoki; Sone, Toshimasa; Hamazaki, Kei; Hamazaki, Tomohito; Koido, Yuichi; Asukai, Beltz, Brunet, Bryant, Epstein, Fullerton, Furukawa, Hamazaki, Kawakita, Kessler, Kessler, Kessler, Kitamura, Matsuoka, Matsuoka, Matsuoka, Nishi, Nishi, Nishi, Radloff, Ressler, Schlenger, Shima, Simeon, Wagnild, Weiss",2011.0,,0,0,
8064,Can the patient decide which modules to endorse? An open trial of tailored Internet treatment of anxiety disorders.,"Internet-delivered cognitive behaviour therapy commonly consists of disorder-specific modules that are based on face-to-face manuals. A recent development in the field is to tailor the treatment according to patient profile, which has the potential to cover comorbid conditions in association with anxiety and mood disorders. However, it could be that the patients themselves are able to decide what modules to use. The authors tested this in an open pilot trial with 27 patients with mixed anxiety disorders. Modules were introduced with a brief description, and patients could choose which modules to use. The exception was the two first modules and the last, which involved psychoeducation and relapse prevention. The treatment period lasted for 10 weeks. Results showed large within-group effect sizes, with an average Cohen's d of 0.88. In a structured clinical interview, a majority (54%) had significantly improved 10 weeks after commencing treatment. Only one person dropped out. On the basis of results of this preliminary study, the authors suggest that the role of choice and tailoring should be further explored in controlled trials and that patient choice could be incorporated into Internet-delivered treatment packages. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Andersson, Gerhard; Estling, Fanny; Jakobsson, Ebba; Cuijpers, Pim; Carlbring, Per; Andersson, Andersson, Andersson, Andersson, Andersson, Andersson, Austin, Barkham, Barlow, Beck, Bergstrom, Carlbring, Carlbring, Carlbring, Carlbring, Carver, Christensen, Christensen, Cuijpers, Devineni, First, Frisch, Furmark, Guy, Hedman, Hollandare, Lange, tsson, Marks, Richardson, Rogers, Spek, m, Svanborg, Tate, Titov, Zetterqvist",2011.0,,0,0,
8065,A pragmatic randomized controlled trial of a guided self-help intervention versus a waiting list control in a routine primary care mental health service.,"Objectives: To evaluate the effectiveness of a two session guided self-help (GSH) intervention provided by primary care graduate mental health workers (PCGMHWs) in a primary care mental health service. Design: Pragmatic randomized trial, with a wait list control design. Method: Patients presenting with significant anxiety and depression problems were given one or more self-help booklets at screening and randomly allocated to an immediate (ITG) or delayed treatment group (DTG). Following this, a two-session GSH intervention was provided by one of two PCGMHWs, with a review session to decide on the need for further intervention. The DTG began the intervention 8 weeks after the screening and the primary outcome was Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) scores after 8 weeks. Results: A total of 63 patients were allocated to the ITG, 59 to the DTG. Analysis of covariance, carried out on an intention to treat basis, showed a significant treatment effect, F(1,98) = 15, p < .001, and a comparison of means at 8 weeks showed a significant difference, t(116) = 2.1 (95% CI [1.1, 5.9]), p = .042 with an effect size, d = 0.375. Taking the two groups together, CORE-OM scores for patients who completed the intervention reduced between screening and the review session by an average of 7.9 (95% CI [6.3, 9.5]), effect size of 1.2. Between screening and the review session, 47% showed a reliable and clinically significant improvement. Conclusions: The study provides some support for the effectiveness of a two-session GSH intervention and a stepped-care service model. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Lucock, Mike; Kirby, Rebecca; Wainwright, Nigel; Altman, Barkham, Barkham, Bower, Bright, Cahill, Cohen, Cuijpers, Davison, Den Boer, Den Boer, Evans, Gellatly, Gould, Hotopf, Lecrubier, Lewis, Lovell, Marrs, Mead, Richards, Roth, Roy-Byrne, Scogin, Shadish, Shadish, Westen",2011.0,,0,0,
8066,Glucocorticoids enhance extinction-based psychotherapy.,"Behavioral exposure therapy of anxiety disorders is believed to rely on fear extinction. Because preclinical studies have shown that glucocorticoids can promote extinction processes, we aimed at investigating whether the administration of these hormones might be useful in enhancing exposure therapy. In a randomized, double-blind, placebo-controlled study, 40 patients with specific phobia for heights were treated with three sessions of exposure therapy using virtual reality exposure to heights. Cortisol (20 mg) or placebo was administered orally 1 h before each of the treatment sessions. Subjects returned for a posttreatment assessment 3-5 d after the last treatment session and for a follow-up assessment after 1 mo. Adding cortisol to exposure therapy resulted in a significantly greater reduction in fear of heights as measured with the acrophobia questionnaire (AQ) both at posttreatment and at follow-up, compared with placebo. Furthermore, subjects receiving cortisol showed a significantly greater reduction in acute anxiety during virtual exposure to a phobic situation at posttreatment and a significantly smaller exposure- induced increase in skin conductance level at follow-up. The present findings indicate that the administration of cortisol can enhance extinction-based psychotherapy. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","de Quervain, Dominique J.-F; Bentz, Dorothee; Michael, Tanja; Bolt, Olivia C; Wiederholde, Brenda K; Margraf, Jurgen; Wilhelm, Frank H; Abelson, Abrari, Aerni, Almela, Alpers, Barrett, Bentz, Bohus, Borkovec, Bouton, Brewin, Buchanan, Cai, Cohen, Cohen, Crager, Cuthbert, de Quervain, de Quervain, de Quervain, de Quervain, Dunlap, Ehlers, Emmelkamp, Flood, Foa, Fowles, Hamm, Hautzinger, Hermans, Het, Hofmann, Kindt, Kovacs, Krijn, Kuhlmann, Kuhlmann, Kuhlmann, Kuhlmann, Kukolja, Lang, Laux, LeDoux, McNally, Merz, Mineka, Myers, Muhlberger, Muhlberger, Norberg, Phelps, Quirk, Ressler, Roozendaal, Roozendaal, Rothbaum, Rothbaum, Schiller, Schneider, Soravia, Vansteenwegen, Vickers, Wiederhold, Wiederhold, Witmer, Wolf, Yang",2011.0,,0,0,
8067,A 5-year follow-up of internet-based cognitive behavior therapy for a social anxiety disorder.,"Background: Internet-based cognitive behavior therapy (CBT) has been shown to be a promising method to disseminate cognitive behavior therapy for social anxiety disorder (SAD). Several trials have demonstrated that Internet-based CBT can be effective for SAD in the shorter term. However, the long-term effects of Internet-based CBT for SAD are less well known. Objective: Our objective was to investigate the effect of Internet-based CBT for SAD 5 years after completed treatment. Method: We conducted a 5-year follow-up study of 80 persons with SAD who had undergone Internet-based CBT. The assessment comprised a diagnostic interview and self-report questionnaires. The main outcome measure was the Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR). Additional measures of social anxiety were the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS). Attrition rates were low: 89% (71/80) of the participants completed the diagnostic interview and 80% (64/80) responded to the questionnaires. Results: Mixed-effect models analysis showed a significant effect of time on the three social anxiety measures, LSAS-SR, SIAS, and SPS (F3,98-102 = 16.05-29.20, P < .001) indicating improvement. From baseline to 5-year follow-up, participants' mean scores on the LSAS-SR were reduced from 71.3 (95% confidence interval [CI] 66.1-76.5) to 40.3 (95% CI 35.2-45.3). The effect sizes of the LSAS-SR were large (Cohen's d range 1.30-1.40, 95% CI 0.77-1.90). Improvements gained at the 1-year follow-up were sustained 5 years after completed treatment. Conclusions: Internet-based CBT for SAD is a treatment that can result in large and enduring effects. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Hedman, Erik; Furmark, Tomas; Carlbring, Per; Ljotsson, Brjann; Ruck, Christian; Lindefors, Nils; Andersson, Gerhard; Andersson, Barrett, Beck, Berger, Carlbring, Carlbring, Clark, Clark, Crippa, Fava, First, Fresco, Frisch, Furmark, Furmark, Gueorguieva, Guy, Hedman, Heimberg, Heimberg, Heimberg, Hunt, Knaevelsrud, Mattick, Michelson, Reich, Rohde, Saavedra, Schneier, Svanborg, Tillfors, Titov, Titov, Titov",2011.0,,0,0,
8068,A video clinical global impression scale (CGI) in obsessive compulsive disorder.,"The Clinical Global Impression scale (CGI) is frequently used in clinical research because of its face validity and ease of use but data on its reliability are scarce. Our goal was to estimate the reliability of the scale and compare reliability between face-to-face and video scoring. We analyzed 50 different video interviews recorded during 5 visits of a crossover trial to study the effect of subthalamic nucleus stimulation. Six specialized clinicians rated the CGI using these videos, providing 300 different ratings. The intraclass correlation was lower at inclusion (0.30 [0.13-0.50]) than at later visits (0.68 [0.61-0.80]). Reliability was not influenced by the patients' stimulation status. The mean of at least two independent evaluations of the video is needed to achieve an ICC greater than 0.8. The video CGI is a valid clinical outcome measure suitable for clinical trials. (ClinicalTrials.gov number, NCT00169377). (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Bourredjem, Abderrahmane; Pelissolo, Antoine; Rotge, Jean-Yves; Jaafari, Nematollah; Machefaux, Sebastien; Quentin, Solene; Bui, Eric; Bruno, Nicolas; Pochon, Jean-Baptiste; Polosan, Mircea; Baup, Nicolas; Papetti, Francois; Chereau, Isabelle; Arbus, Christophe; Mallet, Luc; du Montcel, Sophie Tezenas; The French ""Stimulation dans le Trouble Obsessionnel Compulsif (STOC)"" Study Group; Bandelow, Beneke, Dahlke, Goodman, Guy, Haro, Jones, Kadouri, Krystkowiak, Leucht, Leucht, Leucht, Levine, Mallet, Molenberghs, Shrout, Spearing, Streiner, Zaider",2011.0,,0,0,
8069,Randomized comparative study of group versus individual cognitive behavioural therapy for obsessive compulsive disorder.,"Objective: The primary aim of the study was to compare the effectiveness of group and individual cognitive behaviour therapy (CBT) for obsessive compulsive disorder (OCD). Method: One hundred and ten out-patients with OCD were randomly assigned to 15 sessions of either group CBT or individual CBT. Outcome measures were administered before and after treatment, as well as at 6- and 12-month follow-ups. The study was supplemented by a meta-analysis of accomplished comparative studies of group vs. individual CBT for OCD. Results: Large and stable pre-post effect sizes were found for both treatment conditions in the study (d = 1.06-1.24 on the Yale-Brown Obsessive Compulsive Scale). There were no significant between-group differences in outcome at any data point (ds = -0.13 to 0.15). The meta-analysis of four accomplished comparative studies (including the present one) found a between-group mean effect size of d = 0.15 favouring individual over group CBT at posttreatment (95% confidence interval, -0.12, 0.42). Conclusion: The results of this study suggest that OCD can be treated effectively with a group format of CBT, thus sparing some therapist resources, although the four accomplished comparative studies do not rule out the possibility of a small superiority of individually conducted CBT. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Jonsson, H; Hougaard, E; Bennedsen, B. E; Anderson, Beck, Beck, Beck, Braga, Brown, Cohen, Eddy, Fals-Stewart, First, Fisher, Foa, Goodman, Goodman, Hajcak, Hawthorne, Jacobson, Jaurrieta, Jaurrieta, Jonsson, Keeley, O'Connor, Raffin, Salkovskis, Van Blakom, Whittal",2011.0,,0,0,
8070,Pregabalin augmentation in treatment-resistant obsessive-compulsive disorder: A 16-week case series.,"The aim of the present study was to assess the effectiveness of pregabalin (PGB) augmentation in treatment-resistant obsessive-compulsive disorder (OCD). Subjects were seen in the Day Hospital of Psychiatry at the Catholic University Medical School in Rome between January 2009 and May 2010. Both at baseline and at the end of the study (after 16 weeks of treatment), physical examination and laboratory tests were performed to rule out complicating medical conditions, and questionnaires were administered to assess psychiatric symptoms. This is the first case series of PGB augmentation to SSRIs in treatment-refractory OCD. Pregabalin is a new antiepileptic drug characterized by the modulation of excitatory transmission release through blockade of N-type and P/Q-type voltage-dependent calcium channels. With respect to PGB's specific anti- OCD mechanism of action, we should note that increased glutamatergic neurotransmission is hypothesized to underlie the enhanced activity of the corticostriatothalamic system, which presumably constitutes a core pathophysiologic mechanism of OCD symptoms. These preliminary observations suggest that PGB may be an important new option in the pharmacological treatment of refractory OCD, especially with residual anxiety symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Nicola, Marco Di; Tedeschi, Daniela; Martinotti, Giovanni; De Vita, Ofelia; Monetta, Marisa; Pozzi, Gino; Janiri, Luigi; Bandelow, Cloos, Decloedt, Endicott, Goodman, Hamilton, Hamilton, Jenike, Mula, Oulis, Pittenger, Rotge, Ruscio, Siok, Szczypa",2011.0,,0,0,
8071,Internet-based cognitive behavior therapy for obsessive compulsive disorder: A pilot study.,"Background: Cognitive behavior therapy (CBT) is widely regarded as an effective treatment for obsessive compulsive disorder (OCD), but access to CBT therapists is limited. Internet-based CBT (ICBT) with therapist support is a way to increase access to CBT but has not been developed or tested for OCD. The aim of this study was to evaluate ICBT for OCD. Method: An open trial where patients (N = 23) received a 15-week ICBT program with therapist support consisting of psychoeducation, cognitive restructuring and exposure with response prevention. The primary outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), which was assessed by a psychiatrist before and immediately after treatment. Secondary outcomes were self-rated measures of OCD symptoms, depressive symptoms, general functioning, anxiety and quality of life. All assessments were made at baseline and post-treatment. Results: All participants completed the primary outcome measure at all assessment points. There were reductions in OCD symptoms with a large within-group effect size (Cohen's d = 1.56). At post-treatment, 61% of participants had a clinically significant improvement and 43% no longer fulfilled the diagnostic criteria of OCD. The treatment also resulted in statistically significant improvements in self-rated OCD symptoms, general functioning and depression. Conclusions: ICBT with therapist support reduces OCD symptoms, depressive symptoms and improves general functioning. Randomized trials are needed to confirm the effectiveness of this new treatment format. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Andersson, Erik; Ljotsson, Brjann; Hedman, Erik; Kaldo, Viktor; Paxling, Bjorn; Andersson, Gerhard; Lindefors, Nils; Ruck, Christian; Abramowitz, Abramowitz, Abramowitz, Abramowitz, Andersson, Andersson, Andrews, Bachofen, Baer, Berman, Carlbring, Clark, Cuijpers, Cuijpers, Federici, First, Foa, Foa, Foa, Frisch, Fritzler, Fullana, Goisman, Goodman, Greist, Greist, Griffiths, Guy, Hedman, Hedman, Hedman, Hollandare, Jacobi, Jacobson, Jones, Kenwright, Larsson, Lindsay, Ljotsson, Lovella, Marks, Mataix-Cols, Mataix-Cols, Mataix-Cols, Meyer, Moritz, Oldfield, Palmqvist, Rabin, Ravens-Sieberer, Rosenfeld, Saunders, Sheehan, Sheehan, Shervin, Steketee, Svanborg, Svanborg, Tolin, Tolin, Twohig, Zaider, Zlomke",2011.0,,0,0,
8072,Placebo effect after prefrontal magnetic stimulation in the treatment of resistant obsessive-compulsive disorder: A randomized controlled trial.,"Many patients with obsessive-compulsive disorder (OCD) do not achieve satisfactory symptom improvement with conventional treatments. Here, we evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) applied over the right dorsolateral prefrontal cortex (rDLPFC) in patients with treatment-resistant OCD. This was a double-blind randomized trial involving 30 treatment-resistant OCD outpatients, allocated to have either sham or active high-frequency rTMS (over the rDLPFC) added to their treatment regimens for 6 wk, with 6 wk of follow-up. Active rTMS consisted of 30 applications (figure-of-eight coil ; 10 Hz at 110% of motor threshold ; 1 session/d; 40 trains/session; 5 s/train ; 25-s intertrain interval). At weeks 0, 2, 6, 8, and 12, we applied the Yale-Brown Obsessive-Compulsive Scale (YBOCS), Clinical Global Impression (CGI) scale, 14-item Hamilton Anxiety Rating Scale (HAMA-14), 17-item Hamilton Depression Rating Scale (HAMD-17), and 36-item Short-form Health Survey. The primary outcome measure was a positive response (o30% improvement in YBOCS score, together with a 'much improved' or 'very much improved'","Mansur, Carlos Gustavo; Myczkowki, Martin Luiz; de Barros Cabral, Sergio; do Carmo Breda Sartorelli, Maria; Bellini, Bianca Boura; Dias, Alvaro Machado; Bernik, Marcio Antonini; Marcolin, Marco Antonio; Alonso, Aouizerate, Baxter, Ciconelli, Cohen, Denys, First, Fitzgerald, Fitzgerald, George, Goodman, Goodman, Greenberg, Guy, Herwig, Hollander, Kang, Langner, Mantovani, Mantovani, Prasko, Rosario-Campos, Rossini, Sachdev, Sachdev, Sarkhel, Saxena, Schruers, Shavitt, Shetti, Ulloa, Weissman",2011.0,,0,0,
8073,'Cancer coping online': A pilot trial of a self-guided CBT internet intervention for cancer-related distress.,"While internet-based cognitive behaviour therapy (iCBT) programs for mental health conditions has a demonstrated evidence base, the application of iCBT to those experiencing cancer-related distress has not been reported. This study therefore developed and pilot tested a self-guided iCBT program for patients with early stage cancer. Cancer Coping Online is a 6-week intervention which provides information, worksheets, and activities to address commonly experienced physical, emotional, social and communication difficulties. Participants were 12 patients (11 female) recruited over a 3-month period from one public hospital. The primary outcome measures were negative affect and posttraumatic stress. The secondary outcome measures were coping styles (helplessness/hopelessness, anxious preoccupation, cognitive avoidance, fatalism and fighting spirit). Changes over time were measured using within group effect sizes (Cohen's d), with reliable change indices (RCIs) used to assess the clinical significance of changes over time. The intervention led to reductions in negative affect (d = 0.53), helplessness/hopelessness (d = 0.64), anxious preoccupation (d = 0.43), and fatalism (d = 0.42). These reductions were clinically significant for 33% of the sample for negative affect, and for 25% of the sample for helplessness/hopelessness and anxious preoccupation. These results indicate that an iCBT program for cancer patients can reduce distress, and warrant further investigation through a randomised controlled trial. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Beatty, Lisa; Koczwara, Bogda; Wade, Tracey; Andersson, Angell, Bader, Beatty, Beatty, Beatty, Beatty, Carlson, Chiauzzi, Classen, Crawford, Foa, Foley, Ghahari, Griffiths, Gustafson, Helgeson, Hunt, Jacobsen, Jacobsen, Kaldo, Kraaij, Krischer, Ljotsson, Lovibond, Matthey, Newman, Osborn, Owen, Pleva, Rehse, Strom, Tate, van Bestelaar, Wade, Walker, Watson, Williams, Zabora, Zimmermann",2011.0,,0,0,
8074,Treatment of three anxiety disorder cases with acceptance and commitment therapy in a private practice.,"Acceptance and commitment therapy (ACT) for anxiety disorders is a type of cognitive behavioral therapy that focuses on decreasing the behavior regulatory function of anxiety and related cognitions, and has a strong focus on behavior change that is consistent with client values. In this case series, 3 consecutive referrals seeking treatment for anxiety disorders at a private practice were treated with 9-13 sessions of ACT. In-session exposure therapy was not included to determine the effects of ACT without the compounding effects of already proven treatment procedures. The treatment procedure was identical across disorders to test the use of a unified treatment protocol for anxiety disorders: panic disorder with agoraphobia, comorbid social phobia and generalized anxiety disorder, and posttraumatic stress disorder. All participants showed clinical improvement in their specific anxiety disorders a s rated on multiple standardized assessments after treatment, with gains maintained at follow-up (8 months or more). Time series assessments, taken throughout treatment, of anxiety and avoidance behaviors showed large decreases in avoidance but not in anxiety, suggesting ACT was effective by changing the way participants responded to anxiety rather than anxiety itself. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Codd, R. Trent III; Twohig, Michael P; Crosby, Jesse M; Enno, Angela; Abramowitz, Arch, Barlow, Barlow, Becker, Blackledge, Block, Bond, Bouton, Briggs, Brown, Campbell-Sills, DiGiuseppe, Eifert, Eifert, Eifert, Feldner, Forman, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Heimberg, Hofmann, Jourdain, Kelly, Lappalainen, Levitt, Liebowitz, Lull, Marcks, Marcks, Marx, Masuda, McEvoy, Meyer, Molina, Narrow, Orsillo, Powers, Paez-Blarrina, Roemer, Roemer, Ruggiero, Ruiz, Shear, Steele, Stewart, Strosahl, Summerfeldt, Twohig, Twohig, Twohig, Twohig, Twohig, Wilson, Woods, Zettle",2011.0,,0,0,
8075,Routine outcome monitoring in the Netherlands: Practical experiences with a web-based strategy for the assessment of treatment outcome in clinical practice.,"Routine outcome monitoring (ROM) is a method devised to systematically collect data on the effectiveness of treatments in everyday clinical practice. ROM involves documenting the outcome of treatments through repeated assessments. Assistants are employed who perform a baseline assessment comprising a standardized diagnostic interview, administration of rating scales and completion of several self-report measures by the patient. At fixed time intervals, assessments are repeated. Dedicated Web-based software has been developed to assist in this task. ROM informs therapists and patients on the severity of the complaints at intake, and the waxing and waning of symptoms over the course of treatment. Researchers can use ROM for effectiveness research, and managers can use it for benchmarking. The use of ROM for research is illustrated by presenting data on the diagnostic status of patients participating in ROM and data on treatment outcome of a subgroup of patients (with panic disorder) in our database. The results show that implementation of ROM is feasible, and after some initial reservations, most therapists now consider ROM to be a necessary and important adjunct to the clinical treatment. In addition, ROM furthers research as the data can be used to study the phenomenology of psychiatric disorders and the outcome of treatments delivered in everyday practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","de Beurs, E; den Hollander-Gijsman, M. E; van Rood, Y. R; van der Wee, N. J. A; Giltay, E. J; van Noorden, M. S; van der Lem, R; van Fenema, E; Zitman, F. G; Barkham, Barlow, Beck, Burgess, Clark, de Beurs, de Beurs, den Hollander-Gijsman, Derogatis, Ellwood, Endicott, Gilbody, Goekoop, Guy, Holloway, Jacobson, Jensen-Doss, Kessler, Kessler, Knaup, Lambert, Lambert, Lambert, Lee, Livesley, Miller, Rettew, Shear, Sheehan, Slade, Slade, Sperry, Stiles, van Kampen, van Noorden, Veen, Wardenaar, Wing, Wood",2011.0,,0,0,
8076,Multicomponent behavioral treatment for chronic combat-related posttraumatic stress disorder: A randomized controlled trial.,"This study examined the efficacy of a multicomponent cognitive-behavioral therapy, Trauma Management Therapy, which combines exposure therapy and social emotional rehabilitation, to exposure therapy only in a group of male combat veterans with chronic posttraumatic stress disorder (PTSD). Thirty-five male Vietnam veterans with PTSD were randomly assigned to receive either Trauma Management Therapy (TMT) or Exposure Therapy Only (EXP). Participants were assessed at pre-treatment, mid-treatment, and post-treatment. Primary clinical outcomes were reduction of PTSD symptoms and improved social emotional functioning. Results indicated that veterans in both conditions showed statistically significant and clinically meaningful reductions in PTSD symptoms from pre- to post-treatment, though consistent with a priori hypotheses there were no group differences on PTSD variables. However, compared to the EXP group, participants in the TMT group showed increased frequency in social activities and greater time spent in social activities. These changes occurred from mid-treatment (after completion of exposure therapy) to post-treatment (after completion of the social emotional rehabilitation component); supporting the hypothesis that TMT alone would result in improved social functioning. Although the TMT group also had a significant decrease in episodes of physical rage, that change occurred prior to introduction of the social emotional component of TMT. This study demonstrates efficacy of exposure therapy for treating the core symptoms of PTSD among combat veterans with a severe and chronic form of this disorder. Moreover, multi-component CBT shows promise for improving social functioning beyond that provided by exposure therapy alone, particularly by increasing social engagement/interpersonal functioning in a cohort of veterans with severe and chronic PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Beidel, Deborah C; Frueh, B. Christopher; Uhde, Thomas W; Wong, Nina; Mentrikoski, Janelle M; Ballenger, Becker, Blake, Blanchard, Borkovec, Bradley, Brady, Cahill, Chemtob, Cook, Dohrenwend, Echeburua, Elhai, Evans, First, First, Foa, Foa, Foa, Frueh, Frueh, Frueh, Frueh, Frueh, Frueh, Frueh, Grieger, Guy, Hamilton, Hamilton, Hoge, Hotopf, Lejuez, Magruder, Morland, Novaco, Pellegrin, Richardson, Schnurr, Schnurr, Seal, Smith, Stirman, Sundin, Taft, Tarrier, Teten, Turner, Turner, Weathers",2011.0,,0,0,
8077,Association between substance use disorder status and pain-related function following 12 months of treatment in primary care patients with musculoskeletal pain.,"The goal of this study was to examine relationships between substance use disorder (SUD) history and 12-month outcomes among primary care patients with chronic noncancer pain (CNCP). Patients were enrolled in a randomized trial of collaborative care intervention (CCI) versus treatment as usual (TAU) to improve pain-related physical and emotional function. At baseline, 72 of 362 patients (20.0%) had a history of SUD. Compared to CNCP patients without SUD, those with comorbid SUD had poorer pain-related function and were more likely to meet criteria for current major depression and posttraumatic stress disorder (all P values <.05). Logistic regression analyses were conducted to examine whether SUD status was associated with clinically significant change over 12 months in pain-related function (30% reduction in Roland Morris Disability Questionnaire Score). The overall model was not significant in the CCI group. However, within the TAU group, participants with a SUD history were significantly less likely to show improvements in pain-related function (OR = .30, 95% CI = .11-.82). CNCP patients with comorbid SUD reported greater functional impairment at baseline. Patients with SUD who received usual care were 70% less likely to have clinically significant improvements in pain-related function 12 months postbaseline, and SUD status did not impede improvement for the CCI group. Perspective: Chronic noncancer pain patients with a history of a substance use disorder (SUD) report poorer pain-related functioning and are less likely to experience clinically significant improvements from usual pain treatment. Providers should assess for SUD status and provide more intensive interventions for these patients. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Morasco, Benjamin J; Corson, Kathryn; Turk, Dennis C; Dobscha, Steven K; Bodenheimer, Breckenridge, Brooks, Bush, Caldeiro, Chelminski, Cocco, Compton, Currie, Demyttenaere, Dobscha, Dobscha, Dobscha, Duong, Elliott, Fishbain, Fleming, Gureje, Ilgen, Jamison, Jordan, Katzman, Lauridsen, Martell, Morasco, Nedeljkovic, Ostelo, Pinto-Meza, Potter, Pud, Reid, Rhodin, Roland, Roland, Romano, Rosenblum, Savage, Skinner, Smith, Spitzer, Stratford, Trafton, Tsang, Turk, Von Korff, Weathers, Weathers, Weisner",2011.0,,0,0,
8078,Comparing mindfulness and psychoeducation treatments for combat-related PTSD using a telehealth approach.,"This pilot study examined two telehealth interventions to address symptoms of combat-related posttraumatic stress disorder (PTSD) in veterans. Thirty-three male combat veterans were randomly assigned to one of two telehealth treatment conditions: mindfulness or psychoeducation. In both conditions, participants completed 8 weeks of telehealth treatment (two sessions in person followed by six sessions over the telephone) and three assessments (pretreatment, posttreatment, and 6-week follow-up). The mindfulness treatment was based on the tenets of mindfulness-based stress reduction and the psychoeducation manual was based on commonly used psychoeducation materials for PTSD. Results for the 24 participants who completed all assessments indicate that: (1) Telehealth appears to be a feasible mode for delivery of PTSD treatment for veterans; (2) Veterans with PTSD are able to tolerate and report high satisfaction with a brief mindfulness intervention; (3) Participation in the mindfulness intervention is associated with a temporary reduction in PTSD symptoms; and (4) A brief mindfulness treatment may not be of adequate intensity to sustain effects on PTSD symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Niles, Barbara L; Klunk-Gillis, Julie; Ryngala, Donna J; Silberbogen, Amy K; Paysnick, Amy; Wolf, Erika J; Baer, Blake, Blanchard, Boscarino, Bradley, Carmody, Chard, Davidson, Erbes, First, Foa, Foa, Foa, Follette, Friedman, Frueh, Frueh, Garcia, Grossman, Haas, Hoffman, Hoge, Kabat-Zinn, Kabat-Zinn, Kimbrough, Linehan, Luborsky, McLellan, Mohr, Monson, Morland, O'Toole, Resick, Riggs, Roemer, Sanderson, Santorelli, Savoca, Schell, Schottenbauer, Segal, Tuerk, Weathers, Weathers",2012.0,,0,0,
8079,Craving and illicit heroin use among patients in heroin-assisted treatment.,"Aims: To investigate in heroin-assisted treatment (HAT) compared to methadone maintenance treatment (MMT): the course of heroin craving and illicit heroin use, their mutual association, and their association with multi-domain treatment response. Design: RCTs on the efficacy of 12 months co-prescribed injectable or inhalable HAT compared to 12 months continued oral MMT. Setting: Outpatient treatment in MMT- or specialized HAT-centers in the Netherlands. Participants: Chronic, treatment-refractory heroin dependent patients (n =73). Study parameters: General craving for heroin (Obsessive Compulsive Drug Use Scale); self-reported illicit heroin use; multi-domain treatment response in physical, mental and social health and illicit drug use. Findings: The course of heroin craving and illicit heroin use differed significantly, with strong reductions in HAT but not in MMT. General heroin craving was significantly related to illicit heroin use. Heroin craving was not and illicit heroin use was marginally related to multi-domain treatment response, but only in MMT and not in HAT. Conclusions: Heroin craving and illicit heroin use were significantly associated and both strongly decreased in HAT but not in MMT. Craving was not related to multi-domain treatment response and illicit heroin use was marginally related to treatment response in MMT, but not in HAT. The latter was probably due to the strong reduction in illicit heroin use in most patients in HAT and the small sample size of the sub-study. It is hypothesized that the strong reductions in craving for heroin in HAT are related to the stable availability of prescribed, pharmaceutical grade heroin. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Blanken, Peter; Hendriks, Vincent M; Koeter, Maarten W. J; van Ree, Jan M; van den Brink, Wim; Anton, Blanken, Carter, de Wildt, de Wildt, Derogatis, Epstein, Eysenck, Fareed, Fareed, Faupel, Ferri, Field, Fischer, Franken, Franken, Goldstein, Haasen, Hendriks, Kokkevi, Langleben, Lubman, March, Marissen, Marissen, Marsden, O'Brien, Oviedo-Joekes, Perneger, Preston, Rehm, Romo, Rook, Sanderman, Sayette, Strang, Tiffany, Tiffany, Tiffany, Van den Brink, Verheul, Zinberg",2012.0,,0,0,
8080,Effect of acute posttrauma propranolol on PTSD outcome and physiological responses during script-driven imagery.,"Introduction: Animal and human research suggests that the development of posttraumatic stress disorder (PTSD) may involve the overconsolidation of memories of a traumatic experience. Previous studies have attempted to use pharmaceutical agents, especially the beta-adrenergic blocker propranolol, to reduce this overconsolidation. Aims: In this randomized, placebo-controlled study of the efficacy of propranolol in reducing the development of PTSD, we optimized dosages and conducted both psychophysiological and clinical assessments 1 and 3 months after the traumatic event. Forty-one emergency department patients who had experienced a qualifying acute psychological trauma were randomized to receive up to 240 mg/day of propranolol or placebo for 19 days. At 4 and 12 weeks post-trauma, PTSD symptoms were assessed. One week later, participants engaged in script-driven imagery of their traumatic event while psychophysiological responses were measured. Results: Physiological reactivity during script-driven traumatic imagery, severity of PTSD symptoms, and the rate of the PTSD diagnostic outcome were not significantly different between the two groups. However, post hoc subgroup analyses showed that in participants with high drug adherence, at the 5-week posttrauma assessment, physiological reactivity was significantly lower during script-driven imagery in the propranolol than in the placebo subjects. Conclusions: The physiological results provide some limited support for a model of PTSD in which a traumatic conditioned response is reduced by posttrauma propranolol. However, the clinical results from this study do not support the preventive use of propranolol in the acute aftermath of a traumatic event. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hoge, Elizabeth A; Worthington, John J; Nagurney, John T; Chang, Yuchiao; Kay, Elaine B; Feterowski, Christine M; Katzman, Anna R; Goetz, Jared M; Rosasco, Maria L; Lasko, Natasha B; Zusman, Randall M; Pollack, Mark H; Orr, Scott. P; Pitman, Roger K; Brunet, Bryant, Cahill, Cahill, Holbrook, Hurlemann, Marino, McGhee, Orr, Pitman, Pitman, Pitman, Rose, Rozenfeld, Sharp, Southwick, Stein, Vaiva",2012.0,,0,0,
8081,A fresh look at potential mechanisms of change in applied relaxation for generalized anxiety disorder: A case series.,"Applied relaxation (AR), which involves noticing early signs of anxiety and responding with a relaxation response, is an empirically supported treatment for generalized anxiety disorder (GAD). However, research on hypothesized mechanisms of AR (e.g., reduced muscle tension) has been mixed, making it likely that additional mechanisms are contributing to the efficacy of AR. Stemming from more recent conceptualizations of GAD, it is hypothesized that mindfulness, decentering, and acceptance may be potential mechanisms of change in AR. Outcome, mechanism data, and case descriptions from three individuals diagnosed with GAD who received 16 weeks of AR as part of a larger randomized controlled trial are presented to demonstrate the ways that AR may lead to clinical improvement through mindfulness, decentering, and acceptance. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hayes-Skelton, Sarah A; Usmani, Aisha; Lee, Jonathan K; Roemer, Lizabeth; Orsillo, Susan M; Antony, Arch, Arntz, Baer, Baer, Bernstein, Borkovec, Borkovec, Borkovec, Brown, Brown, Butler, Chambless, Conrad, DiNardo, Fresco, Fresco, Frisch, Gellhorn, Hamilton, Hayes, Hayes, Hayes, Hayes-Skelton, Hoffman, Jacobson, Jacobson, Kabat-Zinn, Kessler, Kessler, Lee, Lovibond, Mennin, Meyer, Molina, Newman, Orsillo, Ost, Ost, Ost, Ost, Robichaud, Roemer, Roemer, Safran, Salters-Pedneault, Shear, Siev, Wells, Yonkers",2012.0,,0,0,
8082,Long-term outcome of eight clinical trials of CBT for anxiety disorders: Symptom profile of sustained recovery and treatment-resistant groups.,"Background: Few clinical trials of cognitive behaviour therapy (CBT) for anxiety disorders have conducted follow-up beyond one year post-treatment. This paper summarises the long-term outcome of eight clinical trials of CBT for anxiety disorders in terms of diagnostic status, healthcare usage and symptom severity and compares the symptom profile of participants with the best and worst outcomes relative to chronic depression and the normal population. Methods: Follow-up at 2-14 years with 396 patients (51% of those available to contact) employed structured diagnostic interview, assessment of healthcare usage and self-report measures of symptom severity. This paper concerns 336 participants who had either no disorder or at least one anxiety disorder and information on healthcare usage over the follow-up period. Results: Only 38% recovered with little or no treatment over the follow-up period while 30% had a very poor outcome despite extensive treatment for anxiety over many years. The symptom profile of this 'treatment-resistant' group was comparable to 76 patients with chronic depression and significantly worse than normative data for psychiatric outpatients. Chronic anxiety disorder with co-morbid depression has a more severe symptom profile than chronic anxiety disorder alone. Limitations: The follow-up sample, although broadly representative, may have a bias towards a more favourable picture of overall outcome. Conclusions: The long-term outcome of anxiety disorders, irrespective of diagnosis or active treatment, is diverse but with a tendency towards chronicity. Distinctions between acute and chronic presentations of common mental disorders are more important than distinctions between chronic anxiety and chronic depression. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Durham, Robert C; Higgins, Cassie; Chambers, Julie A; Swan, John S; Dow, Michael G. T; Andersch, Brown, Butler, Cowley, Derogatis, Derogatis, Durham, Emmanuel, Friedman, Hamilton, Jacobson, Lambert, Layard, Rickels, Roth, Seivewright, Spielberger, Swan, Taylor, Tyrer, Watson, Yonkers",2012.0,,0,0,
8083,CYP2C19 genotype predicts steady state escitalopram concentration in GENDEP.,"In vitro work shows CYP2C19 and CYP2D6 contribute to the metabolism of escitalopram to its primary metabolite, N-desmethylescitalopram. We report the effect of CYP2C19 and CYP2D6 genotypes on steady state morning concentrations of escitalopram and N-desmethylescitalopram and the ratio of this metabolite to the parent drug in 196 adult patients with depression in GENDEP, a clinical pharmacogenomic trial. Subjects who had one CYP2D6 allele associated with intermediate metabolizer phenotype and one associated with poor metabolizer (i.e. IM/PM genotypic category) had a higher mean logarithm escitalopram concentration than CYP2D6 extensive metabolizers (EMs) (p = 0.004). Older age was also associated with higher concentrations of escitalopram. Covarying for CYP2D6 and age, we found those homozygous for the CYP2C19*17 allele associated with ultrarapid metabolizer (UM) phenotype had a significantly lower mean escitalopram concentration (2-fold, p = 0.0001) and a higher mean metabolic ratio (p = 0.0003) than EMs, while those homozygous for alleles conferring the PM phenotype had a higher mean escitalopram concentration than EMs (1.55-fold, p = 0.008). There was a significant overall association between CYP2C19 genotypic category and escitalopram concentration (p = 0.0003; p = 0.0012 Bonferroni corrected). In conclusion, we have demonstrated an association between CYP2C19 genotype, including the CYP2C19*17 allele, and steady state escitalopram concentration. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Huezo-Diaz, Patricia; Perroud, Nader; Spencer, Edgar P; Smith, Rebecca; Sim, Sarah; Virding, Susanne; Uher, Rudolf; Gunasinghe, Cerisse; Gray, Jo; Campbell, Desmond; Hauser, Joanna; Maier, Wolfgang; Marusic, Andrej; Rietschel, Marcella; Perez, Jorge; Giovannini, Caterina; Mors, Ole; Mendlewicz, Julien; McGuffin, Peter; Farmer, Anne E; Ingelman-Sundberg, Magnus; Craig, Ian W; Aitchison, Katherine J; Aitchison, Baumann, Bies, Burke, Candiotti, Chen, de Leon, de Morais, Desta, Eichelbaum, Einarson, Fredericson Overo, Freeman, Furuta, Gauderman, Grayson, Gutierrez, Heller, Herrlin, Keers, Kinirons, Kirchheiner, Kurzawski, Llorca, Moore, Ohlsson Rosenborg, Owens, Palovaara, Reis, Rudberg, Sanchez, Sidhu, Sim, Sindrup, Tatsumi, Taylor, Trzepacz, Uher, von Moltke, Wang, Xiao, Yin",2012.0,,0,0,
8084,Integrating religion and spirituality into treatment for late-life anxiety: Three case studies.,"Generalized anxiety disorder (GAD) is common in older adults and, although cognitive behavioral therapy (CBT) is an efficacious treatment for late-life GAD, effect sizes are only moderate and attrition rates are high. One way to increase treatment acceptability and enhance current cognitive behavioral treatments for GAD in older adults might be to incorporate religion/spirituality (R/S). The cases presented here illustrate the use of a 12-week modular CBT intervention for late-life anxiety, designed to allow incorporation of R/S elements in accordance with patient preferences. The three women treated using this protocol chose different levels and methods of R/S integration into therapy. All three women showed substantial improvement in worry symptoms, as well as a variety of secondary outcomes following treatment; these gains were maintained at 6-month follow-up. These preliminary results suggest that the incorporation of R/S into CBT might be beneficial for older adults with GAD. Strengths, limitations, and future directions are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Barrera, Terri L; Zeno, Darrell; Bush, Amber L; Barber, Catherine R; Stanley, Melinda A; Allain, Andreescu, Andrew, Arch, Bastien, Beekman, Beekman, Bourland, Brenes, Brenes, Callahan, Chambless, Chatters, Chen, Crittendon, Diener, First, Givens, Hodge, Hook, Hopko, Kieffer, Knight, Koszycki, Krause, Landreville, Lenze, Levin, Mantella, McCullough, Meyer, Morin, Morrow, Newport, Pachana, Pargament, Paterniti, Paukert, Paukert, Pavot, Phillips, Pinquart, Porensky, Powell, Robb, Roest, Rosmarin, Rosmarin, Schoevers, Sheikh, Smith, Spangler, Spira, Stanley, Stanley, Stanley, Wetherell, Wetherell, Wetherell, Wink, Worthington, Worthington, Worthington",2012.0,,0,0,
8085,Responsiveness of hypochondriacal patients with chronic low-back pain to cognitive-behavioral therapy.,"Background: Evidence has suggested that cognitive-behavioral therapy (CBT) is effective in reducing hypochondriacal symptoms, and another line of evidence has suggested that CBT is also effective in reducing pain and the psychological conditions associated with chronic low-back pain (CLBP). The purpose of this study was to examine the effectiveness of CBT among hypochondriacal patients with and without CLBP. Methods: A total of 182 hypochondriacal patients were randomly assigned to a CBT or control group. The Somatic Symptom Inventory was used to define CLBP, and the Symptom Checklist 90R (SCL90R) was used to assess psychological symptoms. The outcome measures for hypochondriasis, the Whiteley Index (WI) and the Health Anxiety Inventory (HAI) were administered before the intervention and at 6 and 12 months after completion of the intervention. Results: In the total sample, both WI and HAI scores were significantly decreased after treatment in the CBT group compared with the control group. Ninety-three (51%) patients had CLBP; the SCL90R scores for somatization, depression, phobic anxiety, paranoid ideation, and general severity were significantly higher in CLBP(+) group than in the CLBP(-) group at baseline. Although the WI and HAI scores were significantly decreased after treatment in the CLBP(-) group, such significant pre- to post-changes were not found in the CLBP(+) group. Conclusions: CBT was certainly effective among hypochondriacal patients without CLBP, but it appeared to be insufficient for hypochondriacal patients with CLBP. The core psychopathology of hypochondriacal CLBP should be clarified to contribute to the adequate management of hypochondriacal symptoms in CLBP patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Nakao, Mutsuhiro; Shinozaki, Yasuko; Nolido, Nyryan; Ahern, David K; Barsky, Arthur J; Allen, Barsky, Barsky, Barsky, Barsky, Barsky, Barsky, Barsky, Cohen, Derogatis, Derogatis, Glombiewski, Hansen, Harding, Henschke, Hiller, Janowski, Koes, Lamb, Lambeek, Nakao, Nakao, Peralta, Pilowsky, Pilowsky, Salkovskis, Smeets, Sogutlu, Stranjalis, Tyrer, van Hooff, Verhaak, Vickers, Weinstein, Wong",2012.0,,0,0,
8086,Refinement of a brief anxiety sensitivity reduction intervention.,"Objective: Anxiety disorders are the most prevalent psychiatric disorders in the United States and result in substantial burden to the individual and society. Although effective treatments for anxiety disorders have been developed, there has been substantially less focus on interventions aimed at the amelioration of anxiety-related risk and maintenance factors. Anxiety sensitivity (AS) is a well-established, malleable risk and maintenance factor for panic disorder and other psychopathology. The aim of the current investigation was to enhance the efficacy of AS treatment through the refinement of a previously validated intervention. Method: This 1-session intervention utilized psychoeducation and interoceptive exposure to target AS and was compared with a health-focused control intervention among a nontreatment seeking sample (N = 104) of individuals with elevated AS. Results: Study findings indicate that the active treatment group demonstrated significantly greater reductions in AS than the control group at posttreatment and across the 1-month study period. These treatment gains were seen across the ASI subscales. A Month 6 follow-up assessment indicated that the treatment group retained the majority of their AS reduction, whereas the control group retained their elevated AS scores. The intervention responses of participants meeting Axis I diagnostic criteria did not differ from the responses of those without a current diagnosis. Conclusions: Despite the brevity of the treatment intervention, findings demonstrate that it resulted in substantial reductions in AS that were largely maintained 6 months posttreatment. Anxiety treatment and prevention implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Keough, Meghan E; Schmidt, Norman B; Beck, Beck, Broman-Fulks, Chambless, Fedoroff, Feldner, Feldner, First, Gardenswartz, Greenberg, Kessler, McLeish, Ocanez, Olatunji, Reiss, Schmidt, Schmidt, Schmidt, Schmidt, Schmidt, Wang",2012.0,,0,0,
8087,The effect of prayer on depression and anxiety: Maintenance of positive of positive influence one year after prayer intervention.,"Objective: To investigate whether the effect of direct contact person-to-person prayer on depression, anxiety, and positive emotions is maintained after 1 year. Design, Setting, and Participants: One-year follow-up of subjects with depression and anxiety who had undergone prayer intervention consisting of six weekly 1-hour prayer sessions conducted in an office setting. Subjects (44 women) completed Hamilton Rating Scales for Depression and Anxiety, Life Orientation Test, and Daily Spiritual Experiences Scale after finishing a series of six prayer sessions and then again a month later in an initial study. The current study reassessed those subjects with the same measures 1 year later. One-way repeated measures ANOVAs were used to compare findings pre-prayer, immediately following the six prayer sessions, and 1 month and again 1 year following prayer interventions. Results: Evaluations post-prayer at 1 month and 1 year showed significantly less depression and anxiety, more optimism, and greater levels of spiritual experience than did the baseline (pre-prayer) measures (p < 0.01 in all cases). Conclusions: Subjects maintained significant improvements for a duration of at least 1 year after the final prayer session. Direct person-to-person prayer may be useful as an adjunct to standard medical care for patients with depression and anxiety. Further research in this area is indicated. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Boelens, Peter A; Reeves, Roy R; Replogle, William H; Koenig, Harold G; Astin, Beutler, Boelens, Hamilton, Hamilton, Kandel, Kessler, Kessler, Koenig, Masters, Matthews, Murray, Scheier, Schwartz, Teasdale, Underwood",2012.0,,0,0,
8088,Dissociative experiences during sexual behavior among a sample of adults living with HIV infection and a history of childhood sexual abuse.,"Little attention has been given to the occurrence of dissociative symptoms during sexual behavior in adults who have experienced childhood sexual abuse (CSA). For this study, 57 adults living with HIV infection who had experienced CSA and were entering a treatment study for traumatic stress completed study assessments and clinical interviews, including a 15-item scale of dissociative experiences during sexual behavior. Predictor variables included Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision diagnoses of posttraumatic stress disorder (PTSD) and dissociative disorders, rape by an intimate partner, duration of CSA, number of perpetrators of CSA, and current sexual satisfaction. A multiple regression analysis was conducted to identify significant associations between predictors and dissociation during sex. Mean differences by clinical diagnosis were also examined. Results indicated that PTSD, dissociative disorders, rape by an intimate partner, duration of CSA, and number of perpetrators of CSA were associated with increased dissociation during sexual behavior. Dissociation during sex likely increases vulnerability to sexual revictimization and risky sexual behavior. Standard behavioral prevention interventions may be ineffective for sexual situations when dissociation occurs, and prevention efforts should be integrated with mental health care for those who have experienced CSA. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hansen, Nathan B; Brown, Lauren J; Tsatkin, Elizabeth; Zelgowski, Brittany; Nightingale, Vienna; Arriola, Aspelmeier, Briere, Briere, Butler, Carlson, Classen, Cloitre, Daigneault, Dalenberg, Davis, Davis, Dell, DiLillo, DiLillo, Draijer, First, Freyd, Gold, Gold, Irish, Kalichman, Kirby, Koenig, Leserman, Malow, Malta, Messman-Moore, Mullen, O'Leary, Peterman, Randolph, Rellini, Sacco, Schloredt, Sikkema, Sikkema, Whetten, Zlotnick, Zurbriggen",2012.0,,0,0,
8089,Cognitive reappraisal self-efficacy mediates the effects of individual cognitive-behavioral therapy for social anxiety disorder.,"Objective: To examine whether changes in cognitive reappraisal self-efficacy (CR-SE) mediate the effects of individually administered cognitive-behavioral therapy (I-CBT) for social anxiety disorder (SAD) on severity of social anxiety symptoms. Method: A randomized controlled trial in which 75 adult patients (21-55 years of age; 53% male; 57% Caucasian) with a principal diagnosis of generalized SAD were randomly assigned to 16 sessions of I-CBT (n = 38) or a wait-list control (WL) group (n = 37). All patients completed self-report inventories measuring CR-SE and social anxiety symptoms at baseline and post-I-CBT/post-WL, and I-CBT completers were also assessed at 1-year posttreatment. Results: Compared with WL, I-CBT resulted in greater increases in CR-SE and greater decreases in social anxiety. Increases in CR-SE during I-CBT mediated the effect of I-CBT on social anxiety. Gains achieved by patients receiving I-CBT were maintained 1-year posttreatment, and I-CBT-related increases in CR-SE were also associated with reduction in social anxiety at the 1-year follow-up. Conclusions: Increasing CR-SE may be an important mechanism by which I-CBT for SAD produces both immediate and long-term reductions in social anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Goldin, Philippe R; Ziv, Michal; Jazaieri, Hooria; Werner, Kelly; Kraemer, Helena; Heimberg, Richard G; Gross, James J; Acarturk, Baker, Bandura, Bandura, Bandura, Beck, Benyon, Borkovec, Brown, Campbell-Sills, Carthy, Clark, Clark, Clark, Clark, Cohen, Cote, Delsignore, DiNardo, Efron, Fedoroff, Fresco, Gaudiano, Goldin, Goldin, Gross, Gross, Heimberg, Heimberg, Hoffart, Hofmann, Hofmann, Hope, Hope, Hope, Kadden, Keller, Kessler, Kraemer, Ledley, Liebowitz, Mortberg, Odgaard, Otto, Pierce, Powers, Rodebaugh, Rottmann, Schnoll, Smits, Stangier, Steele, Stein, Stein, Thomasson, Werner",2012.0,,0,0,
8090,Group music therapy for patients with persistent post-traumatic stress disorder-An exploratory randomized controlled trial with mixed methods evaluation.,"Objectives: Not all patients with post-traumatic stress disorder (PTSD) respond to cognitive behavioural therapy (CBT). Literature suggests group music therapy might be beneficial in treating PTSD. However, feasibility and effectiveness have not been assessed. The study objectives were to assess whether group music therapy was feasible for patients who did not respond to CBT, and whether it has an effect on PTSD symptoms and depression. Design: The study employed mixed methods comprising of an exploratory randomized controlled trial, qualitative content analysis of therapy, and patient interviews. Method: Patients with significant PTSD symptoms (n = 17) following completion of CBT were randomly assigned to treatment (n = 9) or control groups (n = 8). The treatment group received 10 weeks of group music therapy after which exit interviews were conducted. Control group patients were offered the intervention at the end of the study. Symptoms were assessed on the Impact of Events Scale-Revised and Beck Depression Inventory II at the beginning and end of treatment. Results: Treatment-group patients experienced a significant reduction in severity of PTSD symptoms (-20.18; 95% confidence interval [CI]: [-31.23, -9.12]) and a marginally significant reduction in depression (-11.92; 95%CI: [-24.05, 0.21]) at 10 weeks from baseline compared to the control. Patients viewed music therapy as helpful and reported experiences concur with current literature. Conclusions: Group music therapy appears feasible and effective for PTSD patients who have not sufficiently responded to CBT. Limitations include the small sample size and lack of blinding. Further research should address these limitations, test sustainability, and identify specific factors that address symptoms in treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Carr, Catherine; d'Ardenne, Patricia; Sloboda, Ann; Scott, Carleen; Wang, Duolao; Priebe, Stefan; Amir, Beck, Bensimon, Bernardi, Bispham, Bisson, Blacking, Blake, Breslau, Bruscia, Craig, Creamer, D'Ardenne, Davidson, Dixon, Frewen, Gabrielsson, Gavrilovic, Gold, Harvey, Heidenreich, Henderson, Herman, Hoch-Espada, Horowitz, Hughes, Husain, Hussey, Jakupcak, Jones, Kennerly, Kessler, Krout, Lang, Macintosh, Malloch, Maratos, Odell-Miller, Odell-Miller, Orth, Orth, Orth, Orth, Orth, Pavlicevic, Pavlicevic, Priebe, Read-Johnson, Robarts, Robarts, Robertson, Schauer, Spinazzola, Steer, Strehlow, Sutton, Swallow, Talwar, Towse, Tyler, van Der Kolk, Volkman, Weiss, Wigram, Wild",2012.0,,0,0,
8091,Inpatient cognitive behavior therapy for obsessive-compulsive disorder: Effectiveness and predictors of response in routine clinical practice.,"Background: Studies examining the effectiveness of inpatient or outpatient cognitive behavior therapy (CBT) for obsessive-compulsive disorder (OCD) in routine clinical practice are rare. Multi-morbid, psychotherapeutically pre-treated patients are mostly excluded in randomized controlled trails (RCTs). In the present study, effectiveness and outcome predictors of inpatient CBT in a routine clinical setting were examined in a largely unselected sample, and the results were compared with those of RCTs. Methods: 108 patients with OCD were treated with inpatient CBT (mean treatment duration = 52.0 days; SD = 11.9) and examined in a naturalistic design. 91% were psychotherapeutically pre-treated, 76% had co-morbid disorders and 63% received antidepressive medication at admission. The outcome measures (Yale-Brown Obsessive-Compulsive Scale-Self-Rating (Y-BOCS-SR); Beck's Depression Inventory (BDI)) were administered at the beginning and at the end of treatment. Predictor variables were assessed via routine clinical documentation. Results: Obsessive-compulsive and depressive symptoms significantly declined. Effect sizes were large (Y-BOCS-SR: d = 1.7; BDI: d = 0.9), even when prematurely discharged patients were included in the analysis. At the end of treatment, half of the patients were improved and one-third recovered. None of the examined features (symptom severity, co-morbid disorder, depressive disorder, personality disorder, psychotherapeutic pre-treatment, sexual trauma, couple problems, unemployment) had an effect on treatment outcome. Conclusions: Cognitive behavior therapy in a routine clinical inpatient setting can achieve very good results for multi-morbid, pre-treated OCD patients. Compared with inpatient RCTs, the effects were somewhat smaller but, on the other hand, treatment duration was shorter. Adequate evaluation of the effects of different studies requires careful documentation and comparison of relevant study features, e.g. therapy dose, sample characteristics, exclusion criteria/rate and applied measures. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gonner, Sascha; Limbacher, Klaus; Ecker, Willi; Abramowitz, Abramowitz, Abramowitz, Abramowitz, Althaus, Baer, Barrett, Buchanan, Chambless, Cohen, Deacon, Ecker, Eddy, Federici, Foa, Franklin, Fricke, Fricke, Fricke, Gershuny, Goodman, Gonner, Hautzinger, Hiller, Hohagen, Jonsson, Kathmann, Kazis, Keeley, Keijsers, Kordon, Lakatos, Leidig, Leonhart, Mataix-Cols, McLean, Meyer, Moritz, Muller-Svitak, Niedermeier, Rosa-Alcazar, Rufer, Rufer, Ruppert, Simpson, Skoog, Steketee, Steketee, Tolin, Warren",2012.0,,0,0,
8092,Associations between Pittsburgh Sleep Quality Index factors and health outcomes in women with posttraumatic stress disorder.,"Objective: The Pittsburgh Sleep Quality Index (PSQI) is a widely used measure of subjective sleep disturbance in clinical populations, including individuals with posttraumatic stress disorder (PTSD). Although the severity of sleep disturbance is generally represented by a global symptom score, recent factor analytic studies suggest that the PSQI is better characterized by a two- or three-factor model than a one-factor model. This study examined the replicability of two- and three-factor models of the PSQI, as well as the relationship between PSQI factors and health outcomes, in a female sample with PTSD. Methods: The PSQI was administered to 319 women with PTSD related to sexual or physical assault. Confirmatory factor analyses tested the relative fit of one-, two-, and three-factor solutions. Bivariate correlations were performed to examine the shared variance between PSQI sleep factors and measures of PTSD, depression, anger, and physical symptoms. Results: Confirmatory factor analyses supported a three-factor model with Sleep Efficiency, Perceived Sleep Quality, and Daily Disturbances as separate indices of sleep quality. The severity of symptoms represented by the PSQI factors was positively associated with the severity of PTSD, depression, and physical symptoms. However, these health outcomes correlated as much or more with the global PSQI score as with PSQI factor scores. Conclusions: These results support the multidimensional structure of the PSQI. Despite this, the global PSQI score has as much or more explanatory power as individual PSQI factors in predicting health outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Casement, Melynda D; Harrington, Kelly M; Miller, Mark W; Resick, Patricia A; Aloba, Backhaus, Beck, Beck, Beck, Belleville, Belleville, Blake, Buysse, Buysse, Buysse, Calhoun, Carpenter, Cohen, Cole, Cook, Dozois, Foa, Galovski, Germain, Hovens, Koffel, Kotronoulas, Krakow, Magee, Magee, Muthen, Ohayon, Pennebaker, Pilcher, Resick, Resick, Schreiber, Shankar, Shin, Spielberger, Spielberger, Stewart, Weathers",2012.0,,0,0,
8093,Comparison of treatment outcomes for veterans with posttraumatic stress disorder with and without comorbid substance use/dependence.,"Most of the attention to the treatment of patients who have comorbid Substance Use/Dependence Disorder (SUD) and Posttraumatic Stress Disorder (PTSD) has focused on SUD outcomes. This study focuses on the PTSD outcomes of comorbid patients as compared to those with PTSD only. Altogether 8599 Veterans admitted to VA specialized inpatient/residential PTSD programs were assessed for PTSD and SUD symptoms at admission and four months following discharge. Two samples were drawn sequentially in separate phases due to unexpected results in the first sample: 4966 in the first sample and 3633 in the second sample. In the first sample, dually diagnosed Veterans had significantly better PTSD outcomes than Veterans diagnosed with PTSD only. The differences could be attributed primarily to improvement in comorbid SUD symptoms. These results were replicated in the second sample. The results suggest that there may be a synergistic effect operating in the treatment of the two comorbid disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fontana, Alan; Rosenheck, Robert; Desai, Rani; Back, Boudewyns, Desai, Donovan, Fontana, Fontana, Gonzalez, Hien, Jacobsen, Keane, Keane, McGovern, McLellan, Mills, Najavits, Najavits, Ouimette, Ouimette, Read, Schafer, Steindl, Trafton, Triffleman, Zlotnick",2012.0,,0,0,
8094,Generalizability of clinical trial results for generalized anxiety disorder to community samples.,"Background: There has been little research on the generalizability of clinical trials for generalized anxiety disorder (GAD). The present study examines the generalizability of pharmacological and psychotherapy clinical trials' results of individuals with DSM-IV GAD to a large community sample. Methods: Data were drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a large national representative face-to-face sample of 43,093 adults of the United States population. We applied a standard set of eligibility criteria representative of GAD pharmacological and psychotherapy clinical trials to all adults with past 12 months GAD (n = 894), and to a subgroup of participants seeking treatment (n = 329). Our aim was to assess how many participants with GAD would fulfil typical eligibility criteria. Results: We found that more than seven out of 10 participants with GAD were excluded by at least one criterion. In the subgroup of GAD participants who sought treatment, the exclusion rate by at least one criterion raised to more than eight out of 10 participants with GAD. For the overall sample and the treatment-seeking subsample, having a current depression was the criterion excluding the highest percentage of individuals. Having a lifetime history of bipolar disorder, a current significant medical condition, a current diagnosis of alcohol abuse or dependence, and a social or specific phobia also excluded a substantial proportion of individuals in both samples. Conclusions: Clinical trials exclude a majority of adults with GAD. Clinical trials should carefully consider the impact of eligibility criteria on the generalizability of their results. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hoertel, Nicolas; Le Strat, Yann; Blanco, Carlos; Lavaud, Pierre; Dubertret, Caroline; Adam, Baldwin, Baldwin, Ball, Barlow, Barlow, Blanco, Blanco, Blowers, Borkovec, Boter, Bowman, Brawman-Mintzer, Butler, Butler, Canino, Cohen, Cragan, Davidson, Davidson, Dzewaltowski, Feltner, Gaynes, Goldenberg, Grant, Grant, Grant, Grant, Harter, Hartford, Hartford, Hasin, Hasin, Hettema, Humphreys, Humphreys, Jannoun, Judd, Khan, Kirchner, Koponen, Ladouceur, Le Strat, Lenox-Smith, Leucht, March, Mitte, Montgomery, Montgomery, Nicolini, Nimatoudis, Okuda, Olfson, Pande, Pollack, Pollack, Pollack, Power, Rickels, Rickels, Ruscio, Rynn, Silverstone, Steiner, Verdoux, Wan, Weisberg, Wells, Westen, Woodward, Zimmerman, Zimmerman",2012.0,,0,0,
8095,Changes in judgment biases and use of emotion regulation strategies during cognitive-behavioral therapy for social anxiety disorder: Distinguishing treatment responders from nonresponders.,"Although there is much support for the efficacy of cognitive behavioral therapy (CBT) in treating social anxiety disorder (SAD), many patients fail to respond adequately to treatment. In the present study, self-reported judgment biases (probability and cost estimates of negative social events) and emotion regulation strategies (cognitive reappraisal and expressive suppression) were measured at pre-, mid-, and posttreatment in 25 patients with SAD who completed 12 sessions of group CBT. We compared patterns of change across time in judgment biases and use of emotion regulation strategies during therapy among patients who were ultimately classified as responders (n = 15) and nonresponders (n = 10), and analyzed the extent to which early changes during treatment across these variables accounted for overall symptom improvement in social anxiety symptoms. Results revealed that change trajectories in social probability and cost estimates and use of cognitive reappraisal strategies differed as a function of responder status as patients moved through treatment. The early acquisition of cognitive reappraisal skills was uniquely predictive of overall social anxiety symptom reduction. Implications for clinical practice and research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Moscovitch, David A; Gavric, Dubravka L; Senn, Jessica M; Santesso, Diane L; Miskovic, Vladimir; Schmidt, Louis A; McCabe, Randi E; Antony, Martin M; Antony, Antony, Arch, Berk, Campbell-Sills, Campbell-Sills, Clark, Clark, Clark, Clark, Cohen, Cohen, Connor, Davidson, Ehrenreich, Eskildsen, First, Foa, Gravetter, Gross, Gross, Gross, Gross, Guy, Haga, Harris, Heimberg, Hofmann, Jacobson, Kashdan, Kessler, McHugh, McManus, Moore, Morris, Moscovitch, Moses, Norton, Otto, Rapee, Rapee, Smits, Spokas, Steketee, Taylor, Zaider",2012.0,,0,0,
8096,The dynamics of self-esteem in cognitive therapy for avoidant and obsessive-compulsive personality disorders: An adaptive role of self-esteem variability?,"Self-esteem variability is often associated with poor functioning. However, in disorders with entrenched negative views of self and in a context designed to challenge those views, variable self-esteem might represent a marker of change. We examined self-esteem variability in a sample of 27 patients with Avoidant and Obsessive-Compulsive Personality Disorders who received Cognitive Therapy. A therapy coding system was used to rate patients' positive and negative views of self expressed in the first ten sessions of a 52-week treatment. Ratings of negative (reverse scored) and positive view of self were summed to create a composite score for each session. Self-esteem variability was calculated as the standard deviation of self-esteem scores across sessions. More self-esteem variability predicted more improvement in personality disorder and depression symptoms at the end of treatment, beyond baseline and average self-esteem. Early variability in self-esteem, in this population and context, appeared to be a marker of therapeutic change. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cummings, Jorden A; Hayes, Adele M; Cardaciotto, LeeAnn; Newman, Cory F; Barber, Baumeister, Beck, Beck, Beck, Beck, Butler, Carver, de Man, First, Greenier, Grilo, Grilo, Hayes, Hayes, Hayes, Ilardi, Kashdan, Kernis, Kernis, Kernis, Kernis, Knowles, Landis, Leichsenring, Lynym, Oosterwegel, Penava, Pyszczynski, Rhodewalt, Roberts, Roberts, Roberts, Roberts, Roberts, Rosenberg, Rosenberg, Rosenberg, Shrout, Spitzer, Spitzer, Strauss, Swann, Tang, Waschull, Weertman, Young, Zeigler-Hill",2012.0,,0,0,
8097,Brief eclectic psychotherapy v. eye movement desensitization and reprocessing therapy for post-traumatic stress disorder: Randomised controlled trial.,"Background: Trauma-focused cognitive-behavioural therapy (CBT) and eye movement desensitisation and reprocessing therapy (EMDR) are efficacious treatments for post-traumatic stress disorder (PTSD), but few studies have directly compared them using well-powered designs and few have investigated response patterns. Aims: To compare the efficacy and response pattern of a trauma-focused CBT modality, brief eclectic psychotherapy for PTSD, with EMDR (trial registration: ISRCTN64872147). Method: Out-patients with PTSD were randomly assigned to brief eclectic psychotherapy (n = 70) or EMDR (n = 70) and assessed at all sessions on self-reported PTSD (Impact of Event Scale - Revised). Other outcomes were clinician-rated PTSD, anxiety and depression. Results: Both treatments were equally effective in reducing PTSD symptom severity, but the response pattern indicated that EMDR led to a significantly sharper decline in PTSD symptoms than brief eclectic psychotherapy, with similar drop-out rates (EMDR: n = 20 (29%), brief eclectic psychotherapy: n = 25 (36%)). Other outcome measures confirmed this pattern of results. Conclusions: Although both treatments are effective, EMDR results in a faster recovery compared with the more gradual improvement with brief eclectic psychotherapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Nijdam, Mirjam J; Gersons, Berthold P. R; Reitsma, Johannes B; de Jongh, Ad; Olff, Miranda; Bisson, Bradley, Breslau, Carlier, Creamer, Davidson, De Jongh, De Vries, First, Foa, Gersons, Gersons, Hembree, Ironson, Jones, Kessler, Korn, Lee, Lindauer, Olff, Power, Rothbaum, Schnurr, Schnurr, Schnyder, Schottenbauer, Schubert, Seidler, Spinhoven, Spitzer, Taylor, Van Groenestein, Van Minnen, Vaughan, Weiss, Zanarini, Zigmond",2012.0,,0,0,
8098,Fish oil for attenuating posttraumatic stress symptoms among rescue workers after the Great East Japan Earthquake: A randomized controlled trial.,"Presents a study which examined the impact of sex difference for fish oil supplementation on posttraumatic stress disorder (PTSD) symptoms in rescue workers. Participants provided informed consent and were randomly assigned to either the fish oil supplementation plus psychoeducation group or the psychoeducation alone group. The primary outcome was a total score on the Impact of Event Scale-Revised (IES-R) at 12 weeks after shipment of the supplements. Safety of the intervention was evaluated by the presence of adverse events during the observation period, by asking the participants about the presence of such events at 2,4,8, and 12 weeks after the start offish oil supplementation. The two groups were well balanced with respect to baseline characteristics. When adjusted for age, sex, and IES-R score at baseline, there was no significant difference in change of IES-R scores between the two groups. However, in women, there was a significant difference between the two groups when adjusted for age and IES-R scores at baseline. In terms of safety, the occurrence rate of adverse events was not significantly different between the two groups, and none were regarded as serious or led to withdrawal. In conclusion, fish oil supplementation may offer a safe strategy for attenuating PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Nishi, Daisuke; Koido, Yuichi; Nakaya, Naoki; Sone, Toshimasa; Noguchi, Hiroko; Hamazaki, Kei; Hamazaki, Tomohito; Matsuoka, Yutaka; Hamazaki, Kawakita, Kessler, Kitamura, Matsuoka, Matsuoka, Matsuoka, Ressler, Sublette, Weiss",2012.0,,0,0,
8099,"A meta-analysis of imagery rehearsal for post-trauma nightmares: Effects on nightmare frequency, sleep quality, and posttraumatic stress.","This meta-analysis evaluates the efficacy of imagery rehearsal as a treatment for nightmares, general sleep disturbance, and symptoms of post-traumatic stress. Bibliographic databases and cited references were searched to identify clinical trials of imagery rehearsal in individuals with post-trauma nightmares. Thirteen studies met inclusion criteria and reported sleep and post-traumatic stress outcomes in sufficient detail to calculate effect sizes. Results indicate that imagery rehearsal had large effects on nightmare frequency, sleep quality, and PTSD symptoms from the initial to post-treatment assessments. These effects were sustained through 6 to 12 months follow-up. Furthermore, interventions that included both imagery rehearsal and cognitive behavioral therapy for insomnia resulted in greater treatment-related improvement in sleep quality than imagery rehearsal alone. Combined treatment did not improve outcomes for PTSD or nightmares. Notably, effect sizes were small in the single study that included an active-treatment control condition. Future research should identify necessary and sufficient components of interventions for trauma-related sleep disturbance and post-traumatic stress (e.g., exposure, cognitive reappraisal, sleep and circadian regulation). (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Casement, Melynda D; Swanson, Leslie M; Belleville, Belleville, Blake, Bradley, Brett, Buysse, Clum, Cook, Davis, Davis, Davis, Foa, Forbes, Galovski, Germain, Harvey, Harvey, Harvey, Hedges, Higgins, Hoge, Koren, Krakow, Krakow, Krakow, Krakow, Krakow, Krakow, Lamarche, Leskin, Lipsey, Long, Long, Lu, Mellman, Moore, Morin, Morris, Morris, Nappi, Nappi, Neylan, Phelps, Ross, Spoormaker, Swanson, Thompson, Ulmer, Van Etten, Wittmann, Zayfert",2012.0,,0,0,
8100,Appearance concerns and psychological distress among HIV-infected individuals with injection drug use histories: Prospective analyses.,"Morphologic alterations in body composition are common among HIV-infected individuals, and these changes are associated with increased appearance concerns. Previous cross-sectional data indicate that appearance concerns among HIV-infected individuals are related to increased levels of psychological distress. However, to date, no known prospective data have been published on these relationships. The purpose of the current study was to address the temporal prediction of appearance concerns on depression and anxiety severity. Data were culled from a prospective, randomized controlled trial of cognitive behavioral therapy for depression and medication adherence in individuals with a history of injection drug use (IDU). Participants were 89 HIV infected individuals who were randomized to either a cognitive behavioral therapy or treatment as usual condition. Linear mixed-level modeling revealed elevated levels of appearance concerns were prospectively related to increased depression and anxiety, as rated by both clinician-administered and self-report measures. Appearance concerns among depressed, IDU, HIV-infected individuals are associated with changes in psychological distress. Psychosocial interventions should consider the role of appearance as it relates to psychological functioning. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Blashil, Aaron J; Gordon, Janna R; Safren, Steven A; Ammassari, Beck, Beck, Bing, Blashill, Blashill, Cabrero, Crane, Giralt, Gonzalez, Guaraldi, Guaraldi, Huang, Justice, Marin, Montgomery, Morrison, Peplau, Plankey, Safren, Seminari, Sharma, Sharma, Tate, Tien, Wagner, Zea",2012.0,,0,0,
8101,Does a study focused on trauma encourage patients with psychotic symptoms to seek treatment?,"Objective: This study explored, in a randomized trial of psychotherapies for posttraumatic stress disorder (PTSD), why a surprisingly high percentage of study applicants presented with psychotic symptoms and what clinical implications this finding might prompt. Methods: Raters reviewed the records of applicants who completed an initial psychiatric interview and compared those who had psychotic symptoms with all other study-eligible participants and with those who ultimately were enrolled in the study. Results: Of 223 consecutively evaluated individuals who applied for study entry, 38 (17%) were found ineligible because of psychotic symptoms. These individuals were more likely to be male and to have suffered child abuse, and they had taken a greater number of lifetime medications than study-eligible applicants. Most individuals with psychotic symptoms met DSM-IV criteria for PTSD. Conclusions: A trauma-informed framework might be a helpful part of a comprehensive treatment plan for some individuals with psychotic symptoms, possibly leading to greater treatment engagement and more positive outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Amsel, Lawrence V; Hunter, Noel; Kim, San; Fodor, Kinga E; Markowitz, John C; Bendall, Blake, Braakman, Campbell, First, Frueh, Fuller, Goodman, Grubaugh, Hamner, Rathod, Spitzer",2012.0,,0,0,
8102,Treatment specific competence predicts outcome in cognitive therapy for social anxiety disorder.,"Several studies have demonstrated a positive relationship between competence and outcome in CBT for depression but studies of CBT for anxiety disorders are lacking. The present study explores the relationship between competence and outcome in cognitive therapy (CT) for social anxiety disorder, using hierarchical linear modeling analyses (HLM). Data were drawn from a multicenter randomized controlled trial. Five trained raters evaluated videotapes of two therapy sessions per patient using the Cognitive Therapy Competence Scale for Social Phobia (CTCS-SP). Overall adherence to the treatment manual and patient difficulty were also assessed. Patient outcome was rated by other assessors using the Clinical Global Impression Improvement Scale (CGI-I) and the Liebowitz Social Anxiety Scale (LSAS). Results indicated that competence significantly predicted patient outcome on the CGI-I (b 1/4 .79) and LSAS ( b 1/4 .59). Patient difficulty and adherence did not further improve prediction. The findings support the view that competence influences outcome and should be a focus of training programs. Further research is needed to compare different ways of assessing competence and to understand the complex relationships between competence and other therapy factors that are likely to influence outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ginzburg, Denise M; Bohn, Christiane; Hofling, Volkmar; Weck, Florian; Clark, David M; Stangier, Ulrich; Berge, Bryk, Castonguay, Chambless, Clark, Clark, Clark, Clark, Clark, Clark, Elkin, Feeley, Foley, Fresco, Guy, Heimberg, Heinrichs, Huppert, Keijsers, Liebowitz, Liebowitz, McHugh, McManus, Mortberg, Muthen, Nathan, Perepletchikova, Portney, Roth, Roth, Shafran, Shrout, Stangier, Stangier, Stangier, Stangier, Stein, Von Consbruch, Waller, Webb, Weck, Young, Zaider",2012.0,,0,0,
8103,Transdiagnostic group cognitive-behavioral therapy for anxiety disorders: A 10-week open-label clinical trial.,"Objective: To evaluate the efficacy of cognitive-behavioral group therapy for anxiety disorders, investigate the important therapeutic factors in group therapy, and providing experimental evidences for further clinical practice. Methods: Totally 34 anxiety disorder outpatients meeting criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) received cognitive-behavior group therapy for 10 weeks. The State-Trait Anxiety Inventory (STAI) were administered before and after the treatment. The Group Therapeutic Factors Questionnaire and a self-made questionnaire for cognitive-behavioral techniques were also filled out. Results: Compared to baseline, the patients had significant reduction in the scores at anxiety after treatment [(34. 9 +/- 6.4) vs. (53.6 +/- 5.4), P < 0.01], with no different score reduction between any primary diagnose. The important group therapeutic factors related to treatment were interpersonal gain, self-realization, universality, imparting information, group cohesiveness, existential factors, catharsis, instillation of hope, interpersonal pay-out, altruism, the corrective recapitulation of the primary family group, and imitative behavior. The most effective ingredients of CBT were psychoeducation, social skills and relaxation training. Conclusion: The study shows the effect of transdiagnostic anxiety treatment models and provide preliminary support for the assumption that individuals with different anxiety diagnoses can be treated equally within the same treatment protocol. Psychoeducation, social skills and relaxation training may be most-effective ingredients of CBT in group therapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Liu, Wen-Juan; Ji, Jian-Lin; Ye, Chen-Yu; Chen, Hua; Barlow, Norton, Norton, Norton, Norton, Olatunji, Otte",2012.0,,0,0,
8104,Treating patients who strain the research psychotherapy paradigm.,"Clinical trials of psychotherapy require diagnostic homogeneity, which implies a convergence of clinical presentations. Yet research study patients present diversely, and patients who do not fit a treatment paradigm may greatly complicate delivery of the study psychotherapy. The research literature has not addressed this issue. The authors use case illustrations of three psychotherapies-Prolonged Exposure, Relaxation Therapy, and Interpersonal Psychotherapy-from an ongoing psychotherapy outcome trial of posttraumatic stress disorder to describe psychotherapeutic responses to complex, ""atypical"" patients who strain standard treatment paradigms. Therapists required flexibility, and occasionally deviations from strict protocol, in treating heterodox patients. Such heterogeneity of presentation may have implications for psychotherapy outcome in research trials. Despite lack of discussion in the literature, many trials may face such issues (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Markowitz, John C; Kaplowitz, Matthew; Suh, Eun-Jung; Meehan, Kevin B; Neria, Yuval; Jonker, Hanske; Rafaeli, Alexandra; Lovell, Karina; Blake, Bleiberg, Borkovec, Castonguay, Chambless, First, Foa, Foley, Frank, Goldfried, Greenacre, Hamilton, Hill, Jacobsen, Kessler, Markowitz, Markowitz, Rafaeli, Wachtel, Weathers, Weissman, Westen, Westen",2012.0,,0,0,
8105,"Online exposure treatment for spider fear: The effects of moving versus static images on treatment adherence, fear elicitation and habituation.","This research aimed to examine the effects of moving (videos) versus static (pictures) images on habituation and progression in a hierarchy during online symbolic exposure (OSE) for spider fear. Participants were 351 people with high spider fear who logged on to an OSE website (www.feardrop.com) for self-help purposes. The inclusion of moving images in the exposure hierarchy increased adherence rates relative to static images, particularly among those with lower relative to higher spider fear. Those who viewed moving images at Stage 2 showed higher Subjective Units of Distress Scale (SUDS) ratings overall, but a similar pattern of habituation relative to those who viewed static images. In addition, 71% of participants completed at least one stage of the OSE program, representing an improvement from 30% adherence in previous research that used an earlier version of the program. These findings support the development of tailored exposure hierarchies to maximise adherence and treatment benefit for individual participants. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Matthews, Allison J; Scanlan, Joel D; Kirkby, Ken C; Alonso, Bornas, Bornas, Christensen, Courtney, Foa, Hope, Huijding, Johnstone, Lovibond, Matthews, Matthews, Muris, Naran, Somers, Stinson, Szymanski, Wells, Wolitzky-Taylor, Ost",2012.0,,0,0,
8106,Does a pre-treatment diagnostic interview affect the outcome of Internet-based self-help for social anxiety disorder? A randomized controlled trial.,"Background: Numerous studies suggest that Internet-based self-help treatments are effective in treating anxiety disorders. Trials evaluating such interventions differ in their screening procedures and in the amount of clinician contact in the diagnostic assessment phase. The present study evaluates the impact of a pre-treatment diagnostic interview on the outcome of an Internet-based treatment for Social Anxiety Disorder (SAD). Method: One hundred and nine participants seeking treatment for SAD were randomized to either an interview-group (IG, N = 53) or to a non-interview group (NIG, N = 56). All participants took part in the same 10-week cognitive-behavioural unguided self-help programme. Before receiving access to the programme, participants of the IG underwent a structured diagnostic interview. Participants of the NIG started directly with the programme. Results: Participants in both groups showed significant and substantial improvement on social anxiety measures from pre-to post-assessment (dIG = 1.30-1.63; dNIG = 1.00-1.28) and from pre- to 4-month follow-up assessment (dIG = 1.38-1.87; dNIG = 1.10-1.21). Significant between-groups effects in favour of the IG were found on secondary outcome measures of depression and general distress (d = 0.18-0.42). Conclusions: These findings suggest that Internet-based self-help is effective in treating SAD, whether or not a diagnostic interview is involved. However, the pre-treatment interview seems to facilitate change on secondary outcomes such as depression and general distress. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Boettcher, Johanna; Berger, Thomas; Renneberg, Babette; Abramson, Andersson, Andersson, Andersson, Andersson, Attkisson, Baker, Barak, Beck, Berger, Berger, Berger, Botella, Carlbring, Carlbring, Carlbring, Carlbring, Carlbring, Chan, Christensen, Clark, Clark, Clarke, Clarke, Cohen, Derogatis, Franke, Furmark, Fydrich, Gibbons, Hautzinger, Hedman, Henkel, Houck, Jacobson, Kessler, Klein, Lincoln, Marks, Mattick, Minero, Olfson, Preacher, Rapee, Rosnow, Schmidt, Spek, Stangier, Stangier, Stangier, Suppiger, Titov, Titov, Titov, Titov, Titov, Titov, Wang, Wittchen",2012.0,,0,0,
8107,Adaptive disclosure: An open trial of a novel exposure-based intervention for service members with combat-related psychological stress injuries.,"We evaluated the preliminary effectiveness of a novel intervention that was developed to address combat stress injuries in active-duty military personnel. Adaptive disclosure (AD) is relatively brief to accommodate the busy schedules of active-duty service members while training for future deployments. Further, AD takes into account unique aspects of the phenomenology of military service in war in order to address difficulties such as moral injury and traumatic loss that may not receive adequate and explicit attention by conventional treatments that primarily address fear-inducing life-threatening experiences and sequelae. In this program development and evaluation open trial, 44 marines received AD while in garrison. It was well tolerated and, despite the brief treatment duration, promoted significant reductions in PTSD, depression, negative posttraumatic appraisals, and was also associated with increases in posttraumatic growth. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Gray, Matt J; Schorr, Yonit; Nash, William; Lebowitz, Leslie; Amidon, Amy; Lansing, Amy; Maglione, Melissa; Lang, Ariel J; Litz, Brett T; Blanchard, Bradley, Cigrang, Dohrenwend, Foa, Foa, Friedman, Greenberg, Hoge, Hoge, Lichtenthal, Litz, Litz, Maguen, Monson, Nash, Nash, Prigerson, Prigerson, Ready, Ruggiero, Saunders, Schnurr, Spitzer, Steenkamp, Tedeschi",2012.0,,0,0,
8108,Predictors of patient adherence to cognitive-behavioral therapy for obsessive-compulsive disorder.,"This study examined potential predictors of patient adherence to exposure and response prevention (EX/RP) and whether patient adherence mediated the relationship between these predictors and post-treatment OCD severity. The sample consisted of 28 adults (18-70 years old) with obsessive-compulsive disorder (OCD) who received EX/RP as part of a clinical trial described in detail elsewhere. In brief, patients participated in 8 weeks of EX/RP that included 3 introductory sessions and 15 twice-weekly 90-minute exposure sessions following the guidelines of Kozak and Foa. The findings have several implications. First, therapeutic alliance predicted treatment outcome through its impact on patient adherence. Second, readiness for treatment also predicted treatment outcome through patient adherence. Third, hoarding status predicted poorer treatment outcome through patient adherence. If these findings are replicated, future research should develop interventions to enhance therapeutic alliance and treatment readiness, deliver these interventions to those who show poor alliance or treatment readiness, and test whether this leads to improved patient adherence and thereby outcome, as these findings suggest. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Maher, Michael J; Wang, Yuanjia; Zuckoff, Allan; Wall, Melanie M; Franklin, Martin; Foa, Edna B; Simpson, Helen Blair; De Araujo, Devilly, Dozois, Eisen, Endicott, First, Foa, Frost, Goodman, Goodman, Halperin, Hamilton, Kozak, MacKinnon, Maher, McConnaughy, Sheehan, Simpson, Simpson, Simpson, Simpson, Steketee",2012.0,,0,0,
8109,"N-acetylcysteine add-on treatment in refractory obsessive-compulsive disorder: A randomized, double-blind, placebo-controlled trial.","Objective: This study aimed to evaluate the efficacy and safety of N-acetylcysteine, a glutamate-modulating agent, in patients with treatment-refractory obsessive-compulsive disorder as an adjunct to serotonin reuptake inhibitor treatment. Methods: Forty-eight patients (36 women; mean +/- SD age, 30.93 +/- 4.99) with obsessive-compulsive disorder who failed to respond to a course of serotonin reuptake inhibitor treatment were randomized to a 12-week intervention period of N-acetylcysteine (up to 2400 mg/d) or placebo. Primary outcome measures were the change in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score from baseline to end point and the rate of full response in each group at the end of trial. Full response was defined as 35% or greater reduction in Y-BOCS score from baseline. Results: Changes of Y-BOCS score were different over time (P < 0.001) and between groups (P < 0.001). N-acetylcysteine-assigned patients showed significantly improved mean Y-BOCS score (P = 0.003) and Clinical Global Impression-Severity of Illness scale score (P = 0.01) but not Clinical Global Impression-Improvement scale score at study end point. Of the patients in the N-acetylcysteine group, 52.6% were full responders at the end of the study, which was significantly higher than 15% of the patients in the placebo group (P = 0.013). Conclusion: This trial suggests that N-acetylcysteine may be a safe and effective option to augment standard treatment in patients with refractory obsessive-compulsive disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Afshar, Hamid; Roohafza, Hamidreza; Mohammad-Beigi, Hamid; Haghighi, Mohammad; Jahangard, Leila; Shokouh, Pedram; Sadeghi, Masoumeh; Hafezian, Hasan; Arnold, Aruoma, Berk, Bhattacharyya, Chakrabarty, Cone, Dean, Decloedt, Emsley, Ersan, Ferrao, Figueroa, Goodman, Grant, Grant, Greenberg, Guy, Han, Hollander, Insel, Khan, Kumar, Lafleur, Malek-Ahmadi, March, Mathew, McGrath, Moran, Nascimento, Ng, Nordstrom, Odlaug, Ozkara, Pallanti, Pendyala, Piccmelli, Pittenger, Pittenger, Poyurovsky, Saxena, Scalley, Selek, Stein, Stewart, Van Noppen",2012.0,,0,0,
8110,Metacognitive therapy for obsessive compulsive disorder by videoconference: A preliminary study.,"Evidence-supported therapy for obsessive-compulsive disorder (OCD) is often difficult to access, especially in rural and remote areas. Videoconferencing is gaining momentum as a means of improving access. Metacognitive therapy (MCT) has already been found to be effective for OCD when delivered face-to-face. This preliminary study explored whether videoconference-based MCT can be effective for OCD. Three participants completed a brief course of MCT using videoconferencing. Participants experienced clinically significant reductions in OCD symptoms, depression, anxiety, and stress, some of which were maintained after a 6- to 8-week follow-up period. Results suggest that videoconferencing MCT can be effective for OCD. Implications for clinicians are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Fitt, Samantha; Rees, Clare; Andrews, Antonacci, Antony, Brown, Busseri, Eddy, Elliott, First, Fisher, Fisher, Foa, Franklin, Glueckauf, Goodman, Hageman, Himle, Horvath, Hufford, Jacobson, Jacobson, Lee, Lovibond, McLean, Oakes, Rees, Rees, Rees, Salkovskis, Schopp, Spada, Stanley, Strong, Taylor, Tracey, Wells, Wells, Wells, Whittal, Woody",2012.0,,0,0,
8111,Internet administration of the Dimensional Obsessive-Compulsive Scale: A psychometric evaluation.,"The Dimensional Obsessive-Compulsive Scale (DOCS) was designed to address the current limitations of existing obsessive-compulsive (OC) symptom measures and is a self-report questionnaire that assesses the severity of the four most empirically supported OC symptom dimensions. The aim of this study was to examine the psychometric properties of a Swedish version of the DOCS when administered via the Internet. Internal consistency, factor structure, and convergent and discriminant validity were examined in a sample consisting of 101 patients diagnosed with obsessive-compulsive disorder. The DOCS sensitivity to treatment effects were examined in a sample consisting of 48 patients treated with Internet-delivered cognitive behavioral therapy were the main intervention was exposure with response prevention. Results showed that the internal consistency was high. The DOCS also showed adequate convergent and discriminant validity, as well as fair sensitivity to treatment effects. The factor analysis supported the DOCS four-factor solution. In summary, the results from the present study give initial support that the DOCS can be administered via the Internet with adequate psychometric properties. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Enander, Jesper; Andersson, Erik; Kaldo, Viktor; Lindefors, Nils; Andersson, Gerhard; Ruck, Christian; Abramowitz, Abramowitz, Andersson, Andersson, Andersson, Buchanan, Buchanan, Campbell, Carlbring, Cohen, Coles, Deacon, Federici, First, Foa, Foa, Goodman, Grabill, Hedman, Hollandare, Kim, Leckman, Mataix-Cols, McKay, Montgomery, Simpson, Simpson, Steiger, Svanborg, Svanborg, Tourangeau, Weissman, Wootton",2012.0,,0,0,
8112,Gender differences in clinical manifestations and outcomes among hospitalized patients with behavioral and psychological symptoms of dementia.,"Objective: To clarify whether hospitalized patients with behavioral and psychological symptoms of dementia (BPSD) show gender differences in manifested symptoms and outcomes. Method: A chart review study of patients hospitalized from April 2006 to March 2008 for the treatment of BPSD was conducted. We evaluated the prevalence of symptoms in each of 7 clusters constituting a subscale of the Behavioral Pathology in Alzheimer's Disease Rating Scale and the incidence of favorable discharge, defined as discharge to the patient's own home or care facility. Dementia was diagnosed according to DSM-IV. Results: The study cohort comprised 122 men and 170 women. The men were more likely than the women to present with aggressiveness (78% vs 52%, P < .001) and diurnal rhythm disturbances (89% vs 79%, P < .05) and less likely to present with paranoid, delusional ideation (12% vs 41%, P < .001); hallucination (7% vs 29%, P < .001); affective disturbances (20% vs 40%, P < .001); and anxieties and phobias (15% vs 44%, P < .001). Incidence of favorable discharge was lower in the men (58% vs 77%, P = .001). Even after matching for age, sociodemographic factors, and physical and cognitive functions, the differences in these symptoms persisted, with the exception of diurnal rhythm disturbances. Incidence of favorable discharge was lower in the men (60% vs 77%, P = .0173). Conclusion: The data demonstrated gender differences in BPSD and outcomes among hospitalized patients. The findings should be considered when deciding on the optimal management plan for patients with BPSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kitamura, Tatsuru; Kitamura, Maki; Hino, Shoryoku; Tanaka, Nana; Kurata, Koichi; Alexander, Arai, Belle, Bidzan, Buchanan, Callahan, Cohen-Mansfield, Cohen-Mansfield, Eastley, Fernandez, Finkel, Folstein, Hall, Heyman, Ikeda, Ito, Kunik, Kunik, Kunik, Kyomen, Lapane, Larson, Llibre Rodriguez, Lonergan, Lovheim, Luengo-Fernandez, Matsuoka, Menon, Murayama, Nishimura, Oakes, Ono, Ott, Pot, Reisberg, Schneider, Schneider, Schreiner, Schulz, Senanarong, Sorensen, Steinberg, Sukomck, Terada, Voyer",2012.0,,0,0,
8113,Do cognitive reappraisal and diaphragmatic breathing augment interoceptive exposure for anxiety sensitivity?,"Interoceptive exposure (IE) is an effective procedure for reducing anxiety sensitivity (AS) and the symptoms of panic disorder. However, considerable variance exists in how IE is delivered among clinicians, and the extent to which IE is enhanced by the concurrent use of cognitive reappraisal (CR) and diaphragmatic breathing (DB) is unclear. Participants (N = 58) with high AS were randomly assigned to one of four single-session interventions: (a) IE only, (b) IE + CR, (c) IE + CR + DB, or (d) expressive writing control. IE was superior to expressive writing in reducing AS and associated anxiety symptoms. The addition of CR and DB did not enhance the benefits of IE at either posttreatment or 1-week follow-up. These findings highlight the specific efficacy of IE in reducing AS and call into question the common practice of combining IE with cognitive and breathing strategies. Theoretical and clinical implications are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Deacon, Brett J; Lickel, James J; Possis, Elizabeth A; Abramowitz, Jonathan S; Mahaffey, Brittain; Wolitzky-Taylor, Kate; Abramowitz, Antony, Arntz, Barlow, Barlow, Beck, Brown, Bryk, Carter, Clark, Deacon, Devilly, Gould, Hayes, Hayward, Lickel, Lickel, McNally, Morris, Powers, Rapee, Raudenbush, Reiss, Schmidt, Schmidt, Schmidt, Schmidt, Smits, Smits, Smits, Taylor, Watt",2012.0,,0,0,
8114,Brief acceptance and commitment therapy and exposure for panic disorder: A pilot study.,"Cognitive and biobehavioral coping skills are central to psychosocial therapies and are taught to facilitate and improve exposure therapy. While traditional coping skills are aimed at controlling maladaptive thoughts or dysregulations in physiology, newer approaches that explore acceptance, defusion, and values-based direction have been gaining interest. Acceptance and Commitment Therapy (ACT) involves creating an open, nonjudgmental stance toward whatever thoughts, feelings, and bodily sensations arise in a given moment, experiencing them for what they are, and moving toward them while inner experiences such as anxiety are present. This approach can be seen as consistent with exposure therapies and may be utilized to organize and facilitate engagement in exposure exercises. This study examines the feasibility and efficacy for combining a brief ACT protocol with traditional exposure therapy. Eleven patients with panic disorder with or without agoraphobia received 4 sessions of ACT followed by 6 sessions of exposure therapy, with data collected on a weekly basis. Acquisition of ACT skills and their application during exposure was monitored using a novel ""think-aloud"" technology. Treatment was associated with clinically significant improvements in panic symptom severity, willingness to allow inner experiences to occur, and reductions in avoidant behavior. Although preliminary, results suggest that our brief training in ACT only (as assessed prior to exposure exercises) and in combination with exposure therapy was acceptable to patients and offered benefits on the order of large effect sizes. Clinical and research implications are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Meuret, Alicia E; Twohig, Michael P; Rosenfield, David; Hayes, Steven C; Craske, Michelle G; Andrews, Arch, Baer, Baker, Barlow, Brown, Brown, Brown, Campbell-Sills, Chambless, Codd, Craske, Culver, Dalrymple, Davison, Davison, Devilly, DiNardo, Eifert, First, Fletcher, Forman, Haby, Hamer, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hofmann, Kazdin, Kircanski, Kocovski, Lappalainen, Levitt, Levitt, Maas, McNally, Meuret, Meuret, Meuret, Norton, Orsillo, Reiss, Roemer, Segal, Shear, Shear, Singer, Snijders, Twohig, Twohig, Westen, Wetherell, Williams, Wolitzky-Taylor, Zettle",2012.0,,0,0,
8115,Opposing breathing therapies for panic disorder: Randomized controlled trial of lowering vs raising end-tidal Pco2.,"Background: Teaching anxious clients to stop hyperventilating is a popular therapeutic intervention for panic. However, evidence for the theory behind this approach is tenuous, and this theory is contradicted by an opposing theory of panic, the false-suffocation alarm theory, which can be interpreted to imply that the opposite would be helpful. Objective: To test these opposing approaches by investigating whether either, both, or neither of the 2 breathing therapies is effective in treating patients with panic disorder. Method: We randomly assigned 74 consecutive patients with DSM-IV-diagnosed panic disorder (mean age at onset = 33.0 years) to 1 of 3 groups in the setting of an academic research clinic. One group was trained to raise its end-tidal Pco2 (partial pressure of carbon dioxide, mm Hg) to counteract hyperventilation by using feedback from a hand-held capnometer, a second group was trained to lower its end-tidal Pco2 in the same way, and a third group received 1 of these treatments after a delay (wait-list). We assessed patients physiologically and psychologically before treatment began and at 1 and 6 months after treatment. The study was conducted from September 2005 through November 2009. Results: Using the Panic Disorder Severity Scale as a primary outcome measure, we found that both breathing training methods effectively reduced the severity of panic disorder 1 month after treatment and that treatment effects were maintained at 6-month follow-up (effect sizes at 1-month follow-up were 1 34 for the raise-CO2 group and 1 53 for the lower-CO2 group; P < .01). Physiologic measurements of respiration at follow-up showed that patients had learned to alter their Pco2 levels and respiration rates as they had been taught in therapy. Conclusions: Clinical improvement must have depended on elements common to both breathing therapies rather than on the effect of the therapies themselves on CO2 levels. These elements may have been changed beliefs and expectancies, exposure to ominous bodily sensations, and attention to regular and slow breathing. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kim, Sunyoung; Wollburg, Eileen; Roth, Walton T; Abelson, Abelson, Bagiella, Barlow, Beck, Beck, Biber, Bryk, Chambless, Chambless, Clark, Clark, Cohen, Craske, Garssen, Garssen, Gorman, Gorman, Han, Hardonk, Hegel, Hibbert, Hibbert, Hibbert, Holt, Kabat-Zinn, Klein, Klein, Ley, Ley, Ley, Ley, Ley, Maddock, Meuret, Munjack, Papp, Peterson, Rapee, Rapee, Roth, Roth, Roth, Salkovskis, Schmidt, Shear, Spitzer, Telch, van Zijderveld, Wilhelm, Wilhelm, Wollburg, Woods",2012.0,,0,0,
8116,Changes in facets of mindfulness and posttraumatic stress disorder treatment outcome.,"Though there has been a recent surge of interest in the relations between facets of mindfulness and Posttraumatic Stress Disorder (PTSD), there has been a dearth of empirical studies investigating the impact of changes in facets of mindfulness on PTSD treatment outcomes. The present study tested the prospective associations between pre- to post-treatment changes in facets of mindfulness and PTSD and depression severity at treatment discharge, among 48 military Veterans in residential PTSD treatment adhering to a cognitive-behavioral framework. Together, changes in facets of mindfulness significantly explained post-treatment PTSD and depression severity (19-24% of variance). Changes in acting with awareness explained unique variance in post-treatment PTSD severity and changes in nonjudgmental acceptance explained unique variance in post-treatment depression severity. These results remained significant after adjusting for shared variance with length of treatment stay. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Boden, Matthew Tyler; Bernstein, Amit; Walser, Robyn D; Bui, Leena; Alvarez, Jennifer; Bonn-Miller, Marcel O; Alvarez, Baer, Baer, Beck, Bernstein, Bishop, Brown, Bryant, Dimidjian, Elhai, Hofmann, Jacobson, Jacobson, Kimbrough, Kumar, Mitmansgruber, Owens, Resick, Resick, Resick, Resick, Tanay, Thompson, Vujanovic, Vujanovic, Weathers, Zayfert",2012.0,,0,0,
8117,Combat-related PTSD nightmares and imagery rehearsal: Nightmare characteristics and relation to treatment outcome.,"The characteristics of nightmares of 48 male U.S. Vietnam war veterans with combat-related posttraumatic stress disorder (PTSD), as well as revised dream scripts developed in the course of Imagery Rehearsal therapy, were examined in relation to pretreatment symptomatology and treatment outcome. Features, content, and themes of nightmares and rescripted dreams were coded by 2 independent raters. Nightmares were replete with scenes of death and violence and were predominantly replays of actual combat events in which the veteran was under attack and feared for his life. Although addressing or resolving the nightmare theme with rescripting was associated with a reduction in sleep disturbance, references to violence in the rescripted dream were related to poorer treatment outcome in nightmare frequency; B = 5.69 (SE = 1.14). The experience of olfactory sensations in nightmares, a possible index of nightmare intensity, was also related to poorer treatment response; B = 2.95 (SE = 1.06). Imagery rehearsal for individuals with severe, chronic PTSD and fairly replicative nightmares may be most effective when the rescripted dream incorporates a resolution of the nightmare theme and excludes violent details. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Harb, Gerlinde C; Thompson, Richard; Ross, Richard J; Cook, Joan M; Blagrove, Blake, Buysse, Cook, Davis, Davis, Domhoff, Esposito, Foa, Fontana, Forbes, Galovski, Germain, Hall, Harb, Hartman, Jaycox, King, Krakow, Krakow, Leskin, McLay, Mellman, Phelps, Revonsuo, Ross, Schreuder, Schreuder, Spoormaker, van der Kolk, Vermetten, Vermetten, Watson, Weathers, Wittmann, Zadra",2012.0,,0,0,
8118,The treatment of mental contamination: A case series.,"The recommended treatment for obsessive-compulsive disorder (OCD) is cognitive behavior therapy (CBT) incorporating exposure and response prevention (ERP), which is effective for approximately 50% of patients. However, there has been little advance in treatment outcomes since the introduction of ERP in 1979. It has been suggested that some progress can be made in treating contamination obsessions and washing compulsions by addressing feelings of dirtiness and contamination that arise without physical contact with a tangible contaminant. To date, the treatment of these ""mental contamination"" fears in OCD has not been systematically explored. This paper reports on a case series of 12 participants with OCD who received 10 to 20 sessions of a CBT-based treatment for mental contamination. At the end of treatment, 7 participants no longer met the diagnostic criteria for OCD and mental contamination and these gains were maintained at 6-month follow-up. The clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Coughtrey, Anna E; Shafran, Roz; Lee, Michelle; Rachman, Stanley; Abramowitz, Agras, Beck, Beck, Beck, Beck, Bobes, Brown, Chambless, Clark, Cottraux, Coughtrey, Eddy, Fisher, Foa, Foa, Freeston, Goodman, Jacobson, Jenike, Kessler, Kim, Niederauer, Rachman, Rachman, Rachman, Radomsky, Riley, Salkovskis, Salkovskis, Shafran, Sookman, Stanley, Volz, Warnock-Parkes, Whittal, Whittal, Wild, Wilhelm",2013.0,,0,0,
8119,Valproic acid but not D-cycloserine facilitates sleep-dependent offline learning of extinction and habituation of conditioned fear in humans.,"The effectiveness of D-cycloserine (DCS), an N-methyl-D-aspartate glutamate receptor partial agonist, and valproic acid (VPA), a histone deacetylase inhibitor, in facilitating the extinction of fear-conditioned memory has been explored in humans and animals. Here, we confirmed whether DCS (100 mg) and VPA (400 mg) act in off-line learning processes during sleep or waking, for further clinical application to anxiety disorders and posttraumatic stress disorder (PTSD). We performed a randomized, blind, placebo-controlled clinical trial in 90 healthy adults. Visual cues and electric shocks were used as the conditioned stimulus (CS) and unconditioned stimulus (US), respectively. The extinction effect was observed not in simple recall after the extinction of coupled CS-US, but was observed in the post-re-exposure phase after unexpected re-exposure to reinstatement CS-US coupling. Newly acquired conditioned fear was also eliminated or habituated by DCS and VPA administration, in line with previous findings. Furthermore, VPA facilitated the off-line learning process of conditioned fear extinction and habituation during sleep, while DCS facilitated this process during waking. These novel findings suggest that DCS and VPA might enhance exposure-based cognitive therapy for anxiety disorders and PTSD by reducing the vulnerability to reinstatement and preventing relapses of fear-conditioned responses, and provide evidence for a peculiarity of the sleep-dependent off-line learning process for conditioned fear extinction. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kuriyama, Kenichi; Honma, Motoyasu; Yoshiike, Takuya; Kim, Yoshiharu; Alhaider, Artola, Bredy, Bredy, Bryant, Carr, Casu, Chateauvieux, Chhatwal, Davis, Diekelmann, Fanselow, Foa, Gottlicher, Guastella, Guastella, Guzman-Marin, Hofmann, Hofmann, Jeon, Jornada, Kirkwood, Klotz, Kuriyama, Kuriyama, Kushner, Ledgerwood, Ledgerwood, LeDoux, Lee, Levenson, Li, Miller, Myers, Neir, Onur, Orr, Otto, Ou, Phillips, Quirk, Quirk, Rattiner, Ressler, Rosenberg, Rumpel, Santini, Sheth, Shin, Song, Stickgold, Tononi, Varga-Weisz, Vecsey, Walker, Wilder, Wilhelm, Yang",2013.0,,0,0,
8120,"Gender-specific effects of an augmented written emotional disclosure intervention on posttraumatic, depressive, and HIV-disease-related outcomes: A randomized, controlled trial.","Objective: Trauma histories and symptoms of PTSD occur at very high rates in people with HIV and are associated with poor disease management and accelerated disease progression. The authors of this study examined the efficacy of a brief written trauma disclosure intervention on posttraumatic stress, depression, HIV-related physical symptoms, and biological markers of HIV disease progression. Method: HIV-infected men and women were randomized to four 30-min expressive writing sessions in either a treatment (trauma writing) or an attention control (daily events writing) condition. The disclosure intervention augmented the traditional emotional disclosure paradigm with probes to increase processing by focusing on trauma appraisals, self-worth, and problem solving. Outcomes were assessed at baseline, 1-, 6-, and 12-month follow-up. Results: Hierarchical linear modeling (N = 244, intent-to-treat analyses) revealed no significant treatment effects for the group as a whole. Gender by treatment group interactions were significant such that women in the trauma-writing group had significantly reduced posttraumatic stress disorder (PTSD) symptoms (p = .017), depression (p = .009), and HIV-related symptoms (p = .022) compared with their controls. In contrast, men in the trauma-treatment condition did not improve more than controls on any outcome variables. Unexpectedly, men in the daily-event-writing control group had significantly greater reductions in depression then men in the trauma-writing group. Treatment effects were magnified in women when the analysis was restricted to those with elevated PTSD symptoms at baseline. Conclusions: A brief (4-session) guided written emotional disclosure intervention resulted in significant and meaningful reductions in PTSD, depression, and physical symptoms for women with HIV, but not for men. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ironson, Gail; O'Cleirigh, Conall; Leserman, Jane; Stuetzle, Rick; Fordiani, Joanne; Fletcher, MaryAnn; Schneiderman, Neil; Bisson, Bradley, Broderick, Brody, Bugg, Burack, Cepeda, Chard, Chida, Cole, Davidson, Davidson, Eisenberger, First, Foa, Frattaroli, Frisina, Gidron, Gidron, Gidron, Gillis, Gore-Felton, Hamilton, Hammill, Harris, Harris, Horowitz, Ickovics, Ironson, Ironson, Israelski, Kalichman, Kelley, Kemeny, Kemeny, Kimerling, Kimerling, Kraft, Leserman, Leserman, Leserman, Leserman, Leserman, Low, Lumley, Lumley, Mayne, McNair, Monson, Moskowitz, O'Cleirigh, O'Cleirigh, O'Cleirigh, O'Cleirigh, Pence, Pennebaker, Pennebaker, Pennebaker, Pennebaker, Pennebaker, Petrie, Raudenbush, Reisner, Resick, Resick, Resick, Resick, Richards, Rivkin, Rosenberg, Schoutrop, Sloan, Sloan, Smyth, Smyth, Smyth, Smyth, Stanton, Stanton, Temoshok, van Middendorp, Wagner, Warner, Whetten, Whetten, Willmott, Wyatt, Zlotnick",2013.0,,0,0,
8121,Cognitive change predicts symptom reduction with cognitive therapy for posttraumatic stress disorder.,"Objective: There is a growing body of evidence for the effectiveness of trauma-focused cognitive behavior therapy (TF-CBT) for posttraumatic stress disorder (PTSD), but few studies to date have investigated the mechanisms by which TF-CBT leads to therapeutic change. Models of PTSD suggest that a core treatment mechanism is the change in dysfunctional appraisals of the trauma and its aftermath. If this is the case, then changes in appraisals should predict a change in symptoms. The present study investigated whether cognitive change precedes symptom change in Cognitive Therapy for PTSD, a version of TF-CBT. Method: The study analyzed weekly cognitive and symptom measures from 268 PTSD patients who received a course of Cognitive Therapy for PTSD, using bivariate latent growth modeling. Results: Results showed that (a) dysfunctional trauma-related appraisals and PTSD symptoms both decreased significantly over the course of treatment, (b) changes in appraisals and symptoms were correlated, and (c) weekly change in appraisals significantly predicted subsequent reduction in symptom scores (both corrected for the general decrease over the course of therapy). Changes in PTSD symptom severity did not predict subsequent changes in appraisals. Conclusions: The study provided preliminary evidence for the temporal precedence of a reduction in negative trauma-related appraisals in symptom reduction during trauma-focused CBT for PTSD. This supports the role of change in appraisals as an active therapeutic mechanism. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kleim, Birgit; Grey, Nick; Wild, Jennifer; Nussbeck, Fridtjof W; Stott, Richard; Hackmann, Ann; Clark, David M; Ehlers, Anke; Baron, Beck, Beck, Bisson, Bradley, Brewin, Clark, Clark, Cohen, Dalgleish, DeRubeis, Duffy, Dunmore, Ehlers, Ehlers, Ehlers, Ehlers, Ehlers, Ehlers, Ehlers, First, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Gillespie, Hagenaars, Hoffart, Hofmann, Hofmann, Ilardi, Kazdin, King, Kraemer, Kraemer, MacDonald, McArdle, McArdle, Moser, Murphy, Muthen, Owens, Resick, Resick, Resick, Schnurr, Smith, Stein, Stewart, Stice, Strunk, Tang, Teachman, Vogele, Vogt",2013.0,,0,0,
8122,Patient characteristics and variability in adherence and competence in cognitive-behavioral therapy for panic disorder.,"Although associations with outcome have been inconsistent, therapist adherence and competence continues to garner attention, particularly within the context of increasing interest in the dissemination, implementation, and sustainability of evidence-based treatments. To date, research on therapist adherence and competence has focused on average levels across therapists. With a few exceptions, research has failed to address multiple sources of variability in adherence and competence, identify important factors that might account for variability, or take these sources of variability into account when examining associations with symptom change. Objective: (a) statistically demonstrate between- and within-therapist variability in adherence and competence ratings and examine patient characteristics as predictors of this variability and (b) examine the relationship between adherence/competence and symptom change. Method: Randomly selected audiotaped sessions from a randomized controlled trial of cognitive-behavioral therapy for panic disorder were rated for therapist adherence and competence. Patients completed a self-report measure of panic symptom severity prior to each session and the Inventory of Interpersonal Problems-Personality Disorder Scale prior to the start of treatment. Results: Significant between- and within-therapist variability in adherence and competence were observed. Adherence and competence deteriorated significantly over the course of treatment. Higher patient interpersonal aggression was associated with decrements in both adherence and competence. Neither adherence nor competence predicted subsequent panic severity. Conclusions: Variability and ""drift"" in adherence and competence can be observed in controlled trials. Training and implementation efforts should involve continued consultation over multiple cases in order to account for relevant patient factors and promote sustainability across sessions and patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Boswell, James F; Gallagher, Matthew W; Sauer-Zavala, Shannon E; Bullis, Jacqueline; Gorman, Jack M; Shear, M. Katherine; Woods, Scott; Barlow, David H; Aaronson, Barber, Barlow, Barlow, Barlow, Barlow, Bateman, Borkovec, Boswell, Castonguay, Castonguay, Castonguay, Clarkin, DeRubeis, Dozier, Fava, Gould, Henggeler, Hermesh, Hill, Horowitz, Houck, Huppert, Huppert, Imel, Kim, Kim, Mayne, McHugh, Meehan, Monsen, Newman, Owen, Pilkonis, Raudenbush, Ryle, Scarpa, Schoenwald, Sharpless, Shear, Singer, Snijders, Stiles, Stiles, Stiles, Tabachnick, Telch, Webb, White, White, White",2013.0,,0,0,
8123,Evaluation of the effects of venlafaxine and pregabalin on the carbon dioxide inhalation models of Generalised Anxiety Disorder and panic.,"Previous studies have shown that subjective and objective symptoms of anxiety induced by 7.5% CO2 inhalation can be attenuated by anxiolytics such as lorazepam and, to a lesser extent, paroxetine. Venlafaxine and pregabalin, two other licensed treatments for Generalised Anxiety Disorder, were used to further investigate the 7.5% and 35% CO2 models of anxiety in healthy volunteers. Fifty-four participants were randomised to receive either placebo, venlafaxine or pregabalin. Study treatments were dosed incrementally over a three week period, to reach daily doses of 150mg venlafaxine and 200mg pregabalin by the CO2 challenge test day. Participants inhaled air 7.5% CO2 for 20 minutes (single-blind presentation), and a non-blinded single vital capacity of 35% CO2. Subjective ratings were recorded before and after each inhalation. Both 7.5% and 35% CO2 inhalations produced the expected effects of increased ratings of symptoms of panic and anxiety, with increased blood pressure and heart rate. No significant treatment effects were found, although there were trends towards a reduction in feeling tense and nervous by both drugs compared with placebo during the 7.5% CO2 challenge, and a reduction in alertness generally in the venlafaxine group compared with the pregabalin group. In contrast with the clear anxiolytic effects of benzodiazepines reported in several previous CO2 studies, these findings suggest that the anxiogenic effects of CO2 challenges are not significantly influenced by these serotonergic and GABAergic anxiolytics. This may be due to a lack of sensitivity of the CO2 challenges in healthy volunteers to these drug types. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Diaper, Alison; Osman-Hicks, Victoria; Rich, Ann S; Craig, Kevin; Dourish, Colin T; Dawson, Gerard R; Nutt, David J; Bailey, Jayne E; Argyropoulos, Attwood, Bailey, Bailey, Bailey, Bailey, Bailey, Bailey, Bailey, Bailey, Baldwin, Bandelow, Bell, Bertani, Bertani, Clark, Cloninger, Cloninger, Coupland, Davidson, Davidson, Eysenck, Eysenck, File, Gee, Gorman, Holliday, Hood, Kelsey, Kessler, Kim, Liebowitz, Liebowitz, Lydiard, Meoni, Montgomery, Nardi, Nutt, Papadopoulos, Perna, Peterson, Pohl, Pollack, Pols, Reiss, Rickels, Rickels, Sanderson, Schruers, Seddon, Spielberger, Stahl, Tiihonen, Valenca, Valenca, Ying, Zwanzger",2013.0,,0,0,
8124,Cognitive-behavioral treatment for posttraumatic nightmares: An investigation of predictors of dropout and outcome.,"This study examined factors predicting treatment dropout and outcome in 124 male Vietnam War veterans with chronic, severe posttraumatic stress disorder treated in a randomized controlled trial of two cognitive-behavioral group therapies for combat-related nightmares. Though significant bivariate predictors of dropout in the imagery rehearsal condition included non-African American race, use of selective serotonin reuptake inhibitors, more traumas, and lower perceived treatment credibility, none of these variables uniquely predicted dropout in multivariate analyses. In the sleep and nightmare management condition, only low avoidance symptoms predicted dropout. Use of benzodiazepines and higher reexperiencing symptoms predicted posttreatment nightmare frequency in imagery rehearsal; although baseline sleep quality and higher avoidance symptoms predicted posttreatment sleep quality. In sleep and nightmare management, only poorer sleep quality predicted posttreatment nightmares, although poorer baseline sleep quality and higher avoidance symptoms predicted posttreatment sleep quality. Practical and clinical implications, including the use of ""socialization"" strategies (e.g., patient testimonials, in-depth explanation of treatment rationale), are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cook, Joan M; Thompson, Richard; Harb, Gerlinde C; Ross, Richard J; Blake, Borkovec, Bryant, Buysse, Byers, Carpenter, Cook, Davis, Davis, Davis, Devilly, Elliott, First, Forbes, Galovski, Germain, Germain, Green, Harb, Hembree, Hembree, Hosmer, Keane, Krakow, Krakow, Krakow, Krakow, Laffaye, Lester, Levin, Long, Lu, Lund, Moore, Morin, Nappi, Nappi, Neylan, Okajima, Ong, Rosenheck, Ross, Spoormaker, Swanson, Tarrier, Tarrier, Taylor, Taylor, Ulmer, Van der Kolk, van Minnen, Wells, Wittmann, Zadra, Zayfert, Zoellner",2013.0,,0,0,
8125,Predictors of treatment satisfaction among older adults with anxiety in a primary care psychology program.,"Increasing numbers of patients are treated in integrated primary care mental health programs. The current study examined predictors of satisfaction with treatment in patients from a randomized clinical trial of late-life generalized anxiety disorder (GAD) in primary care. Higher treatment satisfaction was associated with receiving CBT rather than enhanced usual care. Treatment credibility, treatment expectancies, social support, and improvements in depression and anxiety symptoms predicted higher treatment satisfaction in the total sample. In the CBT group, only credibility and adherence with treatment predicted satisfaction. This suggests that older patients receiving CBT who believe more strongly in the treatment rationale and follow the therapist's recommendations more closely are likely to report satisfaction at the end of treatment. In addition, this study found that adherence mediated the relationship between treatment credibility and treatment satisfaction. In other words, patients' perceptions that the treatment made sense for them led to greater treatment adherence which then increased their satisfaction with treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hundt, Natalie E; Armento, Maria E. A; Porter, Bennett; Cully, Jeffrey A; Kunik, Mark E; Stanley, Melinda; Akkerman, Ankuta, Attkisson, Beck, Bollen, Borkovec, Burgmer, Calsyn, Chen, Cleary, Constantino, Corrigan, Deane, Dearing, Devilly, DiMatteo, Dozois, Druss, Dryden, Festinger, First, Fitzpatrick, Garland, Green, Greenfield, Hansson, Hasler, Hawkins, Karlin, Katon, Katon, Kraemer, Lambert, Larsen, Lee, Linder-Pelz, Lippens, Meyer, Preacher, Propst, Rollman, Roy-Byrne, Roy-Byrne, Segal, Stanley, Stanley, Stanley, Stanley, Sun, Unutzer, Ware, Wetherell, Wetherell, Wetherell, Whisman, Williams, Wolitzky-Taylor, Zimet, Zimet",2013.0,,0,0,
8126,"Effect of telehealth on quality of life and psychological outcomes over 12 months (Whole Systems Demonstrator telehealth questionnaire study): Nested study of patient reported outcomes in a pragmatic, cluster randomised controlled trial.","Objective: To assess the effect of second generation, home based telehealth on health related quality of life, anxiety, and depressive symptoms over 12 months in patients with long term conditions. Design: A study of patient reported outcomes (the Whole Systems Demonstrator telehealth questionnaire study; baseline n = 1573) was nested in a pragmatic, cluster randomised trial of telehealth (the Whole Systems Demonstrator telehealth trial, n = 3230). General practice was the unit of randomisation, and telehealth was compared with usual care. Data were collected at baseline, four months (short term), and 12 months (long term). Primary intention to treat analyses tested treatment effectiveness; multilevel models controlled for clustering by general practice and a range of covariates. Analyses were conducted for 759 participants who completed questionnaire measures at all three time points (complete case cohort) and 1201 who completed the baseline assessment plus at least one other assessment (available case cohort). Secondary per protocol analyses tested treatment efficacy and included 633 and 1108 participants in the complete case and available case cohorts, respectively. Setting: Provision of primary and secondary care via general practices, specialist nurses, and hospital clinics in three diverse regions of England (Cornwall, Kent, and Newham), with established integrated health and social care systems. Participants: Patients with chronic obstructive pulmonary disease (COPD), diabetes, or heart failure recruited between May 2008 and December 2009. Main outcome measures: Generic, health related quality of life (assessed by physical and mental health component scores of the SF-12, and the EQ-5D), anxiety (assessed by the six item Brief State-Trait Anxiety Inventory), and depressive symptoms (assessed by the 10 item Centre for Epidemiological Studies Depression Scale). Results: In the intention to treat analyses, differences between treatment groups were small and non-significant for all outcomes in the complete case (0.480 <= P <= 0.904) or available case (0.181 <= P <= 0.905) cohorts. The magnitude of differences between trial arms did not reach the trial defined, minimal clinically important difference (0.3 standardised mean difference) for any outcome in either cohort at four or 12 months. Per protocol analyses replicated the primary analyses; the main effect of trial arm (telehealth v usual care) was non-significant for any outcome (complete case cohort 0.273 <= P <= 0.761; available case cohort 0.145 <= P <= 0.696). Conclusions: Second generation, home based telehealth as implemented in the Whole Systems Demonstrator Evaluation was not effective or efficacious compared with usual care only. Telehealth did not improve quality of life or psychological outcomes for patients with chronic obstructive pulmonary disease, diabetes, or heart failure over 12 months. The findings suggest that concerns about potentially deleterious effect of telehealth are unfounded for most patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cartwright, Martin; Hirani, Shashivadan P; Rixon, Lorna; Beynon, Michelle; Doll, Helen; Bower, Peter; Bardsley, Martin; Steventon, Adam; Knapp, Martin; Henderson, Catherine; Rogers, Anne; Sanders, Caroline; Fitzpatrick, Ray; Barlow, James; Newman, Stanton P; Whole Systems Demonstrator evaluation team; Allison, Andresen, Anker, Antonicelli, Barlow, Bartoli, Bensink, Boey, Bolton, Bower, Bowling, Chaudhry, Chaudhry, Christensen, Chumbler, Ciechanowski, Clark, Clarke, Cohen, Davies, Dawson, Doblhammer, Eborall, Ekeland, Eldridge, Engstrom, Ferrer, Gibbons, Glasgow, Greenhalgh, Henderson, Heo, Heritier, Higgins, Inglis, Jansa, Jenkinson, Katsura, Klimidis, Koehler, Konstam, Lesman-Leegte, Little, Lloyd, Mackintosh, Maljanian, Mancuso, Maric, Marteau, Martinez, Maurer, McLean, Mikkelsen, Moussavi, Perpina-Galvan, Peyrot, Pickard, Piette, Polisena, Polisena, Polisena, Putman-Casdorph, Rabin, Ramaekers, Regan, Rice, Robine, Rodriguez-Artalejo, Rogers, Rutledge, Sanders, Schafer, Schafer, Schmidt, Seibert, Sood, Spillman, Steventon, Van Manen, Ware, Whitlock, Yohannes",2013.0,,0,0,
8127,An evaluation of the effects of diagnostic composition on individual treatment outcome within transdiagnostic cognitive-behavioral group therapy for anxiety.,"Recently, studies have supported the efficacy of treating anxiety disorders utilizing a transdiagnostic, or non-diagnosis-specific, framework (Erickson, D. H. (2003). Group cognitive behavioural therapy for heterogeneous anxiety disorders. Cognitive Behaviour Therapy, 32, 179-186; Garcia, M. S. (2004). Effectiveness of cognitive-behavioural group therapy in patients with anxiety disorders. Psychology in Spain, 8, 89-97; Norton, P. J., & Hope, D. A. (2005). Preliminary evaluation of a broad-spectrum cognitive-behavioral group therapy for anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 36, 79-97). Transdiagnostic group treatment packages focus on the common aspects inherent across the anxiety disorders such as behavioral and cognitive avoidance, and faulty cognitive appraisals of threat potential or meaning (Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205-230). Although research supports the overall efficacy of transdiagnostic cognitive behavior therapy (CBT) for anxiety disorders (Norton, P. J., & Philipp, L. M. (2008). Transdiagnostic approaches to the treatment of anxiety disorders: A quantitative review. Psychotherapy: Theory, Research, Practice and Training, 45, 214-226), the effect of diagnostically mixed group composition on individual outcomes is less clear. This study investigated the relationship between group composition and treatment outcome within diagnostically heterogeneous groups with the purpose of determining if diagnostic heterogeneity differentially impacted treatment outcome for 84 individuals during a 12-week transdiagnostic cognitive-behavioral group anxiety treatment program (Norton, P. J. (2012a). Group cognitive-behavioral therapy of anxiety: A transdiagnostic treatment manual. New York: Guilford). The diagnostic makeup of the treatment group was examined at the beginning of treatment and at the end of treatment, and the results indicated that the diagnostic makeup of the treatment group had no significant impact on individual treatment outcome. These findings have direct implications for the delivery of transdiagnostic treatments, and are discussed in terms of their global implications for the transdiagnostic approach to the treatment of anxiety disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Chamberlain, Lance D; Norton, Peter J; Barlow, Brown, Dugas, Ellard, Erickson, Erickson, Erickson, Faul, Garcia, Hedeker, Heimberg, Heimberg, Hollon, Mansell, McEvoy, McLean, Norton, Norton, Norton, Norton, Norton, Norton, Norton, Norton, Norton, Resick, Rutan, Spielberger, Telch, Vinogradov, Yalom",2013.0,,0,0,
8128,Work outcomes and their predictors in the Redesigning Daily Occupations (ReDO) rehabilitation programme for women with stress-related disorders.,"Background/Aim: Previous research has shown that the Redesigning Daily Occupations programme reduced the degree of sick leave and increased return to work rates among women on sick leave for stress-related disorders when compared with ""care as usual"". To further investigate the Redesigning Daily Occupations intervention, this study explored changes in the work situation from baseline to a 12-month follow-up in the Redesigning Daily Occupations group compared with the ""care as usual"" group and analysed any predictors of change. Methods: A matched-control design was used and 84 women were recruited. Objective (return to work and sick leave) and subjective work outcomes (perceptions of the worker role and the work environment) were explored. Potential predictors were clinical and demographic variables and an anxiety-depression factor. Results: In both groups, large positive effect sizes from baseline to follow-up were found regarding the objective outcomes, a moderate positive effect size was found for perceived work environment, whereas perceived worker role remained unaffected. Previous work rehabilitation predicted objective work outcomes in both groups. Higher education and older age were predictors of subjective outcomes in the Redesigning Daily Occupations group, whereas a more severe anxiety-depression rating was negative for work environment ratings in the ""care as usual"" group. Conclusions: Return to work seemed possible without a change in the women's perceptions of the worker role; rather they renegotiated their view of the work environment. The Redesigning Daily Occupations programme was found to be promising, with a positive effect on return to work and sick leave reduction. It seemed more suitable for the higher educated and older women. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Eklund, Mona; Wastberg, Birgitta A; Erlandsson, Lena-Karin; Altman, Bjelland, Blonk, Brouwers, Clark, Cohen, de Vente, Ekbladh, Eklund, Erlandsson, Erlandsson, Erlandsson, Erlandsson, Forsyth, Hansen, Jackson, Karlson, Kielhofner, Kielhofner, Lander, Persson, Schene, Stenlund, Uegaki, van der Klink, van der Klink, van Oostrom, Wallstedt-Paulsson, Wampold, Wastberg, Wastberg, Wastberg, Zigmond",2013.0,,0,0,
8129,Tachikawa Project for Prevention of Posttraumatic Stress Disorder with Polyunsaturated Fatty Acid (TPOP): Study protocol for a randomized controlled trial.,"Background: Preclinical and clinical studies suggest that supplementation with omega-3 fatty acids after trauma might reduce subsequent posttraumatic stress disorder (PTSD). To date, we have shown in an open trial that PTSD symptoms in critically injured patients can be reduced by taking omega-3 fatty acids, hypothesized to stimulate hippocampal neurogenesis. The primary aim of the present randomized controlled trial is to examine the efficacy of omega-3 fatty acid supplementation in the secondary prevention of PTSD following accidental injury, as compared with placebo. This paper describes the rationale and protocol of this trial. Methods/design: The Tachikawa Project for Prevention of Posttraumatic Stress Disorder with Polyunsaturated Fatty Acid (TPOP) is a double-blinded, parallel group, randomized controlled trial to assess whether omega-3 fatty acid supplementation can prevent PTSD symptoms among accident-injured patients consecutively admitted to an intensive care unit. We plan to recruit accident-injured patients and follow them prospectively for 12 weeks. Enrolled patients will be randomized to either the omega-3 fatty acid supplement group (1,470 mg docosahexaenoic acid and 147 mg eicosapentaenoic acid daily) or placebo group. Primary outcome is score on the Clinician-Administered PTSD Scale (CAPS). We will need to randomize 140 injured patients to have 90% power to detect a 10-point difference in mean CAPS scores with omega-3 fatty acid supplementation compared with placebo. Secondary measures are diagnosis of PTSD and major depressive disorder, depressive symptoms, physiologic response in the experiment using script-driven imagery and acoustic stimulation, serum brain-derived neurotrophic factor, health-related quality of life, resilience, and aggression. Analyses will be by intent to treat. The trial was initiated on December 13 2008, with 104 subjects randomized by November 30 2012. Discussion: This study promises to be the first trial to provide a novel prevention strategy for PTSD among traumatized people. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Matsuoka, Yutaka; Nishi, Daisuke; Yonemoto, Naohiro; Hamazaki, Kei; Matsumura, Kenta; Noguchi, Hiroko; Hashimoto, Kenji; Hamazaki, Tomohito; Ando, Asukai, Asukai, Baker, Beltz, Blake, Bligh, Brewin, Brunet, Bryant, Buss, Calderon, Connor, Ehlers, Feng, Folstein, Freeman, Fukuhara, Gil, Hamanaka, Hamazaki, Hepp, Hibbeln, Hibbeln, Hoge, Itomura, Kawakita, Kitamura, Kobayashi, Krug, Kugaya, Lin, MacKenzie, Martins, Martins, Matsumura, Matsuoka, Matsuoka, Matsuoka, Matsuoka, Matsuoka, Matsuoka, McHorney, Montgomery, Nishi, Nishi, Noaghiul, O'Donnell, O'Donnell, Oken, Orr, Otsubo, Ozer, Pitman, Pitman, Ressler, Ross, Sawazaki, Schnyder, Schnyder, Schnyder, Scott, Shalev, Sheehan, Squire, Sublette, Suzuki, Takahashi, Teasdale, Tsubono, Tsugane, Tucker, Vaiva, Venna, Verger, Ware, Weiss, Wu, Zigmond",2013.0,,0,0,
8130,A randomized controlled open-label study of right and left lateral EEG biofeedback treatment of generalized anxiety disorder.,"Objective: The objective of this research is to investigate the effects of electroencephalogram (EEG) biofeedback training of alpha activity over the parietal lobe in patients with generalized anxiety disorder (GAD), and to compare the effects of training of alpha activity over the left parietal lobe and right parietal lobe in patients with GAD. Methods: Twenty-six female patients with GAD according to the Diagnostic and Statistical Manual of Mental Disorders (4th edition, DSM-IV) criteria for GAD were included in this study, and these patients were randomized into two groups: the left parietal lobe training group (n = 13) and the right parietal lobe training group (n = 13). Patients received a total of 10 times training, in which each training consisted of a 40 minutes training session every three days. The degree of anxiety, depression and insomnia symptoms before the first time training, after the fifth time training and after the last time training were evaluated using the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI-II) and Insomnia Severity Index (ISI). Results: In the left parietal lobe training group, the scores of STAI-S[(38.7 +/- 8.8), (35.2 +/- 9.2) vs. (47.2 +/- 10.7), P < 0.05] and ISI [(13.0 +/- 5.2), (8.4 +/- 4.7) vs. (17.5 +/- 5.3), P < 0.05.] decreased after 5 and 10 times of training. In the right parietal lobe training group, the scores of STAI-S[(37.3 +/- 6.4), (29.9 +/- 6.2) vs. (44.9 +/- 12.4), P < 0.05], STAI-T[ (40.9 +/- 6.4), (36.9 +/- 6.9) vs. (47.8 +/- 7.5), P < 0.05] and ISI [(10.2 +/- 5.1), (6.9 +/- 3.1) vs. (15.5 +/- 6.9), P < 0.05] decreased after 5 and 10 times of training. The BDI-II scores [(10.3 +/- 6.0) vs. (17.7 +/- 7.2), P < 0.05] decreased after 10 times of training. Conclusion: Our findings suggest that EEG biofeedback training of alpha activity over the parietal lobe could improve the anxiety and insomnia symptom in patients with GAD. EEG biofeedback training of alpha activity over the right parietal lobe could also improve their anxiety trait and depressive symptom. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hou, Yue; Wang, Yu-Ping; Zhan, Shu-Qin; Li, Ning; Huang, Zhao-Yang; Wang, Li; Bar-Haim, Bastien, Duffy, Fan, Hardt, Hurley, Isotani, Johnson, Michael, Ohayon, Posner, Schwartz",2013.0,,0,0,
8131,The effect of educational audiotape programme on anxiety and depression in patients undergoing coronary artery bypass graft.,"Aims and objectives: To investigate use of educational audiotape programme on anxiety and depression in patients undergoing coronary artery bypass graft (CABG). Background: Anxiety and depression after CABG are the most common complications, having a negative impact on the prognosis of heart disease, leading to special needs according to their new physical and mental conditions. Design: Randomised clinical trial. Methods: This study conducted in Iran, 70 patients undergoing CABG were included and divided into two equal groups, the control group and intervention group. They were followed up for six weeks. An audiotape educational programme was given to the intervention group after surgery in addition to the routine training. But patients in the control group received only routine training. Anxiety and depression were assessed by Hospital Anxiety and Depression Scale, a standardised questionnaire for anxiety and depression. Data were collected before and six weeks after the intervention. For the comparison of mean scores between the groups, the data were analysed in SPSS, version 16, using independent T-test and paired T-test. Results: The mean scores obtained in both anxiety and depression dimensions were significantly different between the intervention and control groups. Conclusions: Audiotape educational programme used by patients undergoing CABG decreases the level of their anxiety and depression after cardiac surgery. Relevance to clinical practice: The most significant finding was the importance of audiotape educational programme to meet the needs of the CABG patients, which suggest that patient education through audiotape can be effective in self-care after heart surgery and nurses can use an audiotape containing preparatory information to improve outcomes and reduce anxiety and depression in patients having CABG. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hoseini, Shirzad; Soltani, Fahimeh; Babaee Beygi, Mohammadali; Zarifsanaee, Nahid; Adib, Alison, Ameli, Beiraghi, Brugemann, Davies, Dijk, Eisenberg, Fredricks, Ghafari, Hemingway, Herrmann, Jalili, Kurlansky, Mahoori, Mohamadi, Montazeri, Moore, Moser, Rafiee, Rozanski, Sabzmakan, Sadeghi, Safabakhsh, Shoul, Stafford, Tsai, Utriyaprasit, Zigmond",2013.0,,0,0,
8132,Anxiety sensitivity and interoceptive exposure: A transdiagnostic construct and change strategy.,"Recent findings support the relevance of anxiety sensitivity (AS) and interoceptive exposure (IE) across emotional disorders. This study (a) evaluated levels of AS across different anxiety disorders, (b) examined change in AS over the course of transdiagnostic psychological intervention, and its relationship with outcome, and (c) described the implementation of IE to address AS with patients with different anxiety disorders. Participants (N = 54) were patients who received treatment with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) in two consecutive treatment trials. Participants completed a measure of AS at pre- and posttreatment, and multiple occasions during treatment. Symptom severity was assessed at pre- and posttreatment, and clinical information related to physical symptoms and IE were collected as part of routine clinical practice. Elevated AS was observed at pretreatment across diagnoses and decreases in AS were observed from pre- to posttreatment. Similar changes occurred across the diagnostic categories, notably coinciding with the introduction of IE. Change in AS was correlated with reduced symptom levels at posttreatment and 6-month follow-up. Patients with different anxiety disorders endorsed similar physical symptoms and practiced similar IE exercises with similar effects. Results provide preliminary support for the usefulness of IE as a treatment strategy across the spectrum of anxiety disorders, and additional support for the transdiagnostic relevance of AS. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Boswell, James F; Farchione, Todd J; Sauer-Zavala, Shannon; Murray, Heather W; Fortune, Meghan R; Barlow, David H; Antony, Baillie, Bandura, Barlow, Barlow, Barlow, Barlow, Beck, Borkovec, Boswell, Bouton, Bouton, Brown, Brown, Carl, Clark, Craske, Craske, Craske, Dempster, DiNardo, Do, Ellard, Enders, Enders, Fairburn, Farchione, Foa, Goodwin, Hayes, Heimberg, Hope, Houck, Little, McConnaughy, McHugh, McNally, McNally, Meuret, Mineka, Naragon-Gainey, Norton, Peterson, Reed, Reiss, Reiss, Reiss, Reiss, Reiss, Salkovskis, Sauer-Zavala, Schafer, Schmidt, Schmidt, Shear, Simon, Taylor, Vujanovic, Wald, Wald, Wald",2013.0,,0,0,
8133,Brief alcohol counseling improves mental health functioning in veterans with alcohol misuse: Results from a randomized trial.,"Background: Alcohol misuse occurs at high rates among U.S. Military Veterans presenting to primary care and is linked to numerous negative social and health consequences. The Veterans Health Administration has recently implemented brief alcohol interventions (BAI) in VA primary care settings. An emerging literature suggests that BAIs that target alcohol consumption may also have secondary health benefits such as reducing symptoms of depression and anxiety in civilian samples. The present study sought to examine whether secondary health benefits of BAIs observed in civilians generalize to a sample of alcohol misusing Veterans presenting to primary care. Methods: Veterans (N = 167) screening positive for alcohol misuse during a routine primary care visit were randomized to receive treatment-as-usual (TAU) or TAU plus a web-delivered BAI. Assessment of overall mental health functioning, posttraumatic stress disorder, and depression occurred at baseline, three- and six-month post-treatment. Results: Veterans receiving both BAI protocols demonstrated significant improvements in mental health functioning, depressive symptoms, and use of approach coping from baseline to six-month follow-up. No differential treatment effects on these outcomes were observed. Limitations: Findings are limited by the lack of a no-treatment control group, and the potential impact of regression to the mean and assessment effects on outcomes. Conclusions: Our findings replicate prior studies suggesting that a single-dose BAI may have some secondary mental health benefits for Veterans presenting to primary care with alcohol misuse. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cucciare, Michael A; Boden, Matthew Tyler; Weingardt, Kenneth R; Ames, Babor, Baker, Bliese, Bradley, Bradley, Cucciare, Cucciare, Cucciare, Finney, Fleming, Fleming, Fleming, Hawkins, Hester, Hruska, Jakupcak, Kay-Lambkin, Kypri, Lapham, Lemke, Marshall, McDonald, Moggi, Moos, Moos, Mukamal, Neighbors, Randall, Spitzer, Ware, Ware, Weathers, Williams, Wilton",2013.0,,0,0,
8134,A pilot randomized controlled trial of an early multidisciplinary model to prevent disability following traumatic injury.,"Purpose: Chronic pain, posttraumatic stress disorder (PTSD), and depression are common outcomes following traumatic injury. Yet, screening and early intervention to prevent the onset of these disorders do not occur routinely in acute trauma settings. This pilot study examined the clinical utility of screening and early multidisciplinary intervention for reducing disability following traumatic injury. Method: 142 non-severe head injured trauma inpatients (26% female, Injury Severity Score M = 9.65, M age = 36 years) were assessed for injury-related factors, pain, and psychological function within 4 weeks post injury. Patients were randomly allocated to a Multidisciplinary Intervention (MI) or Usual Care (UC) group. MI patients received assessment and treatment at one and 3 months post injury from pain and rehabilitation medicine doctors, physiotherapists, occupational therapists, and clinical psychologists. Outcomes at 6 months were then compared. Results: Acute pain intensity, posttraumatic adjustment, depression and acute trauma symptoms, and alcohol use predicted a significant 26%, 49%, 56%, and 30% of the variance in pain, depressive, and PTSD severity, and physical mobility respectively at 6 months. Despite MI group patients reporting no improvement in the severity of pain and psychological symptoms, these patients reported significantly improved relief from pain symptoms as a result of treatment at 6 months. Twenty four per cent of the UC group initially below the cut-off for being at risk of developing PTSD/Depression received new clinical diagnoses at 6 months compared with none of the 'not at risk' MI group attendees who remained asymptomatic. Conclusions: Early findings point to the value of early screening to identify patients at risk of treatable pain, physical, and psychological impairments. Moreover, early multidisciplinary intervention models following traumatic injury show promise for protecting against the onset of posttraumatic psychological disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Browne, Allyson L; Appleton, Sally; Fong, Kim; Wood, Fiona; Coll, Fiona; de Munck, Sonja; Newnham, Elizabeth; Schug, Stephan A; Benight, Berg, Berg, Blanchard, Brewin, Brewin, Bryant, Bryant, Bryant, Butland, Cahalin, Castillo, Cho, Clay, Cleeland, Coffey, Corry, Edwards, Evans, Finlay, Foa, Freynhagen, Granger, Greenberg, Holbrook, Holbrook, Holmes, Jacobsen, Jenewein, Jenewein, Karjalanein, Kendall, Kerns, Lecrubier, Lee, Liedl, Linacre, Lyness, MacKenzie, Mason, Mayou, McFarlane, McLean, McNally, Michaels, Miyamoto, Montgomery, Norman, O'Donnell, Otis, Radloff, Ravaud, Roberts, Roelofs, Rothenhausler, Ruggiero, Saunders, Schug, Shalev, Sharp, Sheehan, Shirao, Solomon, Ware, Weathers, Williamson, Zatzick, Zeckey",2013.0,,0,0,
8135,Effectiveness of a cognitive behavioural group therapy (CBGT) for social anxiety disorder: Immediate and long-term benefits.,"This study examines the effectiveness of a group CBT (CBGT) intervention in reducing a variety of symptoms and problem areas associated with social anxiety disorder. A longitudinal cohort design assessed changes in standardized psychological scales assessing general mood and specific aspects of social anxiety. Questionnaires were completed pre-programme (time 1, n = 252), post-programme (time 2, n = 202), and at 12 months follow-up (time 3, n = 93). A consistent significant pattern was found for all variables: pre-intervention scores were significantly higher than both post-intervention scores and 12-month follow-up scores. Large effect sizes were found and rates of clinical significant changes varied, with over half of the participants recording clinically significant changes in general mood. Individual CBT can be translated successfully into a group format for social anxiety. Given the high completion rate, the intervention is acceptable to participants, feasible, and effective in a routine clinical service. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","McCarthy, Odhran; Hevey, David; Brogan, Amy; Kelly, Brendan D; Beck, Beck, Bjornsson, Brown, Chambless, Chambless, Clark, Clark, Coles, de Wit, Ehlers, Evans, Faytout, Fedoroff, Feske, Gaston, Gould, Heimberg, Heimberg, Issakidis, Jacobson, Kessler, Killaspy, Mattick, McEvoy, Mortberg, Oei, Richards, Rodebaugh, Sato, Scholing, Stangier, Steketee, Taube-Schiff, Taylor, Wells",2013.0,,0,0,
8136,A randomized trial of two forms of cognitive behaviour therapy for an older adult population with subclinical health anxiety.,"Seniors have been consistently under-represented in the health anxiety treatment literature. The aim of this study was to test the efficacy of a six-session enhanced cognitive behaviour therapy (ECBT) programme for subclinical health anxiety in seniors, and to examine whether the programme fostered therapeutic alliance and motivation for psychotherapy as compared to a standard cognitive behavioural therapy (SCBT) programme and wait-list control (WLC). Fifty-seven seniors with subclinical health anxiety were randomly assigned to six weeks of SCBT, ECBT, or WLC. At pre-treatment, post-treatment, and three-month follow-up, participants completed questionnaires on health anxiety and its dimensions, and other related psychological constructs. Therapeutic alliance and motivation measures were completed after Sessions 1, 3, and 6. At post-treatment, participants in the SCBT and ECBT groups showed significantly lower health anxiety when compared to WLC, with reductions on the subscale measuring disease fear/phobia. Significantly, more participants in the SCBT (66.7%) and ECBT (55.6%) conditions demonstrated clinically significant change on health anxiety compared to the WLC condition (11%). Gains were maintained at three months. There were minimal differences found between the SCBT and ECBT groups on therapeutic alliance and motivation. The findings indicated that both forms of CBT were efficacious for reducing some of the health anxious thoughts and beliefs in seniors. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bourgault-Fagnou, Michelle D; Hadjistavropoulos, Heather D; Adams, Alberts, Asmundson, Barsky, Barsky, Barsky, Barsky, Barsky, Beaber, Boston, Bourgault-Fagnou, Brink, Byers, Dennis, Dugas, Ferguson, Greeven, Hadjistavropoulos, Hanback, Hedman, Hiller, Horvath, Jacobson, Kehler, Keijsers, Mohlman, Mohlman, Pilowsky, Rode, Salkovskis, Salkovskis, Schulz, Seivewright, Snyder, Sorensen, Spielberger, Stanley, Stanley, Tabachnick, Tang, Taylor, Taylor, Tracey, Tyrer, van Breukelen, Vickers, Vranceanu, Westen, Wetherall, Yesavage",2013.0,,0,0,
8137,Effectiveness of deep transcranial magnetic stimulation combined with a brief exposure procedure in post-traumatic stress disorder-A pilot study.,"Background: Post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder induced by traumatic experiences. To date, psychotherapy and drug treatment achieve only partial success, indicating need for further development of treatment strategies. Recent research has found that impaired acquired fear extinction capability serves as an important factor at the pathogenesis of the disorder. Medial prefrontal cortex (mPFC) hypo-activity has been implicated in this extinction impairment, providing insight as to why some trauma exposed individuals will develop PTSD. Objective: To test whether fear extinction can be facilitated and therapeutic effect achieved by repeated mPFC deep transcranial magnetic stimulation (DTMS) of PTSD patients resistant to standard treatment. Methods: In a double-blind study, 30 PTSD patients were enrolled and randomly assigned into 3 treatment groups: A) DTMS after brief exposure to the traumatic event with the script-driven imagery procedure; B) DTMS after brief exposure to a non-traumatic event; C) sham stimulation after brief exposure to the traumatic event. Results: Significant improvement was demonstrated in the intrusive component of the CAPS scale in patients administered DTMS after exposure to the traumatic event script, while patients in the control groups showed no significant improvement. Similar trend was demonstrated in the Total-CAPS score as in the other rating scales. A significant reduction in the HR response to the traumatic script was evident in group A, further supporting the above results. Conclusions: Combining brief script-driven exposure with DTMS can induce therapeutic effects in PTSD patients. A wide multi-center study is suggested to substantiate these findings. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Isserles, Moshe; Shalev, Arieh Y; Roth, Yiftach; Peri, Tuvia; Kutz, Ilan; Zlotnick, Elad; Zangen, Abraham; Baek, Bisson, Blake, Boggio, Choi, Cohen, Davidson, Foa, Francati, Harel, Isserles, Kennedy, Kessler, Kessler, Koenigs, LeDoux, Levkovitz, Levkovitz, Levkovitz, Lindauer, Milad, Milad, O'Reardon, Osuch, Pitman, Quirk, Quirk, Quirk, Roth, Roth, Shalev, Shin, Stein, Watts, Zangen",2013.0,,0,0,
8138,Alcohol use biomarkers predicting cognitive performance: A secondary analysis in veterans with alcohol dependence and posttraumatic stress disorder.,"Objective: We conducted a secondary analysis of baseline data from a recently completed pharmacological pilot clinical trial among 30 veterans with alcohol dependence and posttraumatic stress disorder (PTSD). This trial included baseline measures of alcohol use biomarkers, both indirect (carbohydrate-deficient transferrin, GGT [gamma-glutamyltransferase], mean corpuscular volume, AST [aspartate aminotransferase], alanine aminotransferase) and direct (ethyl glucuronide, ethyl sulfate), as well as neurocognitive measures (Trail Making Test parts A and B, Hopkins Verbal Learning Test-Revised, Balloon Analogue Risk Task, Delay Discounting Task). Methods: Two regression models were estimated and tested for each neurocognitive measure (dependent measure). The first model included the alcohol use biomarker alone as the predictor. The second model included the alcohol use biomarker along with the following 3 additional predictors: Beck Depression Inventory, Clinician-Administered PTSD Scale, and receiving medications. Results: In both models, the indirect biomarkers, such as GGT and AST, significantly predicted performance on the Hopkins Verbal Learning Test-Revised %Retention. GGT alone significantly predicted performance on the Trail Making Test part A. Conclusions: Indirect alcohol use biomarkers may have a specific role in identifying those veterans with alcohol dependence and PTSD who have impaired cognitive performance. However, direct alcohol use biomarkers may not share such a role. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kalapatapu, Raj K; Delucchi, Kevin L; Lasher, Brooke A; Vinogradov, Sophia; Batki, Steven L; Altman, Arria, Bates, Beck, Blake, Bowen, Brandt, Brust, Carter, Chen, Cohen, Copersino, Copersino, Danon, de Bruin, Dick, Everett, Fals-Stewart, Fals-Stewart, Field, Field, First, Fontana, Gotlib, Horner, Ingall, Irwin, Jacobsen, Junghanns, Kalapatapu, Kirby, Lejuez, MacCallum, Maes, McCauley, Moore, Noel, O'Mahony, Pettinati, Pfefferbaum, Qureshi, Rehm, Richardson, Schafer, Schrimsher, Shah, Shelton, Smith, Sobell, Stavro, Stetter, Subramanian, Tarter, Tombaugh, Van Thriel, Wain, Walton, Wurst, Yavuz",2013.0,,0,0,
8139,Randomized trial on the effectiveness of long- and short-term psychotherapy on psychiatric symptoms and working ability during a 5-year follow-up.,"Background: The information on whether long-term psychotherapy is superior in comparison with short-term therapies during a long time-perspective in the treatment of mood and anxiety disorder is incomplete. Aims: The present study addresses this question in a clinical trial with an exceptionally long follow-up. Methods: In the Helsinki Psychotherapy Study, 326 outpatients with mood or anxiety disorder were randomly assigned to long-term psychodynamic psychotherapy and two types of short-term psychotherapy (short-term psychodynamic psychotherapy and solution-focused therapy) and were followed up for 5 years from the start of treatment. The outcome measures were psychiatric symptoms measured by Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), Symptom Check List, anxiety scale (SCL-90-Anx), Hamilton Anxiety Rating Scale (HARS) and Symptom Check List, Global Severity Index (SCL-90-GSI), and working ability measured by the Work Ability Index (WAI), the Work-subscale (SAS-Work) of the Social Adjustment Scale (SAS-SR) and the Perceived Psychological Functioning Scale (PPF). Furthermore, remission variables based on changes in psychiatric symptoms and use of auxiliary treatment, were used. Results: After the 5-year follow-up, the rate of recovery from psychiatric symptoms and the work ability improvement rate remained higher in the long-term therapy group, whereas no differences in the effectiveness of the two short-term therapies of different modalities were found. Conclusions: Long-term psychotherapy is more effective than short-term therapy during a long follow-up, suggesting the need for a careful evaluation of suitability to short-term therapy. More research on the long-term effects of psychotherapy in large-scale studies is still needed, however. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Knekt, Paul; Lindfors, Olavi; Sares-Jaske, Laura; Virtala, Esa; Harkanen, Tommi; Beck, Bhar, Busch, Cape, Cuijpers, Cuijpers, de Maat, de Shazer, Derogatis, Driessen, Gabbard, Graubard, Greenland, Hamilton, Hamilton, Hensing, Harkanen, Judd, Knekt, Knekt, Knekt, Knekt, Knekt, Lee, Lehtinen, Leichsenring, Leichsenring, Leichsenring, Liang, Malan, Migon, Perry, Rubin, Shapiro, Sifneos, Svartberg, Tuomi, Verbeke, Weissman",2013.0,,0,0,
8140,Randomized controlled trial of a brief dyadic cognitive-behavioral intervention designed to prevent PTSD.,"Background: There is a dearth of effective interventions to prevent the development of post-traumatic stress disorder (PTSD). Method: We evaluated the efficacy of a brief dyadic two-session cognitive-behavioral intervention through a controlled trial involving trauma-exposed individuals recruited at the hospital's emergency room. Participants were randomly assigned to either the dyadic intervention group (n = 37) or to a waiting list (assessment only) group (n = 37). Results: In an intent-to-treat analysis, a time-by-group interaction was found, whereby the treated participants had less PTSD symptoms at the post-treatment but not at the pre-treatment compared to controls. Controlling for the improvement observed in the control participants, the intervention yielded a net effect size of d = 0.39. Conclusions: A brief, early, and effective intervention can be provided by nurses or social workers in hospital settings, at a fairly low cost to individuals presenting to the emergency room as the result of trauma exposure. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Brunet, Alain; Des Groseilliers, Isabeau Bousquet; Cordova, Matthew J; Ruzek, Josef I; Birmes, Bisson, Bisson, Bisson, Blake, Bolton, Bradley, Breslau, Brewin, Brunet, Brunet, Cohen, Collins, Cordova, Cordova, Creamer, Dupont, Fleiss, Guay, Jehel, Kearns, Kornor, Lecrubier, Lepore, Lepore, Marmar, Mayou, Olff, Olff, Ozer, Poundja, Rothbaum, Ruzek, Teasdale, Van Emmerik, Vernberg, Weiss, Weissman",2013.0,,0,0,
8141,Group cognitive-behavioral therapy for panic disorder with and without agoraphobia: An effectiveness study.,"Objective: Although numerous studies have demonstrated the effectiveness of both individual and group cognitive-behavioral psychotherapy (CBT), many authors have questioned the translation of these interventions into routine clinical practice. The aim of this study was to assess the effectiveness of group CBT in patients diagnosed with panic disorder, with or without agoraphobia, in routine clinical practice. Methods: The study involved 96 patients diagnosed according to the DSM-IV criteria. Treatment consisted of 10 psychotherapy sessions of 2 hours each in a local health authority. A battery of psychometric instruments was used to assess variables including psychological symptoms, subjective well-being and psychosocial functioning before and after therapy. In addition to the evaluation of treatment outcome, final scores were compared to population norms and benchmarked against similar studies. Result: Almost all scores of the clinical scales used improved significantly. Only 42% of patients who were initially above the clinical cut-off on the CORE-OM showed clinically significant changes, and 20% of patients were below the clinical cut-off after treatment. Post-treatment CORE-OM scores were not significantly different from the values observed in the general population. These findings are consistent with those of comparable studies. Discussion: Group CBT is effective in routine clinical practice. In addition to reducing anxiety symptoms, treatment also results in an improvement of other related variables such as subjective well-being. Owing to its better patient-therapist ratio, group CBT should be considered as an alternative to individual CBT in routine clinical care in public services. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Mastrocinque, Concettina; De Wet, Daniel; Fagiolini, Andrea; Andrews, Andrews, Andrews, Bandelow, Barkham, Bisson, Borkovec, Boschen, Braga, Buller, Chambless, Cohen, Covin, Deacon, Derogatis, Eddy, Erickson, Evans, Hamilton, Hoagwood, Hofmann, Jacobson, Jacobson, Kendall, Kessler, Leveni, Lutz, McEvoy, Mirabella, Mitte, Morosini, Norton, Oei, Oei, Olatunji, Otte, Palmieri, Persons, Rosenberg, Sanderson, Seligman, Stewart, Stuart, Taylor, Tucker, Westbrook, Westen",2013.0,,0,0,
8142,The development of an assessment clinic (ASPA) in south Essex partnership trust. Observations and outcomes in the period December 2011 - April 2013.,"A new Assessment service (ASPA) which has been developed in Bedford within the Community Psychiatric Team has been described. Demography of patients referred to the service as well as their diagnoses are explained. Outcomes of treatment in this assessment service are also assessed. The most common diagnoses were mood disorders. These were generally equally divided between patients with unipolar and bipolar disorder. The next most common diagnosis was obsessive compulsive disorder. Within the period, approximately one third of patients were referred back to primary care, one third were still in the assessment process, and one third had been admitted to secondary care community services. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Hankir, Ahmed; Sadiq, Asad; Zaman, Rashid; Agius, Mark; Angst, Angst, Bauer, Cate Carter, Grant, Judd, Loranger, Merikangas, Tohen, Tohen, Waraich, Weissman",2013.0,,0,0,
8143,"Subsyndromal depression and anxiety in older adults: Health related, functional, cognitive and diagnostic implications.","Subsyndromal depression in later life is common in primary care. Comorbid anxiety disorders could exacerbate the negative effect of subsyndromal depression on functioning, health-related quality of life, comorbidity and/or cognition. We examined anxiety disorders co-existing with subsyndromal depression in participants >=age 50 in an NIH trial of Problem Solving Therapy for Primary Care for indicated prevention of major depression. There were 247 participants, with Centers for Epidemiologic Studies-Depression scores >=11. Participants could have multiple psychiatric diagnoses: 22% of the sample had no DSM IV diagnosis; 39% of the sample had only 1 DSM IV diagnosis; 28% had 2 diagnoses; 6% had 3 DSM IV diagnoses; 4% had 4 DSM IV diagnoses; and 1% had 5 diagnoses. Furthermore, 34% of participants had a current comorbid DSM IV diagnosis of a syndromal anxiety disorder. We hypothesized that those with subsyndromal depression, alone relative to those with co-existing anxiety disorders, would report better health-related quality of life, less disability, less medical comorbidity and less cognitive impairment. However, there were no differences in quality of life based on the SF 12 nor in disability based on Late Life Function and Disability Instrument scores. There were no differences in medical comorbidity based on the Cumulative Illness Scale-Geriatrics scale scores nor in cognitive function based on the Executive Interview (EXIT), Hopkins Verbal Learning Test-Revised and Mini-Mental Status Exam. Our findings suggest that about one third of participants 50 years and older with subsyndromal depression have comorbid anxiety disorders; however, this does not appear to be associated with worse quality of life, functioning, disability, cognitive function or medical comorbidity. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kasckow, J. W; Karp, J. F; Whyte, E; Butters, M; Brown, C; Begley, A; Bensasi, S; Reynolds, C. F; Arean, Bruce, Chamberlain, DeLuca, Derogatis, Doering, First, Folstein, Hamilton, Karp, Karsten, Kasckow, Kasckow, Kessler, Kvaal, Lenze, Lyness, Lyness, Miller, Royall, Sayers, Shankman, Shapiro, Sriwattanakomen, Sriwattanakomen, Ware",2013.0,,0,0,
8144,"Prediction of treatment response and the effect of independent component neurofeedback in obsessive-compulsive disorder: A randomized, sham-controlled, double-blind study.","Aims: The goal of this study was to assess the effect of independent component neurofeedback (NFB) on EEG and clinical symptoms in patients with obsessive-compulsive disorder (OCD). Subsequently, we explored predictors of treatment response and EEG correlates of clinical symptoms. Methods: In a randomized, double-blind, parallel design, 20 inpatients with OCD underwent 25 sessions of NFB or sham feedback (SFB). NFB aimed at reducing EEG activity in an independent component previously reported abnormal in this diagnosis. Resting-state EEG recorded before and after the treatment was analyzed to assess its posttreatment changes, relationships with clinical symptoms and treatment response. Results: Overall, clinical improvement in OCD patients was not accompanied by EEG change as assessed by standardized low-resolution electromagnetic tomography and normative independent component analysis. Pre- to posttreatment comparison of the trained component and frequency did not yield significant results; however, in the NFB group, the nominal values at the downtrained frequency were lower after treatment. The NFB group showed significantly higher percentage reduction of compulsions compared to the SFB group (p = 0.015). Pretreatment higher amount of delta (1-6 Hz) and low alpha oscillations as well as a lower amount of high beta activity predicted a worse treatment outcome. Source localization of these delta and high beta oscillations corresponded with previous EEG resting- state findings in OCD patients compared to healthy controls. Conclusion: Independent component NFB in OCD proved useful in percentage improvement of compulsions. Based on our correlation analyses, we hypothesize that we targeted a network related to treatment resistance. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Koprivova, Jana; Congedo, Marco; Raszka, Michal; Prasko, Jan; Brunovsky, Martin; Horacek, Jiri; Arns, Beauregard, Beck, Beck, Bloch, Cannon, Choi, Ciesielski, Congedo, Congedo, Congedo, Endrass, Fontenelle, Gevensleben, Goodman, Hammond, Kamiya, Knyazev, Knyazev, Koprivova, Koprivova, Lansbergen, Laufs, Luu, Maihofner, Menzies, Moore, Nagai, Onton, Pascual-Marqui, Pascual-Marqui, Rauch, Rauch, Shapira, Sherlin, Shin, Sterman, Talairach, Ullsperger, Velikova, Vogt, Westfall, Wyrwicka",2013.0,,0,0,
8145,Abnormal resting-state activities and functional connectivities of the anterior and the posterior cortexes in medication-naive patients with obsessive-compulsive disorder.,"Background: Obsessive-compulsive disorder (OCD) is a mental illness characterized by the loss of control. Because the cingulate cortex is believed to be important in executive functions, such as inhibition, we used functional magnetic resonance imaging (fMRI) techniques to examine whether and how activity and functional connectivity (FC) of the cingulate cortex were altered in drug-naive OCD patients. Methods: Twenty-three medication-naive OCD patients and 23 well-matched healthy controls received fMRI scans in a resting state. Functional connectivities of the anterior cingulate (ACC) and the posterior cingulate (PCC) to the whole brain were analyzed using correlation analyses based on regions of interest (ROI) identified by the fractional amplitude of lowfrequency fluctuation (fALFF). Independent Component Analysis (ICA) was used to identify the resting-state sub-networks. Results: fALFF analysis found that regional activity was increased in the ACC and decreased in the PCC in OCD patients when compared to controls. FC of the ACC and the PCC also showed different patterns. The ACC and the PCC were found to belong to different resting-state sub-networks in ICA analysis and showed abnormal FC, as well as contrasting correlations with the severity of OCD symptoms. Conclusions: Activity of the ACC and the PCC were increased and decreased, respectively, in the medication-naive OCD patients compared to controls. Different patterns in FC were also found between the ACC and the PCC with respect to these two groups. These findings implied that the cardinal feature of OCD, the loss of control, may be attributed to abnormal activities and FC of the ACC and the PCC. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Cheng, Yuqi; Xu, Jian; Nie, Binbin; Luo, Chunrong; Yang, Tao; Li, Haijun; Lu, Jin; Xu, Lin; Shan, Baoci; Xu, Xiufeng; Alvarez, Assaf, Barbey, Biswal, Calhoun, Cavedini, First, Fitzgerald, Fontenelle, Gilbert, Graybiel, Halsband, Harrison, Hasselbalch, Hesse, Kennerley, Kerns, Kiviniemi, Liao, Liu, Maltby, Menzies, Milad, Modell, Morein-Zamir, Paus, Perani, Sakai, Sambataro, Saxena, Schlosser, Song, Stein, van de Ven, van den Heuvel, van den Heuvel, van Veen, van Veen, Vogt, Vogt, Vogt, Walton, Yucel",2013.0,,0,0,
8146,"Treatment response, symptom remission, and wellness in obsessive-compulsive disorder.","Background: Obsessive-compulsive disorder (OCD) is defined both by intrusive, unwanted thoughts, images, or impulses and by repetitive behavioral or mental acts that are often performed to try to alleviate anxiety. The ultimate goal of treatment for OCD is to reduce the symptoms as well as help patients achieve ""wellness."" Currently, however, there are no widely accepted, empirically supported criteria for determining wellness in OCD. Method: Building on previous research, the current study examined the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score that most reliably identified patients who responded to treatment, those who achieved symptom remission, and those who achieved wellness. The current study pooled data from 4 randomized controlled OCD treatment trials (N = 288), which took place between 1990 and 2011 at 2 academic sites. Participants (mean age = 36.8 years) had a primary diagnosis of DSM-IV-TR OCD (mean Y-BOCS score = 25.9). Results: Signal detection analyses showed that a pretreatment-to-posttreatment reduction of >= 35% on the Y-BOCS was most predictive of treatment response as defined by the Clinical Global Impressions (CGI)-Improvement scale. A posttreatment Y-BOCS score of <= 14 was the best predictor of symptom remission, whereas a score of <= 12 was the best predictor of wellness, as defined by symptom remission (defined by the CGI-Severity scale), good quality of life (as measured by the Quality of Life Enjoyment and Satisfaction Questionnaire), and a high level of adaptive functioning (as assessed by the Social Adjustment Scale-Self-Report). Because efficiency (0.86) and specificity (0.88) were highest at the cutoff of <= 12, this cutoff score was determined to be the best indicator of wellness. Conclusions: The present findings support the convergent validity of the Y-BOCS with other measures of well-being (quality of life, adaptive functioning) and highlight the utility of a Y-BOCS score <= 12 as a solo indicator of wellness in outcome studies. The use of empirically supported criteria for defining wellness in OCD is recommended to facilitate comparisons across treatment outcome studies and to inform clinical treatment planning. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Farris, Samantha G; McLean, Carmen P; Van Meter, Page E; Simpson, Helen Blair; Foa, Edna B; Bandelow, Bergeron, Bystntsky, Chmura Kraemer, Davidoff, Eddy, Endicott, Fischer, Foa, Gladis, Goodman, Goodman, Goodman, Guy, Hollander, Huppert, Jacobson, Kazdin, Koran, Lewin, Montz, Pallanti, Rapaport, Ruscio, Simpson, Simpson, Simpson, Simpson, Simpson, Storch, Tolin, Viera, Weissman, Weissman, Woody, Zimmerman",2013.0,,0,0,
8147,Randomized sham controlled trial of repetitive transcranial magnetic stimulation to the dorsolateral prefrontal cortex for the treatment of panic disorder with comorbid major depression.,"Background: In an open-label trial low-frequency repetitive transcranial magnetic stimulation (rTMS) to the right dorsolateral prefrontal cortex (DLPFC) significantly improved symptoms of panic disorder and major depression. Here we present data of a randomized double-blind study. Methods: Twenty-five patients were assigned 4 weeks of active or sham rTMS to the right DLPFC. rTMS parameters consisted of 1800 stimuli/day, 1-Hz, at 110% of resting motor threshold. Response was defined as a >=40% decrease on the panic disorder severity scale and a >=50% decrease on the Hamilton depression rating scale. At the end of the randomized phase, patients were offered the option of receiving open-label rTMS for an additional 4 weeks. Results: Repeated-measures ANOVA revealed significantly better improvement in panic symptoms with active compared with sham rTMS, but no significant difference in depression. At 4 weeks, response rate for panic disorder was 50% with active rTMS and 8% with sham. After 8 weeks of active rTMS, response rate was 67% for panic and 50% for depressive symptoms. Repeated-measure ANOVA showed significant improvements in panic disorder, major depression, clinical global impression, and social adjustment. Clinical improvement was sustained at 6-month follow-up. Limitations: Limitation of this study is the relatively small sample size. Conclusions: Although 4 weeks of rTMS was sufficient to produce a significant effect in panic symptoms, a longer course of treatment resulted in better outcomes for both panic disorder and major depression. These data suggest that inhibitory rTMS to the right DLPFC affects symptoms expression in comorbid anxiety and depression. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Mantovani, Antonio; Aly, Mohamed; Dagan, Yael; Allart, Anouk; Lisanby, Sarah H; Aaronson, Berkowitz, Crost, Diemer, Dresler, Fava, Fava, First, Fitzgerald, Fitzgerald, Frank, Furukawa, Garcia-Toro, Gershon, Guaiana, Isenberg, Katz, Klein, Lisanby, Mantovani, Mantovani, Mantovani, Mantovani, Mantovani, McDonald, McGrath, Nordahl, Papakostas, Pizzagalli, Pollack, Prasko, Prasko, Rossi, Rossi, Rossini, Sakkas, Silverstone, Tomarken, Trivedi, Zwanzger",2013.0,,0,0,
8148,Pain adversely affects outcomes to a collaborative care intervention for anxiety in primary care.,"Background: Primary care patients with Panic Disorder (PD) and Generalized Anxiety Disorder (GAD) experience poorer than expected clinical outcomes, despite the availability of efficacious pharmacologic and non-pharmacologic treatments. A barrier to recovery from PD/GAD may be the co-occurrence of pain. Objective: To evaluate whether pain intensity interfered with treatment response for PD and/or GAD in primary care patients who had received collaborative care for anxiety disorders. Design: A secondary data analysis of a randomized, controlled effectiveness trial comparing a telephone-delivered collaborative care intervention for primary care patients with severe PD and/or GAD to their doctor's ""usual"" care. Participants: Patients had to have a diagnosis of PD and/or GAD and a severe level of anxiety symptoms. The 124 patients randomized at baseline to the collaborative care intervention were analyzed. Participants were divided into two pain intensity groups based on their response to the SF-36 Bodily Pain scale (none or mild pain vs. at least moderate pain). Main Measures: Pain was assessed using the Bodily Pain scale of the SF-36. Anxiety symptoms were measured with the Hamilton Anxiety Rating Scale (HRS-A), Panic Disorder Severity Scale (PDSS) and Generalized Anxiety Disorder Severity Scale (GADSS). Measures were collected over 12 months. Key Results: At baseline, patients with at least moderate pain were significantly more likely to endorse more anxiety symptoms on the HRS-A than patients with no pain or mild pain (P < .001). Among patients with severe anxiety symptoms, 65 % (80/124) endorsed experiencing at least moderate pain in the previous month. A significantly lesser number of patients achieved a 50 % improvement at 12 months on the HRS-A and GADSS if they had at least moderate pain as compared to patients with little or no pain (P = 0.01 and P = 0.04, respectively). Conclusions: Coexisting pain was common in a sample of primary care patients with severe PD/GAD, and appeared to negatively affect response to anxiety treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Morone, Natalia E; Belnap, Bea Herbeck; He, Fanyin; Mazumdar, Sati; Weiner, Debra K; Rollman, Bruce L; Asmundson, Bair, Barlow, Barlow, Bech, Burton, Demyttenaere, Dersh, Goldstein, Gorman, Graham, Hamilton, Karp, Karp, Katz, Keefe, Kerns, Kessler, Kessler, Kroenke, Leon, Leon, Massion, McWilliams, Melzack, Olfson, Regier, Rickels, Rollman, Rollman, Rollman, Rollman, Rost, Roy-Byrne, Schulberg, Schweizer, Shear, Shear, Shear, Sherbourne, Spitzer, Spitzer, Teh, Tiemens, Verhaak, Ware, Wittchen, Young",2013.0,,0,0,
8149,Predictors of completion of exposure therapy in OEF/OIF veterans with posttraumatic stress disorder.,"Background: Despite large-scale dissemination and implementation efforts of evidence-based psychotherapy to veterans from Operation Enduring/Iraqi Freedom (OEF/OIF), little is known regarding the factors that contribute to the successful completion of these treatments in this high-risk population. The present study investigated predictors of treatment completion during a standardized exposure-based psychotherapy for PTSD. Methods: Ninety-two OEF/OIF combat veterans enrolled in a randomized controlled trial for an eight session exposure-based psychotherapy for PTSD. All participants completed structured clinical interviews and several background and symptom questionnaires. Of the initial 92 participants, 28% of the sample (n = 26) discontinued treatment prior to completion of the trial. Results: Predictors of discontinuation of treatment were assessed with a hierarchical logistic regression. Disability status was positively associated with treatment discontinuation, and postdeployment social support was negatively associated with discontinuation. In contrast to previous findings, other factors, such as age and PTSD symptomatology, were not identified as significant predictors. Conclusions: The present study suggested that disability status at the start of treatment increases the risk for treatment discontinuation whereas increased social support buffers against discontinuation. Together, these findings highlight the importance of increased assessment and early intervention when these factors are present to potentially reduce treatment discontinuation and improve treatment outcomes in OEF/OIF veterans with PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Gros, Daniel F; Price, Matthew; Yuen, Erica K; Acierno, Ron; Beck, Blake, Brooks, Cohen, Cully, Erbes, First, Frueh, Garcia, Gros, Gros, Gros, Gros, Gros, Gros, Gros, Gros, Grubaugh, Hoge, Hoge, Jakupcak, King, Maguen, Miller, Milliken, Monson, Monson, Monson, Price, Price, Ruzek, Schafer, Seal, Seal, Strachan, Tuerk, Weathers",2013.0,,0,0,
8150,Changes in anger in relationship to responsivity to PTSD treatment.,"This study examined the clinical course of different dimensions of anger and their relationship to change in posttraumatic stress disorder (PTSD) in a sample of 139 female survivors of interpersonal violence suffering from PTSD. Specifically, this study evaluated differences in the rates of change in anger dimensions by responsivity to treatment status (responders, nonresponders, and dropouts). Responders and nonresponders did not differ in rate of change on state anger and anger directed inward, suggesting that treatment led to improvements in these dimensions of anger regardless of final PTSD diagnosis. Responders did evidence statistically significantly more change in trait anger and control over one's anger than did the nonresponders, suggesting that changes in these dimensions of anger may be related to recovery from PTSD. Individuals who terminated therapy prematurely did not experience the same gains in state anger, trait anger, or anger-in as those who completed treatment. Differences in rates of change (linear vs. quadratic growth patterns), particularly with respect to continued improvement in anger following treatment completion, are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Galovski, Tara E; Elwood, Lisa S; Blain, Leah M; Resick, Patricia A; Arntz, Biesanz, Blake, Blake, Bradley, Cahill, Cohen, Deffenbacher, Foa, Forbes, Funkenstein, Galovski, Izard, Jakupcak, Novaco, Olatunji, Orth, Orth, Orth, Owens, Pinheiro, Ployhart, Raudenbush, Resick, Resick, Rizvi, Schnurr, Singer, Spielberger, Spielberger, Stapleton, Taylor, Taylor, van Minnen",2014.0,,0,0,
8151,Comparing holographic reprocessing and prolonged exposure for women veterans with sexual trauma: A pilot randomized trial.,"This pilot study compares an emerging evidence-based treatment, holographic reprocessing (HR) to prolonged exposure (PE) versus a person-centered (PC) control group to treat symptoms of distress in female Veterans with sexual trauma. In contrast to PE, HR does not include exposure to a target event of trauma. Instead, HR focuses on healing the internal working model or type of attachment style that may form as a result of interpersonal trauma or maltreatment. The model reveals how people perceive themselves and others. These perceptions set in motion emotional, cognitive, and behavioral tendencies wherein people unconsciously replicate similar types of relationships that reinforce their worldview. Fifty-one female Veterans with sexual trauma were randomly assigned to one of three treatments and completed pre- and post-treatment measures of psychiatric symptoms (anxiety, depression, and PTSD) and post-traumatic cognitions. ANOVAs found significant decreases on all variables. Post-hoc comparisons revealed that HR and PE treatments demonstrated significantly greater decreases in symptoms compared to the PC control group. Chi square analyses revealed that HR produced a significantly lower dropout rate 1 (6 %) compared to PE 7 (41 %) and PC 6 (35 %). These initial results are promising and further investigation of HR is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Katz, Lori S; Douglas, Sarah; Zaleski, Kristen; Williams, Jenny; Huffman, Cristi; Cojucar, Geta; Ainsworth, Alexander, Asner-Self, Basharpoor, Blanchard, Bowlby, Bowlby, Derogatis, Epstein, Foa, Foa, Foa, Foa, Foa, Garcia, Gendlin, Goldzweig, Hayes, Katz, Katz, Katz, Kelly, Main, McIsaac, McIsaac, Resick, Resick, Rogers, Rogers, Rothbaum, Schnurr, Schnurr, Smucker, Suris, Wachtel, Wallin, Weathers, White, Young, Zayfert",2014.0,,0,0,
8152,How well do randomized controlled trial data generalize to 'real-world' clinical practice settings? A comparison of two generalized anxiety disorder studies.,"The aim of this post-hoc comparison is to compare efficacy and tolerability results from two generalized anxiety disorder (GAD) studies: a placebo-controlled, randomized controlled trial (RCT) and a study conducted in the clinical practice setting, and to evaluate the extent to which results from RCTs in GAD patients can be generalized to clinical practice. In the clinical practice study, GAD outpatients (n = 578) were treated with 4 weeks of pregabalin 150-600 mg/day. In the double-blind placebo-controlled RCT, GAD outpatients (n = 249) were randomized to 8 weeks of pregabalin (300-600 mg/day), or placebo (only the first 4 weeks are included in the current analysis). Efficacy measures included the Hospital Anxiety and Depression Scale-Anxiety and Depression subscales (HADS-A; HADS-D), a visual analogue anxiety scale (VAS-Anxiety), and the Medical Outcomes Study Sleep Problems Index (MOS-SPI). Baseline HADS-A and HADS-D scores were both higher in the clinical practice study vs. the RCT. In the RCT, treatment with pregabalin resulted in significantly greater Week 4 change vs. placebo in the HADS-A (-5.3 vs. -3.9; P < 0.005), VAS-Anxiety (-24.0 vs. -13.3; P < 0.02), MOS-SPI (-19.1 vs. -9.5; P < 0.01), and HADS-D (-2.7 vs. -1.4; P < 0.05). The magnitude of Week 4 improvement on pregabalin in the clinical practice study was numerically larger on the HADS-A (-5.9), VAS-Anxiety (-36.0), MOS-SPI (-22.7), and HADS-D (-5.1), despite use of lower doses. These results suggest that clinical practice patients with GAD may achieve comparable efficacy on lower doses of pregabalin than tested in RCTs, despite having comparable levels of anxiety symptom severity at baseline. The current exploratory comparison also suggests that results from RCTs in patients with GAD may not be directly generalizable to clinical practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kasper, Siegfried; Brasser, Matthias; Schweizer, Edward; Lyndon, Gavin; Prieto, Rita; Bandelow, Bech, Citrome, Feltner, Feltner, Flather, Guy, Hays, Herrmann, Hidalgo, Kasper, Khan, Khan, Lydiard, Moller, Montgomery, Montgomery, Muller, Pande, Pohl, Rickels, Rickels, Rickels, Rutherford, Snaith, Treweek, Tunis, Zigmond",2014.0,,0,0,
8153,Characteristics and drinking patterns of veterans with alcohol dependence with and without post-traumatic stress disorder.,"Alcohol use disorders and post-traumatic stress disorder (PTSD) are highly prevalent and commonly co-occur, notably in veterans. We explored differences in the pre-treatment characteristics of veterans with alcohol dependence (AD) alone compared to those with co-occurring AD and PTSD. Veterans were recruited to participate in two different treatment studies and baseline characteristics were compared. Those with co-occurring illnesses demonstrated significantly higher pre-treatment pathology across all psychopathological domains. While those with AD alone averaged more days of drinking and had more heavy drinking days, those with co-occurring illnesses reported more drinking-related symptoms. The presence of a major depressive episode had no effect on drinking. With in the PTSD group, combat exposure was associated with increased drinking independent of the severity of PTSD symptoms. This study underscores the importance of screening for comorbidity in clinical treatment settings, and for collecting detailed drinking histories and assessing psychiatric symptoms across all domains of psychopathology. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fuehrlein, Brian; Ralevski, Elizabeth; O'Brien, Erin; Jane, J. Serrita; Arias, Albert J; Petrakis, Ismene L; Adams, Blake, Brown, Costa, Costa, Derogatis, First, Goetzel, Hamilton, Hassija, Hoge, Hoge, Hoge, Jacobsen, Kalman, Kerfoot, Kranzler, Krystal, McCarthy, Milliken, Riggs, Roy-Byrne, Sanderson, Skinner, Sobell, Stewart",2014.0,,0,0,
8154,"PTSD is a chronic, fluctuating disorder affecting the mental quality of life in older adults.","Objectives: Examine the longitudinal course of posttraumatic stress disorder (PTSD) in older adults and its influence on mental health quality of life (MHQoL). Design: Evaluation performed at baseline, and 3 and 6 months postrandomization as part of a longitudinal trial. Participants and settings: A total of 1,185 participants, with a mean (+/- SD) age of 73.53 (+/- 5.98) years, at seven primary care sites (including five Veterans Affairs clinics), were divided into four groups, namely, no trauma (n = 661), trauma only (n = 319), partial PTSD (n = 114), and PTSD (n = 81), based on reports of trauma and associated PTSD symptoms. Measurements: The prevalence of comorbid depression, anxiety, and alcohol use disorders, assessed using the Diagnostic and Statistical Manual, Fourth Edition, criteria and changes in MHQoL, as assessed by the Short Forme36 mental component score. Results: At baseline, the PTSD group had higher frequencies of comorbid depression and anxiety disorders and worse MHQoL than the other groups. Both chronic (participants diagnosed with PTSD at all three assessments) and fluctuating (participants moving to or from one of the other groups) trajectories of course were observed during the follow-up period, which appeared to be separate from that of the comorbid disorders. Even after accounting for those comorbid disorders, PTSD had an independent association with poorer MHQoL at multiple time points, especially in men, whereas trauma without PTSD symptoms (trauma only) had better MHQoL. Conclusions: PTSD had chronic and fluctuating courses,with negative effects onMHQoL, while partial PTSD might represent a transitional state, underscoring the need to better identify and treat PTSD at any phase in later life. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Chopra, Mohit P; Zhang, Hongmei; Kaiser, Anica Pless; Moye, Jennifer A; Llorente, Maria D; Oslin, David W; Spiro, Avron III; Bartels, Beard, Bonanno, Bremner, Chapman, Chaudieu, Chopra, Chung, David, Dirkzwager, Durai, Glaesmer, Katzman, Kessler, Kimbrell, McHorney, McLaughlin, Meeks, Mittal, Mohamed, Mylle, Pietrzak, Port, Rauch, Richardson, Robins, Sheehan, Shiner, Solomon, Southwick, Spiro, Thorp, Yehuda",2014.0,,0,0,
8155,Combining attention training with internet-based cognitive-behavioural self-help for social anxiety: A randomised controlled trial.,"Guided Internet-based cognitive-behavioural self-help (ICBT) has been proven to be effective for social anxiety disorder (SAD) by several independent research groups. However, as the proportion of clinical significant change has room for improvement, new treatments should be developed and investigated. A novel treatment is attention bias modification (ABM). This study aimed at evaluating the combination of ABM and ICBT. We compared two groups, one group receiving ICBT and ABM targeting attentional avoidance and the other group receiving ICBT and control training. ABM and control training tasks were both based on the dot-probe paradigm. A total of 133 participants, diagnosed with SAD, were randomised to these two groups. The attention training group (N = 66) received 2 weeks of daily attention training followed by 9 weeks of ICBT. The control group (N = 67) received 2 weeks of daily control training, also followed by 9 weeks of ICBT. Social anxiety measures as well as the attention bias were assessed at pre-assessment, at week 2, and at post-treatment. Results showed no significant differences between the attention training group and the control group. Both groups improved substantially on social anxiety symptoms from pre- to post-assessment (dwithin = 1.39-1.41), but showed no change in attention processes (dwithin = 0.10-0.17). In this trial, the attention modification training failed to induce differential change in attention bias. Results demonstrate that the applied ABM procedure with its focus on the reduction of attentional avoidance was ineffective in the Internet-based setting. The results do not suggest that adding ABM targeting attentional avoidance to ICBT results in better outcomes than ICBT alone. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Boettcher, Johanna; Hasselrot, Jonas; Sund, Erik; Andersson, Gerhard; Carlbring, Per; Amir, Amir, Amir, Amir, Andersson, Andersson, Andersson, Asmundson, Baker, Beard, Berger, Berger, Boettcher, Boettcher, Boettcher, Boettcher, Botella, Bradley, Calamaras, Carlbring, Carlbring, Carlbring, Chen, Cisler, Clark, Clark, Clark, Dear, Fehm, Field, Fresco, Frisch, Furmark, Gotlib, Hallion, Harnett, Hedman, Heeren, Helfinstein, Issakidis, Jacobson, Jose, Keller, Kessler, Klumpp, Klumpp, Lambert, Lambert, Lang, Legerstee, Li, Lindner, Lundh, MacLeod, Mathews, Mathews, Mattick, Mogg, Mogg, Mogg, Mueller, Musa, Muhlberger, Neubauer, Nielsen, Olfson, Pflugshaupt, Pishyar, Price, Rapee, Rapee, Roberts, Rosnow, Samuelsson, Schmidt, Schmukle, Schofield, Staugaard, Svanborg, Thorndike, Tillfors, Titov, Titov, Vassilopoulos, Wang, Waters, Wieser",2014.0,,0,0,
8156,"Functional effects of chronic paroxetine versus placebo on the fear, stress and anxiety brain circuit in social anxiety disorder: Initial validation of an imaging protocol for drug discovery.","Recent studies suggest that pharmacologic effects of anxiolytic agents can be mapped as functional changes in the fear, stress and anxiety brain circuit. In this work we investigated the effects of a standard treatment, paroxetine (20 mg/day), in subjects with Social Anxiety Disorder (SAD) versus placebo using different fMRI paradigms. The fMRI sessions, performed before and after the treatment, consisted of a public exposition of recorded performance task (PERPT), an emotional face processing task (EFPT) and a 6-min resting state followed by an off-scanner public speaking test. Paroxetine significantly improved the clinical conditions of SAD patients (n = 17) vs. placebo (n = 16) as measured with Clinical Global Inventory-Improvement (CGI-I) while no change was seen when using Liebowitz Social Anxiety Scale, as expected given the small size of the study population. Paroxetine reduced the activation of insula, thalamus and subgenual/anterior cingulate cortex (ACC) in PERPT. Resting-state fMRI assessment using Independent Component Analysis indicated that paroxetine reduced functional connectivity in insula, thalamus and ACC when compared with placebo. Both paradigms showed significant correlation with CGI-I in rostral prefrontal cortex. Conversely, paroxetine compared to placebo produced activation of right amygdala and bilateral insula and no effects in ACC when tested with EFPT. No treatment effects on distress scores were observed in the off-scanner Public Speaking Test. Overall this study supports the use of fMRI as sensitive approach to explore the neurobiological substrate of the effects of pharmacologic treatments and, in particular, of resting state fMRI given its simplicity and task independence. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gimenez, Monica; Ortiz, Hector; Soriano-Mas, Carles; Lopez-Sola, Marina; Farre, Magi; Deus, Joan; Martin-Santos, Rocio; Fernandes, Sofia; Fina, Paolo; Bani, Massimo; Zancan, Stefano; Pujol, Jesus; Merlo-Pich, Emilio; Aupperle, Blair, Britton, Cardoso de Almeida, Clauss, Cooney, Etkin, Etkin, Findling, Fox, Fu, Furmark, Furmark, Gimenez, Godlewska, Goldin, Graeff, Hariri, Harmer, Harrison, Hedges, Henseler, Kumar, Lees, Li, Liebowitz, Lorberbaum, Marsh, McCabe, Northoff, Paulus, Paulus, Phan, Phan, Pujol, Pujol, Schneier, Shin, Simmons, Spielberger, Spitzer, Tendolkar, Thomas, Tromp, Valenzuela, Wagner, Whalen, Wittchen, Wollweber",2014.0,,0,0,
8157,Cost-effectiveness of a stepped care programme to prevent depression and anxiety in residents in homes for the older people: A randomised controlled trial.,"Background: Depression and anxiety are common in residents of elderly homes. Both disorders have negative effects on functioning, well-being and health-care utilisation. Besides treatment, prevention can be an option to reduce the burden of mental disorders. The objective of this study was to evaluate the cost-effectiveness of a stepped care programme to prevent the onset of depression and anxiety disorders in residents of elderly homes compared with usual care from a societal perspective. Methods: Outcomes were incidence of depression and/or anxiety, severity of depressive and anxiety symptoms and quality-adjusted life years. Health-care utilisation was measured during interviews. Multiple imputation was used to impute missing cost and effect data. Uncertainty around cost differences and incremental cost-effectiveness ratios was estimated using bootstrapping. Cost-effectiveness planes and acceptability curves were created. Results: The incidence of depression and anxiety combined in the intervention group was not reduced in comparison with the usual care group. There was also no effect on the other outcomes. Mean total costs in the intervention group were 838 higher than in the usual care group, but this difference was not statistically significant (95% confidence interval, -593 to 2420). Cost-effectiveness planes showed that there was considerable uncertainty. Cost-effectiveness acceptability curves showed that the maximum probability of the intervention being cost-effective in comparison with usual care was 0.46 for reducing the incidence of depression and anxiety combined. Conclusion: A stepped care programme to prevent depression and anxiety in older people living in elderly homes was not considered cost-effective in comparison with usual care. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bosmans, J. E; Dozeman, E; van Marwijk, Harm W. J; van Schaik, Digna J. F; Stek, Max L; Beekman, Aartjan T. F; van der Horst, Henriette E; Alexopoulos, Andrews, Baldwin, Beekman, Beekman, Bisschop, Blazer, Bohlmeijer, Boorsma, Briggs, Burton, Cuijpers, de Beurs, de Jong-Gierveld, Dozeman, Dozeman, Dozeman, Efron, Fenwick, Folstein, Hakkaart-van Roijen, Hakkaart-van Roijen, Haringsma, Lamers, Oostenbrink, Radloff, Rubin, Seitz, Serrano, Smit, Thakur, van Buuren, Van't Veer-Tazelaar, van't Veer-Tazelaar, Veer-Tazelaar, Wolitzky-Taylor, Zigmond",2014.0,,0,0,
8158,Predictors of response to individual and group cognitive behaviour therapy of social phobia.,"Objectives: Increased knowledge of factors that predict treatment outcome is important for planning and individualizing of treatment. This study analysed predictors of response to individual cognitive therapy (ICT), and intensive (3-week) group cognitive treatment (IGCT) for social phobia. Method: Participants (n = 54) met diagnostic criteria for social phobia within a randomized controlled trial. Predictors assessed were fear of negative evaluation, anticipatory worry, self-directedness (SD) and cluster C personality disorder. Results were analysed by means of multiple regression analyses with both groups combined, and for each of the treatment groups. Results: Anticipatory worry, an aspect of a harm-avoidance personality trait, was the strongest negative predictor of outcome in ICT and IGCT both at post-treatment and 1-year follow-up. Whereas low SD, signs of cluster C personality disorder and fear of negative evaluation were negative predictors of post-treatment outcome in ICT, the corresponding pattern of results was not to be found in IGCT. Conclusions: Anticipatory worry appears to be a particularly importanttrait forexplaining variance in the outcome of social phobia. The finding is consistent with the assumed stability of such personality traits over time. Further studies are warranted to replicate the finding. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mortberg, Ewa; Andersson, Gerhard; Allgulander, Baker, Borge, Brown, Bruce, Brandstrom, Carver, Caseras, Chambless, Ciesla, Clark, Clark, Clark, Cloninger, Cloninger, Dimaggio, Ekselius, Faytout, Fedoroff, First, Fresco, Hayes, Hofmann, Hope, Hummelen, Jones, Juster, Kessler, Liebowitz, Mardaga, Massion, Mattick, Mattick, Mennin, Musa, Mortberg, Mortberg, Mortberg, Ponniah, Price, Rodebaugh, Sanderson, Schmaling, Scholing, Stekette, Svrakic, Svrakic, Tyrer, van Velzen, Watson, Zaider, Ost",2014.0,,0,0,
8159,Social support as a predictor of the outcome of depressive and anxiety disorder in short-term and long-term psychotherapy.,"Social support is known to be important for well-being of individuals, but it is not clear how it predicts psychotherapy outcome in patients suffering from depressive or anxiety disorders. The aim of the present study was to study the prediction of social support on the outcome of short-term and long-term psychotherapy. In the Helsinki Psychotherapy Study, 326 psychiatric outpatients, aged 20-46 years, and suffering from depressive or anxiety disorders, were randomly assigned to short-term psychotherapy (short-term psychodynamic or solution-focused) or long-term psychodynamic psychotherapy. The level of social support at baseline was assessed using the Brief Inventory of Social Support and Integration (BISSI). Psychiatric symptoms were assessed with the Symptom Check List, Global Severity Index (SCL-90-GSI) at baseline and four times during a 3-year follow-up. Patients with a high level of social support before treatment benefitted more from long-term than short-term therapy at the 3-year follow-up, whereas patients with a low level of social support experienced no such benefit. Pretreatment social support seems to predict differentially short- and long-term psychotherapy and thus needs to be acknowledged when evaluating patient0s resources and treatment options. More research is needed to verify these findings. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lindfors, Olavi; Ojanen, Sakari; Jaaskelainen, Tuija; Knekt, Paul; Antonovsky, Azim, Barker, Barnett, Beck, Bergeman, Bergeman, Berkman, Brugha, Brugha, Chronister, Cohen, De Shazer, Derogatis, Ertel, Eurelings-Bontekoe, Eurelings-Bontekoe, Gabbard, Harkanen, Harkapaa, Heinonen, Johnson, Kawachi, Kernberg, Knekt, Knekt, Knekt, Knekt, Laaksonen, Lara, Lee, Leibert, Lindfors, Malan, Marziali, Migon, Mikulincer, Monroe, Moos, Roehrle, Sifneos, Smith, Thoits, Turner, Verbeke, Wallston",2014.0,,0,0,
8160,Randomised controlled trial of a cognitive narrative intervention for complicated grief in widowhood.,"Objective: The implementation of bereavement interventions is frequently requested, and its effectiveness has been controversial. The aim of this study is to evaluate the effectiveness of a cognitive narrative intervention for complicated grief (CG) for controlling post-traumatic and depressive issues. Method: The study is a randomised controlled trial and uses the Socio Demographic Questionnaire (SDQ), the Inventory of Complicated Grief (ICG), the Beck Depression Inventory (BDI) and the Impact of Events Scale-Revised (IES-R). There were three phases in the study: (1) The SDQ and CG evaluations were applied to bereaved elders (n = 82). The bereaved elders with the 40 highest ICG values (>= 25) were randomly allocated into two groups: the intervention group (n = 20) and control group (n = 20); (2) participants were evaluated using the BDI and IES-R and the IG gave informed consent to participate in an intervention with four weekly 60-min sessions addressing recall, emotional and cognitive subjectivation, metaphorisation and projecting. (3) Two months later, the ICG, BDI and IES-R assessments were repeated. Results: Outcome measures showed a statistically significant reduction of CG, depressive and traumatic symptoms compared to the controls. Very high effect sizes for the ICG, BDI and IES-R reflect the effectiveness of the intervention along the longitudinal profile. Conclusions: These results reinforce the importance of brief interventions that combine a reduced number of sessions with lower costs, which is reflected in an increased adherence to the programme along with high effectiveness. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Barbosa, Virginia; Sa, Monica; Rocha, Jose Carlos; Allumbaugh, Bennett, Boelen, Boelen, Bonanno, Bonanno, Bryman, Castanheira, Castro, Currier, Frade, Gana, Golden, Goncalves, Goncalves, Goncalves, Greenberg, Jacobs, Jane-Llopis, Jane-Llopis, Kang, Kato, Kristjanson, Lichtenthal, Lichtenthal, Maccallum, Munoz, Neimeyer, Neimeyer, Newson, Nezu, O' Connor, Parkes, Parkes, Pennebaker, Piper, Prigerson, Prigerson, Prigerson, Rocha, Rosner, Schut, Shear, Silva, Simon, Sousa, Stroebe, Stroebe, Stroebe, Tomita, van der Houwen, Vaz Serra, Wagner, Wittouck, Zisook, Zuckoff",2014.0,,0,0,
8161,"Attention bias modification training via smartphone to reduce social anxiety: A randomized, controlled multi-session experiment.","Testing feasibility and efficacy of psychological treatment via mobile devices is important, given its potential benefits for high-dosage treatment delivery, widespread and inexpensive dissemination, and efficient research methods. We conducted the first randomized controlled trial of attention bias modification training delivered via smartphones, comparing this training to control training in a double-blind design, also including a waitlist condition. All participants performed a variant of dot-probe training involving faces with neutral and disgust (representative of social threat) expressions in brief sessions three times daily over 4 weeks on their own smartphones, at home or anywhere they chose. Attention bias modification, also known as cognitive bias modification of attention, training included a contingency to induce attentional deployment away from disgust faces, whereas the control training included no contingency. Participants completed weekly Internet-based self-report symptom assessments as well as smartphone-delivered dot-probe attention bias assessments, whose reliability findings supported the viability of using smartphones for reaction-time based assessments. The between-groups training effect on attention bias scores was small, showing statistical significance in some analyses and not in others. On measures of social anxiety, intention-to-treat analyses (n = 326) revealed significant pre-post treatment declines with medium to large effect sizes in both training groups, whereas small declines in a waitlist group were nonsignificant. Both training groups showed greater reductions in social anxiety than did waitlist; however, the benefits under these two training conditions were statistically indistinguishable. Improvements in the two training conditions beyond those of waitlist could be attributable to any factors common to them, but not to the contingency training specific to active attention bias modification training. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Enock, Philip M; Hofmann, Stefan G; McNally, Richard J; Amir, Amir, Amir, Amir, Antony, Ataya, Baker, Bar-Haim, Barlow, Beard, Boettcher, Boettcher, Browning, Bunnell, Carlbring, Cox, Damian, Eldar, Enock, Enock, Enock, Fox, Fresco, Fresco, Gee, Gelman, Hakamata, Hakamata, Hallion, Hedman, Heeren, Heimberg, Li, Liebowitz, Lovibond, MacLeod, MacLeod, MacLeod, MacLeod, Matsumoto, Mattick, McNally, Meyer, Neubauer, Pinheiro, Rodebaugh, Rytwinski, Sawyer, Schmidt, Schmukle, Staugaard, Ulrich, Waechter, Wald, Watson, Wells, Zlomke",2014.0,,0,0,
8162,The effect of acutely administered MDMA on subjective and BOLD-fMRI responses to favourite and worst autobiographical memories.,"3,4-methylenedioxymethamphetamine (MDMA) is a potent monoamine-releaser that is widely used as a recreational drug. Preliminary work has supported the potential of MDMA in psychotherapy for post-traumatic stress disorder (PTSD). The neurobiological mechanisms underlying its putative efficacy are, however, poorly understood. Psychotherapy for PTSD usually requires that patients revisit traumatic memories, and it has been argued that this is easier to do under MDMA. Functional magnetic resonance imaging (fMRI) was used to investigate the effect of MDMA on recollection of favourite and worst autobiographical memories (AMs). Nineteen participants (five females) with previous experience with MDMA performed a blocked AM recollection (AMR) paradigm after ingestion of 100 mg of MDMA-HCl or ascorbic acid (placebo) in a double-blind, repeated-measures design. Memory cues describing participants' AMs were read by them in the scanner. Favourite memories were rated as significantly more vivid, emotionally intense and positive after MDMA than placebo and worst memories were rated as less negative. Functional MRI data from 17 participants showed robust activations to AMs in regions known to be involved in AMR. There was also a significant effect of memory valence: hippocampal regions showed preferential activations to favourite memories and executive regions to worst memories. MDMA augmented activations to favourite memories in the bilateral fusiform gyrus and somatosensory cortex and attenuated activations to worst memories in the left anterior temporal cortex. These findings are consistent with a positive emotional-bias likely mediated by MDMA's pro-monoaminergic pharmacology. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Carhart-Harris, R. L; Wall, M. B; Erritzoe, D; Kaelen, M; Ferguson, B; De Meer, I; Tanner, M; Bloomfield, M; Williams, T. M; Bolstridge, M; Stewart, L; Morgan, C. J; Newbould, R. D; Feilding, A; Curran, H. V; Nutt, D. J; Anderson, Anderson, Bach, Bedi, Bedi, Beringer, Bickart, Brewin, Broadbear, Button, Cahir, Carhart-Harris, Cowen, Daselaar, de la Torre, Diukova, Duman, Erritzoe, Friston, Friston, Frokjaer, Gallagher, Godlewska, Greer, Griffiths, Griffiths, Grob, Harmer, Harmer, Hofmann, Hysek, Iannetti, Kolbrich, Kometer, Kuypers, Lanius, Lanius, Lenzi, Liechti, Liechti, MacLean, Macleod, Meyer, Meyer, Meyer, Mithoefer, Mithoefer, Murphy, Musser, Nichols, Nutt, Piefke, Protopopescu, Ramaekers, Rauch, Ressler, Rothman, Sessa, Sharot, Jacques, Svoboda, Tranter, Urban, van Wei, Weiner",2014.0,,0,0,
8163,One session treatment of cognitive and behavioral therapy and virtual reality for social and specific phobias. Preliminary results from a randomized clinical trial.,"This randomized clinical trial aimed to investigate the efficacy of one session treatment of VRCBT (cognitive behavioral therapy combined with virtual reality) for patients with social phobia, flight phobia and acrophobia. Additionally we concentrated on investigating if and to what extent do working alliance, patients' expectations and therapists' performance contribute to this change. Our preliminary results include data from a sample of 32 participants diagnosed with social phobia (N = 15), flight phobia (N = 9) and acrophobia (N = 8) who were randomly assigned to either immediate treatment or WL control group. Results indicated no significant differences between the two groups. Significant differences were shown between pre- and post-treatment for the majority of the measures used. Patients' expectations, working alliance and therapists' performance proved to be predictors of change. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Moldovan, Ramona; David, Daniel; Beck, Bordin, Botella, Botella, Chambless, Choy, Choy, Coelho, Cohen, Collins, Craske, David, Deacon, DiGiuseppe, Eddy, Ellis, Emmelkamp, Garcia-Palacios, Hofmann, Horvath, Klinger, Leary, Liebowitz, Muhlberger, Narrow, Nousi, Ost, Ost, Parsons, Powers, Rothbaum, Rothbaum, Rothbaum, Ruscio, Spielberger, Tichenor, Tracey, Van Gerwen, Wallach, Witmer, Wolitzky-Taylor, Wolpe, Zlomke",2014.0,,0,0,
8164,Cognitive behaviour therapy to improve mood in people with epilepsy: A randomised controlled trial.,"This study compared a 9-week individualised Cognitive Behaviour Therapy (CBT) programme for people with epilepsy (PWE), with a wait-list control. Fifty-nine PWE were randomised and 45 (75%) completed post-treatment outcomes. People with lower quality of life (QoL), particularly for cognitive functioning, were more likely to drop out. Analyses based on treatment completers demonstrated significant improvements on the Neurological Depressive Disorders Inventory for Epilepsy (p = .045) and Hospital Anxiety Depression Scale-Depression subscale (p = .048). Importantly, CBT significantly reduced the likelihood of clinical depressive symptoms (p = .014) and suicidal ideation (p = .005). Improvements were not observed for anxiety, QoL or maintained overtime for depression. Results suggest that CBT was effective, however, and could be improved to increase patient retention and long-term outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gandy, Milena; Sharpe, Louise; Nicholson Perry, Kathryn; Thayer, Zoe; Miller, Laurie; Boserio, Janet; Mohamed, Armin; Barry, Beyenburg, Bjelland, Boylan, Bragatti, Brandt, Bright, Chaytor, Christoph, Ciechanowski, Cohen, Cramer, Cramer, Crawford, de Araujo, Dear, Desai, Elger, Fiest, Filho, Gandy, Gandy, Gilliam, Hall, Helmstaedter, Hermann, Jones, Kanner, Kanner, Kanner, Kanner, Kerr, LaFrance, Martinovic, Mathias, Nilsson, Noe, Ramarantnam, Sanchez-Gistau, Sharpe, Sharpe, Sharpe, Sharpe, Spinhoven, Taylor, Thompson, Verrotti, Vingerhoets, Zigmond",2014.0,,0,0,
8165,Impairments in goal-directed actions predict treatment response to cognitive-behavioral therapy in social anxiety disorder.,"Social anxiety disorder is characterized by excessive fear and habitual avoidance of social situations. Decision-making models suggest that patients with anxiety disorders may fail to exhibit goal-directed control over actions. We therefore investigated whether such biases may also be associated with social anxiety and to examine the relationship between such behavior with outcomes from cognitive-behavioral therapy. Patients diagnosed with social anxiety and controls completed an instrumental learning task in which two actions were performed to earn food outcomes. After outcome devaluation, where one outcome was consumed to satiety, participants were re-tested in extinction. Results indicated that, as expected, controls were goal-directed, selectively reducing responding on the action that previously delivered the devalued outcome. Patients with social anxiety, however, exhibited no difference in responding on either action. This loss of a devaluation effect was associated with greater symptom severity and poorer response to therapy. These findings indicate that variations in goal-directed control in social anxiety may represent both a behavioral endophenotype and may be used to predict individuals who will respond to learning-based therapies. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Alvares, Gail A; Balleine, Bernard W; Guastella, Adam J; Adams, Antony, Aupperle, Balleine, Balleine, Brown, Clarke, Clarke, Cohen, Craske, Davidson, Dayan, De Wit, De Wit, Dias-Ferreira, Dickinson, First, Foa, Fresco, Garner, Gillan, Hartley, Heimberg, Heimberg, Kessler, Kroenke, Nelson, Patton, Paulus, Potts, Rapee, Rapee, Roberson-Nay, Schwabe, Schwabe, Schwabe, Shrive, Spielberger, Starcke, Tricomi, Uren, Valentin, Ahs",2014.0,,0,0,
8166,Feasibility and outcome of dialogical exposure therapy for posttraumatic stress disorder: A pilot study with 25 outpatients.,"Objective: The research on psychotherapy for posttraumatic stress disorder (PTSD) stems predominantly from a cognitive-behavioral orientation while other approaches are underrepresented. We evaluated dialogical exposure in trauma therapy (DET), a treatment for PTSD combining cognitive-behavioral elements with an interpersonal, gestalt-based framework. Methods: In this uncontrolled pilot trial, 25 PTSD patients were treated with DET in an outpatient setting and 21 completed therapy. Results: There was a significant reduction in self-rated PTSD symptoms from pre- to posttreatment. Effect sizes were large in the completer sample and moderate to large in the intent-to-treat sample. General psychopathology also decreased significantly. The dropout rate was rather low at 16%. Conclusion: These results show that further research on DET as a treatment for PTSD is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Butollo, Willi; Konig, Julia; Karl, Regina; Henkel, Christine; Rosner, Rita; Bisson, Blanchard, Bradley, Breslau, Brahler, Butollo, Butollo, Cohen, Creamer, Derogatis, Derogatis, Ehring, Foa, Franke, Geisheim, Griesel, Hagl, Hembree, Hiller, Horowitz, Horowitz, Jacobson, Jacobson, Maercker, Paivio, Paivio, Powers, Resick, Resick, Rosner, Schottenbauer, Sloan, Weiss, Wittchen",2014.0,,0,0,
8167,Providers' perspectives regarding the feasibility and utility of an Internet-based mental health intervention for veterans.,"Although support for Internet-based interventions (IBIs) has grown significantly in the past decade, few interventions are designed specifically for veterans with posttraumatic stress disorder and other mental health problems. Additionally, research guiding IBI development is limited. We solicited feedback from providers familiar with the needs and preferences of Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF) veterans with mental health problems to inform the development of an IBI. Thematic interviews were conducted with 17 Veterans Affairs providers to (a) gain insight into the unique problems and needs of OIF/OEF veterans, (b) obtain feedback on the content and presentation of the IBI, and (c) generate suggestions regarding the effective delivery of the IBI. Providers were receptive to the use of IBIs and were vocal in their need for novel approaches and tools to address the mental health needs of their patients. They noted several advantages to IBIs such as their ability to circumvent access-to-care barriers and their ease of use and likely appeal to OIF/OEF veterans. They also noted challenges associated with IBIs, including obtaining sufficient motivation and buy-in from veterans given the distal nature of IBIs. Finally, providers offered several recommendations regarding the content and design of the IBI, as well as strategies for effective marketing and dissemination. Provider feedback was valuable in the development of an IBI that is responsive to the mental health needs of OIF/OEF veterans and in learning about how best to promote IBIs. Similar approaches can be used by stakeholders interested in developing IBIs for novel populations and settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Grubaugh, Anouk L; Gros, Kirstin Stauffacher; Davidson, Tatiana M; Frueh, B. Christopher; Ruggiero, Kenneth J; Amstadter, Bass, Brief, Burnam, Charmaz, Frueh, Frueh, Frueh, Hoge, Hoge, Internet, Karlin, Karlin, Kim, Litz, Pietrzak, Price, Robins, Sayer, Seal, Smith, Spoont, Stecker, Tanielian, Zickuhr",2014.0,,0,0,
8168,Cognitive-behavioral therapy for panic disorder with agoraphobia in older people: A comparison with younger patients.,"Background: Older adults with panic disorder and agoraphobia (PDA) are underdiagnosed and undertreated, while studies of cognitive-behavioral therapy (CBT) are lacking. This study compares the effectiveness of CBT for PDA in younger and older adults. Methods: A total of 172 patients with PDA (DSM-IV) received manualized CBT. Primary outcome measures were avoidance behavior (Mobility Inventory Avoidance scale) and agoraphobic cognitions (Agoraphobic Cognitions Questionnaire), with values of the younger (18-60 years) and older (>=60 years) patients being compared using mixed linear models adjusted for baseline inequalities, and predictive effects of chronological age, age at PDA onset and duration of illness (DOI) being examined using multiple linear regressions. Results: Attrition rates were 2/31 (6%) for the over-60s and 31/141 (22%) for the under-60s group (chi2 = 3.43, df = 1, P = .06). Patients in both age groups improved on all outcome measures with moderate-to-large effect sizes. Avoidance behavior had improved significantly more in the 60+ group (F = 4.52, df = 1,134, P = .035), with agoraphobic cognitions showing no age-related differences. Baseline severity of agoraphobic avoidance and agoraphobic cognitions were the most salient predictors of outcome (range standardized betas 0.59 through 0.76, all P-values < .001). Apart from a superior reduction of agoraphobic avoidance in the 60+ participants (beta = -0.30, P = .037), chronological age was not related to outcome, while in the older patients higher chronological age, late-onset type and short DOI were linked to superior improvement of agoraphobic avoidance. Conclusions: CBT appears feasible for 60+ PDA-patients, yielding outcomes that are similar and sometimes even superior to those obtained in younger patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hendriks, Gert-Jan; Kampman, Mirjam; Keijsers, Ger P. J; Hoogduin, Cees A. L; Voshaar, Richard C. Oude; Arch, Arrindell, Bandelow, Basoglu, Basoglu, Beaudreau, Beck, Beck, Beekman, Boswell, Bouman, Bouman, Chambless, Chambless, Coupland, Craske, Craske, Craske, Crittendon, de Beurs, de Beurs, de Beurs, Derogatis, DiNardo, Dow, Dow, Dozeman, Ensrud, Ensrud, Flint, Fuentes, Gale, Gallo, Goldberg, Goncalves, Gould, Grenier, Griez, Haby, Hartikainen, Hendriks, Hendriks, Hendriks, Kampman, Katerndahl, Kessler, Khawaja, Mohlman, Mohlman, Mohlman, Mohlman, Mohlman, Pinquart, Porensky, Prusoff, Schuurmans, Schuurmans, Segui, Seung Kim, Shear, Sheehan, Sheikh, Slade, Stanley, Stanley, Stanley, Thorp, Unutzer, Webb, Wetherell, Wetherell, Wetherell, Wetherell, Wetherell, Wetherell, Wetherell, Wetherell, Wittchen",2014.0,,0,0,
8169,Amelioration of psychiatric symptoms through exposure to music individually adapted to brain rhythm disorders-A randomised clinical trial on the basis of fundamental research.,"Introduction: This pilot study examined, whether long-term exposure of psychiatric patients to music that was individually adapted to brain rhythm disorders associated with psychoticism could act to ameliorate psychiatric symptoms. Methods: A total of 50 patients with various psychiatric diagnoses were randomised in a 1:1 ratio to listen to CDs containing either music adapted to brain rhythm anomalies associated with psychoticism-measured via a specific spectral analysis-or standard classical music. Participants were instructed to listen to the CDs over the next 18 months. Psychiatric symptoms in both groups were assessed at baseline and at 4, 8 and 18 months, using the Brief Symptom Inventory (BSI). Results: At 18 months, patients in the experimental group showed significantly decreased BSI scores compared to control patients. Intriguingly, this effect was not only seen for symptoms of psychoticism and paranoia but also for anxiety, phobic anxiety and somatisation. Conclusions: Exposure to the adapted music was effective in ameliorating psychotic, anxiety and phobic anxiety symptoms. Based on the theories of neuroplasticity and brain rhythms, it can be hypothesised that this intervention may be enhancing brain-rhythm synchronisation and plasticity in prefrontal-hippocampal circuits that are implicated in both psychosis/paranoia and anxiety/phobic anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Muller, Wolf; Haffelder, Gunter; Schlotmann, Angelika; Schaefers, Andrea T.U; Teuchert-Noodt, Gertraud; Akil, Bagorda, Basar, Begic, Bersani, Browne, Brummelte, Bruscia, Busche, Buzsaki, Campbell, Chaim, Chan, Dawirs, Dawirs, Derogatis, Derogatis, Diaz, Doron, Eisch, Fachner, Fell, Ferrarelli, Florio, Foxe, George, Gonzalez-Burgos, Gooding, Gordon, Grocke, Guetin, Haffelder, Hoptman, Hughes, Inta, Knyazev, Knyazev, Kopell, Laruelle, Lesting, Lesting, Lisman, Larincz, Mai, Mossler, Pape, Putman, Raghavachari, Revest, Schaefers, Schaefers, Schnitzler, Seidenbecher, Sharott, Siapas, Silverman, Singer, Spencer, Spitzer, Steele, Stein, Tomatis, Traub, Tsujimoto, Uhlhaas, van Praag, Weinberger, Williamson, Witte, Yilmazer-Hanke, Zhang",2014.0,,0,0,
8170,A clinical trial of cranial electrotherapy stimulation for anxiety and comorbid depression.,"Background: Anxiety disorders are among the most prevalent mental disorders and are usually treated with medication and/or psychotherapy. When anxiety disorders are accompanied with comorbid depression, this further complicates the treatment process. Medication compliance is a common problem due to adverse side effects and new and effective treatments that have minimal side effects are needed for the treatment of anxiety and depression. This study used a randomized, double-blind, sham controlled design to examine the effectiveness of CES as a treatment for anxiety disorders and comorbid depression in a primary care setting. The study was registered at clinicaltrials.gov, NCT01533415. Methods: One hundred and fifteen participants, age 18 years and over, with a primary diagnosis of an anxiety disorder were enrolled from February 2012 to December 2012 The Hamilton Rating Scale for Anxiety (HAM-A) and the Hamilton Depression Rating Scale17 (HAM-D17) were used for baseline and outcome measures at weeks one, three, and five. Response to treatment was defined as a reduction of >=50% or more on these measures. Results: Analysis of covariance revealed a significant difference between the active CES group and the sham CES group on anxiety (p = 0.001, d = 0.94) and on depression (p = 0.001, d = 0.78) from baseline to endpoint of study in favor of the active CES group. Conclusions: CES significantly decreases anxiety and comorbid depression. Subjects reported no adverse events during the study. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Barclay, Timothy H; Barclay, Raymond D; Andrade, Beck, Beneditti, Bespalov, Bystritsky, Cohen, Dolnak, Faul, Faul, Ferdjallah, Ferguson, Gilula, Gros, Kaufman, Kennerly, Kessler, Kessler, Kirsch, Klawansky, Kobak, Lingam, Liss, Merikangas, Michael, Nardone, Shealy, Shealy, Starr, Stewart-Williams, Swanson, Voris, Walsh, Wittchen, Womak",2014.0,,0,0,
8171,Low baseline pCO2 predicts poorer outcome from behavioral treatment: Evidence from a mixed anxiety disorders sample.,"Low levels of end-tidal partial pressure of carbon dioxide (pCO2)-the amount of carbon dioxide measured from expired air-are commonly found in individuals with anxiety disorders but have not been examined as predictors of outcome from anxiety treatment. The current study examined pre-treatment baseline pCO2 as a predictor of outcome from cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for anxiety disorders. Sixty-one individuals with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) defined principal anxiety disorder diagnosis completed 12 sessions of either CBT or ACT. Baseline pCO2 was measured prior to entering treatment. Self-reported anxiety symptoms and quality of life were assessed at pre-treatment, post-treatment, and 6- and 12-month follow-up from baseline. Low baseline pCO2 was associated with higher anxiety symptoms and lower quality of life across follow-up timepoints, above and beyond baseline symptom severity. These results suggest that low baseline pCO2 predicts poorer outcome from CBT and ACT for anxiety and may warrant treatment that directly addresses respiratory dysregulation. ©2014 Elsevier Ireland Ltd. All rights reserved. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Davies, Carolyn D; Craske, Michelle G; Arch, Arch, Arch, Asmundson, Braune, Brown, Chambless, Conrad, Craske, Craske, Craske, Dager, De Ruiter, Doehrmann, Dow, Eifert, Falconer, Frisch, Frisch, Gorman, Hofmann, Holt, Jansson, Jerremalm, Kessler, Klein, Laffey, Ley, Ley, McDonough, Menzies, Meuret, Meuret, Meuret, Meuret, Meuret, Meuret, Michelson, Mohring, Oakes, Ost, Papp, Reiss, Roth, Schuurmans, Schwartz, Selby, Snijders, Steketee, Tabachnick, Tolin, Watanabe, Watson, Watson, Wientjes, Wilhelm, Wolitzky-Taylor, Woods",2014.0,,0,0,
8172,Perfectionism dimensions as predictors of symptom dimensions of obsessive-compulsive disorder.,"The correlation between obsessive-compulsive disorder (OCD) and perfectionism is well documented, yet it remains unclear if dimensions of perfectionism vary as a function of OCD symptom dimensions. To this end, the present study investigated the unique associations between dimensions of perfectionism (i.e., concern over mistakes, doubts about actions, personal standards, parental criticism, parental expectations, and organization) and OCD symptom dimensions (i.e., hoarding, washing, checking, ordering, obsessing, and neutralizing). The study included adult patients with OCD (N = 46) from a residential OCD treatment program. Consistent with previous research, doubts about actions was a significant predictor of overall OCD severity and OCD checking symptoms. The organization dimension of perfectionism was a significant predictor of OCD ordering symptoms. The current study provides evidence for the unique relationships between OCD symptoms and perfectionism dimensions that encourage a movement toward greater phenotypic specificity within existing models of OCD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Martinelli, Mary; Chasson, Gregory S; Wetterneck, Chad T; Hart, John M; Bjorgvinsson, Throstur; Alcolado, Alvarenga, Antony, Antony, Ashbaugh, Ashby, Bieling, Boschen, Calamari, Calleo, Calvo, Cefalu, Chik, Coles, Cougle, Cullen, Dar, Foa, Frost, Frost, Frost, Frost, Frost, Frost, Harkin, Julien, Kyrios, Lee, Libby, Moretz, Myers, Nedeljkovic, Purdon, Rachman, Rice, Stallman, Stober, Taberner, Timpano, Tolin, Tolin, van den Hout, Viar, Wetterneck, Wheaton, Wu, Yorulmaz",2014.0,,0,0,
8173,Amygdala-frontal couplings characterizing SSRI and placebo response in social anxiety disorder.,"[Correction Notice: An Erratum for this article was reported in Vol 17(8) of International Journal of Neuropsychopharmacology (see record 2014-27454-022). In the original article, an author was inadvertently omitted from this article. The correct author list and affiliation are present in the erratum.] In patients with social anxiety disorder (SAD) it has been reported that selective serotonin reuptake inhibitors (SSRIs) and placebo induce anxiolytic effects by attenuating neural activity in overlapping amygdala subregions, i.e. left basolateral and right ventrolateral amygdala. However, it is not known whether these treatments inhibit amygdala subregions via similar or distinct brain pathways. As anxiolytic treatments may alter amygdala-frontal couplings we investigated differences and similarities in amygdala-frontal functional co-activation patterns between responders and nonresponders to SSRIs and placebo in patients with SAD. Positron emission tomography (PET) with oxygen-15-labeled water was used to measure anxiety-related regional cerebral blood flow in 72 patients with SAD before and after 6-8 wk of treatment under double-blind conditions. Functional couplings were evaluated with a seed region approach using voxel values from the left basolateral and right ventrolateral amygdala. Responders and nonresponders to SSRIs and placebo showed different treatment-induced co-activations between the left amygdala and the dorsolateral prefrontal cortex (dlPFC) as well as the rostral anterior cingulate cortex (ACC). Conjunction analysis suggested shared anxiolysis-dependent inverse co-activations in SSRI and placebo responders between the left amygdala-dlPFC and left amygdala-rostral ACC, and a shared positive co-activation between left amygdala-dorsal ACC. We demonstrate that amygdala-frontal co-activation patterns differentiate effective from ineffective anxiolytic treatments and that SSRI and placebo responders share overlapping neuromodulatory paths that may underlie improved emotion regulation and reduced expression of anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Faria, Vanda; Ahs, Fredrik; Appel, Lieuwe; Linnman, Clas; Bani, Massimo; Bettica, Paolo; Pich, Emilio Merlo; Fredrikson, Mats; Furmark, Tomas; Anand, Andrade, Atlas, Banks, Benedetti, Benedetti, Bingel, Bueno, Cammarota, Chen, Cole, Colloca, Etkin, Etkin, Faria, Faria, First, Freitas-Ferrari, Furmark, Furmark, Furmark, Furmark, Gashghaei, Gimenez, Green, Guyer, Hahn, Hartley, Kim, Korb, Krummenacher, LeDoux, Mai, Maldjian, Mayberg, Mayberg, Mayberg, Milad, Miskovic, Ochsner, Oosterbaan, Petrovic, Petrovic, Petrovic, Phan, Phillips, Pizzagalli, Pizzagalli, Prater, Ray, Robinson, Roy, Salzman, Slancaster, Spielberger, Stein, Swanson, Talairach, Whalen, Zaider",2014.0,,0,0,
8174,Working alliance in individual and group cognitive therapy for social anxiety disorder.,"The tripartite model of working alliance, including the therapeutic bond and agreement on tasks and goals, was examined in 54 patients who received individual or group cognitive behavior therapy (CBT) for social anxiety disorder (SAD) in a randomized trial. Alliance was significantly stronger in individual relative to group CBT but generally not related to outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mortberg, Ewa; Andersson, Bordin, Clark, First, Horvath, Martin, Mattick, Mortberg, Mortberg, Stekette, Tracey, Webb, Woody",2014.0,,0,0,
8175,"Pilot study of Creating Change, a new past-focused model for PTSD and substance abuse.","Background and Objectives: Creating Change (CC) is a new past-focused behavioral therapy model developed for comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD). It was designed to address current gaps in the field, including the need for a past-focused PTSD/SUD model that has flexibility, can work with complex clients, responds to the staffing and resource limitations of SUD and other community-based treatment programs, can be conducted in group or individual format, and engages clients and clinicians. It was designed to follow the style, tone, and format of Seeking Safety, a successful present-focused PTSD/SUD model. CC can be used in conjunction with SS and/or other models if desired. Methods: We conducted a pilot outcome trial of the model with seven men and women outpatients diagnosed with current PTSD and SUD, who were predominantly minority and low-income, with chronic PTSD and SUD. Assessments were conducted pre- and post-treatment. Results: Significant improvements were found in multiple domains including some PTSD and trauma-related symptoms (eg, dissociation, anxiety, depression, and sexual problems); broader psychopathology (eg, paranoia, psychotic symptoms, obsessive symptoms, and interpersonal sensitivity); daily life functioning; cognitions related to PTSD; coping strategies; and suicidal ideation (altogether 19 variables, far exceeding the rate expected by chance). Effect sizes were consistently large, including for both alcohol and drug problems. No adverse events were reported. Discussion and Conclusions: Despite study methodology limitations, CC is promising. Scientific Significance: Clients can benefit from past-focused therapy that addresses PTSD and SUD in integrated fashion. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Najavits, Lisa M; Johnson, Kay M; Box, Bradley, Brady, Briere, Cloitre, Courtois, Derogatis, Eisen, Foa, Foa, Gidron, Green, Herman, Hien, Janoff-Bulman, Kessler, Krinsley, Larsen, Linehan, Luborsky, McLellan, McLellan, Mills, Najavits, Najavits, Najavits, Najavits, Najavits, Najavits, Najavits, Najavits, Najavits, Neuner, Sannibale, Schwarz, Shapiro, Sheehan, Tobin, van Dam, van der Kolk, Weathers, Wright",2014.0,,0,0,
8176,Double blind design and the use of psychological placebos in outcomes research in psychotherapy: Is it possible? A pilot feasibility study.,"Double blind design and placebos have been of crucial importance in medical clinical research. Their use in outcomes research in the field of psychotherapy has been controversial, though. Their feasibility in such case has been denied by many authors based on the assumption that the psychotherapist would need to know the nature of the applied procedure. In view of this, the author has conducted a pilot feasibility study on three subjects within the context of his doctoral dissertation. Said dissertation aims at establishing the role of alternating bilateral auditory stimulation in the processing of traumatic memories as used in the EMDR (Eye Movement Desensitization and Reprocessing) technique. To such end, the EMDR basic principles and procedures are introduced -with particular attention to alternating bilateral auditory stimulation- and a pilot study using placebos during EMDR administration is presented in detail. The goals of this study are testing the feasibility of: (a) using a psychological placebo in EMDR therapy,and (b) applying a double blind design study in EMDR outcomes research. A single case experimental design was performed on three different patients suffering from PTSD (Posttraumatic Stress Disorder). A symptomatology baseline was established through out three weekly sessions using the DTS (Davidson Trauma Scale) and the OQ-45.2 (Outcomes Questionnaire 45.2). First, three CDs were recorded -one with no sound at all (CD-1, silence condition); another one with auditory stimulation consisting of a tic-tac sound recorded in monaural condition, and reproduced simultaneously over both earphones at a rate of one beat per second (CD-2, monaural condition) and a third one with alternating bilateral auditory stimulation consisting of the exact same sound recorded in stereophonic condition, and reproduced alternatively over the left and right earphones (CD-3,stereo condition)-. At a second stage, these three experimental conditions were assigned randomly to the three subjects, who were administered: (a) EMDR protocol without any type of stimulation, with no sound coming out of the earphones using CD-1 (placebo 1), (b) EMDR protocol with simultaneous bilateral auditory stimulation using CD-2 (placebo 2), and (c) EMDR protocol with alternating bilateral auditory stimulation using CD-3 (active treatment). In all cases, the experimental conditions were implemented during three full sessions in which the CDs were reproduced for the subjects through earphones, instead of speakers, to ensure that the psychotherapist was unaware of the actual conditions. Subsequently, the standard EMDR protocol was administered to each subject until the end of the treatment, determined either by the symptoms being resolved or the maximum of ten sessions being completed. As a result of this pilot study, the author concludes that the feasibility of using double blind studies and placebos in EMDR psychotherapy has indeed been established. Since no apparent difficulties in the administration of the placebos were detected during the study, the use of psychological placebos seems viable. Such procedure is equally credible for the patient as well as for the psychotherapist, which renders possible the development of a double blind design in EMDR outcomes research. It should be noted, though, that the credibility of the placebo was not formally assessed, but rather was perceived through the author's informal observation. Developing assessment criteria and formal tools to evaluate the credibility of placebo procedures is advisable if future investigations on the subject are to be carried. Even though this study was conducted under a Single Case Experimental Design, the placebo procedure employed could be easily adapted for its use in between group's designs. Finally, some of the possible applications and consequences regarding the introduction of placebos and double blind design in psychotherapy research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cazabat, Eduardo H; Albright, Barker, Barkham, Barlow, Beins, Bergman, Borkovec, Borkovek, Carbonell, Carr, Cazabat, Chambless, Chambless, Chambless, Charney, Christman, Cusack, Davidson, Davidson, Devilly, Ehlers, Fernandez alvarez, Freeman, Goodwin, Haworth, Heppner, Herbert, Herbert, Herbert, Howitt, Krauth, Lambert, Lambert, Lee, Lilienfeld, Marczyk, Maristany, Maxfield, McLeod, McMillan, McNally, Nowill, Oren, Propper, Richaud De Minzi, Roberts, Rothbaum, Rubin, Rubin, Santibanez Fernandez, Schubert, Servan-Schreiber, Shapiro, Shapiro, Shapiro, Shapiro, Simons, Spector, Stickgold, Turpin, Villafane, Von Bergen, Wojciechowski",2014.0,,0,0,
8177,Development and initial evaluation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders.,"Considerable attention has focused on the growing need for evidence-based psychotherapy for veterans with affective disorders within the Department of Veteran Affairs. Despite, and possibly due to, the large number of evidence-based protocols available, several obstacles remain in their widespread delivery within Veterans Affairs Medical Centers. In part as an effort to address these concerns, newer transdiagnostic approaches to psychotherapy have been developed to provide a single treatment that is capable of addressing several, related disorders. The goal of the present investigation was to develop and evaluate a transdiagnostic psychotherapy, Transdiagnostic Behavior Therapy (TBT), in veterans with affective disorders. Study 1 provided initial support for transdiagnostic presentation of evidence-based psychotherapy components in veterans with principal diagnoses of affective disorders (n = 15). These findings were used to inform the development of the TBT protocol. In Study 2, an initial evaluation of TBT was completed in a second sample of veterans with principal diagnoses of affective disorders (n = 29). The findings of Study 2 demonstrated significant improvements in symptoms of depression, anxiety, stress, posttraumatic stress, and related impairment across participants with various principal diagnoses. Together, the investigation provided preliminary support for effectiveness of TBT in veterans with affective disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gros, Daniel F; Barlow, Barlow, Barlow, Bell, Blanchard, Boswell, Bradley, Butler, Craske, Devins, Devins, Devins, Ellard, Farchione, Foa, Ginzburg, Gros, Gros, Gros, Gros, Gros, Hoge, Hoge, Hunt, Kashdan, Kessler, Kessler, Longmore, Lovibond, Magruder, McEvoy, McHugh, Norton, Norton, Norton, Orsillo, Rogers, Ruzek, Schmidt, Sheehan",2014.0,,0,0,
8178,Impact of cognitive-behavioral therapy for social anxiety disorder on the neural bases of emotional reactivity to and regulation of social evaluation.,"We examined whether Cognitive-Behavioral Therapy (CBT) for social anxiety disorder (SAD) would modify self-reported negative emotion and functional magnetic resonance imaging brain responses when reacting to and reappraising social evaluation, and tested whether changes would predict treatment outcome in 59 patients with SAD who completed CBT or waitlist groups. For reactivity, compared to waitlist, CBT resulted in (a) increased brain responses in right superior frontal gyrus (SFG), inferior parietal lobule (IPL), and middle occipital gyrus (MOG) when reacting to social praise, and (b) increases in right SFG and IPL and decreases in left posterior superior temporal gyrus (pSTG) when reacting to social criticism. For reappraisal, compared to waitlist, CBT resulted in greater (c) reductions in self-reported negative emotion, and (d) increases in brain responses in right SFG and MOG, and decreases in left pSTG. A linear regression found that after controlling for CBT-induced changes in reactivity and reappraisal negative emotion ratings and brain changes in reactivity to praise and criticism, reappraisal of criticism brain response changes predicted 24% of the unique variance in CBT-related reductions in social anxiety. Thus, one mechanism underlying CBT for SAD may be changes in reappraisal-related brain responses to social criticism. ClinicalTrials.gov identifier: NCT00380731. http://www.clinicaltrials.gov/ct2/show/NCT00380731?term=social+anxiety+cognitive+behavioral+therapy+Stanford&rank=1. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Goldin, Philippe R; Ziv, Michal; Jazaieri, Hooria; Weeks, Justin; Heimberg, Richard G; Gross, James J; Amir, Arsalidou, Birbaumer, Blair, Blair, Boccia, Brown, Buhle, Campbell-Sills, Canton, Clark, Cohen, Cooney, Cox, Crowne, D'Avanzato, Di Nardo, Efron, Etkin, Fan, Forman, Fresco, Furmark, Glover, Goldberg, Goldin, Goldin, Goldin, Goldin, Gordon, Gross, Gross, Gusnard, Heimberg, Hope, Hope, Klumpp, Kocovski, Ledley, Liebowitz, Messina, Moscovitch, Oldfield, Petrides, Porto, Price, Pujol, Rytwinski, Sato, Schmitz, Schultz, Sergent, Stein, Stein, Straube, Talairach, Trautmann, Ungerleider, Van Ameringen, Werner, Ziv",2014.0,,0,0,
8179,"A randomized clinical trial of Observed and Experiential Integration (OEI): A simple, innovative intervention for affect regulation in clients with PTSD.","Since 1994 an innovative treatment has been in development for psychological trauma, known as Observed & Experiential Integration (OEI; Bradshaw, Cook, & McDonald, 2011; Cook & Bradshaw, 1999, 2002). In this small pilot RCT, OEI outperformed a delayed treatment control condition for reduction of PTSD symptoms on the Clinician-Administered PTSD Scale (CAPS) and the Impact of Event Scale-Revised (IES-R). A script-driven symptom provocation protocol was employed. Ten mixed trauma survivors (3 male, 7 female) received three 1-hour sessions of OEI ""Switching"". After the delayed treatment group received the same intervention, all but one participant no longer met the criteria for PTSD. In this report, the RCT is supplemented by a qualitative 2-year follow up. OEI Switching can be easily taught to clients for affect regulation during, and between, sessions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bradshaw, Richard A; McDonald, Marvin J; Grace, Ronwyn; Detwiler, Laurie; Austin, Kevin; Bernstein, Blake, Bohart, Bradshaw, Bradshaw, Briere, Butterfield, Carlson, Chemtob, Cloitre, Cook, Cook, Courtois, Dennison, Dennison, Feinstein, Foa, Gendlin, Hannaford, Hopper, Horowitz, Ironson, Lang, Lanius, Lanius, Levin, Linehan, McCloud, Najavits, Orr, Paivio, Pitman, Pitman, Pitman, Rauch, Resick, Rothbaum, Schiffer, Schiffer, Schiffer, Schiffer, Schiffer, Schiffer, Schiffer, Schiffer, Schore, Schore, Shapiro, Shapiro, Shin, Stickgold, van der Kolk, van der Kolk, Weiss, Wolpe",2014.0,,0,0,
8180,Early traumatized inpatients high in psychoform and somatoform dissociation: Characteristics and treatment response.,"This study examined the clinical relevance of differences in psychoform and somatoform dissociative symptoms in 55 early traumatized inpatients. The high psychoform and somatoform dissociative group (n = 18), somatoform dissociative group (n = 22), and nondissociative group (n = 15) did not differ on abuse severity, depressive symptoms, interpersonal problems, Axis I or II comorbidity, or deterioration rates. Compared to the other 2 groups, the highly dissociative group was characterized by younger age, living alone, higher levels of posttraumatic and general distress, more frequent reports of suicidality, self-mutilation, eating problems, and less favorable treatment response. The results highlight the clinical relevance of using dissociation measures for identifying subgroups of patients with severe psychopathology who may be more treatment resistant. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Jepsen, Ellen K. K; Langeland, Willie; Heir, Trond; Baars, Beck, Bernstein, Boon, Brand, Brand, Briere, Carlson, Cloitre, Cloitre, Cohen, Dell, Dell, Derogatis, Dorrepaal, Dozois, Ellason, Ellason, Farina, Fink, First, Herman, Horowitz, Jacobson, Jepsen, Jepsen, Johnson, Lipsanen, Maaranen, Mueller-Pfeiffer, Neal, Nijenhuis, Nijenhuis, Pedersen, Pedersen, Resick, Sheehan, Spinazzola, Steinberg, Steinberg, Waller, Zanarini, Sar",2014.0,,0,0,
8181,Effectiveness of cognitive processing therapy for treating posttraumatic stress disorder.,"Analyzing 11 studies, we evaluated the effectiveness of cognitive processing therapy (CPT) for treating posttraumatic stress disorder (PTSD) and co-occurring depression symptoms in individuals diagnosed with PTSD. Separate meta-analytic procedures for between-group studies using waitlist or alternative treatment comparisons yielded large to very large effect sizes for CPT versus waitlist, and medium to large effect sizes when CPT was compared to alternative treatments. Implications for evidence-supported practice and study limitations are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lenz, Stephen; Bruijn, Brian; Serman, Nina S; Bailey, Laura; Ahrens, Alvarez, Borofsky, Boyraz, Brewin, Chambless, Chambless, Chard, Cohen, Cooper, Cooper, Davidson, Deacon, Ditlevson, Forbes, Galovski, Garg, Gradus, Green, Hammock, Hinton, Hoge, Hollon, Kessler, Kunst, Laffaye, Lenz, Lipsey, Makinson, Marotta, McHugh, Monson, Nepon, Nishith, Nixon, Palgi, Pinna, Resick, Resick, Resick, Resick, Sabri, Schell, Seligman, Sledjeski, Spinazzola, Strauser, Suris, Taylor, Valentine, Zappert",2014.0,,0,0,
8182,Attachment style moderates the effects of oxytocin on social behaviors and cognitions during social rejection: Applying a research domain criteria framework to social anxiety.,"Whereas the Diagnostic and Statistical Manual of Mental Disorders (DSM) categorizes individuals with similar self-reported symptoms, the research domain criteria offers a new approach for classifying mental disorders on the basis of dimensions of observable behaviors and neurobiological measures. The objective of this proof-of-concept study was to adopt this approach by distinguishing individuals on the basis of disorder-related personality traits during an experimental manipulation that targeted a disorder-related biological mechanism. In a double-blind, placebo-controlled study design, we examined whether attachment style moderated the effect of oxytocin administration on social behaviors and cognitions during a social-exclusion test in individuals with social anxiety disorder. Among participants who received oxytocin, as opposed to a placebo, only individuals with low attachment avoidance displayed more social affiliation and cooperation, and only those with high attachment avoidance showed faster detection of disgust and neutral faces. Thus, attachment style moderated oxytocin's effects among individuals who shared the same DSM diagnosis. We conclude that neurobiological tests can inform new classification strategies by adopting a research domain criteria framework. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fang, Angela; Hoge, Elizabeth A; Heinrichs, Markus; Hofmann, Stefan G; Bartz, Baumgartner, Boyce, Brennan, Buchheim, Congdon, Costa, Davis, DiNardo, Domes, Ellenbogen, Essex, Evans, Guastella, Guastella, Harb, Heinrichs, Heinrichs, Heinrichs, Hek, Hofmann, Insel, Kosfeld, Kumsta, Labuschagne, Labuschagne, Liebowitz, MacDonald, Mattick, Meyer-Lindenberg, Niciu, Posner, Posner, Russ, Sanislow, Watson, Williams, Williams",2014.0,,0,0,
8183,"Unmet needs, psychological distress and quality of life in men commencing radiotherapy for prostate cancer","OBJECTIVES: Prostate cancer is the second most common cancer in men worldwide. Commencing radiotherapy is a particularly difficult time, when there is a high need for information and support to manage physical and psychosocial symptoms. However, these needs and concerns are often unreported by men and undetected by health professionals, potentially resulting in elevated distress. This project examined unmet needs, distress and quality of life in a large sample of men commencing radiotherapy for prostate cancer. METHOD: A consecutive sample of 330 men (response rate 70%) with prostate cancer commencing potentially curative radiotherapy for the first time participated in a randomised controlled trial testing the effectiveness of a psycho-educational intervention. Baseline data is reported. Questionnaires assessed unmet needs using Supportive Care Needs Survey (SCNS), anxiety and depression using Hospital Anxiety and Depression Scale (HADS), distress using the Distress Thermometer (DT) and quality of life using the Expanded Prostate Cancer Index Composite (EPIC). RESULTS: 20% reported probable anxiety and 8% reported probable caseness for depression on HADS. 19% reported clinically significant distress on the DT. 93% reported at least one unmet need (mean = 13 of total 34 needs). The highest unmet need was having a staff member to discuss all aspects of cancer and treatment (36%). High needs correlated with higher anxiety, depression and distress across all domains (p < 0.01). 36% reported sexual functioning as a significant problem on the EPIC. CONCLUSIONS: This study indicates that many men with prostate cancer experience high levels of unmet needs, psychological distress and poor sexual functioning prior to commencing radiotherapy, despite an absence of treatment side-effects and a good prognosis. This is particularly evident in the psychological, health system information and sexuality domains. This study highlights the need for better methods for detecting unmet needs at treatment commencement and tailored interventions to reduce needs and distress for this vulnerable group.",Lotfi-Jam K.; Dolling L.; Sharkey K.; Gough K.; Dudgeon P.; Aranda S.; Schofield P.,2010.0,10.1002/pon.1776,0,0,
8184,Gamma ventral capsulotomy for obsessive compulsive-disorder: Interim results of a randomized controlled trial,"Background: Up to 40 % of Obsessive Compulsive Disorder (OCD) patients do not respond to conventional treatments. For this subgroup, an improved, stereotactic radiosurgery (Gamma ventral capsulotomy-GVC) was developed. We report the updated results from a pilot study with this new technique, as well as from a double-blind, randomized controlled trial (DB-RCT). Methods: Twenty one refractory DSM-IV OCD patients were selected. The first five patients were included in a pilot study. The other 16 subjects randomly received active (8 patients) or “sham” (7 patients) radiosurgery. One patient is still under blind condition. Periodical pre and post-operative followup assessments were provided, including psychopathological, global status, neuropsychological and personality scales, and magnetic resonance imaging scans with voxel-based morphometry (VBM). Results: Three patients from the pilot study and three patients from the RCT active group became responders. As a whole, six out of thirteen (46 %) patients who had received active radiosurgery responded, 12 months or more after surgery. For the sham group, none responded for 12 months of follow-up. Manic episodes, delirium, episodic headaches, dizziness, nausea were few times observed. One patient presented a cyst and transient cognitive changes. Improved simple visual attention (p=0.04), logical memory (p=0.04), and verbal/full IQs (p=0.04) were observed in the pilot patients. Post-operative VBM analysis (pilot patients) suggests increased gray matter volume in right inferior frontal gyri (BA47). VBM analysis for the RCT patients is under way. Conclusions: Preliminary findings indicate that GVC for OCD shows some efficacy, with relatively few adverse effects.",Lopes A.C.; Canteras M.M.; Batistuzzo M.; De Mathis M.E.; D'Alcante C.C.; Taub A.; Duran F.L.S.; Gouvêa F.S.; Hoexter M.Q.; Greenberg B.D.; Norén G.; Rasmussen S.A.; Castro C.C.; Leite C.; Filho G.B.; Shavitt R.G.; Miguel E.C.,2010.0,10.1016/j.biopsych.2010.03.009,0,0,
8185,Improving the psychosocial health of people with cancer and their carers: A community-based approach,"OBJECTIVES: Although clinical practice guidelines advise routine screening for psychological distress to facilitate referral to evidence-based care, this frequently does not occur in practice. This presentation presents the design of a two-arm randomised controlled trial with distressed patients and carers, comparing minimal contact self-management versus an individualised tele-based cognitive behavioural intervention. Uniquely, the study was undertaken within a practice-based setting to facilitate rapid translation into practice after study completion and to ensure ecological validity. METHOD: Patients (n = 280) and carers (n = 280) contacting the participating community-based cancer Helplines during the study period and screening positive for distress were recruited and randomised to 1) a nurse-led 30-45 minute telephone support session and given a self-management manual or 2) a tele-based, psychologist delivered cognitive behavioural intervention. Participants' anxiety and depression, cancer specific distress, unmet supportive care needs, positive adjustment, and overall QOL are assessed at baseline and 2, 6 and 12 months post-recruitment. RESULTS: The presentation will discuss the challenges of undertaking this work within a practice setting, including competing workloads, unfamiliarity with research protocols, and help giving attitudes. Baseline data outlining the adjustment problems experienced by these patients and carers will be presented. CONCLUSIONS: Cancer Helplines are highly accessed by distressed patients and carers and provide a unique point of articulation for distress screening and evidence-based care. However, there are skill and attitudinal barriers to be overcome in order for distress screening to become standard care; and the heterogeneous nature of the psychological problems these clients display presents challenges for both research and practice.",Chambers S.; Girgis A.; Occhipinti S.; Hutchison S.; Turner J.; Carter R.; Dunn J.,2010.0,10.1002/pon.1776,0,0,
8186,Randomised Controlled Trial (RCT) of a comprehensive post-treatment support package (survivor-care) for bowel cancer survivors,"OBJECTIVES: Bowel (or colorectal) cancer (CRC) is the most common cancer affecting Australian men and women. The illness and its treatments can cause distressing physical side-effects, impact on the person's emotional and psychological state and adversely affect social, occupational and relationship functioning. This presentation will report on the effectiveness of an innovative supportive care program (SurvivorCare) for people with potentially curative CRC, aiming to reduce psychological distress and unmet needs. METHOD: Patients will be randomised to receive usual care or the SurvivorCare package, which comprises: (a) survivorship educational materials; (b) a tailored survivorship care plan for the patient, GP and specialists; (c) a nurse-led end of treatment consultation, followed by telephone-based follow up 1, 3 and 7 weeks post-treatment session. This study will aim to recruit 334 patients from up to 12 Australian cancer treatment centres. Psychological distress will be the primary study outcome. RESULTS: The study is due to commence recruitment in early 2010. In pilot testing, 10 people received the complete package. All survivors considered it appropriate, relevant and useful. Survivors and staff found the intervention to be highly acceptable. CONCLUSIONS: The pilot study supported the intervention's suitability and feasibility. The intervention was well-received by patients and can potentially help them manage their concerns and worries. If SurvivorCare is shown to reduce distress and unmet needs, it will be possible to quickly and broadly disseminate this model of care.",Jefford M.; Schofield P.; Aranda S.; Young J.; Butow P.,2010.0,10.1002/pon.1776,0,0,
8187,Catastrophizing delays the analgesic effect of distraction,"Behavioral analgesic techniques such as distraction reduce pain in both clinical and experimental settings. Individuals differ in the magnitude of distraction-induced analgesia, and additional study is needed to identify the factors that influence the pain relieving effects of distraction. Catastrophizing, a set of negative emotional and cognitive processes, is widely recognized to be associated with increased reports of pain. We sought to evaluate the relationship between catastrophizing and distraction analgesia. Healthy participants completed three sessions in a randomized order. In one session (Pain Alone), pain was induced by topical application of a 10% capsaicin cream and simultaneous administration of a tonic heat stimulus. In another session (Pain + Distraction), identical capsaicin + heat application procedures were followed, but subjects played video games that required a high level of attention. During both sessions, verbal ratings of pain were obtained and participants rated their degree of catastrophizing. During the other session (Distraction Alone) subjects played the video games in the absence of any pain stimulus. Pain was rated significantly lower during the distraction session compared to the ""Pain Alone"" session. In addition, high catastrophizers rated pain significantly higher regardless of whether the subjects were distracted. Catastrophizing did not influence the overall degree of distraction analgesia; however, early in the session high catastrophizers had little distraction analgesia, though later in the session low and high catastrophizers rated pain similarly. These results suggest that both distraction and catastrophizing have substantial effects on experimental pain in normal subjects and these variables interact as a function of time. © 2009 International Association for the Study of Pain.",Campbell C.M.; Witmer K.; Simango M.; Carteret A.; Loggia M.L.; Campbell J.N.; Haythornthwaite J.A.; Edwards R.R.,2010.0,10.1016/j.pain.2009.11.012,0,0,
8188,Unintentional memory inhibition is weakened in non-clinical dissociators,"Although participants with dissociation proneness showed inefficient cognitive inhibition, whether and under what stimulus-task contexts dissociators show inefficient memory inhibition remains inconclusive. This study investigated the relationship between trait dissociation and basic operation of memory control using a non-clinical sample. To reduce the involvement of strategic control and the influence of emotionality, the retrieval-practice paradigm was adopted to examine unintentional memory inhibition of neutral materials. Both the low- and middle-dissociation groups showed the forgetting effect, resulting from suppressing competing memories while retrieving a target. In contrast, the high-dissociation group did not show the forgetting effect although their performance in the baseline condition and in recalling practiced items was comparable to the other two groups. High dissociation proneness is linked with weakened memory inhibition that may cause diverse memory problems in clinical patients. © 2009 Elsevier Ltd. All rights reserved.",Chiu C.-D.; Yeh Y.-Y.; Huang C.-L.; Wu Y.-C.; Chiu Y.-C.; Lin C.-C.,2010.0,10.1016/j.jbtep.2009.11.003,0,0,
8189,Aseptic meningitis with a twist,"LEARNING OBJECTIVE 1: Enhance clinician awareness of an often overlooked yet potentially life-threatening cause of meningitis. LEARNING OBJECTIVE 2: Describe the clinical syndrome, therapies and complications of neurosarcoidosis. CASE: A 43 year-old African-American woman with a history of asthma, depression, and post-traumatic stress disorder presented with worsening weakness, tremors, behavioral changes and hallucinations. Her symptoms began two months prior to admission with increasing weakness in her lower extremities, gait instability causing her increased falls, increased bilateral upper extremity tremor, mood lability, agitation, paranoia and visual hallucinations. She also developed new-onset bowel and bladder incontinence and inability to walk one week prior to admission. Physical exam revealed photosensitivity, slurred speech, intention tremor, cogwheeling in both upper extremities, startle myoclonus, slowed rapid alternating movements, and a magnetic gait with apraxia. Brain MRI initially showed lateral ventricular enlargement and enhancement around the basal cisterns and within the posterior fossa. CBC showed mild microcytic anemia, and HIV screening, hepatic function tests, viral hepatits serologies, Lyme disease titers, and autoimmune studies were all negative. Cerobrospinal fluid analysis revealed a low glucose at 34 mg/dL, 111 leukocytes with 51% lymphocytes, 6 red blood cells, and elevated protein at 309 mg/dL. Bacterial cultures, fungal cultures, flow cytometry for looking for lymphoma, VDRL, and HSV screens were negative. The patient was started on ceftriaxone, vancomycin, and acyclovir for possible meningitis. As the patient was not improving, repeat brain MRI revealed leptomeningeal enhancement predominantly involving the basilar cisterns and extending along the brainstem and cranial nerves. Subsequent PET scan was done revealing enlarged kidneys with increased FDG uptake. A kidney biopsy was done showing noncaseating granulomatous inflammation, consistent with sarcoidosis. Based on these findings and her aseptic meningitis, the diagnosis of neurosarcoidosis was made. DISCUSSION: Sarcoidosis has a myriad of possible presentations, including meningitis or encephalopathy. Neurologic manifestations are rare with sarcoidosis, with an estimated frequency of <5%. Neurosarcoid aseptic meningitis can look clinically indistinguishable from viral infections, tuberculosis or syphilis. Cerebrospinal fluid findings in patients with neurosarcoidosis may include pleocytosis (mainly lymphocytosis), elevated protein levels or cells (up to 81% of patients), and decreased glucose levels (20% of patients). In general, neurosarcoidosis carries a poorer prognosis than any of the protean manifestations of the disease. Of all deaths due primarily to sarcoidosis, 25% occur in patients with CNS localization. Although there are no controlled trials of the treatment of neurosarcoidosis, corticosteroids are generally accepted as the first line of treatment. Patients with neurosarcoidosis can have a monophasic illness, a relapsing-remitting course, or progressive disease punctuated by episodic deteriorations. Approximately 10 percent of patients die as a direct result of the inflammatory process or its treatment. Typically these patients have CNS parenchymal disease or hydrocephalus and are often profoundly immunocompromised due to treatment.",Farrington L.; Pfeifer K.,2010.0,10.1007/s11606-010-1338-5,0,0,
8190,Clinical controlled study of venlafaxine and fluoxetine in treatment of obsessive-compulsive disorder,"Objective: The aim of this study was to compare the clinical efficacy and the safety of venlafaxine and fluoxetine in the treatment of obsessive-compulsive disorder (OCD). Methods: One hundred and Eight inpatients who met the Diagnostic and Statistical Manual of Mental Disorders, the Forth Edition(DSM-IV) for OCD were involved in this study. The subjects were randomly divided into venlafaxine group or fluoxetine group. Efficacy of venlafaxine and fluoxetine in treatment of OCD were assessed with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Clinical Global Impression-Severity(CGI-S) , the side effects were evaluated with Treatment Emergent Symptom Scale (TESS). Results: The therapeutic efficacy in venlafaxine group was similar to that in fluoxetine (70.36%vs68.29%, P>0.05) after eight weeks' therapy. The improve-rates of Y-BOCS after 2 weeks' therapy of venlafaxine were significant higher than those of baseline, while the improve-rates of Y-BOCS after 4 weeks' therapy of fluoxetine were significant higher than those of baseline(P< 0.05). The side effects of venlafaxine group were similar to fluoxetine group (P>0.05). Conclusion: The results indicate that both venlafaxine and fluoxetine is effective in the treatment of OCD , but venlafaxine work faster than fluoxutine.",Liu H.; Ji C.; Xiao W.; Wang G.,2010.0,10.1016/S0924-9338(10)70941-X,0,0,
8191,Aripiprazole augmentation in the treatment of drug-resistant obsessive-compulsive disorder: Case series,"Objective: Obsessive-compulsive disorder (OCD) is a debilitating condition with a lifetime prevalence of 2%-3% (1,2). Although serotonin reuptake inhibitors (SSRIs) has improved the treatment and prognosis of OCD, a notable percantage of patients (from 40% to 60%) do not respond to treatment (3). One of the most studied strategies for the drug-resistant OCD is the augmentation of antipsychotic drugs to SRI treatment. To date there is limited data regarding the use of aripiprazole in patients with treatment resistant OCD. In this study we aimed to investigate the effects of aripiprazole on augmenting SSRIs in patients with drug-resistant OCD. Methods: Ten patients diagnosed with drug-resistant OCD who admitted to psychiatric outpatient clinic of Sisli Etfal Research and Teaching Hospital were included in the study. One patient was excluded from the study due to a general medical condition, and two subjects could not complete the study due to adverse events. Yale- Brown Obsessive Compulsive Scale (YBOCS) was administered to evaluate the severity of symptoms and SCID-I was used to confirm the diagnosis. Aripiprazole 5 mg/day was introduced as augmentation strategy to SSRI treatment and increased up to a maximum of 20 mg/day. Results: Y-BOCS scores declined from baseline by 10% to 54% over the 10 week period. Patients showed significant improvement over the 10 week period (Yale-Brown Obsessive Compulsive Scale total scores at week 10 as compared to baseline - all patients: d.f.=6, P<0.001). Conclusion: This study supports the notion that the augmentation of SSRIs with aripiprazole as a valid strategy in the treatment of drug resistant OCD. This report also points out that randomized double-blind controlled trials are needed to further clarify the results.",Karamustafalioglu O.; Yavuz B.G.; Tankaya O.; Cevik M.; Akbiyik M.; Toprak E.; Bakim B.; Ozcelik B.; Ceylan Y.C.,2010.0,10.1017/S1461145710000635,0,0,
8192,Feeling of doing in obsessive-compulsive checking,"Research on self-agency emphasizes the importance of a comparing mechanism, which scans for a match between anticipated and actual outcomes, in the subjective experience of doing. This study explored the ""feeling of doing"" in individuals with checking symptoms by examining the mechanism involved in the experienced agency for outcomes that matched expectations. This mechanism was explored using a task in which the subliminal priming of potential action-effects (emulating outcome anticipation) generally enhances people's feeling of causing these effects when they occur, due to the unconscious perception of a match between primed and observed outcomes. The main result revealed a negative relationship between checking and self-agency for observed outcomes that were primed prior to actions. This suggests that checking individuals fail to grasp the correspondence between actual outcomes of their actions and expected ones. We discuss the possible role of undermined self-agency in checking phenomena and its relationship with cognitive dysfunction. © 2010 Elsevier Inc. All rights reserved.",Belayachi S.; Van der Linden M.,2010.0,10.1016/j.concog.2010.02.001,0,0,
8193,Evaluation of the Atypical Response scale of the Trauma Symptom Inventory-2 in detecting simulated posttraumatic stress disorder,"This investigation evaluated the Atypical Response (ATR) scale of the Trauma Symptom Inventory - 2nd edition (TSI-2) in terms of its ability to distinguish genuine symptoms of posttraumatic stress disorder (PTSD) from simulated PTSD. Seventy-five undergraduate students were trained to simulate PTSD and were given monetary incentives to do so. Their responses on the PTSD Checklist (PCL), TSI-2 ATR, and Personality Assessment Inventory (PAI) validity scales were compared to responses of 49 undergraduate students with genuine symptoms of PTSD instructed to respond honestly on testing. Results indicate that the revised version of the ATR is superior to the original version in detecting malingered PTSD. Discriminant Function Analyses revealed correct classification of 75% of genuinely distressed individuals and 74% of PTSD simulators. © 2010 Elsevier Ltd.",Gray M.J.; Elhai J.D.; Briere J.,2010.0,10.1016/j.janxdis.2010.02.011,0,0,
8194,Olanzapine augmentation for treatment-resistant obsessive-compulsive disorder: A case report,"Objective: We report the case of a patient with treatment-resistant obsessive-compulsive disorder (OCD) that had a significant reduction in obsessive-compulsive symptoms after the addition of the atypical antipsychotic to the Selective serotonin reuptake inhibitors (SSRIs) Methods: Ms. A, a 31-year-old woman, with no family history of psychiatric disorders has been suffering from OCD for 4 years. His main obsession was contamination, and his compulsions (washing rituals) occupied 12 hours a day, rendering him unfit for work in there house or employment. Various treatments had been ineffective. His Yale-Brown Obsessive Compulsive Scale total score (Y-BOCS) at his first psychiatric interview was 38. He was taking clomipramine, sertraline, haloperidol, amisulpride, and alprazolam. Previous trials did not result in clinically meaningful responses (side effects prevented titration to higher doses), however all psychiatric drugs were discontinued except sertraline (100 mg/day) associated with olanzapine (5 mg/day). Result: After 10 days, Ms. A reported significantly lessened anxiety and, after three months, significantly lessened obsessive-compulsive symptoms. By the fourth month, his symptoms were occurring for only few hours week Y-BOCS total score of 16). At this point, the addition of olanzapine would appear to be a useful short- and long-term strategy for augmenting SRI effectiveness in resistant OCD patients. Conclusion: Current options for treatment-resistant OCD include switching to an alternative selective serotonin reuptake inhibitor or augmentation with other agents. Our case suggests that olanzapine may be an option for treatment-resistant OCD, but controlled studies are needed to substantiate this observation.",Darghal M.,2010.0,10.1016/S0924-9338(10)70331-X,0,0,
8195,Olanzapine augmentation for treatment-resistant obsessive-compulsive disorder,"Objective: We report the case of a patient with treatment-resistant obsessive-compulsive disorder (OCD) that had a significant reduction in obsessive-compulsive symptoms after the addition of the atypical antipsychotic to the Selective serotonin reuptake inhibitors (SSRIs) Methods: Ms. A, a 31-year-old woman, with no family history of psychiatric disorders has been suffering from OCD for 4 years. His main obsession was contamination, and his compulsions (washing rituals) occupied 12 hours a day, rendering him unfit for work in there house or employment. Various treatments had been ineffective. His Yale-Brown Obsessive Compulsive Scale total score (Y-BOCS) at his first psychiatric interview was 38. He was taking clomipramine, sertraline, haloperidol, amisulpride, and alprazolam. Previous trials did not result in clinically meaningful responses (side effects prevented titration to higher doses), however all psychiatric drugs were discontinued except sertraline (100 mg/day) associated with olanzapine (5 mg/day). Result: After 10 days, Ms. A reported significantly lessened anxiety and, after three months, significantly lessened obsessive-compulsive symptoms. By the fourth month, his symptoms were occurring for only few hours week (Y-BOCS total score of 16). At this point, the addition of olanzapine would appear to be a useful short- and long-term strategy for augmenting SRI effectiveness in resistant OCD patients. Conclusion: Current options for treatment-resistant OCD include switching to an alternative selective serotonin reuptake inhibitor or augmentation with other agents. Our case suggests that olanzapine may be an option for treatment-resistant OCD, but controlled studies are needed to substantiate this observation.",Darghal M.,2010.0,10.1016/S0924-9338(10)70352-7,0,0,
8196,Rating scales and standardised diagnostics in daily routine,"To assess the efficacy of psychiatric treatments, rating scales are essential. In this presentation, methodological and statistical problems associated with the use of rating scales in psychiatry are discussed, by taking the anxiety disorders as an example. Not only standard symptom-specific rating scales, such as the Hamilton Anxiety Scale (HAMA), but also global measures such as the Clinical Global Impression Scale (CGI) and Quality of Life scales are used, as not only improvement of single symptoms, but also an overall increase of a patient's well-being should be the focus of a clinical trial. However, due to high placebo response rates in anxiety disorders, the use of rating scales is determined by the need for an instrument, which is sensitive enough to detect differences between active drugs and placebo (or between a certain psychological treatment and a psychological placebo). Quality of Life scales often do not detect such differences, as domains such as partnership or employment do not show rapid changes within the 8-12 weeks of a clinical study. Moreover, when using too many different scales, problems of multiple testing occur. The outcome of a clinical study is often described by the number of patients who responded or remitted, as these endpoints are easily understood by patients. “Response” is commonly defined as a ≥ 50 % reduction on these standard scales. However, this definition is arbitrary, and cut-off points should rather be founded on empirical data than on a thumb rule. The definition of “remission” on standard scale scores varies from study to study and is also very subjective. An analysis of available treatment studies in patients with anxiety disorders revealed that these definitions do not necessarily reflect clinical reality. Also, “number needed to treat” is an endpoint, which may lead to inaccurate assessments from a statistical point of view, because it is based on a subjective definition of remission. The adequate use of rating scales also touches ethical questions.",Bandelow B.,2010.0,10.1016/S0924-9338(10)70166-8,0,0,
8197,Relations between PTSD and response to brief alcohol interventions in college students,"Post-traumatic Stress Disorder (PTSD) is associated with high rates of substance abuse (Ouimette and Brown, 2003) and may be related to poor response to substance abuse interventions (Bradizza et al., 2006). Among college students, brief interventions for substance abuse have resulted in significant reductions in drinking and alcohol-related problems relative to control conditions (Marlatt et al., 1998; Murphy et al., 2001). It is unclear how trauma-exposed students may respond differently to brief alcohol interventions. Given the high rate of trauma exposure among college students (1 study estimated the prevalence to be 74.5%; Elhai and Simons, 2007), the development of PTSD may mitigate the efficacy of brief interventions in this population. This presentation would examine the relations between PTSD and responses to brief motivational interventions aimed at reducing heavy drinking. Data for this investigation were collected from 2 randomized clinical trials examining the efficacy of brief interventions (motivational interviewing and computer-based interventions) for substance use among college students. Participants were recruited from either a campus health center or a required first-year course and all endorsed at least 1 past month heavy drinking episode (HDEs; 5/4 or more drinks in 1 occasion for a man/woman). Measures include the Daily Drinking Questionnaire, The Readiness to Change Questionnaire, The Trauma History Screen, and The Primary Care-PTSD Screen. Two hundred and seven participants completed the baseline assessment and intervention session. The majority (53.1%) of participants were women and 68.1% described themselves as White or Caucasian. A hierarchical regression controlling for baseline alcohol consumption indicated that PTSD symptoms were significantly associated with baseline motivation to change (t = 3.35; p <.01) such that higher levels of PTSD symptoms were associated with greater motivation to change drinking. PTSD symptoms were not significantly predictive of change in motivation (from baseline) immediately following the intervention (i.e., proximal response to intervention). At 1-month follow-up PTSD symptoms did not predict alcohol consumption after controlling for baseline consumption suggesting that despite higher motivation, individuals with PTSD respond similarly to brief interventions. One and 6-month post-intervention data will be evaluated.",Monahan C.J.; Mcdevitt-Murphy M.E.; Murphy J.G.,2010.0,10.1111/j.1530-0277.2010.01211.x,0,0,
8198,Effect of pregabalin in patients with generalised anxiety disorder and psychiatric comorbidities,"Objective: Pregabalin is an alpha2-delta-ligand, with analgesic, anticonvulsant and anxiolytic activity. It has been shown to be effective and well tolerated in the treatment of GAD and other disorders in comprehensive clinical trial programs. On the basis of a large prospective cohort of ambulatory GAD patients we describe the prevalence of psychiatric symptoms at inclusion in the study, and the response to treatment with pregabalin. Methods: In a 4-week open-label observational trial, 331 physicians (mainly psychiatrists) documented 578 consecutive adult patients with GAD. GAD severity was among others rated using the Hospital Anxiety and Depression Scale (HADS-A), response by the Patient Global Impression of Change Scale (PGIC). Results: The most frequent comorbiditiy were sleep disorders (n=261, 45.1 %), followed by panic disorders (n=191, 33.0 %), social phobia (n=140, 24.2%) and depression (n=111, 19.2 %). Symptoms of anxiety, evidenced by mean HADS-A score, decreased from 15.4 (95% confidence interval 15.1; 15.6) by 5.9 units at final visit. In general, there were no significant differences in treatment outcomes (HADS-A reduction; PGIC response) in GAD patients with comorbid depressive symptoms, panic disorder, and/or social phobia, compared with the total population. Conclusion: The baseline data of the study support the substantial burden of disease by concomitant psychiatric comorbidities in patients with GAD. Pregabalin treatment was associated with a substantial decrease of anxiety and showed comparable results in GAD patients with different psychiatric comorbidities.",Brasser M.; Kasper S.,2010.0,10.1017/S1461145710000635,0,0,
8199,CBT for co-occurring anxiety disorders in alcohol dependence treatment patients: A randomized controlled trial,"Purpose: Anxiety disorders frequently co-occur with alcohol dependence, marking a two-to three-fold increase in the risk of returning to drinking within four months of standard treatment for alcohol dependence. Further, a relapse to drinking following treatment tends to be more severe when a co-occurring anxiety disorder is present. It was against this background that we developed a cognitive-behavioral therapy (CBT) aimed at treating co-occurring anxiety disorders in patients undergoing a community-based treatment for alcohol dependence. The purpose of the present work is to test the clinical benefits of this CBT treatment relative to a credible control treatment in a real-world clinical setting. Method: We attempted to screen all new patients admitted to a residential program for the treatment of alcohol dependence and recruited those who had a co-occurring anxiety disorder (panic disorder, generalized anxiety disorder or social phobia). We randomly assigned participating patients to receive either the CBT or control therapy (relaxation training). Both treatments included six one-hour sessions conducted while the patient was in the residential alcohol dependence treatment program. We assessed patients at baseline, post treatment and four months after treatment. Results: After a four-year data collection effort, enrollment has been completed as of January 2010 (N=350) and all follow-ups will be completed by April 2010. With attrition, we expect to have 265 cases with completed data (approximately 44 patients per anxiety diagnosis per treatment group). By the time of the RSA annual conference in June 2010, these data will be analyzed to determine: (i) if the CBT, compared to the control treatment, leads to a greater remission of anxiety disorders and decrease in anxiety symptoms; and, (ii) if the CBT, relative to the control condition, decreases the occurrence and/or severity of alcohol relapse. Notably, the study's design and sample size allow us to address these questions separately for each of the three specific anxiety disorder subtypes included. Conclusions: We believe this to be the largest randomized controlled trial of a CBT treatment for co-occurring anxiety disorders in alcohol use disorder treatment patients conducted to date. It employs random assignment and a credible control condition in a real-world treatment setting. Findings will provide a definitive test of the study hypotheses with the potential to directly influence clinical practice.",Kushner M.G.; Maurer E.; Thuras P.; Donahue C.; Frye B.; Johnson J.; Van Demark J.; Haeny A.; Lee S.,2010.0,10.1111/j.1530-0277.2010.01210.x,0,0,
8200,A prevention programme for somatoform disorders is effective for affective disorders,"Objective: To assess the effectiveness of a psychoeducational programme for the primary prevention of somatoform disorders in healthy primary care patients. Methods: Randomized, controlled trial. Participants (N=104) were randomly assigned to: (1) a psychoeducational intervention, or (2) no intervention at all. The primary outcome measure was somatoform disorder psychiatric diagnosis at 5-year follow-up. Secondary outcome measures were hypochondriasis, locus of control and attribution of symptoms and psychological distress. Results: At 3 and 6 months, and 5 years, the intervention group significantly decreased hypochondriasis and somatic attributions; and increased psychological and normalizing attributions and internal locus of control. Five years after baseline, the prevalence of somatoform disorders showed no differences between both groups. Nevertheless, overall psychiatric morbidity was less prevalent in the intervention group (odds ratio: 2.72; 95% CI:1.10-6.72). In addition, a decrease in depression and anxiety subscales and in overall General Health Questionnaire scoring (p<.05) was found in the intervention group. Conclusions: A primary prevention programme for somatization seems to be useful, not to decrease somatoform disorders, but to prevent anxiety and depressive disorders. The effects of overlapping psychobiological mechanisms are discussed.",Garcia-Campayo J.; Arevalo E.; Claraco L.M.; Alda M.; Lopez Del Hoyo Y.,2010.0,,0,0,
8201,Assessing feasibility and potential effectiveness of a variant of dignity therapy for terminally ill cancer patients in Taiwan: A pilot study,"Background: Dignity Therapy(DT) - a novel psychotherapeutic intervention - has been demonstrated to alleviate suffering and elevate mood in terminally ill patients. Over half of Taiwanese hospice patients experience psychological and spiritual suffering. Hence, a feasibility study to evaluate the appropriateness of DT in Taiwan was conducted. Because of its culturally-bound attributes, a variant of dignity therapy in Taiwan was developed based on a preliminary study we conducted exploring the concept of dignity in Taiwan. The DT intervention consists of a research nurse interviewing patients using dignity therapeutic questions, transcription and editing of the transcription with patient's advice and agreement leading to development of a 'generativity' document given to individuals selected by the patient. Objective: To assess the feasibility, appropriateness and potential impact of a variant of dignity therapy to address emotional-existential distress in terminally ill cancer patients in Taiwan. Methods: A repeated measures pre-test post-test one group study design was employed. Outcome measures included dignity, suffering, depression, psychological distress and existential well-being. Qualitative interviews with patients, their significant others and professionals were also conducted after the intervention. Results: 13 patients, 10 patients' significant others and 9 professionals consented to participate. Outcome measurements show a small improvement in the sense of dignity, psychological distress and existential well-being. The qualitative interviews demonstrated the intervention enabled patients to express love, resolve conflict in relationships, and get more self-understanding through the DT process. Patients' significant others evaluated DT positively and showed the document they were given to others at patients' funeral ceremonies. Conclusion: The feasibility and potential impact of DT was confirmed and a large scale randomized controlled trial is warranted.",Li H.-C.; Armes J.; Richardson A.,2010.0,10.1177/0269216310366390,0,0,
8202,Focused Conference Group: P17 - New approaches and targets in psychiatry the impact of psychiatry clinical trials over the clinical practice. The cuban experience,"Five of the ten leading worldwide disability causes (major depression, schizophrenia, bipolar disorders, alcoholism and obsessive compulsive disorders) are mental problems. They are relevant as in poor as in rich countries, and all predictions indicate there will be a dramatic increase in the coming years The National Coordinating Centre for Clinical Trials (CENCEC) is a Clinical Research Organization. Three clinical trials in psychiatry had been performed, since CEN-CEC's creation up to now. The present paper had the objective of evaluating the impact of these psychiatry clinical trials over the clinical practice in Cuba. With that purpose, quality and efficiency indicators (structure, process and results) of the hospitality services were analysed. The conduction of clinical trials in psychiatry had a positive impact over the clinical practice in Cuba. Those trials permitted the institutions to achieve the acquisition of material resources to better the infrastructure of the medical services needed to treat psychiatric patients. Besides that, vitally important was the training of a huge number of specialists throughout the Island, which permitted the update of the national and international art of mental illness, the acquisition of skills and competence in the use of psychotherapy, how to handle placebo response and suicide risk, the acquisition of specific and updated bibliography, usually not available in the country, the introduction of diagnostic and assessment tools to clinical practice and the possibility of treatment for some patients with the first line of medications.",Cabrera R.V.; Rodriguez Y.M.; Perez Y.B.,2010.0,10.1111/j.1742-7843.2010.00600.x,0,0,
8203,Aripiprazole use in TS: A two year retrospective experience in 27 patients,"Objective: To evaluate the clinical efficacy and tolerability of aripiprazole in treating motor and phonic tics in patients with Tourette syndrome (TS). Background: Observational studies have suggested that the atypical antipsychotic, aripiprazole, may be useful in the treatment of tics, and possibly mood and anxiety disorders associated with TS. Compared to other antipsychotics, aripiprazole has a unique in vitro mechanism of action as a dopamine D2 and serotonin 5-HT(1A) partial agonist, and a serotonin 5-HT(2A) antagonist. Methods: This was a retrospective chart review on the use of aripiprazole in 27 patients with TS [mean age (±SEM) 20±11 yrs] followed for 24 ±5 months [range 1-48]. Aripiprazole was titrated to clinical effect on tics [range 1-30 mg/d; mean dose 10±2 mg/d]. Using intent to treat, chart data was reviewed and scored independently at baseline and at time of last observation by a movement disorders fellow (GR) using clinical global improvement (CGI) scales for tics, OCD and ADHD and a Worst Tic Intensity Scale. Results: Of the 27 patients, 24 (89%) had co-morbid OCD and 19 (70%) had ADHD. Ten stopped aripiprazole, seven due to lack of efficacy and 3 due to intolerance. Seventeen are still on it. Using all data, Tic CGI-Severity improved from 4.6±0.2 to 3.6±0.2 (p <0.001), and worst tic intensity from 69±4 to 41±5 (p<0.001). Sixteen patients were much improved or better, 3 minimally improved and 8 unchanged or worse. OCD CGI scores improved slightly whereas ADD CGI did not. Intolerance was most often due to akathisia at doses between 5-15 mg/d. Conclusions: These results are encouraging given the positive responses in a large proportion of subjects previously refractory to other antipsychotics. The conclusions are tempered by the uncontrolled, open-label nature of the observations. However, the prolonged follow up makes it more difficult to dismiss the findings as placebo responses. Reliance on CGI scores comes at the loss of the fine grain characterization of the clinical response that is possible with more detailed rating scales. Nonetheless, the results are consistent with others in the literature suggesting that aripiprazole may be beneficial in the treatment of tics and anxiety symptoms in TS. These findings inform and justify controlled clinical trials of aripiprazole in TS.",Juncos J.J.; Revuelta G.J.,2010.0,10.1002/mds.23162,0,0,
8204,Aripiprazole augmentation of antidepressant therapy of severe obsessive-compulsive disorder: A preliminary study,"Introduction: Even if controlled trials have proven that aripiprazole is safe and efficacious in schizophrenia and bipolar disorder, only a few published data explore its effectiveness and safety in OCD as augmentation therapy with contrastant results (1-3). The aim of the present study is to investigate the efficacy of flexible doses of aripiprazole as augmentation agent in the treatment of severe OCD patients who failed to respond to a background combinated therapy with cloimipramine and escitalopram. Methods: Adult subjects, aged between 18 and 65 years old, meeting DSM-IV criteria for OCD who, after a 12 week screening phase during wich they take a 6 weeks treatment with cloimipramine (25/225 mg/die) then a second 6 weeks treatment with cloimipramine (75/150 mg/die) plus escitalopram (5/20 mg/die), still obtaine a Yale-Brown Obsessive Compulsive Scale (YBOCS) score > 23, are entering into a 12-week open-label trial of augmentation therapy with aripiprazole (5-30 mg/day). Safety assessments include evaluation of vital signs, cardiological functionality, weight, and treatment-emergent side effects. Patients are considered responsive to augmentation therapy if the YBOCS final score has at least 30% degreed from baseline. Results: Until now five subjects, two males and three females, have been enrolled and completed the 12 week study phase. Preliminary results show that the mean total YBOCS score has been at baseline 30.2, and at 12 weeks it decreased to 16.8. The obsessive YBOCS mean score has been at baseline 16 and at 12 week it decreased to 8.6. The compulsive YBOCS mean score has been at baseline 14.2 and at 12 week it decreased to 8.2. The mean aripirpazole dosage has been 13 mg/die. Four subjects have responded to treatment showing a 30% or greater reduction in YBOCS total score. For these patients the mean aripiprazole dosage has been 8.75 mg/die. In the non responder patient aripiprazole has been tritate up to 30 mg/die without success. Two patients have reported dry mouth and one patient akathisia but no action has been taken. No significative changes have been reported in cardiological activity, vital signs and weight. Conclusions: Although from a small, open-label study, these preliminary results suggest that adding aripiprazole to antidepressant combinated therapy could be a good strategy for treatment severe-extreme OCD patients. Aripiprazole has shown similar efficacy in reduction both YBOCS obsessive and compulsive scores. The combination of aripiprazole with cloimipramine and escitalopram has been well tollerated. Any patient dropped out from the study. Going on with the enrollment, statistical analysis will be provided. If the trend will be confirmed, these data point toward an antiobsessive potency of aripiprazole. On one hand this study will be allineated with such evidences of literature (1,2), on the other hand will disconfirm that the augmentation therapy with second generation antipsychotics shouldn't be good in OCD due to the hypothesis that the antagonist effect on 5-HT2 receptors may be related to atypical antipsychotic-induced OCS (3).",Casale M.; Braiotta R.; Cerruti C.; Di Pierro E.P.; Guerriero T.; Maucioni F.; Morello A.; Tortorella T.; Mautone A.,2010.0,10.1016/S0924-977X(10)70827-0,0,0,
8205,The role of biofeedback in the treatment of vasovagal Syncope,"Introduction: Biofeedback treatment, a behavioral training program that enables an individual to gain voluntary control over an autonomic bodily function, using feedback provided by a monitoring device has been proposed for the treatment of patients (pts) with blood injury phobia. The aim of this prospective, randomised, placebo-controlled study was to evaluate the efficacy of biofeedback treatment in pts with recurrent vasovagal syncope (VVS). Methods: We studied 20 consecutive pts (mean age 34±10 years, 65% females) with recurrent VVS (median 5.5 syncopal episodes), positive head-up tilt testing and no other comorbidities. Pts were randomised 1:1 to biofeedback treatment (biofeedback-assisted heart rate stabilisation using Biofeedback 2000 X-PERT version 1.0 -V SCHUH-FRIED GmbH) or to placebo (educational counseling) with one visit a week for 5 weeks and were followed up for at least 1 year. Results: No significant differences in baseline clinical characteristics and syncopal frequency were found between the active and placebo groups. The median follow-up was 13±1 months. The mean number of syncope during follow-up was significantly lower, and the percentage of pts with at least one syncopal recurrence was slightly lower, although not statistically significant in active group with respect to the placebo group (0.1 ± 0.31 vs 0.5±0.52, p= 0.0008; 40% vs 60%, p=ns). Conclusions: The results of this preliminary study suggest that the biofeedback treatment might be proposed as a non-pharmacological therapeutical approach in very symptomatic vasovagal fainters.",Madalosso M.; Giada F.; Di Natale A.; Buodo G.; Palomba D.; Raviele A.,2010.0,10.1007/s10840-010-9483-7,0,0,
8206,Olanzapine in the treatment of anorexia nervosa: A case report,"Anorexia Nervosa (AN) is a complex and severe psychiatric disease, whose etiopathogenesis is still little-known, it involves mainly young women between 15 and 20 years old (1). The AN, according to the criteria of DSM IV, is characterized by marked symptoms such as the weight loss due to the drastic reduction of the food intake, intense fear of increasing weight and to accumulate fat even though it is underweight, with or without compensating phenomena as self-induced vomiting, the use of laxatives and diuretics (2). At today, the treatment of the AN is quite uncertain (3). Many drugs have been used recently with encouraging results (4). One of the main reasons that explain the reduced effectiveness of several drugs in controlling the AN symptoms is that all the drugs evaluated have not been sufficiently cut the possible neuro-biological implications underlying the anorexic pathology. The use of atypical antipsychotics, particularly the olanzapine, although in clinical trials on a small number of patients, showed an improvement in weight and in eating behavior and some psychopathological aspects such as anxiety, the obsessive and compulsive behavior, the perfectionism, the idea of thinness, the delusions about body image, hostility and loss of perception of reality. Here we report a clinical case of a young patient suffering from AN-treated with olanzapine. The anorexic patient named A.R. was a young woman (19 years old) followed by our MHU (Mental Health Unit) starting by November 2008. A.R. showed a diagnosis of AN with a marked weight loss (15 kg in two years) because of an incongruous and spontaneous calorie diet. Her clinical history showed that her anorexic symptoms were previously treated with an individual and family psychotherapy as well as with nutritional supplements and multivitamins, prescribed by family doctor without any significant clinical improvement. At the first our clinical examination, she weighed 44 kg for a height of 162 cm (BMI 17.5), with frequent episodes of self-induced vomiting and excessive physical exercise: she walked for 2/3 hours per day. Along with a simple and balanced program of nutritional rehabilitation, our anorexic patient was treated with olanzapine 2.5 mg/day for the first month and 5 mg/day for three months. At the beginning and the end of observation period, our anorexic patient has completed a psychometric test for self-eating disorders (DCA), the Eating Disorder Inventory (EDI), to evaluate the size of certain psychological traits or groups of symptoms typical of the DCA, as the drive for thinness, bulimia ideas, dissatisfaction with their body, inadequacy, perfectionism, interpersonal conflict, fear of maturity. The control of the body weight occurred every two weeks and no side effects were observed during olanzapine treatment. After four months of olanzapine treatment both the weight and BMI of our anorexic patient were slightly increased. In addition, the EDI scores are generally improved, especially in sub-scale for perfectionism, the drive for thinness and a sense of inadequacy. Given the above evidences, it is reasonable to assume the use of olanzapine in the treatment of AN.",Capasso A.; Petrella C.; Milano W.,2010.0,10.1016/S0924-977X(10)70676-3,0,0,
8207,Preliminary results of therapists' adherence in a randomised clinical cognitivebehavioural therapy trial for panic disorder and agoraphobia,"Background: Therapist's adherence refers to the degree to which a therapist is compliant with an intended intervention and respects the use of prescribed and proscribed aspects by a specific manual [1]. The examination of adherence in clinical trials is considered to be a mandatory step, before enabling to make assumptions about the active mechanisms of change. A better understanding of adherence could have implications for treatment planning, realization and attrition. Thus, in this report we examine the association of therapist's adherence with patients dropout risk and clinical outcome, taking into account several moderators, like symptom severity, comorbid disorders, and therapists experience. Method: Data were collected as part of a multicenter trial involving N= 270 patients diagnosed with PD/A treated by a total of 61 therapists and a total number of 728 rated video tapes sessions. Dropout was defined as unilateral treatment termination by the patient without the therapist's endorsement before post and comprised n = 45 patients. Therapy sessions were analyzed by raters using Therapist Adherence and Competence Ratings Scales (TACRS) developed for this study. Changes in panic and agoraphobic symtomatology were assessed at intake and post or last available assessment by the Hamilton Rating Scale for Anxiety (HAM-A); Panic Agoraphobia Scale (PAS); Clinical Global Impression (CGI); and Mobility Inventory (MI). Results: Differences in adherence between completers and dropouts became non-significant though, when controlling for moderators (RRR = 0.94, p = 0.5). Further, levels of adherence did not differ significantly in dropouts divided by timing of treatment attrition (early vs. middle vs. late) and reasons (exposure-related vs. others). Completers and dropouts differ significantly in all outcome measures with a significant greater improvement for completers of -7.01±.67 points more in the HAMA-A, -0.91±1 in the CGI, -3.07±.95 in the PAS, -0.5±.07 in the MI (alone) and -0.2±0.06 in the MI (accompanied). Regarding the association of adherence and outcome it is noteworthy that there are indications for an interaction, meaning that completers tend to benefit more from lower levels of adherence, whereas dropouts did not. These differences were shown to be significant in one measures (PAS: β = -1.75, p = 0.013, CI = -3.213, -0.36), also when adjusted for comorbidity (β = -1.80, p = 0.013, CI = -3.23, -0.38) and therapist experience (β = -1.86, p = 0.015, CI = -3.36, -0.37). Conclusion: Preliminary results suggest that adherence did not directly influence premature treatment termination. However, close adherence to protocol was associated with symptomatic improvement in dropouts. In contrast, a flexible treatment approach seems to be advantageous for completers. These results add to the small but growing literature suggesting that special levels of adherence contribute differently to treatment outcome. A promising compromise might be that adherence between a lax and rigid level appears to be the best strategy improving outcome. Results offer preliminary support for considering several patient groups when investigating the link between adherence and symptomatic change. Future studies should address patients' variables which might influence adherence-outcome relationships, such as personality, motivation or coping strategy.",Hauke C.; Gloster A.T.; Wittchen H.U.,2010.0,10.1016/S0924-977X(10)70789-6,0,0,
8208,Verbal memory deficits in patients with posttraumatic stress disorder with and without major depression,Introduction: Deficits in verbal memory are the most consistent neuropsychological finding in posttraumatic stress disorder (PTSD) in different trauma populations [1]. A recent study in asylum seekers found that memory deficits in PTSD are related to depressive symptoms [2]. The purpose of the current study is to investigate verbal memory deficits in PTSD patients in a diverse trauma population with and without major depressive disorder (MDD). We hypothesized that PTSD +MDD patients would have significantly lower scores on neuropsychological tests of verbal memory than PTSD patients without MDD. Method: Participants were 140 outpatients who had a diagnosis of PTSD after various kinds of single traumatic events who sought treatment at the Department of Psychiatry of the Academic Medical Center at the University of Amsterdam. They agreed to participate in a randomized clinical trial comparing the effects of two forms of trauma-focused psychotherapy. The PTSD +MDD group consisted of 84 patients who met criteria for major depressive disorder at baseline and the,Nijdam M.J.; Olff M.,2010.0,10.1016/S0924-977X(10)70784-7,0,0,
8209,Asv therapy in anxious or insomnia patients with complex sleep apnea,"Introduction: Adaptive servoventilation (ASV) is currently used to treat CSA in SDB patients with CHF or chronic opiate use. Our clinical experience shows insomnia and anxiety patients with SDB also fail CPAP/BPAP due to central apneas induced during titration studies (complex sleep apnea). We conducted a chart review of insomnia and anxiety patients that completed ASV titrations to compare with their initial PAP therapy outcomes. Methods: We reviewed charts of all patients with ASV titrations from Maimonides Sleep Arts and Sciences from 01/08 to 09/09. Patients were included if they reported one of the following: chronic insomnia, anxiety disorder, depression, PTSD, OCD, panic attacks, or claustrophobia. All patients had previously undergone titrations with CPAP and BPAP before ASV titrations. Patients were excluded with CHF, chronic opiate use, or no follow up contact. Results: Of 87 ASV patients, 60 qualified. Patients served as their own historical controls of CPAP/BPAP use: 2.9% of patients could not tolerate traditional CPAP/BPAP in the lab; 20% could not use CPAP/ BPAP consistently at home, 57.1% used CPAP/BPAP consistently with poor responses, 20% used CPAP/BPAP consistently with marginal improvements. PSG findings in sequential order revealed the following central apnea indices [mean (SD)]: diagnostic 2.45 (4.04); most recent CPAP/BPAP titration 16.17 (17.42); ASV titration 0.28 (1.04); and, 50 patients eliminated central apneas. All 60 were prescribed ASV, and 88.6% currently use their device regularly. Conclusion: These anxiety and insomnia patients demonstrated a dramatic increase in CAI with CPAP/BPAP, almost seven times greater than diagnostic testing and consistent with complex sleep apnea. One hundred percent failed CPAP/BPAP adherence and outcomes. ASV markedly reduced CAI, and nearly all patients are currently using ASV; outcomes data are being collected. Randomized controlled trials should test whether ASV therapy yields greater adherence and better outcomes compared to CPAP/BPAP therapy for insomnia and anxiety patients with SDB.",Krakow B.; Romero E.A.; Ulibarri V.A.; Kikta S.M.; Thomas R.J.,2010.0,,0,0,
8210,Optimal management of bladder retention following vaginal prolapse surgery: A randomized controlled trial comparing clean intermittent catheterization (CIC) and transurethral indwelling catheterisation (TIC),"Hypothesis / aims of study Abnormal post voiding residual bladder volume (PVR) is one of the most common complications of vaginal prolapse surgery. Often management is either clean intermittent catheterization (CIC) or transurethral indwelling catheterisation (TIC). As there is no evidence and thus no consensus about the optimal management, we randomly compared both interventions to investigate which of these modalities yields the shortest time to normalize bladder emptying, which modality has the lowest morbidity and which modality is preferred most by patients. ≤ Study design, materials and methods Multi-centre randomized controlled trial in 5 teaching hospitals and 1 non teaching hospital in the Netherlands from August 2007 till May 2009. All patients older than 18 years who underwent vaginal prolapse surgery were eligible. Exclusion criteria were any neurological or anxiety disorder or the need of combined anti-incontinence surgery. All patients initially received an indwelling catheter which was removed on the first postoperative day.After removal of this catheter PVR was measured using an abdominal bladder scan. In case of abnormal PVR (defined as a residual volume of more than 150 ml) patients were randomized by a computer to either CIC or TIC during 72 hours. As primary outcome we selected the duration of catheterization (in hours) until PVR normalized. Secondary outcomes included bacteriuria and UTI at the moment of normalized PVR, number of performed catheterizations and duration of hospitalization. The trial was powered to detect a decrease of 12 hours in required duration of catheterization between both groups (power 90%, alpha = 0.05, assumed standard deviation = 0.6 days). We planned to recruit 74 patients assuming a loss to follow-up of 15%. An intention to treat analysis was performed. Alongside this randomized trial a patient preference study was performed to evaluate how patients trade the risk on urinary tract infections to the risk of longer duration of treatment until PVR normalizes. This was done by taking a face to face interview using written treatment scenarios. In the initial scenario the duration of treatment and the risk of urinary tract infections (UTI) was set at 3 days and 30%, respectively, for both treatment options. After expressing a preference for one of the treatment options, the duration of treatment and the risk of UTI after CIC were systematically varied to measure at which scenario patients switched from their initial preference. Results In the RCT a total of 87 patients were randomized of which 45 patients were included in the CIC group and 42 patients in the TIC group. No patients were lost to follow up. Patient characteristics, pre-operative prolapse staging (POP-Q), surgery time and preoperative blood loss were similar between groups (data not shown). In the CIC group a significantly shorter duration of catheterization was observed (18 hours in the CIC group versus 72 hours in theTIC group, p < 0.001) together with a lower risk to develop bacteriuria or UTI (14 vs 38%, p=0.02 respectively 12 vs 33%, p=0.02) and shorter hospitalization (2 vs 4 days, p < 0.001) (see table). No adverse events related to the catheterization occurred in the two groups. In figure 1 preferences for 3 possible durations of CIC are shown. Combining these scenarios with a hypothetical difference in UTI risk between both interventions generates several combinations of duration of CIC and difference in UTI risk. For each of these combinations patients have expressed their preference for CIC relative to TIC (Y-axis). The combination as observed in our RCT corresponded to a preference for CIC over TIC in 99% of the patients. Interpretation of results CIC results in a shorter duration of treatment and lower risk of bacteriuria and UTI than TIC during 72 hours. Given these conditions 99% of the patients prefer CIC over TIC. We hypothesize that repetitive filling and emptying of the bladder trains the bladder in filling sensation and adequate responding to this sensation whereas in case of TIC this learning effect is not present. The lower bacteriuria risk in the CIC group may be explained by a shorter overall exposure to a catheter and the rinsing of the bladder that results in more adequate clearance of bacteriuria than continued drainage. Concluding message For the treatment of abnormal post void residuals after vaginal prolapse surgery, clean intermittent catheterization is preferableabove transurethral indwelling catheterization.(Table presented).",Hakvoort R.A.; Thijs S.; Bouwmeester F.; Ruhe I.; Vernooij M.; Broekman A.; Burger M.; Emanuel M.H.; Roovers J.P.,2010.0,10.1002/nau.20973,0,0,
8211,Pragmatic and idiosyncratic acts in human everyday routines: The counterpart of compulsive rituals,"Our daily activities are comprised of motor routines, which are behavioral templates with specific goals, typically performed in an automatic fixed manner and without much conscious attention. Such routines can seem to resemble pathologic rituals that dominate the motor behavior of obsessive-compulsive disorder (OCD) and autistic patients. This resemblance raises the question of what differentiates and what is common in normal and pathologic motor behavior. Indeed, pathologic motor performance is often construed as an extended stereotyped version of normal everyday routines. In this study we applied ethological tools to analyze six motor routines performed by 60 adult human volunteers. We found that longer normal everyday routines included more repetitions, but not more types of acts, and that in each routine, most acts were performed either by all individuals (pragmatic acts) or by only one individual (idiosyncratic components). Thus, normal routines consist in a relatively rigid part that is shared by all individuals that perform the routine, and a flexible part that varies among individuals. The present results, however, do not answer the question of whether the flexible individual part changes or remains constant over routine repetition by the same person. Comparing normal routines with OCD rituals revealed that the latter comprise an exaggeration of the idiosyncratic component. Altogether, the present study supports the view that everyday normal routines and pathologic rituals are opposite processes, although they both comprise rigid motor behavioral sequences. © 2010 Elsevier B.V.",Keren H.; Boyer P.; Mort J.; Eilam D.,2010.0,10.1016/j.bbr.2010.03.051,0,0,
8212,Characterization of soluble microbial products and their fouling impacts in membrane bioreactors,"Membrane bioreactor (MBR) fouling is not only influenced by the soluble microbial products (SMP) concentration but by their characteristics. Experiments of separate producing biomass associated products (BAP) and utilization associated products (UAP) allowed the separation of BAP and UAP effects from sludge water (SW). Thus, filtration of individual SMP components and further characterization becomes possible. Unstirred cell filtration was used to study fouling mechanisms and liquid chromatography-organic carbon detection (LC-OCD) and fluorescence excitation-emission matrix (EEM) were used to characterize the foulant. Generally, the SMP exhibiting characteristics of higher molecular weight, greater hydrophilicity and a more reduced state showed a higher retention percentage. However, the higher retention does not always yield higher fouling effects. The UAP filtration showed the highest specific cake resistance and pore blocking resistance attributed to their higher percentage of low molecular weight molecules, although their retention percentage was lower than the SW and BAP filtration. The UAP produced in the cell proliferation phase appeared to have the highest fouling potential. © 2010 American Chemical Society.",Jiang T.; Kennedy M.D.; Schepper V.D.; Nam S.-N.; Nopens I.; Vanrolleghem P.A.; Amy G.,2010.0,10.1021/es100442g,0,0,
8213,Specificity of cognitive emotion regulation strategies: A transdiagnostic examination,"Despite growing interest in the role of regulatory processes in clinical disorders, it is not clear whether certain cognitive emotion regulation strategies play a more central role in psychopathology than others. Similarly, little is known about whether these strategies have effects transdiagnostically. We examined the relationship between four cognitive emotion regulation strategies (rumination, thought suppression, reappraisal, and problem-solving) and symptoms of three psychopathologies (depression, anxiety, and eating disorders) in an undergraduate sample (N. =252). Maladaptive strategies (rumination, suppression), compared to adaptive strategies (reappraisal, problem-solving), were more strongly associated with psychopathology and loaded more highly on a latent factor of cognitive emotion regulation. In addition, this latent factor of cognitive emotion regulation was significantly associated with symptoms of all three disorders. Overall, these results suggest that the use of maladaptive strategies might play a more central role in psychopathology than the non-use of adaptive strategies and provide support of a transdiagnostic view of cognitive emotion regulation. © 2010 Elsevier Ltd.",Aldao A.; Nolen-Hoeksema S.,2010.0,10.1016/j.brat.2010.06.002,0,0,
8214,Angry Facial Expressions Hamper Subsequent Target Identification,"There is considerable evidence indicating that people are primed to monitor social signals of disapproval. Thus far, studies on selective attention have concentrated predominantly on the spatial domain, whereas the temporal consequences of identifying socially threatening information have received only scant attention. Therefore, this study focused on temporal attention costs and examined how the presentation of emotional expressions affects subsequent identification of task-relevant information. High (n = 30) and low (n = 31) socially anxious women were exposed to a dual-target rapid serial visual presentation (RSVP) paradigm. Emotional faces (neutral, happy, angry) were presented as the first target (T1) and neutral letter stimuli (p, q, d, b) as the second target (T2). Irrespective of social anxiety, the attentional blink was relatively large when angry faces were presented as T1. This apparent prioritized processing of angry faces is consistent with evolutionary models, stressing the importance of being especially attentive to potential signals of social threat. © 2010 American Psychological Association.",de Jong P.J.; Koster E.H.W.; van Wees R.; Martens S.,2010.0,10.1037/a0019353,0,0,
8215,Symptoms of endometriosis; Pathologic basis,"Traditionally, endometriosis has been considered an estrogendependent disease of the female reproductive system with chronic but variable in intensity and character pain symptoms originating from the female pelvis. Generalized symptoms reported by many affected women have been considered psychosomatic in nature and were commonly ignored. It is not a surprise, therefore, that the diagnostic delay was much longer in women with symptomatic endometriosis than in those with infertility (Dmowski, et al. 1977). During the past two decades, we and others demonstrated abnormal activation of the immune system and functional changes in both cell-mediated and humoral immunity in women with endometriosis. These alterations may explain the variety of generalized symptoms and systemic changes reported by affected women. Increased levels of inflammatory cytokines, growth factors, and prostaglandins in the peripheral blood and peritoneal fluid and markedly elevated production of these substances by peripheral blood monocytes and peritoneal macrophages, may be responsible for low-grade fever, malaise, prostration, fatigue, nausea, vomiting, diarrhea, and chronic aches and pains variable in character, intensity, and location. Recently, immunohistochemical studies from separate laboratories demonstrated the presence of nerve fibers and nerve growth factors (NGF) in the ectopic endometrium but more interestingly, also in the uterine endometrium of affected women. The presence of sensory, adrenergic, and cholinergic nerve fibers in eutopic endometrium appears to be substantially increased in women with endometriosis compared to those without the disease It is quite likely that these nerve fibers transmit pain stimuli from the uterus as well as from endometriotic implants, and out of the pelvis through neural ganglia including the stellate ganglion located in the neck to the Central Nervous System (CNS). A decrease in the concentration of these nerve fibers was demonstrated after treatment of endometriosis and in association with symptomatic improvement. In experimental studies, activated macrophages, macrophage-conditioned media, or TNF-α stimulate neurite outgrowth and induce NGFs in astrocytes which express TNF-R1 and TNF-R2. This is consistent with our own reports of increased concentrations of activated monocytes/macrophages and increased synthesis of TNF-α in endometriosis (Braun, et al. 1996). Increased CNS levels of NGF and other neural growth factors have been associated with clinical depression common to endometriosis and Chronic Pain Syndromes. Taken together, these findings have lead us to hypothesize a causal relationship between immunologic factors known to be abnormal in endometriosis, nerve growth factor abnormalities recently described in eutopic and ectopic endometrium, and the clinical symptomatology of this disease. Furthermore, because the stellate ganglion block (SGB) has been shown to be beneficial in Post-Traumatic Stress Disorder and in Chronic Visceral Pain Syndromes, we further postulated that this procedure might also produce clinically significant effects in endometriosis. To evaluate this hypothesis, we performed SGB in a pilot study involving four women with Chronic Pelvic Pain Syndrome associated with pelvic endometriosis. All seemed to have a significant symptomatic improvement lasting for 3-4 months after 1 or 2 SGBs. A prospective clinical trial is currently underway.",Dmowski W.P.; Braun D.P.,2010.0,10.1016/S1472-6483(10)62428-5,0,0,
8216,"Posttraumatic stress disorder can easily be faked, but faking can be detected in most cases","Background: Symptom overreporting and malingering are a topic of utmost importance in the field of forensic assessment in cases of claimed posttraumatic stress disorder (PTSD). Individuals may be coached regarding the symptoms of the condition they claim and regarding malingering detection strategies. Symptom validity tests (SVTs) should be as resistant against such knowledge as possible. Method: Healthy, well-educated volunteers were instructed to simulate how a person in a forensic examination may respond in order to convincingly feign mental disorder after a traumatic event. Four groups of these experimental malingerers (n = 20, each) were given different scenarios. In a 2 √ó2 experimental design, they received either specific PTSD symptom information or not, and either a warning against exaggerating or not. Results: Using a regression based formula for the German version of the Impact of Event Scale-Revised, the majority of simulators were wrongly classified as PTSD patients; in performance tests, they also demonstrated cognitive impairment. However, 96 percent of the participants were correctly classified as malingerers when a multi-method approach of symptom validity assessment was used. The Structured Inventory for Malingered Symptomatology, the Morel Emotional Numbing Test, and the Word Memory Test performed well in identifying feigned PTSD, while the MMPI-2 Fake Bad Scale and the Reliable Digit Span did so to a lesser degree. Only three simulators who received symptom information and warning were able to pass all five symptom validity measures. Participants who received symptom information alone were not able to perform in a more convincing way. Conclusion: The results demonstrate that PTSD symptoms can easily be presented by healthy adults. Within the framework of this experimental analog study it was shown that feigned PTSD can be detected in most cases if a multimethod approach to symptom validity assessment is employed. The usefulness of symptom validity testing in real-world forensic evaluations has been demonstrated by a number of other studies.",Merten T.; Lorenz R.; Schlatow S.,2010.0,,0,0,
8217,Embarrassment's effect on facial processing,"Embarrassment's effect on interpersonal perception, specifically facial processing, was explored. Previous work on social anxiety, which some suggest is similar to embarrassment, finds that socially-anxious individuals tend to avoid negative feedback, such as angry eyes. The current work examined whether embarrassment leads to a similar bias or alternatively whether embarrassed individuals are motivated to look for social feedback in order to reconcile with their audience. Eye movements were recorded while participants looked at four different emotional expressions. Embarrassed participants' fixated proportionally more on the eyes than controls and also fixated proportionally less on other less emotionally informative areas of the face compared to controls. Embarrassment appears to have different effects on facial information processing than social anxiety. The authors suggest this is due to asymmetries in motivational states elicited in social anxiety and embarrassment. © 2009 Psychology Press.",Darby R.S.; Harris C.R.,2010.0,10.1080/02699930903211183,0,0,
8218,10th International Forum on Mood and Anxiety Disorders,"The proceedings contain 74 papers. The topics discussed include: the effects of typical and atypical antipsychotics on inducing obsessive-compulsive symptoms in patients with schizophrenia; the many faces of anxiety in later life; effects of cholinergic system of medial prefrontal cortex on anxiety-related behaviors; a double-blind, placebo-controlled study of augmentation with LY2216684 for major depressive disorder patients who are partial responders to selective serotonin reuptake inhibitors; pooled analysis of the efficacy of adjunctive quetiapine XR in patients with major depressive disorder and high or low levels of baseline anxiety; adjunctive quetiapine XR and its effects on sleep disturbance and quality: a pooled analysis from two acute studies in MDD; improvement of sexual function in depressed outpatients treated with milnacipran; and plasma serotonin level of Vietnam war veterans with posttraumatic stress disorder and symptom severity.",,2010.0,,0,0,
8219,Adjunctive quetiapine XR and its effects on sleep disturbance and quality: A pooled analysis from two acute studies in MDD,"Background: Disrupted sleep is common in depression. Effects of once-daily extended release quetiapine fumarate (quetiapine XR) adjunct to ongoing antidepressant (AD) on restoration of sleep and sleep quality in patients with MDD and an inadequate response to prior AD were investigated. Methods: Pooled data from two (D1448C00006/D1448C00007) 6-week, double-blind, randomised, placebo (placebo + AD)-controlled studies of adjunctive quetiapine XR (150mg/day and 300mg/day) were analysed. Primary endpoint (both studies): change in MADRS total score versus placebo + AD. This post hoc analysis was based on the following secondary endpoints: change from randomisation in MADRS item 4 (reduced sleep), HAM-D items 4, 5 and 6 (insomnia-early, -middle and -late, respectively), sleep disturbance factor (HAM-D items 4 + 5 + 6) and sleep quality (PSQI global score). Change in MADRS total score in patients with baseline HAM-D sleep disturbance factor score ‚â• 4 or < 4, (high and low sleep disturbance, respectively), was evaluated. Results: 939 patients randomised; MITT population included 919 patients: adjunctive quetiapine XR 150mg/day (n = 309), 300mg/day (n = 307), placebo + AD (n = 303). At Week 6, adjunctive quetiapine XR reduced MADRS item 4, HAM-D sleep disturbance factor, HAM-D items 4, 5 and 6 and PSQI global scores from baseline (p < 0.001, both doses versus placebo + AD). In patients with high baseline sleep disturbance (n = 226, adjunctive quetiapine XR 150mg/day; n = 215, 300mg/day; n = 210, placebo + AD), adjunctive quetiapine XR improved (p < 0.01) MADRS total score versus placebo + AD from Week 1. In patients with low baseline sleep disturbance (n = 83, adjunctive quetiapine XR 150mg/day; n = 92, 300mg/day; n = 93, placebo + AD), adjunctive quetiapine XR (both doses) improved MADRS total score versus placebo + AD at Weeks 1 (p < 0.01) and 2 (p < 0.05) only. Conclusions: Adjunctive quetiapine XR significantly restored sleep and improved sleep quality in patients with MDD and an inadequate response to prior AD. In patients with high baseline sleep disturbance, adjunctive quetiapine XR improved depressive symptoms from Week 1. For patients with low sleep disturbance, a smaller sample size limited the statistical power; however, adjunctive quetiapine XR was effective in these patients. Research funded by AstraZeneca Pharmaceuticals.",Bauer M.; McIntyre R.S.; Szamosi J.; Eriksson H.,2010.0,10.3109/13651501.2010.527734,0,0,
8220,Pooled analysis of the efficacy of adjunctive quetiapine XR in patients with major depressive disorder and high or low levels of baseline anxiety,"Background: Patients with MDD and high anxiety levels typically experience more severe depression and functional impairment than patients with low anxiety. Effects of once-daily extended release quetiapine fumarate (quetiapine XR) adjunct to antidepressants (AD) in patients with MDD and high or low baseline anxiety levels were investigated. Methods: Pooled data from two (D1448C00006/D1448C00007) 6-week, double-blind, randomised, placebo-controlled trials in patients with inadequate response to AD were analysed. Patients received adjunctive quetiapine XR (150mg/day or 300mg/day) or placebo + AD. Primary endpoint (both studies): change in MADRS total score versus placebo + AD. Secondary endpoints included: Week 6 change in MADRS, HAM-A and CGI-S total scores in patients with high or low baseline anxiety levels, defined as HAM-A total score ‚â• 20 or < 20, respectively. Results: For patients with high baseline anxiety levels (n = 433), adjunctive quetiapine XR 300mg/day (-15.92, p < 0.05) but not 150mg/day (-15.20, p = 0.122) significantly reduced MADRS total scores versus placebo + AD (-13.49) at Week 6. Adjunctive quetiapine XR 300mg/day significantly improved HAM-A total score (-12.19, p < 0.05) and CGI-S total score (-1.68, p<0.05) versus placebo + AD (-10.18, -1.37, respectively) at Week 6; reductions with adjunctive quetiapine XR 150mg/day at Week 6 were -11.70 (p = 0.082) and -1.60 (p = 0.131) for HAM-A and CGI-S total scores, respectively. For patients with low baseline anxiety levels (n = 486), adjunctive quetiapine XR 150mg/day (-13.99, p < 0.001) and 300mg/day (-13.98, p < 0.001) significantly improved MADRS total scores versus placebo + AD (-10.83) at Week 6. Adjunctive quetiapine XR 150mg/day and 300mg/day significantly improved HAM-A total score (-6.59, p < 0.01; -6.48, p < 0.05) and CGI-S total score (-1.63, p < 0.001; -1.52, p < 0.01) at Week 6 versus placebo + AD (-4.93, -1.16, respectively). Reported adverse events were similar in both cohorts and were consistent with the known tolerability profile of quetiapine. Conclusions: In patients with MDD and inadequate response to prior AD, adjunctive quetiapine XR was effective at reducing depressive and anxiety symptoms in patients with high (quetiapine XR 300mg/day) and low (quetiapine XR 150 and 300mg/day) baseline anxiety levels. Research funded by AstraZeneca Pharmaceuticals.",Bandelow B.; Bauer M.; Vieta E.; El-Khalili N.; Udd M.; Gustafsson U.; Eriksson H.,2010.0,10.3109/13651501.2010.527734,0,0,
8221,"A double-blind, placebo-controlled study of augmentation with LY2216684 for major depressive disorder patients who are partial responders to selective serotonin reuptake inhibitors","Background/Aims: Many patients treated with selective serotonin reuptake inhibitors (SSRIs) for major depressive disorder (MDD) achieve clinically meaningful benefit, but experience residual symptoms and impairment. LY2216684 HCl (2-Morpholinemethanol, a-[(5-fluoro-2-methoxyphenyl) methyl]-α-(tetrahydro-2H-pyran-4-yl)-, hydrochloride, (αR, 2S)) is a selective norepinephrine reuptake inhibitor. This study examined whether adjunctive treatment with LY2216684 improved outcomes in patients with MDD who were partial responders to SSRIs. Methods: This was a double-blind, placebocontrolled, 11-week trial with adjunctive flexibly dosed LY2216684 6-18 mg once daily or placebo. Key inclusion criteria were SSRI treatment for ≥ 6 weeks, partial response by investigator's opinion, and GRID 17-item Hamilton Depression Rating Scale total score ≥ 16. The primary outcome measure was mean change in the Montgomery-Asberg Depression Rating Scale (MADRS) total score. The prespecified primary evaluable sample was patients who improved < 25% on the Quick Inventory for Depression Scale Self-Report 16 items total score during a 2-week double-blind placebo lead-in period. Secondary measures included remission rate (MADRS ≤ 10), Sheehan Disability Scale global functioning impairment score, and Fatigue Associated with Depression scale scores. Tolerability and safety outcomes were assessed. Results: Of 227 patients (placebo, N = 111; LY2216684, N = 116), 69.6% were female; mean age = 45.4 years. LY2216684-treated patients had numerically greater improvement in MADRS total score (p = 0.18), greater rates of remission (p = 0.044), greater improvement in overall role functioning (p = 0.039), and greater reduction of functional impact of fatigue (p = 0.012) compared with placebo-treated patients. In the LY2216684 group, the most frequent treatment-emergent adverse events were hyperhidrosis (7.2%, p = 0.017), nausea (7.2%, p = 0.129), dizziness (4.5%, p = 0.113), and erectile dysfunction and testicular pain in males (6.3% for both events, p = 0.211). LY2216684-treated patients significantly differed from placebo-treated patients in the mean changes in standing pulse rate (placebo = 0.51 bpm [SE = 1.05], LY2216684 = 7.18 [SE = 1.04]; p ≤ 0.001) and diastolic blood pressure (placebo = -0.60 mmHg [SE = 0.74], LY2216684 = 1.99 [SE = 0.74]; p = 0.012). Conclusions: Adjunctive treatment with LY2216684 for patients with MDD who had a partial response to SSRIs was associated with higher remission rates and improved functioning compared with placebo; it was well-tolerated.",Ball S.; Dellva M.; D'Souza D.; Marangell L.; Russell J.; Goldberger C.,2010.0,10.3109/13651501.2010.527734,0,0,
8222,Influence of comorbid anxiety disorders on outcome in major depression,"Coexisting anxiety symptoms and comorbid anxiety disorders are common in patients with major depressive disorder - anxiety symptoms are reported by approximately 60% of patients, and comorbid anxiety disorders are seen in around 50% of patients. Early studies encouraged the widespread consensus that patients with comorbid mood and anxiety disorders had more severe symptoms. Similarly, comorbidity of anxiety disorders with major depression has usually been thought to be associated with a less favourable long-term outcome, with longer persistence of symptoms and a greater risk of continuing social and occupational impairment. In addition, the presence of prominent anxiety symptoms in depressed patients is generally considered to be associated with a lower overall response rate to treatment. This review will examine four aspects of the relationship between major depressive disorder and comorbid anxiety disorders: the pattern of coexisting anxiety and depressive symptoms in occupational and clinical samples; whether the comorbid condition is indeed more severe than 'pure' major depression: whether comorbidity is associated with worse clinical outcomes than are seen in major depressive disorder alone; and whether the response to antidepressant treatment differs, between depressed patients with or without comorbid anxiety disorders. Although not all evidence is consistent, in general terms the presence of comorbid anxiety disorders in patients with major depressive disorder is associated with greater severity of symptoms and more pronounced impairment; the course of illness is less favourable in patients with the comorbid condition; and relatively fewer depressed patients respond to antidepressant treatment and achieve remission of symptoms, if affected by comorbid anxiety disorders. There is a need for randomised placebo-controlled studies specifically in patients with comorbid major depressive disorder and anxiety disorders, in order to determine whether this patient group differs from those with 'pure' major depression, in its responsiveness to pharmacological or psychological interventions, as this group comprises the probable majority of depressed individuals seen within routine clinical practice settings.",Baldwin D.,2010.0,10.3109/13651501.2010.527733,0,0,
8223,Stigma against premenstrual dysphoria caused by the influence of ideologically rooted argumentation on the actions of regulatory authorities,"While a scientifically based questioning of current psychiatric diagnoses and treatments is obviously important for progress, argumentation rooted in anti-psychiatric ideology has proven less helpful, and caused considerable harm, both by depriving patients of effective treatment, and by enhancing the stigma and burden of psychiatric morbidity. In this presentation, the case of premenstrual dysphoria (PMD) will be discussed to illustrate how psychiatry, more than other medical disciplines, is at risk of being influenced by ideology and non-scientific arguments. The existence of PMD was recognized already by Hippocrates, and has been confirmed in a vast number of studies conducted in different cultures. It is well established that premenstrual complaints cause a marked reduction in life quality, and some studies suggest that they also enhance the risk for suicide. Luckily, however, PMD is a highly treatable condition: many controlled studies thus unanimously confirm that selective serotonin reuptake inhibitors (SSRIs) markedly reduce the symptoms in a vast majority of patients, and that the onset of action is short enough to permit the treatment to be restricted to the symptomatic phase of the cycle. While it may hence seem as a reasonably stance that women having large parts of their lives ruined by the burden of PMD should be offered the opportunity to test this safe and well-tried treatment, many debaters have found reasons to fiercely oppose this idea, by claiming, for example, that PMD is a non-existing condition, or a social construct (in spite of the fact that it has a very robust and well-established biological basis, i.e. the cyclical influence of sex steroids on the brain). As will be discussed in this presentation, this arguing, which seems to be rooted in an unhealthy mixture of anti-psychiatry and an extreme variant of feminism, has contributed both to the reluctance of including PMD among the established diagnoses in DSM, and to the fact that no SSRI is approved for this indication in Europe.",Eriksson E.,2010.0,10.3109/13651501.2010.527733,0,0,
8224,Behavioural treatment of AIDS-focused illness phobia.,"Seven cases (Ss aged 20-31 yrs) are described in which the central symptoms were fear of contracting acquired immune deficiency syndrome (AIDS), avoidance of related cues, rituals, and reassurance-seeking. Associated features include previous illness phobias and obsessive-compulsive disorder. Treatment with exposure and response prevention (plus a cognitive session in 1 case), led to improvement sustained up to 3 mo after discharge, although 1 patient stopped treatment prematurely. Controlled trials of behavioral treatment in hypochondriasis are required. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Logsdail, Stephen; Lovell, Karina; Warwick, Hilary; Marks, Isaac",1991.0,,0,0,
8225,"""Clinical Global Impressions"" (ECDEU): Some critical comments.","Investigated, using clinical trials, the semantic, logical, and statistical properties of the Clinical Global Impressions Scale (CGIS). Ss were 175 patients with schizophrenic, depressive, or anxiety diseases. The CGIS may induce inconsistent rating behavior, contains redundant information, and consists of items that show abnormal distribution properties. Some of these items are inappropriately constructed or cast some doubts on their significance as measurements is doubtful. It is suggested that item No 1 (seriousness of disease) be used at the beginning of a study only, and item No 2 (global improvement) be used sparingly and as single measurement to express the doctor's general impression. There would seem to be no basis for the judgment of a pure drug effect (item No 3). Poor distribution properties and a presumably restricted significance of change ratings suggest that parametric statistics should not be used. (German abstract) (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Beneke, M; Rasmus, W",1992.0,,0,0,
8226,Alexithymia as a predictor of treatment response in post-traumatic stress disorder.,"Examined the relationship of alexithymia (ALX) to treatment response, by assessing ALX before starting treatment, then randomly assigning posttraumatic stress disorder (PTSD) patients to imipramine, phenelzine, or placebo, all in combination with psychotherapy. 57 veterans with PTSD completed the Alexithymia Provoked Response Questionnaire (APRQ) by J. H. Krystal et al (see record 1987-07741-001) upon entering an 8-wk randomized trial comparing 18 phenelzine, 23 imipramine, and 16 placebo Ss. Low ALX on the APRQ significantly predicted improvement on the avoidance items of the Impact of Events Scale (M. Horowitz et al, 1972), particularly among patients treated with placebo, but was not associated with changes in the intrusion items of the scale. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kosten, Thomas R; Krystal, John H; Giller, Earl L; Frank, Julia; Dan, Elisheva",1992.0,,0,0,
8227,Quantitative electroencephalographic effects of caffeine in panic disorder.,"Examined the EEG activity of 7 adult patients with panic disorder and 7 normal control Ss during the randomized double-blind, placebo-controlled administration of oral caffeine (7 mg/kg). Caffeine was associated with a significant increase in peak occipital alpha frequency and significant decreases in occipital alpha amplitude, central beta amplitude, and central theta amplitude. Despite the observation that caffeine increased anxiety more in the patients with panic disorder than in the normal control Ss, the 2 groups did not differ in their EEG responses to caffeine. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Newman, Francis X; Stein, Murray B; Trettau, Joan R; Coppola, Richard; Uhde, Thomas W",1992.0,,0,0,
8228,A comparison of symptom determinants of patient and clinician global ratings in patients with panic disorder and depression.,"Examined the relationships among syndromal symptomatology and Clinical Global Impression (CGI) severity and improvement ratings in a study of patients (aged 20-65 yrs) who met Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) criteria for both panic disorder and depression. Anticipatory anxiety and depression ratings were significantly associated with each CGI item. Frequency of panic attacks was consistently related to the clinician's rating of severity but was only sporadically related to clinician and patient improvement ratings. These findings were fairly consistent during course of treatment with either alprazolam, imipramine, or placebo. Results suggest that, while the CGI appears to be used systematically, global ratings are not merely a composite of symptomatology. However, CGI appears to have good internal consistency and concurrent validity, and its continued use in clinical trials is supported. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Leon, Andrew C; Shear, M. Katherine; Klerman, Gerald L; Portera, Laura; Rosenbaum, Jerrold F; Goldenberg, Idell",1993.0,,0,0,
8229,"A double-blind, placebo-controlled study comparing the efficacy and safety of ipsapirone versus lorazepam in patients with generalized anxiety disorder: A prospective multicenter trial.","Administered ipsapirone at daily dose levels of 10 to 30 mg, lorazepam at a daily dose of 2 to 6 mg, or placebo to 317 outpatients with generalized anxiety disorder (GAD) of moderate or greater severity. Efficacy was measured by changes in depression and anxiety measures before and after the 4-wk acute (drug) treatment period. 253 patients completed the treatment (ipsapirone, N = 80; lorazepam, N = 85; and placebo, N = 82). Ratings from the Physician Withdrawal Checklist demonstrated greater withdrawal symptoms in Ss treated with lorazepam as compared with Ss on ipsapirone. Both lorazepam and ipsapirone demonstrated significantly more side effects than placebo. Ipsapirone was shown to be equally as effective as lorazepam in the management of GAD, and as a result of fewer withdrawal symptoms, ipsapirone may represent a more rational and selective therapy for GAD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cutler, Neal R; Sramek, John J; Keppel Hesselink, Jan M; Krol, Alice; Roeschen, Julie; Rickels, Karl; Schweizer, Edward",1993.0,,0,0,
8230,Treatment outcome in test anxiety research: A review and meta-analysis.,"Although the general efficiousness of psychotherapy is now rarely questioned, the effectiveness of various treatment modalities for specific disorders is more uncertain. This review examines the effectiveness of psychotherapy in treating test anxiety. Sixty-nine controlled studies of various forms of psychotherapeutic intervention for test anxiety were reviewed. Their cumulative results were examined using meta-analysis. The relative outcomes of behavioral, cognitive, skills training, and combinations of these interventions were observed. The effectiveness of these treatments on various outcome measures are discussed. On measures of test anxiety, large effect sizes for systematic desensitization and cognitive treatments were observed. Smaller effect sizes were noted for relaxation procedures and skills training. Trait anxiety instruments showed large treatment effects for behavioral techniques, moderate effects for cognitive therapies, and smaller effects for skills training. A trend toward larger effect sizes for combined treatments was suggested. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gambles, David H",1995.0,,0,0,
8231,A Twelve Step model for the treatment of traumatized families.,"Using the Twelve Steps of Alcoholics Anonymous, this study examines its application to the treatment of traumatized victims and their families. The study's hypotheses focused on the role of stress and social support on the victim's quality of life as well as the families, as a consequence of the treatment. In addition, a control group was established to determine if traditional family therapy was more effective than the Twelve Step approach in ameliorating trauma symptoms. The study's participants consisted of 51 families identified as having one member suffering from traumatic stress. The multiple regression analysis revealed that the victim's quality of life was improved as a result, through the intervening variables of stress and social support. It was also found to be effective in reducing family stress and indirectly then enhancing the family's quality of life. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Johnson, Diane Guercio",1995.0,,0,0,
8232,Intensive alpha-theta brainwave training for adults with childhood sexual trauma-related post-traumatic stress disorder.,"A pilot study was conducted with three adult survivors of childhood sexual trauma and incest utilizing intensive alpha-theta brainwave biofeedback training coupled with visualization and therapeutic massage. Subjects were one adult female incest survivor, one adult male incest survivor, and one female adult survivor of childhood sexual trauma residing in the metropolitan Denver, Colorado area. Subjects were referred for treatment by local psychologists; the Rape Assistance Program in Denver, Wings in Lakewood, and a local psychiatrist. The focus of the study was to investigate the effects of intensive alpha-theta brainwave training coupled with visualization and therapeutic massage as a means of relieving the symptoms of Post-traumatic Stress Disorder in adult survivors of childhood sexual trauma and incest. It was a descriptive pilot study to investigate the following: (1)Was there an increase in the subjects' sense of self empowerment? (2) Was there an increase in the self-esteem of the subjects? (3) Was there an increase in the subjects' abilities to self- regulate? (4) Was there an increase in the subjects' abilities to relax? (5) Was there movement toward healing the emotional/spiritual wounds related to the sexual trauma? Results indicated that the two individuals who completed the treatment protocol derived significant therapeutic benefit, including positive changes in personality testing. While multi-component treatment helped some (participants), it is not possible to attribute success to any particular aspect of the treatment. There were indications that clinical shaping may have played a role in helping clients to learn self-regulation skills. The results suggested that individuals who remain in an abusive environment are unlikely to succeed in treatment. Finally, a direct correlation was not demonstrated between time spent in the reverie state and the value and intensity of corresponding images. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Banks, Rebecca",1995.0,,0,0,
8233,The efficacy of Morita therapy applied in a group modality for socially phobic adults: An outcome study.,"Morita therapy is a clinical approach which originated in Japan and is finding increasing use in the West. While the popularity of Morita therapy has been rising, there have been few controlled empirical investigations into its effectiveness. The present work was undertaken to address this issue. Twenty-two socially phobic adults participated in a study designed to assess the efficacy of a brief (4-session) Morita therapy group. Subjects were assigned to two groups, experimental and wait-list control, and all were given the Social Avoidance and Distress Scale, the Fear of Negative Evaluation Scale, and the Self and Anxiety Questionnaire to complete both before and after their participation in the group. Subjects in the experimental group completed the questionnaires at pre-, posttest, and at approximately one-month follow-up. Subjects in the wait-list control condition completed the questionnaires at pretest1 and pretest2--the ""control"" period corresponding to the experimental condition's participation in the group intervention--as well as at posttest and follow-up. Results indicate that while subjects in the control condition showed no significant change on any measure during the control period, subjects in the experimental condition demonstrated significant improvements across all measures, after their participation in the group. Subjects in the control condition, subsequent to their participation in group, likewise showed significant improvements on all measures of social anxiety and avoidance behavior. Follow-up data indicates that these results persisted for all subjects at approximately one-month after the group intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Aposhyan, Howard Missak",1995.0,,0,0,
8234,The effect of varying the rate of the eye movements in eye movement desensitization reprocessing (EMDR) with battered women.,"The rapid saccades used in eye movement desensitization reprocessing (EMDR) have been reputed to be critical to its efficacy (Lipke & Botkin, 1992; Shapiro, 1989a). To evaluate this hypothesis, the rate of the eye movements was varied in this study. Subjects included 27 battered women who were rated PTSD-positive by a modified version of the Symptom Checklist (MSC) (Foy, Sipprelle, Rueger & Carroll, 1984). Participants were randomly assigned to one of three groups: EMDR Fast, EMDR Slow or Control. Prior to treatment, subjects completed the Revised Impact of Events Scale (IES) (Horowitz, Wilner & Alvarez, 1979). Treatment involved one experimental session lasting up to 90 minutes. Dependent variables included the Subjective Units of Distress (SUDs) (Jensen, 1994; Pitman, Orr, Altman, Longpre, Poire, & Lasko, 1993; Renfrey & Spates, 1994) (derived from the Subjective Units of Disturbance Scale (Wolpe, 1969, 1982, 1990)), the Validity of Cognition (VOC) (Shapiro, 1989a) and the Vividness of Traumatic Image (VTI) Scales as well as the Intrusion subscales of the MSC and the IES. At post-treatment one week later, subjects again provided responses to the five dependent variables and, for ethical reasons, were provided another session of treatment at the EMDR Fast rate if their SUDs were 2 or greater. Results of the mixed, two factor analyses indicated no differences between the groups. Hence, the outcomes showed that the rapid eye movements did not provide a differential treatment effect as hypothesized. All groups experienced improvement on the SUDs and VTI Scales and the MSC Intrusion subscale, supporting occurrence of an exposure effect. This investigation was the first controlled EMDR study conducted with battered women, as well as the first experiment on this procedure using a clinical population in which the rate of the eye movements was varied. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Becich, Helen A",1995.0,,0,0,
8235,Learning behavioral medicine techniques for groups from the inside out.,"In this qualitative study, autogenic training, thermal biofeedback, visualization, imagery, music, and breathing training were combined using an understanding of autonomic nervous system and family systems framework in Mind-Body Self-Regulation Groups (MSG) for people with chronic and life-threatening illnesses. MSG represents a new intervention using a group format with the self-regulation skills which are combined with the group and its therapeutic group factors. A MSG has an educational purpose, and it relies upon a combination of group support and self-regulation skills to effect physiological change. Behavioral medicine techniques are first described as they were applied to exploring a treatment for chronic post-mastectomy lymphedema of the arm. The use of biofeedback and music-stimulated imagery within a family systems framework led to a reduction in an edema which had been stable for 26 years. Experiences of members of seven different MSG illustrate the introduction of each of the behavioral medicine techniques. The medical conditions represented were migraine and food allergies, ovarian cancer, post-traumatic back pain, shingles, hypertension, intestinal permeability problem, fibromyalgia, AIDS, chronic fatigue syndrome, cardiovascular disease, breast cancer, and colon cancer. Post-treatment interviews with five group participants revealed a lasting impact upon life-style and illness. Participants continued, post-group, to incorporate various techniques learned in the group to lower autonomic arousal and reduce or eliminate symptoms of the illness. Recommendations are: (a) to adopt MSG as an adjunctive treatment for medical illnesses; (b) to study the effects of MSG on longevity and quality of life with cancer patients; (c) to study the effects of self-regulation techniques in combination with interpersonally oriented group psychotherapy; (d) to collect both qualitative and quantitative data in research on MSG; (e) to encourage the incorporation of family sy (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Esty, Mary Lee",1995.0,,0,0,
8236,Eye movement desensitization of public-speaking anxiety: A partial dismantling.,"39 undergraduates and 1 graduate student were recruited for treatment of public speaking anxiety. 10 Ss received standard eye movement desensitization treatment; 10 Ss were instructed to close their eyes and were exposed to a moving audio stimulus; 10 Ss kept their eyes focused on their hands resting in their laps; and 10 Ss in the control group received no treatment. Ss in the treatment groups were treated individually; all Ss took part in pretest and follow-up assessments and standardized self-reports and psychophysiological and performance measures. All treatment procedures had significant effects of Ss"" reports of improvement in public speaking anxiety and on 1 measure of public speaking anxiety. Results suggest that eye movements are not essential to the effectiveness of the general treatment approach. It is suggested that eye movement desensitization may consist of a ""dosed flooding"""" procedure. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Foley, Terry; Spates, C. Richard",1995.0,,0,0,
8237,Eye movement desensitization and reprocessing in the treatment of test anxiety: A study of the effects of expectancy and eye movement.,"Investigated the effects of high- vs low-expectancy for change and eye movement vs non-eye movement desensitization in the reduction of test anxiety in 41 undergraduate volunteers (primarily females). Ss were randomly assigned to 1 of the 4 conditions (e.g., high expectancy/eye movement). After a 60-min session in the treatment condition to which they were assigned, Ss were measured using a subjective units of disturbance scale and a validity of cognition scale. The Test Anxiety Inventory was administered pre- and posttreatment. Data indicate that all Ss, regardless of treatment condition, showed a significant decrease in anxiety after treatment. Ss in the eye-movement condition reported feeling less anxious than those in the non-eye-movement condition. There was no effect for expectancy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gosselin, Phillip; Matthews, William J",1995.0,,0,0,
8238,Eating disorders among patients incarcerated only for repeated shoplifting: A retrospective quasi-case-control study in a medical prison in Japan.,"Background: Shoplifting is a serious problem among patients with eating disorders. For more than a decade, we have treated many patients with eating disorders incarcerated in Hachioji Medical Prison only for repeated shoplifting. Methods: We analyzed the prison records and medical records of female psychiatric patients transferred to Hachioji Medical Prison between 2002 and 2011. Based on the offense listed at the time of sentencing, we extracted a shoplifting group and a drug-offense group from among all patients with eating disorders. One patient from the former group who had used substances and two from the latter group who had never shoplifted were excluded from the study. The groups had 41 and 14 patients, respectively. A control group comprised patients with other mental disorders (n = 34). We compared eating disorder histories and subtypes, weight changes, comorbidities, life histories, past behavioral problems, and clinical behavioral problems among the three groups. Results: The shoplifting group exhibited less impulsive behavior, substance abuse, antisocial features, borderline personality disorder, and past bulimia than did the drug-offense and control groups. The shoplifting group had higher educational achievement and steadier employment; however, their eating disorder histories and interpersonal dysfunction were more severe, and they had a higher psychiatric treatment dropout rate. There were also significant relationships with low body weight, anorexia nervosa-restricting type, obsessive-compulsive behaviors, and obsessive-compulsive personality disorder in the shoplifting group. During the clinical course, food refusal, excessive exercise, food hoarding, and falsification of dietary intake amounts were more frequently observed in the shoplifting group. Conversely, drug requests and occurrences of self-harm were less frequent in the shoplifting group than in the drug-offense group. Conclusions: Although these results may be associated with specific characteristics of patients with eating disorders in the medical prison setting, we concluded that the repeated shoplifting by these patients is unrelated to antisocial or impulsive characteristics but is deeply rooted in these patients' severe and undertreated eating disorder psychopathology. Strong supportive treatment should be considered for patients with eating disorders who develop shoplifting behaviors. Further research is required to elucidate the mechanisms responsible for the relationship between shoplifting and eating disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Asami, Tomokuni; Okubo, Yoshiro; Sekine, Mizuho; Nomura, Toshiaki; Adkins, Baum, Bewell-Weiss, Birmingham, Blanco, Bratland-Sanda, Brener, Casper, Claes, Crisp, Davis, Eddy, Fichter, Fullerton, Garfinkel, Goldner, Holm, Johnston, Krahn, Lacey, Lacey, Matsunaga, McElroy, Myers, Nagata, Norton, Nozoe, Penas-Lledo, Ramsay, Sallet, Selby, Suzuki, Takagi, Vandereycken, Wagner, Watson, Wiederman, Yoshinaga",2014.0,,0,0,
8239,"Transcranial bright light treatment via the ear canals in seasonal affective disorder: A randomized, double-blind dose-response study.","Background: Bright light treatment is effective for seasonal affective disorder (SAD), although the mechanisms of action are still unknown. We investigated whether transcranial bright light via the ear canals has an antidepressant effect in the treatment of SAD. Methods: During the four-week study period, 89 patients (67 females; 22 males, aged 22-65, mean +/- SD age: 43.2 +/- 10.9 years) suffering from SAD were randomized to receive a 12-min daily dose of photic energy of one of three intensities (1 lumen/0.72 mW/cm2; 4 lumens/2.881 mW/cm2; 9 lumens/6.482 mW/cm2) via the ear canals. The light was produced using light-emitting diodes. The severity of depressive symptoms was assessed with the Hamilton Depression Rating Scale-Seasonal Affective Disorder (SIGH-SAD), the Hamilton Anxiety Rating Scale (HAMA), and the Beck Depression Inventory (BDI). Cognitive performance was measured by the Trail Making Test (TMT). The within-group and between-group changes in these variables throughout the study were analysed with a repeated measures analysis of variance (ANOVA), whereas gender differences at baseline within the light groups were analysed using Student's t-tests. Results: Patients in all three groups showed significant decreases in their BDI, HAMA, and SIGH-SAD scores. Response rates, i.e., an at least 50% decrease of symptoms as measured by the BDI, were 74%-79% in the three treatment groups. Corresponding variations for the SIGH-SAD and the HAMA were 35-45% and 47-62%, respectively. No intensity-based dose-response relationships in the improvement of anxiety and depressive symptoms or cognitive performance between treatment groups were observed. Approximately one in four patients experienced mild adverse effects, of which the most common were headache, insomnia, and nausea. Conclusions: These results suggests that transcranial bright light treatment may have antidepressant and anxiolytic effect in SAD patients, as both self- and psychiatrist-rated depressive and anxiety symptoms decreased in all treatment groups. These improvements are comparable to findings of earlier bright light studies that used conventional devices. The lack of dose response may be due to a saturation effect above a certain light intensity threshold. Further studies on the effects of transcranial bright light with an adequate placebo condition are needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Jurvelin, Heidi; Takala, Timo; Nissila, Juuso; Timonen, Markku; Ruger, Melanie; Jokelainen, Jari; Rasanen, Pirkko; Anderson, Avery, Ayers, Baxendale, Beck, Berson, Blackshaw, Bromundt, Brunoni, Cajochen, Chang, Cusin, Desan, Eastman, Enns, Flory, Ganong, Glickman, Golden, Hagfors, Hamilton, Hartford, Hattar, Herrera-Guzman, Jurvelin, Kaptchuk, Kasof, Kirsch, Kojima, Koorengevel, Koponen, Lam, Lam, Lee, Lein, Levitt, Lewy, Madrid, Magnusson, Magnusson, Meesters, Mersch, Michalon, Moan, Moller, Nissila, Nissila, Panda, Parkington, Partonen, Peirson, Persinger, Pjrek, Porter, Ravindan, Rief, Roecklein, Rosenthal, Salthouse, Schneibel, Schwartz, Sheenan, Sohn, Starck, Stein, Tam, Tarttelin, Terman, Terman, Terman, Terman, Terman, Terman, Terman, Timonen, Tombaugh, Tulppo, Tulppo, Ugryumova, Vandewalle, Vandewalle, Walsh, Wehr, Williams, Youngstedt, Zeitzer",2014.0,,0,0,
8240,Comparison of cognitive behavioral therapy and supportive psychotherapy for the treatment of depression following traumatic brain injury: A randomized controlled trial.,"Objective: To determine the efficacy of 2 different interventions (cognitive behavioral therapy [CBT] and supportive psychotherapy [SPT]) to treat post-traumatic brain injury (TBI) depression. Participants: A sample of 77 community-dwelling individuals with a TBI, and a diagnosis of depression. Participants were randomized into treatment conditions either CBT or SPT and received up to 16 sessions of individual psychotherapy. Measures: Participants completed the Structured Clinical Interview for DSM-IV and self-report measures of depression (Beck Depression Inventory-Second Edition), anxiety (State-Trait Anxiety Inventory), perceived social support (Interpersonal Support Evaluation List), stressful life events (Life Experiences Survey), and quality of life (QOL) before beginning and immediately following treatment. Results: No significant differences were found at baseline between CBT and SPT groups on demographic factors (sex, age, education, race, and time since injury) or baseline measures of depression, anxiety, participation, perceived social support, stressful life events, or QOL. Analyses of variance revealed significant time effects for the Beck Depression Inventory-Second Edition, State-Trait Anxiety Inventory, and QOL outcome measures but no group effects. Intention-to-treat mixed effects analyses did not find any significant difference in patterns of scores of the outcome measures between the CBT and SPT intervention groups. Conclusions: Both forms of psychotherapy were efficacious in improving diagnoses of depression and anxiety and reducing depressive symptoms. These findings suggest that in this sample of individuals with TBI, CBT was not more effective in treating depression than SPT, though further research is needed with larger sample sizes to identify different components of these interventions that may be effective with different TBI populations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ashman, Teresa; Cantor, Joshua B; Tsaousides, Theodore; Spielman, Lisa; Gordon, Wayne; Andrews, Anson, Ashendorf, Ashman, Ashman, Backhaus, Beck, Beck, Bell, Bombardier, Bombardier, Brookings, Bryant, Bryant, Butler, Bedard, Cabral, Campbell, Castonguay, Cohen, Cuijpers, Curran, Dikmen, Doering, Driver, Etchells, Fann, Fann, Fann, Farrin, First, Gardner, Gertler, Glenn, Green, Guillamondegui, Gurr, Hart, Hassett, Hesdorffer, Hibbard, Hill, Hodgson, Hoffman, Hoge, Holsinger, Jorge, Kessler, Koponen, Kreutzer, Kroenke, Kuiper, Lambert, Levy, Li, Lykouras, McMillan, Medd, Meichenbaum, Mittenberg, Mohr, Ouellet, Ownsworth, Pinsker, Powell, Rapoport, Rasquin, Sarason, Schnyder, Schoenberger, Schulz, Seel, Simpson, Sinnakaruppan, Sliwinski, Spielberger, Spitzer, Svendsen, Taylor, Tiersky, Topolovec-Vranic, Tsaousides, Tsaousides, Vanderploeg, Wade, Wade, Wampold, Wampold, Whelan-Goodinson, Williams, Winston",2014.0,,0,0,
8241,Cognitive bias modification of attention is less effective under working memory load.,"Cognitive bias modification for attentional bias (CBM-A) attempts to alleviate anxiety by training an attentional bias away from threat. Several authors have argued that CBM-A in fact trains top-down, reactive counteraction of the tendency to orient towards threat. Imposing a working memory (WM) load during training should therefore limit its efficacy, since WM resources are required for goal-driven control of attention. Twenty-eight subclinical high-anxious participants completed two sessions of CBM-A or placebo training: one under a high WM load, and one under a low WM load. Attentional bias was assessed after each training. CBM-A produced an attentional bias away from threat under low load, but not under high load. These results suggest CBM-A trains top-down counteraction of orienting to threat. It also suggests the administration of CBM-A in the home environment may be affected by everyday worries and distractions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Booth, Robert W; Mackintosh, Bundy; Mobini, Sirous; Oztop, Pinar; Nunn, Samantha; Amir, Amir, Attwood, Baert, Bar-Haim, Booth, Braver, Brosan, Browning, Browning, Carlbring, Cohen, Enock, Field, Fox, Hakamata, Hallion, Koster, Larson, Lavie, MacLeod, MacLeod, MacLeod, Mobini, Redick, See, Spielberger, Tekcan, Waters, Oner",2014.0,,0,0,
8242,Cognitive behavioural treatment for the chronic post-traumatic headache patient: A randomized controlled trial.,"Background: Chronic post-traumatic headache (CPTH) after mild head injury can be difficult to manage. Research is scarce and successful interventions are lacking. Methods: Ninety patients with CPTH according to ICHD-2 criteria were enrolled from the Danish Headache Center into a randomized, controlled trial. Patients were randomly assigned to either a waiting list group or to a nine-week CBT group intervention. At baseline and after 26 weeks all patients completed the Rivermead Post Concussion Symptoms Questionnaire, SF-36, SCL-90-R and a headache diary. Results: The CBT had no effect on headache and pressure pain thresholds and only a minor impact on the CPTH patients' quality of life, psychological distress, and the overall experience of symptoms. The waiting-list group experienced no change in headache but, opposed to the treatment group, a significant decrease in somatic and cognitive symptoms indicating a spontaneous remission over time. Conclusions: Our primarily negative findings confirm that management of patients with CPTH still remains a considerable challenge. Psychological group therapy with CBT might be effective in an earlier stage of CPTH and in less severely affected patients but our findings strongly underline the need for randomized controlled studies to test the efficacy of psychological therapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kjeldgaard, Dorte; Forchhammer, Hysse B; Teasdale, Thomas W; Jensen, Rigmor H; Aaseth, Altman, Baandrup, Beck, Bendtsen, Bjorner, Blanchard, de Groot, DiTommaso, Ellis, Evans, Ferguson, Gladstone, Gurr, Ham, Hickling, Jacobson, Jensen, King, Kjeldgaard, Kjeldgaard, Lange, Lew, Lucas, Medina, Munksgaard, Nash, Olsen, Penzien, Russell, Stetter, Sullivan, Tatrow, Ware, Ware, Watanabe, Zasler, Zeeberg",2014.0,,0,0,
8243,Trauma exposure and cigarette smoking: The impact of negative affect and affect-regulatory smoking motives.,"Cognitive-affective mechanisms related to the maintenance of smoking among trauma-exposed individuals are largely unknown. Cross-sectional data from trauma-exposed treatment-seeking smokers (n = 283) were utilized to test a series of multiple mediator models of trauma exposure and smoking, as mediated by the sequential effects of negative affect and affect-modulation smoking motives. The sequential effects of both mediators indirectly predicted the effect of greater trauma exposure types on nicotine dependence, a biochemical index of smoking, perceived barriers to smoking cessation, and greater withdrawal-related problems during past quit attempts. Negative affect and affect-modulation motives for smoking may contribute to the trauma-smoking association. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Farris, Samantha G; Zvolensky, Michael J; Beckham, Jean C; Vujanovic, Anka A; Schmidt, Norman B; Beckham, Beckham, Beckham, Bonn-Miller, Bonn-Miller, Bonn-Miller, Boscarino, Brown, Calhoun, Calhoun, Cook, Feldner, Feldner, First, Foa, Hapke, Hayes, Hayes, Heatherton, Helstrom, Hruska, Ikard, Kassel, Kessler, Lasser, Macnee, Marshall, McFall, Parslow, Pomerleau, Preacher, Preacher, Read, Roberts, Schnurr, Spitzer, Watson, Weaver, Zvolensky",2014.0,,0,0,
8244,Testing the effectiveness of an acceptance and commitment therapy group intervention for obsessive-compulsive disorder.,"This open clinical trial outcome study assessed the effectiveness of an 8-week Acceptance and Commitment Therapy (ACT) group intervention for adults with obsessive compulsive disorder (OCD). A total of 15 participants were enrolled in the group treatment, and 11 individuals completed the treatment and assessments. Assessments occurred at pre-treatment, post-treatment, and 3-month follow-up. Group statistics did not reveal a significant reduction in OCD symptomatology, but individual improvements were seen. Thirty-six percent of participants reduced their Yale-Brown Obsessive Compulsive Disorder Scale (Y-BOCS) score by a severity range (e.g., moderate to mild). At post-treatment a weekly tally of minutes spent on compulsions was reduced by 31% from pre-treatment for the entire group. At follow-up this reduction increased to 58% from pre-treatment. Group statistics showed significant positive changes in levels of thought suppression and psychological flexibility. Participants found the ACT group intervention to be an acceptable treatment. Although group statistics did not support the study hypotheses, individual participant trends show improvement and thus further, larger-scale study of this group intervention is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Foret, Megan M",2014.0,,0,0,
8245,Simulated job interview improves skills for adults with serious mental illnesses.,"Adults with serious mental illnesses (e.g., Autism Spectrum Disorder [ASD], schizophrenia, post-traumatic stress disorder [PTSD]) often have difficulties obtaining employment. The Job Interview Training System with Molly Porter, developed in collaboration with Yale and Northwestern Universities and vocational rehabilitation specialists with funding from The National Institutes of Health (R43/44MH080496), allows learners to practice job interviews on computers in a stress free environment. The system includes user-driven educational materials, an interactive job application, a practice simulation with a fictional interviewer (Molly Porter), and extensive feedback. SIMmersion's PeopleSIMTM technology allows each conversation with Molly to provide a unique interview experience, enabling users to gain confidence while building skills. The on-screen coach provides insight during the conversation, and a comprehensive after-action review provides learners with feedback on the entire interview. In a randomized control trial, the system was proven effective at improving participants' interview skills and confidence. Ninety-six (96) unemployed adults with ASD (n=26), schizophrenia/other (n=37) or PTSD (n=33) were recruited. Participants were randomized into control (n=32) and experimental (n=64) conditions. The control group was ""wait-listed"" to receive training, and the experimental group used the training system with Molly Porter. Both groups completed pre- and post-intervention role-play interviews and self-assessment questionnaires. Analyses of covariance showed that the simulation provided a highly significant training effect, with experimental group participants scoring better in the role-play interviews and self-assessing higher than control group participants. By increasing skills and confidence, this system may ultimately reduce the length of unemployment for adults with mental illnesses. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Humm, Laura Boteler; Olsen, Dale; Be, Morris; Fleming, Michael; Smith, Matthew; Huffcutt, Bond, Salyers, Gold, Issenberg",2014.0,,0,0,
8246,Treatment of flying phobia using virtual reality exposure with or without cognitive restructuring: Participants' preferences.,"This study analyses participants' preferences regarding two exposure treatment modalities for Fear of Flying (FF): virtual reality exposure treatment (VRET) by itself or VRET plus cognitive restructuring (VRET + CR). An alternating treatment conditions design was established and a non-concurrent multiple baseline design across individuals (four participants) was used. Both conditions were equally effective and after the treatment all the participants took a flight. At the end of each session the participants were asked for their opinion on the condition they received. High mean scores were obtained in both conditions; non-significant differences between the two conditions were found. When the treatment was finished the participants were also asked for then preferences regarding both treatment conditions. All participants preferred VRET + CR, considered it more effective, recommended it more to others, and claimed this treatment was less aversive. These data contribute to the literature focused on the importance of taking into account patient preferences. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Botella, Cristina; Breton-Lopez, Juana; Serrano, Berenice; Garcia-Palacios, Azucena; Quero, Soledad; Banos, Rosa; Anthony, Barlow, Barlow, Banos, Banos, Banos, Beck, Becker, Blanchard, Borkovec, Borril, Botella, Botella, Botella, Botella, Choy, Clough, Clough, DiNardo, Essau, Garcia-Palacios, Herscn, Hofmann, Hofmann, Howard, Kazdin, Krijn, Krijn, Maatjes, Marks, Marks, Marks, Meyerbroker, Moriana, Muhlberger, Nathan, Olatunji, Opris, Powers, Richard, Rothbaum, Soto-Perez, Spring, Titov, Tortella-Feliu, Wiederhold, Wolitzky-Taylor, Wolpe",2014.0,,0,0,
8247,Telephone-delivered psychotherapy for rural-dwelling older adults with generalized anxiety disorder: Study protocol of a randomized controlled trial.,"Background: Generalized Anxiety Disorder (GAD), characterized by excessive and uncontrollable worry, has a negative impact on the health, well-being, and functioning of older adults. Cognitive behavioral therapy has demonstrated efficacy in reducing anxiety and worry in older adults, but the generalizability of these findings to community-dwelling older adults is unknown. The aim of the current study is to examine the efficacy of a cognitive-behavioral intervention delivered by telephone in reducing anxiety and worry in rural community-dwelling older adults with GAD. Methods/Design: We propose a randomized controlled trial comparing telephone-delivered cognitive behavioral therapy (CBT-T) with nondirective supportive therapy (NST-T). One hundred seventy six adults 60 years and older diagnosed with GAD will be randomized to one of the two treatment conditions. The primary outcomes are self-report worry and clinician-rated anxiety. Secondary outcomes include depressive symptoms, sleep, quality of life, and functional status. Discussion: It is hypothesized that CBT-T will be superior to NST-T in reducing anxiety and worry among older adults with GAD. Further, CBT-T is hypothesized to be superior to NST-T in reducing problems with depressive symptoms, sleep, functional status and quality of life. If this program is successful, it could be implemented as a low-cost program to treat late-life anxiety, especially in rural areas or in circumstances where older adults may not have access to qualified mental health providers. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Brenes, Gretchen A; Danhauer, Suzanne C; Lyles, Mary F; Miller, Michael E; Andlin-Sobocki, Barrowclough, Baskin, Bastien, Beck, Beck, Beekman, Borkovec, Borkovec, Borkovec, Borkovec, Brenes, Brenes, Brenes, Craske, Crittendon, First, Gadermann, Gonclaves, Gould, Gum, Hamilton, Hopko, Kessler, Mantella, McHorney, McHorney, Meyer, Mohlman, Rejeski, Rejeski, Shear, Stanley, Stanley, Stanley, Stanley, Stanley, Wang, Ware, Ware, Weeks, Wetherell, Wetherell, Wetherell, Zickuhr",2014.0,,0,0,
8248,A two-site pilot randomized 3 day trial of high dose left prefrontal repetitive transcranial magnetic stimulation (rTMS) for suicidal inpatients.,"Background: Suicide attempts and completed suicides are common, yet there are no proven acute medication or device treatments for treating a suicidal crisis. Repeated daily left prefrontal repetitive transcranial magnetic stimulation (rTMS) for 4-6 weeks is a new FDA-approved treatment for acute depression. Some open-label rTMS studies have found rapid reductions in suicidality. Design: This study tests whether a high dose of rTMS to suicidal inpatients is feasible and safe, and also whether this higher dosing might rapidly improve suicidal thinking. This prospective, 2-site, randomized, active sham-controlled (1:1 randomization) design incorporated 9 sessions of rTMS over 3 days as adjunctive to usual inpatient suicidality treatment. The setting was two inpatient military hospital wards (one VA, the other DOD). Patients: Research staff screened approximately 377 inpatients, yielding 41 adults admitted for suicidal crisis. Because of the funding source, all patients also had either post-traumatic stress disorder, mild traumatic brain injury, or both. TMS methods: Repetitive TMS (rTMS) was delivered to the left prefrontal cortex with a figure-eight solid core coil at 120% motor threshold, 10 Hertz (Hz), 5 second (s) train duration, 10 s intertrain interval for 30 minutes (6000 pulses) 3 times daily for 3 days (total 9 sessions; 54,000 stimuli). Sham rTMS used a similar coil that contained a metal insert blocking the magnetic field and utilized electrodes on the scalp, which delivered a matched somatosensory sensation. Main outcome measure: Primary outcomes were the daily change in severity of suicidal thinking as measured by the Beck Scale of Suicidal Ideation (SSI) administered at baseline and then daily, as well as subjective visual analog scale measures before and after each TMS session. Mixed model repeated measures (MMRM) analysis was performed on modified intent to treat (mITT) and completer populations. Results: This intense schedule of rTMS with suicidal inpatients was feasible and safe. Minimal side effects occurred, none differing by arm, and the 3-day retention rate was 88%. No one died of suicide within the 6 month followup. From the mITT analyses, SSI scores declined rapidly over the 3 days for both groups (sham change -15.3 points, active change -15.4 points), with a trend for more rapid decline on the first day with active rTMS (sham change -6.4 points, active -10.7 points, P = 0.12). This decline was more pronounced in the completers subgroup [sham change -5.9 (95% CI: -10.1, -1.7), active -13 points (95% CI: -18.7, -7.4); P = 0.054]. Subjective ratings of 'being bothered by thoughts of suicide' declined nonsignificantly more with active rTMS than with sham at the end of 9 sessions of treatment in the mITT analysis [sham change -31.9 (95% CI: -41.7, -22.0), active change -42.5 (95% CI: -53.8, -31.2); P = 0.17]. There was a significant decrease in the completers sample [sham change -24.9 (95% CI: -34.4, -15.3), active change -43.8 (95% CI: -57.2, -30.3); P = 0.028]. Conclusions: Delivering high doses of left prefrontal rTMS over three days (54,000 stimuli) to suicidal inpatients is possible and safe, with few side effects and no worsening of suicidal thinking. The suggestions of a rapid anti-suicide effect (day 1 SSI data, Visual Analogue Scale data over the 3 days) need to be tested for replication in a larger sample. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","George, Mark S; Raman, Rema; Benedek, David M; Pelic, Christopher G; Grammer, Geoffrey G; Stokes, Karen T; Schmidt, Matthew; Spiegel, Chad; DeAlmeida, Nancy; Beaver, Kathryn L; Borckardt, Jeffrey J; Sun, Xiaoying; Jain, Sonia; Stein, Murray B; Amat, Anderson, Arana, Arana, Baratta, Baratta, Barth, Beck, Bluml, Borckardt, Borckardt, Borckardt, Borckardt, Borckardt, Borckardt, Borckardt, Borckardt, Borckardt, Borckardt, Borckardt, Christianson, Cipriani, Fawcett, Fink, George, George, George, George, George, George, Gold, Hadley, Hamilton, Holtzheimer, Jollant, Kay, Kemp, Larkin, Madsen, Martin, Miller, Mishory, O'Reardon, Olfson, Oquendo, Perlis, Pridmore, Rossi, Roy-Byrne, Seligman, Stein, Taylor, Taylor, Troister, Vollmayr, Young",2014.0,,0,0,
8249,MDMA enhances emotional empathy and prosocial behavior.,"3,4-Methylenedioxymethamphetamine (MDMA, 'ecstasy') releases serotonin and norepinephrine. MDMA is reported to produce empathogenic and prosocial feelings. It is unknown whether MDMA in fact alters empathic concern and prosocial behavior. We investigated the acute effects of MDMA using the Multifaceted Empathy Test (MET), dynamic Face Emotion Recognition Task (FERT) and Social Value Orientation (SVO) test. We also assessed effects of MDMA on plasma levels of hormones involved in social behavior using a placebo-controlled, double-blind, random-order, cross-over design in 32 healthy volunteers (16 women). MDMA enhanced explicit and implicit emotional empathy in the MET and increased prosocial behavior in the SVO test in men. MDMA did not alter cognitive empathy in the MET but impaired the identification of negative emotions, including fearful, angry and sad faces, in the FERT, particularly in women. MDMA increased plasma levels of cortisol and prolactin, which are markers of serotonergic and noradrenergic activity, and of oxytocin, which has been associated with prosocial behavior. In summary, MDMA sex-specifically altered the recognition of emotions, emotional empathy and prosociality. These effects likely enhance sociability when MDMA is used recreationally and may be useful when MDMA is administered in conjunction with psychotherapy in patients with social dysfunction or post-traumatic stress disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Hysek, Cedric M; Schmid, Yasmin; Simmler, Linda D; Domes, Gregor; Heinrichs, Markus; Eisenegger, Christoph; Preller, Katrin H; Quednow, Boris B; Liechti, Matthias E; Anderson, Bedi, Bedi, Blair, Brunt, Crockett, Davis, Di Simplicio, Domes, Domes, Dumont, Dziobek, Guastella, Harmer, Harmer, Harmer, Harris, Haruno, Hinkelmann, Hurlemann, Hysek, Hysek, Hysek, Hysek, Hysek, Hysek, Janke, Kirsch, Knutson, Knutson, Kometer, Kosfeld, Kumsta, Liechti, Marsh, Mithoefer, Mithoefer, Morgenthaler, Murphy, Neumann, Neumann, Oehen, Ogeil, Paulus, Pringle, Reneman, Rosenson, Simmler, Smeets, Smith, Stevens, Thompson, Thompson, van Dijken, Wood, Zak, Zald",2014.0,,0,0,
8250,Standardized treatment manuals: Does adherence matter?,"The importance and utility of treatment manuals is controversial, especially with respect to how rigidly they should be implemented. This study examined therapist adherence across the course of CBT and how several patient characteristics influence the association between adherence and outcome. Patients diagnosed with panic disorder with agoraphobia (n = 220, 72.7% female, average age of 34.9 years) were treated in one of two CBT variations: with (T+) and without (T-) explicit therapist-guided exposure. Although adherence did not crucially influence outcome at a global level, results suggest that symptom severity and patients' motivation to continue treatment interacted with adherence to predict outcome. Importantly, these effects differed across timing and treatment conditions. Our findings showed the benefits of individualising the implementation of the treatment manual. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Hauke, Christina; Gloster, Andrew T; Gerlach, Alexander L; Richter, Jan; Kircher, Tilo; Fehm, Lydia; Stoy, Meline; Lang, Thomas; Klotsche, Jens; Einsle, Franziska; Deckert, Jurgen; Wittchen, Hans-Ulrich; Addis, Bandelow, Barber, Barber, Barber, Berking, Boerner, Borrelli, Borrelli, Brown, Castonguay, Cicchetti, Craske, de Haan, Dennhag, DeRubeis, DeRubeis, Elkin, Emmelkamp, Emmelkamp, Feeley, Foley, Forehand, Ghaderi, Gloster, Gloster, Gloster, Godfrey, Guy, Henry, Hogue, Huey, Huppert, Jacobson, Kazdin, Kendall, Kendall, Lang, Loeb, Luborsky, Mazzucchelli, McHugh, Nezu, Olatunji, Perepletchikova, Perepletchikova, Rabe-Hesketh, Richard, Schoenwald, Schulte, Sharpless, Shear, Smith, Tracey, Tracey, Waltz, Webb, Webb, Weck, Wittchen, Wittchen",2014.0,,0,0,
8251,A standalone Internet cognitive behavior therapy treatment for social anxiety in adults who stutter: CBTpsych.,"Purpose: Social anxiety is common for those who stutter and efficacious cognitive behavior therapy (CBT) for them appears viable. However, there are difficulties with provision of CBT services for anxiety among those who stutter. Standalone Internet CBT treatment is a potential solution to those problems. CBTpsych is a fully automated, online social anxiety intervention for those who stutter. This report is a Phase I trial of CBTpsych. Method: Fourteen participants were allowed 5 months to complete seven sections of CBTpsych. Pre-treatment and post-treatment assessments tested for social anxiety, common unhelpful thoughts related to stuttering, quality of life and stuttering frequency. Results: Significant post-treatment improvements in social anxiety, unhelpful thoughts, and quality of life were reported. Five of seven participants diagnosed with social anxiety lost those diagnoses at post-treatment. The two participants who did not lose social anxiety diagnoses did not complete all the CBTpsych modules. CBTpsych did not improve stuttering frequency. Eleven of the fourteen participants who began treatment completed Section 4 or more of the CBTpsych intervention. Conclusions: CBTpsych provides a potential means to provide CBT treatment for social anxiety associated with stuttering, to any client without cost, regardless of location. Further clinical trials are warranted. Educational objectives: At the end of this activity the reader will be able to: (a) describe that social anxiety is common in those who stutter; (b) discuss the origin of social anxiety and the associated link with bullying; (c) summarize the problems in provision of effective evidence based cognitive behavior therapy for adults who stutter; (d) describe a scalable computerized treatment designed to tackle the service provision gap; (e) describe the unhelpful thoughts associated with stuttering that this fully automated computer program was able to tackle; (f) list the positive outcomes for individuals who stuttered that participated in this trial such as the reduction of social anxiety symptoms and improvement in the quality of life for individuals who stuttered and participated in this trial. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Helgadottir, Fjola Dogg; Menzies, Ross G; Onslow, Mark; Packman, Ann; O'Brian, Sue; Antony, Atkins, Barak, Beck, Beck, Beidel, Blomgren, Blumgart, Boudreau, Brundage, Clark, Clark, Clark, Clark, Davidson Thompson, Endler, Ezrati-Vinacour, Guitar, Helgadottir, Helgadottir, Iverach, Iverach, Kiluk, Klein, Lincoln, Lovibond, McIntyre, Menzies, Menzies, Mortberg, Plexico, Quesal, Rapee, Spielberger, St Clare, Stangier, Stein, Toomey, Watson, Wells, Yaruss",2014.0,,0,0,
8252,Short-term effectiveness of web-based guided self-help for phobic outpatients: Randomized controlled trial.,"Background: Internet-based guided self-help has been successfully used in the general population, but it is unknown whether this method can be effectively used in outpatient clinics for patients waiting for face-to-face psychotherapy for phobias. Objective: The aim was to assess the clinical effectiveness of Phobias Under Control, an Internet-based intervention based on exposure therapy with weekly guidance. Methods: We conducted a randomized controlled trial, recruiting 212 outpatients scheduled to receive face-to-face psychotherapy for any type of phobia at an outpatient clinic. Participants suffering from at least 1 DSM-IV or ICD-10 classified phobia (social phobia, agoraphobia with or without panic disorder, and/or specific phobia as ascertained by a telephone interview at baseline) were randomly allocated to either a 5-week Internet-based guided self-help program based on exposure therapy with weekly student support followed by face-to-face psychotherapy (n = 105) or a wait-list control group followed by face-to-face psychotherapy (n = 107). Primary outcome was the Fear Questionnaire (FQ). Secondary outcomes were the Beck Anxiety Inventory (BAI) and Center of Epidemiological Studies-Depression scale (CES-D). Assessments took place by telephone at baseline (T0) and on the Internet at posttest (T1, self-assessment at 5 weeks after baseline). Missing data at T1 were imputed. Results: At posttest, analysis of covariance on the intention-to-treat sample showed significant but small effect sizes between intervention and control groups on the FQ (d = 0.35, P = .02), CES-D (d = 0.34, P = .03), and a nonsignificant effect size on the BAI (d = 0.28. P = .05). Although initial acceptance was good, high nonresponse was observed, with 86 of 212 participants (40.5%) lost to follow-up at T1 and only 14 of 105 (13.3%) intervention participants finishing all 5 weeks. Conclusions: Phobias Under Control is modestly effective in lowering phobic and depressive symptoms in a relatively short period and may be clinically beneficial when implemented in routine outpatient practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kok, Robin N; van Straten, Annemieke; Beekman, Aartjan T. F; Cuijpers, Pim; Acarturk, Al-Asadi, Andersson, Andersson, Andrews, Beck, Bell, Berger, Bijl, Blankers, Blankers, Boettcher, Bornas, Bower, Carlbring, Carr, Carter, Christensen, Clark, Cuijpers, Dalrymple, de Beurs, de Brey, De Neef, Deacon, Dingemans, Donker, Donkin, Eskildsen, Eysenbach, Furukawa, Green, Groenwold, Hans, Hedman, Hedman, Hedman, Hilvert-Bruce, Issakidis, Karyotaki, Kelders, Kenter, Kiropoulos, Kok, Kok, Konnopka, Leyfer, Liublinska, Marks, Marks, Marks, Mendlowicz, Moessner, Muller, Nguyen, Ost, Ougrin, Proudfoot, Radloff, Reger, Schneider, Seekles, Smit, Spijker, Swift, Sanchez-Meca, Titov, Van Zuuren, Van't Hof, Weiller, Wittchen, Wittchen, Wojtowicz, Woodford, Zimmerman",2014.0,,0,0,
8253,"Prevention of generalized anxiety disorder using a web intervention, iChill: Randomized controlled trial.","Background: Generalized Anxiety Disorder (GAD) is a high prevalence, chronic disorder. Web-based interventions are acceptable, engaging, and can be delivered at scale. Few randomized controlled trials evaluate the effectiveness of prevention programs for anxiety, or the factors that improve effectiveness and engagement. Objective: The intent of the study was to evaluate the effectiveness of a Web-based program in preventing GAD symptoms in young adults, and to determine the role of telephone and email reminders. Methods: A 5-arm randomized controlled trial with 558 Internet users in the community, recruited via the Australian Electoral Roll, was conducted with 6- and 12-month follow-up. Five interventions were offered over a 10-week period. Group 1 (Active website) received a combined intervention of psycho-education, Internet-delivered Cognitive Behavioral Therapy (ICBT) for anxiety, physical activity promotion, and relaxation. Group 2 (Active website with telephone) received the identical Web program plus weekly telephone reminder calls. Group 3 (Active website with email) received the identical Web program plus weekly email reminders. Group 4 (Control) received a placebo website. Group 5 (Control with telephone) received the placebo website plus telephone calls. Main outcome measures were severity of anxiety symptoms as measured by the GAD 7-item scale (GAD-7) (at post-test, 6, and 12 months). Secondary measures were GAD caseness, measured by the Mini International Neuropsychiatric Interview (MINI) at 6 months, Centre for Epidemiologic Studies-Depression scale (CES-D), Anxiety Sensitivity Index (ASI), Penn State Worry Questionnaire (PSWQ), and Days out of Role. Results: GAD-7 symptoms reduced over post-test, 6-month, and 12-month follow-up. There were no significant differences between Group 4 (Control) and Groups 1 (Active website), 2 (Active website with telephone), 3 (Active website with email), or 5 (Control with telephone) at any follow-up. A total of 16 cases of GAD were identified at 6 months, comprising 6.7% (11/165) from the Active groups (1, 2, 3) and 4.5% (5/110) from the Control groups (4, 5), a difference that was not significant. CES-D, ASI, and PSWQ scores were significantly lower for the active website with email reminders at post-test, relative to the control website condition. Conclusions: Indicated prevention of GAD was not effective in reducing anxiety levels, measured by GAD-7. There were significant secondary effects for anxiety sensitivity, worry, and depression. Challenges for indicated prevention trials are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Christensen, Helen; Batterham, Philip; Mackinnon, Andrew; Griffiths, Kathleen M; Hehir, Kanupriya Kalia; Kenardy, Justin; Gosling, John; Bennett, Kylie; Andrews, Andrews, Bados, Borkovec, Calear, Chiu, Christensen, Christensen, Christensen, Christensen, Christensen, Christensen, Christensen, Cuijpers, Donker, Dozeman, Eysenbach, Farrer, Feldner, Fresco, Greenberg, Griffiths, Griffiths, Henderson, Herring, Mrazek, Jayakody, Joling, Judd, Kenardy, Kenardy, Kessler, Kessler, Kessler, Kroenke, Kroenke, Linden, McHugh, McIntosh, Mohr, Patel, Peterson, Pitceathly, Prochaska, Radloff, Rubin, Saunders, Schneider, Sheehan, Spitzer, Tyrer, van't Veer-Tazelaar, van't Veer-Tazelaar, Verbeke, Woodall",2014.0,,0,0,
8254,The role of obsessive beliefs and inferential confusion in predicting treatment outcomes for different subtypes of obsessive-compulsive disorder.,"The current study sought to investigate the cognitive dimensions associated with subtypes of obsessive-compulsive disorder (OCD) and determine whether changes in symptoms following inference-based therapy (IBT) coincided with the modification of cognitive domains. Fifty-nine participants were classified into various OCD subtypes using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and completed the Y-BOCS, Obsessional Beliefs Questionnaire (OBQ-44), Inferential Confusion Questionnaire: The Expanded Version (ICQ-EV), Beck Depression Inventory, the Second Edition (BDI-II), and Beck Anxiety Inventory (BAI) before and after therapy. It was found that the OBQ-44 belief domain Importance/Control of Thoughts was associated with the impulse phobia subtype. Inferential confusion levels were found to be similar across subtypes. Change in OCD symptoms was correlated with change in the level of inferential confusion and of the OBQ belief domain Responsibility/Threat Estimation. Percentage of change in levels of inferential confusion was found to be the most important predictor of OCD symptoms explaining 32% of the variance. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Del Borrello, Loide; O'Connor, Kieron; Aardema, Aardema, Aardema, Aardema, Aardema, Abramowitz, Abramowitz, Abramowitz, Abramowitz, Abramowitz, Beck, Beck, Bourque, Bouvard, Brown, Brown, Calamari, Cohen, Coles, First, First, Fisher, Foa, Freeston, Goodman, Grenier, Julien, Julien, Kaiser, Keeley, Mataix-Cols, Mayerovitch, Mollard, O'Connor, O'Connor, O'Connor, O'Connor, O'Connor, O'Connor, O'Connor, Polman, Rachman, Salkovskis, Salkovskis, Summerfeldt, Taylor, Tolin, Ventura",2014.0,,0,0,
8255,Ondansetron or placebo in the augmentation of fluvoxamine response over 8 weeks in obsessive-compulsive disorder.,"The aim of this study was to investigate the efficacy and safety of ondansetron as an augmentative agent to fluvoxamine in the treatment of patients with obsessive- compulsive disorder (OCD). Forty-six men and women, aged 18-60 years, who fulfilled the diagnostic criteria of OCD on the basis of the DSM-IV-TR and had a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of at least 21 were recruited into the study. The patients randomly received either ondansetron (8 mg/day) or placebo for 8 weeks. All patients received fluvoxamine (100 mg/day) for the first 4 weeks, followed by 200 mg/day for the rest of the trial. The patients were assessed using the Y-BOCS and the adverse event checklists at baseline, and the second, fourth, sixth, and eighth week. Forty-four patients completed the study. The Y-BOCS total score as well as the Y-BOCS obsession subscale score and compulsion subscale score showed significantly greater reduction in the ondansetron group than in the placebo group. There was no significant difference in adverse events between the two groups. In this 8-week double-blind randomized-controlled trial, ondansetron showed significant beneficial effect as an augmentative agent with fluvoxamine in patients with moderate to severe OCD and it was generally well tolerated. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Heidari, Mahnaz; Zarei, Maryam; Hosseini, Seyed M. R; Taghvaei, Rheleh; Maleki, Haleh; Tabrizi, Mina; Fallah, Jalil; Akhondzadeh, Shahin; Aboujaoude, Akhondzadeh, Amiaz, Aouizerate, Askari, Bloch, Bystritsky, Carmin, Dawes, Denys, Enoch, Erzegovesi, Feusner, Fontenelle, Ghaleiha, Goldsmith, Goodman, Goodman, Goodman, Gregory, Haghighi, Hewlett, Hewlett, Hezel, Hollander, Horwath, Insel, Johnson, Kapur, Karno, Kim, Koran, Kushner, Liang, Liu, McBride, Mcdougle, Mcdougle, Meneses, Pallanti, Pallanti, Pasquini, Pigott, Pittenger, Poyurovsky, Ramasubbu, Rodd, Romach, Ruscio, Sasson, Shapira, Skapinakis, Soltani, Stahl, Stewart, Storch, Toren, Warneke, Westenberg, Wilhelm, Wu, Ye, Zhang",2014.0,,0,0,
8256,No impact of deep brain stimulation on fear-potentiated startle in obsessive-compulsive disorder.,"Deep brain stimulation (DBS) of the ventral internal capsule is effective in treating therapy refractory obsessive-compulsive disorder (OCD). Given the close proximity of the stimulation site to the stria terminalis (BNST), we hypothesized that the striking decrease in anxiety symptoms following DBS could be the result of the modulation of contextual anxiety. However, the effect of DBS in this region on contextual anxiety is as of yet unknown. Thus, the current study investigated the effect of DBS on contextual anxiety in an experimental threat of shock paradigm. Eight patients with DBS treatment for severe OCD were tested in a double-blind crossover design with randomly assigned 2-week periods of active and sham stimulation. DBS resulted in significant decrease of obsessive-compulsive symptoms, anxiety, and depression. However, even though the threat manipulation resulted in a clear context-potentiated startle effect, none of the parameters derived from the startle recordings was modulated by the DBS. This suggests that DBS in the ventral internal capsule is effective in treating anxiety symptoms of OCD without modulating the startle circuitry.We hypothesize that the anxiety symptoms present in OCD are likely distinct from the pathological brain circuits in defensive states of other anxiety disorders. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Baas, Johanna M. P; Klumpers, Floris; Mantione, Mariska H; Figee, Martijn; Vulink, Nienke C; Schuurman, P. Richard; Mazaheri, Ali; Denys, Damiaan; Abelson, Ahmari, Alvarez, Baas, Blanchard, Blumenthal, Boyer, Buhlmann, Cannistraro, Craske, Davis, de Olmos, Deckersbach, Denys, Denys, Denys, Do-Monte, Eilam, Etkin, First, Greenberg, Greenberg, Grillon, Grillon, Grillon, Hoehn-Saric, Hoenig, Klumpers, Koran, Mai, Mallet, Mechias, Melzig, Milad, Mobbs, Nuttin, Nuttin, Purcell, Rauch, Rodriguez-Romaguera, Rotge, Simon, Stein, Straube, Sturm, Sullivan, Swerdlow, Szechtman, van den Heuvel, van den Heuvel, van den Munckhof, Walker, Walker, Whiteside, Woody",2014.0,,0,0,
8257,Further support for the acceptability-enhancing roles of safety behavior and a cognitive rationale in cognitive behavioral therapy for anxiety disorders.,"It has been proposed that the judicious use of safety behavior may enhance the acceptability of cognitive behavioral therapy (CBT). Indeed, Milosevic and Radomsky (2013a) found that descriptions of CBT incorporating safety behavior were more acceptable than those that discouraged safety behavior. This study aimed to replicate and extend this work. Participants were 688 undergraduates who rated the acceptability of descriptions of CBT varying in safety behavior (judicious or discouraged) and rationale (cognitive or extinction). Consistent with Milosevic and Radomsky, CBT with safety behavior was significantly more acceptable than traditional CBT. Cognitively based CBT was preferred over extinction-based CBT. The effects of prior treatment and general distress were also examined. Overall, previous treatment and greater anxiety were associated with significantly lower acceptability ratings. Results support the acceptability-enhancing role of safety behavior in CBT and are discussed in terms of cognitive-behavioral theory and treatment of anxiety and related disorders. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Levy, Hannah C; Senn, Jessica M; Radomsky, Adam S; Abramowitz, Aderka, Bados, Barlow, Beck, Beck, Deacon, Deacon, Deacon, Foa, Foa, Hembree, Hood, Kim, Levy, Mancebo, McKay, McManus, Milosevic, Milosevic, Milosevic, Olatunji, Oppenheimer, Parrish, Powers, Rachman, Rachman, Rector, Salkovskis, Salkovskis, Salkovskis, Stobie, Tarrier, Thwaites, Van den Hout",2014.0,,0,0,
8258,"Improving access to psychological services through therapist-assisted, Internet-delivered cognitive behaviour therapy.","Depression and anxiety are prevalent yet undertreated conditions. Therapist-assisted Internet-delivered cognitive behaviour therapy (ICBT) is efficacious for these conditions and can serve to overcome barriers to accessing mental health care (e.g., distance, time). In therapist-assisted ICBT, patients review cognitive behavioural treatment materials over the Internet. In addition, providers offer support and direction most commonly through weekly emails or phone calls. Despite the evidence for and advantages of therapist-assisted ICBT, very few patients have access to this treatment in Canada. In this paper, we describe the Online Therapy Unit for Service, Education and Research that was developed at the University of Regina to improve patient access to ICBT in Saskatchewan. With the support of national and provincial funding, this unit created an ICBT web application for the treatment of depression and anxiety, established policies and procedures for delivery of ICBT, trained therapists to deliver the service, and has been coordinating the delivery of ICBT across multiple diverse settings in Saskatchewan. The current paper describes how the Unit is organized and collaborates with community mental health clinics, thus serving to improve access to ICBT. We provide information on the web application, and the process of ICBT from both the patient and provider perspective. We further describe patient and provider utilization of and feedback about ICBT along with recent and future directions for the Unit. Thus far, the Unit has had a positive impact expanding access to psychological services in Saskatchewan and has the potential to inform similar initiatives in other provinces. (PsycINFO Database Record (c) 2017 APA, all rights reserved) Abstract (French) La depression et l'anxiete sont des troubles courants, mais les gens qui en souffrent restent souvent sans traitement. La therapie cognitivo-comportementale offerte en ligne (TCCL) par des therapeutes s'est revelee efficace pour ces conditions et peut aider a aplanir les obstacles a l'obtention de soins de sante mentale (par ex., en raison de la distance ou du manque de temps). Dans le cadre de ce type de therapie, les patients obtiennent en ligne des documents sur la therapie comportementale. De plus, les therapeutes leur offrent un soutien et une orientation, le plus souvent au moyen de courriels ou par telephone une fois par semaine. En depit des preuves et des avantages en faveur de la TCCL, tres peu de patients au Canada y ont acces. Dans cet article, nous decrivons la Online Therapy Unit for Service, Education and Research qui a ete etablie a l'Universite de Regina dans le but d'ameliorer l'acces a la TCCL. Grace a des fonds provenant de sources nationales et provinciales, l'unite a cree une application Web pour les services de TCCL pour le traitement de la depression et de l'anxiete, a etabli des politiques et des procedures pour la prestation du traitement, et a forme des therapeutes a cette fin. Elle coordonne la prestation de ces services au sein de divers environnements en Saskatchewan. L'article decrit l'organisation de l'unite ainsi que sa facon de travailler en collaboration avec des cliniques communautaires de sante mentale afin d'ameliorer l'acces a la TCCL. Il decrit aussi l'application Web et le procede therapeutique, a la fois du point de vue du patient et du therapeute. Il precise l'utilisation des services par le patient et le fournisseur, et presente les commentaires obtenus sur la TCCL et les prochaines etapes pour l'unite. A ce jour, l'unite a eu des repercussions positives en elargissant l'acces a des services psychologiques en Saskatchewan et elle a le potentiel de contribuer, a titre de source d'information, a des initiatives dans d'autres provinces. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Hadjistavropoulos, Heather D; Alberts, Nicole M; Nugent, Marcie; Marchildon, Greg; Andersson, Andersson, Andrews, Collins, Cuijpers, Dear, Dear, Gainsbury, Green, Hadjistavropoulos, Hadjistavropoulos, Hadjistavropoulos, Hedman, Hedman, Houck, Klein, Kroenke, Osman, Pearson, Robinson, Sheehan, Spek, Spitzer, Sunderland, Titov, Titov, Wagner, Wootton",2014.0,,0,0,
8259,The importance of group cohesion in inpatient treatment of combat-related PTSD.,"Post-traumatic stress disorder (PTSD) is the most widespread mental illness resulting from exposure to combat, necessitating an increase in the provision of group therapy. This pilot study examined the efficacy of, and treatment outcome predictors associated with, group inpatient treatment of combat-related PTSD. Participants included 38 active duty military personnel deployed during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), diagnosed with PTSD, and consecutive admissions to an inpatient PTSD treatment facility. A paired samples t-test revealed significant change in symptom severity and global functioning between pre- and post-treatment. Multiple regression analyses supported the predictive utility of baseline symptomatology and group cohesion (> 50% of the variance in treatment outcome), highlighting the importance of group cohesion in the efficacy of group treatment for combat-related PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Ellis, Carilyn C; Peterson, Mary; Bufford, Rodger; Benson, Jon; Bringhurst, Creamer, Crowe, Duncan, Forbes, Forbes, Freedberg, Gaston, Gaston, Gavlovski, Hamblen, Karatzias, Keen, Kessler, King, Kingsley, Kline, Lambert, Miller, Morey, Resick, Riddle, Weathers",2014.0,,0,0,
8260,TBI symptoms improve after PTSD remediation with emotional freedom techniques.,"A group of 59 veterans with clinical levels of posttraumatic stress disorder (PTSD) symptoms received emotional freedom techniques (EFT) coaching in a randomized controlled trial. A significant percentage dropped below the clinical threshold after 6 sessions of EFT (86%, p < .0001) and remained subclinical at 3-month and 6-month follow-ups. Traumatic brain injury (TBI) and somatoform symptoms isolated from the data set for detailed analysis are presented in the current paper. Compared with pretest, significant reductions in TBI symptoms were found after 3 sessions, with a further reduction after 6 months (-41%, p < .0021). Participant gains were maintained on 3-month and 6-month follow-ups (p < .0006). These results point to the poorly defined distinction between TBI and PTSD symptoms, the potential for partial TBI rehabilitation as a sequel to successful PTSD treatment, and the possibility of long-term maintenance of clinical gains. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Church, Dawson; Palmer-Hoffman, Julie; Bogdanova, Bryant, Carroll, Chambless, Cherkin, Church, Church, Church, Church, Church, Church, Church, Craig, Craig, Craig, Davison, Feinstein, Feinstein, Fox, Girard, Gurret, Hartung, Hoge, Horowitz, Hui, Jonas, Kanter, Kennedy, Legome, Maruish, McCrea, McFadden, Miller, Nolin, Okie, Polusny, Rona, Ruff, Ruff, Sammons, Schneiderman, Schwarzbold, Seal, Spitzer, Stalnacke, Tanielian, Theeler, Vanderploeg, Vanderploeg, Vasterling, Waite, Weathers, Wolpe",2014.0,,0,0,
8261,"A randomised controlled study of the effects of the attention training technique on traumatic stress symptoms, emotional attention set shifting and flexibility.","Attention Training (ATT) is a technique used in metacognitive therapy but it has also been shown to produce stand-alone effects. The present study replicates and extends an earlier study of the effects of ATT on traumatic-stress symptoms. A sample of 60 university students who reported a traumatic life event were randomly assigned to either an ATT group (n = 29) or a control group (n = 31). They were exposed to a recorded narrative of their stressful experience before and after the intervention and the primary outcomes were frequency of intrusions and negative affect reported. Secondary outcomes included self-report and performance-based measures of attention flexibility. ATT significantly reduced intrusions and improved negative affect in individuals who had experienced a stressful life event. The technique also appeared to reduce self-focused attention, increase attention flexibility and modified performance on an emotional attention set shifting task. The results suggest that ATT can be beneficial in reducing specific traumatic stress symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Callinan, Sheila; Johnson, Dan; Wells, Adrian; Bryant, Cavanagh, Clark, Cohen, Derryberry, Eysenck, Foa, Gold, Horowitz, Johnson, Kessler, MacLeod, Matthews, McEvoy, Monsell, Nassif, Nassif, Papageorgiou, Papageorgiou, Roberts, Siegle, Valmaggia, Verbruggen, Watson, Wells, Wells, Wells, Wells, Wells, Whitmer, Williams",2015.0,,0,0,
8262,How to deal with negative thoughts? A preliminary comparison of detached mindfulness and thought evaluation in socially anxious individuals.,"This study compared two techniques, detached mindfulness (DM) and thought evaluation (TE), for dealing with negative thoughts that are drawn from different treatment modalities. Twelve participants with high social anxiety practised each technique in a cross-over repeated measures design before giving a speech. It was predicted that each technique would be advantageous, but that DM would be superior to TE overall. Results showed that both techniques improved anxiety scores. DM led to reductions in the observer-perspective, negative beliefs, and anticipatory processing as well. The overall change attributed to DM was greater than that attributed to TE. The results also suggested that combining these techniques in certain ways might prove disadvantageous. Results are discussed in terms of the potential clinical implications. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gkika, Styliani; Wells, Adrian; Aderka, Baker, Beck, Clark, Field, George, Greenberger, Harvey, Hedman, Hinrichsen, Hirsch, Hirsch, Hofmann, Lovibond, Mattick, Mills, Rapee, Rapee, Rodebaugh, Salaberria, Scholing, Senn, Smits, Stopa, Stopa, Taylor, Vassilopoulos, Vassilopoulos, Vassilopoulos, Watson, Wells, Wells, Wells, Wells, Wells, Zlomke",2015.0,,0,0,
8263,The utilization of unified protocols in behavioral cognitive therapy in transdiagnostic group subjects: A clinical trial.,"Background: The practicing of protocols based on behavioral cognitive therapy (CBT) have been frequently used in the last decades and adapted to better manage the necessities of patients and providers. Objectives: The goal is to build a treatment that is evidence-based-for that reason the unified protocol for multiple emotional disorders (transdiagnostics) have been utilized to simplify treatment-without losing scientific traits. The main goal of this study is to evaluate the unified protocol in groups of patients with depression and anxiety disorders. Materials and methods: In a pool of 48 subjects, divided in two groups, one was submitted to 12 intervention sessions of the unified protocol while the other was solely given medication. MINI, BAI and BDI were the instruments used at the beginning and at the end of treatment. Results: The results were highly significant (p < 0.001) in as much as with the improvement of anxiety and depressive disorders as it was in the group which was treated with the unified protocol compared with the group which was only given medication Limitations: Limitations of this study were the number of sample participants and the non-randomization of subjects in both groups. Conclusion: Group therapy has not been largely implemented though it is deemed very useful for treatments when the unified protocol is used in transdiagnostic patients. Not only does it allow for emotional stabilizing and socialization but it also enables subjects with an altruistic feeling amongst themselves. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","de Ornelas Maia, Ana Claudia Correa; Nardi, Antonio Egidio; Cardoso, Adriana; Amorim, Barlow, Barlow, Beck, Beck, Borkovec, Boswell, Brown, Brown, Button, Cape, Cunha, de Ornelas, Donker, Dudley, Gould, Hunot, Kraus, Lambert, Leichsenring, Norton, Pehlivanidis, Roemer, Sheehan, Teasdale, Tolin, Wood, Wood-Dauphinee",2015.0,,0,0,
8264,Cold hyperalgesia associated with poorer prognosis in lateral epicondylalgia: A 1-year prognostic study of physical and psychological factors.,"Background: Predictors of outcome in lateral epicondylalgia, which is mainly characterized as a mechanical hyperalgesia, are largely limited to sociodemographic and symptomatic factors. Quantitative sensory testing is used to study altered pain processing in various chronic pain conditions and may be of prognostic relevance. Methods: The predictive capacity of early measures of physical and psychological impairment on pain and disability and mechanical hyperalgesia, were examined using data from 41 patients assigned to placebo in a prospective randomized controlled trial of unilateral lateral epicondylalgia. Quantitative sensory testing (pressure, cold pain thresholds), motor function (pain-free grip), and psychological factors (Tampa Scale of Kinesiophobia, Hospital Anxiety and Depression Scale) were measured at baseline. The outcome measures were the Patient-rated Tennis Elbow Evaluation (PRTEE) scale and pressure pain threshold (PPT) measured by digital algometry at the affected elbow. Backward stepwise linear regression was used to predict PRTEE and PPT scores at 2 and 12 months. Results: Cold pain threshold was the only consistent predictor for both PRTEE (P < 0.034) and PPT (P < 0.048). Initial PRTEE was the strongest single predictor of PRTEE at 2 months, whereas female sex was the strongest single predictor of PPT (P < 0.002). At 1 year, final models explained 9% to 52% of the variability in pain and disability and mechanical hyperalgesia, respectively. Discussion: Early assessment of cold pain threshold could be a useful clinical tool to help identify patients at risk of poorer outcomes and might provide direction for future research into mechanism-based treatment approaches for these patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Coombes, Brooke K; Bisset, Leanne; Vicenzino, Bill; Alizadehkhaiyat, Belmonte, Bisset, Bisset, Collins, Coombes, Coombes, Coombes, Crombez, Desmeules, Fernandez-Carnero, Fernandez-Carnero, Finniss, Giesecke, Hay, Hudak, Jensen, Jull, Karels, Mallen, Neziri, Overend, Pallant, Roelofs, Rompe, Ruiz-Ruiz, Scott, Shiri, Singh, Smidt, Smidt, Smidt, Solveborn, Sterling, Sterling, Sterling, Sterling, Stratford, Stratford, Vicenzino, Vlaeyen, Walker-Bone, Walton, Wilder-Smith",2015.0,,0,0,
8265,"Smoking processes, panic, and depressive symptoms among treatment-seeking smokers.","Objectives: The present study evaluated the relative contribution of panic and depressive symptoms in relation to past cessation difficulties and smoking motives among treatment-seeking daily smokers. Methods: The sample included 392 treatment-seeking daily smokers (47.07% female; Mage = 35.48; SD = 13.56), who reported smoking an average of 10 or more cigarettes daily for at least one year. Results: Findings indicated that panic and depressive symptoms were significantly associated with quit problems as well as addictive and negative affect motives for smoking. However, depressive symptoms were not associated with habitual smoking motives. Conclusions: Differential patterns of associations with smoking-based processes imply that although panic and depression are related, there are important distinctions. Such data highlight the need for additional research to examine the putative role of panic and depressive symptoms in relation to smoking behaviors to further elucidate the mechanisms through which panic, depression, and smoking impact one another. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Foster, Dawn W; Langdon, Kirsten J; Schmidt, Norman B; Zvolensky, Michael; Amering, Ameringer, Bonn-Miller, Breslau, Brown, Burgess, Cohen, Goodwin, Grant, Haas, Heatherton, Johnson, Kahler, Kahler, Kandel, Kimbrel, Korte, Lasser, Leventhal, Levy, Leyro, Marshall, McNally, Morissette, Niaura, Peasley-Miklus, Piper, Pomerleau, Pomerleau, Raupach, Reiss, Saunders, Shiffman, Vinci, Watson, Williams, Zvolensky, Zvolensky, Zvolensky, Zvolensky, Zvolensky",2015.0,,0,0,
8266,Training in the implementation of prolonged exposure therapy: Provider correlates of treatment outcome.,"The authors examined the degree to which provider characteristics, such as profession, treatment orientation, prior experience in treating posttraumatic stress disorder (PTSD), prior experience with prolonged exposure (PE) therapy, and attitudes about PE, were related to the clinical outcomes of veterans receiving care from clinicians participating in the national Department of Veterans Affairs (VA) PE Training Program. Positive patient outcomes were achieved by providers of every profession, theoretical orientation, level of clinical experience treating PTSD, and prior PE training experience. With 1,105 providers and 32 predictors (13 provider variables), power was at least 90% power to detect an effect of beta = .15. Profession was the only provider characteristic significantly related to outcomes, but the mean effect (a 2 point difference on the PTSD Checklist) was too small to be clinically meaningful. The results support the intensive training model used in the VA PE training program and demonstrate that clinicians of varying backgrounds can be trained using interactive training workshops followed by case consultation to deliver PE effectively. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Eftekhari, Afsoon; Crowley, Jill J; Ruzek, Josef I; Garvert, Donn W; Karlin, Bradley E; Rosen, Craig S; Beck, Beidas, Eftekhari, Foa, Huppert, Karlin, Lenth, Monson, Ruzek, Schnurr, Weathers, Wilkins",2015.0,,0,0,
8267,Imagery enhancements increase the effectiveness of cognitive behavioural group therapy for social anxiety disorder: A benchmarking study.,"Emerging evidence suggests that imagery-based techniques may enhance the effectiveness of traditional verbal-linguistic cognitive interventions for emotional disorders. This study extends an earlier pilot study by reporting outcomes from a naturalistic trial of an imagery-enhanced cognitive behavioural group therapy (IE-CBGT, n = 53) protocol for social anxiety disorder (SAD), and comparing outcomes to historical controls who completed a predominantly verbally-based group protocol (n = 129). Patients were consecutive referrals from health professionals to a community clinic specialising in anxiety and mood disorders. Both treatments involved 12, two-hour group sessions plus a one-month follow-up. Analyses evaluated treatment adherence, predictors of dropout, treatment effect sizes, reliable and clinically significant change, and whether self-reported tendencies to use imagery in everyday life and imagery ability predicted symptom change. IE-CBGT patients were substantially more likely to complete treatment than controls (91% vs. 65%). Effect sizes were very large for both treatments, but were significantly larger for IE-CBGT. A higher proportion of the IE-CBGT patients achieved reliable change, and better imagery ability was associated with larger symptom change. Outcomes compared very favourably to published group and individual treatments for SAD, suggesting that IE-CBGT may be a particularly effective and efficient mode of treatment delivery. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","McEvoy, Peter M; Erceg-Hurn, David M; Saulsman, Lisa M; Thibodeau, Michel A; Andrews, Beck, Carleton, Chiupka, Clark, Clark, Cox, Cumming, DeWit, Edwards, Hackmann, Hackmann, Harvey, Hayes, Heimberg, Hirsch, Hirsch, Hofmann, Holmes, Holmes, Holmes, Hunt, Jacobson, Kosslyn, Leary, Lee, Lenth, Lincoln, Lovibond, Marks, Mattick, McEvoy, McEvoy, McEvoy, McEvoy, McKelvie, Morina, Morris, Moscovitch, Newcombe, Ng, Nilsson, Page, Pinheiro, Rapee, Rapee, Reisberg, Richardson, Rodebaugh, Sawilowsky, Shah, Shah, Sheehan, Sheehan, Stewart, van Buuren, Weeks, Wild",2015.0,,0,0,
8268,Perception matters for clinical perfectionism and social anxiety.,"Despite research documenting a relationship between social anxiety and perfectionism, very little research has examined the relationship between social anxiety and clinical perfectionism, defined as the combination of high personal standards and high maladaptive perfectionistic evaluative concern. In the current studies we examined whether clinical perfectionism predicted social anxiety in a large sample of undergraduates (N = 602), in a clinical sample of participants diagnosed with social anxiety disorder (SAD; N = 180), and by using a variance decomposition model of self- and informant-report of perfectionism (N = 134). Using self-report, we found that an interaction of personal standards and evaluative concern predicted both social interaction anxiety and fear of scrutiny, but not in the theorized direction. Specifically, we found that self-report of low standards and high evaluative concern was associated with the highest levels of social anxiety, suggesting that when individuals with SAD hold low expectations for themselves combined with high concerns about evaluation, social anxiety symptoms may increase. Alternatively, when an informants' perspective was considered, and more consistent with the original theory, we found that the interaction of informant-only report of personal standards and shared-report (between both primary participant and informant) of concern over mistakes was associated with self-reported social anxiety, such that high concern over mistakes and high personal standards predicted the highest levels of social anxiety. Theoretical, clinical, and measurement implications for clinical perfectionism are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Levinson, Cheri A; Rodebaugh, Thomas L; Shumaker, Erik A; Menatti, Andrew R; Weeks, Justin W; White, Emily K; Heimberg, Richard G; Warren, Cortney S; Blanco, Carlos; Schneier, Franklin; Liebowitz, Michael R; Alden, Antony, Asparouhov, Bentler, Blatt, Boomsma, Brown, Brown, Clark, Clark, Cox, Di Nardo, Dibartolo, Dibartolo, Dickie, Dunkley, Egan, Egan, Egan, Fernandez, First, Frost, Frost, Frost, Gaudreau, Glover, Hayes, Heimberg, Hewitt, Juster, Levinson, Levinson, Liebowitz, Lundh, Lundh, Lundh, Mattick, Moscovitch, Muthen, Neter, Peters, Rapee, Rapee, Rice, Riley, Rodebaugh, Rodebaugh, Rodebaugh, Rodebaugh, Safren, Shafran, Shafran, Sheehan, Shim, Shumaker, Slaney, Slaney, Steiger, Stoeber, Terry-Short, Tucker, Wallace, Wheeler, Zeller, Zuroff",2015.0,,0,0,
8269,Increased sleep need and daytime sleepiness 6 months after traumatic brain injury: A prospective controlled clinical trial.,"Post-traumatic sleep-wake disturbances are common after acute traumatic brain injury. Increased sleep need per 24 h and excessive daytime sleepiness are among the most prevalent post-traumatic sleep disorders and impair quality of life of trauma patients. Nevertheless, the relation between traumatic brain injury and sleep outcome, but also the link between post-traumatic sleep problems and clinical measures in the acute phase after traumatic brain injury has so far not been addressed in a controlled and prospective approach. We therefore performed a prospective controlled clinical study to examine (i) sleep-wake outcome after traumatic brain injury; and (ii) to screen for clinical and laboratory predictors of poor sleep-wake outcome after acute traumatic brain injury. Forty-two of 60 included patients with first-ever traumatic brain injury were available for follow-up examinations. Six months after trauma, the average sleep need per 24 h as assessed by actigraphy was markedly increased in patients as compared to controls (8.3 +/- 1.1 h versus 7.1 +/- 0.8 h, P < 0.0001). Objective daytime sleepiness was found in 57% of trauma patients and 19% of healthy subjects, and the average sleep latency in patients was reduced to 8.7 +/- 4.6 min (12.1 +/- 4.7 min in controls, P = 0.0009). Patients, but not controls, markedly underestimated both excessive sleep need and excessive daytime sleepiness when assessed only by subjective means, emphasizing the unreliability of self-assessment of increased sleep propensity in traumatic brain injury patients. At polysomnography, slow wave sleep after traumatic brain injury was more consolidated. The most important risk factor for developing increased sleep need after traumatic brain injury was the presence of an intracranial haemorrhage. In conclusion, we provide controlled and objective evidence for a direct relation between sleep-wake disturbances and traumatic brain injury, and for clinically significant underestimation of post-traumatic sleep-wake disturbances by trauma patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Imbach, Lukas L; Valko, Philipp O; Li, Tongzhou; Maric, Angelina; Symeonidou, Evangelia-Regkina; Stover, John F; Bassetti, Claudio L; Mica, Ladislav; Werth, Esther; Baumann, Christian R; Baumann, Baumann, Berger, Carmichael, Castriotta, Cetas, Chapotot, Chaumet, Cippa, Crompton, Crompton, Dijk, Guilleminault, Hautzinger, Iber, King, Lamers, Masel, Mathias, Mignot, Ouellet, Parcell, Ponsford, Schreiber, Sommerauer, Stickgold, Tononi, Valko, Vos",2015.0,,0,0,
8270,Aerobic exercise training facilitates the effectiveness of cognitive behavioral therapy in panic disorder.,"Background: Physical activity has been discussed as a therapeutic alternative or add-on for the treatment of anxiety disorders. We studied whether aerobic exercise compared to physical activity with low impact can improve the effect of cognitive behavioral therapy (CBT) in patients with panic disorder (PD) with/without agoraphobia. Methods: Forty-seven patients received group CBT treatment over 1 month, which was augmented with an 8-week protocol of either aerobic exercise (three times/week, 30 min, 70% VO2max; n = 24) or a training program including exercises with very low intensity (n = 23) in a randomized controlled double-blind design. The primary outcome measure was the total score on the Hamilton Anxiety Scale (Ham-A). A 2 x 3 analysis of covariance (ANCOVA) with baseline value as a covariate was conducted for data analysis. Results Time x group interaction for the Ham-A revealed a significant effect (P = .047, eta2p = .072), which represented the significant group difference at a 7-month follow-up. For the other clinical outcome measures no statistical significance emerged, although improvement was more sustained in the exercise group. Conclusions: For patients with PD, regular aerobic exercise adds an additional benefit to CBT. This supports previous results and provides evidence about the intensity of exercise that needs to be performed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gaudlitz, Katharina; Plag, Jens; Dimeo, Fernando; Strohle, Andreas; Abu-Omar, Abu-Omar, Bandelow, Bandelow, Bandelow, Bartley, Beck, Broocks, Craig, Dratcu, Esquivel, Gaudlitz, Gloster, Goodwin, Hamilton, Hamilton, Harvey, Hoffmann, Hofmann, Jayakody, Knubben, Lang, Martinsen, McHugh, Merom, Meyer, Morris, Moses, Plag, Plante, Salmon, Sheehan, Stephens, Steptoe, Steptoe, Strohle, Strohle, ten Have, Wedekind, Weyerer, Wolff, Zschucke",2015.0,,0,0,
8271,Internet-based guided self-help for parents of children on cancer treatment: A randomized controlled trial.,"Objective: The aim of the study was to investigate the feasibility and preliminary efficacy of an Internet-based guided self-help intervention for posttraumatic stress symptoms (PTSS) and related symptoms in parents of children on cancer treatment. Methods: Parents of children on cancer treatment, who fulfilled the modified symptom criteria on the PTSD Checklist, were randomly allocated to the intervention or to a wait-list control condition. The intervention group accessed a 10-week guided self-help program via the Internet based on principles from cognitive behavior therapy. The primary outcome PTSS and the secondary outcomes depression and anxiety were assessed by self-report preintervention and postintervention. Results: Seven hundred forty-seven parents were approached and informed about the study, 92 were assessed for eligibility, and 58 were included and randomized to the intervention (n = 31) or wait list (n = 27). Eightteen participants completed the intervention. Intention-to-treat analyses indicated a significant effect of the intervention on PTSS with a large between-group effect size at postassessment (Cohen's d = 0.88). The intervention group reported reductions in PTSS with a large within-group effect size (d = 1.62) compared with a minimal reduction in the wait-list group (d = 0.09). There was a significant intervention effect on depression and anxiety and reductions in the intervention group with large within-group effect sizes (d = 0.85-1.09). Conclusions: Findings indicate a low enrollment rate and considerable attrition but also that Internet-based guided self-help shows promise for parents of children on cancer treatment who report a high level of PTSS and would like to take part in an Internet-based intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cernvall, Martin; Carlbring, Per; Ljungman, Lisa; Ljungman, Gustaf; von Essen, Louise; Beck, Beck, Blanchard, Boman, Borenstein, Breslau, Cernvall, Christensen, Cohen, Dolgin, Farmer, Feingold, Fotiadou, Gustafsson, Hayes, Hedman, Ivarsson, Jacobson, Kazak, Kazak, Ljungman, Marsac, Marsland, Poder, Poder, Ruggiero, Sahler, Sahler, Salim, Shaw, Singer, Stehl, Wade, Weathers, Wells",2015.0,,0,0,
8272,Therapy on the move: The development of a therapeutic smartphone application.,"The present research investigated the use of a Smartphone App as an adjunct in the treatment of a range of anxiety disorders. The primary aim of the App was to increase client adherence to between session therapy tasks, involving homework practice of a range of skills and tasks known to be associated with successful treatment of anxiety disorders. Homework is an important component of many therapeutic approaches, allowing clients to practise therapeutic skills between sessions, as well as providing continuity between sessions (Freeman & Rosenfield, 2002). Greater client adherence to homework tasks has been associated with improved treatment outcomes, and may be particularly important for reducing the risk of relapse (Scheel, Hanson, & Razzhavaikina, 2004). However, despite the benefits of engagement with homework tasks, client adherence to these activities can often be a significant barrier to treatment (Addis & Jacobson, 2000; Burns & Nolenhoeksema, 1991; Detweiler & Whisman, 1999; Detweiler-Bedell & Whisman, 2005). It is also one area in which the use of adjunctive technologies may have the greatest impact. The aim of this paper was to describe the development and pilot testing of a therapeutic Smartphone application, namely, PsychAssist. This application was designed as an adjunct to face-to-face therapy in the treatment of anxiety disorders among adults. The App was developed with the purpose of enhancing client engagement and adherence to between session (homework) tasks to improve maintenance and generalization of therapeutic behaviours. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Clough, Bonnie A; Casey, Leanne M; Addis, Barlow, Barnett, Boisseau, Boschen, Burns, Carlbring, Casey, Clough, Clough, Clough, Detweiler, Detweiler-Bedell, DiNardo, Donker, Ellard, Freeman, Lambert, Lovibond, Matthews, Mundt, Norman, Palmier-Claus, Preziosa, Raento, Reger, Rizvi, Robinson, Scheel, Taylor, Watson",2015.0,,0,0,
8273,"CBT group intervention for depression, anxiety, and motor symptoms in Parkinson's disease: Preliminary findings.","Nonpharmacological therapies, like cognitive behavioral therapy (CBT), for the treatment of non-motor symptoms (NMS) in Parkinson's disease (PD) have received only little attention. Promising results derive from a few studies that examined the efficacy of individual CBT for depression and anxiety in Parkinson's disease. To date no trial has evaluated the utility of CBT group for NMS in Parkinson's disease. The aim of the present preliminary study was to observe whether CBT group therapy is useful for both NMS and motor symptoms (MS) in patients affected by Parkinson's disease. The results suggested that CBT group was effective in treating depression and anxiety symptoms and can reduce the severity of MS in patients suffering from PD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Berardelli, Isabella; Pasquini, Massimo; Bloise, Maria; Tarsitani, Lorenzo; Biondi, Massimo; Berardelli, Alfredo; Fabbrini, Giovanni; A'Campo, Aarsland, Alonso, Beck, Beck, Berardelli, Bernard, Bieling, Charidimou, Chaudhuri, Chaudhuri, Cole, De Boer, Dickson, Dobkin, Dobkin, Dobkin, Dobkin, Fahn, Farabaugh, Feeney, Fennell, Fenelon, Guy, Hamilton, Hedlund, Heinrichs, Hoehn, Leszcz, Leszcz, McDermut, Okai, Ormont, Overall, Riedel, Seppi, Silver, Simons, Simuni, Sproesser, Troeung, Vajda, Veazey, White, Yalom, Yang, Yang",2015.0,,0,0,
8274,Testing a reality orientation program in patients with traumatic brain injury in a neurointensive care unit.,"Primary Objective: The aim of this study was to examine the effect of a systematic reality orientation program (RO) introduced in a neurointensive care unit on duration of posttraumatic amnesia (PTA) and outcomes of patients with traumatic brain injury (TBI). Research Design: This study used a quasiexperimental, prospective design. Methods and Procedures: Twenty-four patients (intervention) with a significant TBI classified as moderate-to-severe injuries as measured by scores of less than 12 on the Glasgow Coma Scale underwent an RO program compared with a similar group of 38 patients (control) who received a conventional rehabilitation program. The Rancho Los Amigos Score was used to assess the cognitive level 24 hours after the end of sedation, and the Galveston Orientation and Amnesia Test was used daily to assess orientation and duration of PTA. The Glasgow Outcome Scale Extended was then used as an indicator of clinical outcome after 12 months. Main Outcomes and Results: The preliminary results indicated that patients who received the RO had a higher mean of the Glasgow Outcome Scale Extended (SD = 1.53) than those receiving the usual care (SD = 1.35) despite that the groups differed significantly (p = .01) in PTA duration. Conclusion: Patients with TBI may benefit from early assessment and systematic RO nursing intervention. The RO may facilitate patients with PTA to regain orientation and interact with their surroundings in the neurointensive care unit to optimize the recovery. However, further studies with focus on timing, intensity, and duration are needed to evaluate the influence of an early RO approach on PTA and outcomes in patients experiencing TBI. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Langhorn, Leanne; Holdgaard, Dorte; Worning, Lene; Sorensen, Jens C; Pedersen, Preben U; Ahmed, Alderson, Brown, Chua, Cicerone, Corrigan, Cullen, De Guise, De Guise, Ellenberg, Furbringer e Silva, Gordon, Gouvier, Greenwald, Greenwood, Hagen, Huang, Jacobs, Jennett, Jennett, Katz, Khan, King, Kosch, Levin, Llompart-Pou, Lombard, Mackay, Makley, Murray, Nakase-Richardson, Newberry, Niemeier, Orff, Patton, Ponsford, Russell, Shekleton, Sherer, Shores, Sigurdardottir, Spector, Spector, Tate, Tate, Teasdale, Teasdale, Thomas, Tittle, Turner-Stokes, Turner-Stokes, Vance, Walker, Weir, Wilson, Wilson, Woodrow, Woods, Yap, Zafonte, Zanetti, Zencius",2015.0,,0,0,
8275,Internet and computer-based cognitive behavioral therapy for anxiety and depression in youth: A meta-analysis of randomized controlled outcome trials.,"Background: Anxiety and depression in children and adolescents are undertreated. Computer- and Internet- based cognitive behavioral treatments (cCBT) may be an attractive treatment alternative to regular face-to-face treatment. This meta-analysis aims to evaluate whether cCBT is effective for treating symptoms of anxiety and depression in youth. Methods and Findings: We conducted systematic searches in bibliographical databases (Pubmed, Cochrane controlled trial register, PsychInfo) up to December 4, 2013. Only randomized controlled trials in which a computer-, Internet- or mobile-based cognitive behavioral intervention targeting either depression, anxiety or both in children or adolescents up to the age of 25 were compared to a control condition were selected.We employed a random-effects pooling model in overall effect analyses and a mixed effect model for sub-group analyses. Searches resulted in identifying 13 randomized trials, including 796 children and adolescents that met inclusion criteria. Seven studies were directed at treating anxiety, four studies at depression, and two were of a transdiagnostic nature, targeting both anxiety and depression. The overall mean effect size (Hedges' g) of cCBT on symptoms of anxiety or depression at post-test was g = 0.72 (95% CI:0.55-0.90, numbers needed to be treated (NNT) = 2.56). Heterogeneity was low (I2 = 20.14%, 95% CI: 0-58%). The superiority of cCBT over controls was evident for interventions targeting anxiety (g = 0.68; 95% CI: 0.45-0.92; p < .001; NNT = 2.70) and for interventions targeting depression (g = 0.76; 95% CI: 0.41-0.12; p < .001; NNT = 2.44) as well as for transdiagnostic interventions (g = 0.94; 95% CI: 0.23-2.66; p < .001; NNT = 2.60). Conclusions: Results provide evidence for the efficacy of cCBT in the treatment of anxiety and depressive symptoms in youth. Hence, such interventions may be a promising treatment alternative when evidence based face-to-face treatment is not feasible. Future studies should examine long-term effects of treatments and should focus on obtaining patient-level data from existing studies, to perform an individual patient data meta-analysis. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ebert, David Daniel; Zarski, Anna-Carlotta; Christensen, Helen; Stikkelbroek, Yvonne; Cuijpers, Pim; Berking, Matthias; Riper, Heleen; Andersson, Andrews, Angold, Angold, Axelson, Barrett, Bennett, Bodden, Borenstein, Brady, Buntrock, Burns, Calear, Calear, Compton, Costello, Cunningham, Duval, Egger, Ehrenreich, Essau, Fleming, Ford, Gulliver, Haug, Hedman, Higgins, Higgins, Hofstra, Ioannidis, James, Kataoka, Kazdin, Keller, Khanna, Klein, Kontopantelis, Kraemer, Laupacis, Lin, Makarushka, March, Merikangas, Michael, Orsini, Orvaschel, Parker, Rao, Reynolds, Rozental, Sawyer, Sethi, Spence, Stallard, Stasiak, Storch, Tillfors, Tillfors, Van der Zanden, van Zoonen, Weisz, Weisz, Weisz, Woodward, Wuthrich, Zachrisson",2015.0,,0,0,
8276,A pilot randomized placebo-controlled trial of adjunctive aripiprazole for chronic PTSD in US military Veterans resistant to antidepressant treatment.,"Many individuals with post-traumatic stress disorder (PTSD) experience persistent symptoms despite pharmacological treatment with antidepressants. Several open-label monotherapy and adjunctive studies have suggested that aripiprazole (a second-generation antipsychotic) may have clinical utility in PTSD. However, there have been no randomized placebo-controlled trials of aripiprazole use for PTSD. We thus conducted a pilot randomized controlled trial of adjunctive aripiprazole versus placebo among Veterans with chronic PTSD serving in the US military since 11 September 2001 to assess the feasibility, safety, tolerability, and therapeutic potential of aripiprazole. Sixteen Veterans were randomized, and 14 completed at least 4 weeks of the study; 12 completed the entire 8-week trial. Outcome measures included the Clinician-Administered PTSD Scale (CAPS), PTSD Checklist, Beck Depression Inventory, Second Edition, and Positive and Negative Syndrome Scale scores. Aripiprazole was well-tolerated in this cohort, and improvements in CAPS, PTSD Checklist, Beck Depression Inventory, Second Edition, and Positive and Negative Syndrome Scale scores were as hypothesized. Although CAPS change scores did not reach statistical significance, aripiprazole outperformed placebo by 9 points on the CAPS in the last observation carried forward analysis compared with the placebo group (n = 7 per group), and by 20 points in the group randomized to aripiprazole that completed the entire study (n = 5) compared with the placebo group (n = 7). Results suggest promise for aripiprazole as an adjunctive strategy for the treatment of PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Naylor, Jennifer C; Kilts, Jason D; Bradford, Daniel W; Strauss, Jennifer L; Capehart, Bruce P; Szabo, Steven T; Smith, Karen D; Dunn, Charlotte E; Conner, Kathryn M; Davidson, Jonathan R. T; Wagner, Henry Ryan; Hamer, Robert M; Marx, Christine E; Ahearn, Bartzokis, Berger, Berman, Berman, Blake, Brady, Butterfield, Carey, Connor, Conway, Geracioti, Hamner, Heppner, Kane, Keck, Kessler, Kozaric-Kovacic, Kozaric-Kovacic, Krystal, Marcus, Marshall, Mello, Monnelly, Padala, Petty, Pivac, Pivac, Reich, Robert, Rothbaum, Simon, Stein, Villarreal, Youssef",2015.0,,0,0,
8277,Resilient but addicted: The impact of resilience on the relationship between smoking withdrawal and PTSD.,"Nicotine use is common among people with posttraumatic stress disorder (PTSD). Resilience, which is reflected in one's ability to cope with stress, has been shown to be associated with lower cigarette smoking and posttraumatic stress symptoms, but relationships among these three variables have not been examined. This study investigates the relationships of resilience and nicotine withdrawal with each other and in relation to PTSD symptoms. Participants were 118 cigarette smokers with PTSD seeking treatment for PTSD and nicotine use. Data were randomly cross-sectionally sampled from three time points: week 0, week 12, and week 27 of the study. Hierarchical multiple regression analyses revealed main effects of both resilience and nicotine withdrawal symptoms on PTSD severity, controlling for the sampled time point, negative affect, and expired carbon monoxide concentration. Consistent with prior research, PTSD severity was higher among individuals who were less resilient and for those who had greater nicotine withdrawal. There was an interaction between resilience and nicotine withdrawal on self-reported PTSD severity, such that greater resilience was associated with lower PTSD severity only among participants with low nicotine withdrawal symptoms. Among individuals with high nicotine withdrawal, PTSD severity was high, regardless of resilience level. These results suggest that resilience is a protective factor for PTSD severity for those with low levels of nicotine withdrawal, but at high levels of nicotine withdrawal, the protective function of resilience is mitigated. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Asnaani, Anu; Alpert, Elizabeth; McLean, Carmen P; Foa, Edna B; Asnaani, Beckham, Beckham, Bensimon, Connor, Dedert, Feldner, Feldner, Fincham, First, Foa, Foa, Gillihan, Goldstein, Green, Hapke, Hawkins, Heatherton, Holmbeck, Hughes, Lobbestael, Marshall, Nishi, Pergadia, Rasmusson, Richards, Shiffman, Spitzer, Spitzer, Taylor, Tran, Tuerk, van der Velden, Wingo, Wrenn, Ziedonis, Zvolensky",2015.0,,0,0,
8278,Investigating the relationship between competence and patient outcome with CBT.,"Little is understood about the relationship between therapist competence and the outcome of patients treated for common mental health disorders. Understanding the relationship between competence and patient outcome is of fundamental importance to the dissemination and implementation of Cognitive Behavioural Therapy (CBT). The current study extends existing literature by exploring the relationship between CBT competence and patient outcome in routine clinical practice within the framework of the British Government's Improving Access to Psychological Therapies (IAPT) programme. Participants comprised 43 therapists treating 1247 patients over a training period of one year. Results found little support of a general association between CBT competence and patient outcome; however significantly more patients of the most competent therapists demonstrated a reliable improvement in their symptoms of anxiety than would be expected by chance alone, and fewer experienced no reliable change. Conversely, significantly more patients treated by the least competent therapists experienced a reliable deterioration in their symptoms than would be expected. The implications of these results for the dissemination and implementation of CBT are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Branson, Amanda; Shafran, Roz; Myles, Pamela; Barber, Barber, Barnfield, Bein, Blackburn, Blackburn, Branson, Brown, Clark, Clark, Costa, Dimidjian, Evans, Fairburn, Ginzburg, Gyani, Heinonen, Huppert, Jacobson, Jacobson, James, Keen, Kolb, Kroenke, Manring, McManus, Moore, Muse, Okiishi, Okiishi, Riso, Shrout, Simons, Singer, Spitzer, Strunk, Trepka, Vallis, Webb, Wilborg, Yager, Young",2015.0,,0,0,
8279,A randomised controlled trial of group cognitive behavioural therapy for perfectionism.,"Perfectionism is associated with symptoms of anxiety disorders, eating disorders and mood disorders. Treatments targeting perfectionism may reduce the symptoms of these disorders (Egan, Wade, & Shafran, 2011). This study is the first randomised controlled trial to investigate the efficacy of group cognitive behavioural therapy (CBT) for perfectionism. Forty-two participants with elevated perfectionism and a range of anxiety, eating and mood disorders were randomised to group CBT for perfectionism or a waitlist control. The treatment group reported significantly greater pre-post reductions in perfectionism, symptoms of depression, eating disorders, social anxiety, anxiety sensitivity and rumination, as well as significantly greater pre-post increases in self-esteem and quality of life compared to the waitlist control group. The impact of treatment on most of these outcomes was mediated by pre-post change in perfectionism (Concern over Mistakes). Treatment gains were reliable and clinically significant, and were maintained at 6-month follow-up. Findings support group CBT for perfectionism being an efficacious treatment for perfectionism and related psychopathology, as well as increasing self-esteem and quality of life. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Handley, Alicia K; Egan, Sarah J; Kane, Robert T; Rees, Clare S; Anderson, Antony, Antony, Beck, Bieling, Bieling, Blatt, Brown, Cohen, Collins, Craske, Dunkley, Egan, Egan, Egan, Egan, Evans, Fairburn, Fairburn, Faul, Frost, Gray-little, Hewitt, Himle, Holden, Imber, Jacobson, Keppel, Kessler, Lloyd, Lovibond, McEvoy, Meyer, Moher, Mond, Mond, Muthen, Pleva, Radhu, Richardson, Riley, Ritsner, Rosenberg, Saghaei, Segal, Shafran, Shafran, Sheehan, Sheehan, Steele, Steele, Steele, Taylor, Thiels, Troop, Weissman",2015.0,,0,0,
8280,Repetitive negative thinking predicts depression and anxiety symptom improvement during brief cognitive behavioral therapy.,"Repetitive negative thinking (RNT) is a common symptom across depression and anxiety disorders and preliminary evidence suggests that decreases in rumination and worry are related to improvement in depression and anxiety symptoms. However, despite its prevalence, relatively little is known about transdiagnostic RNT and its temporal associations with symptom improvement during treatment. The current study was designed to examine the influence of RNT on subsequent depression and anxiety symptoms during treatment. Participants (n = 131; 52% female; 93% White; M = 34.76 years) were patients presenting for treatment in a brief, cognitive behavior therapy based, partial hospitalization program. Participants completed multiple assessments of depression (Center for the Epidemiological Studies of Depression-10 scale), anxiety (the 7-item Generalized Anxiety Disorder Scale), and repetitive negative thinking (Perseverative Thinking Questionnaire) over the course of treatment. Results indicated statistically significant between and within person effects of RNT on depression and anxiety, even after controlling for the effect of time, previous symptom levels, referral source, and treatment length. RNT explained 22% of the unexplained variability in depression scores and 15% of the unexplained variability in anxiety scores beyond that explained by the control variables. RNT may be an important transdiagnostic treatment target for anxiety and depression. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kertz, Sarah J; Koran, Jennifer; Stevens, Kimberly T; Bjorgvinsson, Throstur; Andresen, Beard, Beard, Beck, Beck, Bjorgvinsson, Bjorgvinsson, Cheng, Ciesla, Cole, Craske, Cronbach, Donegan, Ehring, Ehring, Ellard, Farabaugh, Fresco, Hawley, Insel, Irwin, Jones, Kertz, Kessler, Kroenke, Linehan, Littell, Little, Lowe, Martell, Mennin, Mennin, Michalak, Mortberg, Newby, Nolen-Hoeksema, Olatunji, Querstret, Raudenbush, Raudenbush, Robins, Schmaling, Segerstrom, Shadish, Sheehan, Siddique, Siegle, Singer, Spitzer, Takano, Teismann, Van Aalderen, Watkins, Watkins, Watkins, Watkins, Wells, White, Wilkinson, Wolfinger, Zetsche",2015.0,,0,0,
8281,Sudden gains and deteriorations in the treatment of posttraumatic stress disorder in World Trade Center responders.,"This study sought to examine the prevalence of sudden gains and deteriorations (i.e., symptom reduction/improvement during treatment) and their influence on treatment outcomes among World Trade Center responders with probable posttraumatic stress disorder. Thirty-six outpatient clients received at least three sessions of integrative psychotherapy, which included elements of psychodynamic and cognitive-behavioral therapy approaches, under routine clinical conditions. Approximately 19% of clients experienced a sudden gain and 27% of clients experienced a sudden deterioration. Those who experienced deteriorations had worse therapy outcomes compared with those who did not. Clinical implications are discussed, including the importance of routine monitoring of client treatment response for sudden deteriorations to enhance positive treatment outcomes. Future research with larger samples is needed to further evaluate the mechanisms of sudden gains and sudden deteriorations in this population. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Haugen, Peter Tejas; Goldman, Rachel E; Owen, Jesse; Aderka, Anderson, Andrusyna, Benish, Brady, Brandt, Brown, Bryant, Cardozo, Deisinger, Doane, Forbes, Galloucis, Gaynor, Gersons, Haugen, Haugen, Hayes, Hilsenroth, Hoge, Horowitz, Imel, Jacobson, Jun, Kelly, Kelly, Lambert, Lambert, Lambert, Lambert, Lambert, Lambert, McCaslin, Owen, Penalba, Tang, Weathers, Yarvis",2015.0,,0,0,
8282,Treating treatment-resistant patients with panic disorder and agoraphobia using psychotherapy: A randomized controlled switching trial.,"Background: Nonresponsiveness to therapy is generally acknowledged, but only a few studies have tested switching to psychotherapy. This study is one of the first to examine the malleability of treatment-resistant patients using acceptance and commitment therapy (ACT). Methods: This was a randomized controlled trial that included 43 patients diagnosed with primary panic disorder and/or agoraphobia (PD/A) with prior unsuccessful state-of-the-art treatment (mean number of previous sessions = 42.2). Patients were treated with an ACT manual administered by novice therapists and followed up for 6 months. They were randomized to immediate treatment (n = 33) or a 4-week waiting list (n = 10) with delayed treatment (n = 8). Treatment consisted of eight sessions, implemented twice weekly over 4 weeks. Primary outcomes were measured with the Panic and Agoraphobia Scale (PAS), the Clinical Global Impression (CGI), and the Mobility Inventory (MI). Results: At post-treatment, patients who received ACT reported significantly more improvements on the PAS and CGI (d = 0.72 and 0.89, respectively) than those who were on the waiting list, while improvement on the MI (d = 0.50) was nearly significant. Secondary outcomes were consistent with ACT theory. Follow-up assessments indicated a stable and continued improvement after treatment. The dropout rate was low (9%). Conclusions: Despite a clinically challenging sample and brief treatment administered by novice therapists, patients who received ACT reported significantly greater changes in functioning and symptomatology than those on the waiting list, with medium-to-large effect sizes that were maintained for at least 6 months. These proof-ofprinciple data suggest that ACT is a viable treatment option for treatment-resistant PD/A patients. Further work on switching to psychotherapy for nonresponders is clearly needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gloster, Andrew T; Sonntag, Rainer; Hoyer, Jurgen; Meyer, Andrea H; Heinze, Simone; Strohle, Andreas; Eifert, Georg; Wittchen, Hans-Ulrich; Arch, Arch, Baer, Bandelow, Bandelow, Bandelow, Barlow, Beck, Beck, Chambless, Chambless, Chambless, Dalrymple, Deacon, Durham, Eifert, Eifert, Essau, Fava, Fava, Fava, Fava, Fava, Fava, Gloster, Gloster, Gloster, Gloster, Gloster, Gould, Gratz, Guy, Hayes, Hayes, Herzberg, Hofmann, Kazdin, Kenny, Lachner, McGrath, Palatnik, Pinheiro, Pollack, Reed, Reiss, Robins, Rodrigues, Schlaepfer, Shear, Taylor, van Balkom, van Buuren, Wegner, White, Wittchen, Wittchen",2015.0,,0,0,
8283,"Sleep diaries of Vietnam War veterans with chronic PTSD: The relationships among insomnia symptoms, psychosocial stress, and nightmares.","Impaired sleep and nightmares are known symptoms of posttraumatic stress disorder (PTSD) in the veteran population. In order to assess prospectively the sleep disturbances in this population, sleep diaries are an effective way to obtain information over an extended period of time. In this investigation, a sample of veterans (N = 105) completed daily sleep diaries for a 6-week period. Greater PTSD severity and nightmare-related distress were correlated with more awakenings, shorter duration of sleep, longer sleep latency, and greater frequency of nightmares. Perceived frequency of daytime stressors was associated with an increased number of nightmares, nightmare-related distress, and longer sleep latency. The use of sleep diaries in future investigations may allow targeted treatments for veteran populations with PTSD and sleep disturbances. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gehrman, Philip R; Harb, Gerlinde C; Cook, Joan M; Barilla, Holly; Ross, Richard J; Babson, Beck, Belleville, Blake, Buysse, Cook, Galovski, Healey, Krakow, Lancee, Levin, Maislin, Nappi, Neylan, Perlis, Ross, Stone, Weathers, Zadra, Zayfert",2015.0,,0,0,
8284,The panic disorder screener (PADIS): Development of an accurate and brief population screening tool.,"The Panic Disorder Screener (PADIS) was developed as a new screener to identify panic disorder in the community and to assess severity of symptoms. The PADIS was developed to fill a gap in existing screening measures, as there are no brief panic screeners available that assess severity. The current study aimed to test the performance of the screener relative to the Patient Health Questionnaire-panic scale (PHQ-panic). The 4-item PADIS was administered to 12,336 young Australian adults, together with the PHQ-panic. A subsample of 1674 participants also completed a phone-based clinical interview to determine whether they met DSM-IV criteria for panic disorder. The PADIS (77% sensitivity, 84% specificity) had higher sensitivity for identifying panic disorder based on clinical criteria than the PHQ-panic (57% sensitivity, 91% specificity), although with reduced specificity. Administration of the PADIS required a mean of 1.9 items, compared to 4.7 items for the PHQ-panic. Each one-point increase in PADIS score was associated with 69% increased odds of meeting clinical criteria for panic disorder. The PADIS was found to be a valid, reliable and brief panic screener that is freely available for use in research and clinical settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Batterham, Philip J; Mackinnon, Andrew J; Christensen, Helen; Andersson, Andrade, Bunaciu, Burgess, Christensen, Christensen, Christensen, Connor, Eaton, Gadermann, Houck, Katerndahl, Kessler, Kessler, Kessler, Kessler, Korte, Kroenke, Lowe, Mackinnon, Narrow, Shear, Sheehan, Slade, Spitzer, Spitzer, Teesson, van Ballegooijen, Von Korff, Williams, Wittkampf",2015.0,,0,0,
8285,Individualized guided Internet-delivered cognitive-behavior therapy for chronic pain patients with comorbid depression and anxiety: A randomized controlled trial.,"Objectives: Depression and anxiety are commonly seen in patients with chronic pain which affects the patient's daily life functioning. Although considerable attention has been devoted to explain why depression and anxiety are frequent comorbid with chronic pain, little empirical work has been conducted on interventions that target depression and anxiety and chronic pain. The present study was designed to test an individualized cognitive-behavioral treatment delivered through the internet for persons with chronic pain and emotional distress. Materials and Methods: A total of 52 patients with chronic pain and depression were included and randomized to either treatment for 8 weeks or to a control group that participated in a moderated online discussion forum. Results: Intent-to-treat analyses showed significant decreases regarding depressive symptoms and pain disability in the treatment group. Results on the primary outcomes of depression and anxiety were in favor of the treatment group. Reductions were also found on pain catastrophizing. Discussion: One-year follow-up showed maintenance of improvements. We conclude that an individualized guided internet-delivered treatment based on cognitive-behavior therapy can be effective for persons with chronic pain comorbid emotional distress. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Buhrman, Monica; Syk, Martin; Burvall, Olle; Hartig, Terry; Gordh, Torsten; Andersson, Gerhard; Allen, Andersson, Andersson, Andersson, Andersson, Andersson, Andersson, Andersson, Andrews, Arnow, Asmundson, Asmundson, Beck, Bender, Bergman Nordgren, Bergstrom, Bergstrom, Blankers, Blyth, Bondolfi, Breivik, Bruce, Buchanan, Buenaver, Buhrman, Buhrman, Buhrman, Carlbring, Carlbring, Carlbring, Carpenter, Carroll, Cohen, Crombez, Cuipers, Cujpers, Dear, Dersh, Dimidjan, Dobson, Eccleston, Ecclestson, Fantino, Finan, Fish, Frisch, Fydrich, Hedman, Hoffman, Hollandare, Iliffe, Jacobson, Jarvik, Jensen, Johansson, Keogh, Kerns, Kerns, Kiropoulos, Lerman, Lin, Lindner, Lorig, Macea, McCracken, McWilliams, Pagoto, Peterson, Peterson, Pigeon, Rini, Rosenstiel, Ruehlman, Salzer, Silfvernagel, Song, Speer, Spek, Spitzer, Sullivan, Sullivan, Svanborg, Svansborg, Tait, Tait, Turk, van Ballegooijen, Vickers, Vlaeyen, Vowles, Waddell, Wicksell, Williams, Zimmerman",2015.0,,0,0,
8286,Effectiveness of case management-based aftercare coordination by phone for patients with depressive and anxiety disorders: Study protocol for a randomized controlled trial.,"Background: Depressive and anxiety disorders are highly prevalent, but only a small percentage (approximately 50%) of patients receive appropriate treatment. Relevant barriers include communication and coordination gaps between different providers that result from the lack of integration between different care-giving systems. Aftercare following inpatient treatment represents one of these gaps because systematic follow-up care does not exist. Case management-based aftercare coordination by phone might be a promising approach to overcoming this gap and improving long-term treatment outcomes. Case management is a patient-centered and situation-based approach comprising systematic tracking and support of patients by a case manager.Methods/design: The effectiveness of aftercare coordination will be investigated in a prospective randomized controlled trial in four psychotherapeutic inpatient routine care units (St. Franziska-Stift Bad Kreuznach, MediClin Seepark Klinik Bad Bodenteich, Segeberger Kliniken Gruppe Bad Segeberg and Luisenklinik Bad Durrheim). The patients receiving aftercare coordination (intervention group; IG) will be compared with those who receive treatment as usual (TAU control group; CG). Eligible patients will be required to have a diagnosis of an anxiety and/or depressive disorder and a recommendation for follow-up outpatient psychotherapy.Discussion: This study will determine whether case management-based aftercare coordination by phone is an adequate approach for overcoming treatment barriers in the clinical pathways of patients with depressive and anxiety disorders. If proven effective, an accessible supplementary treatment approach that will help to maintain and even improve long-term treatment outcomes will be made available for patients following inpatient treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kivelitz, Laura; Schulz, Holger; Melchior, Hanne; Watzke, Birgit; Bassler, Beck, Beck, Burcusa, Chambless, Chambless, Cohen, Collins, Deck, Dilling, Ehlers, Ellert, Gensichen, Gensichen, Harfst, Jacobi, Kivelitz, Klesse, Lambert, Lehmann, Luborsky, Lowe, Mack, Margraf, Martin, Mattick, Rabung, Rollman, Schneider, Schulz, Schwarzer, Spitzer, Ware, Ware, Weck",2015.0,,0,0,
8287,Imagery vividness ratings during exposure treatment for posttraumatic stress disorder as a predictor of treatment outcome.,"Within exposure-based trauma treatments for posttraumatic stress disorder (PTSD), imagery vividness during imaginal exposure of the traumatic memory is an understudied but potentially important predictor of treatment outcome. Further, to our knowledge, this relationship has only been studied in women to date, and never among individuals with PTSD and substance use disorders which could impact ability to produce vivid mental imagery and its impact. The current study investigated whether imagery vividness ratings during in-session exposure predicted post-treatment PTSD symptom severity in a sample of men and women with comorbid PTSD and substance use disorders, and also examined whether gender moderated this relationship. A sample of 71 participants who received an exposure-based trauma treatment were included in the analyses. PTSD symptom severity was assessed using both the Clinician Administered PTSD Scale (CAPS) and the Impact of Event Scale-Revised (IES-R). Results varied according to method of assessing PTSD symptom severity. Higher imagery vividness was associated with better treatment outcome when assessed by the CAPS, with vividness in later sessions relating more strongly to outcome than vividness in earlier sessions. With the IES-R, higher imagery vividness ratings predicted more favorable treatment outcome for men, but less favorable treatment outcomes for women. Findings are discussed in the context of using imagery vividness to maximize treatment outcomes and future research directions involving scientific replication. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mota, Natalie P; Schaumberg, Katherine; Vinci, Christine; Sippel, Lauren M; Jackson, Michelle; Schumacher, Julie A; Coffey, Scott F; Blake, Brady, Bryant, Campos, Coffey, Ersche, Field, Foa, Foa, Foa, Foa, Foa, Foa, Glass, Hackmann, Hofmann, Hox, Hyer, Jovanovski, Karatzias, Kessler, Kessler, London, Marks, Milad, Niedzwienska, Olff, Powers, Rauch, Richardson, Robins, Rothbaum, Scott, Solowij, Stark, Walker, Weathers, Weiss, Weiss, Wild, Wolpe",2015.0,,0,0,
8288,Long-term consequences of severe health anxiety on sick leave in treated and untreated patients: Analysis alongside a randomised controlled trial.,"Health anxiety (HA) is prevalent and costly for health services. However, little is known about the full societal burden of HA. Based on complete register data, we (1) compared weeks on sickness-related benefits (SB) in untreated patients with severe HA (n = 126) with a matched population sample (n = 12,600); and (2) tested whether Acceptance & Commitment group Therapy (ACT-G) (n = 63) reduced weeks on SB during the first year after randomisation compared to a waitlist (n = 63). We found that (1) HA patients showed a six-monthly increment of 2 weeks on SB compared with the general population (p < 0.0001), and (2) that ACT-G and the waitlist showed no difference in their ability to reduce SB during the first year (p = 0.246). We conclude that HA is associated with a considerable societal burden. A possible beneficial effect of psychotherapy on SB needs further investigation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Eilenberg, Trine; Frostholm, Lisbeth; Schroder, Andreas; Jensen, Jens S; Fink, Per; Barsky, Barsky, Barsky, Bouman, Carstensen, Carstensen, Creed, Eilenberg, Eilenberg, Fink, Fink, Fjorback, Gureje, Hayes, Hedman, Hedman, Hjollund, Hoffmann, Konnopka, Martin, Sunderland, Thomson, Tyrer",2015.0,,0,0,
8289,Adult attachment as a moderator of treatment outcome for generalized anxiety disorder: Comparison between cognitive-behavioral therapy (CBT) plus supportive listening and CBT plus interpersonal and emotional processing therapy.,"Objective: To determine whether baseline dimensions of adult insecure attachment (avoidant and anxious) moderated outcome in a secondary analysis of a randomized controlled trial comparing cognitive-behavioral therapy (CBT) plus supportive listening (CBT + SL) versus CBT plus interpersonal and emotional processing therapy (CBT + I/EP). Method: Eighty-three participants diagnosed with generalized anxiety disorder (GAD) were recruited from the community and assigned randomly to CBT + SL (n = 40) or to CBT + I/EP (n = 43) within a study using an additive design. PhD-level psychologists treated participants. Blind assessors evaluated participants at pretreatment, posttreatment, 6-month, 12-month, and 2-year follow-up with a composite of self-report and assessor-rated GAD symptom measures (Penn State Worry Questionnaire, Hamilton Anxiety Rating Scale, Clinician's Severity Rating). Avoidant and anxious attachment were assessed using self-reported dismissing and angry states of mind, respectively, on the Perceptions of Adult Attachment Questionnaire. Results: Consistent with our prediction, at all assessments higher levels of dismissing styles in those who received CBT + I/EP predicted greater change in GAD symptoms compared with those who received CBT + SL for whom dismissiveness was unrelated to the change. At postassessment, higher angry attachment was associated with less change in GAD symptoms for those receiving CBT + I/EP, compared with CBT + SL, for whom anger was unrelated to change in GAD symptoms. Pretreatment attachment-related anger failed to moderate outcome at other time points and therefore, these moderation effects were more short-lived than the ones for dismissing attachment. Conclusions: When compared with CBT + SL, CBT + I/EP may be better for individuals with GAD who have relatively higher dismissing styles of attachment. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Impact Statement What is the public health significance of this article?-When choosing a treatment for individuals with generalized anxiety disorder, this study suggests the potential importance of taking adult attachment into account. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Newman, Michelle G; Castonguay, Louis G; Jacobson, Nicholas C; Moore, Ginger A; Afifi, Ainsworth, Alden, Behar, Berant, Bifulco, Birnbaum, Borkovec, Borkovec, Bowlby, Bowlby, Brennan, Brown, Brown, Brown, Byrd, Cassidy, Cassidy, Castonguay, Davis, Dozier, Dozier, Dunlap, Dunst, Erickson, Feeney, Feeney, Fraley, Fraley, Fraley, George, Greenberg, Hamilton, Hazan, Horowitz, Horowitz, Kobak, Lavy, Lichtenstein, Linehan, Llera, Llera, Main, Mennin, Mennin, Meyer, Mickelson, Mikulincer, Mikulincer, Mikulincer, Molina, Moutsiana, Mundry, Muris, Muris, Muris, Newman, Newman, Newman, Newman, Newman, Newman, Priest, Przeworski, Rosario-Martinez, Safran, Sbarra, Skourteli, Tasca, Tasca, Turk, Vogel, Warren, Whisman, Williams",2015.0,,0,0,
8290,Race/ethnicity and treatment outcome in a randomized controlled trial for trichotillomania (hair-pulling disorder).,"Objective: Treatment outcome was compared among non-Hispanic White and racial/ethnic minority participants with trichotillomania (TTM), or hair-pulling disorder. Method: Symptom severity, quality of life, and TTM-related disability were compared in a behavior therapy trial with a stepped care approach: web-based self-help and then individual behavior therapy. The sample comprised 72% (n = 38) non-Hispanic White participants and 28% (n = 15) minority participants. Results: The ethnic groups responded differently to treatment, with fewer minority participants showing improvement during web-based self-help. Response rates were equivalent between ethnic groups during the in-person behavior therapy. These results should be interpreted with caution because of the small sample size of minorities in the study and consequent inability to analyze results for each racial/ethnic group individually. Conclusions: Future studies should focus on the investigation of factors that may enable or hinder racial and ethnic minority participants to benefit from online and/or self-help behavior therapy for TTM. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Falkenstein, Martha J; Rogers, Kate; Malloy, Elizabeth J; Haaga, David A. F; Abe-Kim, Arbuckle, Azrin, Bloch, Carter, Conelea, Diefenbach, First, Foa, Friedman, Hatch, Himle, Jacobson, Keijsers, Kessler, Keuthen, Keuthen, Larsen, Lorence, Malgady, Mansueto, McGuire, Mouton-Odum, Neal, Neal-Barnett, Neal-Barnett, Neal-Barnett, Neal-Barnett, Neal-Barnett, Neighbors, Neighbors, O'Sullivan, Organista, Rogers, Rothbaum, Ruscio, Sheehan, Stanley, Williams, Williams, Williams, Williams, Williams, Winchel, Woods, Woods",2015.0,,0,0,
8291,"Brief report: Symptoms of PTSD, coping strategies, and social adjustment among survivors of early life interpersonal trauma.","Dysphoria symptoms of posttraumatic stress disorder (PTSD) have been associated with impairments in social functioning; however, this relationship has been unexamined among interpersonal trauma populations. A sample of 303 women with a history of early life interpersonal trauma completed measures of PTSD severity, coping, and social functioning. Results revealed that dysphoria symptoms had a strong and unique association with total social adjustment and social functioning (i.e., social activities). Active coping significantly mediated the relationship between dysphoria symptoms and total social adjustment, and active coping and seeking emotional support significantly mediated the relationship between dysphoria symptoms and social functioning. Findings elucidate variants of coping that might compound impaired social functioning and highlight the value of integrating coping skills into PTSD interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hassija, Christina M; Garvert, Donn W; Cloitre, Marylene; Agaibi, Asmundson, Baschnagel, Beck, Carver, Cloitre, Cloitre, Elhai, Erbes, Foa, Folkman, Hassija, Hu, Kessler, King, Kline, Littleton, Pietrzak, Preacher, Ruscio, Sayers, Simms, Skinner, Stevens, Taylor, Weissman, Yufik",2015.0,,0,0,
8292,Aerobic exercise reduces symptoms of posttraumatic stress disorder: A randomized controlled trial.,"Evidence suggests aerobic exercise has anxiolytic effects; yet, the treatment potential for posttraumatic stress disorder (PTSD) and responsible anxiolytic mechanisms have received little attention. Emerging evidence indicates that attentional focus during exercise may dictate the extent of therapeutic benefit. Whether benefits are a function of attentional focus toward or away from somatic arousal during exercise remains untested. Thirty-three PTSD-affected participants completed two weeks of stationary biking aerobic exercise (six sessions). To assess the effect of attentional focus, participants were randomized into three exercise groups: group 1 (attention to somatic arousal) received prompts directing their attention to the interoceptive effects of exercise, group 2 (distraction from somatic arousal) watched a nature documentary, and group 3 exercised with no distractions or interoceptive prompts. Hierarchal linear modeling showed all groups reported reduced PTSD and anxiety sensitivity (AS; i.e., fear of arousal-related somatic sensations) during treatment. Interaction effects between group and time were found for PTSD hyperarousal and AS physical and social scores, wherein group 1, receiving interoceptive prompts, experienced significantly less symptom reduction than other groups. Most participants (89%) reported clinically significant reductions in PTSD severity after the two-week intervention. Findings suggest, regardless of attentional focus, aerobic exercise reduces PTSD symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fetzner, Mathew G; Asmundson, Gordon J. G; Abrantes, Arch, Arntz, Asmundson, Asmundson, Beekley, Blanchard, Blumenthal, Bonanno, Bossini, Broman-Fulks, Broocks, Brown, Campbell, Carleton, Chisholm, Craske, Deacon, Devins, Diaz, Feilding, First, Germain, Gledhill, Hansen, Heck, Herring, Hovland, Jukupcak, Kearney, Long, Manger, Merom, Morgan, Newman, Otto, Radloff, Sabourin, Salmon, Schulz, Sheehan, Smits, Stein, Strohle, Taylor, Wald, Watt, Weathers, Wedekind, Zanarini, Zanarini",2015.0,,0,0,
8293,Alleviating emotional distress in adolescent and young adult cancer survivors: An open trial of metacognitive therapy.,"Purpose: Metacognitive therapy (MCT) is an effective psychological treatment for a range of emotional disorders. However, the applicability of MCT to treating emotional distress in physical health populations has yet to be tested. The present study examined the potential of MCT for alleviating emotional distress in adolescent and young adult cancer (AYAC) survivors. Methods: Twelve AYAC survivors, aged 18-23, who had completed acute medical treatment participated in this pilot open trial with 6 months follow-up. Each participant completed a baseline period followed by 8-14 sessions of MCT that targeted perseverative thinking (worry and rumination), attentional control, and metacognitive beliefs. The primary outcome variable was severity of depression and anxiety symptoms as measured by the Hospital Anxiety and Depression Scale (HADS). Results: MCT was associated with large and statistically significant reductions in anxiety, depression, trauma symptoms, and metacognitive beliefs and processes. In the intention-to-treat sample, 50% of participants met standardized criteria for recovery on the HADS at posttreatment and these gains were maintained through to 6-month follow-up. Conclusion: MCT is a promising transdiagnostic approach to treating different forms of emotional distress in AYAC survivors. Further investigation in controlled trials is now warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fisher, Peter L; McNicol, Kirsten; Young, Bridget; Smith, Ed; Salmon, Peter; Agras, Boyes, Crawford, Devilly, Durlak, Fisher, Harvey, Jacobson, Lucketl, McNicol, Morrison, Norton, Park, Priichard-Jones, Rees, Schulte-van Maaren, Schwartz, Seitz, Sunsom-Daly, Thomsen, Weiss, Wells, Wells, Wells, Wells, Wells, Wells, Wells, Wells, Wells, Woodward, Yuen, Zebrack, Zebrack, Zigmond",2015.0,,0,0,
8294,A randomized controlled trial of emotion recognition training after traumatic brain injury.,"Objective: To examine the effectiveness of 2 affect recognition interventions (Faces and Stories) in people with a traumatic brain injury. Setting: Postacute rehabilitation facilities. Participants: A total of 203 participants with moderate to severe traumatic brain injury were screened; 71 were eligible and randomized to the Faces (n = 24), Stories (n = 23), and Control interventions (n = 24). Participants were an average of 39.8 years of age and 10.3 years postinjury; 74% of participants were male. Design: Randomized controlled trial with immediate, 3-month, and 6-month follow-up posttests. Interventions were 9 hours of computer-based training with a therapist. Measures: Diagnostic Assessment of Nonverbal Accuracy 2-Adult Faces; Emotional Inference From Stories Test; Empathy (Interpersonal Reactivity Index); and Irritability and Aggression (Neuropsychiatric Inventory). Results: The Faces Intervention did significantly better than the Control Intervention on the Diagnostic Assessment of Nonverbal Accuracy 2-Adult Faces (P = .031) posttreatment; no time effect or group interaction was observed. No other significant differences were noted for the Faces Intervention. No significant differences were observed between the Stories and the Control Interventions; however, a significant time effect was found for the Emotional Inference From Stories Test. Conclusion: The Faces Intervention effectively improved facial affect recognition in participants with chronic post-traumatic brain injury, and changes were maintained for 6 months. Future work should focus on generalizing this skill to functional behaviors. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Neumann, Dawn; Babbage, Duncan R; Zupan, Barbra; Willer, Barry; Albert, Andersen, Babbage, Beck, Bibby, Bornhofen, Bornhofen, Bornhofen, Bowers, Braun, Brookshire, Ciurli, Cummings, Davis, Davis, de Sousa, de Sousa, Decety, Driscoll, Dywan, Ferstl, Guercio, Kilmer, Knox, Masanic, McDonald, McIntire, Mehrabian, Milders, Munro, Neumann, Neumann, Nowicki, Nowicki, Planalp, Radice-Neumann, Radice-Neumann, Rao, Riggio, Shamay-Tsoory, Shamay-Tsoory, Spell, Spikman, Yim, Yirmiya, Zupan, Zupan, Zupan",2015.0,,0,0,
8295,"The structured clinical interview for complicated grief: Reliability, validity, and exploratory factor analysis.","Background: Complicated grief (CG) has been recently included in the DSM-5, under the term ""persistent complex bereavement disorder,"" as a condition requiring further study. To our knowledge, no psychometric data on any structured clinical interview for CG (SCI-CG) is available to date. In this manuscript, we introduce the SCI-CG, a 31-item ""SCID-like"" clinician-administered instrument to assess the presence of CG symptoms. Methods: Participants were 281 treatment-seeking adults with CG (77.9% [n = 219] women, mean age = 52.4, standard deviation [SD] = 17.8) who were assessed with the SCI-CG and measures of depression, posttraumatic stress, anxiety, functional impairment. Results: The SCI-CG exhibited satisfactory internal consistency (alpha = .78), good test-retest reliability (interclass correlation [ICC] 0.68, 95% CI [0.60-0.75]), and excellent interrater reliability (ICC = 0.95, 95% CI [0.89-0.98]). Exploratory factor analyses revealed that a five-factor structure, explaining 50.3% of the total variance, was the best fit for the data. Conclusions: The clinician-rated SCI-CG demonstrates good internal consistency, reliability, and convergent validity in treatment-seeking individuals with CG and therefore can be a useful tool to assess CG. Although diagnostic criteria for CG have yet to be adequately validated, the SCI-CG may facilitate this process. The SCI-CG can now be used as a validated instrument in research and clinical practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bui, Eric; Mauro, Christine; Robinaugh, Donald J; Skritskaya, Natalia A; Wang, Yuanjia; Gribbin, Colleen; Ghesquiere, Angela; Horenstein, Arielle; Duan, Naihua; Reynolds, Charles; Zisook, Sidney; Simon, Naomi M; Shear, M. Katherine; Beck, Boelen, Bonanno, Davidson, Faschingbauer, First, First, Jacobs, Kersting, Marques, Mundt, Murphy, Muthen, Nasreddine, Neimeyer, Prigerson, Prigerson, Prigerson, Prigerson, Robinaugh, Robinaugh, Rush, Shear, Shear, Shear, Shear, Shear, Simon, Simon, Tomita",2015.0,,0,0,
8296,Stepped care versus face-to-face cognitive behavior therapy for panic disorder and social anxiety disorder: Predictors and moderators of outcome.,"Objective: To investigate predictors and moderators of treatment outcome by comparing immediate face-to-face cognitive behavioral therapy (FtF-CBT) to a Stepped Care treatment model comprising three steps: Psychoeducation, Internet-delivered CBT, and FtF-CBT for panic disorder (PD) and social anxiety disorder (SAD). Method: Patients (N = 173) were recruited from nine public mental health out-patient clinics and randomized to immediate FtF-CBT or Stepped Care treatment. Characteristics related to social functioning, impairment from the anxiety disorder, and comorbidity was investigated as predictors and moderators by treatment format and diagnosis in multiple regression analyses. Results: Lower social functioning, higher impairment from the anxiety disorder, and a comorbid cluster C personality disorder were associated with significantly less improvement, particularly among patients with PD. Furthermore, having a comorbid anxiety disorder was associated with a better treatment outcome among patients with PD but not patients with SAD. Patients with a comorbid depression had similar outcomes from the different treatments, but patients without comorbid depression had better outcomes from immediate FtF-CBT compared to guided self-help. Conclusions: In general, the same patient characteristics appear to be associated with the treatment outcome for CBT provided in low- and high-intensity formats when treated in public mental health care clinics. The findings suggest that patients with lower social functioning and higher impairment from their anxiety disorder benefit less from these treatments and may require more adapted and extensive treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Haug, Thomas; Nordgreen, Tine; Ost, Lars-Goran; Kvale, Gerd; Tangen, Tone; Andersson, Gerhard; Carlbring, Per; Heiervang, Einar R; Havik, Odd E; Aaronson, Allen, Andersson, Andersson, Andrews, Anglim, Arbuckle, Arch, Baillie, Barber, Barlow, Barlow, Bennett-Levy, Borge, Brown, Brown, Butler, Carlbring, Carlbring, Chambless, Chambless, Chambless, Chambless, Chen, Clark, Clark, Clark, Clark, Clark, Craske, Cuijpers, Di Nardo, Dow, Dow, Enders, Enders, Eskildsen, Fernandez-Ballesteros, Field, Finkbeiner, First, First, Fournier, Goldin, Haaga, Hansen, Haug, Hedman, Hedman, Heimberg, Heimberg, Hendriks, Hofmann, Hofmann, Holmbeck, Kampman, Kazantzis, Kazdin, Kraemer, Lambert, Lewontin, Lincoln, Mattick, Mausbach, McCabe, McEvoy, McEvoy, Mehlsteibl, Meichenbaum, Merton, Myhr, Netland, Newman, Newman, Nordgreen, Nordgreen, Nordgreen, Norton, Olatunji, Olatunji, Rosenthal, Sharp, Steketee, Swift, Tabachnick, Taylor, Telch, Tsao, Tsao, Tsao, Van Velzen, Wade, Wolitzky-Taylor",2015.0,,0,0,
8297,Evaluating changes in judgmental biases as mechanisms of cognitive-behavioral therapy for social anxiety disorder.,"Reductions in judgmental biases concerning the cost and probability of negative social events are presumed to be mechanisms of treatment for SAD. Methodological limitations of extant studies, however, leave open the possibility that, instead of causing symptom relief, reductions in judgmental biases are correlates or consequences of it. The present study evaluated changes in judgmental biases as mechanisms explaining the efficacy of CBT for SAD. Participants were 86 individuals who met DSM-IV-TR criteria for a primary diagnosis of SAD, participated in one of two treatment outcome studies of CBT for SAD, and completed measures of judgmental (i.e., cost and probability) biases and social anxiety at pre-, mid-, and posttreatment. Treated participants had significantly greater reductions in judgmental biases than not-treated participants; pre-to-post changes in cost and probability biases statistically mediated treatment outcome; and probability bias at midtreatment was a significant predictor of treatment outcome, even when modeled with a plausible rival mediator, working alliance. Contrary to hypotheses, cost bias at midtreatment was not a significant predictor of treatment outcome. Results suggest that reduction in probability bias is a mechanism by which CBT for SAD exerts its effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Calamaras, Martha R; Tully, Erin C; Tone, Erin B; Price, Matthew; Anderson, Page L; Altman, Anderson, Anderson, Antony, Busseri, Clark, Collins, Des Jarlais, Fedoroff, Feske, Finkel, First, Foa, Foa, Foa, Gould, Hoffart, Hofmann, Hofmann, Hofmann, Hofmann, Horvath, Horvath, Kazdin, Kenny, Kessler, Kraemer, Leary, Longmore, MacCallum, MacKinnon, McManus, Menard, Muthen, Nelson, Powers, Rapee, Rapee, Rieckmann, Rodebaugh, Smits, Smits, Steketee, Taylor, Tracey, Uren, Weeks, Wells, Wilson",2015.0,,0,0,
8298,Psycho-educative protocol in spa treatment for introduction and feasibility in withdrawal from benzodiapezines.,"Objective: The consumption of benzodiazepines in France has become a public health issue, which has been the subject of many a national report over these last years (HAS, INPES, OPEPS, ANSM...). Since the 1990s, numerous works have pointed out the excessively high level of consumption in psychotropic medication. In 2009, France came second as a European country after Portugal in anxiolytic consumption, and second after Sweden in consumption of hypnotics. Every year, 1 French person out of 5 consumes at least one benzodiazepines or one related molecule. This consumption of anxiolytics is in majority feminine and increases with age. It is also known that the introduction of a treatment by benzodiazepines leads to an average of 7-month continual consumption and for 52 % of those patients an average exposure for a further 2 consecutive years. The HAS Autumn 2007 report reminds people that benzodiazepines intake endangers the risks of falls (grade B), cognitive alteration (grade C) and accidents on the public highway (grade C), whereas when stopping progressively and supervising use of benzodiazepines, it may improve certain cognitive functions. Facing up to this problem, there are very few efficient therapeutic strategies for withdrawal or maintenance in stopping the medicinal consumption. Materials and methods: In recent studies, balneotherapy has shown its efficacy in treating generalised anxiety disorder. Furthermore, psycho-educative programmes have proved to be efficient in addiction studies to prevent relapse. In this way, the project associating a psycho-educative programme of cognitive and behavioural type with a 3-week spa treatment, validated by experts appeared to be credible. The programme was constituted and set up in 4 out of 5 of the French psychiatric spa resorts. The programme consisted in associating behavioural and cognitive-based therapy, motivational support and relaxation sessions. A psychologist clinician specializing in behavioural and cognitive therapy trained each team. Seventy patients with an average age of 54 years and 9 months took part in the protocol. They were divided up into 9 groups of 6 to 12 patients over the 4 centres. The aim of the study consisted in ensuring a lasting withdrawal from benzodiazepines. At the outcome of the treatment, a longitudinal follow-up was carried out on Day 5, day 30, day 60, day 100, day 180. The methodological assessment of this study was implemented by the ISPED of Bordeaux II. Results: The results are still being analysed, but it can already be concluded that the feasibility of setting up such a programme in a spa resort has been shown from the very encouraging incoming results in terms of the objective of withdrawal in 6 months of benzodiazepines. Conclusions: Thermal medicine, which may be associated with an undertaking in behavioural and cognitive therapy can well be a therapeutic solution adapted to the taking-in of those with stable chronic dependency to benzodiazepines in particular. This study is the first clinical trial assessing the efficacy of balneotherapy associated with a psycho-educative treatment in withdrawal from benzodiazepines. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dubois, Olivier; Hergueta, Thierry; Diallo, Abou; Salamon, Roger; Vaugeois, Christiane; de Maricourt, Pierre; Galinowski, Andre; Corsenac, Dubois, Dubois, Hartikainen, Hemmelgarn, Leipzig, Leveille, Ray, Salamon, Uhart, Van Der Hooft",2015.0,,0,0,
8299,Course of symptom change during anxiety treatment: Reductions in anxiety and depression in patients completing the Coordinated Anxiety Learning and Management program.,"When treating anxious patients with co-occurring depression, research demonstrates that both types of symptoms independently improve. The current analyses examined how reductions in anxiety and depression may be interrelated both during treatment, as well as over time following treatment. Participants were 503 individuals with one or more DSM-IV anxiety disorders who completed a collaborative care anxiety management program. Anxiety and depression were assessed at each treatment session (i.e., session by session data) and also at 6, 12, and 18-month post-baseline assessments (i.e., long-term outcomes data). Mediation analyses examined changes in symptoms in session by session data and long-term outcomes data. Anxiety and depression changed reciprocally in session by session data; change in anxiety mediated change in depression to a greater extent than vice versa. In the long-term outcomes data, change in anxiety mediated change in depression. However, the reverse mediation model of the long-term outcomes period revealed that accounting for changes in depression altered the effect of time on anxiety. Thus, temporal change during active treatment may share similarities with those related to maintaining gains after treatment, although differences arose in the reverse mediation models. Limitations of the methodology and implications of anxiety treatment for depression outcomes are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bomyea, Jessica; Lang, Ariel; Craske, Michelle G; Chavira, Denise A; Sherbourne, Cathy D; Rose, Raphael D; Golinelli, Daniela; Campbell-Sills, Laura; Welch, Stacy S; Sullivan, Greer; Bystritsky, Alexander; Roy-Byrne, Peter; Stein, Murray B; Aderka, Allen, Baron, Bauer, Beard, Brown, Brown, Brown, Bruce, Campbell-Sills, Campbell-Sills, Craske, Craske, Dempsey, Derogatis, Dupont, Emmrich, Farchione, Huang, Joormann, Kaufman, Kenny, Kessler, Kring, Kroenke, Kroenke, Mackinnon, MacKinnon, Maxwell, Mennin, Mineka, Moscovitch, Norman, Norton, Olatunji, Persons, Rapaport, Rose, Roy-Byrne, Roy-Byrne, Rudolph, Russell, Sheehan, Telch, Tourian, van Balkom, Zbozinek",2015.0,,0,0,
8300,Music therapy as an adjunct to standard treatment for obsessive compulsive disorder and co-morbid anxiety and depression: A randomized clinical trial.,"Background: Previous studies have highlighted the potential therapeutic benefits of music therapy as an adjunct to standard care, in a variety of psychiatric ailments including mood and anxiety disorders. However, the role of music in the treatment of obsessive-compulsive disorder (OCD) have not been investigated to date. Methods: In a single-center, parallel-group, randomized clinical trial (NCT02314195) 30 patients with OCD were randomly assigned to standard treatment (pharmacotherapy and cognitive-behavior therapy) plus 12 sessions of individual music therapy (n = 15) or standard treatment only (n = 15) for one month. Maudsley Obsessive-Compulsive Inventory, Beck Anxiety Inventory, and Beck Depression Inventory-Short Form were administered baseline and after one month. Results: Thirty patients completed the study. Music therapy resulted in a greater decrease in total obsessive score (post-intervention score: music therapy + standard treatment: 12.4 +/- 1.9 vs standard treatment only: 15.1 +/- 1.7, p < 0.001, effect size = 56.7%). For subtypes, significant between-group differences were identified for checking (p = 0.004), and slowness (p = 0.019), but not for washing or responsibility. Music therapy was significantly more effective in reducing anxiety (post-intervention score: music therapy+standard treatment: 16.9 +/- 7.4 vs standard treatment only: 22.9 +/- 4.6, p < 0.001, effect size = 47.0%), and depressive symptoms (post-intervention score: music therapy+standard treatment: 10.8 +/- 3.8 vs standard treatment: 17.1 +/- 3.7, p < 0.001, effect size = 47.0%). Limitations: Inclusion of a small sample size, lack of blinding due to the nature of the intervention, short duration of follow-up. Conclusion: In patients with OCD, music therapy, as an adjunct to standard care, seems to be effective in reducing obsessions, as well as co-morbid anxiety and depressive symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bidabadi, Shahrzad Shirani; Mehryar, Amirhooshang; Basoglu, Beck, Beck, Beck, Bloch, Bruscia, Chan, Elliott, Erkkila, Fineberg, Ghassemzadeh, Goldbeck, Grant, Hodgson, Hojat, Jenike, Kaviani, Lin, Mancebo, Maratos, McKay, McLean, Meca, Mohammadi, Mossler, Pinto, Ravizza, Sarris, Silverman",2015.0,,0,0,
8301,Validation of the Geriatric Anxiety Inventory in a duloxetine clinical trial for elderly adults with generalized anxiety disorder.,"Background: The Generalized Anxiety Inventory (GAI) has been developed for use in the assessment of anxiety symptoms in older adults (>= 65 years), but previous validation work has not examined the psychometric qualities of the instrument in relation to treatment. The objective of this study was to examine the performance of the GAI for its internal reliability, convergent and divergent validity, and its sensitivity to treatment. Methods: Elderly patients with generalized anxiety disorder (GAD) participated in a 10-week double-blind study of duloxetine treatment for patients with GAD. Anxiety symptoms were assessed with the Hamilton Anxiety Rating Scale (HAMA), the Hospital Anxiety and Depression Scale (HADS) anxiety and depression subscales, and the GAI. Internal reliability of the GAI was assessed with Cronbach's alpha. Correlations among the HAMA, HADS, and GAI scores were analyzed to determine convergent and divergent validity. Patients were also compared on remission status using recommended cut-off scores for the GAI. Results: Patients with GAD, who were at least 65 years of age, were randomly assigned to double-blind treatment with either duloxetine (N = 151) or placebo (N = 140) for 10 weeks acute therapy. The mean change on the GAI was significantly greater with duloxetine compared with placebo treatment (-8.36 vs. -4.96, respectively, p <= 0.001). The GAI demonstrated good internal consistency, good convergent and divergent validity, but suggested cut-off values for caseness with the GAI did not correspond to remission status as measured by the HAMA. Conclusions: Within an elderly patient population with GAD, the GAI demonstrated sound psychometric qualities and sensitivity to change with treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ball, Susan G; Lipsius, Sarah; Escobar, Rodrigo; Alaka, Byers, Cheung, Diefenbach, Diefenbach, Folstein, Gerolimatos, Golden, Guy, Guy, Hamilton, Lipman, Marquez-Gonzalez, Matheson, Matza, Pachana, Raskin, Roemer, Shear, Sheehan, Thiessen, Zigmond",2015.0,,0,0,
8302,"Obsessive-compulsive disorder, psychosis, and bipolarity: A longitudinal cohort and multigenerational family study.","Obsessive-compulsive disorder (OCD) often co-occurs with psychotic and bipolar disorders; this comorbidity complicates the clinical management of these conditions. In this population-based longitudinal and multigenerational family study, we examined the patterns of comorbidity, longitudinal risks, and shared familial risks between these disorders. Participants were individuals with a diagnosis of OCD (n = 19 814), schizophrenia (n = 58 336), bipolar disorder (n = 48 180), and schizoaffective disorder (n = 14 904) included in the Swedish Patient Register between January 1969 and December 2009; their first-, second-, and third-degree relatives; and population-matched (1:10 ratio) unaffected comparison individuals and their relatives. The Swedish Prescribed Drug Register was used to control for the potential effect of medication in the longitudinal analyses. Individuals with OCD had a 12-fold increased risk of having a comorbid diagnosis of schizophrenia and a 13-fold increased risk of bipolar disorder and schizoaffective disorder. Longitudinal analyses showed that individuals first diagnosed with OCD had an increased risk for later diagnosis of all other disorders, and vice versa. The risk of bipolar disorder was reduced, but not eliminated, when the use of selective serotonin reuptake inhibitors was adjusted for. OCD-unaffected first-, second-, and third-degree relatives of probands with OCD had a significantly increased risk for all 3 disorders; the magnitude of this risk decreased as the genetic distance increased. We conclude that OCD is etiologically related to both schizophrenia spectrum and bipolar disorders. The results have implications for current gene-searching efforts and for clinical practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cederlof, Martin; Lichtenstein, Paul; Larsson, Henrik; Boman, Marcus; Ruck, Christian; Landen, Mikael; Mataix-Cols, David; Alevizos, Alevizos, Allsopp, Angst, Berman, Berrios, Bottas, Cunill, de Haan, DeLisi, Eisen, Ekholm, Ghaemi, Hantouche, Henin, Iervolino, Khullar, Kruger, Kwon, Lee, Leverich, Lichtenstein, Ludvigsson, Lykouras, Mataix-Cols, Mattheisen, Meier, Murphy, Nechmad, Perugi, Perugi, Phillips, Poyurovsky, Ruscio, Scheltema Beduin, Sellgren, Sterk, Stewart, Swets, Szatmari, Tibbo, Tien, Timpano, Viktorin, Wettermark",2015.0,,0,0,
8303,Can low-cost strategies improve attendance rates in brief psychological therapy? Double-blind randomized controlled trial.,"Objectives: To assess if telephone text message appointment reminders and orientation leaflets can increase the proportion of patients who attend brief interventions after being assessed as suitable for guided self-help following cognitive behavioral therapy principles. Method: Attendance was operationally defined as having accessed at least 1 therapy appointment. A secondary outcome was the proportion of attenders who completed or dropped out of therapy. After initial assessment, 254 patients with depression and anxiety disorders were randomly assigned to 1 of 3 groups: (a) usual waitlist control, (b) leaflet, (c) leaflet plus text message. Differences in the proportions of patients who started and completed therapy across groups were assessed using chi-square and logistic regression analyses. Results: Overall, 63% of patients in this sample attended therapy. Between-group differences were not significant for attendance, x2(2) = 3.94, p = .14, or completion rates, x2(2) = 2.98, p = .23. These results were not confounded by demographic or clinical characteristics. Conclusions: Low-cost strategies appear to make no significant difference to therapy attendance and completion rates. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Delgadillo, Jaime; Moreea, Omar; Murphy, Elizabeth; Ali, Shehzad; Swift, Joshua K; Andersen, Barrett, Bennett-Levy, Benway, Bower, Carey, Carrion, Clough, Clough, Constantino, Cuijpers, Daniels, Delgadillo, Garfield, Garland, Gellatly, Gollwitzer, Gollwitzer, Grant, Guy, Gyani, Hasvold, Holdsworth, Joe, Joe, Joyce, Killaspy, Kroenke, Kroenke, Kruse, Kushner, Lecomte, Lefforge, Lemeshow, Martin, Meyer, Mitchell, Moos, Mundt, Murphy, Newman, Paddison, Paige, Powers, Reda, Richards, Schauman, Self, Sheeran, Simpson, Sims, Swenson, Swift, Swift, Swift, Tryon, Tryon, Tryon, VanDeMark, Varley, Vogel, Wang, Westra, Wierzbicki",2015.0,,0,0,
8304,Predictive validity of the Trauma Screening Questionnaire in detecting posttraumatic stress disorder in patients with psychotic disorders.,"Background: Post-traumatic stress disorder (PTSD) is highly prevalent in patients with a psychotic disorder. Because a PTSD diagnosis is often missed in patients with psychosis in routine care, a valid screening instrument could be helpful. Aims: To determine the validity of the Trauma Screening Questionnaire (TSQ) as a screening tool for PTSD among individuals with psychotic disorders. Method: Among 2608 patients with a psychotic disorder, the rate of trauma exposure was determined and the TSQ was administered to screen for PTSD. PTSD status was verified in 455 patients using the Clinician-Administered PTSD Scale (trial registration: ISRCTN 79584912). Results: Trauma exposure was reported by 78.2% of the 2608 patients. PTSD prevalence was estimated at 16% (95% CI 14.6-17.4%) compared with 0.5% reported in the patients' clinical charts. A TSQ cut-off score of six predicted PTSD with 78.8% sensitivity, 75.6% specificity, 44.5% correct positives and 93.6% correct negatives. Conclusions: The TSQ seems to be a valid screening tool for PTSD in patients with a psychotic disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","de Bont, Paul A. J. M; van den Berg, David P. G; van der Vleugel, Berber M; de Roos, Carlijn; de Jongh, Ad; van der Gaag, Mark; van Minnen, Agnes; Achim, Becker, Blake, Brewin, Brewin, Brown, Classen, Cusack, de Bont, de Bont, de Vries, Dekkers, Foa, Frueh, Galletly, Grubaugh, Lecrubier, Lommen, Lothian, Morrison, Mueser, Olff, Read, Read, Read, Ronconi, Sautter, Shaw, Sheehan, Steel, Van den Berg, van den Berg, van Minnen, van Minnen, Van Vliet, Varese, Walters, Weathers, Weathers, Weathers",2015.0,,0,0,
8305,Does successful smoking cessation reduce anxious arousal among treatment-seeking smokers?,"Introduction: There is limited work that has examined the effect of quitting smoking on anxious arousal, an underlying dimension of anxiety symptoms and psychopathology. Method: Smokers (n = 185, 54.1% female) enrolled in a smoking cessation treatment trial were monitored post-cessation in terms of abstinence status (biochemically verified; at Weeks 1, 2, and Month 1 post-quit) and severity of panic-relevant symptoms (self-reported; at Month 1 and 3 post-quit). Structural equation models were conducted, adjusting for participant sex, age, treatment condition, and pre-cessation nicotine dependence, presence of depressive/anxiety disorders, anxious arousal, and anxiety sensitivity. Results: After adjusting for covariates, participants who remained abstinent for one month (n = 80; 43.2%) relative to those who did not (n = 105; 56.8%) demonstrated significant reductions in anxious arousal at Month 1 (beta = -.26, p = .04) and Month 3 post-quit (beta = -.36, p = .006); abstinence status had a non-significant effect on anxious arousal severity at Month 3 after controlling for Month 1 anxious arousal (beta = -.18, p = .09). Discussion: Findings align with theoretical models of smoking-anxiety interplay and suggest that smoking cessation can result in reductions in anxious arousal. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Farris, Samantha G; Allan, Nicholas P; Morales, Patricia C; Schmidt, Norman B; Zvolensky, Michael J; Amering, Ameringer, Becona, Berlin, Bernstein, Breslau, Brown, Brown, Browne, Capron, Cavazos-Rehg, Clark, Cosci, Dawkins, Fiore, First, Goodwin, Heatherton, Hu, Isensee, Jamal, Johnson, Johnson, Kassel, Kassel, Kirchner, Leventhal, Leventhal, McDermott, McLeish, Morissette, Moshagen, Mulaik, Muthen, Perkins, Piper, Piper, Shahab, Solomon, Taylor, Taylor, Vessichhio, Watson, Watson, Watson, Watson, Ziedonis, Zvolensky, Zvolensky, Zvolensky, Zvolensky, Zvolensky, Zvolensky",2015.0,,0,0,
8306,Treatment of active duty military with PTSD in primary care: A follow-up report.,"First-line trauma-focused therapies offered in specialty mental health clinics do not reach many veterans and active duty service members with posttraumatic stress disorder (PTSD). Primary care is an ideal environment to expand access to mental health care. Several promising clinical case series reports of brief PTSD therapies adapted for primary care have shown positive results, but the long-term effectiveness with military members is unknown. The purpose of this study was to determine the long-term outcome of an open trial of a brief cognitive-behavioral primary care-delivered protocol developed specifically for deployment-related PTSD in a sample of 24 active duty military (15 men, 9 women). Measures of PTSD symptom severity showed statistically and clinically significant reductions from baseline to posttreatment that were maintained at the 6-month and 1-year follow-up assessments. Similar reductions were maintained in depressive symptoms and ratings of global mental health functioning. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cigrang, Jeffrey A; Rauch, Sheila A. M; Mintz, Jim; Brundige, Antoinette; Avila, Laura L; Bryan, Craig J; Goodie, Jeffrey L; Peterson, Alan L; STRONG STAR Consortium; Blanchard, Bower, Bryan, Cahill, Cigrang, Corso, Eftekhari, Engel, Foa, Foa, Forbes, Harmon, Hirano, Hunter, Jakupcak, Kroenke, Kroenke, Mouilso, Possemato, Price, Richardson, Sripada, Steenkamp, Weathers",2015.0,,0,0,
8307,Cost and probability biases in social phobia: Evaluating their relation to attention bias and treatment outcome.,"Social phobia is maintained in part by judgmental biases concerning the probability and cost of negative social events. One hypothesized mechanism of action of cognitive behavioral therapy (CBT) for anxiety disorders is its reduction in the exaggerated probabilities and costs associated with feared outcomes, termed the ""cognitive mediation hypothesis"" (Foa & Kozak, 1986). A number of studies have examined the cognitive mediation hypothesis; some investigations find cost bias to be more important to treatment outcome, whereas others find probability bias to be more important. However, methodological limitations of several of these studies leave open the possibility that changes in judgmental biases are simply correlates or consequences of social anxiety reduction. Attentional processes, which mark the first discrimination of incoming information, may serve as precursors to cognitive processes like probability and cost estimates. Though intuitively linked, whether social phobics' pattern of attending to external threat cues is correlated with their appraisals of the cost and probability of negative events has yet to be examined empirically. The current project examines cost and probability biases and their relation to attention bias and treatment outcome in a randomized controlled trial of CBT for social phobia. It was found that, contrary to hypotheses, greater attentional bias for threat in either direction (vigilance or avoidance) did not predict higher cost and probability estimates. However, a significant relation was observed between attentional vigilance and outcome probability estimates, such that greater vigilance for threat predicted greater estimates of the likelihood that negative social events will occur. As hypothesized, early changes in cost and probability biases predicted later changes in social anxiety symptoms (and not vice versa). Changes in probability estimates were a stronger predictor of treatment outcome than changes in cost estimates. Broadly, findings provide support for the cognitive mediation hypothesis of social phobia and point to both outcome cost and outcome probability as potential treatment mechanisms. Findings are discussed in the context of extant theories of social phobia, and directions for future research are proposed. INDEX WORDS: Cost bias, Probability bias, Attention bias, Social phobia (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Calamaras, Martha R",2015.0,,0,0,
8308,Dialogical exposure with traumatically bereaved Bosnian women: Findings from a controlled trial.,"Objective: In this trial, we compared the relative efficacy of dialogical exposure group treatment using Gestalt empty-chair method with a supportive group in the treatment of symptoms stemming from traumatic loss in a post-war society. Methods: One-hundred and nineteen women whose husbands were either killed or registered as missing during the war in Bosnia and Herzegovina were quasi-randomized to seven sessions of group treatment with dialogical exposure or to an active control condition. Results: Both interventions resulted in significant improvement from baseline to post-treatment for both kinds of loss, in terms of post-traumatic symptoms, general mental health and grief reactions, with the exception of depression and traumatic grief in the control condition. Regarding mean effect sizes (Cohen's d), pre-treatment to post-treatment improvements were moderate (d = 0.56) for the dialogical exposure group and small (d = 0.34) for the supportive group. Treatment gains were maintained at least until the 1-year follow-up. In controlled comparisons, dialogical exposure was superior concerning traumatic grief (Cohen's d = 0.37) and post-traumatic avoidance (d = 0.73) at post-treatment. Conclusions: Results show that short-term dialogical exposure group treatment was moderately effective in treating traumatically bereaved women. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hagl, Maria; Powell, Steve; Rosner, Rita; Butollo, Willi; Beder, Bell, Boelen, Bonanno, Boss, Butollo, Butollo, Butollo, Butollo, Butollo, Butollo, Campbell, Cloitre, Currier, Dahl, Field, Foa, Goldberg, Goldberg, Goldberg, Goulding, Green, Greenberg, Greenberg, Horowitz, Horowitz, Jacobson, Kellogg, Lambert, Layne, Layne, Lichtenthal, Maercker, Maercker, Momartin, Mooren, Morina, Neal, Neria, Paivio, Paivio, Paivio, Paivio, Perls, Perls, Pfefferbaum, Powell, Powell, Prigerson, Quirk, Roos, Rosner, Shear, Sloan, Spinazzola, Steinberg, Thornton, Tobin, Tokaca, Tully, Werneke, Young, Zvizdic",2015.0,,0,0,
8309,Exploring the relationship between eating disorder symptoms and substance use severity in women with comorbid PTSD and substance use disorders.,"Background: Eating disorders (ED) and substance use disorders (SUD) commonly co-occur, especially in conjunction with posttraumatic stress disorder (PTSD), yet little is known about ED and ED symptoms in women presenting to addiction treatment programs. Objective: We examined the association between ED symptoms and substance use frequency and severity in a sample of women with a DSM IV diagnosis of current SUD and PTSD enrolled in SUD treatment. Method: Participants were 122 women from four substance abuse treatment sites who participated in a multi-site clinical trial through the National Institute of Drug Abuse Clinical Trials Network (NIDA CTN). The Eating Disorder Examination-Questionnaire (EDE-Q), the Clinician's Administered PTSD Scale (CAPS) and the Addiction Severity Index (ASI) were administered at baseline and correlational analyses were performed. Variables that significantly correlated with EDE-Q total and subscale scores were entered into a linear regression analysis. Results: Scores on the EDE-Q Global scale, as well as the Eating Concern, Weight Concern and Shape Concern subscales of the EDE-Q were significantly associated with Caucasian race/ethnicity, past 30 day opiate use, higher ASI Psychiatric Subscale score and lower ASI Employment Subscale score. Conclusion: Although exploratory, these findings suggest that there may be a relationship between addiction severity, use of certain drugs of abuse and eating disorder symptoms, particularly those involving weight and shape concerns in women with comorbid PTSD and SUD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Killeen, Therese; Brewerton, Timothy D; Campbell, Aimee; Cohen, Lisa R; Hien, Denise A; Avena, Avena, Baker, Baldo, Berg, Black, Blake, Blumenthal, Brecht, Brewerton, Brewerton, Brewerton, Bulik, Calero-Elvira, Cochrane, Cohen, Cook, Corstorphine, Dansky, Daubenmier, Deep, Fairburn, Franko, Gearhardt, Gray, Grilo, Grilo, Hien, Hilbert, Hudson, Hudson, Jacka, Kaye, Keating, Lindsay, Marques, Matthews, McLellan, Mond, Mond, Najavits, Piran, Quick, Reba-Harrelson, Robbins, Sanchez-Villegas, Spindler, Striegel-Moore, Striegel-Moore, Volkow, Volkow, Volkow, Volkow, Wagner, Wang, Warren, Weathers, Wolfe",2015.0,,0,0,
8310,"Importance of Virtual Reality to Virtual Reality Exposure Therapy, study design of a randomized trial.","Post Traumatic Stress Disorder (PTSD) can be a debilitating problem in service members who have served in Iraq or Afghanistan. Virtual Reality Exposure Therapy (VRET) is one of the few interventions demonstrated in randomized controlled trials to be effective for PTSD in this population. There are theoretical reasons to expect that Virtual Reality (VR) adds to the effectiveness of exposure therapy, but there is also added expense and difficulty in using VR. Described is a trial comparing outcomes from VRET and a control exposure therapy (CET) protocol in service members with PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","McLay, Robert N; Baird, Alicia; Murphy, Jennifer; Deal, William; Tran, Lily; Anson, Heather; Klam, Warren; Johnston, Scott; Blake, Bond, Cohen, Difede, Foa, Forbes, Leon, Lund, Martin, McLay, McLay, Meites, Reeves, Rothbaum, Sheehan, Smith, Wiederhold",2015.0,,0,0,
8311,Anxiety disorder-specific predictors of treatment outcome in the Coordinated Anxiety Learning and Management (CALM) trial.,"Identifying baseline characteristics associated with treatment outcome in generalized anxiety disorder, panic disorder, social anxiety disorder (SAD) or post-traumatic stress disorder. We performed two secondary analyses of the Coordinated Anxiety Learning and Management trial. Baseline characteristics and their interactions with treatment assignment were analyzed via stepwise logistic regression models and receiver-operating criterion analyses by disorder predicting remission and response for each disorder. Predictors for poor outcome across diagnoses were comorbid depression and low socioeconomic status. Good outcome was associated with positive treatment expectancy and high self-efficacy expectancy. SAD had the lowest rate of remission and response compared to the other anxiety disorders, and differed in respect to its predictors of treatment outcome. Perceived social support predicted treatment outcome in SAD. The special role of SAD among the other anxiety disorders requires further study both because of its worse prognosis and its more specific treatment needs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Jakubovski, Ewgeni; Bloch, Michael H; Adler, Berman, Bouchard, Bruce, Campbell-Sills, Connor, Craske, Falconnier, Fournier, Houck, Jakubovski, Kelly, Kessler, Kessler, Kessler, Kraemer, Kraemer, Kroenke, Ledley, Mersch, Penninx, Powers, Price, Roy-Byrne, Roy-Byrne, Ruggiero, Scheibe, Shear, Sheehan, Sheehan, Sheehan, Stein, Sullivan, Tarrier, Thrasher, Van Ameringen, Wlazlo",2016.0,,0,0,
8312,Experiential avoidance and rumination in parents of children on cancer treatment: Relationships with posttraumatic stress symptoms and symptoms of depression.,"We conducted a cross-sectional survey study to investigate whether there is a relationship between experiential avoidance (EA), rumination, post-traumatic stress symptoms (PTSS), and symptoms of depression, in parents of children on cancer treatment. Data from 79 parents (55 mothers) of 79 children with a median of three months since their cancer diagnosis were included in cross-sectional analyses. EA and rumination were positively correlated with PTSS and symptoms of depression. EA and rumination did not provide incremental explained variance in PTSS over and above that explained by symptoms of depression, while controlling for symptoms of anxiety and demographic characteristics. However, EA and rumination provided incremental explained variance in symptoms of depression over and above that explained by PTSS, while controlling for symptoms of anxiety and demographic characteristics. Rumination and EA are important constructs in the understanding of PTSS and symptoms of depression in parents of children on cancer treatment. Future research should delineate the temporal relationships between these constructs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cernvall, Martin; Skogseid, Ellen; Carlbring, Per; Ljungman, Lisa; Ljungman, Gustaf; von Essen, Louise; Beck, Beck, Blanchard, Boman, Bond, Breslau, Campbell-Sills, Cernvall, Cernvall, Chawla, Clohessy, Dolgin, Ehlers, Ehring, Ehring, Farmer, Fledderus, Greco, Gross, Hayes, Hayes, Kazak, Kenny, Koller, Ljungman, Ljungman, Marx, Morina, Murray, Nolen-Hoeksema, Orcutt, Plumb, Poder, Poder, Ruggiero, Smith, Spinhoven, Tull, Weathers, Wells, Wenzlaff",2016.0,,0,0,
8313,"Economic evaluation of schema therapy and clarification-oriented psychotherapy for personality disorders: A multicenter, randomized controlled trial.","Purpose: To compare from a societal perspective the cost-effectiveness and cost-utility of schema therapy, clarification-oriented psychotherapy, and treatment as usual for patients with avoidant, dependent, obsessive-compulsive, paranoid, histrionic, and/or narcissistic personality disorder. Method: A multicenter, randomized controlled trial, single-blind parallel design, was conducted between May 2006 and December 2011 in 12 Dutch mental health institutes. Data from 320 patients (diagnosed according to DSM-IV criteria) randomly assigned to schema therapy (n = 145), treatment as usual (n = 134), or clarification-oriented psychotherapy (n = 41) were analyzed. Costs were repeatedly measured during 36 months by interview and patient registries. Primary outcome measures were proportion of recovered patients as measured with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders for the cost-effectiveness analysis, and quality-adjusted life-years (QALYs) for the cost-utility analysis. Bootstrap replications in the cost-effectiveness and the cost-utility planes were used to estimate the probability that one treatment was more cost-effective than the other. Mixed gamma regression on net monetary benefit for different levels of willingness to pay for extra effects was used as sensitivity analysis. Additional sensitivity analyses were done to assess robustness of the results. Results: Due to higher clinical effects and lower costs, schema therapy was dominant over the other treatments in the cost-effectiveness analyses. Schema therapy has the probability of being the most cost-effective treatment (78% at 0 to 96% at 37,500 [$27,375] willingness to pay per extra recovery). Treatment as usual was more cost-effective than clarification-oriented psychotherapy due to lower costs. In the cost-utility analysis, schema therapy had a stable 75% probability of being cost-effective. Sensitivity analyses confirmed these findings. Conclusions: The results support the cost-effectiveness of schema therapy but not of clarification-oriented psychotherapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bamelis, Lotte L. M; Arntz, Arnoud; Wetzelaer, Pim; Verdoorn, Ryanne; Evers, Silvia M. A. A; Bamelis, Bamelis, Bartak, Briggs, Brooks, De Koning, Dolan, Drummond, First, Giesen-Bloo, Glick, Goossens, Graham, Huang, Koopmanschap, Lamers, Lobbestael, Nadort, Newton-Howes, Noben, Olesen, Oostenbrink, Oostenbrink, Schotte, Schotte, Soeteman, Soeteman, Soeteman, van Asselt, van Asselt, van Asselt, van Asselt, Wagner, Weertman, Wlebe",2015.0,,0,0,
8314,"Integrated cognitive behavioral therapy versus cognitive processing therapy for adults with depression, substance use disorder, and trauma.","The comorbidity of substance use disorder (SUD), depression, and PTSD is common among veterans. Prior research has shown that among veterans with SUD and depression, those with PTSD did not maintain cognitive-behavioral treatment gains as well as those without PTSD. Thus, the current study was designed to evaluate whether adding trauma-focused treatment following an initial group-based integrated cognitive behavioral treatment (ICBT) for SUD and depression improved treatment outcomes. Participants were 123 veterans (89% male) recruited from the VA San Diego Healthcare System. All participants received ICBT in twice weekly, group-delivered sessions for 12 weeks (Phase 1). Participants were then randomized to receive 12 sessions of individual follow-up sessions (Phase 2) utilizing either ICBT or cognitive processing therapy that was modified to integrate SUD treatment (CPT-M). Results indicated that PTSD and depression symptoms slightly improved at the end of Phase 1 group ICBT and further improved through Phase 2 individual treatment (except for participants without PTSD who received CPT-M), with treatment gains maintained one year later. Substance use significantly improved at the end of Phase 1 group ICBT and these improvements were maintained through Phase 2 and the one year follow-up. Participants in the trauma-focused Phase 2 treatment (CPT-M) exhibited similar levels of symptom reduction and maintenance of treatment gains as those in the non-trauma-focused Phase 2 treatment (ICBT). However, there was a slight advantage for Phase 2 CPT-M over Phase 2 ICBT with respect to heavy drinking outcomes for individuals with PTSD. Overall, the combination of group ICBT followed by either CPT-M or ICBT individual therapy appears to be effective for veterans with depression, SUD, and trauma history. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Haller, Moira; Norman, Sonya B; Cummins, Kevin; Trim, Ryan S; Xu, Xiaomin; Cui, Ruifeng; Allard, Carolyn B; Brown, Sandra A; Tate, Susan R; Blake, Bonin, Brady, Bright, Carey, Carlier, Currie, Darves-Bornoz, Driessen, Felker, Foa, Ford, Frees, Grant, Green, Hamilton, Harrell, Hegel, Hemmy Asamsama, Holtzheimer, Kadden, Kay-Lambkin, Kaysen, Kessler, Kessler, Lydecker, McCarthy, McCauley, McGovern, Monson, Munoz, Narula, Norman, Norman, Ouimette, Resick, Resick, Roberts, Robins, Singer, Sobell, Souza, Stewart, van Dam, Weathers, Weathers, Weis, West, Willenbring",2016.0,,0,0,
8315,Exploring personality diagnosis stability following acute psychotherapy for chronic posttraumatic stress disorder.,"Background: Axis I comorbidity complicates diagnosing axis II personality disorders (PDs). PDs might influence Axis I outcome. No research has examined psychotherapy effects on PDs of treating Axis I comorbidity. Secondary analysis of a randomized controlled trial examined PD diagnostic stability after brief psychotherapy of chronic posttraumatic stress disorder (PTSD). Methods: Patients with chronic PTSD were randomly assigned to 14 weeks of prolonged exposure, interpersonal psychotherapy, or relaxation therapy. Assessments included the Structured Clinical Interview for DSM-IV, Patient Version (SCID-P) and Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) at baseline, week 14, and for treatment responders (>= 30% clinician-administered PTSD scale improvement, defined a priori) at week 26 follow-up. We hypothesized patients whose PTSD improved would retain fewer baseline PD diagnoses posttreatment, particularly with personality traits PTSD mimics, e.g. paranoid and avoidant. Results: Forty-seven (47%) of 99 SCID-II patients evaluated at baseline received a SCID-II diagnosis: paranoid (28%), obsessive-compulsive (27%), and avoidant (23%) PDs were most prevalent. Among 78 patients who repeated SCID-II evaluations posttreatment, 45% (N = 35) had baseline PD diagnoses, of which 43% (N = 15/35) lost at week 14. Three (7%) patients without baseline PDs acquired diagnoses at week 14; 10 others shifted diagnoses. Treatment modality and PTSD response were unrelated to PD improvement. Of treatment responders reevaluated at follow-up (N = 44), 56% with any baseline Axis II diagnosis had none at week 26. Conclusion: This first evaluation of Axis I psychotherapy effects on personality disorder stability found that acutely treating a chronic state decreased apparent trait-across most PDs observed. These exploratory findings suggest personality diagnoses may have limited prognostic meaning in treating chronic PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Markowitz, John C; Petkova, Eva; Biyanova, Tatyana; Ding, Ke; Suh, Eun Jung; Neria, Yuval; Blake, Cyranowski, Davidson, Dunn, Fava, First, Gibbon, Grilo, Grilo, Gunderson, Hamed, Herman, Hirschfeld, Hyler, Johnson, Kendler, Kessler, Lopez-Castroman, Maffei, Markowitz, Markowitz, Markowitz, Markowitz, Markowitz, Millon, Milrod, Mulder, Nesselroade, Oldham, Pagura, Shea, Shea, Shea, Spitzer, Vergara-Moragues, Weathers, Weertman, Westphal, Zanarini, Zimmerman, Zimmerman, Zimmerman, Zimmerman",2015.0,,0,0,
8316,The unified protocol for transdiagnostic treatment of emotional disorders: Preliminary exploration of effectiveness for group delivery.,"The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has demonstrated promising results among patients with heterogeneous anxiety and comorbid depressive disorders when delivered on an individual basis, but greater efficiencies may be achieved with group-based applications. The aim of the present study was to provide a preliminary exploration of the UP when delivered in a group format. Among diagnostically diverse patients (N = 11), the UP group treatment resulted in moderate to strong effects on anxiety and depressive symptoms, functional impairment, quality of life, and emotion regulation skills, as well as good acceptability and overall satisfaction ratings from patients. Three clinical cases are presented in detail to illustrate the group-based UP delivery, followed by a critical discussion of associated challenges and proposed guidelines for group administration, as well as directions for future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bullis, Jacqueline R; Sauer-Zavala, Shannon; Bentley, Kate H; Thompson-Hollands, Johanna; Carl, Jenna R; Barlow, David H; Barlow, Barlow, Barlow, Barlow, Barlow, Barlow, Bentley, Borkovec, Boswell, Brown, Cohen, Craske, Di Nardo, Ellard, Ellard, Endicott, Erickson, Erickson, Erickson, Farchione, Gamez, Garcia, Lovibond, Marks, McDermut, Mundt, Norman, Norton, Norton, Norton, Norton, Norton, Norton, Norton, Peterson, Reiss, Sauer-Zavala, Schmidt, Semple, Sharp, Teasdale, Watson, Whitfield, Wilamowska",2015.0,,0,0,
8317,"No effects of 20 Hz-rTMS of the primary motor cortex in vegetative state: A randomised, sham-controlled study.","We assessed the effects of a non-invasive neuromodulatory intervention with repetitive transcranial magnetic stimulation (rTMS) of the motor cortex in patients with vegetative state (VS) by a randomised, sham-controlled study with a cross-over design. Eleven patients classified as being in VS (9 post-anoxic, 2 post-traumatic, time elapsed from the injury 9-85 months) were included in the study. Real or sham 20 Hz rTMS were applied to the left primary motor cortex (M1) for 5 consecutive days. Primary outcome measures were changes in the JFK Coma Recovery Scale-Revised (CRS-R) scale total score and Clinical Global Impression Improvement (CGI-I) scale. Additional measures were EEG changes and impression of the patients' relatives using the CGI-I scale. Evaluations were blindly performed at baseline, after the first day of treatment, immediately after the end of the 5-days treatment, 1 week and 1 month later. Slight changes observed in the CRS-R and CGI-I scores did not significantly differ between real or sham stimulation conditions. EEG was not significantly changed on average, although spots of brain reactivity were occasionally found underneath the stimulation point. Findings did not provide evidence of therapeutic effect of 20 Hz rTMS of the M1 in chronic VS, at least with conventional coils and current safety parameters. Therefore, they might be useful to better allocate human and financial resources in future trials. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Cincotta, Massimo; Giovannelli, Fabio; Chiaramonti, Roberta; Bianco, Giovanni; Godone, Marco; Battista, Donato; Cardinali, Consuelo; Borgheresi, Alessandra; Sighinolfi, Antonella; D'Avanzo, Anna Maria; Breschi, Marco; Dine, Ylli; Lino, Mario; Zaccara, Gaetano; Viggiano, Maria Pia; Rossi, Simone; Bestmann, Denslow, Gangitano, Giacino, Giacino, Gosseries, Guy, Louise-Bender Pape, Maeda, Manganotti, Monti, Naro, Naro, Piccione, Ragazzoni, Rosanova, Rossi, Rossi, Rossini, Schiff, Schnakers, Sommer, Synek, Thibaut, Yamamoto, Yamamoto",2015.0,,0,0,
8318,An evaluation of the feasibility and safety of a home-based telemental health treatment for posttraumatic stress in the U.S. military.,"Background: Although home-based telemental health options have the potential to greatly expand the range of services available to U.S. military service members, there remains a need to demonstrate that home-based care is technically feasible, safe, and effective and meets the military health system's standards of care before widespread implementation can be achieved. The purpose of this preliminary study was to evaluate the feasibility and safety of providing U.S. military service members with a behavioral health treatment delivered directly to the home using videoconferencing. Materials and Methods: Ten previously deployed soldiers volunteered to complete eight sessions of a novel behavioral activation treatment for post-traumatic stress disorder. The primary clinical outcomes assessed included symptoms of posttraumatic stress and depression. Patient safety data and attitudes about seeking mental health services, treatment satisfaction, treatment adherence, and treatment compliance were also assessed. Results: Clinically significant reductions in posttraumatic stress symptom severity and depression symptoms were observed. Soldiers indicated high levels of satisfaction with the treatment, and there were no adverse events requiring activation of emergency safety procedures. Technical problems associated with the network were observed but successfully mitigated. Conclusions: The results provide initial support for the feasibility and safety of telemental health treatments delivered by videoconferencing to the homes of soldiers. The optimal technical infrastructure needs to be determined to support expansion of synchronous videoconferencing capabilities to the home. The findings provide preliminary evidence of the feasibility, safety, and high user satisfaction with home-based telemental health in the military setting. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Luxton, David D; Pruitt, Larry D; O'Brien, Karen; Kramer, Gregory; Attkisson, Beck, Beck, Blake, Buysse, Carpenter, Cohen, Dimidjian, Foa, Godleski, Gros, Hewitt, Hilty, Jakupcak, Jakupcak, Larsen, Luxton, Luxton, Martell, Mullen, Schnurr, Shore, Strachan, Strachan, Wagner, Weathers",2015.0,,0,0,
8319,Early intervention for preventing posttraumatic stress disorder: An Internet-based virtual reality treatment.,"Background: Posttraumatic stress disorder (PTSD) develops in approximately 20% of people exposed to a traumatic event, and studies have shown that cognitive-behavioral therapy (CBT) is effective as a treatment for chronic PTSD. It has also been shown to prevent PTSD when delivered early after a traumatic event. However, studies have shown that uptake of early treatment is generally low, and therefore, the need to provide interventions through other mediums has been identified. The use of technology may overcome barriers to treatment. Objective: This paper describes a randomized controlled trial that will examine an early CBT intervention for PTSD. The treatment incorporates virtual reality (VR) as a method for delivering exposure-based elements of the treatment. The intervention is Internet based, such that the therapist and patient will ''meet'' in a secure online site. This site will also include multi-media components of the treatment (such as videos, audios, VR) that can be accessed by the patient between sessions. Method: Two hundred patients arriving to a Level 1 emergency department following a motor vehicle accident will be randomly assigned to either treatment or control groups. Inclusion criteria are age 18-65, PTSD symptoms 2 weeks posttrauma related to current trauma, no suicidality, no psychosis. Patients will be assessed by telephone by a team blind to the study group, on four occasions: before and after treatment, and 6 and 12 months posttreatment. The primary outcome is PTSD symptoms at follow up. Secondary outcomes include depression and cost effectiveness. Analyses will be on an intention-to-treat basis. Discussion: The results will provide more insight into the effects of preventive interventions, in general, and Internet-based early interventions, in particular, on PTSD, in an injured population, during the acute phase after trauma. We will discuss possible strengths and limitations. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Freedman, Sara A; Dayan, Ehud; Kimelman, Yael Bleich; Weissman, Heidi; Eitan, Renana; Beck, Bisson, Bollen, Bryant, Bryant, Difede, Difede, First, Freedman, Freedman, Hoge, Kazdin, Kearns, Klein, Knaevelsrud, Lange, Lisetti, Little, Meyerbroker, Mouthaan, Muthen, Rothbaum, Ruwaard, Shalev, Shalev, Sijbrandij, Van Roijen, Weathers, Weathers",2015.0,,0,0,
8320,"Repetitive Transcranial Magnetic Stimulation (rTMS) improves symptoms and reduces clinical illness in patients suffering from OCD: Results from a single-blind, randomized clinical trial with sham cross-over condition.","Objectives: Both psychotherapeutic and psychopharmacological methods are used in the treatment of patients suffering from obsessive-compulsive disorders (OCD), and both with encouraging but also mixed results. Here, we tested the hypothesis that repetitive Transcranial Magnetic Stimulation (rTMS) improves symptoms and reduces illness severity in patients suffering from treatment-resistant OCD. Methods: A total of 21 patients (57% females; mean age: M = 35.8 years) suffering from treatment-resistant OCD were randomly assigned either to an rTMS-first-sham-second, or a sham-first-rTMS-second condition. Treatment sessions lasted for 4 weeks with five sessions per week, each of about 50 min duration. Symptoms were assessed via both self- and expert-ratings. Results: Both self- and expert-reported symptom severity reduced in the rTMS condition as compared to the sham condition. Full- and partial responses were observed in the rTMS-condition, but not in the sham-condition. Conclusions: The pattern of results from this single-blind, sham- and cross-over design suggests that rTMS is a successful intervention for patients suffering from treatment-resistant OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Haghighi, Mohammad; Shayganfard, Mehran; Jahangard, Leila; Ahmadpanah, Mohammad; Bajoghli, Hafez; Pirdehghan, Azar; Holsboer-Trachsler, Edith; Brand, Serge; Ackerman, Baxter, Berlim, Blom, First, Foa, Franklin, Ghaleiha, Goodman, Grabill, Guy, Haghighi, Hezel, Hollander, Jaafari, Kang, Karno, Kessler, Leon, Ma, Mantovani, Mataix-Cols, Nakao, Pallanti, Piras, Rauch, Ridding, Ruffini, Ruscio, Sachdev, Sarkhel, Saxena, Siebner, Stewart, Swedo, Wu, Yoo",2015.0,,0,0,
8321,Computer-assisted cognitive behavior therapy for obsessive-compulsive disorder: A randomized trial on the impact of lay vs. professional coaching.,"Background: The purpose of the study was to examine the impact of computerized cognitive behavior therapy (CBT) self-help treatment for obsessive-compulsive disorder (OCD) (BT Steps) both alone and when supported by coaching from either a lay non-therapist coach or an experienced CBT therapist. Methods: Eighty-seven subjects with clinically significant OCD were recruited through newspaper ads and randomly assigned to receive 12 weeks of treatment with either BT Steps alone (n = 28), BT Steps with non-therapist coaching (n = 28), or BT Steps with CBT therapist coaching (n = 31). Subjects worked on BT Steps at their own pace. Subjects receiving BT Steps alone received a welcome call from the project manager. Subjects randomized to either of the coaching arms received regularly scheduled weekly phone calls for coaching, encouragement, and support. No formal therapy was provided by the coaches; thus, both lay and CBT coaches completed the same tasks. Results: All three treatment arms showed a significant reduction in Yale-Brown Obsessive Compulsive Scale (YBOCS) scores, with mean (SD) changes of 6.5 (5.7), 7.1 (6.1), and 6.5 (6.1) for the no coaching, lay coaching, and therapist coaching arms, respectively (all p's < .001). These represent effect sizes of 1.16, 1.41, and 1.12, respectively. No significant differences were found between treatment arms on YBOCS change scores, F(2) = 0.10, p = .904, or number of exposures sessions done (F(2) = 0.033, p = .967). When asked which method of therapy (computer vs. clinician) they preferred, 48% said computer, 33% said face-to-face therapy, and 19% had no preference. Conclusions: Results support the use of online self-help for the treatment of moderate OCD. The addition of coaching by either a lay coach or a CBT therapist coach did not significantly improve outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kobak, Kenneth A; Greist, Revere; Jacobi, David M; Levy-Mack, Hollie; Greist, John H; Abramowitz, Andersson, Andersson, Andersson, Andersson, Andrews, Baer, Bangor, Blanco, Bower, Brooke, Chamberlain, Chambless, Clay, Cohen, Cohen, Craig, Cuijpers, Cuthbert, Diefenbach, Dunbar, DuPont, Fairburn, First, Foa, Franx, Gilliam, Goodman, Greist, Grist, Gutierrez, Hofmann, Hollander, Jayakumar, Jenike, Kaltenthaler, Kenwright, Kessler, Khan, Khanna, Kobak, Kobak, Lovell, Marks, Marks, Marks, Marks, McCrone, Mojtabai, Mundt, Murray, Norton, Patel, Pato, Posner, Pozza, Robins, Rosenfeld, Seekles, Selmi, Spek, Stein, Stewart, Stewart, Tolin, Torres, van Straten, Warren, Whaley, Wootton, Wootton, Wootton",2015.0,,0,0,
8322,Cost-effectiveness of internet-based cognitive behavior therapy for obsessive-compulsive disorder: Results from a randomized controlled trial.,"Obsessive-compulsive disorder (OCD) is a common and disabling disorder. Although evidence-based psychological treatments exists, such as cognitive behavior therapy (CBT), the cost-effectiveness of CBT has not been properly investigated. In this trial, we used health economic data from a recently conducted randomized controlled trial, where 101 OCD patients were allocated to either internet-based CBT (ICBT) or control condition (online support therapy). We analyzed treatment effectiveness in relation to costs, using both a societal- (including all direct and indirect costs) and a health care unit perspective (including only the direct treatment costs). Bootstrapped net benefit regression analyses were also conducted, comparing the difference in costs and effects between ICBT and control condition, with different willingness-to-pay scenarios. Results showed that ICBT produced one additional remission for an average societal cost of $931 and this figure was even lower ($672) when narrowing the perspective to treatment costs only. The cost-utility analysis also showed that ICBT generated one additional QALY to an average price of $7186 from a societal perspective and $4800 when just analyzing the treatment costs. We conclude that ICBT is a cost-effective treatment and the next step in this line of research is to compare the cost-effectiveness of ICBT with face-to-face CBT. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Andersson, Erik; Hedman, Erik; Ljotsson, Brjann; Wikstrom, Maja; Elveling, Elin; Lindefors, Nils; Andersson, Gerhard; Kaldo, Viktor; Ruck, Christian; Abramowitz, Andersson, Andersson, Andersson, Andersson, Bergstrom, Blanco, Crippa, Cuijpers, Cuijpers, Diefenbach, Drummond, Gava, Ginsberg, Goodman, Grosse, Hajebi, Hakkaart-van Roijen, Hedman, Hedman, Hedman, Hunot, Jacobson, Kohn, Larsson, Litz, Marques, Mataix-Cols, McCrone, Patel, Rabin, Reinhardt, Rohde, Shapiro, Smit, Tolin, Torres, Ward, Wootton, Wootton",2015.0,,0,0,
8323,Impaired trial-by-trial adjustment of cognitive control in obsessive compulsive disorder improves after deep repetitive transcranial magnetic stimulation.,"Background: Adaptive decision making requires the adjustment of behaviour following an error. Some theories suggest that repetitive thoughts and behaviours in obsessive compulsive disorder (OCD) are driven by malfunctioning error monitoring. This malfunction may relate to demonstrated hyperactivity in the medial prefrontal cortex (mPFC), including the dorsal anterior cingulate cortex. In this study, we measured aspects of error monitoring in individuals with OCD and administered deep low frequency repetitive transcranial magnetic stimulation (rTMS) in an attempt to modulate error monitoring capacity. Methods: For this pilot study, ten OCD patients and 10 aged-matched healthy controls completed modified versions of the Eriksen Flanker task before and after one session of deep 1 Hz rTMS (1200 pulses) over the mPFC (Brodmann areas 24 and 32). OCD patients received nine additional sessions of daily rTMS to assess their clinical response. Flanker tasks were repeated with patients post-treatment. Results: Overall error rates were higher for patients compared to controls. When subjects were asked to report their errors, OCD patients were able to report fewer of their errors than the control group. In contrast to controls, patients did not demonstrate a normal post-error slowing (PES) phenomenon. This abnormal PES was mainly driven by abnormally slow response times (RTs) following correct responses rather than a failure to slow down after errors. Patients' symptoms and slowed RTs following correct responses improved after ten sessions of rTMS. Conclusions: Certain aspects of error monitoring, namely conscious error report and post error slowing, are impaired in OCD. These impairments can at least be partly corrected by 1 Hz deep rTMS over the mPFC. Simultaneous improvement of OCD symptoms by this method might suggest a correlation between error monitoring impairment and OCD pathophysiology. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Modirrousta, Mandana; Meek, Benjamin P; Sareen, Jitender; Enns, Murray W; Beck, Beck, Bogte, Candidi, Chen, Coles, De Ridder, Dehaene, Endrass, Fitzgerald, Gehring, Goodman, Hajcak, Hajcak, Hajcak, Harmer, Hayward, Hayward, Holroyd, Iyer, Jentzsch, Johannes, Kerns, Liu, Maltby, Menzies, Modirrousta, Modirrousta, Pailing, Pitman, Rabbitt, Ridderinkhof, Riesel, Rollnik, Rotge, Scheffers, Sergeant, Speer, Speer, Stern, Stokic, Terao, Ursu, Vanneste, Whiteside, Yucel",2015.0,,0,0,
8324,Cost-effectiveness of an internet-based booster program for patients with obsessive-compulsive disorder: Results from a randomized controlled trial.,"Cognitive behavior therapy (CBT) is an effective treatment for OCD when delivered face-to-face, in group-format and also via the internet. However, despite overall large effect sizes, a considerable amount of the patients relapse. One intervention that has the potential to reduce these relapse rates is booster programs, but if booster program is a cost-effective method of preventing relapse is still unknown. We used health economical data from a recent randomized controlled trial, where patients who had undergone an internet-based CBT were randomly allocated to receive an additional booster program. Assessment points were 4-, 7-, 12- and 24-month. Health economical data were primarily analyzed using a societal perspective. Results showed that the booster program was effective in preventing relapse, and the cost of one avoided relapse was estimated to $1066-1489. Cost-effectiveness acceptability curves showed that the booster program had a 90% probability of being cost-effective given a willingness to pay of $1000-1050 the first year, but this figure grew considerably after two years ($2500-5500). We conclude that internet-based booster programs are probably a cost-effective alternative within one-year time frame and that more treatment may be needed to maintain adequate cost-effectiveness up to two years. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Andersson, Erik; Ljotsson, Brjann; Hedman, Erik; Mattson, Simon; Enander, Jesper; Andersson, Gerhard; Kaldo, Viktor; Lindefors, Nils; Ruck, Christian; Abramowitz, Andersson, Andersson, Andersson, Andersson, Braga, Crippa, Cummings, Drummond, Eyberg, Fisher, Gava, Goodman, Grosse, Hajebi, Hakkaart-van Roijen, Hedman, Hedman, Herbst, Jacobson, Lane, Mallinckrodt, McCrone, Patel, Ravizza, Rohde, Rufer, Saha, Simpson, Simpson, Smit, van Oppen, van Roijen, Whisman, Whittal, Wootton, Wootton, Wootton",2015.0,,0,0,
8325,Treatment outcome and predictors of Internet guided self-help for obsessive-compulsive disorder.,"Internet-guided self-help (iGSH) has amassed significant empirical support for a variety of psychiatric conditions; however, it is not known who responds best to these treatments. This open trial examined the clinical outcomes and predictors of a 17-week iGSH program for obsessive-compulsive disorder (OCD). Therapist support was provided either in person or by phone 9 times for an average of 13minutes per session. Twenty-four patients initiated treatment, and 17 of these (70.8%) completed. Results of the intent-to-treat sample indicated statistically significant improvements at posttreatment with large treatment effects for OCD symptoms as assessed by the Yale Brown Obsessive-Compulsive Scale (d = 0.87), and small to moderate improvements in depression (d = 0.19), functioning (d = 0.53), and quality of life (d = -0.18). These outcomes were largely maintained over a 6-month follow-up. Readiness to reduce avoidance of OCD triggers and attendance to therapist sessions were moderately associated with posttreatment response, and correctly classified the responder status (defined as clinically significant change) of nearly 9 out of 10 patients at posttreatment. These same variables did not predict responder status at 6-month follow-up. These results lend further empirical support to iGSH as a treatment for OCD and provide direction on the development of predictor models to identify patients who are and are not likely to acutely respond to iGSH. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Diefenbach, Gretchen J; Wootton, Bethany M; Bragdon, Laura B; Moshier, Samantha J; Tolin, David F; Andersson, Andersson, Andersson, Bachofen, Bachofen, Bendelin, Boettcher, Brown, Carroll, Cohen, Cuijpers, Diefenbach, Dwolatzky, Frisch, Frisch, Gilliam, Goodman, Goodman, Greist, Greist, Guy, Harris, Herbst, Hilvert-Bruce, Jacobson, Johnson, Keeley, Kenwright, Koran, Leon, Leon, Lovibond, Maher, Mahoney, Maltby, March, Marks, Marques, Mataix-Cols, Mohlman, Olatunji, Sheehan, Sheehan, Shoham, Simpson, Simpson, Simpson, Steketee, Tolin, Vandborg, Woods, Wootton, Wootton, Wootton, Wootton",2015.0,,0,0,
8326,Resting-state connectivity of the amygdala predicts response to cognitive behavioral therapy in obsessive compulsive disorder.,"Background: Obsessive-compulsive disorder (OCD) is a psychiatric disorder which is characterized by recurrent intrusive thoughts (obsessions) and ritualized, repetitive behaviors or mental acts (compulsions). The gold standard for the treatment of OCD is cognitive behavioral therapy (CBT) with exposure and response prevention. This is the first study exploring the predictive value of resting-state functional connectivity for the outcome of CBT. Methods: We assessed whole-brain resting-state functional connectivity in a group of 17 un-medicated OCD inpatients prior to CBT compared to 19 healthy controls using functional magnetic resonance imaging. The graph theoretical metric degree centrality served as indicator for altered voxel-wise whole-brain functional connectivity. The relative change in the Yale-Brown Obsessive Compulsive Scale (YBOCS) score was used to evaluate treatment outcome. Results: The degree centrality of the right basolateral nuclei group of the amygdala was positively correlated with the response to subsequent CBT. OCD patients showed a lower degree centrality of the superficial amygdala (bilateral). Conclusions: Our results suggest that two different sub-regions of the amygdala and their respective neural networks are affected in OCD: the superficial amygdala and networks related to evaluation of reinforcers and risk anticipation and the basolateral amygdala which is implicated in fear processing. The diminished CBT response in patients showing a lower degree centrality of the basolateral amygdala reflects a deficient fear circuit in these patients which may impact fear extinction as a core mechanism of exposure-based CBT. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Gottlich, Martin; Kramer, Ulrike M; Kordon, Andreas; Hohagen, Fritz; Zurowski, Bartosz; Abramowitz, Adler, Admon, Amunts, Anticevic, Arnott, Baxter, Baxter, Baxter, Bennett, Berlim, Beucke, Breiter, Brody, Bryant, Buckner, Bullmore, Bzdok, Bzdok, Chamberlain, Chamberlain, Cohen, Cooper, Cooper, de Wit, Denys, Eickhoff, Etkin, Figee, Figee, Fitzgerald, Fitzgerald, Fullana, Goodman, Goossens, Gottlich, Gottlich, Gottlich, Hamilton, Harrison, Herry, Hofmann, Hou, Kalisch, Kim, LeDoux, Linnman, Maltby, Maren, Mataix-Cols, Menzies, Milad, Milad, Milad, Milad, Munte, Murphy, Murray, O'Neill, Olatunji, Oldfield, Orsini, Pallanti, Paraskevopoulos, Phelps, Poldrack, Power, Pujol, Quirk, Rauch, Repa, Rosa-Alcazar, Rotge, Roy, Saad, Saxena, Saxena, Saxena, Saxena, Schlosser, Schuller, Schwartz, Shapira, Shin, Simon, Stuber, Swedo, Valente, van den Heuvel, van den Heuvel, Van Dijk, Veale, Watkins, Yan, Zhang, Zuo, Zurowski",2015.0,,0,0,
8327,Alexithymia and personality in patients with anxiety disorders and major depression: Effects on treatment outcome.,"Objectives: Alexithymia is frequently associated with major depression and anxiety disorders, and in the literature it is considered as a negative prognostic factor in the treatment of these disorders. Nevertheless, limited evidence is available about the effect of alexithymia on treatment outcome. In this study, we analyze the presence of alexithymia in patients with depressive or anxiety disorders. In addition, we investigate the effects of alexithymia considered as a single factor, and the interaction between alexithymia and socio-demographics and clinical variables (personality traits) as modulators of response to combined treatment. Materials and methods: Eighteen outpatients with major depression or anxiety disorders underwent pharmacotherapy and individual psychodynamic psychotherapy. Subjects were assessed using the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A) and the Toronto Alexithymia Scale 20-item (TAS-20) at baseline and after eight weeks of treatment. Personality traits were assessed with the SCID II at baseline. Outcome was the change in scores of HAM-D and HAM-A from baseline to the eight weeks of treatment. Predictor was the TAS score. The statistical relationship between outcome and predictor was analyzed by linear regression. In the regression model, we included stratification factors (socio-demographics and clinical variables) as covariates if they had a significant statistic relationship with the main outcome and their interaction with the main outcome is included. Results: After eight weeks of treatment, we observed an improvement of 78% on HAM-D and of 69% on HAM-A, while 55.5% of subjects were not alexithymic, 22.2% were borderline alexithymic and 5.5% were diagnosed as alexithymic. No significant effect resulted from the analysis of alexithymia as a modulator of response to anxiety or depressive symptoms. On the other hand, the combination of alexithymia with ""older age"" predicted worse outcome by the HAM-D (p = 0.02873). Moreover, we observed a negative correlation between ""obsessive-compulsive personality traits"" and improvement on HAM-D (p = 0.002314), and a positive correlation between alexithymia and obsessive-compulsive personality traits (p = 0.02629). Conclusions: Alexithymia may interfere with response to treatment in subjects with depressive or anxiety disorders when combined with other socio-demographic and clinical variables. Further research is mandatory to confirm these results. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Mori, E; Drago, A; De Ronchi, D; Serretti, A; Bach, Bach, Bagby, Bamonti, Brieger, Cartensen, Cramer, De Berardis, Dimaggio, Eizaguirre, Evans, Farabaugh, Farabaugh, Fava, Fava, First, Grabe, Grant, Gunderson, Gunzelmann, Hamilton, Hamilton, Haviland, Hayden, Honkalampi, Honkalampi, Honkalampi, Honkalampi, Honkalampi, Ilardi, Katona, Kauhanen, Kirmayer, Klein, Kupfer, Leweke, Lipsanen, Lopez-Castroman, Loranger, Luminet, Marton, Mattila, McCallum, Morey, Mori, Nemiah, Nicolo, Ogrodniczuk, Ogrodniczuk, Ogrodniczuk, Ozsahin, Parker, Parker, Parker, Pasini, Pfohl, Pfohl, Picardi, Porcelli, Reich, Reich, Rufer, Saarijarvi, Saarijarvi, Saarijarvi, Sakuraba, Sato, Shea, Sheehan, Sifneos, Taylor, Taylor, Taylor, Taylor, Todarello, Valliant, Viinamaki, Viinamaki, Wise, Zeitlin",2015.0,,0,0,
8328,"Effects of therapeutic relationship, expectancy, and credibility in breathing therapies for anxiety.","The authors investigated the effects of the quality of the therapeutic alliance, expectancy of improvement, and credibility of treatment on the outcome of two breathing therapies for anxiety and panic. Data were collected during a randomized clinical trial evaluating the efficacy of two theoretically opposing, end-tidal pCO2 feedback-assisted breathing therapies for patients experiencing anxiety attacks. In this study, five weekly individual breathing therapy sessions were administered for the patients who were experiencing anxiety attacks as symptoms of various anxiety disorders. The outcome of this trial indicated that regardless of the opposing breathing instructions (raise or lower pCO2) used in the two breathing therapies, patients in both treatment groups improved equally after treatment. Nonspecific factors rather than the different directions of pCO2 changes could have played a role in the improvement. Regression analyses showed that for both therapies patient-rated therapeutic alliance was predictive of improvement at the 1-month follow-up, and that patient-rated confidence that the therapy would produce improvement, an aspect of its credibility, accounted for almost half of the variance in improvement at the 6-month follow-up. Thus, two factors usually considered nonspecific were identified to be potent predictors of treatment outcome. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kim, Sunyoung; Roth, Walton T; Wollburg, Eileen; Baldwin, Barrett-Lennard, Beck, Chambless, Constantino, Devilly, Dinger, First, Horvath, Horvath, Joyce, Joyce, Keijsers, Kim, Martin, Patterson, Peterson, Price, Roth, Roth, Safren, Shear, Simmons, Sotsky, Tracy, Van Minnen, Vogel, Westra, Wollburg",2015.0,,0,0,
8329,Prognostic subgroups for remission and response in the Coordinated Anxiety Learning and Management (CALM) trial.,"Objective: Most patients with anxiety disorders receive treatment in primary care settings. Limited moderator data are available to inform clinicians of likely prognostic outcomes for individual patients. We identify baseline characteristics associated with outcome in adults seeking treatment for anxiety disorders. Method: We conducted an exploratory moderator analysis from the Coordinated Anxiety Learning and Management (CALM) trial. In the CALM trial, 1,004 adults who met DSM-IV criteria for generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, and/or posttraumatic stress disorder (PTSD) were randomized to usual care (UC) or a collaborative care intervention (ITV) of cognitive-behavioral therapy and/or pharmacotherapy between June 2006 and April 2008. Logistic regression was used to examine baseline characteristics associated with remission and response overall and by treatment condition. Receiver operating curve (ROC) analyses identified subgroups associated with similar likelihood of response and remission of global anxiety symptoms. Remission was defined as score < 6 on the 12-item Brief Symptom Inventory (BSI-12) anxiety and somatization subscales. Response was defined as at least 50% reduction on BSI-12, or meeting remission criteria. Results: Randomization to ITV over UC was often the strongest predictor of outcome. Several baseline patient characteristics were associated with poor treatment outcome including comorbid depression, increased severity of underlying anxiety disorder(s) (P < .001), low socioeconomic status (perceived [P < .001] and actual [P < .05]), and limited social support (P < .001). Patient characteristics associated with particular benefit from ITV were being female (P < .05), increased depression (P < .01)/GAD severity (P < .05), and low socioeconomic status (P < .05). ROC analysis demonstrated prognostic subgroups with large differences in response likelihood. Conclusions: Further research should focus on the effectiveness of implementing the ITV intervention of CALM in community treatment centers where patients typically are of low socioeconomic status and may particularly benefit from ITV. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kelly, J. MacLaren; Jakubovski, Ewgeni; Bloch, Michael H; Aaronson, Abramowitz, Adler, Adler, Andrade, Berman, Bohn, Brown, Bruce, Campbell-Sills, Campbell-Sills, Chambless, Clegg, Cohen, Collimore, Connor, Craske, Derogatis, Dohrenwend, Dreessen, Houck, Kanjilal, Kessler, Kessler, Kessler, Kessler, Kessler, Kraemer, Kroenke, Ledley, Lorant, Marmot, McAlpine, Newman, Olatunji, Penninx, Ramnero, Ronalds, Roy-Byrne, Roy-Byrne, Ruggiero, Sareen, Sareen, Schechter, Shear, Sheehan, Simon, Siringhini, Southam-Gerow, Stein, Sullivan, van Balkom, Wang, Weathers, Wolitzky-Taylor, Young",2015.0,,0,0,
8330,Grief-related panic symptoms in Complicated Grief.,"Background: Although Complicated Grief (CG) has been associated with comorbid Panic Disorder (PD), little is known about panic attacks in CG, and whether panic symptoms may be grief-related. The present study examines the presence and impact of grief-related panic symptoms in CG. Methods: Individuals with CG (n=146, 78% women, mean (SD) age = 52.4(15.0)) were assessed for CG, DSM-IV diagnoses, work and social impairment, and with the Panic Disorder Severity Scale modified to assess symptoms ""related to or triggered by reminders of your loss"" and anticipatory worry. Results: Overall, 39.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and 32.2% reported some level of anticipatory worry about grief-related panic. Of interest, 17% met DSM criteria for PD. Among those without PD, 34.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and this was associated with higher CG symptom severity (t = -2.23, p < 0.05), and functional impairment (t = -3.31, p < 0.01). Among the full sample, controlling for CG symptom severity and current PD, the presence of at least one full or limited-symptom grief-related panic attack was independently associated with increased functional impairment (B(SE) = 4.86(1.7), p < 0.01). Limitations: Limitations include a lack of assessment of non-grief-related panic symptoms and examination of a sample of individuals seeking treatment for CG. Conclusions: Grief-related panic symptoms may be prevalent among individuals with CG and independently contribute to distress and functional impairment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Bui, Eric; Horenstein, Arielle; Shah, Riva; Skritskaya, Natalia A; Mauro, Christine; Wang, Yuanjia; Duan, Naihua; Reynolds, Charles F III; Zisook, Sidney; Shear, M. Katherine; Simon, Naomi M; Boelen, Boelen, Bui, Craske, First, Gupta, Houck, Kersting, Marques, Mundt, Nasreddine, Prigerson, Robinaugh, Schmidt, Shear, Simon, Tull",2015.0,,0,0,
8331,Clients' experiences of returning to the trauma site during PTSD treatment: An exploratory study.,"Background: Visits to the location of the trauma are often included in trauma-focused cognitive behavioural therapy (TF-CBT) for post-traumatic stress disorder (PTSD), but no research to date has explored how service users experience these visits, or whether and how they form an effective part of treatment. Aims: The study aimed to ascertain whether participants found site visits helpful, to test whether the functions of the site visit predicted by cognitive theories of PTSD were endorsed, and to create a grounded theory model of how site visits are experienced. Method: Feedback was collected from 25 participants who had revisited the scene of the trauma as part of TF-CBT for PTSD. The questionnaire included both free text items, for qualitative analysis, and forced-choice questions regarding hypothesized functions of the site visit. Results: Overall, participants found the site visits helpful, and endorsed the functions predicted by the cognitive model. A model derived from the feedback illustrated four main processes occurring during the site visit: ""facing and overcoming fear""; ""filling in the gaps""; ""learning from experiences"" and ""different look and feel to the site"", which, when conducted with ""help and support"", usually from the therapist, led to a sense of ""closure and moving on"". Conclusions: Therapist-accompanied site visits may have various useful therapeutic functions and participants experience them positively. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Murray, Hannah; Merritt, Chris; Grey, Nick; Difede, Ehlers, Ehlers, Foa, Foa, Glaser, Goncalves, Grey, Jaycox, Jones, Mundfrom, Murray, Rizzo, Rizzo, Shearing, Strauss, Tolin, Viera",2016.0,,0,0,
8332,Untangling attention bias modification from emotion: A double-blind randomized experiment with individuals with social anxiety disorder.,"Background: Uncertainty abounds regarding the putative mechanisms of attention bias modification (ABM). Although early studies showed that ABM reduced anxiety proneness more than control procedures lacking a contingency between cues and probes, recent work suggests that the latter performed just as well as the former did. In this experiment, we investigated a non-emotional mechanism that may play a role in ABM. Methods: We randomly assigned 62 individuals with a DSM-IV diagnosis of social anxiety disorder to a single-session of a non-emotional contingency training, non-emotional no-contingency training, or control condition controlling for potential practice effects. Working memory capacity and anxiety reactivity to a speech challenge were assessed before and after training. Results: Consistent with the hypothesis of a practice effect, the three groups likewise reported indistinguishably significant improvement in self-report and behavioral measures of speech anxiety as well as in working memory. Repeating the speech task twice may have had anxioltyic benefits. Limitations: The temporal separation between baseline and post-training assessment as well as the scope of the training sessions could be extended. Conclusions: The current findings are at odds with the hypothesis that the presence of visuospatial contingency between non-emotional cues and probes produces anxiolytic benefits. They also show the importance of including a credible additional condition controlling for practice effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Heeren, Alexandre; Coussement, Charlotte; McNally, Richard J; Amir, Beck, Beck, Bishop, Bomyea, Bruchon-Schweitzer, Calamia, Calero, Clarke, Cohen, Cristea, Duff, Duff, Duff, Emmelkamp, Enock, Faul, Heeren, Heeren, Heeren, Heeren, Heeren, Heeren, Hook, Julian, Klumpp, Lecrubier, Li, Liebowitz, Linetzky, MacLeod, MacLeod, MacLeod, McNally, Miller, Morrison, Mulac, Myers, Peschard, Pessoa, Schmidt, Spielberger, Wechsler, Wolpe",2016.0,,0,0,
8333,Augmenting cognitive processing therapy to improve sleep impairment in PTSD: A randomized controlled trial.,"Objective: Despite the success of empirically supported treatments for posttraumatic stress disorder (PTSD), sleep impairment frequently remains refractory after treatment. This single-site, randomized controlled trial examined the effectiveness of sleep-directed hypnosis as a complement to an empirically supported psychotherapy for PTSD (cognitive processing therapy [CPT]). Method: Participants completed either 3 weeks of hypnosis (n = 52) or a symptom monitoring control condition (n = 56) before beginning standard CPT. Multilevel modeling was used to investigate differential patterns of change to determine whether hypnosis resulted in improvements in sleep, PTSD, and depression. An intervening variable approach was then used to determine whether improvements in sleep achieved during hypnosis augmented change in PTSD and depression during CPT. Results: After the initial phase of treatment (hypnosis or symptom monitoring), the hypnosis condition showed significantly greater improvement than the control condition in sleep and depression, but not PTSD. After CPT, both conditions demonstrated significant improvement in sleep and PTSD; however, the hypnosis condition demonstrated greater improvement in depressive symptoms. As sleep improved, there were corresponding improvements in PTSD and depression, with a stronger relationship between sleep and PTSD. Conclusion: Hypnosis was effective in improving sleep impairment, but those improvements did not augment gains in PTSD recovery during the trauma-focused intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Impact Statement What is the public health significance of this article?-This study suggests that hypnosis may be a viable treatment option in a stepped-care approach for treating sleep impairment in individuals suffering from PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Galovski, Tara E; Harik, Juliette M; Blain, Leah M; Elwood, Lisa; Gloth, Chelsea; Fletcher, Thomas D; Babson, Backhaus, Barlow, Bastien, Beck, Belleville, Blake, Buysse, Casement, Cordi, Cordi, Davis, DeViva, DeViva, Feingold, Foa, Forbes, Forbes, Forbes, Galovski, Galovski, Germain, Hansen, Harvey, Kennedy, Krakow, Krakow, Krakow, Krull, Long, MacKinnon, MacKinnon, Manber, McCurry, Modlin, Montgomery, Moore, Moore, Morin, Ohayon, Pinheiro, Pinheiro, Resick, Schoenfeld, Scholz, Schottenbauer, Singer, Spira, Spoormaker, Staner, Stanton, Stanton, Talbot, Tsuno, Ulmer, van der Kolk, Weathers, Wright, Zayfert",2016.0,,0,0,
8334,The outcome of short- and long-term psychotherapy 10 years after start of treatment.,"Background: Empirical evidence on whether patients' mental health and functioning will be more improved after long-term than short-term therapy is scarce. We addressed this question in a clinical trial with a long follow-up. Method: In the Helsinki Psychotherapy Study, 326 out-patients with mood or anxiety disorder were randomly assigned to long-term psychodynamic psychotherapy (LPP), short-term psychodynamic psychotherapy (SPP) or solution-focused therapy (SFT) and were followed for 10 years. The outcome measures were psychiatric symptoms, work ability, personality and social functioning, need for treatment, and remission. Results: At the end of the follow-up, altogether 74% of the patients were free from clinically elevated psychiatric symptoms. Compared with SPP, LPP showed greater reductions in symptoms, greater improvement in work ability and higher remission rates. A similar difference in symptoms and work ability was observed in comparison with SFT after adjustment for violations of treatment standards. No notable differences in effectiveness between SFT and SPP were observed. The prevalence of auxiliary treatment was relatively high, 47% in SFT, 58% in SPP and 33% in LPP, and, accordingly, the remission rates for general symptoms were 55, 45 and 62%, respectively. Conclusions: After 10 years of follow-up, the benefits of LPP in comparison with the short-term therapies are rather small, though significant in symptoms and work ability, possibly due to more frequent use of auxiliary therapy in the short-term therapy groups. Further studies should focus on the choice of optimal length of therapy and the selection of factors predicting outcome of short- v. long-term therapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Knekt, P; Virtala, E; Harkanen, T; Vaarama, M; Lehtonen, J; Lindfors, O; Andrews, Antonovsky, Benjamin, Bond, De Shazer, Derogatis, Gabbard, Gabbard, Graubard, Heinonen, Hoglend, Holi, Horowitz, Huber, Harkanen, Harkanen, Knekt, Knekt, Knekt, Knekt, Knekt, Koskinen, Laaksonen, Laaksonen, Lee, Leichsenring, Leichsenring, Liang, Lindfors, Malan, Migon, Perry, Rhebergen, Rubin, Shedler, Smit, Steinert, Town, Tuulio-Henriksson, Verbeke, Vittengl, Weissman, Wilczek",2016.0,,0,0,
8335,"Feasibility, acceptability, and potential efficacy of the PTSD Coach app: A pilot randomized controlled trial with community trauma survivors.","Objective: Posttraumatic stress disorder (PTSD) is a major public health concern. Although effective treatments exist, affected individuals face many barriers to receiving traditional care. Smartphones are carried by nearly 2 thirds of the U.S. population, offering a promising new option to overcome many of these barriers by delivering self-help interventions through applications (apps). As there is limited research on apps for trauma survivors with PTSD symptoms, we conducted a pilot feasibility, acceptability, and potential efficacy trial of PTSD Coach, a self-management smartphone app for PTSD. Method: A community sample of trauma survivors with PTSD symptoms (N = 49) were randomized to 1 month using PTSD Coach or a waitlist condition. Self-report assessments were completed at baseline, postcondition, and 1-month follow-up. Following the postcondition assessment, waitlist participants were crossed-over to receive PTSD Coach. Results: Participants reported using the app several times per week, throughout the day across multiple contexts, and endorsed few barriers to use. Participants also reported that PTSD Coach components were moderately helpful and that they had learned tools and skills from the app to manage their symptoms. Between conditions effect size estimates were modest (d = -0.25 to -0.33) for PTSD symptom improvement, but not statistically significant. Conclusions: Findings suggest that PTSD Coach is a feasible and acceptable intervention. Findings regarding efficacy are less clear as the study suffered from low statistical power; however, effect size estimates, patterns of within group findings, and secondary analyses suggest that further development and research on PTSD Coach is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Miner, Adam; Kuhn, Eric; Hoffman, Julia E; Owen, Jason E; Ruzek, Josef I; Taylor, C. Barr; Amstadter, Cukor, Donker, Donkin, Foa, Free, Hoffman, Hoge, Kazdin, Kazdin, Kessler, Kessler, Kessler, Kuhn, Lopez, Mohr, Monson, Read, Roberts, Shalev, Smith, Spence, Weathers, Wilkins",2016.0,,0,0,
8336,Baseline patient characteristics predicting outcome and attrition in cognitive therapy for social phobia: Results from a large multicentre trial.,"We examined the role of baseline patient characteristics as predictors of outcome (end-state functioning, response and remission) and attrition for cognitive therapy (CT) in social anxiety disorder (SAD). Beyond socio-demographic and clinical variables such as symptom severity and comorbidity status, previously neglected patient characteristics (e.g., personality, self-esteem, shame, interpersonal problems and attachment style) were analysed. Method Data came from the CT arm of a multicentre RCT with n = 244 patients having DSM-IV SAD. CT was conducted according to the manual by Clark and Wells. Severity of SAD was assessed at baseline and end of treatment with the Liebowitz Social Anxiety Scale (LSAS). Multiple linear regression analyses and logistic regression analyses were applied. Results Up to 37% of the post-treatment variance (LSAS) could be explained by all pre-treatment variables combined. Symptom severity (baseline LSAS) was consistently negatively associated with end-state functioning and remission, but not with response. Number of comorbid diagnoses was negatively associated with end-state functioning and response, but not with remission. Self-esteem was positively associated with higher end-state functioning and more shame with better response. Attrition could not be significantly predicted. Conclusions The results indicate that the initial probability for treatment success mainly depends on severity of disorder and comorbid conditions while other psychological variables are of minor importance, at least on a nomothetic level. This stands in contrast with efforts to arrive at an empirical-based foundation for differential indication and argues to search for more potent moderators of therapeutic change rather on the process level. Key Practitioner Message: 1. Personality, self-esteem, shame, attachment style and interpersonal problems do not or only marginally moderate the effects of interventions in CT of social phobia. 2. Symptom severity and comorbid diagnoses might affect treatment outcome negatively. 3. Beyond these two factors, most patients share a similar likelihood of treatment success when treated according to the manual by Clark and Wells. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hoyer, Juergen; Wiltink, Joerg; Hiller, Wolfgang; Miller, Robert; Salzer, Simone; Sarnowsky, Stephan; Stangier, Ulrich; Strauss, Bernhard; Willutzki, Ulrike; Leibing, Eric; Abbott, Alden, Allen, Babyak, Bandelow, Bender, Birtchnell, Blanco, Brown, Clark, Clark, Clark, Cloninger, Constantino, Davidson, Davies-Osterkamp, Deusinger, Driessen, Durham, Ehrenthal, Fehm, Fehm, Frei, Gilbert, Hautzinger, Hofler, Horowitz, Hoyer, Jacobson, Kashdan, Kocherscheidt, Krebs, Leichsenring, Leichsenring, Leichsenring, Levy, Liebowitz, Lincoln, Linden, Matos, McEvoy, Mennin, Mululo, Niles, Olatunji, Powers, Ruscio, Salzer, Stangier, Stangier, Stangier, Tsai, Uhmann, van Velzen, von Consbruch, Wittchen",2016.0,,0,0,
8337,Drinking to cope with negative emotions moderates alcohol use disorder treatment response in patients with co-occurring anxiety disorder.,"Background: Epidemiological studies and theory implicate drinking to cope (DTC) with anxiety as a potent moderator of the association between anxiety disorder (AnxD) and problematic alcohol use. However, the relevance of DTC to the treatment of alcohol use disorder (AUD) in those with a co-occurring AnxD has not been well studied. To address this, we examined whether DTC moderates the impact of two therapies: (1) a cognitive behavioral therapy (CBT) designed to reduce DTC and anxiety symptoms; (2) a progressive muscle relaxation training (PMRT) program designed to reduce anxiety symptoms only. Methods: Patients undergoing a standard AUD residential treatment with a co-occurring AnxD (N = 218) were randomly assigned to also receive either the CBT or PMRT. DTC in the 30 days prior to treatment was measured using the Unpleasant Emotions subscale of the Inventory of Drinking Situations. Results: Confirming the predicted moderator model, the results indicated a significant interaction between treatment group and level of pre-treatment DTC behavior. Probing this interaction revealed that for those reporting more pre-treatment DTC behavior, 4-month alcohol outcomes were superior in the CBT group relative to the PMRT group. For those reporting less pre-treatment DTC behavior, however, 4-month alcohol outcomes were similar and relatively good in both treatment groups. Conclusions: These findings establish a meaningful clinical distinction among those with co-occurring AUD-AnxD based on the degree to which the symptoms of the two disorders are functionally linked through DTC. Those whose co-occurring AUD-AnxD is more versus less strongly linked via DTC are especially likely to benefit from standard AUD treatment that is augmented by a brief CBT designed to disrupt this functional link. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Anker, J. J; Kushner, M. G; Thuras, P; Menk, J; Unruh, A. S; Agrawal, Annis, Annis, Beck, Bernstein, Book, Bowen, Cannon, Crum, Crum, Driessen, Falk, Feinstein, First, Goldsmith, Ham, Hobbs, Horton, Kessler, Kessler, Koob, Koob, Kushner, Kushner, Kushner, Kushner, Kushner, Kushner, Lau-Barraco, Manzoni, Marlatt, McClelland, Menary, Norton, O'Malley, Parra, Pedersen, Pettinati, Randall, Schade, Schuckit, Siev, Sobell, Spielberger, Stasiewicz, Stasiewicz, Terlecki, Thomas, Waldrop",2016.0,,0,0,
8338,Working alliance and competence as predictors of outcome in cognitive behavioral therapy for social anxiety and panic disorder in adults.,"Objective: The research on the association between the working alliance and therapist competence/adherence and outcome from cognitive behavioral therapy (CBT) is limited and characterized by inconclusive findings. This study investigates the working alliance and competence/adherence as predictors of outcome of CBT for social anxiety disorder (SAD) and panic disorder (PD). Method: Eighty-two clinically referred patients (58.5% female; age: M = 33.6 years, SD = 10.3) with PD (n = 31) or SAD (n = 51) were treated with 12 sessions of manualized CBT by 22 clinicians with limited CBT experience in a randomized controlled effectiveness trial. Independent assessors rated the CBT competence/adherence of the therapists using a revised version of the Cognitive Therapy Adherence and Competence Scale, and the patients rated the quality of the working alliance using the Working Alliance Inventory-short form in therapy sessions 3 and 8. The outcome was assessed by independent assessors as well as by patients self-report. A total of 20.7% of the patients (27.5% SAD, 9.7% PD) dropped out during treatment. The association between the alliance, competence/adherence, outcome and dropout was investigated using multiple regression analyses. Results: Higher therapist' competence/adherence early in the therapy was associated with a better outcome among PD patients, lower competence/adherence was associated with dropout among SAD patients. Higher rating of the alliance late in the therapy was associated with a better outcome, whereas lower alliance rating late in the therapy was associated with dropout. Conclusion: The findings indicate that the therapist competence/adherence and the working alliance have independent contributions to the outcome from CBT for anxiety disorders, but in different phases of the treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Haug, Thomas; Nordgreen, Tine; Ost, Lars-Goran; Tangen, Tone; Kvale, Gerd; Hovland, Ole Johan; Heiervang, Einar R; Havik, Odd E; Acarturk, Aderka, Ahn, Arbuckle, Barber, Barber, Barber, Barber, Barber, Barber, Barlow, Bordin, Boswell, Brown, Castonguay, Chambless, Clark, Clark, Clerkin, Crits-Christoph, Crits-Christoph, Cuijpers, Cuijpers, Del Re, DeRubeis, Derubeis, Di Nardo, Dobson, Enders, Enders, Feeley, Fernandez-Ballesteros, Field, Finkbeiner, First, First, Fluckiger, Forkmann, Ginzburg, Hahs-Vaughn, Haug, Heck, Heimberg, Hoffart, Hofmann, Horvath, Horvath, Huppert, Huppert, Huppert, Kazdin, Kazdin, Kessler, Kuyken, Lewontin, Martin, Mattick, Messer, Mortberg, Muse, Newman, Newman, Nordgreen, Norton, Olatunji, Ramnero, Roth, Shaw, Strunk, Tabachnick, Taylor, Tracey, Trepka, Waddington, Warner, Webb, Webb, Weck, Woody",2016.0,,0,0,
8339,Symptom exacerbations in trauma-focused treatments: Associations with treatment outcome and non-completion.,"Trauma-focused treatments are underutilized, partially due to clinician concerns that they will cause symptom exacerbation or dropout. We examined a sample of women undergoing Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), and a version of CPT (CPT-C) without a written trauma narrative to investigate the possibility of symptom exacerbation. Participants (n = 192) were drawn from two RCT's. Participants were administered self-report measures of PTSD symptoms (i.e., the PTSD Symptom Scale or Posttraumatic Diagnostic Scale [PSS/PDS]) and the Clinician-Administered PTSD Scale. Exacerbations were defined as increases greater than 6.15 points on the PSS/PDS. A minority of participants experienced PTSD exacerbations during treatment, and there were no significant differences across treatment type (28.6% in CPT, 20.0% in PE, and 14.7% in CPT-C). Neither diagnostic nor trauma-related factors at pre-treatment predicted symptom exacerbations. Those who experienced exacerbations had higher post-treatment PSS/PDS scores and were more likely to retain a PTSD diagnosis (both small but statistically significant effects). However, even those who experienced an exacerbation experienced clinically significant improvement by end of treatment. Further, symptom exacerbations were not related to treatment non-completion. These results indicate that trauma-focused treatments are safe and effective, even for the minority of individuals who experience temporary symptom increases. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Larsen, Sadie E; Stirman, Shannon Wiltsey; Smith, Brian N; Resick, Patricia A; Aderka, Becker, Berger, Blake, Blake, Cahill, Chard, Cloitre, Cook, Cook, Devilly, Devilly, Doane, Ehlers, Feeny, Feindler, Foa, Foa, Foa, Foa, Foa, Foa, Foa, Gradus, Gutner, Hamblen, Hayes, Hayes, Hembree, Jacobson, Jayawickreme, Karlin, Keller, Kelly, Killeen, Kilpatrick, Lester, Lilienfeld, Mott, Olatunji, Pitman, Pitman, Pitman, Resick, Resick, Resick, Resick, Resick, Resick, Rosen, Rosen, Rowan, Shiner, Stein, Tarrier, Weathers",2016.0,,0,0,
8340,Structural but not functional neuroplasticity one year after effective cognitive behaviour therapy for social anxiety disorder.,"Effective psychiatric treatments ameliorate excessive anxiety and induce neuroplasticity immediately after the intervention, indicating that emotional components in the human brain are rapidly adaptable. Still, the interplay between structural and functional neuroplasticity is poorly understood, and studies of treatment-induced long-term neuroplasticity are rare. Functional and structural magnetic resonance imaging (using 3T MRI) was performed in 13 subjects with social anxiety disorder on 3 occasions over 1year. All subjects underwent 9 weeks of Internet-delivered cognitive behaviour therapy in a randomized cross-over design and independent assessors used the Clinically Global Impression-Improvement (CGI-I) scale to determine treatment response. Gray matter (GM) volume, assessed with voxel-based morphometry, and functional blood-oxygen level-dependent (BOLD) responsivity to self-referential criticism were compared between treatment responders and non-responders using 2 x 2 (group x time; pretreatment to follow-up) ANOVA. At 1-year follow-up, 7 (54%) subjects were classified as CGI-I responders. Left amygdala GM volume was more reduced in responders relative to non-responders from pretreatment to 1-year follow-up (Z = 3.67, Family-Wise Error corrected p = 0.02). In contrast to previous short-term effects, altered BOLD activations to self-referential criticism did not separate responder groups at follow-up. The structure and function of the amygdala changes immediately after effective psychological treatment of social anxiety disorder, but only reduced amygdala GM volume, and not functional activity, is associated with a clinical response 1year after CBT. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mansson, Kristoffer N. T; Salami, Alireza; Carlbring, Per; Boraxbekk, C.-J; Andersson, Gerhard; Furmark, Tomas; Allen, Andersson, Andersson, Association, Blair, Boettcher, Cannon, Carlbring, Fresco, Fu, Furmark, Furmark, Goldin, Goldin, Huyser, Klumpp, Kuhn, Lueken, Maldjian, Mansson, Mansson, Mansson, May, Nyberg, Radua, Salami, Schienle, Wenger, Zaider",2017.0,,0,0,
8341,Long-term cost-effectiveness of cognitive behavioral therapy versus psychodynamic therapy in social anxiety disorder.,"Background: To determine the cost-effectiveness of cognitive behavioral therapy (CBT) versus psychodynamic therapy (PDT) in the treatment of social anxiety disorder after a follow-up of 30 months from a societal perspective. Methods: This analysis was conducted alongside the multicenter SOPHO-NET trial; adults with a primary diagnosis of social anxiety disorder received CBT (n = 209) or PDT (n = 207). Data on health care utilization and productivity loss were collected at baseline, after 6 months (posttreatment), and three further follow-ups to calculate direct and indirect costs. Anxiety-free days (AFDs) calculated based on remission and response were used as measure of effect. The incremental cost-effectiveness ratio (ICER) was determined. Net benefit regressions, adjusted for comorbidities and baseline differences, were applied to derive cost-effectiveness acceptability curves. Results: In the descriptive analysis, the unadjusted ICER favored CBT over PDT and the adjusted analysis showed that CBT's cost-effectiveness relative to PDT depends on the willingness to pay (WTP) per AFD. As baseline costs differed substantially the unadjusted estimates might be deceptive. If additional WTPs for CBT of 0, 10, and 30 were assumed, the probability of CBT being cost-effective relative to PDT was 65, 83, and 96%. Direct costs increased compared to baseline across groups, whereas indirect costs did not change significantly. Results were sensitive to considered costs. Conclusions: If the society is willing to pay >= 30 per additional AFD, CBT can be considered cost-effective, relative to PDT, with certainty. To further increase the cost-effectiveness more knowledge regarding predictors of treatment outcome seems essential. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Egger, Nina; Konnopka, Alexander; Beutel, Manfred E; Herpertz, Stephan; Hiller, Wolfgang; Hoyer, Juergen; Salzer, Simone; Stangier, Ulrich; Strauss, Bernhard; Willutzki, Ulrike; Wiltink, Joerg; Leibing, Eric; Leichsenring, Falk; Konig, Hans-Helmut; Acarturk, Acarturk, Azur, Bandelow, Barber, Boegels, Brown, Chisholm, Egger, Fehm, Fenwick, Graf von der Schulenburg, Graham, Hedman, Hedman, Heinrich, Hoch, Hoch, Hoyer, Joesch, Johnston, Leibing, Katon, Katon, Kessler, Kilian, Knijnik, Konnopka, Lave, Leichsenring, Leichsenring, Leichsenring, Leichsenring, Lipsitz, Maljanen, Manning, Mennin, Olesen, Raghunathan, Stangier, Unutzer, van Buuren, Wan, Wiltink, Wittchen, Zentner, Zethraeus",2016.0,,0,0,
8342,Fixed 50:50 mixture of nitrous oxide and oxygen to reduce lumbar-puncture-induced pain: A randomized controlled trial.,"Background and purpose: Lumbar puncture (LP) has been frequently performed for more than a century. This procedure is still stressful and often painful. The aim of the study was to evaluate the efficacy of a fixed 50% nitrous oxide-oxygen mixture compared to placebo to reduce immediate procedural pain and anxiety during LP. Methods: A randomized controlled trial was conducted involving adults who needed a cerebrospinal fluid analysis. Patients were randomly assigned to inhale either a fixed 50% nitrous oxide-oxygen mixture (50% N2O-O2) or medical air (22% O2-78% N2). Cutaneous application of a eutectic mixture of local anaesthetics was systematically done and all LPs were performed with pencil point 25G needles (20G introducer needle). The primary end-point was the maximal pain level felt by the patient during the procedure, the maximal anxiety level being a secondary outcome, both measured using a numerical rating scale (0-10). Results: A total of 66 consecutive patients were randomized. The analysis was intention to treat. The maximal pain was 4.9 +/- 2.7 for the 33 patients receiving air and 2.7 +/- 2.7 for the 33 receiving 50% N2O-O2 (P = 0.002). Similarly, the maximal LP-induced anxiety was 4.5 +/- 3.1 vs. 2.6 +/- 2.6 (P = 0.009), respectively. The number needed to treat to avoid one patient undergoing significant pain (pain score >= 4/10) was 2.75. Body mass index >25 kg/m2 was significantly associated with higher pain intensity (P = 0.03). No serious adverse events were attributable to 50% N2O-O2 inhalation. Conclusions: Inhalation of a fixed 50% N2O-O2 mixture is efficient to reduce LP-induced pain and anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Moisset, X; Sia, M. A; Pereira, B; Taithe, F; Dumont, E; Bernard, L; Clavelou, P; Aboumarzouk, Agostini, Atassi, Boulland, Douard, Drummond, Ducasse, Edwards, Farrar, Gillman, Jevtovic-Todorovic, Kapelushnik, Klomp, Koscielniak-Nielsen, Lawrence, Mazdak, Meskine, Myles, Pedersen, Quincke, Sharma, Shiri, Spielberger, Tramer, Yoon, Zacny, Zigmond",2017.0,,0,0,
8343,The role of theory-specific techniques and therapeutic alliance in promoting positive outcomes: Integrative psychotherapy for World Trade Center responders.,"World Trade Center responders demonstrate high symptom burden, underscoring the importance of refining treatment approaches for this cohort. One method is examining the impact of therapy techniques on outcomes, and the interactions between technique and alliance on outcomes. This study a) examined the interaction of early treatment techniques on integrative psychotherapy outcomes and b) explored whether associations differed at varying levels of alliance. Twenty-nine adult responders diagnosed with partial or full posttraumatic stress disorder received outpatient psychotherapy and completed weekly measures of alliance, technique, and symptom distress. Analyses indicated significant interactions between 1) alliance and psychodynamic interventions on outcomes and 2) alliance and cognitive behavioral (CB) interventions on outcomes. Clients with high alliance had better outcomes when their therapist used fewer CB techniques. No meaningful differences were found between technique and outcomes for clients with lower alliance. These findings reiterate the critical roles technique and responsiveness to the alliance play in engendering successful outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Haugen, Peter Tejas; Werth, Aditi Sinha; Foster, Alyce Lauren; Owen, Jesse; Ackerman, Clemence, DeFife, Difede, Difede, Gaston, Gersons, Goldman, Hatcher, Hatcher, Haugen, Haugen, Hilsenroth, Hilsenroth, Hilsenroth, Hoglend, Horowitz, Horvath, Lambert, Lambert, Lambert, Levy, Martin, McCarthy, Miller, Owen, Owen, Rumpold, Sexton, Silove, Weathers, Webb, Yarvis",2016.0,,0,0,
8344,"Alcohol consumption, craving, and craving control efforts assessed daily in the context of readiness to change among individuals with alcohol dependence and PTSD.","Research has demonstrated the positive association between alcohol craving and alcohol use and has identified craving as a central component of alcohol use disorders (AUD). Despite potential clinical implications, few studies have examined the relationship between craving and alcohol use in individuals with AUD and common psychiatric comorbidities or explored possible moderators of the craving-alcohol use relationship. The current study used daily monitoring data to: 1) replicate previous findings detecting a positive relationship between craving and alcohol use in individuals with AUD and co-occurring posttraumatic stress disorder (PTSD) and 2) extend these findings by examining the influence of initial change motivation on the craving-use relationship and within-day associations among craving, efforts to control craving, and alcohol consumption. Participants were 84 individuals with alcohol dependence and PTSD enrolled in an intervention study. Generalized estimating equations using pre-treatment baseline daily data revealed significant main effects for craving, craving control, and motivation to change alcohol use. Daily craving was positively related to alcohol use. Greater change motivation and craving control (i.e., efforts to resist craving, avoidance of thoughts and feelings related to craving) were negatively related to alcohol use. A significant interaction was detected between baseline change motivation and daily craving indicating that the association between craving and alcohol use was significantly stronger for those with low baseline change motivation. A significant interaction was also detected between craving control and daily craving, suggesting that participants were more likely to consume alcohol when experiencing high levels of craving if they reported low levels of craving control. Findings bolster the idea that efforts to prevent or ameliorate craving are critical to treatment success for individuals with AUD and PTSD who are seeking to reduce or quit drinking. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Browne, Kendall C; Wray, Tyler B; Stappenbeck, Cynthia A; Krenek, Marketa; Simpson, Tracy L; Adamson, Agrawal, Allison, Anton, Badour, Blanco, Bouchery, Brady, Buckner, Carey, Chandra, Coffey, Coffey, Connolly, Cooney, Drapkin, Enders, Evern, First, Flannery, Foa, Garland, Grusser, Hardin, Hayes, Hayes, Heilig, Hendershot, Holt, Jung, Kavanagh, Keyes, Klien, Kranzler, Levola, Litt, Love, Marhe, Meyer, Miller, Miller, Muraven, Oslin, Ouimette, Palfai, Preston, Prochaska, Raudenbush, Ray, Read, Saladin, Simpson, Smedslund, Tiffany, Torchalla",2016.0,,0,0,
8345,Integrated cognitive behavioral therapy for comorbid cannabis use and anxiety disorders.,"Cannabis use disorders (CUDs) co-occur with anxiety disorders at high rates, presumably because some individuals with anxiety disorders may rely on cannabis to manage anxiety. Motivation enhancement therapy (MET) combined with cognitive-behavioral therapy (CBT) is an efficacious intervention for CUD, yet outcomes are worse for patients with elevated anxiety. The integration of MET-CBT with False Safety Behavior Elimination Treatment (FSET) may be useful with anxious CUD patients, as the use of cannabis to manage anxiety can be targeted as a false safety behavior. Here, we describe the integrated treatment and the successful use of it among two patients-one with CUD and comorbid social anxiety disorder (SAD) and one with CUD and comorbid SAD and generalized anxiety disorder. Data support the feasibility of this integrated treatment as a viable approach to the treatment of CUD and comorbid anxiety disorders. Future controlled trials are now warranted to further evaluate the intervention. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Buckner, Julia D; Ecker, Anthony H; Beighley, Jennifer S; Zvolensky, Michael J; Schmidt, Norman B; Shah, Sonia M; Carroll, Kathleen M; Allen, Brown, Brown, Brozovich, Buckner, Buckner, Buckner, Buckner, Buckner, Buckner, Buckner, Buckner, Buckner, Cougle, Courbasson, DiNardo, Fals-Stewart, First, Heimberg, Heimberg, Mattick, Meyer, Molina, Moore, Salkovskis, Schmidt, Sobell, Steinberg, Stewart, Stinson, Stinson, Watson, Westra, Zvolensky",2016.0,,0,0,
8346,Predictors of outcome of an Internet-based cognitive-behavioural therapy for post-traumatic stress disorder in older adults.,"Objectives: The aim of this study was to evaluate the role of resource-oriented variables such as self-efficacy, locus of control (LOC) and post-traumatic growth (PTG) in predicting treatment response in older adults with post-traumatic stress. Methods: Fifty-eight older adults with subsyndromal or greater severity of war-associated post-traumatic stress disorder (PTSD) symptoms completed a randomized controlled Internet-based cognitive-behavioural therapy (CBT) with immediate and delayed treatment groups. Assessments of PTSD severity and resource-oriented variables of self-efficacy, LOC and PTG were conducted at baseline, post-treatment and at a 6-month follow-up. Results: Results revealed that pre-treatment scores on measures of internal LOC and PTG predicted PTSD symptom severity at post-treatment, even after controlling for initial PTSD. At a 6-month follow-up, internal LOC continued to predict PTSD symptom severity. In addition, repeated-measures analyses of variance revealed that, relative to older adults with low internal LOC and PTG, older adults with high internal LOC and PTG, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. Conclusion: These findings suggest that greater locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Assessment of these constructs may be useful in identifying trauma survivors who are most likely to respond to CBT. Practitioner points: 1. Greater internal locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. 2. Older adults with initial high internal locus of control and post-traumatic growth, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. 4. It could be assumed that patients with initial functional appraisals could benefit easier and faster from a trauma-focused cognitive-behavioural therapy compared to individuals with lower internal locus of control and post-traumatic growth (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Bottche, Maria; Kuwert, Philipp; Pietrzak, Robert H; Knaevelsrud, Christine; Benight, Benight, Bisson, Blanchard, Carlbring, Dalgleish, Ehlers, Ehlers, Ehlers, Flatten, Foa, Foa, Foa, Hagenaars, Jaycox, Karatzias, Kleim, Knaevelsrud, Knaevelsrud, Krampen, Lange, Leiderman-Cerniglia, Levenson, Linley, Maercker, Maercker, Marks, McKeever, Mellon, Munley, Park, Pooley, Resick, Rizvi, Schwarzer, Schwarzer, Shaw, Stelzl, Tagay, Tarrier, Tedeschi, Tedeschi, Van Minnen, Zoellner",2016.0,,0,0,
8347,Interpersonal problems predict differential response to cognitive versus behavioral treatment in a randomized controlled trial.,"Objective:We examined dimensional interpersonal problems as moderators of cognitive behavioral therapy (CBT) versus its components (cognitive therapy [CT] and behavioral therapy [BT]). We predicted that people with generalized anxiety disorder (GAD) whose interpersonal problems reflected more dominance and intrusiveness would respond best to a relaxation-based BT compared to CTor CBT, based on studies showing that people with personality features associated with a need for autonomy respond best to treatments that are more experiential, concrete, and self-directed compared to therapies involving abstract analysis of one's problems (e.g., containing CT). Method: This was a secondary analysis of Borkovec, Newman, Pincus, and Lytle (2002). Forty-seven participants with principal diagnoses of GAD were assigned randomly to combined CBT (n = 16),CT (n = 15), or BT (n = 16). Results: As predicted, compared to participants with less intrusiveness, those with dimensionally more intrusiveness responded with greater GAD symptom reduction to BT than to CBT at posttreatment and greater change to BT than to CT or CBT across all follow-up points. Similarly, those with more dominance responded better to BT compared to CT and CBT at all follow-up points. Additionally, being overly nurturant at baseline was associated with GAD symptoms at baseline, post, and all follow-up time-points regardless of therapy condition. Conclusions: Generally anxious individuals with domineering and intrusive problems associated with higher need for control may respond better to experiential behavioral interventions than to cognitive interventions, which may be perceived as a direct challenge of their perceptions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Newman, Michelle G; Jacobson, Nicholas C; Erickson, Thane M; Fisher, Aaron J; Ablon, Afifi, Alden, Alden, Bates, Benjamin, Bernstein, Beutler, Beutler, Beutler, Beutler, Beutler, Borkovec, Borkovec, Bruss, Calvert, Cassidy, Cooney, Crits-Christoph, Di Nardo, Dowd, Dunst, Erickson, Erickson, Friedman, Gamez, Gasperini, Goldfried, Grant, Gurtman, Gurtman, Hamilton, Hardy, Hebert, Hilbert, Horowitz, Horowitz, Jones, Kachin, Kadden, Keijsers, Kuznetsova, Lahmann, Leal, Lorentzen, Ma, McEvoy, McEvoy, Meyer, Molina, Moras, Muthen, Newman, Newman, Newman, Newman, Ogrodniczuk, Paul, Przeworski, Renner, Rosario-Martinez, Salzer, Simon, Spielberger, Torgersen, Vinnars, Vittengl, Welsh, Wiggins, Wolf, Wright",2017.0,,0,0,
8348,Support for the efficacy of behavioural activation in treating anxiety in breast cancer patients.,"Objective: Anxiety disorders are commonly experienced by breast cancer patients and are associated with decreased quality of life, significant deterioration in recreational and physical activities, sleep problems, and increased pain and fatigue. Behavioural activation (BA) is an empirically validated treatment for depression but is much less often studied in the treatment of anxiety symptomology. Considering that depression and anxiety disorders frequently coexist in breast cancer patients and given highly overlapping symptom patterns, it is reasonable to postulate that BA might help attenuate anxiety symptoms. Method: Addressing this issue as a follow-up to three recently completed clinical trials, the efficacy of BA for treating anxiety in breast cancer patients was examined (n = 71). Results: Based on a reliable change index, 41% of patients experienced clinically significant anxiety reductions, with these breast cancer patients more likely to have severe anxiety and depression at pre-treatment. Item analyses indicated that BA is generally effective in reducing most symptoms of anxiety, including somatic and cognitive manifestations. Conclusions: BA may represent a parsimonious and practical treatment that may reduce anxiety symptoms in breast cancer patients. Study limitations and future research directions are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Hopko, Derek R; Lejuez, Carl W; Ryba, Marlena M; Shorter, Rebecca L; Bell, John L; Allen, Andrykowski, Antony, Arco, Armento, Arnau, Barlow, Barlow, Barlow, Beck, Beck, Beck, Bridges, Brown, Burgess, Chu, Creamer, Cuijpers, Dimidjian, Fann, Farchione, First, Fournier, Gorman, Hart, Heron Speirs, Hiller, Hopko, Hopko, Hopko, Hopko, Hopko, Hopko, Hopko, Ionescu, Jacobson, Jakupcak, Katz, Kessler, Lejuez, Linden, Lundervold, Mazzucchelli, McIndoo, Miller, Mitchell, Mulick, Osman, Perneger, Rivas-Vazquez, Ruggiero, Sandoval, Schneider, Soleimani, Spiegel, Tamagawa, Vialou, Wagner, Young",2016.0,,0,0,
8349,Effects of intranasal oxytocin on amygdala reactivity to emotional faces in recently trauma-exposed individuals.,"There is a need for effective, early post-trauma preventive interventions for post-traumatic stress disorder (PTSD). Attenuating amygdala hyperreactivity early post-trauma, a likely PTSD vulnerability factor, may decrease PTSD risk. Since oxytocin modulates amygdala reactivity to emotional stimuli, oxytocin administration early post-trauma may be a promising candidate for PTSD prevention. In a randomized double-blind placebo-controlled fMRI study, we investigated effects of a single intranasal oxytocin administration (40 IU) on amygdala reactivity to happy, neutral and fearful faces in 41 recently trauma-exposed men and women showing moderate to high distress after initial post-trauma screening. We explored treatment interactions with sex. Participants were scanned within 11 days post-trauma. Compared with placebo, oxytocin significantly increased right amygdala reactivity to fearful faces. There was a significant treatment by sex interaction on amygdala reactivity to neutral faces, with women showing increased left amygdala reactivity after oxytocin. These findings indicate that a single oxytocin administration may enhance fearful faces processing in recently trauma-exposed individuals and neutral faces processing in recently trauma-exposed women. These observations may be explained by oxytocin-induced increased salience processing. Clinical implications of these findings for PTSD prevention should be further investigated. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Frijling, Jessie L; van Zuiden, Mirjam; Koch, Saskia B. J; Nawijn, Laura; Veltman, Dick J; Olff, Miranda; Acheson, Admon, Admon, Admon, Amos, Bartz, Bartz, Bertsch, Blake, Brett, Brewin, Burghardt, Caldwell, Cardoso, Chini, Cohen, de Vries, Delahanty, Derntl, deRoon-Cassini, Dodhia, Domes, Domes, Domes, Domes, Eckstein, Eickhoff, Etkin, Feifel, Feldman, Frijling, Fusar-Poli, Gamer, Grillon, Grimm, Guzman, Guzman, Huber, Kessler, Kirsch, Koch, LaBar, Labuschagne, Langner, LeDoux, Macdonald, MacDonald, Mahan, McLaughlin, Montag, Mouthaan, Nishi, Ohlsson, Ostrowski, Ozer, Petrovic, Pull, Rose, Sauer, Shamay-Tsoory, Sheehan, Shin, Simeon, Slattery, Toth, Tzourio-Mazoyer, van Wingen, van Zuiden, Walters, Wigton, Zohar, Zohar, Zoicas",2016.0,,0,0,
8350,Client retrospective accounts of corrective experiences in motivational interviewing integrated with cognitive behavioral therapy for generalized anxiety disorder.,"A corrective experience (CE) is one ""in which a person comes to understand or experience affectively an event or relationship in a different and unexpected way"" (Castonguay & Hill, 2012, p. 5). CEs disconfirm clients' expectations based on past problematic experiences, and can be emotional, relational, behavioral, and/or cognitive. This qualitative study explored corrective shifts among recovered participants (N = 8) who had received motivational interviewing (MI) integrated with cognitive behavioral therapy (CBT) in a randomized controlled trial comparing CBT alone to MI-CBT for generalized anxiety disorder (Westra, Constantino, & Antony, 2016). We administered a posttherapy interview querying their experience of, and explanations for, any shifts in therapy. Grounded theory analysis yielded three core themes: in command of the worry train, experiencing myself in new ways in therapy, and oriented toward change. Findings are discussed in terms of MI theory, and clinical implications for therapists are provided. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Macaulay, Christianne; Angus, Lynne; Khattra, Jasmine; Westra, Henny; Ip, Jennifer; Adler, Alexander, Angus, Angus, Bohart, Borkovec, Castonguay, Constantino, Constantino, Freeston, Glaser, Goldfried, Greenberg, Hayes, Heatherington, Kertes, Khattra, Marcus, Meyer, Miller, Orlinsky, Rennie, Rennie, Rennie, Rogers, Rogers, Westra, Westra, Westra",2017.0,,0,0,
8351,A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth.,"This is the first randomized controlled trial to evaluate non-inferiority of Prolonged Exposure (PE) delivered via home-based telehealth (HBT) compared to standard in-person (IP) PE. One-hundred thirty two Veterans recruited from a Southeastern Veterans Affairs Medical Center and affiliated University who met criteria for posttraumatic stress disorder (PTSD) were randomized to receive PE via HBT or PE via IP. Results indicated that PE-HBT was non-inferior to PE-IP in terms of reducing PTSD scores at post-treatment, 3 and 6 month follow-up. However, non-inferiority hypotheses for depression were only supported at 6 month follow-up. HBT has great potential to reduce patient burden associated with receiving treatment in terms of travel time, travel cost, lost work, and stigma without sacrificing efficacy. These findings indicate that telehealth treatment delivered directly into patients' homes may dramatically increase the reach of this evidence-based therapy for PTSD without diminishing effectiveness. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Acierno, Ron; Knapp, Rebecca; Tuerk, Peter; Gilmore, Amanda K; Lejuez, Carl; Ruggiero, Kenneth; Muzzy, Wendy; Egede, Leonard; Hernandez-Tejada, Melba A; Foa, Edna B; Acierno, Beachler, Beck, Blake, Bolton, Bose, Cohen, Dworkin, Egede, Elford, First, Foa, Foa, Foa, Foa, Fortney, Friedman, Fulton, Glueckauf, Goodson, Gros, Gros, Hogan, Hoge, Hoge, Iversen, Jerome, Kang, Keane, Kim, Kulka, Maieritsch, Monson, Morland, Morland, Morland, Morland, Mouilso, Orsillo, Perednia, Ramchand, Ramchand, Schumi, Seal, Shore, Steer, Tuerk, Tuerk, Tuerk, Weathers, Weathers, Weathers, Williams, Wolf, Wright, Yoder, Ziemba",2017.0,,0,0,
8352,"Perceived parental bonding, early maladaptive schemas and outcome in schema therapy of cluster c personality problems.","Objective: The objective of this paper was to examine the relationships between perceived parental bonding, Early Maladaptive Schemas (Young et al., 2003), and outcome of schema therapy of Cluster C personality problems and whether the perceptions of parental bonding could be influenced by schema therapy. Method: The sample consisted of 45 patients with panic disorder and/or agoraphobia and Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Cluster C personality traits who participated in an 11-week inpatient programme consisting of two phases; the first was a 5-week panic/agoraphobia-focused cognitive therapy, whereas the second phase was a personality-focused schema therapy. The patients were assessed at pre-treatment, mid-treatment and post-treatment and at 1-year follow-up. Results: Opposite to our hypothesis, lower paternal care at pre-treatment was related to more reduction in Cluster C personality traits from pre-treatment to 1-year follow-up. Maternal protection was related to the schema domains of impaired autonomy and exaggerated standards. Overall schema severity and the schema emotional inhibition at pre-treatment were associated with less change in Cluster C traits. Perceived maternal care was reduced from pre-treatment to 1-year follow-up, and more reduction in maternal care was related to less reduction in Cluster C traits. Discussion: Parental bonding failed to predict treatment outcome in the expected direction, but maternal protection was related to two of the schema domains. Overall schema severity and the particular schema emotional inhibition predicted outcome. Furthermore, perceived maternal care was reduced from before to after treatment. Future studies should examine these questions in larger samples of Cluster C patients receiving schema therapy of a longer duration. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Lunding, Synve Hoffart; Hoffart, Asle; Arntz, Barber, Baron, Beck, Bowlby, Chambers, Chambless, Chambless, Clark, Cohen, First, First, Haaland, Hawton, Hoffart, Hoffart, Hoffart, Hoffart, Hoffart, Hoffart, Lee, Lee, Lizardi, McGinn, Nordahl, Parker, Perry, Renner, Richter, Ryum, Sakado, Schmidt, Shah, Shrout, Sobel, Thimm, Vallis, Young, Young",2016.0,,0,0,
8353,Exploring outcomes related to anxiety and depression in completers of a randomized controlled trial of complicated grief treatment.,"The present study examines a more fine-grained analysis of anxiety-related and depression-related outcomes amongst a sample of treatment completers who were assigned to complicated grief treatment (CGT) (n = 35) or interpersonal psychotherapy (IPT) (n = 34) in a previously reported randomized controlled trial. We examined effects of antidepressant use and measures of anxiety and depression, focusing especially on guilt related to the death or deceased and grief-related avoidance in order to further understand the differential effectiveness of CGT and IPT amongst participants who received the full course of treatment. Analyses showed that CGT produced greater reductions in anxiety and depressive symptoms including negative thoughts about the future and grief-related avoidance. CGT's advantage over IPT in lowering depression was most pronounced amongst those not taking antidepressants. Our results further elucidate CGT effects and support the idea that CG and major depressive disorder are distinct conditions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Glickman, Kim; Shear, M. Katherine; Wall, Melanie; Beck, Beck, Boelen, Boelen, Bui, Hamilton, Hewitt, Kersting, Maercker, Prigerson, Prigerson, Shear, Shear, Shear, Shear, Simon, Steer, Wagner",2016.0,,0,0,
8354,"Increases of plasma levels of glial fibrillary acidic protein, tau, and amyloid beta up to 90 days after traumatic brain injury.","Glial fibrillary acidic protein (GFAP), microtubule-associated protein tau, and amyloid beta peptide (Abeta42) have been proposed as diagnostic and prognostic biomarkers in traumatic brain injury (TBI). Single molecule array (Simoa) is a novel technology that employs highly sensitive immunoassays for accurate measurements of candidate biomarkers found at low concentration in biological fluids. Our objective was to trace the trajectory of tau, GFAP, and Abeta42 levels in plasma from the acute through subacute stages after TBI, compared with controls. Samples from 34 TBI subjects enrolled in the Citicoline Brain Injury Treatment Trial (COBRIT) were studied. Injury severity was assessed by Glasgow Coma Scale (GCS) and admission CT. Glasgow Outcome Scale Extended (GOSE) was assessed 6 months after injury. Plasma was collected within 24 h (Day 0), and 30 and 90 days after the TBI. Plasma collected from 69 healthy volunteers was used for comparison. At every time point, increases were noted in plasma GFAP (p < 0.0001 for all comparisons), tau (p < 0.0001, p < 0.0001, and p = 0.0044, at Days 0, 30, and 90, respectively), and Abeta42 (p < 0.001, p < 0.0001, and p = 0.0203, respectively) in TBI cases compared with controls. The levels were maximal at Day 0 for GFAP and tau and at Day 30 for Abeta42. Area under curve (AUC) analyses for Day 0 GFAP and tau were excellent for discrimination of complicated mild TBI (cmTBI) from controls (0.936 and 0.901, correspondingly). Discriminant component analysis (DCA) for all three biomarkers at Days 0 and 30 differentiated controls from cmTBI (91.1% and 89.7% correctly classified, at each time point). Duration of post-traumatic amnesia (PTA) correlated weakly with tau levels at 30 days (Spearman's r = 0.40; 95% CI 0.0003-0.60, p = 0.044). The Marshall CT Grade on admission correlated weakly with Day 30 tau levels (Spearman's r = 0.41; 95% CI 0.04-0.68, p = 0.027). Day 30 Abeta42 correlated with GOSE (standardized beta -0.486, p = 0.042). GFAP, tau and Abeta42 were increased up to 90 days after TBI compared with controls. Total tau levels correlated with clinical and radiological variables of TBI severity. Plasma Abeta42 correlated with clinical outcome. Combination of all three biomarkers at Days 0 and 30 can be used to differentiate controls from cmTBI populations, and may be useful as biomarkers of TBI in both acute and subacute phases. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Bogoslovsky, Tanya; Wilson, David; Chen, Yao; Hanlon, David; Gill, Jessica; Jeromin, Andreas; Song, Linan; Moore, Carol; Gong, Yunhua; Kenney, Kimbra; Diaz-Arrastia, Ramon; Anderson, Bazarian, Berger, Bledsoe, Blennow, Bohmer, Buonora, Corso, Diaz-Arrastia, Emmerling, Franz, Gabbita, Gatson, Gentleman, Hong, Irizarry, Izumi, Johnson, Johnson, Kavalci, Lawrence, Lesko, Marshall, Mehta, Mondello, Neselius, Olivera, Olsson, Ost, Papa, Quiroz, Randall, Rissin, Rosengren, Shahim, Sherer, Strathmann, Vos, Wang, Washington, Wilson, Wilson, Zafonte, Zetterberg",2017.0,,0,0,
8355,Predicting post-traumatic stress disorder treatment response in refugees: Multilevel analysis.,"Objectives: Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of which are largely unknown. This study aimed at improving PTSD treatment for adult refugees by identifying PTSD treatment response predictors. Design: A prospective longitudinal multilevel modelling design was used to predict PTSD severity scores over time. We analysed data from a randomized controlled trial with pre-, post-, and follow-up measurements of the safety and efficacy of eye movement desensitization and reprocessing and stabilization in asylum seekers and refugees suffering from PTSD. Methods: Lack of refugee status, comorbid depression, demographic, trauma-related and treatment-related variables were analysed as potential predictors of PTSD treatment outcome. Treatment outcome data from 72 participants were used. Results: The presence (B = 6.5, p = .03) and severity (B = 6.3, p < .01) of a pre-treatment depressive disorder predicted poor treatment response and explained 39% of the variance between individuals. Conclusions: Refugee patients who suffer from PTSD and severe comorbid depression benefit less from treatment aimed at alleviating PTSD. Results highlight the need for treatment adaptations for PTSD and comorbid severe depression in traumatized refugees, including testing whether initial targeting of severe depressive symptoms increases PTSD treatment effectiveness. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Haagen, Joris F. G; ter Heide, F. Jackie June; Mooren, Trudy M; Knipscheer, Jeroen W; Kleber, Rolf J; Angelakis, Bedard-Gilligan, Betancourt, Blake, Bogic, Briggs, Brune, Bryant, Buhmann, Burri, Charney, Chu, Cloitre, Drozdek, Fazel, Graham, Hox, Hox, Hruschka, Keller, Kersting, Kessler, Knipscheer, Lambert, Li, McDonagh, McFarlane, Miller, Miller, Mollica, Momartin, Moons, Moynihan, Nickerson, Raghavan, Riley, Shapiro, Silove, Slobodin, Sondergaard, Steel, Steinert, Stenmark, Stenmark, Summerfield, Taylor, Ter Heide, Van Wyk, Vink, Vink, Weathers",2017.0,,0,0,
8356,"A cluster randomised controlled trial protocol of an adapted intervention for alcohol use disorders in people living with HIV and AIDS: Impact on alcohol use, general functional ability, quality of life and adherence to HAART.","Background: Interventions for alcohol use disorders (AUDs) in HIV infected individuals have been primarily targeted at HIV risk reduction and improved antiretroviral treatment adherence. However, reduction in alcohol use is an important goal. Alcohol use affects other key factors that may influence treatment course and outcome. In this study the authors aim to administer an adapted intervention for AUDs to reduce alcohol use in people living with HIV/AIDS (PLWHA). Methods: This study is a cluster randomised controlled trial at 16 HIV care clinics. A motivational interviewing and cognitive behavioural therapy based intervention for AUDs, developed through adaptation and piloted in Zimbabwe, will be administered to PLWHA with AUDs recruited at HIV clinics. The intervention will be administered over 16 sessions at 8 HIV clinics. This intervention will be compared with an equal attention control in the form of the World Health Organization Mental Health Gap Action Programme (WHO mhGAP) guide, adapted for the Zimbabwean context. General function, quality of life, and adherence to highly active antiretroviral treatment (HAART) will be secondary outcomes. Booster sessions will be administered to both groups at 3 and 6 months respectively. The primary outcome measure will be the Alcohol Use Disorder Identification Test (AUDIT) score. The World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0), World Health Organisation Quality of Life (WHOQoL) HIV, viral load, and CD4 counts will be secondary outcome measures. Outcome assessments will be administered at baseline, 3, 6, and 12 months. Moderating factors such as perceived social support, how people cope with difficult situations and post-traumatic exposure and experience will be assessed at baseline. Trained research assistants will recruit participants. The outcome assessors who will be trained in administering the outcome and moderating tools will be blinded to the treatment arms allocated to the participants. However, the principal investigator, participants and intervention staff will be unblinded. Data will be analysed using STATA Version 14. Primary and secondary outcomes will be measured at four time points that is; at baseline, 3, 6, and 12 months respectively. All participants will be included in the analysis of primary and secondary outcome measures. The mean AUDIT scores will be compared between groups using student t-tests. Multilevel logistic regression analysis will be performed for binominal variables and multilevel linear regression for continuous variables. Descriptive statistics will be computed for baseline and follow-up assessments. Discussion: The study will be the first to address problematic alcohol use in PLWHA in Zimbabwe. It seeks to use local resources in delivering a modified, brief, evidence-based, and culturally contextualised intervention. The study results will determine the effectiveness of adapting psychological interventions for AUDs in HIV infected adults using a task-sharing framework. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Madhombiro, Munyaradzi; Dube-Marimbe, Bazondlile; Dube, Michelle; Chibanda, Dixon; Zunza, Moleen; Rusakaniko, Simbarashe; Stewart, David; Seedat, Soraya; Adams, Babor, Backs-Dermott, Bajunirwe, Baker, Berman, Berman, Braithwaite, Breuer, Bush, Carver, Chandiwana, Collins, Davidson, Davidson, Deller, Durbeej, Gache, Gearing, Hahn, Hanass-Hancock, Holmes, Justice, Kalichman, Killip, Lehmann, Liu, Mayston, Molina, Morojele, Morojele, Moyer, Naicker, Neuman, Organization, Organization, Pandrea, Peltzer, Pinninti, Sacktor, Samet, Sander, Schneider, Sheehan, Starace, Stevens, Theall, Tran, Valenti, Valvano, Voluse, Wagner, Whetten, Orley, Willie, Wu, Zimet, Ustun",2017.0,,0,0,
8357,Degree of correspondence between daily monitoring and retrospective recall of alcohol use among men and women with comorbid AUD and PTSD.,"Background and Objectives: The majority of studies that have identified good correspondence between daily monitoring and retrospective recall of alcohol use have included participants who are relatively stable, are moderate drinkers, report abstinence, and are not diagnosed with comorbid disorders. The current study examined degree of correspondence between alcohol use that was reported daily via interactive voice response (IVR) telephone monitoring and retrospectively using an abbreviated Form-90 (Form-35) covering the same 35-day time period. Methods: Participants were 54 men and women with comorbid alcohol dependence and posttraumatic stress disorder (PTSD) who reported drinking during the time period. Results: Results indicated that participants reported more drinking days via IVR. Correspondence was strong between the reporting methods for aggregate-level alcohol use variables, including presence/absence of drinking days and heavy drinking days and standard drinks, and associations increased for weeks closer to the assessment date for drinking days and heavy drinking days. Day-today agreement was moderate for drinking days and heavy drinking days, though there was large between-person variability in correspondence between reporting methods. Post-hoc analyzes suggested that men and participants who drink more tend to have lower correspondence between assessment methods. Discussion and Conclusions: Overall, findings partially replicated previous research and extend our knowledge of alcohol assessment in a comorbid sample. Scientific Significance: Findings highlight the importance of considering the influence that moderating variables have on reporting of alcohol use. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Krenek, Marketa; Lyons, Robert; Simpson, Tracy L; Bernhardt, Blanco, Carney, First, Foa, Grant, Hamilton, Helzer, Kranzler, Leigh, Lincoln, Midanik, Miller, Patrick, Perrine, Roberts, Room, Schottenbauer, Searles, Searles, Searles, Shiffman, Shiffman, Simpson, Sobell, Sobell, Toll, Tonigan, Tucker",2016.0,,0,0,
8358,Interpersonal psychotherapy (IPT) for major depression following perinatal loss: A pilot randomized controlled trial.,"This randomized controlled pilot trial examined the feasibility, acceptability, and preliminary efficacy of an adapted interpersonal psychotherapy (IPT) for major depressive disorder (MDD) following perinatal loss (miscarriage, stillbirth, or early neonatal death). Fifty women who experienced a perinatal loss within the past 18 months, whose current depressive episode onset occurred during or after the loss, were randomized to the group IPT adapted for perinatal loss (the Group IPT for Major Depression Following Perinatal Loss manual developed for this study is available at no cost by contacting either of the first two authors) or to the group Coping with Depression (CWD), a cognitive behavioral treatment which did not focus on perinatal loss nor social support. Assessments occurred at baseline, treatment weeks 4 and 8, post-treatment, and 3 and 6 months after the end of treatment. IPT was feasible and acceptable in this population. Although some participants were initially hesitant to discuss their losses in a group (as occurred in IPT but not CWD), end of treatment satisfaction scores were significantly (p = 0.001) higher in IPT than in CWD. Confidence intervals around between-groups effect sizes favored IPT for reductions in depressive symptoms during treatment as well as for improvement in mode-specific targets (social support, grief symptoms) and recovery from a post-traumatic stress disorder over follow-up. This group IPT treatment adapted for MDD after perinatal loss is feasible, acceptable, and possibly efficacious. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Johnson, Jennifer E; Price, Ann Back; Kao, Jennifer Chienwen; Fernandes, Karen; Stout, Robert; Gobin, Robyn L; Zlotnick, Caron; Abboud, Antill, Armstrong, Beck, Beutel, Beutel, Biondi, Boyle, Carrera, Clark, Clarke, Cordle, Cuijpers, Dahlem, Faes, Forrest, Gilbert, Hamilton, Hollon, Janssen, Johnson, Keller, Keller, Kersting, Kersting, Klier, Koszycki, Kraemer, Larsen, Lewinsohn, Murray, Najavits, Neugebauer, Neugebauer, Nikcevic, O'Hara, Pearlstein, Petrozza, Prigerson, Ritsher, Schaap, Shear, Spinelli, Stirtzinger, Swanson, Swanson, Swanson, Swanson, Weissman, Weissman, Zeanah",2016.0,,0,0,
8359,Habituation of distress and craving during treatment as predictors of change in PTSD symptoms and substance use severity.,"Objective: Increasing evidence supports the efficacy of trauma-focused exposure therapy in the treatment of posttraumatic stress disorder (PTSD) and co-occurring substance use disorders. Little is known, however, about the mechanisms of change in treatment for patients with PTSD and co-occurring substance use disorders. The aim of the present study was to examine whether within- and between-session habituation of distress and substance craving during imaginal exposure relates to treatment outcomes among U.S. military veterans with PTSD and a co-occurring substance use disorder (N = 54). Method: Veterans received Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure, a manualized integrated treatment combining prolonged exposure with cognitive-behavioral therapy for substance use disorders as part of a larger randomized clinical trial. Self-reported distress and craving ratings were collected during each imaginal exposure session. Results: Data were analyzed using a series of random intercept and slope multilevel linear and generalized linear models. Results revealed that between-session habituation of distress and craving was associated with greater improvement in PTSD symptoms during treatment. Between-session habituation of craving was also associated with a marginally greater reduction in frequency of substance use among participants still reporting use during treatment. Within-session habituation of distress was unrelated to treatment outcome. Conclusion: Together, these findings indicate that habituation in both distress and craving may be important in maximizing treatment outcome for patients with PTSD and comorbid substance use disorders. (PsycINFO Database Record (c) 2017 APA, all rights reserved) Impact Statement What is the public health significance of this article?-This study highlights the importance of repeatedly measuring distress and substance craving during exposure to memories of traumatic events during trauma-focused treatments among Veterans with co-occurring post traumatic stress disorder (PTSD) and substance abuse. Improvements in distress across treatment sessions predicts better treatment response for PTSD symptoms, while improvements in craving predicts better treatment response for both PTSD symptoms and substance abuse. To maximize gains in treatment, it may be important to focus on monitoring improvement in distress and craving changes. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Badour, Christal L; Flanagan, Julianne C; Gros, Daniel F; Killeen, Therese; Pericot-Valverde, Irene; Korte, Kristina J; Allan, Nicholas P; Back, Sudie E; Back, Back, Back, Blake, Brady, Carey, Carroll, Craske, Drummond, Flanagan, Foa, Foa, Foa, Foa, McCauley, Mills, Nacasch, Olsen, Roberts, Sheehan, Shek, Sobell, Solomon, Torchalla, Weathers, Wolpe",2017.0,,0,0,
8360,Effect of anticipatory stress on placebo alcohol consumption in a bar laboratory.,"ABSTRACTBackground: Only one laboratory study has examined the relation between stress and alcohol use in an ecologically valid drinking context. In that prior study, drinking was measured after the stressful situation. Objective: To examine the effect of an anticipatory stressor, and trait social anxiety on ""alcohol"" consumption in a bar laboratory. Methods: College students aged 18 and older (N = 127) in same-sex groups of two or three participants took part in a study that ostensibly examined alcohol's effect on language fluency. Using a between-subjects design, participants were randomly assigned to a stress or control condition. Participants in the stress condition anticipated giving a stressful speech for the fluency procedure, whereas those in the control group anticipated a nonstressful activity. Before the alleged fluency task, groups could order and consume mixed drinks ad lib in a bar laboratory. No beverages actually contained alcohol, but we used a validated procedure to ensure that participants included in these analyses were deceived. Primary analyses were performed with a hierarchical linear model (HLM) due to a substantial group/modeling effect. Results: Counter to expectations, participants in the control group consumed more placebo alcohol than those in the stress condition. This main effect was moderated by past 3 months' drinks per week, such that the effect was attenuated (or reversed) among heavy drinkers. No main or interaction effects were observed for trait social anxiety. Conclusions: Some stressors (i.e., those invoking performance anxiety) may decrease consumption. People with higher levels of alcohol involvement might be especially motivated to drink for tension reduction purposes. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Bernstein, Michael H; Wood, Mark D; Bacon, Battista, Bernstein, Bot, Caudill, Collins, Corcoran, Foster, Grant, Higgins, Horn, Hull, Kidorf, Larsen, Larsen, Larsen, Maas, Magrys, Maki, Marlatt, Marlatt, Marteau, Mattick, McGrath, McNair, Morrison, Patil, Peters, Quigley, Sayette, Sayette, Sher, Sher, Sher, Spielberger",2017.0,,0,0,
8361,International Phase II clinical trial of CBTPsych: A standalone internet social anxiety treatment for adults who stutter.,"Purpose: CBTPsych is an individualized, fully automated, standalone Internet treatment program that requires no clinical contact or support. It is designed specifically for those who stutter. Two preliminary trials demonstrated that it may be efficacious for treating the social anxiety commonly associated with stuttering. However, both trials involved pre- and post-treatment assessment at a speech clinic. This contact may have increased compliance, commitment and adherence with the program. The present study sought to establish the effectiveness of CBTPsych in a large international trial with no contact of any kind from researchers or clinicians. Method: Participants were 267 adults with a reported history of stuttering who were given a maximum of 5 months access to CBTPsych. Pre- and post-treatment functioning was assessed within the online program with a range of psychometric measures. Results: Forty-nine participants (18.4%) completed all seven modules of CBTPsych and completed the post-treatment online assessments. That compliance rate was far superior to similar community trials of self-directed Internet mental health programs. Completion of the program was associated with large, statistically and clinically significant reductions for all measures. The reductions were similar to those obtained in earlier trials of CBTPsych, and those obtained in trials of in-clinic CBT with an expert clinician. Conclusions: CBTPsych is a promising individualized treatment for social anxiety for a proportion of adults who stutter, which requires no health care costs in terms of clinician contact or support. Educational objectives: The reader will be able to: (a) discuss the reasons for investigating CBTPsych without any clinical contact; (b) describe the main components of the CBTPsych treatment; (c) summarize the results of this clinical trial; (d) describe how the results might affect clinical practice, if at all. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Menzies, Ross; O'Brian, Sue; Lowe, Robyn; Packman, Ann; Onslow, Mark; Amster, Antony, Blood, Blumgart, Boberg, Bower, Brown, Christensen, Clark, Craig, Crawford, Ezrati-Vinacour, Fairburn, Fairburn, Farvolden, Fry, Fry, Heimberg, Helgadottir, Helgadottir, Helgadottir, Huinck, Iverach, Iverach, Iverach, Loucas, Lovibond, Mattick, McColl, Menzies, Oei, Smith, St Clare, Stein, Watson",2016.0,,0,0,
8362,Low intensity interventions for Obsessive-Compulsive Disorder (OCD): A qualitative study of mental health practitioner experiences.,"Background: Obsessive-compulsive disorder (OCD) is a debilitating mental health disorder that can substantially impact upon quality of life and everyday functioning. Guidelines recommend pharmacological and psychological treatments, using a cognitive behaviour therapy approach (CBT) including exposure and response prevention, but access has generally been poor. Low intensity psychological interventions have been advocated. The evidence base for these interventions is emerging but there is a paucity of information regarding practitioners' perceptions and experiences of supporting individuals with OCD using this approach. Methods: Qualitative interviews were undertaken with psychological wellbeing practitioners (PWPs) (n = 20) delivering low intensity psychological interventions for adults with OCD within the context of a large pragmatic effectiveness trial. Interviews explored the feasibility and acceptability of delivering two interventions; guided self-help and supported computerised cognitive behaviour therapy (cCBT), within Improving Access to Psychological Therapies (IAPT) services in NHS Trusts. Interviews were recorded with consent, transcribed and analysed using thematic analysis. Results: PWPs acknowledged the benefits of low intensity psychological interventions for individuals experiencing OCD symptoms on an individual and population level. Offering low intensity support provided was perceived to have the opportunity to overcome existing service barriers to access treatment, improve patient choice and flexibility. Professional and service relevant issues were also recognised including self-beliefs about supporting people with OCD and personal training needs. Challenges to implementation were recognised in relation to practitioner resistance and intervention delivery technical complications. Conclusions: This study has provided insight into the implementation of new low intensity approaches to the management of OCD within existing mental health services. Benefits from a practitioner, service and patient perspective are identified and potential challenges highlighted. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Gellatly, Judith; Pedley, Rebecca; Molloy, Christine; Butler, Jennifer; Lovell, Karina; Bee, Penny; Anderson, Andersson, Baer, Bee, Bee, Belloch, Clark, Fontenelle, Glaser, Goodman, Goodwin, Green, Herbst, Knopp-Hoffer, Knowles, Kohn, Lovell, Lovell, Lovell, Mahoney, Marques, May, McHugh, Moore, Rennick-Egglestone, Richards, Richards, Rizq, Rizq, Rogers, Sandelowski, Sheehan, Stengler-Wenzke, Torres, Turner, Turpin, Turpin, Waller, Wootton, Wootton, Wootton, Ustun",2017.0,,0,0,
8363,Trauma and trichotillomania: A tenuous relationship.,"Some have argued that hair pulling in trichotillomania (TTM) is triggered by traumatic events, but reliable evidence linking trauma to TTM is limited. However, research has shown that hair pulling is associated with emotion regulation, suggesting a connection between negative affect and TTM. We investigated the associations between trauma, negative affect, and hair pulling in a cross-sectional sample of treatment seeking adults with TTM (N = 85). In the current study, participants' self-reported traumatic experiences were assessed during a structured clinical interview, and participants completed several measures of hair pulling severity, global TTM severity, depression, anxiety, experiential avoidance, and quality of life. Those who experienced trauma had more depressive symptoms, increased experiential avoidance, and greater global TTM severity. Although the presence of a trauma history was not related to the severity of hair pulling symptoms in the past week, depressive symptoms mediated the relationship between traumatic experiences and global TTM severity. These findings cast doubt on the notion that TTM is directly linked to trauma, but suggest that trauma leads to negative affect that individuals cope with through hair pulling. Implications for the conceptualization and treatment of TTM are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Houghton, David C; Mathew, Abel S; Twohig, Michael P; Saunders, Stephen M; Franklin, Martin E; Compton, Scott N; Neal-Barnett, Angela M; Woods, Douglas W; Baron, Beck, Beck, Beck, Begotka, Boughn, Breslau, Christenson, Christenson, Diefenbach, Diefenbach, First, Flores, Frisch, Fydrich, Gershuny, Greenberg, Guy, Hajcak, Heim, Houghton, Houghton, Kessler, Keuthen, Keuthen, Littleton, Lochner, Mansueto, McGuire, Merrill, Nakell, Ninan, Norberg, O'Sullivan, Ozten, Perkonigg, Phillips, Roberts, Roberts, Roberts, Shalev, Shusterman, Sobel, Stanley, Swedo, Ullman, Woods",2016.0,,0,0,
8364,"IntelliCare: An eclectic, skills-based app suite for the treatment of depression and anxiety.","Background: Digital mental health tools have tended to use psychoeducational strategies based on treatment orientations developed and validated outside of digital health. These features do not map well to the brief but frequent ways that people use mobile phones and mobile phone apps today. To address these challenges, we developed a suite of apps for depression and anxiety called IntelliCare, each developed with a focused goal and interactional style. IntelliCare apps prioritize interactive skills training over education and are designed for frequent but short interactions. Objective: The overall objective of this study was to pilot a coach-assisted version of IntelliCare and evaluate its use and efficacy at reducing symptoms of depression and anxiety. Methods: Participants, recruited through a health care system, Web-based and community advertising, and clinical research registries, were included in this single-arm trial if they had elevated symptoms of depression or anxiety. Participants had access to the 14 IntelliCare apps from Google Play and received 8 weeks of coaching on the use of IntelliCare. Coaching included an initial phone call plus 2 or more texts per week over the 8 weeks, with some participants receiving an additional brief phone call. Primary outcomes included the Patient Health Questionnaire-9 (PHQ-9) for depression and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety. Participants were compensated up to US $90 for completing all assessments; compensation was not for app use or treatment engagement. Results: Of the 99 participants who initiated treatment, 90.1% (90/99) completed 8 weeks. Participants showed substantial reductions in the PHQ-9 and GAD-7 (P < .001). Participants used the apps an average of 195.4 (SD 141) times over the 8 weeks. The average length of use was 1.1 (SD 2.1) minutes, and 95% of participants downloaded 5 or more of the IntelliCare apps. Conclusions: This study supports the IntelliCare framework of providing a suite of skills-focused apps that can be used frequently and briefly to reduce symptoms of depression and anxiety. The IntelliCare system is elemental, allowing individual apps to be used or not used based on their effectiveness and utility, and it is eclectic, viewing treatment strategies as elements that can be applied as needed rather than adhering to a singular, overarching, theoretical model. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Mohr, David C; Tomasino, Kathryn Noth; Lattie, Emily G; Palac, Hannah L; Kwasny, Mary J; Weingardt, Kenneth; Karr, Chris J; Kaiser, Susan M; Rossom, Rebecca C; Bardsley, Leland R; Caccamo, Lauren; Stiles-Shields, Colleen; Schueller, Stephen M; Andersson, Arnberg, Arroll, Bedi, Beutler, Chorpita, Churchill, Cuijpers, Donker, Dwight-Johnson, Harris, Helander, Hofmann, Huguet, Kazdin, Krebs, Kroenke, Lattie, Lowe, Martin, Mohr, Mohr, Mohr, Mohr, Mohr, Oulasvirta, Parks, Priest, Proudfoot, Renton, Richards, Roepke, Schueller, Schueller, Schueller, Sheehan, Shen, Spitzer, Stiles-Shields, Titov, Torous, Torous, Vaish, Versluis, Watts",2017.0,,0,0,
8365,Post-9/11 veterans and their partners improve mental health outcomes with a self-directed mobile and Web-based wellness training program: A randomized controlled trial.,"Background: Veterans with history of deployment in the Global War on Terror face significant and ongoing challenges with high prevalences of adverse psychological, physical, spiritual, and family impacts. Together, these challenges contribute to an emerging public health crisis likely to extend well into the future. Innovative approaches are needed that reach veterans and their family members with strategies they can employ over time in their daily lives to promote improved adjustment and well-being. Objective: The objective of this study was to evaluate effects of use of a Web-based, self-directed program of instruction in mind- and body-based wellness skills to be employed by Global War on Terror veterans and their significant relationship partners on mental health and wellness outcomes associated with postdeployment readjustment. Methods: We recruited 160 veteran-partner dyads in 4 regions of the United States (San Diego, CA; Dallas, TX; Fayetteville, NC; and New York, NY) through publicity by the Iraq and Afghanistan Veterans of America to its membership. Dyads were randomly allocated to 1 of 4 study arms: Mission Reconnect (MR) program alone, MR plus the Prevention and Relationship Enhancement Program (PREP) for Strong Bonds weekend program for military couples, PREP alone, and waitlist control. We administered a battery of standardized and investigator-generated instruments assessing mental health outcomes at baseline, 8 weeks, and 16 weeks. Dyads in the MR arms were provided Web-based and mobile app video and audio instruction in a set of mindfulness-related stress reduction and contemplative practices, as well as partner massage for reciprocal use. All participants provided weekly reports on frequency and duration of self-care practices for the first 8 weeks, and at 16 weeks. Results: During the first 8-week reporting period, veterans and partners assigned to MR arms used some aspect of the program a mean of 20 times per week, totaling nearly 2.5 hours per week, with only modest declines in use at 16 weeks. Significant improvements were seen at 8 and 16 weeks in measures of posttraumatic stress disorder, depression, sleep quality, perceived stress, resilience, self-compassion, and pain for participants assigned to MR arms. In addition, significant reductions in self-reported levels of pain, tension, irritability, anxiety, and depression were associated with use of partner massage. Conclusions: Both veterans and partners were able to learn and make sustained use of a range of wellness practices taught in the MR program. Home-based, self-directed interventions may be of particular service to veterans who are distant from, averse to, or prohibited by schedule from using professional services. Leveraging the partner relationship may enhance sustained use of self-directed interventions for this population. Use of the MR program appears to be an accessible, low-cost approach that supports well-being and reduces multiple symptoms among post-9/11 veterans and their partners. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kahn, Janet R; Collinge, William; Soltysik, Robert; Allen, Allen, Alschuler, Baker, Beardslee, Beck, Busby, Buysse, Caputo, Cohen, Collinge, Collinge, Collinge, Crawford, Dallal, de Burgh, Engel, Eysenbach, Field, Fredrickson, Fredrickson, Garland, Haskell, Hempel, Hourani, Johnson, Kerns, Kozak, Markman, Matthias, McLeland, Milliken, Neff, Otis, Outcalt, Ramchand, Schuman, Seppala, Sharpless, Stanley, Tanielian, Tanielian, Tugade, Walker, Weathers, Williams, Yarnold, Zimet",2016.0,,0,0,
8366,Multiple comorbidities of 21 psychological disorders and relationships with psychosocial variables: A study of the online assessment and diagnostic system within a Web-based population.,"Background: While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables. Objective: We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life. Methods: An online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age. Results: A 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same two disorders. Conclusions: Comorbidities of several psychological disorders using an online assessment tool within a Web-based population were similar to those found in face-to-face clinics using traditional assessment tools. Results provided support for the transdiagnostic approaches and confirmed the positive relationship between comorbidity and suicidal ideation, the negative relationship between comorbidity and social support, and the negative relationship comorbidity and quality of life. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","AL-Asadi, Ali M; Klein, Britt; Meyer, Denny; Al-Asadi, Al-Asadi, Albert, Allen, Almeida-Filho, Andersson, Andrews, Atalay, Axelson, Barlow, Blinder, Brady, Brown, Bulik, Carter, Casper, Conway, Cororve, Dansky, Farabaugh, Fava, Fava, Fava, Fornari, Garfinkel, Godart, Godart, Godart, Gorman, Gum, Halmi, Hinrichsen, Hudson, Hughes, Ivanenko, Iwasaki, Jordan, Keel, Kessler, Kessler, Klein, Laessle, Lilenfeld, Liu, Mackenzie, Marshall, McEvoy, McGovern, McManus, Moses, Naragon-Gainey, Pallister, Petersen, Phillips, Piran, Rauch, Roca, Rush, Rush, Salbach-Andrae, Schoevers, Schwalberg, Slade, Swanson, Swinbourne, Taylor, Teesson, Tsuno, Vollebergh, Wade, Watson, Zimmerman",2015.0,,0,0,
8367,The diagnostic validity and reliability of an Internet-based clinical assessment program for mental disorders.,"Background: Internet-based assessment has the potential to assist with the diagnosis of mental health disorders and overcome the barriers associated with traditional services (eg, cost, stigma, distance). Further to existing online screening programs available, there is an opportunity to deliver more comprehensive and accurate diagnostic tools to supplement the assessment and treatment of mental health disorders. Objective: The aim was to evaluate the diagnostic criterion validity and test-retest reliability of the electronic Psychological Assessment System (e-PASS), an online, self-report, multidisorder, clinical assessment and referral system. Methods: Participants were 616 adults residing in Australia, recruited online, and representing prospective e-PASS users. Following e-PASS completion, 158 participants underwent a telephone-administered structured clinical interview and 39 participants repeated the e-PASS within 25 days of initial completion. Results: With structured clinical interview results serving as the gold standard, diagnostic agreement with the e-PASS varied considerably from fair (eg, generalized anxiety disorder: kappa = .37) to strong (eg, panic disorder: kappa = .62). Although the e-PASS' sensitivity also varied (0.43-0.86) the specificity was generally high (0.68-1.00). The e-PASS sensitivity generally improved when reducing the e-PASS threshold to a subclinical result. Test-retest reliability ranged from moderate (eg, specific phobia: kappa = .54) to substantial (eg, bulimia nervosa: kappa = .87). Conclusions: The e-PASS produces reliable diagnostic results and performs generally well in excluding mental disorders, although at the expense of sensitivity. For screening purposes, the e-PASS subclinical result generally appears better than a clinical result as a diagnostic indicator. Further development and evaluation is needed to support the use of online diagnostic assessment programs for mental disorders. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Nguyen, David Phong; Klein, Britt; Meyer, Denny; Austin, David William; Abbott, Jo-Anne M; Aboraya, Aziz, Barak, Barak, Barak, Bastien, Batterham, Brown, Brown, Brugha, Buchanan, Carlbring, Cohen, Donker, Endicott, Farvolden, Field, First, First, Garb, Garcia-Lizana, Hilsenroth, Hyler, Joshi, Jowett, Klein, Kobak, Lalkhen, Landis, Lecrubier, Lin, Mallen, Pilkonis, Rohde, Sheehan, Sheskin, Streiner, van Ballegooijen, Walter, Wichers, Wittchen",2015.0,,0,0,
8368,"Effect of continuous positive airway pressure treatment on depression, anxiety and perceived stress levels in patients with obstructive sleep apnea syndrome.","Objective: The aim of this study is to determine the effects of continuous positive airway pressure (CPAP) treatment on depression, anxiety, and perceived stress levels and to identify factors predictive of treatment efficacy in patients with obstructive sleep apnea syndrome (OSAS). Method: This study included 51 patients admitted to the Adiyaman University Medical School Otorhinolaryngology Department or Eskisehir Yunus Emre State Hospital between January and September 2014 with one or more complaints including snoring, excessive daytime sleepiness, or apnea witnessed by the partner. Diagnosis of OSAS was made by polysomnography and CPAP treatment was initiated. Depression levels were assessed in all study subjects using the Hospital Anxiety and Depression Scale (HADS) at the start of treatment and at 3 months. Anxiety levels were assessed using both the HADS and the State and Trait Anxiety Inventory (STAI), and perceived stress level was assessed using the Perceived Stress Questionnaire (PSQ). Results: After CPAP treatment, we observed significant decreases in both the Depression and Anxiety Subscales of the HADS, in the Trait Anxiety subscale of the STAI, and in the PSQ. An evaluation of the initial parameters that predict improvements in these scales revealed that snoring time predicted decreases in all scale scores. Conclusions: In OSAS patients CPAP treatment has positive effects on psychological parameters like depression, anxiety, and perceived stress. We suggest that possible psychogenic benefits should be considered when deciding to start CPAP treatment, particularly in patients with pronounced and extended snoring who may also have social problems. (PsycINFO Database Record (c) 2017 APA, all rights reserved) Abstract (Turkish) Amac: Bu calismanin amaci Obstruktif Uyku Apnesi Sendromu (OUAS) olan hastalarda surekli pozitif havayolu basinci (SPHB) tedavisinin depresyon, kaygi ve algilanan stres duzeyleri uzerine etkilerini ve hastalarda tedaviden fayda gormeyi ongoren etkenleri belirlemektir. Yontem: Bu calismaya Ocak-Eylul 2014 tarihleri arasinda, Adiyaman Universitesi Tip Fakultesi Kulak Burun Bogaz (KBB) ve Eskisehir Yunus Emre Devlet Hastanesi KBB polikliniklerine horlama, gunduz asiri uyku hali veya tanikli apne belirtileri ile basvuran 51 hasta alindi. Hastalara polisomnografi ile OUAS tanisi konduktan sonra SPHB tedavisi baslandi. Hastalarin depresyon duzeylerini belirlemek icin SPHB tedavisi oncesinde ve tedavinin 3. ayinda Hastane Anksiyete ve Depresyon Olcegi (HADO), anksiyete duzeylerini belirlemek icin Durumluk ve Surekli Kaygi Olcegi (DSKO) ve algilanan stres duzeylerini belirlemek icin Algilanan Stres Olcegi (ASO) uygulandi. Bulgular: SPHB tedavisi sonrasinda hastalarda HADO'nun hem depresyon hem de anksiyete alt olceklerinde, DSKO'nun Surekli Kaygi alt olceginde ve ASO'de anlamli duzeyde azalma oldu. Bu olceklerdeki azalmayi ongoren baslangic degiskenleri incelendiginde horlama suresinin anlamli azalma gozlenen tum olcek puanlarindaki azalmayi ongordugu belirlendi. Sonuc: SPHB tedavisi OUAS hastalarinda hem kaygi hem de depresyon duzeylerinde azalma saglamistir. SPHB tedavisine baslama karari verilirken, ozellikle sosyal sorunlar da yasayabilecek horlama suresi uzun olan hastalarda olmak uzere, olasi psikolojik faydalarin hesaba katilmasi gerektigine inaniyoruz. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Celik, Mustafa; Sarikaya, Yasin; Acar, Mustafa; Kalenderoglu, Aysun; Dogan, Sedat; Kaskalan, Emin; Karatas, Mehmet",2016.0,,0,0,
8369,Increasing valued behaviors precedes reduction in suffering: Findings from a randomized controlled trial using ACT.,"Background: Psychological flexibility theory (PFT) suggests three key processes of change: increases in value-directed behaviors, reduction in struggle with symptoms, and reduction in suffering. We hypothesized that Acceptance and Commitment Therapy (ACT) would change these processes and that increases in valued action and decreases in struggle would precede change in suffering. Method: Data were derived from a randomized clinical trial testing ACT (vs. waitlist) for treatment-resistant patients with primary panic disorder with/without agoraphobia (n = 41). Valued behavior, struggle, and suffering were assessed at each of eight sessions. Results: Valued actions, struggle, and suffering all changed over the course of therapy. Overall changes in struggle and suffering were interdependent whereas changes in valued behavior were largely independent. Levels of valued behaviors influenced subsequent suffering, but the other two variables did not influence subsequent levels of valued action. Discussion: This finding supports a central tenet of PFT that increased (re-)engagement in valued behaviors precedes reductions in suffering. Possible implications for a better understanding of response and non-response to psychotherapy are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Gloster, Andrew T; Klotsche, Jens; Ciarrochi, Joseph; Eifert, Georg; Sonntag, Rainer; Wittchen, Hans-Ulrich; Hoyer, Jurgen; Arch, Barlow, Chambless, Ciarrochi, Clarke, Craske, Craske, Craske, Dimidjian, Duncan, Eifert, Eifert, Gloster, Gloster, Gloster, Grosse, Guy, Hayes, Hayes, Hayes, Hayes, Hoffart, Kashdan, Lejuez, Levin, Levitt, Lipsey, McArdle, McArdle, Michalak, Michelson, Muthen, Schlaepfer, Selig, Taylor, Wallerstein, Wenzlaff",2017.0,,0,0,
8370,Acceptance-based exposure therapy for public speaking anxiety.,"Public speaking anxiety (PSA), diagnosed at clinical levels as social anxiety disorder, nongeneralized type, is associated with significant distress and impairment in a substantial portion of the population (Aderka et al., 2012). Empirically supported behavioral treatments for PSA generally include in vivo and/or simulated exposure, usually presented with some form of rationale or context (e.g., habituation). Newer acceptance-based therapies frame exposure as an opportunity to increase one's willingness to experience anxiety, while engaging in valued behaviors. The present study examined the acceptability, feasibility, and preliminary effectiveness of acceptance-based exposure treatment for PSA compared to standard habituation-based exposure in a clinical population. Treatment was delivered in a group format over 6 weekly sessions. Participants receiving acceptance-based exposure (ABE) were significantly more likely than those receiving habituation-based exposure (HAB) to achieve diagnostic remission by 6-week follow-up. Those in the ABE condition rated this intervention equally acceptable and credible compared to participants receiving the habituation-based approach, and improvement on other outcome measures was comparable across conditions. Participants in both groups demonstrated significant and equivalent improvement on measures of public-speaking-related cognitions, confidence, and social skills. Baseline levels of mindful awareness moderated change in public-speaking-related cognitions across conditions, and baseline defusion moderated change in state anxiety for the ABE condition only. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","England, Erica L; Herbert, James D; Forman, Evan M; Rabin, Stephanie J; Juarascio, Adrienne; Goldstein, Stephanie P; Acarturk, Aderka, Allen, Ayres, Block, Block, Cardaciotto, Dalrymple, Edwards, Feske, First, Forman, Furmark, Gould, Hayes, Hayes, Heimberg, Heimberg, Herbert, Herbert, Hofmann, Hofmann, Hofmann, Hofmann, Holt, Hook, Hope, Knappe, Kocovski, McEvoy, Motley, Newman, Orsillo, Ossman, Pollard, Ruscio, Safren, Salkovskis, Salkovskis, Southworth, Spielberger, Taylor, Williams, Wolpe, Zaider, Zanarini",2012.0,,0,0,
8371,Social relationship satisfaction and PTSD: Which is the chicken and which is the egg?,"Background: Impaired social relationships are linked with higher levels of posttraumatic stress disorder (PTSD), but the association's underlying dynamics are unknown. PTSD may impair social relationships, and, vice versa, poorer relationship quality may interfere with the recovery from PTSD. Objective: This work longitudinally evaluates the simultaneous progression of PTSD symptoms and social relationship satisfaction (SRS) in a large cohort of recent trauma survivors. It also explores the effect of cognitive behavior therapy (CBT) on the association between the two. Method: Consecutive emergency department trauma admissions with qualifying PTSD symptoms (n = 501) were assessed 3 weeks and 5 months after trauma admission. The World Health Organization Quality of Life evaluated SRS and the Clinician Administered PTSD Scale evaluated PTSD symptom severity. Ninety-eight survivors received CBT between measurement sessions. We used Structural Equation Modeling to evaluate cross-lagged effects between the SRS and PTSD symptoms. Results: The cross-lagged effect of SRS on PTSD was statistically significant (beta = -0.12, p = 0.01) among survivors who did not receive treatment whilst the effect of PTDS on SRS was nil (beta = -0.02, p = 0.67). Both relationships were non-significant among survivors who received CBT. Discussion: SRS and PTSD are highly associated, and this study shows that changes in SRS in the early aftermath of traumatic events contribute to changes in PTSD, rather than vice versa. SRS impacts natural recovery, but not effective treatment. This study suggests that being satisfied with one's relationships might be considered as an important factor in natural recovery from trauma, as well as in intervention. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Freedman, Sara A; Gilad, Moran; Ankri, Yael; Roziner, Ilan; Shalev, Arieh Y; Andrews, Bandalos, Berz, Beutler, Blake, Campbell, Cundiff, De Burgh, Dekel, Dekel, Finkel, First, Freedman, Gewirtz, Goodman, Group, Holmbeck, Hu, Kaniasty, Kessler, King, Koenen, Little, Lunney, Monson, Muthen, Shalev, Shalev, Solomon, Stacy, Tarrier, Thrasher",2015.0,,0,0,
8372,Relationships between amount of post-intervention mindfulness practice and follow-up outcome variables in an acceptance-based behavior therapy for Generalized Anxiety Disorder: The importance of informal practice.,"Because most behavioral treatments are time-limited, skills and practices that foster long-term maintenance of gains made during treatment are of critical importance. While some studies have found mindfulness practice to be associated with improvements in outcome variables over the course of treatment (Vettese, Toneatto, Stea, Nguyen, & Wang, 2009), very little is known about the effects of continued mindfulness practice following treatment termination. The current study examined the relationships between separate single item measurements of three types of mindfulness practices (formal, informal, and mindfulness of breath in daily life) and long-term outcomes in worry, clinician-rated anxiety severity, and quality of life following treatment with an acceptance-based behavior therapy (ABBT) for Generalized Anxiety Disorder (GAD) in two separate treatment studies. Results from Study 1 showed that at 9-month follow-up, amount of informal mindfulness practice was significantly related to continued beneficial outcomes for worry, clinician-rated anxiety severity, and quality of life. Similarly, in Study 2, at 6-month follow-up informal mindfulness practice was significantly related to continued beneficial outcomes for anxiety severity and worry, and at 12-month follow-up informal mindfulness practice was significantly related to continued beneficial outcomes for quality of life and worry, and mindfulness of breath was significantly related to quality of life. When results from the final time point in both studies were combined, informal practice was significant related to all three outcome variables, and mindfulness of breath was significantly related to worry and quality of life. Formal practice was not significantly related to outcomes in either study, or in the combined sample. These findings support the further study of informal mindfulness practices as important tools for continued beneficial clinical outcomes following treatment for people with a principal diagnosis of GAD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Morgan, Lucas P.K; Graham, Jessica R; Hayes-Skelton, Sarah A; Orsillo, Susan M; Roemer, Lizabeth; Brown, Carmody, Cohen, Davidson, Deatherage, DiNardo, Dozois, Dunlop, Forman, Frisch, Gross, Hayes, Hayes, Hayes-Skelton, Hofmann, Kabat-Zinn, Kabat-Zinn, Kabat-Zinn, Kazantzis, Linehan, Mathew, Meyer, Ostafin, Powers, Roemer, Roemer, Segal, Sephton, Sobczak, Tabachnick, Vettese, Vowles",2014.0,,0,0,
8373,A pilot study of processes of change in group-based acceptance and commitment therapy for health anxiety.,"Background: Health anxiety or hypochondriasis is a disabling and persistent disorder with a high prevalence in primary care, and insufficient treatment opportunities and knowledge of treatment processes. Acceptance and Commitment Therapy (ACT) is a third-wave behavioral therapy, which has shown positive treatment effects in a variety of mental disorders. ACT is proposed to work through the process of 'psychological flexibility', but no studies have yet examined possible processes of change in an ACT-based treatment of health anxiety. Aim: The pilot study investigated whether changes in 'psychological flexibility' and 'mindfulness' mediated treatment outcome in health anxiety symptoms. Methods: 34 Danish patients with severe health anxiety were allocated to 10 sessions of group-based ACT. The patients completed self-report questionnaires at baseline, at end of treatment and at 6-month follow-up, measuring health anxiety symptoms (Whiteley Index), psychological flexibility (AAQ-II) and mindfulness (FFMQ). Results: Paired t-tests showed that psychological flexibility and mindfulness increased significantly during treatment (effect sizes ranged from SRM=.55-.76, p<.05). Regression analysis and Likelihood Ratio Tests showed that in particular psychological flexibility was significantly associated with the previously reported 49% reduction in health anxiety symptoms at 6-month followup. Conclusions: Findings from the uncontrolled study indicated that the decrease in health anxiety symptoms at 6-month follow-up was associated with the change in psychological flexibility and mindfulness during treatment. These findings support the processes of change proposed in ACT. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Hoffmann, Ditte; Halsboe, Lea; Eilenberg, Trine; Jensen, Jens S; Frostholm, Lisbeth; Baer, Baer, Baer, Baer, Baron, Barsky, Barsky, Bond, Boulanger, Chawla, Ciarrochi, Cohen, Conradt, Creed, Dalrymple, Eifert, Eilenberg, Fayers, Fink, Fink, Fink, Greeven, Gureje, Hayes, Hayes, Hayes, Hayes, Hedman, Hesser, Kazdin, Khoury, Kocovski, Levin, McManus, Mykletun, Noyes, Plumb, Powers, Ruiz, Ruiz, Segal, Sunderland, Thompson, Thomson, Walker, Weck, Zettle",2014.0,,0,0,
8374,Patients' expectations and satisfaction towards an Internet-based treatment for flying phobia: Preliminary data.,"The treatment of choice for specific phobias is in vivo exposure. Despite the proven efficacy of this technique, it is linked to a number of limitations in its acceptation. Information and Communication Technologies (i.e., computer -assisted exposure programs and Internet) could help to overcome these issues. However, to our knowledge, no other studies investigate the acceptability of an Internet-based treatment for Flying Phobia. The aim of this work is to offer data about the patients' expectations and satisfaction towards NO-FEAR Airlines in a pilot study. The sample was composed by four participants residents in Spain (N = 3) and Colombia (N = 1). Participants completed the Treatment Expectation- Satisfaction Questionnaire, reporting high expectations (M = 8.7; SD = .85) and satisfaction (M = 9.4; SD = .44) about the treatment. In conclusion, NO-FEAR Airlines was a well accepted Internet-based Treatment for FP. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Campos, Daniel; Quero, Soledad; Breton-Lopez, Juana; Soler, Carla; Mor, Sonia; Botella, Cristina; Garcia-Palacios, Andrews, Marks, Olatunji, Oakes, Tortella-Feliu, Nathan, Quero",2016.0,,0,0,
8375,Brain activation during fear extinction predicts exposure success.,"Background: Exposure therapy, a gold-standard treatment for anxiety disorders, is assumed to work via extinction learning, but this has never been tested. Anxious individuals demonstrate extinction learning deficits, likely related to less ventromedial prefrontal cortex (vmPFC) and more amygdala activation, but the relationship between these deficits and exposure outcome is unknown. We tested whether anxious individuals who demonstrate better extinction learning report greater anxiety reduction following brief exposure. Methods: Twenty-four adults with public speaking anxiety completed (1) functional magnetic resonance imaging during a conditioning paradigm, (2) a speech exposure session, and (3) anxiety questionnaires before and two weeks postexposure. Extinction learning was assessed by comparing ratings to a conditioned stimulus (neutral image) that was previously paired with an aversive noise against a stimulus that had never been paired. Robust regression analyses examined whether brain activation during extinction learning predicted anxiety reduction two weeks postexposure. Results: On average, the conditioning paradigm resulted in acquisition and extinction effects on stimulus ratings, and the exposure session resulted in reduced anxiety two weeks post-exposure. Consistent with our hypothesis, individuals with better extinction learning (less negative stimulus ratings), greater activation in vmPFC, and less activation in amygdala, insula, and periaqueductal gray reported greater anxiety reduction two weeks postexposure. Conclusion: To our knowledge, this is the first time that the theoretical link between extinction learning and exposure outcome has been demonstrated. Future work should examine whether extinction learning can be used as a prognostic test to determine who is most likely to benefit from exposure therapy. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Ball, Tali Manber; Knapp, Sarah E; Paulus, Martin P; Stein, Murray B; Barrett, Bremner, Bryant, Cox, Craske, Deacon, Eklund, Etkin, Foa, Fonzo, Glenn, Gottfried, Graham, Guthrie, Hauner, Heimberg, Herry, Hofmann, Hofmann, Hofmann, Huber, Kessler, Kim, Kroenke, Lecrubier, LeDoux, Lissek, Livneh, Lommen, Longmore, McNally, McNally, Milad, Milad, Milad, Mineka, Norman, Orr, Paul, Phillips, Quirk, Rachman, Rauch, Saad, Sehlmeyer, Sehlmeyer, Sotres-Bayon, Sotres-Bayon, Talairach, Tsao, Vasey, Wager, Whitfield-Gabrieli",2017.0,,0,0,
8376,Anxiety and cannabis-related problem severity among dually diagnosed outpatients: The impact of false safety behaviors.,"Cannabis use disorder (CUD) co-occurs with anxiety disorders at high rates. Little is known about the mechanisms linking CUD and anxiety disorders. One theoretically-driven perspective is that individuals with anxiety disorders may be more apt to use FSBs (i.e., behaviors that may be effective in decreasing anxiety in the short-term, but can maintain and even exacerbate anxiety in the long-term), which can perpetuate cannabis use despite cannabis-related problems. The present study tested whether FSB use explained the relation of anxiety symptom severity with cannabis quantity and related problems among 77 adults with CUD and comorbid anxiety disorders seeking outpatient CUD treatment. Results indicated that FSB frequency was significantly related to anxiety symptom severity and cannabis problem severity, but not cannabis quantity. Anxiety symptom severity was indirectly (via FSB frequency) related to cannabis problem severity, but not to cannabis quantity. These novel findings suggest that more frequent use of FSBs may play an important role in cannabis problem severity among individuals with CUD and anxiety disorders. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Buckner, Julia D; Zvolensky, Michael J; Ecker, Anthony H; Jeffries, Emily R; Lemke, Austin W; Dean, Kimberlye E; Businelle, Michael S; Gallagher, Matthew W; Agosti, Bernstein, Brown, Brown, Brown, Buckner, Buckner, Buckner, Buckner, Buckner, Buckner, Buckner, Buckner, Buckner, Buckner, Buckner, Comeau, Crippa, Ecker, Erceg-Hurn, First, Fresco, Hope, Hu, Kenny, Keough, Kline, Korte, Lozano, Marmorstein, Mattick, Meyer, Norton, O'Farrell, Reilly, Robinson, Salkovskis, Schmidt, Sobell, Stephens, Stinson, Ventura, Zvolensky",2017.0,,0,0,
8377,Day hospital treatment as a missing link for single patients with posttraumatic stress disorder (PTSD): A preliminary study.,"Background: The aim of this study was to examine the day hospital treatment outcome on severity of clinical manifestations, general neuroticism and coping mechanisms in patients suffering from chronic combat-related PTSD. Subjects and Methods: The sample consisted of 38 consecutive patients admitted to the Day Hospital treatment of PTSD during one year observation period. The average age of the sample was 46.03 years. The patients completed 3 self-report measures upon admission to the hospital and upon discharge: The Mississippi scale for combat-related PTSD (M-PTSD), The Crown-Crisp experiential index (CCEI), and The COPE inventory. Results: There was no significant change in the severity of clinical manifestations of PTSD, general neuroticism and coping mechanisms among the whole sample. However, compared to married participants and participants with children, single participants and those without children reported higher levels of anxiety when admitted to the hospital, but lower levels at discharge. In addition, patients without children reduced their avoidance behavior during the treatment. Conclusion: This preliminary study showed that single patients and those without children may benefit more from the day hospital treatment program. Our findings emphasize the importance of social support in the recovery process of severely traumatized persons, and may assist with the development of more effective therapeutic approaches. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kezic, Slobodanka; Britvic, Dolores; Caratan, Sandra; Gorsic, Lada; Ivezic, Ena; Matic, Katarina; Filipcic, Igor; Boscarino, Bravo-Mehmedbasic, Britvic, Britvic, Carver, Creamer, Creamer, Crown, Evans, Foa, Hammarberg, Hudek-Knezevic, Jakovljevic, Jaksie, Johnson, Keane, Kezic, Kezic, Klaric, Kuterovac-Jagodic, Ljubotina, Negrusa, Panagioti, Priebe, Robinaugh, Solomon, Solomon, Wilson",2016.0,,0,0,
8378,"Combined ""top-down"" and ""bottom-up"" intervention for anxiety sensitivity: Pilot randomized trial testing the additive effect of interpretation bias modification.","Objective: Anxiety disorders contribute substantially to the overall public health burden. Anxiety sensitivity (AS), a fear of anxiety-related sensations, is one of the few known malleable risk factors for anxiety pathology. Previous AS reduction treatments have primarily utilized ""top-down"" (e.g., psychoeducation) interventions. The goal of the current study was to evaluate the effect of adding a ""bottom-up"" (interpretation bias modification; CBM-I) intervention to an AS psychoeducation intervention. Design: Single-site randomized controlled trial. Participants completed either a 1) Psychoeducation + active CBM-I or 2) Psychoeducation + control CBM-I intervention. Change in AS was assessed post-intervention and at a one-month follow-up. Participants: Individuals with elevated levels of AS. Intervention: Single-session computer-delivered intervention for AS. Results: Accounting for baseline ASI-3 scores, post-intervention ASI-3 scores were significantly lower in the combined condition than in the psychoeducation + control CBM-I condition (beta = 0.24, p < 0.05; d = 0.99). The active CBM-I plus psychoeducation AS intervention was successful in reducing overall AS (59% post-intervention; p < 0.05, Cohen's d = 0.99) and these reductions were maintained through one month post-intervention (52%; p < 0.05, Cohen's d = 1.18). Participants in the active condition reported significantly lower rates of panic responding to a vital-capacity CO2 challenge (OR = 6.34, 95% CI = 1.07 -37.66) ciange in interpretation bias significantly mediated the relationship between treatment condition and post-treatment AS reductions. Conclusions: The current intervention was efficacious in terms of immediate and one-month AS reductions. Given its brevity, low-cost, low-stigma and portability, this intervention could lead to reducing the burden of anxiety disorders. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Capron, Daniel W; Norr, Aaron M; Allan, Nicholas P; Schmidt, Norman B; Bargh, Barlow, Beard, Beard, Beck, Beck, Bishop, Blomhoff, Brettschneider, Broman-Fulks, Brosan, Chambless, Clark, Clark, Clerkin, Cristea, Derakshan, Faul, Feingold, Feldner, Gardenswartz, Haug, Hayes, Hofmann, Joormann, Keough, Kessler, Kim, Kuckertz, Liebowitz, MacDonald, MacLeod, Menne-Lothmann, Moors, Oglesby, Olatunji, Otto, Pollack, Power, Preacher, Rapee, Rauch, Reiss, Salemink, Schmidt, Schmidt, Schmidt, Schmidt, Schneider, Spielberger, Steinman, Taylor, Taylor, Teachman, Telch, Watt, Williams",2017.0,,0,0,
8379,Lisdexamfetamine dimesylate effects on binge eating behaviour and obsessive-compulsive and impulsive features in adults with binge eating disorder.,"In a published 11-week, placebo-controlled trial, 50 and 70 mg/d lisdexamfetamine dimesylate (LDX), but not 30 mg/d LDX, significantly reduced binge eating days (primary endpoint) in adults with binge eating disorder (BED). This report provides descriptions of LDX effects on secondary endpoints (Binge Eating Scale [BES]; Three-Factor Eating Questionnaire [TFEQ]; Yale-Brown Obsessive Compulsive Scale modified for Binge Eating [Y-BOCS-BE]; and the Barratt Impulsiveness Scale, version 11 [BIS-11]) from that study. Week 11 least squares mean treatment differences favoured all LDX doses over placebo on the BES (p <= 0.03), TFEQ Disinhibition and Hunger subscales (all p < 0.05), and Y-BOCS-BE total, obsessive, and compulsive scales (all p <= 0.02) and on BIS-11 total score at 70 mg/d LDX (p = 0.015) and the TFEQ Cognitive Restraint subscale at 30 and 70 mg/d LDX (both p < 0.05). These findings indicate that LDX decreased global binge eating severity and obsessive-compulsive and impulsive features of BED in addition to binge eating days. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","McElroy, Susan L; Mitchell, James E; Wilfley, Denise; Gasior, Maria; Ferreira-Cornwell, M. Celeste; McKay, Michael; Wang, Jiannong; Whitaker, Timothy; Hudson, James I; Adler, Appolinario, Bas, Bello, Berridge, Brewer, Claudino, Crow, Davis, Deal, Fineberg, Galanti, Goldfein, Goodman, Gormally, Heal, Hsu, Hudson, Kalarchian, Kessler, Marcus, McElroy, McElroy, McElroy, McElroy, McElroy, McElroy, McElroy, McElroy, McElroy, Nasser, Panagiotou, Patton, Pennick, Schag, Schag, Stanford, Stunkard, Stunkard, Timmerman, Vannucci, Wigal, Yeomans",2016.0,,0,0,
8380,Prediction of treatment outcome in patients with obsessive-compulsive disorder with low-resolution brain electromagnetic tomography: A prospective EEG study.,"The issue of predicting treatment response and identifying, in advance, which patient will profit from treating obsessive-compulsive disorder (OCD) seems to be an elusive goal. This prospective study investigated brain electric activity [using Low-Resolution Brain Electromagnetic Tomography (LORETA)] for the purpose of predicting response to treatment. Forty-one unmedicated patients with a DSM-IV diagnosis of OCD were included. A resting 32-channel EEG was obtained from each participant before and after 10 weeks of standardized treatment with sertraline and behavioral therapy. LORETA was used to localize the sources of brain electrical activity. At week 10, patients were divided into responders and non-responders (according to a reduction of symptom severity >50% on the Y-BOCS). LORETA analysis revealed that at baseline responders showed compared to non-responders a significantly lower brain electric activity within the beta 1 (t = 2.86, p < 0.05), 2 (t = 2.81, p < 0.05), and 3 (t = 2.76, p < 0.05) frequency bands and ROI analysis confirmed a reduced activity in alpha 2 (t = 2.06, p < 0.05) in the anterior cingulate cortex (ACC). When baseline LORETA data were compared to follow-up data, the analysis showed in the responder group a significantly lower brain electrical resting activity in the beta 1 (t = 3.17. p < 0.05) and beta 3 (t = 3.11. p < 0.05) frequency bands and equally for the ROI analysis of the orbitofrontal cortex (OFC) in the alpha 2 (t = 2.15. p < 0.05) frequency band. In the group of non-responders the opposite results were found. In addition, a positive correlation between frequency alpha 2 (rho = 0.40, p = 0.010), beta 3 (rho = 0.42, p = 0.006), delta (rho = 0.33, p = 0.038), theta (rho = 0.34, p = 0.031), alpha 1 (rho = 0.38, p = 0.015), and beta1 (rho = 0.34, p = 0.028) of the OFC and the bands delta (rho = 0.33, p = 0.035), alpha 1 (rho = 0.36, p = 0.019), alpha 2 (rho = 0.34, p = 0.031), and beta 3 (rho = 0.38, p = 0.015) of the ACC with a reduction of the Y-BOCS scores was identified. Our results suggest that measuring brain activity with LORETA could be an efficient and applicable technique to prospectively identify treatment responders in OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Krause, Daniela; Folkerts, Malte; Karch, Susanne; Keeser, Daniel; Chrobok, Agnieszka I; Zaudig, Michael; Hegerl, Ulrich; Juckel, Georg; Pogarell, Oliver; Alptekin, Andreou, Anticevic, Aouizerate, Baldwin, Beck, Beucke, Brennan, Diener, Eisen, Ferguson, Fontenelle, Goncalves, Goodman, Hamilton, Hodgson, Holmes, Huber, Kennedy, Kuskowski, Lacerda, Laux, Lewin, Marazzi, Mientus, Mulert, Pascual-Marqui, Pascual-Marqui, Qin, Rauch, Schiepek, Sherlin, Swedo, Tang, Team, Tolin, Towle, Velikova, Venables, Yohai, Zimmerman",2016.0,,0,0,
8381,Effects of repetitive transcranial magnetic stimulation over supplementary motor area in patients with schizophrenia with obsessive-compulsive-symptoms: A pilot study.,"In patients with schizophrenia, obsessive-compulsive symptoms (OCS) are associated with lower rates of quality of life and polypharmacy. No previous controlled studies have tested the efficacy of repetitive transcranial magnetic stimulation (rTMS) on the treatment of OCS in this population. The present study examined the therapeutic effects of rTMS applied to the supplementary motor area (1Hz, 20 min, 20 sessions) on OCS and general symptoms in patients with schizophrenia or schizoaffective disorder, and whether this intervention can produce changes in plasma levels of brain derived neurotrophic factor (BDNF). A double-blind randomized controlled trial was conducted. Active and sham rTMS were delivered to 12 patients (6 on each group). Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Brief Psychiatric Rating Scale (BPRS) scores, as well as BDNF levels, were assessed before, after, and 4 weeks after treatment. rTMS did not significantly change the outcomes after treatment and on the follow-up (Y-BOCS: Wald's X2 = 3.172; p = 0.205; BPRS: X2 = 1.629; p = 0.443; BDNF: X2= 2.930; p = 0.231). There seemed to be a trend towards improvement of BPRS scores 4 weeks after rTMS treatment comparing with sham (Cohen's d = 0.875, with 32.9% statistical power). No side effects were reported. Future studies with larger sample sizes are needed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Mendes-Filho, Vauto Alves; de Jesus, Danilo Rocha; Belmonte-de-Abreu, Paulo; Cachoeira, Carolina Tosetto; Rodrigues Lobato, Maria Ines; Alonso, Andreasen, Asevedo, Avenanti, Barr, Berk, Berlim, Bressan, Brietzke, Buchanan, Cunha, Daskalakis, de Jesus, de Jesus, Downar, Fernandes, Fitzgerald, Fitzgerald, Freitas, Gahr, George, Gomes, Goodman, Goodman, Hadi, Jaafari, Kang, Lefaucheur, Leung, Mansur, Mantovani, Mantovani, Mukhopadhaya, Muller, Praeg, Prasko, Pridmore, Richter, Ricken, Rosa, Ruffini, Sachdev, Sampson, Sarkhel, Schirmbeck, Schirmbeck, Shi, Slotema, Stilo, Triggs, van den Heuvel, Wassermann",2016.0,,0,0,
8382,"Transcranial direct current stimulation for obsessive-compulsive disorder: A randomized, controlled, partial crossover trial.","Background: Presupplementary motor area (pre-SMA) hyperactivity has been detected in obsessive-compulsive disorder (OCD) patients. However, it is not understood whether this is a putative primary cause or a compensatory mechanism in OCD pathophysiology. Considering the polarity-dependent effects on cortical excitability of transcranial direct current stimulation (tDCS), we applied cathodal and/or anodal tDCS to the pre-SMA of OCD patients to test which current polarity might better improve symptoms. Methods: Twelve OCD patients received initially 10 anodal (n = 6) or cathodal (n = 6) daily consecutive 2 mA/20 min tDCS sessions with the active electrode placed bilaterally on the pre-SMA. In case of improvement or no change in symptoms severity, the subjects were maintained on the same current polarity for 10 more sessions. In case of symptoms worsening after the first 10 sessions they were switched to the other polarity for 10 more sessions to test the hypothesis of a polarity-dependent effect. Therefore, each subject received 20 tDCS sessions. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Sheehan Disability Scale (SDS)were administered biweekly to assess changes in symptoms severity. Results: After 10 sessions, 50% of patients who initially received anodal stimulation were switched to cathodal, while 100% of patients initially assigned to cathodal stimulation continued on the same polarity. At the end of the study, a statistically significant decrease was observed in the mean Y-BOCS scores of those patients who under went cathodal tDCS.No pre-post difference was found in the scores of patients following anodal tDCS. Conclusions: Cathodal but not anodal tDCS over the pre-SMA significantly improved OCD symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","D'Urso, Giordano; Brunoni, Andre R; Mazzaferro, Maria Pia; Anastasia, Annalisa; de Bartolomeis, Andrea; Mantovani, Antonio; Adams, Bation, Batsikadze, Berlim, Brunelin, Brunoni, Brunoni, Chikazoe, D'Urso, D'Urso, de Wit, First, First, Gomes, Goodman, Greenberg, Greenberg, Hazari, Kumar, Landeros-Weisenberger, Lopes, Mantovani, Mantovani, Mathers, Matsunaga, Milad, Mondino, Monte-Silva, Narayanaswamy, Nitsche, Nitsche, Pallanti, Parazzini, Parazzini, Rabinowitz, Rahman, Reis, Ruscio, Russo, Senco, Shafi, Sheehan, Sheehan, Simpson, Steketee, Tortella, Volpato, Yucel, Zheng, Zimmermann, Zimmermann",2016.0,,0,0,
8383,Duloxetine augmentation in resistant obsessive-compulsive disorder: A double-blind controlled clinical trial.,"Introduction: The aim of this study is to evaluate the efficacy of duloxetine augmentation in treatment of resistant obsessive-compulsive disorder (OCD). Methods: This augmentation trial was designed as an 8-week randomized controlled, double-blind study. Forty-six patients experiencing OCD who had failed to respond to at least 12 weeks of treatment with a selective serotonin reuptake inhibitor (fluoxetine, citalopram, or fluvoxamine) were randomly allocated to receive duloxetine or sertraline plus their current anti-OCD treatment. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure. Treatment response was defined as 25% or more decrease in scores of Y-BOCS. The mean dosage of duloxetine was 44.4 mg/d (range, 20-60 mg/d), and the mean dosage of sertraline was 123.8 mg/d (range, 50-200 mg/d). Results: Forty-six patients (24 of 30 in duloxetine group and 22 of 27 in sertraline group) completed the trial. Both groups showed improvement during the 8-week study period (mean Y-BOCS total score at week 8 as compared with baseline: P < 0.001 & P < 0.001) without significant difference (P = 0.861). Those receiving duloxetine plus their initial medications experienced a mean decrease of 33.0% in Y-BOCS score, and the patients with sertraline added to their initial medication experienced a mean decrease of 34.5% in Y-BOCS. Discussion: Our double-blind controlled clinical trial showed duloxetine to be as effective as sertraline in reducing obsessive and compulsive symptoms in patients with resistant OCD. However, it needs to be noted that our study is preliminary, and larger double-blind placebo-controlled studies are necessary to confirm the results. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Mowla, Arash; Boostani, Sanaz; Dastgheib, Seyed Ali; Barth, Blier, Boyer, Crespo Facorro, Dell'osso, Denys, Denys, Dougherty, Eddy, Goodman, Goodman, Kessler, Lee, Luis Blay, Marazziti, McDougle, Mowla, Petersen, Pigott, Pittenger, Rauch, Sahraian, Sansone, Sevincok, Stahl, Yaryura-Tobias, Yeh",2016.0,,0,0,
8384,Can the efficacy of behavioral and cognitive therapy for obsessive compulsive disorder be augmented by innovative computerized adjuvant?,"Aim: Cognitive behavioral therapy (CBT) is recognized as an effective treatment for obsessive-compulsive disorder (OCD). To maximize its effectiveness, we designed an ""experimental"" CBT defined by the addition of a computerized psychoeducative tool. Method: In a participative process involving patients through meetings of the French OCD association (AFTOC) and therapists through methodological workshops, we built a therapeutic tool from an experimental checking task. This task, which had been published in an earlier work, was adapted for its psychoeducative dimension. We here report on a randomized double-blind trial which included 35 patients with a moderate to severe OCD (Yale-Brown obsessive-compulsive scale, YBOCS between 16 and 25) predominant checking symptoms, no comorbidities, and 2-month stabilized or no treatment. Patients were randomly assigned to either ""standard"" versus ""experimental"" CBT. Both therapies were conducted by four CBT-experienced therapists specialized in OCD through weekly individualized sessions over 3 months. Therapy sessions of the experimental CBT were conducted as the standard CBT except for a short exercise with the computerized psychoeducative tool performed by the patient and debriefed with the therapist at the end of the sessions. Patients were assessed before, during, after therapy and again 6 months later using standard clinical tools and a neurobehavioral assessment based on an original symptom-provocation task with anxiety ratings including three types of photographs: neutral, generic inducing obsessions (e.g., doorknobs, electric wires...) and personalized (taken by the patients in their own environment). Results: Clinically, ""standard"" and ""experimental"" CBT resulted in a significant but equivalent improvement (48% vs 45% reduction of the Y-BOCS score; P = 0.36; d = 0.12). Therapists were satisfied with the psychoeducative dimension of the computerized psychoeducative tool but reported variable acceptance across patients. Patients appreciated its usability. The clinical improvement was associated with a reduction of the task-induced anxiety (r = 0.42, P < 0.05), especially towards personalized items (-28,2% vs -20.41% for generic and -6.24% for neutral photographs, P < 0.001). Mid-therapy response level was predictive of the final improvement (r = 0.82, P < 0.001). Conclusion: The computerized tool may provide a well-accepted therapeutic adjuvant even though it doesn't improve the therapeutic effect. Using a personalized symptom-provocation task reveals the parallel evolution of symptoms and neurobehavioral markers through CBT. Despite the difficulty of improving an evidence-based therapy, mid-therapy results call for investigating the possible adjustments of treatment strategies at an early stage. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Morgieve, M; N'Diaye, K; Clair, A.-H; Pelissolo, A; Mallet, L; Abramowitz, Aouizerate, Baxter, Beck, Beevers, Bouvard, Breton-Lopez, Castelnuovo, Castonguay, Clark, Cottraux, Cuijpers, Foroushani, Gava, Goodman, Jonsson, Kim, Laurenceau, Lind, Linden, Linden, Lovell, Mallet, Marks, Mataix-Cols, Meyerbroker, Morgieve, Morgieve, Proudfoot, Rauch, Rotge, Roth, Ruscio, Schiepek, Schwartz, Servant, Sheehan, Simon, Spielberger, Steketee, Wampold",2016.0,,0,0,
8385,Clinical presentation of not-just right experiences (NJREs) in individuals with OCD: Characteristics and response to treatment.,"There is increasing recognition that instead of being motivated by a desire to prevent harm and reduce anxiety, some obsessive-compulsive symptoms may be driven by a desire to get things 'just right' or 'complete' and to reduce a sense of discomfort. However, existing data is largely from non-clinical samples. Therefore, in the current paper we examine the clinical presentation of not just right experiences (NJREs) in patients diagnosed with OCD and compare their experiences to both anxious and unselected controls. Then, we provide preliminary data on NJREs before and after cognitive behavioral therapy (exposure and response prevention). First, individuals with OCD were found to report experiencing significantly more NJREs and being more distressed by them compared to anxious controls and unselected controls. Next, there was some support for the specificity of NJREs to feelings of incompleteness. Finally, we found that after completing treatment, patients reported experiencing significantly less NJREs and experienced less distress associated with the NJREs. In conclusion we believe that more work on the role of NJREs is warranted and that characterizing OCD symptoms as either based on harm avoidance or incompleteness/NJREs may be a useful framework for classifying OCD symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Coles, Meredith E; Ravid, Ariel; Abramowitz, Abramowitz, Adler, Belloch, Catapano, Coles, Coles, Ecker, Fergus, Ferrao, Foa, Foa, Foa, Franklin, Ghisi, Ghisi, Goodman, Kishore, Kozak, Little, Ost, Pietrefesa, Pietrefesa, Pitman, Rosario, Schafer, Schienle, Schubert, Sica, Simonds, Starcevic, Subramaniam, Summerfeldt, Summerfeldt, Summers, Tabachnik, Wilhelm",2016.0,,0,0,
8386,Toward evidence-based medical statistics: A Bayesian analysis of double-blind placebo-controlled antidepressant trials in the treatment of anxiety disorders.,"The Food and Drug Administration (FDA) uses a p < 0.05 null-hypothesis significance testing framework to evaluate ""substantial evidence"" for drug efficacy. This framework only allows dichotomous conclusions and does not quantify the strength of evidence supporting efficacy. The efficacy of FDA-approved antidepressants for the treatment of anxiety disorders was re-evaluated in a Bayesian framework that quantifies the strength of the evidence. Data from 58 double-blind placebo-controlled trials were retrieved from the FDA for the second-generation antidepressants for the treatment of anxiety disorders. Bayes factors (BFs) were calculated for all treatment arms compared to placebo and were compared with the corresponding p-values and the FDA conclusion categories. BFs ranged from 0.07 to 131,400, indicating a range of no support of evidence to strong evidence for the efficacy. Results also indicate a varying strength of evidence between the trials with p < 0.05. In sum, there were large differences in BFs across trials. Among trials providing ""substantial evidence"" according to the FDA, only 27 out of 59 dose groups obtained strong support for efficacy according to the typically used cutoff of BF >= 20. The Bayesian framework can provide valuable information on the strength of the evidence for drug efficacy. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Monden, Rei; Vos, Stijn; Morey, Richard; Wagenmakers, Eric-Jan; De Jonge, Peter; Roest, Annelieke M; Blake, Davidson, De Vries, Edwards, Eyding, Goodman, Goodman, Goodman, Grendar, Hamilton, Ioannidis, Ioannidis, Johnson, Kass, Kirsch, Lavine, Liebowitz, Love, Morey, Morey, Roest, Rosenthal, Rouder, Rouder, Simonsohn, Turner, Turner, Turner, Wagenmakers, Weathers, Wetzels",2016.0,,0,0,
8387,Impact of cognitive-behavioral group therapy for obsessive-compulsive disorder on family accommodation: A randomized clinical trial.,"The aim of this study was to assess the impact of cognitive-behavioral group therapy (CBGT) with the brief involvement of family members on family accommodation and to identify predictors of family accommodation reduction (patient and family member characteristics). This randomized clinical trial assessed 98 pairs of patients with obsessive-compulsive disorder (OCD) and their family members: 52 (53.1%) were allocated to the intervention group (12 CBGT sessions-two with the family member), and 46 (46.9%) to a waiting list (control group). Symptom severity and family accommodation were assessed before and after CBGT. There was significant improvement of OCD symptoms and family accommodation scores after CBGT in the intervention group vs. the control group. The following variables were significant predictors of family accommodation reduction after multivariate analysis: patient characteristics-absence of comorbid unipolar disorder, lower obsession score, and higher education level; family member characteristics-higher hoarding score. The model explained 47.2% of the variance in family accommodation scores after treatment. CBGT for patients with OCD and the brief involvement of family members contributed to reduce family accommodation. Both patient and family member characteristics were predictors of family accommodation reduction. This finding can help qualify CBGT protocols. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Gomes, Juliana Braga; Cordioli, Aristides Volpato; Bortoncello, Cristiane Flores; Braga, Daniela Tusi; Goncalves, Francine; Heldt, Elizeth; Abramowitz, Albert, Amir, Barrett, Beck, Beck, Calvocoressi, Calvocoressi, Cordioli, Cordioli, Cunha, Ferrao, Ferrao, First, Foa, Garcia, Gomes, Gomes, Gomes, Goodman, Guy, Jonsson, Jonsson, Lebowitz, McKay, Merlo, Miguel, Peris, Quarantini, Raffin, Souza, Stewart, Storch, Storch, Thompson-Hollands, Van Noppen",2016.0,,0,0,
8388,D-cycloserine addition to exposure sessions in the treatment of patients with obsessive-compulsive disorder.,"Background: Preliminary studies have shown that the addition of the partial NMDA-agonist D-cycloserine (DCS) might be promising in enhancing the results of exposure therapy in obsessive-compulsive disorder (OCD). We examined the effect of DCS addition to exposure therapy in a somewhat larger sample of OCD patients with special attention to subgroups, because of the heterogeneity of OCD. Methods: A randomized, double-blind, placebo controlled trial was conducted in 39 patients with OCD. Patients received 6 guided exposure sessions, once a week. One hour before each session 125mg DCS or placebo was administered. Results: Scores on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) declined more in the DCS group than in the placebo group, but the difference did not reach statistical significance (P = 0.076, partial eta2 = 0.13). Response percentages also did not differ between the DCS and the placebo group (37% and 15% respectively). In the 'cleaning/contamination' subgroup a significant effect was found in favour of DCS (P = 0.033, partial eta2 = 0.297). Conclusions: The results of this study did not support the application of DCS to exposure therapy in OCD. Some specific aspects need further investigation: efficacy of DCS in a larger 'cleaning/contamination' (sub-)group, DCS addition only after successful sessions, interaction with antidepressants. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","de Leeuw, A. S; van Megen, H. J. G. M; Kahn, R. S; Westenberg, H. G. M; Abramowitz, Abramowitz, Andersson, Arindell, Beck, Blier, Bontempo, Chasson, de Kleine, Dell'Osso, Eddy, Farrell, Farris, First, Fisher, Foa, Franklin, Goodman, Goodman, Guy, Harrison, Iervolino, Knopp, Kushner, Lewin, Mancebo, Mataix-Cols, Mataix-Cols, Neziroglu, Norberg, Parnas, Quirk, Rachman, Raine, Ressler, Rothbaum, Rufer, Sanavio, Santana, Shetti, Smits, Stein, Storch, Storch, Thiel, Tolin, van Berckel, van Berckel, van den Heuvel, van der Does, Van Oppen, Visser, Vollema, Wilhelm, Williams",2017.0,,0,0,
8389,Randomized controlled trial of adjunctive EEG-biofeedback treatment of obsessive-compulsive disorder.,"Background: Current interventions for obsessive-compulsive disorder (OCD) are often of limited benefit. Aim: To evaluate the effect of adjunctive treatment with EEG biofeedback training on the symptoms and cognitive functioning of individuals with OCD. Methods: A total of 79 individuals with OCD were randomly assigned to the study group (n = 40) or the control group (n = 39). The control group was treated using a combination of sertraline (50 to 200 mg/d) and weekly cognitive behavioral therapy sessions by trained therapists for 8 weeks; the study group was treated using the same regimen plus EEG biofeedback sessions 5 times per week. The Yale Brown Obsessive Compulsive Scale (YBOCS) was administered by a psychiatrist who was blind to patients' treatment status before treatment and at the end of the 2nd, 4th, 6th and 8th week for treatment; the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was administered before and after the 8-week trial. Results: Three individuals dropped out of the study group and four dropped out of the control group (chi2 = 0.186, p = 0.712). At the end of the study, treatment was considered effective in 32 of the 37 (86.5%) participants in the study group and in 22 of the 35 (62.9%) participants in the control group (chi2 = 5.36, p = 0.021). Repeated measures analysis of variance showed that the improvement in OCD symptoms was greater in the study group than the control group by the 6th week of treatment. At the end of the trial all 5 cognitive dimensions assessed by the RBANS were significantly better in study groups subjects than in control group subjects and the changes in the YBOCS score were significantly correlated with changes in the RBANS overall score in the study group (r = 0.43, p = 0.007), but not in the control group (r = 0.171, p = 0.327). Conclusions: This methodologically rigorous study demonstrates that 8 weeks of adjunctive treatment with EEG biofeedback training can significantly improve the clinical symptoms and cognitive functioning of OCD patients being treated with medication and psychotherapy. Further work is needed to assess the long-term effects of biofeedback training and the need for booster sessions after an initial period of training. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Deng, Xiaopeng; Wang, Gaohua; Zhou, Lifang; Zhang, Xinfeng; Yang, Mei; Han, Gangya; Tu, Zheming; Liu, Bo; Addington, Cai, Fan, Feng, Jiao, Lazarov, Li, Liu, Mantella, Wang, Wang, Wang, Xu, Ye, Zhang, Zhang, Zhao, Zhen, Zhou, Zhou",2014.0,,0,0,
8390,Adult separation anxiety disorder in complicated grief: An exploratory study on frequency and correlates.,"Introduction: Complicated grief (CG) has been the subject of increasing attention in the past decades but its relationship with separation anxiety disorder (SEPAD) is still controversial. The aim of the current study was to explore the prevalence and clinical significance of adult SEPAD in a sample of help-seeking individuals with CG. Methods: 151 adults with CG, enrolled in a randomized controlled trial comparing the effectiveness of (CG) treatment to that of interpersonal therapy, were assessed by means of the Inventory of Complicated Grief (ICG), the Structured Clinical Interview for DSM-IV, the Hamilton Rating Scale for Depression (HAM-D), the Work and Social Adjustment Scale (WSAS), the Adult Separation Anxiety Questionnaire (ASA-27), the Grief Related Avoidance Questionnaire (GRAQ), the Peritraumatic Dissociative Experiences Questionnaire (PDEQ), and the Impact of Events Scale (IES). Results: 104 (68.9%) individuals with CG were considered to have SEPAD (ASA-27 score >= 22). Individuals with SEPAD were more likely to have reported a CG related to the loss of another close relative or friend (than a parent, spouse/partner or a child) (p =.02), as well as greater scores on the ICG (p = < .001), PDEQ (p = .004), GRAQ (p < .001), intrusion (p < .001) and avoidance (p = <.001) IES subscales, HAM-D (p < .001) and WSAS (p = .006). ASA-27 total scores correlated with ICG (p < .0001), PDEQ (p < .001) GRAQ (p < .0001) scores and both the IES intrusion (p < .0001) and IES avoidance (p < .0001) subscale scores. People with SEPAD had higher rates of lifetime post-traumatic stress disorder (PTSD) (p = .04) and panic disorder (PD) (p = .01). Conclusions: SEPAD is highly prevalent among patients with CG and is associated with greater symptom severity and impairment and greater comorbidity with PTSD and PD. Further studies will help to confirm and generalize our results and to determine whether adult SEPAD responds to CG treatment and/or moderates CG treatment response. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Gesi, Camilla; Carmassi, Claudia; Shear, Katherine M; Schwartz, Theresa; Ghesquiere, Angela; Khaler, Julie; Dell'Osso, Liliana; Aaronson, Boelen, Boelen, Boelen, Bowlby, Bowlby, Bowling, Carmassi, Carmassi, Carmassi, Carmassi, Cassano, Cyranowski, Dell'Osso, Dell'Osso, Dell'Osso, Dell'Osso, Dillen, Eapen, Fagiolini, First, Fraley, Gesi, Golden, Hamilton, Holland, Horowitz, Jacobs, Kirsten, Kristensen, Lee, Manicavasagar, Manicavasagar, Manicavasagar, Manicavasagar, Marmar, Middleton, Miniati, Mundt, Pini, Pini, Prigerson, Prigerson, Prigerson, Shear, Shear, Shear, Shear, Shear, Shear, Silove, Silove, Silove, Silove, Silove, Silove, Silverman, Szanto, van Doorn, Vanderwerker, Wijeratne",2017.0,,0,0,
8391,A preliminary investigation of a relapse prevention mobile application to maintain smoking abstinence among individuals with posttraumatic stress disorder.,"Objectives: Smokers with posttraumatic stress disorder (PTSD) have increased difficulty achieving and maintaining abstinence. Contingency management approaches to smoking cessation interventions have demonstrated short-term efficacy but are limited by high rates of relapse. The goal of this pilot study was to evaluate the usability and feasibility of a smartphone-based smoking cessation application (Stay Quit Coach) designed to prevent relapse among individuals with PTSD. Methods: Smokers (N = 11) were randomized to (1) QUIT4EVER, an intervention combining mobile contingency management smoking cessation counseling and medications, and Stay Quit Coach or (2) a contact control condition that was identical to QUIT4EVER except Stay Quit Coach was not included. The primary outcome was prolonged smoking abstinence. Results: Among those queried during the follow-up periods, average Stay Quit Coach helpfulness ratings were high and ranged from 7.25 to 10 on a 10-point Likert scale (with higher scores corresponding to greater helpfulness). The Stay Quit Coach was rated by participants as being most effective at helping to quit smoking, helping to remain quit, and providing support and relevant information about quitting. Among the three quitters in the QUIT4EVER group, all reported abstinence at 3 and 6 months; however, abstinence was only bioverified for one quitter at 6 months. Among the four quitters in the contact control condition group, three reported abstinence at 3 and 6 months, but abstinence was not confirmed by bioverification. Conclusions: Smokers with PTSD express interest in and helpfulness of Stay Quit Coach for remaining abstinent after a quit attempt. Combined use of mobile contingency management and Stay Quit Coach is a feasible and acceptable adjunctive smoking cessation treatment for reducing smoking among smokers with PTSD. Adequately powered clinical trials are needed to demonstrate the long-term efficacy of this combined approach to smoking cessation. This study [Use of Technological Advances to Prevent Smoking Relapse among Smokers with PTSD (QUIT4EVER)] was registered on www.clinicaltrials.gov. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Hicks, Terrell A; Thomas, Shaun P; Wilson, Sarah M; Calhoun, Patrick S; Kuhn, Eric R; Beckham, Jean C; Abroms, Agboola, Beck, Beckham, Blake, Carpenter, Carroll, Catz, Donker, Fiore, First, Gwaltney, Hapke, Heatherton, Hertzberg, Hoffman, Hughes, Jorenby, Kirby, Knapp, Kollins, Ledgerwood, Lee, McFall, Morisky, Petry, Prendergast, Roll, Sobell, Stitzer, Stitzer, Tidey, Tiffany, Toll",2017.0,,0,0,
8392,Relation between treatment satisfaction and treatment outcome in veterans with posttraumatic stress disorder.,"Existing measures of patient treatment satisfaction are largely characterized by a lack of psychometric evaluation, varied definitions across studies, and small numbers of items. The present study evaluated a patient treatment satisfaction questionnaire specifically designed for psychiatric outpatient treatment satisfaction, the Charleston Psychiatric Outpatient Satisfaction Scale (CPOSS), to extend previous findings by examining: 1) the psychometric properties of the CPOSS and the common domains within patient treatment satisfaction, and 2) the preliminary relations between the CPOSS and treatment outcome during exposure therapy in patients with posttraumatic stress disorder (PTSD). The present investigation included two studies. The first involved 170 combat veterans with PTSD who completed brief psychotherapy, and whose post-treatment CPOSS scores were used for the factor analytic investigations. The second study involved 63 combat veterans with PTSD who received a course of brief exposure-based psychotherapy and completed pre- and post-treatment assessments to investigate the relations between the CPOSS and treatment outcome. The first study supported the psychometric properties of the CPOSS, including identifying four psychometrically-sound subscales for: respectful care, appearance of facility, convenience of facility, and recommendation to friends/family. The second study demonstrated that the CPOSS was a significant predictor of post-treatment PTSD symptoms, relative to demographics and pre-treatment symptoms. Together, these findings support the use of the CPOSS as a valuable addition in psychiatric outpatient settings to both assess and potentially improve patient treatment satisfaction. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gros, Daniel F; Gros, Kirstin Stauffacher; Acierno, Ron; Frueh, B. Christopher; Morland, Leslie A; Anttkisson, Blake, Blanchard, Brown, Burnett-Zeigler, Cone, Foa, Fontana, Foster, Frueh, Gros, Gros, Gros, Gros, Hermann, Horn, Howard, Kaltenthaler, Lebow, McCord, Morland, Morland, Napoles, Orsillo, Pellegrin, Reilly, Resick, Riggs, Strachan, van Millen, Weathers",2013.0,,0,0,
8393,A pilot study of brief psychodynamic psychotherapy for depression and anxiety in young Iranian adults: The effect of attachment style on outcomes.,"This pilot study examines the feasibility and efficacy of a brief psychodynamic therapy called brief empathic psychotherapy (BEP; B. Seruya, 1997, Empathic brief psychotherapy, Jason Aronson, Northvale, NJ) as a treatment for anxiety and depressive symptoms in a group of young university students in Iran. The study used an uncontrolled repeated-measures design with data collected at baseline, completion of treatment and at 3 months following completion. Participants were 20 students from an Iranian university who presented to the university's health center with symptoms of anxiety and depression. All subjects were Persian. There were 9 men and 11 women participants, aged 19 to 24 years. Participants completed the Depression Anxiety Stress Scale, short-form (A. Sahebi, M. J. Asghari, & R. S. Salari, 2004) and the Adult Attachment Scale (AAS; C. Hazan & P. Shaver, 1987) at each time point. The recruited sample included an equal number of participants with avoidant and anxious attachment styles, based on participants' AAS scores. Both the anxious and the avoidant groups received 12 sessions of weekly individual therapy. Substantial and statistically significant posttreatment reductions were found in anxiety and depression symptoms for both attachment styles and these reductions increased in the follow-up period. Effect sizes were very large by Cohen's criteria. This pilot study suggests that there is preliminary support for BEP as a feasible and potentially efficacious treatment of anxiety and depression in an Iranian cultural context. The study also suggests that BEP may be equally effective for individuals with either avoidant or ambivalent attachment styles, although this finding requires further investigation. Findings are discussed in terms of different therapeutic approaches suitable for individuals with anxious versus avoidant attachment styles. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Heidari, Shima; Lewis, Andrew J; Allahyari, Abbasali; Azadfallah, Parviz; Bertino, Melanie D; Abedian, Besharat, Blatt, Bosmans, Conradi, Davanloo, Diamond, Driessen, Fonagy, Ghodsi, Grunebaum, Hazan, Horowitz, Kessler, Khodayarifard, Koppers, Lee, Lemma, Lewis, Lewis, Li, Lovibond, Main, Manicavasagar, McBride, Melyani, Nilforooshan, Oskis, Parish, Rezaeian, Rice, Rudy, Sahebi, Seruya, Shaver, Shedler, Smith, Suchman, Surcinelli, Wachtel, Walsh, Waxler, Wei",2013.0,,0,0,
8394,Maximizing the efficacy of interoceptive exposure by optimizing inhibitory learning: A randomized controlled trial.,"Cognitive-behavioral treatments for panic disorder (PD) emphasize interoceptive exposure (IE) to target anxiety sensitivity (AS) but vary considerably in its manner of delivery. This randomized controlled trial was conducted to compare the efficacy of the low-dose delivery of IE exercises often prescribed in treatment protocols to an intensive form of IE hypothesized to optimize inhibitory learning. Participants (N = 120) with elevated AS were randomly assigned to one of four single-session interventions: (a) low-dose IE as prescribed in Barlow and Craske's Panic Control Treatment, (b) low-dose IE without controlled breathing or a lengthy between-trial rest period, (c) intensive IE, or (d) expressive writing control. Compared to the other conditions, intensive IE produced significantly greater reductions in AS and fearful responding to a straw breathing task from pretreatment to posttreatment. Maintenance of gains during the follow-up period did not differ between conditions. Changes in fear toleration and negative outcome expectancies fully mediated the superior efficacy of intensive IE over low-dose IE. The two low intensity IE conditions produced particularly high rates of fear sensitization on between-trial and outcome variables. The findings suggest that the intensive delivery of IE exercises has the potential to improve the efficacy of exposure-based treatments for PD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Deacon, Brett; Kemp, Joshua J; Dixon, Laura J; Sy, Jennifer T; Farrell, Nicholas R; Zhang, Annie R; Abramowitz, Antony, Antony, Barlow, Barlow, Beck, Beck, Beck, Beck, Bouton, Broman-Fulks, Brown, Carter, Clark, Cox, Craske, Craske, Craske, Deacon, Deacon, Deacon, Devilly, Foa, Foa, Gloster, Keough, Kozak, Lilienfeld, McHugh, Meuret, Otto, Otto, Preacher, Preacher, Rachman, Raffa, Rapee, Reiss, Rubin, Schmidt, Schmidt, Schmidt, Simmons, Smits, Taylor, Taylor",2013.0,,0,0,
8395,Enhancing recovery rates: Lessons from year one of IAPT.,"Background: The English Improving Access to Psychological Therapies (IAPT) initiative aims to make evidence-based psychological therapies for depression and anxiety disorder more widely available in the National Health Service (NHS). 32 IAPT services based on a stepped care model were established in the first year of the programme. We report on the reliable recovery rates achieved by patients treated in the services and identify predictors of recovery at patient level, service level, and as a function of compliance with National Institute of Health and Care Excellence (NICE) Treatment Guidelines. Method: Data from 19,395 patients who were clinical cases at intake, attended at least two sessions, had at least two outcomes scores and had completed their treatment during the period were analysed. Outcome was assessed with the patient health questionnaire depression scale (PHQ-9) and the anxiety scale (GAD-7). Results: Data completeness was high for a routine cohort study. Over 91% of treated patients had paired (pre-post) outcome scores. Overall, 40.3% of patients were reliably recovered at post-treatment, 63.7% showed reliable improvement and 6.6% showed reliable deterioration. Most patients received treatments that were recommended by NICE. When a treatment not recommended by NICE was provided, recovery rates were reduced. Service characteristics that predicted higher reliable recovery rates were: high average number of therapy sessions; higher step-up rates among individuals who started with low intensity treatment; larger services; and a larger proportion of experienced staff. Conclusions: Compliance with the IAPT clinical model is associated with enhanced rates of reliable recovery. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gyani, Alex; Shafran, Roz; Layard, Richard; Clark, David M; Clark, Clark, Glover, Jacobson, Kroenke, Kroenke, Kwan, Layard, Layard, Lemeshow, McManus, Menard, Mickey, Spitzer",2013.0,,0,0,
8396,Screening high-risk patients and assisting in diagnosing anxiety in primary care: The Patient Health Questionnaire evaluated.,"Background: Questionnaires may help in detecting and diagnosing anxiety disorders in primary care. However, since utility of these questionnaires in target populations is rarely studied, the Patient Health Questionnaire anxiety modules (PHQ) were evaluated for use as: a) a screener in high-risk patients, and/or b) a case finder for general practitioners (GPs) to assist in diagnosing anxiety disorders. Methods: A cross-sectional analysis was performed in 43 primary care practices in the Netherlands. The added value of the PHQ was assessed in two samples: 1) 170 patients at risk of anxiety disorders (or developing them) according to their electronic medical records (high-risk sample); 2) 141 patients identified as a possible 'anxiety case' by a GP (GP-identified sample). All patients completed the PHQ and were interviewed using the Mini International Neuropsychiatric interview to classify DSM-IV anxiety disorders. Psychometric properties were calculated, and a logistic regression analysis was performed to assess the diagnostic value of the PHQ. Results: Using only the screening questions of the PHQ, the area under the curve was 83% in the high-risk sample. In GP-identified patients the official algorithm showed the best characteristics with an area under the curve of 77%. Positive screening questions significantly increased the odds of an anxiety disorder diagnosis in high-risk patients (odds ratio = 23.4; 95% confidence interval 6.9 to 78.8) as did a positive algorithm in GP-identified patients (odds ratio = 13.9; 95% confidence interval 3.8 to 50.6). Conclusions: The PHQ screening questions can be used to screen for anxiety disorders in high-risk primary care patients. In GP-identified patients, the benefit of the PHQ is less evident. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Muntingh, Anna D. T; De Heer, Eric W; Van Marwijk, Harm W. J; Ader, Herman J; Van Balkom, Anton J. L. M; Spinhoven, Philip; Van der Feltz-Cornelis, Christina M; Baas, Batelaan, Bunevicius, Buszewicz, Christensen, Diez-Quevedo, Eack, Fischer, Flensborg-Madsen, Franx, Gilbody, Gunn, Hassink-Franke, Janssen, Karsten, Kessler, Kirmayer, Kroenke, Kroenke, Lowe, Muntingh, Navines, Ormel, Pepe, Persoons, Rasbash, Richards, Sackett, Sheehan, Smolders, Spinhoven, Spitzer, Spitzer, Spitzer, Terluin, Terluin, Tiemens, Van Vliet, Wittchen, Wittkampf, Zigmond",2013.0,,0,0,
8397,Alliance and outcome in varying imagery procedures for PTSD: A study of within-person processes.,"The present study examined both the intraindividual relationship between alliance components (task, goal, and bond) and subsequent posttraumatic stress disorder (PTSD) symptoms over the course of therapy and the interindividual relationships between the initial level of the alliance components and overall PTSD outcome. PTSD patients (n = 65) were randomized to either standard prolonged exposure, which includes imaginal exposure (IE) to the traumatic memory, or modified prolonged exposure, where imagery rescripting (IR) of the memory replaced IE as the imagery component of prolonged exposure in a 10-week residential program. They were assessed repeatedly (weekly) on alliance and PTSD symptom measures. The centering method of detrending (Curran & Bauer, 2011) was used to separate the variance related to the intraindividual process of change during treatment (within-person component) from the variance related to initial individual differences (between-person component). The hypothesis of a negative within-person effect of the alliance components agreement about the tasks of therapy and bond on subsequent PTSD symptoms was supported for the component task agreement. As expected, this effect was stronger in IE than in IR. Moreover, there was a negative relationship between interindividual differences in initial Task and Bond scale scores and slope of PTSD symptoms over the course of therapy. By contrast, within-person variations in PTSD symptoms did not predict subsequent alliance components. The present results suggest the importance of agreement about therapy tasks during the process of IE or IR within prolonged exposure for PTSD patients, particularly in IE. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hoffart, Asle; Oktedalen, Tuva; Langkaas, Tomas Formo; Wampold, Bruce E; Arntz, Bordin, Borenstein, Cloitre, Curran, Dalgleish, Falkenstrom, First, Fitzmaurice, Fluckiger, Foa, Foa, Foa, Foa, Grunert, Hatcher, Hoffman, Horvath, Horvath, Horvath, Horvath, Keller, Lee, Safran, Sheehan, Shrout, Smucker, Snijder, Spitzer, Tasca, Ulvenes, Wampold, Webb",2013.0,,0,0,
8398,Post-traumatic stress disorder and the outcome of dialectical behaviour therapy for borderline personality disorder.,"Background: Individuals with borderline personality disorder (BPD) and comorbid post-traumatic stress disorder (PTSD) have a worse prognosis than individuals with BPD alone. A common view is that the emotional instability and impulsivity of BPD should be treated before attempting to address trauma. However, PTSD symptoms may interfere with patients' ability to benefit from such 'stabilizing' treatments. Methods: The effect of BPD-PTSD comorbidity on self-harm and BPD symptom outcomes was evaluated in 89 patients receiving dialectical behaviour therapy, using multilevel modelling. Results: Patients with comorbid BPD-PTSD showed a trend towards elevated BPD symptoms throughout the treatment year (beta = 2.12, 95% CI =-0.21-4.44, p = 0.07). There was a three-way interaction between PTSD comorbidity, treatment completion and time, whereby PTSD comorbidity was associated with less reduction in self-harm frequency over time, but only in those completing the full 12 months of treatment (incident risk ratio = 1.16, 95% CI = 1.04-1.30, p < 0.01). Conclusion: Patients with comorbid PTSD had a poorer outcome from dialectical behaviour therapy than those with BPD alone, possibly because of the negative impact of unaddressed trauma. The results provide further grounds for recently developed treatments targeting BPD traits and PTSD symptoms simultaneously. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Barnicot, Kirsten; Priebe, Stefan; Barnicot, Barnicot, Bateman, Beecham, Brown, Clarkin, Fink, First, Foa, Frankenburg, Golier, Harned, Harned, Harned, Herman, Jacob, Lecrubier, Lewis, Linehan, Linehan, Maffei, Neacsiu, Nysaeter, Pagura, Priebe, Rabe-Hesketh, Rabe-Hesketh, Sheehan, Sheehan, Steil, Stepp, Stoffers, Tetley, van der Kolk, Vignarajah, Zanarini, Zanarini, Zanarini, Zanarini, Zlotnick",2013.0,,0,0,
8399,Comorbidity and Internet-delivered transdiagnostic cognitive behavioural therapy for anxiety disorders.,"Internet-delivered transdiagnostic anxiety interventions aim to reduce symptoms across several anxiety disorders using one treatment protocol. However, it is unclear whether comorbidity affects outcomes of such treatment. This study re-examined data from a recent randomised controlled trial (N = 129) that evaluated the efficacy of an Internet-delivered transdiagnostic cognitive behavioural therapy (iCBT) intervention for participants with principal diagnoses of generalised anxiety disorder (GAD), social phobia (SP) panic disorder and agoraphobia (PDA), of whom 72% met criteria for a comorbid anxiety disorder or depression. Participants were divided into two groups based on whether or not they had a comorbid disorder before treatment. Participants with comorbid conditions reported higher symptom levels at pre-treatment, posttreatment, and follow-up across a range of measures. Both groups showed significant reductions in symptoms over treatment; however, participants with comorbid disorders showed greater reductions in measures of GAD, PDA, SP, depression, and neuroticism. In addition, treatment significantly reduced the number of comorbid diagnoses at follow-up. These results indicate transdiagnostic iCBT protocols have the potential to reduce comorbidity. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Johnston, Luke; Titov, Nickolai; Andrews, Gavin; Dear, Blake F; Spence, Jay; Allen, Andersson, Andrews, Andrews, Barlow, Brown, Burgess, Costa, Craske, Cuijpers, Cuijpers, Davis, Dear, Dear, Ehrenreich, Emmanuel, Erickson, Farchione, Green, Houck, Johnston, Kazdin, Kessler, Kroenke, Kroenke, Lecrubier, Leon, Lowe, Mansell, Mattick, McEvoy, McEvoy, Meyer, Newman, Norton, Norton, Norton, Olatunji, Peters, Richards, Robinson, Sheehan, Sheehan, Spinhoven, Spitzer, Titov, Titov, Titov, Titov, Titov, Tsao, Wims",2013.0,,0,0,
8400,Patient expectations in internet-based self-help for social anxiety.,"A number of controlled trials have demonstrated the efficacy of Internet-based cognitive-behaviour therapy for treating social anxiety disorder (SAD). However, little is known about what makes those interventions work. The current trial focuses on patient expectations as one common mechanism of change. The study examines whether patients' expectancy predicts outcome, adherence, and dropout in an unguided Internet-based self-help programme for SAD. Data of 109 participants in a 10-week self-help programme for SAD were analysed. Social anxiety measures were administered prior to the intervention, at week 2, and after the intervention. Expectancy was assessed at week 2. Patient expectations were a significant predictor of change in social anxiety (beta=2.35 to 2.40, all p<.003). Patient expectations also predicted treatment adherence (beta=.27, p=.02). Patients with higher expectations showed more adherence and better outcome. Dropout was not predicted by expectations. The effect of positive expectations on outcome was mediated by early symptom change (from week 0 to week 2). Results suggest that positive outcome expectations have a beneficial effect on outcome in Internet-based self-help for SAD. Furthermore, patient expectations as early process predictors could be used to inform therapeutic decisions such as stepping up patients to guided or face-to-face treatment options. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Boettcher, Johanna; Renneberg, Babette; Berger, Thomas; Andersson, Andersson, Andrews, Arnkoff, Baker, Barak, Beck, Berger, Berger, Boettcher, Botella, Carlbring, Carlbring, Carlbring, Chambless, Christensen, Clark, Clark, Constantino, Devilly, Dew, Donkin, Eskildsen, Frank, Furmark, Grawe, Greenberg, Haas, Hedman, Hedman, Hoffart, Lambert, Lutz, MacKinnon, Mattick, Melville, Messer, Noble, Nordgreen, Olfson, Preacher, Price, Rosnow, Safren, Spek, Spratt, Stangier, Stangier, Titov, Titov, Titov, Titov, Titov, Titov, Walach, Wang, Weinberger, Wittchen",2013.0,,0,0,
8401,Attentional bias and emotional reactivity as predictors and moderators of behavioral treatment for social phobia.,"Cognitive behavioral therapy (CBT) is a well-established treatment for anxiety disorders, and evidence is accruing for the effectiveness of acceptance and commitment therapy (ACT). Little is known about factors that relate to treatment outcome overall (predictors), or who will thrive in each treatment (moderators). The goal of the current project was to test attentional bias and negative emotional reactivity as moderators and predictors of treatment outcome in a randomized controlled trial comparing CBT and ACT for social phobia. Forty-six patients received 12 sessions of CBT or ACT and were assessed for self-reported and clinician-rated symptoms at baseline, post treatment, 6, and 12 months. Attentional bias significantly moderated the relationship between treatment group and outcome with patients slow to disengage from threatening stimuli showing greater clinician-rated symptom reduction in CBT than in ACT. Negative emotional reactivity, but not positive emotional reactivity, was a significant overall predictor with patients high in negative emotional reactivity showing the greatest self-reported symptom reduction. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Niles, Andrea N; Mesri, Bita; Burklund, Lisa J; Lieberman, Matthew D; Craske, Michelle G; Amir, Arch, Arch, Arch, Baker, Bar-Haim, Brown, Brown, Bruhl, Burklund, Butler, Cahill, Campbell-Sills, Canli, Chen, Chen, Clark, Craske, Craske, Craske, Craske, Doehrmann, Eifert, Fox, Fox, Fresco, Georgiou, Goldin, Guttman, Hayes, Hayward, Heimberg, Heinrichs, Hope, Krueger, Lang, Loerinc, Mackinnon, Mackintosh, MacLeod, MacLeod, MacLeod, Mansell, Mattick, Meuret, Mogg, Norton, Osman, Prenoveau, Price, Rapee, See, Semple, Shah, Siegle, Tabachnick, Tolin, Tottenham, Von Hippel, Waters, Watson, Watson, Westermann, Wolitzky-Taylor",2013.0,,0,0,
8402,Mediators in psychological treatment of social anxiety disorder: Individual cognitive therapy compared to cognitive behavioral group therapy.,"According to cognitive-behavioral models of social anxiety disorder (SAD), four of the important maintaining mechanisms are avoidance, self-focused attention, anticipatory processing and post-event cognitive processing. Individual cognitive therapy (ICT) and cognitive behavioral group therapy (CBGT) both have substantial empirical support. However, it is unclear whether they achieve their effects by similar or different mechanisms. The aim of this study was to investigate whether changes in the four maintenance processes mediate clinical improvement in ICT and CBGT for SAD. We analyzed data from participants (N = 94) who received either ICT or CBGT in two separate RCTs. The results showed that ICT had larger effects than CBGT on social anxiety and each of the four potential mediators. More pertinently, moderated mediation analyses revealed significant between-treatment differences. Whereas improvement in ICT was mainly mediated by reductions in avoidance and self-focused attention, improvement in CBGT was mediated by changes in self-focused attention and in anticipatory and post-event processing. These results support the importance of the putative mediators, but suggest that their relative weights are moderated by treatment type. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hedman, Erik; Mortberg, Ewa; Hesser, Hugo; Clark, David M; Lekander, Mats; Andersson, Erik; Ljotsson, Brjann; Acarturk, Baron, Bauer, Blanco, Boden, Bogels, Brozovich, Carver, Clark, Clark, Clark, Clark, Collins, Davidson, First, Fresco, Furmark, Gangemi, Gaydukevych, Gelernter, Gruber, Hedeker, Hedman, Hedman, Heimberg, Heimberg, Heimberg, Herbert, Herbert, Hofmann, Hope, Kazdin, Kenny, Kessler, Kraemer, Laposa, Ledley, Leichsenring, MacKinnon, Mackinnon, Manassis, Mattick, McEvoy, McEvoy, Morgan, Mortberg, Mortberg, Mulken, Nilsson, Otto, Preacher, Price, Rapee, Raudenbush, Schafer, Schultz, Shadish, Sloan, Snijders, Spurr, Stangier, Stangier, Wells, Wells, Wells, Wittchen, Yonkers",2013.0,,0,0,
8403,Negative religious coping as a mediator of trauma symptoms in older survivors.,"Forty-three spiritually distressed older women (aged 55-83) who had survived multiple types of interpersonal trauma participated in a spiritually focused group intervention designed to address spiritual struggles related to earlier abuse and to enhance spiritual coping. It was hypothesized that the intervention would increase spiritual well-being and that religious/spiritual coping would mediate the relationship between the intervention and the outcomes of depression, posttraumatic stress, anxiety, somatic symptoms, and spiritual well-being. The results provide strong initial support for the importance of understanding the effect of negative religious/spiritual coping on depression and anxiety symptoms in older religious survivors of interpersonal trauma. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Bowland, Sharon; Edmond, Tonya; Fallot, Roger D; Allen, Augsburger, Beck, Bowland, Bowland, Briere, Briere, Bright, Bufford, Cascardi, Coid, Coid, Cole, Crowther, Drake, Ellison, Enright, Fallot, Fallot, Felitti, Floyd, Foa, Freedman, Gall, Golding, Graziano, Hall, Harris, Harris, Idler, Janoff-Bulman, Jordan, Koenig, Koenig, Koenig, Kraemer, Kroenke, Lazarus, McCullough, Murray-Swank, Pargament, Pargament, Pargament, Pargament, Pargament, Prochaska, Ramsey, Somer, Tjaden, Watlington, Wilke, Wink, Worthington, Yesavage",2013.0,,0,0,
8404,"EMDR and CBT for cancer patients: Comparative study of effects on PTSD, anxiety, and depression.","This pilot study examined the efficacy of eye movement desensitization and reprocessing (EMDR) treatment compared with cognitive behavioral therapy (CBT) in treating posttraumatic stress disorder (PTSD) in oncology patients in the follow-up phase of the disease. The secondary aim of this study was to assess whether EMDR treatment has a different impact on PTSD in the active treatment or during the followup stages of disease. Twenty-one patients in follow-up care were randomly assigned to EMDR or CBT groups, and 10 patients in the active treatment phase were assigned to EMDR group. The Impact of Event Scale-Revised (IES-R) and Clinician-Administered PTSD Scale (CAPS) were used to assess PTSD at pretreatment and 1 month posttreatment. Anxiety, depression, and psychophysiological symptoms were also evaluated. For cancer patients in the follow-up stage, the absence of PTSD after the treatment was associated with a significantly higher likelihood of receiving EMDR rather than CBT. EMDR was significantly more effective than CBT in reducing scores on the IES-R and the CAPS intrusive symptom subscale, whereas anxiety and depression improved equally in both treatment groups. Furthermore, EMDR showed the same efficacy both in the active cancer treatment and during the follow-up of the disease. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Capezzani, Liuva; Ostacoli, Luca; Cavallo, Marco; Carletto, Sara; Fernandez, Isabel; Solomon, Roger; Pagani, Marco; Cantelmi, Tonino; Andersen, Arabia, Beck, Beck, Bisson, Blake, Bruce, Butler, Castrogiovanm, Chemtob, Cordova, DuHamel, Ellis, Foa, Foa, Friedberg, Grant, Jackson, Mehnert, Morasso, Onofri, Pancheri, Rothbaum, Schneider, Shapiro, Shapiro, Smith, Spielberger, Taylor, Weathers, Weiss",2013.0,,0,0,
8405,"The effects of assertiveness training in patients with schizophrenia: A randomized, single-blind, controlled study.","Aims: In this study, we investigated the effects of group assertiveness training on assertiveness, social anxiety and satisfaction with interpersonal communication among patients with chronic schizophrenia. Background: Only limited studies highlighted the effectiveness of group assertiveness training among inpatients with schizophrenia. Given the lack of group assertiveness training among patients with schizophrenia, further development of programmes focusing on facilitating assertiveness, self-confidence and social skills among inpatients with chronic schizophrenia is needed. Design: This study used a prospective, randomized, single-blinded, parallel-group design. Methods: This study employed a prospective, randomized, parallel-group design. Seventy-four patients were randomly assigned to experimental group receiving 12 sessions of assertiveness training, or a supportive control group. Data collection took place for the period of June 2009-July 2010. Results: Among patients with chronic schizophrenia, assertiveness, levels of social anxiety and satisfaction with interpersonal communication significantly improved immediately after the intervention and at the 3-month follow-up in the intervention group. The results of a generalized estimating equation (GEE) indicated that: (1) assertiveness significantly improved from pre- to postintervention and was maintained until the follow-up; (2) anxiety regarding social interactions significantly decreased after assertiveness training; and (3) satisfaction with interpersonal communication slightly improved after the 12-session intervention and at the 3-month follow-up. Conclusion: Assertiveness training is a non-invasive and inexpensive therapy that appears to improve assertiveness, social anxiety and interpersonal communication among inpatients with chronic schizophrenia. These findings may provide a reference guide to clinical nurses for developing assertiveness-training protocols. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lee, Tso-Ying; Chang, Shih-Chin; Chu, Hsin; Yang, Chyn-Yng; Ou, Keng-Liang; Chung, Min-Huey; Chou, Kuei-Ru; Alberti, Aschen, Chang, Hayakawa, Hayman, Hecht, Jones, Kanas, Leary, Lin, Lin, Morlan, Overall, Rathus, Seo, Sheldon, Shiina, Shiina, Sun, Tarrier, Tavakoli",2013.0,,0,0,
8406,Effectiveness of Internet-based cognitive behaviour therapy for panic disorder in routine psychiatric care.,"Objective: Guided Internet-based cognitive behaviour therapy (ICBT) for panic disorder has been shown to be efficacious in several randomized controlled trials. However, the effectiveness of the treatment when delivered within routine psychiatric care has not been studied. The aim of this study was to investigate the effectiveness of ICBT for panic disorder within the context of routine psychiatric care. Method: We conducted a cohort study investigating all patients (n = 570) who had received guided ICBT for panic disorder between 2007 and 2012 in a routine care setting at an out-patient psychiatric clinic providing Internet-based treatment. The primary outcome measure was the Panic Disorder Severity Scale-Self-report (PDSS-SR). Results: Participants made large improvements from screening and pretreatment assessments to posttreatment (Cohen's d range on the PDSS-SR = 1.07-1.55). Improvements were sustained at 6-month follow-up. Conclusion: This study suggests that ICBT for panic disorder is as effective when delivered in a routine care context as in the previously published randomized controlled trials. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hedman, E; Ljotsson, B; Ruck, C; Bergstrom, J; Andersson, G; Kaldo, V; Jansson, L; Andersson, E; Blom, K; El Alaoui, S; Falk, L; Ivarsson, J; Nasri, B; Rydh, S; Lindefors, N; Alonso, Alonso, Andersson, Andersson, Andersson, Ansell, Attkisson, Bergstrom, Carlbring, Carlbring, Carlbring, Carlbring, Costa, Flay, Gelder, Gueorguieva, Hedman, Hedman, Hedman, Hendriks, Hollandare, Houck, Hunsley, Jacobson, Kessler, Kiropoulos, Lewis, Marks, Mohr, Norcross, Ruwaard, Sanchez-Meca, Shadish, Sheehan, Svanborg, Volirath, Wade, Walters, Wims",2013.0,,0,0,
8407,The SCIentinel study-Prospective multicenter study to define the spinal cord injury-induced immune depression syndrome (SCI-IDS)-Study protocol and interim feasibility data.,"Background: Infections are the leading cause of death in the acute phase following spinal cord injury and qualify as independent risk factor for poor neurological outcome (""disease modifying factor""). The enhanced susceptibility for infections is not stringently explained by the increased risk of aspiration in tetraplegic patients, neurogenic bladder dysfunction, or by high-dose methylprednisolone treatment. Experimental and clinical pilot data suggest that spinal cord injury disrupts the balanced interplay between the central nervous system and the immune system. The primary hypothesis is that the Spinal Cord Injury-induced Immune Depression Syndrome (SCI-IDS) is 'neurogenic' including deactivation of adaptive and innate immunity with decreased HLA-DR expression on monocytes as a key surrogate parameter. Secondary hypotheses are that the Immune Depression Syndrome is i) injury level- and ii) severity-dependent, iii) triggers transient lymphopenia, and iv) causes qualitative functional leukocyte deficits, which may endure the post-acute phase after spinal cord injury. Methods/Design: SCIentinel is a prospective, international, multicenter study aiming to recruit about 118 patients with acute spinal cord injury or control patients with acute vertebral fracture without neurological deficits scheduled for spinal surgery. The assessment points are: i) < 31 hours, ii) 31-55 hours, iii) 7 days, iv) 14 days, and v) 10 weeks post-trauma. Assessment includes infections, concomitant injury, medication and neurological classification using American Spinal Injury Association impairment scale (AIS) and neurological level. Laboratory analyses comprise haematological profiling, immunophenotyping, including HLA-DR expression on monocytes, cytokines and gene expression of immune modulators. We provide an administrative interim analysis of the recruitment schedule of the trial. Discussion: The objectives are to characterize the dysfunction of the innate and adaptive immune system after spinal cord injury and to explore its proposed 'neurogenic' origin by analyzing its correlation with lesion height and severity. The trial protocol considers difficulties of enrolment in an acute setting, and loss to follow up. The administrative interim analysis confirmed the feasibility of the protocol. Better understanding of the SCI-IDS is crucial to reduce co-morbidities and thereby to attenuate the impact of disease modifying factors to protect neurological ""outcome at risk"". This putatively results in improved spinal cord injury medical care. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kopp, Marcel A; Druschel, Claudia; Meisel, Christian; Liebscher, Thomas; Prilipp, Erik; Watzlawick, Ralf; Cinelli, Paolo; Niedeggen, Andreas; Schaser, Klaus-Dieter; Wanner, Guido A; Curt, Armin; Lindemann, Gertraut; Nugaeva, Natalia; Fehlings, Michael G; Vajkoczy, Peter; Cabraja, Mario; Dengler, Julius; Ertel, Wolfgang; Ekkernkamp, Axel; Martus, Peter; Volk, Hans-Dieter; Unterwalder, Nadine; Kolsch, Uwe; Brommer, Benedikt; Hellmann, Rick C; Saidy, Ramin R. Ossami; Laginha, Ines; Pruss, Harald; Failli, Vieri; Dirnagl, Ulrich; Schwab, Jan M; Bao, Burgdorfer, Cameron, Campagnolo, Campagnolo, Cruse, Davis, DeVivo, Docke, Failli, Furlan, Haeusler, Harms, Held, Kirshblum, Kliesch, Landelle, Lucin, Mann, Marino, Marino, Meisel, Meisel, Ng, Riegger, Riegger, Riegger, Ronco, Soden, Strohmeyer, Thuret, Zhang, Zorner",2013.0,,0,0,
8408,Assessing bodily preoccupations is sufficient: Clinically effective screening for hypochondriasis.,"Objective: Hypochondriasis is a persistent psychiatric disorder and is associated with increased utilisation of health care services. However, effective psychiatric consultation interventions and CBT treatments are available. In the present study, we provide evidence of clinically effective screening for hypochondriasis. We describe the clinically effective identification of patients with a high probability of suffering from hypochondriasis. This identification is achieved by means of two brief standardised screening instruments, namely the Bodily Preoccupation (BP) Scale with 3 items and the Whiteley-7 (WI-7) with 7 items. Methods: Both the BP scale and the WI-7 were examined in a sample of 228 participants (72 with hypochondriasis, 80 with anxiety disorders and 76 healthy controls) in a large psychotherapy outpatients' unit, applying the DSM-IV criteria. Cut-off values for the BP scale and the WI-7 were computed to identify patients with a high probability of suffering from hypochondriasis. Additionally, other self-report symptom severity scales were completed in order to examine discriminant and convergent validity. Data was collected from June 2010 to March 2013. Results: The BP scale and the WI-7 discriminated significantly between patients with hypochondriasis and those with an anxiety disorder (d = 2.42 and d = 2.34). Cut-off values for these two screening scales could be provided, thus identifying patients with a high probability of suffering from hypochondriasis. Conclusions: In order to reduce costs, the BP scale or the WI-7 should be applied in medical or primary care settings, to screen for patients with a high probability of hypochondriasis and to transfer them to further assessment and effective treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hofling, Volkmar; Weck, Florian; Barrett, Beck, Christensen, Conradt, Derogatis, Fink, Fink, Fink, First, Franke, Grafe, Gropalis, Hautzinger, Hedman, Hedman, Hiller, Hiller, Hinz, Kellner, Kroenke, Lee, Longley, Margraf, Muthen, Olatunji, Pilowsky, Rief, Rief, Sakai, Schermelleh-Engel, Seivewright, Starcevic, Sunderland, Van Ravesteijn, Weck, Weck, Weck, Weck, Witthoft, Youden, Zimmermann",2013.0,,0,0,
8409,Mindfulness-based stretching and deep breathing exercises normalize serum cortisol levels and reverse symptoms of PTSD: A prospective randomized-controlled trial.,"Context: Cortisol, the human glucocorticoid, plays a key role in the pathophysiology of posttraumatic stress disorder (PTSD). It is known that individuals with chronic PTSD suffer from low basal cortisol levels. Endogenic normalization of basal cortisol concentration through exercise may have a therapeutic effect on treating PTSD symptoms, yet little is known about the association between exercise-induced endogenic increase of cortisol and PTSD symptom reduction. Objective: To identify whether mindfulness-based stretching and deep breathing exercise (MBX) increases basal cortisol levels, examine if MBX reduces PTSD symptom severity, and evaluate MBX as a complementary intervention for PTSD. Design: Prospective, randomized, controlled. Setting: University of New Mexico Hospital. Participants: 29 nurses with PTSD symptoms, ages 45-53, with 28 female. Intervention: 8-week bi-weekly 60-minute MBX sessions. Main Outcome Measures: Serum cortisol and PTSD Checklist-Civilian version (PCL-C) at weeks 0, 4, 8, 12, and 16. Results: Twenty-eight participants completed the study procedures. In EX group, mean basal serum cortisol levels increased significantly from 9.6+/-4.1 microg/dl at baseline to 14.6+/-5.7 microg/dl at week 8 (p=0.0039); PTSD symptom severity decreased significantly from mean PCL-C scores of 43.1+/-11.2 at baseline to 24+/-3.3 at week 8 (p=0.0002); and the effects were maintained at follow-up at week 16 with mean basal serum cortisol concentration of 14.0+/-3.9 microg/dl (p= 0.5706) and mean PCL-C scores of 25.0+/-5.1 (p=0.8013). Conclusions: The results indicate a strong relationship between changes in cortisol levels and changes in PTSD symptom severity. This study provides preliminary evidence that programs aimed at reducing symptom severity in individuals with chronic PTSD should consider a mind-body intervention. To our knowledge, this is the first randomized controlled trial to assess the therapeutic benefits of MBX in individuals with PTSD symptoms using both biomarkers and PCL-C scores measuring the long-term effects of cortisol changes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kim, Sang Hwan",2013.0,,0,0,
8410,Treatment moderation and secondary outcomes: Results from a randomized clinical trial.,"The present study pursued two objectives in the context of a randomized clinical trial of cognitive-behavioral therapy with parent (CBT/P) and group (GCBT) involvement. The first objective was to examine the variability in treatment outcome. There were three specific aims within the first objective, to evaluate: (1) youth characteristics (age, depressive, and externalizing disorders) as moderators of treatment outcome; (2) the differential outcome of the treatment approaches as a function of youth characteristics; and (3) the relative efficacy of the treatment approaches at each level of the moderators. The second objective was to evaluate the efficacy of anxiety treatments along secondary depressive symptoms and externalizing behaviors. There were five specific aims within the second objective, to evaluate: (1) whether anxiety treatment yields reductions in secondary problems, (2) the efficacy of anxiety treatments in reducing secondary problems as a function of approach and youth characteristics, (3) whether reductions in anxiety symptoms significantly mediate changes in secondary problems, (4) the directionality of change in the hypothesized mediated relations, and (5) whether the hypothesized mediated relations are moderated by treatment approach and youth characteristics. The specific aims were pursued using data collected from 183 youth and their mothers. Research questions were tested using multiple regressions and structural equation modeling. Age, depressive, and externalizing disorders were significant moderators. CBT/P relative to GCBT lowered anxiety more for younger than older youth. GCBT relative to CBT/P lowered anxiety more for older than younger youth. GCBT relative to CBT/P lowered anxiety more for depressed youth than non-depressed youth. GCBT relative to CBT/P lowered anxiety less for externalizing youth than non-externalizing youth. Treatment reduced depressive symptoms and externalizing problem behaviors. Reductions in anxiety mediated changes in depressive symptoms and externalizing problem behaviors. Reversed directionality was found in the relation between social anxiety and depressive symptoms. In CBT/P the direction of change was from depressive to social anxiety. The opposite was true in GCBT. Reductions in social anxiety mediated posttreatment changes in depressive symptoms in GCBT but not CBT/P. The reverse was true at follow-up. Reductions in social anxiety mediated changes in depressive symptoms for girls but not boys. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Motoca, Luci M",2013.0,,0,0,
8411,"Future directions of deep brain stimulation: Current disorders, new technologies.","This article presents an overview of the future directions of deep brain stimulation for current disorders with new technologies. Deep brain stimulation (DBS) is a surgical neuromodulation therapy with several neuropsychiatric applications. Compared with other device-based brain stimulation treatments, DBS offers the unique possibility to target deep neural structures directly with proven safety and efficacious outcomes. DBS has the potential to normalize reward processing; reduce impulsivity; and attenuate addictive behavior. The reward circuitry is already a target for obsessive compulsive disorder (OCD) and major depressive disorder (MDD) in humans, but neuro circuitry underlying drug addiction makes DBS a viable treatment option for patients with this condition. A novel circuit-based strategy to treat Alzheimer's disease (AD) is the use of DBS to the hippocampal fornix. DBS mechanism of action may involve the up regulation of processing, capacity, and/or sustained integrity of these neuronal circuits. DBS is an available yet novel therapeutic option for several treatment resistant neuropsychiatric disorders. DBS is already available in the therapeutic toolbox for the practicing psychiatrist and it offers options and hope for the most difficult and treatment-refractory patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Arulpragasam, Amanda R; Chou, Tina; Kaur, Navneet; Corse, Andrew K; Deckersbach, Thilo; Camprodon, Joan A; Ackermans, Chen, Covalin, Gubellini, Gutman, Haber, Halpern, Heldmann, Henderson, Hikosaka, Houeto, Israel, Ito, Knapp, Kuhn, Kuhn, Kuhn, Laxton, Liu, Lyketsos, Mian, Rouaud, Sani, Shahed, Sun, Tye, Van der Linden, van der Plasse, Vandewalle, Vassoler, Witten, Yu",2013.0,,0,0,
8412,Effectiveness of an internet intervention (Deprexis) for depression in a united states adult sample: A parallel-group pragmatic randomized controlled trial.,"Objective: To examine the effectiveness of an Internet intervention for depression with a randomized, controlled trial in a large sample of adults recruited from the United States. Method: The current study examines the effectiveness of Deprexis, an Internet treatment for depression that was provided with relatively minimal support. There were 376 treatment-seeking adults (mean age = 32 years; 74% female; 77% Caucasian, 7% Asian, 7% multiple races, 4% African American, and 11% Hispanic/Latino) with elevated depression (Quick Inventory of Depressive Symptoms-Self-Report [QIDS-SR] > = 10) who were randomized to receive an 8-week course of treatment immediately (n = 285) or after an 8-week delay (n = 91; i.e., waitlist control). Results: Intention-to-treat analyses indicated that treatment was associated with greater reduction in self-reported symptoms of depression (effect size d = .80) and 12 times greater likelihood of experiencing at least 50% symptom improvement compared with waitlist control. Similar effects were observed for several secondary outcomes, such as interviewer-rated depression symptoms, well-being, and depression-related disability. Treatment effects for symptoms of social anxiety, panic, and traumatic intrusions were relatively small. Conclusion: Results suggest that Deprexis can produce symptomatic improvement among depressed adults recruited from the United States. Additional research is needed that examines whether improvements are maintained over time and who is particularly likely to respond to this form of treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved) Impact Statement What is the public health significance of this article?-This study suggests that a minimally supported and easily accessible internet intervention, known as Deprexis, can be an effective form of treatment compared with care as usual for adults with depression. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Beevers, Christopher G; Pearson, Rahel; Hoffman, James S; Foulser, A. Alban; Shumake, Jason; Meyer, Bjorn; Alonso, Andersson, Andrews, Andrews, Arnberg, Bates, Berger, Berger, Boettcher, Bower, Brody, Choirat, Christensen, Cooper, Cuijpers, Cuijpers, Cuijpers, Del Re, Donkin, Ekers, Eysenbach, Fischer, Geraghty, Gilbody, Glanz, Graham, Greenberg, Hames, Hamilton, Hedman, Hofmann, Hollon, Honaker, Johansson, Karyotaki, Kenter, Kenter, Kessler, Klein, Knesevich, Krebs, Kuyken, Lustria, Meyer, Meyer, Meyer, Mohr, Moritz, Moritz, Posner, Renton, Richards, Rosenthal, Rozental, Rubin, Rush, Rush, Schroder, Sheehan, Sheehan, Spek, Titov, Trajkovic, Trivedi, Trivedi, Twomey, Watson, Wickham, Wickham, Wickham, Wickham",2017.0,,0,0,
8413,Impact of comorbid anxiety and depressive disorders on treatment response to cognitive behavior therapy for insomnia.,"Objective: To evaluate the impact of comorbid anxiety or depressive disorders on treatment response to cognitive-behavior therapy (CBT) for insomnia, behavior therapy (BT), or cognitive therapy (CT). Method: Participants were 188 adults (117 women; Mage = 47.4 years) with chronic insomnia, including 45 also presenting a comorbid anxiety or mild to moderate depressive disorder. They were randomized to BT (n = 63), CT (n = 65), or CBT (n = 60). Outcome measures were the proportion of treatment responders (decrease of >=8 points on the Insomnia Severity Index; ISI) and remissions (ISI score < 8) and depression and anxiety symptoms. Results: Proportion of treatment responders and remitters in the CBT condition was not significantly different between the subgroups with and without comorbidity. However, the proportion of responders was lower in the comorbidity subgroup compared to those without comorbidity in both the BT (34.4% vs. 81.6%; p = .007) and CT (23.6% vs. 57.6%; p = .02) alone conditions, although remission rates and prepost ISI change scores were not. Pre to post change scores on the depression (-10.6 vs. -3.9; p < .001) and anxiety measures (-9.2 vs. -2.5; p = .01) were significantly greater in the comorbidity subgroup relative to the subgroup without comorbidity but only for those treated with the full CBT; no difference was found for those treated with either BT or CT alone. Conclusions: The presence of a comorbid anxiety or mild to moderate depressive disorder did not reduce the efficacy of CBT for insomnia, but it did for its single BT and CT components when used alone. (PsycINFO Database Record (c) 2017 APA, all rights reserved) Impact Statement What is the public health significance of this article?-This study indicates that cognitive-behavior therapy is effective for treating insomnia disorder, even when there is a coexisting anxiety disorder or a depressive disorder of mild to moderate severity. Individuals with a coexisting anxiety disorder or mild to moderate depression disorder may also expect relief from their concurrent psychological symptoms even when treatment focuses specifically on insomnia. The findings suggest that it is important to include both the behavioral and cognitive components of CBT to optimize treatment outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Belanger, Lynda; Harvey, Allison G; Fortier-Brochu, Emilie; Beaulieu-Bonneau, Simon; Eidelman, Polina; Talbot, Lisa; Ivers, Hans; Hein, Kerrie; Lamy, Manon; Soehner, Adriane M; Merette, Chantal; Morin, Charles M; Baglioni, Bastien, Beck, Beck, Beck, Belanger, Belanger, Belleville, Bootzin, Breslau, Buysse, Buysse, Cohen, Edinger, Edinger, Edinger, Faul, First, Harvey, Harvey, Harvey, Harvey, Harvey, Harvey, Hochberg, Jansson-Frojmark, Manber, Morin, Morin, Morin, Morin, Morin, Morin, Nierenberg, Perlis, Rechtschaffen, Ree, Roth, Sarsour, Sivertsen, Spielberger, Spielman, Spielman, Talbot, Tang, Taylor, van de Laar, Wagley, Zayfert",2016.0,,0,0,
8414,Cognitive behavioral therapy for compulsive buying behavior: Predictors of treatment outcome.,"Background: Compulsive buying behavior (CBB) is receiving increasing consideration in both consumer and psychiatric-epidemiological research, yet empirical evidence on treatment interventions is scarce and mostly from small homogeneous clinical samples. Objectives: To estimate the short-term effectiveness of a standardized, individual cognitive behavioral therapy intervention (CBT) in a sample of n = 97 treatment-seeking patients diagnosed with CBB, and to identify the most relevant predictors of therapy outcome. Method: The intervention consisted of 12 individual CBT weekly sessions, lasting approximately 45minutes each. Data on patients' personality traits, psychopathology, sociodemographic factors, and compulsive buying behavior were used in our analysis. Results: The risk (cumulative incidence) of poor adherence to the CBT program was 27.8%. The presence of relapses during the CBT program was 47.4% and the dropout rate was 46.4%. Significant predictors of poor therapy adherence were being male, high levels of depression and obsessive-compulsive symptoms, low anxiety levels, high persistence, high harm avoidance and low self-transcendence. Conclusion: Cognitive behavioral models show promise in treating CBB, however future interventions for CBB should be designed via a multidimensional approach in which patients' sex, comorbid symptom levels and the personality-trait profiles play a central role. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Granero, R; Fernandez-Aranda, F; Mestre-Bach, G; Steward, T; Bano, M; Aguera, Z; Mallorqui-Bague, N; Aymami, N; Gomez-Pena, M; Sancho, M; Sanchez, I; Menchon, J. M; Martin-Romera, V; Jimenez-Murcia, S; Aboujaoude, Benson, Benson, Black, Black, Black, Cloninger, Derogatis, Derogatis, Di Nicola, Domjan, El-Guebaly, Faber, Filomensky, First, Gendreau, Gomez-Pena, Granero, Grant, Grant, Gutierrez-Zotes, Hollander, Ismael, Jimenez-Murcia, Jimenez-Murcia, Jimenez-Murcia, Jimenez-Murcia, Kellett, Kessler, Koran, Koran, Lee, Leeman, Lejoyeux, Lopez-Torrecillas, Lourenco Leite, Maraz, McElroy, Mitchell, Mochcovitch, Monahan, Mueller, Mueller, Mueller, Muller, Muller, Muller, Muller, Piquet-Pessoa, Potenza, Raab, Raab, Ridgway, Rose, Spinella, Stein, Svrakic, Tavares, Thompson, Valence, Weinstein, Williams, Yi",2017.0,,0,0,
8415,Gender difference in attentional bias toward negative and positive stimuli in generalized anxiety disorder.,"Females are two times as likely as males to develop generalized anxiety disorder (GAD; Steiner et al., 2005; Vesga-Lopez et al., 2008). Moreover, the clinical presentation of GAD is different across genders. One explanation for these differences may be the role of cognitive biases involved in GAD between genders. In the present study, we used an exogenous spatial cueing task to examine gender differences in attentional bias for negative and positive information in 118 individuals with a primary diagnosis of GAD. Males and females did not differ in their attentional bias for idiographically selected negative or neutral words. However, women showed a significantly larger attentional bias for positive words than did men. Results suggest that developing gender-specific treatments for GAD could improve treatment response rates. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kinney, Kerry L; Boffa, Joseph W; Amir, Nader; Amir, Amir, Angst, Beck, Beck, Borkovec, Borkovec, Bradley, Brown, Chambless, Clark, Compton, Fan, First, Greenberg, Hamilton, Iacoviello, Koster, Leon, Mathews, Merritt, Meyer, Mogg, Mogg, Newman, Nunnally, Posner, Price, Ratcliff, Rodriguez, Rubio, Spielberger, Steiner, Steinert, Tran, Vesga-Lopez, Waters, Wittchen, Yiend, Zvielli",2017.0,,0,0,
8416,Patient rating of therapeutic factors and response to cognitive-behavioral group therapy in patients with obsessive-compulsive disorder.,"Group therapy involves complex mechanisms that rely on certain therapeutic factors to promote improvement. The objective of this study was to assess patient rating of therapeutic factors during cognitive-behavioral group therapy (CBGT) and to investigate the correlation between patient rating and outcome of CBGT for the treatment of obsessive-compulsive disorder (OCD). In the present clinical trial, 15 patients participated in a 12-session CBGT protocol. Severity of symptoms was assessed before and after CBGT with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Clinical Global Impression (CGI), Hamilton Anxiety Scale (HAM-A), and Beck Depression Inventory (BDI). Yalom's Curative Factors Questionnaire was administered at the end of each session for patient rating of the usefulness of 12 therapeutic factors to treat OCD. There was a significant interaction between improvement in obsessive-compulsive symptoms and patient rating of altruism, universality, interpersonal learning input and output, family reenactment, self-understanding, and existential factors over time. The results show that group therapeutic factors positively influence the response to CBGT in OCD patients. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Behenck, Andressa S; Gomes, Juliana Braga; Heldt, Elizeth; Amorim, Asbahr, Beck, Bieling, Braga, Butler, Choi, Delucia-Waack, Diefenbeck, Eisen, Gorenstein, Guy, Ito, Koran, Nogueira, Oei, Renshaw, Santos, Shear, Sousa, Souza, Taube-Schiff, Volpato Cordioli, Yalom, Yalom",2016.0,,0,0,
8417,Depressive symptoms mediate the relationship between changes in emotion regulation during treatment and abstinence among women with alcohol use disorders.,"Women with alcohol use disorders (AUD) experience high rates of co-occurring conditions, such as depression and posttraumatic stress disorder (PTSD), which can complicate treatment engagement and response. Therefore, identifying factors that underlie alcohol use, depression, and PTSD symptoms in women with AUD has important treatment implications. The current study investigated emotion regulation as one such underlying factor. We tested a model that examined the extent to which changes in emotion regulation during treatment predicted women's depression and PTSD symptom severity at treatment completion and subsequent alcohol use following treatment. The study included 48 participants enrolled in a randomized controlled trial of interpersonal psychotherapy versus usual care for women with co-occurring alcohol dependence and major depression. Assessments were conducted at baseline, posttreatment (16 weeks), and follow-up (24 weeks). Descriptive statistics of baseline data revealed heightened levels of emotion dysregulation in this sample, which were related to fewer days abstinent from alcohol, more negative consequences from alcohol, and greater PTSD symptom severity. Women's lower depressive symptoms at the end of treatment were found to mediate the relationship between improved emotion regulation during the treatment period and greater abstinence following treatment. Posttreatment PTSD symptoms, however, were not found to mediate that relationship. These results suggest that improvements in depressive symptoms during treatment are associated with emotion regulation at the end of treatment, which may contribute to greater abstinence from alcohol following treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Holzhauer, Cathryn Glanton; Gamble, Stephanie A; Babor, Barlow, Beck, Berking, Boden, Bonn-Miller, Bornovalova, Brown, Conrod, Creech, Dimeff, Eftekhari, Fairholme, Falsetti, Flynn, Foulds, Goldstein, Gratz, Greenfield, Hasin, Hasin, Hayes, Hayes, Hofmann, Karpyak, Keller, Kessler, Kring, Kroenke, Lehavot, Linehan, Longabaugh, Lutz, Miller, Moore, Najavits, Nolen-Hoeksema, Roemer, Rubonis, Ruiz, Samet, Sobell, Sobell, Sobell, Stasiewicz, Stewart, Tull, Walitzer, Weiss, White, Whiteside",2017.0,,0,0,
8418,Anxiety patients show reduced working memory related dlPFC activation during safety and threat.,"Background: Anxiety patients exhibit deficits in cognitive tasks that require prefrontal control of attention, including those that tap working memory (WM). However, it is unclear whether these deficits reflect threat-related processes or symptoms of the disorder. Here, we distinguish between these hypotheses by determining the effect of shock threat versus safety on the neural substrates of WM performance in anxiety patients and healthy controls. Methods: Patients, diagnosed with generalized and/or social anxiety disorder, and controls performed blocks of an N-back WM task during periods of safety and threat of shock. We recorded blood-oxygen-level dependent (BOLD) activity during the task, and investigated the effect of clinical anxiety (patients vs. controls) and threat on WM load-related BOLD activation. Results: Behaviorally, patients showed an overall impairment in both accuracy and reaction time compared to controls, independent of threat. At the neural level, patients showed less WM load-related activation in the dorsolateral prefrontal cortex, a region critical for cognitive control. In addition, patients showed less WM load-related deactivation in the ventromedial prefrontal cortex and posterior cingulate cortex, which are regions of the default mode network. Most importantly, these effects were not modulated by threat. Conclusions: This work suggests that the cognitive deficits seen in anxiety patients may represent a key component of clinical anxiety, rather than a consequence of threat. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Balderston, Nicholas L; Vytal, Katherine E; O'Connell, Katherine; Torrisi, Salvatore; Letkiewicz, Allison; Ernst, Monique; Grillon, Christian; Abdi, Alvarez, Amaro, Andreescu, Badre, Balderston, Barch, Basten, Basten, Bishop, Blair, Blair, Brookes, Clarke, Collins, Cornwell, Cox, Delgado, Derakshan, Diekhof, Diener, Donoso, Dretsch, Dunning, Esposito, Etkin, Eysenck, Fales, Fiddick, First, Fonov, Fonov, Forster, Gold, Greenberg, Grillon, Grillon, Grillon, Grillon, Grillon, Hansen, Hasler, Hettema, Honzel, Koechlin, Kucyi, Lang, Lavric, Linden, Mennin, Milad, Milad, Morey, Morey, Morgan, Nee, Nili, Nitschke, Northoff, Owen, Phelps, Rayner, Robinson, Robinson, Robinson, Robinson, Ruscio, Shackman, Sheline, Strawn, Strawn, Telzer, Tomasi, Vytal, Vytal, Vytal, Zhang",2017.0,,0,0,
8419,Cognitive behavior therapy for late-life generalized anxiety disorder delivered by lay and expert providers has lasting benefits.,"Objective: Peaceful Living, a cognitive-behavioral treatment (CBT) for late-life generalized anxiety disorder (GAD), produced positive outcomes in GAD severity, anxiety, depression, insomnia, and mental health quality of life relative to usual care with treatment delivered by either bachelor-level lay providers (BLPs) or PhD-level expert providers (PLPs). We examined long-term maintenance of gains during 12 months following CBT for patients in this trial who received the intervention delivered by BLPs and PLPs and completed post-treatment assessments. Methods: Participants were 112 older adults (mean age, 66.83 years) with GAD recruited from primary care who received CBT from BLPs (n = 52) or PLPs (n = 60) and completed post-treatment assessments. Assessments were given at post-treatment and at 6- and 12-month follow-up. Primary outcomes assessed long-term maintenance of gains in worry (Generalized Anxiety Disorder Severity Scale) and anxiety (State-Trait Anxiety Inventory, Structured Interview Guide for the Hamilton Anxiety Scale). Secondary outcomes assessed depression (Patient Health Questionnaire), mental health quality of life (Medical Outcomes Study Short Form-mental wellness scale), and sleep (Insomnia Severity Index). Results: At 6- and 12-month follow-ups, post-treatment reductions in GAD severity, anxiety, depression, and improvements in mental health quality of life and sleep were maintained for patients in both groups. No differences were found, based on provider group. Conclusion: Treatment of late-life anxiety delivered by nonexpert lay providers working under supervision of licensed providers has lasting benefits. These findings support the potential of new models of care for older adults that may expand reach of mental health services. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Freshour, Jessica S; Amspoker, Amber B; Yi, Misung; Kunik, Mark E; Wilson, Nancy; Kraus-Schuman, Cynthia; Cully, Jeffrey A; Teng, Ellen; Williams, Susan; Masozera, Nicholas; Horsfield, Matthew; Stanley, Melinda; Andreescu, Ayers, Barrera, Bastien, Bourland, Brenes, Callahan, Calleo, Carriere, Choi, Collins, den Boer, Goncalves, Gum, Jenkinson, Kessler, Klein, Kraus-Schuman, Kroenke, Lenth, Lenze, Li, Mantella, Martens, McHorney, Mohr, Montgomery, Razykov, Roundy, Shear, Shear, Spielberger, Stanley, Stanley, Stanley, Twisk, Wetherell, Wetherell, Wolitzky-Taylor, Yuan",2016.0,,0,0,
8420,An open effectiveness trial of a multimodal inpatient treatment for depression and anxiety among adults with serious mental illness.,"Objective: This prospective open effectiveness trial examined symptom change trajectories and rates of remission from depression and anxiety in an intensive multimodal inpatient treatment for adults with serious mental illness (SMI). Patient baseline characteristics were examined as mediators/moderators of treatment response. Methods: Adult inpatients with SMI (N = 994) completed an average of 39 days of inpatient treatment. Latent growth curve (LGC) methods were used to model symptom trajectories, estimating expected remission based on individual patterns of change observed across the sample. Results: Absolute reductions in symptoms were substantial, with large effect size improvements for both depression (d = 1.21, 95% CI [1.13, 1.29]) and anxiety (d = 1.13, 95% CI [1.05, 1.21]). For those presenting with elevated depressive symptoms (Patient Health Questionnaire-Depression >= 5.0; 87.5% of the sample), 46.9% evidenced remission from admission to discharge. Among patients presenting with significant anxiety (Patient Health Questionnaire-Generalized Anxiety Disorder Screener >= 5.0; 84.5% of the sample), 50.0% evidenced remission from admission to discharge. Mediation analyses revealed that depression and anxiety severity decreased more rapidly with increasing age and initial levels of experiential avoidance. Conclusions: Rates of remission of depression and anxiety were greater than anticipated in this large cohort of adult SMI inpatients and may be related to intensity and length of hospitalization. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Fowler, J. Christopher; Clapp, Joshua D; Madan, Alok; Allen, Jon G; Frueh, B. Christopher; Oldham, John M; Arbuckle, Barlow, Bateman, Bauer, Beckes, Bentler, Blatt, Bollen, Bond, Browne, Campbell-Sills, Caspi, Clapp, Driessen, Druss, Dunner, Ellard, Fawcett, First, First, Fowler, Fowler, Fowler, Frame, Goldberg, Gratz, Groat, Hayes, Hollon, Hu, Huppert, Hyman, Kendler, Kessler, Kessler, Kline, Kroenke, Leichsenring, Linehan, Lowe, Lowe, Madan, Mennin, Muthen, Narrow, Ressler, Rush, Smith, Thase, Westen, Wooderson",2017.0,,0,0,
8421,Repeated stimulation of the posterior parietal cortex in patients in minimally conscious state: A sham-controlled randomized clinical trial.,"The article presents a study with aim, Repeated Stimulation of the Posterior Parietal Cortex in Patients in Minimally Conscious State: A Sham-Controlled Randomized Clinical Trial. Thirty-seven patients in MCS were enrolled int this trial and thirty-three completed the study (mean age 57 +/- 11 years; 13 women; interval 6 +/- 5 months; 20 post-traumatic). Four patients dropped-out because of medical complication (unrelated to tDCS) or due to a transfer to another facility. The present study shows that tDCS over the posterior parietal cortex improves the recovery of clinical sign(s) of consciousness in some patients in MCS; however, the effects did not last when reassessed at 5-day follow-up. When comparing the effect sizes (0.43 vs 0.31), the number of responders (56 vs 27%) and the duration of the effect with our previous study on tDCS targeting the left prefrontal cortex, authors found stronger effects for the prefrontal stimulation. Stimulating the posterior parietal cortex might influence cortico-cortical and cortico-thalamic connectivity, which are both degenerated in patients with DOC. The results lead to several follow-up questions and future studies: 1) Was the difference between responders and non responders associated with anatomical differences induced by the mechanism of brain lesions? 2) Does prefrontal tDCS induce a larger magnitude of effects or some participants would respond better to prefrontal tDCS and others to parietal tDCS? 3) Can parameters of tDCS be optimized to induce larger and more long-lasting effects? 4) Can tDCS improve brain activity as measured by neuroimaging tools? (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Huang, Wangshan; Wannez, Sarah; Fregni, Felipe; Hu, Xiaohua; Jing, Shan; Martens, Geraldine; He, Minhui; Di, Haibo; Laureys, Steven; Thibaut, Aurore; Altman, Angelakis, Bikson, Di, Giacino, Lant, Laureys, Laureys, Thibaut, Thibaut",2017.0,,0,0,
8422,"Mental health utilization patterns during a stepped, collaborative care effectiveness trial for PTSD and depression in the military health system.","Background: Integrated health care models aim to improve access and continuity of mental health services in general medical settings. STEPS-UP is a stepped, centrally assisted collaborative care model designed to improve posttraumatic stress disorder (PTSD) and depression care by providing the appropriate intensity and type of care based on patient characteristics and clinical complexity. STEPS-UP demonstrated improved PTSD and depression outcomes in a large effectiveness trial conducted in the Military Health System. The objective of this study was to examine differences in mental health utilization patterns between patients in the stepped, centrally assisted collaborative care model relative to patients in the collaborative care as usual-treatment arm. Methods: Patients with probable PTSD and/or depression were recruited at 6 large military treatment facilities, and 666 patients were enrolled and randomized to STEPS-UP or usual collaborative care. Utilization data acquired from Military Health System administrative datasets were analyzed to determine mental health service use and patterns. Clinical complexity and patient characteristics were based on self-report questionnaires collected at baseline. Results: Compared with the treatment as usual arm, STEPS-UP participants received significantly more mental health services and psychiatric medications across primary and specialty care settings during the year of their participation. Patterns of service use indicated that greater clinical complexity was associated with increased service use in the STEPS-UP group, but not in the usual-care group. Conclusions: Results suggest that stepped, centrally assisted collaborative care models may increase the quantity of mental health services patients receive, while efficiently matching care on the basis of the clinical complexity of patients. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Belsher, Bradley E; Jaycox, Lisa H; Freed, Michael C; Evatt, Daniel P; Liu, Xian; Novak, Laura A; Zatzick, Douglas; Bray, Robert M; Engel, Charles C; Aiken, Belsher, Bower, Cantrell, Duan, Engel, Engel, Engel, Fortney, Fortney, Hoge, Hoge, Katon, Kessler, Kroenke, Lang, Lee, Liu, Manning, McDonald, Oxman, Rubenstein, Schnurr, Tanielian, van Straten, Ware, Weathers, Williams, Woltmann, Wong",2016.0,,0,0,
8423,"Is specialized integrated treatment for comorbid anxiety, depression and alcohol dependence better than treatment as usual in a public hospital setting?","Aim: To assess the effectiveness of a 12 week specialized, integrated intervention for alcohol dependence with comorbid anxiety and/or mood disorder using a randomized design in an outpatient hospital setting. Methods: Out of 86 patients meeting the inclusion criteria for alcohol dependence with suspicion of comorbid anxiety and/or depressive disorder, 57 completed a 3-week stabilization period (abstinence or significantly reduced consumption). Of these patients, 37 (65%) met a formal diagnostic assessment of an anxiety and/or depressive disorder and were randomized to either (a) integrated intervention (cognitive behavioural therapy) for alcohol, anxiety and/or depression, or (b) usual counselling care for alcohol problems. Results: Intention-to-treat analyses revealed a beneficial treatment effect of integrated treatment relative to usual counselling care for the number of days to relapse (chi2 = 6.42, P < 0.05) and lapse (chi2 = 10.73, P < 0.01). In addition, there was a significant interaction effect of treatment and time for percentage days of abstinence (P < 0.05). For heavy drinking days, the treatment effect was mediated by changes in DASS anxiety (P < 0.05). There were no significant treatment interaction effects for DASS depression or anxiety symptoms. Conclusions: These results provide support for integrated care in improving drinking outcomes for patients with alcohol dependence and comorbid depression/anxiety disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Morley, K. C; Baillie, A; Leung, S; Sannibale, C; Teesson, M; Haber, P. S; Andrews, Andrews, Anton, Back, Baillie, Baker, Brady, Brown, Brown, Brown, Connor, Darke, Dutra, Foa, Jarvis, Kelly, Kessler, Lai, Lehert, Loranger, Lovibond, Miller, Monti, Morley, Morley, Morley, Najavits, Persons, Randall, Rapee, Rapee, Rawson, Reoux, Riper, Sannibale, Sannibale, Schade, Skinner, Skinner, Sobell, Sobell, Teesson, Williams",2016.0,,0,0,
8424,Screening of anxiety and quality of life in people with epilepsy.,"Purpose: Up to 60% of people with epilepsy (PwE) have psychiatric comorbidity including anxiety. Anxiety remains under recognized in PwE. This study investigates if screening tools validated for depression could be used to detect anxiety disorders in PWE. Additionally it analyses the effect of anxiety on QoL. Method: 261 participants with a confirmed diagnosis of epilepsy were included. Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and Emotional Thermometers (ET), both validated to screen for depression were used. Hospital Anxiety and Depression Scale-Anxiety (HADS-A) with a cut off for moderate and severe anxiety was used as the reference standard. QoL was measured with EQ5-D. Sensitivity, specificity, positive and negative predictive value and ROC analysis as well as multivariate regression analysis were performed. Results: Patients with depression (n = 46) were excluded as multivariate regression analysis showed that depression was the only significant determinant of having anxiety in the group. Against HADS-A, NDDI-E and ET-7 showed highest level of accuracy in recognizing anxiety with ET7 being the most effective tool. QoL was significantly reduced in PwE and anxiety. Conclusion: Our study showed that reliable screening for moderate to severe anxiety in PwE without co-morbid depression is feasible with screening tools for depression. The cut off values for anxiety are different from those for depression in ET7 but very similar in NDDI-E. ET7 can be applied to screen simultaneously for depression and ""pure"" anxiety. Anxiety reduces significantly QoL. We recommend screening as an initial first step to rule out patients who are unlikely to have anxiety. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Gur-Ozmen, Selen; Leibetseder, Annette; Cock, Hannah R; Agrawal, Niruj; von Oertzen, Tim J; Beyenburg, Choi-Kwon, Fisher, Gaitatzis, Gaus, Gilliam, Gilliam, Jackson, Jobe, Kanner, Kanner, Kanner, Katz, Kimiskidis, Lee, Mitchell, Mitchell, Mitchell, Mula, Osman, Pickard, Rampling, Schmitz, Silberstein, Snaith, Suda, Tellez-Zenteno, Zigmond",2017.0,,0,0,
8425,Can lncRNAs be indicators for the diagnosis of early onset or acute schizophrenia and distinguish major depressive disorder and generalized anxiety disorder?-A cross validation analysis.,"Depression and anxiety are apparent symptoms in the early onset or acute phase of schizophrenia (SZ), which complicate timely diagnosis and treatment. It is imperative to seek an indicator to distinguish schizophrenia from depressive and anxiety disorders. Using lncRNA microarray profiling and RT-PCR, three up-regulated lncRNAs in SZ, six downregulated lncRNAs in major depressive disorder (MDD), and three up-regulated lncRNAs in generalized anxiety disorder (GAD) had been identified as potential biomarkers. All the lncRNAs were, then, cross-validated in 40 SZ patients, 40 MDD patients, 40 GAD patients, and 40 normal controls. Compared with controls, three up-regulated SZ lncRNAs had a significantly down-regulated expression in GAD, and no remarkable differences existed between MDD and the controls. Additionally, the six down-regulated MDD lncRNAs were expressed in an opposite fashion in SZ, and the expression of the three up-regulated GAD lncRNAs were significantly different between SZ and GAD. These results indicate that the expression patterns of the three up-regulated SZ lncRNAs could not be completely replicated in MDD and GAD, and vice versa. Thus, these three SZ lncRNAs seem to be established as potential indicators for diagnosis of schizophrenia and distinguishing it from MDD and GAD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Cui, Xuelian; Niu, Wei; Kong, Lingming; He, Mingjun; Jiang, Kunhong; Chen, Shengdong; Zhong, Aifang; Li, Wanshuai; Lu, Jim; Zhang, Liyi; Abdolmaleky, Achim, Barry, Bauer, Bermanzohn, Buckley, Burmeister, Chen, Chen, Corvin, Crosby, Cui, Eker, Fukumoto, Hamilton, Hamilton, He, Hsu, Huang, James, Kay, Lehman, Mattick, McGrath, Moffitt, O'Donovan, Pasmant, Ponjavic, Qureshi, Ripke, Ruggero, Sohler, Spadaro, Sun, Tan, Temmingh, Thomas, van Os, van Os, Vassos, Vialou, Wang, Williams, Xu, Zhang",2017.0,,0,0,
8426,'It will get even better': Preliminary findings from a trauma-focused psychotherapy effectiveness study reveal false positive patients' long-term outcome expectations after the treatment.,"Background: There is considerable evidence that outcome expectations may predict psychotherapy outcomes. However, little is known about the long-term outcome expectations following the end of the treatment. Aims: The aim of this study was to evaluate patients' long-term outcome expectations after trauma-focused post-traumatic stress disorder (PTSD) psychotherapy in a single group effectiveness study. Methods: Twenty participants with various traumatic experiences who completed the Brief Eclectic Psychotherapy for Post-Traumatic Stress Disorder (BEPP) and all the assessments were included into the study. Self-report measures were used to evaluate the therapeutic outcomes: Impact of Event Scale-Revised (IES-R), Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at pre-treatment, post-treatment, and 6-month follow-up. Subjective Units of Distress Scale was used to measure long-term outcome expectations at post-treatment, asking participants to measure the expected distress in 6 months following the treatment. Assessments at 6-month follow-up were used to estimate the accuracy of patients' expectations of their distress at previous post-treatment assessment. Results: Significant decline of PTSD symptoms at post-treatment with large effect sizes was observed. At post-treatment assessment participants expected significant improvement of their condition in 6 months after the treatment. However, therapeutic effects remained stable at the 6-month follow-up. Conclusion: It is concluded that the PTSD patients, even after successful trauma-focused treatment, tend to expect further significant positive changes. However, therapeutic effects were stable half a year after the psychotherapy, and patients tend to have false expectations about further improvement of their condition. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Kazlauskas, Evaldas; Jovarauskaite, Lina; Mazulyte, Egle; Skruibis, Paulius; Dovydaitiene, Migle; Eimontas, Jonas; Zelviene, Paulina; Belsher, Brown, Constantino, Constantino, Creamer, Delsignore, Devilly, Evans, Foa, Gersons, Gersons, Greenberg, Kazlauskas, Kazlauskas, Kazlauskas, Lindauer, Newman, Nijdam, Schnyder, Steinert, Viliunien_e, Weathers, Weiss, Westra",2017.0,,0,0,
8427,Rapid human immunodeficiency virus testing and risk prevention in residents of battered women's shelters.,"Background: Human immunodeficiency virus (HIV) infection and intimate partner violence (IPV) are interconnected public health problems. However, few HIV prevention interventions address the unique needs of IPV survivors in shelter and none of the Centers for Disease Control and Prevention's best-evidence risk reduction interventions adequately explore the complex relationship between IPV and HIV risk. Although battered women's shelters provide a safe and supportive environment for women in crisis, most do not offer HIV risk reduction services or sexual safety planning. Methods: This study evaluated the feasibility, acceptability, and initial efficacy of rapid HIV testing and brief risk prevention intervention developed for residents of battered women's shelters. The Safe Alternatives For Empowered sex for intimate partner violence intervention (SAFE-IPV) was evaluated in an open trial (N = 98). Participants were assessed with a series of standardized interviews and self-reports at screening and 3 months after leaving the shelter. Results: Few eligible participants declined SAFE-IPV and participants who received SAFE-IPV reported high levels of satisfaction. No participants in the open trial tested positive for HIV. However, participants reported significantly fewer unprotected vaginal and anal sexual occasions and increased intentions to engage in risk preventative behaviors 3 months after leaving shelter compared with the 3 months before shelter. Additionally, participants reported significant improvements on HIV risk factors addressed in SAFE-IPV at the 3-month follow-up (i.e., reduced emotional, physical, and sexual harm by abuser, posttraumatic stress symptoms, hazardous alcohol use, and drug use). Discussion: These results extend prior research on HIV prevention with women with IPV, demonstrating the acceptability, feasibility, and initial efficacy of SAFE-IPV within battered women's shelter settings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Johnson, Dawn M; Johnson, Nicole L; Beckwith, Curt G; Palmieri, Patrick A; Zlotnick, Caron; Attkisson, Black, Carey, Cattaneo, Cavanaugh, Cavanaugh, Coman, Davidson, Draucker, Harris, Li, Marshall, McCree, Metcalf, Metzger, Phillips, Pilcher, Prowse, Rountree, Rountree, Rountree, Rountree, Saunders, Sobell, Stein",2017.0,,0,0,
8428,Reducing intrusive traumatic memories after emergency caesarean section: A proof-of-principle randomized controlled study.,"Preventative psychological interventions to aid women after traumatic childbirth are needed. This proof-of-principle randomized controlled study evaluated whether the number of intrusive traumatic memories mothers experience after emergency caesarean section (ECS) could be reduced by a brief cognitive intervention. 56 women after ECS were randomized to one of two parallel groups in a 1:1 ratio: intervention (usual care plus cognitive task procedure) or control (usual care). The intervention group engaged in a visuospatial task (computer-game 'Tetris' via a handheld gaming device) for 15 min within six hours following their ECS. The primary outcome was the number of intrusive traumatic memories related to the ECS recorded in a diary for the week post-ECS. As predicted, compared with controls, the intervention group reported fewer intrusive traumatic memories (M = 4.77, SD = 10.71 vs. M = 9.22, SD = 10.69, d = 0.647 [95% CI: 0.106, 1.182]) over 1 week (intention-to-treat analyses, primary outcome). There was a trend towards reduced acute stress re-experiencing symptoms (d = 0.503 [95% CI: -0.032, 1.033]) after 1 week (intention-to-treat analyses). Times series analysis on daily intrusions data confirmed the predicted difference between groups. 72% of women rated the intervention ""rather"" to ""extremely"" acceptable. This represents a first step in the development of an early (and potentially universal) intervention to prevent postnatal posttraumatic stress symptoms that may benefit both mother and child. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Horsch, Antje; Vial, Yvan; Favrod, Celine; Harari, Mathilde Morisod; Blackwell, Simon E; Watson, Peter; Iyadurai, Lalitha; Bonsall, Michael B; Holmes, Emily A; Andrade, Baddeley, Bastos, Bauer, Beck, Bourne, Brewin, Brewin, Clark, Conover, Creedy, Ehlers, Fenech, Foa, Galatzer-Levy, Gordon, Green, Grey, Grey, Grey, Hansen, Harvey, Hastie, Holmes, Holmes, Holmes, Holmes, Holmes, Iyadurai, James, James, Kavanagh, King, McDonald, McGaugh, McKenzie-McHarg, Morland, Nader, Parfitt, Parfitt, Pierrehumbert, Poland, Porcheret, Roberts, Rose, Rothbaum, Seng, Soderquist, Stein, Walker, White, Zigmond",2017.0,,0,0,
8429,Art therapy and cognitive processing therapy for combat-related PTSD: A randomized controlled trial.,"This randomized controlled trial was designed to determine if art therapy in conjunction with Cognitive Processing Therapy (CPT) was more effective for reducing symptoms of combat posttraumatic stress disorder (PTSD) than CPT alone. Veterans (N = 11) were randomized to receive either individual CPT, or individual CPT in conjunction with individual art therapy. PTSD Checklist-Military Version and Beck Depression Inventory-II scores improved with treatment in both groups with no significant difference in improvement between the experimental and control groups. Art therapy in conjunction with CPT was found to improve trauma processing and veterans considered it to be an important part of their treatment as it provided healthy distancing, enhanced trauma recall, and increased access to emotions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Campbell, Melissa; Decker, Kathleen P; Kruk, Kerry; Deaver, Sarah P; Beck, Beck, Bell, Campbell, Cross, Deaver, Forbes, Fulton, Gantt, Gantt, Goetter, Goldberg, Harber, Henderson, Johnsen, Johnson, Kaiser, Kaiser, Kang, Kopytin, Langer, Lyshak-Stelzer, Macdonald, Morgan, Naff, Nishith, Norris, Pietrzak, Pifalo, Pifalo, Ponniah, Price, Rankin, Resick, Riggs, Sarid, Spiegel, Talwar, Tinnin, Tripp, van der Kolk, Weathers, Weathers, Wisco, Wisco",2016.0,,0,0,
8430,"Telephone problem solving for service members with mild traumatic brain injury: A randomized, clinical trial.","Mild traumatic brain injury (mTBI) is a common injury for service members in recent military conflicts. There is insufficient evidence of how best to treat the consequences ofmTBI. In a randomized, clinical trial, we evaluated the efficacy of telephone-delivered problem-solving treatment (PST) on psychological and physical symptoms in 356 post-deployment active duty service members from Joint Base Lewis McChord, Washington, and Fort Bragg, North Carolina. Members with medically confirmed mTBI sustained during deployment to Iraq and Afghanistan within the previous 24 months received PST or education-only (EO) interventions. The PST group received up to 12 biweekly telephone calls from a counselor for subject-selected problems. Both groups received 12 educational brochures describing common mTBI and post-deployment problems, with follow-up for all at 6 months (end of PST), and at 12 months. At 6 months, the PST group significantly improved on a measure of psychological distress (Brief Symptom Inventory; BSI-18) compared to the EO group (p = 0.005), but not on post-concussion symptoms (Rivermead Post-Concussion Symptoms Questionnaire [RPQ]; p = 0.19), the two primary endpoints. However, these effects did not persist at 12-month follow-up (BSI, p = 0.54; RPQ, p = 0.45). The PST group also had significant short-term improvement on secondary endpoints, including sleep (p = 0.01), depression (p = 0.03), post-traumatic stress disorder (p = 0.04), and physical functioning (p = 0.03). Participants preferred PST over EO (p < 0.001). Telephone-delivered PST appears to be a well-accepted treatment that offers promise for reducing psychological distress after combat-related mTBI and could be a useful adjunct treatment post-mTBI. Further studies are required to determine how to sustain its effects. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Bell, Kathleen R; Fann, Jesse R; Brockway, Jo Ann; Cole, Wesley R; Bush, Nigel E; Dikmen, Sureyya; Hart, Tessa; Lang, Ariel J; Grant, Gerald; Gahm, Gregory; Reger, Mark A; St. De Lore, Jef; Machamer, Joan; Ernstrom, Karin; Raman, Rema; Jain, Sonia; Stein, Murray B; Temkin, Nancy; INTRuST Investigators; Al Sayegh, Arean, Attkisson, Bell, Bell, Bell, Bell, Bell, Bombardier, Brooks, Bush, Buysse, Choi, Connor, Daggett, Derogatis, Fann, Galarneau, Gilbert, Hoge, Hoge, Hopko, Jacobson, Johnson, Kasckow, King, Kroenke, Ladouceur, Marx, Meachen, Saunders, Schneiderman, Schnurr, Schottenbauer, Seal, Sheehan, Steenkamp, Ware, Weathers, Wilk, Wilson",2017.0,,0,0,
8431,Web-based acceptance and commitment therapy for mental health problems in college students: A randomized controlled trial.,"There are significant challenges in addressing the mental health needs of college students. The current study tested an acceptance and commitment therapy (ACT), web-based self-help program to treat a broad range of psychological problems students struggle with. A sample of 79 college students was randomized to web-based ACT or a waitlist condition, with assessments at baseline and posttreatment. Results indicated adequate acceptability and program engagement for the ACT website. Relative to waitlist, participants receiving ACT improved on overall distress, general anxiety, social anxiety, depression, academic concerns, and positive mental health. There were no between-group effects on eating concerns, alcohol use, or hostility, or on some key ACT process of change measures. ACT participants improved more on mindful acceptance and obstruction to valued living, both of which mediated treatment outcomes. Results are discussed in the context of lessons learned with the website prototype, and areas for further research are presented. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Levin, Michael E; Haeger, Jack A; Pierce, Benjamin G; Twohig, Michael P; Andersson, Bangor, Black, Blanco, Bluett, Bohlmeijer, Bond, Bricker, Calear, Cardaciotto, Chase, Enders, Gallagher, Gillanders, Hayes, Hayes, Hooper, Hunt, Keyes, Lannin, Lappalainen, Lee, Levin, Levin, Muthen, Richards, Smout, Trompetter, Tullis",2017.0,,0,0,
8432,"Negative rumination in social anxiety: A randomised trial investigating the effects of a brief intervention on cognitive processes before, during and after a social situation.","Background and objectives: According to cognitive models of Social Anxiety Disorder (SAD), negative rumination is a key maintaining factor in the vicious cycle of social anxiety. However, there is a scarcity of research investigating treatment effects on rumination in social anxiety, as well as other key cognitive variables. The current study aimed to determine the effectiveness of a brief intervention on a range of cognitive processes, most notably negative rumination. Additionally, predictors of negative rumination and state anxiety are also investigated. Methods: Participants with a diagnosis of SAD were randomly allocated to an intervention (n = 24) or control group (n = 23). Participant's initially completed trait and state based measures with the intervention group also completing a brief cognitive intervention. One-week later participants completed state anxiety and cognitive measures before and after a speech task. Finally, one-week post-speech task participants completed further trait and state based measures. Results: While the brief cognitive intervention had positive effects on some of the cognitive processes measured at different time points of the study, levels of negative rumination remained stable. Predictors of negative rumination and state anxiety were consistent with cognitive models of SAD. Limitations: The brief nature of the intervention and temporal stance of the intervention (delivered one-week before the speech) may have impacted outcomes. Conclusions: Cognitive technique can potentially impact a range of key processes that maintain SAD, however, more powerful and tailored interventions are needed that address the different processes at play before, during and after a social situation for socially anxious individuals. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Modini, Matthew; Abbott, Maree J; Abbott, Abbott, Acarturk, Chen, Clark, DiNardo, Edwards, Field, First, Gold, Green, Heimberg, Hofmann, Leary, Lovibond, Mattick, Mayo-Wilson, Modini, Penney, Peters, Rapee, Rapee, Rapee, Shikatani, Stevens, Vassilopoulos",2017.0,,0,0,
8433,Secondary distress in violence researchers: A randomised trial of the effectiveness of group debriefings.,"Background: Secondary distress including emotional distress, vicarious trauma (VT) and secondary traumatic stress (STS) due to exposure to primary trauma victims have been described in helping professionals and in violence researchers. To our knowledge, there are few prevalence studies, and no tailored interventions have been tested to reduce secondary distress in violence researchers. The study aims to (1) describe the epidemiology of secondary distress experienced by violence researchers; to (2) assess the effectiveness of group debriefings in mitigating secondary distress; to (3) assess risk and protective factors. Methods: We conducted an un-blinded, individually randomised trial with parallel assignment. Eligible participants were 59 Ugandan researchers employed by the Good Schools Study to interview children who experienced violence in a district of Uganda. Fifty-three researchers agreed to participate and were randomly allocated. The intervention group (n = 26) participated in three group debriefings and the control group (n = 27) in three leisure sessions (film viewings). The primary outcome was change in levels of emotional distress (SRQ-20); secondary outcomes were levels of VT and STS at end-line. A paired t-test assessed the difference in mean baseline and end-line emotional distress. Un-paired t-tests compared the change in mean emotional distress (baseline vs. end-line), and compared levels of VT and STS at end-line. Separate logistic regression models tested the association between end-line emotional distress and a-priori risk or protective factors. Results: Baseline and end-line levels of emotional distress were similar in control (p = 0.47) and intervention (p = 0.59) groups. The superiority of group debriefing over leisure activities in lowering levels of emotional distress in the intervention group (n = 26; difference in SRQ-20 = 0.23 [SD = 2.18]) compared to the control group (n = 26; difference in SRQ-20 = 0.23 [SD = 1.63]) could not be detected (p = 1). In regression analysis (n = 48), baseline distress increased the odds of end-line distress (OR = 16.1, 95%CI 2.82 to 92.7, p = 0.002). Perceived organisational support (OR = 0.09, 95%CI 0.01 to 0.69, p = 0.02) and belief in God (OR = 0.21, 95%CI 0.03 to 1.26, p = 09) was protective against end-line distress. Conclusion: We found no evidence that violence researchers experienced elevated emotional distress after doing violence research. There was no difference between group debriefings and leisure activities in reducing distress in our sample. However, the hypotheses presented should not be ruled out in other violence research settings. Our findings suggest that organisational support is a significant protective factor and belief in God may be an important coping mechanism. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Grundlingh, Heidi; Knight, Louise; Naker, Dipak; Devries, Karen; Abramsky, Adams, Altman, Aparicio, Beck, Bell, Beusenberg, Bonach, Bride, Brunet, Campbell, Cieslak, Coles, Coles, Coles, Coles, Creamer, Deahl, Devilly, Devries, Devries, Devries, Devries, Ellsberg, Eun, Everly, Figley, Garcia-Moreno, Heise, Hoffmann, Jurisch, Levin, Maier, Mangone, Mitchell, Mitchell, Mitchell, Mollart, Motta, Nakigudde, Nurmi, Pack, Pearlman, Rose, Rose, Sabin-Farrell, Salston, Scholte, Schraiber, Smith, Stamm, Stoler, Van Emmerik, Vizcarra, Vrklevski, Wasco, Wessely, Woolhouse",2017.0,,0,0,
8434,A single session of repetitive transcranial magnetic stimulation of the prefrontal cortex reduces cue-induced craving in patients with gambling disorder.,"Background: Gambling disorder (GD) is common and disabling addictive disorder. In patients with substance use disorders, the application of repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) offers promise to alleviate craving. We hypothesized that applying real compared to sham rTMS over the left DLPFC would reduce gambling craving in patients with GD. Methods: In a randomized sham-controlled crossover design, 22 treatment-seeking patients with GD received real or sham treatment with high frequency rTMS over the left DLPFC followed a week later by the other type of treatment. Before and after each rTMS session, participants rated their gambling craving (from 0 to 100) before and after viewing a gambling video used as a cue. We used the Yale-Brown Obsessive Compulsive Scale adapted for Pathological Gambling to assess gambling behavior before and 7 days after each rTMS session. Results: As compared to sham (mean +0.74; standard deviation +/- 3.03), real rTMS significantly decreased cue-induced craving (-2.12+/-3.39; F(1,19) = 4.87; P = 0.04; partial eta2 = 0.05; 95% CI: 0.00-0.21). No significant effect of rTMS was observed on gambling behavior. Conclusions: Patients with GD reported decreased cue-induced craving following a single session of high frequency rTMS applied over the left DLPFC. Further large randomized controlled studies are needed to determine the usefulness of rTMS in GD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Gay, A; Boutet, C; Sigaud, T; Kamgoue, A; Sevos, J; Brunelin, J; Massoubre, C; Addolorato, Amiaz, Barth, Blaszczynski, Bowden-Jones, Bradfield, Brunelin, Camprodon, Claudino, Cowlishaw, Dinur-Klein, Downar, Dunlop, Dunlop, Eichhammer, Enokibara, Fitzgerald, George, Gershon, Goudriaan, Goudriaan, Grall-Bronnec, Hanlon, Hasin, Herremans, Hodgins, Hone-Blanchet, Jansen, Kim, Koob, Lesieur, Li, Lupi, Mishra, Nauczyciel, Oei, Paliwal, Pallanti, Pascual-Leone, Politi, Rose, Rosenberg, Rusjan, Schonfeldt-Lecuona, Sheehan, Skinner, Smith, Tiffany, Tranulis, Van den Eynde, Van den Eynde, Walpoth, Williams, Zack",2017.0,,0,0,
8435,Enhancing the reach of cognitive-behavioral therapy targeting posttraumatic stress in acute care medical settings.,"Objective: Injured patients presenting to acute care medical settings have high rates of posttraumatic stress disorder (PTSD) and comorbidities, such as depression and substance use disorders. Integrating behavioral interventions that target symptoms of PTSD and comorbidities into the acute care setting can overcome common barriers to obtaining mental health care. This study examined the feasibility and acceptability of embedding elements of cognitive-behavioral therapy (CBT) in the delivery of routine postinjury care management. The investigation also explored the potential effectiveness of completion of CBT element homework that targeted PTSD symptom reduction. Methods: This study was a secondary analysis of data from a U.S. clinical trial of the effectiveness of a stepped collaborative care intervention versus usual care for injured inpatients. The investigation examined patients' willingness at baseline (prerandomization) to engage in CBT and pre- and postrandomization mental health service utilization among 115 patients enrolled in the clinical trial. Among intervention patients (N = 56), the investigation examined acceptability of the intervention and used multiple linear regression to examine the association between homework completion as reported by the care manager and six-month PTSD symptom reduction as assessed by the PTSD Checklist-Civilian DSM-IV Version. Results: Patients in the intervention condition reported obtaining significantly more psychotherapy or counseling than patients in the control group during the six-month follow-up, as well as a high degree of intervention acceptability. Completion of CBT element homework assignments was associated with improvement in PTSD symptoms. Conclusions: Integrating behavioral interventions into routine acute care service delivery may improve the reach of evidence-based mental health care targeting PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Darnell, Doyanne; O'Connor, Stephen; Wagner, Amy; Russo, Joan; Wang, Jin; Ingraham, Leah; Sandgren, Kirsten; Zatzick, Douglas; Blanchard, Cunningham, Curran, Forbes, Gilbody, Glasgow, Gros, Jacobson, Jakupcak, Katon, Katzelnick, Kazantzis, Kearns, Koepsell, Love, MacKenzie, Mausbach, McGinn, Monson, Ringle, Roy-Byrne, Russo, Titov, Trusz, Unutzer, Wagner, Wang, Weathers, Zatzick, Zatzick, Zatzick, Zatzick",2017.0,,0,0,
8436,The role of patient characteristics in the concordance of daily and retrospective reports of PTSD.,"Research has documented discrepancies between daily and retrospective reports of psychological symptoms in a variety of conditions. A limited number of studies have assessed these discrepancies in samples of individuals with posttraumatic stress disorder (PTSD), with even less research addressing potential covariates that may influence such discrepancies. In the current study, 65 individuals with co-occurring PTSD and alcohol use disorder (AUD) completed daily assessments of their PTSD symptoms for 1 month, followed by a standard retrospective report of PTSD over the same month. Initial analyses explored the mean levels of daily and retrospective PTSD symptoms, while multilevel models assessed the level of agreement between daily and retrospective reports and the role of demographic variables and comorbid psychopathology (e.g., depression) or substance use (e.g., alcohol use) in moderating the association of daily and retrospective reports. Results showed that retrospective reports of arousal and avoidance symptoms were weakly related to daily reports of these symptoms, while reports of reexperiencing and numbing symptoms showed better agreement. Intra-individual alcohol consumption also moderated associations of reexperiencing and avoidance symptoms, such that on days individuals drank more, their daily reports resembled their retrospective reports less well. Future research should explore the degree to which these results generalize to nondually diagnosed samples, as well as the role such reporting discrepancies may play in PTSD treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Campbell, Sarah B; Krenek, Marketa; Simpson, Tracy L; Barrett, Ben-Zeev, Ben-Zeev, Blanchard, Cohen, Cranford, De Beurs, Debell, Dewey, Dunmore, Ebner-Priemer, Ebner-Priemer, Feeny, First, Foa, Foa, Frueh, Hamilton, Harvey, Koster, Krenek, Kroenke, Leigh, Levine, McAuliffe, Miller, Monson, Naragon-Gainey, Nezlek, Palmieri, Priebe, Resick, Robinson, Schafer, Scott, Searles, Shiffman, Simpson, Singer, Stone, Van den Brink, Weathers, Williams",2017.0,,0,0,
8437,A randomized controlled trial of functional analytic psychotherapy versus watchful waiting: Enhancing social connectedness and reducing anxiety and avoidance.,"Treatments targeting social connectedness have the potential to address a significant public health concern. Functional analytic psychotherapy (FAP) is based on a behavioral interpretation of how the therapeutic relationship can serve as a significant agent of change. Examine the efficacy of FAP compared to watchful waiting (WW) in a randomized controlled trial. Twenty-two participants with difficulties in interpersonal relating, according to the Fear of Intimacy Scale (FIS), and who met Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria for an anxiety disorder or avoidant personality disorder, were randomized to 6 (45-60 min) sessions of FAP (n = 11) or 6 (15 min) sessions of WW (n = 11). FAP outcomes were superior on the primary dependent variables: FIS, Psychiatric Diagnostic Screening Questionnaire (PDSQ) total symptom score, and DSM-IV-TR diagnostic status (as determined by blinded assessors). Adherence coding of sessions showed group differences on the FAP subscale (application of the FAP rules), but not on the supportive listening subscale. Measures of therapeutic alliance also favored FAP. The Working Alliance Inventory-Short Form (WAI) served as a statistical mediator of the relationship between treatment and FIS change and the FAP subscale mediated change on the PDSQ. FAP was more beneficial than WW and, while not definitive, some evidence was found to support the hypothesis that the effects were mediated by events occurring in the therapy relationship. These results are consistent with the FAP model of change. Replication and extension with larger and more diverse samples and more stringent control conditions seems warranted. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Maitland, Daniel W. M; Petts, Rachel A; Knott, Lindsey E; Briggs, Christopher A; Moore, Justin A; Gaynor, Scott T; Borm, Broten, Busch, Busseri, Cacioppo, Callaghan, Callaghan, Clore, Cohen, Corrigan, Cuthbert, D'Amico, Descutner, Duncan, First, Follette, Follette, Garcia, Greenberg, Hanson, Hayes, Hayes, Hayes, Holt-Lunstad, Horowitz, Horvath, Kanter, Kazdin, Kazdin, Kohlenberg, Kohlenberg, Kohlenberg, Maitland, Maitland, Mangabeira, Mansell, Messer, Miller, Munder, Norusis, Preacher, Rounsaville, Segrin, Stuart, Tabachnick, Tracey, Tsai, Uchino, Van Breukelen, Vilardaga, Weeks, Wetterneck, Zimmerman",2016.0,,0,0,
8438,Problem Management Plus (PM+) in the management of common mental disorders in a specialized mental healthcare facility in Pakistan; study protocol for a randomized controlled trial.,"Background: The World Health Organization (WHO) has developed Problem Management Plus (PM+), a 5-session, psychological intervention program delivered by trained non-specialist that addresses common mental disorders. The objectives of this study are to evaluate effectiveness and cost-effectiveness of PM+ in a specialized mental health care facility in Pakistan. Methods: A single blind individual randomized controlled trial (RCT) will be carried out in the outpatient department of a specialized mental healthcare facility in Rawalpindi, Pakistan. After informed consent, patients with high psychological distress (General Health Questionnaire-12 (score >2) and functional impairment (WHO Disability Assessment Schedule 2.0 score >16) will be randomised to PM+ plus treatment as usual (n = 96) or TAU only (n = 96). The primary outcome is the psychological distress, measured by levels of anxiety and depression on the Hospital Anxiety and Depression Scale and improvement in functioning as measured by WHODAS at 20 weeks after baseline. Secondary outcomes include improvement in symptoms of depression, post-traumatic stress disorder, levels of social support and cost effectiveness evaluation. Qualitative interviews will be conducted to evaluate the process of implementing PM+ including barriers and facilitators in implementation and possibility of integration of PM+ program in specialized mental health care facilities in Pakistan. Discussion: The results of this study will be helpful in evaluating the effectiveness of the approach of training non specialists, based in the specialized mental health care facilities in delivering evidence based psychological interventions in the low resource settings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)","Hamdani, Syed Usman; Ahmed, Zainab; Sijbrandij, Marit; Nazir, Huma; Masood, Aqsa; Akhtar, Parveen; Amin, Hania; Bryant, Richard A; Dawson, Katie; van Ommeren, Mark; Rahman, Atif; Minhas, Fareed Aslam; Ahmer, Akhtar, Ashworth, Bolton, Bolton, Buttorff, Chisholm, Chisholm, Czachowski, Dawson, Dua, Eaton, Goldberg, Group, Halepota, Heoinsson, Husain, Kakuma, Khalily, Kidwai, Kroenke, Mauro, Minhas, Mollica, Mumford, Murray, Naeem, Patel, Patel, Rahman, Rahman, Rahman, Rahman, Saxena, Shoukat, Some, Tol, Votruba, Weathers, Whiteford, Zigmond, Zimet",2017.0,,0,0,
8439,An interactive voice response program to reduce drinking relapse: a feasibility study.,"Substance-abusing patients often relapse soon after undergoing treatment, thus requiring intensive aftercare or re-treatment. More efficient monitoring and follow-up of patients could contribute to better treatment outcomes. This study evaluated the feasibility of a computer-automated interactive voice response (IVR) system to reduce relapse following discharge from residential treatment. Sixty participants completing a residential treatment program and meeting DSM-IV criteria for alcohol dependence were randomized to three groups: (1) daily IVR reporting with personal follow-up on noncompliant callers; (2) daily IVR reporting without follow-up; or (3) no IVR reporting (control group). At 30, 90, and 180 days after discharge, participants were interviewed to obtain timeline follow-back drinking data and completed the Work and Social Adjustment Scale, Obsessive-Compulsive Drinking Scale, SF-36, and Drinker Inventory of Consequences. This pilot study suggests that using automated IVR technology to monitor clients after discharge is feasible and warrants further research and development. IVR systems also provide the potential for delivering individualized feedback.",Mundt JC.; Moore HK.; Bean P.,2006.0,10.1016/j.jsat.2005.08.010,0,0,
8440,Incremental cost-effectiveness of a collaborative care intervention for panic disorder.,"Panic disorder is a prevalent, often disabling, disorder among primary-care patients, but there are large gaps in quality of treatment in primary care. This study describes the incremental cost-effectiveness of a combined cognitive behavioral therapy (CBT) and pharmacotherapy intervention for patients with panic disorder versus usual primary-care treatment. This randomized control trial recruited 232 primary-care patients meeting DSM-IV criteria for panic disorder from March 2000 to March 2002 from six primary-care clinics from university-affiliated clinics at the University of Washington (Seattle) and University of California (Los Angeles and San Diego). Patients were randomly assigned to receive either treatment as usual or a combined CBT and pharmacotherapy intervention for panic disorder delivered in primary care by a mental health therapist. Intervention patients had up to six sessions of CBT modified for the primary-care setting in the first 12 weeks, and up to six telephone follow-ups over the next 9 months. The primary outcome variables were total out-patient costs, anxiety-free days (AFDs) and quality adjusted life-years (QALYs). Relative to usual care, intervention patients experienced 60.4 [95% confidence interval (CI) 42.9-77.9] more AFDs over a 12-month period. Total incremental out-patient costs were 492 US dollars higher (95% CI 236-747 US dollars ) in intervention versus usual care patients with a cost per additional AFD of 8.40 US dollars (95% CI 2.80-14.0 US dollars ) and a cost per QALY ranging from 14,158 US dollars (95% CI 6,791-21,496 US dollars ) to 24,776 US dollars (95% CI 11,885-37,618 US dollars ). The cost per QALY estimate is well within the range of other commonly accepted medical interventions such as statin use and treatment of hypertension. The combined CBT and pharmacotherapy intervention was associated with a robust clinical improvement compared to usual care with a moderate increase in ambulatory costs.",Katon W.; Russo J.; Sherbourne C.; Stein MB.; Craske M.; Fan MY.; Roy-Byrne P.,2006.0,10.1017/S0033291705006896,0,0,
8441,"Meaning-making intervention during breast or colorectal cancer treatment improves self-esteem, optimism, and self-efficacy.","Existential issues often accompany a diagnosis of cancer and remain one aspect of psychosocial oncology care for which there is a need for focused, empirically tested interventions. This study examined the efficacy of a novel psychological intervention specifically designed to address existential issues through the use of meaning-making coping strategies on psychological adjustment to cancer. Eighty-two breast or colorectal cancer patients were randomly chosen to receive routine care (control group) or up to four sessions that explored the meaning of the emotional responses and cognitive appraisals of each individual's cancer experience within the context of past life events and future goals (experimental group). This paper reports the results from 74 patients who completed and returned pre- and post-test measures for self-esteem, optimism, and self-efficacy. After controlling for baseline scores, the experimental group participants demonstrated significantly higher levels of self-esteem, optimism, and self-efficacy compared to the control group. The results are discussed in light of the theoretical and clinical implications of meaning-making coping in the context of stress and illness.",Lee V.; Robin Cohen S.; Edgar L.; Laizner AM.; Gagnon AJ.,2006.0,10.1016/j.socscimed.2005.11.041,0,0,
8442,Group debriefing for people with chronic diseases during the SARS pandemic: Strength-Focused and Meaning-Oriented Approach for Resilience and Transformation (SMART).,"This study presented preliminary results on the efficacy of a novel group debriefing model called Strength-Focused and Meaning-Oriented Approach for Resilience and Transformation (SMART). The SMART debriefing (1) aimed at boosting resilience and catalyzing transformation among persons undergoing stressful events, (2) adopted a growth-oriented and holistic approach of health promotion, and (3) employed methods drawn from various indigenous sources (e.g. Asian philosophies and Traditional Chinese Medicine). Participants (N=51) were people with chronic diseases recruited about 1 month (August 2003) after the Severe Acute Respiratory Syndrome (SARS) outbreak was eventually under control, after causing widespread panic in Hong Kong. After the one-day group debriefing, participants showed significant decrease in depression level, as measured by Brief Symptom Inventory (Derogatis & Melisaratos, 1983, Psychological Medicine, 13(3), 595-605) and changes in cognitive appraisal towards SARS. Such changes were sustained in a 1-month follow-up. Clinical implications and directions for further study were discussed.",Ng SM.; Chan TH.; Chan CL.; Lee AM.; Yau JK.; Chan CH.; Lau J.,2006.0,10.1007/s10597-005-9002-y,0,0,
8443,Heart rate responsivity to script-driven imagery in posttraumatic stress disorder: specificity of response and effects of psychotherapy.,"Previous psychophysiological studies of posttraumatic stress disorder (PTSD) have found heightened physiological responsivity to trauma-specific stimuli, but mostly in combat veterans with high comorbidity rates and with psychiatric medication. Our aim was to investigate psychophysiological responses in two new populations while excluding those confounding influences and to assess the effects of psychotherapy on such responses. Thirty-nine subjects with PTSD (24 civilian outpatients and 15 police officers) and 15 trauma-exposed, non-PTSD control subjects underwent psychophysiological assessment while listening to neutral, stressful, and trauma scripts. Psychophysiological measures were heart rate (HR) and blood pressure in combination with subjective anxiety ratings. In a randomized clinical trial, 20 of the civilians were then assigned to treatment or waitlist groups. Psychophysiological assessment was repeated on them after the treatment stage. Both civilians and police with PTSD showed significantly higher HR responses to trauma scripts than the control subjects. After successful psychotherapy with the civilians, HR responsivity to the trauma scripts was significantly reduced, and it correlated positively with PTSD clinical symptoms. We confirmed previous findings of heightened psychophysiological responses in PTSD for two new populations while minimizing comorbidity and medication as confounding factors. Successful psychotherapy normalized HR response to trauma imagery.",Lindauer RT.; van Meijel EP.; Jalink M.; Olff M.; Carlier IV.; Gersons BP.,,10.1097/01.psy.0000188566.35902.e7,0,0,
8444,"A prospective, randomized, clinical and radiographic study after arthroscopic Bankart reconstruction using 2 different types of absorbable tacks.","The aim of the study was to compare the clinical and radiographic results after arthroscopic Bankart reconstruction using 2 different types of absorbable implant. Randomized controlled trial. A randomized series of 40 patients who had recurrent, unidirectional, post-traumatic shoulder instability were included in the study. All patients underwent an arthroscopic Bankart reconstruction involving either polygluconate co-polymer (PGACP group, n = 20) or self-reinforced poly-L-lactic acid polymer (PLLA group, n = 20) tack implants. The patients underwent clinical and radiographic assessments preoperatively and at 2 years. Additional radiographic assessments were performed at 6 months. Preoperatively, the study groups were comparable in terms of demographics as well as clinical parameters. One patient in each group had a redislocation (5%) during the follow-up period of 2 years. No subluxations were registered. No statistically significant differences were found between the study groups in terms of strength in abduction, range of motion, and Rowe or Constant scores. There was a significant increase in degenerative changes during the follow-up period in both study groups (P = .004). However, no significant differences in degenerative changes were registered between the study groups either preoperatively or at the 2-year follow-up. There were no significant differences in the radiographic visibility of the drill holes used for the absorbable implants between the study groups at the 6-month assessment. However, at the 2-year assessment, the radiographic visibility of the drill holes was significantly greater (P = .004) in the patients in the PLLA group than those in the PGACP group. At the 2-year assessment, no correlation was found between the appearance of the drill holes and the degenerative findings (PGACP group, rho = 0.44; PLLA group, rho = 0.42). Two years after arthroscopic Bankart reconstruction using either PGA polymer or PLA polymer implants, the overall clinical results were comparable. Radiographic assessments revealed that the degenerative changes increased in both study groups during the follow-up period. Furthermore, the visibility of the drill holes on the 2-year radiographs was greater after using PLLA implants than after using PGACP implants. Level I.",Magnusson L.; Ejerhed L.; Rostgård-Christensen L.; Sernert N.; Eriksson R.; Karlsson J.; Kartus JT.,2006.0,10.1016/j.arthro.2005.12.016,0,0,
8445,Solving interpersonal problems correlates with symptom improvement in interpersonal psychotherapy: preliminary findings.,"Interpersonal psychotherapy (IPT) research has addressed outcome more than mechanism. This study used the novel Interpersonal Psychotherapy Outcome Scale (IPOS) to test the theoretical axiom that symptomatic improvement in IPT reflects resolution of interpersonal problem areas. The IPOS rates change in focal interpersonal problem areas on a 5-point scale. Patients (N = 24) and therapists (N = 7) in a time-limited IPT outcome study of dysthymic disorder, and patients (N = 11) in an open trial for posttraumatic stress disorder, completed the IPOS at treatment termination. All responding dysthymic subjects (N = 24) and therapists (N = 21) reported interpersonal gains: dysthymic patients scored 4.39 (SD = 0.52) out of 5, therapists 4.27 (0.53). Posttraumatic stress disordered patients rated 4.75 (0.34). Patient and therapist IPOS ratings correlated with objectively measured symptomatic improvement with full or trend statistical significance. Despite methodological limitations, initial testing of the IPOS supports the theorized link between resolving interpersonal crises and improvement in IPT.",Markowitz JC.; Bleiberg KL.; Christos P.; Levitan E.,2006.0,10.1097/01.nmd.0000195314.80210.41,0,0,
8446,"Psychotropic medication use, personality disorder and improvement in long-term dynamic psychotherapy.","Patients receiving long-term dynamic psychotherapy often have both depression and personality disorders (PDs) and take medications concurrently. Our goal was to determine the extent of medication use in an outpatient sample and the relationships of medication use and PD status to diagnostic and symptom measures. Fifty-three patients (25 of whom were taking medications at intake) who entered a long-term psychodynamic psychotherapy study for the treatment of chronic or recurrent depression, anxiety, and/or PDs were followed up to 7 years. PD patients who received combined therapy showed significant improvement in functioning and distress, while those receiving only psychotherapy showed significant improvement in depression and distress. Non-PD patients receiving only psychotherapy showed significant improvement in functioning. Long-term dynamic psychotherapy was associated with improvement in symptoms and functioning for the sample as a whole. PD pathology and being on medications at intake acted as moderator variables: PD predicted a smaller effect size in depression and functioning, while medications predicted a smaller effect size in depression only.",Bond M.; Perry JC.,2006.0,10.1097/01.nmd.0000195345.27277.2f,0,0,
8447,Efficacy of three treatment protocols for adolescents with social anxiety disorder: a 5-year follow-up assessment.,"Few studies have reported long-term follow-up data in adults and even fewer in adolescents. The purpose of this work is to report on the longest follow-up assessment in the literature on treatments for adolescents with social phobia. A 5-year follow-up assessment was conducted with subjects who originally received either Cognitive Behavioral Group Therapy for Adolescents (CBGT-A), Social Effectiveness Therapy for Adolescents--Spanish version (SET-Asv), or Intervención en Adolescentes con Fobia Social--Treatment for Adolescents with Social Phobia (IAFS) in a controlled clinical trial. Twenty-three subjects completing the treatment conditions were available for the 5-year follow-up. Results demonstrate that subjects treated either with CBGT-A, SET-Asv and IAFS continued to maintain their gains after treatments were terminated. Either the CBGT-A, SET-Asv and IAFS can provide lasting effects to the majority of adolescents with social anxiety. Issues that may contribute to future research and clinical implications are discussed.",Garcia-Lopez LJ.; Olivares J.; Beidel D.; Albano AM.; Turner S.; Rosa AI.,2006.0,10.1016/j.janxdis.2005.01.003,0,0,
8448,Videoconferencing-based cognitive-behavioral therapy for obsessive-compulsive disorder.,"Obsessive-compulsive disorder (OCD) is a prevalent, chronic and disabling anxiety disorder. Despite the efficacy and strength of pharmacologic interventions for OCD, medications are not always well accepted or effective, making an efficacious psychosocial alternative especially attractive. Cognitive-behavioral therapy (CBT) has been established as an effective treatment for adult OCD, yet access to such treatment is limited, especially in rural areas. Technological advances allow for therapy to be provided in a real-time format over a videoconferencing network. This method allows therapists to provide state-of-the-art treatment to patients who would not otherwise have access to it. This paper presents three cases of OCD successfully treated via videoconferencing CBT. The presence of OCD was established via structured clinical interview and clinician-rated outcome measures were completed by evaluators blinded to the method of treatment. A multiple baseline across individuals design was used to support the internal validity of the CBT outcome data. Patient ratings of therapeutic alliance were high across all three cases. Information gathered from qualitative interviews post-treatment confirmed quantitative measures finding high levels of patient satisfaction. This pilot study suggests that videoconferencing-based CBT is a promising method to bring appropriate treatment to thousands who live far distances from well-trained therapists.",Himle JA.; Fischer DJ.; Muroff JR.; Van Etten ML.; Lokers LM.; Abelson JL.; Hanna GL.,2006.0,10.1016/j.brat.2005.12.010,0,0,
8449,The role of imagery in the maintenance and treatment of snake fear.,"Two studies assessed the role of mental imagery in the maintenance of fear of common phobic stimuli. Study 1 asked participants who were afraid of a wide range of phobic stimuli to report their visual and somatic imagery. Blind ratings of the imagery on horror and vividness were positively correlated with participant's self-reported fear and avoidance. Study 2 tested the efficacy of modifying imagery using cognitive restructuring compared to in vivo exposure and a minimal exposure, relaxation control in snake fearful participants. Both active treatment groups improved significantly more than the control group in self-reported snake fearfulness and behavioral approach. Condition also interacted with initial severity. Highly fearful subjects responded better to the cognitive imagery modification than to the in vivo exposure, and found the cognitive intervention significantly less aversive. These results are seen as supporting a cognitive model of the maintenance of specific phobia.",Hunt M.; Bylsma L.; Brock J.; Fenton M.; Goldberg A.; Miller R.; Tran T.; Urgelles J.,2006.0,10.1016/j.jbtep.2005.12.002,0,0,
8450,Cerebral hemodynamic changes gauged by transcranial Doppler ultrasonography in patients with posttraumatic brain swelling treated by surgical decompression.,"The use of decompressive craniectomy has experienced a revival in the previous decade, although its actual benefit on patients' neurological outcome remains the subject of debate. A better understanding of the intracranial pressure dynamics, as well as of the metabolic and hemodynamic brain processes, may be useful in assessing the effect of this surgery on the pathophysiology of the swollen brain. The aim of this study was to use transcranial Doppler (TCD) ultrasonography to examine the hemodynamic changes in the brain after decompressive craniectomy in patients with head injury, in addition to examining the relationship between such hemodynamic changes and the patient's neurological outcome. Nineteen patients presenting with traumatic brain swelling and cerebral herniation syndrome who had undergone decompressive craniectomy with dural expansion were studied prospectively. The TCD ultrasonography measurements were performed bilaterally in both the middle cerebral artery (MCA) and in the distal portion of the cervical internal carotid artery (ICA) immediately prior to and after surgical decompression. After surgery, the mean blood flow velocity (BFV) rose to 175 +/- 209% of preoperative values in the MCA of the operated side, while rising to 132 +/- 183% in the contralateral side; the difference between the mean BFV increase in in the MCA of both the decompressed and the opposite side reached statistical significance (p < 0.05). The mean BFV of the extracranial ICA increased to 91 +/- 119% in the surgical side and 45 +/- 60% in the opposite side. Conversely, the MCA pulsatility index (PI) values decreased, on average, to 33 +/- 36% of the preoperative value in the operated side and to 30 +/- 34% on the opposite side; the MCA PI value reductions were significantly greater in the decompressed side when compared with the contralateral side (p < 0.05). The PI of the extracranial ICA reduced, on average, to 37 +/- 23% of the initial values in the operated side and to 24 +/- 34%, contralaterally. No correlation was verified between the neurological outcome and cerebral hemodynamic changes seen on TCD ultrasonography. Decompressive craniectomy results in a significant elevation of cerebral BFV in most patients with traumatic brain swelling and transtentorial herniation syndrome. The increase in cerebral BFV may also occur in the side opposite the decompressed hemisphere; the cerebral BFV increase is significantly greater in the operated hemisphere than contralaterally. Concomitantly, PI values decrease significantly postoperatively, mainly in the decompressed cerebral hemisphere, indicating reduction in cerebrovascular resistance.",Bor-Seng-Shu E.; Hirsch R.; Teixeira MJ.; De Andrade AF.; Marino R.,2006.0,10.3171/jns.2006.104.1.93,0,0,
8451,Augmentation of exposure therapy with D-cycloserine for social anxiety disorder.,"Social anxiety disorder (SAD) is common and debilitating. Although exposure therapy is one of the most effective forms of psychotherapy for this disorder, many patients remain symptomatic. Fear reduction in exposure therapy is similar to extinction learning, and early clinical data with specific phobias suggest that the treatment effects of exposure therapy for SAD may be enhanced with d-cycloserine, an agonist at the glutamatergic N-methyl-d-aspartate receptor. To determine whether short-term treatment with 50 mg of d-cycloserine enhances the efficacy of exposure therapy for SAD. Randomized, double-blind, placebo-controlled augmentation trial examining the combination of d-cycloserine or pill placebo with exposure therapy for SAD. Patients were self-referred from the general community to 1 of 3 research clinics. Twenty-seven participants meeting DSM-IV criteria for SAD with significant public speaking anxiety. Following a diagnostic interview and pretreatment assessment, participants received 5 therapy sessions delivered in either an individual or group therapy format. The first session provided an introduction to the treatment model and was followed by 4 sessions emphasizing exposure to increasingly challenging public speech situations with videotaped feedback of performances. One hour prior to each session, participants received single doses of d-cycloserine or placebo. Symptoms were assessed by patient self-report and by clinicians blind to the randomization condition before treatment, after treatment, and 1 month after the last session. Participants receiving d-cycloserine in addition to exposure therapy reported significantly less social anxiety compared with patients receiving exposure therapy plus placebo. Controlled effect sizes were in the medium to large range. The pilot data provide preliminary support for the use of short-term dosing of d-cycloserine as an adjunctive intervention to exposure therapy for SAD.",Hofmann SG.; Meuret AE.; Smits JA.; Simon NM.; Pollack MH.; Eisenmenger K.; Shiekh M.; Otto MW.,2006.0,10.1001/archpsyc.63.3.298,0,0,
8452,"Arthrodesis of small joints, illustrated by the carpometacarpal joint of the thumb.","Elimination of pain, impairment of function, and loss of power due to basal joint osteoarthritis of the thumb. Idiopathic or posttraumatic osteoarthritis of the basal joint of the thumb. The technique is equally suitable for arthrodesis of the first tarsometatarsal joint or the first metatarsophalangeal joint following a failed Keller-Brandes operation or failed prosthesis. Total or subtotal resection of the trapezium. Osteoarthritis of the distal scaphoid joint (triscaphoid joint). Technique for a stable fixation of small joints, illustrated by arthrodesis of the carpometacarpal joint of the thumb. A plate is bent distally and used as a washer for a small-fragment compression screw, crossing the former joint space and the inserted bone graft. Additional compression is achieved by asymmetric drilling of the proximal screw (asymmetric insertion principle). Plaster splint for 5 days, then early functional treatment. In a clinical trial, 16 patients with idiopathic basal joint osteoarthritis of the thumb (18 joints) were followed up for an average of 6 years postoperatively. The main objective of the operation, namely, pain relief, was achieved in all cases. Only one case required revision due to nonunion.",Marti RK.; Schröder J.,2006.0,10.1007/s00064-006-1162-6,0,0,
8453,Combination of free-breathing and breathhold steady-state free precession magnetic resonance angiography for detection of coronary artery stenoses.,"To analyze the incremental diagnostic value of a combination of two approaches (free-breathing and breathhold) vs. the sole free-breathing approach to coronary magnetic resonance angiography (CMRA) for detection of significant stenoses. Thirty patients were consecutively included in this prospective trial. CMRA was performed on a 1.5-T MR scanner (Magnetom Sonata, Siemens) using a balanced steady-state free precession (SSFP) sequence during free-breathing (2.4 x 0.9 x 0.7 mm3). Breathholding acquisitions (3.0 x 1.5 x 0.7 mm3) were only performed in cases in which the quality of free-breathing CMRA precluded assessment. Patients with contraindications to CMRA, claustrophobia, or nonassessable images were not excluded from the assessment of diagnostic accuracy (intention-to-diagnose design). In 60% of all free-breathing coronary acquisitions the image quality was adequate for diagnostic assessment. For the remaining 40% of the cases, breathhold acquisitions were obtained. The sensitivity, specificity, nonassessable rate, and accuracy in identifying main coronary branches with significant stenoses using the combination of both breathing approaches and the free-breathing approach alone were 65% vs. 32%, 73% vs. 53%, 24% vs. 52%, and 71% vs. 46%, respectively (P < 0.001). In this consecutive cohort of patients, the combination of free-breathing and breathhold CMRA significantly improved diagnostic accuracy. Nevertheless, even this combination did not reach accuracies sufficient for routine clinical application.",Dewey M.; Teige F.; Schnapauff D.; Laule M.; Borges AC.; Rutsch W.; Hamm B.; Taupitz M.,2006.0,10.1002/jmri.20568,0,0,
8454,Language use in imagined dialogue and narrative disclosures of trauma.,"Support exists in many populations for the use of written disclosure to express thoughts and emotions about a traumatic experience. The present study examined language use in a variation of the writing task modified to include an imagined dialogue with another person. We hypothesized that this method would increase cognitive, affective, and present-tense word use, all of which are linked with beneficial outcomes from writing. We randomly assigned 169 college students to write in one of three conditions: trauma narrative, trauma dialogue, or control writing. Results suggested that writing about traumatic experiences in the form of a dialogue promotes greater present-oriented, affective experiencing and cognitive processing than does writing in the form of a narrative.",Burke PA.; Bradley RG.,2006.0,10.1002/jts.20102,0,0,
8455,Dual electrode thalamic deep brain stimulation for the treatment of posttraumatic and multiple sclerosis tremor.,"To report the results of ventralis intermedius nucleus/ventralis oralis posterior nucleus (VIM) plus ventralis oralis anterior (VOA)/ventralis oralis posterior (VOP) thalamic deep brain stimulation (DBS) for the treatment of posttraumatic and multiple sclerosis tremor. The treatment of posttraumatic tremor and multiple sclerosis tremor, by either medication or surgery, has proven difficult. Lesions and DBS have had mixed and somewhat disappointing results. Previously, we reported the use of two DBS electrodes (one at the VIM/VOP border and one at the VOA/VOP border) as effective for the treatment of posttraumatic tremor in a single patient. In this study, we report the results of this technique on four patients. Four patients with either posttraumatic tremor (n = 3) or multiple sclerosis tremor (n = 1) underwent placement of two DBS electrodes (one at the VIM/VOP border and one at the VOA/VOP border). Patients underwent preoperative testing and testing at a minimum of 6 months after implantation in four conditions: On VIM DBS/On VOA/VOP DBS; On VIM DBS/Off VOA VOP DBS (5 h DBS washout); Off VIM DBS/Off VOA/VOP DBS (12 h overnight washout); and Off VIM DBS/On VOA/VOP DBS (5 h DBS washout). Each of the patients showed improvements in all four conditions when compared with the baseline. All of the improvements were maintained with chronic DBS, without tremor rebound. An analysis was performed to determine whether each condition was associated with symptom reduction (percentage change). The percentage reduction was significant for each condition and measure, despite the small number of participants. For the total tremor rating scale score, the Off VIM/Off VOA/VOP condition yielded less symptom reduction than the On VIM condition or the On VOA/VOP condition. The On VIM and On VOA/VOP conditions did not differ significantly from each other in terms of contralateral upper extremity symptoms or total clinical score. Activation of both the VIM and VOA/VOP electrodes was associated with the greatest symptom reduction. Tremors, such as those examined in this study, that are refractory to medications and have a poor response to VIM DBS monotherapy, may respond favorably to VIM plus VOA/VOP DBS. Two electrodes may be better than one for the treatment of certain disorders; however, more study will be required to confirm this hypothesis.",Foote KD.; Seignourel P.; Fernandez HH.; Romrell J.; Whidden E.; Jacobson C.; Rodriguez RL.; Okun MS.,2006.0,10.1227/01.NEU.0000192692.95455.FD,0,0,
8456,[The HINTEGRA ankle: short- and mid-term results].,"The HINTEGRA ankle was developed as an attempt to specifically address the needs of minimal bone resection, extended bone support, proper ligament balancing, and minimal contact stresses within and around the prosthesis. The purpose of this article was to present the design and rationale of this prosthesis, and to analyze the clinical and radiological short- to mid-term results particularly with respect to the revisions and learning curve. Of the 278 total ankle replacements (between 2000 and 2004) with the HINTEGRA ankle, 271 ankles [patients: 261, males: 133, females: 128, age: 58.4 years (range: 25-90 years)] were clinically and radiographically assessed after 36.1 months (range: 12-64 months). The preoperative diagnosis was post-traumatic osteoarthrosis in 206 cases (76.0%), systemic arthritis in 34 cases (12.5%), and a primary osteoarthrosis in 31 cases (11.5%). Beside 4 perioperative and 19 early postoperative complications, a late complication occurred in 40 cases (14.8%). Of these, 22 complications (8.2%) were not related to implants, and 18 complications (6.6%) were related to implants. In all, 39 cases (14.4%) were revised; of these, 5 cases (1.8%) were revised to ankle arthrodesis. All other 34 revision arthroplasties were successful and did not evidence any differences in the outcome to the non-revised ankles. The AOFAS hindfoot score improved from 40.3 (range: 14-61) to 85.0 (range: 44-100) points at last follow-up. Radiographically, the tibial component was stable in all remaining 266 ankles, and no tilting of the component occurred since surgery. The talar component was positioned too posteriorly in 12 ankles (4.4%). The concept of minimal bone resection and wide bony support was shown to be successful on the tibial and talar sides. Most complications occurred in the early cases of this series, and the learning curve was found to be short and steep. Despite the high amount of post-traumatic cases with limited soft tissue quality, the obtained function, pain relief, and patient satisfaction were promising and, compared with other devices, the results mostly were superior. This may support the belief that anatomically shaped surfaces, as is the case in the HINTEGRA ankle, may advance success in total ankle replacement.",Hintermann B.; Valderrabano V.; Knupp M.; Horisberger M.,2006.0,10.1007/s00132-006-0941-y,0,0,
8457,Combined anterior plus posterior stabilization versus posterior short-segment instrumentation and fusion for mid-lumbar (L2-L4) burst fractures.,"Prospective randomized study. OBJECTIVES.: To compare the results of the combined anterior-posterior surgery (Group A) with posterior ""short-segment"" transpedicular fixation (SSTF) (Group B) in mid-lumbar burst fractures. There are no comparative randomized clinical studies on the outcome following operative treatment of mid-lumbar fractures. Forty consecutive patients with L2-L4 fresh single A3-type/AO burst fractures and load sharing score up to 6 were randomly selected to underwent either combined one-stage anterior stabilization with mesh cage and SSTF (Group A) or solely SSTF with intermediate screws in the fractured vertebra (Group B). Kyphotic Gardner angle, anterior and posterior vertebral body height (PVBHr, AVBHr), spinal canal encroachment (SCE), SF-36, VAS, and Frankel classification were used. The follow-up observation averaged 46 and 48 months for Group A and B, respectively. Operative time, blood loss, and hospital stay were significant more in Group A. More surgical complications were observed in the Group A. After surgery, VAS was reduced to 4.3 and 3.6 for Group A and Group B, respectively. The SF-36 domains Role physical and Bodily pain improved significantly only in Group B (P = 0.05) and (P = 0.06), respectively. Correction of AVBHr, PVBHr, and spinal canal clearance was similar in both groups. Spinal canal clearance did not differ between the two groups, but it was continuous until the last evaluation in Group B. The final Gardner angle loss of correction averaged 2 degrees and 5 degrees for Group A and Group B, respectively. The posttraumatic Gardner deformity did not significantly improve by SSTF at the final evaluation in the spines of Group B. Gardner angle correlated significantly with SCE in Group B and Group A in all three periods and in the last evaluation, respectively. Frankel grade did not correlate with loss of correction of AVBHr and PVBHr in Group A, while it significantly correlated with loss of PVBHr correction and SCE in the patients of Group B. There was no neurologic deterioration after surgery in any patient. VAS and SF-36 scores did not significantly correlate with the loss of kyphotic angle correction and AVBHr, PVBHr at the final observation in any patient of both groups. SSTF offered similar significant short-term correction of posttraumatic deformities associated with mid-lumbar A3-burst fractures, but better clinical results as compared to combined surgery. However, SSTF did not significantly maintain the after surgery achieved correction of local posttraumatic kyphosis at the final evaluation. Thus, SSTF is not recommended for operative stabilization of fractures with this severity.",Korovessis P.; Baikousis A.; Zacharatos S.; Petsinis G.; Koureas G.; Iliopoulos P.,2006.0,10.1097/01.brs.0000209251.65417.16,0,0,
8458,Computer-aided vs. tutor-delivered teaching of exposure therapy for phobia/panic: randomized controlled trial with pre-registration nursing students.,"Exposure therapy is effective for phobic anxiety disorders (specific phobias, agoraphobia, social phobia) and panic disorder. Despite their high prevalence in the community, sufferers often get no treatment or if they do, it is usually after a long delay. This is largely due to the scarcity of healthcare professionals trained in exposure therapy, which is due, in part, to the high cost of training. Traditional teaching methods employed are labour intensive, being based mainly on role-play in small groups with feedback and coaching from experienced trainers. In an attempt to increase knowledge and skills in exposure therapy, there is now some interest in providing relevant teaching as part of pre-registration nurse education. Computers have been developed to teach terminology and simulate clinical scenarios for health professionals, and offer a potentially cost effective alternative to traditional teaching methods. To test whether student nurses would learn about exposure therapy for phobia/panic as well by computer-aided self-instruction as by face-to-face teaching, and to compare the individual and combined effects of two educational methods, traditional face-to-face teaching comprising a presentation with discussion and questions/answers by a specialist cognitive behaviour nurse therapist, and a computer-aided self-instructional programme based on a self-help programme for patients with phobia/panic called FearFighter, on students' knowledge, skills and satisfaction. Randomised controlled trial, with a crossover, completed in 2 consecutive days over a period of 4h per day. Ninety-two mental health pre-registration nursing students, of mixed gender, age and ethnic origin, with no previous training in cognitive behaviour therapy studying at one UK university. The two teaching methods led to similar improvements in knowledge and skills, and to similar satisfaction, when used alone. Using them in tandem conferred no added benefit. Computer-aided self-instruction was more efficient as it saved teacher preparation and delivery time, and needed no specialist tutor. Computer-aided self-instruction saved almost all preparation time and delivery effort for the expert teacher. When added to past results in medical students, the present results in nurses justify the use of computer-aided self-instruction for learning about exposure therapy and phobia/panic and of research into its value for other areas of health education.",Gega L.; Norman IJ.; Marks IM.,2007.0,10.1016/j.ijnurstu.2006.02.009,0,0,
8459,Quality of life and treatment outcome in panic disorder: cognitive behavior group therapy effects in patients refractory to medication treatment.,"Improvements in quality of life (QoL) as well as symptomatic relief are important outcomes for the treatment of panic disorder (PD). The aim of this study is to assess the impact of brief cognitive behavior group therapy (CBGT) for panic disorder on QoL and to identify the clinical features associated with these changes. Thirty-six patients with PD refractory to pharmacological treatment took part in a treatment protocol consisting of 12 sessions of CBGT. To evaluate the changes in QoL, the WHOQOL-bref was administered before and after treatment. Thirty-two patients completed the treatment. Significant improvement in all domains of QoL was observed (p< 0.001), which was associated with reductions in general and anticipatory anxiety (p = 0.018) and agoraphobic avoidance (p = 0.046). Consistent with previous findings, associations between QoL and panic-free status did not reach significance in this small study (p = 0.094). CBGT was efficacious in the treatment of PD; the symptoms of anticipatory anxiety and avoidance appear to be more important than episodic panic episodes in affecting QoL.",Heldt E.; Blaya C.; Isolan L.; Kipper L.; Teruchkin B.; Otto MW.; Fleck M.; Manfro GG.,2006.0,10.1159/000091776,0,0,
8460,From fear to love: individual differences in implicit spider associations.,"The Implicit Association Test (IAT) was used to investigate automatic fear associations in fear of spiders. Fear associations toward spiders were measured among spider fearful and nonfearful participants (Experiment 1) as well as among nonfearfuls and spider enthusiasts (Experiment 2). It was shown that the IAT is sensitive to personal automatic fear associations and therefore distinguishes between high-fearful, nonfearful, and enthusiastic participants. Moreover, implicit spider associations measured by the IAT predicted avoidance behavior beyond self-reports. The results of Experiment 2 provide additional support for the argument that implicit spider associations are different from general stereotypes or knowledge about spiders.",Ellwart T.; Rinck M.; Becker ES.,2006.0,10.1037/1528-3542.6.1.18,0,0,
8461,Naltrexone renders one-session exposure therapy less effective: a controlled pilot study.,"In vivo exposure has become the gold standard treatment for specific phobia. The endogenous opioid system is one mechanism proposed to explain why exposure provides such quick and effective treatment for specific phobia. The effect of naltrexone on fear and avoidance behavior was investigated among 15 specific phobia participants who received exposure treatment. Participants were randomly assigned to receive naltrexone, placebo, or no drug prior to attending one-session exposure treatment. Mixed effects regression results revealed that across time, the naltrexone group tolerated significantly less time in the room with the feared animal (Behavioral Avoidance Index) as compared to the placebo and no drug groups. Phobic individuals assigned to the naltrexone group had significantly higher fear ratings across time in comparison to the placebo group. Results provide support for the endogenous opioid system as a potential underlying biological mechanism associated with behavioral changes during in vivo exposure.",Kozak AT.; Spates CR.; McChargue DE.; Bailey KC.; Schneider KL.; Liepman MR.,2007.0,10.1016/j.janxdis.2006.03.011,0,0,
8462,Impact of PTSD comorbidity on one-year outcomes in a depression trial.,"Low-income African American, Latino, and White women were screened and recruited for a depression treatment trial in social service and family planning settings. Those meeting full criteria for major depression (MDD; N = 267) were randomized to cognitive-behavior therapy (CBT), antidepressant medication, or community mental health referral. All randomly assigned participants were evaluated by baseline telephone and clinical interview, and followed by telephone for one year. Posttraumatic stress disorder (PTSD) comorbidity was assessed at baseline and one-year follow-up in a clinical interview. At baseline, 33% of the depressed women had current comorbid PTSD. These participants had more exposure to assaultive violence, had higher levels of depression and anxiety, and were more functionally impaired than women with depression alone. Depression in both groups improved over the course of one year, but the PTSD subgroup remained more impaired throughout the one-year follow-up period. Thus, evidence-based treatments (antidepressant medication or structured psychotherapy) decrease depression regardless of PTSD comorbidity, but women with PTSD were more distressed and impaired throughout. Including direct treatment of PTSD associated with interpersonal violence may be more effective in alleviating depression in those with both diagnoses.",Green BL.; Krupnick JL.; Chung J.; Siddique J.; Krause ED.; Revicki D.; Frank L.; Miranda J.,2006.0,10.1002/jclp.20279,0,0,
8463,[Effectiveness and tolerability of addition of risperidone in obsessive-compulsive disorder with poor response to serotonin reuptake inhibitors].,"The addition of typical and atypical antipsychotics in patients with obsessive-compulsive disorder (OCD) resistant to serotonin reuptake inhibitors (SRI) has been reported as a useful augmentation strategy. Although antipsychotic monotherapy has been associated with ineffectiveness and even increase of psychotic symptoms (especially in psychotic patients), antipsychotics as concomitant medications have proven to be effective in several case series and pilot clinical trials. The objective of this case series was to evaluate effectiveness of risperidone as add on therapy to current SRIs treatment in OCD refractory to treatment patients. Risperidone add on therapy in moderate and severe treatment resistant OCD patients was reviewed. Case reports were patients fulfilling the following criteria: a) treatment follow-up of at least 12 weeks; b) SRI adequate doses, y c) Y-BOCS score higher than 16 score before starting treatment. A three month follow-up period was reviewed. Risperidone starting dose was low (mean 1.5 mg/day) and was increased following clinical criteria. Therapeutic response and tolerability were evalated with the following scales: Y-BOCS, CGI of change, UKU (neurological subscale) and spontaneous reported adverse events. Response criteria were the following: at least 35% of reduction in Y-BOCS from basal score and final score less than 16 and CGI-C ""much improved"" or ""very much improved"" (score 1 or 2). Intention to treat analysis was performed (patients who reported at least one risperidone dose and effectiveness measure). 31 patients had at least one effectiveness evaluation and 21/31 patients (67.8 %) were considered treatment responders. Mean risperidone dose was 3.8 mg/day. In general, risperidone was well tolerated: serious or unexpected adverse event were not reported. Risperidone as add on therapy to SRI in moderate-severe, refractory to treatment OCD patients, may be an effective and safe strategy.",Arias Horcajadas F.; Soto JA.; García-Cantalapiedra MJ.; Rodríguez Calvin JL.; Morales J.; Salgado M.,,,0,0,
8464,An open pilot study of interpersonal psychotherapy for panic disorder (IPT-PD).,"Interpersonal psychotherapy (IPT) is a time-limited psychotherapy initially developed to treat depression. It has yet to be studied systematically for treatment of panic disorder. We modified IPT for the treatment of panic disorder and tested this treatment in an open clinical trial with 12 patients seeking treatment of DSM-IV panic disorder. Patients were assessed before during and after treatment. At completion of treatment, nine patients (75%) were independently categorized as responders (i.e., rated as much improved or very much improved on the Clinical Global Impression-Change Scale). Substantial improvement was found for panic symptoms, associated anxiety and depressive symptoms, and physical and emotional well-being. Degree of change in this sample approximated that obtained in studies using established treatments such as cognitive behavioral therapy. Results, though preliminary, suggest that IPT may have efficacy as a primary treatment of panic disorder. Further study is warranted.",Lipsitz JD.; Gur M.; Miller NL.; Forand N.; Vermes D.; Fyer AJ.,2006.0,10.1097/01.nmd.0000221302.42073.a1,0,0,
8465,Effects of a brief behavioral treatment for PTSD-related sleep disturbances: a pilot study.,"Sleep disturbances are a core feature of post-traumatic stress disorder (PTSD), and are often resistant to first-line pharmacological and psychological PTSD interventions. The goal of this pilot study was to explore the effects of a very brief intervention for PTSD-related nightmares and insomnia in victims of violent crimes with PTSD. Seven adult victims of violent crimes with a current diagnosis of PTSD received a single, 90-min intervention session that used cognitive-behavioral techniques aimed at reducing post-traumatic nightmares and insomnia. Sleep diary measures, and measures of sleep quality, PTSD severity, anxiety, and depression were completed at baseline and 6 weeks post-intervention. Improvements in self-report and sleep diary measures of sleep quality and dream frequency were observed post-intervention. Clinically meaningful reductions in daytime PTSD symptom severity were also observed. A very brief behavioral intervention targeting post-traumatic nightmares and insomnia was associated with significant improvements in sleep and daytime PTSD symptom severity. Brief sleep-focused intervention may be helpful adjuncts to first-line PTSD treatments.",Germain A.; Shear MK.; Hall M.; Buysse DJ.,2007.0,10.1016/j.brat.2006.04.009,0,0,
8466,A pilot study of behavioral activation for veterans with posttraumatic stress disorder.,"A pilot study was conducted to investigate the feasibility and effectiveness of behavioral activation (BA) therapy for veterans with posttraumatic stress disorder (PTSD). Eleven veterans seeking treatment at a Veterans Administration outpatient PTSD clinic were enrolled in the study protocol, consisting of 16-weekly individual sessions of BA. Nine veterans completed the protocol, one participant completed 15 sessions, and one dropped out after one session. Clinician-rated PTSD symptom severity showed significant pre- to posttreatment improvement and was associated with a moderate effect size. A number of participants also were improved on measures of depression and quality of life, but changes did not reach statistical significance. Findings suggest that BA is a well-tolerated, potentially beneficial intervention for veterans with chronic symptoms of PTSD.",Jakupcak M.; Roberts LJ.; Martell C.; Mulick P.; Michael S.; Reed R.; Balsam KF.; Yoshimoto D.; McFall M.,2006.0,10.1002/jts.20125,0,0,
8467,The OCI-R: validation of the subscales in a clinical sample.,"The psychometric properties of the Obsessive-Compulsive Inventory-Revised (OCI-R) subscales have not been validated in a clinical sample of individuals diagnosed with obsessive-compulsive disorder (OCD). Data were collected on 186 patients diagnosed with OCD and 17 patients diagnosed with generalized anxiety disorder (GAD) using the OCI-R and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Confirmatory factor analysis revealed an acceptable factor structure. Patients with a given primary symptom subtype were elevated on the corresponding subscale of the OCI-R compared to other OCD patients and patients with GAD. In addition, patients who acknowledged that symptom subtype as present but not primary on the Y-BOCS had elevated OCI-R scores on that scale compared to patients who did not endorse that symptom subtype and patients with GAD. Results indicate that the subscales of the OCI-R are valid measures of six symptom subtypes of OCD. The OCI-R is a psychometrically sound, brief instrument. The current data combined with previous efforts suggest that it is appropriate for clinical and non-clinical populations, and for clinical and research purposes. Further research should examine the sensitivity of the specific subscales to treatment effects, and the potential for adding more items to account for other symptom domains of OCD.",Huppert JD.; Walther MR.; Hajcak G.; Yadin E.; Foa EB.; Simpson HB.; Liebowitz MR.,2007.0,10.1016/j.janxdis.2006.05.006,0,0,
8468,PRISM-E: comparison of integrated care and enhanced specialty referral models in depression outcomes.,"This study, entitled Primary Care Research in Substance Abuse and Mental Health for the Elderly, examined six-month outcomes for older primary care patients with depression who received different models of treatment. Clinical outcomes were compared for patients who were randomly assigned to integrated care or enhanced specialty referral. Integrated care consisted of mental health services co-located in primary care in collaboration with primary care physicians. Enhanced specialty referral consisted of referral to physically separate, clearly identified mental health or substance abuse clinics. A total of 1,531 patients were included; their mean age was 73.9 years. Remission rates and symptom reduction for all depressive disorders were similar for the two models at the three- and six-month follow-ups. For the subgroup with major depression, the enhanced specialty referral model was associated with a greater reduction in depression severity than integrated care, but rates of remission and change in function did not differ across models of care for major depression. Six-month outcomes were comparable for the two models. For the subgroup with major depression, reduction in symptom severity was superior for those randomly assigned to the enhanced specialty referral group.",Krahn DD.; Bartels SJ.; Coakley E.; Oslin DW.; Chen H.; McIntyre J.; Chung H.; Maxwell J.; Ware J.; Levkoff SE.,2006.0,10.1176/ps.2006.57.7.946,0,0,
8469,[Arthroscopic Bankart operation using absorbable suture anchors].,"Arthroscopic refixation of the labrum-ligament complex at the glenoid. Posttraumatic anterior or anterior-inferior shoulder instability with Bankart or ALPSA lesion (anterior labral periosteal sleeve avulsion). Atraumatic shoulder instability. Instabilities due to blunted or frayed degeneration of the labrum-ligament complex. HAGL lesion (humeral avulsion of the glenohumeral ligaments) with humeral detachment of the glenohumeral ligaments. Larger bony glenoid defects. Mobilization of the labrum-ligament complex from the neck of the glenoid, superior tightening and refixation at the glenoid rim with the aid of absorbable suture anchors. Immobilization of the affected arm for 4 weeks in an immobilization bandage with abduction pillows. Daily pendulum exercises. Active flexion up to 70 degrees and abduction up to 40 degrees, all in neutral or internal rotation. Avoidance of external rotation for a total of 6 weeks. From January 1999 to December 2001, 58 patients with a Bankart or ALPSA lesion were treated with arthroscopic shoulder stabilization using absorbable suture anchors and slowly absorbable braided sutures. 56 patients underwent a follow-up clinical examination after, on average, 31 months (24-48 months). None of these patients had suffered more than five shoulder dislocations before the operation (average 2.8). Of the intraoperative lesions, a plain Bankart lesion was present in twelve patients (21.4%), 44 patients had an ALPSA lesion (78.6%), of which one in two were combined with an SLAP 2 or SLAP 3 lesion (superior labrum from anterior to posterior). In the evaluation using the Rowe Score, there was an excellent result for 40 patients (71.4%), and a good result for twelve (21.4%). Four patients suffered a repeat dislocation and were therefore classified as poor results (7.2%).",Hoffmann F.,2006.0,10.1007/s00064-006-1165-3,0,0,
8470,A randomized controlled trial of the effect of D-cycloserine on exposure therapy for spider fear.,"Previous research [Hofmann SG, Meuret AE, Smits JA, Simon NM, Pollack MH, Eisenmenger K, et al. Augmentation of exposure therapy for social anxiety disorder with D-cycloserine. Archives of General Psychiatry 2006;63:298-304; Ressler KJ, Rothbaum BO, Tannenbaum L, Anderson P, Graap K, Zimand E, et al. Cognitive enhancers as adjuncts to psychotherapy: use of d-cycloserine in phobic individuals to facilitate extinction of fear. Archives of General Psychiatry 2004;61:1136-44] suggests that d-cycloserine (DCS) facilitates the reduction of clinical fear in humans. We used a well established intervention to evaluate the effectiveness of administering DCS as an adjunct to exposure therapy in a heightened, but sub-clinical, fear population. Over two studies, 100 spider-fearful participants were allocated to DCS or placebo before treatment and were assessed at pre-, immediate post-, and 3.5 weeks post-treatment. Significant treatment effects and return of fear was observed at follow-up, particularly in non-treatment contexts; however, both studies failed to demonstrate any enhancing effects of DCS (50 or 500 mg). DCS did not enhance the reduction of spider fears or the generalisation of treatment of a single session of exposure-based therapy. These results suggest that DCS may not enhance loss of non-clinical levels of fear in human populations.",Guastella AJ.; Dadds MR.; Lovibond PF.; Mitchell P.; Richardson R.,2007.0,10.1016/j.jpsychires.2006.05.006,0,0,
8471,Quality of life in patients with chronic obstructive pulmonary disease and comorbid anxiety or depression.,"The authors examined 179 veterans with chronic obstructive pulmonary disease (COPD) to determine the relative contribution of clinical depression and/or anxiety (Beck Depression and Beck Anxiety Inventories) to their quality of life (Chronic Respiratory Questionnaire and Medical Outcomes Survey Short Form). Multiple-regression procedures found that both depression and anxiety were significantly related to negative quality-of-life outcomes (anxiety with both mental and physical health quality-of-life outcomes, and depression primarily with mental health). When comorbid with COPD, mental health symptoms of depression and anxiety are some of the most salient factors associated with quality-of-life outcomes.",Cully JA.; Graham DP.; Stanley MA.; Ferguson CJ.; Sharafkhaneh A.; Souchek J.; Kunik ME.,,10.1176/appi.psy.47.4.312,0,0,6204
8472,Three-year outcomes in deep brain stimulation for highly resistant obsessive-compulsive disorder.,"Deep brain stimulation (DBS) of the anterior limb of the internal capsule has been shown to be beneficial in the short term for obsessive-compulsive disorder (OCD) patients who exhaust conventional therapies. Nuttin et al, who published the first DBS for OCD series, found promising results using a capsule target immediately rostral to the anterior commissure extending into adjacent ventral capsule/ventral striatum (VC/VS). Published long-term outcome data are limited to four patients. In this collaborative study, 10 adult OCD patients meeting stringent criteria for severity and treatment resistance had quadripolar stimulating leads implanted bilaterally in the VC/VS. DBS was activated openly 3 weeks later. Eight patients have been followed for at least 36 months. Group Yale-Brown Obsessive Compulsive Scale (YBOCS) scores decreased from 34.6+/-0.6 (mean+/-SEM) at baseline (severe) to 22.3+/-2.1 (moderate) at 36 months (p < 0.001). Four of eight patients had a > or =35% decrease in YBOCS severity at 36 months; in two patients, scores declined between 25 and 35%. Global Assessment of Functioning scores improved from 36.6+/-1.5 at baseline to 53.8+/-2.5 at 36 months (p < 0.001). Depression and anxiety also improved, as did self-care, independent living, and work, school, and social functioning. Surgical adverse effects included an asymptomatic hemorrhage, a single seizure, and a superficial infection. Psychiatric adverse effects included transient hypomanic symptoms, and worsened depression and OCD when DBS was interrupted by stimulator battery depletion. This open study found promising long-term effects of DBS in highly treatment-resistant OCD.",Greenberg BD.; Malone DA.; Friehs GM.; Rezai AR.; Kubu CS.; Malloy PF.; Salloway SP.; Okun MS.; Goodman WK.; Rasmussen SA.,2006.0,10.1038/sj.npp.1301165,0,0,
8473,Dropouts versus completers among chronically depressed outpatients.,"Premature termination is common among patients treated for depression with either pharmacotherapy or psychotherapy. Yet little is known about factors associated with premature treatment termination among depressed patients. This study examines predictors of, time to, and reasons for dropout from the 12-week acute phase treatment of nonpsychotic adult outpatients, age 18-75, with chronic major depression who were randomly assigned to nefazadone alone (MED), cognitive behavioral analysis system of psychotherapy alone (CBASP) or both treatments (COMB). Of 681 randomized study participants, 156 were defined as dropouts. Dropout rates were equivalent across the three treatments. Among dropouts, those in COMB remained in treatment (Mean=40 days) significantly longer than those in either MED (Mean=27 days) or CBASP (Mean=28 days). Dropouts attributed to medication side-effects were significantly lower in COMB than in MED, suggesting that the relationship with the psychotherapist may increase patient willingness to tolerate side-effects associated with antidepressant medications. Ethnic or racial minority status, younger age, lower income, and co-morbid anxiety disorders significantly predicted dropout in the full sample. Within treatments, differences between completers and dropouts in minority status and the prevalence of anxiety disorders were most pronounced in MED. Among those receiving CBASP, dropouts had significantly lower therapeutic alliance scores than completers. The sample included only individuals with chronic depression. Predictors of dropout included baseline patient characteristics, but not early response to treatment. Ethnic and racial minorities and those with comorbid anxiety are at higher risk of premature termination, particularly in pharmacotherapy, and may require modified treatment strategies.",Arnow BA.; Blasey C.; Manber R.; Constantino MJ.; Markowitz JC.; Klein DN.; Thase ME.; Kocsis JH.; Rush AJ.,2007.0,10.1016/j.jad.2006.06.017,0,0,
8474,Seeking safety therapy for adolescent girls with PTSD and substance use disorder: a randomized controlled trial.,"This randomized, controlled trial evaluated a manualized psychotherapy, Seeking Safety (SS), for posttraumatic stress disorder (PTSD) and substance use disorder (SUD) in adolescent females. To our knowledge, no prior study has evaluated any psychotherapy designed for this population. SS was compared to treatment as usual (TAU) for 33 outpatients, at intake, end-of-treatment, and 3 months follow-up. SS evidenced significantly better outcomes than TAU in a variety of domains at posttreatment, including substance use and associated problems, some trauma-related symptoms, cognitions related to SUD and PTSD, and several areas of pathology not targeted in the treatment (e.g., anorexia, somatization). Effect sizes were generally in the moderate to high range. Some gains were sustained at follow-up. SS appears a promising treatment for this population, but needs further study and perhaps additional clinical modification.",Najavits LM.; Gallop RJ.; Weiss RD.,2006.0,10.1007/s11414-006-9034-2,0,0,
8475,Substance use disorder comorbidity in major depressive disorder: a confirmatory analysis of the STAR*D cohort.,"The demographics and clinical features were compared between those with (29.4%) and without concurrent substance use disorder (SUD) in 2541 outpatients with major depression (MDD) enrolled in the Sequenced Treatment Alternatives to Relieve Depression study. Compared to those without SUD, MDD patients with concurrent SUD were more likely to be younger, male, divorced or never married, and at greater current suicide risk, and have an earlier age of onset of depression, greater depressive symptomatology, more previous suicide attempts, more frequent concurrent anxiety disorders, and greater functional impairment (p = 0.048 to <0.0001). They were also less likely to be Hispanic and endorse general medical comorbidities (p = 0.006 and 0.002, respectively).",Davis LL.; Frazier E.; Husain MM.; Warden D.; Trivedi M.; Fava M.; Cassano P.; McGrath PJ.; Balasubramani GK.; Wisniewski SR.; Rush AJ.,,10.1080/10550490600754317,0,0,6223
8476,A case series to pilot cognitive behaviour therapy for women with urinary incontinence.,"Psychological factors have been identified with respect to female urinary incontinence. However, there is limited research regarding psychological interventions. The effectiveness of cognitive behaviour therapy (CBT) as a treatment for women with urinary incontinence was investigated. The study adopted an AB case series design with a follow-up phase. Ten women with urinary incontinence each attended individual sessions. The Hospital anxiety and depression scale (HADS) and Incontinence Quality of Life (I-QOL) were administered pre-treatment, post-treatment, and 3-months post-treatment. Participants kept weekly records of bladder functioning. An unstandardized client satisfaction questionnaire was administered at 3-months post-treatment. Anxiety and depression, as measured by the HADS did not show any significant changes. Improvements in incontinence-related quality of life reached statistical significance at the post-treatment administration and were maintained at the 3-months post-treatment follow-up. Significant changes in bladder functioning were not apparent until the 3-month post-treatment follow-up. The satisfaction questionnaires suggest that the participants found the intervention of value. The findings of this study tentatively suggest that incontinence-related quality of life might be improved by involvement in a CBT intervention. Some modest improvements occurred in bladder functioning. Further research is required to confirm these findings.",Garley A.; Unwin J.,2006.0,10.1348/135910705X53876,0,0,
8477,Sudden gains during therapy of social phobia.,"The present study investigated the phenomenon of sudden gains in 107 participants with social phobia (social anxiety disorder) who received either cognitive-behavioral group therapy or exposure group therapy without explicit cognitive interventions, which primarily used public speaking situations as exposure tasks. Twenty-two out of 967 session-to-session intervals met criteria for sudden gains, which most frequently occurred in Session 5. Individuals with sudden gains showed similar improvements in the 2 treatment groups. Although cognitive-behavioral therapy was associated with more cognitive changes than exposure therapy, cognitive changes did not precede sudden gains. In general, the results of this study question the clinical significance of sudden gains in social phobia treatment.",Hofmann SG.; Schulz SM.; Meuret AE.; Moscovitch DA.; Suvak M.,2006.0,10.1037/0022-006X.74.4.687,0,0,
8478,Understanding suicidal ideation in psychosis: findings from the Psychological Prevention of Relapse in Psychosis (PRP) trial.,"To examine the clinically important phenomenon of suicidal ideation in psychosis in relation to affective processes and the multidimensional nature of hallucinations and delusions. In a cross-sectional study of 290 individuals with psychosis, the associations between level of suicidal ideation, affective processes, positive symptoms, clinical and demographic variables were examined. Forty-one per cent of participants expressed current suicidal ideation. Suicidal ideation was associated with depressed mood, anxiety, low self-esteem, negative illness perceptions, negative evaluative beliefs about the self and others and daily alcohol consumption. Frequency of auditory hallucinations and preoccupation with delusions were not associated with suicidal ideation; however, positive symptom distress did relate to suicidal thoughts. Affective dysfunction, including distress in response to hallucinations and delusions, was a key factor associated with suicidal ideation in individuals with psychotic relapse. Suicidal ideation in psychosis appears to be an understandable, mood-driven process, rather than being of irrational or 'psychotic' origin.",Fialko L.; Freeman D.; Bebbington PE.; Kuipers E.; Garety PA.; Dunn G.; Fowler D.,2006.0,10.1111/j.1600-0447.2006.00849.x,0,0,
8479,Bright light therapy for seasonal affective disorder in Israel (latitude 32.6 degrees N): a single case placebo-controlled study.,"We describe a patient diagnosed as having seasonal affective disorder (SAD, winter depression), an unlikely condition in Israel (latitude 32.6 degrees N), a country with relatively minor daylight photoperiodic changes between seasons. Case report. A 46-year-old woman with a clinical picture of depression (Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria for 'major depression with seasonal pattern') reacted positively to 3 weeks of daily bright light therapy of 10,000 lux/wide spectrum. She was asked to wear dark sunglasses during placebo sessions to accommodate an A-B-C single-case-design. The intervention resulted in an improvement of 74-80% in the Hamilton anxiety and depression scales (clinician-rated) and the Beck depression inventory, similar to results obtained in high latitude regions. The depression and anxiety levels returned close to baseline levels following 1 week of the placebo intervention. Seasonal affective disorder is apparently not limited to certain latitudes. The effect of light therapy was short-lived after discontinuation of the treatment, with rapid relapse occurring in the placebo phase.",Moscovici L.,2006.0,10.1111/j.1600-0447.2006.00844.x,0,0,
8480,Bilateral anterior cingulotomy for refractory obsessive-compulsive disorder: Long-term follow-up results.,"To investigate the long-term efficacy and adverse cognitive effects of stereotactic bilateral anterior cingulotomy as a treatment for refractory obsessive-compulsive disorder (OCD) patients. Seventeen patients suffering from refractory OCD underwent stereotactic bilateral anterior cingulotomies and were followed for 24 months. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Clinical Global Impression and other neuropsychological tests were used to assess the efficacy and cognitive changes of cingulotomy. The tests were taken before and 12 and 24 months after surgery. The mean improvement rate of the Y-BOCS score achieved from the baseline was 48%. Eight patients out of 17 met the responder criteria. During the 24-month follow-up, there were no significant adverse effects observed after surgery. Bilateral anterior cingulotomy was effective for the treatment of refractory OCD, and no other significant adverse cognitive effects on long-term follow-up were found.",Jung HH.; Kim CH.; Chang JH.; Park YG.; Chung SS.; Chang JW.,2006.0,10.1159/000095031,0,0,
8481,Predicting treatment outcome on three measures for post-traumatic stress disorder.,"The aim of the present study was to investigate predictors of treatment outcome for Posttraumatic Stress Disorder (PTSD) after treatment completion and at 15-months follow-up (n = 48), in a trial of Eye Movement Desensitisation and Reprocessing (EMDR) versus Imaginal Exposure and Cognitive Restructuring (E+CR). Factors associated with treatment outcome were investigated using regression analyses with the mean change scores in three assessor and self-rated PTSD symptomatology measures, including the Clinician-Administered PTSD Scale (CAPS), the Impact of Events Scale (IES) and the PTSD Symptom Checklist (PCL) from pre- to post-treatment and pre-treatment to follow-up as the dependent variables and demographics, trauma, clinical and personality measures as independent variables. Irrespective to outcome measures and assessment points it was found that four variables were able to predict significantly treatment outcome. These included baseline PTSD symptomatology, number of sessions, gender and therapy type. Overall, our results showed that it is difficult to use pre-treatment variables as a powerful and reliable tool for predicting treatment outcome, as significant predictors were found to be sample-specific and outcome measure-specific. Clinical relevance of the present results and directions for future research are discussed.",Karatzias A.; Power K.; McGoldrick T.; Brown K.; Buchanan R.; Sharp D.; Swanson V.,2007.0,10.1007/s00406-006-0682-2,0,0,
8482,A cognitive-behavioral treatment for battered women with PTSD in shelters: findings from a pilot study.,"Despite the high rates of posttraumatic stress disorder (PTSD) among battered women in shelters, virtually no treatments for these women have been developed or tested. This study evaluated the initial feasibility and efficacy of an individual, cognitive-behavioral treatment for battered women with PTSD or subthreshold PTSD in shelters. Eighteen women participated in an open-trial where they received a new treatment, Helping to Overcome PTSD with Empowerment (HOPE). Intent-to-treat analyses indicate that participants experienced significant decreases in PTSD symptoms, depressive symptoms, in their loss of resources and degree of social impairment; and significant increases in their effective use of community resources. These gains were maintained over time. Results should be interpreted with caution due to the small sample size and lack of a control group.",Johnson DM.; Zlotnick C.,2006.0,10.1002/jts.20148,0,0,
8483,EEG correlates of startle reflex with reactivity to eye opening in psychiatric disorders: preliminary results.,"Previous studies have shown alterations of eyeblink reflex in patients with various psychiatric disorders. It has previously been demonstrated by our group that EEG measures of the reactivity to eye opening could effectively predict patient-reported startle response in patients with acute stress reaction. In our present study, EEG spectral power analysis and eyeblink electrical startle responses were acquired from a total of 39 patients diagnosed with various psychiatric disorders: 7 patients with schizophrenia, 10 patients with major depressive disorder (MDD), 10 patients with panic disorder, 5 patients with posttraumatic stress disorder (PTSD) and 7 patients with generalized anxiety disorder (GAD). EEG percent power data of each frequency band (delta, theta, alpha, beta) obtained from the 19 leads under open or closed eyelid conditions were used to calculate the arithmetical difference between eyes-open and eyes-closed states as representative of ""EEG reactivity to eye opening"". Data was analyzed separately for each diagnostic group. For all of the disorders, right-sided R2c (contralateral secondary component) latency was the single eyeblink startle measure that was found to be significantly correlated with EEG reactivity to eye opening. The correlation was most significant for right temporal theta frequency in schizophrenia, right temporal theta frequency in MDD, left central beta frequency in panic disorder, left parietotemporal delta frequency in PTSD and right occipital alpha frequency in GAD. Findings showed a newly identified pattern that has potential scientific and clinical value with respect to psychiatric medicine.",Arikan K.; Boutros NN.; Bozhuyuk E.; Poyraz BC.; Savrun BM.; Bayar R.; Gunduz A.; Karaali-Savrun F.; Yaman M.,2006.0,10.1177/155005940603700313,0,0,
8484,Telephone administered cognitive behaviour therapy for treatment of obsessive compulsive disorder: randomised controlled non-inferiority trial.,"To compare the effectiveness of cognitive behaviour therapy delivered by telephone with the same therapy given face to face in the treatment of obsessive compulsive disorder. Randomised controlled non-inferiority trial. Two psychology outpatient departments in the United Kingdom. 72 patients with obsessive compulsive disorder. 10 weekly sessions of exposure therapy and response prevention delivered by telephone or face to face. Yale Brown obsessive compulsive disorder scale, Beck depression inventory, and client satisfaction questionnaire. Difference in the Yale Brown obsessive compulsive disorder checklist score between the two treatments at six months was -0.55 (95% confidence interval -4.26 to 3.15). Patient satisfaction was high for both forms of treatment. The clinical outcome of cognitive behaviour therapy delivered by telephone was equivalent to treatment delivered face to face and similar levels of satisfaction were reported. Current Controlled Trials ISRCTN500103984 [controlled-trials.com].",Lovell K.; Cox D.; Haddock G.; Jones C.; Raines D.; Garvey R.; Roberts C.; Hadley S.,2006.0,10.1136/bmj.38940.355602.80,0,0,
8485,Mental reinstatement of context and return of fear in spider-fearful participants.,"Extant findings in the animal and human conditioning literature demonstrate that renewal, termed return of fear in studies with humans, occurs when reexposure to a previously feared phobic stimulus occurs in a context different than the one present during extinction. The present study investigated whether mental reinstatement of the treatment context at follow-up could attenuate context-based return of fear. Forty-eight spider-fearful individuals received exposure therapy in one of two contexts, and were followed-up 1 week later in the treatment or a new context. Half of the participants received instructions to mentally reinstate the treatment context before the follow-up test. Self-report data replicated previous research on contextually driven return of fear. Furthermore, participants who mentally reinstated the treatment context, before encountering the phobic stimulus in a new context at follow-up, had less return of fear than those who did not. Limitations of the current study, as well as implications for phobia treatment, are discussed.",Mystkowski JL.; Craske MG.; Echiverri AM.; Labus JS.,2006.0,10.1016/j.beth.2005.04.001,0,0,
8486,Interpretation biases in victims and non-victims of interpersonal trauma and their relation to symptom development.,"Previous studies examining information processing in posttraumatic stress disorder (PTSD) have focused on attention and memory biases, with few studies examining interpretive biases. The majority of these studies have employed lexically based methodologies, rather than examining the processing of visual information. In the present study, victims (N=40) and non-victims (N=41) of interpersonal trauma viewed a series of short positive, neutral, and threatening filmstrips of social situations with ambiguous endings. Participants were then asked about their perceptions and interpretations of the situations. Victims perceived threatening situations as more predictable and more quickly increasing in risk than non-victims. Trauma status interacted with the perceived predictability of positive situations and the perceived speed with which neutral situations reached their conclusion to predict anxious symptoms. In addition, trauma status interacted with the perceived increase in risk of positive situations to predict PTSD symptoms. The implications of these findings for theories of PTSD are discussed.",Elwood LS.; Williams NL.; Olatunji BO.; Lohr JM.,2007.0,10.1016/j.janxdis.2006.08.006,0,0,
8487,Substance abuse treatment and psychiatric comorbidity: do benefits spill over? Analysis of data from a prospective trial among cocaine-dependent homeless persons.,"Comorbid psychiatric illness can undermine outcomes among homeless persons undergoing addiction treatment, and psychiatric specialty care is not always readily available. The prognosis for nonsubstance abuse psychiatric diagnoses among homeless persons receiving behaviorally-based addiction treatment, however, is little studied. Data from an addiction treatment trial for 95 cocaine-dependent homeless persons (1996-1998) were used to profile psychiatric diagnoses at baseline and 6 months, including mood-related disorders (e.g. depression) and anxiety-related disorders (e.g. post-traumatic stress disorder). Treatment interventions, including systematic reinforcement for goal attainment, were behavioral in orientation. There was a 32% reduction in the prevalence of comorbid non-addiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32%) and anxiety-related disorders (-20%) (p = 0.12). Among cocaine-dependent homeless persons with psychiatric comorbidity undergoing behavioral addiction treatment, a reduction in comorbid psychiatric disorder prevalence was observed over 6 months. Not all participants improved, suggesting that even evidence-based addiction treatment will prove insufficient for a meaningful proportion of the dually diagnosed homeless population.",Kertesz SG.; Madan A.; Wallace D.; Schumacher JE.; Milby JB.,2006.0,10.1186/1747-597X-1-27,0,0,
8488,Multifaceted psychosocial intervention program for breast cancer patients after first recurrence: feasibility study.,"We developed a novel multifaceted psychosocial intervention program which involves screening for psychological distress and comprehensive support including individually tailored psychotherapy and pharmacotherapy provided by mental health professionals. The purpose of the present study was to investigate the feasibility of the intervention program and its preliminary usefulness for reducing clinical psychological distress experienced by patients with recurrent breast cancer. The subjects who participated in the 3 months intervention program completed psychiatric diagnostic interview and several self-reported measures regarding psychological distress, traumatic stress, and quality of life. The assessments were conducted before the intervention (T1), after the intervention (T2), and 3 months after the intervention (T3). A total of 50 patients participated in the study. The rates of participation in and adherence to the intervention program were 85 and 86%, respectively. While the proportion of psychiatric disorders at T2 (11.6%) was not significantly different from that at T1 (22.0%) (p = 0.15), the proportion of that at T3 (7.7%) had significantly decreased compared with that at T1 (p = 0.005). The novel intervention program is feasible, is a promising strategy for reducing clinically manifested psychological distress and further controlled studies are warranted.",Akechi T.; Taniguchi K.; Suzuki S.; Okamura M.; Minami H.; Okuyama T.; Furukawa TA.; Uchitomi Y.,2007.0,10.1002/pon.1101,0,0,
8489,Efficacy of cognitive-behavioral interventions targeting personality risk factors for youth alcohol misuse.,"Sensation seeking, anxiety sensitivity, and hopelessness are personality risk factors for alcohol use disorders, each associated with specific risky drinking motives in adolescents. We developed a set of interventions and manuals that were designed to intervene at the level of personality risk and associated maladaptive coping strategies, including alcohol misuse. Manuals contained psychoeducational information on the target personality risk factor and how it is associated with maladaptive coping, as well as exercises targeting maladaptive cognitions and behaviors specific to each personality type. We tested the efficacy of these novel interventions on reducing drinking behavior by randomly assigning 297 Canadian high school students (56% girls, mean age 16, mean grade 11) to personality-targeted interventions (group format; 2 sessions) or to a no-treatment control group. Intent-to-treat analyses indicated beneficial effects of the intervention and Intervention x Personality interactions on drinking rates, drinking quantity, binge drinking, and problem drinking symptoms at 4-month follow-up.",Conrod PJ.; Stewart SH.; Comeau N.; Maclean AM.,2006.0,10.1207/s15374424jccp3504_6,0,0,
8490,Reduction of cancer-specific thought intrusions and anxiety symptoms with a stress management intervention among women undergoing treatment for breast cancer.,"After surgery for breast cancer, many women experience anxiety relating to the cancer that can adversely affect quality of life and emotional functioning during the year postsurgery. Symptoms such as intrusive thoughts may be ameliorated during this period with a structured, group-based cognitive behavior intervention. A 10-week group cognitive behavior stress management intervention that included anxiety reduction (relaxation training), cognitive restructuring, and coping skills training was tested among 199 women newly treated for stage 0-III breast cancer. They were then followed for 1 year after recruitment. The intervention reduced reports of thought intrusion, interviewer ratings of anxiety, and emotional distress across 1 year significantly more than was seen with the control condition. The beneficial effects were maintained well past the completion of adjuvant therapy. Structured, group-based cognitive behavior stress management may ameliorate cancer-related anxiety during active medical treatment for breast cancer and for 1 year following treatment. Group-based cognitive behavior stress management is a clinically useful adjunct to offer to women treated for breast cancer.",Antoni MH.; Wimberly SR.; Lechner SC.; Kazi A.; Sifre T.; Urcuyo KR.; Phillips K.; Smith RG.; Petronis VM.; Guellati S.; Wells KA.; Blomberg B.; Carver CS.,2006.0,10.1176/ajp.2006.163.10.1791,0,0,
8491,"A pragmatic, unblinded randomised controlled trial comparing an occupational therapy-led lifestyle approach and routine GP care for panic disorder treatment in primary care.","Treated anxiety increased in the UK by over 30% since 1994. Medication and psychological treatment is most common, but outcomes are sometimes poor, with high relapse rates. Lifestyle has a potential role in treatment, but is not considered in clinical guidelines. Panic disorder is potentially influenced by lifestyle factors. 16 week unblinded pragmatic randomised controlled trial in 15 East of England primary care practices (2 Primary Care Trusts). Participants met DSM-IV criteria for panic disorder with/without agoraphobia. Follow-up at 20 weeks and 10 months. Control arm, unrestricted routine GP care. Trial Arm, Occupational therapy-led lifestyle treatment comprising: lifestyle review of fluid intake, diet pattern, exercise, caffeine, alcohol and nicotine; negotiation of positive lifestyle changes; monitoring and review of impact of changes. Beck Anxiety Inventory. Intention-to-treat analysis provided between-group comparisons using analysis of co-variance. Bonferroni method to adjust p-values. From 199 referrals, 36 GP care and 31 lifestyle arm patients completed to final follow-up. Significantly lower lifestyle arm BAI scores at 20 weeks (p<0.001), non-significant (p=0.167) at 10 months after Bonferroni correction. 63.6% lifestyle arm, and 40% GP arm patients (p=0.045) panic-free at 20 weeks; 67.7% and 48.5% (p=0.123) respectively at 10 months. Final study size/power calls for caution in interpreting findings. A lifestyle approach may provide a clinically effective intervention at least as effective as routine GP care, with significant improvements in anxiety compared with routine GP care at the end of treatment. Further study is required before suggesting practice changes.",Lambert RA.; Harvey I.; Poland F.,2007.0,10.1016/j.jad.2006.08.026,0,0,
8492,Diagnostic performance of MRI and MR myelography in infants with a brachial plexus birth injury.,"Detailed evaluation of a brachial plexus birth injury is important for treatment planning. To determine the diagnostic performance of MRI and MR myelography in infants with a brachial plexus birth injury. Included in the study were 31 children with perinatal brachial plexus injury who underwent surgical intervention. All patients had cervical and brachial plexus MRI. The standard of reference was the combination of intraoperative (1) surgical evaluation and (2) electrophysiological studies (motor evoked potentials, MEP, and somatosensory evoked potentials, SSEP), and (3) the evaluation of histopathological neuronal loss. MRI findings of cord lesion, pseudomeningocele, and post-traumatic neuroma were correlated with the standard of reference. Diagnostic performance characteristics including sensitivity and specificity were determined. From June 2001 to March 2004, 31 children (mean age 7.3 months, standard deviation 1.6 months, range 4.8-12.1 months; 19 male, 12 female) with a brachial plexus birth injury who underwent surgical intervention were enrolled. Sensitivity and specificity of an MRI finding of post-traumatic neuroma were 97% (30/31) and 100% (31/31), respectively, using the contralateral normal brachial plexus as the control. However, MRI could not determine the exact anatomic area (i.e. trunk or division) of the post-traumatic brachial plexus neuroma injury. Sensitivity and specificity for an MRI finding of pseudomeningocele in determining exiting nerve injury were 50% and 100%, respectively, using MEP, and 44% and 80%, respectively, using SSEP as the standard of reference. MRI in infants could not image well the exiting nerve roots to determine consistently the presence or absence of definite avulsion. In children younger than 18 months with brachial plexus injury, the MRI finding of pseudomeningocele has a low sensitivity and a high specificity for nerve root avulsion. MRI and MR myelography cannot image well the exiting nerve roots to determine consistently the presence or absence of avulsion of nerve roots. The MRI finding of post-traumatic neuroma has a high sensitivity and specificity in determining the side of the brachial plexus injury but cannot reveal the exact anatomic area (i.e. trunk or division) involved. The information obtained is, however, useful to the surgeon during intraoperative evaluation of spinal nerve integrity for reconstruction.",Medina LS.; Yaylali I.; Zurakowski D.; Ruiz J.; Altman NR.; Grossman JA.,2006.0,10.1007/s00247-006-0321-0,0,0,
8493,Benzodiazepine discontinuation among adults with GAD: A randomized trial of cognitive-behavioral therapy.,"This study evaluated the specific effectiveness of cognitive-behavior therapy (CBT) combined with medication tapering for benzodiazepine discontinuation among generalized anxiety disorder (GAD) patients by using a nonspecific therapy control group. Sixty-one patients who had used benzodiazepines for more than 12 months were randomly assigned to the experimental conditions. Nearly 75% of patients in the CBT condition completely ceased benzodiazepine intake, as compared with 37% in the control condition. Results of the 3-, 6-, and 12-month follow-ups confirmed the maintenance of complete cessation. Discontinuation rates remained twice as high in the CBT condition. The number of patients who no longer met GAD criteria was also greater in the CBT condition. The addition of specific CBT components thus seemed to facilitate benzodiazepine tapering among patients with GAD.",Gosselin P.; Ladouceur R.; Morin CM.; Dugas MJ.; Baillargeon L.,2006.0,10.1037/0022-006X.74.5.908,0,0,
8494,Neuropsychological impairment in obsessive-compulsive disorder--improvement over the course of cognitive behavioral treatment.,"A large body of studies demonstrates mild cognitive dysfunction in patients with Obsessive Compulsive Disorder (OCD). Few trials have investigated whether this dysfunction can be improved by treatment. Thirty unmedicated inpatients with OCD were administered a comprehensive neuropsychological test battery before and after 12 weeks of cognitive behavioral therapy (CBT). Thirty-nine carefully matched healthy controls were tested twice within the same interval. At baseline, patients exhibited significant impairments on several tests which normalized at follow-up. A significant group x time interaction was found for tests of nonverbal memory, set shifting and flexible, self guided behavior. Major responders improved significantly more than minor responders on the Rey-Osterrieth Figure immediate and delayed recall. Results suggest that cognitive dysfunction in OCD can improve in the course of treatment. We hypothesize that particularly cognitive behavioral treatment enables OCD patients to think and act in a more flexible way that helps them to develop more effective cognitive strategies.",Katrin Kuelz A.; Riemann D.; Halsband U.; Vielhaber K.; Unterrainer J.; Kordon A.; Voderholzer U.,2006.0,10.1080/13803390500507246,0,0,
8495,Cognitive behavioral therapy for panic disorder and comorbidity: more of the same or less of more?,"This study compared the effects of a higher dose of cognitive behavioral therapy (CBT) for panic disorder versus CBT for panic disorder combined with ""straying"" to CBT for comorbid disorders in individuals with a principal diagnosis of panic disorder with or without agoraphobia. Sixty-five participants were randomly assigned to one of two treatment conditions, either CBT focused solely upon panic disorder and agoraphobia or CBT that simultaneously addressed panic disorder and agoraphobia and, to a lesser degree, the most severe comorbid condition. Results indicated a significant reduction in panic disorder severity and a decline in severity of comorbid diagnoses across both treatment conditions. However, individuals receiving CBT focused only on panic disorder were more likely to meet high end-state functioning at post-treatment, even in intent-to-treat analyses, and report zero panic attacks at the 1-year follow-up, although this effect was not retained in intent-to-treat analyses. At follow-up, CBT focused only on panic disorder yielded more substantial improvement in the most severe baseline comorbid condition, although not in intent-to-treat analyses, and a greater proportion of individuals in this treatment condition were rated as having no comorbid diagnoses, even in intent-to-treat analyses. These findings raise the possibility that remaining focused on CBT for panic disorder may be more beneficial for both principal and comorbid diagnoses than combining CBT for panic disorder with 'straying' to CBT for comorbid disorders.",Craske MG.; Farchione TJ.; Allen LB.; Barrios V.; Stoyanova M.; Rose R.,2007.0,10.1016/j.brat.2006.09.006,0,0,
8496,The effectiveness of computerized cognitive behavioural therapy in routine care.,"The efficacy of a Computerized Cognitive Behavioural Therapy (CCBT) package, Beating the Blues, has been demonstrated in a large randomized controlled trial. The current study tests the generalizability of this finding in a naturalistic non-randomized trial. 219 patients with anxiety and/or depression were recruited to receive CCBT in routine care. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) and Work and Social Adjustment scale (WSA) were administered pre-treatment, immediately on completing treatment and at 6 months post-treatment. Single-item self-report measures of anxiety and depression were also collected during each treatment session. Completer and intention-to-treat analysis demonstrated statistically and clinically significant improvements on the CORE-OM, WSA and in self-reported anxiety and depression. Intention-to-treat analysis indicated an average 0.29-point drop on the CORE-OM, equating to an uncontrolled pre-post effect size of 0.50. Research completers achieved an average 0.61-point drop equating to an uncontrolled pre-post size of 1.00 on the same measure. Where data was available (18%), these benefits were maintained at week 32 (6 months follow-up). CCBT can be an effective first line tool within a stepped care framework for the management of common mental health problems.",Cavanagh K.; Shapiro DA.; Van Den Berg S.; Swain S.; Barkham M.; Proudfoot J.,2006.0,10.1348/014466505X84782,0,0,
8497,Does occasional cannabis use impact anxiety and depression treatment outcomes?: Results from a randomized effectiveness trial.,"This study investigated the extent to which occasional cannabis use moderated anxiety and depression outcomes in the Collaborative Care for Anxiety and Panic (CCAP) study, a combined cognitive-behavioral therapy (CBT) and pharmacotherapy randomized effectiveness trial. Participants were 232 adults from six university-based primary care outpatient clinics in three West Coast cities randomized to receive either the CCAP intervention or the usual care condition. Results showed significant (P<.01) evidence of an interaction between treatment group (CCAP vs. usual care) and cannabis use status (monthly vs. less than monthly) for depressive symptoms, but not for panic disorder or social phobia symptoms (all P>.05). Monthly cannabis users' depressive symptoms improved in the CCAP intervention just as much as those who used cannabis less than monthly, whereas monthly users receiving usual care had significantly more depressive symptoms than those using less than monthly. A combined CBT and medication treatment intervention may be a promising approach for the treatment of depression among occasional cannabis users.",Bricker JB.; Russo J.; Stein MB.; Sherbourne C.; Craske M.; Schraufnagel TJ.; Roy-Byrne P.,2007.0,10.1002/da.20248,0,0,
8498,Low-income depressed older adults with psychiatric comorbidity: secondary analyses of response to psychotherapy and case management.,"This study examined the influence of comorbid anxiety and personality disorders on depression treatment response in 67 low-income older adults. Participants were randomized to clinical case management, cognitive-behavioral group therapy, or both for 6 months. Outcomes were assessed at baseline, post-treatment, and 6 and 12 months after treatment. Dropout and depression diagnoses were similar across groups. Participants with comorbidity had more depressive and anxiety symptoms at most time points; degree of improvement did not differ significantly. Of participants with personality disorder, none met criteria at post-treatment (three relapsed by 12-month follow-up). Findings suggest depressed low-income elders with anxiety or personality disorders can be retained and benefit from depression treatment, but may require additional interventions to achieve similar levels of depressive symptoms.",Gum AM.; Are√°n PA.; Bostrom A.,2007.0,10.1002/gps.1702,0,0,
8499,Conscious and unconscious sensory inflows allow effective control of the functions of the human brain and heart at the initial ageing stage.,"The authors of the present article based their assumption on the concept that the sensory systems are the ""windows to the brain"" through which various functions of the human organism can be controlled. Comprehension of the fundamental mechanisms of the optimization of the sensory systems, brain, and cardiac functions has increased based on the prolonged sensory flows using conscious and unconscious aromatherapy and multimodal sensory activation. Sensory flow evoked stable systemic responses, including adaptive alteration of psycho-emotional state, attention, memory, sensorimotor reactions, intersensory interaction, visual information processing, statokinetic stability, and autonomic heart rhythm control. The efficacy and expediency of the use of sensory flow for non-medicinal correction of vital functions of the human organism at the initial stages of ageing was revealed.",Bykov AT.; Malyarenko TN.; Malyarenko YE.; Terentjev VP.; Dyuzhikov AA.,2006.0,,0,0,
8500,[Effects of therapy goal oriented cognitive behavioural aftercare measures on therapy transfer following inpatient psychosomatic rehabilitation].,"After discharge from inpatient psychosomatic rehabilitation patients often face problems to transfer and stabilize the modifications they have achieved in the clinic. Using targeted outpatient aftercare interventions up to eight weeks after discharge from the inpatient programme we tried to support this transfer, thus enhancing treatment effectiveness. The evaluation was carried out as a field experiment. Patients were matched into pairs and then allocated randomly to either a control or an experimental condition. The experimental group, which had participated in specific aftercare measures after inpatient therapy, was compared to the control group at ""discharge from clinic"" and ""twelve weeks post-discharge"" relative to a number of variables relevant in therapy outcome. Twelve weeks post-discharge patients who had participated in aftercare measures show significantly better progress relative to their physical and psychological complaints than patients in the control group. Also, they are more capable of coping with psychosocial demands of their everyday life. They experience better control of their symptoms and they are more successful in attaining the goals they have set for themselves for the time after discharge. The findings show that supplementing psychosomatic inpatient rehabilitation with specific aftercare measures will lead to better transfer and to increased effectiveness of psychosomatic rehabilitation. Also on account of our results, outpatient rehab aftercare programmes have in the meantime become a regular component of inpatient psychosomatic rehabilitation in Germany.",Gönner S.; Bischoff C.; Ehrhardt M.; Limbacher K.,2006.0,10.1055/s-2006-932614,0,0,6602
8501,Arthroscopic distal clavicle resection in athletes: a prospective comparison of the direct and indirect approach.,"The clinical success of arthroscopic distal clavicle resection for athletes has been well documented. There are, however, no published studies that prospectively compare the recovery rates in athletes as well as the outcomes of the indirect versus direct approaches. Both procedures are equally successful; however, the direct approach affords faster return to sports. Randomized controlled clinical trial; Level of evidence, 2. Thirty-eight consecutive athletes with osteolysis of the distal clavicle or isolated posttraumatic arthrosis of the acromioclavicular joint without instability underwent arthroscopic distal clavicle resection. The patients were randomized into 2 groups: a direct superior approach and an indirect subacromial approach. American Shoulder and Elbow Surgeons and Athletic Shoulder Scoring System scores were measurable outcomes. Thirty-four athletes were available for a minimum 2-year follow-up. The 2 groups were similar, including preoperative American Shoulder and Elbow Surgeons and Athletic Shoulder Scoring System scores. Both groups demonstrated significant improvement in both scores at final follow-up when compared with preoperative scores (P < .001). The direct group demonstrated higher American Shoulder and Elbow Surgeons (82 vs 64) and Athletic Shoulder Scoring System (74 vs 56) scores at week 2 (P < .001) and week 6 (American Shoulder and Elbow Surgeons, 88 vs 77; Athletic Shoulder Scoring System, 87 vs 73) (P < .001). At final follow-up, both groups demonstrated excellent clinical outcomes, even though there was a statistical difference in scores, with the direct group scoring better (American Shoulder and Elbow Surgeons, 95.7 vs 91.2; Athletic Shoulder Scoring System -94.9 vs 88.3). The direct group demonstrated faster return to sports (mean, 21 days) than the indirect group (mean, 42 days) (P < .001). Radiographic analysis demonstrated an equivalent resection. One patient in each group had a clinically insignificant increase in coracoclavicular distance. Both the direct superior approach and the indirect subacromial approach to the arthroscopic distal clavicle resection result in successful clinical outcome with clinically insignificant difference at final follow-up. Athletes treated with the direct superior approach improved faster clinically and returned to sports earlier.",Charron KM.; Schepsis AA.; Voloshin I.,2007.0,10.1177/0363546506294855,0,0,
8502,Characteristics of cocaine- and marijuana-dependent subjects presenting for medication treatment trials.,"Evaluation of the characteristics of individuals presenting for substance abuse treatment can provide important information to help focus treatment services. In this study, demographic and clinical characteristics of individuals presenting for medication trials for the treatment of cocaine or marijuana dependence were compared. Marijuana-dependent subjects were generally younger than cocaine-dependent subjects, more likely to be Caucasian, and completed more years of education. Marijuana-dependent subjects also reported significantly more days using than cocaine-dependent subjects, as well as higher levels of craving. Some differences in psychiatric symptomatology were also noted, with cocaine-dependent subjects more likely to report anxiety symptoms and marijuana-dependent subjects reporting more past depressive episodes. Past and current other drug use was similar between the two groups. These results highlight the significant impairments associated with marijuana and cocaine dependence.",McRae AL.; Hedden SL.; Malcolm RJ.; Carter RE.; Brady KT.,2007.0,10.1016/j.addbeh.2006.10.007,0,0,
8503,Attachment as moderator of treatment outcome in major depression: a randomized control trial of interpersonal psychotherapy versus cognitive behavior therapy.,"Anxiety and avoidance dimensions of adult attachment insecurity were tested as moderators of treatment outcome for interpersonal psychotherapy (IPT) and cognitive- behavioral therapy (CBT). Fifty-six participants with major depression were randomly assigned to these treatment conditions. Beck Depression Inventory--II, Six-Item Hamilton Rating Scale for Depression scores, and remission status served as outcome measures. Patients higher on attachment avoidance showed significantly greater reduction in depression severity and greater likelihood of symptom remission with CBT as compared with IPT, even after controlling for obsessive-compulsive and avoidant personality disorder symptoms. Results were replicated across treatment completers and intent-to-treat samples. These results suggest that it is important to consider the interaction between attachment insecurity and treatment type when comparing efficacy of treatments.",McBride C.; Atkinson L.; Quilty LC.; Bagby RM.,2006.0,10.1037/0022-006X.74.6.1041,0,0,
8504,Concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT zones in defining levels of severity among out-patients with alcohol dependence in the COMBINE study.,"To examine among alcohol-dependent out-patient clients the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) total score and 'zones' suggested by the World Health Organization for defining levels of severity of alcohol use problems. Participants were classified into AUDIT zones (AUDIT total score = 8-15, 16-19, 20-40) and compared on measures of demographics, treatment goals, alcohol consumption, alcohol-related consequences, severity of dependence, physiological dependence, tolerance, withdrawal and biomarkers of alcohol use. Eleven out-patient academic clinical research centers across the United States. Participants Alcohol dependent individuals (n = 1335) entering out-patient treatment in the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) study. The AUDIT was administered as part of an initial screening. Baseline measures used for concurrent validation included the Structured Clinical Interview for Diagnostic and Statistical Manual, 4th edition (DSM-IV) Disorders, the Alcohol Dependence Scale, the Drinker Inventory of Consequences, the Obsessive-Compulsive Drinking Scale, the University of Rhode Island Change Assessment, the Thoughts about Abstinence Scale, the Form-90, %carbohydrate-deficient transferrin and gamma-glutamyl transferase. Findings Indicators of severity of dependence and alcohol-related problems increased linearly with total score and differed significantly across AUDIT zones. The highest zone, with scores of 20 and above, was markedly different with respect to severity from the other two zones and members of this group endorsed an abstinence goal more strongly. The AUDIT total score is a brief measure that appears to provide an index of severity of dependence in a sample of alcohol-dependent individuals seeking out-patient treatment, extending its potential utility beyond its more traditional role as a screening instrument in general populations.",Donovan DM.; Kivlahan DR.; Doyle SR.; Longabaugh R.; Greenfield SF.,2006.0,10.1111/j.1360-0443.2006.01606.x,0,0,
8505,"Temporal relationship between dysfunctional beliefs, self-efficacy and panic apprehension in the treatment of panic disorder with agoraphobia.","The aim of this study is to assess if changes in dysfunctional beliefs and self-efficacy precede changes in panic apprehension in the treatment of panic disorder with agoraphobia. Subjects participated in a larger study comparing the effectiveness of cognitive restructuring and exposure. Four variables were measured: (a) the strength of each subject's main belief toward the consequence of a panic attack; (b) perceived self-efficacy to control a panic attack in the presence of panicogenic body sensations; (c) perceived self-efficacy to control a panic attack in the presence of panicogenic thoughts; and (d) the level of panic apprehension of a panic attack. Variables were recorded daily on a ""0"" to ""100"" scale using category partitioning. Multivariate time series analysis and ""causality testing"" showed that, for all participants, cognitive changes preceded changes in the level of panic apprehension. Important individual differences were observed in the contribution of each variable to the prediction of change in panic apprehension. Changes in apprehension were preceded by changes in belief in three cases, by changes in self-efficacy in six cases, and by changes in both belief and self-efficacy in the remaining three cases. This pattern was observed in participants in the exposure condition as well as those in the cognitive restructuring condition. These results provide more empirical support to the hypothesis that cognitive changes precede improvement. They also underlie the importance of individual differences in the process of change. Finally, this study does not support the hypothesis that exposure and cognitive restructuring operate through different mechanisms, namely a behavioral one and a cognitive one.",Bouchard S.; Gauthier J.; Nouwen A.; Ivers H.; Vallières A.; Simard S.; Fournier T.,2007.0,10.1016/j.jbtep.2006.08.002,0,0,
8506,Adherence to treatment among economically disadvantaged patients with panic disorder.,"The purpose of this study was to examine the feelings of disadvantaged patients about and experiences of treatment for anxiety disorders in primary care settings. The patients had participated in the Collaborative Care for Anxiety and Panic study, which tested the effectiveness of an intervention to help primary care providers treat panic disorder. The treatment comprised cognitive behavioral therapy (CBT) combined with pharmacotherapy administered by primary care physicians with the expert advice of a psychiatrist. Post hoc semistructured interviews were conducted with 21 intervention participants who were classified according to adherence or nonadherence to treatment. The interview focused on reactions to CBT; reactions to the different features of the intervention, such as therapy sessions, demonstration videotapes, exercises, and a workbook; and comfort with the therapist. Two members of the research team independently coded, analyzed, and interpreted the data. Three themes emerged: information was empowering and reduced the sense of isolation experienced by participants, participants engaged in a dynamic and iterative personalized assessment of the intervention, and barriers to adherence were predominantly logistical. Results indicate that the extent to which patients chose to remain in treatment and follow treatment recommendations was rarely an all-or-nothing phenomenon. In a disadvantaged population such decisions seem to be influenced by the beliefs of the patient about what will and will not be effective in his or her individual case, an ongoing self-assessment of well-being, and the logistical barriers that come into play.",Mukherjee S.; Sullivan G.; Perry D.; Verdugo B.; Means-Christensen A.; Schraufnagel T.; Sherbourne CD.; Stein MB.; Craske MG.; Roy-Byrne PP.,2006.0,10.1176/ps.2006.57.12.1745,0,0,
8507,Trauma-focused imaginal exposure for individuals with comorbid posttraumatic stress disorder and alcohol dependence: revealing mechanisms of alcohol craving in a cue reactivity paradigm.,"With a sample (N = 43) of participants meeting current diagnostic criteria for both alcohol dependence and posttraumatic stress disorder (PTSD), the authors tested the hypothesis that alcohol craving elicited by a trauma cue might be attenuated if trauma-elicited negative emotion were reduced following trauma-focused imaginal exposure. In a laboratory-based experiment, participants were randomly assigned to either trauma-focused imaginal exposure or imagery-based relaxation. A cue reactivity paradigm was used to assess alcohol craving prior to, and after completion of, the 6 clinical sessions. Attrition was high but did not differ between experimental conditions. For study completers, PTSD symptoms decreased in the exposure condition but not in the relaxation condition. Alcohol craving and distress elicited by trauma images decreased in the exposure condition but did not change in the relaxation condition. Results support the hypothesis that negative emotion is a mechanism of alcohol craving.",Coffey SF.; Stasiewicz PR.; Hughes PM.; Brimo ML.,2006.0,10.1037/0893-164X.20.4.425,0,0,
8508,A randomised controlled trial of group debriefing.,"There has never been published a randomised controlled trial of group debriefing. In this study we employed an analogue study with students to conduct the first such trial. Sixty-four participants were shown a stressful video of paramedics attending to injured and dead victims of a road traffic accident. Half the participants were subsequently debriefed and half were provided with tea and biscuits and allowed to talk amongst themselves. A 1 month follow-up was administered. It was found that, while the video was rated as distressing, there were no significant differences between the debriefed and non-debriefed groups on measures of affective distress and trauma symptoms. Those who were debriefed later recalled having wanted to talk more to someone about the video than those who were not debriefed. It is suggested that cognitive dissonance may explain this result.",Devilly GJ.; Annab R.,2008.0,10.1016/j.jbtep.2006.09.003,0,0,
8509,A practical screening tool for anxiety and depression in patients with chronic breathing disorders.,"Obstructive lung diseases are associated with high rates of depression and anxiety, yet many patients are never screened or treated. This study evaluated the five-question Depression and Anxiety modules of the Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Questionnaire as a telephone screen in 1,632 patients with chronic breathing disorders at a Veterans Affairs Medical Center in Houston, TX. Subsequent testing of 828 patients with the Beck Depression Inventory-II and the Beck Anxiety Inventory showed that the sensitivity and specificity, respectively, of the Depression and Anxiety modules of the PRIME-MD Patient Questionnaire screening were 94.6% and 49.5% (Depression); 93.7% and 32.2% (Anxiety); and 97.7%, and 36.0% (combined screen), with an overall accuracy of 80.7%. In such populations, these two modules of the PRIME-MD Patient Questionnaire may be a useful screening tool.",Kunik ME.; Azzam PN.; Souchek J.; Cully JA.; Wray NP.; Krishnan LL.; Nelson HA.; Stanley MA.,,10.1176/appi.psy.48.1.16,0,0,7107
8510,Repetitive Transcranial Magnetic Stimulation (rTMS) in the treatment of panic disorder (PD) with comorbid major depression.,"Studies suggest that the dorsolateral prefrontal cortex (DLPFC) participates in neural circuitry that is dysregulated in Panic Disorder (PD) and Major Depressive Disorder (MDD). We tested whether low-frequency repetitive Transcranial Magnetic Stimulation (rTMS) could normalize the overactivity of right frontal regions and thereby improve symptoms. Six patients with PD and comorbid MDD were treated with daily active 1-Hz rTMS to the right DLPFC for 2 weeks in this open-label trial. Clinical improvements were apparent as early as the first week of treatment. After the second week, 5/6 of patients showed improvements in panic and anxiety, and 4/6 showed a decrease in depression, with sustained improvement at 6 months of follow-up. Right hemisphere resting motor threshold increased significantly after rTMS. Limitations of this study are the open design and the small sample size. Slow rTMS to the right DLPFC resulted in significant clinical improvement and reduction of ipsilateral motor cortex excitability. Replications in larger sample will help to clarify the relevance of this preliminary data and to define the potential role of right DLPFC rTMS in panic with major depression.",Mantovani A.; Lisanby SH.; Pieraccini F.; Ulivelli M.; Castrogiovanni P.; Rossi S.,2007.0,10.1016/j.jad.2006.11.027,0,0,
8511,TENS relieves acute posttraumatic hip pain during emergency transport.,"In Central Europe, ambulances for patients suffering from pain caused by nonlife-threatening trauma, such as hip fractures are staffed by medical personnel (medics) without physicians. Thus, there is an urgent need for nonpharmacological interventions that can be applied during the transport by basic life-support (BLS) medical personnel. In all, 101 patients were screened for participation in this randomized placebo-controlled double-blind study, and randomly assigned to two groups (verum and sham transcutaneous electrical nerve stimulation [TENS]). First, medic A recorded all baseline parameters and measurements, then medic B performed TENS in absence of medic A. At the end of transportation, medic A performed data collection. Each patient was asked to grade his/her pain and anxiety level on visual analog scales (VAS, 0 to 100 mm). From 101 screened patients fulfilling the entry criteria, 29 declined consent and 9 had to be excluded from the analysis because of their final diagnosis. Therefore, the data from 30 patients (group 1, verum TENS) as well as from 33 patients (group 2 [control], sham TENS) were analyzed. No significant differences in potentially influencing factors were found before treatment. Pain scores upon arrival at the hospital differed significantly between group 1 and group 2 (p < 0.01). In group 1, pain reduction was observed between departure from the site of emergency and arrival at the hospital (VAS: 89 +/- 9 to 59 +/- 6 mm), whereas pain scores remained nearly unchanged in group 2 (VAS: 86 +/- 12 to 79 +/- 11 mm). Our findings show that TENS is a valuable and fast-acting pain treatment under the difficult circumstances of ""out-of-hospital rescue"". Because of its lack of side effects, it could also be a valuable tool in the hospital.",Lang T.; Barker R.; Steinlechner B.; Gustorff B.; Puskas T.; Gore O.; Kober A.,2007.0,10.1097/01.ta.0000197176.75598.fc,0,0,
8512,Post-traumatic hypotension: should systolic blood pressure of 90-109 mmHg be included?,"It is generally accepted that patients with a systolic blood pressure (SBP)<90 mmHg are in ""shock"" and have a worse prognosis than patients with a higher SBP. Our objective was to determine if patients with a SBP of 90-109 mmHg have a worse outcome than patients with a higher SBP following trauma. Patients with gastric, small bowel, and/or diaphragm injuries were identified retrospectively through the trauma database from 1980-2003. All 2071 patients underwent emergent laparotomy at an urban, level one trauma center. The mortality rate of patients with a SBP of 90-109 mmHg in the ED or OR was 5% (17/354) and significantly higher than the 1% (12/1020) mortality seen in patients with a SBP of 110 mmHg or greater (P<0.001). The average length of stay of patients with a SBP of 90-109 mmHg was 15+/-14 days and was significantly longer than the 11+/-11 days seen in patients with a higher SBP. If the SBP was 90-109 mmHg, the infection rate was 39% (131/340), and this was significantly higher than the 22% (219/1016) infection rate seen in patients with higher SBP (P<0.001). Trauma patients with a systolic blood pressure of 109 mmHg or below are at increased risk for morbidity and mortality following trauma. Patients with a systolic blood pressure of 90-109 mmHg following trauma should be considered as a special group requiring aggressive resuscitation and surgery. Early operative control of hemorrhage in these patients can reduce mortality and infection.",Edelman DA.; White MT.; Tyburski JG.; Wilson RF.,2007.0,10.1097/01.shk.0000239772.18151.18,0,0,
8513,Treating adolescents with social anxiety disorder in school: an attention control trial.,"Anxiety disorders are often undetected and untreated in adolescents. This study evaluates the relative efficacy of a school-based, cognitive-behavioral intervention compared to an educational-supportive treatment for adolescents with social anxiety disorder. Thirty-six students (30 females), ages 14 to 16, were randomized to a 12-week specific intervention, Skills for Social and Academic Success (SASS), or a credible attention control matched for structure and contact, conducted in school. Independent evaluations and adolescent self-reports indicated significant reduction in social anxiety for SASS compared to the control group. Parent reports of their children's social anxiety did not discriminate between treatments. In the specific intervention, 59%, compared to 0% in the control, no longer met criteria for social anxiety disorder following treatment. Superiority of the SASS intervention was maintained 6 months after treatment cessation. The study provides evidence that intervention for social anxiety disorder that emphasizes exposure and social skills is efficacious. Results indicate that clinical improvement is sustained for at least 6 months, and that, overall, adolescents with social anxiety disorder do not respond to non-specific treatment. This investigation has public health implications by demonstrating that effective interventions can be transported to nonclinical settings.",Masia Warner C.; Fisher PH.; Shrout PE.; Rathor S.; Klein RG.,2007.0,10.1111/j.1469-7610.2007.01737.x,0,0,
8514,Do self-statements enhance the effectiveness of virtual reality exposure therapy? A comparative evaluation in acrophobia.,"There is a clear need for more detailed analysis of the role of cognitive self-statements in virtual reality exposure therapy (VRET). To date, no research on this topic has been done. The primary aim of this study was to investigate whether coping self-statements would enhance the effectiveness of VRET. In a randomized crossover design, 26 patients with acrophobia (DSM-IV diagnosis of specific phobia) were randomly assigned to two sessions of VRET followed by two sessions of VRET plus coping self-statements, or the other way around: first two sessions of VRET plus coping self-statements followed by two sessions of VRET. Results showed that VRET, regardless of addition of coping self-statements, decreased anxiety of heights, decreased avoidance of height situations, and improved attitudes towards heights. However, at 6-month follow-up, most gains during treatment were not fully retained.",Krijn M.; Emmelkamp PM.; Olafsson RP.; Schuemie MJ.; van der Mast CA.,2007.0,10.1089/cpb.2006.9943,0,0,
8515,Underdiagnosis of comorbid mental illness in repeat DUI offenders mandated to treatment.,"Repeat offenders for DUI are routinely mandated to undergo alcohol treatment. These individuals have been shown to have high rates of co-occurring psychiatric disorders, which can be important for the conduct and outcomes of alcohol treatment. The extent to which treatment providers are aware of these disorders and modify treatment accordingly is unknown. As part of a larger study to investigate the impact of sanction conditions on probation outcomes, we screened 233 patients for psychiatric conditions and compared the findings with the psychiatric conditions identified during mandatory treatment by independent treatment providers. Adjusted rates of underdiagnosis were commonly high: 97.2% of bipolar disorder cases, 67.5% of major depression cases, 100% of obsessive-compulsive disorder cases, and 37.3% of drug use disorder cases remained undiagnosed during treatment. Rates of overdiagnosis were low for all disorders, with the exception of drug use disorders. These rates of underdiagnosis represent missed opportunities to improve treatment outcomes among repeat DUI offenders.",McMillan GP.; Timken DS.; Lapidus J.; C'de Baca J.; Lapham SC.; McNeal M.,2008.0,10.1016/j.jsat.2007.04.012,0,0,
8516,Generalized social anxiety disorder and avoidant personality disorder: structural analysis and treatment outcome.,"There has been considerable controversy about whether generalized social phobia (GSP) and avoidant personality disorder (APD) are redundant diagnostic categories. In light of the ongoing controversy, more data are needed to help determine whether GSP and APD are independent constructs. Data were obtained from 335 people seeking treatment for GSP at a two site clinical trial. Indicators of GSP and APD were obtained along with assessments of demographic factors, level of functioning, and indicators of related psychopathology. Confirmatory factor analyses of indicators of GSP and APD suggested a somewhat better fit for a two-factor solution. Comparisons of GSP patients with and without APD suggested that in addition to having more severe social phobia symptoms, patients with APD were more depressed on a self-report measure and had more functional impairment, thereby suggesting potential utility of the diagnostic category of APD. Furthermore, the presence of APD predicted treatment response, in that patients with APD had more change early in treatment than those without APD. APD and GSP remain highly related constructs, and different aspects of these data support and dispute the utility of the diagnosis of APD in GSP. Possible new directions in conceptualizing APD are discussed.",Huppert JD.; Strunk DR.; Ledley DR.; Davidson JR.; Foa EB.,2008.0,10.1002/da.20349,0,0,
8517,Screening for posttraumatic stress disorder in VA primary care patients with depression symptoms.,"Unrecognized posttraumatic stress disorder (PTSD) is common and may be an important factor in treatment-resistant depression. Brief screens for PTSD have not been evaluated for patients with depression. The objective was to evaluate a 4-item screen for PTSD in patients with depression. Baseline data from a depression study were used to evaluate sensitivity, specificity, and likelihood ratios (LRs) using the PTSD checklist (PCL-17) as the reference standard. Subjects are 398 depressed patients seen in Veterans Affairs (VA) primary care clinics. The Patient Health Questionnaire (PHQ) for depression, PCL-17, and 4-item screen for PTSD were used. Patients had a mean PHQ score of 14.8 (SD 3.7). Using a conservative PCL-17 cut point ""(>50)"", the prevalence of PTSD was 37%. PCL-17 scores were strongly associated with PHQ scores (r = 0.59, P < 0.001). Among the 342 (86%) patients endorsing trauma, a score of 0 on the remaining 3 symptom items had a LR = 0.21, score of 1 a LR = .62, score of 2 a LR = 1.36, and score of 3 a LR = 4.38. Most depressed VA primary care patients report a history of trauma, and one third may have comorbid PTSD. Our 4-item screen has useful LRs for scores of 0 and 3. Modifying item rating options may improve screening characteristics.",Gerrity MS.; Corson K.; Dobscha SK.,2007.0,10.1007/s11606-007-0290-5,0,0,
8518,"A pragmatic randomised, controlled trial of intensive care follow up programmes in improving longer-term outcomes from critical illness. The PRACTICAL study.","A number of intensive care (ICU) patients experience significant problems with physical, psychological, and social functioning for some time after discharge from ICU. These problems have implications not just for patients, but impose a continuing financial burden for the National Health Service. To support recovery, a number of hospitals across the UK have developed Intensive Care follow-up clinics. However, there is a lack of evidence base to support these, and this study aims to test the hypothesis that intensive care follow up programmes are effective and cost-effective at improving physical and psychological quality of life in the year after intensive care discharge. This is a multi-centre, pragmatic, randomised controlled trial. Patients (n = 270) will be recruited prior to hospital discharge from three intensive care units in the UK, and randomised to one of two groups. The control group will receive standard in-hospital follow-up and the intervention group will participate in an ICU follow-up programme with clinic appointments 2-3 and 9 months after ICU discharge. The primary outcome measure is Health-related Quality of Life (HRQoL) 12 months after ICU discharge as measured by the Short Form-36. Secondary measures include: HRQoL at six months; Quality-adjusted life years using EQ-5D; posttraumatic psychopathology as measured by Davidson Trauma Scale; and anxiety and depression using the Hospital Anxiety and Depression Scale at both six and twelve months after ICU discharge. Contacts with health services in the twelve months after ICU discharge will be measured as part of the economic analysis. The provision of intensive care follow-up clinics within the UK has developed in an ad hoc manner, is inconsistent in both the number of hospitals offering such a service or in the type of service offered. This study provides the opportunity to evaluate such services both in terms of patient benefit and cost-effectiveness. The results of this study therefore will inform clinical practice and policy with regard to the appropriate development of such services aimed at improving outcomes after intensive care. ISRCTN24294750.",Cuthbertson BH.; Rattray J.; Johnston M.; Wildsmith JA.; Wilson E.; Hernendez R.; Ramsey C.; Hull AM.; Norrie J.; Campbell M.,2007.0,10.1186/1472-6963-7-116,0,0,
8519,"Cognitive errors, symptom severity, and response to cognitive behavior therapy in older adults with generalized anxiety disorder.","Recent research by Wetherell et al. investigating the differential response to group-administered cognitive behavior therapy (CBT) for generalized anxiety disorder (GAD) in older adults found that GAD severity, homework adherence, and psychiatric comorbidity predicted statistically significant improvement. The current study investigated whether the presence/absence of cognitive errors on separate domains of the Mini-Mental State Exam (MMSE) predicted baseline differences in symptom severity and improvement following CBT, above and beyond already established predictors. Baseline characteristics were investigated in a sample of 208 older patients diagnosed with GAD. Predictors of treatment response were examined in a subsample of 65 patients who completed CBT and were included in a prior study by Wetherell et al. of response predictors. Results from the baseline sample indicated that only subjects who committed an error on the MMSE Working Memory domain exhibited increased severity in anxiety and depressive symptoms. Results from the treatment sample indicated that an error on the MMSE Orientation domain was a significant predictor of outcome at 6-month follow-up, while controlling for previously established predictors. Patients who committed at least one error in this domain showed decreased response relative to patients who committed no errors. In this sample of older adults diagnosed with GAD, poor performance on the MMSE Working Memory domain was associated with increased baseline anxiety and depression, while baseline performance differences on the MMSE Orientation domain predicted outcome six months after CBT intervention.",Caudle DD.; Senior AC.; Wetherell JL.; Rhoades HM.; Beck JG.; Kunik ME.; Snow AL.; Wilson NL.; Stanley MA.,2007.0,10.1097/JGP.0b013e31803c550d,0,0,
8520,One-year follow-up of cognitive behavioral therapy for phobic postural vertigo.,"Phobic postural vertigo is characterized by dizziness in standing and walking despite normal clinical balance tests. Patients sometimes exhibit anxiety reactions and avoidance behavior to specific stimuli. Different treatments are possible for PPV, including vestibular rehabilitation exercises, pharmacological treatment, and cognitive behavioral therapy. We recently reported significant benefits of cognitive behavioural therapy for patients with phobic postural vertigo. This study presents the results of a one-year follow-up of these patients. Swedish translations of the following questionnaires were administered: (Dizziness Handicap Inventory, Vertigo Symptom Scale, Vertigo Handicap Questionnaire, and Hospital Anxiety and Depression Scale) were administered to 20 patients (9 men and 11 women; mean age 43 years, range 23-59 years) one year after completion of cognitive behavioral therapy. Test results were similar to those obtained before treatment, showing that no significant treatment effects remained. Cognitive behavioral therapy has a limited long-term effect on phobic postural vertigo. This condition is more difficult to treat than panic disorder with agoraphobia. Vestibular rehabilitation exercises and pharmacological treatment might be the necessary components of treatment.",Holmberg J.; Karlberg M.; Harlacher U.; Magnusson M.,2007.0,10.1007/s00415-007-0499-6,0,0,
8521,Comorbidity and high-risk behaviors in treatment-seeking adolescents with bulimia nervosa.,"The purpose of this brief report is to describe the comorbid diagnoses and high-risk behaviors in a sample of adolescents with bulimia nervosa (BN). Eighty adolescents enrolled in a RCT for BN that compared family-based therapy with individual-supportive psychotherapy completed the Eating Disorder Examination and the Schedule for Affective Disorder and Schizophrenia for School Age Children (K-SADS). A total of 62.5% of the sample had a comorbid diagnosis as determined by the K-SADS. The majority of these presented with a major mood disorder. In addition, 25% of the sample had previously attempted suicide or self-harmed, 65.8% had consumed alcohol, and 30% had used illegal drugs. Suicidal behavior, drug use, and presence of a comorbid diagnosis were not related to diagnosis (full BN vs. subthreshold BN) or age. Comorbidity and high-risk health behaviors in adolescents with BN mirror those of adults with BN although not at similar rates.",Fischer S.; le Grange D.,2007.0,10.1002/eat.20442,0,0,
8522,Cost-efficacy of individual and combined treatments for panic disorder.,"The objective of this study was to examine the relative cost-efficacy of empirically supported treatments for panic disorder. As psychosocial, pharmacologic, and combined treatments have all demonstrated efficacy in the treatment of panic disorder, cost-efficacy analysis provides an additional source of information to guide clinical decision making. Cost-efficacy was examined based on results from the Multicenter Comparative Treatment Study of Panic Disorder, a randomized controlled trial of treatment for panic disorder (DSM-III-R). The trial was conducted from May 1991 to April 1998. Cost-efficacy ratios representing the cost per 1-unit improvement in Panic Disorder Severity Scale mean item score were calculated for 3 monotherapies (cognitive-behavioral therapy [CBT], imipramine, and paroxetine) and 2 combination treatments (CBT-imipramine and CBT-paroxetine) at the end of acute, maintenance, and follow-up phases. Results demonstrated consistently greater cost-efficacy for individual over combined treatments, with imipramine representing the most cost-efficacious treatment option at the completion of the acute phase (cost-efficacy ratio = $972) and CBT representing the most cost-efficacious option at the end of maintenance treatment (cost efficacy ratio = $1449) and 6 months after treatment termination (cost-efficacy ratio = $1227). In the context of similar efficacy for combined treatments, but poorer cost-efficacy, current monotherapies should be considered the first-line treatment of choice for panic disorder. Additionally, CBT emerged as the most durable and cost-effective monotherapy and, hence, should be considered as a particularly valuable treatment from the perspective of cost accountability.",McHugh RK.; Otto MW.; Barlow DH.; Gorman JM.; Shear MK.; Woods SW.,2007.0,,0,0,
8523,Amygdala hyperfunction in phobic fear normalizes after exposure.,"The amygdala is implicated as a key brain structure in fear processing. Studies exploring this process using the paradigm of fear conditioning have implicated the amygdala in fear acquisition and in generating behavioral fear responses. As such, fear extinction could be expected to induce a reduction in amygdala activity. However, exposure in specific phobia has never been shown persistently to reduce amygdala activity. By means of event-related functional magnetic resonance imaging, responses to phobia-related, general threat, and neutral pictures were measured before and 2 weeks after an intensive exposure session in 20 subjects with specific phobia for spiders and compared with healthy control subjects. Phobic subjects showed increased amygdala activity at baseline. This hyperactivity was significantly reduced 2 weeks after exposure therapy. Furthermore, a significant reduction of hyperactivity in anterior cingulate cortex and insula was found postexposure. To our knowledge, this is the first study demonstrating the effect of exposure on the amygdala in specific phobia. Our findings suggest that exposure therapy can have an effect on subcortical structures.",Goossens L.; Sunaert S.; Peeters R.; Griez EJ.; Schruers KR.,2007.0,10.1016/j.biopsych.2007.04.024,0,0,
8524,Treatment response of bipolar and unipolar alcoholics to an inpatient dual diagnosis program.,"Depressed and bipolar alcoholics represent a significant affective subgroup that has a poorer prognosis than either diagnosis alone. To date few systematic treatment programs have been developed to treat dual diagnosis. An inpatient treatment program was developed at St Patrick's Hospital Dublin to treat dual diagnosis clients with alcohol dependence and either unipolar or bipolar affective disorder. Clients (N=232) were assessed for depression, anxiety, elation, cravings, drink and drug intake on admission, discharge, 3 and 6 months post-discharge from the program. In the overall group there was a reduction in number of drinking days and units per drinking day over the study (p<.01). There was a 71.8% complete abstinent rate at 3 months and 55.8% at 6 months in the depression group, non-significantly greater than for the bipolar group at 64.7% and 54.1% respectively. Gamma GT, MCV and craving scores were significantly reduced over time (p<.01). Mania, depression and anxiety inventory scores fell over time in both groups (p<.01). 15-21-year olds were more severely anxious, had higher illicit drug use, and were more likely to relapse to drug use than older clients. Bipolar 1 clients were significantly more likely than bipolar 2 clients to be on mood stabilisers at all follow-up stages (p<.001). No control group was used. There is evidence for efficacy of a specifically designed dual diagnosis inpatient treatment program as both depressed and bipolar alcoholics had significant reductions in all measurements of mood, craving, and alcohol/drug consumption by self report and biological markers, suggesting both diagnoses can be effectively treated together.",Farren CK.; Mc Elroy S.,2008.0,10.1016/j.jad.2007.07.006,0,0,
8525,Stigma and the military: evaluation of a PTSD psychoeducational program.,"Trauma risk management (TRiM) is an intensive posttraumatic stress disorder (PTSD) psychoeducational management strategy based on peer-group risk assessment developed by the UK Royal Navy (RN). TRiM seeks to modify attitudes about PTSD, stress, and help-seeking and trains military personnel to identify at-risk individuals and refer them for early intervention. This quasiexperimental study found that TRiM training significantly improved attitudes about PTSD, stress, and help-seeking from TRiM-trained personnel. There was a nonsignificant effect on attitudes to seeking help from normal military support networks and on general health. Within both the military and civilian populations, stigma is a serious issue preventing help-seeking and reducing quality of life. The results suggest that TRiM is a promising antistigma program within organizational settings.",Gould M.; Greenberg N.; Hetherton J.,2007.0,10.1002/jts.20233,0,0,
8526,Impact of behavioral contingency management intervention on coping behaviors and PTSD symptom reduction in cocaine-addicted homeless.,"The purpose of this study was to examine changes in posttrauma symptoms among 118 homeless cocaine-dependent adults participating in a randomly controlled trial studying effective treatments for dually diagnosed homeless individuals. Among those with trauma exposure and PTSD symptoms, the group receiving more behaviorally intensive, contingency management treatment had significantly greater reductions in PTSD symptomatology than did the group receiving less-intensive treatment. Regression analyses revealed that greater positive distraction coping and lower negative avoidance coping at baseline, in addition to changes in avoidance coping over the 6-month study period, were significantly related to greater symptom and severity reductions. The study provides some initial evidence of important treatment outcomes other than abstinence in addiction-related interventions.",Lester KM.; Milby JB.; Schumacher JE.; Vuchinich R.; Person S.; Clay OJ.,2007.0,10.1002/jts.20239,0,0,
8527,"[Evolution of treatment and consumption in persons with cocaine dependence, at 12-months, in respect of the associated psychopathology and daily functioning].","The aim of the present study is to analyse the evolution, at 12-months, of patients with cocaine dependence undergoing treatment in drug abuse centres. We examined the relationship between sociodemographic variables, drug use characteristics, and psychopathological characteristics with maintenance of drug abstinence and the evolution of daily functioning evaluated by the therapist at 3-, 6- and 12-months. The most outstanding results are that subjects with a dependent personality pattern, according to the MCMI-II, are more likely to maintain cocaine abstinence during the 12-months following the preliminary assessment. Moreover, the variables more related with a worse daily functioning at 12-months are injected or smoked cocaine use, previous treatments for drug use and having used heroin on some occasion. Therefore, drug related aspects and not psychopathological characteristics are more important when analysing the 12-months evolution in these subjects.",López Durán A.; Becoña Iglesias E.; Lloves Moratinos M.; Moneo Montes A.; Vieitez Fernández I.; Cancelo Martínez J.; Estévez Vorkauf C.; Sobradelo Lens J.; García Janeiro JM.; Senra Comesaña A.; Fernandez Lorena C.; Lage López MT.; Díaz Castro E.,2007.0,,0,0,
8528,Vagally mediated heart rate variability and heart rate entropy as predictors of treatment outcome in flight phobia.,"In the present study a computer-assisted exposure-based treatment was applied to 54 flight phobics and the predictive role of vagally mediated heart rate (HR) variability (high frequency, 0.15-0.4 Hz band power) and heart rate entropy (HR time series sample entropy) on treatment outcome was investigated. Both physiological measures were taken under controlled breathing at 0.2 Hz and during exposure to a fearful sequence of audiovisual stimuli. Hierarchical regression analyses were conducted to assess the predictive power of these variables in these conditions on treatment self-report measures at the end of treatment and at 6 months follow-up, as well as on the behavioral treatment outcome (i.e. flying at the end of treatment). Regression models predicting significant amounts of outcome variance could be built only when HR entropy was added to the HR variability measure in a second step of the regression analyses. HR variability alone was not found to be a good predictor of neither self-reported nor behavioral treatment outcomes.",Bornas X.; Llabrés J.; Tortella-Feliu M.; Fullana MA.; Montoya P.; López A.; Noguera M.; Gelabert JM.,2007.0,10.1016/j.biopsycho.2007.07.007,0,0,
8529,Effectiveness of short-term and long-term psychotherapy on work ability and functional capacity--a randomized clinical trial on depressive and anxiety disorders.,"Insufficient evidence exists about the effect of different therapies on work ability for patients with psychiatric disorders. The present study compares improvements in work ability in two short-term therapies and one long-term therapy. In the Helsinki Psychotherapy Study, 326 outpatients with depressive or anxiety disorder were randomly assigned to long-term and short-term psychodynamic psychotherapy, and solution-focused therapy. The patients were followed for 3 years from the start of treatment. Primary outcome measures were the Work Ability Index (WAI), the Work-subscale (SAS-Work) of the Social Adjustment Scale (SAS-SR), Perceived Psychological Functioning Scale, the prevalence of patients employed or studying, and the number of sick-leave days. Work ability was statistically significantly improved according to WAI (15%), SAS-Work (17%), and Perceived Psychological Functioning Scale (21%) during the 3-year follow-up. No differences in the work ability scores were found between two short-term therapies. The short-term therapies showed 4-11% more improved work ability scores than long-term therapy at the 7 month follow-up point. During the second year of follow-up, no significant differences were found between therapies. After 3 years of follow-up, long-term therapy was more effective than the short-term therapies with 5-12% more improved scores. No differences in the prevalence of individuals employed or studying or in the number of sick-leave days were found between therapies during follow-up. Short-term therapies give benefits more quickly than long-term therapy on work ability but in the long run long-term therapy is more effective than short-term therapies. More research is needed to confirm these findings.",Knekt P.; Lindfors O.; Laaksonen MA.; Raitasalo R.; Haaramo P.; Järvikoski A.;  .,2008.0,10.1016/j.jad.2007.08.005,0,0,
8530,Organization of co-occurring Axis II features in borderline personality disorder.,"Considerable heterogeneity exists in the comorbid Axis II features that frequently accompany borderline personality disorder (BPD). These features have potential to be meaningfully organized, relate to specific BPD presentation, and have implications for treatment process and outcome. The present study explored patterns of Axis II comorbidity in order to identify subtypes of BPD. A well-defined sample of 90 patients diagnosed with BPD was recruited as part of an RCT study. Participants were administered the International Personality Disorder Examination (Loranger, 1999) to diagnose BPD and assess comorbid Axis II features. Other measures were also administered to assess aspects of current work and relationship functioning, symptomatology, and self-concept. Q-factoring was used to develop subtypes based on commonly occurring Axis II profiles, identifying three: Cluster A (elevated paranoid and schizotypal features), Cluster B (elevated narcissistic and histrionic features), and Cluster C (elevated avoidant and obsessive-compulsive features). An additional factor analysis revealed two dimensions underlying the comorbid features identifiable as: extraversion versus introversion and antagonism versus constraint. Validity of these two maps of comorbidity was explored in terms of the BPD criteria themselves, as well as on work and relationship functioning, identity diffusion, views of self and others, positive and negative affect, behavioural dyscontrol, and symptomatic distress. Clinically meaningful subtypes can be identified for BPD based on co-occurring Axis II features. Further research is needed to replicate and further establish base-rates of these subtypes as well as their differential implications for treatment.",Critchfield KL.; Clarkin JF.; Levy KN.; Kernberg OF.,2008.0,10.1348/014466507X240731,0,0,
8531,The effect of emotional stress on involuntary and voluntary conscious memories.,"Clinical theories of post-traumatic stress disorder often claim that intrusive (involuntary) memories favour emotionally stressful material and that these memories come with more sensory imagery and emotional reliving compared to voluntary memories. However, these assumptions have not been verified experimentally. Here we obtained recordings of emotional reactions to aversive pictures at the time of encoding, as well as records of involuntary and voluntary memories of these pictures in a subsequent diary study. A comparison of individual ratings, obtained during encoding, of pictures recalled involuntarily and voluntarily showed that emotional stress at encoding increased overall accessibility, independent of whether recall was voluntary or involuntary. However at the time of recall, voluntary memories scored higher on narrative content and on measures of imagery. The findings are compatible with research on emotion and memory in general, but challenge clinical claims of differential involuntary versus voluntary access to emotionally stressful events.",Hall NM.; Berntsen D.,2008.0,10.1080/09658210701333271,0,0,
8532,Treating deficits in emotion perception following traumatic brain injury.,"The present research aimed to investigate whether social perception deficits commonly experienced in the adult traumatic brain injury (TBI) population can be successfully remediated through cognitive rehabilitation. Twelve outpatient volunteers (11 male, 1 female; age range 20-57 years) with severe, chronic TBI (mean length of post-traumatic amnesia 121 days, range 58-210 days; mean months post- injury 93.58, range 17-207 months) participated in a randomised controlled trial. Participants were randomly allocated to treatment and waitlist control groups following assessment on a range of emotion perception and psychosocial measures. Treatment comprised 25 hours, across 8 weeks, of a programme specifically designed to address emotion perception which incorporated a variety of remediation techniques shown to be effective with the TBI population. Results indicated that participants significantly improved both in judging basic emotional stimuli when presented in a naturalistic format (i.e., video vignettes) and in making social inferences on the basis of speaker demeanour. This is the first known treatment study dealing with emotion perception deficits in individuals with TBI.",Bornhofen C.; Mcdonald S.,2008.0,10.1080/09602010601061213,0,0,
8533,Specific and nonspecific comorbidity in anorexia nervosa.,"This article reports lifetime Axis I and II comorbidity in women with anorexia nervosa (AN), and ascertains specific and nonspecific comorbidity in AN compared to clinical samples of women with bulimia nervosa (BN) or major depression (DEP). Outpatient AN (n = 56), BN (n = 132), and DEP (n = 100) samples were assessed using Structured Clinical Interviews I and II for DSM-III-R. Baseline data were compared using univariate statistics and logistic regression. In the AN sample as a whole, specific elevations were found for prevalences of obsessive compulsive disorder. The AN-binge eating purging subtype (AN-BP) and the BN sample had elevated prevalences of Cluster B personality disorders. Cluster C prevalences were elevated across samples. Evidence of AN-specific, eating disorder-specific, and nonspecific comorbidity illustrates the heterogeneity in AN. Further research is need to examine the relative impact of specific and nonspecific comorbidity in AN subtypes and AN as a whole.",Jordan J.; Joyce PR.; Carter FA.; Horn J.; McIntosh VV.; Luty SE.; McKenzie JM.; Frampton CM.; Mulder RT.; Bulik CM.,2008.0,10.1002/eat.20463,0,0,
8534,Effects of eye movement versus therapist instructions on the processing of distressing memories.,"The effectiveness of components of eye movement desensitization and reprocessing (EMDR) was tested by randomly assigning 48 participants to either an eye movement or an eye stationary condition and to one of two types of therapist instructions (reliving or distancing). Participants were university students (mean age 23) who were asked to recall a personal distressing memory with measures of distress and vividness taken before and after treatment, and at follow-up. There was no significant effect of therapist's instruction on the outcome measures. There was a significant reduction in distress for eye movement at post-treatment and at follow-up but overall no significant reduction in vividness. Post hoc analysis revealed a significant reduction in vividness only for the eye movement and distancing instruction condition. The results were consistent with other evidence that the mechanism of change in EMDR is not the same as traditional exposure.",Lee CW.; Drummond PD.,2008.0,10.1016/j.janxdis.2007.08.007,0,0,
8535,Music imagery for adults with acute leukemia in protective environments: a feasibility study.,"Patients receiving intensive chemotherapy can experience increased distressed related to both the cancer diagnosis and treatment isolation. If not addressed, distress can lead to anxiety, depression, and post-traumatic stress disorder. The purpose of this study was to determine the feasibility and possible benefits of a music imagery intervention for patients hospitalized in a protective environment for the treatment of acute leukemia or high-grade non-Hodgkin's lymphoma. Adults receiving intensive myelosuppressive chemotherapy in a protective environment were randomized to standard care or standard care plus music imagery. The music imagery sessions occurred twice weekly for up to eight sessions. Patients were encouraged to use the music imagery daily. The principal criteria of feasibility were rate of consent, rate of completion of scheduled sessions, and rate of questionnaire completion. Forty-nine out of 78 patients consented, a 63% consent rate. Seventy-two percent of all scheduled music imagery sessions were completed. The rate of questionnaire completion was 60% with missing data because of illness severity and early discharge. The principal outcomes of benefit (e.g., efficacy) were positive and negative affects, fatigue, and anxiety. Both groups improved over time on all outcomes (all p < 0.001). However, a subgroup of individuals with low baseline negative affect who received the intervention reported significantly less anxiety at discharge than individuals with low baseline negative affect who did not receive the intervention. Music imagery is feasible for adults with acute leukemia in protected environments. Patients with lower initial distress may benefit from a music imagery program in terms of reduced anxiety at discharge.",Burns DS.; Azzouz F.; Sledge R.; Rutledge C.; Hincher K.; Monahan PO.; Cripe LD.,2008.0,10.1007/s00520-007-0330-z,0,0,
8536,"Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: a randomized, double-blind, controlled study.","All therapists direct their attention in some manner during psychotherapy. A special form of directing attention, 'mindfulness', is recommended. This study aimed to examine whether, and to what extent, promoting mindfulness in psychotherapists in training (PiT) influences the treatment results of their patients. The therapeutic course and treatment results of 124 inpatients, who were treated for 9 weeks by 18 PiTs, were compared. The PiTs were randomly assigned to 1 of 2 groups: (i) those practicing Zen meditation (MED; n = 9 or (ii) control group, which did not perform meditation (noMED; n = 9). The results of treatment (according to the intent-to-treat principle) were examined using the Session Questionnaire for General and Differential Individual Psychotherapy (STEP), the Questionnaire of Changes in Experience and Behavior (VEV) and the Symptom Checklist (SCL-90-R). Compared to the noMED group (n = 61), the patients of PiTs from the MED group (n = 63) had significantly higher evaluations (according to the intent-to-treat principle) for individual therapy on 2 STEP scales, clarification and problem-solving perspectives. Their evaluations were also significantly higher for the entire therapeutic result on the VEV. Furthermore, the MED group showed greater symptom reduction than the noMED group on the Global Severity Index and 8 SCL-90-R scales, including Somatization, Insecurity in Social Contact, Obsessiveness, Anxiety, Anger/Hostility, Phobic Anxiety, Paranoid Thinking and Psychoticism. This study indicates that promoting mindfulness in PiTs could positively influence the therapeutic course and treatment results in their patients.",Grepmair L.; Mitterlehner F.; Loew T.; Bachler E.; Rother W.; Nickel M.,2007.0,10.1159/000107560,0,0,
8537,COPD education and cognitive behavioral therapy group treatment for clinically significant symptoms of depression and anxiety in COPD patients: a randomized controlled trial.,"Chronic obstructive pulmonary disease (COPD) affects 14 to 20 million Americans and is associated with increased prevalence of affective disorders, contributing significantly to disability. This study compared cognitive behavioral therapy (CBT) group treatment for anxiety and depression with COPD education for COPD patients with moderate-to-severe anxiety and/or depressive symptoms. A randomized controlled trial (RCT) was conducted between 11 July 2002 and 30 April 2005 at the Michael E. DeBakey VA Medical Center, Houston, TX. Participants were 238 patients treated for COPD the year before, with forced expiratory value in 1 second (FEV)1/forced vital capacity (FVC)<70% and FEV1<70% predicted, and symptoms of moderate anxiety and/or moderate depression, who were being treated by a primary care provider or pulmonologist. Participants attended eight sessions of CBT or COPD education. Assessments were at baseline, at 4 and 8 weeks, and 4, 8 and 12 months. Primary outcomes were disease-specific and generic quality of life (QoL) [Chronic Respiratory Questionnaire (CRQ) and Medical Outcomes Survey Short Form-36 (SF-36) respectively]. Secondary outcomes were anxiety [Beck Anxiety Inventory (BAI)], depressive symptoms [Beck Depression Inventory-II (BDI-II)], 6-minute walk distance (6MWD) and use of health services. Both treatments significantly improved QoL, anxiety and depression (p<0.005) over 8 weeks; the rate of change did not differ between groups. Improvements were maintained with no significant change during follow-up. Ratios of post- to pretreatment use of health services were equal to 1 for both groups. CBT group treatment and COPD education can achieve sustainable improvements in QoL for COPD patients experiencing moderate-to-severe symptoms of depression or anxiety.",Kunik ME.; Veazey C.; Cully JA.; Souchek J.; Graham DP.; Hopko D.; Carter R.; Sharafkhaneh A.; Goepfert EJ.; Wray N.; Stanley MA.,2008.0,10.1017/S0033291707001687,0,0,
8538,Trial of interpersonal counselling after major physical trauma.,"The purpose of the present study was to determine if interpersonal counselling (IPC) was effective in reducing psychological morbidity after major physical trauma. One hundred and seventeen subjects were recruited from two major trauma centres and randomized to treatment as usual or IPC in the first 3 months following trauma. Measures of depressive, anxiety and post-traumatic symptoms were taken at baseline, 3 months and 6 months. The Structured Clinical Interview for DSM IV diagnoses was conducted at baseline and at 6 months to assess for psychiatric disorder. Fifty-eight patients completed the study. Only half the patients randomized to IPC completed the therapy. At 6 months the level of depressive, anxiety and post-traumatic symptoms and the prevalence of psychiatric disorder did not differ significantly between the intervention and treatment-as-usual groups. Subjects with a past history of major depression who received IPC had significantly higher levels of depressive symptoms at 6 months. IPC was not effective as a universal intervention to reduce psychiatric morbidity after major physical trauma and may increase morbidity in vulnerable individuals. Patient dropout is likely to be a major problem in universal multi-session preventative interventions.",Holmes A.; Hodgins G.; Adey S.; Menzel S.; Danne P.; Kossmann T.; Judd F.,2007.0,10.1080/00048670701634945,0,0,
8539,Comparing acceptance and refusal rates of virtual reality exposure vs. in vivo exposure by patients with specific phobias.,"The present survey explored the acceptability of virtual reality (VR) exposure and in vivo exposure in 150 participants suffering from specific phobias. Seventy-six percent chose VR over in vivo exposure, and the refusal rate for in vivo exposure (27%) was higher than the refusal rate for VR exposure (3%). Results suggest that VR exposure could help increase the number of people who seek exposure therapy for phobias.",Garcia-Palacios A.; Botella C.; Hoffman H.; Fabregat S.,2007.0,10.1089/cpb.2007.9962,0,0,
8540,A randomized controlled effectiveness trial of acceptance and commitment therapy and cognitive therapy for anxiety and depression.,"Acceptance and commitment therapy (ACT) has a small but growing database of support. One hundred and one heterogeneous outpatients reporting moderate to severe levels of anxiety or depression were randomly assigned to traditional cognitive therapy (CT) or to ACT. To maximize external validity, the authors utilized very minimal exclusion criteria. Participants receiving CT and ACT evidenced large, equivalent improvements in depression, anxiety, functioning difficulties, quality of life, life satisfaction, and clinician-rated functioning. Whereas improvements were equivalent across the two groups, the mechanisms of action appeared to differ. Changes in ""observing"" and ""describing"" one's experiences appeared to mediate outcomes for the CT group relative to the ACT group, whereas ""experiential avoidance,"" ""acting with awareness,"" and ""acceptance"" mediated outcomes for the ACT group. Overall, the results suggest that ACT is a viable and disseminable treatment, the effectiveness of which appears equivalent to that of CT, even as its mechanisms appear to be distinct.",Forman EM.; Herbert JD.; Moitra E.; Yeomans PD.; Geller PA.,2007.0,10.1177/0145445507302202,0,0,
8541,Therapist adherence and competence with manualized cognitive-behavioral therapy for PTSD delivered via videoconferencing technology.,"Using secondary analyses from a randomized trial comparing the effectiveness of manualized cognitive-behavioral therapy for posttraumatic stress disorder, we compared ratings of therapist competency and adherence between two service delivery modes: telepsychiatry (TP) and same room (SR). Patients were 38 male treatment-seeking veterans recruited from a veterans affairs medical center. Domains of therapist competence and adherence included structuring sessions, implementing session activities, providing feedback, dealing with difficulties, developing rapport, and conveying empathy. Only one difference emerged between the two treatment conditions, with more favorable ratings on this item in the TP condition. Findings suggest that therapist competence and adherence to cognitive-behavioral therapy is similar whether the treatment is delivered via TP or by traditional means, and TP does not compromise therapists' ability to effectively structure sessions or build rapport with patients. These data further support the use of TP to address shortages in access to mental health care.",Frueh BC.; Monnier J.; Grubaugh AL.; Elhai JD.; Yim E.; Knapp R.,2007.0,10.1177/0145445507302125,0,0,
8542,Avoidant encoding in acute stress disorder: a prospective study.,"This study investigated the relationship between ongoing posttraumatic adjustment and encoding style. Eleven acute stress disorder (ASD) participants and 14 non-traumatized controls completed the item method of directed forgetting and were retested 1 year later. Trauma-related, positive and neutral words were followed by a ""remember"" or ""forget"" instruction. At Time 1, ASD participants demonstrated directed forgetting for trauma and neutral words; controls showed directed forgetting for all word types. At Time 2, directed forgetting was replicated in controls for each word type, but only for neutral words in the ASD group. Directed forgetting effects were absent for positive words in the ASD group. The findings raise the possibility that individuals who develop ASD possess an encoding style for positive material that reflects a trait-like manner of information processing.",Moulds ML.; Bryant RA.,2008.0,10.1002/da.20368,0,0,
8543,Treatment of depression and anxiety in infertile women: cognitive behavioral therapy versus fluoxetine.,"Infertility is a stressful event that can give rise to psychological difficulties. Both psychotherapy and pharmacotherapy are well-established treatments for depression and anxiety. The aim of this study was to compare the effectiveness of cognitive behavioral therapy with fluoxetine in the resolution or decreasing of depression and anxiety in infertile women. In a randomized controlled clinical trial, 89 mild to moderate depressed infertile women (Beck scores 10-47) were recruited into three groups; cognitive behavior therapy (CBT), antidepressant therapy, and a control group. Twenty-nine participants in the CBT method received relaxation training, restructuring, and eliminating of negative automatic thoughts and dysfunctional attitudes to depression for 10 sessions. Thirty participants in the pharmacotherapy group took 20 mg fluoxetine daily for 90 days. Thirty control subjects did not receive any intervention. All participants completed the Beck Depression Inventory and Cattell Anxiety Inventory at the beginning and end of the study. Chi2 test, paired t-test, and ANOVA were used to analyze the data. The resolution of depression in the three groups was: fluoxetine group 50%, CBT 79.3%, and control 10%. The mean of the Beck scores at the beginning and end of the study was respectively: fluoxetine 23.2+/-8.6 versus 14.3+/-8.5(p<0.001), CBT 20.1+/-7.9 versus 7.7+/-4.8 (p<0.001), and control 19.8+/-8.5 versus 19.7+/-8.4 (p=0.9). Although both fluoxetine and CBT decreased significantly the mean of BDI scores more than that of the control group, the decrease in the CBT group was significantly more than fluoxetine group. The CBT method decreased significantly the mean of the Cattell scores more than the fluoxetine and control groups, but the decrease in the anxiety mean scores of that fluoxetine group was no more than that of control group. CBT was not only a reliable alternative to pharmacotherapy but also was superior to fluoxetine in the resolution or reducing of depression and anxiety of infertile women. Fluoxetine was superior to no therapy in the treatment of depression but not anxiety.",Faramarzi M.; Alipor A.; Esmaelzadeh S.; Kheirkhah F.; Poladi K.; Pash H.,2008.0,10.1016/j.jad.2007.09.002,0,0,
8544,Imagery rescripting versus in vivo exposure in the treatment of snake fear.,"This study compared imagery rescripting, in vivo exposure therapy and their combination in the treatment of snake fear. Imaginal ability was assessed pre-treatment, and was correlated with baseline avoidance. Snake fearful individuals were randomly assigned to cognitive therapy involving imagery rescripting, in vivo exposure, a combination of the two, or a relaxation control. All active treatment groups improved significantly more than the control group in both fearfulness and behavioral approach. There were no significant differences between the active treatment groups, although the combined treatment tended to be slightly more efficacious.",Hunt M.; Fenton M.,2007.0,10.1016/j.jbtep.2007.09.001,0,0,
8545,Promoting walking as an adjunct intervention to group cognitive behavioral therapy for anxiety disorders--a pilot group randomized trial.,"A group randomized trial of adding a home-based walking program to a standard group cognitive behavioral therapy (GCBT+EX) was compared with groups receiving GCBT and educational sessions (GCBT+ED). The study was implemented in an outpatient clinic providing GCBT for clients diagnosed with panic disorder, generalized anxiety disorder or social phobia. Pre- and post-treatment measures included the self-report depression, anxiety, and stress scale (DASS-21) and measures of physical activity. From January 2004 to May 2005, six groups were allocated to GCBT+EX (n=38) and five to GCBT+ED (n=36). Analysis of covariance for completed cases (GCBT+EX, n=21; GCBT+ED, n=20), adjusting for the group design, baseline DASS-21 scores, and anxiety diagnosis showed significant effect for GCBT+EX on depression, anxiety, and stress (regression coefficients=-6.21, -3.41, and -5.14, respectively, p<0.05) compared to the GCBT+ED. The potential of exercise interventions as adjunct to GCBT for anxiety disorder needs to be further explored.",Merom D.; Phongsavan P.; Wagner R.; Chey T.; Marnane C.; Steel Z.; Silove D.; Bauman A.,2008.0,10.1016/j.janxdis.2007.09.010,0,0,
8546,[Predictors of health-care utilization of patients with Crohn's disease: results of a prospective randomized multicenter trial].,"The objective of the study was to identify predictors of health-care utilization in Crohn's disease. Therefore, data of 499 patients was collected over a 2-year period. A sample of 87 patients was taken and analyzed. Health-care utilization was measured as work disability days and hospital bed days. Sociodemographic, mental as well as somatic variables were used as possible predictors of health-care utilization. In a linear regression model with work disability days, the variables gender (b = 43.01; p = 0.032) and depressiveness (b = 2.949; p = 0.014) turned out to be significant (R(2) = 0.189). In a linear regression model with hospital bed days, the variables gender (b = 19.863; p = 0.006) and age (b = 0.785; p = 0.029) proved to be significant (R(2) = 0.114). No significant result was found for somatic variables such as severity of disease. Psychosocial variables such as depressiveness, gender and age have, therefore, a low but measurable impact on health-care utilization of patients with Crohn's disease. Increased consideration of these variables in clinical practice would not only improve the quality of life of these patients but also reduce health-care utilization.",Burgdorf F.; Schreyögg J.; Keller W.; von Wietersheim J.; Deter HC.;  .,2007.0,10.1007/s00063-007-1115-3,0,0,
8547,Accuracy of body image perception and preferred weight loss strategies in schizophrenia: a controlled pilot study.,"Obesity in severely mentally ill (SMI) populations is an increasing problem, but there is no controlled data regarding the relationship between SMI and weight perception. Fifty patients with schizophrenia and 50 demographically matched control participants were recruited. Weight, height, and body image accuracy were assessed for all participants, and assessments of mood, psychotic symptom severity and anxiety, and preferred modes of weight loss were assessed for the schizophrenia sample. Patients with schizophrenia were significantly more likely to be obese than controls (46% vs. 18%, P < 0.005), and most patients expressed an interest in losing weight. Obese participants with schizophrenia underestimated their body size (11.0%) more than controls (4.9%) (P < 0.05). Patients with schizophrenia are more likely to underestimate their body size, independent of the effects of obesity. However, they also express concern about weight issues and willingness to participate in psychoeducational groups targeted at weight loss.",Loh C.; Meyer JM.; Leckband SG.,2008.0,10.1111/j.1600-0447.2007.01123.x,0,0,
8548,Randomized trial on the effectiveness of long-and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up.,"Insufficient evidence exists for a viable choice between long- and short-term psychotherapies in the treatment of psychiatric disorders. The present trial compares the effectiveness of one long-term therapy and two short-term therapies in the treatment of mood and anxiety disorders. In the Helsinki Psychotherapy Study, 326 out-patients with mood (84.7%) or anxiety disorder (43.6%) were randomly assigned to three treatment groups (long-term psychodynamic psychotherapy, short-term psychodynamic psychotherapy, and solution-focused therapy) and were followed up for 3 years from start of treatment. Primary outcome measures were depressive symptoms measured by self-report Beck Depression Inventory (BDI) and observer-rated Hamilton Depression Rating Scale (HAMD), and anxiety symptoms measured by self-report Symptom Check List Anxiety Scale (SCL-90-Anx) and observer-rated Hamilton Anxiety Rating Scale (HAMA). A statistically significant reduction of symptoms was noted for BDI (51%), HAMD (36%), SCL-90-Anx (41%) and HAMA (38%) during the 3-year follow-up. Short-term psychodynamic psychotherapy was more effective than long-term psychodynamic psychotherapy during the first year, showing 15-27% lower scores for the four outcome measures. During the second year of follow-up no significant differences were found between the short-term and long-term therapies, and after 3 years of follow-up long-term psychodynamic psychotherapy was more effective with 14-37% lower scores for the outcome variables. No statistically significant differences were found in the effectiveness of the short-term therapies. Short-term therapies produce benefits more quickly than long-term psychodynamic psychotherapy but in the long run long-term psychodynamic psychotherapy is superior to short-term therapies. However, more research is needed to determine which patients should be given long-term psychotherapy for the treatment of mood or anxiety disorders.",Knekt P.; Lindfors O.; Härkänen T.; Välikoski M.; Virtala E.; Laaksonen MA.; Marttunen M.; Kaipainen M.; Renlund C.;  .,2008.0,10.1017/S003329170700164X,0,0,
8549,Sex differences in response to an observational fear conditioning procedure.,"The present study evaluated sex differences in observational fear conditioning using modeled ""mock"" panic attacks as an unconditioned stimulus (UCS). Fifty-nine carefully prescreened healthy undergraduate participants (30 women) underwent 3 consecutive differential conditioning phases: habituation, acquisition, and extinction. It was expected that participants watching a confederate display mock panic attacks (UCS) paired with a previously neutral stimulus (CS(+)) would learn to respond fearfully to the CS(+), but not to the CS(-) (i.e., a stimulus never associated with displays of panic). Women also were expected to report more distress and ratings of panic to the CS(+) than the CS(-) compared to men, but no sex differences were anticipated on autonomic indices of conditioning (i.e., electrodermal responses). Consistent with expectation, aversive conditioning was demonstrated by greater magnitude electrodermal and verbal-evaluative (e.g., subjective units of distress scale, panic ratings) responses to the CS(+) over the CS(-), with women reporting more distress to the CS(+) over the CS(-), but not greater autonomic conditioning, compared to men. Overall, the results support the notion that modeled panic attacks can serve as a potent UCS for both men and women. Discussion focuses on sex differences in observational fear conditioning and its relation to the clinical presentation of anxiety disorders.",Kelly MM.; Forsyth JP.,2007.0,10.1016/j.beth.2006.10.007,0,0,
8550,The effect of stressor severity on outcome following group debriefing.,"This analogue study reports data on the efficacy of group debriefing in the mitigation of distress for a stressful video, which had two levels of severity. It also provides a new procedure for use in experimental psychopathology studies. One hundred and nineteen participants were shown one of two stressful videos and, subsequently, 67 participants received group debriefing whilst 52 participants acted as a control. A statistical difference was found between the two groups for level of distress at follow-up, with those who had watched the more stressful video scoring higher on video distress and trauma-type symptomatology than those who watched the less stressful video. This was particularly the case for those who received debriefing -- adding further caution to the longer-term effects of systematised group interventions following harrowing events.",Devilly GJ.; Varker T.,2008.0,10.1016/j.brat.2007.09.004,0,0,
8551,Method of recruitment and the scores of self-report measures: the example of worry in the elderly.,"Due to the difficulties in recruiting elderly people for psychological studies, a wide range of recruitment methods has been used. The underlying assumption that the recruitment method does not seriously affect the results has to be tested. Results in different worry measures are compared between three samples which were recruited with different strategies: (i) randomization sampling from the census of an urban area (random sample; n=97); (ii) people involved in leisure activities in senior centers (convenience sample; n=142); and (iii) people from the close environment of psychology students (snowball sample; n=60). People from those samples, aged 65 and more, completed the Penn State Worry Questionnaire (trait-worry), and the Worry Scale (contents of worry). Differences were found for several demographic characteristics. There were marked differences between samples in the percentage of individuals endorsing cut-score criteria for generalized anxiety disorder (GAD), with a very high percentage for the snowball sample. For all of the worry measures, analyzes of variance revealed significantly higher total scores for the non-randomly selected samples (p<0.01). Comparing the latter samples, higher trait worry (p<0.01) and more worrying about health and personal competencies (p<0.01) was found in the snowball sample. These results suggest that the sample recruitment method can specifically and seriously affect the outcomes of studies with elderly people, thus limiting the generalization of their results.",Izal M.; Nuevo R.; Montorio I.; Pérez-Rojo G.,,10.1016/j.archger.2007.09.009,0,0,6474
8552,Residential cognitive therapy versus residential interpersonal therapy for social phobia: a randomized clinical trial.,"Eighty patients meeting DSM-IV criteria for social phobia were randomly assigned to 10 weeks of residential cognitive therapy (RCT) or residential interpersonal therapy (RIPT). Subjects were assessed at pretreatment, midtreatment, posttreatment, and 1 year after end of treatment. The patients reported chronic, highly comorbid social phobia. Most had tried other treatments without success. Existing individual treatment protocols for cognitive therapy and interpersonal therapy were extensively modified for an integrated group, individual, and residential format. The RCT and RIPT patients improved significantly on the primary outcome measures from pre- to posttreatment. No significant differences were observed between treatments. Patients also completed three weekly secondary outcome measures; on one, social role security, RCT was superior to RIPT. The entire sample reported continued improvement from posttreatment to 1-year follow-up, indicating that improvements were robust. RCT in the present trial was associated with less improvement compared to individual CT in other recent trials.",Borge FM.; Hoffart A.; Sexton H.; Clark DM.; Markowitz JC.; McManus F.,2008.0,10.1016/j.janxdis.2007.10.002,0,0,
8553,A brief cognitive behavioural preimplantation and rehabilitation programme for patients receiving an implantable cardioverter-defibrillator improves physical health and reduces psychological morbidity and unplanned readmissions.,"To assess the clinical and cost effectiveness of a brief home-based cognitive behavioural rehabilitation programme (the ICD Plan) for patients undergoing implantation of a cardiac defibrillator. A prospective multicentred, intention-to-treat, cluster-randomised controlled trial. Eight implantable cardioverter-defibrillator (ICD) implantation centres in the UK. Consecutive series of patients undergoing implantation with an ICD. The control group received usual care and advice from an experienced healthcare professional. The intervention group received usual care plus the ICD Plan. The plan was introduced before implantation, with three further brief telephone contacts with the nurse over the next 12 weeks. Health-related quality of life (Short Form Health Survey (SF-12)), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), activity limitations (subscale from the Seattle Angina Questionnaire (SAQ)), unplanned admissions and other economic data using a questionnaire developed for the study. 192 patients were recruited to the study (71 intervention, 121 control). At 6 months after surgery the intervention group had better physical health (37.83 vs 34.24; p<0.01), fewer limitations in physical activity (34.02 vs 31.72; p = 0.04), a greater reduction in the proportion of patients with a borderline diagnosis of anxiety (21% vs 13%; p = 0.60) and depression (13% vs 2%; p = 0.30), more planned ECGs (89% vs 66%; p = 0.04) and 50% fewer unplanned admissions (11% vs 22%; p<0.01). The ICD Plan improved health-related quality of life, reduced the incidence of clinically significant psychological distress and significantly reduced unplanned readmissions. It is a cost effective and easily implemented method for delivering rehabilitation and psychological care to patients undergoing ICD implantation. ISRCTN70212111.",Lewin RJ.; Coulton S.; Frizelle DJ.; Kaye G.; Cox H.,2009.0,10.1136/hrt.2007.129890,0,0,
8554,Appraisals of obsessional thoughts in normal samples.,"Cognitive theories of obsessive-compulsive disorder (OCD) posit that appraisals about the significance of thoughts are critical in the development and persistence of obsessions. Rachman [(1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35, 793-802.] proposes that appraisals of unwanted thoughts distinguish clinical obsessions from normal intrusive thoughts; thoughts appraised as important and personally significant are expected to be upsetting and recur. Appraisals are also expected to be related to symptoms of OCD. To explore the features of normal appraisals of obsession-like thoughts, nonclinical participants in two studies rated the personal significance of intrusive thoughts portrayed in vignettes containing prototypical themes associated with primary obsessions: aggressive, sexual, and blasphemous thoughts. Unwanted intrusive thoughts that were described as occurring more frequently were appraised as more personally significant, but participants appraised these socially unacceptable thoughts similarly whether they imagined having personally experienced them or a friend confiding about having experienced them. Appraisals in both studies were related to subclinical OC symptoms and OC beliefs.",Corcoran KM.; Woody SR.,2008.0,10.1016/j.brat.2007.10.007,0,0,
8555,Domains of quality of life and symptoms in male veterans treated for posttraumatic stress disorder.,"This study examined the relationship between domains of quality of life and posttraumatic stress disorder (PTSD) symptoms in 319 male veterans in a randomized trial of group psychotherapy. Confirmatory factor analyses suggested a 4-factor model of quality of life (achievement, self-expression, relationships, and surroundings) fit better than a unidimensional model. Clinically meaningful symptom change was associated with greater change in all quality of life domains. At pretreatment, numbing symptoms uniquely predicted all quality of life domains. Change in avoidance and hyperarousal uniquely predicted change in achievement. Change in reexperiencing uniquely predicted change in self-expression. Change in numbing uniquely predicted change in relationships. Examining change in PTSD symptoms and quality of life domains may provide important information for treatment planning and evaluation.",Lunney CA.; Schnurr PP.,2007.0,10.1002/jts.20269,0,0,
8556,Long-term outcomes following decompressive craniectomy for severe head injury.,"Severe head injury is one of the commonest indications for neurosurgical intervention. For the neurosurgeon, the operative last resort in cases of generalised brain oedema of traumatic origin is the decompressive craniectomy. Is it possible to use predictive factors to ascertain what degree of success, in terms of both the acute and long-term outcome, is to be expected in patients who undergo this treatment? The clinical records of 131 patients treated with decompressive craniectomy for severe head injury were evaluated. All patients were operated on between September 1997 and September 2005 in the neurosurgical department of the Unfallkrankenhaus Berlin. A follow-up examination was carried out 49 +/- 25 months after the initial trauma. The clinical outcome was compared with several patient and radiographic factors to establish if any of these showed a relationship to the long-term outcome. A significant relationship was demonstrated between quality of outcome and the Glasgow Coma Scale score on admission. Quality of outcome was similarly related to the age of the patient, the condition of the basal cisterns and the degree of midline shift in the initial cranial computed tomography. Factors which correlated with poor outcome included pupil reactivity on admission, established clotting disorders and posttraumatic hydrocephalus internus. Hyperglycaemia and initial acidosis were also associated with a poor outcome. The clinical outcome in patients with a severe head injury is to a great degree determined by the extent and type of the primary injury. When considering decompressive hemicraniectomy as a treatment for raised intracranial pressure following traumatic brain injury, the predictive factors detailed here should be taken into consideration.",Meier U.; Ahmadi S.; Killeen T.; Al-Zain FT.; Lemcke J.,2008.0,,0,0,
8557,A randomized controlled trial of D-cycloserine enhancement of exposure therapy for social anxiety disorder.,"Pilot research has suggested that D-cycloserine (DCS) enhances treatment outcomes for anxiety disorders when employed as an adjunct to exposure therapy (ET). The aim of this study was to determine whether 50 mg of DCS enhances ET for social anxiety disorder (SAD) according to a comprehensive set of symptom and life impairment measures. In a randomized double-blind placebo-controlled trial, we administered 50 mg of DCS or placebo in combination with ET to 56 participants who met primary diagnosis for SAD. Participants administered DCS reported greater improvement on measures of symptom severity, dysfunctional cognitions, and life-impairment from SAD in comparison with placebo-treated participants. Effect sizes were mostly in the medium range. Results also indicated that the amount of adaptive learning about one's ability to give speeches in front of an audience interacted with DCS to enhance treatment outcome. This study shows that the administration of DCS before ET enhances treatment outcomes for SAD. Results also provide the first preliminary evidence to suggest that DCS moderates the relationship between a reduction in negative appraisals about one's speech performance and improvement in overall SAD symptoms.",Guastella AJ.; Richardson R.; Lovibond PF.; Rapee RM.; Gaston JE.; Mitchell P.; Dadds MR.,2008.0,10.1016/j.biopsych.2007.11.011,0,0,
8558,Effectiveness of brief alcohol interventions for general practice patients with problematic drinking behavior and comorbid anxiety or depressive disorders.,"Brief interventions (BIs) are effective methods to reduce problematic drinking. It is not known, if the effectiveness of BI differs between patients with or without comorbid depression or anxiety disorders. In a randomized controlled BI study with two intervention groups and one control condition, data were collected from 408 general practice (GP) patients with alcohol use disorders, at-risk drinking or binge drinking. 88 participants were diagnosed with comorbid anxiety and/or depressive disorders. The effectiveness of BI was assessed at a 12-month follow-up in relation to the presence and absence of comorbidity. Reduction of drinking in six ordered categories (g/alcohol) between baseline and follow-up served as the outcome variable. BI were significantly related to reduction of drinking in the non-comorbid (-2.64 g/alcohol vs. -8.61 g/alcohol; p=.03) but not in the comorbid subsample (-22.06 g/alcohol vs. -22.09 g/alcohol; p=.76). Compared to non-comorbid participants, a significantly higher reduction of drinking was found for comorbid individuals (-6.55 g/alcohol vs. -22.08 g/alcohol; p=.01). An ordinal regression analysis revealed comorbidity to be a positive predictor for reduction of drinking (estimator=.594; CI=.175-1.013; p<.01). When entering the variables amount of drinking at baseline, intervention and classification of problematic drinking, these became significant predictors, whereas comorbidity showed only a tendency. BI did not significantly effect a reduction of drinking in comorbid patients. As BI are known to be less effective for dependent drinkers, a larger proportion of dependents among the comorbid might have limited the effectiveness of BI. Future studies with larger sample sizes of comorbid problem drinkers are necessary to confirm the results.",Grothues JM.; Bischof G.; Reinhardt S.; Meyer C.; John U.; Rumpf HJ.,2008.0,10.1016/j.drugalcdep.2007.11.015,0,0,
8559,Impairment of health-related quality of life in functional dyspepsia and chronic liver disease: the influence of depression and anxiety.,"Health-related quality of life (HRQOL) is a marker of disease severity. Data on the relative impairment of HRQOL in chronic liver disease (CLD) and functional gastrointestinal disorders are lacking and no studies have assessed the link between impairment of HRQOL and psychosocial factors yet. To assess predictors for, and the impairment of, HRQOL in CLD and FD. In 181 functional dyspepsia (FD) patients, 204 CLD patients and 337 healthy blood donors, HRQOL was assessed with the Short Form-36 (mental and physical component), and anxiety and depression utilizing the Hospital Anxiety and Depression Scale. Compared with HC, HRQOL is significantly lower in FD and CLD (P-value for all <0.001). The mental but not physical component of HRQOL was significantly more impaired in FD compared with CLD (P < 0.05). After adjusting for confounders, impairment of mental (P < 0.001) and physical (P = 0.005) component of HRQOL was associated with the severity of CLD and FD. In FD, the multivariate analysis revealed depression and severity of symptoms as the most important predictors of HRQOL (R2 = 21.9 and 7.1). In CLD, the mental component of HRQOL was associated with depression and anxiety (R(2) = 9.9 and 9.7). In tertiary care, HRQOL is more severely impaired in FD compared with CLD. Co-morbid psychiatric conditions significantly contribute to the impairment of HRQOL.",Haag S.; Senf W.; Häuser W.; Tagay S.; Grandt D.; Heuft G.; Gerken G.; Talley NJ.; Holtmann G.,2008.0,10.1111/j.1365-2036.2008.03619.x,0,0,
8560,The renewal of extinguished conditioned fear with fear-relevant and fear-irrelevant stimuli by a context change after extinction.,"The acquisition, extinction, and subsequent recovery of conditioned fear can be influenced by the nature of the conditional stimulus (CS) and the context in which the CS is presented. The combined effects of these factors were examined in a differential fear-conditioning procedure with humans. Fear-relevant or fear-irrelevant CSs were followed by a shock unconditional stimulus (US) during acquisition and presented alone during extinction. The CSs were images presented upon different background contexts. Half the participants received the same context during acquisition and extinction and the remaining received different contexts. All participants received test trials in the same context as acquisition. In Experiment 1 (N=64), a renewal of shock expectancy and skin conductance responses was found during test for fear-relevant and fear-irrelevant CSs when extinction was given in a different context. In Experiment 2 (N=72), renewal for fear-relevant stimuli was enhanced when acquisition and test was given in an indoor office context and extinction in an outdoor bush context. The opposite context configuration produced the strongest renewal for fear-irrelevant stimuli. The return of extinguished conditioned fear can occur to fear-relevant stimuli that are commonly associated with clinical fears and its strength may be enhanced when the stimuli are encountered in certain contexts after extinction.",Neumann DL.; Longbottom PL.,2008.0,10.1016/j.brat.2007.12.004,0,0,
8561,Effects of progressive muscle relaxation training on anxiety and depression in patients enrolled in an outpatient pulmonary rehabilitation program.,"This prospective, randomized controlled trial examined the effect of progressive muscle relaxation (PMR) training on anxiety and depression in patients with chronic breathing disorders receiving pulmonary rehabilitation (PR). Eighty-three subjects with chronic breathing disorders entering the 8-week PR program were randomly assigned to a standard care or intervention group. The standard program included 2 days per week of exercise, education and psychosocial support delivered by a multidisciplinary team. The intervention group received additional sessions of PMR training using a prerecorded tape for 25 min/week during weeks 2-8. Primary outcome measures were levels of anxiety and depression evaluated by the Hospital Anxiety and Depression Scale. For anxiety, there was an overall significant improvement within each group over time (p < 0.0001). There was no statistically significant group-time interaction (p = 0.17) and no statistically significant difference between the groups (p = 0.22), despite lower scores for every time point in the PMR group. For depression, there was an overall significant improvement within each group over time (p < 0.0001). Although the difference between the groups (p = 0.09) and group-time interaction (p = 0.07) did not reach statistical significance, the results again favored the PMR group for weeks 5-8. Depression scores were lower for the PMR throughout weeks 1-8. PR is effective in reducing anxiety and depressive level in chronic lung patients. Our findings suggest that adding structured PMR training to a well-established PR program may not confer additional benefit in the further reduction of anxiety and depression in patients receiving PR.",Lolak S.; Connors GL.; Sheridan MJ.; Wise TN.,2008.0,10.1159/000112889,0,0,
8562,An integrated approach to panic prevention targeting the empirically supported risk factors of smoking and anxiety sensitivity: theoretical basis and evidence from a pilot project evaluating feasibility and short-term efficacy.,"Consistent with a risk reduction model of targeted prevention, the present investigation piloted and empirically evaluated the feasibility and short-term efficacy of a first-generation panic prevention program that targeted two malleable risk factors for panic development-anxiety sensitivity and daily cigarette smoking. Members of a high risk cohort, defined by high levels of anxiety sensitivity and current daily smoking (n=96), were randomly assigned to either (1) a one session intervention focused on proximally increasing motivation to quit smoking and reducing anxiety sensitivity to distally prevent the development of panic or (2) a health information control condition of comparable length. Participants were followed for 6 months. Consistent with hypotheses, those in the treatment condition showed reduced anxiety sensitivity and this effect was maintained across the follow-up period. Limited evidence also suggested the intervention increased motivation to quit smoking. We discuss how this prevention protocol can be modified in the future to enhance its effects as part of second-generation larger-scale outcome evaluations.",Feldner MT.; Zvolensky MJ.; Babson K.; Leen-Feldner EW.; Schmidt NB.,2008.0,10.1016/j.janxdis.2008.01.005,0,0,
8563,Differences in posttraumatic stress disorder diagnostic rates and symptom severity between Criterion A1 and non-Criterion A1 stressors.,"This study addresses the ongoing controversy regarding the definition of DSM-IV posttraumatic stress disorder's (PTSD) traumatic stressor criterion (A1). A sample of 119 college students completed the PTSD Symptom Scale separately in relation to both Criterion A1 and non-Criterion A1 stressful events, using a mixed between-groups (administration order) and within-subjects (stressor type) design. Contrary to what was expected, analyses revealed that non-Criterion A1 events were associated with greater likelihood of ""probable"" PTSD diagnoses and a greater PTSD symptom frequency than Criterion A1 events. Symptom frequency relationships, however, were moderated by the order in which the measures were administered. The non-Criterion A1 PTSD scores were only higher when non-Criterion A1 measures were presented first in the administration order. Similar patterns of differences in PTSD scores between stressor types were also found across the three PTSD symptom criteria. Implications are discussed as to the ongoing controversy of the PTSD construct.",Long ME.; Elhai JD.; Schweinle A.; Gray MJ.; Grubaugh AL.; Frueh BC.,2008.0,10.1016/j.janxdis.2008.01.006,0,0,
8564,Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT?,"This study compared Panic Online (PO), an internet-based CBT intervention, to best-practice face-to-face CBT for people with panic disorder with or without agoraphobia. Eighty-six people with a primary diagnosis of panic disorder were recruited from Victoria, Australia. Participants were randomly assigned to either PO (n=46) or best practice face-to-face CBT (n=40). Effects of the internet-based CBT program were found to be comparable to those of face-to-face CBT. Both interventions produced significant reductions in panic disorder and agoraphobia clinician severity ratings, self reported panic disorder severity and panic attack frequency, measures of depression, anxiety, stress and panic related cognitions, and displayed improvements in quality of life. Participants rated both treatment conditions as equally credible and satisfying. Participants in the face-to-face CBT treatment group cited higher enjoyment with communicating with their therapist. Consistent with this, therapists' ratings for compliance to treatment and understanding of the CBT material was higher in the face-to-face CBT treatment group. PO required significantly less therapist time than the face-to-face CBT condition.",Kiropoulos LA.; Klein B.; Austin DW.; Gilson K.; Pier C.; Mitchell J.; Ciechomski L.,2008.0,10.1016/j.janxdis.2008.01.008,0,0,
8565,Adverse events in an integrated trauma-focused intervention for women in community substance abuse treatment.,"A substantial number of women who enter substance abuse treatment have a history of trauma and meet criteria for posttraumatic stress disorder (PTSD). Fear regarding the extent to which PTSD treatment can evoke negative consequences remains a research question. This study explored adverse events related to the implementation of an integrated treatment for women with trauma and substance use disorder (Seeking Safety) compared with a nontrauma-focused intervention (Women's Health Education). Three hundred fifty-three women enrolled in community substance abuse treatment were randomized to 1 of the 2 study groups and monitored weekly for adverse events. There were no differences between the two intervention groups in the number of women reporting study-related adverse events (28 [9.6%] for the Seeking Safety group and 21[7.2%] for the Women's Health Education group). Implementing PTSD treatment in substance abuse treatment programs appears to be safe, with minimal impact on intervention-related adverse psychiatric and substance abuse symptoms. More research is needed on the efficacy of such interventions to improve outcomes of PTSD and substance use.",Killeen T.; Hien D.; Campbell A.; Brown C.; Hansen C.; Jiang H.; Kristman-Valente A.; Neuenfeldt C.; Rocz-de la Luz N.; Sampson R.; Suarez-Morales L.; Wells E.; Brigham G.; Nunes E.,2008.0,10.1016/j.jsat.2007.12.001,0,0,
8566,PTSD remission after prolonged exposure treatment is associated with anterior cingulate cortex thinning and volume reduction.,"Background: Brain structures underlying posttraumatic stress disorder (PTSD) have been a focus of imaging studies, but associations between treatment outcome and alterations in brain structures remain largely unexamined. We longitudinally examined the relation of structural changes in the rostral anterior cingulate cortex (rACC), a previously identified key region in the PTSD fear network, to outcome of prolonged exposure (PE) treatment. Method: The sample included 78 adults (53 women): 41 patients with PTSD and 37 trauma-exposed healthy volunteers (TE-HCs). Patients underwent a 10-week course of PE treatment and completed pre- and posttreatment assessments and magnetic resonance imaging (MRI) structural scans. TE-HCs also underwent assessment and MRI at baseline and 10 weeks later. PE remitters (n = 11), nonremitters (n = 14), and TE-HCs, were compared at baseline on demographic and clinical characteristics and ACC structure. Remitters, nonremitters, and TE-HCs were compared for pre- to posttreatment clinical and structural ACC change, controlling for potential confounding variables. Results: There were no baseline differences in structure between PTSD and TE-HCs or remitters and nonremitters. Following treatment, PTSD remitters exhibited cortical thinning and volume decrease in the left rACC compared with PTSD nonremitters and TE-HCs. Conclusions: These results, while in need of replication, suggest that PE treatment for PTSD, by extinguishing maladaptive trauma associations, may promote synaptic plasticity and structure change in rACC. Future research should explore possible underlying mechanisms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Helpman, Liat; Papini, Santiago; Chhetry, Binod T; Shvil, Erel; Rubin, Mikael; Sullivan, Gregory M; Markowitz, John C; Mann, J. John; Neria, Yuval; Asnaani, Baldacara, Blake, Brown, Bryant, Chao, Chu, Craik, Dale, Dickie, Dickstein, Etkin, Etkin, First, Fischl, Fischl, Foa, Foa, Foa, Foa, Freed, Fullana, Gupta, Hamilton, Han, Hutton, Johansen, Jones, Karl, Landre, Lebron-Milad, Levy-Gigi, Lindauer, Moench, Naifeh, O'Doherty, Rauch, Reuter, Rosas, Salat, Schnyder, Shenhav, van Rooij, Wager, Westphal, Whipple, Winkler, Woodward",2016.0,,0,0,
8567,Trauma-informed mindfulness-based stress reduction for female survivors of interpersonal violence: Results from a stage I RCT.,"Objective: This pilot randomized controlled trial evaluated a novel trauma-informed model of mindfulness-based stress reduction (TI-MBSR) as a phase I trauma intervention for female survivors of interpersonal violence (IPV). Method: A community-based sample of women (mean age = 41.5, standard deviation = 14.6) with a history of IPV was randomly assigned to an 8-week TI-MBSR intervention (n = 23) or a waitlist control group (n = 22). Symptoms of posttraumatic stress disorder (PTSD) and depression as well as anxious and avoidant attachment were assessed pre- and postintervention. Results: Relative to the control group, participation in TI-MBSR was associated with statistically and clinically significant decreases in PTSD and depressive symptoms and significant reductions in anxious attachment. Retention in the intervention was high, with most participants completing at least 5 of the 8 sessions for the intervention. Minutes of mindfulness practice per week significantly predicted reductions in PTSD symptoms. Conclusion: TI-MBSR appears to be a promising and feasible phase I intervention for female survivors of interpersonal trauma. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kelly, Amber; Garland, Eric L; Adedokun, Ainsworth, Allen, Allen, Allen, Allen, Beck, Beck, Black, Bowen, Bowlby, Bowlby, Breslau, Cloitre, Courtois, Dutton, Elhai, Elhai, Felitti, Follette, Fraley, Freud, Gallegos, Garland, Giller, Goyal, Grossman, Harrington, Herman, Himelstein, Holbrook, Iverson, Kabat-Zin, Kabat-Zinn, Kabat-Zinn, Kabat-Zinn, Kearney, Kessler, Kessler, Kimbrough, King, Kristeller, Lecrubier, Lilly, Little, McNemar, Mikulincer, Miller, Neff, Ogden, Onken, Pearlman, Perkins, Rothschild, Saakvitne, Saakvitne, Samuelson, Santorelli, Seedat, Segal, Sherin, Siegel, Singer, Smith, Staub, Tang, Teasdale, van der Kolk, Weathers, Weaver, Yehuda",2016.0,,0,0,
8568,Psychometric properties of the mini-social phobia inventory (Mini-SPIN) in a large online treatment-seeking sample.,"The Mini-Social Phobia Inventory (Mini-SPIN) is a brief, three-item measure designed as a screening tool for social anxiety disorder (SAD). This study investigated the Mini-SPIN's psychometric properties in a series of trials of Internet-delivered treatment. Participants were 993 people seeking Internet-delivered cognitive behavioural therapy for a range of anxiety and mood disorders. Participants completed the Mini-SPIN, and were diagnosed using the Mini International Neuropsychiatric Interview Version 5.0.0 (MINI). They also completed measures of depression, general anxiety, panic, neuroticism and general impairment. The Mini-SPIN's ability to discriminate between people with and without SAD, within a large sample of people seeking treatment for a range of psychological disorders, was assessed at initial assessment and three-month follow-up. The Mini-SPIN's criterion group validity, internal consistency, test-retest reliability, construct validity and responsiveness to treatment were also examined. Results demonstrated that the Mini-SPIN has an excellent ability to discriminate between those with and without SAD in a highly comorbid clinical sample, and also has good criterion group validity. The Mini-SPIN also exhibited excellent internal consistency, good test-retest reliability, and was responsive to treatment. These results highlight the Mini-SPIN's potential as an efficient and reliable measure of SAD in heterogenous populations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fogliati, Vincent J; Terides, Matthew D; Gandy, Milena; Staples, Lauren G; Johnston, Luke; Karin, Eyal; Rapee, Ronald M; Titov, Nickolai; Dear, Blake F; Acarturk, Aderka, Alonso, Andersson, Andersson, Aydos, Butler, Cameron, Carlbring, Carleton, Chartier, Cohen, Connor, Connor, Costa, Crome, Cuijpers, D'El Rey, D'El Rey, de Lima Osorio, De Vente, Dear, Dear, Dear, Dear, Feldman, Fogliati, Fresco, Furukawa, Gandy, Garcia-Lopez, Hanley, Hedman, Hedman, Hedman, Heimberg, Hoek, Hosmer, Houck, Hsiao, Johansson, Katzelnick, Kessler, Kessler, Kessler, Kessler, Klein, Kotov, Kroenke, Kroenke, Lampe, Lampe, Leon, Liebowitz, Lowe, Lowe, Mason, Mattick, McEvoy, Metz, Muskens, Newby, Newby, Olfson, Osorio, Peters, Raj, Ranta, Rapee, Regier, Roberson-Nay, Rohde, Ruscio, Ruwaard, Schneier, Schry, Seeley-Wait, Sheehan, Sheehan, Silverman, Spitzer, Stein, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Turner, Weeks",2016.0,,0,0,
8569,Supplemental nicotine preloading for smoking cessation in posttraumatic stress disorder: Results from a randomized controlled trial.,"Background: Individuals with posttraumatic stress disorder (PTSD) are more likely to smoke and more likely to relapse following a quit attempt than individuals without PTSD. Thus, there is a significant need to study promising interventions that might improve quit rates for smokers with PTSD. One such intervention, supplemental nicotine patch-preloading, entails the use of nicotine replacement therapy prior to quitting. Objective The objective of this study was to conduct a randomized controlled trial of the efficacy of supplemental nicotine patch-preloading among smokers with PTSD. We hypothesized that, relative to participants in the placebo condition, participants in the nicotine patch-preloading condition would: (1) smoke less and experience reduced craving for cigarettes during the nicotine patch-preloading phase; (2) experience less smoking-associated relief from PTSD symptoms and negative affect during the preloading phase; and (3) exhibit greater latency to lapse, and higher short- and long-term abstinence rates. Methods: Sixty-three smokers with PTSD were randomized to either nicotine or placebo patch for three weeks prior to their quit date. Ecological momentary assessment was used to assess craving, smoking, PTSD symptoms, and negative affect during the preloading period. Results: Nicotine patch-preloading failed to reduce smoking or craving during the preloading phase, nor was it associated with less smoking-associated relief from PTSD symptoms and negative affect. Moreover, no differences were observed between the treatment conditions for time to lapse, 6-week abstinence, or 6-month abstinence. Conclusions: The findings from the present research suggest that supplemental nicotine patch-preloading is unlikely to substantially enhance quit rates among smokers with PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dennis, Paul A; Kimbrel, Nathan A; Dedert, Eric A; Beckham, Jean C; Dennis, Michelle F; Calhoun, Patrick S; Beckham, Beckham, Beckham, Benowitz, Blake, Breslau, Bullen, Calhoun, Cappelleri, Cook, Croghan, Dedert, Dedert, Feldner, Fiore, First, Francis, Gwaltney, Heatherton, Hertzberg, Hertzberg, Hughes, Kahler, King, Koenen, Lasser, McFall, Morissette, Rasmusson, Rose, Rose, Rose, Schnoll, Schuurmans, Snijders, Stead, Volz, Weathers",2016.0,,0,0,
8570,Development and randomized trial evaluation of a novel computer-delivered anxiety sensitivity intervention.,"Objective: Anxiety disorders contribute substantially to the overall public health burden of psychopathology. Anxiety sensitivity (AS), a fear of anxiety related sensations, is one of the few known malleable risk factors for anxiety pathology. Previous AS reduction treatments have utilized highly trained clinicians. A completely-computerized AS treatment would reduce costs and increase dissemination possibilities. Cognitive bias modification for interpretation biases (CBM-I) interventions have shown clinically significant reductions in anxiety symptoms. Another emerging literature focused on learning has shown context-shifting tasks can greatly increase learning without adding logistical burden to an intervention. The current study evaluated a CBM-I for AS that utilized a context-shifting task to deliver twice the treatment dose of extant interventions. Design: Single-site randomized controlled trial. Participants completed an intervention appointment, as well as one-week and one-month follow-up assessments. Participants: Individuals with elevated levels of AS. Intervention: Single-session computer-delivered CBM-I for AS. Results: Results indicate that the CBM-I for AS was successful in reducing overall AS (62% post-intervention) and these reductions were maintained through one-month post-intervention (64%). Results also revealed that individuals in the active condition reported significantly less incidents of panic responding to a physiological straw-breathing challenge and that change in interpretation bias significantly mediated the relationship between treatment condition and post-treatment AS reductions. Conclusions: Taken together, the results show that the current CBM-I intervention was strong in terms of immediate and one-month AS reductions. Given its brevity, low cost, low stigma and portability, this intervention could have substantial impact on reducing the burden of anxiety disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Capron, Daniel W; Schmidt, Norman B; Allan, Baxter, Beard, Beard, Benware, Broman-Fulks, Brosan, Chambless, Clerkin, Faul, Feldner, Gardenswartz, Greenberg, Hayes, Hirsch, Hoppitt, Jang, Keough, Kessler, Liebowitz, MacDonald, MacLeod, Marsic, Mathews, Munoz, Olatunji, Pastotter, Pastotter, Preacher, Reiss, Reiss, Salemink, Salemink, Schmidt, Schmidt, Schmidt, Schmidt, Schmidt, Schneider, Sederberg, Smits, Steinman, Taylor, Taylor, Telch, Watson, Williams, Zinbarg",2016.0,,0,0,
8571,Psilocybin with psychological support for treatment-resistant depression: An open-label feasibility study.,"Background: Psilocybin is a serotonin receptor agonist that occurs naturally in some mushroom species. Recent studies have assessed the therapeutic potential of psilocybin for various conditions, including end-of-life anxiety, obsessive-compulsive disorder, and smoking and alcohol dependence, with promising preliminary results. Here, we aimed to investigate the feasibility, safety, and efficacy of psilocybin in patients with unipolar treatment-resistant depression. Methods: In this open-label feasibility trial, 12 patients (six men, six women) with moderate-to-severe, unipolar, treatment-resistant major depression received two oral doses of psilocybin (10 mg and 25 mg, 7 days apart) in a supportive setting. There was no control group. Psychological support was provided before, during, and after each session. The primary outcome measure for feasibility was patient-reported intensity of psilocybin's effects. Patients were monitored for adverse reactions during the dosing sessions and subsequent clinic and remote follow-up. Depressive symptoms were assessed with standard assessments from 1 week to 3 months after treatment, with the 16-item Quick Inventory of Depressive Symptoms (QIDS) serving as the primary efficacy outcome. This trial is registered with ISRCTN, number ISRCTN14426797. Findings: Psilocybin's acute psychedelic effects typically became detectable 30-60 min after dosing, peaked 2-3 h after dosing, and subsided to negligible levels at least 6 h after dosing. Mean self-rated intensity (on a 0-1 scale) was 0.51 (SD 0.36) for the low-dose session and 0.75 (SD 0.27) for the high-dose session. Psilocybin was well tolerated by all of the patients, and no serious or unexpected adverse events occurred. The adverse reactions we noted were transient anxiety during drug onset (all patients), transient confusion or thought disorder (nine patients), mild and transient nausea (four patients), and transient headache (four patients). Relative to baseline, depressive symptoms were markedly reduced 1 week (mean QIDS difference -11.8, 95%","Carhart-Harris, Robin L; Bolstridge, Mark; Rucker, James; Day, Camilla M. J; Erritzoe, David; Kaelen, Mendel; Bloomfield, Michael; Rickard, James A; Forbes, Ben; Feilding, Amanda; Taylor, David; Pilling, Steve; Curran, Valerie H; Nutt, David J; Bogenschutz, Bonson, Boulougouris, Bouso, Buchborn, Carhart-Harris, Carhart-Harris, Carhart-Harris, Gasser, Gaynes, Greenberg, Griffiths, Grob, Halberstadt, Harvey, Hendricks, Hofmann, Hofmann, Ibrahim, Johnson, Johnson, Johnson, Krebs, Moreno, Osorio Fde, Rush, Sackeim, Studerus, Vaidya",2016.0,,0,0,
8572,Family-based therapy for young adults with anorexia nervosa restores weight.,"Objective: We examined the preliminary acceptability and efficacy of family-based therapy (FBT) for weight restoration in young adults (FBTY) with Anorexia Nervosa (AN). Method: Twenty-two primarily female participants ranging from age 18 to 26, with AN or atypical AN (ICD-10) and their support adults were enrolled in a 6-month open trial of FBTY. Participants were assessed at baseline, after treatment, and at six and 12 month follow-up visits. The primary outcome was BMI and secondary outcomes included eating disorder psychopathology, current eating disorder obsessions, and compulsions, number of other Axis I disorders and global assessment of functioning. Results: Although FBTY was rated as suitable by participants and their support adults, during FBTY, 9/22 participants dropped out and 3/22 dropped out at follow-up assessments. Despite being offered 18-20 sessions over six months, a mean of 12 FBTY sessions (SD = 6) were attended. After FBTY, 15 of the intent-to-treat sample of 22 were no longer underweight (BMIs >= 19 kg/m2) and 12 months after treatment, 13/22 were no longer underweight. The magnitude of the BMI increase during FBTY (Hedges g = 1.20, 95th percentile CI = 0.55-1.85) was comparable to findings for adolescent FBT for AN. Secondary outcomes also improved. Discussion: FBTY for young adults with AN and atypical AN, which involves support adults participants have chosen, results in weight restoration that is sustained up to a year after treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Chen, Eunice Y; Weissman, Jessica A; Zeffiro, Thomas A; Yiu, Angelina; Eneva, Kalina T; Arlt, Jean M; Swantek, Michael J; Agras, Campbell, Chen, Couturier, Dimitropoulos, Fairburn, First, Furstenberg, Gutmann, Jacobson, Keller, Le Grange, Lock, Lock, Mazure, Rieger, Watson",2016.0,,0,0,
8573,"A randomized, controlled pilot study of a single-session psychoeducation treatment for urban, culturally diverse, trauma-exposed adults.","This randomized pilot study aimed to determine whether a single session of psychoeducation improved mental health outcomes, attitudes toward treatment, and service engagement among urban, impoverished, culturally diverse, trauma-exposed adults. Sixty-seven individuals were randomly assigned to a single-session psychoeducation treatment or a delayed treatment comparison control group. The control group was found to be superior to the treatment group at posttest with respect to symptoms of posttraumatic stress disorder, anxiety, and occupational and family disability. At follow-up, all participants had completed the psychoeducation treatment, and a mixed-effects model indicated significant improvements over time in symptoms of posttraumatic stress disorder, anxiety, depression, somatization, and attitudes toward treatment. Ninety-eight percent of the participants reported the psychoeducation was helpful at follow-up. Participants also reported a 19.1% increase in mental health service utilization at follow-up compared with baseline. Implications for treatment and future research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Ghafoori, Bita; Fisher, Dennis; Korosteleva, Olga; Hong, Madelyn; Alim, Amaya-Jackson, Back, Blanchard, Breslau, Breslau, Breslau, Cohen, Derogatis, Ehlers, Eisenman, Elhai, Ennis, Esters, Fischer, Foa, Foa, Galovski, Gavrilovic, Gelberg, Ghafoori, Ghafoori, Gillespie, Glodich, Glover, Gray, Jaycox, Kay-Lambkin, Kelly, Koenen, Lee, Leon, Mendenhall, Mezuk, Mills, Miranda, Morgan Owusu, Neuner, Resnick, Roberts, Rose, Rothbaum, Santiago, Sheehan, Silverstein, Weathers, Wessely, Yeomans, Zehnder",2016.0,,0,0,
8574,"Pain, range of motion, and psychological symptoms in a population with frozen shoulder: A randomized controlled dismantling study of clinical EFT (emotional freedom techniques).","SCIENTIFIC ABSTRACT Clinical EFT (emotional freedom techniques) combines acupoint stimulation with elements of cognitive and exposure therapy. Numerous studies have demonstrated the efficacy of EFT for depression, anxiety, phobias, PTSD, and other psychological conditions. The current study assesses whether acupoint stimulation is an active ingredient or whether treatment effects are due to nonspecific factors. Thirty-seven participants with ""frozen shoulder"" consisting of limited range of motion (ROM) and pain were randomized into a wait list, or 1 of 2 treatment groups. ROM, pain, and the breadth and depth of psychological conditions such as anxiety and depression were assessed before and after a 30-min treatment session, and 30 days later. One treatment group received clinical EFT, while the other received an identical cognitive/exposure protocol but with diaphragmatic breathing (DB) substituted for acupoint stimulation. No significant improvement in any psychological symptom was found in the wait list. Participants in both the EFT and DB groups demonstrated significant posttest improvement in psychological symptoms and pain. Follow-up showed that both groups maintained their gains for pain, with EFT superior to DB, but only the EFT group maintained gains for psychological symptoms (p < .001). Large EFT treatment effects were found, with a Cohen's d = .9 for anxiety and pain, and d = 1.1 for depression. Though EFT showed a greater trend for improved ROM in most dimensions of movement, changes were nonsignificant for most measures in all groups. Reductions in psychological distress were associated with reduced pain as well as with improved ROM. The results are consistent with 5 earlier dismantling studies showing that acupoint stimulation is an active ingredient in EFT treatment. The study adds further support to other clinical trials indicating that clinical EFT is an efficacious evidence-based treatment for pain and psychological conditions. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Impact Statement Clinical EFT (emotional freedom techniques) combines fingertip stimulation of acupuncture points (acupressure) with elements drawn from cognitive and exposure therapies. Numerous studies have demonstrated the efficacy of EFT for depression, anxiety, phobias, posttraumatic stress disorder (PTSD), and other psychological conditions. The current study was designed to measure whether acupressure is an active ingredient in EFT, or whether its effects are due to its cognitive and exposure elements, or factors common to all therapies like sympathetic attention and belief in a positive outcome. In this study, 37 participants with ""frozen shoulder"" consisting of limited range of motion (ROM) and pain were randomized into a wait list, or 1 of 2 treatment groups. ROM, pain, and psychological conditions such as anxiety and depression were assessed before and after a 30-min treatment session, and 30 days later. One treatment group received clinical EFT, while the other received all the elements of EFT but with diaphragmatic breathing (DB) substituted for acupressure. No statistically significant improvement (1 possibility in 20) in any psychological symptom was found in the wait list group. After treatment, participants in the both the EFT and DB groups demonstrated statistically significant improvements in psychological symptoms and pain. Follow-up showed that both groups maintained their gains for pain, with EFT superior to DB, but only the EFT group maintained their gains for psychological symptoms. Statistically large EFT treatment effects were found for anxiety, pain, and depression. ROM changes were not statistically significant for most measures in any of the groups. The EFT group showed a significant association between reductions in psychological distress and pain. The results are consistent with 5 earlier studies showing that acupressure is an active ingredient in EFT treatment and not an inert ingredient or a placebo. The study adds further support to other clinical trials indicating that clinical EFT is an evidence-based and effective treatment for pain and psychological conditions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Church, Dawson; Nelms, Jerrod; Autry, Bacon, Baker, Baker, Bakker, Belanoff, Binder, Boath, Bougea, Boyle, Brattberg, Chambless, Chambless, Chambless, Church, Church, Church, Church, Church, Church, Church, Church, Church, Church, Church, Church, Church, Clond, Craig, Davison, DeGuire, Dias, Diercks, Faling, Fang, Feinstein, Felitti, Flint, Ford, Fox, Fried, Gaudiano, Gerhardt, Geronilla, Gilomen, Gurret, Harvey, Hodge, Hui, Jain, Lambrou, Lane, Lenze, Martarelli, Maruish, Maslach, Mill, Mollon, Napadow, Nelms, Pasahow, Reeves, Reynolds, Rogers, Rosen, Rugulies, Salas, Schulz, Sebastian, Shaffer, Stewart, Stewart, Stone, Suarez, Swingle, Swingle, Vasterling, Waite, Wells, Wolpe, Yamaguti, Yount, Zuckerman",2016.0,,0,0,
8575,Working alliance in Internet-based cognitive-behavioral therapy for obsessive-compulsive disorder.,"The patient-therapist relation has consistently been found to be of importance for the outcome of psychotherapy with an overall effect size of r = 0.275. The same relevance of the patient-therapist relation holds true for the treatment of obsessive-compulsive disorder (OCD). Cognitive-behavioral psychotherapy (CBT) with exposure and response prevention (ERP) constitutes an effective treatment for OCD and is recommended as the first-line treatment. Yet, only a minority of patients receives it. The developing field of Internet-based CBT (iCBT) is a promising opportunity for further dissemination. Due to the anxiety-provoking nature of ERP, the treatment is associated with high levels of discomfort and is often perceived as demanding. Consequently, it seems of particular importance to establish a stable patient-therapist relation. The present data analysis was part of a randomized controlled trial on the efficacy of a text-based iCBT with therapist guidance and ERP for treating patients with OCD. In this trial, we observed a high level of acceptance and strong and stable effect sizes of the intervention. The present analysis focused on the patient therapist relation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Herbst, Nirmal; Franzen, Guido; Voderholzer, Ulrich; Thiel, Nicola; Knaevelsrud, Christine; Hertenstein, Elisabeth; Nissen, Christoph; Kulz, Anne Katrin; Bee, Eaton, Hatcher, Herbst, Horvath, Schwartz, Sucala, Vogel, Vogel",2016.0,,0,0,
8576,Enhanced effects of combined cognitive bias modification and computerised cognitive behaviour therapy on social anxiety.,"This study examines whether combined cognitive bias modification for interpretative biases (CBM-I) and computerised cognitive behaviour therapy (C-CBT) can produce enhanced positive effects on interpretation biases and social anxiety. Forty socially anxious students were randomly assigned into two conditions, an intervention group (positive CBM-I + C-CBT) or an active control (neutral CBM-I + C-CBT). At pre-test, participants completed measures of social anxiety, interpretative bias, cognitive distortions, and social and work adjustment. They were exposed to 6 x 30 min sessions of web-based interventions including three sessions of either positive or neutral CBM-I and three sessions of C-CBT, one session per day. At post-test and two-week follow-up, participants completed the baseline measures. A combined positive CBM-I + C-CBT produced less negative interpretations of ambiguous situations than neutral CBM-I + C-CBT. The results also showed that both positive CBM-I + C-CBT and neutral CBM-I + C-CBT reduced social anxiety and cognitive distortions as well as improving work and social adjustment. However, greater effect sizes were observed in the positive CBM-I + C-CBT condition than the control. This indicates that adding positive CBM-I to C-CBT enhanced the training effects on social anxiety, cognitive distortions, and social and work adjustment compared to the neutral CBM-I + C-CBT condition. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Butler, Emma; Mobini, Sirous; Rapee, Ronald M; Mackintosh, Bundy; Reynolds, Shirley A; Amir, Amir, Antony, Beard, Beard, Beard, Beck, Beck, Berger, Bowler, Butler, Carlbring, Clark, Clark, Connor, Davidson, Fedoroff, Fehm, Gross, Heimberg, Heinrichs, Hertel, Hirsch, Hofmann, Holmes, Huppert, Kessler, Khalili-Torghabeh, Mackintosh, MacLeod, Mataix-Cols, Mathews, Mobini, Mobini, Mobini, Mobini, Mundt, Murphy, Rapee, Salemink, Salemink, Stein, Stopa",2015.0,,0,0,
8577,"Health, dietary habits, and achievement motivation in college students with self-reported ADHD diagnosis.","Objective: The present study aimed to investigate aspects of health and motivation in a subpopulation of college students with ADHD. Method: Seventy-seven college students with self-reported ADHD (49 women; M age = 25.82, SD = 4.62) and 120 college students without ADHD (65 women; M age = 25.17, SD = 5.41) participated in an online survey assessing their health, dietary habits, and achievement motivation. Results: College students with ADHD showed impairment in psychological functioning, impairment in their mental health, and reported more ambition and less self-control. Furthermore, we found gender differences: Women with ADHD reported worse psychological functioning, and the gender differences in obsessive-compulsive behavior and compensatory effort were mediated by the timing of diagnosis. Conclusion: College students, especially women, with ADHD struggle with health-related issues. Some of these gender differences might be due to under diagnosis of girls in childhood. Differences in achievement motivation might indicate compensatory mechanisms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Merkt, Julia; Gawrilow, Caterina; Abikoff, Baron, Biederman, Biederman, Biederman, Blase, Bohm, Bullinger, Byrne, Cortese, Cortese, Cortese, Davidson, de Zwaan, Derks, Derogatis, Dunn, Fayyad, Fedele, Franke, Frazier, Gaub, Gawrilow, Gawrilow, Gershon, Gjervan, Gjervan, Globalpark, Gosling, Gut, Hall, Harackiewicz, Huss, Kaminski, Kessler, Klein, McGee, McGraw, Merkt, Milich, Nelson, Newark, O'Callaghan, Olivier, Pagoto, Preacher, Preacher, Preacher, Preckel, Pudel, Ramo, Ramos Olazagasti, Richards, Rucklidge, Rucklidge, Schuler, Simon, Stunkard, von Aster, Weigold, Weyandt, Weyandt",2016.0,,0,0,
8578,"Trauma symptoms, recovery, and participation in the Wellness Management and Recovery (WMR) program.","Despite the disproportionate prevalence of posttraumatic stress disorder (PTSD) among individuals with severe mental illness (SMI), and the emergence of effective trauma-specific treatments for comorbid PTSD/SMI, PTSD remains undertreated in this population. Literature points to two reasons for such: underdiagnosing of PTSD among individuals with SMI, and lack of clinician confidence/training in trauma-specific issues. A meta-analysis found non-trauma-specific groups reduced trauma symptoms in non-SMI populations. Against this backdrop, the purpose of this study was to determine whether individuals with SMI and trauma symptoms reported reduced trauma symptoms following completion of a non-trauma-specific, recovery-focused group treatment, the Wellness Management and Recovery (WMR) program. Pre- and post-WMR data were obtained from 54 participants via the Mental Health Recovery Measure and Posttraumatic Stress Disorder Checklist. Participants reported significant improvements in mental health recovery, and significant decreases in trauma symptoms. Results suggested that WMR-a non-trauma-specific group program-may offer promise in reducing trauma symptoms among individuals with SMI who may not have access to evidence-based trauma-specific treatments and/or who may not wish to specifically address trauma issues. Further exploration of the potential of WMR participation to reduce trauma symptoms among individuals with SMI is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Lee, Alisha; Bullock, Wesley A; Hoy, Janet; Bonugli, Braiterman, Briere, Bullock, Bullock, Classen, Cusack, Cusack, Elhai, Elhai, Fischer, Foa, Fowler, Frueh, Frueh, Frueh, Fardig, Grubaugh, Harding, Harding, Hien, Howgego, Jacobson, Kessler, Kessler, Kimbrough, Lee, Leverich, Levitt, Lommen, Lynch, Macguire, Manning, Mauritz, Medved, Mowbray, Mueser, Mueser, Mueser, Mueser, Mueser, Mueser, Mueser, Najavits, Norman, O'Fallon, O'Hare, O'Rourke, Panagioti, Salyers, Schnurr, Sherman, Simpson, Sloan, Sloan, Solomon, Steil, van den Berg, Weathers, Weathers, Wolff, Young, Young, Zanville",2016.0,,0,0,
8579,A random controlled study comparing anxiety ratification therapy and mindfulness-based strategy in managing obsessions.,"Objective: To test the efficacy of anxiety ratification therapy during brief exposure to obsessions in obsessive-compulsive patients. Methods: Totally 60 patients with obsessive-compulsive disorder were recruited and randomized into 3 groups. Patients were asked to listen to their own obsession through headphones during three time phases, at baseline, during an intervention phase and during a return to baseline. During the intervention phase, they were instructed to deal with their obsessions using anxiety ratification instructions (n = 20), mindfulness instructions (n = 20) or exposure instructions (n = 20). The improvement of anxiety, urge to neutralize and distress were assessed with the Visual Analogue Scale (VAS). Results: Fifty-three patients successfully completed the experiment. From the baseline to a return to baseline, anxiety and distress did not improve significantly (Ps > 0.05), while urge to neutralize significantly elevated (P < 0.05) in exposure group. Patients experienced a greater decline in anxiety and urge to neutralize in anxiety ratification group and mindfulness group (Ps < 0.05) from the baseline to a return to baseline. From the baseline to a return to baseline, patients'distress declined significantly in anxiety ratification group (n < 0.05), whereas the difference of mindfulness group was not significant (n > 0.05). Anxiety ratification therapy had the effect size (d) ranging between 0.66 and 0.70, and mindfulness had the effect size (d) ranging between 0.39 and 0.54. Conclusion: The results provide the evidence that anxiety ratification therapy could significantly improve the anxiety, urge to neutralize and distress of patients with obsessive-compulsive disorder, and help them to effectively manage their obsessions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hu, Si-Si; Wang, Meng-Yun; Xiong, Ling; Zhang, Zhong-Ming; Boschen, Brennan, Cohen, de Zoysa, Fabricant, Foa, Freeston, Hale, Kemp, Mangas, Marcks, Najmi, Purdon, Reips, Sahraian, Salkovskis, Simpson, Stem, Van Ameringen, van den Hout, Wahl, Whittal, Williams, Woodfoide, Zhang",2016.0,,0,0,
8580,Effects of mindfulness training on individuals experiencing post-breakup distress: A randomized controlled trial.,"Relationship breakups are a common part of most young adults' experience and frequently cause considerable emotional and psychological distress. The current study used a randomized, longitudinal approach to assess the effectiveness of mindfulness training, as compared to relaxation training and no-treatment control, for individuals dealing with the recent breakup of a romantic relationship. The purpose of the study was to examine the association between mindfulness, spirituality, attachment, and psychological symptoms. Potential moderating and mediating effects of spirituality and/or attachment were of particular interest. Eighty seven participants took part in the full eight-week study. They completed assessment measures at pre, post, and follow-up time points. A series of mixed design repeated measures ANCOVAs, with religiousness entered as a covariate, assessed main and interaction effects of mindfulness training, spirituality, and attachment on outcomes. While mindfulness was not significantly more effective than relaxation and no-treatment, and hypotheses related to moderation were not supported, attachment style was found to be a predictor of several outcomes, including positive emotion and forgiveness. In addition, mediation analyses showed that spirituality mediated the relationship between baseline mindfulness and anger rumination, positive emotions, post-traumatic growth, and forgiveness, suggesting that the effects of mindfulness on psychological distress occur in part through changes in spirituality. Future exploration of the role of spirituality in mindfulness interventions seems warranted, particularly for individuals with lower baseline spirituality and/or higher baseline distress who appear most likely to benefit. In addition, future research on attachment might focus on the differential response to treatment of individuals with insecure attachment styles. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Falb, Melissa D",2016.0,,0,0,
8581,Pattern destabilization and emotional processing in cognitive therapy for personality disorders.,"Clinical trials of treatments for personality disorders can provide a medium for studying the process of therapeutic change with particularly entrenched and self-perpetuating systems and might reveal important principles of system transition. We examined the extent to which maladaptive personality patterns were destabilized in a trial of cognitive therapy personality disorders (CT-PD) and how destabilization was associated with emotional processing and treatment outcomes. Dynamic systems theory was used as a theoretical framework for studying change. Method: Participants were 27 patients diagnosed with Avoidant or Obsessive Compulsive Personality Disorder (AVPD or OCPD), who completed an open trial of CT-PD. Raters coded treatment sessions using a coding system that operationalizes emotional processing, as well as cognitive, affective, behavioral, and somatic components of pathological (negative) and more adaptive (positive) patterns of functioning. Pattern destabilization (dispersion) scores during the early phase of treatment (phase 1: session 1-10) and the schema-focused phase (phase 2: session 11-34) were calculated using a program called GridWare. Results: More pattern destabilization and emotional processing in the schema-focused phase of CT-PD predicted more improvement in personality disorder symptoms and positive pattern strength at the end of treatment, whereas these variables in phase 1 did not predict outcome. Conclusion: In addition to illustrating a quantitative method for studying destabilization and change of patterns of psychopathology, we present findings that are consistent with recent updates of emotional processing theory and with principles from dynamic systems theory. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hayes, Adele M; Yasinski, Carly; Arntz, Beck, Beck, Beck, Beck, Blackburn, Borsboom, Borsboom, Bouton, Carey, Carl, Cervone, Clark, Cloninger, Cramer, Craske, Cummings, Dakos, Dakos, Dakos, Dozois, Dozois, Dozois, Dunn, Ebner-Priemer, First, Fisher, Foa, Foa, Garland, Granic, Greenberg, Hayes, Hayes, Hayes, Hayes, Hayes, Hayes, Hollenstein, Hollenstein, Holtforth, Kashdan, Kelso, Kelso, Lamey, Landis, Lang, Leichsenring, Lewis, Lobbestael, Lunkenheimer, Maurer, McCarthy, Mischel, Mischel, Mischel, Nesselroade, Newman, Pascual-Leone, Pos, Read, Salvatore, Scheffer, Schiepek, Schiepek, Schiepek, Schiepek, Schiepek, Schiller, Schmittmann, Spitzer, Spitzer, Strauss, Teasdale, Thelen, Thelen, Tschacher, Tschacher, Vallacher, van der Maas, van Geert, van Geert, van Vreeswijk, Watkins, Whelton, Young, Young, Zeigler-Hill",2015.0,,0,0,
8582,Behavioral treatment of feelings of incompleteness: A randomized controlled trial.,"Two core dimensions of obsessive-compulsive disorder (OCD), harm avoidance and incompleteness, have been proposed to underlie overt symptom subtypes (Summerfeldt, 2004). Foa, Abramowitz, Franklin and Kozak (1999) have found that patients with OCD who could not articulate fears of a specific consequence (i.e. harm) of not completing rituals displayed less improvement from cognitive behavioral therapy using exposure and response prevention (ERP) than patients who could articulate feared consequences (i.e., were motivated by harm avoidance). Summerfeldt (2008) argued that current treatments may not be as effective for patients with feelings of incompleteness as they do not report obsessional fears that can be disconfirmed in treatment and has suggested that exposure treatment with a focus on purposefully leaving stimuli incomplete would be effective for such individuals. The aims of the current study were to: (1) evaluate the effectiveness of a purely exposure-based treatment (ERP) for feelings of incompleteness in comparison to progressive muscle relaxation (PMR) among individuals with elevated levels of dispositional incompleteness; and (2) determine if reductions in feelings of incompleteness were associated with reductions in multiple OC symptom dimensions and perfectionism. Undergraduate students with elevated feelings of incompleteness completed self-report questionnaires and behavioral assessments of incompleteness (visual and tactile), ordering and arranging, washing, and contamination approach during a pretreatment evaluation. Forty-eight participants were randomly assigned to complete three sessions of either ERP or PMR. Following these sessions, participants completed a post-treatment evaluation including the questionnaires and behavioral assessments administered at pretreatment, and a behavioral assessment of checking. Participants completed questionnaires one month following the post-treatment assessment. Results suggest that ERP, in comparison to PMR, was effective in reducing visual and tactile incompleteness on behavioral tasks; however, there were no differences between groups on other behavioral measures of OC symptoms or task-related perfectionism. No group differences were found on self-report measures of dispositional incompleteness, OCD symptoms, or perfectionism at post-treatment or follow up. ERP did result in greater reductions in harm avoidance at post-treatment compared to PMR. Exploratory moderation analyses revealed that among individuals low in pretreatment OCD severity, ERP was associated with greater reductions in incompleteness, ordering symptoms, and trait anxiety than PMR; no effects of condition were found among those high in pre-treatment OCD symptoms. These findings suggest a higher dose of ERP may be necessary to reduce incompleteness among individuals with elevated OCD symptoms. Further clinical implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Fitch, Kristin E",2016.0,,0,0,
8583,Use of a two-phase process to identify possible cases of mental ill health in the UK military.,"Two-phase mental health screening methods, in which an abridged mental health measure is used to establish who should receive a more comprehensive assessment, may be more efficient and acceptable to respondents than a stand-alone complete questionnaire. Such two-phase methods are in use in US armed forces post-deployment mental health screening. This study assesses the sensitivity and specificity of abridged instruments (used in the first phase) compared to the full instruments (the second phase), and whether false negative cases resulting from the use of abridged tests were detected by another test, among a UK military screening sample. Data from a group of UK Armed Forces personnel (n = 1464) who had completed full questionnaires assessing symptoms of post-traumatic stress disorder (PTSD) (PTSD Checklist-Civilian Version, PCL-C) and alcohol misuse (Alcohol Use Disorder Identification Test, AUDIT) were used. An abridged version of the PCL-C performed well in discriminating potential PTSD cases (as measured by the full instrument); AUDIT showed less discriminatory power, particularly due to poor specificity. Many cases missed by one abridged test would have been detected by an alternative test. Thus two-phase screening designs reduce the resource burden of a project without substantial loss of sensitivity for PTSD, but are less effective in discriminating potential cases of alcohol misuse. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Burdett, Howard; Fear, Nicola T; Jones, Norman; Greenberg, Neil; Wessely, Simon; Rona, Roberto J; Babor, Blake, Blanchard, Bliese, Cook, Dillman, Dunn, Fear, Fear, Galesic, Herzog, Hines, Hoge, Hotopf, Kang, Kroenke, Kroenke, Kroenke, Lang, Levin, Mulligan, Prins, Reinert, Reinert, Rona, Rona, Rona, Schwartz, Searle, Sundin, Terhakopian, VanGeest, Weathers, Youden, Zamorski, Zweig",2016.0,,0,0,
8584,Psychometric properties of the Affect Phobia Test.,"The aim of this study was to make the first evaluation of the psychometric properties of the Affect Phobia Test, using the Swedish translation-a test developed to screen the ability to experience, express and regulate emotions. Data was collected from a clinical sample (N = 82) of patients with depression and/or anxiety participating in randomized controlled trial of Internet-based affect-focused treatment, and a university student sample (N = 197). The internal consistency for the total score was satisfactory (Clinical sample alpha = 0.88/Student sample alpha = 0.84) as well as for all the affective domains, except Anger/Assertion (alpha = 0.44/0.36), Sadness/Grief (alpha = 0.24/0.46) and Attachment/Closeness (alpha = 0.67/0.69). Test retest reliability was satisfactory (ICC > 0.77) for the total score and for all the affective domains except for Sadness/Grief (ICC = 0.04). The exploratory factor analysis resulted in a six-factor solution and did only moderately match the test's original affective domains. An empirical cut-off between the clinical and the university student sample were calculated and yielded a cut-off of 72 points. As expected, the Affect Phobia test showed negative significant correlations in the clinical group with measures on depression (rxy = -0.229; p < 0.01) and anxiety (rxy = -0.315; p < 0.05). The conclusion is that the psychometric properties are satisfactory for the total score of the Affect Phobia Test but not for some of the test's affective domains. Consequently the domains should not be used as subscales. The test can discriminate between individuals who seek help for psychological problems and those who do not. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Frankl, My; Philips, Bjorn; Berggraf, Lene; Ulvenes, Pal; Johansson, Robert; Wennberg, Peter; Alcaro, Baker, Bartol, Bond, Cacioppo, Darwin, Davis, Frankl, Gamez, Greenberg, Gross, Gross, Harkness, Hayes, Hayes, Hayes, Jacobson, Johansson, Kahneman, LeDoux, LeDoux, Linehan, McCullough, McCullough, McCullough, McCullough Vaillant, Neff, Panksepp, Panksepp, Panksepp, Redelmeier, Shteynberg, Stanton, Stern, Tomkins, Zaki",2016.0,,0,0,
8585,Functional analytic psychotherapy compared to watchful waiting for enhancing social connectedness: A randomized clinical trial with a diagnosed sample.,"The efficacy of Functional Analytic Psychotherapy (FAP) has not yet been show in randomized controlled trials in any population. The current study utilized a stratified randomization technique conducted by a computer system to assign twenty-three college students recruited for difficulties in interpersonal functioning who scored one standard deviation below the norm on the Fear of Intimacy Scale and met diagnostic criteria via independent assessment for Major Depressive Disorder, Generalized Anxiety Disorder, Social Anxiety Disorder, Avoidant Personality Disorder, or Dependent Personality Disorder to either a FAP condition or a Watchful Waiting Condition to assess the conditions ability to increase social relating and decrease psychological distress immediately following treatment. Twenty-two (eleven in each condition) participant's results were analyzed showing mean differences reaching significance on the fear of intimacy scale and a measure of psychological distress (Psychiatric Diagnostic Screening Questionnaire). Additional measures showed emerging evidence that supports FAP's proposed mechanism of action. Results suggest that a brief FAP intervention can be beneficial for increasing interpersonal relating and decreasing psychological distress. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Maitland, Daniel W. M",2016.0,,0,0,
8586,Pilot RCT of the use of video interactive guidance with preterm babies.,"Objective: To assess the potential of video interaction guidance (VIG) to increase sensitivity in parents of preterm infants. Background: Parental sensitivity has been identified as explaining some but not all of the capacity of full-term infants for later affect-regulation via its impact on the infant's attachment system. Video interaction guidance (VIG) appears to be a promising intervention to improve parental sensitivity. Methods: A pilot randomised control trial was undertaken of the effectiveness of VIG in improving parental sensitivity using the CARE-Index as a primary outcome measure. Secondary outcomes included parenting stress, depression and anxiety, and post-traumatic stress. Data were collected at baseline and post-intervention, and analysed on an intent-to-treat basis, using analyses of covariance. Results: Thirty-one parents of an infant born at 32 weeks or less gestation were recruited from a city neonatal intensive care unit (NICU). The results show large but non-significant differences favouring the intervention group for both parental sensitivity (d = 0.86; p = 0.069) and infant cooperativeness (d = 0.78; p = 0.10). There were also medium to large non-significant differences favouring the intervention group for depression (d = 0.33; p = 0.41), anxiety (d = 0.38; p = 0.30), and parenting stress (d = 0.87; p = 0.14). There was no difference between groups in the proportion of parents with post-traumatic stress disorder (RR: 1.05; 95% CI: 0.85-1.37). Conclusion: VIG appears to be a promising intervention with which to increase parental sensitivity in parents of preterm infants, but additional components explicitly targeting parental trauma may also be needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Barlow, Jane; Sembi, Sukhdev; Underdown, Angela; Agostini, Ainsworth, Allen, Bakermans-Kranenburg, Bakermans-Kranenburg, Beebe, Behrman, Benzies, Borghini, Brecht, Campbell, Cassibba, Crittenden, Crittenden, Crnic, De Wolff, Field, Franck, Freedy, Gueron-Sela, Hoffenkamp, Holditch-Davis, Hoivik, Kalinauskiene, Kennedy, Klein Velderman, Korja, Landry, Longin, Madigan, Malatesta, McGowan, Meyer, Miles, Milgrom, Minde, Montirosso, Muller-Nix, Mykletun, Pierrehumbert, Prins, Salvatori, Sansaini, Schmucker, Terry, Terry, Treyvaud, van Doesum, Zelkowitz, Zigmond",2016.0,,0,0,
8587,Virtual reality exposure using three-dimensional images for the treatment of social phobia.,"Objective: To test a potential treatment for social phobia, which provides exposure to phobia-inducing situations via computer-generated, three-dimensional images, using an open clinical trial design. Methods: Twenty-one patients with a DSM-IV diagnosis of social phobia took part in the trial. Treatment consisted of up to 12 sessions of exposure to relevant images, each session lasting 50 minutes. Results: Improvements in social anxiety were seen in all scales and instruments used, including at follow-up 6 months after the end of treatment. The average number of sessions was seven, as the participants habituated rapidly to the process. Only one participant dropped out. Conclusion: This study provides evidence that exposure to computer-generated three-dimensional images is relatively inexpensive, leads to greater treatment adherence, and can reduce social anxiety. Further studies are needed to corroborate these findings. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Gebara, Cristiane M; Barros-Neto, Tito P. de; Gertsenchtein, Leticia; Lotufo-Neto, Francisco; Anderson, Barros-Neto, Beck, Blanco, Botella, Botella, Butler, Choi, Ciconelli, Emmelkamp, Fava, First, Forni-Santos, Favero, Garcia, Garcia-Palacios, Garcia-Palacios, Glantz, Gorenstein, Guy, Heimberg, Hollon, Ingul, Jorstad-Stein, Klinger, Krijn, Krijn, Liebowitz, Lincoln, Lister, Michaliszyn, Orsini, Price, Riva, Robillard, Rothbaum, Safir, Sheehan, Shiban, Wallach, Ware, Weissman, Weissman, Wolpe",2016.0,,0,0,
8588,"Effects of telephone-delivered cognitive-behavioral therapy and nondirective supportive therapy on sleep, health-related quality of life, and disability.","Objectives: The purpose of this study was to compare the effects of cognitive-behavioral therapy delivered by telephone (CBT-T) and telephone-delivered nondirective supportive therapy (NST-T) on sleep, health-related quality of life, and physical disability in rural older adults with generalized anxiety disorder. Methods: This was a secondary analysis of a randomized clinical trial on 141 rural-dwelling adults 60 years and older diagnosed with generalized anxiety disorder. Sleep was assessed with the Insomnia Severity Index. Health-related quality of life was assessed with the 36-item Short-Form Health Survey (SF-36). Physical disability was assessed with the Pepper Center Tool for Disability. Assessments occurred at baseline, 4 months, 9 months, and 15 months. Results: Insomnia declined in both groups from baseline to 4 months, with a significantly greater improvement among participants who received CBT-T. Similarly, Mental and Physical Component Summaries of the SF-36 declined in both groups, with a differential effect favoring CBT-T. Participants in both interventions reported declines in physical disability, although there were no significant differences between the two interventions. Improvements in insomnia were maintained at the 15-month assessment, whereas between-group differences shrank on the Mental and Physical Component Summaries of the SF-36 by the 15-month assessment. Conclusion: CBT-T was superior to NST-T in reducing insomnia and improving health-related quality of life. The effects of CBT-T on sleep were maintained 1 year after completing the treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Brenes, Gretchen A; Danhauer, Suzanne C; Lyles, Mary F; Anderson, Andrea; Miller, Michael E; Bastien, Beekman, Belleville, Benjamini, Borkovec, Borkovec, Brenes, Brenes, Brenes, Brenes, Bush, Butnoriene, Comer, Dam, Fernandez-Mendoza, Hendriks, Ip, Liang, Lu, Mackenzie, Martens, Phillips, Porensky, Rejeski, Stanley, Stanley, Stanley, Stone, Ware, Wetherell",2016.0,,0,0,
8589,E-mail support as an adjunct to cognitive-behavioral group therapy for social anxiety disorder: Impact on dropout and outcome.,"The present study evaluates the impact of semi-individualized e-mail support as an adjunct to cognitive behavioral group therapy (CBGT) for social anxiety disorder (SAD) on dropout and outcome. The effectiveness of additional semi-individualized e-mail support was evaluated for the whole sample and for a subsample of patients at risk of dropping out of therapy. A total of 91 patients with SAD were allocated either to the intervention condition (CBGT with e-mail support), or to the control condition (CBGT without e-mail support). Anxiety symptoms, depression, global symptomatology and life satisfaction were assessed at pretreatment, post-treatment and follow-up (3, 6 and 12 months). From pre-treatment to post-treatment, both groups improved significantly on all symptom measures. Therapy gains were maintained at the 1-year follow-up. Subsample analyses showed that CBGT+e-mail was more effective than CGBT alone in reducing symptom severity among patients missing at least two therapy sessions. Additionally, in this subgroup, those receiving additional e-mail support showed a tendency towards lower dropout rates. Based on the results of this study, semi-individualized e-mail support between sessions seems to enhance the effectiveness of CBGT for SAD patients at risk of dropping out of treatment and should be considered as an additional tool in clinical practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Delsignore, Aba; Rufer, Michael; Emmerich, Juliane; Weidt, Steffi; Bruhl, Annette Beatrix; Moergeli, Hanspeter; Andersson, Baker, Beck, Beck, Berger, Berger, Blanco, Carraro, Clark, Delsignore, Ebert, Fresco, Gadit, Gysin-Maillart, Hautzinger, Hedman, Heinrichs, Henrich, Hope, Klaghofer, Lancee, Lecrubier, Margraf, Matthick, McDaniel, McEvoy, Murdoch, Peterson, Pyle, Shingleton, Stangier, Tillfors, Titov, Wersebe, Wolf",2016.0,,0,0,
8590,Avoidance in hypochondriasis.,"The DSM-5 diagnosis of illness anxiety disorder adds avoidance as a component of a behavioral response to illness fears-one that was not present in prior DSM criteria of hypochondriasis. However, maladaptive avoidance as a necessary or useful criterion has yet to be empirically supported. Methods: 195 individuals meeting DSM-IV criteria for hypochondriasis based on structured interview completed a variety of self-report and clinician-administered assessments. Data on maladaptive avoidance were obtained using the six-item subscale of the clinician-administered Hypochondriasis-Yale Brown Obsessive Compulsive Scale-Modified. To determine if avoidance emerged as a useful indicator in hypochondriasis, we compared the relative fit of continuous latent trait, categorical latent class, and hybrid factor mixture models. Results: A two-class factor mixture model fit the data best, with Class 1 (n = 147) exhibiting a greater level of severity of avoidance than Class 2 (n = 48). The more severely avoidant group was found to have higher levels of hypochondriacal symptom severity, functional impairment, and anxiety, as well as lower quality of life. Conclusion: These results suggest that avoidance may be a valid behavioral construct and a useful component of the new diagnostic criteria of illness anxiety in the DSM-5, with implications for somatic symptom disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Doherty-Torstrick, Emily R; Walton, Kate E; Barsky, Arthur J; Fallon, Brian A; Abramowitz, Abramowitz, Bailer, Barsky, Barsky, Beck, Bergner, Burnham, Clark, Dillon, Endicott, Escobar, Fallon, Fallon, Fink, Finkelstein, Freud, Greeven, Guy, Hallquist, Harman, Harnam, Heywood, Kim, McLachlan, Muthen, Muthen, Neziroglu, Nylund, Odgers, Pilowsky, Rush, Salkovskis, Sheehan, Simmel, Skritskaya, Spielberger, Stevanovic, Storch, Storch, Wall, Walton, Warwick",2016.0,,0,0,
8591,Factors associated with pain level in non-cardiac chest pain patients with comorbid panic disorder.,"Background: Panic disorder (PD) is highly prevalent in patients with non-cardiac chest pain (NCCP). This study aims to explore the role of psychological factors (PD intensity, anxiety sensitivity, heart-related fear, attention and avoidance) common to NCCP and PD in predicting chest pain levels in patients with both conditions. Methods: This association was investigated in emergency department patients with NCCP and PD receiving either evidence-based treatment of PD or treatment as usual. Patients were assessed at baseline and 14 weeks later for post-treatment. Results: Only heart-focused fear and attention for cardiac sensations independently explained a significant portion of the variance in baseline pain (n = 66). At 3 months follow-up (n = 53), changes in heart-related fear was the only factor independently associated with changes in chest pain intensity. Even in patients with PD, fear specific to cardiac sensations seems to play a central role in determining NCCP intensity. Conclusion: These results suggest that the efficacy of intervention for patients with PD and comorbid NCCP could be improved by targeting heart-related fear and attention. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Foldes-Busque, Guillaume; Hamel, Stephanie; Belleville, Genevieve; Fleet, Richard; Poitras, Julien; Chauny, Jean-Marc; Vadeboncoeur, Alain; Lavoie, Kim L; Marchand, Andre; Aikens, Asmundson, Asmundson, Asmundson, Bandelow, Bandelow, Belleville, Bull Bringager, Carter, Cheung, Colloca, Craske, Craske, Dammen, De Cort, Deacon, DiNardo, Eifert, Eifert, Eifert, Eslick, Eslick, Fagring, Fagring, Fleet, Fleet, Foldes-Busque, Graham, Keogh, Keogh, Kessler, Marchand, Mayou, Melzack, Peterson, Potts, Reiss, van Beek, White, White, White, Woud",2016.0,,0,0,
8592,Depressive symptomatology mediates associations with community reintegration in veterans with TBI.,"Community reintegration (CR) is a challenge for military veterans with traumatic brain injury (TBI). Posttraumatic stress disorder (PTSD), depression, bodily pain, and limitations in physical functioning-common comorbidities with TBI in veterans-have all been associated with problems in CR, but their interrelationships are unclear. The role of depression as a possible mediator of effects on CR has not been examined. We tested depressive symptoms as a possible mediator of CR's associations with physical limitations, PTSD, and bodily pain. This cross-sectional study used baseline data from a larger randomized controlled trial that evaluated the impact of an in-home intervention for veterans with TBI and their families. Eighty-three military veterans with TBI recruited from a medical rehabilitation service at an urban U.S. Department of Veterans Affairs medical center participated in the study. Interview instruments measured CR, depressive symptoms, physical limitations (limitations in physical functioning), bodily pain, quality of the relationship with key family members, and sociodemographic characteristics. PTSD was determined through review of the electronic medical record. Interview data were collected in veterans' homes. Depressive symptoms totally mediated the association between physical limitations and CR and the association between PTSD and CR. The bodily pain-CR association was not significant after quality of relationship had been entered into the regression models. Findings suggest that interventions to increase CR of veterans with TBI should address depression, a treatable condition. Replication of our mediation findings in larger veteran and civilian samples with TBI is needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Moriarty, Helene; Winter, Laraine; True, Gala; Robinson, Keith; Short, Thomas H; Andresen, Arciniegas, Baron, Bronfenbrenner, Bryan, Bryant, Carlson, Chang, Chapman, Corrigan, Daggett, Doig, Efron, Fann, Fleming, Frazier, Freedman, Gomez-Hernandez, Gordon, Hadlandsmyth, Hart, Hibbard, Hoge, Holmbeck, Jorge, Jorge, Kazis, Kim, Kraemer, Kraemer, Kupersmith, Lequerica, Levin, MacKinnon, Malec, Mascialino, McCabe, Moldover, Moriarty, Moriarty, Okie, Otis, Pagulayan, Rao, Reistetter, Resnik, Resnik, Ross, Ruff, Ruff, Salter, Sander, Sayer, Sayer, Schmidt, Schneiderman, Schonberger, Shen, Sobel, Stalnacke, Tanev, Taylor, Terrio, Willemse-van Son, Williamson, Williamson, Williamson, Winkler, Winter, Zastowny",2016.0,,0,0,
8593,Effects of anxiety on caloric intake and satiety-related brain activation in women and men.,"Objective: To test the relationship of anxiety to caloric intake and food cue perception in women and men. Methods: Fifty-five twins (26 complete, 3 incomplete pairs; 51% women) underwent 2 functional magnetic resonance imaging (fMRI) scans (before and after a standardized meal) and then ate at an ad libitum buffet to objectively assess food intake. State and trait anxiety were assessed using the State-Trait Anxiety Inventory. During the fMRI scans, participants viewed blocks of fattening and nonfattening food images, and nonfood objects. Results: In women, higher trait anxiety was associated with a higher body mass index (BMI) (r = 0.40, p = .010). Trait anxiety was positively associated with kilocalories consumed at the buffet (r = 0.53, p = .005) and percent kilocalories consumed from fat (r = 0.30, p = .006), adjusted for BMI. In within-pair models, which control for shared familial and genetic factors, higher trait anxiety remained associated with kilocalories consumed at the buffet (p = .66, p = .014), but not with BMI. In men, higher state anxiety was related to macronutrient choices, but not to total caloric intake or BMI.FMRI results revealed that women with high trait anxiety did not suppress activation by fattening food cues across brain regions associated with satiety perception after eating a standardized meal (low anxiety, mean difference = -15.4, p < .001; high anxiety, mean difference = -1.53, p = .82, adjusted for BMI). Conclusions: In women, trait anxiety may promote excess caloric consumption through altered perception of high-calorie environmental food cues, placing women with genetic predispositions toward weight gain at risk of obesity. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Mestre, Zoe Lucille; Melhorn, Susan J; Askren, Mary K; Tyagi, Vidhi; Gatenby, Christopher; Young, Liza; Mehta, Sonya; Webb, Mary F; Grabowski, Thomas J; Schur, Ellen A; Anderson, Batterham, Berggren, Bergin, Bruce, Cornier, Desikan, Dimitropoulos, Elks, Flint, Gariepy, Goldstone, Greve, Hardaway, Herman, Hettema, Jarcho, Jenkinson, Jenkinson, Jenkinson, Julian, Killgore, LaBar, Lau, Lowe, Marniemi, Mehta, Mifflin, Platte, Polivy, Rothemund, Rutters, Schneider, Schur, Schur, Scott, Simon, Smeets, Spielberger, Stoeckel, Strachan, Stunkard, Stunkard, Sylvester, Uher, van der Laan, van Strien, Woolrich, Zhang, Zhao",2016.0,,0,0,
8594,Transdiagnostic internet-delivered cognitive behaviour therapy in Canada: An open trial comparing results of a specialized online clinic and nonspecialized community clinics.,"Effects of Internet-delivered cognitive behaviour therapy (ICBT) for anxiety and depression are not well understood when delivered in non-specialized as compared to specialized clinic settings. This open trial (n = 458 patients) examined the benefits of transdiagnostic-ICBT when delivered in Canada by therapists (registered providers or graduate students) working in either a specialized online clinic or one of eight nonspecialized community clinics. Symptoms of depression and anxiety were assessed at pre-treatment, post-treatment and at 3-month follow-up. Completion rates and satisfaction were high. Significant and large reductions (effect sizes 1.17-1.31) were found on symptom measures. Completion rates, satisfaction levels and outcomes did not differ whether ICBT was delivered by therapists working in a specialized online clinic or nonspecialized community clinics. Differences were also not found between registered providers and graduate students, or therapists trained in psychology or another discipline. The findings support the public health potential of ICBT. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Hadjistavropoulos, H. D; Nugent, M. M; Alberts, N. M; Staples, L; Dear, B. F; Titov, N; Allen, Andersson, Andersson, Andrews, Bandelow, Baumeister, Damschroder, Dear, Devilly, Donker, Flay, Gilbody, Glasgow, Gyani, Hadjistavropoulos, Hadjistavropoulos, Hedman, Houck, Jacobson, Johnston, Kazdin, Kenter, Kessler, Kessler, Kroenke, Kroenke, Manea, Newby, Peters, Rozental, Sheehan, Spitzer, Titov, Titov, Titov, Wang",2016.0,,0,0,
8595,Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for Social Anxiety Disorder and comorbid disorders: A randomized controlled trial.,"Disorder-specific (DS-CBT) and transdiagnostic (TD-CBT) cognitive behaviour therapy have both been used to treat social anxiety disorder (SAD). This study compared internet-delivered DS-CBT and TD-CBT for SAD across clinician-guided (CG-CBT) and self-guided (SG-CBT) formats. Participants with SAD (n=233) were randomly allocated to receive internet-delivered TD-CBT or DS-CBT and CG-CBT or SG-CBT. Large reductions in symptoms of SAD (Cohen's d >= 1.01; avg. reduction>=30%) and moderate-to-large reductions in symptoms of comorbid depression (Cohen's d >= 1.25; avg. reduction>=39%), generalised anxiety disorder (Cohen's d >= 0.86; avg. reduction>=36%) and panic disorder (Cohen's d >= 0.53; avg. reduction>=25%) were found immediately post-treatment and were maintained or further improved to 24-month follow-up. No marked differences were observed between TD-CBT and DS-CBT or CG-CBT and SG-CBT highlighting the potential of each for the treatment of SAD and comorbid disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Dear, B. F; Staples, L. G; Terides, M. D; Fogliati, V. J; Sheehan, J; Johnston, L; Kayrouz, R; Dear, R; McEvoy, P. M; Titov, N; Acarturk, Andersson, Andersson, Andersson, Andersson, Andrews, Andrews, Barlow, Berger, Berger, Butler, Clark, Clark, Clarke, Connor, Costa, Craske, Cuijpers, Cuijpers, Cuijpers, Dear, Dear, Dear, Dear, El Alaoui, Fehm, Fogliati, Fogliati, Griffith, Hoffman, Houck, Hubbard, Johnston, Kazdin, Kazdin, Kessler, Kroenke, Kroenke, Kroenke, Kroenke, Lecrubier, Leon, Liebowitz, Lowe, Mattick, McEvoy, McEvoy, McEvoy, McHugh, McManus, Newby, Norton, Osorio, Richards, Sheehan, Spinhoven, Spitzer, Stewart, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Titov, Waller, Weeks",2016.0,,0,0,
8596,Use of a structured mirrors intervention does not reduce delirium incidence but may improve factual memory encoding in cardiac surgical ICU patients aged over 70 years: A pilot time-cluster randomized controlled trial.,"Introduction: Post-operative delirium remains a significant problem, particularly in the older surgical patient. Previous evidence suggests that the provision of supplementary visual feedback about ones environment via the use of a mirror may positively impact on mental status and attention (core delirium diagnostic domains). We aimed to explore whether use of an evidence-based mirrors intervention could be effective in reducing delirium and improving post-operative outcomes such as factual memory encoding of the Intensive Care Unit (ICU) environment in older cardiac surgical patients. Methods: This was a pilot time-cluster randomized controlled trial at a 32-bed ICU, enrolling 223 patients aged 70 years and over, admitted to ICU after elective or urgent cardiac surgery from October 29, 2012 to June 23, 2013. The Mirrors Group received a structured mirrors intervention at set times (e.g., following change in mental status). The Usual Care Group received the standard care without mirrors. Primary outcome was ICU delirium incidence; secondary outcomes were ICU delirium days, ICU days with altered mental status or inattention, total length of ICU stay, physical mobilization (balance confidence) at ICU discharge, recall of factual and delusional ICU memories at 12 weeks, Health-Related Quality of Life at 12 weeks, and acceptability of the intervention. Results: The intervention was not associated with a significant reduction in ICU delirium incidence [Mirrors: 20/115 (17%); Usual Care: 17/108 (16%)] or duration [Mirrors: 1 (1-3); Usual Care: 2 (1-8)]. Use of the intervention on ICU was predictive of significantly higher recall of factual (but not delusional) items at 12 weeks after surgery (p = 0.003) and acceptability was high, with clinicians using mirrors at 86% of all recorded hourly observations. The intervention did not significantly impact on other secondary outcomes. Conclusion: Use of a structured mirrors intervention on the post-operative ICU does not reduce delirium, but may result in improved factual memory encoding in older cardiac surgical patients. This effect may occur via mechanisms unrelated to delirium, altered mental status, or inattention. The intervention may provide a new means of improving outcomes in patients at risk of post-ICU anxiety and/or Post-Traumatic Stress Disorder. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Giraud, Kimberly; Pontin, Megan; Sharples, Linda D; Fletcher, Paul; Dalgleish, Tim; Eden, Allaina; Jenkins, David P; Vuylsteke, Alain; Altschuler, Brown, Corlett, Ely, Ely, Freysteinson, Freysteinson, Girard, Gottesman, Hughes, Inouye, Inouye, Jones, Jones, Jones, Koster, Milbrandt, Murray, Nashef, Page, Papke, Powell, Rudolph, Sackey, Schneider, Schweickert, Sessler, Sutbeyaz, Tabak, Vanhaudenhuyse, Zou",2016.0,,0,0,
8597,"Mindfulness-Oriented Recovery Enhancement versus CBT for cooccurring substance dependence, traumatic stress, and psychiatric disorders: Proximal outcomes from a pragmatic randomized trial.","In many clinical settings, there is a high comorbidity between substance use disorders, psychiatric disorders, and traumatic stress. Novel therapies are needed to address these co-occurring issues efficiently. The aim of the present study was to conduct a pragmatic randomized controlled trial comparing Mindfulness-Oriented Recovery Enhancement (MORE) to group Cognitive-Behavioral Therapy (CBT) and treatment-as-usual (TAU) for previously homeless men residing in a therapeutic community. Men with co-occurring substance use and psychiatric disorders, as well as extensive trauma histories, were randomly assigned to 10 weeks of group treatment with MORE (n = 64), CBT (n = 64), or TAU (n = 52). Study findings indicated that from pre-to post-treatment MORE was associated with modest yet significantly greater improvements in substance craving, post-traumatic stress, and negative affect than CBT, and greater improvements in post-traumatic stress and positive affect than TAU. A significant indirect effect of MORE on decreasing craving and post-traumatic stress by increasing dispositional mindfulness was observed, suggesting that MORE may target these issues via enhancing mindful awareness in everyday life. This pragmatic trial represents the first head-to-head comparison of MORE against an empirically-supported treatment for co-occurring disorders. Results suggest that MORE, as an integrative therapy designed to bolster self-regulatory capacity, may hold promise as a treatment for intersecting clinical conditions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Garland, Eric L; Roberts-Lewis, Amelia; Tronnier, Christine D; Graves, Rebecca; Kelley, Karen; Baer, Baker, Boden, Bowen, Bryant, Chiesa, Cukor, Derogatis, DiClemente, Eldridge, Fazel, Flannery, Flynn, Garland, Garland, Garland, Garland, Garland, Garland, Garland, Garland, Garland, Garland, Garland, Garland, Gerger, Goyal, Kearney, Kelly, Khantzian, Kilgore, King, Koob, Koob, Leeies, Little, Magor-Blatch, Monti, Mylle, Najavits, Najavits, Najavits, Najavits, Najavits, Norcross, Roberts, Roland, Satterthwaite, Schnurr, Sheehan, Singer, Skinner, Torchalla, Urbaniak, Watson, Weathers, Witkiewitz",2016.0,,0,0,
8598,Exercise training and health-related quality of life in generalized anxiety disorder.,"Objective: To quantify the effects of six-weeks of resistance (RET) and aerobic exercise training (AET) on quality of life (QoL) among sedentary women with Generalized Anxiety Disorder (GAD). Design: Data from our published randomized controlled trial of the effects of six-weeks of either RET or AET among GAD patients were analyzed. Method: Thirty women with GAD were randomized to either six weeks of twice-weekly lower-body weightlifting or cycling, or wait-list control (WL). SF-36 subscales assessed dimensions of QoL. Hedges' d effect sizes (95%CIs) quantified the magnitude of change in response to exercise training compared to WL. Results: RET significantly improved role-physical (d = 1.04; 95%CI: [0.11-1.97]), role-emotional (d = 0.96; [0.04-1.89]), and mental health (d = 1.05; [0.11-1.98]). AET resulted in significant improvements in physical function (d = 1.31; [0.34-2.27]) and vitality (d = 0.93; [0.01-1.85]). Conclusions: Exercise training improves dimensions of QoL among GAD patients. The largest effects were observed for role impairments, physical function, vitality, and mental health. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Herring, Matthew P; Johnson, Kristen E; O'Connor, Patrick J; Alonso, Blair, Brown, Cumming, Hedges, Henning, Herring, Herring, Hoffman, Inaba, Kessler, Kessler, Kessler, Kessler, Kimura, Lindheimer, Martin, Meyer, Newman, Rosenbaum, Schmitz, Sillanpaa, van Tol, Ware, Zimmerman",2016.0,,0,0,
8599,Trait anxiety mediates the effect of stress exposure on post-traumatic stress disorder and depression risk in cardiac surgery patients.,"Background: Post-traumatic stress disorder (PTSD) and depression are common after cardiac surgery. Lifetime stress exposure and personality traits may influence the development of these psychiatric conditions. Methods: Self-reported rates of PTSD and depression and potential determinants (i.e., trait anxiety and stress exposure) were established 1.5 to 4 years after cardiac surgery. Data was available for 1125 out of 1244 (90.4%) participants. Multivariable linear regressions were conducted to investigate mediating and/or moderating effects of trait anxiety on the relationship between stress exposure, and PTSD and depression. Pre-planned subgroup analyses were performed for both sexes. Results: PTSD and depression symptoms were present in 10.2% and 13.1% of the participants, respectively. Trait anxiety was a full mediator of the association between stress exposure and depression in both the total cohort and female and male subgroups. Moreover, trait anxiety partially mediated the relationship between stress exposure and PTSD in the full cohort and the male subgroup, whereas trait anxiety fully mediated this relationship in female patients. Trait anxiety did not play a moderating role in the total patient sample, nor after stratification on gender. Limitations: The unequal distribution of male (78%) and female patients (22%) might limit the generalizability of our findings. Furthermore, risk factors were investigated retrospectively and with variable follow-up time. Conclusions: In cardiac surgery patients, trait anxiety was found to be an important mediator of postoperative PTSD and depression. Prospective research is necessary to verify whether these factors are reliable screening measures of individuals' vulnerability for psychopathology development after cardiac surgery. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Kok, Lotte; Sep, Milou S; Veldhuijzen, Dieuwke S; Cornelisse, Sandra; Nierich, Arno P; van der Maaten, Joost; Rosseel, Peter M; Hofland, Jan; Dieleman, Jan M; Vinkers, Christiaan H; Joels, Marian; van Dijk, Diederik; Hillegers, Manon H; Agorastos, Aiken, Barnes, Baron, Beck, Beck, Bening, Bernstein, Binder, Bouchoucha, Dieleman, DiGangi, Donders, Dortland, Dozois, Gold, Granja, Griffiths, Groenwold, Holmbeck, Hong, Horovitz, Hovens, Jaksic, Jones, Kadak, Koeske, Kok, Kraemer, Kress, Kvaal, Little, Maripuu, McKhann, Musselman, Nashef, Penacoba-Puente, Pirraglia, Rubin, Scott, Solomon, Spielberger, Spindler, Thombs, Tully, Van der Ploeg, Van Zelst, Van Zelst, Van Zuiden, Van Zuiden, Vinkers, Viswanath, Wolfe",2016.0,,0,0,
8600,"Stigma, perceived barriers to treatment, attitudes, and readiness to change in recent trauma survivors: A randomized controlled trial of an online intervention.","Trauma exposure is common in the general population. A portion of these individuals go on to develop acute stress reactions immediately following a trauma and are at risk for developing posttraumatic stress disorder (PTSD). While treatments are available individuals do not initiate care due to various barriers. Attitudes regarding treatment and readiness to seek help may contribute to such barriers. Evidence-based internet interventions offer a useful strategy to reduce barriers to treatment across a variety of populations. One way to enhance treatment engagement among recent trauma survivors may be to provide online interventions focused on psychoeducation and motivational enhancement to seek more intensive forms of care. The purpose of this pilot study was to examine stigma and barriers to treatment, trauma-related barriers to treatment, attitudes regarding professional help, and readiness to seek treatment among trauma survivors who were yet to seek professional trauma related services. Participants were randomly assigned to a control or intervention condition. The intervention consisted of several interactive modules outlining education regarding trauma symptoms, treatment options, and motivational enhancement exercises regarding seeking treatment, and overcoming trauma-specific barriers to seeking help. Results indicated significant associations such that greater avoidance was associated with greater perceived stigma and barriers to care, greater trauma-specific barriers to care and less positive attitudes toward treatment at baseline. More positive attitudes toward seeking help were associated with lower perceived stigma and barriers to care, lower trauma-specific barriers to care, and greater readiness to change at baseline. Following the online intervention significant differences occurred. Participants in the intervention condition showed a greater increase in readiness to change compared to the control condition. This pilot study adds to the literature on attitudinal barriers and readiness to change in recent trauma survivors and provides evidence that a brief online educational and motivational enhancement intervention is feasible and effective in impacting readiness to change. Despite methodological and sample size limitations, this study suggests important directions for clinical practice and future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Esfahani, Sahar",2016.0,,0,0,
8601,Non-invasive ultrasonic thalamic stimulation in disorders of consciousness after severe brain injury: A first-in-man report.,"Presents a study which aims to present a first-in-man report of non-invasive ultrasonic thalamic stimulation in disorders of consciousness after severe brain injury. As part of a ""first-in-man"" clinical trial aimed at testing the feasibility, safety, and initial efficacy of thalamic low intensity focused ultrasound pulsation (LIFUP) in patients suffering from post-traumatic disorders of consciousness (DOC), the authors recruited one patient. The procedure included four clinical assessments of level of consciousness and responsiveness. Two assessments occurred pre-LIFUP sonication, one on the day prior to sonication and one on the day of. Two clinical assessments occurred post-LIFUP, one on the day of sonication and one on the day after. Three days post-LIFUP the patient demonstrated full language comprehension, reliable response to command, and reliable communication, consistent with emergence from MCS. Five days post-LIFUP the patient attempted to walk. The post-LIFUP improvements also suggest that the procedure was well tolerated and safe. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Monti, Martin M; Schnakers, Caroline; Korb, Alexander S; Bystritsky, Alexander; Vespa, Paul M; Bystritsky, Giacino, Giacino, Legon, Monti, Monti, Schiff, Schiff, Thibaut, Yoo",2016.0,,0,0,
8602,Associations between PTSD and intimate partner and non-partner aggression among substance using veterans in specialty mental health.,"Background: Risk factors of violence perpetration in veterans include substance use and posttraumatic stress disorder (PTSD); however, it is unknown whether these factors are associated with greater risk for partner or non-partner violence. This study investigated the associations between probable PTSD, heavy drinking, marijuana use, cocaine use, and partner and non-partner violence perpetration. Methods: Self-report questionnaires assessing past-year partner and non-partner aggression (CTS2) as well as past-month substance use (SAOM), probable PTSD (PCL-C), and probable depression (PHQ-9) were administered to 810 substance using veterans entering VA mental health treatment. Results: In bivariate analyses, probable PTSD in substance using veterans was associated with violence perpetration (partner physical, chi2 = 11.46, p = 0.001, phi = 0.12; non-partner physical, chi2 = 50.64, p < 0.001, phi = 0.25; partner injury, chi2 = 6.41, p = 0.011, phi = 0.09; non-partner injury, chi2 = 42.71, p < 0.001, phi = 0.23). In multiple logistic regression analyses that adjusted for sociodemographic characteristics, probable PTSD was independently associated with non-partner physical (odds ratio [OR], 2.82; 95% confidence interval [CI], 1.97-4.05) and injury aggression (OR, 3.96; CI, 2.56-6.13). Cocaine and heavy drinking were independently associated with non-partner physical and injury aggression and non-partner injury aggression respectively. Conclusions: The results provide evidence that probable PTSD, heavy drinking, and cocaine use are associated with increased risk of non-partner violence perpetration in substance using veterans. These results underscore the importance of screening for PTSD symptoms and violence perpetration towards non-partners in substance using veterans presenting for treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Buchholz, Katherine R; Bohnert, Kipling M; Sripada, Rebecca K; Rauch, Sheila A. M; Epstein-Ngo, Quyen M; Chermack, Stephen T; Alexandercikova, Brown, Chermack, Chermack, Chermack, Chermack, Crane, Driessen, Elbogen, Epstein-Ngo, Epstein-Ngo, Hahn, Harford, Heinz, Kroenke, Macdonald, MacManus, Marshall, Moore, Murphy, Murray, Najavits, Najavits, Najavits, O'Farrell, O'Farrell, Okuda, Owens, Pulay, Ruggiero, Seal, Simpson, Singh, Smith, Sontag, Stappenbeck, Straus, Taft, Taft, Teten, Walton, Walton, Weathers",2017.0,,0,0,
8603,Treating depression and anxiety with digital cognitive behavioural therapy for insomnia: A real world NHS evaluation using standardized outcome measures.,"Background: Evidence suggests that insomnia may be an important therapeutic target to improve mental health. Aims: Evaluating changes in symptoms of depression and anxiety after supported digital cognitive behavioural therapy (dCBT) for insomnia delivered via a community-based provider (Self Help Manchester) of the Improving Access to Psychological Therapies (IAPT) service. Method: Supported dCBT for insomnia was delivered to 98 clients (mean age 44.9 years, SD 15.2, 66% female) of Self Help Manchester. All clients received six support calls from an eTherapy coordinator to support the self-help dCBT. During these calls levels of depression (Patient Health Questionnaire, PHQ-9) and anxiety (Generalized Anxiety Disorder, GAD-7) were determined. Results: Depression (Mdifference-5.7, t(70) = 12.5, p < .001) and anxiety [Generalized Anxiety Disorder-7 (GAD-7), Mdifference-4.1, t(70) = 8.0, p < .001] were reduced following supported dCBT for insomnia. This translated into an IAPT recovery rate of 68% for depression and anxiety. Conclusions: These results suggest that dCBT for insomnia alleviates depression and anxiety in clients presenting with mental health complaints in routine healthcare. (PsycINFO Database Record (c) 2016 APA, all rights reserved)","Luik, Annemarie I; Bostock, Sophie; Chisnall, Leanne; Kyle, Simon D; Lidbetter, Nicky; Baldwin, Nick; Espie, Colin A; Bastien, Christensen, Espie, Gyani, Kroenke, Spitzer",2017.0,,0,0,
8604,Oral health and oral treatment needs in patients fulfilling the DSM-IV criteria for dental phobia: Possible influence on the outcome of cognitive behavioral therapy.,"To describe oral health and oral treatment needs in a group of dental phobic patients (DSM-IV) and to explore possible relationships between these factors and changes in self-reported dental anxiety before and after phobia treatment. Forty patients (25 women) fulfilling the DSM-IV criteria for specific phobia were included in the study. Mean age of the group was 34.9 years (range 19-60) and mean dental avoidance was 11.2 years (range 3-30 years). They were treated with cognitive behavioral therapy (CBT) during either one session (3 h) or five sessions (1 h each). Oral health was evaluated by orthopantomogram and clinical examination. The outcome of the CBT was measured by the change in dental anxiety scores (DAS, DFS) and in positive and negative thoughts during a standardized dental behavior test from pretreatment to 1-year follow-up. Mean (SD) DMFT was 16.5 (5.8), range 3-26; DT was 6.6 (4.2). Mean number of teeth with dental treatment need (restorative, periodontal, extractions, etc.) was 9.6 (6.9), range 1-28. There were statistically significant correlations between number of decayed teeth and decrease in negative thoughts (r=-0.39, p=0.048) and maximum anxiety (r=-0.65, p=0.001). The total number of teeth with treatment need correlated with an increase in positive thoughts (r=0.60, p=0.001) and decrease in maximum anxiety (r=0.50, p=0.015). There are large variations in oral health and treatment needs among patients fulfilling the DSM-IV criteria for dental phobia. Patients with the best dental health and lowest treatment needs experience the largest increase in positive cognitions during exposure to dental treatment at 1-year follow-up.",Agdal ML.; Raadal M.; Skaret E.; Kvale G.,2008.0,10.1080/00016350701793714,0,0,
8605,Maternal anxiety predicts favourable treatment outcomes in anxiety-disordered adolescents.,"To determine the differential impact of maternal and paternal internalizing psychopathology on cognitive-behavioural treatment (CBT) outcome of anxiety-disordered children and adolescents. Participants consisted of 127 children and 51 adolescents with a primary anxiety diagnosis. Children were randomly assigned to a standardized group CBT or individual CBT; adolescents received individual CBT. Parents received four training sessions. Participants were evaluated at pre- and post-treatment with a clinical interview and with self- and parent-reported questionnaires. Lifetime anxiety and mood disorders in parents were obtained with a clinical interview. For children, no associations were found between maternal and paternal anxiety or mood disorders and treatment outcome. For adolescents, however, maternal lifetime anxiety disorders were positively associated with pre-post-treatment improvement in clinician severity ratings and with treatment success. Lifetime maternal anxiety disorders were significantly associated with favourable treatment outcomes in adolescents. Paternal disorders were not associated with treatment response.",Legerstee JS.; Huizink AC.; van Gastel W.; Liber JM.; Treffers PD.; Verhulst FC.; Utens EM.,2008.0,10.1111/j.1600-0447.2008.01161.x,0,0,
8606,Borderline personality characteristics and treatment outcome in cognitive-behavioral treatments for PTSD in female rape victims.,"Many studies report that comorbid borderline personality pathology is associated with poorer outcomes in the treatment of Axis I disorders. Given the high rates of comorbidity between borderline personality pathology and posttraumatic stress disorder (PTSD), it is essential to determine whether borderline symptomatology affects PTSD treatment outcome. This study examined the effects of borderline personality characteristics (BPC) on 131 female rape victims receiving cognitive-behavioral treatment for PTSD. Higher BPC scores were associated with greater pretreatment PTSD severity; however, individuals with higher levels of BPC were just as likely to complete treatment and also as likely to show significant treatment response on several outcome measures. There were no significant interactions between type of treatment and BPC on the outcome variables. Findings suggest that women with borderline pathology may be able to benefit significantly from cognitive-behavioral treatment for PTSD.",Clarke SB.; Rizvi SL.; Resick PA.,2008.0,10.1016/j.beth.2007.05.002,0,0,
8607,Rostral anterior cingulate volume predicts treatment response to cognitive-behavioural therapy for posttraumatic stress disorder.,"To index the extent to which treatment response in posttraumatic stress disorder (PTSD) is predicted by rostral anterior cingulate cortex (rACC) volume. We used structural magnetic resonance imaging in a 1.5 T scanner to examine subjects with PTSD (n = 13), traumatized control subjects (n = 13) and nontraumatized control subjects (n = 13). Subjects with PTSD then participated in 8 sessions of cognitive-behavioural therapy, after which we reassessed them for PTSD. According to voxel-based morphometry, treatment responders had larger rACC volume than nonresponders. Further, symptom reduction was associated with larger rACC volume. Consistent with evidence for the neural bases of extinction learning, PTSD patients with larger rACC volume may be better able to regulate fear during cognitive-behavioural therapy and thus achieve greater treatment gains.",Bryant RA.; Felmingham K.; Whitford TJ.; Kemp A.; Hughes G.; Peduto A.; Williams LM.,2008.0,,0,0,
8608,Evaluation of a brief aerobic exercise intervention for high anxiety sensitivity.,"Anxiety sensitivity, or the belief that anxiety-related sensations can have negative consequences, has been shown to play an important role in the etiology and maintenance of panic disorder and other anxiety-related pathology. Aerobic exercise involves exposure to physiological cues similar to those experienced during anxiety reactions. The present study sought to investigate the efficacy of a brief aerobic exercise intervention for high anxiety sensitivity. Accordingly, 24 participants with high anxiety sensitivity scores (Anxiety Sensitivity Index-Revised scores >28) were randomly assigned to complete either six 20-minute sessions of aerobic exercise or a no-exercise control condition. The results indicated that individuals assigned to the aerobic exercise condition reported significantly less anxiety sensitivity subsequent to exercise, whereas anxiety sensitivity scores among non-exercisers did not significantly change. The clinical research and public health implications of these findings are discussed, and several potential directions for additional research are recommended.",Broman-Fulks JJ.; Storey KM.,2008.0,10.1080/10615800701762675,0,0,
8609,Change in interpersonal problems after cognitive agoraphobia and schema-focused therapy versus psychodynamic treatment as usual of inpatients with agoraphobia and Cluster C personality disorders.,"The aim was to study whether patients with panic disorder with agoraphobia and co-occurring Cluster C traits would respond differently regarding change in interpersonal problems as part of their personality functioning when receiving two different treatment modalities. Two cohorts of patients were followed through three months' in-patient treatment programs and assessed at follow-up one year after end of treatment. The one cohort comprised 18 patients treated with ""treatment as usual"" according to psychodynamic principles, the second comprised 24 patients treated in a cognitive agoraphobia and schema-focused therapy program. Patients in the cognitive condition showed greater improvement in interpersonal problems than patients in the treatment as usual condition. Although this quasi-experimental study has serious limitations, the results may indicate that agoraphobic patients with Cluster C traits should be treated in cognitive agoraphobia and schema-focused programs rather than in psychodynamic treatment as usual programs in order to reduce their level of interpersonal problems.",Gude T.; Hoffart A.,2008.0,10.1111/j.1467-9450.2008.00629.x,0,0,
8610,A spiritually based group intervention for combat veterans with posttraumatic stress disorder: feasibility study.,"To assess the feasibility, effect sizes, and satisfaction of mantram repetition -- the spiritual practice of repeating a sacred word/phrase throughout the day -- for managing symptoms of posttraumatic stress disorder (PTSD) in veterans. A two group (intervention vs. control) by two time (pre- and postintervention) experimental design was used. Veterans were randomly assigned to intervention (n = 14) or delayed-treatment control (n = 15). Measures were PTSD symptoms, psychological distress, quality of life, and patient satisfaction. Effect sizes were calculated using Cohen's d. Thirty-three male veterans were enrolled, and 29 (88%) completed the study. Large effect sizes were found for reducing PTSD symptom severity (d = -.72), psychological distress (d = -.73) and increasing quality of life (d = -.70). A spiritual program was found to be feasible for veterans with PTSD. They reported moderate to high satisfaction. Effect sizes show promise for symptom improvement but more research is needed.",Bormann JE.; Thorp S.; Wetherell JL.; Golshan S.,2008.0,10.1177/0898010107311276,0,0,
8611,[Isometric hip muscle strength in posttraumatic below-knee amputees].,"Traumas and war injuries, next to chronic occlusive artery disease and diabetes mellitus-derived complications, are the most frequent cause of the lower limbs amputation. They affect mostly younger population that need a higher level of activities as compared with the elderly. Medical rehabilitation is very significant for the muscle performance improvement in this population providing their social reintegration. The aim of this study was to investigate the effect of below-knee amputation on the hip isometric muscle strength and effect of rehabilitation on improvement of hip muscle strength in below-knee amputees, secondary to war wounding. Forty below-knee amputees (after war wounding), average age 35.6 +/- 10.6 years, that were included in primary rehabilitation program with prosthetics, were examined. Objective parameters were used to evaluate therapeutical effects. Isometric muscle strength of hip flexors, extensors, abductors and adductors was measured by dynamometer and expressed in Newton (N) at admission, control and discharge for each patient. Average length of the treatment was 51 +/- 34.1 days. For isometric hip flexors (t = -1.99346, p < 0.05), extensors (t = -4.629073, p < 0.001), abductors (t = -4.9408, p < 0.001) and adductors (t = -2.00228, p < 0.05), muscle strength was significantly less on the amputated than on nonamputated side. The highest differences in muscle strength between amputated and nonamputated limbs were noted for hip abductors (26.6%) and extensors (23.3%). There was significant improvement of mean values of strength for all examined hip muscles after rehabilitation and prosthetics for both legs in comparison to beginning of the therapy. The hip abductor on the amputated side was for 19.4% weaker after rehabilitation in comparison to the non-amputated limb. Decreases of isometric muscle strength in all examined hip muscles were observed, more in the amputated limb. Rehabilitation with prosthetics is a successful method for improving isometric hip muscle strength on the both, amputated and non-amputated limbs in war wounded below-knee amputees.",Jandrić S.,2007.0,,0,0,6477
8612,Magnetic resonance imaging finding in severe head injury patients with normal computerized tomography.,"Computerized tomography (CT) has been the primary diagnostic instrument of neurosurgical centers for head injury until now. However, there is a subgroup of patients who have persisting neurological deficits without visible pathology on CT. Between 2000 and 2002, 3000 patients were enrolled in this prospective study in emergency unit. There was a total of 124 patients (4.1%) who had persisting severe neurological deficits with normal findings on repeated CT scans. These patients underwent 1.5 Tesla cranial MRI study between posttraumatic days 2 and 10 (5.2+/-4.5). Data on epidemiological, clinical, radiological factors and final outcome were collected. 76 (61.2%) of the patients were male and 48 (38.7%) were female. 113 (91.1%) of the 124 patients showed significant primary pathology on MRI study. The most common pathology was shear injuries in 75 (60.4%) followed by cortical contusion in 45 (36.2%) cases. 27 (21.7%) patients showed primary brain stem lesions and 8 (0.6%) patients showed subcortical gray matter lesions. 32 patients showed mixed lesions. There was one traumatic aneurysm detected. The MRI examination in head injury is informative in detecting subtle lesions when the neurological condition cannot be explained by CT.",Kara A.; Celik SE.; Dalbayrak S.; Yilmaz M.; Akansel G.; Tireli G.,2008.0,,0,0,
8613,Combined therapy of major depression with concomitant borderline personality disorder: comparison of interpersonal and cognitive psychotherapy.,"The combination of antidepressants and brief psychotherapies has been proven more efficacious in treating major depression and is particularly recommended in patients with concomitant personality disorders. We compare the effects of 2 combined therapies, fluoxetine and interpersonal therapy (IPT) or fluoxetine and cognitive therapy (CT), on major depression in patients with borderline personality disorder (BPD). Thirty-five consecutive outpatients with a diagnosis of BPD and a major depressive episode (not bipolar and not psychotic) were enrolled. They were randomly assigned to 1 of the 2 combined treatments and treated for 24 weeks. Assessment included a semistructured interview, Clinical Global Impression (CGI) scale, Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Beck Depression Inventory-II (BDI-II), Social and Occupational Functioning Assessment Scale (SOFAS), Satisfaction Profile (SAT-P) for quality of life (QOL), and Inventory of Interpersonal Problems (IIP-64). Statistical analysis was performed using the univariate General Linear Model to calculate the effects of duration and type of treatment. No significant differences between treatments were found at CGI, HDRS, BDI-II, and SOFAS score. Combined treatment with CT had greater effects on HARS score and on psychological functioning factor of SAT-P. Combined treatment with IPT was more effective on social functioning factor of SAT-P and on domains domineering or controlling and intrusive or needy of IIP-64. Both combined therapies are efficacious in treating major depression in patients with BPD. Differences between CT and IPT concern specific features of subjective QOL and interpersonal problems. These findings lack reliable comparisons and need to be replicated.",Bellino S.; Zizza M.; Rinaldi C.; Bogetto F.,2007.0,10.1177/070674370705201106,0,0,
8614,"Establishing family foundations: intervention effects on coparenting, parent/infant well-being, and parent-child relations.","This study investigated the ability of a theoretically driven, psychosocial prevention program implemented through childbirth education programs to enhance the coparental relationship, parental mental health, the parent-child relationship, and infant emotional and physiological regulation. A sample of 169 heterosexual, adult couples who were expecting their 1st child was randomized to intervention and control conditions. The intervention families participated in Family Foundations, a series of 8 classes, delivered before and after birth, that was designed as a universal prevention program (i.e., it was applicable to all couples, not just those at high risk). Intent-to-treat analyses indicated significant program effects on coparental support, maternal depression and anxiety, distress in the parent-child relationship, and several indicators of infant regulation. Intervention effects were not moderated by income, but greater positive impact of the program was found for lower educated parents and for families with a father who reported higher levels of insecure attachment in close relationships. These findings support the view that coparenting is a potentially malleable intervention target that may influence family relationships as well as parent and child well-being.",Feinberg ME.; Kan ML.,2008.0,10.1037/0893-3200.22.2.253,0,0,
8615,Transference interpretations in dynamic psychotherapy: do they really yield sustained effects?,"Transference interpretation has remained a core ingredient in the psychodynamic tradition, despite limited empirical evidence for its effectiveness. In this study, the authors examined long-term effects of transference interpretations. This was a randomized controlled clinical trial, dismantling design, plus follow-up evaluations 1 year and 3 years after treatment termination. One hundred outpatients seeking psychotherapy for depression, anxiety, personality disorders, and interpersonal problems were referred to the study therapists. Patients were randomly assigned to receive weekly sessions of dynamic psychotherapy for 1 year with or without transference interpretations. Five full sessions from each therapy were rated in order to document treatment fidelity. Outcome variables were the Psychodynamic Functioning Scales (clinician rated) and the Inventory of Interpersonal Problems (self-report). Rating on the Quality of Object Relations Scale (lifelong pattern) and presence of a personality disorder were postulated moderators of treatment effects. Change over time was assessed using linear mixed models. Despite an absence of differential treatment efficacy, both treatments demonstrated significant improvement during treatment and also after treatment termination. However, patients with a lifelong pattern of poor object relations profited more from 1 year of therapy with transference interpretations than from therapy without transference interpretations. This effect was sustained throughout the 4-year study period. The goal of transference interpretation is sustained improvement of the patient's relationships outside of therapy. Transference interpretation seems to be especially important for patients with long-standing, more severe interpersonal problems.",H√∏glend P.; B√∏gwald KP.; Amlo S.; Marble A.; Ulberg R.; Sjaastad MC.; S√∏rbye O.; Heyerdahl O.; Johansson P.,2008.0,10.1176/appi.ajp.2008.07061028,0,0,
8616,The relationship of treatment preferences and experiences to outcome in generalized anxiety disorder (GAD).,"The relationship of treatment preferences and experiences to outcome was explored in patients with generalized anxiety disorder (GAD). Patients were randomly allocated to either affect-focused body psychotherapy (ABP) (N=26) or standard psychiatric out-patient treatment (N=17). Initial preferences and subsequent experiences of treatment interventions were measured using a questionnaire focusing on support, inward reflection, concrete and directive problem solving, and affective expression. Outcome was assessed after 1 and 2 years in relation to symptom change. ABP patients reported being helped by supportive and reflective treatment interventions to a greater extent than controls. ABP patients also had more positive experiences of supportive and emotionally expressive interventions than they had expected at initial assessment. When patients were divided into two groups on the basis of patterns of preferences and experiences using cluster analysis, it was found that differences in outcome were considerably more marked for clusters than treatment groups. It is concluded that treatment preferences may have considerable interpersonal potential in therapy; how therapists utilize this potential may be important for improving outcome.",Levy Berg A.; Sandahl C.; Clinton D.,2008.0,10.1348/147608308X297113,0,0,
8617,The effect of telephone counselling on reducing post-traumatic symptoms after mild traumatic brain injury: a randomised trial.,"Mild traumatic brain injury (MTBI) is a significant public health problem affecting approximately 1 million people annually in the USA. A total of 10-15% of individuals are estimated to have persistent post-traumatic symptoms. This study aimed to determine whether focused, scheduled telephone counselling during the first 3 months after MTBI decreases symptoms and improves functioning at 6 months. This was a two-group, parallel, randomised clinical trial with the outcome assessed by blinded examiner at 6 months after injury. 366 of 389 eligible subjects aged 16 years or older with MTBI were enrolled in the emergency department, with an 85% follow-up completion rate. Five telephone calls were completed, individualised for patient concerns and scripted to address education, reassurance and reactivation. Two composites were analysed, one relating to post-traumatic symptoms that developed or worsened after injury and their impact on functioning, the other related to general health status. The telephone counselling group had a significantly better outcome for symptoms (6.6 difference in adjusted mean symptom score, 95% confidence interval (CI) 1.2 to 12.0), but no difference in general health outcome (1.5 difference in adjusted mean functional score, 95% CI 2.2 to 5.2). A smaller proportion of the treatment group had each individual symptom (except anxiety) at assessment. Similarly, fewer of the treatment group had daily functioning negatively impacted by symptoms with the largest differences in work, leisure activities, memory and concentration and financial independence. Telephone counselling, focusing on symptom management, was successful in reducing chronic symptoms after MTBI. ClinicalTrials.gov, #NCT00483444.",Bell KR.; Hoffman JM.; Temkin NR.; Powell JM.; Fraser RT.; Esselman PC.; Barber JK.; Dikmen S.,2008.0,10.1136/jnnp.2007.141762,0,0,
8618,The panic attack-posttraumatic stress disorder model: applicability to orthostatic panic among Cambodian refugees.,"This article examines the ability of the panic attack-posttraumatic stress disorder (PTSD) model to predict how panic attacks are generated and how panic attacks worsen PTSD. The article does so by determining the validity of the panic attack-PTSD model in respect to one type of panic attack among traumatized Cambodian refugees: orthostatic panic (OP) attacks (i.e. panic attacks generated by moving from lying or sitting to standing). Among Cambodian refugees attending a psychiatric clinic, the authors conducted two studies to explore the validity of the panic attack-PTSD model as applied to OP patients (i.e. patients with at least one episode of OP in the previous month). In Study 1, the panic attack-PTSD model accurately indicated how OP is seemingly generated: among OP patients (N = 58), orthostasis-associated flashbacks and catastrophic cognitions predicted OP severity beyond a measure of anxious-depressive distress (Symptom Checklist-90-R subscales), and OP severity significantly mediated the effect of anxious-depressive distress on Clinician-Administered PTSD Scale severity. In Study 2, as predicted by the panic attack-PTSD model, OP had a mediational role in respect to the effect of treatment on PTSD severity: among Cambodian refugees with PTSD and comorbid OP who participated in a cognitive behavioural therapy study (N = 56), improvement in PTSD severity was partially mediated by improvement in OP severity.",Hinton DE.; Hofmann SG.; Pitman RK.; Pollack MH.; Barlow DH.,2008.0,10.1080/16506070801969062,0,0,
8619,Multiple channel exposure therapy for women with PTSD and comorbid panic attacks.,"Multiple channel exposure therapy (M-CET; Falsetti & Resnick, 2000) was developed to treat posttraumatic stress disorder (PTSD) with comorbid panic attacks and can be administered in a group format. In addition to being a cost-effective way to provide treatment, group treatment for those with PTSD has been proposed as potentially very beneficial for addressing feelings of shame related to the traumatic event as well as social isolation in general (Foy et al., 2000). Previous studies of M-CET indicate that it may be effective for the treatment of PTSD with comorbid panic attacks (Falsetti et al., 2001, 2003, 2005). The authors examine the relationship of PTSD and panic symptoms pre- and posttreatment and present 6-month follow-up data on the long-term effectiveness of M-CET.",Falsetti SA.; Resnick HS.; Davis JL.,2008.0,10.1080/16506070801969088,0,0,
8620,"Improvement of psychic and somatic symptoms in adult patients with generalized anxiety disorder: examination from a duloxetine, venlafaxine extended-release and placebo-controlled trial.","This study examined the efficacy and tolerability of duloxetine and venlafaxine extended-release (XR) treatment for generalized anxiety disorder (GAD), with a secondary focus on psychic and somatic symptoms within GAD. The design was a 10-week, multi-center, double-blind placebo-controlled study of duloxetine (20 mg or 60-120 mg once daily) and venlafaxine XR (75-225 mg once daily) treatment. Efficacy was measured using the Hamilton Anxiety Rating Scale (HAMA), which includes psychic and somatic factor scores. Tolerability was measured by occurrence of treatment-emergent adverse events (TEAEs) and discontinuation rates. Adult out-patients (mean age 42.8 years; 57.1% women) with DSM-IV-defined GAD were randomly assigned to placebo (n=170), duloxetine 20 mg (n=84), duloxetine 60-120 mg (n=158) or venlafaxine XR 75-225 mg (n=169) treatment. Each of the three active treatment groups had significantly greater improvements on HAMA total score from baseline to endpoint compared with placebo (p=0.01-0.001). For the HAMA psychic factor score, both duloxetine treatment arms and venlafaxine XR demonstrated significantly greater improvement compared with placebo (p=0.01-0.001). For the HAMA somatic factor score, the mean improvement in the duloxetine 60-120 mg and venlafaxine XR groups was significantly greater than placebo (p0.05 and p0.01 respectively), whose mean improvement did not differ from the duloxetine 20 mg group (p=0.07). Groups did not differ in study discontinuation rate due to adverse events. Duloxetine and venlafaxine treatment were each efficacious for improvement of core psychic anxiety symptoms and associated somatic symptoms for adults with GAD.",Nicolini H.; Bakish D.; Duenas H.; Spann M.; Erickson J.; Hallberg C.; Ball S.; Sagman D.; Russell JM.,2009.0,10.1017/S0033291708003401,0,0,
8621,Deep brain stimulation of the ventral internal capsule/ventral striatum for obsessive-compulsive disorder: worldwide experience.,"Psychiatric neurosurgery teams in the United States and Europe have studied deep brain stimulation (DBS) of the ventral anterior limb of the internal capsule and adjacent ventral striatum (VC/VS) for severe and highly treatment-resistant obsessive-compulsive disorder. Four groups have collaborated most closely, in small-scale studies, over the past 8 years. First to begin was Leuven/Antwerp, followed by Butler Hospital/Brown Medical School, the Cleveland Clinic and most recently the University of Florida. These centers used comparable patient selection criteria and surgical targeting. Targeting, but not selection, evolved during this period. Here, we present combined long-term results of those studies, which reveal clinically significant symptom reductions and functional improvement in about two-thirds of patients. DBS was well tolerated overall and adverse effects were overwhelmingly transient. Results generally improved for patients implanted more recently, suggesting a 'learning curve' both within and across centers. This is well known from the development of DBS for movement disorders. The main factor accounting for these gains appears to be the refinement of the implantation site. Initially, an anterior-posterior location based on anterior capsulotomy lesions was used. In an attempt to improve results, more posterior sites were investigated resulting in the current target, at the junction of the anterior capsule, anterior commissure and posterior ventral striatum. Clinical results suggest that neural networks relevant to therapeutic improvement might be modulated more effectively at a more posterior target. Taken together, these data show that the procedure can be successfully implemented by dedicated interdisciplinary teams, and support its therapeutic promise.",Greenberg BD.; Gabriels LA.; Malone DA.; Rezai AR.; Friehs GM.; Okun MS.; Shapira NA.; Foote KD.; Cosyns PR.; Kubu CS.; Malloy PF.; Salloway SP.; Giftakis JE.; Rise MT.; Machado AG.; Baker KB.; Stypulkowski PH.; Goodman WK.; Rasmussen SA.; Nuttin BJ.,2010.0,10.1038/mp.2008.55,0,0,
8622,Anxiety symptom focus in sessions of cognitive therapy for depression.,"The comorbid patient presents an especially difficult problem to a therapist who is attempting to implement a short-term, focused therapy. The current study investigates the effect of comorbid anxiety on cognitive therapy for depression. Participants were a subset of patients (N=24) assigned to the cognitive therapy arm of a large, randomized, controlled trial of treatment for depression. From intake assessments, patients were classified as having low or high levels of comorbid anxiety. Two videotapes of each patient's therapy sessions were coded. Irrespective of intake anxiety level, more time and effort spent addressing anxiety in session was found to predict less improvement in both depression and anxiety symptoms over the course of treatment.",Gibbons CJ.; DeRubeis RJ.,2008.0,10.1016/j.beth.2007.05.006,0,0,
8623,Is the collaborative chronic care model effective for patients with bipolar disorder and co-occurring conditions?,"The effectiveness of bipolar collaborative chronic care models (B-CCMs) among those with co-occurring substance use, psychiatric, and/or medical conditions has not specifically been assessed. We assessed whether B-CCM effects are equivalent comparing those with and without co-occurring conditions. We reanalyzed data from the VA Cooperative Study #430 (n=290), an 11-site randomized controlled trial of the B-CCM compared to usual care. Moderators included common co-occurring conditions observed in patients with bipolar disorder, including substance use disorders (SUD), anxiety, psychosis; medical comorbidities (total number), and cardiovascular disease-related conditions (CVD). Mixed-effects regression models were used to determine interactive effects between moderators and 3-year primary outcomes. Treatment effects were comparable for those with and without co-occurring substance use and psychiatric conditions, although possibly less effective in improving physical quality of life in those with CVD-related conditions (Beta=-6.11;p=0.04). Limitations included multiple comparisons and underpowered analyses of moderator effects. B-CCM effects were comparable in patients with co-occurring conditions, indicating that the intervention may be generally applied. Specific attention to physical quality of life in those with CVD maybe warranted.",Kilbourne AM.; Biswas K.; Pirraglia PA.; Sajatovic M.; Williford WO.; Bauer MS.,2009.0,10.1016/j.jad.2008.04.010,0,0,
8624,Family history of psychological problems in generalized anxiety disorder.,"The current investigation examined self-reported family history of psychological problems in a large sample of individuals diagnosed with generalized anxiety disorder (GAD) and nonanxious controls. The GAD participants were all individuals receiving cognitive-behavioral therapy as part of two large randomized clinical trials. Family history information was obtained from the Anxiety Disorders Interview Schedule-Revised (ADIS-R; DiNardo & Barlow, 1988). The results indicate that, compared to control participants, individuals with GAD were more likely to have family members with anxiety problems, but not other psychological problems. Possible mechanisms for the familial transmission of GAD are discussed.",McLaughlin KA.; Behar E.; Borkovec TD.,2008.0,10.1002/jclp.20497,0,0,
8625,Treatment of acute stress disorder: a randomized controlled trial.,"Recent trauma survivors with acute stress disorder (ASD) are likely to subsequently develop chronic posttraumatic stress disorder (PTSD). Cognitive behavioral therapy for ASD may prevent PTSD, but trauma survivors may not tolerate exposure-based therapy in the acute phase. There is a need to compare nonexposure therapy techniques with prolonged exposure for ASD. To determine the efficacy of exposure therapy or trauma-focused cognitive restructuring in preventing chronic PTSD relative to a wait-list control group. A randomized controlled trial of civilians who experienced trauma and who met the diagnostic criteria for ASD (N = 90) seen at an outpatient clinic between March 1, 2002, and June 30, 2006. Patients were randomly assigned to receive 5 weekly 90-minute sessions of either imaginal and in vivo exposure (n = 30) or cognitive restructuring (n = 30), or assessment at baseline and after 6 weeks (wait-list group; n = 30). Measures of PTSD at the 6-month follow-up visit by clinical interview and self-report assessments of PTSD, depression, anxiety, and trauma-related cognition. Intent-to-treat analyses indicated that at posttreatment, fewer patients in the exposure group had PTSD than those in the cognitive restructuring or wait-list groups (33% vs 63% vs 77%; P = .002). At follow-up, patients who underwent exposure therapy were more likely to not meet diagnostic criteria for PTSD than those who underwent cognitive restructuring (37% vs 63%; odds ratio, 2.10; 95% confidence interval, 1.12-3.94; P = .05) and to achieve full remission (47% vs 13%; odds ratio, 2.78; 95% confidence interval, 1.14-6.83; P = .005). On assessments of PTSD, depression, and anxiety, exposure resulted in markedly larger effect sizes at posttreatment and follow-up than cognitive restructuring. Exposure-based therapy leads to greater reduction in subsequent PTSD symptoms in patients with ASD when compared with cognitive restructuring. Exposure should be used in early intervention for people who are at high risk for developing PTSD.",Bryant RA.; Mastrodomenico J.; Felmingham KL.; Hopwood S.; Kenny L.; Kandris E.; Cahill C.; Creamer M.,2008.0,10.1001/archpsyc.65.6.659,0,0,
8626,Continual training of attentional bias in social anxiety.,"Using the dot-probe paradigm, it has been shown that high social anxiety is associated with an attentional bias toward negative information. In the present study, individuals with high social anxiety were divided into two groups randomly. One group was the attentional bias training group (Group T), and the other was the control group (Group C). For Group T, 7 days' continuous training of attentional bias was conducted using the dot-probe paradigm to make socially anxious individuals focus more on positive face pictures. The results showed that the training was effective in changing attentional bias in Group T. Scores of the Social Interaction Anxiety Scale (SIAS) in Group T were reduced compared to Group C, while the scores of Social Phobia Scale (SPS) and scores of Negative Evaluation Scale (FNE) showed no difference between the two groups, which suggested a limited reduction of social anxiety.",Li S.; Tan J.; Qian M.; Liu X.,2008.0,10.1016/j.brat.2008.04.005,0,0,
8627,Is age a key determinant of mortality and neurological outcome after acute traumatic spinal cord injury?,"Given the potential impact of age on mortality, neurological outcomes and the extent of post-traumatic neural degeneration, we examined these issues using a large, prospectively accrued clinical database (n=485) supplemented by analysis of postmortem spinal cord tissue (n=12) to compare axonal survival and white matter degeneration in younger versus elderly individuals with spinal cord injury (SCI). Elderly individuals (> or = 65 years) had significantly greater mortality rates than younger individuals at 30 days, at 6 months and at 1 year following SCI (46.88% versus 4.86%, respectively; p<0.0001). However, among survivors, age was not significantly associated with motor and sensory outcomes at 6 weeks, 6 months and 1 year post-SCI in univariate and multivariate analyses. Correspondingly, neuroanatomical analysis of postmortem spinal cord tissue revealed no significant age-related differences for extent of myelin degeneration or number of intact axons within sensory, motor and autonomic spinal cord tracts post-SCI. Treatment protocols for SCI need to identify preventable predictors of mortality in the elderly post-SCI, recognizing that the potential for neurological recovery among elderly survivors of SCI is similar to that of younger individuals.",Furlan JC.; Bracken MB.; Fehlings MG.,2010.0,10.1016/j.neurobiolaging.2008.05.003,0,0,
8628,A group randomized trial of critical incident stress debriefing provided to U.S. peacekeepers.,"In a group randomized trial of critical incident stress debriefing (CISD) with platoons of 952 peacekeepers, CISD was compared with a stress management class (SMC) and survey-only (SO) condition. Multilevel growth curve modeling found that CISD did not differentially hasten recovery compared to the other two conditions. For those soldiers reporting the highest degree of exposure to mission stressors, CISD was minimally associated with lower reports of posttraumatic stress and aggression (vs. SMC), higher perceived organizational support (vs. SO), and more alcohol problems than SMC and SO. Soldiers reported that they liked CISD more than the SMC, and CISD did not cause undue distress.",Adler AB.; Litz BT.; Castro CA.; Suvak M.; Thomas JL.; Burrell L.; McGurk D.; Wright KM.; Bliese PD.,2008.0,10.1002/jts.20342,0,0,
8629,Pilot study on prolonged exposure of Japanese patients with posttraumatic stress disorder due to mixed traumatic events.,"This pilot study investigated the feasibility of Prolonged Exposure (PE) treatment for Japanese patients with posttraumatic stress disorder (PTSD) due to mixed traumatic events. Among 12 participants in this study, 9 women and 1 man completed between 9 and 15 weekly individual PE sessions; 2 female participants dropped out in early sessions. Among completers, the authors identified a significant reduction of symptom severity scores from pretreatment to posttreatment in terms of PTSD and depression on therapist-rated and self-rated measurements. Symptom levels remained low in 3- and 6-month follow-up assessments. Our findings suggest that PE is feasible and can be accepted for PTSD patients not only in Western countries, but also for those in Japan.",Asukai N.; Saito A.; Tsuruta N.; Ogami R.; Kishimoto J.,2008.0,10.1002/jts.20337,0,0,
8630,Single-case experimental studies of a self-help manual for traumatic stress in earthquake survivors.,"Studies showed that earthquake-related posttraumatic stress disorder could be reduced by a single session of therapist instructions for self-exposure to fear cues. Eight single-case experimental studies examined whether such instructions were as effective when delivered through a self-help manual after an initial assessment. After two baseline assessments conducted at the participants homes, the manual was delivered to the participants, who were then assessed at week 10 (post-treatment) and at 1-, 3-, and 6-month post-treatment. After minimal improvement during the baseline, treatment achieved marked improvement in seven survivors, leading to effect sizes comparable to those obtained by therapist-delivered treatment. Self-help appears to be a promising approach in cost-effective survivor care.",Başoğlu M.; Salcioğlu E.; Livanou M.,2009.0,10.1016/j.jbtep.2008.04.001,0,0,
8631,"A randomized, controlled trial of group cognitive-behavioral therapy for compulsive buying disorder: posttreatment and 6-month follow-up results.","The purpose of this study was to conduct a randomized trial comparing the efficacy of a group cognitive-behavioral therapy (CBT) intervention designed for the treatment of compulsive buying disorder to a waiting list control (WLC) group. Thirty-one patients with compulsive buying problems according to the criteria developed by McElroy et al. were assigned to receive active treatment (12 weekly sessions and 6-month follow-up) and 29 to the WLC group. The treatment was specifically aimed at interrupting and controlling the problematic buying behavior, establishing healthy purchasing patterns, restructuring maladaptive thoughts and negative feelings associated with shopping and buying, and developing healthy coping skills. Primary outcome measures were the Compulsive Buying Scale (CBS), the Yale-Brown Obsessive Compulsive Scale-Shopping Version (YBOCS-SV), and the German Compulsive Buying Scale (G-CBS). Secondary outcome measures were the Symptom Checklist-90-Revised (SCL-90-R), the Barratt Impulsiveness Scale (BIS-11), and the Saving Inventory-Revised (SI-R). The study was completed between November 2003 and May 2007 at the University Hospital of Erlangen, Bavaria, Germany. Multivariate analysis revealed significant differences between the CBT and the WLC groups on the primary outcome variables (outcome-by-time-by-group effect, Pillai's trace, F = 6.960, df = 1, p = .002). The improvement was maintained during the 6-month follow-up. The treatment did not affect other psychopathology, e.g., compulsive hoarding, impulsivity, or SCL-90-R scores. We found that lower numbers of visited group therapy sessions and higher pretreatment hoarding traits as measured with the SI-R total score were significant predictors for nonresponse. The results suggest that a disorder-specific cognitive-behavioral intervention can significantly impact compulsive buying behavior.",Mueller A.; Mueller U.; Silbermann A.; Reinecker H.; Bleich S.; Mitchell JE.; de Zwaan M.,2008.0,,0,0,
8632,Change in posttraumatic stress disorder symptoms: do clinicians and patients agree?,"This study assessed the longitudinal association between clinician and patient ratings of posttraumatic stress disorder (PTSD) symptoms over the course of 2 different randomized clinical trials of veterans with chronic PTSD. One trial, the Department of Veterans Affairs Cooperative Study 420 (CSP 420; N = 360) compared trauma-focused and present-centered group therapies, and the 2nd trial compared cognitive processing theory and a waitlist control condition (N = 60). Linear mixed effects modeling revealed significant associations between clinician ratings (Clinician-Administered PTSD Scale; CAPS; D. D. Blake et al., 1990) and patient ratings (Posttraumatic Stress Disorder Checklist; PCL; F. W. Weathers, B. T. Litz, J. A. Herman, J. A. Huska, & T. M. Keane, 1993) in total and symptom clusters of PTSD. Contrary to hypothesis, the amount of change on the CAPS ranged from .75 to .82 standard deviations for every 1 standard deviation change on the PCL. The CAPS and PCL were more closely associated in the trauma-focused vs. present-centered treatment condition in CSP 420, and especially regarding hyperarousal symptoms. When comparing categorization of clinically significant change on the CAPS and PCL, the authors found no differences in the percentages of agreement between clinicians and patients in improvement and exacerbation. The value of multimodal assessment of PTSD treatment outcomes is discussed.",Monson CM.; Gradus JL.; Young-Xu Y.; Schnurr PP.; Price JL.; Schumm JA.,2008.0,10.1037/1040-3590.20.2.131,0,0,
8633,Study protocol: the Intensive Care Outcome Network ('ICON') study.,"Extended follow-up of survivors of ICU treatment has shown many patients suffer long-term physical and psychological consequences that affect their health-related quality of life. The current lack of rigorous longitudinal studies means that the true prevalence of these physical and psychological problems remains undetermined. The ICON (Intensive Care Outcome Network) study is a multi-centre, longitudinal study of survivors of critical illness. Patients will be recruited prior to hospital discharge from 20-30 ICUs in the UK and will be assessed at 3, 6, and 12 months following ICU discharge for health-related quality of life as measured by the Short Form-36 (SF-36) and the EuroQoL (EQ-5D); anxiety and depression as measured by the Hospital Anxiety and Depression Scale (HADS); and post traumatic stress disorder (PTSD) symptoms as measured by the PTSD Civilian Checklist (PCL-C). Postal questionnaires will be used. The ICON study will create a valuable UK database detailing the prevalence of physical and psychological morbidity experienced by patients as they recover from critical illness. Knowledge of the prevalence of physical and psychological morbidity in ICU survivors is important because research to generate models of causality, prognosis and treatment effects is dependent on accurate determination of prevalence. The results will also inform economic modelling of the long-term burden of critical illness. ISRCTN69112866.",Griffiths JA.; Morgan K.; Barber VS.; Young JD.,2008.0,10.1186/1472-6963-8-132,0,0,
8634,Self-esteem in patients with borderline and avoidant personality disorders.,"This study compared self-esteem in patients with avoidant personality disorder (APD) and borderline personality disorder (BPD). Patients diagnosed with one or more personality disorders answered the questionnaire Index of Self Esteem as part of a comprehensive evaluation within the setting of a treatment trial. Our hypotheses were that (1) both patients with APD and patients with BPD would report low levels of self-esteem, (2) patients with APD would report lower self-esteem than patients with BPD. We further expected that (3) patients with higher levels of depression would report lower levels of self-esteem, but that (4) both borderline and avoidant personality pathology would contribute to explained variance in self-esteem beyond what would be accounted for by depression. All of our hypotheses were supported. The results from our study showed a significant difference in self-esteem level between the two personality disorders, patients with APD reporting lower self-esteem than patients with BPD. Subjects with both disorders were measured to have self-esteem levels within the range that presumes clinical problems. Self-esteem represents an important quality of subjective experience of the self, and the study of self-esteem in PDs can offer new and important knowledge of PDs as self-pathology.",Lynum LI.; Wilberg T.; Karterud S.,2008.0,10.1111/j.1467-9450.2008.00655.x,0,0,
8635,"Rationale, design, and baseline findings from a randomized trial of collaborative care for chronic musculoskeletal pain in primary care.","This article describes the rationale, design, and baseline findings from an ongoing study of collaborative care for chronic musculoskeletal pain and comorbid depression. Cluster randomized clinical trial. Forty-two clinicians and 401 patients from five Veterans Affairs primary care clinics. The intervention was based on the chronic care model, and included patient and provider activation and education, patient assessment, outcomes monitoring, and feedback to providers over 12 months. The intervention team consisted of a full-time psychologist care manager and a part-time physician internist. Approaches included goal setting emphasizing function, patient activation and educating about fear avoidance, and care management. Main outcomes are Roland-Morris Disability Questionnaire (RMDQ) score, depression severity (Patient Health Questionnaire-9), and pain severity (Chronic Pain Grade Severity subscale) at 6 and 12 months. Fifteen percent of primary care patients mailed a study advertisement letter requested screening for the study. The mean age of enrolled patients was 62. Back and neck or joint pain diagnoses were present in 67% and 65% of patients, respectively. Mean pain duration was 15 years, and mean RMDQ score (range 0-24) was 14.7 (standard deviation = 4.4). Sixty-five percent of patients were receiving disability. Eighteen percent of patients met criteria for major depression, 17% for posttraumatic stress disorder, and 9% for alcohol misuse. Thirty-nine percent of patients felt strongly that experiencing pain was a sign of damage, and 60% reported strong avoidance of painful activities. These baseline data support the rationale to develop a multifaceted approach to treat chronic pain in primary care that includes detection and treatment of psychiatric comorbidity.",Dobscha SK.; Corson K.; Leibowitz RQ.; Sullivan MD.; Gerrity MS.,2008.0,10.1111/j.1526-4637.2008.00457.x,0,0,
8636,"Hypnotherapy in the treatment of chronic combat-related PTSD patients suffering from insomnia: a randomized, zolpidem-controlled clinical trial.","This study evaluated the benefits of add-on hypnotherapy in patients with chronic PTSD. Thirty-two PTSD patients treated by SSRI antidepressants and supportive psychotherapy were randomized to 2 groups: 15 patients in the first group received Zolpidem 10 mg nightly for 14 nights, and 17 patients in the hypnotherapy group were treated by symptom-oriented hypnotherapy, twice-a-week 1.5-hour sessions for 2 weeks. All patients completed the Stanford Hypnotic Susceptibility Scale, Form C, Beck Depression Inventory, Impact of Event Scale, and Visual Subjective Sleep Quality Questionnaire before and after treatment. There was a significant main effect of the hypnotherapy treatment with PTSD symptoms as measured by the Posttraumatic Disorder Scale. This effect was preserved at follow-up 1 month later. Additional benefits for the hypnotherapy group were decreases in intrusion and avoidance reactions and improvement in all sleep variables assessed.",Abramowitz EG.; Barak Y.; Ben-Avi I.; Knobler HY.,2008.0,10.1080/00207140802039672,0,0,
8637,"Cognitive-behaviour therapy for patients with Abridged Somatization Disorder (SSI 4,6) in primary care: a randomized, controlled study.","Somatoform disorders are characterized by the presence of multiple somatic symptoms without an organic cause that completely explains their symptoms. These patients generate a high cost in health services. We aim to evaluate the effectiveness and feasibility of a cognitive-behaviour therapy (CBT) programme, administered in group and individual formats in primary care for patients who are diagnosed with abridged somatization disorder.  Multicentre, randomized, controlled trial involving 3 groups, one of which is the control group consisting of standardized recommended treatment for somatization disorder in primary care (Smith's norms) and the 2 others, the intervention groups, consisting of cognitive-behavioural therapy (10 sessions) administered in individual format (intervention group 1) or in group format (intervention group 2). 29 primary care health centres in the province of Zaragoza and 3 primary care health centres in the province of Mallorca, Spain. N = 204 patients, (68 in each of the three groups), aged 18-65 years, able to understand and read Spanish, who fulfil Escobar's criteria of Abridgged Somatization Disorder (SSI 4,6), stable with pharmacotherapy over the previous month, and who will remain stable for the next 3 months in the doctor's opinion, having signed informed consent.  Standardized recommended treatment for somatization disorder in primary care (Smith's norms). INTERVENTION group: 10 weekly sessions of CBT, following a protocol designed by Prof. Escobar's group at UMDNJ, USA. There are 2 different treatment conditions: individual and group format. Survey on the use of health services, number and severity of somatic symptoms, anxiety, depression, quality of life and clinical global impression. The interviewers will not know which group the patient belongs to (blind). The assessments will be carried out at baseline, post-treatment, 6 months and 12 post-treatment. Utilization of health services, number and severity of somatic symptoms. The analysis will be per intent to treat. We will use the general linear models of the SPSS v.15 statistical package, to analyse the effect of treatment on the result variable (utilization of health services, number and severity of somatic symptoms). It is necessary to develop more effective psychological treatments for somatoform disorders. This randomised clinical trial will determine whether cognitive behaviour therapy, both in group or in individual format, is effective for the treatment of these patients. Current controlled trials ISRCTN69944771.",Magallón R.; Gili M.; Moreno S.; Bauzá N.; García-Campayo J.; Roca M.; Ruiz Y.; Andrés E.,2008.0,10.1186/1471-244X-8-47,0,0,
8638,A preliminary study of fMRI-guided rTMS in the treatment of generalized anxiety disorder.,"Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive method that holds promise for treating several psychiatric disorders. Yet the most effective location and parameters for treatment need more exploration. Also, whether rTMS is an effective treatment for individuals with a DSM-IV diagnosis of generalized anxiety disorder (GAD) has not been empirically tested. The goal of this pilot study was to evaluate whether functional magnetic resonance imaging (fMRI)-guided rTMS is effective in reducing symptoms of GAD. Ten participants with a DSM-IV diagnosis of GAD, recruited from the UCLA Anxiety Disorders Program, and between the ages of 18 and 56 years were enrolled in the study from August 2006 to March 2007. A pretreatment symptom provocation fMRI experiment was used to determine the most active location in the prefrontal cortex of the participants. Ten participants completed 6 sessions of rTMS over the course of 3 weeks, stereotactically directed to the previously determined prefrontal location. The primary efficacy measures were the Hamilton Rating Scale for Anxiety (HAM-A) and the Clinical Global Impressions-Improvement of Illness (CGI-I) scale. Response to treatment was defined as a reduction of 50% or more on the HAM-A and a CGI-I score of 1 or 2 (""very much improved"" or ""much improved,"" respectively). Overall, rTMS was associated with significant decreases in HAM-A scores (t = 6.044, p = .001) indicative of clinical improvement in GAD symptoms. At endpoint, 6 (60%) of the 10 participants who completed the study showed reductions of 50% or more on the HAM-A and a CGI-I score of 1 or 2; those 6 subjects also had an endpoint HAM-A score < 8, therefore meeting criteria for remission. Results of the current study suggest that fMRI-guided rTMS treatment may be a beneficial technique for the treatment of anxiety disorders. Limitations include a small sample size and open-label design with a technology that may be associated with a large placebo response. These limitations necessitate further research to determine whether rTMS is indeed effective in treating anxiety disorders.",Bystritsky A.; Kaplan JT.; Feusner JD.; Kerwin LE.; Wadekar M.; Burock M.; Wu AD.; Iacoboni M.,2008.0,,0,0,
8639,A naturalistic prospective open study of the effects of adjunctive therapy of sexual dysfunction in chronic PTSD patients.,"Post-traumatic Stress Disorder (PTSD) symptoms cause dysfunction in broad areas of patients' lives and those of their families. Sexual dysfunction (SD) is common in these patients and aggravates their distress, affecting overall sexual activity, desire, arousal, orgasm, activity and satisfaction. PTSD clinic patients are frequently referred for consultation and treatment in the SD clinic. This prospective naturalistic follow-up study of a random group of patients was intended to evaluate response to pharmacologic and psychotherapeutic interventions for SD, in terms of both sexual functioning and overall symptomatology. Ten patients fulfilling DSM-IV diagnostic criteria for PTSD (one woman and nine men) were recruited. Treatment for the sexual symptoms was tailored individually and was administered in addition to the continuing (stable) treatment in the PTSD clinic. After two months of treatment for the sexual symptoms, statistically significant improvements in all domains of sexual functioning were observed. In parallel, statistically significant improvements in all domains of the Impact of Events Scale scores were observed, both on the avoidance and intrusive subscales. There were no significant differences in response to treatment in terms of time elapsed since the onset of PTSD, or the pattern or severity of sexual and PTSD symptoms. The results of this modest study demonstrate the importance of relating to the SD of PTSD patients irrespective of the duration or severity of their disorder. In this mixed group of PTSD patients with varied duration of symptoms, both SD and PTSD core symptoms improved significantly in response to individually tailored adjunctive treatment of the SD.",Chudakov B.; Cohen H.; Matar MA.; Kaplan Z.,2008.0,,0,0,
8640,Can imaginal exposure reduce intrusive memories in depression? A case study.,"The presence of intrusive memories as an overlapping feature of depression and posttraumatic stress disorder (PTSD) raises the possibility that common therapeutic approaches may be effective. Imaginal exposure (IE) is the gold-standard treatment for PTSD and directly reduces both PTSD and depression symptoms in traumatized individuals. The objective of this pilot study was to use a single-case design to trial the use of IE to target intrusive memories of a negative life event as a treatment for major depression. The participant was experiencing depression after a relationship breakup. Pre-posttreatment measures (clinical interview and self-report) showed a decrease in frequency of intrusive memories and improved mood, such that the participant no longer met diagnostic criteria for major depression at posttreatment or at 6-month follow-up. This case is an important first step in demonstrating the possible value of IE as an inclusion in therapy to reduce intrusive memories in patients whose depressive episode is precipitated by a stressor. Further application of IE to additional depressed clients in the context of a case series is needed to provide preliminary evidence of its efficacy as a treatment for depressive disorders.",Kandris E.; Moulds ML.,2008.0,10.1080/16506070802117950,0,0,
8641,The effectiveness of cognitive behavioral therapy for generalized anxiety disorder in a frontline service setting.,"The goal of the current study was to test the generalizability of cognitive behavioral therapy (CBT) for generalized anxiety disorder (GAD) in a frontline service setting. Twenty-nine patients who presented to treatment clinics with problematic worry were provided CBT for GAD. Among the intent-to-treat sample, there were no significant changes in worry or depression from pre- to posttreatment. Treatment completers showed significant pre- to posttreatment reductions on measures of worry and depression. The magnitude of change was smaller than has been reported in randomized control trials (RCTs). Although the frontline service setting differed from RCT settings in multiple ways, treatment completers nonetheless achieved moderate to large decreases in self-reported worry and depression.",Kehle SM.,2008.0,10.1080/16506070802190262,0,0,
8642,Treatment of panic disorder with agoraphobia: randomized placebo-controlled trial of four psychosocial treatments combined with imipramine or placebo.,"Few randomized controlled trials have included panic disorder patients with moderate to severe agoraphobia. Therefore, this population was studied using pharmacotherapy as well as psychotherapy. At the time of the study, imipramine was widely used as a pharmacological treatment. Also, current practice guidelines for patients with panic disorder find selective serotonin reuptake inhibitors and tricyclic antidepressants roughly comparable in terms of efficacy. Therefore, the main objective of this study is to compare four psychosocial treatments-cognitive and graded in vivo exposure treatments, graded in vivo exposure, cognitive treatment, and supportive therapy-to evaluate the benefits of combining cognitive therapy with exposure in vivo. These treatments were combined with imipramine or placebo for a total of eight experimental conditions. Participants presented moderate to severe agoraphobia. The method involved a randomized, double-blind, placebo-controlled trial with 137 participants who completed a 14-session protocol involving the treatments just mentioned. Measures were taken at baseline and posttreatment and at 3-, 6-, and 12-month follow-up. All treatment conditions were statistically and clinically effective in reducing self-reported panic-agoraphobia symptoms over the 1-year follow-up. No statistical differences were observed between imipramine and placebo conditions. This study found that all treatment modalities helped reduce panic and agoraphobic symptomatology over a 1-year follow-up period. These surprising results support the need to document the relations among the various components of an intervention. This would make it possible to assess the relative efficacy of the treatment components rather than of the intervention as a whole.",Marchand A.; Coutu MF.; Dupuis G.; Fleet R.; Borgeat F.; Todorov C.; Mainguy N.,2008.0,10.1080/16506070701743120,0,0,
8643,Reducing symptoms of trauma among carers of people with psychosis: pilot study examining the impact of writing about caregiving experiences.,"To establish whether writing about experiences of the first episode of psychosis may alleviate trauma-like symptoms among carers of people with psychosis. A total of 37 people caring for someone with early psychosis were randomized to two conditions: either writing about the first psychotic episode, or writing about time management. Data were collected before and after intervention, and 8 weeks later. Those in the writing group were significantly less likely to avoid reminders and feelings associated with their relative's episode at follow up. Furthermore, carers in this group who exhibited trauma-like symptoms had significantly greater reductions in trauma severity. Written emotional disclosure can help carers who are experiencing trauma symptoms following a relative's first episode of psychosis. If writing about emotional events is beneficial through mechanisms of exposure then screening participants for trauma symptoms may eliminate previous research inconsistencies. These results, however, need to be replicated in a larger study.",Barton K.; Jackson C.,2008.0,10.1080/00048670802203434,0,0,
8644,[Observation on therapeutic effect of auricular acupuncture combined with body acupuncture for treatment of cardiac neurosis].,"To find an effective therapy for cardiac neurosis. Seventy-two cases were randomly divided into an acupuncture group and a medication group, 36 cases in each group. The acupuncture group were treated with auricular acupuncture combined with body acupuncture, with auricular points Shenmen, Jiaogan (sympathesis), Xin (heart), etc. and body points Xinshu (BL 15), Shenmen (HT 7), Neiguan (PC 6), etc. selected; the medication group were treated with oral administration of Betaloc and Oryzanol. Their therapeutic effects were compared after treatment for 2 months. The cured rate was 77.8% in the acupuncture group and 52.8% in the medication group with very significant differences (P < 0.01), the former being better than the latter. Auricular acupuncture combined with body acupuncture is the best method for treatment of cardiac neurosis.",Mu GM.; Lu YY.,2008.0,,0,0,7300
8645,Stereotactic lesioning for mental illness.,"The authors report stereotactically created lesioning by radiofrequency or Cyberknife radiosurgery for patients with mental illness. Since 1993, thirty-eight patients have undergone stereotactic psychosurgery for medically intractable mental illnesses. Two patients had aggressive behavior. Twenty-five patients suffered from Obsessive-Compulsive Disorder (OCD) and ten patients had depression. Another patient suffered from atypical psychosis. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior. Limbic leucotomy or anterior cingulotomy was done for OCD and subcaudate tractotomy with or without cingulotomy was done for depression. In twenty-three patients, the lesions were made by a radiofrequency (RF) lesion generator. In fifteen cases, the lesions were made with CyberKnife Radiosurgery (CKRS). The Overt Aggression Scale (OAS) declined from 8 to 2 with clinical improvement during follow up period. With long-term follow up (meaning 57 months) in 25 OCDs, the mean Yale Brown Obsessive Compulsive Score (YBOCS) declined from 34 to 13 (n = 25). The Hamilton Depression scale (HAMD) for ten patients with depression declined from 38.5 to 10.5 (n = 10). There was no operative mortality and no significant morbidity except one case with transient urinary incontinence. Authors suggest that stereotactic psychosurgery by RF and CKRS could be a safe and effective means of treating some medically intractable mental illnesses.",Kim MC.; Lee TK.,2008.0,,0,0,
8646,"Differences between daily smokers, chippers, and nonsmokers with co-occurring anxiety and alcohol-use disorders.","Tobacco use is disproportionately represented among both alcohol-use disorders (AUDs) and anxiety disorders (ANX) compared to the general population [Kalman, D. A., Morissette, S. B., & George, T. P. (2005). Co-morbidity of nicotine and tobacco use in psychiatric and substance use disorders. The American Journal on Addictions, 14, 1-18]. Despite this common overlap, little is known about how smokers with co-occurring AUD-ANX differ from their nonsmoking counterparts. Seventy-two patients participated in a larger clinical trial evaluating the efficacy of venlafaxine and cognitive-behavioral therapy for AUD-ANX. Differences between daily smokers (n=23), chippers (n=12) and nonsmokers (n=37) with AUD-ANX were examined with respect to intensity and frequency of alcohol use, anxiety symptoms, depressed mood, and stress. Point prevalence of current daily smoking was 31.9%, which is considerably lower than traditionally reported in AUD studies. Consistent with predictions, daily smokers reported higher levels of alcohol dependence, average drinks per drinking occasion, and peak blood concentration levels in a day than nonsmokers during the 90 days prior to assessment. Chippers were nonsignificantly different from either smokers or nonsmokers. Smokers and nonsmokers did not differ with respect to percent heavy drinking days or emotional symptoms.",Morissette SB.; Gulliver SB.; Kamholz BW.; Duade J.; Farchione T.; Devine E.; Brown TA.; Barlow DH.; Ciraulo D.,2008.0,10.1016/j.addbeh.2008.06.012,0,0,
8647,An experimental clinical trial of a cognitive-behavior therapy package for chronic stuttering.,"The aims of the present study were to (a) examine the rate of social phobia among adults who stutter, (b) study the effects of speech restructuring treatment on social anxiety, and (c) study the effects on anxiety and stuttering of a cognitive-behavior therapy (CBT) package for social anxiety. Thirty-two adults with chronic stuttering were randomly allocated to receive either speech restructuring following a CBT package for social anxiety or speech restructuring alone. Data were obtained on a variety of speech and psychological measures at pre-treatment, post-CBT, post-speech restructuring, and 12 months follow-up. Sixty percent of our cohort were diagnosed with social phobia. Speech restructuring treatment alone had no impact on the social phobia of our cohort at 12 months follow-up. At follow-up, participants who had received CBT showed no social phobia and greater improvements than control participants on a range of psychological measures of anxiety and avoidance. However, the CBT package made no difference to the speech outcomes of those with social phobia. The CBT treatment was associated with significant and sustained improvements in psychological functioning but did not improve fluency.",Menzies RG.; O'Brian S.; Onslow M.; Packman A.; St Clare T.; Block S.,2008.0,10.1044/1092-4388(2008/07-0070),0,0,
8648,Effectiveness of a school-based group psychotherapy program for war-exposed adolescents: a randomized controlled trial.,"To evaluate the comparative effectiveness of a classroom-based psychoeducation and skills intervention (tier 1) and a school-based trauma- and grief-focused group treatment (tier 2) of a three-tiered mental health program for adolescents exposed to severe war-related trauma, traumatic bereavement, and postwar adversity. A total of 127 war-exposed and predominantly ethnic Muslim secondary school students attending 10 schools in central Bosnia who reported severe symptoms of posttraumatic stress disorder (PTSD), depression, or maladaptive grief and significant impairment in school or relationships were randomly assigned to one of two experimental conditions. These included either an active-treatment comparison condition (tier 1), consisting of a classroom-based psychoeducation and skills intervention alone (n = 61, 66% girls, mean age 16.0 years, SD 1.13) or a treatment condition composed of both the classroom-based intervention and a 17-session manual-based group therapy intervention (tier 2), trauma and grief component therapy for adolescents (n = 66, 63% girls, mean age 15.9 years, SD 1.11). Both interventions were implemented throughout the school year. Distressed students who were excluded from the study due to acute risk for harm (n = 9) were referred for community-based mental health services (tier 3). Program effectiveness was measured via reductions in symptoms of PTSD, depression, and maladaptive grief assessed at pretreatment, posttreatment, and 4-month follow-up. Analysis of mean-level treatment effects showed significant pre- to posttreatment and posttreatment to 4-month follow-up reductions in PTSD and depression symptoms in both the treatment and comparison conditions. Significant pre- to posttreatment reductions in maladaptive grief reactions were found only in the treatment condition. Analyzed at the individual case level, the percentages of students in the treatment condition who reported significant (p <.05) pre- to posttreatment reductions in PTSD symptoms (58% at posttreatment, 81% at 4-month follow-up) compare favorably to those reported in controlled treatment efficacy trials, whereas the percentages who reported significant reductions in depression symptoms (23% at posttreatment, 61% at follow-up) are comparable to, or higher than, those found in community treatment settings. Lower but substantial percentages of significant symptom reduction were found for PTSD (33% at posttreatment, 48% at follow-up) and depression symptoms (13% at posttreatment; 47% at follow-up) in students in the comparison condition. The odds of significant symptom reduction were higher for PTSD symptoms at both posttreatment and 4-month follow-up and for maladaptive grief at posttreatment (no follow-up was conducted on maladaptive grief). Rates of significantly worsened cases were generally rare in both the treatment and comparison conditions. A three-tiered, integrative mental health program composed of schoolwide dissemination of psychoeducation and coping skills (tier 1), specialized trauma- and grief-focused intervention for severely traumatized and traumatically bereaved youths (tier 2), and referral of youths at acute risk for community-based mental health services (tier 3) constitutes an effective and efficient method for promoting adolescent recovery in postwar settings.",Layne CM.; Saltzman WR.; Poppleton L.; Burlingame GM.; Pasalić A.; Duraković E.; Musić M.; Campara N.; Dapo N.; Arslanagić B.; Steinberg AM.; Pynoos RS.,2008.0,10.1097/CHI.0b013e31817eecae,0,0,
8649,A randomized controlled trial of exposure therapy and cognitive restructuring for posttraumatic stress disorder.,"Previous studies have reported that adding cognitive restructuring (CR) to exposure therapy does not enhance treatment gains in posttraumatic stress disorder (PTSD). This study investigated the extent to which CR would augment treatment response when provided with exposure therapy. The authors randomly allocated 118 civilian trauma survivors with PTSD to receive 8 individually administered sessions of either (a) imaginal exposure (IE), (b) in vivo exposure (IVE), (c) IE combined with IVE (IE/IVE), or (d) IE/IVE combined with CR (IE/IVE/CR). There were fewer patients with PTSD in the IE/IVE/CR (31%) condition than the IE (75%), IVE (69%), and IE/IVE (63%) conditions at a 6-month follow-up assessment. The IE/IVE/CR condition resulted in larger effect sizes than each of the other conditions in terms of PTSD and depressive symptoms. These findings suggest that optimal treatment outcome may be achieved by combining CR with exposure therapy in treating PTSD patients.",Bryant RA.; Moulds ML.; Guthrie RM.; Dang ST.; Mastrodomenico J.; Nixon RD.; Felmingham KL.; Hopwood S.; Creamer M.,2008.0,10.1037/a0012616,0,0,
8650,Functional MRI study of brain activation alterations in patients with obsessive-compulsive disorder after symptom improvement.,"Dysfunction of the frontal-subcortical circuits has been the most common finding in the pathophysiology of obsessive-compulsive disorder (OCD), and recent neuropsychological studies have shown cognitive impairments in OCD. To clarify the pathophysiology of OCD without the confounding effects of medication, we investigated the alterations of brain function in OCD patients and changes after clinical improvement due solely to behavior therapy. The participants were 11 outpatients with OCD and 19 normal controls. The patients received 12 weeks of behavior therapy. We investigated the differences in the behavioral performance and functional magnetic resonance imaging results during the Stroop test in the patients and normal controls, and their changes after treatment in the patients. The patients showed less activation in the anterior cingulate gyrus and cerebellum than control subjects. Following significant improvement in OC symptoms, the cerebellum and parietal lobe showed increased activation, and the orbitofrontal cortex, middle frontal gyrus, and temporal regions showed decreased activation during the Stroop task, and performance of the task itself improved. Our findings suggest that dysfunction of the posterior brain regions, especially the cerebellum, is involved in the pathogenesis of OCD, and that normalization in function can occur with improvement of OC symptoms.",Nabeyama M.; Nakagawa A.; Yoshiura T.; Nakao T.; Nakatani E.; Togao O.; Yoshizato C.; Yoshioka K.; Tomita M.; Kanba S.,2008.0,10.1016/j.pscychresns.2007.11.001,0,0,
8651,A multi-session interpretation modification program: changes in interpretation and social anxiety symptoms.,"Previous research suggests that socially anxious individuals interpret ambiguous social information in a more threatening manner compared to non-anxious individuals. Recently, studies have experimentally modified interpretation and shown that this subsequently affected anxiety in non-anxious individuals. If similar procedures can modify interpretation biases in socially anxious individuals, they may lead to a reduction in social anxiety symptoms. In the current study, we examined the effect of a computerized Interpretation Modification Program (IMP) on interpretation bias and social anxiety symptoms. Twenty-seven socially anxious individuals were randomly assigned to the IMP or a control condition. Participants completed eight computer sessions over four weeks. The IMP modified interpretation by providing positive feedback when participants made benign interpretations and negative feedback in response to threat interpretations. The IMP successfully decreased threat interpretations, increased benign interpretations, and decreased social anxiety symptoms compared to the control condition. Moreover, changes in benign interpretation mediated IMP's effect on social anxiety. This initial trial suggests that interpretation modification may have clinical utility when applied as a multi-session intervention.",Beard C.; Amir N.,2008.0,10.1016/j.brat.2008.05.012,0,0,
8652,Autologous olfactory ensheathing cell transplantation in human paraplegia: a 3-year clinical trial.,"Olfactory ensheathing cells show promise in preclinical animal models as a cell transplantation therapy for repair of the injured spinal cord. This is a report of a clinical trial of autologous transplantation of olfactory ensheathing cells into the spinal cord in six patients with complete, thoracic paraplegia. We previously reported on the methods of surgery and transplantation and the safety aspects of the trial 1 year after transplantation. Here we address the overall design of the trial and the safety of the procedure, assessed during a period of 3 years following the transplantation surgery. All patients were assessed at entry into the trial and regularly during the period of the trial. Clinical assessments included medical, psychosocial, radiological and neurological, as well as specialized tests of neurological and functional deficits (standard American Spinal Injury Association and Functional Independence Measure assessments). Quantitative test included neurophysiological tests of sensory and motor function below the level of injury. The trial was a Phase I/IIa design whose main aim was to test the feasibility and safety of transplantation of autologous olfactory ensheathing cells into the injured spinal cord in human paraplegia. The design included a control group who did not receive surgery, otherwise closely matched to the transplant recipient group. This group acted as a control for the assessors, who were blind to the treatment status of the patients. The control group also provided the opportunity for preliminary assessment of the efficacy of the transplantation. There were no adverse findings 3 years after autologous transplantation of olfactory ensheathing cells into spinal cords injured at least 2 years prior to transplantation. The magnetic resonance images (MRIs) at 3 years showed no change from preoperative MRIs or intervening MRIs at 1 and 2 years, with no evidence of any tumour of introduced cells and no development of post-traumatic syringomyelia or other adverse radiological findings. There were no significant functional changes in any patients and no neuropathic pain. In one transplant recipient, there was an improvement over 3 segments in light touch and pin prick sensitivity bilaterally, anteriorly and posteriorly. We conclude that transplantation of autologous olfactory ensheathing cells into the injured spinal cord is feasible and is safe up to 3 years of post-implantation, however, this conclusion should be considered preliminary because of the small number of trial patients.",Mackay-Sim A.; Féron F.; Cochrane J.; Bassingthwaighte L.; Bayliss C.; Davies W.; Fronek P.; Gray C.; Kerr G.; Licina P.; Nowitzke A.; Perry C.; Silburn PA.; Urquhart S.; Geraghty T.,2008.0,10.1093/brain/awn173,0,0,
8653,Outcome of additional behaviour therapy including treatment discontinuation for fluvoxamine non-responders with obsessive-compulsive disorder.,,Nakatani E.; Nakagawa A.,2008.0,10.1159/000151521,0,0,
8654,The pattern of subjective anxiety during in-session exposures over the course of cognitive-behavioral therapy for clients with social anxiety disorder.,"Exposure-based therapies are efficacious treatments for social anxiety disorder (i.e., Gould et al., 1997). Much of the theory behind these treatments is derived from Foa and colleagues' (Foa, Huppert, & Cahill, 2005; Foa & Kozak, 1986) work on emotional processing. However, there has been little research examining individual differences in emotional processing patterns within and between treatment sessions among clients with social anxiety disorder. This study utilized longitudinal data analytic methods to examine changes in subjective anxiety during the first 3 exposure sessions in group and individual cognitive-behavioral therapy for social anxiety disorder. The results of this study provide preliminary evidence that, although anxiety generally decreases across exposures, some individuals experience considerable fluctuations in anxiety during a single exposure. Although anxiety during the first exposure was not significantly related to outcome, the relationship between anxiety during exposure and outcome became stronger during subsequent exposures. Overall, this study highlights the need to conduct more fine-grained analyses to better understand the mechanisms underlying exposure-based therapies for social anxiety disorder.",Hayes SA.; Hope DA.; Heimberg RG.,2008.0,10.1016/j.beth.2007.09.001,0,0,
8655,Attentional retraining: a randomized clinical trial for pathological worry.,"Research has consistently shown that highly anxious individuals tend to show an attentional bias in favor of threat cues (i.e., a threat bias). Further, recent evidence suggests that it is possible to modify patterns of attention allocation for such stimuli and the resulting changes in attention allocation alter affective responses to stress. However, to date such changes in patterns of attention have been shown only over brief time intervals and only in non-anxious individuals who lack a pre-existing attentional bias. In contrast, the present study tested the efficacy of such attentional training in a sample of severe worriers over an extended period of time using psychometrically validated measures of anxiety and depression. Twenty-four adult participants reporting severe worry were randomly assigned to receive five sessions of either computer-delivered attentional retraining or sham training. The study was conducted from January to August 2001 and June to August 2002. Significant Treatment Group X Time interactions were found for both threat bias (p=001) and a composite measure of anxious and depressive symptoms (p=.002). Compared to sham-training, the active retraining program produced significant reductions in both threat bias and symptoms. These data support the view that an attentional bias in favor of threat cues is an important causal factor in generalized anxiety and suggest that a computer-based attentional retraining procedure may be an effective component of treatment.",Hazen RA.; Vasey MW.; Schmidt NB.,2009.0,10.1016/j.jpsychires.2008.07.004,0,0,
8656,Reduction of pain-related fear and disability in post-traumatic neck pain: a replicated single-case experimental study of exposure in vivo.,"For patients with acute post-traumatic neck pain (PTNP), pain-related fear has been identified as a potential predictor of chronic disability. If such is the case, fear reduction should enhance the prevention of further pain disability and distress after traumatic neck pain disability. However, exposure-based treatments have not been tested in patients with PTNP. Using a replicated single-case crossover phase design with multiple measurements, this study examined whether the validity of a graded exposure in vivo, as compared with usual graded activity, extends to PTNP. Eight patients who reported substantial pain-related fear were included in the study. Daily changes in pain intensity, pain-related fear, pain catastrophizing, and activity goal achievement were assessed. Before and after each intervention, and at 6-month follow-up, standardized questionnaires of pain-related fear and pain disability were administered, and, to quantify daily physical activity level, patients carried an ambulatory activity monitor. The results showed decreasing levels of self-reported pain-related fear, pain intensity, disability, and improvements in physical activity level only when graded exposure in vivo was introduced, and not in the graded activity condition. The results are discussed in the context of the search for customized treatments for PTNP. This is the first study showing that the effects of graded exposure in vivo generalize to patients with chronic PTNP reporting elevated levels of pain-related fear. This could help clinicians to customize treatments for PTNP.",de Jong JR.; Vangronsveld K.; Peters ML.; Goossens ME.; Onghena P.; Bulté I.; Vlaeyen JW.,2008.0,10.1016/j.jpain.2008.06.015,0,0,
8657,The effect of failure on cognitive and psychological symptom validity tests in litigants with symptoms of post-traumatic stress disorder.,"This study examined the influence of performance on cognitive and psychological symptom validity tests on neuropsychological and psychological test performance in claimants evaluated in a medico-legal context (N = 301) with symptoms of PTSD. A second purpose of this study was to examine the influence of the severity of PTSD symptoms on cognitive test performance after excluding patients who failed to put forth adequate best effort and who exaggerated psychiatric symptoms. Patients were administered a battery of neuropsychological measures that were aggregated into a composite measure, the Cognitive-Test Battery Mean (C-TBM). Patients were also administered a battery of psychological tests that were aggregated into another composite measure, the Psychological-Test Battery Mean (P-TBM). We found that failure on cognitive symptom validity tests was associated with significantly poorer neuropsychological functioning, but there was not a significant effect on psychological symptoms. Conversely, failure on psychological symptom validity tests was associated with higher levels of psychopathology, but there was not a significant effect on cognitive ability. Finally, once patients were screened for adequate effort and genuine symptom reporting, the severity of PTSD symptoms did not appear to influence cognitive ability. This is the first study that assessed both types of symptom validity testing in PTSD claimants, which is important given that previous literature has demonstrated cognitive impairment in PTSD and that individuals with PTSD tend to claim cognitive impairment. Implications of these findings are discussed with regard to the existing literature and the relationship between these two types of symptom validity tests.",Demakis GJ.; Gervais RO.; Rohling ML.,2008.0,10.1080/13854040701564482,0,0,
8658,A cluster randomized controlled trial of cognitive behaviour therapy for common mental disorders in patients with advanced cancer.,"Cognitive behaviour therapy (CBT) has been shown to reduce psychological morbidity in people with cancer, but no randomized controlled trial (RCT) exists in palliative care. We aimed to determine whether home care nurses could be taught to deliver basic cognitive behavioural techniques and so reduce symptoms of anxiety and depression. Clinical nurse specialists (CNSs) at St Christopher's Hospice were randomly allocated to receive training in CBT or continue their usual practice. At the end of the trial, nurses were rated on the Cognitive Therapy First Aid Rating Scale (CTFARS) for CBT competence. Home care patients who scored as possible cases on the Hospital Anxiety and Depression Scale (HADS) entered the trial. Participants received home care nursing visits. Assessments were carried out at baseline, 6, 10 and 16 weeks. Eight nurses received CBT training and seven continued practice as usual. The mean CTFARS scores were 35.9 for the CBT nurses and 19.0 for the controls (p=0.02). A total of 328 patients (54%) were possible cases and 80 entered the trial; most of those excluded were too ill to participate. There was an interaction between group and time: individuals receiving CBT had lower anxiety scores over time [coefficient -0.20, 95% confidence interval (CI) -0.35 to -0.05, p=0.01]. No effect of the training was found for depression. It is possible to conduct a randomized trial of psychological interventions in palliative care but there is considerable attrition from physical morbidity and mortality. Nurses can learn to integrate basic CBT methods into their clinical practice. This training may be associated with better outcomes for symptoms of anxiety.",Moorey S.; Cort E.; Kapari M.; Monroe B.; Hansford P.; Mannix K.; Henderson M.; Fisher L.; Hotopf M.,2009.0,10.1017/S0033291708004169,0,0,
8659,A pilot study of clonazepam versus psychodynamic group therapy plus clonazepam in the treatment of generalized social anxiety disorder.,"Both psychodynamic group therapy (PGT) and clonazepam are used as treatment strategies in reducing symptoms of generalized social anxiety disorder (GSAD). However, many individuals remain symptomatic after treatment with PGT or clonazepam. Fifty-eight adult outpatients with a diagnosis of GSAD according to DSM-IV were randomized to 12 weeks PGT plus clonazepam or clonazepam. The Clinical Global Impression-Improvement (CGI-I) Scale was the primary efficacy measure. Secondary efficacy measures included the Liebowitz Social Anxiety Scale (LSAS) total score, the World Health Organization Instrument to Assess Quality of Life-Brief (WHOQOL-Bref) Scale and the Beck Depression Inventory (BDI). CGI-I data from 57 patients (intent-to-treat population) showed that patients who received PGT plus clonazepam presented significantly greater improvement than those who received clonazepam (P=0.033). There were no significant differences between the two groups in the secondary efficacy measures. Our study suggests that the combination of PGT with clonazepam may be a promising strategy for the treatment of GSAD, regarding gains in the global functioning. However the present study failed to detect more specific changes in social anxiety symptomatology between the two groups.",Knijnik DZ.; Blanco C.; Salum GA.; Moraes CU.; Mombach C.; Almeida E.; Pereira M.; Strapasson A.; Manfro GG.; Eizirik CL.,2008.0,10.1016/j.eurpsy.2008.05.004,0,0,
8660,Which symptoms predict recurrence of depression in women treated with maintenance interpersonal psychotherapy?,"Even low levels of residual symptoms are known to increase the risk of relapse and early recurrence of major depression. It is not known if ongoing psychotherapy lessens this risk. We therefore examined the impact of persistent symptoms, including mood, insomnia, and anxiety symptoms, on time to recurrence in women receiving maintenance interpersonal psychotherapy (IPT-M) for recurrent depression. We analyzed data on 131 women aged 20-60 from a 2-year randomized trial of weekly versus twice-monthly versus monthly IPT-M. Participants achieved remission with IPT alone (n=99) or IPT plus sequential antidepressant medication (n=32). Medications were tapered before starting maintenance treatment. Residual symptoms were assessed with the Hamilton Rating Scale for Depression (HRSD; total score and subscales); insomnia was also assessed in 76 women with the Pittsburgh Sleep Quality Index (PSQI). Data analyses used Cox proportional hazards regression models. Neither overall burden of residual symptoms (HRSD total score), nor HRSD mood and anxiety subscale scores predicted recurrence during ongoing IPT-M. In contrast, persistent insomnia measured both by the HRSD-17 insomnia subscale and the PSQI predicted recurrence. Women with persistent insomnia who required sequential pharamacotherapy had the highest recurrence rate (65%) compared to women requiring sequential treatment without insomnia (13%), or women who had recovered with IPT alone but had persistent insomnia (21%) or no insomnia (18%). Persistent insomnia following the recovery from an episode of recurrent major depression is associated with increased risk of recurrence despite maintenance psychotherapy, particularly for those withdrawn from antidepressant medication.",Dombrovski AY.; Cyranowski JM.; Mulsant BH.; Houck PR.; Buysse DJ.; Andreescu C.; Thase ME.; Mallinger AG.; Frank E.,2008.0,10.1002/da.20467,0,0,
8661,"Stressful events and support during birth: the effect on anxiety, mood and perceived control.","Following childbirth, 16% of women may have anxiety disorders and 2% develop PTSD. It is important to identify factors that influence women's emotional reactions to birth. This study investigated how stressful events and support from hospital staff during birth each affects women's anxiety and perceived control. A between-subjects experimental design used birth stories to manipulate levels of stressful events (high/low) and support (high/low) during birth. Participants (n=137) imagined undergoing one of the birth experiences and rated their perceived control, mood, and anxiety. Manipulation checks indicated the birth stories reliably elicited mood responses. Anxiety, mood, and perceived control were more strongly influenced by support than by stressful events. There was a significant interaction between stressful events and support for perceived control. Level of support from hospital staff during birth has a greater effect on women's emotional reactions than stressful events. Supportive care during birth increases perceived control and reduces anxiety and negative mood.",Ford E.; Ayers S.,2009.0,10.1016/j.janxdis.2008.07.009,0,0,
8662,"Efficacy of functional relaxation and patient education in the treatment of somatoform heart disorders: a randomized, controlled clinical investigation.","Recurrent heart problems and, especially, chest pain in the absence of somatic heart disease is a common finding, although challenging to treat. The authors assessed a body-oriented approach to the somatic fixation frequently seen in these patients. They conducted a controlled study to assess the effect of functional relaxation in 22 patients with non-specific chest pain. The primary outcome measures were self-reported changes on the subscales Somatization and Anxiety of the Symptom Checklist of Derogatis, as well as the subscale Cardiovascular Complaints of the Giessen Inventory of Complaints. Significant improvements of the primary outcome measures were observed in patients treated with functional relaxation, whereas no significant improvements could be seen in the control group. Functional relaxation appears to be a safe and effective, non-pharmacological approach in the treatment of non-specific chest pain.",Lahmann C.; Loew TH.; Tritt K.; Nickel M.,,10.1176/appi.psy.49.5.378,0,0,7114
8663,Association of depression and anxiety alone and in combination with chronic musculoskeletal pain in primary care patients.,"To assess the relationship between depression and anxiety comorbidity on pain intensity, pain-related disability, and health-related quality of life (HRQL). Analysis of baseline data from the Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) study. All patients (n = 500) had chronic pain (>or=3-month duration) of the low back, hip, or knee. Patients with depression were oversampled for the clinical trial component of SCAMP and thus represented 50% of the study population. Patients were categorized according to pain comorbid with depression, anxiety, or both. We used analysis of variance and multivariate analysis of variance models to assess the relationships between independent and dependent variables. Participants had a mean age of 59 years; they were 55% women, 56% White, and 40% Black. Fifty-four percent (n = 271) reported pain only, 20% (n = 98) had pain and depression, 3% (n = 15) had pain and anxiety, and 23% (n = 116) had pain, depression, and anxiety. Patients with pain and both depression and anxiety experienced the greatest pain severity (p < .0001) and pain-related disability (p < .0001). Psychiatric comorbidity was strongly associated with disability days in the past 3 months (p < .0001), with 18.1 days reported by patients with pain only, 32.2 days by those with pain and anxiety, 38.0 days by those with pain and depression, and 42.6 days in those with all three conditions. We found a similar pattern of poorer HRQL (p < .0001) in those with pain, depression, and anxiety. The added morbidity of depression and anxiety with chronic pain is strongly associated with more severe pain, greater disability, and poorer HRQL.",Bair MJ.; Wu J.; Damush TM.; Sutherland JM.; Kroenke K.,2008.0,10.1097/PSY.0b013e318185c510,0,0,
8664,Sudden gains in group cognitive-behavioral therapy for panic disorder.,"The current study investigates sudden gains (rapid symptom reduction) in group cognitive-behavioral therapy for panic disorder. Sudden gains occurring after session 2 of treatment predicted overall symptom reduction at treatment termination and some changes in cognitive biases. Meanwhile, sudden gains occurring immediately following session 1 were not associated with symptom reduction or cognitive change. Together, this research points to the importance of examining sudden gains across the entire span of treatment, as well as the potential role of sudden gains in recovery from panic disorder.",Clerkin EM.; Teachman BA.; Smith-Janik SB.,2008.0,10.1016/j.brat.2008.08.002,0,0,
8665,Five factor model personality factors moderated the effects of an intervention to enhance chronic disease management self-efficacy.,"Peer led interventions can enhance patient self-efficacy for managing chronic illnesses, but little is known regarding the moderators or duration of their effects. We hypothesized Homing in on Health (HIOH), a variant of the Chronic Disease Self-Management Program, would be most effective in patients high in neuroticism and low in extraversion, openness, agreeableness, and/or conscientiousness. Analysis of data from subjects (N=415) enrolled in an ongoing randomized controlled trial. Regression analyses were conducted to explore whether Five Factor Model (FFM) personality factors moderated the effects of HIOH, delivered in subjects' homes or via telephone, on disease management self-efficacy. Data were collected at 6 time points over the course of 1 year. Compared with control and telephone HIOH, home HIOH significantly increased self-efficacy, an effect peaking at 6 weeks and fully attenuating by 1 year. Moderation analyses revealed the benefit was confined to patients higher in neuroticism and/or lower in conscientiousness, agreeableness, and extraversion. A peer led intervention to enhance disease management self-efficacy had only short-term effects, and FFM personality factors moderated those effects. Measuring personality factors in chronically ill individuals may facilitate targeting of self-management interventions to those most likely to respond.",Franks P.; Chapman B.; Duberstein P.; Jerant A.,2009.0,10.1348/135910708X360700,0,0,
8666,Written emotional disclosure: a controlled study of the benefits of expressive writing homework in outpatient psychotherapy.,"The current study investigated the extent to which outpatient psychotherapy clients benefited from Pennebaker's expressive writing protocol (Pennebaker & Beall, 1986) adapted for use as a homework intervention. Participants were randomly assigned to written emotional disclosure or writing control conditions. Pre- and postintervention outcome measures were collected for three consecutive therapy sessions. Clients in the written emotional disclosure group showed significantly greater reductions in anxiety and depressive symptoms as well as greater overall progress in psychotherapy in comparison to the writing control group. Results suggest that emotional disclosure writing homework, in conjunction with outpatient psychotherapy, facilitates therapeutic process and outcome.",Graf MC.; Gaudiano BA.; Geller PA.,2008.0,10.1080/10503300701691664,0,0,
8667,Individual versus group cognitive-behavioral treatment for obsessive-compulsive disorder: a controlled pilot study.,"This study sought to examine the effectiveness of group and individual cognitive-behavioral treatment (CBT) and to compare the results with those of a wait-list control group among a sample of patients with obsessive-compulsive disorder (OCD). Fifty-seven individuals diagnosed with OCD were evaluated pre- and posttreatment with the Yale-Brown Obsessive Compulsive Scale and the Hamilton Rating Scales for Anxiety and Depression. Both group and individual CBT obtained statistically significant reductions in anxiety and depressive symptoms. Patients in individual treatment achieved a statistically significant reduction in OCD symptoms compared with those in group treatment, but their dropout rate was twice as high. Patients with symmetry and order rituals presented less improvement in anxiety symptoms than those with other rituals. Associated general symptoms were lower in patients receiving either mode of CBT compared with wait-list participants. The authors found that individual treatment is more effective in reducing obsessive-compulsive symptoms than group treatment.",Jaurrieta N.; Jimenez-Murcia S.; Menchón JM.; Del Pino Alonso M.; Segalas C.; Alvarez-Moya EM.; Labad J.; Granero R.; Vallejo J.,2008.0,10.1080/10503300802192141,0,0,
8668,A randomized trial of brief cognitive-behavioral therapy for prevention of generalized anxiety disorder.,,Higgins DM.; Hecker JE.,2008.0,,0,0,
8669,Posterior fracture dislocation of the ankle: technique and clinical experience using a posteromedial surgical approach.,"The purpose of this study is to revisit the posteromedial surgical approach to the ankle and report the clinical outcomes of this technique in a cohort of 17 patients. Retrospective. Level I trauma center. Seventeen patients between 1990 and 2006 were treated using a posteromedial surgical approach to the ankle. Thirteen presented with a posterior ankle fracture dislocation and 4 with an ankle fracture without dislocation producing a large posterior malleolar fragment. There were 6 males and 11 females, from 23 to 80 years of age (mean 45.2 years). All but 2 patients underwent open reduction and internal fixation of the posterior malleolar fracture using a single posteromedial approach. A combined surgical approach (posteromedial and posterolateral) to the ankle was used in 2 cases. The Foot and Ankle Outcomes Questionnaire was used to evaluate postoperative ankle pain, function, stiffness and swelling, and giving way. Posttraumatic osteoarthritis was assessed using an adapted 4-point radiographic grading system. Follow-up data on 12 patients were obtained at a mean interval of 9.4 years. There were no wound complications. The average global foot and ankle score was 87 points (range 69-100). The degree of arthrosis was grades 0 in 3 ankles, I in 1 ankle, II in 5 ankles, and III in 3 ankles. The posteromedial approach offers an effective technique for fracture reduction and buttress plate fixation of large posterior malleolar fragments. Good short- and mid-term clinical results should be expected.",Bois AJ.; Dust W.,2008.0,10.1097/BOT.0b013e318184ba4e,0,0,
8670,Gamma ventral capsulotomy for treatment of resistant obsessive-compulsive disorder: a structural MRI pilot prospective study.,"The purpose of this study was to investigate regional structural abnormalities in the brains of five patients with refractory obsessive-compulsive disorder (OCD) submitted to gamma ventral capsulotomy. We acquired morphometric magnetic resonance imaging (MRI) data before and after 1 year of radiosurgery using a 1.5-T MRI scanner. Images were spatially normalized and segmented using optimized voxel-based morphometry (VBM) methods. Voxelwise statistical comparisons between pre- and post-surgery MRI scans were performed using a general linear model. Findings in regions predicted a priori to show volumetric changes (orbitofrontal cortex, anterior cingulate gyrus, basal ganglia and thalamus) were reported as significant if surpassing a statistical threshold of p<0.001 (uncorrected for multiple comparisons). We detected a significant regional postoperative increase in gray matter volume in the right inferior frontal gyri (Brodmann area 47, BA47) when comparing all patients pre and postoperatively. Our results support the current theory of frontal-striatal-thalamic-cortical (FSTC) circuitry involvement in OCD pathogenesis. Gamma ventral capsulotomy is associated with neurobiological changes in the inferior orbitofrontal cortex in refractory OCD patients.",Cecconi JP.; Lopes AC.; Duran FL.; Santos LC.; Hoexter MQ.; Gentil AF.; Canteras MM.; Castro CC.; Norén G.; Greenberg BD.; Rauch SL.; Busatto GF.; Miguel EC.,2008.0,10.1016/j.neulet.2008.09.061,0,0,
8671,Changes in respiration mediate changes in fear of bodily sensations in panic disorder.,"The purpose of the study was to examine whether changes in pCO(2) mediate changes in fear of bodily sensation (as indexed by anxiety sensitivity) in a bio-behavioral treatment for panic disorder that targets changes in end-tidal pCO(2). Thirty-five panic patients underwent 4 weeks of capnometry-assisted breathing training targeting respiratory dysregulation. Longitudinal mediation analyses of the changes in fear of bodily symptoms over time demonstrated that pCO(2), but not respiration rate, was a partial mediator of the changes in anxiety sensitivity. Results were supported by cross lag panel analyses, which indicated that earlier pCO(2) levels predicted later levels of anxiety sensitivity, but not vice versa. PCO(2) changes also led to changes in respiration rate, questioning the importance of respiration rate in breathing training. The results provide little support for changes in fear of bodily sensations leading to changes in respiration, but rather suggest that breathing training targeting pCO(2) reduced fear of bodily sensations in panic disorder.",Meuret AE.; Rosenfield D.; Hofmann SG.; Suvak MK.; Roth WT.,2009.0,10.1016/j.jpsychires.2008.08.003,0,0,
8672,Effect of medication and psychotherapy on heart rate variability in panic disorder.,"Panic disorder (PD) patients have been shown to have reduced heart rate variability (HRV). Low HRV has been associated with elevated risk for cardiovascular disease. Our aim was to investigate the effects of treatment on heart rate (HR) in patients with PD through a hyperventilation challenge. We studied 54 participants, 43 with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) PD and 11 controls. Subjects lay supine with their heads in a plastic canopy chamber, resting for 15 min and then breathing at a rate of 30 breaths per minute for 10 min. HRV was sampled for spectral analysis. Clinical and behavioral measures of anxiety were assessed. Treatment was chosen by patients: either 12 weeks of CBT alone or CBT with sertraline. All patients showed significant decrease on clinical measures from baseline and 31 were treatment responders, 8 dropped out of the study before completion of the 12-week treatment phase and 4 were deemed nonresponders after 12 weeks of treatment. Although both treatments led to significant clinical improvement, only CBT alone demonstrated a significant reduction in HR and increase in HRV. Our study replicated the finding that increased HR and decreased HRV occur in PD patients. Given the evidence of cardiac risk related to HRV, CBT appears to have additional benefits beyond symptom reduction. The mechanisms of this difference between CBT and sertraline are unclear and require further study.",Garakani A.; Martinez JM.; Aaronson CJ.; Voustianiouk A.; Kaufmann H.; Gorman JM.,2009.0,10.1002/da.20533,0,0,
8673,[Pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis with inspiratory muscle training].,"Evaluation of effectiveness of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis (IPF) has not yet been presented in medical literature. The objective of the study is to analyze the influence of inspiratory muscle training on dyspnea (oxygen cost diagram [OCD], baseline dyspnea index [BDI]), quality of life (SF-36), results of 6 MWT (distance, dyspnea in Borg's scale), maximal inspiratory pressure (MIP), and lung function tests (IC, TLC, VC, FEV1, DLCO(SB), DLCO/VA) in patients with IPF. Investigations were conducted before, after 6 and 12 weeks of pulmonary rehabilitation performed in 2 groups of patients: study group (GB)--16 patients--with inspiratory muscle training added to general body conditioning and in control group (GK)--14 patients--who performed only general body conditioning. After 12 weeks of rehabilitation in SG we noticed the significant decrease of dyspnoea before (p = 0.028) and after (p = 0.012) 6 MWT, increase of distance in 6 MWT (p = 0.001), increase of MIP (p = 0.006), decrease of dyspnoea in BDI (p = 0.001) and improvement of quality of life (SF-36/PCS; p = 0.030) in comparison to baseline values. In the GK we observed increase of distance in 6MWT (p = 0.001) and improvement in quality of life (SF-36/PCS; p = 0.016). No improvement in sensation of dyspnea during 6MWT, BDI and MIP was noticed in the GK. Adding inspiratory muscle training increases effectiveness of pulmonary rehabilitation in IPF patients.",Jastrzebski D.; Kozielski J.; Zebrowska A.,2008.0,,0,0,
8674,The role of common factors in residential cognitive and interpersonal therapy for social phobia: a process-outcome study.,"This study examined the role of common factors in residential cognitive therapy (RCT) and residential interpersonal therapy (RIPT) for social phobia. Eighty social phobic patients were randomized to 10 weeks of RCT or RIPT. Patients and their individual therapists completed process and suboutcome measures weekly. The ratings were examined using linear mixed models. Most patient-rated process variables showed U-shaped (quadratic) patterns over the course of treatment. Therapist-rated alliance increased linearly. Therapist-rated first-week alliance and empathy predicted improvement in social role security over the course of therapy. The weekly fluctuations in common process predicted subsequent fluctuations in suboutcomes in seven of 10 possible cases, whereas suboutcomes predicted process in four cases. The results support the causal role of common factors.",Hoffart A.; Borge FM.; Sexton H.; Clark DM.,2009.0,10.1080/10503300802369343,0,0,
8675,An effectiveness trial of cognitive behaviour therapy in a representative sample of outpatients with psychosis.,"The efficacy of cognitive behaviour therapies for psychosis (CBTp) has been sufficiently established for its inclusion in some national treatment guidelines. However, treatment efficacy does not guarantee effectiveness in routine practice, where clinician expertise and patient mix may be different. Thus, we evaluated the applicability, acceptability and effectiveness of CBTp when offered routinely in a public mental health service. A prospectively recruited representative sample (N=94) of patients with psychotic disorders from a geographic catchment area in Melbourne, Australia, was randomized to CBTp or treatment as usual. The CBTp intervention included psychoeducation, positive symptom, and co-morbid problem components. Therapists collaboratively negotiated goals with patients and utilized treatment components from a manual. Intention-to-treat analyses used data at baseline, 9 months and 18 months. Working alliance and client satisfaction measures indicated excellent acceptability. Both groups improved to a similar degree on the Positive And Negative Syndrome Scale, with no advantage for the CBTp group. The most frequent CBTp components implemented were co-morbid disorders/personal issues and personalized psychoeducation; working with persisting symptoms was the main focus in relatively few sessions. The lack of advantage for the CBTp group may be due to: the infrequent focus on positive symptoms (the most replicated outcome domain for CBTp); the unselected nature of the patients (rather than those with distressing symptoms or referred by clinicians); or, to insufficient therapist expertise.",Farhall J.; Freeman NC.; Shawyer F.; Trauer T.,2009.0,10.1348/014466608X360727,0,0,
8676,The effects of a mindfulness intervention on obsessive-compulsive symptoms in a non-clinical student population.,"This controlled pilot study tested the effects of a mindfulness intervention on obsessive compulsive disorder (OCD) symptoms and tested the psychological processes possibly mediating such effects. Participants with OCD symptoms (12 women, 5 men) received either mindfulness training (N=8) or formed a waiting-list control group (N = 9). Meditation included 8 group meetings teaching meditative breathing, body-scan, and mindful daily living, applied to OCD. The intervention had a significant and large effect on mindfulness, OCD symptoms, letting go, and thought-action fusion. Controlling for changes in ""letting go,"" group effects on change in OCD symptoms disappeared, pointing at a mediating role for letting go. This may be the first controlled study demonstrating that a mindfulness intervention reduces OCD symptoms, possibly explained by increasing letting go capacity. If replicated in larger and clinical samples, mindfulness training may be an alternative therapy for OCD.",Hanstede M.; Gidron Y.; Nyklícek I.,2008.0,10.1097/NMD.0b013e31818786b8,0,0,
8677,Cephalic versus oronasal mask for noninvasive ventilation in acute hypercapnic respiratory failure.,"Compared to oronasal interfaces, a cephalic mask has a larger inner volume, covers the entire anterior surface of the face and limits the risk of deleterious cutaneous side effects during noninvasive ventilation (NIV). The present clinical study aimed to compare the clinical efficacy of a cephalic mask versus an oronasal mask in patients with acute hypercapnic respiratory failure (AHRF). Randomized controlled study in a Respiratory Intermediate Care Unit. All consecutive patients admitted for AHRF were randomly assigned to receive bilevel NIV either with a cephalic mask (n = 17) or an oronasal mask (n = 17) during the first 48 h. The main outcome criterion was the improvement of arterial pH, 24 h after NIV initiation. Secondary criteria included PaCO(2) and physiological parameters. Compared to values at inclusion, pH, PaCO(2), encephalopathy score, respiratory distress score and respiratory frequency improved significantly and similarly with both masks. None of these parameters showed statistically significant differences between the masks at each time point throughout the study period. Mean delivered inspiratory and expiratory pressures were similar in both patient groups. Tolerance of the oronasal mask was improved at 24 h and further. One patient with the cephalic mask suffered from claustrophobia that did not lead to premature study interruption. In spite of its larger inner volume, the cephalic mask has the same clinical efficacy and requires the same ventilatory settings as the oronasal mask during AHRF.",Cuvelier A.; Pujol W.; Pramil S.; Molano LC.; Viacroze C.; Muir JF.,2009.0,10.1007/s00134-008-1327-x,0,0,
8678,Impact of stress on paranoia: an experimental investigation of moderators and mediators.,"Vulnerability-stress models ascribe stress a pivotal role in the development of psychosis. However, moderating and mediating mechanisms translating stress into psychosis and the specificity of the association are not clearly established. It is hypothesized that stress will trigger paranoid ideation in vulnerable individuals through an increase in negative emotion. Using a repeated-measures design, 64 healthy participants with varying levels of vulnerability [psychosis symptoms assessed by the Community Assessment of Psychic Experiences (CAPE)] were assigned to a stress and a non-stress condition in random order. Stress was induced by exposing participants to building-site noise (75 dB) applied concurrently with difficult knowledge questions. Symptoms of paranoia, depression and obsessive compulsive disorder (OCD) were assessed by state-adapted versions of clinical scales. In the stress condition there was an increase in paranoia, depression and negative emotion. Multilevel linear modeling (MLM) revealed the increase in paranoia under stress to be moderated by the level of vulnerability and mediated by anxiety. Although participants generally showed an increase in anxiety under stress, anxiety was more strongly related to paranoia in participants with higher baseline symptomatology. The results support and specify the role of emotional reactions to stressors on the pathway from vulnerability to psychosis and highlight the relevance of anxiety.",Lincoln TM.; Peter N.; Schäfer M.; Moritz S.,2009.0,10.1017/S0033291708004613,0,0,
8679,Treatment of posttraumatic stress disorder in postwar Kosovar adolescents using mind-body skills groups: a randomized controlled trial.,"To determine whether participation in a mind-body skills group program based on psychological self-care, mind-body techniques, and self-expression decreases symptoms of posttraumatic stress disorder (PTSD). Eighty-two adolescents meeting criteria for PTSD according to the Harvard Trauma Questionnaire (which corresponds with 16 of the 17 diagnostic criteria for PTSD in DSM-IV) were randomly assigned to a 12-session mind-body group program or a wait-list control group. The program was conducted by high school teachers in consultation with psychiatrists and psychologists and included meditation, guided imagery, and breathing techniques; self-expression through words, drawings, and movement; autogenic training and biofeedback; and genograms. Changes in PTSD symptoms were measured using the Harvard Trauma Questionnaire. The study was conducted from September 2004 to May 2005 by The Center for Mind-Body Medicine at a high school in the Suhareka region of Kosovo. Students in the immediate intervention group had significantly lower PTSD symptom scores following the intervention than those in the wait-list control group (F = 29.8, df = 1,76; p < .001). Preintervention and postintervention scores (mean [SD]) for the intervention group were 2.5 (0.3) and 2.0 (0.3), respectively, and for the control group, 2.5 (0.3) and 2.4 (0.4), respectively. The decreased PTSD symptom scores were maintained in the initial intervention group at 3-month follow-up. After the wait-list control group received the intervention, there was a significant decrease (p < .001) in PTSD symptom scores compared to the preintervention scores. Mind-body skills groups can reduce PTSD symptoms in war-traumatized high school students and can be effectively led by trained and supervised schoolteachers.",Gordon JS.; Staples JK.; Blyta A.; Bytyqi M.; Wilson AT.,2008.0,,0,0,
8680,The Yale-Brown-Cornell eating disorder scale in women with anorexia nervosa: what is it measuring?,"The Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS) assesses eating disorder preoccupations, rituals, and symptom severity. This study examines the YBC-EDS in relation to eating disorder psychopathology, obsessionality, and impulsivity variables in women with anorexia nervosa (AN) and sensitivity of the YBC-EDS to change after psychotherapy. Participants were 56 women with ""spectrum"" AN (14.5 < BMI < 19). Variables examined in relation to the YBC-EDS were as follows: eating pathology, obsessionality (obsessive compulsive disorder and personality diagnoses, perfectionism), and impulsivity (borderline personality, impulsive traits, and behaviors). YBC-EDS scores were examined pre- and post-treatment. Eating Disorder Examination scores most strongly predicted the YBC-EDS. As expected, perfectionism was significantly associated, but so was impulsivity. YBC-EDS scores were significantly different in those with good versus poor global outcome after therapy. Unexpectedly, maximum lifetime BMI was correlated with the YBC-EDS. The YBC-EDS most strongly measured eating disorder severity and reflected change after psychotherapy for AN.",Jordan J.; Joyce PR.; Carter FA.; McIntosh VV.; Luty SE.; McKenzie JM.; Frampton CM.; Bulik CM.,2009.0,10.1002/eat.20605,0,0,
8681,MDMA-assisted psychotherapy using low doses in a small sample of women with chronic posttraumatic stress disorder.,"The purpose of this study was to investigate the safety of different doses of MDMA-assisted psychotherapy administered in a psychotherapeutic setting to women with chronic PTSD secondary to a sexual assault, and also to obtain preliminary data regarding efficacy. Although this study was originally planned to include 29 subjects, political pressures led to the closing of the study before it could be finished, at which time only six subjects had been treated. Preliminary results from those six subjects are presented here. We found that low doses of MDMA (between 50 and 75 mg) were both psychologically and physiologically safe for all the subjects. Future studies in larger samples and using larger doses are needed in order to further clarify the safety and efficacy of MDMA in the clinical setting in subjects with PTSD.",Bouso JC.; Doblin R.; Farré M.; Alcázar MA.; Gómez-Jarabo G.,2008.0,10.1080/02791072.2008.10400637,0,0,
8682,Subthalamic nucleus stimulation in severe obsessive-compulsive disorder.,"Severe, refractory obsessive-compulsive disorder (OCD) is a disabling condition. Stimulation of the subthalamic nucleus, a procedure that is already validated for the treatment of movement disorders, has been proposed as a therapeutic option. In this 10-month, crossover, double-blind, multicenter study assessing the efficacy and safety of stimulation of the subthalamic nucleus, we randomly assigned eight patients with highly refractory OCD to undergo active stimulation of the subthalamic nucleus followed by sham stimulation and eight to undergo sham stimulation followed by active stimulation. The primary outcome measure was the severity of OCD, as assessed by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), at the end of two 3-month periods. General psychopathologic findings, functioning, and tolerance were assessed with the use of standardized psychiatric scales, the Global Assessment of Functioning (GAF) scale, and neuropsychological tests. After active stimulation of the subthalamic nucleus, the Y-BOCS score (on a scale from 0 to 40, with lower scores indicating less severe symptoms) was significantly lower than the score after sham stimulation (mean [+/-SD], 19+/-8 vs. 28+/-7; P=0.01), and the GAF score (on a scale from 1 to 90, with higher scores indicating higher levels of functioning) was significantly higher (56+/-14 vs. 43+/-8, P=0.005). The ratings of neuropsychological measures, depression, and anxiety were not modified by stimulation. There were 15 serious adverse events overall, including 1 intracerebral hemorrhage and 2 infections; there were also 23 nonserious adverse events. These preliminary findings suggest that stimulation of the subthalamic nucleus may reduce the symptoms of severe forms of OCD but is associated with a substantial risk of serious adverse events. (ClinicalTrials.gov number, NCT00169377.)",Mallet L.; Polosan M.; Jaafari N.; Baup N.; Welter ML.; Fontaine D.; du Montcel ST.; Yelnik J.; Chéreau I.; Arbus C.; Raoul S.; Aouizerate B.; Damier P.; Chabardès S.; Czernecki V.; Ardouin C.; Krebs MO.; Bardinet E.; Chaynes P.; Burbaud P.; Cornu P.; Derost P.; Bougerol T.; Bataille B.; Mattei V.; Dormont D.; Devaux B.; Vérin M.; Houeto JL.; Pollak P.; Benabid AL.; Agid Y.; Krack P.; Millet B.; Pelissolo A.;  .,2008.0,10.1056/NEJMoa0708514,0,0,
8683,A randomised controlled trial of the effectiveness of writing as a self-help intervention for traumatic injury patients at risk of developing post-traumatic stress disorder.,"The study investigated the effects of writing and self-help information on severity of psychological symptoms in traumatic injury patients at risk for developing post-traumatic stress disorder (PTSD). Patients attending Accident and Emergency (A & E), were screened for Acute Stress Disorder and randomised to an information control group (n=36) or a writing and information group (n=31). Participants in both groups received an information booklet one-month post-injury. Participants in the writing group also wrote about emotional aspects of their trauma during three 20-min sessions, five to six weeks post-injury. Psychological assessments were completed within one month and at three and six months post-injury. There were significant improvements on measures of anxiety, depression and PTSD over time. Differences between groups on these measures were not statistically significant. However, subjective ratings of the usefulness of writing were high. In conclusion, the results do not currently support the use of writing as a targeted early intervention technique for traumatic injury patients at risk of developing PTSD.",Bugg A.; Turpin G.; Mason S.; Scholes C.,2009.0,10.1016/j.brat.2008.10.006,0,0,
8684,State anxiety and subjective well-being responses to acute bouts of aerobic exercise in patients with depressive and anxiety disorders.,"Acute aerobic exercise is associated with a reduction in state anxiety and an improvement in subjective well-being. The objective of the present study was to contrast the effects of aerobic exercise at self-selected intensity versus prescribed intensity on state anxiety and subjective well-being (negative affect, positive well-being and fatigue) in patients with depressive and/or anxiety disorders. In addition, the potential impact of heart rate feedback was assessed. Nineteen men and 29 women performed three test conditions on a bicycle ergometer during 20 minutes: two tests at self-selected intensity; one with and another without heart rate feedback, and a third test at the prescribed intensity of 50% of the maximal heart rate reserve according to Karvonen. Tests were executed in random order. State anxiety and subjective well-being were evaluated using the state anxiety inventory and the subjective exercise experiences scale. After 20 minutes cycling, patients showed significantly decreased state anxiety and negative affect in the three conditions. The magnitude of the reduction did not differ significantly between the three conditions. Only cycling at self-selected intensity enhanced positive well-being. Cycling at 50% of the maximal heart rate reserve decreased fatigue, whereas cycling at self-selected intensity increased fatigue. The response in state anxiety and negative affect was unaffected by the type of aerobic exercise. Self-selected intensity influenced exercise-induced changes in positive well-being and fatigue in a positive and negative way, respectively.",Knapen J.; Sommerijns E.; Vancampfort D.; Sienaert P.; Pieters G.; Haake P.; Probst M.; Peuskens J.,2009.0,10.1136/bjsm.2008.052654,0,0,
8685,Effect of a vocationally-focused brief cognitive behavioural intervention on employment-related outcomes for individuals with mood and anxiety disorders.,"Despite an increasing emphasis on the importance of vocational success to the quality of life of individuals with mental illness (Bond, Drake, & Becker, 2008), minimal work has examined the impact of cognitive behavioural interventions that focus on vocational stressors. Vocational stressors commonly faced by persons with mental illness include difficulties with work task completion, obtaining employment, and coping with interpersonal stressors (Becker et al., 1998). The purpose of this pilot study was to examine the effectiveness of a brief cognitive behavioural therapy group intervention that targets vocational stressors for individuals whose vocational functioning had been significantly impacted by mental illness. Participants included 16 individuals with mood and anxiety disorder diagnoses. After this intervention, it was found that employed persons reported an improved sense of mastery in the completion of work tasks, improved satisfaction with work supervision, and decreased satisfaction with advancement and job security. Unemployed participants reported improved expectancy for employment success.",Kidd SA.; Boyd GM.; Bieling P.; Pike S.; Kazarian-Keith D.,2008.0,10.1080/16506070802473189,0,0,
8686,The effect of a single-session attention modification program on response to a public-speaking challenge in socially anxious individuals.,"Research suggests that individuals with social anxiety show an attention bias for threat-relevant information However, few studies have directly manipulated attention to examine its effect on anxiety. In the current article, the authors tested the hypothesis that an attention modification program would be effective in reducing anxiety response and improving performance on a public-speaking challenge. Socially anxious participants completed a probe detection task by identifying letters (E or F) replacing one member of a pair of faces (neutral or disgust). The authors trained attention by including a contingency between the location of the neutral face and the probe in one group (Attention Modification Program; AMP). Participants in the AMP group showed significantly less attention bias to threat after training and lower levels of anxiety in response to a public-speaking challenge than did the participants in the Attention Control Condition (ACC) group. Moreover, blind raters judged the speeches of those in the AMP group as better than those in the ACC group. These results are consistent with the hypothesis that attention plays a causal role in the maintenance of social anxiety.",Amir N.; Weber G.; Beard C.; Bomyea J.; Taylor CT.,2008.0,10.1037/a0013445,0,0,
8687,Does interpersonal loss preceding panic disorder onset moderate response to psychotherapy? An exploratory study.,"Little research has addressed moderators of treatment outcome for anxiety disorders, and none has considered interpersonal loss as a predictor of outcome. To examine the effect of interpersonal loss events within the 6 weeks preceding panic disorder onset as a moderator of outcome in a randomized controlled trial of Panic-Focused Psychodynamic Therapy (PFPP) and Applied Relaxation Therapy (ART). Researchers hypothesized that such loss events would predict better outcome in PFPP but would not affect ART outcome. Forty-nine subjects with panic disorder were randomly assigned to a 12-week course of PFPP or ART. Independent raters blinded to treatment condition and study hypotheses rated subjects on the Panic Disorder Severity Scale (PDSS) and Sheehan Disability Scale. Exploratory analyses assessed between-group effect size for PFPP and ART following standard moderator analytic procedures. The trial was conducted between February 2000 and January 2005. Three quarters of subjects reported a narrowly defined interpersonal loss (LOSS) in the 6 weeks preceding panic disorder onset. These subjects had a mean (SD) duration of panic disorder of 8.2 (9.5) years. PFPP was more efficacious than ART, but LOSS did not moderate PFPP outcome. An unexpected finding was that LOSS moderated ART outcome: subjects without LOSS showed no response to ART (PDSS mean (SD) change score = 0.00 [2.90]), whereas LOSS had a pre-post mean (SD) change score of 4.29 (5.60). Neither examination of potential confounding variables nor sensitivity analyses of assumptions regarding attrition altered these findings. Interpersonal loss events preceding onset of panic disorder were more common even than in prior studies. These losses moderated outcome in ART, a therapy that does not focus on such losses. Implications and the need for future research before incorporating these findings into clinical practice are discussed. clinicaltrials.gov Identifier: NCT00128388.",Klass ET.; Milrod BL.; Leon AC.; Kay SJ.; Schwalberg M.; Li C.; Markowitz JC.,2009.0,,0,0,
8688,Can we apply the dual-pathway model of overeating to a population of weight-preoccupied overweight women?,"The aim of the study is to verify the applicability of the dual-pathway model among weight-preoccupied overweight women and to document the restraint pathway, the negative affect pathway, and the possibility of a direct pathway from body dissatisfaction to overeating. Structural equations were performed to test the model on baseline data of 153 weight-preoccupied overweight women recruited to participate in a randomized trial. Findings suggest that the model obtains satisfactory fit. Although the restraint pathway is partially supported, the negative affect pathway is confirmed. A third pathway linking directly body dissatisfaction to overeating is also evidenced. The dual-pathway model of overeating seems to be representative of the reality of weight-preoccupied overweight women, which could be pointed as a population in need of clinical attention, particularly considering the dramatically increasing rates of obesity.",Gagnon-Girouard MP.; Bégin C.; Provencher V.; Tremblay A.; Boivin S.; Lemieux S.,2009.0,10.1002/eat.20614,0,0,
8689,Psychiatric epidemiology of the elderly population in Chile.,"Little attention has been given to the prevalence rate of mental illness among elderly adults in Latin America. The prevalence rates for psychiatric disorders in Chile among those 65 and older compared with younger individuals, and the prevalence rate of psychiatric disorders among those age 75 and older are presented. A stratified random sample of 2,659 individuals. Four provinces representative of the Chile's population were surveyed. Adults age 15 and older were interviewed; however, the analysis is limited to those over age 20. The Composite International Diagnostic Interview was administered to obtain Diagnostic and Statistical Manual of Mental Disorders, Third Edition-R diagnoses. Lifetime and 12-month prevalence rates were estimated. Of the 2,659 interviewed 352 were over age 64. Overall, elderly adults had lower prevalence rates of lifetime disorders than the younger population, 20% in comparison with 34%. Dysthymia, agoraphobia, simple phobia, and alcohol dependence disorders were noted to be less common among elderly subjects. Those over the age of 64 in comparison with those over the age of 74 had higher prevalence rates of disorders. A sizable proportion of the disorders among older adults began after the age of 59. One third of elderly respondents with major depression had a late onset disorder. Service utilization was similar between elderly individuals and younger respondents, except for use of specialized psychiatric services, which was lower among elderly adults. Both lifetime and 1-year prevalence of mental disorders were less common in older than in younger persons; however, among elderly adults late onset disorders were not uncommon. Additional studies of the prevalence rates of disorders among older individuals in Latin America are needed for public health planning.",Kohn R.; Vicente B.; Saldivia S.; Rioseco P.; Torres S.,2008.0,10.1097/JGP.0b013e31818a0e1c,0,0,
8690,Randomized trial of internet-delivered self-help with telephone support for pathological gamblers.,"Although effective therapies for pathological gambling exist, their uptake is limited to 10% of the target population. To lower the barriers for help seeking, the authors tested an online alternative in a randomized trial (N = 66). The participants were pathological gamblers not presenting with severe comorbid depression. A wait-list control was compared with an 8-week Internet-based cognitive behavior therapy program with minimal therapist contact via e-mail and weekly telephone calls of less than 15 min. Average time spent on each participant, including phone conversations, e-mail, and administration, was 4 hr. The Internet-based intervention resulted in favorable changes in pathological gambling, anxiety, depression, and quality of life. Composite between-group effect size (Cohen's d) at posttreatment was 0.83. Follow-ups carried out in the treatment group at 6, 18, and 36 months indicated that treatment effects were sustained (ds = 2.58, 1.96, and 1.98). This evidence is in support of Internet-delivered treatment for pathological gamblers. However, it is not clear how effective the treatment is for more severely depressed individuals.",Carlbring P.; Smit F.,2008.0,10.1037/a0013603,0,0,
8691,[Symptoms of depression and anxiety in patients with coronary heart disease: natural course and results of a psychotherapeutic pilot study].,"In this pilot study we examined the natural course of depressive and anxiety symptoms in patients with coronary heart disease over a period of 1(1/2) years. Additionally, we examined patients' interest in participation in a group-psychotherapy. The intervention and its effects on symptom reduction were tested in a subgroup of patients. Assessment of anxiety and depression (HADS) in 58 cardiology inpatients at 3 time points (t1 after one year, t2 after 1(1/2) years). N = 9 patients were additionally included in a 6-month psychotherapy intervention and compared to N = 14 untreated patients. 79 % of the patients were interested in beginning a psychotherapy intervention. Without psychotherapeutic treatment, the average psychological strain remained stable over the time of investigation. Intervention-group patients, however, achieved a significant (60 %) reduction in depression and anxiety scores. Implications for the clinical practice and further investigations are discussed.",Merswolken M.; Albert W.; Orth-Gomér K.; Pauschinger M.; Deter HC.,2008.0,10.13109/zptm.2008.54.4.381,0,0,
8692,Cognitive behavioral group therapy for social phobia with or without attention training: a controlled trial.,"The Self-Regulatory Executive Function model [S-REF; Wells, A., & Matthews, G. (1996). Modelling cognition in emotional disorder: the S-REF model. Behaviour Research and Therapy, 34, 881-888] proposes that metacognitive beliefs, inflexible self-focused attention, and perseverative thinking (rumination and worry) play an important role in maintaining emotional dysfunction. Attention training [ATT; Wells, A. (1990). Panic disorder in association with relaxation induced anxiety: an attentional training approach to treatment. Behavior Therapy, 21, 273-280] is a technique designed to increase attentional control and flexibility, and thereby lessen the impact of these maintaining factors. The main aim of this study was to determine whether or not supplementing cognitive behavioral group therapy (CBGT) with ATT could potentiate greater changes in social anxiety, depression, attentional control, metacognitive beliefs, and anticipatory and post-event processing in a clinical sample with social phobia. Patients (N=81) were allocated to CBGT with ATT or relaxation training (RT). ATT did not potentiate greater change on any outcome variable, with both groups achieving significant improvements on all measures. Exploratory correlational analyses (pre-treatment and changes scores) showed that some metacognitive beliefs were associated with attentional control, anticipatory processing, and symptoms of social anxiety and depression. However, attentional control was more consistently associated with anticipatory processing, post-event processing, and symptoms of social anxiety and depression, than with metacognitive beliefs. Results are discussed with reference to cognitive behavioral models of social phobia. It is tentatively concluded that while supplementing CBGT with ATT does not improve outcomes, increasing attentional control during CBGT is associated with symptom relief.",McEvoy PM.; Perini SJ.,2009.0,10.1016/j.janxdis.2008.10.008,0,0,
8693,Individual versus group cognitive behavioral treatment for obsessive-compulsive disorder: follow up.,"To compare the effectiveness of two forms of cognitive behavioral treatment (CBT; group and individual) in a sample of patients with obsessive-compulsive disorder (OCD) at 6-month and 12-month follow up. Thirty-eight subjects meeting DSM-IV-TR OCD criteria completed 20 sessions of individual and group CBT. They were assessed using the Yale-Brown Obsessive-Compulsive Scale and the Hamilton Anxiety and Depression Scales at baseline, after treatment and at 6-month and 12-month follow up. The clinical improvement obtained at the end of the treatment was maintained at 6-month and 12-month follow up. The clinical outcome of the individual treatment (IT) and the group treatment (GT) was the same. The dropout rates were significantly higher in women than in men, but were similar for IT and GT. CBT was effective in a sample of OCD patients. Individual and group CBT had similar results at 6-month and 12-month follow up. The clinical implications of these findings are discussed.",Jaurrieta N.; Jiménez-Murcia S.; Alonso P.; Granero R.; Segalàs C.; Labad J.; Menchón JM.,2008.0,10.1111/j.1440-1819.2008.01873.x,0,0,
8694,Anger potentiates the reporting of threatening interpretations: an experimental study.,"This paper reports the results of an experiment investigating the effect of induced anger on interpretational bias using the homophone spelling task. Four groups of participants experienced anger, anxiety, happy or neutral mood inductions and then completed the homophone spelling task. Participants who experienced anger and anxiety inductions reported significantly more threat/neutral homophones as threats compared to control participants; moods had an emotion-congruent effect on threat reporting, with negative moods increasing the tendency to report threat/neutral homophones as threats and positive moods increasing the tendency to report positive/neutral homophones as positive. The findings provide evidence that anger potentiates the reporting of threatening interpretations and does so independently of any effect of concurrent levels of state and trait anxiety. The mechanism mediating this effect is unclear, but the results do lend support to those theories of psychopathology--and especially of PTSD--that see a causal role for anger in the maintenance of symptoms.",Barazzone N.; Davey GC.,2009.0,10.1016/j.janxdis.2008.10.007,0,0,
8695,A randomized trial of the effect of prayer on depression and anxiety.,"To investigate the effect of direct contact person-to-person prayer on depression, anxiety, positive emotions, and salivary cortisol levels. Cross-over clinical trial with depression or anxiety conducted in an office setting. Following randomization to the prayer intervention or control groups, subjects (95% women) completed Hamilton Rating Scales for Depression and Anxiety, Life Orientation Test, Daily Spiritual Experiences Scale, and underwent measurement of cortisol levels. Individuals in the direct person-to-person prayer contact intervention group received six weekly 1-hour prayer sessions while those in the control group received none. Rating scales and cortisol levels were repeated for both groups after completion of the prayer sessions, and a month later. ANOVAs were used to compare pre- and post-prayer measures for each group. At the completion of the trial, participants receiving the prayer intervention showed significant improvement of depression and anxiety, as well as increases of daily spiritual experiences and optimism compared to controls (p < 0.01 in all cases). Subjects in the prayer group maintained these significant improvements (p < 0.01 in all cases) for a duration of at least 1 month after the final prayer session. Participants in the control group did not show significant changes during the study. Cortisol levels did not differ significantly between intervention and control groups, or between pre- and post-prayer conditions. Direct contact person-to-person prayer may be useful as an adjunct to standard medical care for patients with depression and anxiety. Further research in this area is indicated.",Boelens PA.; Reeves RR.; Replogle WH.; Koenig HG.,2009.0,10.2190/PM.39.4.c,0,0,
8696,Does post-event cognitive load undermine thought suppression and increase intrusive memories after exposure to an analogue stressor?,"Ironic process theory has been used in part to explain the phenomenon of intrusive memories in various disorders including post-traumatic stress disorder. How thought suppression interacts with other cognitive processes believed to be instrumental in the development of traumatic intrusive memory was tested. In an analogue design 120 participants were randomised to five conditions, four of which also required participants to attempt to suppress intrusive memories after viewing a film of traumatic content. Participants in three conditions were also required to perform concurrent tasks that acted as a cognitive load during suppression. Intrusive memories were recorded during the experimental phase and at 1-week follow-up. Contrary to predictions, post-film processing did not undermine suppression success. There was some suggestion that post-film processing resulted in those participants experiencing intrusions of shorter duration than the no-suppression control group in two 5-minute intrusion monitoring intervals at the initial and follow-up phase of the experiment, but this was not reflected in a 1-week diary measure of intrusions. All experimental groups performed in a similar fashion in terms of memory testing of the film's content. The findings are discussed in the context of ironic process theory and cognitive models of post-traumatic stress.",Nixon RD.; Cain N.; Nehmy T.; Seymour M.,2009.0,10.1080/09658210802592353,0,0,
8697,"Generalized anxiety disorder in older medical patients: diagnostic recognition, mental health management and service utilization.","Primary care physicians often treat older adults with Generalized Anxiety Disorder. Objective To estimate physician diagnosis and recognition of anxiety and compare health service use among older adults with GAD with two comparison samples with and without other DSM diagnoses. Participants were 60+ patients of a multi-specialty medical organization. Administrative database and medical records were reviewed for a year. Differences in frequency of health service use were analyzed with logistic regression and between-subjects analysis of covariance. Physician diagnosis of GAD was 1.5% and any anxiety was 9%, and recognition of anxiety symptoms was 34% in older adults with GAD. After controlling for medical comorbidity, radiology appointments were increased in the GAD group relative to those with and without other psychiatric diagnoses, chi(2) (2, N = 225) = 4.75, p < .05. Most patients with anxiety do not have anxiety or symptoms documented in their medical records.",Calleo J.; Stanley MA.; Greisinger A.; Wehmanen O.; Johnson M.; Novy D.; Wilson N.; Kunik M.,2009.0,10.1007/s10880-008-9144-5,0,0,
8698,The psychological toll of the Intifada: symptoms of distress and coping in Israeli soldiers.,"Detrimental effects of military service among the civilian Palestinian population have been reported in soldiers. To examine the frequency and type of stressors encountered by soldiers in close contact with the CPP and its relationship with post-traumatic symptomatology. We also investigated coping methods and the preferred types of professional help. Using random digit dialing methodology we conducted a phone survey of veteran soldiers, men (n=167) and women (n=59) in close contact with the CPP; the comparison group comprised male veteran soldiers with no CPP exposure (n=74). We used focus groups to develop context-related measures to assess exposure to violent incidents, coping modes and preferred modes of professional assistance. We included measures of traumatic exposure, post-traumatic stress symptoms and post-traumatic stress disorder. Soldiers who served among the CPP had greater exposure to traumatic events and to civilian-related violent incidents (more than half as victims, and a third as perpetrators); and 17.4% perceived their behavior as degrading civilians. Primary traumatic exposure, perceived health problems and avoidance coping were found to be risk factors for PTS and PTSD. Involvement in incidents that may have degraded Palestinian civilians predicted PTS. Friction with the CPP in itself does not constitute a risk factor for psychopathology among soldiers. However, contact with this population entails more exposure to traumatic events, which may cause PTS and PTSD. Furthermore, a relative minority of soldiers may be involved in situations that may degrade civilians, which is a risk factor for PTS. To avoid violent and sometimes degrading behaviors, appropriate psycho-educational and behavioral preparation should be provided.",Bleich A.; Gelkopf M.; Berger R.; Solomon Z.,2008.0,,0,0,
8699,Impact of a meaning-centered intervention on job satisfaction and on quality of life among palliative care nurses.,"Palliative care (PC) nurses experience several recurrent organizational, professional, and individual challenges. To address existential and emotional demands, the meaning-centered intervention was recently developed. The intervention applied didactic and process-oriented strategies, including guided reflections, experiential exercises, and education based on themes of Viktor Frankl's logotherapy. The objective of this study was to test its efficiency to improve job satisfaction and quality of life in PC nurses from three regional districts in Quebec Province, Canada. A randomized waiting-list group design was conducted, intervention group (n=56) versus waiting-list group (n=53). Job satisfaction, perception of benefits of working in PC, and spiritual and emotional quality of life were measured at pre-, posttest, and 3-month follow-up. The PC nurses in the experimental group reported more perceived benefits of working in PC after the intervention and at follow-up. Spiritual and emotional quality of life remained, however, unaffected by the intervention. To explain null findings, theoretical and methodological challenges, related to existential interventions, such as choice of outcomes, and selection bias (participants recruited were healthy workers) are discussed. Future directions and strategies to deal with those issues are proposed.",Fillion L.; Duval S.; Dumont S.; Gagnon P.; Tremblay I.; Bairati I.; Breitbart WS.,2009.0,10.1002/pon.1513,0,0,
8700,Approach-avoidance coping conflict in a sample of burn patients at risk for posttraumatic stress disorder.,"Following an acute burn injury, higher distress is consistently observed among individuals exhibiting a conflict between approach coping (e.g., processing) and avoidance coping (e.g., suppression) relative to those individuals who use only one of these methods. Study objectives were to determine if contradictory coping messages would lead to such approach-avoidance coping conflict and to determine if experiment-induced coping conflict is also associated with higher distress. Participants (n=59 adults hospitalized with acute burn injuries) were assigned randomly to experimental conditions differing in the order in which training was provided in two ways of coping with posttrauma re-experiencing symptoms (i.e., process-then-suppress versus suppress-then-process). The primary dependent variable was coping behavior during the 24-hr posttraining period. Coping behavior was categorized as approach coping (processing), avoidance coping (suppressing), or approach-avoidance coping conflict (both) on the basis of median splits on subscales assessing these behaviors. Secondary analyses examined the relationship between this experiment-induced coping conflict and re-experiencing symptoms. Results indicated that participants in the process-then-suppress condition, relative to the suppress-then-process condition, were significantly more likely to exhibit approach-avoidance coping conflict (i.e., above median split on both processing and suppressing) during the next 24 hr. Furthermore, approach-avoidance coping conflict was associated with greater re-experiencing symptoms assessed via self-report and by blinded coding of recorded speech. It is concluded that the order of coping skill training can influence treatment outcome, success of coping methods, and overall levels of distress. therefore, training in stabilizing and calming methods should precede training in active processing following stressful life events.",Fauerbach JA.; Lawrence JW.; Fogel J.; Richter L.; Magyar-Russell G.; McKibben JB.; McCann U.,2009.0,10.1002/da.20439,0,0,
8701,"Treatment of severe, treatment-refractory obsessive-compulsive disorder: a study of inpatient and community treatment.","This research reports on a prospective outcome study of two cohorts of patients with severe, chronic, resistant obsessive-compulsive disorder (OCD). One cohort consisted of a total of 52 patients treated in an inpatient setting, while the second group comprised 65 patients treated in a community-outpatient setting. Treatment consistent primarily of intensive graded exposure and self-imposed response prevention augmented with cognitive restructuring. The groups demonstrated significant improvement over the course of treatment. In the inpatient and community groups, there was significant improvement over the first 12 weeks of treatment, and further improvement between 12 and 24 weeks. These results suggest that even for patients who have demonstrated treatment-resistance, there may be benefit in intensive behavioral treatment of OCD. In addition it was found that even for those patients with the most profound refractory OCD and complicating factors inpatient stays of up to 24 weeks were effective in reducing symptoms.",Boschen MJ.; Drummond LM.; Pillay A.,2008.0,,0,0,
8702,Change processes in residential cognitive and interpersonal psychotherapy for social phobia: a process-outcome study.,"The purpose of this study was to test cognitive and interpersonal models for improving social phobia. Eighty patients with social phobia were randomized to 10-week residential cognitive (RCT) or residential interpersonal psychotherapy (RIPT). They completed process measures every Thursday and a sub-outcome measure every Monday. The ratings were analyzed with mixed models. Weekly changes in the process variables derived from the cognitive model (self-focus, estimated probability and estimated cost of negative social events, safety behaviors) predicted subsequent weekly changes in social anxiety. Changes in the interpersonal variable perceived acceptance by others also predicted subsequent changes in social anxiety. On the other hand, changes in social anxiety predicted changes in the four cognitive variables. There were no interactive effects of process with treatment. The cognitive variables decreased during treatment to a similar degree in both treatments. The results indicate that, to reduce social anxiety, therapy should target self-focus, estimated probability and cost of feared social events, safety behaviors, and perceived acceptance by others. The process of improvement may involve positive cycles in that a reduction of social anxiety, in turn, appeared to impact self-focus, probability, cost, and safety behaviors.",Hoffart A.; Borge FM.; Sexton H.; Clark DM.,2009.0,10.1016/j.beth.2007.12.003,0,0,
8703,Observations on unaided smoking cessation after deep brain stimulation of the nucleus accumbens.,"We explore whether clinical research on deep brain stimulation (DBS) of the nucleus accumbens (NAc) to treat addiction is justified besides theoretical speculation. Since 2004, 10 patients who were also smokers were treated at the University of Cologne for Tourette's syndrome (TS), obsessive-compulsive disorders (OCD) or anxiety disorders (AD) by DBS of the NAc. We assessed their smoking behavior after DBS and (in retrospection) before by the Fagerstrom Test for Nicotine Dependence (FTND) and additional items. Three male patients were able to quit smoking after DBS. They were less dependent and higher motivated compared to the rest of the sample. They are stimulated with a higher voltage. During 1-year, 2-year, and 30-month follow-ups, we found a higher rate of successful smoking cessation (20, 30 and 30%) compared to unaided smoking cessation in the general population (13, 19 and 8.7%). Albeit the results of the study are severely limited by the method of retrospective self-assessment of psychiatric patients, further research of DBS of the NAc to treat addiction seems justified. In addition to biological mediators, psychosocial factors should be assessed in further prospective studies.",Kuhn J.; Bauer R.; Pohl S.; Lenartz D.; Huff W.; Kim EH.; Klosterkoetter J.; Sturm V.,2009.0,10.1159/000228930,0,0,
8704,Pre-treatment predictors and in-treatment factors associated with change in avoidant and dependent personality disorder traits among patients with social phobia.,"We examined changes in avoidant and dependent personality disorder dimensions, and pre-treatment and in-treatment factors associated with such changes in 77 patients, randomized to medication-free residential cognitive (CT) or residential interpersonal therapy for social phobia. Personality disorders and personality dimensions according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were assessed at pre-treatment and at one-year post-treatment. Both treatments were associated with a decrease in avoidant and dependent personality dimensions; dependent dimension decreased more in CT. Changes in cognitive factors predicted changes in both personality dimensions, whereas changes in symptoms or interpersonal factors did not. Change in the cognitive factor estimated cost was the most powerful predictor in the avoidant dimension, as it was the only predictor that remained significant in the forward regression analyses. Change in the cognitive factor estimated cost, and treatment were the most powerful predictors of change in the dependent dimension. Pre-treatment use of anxiolytics predicted larger changes in both PD dimensions.",Borge FM.; Hoffart A.; Sexton H.; Martinsen E.; Gude T.; Hedley LM.; Abrahamsen G.,,10.1002/cpp.640,0,0,
8705,Implementation of Internet-based preventive interventions for depression and anxiety: role of support? The design of a randomized controlled trial.,"Internet-based self-help is an effective preventive intervention for highly prevalent disorders, such as depression and anxiety. It is not clear, however, whether it is necessary to offer these interventions with professional support or if they work without any guidance. In case support is necessary, it is not clear which level of support is needed. This study examines whether an internet-based self-help intervention with a coach is more effective than the same intervention without a coach in terms of clinical outcomes, drop-out and economic costs. Moreover, we will investigate which level of support by a coach is more effective compared to other levels of support. In this randomized controlled trial, a total of 500 subjects (18 year and older) from the general population with mild to moderate depression and/or anxiety will be assigned to one of five conditions: (1) web-based problem solving through the internet (self-examination therapy) without a coach; (2) the same as 1, but with the possibility to ask help from a coach on the initiative of the respondent (on demand, by email); (3) the same as 1, but with weekly scheduled contacts initiated by a coach (once per week, by email); (4) weekly scheduled contacts initiated by a coach, but no web-based intervention; (5) information only (through the internet). The interventions will consist of five weekly lessons. Primary outcome measures are symptoms of depression and anxiety. Secondary outcome measures are drop-out from the intervention, quality of life, and economic costs. Other secondary outcome measures that may predict outcome are also studied, e.g. client satisfaction and problem-solving skills. Measures are taken at baseline (pre-test), directly after the intervention (post-test, five weeks after baseline), 3 months later, and 12 months later. Analysis will be conducted on the intention-to-treat sample. This study aims to provide more insight into the clinical effectiveness, differences in drop-out rate and costs between interventions with and without support, and in particular different levels of support. This is important to know in relation to the dissemination of internet-based self-help interventions. Nederlands Trial Register (NTR): TC1355.",Donker T.; van Straten A.; Riper H.; Marks I.; Andersson G.; Cuijpers P.,2009.0,10.1186/1745-6215-10-59,0,0,
8706,Screening for intimate partner violence in health care settings: a randomized trial.,"Whether intimate partner violence (IPV) screening reduces violence or improves health outcomes for women is unknown. To determine the effectiveness of IPV screening and communication of positive results to clinicians. Randomized controlled trial conducted in 11 emergency departments, 12 family practices, and 3 obstetrics/gynecology clinics in Ontario, Canada, among 6743 English-speaking female patients aged 18 to 64 years who presented between July 2005 and December 2006, could be seen individually, and were well enough to participate. Women in the screened group (n=3271) self-completed the Woman Abuse Screening Tool (WAST); if a woman screened positive, this information was given to her clinician before the health care visit. Subsequent discussions and/or referrals were at the discretion of the treating clinician. The nonscreened group (n=3472) self-completed the WAST and other measures after their visit. Women disclosing past-year IPV were interviewed at baseline and every 6 months until 18 months regarding IPV reexposure and quality of life (primary outcomes), as well as several health outcomes and potential harms of screening. Participant loss to follow-up was high: 43% (148/347) of screened women and 41% (148/360) of nonscreened women. At 18 months (n = 411), observed recurrence of IPV among screened vs nonscreened women was 46% vs 53% (modeled odds ratio, 0.82; 95% confidence interval, 0.32-2.12). Screened vs nonscreened women exhibited about a 0.2-SD greater improvement in quality-of-life scores (modeled score difference at 18 months, 3.74; 95% confidence interval, 0.47-7.00). When multiple imputation was used to account for sample loss, differences between groups were reduced and quality-of-life differences were no longer significant. Screened women reported no harms of screening. Although sample attrition urges cautious interpretation, the results of this trial do not provide sufficient evidence to support IPV screening in health care settings. Evaluation of services for women after identification of IPV remains a priority. clinicaltrials.gov Identifier: NCT00182468.",MacMillan HL.; Wathen CN.; Jamieson E.; Boyle MH.; Shannon HS.; Ford-Gilboe M.; Worster A.; Lent B.; Coben JH.; Campbell JC.; McNutt LA.;  .,2009.0,10.1001/jama.2009.1089,0,0,
8707,Long-term effects of an internet-based treatment for posttraumatic stress.,"Advances in communication technology offer additional strategies for providing psychological treatment. Previous trials of Internet-based treatment approaches reported significant reductions in posttraumatic stress and related symptoms in response to Internet-based treatments relative to control groups. However, empirical data on the long-term effects of those approaches are sparse. In order to evaluate the long-term effect of an Internet-based intervention, the authors conducted an 18-month follow-up of an Internet-based cognitive behavioural therapy for posttraumatic stress. Severity of posttraumatic stress symptoms was the primary outcome. Additional measures were depression, anxiety, mental and physical health, and health care utilization during the follow-up period. Treatment group participants (n = 34) were assessed 1.5 years after completing treatment. Results indicated that reductions in symptoms of posttraumatic stress symptoms, depression, and anxiety found at posttreatment were sustained during the 18-month follow-up period. Preliminary evidence on long-term effects of Internet-based health care as shown in this study is promising. However, research with larger and clinically more diverse samples is needed to fully assess the clinical impact and potential of Internet-based health care provision.",Knaevelsrud C.; Maercker A.,2010.0,10.1080/16506070902999935,0,0,
8708,Use of the late-life function and disability instrument to assess disability in major depression.,"To determine whether there was greater disability in subjects with depression than in those without, the correlation between disability and depression severity and quality of life, and whether improvement in disability after antidepressant pharmacotherapy was greater in those who responded to antidepressant treatment. Disability in subjects with and without depression from two different studies was compared for 22 weeks. Correlations were performed for the subjects with depression between disability and depression, anxiety, health-related quality of life (HRQOL), and medical comorbidity. T-tests were used to compare disability between subjects who did and did not respond to antidepressant treatment and change in disability after pharmacotherapy. Late-life depression research clinic. The 313 subjects were recruited from primary care and the community and were aged 60 and older; 244 subjects were participants in a depression treatment protocol, and 69 subjects without depression participated in a separate longitudinal observational study of the mental and cognitive health of depression-free older adults. The Late-Life Function and Disability Instrument (LL-FDI), a measure of instrumental activity of daily living, personal role, and social role functioning. Subjects with depression scored lower than controls for domains measuring limitation (can do) and frequency (does do) of activities. Both disability domains correlated with depression severity, anxiety, HRQOL, and cognition. Disability improved with antidepressant treatment; for partial responders who continued to receive higher-dose antidepressant treatment out to 22 weeks, there was continued improvement, although not to the level of comparison subjects without depression. The LL-FDI appears to discriminate subjects with depression from those without, correlates with depression severity, and demonstrates sensitivity to antidepressant treatment response. We recommend further investigation of the LL-FDI and similar disability instruments for assessing depression-related disability.",Karp JF.; Skidmore E.; Lotz M.; Lenze E.; Dew MA.; Reynolds CF.,2009.0,10.1111/j.1532-5415.2009.02398.x,0,0,
8709,[Endoscopic decompression of the ulnar nerve in cubital tunnel syndrome].,"Long endoscopic in situ decompression of the ulnar nerve in cubital tunnel syndrome (sulcus ulnaris syndrome) with direct visualization and minimal incision. Every cubital tunnel syndrome including a posttraumatic or arthrotic etiology, cubitus valgus, nerve dislocation, or other causes. Revision surgery after primary endoscopic decompression. Relative: irritation of the ulnar nerve by recurrent luxation. Relative: previous open primary surgery. Minimal longitudinal incision in the retrocondylar groove. The Osborne ligament is opened and the ulnar nerve identified. Dissection of a subcutaneous tunnel in the direction of the nerve. Decompression of the ulnar nerve by opening the muscle fascia proximally and distally while preserving all sensory nerves. Afterwards, the submuscular membrane with its fibrous bands between flexor carpi ulnaris and the nerve is opened while preserving all motor branches of the ulnar nerve. Bulky, slightly compressive dressing of the entire upper extremity to prevent excessive motion in 20 degrees elbow flexion for 3 days. Then, free motion is allowed during the day. At night, the arm should be kept in near extension for 14 days. Muscular atrophy prior to surgery should imply focused physiotherapy for ulnaris-innervated muscles 8 weeks postoperatively. 52 patients were operated using this method. 53% felt an immediate improvement right after surgery. 47 patients (90%) were available for reexamination after 8 months. Two-point discrimination, grip and pinch strength, and nerve conduction velocity had improved significantly to normal levels. Results, measured with the modified Bishop Rating System, were excellent in 66%, good in 32%, and fair in 2%. There were no poor results. Patients with advanced stages of disease also achieved good results.",Bultmann C.; Hoffmann R.,2009.0,10.1007/s00064-009-1707-6,0,0,
8710,[Patella fracture].,"Reconstruction of the extensor apparatus of the knee joint. Open reduction and stable internal fixation of patella fractures. Exact reconstruction of the articular surface of the patellofemoral joint. Open and closed fractures. Fractures with an intraarticular incongruity (> 2 mm). Incapability of extension of the knee also in nondisplaced fractures of the patella. In the context of internal fixations of additional periarticular fractures of the knee joint. Compromised general health status or associated injuries. Compromised local soft-tissue situation (contamination, poor soft-tissue cover). Relative: nondisplaced transverse fractures (no displacement in 40 degrees of flexion). Relative: nondisplaced longitudinal fractures(3). Relative: nondisplaced radiating fractures(3). Relative: nondisplaced fractures of the distal pole without involvement of the joint surface and intact extensor apparatus(3). Longitudinal parapatellar incision. Tension band wiring. Lag screw osteosynthesis. Combination of tension band wiring and lag screws. Patellectomy (partial/complete). Thrombosis prophylaxis. Early physiotherapy. Knee brace. 70% good to excellent results. 30% chronic pain and posttraumatic arthritis. Loss of motion (limited extension).",Dietz SO.; Hessmann MH.; Gercek E.; Rommens PM.,2009.0,10.1007/s00064-009-1708-5,0,0,
8711,"Depression, anxiety, and somatoform disorders: vague or distinct categories in primary care? Results from a large cross-sectional study.","Depression, anxiety, and somatization are the most frequently observed mental disorders in primary health care. Our main objective was to draw on the often neglected general practitioners' (GPs) perspective to investigate what characterizes these three common mental diagnoses with regard to creating more suitable categories in the DSM-V and ICD-11. We collected independent data from 1751 primary care patients (participation rate=77%) and their 32 treating GPs in Germany. Patients filled out validated patient self-report measures for depression (PHQ-9), somatic symptom severity (PHQ-15), and illness anxiety (Whiteley-7), and questions regarding coping and attribution of illness. GPs' clinical diagnoses and associated features were assessed. Patients diagnosed by their GPs with depression, anxiety, and/or somatoform disorders were significantly older, less educated, and more often female than the reference group not diagnosed with a mental disorder. They had visited the GP more often, had a longer duration of symptoms, and were more often under social or financial stress. Among the mental disorders diagnosed by the GPs, depression (OR=4.4; 95% CI=2.6 to 7.5) and comorbidity of somatoform, depressive, and anxiety disorders (OR=9.5; 95% CI=4.6 to 19.4) were associated with the largest degrees of impairment compared to the reference group. Patients diagnosed as having a somatoform/functional disorder only had mildly elevated impairment on all dimensions (OR=2.0; 95% CI=1.4 to 2.7). Similar results were found for the physicians' attribution of psychosocial factors for cause and maintenance of the disease, difficult patient-doctor relationship, and self-assessed mental disorder. In order to make the DSM-V and ICD-11 more suitable for primary care, we propose providing appropriate diagnostic categories for (1) the many mild forms of mental syndromes typically seen in primary care; and (2) the severe forms of comorbidity between somatoform, depressive, and/or anxiety disorder, e.g., with a dimensional approach.",Hanel G.; Henningsen P.; Herzog W.; Sauer N.; Schaefert R.; Szecsenyi J.; Löwe B.,2009.0,10.1016/j.jpsychores.2009.04.013,0,0,
8712,Feasibility and preliminary outcomes from a pilot study of coping skills training for adolescent--young adult survivors of childhood cancer and their parents.,"Uncertainty is a central feature of long-term childhood cancer survivorship during which time it principally has to do with late effects. Therefore, the purposes of this article are (a) to assess feasibility of a randomized clinical trial of a telephone-delivered coping skills training (CST) intervention in terms of recruitment, retention, and timeline, as well as the performance of the study measures; and (b) to demonstrate trends in change on outcomes within the context of a small pilot study. The results of this pilot study suggest that HEROS PLUS CST has clinical relevance and that in-person long-term follow-up plus telephone-delivered psychosocial care is a practical way to deliver integrated care to adolescent-young adult childhood cancer survivors and their parents.",Judge Santacroce S.; Asmus K.; Kadan-Lottick N.; Grey M.,,10.1177/1043454209340325,0,0,6507
8713,Cost-effectiveness analysis of an occupational therapy-led lifestyle approach and routine general practitioner's care for panic disorder.,"To assess the cost-effectiveness of an occupational therapy-led lifestyle approach to treating panic disorder in primary care compared with routine general practitioner's (GP) care. The burden of mental health disorders is considerable. Cost-effective interventions are necessary to alleviate some of these burdens. Habitual lifestyle behaviours influence mood, although to date mainly single lifestyle factor trials have been conducted to examine the effects on anxiety. An economic evaluation was conducted alongside an unblinded pragmatic randomised controlled trial with assessment at 5 and 10 months. Costs and consequences, as measured by the Beck anxiety inventory (BAI) and quality adjusted life years (QALYs), were compared using incremental cost-effectiveness ratios (ICERs). The occupational therapy-led lifestyle intervention was more costly than routine GP care at both 5 and 10 months. Significant outcome improvements were evident at 5 months when using the BAI, although these were not maintained at 10 months. Small differences in mean QALYs were found. The estimated ICER was 36 pounds per BAI improvement for 5 months and 39 pounds for 10 months, and 18,905 pounds per QALY gained for 5 months and 8,283 pounds for 10 months. If the maximum willingness to pay per additional QALY is 30,000 pounds, then there is an 86% chance that a lifestyle intervention may be considered to be value-for-money over 10 months.",Lambert RA.; Lorgelly P.; Harvey I.; Poland F.,2010.0,10.1007/s00127-009-0114-5,0,0,
8714,Mechanisms of efficacy of CBT for Cambodian refugees with PTSD: improvement in emotion regulation and orthostatic blood pressure response.,"Based on the results of a randomized controlled trial, we examined a model of the mechanisms of efficacy of culturally adapted cognitive-behavior therapy (CBT) for Cambodian refugees with pharmacology-resistant posttraumatic stress disorder (PTSD) and comordid orthostatic panic attacks (PAs). Twelve patients were in the initial treatment condition, 12 in the delayed treatment condition. The patients randomized to CBT had much greater improvement than patients in the waitlist condition on all psychometric measures and on one physiological measure-the systolic blood pressure response to orthostasis (d = 1.31)-as evaluated by repeated-measures MANOVA and planned contrasts. After receiving CBT, the Delayed Treatment Group improved on all measures, including the systolic blood pressure response to orthostasis. The CBT treatment's reduction of PTSD severity was significantly mediated by improvement in orthostatic panic and emotion regulation ability. The current study supports our model of the generation of PTSD in the Cambodian population, and suggests a key role of decreased vagal tone in the generation of orthostatic panic and PTSD in this population. It also suggests that vagal tone is involved in emotion regulation, and that both vagal tone and emotion regulation improve across treatment.",Hinton DE.; Hofmann SG.; Pollack MH.; Otto MW.,2009.0,10.1111/j.1755-5949.2009.00100.x,0,0,
8715,Randomized sham-controlled trial of repetitive transcranial magnetic stimulation in treatment-resistant obsessive-compulsive disorder.,"In open trials, 1-Hz repetitive transcranial magnetic stimulation (rTMS) to the supplementary motor area (SMA) improved symptoms and normalized cortical hyper-excitability of patients with obsessive-compulsive disorder (OCD). Here we present the results of a randomized sham-controlled double-blind study. Medication-resistant OCD patients (n=21) were assigned 4 wk either active or sham rTMS to the SMA bilaterally. rTMS parameters consisted of 1200 pulses/d, at 1 Hz and 100% of motor threshold (MT). Eighteen patients completed the study. Response to treatment was defined as a > or = 25% decrease on the Yale-Brown Obsessive Compulsive Scale (YBOCS). Non-responders to sham and responders to active or sham rTMS were offered four additional weeks of open active rTMS. After 4 wk, the response rate in the completer sample was 67% (6/9) with active and 22% (2/9) with sham rTMS. At 4 wk, patients receiving active rTMS showed on average a 25% reduction in the YBOCS compared to a 12% reduction in those receiving sham. In those who received 8-wk active rTMS, OCD symptoms improved from 28.2+/-5.8 to 14.5+/-3.6. In patients randomized to active rTMS, MT measures on the right hemisphere increased significantly over time. At the end of 4-wk rTMS the abnormal hemispheric laterality found in the group randomized to active rTMS normalized. The results of the first randomized sham-controlled trial of SMA stimulation in the treatment of resistant OCD support further investigation into the potential therapeutic applications of rTMS in this disabling condition.",Mantovani A.; Simpson HB.; Fallon BA.; Rossi S.; Lisanby SH.,2010.0,10.1017/S1461145709990435,0,0,
8716,[Sports activity and proprioceptive ability after arthroscopic capsulolabral repair of post-traumatic shoulder instability].,"The aim of the study was to evaluate the clinical and functional outcome after arthroscopic transglenoid stabilisation of post-traumatic shoulder instabilities. Besides assessing the sports activity level, a special emphasis was put into evaluating the proprioceptive ability in a clinical-experimental setting as well as comparisons with a control group. We evaluated the functional results of 35 patients after arthroscopic stabilisation of post-traumatic, unidirectional anterior shoulder instabilities at a mean of 47.4 +/- 12.8 months postoperatively. Criteria such as subjective level of contentedness, range of motion, stability and sports activity as well as the Constant and Rowe scores were recorded. Joint position sense was assessed in 30 degrees internal and external rotation with the passive angle reproduction test using an inclinometer. The difference between the discerned and the target joint position was used as a measure of proprioceptive ability. Results were compared to the contralateral shoulder as well as to a control group consisting of 31 volunteers without any history of shoulder pain or injury. The Mann-Whitney U-test was used for statistical analysis. The level of subjective satisfaction on a visual analogue scale was 9.3 +/- 1.1 points. ROM testing showed a mean loss of 4.8 +/- 5.1 degrees of external rotation compared to the contralateral shoulder. A mean Constant score of 88.9 +/- 7.8 and a mean Rowe score of 86.7 +/- 19.0 points were obtained. Four patients had a reluxation of the shoulder, in 3 cases due to an adequate traumatic event. 20 of 24 athletes (83 %) were able to return to their previous sports activity level without any restrictions. Passive angle reproduction testing showed no significant difference regarding the proprioceptive ability between operated shoulders in internal and external rotation (mean angle difference IRO = 2.6 +/- 1.4 degrees , ARO = 3.3 +/- 1.5 degrees ) compared to the contralateral shoulder (2.9 +/- 1.5 degrees , 3.6 +/- 1.8 degrees , p = 0.56/0.36) as well as compared to the control group (3.0 +/- 1.1 degrees , 3.4 +/- 1.1 degrees , p = 0.67/0.32). The results of this study indicate that arthroscopic transglenoid shoulder stabilisation is a sufficient technique for the treatment of post-traumatic shoulder instability. Arthroscopic capsulolabral reconstruction led to a complete restoration of the proprioceptive ability in internal and external rotation. 83 % of the patients were able to return to their preoperative sports activity level.",Konrad GG.; Rössler V.; Kreuz PC.; Südkamp NP.,,10.1055/s-0029-1185980,0,0,
8717,Complementary and alternative medicine use in Gilles de la Tourette syndrome.,"The aim of this study was to describe the use of complementary and alternative medicine (CAM) in patients with Tourette syndrome (TS) and explore associations with CAM use. In recent years CAM use has increased, but rates of CAM use in TS patients are not reported. Consecutive TS patients or their parent(s), seen in an academic movement disorder center, completed a questionnaire regarding their use of CAM. One hundred TS patients or parents completed the questionnaire, mean age 21.5 +/- 13.5, 76 males, 87 Caucasians. Sixty four patients had used at least one CAM modality. CAM treatments used were prayer (28), vitamins (21), massage (19), dietary supplements (15), chiropractic manipulations (12), meditation (10), diet alterations (nine), yoga (nine), acupuncture (eight), hypnosis (seven), homeopathy (six), and EEG biofeedback (six). Fifty six percent of patients using CAM reported some improvement. Users paid out of pocket for 47% of treatments pursued, and 19% of these payers received partial reimbursement by third party payer. Users and non-users did not differ in age, gender, race, income, educational level, general health, tic severity, medication use for TS, current satisfaction from medications or experience of side effects from medications. CAM use was associated with the presence of affective disorder (P = 0.004), but not with either ADHD or OCD. Among CAM users, 80% initiated CAM without informing their doctor. CAM is commonly used in children and adults with TS, and often without the neurologist's knowledge. Physicians should inquire about CAM to understand the spectrum of interventions that patients with TS use.",Kompoliti K.; Fan W.; Leurgans S.,2009.0,10.1002/mds.22724,0,0,
8718,A randomized controlled study of sequentially applied repetitive transcranial magnetic stimulation in obsessive-compulsive disorder.,"The present study investigated possible therapeutic effects and safety of sequentially combined low-frequency repetitive transcranial magnetic stimulation (rTMS) to the right dorsolateral prefrontal cortex and supplementary motor area in patients with treatment-resistant obsessive-compulsive disorder. Between February 2007 and January 2008, we carried out a study with a rater-blinded, sham-controlled design in which 20 patients with treatment-resistant obsessive-compulsive disorder, confirmed by a psychiatrist after use of the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinician Version, were randomly assigned to either active rTMS (n = 10) or sham treatment (n = 10). Over 10 days, rTMS of 1 Hz was given at 110% of the motor threshold for 20 minutes over the right dorsolateral prefrontal cortex and sequentially at 1 Hz at 100% of the motor threshold for 20 minutes over the supplementary motor area. The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (YBOCS) score. For the between-group analyses, there were no significant differences over 4 weeks between the active and sham groups on the YBOCS (F = 0.01, P = .92) and the Montgomery-Asberg Depression Rating Scale (MADRS; F = 0.39, P = .54). In repeated-measures analyses on all subjects, there was a significant effect of time on the YBOCS (F = 5.48, P = .009) and the MADRS (F = 6.55, P = .004). There were no significant group-by-time interactions for the YBOCS (F = 0.03, P = .94) or the MADRS (F = 0.09, P = .67). These findings suggest that 10 sessions of sequential rTMS of the right dorsolateral prefrontal cortex and the supplementary motor area at low frequency had no therapeutic effect on obsessive-compulsive symptoms. However, rTMS was a safe method of treatment, and there was no significant change in cognitive function after rTMS. Further controlled studies using a more sophisticated sham system in larger samples are required to confirm the effect of rTMS in obsessive-compulsive disorder. clinicaltrials.gov Identifier: NCT00932204.",Kang JI.; Kim CH.; Namkoong K.; Lee CI.; Kim SJ.,2009.0,10.4088/JCP.08m04500,0,0,
8719,"A randomized, controlled clinical trial of standard, group and brief cognitive-behavioral therapy for panic disorder with agoraphobia: a two-year follow-up.","A randomized controlled clinical trial with a wait-list control group was conducted to examine the effectiveness of three modalities (brief, group, and standard) of cognitive-behavioral treatment (CBT) for panic disorder with agoraphobia. A total of 100 participants meeting DSM-IV criteria were randomly assigned to each treatment condition: a 14-session standard CBT (n=33), a 14-session group CBT (n=35) and a 7-session brief CBT (n=32). Participants received a self-study manual and were assigned weekly readings and exercises. The results indicate that regardless of the treatment condition, CBT for moderate to severe PDA is beneficial in medium and long term. To this effect, all three-treatment conditions significantly reduced the intensity of symptoms, increased participants' quality of life, offered high effect sizes, superior maintenance of gains over time, and lower rates of relapse, compared to the wait-list control.",Marchand A.; Roberge P.; Primiano S.; Germain V.,2009.0,10.1016/j.janxdis.2009.07.019,0,0,
8720,Imaginal desensitisation plus motivational interviewing for pathological gambling: randomised controlled trial.,"Sixty-eight individuals were randomised to either six sessions of imaginal desensitisation plus motivational interviewing (IDMI) or Gamblers Anonymous. Individuals assigned to IDMI had significantly greater reductions in Yale-Brown Obsessive Compulsive Scale Modified for Pathological Gambling total scores, gambling urges and gambling behaviour. People who failed to respond to Gamblers Anonymous reported significantly greater reduction in pathological gambling symptoms following later assignment to IDMI. Abstinence was achieved by 63.6% during the acute IDMI treatment period.",Grant JE.; Donahue CB.; Odlaug BL.; Kim SW.; Miller MJ.; Petry NM.,2009.0,10.1192/bjp.bp.108.062414,0,0,
8721,Physiological correlates of applied tension may contribute to reduced fainting during medical procedures.,"Applied tension (AT) is a behavioral technique used to reduce symptoms such as dizziness and fainting in people with blood and injury phobias as well as medical patients undergoing invasive procedures. AT has been found to reduce dizziness and fainting in several studies of blood donors. The purpose of this study was to examine the psychophysiological effects of AT in the context of blood donation. Ninety-eight young adult blood donors wore ambulatory physiological monitors and were randomly assigned to one of two groups that practiced AT or one that did not. Measures of blood pressure, heart rate, stroke volume, and other physiological parameters were obtained while participants gave blood. Donors who did not practice AT were more likely to report symptoms in the donation chair and generally displayed a pattern of physiological activity consistent with risk for a vasovagal reaction. For example, heart rate and total peripheral resistance decreased. The drop in heart rate was probably due at least in part to an increase in vagal parasympathetic nervous system activity, as suggested by an increase in high-frequency heart rate variability. In contrast, donors who practiced AT displayed stable heart rate and high-frequency heart rate variability. The results suggest that the physiological effects of AT, particularly the inhibition of vagal activity, interfere with those promoting a vasovagal reaction. There may be a number of useful applications for AT in medical settings.",Ditto B.; Byrne N.; Holly C.,2009.0,10.1007/s12160-009-9114-7,0,0,
8722,Providing emotional stability through relaxation training.,"To determine the effects of integrative relaxation training (IRT) on emotional stability, we exposed 32 patients diagnosed with anxiety disorder to a pre-test (16PF) and to 12 sessions of group psychoeducation training. Patients were randomly assigned to 2 groups (study 17 and control 15 patients). The study group received 12 weekly group sessions of IRT. Level of anxiety was evaluated in a post-test using a questionnaire and the State-Trait Anxiety Inventory (STAI). Emotional stability and level of anxiety were significantly reduced in the study group: there was a marked increase in scores for emotionally s and venturesome and a decrease in scores for apprehensive and tense. The STAI score was statistically significantly lower in the study group.",Janbozorgi M.; Zahirodin A.; Norri N.; Ghafarsamar R.; Shams J.,,,0,0,6476
8723,First item response theory analysis on Tampa Scale for Kinesiophobia (fear of movement) in arthritis.,"To conduct the initial modern measurement theory analyses because of its many advantages on the Tampa Scale for Kinesiophobia and emerging evidence suggesting that fear of movement influences functional disability in people with arthritis. Secondary analysis of 347 participants from a randomized controlled trial evaluating The People with Arthritis Can Exercise program. The original Tampa Scale for Kinesiophobia has 17 items and we collected 16 items (excluding item 6). An item response theory analysis was conducted using the graded response model in MULTILOG. Before this, a series of factor analyses assessed the unidimensionality assumption of this model. Based on the factor analyses, we removed the reverse-coded items (4, 8, 12, and 16). The item response theory analysis revealed that item 13 had an exceedingly low slope and was dropped. Item response theory analyses looked at each item's performance and we can strongly suggest using our modified scale (11 items out of the 16 items), which provides relatively uniform precision of measurement across a wide range of fear of movement in people with arthritis. The item parameters from this study can build a computerized adaptive testing for this scale.",Mielenz TJ.; Edwards MC.; Callahan LF.,2010.0,10.1016/j.jclinepi.2009.04.011,0,0,
8724,Collaborative stepped care for anxiety disorders in primary care: aims and design of a randomized controlled trial.,"Panic disorder (PD) and generalized anxiety disorder (GAD) are two of the most disabling and costly anxiety disorders seen in primary care. However, treatment quality of these disorders in primary care generally falls beneath the standard of international guidelines. Collaborative stepped care is recommended for improving treatment of anxiety disorders, but cost-effectiveness of such an intervention has not yet been assessed in primary care. This article describes the aims and design of a study that is currently underway. The aim of this study is to evaluate effects and costs of a collaborative stepped care approach in the primary care setting for patients with PD and GAD compared with care as usual. The study is a two armed, cluster randomized controlled trial. Care managers and their primary care practices will be randomized to deliver either collaborative stepped care (CSC) or care as usual (CAU). In the CSC group a general practitioner, care manager and psychiatrist work together in a collaborative care framework. Stepped care is provided in three steps: 1) guided self-help, 2) cognitive behavioral therapy and 3) antidepressant medication. Primary care patients with a DSM-IV diagnosis of PD and/or GAD will be included. 134 completers are needed to attain sufficient power to show a clinically significant effect of 1/2 SD on the primary outcome measure, the Beck Anxiety Inventory (BAI). Data on anxiety symptoms, mental and physical health, quality of life, health resource use and productivity will be collected at baseline and after three, six, nine and twelve months. It is hypothesized that the collaborative stepped care intervention will be more cost-effective than care as usual. The pragmatic design of this study will enable the researchers to evaluate what is possible in real clinical practice, rather than under ideal circumstances. Many requirements for a high quality trial are being met. Results of this study will contribute to treatment options for GAD and PD in the primary care setting. Results will become available in 2011. NTR1071.",Muntingh AD.; van der Feltz-Cornelis CM.; van Marwijk HW.; Spinhoven P.; Assendelft WJ.; de Waal MW.; Hakkaart-van Roijen L.; Adèr HJ.; van Balkom AJ.,2009.0,10.1186/1472-6963-9-159,0,0,
8725,A validation study of the alcohol dependence scale.,"The primary purpose of this study was to provide a comprehensive assessment of the underlying factor structure of the Alcohol Dependence Scale (ADS). Secondary goals included assessing concurrent validity of the total ADS and subscales derived from the factor analyses with variables related to alcohol dependence and further evaluating the validity of two proposed dichotomously scored, reduced-item ADS measures. Responses to the ADS were obtained from participants who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for alcohol dependence in two large randomized clinical trials: COMBINE (Combining Medications and Behavioral Interventions Study; n = 1,335; 69% male) and Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity; n = 1,666; 75% male). Both exploratory and confirmatory factor analyses were conducted, and validity coefficients were obtained. Across samples, analyses supported a correlated, three-factor solution representing loss of behavioral control and heavy drinking, obsessive-compulsive drinking style, and psychoperceptual and psychophysical withdrawal. The ADS was significantly related to other measures of severity of dependence, craving for and preoccupation with drinking, temptation to drink and confidence in the ability to not drink in high-risk relapse situations, heavy and sustained drinking patterns, concerns about negative alcohol-related consequences, and awareness of problematic drinking. These findings support a three-factor solution for the ADS and its ability to assess the construct of alcohol dependence in a reliable and valid manner. The 12-item reduced ADS measure (reflecting mostly dependence-related items), as opposed to the 9-item reduced ADS measure (generally excessive drinking items), provided validity coefficients comparable to the total, 25-item ADS.",Doyle SR.; Donovan DM.,2009.0,,0,0,
8726,Prevention of panic attacks and panic disorder in COPD.,"This study examined whether cognitive behavioural therapy (CBT) could prevent the development or worsening of panic-spectrum psychopathology and anxiety symptoms in chronic obstructive pulmonary disease (COPD). 41 patients with COPD, who had undergone pulmonary rehabilitation, were randomised to either a four-session CBT intervention condition (n = 21) or a routine care condition (n = 20). Assessments were at baseline, post-intervention, and at 6-, 12- and 18-month follow-ups. Primary outcomes were the rates of panic attacks, panic disorder and anxiety symptoms. Secondary outcomes were depressive symptoms, catastrophic cognitions about breathing difficulties, disease-specific quality of life and hospital admission rates. There were no significant differences between the groups on outcome measures at baseline. By the 18-month follow-up assessment, 12 (60%) routine care group participants had experienced at least one panic attack in the previous 6 months, with two (17%) of these being diagnosed with panic disorder, while no CBT group participants experienced any panic attacks during the follow-up phase. There were also significant reductions in anxiety symptoms and catastrophic cognitions in the CBT group at all three follow-ups and a lower number of hospital admissions between the 6- and 12-month follow-ups. The study provides evidence that a brief, specifically targeted CBT intervention can treat panic attacks in COPD patients and prevent the development and worsening of panic-spectrum psychopathology and anxiety symptoms.",Livermore N.; Sharpe L.; McKenzie D.,2010.0,10.1183/09031936.00060309,0,0,
8727,The relationship between concurrent substance use disorders and eating disorders with personality disorders.,"The current pilot study investigated whether patients with concurrent substance use disorders and eating disorders (SUD and ED) who experienced a reduction in SUD and ED symptoms following treatment for SUD and ED also experienced a reduction in personality disorder (PD) symptoms. Twenty patients with SUD and ED and PD were assessed pre and post treatment using clinical interviews, self-report questionnaires, and a therapist questionnaire on DSM-IV-TR symptoms for PD. Symptoms for the personality disorders were reduced following treatment. This reduction was correlated with a decrease in the number of symptoms of ED at post treatment. Chronic concurrent SUD and ED may make it difficult to separate PD symptoms from co-occurring disorders. Many features attributed to PDs may be reduced when problematic substance use and disordered eating are addressed, a fact that may increase clinician and patients'optimism about therapeutic change.",Courbasson C.; Brunshaw JM.,2009.0,10.3390/ijerph6072076,0,0,
8728,The effect of choice between test anxiety treatment options on treatment outcomes.,"Evidence regarding the effect of clients' choice of treatment on treatment outcome is inconsistent. This possible effect was examined by presenting participants with two treatments of test anxiety: advanced muscle relaxation and changing of internal dialogue. Clients (N=73) were allocated to three groups: choice (participants chose their preferred treatment), no choice (participants were assigned to their preferred treatment but were led to believe they couldn't choose the treatment they were assigned to), and wait-list control (participants received no treatment until the end of the study). There was a significant linear pattern, with the choice group performing better than the no-choice group with no feeling of control, which in turn performed better than the control group. Limitations and suggestions for future research are discussed.",Handelzalts JE.; Keinan G.,2010.0,10.1080/10503300903121106,0,0,
8729,Looking beyond fear: the extinction of other emotions implicated in anxiety disorders.,"Previous research examining anxiety has traditionally focused on models of fear. More recently, attention has been directed to the role of disgust as an important emotion in the context of certain anxiety disorders. Further, it has been suggested that disgust, a form of evaluative responding, may be resistant to extinction and may contribute to relapse. However, previous work on this has largely relied on self-report ratings. In the current experiment, using a disgust conditioning and extinction procedure, disgust reactions were indeed shown to be resistant to extinction, as indexed by both self-report and an objective behavioral measure (visual avoidance). Furthermore, our research shows that individuals with greater levels of disgust sensitivity exhibit heightened resistance to extinction. In addition, expectancy of the disgusting US during extinction was dissociated from measures of disgust responding. Given that the treatment of choice for anxiety disorders (exposure therapy) is based on models of extinction, this research suggests that current treatments for anxiety disorders may not be adequately targeting disgust reactions, a crucial maintaining factor in certain anxiety disorders. As such, this inattention to disgust reactions may reduce the effectiveness of treatment in the short-term or may leave the patient vulnerable to relapse in the long-term.",Mason EC.; Richardson R.,2010.0,10.1016/j.janxdis.2009.08.007,0,0,
8730,Benefits of combining massage therapy with group interpersonal psychotherapy in prenatally depressed women.,"One hundred and twelve pregnant women who were diagnosed depressed were randomly assigned to a group who received group Interpersonal Psychotherapy or to a group who received both group Interpersonal Psychotherapy and massage therapy. The group Interpersonal Psychotherapy (1h sessions) and massage therapy (20 min sessions) were held once per week for 6 weeks. The data suggested that the group who received psychotherapy plus massage attended more sessions on average, and a greater percentage of that group completed the 6-week program. The group who received both therapies also showed a greater decrease in depression, depressed affect and somatic-vegetative symptom scores on the Center for Epidemiological Studies-Depression Scale (CES-D), a greater decrease in anxiety scale (STAI) scores and a greater decrease in cortisol levels. The group therapy process appeared to be effective for both groups as suggested by the increased expression of both positive and negative affect and relatedness during the group therapy sessions. Thus, the data highlight the effectiveness of group Interpersonal Psychotherapy and particularly when combined with massage therapy for reducing prenatal depression.",Field T.; Deeds O.; Diego M.; Hernandez-Reif M.; Gauler A.; Sullivan S.; Wilson D.; Nearing G.,2009.0,10.1016/j.jbmt.2008.10.002,0,0,
8731,Predictors of symptoms of posttraumatic stress and depression in family members after patient death in the ICU.,"Patients' deaths in the ICU have been associated with a high burden of psychologic symptoms in families. This study identifies characteristics associated with psychologic symptoms in family members. Families of patients dying in the ICU or within 30 h of ICU discharge in 11 hospitals previously participated in a randomized trial. In the current study, we assessed these families for symptoms of posttraumatic stress disorder (PTSD) and depression with follow-up surveys. Outcomes included validated measures of PTSD (PTSD Checklist) and depressive (Patient Health Questionnaire) symptoms. Predictors included family member mental-health history, involvement in decision making, and demographics. Surveys were completed by 226 families. Response rate was 46% in the original randomized trial and 82% in this study. Prevalence (95% CI) of PTSD and depressive symptoms were 14.0% (9.7%-19.3%) and 18.4% (13.5%-24.1%), respectively. Family characteristics associated with increased symptoms included: female gender (PTSD, P = .020; depression, P = .005), knowing the patient for a shorter duration (PTSD, P = .003; depression, P = .040), and discordance between family members' preferences for decision making and their actual decision-making roles (PTSD, P = .005; depression, P = .049). Depressive symptoms were also associated with lower educational level (P = .002). Families with psychologic symptoms were more likely to report that access to a counselor (PTSD, P < .001; depression, P = .003) and information about spiritual services might have been helpful while the patient was in the ICU (PTSD, P = .024; depression, P = .029). Families demonstrated a high prevalence of psychologic symptoms after a death in the ICU. Characteristics associated with symptoms may help target interventions to reduce these symptoms. clinicaltrials.gov; Identifier: NCT00685893.",Gries CJ.; Engelberg RA.; Kross EK.; Zatzick D.; Nielsen EL.; Downey L.; Curtis JR.,2010.0,10.1378/chest.09-1291,0,0,
8732,The association of depression and anxiety with health-related quality of life in cancer patients with depression and/or pain.,"Depression is known to be a major problem in cancer patients, and evidence is emerging about the importance of anxiety. Because the disorders are highly comorbid, we examined the relationship of anxiety and depression with health-related quality of life (HRQL) in cancer patients. Sample included 405 adult oncology patients participating in a randomized controlled trial of telecare management for pain and depression. This secondary cross-sectional analysis of baseline data examined independent and additive effects of anxiety and depression on HRQL, disability, and somatic symptom severity. In 397 patients who screened positive for either pain or depression or both, 135 had comorbid anxiety and depression, 174 had depression but not anxiety, and 88 had neither. Differences existed across all nonphysical HRQL domains and were more pronounced incrementally across the three groups in the expected direction. In GLM modeling, anxiety and depression were each associated with all the domains when modeled separately (p<0.0001). When modeled together, anxiety and depression had independent and additive effects on the mental health domains of HRQL and on somatic symptom burden. In other domains (vitality, perceived disability, overall quality of life, and general health perceptions), only depression had an effect. Anxiety and depression have strong and independent associations with mental health domains and somatic symptom burden in cancer patients. However, depression has a more pervasive association with multiple other domains of HRQL. Paying attention to both anxiety and depression may be particularly important when addressing mental health needs and somatic symptom distress.",Brown LF.; Kroenke K.; Theobald DE.; Wu J.; Tu W.,2010.0,10.1002/pon.1627,0,0,
8733,[Internal fixation of acetabular both-column fractures via the ilioinguinal approach].,"Open anatomic reduction and stable internal fixation of both-column acetabular fractures by screw and plate osteosynthesis via the ilioinguinal approach. Displaced both-column fractures of the acetabulum with incongruence of the hip joint, central femoral head displacement, unstable hip joint, and/or loss of hip joint congruence without the potential of a secondary congruence (near anatomic fragment orientation due to ligamentotaxis). General contraindications. Displaced fracture of the posterior wall. Extension of the posterior column fracture to the apex of the greater sciatic notch. Indirect open reduction of a both-column fracture of the acetabulum that is typically characterized by a multifragmentary anterior column fracture and a simple posterior column fragment using an ilioinguinal approach. Stepwise reduction and reconstruction of the anterior column according to the ""proximal-to-distal"" rule. Reduction and fixation of the posterior column fragment against the reconstructed anterior column. Partial weight bearing for 8-12 weeks with 15 kg body weight, beginning on the 2nd postoperative day. Thereafter, pain-dependent weight bearing. Thrombosis prophylaxis. Analysis of 27 patients treated between 1991 and 2005. A high-velocity trauma was the cause of injury in 74.1% of cases. Most patients showed an isolated injury of the acetabulum. In 55.5%, an additional central hip joint displacement was observed. A primary injury to the sciatic nerve was present in 14.8% of cases. Mean fracture gap/step was 14.3 mm. 81.5% of these fractures were anatomically reduced and stabilized; all joints were congruent. At 2-year follow-up, 14 out of 17 patients had no signs of posttraumatic osteoarthritis. Excellent and good functional results according to the Merle d'Aubigné Score were observed in eleven and five cases, respectively. One patient had a moderate functional outcome.",Gänsslen A.; Krettek C.,2009.0,10.1007/s00064-009-1804-6,0,0,
8734,[Internal fixation of acetabular posterior wall fractures].,"Open anatomic reduction and stable internal fixation of a posterior wall fracture of the acetabulum by screw and plate osteosynthesis via the Kocher-Langenbeck appoach. Displaced fractures or fracture-dislocations of the posterior wall of the acetabulum in combination with an unstable hip joint, presence of an additional femoral head fracture or intraarticular fragments, reduction inability in fracture-dislocations or deterioration of an additional sciatic nerve injury. Poor general condition (due to additional injuries or medical disease). Local soft-tissue damage. Presence of only small bony avulsion fragments of the posterior capsule with hip joint stability. Open reduction of the posterior wall fracture with stable internal fixation by screw and plate osteosynthesis. Depending on their presence: reduction and fixation of marginal impaction zones. Partial weight bearing of the injured side with 15 kg body weight for 6 weeks. Thereafter, pain-dependent weight bearing. In cases of marginal impaction partial weight bearing is extended to 12 weeks. Between January 1, 1972 and December 31, 2005, 137 patients with fractures of the posterior wall of the acetabulum were treated operatively. A high-velocity trauma was the cause of injury in 91.1% of cases. 94.1% of these patients had an additional hip dislocation, which was reduced within 6 h post injury in 83.7%. A primary sciatic nerve injury was present in 22.2%. Additional injuries to the acetabular cartilage were found in 43%, additional femoral head lesions in 27.4%, and Pipkin fractures in 14.1%. Anatomic joint reconstruction (0-1 mm) was observed in 96.3%, the other five patients had near anatomic reconstructions (2-5 mm). All hip joints were congruent on conventional radiography. The overall complication rate was 11.8%. Osteosynthesis-related complications were seen in 6.7%. 86 patients had follow-up results after a mean of 52 months. A perfect or good functional result (Merle d'Aubigné Score) was observed in 73.3% of cases, a posttraumatic arthrosis of the hip joint was present in 31.4%.",Gänsslen A.; Steinke B.; Krettek C.,2009.0,10.1007/s00064-009-1805-5,0,0,
8735,Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: A randomized clinical trial.,"Research has shown that mindfulness-based treatment interventions may be effective for a range of mental and physical health disorders in adult populations, but little is known about the effectiveness of such interventions for treating adolescent conditions. The present randomized clinical trial was designed to assess the effect of the mindfulness-based stress reduction (MBSR) program for adolescents age 14 to 18 years with heterogeneous diagnoses in an outpatient psychiatric facility (intent-to-treat N = 102). Relative to treatment-as-usual control participants, those receiving MBSR self-reported reduced symptoms of anxiety, depression, and somatic distress, and increased self-esteem and sleep quality. Of clinical significance, the MBSR group showed a higher percentage of diagnostic improvement over the 5-month study period and significant increases in global assessment of functioning scores relative to controls, as rated by condition-naïve clinicians. These results were found in both completer and intent-to-treat samples. The findings provide evidence that MBSR may be a beneficial adjunct to outpatient mental health treatment for adolescents.",Biegel GM.; Brown KW.; Shapiro SL.; Schubert CM.,2009.0,10.1037/a0016241,0,0,
8736,Battlemind debriefing and battlemind training as early interventions with soldiers returning from iraq: Randomization by platoon.,"Researchers have found that there is an increase in mental heath problems as a result of military-related traumatic events, and such problems increase in the months following return from combat. Nevertheless, researchers have not assessed the impact of early intervention efforts with this at-risk population. In the present study, the authors compared different early interventions with 2,297 U.S. soldiers following a year-long deployment to Iraq. Platoons were randomly assigned to standard postdeployment stress education, Battlemind debriefing, and small and large group Battlemind training. Results from a 4-month follow-up with 1,060 participants showed those with high levels of combat exposure who received Battlemind debriefing reported fewer posttraumatic stress symptoms, depression symptoms, and sleep problems than those in stress education. Small group Battlemind training participants with high combat exposure reported fewer posttraumatic stress symptoms and sleep problems than stress education participants. Compared to stress education participants, large group Battlemind training participants with high combat exposure reported fewer posttraumatic stress symptoms and lower levels of stigma and, regardless of combat exposure, reported fewer depression symptoms. Findings demonstrate that brief early interventions have the potential to be effective with at-risk occupational groups.",Adler AB.; Bliese PD.; McGurk D.; Hoge CW.; Castro CA.,2009.0,10.1037/a0016877,0,0,
8737,Congruence between culturally competent treatment and cultural needs of older Latinos.,"This study investigated a new 2-factor construct, termed cultural congruence, which is related to cultural competence in the delivery of mental health services to ethnic minority clients. Cultural congruence was defined as the distance between the cultural competence characteristics of the health care organization and the clients' perception of those elements according to their cultural needs. The measure evidenced both reliability and validity in predicting criterion-related indicators. Older Hispanic/Latino clients (N = 272) receiving mental health services either through integrated primary care or referral to specialized mental health care were assessed for depression and anxiety symptomatology and health status at baseline, 3-, and 6-month follow-up treatment. Results indicated that cultural congruence predicted treatment outcomes (reduction of symptomatology) independent of treatment and evidenced moderator effects with respect to depression, suicidality, anxiety, and physical health criteria. Cultural congruence was more effective under the condition of the enhanced specialty referral model than under the integrated primary care model. Results are discussed in terms of how the new construct of cultural congruence extends knowledge of culturally competent mental health practice among the older Hispanic/Latino population.",Costantino G.; Malgady RG.; Primavera LH.,2009.0,10.1037/a0016341,0,0,
8738,The psychological impact of being offered surveillance colonoscopy following attendance at colorectal screening using flexible sigmoidoscopy.,"To examine the psychological impact of being assigned to colonoscopic surveillance following detection of adenomatous polyps at flexible sigmoidoscopy (FS) screening. Participants invited for screening in 12 of the 14 study centres in the UK FS Trial. A postal survey following FS screening assessed bowel cancer worry, psychological distress, generalized anxiety, bowel symptoms, general practitioner (GP) visits, positive emotional consequences of screening, and reassurance among people with no polyps (n = 26,573), lower-risk polyps removed at FS (n = 7401) and higher-risk polyps who underwent colonoscopy and were either assigned to colonoscopic surveillance (n = 1543) or discharged (n = 183). A sub-sample (n = 6389) also completed a questionnaire prior to screening attendance that measured bowel cancer worry, generalized anxiety, bowel symptoms and GP visits, making it possible to examine longitudinal changes in this group. People offered surveillance reported lower psychological distress and anxiety than those with either no polyps or lower-risk polyps. The surveillance group also reported more positive emotional benefits of screening than the other outcome groups. Post-screening bowel cancer worry and bowel symptoms were higher in people assigned to surveillance, but both declined over time, reaching levels observed in either one or both of the other two groups found to have polyps, suggesting these results were a consequence of polyp detection rather than surveillance per se. Few differences were observed between the group assigned surveillance and the group discharged following colonoscopy. The results of the current study are broadly reassuring and indicate that referral for colonoscopic surveillance is not associated with adverse psychological consequences.",Miles A.; Atkin WS.; Kralj-Hans I.; Wardle J.,2009.0,10.1258/jms.2009.009041,0,0,
8739,Prevention of depression and anxiety in adolescents: a randomized controlled trial testing the efficacy and mechanisms of Internet-based self-help problem-solving therapy.,"Even though depression and anxiety are highly prevalent in adolescence, youngsters are not inclined to seek help in regular healthcare. Therapy through the Internet, however, has been found to appeal strongly to young people. The main aim of the present study is to examine the efficacy of preventive Internet-based guided self-help problem-solving therapy with adolescents reporting depressive and anxiety symptoms. A secondary objective is to test potential mediating and moderating variables in order to gain insight into how the intervention works and for whom it works best. This study is a randomized controlled trial with an intervention condition group and a wait-list control group. The intervention condition group receives Internet-based self-help problem-solving therapy. Support is provided by a professional and delivered through email. Participants in the wait-list control group receive the intervention four months later. The study population consists of adolescents (12-18-year-olds) from the general population who report mild to moderate depressive and/or anxiety symptoms and are willing to complete a self-help course. Primary outcomes are symptoms of depression and anxiety. Secondary outcomes are quality of life, social anxiety, and cost-effectiveness. The following variables are examined for their moderating role: demographics, motivation, treatment credibility and expectancy, externalizing behaviour, perceived social support from parents and friends, substance use, the experience of important life events, physical activity, the quality of the therapeutic alliance, and satisfaction. Mediator variables include problem-solving skills, worrying, mastery, and self-esteem. Data are collected at baseline and at 3 weeks, 5 weeks, 4 months, 8 months, and 12 months after baseline. Both intention-to-treat and completer analyses will be conducted. This study evaluates the efficacy and mechanisms of Internet-based problem-solving therapy for adolescents. If Internet-based problem-solving therapy is shown to reduce depressive and anxiety symptoms in adolescents, the implication is to implement the intervention in clinical practice. Strengths and limitations of the study are discussed. Netherlands Trial Register NTR1322.",Hoek W.; Schuurmans J.; Koot HM.; Cuijpers P.,2009.0,10.1186/1745-6215-10-93,0,0,
8740,Rapid tryptophan depletion following cognitive behavioural therapy for panic disorder.,"The aim of this study was to examine the effect of rapid tryptophan depletion (RTD) combined with a panicogenic challenge in patients with panic disorder who had responded to treatment with cognitive behavioural therapy (CBT). We hypothesised that RTD (compared with the control drink) would result in an increase in anxiety symptoms when provoked by a panicogenic challenge with the benzodiazepine antagonist, flumazenil. Nine patients with panic disorder who had responded to CBT received a tryptophan-free amino acid drink on one occasion and a control drink on the other in a double-blind crossover design. In addition, they received flumazenil and placebo infusions on each day. Our hypothesis regarding the effects of RTD was supported by findings of a significant interaction between RTD and flumazenil on measures from visual analogues scales (total) and the Spielberger State Anxiety inventory. A somewhat unexpected finding was that in this group of CBT responders, the panicogenic effect of flumazenil was not completely blocked by treatment. This meant that although four of the nine subjects (44%) reported a panicogenic effect of flumazenil on the RTD day, this was not significantly different from the rate of panic attacks in response to flumazenil on the control day. We suggest that the partial return of symptoms in response to flumazenil reflects a vulnerability to RTD in this group of panic disorder patients who had responded to treatment with CBT.",Bell C.; Hood S.; Potokar J.; Nash J.; Adrover M.; Frampton C.; Hince D.; Rich A.; Argyropoulos S.; Nutt D.,2011.0,10.1007/s00213-009-1696-z,0,0,
8741,[Psychosomatic rehabilitation: effects of pre-treatment counselling under the statutory pension insurance scheme].,"Currently, little is known about the influence of pre-treatment in rehabilitation outcomes of patients with psychosomatic symptoms. This study examines whether there are differences in therapy motivation and impairment between patients with and those without pre-treatment measures. Additionally, the outcome for patients with prior knowledge of psychosomatic rehabilitation is analyzed. As part of a randomized controlled pre-post design the Patients' questionnaire of therapy motivation (PAREMO) and the Brief Symptom Inventory (BSI) were distributed to 166 patients in psychosomatic rehabilitation. The selection of patients with prior knowledge of psychosomatic rehabilitation was made according to the scale ""knowledge"" of the patients' questionnaire. Changes were tested by analysis of variance at two treatment points. Although there were positive effects of rehabilitation, no interaction was found between measurement points and groups. The analyses of patients without prior knowledge of psychosomatic rehabilitation showed different outcomes for males and females. Higher rehabilitation outcomes for females than for males were found on the BSI scales ""somatisation"", ""phobic anxiety"", and ""psychoticism"". The findings show that pre-treatment facilitates the patients' approach to psychosomatic rehabilitation. Apart from receiving information patients should be motivated more strongly and their confidence in psychosomatic rehabilitation strengthened.",Best M.; Lange M.; Karpinski N.; Hessel A.; Söpper-Terborg B.; Sieling W.; Petermann F.,2009.0,10.1055/s-0029-1239544,0,0,5330
8742,Learning the futility of the thought suppression enterprise in normal experience and in obsessive compulsive disorder.,"The belief that we can control our thoughts is not inevitably adaptive, particularly when it fuels mental control activities that have ironic unintended consequences. The conviction that the mind can and should be controlled can prompt people to suppress unwanted thoughts, and so can set the stage for the intrusive return of those very thoughts. An important question is whether or not these beliefs about the control of thoughts can be reduced experimentally. One possibility is that behavioral experiments aimed at revealing the ironic return of suppressed thoughts might create a lesson that could reduce unrealistic beliefs about the control of thoughts. The present research assessed the influence of the thought suppression demonstration on beliefs about the control of thoughts in a non-clinical sample, and among individuals with obsessive-compulsive disorder (OCD). In Study 1, we assessed the effect of the thought suppression demonstration on beliefs about the control of thoughts among low and high obsessive individuals in the non-clinical population (N = 62). In Study 2, we conducted a similar study with individuals with OCD (N = 29). Results suggest that high obsessive individuals in the non-clinical population are able to learn the futility of suppression through the thought suppression demonstration and to alter their faulty beliefs about the control of thoughts; however, for individuals with OCD, the demonstration may be insufficient for altering underlying beliefs. For individuals with OCD, the connection between suppressing a neutral thought in the suppression demonstration and suppressing a personally relevant obsession may need to be stated explicitly in order to affect their obsessive beliefs.",Najmi S.; Reese H.; Wilhelm S.; Fama J.; Beck C.; Wegner DM.,2010.0,10.1017/S1352465809990439,0,0,
8743,The effects of modifying interpretation bias on worry in generalized anxiety disorder.,"This study investigated whether facilitating a benign interpretive bias decreases negative thought intrusions in generalized anxiety disorder (GAD). Clients were randomly allocated to an interpretation modification condition in which they repeatedly accessed benign meanings of emotionally ambiguous homographs and scenarios, or to a control condition in which they accessed threat and benign meanings with equal frequency. Worry frequency was assessed using a breathing focus task that involved categorising the valence of thought intrusions before and after an instructed worry period. Interpretation bias was assessed during the modification tasks, and on a different measure of interpretation bias (sentence completion) following a period of worry. The experimental procedure modified interpretations made during training, and in the later sentence completion task. Furthermore, compared to the control group, the benign group showed fewer negative thought intrusions during breathing focus (as rated by both participants and an assessor). These findings show that it is possible to induce a more benign interpretive bias in GAD clients and that this reduces negative thought intrusions.",Hayes S.; Hirsch CR.; Krebs G.; Mathews A.,2010.0,10.1016/j.brat.2009.10.006,0,0,
8744,An open trial with cognitive behavioral therapy for blood- and injection phobia in pregnant women-a group intervention program.,"Around 7% of pregnant women suffer from blood- and injection phobia. The aim was to investigate if cognitive behavior group therapy (CBT) is effective in treating pregnant women's blood- and injection phobia. Thirty pregnant women with blood- and injection phobia according to DSM-IV took part in an open treatment intervention. A two-session cognitive behavior group therapy was conducted. As controls, 46 pregnant women with untreated blood- and injection phobia and 70 healthy pregnant women were used. Repeated measures ANOVA were performed. The scores for the CBT treatment group on the ""Injection Phobia Scale-Anxiety"" were reduced both after each treatment session and postpartum (p < 0.001). Anxiety and depressive symptoms were also reduced (p < 0.001). Cognitive-behavior group therapy for pregnant women with blood- and injection phobia is effective and stable up to at least 3 months postpartum. It seems also to reduce anxiety and depressive symptoms during pregnancy.",Lilliecreutz C.; Josefsson A.; Sydsjö G.,2010.0,10.1007/s00737-009-0126-x,0,0,
8745,Group psychotherapy of dysfunctional fear of progression in patients with chronic arthritis or cancer.,"This study investigated the effectiveness of brief psychotherapeutic group interventions in reducing dysfunctional fear of disease progression (FoP). The interventions comprised either cognitive-behavioral group therapy or supportive-experiential group therapy. We tested whether these generic interventions would prove effective in different illness types. Chronic arthritis in- patients (n = 174) and cancer in-patients (n = 174), respectively, were randomized to receive one of the two interventions. The patients provided data before intervention, at discharge, and at 3 and 12 months of follow-up. FoP was the primary outcome, secondary outcomes were anxiety, depression and quality of life. A treatment-as-usual control group provided data on the primary outcome. Patients with chronic arthritis indicated higher levels of FoP than cancer patients. The results revealed that, compared with no specialized intervention, both group therapies were effective in reducing dysfunctional FoP, but only among cancer patients. The effect sizes were 0.54 (cognitive-behavioral therapy) and 0.50 (supportive experiential therapy). The interventions were not differently effective in reducing the secondary outcomes. Dysfunctional FoP can be effectively targeted with brief group interventions. Psychotherapeutic interventions for reducing FoP should focus on specific illness characteristics.",Herschbach P.; Berg P.; Waadt S.; Duran G.; Engst-Hastreiter U.; Henrich G.; Book K.; Dinkel A.,2010.0,10.1159/000254903,0,0,
8746,Does the judicious use of safety behaviors improve the efficacy and acceptability of exposure therapy for claustrophobic fear?,"Exposure therapy is traditionally conducted with an emphasis on the elimination of safety behaviors. However, theorists have recently suggested that the judicious use of safety behaviors may improve the tolerability of this treatment without reducing its efficacy. The present study tested this notion by randomly assigning participants with high claustrophobic fear to receive a single-session intervention with or without access to safety aids during early exposure trials. Improvement was generally equivalent between the treatment conditions, and no reliable benefits or drawbacks were associated with the judicious use of safety behaviors. The theoretical and clinical implications of these findings are discussed.",Deacon BJ.; Sy JT.; Lickel JJ.; Nelson EA.,2010.0,10.1016/j.jbtep.2009.10.004,0,0,
8747,Mechanism of action in CBT (MAC): methods of a multi-center randomized controlled trial in 369 patients with panic disorder and agoraphobia.,"Cognitive behavioral therapy (CBT) is efficacious for panic disorder with agoraphobia (PD/A). Nevertheless, the active ingredients of treatment and the mechanisms through which CBT achieves its effects remain largely unknown. The mechanisms of action in CBT (MAC) study was established to investigate these questions in 369 patients diagnosed with PD/A. The MAC study utilized a multi-center, randomized controlled design, with two active treatment conditions in which the administration of exposure was varied, and a wait-list control group. The special feature of MAC is the way in which imbedded experimental, psychophysiological, and neurobiological paradigms were included to elucidate therapeutic and psychopathological processes. This paper describes the aims and goals of the MAC study and the methods utilized to achieve them. All aspects of the research design (e.g., assessments, treatment, experimental procedures) were implemented so as to facilitate the detection of active therapeutic components, and the mediators and moderators of therapeutic change. To this end, clinical, behavioral, physiological, experimental, and genetic data were collected and will be integrated.",Gloster AT.; Wittchen HU.; Einsle F.; Höfler M.; Lang T.; Helbig-Lang S.; Fydrich T.; Fehm L.; Hamm AO.; Richter J.; Alpers GW.; Gerlach AL.; Ströhle A.; Kircher T.; Deckert J.; Zwanzger P.; Arolt V.,2009.0,10.1007/s00406-009-0065-6,0,0,
8748,Do treatment improvements in PTSD severity affect substance use outcomes? A secondary analysis from a randomized clinical trial in NIDA's Clinical Trials Network.,"The purpose of the analysis was to examine the temporal course of improvement in symptoms of posttraumatic stress disorder (PTSD) and substance use disorder among women in outpatient substance abuse treatment. Participants were 353 women randomly assigned to 12 sessions of either trauma-focused or health education group treatment. PTSD and substance use assessments were conducted during treatment and posttreatment at 1 week and after 3, 6, and 12 months. A continuous Markov model was fit on four defined response categories (nonresponse, substance use response, PTSD response, or global response [improvement in both PTSD and substance use]) to investigate the temporal association between improvement in PTSD and substance use symptom severity during the study's treatment phase. A generalized linear model was applied to test this relationship over the follow-up period. Subjects exhibiting nonresponse, substance use response, or global response tended to maintain original classification; subjects exhibiting PTSD response were significantly more likely to transition to global response over time, indicating maintained PTSD improvement was associated with subsequent substance use improvement. Trauma-focused treatment was significantly more effective than health education in achieving substance use improvement, but only among those who were heavy substance users at baseline and had achieved significant PTSD reductions. PTSD severity reductions were more likely to be associated with substance use improvement, with minimal evidence of substance use symptom reduction improving PTSD symptoms. Results support the self-medication model of coping with PTSD symptoms and an empirical basis for integrated interventions for improved substance use outcomes in patients with severe symptoms.",Hien DA.; Jiang H.; Campbell AN.; Hu MC.; Miele GM.; Cohen LR.; Brigham GS.; Capstick C.; Kulaga A.; Robinson J.; Suarez-Morales L.; Nunes EV.,2010.0,10.1176/appi.ajp.2009.09091261,0,0,
8749,The effect of single-session interpretation modification on attention bias in socially anxious individuals.,"Research suggests that individuals with social anxiety interpret ambiguous social information negatively (e.g., Amir, Foa, & Coles, 1998) and that much negative interpretation bias may share a common mechanism with other information processing biases (e.g., Mathews, Mackintosh, & Fulcher, 1997). In the current study, we examined effectiveness of an Interpretation Modification Program in changing attention biases in socially anxious individuals. Participants were randomly assigned to either an Interpretation Modification Program (IMP) that guided them to make benign interpretations of ambiguous social scenarios or an Interpretation Control Condition (ICC) that did not guide participants' interpretation in either direction. Results revealed that individuals in the IMP group demonstrated greater ability to disengage attention from threat stimuli after completing the program, while individuals in the ICC did not. These results are consistent with the hypothesis that information processing biases in anxious individuals may share a common mechanism that may contribute to the maintenance of anxiety.",Amir N.; Bomyea J.; Beard C.,2010.0,10.1016/j.janxdis.2009.10.005,0,0,
8750,"Assessing posttraumatic stress disorder with or without reference to a single, worst traumatic event: examining differences in factor structure.","The authors examined the effects of a methodological manipulation on the Posttraumatic Stress Disorder (PTSD) Checklist's factor structure: specifically, whether respondents were instructed to reference a single worst traumatic event when rating PTSD symptoms. Nonclinical, trauma-exposed participants were randomly assigned to 1 of 2 PTSD assessment conditions: referencing PTSD symptoms to their worst trauma (trauma-specific group, n = 218) or to their overall trauma history in general (trauma-general group, n = 234). A 3rd group of non-trauma-exposed participants (n = 464) rated PTSD symptoms globally from any stressful event. Using confirmatory factor analysis, the authors show that the 4-factor PTSD model proposed by D. W. King, G. A. Leskin, L. A. King, and F. W. Weathers (1998; separating effortful avoidance and emotional numbing) demonstrated the best model fit for trauma-general and non-trauma-exposed participants. The 4-factor PTSD model proposed by L. J. Simms, D. Watson, and B. N. Doebbeling (2002; emphasizing a general dysphoria factor) demonstrated the best model fit for trauma-specific participants. Measurement invariance testing revealed that non-trauma-exposed participants were different from both trauma-exposed groups on factor structure parameters, but trauma groups were not substantially different from each other.",Elhai JD.; Engdahl RM.; Palmieri PA.; Naifeh JA.; Schweinle A.; Jacobs GA.,2009.0,10.1037/a0016677,0,0,
8751,Targeting the probability versus cost of feared outcomes in public speaking anxiety.,"Cognitive-behavioral theory suggests that social phobia is maintained, in part, by overestimates of the probability and cost of negative social events. Indeed, empirically supported cognitive-behavioral treatments directly target these cognitive biases through the use of in vivo exposure or behavioral experiments. While cognitive-behavioral theories and treatment protocols emphasize the importance of targeting probability and cost biases in the reduction of social anxiety, few studies have examined specific techniques for reducing probability and cost bias, and thus the relative efficacy of exposure to the probability versus cost of negative social events is unknown. In the present study, 37 undergraduates with high public speaking anxiety were randomly assigned to a single-session intervention designed to reduce either the perceived probability or the perceived cost of negative outcomes associated with public speaking. Compared to participants in the probability treatment condition, those in the cost treatment condition demonstrated significantly greater improvement on measures of public speaking anxiety and cost estimates for negative social events. The superior efficacy of the cost treatment condition was mediated by greater treatment-related changes in social cost estimates. The clinical implications of these findings are discussed.",Nelson EA.; Deacon BJ.; Lickel JJ.; Sy JT.,2010.0,10.1016/j.brat.2009.11.007,0,0,
8752,Continuous positive airway pressure therapy reduces right ventricular volume in patients with obstructive sleep apnea: a cardiovascular magnetic resonance study.,"There are few data on the effects of continuous positive airway pressure (CPAP) therapy on the structural and functional characteristics of the right heart in patients with obstructive sleep apnea (OSA). We sought to leverage the advantages of cardiac magnetic resonance imaging (CMR) and hypothesized that CPAP treatment would improve right ventricular (RV) function in a group of patients with OSA who were free of other comorbid conditions. Patients with severe (apnea-hypopnea index > or = 30/h) untreated OSAwere prospectively enrolled. CMR included 3-dimensional measurement of biventricular size and function, and rest/stress myocardial perfusion and was performed at baseline and after 3 months of CPAP therapy. Fifteen patients with mild to moderate desaturation were enrolled; 2 could not undergo CMR due to claustrophobia and obesity. There were significant decreases in the Epworth Sleepiness Scale score (p < 0.0001) and RV end-systolic and RV end-diastolic volumes (p < 0.05) with CPAP. There was a trend toward improvement in RV ejection fraction, but the improvement did not reach statistical significance. Other measures such as left ventricular volumes, left ventricular ejection fraction, myocardial perfusion reserve index, and thickness of the interventricular septum and ventricular free wall did not change significantly. This preliminary study found that CPAP treatment decreases RV volumes in patients with severe OSA who are otherwise healthy. CMR offers a novel technique to determine the effects of CPAP on ventricular structure and function in patients with OSA. A randomized controlled study is needed to confirm the results of our study.",Magalang UJ.; Richards K.; McCarthy B.; Fathala A.; Khan M.; Parinandi N.; Raman SV.,2009.0,,0,0,
8753,Treating spider phobia using Neuro Emotional Technique: findings from a pilot study.,"Specific phobia, the most common anxiety disorder, can disrupt lives, limit work efficiency, reduce self-esteem, and strain relationships. Current interventions show some degree of success, yet relapse is common. Consequently, the need for a more effective and durable intervention is evident. The purpose of this pilot study is to investigate the efficacy of a new intervention, Neuro Emotional Technique (NET), on individuals with spider phobia, and to determine whether further investigation is warranted. Participants who met the inclusion criterion that spider phobia impacted their daily lives were randomized to either a control group that received no intervention (N = 7), or to an experimental group that received two 30-minute sessions of NET approximately 2 weeks apart (N = 8). The primary measure was the Subjective Units of Distress Scale, and secondary measures were the Spider Questionnaire, Behavioral Assessment Test, Beck Anxiety Inventory, and change in heart rate (HR). Compared with the no-intervention control group, statistical analysis indicates a significant advantage for the NET group in regard to state anxiety/subjective distress, reported fear, and avoidant behavior. The difference between the two groups for general anxious symptomatology (trait anxiety) and change in HR was not statistically significant. No adverse reactions were reported. The findings of this pilot study suggest that NET is a promising intervention for spider phobia in adults. A larger, full-scale study is required to confirm these results.",Jensen AM.; Ramasamy A.,2009.0,10.1089/acm.2008.0595,0,0,
8754,Depression and anxiety: their predictive function for weight loss in obese individuals.,"To investigate the impact of current mental disorders on weight loss with special consideration of depressive and/or anxiety disorders as well as binge eating behavior in obese individuals undergoing different weight loss treatments. Three different samples of obese individuals were investigated in a prospective, longitudinal study: participants in a conventional weight loss treatment program (CONV TREAT; n = 250), obesity surgery patients (OBES SURG; n = 153), and obese control individuals (OC; n = 128). Current mental disorders and BMI were assessed at baseline and at 4-year follow-up. OBES SURG patients with a depressive and/or anxiety disorder lost significantly less weight compared with those without a comorbid mental diagnosis. This result was not detected for CONV TREAT participants. A trend to gain weight was seen in OC participants with a depressive and/or anxiety disorder, whereas OC participants without current mental disorders at baseline lost some weight. Binge eating behavior at baseline did not predict weight loss at 4-year followup. These results underline the importance of addressing current depressive and anxiety disorders in obese patients, especially when such patients are undergoing obesity surgery.",Legenbauer T.; De Zwaan M.; Benecke A.; Muhlhans B.; Petrak F.; Herpertz S.,2009.0,10.1159/000226278,0,0,
8755,Evidence for poorer outcome in patients with severe negative trauma-related cognitions receiving prolonged exposure plus cognitive restructuring: implications for treatment matching in posttraumatic stress disorder.,"In the current article, we address the existing assumption in the literature on cognitive behavioral treatment of PTSD that patients with severe negative trauma-related cognitions would benefit more from a treatment package that includes exposure and cognitive techniques compared with a treatment that includes exposure only. To test this assumption, 54 PTSD patients were randomized to prolonged exposure therapy or prolonged exposure therapy plus cognitive restructuring. Contrary to expectations, findings revealed that patients characterized by more severe pretreatment trauma-related cognitions (and more severe pretreatment PTSD symptoms) fared slightly worse in treatment combining exposure and cognitive restructuring. However, there was no relationship between pre- and post-treatment measures of negative cognitions and PTSD symptoms in the exposure alone group. The implications of these findings for examining Person X Treatment interactions and the efficacy of combining treatments for PTSD are discussed.",Moser JS.; Cahill SP.; Foa EB.,2010.0,10.1097/NMD.0b013e3181c81fac,0,0,
8756,Matrix-induced autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee: a 2-year randomised study.,"Cartilage defects occur in approximately 12% of the population and can result in significant function impairment and reduction in quality of life. Evidence for the variety of surgical treatments available is inconclusive. This study aimed to compare the clinical outcomes of patients with symptomatic cartilage defects treated with matrix-induced autologous chondrocyte implantation (MACI or microfracture (MF). Included patients were >or= 18 and <or= 50 years of age with symptomatic, post-traumatic, single, isolated chondral defects (4-10 cm2) and were randomised to receive MACI or MF. Patients were followed up 8-12, 22-26 and 50-54 weeks post-operatively for efficacy and safety evaluation. Outcome measures were the Tegner, Lysholm and ICRS scores. Sixty patients were included in a randomised study (40 MACI, 20 MF). The difference between baseline and 24 months post-operatively for both treatment groups was significant for the Lysholm, Tegner, patient ICRS and surgeon ICRS scores (all P < 0.0001). However, MACI was significantly more effective over time (24 months versus baseline) than MF according to the Lysholm (P = 0.005), Tegner (P = 0.04), ICRS patient (P = 0.03) and ICRS surgeon (P = 0.02) scores. There were no safety issues related to MACI or MF during the study. MACI is superior to MF in the treatment of articular defects over 2 years. MACI and MF are complementary procedures, depending on the size of the defect and symptom recurrence. The MACI technique represents a significant advance over both first and second generation chondrocyte-based cartilage repair techniques for surgeons, patients, health care institutions and payers in terms of reproducibility, safety, intraoperative time, surgical simplicity and reduced invasiveness.",Basad E.; Ishaque B.; Bachmann G.; Stürz H.; Steinmeyer J.,2010.0,10.1007/s00167-009-1028-1,0,0,
8757,Cognitive mediation of panic reduction during an early intervention for panic.,"This study investigated cognitive mediation of improvement in panic disorder (PD) symptomatology during and after an early intervention for panic symptoms in subthreshold and mild PD. We executed a pragmatic, pre-post, two-group, multi-site, randomized trial of an early intervention for panic symptoms, based on cognitive-behavioural therapy, vs. a wait-list control group in a sample of 217 participants with subthreshold PD or mild PD. First, two of the three subscales of the mediator variable Panic Appraisal Inventory (PAI-anticipation and PAI-coping) significantly mediated residual change in PD symptomatology on the PD Severity Scale-Self Report. Second, preintervention to postintervention PAI-anticipation and PAI-coping change scores significantly predicted postintervention to follow-up change in PD symptomatology after controlling for other change scores. However, the converse association was also significant. The results suggest that changes in cognitions may mediate changes in PD symptomatology and that the process of change is circular.",Meulenbeek P.; Spinhoven P.; Smit F.; van Balkom A.; Cuijpers P.,2010.0,10.1111/j.1600-0447.2009.01530.x,0,0,
8758,Evidence-based nursing: effects of a structured nursing program for the health promotion of Korean women with Hwa-Byung.,"The objectives of this study were to develop a culturally tailored nursing program for patients with Hwa-Byung (HB) and to test the effects of the nursing intervention. The structured nursing intervention program was based on a transcultural theoretical framework in which patients with HB received therapies consisting of music therapy, drama, and group therapy. Hwa-Byung is a culture-bound syndrome, literally translated as anger syndrome, attributed to the suppression of anger. Individuals experience a decrease in quality of life as a result of insufficient treatment. Current health care programs do not meet the needs of these individuals, who still need nursing interventions. A culturally tailored therapy is effective and appropriate for patients with illnesses related to their cultural background. Evidence-based nursing is a crucial approach in verifying the effects of nursing care and in enhancing the body of knowledge on nursing science. A nonequivalent, nonsynchronized, and controlled study design was applied to experimental and control groups of an even number of women. The nursing program was generally effective in the mental health condition test; the mental health condition of the experimental group was significantly more improved as compared with that of the control group. The program was particularly effective in the categories of somatization, depression, psychoticism, and hostility. The data indicate that the mental health of patients with HB could be improved with the use of nursing intervention programs. Nurses need to understand the cultural background of patients and provide culture-sensitive interventions for effective patient-oriented care.",Choi YJ.; Lee KJ.,2007.0,10.1016/j.apnu.2006.07.006,0,0,
8759,A comparison of medication side effect reports by panic disorder patients with and without concomitant cognitive behavior therapy.,"The authors assessed whether adding cognitive behavior therapy (CBT) to imipramine for patients with panic disorder decreased the severity of side effects and dropouts from side effects. Data were analyzed for 172 panic disorder patients who were randomly assigned to receive imipramine alone, imipramine plus CBT, or placebo. Mixed-effects models were used to assess longitudinal differences among the treatment groups with respect to side effect burden and dropout rates during the acute, maintenance, and follow-up phases of treatment. Patients treated with imipramine plus CBT experienced less severe fatigue/weakness, dry mouth, and sweating and had a lower rate of dropout due to side effects compared with those treated with imipramine only. The addition of CBT to medication treatment with imipramine was associated with less severe side effects and fewer dropouts due to perceived side effects than treatment with imipramine alone.",Marcus SM.; Gorman J.; Shear MK.; Lewin D.; Martinez J.; Ray S.; Goetz R.; Mosovich S.; Gorman L.; Barlow D.; Woods S.,2007.0,10.1176/ajp.2007.164.2.273,0,0,
8760,A communication strategy and brochure for relatives of patients dying in the ICU.,"There is a need for close communication with relatives of patients dying in the intensive care unit (ICU). We evaluated a format that included a proactive end-of-life conference and a brochure to see whether it could lessen the effects of bereavement. Family members of 126 patients dying in 22 ICUs in France were randomly assigned to the intervention format or to the customary end-of-life conference. Participants were interviewed by telephone 90 days after the death with the use of the Impact of Event Scale (IES; scores range from 0, indicating no symptoms, to 75, indicating severe symptoms related to post-traumatic stress disorder [PTSD]) and the Hospital Anxiety and Depression Scale (HADS; subscale scores range from 0, indicating no distress, to 21, indicating maximum distress). Participants in the intervention group had longer conferences than those in the control group (median, 30 minutes [interquartile range, 19 to 45] vs. 20 minutes [interquartile range, 15 to 30]; P<0.001) and spent more of the time talking (median, 14 minutes [interquartile range, 8 to 20] vs. 5 minutes [interquartile range, 5 to 10]). On day 90, the 56 participants in the intervention group who responded to the telephone interview had a significantly lower median IES score than the 52 participants in the control group (27 vs. 39, P=0.02) and a lower prevalence of PTSD-related symptoms (45% vs. 69%, P=0.01). The median HADS score was also lower in the intervention group (11, vs. 17 in the control group; P=0.004), and symptoms of both anxiety and depression were less prevalent (anxiety, 45% vs. 67%; P=0.02; depression, 29% vs. 56%; P=0.003). Providing relatives of patients who are dying in the ICU with a brochure on bereavement and using a proactive communication strategy that includes longer conferences and more time for family members to talk may lessen the burden of bereavement. (ClinicalTrials.gov number, NCT00331877.)",Lautrette A.; Darmon M.; Megarbane B.; Joly LM.; Chevret S.; Adrie C.; Barnoud D.; Bleichner G.; Bruel C.; Choukroun G.; Curtis JR.; Fieux F.; Galliot R.; Garrouste-Orgeas M.; Georges H.; Goldgran-Toledano D.; Jourdain M.; Loubert G.; Reignier J.; Saidi F.; Souweine B.; Vincent F.; Barnes NK.; Pochard F.; Schlemmer B.; Azoulay E.,2007.0,10.1056/NEJMoa063446,0,0,
8761,Effectiveness of a meditation-based stress management program as an adjunct to pharmacotherapy in patients with anxiety disorder.,"The objective of this study was to examine the effectiveness of a meditation-based stress management program in patients with anxiety disorder. Patients with anxiety disorder were randomly assigned to an 8-week clinical trial of either a meditation-based stress management program or an anxiety disorder education program. The Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory, and the Symptom Checklist--90-Revised (SCL-90-R) were used to measure outcome at 0, 2, 4, and 8 weeks of the program. Compared to the education group, the meditation-based stress management group showed significant improvement in scores on all anxiety scales (HAM-A, P=.00; STAI state, P=.00; STAI trait, P=.00; anxiety subscale of SCL-90-R, P=.00) and in the SCL-90-R hostility subscale (P=.01). Findings on depression measures were inconsistent, with no significant improvement shown by subjects in the meditation-based stress management group compared to those in the education group. The meditation-based stress management group did not show significant improvement in somatization, obsessive-compulsive symptoms, and interpersonal sensitivity scores, or in the SCL-90-R phobic anxiety subscale compared to the education group. A meditation-based stress management program can be effective in relieving anxiety symptoms in patients with anxiety disorder. However, well-designed, randomized, and controlled trials are needed to scientifically prove the worth of this intervention prior to treatment.",Lee SH.; Ahn SC.; Lee YJ.; Choi TK.; Yook KH.; Suh SY.,2007.0,10.1016/j.jpsychores.2006.09.009,0,0,
8762,Depression and anxiety in visually impaired older people.,"To investigate the association between visual impairment and depression and anxiety in older people in Britain. Population-based cross-sectional study. Thirteen thousand nine hundred people aged 75 years and older in 49 family practices in Britain. Vision was measured in 13 900 people aged 75 years and older in 49 family practices taking part in a randomized trial of health screening that included depression (Geriatric Depression Scale [GDS-15]) and anxiety (General Health Questionnaire [GHQ-28]). Cause of visual impairment (binocular acuity less than 6/18) was assessed from medical records. Analysis was by logistic regression (odds ratio [OR] and 95% confidence interval [CI]), taking account of potential health and social confounders. Levels of depression and anxiety. Visually impaired people had a higher prevalence of depression compared with people with good vision. Of visually impaired older people, 13.5% were depressed (GDS-15 score of 6 or more) compared with 4.6% of people with good vision (age- and gender-adjusted OR, 2.69; 95% CI, 2.03-3.56). Controlling for potential confounding factors, particularly activities of daily living, markedly attenuated the association between visual impairment and depression (OR, 1.26; 95% CI, 0.94-1.70). There was little evidence for any association between visual impairment and anxiety. On the GHQ-28 scale, 9.3% of visually impaired people had 2 or more symptoms of anxiety compared with 7.4% of people with good vision. Although cause and effect cannot be established in a cross-sectional study, it is plausible that people with visual impairment are more likely to experience problems with functioning, which in turn leads to depression.",Evans JR.; Fletcher AE.; Wormald RP.,2007.0,10.1016/j.ophtha.2006.10.006,0,0,
8763,Reducing the number of emergency department visits and costs associated with anxiety: a randomized controlled study.,"To demonstrate the economic effects of an intervention for members discharged from the emergency department (ED) with anxiety diagnoses. Randomized controlled study. Adults with commercial, Medicare, or Medicaid insurance coverage enrolled in a health maintenance organization and discharged from an ED with anxiety diagnoses were randomly assigned to receive usual care (n = 300) or a stepped-care intervention (n = 307). Psychiatric ED and outpatient visit utilization and cost data identified by claims were collected for 6 months following the initial ED visit. Members assigned to receive the intervention demonstrated significantly fewer ED visits and lower associated facility costs in the 6 months following discharge compared with those assigned to usual care. No significant differences in psychiatric outpatient visit costs were observed. Members receiving usual care made 117 visits to the ED for a psychiatric condition during the follow-up period, for a mean of 0.39 visits per member and a mean facility cost of 118.15 dollars per member, while members receiving case management services made 79 visits to the ED for a psychiatric condition during the follow-up period, for a mean of 0.26 visits per member and a mean facility cost of 70.63 dollars per member. The intervention resulted in a savings of 7.92 dollars in ED costs per member per month for all psychiatric diagnoses during the 6-month study period. The case management-based intervention effectively reduced psychiatric ED recidivism and costs for members discharged from the ED with an anxiety diagnosis, without significantly affecting psychiatric outpatient visit costs.",Kolbasovsky A.; Reich L.; Futterman R.; Meyerkopf N.,2007.0,,0,0,
8764,[Writing assignments about stressful and/or traumatic events do not benefit patients with anxiety disorders].,"Several studies have indicated that patients with mild anxiety symptoms may benefit from writing about life events that they have found stressful. However, there is very little research done into the effects of this technique. To find out whether writing about stressful and/or traumatic events would also benefit patients with severe anxiety disorders. Our sample consisted of 32 patients (24 women and 8 men) with anxiety disorders. They were randomly assigned to 2 groups, one being an experimental group, the other a control group. Eighteen patients were asked to write about the most stressful events they had experienced and 14 were asked to write about trivial topics. Each patient completed 4 writing sessions over a 2-week period. A follow-up writing session took place six weeks later. Anxiety symptoms and mood were measured by means of the Symptom Check List, the Penn State Worry Questionnaire, the Impact of Event Scale and the Profile of Mood State. The immediate effect of writing on mood was scored by means of a simple questionnaire. The mood of the patients in the experimental writing group deteriorated markedly during a short time. Multivariate analyses conducted on repeated measurements did not reveal any significant effects. The interaction between the experimental group and the test scores was not significant either. At follow-up psychic functioning and mood in the experimental group were no better that in the control group. Writing about stressful and/or traumatic events is a very taxing activity for patients (pain). This has often been demonstrated in the past. The results show that simply writing about stressful events is definitely not a successful way of reducing anxiety symptoms (no gain).",Lammerts van Bueren N.,2007.0,,0,0,7117
8765,Interactive effects of memory structuring and gender in preventing posttraumatic stress symptoms.,"This study retested effects of a Memory Structuring Intervention (MSI) and the moderating role of gender in relation to posttraumatic stress disorder (PTSD) symptoms. Thirty-four traffic accident victims with high pulse rates were randomly assigned to MSI or supportive listening (control) phone conversations soon after accidents. Based on converging clinical and neuroscience research, the MSI taught chronological organization, labeling emotions/sensations, and describing causality. PTSD symptoms were assessed 3 months later. No overall group differences were found. However, a group by gender interaction revealed that, for women, the MSI was associated with less PTSD symptoms than the control treatment, while the opposite pattern was seen in men. Limitations and possible explanations for these findings are discussed.",Gidron Y.; Gal R.; Givati G.; Lauden A.; Snir Y.; Benjamin J.,2007.0,10.1097/01.nmd.0000254676.11987.5d,0,0,
8766,Assessing obsessive compulsive symptoms and cognitions on the internet: evidence for the comparability of paper and Internet administration.,"Administration of psychological questionnaires via the Internet has gained popularity in recent years and touts many advantages. However, before questionnaires that were originally developed as paper-and-pencil measures can be confidently administered over the Internet, it is necessary to document the equivalence of the paper and computer-generated versions [American Psychological Association. (1986). Guidelines for computer-based tests and interpretations. Washington, DC: American Psychological Association; Cohen, R.J., Swerdlik, M.E., & Smith, D.K. (1992). Psychological testing and assessment (2nd ed.). Mountain View, CA: Mayfield Publishing; Cronbach, L.J. (1990). Essentials in psychological testing (5th ed.). New York: Harper Collins; Meier, S. (1994). The chronic crisis in psychological measurement and assessment: A historical survey. San Diego: Academic Press; Schulenberg, S.E., & Yutrzenka, B.A. (2001). Equivalence of computerized and conventional versions of the Beck Depression Inventory- II (BDI-II). Current Psychology: Developmental, Learning, Personality, Social, 20, 216-230]. The current study tested this equivalence for the Obsessive Compulsive Inventory [Foa, E.B., Kozak, M.J., Salkovskis, P.M, Coles, M.E., & Amir, N. (1998). The validation of a new obsessive compulsive disorder scale: The obsessive-compulsive inventory. Psychological Assessment, 10(3), 206-214] and the Obsessive Beliefs Questionnaire-44 [Obsessive Compulsive Cognitions Working Group. (2005). Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory-Part 2: Factor analyses and testing of a brief version. Behaviour Research and Therapy, 43, 1527-1543] in an unselected student sample. Study results support the equivalence of these measures of obsessive compulsive disorder (OCD) symptoms and beliefs independent of administration method (paper versus secure project website). These findings create new opportunities for conducting OCD-related research online.",Coles ME.; Cook LM.; Blake TR.,2007.0,10.1016/j.brat.2006.12.009,0,0,
8767,Does a combination of intensive cognitive-behavioral pain management and a spinal implantable device confer any advantage? A preliminary examination.,"Research suggests that a combination of a somatic and a psychosocial intervention for chronic noncancer pain should be associated with a better outcome than either alone. This study presents data on a series of 31 patients who underwent sequential treatment with an implantable device targeting pain relief and a cognitive-behavioral pain management program that targeted improved function. A combination of treatments was used as there was a suboptimal response to the initial treatment. There were improvements in a range of outcomes at a long-term follow-up. Significant improvements were found in disability, affective distress, self-efficacy, and catastrophizing, but not in average pain severity. Further analyses failed to demonstrate an order effect. These results support the view that combined somatic and psychosocial interventions can achieve better outcomes than either alone in selected chronic pain patients. This approach requires that psychological assessment is essential before the use of an implantable device. This may not only improve patient selection, but also identify psychosocial factors that may be modified to enhance the effectiveness of invasive interventions. In addition, consideration for an implantable device following a suboptimal response to treatment in a cognitive-behavioral pain management program should include a re-evaluation of the patients' beliefs and use of self-management (coping) strategies before deciding on further treatment options.",Molloy AR.; Nicholas MK.; Asghari A.; Beeston LR.; Dehghani M.; Cousins MJ.; Brooker C.; Tonkin L.,2006.0,10.1111/j.1533-2500.2006.00069.x,0,0,
8768,Combining alprazolam with systematic desensitization therapy for dental injection phobia.,"To determine whether a benzodiazepine facilitates systematic desensitization, 144 subjects with dental injection phobia received systematic desensitization in combination with placebo or one of two doses of alprazolam (0.5mg or 0.75mg). Systematic desensitization therapy included computer-controlled presentation of digitized video segments followed by in vivo exposure segments, culminating in an actual dental injection. Subjects advanced to the next hierarchy segment when low anxiety was reported during a segment. Alprazolam and placebo groups progressed at the same rate. The 0.75mg group had elevated heart rates while watching video segments compared with placebo. In a subsequent behavioral avoidance test (during which subjects were randomized to a new drug condition), there was no indication that state-dependent learning had occurred. Dental fear was reduced similarly in all groups for 1 year after study completion. No advantage was found to combining alprazolam with systematic desensitization for dental injection phobia.",Coldwell SE.; Wilhelm FH.; Milgrom P.; Prall CW.; Getz T.; Spadafora A.; Chiu IY.; Leroux BG.; Ramsay DS.,2007.0,10.1016/j.janxdis.2007.01.001,0,0,
8769,Recognition of facial expressions in obsessive-compulsive disorder.,"Sprengelmeyer et al. [Sprengelmeyer, R., Young, A. W., Pundt, I., Sprengelmeyer, A., Calder, A. J., Berrios, G., et al. (1997). Disgust implicated in obsessive-compulsive disorder. Proceedings of the Royal Society of London, 264, 1767-1773] found that patients with OCD showed severely impaired recognition of facial expressions of disgust. This result has potential to provide a unique window into the psychopathology of OCD, but several published attempts to replicate this finding have failed. The current study compared OCD patients to normal controls and panic disorder patients on ability to recognize facial expressions of negative emotions. Overall, the OCD patients were impaired in their ability to recognize disgust expressions, but only 33% of patients showed this deficit. These deficits were related to OCD symptom severity and general functioning, factors that may account for the inconsistent findings observed in different laboratories.",Corcoran KM.; Woody SR.; Tolin DF.,2008.0,10.1016/j.janxdis.2007.01.003,0,0,
8770,Residual symptoms and recurrence during maintenance treatment of late-life depression.,"Many older patients who recover from an episode of major depression continue to suffer from depressed mood, anxiety, and sleep problems. Our study assesses the impact of these residual symptoms on the risk of recurrence during maintenance treatment of late-life depression. We analyzed data from a randomized clinical trial of maintenance treatment in patients with unipolar depression aged > or =70, 116 of whom remitted and remained stable during open pharmacotherapy and interpersonal psychotherapy (IPT) and were randomized to clinical management/pharmacotherapy; clinical management/placebo; monthly maintenance IPT/ pharmacotherapy; or monthly maintenance IPT/placebo. We assessed the impact of overall residual symptoms (based on the Hamilton Depression Rating Scale (HAM-D) total score) and of specific residual symptom clusters - mood symptoms (depressed mood, guilt, suicidality, energy/interests), sleep disturbance (early, middle, late insomnia), and anxiety (agitation, psychic and somatic anxiety, hypochondriasis) measured at randomization. Sleep disturbance was also assessed with the Pittsburgh Sleep Quality Index (PSQI). We used Cox proportional hazards regression models controlling for assignment to antidepressant medication versus placebo to identify predictors of recurrence. Residual anxiety and residual sleep disturbance (as measured by the PSQI but not the HAM-D) independently predicted early recurrence. Use of HAM-D clusters to define residual symptoms; analysis limited to completers of acute and continuation treatment. In patients with late-life depression who have remitted with pharmacotherapy and psychotherapy, the deleterious effect of residual symptoms is due to persisting anxiety and, possibly, residual sleep disturbance.",Dombrovski AY.; Mulsant BH.; Houck PR.; Mazumdar S.; Lenze EJ.; Andreescu C.; Cyranowski JM.; Reynolds CF.,2007.0,10.1016/j.jad.2007.01.020,0,0,
8771,Temperament and character dimensions in patients with social phobia: patterns of change following treatments?,"The aim of this study was to examine Temperament and Character Inventory (TCI) profiles in patients with social phobia (DSM-IV) and to outline patterns of change following intensive group cognitive therapy (IGCT), individual cognitive therapy (ICT) and treatment as usual (TAU). One hundred patients recruited by advertisements in local papers were randomized to IGCT, ICT and TAU. Patients (n=59) who completed diagnostic evaluation and TCI assessments at baseline and 1-year follow-up were examined in this study. Patients differed from healthy controls in novelty seeking (NS), harm avoidance (HA), self-directedness (SD), cooperativeness (C), and self-transcendence (ST). Treatments overall were associated with decrease in HA, while increase in SD was observed after psychotherapy only. Reduced social anxiety was correlated with decrease in HA and increase in SD. High HA at baseline was related to poor treatment outcome in all treatments. To conclude, patients with social phobia show a temperamental vulnerability for developing anxiety and character traits associated with personality disorders. Successful treatment is related to decrease in HA and increase in SD. High HA at baseline may suggest a need for extensive treatment in order to achieve remission.",Mörtberg E.; Bejerot S.; Aberg Wistedt A.,2007.0,10.1016/j.psychres.2006.10.003,0,0,
8772,Cervical spine stabilization by plate-cage. Clinical evaluation.,"Cervical plate-cages have recently been introduced to clinical practice. Clinical and radiographic results of D-Fun-CE plate-cage stabilization were studied. 34 patients were treated surgically with the mean follow-up of 25 months. All cases were divided into 3 groups. Group 1 (n = 15) included posttraumatic cases after one-level discectomies, group 2 (n = 14) included patients with disc degenerative changes after one-level discectomies, and group 3 (n = 9) encompassed patients after two- and three-level discectomies. In the clinical evaluation ASIA scale, Odom's criteria and VAS scale were used. General and local cervical lordoses were assessed by Jackson's method. Subsidence was determined by modified Tye's method. Statistical significance of differences was assessed by Wilcoxon and Mann-Whitney tests. At follow-up, 14 patients (93%) from group 1 improved at least by one degree on the ASIA scale. In Odom's criteria, 79% of patients in group 2 gained very good results, 14% good, and 7% satisfactory; but in group 3 only 56% of patients achieved very good, 22% good, and 22% satisfactory results. On the VAS scale, pain decreased from a mean of 6 to 1.4 after surgery and to 1.3 at follow-up. Overall averaged general cervical lordosis increased from 9.8 degrees before surgery to 19 degrees after surgery and to 19.2 degrees at follow-up. Local cervical lordosis changed from a mean of -2 degrees , to 9.8 degrees and 9.4 degrees , respectively. Subsidence in group 1 averaged 1.2 mm; in group 2, 0.6 mm; and in group 3, 2.4 mm. The results indicate good stabilization properties of the D-Fun-CE plate-cage. All patients achieved spondylodesis, which is especially beneficial for multilevel cases. Subsidence was noted in the majority of operated cases (76.7% of patients) but its size increased together with the number of fused levels.",Hakalo J.; Wronski J.,,,0,0,
8773,Implications of naturalistic use of pharmacotherapy in CBT treatment for panic disorder.,"This study examined naturalistic medication use and cognitive behavioral therapy (CBT) treatment outcomes in 105 patients meeting DSM-IV criteria for panic disorder (PD), assessed by structured clinical interview. The association between pre- and post-treatment use of SSRIs, benzodiazepines (BZs), and any anti-anxiety or anti-depressant (A/D) medication were investigated for three indicators of treatment outcome (PD severity, presence of agoraphobia (AG), anxiety sensitivity) at post-treatment and 6-month follow-up. Controlling for pre-treatment severity, pre-treatment SSRI use was associated with worse outcomes for AG (p=.04) and anxiety sensitivity (p=.047); post-treatment SSRI use was associated with delayed improvements in PD severity (p=.05). Pre-treatment use of A/D was associated with poorer PD severity outcomes (p=.04). Post-treatment use of A/D was associated with higher anxiety sensitivity scores across post-treatment and 6-month follow-up (p=.03). BZ use was not associated with significantly worse outcomes. However, there was a decrease in the number of patients using BZs from pre-treatment to post-treatment (p=.06) and follow-up (p=.006). In conclusion, controlling for pre-treatment severity, pre- and post-treatment use of SSRIs and A/D was associated with poorer outcomes, particularly for PD severity and anxiety sensitivity.",Arch JJ.; Craske MG.,2007.0,10.1016/j.brat.2007.01.005,0,0,
8774,On treatment with eye movement desensitization and reprocessing of chronic post-traumatic stress disorder in public transportation workers--a randomized controlled trial.,"Previous studies on post-traumatic stress disorder (PTSD) investigated a variety of treatments and included mostly patients victims of sexual and combat assault. This study aimed to determine the short-term efficacy of eye movement desensitization and reprocessing (EMDR) in occupation-based PTSD. Employees of the public transportation system in Stockholm, who had been experiencing a person-under-train accident or had been assaulted at work were recruited. Subjects with trauma exposure since more than 3 months but less than 6 years were included. Twenty-four subjects who fulfilled the DSM-IV criteria for PTSD were randomized to either EMDR therapy (n=13) or waiting list (WL, n=11). They were assessed pre-treatment and shortly after completion of treatment or WL period. The pre-defined primary outcome variable was full PTSD diagnosis. Secondary outcome variables were the results of various psychometric scales. Twelve participants began and completed five sessions of EMDR and nine completed the WL. After therapy, eight subjects in the EMDR group (67%) and one (11%) in WL did not fulfil the criteria for PTSD diagnosis (difference, P=0.02). Among the secondary outcome variables, there were significant differences post-treatment between the groups EMDR/WL in Global Assessment of Function (GAF) score and Hamilton Depression (HAM-D) score. This study indicates that EMDR has a short-term effect on PTSD in public transportation workers exposed to occupational traumatic events. Such intensive and brief therapy might be further validated in larger samples of exposed workers with longer periods of follow-up.",Högberg G.; Pagani M.; Sundin O.; Soares J.; Aberg-Wistedt A.; Tärnell B.; Hällström T.,2007.0,10.1080/08039480601129408,0,0,
8775,Use of skills learned in CBT for fear of flying: managing flying anxiety after September 11th.,"Although there is evidence that cognitive behavioral therapy (CBT) is effective in the treatment for fear of flying (FOF), there are no studies that specifically examine which skills taught in treatment are being used by clients after treatment is completed. This study examines whether participants report using skills taught in treatment for FOF after treatment is completed and whether the reported use of these skills is associated with reduced flying anxiety in the face of fear-relevant event, the September 11th terrorist attacks, and over the long-term. One hundred fifteen participants were randomly assigned to and completed eight sessions of individual CBT treatment for FOF. Fifty-five participants were reassessed in June 2002, an average of 2.3 years after treatment. Surveys were also collected from 33 individuals who did not receive treatment for FOF. Results indicated that treatment completers were more likely to report using skills taught in treatment than individuals who had not received treatment. In addition, self-reported use of skills among previously treated individuals was associated with lower levels of flying anxiety. These findings suggest that use of skills taught in CBT treatment is associated with reduced flying anxiety in the face of a fear-relevant event and over the long term.",Kim S.; Palin F.; Anderson P.; Edwards S.; Lindner G.; Rothbaum BO.,2008.0,10.1016/j.janxdis.2007.02.006,0,0,
8776,Acupuncture treatment for women with concurrent substance use and anxiety/depression: an effective alternative therapy?,"This exploratory study evaluated the benefits of adding auricular acupuncture to a 21-day outpatient structured psychoeducational treatment program for women with concurrent substance use problems, anxiety, and depression. Women receiving acupuncture (n = 185) reported having reduced physiological cravings for substances, felt significantly less depressed, less anxious, and were better able to reflect on and resolve difficulties than women in the control group (n = 101). It was found that auricular acupuncture, as an adjunct therapy to a comprehensive psychoeducational treatment program for women with addictions, shows promise in being an effective, more viable treatment alternative to anxiolytics.",Courbasson CM.; de Sorkin AA.; Dullerud B.; Van Wyk L.,,,0,0,
8777,Effect of comorbid anxiety on treatment response and relapse risk in late-life depression: controlled study.,"Comorbid anxiety is common in depressive disorders in both middle and late life, and it affects response to antidepressant treatment. To examine whether anxiety symptoms predict acute and maintenance (2 years) treatment response in late-life depression. Data were drawn from a randomised double-blind study of pharmacotherapy and interpersonal psychotherapy for patients age 70 years and over with major depression. Anxiety symptoms were measured using the Brief Symptom Inventory. Survival analysis tested the effect of pre-treatment anxiety on response and recurrence. Patients with greater pretreatment anxiety took longer to respond to treatment and had higher rates of recurrence. Actuarial recurrence rates were 29% (pharmacotherapy, lower anxiety), 58% (pharmacotherapy, higher anxiety), 54% (placebo, lower anxiety) and 81% (placebo, higher anxiety). Improved identification and management of anxiety in late-life depression are needed to achieve response and stabilise recovery.",Andreescu C.; Lenze EJ.; Dew MA.; Begley AE.; Mulsant BH.; Dombrovski AY.; Pollock BG.; Stack J.; Miller MD.; Reynolds CF.,2007.0,10.1192/bjp.bp.106.027169,0,0,
8778,An experimental study of the role of vulnerability related perceptions in spider fear: comparing an imaginal and in vivo encounter.,"The effect of manipulating perceptions of the uncontrollability, unpredictability and dangerousness of a spider was assessed using both an imaginal and in vivo task involving an encounter with a spider. Participants were randomly assigned to one of eight conditions formed by the crossing of factors. Experimental manipulations of uncontrollability, unpredictability and dangerousness all had a significant effect on Task Related Spider Fear in the in vivo exposure task. Results indicated a greater effect on task related fear for in vivo exposure (R(2)=.258) compared to imaginal exposure (R(2)=.053). Perceptions of spiders as uncontrollable, unpredictable and dangerous accounted for much of the variance in spider fear beyond that accounted for by the experimental manipulations. The idea that perceptions of spiders as uncontrollable, unpredictable and dangerous are causally related to spider fear was supported with in vivo exposure being a stronger modality for fear modification than imaginal exposure.",Armfield JM.,2008.0,10.1016/j.janxdis.2007.03.003,0,0,
8779,Which panic disorder patients benefit from which treatment: cognitive therapy or antidepressants?,"Beliefs about the controllability of a disorder may be relevant in the causation, maintenance and treatment of disorders. We investigated whether congruence between patients' beliefs about controllability of a panic disorder and the type of treatment provided predicted outcome. The differential effectiveness of cognitive therapy and antidepressant treatment (paroxetine or clomipramine) was investigated in a sample of 129 panic disorder patients in a 12-week, pretest posttest placebo-controlled study. Panic frequency, agoraphobic avoidance, anxiety, depression, and disability were measured with various validated interviewer and self-report measures. Beliefs about controllability were measured with the Multidimensional Anxiety Locus of Control Scale measuring an internal, chance, therapist and medication locus of control. In order to analyze aptitude-treatment interactions a new strategy called the Regression Trunk Approach was used in addition to classical hierarchical multiple regression analysis. Using the Regression Trunk Approach we found that locus of control orientation (LOC) predicted the differential effectiveness of cognitive therapy. Those patients with a medium internal LOC who received cognitive therapy performed significantly better than all patients who received a placebo pill on 8 of the 10 outcome variables. We did not find a differential LOC effect for antidepressant treatment. No evidence for aptitude-treatment interactions using hierarchical multiple regression analysis was found. Moderately strong beliefs about self-control of panic disorder congruent with the cognitive intervention provided seem to moderate treatment effectiveness. Future studies must be more attentive to the nonlinear effects of patient characteristics on the outcome of different types of treatments.",Dusseldorp E.; Spinhoven P.; Bakker A.; van Dyck R.; van Balkom AJ.,2007.0,10.1159/000099842,0,0,
8780,Six-month treatment outcomes of cocaine-dependent patients with and without PTSD in a multisite national trial.,"This study examined 6-month treatment outcomes among 428 cocaine-dependent outpatients with (n = 34) and without (n = 394) posttraumatic stress disorder (PTSD) in a randomized controlled multisite clinical trial of manual-based psychotherapies for substance use disorder (SUD). Assessments were completed at baseline and monthly during the 6-month treatment. With longitudinal mixed-effects models, we compared outcomes between SUD-PTSD and SUD-only patients and also examined rates of within-group change. Results indicated a highly consistent pattern: the SUD-PTSD patients were more impaired to begin with and remained so across time compared with SUD-only patients (with the exception of substance use and addiction-related legal and employment problems, which did not differ between groups). Also, the SUD-PTSD patients improved less than SUD-only patients in alcohol use and the majority of addiction-related psychosocial problems. However, the two groups did not differ significantly in improvement over time on drug use or global psychological severity. The greater impairment and relative lack of improvement of SUD-PTSD patients, compared with those with SUD-only, suggest a need for dual-diagnosis treatments that more directly target their areas of difficulty.",Najavits LM.; Harned MS.; Gallop RJ.; Butler SF.; Barber JP.; Thase ME.; Crits-Christoph P.,2007.0,,0,0,
8781,Minimum 5-year follow-up surgical results of post-traumatic thoracic and lumbar kyphosis treated with anterior instrumentation: comparison of anterior plate and dual rod systems.,"A retrospective follow-up study of post-traumatic thoracic and lumbar kyphosis after anterior instrumentation with anterior plate and dual rod systems. To investigate the outcome of anterior vertebrectomy, anterior strut grafting, and anterior instrumentation in patients with > 30 degrees sagittal contour deformity. Post-traumatic kyphosis may lead to mechanical pain due to the impairment of physiologic sagittal contours as well as cosmetic complaints. Forty patients with post-traumatic kyphosis were followed for a minimum of 5 years. Mean age was 44.7 +/- 12.4 years (range, 18-65 years); 18 were female and 22 were male. All patients underwent anterior vertebrectomy and decompression; anterior fusion was carried out with costal or iliac ala grafts. Patients were randomly assigned into 2 treatment groups: correction and internal fixation was performed by using either plate-screw (n = 20) or double rod-screw (n = 20). Patients were also evaluated clinically by using Pain and Functional Assessment Scale (PFA) and SRS-22 questionnaire. Before surgery, the mean value for local sagittal contours was 51.4 degrees +/- 13.8 degrees; after surgery, it was reduced to 7.0 degrees +/- 7.6 degrees, resulting in an 88.7% +/- 11.3% correction (P = 0.00). At the last follow-up visit, a mean correction loss of 1.4 degrees +/- 1.8 degrees was found. A statistically significant improvement in local kyphosis angles and PFA scores was found after surgery and at the last visit. In 92.5% of the patients (n = 36), pain completely resolved; and in the remaining 3 patients, it is markedly reduced. Neurologic improvement was achieved in all of the 24 patients with neural claudication and other neurologic findings. Solid fusion mass was obtained in all patients. The type of instrumentation system did not differ significantly in terms of kyphotic deformity correction rates, correction losses, PFA scores, and SRS-22 scores. Final PFA scores showed a statistically significant correlation with SRS-22 scores (r = -0.918, P < 0.01). Final pain, function, mental status, self image and satisfaction domain scores and total SRS-22 score were > or = 4. The time from trauma to operation and the severity of kyphotic deformity were inversely correlated with postoperative correction rates. On the other hand, these 2 parameters were positively correlated with both final PFA and final SRS-22 scores (P < 0.01). In light of the present study's findings, we suggest that the technique of anterior decompression, strut grafting, and anterior instrumentation is an effective method for the treatment of post-traumatic kyphotic deformity and that the success of the technique depends on the time from trauma to operation and the severity of baseline deformity, regardless of the type of instrumentation.",Benli IT.; Kaya A.; Uruç V.; Akalin S.,2007.0,10.1097/01.brs.0000260796.77990.f7,0,0,
8782,Integrating smoking cessation into mental health care for post-traumatic stress disorder.,"Post-traumatic stress disorder (PTSD) is associated with a high prevalence of smoking, heavy cigarette consumption and low cessation rates. This manuscript describes the design of a randomized, multisite effectiveness trial to test whether integrating smoking cessation treatment into mental health care (integrated care) improves prolonged abstinence rates among veterans with PTSD, compared with referral to specialized smoking cessation clinics (usual standard of care). Secondary objectives are to assess the cost-effectiveness of integrated care relative to usual standard of care, identify treatment variables that mediate differences between conditions in outcome and determine whether smoking cessation is associated with worsening PTSD and/or depression. Following randomization, subjects (projected n = 1400) from 10 Veterans Health Administration (VHA) medical centers complete follow-up assessments every three or six months for up to four years. Endpoints include 1-year prolonged abstinence at 18 months postrandomization, 7- and 30-day point-prevalence abstinence and measures of depression, PTSD and economic outcomes. This study is unique in providing the largest scale test of the feasibility and effectiveness of having mental health clinicians implement evidence-based smoking cessation treatment in psychiatric care settings for veterans with PTSD. It incorporates methodological features that are desirable for cessation treatment trials, including: a) assessment of clinically meaningful long-term smoking outcomes; b) a manual guiding delivery of the experimental intervention; c) independent ratings of clinician competence and treatment adherence and d) methods for training clinicians that would enhance implementation of tobacco cessation treatment in large health care systems. Use of an exclusively VHA sample with few females limits generalizability. The process for meeting challenges in designing this study may provide planning of other large-scale clinical effectiveness trials in tobacco control. Findings have potential to initiate system-wide change in clinical practice patterns for tobacco cessation treatment involving patients with mental disorders.",McFall M.; Saxon AJ.; Thaneemit-Chen S.; Smith MW.; Joseph AM.; Carmody TP.; Beckham JC.; Malte CA.; Vertrees JE.; Boardman KD.; Lavori PW.,2007.0,10.1177/1740774507076923,0,0,
8783,"Deteriorating memory confidence, responsibility perceptions and repeated checking: comparisons in OCD and control samples.","Repeated checking has been repeatedly associated with memory distrust. We sought to extend previous research using a computer-based checking task by incorporating a group of 15 individuals with OCD, and examining the effect of increased perceived responsibility. Participants were asked to repeatedly check a virtual stovetop, with half the participants also placed under a condition of high-perceived responsibility. Our observations replicated previous research showing that the act of repeatedly checking leads to reductions in memory vividness, detail and confidence, without accompanying reductions in memory accuracy. Furthermore, while a sense of increased personal responsibility had little effect on a student control sample, it led to a significant further deterioration in memory confidence in individuals with OCD. These results suggest that in people with OCD, normal reductions in memory confidence over repeated trials are exacerbated and intensified by inflated responsibility perceptions.",Boschen MJ.; Vuksanovic D.,2007.0,10.1016/j.brat.2007.03.009,0,0,
8784,Electroacupuncture treatment of obesity with psychological symptoms.,"The aim was to study the effect of placebo EA, electroacupuncture (EA), and diet on obesity and accompanying psychological symptoms. One hundred and sixty-five volunteer women participated in the study. There were three groups: (i) Placebo EA, (ii) EA, and (iii) diet restriction group. EA was performed by using three ear and six body points. There was a 4.8% reduction in weight of patients with EA application, whereas patients with a diet restriction and placebo EA had a 2.5% and 2.7% weight reduction, respectively. There were significant decreases in phobia, anger, anxiety, obsession, paranoid symptoms, and depression in the EA groups compared to those of the placebo EA and diet groups. It was suggested that electroacupuncture may be an effective therapy for obesity including the psychological signs and symptoms in women.",Cabioglu MT.; Ergene N.; Tan U.,2007.0,10.1080/00207450500535545,0,0,
8785,[A coping with Stress Training (SBT) for persons with mental illness--pilot study on a group training programme in support of occupational rehabilitation].,"This pilot study investigates the effects of a coping with stress training (SBT) programme which had been offered in the Workshop for Disabled People of the Stuttgart Occupational Rehabilitation Center Rudolf-Sophien-Stift to persons with mental illness. The group training is aimed at supporting the participants in coping effectively with stress, avoiding over- or under-stimulation and strengthening positive experiences. In a control-group study design, data was collected from 19 participants of the training group and 11 participants of a (waiting) control group. Data collection was carried out before and after the training. In the pre-post comparison the training group shows a reduction of symptoms in general and especially in somatization, obsessive-compulsiveness, anxiety, and paranoid ideation. The participants showed improvements in quality of life in the areas of capability, ability to enjoy and relax, positive and negative mood. In respect of attitudes of competence and control they showed improvements in internal control attitudes. Also, as regards illness coping and prevalent coping styles, active and problem-oriented coping styles were found to have increased to some extent. In the problem solving training, 84.2% of the participants stated in their self-ratings that they had been able to achieve positive changes in a specific problem area. From a methodological angle it has to be pointed out that the study had examined a very small group. Although a number of open questions remain the results obtained are encouraging and in accordance with the objectives of the training. Further studies need to be carried out with larger samples from different facilities in the fields of medical, vocational and social rehabilitation.",Hammer M.; Plössl I.; Hundsdörfer T.,2007.0,10.1055/s-2007-970582,0,0,
8786,Not just right experience: is it influenced by feelings of guilt?,"Individuals with obsessive-compulsive disorder (OCD) experience increased guilt. Further, these individuals often report uncomfortable sensations of things being not quite right (""not just right experiences""--NJREs). As to the relation between these psychological phenomena, it was hypothesized that feelings of guilt may enhance NJRE. In two experiments, we demonstrated that the induction of a guilty emotion resulted in increased NJRE, and this finding was qualified by an interaction with trait guilt. Induced guilt was followed by stronger feelings of things being not just right only in high-trait-guilt participants. In the low-trait-guilt participants NJRE was weaker. Moreover, we found a meaningful relationship between both NJRE and trait guilt and OCD features.",Mancini F.; Gangemi A.; Perdighe C.; Marini C.,2008.0,10.1016/j.jbtep.2007.02.002,0,0,
8787,Specificity of autobiographical memory in social phobia and major depression.,"Several studies have found evidence for overgeneral autobiographical memory in patients with major depression and other disorders. Individuals with social phobia have been found to report early memories relating to specific experiences of being depreciated or rejected. However, there are no clear results regarding specificity of autobiographical memory in social phobia to date. Experimental design is quasi-experimental: Three groups were compared with regard to specificity of autobiographical memory. Emphasis was laid on matching the groups for age, gender and educational level. Following the Autobiographical Memory Test (AMT) and another recent study, 10 emotional cue words of positive or negative valence were presented to 18 outpatients with social phobia without current comorbid depression, 18 outpatients with major depression without current anxiety disorder and 18 healthy control subjects in a think-aloud task. Participants were asked to report a specific autobiographical event and received sufficient training to ensure that the method had been understood. Results indicated no significant differences between groups for specificity and latency of first specific response. In contrast with earlier studies, an overgeneral response style was not observed in depressed patients. However, significant differences in educational level emerged. Social phobics demonstrated a high ability to recall detailed specific autobiographical memories. Possible explanations for the discrepancy between our results and previous findings regarding depressed patients are discussed in terms of sample characteristics, specific modifications of the AMT-protocol and level of education.",Heidenreich T.; Junghanns-Royack K.; Stangier U.,2007.0,,0,0,
8788,Treatment of type IIIA open fractures of tibial shaft with Ilizarov external fixator versus unreamed tibial nailing.,"The aim of this study was to compare the radiographic results and clinical outcome of unreamed tibial nailing (UTN) and Ilizarov external fixation (IEF) for the treatment of type IIIA open fractures of the tibia. Sixty-one patients with open type IIIA tibial shaft fractures were treated with an IEF (n = 32) or UTN (n = 29). Both groups were compared for union time, secondary outcomes of nonunion, infections, mechanical failure of the implant, and malunion. The average time-to-bone healing was 19 weeks (range 14-23 weeks) for IEF and 21 weeks (range 16-36 weeks) for UTN; it was significantly shorter in the IEF group (P = 0.039). One patient had refracture in the IEF group. Malunion occurred in four patients for each group. Posttraumatic osteomyelitis occurred in two patients in the IEF group and in three patients in the UTN group. In the IEF group, additional surgical procedures were indicated in three cases including sequestrectomy (n = 1), and pin replacement (n = 2). In the UTN group, seven patients needed additional surgery including bone grafting (n = 3), nail exchanged (n = 1), and posttraumatic osteomyelitis (n = 3). The results of the current study showed that IEF technique had a notable incidence of pin-tract infection, joint contracture, and shorthening related to treatment of the delayed union. The UTN technique had the disadvantage of a posttraumatic osteomyelitis and delayed union requiring additional surgery. We believe that the decision to use IEF or UTN should be made on a case-by-case basis.",Inan M.; Halici M.; Ayan I.; Tuncel M.; Karaoglu S.,2007.0,10.1007/s00402-007-0332-9,0,0,
8789,Distraction correction of chronic flexion contractures of PIP joint: comparison between two distraction rates.,"The surgical correction of chronic flexion contractures of the proximal interphalangeal (PIP) joints is quite challenging because the extensive soft-tissue surgery needed is demanding, and the results often are discouraging. Gradual joint distraction recently was shown to be effective in the correction of PIP joint contractures. We performed this study to determine the optimum rate and amount of daily distraction and the optimum duration for which the external fixator should be left in situ after correction. This study compared 2 groups of patients with different distraction rates: one group with 0.5 mm/day and the other group with 1.0 mm/day. We also compared and evaluated the results of external fixation removal at 1 week versus 2 weeks after full correction. The Mini-Orthofix external fixator was used to correct post-traumatic PIP joint contractures in 10 consecutive patients divided into 2 groups. Group 1 consisted of 5 patients who had 0.5 mm of joint distraction per day until full correction followed by an in situ external fixator for 2 weeks. Group 2 consisted of 5 patients who had 1 mm of joint distraction per day until full correction followed by an in situ external fixator for only 1 week. The 2 groups were compared and statistically analyzed. At the 1-year follow-up evaluation there were no statistically significant differences between the 2 groups. The mean range of motion gained was 64 degrees in group 1 and 66 degrees in group 2. There were no recurrences. We concluded that 1 mm of joint distraction per day followed by an in situ external fixator for 1 week may be safe and effective for the correction of chronic post-traumatic contractures of the PIP joint; however, similar studies on a larger group may be necessary before this technique could be recommended universally. Therapeutic I.",Houshian S.; Chikkamuniyappa C.,,10.1016/j.jhsa.2007.02.015,0,0,
8790,Feeling guilty as a source of information about threat and performance.,"OCD patients experience increased feelings of guilt, threat and uncertainty about harm prevention. As to the relation between these phenomena, it was hypothesised that the experience of guilt acts as ""information"" that increases the sense of threat and decreases the sense that preventive action is effective. We tested whether state guilt is used as information about risk and prevention effects and whether people high in trait guilt do so more than others. Participants high and low in trait guilt were included. Three types of affect were experimentally induced: guilt, anxiety and a neutral affect. Then, participants estimated the likelihood and severity of a negative outcome, and the dissatisfaction with preventive performances in two OCD relevant scenarios. Relative to low-trait guilt participants, people high in trait guilt had higher ratings of risk after induction of state guilt. With regards to dissatisfaction with preventive performance, there was only a trend for high-trait guilt participants to respond stronger to state guilt. The results suggest that people with a general inclination to feel guilty use temporary feelings of guilt as information about the threat content of a situation and do so even if the source of state guilt is unrelated to the situation. Implications for the understanding of OCD are discussed.",Gangemi A.; Mancini F.; van den Hout M.,2007.0,10.1016/j.brat.2007.03.011,0,0,
8791,Characteristics and psychosocial needs of victims of violent crime identified at a public-sector hospital: data from a large clinical trial.,"This study explores the feasibility of recruiting acutely injured public-sector crime victims into a research protocol and identifies baseline characteristics associated with posttraumatic distress in the enrolled sample (N=541). Assertive research tracking methods were used to enroll participants, who completed baseline interviews. Descriptive statistics were used to define characteristics of the sample and prevalence of psychosocial problems and posttraumatic distress. Multiple regression analysis was performed to identify predictors of posttraumatic distress. A high percentage (78%) of eligible victims completed baseline interviews within 1 month of victimization. The sample was largely male, ethnic minority, unemployed and living below the poverty level. Trauma symptoms were highly prevalent, with three quarters having significant posttraumatic distress. Female gender, preexisting psychiatric disorder, trauma history, case management needs and employment status were predictive of greater symptomatology. Stabbing victims had lower distress. Comprehensive mental health and case management services that proactively engage disadvantaged victims are needed to meet the complex problems of this population.",Boccellari A.; Alvidrez J.; Shumway M.; Kelly V.; Merrill G.; Gelb M.; Smart S.; Okin RL.,,10.1016/j.genhosppsych.2007.01.008,0,0,
8792,The ineffectiveness of the Hospital Anxiety and Depression Scale for diagnosis in an Omani traumatic brain injured population.,"The rehabilitation of the traumatic brain injury (TBI) patient is especially challenging in non-western populations as the phenotypic indicators as well as the neurobehavioral assessments for the survivors of brain injury are limited. The study screened for the prevalence of anxiety and depressive states among patients with TBI and examined the validity of the Hospital Anxiety and Depression Scale (HADS) to identify TBI patients with comorbid affective dysfunctions, specifically anxiety and depressive disorders, in an Omani population. Sixty-eight survivors of TBI were screened with the semi-structured, Composite International Diagnostic Interview (CIDI) and the HADS. A receiver operating characteristics (ROC) curve was calculated to discriminate the power of the HADS for every possible threshold score. The semi-structured interview revealed the prevalence rate of 57.4% for depressive disorder and 50% for anxiety disorder. The sensitivity (53.8%) and specificity 75.9%, gave the best compromise using the cut-off score of 4, suggesting HADS is not a useful screening tool for this particular population. Phenotypic indicators as detected by CIDI revealed that prevalence of affective dysfunctionality is common among this TBI population. Although the HADS is the most widely used screening instrument in other clinical populations, it does not appear to be a reliable resource in identifying depression and anxiety in people with traumatic brain injury in Oman.",Al-Adawi S.; Dorvlo AS.; Al-Naamani A.; Glenn MB.; Karamouz N.; Chae H.; Zaidan ZA.; Burke DT.,2007.0,10.1080/02699050701311059,0,0,
8793,Brief antenatal cognitive behaviour therapy group intervention for the prevention of postnatal depression and anxiety: a randomised controlled trial.,"The majority of randomised controlled trials examining the effectiveness of antenatal group interventions at preventing postnatal depression in ""at risk"" women have used a ""psychoeducational"" intervention. The aim of the present study is to evaluate the effectiveness of an antenatal cognitive behavioural group intervention in a primary care setting for pregnant women identified with mild to moderate symptoms in pregnancy and/or at risk of developing depression or anxiety in the perinatal period. Subjects were randomised to a CBT group intervention or control condition (information booklet) and administered the EPDS and STAI at pre (Time 1) and post intervention (Time 2), and at 2 months (Time 3) and 4 months postpartum (Time 4). MINIs were administered at Times 1, 3 and 4. Of the 774 women approached, 277 accepted and were suitable; thus 191 were randomised to the CBT intervention and 86 to the control condition. The subsequent 52% drop-out left 89 women ""completing"" the CBT groups and 43 in the control group; these two groups were well matched on demographic variables. Intention to treat analyses revealed relatively low mean baseline EPDS scores (means 6.88 -8.16) with no reduction in EPDS scores in either group from Time 1 to Time 4. MINI depression criteria were fulfilled by 19% of all participants at Time 1 but there was no reduction in depression in either group; in contrast those with MINI anxiety diagnoses reduced from 28% in late pregnancy to 16% at four months postpartum in the CBT group with similar reductions in the control group. Analyses on the 132 ""completers"" showed significant symptomatic improvement over time for both the CBT group and control condition. Depression scores in the most symptomatic women (EPDS>12; N=19) decreased steadily by over 50% over the total time course but there were no differences in improvement between the CBT and control groups. A number of methodological factors may have obscured our results including a tendency to natural remission in mildly symptomatic subjects and the possibility that our control condition was therapeutic in itself. While a modest reduction in depression scores was noted in study ""completers"", both the CBT group intervention control condition were equally beneficial. The reasons for this finding include the low symptom level at baseline; the potential effectiveness of the control condition; and the brevity of the intervention.",Austin MP.; Frilingos M.; Lumley J.; Hadzi-Pavlovic D.; Roncolato W.; Acland S.; Saint K.; Segal N.; Parker G.,2008.0,10.1016/j.jad.2007.04.001,0,0,
8794,Prognostic indices with brief and standard CBT for panic disorder: I. Predictors of outcome.,"Although the effectiveness of cognitive behavioural therapy (CBT) in the management of panic disorder (PD) is now well established, there have been few studies of predictors of outcome with this patient group using clinical effectiveness trial data, a hypothesis-testing model, and a dependent measure of clinically significant change. The data for this study came from a randomized controlled trial of three forms of CBT delivery for PD with and without agoraphobia (two 6-week CBT programmes, one of which was computer assisted, and one therapist-directed 12-week CBT programme), comprising a total of 186 patients across two sites. Based on previous related research, five hypothesized predictors of post-treatment and follow-up outcome were identified and examined, using a series of bivariate and multivariate analyses. The results in general supported the hypotheses. Strength of blood/injury fears, age of initial onset of panic symptoms, co-morbid social anxieties and degree of agoraphobic avoidance were predictive of both measures of post-treatment outcome. Degree of residual social difficulties and the continued use of anxiolytics at post-treatment were also shown to predict poor outcome at the 6-month follow-up. However, strength of continuing dysfunctional agoraphobic cognitions by the end of active treatment did not predict outcome at follow-up for the sample as a whole. The identification of consistent predictors of outcome with CBT has many clinical and research benefits. As CBT, however, is being delivered increasingly in a variety of brief formats, further research is required to identify moderators of response to these 'non-standard' treatment formats.",Dow MG.; Kenardy JA.; Johnston DW.; Newman MG.; Taylor CB.; Thomson A.,2007.0,10.1017/S0033291707000670,0,0,
8795,Prognostic indices with brief and standard CBT for panic disorder: II. Moderators of outcome.,"Despite the growth of reduced therapist-contact cognitive behavioural therapy (CBT) programmes, there have been few systematic attempts to determine prescriptive indicators for such programmes vis-à-vis more standard forms of CBT delivery. The present study aimed to address this in relation to brief (6-week) and standard (12-week) therapist-directed CBT for panic disorder (PD) with and without agoraphobia. Higher baseline levels of severity and associated disability/co-morbidity were hypothesized to moderate treatment effects, in favour of the 12-week programme. Analyses were based on outcome data from two out of three treatment groups (n=72) from a recent trial of three forms of CBT delivery for PD. The dependent variables were a continuous composite panic/anxiety score and a measure of clinical significance. Treatment x predictor interactions were examined using multiple and logistic regression analyses. As hypothesized, higher baseline severity, disability or co-morbidity as indexed by strength of dysfunctional agoraphobic cognitions; duration of current episode of PD; self-ratings of panic severity; and the 36-item Short Form Health Survey (SF-36) (Mental component) score were all found to predict poorer outcome with brief CBT. A similar trend was apparent in relation to baseline level of depression. With high and low end-state functioning as the outcome measure, however, only the treatment x agoraphobic cognitions interaction was found to be significant. While there was no evidence that the above variables necessarily contraindicate the use of brief CBT, they were nevertheless associated with greater overall levels of post-treatment improvement with the 12-week approach.",Dow MG.; Kenardy JA.; Johnston DW.; Newman MG.; Taylor CB.; Thomson A.,2007.0,10.1017/S0033291707000682,0,0,
8796,Prevalence of depression-PTSD comorbidity: implications for clinical practice guidelines and primary care-based interventions.,"Compared to those with depression alone, depressed patients with posttraumatic stress disorder (PTSD) experience more severe psychiatric symptomatology and factors that complicate treatment. To estimate PTSD prevalence among depressed military veteran primary care patients and compare demographic/illness characteristics of PTSD screen-positive depressed patients (MDD-PTSD+) to those with depression alone (MDD). Cross-sectional comparison of MDD patients versus MDD-PTSD+ patients. Six hundred seventy-seven randomly sampled depressed patients with at least 1 primary care visit in the previous 12 months. Participants composed the baseline sample of a group randomized trial of collaborative care for depression in 10 VA primary care practices in 5 states. The Patient Health Questionnaire-9 assessed MDD. Probable PTSD was defined as a Primary Care PTSD Screen > or = 3. Regression-based techniques compared MDD and MDD-PTSD+ patients on demographic/illness characteristics. Thirty-six percent of depressed patients screened positive for PTSD. Adjusting for sociodemographic differences and physical illness comorbidity, MDD-PTSD+ patients reported more severe depression (P < .001), lower social support (P < .001), more frequent outpatient health care visits (P < .001), and were more likely to report suicidal ideation (P < .001) than MDD patients. No differences were observed in alcohol consumption, self-reported general health, and physical illness comorbidity. PTSD is more common among depressed primary care patients than previously thought. Comorbid PTSD among depressed patients is associated with increased illness burden, poorer prognosis, and delayed response to depression treatment. Providers should consider recommending psychotherapeutic interventions for depressed patients with PTSD.",Campbell DG.; Felker BL.; Liu CF.; Yano EM.; Kirchner JE.; Chan D.; Rubenstein LV.; Chaney EF.,2007.0,10.1007/s11606-006-0101-4,0,0,
8797,"Varying cautionary instructions, monetary incentives, and comorbid diagnostic training in malingered psychopathology research.","In this article, we combine two analogue experiments in which we empirically examined three malingering methodological issues in individuals trained and instructed to simulate posttraumatic stress disorder (PTSD) on the Trauma Symptom Inventory (TSI; Briere, 1995). In Experiment 1, we examined TSI scale effects of the following manipulations using a 2 x 2 design with 330 college students: (a) inclusion or exclusion of cautionary instructions regarding believability of participants' simulation and (b) different financial incentive levels. In Experiment 2, we examined comorbid psychiatric diagnostic training with 180 college students who were either trained to simulate PTSD and comorbid major depressive disorder or trained to simulate only PTSD. Caution main effects were significant for all but two TSI Clinical Scales, incentive main effects and interactions were only significant for one Clinical scale each, and the comorbidity manipulation did not yield any scale differences. We discuss malingering research design implications regarding the use of cautionary instructions, financial incentive levels, and comorbid training.",Elhai JD.; Butcher JJ.; Reeves AN.; Baugher SN.; Gray MJ.; Jacobs GA.; Fricker-Elhai AE.; North TC.; Arbisi P.,2007.0,10.1080/00223890701332136,0,0,
8798,A randomized trial of telepsychiatry for post-traumatic stress disorder.,"We compared the efficacy of telepsychiatry and same-room treatment of combat-related post-traumatic stress disorder (PTSD) using cognitive behavioural therapy in 14 weekly, 90-min treatment sessions. Of 97 patients referred for study participation, 38 were randomized (17 into telepsychiatry, 21 into same-room), and approximately 25 (the number differed by instrument) had at least one post-baseline assessment. Measures of clinical and process outcomes were examined. No group differences were found on clinical outcomes at three-month follow-up. Satisfaction with treatment ratings was similar in both groups, with 'strong satisfaction' indicated by veterans in both modalities. Attendance and drop-out were similar in the two groups. The same-room group reported more comfort in talking with their therapist at post-treatment and had better treatment adherence. The results provide preliminary support for the use of telepsychiatry in the treatment of PTSD to improve access to care.",Frueh BC.; Monnier J.; Yim E.; Grubaugh AL.; Hamner MB.; Knapp RG.,2007.0,10.1258/135763307780677604,0,0,
8799,Olanzapine therapy in anorexia nervosa: psychobiological effects.,"Dopamine impairments occur in anorexia nervosa. The aim of this study was to see whether treatment with the atypical dopamine antagonist antipsychotic olanzapine improves the disorder. Thirty anorexics, 18 restricted and 12 bingeing-purging, underwent a 3-month course of cognitive behavioral therapy, plus at random and double-blinded oral olanzapine (2.5 mg for 1 month, 5 mg for 2 months) in half and oral placebo in the other half of them. BMI, psychopathological aspects (eating disorder inventory, Hamilton Rating Scale, Buss-Durkee Rating Scale, Yale Brown Cornell for Eating Disorders Rating Scale, temperament-character inventory), and homovanillic acid blood concentrations for dopamine secretion, were monitored at baseline and then monthly during the trial. At the end of the trial BMI, total eating disorder inventory, total Yale Brown Cornell for Eating Disorders Rating Scale, Buss-Durkee Rating Scale, Hamilton Rating Scale scores and in olanzapine-treated patients the subitems of eating disorder inventory ineffectiveness and maturity fear, of Buss-Durkee Rating Scale direct aggressiveness, of temperament-characteristic inventory persistence had improved significantly. When stratified for anorexia nervosa subtype, BMI changes were significant among anorexia nervosa bingeing-purging patient, 'depression' (Hamilton Rating Scale) and 'direct aggressiveness' (Buss-Durkee Rating Scale) among anorexia nervosa bingeing-purging patients, 'persistence' (temprerament-characteristic inventory), among anorexics restricted patients, with a trend toward significance for obsessivity-compulsivity (Yale Brown Cornell for Eating Disorders Rating Scale). homovanilic acid blood levels increased significantly in the cognitive behavioral therapy+olanzapine group. No correlations were observed between homovanilic acid concentrations and psychopathological parameters. The pharmacological treatment can significantly improve specific aspects of anorexia nervosa.",Brambilla F.; Garcia CS.; Fassino S.; Daga GA.; Favaro A.; Santonastaso P.; Ramaciotti C.; Bondi E.; Mellado C.; Borriello R.; Monteleone P.,2007.0,10.1097/YIC.0b013e328080ca31,0,0,
8800,[Open reduction and internal fixation by primary subtalar arthrodesis for intraarticular calcaneal fractures].,"To prevent the development of painful posttraumatic degenerative joint disease by a primary one-stage procedure to treat calcaneal fractures involving obvious comminution or severe and extensive cartilage damage to the subtalar facet. Sanders type IV calcaneal fractures with severe and extensive cartilage destruction. The definitive indication for arthrodesis can only be established intraoperatively. Severe closed IIIrd or IV nd degree soft-tissue injury according to Tscherne & Oestern. Open fractures. Vascular impairment. Diabetes mellitus. Generalized or local inactivity osteoporosis > grade I according to Kanis. Age > approximately 50 years. Extended lateral approach. Osteosynthesis of the calcaneal fracture, reconstruction of axes, subtalar facet denuded of cartilage, bone graft from the anterior iliac crest, arthrodesis by screw fixation of the subtalar joint. After edema has subsided, mobilization without a cast and partial loading up to 15 kg for 12 weeks. Clinical and radiologic review after 6 and 12 weeks. This operation is performed very rarely. Within a retrospective study including patients over a period of 14 years (1990-2004), a total of 434 patients with a calcaneal fracture were treated surgically. Primary subtalar arthrodesis was performed in only six of these patients. Healing within 4 months was achieved in all six patients. The clinical and radiologic follow-ups took place on average after 4.9 years (2.5-7.5 years). Radiologically, almost anatomic reconstruction of the axes could be achieved (Gissane and Böhler angles, talometatarsal and talocalcaneal angles, calcaneal length and width). The functional outcomes were also good to very good with an average AOFAS (American Orthopaedic Foot and Ankle Society) Score of 88 points (63-94 points) and a Hanover Score of 84 points (62-90 points).",Hüfner T.; Geerling J.; Gerich T.; Zeichen J.; Richter M.; Krettek C.,2007.0,10.1007/s00064-007-1200-z,0,0,
8801,Psychological trauma and PTSD symptoms as predictors of substance dependence treatment outcomes.,"Psychological trauma and post-traumatic stress disorder (PTSD) may complicate and reduce the effectiveness of treatment for substance use disorders (SUDs). This study assessed trauma history and symptoms of simple and complex PTSD at baseline in a randomized trial of contingency management (CM) compared to standard treatment (ST) with 142 cocaine- or heroin-dependent outpatients. History of exposure to each of eight types of psychological trauma was unrelated to treatment outcome, except for witnessed assaults and emotional abuse. Complex PTSD symptoms were inversely associated with short-term treatment outcomes, and PTSD symptoms were positively related to long-term outcome, independent of the effects of demographics, psychological distress, baseline substance use status, and treatment modality. Complex PTSD symptoms warrant further study as a potential negative prognostic factor in SUD interventions.",Ford JD.; Hawke J.; Alessi S.; Ledgerwood D.; Petry N.,2007.0,10.1016/j.brat.2007.04.001,0,0,
8802,Improving outcomes for COPD patients with mild-to-moderate anxiety and depression: a systematic review of cognitive behavioural therapy.,"Anxiety and depression are highly prevalent in patients with chronic obstructive pulmonary disease (COPD) and are associated with lower levels of self-efficacy, impaired health status, poorer treatment outcomes and reduced survival following emergency admission. Cognitive behavioural therapy (CBT) may be effective for treating anxiety and depression in COPD patients but evidence for this is uncertain. A systematic review of controlled trials that evaluated the effectiveness of CBT for treating mild-to-moderate anxiety or depression in adults with clinically stable COPD. Ovid electronic bibliographic databases were searched from inception to May 2006; all content held by the Cochrane Library Issue 3, 2006 was also searched. One small randomized controlled trial (RCT) of moderate quality showed that CBT, when given with exercise training and education, was associated with large and significant treatment effects for both anxiety (-1.39 (95% CIs -2.19, -0.59)) and depression (-0.86 (95% CIs -1.61, -0.11)). Additionally, a larger RCT of higher quality demonstrated that CBT, when given with exercise and education, was associated with large and significant treatment effects for depression (-0.76 (95% CIs -1.34, -0.17)), but not for anxiety. No other included study reported significant reductions in either anxiety or depression in COPD patients given CBT. There is only limited evidence that CBT, when used with exercise and education, can contribute to significant reductions in anxiety and depression in COPD patients. There is scope for a well-powered RCT to evaluate the effectiveness and acceptability of CBT among this patient population.",Coventry PA.; Gellatly JL.,2008.0,10.1348/135910707X203723,0,0,
8803,Outcome of cognitive-behavioural therapy in training practice with anxiety disorder patients.,"This study aims to assess the effectiveness of cognitive-behavioural therapy applied by trainee therapists in patients with anxiety disorders seen in a private university service and to examine whether this effectiveness is comparable to that observed in controlled studies. We compared the effectiveness of cognitive-behavioural therapy at a private centre with that observed in meta-analyses and reviews of controlled studies. Out of the 96 initial patients with anxiety disorder, 64 completed the cognitive-behavioural treatment and 59 also answered a series of questionnaires pre- and post-treatment. The effect size of the intervention was calculated, as were the percentages of patients who improved and those who recovered. The pre-post effect size (1.09) was large, although somewhat lower than those observed in a meta-analysis of Spanish studies and in a range of international meta-analyses; moreover, twice as many hours of treatment were administered (M=27.4) and the drop-out rate was higher (33.3%). The percentages of patients who improved (61%) and those who recovered (52.5%) were roughly comparable to those reported in various reviews of studies performed in anxiety disorders. Cognitive-behavioural therapy applied by trainee therapists in a private university service appears effective, although this efficacy may be somewhat lower than that in controlled studies. Moreover, the duration of treatment and the drop-out rate may be higher.",Bados A.; Balaguer G.; Saldaña C.,2007.0,10.1348/014466507X209961,0,0,
8804,Personality disorders in somatization disorder patients: a controlled study in Spain.,"The aim of this paper is to assess personality disorder (PD) comorbidity in somatization disorder (SD) patients compared with psychiatric controls in a Spanish sample. This is a case-control study. Selection of 70 consecutive SD patients was made, and an age-, sex-, and ethnic-group-matched control group of 70 mood and/or anxiety disorder patients recruited in psychiatric outpatient clinics was selected. PDs were measured using the International Personality Disorder Examination, and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I morbidity was measured by means of the Standardized Polyvalent Psychiatric Interview. PD comorbidity in SD patients was 62.9%, compared to 28.2% in controls [odds ratio (OR)=3.7; 95% confidence interval (95% CI)=1.8-7.6]. The highest ORs of PD in SD patients, compared with controls, were for paranoid (OR=9.2; 95% CI=1.9-43), obsessive-compulsive (OR=6.2; 95% CI=1.2-53.6), and histrionic (OR=3.6; 95% CI=0.9-13.9) PDs. This is a controlled study with the largest sample of SD patients. The prevalence of PD comorbidity is similar to that of a previously published controlled study but is different from those of the most frequent PD subtypes.",Garcia-Campayo J.; Alda M.; Sobradiel N.; Olivan B.; Pascual A.,2007.0,10.1016/j.jpsychores.2006.12.023,0,0,
8805,Evaluating three treatments for borderline personality disorder: a multiwave study.,"The authors examined three yearlong outpatient treatments for borderline personality disorder: dialectical behavior therapy, transference-focused psychotherapy, and a dynamic supportive treatment. Ninety patients who were diagnosed with borderline personality disorder were randomly assigned to transference-focused psychotherapy, dialectical behavior therapy, or supportive treatment and received medication when indicated. Prior to treatment and at 4-month intervals during a 1-year period, blind raters assessed the domains of suicidal behavior, aggression, impulsivity, anxiety, depression, and social adjustment in a multiwave study design. Individual growth curve analysis revealed that patients in all three treatment groups showed significant positive change in depression, anxiety, global functioning, and social adjustment across 1 year of treatment. Both transference-focused psychotherapy and dialectical behavior therapy were significantly associated with improvement in suicidality. Only transference-focused psychotherapy and supportive treatment were associated with improvement in anger. Transference-focused psychotherapy and supportive treatment were each associated with improvement in facets of impulsivity. Only transference-focused psychotherapy was significantly predictive of change in irritability and verbal and direct assault. Patients with borderline personality disorder respond to structured treatments in an outpatient setting with change in multiple domains of outcome. A structured dynamic treatment, transference-focused psychotherapy was associated with change in multiple constructs across six domains; dialectical behavior therapy and supportive treatment were associated with fewer changes. Future research is needed to examine the specific mechanisms of change in these treatments beyond common structures.",Clarkin JF.; Levy KN.; Lenzenweger MF.; Kernberg OF.,2007.0,10.1176/ajp.2007.164.6.922,0,0,
8806,Effects of a brief behavioral treatment for late-life insomnia: preliminary findings.,"Insomnia is a chronic and prevalent sleep disorder in adults older than 65 years. Hypnotics raise safety concerns in this group, and standard behavioral treatments are time consuming. This preliminary report addresses the effects of a brief behavioral treatment for insomnia in older adults who present with the typical psychiatric and medical comorbidities of aging. Thirty-five older adults (10 men, 25 women, mean age = 70.2 +/- 6.4 years old) were randomly assigned to a brief behavioral treatment for insomnia (BBTI; n=17) or to an information-only control (IC; n=18) condition. All subjects completed clinician-administered and self-report measures of sleep quality, as well as a sleep diary, at baseline. Interventions were delivered in a single individual session with a booster session administered 2 weeks later. Postintervention assessments were completed after 4 weeks. Significant improvements in self-report and sleep diary measures and mild-to-moderate improvement in anxiety and depression were observed after treatment in participants randomly assigned to BBTI, as compared with participants randomly assigned to IC. At post-treatment assessment, 12 BBTI participants (71%) and 7 IC participants (39%) met criteria for response. Nine BBTI participants (53%) met criteria for remission, whereas, in the IC group, 3 participants (17%) met the criteria. BBTI was associated with significant improvements in sleep measures and in daytime symptoms of anxiety and depression. BBTI appears to be a promising intervention for older adults with insomnia.",Germain A.; Moul DE.; Franzen PL.; Miewald JM.; Reynolds CF.; Monk TH.; Buysse DJ.,2006.0,,0,0,
8807,Cost-effectiveness of computer-aided behaviour therapy for obsessive-compulsive disorder.,,McCrone P.; Marks IM.; Greist JH.; Baer L.; Kobak KA.; Wenzel KW.; Hirsch MJ.,2007.0,10.1159/000101504,0,0,
8808,Suppressing and focusing on a negative memory in social anxiety: effects on unwanted thoughts and mood.,"Researchers have hypothesized that thought suppression contributes to the large volume of unwanted thoughts in anxiety disorders. However, comparisons to both non-suppression and non-anxious groups are necessary for studies on thought suppression in high anxiety. Participants completed a series of thought verbalization periods and a social interaction. During one period, participants were randomly assigned to focus upon a negative social memory, suppress it, or think freely while monitoring the memory. Results indicated that thought suppression and focusing caused a greater rise and subsequent decline in unwanted thoughts than monitoring instructions for both high and low social anxiety groups. Importantly, highly socially anxious participants had more unwanted thoughts overall, but did not respond significantly differently to thinking instructions when compared to the less anxious group. Interestingly, highly socially anxious participants did report more thought suppression attempts in their everyday life. They also appeared to benefit by experiencing less shyness after suppression when compared to focusing, a pattern not evident for the low social anxiety group.",Magee JC.; Zinbarg RE.,2007.0,10.1016/j.brat.2007.05.003,0,0,
8809,Randomized trial of a meditation-based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder.,"Mindfulness-based stress reduction (MBSR) has been reported to reduce anxiety in a broad range of clinical populations. However, its efficacy in alleviating core symptoms of specific anxiety disorders is not well established. We conducted a randomized trial to evaluate how well MBSR compared to a first-line psychological intervention for social anxiety disorder (SAD). Fifty-three patients with DSM-IV generalized SAD were randomized to an 8-week course of MBSR or 12 weekly sessions of cognitive-behavioral group therapy (CBGT). Although patients in both treatment groups improved, patients receiving CBGT had significantly lower scores on clinician- and patient-rated measures of social anxiety. Response and remission rates were also significantly greater with CBGT. Both interventions were comparable in improving mood, functionality and quality of life. The results confirm that CBGT is the treatment of choice of generalized SAD and suggest that MBSR may have some benefit in the treatment of generalized SAD.",Koszycki D.; Benger M.; Shlik J.; Bradwejn J.,2007.0,10.1016/j.brat.2007.04.011,0,0,
8810,D-cycloserine augmented exposure therapy for obsessive-compulsive disorder.,"D-cycloserine (DCS), a glutamatergic partial N-methyl-d-aspartate (NMDA) agonist, can facilitate extinction learning related to cued fear in animals and humans. We predicted that DCS would accelerate obsession-related distress reduction in patients with obsessive-compulsive disorder (OCD) undergoing extinction-based exposure therapy. We administered DCS (125 mg) or placebo in a double-blind fashion to individuals with OCD approximately 2 hours before each exposure session. D-cycloserine decreased both the number of exposure sessions required to achieve clinical milestones and the rate of therapy dropout. After four exposure sessions, patients in the DCS group reported significantly greater decreases in obsession-related distress compared with the placebo group; however, after additional sessions, the placebo group tended to catch up. D-cycloserine augmentation has the potential to increase the efficiency, palatability, and overall effectiveness of standard exposure therapy for OCD.",Kushner MG.; Kim SW.; Donahue C.; Thuras P.; Adson D.; Kotlyar M.; McCabe J.; Peterson J.; Foa EB.,2007.0,10.1016/j.biopsych.2006.12.020,0,0,
8811,Do comorbid personality disorders moderate panic-focused psychotherapy? An exploratory examination of the American Psychiatric Association practice guideline.,"The American Psychiatric Association (APA) practice guideline for panic disorder recommends psychodynamic psychotherapy for panic disorder patients with comorbid personality disorders. No data underlie this recommendation. This exploratory study assessed the moderating effect of personality disorder on psychodynamic and non-psychodynamic psychotherapy outcome. Forty-nine subjects with primary DSM-IV panic disorder were randomly assigned to 12 weeks of twice-weekly Panic-Focused Psychodynamic Psychotherapy or Applied Relaxation Training. The primary outcome measure was the Panic Disorder Severity Scale; the moderating effect of Axis II psychopathology on the Sheehan Disability Scale was also tested. The trial was conducted between February 2000 and January 2005. Twenty-four subjects (49%) met DSM-IV criteria for a Structured Clinical Interview for DSM-IV Axis II Disorders-diagnosed personality disorder, of whom 19 (79%) had a cluster C diagnosis. Presence of a cluster C diagnosis moderated treatment outcome. Such subjects experienced greater improvements in Panic-Focused Psychodynamic Psychotherapy than subjects without cluster C comorbidity. Despite its small sample size, this exploratory analysis provides initial preliminary evidence corroborating the APA practice guideline recommendation. Future panic disorder clinical trials should explore Axis II moderator effects. ClinicalTrials.gov identifier NCT00128388.",Milrod BL.; Leon AC.; Barber JP.; Markowitz JC.; Graf E.,2007.0,,0,0,
8812,Course of self-reported symptoms of attention deficit and hyperactivity in substance abusers during early treatment.,"Attention deficit and hyperactivity disorder has been associated with poor outcome in studies of substance use disorders. This study aimed to assess the course of self-reported symptoms of both attention deficit and hyperactivity among adults presenting for treatment for substance use disorders. A sample of 75 substance abusers were assessed after they were admitted to a centralized intake unit, and followed at 3 and 6 months after intake by independent interviewers (follow-up rate 81%). Symptoms of attention deficit and hyperactivity were assessed with the Adult Self-report Scale for ADHD (ASRS). Both types of symptoms declined significantly during follow-up, but attention symptoms had a high intraclass correlation (0.79), and hyperactivity had a moderate intraclass correlation (0.64). Both baseline attention deficit and hyperactivity symptoms were associated with worse work and social adjustment after controlling for baseline functioning. Hyperactivity was associated with poorer substance use outcomes at the trend level. In conclusion, both dimensions of ADHD contribute to worse functioning during early treatment for substance abusers, and the ASRS is a reasonably stable measure of ADHD symptoms during early recovery.",Hesse M.,2010.0,10.1016/j.addbeh.2009.12.007,0,0,
8813,"""Coercion Experience Scale"" (CES)--validation of a questionnaire on coercive measures.","Although the authors of a Cochrane Review on seclusion and mechanical restraint concluded that ""there is a surprising and shocking lack of published trials"" on coercive interventions in psychiatry, there are only few instruments that can be applied in trials. Furthermore, as main outcome variable safety, psychopathological symptoms, and duration of an intervention cannot meet the demand to indicate subjective suffering and impact relevant to posttraumatic stress syndromes. An instrument used in controlled trials should assess the patients' subjective experiences, needs to be applicable to more than one intervention in order to compare different coercive measures and has to account for the specific psychiatric context. The primary version of the questionnaire comprised 44 items, nine items on restrictions to human rights, developed on a clinical basis, and 35 items on stressors, derived from patients' comments during the pilot phase of the study. An exploratory factor analysis (EFA) using principal axis factoring (PAF) was carried out. The resulting factors were orthogonally rotated via VARIMAX procedure. Items with factor loadings less than .50 were eliminated. The reliability of the subscales was assessed by calculating Cronbach. Data of 102 patients was analysed. The analysis yielded six factors which were entitled ""Humiliation"", ""Physical adverse effects"", ""Separation"", ""Negative environment"", ""Fear"" and ""Coercion"". These six factors explained 54.5% of the total variance. Cronbach alpha ranged from .67 to .93, which can be interpreted as a high internal consistency. Convergent and discriminant validity yielded both highly significant results (r = .79, p < .001, resp. r = .38, p < .001). The ""Coercion Experience Scale"" is an instrument to measure the psychological impact during psychiatric coercive interventions. Its psychometric properties showed satisfying reliability and validity. For purposes of research it can be used to compare different coercive interventions. In clinical practice it can be used as a screening instrument for patients who need support after coercive interventions to prevent consequences from traumatic experiences. Further research is needed to identify possible diagnostic, therapeutic or prognostic implications of the total score and the different subscales. Current Controlled Trials ISRCTN70589121.",Bergk J.; Flammer E.; Steinert T.,2010.0,10.1186/1471-244X-10-5,0,0,
8814,Efficacy of cognitive behavioural therapy for the treatment of chronic stress in patients with lupus erythematosus: a randomized controlled trial.,"Chronic stress worsens the quality of life (QOL) of lupus patients by affecting their physical and psychological status. The effectiveness of a cognitive-behavioural intervention in a group of patients with lupus and high levels of daily stress was investigated. Forty-five patients with lupus and high levels of daily stress were randomly assigned to a control group (CG) or a therapy group (TG); they received cognitive behavioural therapy (CBT) which consisted of ten consecutive weekly sessions. The following variables were evaluated at baseline and at 3, 9 and 15 months: (1) stress, anxiety, depression, (2) Systemic Lupus Erythematosus Disease Activity Index, somatic symptoms, number of flares, (3) anti-nDNA antibodies, complement fractions C3 and C4 and (4) QOL. A multivariate analysis of repeated measures and various analyses of variance were carried out. We found a significant reduction in the level of depression, anxiety and daily stress in the TG compared to the CG and a significant improvement in QOL and somatic symptoms in the TG throughout the entire follow-up period. We did not find any significant changes in the immunological parameters. CBT is effective in dealing with patients suffering from lupus and high levels of daily stress as it significantly reduces the incidence of psychological disorders associated with lupus and improves and maintains patients' QOL, despite there being no significant reduction in the disease activity index.",Navarrete-Navarrete N.; Peralta-Ramírez MI.; Sabio-Sánchez JM.; Coín MA.; Robles-Ortega H.; Hidalgo-Tenorio C.; Ortego-Centeno N.; Callejas-Rubio JL.; Jiménez-Alonso J.,2010.0,10.1159/000276370,0,0,
8815,Psychophysiological correlates of generalized anxiety disorder with or without comorbid depression.,"It remains uncertain whether generalized anxiety disorder (GAD) and major depressive disorder (MDD) represent two separate diagnostic entities. The goal of this study was to examine whether comorbid MDD distinguishes individuals with GAD on a psychophysiological level during an experimentally-induced worrying procedure. Participants included 39 individuals with GAD, 14 of whom met the criteria for MDD. During the experimental procedure, participants were asked to worry or relax after an initial baseline phase while measuring their heart rate, high frequency heart rate variability (HF-HRV), skin conductance level, and subjective level of anxiety. The two groups did not differ in their subjective anxiety, heart rate response, and skin conductance levels. However, participants with comorbid MDD had greater HF-HRV values throughout the experiment than did those without MDD. At baseline, HF-HRV was significantly correlated with a self-report measure of depression. These results suggest that individuals with comorbid GAD and MDD can be distinguished based on HF-HRV from individuals with GAD but without MDD. These results support the distinction between GAD and MDD.",Hofmann SG.; Schulz SM.; Heering S.; Muench F.; Bufka LF.,2010.0,10.1016/j.ijpsycho.2009.12.016,0,0,
8816,The impact of panic-agoraphobic comorbidity on suicidality in hospitalized patients with major depression.,"Previous research in outpatient samples suggests that panic and agoraphobic comorbidity is related to suicidality in outpatients with major depression. The purpose of the study was to further investigate this relationship specifically in a hospitalized sample. This study examined the severity of current suicidal ideation and behaviors in a psychiatric hospital sample diagnosed with major depressive disorder alone (MDD; n=28) versus MDD plus panic-agoraphobic spectrum disorders (MDD+PAS; n=69). Members of the MDD+PAS group were significantly more likely to have had a suicide attempt history, higher current depression severity, and higher current suicidal severity compared with individuals in the MDD alone group. The relationship between the current suicidality and comorbid PAS remained significant after controlling for the overall depression severity and other clinical factors. These findings suggest that panic-agoraphobic comorbidity is associated with a greater risk for suicidality in hospitalized patients, which cannot be adequately explained by the level of current depression alone. The clinical and research implications for these findings are discussed.",Brown LA.; Gaudiano BA.; Miller IW.,2010.0,10.1002/da.20609,0,0,
8817,"Impact of delirium on distress, health-related quality of life, and cognition 6 months and 1 year after hematopoietic cell transplant.","Delirium commonly occurs during myeloablative hematopoietic cell transplantation (HCT). Little is known about how delirium during the acute phase of HCT affects long-term distress, health-related quality of life (HRQOL), and neurocognitive functioning. This prospective, cohort study examines these outcomes at 6 months and 1 year in 90 patients undergoing HCT. Patients completed a battery assessing distress, HRQOL, and subjective neuropsychological functioning before receiving their first HCT as well as at 6 months and 1 year. Patients with a delirium episode within the 4 weeks after HCT had significantly more distress and fatigue at 6 months (P < .004) and at 1 year (P < .03), compared with patients without delirium. At 1 year, patients with delirium also had worse symptoms of depression and post traumatic stress (P < .03). Patients with delirium had worse physical health on the SF-12 at 6 months (P < .03) and worse mental health on the SF-12 at 1 year (P < .03). At both 6 months and 1 year, patients with delirium after HCT reported worse memory (P < .009) and executive functioning (P < .006). Delirium during the acute phase of HCT is significantly associated with persistent distress, decreased HRQOL, and subjective neurocognitive dysfunction at both 6 months and 1 year.",Basinski JR.; Alfano CM.; Katon WJ.; Syrjala KL.; Fann JR.,2010.0,10.1016/j.bbmt.2010.01.003,0,0,
8818,"Deep brain stimulation for intractable obsessive compulsive disorder: pilot study using a blinded, staggered-onset design.","Prior promising results have been reported with deep brain stimulation (DBS) of the anterior limb of the internal capsule in cases with severe obsessive compulsive disorder (OCD) who had exhausted conventional therapies. In this pilot study, six adult patients (2 male; 4 female) meeting stringent criteria for severe (minimum Yale-Brown Obsessive Compulsive Scale [Y-BOCS] of 28) and treatment-refractory OCD had DBS electrode arrays placed bilaterally in an area spanning the ventral anterior limb of the internal capsule and adjacent ventral striatum referred to as the ventral capsule/ventral striatum. Using a randomized, staggered-onset design, patients were stimulated at either 30 or 60 days following surgery under blinded conditions. After 12 months of stimulation, four (66.7%) of six patients met a stringent criterion as ""responders"" (> or =35% improvement in the Y-BOCS and end point Y-BOCS severity < or =16). Patients did not improve during sham stimulation. Depressive symptoms improved significantly in the group as a whole; global functioning improved in the four responders. Adverse events associated with chronic DBS were generally mild and modifiable with setting changes. Stimulation interruption led to rapid but reversible induction of depressive symptoms in two cases. This pilot study suggests that DBS of the ventral capsule/ventral striatum region is a promising therapy of last resort for carefully selected cases of severe and intractable OCD. Future research should attend to subject selection, lead location, DBS programming, and mechanisms underpinning therapeutic benefits.",Goodman WK.; Foote KD.; Greenberg BD.; Ricciuti N.; Bauer R.; Ward H.; Shapira NA.; Wu SS.; Hill CL.; Rasmussen SA.; Okun MS.,2010.0,10.1016/j.biopsych.2009.11.028,0,0,
8819,Telemedicine for anger management therapy in a rural population of combat veterans with posttraumatic stress disorder: a randomized noninferiority trial.,"To demonstrate the noninferiority of a telemedicine modality, videoteleconferencing, compared to traditional in-person service delivery of a group psychotherapy intervention for rural combat veterans with posttraumatic stress disorder (PTSD). A randomized controlled noninferiority trial of 125 male veterans with PTSD (according to DSM criteria on the Clinician-Administered PTSD Scale) and anger difficulties was conducted at 3 Veterans Affairs outpatient clinics. Participants were randomly assigned to receive anger management therapy delivered in a group setting with the therapist either in-person (n = 64) or via videoteleconferencing (n = 61). Participants were assessed at baseline, midtreatment (3 weeks), posttreatment (6 weeks), and 3 and 6 months posttreatment. The primary clinical outcome was reduction of anger difficulties, as measured by the anger expression and trait anger subscales of the State-Trait Anger Expression Inventory-2 (STAXI-2) and by the Novaco Anger Scale total score (NAS-T). Data were collected from August 2005 to October 2008. Participants in both groups showed significant and clinically meaningful reductions in anger symptoms, with posttreatment and 3 and 6 months posttreatment effect sizes ranging from .12 to .63. Using a noninferiority margin of 2 points for STAXI-2 subscales anger expression and trait anger and 4 points for NAS-T outcomes, participants in the videoteleconferencing condition demonstrated a reduction in anger symptoms similar (""non-inferior"") to symptom reductions in the in-person groups. Additionally, no significant between-group differences were found on process variables, including attrition, adherence, satisfaction, and treatment expectancy. Participants in the in-person condition reported significantly higher group therapy alliance. Clinical and process outcomes indicate delivering cognitive-behavioral group treatment for PTSD-related anger problems via videoteleconferencing is an effective and feasible way to increase access to evidence-based care for veterans residing in rural or remote locations.",Morland LA.; Greene CJ.; Rosen CS.; Foy D.; Reilly P.; Shore J.; He Q.; Frueh BC.,2010.0,10.4088/JCP.09m05604blu,0,0,
8820,A comparison of two implant techniques on patient-based outcome measures: a report of flapless vs. conventional flapped implant placement.,"Flapless implant surgery is considered to offer advantages over the traditional flap access approach. There may be minimized bleeding, decreased surgical times and minimal patient discomfort. Controlled studies comparing patient outcome variables to support these assumptions, however, are lacking. The objective of this clinical study was to compare patient outcome variables using flapless and flapped implant surgical techniques. From January 2008 to October 2008, 16 consecutive patients with edentulous maxillas were included in the study. Patients were randomly allocated to either implant placement with a flapless procedure (eight patients, mean age 54.6 + or - 2.9 years) or surgery with a conventional flap procedure (eight patients, mean age 58.7 + or - 7.2 years). All implants were placed using a Nobel guide CT-guided surgical template. Outcome measures were the Dutch version of the Impact of Event Scale-Revised (IES-R), dental anxiety using the s-DAI and oral health-related quality of life (OHIP-14). Ninety-six implants were successfully placed. All implants were placed as two-phase implants and the after-implant placement dentures were adapted. No differences could be shown between conditions on dental anxiety (s-DAI), emotional impact (IES-R), anxiety, procedure duration or technical difficulty, although the flapless group did score consistently higher. The flap procedure group reported less impact on quality of life and included more patients who reported feeling no pain at all during placement. Differences found in the patient outcome variables do suggest that patients in the flapless implant group had to endure more than patients in the flap group.",Lindeboom JA.; van Wijk AJ.,2010.0,10.1111/j.1600-0501.2009.01866.x,0,0,
8821,Shock waves in the treatment of post-traumatic myositis ossificans.,"Myositis ossificans (MO) is a fairly common evolution in sports activity and can be due to direct trauma or to repeated micro-injuries. The traditional therapeutic approach relies on a variety of treatments, such as physical therapy but evidence of their proven clinical efficacy is lacking. The latest therapeutic option is surgical removal but this is a demolitive procedure and is frequently associated with a significant loss of functional integrity. There are few articles in literature about the treatment of post-traumatic MO, and none on extracorporeal shock wave therapy (ESWT). We illustrate a case series of 24 sportsmen treated with three sessions of electro-hydraulic shockwave therapy and an associated rehabilitation program. Only a partial reduction of the ossification was observed in the X-ray images but all the patients showed signs of functional improvement immediately after therapy. Two months after the therapy, a normal range of motion and no signs of weakness were observed. Three months after treatment, 87.5% of patients resumed regular sports activities.",Buselli P.; Coco V.; Notarnicola A.; Messina S.; Saggini R.; Tafuri S.; Moretti L.; Moretti B.,2010.0,10.1016/j.ultrasmedbio.2009.11.007,0,0,
8822,Facilitating a benign attentional bias reduces negative thought intrusions.,The causal role of biased attention in worry was investigated in an experiment in which high worriers were assigned either to a condition requiring attention to nonthreatening words and text while ignoring worry-related material or to a mixed-attention control condition. The former procedure led to fewer negative thought intrusions in a worry test (as rated by both participants and an assessor) than did the control condition. These findings suggest that attentional bias plays a causal role in worry and that its modification can reduce excessive worry.,Hayes S.; Hirsch CR.; Mathews A.,2010.0,10.1037/a0018264,0,0,
8823,Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder.,"Mindfulness-based stress reduction (MBSR) is an established program shown to reduce symptoms of stress, anxiety, and depression. MBSR is believed to alter emotional responding by modifying cognitive-affective processes. Given that social anxiety disorder (SAD) is characterized by emotional and attentional biases as well as distorted negative self-beliefs, we examined MBSR-related changes in the brain-behavior indices of emotional reactivity and regulation of negative self-beliefs in patients with SAD. Sixteen patients underwent functional MRI while reacting to negative self-beliefs and while regulating negative emotions using 2 types of attention deployment emotion regulation-breath-focused attention and distraction-focused attention. Post-MBSR, 14 patients completed neuroimaging assessments. Compared with baseline, MBSR completers showed improvement in anxiety and depression symptoms and self-esteem. During the breath-focused attention task (but not the distraction-focused attention task), they also showed (a) decreased negative emotion experience, (b) reduced amygdala activity, and (c) increased activity in brain regions implicated in attentional deployment. MBSR training in patients with SAD may reduce emotional reactivity while enhancing emotion regulation. These changes might facilitate reduction in SAD-related avoidance behaviors, clinical symptoms, and automatic emotional reactivity to negative self-beliefs in adults with SAD.",Goldin PR.; Gross JJ.,2010.0,10.1037/a0018441,0,0,
8824,Phase 2 pilot study of Pathfinders: a psychosocial intervention for cancer patients.,"Pathfinders is a multi-faceted psychosocial care program for cancer patients; it was developed in community oncology and adapted to the academic oncology setting. This prospective, single-arm, phase 2 pilot study examined the acceptability and feasibility of Pathfinders for women with metastatic breast cancer. Over 3 months, participants completed patient-reported surveys including the Patient Care Monitor (PCM, review of systems), Functional Assessment of Chronic Illness Therapy-Breast Cancer (FACT-B), Self Efficacy, and a single-item survey asking patients whether the program was helpful to them. A technology-based data collection system was used to capture electronic patient-reported outcomes at point of care, report symptoms in real time to clinicians, and collect warehouse data to provide a detailed longitudinal picture of the patient experience when receiving Pathfinders. Participants (n = 50) were: mean age 51 (SD 11); 76% white, 20% black; 74% married; 50% college degree. Forty-two (n = 42) patients completed baseline and 3-month assessments. Statistically significant improvements (all P < 0.05) occurred in PCM subscales for Distress (mean [SE] = -3.42 [1.21]), Despair (-4.53 [1.56]), and Quality of Life (2.88 [0.97]), and the FACT-B Emotional Wellbeing subscale (2.07 [0.46]). Of the 29 participants asked if Pathfinders was helpful, 27 (93%) responded positively and two did not respond. Other instruments measuring symptoms, quality of life, and self-efficacy showed improvement. In a phase 2 pilot study, Pathfinders was helpful to patients and is feasible in an academic medical center. Follow-up data collected at the 3-month assessment suggest that the program impacts various psychological outcomes, notably distress and despair.",Abernethy AP.; Herndon JE.; Coan A.; Staley T.; Wheeler JL.; Rowe K.; Smith SK.; Shaw H.; Lyerly HK.,2010.0,10.1007/s00520-010-0823-z,0,0,
8825,A multifaith spiritually based intervention for generalized anxiety disorder: a pilot randomized trial.,"This pilot trial evaluated the efficacy of a multifaith spiritually based intervention (SBI) for generalized anxiety disorder (GAD). Patients meeting DSM-IV criteria for GAD of at least moderate severity were randomized to either 12 sessions of the SBI (n=11) delivered by a spiritual care counselor or 12 sessions of psychologist-administered cognitive-behavioral therapy (CBT; n=11). Outcome measures were completed at baseline, post-treatment, and 3-month and 6-month follow-ups. Primary efficacy measures included the Hamilton Anxiety Rating Scale, Beck Anxiety Inventory, and Penn State Worry Questionnaire. Data analysis was performed on the intent-to-treat sample using the Last Observation Carried Forward method. Eighteen patients (82%) completed the study. The SBI produced robust and clinically significant reductions from baseline in psychic and somatic symptoms of GAD and was comparable in efficacy to CBT. A reduction in depressive symptoms and improvement in social adjustment was also observed. Treatment response occurred in 63.6% of SBI-treated and 72.3% of CBT-treated patients. Gains were maintained at 3-month and 6-month follow-ups. These preliminary findings are encouraging and suggest that a multifaith SBI may be an effective treatment option for GAD. Further randomized controlled trials are needed to establish the efficacy of this intervention.",Koszycki D.; Raab K.; Aldosary F.; Bradwejn J.,2010.0,10.1002/jclp.20663,0,0,
8826,Predictors of outcome in residential cognitive and interpersonal treatment for social phobia: do cognitive and social dysfunction moderate treatment outcome?,"The predictors of residential cognitive (RCT) and residential interpersonal Treatment (RIPT) for social phobia were explored. (1) Sotsky et al. (1991) found differential effects of CT and IPT for depression, suggesting that the level of cognitive or social dysfunction predicted differential outcome. We examined whether an analogous effect could be demonstrated in 10 weeks of residential treatment of 80 social phobia subjects. (2) We also included expectations, age of onset, severity of illness, concurrent anxiety, mood, avoidant personality disorder, and body dysmorphic disorder as predictors in this exploratory study. Main outcome was the social phobia subscale of Social Phobia and Anxiety Inventory (SPAI SP). DSM-IV axis I and II interviews were completed. (1) Sotsky et al. (1991) findings were not reproduced. However, RIPT subjects with poor general functioning were less improved following treatment. Subjects with concurrent agoraphobia responded better with RCT than subjects without agoraphobia. (2) Age of onset and expectations were the most powerful predictors of post treatment outcome. Some patient characteristics appear to impact outcome with RIPT and RCT differentially. The findings are discussed.",Borge FM.; Hoffart A.; Sexton H.,2010.0,10.1016/j.jbtep.2010.01.005,0,0,
8827,Effect of PTSD diagnosis and contingency management procedures on cocaine use in dually cocaine- and opioid-dependent individuals maintained on LAAM: a retrospective analysis.,"This randomized clinical trial retrospectively examined the effect of post-traumatic stress disorder (PTSD) and contingency management (CM) on cocaine use in opioid and cocaine dependent individuals maintained on high or low-dose LAAM randomly assigned to CM or a yoked-control condition. Cocaine-positive urines decreased more rapidly over time in those without PTSD versus those with PTSD in the noncontingency condition. In participants with PTSD, CM resulted in fewer cocaine-positive urines compared to the noncontingent condition. This suggests that CM may help improve the potentially worse outcomes in opioid- and cocaine-dependent individuals with PTSD compared to those without PTSD. (Am J Addict 2010;00:1-9).",Mancino MJ.; McGaugh J.; Feldman Z.; Poling J.; Oliveto A.,,10.1111/j.1521-0391.2009.00025.x,0,0,7201
8828,Self-report mindfulness as a mediator of psychological well-being in a stress reduction intervention for cancer patients--a randomized study.,"There is increasing recognition of mindfulness and mindfulness training as a way to decrease stress and increase psychological functioning. The aims of this study were to examine the effects of mindfulness stress reduction training on perceived stress and psychological well-being and to examine if changes in mindfulness mediate intervention effects on these outcomes. Seventy women and one man with a previous cancer diagnosis (mean age 51.8 years, standard deviation = 9.86) were randomized into an intervention group or a wait-list control group. The intervention consisted of an 8-week mindfulness training course. Compared to participants in the control group, participants in the mindfulness training group had significantly decreased perceived stress and posttraumatic avoidance symptoms and increased positive states of mind. Those who participated in the intervention reported a significant increase in scores on the five-facet mindfulness questionnaire (FFMQ) when compared to controls. The increase in FFMQ score mediated the effects of the intervention on perceived stress, posttraumatic avoidance symptoms, and positive states of mind. This study indicates that the improvements in psychological well-being resulting from mindfulness stress reduction training can potentially be explained by increased levels of mindfulness as measured with the FFMQ. The importance of these findings for future research in the field of mindfulness is discussed.",Bränström R.; Kvillemo P.; Brandberg Y.; Moskowitz JT.,2010.0,10.1007/s12160-010-9168-6,0,0,
8829,Internet-based self-help versus one-session exposure in the treatment of spider phobia: a randomized controlled trial.,"The authors compared guided Internet-delivered self-help with one session of live-exposure treatment in a sample of spider-phobic patients. A total of 30 patients were included following screening on the Internet and a structured clinical interview. The Internet treatment consisted of five weekly text modules, which were presented on a web page, a video in which exposure was modelled, and support provided via Internet. The live-exposure treatment was delivered in a 3-hr session following a brief orientation session. The main outcome measure was the behavioural approach test (BAT), and as secondary measures the authors used questionnaires measuring anxiety symptoms and depression. Results showed that the groups did not differ at posttreatment or follow-up, with the exception of the proportion showing clinically significant change on the BAT. At posttreatment 46.2% of the Internet group and 85.7% in the live-exposure group achieved this change. At follow-up the corresponding figures were 66.7% for the Internet group and 72.7% for the live treatment. Within-group effect sizes for the spider phobia questionnaire were large (d = 1.84 and 2.58 for the Internet and live-exposure groups, respectively, at posttreatment). The authors conclude that guided Internet-delivered exposure treatment is a promising new approach in the treatment of spider phobia.",Andersson G.; Waara J.; Jonsson U.; Malmaeus F.; Carlbring P.; Ost LG.,2009.0,10.1080/16506070902931326,0,0,
8830,"Effects of hypnosis as an adjunct to intravenous sedation for third molar extraction: a randomized, blind, controlled study.","The effects of hypnosis/therapeutic suggestion in connection with intravenous sedation and surgery have been described in many clinical publications; however, few randomized, controlled, and blind studies have been performed in the outpatient area. This study aimed to evaluate the use of hypnosis/therapeutic suggestion as an adjunct to intravenous (IV) sedation in patients having 3rd molar removal in an outpatient setting. The patients were randomly assigned to a treatment (n = 46) or control (n = 54) group. The treatment group listened to a rapid conversational induction and therapeutic suggestions via headphones throughout the entire surgical procedure along with a standard sedation dose of intravenous anesthetic. The control group listened to only music without any hypnotic intervention. Intraoperative Propofol administration, patient postoperative pain ratings, and postoperative prescription pain reliever consumption were all significantly reduced in the treatment compared to the control group. Implications of these results are discussed.",Mackey EF.,2010.0,10.1080/00207140903310782,0,0,
8831,"Hypnotizability, posttraumatic stress, and depressive symptoms in metastatic breast cancer.","This study assessed whether high hypnotizability is associated with posttraumatic stress and depressive symptoms in a sample of 124 metastatic breast cancer patients. Hypnotic Induction Profile Scores were dichotomized into low and high categories; posttraumatic intrusion and avoidance symptoms were measured with the Impact of Events Scale (IES); hyperarousal symptoms with items from the Profile of Mood States; and depressive symptoms with the Center for Epidemiologic Studies-Depression Scale. High hypnotizability was significantly related to greater IES total, IES intrusion symptoms, and depressive symptoms. A logistic regression model showed that IES total predicts high hypnotizability after adjusting for depressive symptoms and hyperarousal. The authors relate these results to findings in other clinical populations and discuss implications for the psychosocial treatment of metastatic breast cancer.",Keuroghlian AS.; Butler LD.; Neri E.; Spiegel D.,2010.0,10.1080/00207140903310790,0,0,
8832,Hypnotizability and opinions about hypnosis in a clinical trial for the hypnotic control of pain and anxiety during pregnancy termination.,"This descriptive study evaluates the hypnoanalgesic experience's effect on participants' hypnotizability and opinions about hypnosis and identifies factors associated with hypnotizability. Hypnotizability was assessed using the Stanford Hypnotic Susceptibility Scale: Form A in 290 women 1 month after their participation in a randomized clinical trial evaluating hypnotic intervention for pain/anxiety versus standard care during pregnancy termination. Opinions were collected before and after the intervention. The regression model describing hypnotizability (F = 13.55; p < .0001; R(2) = 0.20) retained 5 variables but not the intervention group. The variable explaining most of total variance (62.9%) was the level of perceived automaticity/involuntariness. Opinions about hypnosis were modified by the hypnotic experience compared to standard care but were not associated with hypnotizability. Exposure to hypnoanalgesia did not influence hypnotizability but modifies significantly the opinions about hypnosis. Consistent with previous findings, perceived automaticity appears to best predict hypnotizability.",Dufresne A.; Rainville P.; Dodin S.; Barré P.; Masse B.; Verreault R.; Marc I.,2010.0,10.1080/00207140903310865,0,0,
8833,Reduced amygdalar and hippocampal size in adults with generalized social phobia.,"Structural and functional brain imaging studies suggest abnormalities of the amygdala and hippocampus in posttraumatic stress disorder and major depressive disorder. However, structural brain imaging studies in social phobia are lacking. In total, 24 patients with generalized social phobia (GSP) and 24 healthy controls underwent 3-dimensional structural magnetic resonance imaging of the amygdala and hippocampus and a clinical investigation. Compared with controls, GSP patients had significantly reduced amygdalar (13%) and hippocampal (8%) size. The reduction in the size of the amygdala was statistically significant for men but not women. Smaller right-sided hippocampal volumes of GSP patients were significantly related to stronger disorder severity. Our sample included only patients with the generalized subtype of social phobia. Because we excluded patients with comorbid depression, our sample may not be representative. We report for the first time volumetric results in patients with GSP. Future assessment of these patients will clarify whether these changes are reversed after successful treatment and whether they predict treatment response.",Irle E.; Ruhleder M.; Lange C.; Seidler-Brandler U.; Salzer S.; Dechent P.; Weniger G.; Leibing E.; Leichsenring F.,2010.0,,0,0,
8834,Anxiety impairs depression remission in partial responders during extended treatment in late-life.,"More than half of older adults with major depressive disorder require extended treatment because of incomplete response during acute treatment. This study characterizes the effect of anxiety on remission during extended treatment for partial responders. Following 6 weeks of escitalopram 10 mg/day+depression care management (DCM), 124 partial responders (Hamilton Rating Scale for Depression (HRSD) scores of 11-14) were randomly assigned to receive extended treatment with escitalopram 20 mg/day+DCM with or without interpersonal psychotherapy (IPT) for 16 weekly sessions. Remission was defined as three consecutive weekly scores <or=7 on the HRSD. We assessed concurrent symptoms of anxiety using the Hamilton Rating Scale for Anxiety at pretreatment and after 6 weeks. We conducted Cox regression analysis of time to remission and logistic modeling of rates of remission. We also explored whether anxiety severity altered any impact of IPT. Pretreatment anxiety was not associated with time to or rates of remission during 16 weeks of extended treatment. In contrast, more severe psychological symptoms of anxiety after 6 weeks of treatment was associated with both longer time to and lower rates of remission. However, there was no evidence that IPT showed any differential effects as a function of anxiety. In partial responders to 6 weeks of lower-dose escitalopram and DCM, planning for extended treatment should account for psychological symptoms of anxiety.",Greenlee A.; Karp JF.; Dew MA.; Houck P.; Andreescu C.; Reynolds CF.,2010.0,10.1002/da.20672,0,0,
8835,The social treatment: the benefits of group interventions in residential care settings.,"We report findings from an intervention study that investigates the impact of group reminiscence (GR) and individual reminiscence (IR) activities on older adults living in care settings. This research aimed to provide a theory-driven evaluation of reminiscence based on a social identity framework. This framework predicts better health outcomes for group-based interventions as a result of their capacity to create a sense of shared social identification among participants. A total of 73 residents, living in either standard or specialized (i.e., dementia) care units, were randomly assigned to one of three interventions: GR (n = 29), IR (n = 24), and a group control activity (n = 20). The intervention took place over 6 weeks, and cognitive screening and well-being measures were administered both pre- and post-intervention. Results indicated that only the group interventions produced effective outcomes and that these differed as a modality-specific function of condition: Collective recollection of past memories enhanced memory performance, and engaging in a shared social activity enhanced well-being. Theoretically, these findings point to the important role that group membership plays in maintaining and promoting health and well-being.",Haslam C.; Haslam SA.; Jetten J.; Bevins A.; Ravenscroft S.; Tonks J.,2010.0,10.1037/a0018256,0,0,
8836,Number of descriptors in cued odor identification tests.,"To investigate whether results from cued odor identification tests are influenced by the number of verbal descriptors presented with each odor and whether a larger number of descriptors would improve the differentiation between individuals with various degrees of olfactory loss. Randomized, crossover study. University Clinic in Brussels. Two hundred thirty-eight study participants (128 with olfactory concerns and 110 control individuals without such concerns). The study took place from March 1, 2008, to April 30, 2009. Results of the 3-alternative forced choice (AFC) and 6-AFC identification tests, which consisted of 32 odor items each. A high correlation was found between the results obtained with the 2 tests. Although no sex-related differences were present, age was found to interact with performance in that lower test scores were obtained for older participants with the 6-AFC test, compared with the 3-AFC test. Of the 2 tests, the 6-AFC better separated participants with self-assessed olfactory deficits from participants without such concerns. It also discriminated more strongly between posttraumatic and postviral and sinonasal underlying causes of olfactory loss. Cued odor identification tests with various numbers of verbal descriptors produce similar results. However, an increasing number of alternative descriptive items seem to allow for better discrimination between individuals with and without olfactory loss.",Negoias S.; Troeger C.; Rombaux P.; Halewyck S.; Hummel T.,2010.0,10.1001/archoto.2009.231,0,0,
8837,Facilitated sensemaking: a feasibility study for the provision of a family support program in the intensive care unit.,"Family members of intensive care unit patients may develop anxiety, depression, and/or posttraumatic stress syndrome. Approaches to prevention are not well defined. Before testing preventive measures, it is important to evaluate which interventions the family will accept, use, and value. The purpose of this study was to evaluate the feasibility of an intervention for support for families of mechanically ventilated adults, grounded in a new midrange nursing theory titled ""Facilitated Sensemaking."" Families were provided a kit of supplies and the primary investigator coached families on how to obtain information, interpret surroundings, and participate in care. Participants were asked to complete an adapted Critical Care Family Needs Inventory and Family Support Program evaluation. Family members of 30 patients consented to participate; 22 participants completed the surveys. Internal consistency reliability of the adapted Critical Care Family Needs Inventory was high (alpha = .96). Results validated the importance of informational needs and provided a score indicating the family member's perception of how well each need was met, weighted by importance, which identified performance improvement opportunities for use by clinical managers. The program evaluation confirmed that families will use this format of support and find it helpful. Personal care supplies (eg, lotion, lip balm) were universally well received. Forty-two referrals to ancillary service were made. Operational issues to improve services were identified. As proposed in the Facilitated Sensemaking model, family members welcomed interventions targeted to help make sense of the new situation and make sense of their new role as caregiver. Planned supportive interventions were perceived as helpful.",Davidson JE.; Daly BJ.; Agan D.; Brady NR.; Higgins PA.,,10.1097/CNQ.0b013e3181d91369,0,0,
8838,Frontostriatal activation in patients with obsessive-compulsive disorder before and after cognitive behavioral therapy.,"Cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) is the psychotherapeutic treatment of choice for obsessive-compulsive disorder (OCD). However, little is known about the impact of CBT on frontostriatal dysfunctioning, known to be the neuronal correlate of OCD. A probabilistic reversal learning (RL) task probing adaptive strategy switching capabilities was used in 10 unmedicated patients with OCD and 10 healthy controls during an event-related functional magnetic resonance imaging (fMRI) experiment. Patients were scanned before and after intensive CBT, controls twice at comparable intervals. Strategy change within the RL task involved activity in a broad frontal network in patients and controls. No significant differences between the groups or in group by time interactions were detected in a whole-brain analysis corrected for multiple comparisons. However, a reanalysis with a more lenient threshold revealed decreased responsiveness of the orbitofrontal cortex and right putamen during strategy change before treatment in patients compared with healthy subjects. A group by time effect was found in the caudate nucleus, demonstrating increased activity for patients over the course of time. Patients with greater clinical improvement, reflected by greater reductions in Yale-Brown Obsessive Compulsive Scale (YBOCS) scores, showed more stable activation in the pallidum. Although these findings are preliminary and need to be replicated in larger samples, they indicate a possible influence of psychotherapy on brain activity in core regions that have been shown to be directly involved both in acquisition of behavioral rules and stereotypes and in the pathophysiology of OCD, the caudate nucleus and the pallidum.",Freyer T.; Klöppel S.; Tüscher O.; Kordon A.; Zurowski B.; Kuelz AK.; Speck O.; Glauche V.; Voderholzer U.,2011.0,10.1017/S0033291710000309,0,0,
8839,Long-term cognitive and psychological outcomes in the awakening and breathing controlled trial.,"Studies have shown that reducing sedation of critically ill patients shortens time on the ventilator and in the intensive care unit (ICU). Little is known, however, of how such strategies affect long-term cognitive, psychological, and functional outcomes. To determine the long-term effects of a wake up and breathe protocol that interrupts and reduces sedative exposure in the ICU. In this a priori planned substudy conducted at one tertiary care hospital during the Awakening and Breathing Controlled Trial, a multicenter randomized controlled trial, we assessed cognitive, psychological, and functional/quality-of-life outcomes 3 and 12 months postdischarge among 180 medical ICU patients randomized to paired daily spontaneous awakening trials with spontaneous breathing trials (SBTs) or to sedation per usual care plus daily SBTs. Cognitive impairment was less common in the intervention group at 3-month follow-up (absolute risk reduction, 20.2%; 95% confidence interval, 1.5-36.1%; P = 0.03) but not at 12-month follow-up (absolute risk reduction, -1.9%; 95% CI, -21.3 to 27.1%; P = 0.89). Composite cognitive scores, alternatively, were similar in the two groups at 3-month and 12-month follow-up (P = 0.80 and 0.61, respectively), as were symptoms of depression (P = 0.59 and 0.82) and posttraumatic stress disorder (P = 0.59 and 0.97). Activities of daily living, functional status, and mental and physical quality of life were similar between groups throughout follow-up. In this trial, management of mechanically ventilated medical ICU patients with a wake up and breathe protocol resulted in similar cognitive, psychological, and functional outcomes among patients tested 3 and 12 months post-ICU. The proven benefits of this protocol, including improved 1-year survival, were not offset by adverse long-term outcomes. Clinical trial registered with www.clinicaltrials.gov (NCT 00097630).",Jackson JC.; Girard TD.; Gordon SM.; Thompson JL.; Shintani AK.; Thomason JW.; Pun BT.; Canonico AE.; Dunn JG.; Bernard GR.; Dittus RS.; Ely EW.,2010.0,10.1164/rccm.200903-0442OC,0,0,
8840,Protocol for a randomised controlled trial investigating the effectiveness of an online e health application for the prevention of Generalised Anxiety Disorder.,"Generalised Anxiety Disorder (GAD) is a highly prevalent psychiatric disorder. Effective prevention in young adulthood has the potential to reduce the prevalence of the disorder, to reduce disability and lower the costs of the disorder to the community. The present trial (the WebGAD trial) aims to evaluate the effectiveness of an evidence-based online prevention website for GAD. The principal clinical question under investigation is the effectiveness of an online GAD intervention (E-couch) using a community-based sample. We examine whether the effect of the intervention can be maximised by either human support, in the form of telephone calls, or by automated support through emails. The primary outcome will be a reduction in symptoms on the GAD-7 in the active arms relative to the non active intervention arms. The WebGAD trial will be the first to evaluate the use of an internet-based cognitive behavioural therapy (CBT) program contrasted with a credible control condition for the prevention of GAD and the first formal RCT evaluation of a web-based program for GAD using community recruitment. In general, internet-based CBT programs have been shown to be effective for the treatment of other anxiety disorders such as Post Traumatic Stress Disorder, Social Phobia, Panic Disorder and stress in clinical trials; however there is no evidence for the use of internet CBT in the prevention of GAD. Given the severe shortage of therapists identified in Australia and overseas, and the low rates of treatment seeking in those with a mental illness, the successful implementation of this protocol has important practical outcomes. If found to be effective, WebGAD will provide those experiencing GAD with an easily accessible, free, evidence-based prevention tool which can be promoted and disseminated immediately.",Christensen H.; Griffiths KM.; Mackinnon AJ.; Kalia K.; Batterham PJ.; Kenardy J.; Eagleson C.; Bennett K.,2010.0,10.1186/1471-244X-10-25,0,0,
8841,Risk factors for depression and anxiety in survivors of acute respiratory distress syndrome.,"Depression and anxiety are common morbidities of critical illness. We assessed risk factors of depression and anxiety in Acute Respiratory Distress Syndrome (ARDS) survivors at 1 and 2 years post-hospital discharge. Risk factors for depression and anxiety at 1 and 2 years were assessed using stepwise multiple regression analyses, with and without 1-year outcomes. ARDS survivors had depression (16% and 23%) and anxiety (24% and 23%) at 1 and 2 years, respectively. Predictors of depression at 1 year were alcohol dependence, female gender and younger age (P=.006). Predictors of anxiety were ratio of arterial oxygen tension to inspired oxygen fraction and duration of mechanical ventilation (P<.005). Predictors of depression at 2 years were depression at 1 year and the presence of cognitive sequelae (P<.0001). Predictors of anxiety at 2 years was anxiety at 1 year (P<.0001). Medical variables that predicted depression or anxiety at 1 year no longer predicted depression and anxiety at 2 years. Medical variables appear to have a short-term effect on psychiatric outcomes. At 2 years lifestyle behaviors including history of smoking along with cognitive sequelae, depression and anxiety at 1 year predict depression and anxiety.",Hopkins RO.; Key CW.; Suchyta MR.; Weaver LK.; Orme JF.,,10.1016/j.genhosppsych.2009.11.003,0,0,6452
8842,"Randomized trial showed that an ""embedded"" survey strategy optimized authorization rates compared with two ""after survey"" strategies in veterans with PTSD.","To test methods to optimize mail survey response and authorization rates (i.e., allowing one's survey to be linked to medical records) when the survey is sensitive and the targeted population has a mental disorder. Randomized controlled trial of 1,099 veterans treated for posttraumatic stress disorder (PTSD) at a Midwestern Veteran Affairs Medical Center. Subjects were randomized to one of three groups: (1) Health Insurance Portability and Accountability Act (HIPAA) authorization form embedded in the survey (checking ""yes"" for consent); (2) HIPAA form requiring signature for consent sent after the survey; or (3) HIPAA form requiring a signature and social security number (SSN) for consent sent after the survey. The ""embedded"" strategy yielded the lowest survey response rate (67.5%) but highest authorization rate (59.1%). Requiring respondents' signatures and SSNs after the survey was returned generated the highest survey response rate (74.2%) but lowest authorization rate (48.7%). However, the response rate difference was not statistically significant. Reported emotional upset was low (1.5%) and primarily directed to the survey, not the HIPAA form. Older age and greater trustfulness were associated with higher authorization rates. Even with our most optimized strategy, authorization rates were disappointingly low.",Murdoch M.; Pietila DM.; Partin MR.,2010.0,10.1016/j.jclinepi.2009.12.006,0,0,
8843,Adding motivational interviewing and thought mapping to cognitive-behavioral group therapy: results from a randomized clinical trial.,"Recent factor-analytic studies of obsessive-compulsive disorder identified consistent symptom dimensions. This study was designed in order to observe which obsessive compulsive symptom dimensions could be changed by adding two individual sessions of motivational interviewing and thought mapping of cognitive-behavioral group therapy using a randomized clinical trial. Forty outpatients with a primary diagnosis of obsessive-compulsive disorder were randomly assigned to receive cognitive-behavioral group therapy (control group) or motivational interviewing+thought mapping plus cognitive-behavioral group therapy. To evaluate changes in symptom dimensions, the Dimensional Yale-Brown Obsessive-Compulsive Scale was administered at baseline and after treatment. At post-treatment, there were statistically significant differences between cognitive-behavioral group therapy and motivational interviewing+thought mapping+cognitive behavioral group therapy groups in the mean total Dimensional Yale-Brown Obsessive-Compulsive Scale score, and in the contamination and aggression dimension score. Hoarding showed a statistical trend towards improvement. These findings suggest that adding motivational interviewing+thought mapping to cognitive-behavioral group therapy can facilitate changes and bring about a decrease in the scores in different obsessive-compulsive disorder symptom dimensions, as measured by the Dimensional Yale-Brown Obsessive-Compulsive Scale. Nonetheless, additional trials are needed to confirm these results.",Meyer E.; Shavitt RG.; Leukefeld C.; Heldt E.; Souza FP.; Knapp P.; Cordioli AV.,2010.0,,0,0,
8844,A randomized clinical trial to examine enhancing cognitive-behavioral group therapy for obsessive-compulsive disorder with motivational interviewing and thought mapping.,"Obsessive-compulsive disorder (OCD) is characterized by repeated and persistent attempts to control thoughts and actions with rituals. These rituals are used in order to prevent feared or personally distressing outcomes. Cognitive behavioral group therapy (CBGT) has been reported to be effective for treating OCD patients. However, about one-third (30%) of patients do not benefit from CBGT. Some of these patients do not show significant improvement and continue to use rituals following CBGT, partially because they fail to complete the exposure and ritual prevention (ERP) exercises. Consequently, it is important to motivate patients to fully engage in CBGT treatment and complete the ERP exercises. A randomized behavioral trial examined 12 weeks of manual directed CBGT, with the addition of individual sessions of Motivational Interviewing (MI) and Thought Mapping (TM), and compared treatment outcome to the effectiveness of CBGT group alone. Subjects were randomized (n=93) into a CBGT group or a CBGT group with MI+TM. When the two groups were compared, both groups reduced OCD symptoms. However, symptom reduction and remission were significantly higher in the MI+TM CBGT group. Positive outcomes were also maintained, with additional symptom reduction at the 3-month follow-up for the MI+TM CBGT group. Adding two individual sessions of MI and TM before CBGT successfully reduced OCD symptoms and was more effective than using CBGT group alone.",Meyer E.; Souza F.; Heldt E.; Knapp P.; Cordioli A.; Shavitt RG.; Leukefeld C.,2010.0,10.1017/S1352465810000111,0,0,
8845,Behavioural group therapy for obsessive-compulsive disorder in Norway. An open community-based trial.,"The aim of the current study was to test the effectiveness of ERP-based 12 weeks group therapy for OCD patients in a community-based, general Norwegian outpatient clinic. The sample consisted of 54 patients diagnosed with OCD. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Beck Depression Inventory (BDI) and the Spielberger State Anxiety Inventory (STAI-S) were administered before treatment, after treatment and at 3- and 12-month follow-ups. Analyses with mixed models for repeated measurements showed that group behavioural therapy offered to OCD patients significantly improved ratings of obsessive-compulsive symptoms, depression and anxiety. These improvements were maintained at 3- and 12-month follow-ups and an additional reduction in obsessive-compulsive symptoms was observed from post-treatment to 3-month follow-up. However, the delayed effect of therapy was no longer present at 12-month follow-up. The results also revealed that the patients had a lower chance for an increased outcome category (e.g. from unchanged to improved or recovered) with high scores on STAI-S at the given observation times (post-treatment, 3- and 12-months follow-ups). Depressive symptoms (BDI) at post-treatment and follow-ups had no significant influences on the three categories of outcome for OCD. In conclusion, the results indicate that behavioural group therapy can successfully be delivered to patients with considerable comorbidity in a real world setting conducted by therapists with limited training in the CBT.",Håland AT.; Vogel PA.; Lie B.; Launes G.; Pripp AH.; Himle JA.,2010.0,10.1016/j.brat.2010.03.005,0,0,
8846,Need for speed: evaluating slopes of OCD recovery in behavior therapy enhanced with d-cycloserine.,"Evidence suggests that the antibiotic d-cycloserine (DCS) enhances the treatment effects of exposure and response prevention (ERP) for Obsessive-Compulsive Disorder (OCD). Further, evidence suggests that the effects of DCS diminish partway through treatment, but it is unclear to what extent. In an effort to evaluate these issues, the current study re-analyzes data from a 10-session randomized controlled trial of ERP+DCS versus ERP+placebo in a sample of 22 adults with OCD. We analyzed repeated-measures mixed models with random slopes and intercepts across different intervals: sessions 1-10, 1-5, and 6-10. The results indicate that the course of ERP was 2.3 times faster over the full 10 sessions for the DCS compared to the placebo group, and nearly six times quicker in the first half of ERP. Further interpretation of the results suggests that DCS does not amplify the effects of ERP, but instead initiates treatment effects sooner in treatment. In addition, DCS does not necessarily lose its effect over repeated use, but instead may exhaust its maximum utility after effectively jump-starting ERP. Ultimately, DCS may provide a means for curtailing treatment costs, decreasing treatment dropout and refusal rates, and enhancing access to care.",Chasson GS.; Buhlmann U.; Tolin DF.; Rao SR.; Reese HE.; Rowley T.; Welsh KS.; Wilhelm S.,2010.0,10.1016/j.brat.2010.03.007,0,0,
8847,Predictors and moderators of time to remission of major depression with interpersonal psychotherapy and SSRI pharmacotherapy.,"Although many studies suggest that, on average, depression-specific psychotherapy and antidepressant pharmacotherapy are efficacious, we know relatively little about which patients are more likely to respond to one versus the other. We sought to determine whether measures of spectrum psychopathology are useful in deciding which patients with unipolar depression should receive pharmacotherapy versus depression-specific psychotherapy. A total of 318 adult out-patients with major depression were randomly assigned to escitalopram pharmacotherapy or interpersonal psychotherapy (IPT) at academic medical centers at Pittsburgh, Pennsylvania and Pisa, Italy. Our main focus was on predictors and moderators of time to remission on monotherapy at 12 weeks. Participants with higher scores on the need for medical reassurance factor of the Panic-Agoraphobic Spectrum Self-Report (PAS-SR) had more rapid remission with IPT and those with lower scores on the psychomotor activation factor of the Mood Spectrum Self-Report (MOODS-SR) experienced more rapid remission with selective serotonin reuptake inhibitor (SSRI) pharmacotherapy. Non-specific predictors of longer time to remission with monotherapy included several panic spectrum and mood spectrum factors and the Social Phobia Spectrum (SHY) total score. Higher baseline scores on the 17- and 25-item Hamilton Depression Rating Scales (HAMD-17 and HAMD-25) and the Work and Social Adjustment Scale (WSAS) also predicted a longer time to remission, whereas being married predicted a shorter time to remission. This exploratory study identified several non-specific predictors but few moderators of psychotherapy versus pharmacotherapy outcome. It offers useful indicators of the characteristics of patients that are generally difficult to treat, but only limited guidance as to who benefits from IPT versus SSRI pharmacotherapy.",Frank E.; Cassano GB.; Rucci P.; Thompson WK.; Kraemer HC.; Fagiolini A.; Maggi L.; Kupfer DJ.; Shear MK.; Houck PR.; Calugi S.; Grochocinski VJ.; Scocco P.; Buttenfield J.; Forgione RN.,2011.0,10.1017/S0033291710000553,0,0,
8848,"Traumatic experiences, major life stressors, and self-reporting a physician-given fibromyalgia diagnosis.","The contribution of stress to the pathophysiology of fibromyalgia has been the subject of considerable debate. The primary purpose of the present study was to evaluate the relationship between traumatic and major life stressors and a fibromyalgia diagnosis in a large group of older women and men. Data were from the federally funded Biopsychosocial Religion and Health Study, and subjects were 10,424 of the 10,988 survey respondents-two-thirds women and one-third men-providing responses to a fibromyalgia question. Average age was 61.0+/-13.5 years. A physician-given fibromyalgia diagnosis in a subject's lifetime was reported by 3.7% of the sample, 4.8% of the women and 1.3% of the men. In two multivariable logistic regression models (all respondents and women only, controlling for age, sex, race/ethnicity, and education), two traumatic experience types (sexual and physical assault/abuse) were associated with a fibromyalgia diagnosis. Two other trauma types (life-threatening and emotional abuse/neglect) and major life stress experiences were not. The highest odds ratios in both models were those for sexual assault/abuse followed by physical assault/abuse. The relationship between age and fibromyalgia was curvilinear in both models (odds ratios rising until approximately age 63 and declining thereafter). In the all-subjects model, being a woman increased the odds of a fibromyalgia diagnosis, and in both models, fibromyalgia was associated with being White (versus non-White) and lower education. We recommend that researchers investigate the relationship between stress and fibromyalgia in concert with genetic and biomarker studies.",Haviland MG.; Morton KR.; Oda K.; Fraser GE.,2010.0,10.1016/j.psychres.2009.08.017,0,0,
8849,A randomized controlled trial of secondary prevention of anxiety and distress in a German sample of patients with an implantable cardioverter defibrillator.,"To evaluate a minimal, easy, accessible intervention targeting anxiety and reduced quality of life in patients with an implantable cardioverter defibrillator (ICD). An estimated 24% to 87% of patients experience anxiety, and 10% to 15% have reduced quality of life. A total of 119 ICD patients were assigned randomly to usual medical aftercare (n = 63) or additional psychological treatment (n = 56) comprising of written information on medical and psychological consequences of an ICD plus 6 months of individual phone counseling. Treatment efficacy was evaluated by comparing T0 (immediately after implantation) and T1 (6 months later) assessments. Although 75% of patients considered the program helpful, age moderated treatment efficacy. As indicated by triple interactions, only in the treatment group, anxiety (HADS-Anxiety, p < .01), psychological distress (SCL-K-9, p < .02), and somatic quality of life (SF-36-PCS, p < .01) improved in ICD patients aged <65 years but deteriorated in older patients (age, 65-75 years). Frequency of ICD discharges was associated with a symptom increase from T0 to T1 in all patients (HADS-Depression, CAQ-Avoidance, and ICD-Constraints; all p < .05). Our findings confirm that psychological treatments cannot be expected to have uniformly positive effects in ICD patients. Our minimal intervention may have adequately addressed ICD-related concerns in younger patients but may have fostered problems in older patients with fewer concerns. Therefore, our findings warrant custom treatment with particular attention to the elderly as well as patients with frequent ICD discharges.",Crössmann A.; Schulz SM.; Kühlkamp V.; Ritter O.; Neuser H.; Schumacher B.; Bauer W.; Pauli P.,2010.0,10.1097/PSY.0b013e3181d9bcec,0,0,
8850,Clinical features and treatment characteristics of compulsive hoarding in Japanese patients with obsessive-compulsive disorder.,"Compulsive hoarding has been studied primarily in Western countries. Here we sought to examine compulsive hoarding in Japanese patients with obsessive-compulsive disorder (OCD). The heterogeneous nature of hoarding was also investigated. One hundred and sixty-eight OCD outpatients were initially assessed to determine the presence or absence of compulsive hoarding, and whether hoarding was primary or secondary to another symptom dimension for which they had received treatment for 1 year. Of the participants, 54 patients were found to have compulsive hoarding. Hoarders were significantly more likely than non-hoarding patients to have more severe psychopathology including elevated severity of OCD symptoms, poorer insight, higher prevalence of comorbid schizotypal or obsessive-compulsive personality disorder, closer association with symmetry dimension, and poorer treatment outcome. Comparisons of subjects with primary and secondary hoarding found that the former group had more severe clinical features, while the latter group hoarded a wider variety of items, including apparently bizarre ones. The prevalence and clinical characteristics of compulsive hoarding in OCD subjects was similar to those reported in Western countries, supporting its trans-cultural consistency. The distinction between primary and secondary hoarding in OCD is clinically useful, and may contribute to the debate about whether hoarding should be a separate diagnostic entity.",Matsunaga H.; Hayashida K.; Kiriike N.; Nagata T.; Stein DJ.,2010.0,,0,0,
8851,Moderators and predictors of response to cognitive-behavioral therapy augmentation of pharmacotherapy in obsessive-compulsive disorder.,"Cognitive-behavioral therapy (CBT) consisting of exposure and response prevention (EX/RP) is efficacious as a treatment for obsessive-compulsive disorder (OCD). However, about half of patients have a partial or poor response to EX/RP treatment. This study examined potential predictors and moderators of CBT augmentation of pharmacotherapy, to identify variables associated with a poorer response to OCD treatment. Data were drawn from a large randomized controlled trial that compared the augmenting effects of EX/RP to stress management training (SMT; an active CBT control) among 108 participants receiving a therapeutic dose of a serotonin reuptake inhibitor (SRI). Stepwise regression was used to determine the model specification. Pretreatment OCD severity and gender were significant moderators of outcome: severity affected SMT (but not EX/RP) outcome; and gender affected EX/RP (but not SMT) outcome. Adjusting for treatment type and pretreatment severity, significant predictors included greater co-morbidity, number of past SRI trials, and lower quality of life (QoL). Significant moderators, including their main-effects, and predictors accounted for 37.2% of the total variance in outcome, comparable to the impact of treatment type alone (R2=30.5%). These findings were replicated in the subgroup analysis of EX/RP alone (R2=55.2%). This is the first randomized controlled study to examine moderators and predictors of CBT augmentation of SRI pharmacotherapy. Although effect sizes for individual predictors tended to be small, their combined effect was comparable to that of treatment. Thus, future research should examine whether monitoring for a combination of these risk factors and targeting them with multi-modular strategies can improve EX/RP outcome.",Maher MJ.; Huppert JD.; Chen H.; Duan N.; Foa EB.; Liebowitz MR.; Simpson HB.,2010.0,10.1017/S0033291710000620,0,0,
8852,Validity and responsiveness of the EQ-5D in assessing and valuing health status in patients with anxiety disorders.,"The EQ-5D is a generic questionnaire which generates a health profile as well as index scores for health-related quality of life that may be used in cost-utility analysis. To examine validity and responsiveness of the EQ-5D in patients with anxiety disorders. 389 patients with anxiety disorders completed the EQ-5D at baseline and 6-month follow-up. Subjective measures of quality of life (WHOQOL-BREF) and psychopathology (BAI, BDI-II, BSQ, ACQ, MI) were used for comparison. Validity was analyzed by assessing associations between EQ-5D scores and related other scores. Responsiveness was analyzed by calculating effect sizes of differences in scores between baseline and follow-up for 3 groups indicating more, constant or less anxiety. Meaningful difference scores for shifting to less or more anxiety were derived by means of regression analysis. 88.4% of respondents reported problems in at least one of the EQ-5D dimension at baseline; the mean EQ VAS score was 63.8. The EQ-5D dimension most consistently associated with the measures used for comparison was 'anxiety/depression'. EQ VAS and EQ-5D index scores were highly correlated (|r|>0.5) with scores of the WHOQOL-BREF dimensions 'physical', 'mental' and 'overall' as well as BAI and BDI-II. The EQ-5D index tended to be the most responsive score. Standardized meaningful difference scores were not significantly different between EQ VAS, EQ-5D index and measures used for comparison. The EQ-5D seems to be reasonably valid and moderately responsive in patients with anxiety disorders. The EQ-5D index may be suitable for calculating QALYs in economic evaluation of health care interventions for patients with anxiety disorders. Current Controlled Trials ISRCTN15716049.",König HH.; Born A.; Günther O.; Matschinger H.; Heinrich S.; Riedel-Heller SG.; Angermeyer MC.; Roick C.,2010.0,10.1186/1477-7525-8-47,0,0,
8853,"A therapist-assisted cognitive behavior therapy internet intervention for posttraumatic stress disorder: pre-, post- and 3-month follow-up results from an open trial.","This study was an open trial evaluation of a 10-week therapist-assisted cognitive behavior therapy (CBT) internet intervention (PTSD Online) undertaken with people with a primary clinical diagnosis of posttraumatic stress disorder (PTSD) (n=22) at pre-assessment. Participants were re-assessed at post-assessment and 3-month follow-up. Significant improvements on PTSD severity ratings and related PTSD symptomatology were observed at post-assessment and maintained at 3-month follow-up. At post-assessment, 69.2% of the sample showed clinically significant improvement and 77% of the sample at follow-up assessment. Non-significant, yet improved, change was observed on all other general psychological measures. Overall, treatment satisfaction was good (69%), participant therapeutic alliance ratings were high (87.5%), and the average total therapist time required was 194.5 min. PTSD Online appears to be an efficacious treatment option for people with PTSD that can be provided entirely remotely, with far less therapist time than traditional face-to-face treatment, and without compromising therapeutic alliance.",Klein B.; Mitchell J.; Abbott J.; Shandley K.; Austin D.; Gilson K.; Kiropoulos L.; Cannard G.; Redman T.,2010.0,10.1016/j.janxdis.2010.04.005,0,0,
8854,Heart rate responses to standardized trauma-related pictures in acute posttraumatic stress disorder.,"Physiological responses to trauma reminders are one of the core symptoms of posttraumatic stress disorder (PTSD). Nevertheless, screening measures for PTSD largely rely on symptom self-reports. It has been suggested that psychophysiological assessments may be useful in identifying trauma survivors with PTSD (Orr and Roth, 2000). This study investigated whether heart rate (HR) responses to standardized trauma-related pictures distinguish between trauma survivors with and without acute PTSD. Survivors of motor vehicle accidents or physical assaults (N=162) watched standardized trauma-related, generally threatening and neutral pictures at 1 month post-trauma while their ECG was recorded. At 1 and 6 months, structured clinical interviews assessed PTSD diagnoses. Participants completed self-report measures of PTSD severity and depression, peritraumatic responses, coping behaviors and appraisals. Trauma survivors with acute PTSD showed greater HR responses to trauma-related pictures than those without PTSD, as indicated by a less pronounced mean deceleration, greater peak responses, and a greater proportion showing HR acceleration of greater than 1 beat per minute. There were no group differences in HR responses to generally threatening or neutral pictures. HR responses to trauma-related pictures contributed to the prediction of PTSD diagnosis over and above what could be predicted from self-reports of PTSD and depression. HR responses to trauma-related pictures were related to fear and data-driven processing during the trauma, safety behaviors, suppression of trauma memories, and overgeneralized appraisals of danger. The results suggest that HR responses to standardized trauma-related pictures may help identify a subgroup of patients with acute PTSD who show generalized fear responses to trauma reminders. The early generalization of triggers of reexperiencing symptoms observed in this study is consistent with associative learning and cognitive models of PTSD.",Ehlers A.; Suendermann O.; Boellinghaus I.; Vossbeck-Elsebusch A.; Gamer M.; Briddon E.; Martin MW.; Glucksman E.,2010.0,10.1016/j.ijpsycho.2010.04.009,0,0,
8855,"The effects of ""psychological inoculation"" versus ventilation on the mental resilience of Israeli citizens under continuous war stress.","Anxiety and hopelessness are common reactions of citizens exposed to continuous war threats. Common interventions focus on support, calming, and emotional ventilation, with few attempts to reduce people's cognitive barriers concerning active coping, which could increase their resilience. This study tested the effects of psychological inoculation (PI), which specifically aims to challenge such barriers, on the mental resilience of Israeli citizens living in Sderot. Participants were randomly assigned to either 2 PI sessions or 2 ventilation sessions, provided over the phone. Anxiety, helplessness, pessimism, and functioning were briefly assessed at baseline and 1 week after interventions. No time, group, or group x time interactions were observed. However, a time x group x sex interaction emerged for helplessness: Men benefited from the PI whereas women benefited from ventilation, in reducing helplessness. Under chronic war stress, it seems difficult to improve people's resilience, although PI may be partly beneficial for men. Further research is needed to test the effects of PI on mental resilience.",Farchi M.; Gidron Y.,2010.0,10.1097/NMD.0b013e3181da4b67,0,0,
8856,"A randomized trial of sertraline, self-administered cognitive behavior therapy, and their combination for panic disorder.","Self-administered cognitive behavior therapy (SCBT) has been shown to be an effective alternative to therapist-delivered treatment for panic disorder (PD). However, it is unknown whether combining SCBT and antidepressants can improve treatment. This trial evaluated the efficacy of SCBT and sertraline, alone or in combination, in PD. Patients (n=251) were randomized to 12 weeks of either placebo drug, placebo drug plus SCBT, sertraline, or sertraline plus SCBT. Those who improved after 12 weeks of acute treatment received treatment for an additional 12 weeks. Outcome measures included core PD symptoms (panic attacks, anticipatory anxiety, agoraphobic avoidance), dysfunctional cognitions (fear of bodily sensations, agoraphobic cognitions), disability, and clinical global impression of severity and improvement. Efficacy data were analyzed using general and generalized linear mixed models. Primary analyses of trends over time revealed that sertraline/SCBT produced a significantly greater rate of decline in fear of bodily sensations compared to sertraline, placebo/SCBT and placebo. Trends in other outcomes were not significantly different over time. Secondary analyses of mean scores at week 12 revealed that sertraline/SCBT fared better on several outcomes than placebo, with improvement being maintained at the end of continuation treatment. Outcome did not differ between placebo and either sertraline monotherapy or placebo/SCBT. Moreover, few differences emerged between the active interventions. This trial suggests that sertraline combined with SCBT may be an effective treatment for PD. The study could not confirm the efficacy of sertraline monotherapy or SCBT without concomitant medication or therapist assistance in the treatment of PD.",Koszycki D.; Taljaard M.; Segal Z.; Bradwejn J.,2011.0,10.1017/S0033291710000930,0,0,
8857,Narrative exposure therapy for posttraumatic stress disorder in tortured refugees: a preliminary uncontrolled trial.,"Torture has severe mental health effects, especially in terms of posttraumatic stress disorder (PTSD) and depression. However, there is still a lack of empirical treatment studies. The present paper presents data on 16 torture survivors receiving 10 sessions of narrative exposure therapy (NET). Symptoms of PTSD and depression, assessed by Clinician-Administered PTSD Scale (CAPS) and Hamilton Rating Scale for Depression (HRSD), decreased significantly from pre-treatment to 6-month follow-up, with Cohen's d effect sizes of 1.16 and 0.84, respectively. Although treatment gains were moderate, further research on evidence-based treatments for PTSD and depression in refugee torture survivors is warranted.",Halvorsen J√ò.; Stenmark H.,2010.0,10.1111/j.1467-9450.2010.00821.x,0,0,
8858,A new hypnotic technique for treating combat-related posttraumatic stress disorder: a prospective open study.,"Many combat veterans with posttraumatic stress disorder (PTSD) have an olfactory component to their traumatic memories that might be utilized by a technique called hypnotherapeutic olfactory conditioning (HOC). Thirty-six outpatients with chronic PTSD, featuring resistant olfactory-induced flashbacks, were treated with six 1.5-hour sessions using hypnosis. The authors used the revised Impact of Events Scale (IES-R), Beck Depression Inventory, and Dissociative Experiences Scale as outcome measures. Significant reductions in symptomatology were recorded by the end of the 6-week treatment period for the IES-R, as well as for the Beck Depression Inventory and the Dissociative Experiences Scale; 21 (58%) of the subjects responded to treatment by a reduction of 50% or more on the IES-R. Improvement was maintained at 6-month and 1-year follow-ups. Use of medication was curtailed. HOC shows potential for providing benefit to individuals suffering from PTSD with olfactory components.",Abramowitz EG.; Lichtenberg P.,2010.0,10.1080/00207141003760926,0,0,
8859,The mediating role of insight for long-term improvements in psychodynamic therapy.,"According to psychoanalytic theory, interpretation of transference leads to increased insight that again leads to improved interpersonal functioning over time. In this study, we performed a full mediational analysis to test whether insight gained during treatment mediates the long-term effects of transference interpretation in dynamic psychotherapy. This study is a randomized clinical trial with a dismantling design. One hundred outpatients seeking psychotherapy for depression, anxiety, personality disorders, and interpersonal problems were randomly assigned to 1 year of weekly sessions of dynamic psychotherapy with transference interpretation or to the same type and duration of treatment with the same therapists but without the use of transference interpretation. Interpersonal functioning and insight were measured pretreatment, posttreatment, and 1 year and 3 years after treatment termination. Contrary to common expectation, patients with a life-long pattern of low quality of object relations and personality disorder pathology profited more from therapy with transference interpretation than from therapy with no transference interpretation. This long-term effect was mediated by an increase in the level of insight during treatment. Insight seems to be a key mechanism of change in dynamic psychotherapy. Our results bridge the gap between clinical theory and empirical research.",Johansson P.; H√∏glend P.; Ulberg R.; Amlo S.; Marble A.; B√∏gwald KP.; S√∏rbye O.; Sjaastad MC.; Heyerdahl O.,2010.0,10.1037/a0019245,0,0,
8860,Endoscopic treatment of prepatellar bursitis.,"Operative treatment of prepatellar bursitis is indicated in intractable bursitis. The most common complication of surgical treatment for prepatellar bursitis is skin problems. For traumatic prepatellar bursitis, we propose a protocol of outpatient endoscopic surgery under local anaesthesia. From September 1996 to February 2001, 60 cases of failed nonoperative treatment for prepatellar bursitis were included. The average age was 33.5 ± 11.1 years (range 21-55). The average operation duration was 18 minutes. Two to three mini-arthroscopic portals were used in our series. No sutures or a simple suture was needed for the portals after operation. After follow-up for an average of 36.3 months, all patients are were symptom-free and had regained knee function. None of the population had local tenderness or hypo-aesthesia around their wound. Their radiographic and sonographic examinations showed no recurrence of bursitis. Outpatient arthroscopic bursectomy under local anaesthesia is an effective procedure for the treatment of post-traumatic prepatellar bursitis after failed conservative treatments. Both the cosmetic results and functional results were satisfactory.",Huang YC.; Yeh WL.,2011.0,10.1007/s00264-010-1033-5,0,0,
8861,Survey of eating disorder symptoms among women in treatment for substance abuse.,"A strong association between substance use disorders (SUDs) and eating disorders (EDs) in women has been established. Yet, little is known about the rates and impact of ED symptoms in women presenting to addiction treatment. The current investigation assessed the prevalence of ED symptoms and their effect on treatment outcomes in a sample of substance abusing women with co-occurring posttraumatic stress disorder (PTSD) enrolled in outpatient substance use programs. Participants were 122 women who participated in a multisite clinical trial comparing two behavioral treatments for co-occurring SUD and PTSD. The Eating Disorder Examination-self report, and measures of PTSD and SUD symptoms were administered at baseline, during treatment and at four follow-up points. Two subgroups emerged; those reporting binge eating in the 28 days prior to baseline (Binge group; n = 35) and those who reported no binge eating episodes (No Binge group; n = 87). Women in the Binge group endorsed significantly higher ED, PTSD, and depression symptoms at baseline than those in the No Binge group. Although all participants showed significant reductions in PTSD symptoms and improvements in abstinence rates during the study period, the improvements for the Binge group were significantly lower. These findings suggest that a subgroup of women with co-occurring PTSD and SUDs, who endorsed binge ED symptoms, responded differently to SUD/PTSD group treatment. Identification of ED symptoms among treatment-seeking women with SUDs may be an important element in tailoring interventions and enhancing treatment outcomes.",Cohen LR.; Greenfield SF.; Gordon S.; Killeen T.; Jiang H.; Zhang Y.; Hien D.,,10.1111/j.1521-0391.2010.00038.x,0,0,6423
8862,Risk reduction for substance use and trauma-related psychopathology in adolescent sexual assault victims: findings from an open trial.,"Limited attention has been paid to the development and evaluation of interventions that reduce risk for substance use, while also targeting trauma-related psychopathology among maltreated adolescents. Risk Reduction through Family Therapy (RRFT) is a multicomponent treatment that integrates principles and interventions from existing empirically supported treatments. The purpose of the current study was to evaluate the feasibility of implementation and initial efficacy of RRFT through an open pilot trial involving a small sample (N = 10) of female adolescents (aged 13-17 years) who had experienced at least one memorable sexual assault in their lifetime. Measures of substance use and substance use risk factors (e.g., family functioning), posttraumatic stress disorder (PTSD), and depression symptoms were assessed pre- and posttreatment as well as at 3-month and 6-month posttreatment follow-up assessments. Results demonstrated reductions in multiple areas, including substance use and related risk factors, PTSD, and depression symptoms, which were maintained through follow-up. Clinical implications and future directions with this line of research are discussed.",Kmett Danielson C.; McCart MR.; de Arellano MA.; Macdonald A.; Doherty LS.; Resnick HS.,2010.0,10.1177/1077559510367939,0,0,
8863,The role of alcohol misuse in PTSD outcomes for women in community treatment: a secondary analysis of NIDA's Women and Trauma Study.,"Individuals with comorbid substance use and posttraumatic stress disorder may differentially benefit from integrated trauma-focused interventions based on specific presenting characteristics such as substance use type and PTSD severity. The current study is a secondary analysis of a NIDA Clinical Trials Network study exploring the effectiveness of two interventions for women with comorbid PTSD and substance use disorders. Generalized estimating equations were used to examine the association of baseline alcohol misuse with PTSD outcome measures over time for all randomized participants. Women entering treatment with baseline alcohol misuse had higher Post Traumatic Stress Disorder Symptom Scale (PSS-SR) total scores (t=2.43, p<.05), cluster C (avoidance/numbing) scores (t=2.63, p<.01), and cluster D (hyper-arousal) scores (t=2.31, p<.05). For women with alcohol misuse, after treatment week 1, PSS-SR scores were significantly lower in the Seeking Safety intervention during treatment (chi(2)(1)=4.00, p<.05) and follow-up (chi(2)(1)=4.87, p<.05) compared to those in the health education intervention. Alcohol misusers in the Seeking Safety group who had higher baseline hyper-arousal severity improved more quickly than those with lower baseline hyper-arousal severity during treatment (chi(2)(1)=4.06, p<.05). These findings suggest that the type of substance abuse at treatment entry may inform treatment selection, predict treatment response among those with co-occurring PTSD and substance use disorders, and indicate a more severe clinical picture.",Hien DA.; Campbell AN.; Ruglass LM.; Hu MC.; Killeen T.,2010.0,10.1016/j.drugalcdep.2010.04.011,0,0,
8864,Personality prototypes in individuals with compulsive buying based on the Big Five Model.,"Personality prototypes based on the Big Five factor model were investigated in a treatment-seeking sample of 68 individuals with compulsive buying (CB). Cluster analysis of the NEO Five-Factor Inventory (NEO-FFI) scales yielded two distinct personality clusters. Participants in cluster II scored significantly higher than those in cluster I on neuroticism and lower on the other four personality traits. Subjects in cluster II showed higher severity of CB, lower degree of control over CB symptoms, and were more anxious, interpersonally sensitive and impulsive. Furthermore, cluster II was characterized by higher rates of comorbid anxiety disorders, and cluster B personality disorders. The two personality prototypes did not differ with respect to obsessive-compulsive features. Finally and of considerable clinical significance, participants in cluster II reported lower remission rates after undergoing cognitive-behavioral therapy. Implications of the results for treatment are discussed.",Mueller A.; Claes L.; Mitchell JE.; Wonderlich SA.; Crosby RD.; de Zwaan M.,2010.0,10.1016/j.brat.2010.05.020,0,0,
8865,Progress monitoring and feedback in psychiatric care reduces depressive symptoms.,"To date, the monitoring of patient progress using standardized assessments has been neglected in hospital-based psychiatric care. Findings in outpatient psychotherapy have demonstrated clinically significant benefits for providing feedback to the sizeable minority of patients who were otherwise unlikely to experience positive outcome (Lambert, 2007). However, a similar system for presenting feedback on patient progress has not yet been assessed for group therapy within psychiatric inpatient settings. The current study aimed to develop and evaluate the effectiveness of a feedback system suitable for use in psychiatric services. In a nonrandomized trial, 1308 consecutive inpatients and day patients, whose diagnoses were primarily depressive and anxiety disorders, completed the World Health Organization's Wellbeing Index (WHO-5) routinely during a ten-day cognitive behavioral therapy group. The first cohort (n=461) received treatment as usual. The second cohort (n=439) completed monitoring measures without feedback, and for patients in the third cohort (n=408), feedback on progress was provided to both clinicians and patients midway through the treatment period. Feedback was effective in reducing depressive symptoms (F(1,649)=6.29, p<.05) for those patients at risk of poor outcome, but not effective in improving wellbeing (F(1,569)=1.14, p>.05). The current findings may be generalized to patient samples that exhibit largely depressive disorders, however rigorous follow-up is warranted. Similar to outpatient settings, feedback appears to be beneficial for improving symptom outcomes but further time may be required for wellbeing to be affected.",Newnham EA.; Hooke GR.; Page AC.,2010.0,10.1016/j.jad.2010.05.003,0,0,
8866,Violent and nonviolent suicide in veterans with substance-use disorders.,"Substance-use disorders (SUDs) increase the risk of suicide. Examining risk factors for violent or nonviolent suicide in those with SUDs could improve suicide-prevention efforts in these individuals. We examined the demographic and clinical predictors of violent and nonviolent suicide among patients with SUDs. This study examined Veterans Affairs (VA) patients with SUDs who were alive at the beginning of Fiscal Year (FY) 2002 and died by suicide during FYs 2002 through 2006 (n = 854) and a random sample of 4,228 SUD patients who did not die by suicide during this period. Data were obtained from VA medical records and the National Death Index. Patients were considered to have an SUD if they received two or more diagnoses of the same SUD from FY 1997 to FY 2001. Of those who died by suicide, 70% (n = 600) used violent means. Diagnoses of depressive, other anxiety, bipolar and posttraumatic stress disorders, schizophrenia, and personality disorders were associated with increased risk of both violent and nonviolent suicide; however, these associations were stronger for nonviolent than violent suicide deaths. Risk of nonviolent suicide was greater among patients with opioid-use disorders or a clinical diagnosis of abuse or dependence (according to the International Classification of Diseases, Tenth Revision) on multiple substances. Most VA patients with SUDs who died from suicide used violent means. No specific SUD was associated with increased risk of violent suicide, but several SUD diagnoses were associated with increased risk of nonviolent suicide. Concurrent psychopathology increased risk for both suicide types; however, the relationship was strongest for nonviolent suicide.",Ilgen MA.; Conner KR.; Valenstein M.; Austin K.; Blow FC.,2010.0,,0,0,
8867,Effects of directed written disclosure on grief and distress symptoms among bereaved individuals.,"Bereavement-specific written disclosure trials have generally demonstrated null effects, but these studies have not directed the focus of writing. This randomized controlled trial compared directed writing that focused on either sense-making or benefit-finding, both associated with adjustment to loss, to traditional, non-directed emotional disclosure and a control condition. Bereaved undergraduates (n = 68) completed three 20-min writing sessions over 1 week. Intervention effects were found on prolonged grief disorder, depressive, and posttraumatic stress symptoms 3 months postintervention, and the benefit-finding condition appeared particularly efficacious. Physical health improved over time in all treatment groups. Findings suggested that directing written disclosure on topics associated with adjustment to bereavement may be useful for grieving individuals.",Lichtenthal WG.; Cruess DG.,2010.0,10.1080/07481187.2010.483332,0,0,
8868,Internet-versus group-administered cognitive behaviour therapy for panic disorder in a psychiatric setting: a randomised trial.,"Internet administered cognitive behaviour therapy (CBT) is a promising new way to deliver psychological treatment, but its effectiveness in regular care settings and in relation to more traditional CBT group treatment has not yet been determined. The primary aim of this study was to compare the effectiveness of Internet-and group administered CBT for panic disorder (with or without agoraphobia) in a randomised trial within a regular psychiatric care setting. The second aim of the study was to establish the cost-effectiveness of these interventions. Patients referred for treatment by their physician, or self-referred, were telephone-screened by a psychiatric nurse. Patients fulfilling screening criteria underwent an in-person structured clinical interview carried out by a psychiatrist. A total of 113 consecutive patients were then randomly assigned to 10 weeks of either guided Internet delivered CBT (n = 53) or group CBT (n = 60). After treatment, and at a 6-month follow-up, patients were again assessed by the psychiatrist, blind to treatment condition. Immediately after randomization 9 patients dropped out, leaving 104 patients who started treatment. Patients in both treatment conditions showed significant improvement on the main outcome measure, the Panic Disorder Severity Scale (PDSS) after treatment. For the Internet treatment the within-group effect size (pre-post) on the PDSS was Cohen's d = 1.73, and for the group treatment it was d = 1.63. Between group effect sizes were low and treatment effects were maintained at 6-months follow-up. We found no statistically significant differences between the two treatment conditions using a mixed models approach to account for missing data. Group CBT utilised considerably more therapist time than did Internet CBT. Defining effect as proportion of PDSS responders, the cost-effectiveness analysis concerning therapist time showed that Internet treatment had superior cost-effectiveness ratios in relation to group treatment both at post-treatment and follow-up. This study provides support for the effectiveness of Internet CBT in a psychiatric setting for patients with panic disorder, and suggests that it is equally effective as the more widely used group administered CBT in reducing panic-and agoraphobic symptoms, as well as being more cost effective with respect to therapist time. ClinicalTrials.gov NCT00845260.",Bergström J.; Andersson G.; Ljótsson B.; Rück C.; Andréewitch S.; Karlsson A.; Carlbring P.; Andersson E.; Lindefors N.,2010.0,10.1186/1471-244X-10-54,0,0,
8869,Psychometric properties of the Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia in patients with shoulder pain.,"To investigate the reliability and validity of 2 commonly used measures of pain related fear in patients with shoulder pain. A preplanned secondary analysis of a prospective single-arm trial involving a repeated-measures design. Outpatient physical therapy clinics. Patients (N=80) with a primary report of shoulder pain. All patients completed the outcome measures at baseline and at follow-up. Patients completed a modified Fear-Avoidance Beliefs Questionnaire (FABQ), the 11-item version of Tampa Scale of Kinesiophobia (TSK-11), and the Shoulder Pain and Disability Index (SPADI) at baseline and at a 48-hour follow-up. Patients were dichotomized as improved or stable at follow-up based on the Global Rating of Change. Factor analysis indicated 3 stable factors for the FABQ and 1 stable factor for the TSK-11. Shoulder specific scoring for the FABQ and TSK-11 were used in subsequent analyses. Test-retest reliability intraclass correlation coefficient (ICC) was substantial for the FABQ and the TSK-11. The FABQ correlated significantly with SPADI pain and disability scores, while the TSK-11 correlated significantly only with SPADI pain scores. The shoulder-specific FABQ-W (work beliefs subscale) was a better than chance predictor of missing days of work during the 48-hour study period. The modified FABQ and TSK-11 may be appropriate for use in patients with shoulder pain. Shoulder-specific scoring of these measures resulted in substantial test-retest reliability, and the FABQ correlated with the SPADI for pain and disability. The FABQ also showed potential for prediction of short-term work loss in this sample. Pain-related fear may be an important variable in patients with shoulder pain and merits future consideration in longitudinal studies.",Mintken PE.; Cleland JA.; Whitman JM.; George SZ.,2010.0,10.1016/j.apmr.2010.04.009,0,0,
8870,No effect of adding brief dynamic therapy to pharmacotherapy in the treatment of obsessive-compulsive disorder with concurrent major depression.,"Until now no studies have investigated the benefits of adding brief dynamic therapy (BDT) to medication in obsessive-compulsive disorder (OCD), while a number of recent investigations have demonstrated the efficacy of supplemental BDT among patients with major depressive disorders (MDD). The objective of the present study was to explore the efficacy of BDT combined with pharmacotherapy in comparison with pharmacotherapy alone in the treatment of OCD with concurrent MDD. A 12-month randomized clinical trial compared a standard selective serotonin reuptake inhibitor treatment with (n = 27) or without (n = 30) supplemental BDT in patients with OCD and concurrent MDD. Supplemental BDT was added during the first 16-week trial; all patients continued to be treated with only pharmacotherapy in the following continuation phase. The primary efficacy assessments were the Yale-Brown Obsessive Compulsive Scale and the 17-item Hamilton Rating Scale for Depression; the secondary efficacy measures included the Clinical Global Impression scale and the Global Assessment of Functioning. The data analysis was conducted on the 'intent-to-treat (ITT) efficacy patient sample'. Fifty patients completed the study. No difference between the 2 treatment groups was found at any point by any assessment method in the ITT study sample. Supplemental BDT in the treatment of patients with OCD with concurrent MDD who are receiving effective medication has no significant clinical effect on both obsessive and depressive symptoms.",Maina G.; Rosso G.; Rigardetto S.; Chiadò Piat S.; Bogetto F.,2010.0,10.1159/000318296,0,0,
8871,A video Clinical Global Impression (CGI) in obsessive compulsive disorder.,"The Clinical Global Impression scale (CGI) is frequently used in clinical research because of its face validity and ease of use but data on its reliability are scarce. Our goal was to estimate the reliability of the scale and compare reliability between face-to-face and video scoring. We analyzed 50 different video interviews recorded during 5 visits of a crossover trial to study the effect of subthalamic nucleus stimulation. Six specialized clinicians rated the CGI using these videos, providing 300 different ratings. The intraclass correlation was lower at inclusion (0.30 [0.13-0.50]) than at later visits (0.68 [0.61-0.80]). Reliability was not influenced by the patients' stimulation status. The mean of at least two independent evaluations of the video is needed to achieve an ICC greater than 0.8. The video CGI is a valid clinical outcome measure suitable for clinical trials (ClinicalTrials.gov number, NCT00169377).",Bourredjem A.; Pelissolo A.; Rotge JY.; Jaafari N.; Machefaux S.; Quentin S.; Bui E.; Bruno N.; Pochon JB.; Polosan M.; Baup N.; Papetti F.; Chéreau I.; Arbus C.; Mallet L.; du Montcel ST.;  .,2011.0,10.1016/j.psychres.2010.06.021,0,0,
8872,"Efficacy of ECT in chronic, severe, antidepressant- and CBT-refractory PTSD: an open, prospective study.","Treatment options are limited in patients with severe, chronic, posttraumatic stress disorder (PTSD). There is little information on the use of electroconvulsive therapy (ECT) for PTSD. Between January 1, 2005, and December 31, 2005, all consenting adults (n=20) with severe, chronic, extensively antidepressant-refractory PTSD were prospectively treated with a fixed course of 6 bilateral ECT treatments administered on an outpatient basis at a twice-weekly frequency. The primary outcome measure was improvement on the Clinician-Administered Posttraumatic Stress Disorder Scale (CAPS). Baseline refractoriness was defined as a failure to respond to an adequate course of at least 4 different antidepressant drugs along with 12 sessions of cognitive behavior therapy. Response to ECT was defined as at least 30% attenuation of CAPS ratings, and remission as an endpoint CAPS score of 20 or less. After ECT, patients were prescribed sertraline (100-150 mg/day) or mirtazapine (15-30 mg/day). All but 3 patients completed the ECT course. An intent-to-treat analysis (n=20) showed statistically and clinically significant improvement in the sample as a whole: CAPS scores decreased by a mean of 34.4%, and depression scores by a mean of 51.1%. Most of the improvement in CAPS and depression ratings developed by the third ECT; that is, by day 10 of treatment, itself. The improvement in CAPS ratings was independent of the improvement in depression ratings; and improvement in CAPS did not differ significantly between patients with less severe vs more severe baseline depression. The response rate was 70%; no patient remitted. In the completer analysis (n=17), mean improvements were 40% and 57% for CAPS and depression ratings, respectively, and the response rate was 82%. Treatment gains were maintained at a 4-6 month follow-up. ECT may improve the core symptoms of PTSD independently of improvement in depression, and may therefore be a useful treatment option for patients with severe, chronic, medication- and CBT-refractory PTSD.",Margoob MA.; Ali Z.; Andrade C.,2010.0,10.1016/j.brs.2009.04.005,0,0,
8873,"The safety and efficacy of {+/-}3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study.","Case reports indicate that psychiatrists administered ±3,4-methylenedioxymethamphetamine (MDMA) as a catalyst to psychotherapy before recreational use of MDMA as 'Ecstasy' resulted in its criminalization in 1985. Over two decades later, this study is the first completed clinical trial evaluating MDMA as a therapeutic adjunct. Twenty patients with chronic posttraumatic stress disorder, refractory to both psychotherapy and psychopharmacology, were randomly assigned to psychotherapy with concomitant active drug (n = 12) or inactive placebo (n = 8) administered during two 8-h experimental psychotherapy sessions. Both groups received preparatory and follow-up non-drug psychotherapy. The primary outcome measure was the Clinician-Administered PTSD Scale, administered at baseline, 4 days after each experimental session, and 2 months after the second session. Neurocognitive testing, blood pressure, and temperature monitoring were performed. After 2-month follow-up, placebo subjects were offered the option to re-enroll in the experimental procedure with open-label MDMA. Decrease in Clinician-Administered PTSD Scale scores from baseline was significantly greater for the group that received MDMA than for the placebo group at all three time points after baseline. The rate of clinical response was 10/12 (83%) in the active treatment group versus 2/8 (25%) in the placebo group. There were no drug-related serious adverse events, adverse neurocognitive effects or clinically significant blood pressure increases. MDMA-assisted psychotherapy can be administered to posttraumatic stress disorder patients without evidence of harm, and it may be useful in patients refractory to other treatments.",Mithoefer MC.; Wagner MT.; Mithoefer AT.; Jerome L.; Doblin R.,2011.0,10.1177/0269881110378371,0,0,
8874,Using the oxygen-cost diagram in ramp-slope selection for dyspneic patients.,"Maximal incremental exercise testing should be completed within 8-12 minutes. The ramp-slope influences the exercise duration. Oxygen-cost diagram (OCD) is a scoring scale for the capability of daily activity performed and therefore can be used to estimate the ramp-slope. The OCD-algorithm and the reported-algorithm were used prospectively in random order for selecting optimal ramp-slope: Ramp-slope(OCD)=Score(OCD)xweight in kg/40 for men and weight/50 for women and Ramp-slope(reported)=(Predicted V(O2peak)-V(O2unloaded))/100. Fifty-three dyspneic patients and 16 normal controls were enrolled to perform a ramp-pattern exercise. Fourteen patients not reaching maximum exercise levels were excluded. The exercise capacity, exercise time, and success rate of loaded exercise between 8 and 12 minutes were measured. Comparing the reported-algorithm to the OCD-algorithm in normal controls, the only difference was that the ramp-slope was higher in males; in patients, the ramp-slope was higher in males, the exercise time shorter and the success rate lower (8.6+/-3.3 vs. 9.4+/-2.1 min, 61.5% vs. 84.6%, both p<0.05); in obese patients, the ramp-slope was lower and the exercise time longer. OCD score can predict the ramp-slope selection for exercise testing in normal controls and dyspneic patients. This may be affected by gender and body weight when using the reported-algorithm for dyspneic patients.",Chuang ML.; Lee CH.; Lin IF.,2010.0,,0,0,
8875,Dialectical behavior therapy as a precursor to PTSD treatment for suicidal and/or self-injuring women with borderline personality disorder.,"This study examined the efficacy of dialectical behavior therapy (DBT) in reducing behaviors commonly used as exclusion criteria for posttraumatic stress disorder (PTSD) treatment. The sample included 51 suicidal and/or self-injuring women with borderline personality disorder (BPD), 26 (51%) of whom met criteria for PTSD. BPD clients with and without PTSD were equally likely to eliminate the exclusionary behaviors during 1 year of DBT. By posttreatment, 50-68% of the BPD clients with PTSD would have been suitable candidates for PTSD treatment. Borderline personality disorder clients with PTSD who began treatment with a greater number of recent suicide attempts and more severe PTSD were significantly less likely to become eligible for PTSD treatment.",Harned MS.; Jackson SC.; Comtois KA.; Linehan MM.,2010.0,10.1002/jts.20553,0,0,
8876,Effects of additional prolonged exposure to psychoeducation and relaxation in acute stress disorder.,"We investigated the effect of prolonged exposure (PE) on the heart rate (HR) and skin conductance response to trauma-related stimuli in acute stress disorder (ASD). Forty recent trauma victims with ASD were randomly assigned to three sessions of either PE or supportive counseling (SC) with both groups also receiving psychoeducation and progressive relaxation. Assessments were carried out before and after treatment and again after 3 months. Four years later, patients were asked by telephone whether they had received further treatment. There were no significant group differences with regard to symptomatic improvement at the end of treatment. Both groups showed initial cardiac acceleration to trauma-related pictures. After treatment the PE group showed attenuation of the HR response and a reduction in spontaneous fluctuations (SF) whereas the SC group showed a decelerative (orienting) response and a marginal increase in SF. Following SC, 43% received further treatment compared to 9% after PE.",Freyth C.; Elsesser K.; Lohrmann T.; Sartory G.,2010.0,10.1016/j.janxdis.2010.06.016,0,0,
8877,"Suicidal, abused African American women's response to a culturally informed intervention.","This study examined (a) the efficacy of a manualized, culturally informed, empowerment-focused psychoeducational group intervention (Nia) designed in accord with the theory of triadic influence or treatment as usual (TAU) for reducing psychological symptomatology (suicidal ideation, depressive symptoms, posttraumatic stress symptoms, general psychological distress), and (b) the effect of Nia versus TAU on the relation between exposure to intimate partner violence (IPV) and psychological symptomatology in these women. Two hundred eight low-socioeconomic-status African American women with a recent history of IPV and a suicide attempt were randomized to Nia or TAU and assessed at baseline, postintervention, and 6- and 12-month follow-up. They were assessed on their levels of IPV (Index of Spouse Abuse), suicidal ideation (Beck Scale for Suicidal Ideation), depressive symptoms (Beck Depression Inventory-II), posttraumatic stress symptoms, and general psychological distress (Brief Symptom Inventory). Hierarchical linear modeling found that women receiving the culturally informed Nia intervention showed more rapid reductions in depressive symptoms and general distress initially, and the between-group difference in depressive symptoms persisted at follow-up. Following intervention, compared with women randomized to TAU, women in Nia exhibited less severe suicidal ideation when exposed to physical and nonphysical IPV. Findings highlight the value of incorporating Nia as an adjunctive intervention for abused, suicidal, low-income women. They underscore the ways the intervention needs to be bolstered to address more directly more mediating and moderating constructs, as well as the need to target more effectively the key outcomes.",Kaslow NJ.; Leiner AS.; Reviere S.; Jackson E.; Bethea K.; Bhaju J.; Rhodes M.; Gantt MJ.; Senter H.; Thompson MP.,2010.0,10.1037/a0019692,0,0,
8878,A randomised pilot of a self-help workbook intervention for breast cancer survivors.,"The aim of this study is to evaluate the efficacy of a self-help workbook for improving adjustment for breast cancer survivors. An RCT compared the workbook (n = 20) with no-workbook controls (n = 20). Coping, traumatic stress and quality of life were measured at baseline, then 3 and 6 months later. No interactions were found. A significant group main effect was found for venting coping; controls used less venting coping than workbook participants (p = 0.034). A significant time main effect was obtained for cognitive functioning (p = 0.003). Reliable change indices showed a trend towards a protective effect across all coping measures for workbook participants compared to controls. Qualitative feedback suggested that participants felt well supported by the intervention, but would have preferred receiving it during treatment. While trends showed some promise for improving coping, endorsement for the workbook was not obtained. The difficulties encountered in recruiting survivors and the resulting implications regarding the feasibility of offering self-help resources to this population are discussed.",Beatty L.; Oxlad M.; Koczwara B.; Wade TD.,2010.0,10.1007/s00520-010-0962-2,0,0,
8879,"A brief motivational interview in a pediatric emergency department, plus 10-day telephone follow-up, increases attempts to quit drinking among youth and young adults who screen positive for problematic drinking.","Adolescents in their late teens and early 20s have the highest alcohol consumption in the United States; binge drinking peaks at age 21-25 years. Underage drinking is associated with many negative consequences, including academic problems and risk of intentional and unintentional injuries. This study tested the effectiveness of pediatric emergency department (PED) screening and brief intervention to reduce alcohol consumption and associated risks. A three-group randomized assignment trial was structured to test differences between intervention (I) and standard assessed control (AC) groups in alcohol consumption and alcohol-related behaviors from baseline to 12 months and to compare the AC group with a minimally assessed control (MAC) group to adjust for the effect of assessment reactivity on control group behavior. Patients aged 14-21 years were eligible if they screened positive on the Alcohol Use Disorders Identification Test (AUDIT) or for binge drinking or high-risk behaviors. The MAC group received a resource handout, written advice about alcohol-related risks, and a 12-month follow-up appointment. Patients in the AC group were assessed using standardized instruments in addition to the MAC protocol. The I group received a peer-conducted motivational intervention, referral to community resources and treatment if indicated, and a 10-day booster in addition to assessment. Measurements included 30-day self-report of alcohol consumption and alcohol-related behaviors, screens for depression and posttraumatic stress disorder, and self-report of attempts to quit, cut back, or change conditions of use, all repeated at follow-up. Motor vehicle records and medical records were also analyzed for changes from baseline to 1-year follow-up. Among 7,807 PED patients screened, 1,202 were eligible; 853 enrolled (I, n = 283; AC, n = 284; MAC, n = 286), with a 12-month follow-up rate of 72%. At 12 months, more than half of enrollees in Reaching Adolescents for Prevention (RAP) attempted to cut back on drinking, and over a third tried to quit. A significantly larger proportion of the I group made efforts to quit drinking and to be careful about situations when drinking compared to AC enrollees, and there was a numerically but not significantly greater likelihood (p = 0.065) among the I group for efforts to cut back on drinking. At 3 months, the likelihood of the I group making attempts to cut back was almost triple that of ACs. For efforts to quit, it was double, and for trying to be careful about situations when drinking, there was a 72% increase in the odds ratio (OR) for the I group. Three-month results for attempts were sustained at 12 months for quit attempts and efforts to be careful. Consumption declined in both groups from baseline to 3 months to 12 months, but there were no significant between-group differences in alcohol-related consequences at 12 months or in alcohol-related risk behaviors. We found a pattern suggestive of assessment reactivity in only one variable at 12 months: the attempt to cut back (73.3% for the I group vs. 64.9% among the AC group and 54.8% among the MAC group). Brief motivational intervention resulted in significant efforts to change behavior (quit drinking and be careful about situations while drinking) but did not alter between-group consumption or consequences.",Bernstein J.; Heeren T.; Edward E.; Dorfman D.; Bliss C.; Winter M.; Bernstein E.,2010.0,10.1111/j.1553-2712.2010.00818.x,0,0,
8880,Movement decoupling: A self-help intervention for the treatment of trichotillomania.,"Trichotillomania (TTM) is classified as an impulse control disorder characterized by the recurrent urge to pull out one's own hair resulting in noticeable hair loss. Cognitive-behavioral therapy, involving habit reversal training, currently represents the treatment of choice. The present study assessed the feasibility and effectiveness of a novel self-help technique, entitled decoupling (DC). DC aims at attenuating TTM by performing movements that decouple the behavioral elements involved in hair pulling. A total of 42 subjects with TTM were recruited via self-help forums for TTM and were randomized either to DC or progressive muscle relaxation (PMR). After four weeks, participants were asked to fill out the same questionnaires as before and rate the effectiveness of the intervention. The completion rate was high and the reliability of the assessments at least satisfactory. The DC group showed a significantly greater decline on the Massachusetts General Hospital - Hair-Pulling Scale, which served as the primary outcome, relative to PMR indicating a medium to strong effect size. Declines on scales tapping depression and obsessive-compulsive disorder were comparable between the two groups. Despite some methodological limitations and the need for replication including follow-up and expert ratings, the present study suggests that DC may prove beneficial to a substantial number of individuals affected with TTM.",Moritz S.; Rufer M.,2011.0,10.1016/j.jbtep.2010.07.001,0,0,
8881,A cluster randomized controlled trial to determine the efficacy of Trauma Risk Management (TRiM) in a military population.,"Trauma Risk Management is a peer-support program that aims to promote help-seeking in the aftermath of traumatic events. Prior to its implementation, the British military conducted a randomized controlled trial of Trauma Risk Management against standard care in 12 warships; 6 were randomized to use Trauma Risk Management after collecting baseline measurements. Follow up after 12-18 months found no significant change in psychological health or stigma scores in either group; however, the studied vessels only encountered low numbers of critical incidents. Additionally, measurements of organizational functioning were modestly better in the Trauma Risk Management ships. The authors conclude that within organizations using Trauma Risk Management may be beneficial and may, in time, lead to a valuable cultural shift.",Greenberg N.; Langston V.; Everitt B.; Iversen A.; Fear NT.; Jones N.; Wessely S.,2010.0,10.1002/jts.20538,0,0,
8882,"Knock, and it will be opened to you? An evaluation of meridian-tapping in obsessive-compulsive disorder (OCD).","Meridian-tapping (MT) is a body-oriented therapeutic technique which among other psychological problems targets anxiety disorders. Despite bold claims by some of its advocates that it brings lasting success in the vast majority of patients with anxiety disorders, solid empirical evidence for its effectiveness is scarce and its theoretical foundations are refuted by many scientists. The present study tested the effectiveness of a published MT self-help approach for obsessive-compulsive disorder (OCD). Following a baseline assessment over the internet including standard outcome measures for OCD (Y-BOCS, OCI-R) and depression (BDI-SF), 70 participants with OCD were randomly allocated to MT or to progressive muscle relaxation (PMR). Four weeks after the dispatch of the self-help manuals (including video demonstrations of the technique), participants were requested to take part in a post assessment. Whereas subjects found MT more helpful than PMR in retrospect (39% versus 19%) and would continue to use it in the future (72% versus 48%) there was no evidence for a stronger decline of OCD symptoms under MT on any of the psychometric measures. Moreover, Y-BOCS scores did not significantly change across time for both interventions. The present study does not support bold claims about the effectiveness of MT as a stand-alone technique. Cognitive-behavioral therapy remains the treatment of choice for OCD. While self-help MT may enhance the well-being of a subgroup of participants, its potential for OCD appears to be small. Exaggerated success claims on the effectiveness of MT in conjunction with degrading appraisals of conventional psychotherapy as made by some of its leading figures may in our view foster fatalism in patients not experiencing major symptom relief by MT.",Moritz S.; Aravena SC.; Guczka SR.; Schilling L.; Eichenberg C.; Raubart G.; Seebeck A.; Jelinek L.,2011.0,10.1016/j.jbtep.2010.07.002,0,0,
8883,Anxiety disorders among methamphetamine dependent adults: association with post-treatment functioning.,"Although anxiety is one of the most prominent psychiatric complaints of methamphetamine (MA) users, little is known about the association between anxiety disorders and treatment outcomes in this population. Using data from 526 adults in the largest psychosocial clinical trial of MA users conducted to date, this study examined psychiatric, substance use, and functional outcomes of MA users with concomitant anxiety disorders 3 years after treatment. Anxiety disorders were associated with poorer alcohol and drug use outcomes, increased health service utilization, and higher levels of psychiatric symptomatology, including suicidality. Addressing anxiety symptoms and syndromes in MA users may be helpful as a means of optimizing treatment outcomes.",Glasner-Edwards S.; Mooney LJ.; Marinelli-Casey P.; Hillhouse M.; Ang A.; Rawson R.;  .,,10.1111/j.1521-0391.2010.00061.x,0,0,
8884,Feelings of betrayal by the United Nations High Commissioner for Refugees and emotionally distressed Sudanese refugees in Cairo.,"Thousands of Sudanese refugees have fled to Cairo, Egypt in the wake of Sudanese civil conflicts. Sudanese refugees were evaluated with respect to symptoms of depression, post-traumatic stress disorder (PTSD) and social stress. Four respondents (22%) indicated that their interactions with the United Nations High Commissioner for Refugees (UNHCR) in Cairo, Egypt were the worst experiences since war-related atrocities. Fourteen participants (63.6%) felt 'extremely' betrayed by the UNHCR on a four point scale. Greater feelings of betrayal by the UNHCR were associated with greater avoidance and arousal symptoms of PTSD, symptoms of depression and trait anger. This is the first study of which we are aware that examines the relationship between sense of betrayal by the UNHCR and symptoms of PTSD, depression and anger among asylum seekers.",Meffert SM.; Musalo K.; Abdo AO.; Alla OA.; Elmakki YO.; Omer AA.; Yousif S.; Metzler TJ.; Marmar CR.,,10.1080/13623699.2010.491395,0,0,7254
8885,"Relationship between respiratory, endocrine, and cognitive-emotional factors in response to a pharmacological panicogen.","The cholecystokinin agonist pentagastrin has been used to study panic attacks in the laboratory and to investigate hypothalamic-pituitary-adrenal axis activity. Its mechanism of panicogenesis remains unclear. Data from other models suggest that respiratory stimulation itself may induce panic, but pentagastrin's effects on respiration are not well established. Data from another model also suggest links between respiratory and HPA axis reactivity and cognitive modulation of both. To further explore these phenomena, we added respiratory measures to a study of cognitive modulation of HPA and anxiety responses to pentagastrin. Healthy subjects received pentagastrin and placebo injections, with measurement of cortisol and subjective responses, on two different laboratory visits. They were randomly assigned to receive standard instructions or one of two versions of previously studied cognitive interventions (to either facilitate coping or increase sense of control), given before each visit. Capnograph measures of heart rate (HR), respiratory rate (RR), and end-tidal pCO(2) were obtained on 24 subjects. Relative to placebo, pentagastrin induced a significant decline in pCO(2) with no change in RR. Cortisol and HR increased, as expected. Cognitive intervention reduced the hyperventilatory response to pentagastrin. Pentagastrin stimulates respiration, likely via increases in tidal volume. Respiratory stimulation could play a role in its panicogenic potency, though perhaps indirectly. As with HPA axis responses, higher-level brain processes may be capable of modulating pentagastrin-induced hyperventilation. This model may be useful for further study of cortical/cognitive control of interacting emotional, respiratory, and neuroendocrine sensitivities, with potential relevance to panic pathophysiology.",Lyubkin M.; Giardino ND.; Abelson JL.,2010.0,10.1002/da.20725,0,0,
8886,An attempt to treat patients who have injured spinal cords with intralesional implantation of concentrated autologous bone marrow cells.,"Spinal cord injury is common among young subjects involved in motor vehicle accidents. Mechanisms and attempts to reverse post-traumatic pathophysiologic consequences are still being investigated. Unfortunately no effective and well-established treatment modality has been developed so far. The regeneration capability of the human nervous system following an injury is highly limited. The study involved four patients (two male, two female) who had suffered spinal cord injury as a result of various types of trauma. On neurologic examination, all the patients were determined to be in American Spinal Injury Association (ASIA) grade A. All patients were treated with decompression, stabilization and fusion for vertebral trauma anteriorly, as well as intralesional implantation of cellular bone marrow concentrates using a posterior approach 1 month after the first operation. The patients were then treated and followed-up in the physical rehabilitation clinic. At the end of the post-operative 1-year follow-up, two of the patients were classified as ASIA C while one was classified as ASIA B. One patient showed no neurologic change; none of the patients suffered from any complications or adverse effects as a result of intralesional application of bone marrow cells. The results of this experimental study show the potential contribution of intralesional implantation of bone marrow to neuronal regeneration in the injured spinal cord, with neuronal changes. In light of the results of this experimental study, the potential for regenerative treatment in injuries of the human spinal cord is no longer a speculation but an observation.",Attar A.; Ayten M.; Ozdemir M.; Ozgencil E.; Bozkurt M.; Kaptanoglu E.; Beksac M.; Kanpolat Y.,2011.0,10.3109/14653249.2010.510506,0,0,
8887,Marijuana craving during a public speaking challenge: Understanding marijuana use vulnerability among women and those with social anxiety disorder.,"Social anxiety disorder (SAD) is associated with risk for developing marijuana dependence, yet it remains unclear whether urge to use marijuana increases in anticipation of social anxiety-provoking situation, during the situation, or afterwards (to avoid post-event processing). The present study examined the timing of marijuana craving in response to a social anxiety task among 60 (50% female; 33% with SAD) marijuana users randomly assigned to either a speech or reading task. Participants completed ratings of marijuana craving at baseline (prior to being informed of task assignment), before, during, and after task. Among women and participants with SAD, the speech task was associated with greater craving than the reading task. This effect was particularly pronounced during the social anxiety induction task. This effect was not observed for men or participants without SAD. Identification of timing of urge to use marijuana has important implications for treatment and relapse prevention of marijuana problems among women and people with SAD (a group at particular risk for marijuana-related problems).",Buckner JD.; Silgado J.; Schmidt NB.,2011.0,10.1016/j.jbtep.2010.07.005,0,0,
8888,Comorbid anxiety disorders and treatment of depression in people with multiple sclerosis.,"Anxiety is highly comorbid with depression, but little is known about the impact of anxiety disorders on the effectiveness of empirically supported psychotherapies for depression. We examined such outcomes for people with Multiple Sclerosis (MS) and depression, with versus without comorbid anxiety disorders. Participants with MS (N = 102) received 16 weeks of telephone-administered psychotherapy for depression and were followed for one year post-treatment. Participants with comorbid anxiety disorders improved to a similar degree during treatment as those without anxiety disorders. Outcomes during follow-up were mixed, and thus we divided the anxiety diagnoses into distress and fear disorders. The distress disorder (GAD) was associated with elevated anxiety symptoms during and after treatment. In contrast, fear disorders (i.e., panic disorder, agoraphobia, social phobia, specific phobia) were linked to depression, specifically during follow-up, across 3 different measures. People with GAD receiving treatment for depression may benefit from additional services targeting anxiety more specifically, while those with comorbid fear disorders may benefit from services targeting maintenance of gains after treatment.",Burns MN.; Siddique J.; Fokuo JK.; Mohr DC.,2010.0,10.1037/a0020492,0,0,
8889,ICU care associated with symptoms of depression and posttraumatic stress disorder among family members of patients who die in the ICU.,"Psychologic symptoms of posttraumatic stress disorder (PTSD) and depression are relatively common among family members of patients who die in the ICU. The patient-level risk factors for these family symptoms are not well understood but may help to target future interventions. We performed a cohort study of family members of patients who died in the ICU or within 30 h of ICU transfer. Outcomes included self-reported symptoms of PTSD and depression. Predictors included patient demographics and elements of palliative care. Two hundred twenty-six patients had chart abstraction and family questionnaire data. Family members of older patients had lower scores for PTSD (P = .026). Family members that were present at the time of death (P = .021) and family members of patients with early family conferences (P = .012) reported higher symptoms of PTSD. When withdrawal of a ventilator was ordered, family members reported lower symptoms of depression (P = .033). There were no other patient characteristics or elements of palliative care associated with family symptoms. Family members of younger patients and those for whom mechanical ventilation is not withdrawn are at increased risk of psychologic symptoms and may represent an important group for intervention. Increased PTSD symptoms among family members present at the time of death may reflect a closer relationship with the patient or more involvement with the patient's ICU care but also suggests that family should be offered the option of not being present.",Kross EK.; Engelberg RA.; Gries CJ.; Nielsen EL.; Zatzick D.; Curtis JR.,2011.0,10.1378/chest.10-0652,0,0,
8890,"Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: a randomised, controlled trial.","Patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD). This study was to evaluate whether a prospectively collected diary of a patient's intensive care unit (ICU) stay when used during convalescence following critical illness will reduce the development of new onset PTSD. Intensive care patients with an ICU stay of more than 72 hours were recruited to a randomised controlled trial examining the effect of a diary outlining the details of the patients ICU stay on the development of acute PTSD. The intervention patients received their ICU diary at 1 month following critical care discharge and the final assessment of the development of acute PTSD was made at 3 months. 352 patients were randomised to the study at 1 month. The incidence of new cases of PTSD was reduced in the intervention group compared to the control patients (5% versus 13%, P = 0.02). The provision of an ICU diary is effective in aiding psychological recovery and reducing the incidence of new PTSD. NCT00912613.",Jones C.; Bäckman C.; Capuzzo M.; Egerod I.; Flaatten H.; Granja C.; Rylander C.; Griffiths RD.;  .,2010.0,10.1186/cc9260,0,0,
8891,Health status after open elbow contracture release.,"Operative contracture release may improve motion of a posttraumatic stiff elbow. In this study, we tested the hypothesis that improvement in ulnohumeral motion after elbow contracture release leads to improvement in general health status and decreases upper-extremity-specific disability. Twenty-three patients with posttraumatic loss of ≥30° of elbow flexion or extension who elected to have an open elbow capsulectomy completed the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) and the Short Form-36 (SF-36) preoperatively and at least one year postoperatively. Pain was measured with use of the American Shoulder and Elbow Surgeons (ASES) Elbow Evaluation instrument. Four patients underwent additional, subsequent procedures to address residual elbow stiffness. One patient who needed several additional procedures, including a total elbow arthroplasty, was considered to have had a failure of the operative contracture release and was excluded from the analysis; this left twenty-two patients in the study. On the average, the arc of flexion and extension improved from 51° preoperatively to 106° postoperatively; the DASH score, from 38 points to 18 points; the SF-36 Physical Component Summary (PCS) score, from 39 points to 49 points (all p < 0.05); and the SF-36 Mental Component Summary (MCS) score, from 49 points to 54 points (p < 0.05). There was no significant correlation between the improvement in the arc of flexion and extension and the improvement in the DASH (p = 0.53), PCS (p = 0.73), or MCS (p = 0.41) score. There also was no correlation between the final arc of flexion and extension and the final DASH score (p = 0.39 for the total score, p = 0.52 for the PCS score, and p = 0.42 for the MCS score). Health status and disability scores improve after open elbow contracture release, but the improvements do not correlate with the improvement in elbow motion. Among multiple objective and subjective factors, pain was a strong predictor of the final general health status and arm-specific disability.",Lindenhovius AL.; Doornberg JN.; Ring D.; Jupiter JB.,2010.0,10.2106/JBJS.H.01594,0,0,
8892,Anxiety and depression in patients with inflammatory bowel disease: comparisons with chronic liver disease patients and the general population.,"Studies on anxiety and depression in inflammatory bowel disease (IBD) yielded inconsistent results. We compared anxiety and depression of patients with Crohn's disease (CD) and ulcerative colitis (UC) controlled for sociodemographic and medical variables with age- and sex-matched controls. In all, 422 IBD patients (50% females, 314 CD, 108 UC) of different settings were compared with 140 age- and sex-matched patients with chronic liver diseases (CLD) of a tertiary care center and with 422 age- and sex-matched persons of a representative sample of the general German population (GP). Anxiety and depression and probable mental disorder were assessed by the German version of the Hospital Anxiety and Depression Scale. Comparisons between CD and UC were adjusted for medical (disease activity, number of IBD-associated diseases) and sociodemographic factors (age, gender, marital status). CD and UC patients did not differ in the levels of anxiety and depression or in the frequency of a probable mental disorder. The levels of anxiety and depression of IBD patients with active disease were higher than that of the GP, but not of the IBD patients in remission. The depression score of the CLD sample was higher than that of the IBD sample (P<0.001), but not the anxiety score. Mental disorders were more frequent in IBD patients with slight (27.7%) and moderate/severe disease activity (49.3%) compared to GP (10.4%) (P<0.001), but not in IBD patients in remission (11.3%). Patients with active IBD should be screened for anxiety and depression.",Häuser W.; Janke KH.; Klump B.; Hinz A.,2011.0,10.1002/ibd.21346,0,0,
8893,Association between substance use disorder status and pain-related function following 12 months of treatment in primary care patients with musculoskeletal pain.,"The goal of this study was to examine relationships between substance use disorder (SUD) history and 12-month outcomes among primary care patients with chronic noncancer pain (CNCP). Patients were enrolled in a randomized trial of collaborative care intervention (CCI) versus treatment as usual (TAU) to improve pain-related physical and emotional function. At baseline, 72 of 362 patients (20.0%) had a history of SUD. Compared to CNCP patients without SUD, those with comorbid SUD had poorer pain-related function and were more likely to meet criteria for current major depression and posttraumatic stress disorder (all P values <.05). Logistic regression analyses were conducted to examine whether SUD status was associated with clinically significant change over 12 months in pain-related function (30% reduction in Roland Morris Disability Questionnaire Score). The overall model was not significant in the CCI group. However, within the TAU group, participants with a SUD history were significantly less likely to show improvements in pain-related function (OR = .30, 95% CI = .11-.82). CNCP patients with comorbid SUD reported greater functional impairment at baseline. Patients with SUD who received usual care were 70% less likely to have clinically significant improvements in pain-related function 12 months postbaseline, and SUD status did not impede improvement for the CCI group. Chronic noncancer pain patients with a history of a substance use disorder (SUD) report poorer pain-related functioning and are less likely to experience clinically significant improvements from usual pain treatment. Providers should assess for SUD status and provide more intensive interventions for these patients.",Morasco BJ.; Corson K.; Turk DC.; Dobscha SK.,2011.0,10.1016/j.jpain.2010.07.010,0,0,
8894,Prolonged exposure versus dynamic therapy for adolescent PTSD: a pilot randomized controlled trial.,"To examine the efficacy and maintenance of developmentally adapted prolonged exposure therapy for adolescents (PE-A) compared with active control time-limited dynamic therapy (TLDP-A) for decreasing posttraumatic and depressive symptoms in adolescent victims of single-event traumas. Thirty-eight adolescents (12 to 18 years old) were randomly assigned to receive PE-A or TLDP-A. Both treatments resulted in decreased posttraumatic stress disorder and depression and increased functioning. PE-A exhibited a greater decrease of posttraumatic stress disorder and depression symptom severity and a greater increase in global functioning than did TDLP-A. After treatment, 68.4% of adolescents beginning treatment with PE-A and 36.8% of those beginning treatment with TLDP-A no longer met diagnostic criteria for posttraumatic stress disorder. Treatment gains were maintained at 6- and 17-month follow-ups. Brief individual therapy is effective in decreasing posttraumatic distress and behavioral trauma-focused components enhance efficacy. CLINICAL TRIAL REGISTRY INFORMATION: Prolonged Exposure Therapy Versus Active Psychotherapy in Treating Post-Traumatic Stress Disorder in Adolescents, URL: http://clinicaltrials.gov, unique identifier: NCT00183690.",Gilboa-Schechtman E.; Foa EB.; Shafran N.; Aderka IM.; Powers MB.; Rachamim L.; Rosenbach L.; Yadin E.; Apter A.,2010.0,10.1016/j.jaac.2010.07.014,0,0,
8895,Effects of safety behaviors on fear reduction during exposure.,"The use of safety behaviors has been considered one of the primary maintaining mechanisms of anxiety disorders; however, evidence suggests that they are not always detrimental to treatment success (Milosevic & Radomsky, 2008). This study examined the effects of safety behaviors on behavioral, cognitive, and subjective indicators of fear during exposure for fear of spiders. A two-stage design was used to examine fear reduction and approach distance during an in vivo exposure task for participants (N=43) assigned to either a safety behavior use (SBU) or no safety behavior use (NSB) condition. Overall, both groups reported significant and comparable reductions in self-reported anxiety and negative beliefs about spiders at posttest and 1-week follow-up. Participants in the SBU group approached the spider more quickly than did participants in the NSB condition; however, participants in the SBU condition showed a small but significant decrease in approach distance at follow-up. These results call for a reconceptualization of the impact of safety behaviors on in vivo exposure.",Hood HK.; Antony MM.; Koerner N.; Monson CM.,2010.0,10.1016/j.brat.2010.08.006,0,0,
8896,Respiratory and cognitive mediators of treatment change in panic disorder: evidence for intervention specificity.,"There are numerous theories of panic disorder, each proposing a unique pathway of change leading to treatment success. However, little is known about whether improvements in proposed mediators are indeed associated with treatment outcomes and whether these mediators are specific to particular treatment modalities. Our purpose in this study was to analyze pathways of change in theoretically distinct interventions using longitudinal, moderated mediation analyses. Forty-one patients with panic disorder and agoraphobia were randomly assigned to receive 4 weeks of training aimed at altering either respiration (capnometry-assisted respiratory training) or panic-related cognitions (cognitive training). Changes in respiration (PCO‚ÇÇ, respiration rate), symptom appraisal, and a modality-nonspecific mediator (perceived control) were considered as possible mediators. The reductions in panic symptom severity and panic-related cognitions and the improvements in perceived control were significant and comparable in both treatment groups. Capnometry-assisted respiratory training, but not cognitive training, led to corrections from initially hypocapnic to normocapnic levels. Moderated mediation and temporal analyses suggested that in capnometry-assisted respiratory training, PCO‚ÇÇ unidirectionally mediated and preceded changes in symptom appraisal and perceived control and was unidirectionally associated with changes in panic symptom severity. In cognitive training, reductions in symptom appraisal were bidirectionally associated with perceived control and panic symptom severity. In addition, perceived control was bidirectionally related to panic symptom severity in both treatment conditions. The findings suggest that reductions in panic symptom severity can be achieved through different pathways, consistent with the underlying models.",Meuret AE.; Rosenfield D.; Seidel A.; Bhaskara L.; Hofmann SG.,2010.0,10.1037/a0019552,0,0,
8897,How does tele-mental health affect group therapy process? Secondary analysis of a noninferiority trial.,"Video teleconferencing (VTC) is used for mental health treatment delivery to geographically remote, underserved populations. However, few studies have examined how VTC affects individual or group psychotherapy processes. This study compares process variables such as therapeutic alliance and attrition among participants receiving anger management group therapy either through traditional face-to-face delivery or by VTC. The current study represents secondary analyses of a randomized noninferiority trial (Morland et al., in press) in which clinical effectiveness of VTC delivery proved noninferior to in-person delivery. Participants were male veterans (N = 112) with posttraumatic stress disorder (PTSD) and moderate to severe anger problems. The present study examined potential differences in process variables, including therapeutic alliance, satisfaction, treatment credibility, attendance, homework completion, and attrition. No significant differences were found between the two modalities on most process variables. However, individuals in the VTC condition exhibited lower alliance with the group leader than those in the in-person condition. Mean self-leader alliance scores were 4.2 (SD = 0.8) and 4.5 (SD = 0.4), respectively, where 5 represents strongly agree and 4 represents agree with positive statements about the relationship, suggesting that participants in both conditions felt reasonably strong alliance in absolute terms. Individuals who had stronger alliance tended to have better anger outcomes, yet the effect was not strong enough to result in the VTC condition producing inferior aggregate outcomes. Our findings suggest that even if group psychotherapy via VTC differs in subtle ways from in-person delivery, VTC is a viable and effective means of delivering psychotherapy.",Greene CJ.; Morland LA.; Macdonald A.; Frueh BC.; Grubbs KM.; Rosen CS.,2010.0,10.1037/a0020158,0,0,
8898,Overcoming barriers to disseminating exposure therapies for anxiety disorders: a pilot randomized controlled trial of training methods.,"The present study evaluated methods for training mental health providers (N=46) in exposure therapies (ETs) for anxiety disorders. A pilot randomized controlled trial compared: (1) an interactive, multimedia online training (ET OLT), (2) the ET OLT plus a brief Motivational Interviewing-based intervention (ET OLT+MI), and (3) a placebo control OLT. Assessments were completed at baseline, post-training, and one-week following training. Both ET OLT and ET OLT+MI received high satisfaction ratings and were comparably effective at increasing knowledge of ETs as well as clinicians' overt efforts to learn and use the treatment. ET OLT+MI was the most effective method for improving clinicians' attitudes toward ETs. Results indicate that OLT is effective for disseminating knowledge about ETs to clinicians, and suggest that supplementing OLT with a brief MI-based intervention may be a promising direction to address potential attitudinal barriers to adopting these highly efficacious treatments.",Harned MS.; Dimeff LA.; Woodcock EA.; Skutch JM.,2011.0,10.1016/j.janxdis.2010.08.015,0,0,
8899,Sleep deprivation facilitates extinction of implicit fear generalization and physiological response to fear.,"Neuroendocrine hormones, which regulate both homeostasis and stress responses, provide homeostatic recovery and sleep suppression to brains under stress. We examined the effects of total sleep deprivation on subsequent enhancement of aversive event memory, implicit fear recognition, and fear conditioning in healthy humans. Three different recognitions (explicit event, implicit emotion, and physiological response) were assessed in two groups of 14 healthy young volunteers (sleep control and sleep deprived) with aversive (motor vehicle accident films) and nonaversive episodic memory stimuli. Both groups were tested on Day 1 of the experiment and again on Days 3 and 10; the sleep-deprived group was totally deprived of initial nocturnal sleep after the first trial on Day 1. Event recognition performances were similar in both groups throughout the study. Implicit fear recognition remained high for aversive stimuli, with generalization of implicit fear recognition occurring for nonaversive stimuli on Day 3 in the sleep control group. Physiological fear and generalized fear responses were observed for every episode, and delayed enhancement of physiological response was only observed for misidentified aversive episodes in the sleep control group on Day 3. However, in the sleep-deprived group, generalization of implicit fear recognition for nonaversive stimuli on Day 3 and all physiological and generalized fear responses on Days 3 and 10 were comprehensively extinguished. Clinically, trauma-exposed victims often experience acute insomnia, indicating that such insomnia might provide prophylactic benefits in reducing the development of posttraumatic stress disorder via extinction of the fear-magnifying effects of memory.",Kuriyama K.; Soshi T.; Kim Y.,2010.0,10.1016/j.biopsych.2010.08.015,0,0,
8900,Deep brain stimulation of the nucleus accumbens for treatment-refractory obsessive-compulsive disorder.,"Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder that affects 2% of the general population. Even when the best available treatments are applied, approximately 10% of patients remain severely afflicted and run a long-term deteriorating course of OCD. To determine whether bilateral deep brain stimulation of the nucleus accumbens is an effective and safe treatment for treatment-refractory OCD. The study consisted of an open 8-month treatment phase, followed by a double-blind crossover phase with randomly assigned 2-week periods of active or sham stimulation, ending with an open 12-month maintenance phase. Academic research. Patients Sixteen patients (age range, 18-65 years) with OCD according to DSM-IV criteria meeting stringent criteria for refractoriness to treatment were included in the study. Treatment with bilateral deep brain stimulation of the nucleus accumbens. Primary efficacy was assessed by score change from baseline on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Responders were defined by a score decrease of at least 35% on the Y-BOCS. In the open phase, the mean (SD) Y-BOCS score decreased by 46%, from 33.7 (3.6) at baseline to 18.0 (11.4) after 8 months (P < .001). Nine of 16 patients were responders, with a mean (SD) Y-BOCS score decrease of 23.7 (7.0), or 72%. In the double-blind, sham-controlled phase (n = 14), the mean (SD) Y-BOCS score difference between active and sham stimulation was 8.3 (2.3), or 25% (P = .004). Depression and anxiety decreased significantly. Except for mild forgetfulness and word-finding problems, no permanent adverse events were reported. Bilateral deep brain stimulation of the nucleus accumbens may be an effective and safe treatment for treatment-refractory OCD. isrctn.org Identifier: ISRCTN23255677.",Denys D.; Mantione M.; Figee M.; van den Munckhof P.; Koerselman F.; Westenberg H.; Bosch A.; Schuurman R.,2010.0,10.1001/archgenpsychiatry.2010.122,0,0,
8901,[Arthrodesis of the infected ankle joint: results with the Ilizarov external fixator].,"The treatment of severe bacterial infections of the ankle joint is difficult and complex. In the case of a chronic infection with destruction of the ankle joint, a tibiotalar arthrodesis with external fixation is the treatment of choice. In this study the results of ankle arthrodesis due to bacterial infection using the Ilizarov external fixator are presented. Between 2001 and 2004 37 patients (10 female, 27 male, mean age 58 years) were treated with a tibiotalar arthrodesis using the Ilizarov fixator. All patients had a confirmed infection in the course of their disease. Active infection was present in 20 patients at the time of the operation. Most secondary ankle arthritides (81 %) were caused post-traumatically after various internal fixation procedures. Previous ankle arthrodeses were tried in 14 cases (12 cases with internal fixation, two cases with external monolateral fixation). Patients were treated with a four-ring Ilizarov frame (in two cases with a five-ring frame) and stainless steel wires. All patients could be included at a mean follow-up of 46 (12-49) months. A modified AOFAS score was used for the functional outcome. The operation took 141 minutes at an average ranging from 90 to 252 minutes. The inpatient treatment lasted between 10 and 63 days (mean 26 days). The time spent in the fixator was 116.7 (69-245) days. All patients were mobilised under full weight bearing with the external fixator. Surgical revision was necessary in 13 patients: four patients needed wound revisions due to ongoing infection, six patients needed wire exchange due to deep infection in three cases and wire breakage in three cases, one patient needed additional wires because of an initially instable frame configuration and two patients needed secondary skin grafting. Bony consolidation was achieved in 32 patients (86.5 %). With a re-arthrodesis performed in four patients using the Ilizarov fixator, the overall fusion rate was 94.6 %. Infection was persistent in two cases with one solid ankle fusion and one ankle pseudarthrosis. At the time of follow-up 35 patients were able to walk under full weight loading with orthopaedic shoe modifications, four patients needed support of a cane and three patients wore an ankle-foot orthesis. The two patients with persistent pseudarthrosis were mobilised in a lower-leg orthesis after declining another surgical revision. The positioning of the hindfoot showed in seven cases an equinus of 10°, in one case a varus of 10° and in two cases a valgus positioning of 10°. A plantigrade foot positioning or with minimal degrees of deviation could be achieved in all other cases. The modified AOFAS score at the time of the follow-up examination ranged from 19 to 86 with an average score of 67.9 points. All patients except three were satisfied or rather satisfied with the treatment procedure and its results. The Ilizarov external fixator is a safe method for ankle fusion in cases of infection. The advances are a possible application at acute infection and immediate mobilisation at full weight bearing. However, it remains a time-consuming and stressful procedure for the patient.",Gessmann J.; Ozokyay L.; Fehmer T.; Muhr G.; Seybold D.,2011.0,10.1055/s-0030-1250360,0,0,
8902,Randomized comparative study of group versus individual cognitive behavioural therapy for obsessive compulsive disorder.,"The primary aim of the study was to compare the effectiveness of group and individual cognitive behaviour therapy (CBT) for obsessive compulsive disorder (OCD). One hundred and ten out-patients with OCD were randomly assigned to 15 sessions of either group CBT or individual CBT. Outcome measures were administered before and after treatment, as well as at 6- and 12-month follow-ups. The study was supplemented by a meta-analysis of accomplished comparative studies of group vs. individual CBT for OCD. Large and stable pre-post effect sizes were found for both treatment conditions in the study (d = 1.06-1.24 on the Yale-Brown Obsessive Compulsive Scale). There were no significant between-group differences in outcome at any data point (ds= -0.13 to 0.15). The meta-analysis of four accomplished comparative studies (including the present one) found a between-group mean effect size of (d= 0.15 favouring individual over group CBT at posttreatment (95% confidence interval, -0.12, 0.42). The results of this study suggest that OCD can be treated effectively with a group format of CBT, thus sparing some therapist resources, although the four accomplished comparative studies do not rule out the possibility of a small superiority of individually conducted CBT.",Jónsson H.; Hougaard E.; Bennedsen BE.,2011.0,10.1111/j.1600-0447.2010.01613.x,0,0,
8903,Innovative service delivery for secondary prevention of PTSD in at-risk OIF-OEF service men and women.,"Service personnel involved in Operation Enduring Freedom/Operation Iraqi Freedom are at high risk for trauma-related physical injury and emotional problems, including posttraumatic stress disorder (PTSD) and major depression. Although evidence-based psychotherapies are increasingly available and effective in treating symptoms of PTSD, a large number of service personnel are reluctant to seek mental health treatments due to both perceived stigma associated with these treatments and geographically-based barriers to care at specialized treatment facilities. The present investigation evaluates an innovation in service delivery designed to address these concerns. Specifically, we are comparing exposure-based therapy for PTSD delivered via traditional, in-person settings to the same exposure-based treatment delivered via telehealth technology. The proposed project is a prospective, randomized repeated measures design with two treatment groups (telehealth and in-person) assessed at pre-treatment, mid-treatment, post-treatment and 3- and 12-month follow-up points. Outcome measures ascertain longer-term effects of the treatments on three domains: clinical, process, and economic. Non-inferiority and superiority analyses will be conducted to determine symptom changes between pre-treatment, post-treatment, and follow-up time points between the two treatment conditions. The study will determine whether an exposure therapy for PTSD delivered via telehealth is at least as successful as the same exposure-based therapy delivered in-person in treating the symptoms of PTSD in both subthreshold and fully diagnosed cases.",Gros DF.; Strachan M.; Ruggiero KJ.; Knapp RG.; Frueh BC.; Egede LE.; Lejuez CW.; Tuerk PW.; Acierno R.,2011.0,10.1016/j.cct.2010.10.003,0,0,
8904,Multicomponent behavioral treatment for chronic combat-related posttraumatic stress disorder: a randomized controlled trial.,"This study examined the efficacy of a multicomponent cognitive-behavioral therapy, Trauma Management Therapy, which combines exposure therapy and social emotional rehabilitation, to exposure therapy only in a group of male combat veterans with chronic posttraumatic stress disorder (PTSD). Thirty-five male Vietnam veterans with PTSD were randomly assigned to receive either Trauma Management Therapy (TMT) or Exposure Therapy Only (EXP). Participants were assessed at pre-treatment, mid-treatment, and post-treatment. Primary clinical outcomes were reduction of PTSD symptoms and improved social emotional functioning. Results indicated that veterans in both conditions showed statistically significant and clinically meaningful reductions in PTSD symptoms from pre- to post-treatment, though consistent with a priori hypotheses there were no group differences on PTSD variables. However, compared to the EXP group, participants in the TMT group showed increased frequency in social activities and greater time spent in social activities. These changes occurred from mid-treatment (after completion of exposure therapy) to post-treatment (after completion of the social emotional rehabilitation component); supporting the hypothesis that TMT alone would result in improved social functioning. Although the TMT group also had a significant decrease in episodes of physical rage, that change occurred prior to introduction of the social emotional component of TMT. This study demonstrates efficacy of exposure therapy for treating the core symptoms of PTSD among combat veterans with a severe and chronic form of this disorder. Moreover, multi-component CBT shows promise for improving social functioning beyond that provided by exposure therapy alone, particularly by increasing social engagement/interpersonal functioning in a cohort of veterans with severe and chronic PTSD.",Beidel DC.; Frueh BC.; Uhde TW.; Wong N.; Mentrikoski JM.,2011.0,10.1016/j.janxdis.2010.09.006,0,0,
8905,Decrease of prefrontal metabolism after subthalamic stimulation in obsessive-compulsive disorder: a positron emission tomography study.,"High-frequency bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) is a promising treatment in refractory obsessive-compulsive disorder (OCD). Using the crossover, randomized, and double-blind procedure adopted by the STOC study, 10 patients treated with high-frequency bilateral STN DBS underwent am 18-fluorodeoxyglucose positron emission tomography (PET) investigation to highlight the neural substratum of this therapeutic approach. The median Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores for all 10 patients were 31 (minimum = 18, maximum = 36) with ""Off-Stimulation"" status and 19 (minimum = 0, maximum = 30) with ""On-Stimulation"" status (p = .05). The OCD patients in Off-Stimulation status showed a hypermetabolism in the right frontal middle and superior gyri, right parietal lobe, postcentral gyrus, and bilateral putamen compared with healthy control subjects. A significant decrease in cerebral metabolism was observed in the left cingulate gyrus and the left frontal medial gyrus in On-Stimulation conditions compared with Off-Stimulation conditions. In addition, the improvement assessed by Y-BOCS scores during the On-Stimulation conditions was positively correlated with PET signal changes at the boundary of the orbitofrontal cortex and the medial prefrontal cortex, between PET signal changes and the Y-BOCS scores modifications in On-Stimulation status. This study suggests that the therapeutic effect of STN DBS is related to a decrease in prefrontal cortex metabolism.",Le Jeune F.; Vérin M.; N'Diaye K.; Drapier D.; Leray E.; Du Montcel ST.; Baup N.; Pelissolo A.; Polosan M.; Mallet L.; Yelnik J.; Devaux B.; Fontaine D.; Chereau I.; Bourguignon A.; Peron J.; Sauleau P.; Raoul S.; Garin E.; Krebs MO.; Jaafari N.; Millet B.;  .,2010.0,10.1016/j.biopsych.2010.06.033,0,0,
8906,Role of intra-operative ultrasound-guided reduction of nasal bone fracture in patient satisfaction and patient nasal profile (a randomized clinical trial).,"The objective of this study was to evaluate the benefits of intra-operative ultrasonic guidance in the management of isolated nasal bone fractures. A prospective, randomized, controlled, double blinded study was designed. Sixty-eight patients who had isolated fracture nose were treated by either a simple closed reduction or by ultrasound-guided reduction (34 patients each) with a follow up for an average of 4.5 and 5.5 months, respectively. Post-traumatic and post-reduction nasal profiles were compared (by blinded photographer), and patient's satisfaction was analyzed after reduction in both groups. We used Student's t test for independent groups to compare between the average patient's scores. The average patient's nasal profile score for closed reduction group was 2.31. Thirteen patients (40.6%) had scored 3, 16 (50%) had scored 2, and three (9.4%) patients had scored 1. The average patient's nasal profile score for ultrasonic assisted group was 2.72. Twenty-four patients (75%) had scored 3, 7 (22%) had scored 2, and one (3%) patient had scored 1. The average patient's satisfaction score for closed reduction was 2.62. Twenty-four patients (75%) had scored 3, 4 (12.5%) patients had scored 2, and 4 (12.5%) patients had scored 1. The average patient's satisfaction score for ultrasonic assisted group was 2.78. Twenty-six patients (81%) scored 3, 5 (16%) patients scored 2, and one (3%) patient scored 1. Patients undergoing ultrasonic nasal bone reduction scored significantly better nasal profile scores than patients undergoing simple closed reduction, on the other hand, patient satisfaction scores had no significant difference between both groups. Treating nasal bone fractures with the assistance of intra-operative ultrasound resulted in a significantly better nasal profile appearance, than treating it by simple closed reduction.",Abu-Samra M.; Selmi G.; Mansy H.; Agha M.,2011.0,10.1007/s00405-010-1401-1,0,0,
8907,Reducing teachers' psychological distress through a mindfulness training program.,"Teachers constitute one of the professional collectives most affected by psychological problems. The purpose of this quasi-experimental study is to examine the efficacy of a mindfulness training programme to reduce psychological distress in a group of teachers. The sample comprised 68 teachers of Secondary School Education, from various public schools; half of them formed the experimental group, and the another half the control group. The levels of psychological distress were measured, in both groups, by the Symptom Checklist-90-R (SCL-90-R) before and after the application of the programme. Statistical analysis shows the significant reduction of three general measures of psychological distress (Global Severity Index, Positive Symptom Distress Index, and Positive Symptom Total), as well in all its dimensions (somatization, obsessive-compulsive, interpersonal sensibility, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism), in the experimental group compared with the control group. Follow-up measures show that these results were maintained for four months after termination of the intervention in the experimental group.",Franco C.; Mañas I.; Cangas AJ.; Moreno E.; Gallego J.,2010.0,,0,0,
8908,Assessment of the efficacy of a psychological treatment for women victims of violence by their intimate male partner.,"This study evaluates the long-term efficacy of a brief psychotherapeutic cognitive-behavioral program in group format for female victims of violence by their intimate partner. 53 battered women were randomized into one of two intervention programs: one including among others exposure technique (n = 28) and another one in which exposure procedures were substituted by communication skills training (n = 25). Additionally, both programs included: psycho-education, breath control, training to improve self-esteem, cognitive restructuring, problem-solving, planning pleasant activities, and relapse prevention. The treatment was carried out in 8 weekly sessions. Measures of posttraumatic symptoms, anxiety, depression, self-esteem and anger expression were analyzed at pre- and post-treatment, and at 1-, 3-, 6- and 12-months follow-ups. Results show a pronounced decrease of posttraumatic, depressive and anxiety symptoms, which maintained in the different measure moments, with scarce difference between the two programs. The results and their clinical implications are discussed.",Crespo M.; Arinero M.,2010.0,,0,0,
8909,Effects of worry on physiological and subjective reactivity to emotional stimuli in generalized anxiety disorder and nonanxious control participants.,"The present study examined the effect of worry versus relaxation and neutral thought activity on both physiological and subjective responding to positive and negative emotional stimuli. Thirty-eight participants with generalized anxiety disorder (GAD) and 35 nonanxious control participants were randomly assigned to engage in worry, relaxation, or neutral inductions prior to sequential exposure to each of four emotion-inducing film clips. The clips were designed to elicit fear, sadness, happiness, and calm emotions. Self reported negative and positive affect was assessed following each induction and exposure, and vagal activity was measured throughout. Results indicate that worry (vs. relaxation) led to reduced vagal tone for the GAD group, as well as higher negative affect levels for both groups. Additionally, prior worry resulted in less physiological and subjective responding to the fearful film clip, and reduced negative affect in response to the sad clip. This suggests that worry may facilitate avoidance of processing negative emotions by way of preventing a negative emotional contrast. Implications for the role of worry in emotion avoidance are discussed.",Llera SJ.; Newman MG.,2010.0,10.1037/a0019351,0,0,
8910,[Impact of preoperative patient education on postoperative pain in consideration of the individual coping style].,"the German guideline for the treatment of acute perioperative and post-traumatic pain (S3-Leitlinie zur Behandlung akuter perioperativer und posttraumatischer Schmerzen) recommends giving preoperative information about postoperative pain and how to influence it. It is expected that the effect of preoperative information is modified by psychological characteristics of the patient. One of these psychological characteristics is the individual coping style. The purpose of the study is to evaluate whether or not patients benefit from preoperative education in relation to their level of negative coping style. the study is based on a 2×2 factorial experimental design with the experimental factor ""treatment"" (education vs control condition) and the factor ""negative coping style"" (high vs low). After informed consent 96 patients undergoing abdominal or vascular surgery were enrolled in the study. Outcomes were pain intensity, pain quality and psychic state. They were assessed by using numerical rating scales and psychometric methods of self-assessment. The data were collected preoperatively and on the first to third postoperative day. patients who received preoperative education experience a greater reduction in postoperative pain than patients without preoperative education do (ES=0.48). The risk for stronger pain (NRS>3) on the third postoperative day is decreased (2.1 vs 14.6%). The influence of negative coping style is altogether minimal. preoperative patient information has positive effects on the postoperative development of pain. Patient information is a valuable addition to the drug pain treatment. The application can be recommended regardless of the level of the patients' negative coping style.",Gräwe JS.; Mirow L.; Bouchard R.; Lindig M.; Hüppe M.,2010.0,10.1007/s00482-010-0994-z,0,0,6615
8911,Comparing thought suppression and mindfulness as coping techniques for spider fear.,"The current study compared thought suppression, focused attention (mindfulness) and unfocused attention as strategies for managing spider fear. Spider fearful participants were exposed to a strategy induction before completing a Behavioural Approach Test (BAT). The BAT is a 10 step measurement of how close participants are willing to move towards a spider. Participants were instructed to use what they learned in the pre-BAT induction to help them advance through the steps of the BAT. The results of the study indicated that participants given the thought suppression or the unfocused attention induction moved through significantly less steps of the BAT than did those given the focused attention (mindful) induction. Additionally, the thought suppression group felt significantly more anxious than the focused and unfocused attention groups following completion of the BAT. These results are discussed in terms of the impact of thought suppression on avoidance behaviour in phobias.",Hooper N.; Davies N.; Davies L.; McHugh L.,2011.0,10.1016/j.concog.2011.05.013,0,0,
8912,All at once or one at a time? A randomized controlled trial comparing two ways to deliver bibliotherapy for panic disorder.,"Bibliotherapy is potentially effective in the treatment of panic disorder (PD). A still unanswered question is whether pacing is important. This study was designed to test whether there is a difference between being assigned a full book as therapy and receiving one individual chapter every week (i.e. pacing). A total of 28 participants were randomized to either 10 paced chapters or one book with 10 chapters. To maximize compliance, short weekly telephone calls were added in both conditions (M = 17.8 min, SD = 4.2). Both treatments showed promising results, with effects maintained up to 2 years and with within-group effect sizes (Cohen's d) between 0.95 and 1.11. Pretreatment ratings of credibility were positively correlated with the change scores at both posttest and 2-year follow-up for three panic measures. Pacing of text material in bibliotherapy for PD is not needed, and all material can be provided at once when the treatment is guided by a therapist.",Carlbring P.; Maurin T.; Sjömark J.; Maurin L.; Westling BE.; Ekselius L.; Cuijpers P.; Andersson G.,2011.0,10.1080/16506073.2011.553629,0,0,
8913,Further evidence for the efficacy of association splitting as a self-help technique for reducing obsessive thoughts.,"Despite improved treatment options, many people with obsessive-compulsive disorder (OCD) do not seek or even actively avoid therapy due to shame or fear of stigmatization. Self-help treatment is increasingly acknowledged as a means to ""treat the untreated"" and to motivate patients for face-to-face psychotherapy. Our group has gathered preliminary evidence for the efficacy of a novel self-help approach entitled association splitting (AS) aimed at the reduction of obsessions. For this study, a total of 46 participants with a likely diagnosis of OCD were randomly allocated to either AS or a waitlist control (WL). Treatment consisted of the self-study of a manual sent via e-mail. At baseline and four weeks later symptoms were assessed online using the self-report version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Obsessive-Compulsive Inventory-Revised (OCI-R), and the Beck Depression Inventory (BDI). A total of 74% of the initial sample took part in the re-assessment. Results were in accordance with prior uncontrolled data indicating that AS is a feasible approach leading to a symptom decline of approximately 25% on the Y-BOCS. The technique also exerted a positive effect on depression (BDI) and the OCI-R subscale obsessive thoughts. The study confirms the feasibility and efficacy of AS for a subgroup of patients with OCD. Ongoing studies explore whether short-term effects are maintained over time and whether therapist-guided therapy may enhance the efficacy of AS.",Moritz S.; Jelinek L.,2011.0,10.1002/da.20843,0,0,
8914,The enhancement of beneficial effects following audio feedback by cognitive preparation in the treatment of social anxiety: a single-session experiment.,"According to cognitive models, negatively biased processing of the publicly observable self is an important aspect of social phobia; if this is true, effective methods for producing corrective feedback concerning the public self should be strived for. Video feedback is proven effective, but since one's voice represents another aspect of the self, audio feedback should produce equivalent results. This is the first study to assess the enhancement of audio feedback by cognitive preparation in a single-session randomized controlled experiment. Forty socially anxious participants were asked to give a speech, then to listen to and evaluate a taped recording of their performance. Half of the sample was given cognitive preparation prior to the audio feedback and the remainder received audio feedback only. Cognitive preparation involved asking participants to (1) predict in detail what they would hear on the audiotape, (2) form an image of themselves giving the speech and (3) listen to the audio recording as though they were listening to a stranger. To assess generalization effects all participants were asked to give a second speech. Audio feedback with cognitive preparation was shown to produce less negative ratings after the first speech, and effects generalized to the evaluation of the second speech. More positive speech evaluations were associated with corresponding reductions of state anxiety. Social anxiety as indexed by the Implicit Association Test was reduced in participants given cognitive preparation. Small sample size; analogue study. Audio feedback with cognitive preparation may be utilized as a treatment intervention for social phobia.",Nilsson JE.; Lundh LG.; Faghihi S.; Roth-Andersson G.,2011.0,10.1016/j.jbtep.2011.05.004,0,0,
8915,Behavioral activation and therapeutic exposure for bereavement in older adults.,"The development and clinical trial of a 5-session behavioral intervention for complicated bereavement (CB) is presented. We conceptualized CB in terms of Major Depression (MDD) and Post-traumatic Stress Disorder (PTSD) and consequently applied treatment components of Behavioral Activation and Therapeutic Exposure (BA-TE). In order to assure standardization of treatment, control costs, and engage patients, a multi-media, multi-context format was adopted to address avoidance and withdrawal behaviors conceptualized as central pathogenic responses in CB. Participants (N = 26) were assessed before and after BA-TE treatment via structured clinical interview and standardized questionnaires in terms of PTSD, MDD, CB, and health concerns. The number of days since the death of the loved one was widely variable and served as a covariate for all outcome analyses. ANCOVAS revealed statistically significant improvement, irrespective of how many days since death had elapsed prior to initiation of intervention, on structured interviews and self-report measures for most outcome variables.",Acierno R.; Rheingold A.; Amstadter A.; Kurent J.; Amella E.; Resnick H.; Muzzy W.; Lejuez C.,2012.0,10.1177/1049909111411471,0,0,
8916,Isolating the effect of Virtual Reality Based Exposure Therapy for agoraphobia: a comparative trial.,"The isolated effect of Virtual Reality Based Exposure Therapy (VRBET) for agoraphobia was analyzed through a comparative trial involving the first 10 agoraphobic participants. The participants were randomly assigned to two groups: VREBT only and VREBT combined with cognitive therapy. All the required Virtual Environments (VE) were created with an inexpensive Game Level Editor (GLE). Outcome measures supported the immersive effect of the VEs. Questionnaires, behavioral tests and physiological measures indicated a positive effect of VRBET alone. The addition of cognitive therapy to VREBT did not appear to generate any significant differences. Consequences for future research and practice are discussed.",Malbos E.; Rapee RM.; Kavakli M.,2011.0,,0,0,
8917,Virtual reality exposure treatment of agoraphobia: a comparison of computer automatic virtual environment and head-mounted display.,In this study the effects of virtual reality exposure therapy (VRET) were investigated in patients with panic disorder and agoraphobia. The level of presence in VRET was compared between using either a head-mounted display (HMD) or a computer automatic virtual environment (CAVE). Results indicate that there was no relationship between the level of experienced presence and treatment outcome. Analyses indicate that VRET in general was more effective than no treatment. No differences in effectiveness were found between VRET using an HMD or CAVE.,Meyerbröker K.; Morina N.; Kerkhof G.; Emmelkamp PM.,2011.0,,0,0,
8918,New technologies to manage exam anxiety.,"A Stress Inoculation Training-based protocol tested if multimedia audio-video content induced emotional changes and reduced exam anxiety in university students. Seventy-five participants took part in six experimental sessions consisting of viewing multimedia content and performing relaxation exercises. Participants were randomly assigned to five experimental groups: 1) audio and video narrative on mobile phone (UMTS); 2) audio and video narrative on DVD (DVD), 3) audio narrative on MP3 player (M3), 4) audio narrative on CD (CD), 5) control group (CTRL). Results showed that audio/video content induced a significant reduction in exam anxiety and an increase of relaxation in students, compared to the audio-only contents.",Grassi A.; Gaggioli A.; Riva G.,2011.0,,0,0,
8919,Cognitive behavior therapy in medication non-responders with obsessive-compulsive disorder: a prospective 1-year follow-up study.,"Evidence of efficacy of cognitive behavior therapy (CBT) in obsessive-compulsive disorder (OCD) non-responsive to multiple trials of serotonin reuptake inhibitors (SRI) is limited. We examined the efficacy of CBT in 31 adult patients with DSM-IV OCD who were non-responders to at least two SRI trials. They received 20-25 sessions of CBT over 3-month duration. The primary outcome measure was ""response"" to treatment [Clinical Global Impressions-Improvement score 1 or 2 and ‚â•35% reduction in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) severity score]. Patients were assessed at baseline, post-treatment and at 3-, 6- and 12-month follow-up. Twenty-six (84%) patients completed treatment and number of responders at post-treatment, 3-, 6- and 12-month follow-up were 23 (74%), 20 (64%), 20 (64%) and 19 (61%) respectively. Quality of homework compliance and baseline Y-BOCS severity predicted remission (Y-BOCS<16) to CBT. CBT is useful in OCD non-responsive to multiple trials of SRI.",Anand N.; Sudhir PM.; Math SB.; Thennarasu K.; Janardhan Reddy YC.,2011.0,10.1016/j.janxdis.2011.05.007,0,0,
8920,Road traffic accidents and posttraumatic stress disorder in an orthopedic setting in South-Eastern Nigeria: a controlled study.,"Psychiatric liaison services are rare in trauma units of various hospitals in Nigeria and other sub-Saharan African countries. The occurrence of road traffic accidents (RTAs) resulting from low standard of road construction and inadequate maintenance have been on the increase in Nigeria. While the physical consequences of such RTAs are obvious, the psychological consequences are often not apparent. This study assessed the prevalence of posttraumatic stress disorder (PTSD) among victims of RTAs and compared same with controls drawn from a population who have not experienced RTAs. It also assessed the associated socio-demographic variables. Study population consisted of one hundred and fifty RTA victims and two different control groups drawn from the population consisting of staffs of Federal Neuropsychiatric Hospital, Enugu, Nigeria and that of National Orthopedic Hospital, Enugu, Nigeria, 150 people in each control group were matched for age and sex with the RTA victims and they were interviewed with PTSD module of Mini International Neuropsychiatric Interview (MINI) and their socio-demographic variables obtained with socio-demographic questionnaire. The prevalence of PTSD among RTA victims and the two control groups were 26.7%, 8.0% and 8.7% respectively. The difference in prevalence was statistically significant with RTA victims more likely to experience PTSD compared to the two control groups (X² = 27.23, df = 2, p = 0.001). Gender influenced the prevalence of PTSD among victims of RTAs and the controls, with females more likely to experience PTSD when compared to the males. Among victims of RTAs, being gainfully employed prior to the accidents increased the likelihood of developing PTSD and this was statistically significant (X² = 20.09, df = 1, p = 0.000). There is urgent need to pay more attention to developing consultation-liaison psychiatry services in trauma units of Nigerian hospitals, including orthopedic hospitals located in different geographical zones of the country.",Iteke O.; Bakare MO.; Agomoh AO.; Uwakwe R.; Onwukwe JU.,2011.0,10.1186/1757-7241-19-39,0,0,
8921,Neuroticism influences brain activity during the experience of visceral pain.,"One particularly important individual dynamic known to influence the experience of pain is neuroticism, of which little is known about in visceral pain research. Our aim was to study the relationship between neuroticism, psychophysiologic response, and brain processing of visceral pain. Thirty-one healthy volunteers (15 male; age range, 22-38 years) participated in the study. The Eysenck Personality Questionnaire was used to assess neuroticism. Skin conductance level, pain ratings, and functional magnetic resonance imaging data were acquired during anticipation of pain and painful esophageal distention. The effect of neuroticism was assessed using correlation analysis. There was a wide spread of neuroticism scores (range, 0-22) but no influence of neuroticism on skin conductance level and pain tolerance or pain ratings. However, a positive correlation between brain activity and neuroticism during anticipation was found in regions associated with emotional and cognitive pain processing, including the parahippocampus, insula, thalamus, and anterior cingulate cortex. These regions showed a negative correlation with neuroticism during pain (P < .001). This study provides novel data suggesting higher neuroticism is associated with engagement of brain regions responsible for emotional and cognitive appraisal during anticipation of pain but reduced activity in these regions during pain. This may reflect a maladaptive mechanism in those with higher neuroticism that promotes overarousal during anticipation and avoidance coping during pain.",Coen SJ.; Kano M.; Farmer AD.; Kumari V.; Giampietro V.; Brammer M.; Williams SC.; Aziz Q.,2011.0,10.1053/j.gastro.2011.06.008,0,0,
8922,Predictors of response to an attention modification program in generalized social phobia.,"At least 3 randomized, placebo-controlled, double-blind studies have supported the efficacy of computerized attention modification programs (AMPs) in reducing symptoms of anxiety in patients diagnosed with an anxiety disorder. In this study we examined patient characteristics that predicted response to AMP in a large sample of individuals diagnosed with generalized social phobia. The sample comprised 112 individuals seeking treatment for generalized social phobia who completed a randomized clinical trial comparing AMP (n = 55) with a placebo condition (i.e., attention control condition; n = 57). We examined the following domains of baseline predictors of treatment response: (a) demographic characteristics (gender, age, ethnicity, years of education); (b) clinical characteristics (Axis I comorbidity, trait anxiety, depression); and (c) cognitive disturbance factors (attentional bias for social threat, social interpretation bias). Results revealed that ethnicity predicted treatment response across both conditions: Participants who self-identified as non-Caucasian displayed better overall response than did Caucasians. The only prescriptive variable to emerge was attentional bias for social threat at preassessment. Participants in the AMP group who exhibited larger attentional bias scores displayed significantly greater reductions in clinician-rated social anxiety symptoms than did their counterparts in the attention control condition. These results suggest that AMP may be targeted to individuals most likely to benefit from these programs.",Amir N.; Taylor CT.; Donohue MC.,2011.0,10.1037/a0023808,0,0,
8923,Attachment security as a mechanism linking foster care placement to improved mental health outcomes in previously institutionalized children.,"Children reared in institutions experience elevated rates of psychiatric disorders. Inability to form a secure attachment relationship to a primary caregiver is posited to be a central mechanism in this association. We determined whether the ameliorative effect of a foster care (FC) intervention on internalizing disorders in previously institutionalized children was explained by the development of secure attachment among children placed in FC. Second we evaluated the role of lack of attachment in an institutionalized sample on the etiology of internalizing disorders within the context of a randomized trial. A sample of 136 children (aged 6-30 months) residing in institutions was recruited in Bucharest, Romania. Children were randomized to FC (n = 68) or to care as usual (CAU; n = 68). Foster parents were recruited, trained, and overseen by the investigative team. Attachment security at 42 months was assessed using the Strange Situation Procedure, and internalizing disorders at 54 months were assessed using the Preschool Age Psychiatric Assessment. Girls in FC had fewer internalizing disorders than girls in CAU (OR = 0.17, p = .006). The intervention had no effect on internalizing disorders in boys (OR = 0.47, p = .150). At 42 months, girls in FC were more likely to have secure attachment than girls in CAU (OR = 12.5, p < .001), but no difference was observed in boys (OR = 2.0, p = .205). Greater attachment security predicted lower rates of internalizing disorders in both sexes. Development of attachment security fully mediated intervention effects on internalizing disorders in girls. Placement into FC facilitated the development of secure attachment and prevented the onset of internalizing disorders in institutionalized girls. The differential effects of FC on attachment security in boys and girls explained gender differences in the intervention effects on psychopathology. Findings provide evidence for the critical role of disrupted attachment in the etiology of internalizing disorders in children exposed to institutionalization.",McLaughlin KA.; Zeanah CH.; Fox NA.; Nelson CA.,2012.0,10.1111/j.1469-7610.2011.02437.x,0,0,
8924,Fracture surgery of the extremities with the intra-operative use of 3D-RX: a randomized multicenter trial (EF3X-trial).,"Posttraumatic osteoarthritis can develop after an intra-articular extremity fracture, leading to pain and loss of function. According to international guidelines, anatomical reduction and fixation are the basis for an optimal functional result. In order to achieve this during fracture surgery, an optimal view on the position of the bone fragments and fixation material is a necessity. The currently used 2D-fluoroscopy does not provide sufficient insight, in particular in cases with complex anatomy or subtle injury, and even an 18-26% suboptimal fracture reduction is reported for the ankle and foot. More intra-operative information is therefore needed.Recently the 3D-RX-system was developed, which provides conventional 2D-fluoroscopic images as well as a 3D-reconstruction of bony structures. This modality provides more information, which consequently leads to extra corrections in 18-30% of the fracture operations. However, the effect of the extra corrections on the quality of the anatomical fracture reduction and fixation as well as on patient relevant outcomes has never been investigated.The objective of this study protocol is to investigate the effectiveness of the intra-operative use of the 3D-RX-system as compared to the conventional 2D-fluoroscopy in patients with traumatic intra-articular fractures of the wrist, ankle and calcaneus. The effectiveness will be assessed in two different areas: 1) the quality of fracture reduction and fixation, based on the current golden standard, Computed Tomography. 2) The patient-relevant outcomes like functional outcome range of motion and pain. In addition, the diagnostic accuracy of the 3D-RX-scan will be determined in a clinical setting and a cost-effectiveness as well as a cost-utility analysis will be performed. In this protocol for an international multicenter randomized clinical trial, adult patients (age > 17 years) with a traumatic intra-articular fracture of the wrist, ankle or calcaneus eligible for surgery will be subjected to additional intra-operative 3D-RX. In half of the patients the surgeon will be blinded to these results, in the other half the surgeon may use the 3D-RX results to further optimize fracture reduction. In both randomization groups a CT-scan will be performed postoperatively. Based on these CT-scans the quality of fracture reduction and fixation will be determined. During the follow-up visits after hospital discharge at 6 and 12 weeks and 1 year postoperatively the patient relevant outcomes will be determined by joint specific, health economic and quality of life questionnaires. In addition a follow up study will be performed to determine the patient relevant outcomes and prevalence of posttraumatic osteoarthritis at 2 and 5 years postoperatively. The results of the study will provide more information on the effectiveness of the intra-operative use of 3D-imaging during surgical treatment of intra-articular fractures of the wrist, ankle and calcaneus. A randomized design in which patients will be allocated to a treatment arm during surgery will be used because of its high methodological quality and the ability to detect incongruences in the reduction and/or fixation that occur intra-operatively in the blinded arm of the 3D-RX. An alternative, pragmatic design could be to randomize before the start of the surgery, then two surgical strategies would be compared. This resembles clinical practice better, but introduces more bias and does not allow the assessment of incongruences that would have been detected by 3D-RX in the blinded arm. Dutch Trial Register NTR 1902.",Beerekamp MS.; Ubbink DT.; Maas M.; Luitse JS.; Kloen P.; Blokhuis TJ.; Segers MJ.; Marmor M.; Schep NW.; Dijkgraaf MG.; Goslings JC.;  .,2011.0,10.1186/1471-2474-12-151,0,0,
8925,The Balloon Analog Insurance Task (BAIT): a behavioral measure of protective risk management.,"Prior methods used to assess individual differences related to risk have not focused on an important component of risk management: how willing individuals are to pay for or take actions to insure what they already have. It is not clear whether this type of protective risk management taps into the same individual differences as does risk taking propensity measured by existing risk taking tasks. We developed a novel task to assess protective risk management, the Balloon Analog Insurance Task (BAIT), which is modeled after the Balloon Analog Risk Task (BART). In the BAIT, individuals are forced to decide how much money they are willing to pay in order to insure a specific fraction of their prior winnings given changing but imprecise levels of risk of monetary loss. Participants completed the BART and BAIT for real monetary rewards, and completed six self report questionnaires. The amount of insurance purchased on the BAIT was positively correlated with scores on the Intolerance of Uncertainty Scale and on the Checking scale of the revised Obsessive Compulsive Inventory. Conversely, the amount of insurance purchased was negatively correlated with scores on the Domain Specific Risk Taking Questionnaire, and on the Psychopathic Personality Inventory (PPI). Furthermore, relationships between insurance purchased and these scales remained significant after controlling for the BART in linear regression analyses, and the BART was only a significant predictor for measures on one scale--the PPI. Our results reveal that behavior on the BAIT taps into a number of individual differences that are not related to behavior on another measure of risk taking. We propose that the BAIT may provide a useful complement to the BART in the assessment of risk management style.",Essex BG.; Lejuez CW.; Qian RY.; Bernstein K.; Zald DH.,2011.0,10.1371/journal.pone.0021448,0,0,
8926,The WRITTEN-HEART study (expressive writing for heart healing): rationale and design of a randomized controlled clinical trial of expressive writing in coronary patients referred to residential cardiac rehabilitation.,"Coronary heart disease (CHD) is typically associated with many cardiovascular risk factors (e.g., elevated blood pressure), low health-related quality of life, depression, anxiety and psychological stress. Expressive writing (EW) has shown beneficial effects on such variables in both people from the community and in patients with a variety of chronic illnesses. However, no study to date has evaluated the physical and psychological effects of the expressive writing procedure on coronary patients referred to cardiac rehabilitation (CR). The clinical effectiveness of a 2-week disease-related expressive writing procedure (writing about one's deepest thoughts and feelings regarding the experience with heart disease) compared with the standard writing task (writing about one's deepest thoughts and feelings about the most traumatic or negative event experienced in the life), a neutral writing condition (writing about the facts regarding heart disease and its treatment) and an empty control condition will be evaluated in a randomized controlled clinical trial (RCT) with repeated follow-up measurements at 3, 6 and 12 months after discharge from CR. The primary outcome is health-related quality of life (SF-12). Secondary outcome measures are depression (BDI-II), anxiety (BAI) and post-traumatic growth (PTGI). Furthermore, the study will explore the moderating effects of coping styles, type D personality, perceived emotional support and participants' evaluative ratings of the writing interventions on the main experimental effects in order to identify sub-groups of patients showing different results. The WRITTEN-HEART study aims to explore and expand the frontiers of the expressive writing research enterprise by investigating the feasibility, safety and clinical efficacy of brief and cost-effective expressive writing interventions in patients with CHD referred to CR. ClinicalTrials.gov NCT01253486.",Manzoni GM.; Castelnuovo G.; Molinari E.,2011.0,10.1186/1477-7525-9-51,0,0,
8927,Dealing with fear of blushing: a psychoeducational group intervention for fear of blushing.,"The clinical impression is that people who fear blushing do not easily seek psychological help for their complaints. Therefore, we designed a low-threshold psychoeducational group intervention to reduce fear of blushing. The intervention followed a cognitive-behavioural approach, but in a course setting, e.g., with 'participants' and 'teachers' instead of 'patients' and 'therapists'. The effectiveness of the course in reducing fear of blushing and social anxiety was tested in a group of blushing-fearful individuals (n = 47) by using an uncontrolled study design. The course consisted of six weekly sessions and one booster session 3 months after the last regular session. Assessments took place upon application, immediately before the intervention, after the sixth session, before the booster session, and at 1-year follow-up. Results showed that the course was effective in reducing fear of blushing as well as symptoms of social anxiety. The positive effect of the course on anxiety measures suggests that it might be a promising approach for treating fear of blushing. The course 'dealing with fear of blushing' is a cognitive-behavioural group intervention in a course setting, e.g., with 'participants' and 'teachers' instead of 'patients' and 'therapists'. The course was effective in reducing anxiety complaints. An effect size of 1.4 and a reduction of approximately 30 points on this Blushing, Trembling and Sweating Questionnaire are comparable with what was reported for individual cognitive-behavioural treatments. Participants evaluated the course positively.",Dijk C.; Buwalda FM.; de Jong PJ.,,10.1002/cpp.764,0,0,
8928,"Change in cartilage thickness, posttraumatic bone marrow lesions, and joint fluid volumes after acute ACL disruption: a two-year prospective MRI study of sixty-one subjects.","Little is known about early morphologic change occurring with an acute injury of the anterior cruciate ligament. Magnetic resonance imaging was used in this study to investigate the two-year change in cartilage thickness, bone marrow lesions, and joint fluid of knees with acute anterior cruciate ligament injury treated surgically or nonsurgically and to identify factors associated with these changes. Sixty-one subjects (sixteen women and forty-five men with a mean age of twenty-six years) with acute anterior cruciate ligament injury to a previously uninjured knee were examined with use of a 1.5-T magnetic resonance imaging scanner at baseline and at three, six, twelve, and twenty-four months after the injury. Thirty-four subjects received rehabilitation and early anterior cruciate ligament reconstruction (a median of 44.5 days after the injury), eleven subjects received rehabilitation and a delayed anterior cruciate ligament reconstruction (408 days), and sixteen received rehabilitation alone. Morphologic measures were obtained from computer-assisted segmentation of magnetic resonance images. Factors tested for association were age, sex, activity level, treatment, and osteochondral fracture at baseline. After twenty-four months, significant cartilage thinning occurred in the trochlea of the femur (mean, -4.3%; standard response mean = 0.88), whereas significant cartilage thickening occurred in the central medial aspect of the femur (mean, +2.7%; standard response mean = 0.46). A younger age at the time of injury was a risk factor for thickening in the central medial aspect of femur, whereas older age at injury was a risk factor for thinning in the trochlea of the femur. Treatment of the torn anterior cruciate ligament was not related to these changes nor was activity level or an osteochondral fracture at baseline. Posttraumatic bone marrow lesions in the lateral aspect of the tibia resolved completely in fifty-four of fifty-eight knees (median, six months) and lesions in the lateral aspect of the femur resolved completely in forty-four of forty-seven knees (median, three months); however, thirty new bone marrow lesions developed in the lateral aspect of twenty-one knees over the two-year period. None of the factors were related to the development of bone marrow lesions. Morphologic change as visualized on magnetic resonance imaging occurs in the knee over the first two years after acute anterior cruciate ligament injury as demonstrated by cartilage thickening (central medial aspect of the femur), cartilage thinning (trochlea of the femur), the resolution of posttraumatic bone marrow lesions in the lateral part of the knee, and the development of new bone marrow lesions laterally. Age and male sex were independent risk factors for change in cartilage morphology.",Frobell RB.,2011.0,10.2106/JBJS.J.00929,0,0,
8929,Cognitive-behavioral therapy for geriatric compulsive hoarding.,"This investigation examined response to a manualized cognitive-behavioral therapy (CBT) protocol for compulsive hoarding (Steketee & Frost, 2007) in a sample of 12 adults over age 65. All participants were cognitively intact, not engaging in any other psychotherapy, and had compulsive hoarding as their primary problem. All received 26 sessions of individual CBT over the course of 17 weeks. The primary outcome measures were the Savings Inventory-Revised and UCLA Hoarding Severity Scale, which were administered at baseline, mid-treatment, post-treatment, and 6-month follow-up. Other outcomes included Clinical Global Impression (CGI) scores, depression, anxiety, disability, and clutter image ratings. Results demonstrated statistically significant changes on hoarding severity and depression. However, only three of the twelve participants were classified as treatment responders at post-treatment, and their gains were not maintained at 6-month follow-up. CGI, anxiety, disability, and clutter ratings were unchanged at post-treatment and follow-up. No participants dropped out, but homework compliance was variable and correlated with decreases in hoarding severity. Findings suggest that older adults with compulsive hoarding may require an enhanced or alternative treatment.",Ayers CR.; Wetherell JL.; Golshan S.; Saxena S.,2011.0,10.1016/j.brat.2011.07.002,0,0,
8930,"[Evaluation of the ""initiative pain-free clinic"" for quality improvement in postoperative pain management. A prospective controlled study].","Demonstration of improved postoperative pain management by implementation of the S3 guidelines on treatment of acute perioperative and posttraumatic pain, by the integrated quality management concept ""quality management acute pain"" of the T√úV Rheinland or by participation in the benchmark project ""Quality improvement in postoperative pain management"" (QUIPS). A prospective controlled study (pre-post design) was carried out in hospitals with various levels of care comparing three hospital groups (n = 17/7/3, respectively). Group 1: participation in the QUIPS project (intraclinic and interclinic comparison of outcome data of postoperative pain treatment), group 2: participation in the quality management acute pain program (certified by T√úV Rheinland), group 3: control group with no involvement in either of the two concepts. In all three groups, an anonymous data collection was performed consisting of patient-reported pain intensity, side effects, pain disability and patient satisfaction. Pain therapy intervention was carried out only in group 2 by an integrated quality management concept (certification project: Quality management acute pain) with a package of measures to improve structure, process and outcome quality. The T√úV Rheinland certified clinics (group 2) showed a significant improvement in the pre-post comparison (before versus after certification) in the areas maximum pain (from visual analogue scale VAS 4.6 to 3.7), stress pain (5.3 to 3.9), pain-related impairment (proportion of patients with pain-linked decreased mobility and movement 26% to 16.1%, coughing and breathing 23.1% to 14.3%) and patient satisfaction (from 13.2 to 13.7; scale 0 completely unsatisfied, 15 very satisfied). The clinics with participation in QUIPS for 2 years also showed a significant improvement in stress pain (numeric rating scale NRS for pain 4.5 to 4.2), pain-linked-limitation of coughing and breathing (28% to 23.6%), and patient satisfaction (from 11.9 to 12.4). There were no differences in postoperative nausea and vomiting between any of the groups. The main objective of the certification concept quality management acute pain as a tool for the successful implementation of the S3 guidelines on treatment of acute perioperative and posttraumatic pain, led to a significant improvement in patient outcome. Participation in QUIPS is an ideal supplement to T√úV Rheinland certification and can be recommended as a benchmarking tool to evaluate outcome.",Lehmkuhl D.; Meissner W.; Neugebauer EA.,2011.0,10.1007/s00482-011-1054-z,0,0,
8931,Group cognitive processing therapy delivered to veterans via telehealth: a pilot cohort.,"The authors report clinical findings from the pilot cohort of the first prospective, noninferiority-designed randomized clinical trial evaluating the clinical outcomes of delivering a cognitive-behavioral group intervention for posttraumatic stress disorder (PTSD), cognitive processing therapy (CPT), via video teleconferencing (VT) compared to the in-person modality. The treatment was delivered to 13 veterans with PTSD residing on the Hawaiian Islands. Results support the general feasibility and safety of using VT. Both groups showed clinically meaningful reductions in PTSD symptoms and no significant between-group differences on clinical or process outcome variables. In keeping with treatment manual recommendations, a few changes were made to the CPT protocol to accommodate this population. Novel aspects of this trial and lessons learned are discussed.",Morland LA.; Hynes AK.; Mackintosh MA.; Resick PA.; Chard KM.,2011.0,10.1002/jts.20661,0,0,
8932,Internet-based cognitive behavior therapy for obsessive compulsive disorder: a pilot study.,"Cognitive behavior therapy (CBT) is widely regarded as an effective treatment for obsessive compulsive disorder (OCD), but access to CBT therapists is limited. Internet-based CBT (ICBT) with therapist support is a way to increase access to CBT but has not been developed or tested for OCD. The aim of this study was to evaluate ICBT for OCD. An open trial where patients (N = 23) received a 15-week ICBT program with therapist support consisting of psychoeducation, cognitive restructuring and exposure with response prevention. The primary outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), which was assessed by a psychiatrist before and immediately after treatment. Secondary outcomes were self-rated measures of OCD symptoms, depressive symptoms, general functioning, anxiety and quality of life. All assessments were made at baseline and post-treatment. All participants completed the primary outcome measure at all assessment points. There were reductions in OCD symptoms with a large within-group effect size (Cohen's d = 1.56). At post-treatment, 61% of participants had a clinically significant improvement and 43% no longer fulfilled the diagnostic criteria of OCD. The treatment also resulted in statistically significant improvements in self-rated OCD symptoms, general functioning and depression. ICBT with therapist support reduces OCD symptoms, depressive symptoms and improves general functioning. Randomized trials are needed to confirm the effectiveness of this new treatment format.",Andersson E.; Ljótsson B.; Hedman E.; Kaldo V.; Paxling B.; Andersson G.; Lindefors N.; Rück C.,2011.0,10.1186/1471-244X-11-125,0,0,
8933,Examining the effects of thought records and behavioral experiments in instigating belief change.,"While the efficacy and effectiveness of CBT protocols are well established, much less is known about the comparative contribution of the various techniques within CBT. The present study examined the relative efficacy, in comparison to a control condition, of two central techniques in CBT: thought records (TRs) and behavioral experiments (BEs). A mixed within and between participants design was used to compare the efficacy of a single session TR and a single session BE intervention with a control intervention, in a non-clinical sample. Ninety one participants were randomly allocated to one of the three conditions. The overall pattern of results suggests that both TR and BE had a beneficial therapeutic impact in comparison to the control condition on beliefs, anxiety, behavior and a standardized measure of symptoms. There was evidence of a small advantage of the BE over the TR intervention in that the target belief changed earlier and change generalized to beliefs about others as well as the self. The findings confirm the utility of both TR and BE interventions and point to BEs as more useful in effecting belief change in that the change in the BE condition occurred sooner and generalized further.",McManus F.; Van Doorn K.; Yiend J.,2012.0,10.1016/j.jbtep.2011.07.003,0,0,
8934,"A self-administered, mild form of exposure therapy for older adults.","Despite the effectiveness of exposure therapy to alleviate trauma-related distress, many older adults are unable or unwilling to enter therapy. Mild forms of exposure therapy, such as completing memory questionnaires about a stressful event, have been shown to reduce distress in younger adults. This study attempted to examine the impact of a mild form of exposure therapy in an older adult population. A community-living sample of 263 older adults nominated a stressful event from their lives, and were randomly assigned to either complete questionnaires concerning their memory of the stressful event, or a control task. Results indicated that those who had completed the memory questionnaires about a nominated stressful event evidenced lower levels of distress two weeks later. This effect was stronger for events that were either more recent or had elevated initial levels of distress. These findings suggest an alternative treatment for older adults who have experienced a stressful or traumatic event.",Boals A.; Banks JB.; Hayslip B.,2012.0,10.1080/13607863.2011.598848,0,0,
8935,The effectiveness of a biblio-based support group for hoarding disorder.,"Compulsive hoarding is characterized by the acquisition of, and failure to discard, a large number of possessions and clutter that prevents the use of living spaces as intended. Current successful treatments such as individual and group cognitive-behavioral therapy are lengthy and costly, requiring a time commitment ranging from four to twelve months, trained clinicians to administer treatment, and multiple home visits. Nonprofessional interventions may provide a cost-effective pre-treatment, adjunct, or alternative for individuals who want to work on hoarding problems but are unable or unwilling to engage in treatment. The purpose of the present study was to investigate the effectiveness of an innovative program consisting of a 13-session non-professionally facilitated biblio-based, action-oriented support group using Tolin, Frost, and Steketee's (2007b) self-help book. In study 1, seventeen self-identified hoarding participants experienced significant decreases in clutter, difficulty discarding, and excessive acquisition from pre-treatment to post-treatment, with reductions evident at mid-treatment. Study 2 replicated the findings of study 1 using interview and observational measures taken in participants' homes. These findings suggest that a facilitated biblio-based group may be a promising intervention for hoarding disorder.",Frost RO.; Pekareva-Kochergina A.; Maxner S.,2011.0,10.1016/j.brat.2011.06.010,0,0,
8936,Using an experimental medicine model to explore combination effects of pharmacological and cognitive interventions for depression and anxiety.,"Selective serotonergic reuptake inhibitors (SSRIs) and cognitive therapies are effective in the treatment of anxiety and depression. Previous research suggests that both forms of treatments may work by altering cognitive biases in the processing of affective information. The current study assessed the effects of combining an SSRI with a cognitive intervention on measures of affective processing bias and resilience to external challenge. A total of 62 healthy participants were randomly assigned to receive either 7 days of citalopram (20 mg) or placebo capsules while also completing either an active or a control version of a computerized cognitive bias training task. After treatment, standard measures of affective processing bias were collected. Participants' resilience to external stress was also tested by measuring the increase in negative symptoms induced by a negative mood induction. Participants who received both citalopram and the active cognitive bias training task showed a smaller alteration in emotional memory and categorization bias than did those who received either active intervention singly. The degree to which memory for negative information was altered by citalopram predicted participants' resistance to the negative mood induction. These results suggest that co-administration of an SSRI and a cognitive training intervention can reduce the effectiveness of either treatment alone in terms of anxiety- and depression-relevant emotional processing. More generally, the findings suggest that pinpointing the cognitive actions of treatments may inform future development of combination strategies in mental health.",Browning M.; Grol M.; Ly V.; Goodwin GM.; Holmes EA.; Harmer CJ.,2011.0,10.1038/npp.2011.159,0,0,
8937,Combined medication and cognitive therapy for generalized anxiety disorder.,"The current study assessed efficacy of combined cognitive behavioral therapy (CBT) and venlafaxine XR compared to venlafaxine XR alone in the treatment of generalized anxiety disorder (GAD) within settings where medication is typically offered as the treatment for this disorder. Patients with DSM-IV-diagnosed GAD who were recently enrolled in a long-term venlafaxine XR study were randomly offered (n=77), or not offered (n=40), the option of adding 12 sessions of CBT. Of those offered CBT, 33% (n=26) accepted and attended at least one treatment session. There were no differences between the combined treatment group and the medication only group on primary or secondary efficacy measures in any of the sample comparisons. Many patients who present in medical/psychopharmacology settings seeking treatment for GAD decline the opportunity to receive adjunctive treatment. Of those that receive CBT, there appears to be no additional benefit of combined treatment compared to venlafaxine XR alone.",Crits-Christoph P.; Newman MG.; Rickels K.; Gallop R.; Gibbons MB.; Hamilton JL.; Ring-Kurtz S.; Pastva AM.,2011.0,10.1016/j.janxdis.2011.07.007,0,0,
8938,Cost-effectiveness of Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: results from a randomized controlled trial.,"Social anxiety disorder (SAD) is highly prevalent and associated with a substantial societal economic burden, primarily due to high costs of productivity loss. Cognitive behavior group therapy (CBGT) is an effective treatment for SAD and the most established in clinical practice. Internet-based cognitive behavior therapy (ICBT) has demonstrated efficacy in several trials in recent years. No study has however investigated the cost-effectiveness of ICBT compared to CBGT from a societal perspective, i.e. an analysis where both direct and indirect costs are included. The aim of the present study was to investigate the cost-effectiveness of ICBT compared to CBGT from a societal perspective using a prospective design. We conducted a randomized controlled trial where participants with SAD were randomized to ICBT (n=64) or CBGT (n=62). Economic data were assessed at pre-treatment, immediately following treatment and six months after treatment. Results showed that the gross total costs were significantly reduced at six-month follow-up, compared to pre-treatment in both treatment conditions. As both treatments were equivalent in reducing social anxiety and gross total costs, ICBT was more cost-effective due to lower intervention costs. We conclude that ICBT can be more cost-effective than CBGT in the treatment of SAD and that both treatments reduce societal costs for SAD.",Hedman E.; Andersson E.; Ljótsson B.; Andersson G.; Rück C.; Lindefors N.,2011.0,10.1016/j.brat.2011.07.009,0,0,
8939,No influence of one right-sided prefrontal HF-rTMS session on alcohol craving in recently detoxified alcohol-dependent patients: results of a naturalistic study.,"Prior research in substance dependence has suggested potential anti-craving effects of repetitive transcranial magnetic stimulation (rTMS) when applied to the dorsolateral prefrontal cortex (DLPFC). However, no single sham-controlled session studies applied to the right DLPFC have been carried-out in recently detoxified alcohol-dependent patients. Furthermore, no studies examined the effect of a single HF-rTMS session on craving in these patients' natural habitat. To further investigate the effect of high-frequency (HF)-rTMS of the right DLPFC on alcohol craving, we performed a prospective, single-blind, sham-controlled study involving 36 hospitalized patients with alcohol dependence syndrome. After successful detoxification, patients were allocated receiving one active or one sham HF-rTMS session. The obsessive-compulsive drinking scale (OCDS) was administered to evaluate the extent of craving just before and after the HF-rTMS session (on Friday), on Saturday and Sunday during the weekend at home, and on Monday when the patient returned to the hospital. One single blind sham-controlled HF-rTMS session applied to the right DLPFC did not result in changes in craving (neither immediately after the stimulation session, nor in patients' natural environment during the weekend). One HF-rTMS stimulation session applied to the right DLPFC had no significant effects on alcohol craving in alcohol dependent patients. One such session could have been too short to alter alcohol craving in a sample of alcohol dependent patients.",Herremans SC.; Baeken C.; Vanderbruggen N.; Vanderhasselt MA.; Zeeuws D.; Santermans L.; De Raedt R.,2012.0,10.1016/j.drugalcdep.2011.07.021,0,0,
8940,Effects of transference work in the context of therapeutic alliance and quality of object relations.,"Transference interpretation is considered as a core active ingredient in dynamic psychotherapy. In common clinical theory, it is maintained that more mature relationships, as well as a strong therapeutic alliance, may be prerequisites for successful transference work. In this study, the interaction between quality of object relations, transference interpretation, and alliance is estimated. One hundred outpatients seeking psychotherapy for depression, anxiety, and personality disorders were randomly assigned to 1 year of weekly sessions of dynamic psychotherapy with transference interpretation or to the same type and duration of treatment, but without the use of transference interpretation. Quality of Object Relations (QOR)-lifelong pattern was evaluated before treatment (P. H√∏glend, 1994). The Working Alliance Inventory (A. O. Horvath & L. S. Greenberg, 1989; T. J. Tracey & A. M. Kokotovic, 1989) was rated in Session 7. The primary outcome variable was the Psychodynamic Functioning Scales (P. H√∏glend et al., 2000), measured at pretreatment, posttreatment, and 1 year after treatment termination. A significant Treatment Group √ó Quality of Object Relations √ó Alliance interaction was present, indicating that alliance had a significantly different impact on effects of transference interpretation, depending on the level of QOR. The impact of transference interpretation on psychodynamic functioning was more positive within the context of a weak therapeutic alliance for patients with low quality of object relations. For patients with more mature object relations and high alliance, the authors observed a negative effect of transference work. The specific effects of transference work was influenced by the interaction of object relations and alliance, but in the direct opposite direction of what is generally maintained in mainstream clinical theory.",H√∏glend P.; Hersoug AG.; B√∏gwald KP.; Amlo S.; Marble A.; S√∏rbye √ò.; R√∏ssberg JI.; Ulberg R.; Gabbard GO.; Crits-Christoph P.,2011.0,10.1037/a0024863,0,0,
8941,Use of auxiliary psychiatric treatment during a 5-year follow-up among patients receiving short- or long-term psychotherapy.,"The need for treatment is, despite of its obvious usefulness, a scarcely used measure of effectiveness in psychotherapy trials. This study considers changes in the need for auxiliary psychiatric treatment after starting short- and long-term psychotherapy and psychoanalysis. Altogether 326 psychiatric outpatients with mood or anxiety disorder were randomly assigned to solution-focused therapy (SFT), short-term psychodynamic psychotherapy (SPP), or long-term psychodynamic psychotherapy (LPP) while 41 self-selected patients were allocated to psychoanalysis (PA). The patients were followed for 5 years from start of treatment. Outcome measures were use of auxiliary psychotherapy, psychotropic medication, and hospitalization for mental reasons. About 60% of the patients used auxiliary treatment during the follow-up. It was most common in the short-term therapy groups and its incidence was highest during the first year after the start of therapy. The average numbers of all therapy sessions among patients starting the therapy were 60, 70, 240, and 670 in SFT, SPP, LPP, and PA, respectively, whereas the corresponding average numbers of study therapy sessions alone were 10, 19, 232, and 646. Over 50% of the patients receiving short-term therapy received on average 4-6 times more therapy sessions than initially assigned. Post-randomization withdrawal was uneven. Auxiliary treatment is usual among patients receiving short- and long-term therapies, and apparently becomes common shortly after the start of treatment. Auxiliary treatment can be used as an outcome measure indicating the need for treatment, should be monitored clinically and considered when interpreting the results of effectiveness studies.",Knekt P.; Lindfors O.; Renlund C.; Sares-Jäske L.; Laaksonen MA.; Virtala E.,2011.0,10.1016/j.jad.2011.07.024,0,0,
8942,Spiritual wellbeing mediates PTSD change in veterans with military-related PTSD.,"A portable practice of repeating a mantram-a sacred word or phrase-has been shown to reduce the severity of posttraumatic stress disorder (PTSD) symptoms in veterans with military trauma. It is thought that the intervention re-directs attention and initiates relaxation to decrease symptom severity, but there may be other mechanisms that may contribute to this improvement. We tested the hypothesis that increases in existential spiritual wellbeing (ESWB) would mediate reductions in self-reported PTSD symptoms following a group mantram intervention. Veterans diagnosed with PTSD from war-related trauma completed 6 weeks of case management plus a group mantram intervention (n = 66) as part of a randomized trial. Measures included PTSD Checklist (PCL) and Functional Assessment of Chronic Illness Therapy-Spiritual Wellbeing. Path analysis was conducted on those who completed treatment to assess ESWB as a possible mediator of change in PCL from baseline to post-treatment. A significant indirect effect, -2.24, 95% CI (-4.17, -1.05) of the mantram intervention on PCL change was found. The path from the mantram intervention to ESWB change was significant and positive (B = 4.89, p < 0.0001), and the path from ESWB change to PCL change was significant and negative (B = -0.46, p = 0.001), thus supporting the hypothesis. Findings suggest that one contributing mechanism that partially explains how the mantram intervention reduces PTSD symptom severity in veterans may be by increasing levels of ESWB.",Bormann JE.; Liu L.; Thorp SR.; Lang AJ.,2012.0,10.1007/s12529-011-9186-1,0,0,
8943,The impact of motivational interviewing on resistance in cognitive behavioural therapy for generalized anxiety disorder.,"The present study simultaneously examined observed resistance and homework compliance in Cognitive Behavioural Therapy (CBT) between those with severe generalized anxiety disorder who did (n =18) and did not (n =17) receive Motivational Interviewing (MI) prior to CBT. Large effects for reduced resistance early in CBT were observed in the MI pretreatment group relative to the no-pretreatment group. Moreover, receiving four sessions of MI was associated with significantly lower levels of resistance, compared to receiving four sessions of CBTalone. Using path analysis, resistance, but not homework compliance, was found to strongly and directly mediate the relationship between treatment group and worry reduction. Findings suggest that MI improves treatment outcomes when added to CBT for generalized anxiety by reducing client resistance to, and increasing client engagement with treatment.",Aviram A.; Westra HA.,2011.0,10.1080/10503307.2011.610832,0,0,
8944,Comparison of group and individual cognitive-behavioral therapy in reducing fear of negative evaluation.,"Previous studies have established the efficacy of group and individual formats of cognitive-behavioral therapy in reducing fear of negative evaluation in social anxiety disorder, but the effectiveness of the group and individual therapies has not been widely assessed. This study was conducted to compare the effectiveness of cognitive-behavior group therapy to individual cognitive-behavioral therapy in social anxiety disorder. 28 patients were randomly allocated to two groups of 14. Each group participated in 12 weekly sessions. The final sample was 22 participants after drop-out. Pretest and posttest data were collected using the Brief Fear of Negative Evaluation Scale and the Beck Depression Inventory-II. Controlling for pretest fear of negative evaluation and depression, cognitive-behavioral group therapy was more effective than individual cognitive-behavioral therapy in reducing fear of negative evaluation, but the clinical significance and improvement rates of the two treatment formats were equivalent.",Dogaheh ER.; Mohammadkhani P.; Dolatshahi B.,2011.0,10.2466/02.21.PR0.108.3.955-962,0,0,
8945,Reduction of claustrophobia with short-bore versus open magnetic resonance imaging: a randomized controlled trial.,"Claustrophobia is a common problem precluding MR imaging. The purpose of the present study was to assess whether a short-bore or an open magnetic resonance (MR) scanner is superior in alleviating claustrophobia. Institutional review board approval and patient informed consent were obtained to compare short-bore versus open MR. From June 2008 to August 2009, 174 patients (139 women; mean age = 53.1 [SD 12.8]) with an overall mean score of 2.4 (SD 0.7, range 0 to 4) on the Claustrophobia Questionnaire (CLQ) and a clinical indication for imaging, were randomly assigned to receive evaluation by open or by short-bore MR. The primary outcomes were incomplete MR examinations due to a claustrophobic event. Follow-up was conducted 7 months after MR imaging. The primary analysis was performed according to the intention-to-treat strategy. With 33 claustrophobic events in the short-bore group (39% [95% confidence interval [CI] 28% to 50%) versus 23 in the open scanner group (26% [95% CI 18% to 37%]; P = 0.08) the difference was not significant. Patients with an event were in the examination room for 3.8 min (SD 4.4) in the short-bore and for 8.5 min (SD 7) in the open group (P = 0.004). This was due to an earlier occurrence of events in the short-bore group. The CLQ suffocation subscale was significantly associated with the occurrence of claustrophobic events (P = 0.003). New findings that explained symptoms were found in 69% of MR examinations and led to changes in medical treatment in 47% and surgery in 10% of patients. After 7 months, perceived claustrophobia increased in 32% of patients with events versus in only 11% of patients without events (P = 0.004). Even recent MR cannot prevent claustrophobia suggesting that further developments to create a more patient-centered MR scanner environment are needed. ClinicalTrials.gov NCT00715806.",Enders J.; Zimmermann E.; Rief M.; Martus P.; Klingebiel R.; Asbach P.; Klessen C.; Diederichs G.; Wagner M.; Teichgräber U.; Bengner T.; Hamm B.; Dewey M.,2011.0,10.1371/journal.pone.0023494,0,0,
8946,The impact of depression on the treatment of obsessive-compulsive disorder: results from a 5-year follow-up.,"Many OCD patients present with comorbid conditions, and major depression is one of the most frequent comorbidities observed. OCD patients with comorbid depression exhibit functional disability and poor quality of life. However, it is unclear whether depressive symptoms are predictive of treatment response, and debate remains whether they should be targeted in the treatment of comorbid patients. The current study aimed at assessing the predictive value of depression and OCD symptoms in the long term outcome of OCD treatment. In the current study, relations between OCD and depressive symptoms were systematically investigated in a group of 121 OCD patients who received 16 sessions of behavior or cognitive therapy either alone or with fluvoxamine. Depression (either as a continuous or categorical variable) was not predictive of treatment response in any of the treatment modalities for up to 5 years of follow-up. Changes in OCD symptoms largely predicted changes in depressive symptoms but not vice versa. Subsequent to participation in the RCT, almost two-thirds of the participants received some form of additional treatment (either pharmacological or psychological), and as a result, it is impossible to determine interaction effects with additional treatment received after the trial. Treatment of OCD with comorbid depression should focus on amelioration of OCD symptoms. When OCD treatment is successful, depressive symptoms are likely to ameliorate as well.",Anholt GE.; Aderka IM.; van Balkom AJ.; Smit JH.; Hermesh H.; de Haan E.; van Oppen P.,2011.0,10.1016/j.jad.2011.07.018,0,0,
8947,Combined cognitive bias modification treatment for social anxiety disorder: a pilot trial.,"Cognitive Bias Modification (CBM) is a promising treatment for Social Anxiety Disorder (SAD). However, previous randomized trials have not systematically examined the combination of CBM for attention (CBM-A) and interpretation (CBM-I) or the credibility and acceptability of these protocols. We conducted a randomized, double-blind placebo-controlled trial (N = 32) to examine the efficacy of a CBM treatment called Attention and Interpretation Modification (AIM) for SAD. AIM comprised eight, twice weekly computer sessions with no therapist contact. During AIM, participants (1) completed a dot probe task in which probes always followed neutral faces when paired with a disgust face, thereby directing attention away from threat and (2) completed a word-sentence association task in which they received positive feedback for making benign interpretations of word-sentence pairs and negative feedback for making negative interpretations. We also assessed participants' perceived credibility of and satisfaction with AIM. Participants receiving AIM reported significantly reduced self-reported (Liebowitz Social Anxiety Scale) symptoms of social anxiety relative to the placebo. These gains were also evident on a behavioral measure (performance on an impromptu speech). AIM met our benchmarks for credibility and acceptability in this community sample, although credibility ratings were modest. Participants reported that CBM-I was more helpful than CBM-A. A combined CBM treatment produced medium-to-large effects on social anxiety. Participants rated AIM as moderately credibly and acceptable. Should these findings be replicated in larger samples, AIM has the potential to be a widely accessible and efficacious treatment for SAD.",Beard C.; Weisberg RB.; Amir N.,2011.0,10.1002/da.20873,0,0,
8948,Age of depressed patient does not affect clinical outcome in collaborative care management.,"Clinical response and remission for the treatment of depression has been shown to be improved utilizing collaborative care management (CCM). Prior studies have indicated that the presence of mental health comorbidities noted by self-rated screening tools at the intake for CCM are associated with worsening outcomes; few have examined directly the impact of age on clinical response and remission. The hypothesis was that when controlling for other mental health and demographic variables, the age of the patient at implementation of CCM does not significantly impact clinical outcome, and that CCM shows consistent efficacy across the adult age spectrum. We performed a retrospective chart analysis of a cohort of 574 patients with a clinical diagnosis of major depression (not dysthymia) treated in CCM who had 6 months of follow-up data. Using the age group as a categorical variable in logistic regression models demonstrated that while maintaining control of all other variables, age grouping remained a nonsignificant predictor of clinical response (P ‚â• 0.1842) and remission (P ‚â• 0.1919) after 6 months of treatment. In both models, a lower Generalized Anxiety Disorder-7 score and a negative Mood Disorder Questionnaire score were predictive of clinical response and remission. However, the initial Patient Health Questionnaire-9 score was a statistically significant predictor only for clinical remission (P = 0.0094), not for response (P = 0.0645), at 6 months. In a subset (n = 295) of the study cohort, clinical remission at 12 months was also not associated with age grouping (P ‚â• 0.3355). The variables that were predictive of remission at 12 months were the presence of clinical remission at 6 months (odds ratio [OR], 7.4820; confidence interval [CI], 3.9301-14.0389; P < 0.0001), clinical response (with persistent symptoms) (OR, 2.7722; CI, 1.1950-6.4313; P = 0.0176), and a lower initial Patient Health Questionnaire-9 score (OR, 0.9121; CI, 0.8475-0.9816; P = 0.0140). Our study suggests that using CCM for depression treatment may transcend age-related differences in depression and result in positive outcomes regardless of age.",Angstman KB.; MacLaughlin KL.; Rasmussen NH.; DeJesus RS.; Katzelnick DJ.,2011.0,10.3810/pgm.2011.09.2467,0,0,
8949,Group cognitive-behavioral therapy versus selective serotonin reuptake inhibitors for obsessive-compulsive disorder: a practical clinical trial.,"Clinical effectiveness of group cognitive-behavioral therapy (GCBT) versus fluoxetine in obsessive-compulsive disorder outpatients that could present additional psychiatric comorbidities was assessed. Patients (18-65 years; baseline Yale-Brown Obsessive-Compulsive-Scale [Y-BOCS] scores ≥ 16; potentially presenting additional psychiatric comorbidities) were sequentially allocated for treatment with GCBT (n=70) or fluoxetine (n=88). Mean Y-BOCS scores decreased by 23.13% in the GCBT and 21.54% in the SSRI groups (p=0.875). Patients presented a mean of 2.7 psychiatric comorbidities, and 81.4% showed at least one additional disorder. A reduction of at least 35% in baseline Y-BOCS scores and CGI ratings of 1 (much better) or 2 (better) was achieved by 33.3% of GCBT patients and 27.7% in the SSRI group (p=0.463). The Y-BOCS reduction was significantly lower in patients with one or more psychiatric comorbidities (21.15%, and 18.73%, respectively) than in those with pure OCD (34.62%; p=0.034). Being male, having comorbidity of Major Depression, Social Phobia, or Dysthymia predicted a worse response to both treatments. Response rates to both treatments were similar and lower than reported in the literature, probably due to the broad inclusion criteria and the resulting sample more similar to the real world population.",Belotto-Silva C.; Diniz JB.; Malavazzi DM.; Valério C.; Fossaluza V.; Borcato S.; Seixas AA.; Morelli D.; Miguel EC.; Shavitt RG.,2012.0,10.1016/j.janxdis.2011.08.008,0,0,
8950,Treatment of secondary dystonia with a combined stereotactic procedure: long-term surgical outcomes.,"There is some debate about the effects of pallidal deep brain stimulation (DBS) or lesioning on secondary dystonia. We applied a multimodal method to maximize the treatment effects of deep brain stimulation in patients with secondary dystonia. Between March 2003 and January 2009, four patients underwent bilateral globus pallidus internus (GPi) DBS and six patients underwent bilateral GPi DBS plus unilateral thalamotomy for treatment of cerebral palsy (CP). Among the patients with secondary dystonia without CP, five were also treated by DBS. We classified patients with generalized secondary dystonia with cerebral palsy into group I and patients with focal dystonia without CP into group II. Clinical outcome assessments were based on Burke-Fahn-Marsden Dystonia Rating Scale movement and disability scores. Heath-related quality of life was assessed with a 36-item short-form general health survey questionnaire preoperatively and at the last follow-up. The movement and disability scores of group I-A had improved by 32.0% (P‚Äâ=‚Äâ0.285) and 14.3% (P‚Äâ=‚Äâ0.593), respectively, at the last follow-up compared with baseline. The movement and disability scores of group I-B had improved by 31.5% and 0.18% at the last follow-up compared with baseline, respectively. In comparison with patients in group I-A, patients in group I-B showed a significant improvement in movement scores for the contralateral arm (P‚Äâ=‚Äâ0.042). Group II patients showed a marked improvement in movement and disability scores of 77.7% (P‚Äâ=‚Äâ0.039) and 80.0% (P‚Äâ=‚Äâ0.041), respectively. We demonstrated that DBS plus unilateral ventralis oralis thalamotomy for CP patients with fixed states in the upper extremities is useful not only to treat secondary dystonic movement but also to improve quality of life. In group II patients with post-traumatic dystonia and tardive dyskinesia, we achieved excellent clinical outcomes using a stereotactic procedure.",Kim JP.; Chang WS.; Chang JW.,2011.0,10.1007/s00701-011-1147-6,0,0,
8951,Evaluating transdiagnostic treatment for distress and impairment in veterans: a multi-site randomized controlled trial of Acceptance and Commitment Therapy.,"Military personnel who engaged in the conflicts in Afghanistan and Iraq frequently present for mental health care because of the stresses of service and readjustment. Although excellent treatments are available to treat the typical presenting problems, there is a need for additional empirically supported treatment approaches for this population. Because these veterans have high levels of comorbidity, transdiagnostic treatment - treatment that applies to more than one diagnosis - may be an efficient approach for this group. Acceptance and Commitment Therapy (ACT) is one such approach that is well-known and has high face validity for veterans, but it has not been rigorously evaluated as a treatment for trauma-related mental health problems. Described herein is an ongoing multi-site randomized clinical trial of ACT as compared to a psychotherapy control. Challenges in designing an RCT to evaluate transdiagnostic treatment and in executing a multi-site psychotherapy trial are discussed.",Lang AJ.; Schnurr PP.; Jain S.; Raman R.; Walser R.; Bolton E.; Chabot A.; Benedek D.,2012.0,10.1016/j.cct.2011.08.007,0,0,
8952,The role of early maladaptive schemas in predicting exposure and response prevention outcome for obsessive-compulsive disorder.,"This is the first study that explores whether early maladaptive schemas are related to treatment outcome for patients with obsessive-compulsive disorder (OCD). The sample consisted of 88 outpatients with a diagnosis of OCD who completed exposure and response prevention treatment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Beck Depression Inventory and Young Schema Questionnaire - Short Form were administered before and after treatment. Regression analyses using post-treatment Y-BOCS as the dependent variable indicated that higher scores on the abandonment schema at pre-treatment were related to poor outcome and explained 7% of the variance in symptoms at post-treatment. Higher scores on the self-sacrifice schema at pre-treatment were related to good outcome and explained 6% of the variance in obsessive-compulsive symptoms at post-treatment. During treatment, only changes in the failure schema were significantly related to good outcome and explained 18% of the variance in symptoms at post-treatment.",Haaland AT.; Vogel PA.; Launes G.; Haaland VØ.; Hansen B.; Solem S.; Himle JA.,2011.0,10.1016/j.brat.2011.08.007,0,0,
8953,Attentional bias in post-traumatic stress disorder diminishes after symptom amelioration.,"Avoidance and hypervigilance to reminders of a traumatic event are among the main characteristics of post-traumatic stress disorder (PTSD). Attentional bias toward aversive cues in PTSD has been hypothesized as being part of the dysfunction causing etiology and maintenance of PTSD. The aim of the present study was to investigate the cognitive strategy underlying attentional bias in PTSD and whether normal cognitive processing is restored after a treatment suppressing core PTSD symptoms. Nineteen healthy controls were matched for age, sex and education to 19 PTSD patients. We used the emotional stroop and detection of target tasks, before and after an average of 4.1 sessions of eye movement desensitization and reprocessing (EMDR) therapy. We found that on both tasks, patients were slower than controls in responding in the presence of emotionally negative words compared to neutral ones. After symptoms removal, patients no longer had attentional bias, and responded similarly to controls. These results support the existence of an attentional bias in PTSD patients due to a disengagement difficulty. There was also preliminary evidence that the disengagement was linked to PTSD symptomatology. It should be further explored whether attentional bias and PTSD involve common brain mechanisms.",El Khoury-Malhame M.; Lanteaume L.; Beetz EM.; Roques J.; Reynaud E.; Samuelian JC.; Blin O.; Garcia R.; Khalfa S.,2011.0,10.1016/j.brat.2011.08.006,0,0,
8954,Group cognitive-behavioral therapy for hoarding disorder: an open trial.,"Although cognitive-behavioral therapy (CBT) appears to be a promising treatment approach for hoarding disorder, treatment to date has been quite labor intensive. The goal of this study, therefore, was to assess the potential effectiveness of group CBT for hoarding, without home visits by the clinician. Forty-five individuals with hoarding disorder enrolled in either a 16 or 20 session program of group CBT; 30 (67%) completed treatment. Using mixed-effects models to account for missing data, we report data from 35 (78%) participants who provided enough data for analysis. Participants demonstrated significant improvements in hoarding symptoms, as well as symptoms of depression and anxiety, and quality of life. Improvements in hoarding symptoms were comparable to two published clinical trials on individual CBT for hoarding disorder. Results of this study suggest that group CBT for hoarding, without home discarding sessions by the clinician, may be an effective treatment option with the potential advantage of increasing treatment access by reducing clinician burden and cost of treatment.",Gilliam CM.; Norberg MM.; Villavicencio A.; Morrison S.; Hannan SE.; Tolin DF.,2011.0,10.1016/j.brat.2011.08.008,0,0,
8955,A randomized study of the effects of mindfulness training on psychological well-being and symptoms of stress in patients treated for cancer at 6-month follow-up.,"There is increasing evidence showing beneficial effects of mindfulness and mindfulness training on various indicators of mental and physical health. This paper reports the 6-month follow-up effects of a mindfulness stress reduction training program among patients treated for cancer on perceived stress, depression, anxiety, post-traumatic stress symptoms, positive states of mind, coping self-efficacy, and mindfulness. Patients with a previous cancer diagnosis were recruited and randomized into an intervention group or a waiting list control group. The intervention consisted of an 8-week mindfulness training course. Compared to participants in the control group, the intervention group showed a larger increase in mindfulness at 6-month follow-up. However, there were no differences on any of the other outcomes between the intervention and control groups. Continued meditation practice was associated with a significant reduction in post-traumatic stress symptoms of avoidance. The study draws attention to the need to better understand the mechanisms behind the effect of mindfulness training and to potential modification of mindfulness interventions to promote sustained benefits over time.",Bränström R.; Kvillemo P.; Moskowitz JT.,2012.0,10.1007/s12529-011-9192-3,0,0,
8956,"Efficacy of the trial-based thought record, a new cognitive therapy strategy designed to change core beliefs, in social phobia.","Social anxiety disorder (SAD) often follows a chronic course and is associated with substantial impairment in functioning. Although results from clinical trials clearly establish evidence for efficacy of cognitive behavioural therapy in treating this disorder, up to 50% of patients with SAD show little or no improvement. Thus, new approaches that have promised in improving the efficacy of treatment for SAD are needed. One such approach is the trial-based thought record (TBTR), which targets the restructuring of patients' core beliefs. To determine whether patients receiving TBTR would report fewer symptoms of social anxiety and general psychiatric distress following treatment, relative to conventional cognitive therapy (CCT). A two-arm randomized trial comparing TBTR (n = 17) with a set of CCT techniques (n = 19), which included the standard seven-column dysfunctional thought record and the positive data log in SAD patients according to DSM-IV. Scores on many outcome measures decreased significantly across the course of treatment in both groups (P < 0·001), including the Liebowitz Social Anxiety Scale, Fear of Negative Evaluation Scale (FNE), Social Avoidance and Distress Scale (SADS), Beck Anxiety Inventory, and Clinical Global Impression - Improvement. In addition, a one-way ancova, taking baseline values as covariates, showed that TBTR was significantly more efficacious than CCT in reducing the scores of FNE (P = 0·01 at mid-treatment and P = 0·004 at post-treatment), and SADS (P = 0·03 at post-treatment). This study provides preliminary evidence that TBTR is at least as efficacious as CCT in reducing symptoms of SAD, pointing to the need for additional studies of TBTR in SAD and other psychiatric disorders.",de Oliveira IR.; Powell VB.; Wenzel A.; Caldas M.; Seixas C.; Almeida C.; Bonfim T.; Grangeon MC.; Castro M.; Galvão A.; de Oliveira Moraes R.; Sudak D.,2012.0,10.1111/j.1365-2710.2011.01299.x,0,0,
8957,Sexual adjustment following early stage cervical and endometrial cancer: prospective controlled multi-centre study.,"The primary aim of this study was to investigate objective and subjective aspects of sexual adjustment for women with early stage cervical and endometrial cancer during the first 6 months post-treatment, compared to women with benign and pre-invasive gynaecological conditions. 'Objective' aspects of sexual function were operationalised as the frequency of sexual activity and 'subjective' aspects as the perceived quality of sexual interactions. This multi-centre controlled study compared sexual outcomes of women treated for early stage cervical and endometrial cancer (n = 53) with (i) benign gynaecological patients (n = 60), as a comparison group for the physical effects of major pelvic surgery, and (ii) pre-invasive cancer patients (n = 52), as a comparison group for the emotional effect of the perceived threat of cancer. All patients were assessed at baseline and at 6 months follow-up using standardised measures of objective and subjective aspects of sexual function, overall satisfaction with sexual life, relationship satisfaction and psychological distress. Despite experiencing treatment-related physical changes, women with early stage cervical and endometrial cancer did not report more severe or longer-lasting sexual sequelae than the benign or pre-invasive groups. There were no significant differences between the three groups or changes over time for the objective, subjective or overall measures of sexual function, controlling for age, psychological distress and relationship satisfaction. The current findings suggest that early stage cervical and endometrial cancer patients fare as well as benign and pre-invasive cancer groups in terms of sexual adjustment over the 6 months post-treatment.",Juraskova I.; Butow P.; Bonner C.; Robertson R.; Sharpe L.,2013.0,10.1002/pon.2066,0,0,
8958,Post-traumatic implant-supported restoration of the anterior maxillary teeth using cancellous bone block allografts.,"To prospectively evaluate the outcome of dental implants placed in the post-traumatic anterior maxilla after ridge augmentation with cancellous freeze-dried block bone allografts. Patients presenting with a history of anterior dentoalveolar trauma with bony deficiencies in the sagittal (≥3 mm) and vertical (<3 mm) planes according to computed tomography were included. The recipient sites were reconstructed with cancellous bone block allografts. After 6 months of healing, implants were placed. The primary outcomes of interest were 1) bone measurements taken before grafting, at the time of implant placement, and at stage 2 operations; 2) implant survival; and 3) complications. The sample was composed of 20 consecutive patients with a mean age of 25 ± 7 years. We used 28 cancellous allogeneic bone blocks, and 31 implants were inserted. Of the 31 implants, 12 were immediately restored. The mean follow-up was 42 ± 15 months. Graft and implant survival rates were 92.8% and 96.8%, respectively. Mean bone gain in the sagittal and vertical planes was 5 ± 0.5 mm horizontally and 2 ± 0.5 mm (P < .001). Successful restoration was achieved in all patients with fixed implant-supported prostheses. Soft tissue complications occurred in 7 patients (35%). Complications after cementation of the crowns were seen in 3 implants (9.6%). All implants remained clinically osseointegrated at the end of the follow-up examination. There was no crestal bone loss around the implants beyond the first implant thread. Cancellous block allograft can be used successfully for post-traumatic implant-supported restoration in the anterior maxilla.",Nissan J.; Gross O.; Mardinger O.; Ghelfan O.; Sacco R.; Chaushu G.,2011.0,10.1016/j.joms.2011.08.002,0,0,
8959,An open trial of a brief transdiagnostic internet treatment for anxiety and depression.,"The present study evaluated the efficacy of a brief version of an internet-administered transdiagnostic CBT protocol, the Wellbeing Program (Titov et al., 2011), designed to treat three anxiety disorders and major depression within the same program. This brief version included the same core CBT skills as the original, but condensed the materials from 8 to 5 online lessons, reduced the duration of treatment from 10 to 8 weeks and did not include an online forum. Thirty-two individuals with a principal diagnosis of major depression, generalised anxiety disorder, panic disorder or social phobia received CBT-based online educational lessons, homework assignments, weekly contact from a clinical psychologist and automated emails. Eighty-one percent of participants completed the lessons within the 8 week program. Post-treatment and 3-month follow-up data were collected from 28/32 and 31/32 participants respectively. Participants improved significantly on the Depression Anxiety and Stress Scales - 21 Item, Patient Health Questionnaire - 9 Item, and Generalised Anxiety Disorder - 7 Item scales, with corresponding within-group effect sizes (Cohen's d) at follow-up of 1.05, .73, and .95, respectively. Participants rated the procedure as highly acceptable with gains of a similar magnitude as those found for the original program, but less time was spent per participant by the clinician in the present trial (mean=44.61 min, SD=34.45) compared to the original program (mean=84.76 min, SD=50.37). These results provide additional support for the efficacy of transdiagnostic iCBT in the treatment of anxiety and depressive disorders and indicate that a brief version may be of benefit.",Dear BF.; Titov N.; Schwencke G.; Andrews G.; Johnston L.; Craske MG.; McEvoy P.,2011.0,10.1016/j.brat.2011.09.007,0,0,
8960,Efficacy of cognitive behavioral internet-based therapy in parents after the loss of a child during pregnancy: pilot data from a randomized controlled trial.,"The loss of a child during pregnancy can be a traumatic event associated with long-lasting grief and psychological distress. This study examined the efficacy of an internet-based cognitive behavioral therapy program for mothers after pregnancy loss. In a randomized controlled trial with a waiting list control group, 83 participants who had lost a child during pregnancy were randomly allocated either to 5 weeks of internet therapy or to a 5-week waiting condition. Within a manualized cognitive behavioral treatment program, participants wrote ten essays on loss-specific topics. Posttraumatic stress, grief, and general psychopathology, especially depression, were assessed pretreatment, posttreatment, and at 3-month follow-up. Intention-to-treat analyses and completer analyses were performed. Relative to controls, participants in the treatment group showed significant improvements in posttraumatic stress, grief, depression, and overall mental health, but not in anxiety or somatization. Medium to large effect sizes were observed, and the improvement was maintained at 3-month follow-up. This internet-based cognitive behavioral therapy program represents an effective treatment approach with stable effects for women after pregnancy loss. Implementation of the program can thus help to improve the health care provision for mothers in this traumatic loss situation.",Kersting A.; Kroker K.; Schlicht S.; Baust K.; Wagner B.,2011.0,10.1007/s00737-011-0240-4,0,0,
8961,"Comorbid social anxiety disorder in clients with depressive disorders: predicting changes in depressive symptoms, therapeutic relationships, and focus of attention in group treatment.","The current study examined whether depressed outpatients with comorbid SAD respond differently to a cognitive-behavioral group intervention and if so, how and why. Using growth curve modeling, we found evidence that depressed clients with comorbid SAD had rapid improvement in depressive symptoms over the course of treatment and generally did not differ from those without comorbidity in developing close therapeutic relationships and modifying the direction of attentional focus away from the self. Non-linear effects demonstrated that rates of change in depressive symptoms, relationship variables, and focus of attention, were most rapid early in treatment. In contrast to hypotheses, trajectories of change in therapeutic relationships and attentional focus did not mediate the effect of SAD on treatment improvement in depressive symptoms. These findings suggest that comorbid SAD does not have a detrimental effect on the course of depression treatment and group-based treatments can be as beneficial for depressed individuals with comorbid SAD. It may be that group-based treatments for depression provide explicit opportunity for emotional processing in social situations (i.e., exposure) and hence mimic efficacious therapies for SAD.",Kashdan TB.; Roberts JE.,2011.0,10.1016/j.brat.2011.10.002,0,0,
8962,An experimental investigation of peer influences on adolescent hostile attributions.,"Aggression in young people has been associated with a bias toward attributing hostile intent to others. However, little is known about the origin of biased social information processing. The current study explored the potential role of peer contagion in the emergence of hostile attribution in adolescents. One hundred thirty-four adolescents (M age = 13.8 years) were assigned to one of two manipulated ""chat-room"" conditions, where they believed they were communicating with online peers (e-confederates) who endorsed either hostile or benign intent attributions. Adolescents showed increased hostile attributions following exposure to hostile e-confederates and reduced hostility in the benign condition. Further analyses demonstrated that social anxiety was associated with a reduced tendency to take on hostile peer attitudes. Neither gender nor levels of aggression influenced individual susceptibility to peer influence, but aggressive adolescents reported greater affinity with hostile e-confederates.",Freeman K.; Hadwin JA.; Halligan SL.,2011.0,10.1080/15374416.2011.614582,0,0,
8963,A phase I study of low-pressure hyperbaric oxygen therapy for blast-induced post-concussion syndrome and post-traumatic stress disorder.,"This is a preliminary report on the safety and efficacy of 1.5 ATA hyperbaric oxygen therapy (HBOT) in military subjects with chronic blast-induced mild to moderate traumatic brain injury (TBI)/post-concussion syndrome (PCS) and post-traumatic stress disorder (PTSD). Sixteen military subjects received 40 1.5 ATA/60 min HBOT sessions in 30 days. Symptoms, physical and neurological exams, SPECT brain imaging, and neuropsychological and psychological testing were completed before and within 1 week after treatment. Subjects experienced reversible middle ear barotrauma (5), transient deterioration in symptoms (4), and reversible bronchospasm (1); one subject withdrew. Post-treatment testing demonstrated significant improvement in: symptoms, neurological exam, full-scale IQ (+14.8 points; p<0.001), WMS IV Delayed Memory (p=0.026), WMS-IV Working Memory (p=0.003), Stroop Test (p<0.001), TOVA Impulsivity (p=0.041), TOVA Variability (p=0.045), Grooved Pegboard (p=0.028), PCS symptoms (Rivermead PCSQ: p=0.0002), PTSD symptoms (PCL-M: p<0.001), depression (PHQ-9: p<0.001), anxiety (GAD-7: p=0.007), quality of life (MPQoL: p=0.003), and self-report of percent of normal (p<0.001), SPECT coefficient of variation in all white matter and some gray matter ROIs after the first HBOT, and in half of white matter ROIs after 40 HBOT sessions, and SPECT statistical parametric mapping analysis (diffuse improvements in regional cerebral blood flow after 1 and 40 HBOT sessions). Forty 1.5 ATA HBOT sessions in 1 month was safe in a military cohort with chronic blast-induced PCS and PTSD. Significant improvements occurred in symptoms, abnormal physical exam findings, cognitive testing, and quality-of-life measurements, with concomitant significant improvements in SPECT.",Harch PG.; Andrews SR.; Fogarty EF.; Amen D.; Pezzullo JC.; Lucarini J.; Aubrey C.; Taylor DV.; Staab PK.; Van Meter KW.,2012.0,10.1089/neu.2011.1895,0,0,
8964,Gray matter volumes in obsessive-compulsive disorder before and after fluoxetine or cognitive-behavior therapy: a randomized clinical trial.,"Serotonin reuptake inhibitors and cognitive-behavior therapy (CBT) are considered first-line treatments for obsessive-compulsive disorder (OCD). However, little is known about their modulatory effects on regional brain morphology in OCD patients. We sought to document structural brain abnormalities in treatment-naive OCD patients and to determine the effects of pharmacological and cognitive-behavioral treatments on regional brain volumes. Treatment-naive patients with OCD (n=38) underwent structural magnetic resonance imaging scan before and after a 12-week randomized clinical trial with either fluoxetine or group CBT. Matched-healthy controls (n=36) were also scanned at baseline. Voxel-based morphometry was used to compare regional gray matter (GM) volumes of regions of interest (ROIs) placed in the orbitofrontal, anterior cingulate and temporolimbic cortices, striatum, and thalamus. Treatment-naive OCD patients presented smaller GM volume in the left putamen, bilateral medial orbitofrontal, and left anterior cingulate cortices than did controls (p<0.05, corrected for multiple comparisons). After treatment with either fluoxetine or CBT (n=26), GM volume abnormalities in the left putamen were no longer detectable relative to controls. ROI-based within-group comparisons revealed that GM volume in the left putamen significantly increased (p<0.012) in fluoxetine-treated patients (n=13), whereas no significant GM volume changes were observed in CBT-treated patients (n=13). This study supports the involvement of orbitofronto/cingulo-striatal loops in the pathophysiology of OCD and suggests that fluoxetine and CBT may have distinct neurobiological mechanisms of action.",Hoexter MQ.; de Souza Duran FL.; D'Alcante CC.; Dougherty DD.; Shavitt RG.; Lopes AC.; Diniz JB.; Deckersbach T.; Batistuzzo MC.; Bressan RA.; Miguel EC.; Busatto GF.,2012.0,10.1038/npp.2011.250,0,0,
8965,Cancer distress reduction with a couple-based skills training: a randomized controlled trial.,"There are few interventions for couples facing cancer. This study aims to investigate the utility of providing dyadic skills to these couples. Woman recently diagnosed with breast or gynecological cancer and their partners were randomly assigned to either a couple-skills intervention (Side by Side) or to cancer education (Couples Control Program). Assessments with self-report and behavioral observation of both partners were conducted four times over 16 months. Multilevel analyses of data from 72 participating couples suggest that females receiving Side by Side showed larger reductions in fear of progression, and couples reported less avoidance in dealing with the cancer, more posttraumatic growth, and better relationship skills relative to the Couples Control Program. All differences favoring Side by Side disappeared by 16 months after the diagnosis. Short-term changes in functioning may be improved by enhancing couples' dyadic skills during acute medical treatment of the disease.",Heinrichs N.; Zimmermann T.; Huber B.; Herschbach P.; Russell DW.; Baucom DH.,2012.0,10.1007/s12160-011-9314-9,0,0,
8966,Impact of physical activity on mood after TBI.,"To examine the effect of a physical activity programme on the mood states of individual's with a traumatic brain injury. Participants were randomly assigned to an experimental (aquatic physical activity intervention) (n = 8) or control group (n = 8). The intervention group completed an 8-week aquatic programme consisting of 24 sessions. The control group completed a vocational rehabilitation class for the same number of weeks and sessions. Participants within the physical activity and control group completed the Profile of Mood States (POMS) pre- and post-programme. The POMS measures six dimensions of mood including tension, depression, anger, vigour, fatigue and confusion. An ANOVA was completed to examine between and within group differences pre- and post-programme. Results for the experimental group indicated significant differences and large effect sizes for tension, depression, anger, vigour, fatigue and confusion. No significant differences were found for the control group across all variables. As research has shown increased disturbances in psychosocial states following a brain injury as well as higher rates of depression, results have important implications for individuals involved in rehabilitation, as physical activity can positively influence mood.",Driver S.; Ede A.,2009.0,10.1080/02699050802695574,0,0,
8967,"A school-based, teacher-mediated prevention program (ERASE-Stress) for reducing terror-related traumatic reactions in Israeli youth: a quasi-randomized controlled trial.","Since September 2000 Israeli children have been exposed to a large number of terrorist attacks. A universal, school-based intervention for dealing with the threat of terrorism as well as with terror-related symptoms, ERASE-Stress (ES), was evaluated in a male religious middle school in southern Israel. The program was administered by the homeroom teachers as part of the school curriculum. It consists of 12 classroom sessions each lasting 90 minutes, and included psycho-educational material, skill training and resiliency strategies delivered to the students by homeroom teachers. One hundred and fourteen 7th and 8th grade students were randomly assigned to the ES intervention or were part of a waiting list (WL). They were assessed on measures of posttraumatic symptomatology, depression, somatic symptoms and functional problems before and 3 months after the intervention or the WL period. Three months after the program ended, students in the experimental group showed significant reduction in all measures compared to the waiting-list control group. The ERASE-Stress program may help students suffering from terror-related posttraumatic symptoms and mitigate the negative effects of future traumatic experiences. Furthermore, a school-based universal program such as the ERASE-Stress may potentially serve as an important and effective component of a community mental health policy for communities affected by terrorism.",Gelkopf M.; Berger R.,2009.0,10.1111/j.1469-7610.2008.02021.x,0,0,
8968,Cognitive behavioural therapy and applied relaxation for generalized anxiety disorder: a time series analysis of change in worry and somatic anxiety.,"The present study examined symptom change profiles in patients with generalized anxiety disorder (GAD) receiving either cognitive behavioural therapy (CBT) or applied relaxation (AR). It was hypothesized that (a) changes in worry would uniquely predict changes in somatic anxiety for most participants receiving CBT and (b) changes in somatic anxiety would uniquely predict changes in worry for most participants in the AR condition. Twenty participants (CBT n = 10; AR n = 10) completed daily ratings of worry and somatic anxiety during therapy, and multivariate time series analysis was used to assess the causal impact of each variable on the other. The hypotheses were not supported because we found no evidence of a match between individual symptom change profiles and treatment condition. Rather, a bidirectional relationship between worry and somatic anxiety was observed in 80% of participants receiving CBT and 70% of participants receiving AR. When only treatment responders were considered, 83% of participants receiving CBT and 86% of those receiving AR had such a bidirectional effect. The findings are discussed in terms of models of psychopathology that posit dynamic interactions between symptom clusters and in terms of the value of examining treatment mechanisms at the individual level.",Dugas MJ.; Francis K.; Bouchard S.,2009.0,10.1080/16506070902980745,0,0,
8969,Effectiveness of mindfulness-based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder.,"Mindfulness-based cognitive therapy (MBCT) has been widely used to treat patients with depressive disorder to prevent relapse. The objective of this study was to examine the effectiveness of newly developed MBCT program as an adjuvant to pharmacotherapy in the treatment of patients with panic disorder or generalized anxiety disorder. Forty-six patients with panic disorder or generalized anxiety disorder were assigned to either MBCT or an anxiety disorder education (ADE) program for a period of 8 weeks. The Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Symptom Checklist-90-Revised (SCL-90-R) were used to assess the patients at 0 week and after the two programs had been running for 2, 4, and 8 weeks. The MBCT group demonstrated significantly more improvement than the ADE group according to all anxiety (HAM-A, p<0.01; BAI, p<0.01; anxiety subscale of SCL-90-R, p=0.01) and depression (HAM-D, p<0.01; BDI, p<0.01; depression subscale of SCL-90-R, p<0.01) scale scores. The obsessive-compulsive and phobic subscales of the SCL-90-R also showed significantly more improvement in the MBCT group. However, no significant improvement was observed in the MBCT group versus the ADE group in terms of the somatization, interpersonal sensitivity, paranoid ideation, or psychoticism subscale scores of the SCL-90-R. MBCT may be effective at relieving anxiety and depressive symptoms in patients with panic disorder or generalized anxiety disorder. However, well-designed, randomized controlled trials are needed.",Kim YW.; Lee SH.; Choi TK.; Suh SY.; Kim B.; Kim CM.; Cho SJ.; Kim MJ.; Yook K.; Ryu M.; Song SK.; Yook KH.,2009.0,10.1002/da.20552,0,0,
8970,A randomized controlled trial of intranasal oxytocin as an adjunct to exposure therapy for social anxiety disorder.,"In humans, oxytocin nasal administration reduces social-threat perception and improves processes involved in communication and the encoding of positive social cues. The aim of this study was to determine whether oxytocin given as an adjunct to exposure therapy improves treatment for social anxiety disorder (SAD) as indicated by a comprehensive set of symptom outcome measures. In a randomized, double-blind, placebo-controlled trial, we administered 24 IU of oxytocin or a placebo in combination with exposure therapy to twenty-five participants who met primary diagnosis for SAD. Participants administered with oxytocin showed improved positive evaluations of appearance and speech performance as exposure treatment sessions progressed. These effects did not generalize to improve overall treatment outcome from exposure therapy. Participants who received oxytocin or placebo reported similar levels of symptom reduction following treatment across symptom severity, dysfunctional cognition, and life-impairment measures. This study shows that the administration of oxytocin improves mental representations of self, following exposure therapy. These effects may be either short term or situation specific. Future research is now needed to determine whether oxytocin can enhance treatment outcomes for SAD when used with greater frequency, with a wider variety of social learning experiences, and in conjunction with interventions that more specifically target change in broader dysfunctional cognitions.",Guastella AJ.; Howard AL.; Dadds MR.; Mitchell P.; Carson DS.,2009.0,10.1016/j.psyneuen.2009.01.005,0,0,
8971,Impact of chronic musculoskeletal pathology on older adults: a study of differences between knee OA and low back pain.,"The study aimed to compare the psychological and physical characteristics of older adults with knee osteoarthritis (OA) vs those of adults with chronic low back pain (CLBP) and to identify psychological and physical predictors of function as measured by gait speed. Secondary data analysis. Eighty-eight older adults with advanced knee OA and 200 with CLBP who had participated in separate randomized controlled trials were selected for this study. Inclusion criteria for both trials included age > or =65 and pain of at least moderate intensity that occurred daily or almost every day for at least the previous 3 months. Psychological constructs (catastrophizing, fear avoidance, self-efficacy, depression, affective distress) and physical measures (comorbid medical conditions, pain duration, pain severity, pain related interference, self-rated health) were obtained. Subjects with CLBP had slower gait (0.88 m/s vs 0.96 m/s, P = 0.002) and more comorbid conditions than subjects with knee pain (mean 3.36 vs 1.97, P < 0.001). All the psychological measures were significantly worse in the CLBP group except the Multidimensional Pain Inventory-Affective Distress score. Self-efficacy, pain severity, and medical comorbidity burden were associated with slower gait regardless of the location of the pain. Older adults with chronic pain may have distinct psychological and physical profiles that differentially impact gait speed. These findings suggest that not all pain conditions are the same in their psychological and physical characteristics and may need to be taken into consideration when developing treatment plans.",Morone NE.; Karp JF.; Lynch CS.; Bost JE.; El Khoudary SR.; Weiner DK.,,10.1111/j.1526-4637.2009.00565.x,0,0,
8972,[Autotransplantation of composit complexes of tissues for restoration of the combined bone-soft tissue post-traumatic defects of the wrist and the hand].,"The experience of treatment of 27 patients, suffering the extended bone-soft tissue defects of the wrist and the hand was summarized. In 12 patients (1-st group) the bone plasty was performed, using nonvascularized fragment of os ilei wing with simultaneous excision of the damaged soft tissues and free transplantation of m. latissimus dorsi or m. serratus anterior flaps. In 15 patients (2-nd group) autotransplantation of m. serratus anterior flap, including the vascularized costal fragments in its content, was performed. The musculo-costal flap application had appeared a perspective procedure while restoration of carpal bones defects. Plastic properties of such a transplant are relative technical simplicity of its mobilization, minimal aesthetic defect in the donor zone, possibility of creation of a necessary long vascular pedicle, tolerance of the complex to infection, what secures the expediency of its application in reconstructive plastic surgery.",Galich SP.; Reznikov AV.,2008.0,,0,0,
8973,"Working with mental health problems: clients' experiences of IPS, vocational rehabilitation and employment.","Although the effectiveness of individual placement and support (IPS) has been well established, little is known about clients' perceptions of the model compared to usual vocational rehabilitation, nor about their experiences of searching for and returning to work with this kind of support. This qualitative study aimed to explore clients' views of the difficulties of obtaining and maintaining employment, their experiences of the support received from their IPS or Vocational Service workers and the perceived impact of work on clients' lives. Semi-structured interviews were conducted with 48 people with psychotic disorders participating in a six-centre international randomised controlled trial of IPS compared to usual vocational rehabilitation. To assess their experiences of the services and the perceived effects of working, two IPS and two Vocational Service clients at each centre who had found work during the study period were interviewed, along with two IPS and two Vocational Service clients at each centre who had not. IPS clients reported having received more help seeking and maintaining employment, whereas Vocational Service clients reported having received more help in finding sheltered employment or placements. Clients who had worked associated this with financial stability, improved social lives, increased self-esteem, integration into society and amelioration of their symptoms, as well as reduced feelings of boredom and isolation, but also reported increased levels of stress. IPS clients as well as Vocational Service ones reported not receiving enough follow-up support, despite this being proposed as a key feature of the model. Findings from the in-depth interviews reflect differences in service models that have also been tested quantitatively but further work in disaggregating the IPS model and assessing the impact of each component would be valuable.",Koletsi M.; Niersman A.; van Busschbach JT.; Catty J.; Becker T.; Burns T.; Fioritti A.; Kalkan R.; Lauber C.; Rössler W.; Tomov T.; Wiersma D.;  .,2009.0,10.1007/s00127-009-0017-5,0,0,
8974,"Influence of total face, facial and nasal masks on short-term adverse effects during noninvasive ventilation.","Failure of noninvasive ventilation (NIV) has been associated with short-term adverse effects related to the use of masks. The aim of this study was to compare the incidence, type and intensity of adverse effects, as well as the comfort, of total face masks (TFMs), facial masks (FMs) and nasal masks (NMs) during NIV. This was a randomized crossover trial involving 24 healthy volunteers submitted to six sessions of NIV in bilevel positive airway pressure mode using the TFM, FM and NM masks at low and moderate-to-high pressure levels. A written questionnaire was applied in order to evaluate eleven specific adverse effects related to the use of the masks. Comfort was assessed using a visual analog scale. The CO2 exhaled into the ventilator circuit was measured between the mask and the exhalation port. The performance of the TFM was similar to that of the NM and FM in terms of comfort scores. Higher pressure levels reduced comfort and increased adverse effects, regardless of the mask type. When the TFM was used, there were fewer air leaks and less pain at the nose bridge, although there was greater oronasal dryness and claustrophobia. Air leaks were most pronounced when the FM was used. The partial pressure of exhaled CO2 entering the ventilator circuit was zero for the TFM. The short-term adverse effects caused by NIV interfaces are related to mask type and pressure settings. The TFM is a reliable alternative to the NM and FM. Rebreathing of CO2 from the circuit is less likely to occur when a TFM is used.",Holanda MA.; Reis RC.; Winkeler GF.; Fortaleza SC.; Lima JW.; Pereira ED.,2009.0,,0,0,
8975,Difference in prevalence of common mental disorder as measured using four questionnaire delivery methods among young people in rural Zimbabwe.,"Previous studies have suggested that interviewer-administered questionnaires can under-estimate the prevalence of depression and suicidal ideation when compared with self-administered ones. We report here on differences in prevalence of reporting mental health between four questionnaire delivery modes (QDM). Mental health was assessed using the Shona Symptom Questionnaire (SSQ), a locally validated 14-item indigenous measure for common mental affective disorders. A representative sample of 1495 rural Zimbabwean adolescents (median age 18) was randomly allocated to one of four questionnaire delivery modes: self-administered questionnaire (SAQ), SAQ with audio (AASI), interviewer-administered questionnaire (IAQ), and audio computer-assisted survey instrument (ACASI). Prevalence of common affective disorders varied between QDM (52.3%, 48.6%, 41.5%, and 63.6% for SAQ, AASI, IAQ, and ACASI respectively (P<0.001)). Fewer participants failed to complete SSQ using IAQ and ACASI than other methods (1.6% vs. 12.3%; P<0.001). Qualitative data suggested that respondents found it difficult answering questions honestly in front of an interviewer. Direction of accuracy cannot be ascertained due to lack of objective or clinical assessments of affective disorders. Estimates of prevalence of psychosomatic symptoms and suicidal ideation varied according to mode of interview. As each mode's direction of accuracy remains unresolved evaluations of interventions continue to be hampered.",Langhaug LF.; Cheung YB.; Pascoe S.; Hayes R.; Cowan FM.,2009.0,10.1016/j.jad.2009.02.003,0,0,
8976,Internet-based treatment for panic disorder: does frequency of therapist contact make a difference?,"Internet-based interventions with therapist support have proven effective for treating a range of mental health conditions. This study examined whether frequency of therapist contact affected treatment outcomes. Fifty-seven people with panic disorder (including 32 with agoraphobia) were randomly allocated to an 8-week Internet-based cognitive behavioural treatment intervention (Panic Online) with either frequent (three e-mails per week) or infrequent (one e-mail per week) support from a psychologist. Posttreatment, intention-to-treat analyses revealed that both treatments were effective at improving panic disorder and agoraphobia severity ratings, panic-related cognitions, negative affect, and psychological and physical quality of life domains, with no differences between conditions. High end-state functioning was achieved by 28.6% of the frequent and infrequent participants, respectively. Therapist alliance, treatment credibility, and satisfaction also did not differ between groups, despite significantly greater therapist time invested in the frequent contact condition. The results provide evidence that the effectiveness of Internet-based mental health interventions may be independent of the frequency of therapist support and may, therefore, be more cost-effective than previously reported.",Klein B.; Austin D.; Pier C.; Kiropoulos L.; Shandley K.; Mitchell J.; Gilson K.; Ciechomski L.,2009.0,10.1080/16506070802561132,0,0,
8977,A comparative study of clinical and radiologic outcomes of unstable colles type distal radius fractures in patients older than 70 years: nonoperative treatment versus volar locking plating.,"To compare final functional and radiographic outcomes of closed reduction and casting (CAST) with open reduction and internal fixation (ORIF) with palmar locking plate for unstable Colles type distal radius fractures (DRFs) in low-demand patients older than 70 years. Retrospective, clinical study. Level 1 university trauma center. Over a mean period of 4 years and 7 months, 130 consecutive patients older than 70 years were treated for an unstable dorsally displaced DRF of which 114 or 87% were followed for 1 year or longer. ORIF (n = 53) using volar locking plate or closed reduction and casting (n = 61). Objective and subjective functional results (active range of motion; grip strength; disabilities of the arm, shoulder and hand (DASH) score; patient-rated wrist evaluation (PRWE) score; visual analog scale; and Green and O'Brien score) and radiographic assessment (dorsal tilt, radial inclination, radial shortening, fracture union, and posttraumatic arthritis) were assessed. At final follow-up, there was no significant difference between the 2 groups for mean ranges of motion, grip strength, DASH score, PRWE score, and Green and O'Brien score. Pain level was significantly less for the patients in the CAST group. An obvious clinical deformity was present in 77% of cast group and none in the ORIF group. At final follow-up, in the ORIF group, there was a mean loss of dorsal tilt of 1.3 degrees, radial inclination of 0.3 degrees, and radial length of 0.5 mm compared with the postoperative measurements. No primary acceptable reduction was achieved in 44% of the CAST group. At final follow-up, in the CAST group, dorsal tilt, radial inclination, and radial shortening averaged -24.4 +/- 12 degrees, 19.2 +/- 6.5 degrees, and +3.9 +/- 2.7 mm, respectively. Malunion occurred in 89% primarily reduced fractures. Dorsal tilt, radial inclination, and radial shortening were significantly better in the ORIF group. Radiographic results (dorsal tilt, radial inclination, and radial shortening) after unstable dorsally displaced DRFs are significantly better in patients treated by ORIF using a volar fixed-angle plate rather than those treated by cast immobilization (P < 0.05). At a mean follow-up time of 4 years and 7 months, the clinical outcomes of active range of motion, the PRWE, DASH, and Green and O'Brien scores do not differ between the 2 methods of treatment. The pain level was significantly less in the CAST group (P < 0.05), and this group experienced no complications. There was no difference between the subjective and functional outcomes for the surgical and the nonsurgical treatments in a cohort of patients older than 70 years. Unsatisfactory radiographic outcome in older patients does not necessarily translate into unsatisfactory functional outcome. Nonoperative treatment may be the preferred method of treatment in this age group.",Arora R.; Gabl M.; Gschwentner M.; Deml C.; Krappinger D.; Lutz M.,2009.0,10.1097/BOT.0b013e31819b24e9,0,0,
8978,Health anxiety and disability pension award: The HUSK Study.,"To examine the hypothesized effect of health anxiety on subsequent disability pension award. Mental disorders are consistently underrecognized in general health care, leading to underestimation of its effects on related social security expenditures. According to medicolegal diagnoses for disability pension award, there are almost no awards of disability benefits for health anxiety or hypochondriasis. There are no empirical longitudinal population-based studies on occupational disability in health anxiety or the extreme of hypochondriasis. Using a historical cohort design, we utilized a unique link between a large epidemiological cohort study (n = 6819) and a comprehensive national database of disability benefits to examine the effect of health anxiety on subsequent disability pension award (n = 277) during 1.0 to 6.6 years of follow-up. The data sources were merged after informed consent, using the national personal identification number. Health anxiety was a strong predictor of disability pension award, exceeding the effect of general anxiety, and comparable to the effect of depression. This effect was partly accounted for by adjustment for income and level of education, and comorbid mental, psychosomatic, or physical conditions. The effect was not limited to high symptom levels, but followed a dose-response association. Despite the robust effect in this prospective study, health anxiety or hypochondriasis was not recognized as medicolegal diagnosis for any awards of disability pension, and was not accounted for by other mental disorders. Health anxiety is a strong, independent, and yet underrecognized risk factor for disability pension award.",Mykletun A.; Heradstveit O.; Eriksen K.; Glozier N.; √òverland S.; Maeland JG.; Wilhelmsen I.,2009.0,10.1097/PSY.0b013e31819cc772,0,0,
8979,"Managing unwanted intrusive thoughts in obsessive-compulsive disorder: relative effectiveness of suppression, focused distraction, and acceptance.","Suppression is one of various mental control techniques that people may use to manage unwanted thoughts. Evidence suggests that it is at best unsustainable and at worst counterproductive. This leads to the question: If suppression is a futile way to respond to unwanted, intrusive thoughts, what is a more effective alternative? In the current study, we evaluated the relative effectiveness of suppression and two alternative mental control techniques-focused distraction and acceptance-on the frequency of intrusions and distress associated with them. Results support the claim that suppression is a counterproductive technique for dealing with unwanted, intrusive thoughts in OCD. However, the harmfulness of suppression was reflected primarily in the magnitude of distress and not in intrusion frequency. Focused distraction and acceptance were the more effective techniques for managing clinically significant intrusive thoughts. We discuss implications for the cognitive treatment for OCD.",Najmi S.; Riemann BC.; Wegner DM.,2009.0,10.1016/j.brat.2009.02.015,0,0,
8980,Sensitivity and specificity of the 3-item memory test in the assessment of post traumatic amnesia.,"To investigate how the type of stimulus (pictures or words) and the method of reproduction (free recall or recognition after a short or a long delay) affect the sensitivity and specificity of a 3-item memory test in the assessment of post traumatic amnesia (PTA). Daily testing was performed in 64 consecutively admitted traumatic brain injured patients, 22 orthopedically injured patients and 26 healthy controls until criteria for resolution of PTA were reached. Subjects were randomly assigned to a test with visual or verbal stimuli. Short delay reproduction was tested after an interval of 3-5 minutes, long delay reproduction was tested after 24 hours. Sensitivity and specificity were calculated over the first 4 test days. The 3-word test showed higher sensitivity than the 3-picture test, while specificity of the two tests was equally high. Free recall was a more effortful task than recognition for both patients and controls. In patients, a longer delay between registration and recall resulted in a significant decrease in the number of items reproduced. Presence of PTA is best assessed with a memory test that incorporates the free recall of words after a long delay.",Andriessen TM.; de Jong B.; Jacobs B.; van der Werf SP.; Vos PE.,2009.0,10.1080/02699050902791414,0,0,
8981,Light pressure massage for patients with severe anxiety.,"Generalised anxiety disorder (GAD) is common in the western world with a lifetime prevalence of 4.3 to 5.9% and is twice as common in women as in men. GAD can have a decisive impact on a patient's everyday life as it is surrounded by unfocused worries and the severe anxiety may interfere with normal social functions. The treatments include cognitive behavioural therapy and/or psychopharmacological drugs. In previous studies the positive effects of massage on anxiety have been shown. The present study described the experience of receiving massage for eight patients with GAD. Findings revealed that the patients were able to rediscover their own capacity during the massage period. This was illuminated by the experience of being relaxed in body and mind, the experience of unconditional attention, the experience of decreased anxiety and the experience of increased self-confidence. The paper ends with a discussion of clinical implications.",Billhult A.; Määttä S.,2009.0,10.1016/j.ctcp.2008.10.003,0,0,
8982,Moderation and mediation in the psychological and drug treatment of chronic tension-type headache: the role of disorder severity and psychiatric comorbidity.,"We evaluated two putative moderators of treatment outcome as well as the role of Headache Management Self-Efficacy (HMSE) in mediating treatment outcomes in the drug and non-drug treatment of chronic tension-type headache (CTTH). Subjects were 169 participants (M=38 yrs.; 77% female; M headache days/mo.=22) who received one of four treatments in the treatment of CTTH trial (JAMA, 2001; 285: 2208-15): tricyclic antidepressant medication, placebo, (cognitive-behavioral) stress-management therapy plus placebo, and stress-management therapy plus antidepressant medication. Severity of CTTH disorder and the presence of a psychiatric (mood or anxiety) disorder were found to moderate outcomes obtained with the three active treatments and with placebo, as well as to moderate the role of HMSE in mediating improvements. Both moderator effects appeared to reflect the differing influence of the moderator variable on each of the three active treatments, as well as the fact that the moderator variables exerted the opposite effect on placebo than on the active treatments. HMSE mediated treatment outcomes in the two stress-management conditions, but the pattern of HMSE mediation was complex, varying with the treatment condition, the outcome measure, and the moderator variable. Irrespective of the severity of the CTTH disorder HMSE fully mediated observed improvements in headache activity in the two stress-management conditions. However, for patients with a mood or anxiety disorder HMSE only partially mediated improvements in headache disability, suggesting an additional therapeutic mechanism is required to explain observed improvements in headache disability in the two stress-management conditions.",Holroyd KA.; Labus JS.; Carlson B.,2009.0,10.1016/j.pain.2009.02.019,0,0,
8983,Cognitive-behavioral therapy for panic disorder in patients being treated for alcohol dependence: Moderating effects of alcohol outcome expectancies.,"Anxiety disorders commonly co-occur with alcohol use disorders and reliably mark a poor response to substance abuse treatment. However, treating a co-occurring anxiety disorder does not reliably improve substance abuse treatment outcomes. Failure to account for individual differences in the functional dynamic between anxiety symptoms and drinking behavior might impede the progress and clarity of this research program. For example, while both theory and research point to the moderating role of tension-reduction alcohol outcome expectancies (TR-AOEs) in the association between anxiety symptoms and alcohol use, relevant treatment studies have not typically modeled TR-AOE effects. We examined the impact of a hybrid cognitive-behavioral therapy (H-CBT) treatment for panic disorder (independent variable) on response to a community-based alcohol dependence treatment program (dependent variable) in patients with higher vs. lower TR-AOEs (moderator). The H-CBT treatment was generally effective in relieving participants' panic symptoms relative to controls. However, TR-AOEs interacted with study cohort (H-CBT vs. control) in predicting response to substance abuse treatment. As expected, the H-CBT was most effective in improving alcohol use outcomes among those with the highest TR-AOEs. The study's primary methodological limitations are related to the quasi-experimental design employed.",Kushner MG.; Sletten S.; Donahue C.; Thuras P.; Maurer E.; Schneider A.; Frye B.; Van Demark J.,,10.1016/j.addbeh.2009.03.011,0,0,
8984,Improving psychological adjustment following a first episode of psychosis: a randomised controlled trial of cognitive therapy to reduce post psychotic trauma symptoms.,"There are few evaluated psychological interventions or theoretical approaches which are specifically aimed at reducing problems related to adjustment and adaptation following a first episode of psychosis. The present study tests the efficacy of a form of CBT (Cognitive Recovery Intervention; CRI) in reducing trauma, depression and low self esteem following a first episode of psychosis, in a single-blind randomised controlled trial. A total of 66 patients who had recently experienced a first episode of psychosis were randomly assigned to CRI or treatment as usual (TAU) and followed up at 6 and 12 months. People receiving CRI tended to have lower levels of post-intervention trauma symptoms and demonstrated greater improvement than those receiving TAU alone. This was especially the case at 6 months for those with high pre-treatment levels of trauma. There was, however, no advantage for the CRI group with regards to reduced depression or improved self esteem. In conclusion, CRI appears to be an effective intervention to help young people adapt to the traumatic aspects of a first episode of psychosis although further evaluation in a larger study is warranted.",Jackson C.; Trower P.; Reid I.; Smith J.; Hall M.; Townend M.; Barton K.; Jones J.; Ross K.; Russell R.; Newton E.; Dunn G.; Birchwood M.,2009.0,10.1016/j.brat.2009.02.009,0,0,
8985,Negative self-appraisals in treatment-seeking survivors of motor vehicle accidents.,"Recent cognitive models stress the impact that negative appraisals have on the maintenance of posttraumatic stress disorder (PTSD). The aim of this study was to investigate the role of posttraumatic negative cognitions in 110 survivors of motor vehicle accidents (MVAs) and to examine the effect of cognitive-behavioral treatment on negative appraisals in a sample of 42 patients with full or sub-syndromal PTSD. We investigated whether posttraumatic negative cognitions predicted PTSD diagnosis and symptom severity, and whether treatment-related changes in negative appraisals were associated with PTSD symptom reduction. Negative posttraumatic cognitions were significantly associated with PTSD diagnosis and severity, and explained 54% of the variance of the PTSD severity. Furthermore, treatment-related reductions in negative appraisals about the self were highly associated with PTSD-symptom-reduction. Our results raise question about whether there are factors that make the self more vulnerable in some people but not in others.",Karl A.; Rabe S.; Zöllner T.; Maercker A.; Stopa L.,2009.0,10.1016/j.janxdis.2009.03.001,0,0,
8986,SPIFA-A presentation of the Structured Psychiatric Interview for General Practice.,"The diagnostic ability of general practitioners (GPs) concerning mental disorders is not optimal, and could be improved by structured diagnostic interviews. Various aspects of the Structured Psychiatric Interview for General Practice (SPIFA) are examined. The inter-rater reliability of the SPIFA, the time used by GPs and specialists and the GPs satisfaction are examined. The properties of the SPIFA are compared with those of the Prime-MD and the MINI schedules. Inter-rater reliability of the SPIFA was tested in 336 patients in general practice. The patients were randomized to two interview strategies. Either both GPs and psychiatrists used the SPIFA, or GPs used the SPIFA and psychiatrists a modified version of the SCID for Axis I disorders. The satisfaction was investigated by a questionnaire sent to 1000 GPs who had SPIFA training. The SPIFA showed adequate inter-rater reliability for depression, anxiety disorders and increased suicidal risk for both interview strategies. In patients with more than two co-morbid disorders, the inter-rater reliability was poor. The mean duration of SPIFA was 21 min for SPIFA screening and 22 min for SPIFA manual. The 192 GPs responding to the questionnaire were mostly satisfied with the SPIFA. The SPIFA seems to be a reliable, valid and helpful instrument for GPs making diagnoses of mental disorders in their patients. Compared with the Prime MD and the MINI, the SPIFA seemed to have comparable psychometric properties but better feasibility in primary care.",Dahl AA.; Krüger MB.; Dahl NH.; Karlsson H.; Von Knorring L.; Stordal E.,2009.0,10.3109/08039480902874769,0,0,
8987,The Clinical Global Impressions scale: errors in understanding and use.,"The Clinical Global Impressions Severity and Improvement scales (CGI-S and CGI-I) are widely included as efficacy data in psychopharmacology new drug application submissions. This study was conducted to determine the extent to which clinical trials investigators included information unrelated to efficacy in their CGI ratings. Forty-five principal investigators provided CGI-S and CGI-I ratings of narratives of patients with major depressive disorder or generalized anxiety disorder. Investigators were blindly randomized to receive narratives that either did (experimental) or did not (control) contain indication-unrelated medical or psychiatric adverse events. Investigators then completed a survey assessing CGI-S and CGI-I rating patterns. CGI-S and CGI-I ratings were significantly more severe and less improved when the narratives contained medical and psychiatric adverse events unrelated to the diseases under study (major depressive disorder and generalized anxiety disorder) than when the narratives did not (Ps < .04). In response to the survey, 46% and 56% of investigators reported that a psychiatric adverse event unrelated to the disease under study would not affect their CGI-S and CGI-I ratings, respectively. Although 87% of investigators reported that their CGI-S and CGI-I ratings would not be affected by a medical adverse event, actual CGI-S ratings were significantly more severe when an unrelated medical adverse event was described as occurring than when it was not (P < .03). Clinical trials investigators' inclusion of indication-irrelevant adverse events threatens the validity of the CGI as an efficacy measure and may contribute to failure to detect efficacy signals in psychopharmacology clinical trials.",Busner J.; Targum SD.; Miller DS.,,10.1016/j.comppsych.2008.08.005,0,0,6135
8988,A randomized study of massed three-week cognitive behavioural therapy schedule for panic disorder.,"To compare the efficacy of massed vs. spaced group cognitive behavioural therapy (CBT) for patients with panic disorder with or without agoraphobia (PD). Thirty-nine PD patients were randomly assigned to massed group CBT (daily 4-h sessions in week 1, two 2-h sessions in week 2 and one 2-h session in week 3) or traditional spaced weekly group CBT (13 consecutive, weekly 2-h sessions). The content and number of hours in the two treatment schedules were identical. Outcome was assessed after treatment, and at 3, 6 and 18 months of follow-up. Both treatment groups achieved significant improvement on all measures with large pre- to post-treatment and pre-treatment to follow-up effect sizes. No between-group differences were registered. Adherence and patient satisfaction did not differ between groups. The massed, 3-week group CBT schedule proved to be effective and feasible for PD patients with outcomes comparable with that of standard, spaced group CBT.",Bohni MK.; Spindler H.; Arendt M.; Hougaard E.; Rosenberg NK.,2009.0,10.1111/j.1600-0447.2009.01358.x,0,0,
8989,Classically conditioned fear responses are preserved following unilateral temporal lobectomy in humans when concurrent US-expectancy ratings are used.,"Previous lesion studies demonstrate that patients who underwent a unilateral temporal lobe resection show impaired skin conductance responding (SCR) to aversively conditioned stimuli. The aim of the current lesion study was to examine whether the amygdala is also critically involved in differential SCR during a more explicit form of fear learning. A simple discrimination task was presented to a unilaterally amygdala-damaged patient group and a control group, in which one neutral stimulus was always followed by an electric shock (CS+), whereas a second stimulus always appeared alone (CS-). To direct attention towards the stimulus contingencies, participants were asked to predict the occurrence of the shock continuously throughout the whole task. The results revealed that patients and controls rapidly acquired contingency knowledge as measured by the online US-expectancy ratings. Crucially, both test groups showed differential SCRs during CS+ and CS- trials. Thus, contrary to earlier findings, robust conditioned SCRs can be obtained in patients with unilateral temporal lobe resection as long as they are able to acquire explicit stimulus contingency knowledge. The two-level account of Ohman and Mineka [Ohman, A., & Mineka, S. (2001). Fears, phobias, and preparedness: Toward an evolved module of fear and fear learning. Psychological Review, 108, 483-522] is proposed in order to explain the diverse lesion data obtained so far.",Coppens E.; Spruyt A.; Vandenbulcke M.; Van Paesschen W.; Vansteenwegen D.,2009.0,10.1016/j.neuropsychologia.2009.04.021,0,0,
8990,A long-term trial of the effectiveness and safety of atypical antipsychotic agents in augmenting SSRI-refractory obsessive-compulsive disorder.,"Although atypical antipsychotic agents have been found effective in the augmentation of serotonin reuptake inhibitors (SRIs) for treatment-resistant obsessive-compulsive disorder (OCD) in short-term trials, there are few data on the effectiveness and safety of these agents in clinical settings over the long term. Subjects (N = 46) who responded to selective SRIs (SSRIs) in an initial 12-week trial were continued on SSRI monotherapy plus cognitive-behavioral therapy (CBT) for 1 year. Subjects (N = 44) who failed to respond to SSRIs were randomly assigned to 1 of 3 atypical antipsychotics -- olanzapine, quetiapine, or risperidone -- and were consecutively treated using SSRI + atypical antipsychotics combined with CBT for 1 year. This study was conducted from January 2006 to November 2007 at Osaka City University Graduate School of Medicine Hospital, Japan. Augmentation with atypical antipsychotics reduced mean +/- SD Yale-Brown Obsessive Compulsive Scale (YBOCS) total scores in SSRI-refractory OCD patients (at initial assessment = 29.3 +/- 9.9, after 1 year = 19.3 +/- 6.8). However, compared to SSRI responders (at initial assessment = 25.8 +/- 11.4, after 1 year = 13.7 +/- 4.6), total YBOCS scores in those who required atypical antipsychotic augmentation were initially higher, and they remained at higher levels than those of SRI responders after 1 year of the treatments. Our work does not sufficiently support the long-term effectiveness of the atypical antipsychotics in the augmentation of SSRIs for treatment-resistant OCD patients. Even though this approach seems useful for some types of OCD patients, such as those with symmetry/ordering and hoarding symptoms, these data emphasize the limitations of the current pharmacotherapeutic options in treatment-refractory OCD, and their chronic use raises a number of safety concerns. (ClinicalTrials.gov) Identifier NCT00854919.",Matsunaga H.; Nagata T.; Hayashida K.; Ohya K.; Kiriike N.; Stein DJ.,2009.0,10.4088/JCP.08m04369,0,0,
8991,"The impact of trauma-focused group therapy upon HIV sexual risk behaviors in the NIDA Clinical Trials Network ""Women and trauma"" multi-site study.","Women in drug treatment struggle with co-occurring problems, including trauma and post-traumatic stress disorder (PTSD), which can heighten HIV risk. This study examines the impact of two group therapy interventions on reduction of unprotected sexual occasions (USO) among women with substance use disorders (SUD) and PTSD. Participants were 346 women recruited from and receiving treatment at six community-based drug treatment programs participating in NIDA's Clinical Trials Network. Participants were randomized to receive 12-sessions of either seeking safety (SS), a cognitive behavioral intervention for women with PTSD and SUD, or women's health education (WHE), an attention control psychoeducational group. Participants receiving SS who were at higher sexual risk (i.e., at least 12 USO per month) significantly reduced the number of USO over 12-month follow up compared to WHE. High risk women with co-occurring PTSD and addiction may benefit from treatment addressing coping skills and trauma to reduce HIV risk.",Hien DA.; Campbell AN.; Killeen T.; Hu MC.; Hansen C.; Jiang H.; Hatch-Maillette M.; Miele GM.; Cohen LR.; Gan W.; Resko SM.; DiBono M.; Wells EA.; Nunes EV.,2010.0,10.1007/s10461-009-9573-7,0,0,
8992,The effect of group music therapy on quality of life for participants living with a severe and enduring mental illness.,"A 10-week group music therapy project was designed to determine whether music therapy influenced quality of life and social anxiety for people with a severe and enduring mental illness living in the community. Ten one-hour weekly sessions including song singing, song writing and improvisation, culminated in each group recording original song/s in a professional studio. The principal outcome measure was the WHOQOLBREF Quality of Life (QoL) Scale; other instruments used were the Social Interaction Anxiety Scale (SIAS) and the Brief Symptom Inventory (BSI). Qualitative data were gathered through focus group interviews and an analysis of lyric themes. Statistically significant improvement was found on five items of the QoL Scale. There were no changes on the BSI indicating that QoL improvement was not mediated by symptomatic change. Themes from the focus groups were: music therapy gave joy and pleasure, working as a team was beneficial, participants were pleasantly surprised at their creativity, and they took pride in their song. An analysis of song lyrics resulted in 6 themes: a concern for the world, peace and the environment; living with mental illness is difficult; coping with mental illness requires strength; religion and spirituality are sources of support; living in the present is healing; and working as a team is enjoyable.",Grocke D.; Bloch S.; Castle D.,2009.0,,0,0,
8993,Does cognitive-behavioral therapy for PTSD improve perceived health and sleep impairment?,"There is a paucity of empirical study about the effects of evidence-based psychotherapy for posttraumatic stress disorder (PTSD) on concurrent health concerns including sleep impairment. This study compares the differential effects of cognitive processing therapy (CPT) and prolonged exposure (PE) on health-related concerns and sleep impairment within a PTSD sample of female, adult rape survivors (N = 108). Results showed that participants in both treatments reported lower health-related concerns over treatment and follow-up, but there were relatively more improvements in the CPT condition. Examination of sleep quality indicated significant improvement in both CPT and PE across treatment and follow-up and no significant differences between treatments. These results are discussed with regard to the different mechanisms thought to underlie the treatments and future innovations in PTSD treatment.",Galovski TE.; Monson C.; Bruce SE.; Resick PA.,2009.0,10.1002/jts.20418,0,0,
8994,A randomized pilot study of motivation enhancement therapy to increase utilization of cognitive-behavioral therapy for social anxiety.,"Despite the efficacy of cognitive-behavioral therapy (CBT), most socially anxious individuals do not seek treatment or seek treatment only after many years of suffering. This study evaluated the efficacy of a three-session motivation enhancement therapy (MET) designed to increase CBT utilization among socially anxious individuals. Twenty-seven non-treatment-seeking socially anxious individuals (92.6% met current DSM-IV criteria for social anxiety disorder) were randomly assigned to either MET for CBT (n = 12) or a control condition (n = 15). The primary outcome was attendance at first CBT appointment. Secondary outcomes included openness to therapist contact and willingness to schedule a CBT appointment. After the intervention, seven of the 12 (58.3%) participants in the MET condition attended a CBT appointment compared to two of 15 (13.3%) control participants. Eight of 11 (72.7%) participants in the MET condition indicated they would like a CBT therapist to contact them compared to four of 12 (33.3%) controls. Further, willingness to schedule a CBT appointment increased at a significantly greater rate in the MET condition. Results suggest MET for CBT may be a time-efficient means to increase CBT utilization among socially anxious individuals.",Buckner JD.; Schmidt NB.,2009.0,10.1016/j.brat.2009.04.009,0,0,
8995,"Blood glucose level, alcohol heavy drinking, and alcohol craving during treatment for alcohol dependence: results from the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) Study.","Heavy drinking may increase blood glucose levels. Moreover, in alcohol-dependent subjects, glucose may play a putative role in alcohol preference. This study investigated the relationship between blood glucose levels and both alcohol heavy drinking and craving in alcohol-dependent subjects participating in the COMBINE Study. The primary objective was to evaluate the relationship between baseline (pretreatment) glucose levels and percentage of heavy drinking day (PHDD) during treatment. The secondary objective was to evaluate the relationship between glucose levels, baseline PHDD, and craving measured by the Obsessive Compulsive Drinking Scale (OCDS). This analysis consisted of 1,324 participants. Baseline glucose levels were significantly and positively associated with PHDD during treatment [F(1, 1225) = 5.21, p = 0.023], after controlling for baseline PHDD [F(1, 1225) = 36.25, p < 0.0001], gender [F (1, 1225) = 3.33, p = 0.07], and body mass index (BMI) [F(1, 1225) = 0.31, p = 0.58]. Higher glucose levels at baseline were associated with a higher percentage of PHDD at pretreatment [F(1, 1304) = 5.96, p = 0.015], after controlling for gender [F(1, 1304) = 0.29, p = 0.59] and BMI [F(1, 1304) = 0.90, p = 0.34]. Glucose was not significantly associated with the OCDS total score [F(1, 1304) = 0.12, p = 0.73], the OCDS Obsessive subscale [F(1, 1304) = 0.35, p = 0.56], or the OCDS Compulsive subscale [F(1, 1304) = 1.19, p = 0.28] scores, after controlling for gender and BMI. A link between pretreatment glucose levels and heavy drinking during treatment was found, suggesting a role of glucose in predicting heavy alcohol consumption. Although caution is needed in the interpretation of these results, elevated glucose and heavy drinking may be affected by a common mechanism and manipulations affecting glucose regulation may influence alcohol consumption.",Leggio L.; Ray LA.; Kenna GA.; Swift RM.,2009.0,10.1111/j.1530-0277.2009.00982.x,0,0,
8996,[Magnetopuncture therapy in the combined corrective treatment of clinical manifestations of non-specific distress syndrome].,"The efficiency of a combined approach to the correction of clinical manifestations of non-specific distress syndrome was evaluated in patients with psychovegetative syndrome by comparing effects of phytoaeroionotherapy, graduated physical exercises, and soft tissue manual therapy in different combinations with simultaneous magnetopuncture therapy and without it. It was shown that above therapeutic modalities combined with magnetotherapy decreased the degree of asymmetry of both right and left heart meridians (by 60.5%) and interhemisphere asymmetry of blood flow in the system of internal carotid arteries (by 74.19%), reduced the tone of cerebral arterioles and veins (by 40.7% and 8.6% respectively), improved symptomes of depression and asthenia (by 23.2% and 63.9% respectively), increased mental performance quotient and activity indices (by 34.7% and 28.7% respectively). These changes were far less significant in the absence of by magnetopuncture therapy.",El'chininov NV.,,,0,0,6293
8997,Early evaluation of acute traumatic coagulopathy by thrombelastography.,"Posttraumatic coagulopathy is a major cause of morbidity. This prospective study evaluated the thrombelastography (TEG) system and PlateletMapping (Haemoscope Corporation, Niles, Ill) values posttrauma, and it correlated those values with transfusions and fatalities. After institutional review board approval, assays were performed on 161 trauma patients. One citrated blood sample was collected onsite (OS), and 1 citrate and 1 heparinized sample were collected within 1 h of arrival to the emergency department (ED). Paired and unpaired t-testing was performed for nominal data with chi square testing for categorical values. Except for a slight increase in clot strength (maximal amplitude (MA)), there were no significant changes from OS to the ED. None of the TEG parameters were significantly different for the 22 patients who required transfusion. PlateletMapping showed lower platelet adenosine diphosphate (ADP) responsiveness in patients who needed transfusions (MA = 22.7 +/- 17.1 vs MA = 35.7 +/- 19.3, P = 0.004) and a correlation of fibrinogen <100 mg/dL with fatalities (P = 0.013). For the 14 fatalities, TEG reaction (R) time was 3703 +/- 11,618 versus 270 +/- 393 s (P = < 0.001), and MA was 46.4 +/- 22.4 versus 64.7 +/- 9.8 mm (P < 0.001). Hyperfibrinolysis (percent fibrinolysis after 60 min (LY60) >15%) was observed in 3 patients in the ED with a 67% fatality rate (P = < 0.001 by chi-square testing). PlateletMapping assays correlated with the need for blood transfusion. The abnormal TEG System parameters correlated with fatality. These coagulopathies were already evident OS. The TEG assays can assess coagulopathy, platelet dysfunction, and hyperfibrinolysis at an early stage posttrauma and suggest more effective interventions.",Carroll RC.; Craft RM.; Langdon RJ.; Clanton CR.; Snider CC.; Wellons DD.; Dakin PA.; Lawson CM.; Enderson BL.; Kurek SJ.,2009.0,10.1016/j.trsl.2009.04.001,0,0,
8998,Can an illness perception intervention reduce illness anxiety in spouses of myocardial infarction patients? A randomized controlled trial.,"To investigate whether a brief in-hospital illness perception intervention for myocardial infarction (MI) patients and their spouses could change spouses' illness perceptions and reduce spouses' anxiety about the illness. Fifty-seven spouses participated in a randomized controlled trial of an illness perception intervention for MI patients. Spouses of patients randomized to the intervention attended one half-hour patient-and-spouse session with a psychologist in addition to standard care. Spouses completed measures of illness perceptions, expectations, and illness anxiety at admission and at 1 week following discharge, and spouses' illness worry was rated by the patients at 3 months. The main outcome for spouses was differences in anxiety between intervention and control groups. One week following discharge, spouses in the intervention group had higher illness understanding, lower concern, stronger causal attributions to hereditary factors, and fewer questions about their partner's heart condition compared to the control group. Intervention group spouses reported more positive expectations about the ability of the patient's heart to recover, and lower perceived likelihood of another MI. They had lower anxiety about the patient doing physical activity and about the patient's medications, and lower distress about the patient's symptoms. Spouses in the intervention group were rated as less worried about the illness at 3 months. Spouses of patients represent a new target for illness perception interventions and these results demonstrate that a brief illness perception intervention can change illness perceptions and reduce anxiety about the illness in spouses of MI patients.",Broadbent E.; Ellis CJ.; Thomas J.; Gamble G.; Petrie KJ.,2009.0,10.1016/j.jpsychores.2008.11.006,0,0,
8999,Physiological responses to brain stimulation during limbic surgery: further evidence of anterior cingulate modulation of autonomic arousal.,"In view of conflicting neuroimaging results regarding autonomic-specific activity within the anterior cingulate cortex (ACC), we investigated autonomic responses to direct brain stimulation during stereotactic limbic surgery. Skin conductance activity and accelerative heart rate responses to multi-voltage stimulation of the ACC (n = 7) and paralimbic subcaudate (n = 5) regions were recorded during bilateral anterior cingulotomy and bilateral subcaudate tractotomy (in patients that had previously received an adequate lesion in the ACC), respectively. Stimulations in both groups were accompanied by increased autonomic arousal. Skin conductance activity was significantly increased during ACC stimulations compared with paralimbic targets at 2 V (2.34 +/- .68 [score in microSiemens +/- SE] vs. .34 +/- .09, p = .013) and 3 V (3.52 +/- .86 vs. 1.12 +/- .37, p = .036), exhibiting a strong ""voltage-response"" relationship between stimulus magnitude and response amplitude (difference from 1 to 3 V = 1.15 +/- .90 vs. 3.52 +/- .86, p = .041). Heart rate response was less indicative of between-group differences. This is the first study of its kind aiming at seeking novel insights into the mechanisms responsible for central autonomic modulation. It supports a concept that interregional interactions account for the coordination of autonomic arousal.",Gentil AF.; Eskandar EN.; Marci CD.; Evans KC.; Dougherty DD.,2009.0,10.1016/j.biopsych.2009.05.009,0,0,
9000,Changes in lifestyle for psychiatric patients three years after the start of short- and long-term psychodynamic psychotherapy and solution-focused therapy.,"Lifestyle is less favourable among individuals suffering from psychiatric disorders. We studied whether psychotherapy brings along changes in lifestyle and whether these changes differ between short-term and long-term psychodynamic psychotherapy (SPP and LPP) and solution-focused therapy (SFT). A total of 326 outpatients, 20-46 years of age, with mood or anxiety disorder were randomly assigned to LPP, SPP and SFT. The lifestyle variables considered were alcohol consumption, smoking, body mass index (BMI), leisure time exercise and serum cholesterol. The patients were monitored for three years from the start of treatment. During the three-year follow-up, BMI and serum cholesterol rose statistically significantly although no statistically significant trends were shown for alcohol consumption, smoking or exercise. SPP showed a disadvantage of increased alcohol consumption and serum cholesterol level when compared with LPP. SFT showed an advantage of reduced smoking in comparison with SPP. Small therapy-specific changes in lifestyle may be a result from psychotherapy treatment. These lifestyle changes are apparently more common in short-term therapy. More studies are needed to verify these findings.",Knekt P.; Laaksonen MA.; Raitasalo R.; Haaramo P.; Lindfors O.,2010.0,10.1016/j.eurpsy.2009.03.006,0,0,
9001,"Psychological distress in women with uterovaginal agenesis (Mayer-Rokitansky-Kuster-Hauser Syndrome, MRKH).","Uterovaginal agenesis (Mayer-Rokitansky-Küster-Hauser Syndrome; MRKH) is a congenital nonformation of the vagina and the uterus, but with normal ovaries. The authors investigated the psychological impact of this disorder, about which very little is known. A group of 66 women with MRKH were compared with 31 control-group women on a range of self-rating scales assessing psychological distress and self-esteem. Women with MRKH had significantly more pathological scores on some of the scales and subscales, such as phobic anxiety and psychoticism (interpersonal alienation), with a similar trend for subscales measuring depression and anxiety. MRKH has a lasting negative impact on affected women's level of psychological distress and self-esteem.",Heller-Boersma JG.; Schmidt UH.; Edmonds DK.,,10.1176/appi.psy.50.3.277,0,0,5611
9002,Group cognitive and behavioral treatment for compulsive hoarding: a preliminary trial.,"Time-limited group cognitive behavioral treatments (GCBT) for obsessive-compulsive disorder have demonstrated improvement in target symptoms. One small sample study of GCBT specifically for hoarding problems also showed benefit. This study examines the efficacy of a specialized GCBT for compulsive hoarding on a larger sample. Thirty-two clients diagnosed with hoarding participated in five groups. Four groups met once weekly for 2 hour over 16 weeks (n=27) and one group met for 20 weeks (n=5). All participants had two individual 90-min home sessions. Self-report assessments were completed at baseline, mid-treatment, and post-treatment about hoarding behavior and related symptoms (e.g., depression). The sample was predominantly female, White, highly educated, unemployed, and not partnered/married; mean age was 53. A majority was diagnosed with major depressive disorder and obsessive-compulsive personality disorder. Participants showed significant improvement from pre- to post-treatment on the Saving Inventory Revised, Saving Cognitions Inventory, Clutter Image Rating, and Clinical Global Severity. The most recent group (n=8) that used a more formalized treatment and research protocol improved significantly more than did earlier members. This study demonstrates the feasibility and modest success of GCBT methods in improving hoarding symptoms. Group treatment may be especially valuable because of its cost-effectiveness, greater client access to trained clinicians, and reduction in social isolation and stigma linked to this problem. Further research is needed to improve the efficacy of GCBT methods for hoarding and to examine durability of change, predictors of outcomes, and processes that influence change.",Muroff J.; Steketee G.; Rasmussen J.; Gibson A.; Bratiotis C.; Sorrentino C.,2009.0,10.1002/da.20591,0,0,
9003,"Short-term psychodynamic psychotherapy and cognitive-behavioral therapy in generalized anxiety disorder: a randomized, controlled trial.","While several studies have shown that cognitive-behavioral therapy (CBT) is an efficacious treatment for generalized anxiety disorder, few studies have addressed the outcome of short-term psychodynamic psychotherapy, even though this treatment is widely used. The aim of this study was to compare short-term psychodynamic psychotherapy and CBT with regard to treatment outcome in generalized anxiety disorder. Patients with generalized anxiety disorder according to DSM-IV were randomly assigned to receive either CBT (N=29) or short-term psychodynamic psychotherapy (N=28). Treatments were carried out according to treatment manuals and included up to 30 weekly sessions. The primary outcome measure was the Hamilton Anxiety Rating Scale, which was applied by trained raters blind to the treatment conditions. Assessments were carried out at the completion of treatment and 6 months afterward. Both CBT and short-term psychodynamic psychotherapy yielded significant, large, and stable improvements with regard to symptoms of anxiety and depression. No significant differences in outcome were found between treatments in regard to the primary outcome measure. These results were corroborated by two self-report measures of anxiety. In measures of trait anxiety, worry, and depression, however, CBT was found to be superior. The results suggest that CBT and short-term psychodynamic psychotherapy are beneficial for patients with generalized anxiety disorder. In future research, large-scale multicenter studies should examine more subtle differences between treatments, including differences in the patients who benefit most from each form of therapy.",Leichsenring F.; Salzer S.; Jaeger U.; Kächele H.; Kreische R.; Leweke F.; Rüger U.; Winkelbach C.; Leibing E.,2009.0,10.1176/appi.ajp.2009.09030441,0,0,
9004,Issues in the design of a randomized noninferiority clinical trial of telemental health psychotherapy for rural combat veterans with PTSD.,"This methodological article provides a description of the design, methods, and rationale of the first prospective, noninferiority designed randomized clinical trial evaluating the clinical and cost implications of delivering an evidence-based cognitive-behavioral group intervention specifically treating posttraumatic stress disorder (PTSD) with a trauma-focused intervention via video teleconferencing (VTC). PTSD is a prevalent mental health problem found among returning Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) military populations. These returning military personnel often live in rural areas and therefore have limited access to care and specialized psychological treatments. In the field of mental health, telemental health (TMH) technology has introduced a potential solution to the persistent problem of access to care in remote areas. This study is enrolling approximately 126 returning veterans with current combat-related PTSD who are receiving services through the Veteran Administration (VA) mental health care clinics on 4 Hawaiian Islands. Cognitive Processing Therapy (CPT), an empirically supported manualized treatment for PTSD, is being delivered across 9 cohorts. Participants are assigned to either the experimental VTC condition or the in-person control condition. Assessments measuring clinical, process, and cost outcomes are being conducted at baseline, mid-treatment, post-treatment, and 3 and 6 months post-treatment. The study employs a noninferiority design to determine if the group treatment delivered via VTC is as good as the traditional in-person modality. In addition, a cost analysis will be performed in order to compare the cost of the 2 modalities. Novel aspects of this trial and specific challenges are discussed.",Morland LA.; Greene CJ.; Rosen C.; Mauldin PD.; Frueh BC.,2009.0,10.1016/j.cct.2009.06.006,0,0,
9005,Sequential allocation to balance prognostic factors in a psychiatric clinical trial.,"This paper aims to describe and discuss a minimization procedure specifically designed for a clinical trial that evaluates treatment efficacy for OCD patients. Aitchison's compositional distance was used to calculate vectors for each possibility of allocation in a covariate adaptive method. Two different procedures were designed to allocate patients in small blocks or sequentially one-by-one. We present partial results of this allocation procedure as well as simulated data. In the clinical trial for which this procedure was developed, successful balancing between treatment arms was achieved. Separately, in an exploratory analysis, we found that if the arrival order of patients was altered, most patients were allocated to a different treatment arm than their original assignment. Our results show that the random arrival order of patients determine different assignments and therefore maintains the unpredictability of the allocation method. We conclude that our proposed procedure allows for the use of a large number of prognostic factors in a given allocation decision. Our method seems adequate for the design of the psychiatric trials used as models. Trial registrations are available at clinicaltrials.gov NCT00466609 and NCT00680602.",Fossaluza V.; Diniz JB.; Pereira Bde B.; Miguel EC.; Pereira CA.,2009.0,,0,0,
9006,Defense style changes with the addition of psychodynamic group therapy to clonazepam in social anxiety disorder.,"Psychodynamic Group Therapy (PGT) and clonazepam are strategies to reduce symptoms of generalized social anxiety disorder (GSAD). The addition of PGT might lead to changes in defense styles. The objective of this study is to examine changes in defense styles when comparing clonazepam to psychodynamic group therapy plus clonazepam in GSAD during 12 weeks. Fifty-seven patients that met DSM-IV criteria for GSAD participated. social anxiety disorder symptoms were evaluated with the Liebowitz Social Anxiety Scale, and defense styles with the Defense Style Questionnaire. All defense styles changed overtime for both groups, especially mature defense style, which increased independently of the treatment allocation group. Regression analyses found that overtime there was a reduction in neurotic defenses in the combined group, whereas there was an increase in the clonazepam group. Neurotic defense style can change toward greater adaptiveness with the addition of PGT to clonazepam in GSAD, even in 12 weeks.",Knijnik DZ.; Salum GA.; Blanco C.; Moraes C.; Hauck S.; Mombach CK.; Strapasson AC.; Manfro GG.; Eizirik CL.,2009.0,10.1097/NMD.0b013e3181aac833,0,0,
9007,Effect of hypnosis on oral function and psychological factors in temporomandibular disorders patients.,"This study investigated the effect of hypnosis in patients with temporomandibular disorders (TMD) with focus on oral function and psychological outcomes. Forty women (mean age +/- s.d.: 38.6 +/- 10.8 years) suffering from TMD (mean duration 11.9 +/- 9.9 years) were randomized to four individual 1-hour sessions of either hypnotic intervention or a control condition of simple relaxation. Pain intensity was assessed three times daily on a 0-10 Numerical Rating Scale. Additional outcomes were TMD-associated symptoms assessed by the Research Diagnostic Criteria examination form and questionnaire, psychological symptoms (Symptom Check List 60), pain coping strategies (Coping Strategies Questionnaire), sleep difficulties (Pittsburgh Sleep Quality Index) and use of analgesics. Data were analyzed with between-groups within-subjects anovas. The hypnosis group significantly reduced the daily NRS pain scores from 4.5 +/- 2.1 at baseline to 2.9 +/- 2.4 after treatment (P < 0.001) compared to the control group where no significant changes were found (4.2 +/- 1.4 to 3.9 +/- 1.5) (P = 0.733). Number needed to treat for a 50% pain reduction was 4.0. The hypnosis group also increased use of the coping strategy 'reinterpreting pain sensations' from 5.2 +/- 6.9 to 10.3 +/- 6.8 (P < 0.001). Both groups exhibited significant reductions in the number of painful muscle palpation sites and pain on palpation (P < 0.004), in number of awakenings due to pain (P < 0.006), and in somatization, obsessive compulsive symptoms and anxiety (P < 0.004). Hypnosis thus appears to effectively reduce some aspects of complex TMD pain.",Abrahamsen R.; Zachariae R.; Svensson P.,2009.0,10.1111/j.1365-2842.2009.01974.x,0,0,
9008,Reducing chronic anxiety by making the threatening event predictable: an experimental approach.,"Panic disorder is characterized by both specific, phased fear and generalized, chronic anxiety. Standard extinction procedures are efficient in reducing specific fear. However, methods based on human conditioning research - that are capable of reducing chronic anxiety have not yet been thoroughly investigated. This study evaluates a new way of reducing chronic anxiety by signaling aversive events (or by making them more predictable). Using an experimental approach with healthy participants, specific fear and chronic anxiety were operationalized in a within-subjects fear-potentiated startle paradigm by, respectively, conditioning to a cue by presenting predictable shocks and conditioning to a context induced by unpredictable shocks. The results clearly demonstrate that context conditioning is reduced when a discrete cue is added that predicts the onset of the aversive event. The data suggest that making unpredictable events, such as for example panic attacks, predictable, may reduce the generalized and sustained anxiety that often complicates exposure treatment.",Fonteyne R.; Vervliet B.; Hermans D.; Baeyens F.; Vansteenwegen D.,2009.0,10.1016/j.brat.2009.06.011,0,0,
9009,A prevention programme for somatoform disorders is effective for affective disorders.,"To assess the effectiveness of a psycho-educational programme for the primary prevention of somatoform disorders in healthy primary care patients. Randomized, controlled trial. Participants (N=104) were randomly assigned to: (1) a psycho-educational intervention, or (2) no intervention at all. The primary outcome measure was somatoform disorder psychiatric diagnosis at 5-year follow-up. Secondary outcome measures were hypochondriasis, locus of control and attribution of symptoms and psychological distress. At 3 and 6 months, and 5 years, the intervention group significantly decreased hypochondriasis and somatic attributions; and increased psychological and normalizing attributions and internal locus of control. Five years after baseline, the prevalence of somatoform disorders showed no differences between both groups. Nevertheless, overall psychiatric morbidity was less prevalent in the intervention group (odds ratio: 2.72; 95%CI:1.10-6.72). In addition, a decrease in depression and anxiety subscales and in overall General Health Questionnaire scoring (p<.05) was found in the intervention group. A primary prevention programme for somatization seems to be useful, not to decrease somatoform disorders, but to prevent anxiety and depressive disorders. The effects of overlapping psychobiological mechanisms are discussed.",García-Campayo J.; Arevalo E.; Claraco LM.; Alda M.; Lopez del Hoyo Y.,2010.0,10.1016/j.jad.2009.06.031,0,0,
9010,Anxiety online: a virtual clinic: preliminary outcomes following completion of five fully automated treatment programs for anxiety disorders and symptoms.,"The development of e-mental health interventions to treat or prevent mental illness and to enhance wellbeing has risen rapidly over the past decade. This development assists the public in sidestepping some of the obstacles that are often encountered when trying to access traditional face-to-face mental health care services. The objective of our study was to investigate the posttreatment effectiveness of five fully automated self-help cognitive behavior e-therapy programs for generalized anxiety disorder (GAD), panic disorder with or without agoraphobia (PD/A), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD) offered to the international public via Anxiety Online, an open-access full-service virtual psychology clinic for anxiety disorders. We used a naturalistic participant choice, quasi-experimental design to evaluate each of the five Anxiety Online fully automated self-help e-therapy programs. Participants were required to have at least subclinical levels of one of the anxiety disorders to be offered the associated disorder-specific fully automated self-help e-therapy program. These programs are offered free of charge via Anxiety Online. A total of 225 people self-selected one of the five e-therapy programs (GAD, n = 88; SAD, n = 50; PD/A, n = 40; PTSD, n = 30; OCD, n = 17) and completed their 12-week posttreatment assessment. Significant improvements were found on 21/25 measures across the five fully automated self-help programs. At postassessment we observed significant reductions on all five anxiety disorder clinical disorder severity ratings (Cohen d range 0.72-1.22), increased confidence in managing one's own mental health care (Cohen d range 0.70-1.17), and decreases in the total number of clinical diagnoses (except for the PD/A program, where a positive trend was found) (Cohen d range 0.45-1.08). In addition, we found significant improvements in quality of life for the GAD, OCD, PTSD, and SAD e-therapy programs (Cohen d range 0.11-0.96) and significant reductions relating to general psychological distress levels for the GAD, PD/A, and PTSD e-therapy programs (Cohen d range 0.23-1.16). Overall, treatment satisfaction was good across all five e-therapy programs, and posttreatment assessment completers reported using their e-therapy program an average of 395.60 (SD 272.2) minutes over the 12-week treatment period. Overall, all five fully automated self-help e-therapy programs appear to be delivering promising high-quality outcomes; however, the results require replication.",Klein B.; Meyer D.; Austin DW.; Kyrios M.,2011.0,10.2196/jmir.1918,0,0,
9011,Mindfulness and the attenuation of post-event processing in social phobia: an experimental investigation.,"The present experimental study examined the ability of metacognitive strategies to reduce the distress associated with post-event processing (PEP). Individuals with DSM-IV generalized social phobia (N = 57) were randomly allocated to receive brief training in mindfulness, distraction, or no training (control group). Next, they underwent an experimental PEP induction. Following the induction, they were instructed to apply the metacognitive strategy (mindfulness or distraction) they were taught or to continue thinking about the social event the way they typically would following such an event (control). Participants rated their distress on a visual analogue scale prior to the PEP induction, and then every minute for 5 min while applying the metacognitive strategy. They also rated their affect immediately after applying the metacognitive strategy. Results suggest that mindfulness reduces distress significantly over the post-event period and results in significantly more positive affect than when receiving no training. In contrast, distraction does not reduce distress over the post-event period performs comparable to receiving no training. The results of this experimental investigation suggest that mindfulness has the potential to reduce distress associated with PEP and provide further support for the clinical utility of mindfulness in the treatment of generalized social phobia.",Cassin SE.; Rector NA.,2011.0,10.1080/16506073.2011.614275,0,0,
9012,Efficacy of a specific model for cognitive-behavioral therapy among panic disorder patients with agoraphobia: a randomized clinical trial.,"Cognitive-behavioral therapy is frequently indicated for panic disorder. The aim here was to evaluate the efficacy of a model for cognitive-behavioral therapy for treating panic disorder with agoraphobia. Randomized clinical trial at Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro. A group of 50 patients with a diagnosis of panic disorder with agoraphobia was randomized into two groups to receive: a) cognitive-behavioral therapy with medication; or b) medication (tricyclic antidepressants or selective serotonin reuptake inhibitors). Although there was no difference between the groups after the treatment in relation to almost all variables with the exception of some items of the Sheehan disability scale and the psychosocial and environmental problems scale, the patients who received the specific therapy presented significant reductions in panic attacks, anticipatory anxiety, agoraphobia avoidance and fear of body sensations at the end of the study, in relation to the group without the therapy. On the overall functioning assessment scale, overall wellbeing increased from 60.8% to 72.5% among the patients in the group with therapy, thus differing from the group without therapy. Although both groups responded to the treatment and improved, we only observed significant differences between the interventions on some scales. The association between specific cognitive-behavioral therapy focusing on somatic complaints and pharmacological treatment was effective among this sample of patients with panic disorder and the response was similar in the group with pharmacological treatment alone.",King AL.; Valença AM.; de Melo-Neto VL.; Freire RC.; Mezzasalma MA.; Silva AC.; Nardi AE.,2011.0,,0,0,
9013,Cognitive-behavioral group therapy versus group psychotherapy for social anxiety disorder among college students: a randomized controlled trial.,"In this randomized controlled trial, cognitive-behavioral group therapy (CBGT) for social anxiety disorder (SAD) was compared to group psychotherapy (GPT), a credible, structurally equivalent control condition that included only nonspecific factors of group treatment (such as group dynamics). Participants were 45 college students at the University of Colorado with a primary diagnosis of SAD. Each treatment condition comprised eight group sessions lasting 2‚Äâhr each. Independent assessors (blind to treatment assignment) assessed participants at baseline and posttreatment with the Clinical Global Impression Scale (CGI) and the Liebowitz Social Anxiety Scale (LSAS). Both treatments were found to be equally credible. There were five noncompleters in the CBGT condition (21.7%) and only one in the GPT condition (4.3%). There were no statistically significant differences posttreatment (controlling for pretreatment scores) between the two treatment conditions, and both treatments were found to be efficacious. Effect sizes for CBGT were similar to earlier studies, and adherence ratings revealed excellent adherence. Treatment of SAD appears to be moving toward individual CBT, partly because of high attrition rates and underutilization of group dynamics in group CBT. However, group therapy has unique therapeutic ingredients, and it may be too early to give up on group treatment altogether. Discussion of these findings included future directions with this treatment modality, especially whether these two types of group treatment could be combined and whether such combination might serve to decrease attrition, enhance efficacy, and facilitate dissemination.",Bjornsson AS.; Bidwell LC.; Brosse AL.; Carey G.; Hauser M.; Mackiewicz Seghete KL.; Schulz-Heik RJ.; Weatherley D.; Erwin BA.; Craighead WE.,2011.0,10.1002/da.20877,0,0,
9014,Changes in risk-taking over the course of an internet-delivered cognitive behavioral therapy treatment for generalized anxiety disorder.,"It has been proposed that a persistent and pervasive tendency to avoid risks is involved in the development and maintenance of clinically significant anxiety. Few studies, however, have examined the clinical implications of risk-aversion, and particularly the association between risk-aversion and treatment outcome. The current study investigated how risk-aversion in specific domains (Social and Recreational) related to treatment outcome in a clinical sample of patients with generalized anxiety disorder (GAD) undergoing internet-delivered cognitive-behavioral therapy (CBT). We hypothesized that: (i) risk-taking would increase as a result of treatment and (ii) risk-taking would mediate changes in symptom severity and impairment as a result of treatment. Individuals recruited online (N=44) meeting diagnostic criteria for GAD were randomized to the treatment (n=24) or control group (n=20). Participants completed measures of symptom severity, impairment and risk-taking before and after treatment. Results partially confirmed our hypotheses, demonstrating that participants in the treatment group significantly increased social and recreational risk-taking scores relative to the control group and risk-taking mediated treatment outcome for depression, but not for anxiety symptoms. The results of this study suggest that social and recreational risk-avoidance decreases following CBT treatment, and this change may mediate treatment outcome for depression. Clinical implications of these findings are discussed.",Lorian CN.; Titov N.; Grisham JR.,2012.0,10.1016/j.janxdis.2011.10.003,0,0,
9015,Exploring variables associated with change in cognitive behaviour therapy (CBT) for anxiety following traumatic brain injury.,"In a pilot randomized controlled trial, we investigated the effectiveness of a 12-weekly anxiety treatment programme adapted for individuals with moderate-severe TBI, based on cognitive behaviour therapy (CBT) and Motivational Interviewing (MI). The current study explored the variables associated with treatment response and group differences in change expectancy and working alliance. Twenty-seven participants recruited from a brain injury rehabilitation hospital were randomly assigned to MI + CBT, non-directive counselling (NDC) + CBT and treatment-as-usual and assessors were blinded to treatment conditions. Correlation and multiple regression were used to examine the association between reduction in anxiety ratings and a number of clinical, injury and cognitive variables. Random effects regression was used to examine group difference in changes in working alliance and expectancy. There was a trend suggesting that greater injury severity may be predictive of poorer response to CBT and injury severity was significantly related to memory functioning. Participants receiving MI pre-treatment showed a greater increase in change expectancy at the end of CBT and at follow-up, but not at the end of MI. There is a need to further investigate the effectiveness of treatment for individuals with different injury severity and to explore the relationship between change expectancy and treatment outcome.",Hsieh MY.; Ponsford J.; Wong D.; McKay A.,2012.0,10.3109/09638288.2011.607219,0,0,
9016,The capacity of acute stress disorder to predict posttraumatic psychiatric disorders.,"One rationale for establishing the acute stress disorder diagnosis was to identify recently trauma-exposed people who may develop later posttraumatic stress disorder (PTSD). This study conducted a multi-site assessment of the extent to which ASD predicts subsequent PTSD, and also major depressive disorder, panic disorder, agoraphobia, social phobia, specific phobia, generalized anxiety disorder, and substance use disorder, 12 months after trauma. Consecutive admissions to 5 major trauma hospitals across Australia (N = 1084) were assessed during hospital admission and within one month of trauma exposure and subsequently re-assessed for psychiatric disorder 12 months after the initial assessment (N = 859). Whereas 120 (10%) patients met criteria for ASD in the initial month after trauma, 83 (10%) met criteria for PTSD, and 268 (31%) had any psychiatric disorder at 12 months. In terms of those diagnosed with ASD, 28 (36%) subsequently met criteria for PTSD and 50 (65%) subsequently developed any psychiatric disorder. Whereas the majority of people with ASD subsequently develop a psychiatric disorder, most people with a disorder at 12 months do not initially display ASD.",Bryant RA.; Creamer M.; O'Donnell M.; Silove D.; McFarlane AC.,2012.0,10.1016/j.jpsychires.2011.10.007,0,0,
9017,"[The effects of multimodal intervention for the primary prevention of cardiovascular diseases on depression, anxiety, and Type-D pattern: initial results of the randomized controlled PreFord trial].","Depression, anxiety, and Type-D pattern are associated with the earlier development and faster progression of cardiovascular disease (CVD). The aim of the randomized controlled PreFord trial was to improve multiple biological and psychosocial risk factors in the primary prevention of CVD. A total of 447 women and men with an ESC risk score >5% were randomly assigned to either multimodal or routine care groups. Somatic and psychosocial variables (HADS, DS-14) were assessed before and after the intervention, and annually for 2 years thereafter. The intervention showed no significant effects on the symptoms of depression, anxiety, and type D personality, either in the whole sample or in those with elevated scores at baseline. Thus, our study did not provide evidence that symptoms of depression, anxiety, or Type D personality can be effectively treated by multimodal behavioral interventions for the primary prevention of CVD.",Albus C.; Bjarnson-Wehrens B.; Gysan DB.; Herold G.; Schneider CA.; zu Eulenburg C.; Predel HG.;  .,2012.0,10.1007/s00059-011-3542-4,0,0,
9018,"Feasibility, reliability and validity of the Dutch translation of the Anxiety, Depression And Mood Scale in older adults with intellectual disabilities.","The informant-based Anxiety, Depression And Mood Scale was translated into Dutch and its feasibility, reliability and validity in older adults (aged ≥ 50 years) with intellectual disabilities (ID) was studied. Test-retest (n = 93) and interrater reliability (n = 83), and convergent (n = 202 and n = 787), discriminant (n = 288) and criterion validity (n = 288) were studied. Convergent and criterion validity were studied for the Depressed mood and General anxiety subscales. Subgroups based on level of ID and autism have been made to study the criterion validity. Psychiatric diagnoses based on the PAS-ADD Interview were used as gold standard. All subscales had good internal consistency (α ≥ 0.80), excellent test-retest reliability (ICC ≥ 0.75) and good interrater reliability (ICC ≥ 0.74), except for the Social avoidance subscale (ICC = 0.57). The Depressed mood subscale showed low correlation (r = 0.44) with the self-report Inventory of Depressive Symptomatology, high correlation with the informant-report Signalizing Depression List for people with ID (r = 0.71) and no correlation with the PAS-ADD's sleep disorders subscale (r = 0.15). Its sensitivity ranged from 73 to 80%, and its specificity from 71 to 79%. The General anxiety subscale showed low correlation with the self-report scales: Glasgow Anxiety Scale (r= 0.37) and Hospital Anxiety and Depression Scale (r = 0.41), and no correlation with the sleep disorder subscale (r = 0.02). Its sensitivity ranged from 67 to 100%, and its specificity from 48 to 81%. The Dutch translation of the ADAMS is reliable and sufficiently valid to screen for anxiety and depression in older people with ID.",Hermans H.; Jelluma N.; van der Pas FH.; Evenhuis HM.,,10.1016/j.ridd.2011.09.018,0,0,
9019,Psychotherapy for social phobia: how do alliance and cognitive process interact to produce outcome?,"The purpose of this study was to ascertain whether and how alliance and specific cognitive process may interact to influence outcome. Eighty social phobic patients were randomized to 10-week residential cognitive or interpersonal therapy, conducted mostly in groups. They completed process and outcome measures weekly. The ratings were analyzed with mixed models. It was found that initial patient-rated alliance predicted the course of social anxiety throughout therapy and that this effect was indirect through the cognitive process. However, this indirect effect did not interact with treatment. There was a trend toward an indirect effect of weekly variations in alliance rated by the individual therapist through weekly variations in subsequent cognitive process on weekly variations in subsequent social anxiety. Thus, the results support a facilitative rather than an active ingredient perspective on the role of alliance.",Hoffart A.; Borge FM.; Sexton H.; Clark DM.; Wampold BE.,2012.0,10.1080/10503307.2011.626806,0,0,
9020,"Cognitive behavior therapy for chronic subjective dizziness: a randomized, controlled trial.","The aim of this study was to evaluate the effects of a brief cognitive behavior therapy (CBT) intervention on the physical symptoms, illness-related disability, and psychologic distress of patients with chronic subjective dizziness. Forty-one patients with chronic subjective dizziness referred by a neurootologic clinic were randomly assigned to immediate treatment or a wait-list control. Three weekly treatment sessions based on the CBT model of panic disorder, adapted for patients with dizziness, were administered by a clinical psychologist. Treatment included psychoeducation, behavioral experiments, exposure to feared stimuli, and attentional refocusing. Outcomes were measured on the Dizziness Handicap Inventory and the Depression, Anxiety and Stress Scales. Two further measures developed for this study; the Dizziness Symptoms Inventory and the Safety Behaviours Inventory were used to measure physical symptoms and safety behaviors. The intervention was associated with significant reductions in disability on the Dizziness Handicap Inventory, reduced dizziness and related physical symptoms on the Dizziness Symptoms Inventory, and reduced avoidance and safety behaviors as measured by the Safety Behaviours Inventory. Pre- to posteffect sizes ranged from 0.98 to 1.15. There was no change in psychologic outcomes measured on the Depression, Anxiety and Stress Scales. A 3-session psychologic intervention based on the CBT model can produce significant improvements in dizziness-related symptoms, disability, and functional impairment among patients with chronic subjective dizziness. This suggests that treatment of this condition may be reasonably simple and cost-effective for most of the patients.",Edelman S.; Mahoney AE.; Cremer PD.,,10.1016/j.amjoto.2011.10.009,0,0,6286
9021,Alcohol expectancies and social self-efficacy as mediators of differential intervention outcomes for college hazardous drinkers with social anxiety.,"The current pilot study examined the roles of two cognitive factors - positive alcohol expectancies of social anxiety reduction and drink refusal self-efficacy relevant to social situations - in mediating greater reduction in alcohol behaviors by the Brief Intervention for Socially Anxious Drinkers (BISAD; n=21) compared to an alcohol psychoeducation (n=20) in a sample of college hazardous drinkers with social anxiety. Mediation analysis results indicated that decreased positive alcohol expectancies and increased drink refusal self-efficacy relevant to social situations accounted for an average of 67% of the variance in treatment outcomes as measured by total quantity of alcohol consumption, heavy drinking days and problems related to alcohol use in the past month. Study results may enhance the understanding of cognitive factors' role in alcohol treatment outcomes, which could in turn improve the efficacy of interventions aimed to reduce hazardous drinking and comorbid social anxiety.",Black JJ.; Tran GQ.; Goldsmith AA.; Thompson RD.; Smith JP.; Welge JA.,2012.0,10.1016/j.addbeh.2011.10.004,0,0,
9022,Parental attention-deficit/hyperactivity disorder predicts child and parent outcomes of parental friendship coaching treatment.,"This study investigated the impact of parental attention-deficit/hyperactivity disorder (ADHD) symptoms on the peer relationships and parent-child interaction outcomes of children with ADHD among families completing a randomized controlled trial of parental friendship coaching (PFC) relative to control families. Participants were 62 children with ADHD (42 boys and 20 girls, 6 through 10 years old) and their parents. Approximately half of the families received PFC (a 3-month parent training intervention targeting the peer relationships of children with ADHD), and the remainder represented a no-treatment control group. Parental inattention predicted equivalent declines in children's peer acceptance in both treatment and control families. However, treatment amplified differences between parents with high versus low ADHD symptoms for some outcomes: Control families declined in functioning regardless of parents' symptom levels. However, high parental inattention predicted increased child peer rejection and high parental inattention and impulsivity predicted decreased parental facilitation among treated families (indicating reduced treatment response). Low parental symptoms among treated families were associated with improved functioning in these areas. For other outcomes, treatment attenuated differences between parents with high versus low ADHD symptoms: Among control parents, high parental impulsivity was associated with increasing criticism over time, whereas all treated parents showed reduced criticism regardless of symptom levels. Follow-up analyses indicated that the parents experiencing poor treatment response are likely those with clinical levels of ADHD symptoms. Results underscore the need to consider parental ADHD in parent training treatments for children with ADHD.",Griggs MS.; Mikami AY.,2011.0,10.1016/j.jaac.2011.08.004,0,0,
9023,"Comparison of two strategies to improve infant sleep problems, and associated impacts on maternal experience, mood and infant emotional health: a single case replication design study.","Infant sleep problems (ISP) are common and have known effects on parental mood. There is debate as to whether treatment strategies may impact on the infant's emotional health. To compare the effectiveness of two treatment strategies for ISP on the infant's sleep, maternal mood, and the infant's emotional health. The two strategies are 1) systematic ignoring with minimal check ('SI-mc': commonly known as 'controlled crying'), and 2) a new, but similar, method where parents feign sleep inside the infant's room before intervening (parental presence with minimal check: 'PP-mc'). Participants were randomised to one of the two conditions. Measures were taken at baseline, then three weeks and four months post-intervention. Data were collected from 16 families with infants aged 6-18 months who were seeking professional help with their infant's sleep difficulties. Measures of infant sleep, maternal experiences and mood, and infant emotional health were collected. Both treatments were effective, with a third to a half of families reporting decreased ISP by 3 week post intervention, and nearly all reporting decreased ISP by follow-up. Similarly, most mothers in both treatments reported improvements to their experiences or mood, and there was no discernable disruption to infant emotional health. These findings support previous research into the effectiveness of SI-mc. The study also expands the research into the effectiveness of parental presence by showing that with the inclusion of the minimal check component, which may be preferred by both parents and clinicians over non-responding to the crying infant, the strategy is as effective as SI-mc.",Matthey S.; Črnčec R.,2012.0,10.1016/j.earlhumdev.2011.10.010,0,0,
9024,Feasibility of exercise training for the short-term treatment of generalized anxiety disorder: a randomized controlled trial.,"Exercise training may be especially helpful for patients with generalized anxiety disorder (GAD). We conducted a randomized controlled trial to quantify the effects of 6 weeks of resistance (RET) or aerobic exercise training (AET) on remission and worry symptoms among sedentary patients with GAD. Thirty sedentary women aged 18-37 years, diagnosed by clinicians blinded to treatment allocation with a primary DSM-IV diagnosis of GAD and not engaged in any treatment other than pharmacotherapy, were randomly allocated to RET, AET, or a wait list (WL). RET involved 2 weekly sessions of lower-body weightlifting. AET involved 2 weekly sessions of leg cycling matched with RET for body region, positive work, time actively engaged in exercise, and load progression. Remission was measured by the number needed to treat (NNT). Worry symptoms were measured by the Penn State Worry Questionnaire. There were no adverse events. Remission rates were 60%, 40%, and 30% for RET, AET, and WL, respectively. The NNT was 3 (95% CI 2 to 56) for RET and 10 (95% CI -7 to 3) for AET. A significant condition-by-time interaction was found for worry symptoms. A follow-up contrast showed significant reductions in worry symptoms for combined exercise conditions versus the WL. Exercise training, including RET, is a feasible, low-risk treatment that can potentially reduce worry symptoms among GAD patients and may be an effective adjuvant, short-term treatment or augmentation for GAD. Preliminary findings warrant further investigation.",Herring MP.; Jacob ML.; Suveg C.; Dishman RK.; O'Connor PJ.,2012.0,10.1159/000327898,0,0,
9025,Does yohimbine hydrochloride facilitate fear extinction in virtual reality treatment of fear of flying? A randomized placebo-controlled trial.,"Research suggests that yohimbine hydrochloride (YOH), a noradrenaline agonist, can facilitate fear extinction. It is thought that the mechanism of enhanced emotional memory is stimulated through elevated noradrenaline levels. This randomized placebo-controlled trial examined the potential exposure-enhancing effects of YOH in a clinical sample of participants meeting DSM-IV criteria for a specific phobia (fear of flying). Sixty-seven participants with fear of flying were randomized to 4 sessions of virtual reality exposure therapy (VRET) combined with YOH (10 mg), or 4 sessions of VRET combined with a placebo. Treatment consisted of 4 weekly 1-hour exposure sessions consisting of two 25-minute virtual flights. At pre- and post- treatment, fear of flying was assessed. The YOH or placebo capsules were administered 1 h prior to exposures. The manipulation of the noradrenaline activity was confirmed by salivary α-amylase (sAA) samples taken pre-, during and post-exposure. Forty-eight participants completed treatment. Manipulation of noradrenaline levels with YOH was successful, with significantly higher levels of sAA in the YOH group when entering exposure. Results showed that both groups improved significantly from pre- to post-treatment with respect to anxiety reduction. However, although the manipulation of noradrenaline activity was successful, there was no evidence that YOH enhanced outcome. Participants improved significantly on anxiety measures independently of drug condition, after 4 sessions of VRET. These data do not support the initial findings of exposure-enhancing effects of YOH in this dosage in clinical populations.",Meyerbroeker K.; Powers MB.; van Stegeren A.; Emmelkamp PM.,2012.0,10.1159/000329454,0,0,
9026,Sudden gains in the treatment of obsessive-compulsive disorder.,"The present study examined sudden gains during treatment for obsessive-compulsive disorder (OCD) and their relationship to short- and long-term outcome. Ninety-one individuals (age 19-64) completed either cognitive treatment, exposure treatment, or their combination with fluvoxamine for OCD. Participants' obsessive-compulsive symptoms were assessed before each weekly treatment session. In addition, obsessive-compulsive and depressive symptoms were assessed pre treatment and post treatment as well as 12 months following treatment termination. Sudden gains were found among 34.1% of participants and constituted 65.5% of the total reduction in obsessive-compulsive symptoms. Compared to individuals who did not experience sudden gains, individuals who experienced sudden gains reported lower levels of OCD symptoms post treatment, and this was maintained during follow-up. Sudden gains are common in treatments for OCD and are predictive of treatment outcome and follow-up. Sudden gains mark a distinct trajectory of response to treatment for OCD. Individuals with sudden gains greatly improve during treatment and maintain their gains during follow-up, whereas individuals without sudden gains improve to a significantly lesser extent. Thus, treatment planning and development can benefit from considering sudden gains and the intra-individual course of improvement.",Aderka IM.; Anholt GE.; van Balkom AJ.; Smit JH.; Hermesh H.; van Oppen P.,2012.0,10.1159/000329995,0,0,
9027,Main and interactive effects of emotion dysregulation and breath-holding duration in relation to panic-relevant fear and expectancies about anxiety-related sensations among adult daily smokers.,"The current study investigated the main and interactive effects of emotion dysregulation and distress tolerance in relation to panic-relevant variables among daily smokers. The sample consisted of 172 adults (61.2% male; M(age)=31.58, SD=11.51), who reported smoking an average of 15.99 cigarettes per day (SD=10.00). Results indicated that both emotion dysregulation and distress tolerance were significantly related to interoceptive fear and agoraphobia. Additionally, emotion dysregulation, but not distress tolerance, was significantly related to anxiety sensitivity. All effects were evident above and beyond the variance accounted for by average cigarettes per day, tobacco-related physical illness, and panic attack history. The interaction between emotion dysregulation and distress tolerance significantly predicted interoceptive and agoraphobic fears as well as the cognitive component of anxiety sensitivity. Such findings underscore the importance of emotion dysregulation and distress tolerance in regard to panic-specific fear and expectancies about anxiety-related sensations among daily smokers.",Brandt CP.; Johnson KA.; Schmidt NB.; Zvolensky MJ.,2012.0,10.1016/j.janxdis.2011.10.007,0,0,
9028,Emotional variability and sustained arousal during exposure.,"In traditional exposure therapy for phobias and anxiety disorders, reduction of fear responding is used as an index of learning. However, recent evidence in animal models suggests that sustained arousal and enhanced fear responding throughout exposure may actually predict better long-term outcomes (Rescorla, 2000). The effects of sustained arousal during exposure were investigated in a clinical analog sample of 59 participants fearful of public speaking. Participants completed exposure with or without the presence of additional excitatory stimuli which were intended to enhance arousal and fear responding throughout exposure. Group assignment (exposure versus exposure with additional excitatory stimuli) did not significantly predict outcome at 1-week follow-up testing, as measured physiologically, subjectively, and behaviorally. A set of regression analyses investigating whether any exposure process measures predicted outcome indicated that sustained arousal throughout exposure as well as variability in subjective fear responding throughout exposure (e.g., Kircanski et al., 2011) predicted lower levels of fear at follow-up testing (p < 0.05; p < 0.001) after controlling for demographic variables as well as pre-exposure fear levels. The excitatory stimuli used failed to produce the intended effects. However, some participants did maintain elevated arousal throughout exposure and this predicted better outcomes at 1-week follow-up testing. Sustained arousal throughout exposure as well as variability in subjective fear responding during exposure may be better predictors of long-term outcomes than habituation of fear across exposure.",Culver NC.; Stoyanova M.; Craske MG.,2012.0,10.1016/j.jbtep.2011.10.009,0,0,
9029,Neuropattern: a new translational tool to detect and treat stress pathology. II. The Teltow study.,"The present study was designed to test the clinical utility of Neuropattern (NP), a newly developed translational diagnostic tool. NP consists of biological and psychological measures that facilitate the identification of functional changes (called ""neuropatterns"") in patients with stress-related health problems. In this prospective, randomized control trial, we expected NP to improve therapeutic efficacy, as compared with the usual treatment. NP was applied to 101 in-patients suffering from various mental disorders (mainly depression, anxiety disorders, and adjustment disorders), and scoring high on the Symptom Checklist-90-R (SCL-90-R) somatization scale. The patients (73% females, mean ± standard deviation age 46 ± 9.03 years) were randomly assigned to two groups: in the experimental group (n = 51), physicians received results from NP diagnostics, while in the control group (n = 50), this information was not available until discharge from the hospital. Improvements of symptoms in consequence of treatment were monitored by two self-rating scales, the SCL-90-R and Short Form-12 health survey, and a physician's clinical global rating (Beeinträchtigungs-Schwere Score). There was a significantly greater improvement in the experimental group in the self-rating assessments on symptom severity (p = 0.03) and quality of life (p = 0.05), but not in the observer rating of emotional, physical, and social-communicative functioning (p = 0.13). Treatment efficacy in patients can be improved by providing the attendant physician and the patient with diagnostic information and treatment recommendations by NP. The role of concrete mediators of treatment efficacy awaits further research.",Hero T.; Gerhards F.; Thiart H.; Hellhammer DH.; Linden M.,2012.0,10.3109/10253890.2011.644605,0,0,
9030,Lifetime traumatic experiences and posttraumatic stress disorder in the German population: results of a representative population survey.,"Only a few European population-based studies on the epidemiology of posttraumatic stress disorder (PTSD) are available to date. This study aims to broaden the epidemiological knowledge of traumatic experiences (TEs), PTSD, and comorbid mental conditions in a representative German sample (N = 2510). The Composite International Diagnostic Interview list of traumatic events, the Posttraumatic Diagnostic Scale, and Patient Health Questionnaire (PHQ)-9 as well as PHQ-15 were used in this survey. Main results were low frequencies of TEs (24%) and PTSD (2.9%). Older participants (>60 years) reported significantly more TEs and more posttraumatic symptoms, whereas there was no significant difference in PTSD prevalence. A third of the subjects diagnosed with PTSD were found positive for depressive syndromes, and 27% were found positive for somatization syndrome. The results show that TEs and posttraumatic symptoms are frequent in senior citizens and thus have to be considered when treating older patients with mental health conditions.",Hauffa R.; Rief W.; Brähler E.; Martin A.; Mewes R.; Glaesmer H.,2011.0,10.1097/NMD.0b013e3182392c0d,0,0,
9031,The influence of posttraumatic stress disorder numbing and hyperarousal symptom clusters in the prediction of physical health status in veterans with chronic tobacco dependence and posttraumatic stress disorder.,"Smoking and PTSD are predictors of poor physical health status. This study examined the unique contribution of PTSD symptoms in the prediction of the SF-36 physical health status subscales accounting for cigarette smoking, chronic medical conditions, alcohol and drug use disorders, and depression. This study examined baseline interview and self-report data from a national tobacco cessation randomized, controlled trial (Veterans Affairs Cooperative Study 519) that enrolled tobacco-dependent veterans with chronic PTSD (N = 943). A series of blockwise multiple regression analyses indicated that PTSD numbing and hyperarousal symptom clusters explained a significant proportion of the variance across all physical health domains except for the Physical Functioning subscale, which measures impairments in specific physical activities. Our findings further explain the impact of PTSD on health status by exploring the way PTSD symptom clusters predict self-perceptions of health, role limitations, pain, and vitality.",Harder LH.; Chen S.; Baker DG.; Chow B.; McFall M.; Saxon A.; Smith MW.,2011.0,10.1097/NMD.0b013e3182392bfb,0,0,
9032,Psychosomatic symptoms among hospital physicians during the Gaza War: a repeated cross-sectional study.,"Research regarding psychosomatic symptoms among hospital physicians during armed conflict is scarce. The current study compared psychosomatic symptoms of exposed and unexposed hospital physicians in two studies. The studies were conducted during 2009 and included a survey of two random samples of hospital physicians, one conducted during the Gaza War and the other conducted six months later. Each sample included hospital physicians who were directly exposed to war related stress and others who were not (Study 1: N = 54; Study 2: N = 31). In Study 1, exposed hospital physicians did not differ from unexposed physicians in the level of psychosomatic symptoms during the war (Psychosomatic Problems Scale 6.48 vs 4.09). However, in Study 2, exposed physicians reported a higher level of psychosomatic symptoms (10.33 vs 3.21). Moreover, analysis of covariance revealed a significant interaction effect of Exposure X Study (F = 7.976; p = .006; ?p2 = .100). Exposure to war-related stress takes a toll on psychosomatic symptoms among hospital physicians. This late onset of psychosomatic symptoms is discussed in light of the cognitive-energetical model.",Ben-Ezra M.; Palgi Y.; Wolf JJ.; Shrira A.,2011.0,,0,0,
9033,Incremental benefits and cost of coordinated anxiety learning and management for anxiety treatment in primary care.,"Improving the quality of mental health care requires integrating successful research interventions into 'real-world' practice settings. Coordinated Anxiety Learning and Management (CALM) is a treatment-delivery model for anxiety disorders encountered in primary care. CALM offers cognitive behavioral therapy (CBT), medication, or both; non-expert care managers assisting primary care clinicians with adherence promotion and medication optimization; computer-assisted CBT delivery; and outcome monitoring. This study describes incremental benefits, costs and net benefits of CALM versus usual care (UC). The CALM randomized, controlled effectiveness trial was conducted in 17 primary care clinics in four US cities from 2006 to 2009. Of 1062 eligible patients, 1004 English- or Spanish-speaking patients aged 18-75 years with panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD) and/or post-traumatic stress disorder (PTSD) with or without major depression were randomized. Anxiety-free days (AFDs), quality-adjusted life years (QALYs) and expenditures for out-patient visits, emergency room (ER) visits, in-patient stays and psychiatric medications were estimated based on blinded telephone assessments at baseline, 6, 12 and 18 months. Over 18 months, CALM participants, on average, experienced 57.1 more AFDs [95% confidence interval (CI) 31-83] and $245 additional medical expenses (95% CI $-733 to $1223). The mean incremental net benefit (INB) of CALM versus UC was positive when an AFD was valued ‚â•$4. For QALYs based on the Short-Form Health Survey-12 (SF-12) and the EuroQol EQ-5D, the mean INB was positive at ‚â•$5000. Compared with UC, CALM provides significant benefits with modest increases in health-care expenditures.",Joesch JM.; Sherbourne CD.; Sullivan G.; Stein MB.; Craske MG.; Roy-Byrne P.,2012.0,10.1017/S0033291711002893,0,0,
9034,Attendance and substance use outcomes for the Seeking Safety program: sometimes less is more.,"This study uses data from the largest effectiveness trial to date on treatment of co-occurring posttraumatic stress and substance use disorders, using advances in statistical methodology for modeling treatment attendance and membership turnover in rolling groups. Women receiving outpatient substance abuse treatment (N = 353) were randomized to 12 sessions of Seeking Safety or a health education control condition. Assessments were completed at baseline and at 1 week, 3, 6, and 12 months posttreatment. Outcome measures were alcohol and cocaine use in the prior 30 days captured using the Addiction Severity Index. Latent class pattern mixture modeling (LCPMM) was used to estimate attendance patterns and to test for treatment effects within and across latent attendance patterns and group membership turnover. Across LCPMM analyses for alcohol and cocaine use, similar treatment attendance patterns emerged: Completers never decreased below an 80% probability of attendance, droppers never exceeded a 41% probability of attendance, and titrators demonstrated a 50% to 80% probability of attendance. Among completers, there were significant decreases in alcohol use from baseline to 1-week posttreatment, followed by nonsignificant increases in alcohol during follow-up. No differences between treatment conditions were detected. Titrators in Seeking Safety had lower rates of alcohol use from 1-week through 12-month follow-up compared with control participants. Droppers had nonsignificant increases in alcohol during both study phases. Cocaine use findings were similar but did not reach significance levels. The impact of client self-modulation of treatment dosage and group membership composition may influence behavioral treatment outcomes among this population.",Hien DA.; Morgan-Lopez AA.; Campbell AN.; Saavedra LM.; Wu E.; Cohen L.; Ruglass L.; Nunes EV.,2012.0,10.1037/a0026361,0,0,
9035,Individual differences in emotionality and peri-traumatic processing.,"Recent cognitive models propose that intrusive trauma memories arise and persist because high levels of emotional arousal triggered by the trauma disrupt conceptual processing of elements of the event, while enhancing sensory/perceptual processing. A trauma film analogue design was used to investigate if the predicted facilitating effects on intrusions from inhibiting conceptual processing and predicted attenuating effects on intrusions from inhibiting sensory processing are moderated by individual differences in emotionality. One hundred and five non-clinical participants viewed a traumatic film while undertaking a conceptual interference task, a sensory interference task, or no interference task. Participants recorded the frequency and intensity of intrusions over the following week. There was no facilitating effect for the conceptual interference task compared to no interference task. A significant attenuation of the frequency of intrusions was evident for those undertaking sensory interference (ŋ(2) = .04). This effect, however, was only present for those with high trait anxiety (d = .82) and not for those with low trait anxiety (d = .08). Relative to high trait anxious controls, high anxious participants who undertook sensory interference also reported lower intensity of intrusions (d = .66). This is the first trauma film analogue study to show that the attenuating effect of concurrent sensory/perceptual processing on the frequency and intensity of subsequent intrusions is evident only for people with high trait anxiety. The results have implications for conceptual models of intrusion development and for their application to the prevention of post traumatic distress.",Logan S.; O'Kearney R.,2012.0,10.1016/j.jbtep.2011.12.003,0,0,
9036,"Relationships among childhood trauma, posttraumatic stress disorder, and dissociation in men living with HIV/AIDS.","This study examined the relationships among dissociation, childhood trauma and sexual abuse, and posttraumatic stress disorder (PTSD) symptoms in HIV-positive men. Data were collected from 167 men enrolled in a randomized clinical trial that examined a group therapy intervention to decrease HIV-related risk behavior and trauma-related stress symptoms. Participants completed the Trauma History Questionnaire, the Impact of Events Scale-Revised, and the Stanford Acute Stress Reaction Questionnaire. Overall, 35.3% of the participants reported having experienced childhood sexual abuse. A total of 55.7% of the sample met diagnostic criteria for PTSD. The intensity of dissociative symptoms that participants endorsed was positively associated with experience of childhood sexual abuse (r‚Äâ=‚Äâ.20, p < .01). Dissociative symptoms were also positively associated with specific PTSD symptoms, notably hyperarousal (r‚Äâ=‚Äâ.69, p < .001). Hierarchical regression indicated that hyperarousal symptoms accounted for more of the variance in dissociation than childhood sexual abuse. These results suggest that childhood sexual abuse may be involved in the development of dissociative symptoms in the context of adulthood stress reactions. Furthermore, the pattern of the association between dissociation and PTSD is consistent with the possibility of a dissociative PTSD subtype among HIV-positive men.",Kamen C.; Bergstrom J.; Koopman C.; Lee S.; Gore-Felton C.,2012.0,10.1080/15299732.2011.608629,0,0,
9037,Dissolving the tenacity of obsessional doubt: implications for treatment outcome.,"Previous research has found that a high impact of possibility based information during reasoning prevents the resolution of doubt among those with Obsessive-Compulsive Disorder (OCD). It was expected that the ability of those with OCD to resolve obsessional doubt would improve following Inference Based Treatment (IBT). The ability to resolve doubt, including the relative impact of reality and possibility based information, was measured before and after treatment with the Inference Processes Task in a group of 35 participants diagnosed with OCD. Results confirmed that IBT improved the participants' ability to resolve obsessional doubt. Those who improved their ability to resolve doubt showed a significantly better treatment outcome. Improvements appeared mostly due to a lowered impact of possibility based information following treatment. The study did not include a control condition although results clearly indicate that the ability to resolve obsessional is closely linked to the most relevant quantifiers of treatment outcome. In addition, relatively small sample sizes prevented more powerful multiple comparisons between groups. Results suggest treatment implications and the relevance of dissolving the tenacity of obsessional doubt in OCD.",Aardema F.; O'Connor K.,2012.0,10.1016/j.jbtep.2011.12.006,0,0,
9038,Paradoxical cardiovascular effects of implementing adaptive emotion regulation strategies in generalized anxiety disorder.,"Recent models of generalized anxiety disorder (GAD) have expanded on Borkovec's avoidance theory by delineating emotion regulation deficits associated with the excessive worry characteristic of this disorder (see Behar, DiMarco, Hekler, Mohlman, & Staples, 2009). However, it has been difficult to determine whether emotion regulation is simply a useful heuristic for the avoidant properties of worry or an important extension to conceptualizations of GAD. Some of this difficulty may arise from a focus on purported maladaptive regulation strategies, which may be confounded with symptomatic distress components of the disorder (such as worry). We examined the implementation of adaptive regulation strategies by participants with and without a diagnosis of GAD while watching emotion-eliciting film clips. In a between-subjects design, participants were randomly assigned to accept, reappraise, or were not given specific regulation instructions. Implementation of adaptive regulation strategies produced differential effects in the physiological (but not subjective) domain across diagnostic groups. Whereas participants with GAD demonstrated lower cardiac flexibility when implementing adaptive regulation strategies than when not given specific instructions on how to regulate, healthy controls showed the opposite pattern, suggesting they benefited from the use of adaptive regulation strategies. We discuss the implications of these findings for the delineation of emotion regulation deficits in psychopathology.",Aldao A.; Mennin DS.,2012.0,10.1016/j.brat.2011.12.004,0,0,
9039,Avoidant coping and treatment outcome in rape-related posttraumatic stress disorder.,"This study investigated the impact of avoidant coping on treatment outcome in rape-related posttraumatic stress disorder (PTSD). Adult women with rape-related PTSD (N = 62) received 9 sessions of prolonged exposure (PE) or eye movement desensitization and reprocessing (EMDR). The mean age for the sample was 34.7 years, and race or ethnicity was reported as 67.7% Caucasian, 25.8% African American, 3.2% Latina, and 3.2% other. PTSD was assessed with the PTSD Symptom Scale-Self-Report (Foa, Riggs, Dancu, & Rothbaum, 1993), and avoidant coping was assessed using the Coping Strategies Inventory-Disengagement subscale (CSI-D; Tobin, Holroyd, Reynolds, & Wigal, 1989). Pretreatment avoidant coping was negatively associated with posttreatment PTSD symptom severity even when controlling for initial severity of total PTSD symptoms and when removing PTSD avoidance symptoms from the analysis to account for potential overlap between avoidant coping and PTSD avoidance symptoms: ΔR2 = .08, b* = -0.31, 95% CI [-0.17, -0.01], t(60) = -2.27, p = .028. The CSI-D pretreatment mean score of 100 predicted a 96% likelihood of experiencing clinically significant change (CSC) during treatment. A CSI-D pretreatment score of 61 was associated with a 40% likelihood of experiencing CSC. PE and EMDR appear to be beneficial for women who frequently engage in avoidant coping responses following rape. A small subset of women with initially low levels of avoidant coping are unlikely to experience a therapeutic response from PE or EMDR.",Leiner AS.; Kearns MC.; Jackson JL.; Astin MC.; Rothbaum BO.,2012.0,10.1037/a0026814,0,0,
9040,Randomized trial comparison of emotion regulation and relational psychotherapies for PTSD with girls involved in delinquency.,"Posttraumatic stress disorder (PTSD) is prevalent in youth involved in delinquency, but it is often not effectively treated. A randomized clinical trial was conducted comparing the outcomes of an emotion regulation therapy (Trauma Affect Regulation: Guide for Education and Therapy, or TARGET) with a relational supportive therapy (Enhanced Treatment as Usual, or ETAU) with 59 delinquent girls (age 13-17 years) who met criteria for full or partial PTSD. Mixed model regression analyses demonstrated generally large effects for pre-post change in PTSD symptoms for both therapies but not in emotion regulation. Both therapies had small to medium effect size changes in anxiety, anger, depression, and posttraumatic cognitions. Treatment √ó Time interactions showed small to medium effects favoring TARGET for change in PTSD (intrusive reexperiencing and avoidance) and anxiety symptoms, posttraumatic cognitions, and emotion regulation, and favoring ETAU for change in hope and anger. Results provide preliminary support for TARGET as a potentially efficacious therapy for PTSD with delinquent girls. Relational therapies such as ETAU also may be beneficial for delinquent girls with PTSD, particularly to enhance optimism and self-efficacy and reduce anger.",Ford JD.; Steinberg KL.; Hawke J.; Levine J.; Zhang W.,2012.0,10.1080/15374416.2012.632343,0,0,
9041,The effects of video and nonnegative social feedback on distorted appraisals of bodily sensations and social anxiety.,"The effects of video feedback and nonnegative feedback from other people were examined as possibly ameliorating distorted appraisals of bodily sensations, as well as subjective and physiological anxiety in socially anxious individuals. Nonnegative feedback from a confederate emphasized the absence of negative outcomes (e.g., did not seem to tremble) rather than the presence of positive outcomes (e.g., looked calm). Socially anxious students were randomly assigned to either the experimental group, which received video and social feedback (n=12), or the control group (n 13). Participants were asked to give a videotaped speech twice. After the first speech, the experimental group watched the videotape of their speech and received feedback from a confederate, whereas the control group watched the video of another person's speech. The intervention improved distorted appraisal of bodily sensations and anticipatory anxiety for the experimental group. However, there were no differential effects on anxiety between the groups during speeches.",Kanai Y.; Sasagawa S.; Chen J.; Sakano Y.,2011.0,10.2466/02.07.09.PR0.109.5.411-427,0,0,
9042,[Conception and evaluation of an 1-hour psychoeducational group intervention for patients with chronic pruritus].,"This study investigated whether dermatology inpatients with chronic pruritus benefit from an 1-hour psychoeducational group therapy, adapted from educational programmes for patients with atopic dermatitis. Such a symptom-specific intervention for patients with chronic pruritus has not been evaluated before. 91 of the 315 group participants (28.9 %) and 175 of the 318 patients who had been admitted to the hospital without group therapy (55.0 %) were examined at admission and discharge using standardised questionnaires (Adjustment to Chronic Skin Diseases Questionnaire, Itch-Cognition Questionnaire) and a Visual Analogue Scale for itch intensity (randomized pre-post study). Evaluation of the standardised questionnaires and of the change in pruritus intensity indicated no additive benefit of group intervention, both for the whole sample and for subgroups with chronic pruritus. The results indicate either that group intervention in this form is not effective or that the dermatological medical treatment of the patients is so efficient that the intervention brings no added benefit. Perhaps an intervention of 1 hour is simply too short. Further conceptual developments of the psychoeducational programme are necessary.",Bosecker P.; Ständer S.; Heuft G.; Dieckmann L.; Schneider G.,2011.0,10.13109/zptm.2011.57.4.377,0,0,
9043,Intertester reliability of a classification system for shoulder pain.,"To describe and determine the intertester reliability of a newly developed classification system of shoulder syndrome recognition. Intertester reliability study. Fourteen primary care physiotherapy clinics. Two hundred and fifty-five patients with shoulder pain. Inclusion criterion: presence of shoulder pain aring within the glenohumeral or associated joints and structures. previous shoulder surgery, surgical candidates, recognised malignancy, systemic illness, or concurrent cervical pain and/or radiculopathy. Examiners were 55 physiotherapists who were arranged in pairs; each patient received two independent and blinded assessments, one by each of the paired physiotherapists. This shoulder classification approach contains three main clinical syndromes: Pattern 1 (impingement pain), Pattern 2 (acromioclavicular joint pain) and Pattern 3 (shoulder pain: frozen shoulder, glenohumeral arthritis, massive cuff tear, subscapularis tear, painful laxity, post-traumatic instability, internal derangement). Percentage agreement and Cohen's kappa coefficient. The mean age of patients was 46.6 years (standard deviation 16.3, range 16 to 86), and 57% were male. Physiotherapists agreed on the pattern of shoulder pain for 205 of the 255 shoulders assessed (agreement rate 80%); the kappa coefficient was 0.664 (95% confidence interval 0.622 to 0.706; P<0.001). Of the 205 agreements, Pattern 1 was the most common condition; physiotherapists agreed on this pattern for 139 patients (68%). Both physiotherapists diagnosed Pattern 2 for 20 patients and Pattern 3 for 46 patients. This clearly defined system uses key elements of the history and examination to classify patients with shoulder pain. The kappa coefficient denotes good reproducibility.",Carter T.; Hall H.; McIntosh G.; Murphy J.; MacDougall J.; Boyle C.,2012.0,10.1016/j.physio.2010.12.003,0,0,
9044,Effects of an 8-week meditation program on mood and anxiety in patients with memory loss.,"This study assesses changes in mood and anxiety in a cohort of subjects with memory loss who participated in an 8-week Kirtan Kriya meditation program. Perceived spirituality also was assessed. Previous reports from this cohort showed changes in cognitive function and cerebral blood flow (CBF). The purpose of this analysis was to assess outcome measures of mood and affect, and also spirituality, and to determine whether or not results correlated with changes in CBF. Fifteen (15) subjects (mean age 62±7 years) with memory problems were enrolled in an 8-week meditation program. Before and after the 8-week meditation, subjects were given a battery of neuropsychologic tests as well as measures of mood, anxiety, and spirituality. In addition, they underwent single photon emission computed tomography scans before and after the program. A region-of-interest template obtained counts in several brain structures that could also be compared to the results from the affect and spirituality measures. The meditation training program resulted in notable improvement trends in mood, anxiety, tension, and fatigue, with some parameters reaching statistical significance. All major trends correlated with changes in CBF. There were nonsignificant trends in spirituality scores that did not correlate with changes in CBF. An 8-week, 12 minute a day meditation program in patients with memory loss was associated with positive changes in mood, anxiety, and other neuropsychologic parameters, and these changes correlated with changes in CBF. A larger-scale study is needed to confirm these findings and better elucidate mechanisms of change.",Moss AS.; Wintering N.; Roggenkamp H.; Khalsa DS.; Waldman MR.; Monti D.; Newberg AB.,2012.0,10.1089/acm.2011.0051,0,0,
9045,Design of a multicentered randomized controlled trial on the clinical and cost effectiveness of schema therapy for personality disorders.,"Despite international guidelines describing psychotherapy as first choice for people with personality disorders (PDs), well-designed research on the effectiveness and cost-effectiveness of psychotherapy for PD is scarce. Schema therapy (ST) is a specific form of psychological treatment that proved to be effective for borderline PD. Randomized controlled studies on the effectiveness of ST for other PDs are lacking. Another not yet tested new specialized treatment is Clarification Oriented Psychotherapy (COP). The aim of this project is to perform an effectiveness study as well as an economic evaluation study (cost effectiveness as well as cost-utility) comparing ST versus COP versus treatment as usual (TAU). In this study, we focus on avoidant, dependent, obsessive-compulsive, paranoid, histrionic and narcissistic PD. In a multicentered randomized controlled trial, ST, and COP as an extra experimental condition, are compared to TAU. Minimal 300 patients are recruited in 12 mental health institutes throughout the Netherlands, and receive an extensive screening prior to enrolment in the study. When eligible, they are randomly assigned to one of the intervention groups. An economic evaluation and a qualitative research study on patient and therapist perspectives on ST are embedded in this trial. Outcome assessments (both for clinical effectiveness and economic evaluation) take place at 6,12,18,24 and 36 months after start of treatment. Primary outcome is recovery from PD; secondary measures include general psychopathological complaints, social functioning and quality of life. Data for the cost-effectiveness and cost-utility analyses are collected by using a retrospective cost interview. Information on patient and therapist perspectives is gathered using in-depth interviews and focus groups, and focuses on possible helpful and impeding aspects of ST. This trial is the first to compare ST and COP head-to-head with TAU for people with a cluster C, paranoid, histrionic and/or narcissistic PD. By combining clinical effectiveness data with an economic evaluation and with direct information from primary stakeholders, this trial offers a complete and thorough view on ST as a contribution to the improvement of treatment for this PD patient group. Netherlands Trial Register (NTR): NTR566.",Bamelis LL.; Evers SM.; Arntz A.,2012.0,10.1186/1471-2458-12-75,0,0,
9046,Placebo-controlled comparison of prazosin and cognitive-behavioral treatments for sleep disturbances in US Military Veterans.,"Pharmacological and cognitive-behavioral treatments targeting insomnia and nightmares have been shown to be effective in the treatment of military veterans with sleep complaints comorbid with symptoms of stress-related disorders, including Post-Traumatic Stress Disorder (PTSD), but the two approaches have not been directly compared. This randomized controlled trial compared the effects of prazosin vs. a behavioral sleep intervention (BSI), targeting nightmares and insomnia against a placebo pill control condition on sleep and daytime symptoms. Fifty United States military veterans (mean age 40.9years, SD=13.2years) with chronic sleep disturbances were randomized to prazosin (n=18), BSI (n=17), or placebo (n=15). Each intervention lasted 8weeks. Participants completed self-report measures of insomnia severity, sleep quality, and sleep disturbances. All kept a sleep diary throughout the intervention period. Polysomnographic studies were conducted pre- and post-intervention. Both active treatment groups showed greater reductions in insomnia severity and daytime PTSD symptom severity. Sleep improvements were found in 61.9% of those who completed the active treatments and 25% of those randomized to placebo. BSI and prazosin were both associated with significant sleep improvements and reductions in daytime PTSD symptoms in this sample of military veterans. Sleep-focused treatments may enhance the benefits of first-line PTSD treatments.",Germain A.; Richardson R.; Moul DE.; Mammen O.; Haas G.; Forman SD.; Rode N.; Begley A.; Nofzinger EA.,2012.0,10.1016/j.jpsychores.2011.11.010,0,0,
9047,The combined predictive effect of patient characteristics and alliance on long-term dynamic and interpersonal functioning after dynamic psychotherapy.,"On the basis of the well-established association between early alliance and outcome, this exploratory study investigated the associations between the therapeutic alliance and long-term outcome, 3 years after treatment termination. In addition to the early alliance, pre-treatment patient characteristics and expectancies that were significantly related to early alliance were included in the statistical analyses. The data are from the First Experimental Study of Transference, a dismantling randomized clinical trial with long-term follow-up. One hundred out-patients who sought psychotherapy due to depression, anxiety and personality disorders were treated. Alliance was measured with Working Alliance Inventory after session 7. Change was determined using linear mixed model analyses. The alliance alone had a significant impact on long-term outcome of the predetermined primary outcome variables of the study: Psychodynamic Functioning Scales and Inventory of Interpersonal Problems. Contrary to common clinical wisdom, when the pre-treatment patient variables were included, more personality disorder pathology was the strongest predictor of favourable outcome, over and above the effect of the alliance, which was no longer significant. Clinical implications are discussed.",Hersoug AG.; H√∏glend P.; Gabbard GO.; Lorentzen S.,,10.1002/cpp.1770,0,0,6405
9048,Use of complementary and alternative medicine in a large sample of anxiety patients.,"To examine a large sample of patients with anxiety and the association between types of complementary and alternative treatments that were used, demographic variables, diagnostic categories, and treatment outcomes. Cross-sectional and longitudinal survey during the Coordinated Anxiety Learning and Management (CALM) study that assessed this intervention against the Usual Care in a sample of patients with anxiety recruited from primary care. Interviewer-administered questionnaires via a centralized telephone survey by blinded assessment raters. The interviews were done at baseline, 6, 12, and 18 months of the study. A total of 1004 adults ages 18-75 who met DSM-IV criteria for Generalized Anxiety Disorder (GAD), Panic Disorder, Social Anxiety Disorder, or Post-Traumatic Stress Disorder. We assessed medication/herbal use, the use of any alternative therapies, and combined Complementary and Alternative Medicine (CAM) use. We found an extensive (43%) use of a variety of CAM treatments that is consistent with previous study results in populations with anxiety. Only a few significant demographic or interventional characteristics of CAM users were found. Users most often had a diagnosis of GAD, were older, more educated, and had two or more chronic medical conditions. CAM users who had a 50% or more drop in anxiety scores over 18 months were less likely to report continued use of alternative therapies. The study confirms the importance of awareness of CAM use in this population for possible interference with traditional first-line treatments of these disorders, but also for finding the best integrative use for patients who require multiple treatment modalities.",Bystritsky A.; Hovav S.; Sherbourne C.; Stein MB.; Rose RD.; Campbell-Sills L.; Golinelli D.; Sullivan G.; Craske MG.; Roy-Byrne PP.,,10.1016/j.psym.2011.11.009,0,0,6138
9049,A randomized controlled trial of supported employment among veterans with posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) is a potentially disabling mental illness that can cause occupational dysfunction. Although vocational rehabilitation is often prescribed for patients with PTSD, standard vocational services are far from adequate in helping them obtain and maintain competitive employment. This study is the first to examine the outcome of evidence-based supported employment for veterans with PTSD. Unemployed veterans with PTSD were randomly assigned to either individual placement and support (IPS) supported employment (N = 42) or a Veterans Health Administration Vocational Rehabilitation Program (VRP) treatment as usual (N = 43). Employment rates and occupational outcomes were followed for 12 months. During the 12-month study, 76% of the IPS participants gained competitive employment, compared with 28% of the VRP participants (number needed to treat = 2.07; χ(2) = 19.84, df = 1, p<.001). Veterans assigned to IPS also worked substantially more weeks than those assigned to VRP (42% versus 16% of the eligible weeks, respectively; Mann-Whitney z test p<.001) and earned higher 12-month income (mean ± SD income of $9,264 ± $13,294 for IPS versus $2,601 ± $6,009 for VRP; Mann-Whitney z test p<.001) during the 12-month period. Veterans with PTSD who received IPS were 2.7 times more likely to gain competitive employment than those who received VRP. Because work is central to recovery, these results should assist stakeholders in planning improved services for veterans with PTSD.",Davis LL.; Leon AC.; Toscano R.; Drebing CE.; Ward LC.; Parker PE.; Kashner TM.; Drake RE.,2012.0,10.1176/appi.ps.201100340,0,0,
9050,Gender differences in the maintenance of response to cognitive behavior therapy for posttraumatic stress disorder.,"To examine potential differential responses in men and women to cognitive behavior therapy for posttraumatic stress disorder (PTSD). Fifty-two men and 56 women diagnosed with PTSD participated in randomized controlled trials of cognitive behavior therapy for PTSD. Participants were randomly allocated to either (a) exposure-only therapy (Ex) or (b) exposure-based treatment combined with cognitive restructuring (ExCR). There were no significant differences between men and women in treatment response immediately after treatment in either Ex or ExCR. At 6-month follow-up, men displayed significantly more severe PTSD symptoms in the Ex group compared with women in the Ex group, and compared with men and women in the ExCR conditions. These findings suggest that men with PTSD have a reduced maintenance of treatment gains following exposure therapy compared with women, but display less relapse if exposure therapy is combined with cognitive therapy. These findings are consistent with evidence that women recall emotional memories and retain extinction memories more strongly than men, which may facilitate emotional processing and long-term treatment gains.",Felmingham KL.; Bryant RA.,2012.0,10.1037/a0027156,0,0,
9051,A naturalistic study of the effect of acupuncture on heart-rate variability.,"To study the effect of acupuncture on heart rate variability (HRV) by using linear and non-linear methods of analysis. 40 patients were recruited consecutively, including patients with insomnia, stomachache, diarrhea, dizziness, cervical syndrome, lower back pain, gonarthritis, peripheral facial paralysis, post-traumatic organic brain syndrome and urinary retention. Different acupoint prescriptions were used, according to the textbook for 5-years' education on traditional Chinese medicine specialty, which is used in Chinese Universities. HRV was recorded before, during, and after acupuncture. Acupuncture substantially reduced variability, causing a 41% reduction in the standard deviation. Using a Fourier analysis, the variances both in the low frequency (LF) and the high frequency (HF) ranges were markedly reduced, but the LF/HF ratio (an indication of sympatho-vagal balance) was not altered. The HR was unchanged. The sample entropy, which is a measure of the complexity of time series, was significantly increased (+35%). Acupuncture produced a pattern of changes different from that seen in pathological conditions, where increased variability and reduced complexity is expected.",Fasmer OB.; Liao H.; Huang Y.; Berle J√ò.; Wu J.; Oedegaard KJ.; Wik G.; Zhang Z.,2012.0,10.1016/j.jams.2011.11.002,0,0,
9052,Anterior versus posterior approach in the treatment of chronic thoracolumbar fractures.,"The purpose of this study was to compare the results of anterior approach vs posterior approach in the treatment of chronic thoracolumbar fractures. A total of 36 patients with chronic thoracolumbar fractures were divided into 2 groups. Group A was treated by an anterior approach and group B was treated by a posterior approach. During the minimum 24-month follow-up period (range, 24-62 months), all patients were prospectively evaluated for clinical and radiologic outcomes. Intraoperative blood loss, operative time, operative complications, pulmonary function, Frankel scale, and American Spinal Injury Association (ASIA) motor score were used for clinical evaluation, and Cobb angle was examined for radiologic outcome. All patients in this study achieved solid fusion, with significant neurologic improvement. Operative time, perioperative blood loss, ASIA score on admission and at final follow-up, and complications of respiratory tract infection and intercostal nerve pain were not significantly different between the 2 groups (P>.05), but complications of hemopneumothorax, abdominal distension, and constipation were fewer in group B (P<.05). Postoperative pulmonary function (P<.05) and correction of posttraumatic kyphosis were better in group B (P<.05).",Chen ZW.; Ding ZQ.; Zhai WL.; Lian KJ.; Kang LQ.; Guo LX.; Liu H.; Lin B.,2012.0,10.3928/01477447-20120123-05,0,0,
9053,Attachment style and coping in relation to posttraumatic stress disorder symptoms among adults living with HIV/AIDS.,"Research indicates that a significant proportion of people living with HIV/AIDS report symptoms of posttraumatic stress disorder (PTSD). Moreover, attachment style has been associated with psychological and behavioral outcomes among persons living with HIV/AIDS. Attachment style may influence the ability to cope with traumatic stress and affect PTSD symptoms. To examine the association between attachment style and coping with PTSD symptoms, we assessed 94 HIV-positive adults on self-report measures of posttraumatic stress, coping, and attachment style. In multiple regression analysis, avoidant attachment and emotion-focused coping were positively and significantly associated with greater PTSD symptomatology. Support was also found for the moderating effects of avoidant and insecure attachment styles on emotion-focused coping in relation to greater PTSD symptoms. Taken altogether, these results suggest that interventions that develop adaptive coping skills and focus on the underlying construct of attachment may be particularly effective in reducing trauma-related symptoms in adults living with HIV/AIDS.",Gore-Felton C.; Ginzburg K.; Chartier M.; Gardner W.; Agnew-Blais J.; McGarvey E.; Weiss E.; Koopman C.,2013.0,10.1007/s10865-012-9400-x,0,0,
9054,"Evaluation of the effectiveness of Face IT, a computer-based psychosocial intervention for disfigurement-related distress.","Some people who have a visible difference (disfigurement) experience psychosocial adjustment problems that can lead to social anxiety and isolation. The aim of this study was to assess the effectiveness of a new computerised CBT-based intervention (Face IT) in reducing anxiety and appearance-related distress for individuals with visible differences. Face IT was tested against a non-intervention control group and standard CBT-based face-to-face delivery. Eighty-three participants were assessed at four time points using the Hospital Anxiety and Depression Scales, Derriford Appearance Scale-24, Body Image Quality of Life Inventory and Fear of Negative Evaluation (FNE). The findings indicate a significant reduction in anxiety and appearance-related distress in both the Face IT intervention and the face-to-face condition. Similar findings were reported for depressive symptoms and FNE. Results at the three and six months follow-up demonstrate increased improvements in psychological functioning with both interventions. This new online psychosocial intervention has been found to be effective at reducing anxiety, depression and appearance concerns amongst individuals with disfigurements, whilst increasing positive adjustment. A remote-access, computer-based intervention offers the potential to provide psychosocial support more easily and in a cost-effective manner to adults with appearance-related distress.",Bessell A.; Brough V.; Clarke A.; Harcourt D.; Moss TP.; Rumsey N.,2012.0,10.1080/13548506.2011.647701,0,0,
9055,Clinical and genetic outcome determinants of Internet- and group-based cognitive behavior therapy for social anxiety disorder.,"No study has investigated clinical or genetic predictors and moderators of Internet-based cognitive behavior therapy (ICBT) compared with cognitive behavioral group therapy for (CBGT) for SAD. Identification of predictors and moderators is essential to the clinician in deciding which treatment to recommend for whom. We aimed to identify clinical and genetic (5-HTTLPR, COMTval158met, and BDNFval66met) predictors and moderators of ICBT and CBGT. We performed three types of analyses on data from a sample comprising participants (N = 126) who had undergone ICBT or CBGT in a randomized controlled trial. Outcomes were i) end state symptom severity, ii) SAD diagnosis, and iii) clinically significant improvement. The most stable predictors of better treatment response were working full time, having children, less depressive symptoms, higher expectancy of treatment effectiveness, and adhering to treatment. None of the tested gene polymorphisms were associated with treatment outcome. Comorbid general anxiety and depression were moderators meaning that lower levels were associated with a better treatment response in ICBT but not in CBGT. We conclude that demographic factors, symptom burden, adherence, and expectations may play an important role as predictors of treatment outcome. The investigated gene polymorphisms do not appear to make a difference.",Hedman E.; Andersson E.; Ljótsson B.; Andersson G.; Andersson E.; Schalling M.; Lindefors N.; Rück C.,2012.0,10.1111/j.1600-0447.2012.01834.x,0,0,
9056,Brief eclectic psychotherapy v. eye movement desensitisation and reprocessing therapy for post-traumatic stress disorder: randomised controlled trial.,"Trauma-focused cognitive-behavioural therapy (CBT) and eye movement desensitisation and reprocessing therapy (EMDR) are efficacious treatments for post-traumatic stress disorder (PTSD), but few studies have directly compared them using well-powered designs and few have investigated response patterns. To compare the efficacy and response pattern of a trauma-focused CBT modality, brief eclectic psychotherapy for PTSD, with EMDR (trial registration: ISRCTN64872147). Out-patients with PTSD were randomly assigned to brief eclectic psychotherapy (n = 70) or EMDR (n = 70) and assessed at all sessions on self-reported PTSD (Impact of Event Scale - Revised). Other outcomes were clinician-rated PTSD, anxiety and depression. Both treatments were equally effective in reducing PTSD symptom severity, but the response pattern indicated that EMDR led to a significantly sharper decline in PTSD symptoms than brief eclectic psychotherapy, with similar drop-out rates (EMDR: n = 20 (29%), brief eclectic psychotherapy: n = 25 (36%)). Other outcome measures confirmed this pattern of results. Although both treatments are effective, EMDR results in a faster recovery compared with the more gradual improvement with brief eclectic psychotherapy.",Nijdam MJ.; Gersons BP.; Reitsma JB.; de Jongh A.; Olff M.,2012.0,10.1192/bjp.bp.111.099234,0,0,
9057,The impact of community-based outreach on psychological distress and victim safety in women exposed to intimate partner abuse.,"Using a longitudinal, randomized controlled trial, this study assessed the impact of a community-based outreach versus a more traditional criminal justice system-based referral program on women's distress and safety following police-reported intimate partner abuse (IPA). Women (N = 236 women) with police-reported IPA were randomly assigned to 1 of 2 interdisciplinary community-coordinated response program conditions: Outreach (community-based victim advocate outreach) or Referral (criminal justice system-based victim advocate referrals to community-based agencies). Participants were interviewed 3 times over a 1-year period: within 26 (median) days of police-reported IPA, 6 months later, and 12 months later. Primary outcome measures included posttraumatic stress disorder and depression symptom severity (Posttraumatic Stress Diagnostic Scale; Beck Depression Inventory-II), fear appraisals (Trauma Appraisal Questionnaire), IPA revictimization (Revised Conflict Tactics Scale), and readiness to leave the relationship with the abuser. One year after the initial interview, women in the Outreach condition reported decreased PTSD and depression symptom severity and fear compared with women in the Referral condition. Although both conditions were unrelated to revictimization in the follow-up year, women in the Outreach condition reported greater readiness to leave the abuser and rated services as more helpful than women in the Referral condition. This is one of the first studies to examine community-based outreach in the context of an interdisciplinary community coordinated response to police-reported IPA. The findings suggest that community-based outreach by victim advocates results in decreased distress levels, greater readiness to leave abusive relationships, and greater perceived helpfulness of services relative to system-based referrals.",DePrince AP.; Labus J.; Belknap J.; Buckingham S.; Gover A.,2012.0,10.1037/a0027224,0,0,
9058,Therapists' professional and personal characteristics as predictors of outcome in short- and long-term psychotherapy.,"Short- and long-term psychotherapies have been found effective for treating mood and anxiety disorders. Although psychotherapists differ in their effectiveness, virtually no comparative research exists on the therapist characteristics beneficial to short- or long-term therapy. Altogether 326 outpatients, aged 20-46 years, and suffering from mood or anxiety disorder, were randomly assigned to either short-term (solution-focused or psychodynamic therapy, combined) or long-term (psychodynamic) psychotherapy, and were followed up for 3 years. Therapies were provided by 55 volunteering therapists with at least 2 years of work experience in the given form of therapy. Therapists' professional and personal characteristics, measured before randomization, were assessed with the Development of Psychotherapists Common Core Questionnaire (DPCCQ). Patients' general psychiatric symptoms were assessed as the main outcome measure at baseline and 3, 7, 9, 12, 18, 24 and 36 months after start of treatment with the Symptom Check List, Global Severity Index (SCL-90-GSI). Active, engaging, and extroverted therapists produced a faster symptom reduction in short-term therapy than in long-term therapy. More cautious, non-intrusive therapists generated greater benefits in long-term therapy during the 3-year follow-up. Therapists' lower confidence and enjoyment in therapeutic work predicted poorer outcomes in short-term therapy in the long run. Generalizability may be limited due to relatively experienced therapists. Therapist characteristics apparently are important determinants of effectiveness of short- and long-term psychotherapy. If confirmed in future studies, results may be applied in training and supervision of therapists as well as in fitting therapy forms with therapist dispositions to maximize treatment benefits.",Heinonen E.; Lindfors O.; Laaksonen MA.; Knekt P.,2012.0,10.1016/j.jad.2012.01.023,0,0,
9059,Does physiologic response to loud tones change following cognitive-behavioral treatment for posttraumatic stress disorder?,"This study examined responses to loud tones before and after cognitive-behavioral treatment for posttraumatic stress disorder (PTSD). Seventy-four women in a PTSD treatment outcome study for rape-related (n = 54) or physical assault-related PTSD (n = 20) were assessed in an auditory loud tone paradigm. Assessments were conducted before and after a 6-week period of cognitive-behavioral therapy. Physiologic responses to loud tones included heart rate (HR), skin conductance (SC), and eye-blink electromyogram (EMG). Groups were formed based upon treatment outcome and included a treatment responder group (no PTSD at posttreatment) and a nonresponder group (PTSD-positive at posttreatment). Treatment was successful for 53 of 74 women (72%) and unsuccessful for 21 women (28%). Responders and nonresponders were not significantly different from each other at pretreatment on the main outcome variables. Treatment responders showed a significant reduction in loud tone-related EMG, HR, and SC responses from pre- to posttreatment (partial η(2) = .24, .31, and .36, respectively; all p < .001) and the EMG and HR responses were significantly smaller than nonresponders at posttreatment (partial η(2) = .11, p = .004 and .19, p < .001, respectively). Successful cognitive-behavioral treatment of PTSD is associated with a quantifiable reduction in physiological responding to loud tones.",Griffin MG.; Resick PA.; Galovski TE.,2012.0,10.1002/jts.21667,0,0,
9060,Determinants of long-term response to group therapy for dysfunctional fear of progression in chronic diseases.,"Prior work demonstrated that cognitive-behavioral (CBT) and supportive-experiential (SET) group interventions can reduce dysfunctional fear of progression (FoP) in patients with chronic diseases. In this secondary analysis of a randomized controlled study, we investigated determinants of long-term response to group therapy for FoP. Response to therapy after 12 months was assessed using the Reliable Change Index (RCI). Outcome data were available for 129 patients with cancer and 116 patients with chronic arthritis. 37.9% of the patients in the CBT group and 32.7% of those attending the SET group indicated response to therapy (p=.402). Educational level predicted long-term response to therapy (OR 2.53, 95% CI 1.33-4.81; p=.005). Medical patients with lower education may need additional attention in order to gain long-lasting benefit from brief group psychotherapy. However, this investigation needs to be replicated in a study that includes a broader range of psychological predictors.",Dinkel A.; Herschbach P.; Berg P.; Waadt S.; Duran G.; Engst-Hastreiter U.; Henrich G.; Book K.,2012.0,10.1080/08964289.2011.640364,0,0,
9061,Combination of CBT with fluoxetine works better for obsessive-compulsive disorder.,,Giasuddin NA.; Nahar JS.; Morshed NM.; Balhara YP.,2012.0,10.1016/j.ajp.2011.11.013,0,0,
9062,Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer.,"Spiritual well-being and sense of meaning are important concerns for clinicians who care for patients with cancer. We developed Individual Meaning-Centered Psychotherapy (IMCP) to address the need for brief interventions targeting spiritual well-being and meaning for patients with advanced cancer. Patients with stage III or IV cancer (N = 120) were randomly assigned to seven sessions of either IMCP or therapeutic massage (TM). Patients were assessed before and after completing the intervention and 2 months postintervention. Primary outcome measures assessed spiritual well-being and quality of life; secondary outcomes included anxiety, depression, hopelessness, symptom burden, and symptom-related distress. Of the 120 participants randomly assigned, 78 (65%) completed the post-treatment assessment and 67 (56%) completed the 2-month follow-up. At the post-treatment assessment, IMCP participants demonstrated significantly greater improvement than the control condition for the primary outcomes of spiritual well-being (b = 0.39; P <.001, including both components of spiritual well-being (sense of meaning: b = 0.34; P = .003 and faith: b = 0.42; P = .03), and quality of life (b = 0.76; P = .013). Significantly greater improvements for IMCP patients were also observed for the secondary outcomes of symptom burden (b = -6.56; P < .001) and symptom-related distress (b = -0.47; P < .001) but not for anxiety, depression, or hopelessness. At the 2-month follow-up assessment, the improvements observed for the IMCP group were no longer significantly greater than those observed for the TM group. IMCP has clear short-term benefits for spiritual suffering and quality of life in patients with advanced cancer. Clinicians working with patients who have advanced cancer should consider IMCP as an approach to enhance quality of life and spiritual well-being.",Breitbart W.; Poppito S.; Rosenfeld B.; Vickers AJ.; Li Y.; Abbey J.; Olden M.; Pessin H.; Lichtenthal W.; Sjoberg D.; Cassileth BR.,2012.0,10.1200/JCO.2011.36.2517,0,0,
9063,A comparative diagnostic assessment of anterior tooth and bone status using panoramic and periapical radiography.,"The aim of the present study was to compare diagnostic assessments of anterior tooth and bone status in a randomised cohort of pre-orthodontic patients using panoramic and periapical radiographs. Four hundred and forty-four cases with matched periapical and panoramic radiographs were examined by three observers. Two were final-year postgraduate endodontic students and the other, a final-year Honours degree dental student. Multi-rater Kappa values were used to assess the reliability of the observers, with a value of 1 equating to complete agreement. With the exception of endodontic Class 1 and 2 palatal invaginations, reliability exceeded 0.95 for all three observers. An assessment of the graduate endodontic students revealed only a marginal increase in the kappa values. Statistical analysis (p < 0.05) determined that developmental anomalies or tooth/bone pathoses were more reliably detected by observers using periapical radiographs compared with panoramic films. This finding has relevance given the likelihood of anterior dental trauma among young children. While there have been considerable improvements in the quality of dental panoramic radiography, the present study indicated that a reliable pre-orthodontic or post-trauma diagnostic assessment should include both panoramic and intra-oral radiographs.",Le T.; Nassery K.; Kahlert B.; Heithersay G.,2011.0,,0,0,
9064,The effects of animal-assisted therapy on wounded warriors in an Occupational Therapy Life Skills program.,"Animal-assisted therapy (AAT) has gained much attention in civilian and military health care. Evidence supports its benefits with varied populations with diseases and disabilities, but no research has been done with injured or ill service members. This pretest, posttest nonrandomized control group study evaluated the effects of AAT on Warriors in transition (N=24) attending an Occupational Therapy Life Skills program with the long-term goal of improving their successful reintegration. Although significant differences were not found between the groups on most measures, anecdotal reports by participants and observers indicate that participants eagerly anticipated being with the therapy dogs, expressed pleasure and satisfaction with the experience, and regretted seeing it end. There were significant correlations between mood, stress, resilience, fatigue, and function at various measurement points. This is the first study to formally assess the benefits of AAT with wounded service members in garrison. Suggestions for future research are provided.",Beck CE.; Gonzales F.; Sells CH.; Jones C.; Reer T.; Zhu YY.,,,0,0,
9065,Mediators of the association of major depressive syndrome and anxiety syndrome with postpartum smoking relapse.,"Based on conceptual models of addiction and affect regulation, this study examined the mechanisms linking current major depressive syndrome (MDS) and anxiety syndrome (AS) to postpartum smoking relapse. Data were collected in a randomized clinical trial from 251 women who quit smoking during pregnancy. Simple and multiple mediation models of the relations of MDS and AS with postpartum relapse were examined using linear regression, continuation ratio logit models, and a bootstrapping procedure to test the indirect effects. Both MDS and AS significantly predicted postpartum smoking relapse. After adjusting for MDS, AS significantly predicted relapse. However, after adjusting for AS, MDS no longer predicted relapse. Situationally based self-efficacy, expectancies of controlling negative affect by means other than smoking, and various dimensions of primary and secondary tobacco dependence individually mediated the effect of both MDS and AS on relapse. In multiple mediation models, self-efficacy in negative/affective situations significantly mediated the effect of MDS and AS on relapse. The findings underscore the negative impact of depression and anxiety on postpartum smoking relapse and suggest that the effects of MDS on postpartum relapse may be largely explained by comorbid AS. The current investigation provided mixed support for affect regulation models of addiction. Cognitive and tobacco dependence-related aspects of negative and positive reinforcement significantly mediated the relationship of depression and anxiety with relapse, whereas affect and stress did not. The findings emphasize the unique role of low agency with respect to abstaining from smoking in negative affective situations as a key predictor of postpartum smoking relapse.",Correa-Fern√°ndez V.; Ji L.; Castro Y.; Heppner WL.; Vidrine JI.; Costello TJ.; Mullen PD.; Cofta-Woerpel L.; Velasquez MM.; Greisinger A.; Cinciripini PM.; Wetter DW.,2012.0,10.1037/a0027532,0,0,
9066,Can a one-hour session of exposure treatment modulate startle response and reduce spider fears?,"Preliminary evidence suggests that 3 hours of behavior therapy can reduce fear responses to phobic stimuli. Most of this research, however, has relied on self-reports and clinician assessments, and failed to include a comparison group. To extend this literature, with 32 adults with spider phobia, we investigated the effects of a single hour of in vivo exposure on subjective and electrophysiological aspects of fear; comparisons were made to a wait-list control group. Pre- and post-assessments included phobia-relevant questionnaires and startle reflex responses to spider, negative, neutral and positive stimuli. Compared to the control group, our one-hour treatment reduced self-reported and physiological responses to spider stimuli. These data provide preliminary support for the ability of affective startle modulation to be changed by very brief exposure therapy.",Kashdan TB.; Adams L.; Read J.; Hawk L.,2012.0,10.1016/j.psychres.2011.12.002,0,0,
9067,"Evaluation of the glycine transporter inhibitor Org 25935 as augmentation to cognitive-behavioral therapy for panic disorder: a multicenter, randomized, double-blind, placebo-controlled trial.","A growing body of evidence supports the efficacy of D-cycloserine (DCS), a partial agonist at the N-methyl-D-aspartate (NMDA) glutamate receptor, as augmentation to cognitive-behavioral therapy (CBT) in the treatment of anxiety disorders. Org 25935 is a glycine transporter 1 inhibitor that acts to increase synaptic glycine levels and enhance NMDA-mediated glutamatergic activity. The aim of this study was to examine the efficacy of a glutamatergic compound other than DCS in a CBT augmentation paradigm. This was a randomized, double-blind, placebo-controlled, parallel-group clinical trial for which participants were recruited from November 2008 through February 2010. Eligible adult patients diagnosed (DSM-IV) with panic disorder with or without agoraphobia (N = 40) were scheduled to receive 5 manualized CBT treatment sessions. Participants were randomly assigned to receive either a dose of Org 25935 (4 mg or 12 mg) or placebo 2 hours prior to the start of CBT sessions 3, 4, and 5. The primary endpoint was symptomatic change as measured by the Panic Disorder Severity Scale (PDSS) 1 week following the last CBT session. Although mean PDSS total scores decreased significantly from baseline to end of treatment in every group, no statistically significant benefit was observed for Org 25935 (4 or 12 mg) over placebo on the primary endpoint or on any secondary efficacy endpoint. Org 25935 showed no safety issues at either dose but was much better tolerated at the 4-mg dose level than at the 12-mg dose level. Org 25935 demonstrated no benefit over placebo in augmenting CBT for panic disorder. Study limitations and implications are discussed. clinicaltrials.gov Identifier: NCT00725725.",Nations KR.; Smits JA.; Tolin DF.; Rothbaum BO.; Hofmann SG.; Tart CD.; Lee A.; Schipper J.; Sjogren M.; Xue D.; Szegedi A.; Otto MW.,2012.0,10.4088/JCP.11m07081,0,0,
9068,The effects of mortality reminders on posttraumatic growth and finding benefits among patients with life-threatening illness and their caregivers.,"Individuals confronted with a life-threatening illness often report posttraumatic growth (PTG) or finding benefits in disease. These positive evaluations of personal strength, perceptions of improved personal relations and new possibilities may represent a defensive response (cf Janus-face model). Three studies investigated the effects of mortality reminders on reports of PTG or benefit findings among people living with life-threatening illness or their caregivers. 80 people living with HIV (study 1), 164 breast cancer survivors (study 2) and 50 family caregivers for a patient with huntington disease (study 3) were randomly assigned to the experimental (mortality reminders) or control conditions. Across three studies, those exposed to mortality reminders reported lower PTG or benefit finding, compared to the controls. These effects were moderated by time elapsed since diagnosis: mortality reminders led to lower PTG/benefit finding among those who received the diagnosis more recently. The results provide an insight into the defensive character of PTG/finding benefits in illness and changes in the function of these beliefs over time elapsing since diagnosis.",Luszczynska A.; Durawa AB.; Dudzinska M.; Kwiatkowska M.; Knysz B.; Knoll N.,2012.0,10.1080/08870446.2012.665055,0,0,
9069,Postdeployment Battlemind training for the U.K. armed forces: a cluster randomized controlled trial.,"Combat exposure can increase the risk of subsequent psychological ill-health in armed forces (AF) personnel. A U.S. postdeployment psycho-educational intervention, Battlemind, showed a beneficial effect on mental health in U.S. military personnel exposed to high combat levels. We evaluated the effectiveness of an anglicized version of postdeployment Battlemind. Battlemind was adapted for the United Kingdom. The main amendments were to sections about carrying weapons, driving, and alcohol misuse. The anglicized Battlemind was compared with the U.K. standard postdeployment brief in a cluster randomized controlled trial. At baseline, 2,443 U.K. AF personnel returning from Afghanistan via Cyprus completed questionnaires about their combat experiences and mental health. Of these, 1,616 (66%) completed 6-month follow-up questionnaires. We used the Posttraumatic Stress Disorder Checklist (PCL-C) to measure probable posttraumatic stress disorder and the General Health Questionnaire (GHQ-12) to measure common mental disorders. Secondary outcomes included alcohol misuse, assessed with the Alcohol Use Disorders Identification Test (AUDIT), and binge drinking. Mixed-effects models were used to account for possible cluster effects. We did not find a difference in mental health or overall AUDIT score. Those who received Battlemind versus the standard brief were less likely to report binge drinking, although the effect size was small (adjusted odds ratio = 0.73, 95% CI [0.58, 0.92]). The anglicized Battlemind did not improve mental health but had a modest impact on the reporting of binge drinking. Alcohol misuse is problematic in military populations; therefore, an intervention that reduces binge drinking may be helpful.",Mulligan K.; Fear NT.; Jones N.; Alvarez H.; Hull L.; Naumann U.; Wessely S.; Greenberg N.,2012.0,10.1037/a0027664,0,0,
9070,Responsiveness of hypochondriacal patients with chronic low-back pain to cognitive-behavioral therapy.,"Evidence has suggested that cognitive-behavioral therapy (CBT) is effective in reducing hypochondriacal symptoms, and another line of evidence has suggested that CBT is also effective in reducing pain and the psychological conditions associated with chronic low-back pain (CLBP). The purpose of this study was to examine the effectiveness of CBT among hypochondriacal patients with and without CLBP. A total of 182 hypochondriacal patients were randomly assigned to a CBT or control group. The Somatic Symptom Inventory was used to define CLBP, and the Symptom Checklist 90R (SCL90R) was used to assess psychological symptoms. The outcome measures for hypochondriasis, the Whiteley Index (WI) and the Health Anxiety Inventory (HAI) were administered before the intervention and at 6 and 12 months after completion of the intervention. In the total sample, both WI and HAI scores were significantly decreased after treatment in the CBT group compared with the control group. Ninety-three (51%) patients had CLBP; the SCL90R scores for somatization, depression, phobic anxiety, paranoid ideation, and general severity were significantly higher in CLBP(+) group than in the CLBP(-) group at baseline. Although the WI and HAI scores were significantly decreased after treatment in the CLBP(-) group, such significant pre- to post-changes were not found in the CLBP(+) group. CBT was certainly effective among hypochondriacal patients without CLBP, but it appeared to be insufficient for hypochondriacal patients with CLBP. The core psychopathology of hypochondriacal CLBP should be clarified to contribute to the adequate management of hypochondriacal symptoms in CLBP patients.",Nakao M.; Shinozaki Y.; Nolido N.; Ahern DK.; Barsky AJ.,,10.1016/j.psym.2011.09.006,0,0,5979
9071,"Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial.","To assess the effectiveness of mindfulness-based stress reduction (MBSR) for mood, breast- and endocrine-specific quality of life, and well-being after hospital treatment in women with stage 0 to III breast cancer. A randomized, wait-listed, controlled trial was carried out in 229 women after surgery, chemotherapy, and radiotherapy for breast cancer. Patients were randomly assigned to the 8-week MBSR program or standard care. Profile of Mood States (POMS; primary outcome), Functional Assessment of Cancer Therapy-Breast (FACT-B), Functional Assessment of Cancer Therapy-Endocrine Symptoms (FACT-ES) scales and the WHO five-item well-being questionnaire (WHO-5) evaluated mood, quality of life, and well-being at weeks 0, 8, and 12. For each outcome measure, a repeated-measures analysis of variance model, which incorporated week 0 measurements as a covariate, was used to compare treatment groups at 8 and 12 weeks. There were statistically significant improvements in outcome in the experimental group compared with control group at both 8 and 12 weeks (except as indicated) for POMS total mood disturbance (and its subscales of anxiety, depression [8 weeks only], anger [12 weeks only], vigor, fatigue, and confusion [8 weeks only]), FACT-B, FACT-ES, (and Functional Assessment of Cancer Therapy subscales of physical, social [8 weeks only], emotional, and functional well-being), and WHO-5. MSBR improved mood, breast- and endocrine-related quality of life, and well-being more effectively than standard care in women with stage 0 to III breast cancer, and these results persisted at three months. To our knowledge, this study provided novel evidence that MBSR can help alleviate long-term emotional and physical adverse effects of medical treatments, including endocrine treatments. MBSR is recommended to support survivors of breast cancer.",Hoffman CJ.; Ersser SJ.; Hopkinson JB.; Nicholls PG.; Harrington JE.; Thomas PW.,2012.0,10.1200/JCO.2010.34.0331,0,0,
9072,Treatment via videoconferencing: a pilot study of delivery by clinical psychology trainees.,"This pilot study explored the outcomes of clinical psychology trainees delivering treatments via videoconferencing. A noncurrent, multiple baseline across subjects and settings. University outpatient psychology clinic. Six clients (two men and four women) with an anxiety or depressive disorder were randomly assigned to received six sessions of individual therapy (either via videoconferencing or face to face) from a male or female clinical psychology trainee. Participants provided daily ratings (0-10) of subjective distress/well-being via text messaging, and at pre-, post-, and 1 month follow-up of treatment, completed the Depression Anxiety Stress Scales and the Outcome Questionnaire-45. Along with the trainees, participants also provided feedback on the therapy experience. The subjective well-being of all participants improved, and all videoconferencing participants showed a statistically and clinically significant reduction in symptomology and gains in general life functioning. Feedback comments were positive. This study suggests that there is value in clinical psychology trainees gaining experience in the delivery of treatments via videoconferencing. Further study is needed to demonstrate the potential for university clinics to deliver mental health services, via this modality, to rural and remote areas.",Dunstan DA.; Tooth SM.,2012.0,10.1111/j.1440-1584.2012.01260.x,0,0,
9073,Intracranial pressure monitoring in severe traumatic brain injury in latin america: process and methods for a multi-center randomized controlled trial.,"In patients with severe traumatic brain injury (TBI), the influence on important outcomes of the use of information from intracranial pressure (ICP) monitoring to direct treatment has never been tested in a randomized controlled trial (RCT). We are conducting an RCT in six trauma centers in Latin America to test this question. We hypothesize that patients randomized to ICP monitoring will have lower mortality and better outcomes at 6-months post-trauma than patients treated without ICP monitoring. We selected three centers in Bolivia to participate in the trial, based on (1) the absence of ICP monitoring, (2) adequate patient accession and data collection during the pilot phase, (3) preliminary institutional review board approval, and (4) the presence of equipoise about the value of ICP monitoring. We conducted extensive training of site personnel, and initiated the trial on September 1, 2008. Subsequently, we included three additional centers. A total of 176 patients were entered into the trial as of August 31, 2010. Current enrollment is 81% of that expected. The trial is expected to reach its enrollment goal of 324 patients by September of 2011. We are conducting a high-quality RCT to answer a question that is important globally. In addition, we are establishing the capacity to conduct strong research in Latin America, where TBI is a serious epidemic. Finally, we are demonstrating the feasibility and utility of international collaborations that share resources and unique patient populations to conduct strong research about global public health concerns.",Carney N.; Lujan S.; Dikmen S.; Temkin N.; Petroni G.; Pridgeon J.; Barber J.; Machamer J.; Cherner M.; Chaddock K.; Hendrix T.; Rondina C.; Videtta W.; Celix JM.; Chesnut R.,2012.0,10.1089/neu.2011.2019,0,0,
9074,Contradictory effects for prevention of depression and anxiety in residents in homes for the elderly: a pragmatic randomized controlled trial.,"The aim of this study was to evaluate the effectiveness of a stepped-care program to prevent the onset of depression and anxiety disorders in elderly people living in residential homes. A pragmatic randomized controlled trial was conducted to compare the intervention with usual care in 14 residential homes in the Netherlands. A total of 185 residents with a minimum score of 8 on the Centre for Epidemiologic Studies Depression Scale, who did not meet the diagnostic criteria for a depressive or anxiety disorder, and were not suffering from severe cognitive impairment, were recruited between April 2007 and December 2008. They were randomized to a stepped-care program (N = 93) or to usual care (N = 92). The stepped-care participants sequentially underwent watchful waiting, a self-help intervention, life review, and a consultation with the general practitioner. The primary outcome measure was the incidence of a major depressive disorder (MDD) or anxiety disorder during a period of one year according to the Mini International Neuropsychiatric Interview. The intervention was not effective in reducing the incidence of the combined outcome of depression and anxiety (incidence rate ratio (IRR) = 0.50; 95% confidence interval (CI) = 0.23-1.12). However, the intervention was superior to usual care in reducing the risk of MDD incidence (IRR = 0.26; 95% CI = 0.12-0.80) contrary to anxiety incidence (IRR = 1.32; 95% CI = 0.48-3.62). These results suggest that the stepped-care program is effective in reducing the incidence of depression, but is not effective in preventing the onset of anxiety disorders in elderly people living in residential homes.",Dozeman E.; van Marwijk HW.; van Schaik DJ.; Smit F.; Stek ML.; van der Horst HE.; Bohlmeijer ET.; Beekman AT.,2012.0,10.1017/S1041610212000178,0,0,
9075,Using session-by-session measurement to compare mechanisms of action for acceptance and commitment therapy and cognitive therapy.,"Debate continues about the extent to which postulated mechanisms of action of cognitive behavior therapies (CBT), including standard CBT (i.e., Beckian cognitive therapy [CT]) and acceptance and commitment therapy (ACT) are supported by mediational analyses. Moreover, the distinctiveness of CT and ACT has been called into question. One contributor to ongoing uncertainty in this arena is the lack of time-varying process data. In this study, 174 patients presenting to a university clinic with anxiety or depression who had been randomly assigned to receive either ACT or CT completed an assessment of theorized mediators and outcomes before each session. Hierarchical linear modeling of session-by-session data revealed that increased utilization of cognitive and affective change strategies relative to utilization of psychological acceptance strategies mediated outcome for CT, whereas for ACT the mediation effect was in the opposite direction. Decreases in self-reported dysfunctional thinking, cognitive ""defusion"" (the ability to see one's thoughts as mental events rather than necessarily as representations of reality), and willingness to engage in behavioral activity despite unpleasant thoughts or emotions were equivalent mediators across treatments. These results have potential implications for the theoretical arguments behind, and distinctiveness of, CT and ACT.",Forman EM.; Chapman JE.; Herbert JD.; Goetter EM.; Yuen EK.; Moitra E.,2012.0,10.1016/j.beth.2011.07.004,0,0,
9076,Mindfulness-based cognitive therapy improves emotional reactivity to social stress: results from a randomized controlled trial.,"The high likelihood of recurrence in depression is linked to a progressive increase in emotional reactivity to stress (stress sensitization). Mindfulness-based therapies teach mindfulness skills designed to decrease emotional reactivity in the face of negative affect-producing stressors. The primary aim of the current study was to assess whether Mindfulness-Based Cognitive Therapy (MBCT) is efficacious in reducing emotional reactivity to social evaluative threat in a clinical sample with recurrent depression. A secondary aim was to assess whether improvement in emotional reactivity mediates improvements in depressive symptoms. Fifty-two individuals with partially remitted depression were randomized into an 8-week MBCT course or a waitlist control condition. All participants underwent the Trier Social Stress Test (TSST) before and after the 8-week trial period. Emotional reactivity to stress was assessed with the Spielberger State Anxiety Inventory at several time points before, during, and after the stressor. MBCT was associated with decreased emotional reactivity to social stress, specifically during the recovery (post-stressor) phase of the TSST. Waitlist controls showed an increase in anticipatory (pre-stressor) anxiety that was absent in the MBCT group. Improvements in emotional reactivity partially mediated improvements in depressive symptoms. Limitations include small sample size, lack of objective or treatment adherence measures, and non-generalizability to more severely depressed populations. Given that emotional reactivity to stress is an important psychopathological process underlying the chronic and recurrent nature of depression, these findings suggest that mindfulness skills are important in adaptive emotion regulation when coping with stress.",Britton WB.; Shahar B.; Szepsenwol O.; Jacobs WJ.,2012.0,10.1016/j.beth.2011.08.006,0,0,
9077,Attention training to reduce attention bias and social stressor reactivity: an attempt to replicate and extend previous findings.,"Cognitive theories suggest that social anxiety is maintained, in part, by an attentional bias toward threat. Recent research shows that a single-session of attention modification training (AMP) reduces attention bias and vulnerability to a social stressor (Amir, Weber, Beard, Bomyea, & Taylor, 2008). In addition, exercise may augment the effects of attention training by its direct effects on attentional control and inhibition, thereby allowing participants receiving the AMP to more effectively disengage attention from the threatening cues and shift attention to the neutral cues. We attempted to replicate and extend previous findings by randomizing participants (N = 112) to a single-session of: a) Exercise + attention training (EX + AMP); b) Rest + attention training (REST + AMP); c) Exercise + attention control condition (EX + ACC); or d) Rest + attention control condition (REST + ACC) prior to completing a public speaking challenge. We used identical assessment and training procedures to those employed by Amir et al. (2008). Results showed there was no effect of attention training on attention bias or anxiety reactivity to the speech challenge and no interactive effects of attention training and exercise on attention bias or anxiety reactivity to the speech challenge. The failure to replicate previous findings is discussed.",Julian K.; Beard C.; Schmidt NB.; Powers MB.; Smits JA.,2012.0,10.1016/j.brat.2012.02.015,0,0,
9078,Haven't we met somewhere before? The effects of a brief Internet introduction on social anxiety in a subsequent face to face interaction.,"Social anxiety occurs in a range of social situations, the salience of which is influenced by prevailing modes of social contact. The emergence of computer mediated communication (CMC), buoyed by the recent explosion of social networks, has changed the way many people make and maintain social contacts. We randomly assigned 30 socially anxious and 30 low social anxiety participants to a brief internet chat introduction or a control internet surfing condition followed by a standardized face to face (FTF) interaction. We hypothesized that for socially anxious participants the chat introduction would reduce anxiety of and preference to avoid the subsequent FTF interaction. Results supported hypotheses for most indices. Findings suggest that, at least for the common situation in which internet chat precedes FTF interaction with the same person, such contact may reduce social anxiety. It is not known whether this decrease would generalize to FTF contact in other contexts. It is suggested that CMC might be construed as a particularly useful form of safety behavior that may help in the allocation of attentional resources to process new information relevant for disconfirmation of negative beliefs maintaining social anxiety. Potential clinical implications are discussed.",Markovitzky O.; Anholt GE.; Lipsitz JD.,2012.0,10.1016/j.brat.2012.02.002,0,0,
9079,Therapeutic alliance in telephone-administered cognitive-behavioral therapy for hematopoietic stem cell transplant survivors.,"A strong therapeutic alliance has been found to predict psychotherapeutic treatment success across a variety of therapeutic modalities and patient populations. However, only a few studies have examined therapeutic alliance as a predictor of psychotherapy outcome among cancer survivors, and none have examined this relation in telephone-administered cognitive-behavioral therapy (T-CBT). This study evaluated the extent to which therapeutic alliance affected psychotherapy outcomes in survivors of hematopoietic stem cell transplantation (HSCT), a treatment for some cancers. Forty-six patients enrolled in a randomized clinical trial of T-CBT for posttraumatic stress disorder (PTSD) completed a baseline assessment (including self-report measures of PTSD symptoms, depression, and general distress), 10 individual T-CBT sessions, and follow-up assessments at 6, 9, and 12 months post-baseline. Therapeutic alliance was assessed after the 3rd T-CBT session with the Working Alliance Inventory, which yields overall and subscale (task, bond, and goal) scores. Analyses revealed that higher total therapeutic alliance scores prospectively predicted decreased depressive symptomatology; higher task scores predicted decreased overall distress, depressive symptomatology, symptoms of re-experiencing, and avoidance; and higher bond scores predicted decreased depressive symptomatology and symptoms of re-experiencing. These results suggest that assessments of therapeutic alliance should be incorporated into routine clinical care, and therapeutic alliance should be specifically cultivated in interventions to maximize psychotherapeutic benefits involving vulnerable populations such as cancer survivors.",Applebaum AJ.; DuHamel KN.; Winkel G.; Rini C.; Greene PB.; Mosher CE.; Redd WH.,2012.0,10.1037/a0027956,0,0,
9080,Acute effects of aerobic exercise on mood and hunger feelings in male obese adolescents: a crossover study.,"The aim of this study was to determine the acute effects of exercise intensity on anxiety, mood states and hunger in obese adolescents. Subjects were eight male obese adolescents (age 15.44 ± 2.06 y; BMI 33.06 ± 4.78 kg/m2). Each subject underwent three experimental trials: (1) Control, seated for 30 min; (2) Low intensity exercise (LIE)--exercise at 10% below ventilatory threshold (VT); (3) High intensity exercise (HIE)--exercise at 10% above VT. Anxiety (STAI Trait/State), mood (POMS) and hunger (VAS) were assessed before and immediately after the experimental sessions. Comparisons between trials and times were assessed using Kruskal-Wallis and Wilcoxon tests, respectively. Associations between variables were described using a Spearman test. The largest increase in hunger was observed after LEI (914.22%). Both exercise sessions increased anxiety, fatigue and decreased vigor (p < 0.05). Acute exercise bouts are associated with negative changes in anxiety and mood, and with increases in hunger in obese adolescents.",Lofrano-Prado MC.; Hill JO.; Silva HJ.; Freitas CR.; Lopes-de-Souza S.; Lins TA.; do Prado WL.,2012.0,10.1186/1479-5868-9-38,0,0,
9081,A randomized placebo-controlled trial of D-cycloserine to enhance exposure therapy for posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) is a complex and debilitating anxiety disorder, and, although prolonged exposure therapy has been proven effective, many patients remain symptomatic after treatment. In other anxiety disorders, the supplementary use of D-cycloserine (DCS), a partial agonist at the glutamatergic N-methyl-D-aspartate receptor, showed promise in enhancing treatment effects. We examined whether augmentation of prolonged exposure therapy for PTSD with DCS enhances treatment efficacy. In a randomized, double-blind, placebo-controlled trial we administered 50 mg DCS or placebo 1 hour before each exposure session to 67 mixed trauma patients, recruited from regular referrals, with a primary PTSD diagnosis satisfying DSM-IV criteria. Although DCS did not enhance overall treatment effects, the participants having received DCS did show a stronger treatment response. Exploratory session-by-session analyses revealed that DCS yielded higher symptom reduction in those participants that had more severe pretreatment PTSD and needed longer treatment. The present study found preliminary support for the augmentation of exposure therapy with DCS, specifically for patients with more severe PTSD needing longer treatment.",de Kleine RA.; Hendriks GJ.; Kusters WJ.; Broekman TG.; van Minnen A.,2012.0,10.1016/j.biopsych.2012.02.033,0,0,
9082,The Believability of Anxious Feelings and Thoughts Questionnaire (BAFT): a psychometric evaluation of cognitive fusion in a nonclinical and highly anxious community sample.,"Cognitive fusion--or the tendency to buy into the literal meaning of thoughts, feelings, and bodily sensations--plays an important role in the etiology and maintenance of anxiety disorders and figures prominently in third-generation behavior therapies such as acceptance and commitment therapy (ACT). Nonetheless, there is a lack of validated self-report measures of cognitive fusion/defusion, particularly in the area of anxiety disorders. We attempted to fill this gap with the development and validation of a self-report cognitive fusion measure, the Believability of Anxious Feelings and Thoughts Questionnaire (BAFT), in both a healthy undergraduate sample (N = 432) and highly anxious community sample (N = 503) undergoing a 12-week online ACT intervention. Results suggested a hierarchical factor structure of the BAFT with three lower order factors and one hierarchical factor and excellent internal consistency for the total BAFT score (i.e., αs = .90 and .91 for the undergraduate and highly anxious samples, respectively) and for its factors. Additionally, the BAFT and all of its factors consistently showed strong construct validity with other relevant process and outcome measures in both samples, strong 12-week test-retest reliability (r = .77) in our highly anxious waitlist control subsample and responsiveness to treatment in our highly anxious intervention subsample. These findings suggest that the BAFT is a reliable and valid measure of cognitive fusion in both healthy and clinical populations.",Herzberg KN.; Sheppard SC.; Forsyth JP.; Credé M.; Earleywine M.; Eifert GH.,2012.0,10.1037/a0027782,0,0,
9083,The adult respiratory distress syndrome cognitive outcomes study: long-term neuropsychological function in survivors of acute lung injury.,"Cognitive and psychiatric morbidity is common and potentially modifiable after acute lung injury (ALI). However, practical measures of neuropsychological function for use in multicenter trials are lacking. To determine whether a validated telephone-based neuropsychological test battery is feasible in a multicenter trial. To determine the frequency and risk factors for long-term neuropsychological impairment. As an adjunct study to the Acute Respiratory Distress Syndrome Clinical Trials Network Fluid and Catheter Treatment Trial, we assessed neuropsychological function at 2 and 12 months post-hospital discharge. Of 406 eligible survivors, we approached 261 to participate and 213 consented. We tested 122 subjects at least once, including 102 subjects at 12 months. Memory, verbal fluency, and executive function were impaired in 13% (12 of 92), 16% (15 of 96), and 49% (37 of 76) of long-term survivors. Long-term cognitive impairment was present in 41 of the 75 (55%) survivors who completed cognitive testing. Depression, post-traumatic stress disorder, or anxiety was present in 36% (37 of 102), 39% (40 of 102), and 62% (63 of 102) of long-term survivors. Enrollment in a conservative fluid-management strategy (P = 0.005) was associated with cognitive impairment and lower partial pressure of arterial oxygen during the trial was associated with cognitive (P = 0.02) and psychiatric impairment (P = 0.02). Neuropsychological function can be assessed by telephone in a multicenter trial. Long-term neuropsychological impairment is common in survivors of ALI. Hypoxemia is a risk factor for long-term neuropsychological impairment. Fluid management strategy is a potential risk factor for long-term cognitive impairment; however, given the select population studied and an unclear mechanism, this finding requires confirmation.",Mikkelsen ME.; Christie JD.; Lanken PN.; Biester RC.; Thompson BT.; Bellamy SL.; Localio AR.; Demissie E.; Hopkins RO.; Angus DC.,2012.0,10.1164/rccm.201111-2025OC,0,0,
9084,Mental retrieval of treatment context in dental phobia.,"The effect of mental retrieval of an exposure session was investigated during a follow-up examination in dental phobia patients. The exposure session took place at the psychology unit and the follow-up a week later at the dental clinic prior to dental treatment while patients were seated in the dental chair. During exposure, individuals with dental phobia (N = 72) were shown a video of a dental appointment, after which they were instructed to imagine themselves receiving dental treatment. During follow-up half of the participants received instructions to mentally retrieve the exposure session and the other half were asked to recall everyday activities. Before and after exposure treatment, and after mental retrieval, participants were shown three dental instruments while heart rate (HR) and avoidance and subjective units of discomfort (SUD) were recorded. Questionnaires of phobic anxiety administered before and after treatment indicated significant improvement. Mental retrieval of treatment was moderately superior to the control condition with regard to avoidance. Over 80% of patients underwent the subsequent dental treatment session. Those not adhering showed initially more dysfunctional cognitions and more desire for control. There is some evidence that retrieval of treatment context may have a moderately beneficial effect on avoidance.",Elsesser K.; Wannemüller A.; Lohrmann T.; Jöhren P.; Sartory G.,2013.0,10.1017/S1352465812000318,0,0,
9085,Effects of an exercise programme on anxiety in adults with intellectual disabilities.,"Although high anxiety is common in people with intellectual disabilities (ID) and the anxiolytic effects of exercise have been systematically recognised in clinical and non-clinical populations, research is scant concerning the role played by exercise on anxiety in people with ID. The purpose of this study was to investigate the effects of a 12-week exercise programme on anxiety states in a group of adults with ID. Twenty-seven individuals with mild to moderate ID were randomly assigned to an exercise group or a control group. The Zung Self-Rating Anxiety Scale adapted for individuals with ID and the State-Trait Anxiety Inventory form Y were used to assess trait and state anxiety. In comparison with the control group, the anxiety scores of people in the exercise group decreased significantly over time.",Carraro A.; Gobbi E.,,10.1016/j.ridd.2012.02.014,0,0,6149
9086,The Pittsburgh Sleep Quality Index in older primary care patients with generalized anxiety disorder: psychometrics and outcomes following cognitive behavioral therapy.,"The Pittsburgh Sleep Quality Index (PSQI) is a widely used, comprehensive self-report measure of sleep quality and impairment, which has demonstrated good psychometric properties within various populations, including older adults. However, the psychometric properties of the PSQI and its component scores have not been evaluated for older adults with generalized anxiety disorder (GAD). Additionally, changes in PSQI global or component scores have not been reported following cognitive-behavioral treatment (CBT) of late-life GAD. This study examined (1) the psychometric properties of the PSQI within a sample of 216 elderly primary care patients age 60 or older with GAD who were referred for treatment of worry and/or anxiety; as well as (2) response to CBT, relative to usual care, for 134 patients with principal or coprincipal GAD. The PSQI demonstrated good internal consistency reliability and adequate evidence of construct validity. Those receiving CBT experienced greater reductions in PSQI global scores at post-treatment, relative to those receiving usual care. Further, PSQI global and component scores pertaining to sleep quality and difficulties falling asleep (i.e., sleep latency and sleep disturbances) demonstrated response to treatment over a 12-month follow-up period. Overall, results highlight the usefulness of the PSQI global and component scores for use in older adults with GAD.",Bush AL.; Armento ME.; Weiss BJ.; Rhoades HM.; Novy DM.; Wilson NL.; Kunik ME.; Stanley MA.,2012.0,10.1016/j.psychres.2012.03.045,0,0,
9087,A prospective randomized controlled trial of dynamic versus static progressive elbow splinting for posttraumatic elbow stiffness.,"Both dynamic and static progressive (turnbuckle) splints are used to help stretch a contracted elbow capsule to regain motion after elbow trauma. There are advocates of each method, but no comparative data. This prospective randomized controlled trial tested the null hypothesis that there is no difference in improvement of motion and Disabilities of the Arm, Shoulder and Hand (DASH) scores between static progressive and dynamic splinting. Sixty-six patients with posttraumatic elbow stiffness were enrolled in a prospective randomized trial: thirty-five in the static progressive and thirty-one in the dynamic cohort. Elbow function was measured at enrollment and at three, six, and twelve months later. Patients completed the DASH questionnaire at enrollment and at the six and twelve-month evaluation. Three patients asked to be switched to static progressive splinting. The analysis was done according to intention-to-treat principles and with use of mean imputation for missing data. There were no significant differences in flexion arc at any time point. Improvement in the arc of flexion (dynamic versus static) averaged 29° versus 28° at three months (p = 0.87), 40° versus 39° at six months (p = 0.72), and 47° versus 49° at twelve months after splinting was initiated (p = 0.71). The average DASH score (dynamic versus static) was 50 versus 45 points at enrollment (p = 0.52), 32 versus 25 points at six months (p < 0.05), and 28 versus 26 points at twelve months after enrollment (p = 0.61). Posttraumatic elbow stiffness can improve with exercises and dynamic or static splinting over a period of six to twelve months, and patience is warranted. There were no significant differences in improvement in motion between static progressive and dynamic splinting protocols, and the choice of splinting method can be determined by the patients and their physicians.",Lindenhovius AL.; Doornberg JN.; Brouwer KM.; Jupiter JB.; Mudgal CS.; Ring D.,2012.0,10.2106/JBJS.J.01761,0,0,
9088,Prediction of the outcome of short- and long-term psychotherapy based on socio-demographic factors.,"Socio-demographic factors predict the outcome of short-term psychotherapy (STT) in the treatment of mood and anxiety disorders, but information on the prediction for long long-term therapy (LPP) is lacking. We aimed to compare the prediction of changes in psychiatric symptoms afforded by socio-demographic factors across two treatment conditions, short- versus long-term psychotherapy. In the Helsinki Psychotherapy Study, 326 outpatients with mood or anxiety disorders, aged 20-46 years, were randomly assigned to STT or LPP. Socio-demographic factors (i.e. age, gender, education, employment status, marital status, and living arrangement) were self-reported. Psychiatric symptoms were measured by the Symptom Check List, Global Severity Index (SCL-90-GSI) and Anxiety scale (SCL-90-Anx), and the Beck Depression Inventory (BDI) at baseline and seven times during a three-year follow-up period. Socio-demographic factors were found to predict symptom development during follow-up irrespective of the baseline symptom level. Patients in a relatively good position, i.e. married and highly educated patients benefited from STT, whereas patients in less advantaged positions, i.e. homemakers, lone parents, and divorced patients needed LPP or did not benefit from either therapy. In several categories of socio-demographic factors, the extent to which a patient's background predicted the outcome of the psychotherapy varied according to whether general, anxiety or depressive symptoms were studied. We were unable to assess widows and pensioners. For ethical reasons, a no-treatment control group with a long follow-up could not be included in the study design. Socio-demographic factors may need to be considered in the selection of patients for short- and long-term therapy.",Joutsenniemi K.; Laaksonen MA.; Knekt P.; Haaramo P.; Lindfors O.,2012.0,10.1016/j.jad.2012.03.027,0,0,
9089,Psychological crisis intervention for the family members of patients in a vegetative state.,"Family members of patients in a vegetative state have relatively high rates of anxiety and distress. It is important to recognize the problems faced by this population and apply psychological interventions to help them. This exploratory study describes the psychological stress experienced by family members of patients in a vegetative state. We discuss the effectiveness of a psychological crisis intervention directed at this population and offer suggestions for future clinical work. A total of 107 family members of patients in a vegetative state were included in the study. The intervention included four steps: acquisition of facts about each family, sharing their first thoughts concerning the event, assessment of their emotional reactions and developing their coping abilities. The Symptom Check List-90 was used to evaluate the psychological distress of the participants at baseline and one month after the psychological intervention. Differences between the Symptom Check List-90 scores at the baseline and follow-up evaluations were analyzed. All participants in the study had significantly higher Symptom Check List-90 factor scores than the national norms at baseline. There were no significant differences between the intervention group and the control group at baseline. Most of the Symptom Check List-90 factor scores at the one-month follow-up evaluation were significantly lower than those at baseline for both groups; however, the intervention group improved significantly more than the control group on most subscales, including somatization, obsessive-compulsive behavior, depression, and anxiety. The results of this study indicate that the four-step intervention method effectively improves the mental health of the family members who received this treatment and lessens the psychological symptoms of somatization, obsessive-compulsive behavior, depression and anxiety.",Li YH.; Xu ZP.,2012.0,,0,0,
9090,Development and preliminary evaluation of a telephone-based coping skills training intervention for survivors of acute lung injury and their informal caregivers.,"Survivors of acute lung injury (ALI) and their informal caregivers have difficulty coping with the physical and emotional challenges of recovery from critical illness. We aimed to develop and pilot test a telephone-based coping skills training intervention for this population. Fifty-eight participants were enrolled overall. A total of 21 patients and 23 caregivers participated in a cross-sectional study to assess coping and its association with psychological distress. This also informed the development of an ALI coping skills training intervention in an iterative process involving content and methodological experts. The intervention was then evaluated in seven patients and seven caregivers in an uncontrolled, prospective, pre-post study. Outcomes included acceptability, feasibility, and symptoms of psychological distress measured with the Hospital Anxiety and Depression Scale (HADS) and Post-Traumatic Symptom Scale (PTSS). Survivors and their caregivers used adaptive coping infrequently, a pattern that was strongly associated with psychological distress. These findings informed the development of a 12-session intervention for acquiring, applying, and maintaining coping skills. In the evaluation phase, participants completed 77 (92 %) of a possible 84 telephone sessions and all (100 %) reported the intervention's usefulness in their daily routine. Mean change scores reflecting improvements in the HADS (7.8 U) and PTSS (10.3 U) were associated with adaptive coping (r = 0.50-0.70) and high self-efficacy (r = 0.67-0.79). A novel telephone-based coping skills training intervention was acceptable, feasible, and may have been associated with a reduction in psychological distress among survivors of ALI and their informal caregivers. A randomized trial is needed to evaluate the intervention.",Cox CE.; Porter LS.; Hough CL.; White DB.; Kahn JM.; Carson SS.; Tulsky JA.; Keefe FJ.,2012.0,10.1007/s00134-012-2567-3,0,0,
9091,Mental contamination: the effects of imagined physical dirt and immoral behaviour.,"There is a growing body of empirical support for Rachman's (1994, 2004, 2006) conceptualization of mental contamination. The aim of this study was to tease apart manipulations of imagined physical descriptions (i.e., clean versus dirty), in the context of both morally sound and reprehensible acts (i.e., consensual versus non-consensual kiss) to expand our understanding of the experimental variables which may evoke mental contamination and address limitations of previous research. Female undergraduate student participants (n = 140) were randomly assigned to listen to one of four audio recordings and imagine receiving either a consensual or non-consensual kiss from a man described as either physically clean or physically dirty. Results indicated that participants who imagined a non-consensual kiss from a physically dirty man reported the greatest feelings of mental contamination; whereas, participants who imagined a consensual kiss from a physically clean man reported the lowest feelings of mental contamination. However, there were few significant differences in mental contamination feelings between those who imagined a consensual kiss from a physically dirty man and those who imagined a non-consensual kiss from a physically clean man. Results are discussed in terms of cognitive-behavioural conceptualizations of and treatments for contamination fears.",Elliott CM.; Radomsky AS.,2012.0,10.1016/j.brat.2012.03.007,0,0,
9092,"Migraine prevalence, alexithymia, and post-traumatic stress disorder among medical students in Turkey.","The aim of this study was to investigate the prevalence of migraine, alexithymia, and post-traumatic stress disorder among medical students at Cumhuriyet University of Sivas in Turkey. A total of 250 medical students participated in this study and answered the questionnaires. The study was conducted in three stages: the self-questionnaire, the neurological evaluation, and the psychiatric evaluation. In the first stage, the subjects completed a questionnaire to assess migraine symptoms and completed the three-item Identification of Migraine Questionnaire, the Toronto Alexithymia Scale, and the Post-Traumatic Stress Disorder Checklist-Civilian Version Scale. The subjects who reported having a migraine underwent a detailed neurological evaluation conducted by a neurologist to confirm the diagnosis. In the final stage, the subjects with a migraine completed a psychiatric examination using the structured clinical interview for DSM-IV-R Axis I. The actual prevalence of migraine among these medical students was 12.6 %. The students with a migraine were diagnosed with alexithymia and post-traumatic stress disorder more frequently than those without migraine. The Migraine Disability Assessment Scale scores correlated with the post-traumatic stress disorder scores. The results of this study indicate that migraine was highly prevalent among medical students in Turkey and was associated with the alexithymic personality trait and comorbid psychiatric disorders including post-traumatic stress disorder. Treatment strategies must be developed to manage these comorbidities.",Balaban H.; Semiz M.; Şentürk IA.; Kavakçı Ö.; Cınar Z.; Dikici A.; Topaktaş S.,2012.0,10.1007/s10194-012-0452-7,0,0,
9093,Effects of a manualized short-term treatment of internet and computer game addiction (STICA): study protocol for a randomized controlled trial.,"In the last few years, excessive internet use and computer gaming have increased dramatically. Salience, mood modification, tolerance, withdrawal symptoms, conflict, and relapse have been defined as diagnostic criteria for internet addiction (IA) and computer addiction (CA) in the scientific community. Despite a growing number of individuals seeking help, there are no specific treatments of established efficacy. This clinical trial aims to determine the effect of the disorder-specific manualized short-term treatment of IA/CA (STICA). The cognitive behavioural treatment combines individual and group interventions with a total duration of 4 months. Patients will be randomly assigned to STICA treatment or to a wait list control group. Reliable and valid measures of IA/CA and co-morbid mental symptoms (for example social anxiety, depression) will be assessed prior to the beginning, in the middle, at the end, and 6 months after completion of treatment. A treatment of IA/CA will establish efficacy and is desperately needed. As this is the first trial to determine efficacy of a disorder specific treatment, a wait list control group will be implemented. Pros and cons of the design were discussed. ClinicalTrials (NCT01434589).",Jäger S.; Müller KW.; Ruckes C.; Wittig T.; Batra A.; Musalek M.; Mann K.; Wölfling K.; Beutel ME.,2012.0,10.1186/1745-6215-13-43,0,0,
9094,Anxiety sensitivity and cognitive-based smoking processes: testing the mediating role of emotion dysregulation among treatment-seeking daily smokers.,"The current study investigated whether emotion dysregulation (difficulties in the self-regulation of affective states) mediated relationships between anxiety sensitivity (fear of anxiety and related sensations) and cognitive-based smoking processes. Participants (n = 197; 57.5% male; mean age = 38.0 years) were daily smokers recruited as part of a randomized control trial for smoking cessation. Anxiety sensitivity was uniquely associated with all smoking processes. Moreover, emotion dysregulation significantly mediated relationships between anxiety sensitivity and the smoking processes. Findings suggest that emotion dysregulation is an important construct to consider in relationships between anxiety sensitivity and cognitive-based smoking processes among adult treatment-seeking smokers.",Johnson KA.; Farris SG.; Schmidt NB.; Zvolensky MJ.,2012.0,10.1080/10550887.2012.665695,0,0,
9095,Panic attack history and anxiety sensitivity in relation to cognitive-based smoking processes among treatment-seeking daily smokers.,"Empirical research has found that panic attacks are related to increased risk of more severe nicotine withdrawal and poor cessation outcome. Anxiety sensitivity (AS; fear of anxiety and related sensations) has similarly been found to be related to an increased risk of acute nicotine withdrawal and poorer cessation outcome. However, research has yet to examine the relative contributions of panic attacks and AS in terms of cognitive-based smoking processes (e.g., negative reinforcement smoking expectancies, addictive and negative affect-based reduction smoking motives, barriers to cessation, problem symptoms experienced while quitting). Participants (n = 242; 57.4% male; M (age) = 38.1) were daily smokers recruited as a part of a larger randomized control trial for smoking cessation. It was hypothesized that both panic attacks and AS would uniquely and independently predict the studied cognitive-based smoking processes. As hypothesized, AS was uniquely and positively associated with all smoking processes after controlling for average number of cigarettes smoked per day, current Axis I diagnosis, and participant sex. However, panic attack history was only significantly related to problem symptoms experienced while quitting smoking. Although past research has demonstrated significant associations between panic attacks and certain aspects of cigarette smoking (e.g., severity of nicotine withdrawal; lower abstinence rates, and negative affect reduction motives), the present findings suggest that AS may be more relevant to understanding beliefs about and motives for smoking behavior as well as perceptions of cessation-related difficulties.",Johnson KA.; Farris SG.; Schmidt NB.; Smits JA.; Zvolensky MJ.,2013.0,10.1093/ntr/ntr332,0,0,
9096,Dissociative experiences during sexual behavior among a sample of adults living with HIV infection and a history of childhood sexual abuse.,"Little attention has been given to the occurrence of dissociative symptoms during sexual behavior in adults who have experienced childhood sexual abuse (CSA). For this study, 57 adults living with HIV infection who had experienced CSA and were entering a treatment study for traumatic stress completed study assessments and clinical interviews, including a 15-item scale of dissociative experiences during sexual behavior. Predictor variables included Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision diagnoses of posttraumatic stress disorder (PTSD) and dissociative disorders, rape by an intimate partner, duration of CSA, number of perpetrators of CSA, and current sexual satisfaction. A multiple regression analysis was conducted to identify significant associations between predictors and dissociation during sex. Mean differences by clinical diagnosis were also examined. Results indicated that PTSD, dissociative disorders, rape by an intimate partner, duration of CSA, and number of perpetrators of CSA were associated with increased dissociation during sexual behavior. Dissociation during sex likely increases vulnerability to sexual revictimization and risky sexual behavior. Standard behavioral prevention interventions may be ineffective for sexual situations when dissociation occurs, and prevention efforts should be integrated with mental health care for those who have experienced CSA.",Hansen NB.; Brown LJ.; Tsatkin E.; Zelgowski B.; Nightingale V.,2012.0,10.1080/15299732.2011.641710,0,0,
9097,Soldiers' perceptions of resilience training and postdeployment adjustment: validation of a measure of resilience training content and training process.,"Group randomized trials of a resilience training program (formerly Battlemind training) demonstrated effectiveness of the program in reducing postdeployment adjustment problems among military personnel. These results are promising, but program evaluation is a dynamic, multifaceted task, and many questions remain. This article is designed to address one component of resilience training program evaluation: soldiers' perceptions of the training. Specifically, a self-report measure assessing attitudes and satisfaction in domains theorized to be important to resilience training was developed. This measure was administered to 782 soldiers who participated in a 1-hr resilience training session at 4-months postdeployment. Several mental health outcomes (e.g., alcohol problems, posttraumatic stress symptoms, physical health symptoms, unit morale) were assessed before training and 6 months later. Structural validity, internal consistency, concurrent validity, and predictive validity of the measure were examined. Analyses identified two factors reflecting attitudes toward Training Content and Training Process. The factors demonstrated good internal consistency, and both correlated with overall training satisfaction and mental health-related attitudes. In addition, both factors predicted significant positive change in a set of mental health outcomes at 6-month follow-up. Implications for postdeployment resilience training are discussed.",Foran HM.; Adler AB.; McGurk D.; Bliese PD.,2012.0,10.1037/a0028178,0,0,
9098,Training and consultation to promote implementation of an empirically supported treatment: a randomized trial.,"The study evaluated the efficacy of three training modalities and the impact of ongoing consultation after training. Cognitive-behavioral therapy (CBT) for anxiety among youths, an empirically supported treatment, was used as the exemplar. Participants were randomly assigned to one of three one-day workshops to examine the efficacy of training modality: routine training (training as usual), computer training (computerized version of training as usual), and augmented training (training that emphasized active learning). After training, all participants received three months of ongoing consultation that included case consultation, didactics, and problem solving. Participants were 115 community therapists (mean age of 35.9 years; 90% were women). Outcome measures included the Adherence and Skill Checklist, used to rate a performance-based role-play; a knowledge test; and the Training Satisfaction Rating Scale. All three training modalities resulted in limited gains in therapist adherence, skill, and knowledge. There was no significant effect of modality on adherence, skill, or knowledge from pretraining to posttraining. Participants were more satisfied with augmented and routine training than with computer training. Most important, number of consultation hours after training significantly predicted higher therapist adherence and skill at the three-month follow-up. The findings suggest that training alone did not result in therapist behavior change. The inclusion of ongoing consultation was critical to influencing therapist adherence and skill. Implications for implementation science and mental health services research are discussed.",Beidas RS.; Edmunds JM.; Marcus SC.; Kendall PC.,2012.0,10.1176/appi.ps.201100401,0,0,
9099,Intensive care diaries and relatives' symptoms of posttraumatic stress disorder after critical illness: a pilot study.,"Relatives of patients recovering from critical illness are at risk of developing posttraumatic stress disorder. To test whether providing a diary to intensive care patients and their relatives reduces the level of symptoms related to posttraumatic stress disorder in the relatives. Observational study of close family members of patients who stayed more than 72 hours in an intensive care unit, recruited in 2 centers of a 12-center randomized controlled trial examining the effect of a diary outlining the details of the patients' stay in the intensive care unit on the development of new-onset posttraumatic stress disorder in patients. The close family members of the patients were recruited to examine the additional effect of the provision of the patient's diary on the family members' symptoms related to posttraumatic stress syndrome. Thirty-six family members were recruited, and 30 completed the study. Family members of patients who received their diary at 1 month had lower levels of symptoms related to posttraumatic stress disorder (P = .03) at the 3-month follow-up than did the control family members. Provision of a diary may help psychological recovery in patients' families after critical illness.",Jones C.; Bäckman C.; Griffiths RD.,2012.0,10.4037/ajcc2012569,0,0,
9100,Randomized trial on the effectiveness of long- and short-term psychotherapy on psychiatric symptoms and working ability during a 5-year follow-up.,"The information on whether long-term psychotherapy is superior in comparison with short-term therapies during a long time-perspective in the treatment of mood and anxiety disorder is incomplete. The present study addresses this question in a clinical trial with an exceptionally long follow-up. In the Helsinki Psychotherapy Study, 326 outpatients with mood or anxiety disorder were randomly assigned to long-term psychodynamic psychotherapy and two types of short-term psychotherapy (short-term psychodynamic psychotherapy and solution-focused therapy) and were followed up for 5 years from the start of treatment. The outcome measures were psychiatric symptoms measured by Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), Symptom Check List, anxiety scale (SCL-90-Anx), Hamilton Anxiety Rating Scale (HARS) and Symptom Check List, Global Severity Index (SCL-90-GSI), and working ability measured by the Work Ability Index (WAI), the Work-subscale (SAS-Work) of the Social Adjustment Scale (SAS-SR) and the Perceived Psychological Functioning Scale (PPF). Furthermore, remission variables based on changes in psychiatric symptoms and use of auxiliary treatment, were used. After the 5-year follow-up, the rate of recovery from psychiatric symptoms and the work ability improvement rate remained higher in the long-term therapy group, whereas no differences in the effectiveness of the two short-term therapies of different modalities were found. Long-term psychotherapy is more effective than short-term therapy during a long follow-up, suggesting the need for a careful evaluation of suitability to short-term therapy. More research on the long-term effects of psychotherapy in large-scale studies is still needed, however.",Knekt P.; Lindfors O.; Sares-Jäske L.; Virtala E.; Härkänen T.,2013.0,10.3109/08039488.2012.680910,0,0,
9101,Involuntary memories after a positive film are dampened by a visuospatial task: unhelpful in depression but helpful in mania?,"Spontaneous negative mental images have been extensively researched due to the crucial role they play in conditions such as post-traumatic stress disorder. However, people can also experience spontaneous positive mental images, and these are little understood. Positive images may play a role in promoting healthy positive mood and may be lacking in conditions such as depression. However, they may also occur in problematic states of elevated mood, such as in bipolar disorder. Can we apply an understanding of spontaneous imagery gained by the study of spontaneous negative images to spontaneous positive images? In an analogue of the trauma film studies, 69 volunteers viewed an explicitly positive (rather than traumatic) film. Participants were randomly allocated post-film either to perform a visuospatial task (the computer game 'Tetris') or to a no-task control condition. Viewing the film enhanced positive mood and immediately post-film increased goal setting on a questionnaire measure. The film was successful in generating involuntary memories of specific scenes over the following week. As predicted, compared with the control condition, participants in the visuospatial task condition reported significantly fewer involuntary memories from the film in a diary over the subsequent week. Furthermore, scores on a recognition memory test at 1 week indicated an impairment in voluntary recall of the film in the visuospatial task condition. Clinical implications regarding the modulation of positive imagery after a positive emotional experience are discussed. Generally, boosting positive imagery may be a useful strategy for the recovery of depressed mood.",Davies C.; Malik A.; Pictet A.; Blackwell SE.; Holmes EA.,,10.1002/cpp.1800,0,0,6221
9102,"Cognitions, behaviours and co-morbid psychiatric diagnoses in patients with chronic fatigue syndrome.","Specific cognitions and behaviours are hypothesized to be important in maintaining chronic fatigue syndrome (CFS). Previous research has shown that a substantial proportion of CFS patients have co-morbid anxiety and/or depression. This study aims to measure the prevalence of specific cognitions and behaviours in patients with CFS and to determine their association with co-morbid anxiety or depression disorders. A total of 640 patients meeting Oxford criteria for CFS were recruited into a treatment trial (i.e. the PACE trial). Measures analysed were: the Cognitive Behavioural Response Questionnaire, the Chalder Fatigue Scale and the Work and Social Adjustment Scale. Anxiety and depression diagnoses were from the Structured Clinical Interview for DSM-IV. Multivariate analysis of variance was used to explore the associations between cognitive-behavioural factors in patients with and without co-morbid anxiety and/or depression. Of the total sample, 54% had a diagnosis of CFS and no depression or anxiety disorder, 14% had CFS and one anxiety disorder, 14% had CFS and depressive disorder and 18% had CFS and both depression and anxiety disorders. Cognitive and behavioural factors were associated with co-morbid diagnoses; however, some of the mean differences between groups were small. Beliefs about damage and symptom focussing were more frequent in patients with anxiety disorders while embarrassment and behavioural avoidance were more common in patients with depressive disorder. Cognitions and behaviours hypothesized to perpetuate CFS differed in patients with concomitant depression and anxiety. Cognitive behavioural treatments should be tailored appropriately.",Cella M.; White PD.; Sharpe M.; Chalder T.,2013.0,10.1017/S0033291712000979,0,0,
9103,A real-world study of the effectiveness of DBT in the UK National Health Service.,"Dialectical behavioral therapy (DBT) has gained widespread popularity as a treatment for borderline personality disorder (BPD), and its efficacy has been demonstrated in several trials. The aim of this study was to evaluate the effectiveness of DBT delivered by staff with a level of training readily achievable in National Health Service care settings for individuals with a Cluster B personality disorder. Randomized control trial methodology was used to compare DBT to treatment as usual (TAU). Forty-two participants entered the trial. Diagnostic and outcome measures were undertaken at assessment, at 6 months, and at 1 year. The clinical outcomes in routine evaluation--outcome measure (CORE-OM) were utilized as the primary outcome measure. Both the DBT and TAU groups improved on the range of measures employed. The DBT group showed a slightly greater decrease in CORE-OM risk scores, suicidality, and post-traumatic stress disorder symptom severity. However, the TAU group showed comparable reductions in all measures and a larger decrease in para-suicidal behaviours and risk. DBT may be an effective treatment delivered by community outpatient services for individuals with a Cluster B personality disorder. Further studies are needed to consider the impact of experience and adherence to DBT in improving outcome.",Feigenbaum JD.; Fonagy P.; Pilling S.; Jones A.; Wildgoose A.; Bebbington PE.,2012.0,10.1111/j.2044-8260.2011.02017.x,0,0,
9104,"An evaluation of the effectiveness and cost effectiveness of the National Exercise Referral Scheme in Wales, UK: a randomised controlled trial of a public health policy initiative.","The Wales National Exercise Referral Scheme (NERS) is a 16-week programme including motivational interviewing, goal setting and relapse prevention. A pragmatic randomised controlled trial with nested economic evaluation of 2160 inactive participants with coronary heart disease risk (CHD, 1559, 72%), mild to moderate depression, anxiety or stress (79, 4%) or both (522, 24%) randomised to receive (1) NERS or (2) normal care and brief written information. Outcome measures at 12 months included the 7-day physical activity recall, the hospital anxiety and depression scale. Ordinal regression identified increased physical activity among those randomised to NERS compared with those receiving normal care in all participants (OR 1.19, 95% CI 0.99 to 1.43), and among those referred for CHD only (OR 1.29, 95% CI 1.04 to 1.60). For those referred for mental health reason alone, or in combination with CHD, there were significantly lower levels of anxiety (-1.56, [corrected] 95% CI -2.75 to -0.38) and depression (-1.39, [corrected] 95% CI -2.60 to -0.18), but no effect on physical activity. The base-case incremental cost-effectiveness ratio was £12,111 per quality adjusted life year, falling to £9741 if participants were to contribute £2 per session. NERS was effective in increasing physical activity among those referred for CHD risk only. Among mental health referrals, NERS did not influence physical activity but was associated with reduced anxiety and depression. Effects were dependent on adherence. NERS is likely to be cost effective with respect to prevailing payer thresholds. Trial registration Current Controlled Trials ISRCTN47680448.",Murphy SM.; Edwards RT.; Williams N.; Raisanen L.; Moore G.; Linck P.; Hounsome N.; Din NU.; Moore L.,2012.0,10.1136/jech-2011-200689,0,0,
9105,"Subtypes in bulimia nervosa: the role of eating disorder symptomatology, negative affect, and interpersonal functioning.","The aim of the study was to investigate whether patients with bulimia nervosa (BN) could be subdivided into clinically meaningful groups reflecting the complex patterns of eating disorder symptoms and personality characteristics that face the clinician. Seventy patients diagnosed with BN using the Eating Disorder Examination were assessed with measures of negative affect, attachment patterns, and interpersonal problems. An exploratory hierarchical cluster analysis was performed. The study found two main subtypes differing primarily in terms of symptom severity and level of negative affect, but these subtypes were further subdivided into four clinically relevant subtypes: A dietary restraint/negative affect/high symptomatic group, an emotionally overcontrolled group, a low dietary restraint/emotionally underregulated group, and a high functioning/securely attached group. The study indicates that cluster-analytic studies, including a broad range of instruments measuring eating disorder symptoms as well as negative affect, relational patterns, and other personality characteristics, may contribute to an integration of previously suggested models of subtypes in BN.",Lunn S.; Poulsen S.; Daniel SI.,2012.0,10.1016/j.comppsych.2012.04.005,0,0,
9106,[EMDR and psychopharmacological therapy in the treatment of the post-traumatic stress disorder].,"This study evaluates the efficacy of two different treatment for post-traumatic stress disorder (PTSD): the psychopharmacological therapy, with a SSRI drug, and EMDR. Two indipendent groups have been administered two different treatments: the treatment with sertraline to the group for psychopharmacological therapy; the treatment with one-week sessions of EMDR to the other group. For the evaluation of the symptoms of PTSD has been used the Clinician-Administered PTSD Scale (CAPS). The inclusion of the subjects in the two groups has been absolutely random. The results confirm previous studies available in literature, pointing out the efficacy of EMDR and of sertraline in improving the post-traumatic symptomatology and the levels of subjective sufference. But the number of subjects which at the end of the study didn't satisfy any more the criteria for PTSD has been absolutely greater in the group treated with EMDR. The study confirms the hypothesis of EMDR as a more efficacious treatment for PTSD compared to psychopharmacological therapy. This result could be a stimolous for further research with greater groups to investigate also the long term efficacy.",Arnone R.; Orrico A.; D'aquino G.; Di Munzio W.,,10.1708/1071.11732,0,0,
9107,[Efficacy of a cognitive-behavioral group therapy in patients with fear of blushing].,"Cognitive behavioral therapy (CBT) has shown to be effective in the treatment of social anxiety disorders (SAD). However, fear of social blushing is almost never measured as a therapeutic outcome variable, even though some data suggest that this dimension constitutes a specific syndrome in social anxiety spectrum, justifying specific therapeutic strategies. For these reasons, we developed a group therapy program including a combination of task concentration training (TCT) and other CBT strategies targeting fear of blushing. We aimed to investigate the efficacy of this program in an open trial conducted in 55 patients suffering from SAD (Diagnostic and statistical manual of mental disorders IV criteria) with fear of blushing. Throughout a program including eleven weekly sessions, systematic measurements of fear of blushing and other anxiety and personality dimensions were performed at inclusion, at the end of the therapy and 3 months later, in order to explore the therapeutic effects of the program on fear of blushing, social anxiety, and other dimensions (Liebowitz social anxiety scale, blushing propensity questionnaire, Rathus assertiveness scale, Rosenberg self-esteem scale, Hospital anxiety and depression scale, Sheehan disability scale). The statistical analyses compared the scores of all measurements at inclusion, at the end of the therapy, and 6 months later. We also calculated the effect size obtained after treatment, and performed a logistic regression to determine the factors associated with a remission of fear of blushing after therapy. The main outcome criterion - the Salpêtrière fear of blushing questionnaire (SFBQ) score - was significantly reduced after treatment (P<0.001) and remained stable at follow up. A satisfying effect size was obtained on this score after treatment (1.7), and 57.6% of subjects were considered in remission on the basis of a SFBQ score of 6 or less. Other measurements of blushing propensity, social anxiety, assertiveness, self-esteem, anxiety, depression and disability showed significant improvement after treatment and reductions remained stable at 3-month follow-up. To be a female and to have a low SFBQ score at inclusion appeared as two independent predictors of good improvement. Despite the preliminary nature of this study, our results suggest the efficacy of this specific group therapy program for erythrophobia. Further controlled and comparative trials are now required to confirm the program efficacy including a comparison between group and individual therapies.",Lobjoie C.; Pélissolo A.,2012.0,10.1016/j.encep.2012.01.011,0,0,
9108,The Buried in Treasures Workshop: waitlist control trial of facilitated support groups for hoarding.,"Hoarding is a serious form of psychopathology that has been associated with significant health and safety concerns, as well as the source of social and economic burden (Tolin, Frost, Steketee, & Fitch, 2008; Tolin, Frost, Steketee, Gray, & Fitch, 2008). Recent developments in the treatment of hoarding have met with some success for both individual and group treatments. Nevertheless, the cost and limited accessibility of these treatments leave many hoarding sufferers without options for help. One alternative is support groups that require relatively few resources. Frost, Pekareva-Kochergina, and Maxner (2011) reported significant declines in hoarding symptoms following a non-professionally run 13-week support group (The Buried in Treasures [BIT] Workshop). The BIT Workshop is a highly structured and short term support group. The present study extended these findings by reporting on the results of a waitlist control trial of the BIT Workshop. Significant declines in all hoarding symptom measures were observed compared to a waitlist control. The treatment response rate for the BIT Workshop was similar to that obtained by previous individual and group treatment studies, despite its shorter length and lack of a trained therapist. The BIT Workshop may be an effective adjunct to cognitive behavior therapy for hoarding disorder, or an alternative when cognitive behavior therapy is inaccessible.",Frost RO.; Ruby D.; Shuer LJ.,2012.0,10.1016/j.brat.2012.08.004,0,0,
9109,Cannabis use vulnerability among socially anxious users: cannabis craving during a social interaction.,"Socially anxious individuals appear especially vulnerable to cannabis-related problems. However, the nature of the social anxiety-cannabis relation remains unclear. The present study examined the timing and specificity of cannabis craving in response to a social anxiety induction task among 82 (71% female) cannabis users randomly assigned to either a social interaction or reading task. Participants completed ratings of substance (cannabis, alcohol, cigarette) craving at baseline (prior to being informed of task assignment), before, during, and after task. The Time √ó Condition interaction was significant such that cannabis craving increased from before to during the task among participants in the social interaction condition, but not among those in the reading condition. This effect was specific to cannabis craving and was not observed for craving for alcohol or cigarettes. Data suggest that increases in state social anxiety may play a role in cannabis use behaviors.",Buckner JD.; Ecker AH.; Vinci C.,2013.0,10.1037/a0029763,0,0,
9110,"Ten-year follow-up of a prospective, randomized clinical study of mosaic osteochondral autologous transplantation versus microfracture for the treatment of osteochondral defects in the knee joint of athletes.","Various techniques have proven to be effective for treating articular cartilage defect (ACD) and osteochondral defect (OCD) of the knee joint, but knowledge regarding which method is best still remains uncertain. To evaluate and compare the outcomes of mosaic-type osteochondral autologous transplantation (OAT) and microfracture (MF) procedures for the treatment of articular cartilage defects of the knee joint in young active athletes. This article represents an update of the clinical results at 10 years. Randomized controlled trial; Level of evidence, 1. Between 1998 and 2002, a total of 60 athletes with a mean age of 24.3 years (range, 15-40 years) and with a symptomatic ACD or OCD in the knee were randomized to undergo either OAT or MF. Patients were then evaluated postoperatively using the International Cartilage Repair Society (ICRS) score, Tegner activity score, radiographs, and magnetic resonance imaging. The mean follow-up time was 10.4 years (range, 9-11 years). Three to 10 years after the OAT and MF procedures, patients had lower ICRS and Tegner scores (P < .05), but both groups still had significant clinical improvement over presurgery scores according to ICRS scores at 10-year follow-up. Statistically significantly better results were detected in patients in the OAT group compared with those in the MF group at 10 years (P < .005). At 10-year follow-up, there were 15 failures (26%), including 4 failures (14%) of the OAT and 11 failures (38%) of MF treatment (P < .05). Seven patients (25%) from the OAT group and 14 patients (48%) from the MF group had radiographic evidence of Kellgren-Lawrence grade I osteoarthritis at 10 years, but these differences were not significant (P = .083) or related to the clinical results. The ICRS and Tegner scores of younger athletes (<25 years at the time of primary surgery) remained significantly higher after 10 years compared with older patients (P < .05); 15 of 20 patients (75%) in the OAT group and 8 of 22 patients (37%) in the MF group maintained the same physical activity level. The OAT technique for ACD or OCD repair in the athletic population allows for a higher rate of return to and maintenance of sports at the preinjury level compared with MF.",Gudas R.; Gudaite A.; Pocius A.; Gudiene A.; Cekanauskas E.; Monastyreckiene E.; Basevicius A.,2012.0,10.1177/0363546512458763,0,0,
9111,Healing Touch with Guided Imagery for PTSD in returning active duty military: a randomized controlled trial.,"Post-traumatic stress disorder (PTSD) remains a significant problem in returning military and warrants swift and effective treatment. We conducted a randomized controlled trial to determine whether a complementary medicine intervention (Healing Touch with Guided Imagery [HT+GI]) reduced PTSD symptoms as compared to treatment as usual (TAU) returning combat-exposed active duty military with significant PTSD symptoms. Active duty military (n = 123) were randomized to 6 sessions (within 3 weeks) of HT+GI vs. TAU. The primary outcome was PTSD symptoms; secondary outcomes were depression, quality of life, and hostility. Repeated measures analysis of covariance with intent-to-treat analyses revealed statistically and clinically significant reduction in PTSD symptoms (p < 0.0005, Cohen's d = 0.85) as well as depression (p < 0.0005, Cohen's d = 0.70) for HT+GI vs. TAU. HT+GI also showed significant improvements in mental quality of life (p = 0.002, Cohen's d = 0.58) and cynicism (p = 0.001, Cohen's d = 0.49) vs. TAU. Participation in a complementary medicine intervention resulted in a clinically significant reduction in PTSD and related symptoms in a returning, combat-exposed active duty military population. Further investigation of GT and biofield therapy approaches for mitigating PTSD in military populations is warranted.",Jain S.; McMahon GF.; Hasen P.; Kozub MP.; Porter V.; King R.; Guarneri EM.,2012.0,,0,0,
9112,Computer-assisted total knee arthroplasty after prior femoral fracture without hardware removal.,"This study presents a consecutive series of patients who underwent total knee arthroplasty (TKA) after prior distal femoral fracture without hardware removal. The purpose of this study was to determine the effectiveness of computer-assisted TKA in patients with posttraumatic arthritis, specifically those with retained hardware after prior distal femoral fracture. The study group included a consecutive series of 16 patients who had developed posttraumatic knee arthritis after a distal femoral fracture with retention of hardware (group A). Patients in the study group were matched with patients who had undergone a computer-assisted TKA using the same implant and software (group B). The indication for TKA in all group B patients was atraumatic arthritis, and surgery was performed during the same period as that in the study group. Patients were matched for age, sex, preoperative range of motion, preoperative severity of arthritis, type and grade of deformity, and implant features. No statistically significant differences existed between the 2 study groups in terms of operative time, duration of hospital stay, or intra- and postoperative complications. At last follow-up, no statistically significant differences existed in Knee Society Scores and Western Ontario and McMaster Universities Arthritis Index scores. Implant alignment and radiological parameters were similar in both groups. This study demonstrated that posttraumatic knee arthritis after prior distal femoral fracture can be safely managed using a computer-assisted TKA without hardware removal. Comparison between the study group and a matched group with atraumatic arthritis showed similar postoperative results and complication rates.",Manzotti A.; Chemello C.; Pullen C.; Cerveri P.; Confalonieri N.,2012.0,10.3928/01477447-20120919-55,0,0,
9113,"A pilot randomized controlled trial of a brief early intervention for reducing posttraumatic stress disorder, anxiety and depressive symptoms in newly diagnosed head and neck cancer patients.","Head and neck cancer (HNC) patients have a high incidence of cancer-related posttraumatic stress disorder (PTSD) and other anxiety and depressive disorders. We report the results from the first pilot randomized controlled trial in which the efficacy of an early cognitive-behavioral therapy (CBT) program was compared with a non-directive supportive counseling (SC) intervention in reducing PTSD, general anxiety and depressive symptoms, and improving perceived quality of life in newly diagnosed, distressed HNC patients undergoing radiotherapy. Thirty-five HNC patients (mean age=54.8 years; 80% males) with elevated levels of PTSD, depression or anxiety were randomized to seven individual sessions of a multi-modal CBT or non-directive SC, concurrent with patients' radiotherapy. The SC intervention provided non-directive counseling support. PTSD, anxiety and depressive symptoms (primary outcomes), and cancer-related appraisals and quality of life (secondary outcomes) were assessed pre-intervention (baseline), 1 month, 6 months and 12 months post-intervention by diagnostic clinical interviews and validated self-report questionnaires. The CBT and SC interventions were found to be equal in their effects in reducing PTSD and anxiety symptoms both in the short and longer term. However, up to 67% of patients in the CBT program no longer met clinical or sub-clinical PTSD, anxiety and/or depression by 12 months post-treatment compared with 25% of patients who received SC. Findings indicate that the early provision of psychotherapy has utility in reducing PTSD, anxiety and depressive symptoms, and preventing chronic psychopathology in distressed HNC patients.",Kangas M.; Milross C.; Taylor A.; Bryant RA.,2013.0,10.1002/pon.3208,0,0,
9114,Long-term follow-up of a randomized controlled trial comparing acceptance and commitment therapy and standard cognitive behavior therapy for anxiety and depression.,"The present study represents one of the first comparisons of the long-term effectiveness of traditional cognitive behavior therapy (i.e., Beckian cognitive therapy; CT) and acceptance and commitment therapy (ACT). One hundred thirty-two anxious or depressed outpatients were randomly assigned to receive either CT or ACT, and were assessed at posttreatment (n=90) and at 1.5-year (n=91) follow-up. As previously reported, the two treatments were equivalently effective at posttreatment according to measures of depression, anxiety, overall (social/occupational/symptom-related) functioning, and quality of life. However, current results suggest that treatment gains were better maintained at follow-up in the CT condition. Clinical significance analyses revealed that, at follow-up, one-third more CT patients were in the clinically normative range in terms of depressive symptoms and more than twice as many CT patients were in the normative range in terms of functioning levels. The possible long-term advantage of CT relative to ACT in this population is discussed.",Forman EM.; Shaw JA.; Goetter EM.; Herbert JD.; Park JA.; Yuen EK.,2012.0,10.1016/j.beth.2012.04.004,0,0,
9115,An investigation of the efficacy of online expressive writing for trauma-related psychological distress in Hispanic individuals.,"This study compared the efficacy of 2 online expressive writing protocols for a traumatic/stressful life event in a Hispanic student sample. Participants who had reported a traumatic event were randomly assigned to either the emotion-focused group or the fact-focused group. The emotion-focused group focused their written accounts on emotions and feelings as well as facts about a stressful/traumatic experience, whereas the fact-focused group focused on facts of a stressful/traumatic event. Both groups completed 3 online writing sessions scheduled for 3 consecutive days, a 1-week online follow-up assessment, and a 5-week online follow-up assessment. Both groups statistically significantly reduced trauma symptoms over time with the emotion-focused group demonstrating statistically significantly greater trauma symptom reductions than the fact-focused group at the 5-week follow-up assessment.",Hirai M.; Skidmore ST.; Clum GA.; Dolma S.,2012.0,10.1016/j.beth.2012.04.006,0,0,
9116,Cognitive processing therapy versus supportive counseling for acute stress disorder following assault: a randomized pilot trial.,"The study tested the efficacy and tolerability of cognitive processing therapy (CPT) for survivors of assault with acute stress disorder. Participants (N=30) were randomly allocated to CPT or supportive counseling. Therapy comprised six individual weekly sessions of 90-min duration. Independent diagnostic assessment for PTSD was conducted at posttreatment. Participants completed self-report measures of posttraumatic stress, depression, and negative trauma-related beliefs at pre-, posttreatment, and 6-month follow-up. Results indicated that both interventions were successful in reducing symptoms at posttreatment with no statistical difference between the two; within and between-group effect sizes and the proportion of participants not meeting PTSD criteria was greater in CPT. Treatment gains were maintained for both groups at 6-month follow-up.",Nixon RD.,2012.0,10.1016/j.beth.2012.05.001,0,0,
9117,"Exposure therapy, D-cycloserine, and functional magnetic resonance imaging in patients with snake phobia: a randomized pilot study.","d-Cycloserine may enhance fear extinction. The effects of d-cycloserine on human brain function are not well understood, with findings suggesting that d-cycloserine could augment exposure therapy via its effects on the neural substrates of emotional learning and extinction or by acting upon different neural pathways. The aim of this exploratory study was to investigate differences in neural response in patients receiving d-cycloserine or placebo in addition to exposure therapy. Twenty adults with snake phobia (DSM-IV specific phobia) received 50 mg of d-cycloserine or placebo (double-blind, randomized) 1 hour prior to a single session of graded exposure therapy in an outpatient specialty clinic. One week before and after treatment, patients completed a clinical examination and snake-stimuli symptom provocation functional magnetic resonance imaging (fMRI) task (primary outcome measure). The d-cycloserine and placebo groups responded equally well to treatment, although the d-cycloserine patients reached the top of the exposure hierarchy more quickly (t = 2.61, P < .05). Only right dorsolateral prefrontal cortex showed an equivalent decrease in hyperactivation to snake stimuli in both groups. Compared to placebo, d-cycloserine augmentation resulted in different ventromedial prefrontal brain activation during processing of phobic stimuli, including enhanced medial orbitofrontal (F = 11.52, P = .001) and subgenual anterior cingulate activation (F = 7.41, P = .008) and normalized perigenual cingulate ""deactivation"" (F = 3.85, P = .05) to snakes. A single administration of d-cycloserine combined with exposure therapy can lead to lasting changes in ventromedial and other prefrontal cortex response to phobic stimuli. These changes are qualitatively different from those seen in patients receiving exposure therapy without d-cycloserine. ClinicalTrials.gov identifier: NCT01450306.",Nave AM.; Tolin DF.; Stevens MC.,2012.0,10.4088/JCP.11m07564,0,0,
9118,Mindfulness-based stress reduction in breast cancer: a qualitative analysis.,"There have been few qualitative investigations evaluating Mindfulness-Based Stress Reduction (MBSR) in breast cancer populations. The nested qualitative analysis reported here explores the acceptability and the perceived effect of MBSR. As part of a larger randomised controlled evaluative trial, 92 participants with stages 0 to III breast cancer completed a short proforma following week 8 of a MBSR programme conducted at The Haven, an integrated cancer support centre in London, UK in 2005-2006. Following thematic analysis, the most positive experiences from participants (n = 92) were reported to be; 1) being calmer, centred, at peace, connected and more confident; 2) the value of mindfulness practice; 3) being more aware; 4) coping with stress, anxiety and panic; 5) accepting things as they are, being less judgemental of myself and others; 6) improved communication and personal relationships and 7) making time and creating space for myself. All participants asked (n = 39) said that following MBSR training they had become more mindful. These understandings will be able to help shape the future teaching of MBSR in breast cancer.",Hoffman CJ.; Ersser SJ.; Hopkinson JB.,2012.0,10.1016/j.ctcp.2012.06.008,0,0,
9119,"A neurophysiological insight into the potential link between transcranial magnetic stimulation, thalamocortical dysrhythmia and neuropsychiatric disorders.","Altered neural oscillations and their abnormal synchronization are crucial factors in the pathophysiology of several neuropsychiatric disorders. There is increasing evidence that the perturbation with an abnormal increase of spontaneous thalamocortical neural oscillations lead to a phenomenon termed Thalamocortical dysrhythmia (TCD) which underlies the symptomatology of a variety of neurological and psychiatric disorders including Parkinson's disease, schizophrenia, epilepsy, neuropathic pain, tinnitus, major depression and obsessive-compulsive disorder. In addition, repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neurophysiological tool that has been shown to both induce a modulation of neural oscillations and alleviate a wide range of human neuropsychiatric pathologies. However, little is known about the precise electrophysiological mechanisms behind the therapeutic effect of rTMS and its potential to improve abnormal oscillations across diverse neuropsychiatric disorders. Here we show, using combined rTMS and surface electroencephalography (EEG), a short lasting frequency-dependent rTMS after-effect on thalamocortical rhythmic interplay of low-frequency oscillations in healthy humans at rest. In particular, high-frequency rTMS (10 Hz) induces a transient synchronised activity for delta (δ) and theta (θ) rhythms thus mimicking the pathological TCD-like oscillations. In contrast, rTMS 1 and 5 Hz have the opposite outcome of de-synchronising low-frequency brain rhythms. These results lead to a new neurophysiological insight of basic mechanisms underlying neurological and psychiatric disorders and a probable electrophysiological mechanism underlying the therapeutic effects of rTMS. Thus, we propose the use of rTMS and EEG as a platform to test possible treatments of TCD phenotypes by restoring proper neural oscillations across various neuropsychiatric disorders.",Fuggetta G.; Noh NA.,2013.0,10.1016/j.expneurol.2012.10.010,0,0,
9120,Home-based functional exercises aimed at managing kinesiophobia contribute to improving disability and quality of life of patients undergoing total knee arthroplasty: a randomized controlled trial.,"To compare the improvement in disability, kinesiophobia, pain, and quality of life obtained by means of home-based functional exercises aimed at managing kinesiophobia with that obtained by giving subjects undergoing total knee arthroplasty (TKA) advice to stay active after discharge from a rehabilitation unit. Randomized controlled trial with 6-months' follow-up. Patients' homes. Patients (N=110; 40 men; mean age, 67y) at the end of a 15-day period of in-hospital rehabilitation after undergoing primary TKA. In the experimental group, before returning home, the patients were asked to continue the functional exercises learned during hospitalization in twice-weekly 60-minute sessions for 6 months, and were given a book containing theoretical information about the management of kinesiophobia. In the control group, the patients were advised to stay active and gradually recover their usual activities. Repeated-measures analysis of covariance with baseline values as the covariates (P<.05) was used to assess the effect of treatment on disability, fear-avoidance beliefs, pain intensity, and quality of life. The analysis revealed a significant time by group interaction in all the variables in favor of the experimental group. Post hoc analysis showed that the effect of the group was statistically significant at the end of home training and follow-up. The treatment effect was clinically tangible in terms of disability and quality of life, and persisted for 6 months after the intervention ended. A home-based program based on functional exercises and the management of kinesiophobia was useful in changing the course of disability, fear-avoidance beliefs, pain, and the quality of life in patients with TKA.",Monticone M.; Ferrante S.; Rocca B.; Salvaderi S.; Fiorentini R.; Restelli M.; Foti C.,2013.0,10.1016/j.apmr.2012.10.003,0,0,
9121,Changes in posttraumatic stress disorder and depressive symptoms during cognitive processing therapy: evidence for concurrent change.,"Trauma-focused psychotherapies reduce both posttraumatic stress disorder (PTSD) and co-occurring depression. However, little is known about the relationship between changes in PTSD and depression during treatment. This study examined the association between changes in PTSD and depression during the course of cognitive processing therapy (CPT) and its treatment components. Data were drawn from a dismantling trial investigating the comparative efficacy of the components of CPT (Resick, Galovski, et al., 2008). One hundred twenty-six women (mean age = 36.14 years) from the original randomized intent-to-treat sample (N = 150) who attended at least 1 treatment session were included in this study. Participants diagnosed with PTSD were assigned to 1 of 3 treatment conditions: the full CPT protocol (n = 44), the cognitive therapy component of CPT (n = 39), and the written account component of CPT (n = 43). The majority of the sample self-identified as Caucasian (67%; 29% African American and 4% Other). Primary outcome measures included the Posttraumatic Diagnostic Scale and Beck Depression Inventory-II, administered at 8 time points (baseline, weekly throughout 6 weeks of treatment, and posttreatment). Multilevel regression analyses were conducted to examine relationships between PTSD and depression during treatment. Results indicated that changes in PTSD and depression were strongly related. Multilevel mediation analyses revealed that changes in PTSD and depression occurred concurrently, with lagged analyses providing no evidence that changes in symptoms of 1 disorder preceded changes in the other. Results suggest that changes in PTSD and depression occur contemporaneously during CPT.",Liverant GI.; Suvak MK.; Pineles SL.; Resick PA.,2012.0,10.1037/a0030485,0,0,
9122,"The relationships among heart rate variability, executive functions, and clinical variables in patients with panic disorder.","Heart rate variability (HRV) is reduced in patients who suffer from panic disorder (PD). Reduced HRV is related to hypoactivity in the prefrontal cortex (PFC), which negatively affects executive functioning. The present study assessed the relationships between vagally mediated HRV at baseline and measures of executive functioning in 36 patients with PD. Associations between these physiological and cognitive measures and panic-related variables were also investigated. HRV was measured using HF-power (ms(2)), and executive functions were assessed with the Wisconsin Card Sorting Test (WCST) and the Color-Word Interference Test (CWIT) from the Delis-Kaplan Executive Function System (D-KEFS). Panic-related variables comprised panic frequency, panic-related distress, and duration of PD. Performance on the neuropsychological measures correlated significantly with HRV. Both panic-related distress and duration of PD were inversely related with measures of HRV and cognitive inhibition. The current findings support the purported relationship between HRV and executive functions involving the PFC.",Hovland A.; Pallesen S.; Hammar √Ö.; Hansen AL.; Thayer JF.; Tarvainen MP.; Nordhus IH.,2012.0,10.1016/j.ijpsycho.2012.10.004,0,0,
9123,Treatment specific competence predicts outcome in cognitive therapy for social anxiety disorder.,"Several studies have demonstrated a positive relationship between competence and outcome in CBT for depression but studies of CBT for anxiety disorders are lacking. The present study explores the relationship between competence and outcome in cognitive therapy (CT) for social anxiety disorder, using hierarchical linear modeling analyses (HLM). Data were drawn from a multicenter randomized controlled trial. Five trained raters evaluated videotapes of two therapy sessions per patient using the Cognitive Therapy Competence Scale for Social Phobia (CTCS-SP). Overall adherence to the treatment manual and patient difficulty were also assessed. Patient outcome was rated by other assessors using the Clinical Global Impression Improvement Scale (CGI-I) and the Liebowitz Social Anxiety Scale (LSAS). Results indicated that competence significantly predicted patient outcome on the CGI-I (β = .79) and LSAS (β = .59). Patient difficulty and adherence did not further improve prediction. The findings support the view that competence influences outcome and should be a focus of training programs. Further research is needed to compare different ways of assessing competence and to understand the complex relationships between competence and other therapy factors that are likely to influence outcome.",Ginzburg DM.; Bohn C.; Höfling V.; Weck F.; Clark DM.; Stangier U.,2012.0,10.1016/j.brat.2012.09.001,0,0,
9124,[The role of hyperlaxity in open stabilisation of post-traumatic shoulder instability].,"Chronic post-traumatic shoulder instabilities as well as post-traumatic shoulder instabilities in association with joint laxity are accepted reasons for open capsular shift and labral refixation. However, it remains unclear whether hyperlaxity influences clinical outcome and reluxation rates. A total of 60 patients (48 men and 12 women) with diagnosed post-traumatic anterior glenohumeral instability were included in the study. Average follow-up was 3.6 ± 0.2 years (median 3.1 years, minimum 2 years, maximum 8 years). 37 patients (61 %) had a joint hyperlaxity grade II or more. In 77 % of the cases glenoid osseus defects were observed (< 20 % of the glenoid fossa). Three cases of shoulder dislocations (5 %) recurred after surgery, following a massive trauma during sports activities. One patient was excluded from the study due to other reasons. The average Rowe scores were 88.7 points. No significant differences were observed between patients with and without concomitant hyperlaxity. From 56 patients without postoperative redislocations 55.2 % had a very good, 34 % a good, and 10.3 % a satisfactory result (Rowe score). The relative constant score and force measurement values were significantly lower in hyperlax shoulders. The average loss of external rotation was 3.9 degrees with the arm at the side and 11 degrees with the arm in 90 degrees of abduction. Our study shows that hyperlaxity does not lead to a higher redislocation rate following open anatomic refixation of the capsule-labrum complex in combination with a capsular shift.",Heers G.; Müller H.; Hedtmann A.,2012.0,10.1055/s-0032-1315269,0,0,
9125,Pilot randomized trial of a cross-diagnosis collaborative care program for patients with mood disorders.,"Chronic care models improved outcomes for persons with mental disorders but to date have primarily been tested for single diagnoses (e.g. unipolar depression). We report findings from a pilot multisite randomized controlled trial of a cross-diagnosis care model for patients with mood disorders. Patients (N = 60) seen in one of four primary care or mental health clinics affiliated with the National Network of Depression Centers were randomized to receive a mood disorder care model, Life Goals Collaborative Care (LGCC, N = 29) or usual care (N = 31). LGCC consisted of five group self-management sessions focused on mood symptom coping and health behavior change strategies followed by monthly patient and provider care management contacts for up to 6 months. Outcomes at 3 and 6 months included mood symptoms (Patient Health Questionnaire-PHQ-9, Internal State Scale-well-being, Generalized Anxiety Disorder scale) and health-related quality of life. Of the 60 enrolled, the mean age was 46.2 (SD = 13.2), 73.3% were female, 16.7% were non-white, and 36.8% had a bipolar disorder diagnosis. LGCC was associated with greater likelihood of depressive symptom remission in 6 months (respectively, 50% versus 19% had a PHQ-9 score ≤9 and 50% reduction in PHQ-9 score, P = .04) and improved well-being (β = 2.66, P ≤ .01, Cohen's D = 0.43). LGCC may improve outcomes for patients regardless of mood diagnosis, potentially providing a feasible and generalizable chronic care model for routine practice settings.",Kilbourne AM.; Li D.; Lai Z.; Waxmonsky J.; Ketter T.,2013.0,10.1002/da.22003,0,0,
9126,A pilot randomized controlled trial of an early multidisciplinary model to prevent disability following traumatic injury.,"Chronic pain, posttraumatic stress disorder (PTSD), and depression are common outcomes following traumatic injury. Yet, screening and early intervention to prevent the onset of these disorders do not occur routinely in acute trauma settings. This pilot study examined the clinical utility of screening and early multidisciplinary intervention for reducing disability following traumatic injury. 142 non-severe head injured trauma inpatients (26% female, Injury Severity Score M = 9.65, M age = 36 years) were assessed for injury-related factors, pain, and psychological function within 4 weeks post injury. Patients were randomly allocated to a Multidisciplinary Intervention (MI) or Usual Care (UC) group. MI patients received assessment and treatment at one and 3 months post injury from pain and rehabilitation medicine doctors, physiotherapists, occupational therapists, and clinical psychologists. Outcomes at 6 months were then compared. Acute pain intensity, posttraumatic adjustment, depression and acute trauma symptoms, and alcohol use predicted a significant 26%, 49%, 56%, and 30% of the variance in pain, depressive, and PTSD severity, and physical mobility respectively at 6 months. Despite MI group patients reporting no improvement in the severity of pain and psychological symptoms, these patients reported significantly improved relief from pain symptoms as a result of treatment at 6 months. Twenty four per cent of the UC group initially below the cut-off for being at risk of developing PTSD/Depression received new clinical diagnoses at 6 months compared with none of the 'not at risk' MI group attendees who remained asymptomatic. Early findings point to the value of early screening to identify patients at risk of treatable pain, physical, and psychological impairments. Moreover, early multidisciplinary intervention models following traumatic injury show promise for protecting against the onset of posttraumatic psychological disorders.",Browne AL.; Appleton S.; Fong K.; Wood F.; Coll F.; de Munck S.; Newnham E.; Schug SA.,2013.0,10.3109/09638288.2012.721047,0,0,
9127,"The ""Arnold Schwarzenegger Effect"": is strength of the ""victim"" related to misinterpretations of harm intrusions?","The present study used an in vivo paradigm to examine whether the victim's vulnerability in a harm-related intrusion affects beliefs about the importance of thoughts (i.e., Thought Action Fusion; TAF). Sixty-six undergraduate students at a large university were randomly assigned to imagine either a vulnerable (e.g., elderly man) or able-bodied individual (e.g., strong youthful male) they know getting into a car accident and provided in vivo ratings of anxiety, guilt, likelihood, moral wrongness, and urges to neutralize. Results indicated that thinking of car accident involving a vulnerable, compared to an able-bodied person, provoked more distress (anxiety and guilt), stronger feelings of moral wrongness, greater urges to cancel the effects of thinking such thoughts, and higher estimates of the likelihood that the collision would occur. The findings of our study broadly support Rachman's (1998) assertion that more significance and importance is attached to negative thoughts about vulnerable or helpless people. Current findings are discussed in terms of the cognitive-behavioral model of obsessions and clinical implications are addressed.",Berman NC.; Wheaton MG.; Abramowitz JS.,2012.0,10.1016/j.brat.2012.09.002,0,0,
9128,Therapy for couples after an affair: a randomized-controlled trial.,"To examine the efficacy of a couples treatment approach for promoting recovery from a recently disclosed affair, 89 couples that disclosed an affair by one of the partners in the past 6 months were randomly assigned to treatment (n = 46) or to a control group that waited about 3 months for treatment (n = 43). The couples completed self-report measures (Beck Depression Inventory, Impact of Event Scale-Revised, Partnership Questionnaire) at pre- and post-treatment. Since about half of the couples dropped out for various reasons (e.g., ongoing affair, separation), we used multiple imputations to handle the missing data problem. We analyzed the dyadic data with hierarchical linear modeling in a two-level model. Significant improvements on scores of anxiety corresponded with large effect sizes for both partners. Yet significant improvements on depression scores were only found for the unfaithful partner with moderate effect size. Results suggest that the treatment can improve individual complaints, but not relationship satisfaction in a sufficient amount for both partners. Hence, future research should address how this intervention could encourage couples to maintain therapy, and how they might achieve more and sustained improvement in relationship satisfaction.",Kröger C.; Reißner T.; Vasterling I.; Schütz K.; Kliem S.,2012.0,10.1016/j.brat.2012.09.006,0,0,
9129,Clinical predictors of long-term outcome in obsessive-compulsive disorder.,"The purpose of this study was to investigate demographic and clinical factors associated with the long-term outcome of obsessive-compulsive disorder (OCD). A hundred ninety-six previously untreated patients with DSM-IV criteria OCD completed a 12-week randomized open trial of group cognitive-behavioral therapy (GCBT) or fluoxetine, followed by 21 months of individualized, uncontrolled treatment, according to international guidelines for OCD treatment. OCD severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) at different times over the follow-up period. Demographics and several clinical variables were assessed at baseline. Fifty percent of subjects improved at least 35% from baseline, and 21.3% responded fully (final Y-BOCS score < or = 8). Worse prognosis was associated with earlier age at onset of OCD (P = 0.045), longer duration of illness (P = 0.001) presence of at least one comorbid psychiatric disorder (P = 0.001), comorbidity with a mood disorder (P = 0.002), higher baseline Beck-Depression scores (P = 0.011), positive family history of tics (P = 0.008), and positive family history of anxiety disorders (P = 0.008). Type of initial treatment was not associated with long-term outcome. After correction for multiple testing, the presence of at least one comorbid disorder, the presence of a depressive disorder, and duration of OCD remained significant. Patients under cognitive-behavioral or pharmacological treatment improved continuously in the long run, regardless of initial treatment modality or degree of early response, suggesting that OCD patients benefit from continuous treatment. Psychiatric comorbidity, especially depressive disorders, may impair the long-term outcome of OCD patients.",Jakubovski E.; Diniz JB.; Valerio C.; Fossaluza V.; Belotto-Silva C.; Gorenstein C.; Miguel E.; Shavitt RG.,2013.0,10.1002/da.22013,0,0,
9130,Mindfulness-based cognitive therapy in obsessive-compulsive disorder - a qualitative study on patients' experiences.,"Cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) is the first-line treatment for patients with obsessive-compulsive disorder (OCD). However, not all of them achieve remission on a longterm basis. Mindfulness-based cognitive therapy (MBCT) represents a new 8-week group therapy program whose effectiveness has been demonstrated in various mental disorders, but has not yet been applied to patients with OCD. The present pilot study aimed to qualitatively assess the subjective experiences of patients with OCD who participated in MBCT. Semi-structured interviews were conducted with 12 patients suffering from OCD directly after 8 sessions of a weekly MBCT group program. Data were analyzed using a qualitative content analysis. Participants valued the treatment as helpful in dealing with their OCD and OCD-related problems. Two thirds of the patients reported a decline in OCD symptoms. Benefits included an increased ability to let unpleasant emotions surface and to live more consciously in the present. However, participants also discussed several problems. The data provide preliminary evidence that patients with OCD find aspects of the current MBCT protocol acceptable and beneficial. The authors suggest to further explore MBCT as a complementary treatment strategy for OCD.",Hertenstein E.; Rose N.; Voderholzer U.; Heidenreich T.; Nissen C.; Thiel N.; Herbst N.; Külz AK.,2012.0,10.1186/1471-244X-12-185,0,0,
9131,Psychological predictors of the recovery from mood or anxiety disorder in short-term and long-term psychotherapy during a 3-year follow-up.,"Choice of optimal treatment length for psychiatric patients requires knowledge about the patients' pre-treatment suitability. This study compares the prediction of seven psychological suitability measures on changes in psychiatric symptoms in short- and long-term psychotherapy over a 3-year follow-up. The psychological suitability of 326 outpatients from the Helsinki Psychotherapy Study, aged 20-46 years, and suffering from mood or anxiety disorders, was assessed at baseline using the Suitability for Psychotherapy Scale (SPS) before randomly assigning them to solution-focused therapy, short-term or long-term psychodynamic psychotherapy. Psychiatric symptoms (Symptom Checklist-90 Global Severity Index) were assessed at baseline and seven times during follow-up. Three patient groups with different prognosis were found when a cumulative SPS score, summing up the values of the seven single suitability measures, was used to predict symptom development: patients with more good (4 or more) than poor values benefited more from short-term therapy, patients with more poor (4-6) than good values benefited more from long-term therapy, and patients with all seven values poor failed to benefit from either short- or long-term therapy. The SPS can apparently be applied before the start of treatment to predict the amount of therapy patients need to recover, although its suitability in therapies of different types needs to be confirmed.",Laaksonen MA.; Knekt P.; Lindfors O.,2013.0,10.1016/j.psychres.2012.09.053,0,0,
9132,The effectiveness of solution-focused therapy and short- and long-term psychodynamic psychotherapy on self-concept during a 3-year follow-up.,"This study compares the effectiveness of solution-focused therapy (SFT) and short- and long-term psychodynamic psychotherapy (SPP and LPP) on self-concept during a 3-year follow-up. Altogether, 326 patients with mood or anxiety disorder were randomized to SFT, SPP, and LPP in the Helsinki Psychotherapy Study. Outcome was assessed using the Structural Analysis of Social Behavior questionnaire at baseline and 7, 12, 24, and 36 months after. Overall, during the first year of follow-up, self-concept improved more in both SFT and SPP than in LPP, indicated by the primary outcome indicators self-directed affiliation (AF) and self-directed autonomy, as well as by most of the eight secondary cluster scores. After the 3-year follow-up, LPP was more effective than SFT in AF and in the cluster scores self-affirm, self-blame, and self-neglect, whereas no difference was noted between LPP and SPP. Long duration and psychodynamic orientation of therapy may be beneficial for self-concept improvement.",Lindfors O.; Knekt P.; Virtala E.; Laaksonen MA.;  .,2012.0,10.1097/NMD.0b013e3182718c6b,0,0,
9133,Guided Internet-delivered cognitive behavioural therapy for chronic pain patients who have residual symptoms after rehabilitation treatment: randomized controlled trial.,"Chronic pain can be treated with cognitive behavioural therapy delivered in multidisciplinary settings. However, relapse is likely, and there is a need for cost-effective secondary interventions for persons with residual problems after rehabilitation. The aim of the present study was to investigate the effects of a guided Internet-delivered cognitive behavioural intervention for patients who had completed multidisciplinary treatment at a pain management unit. A total of 72 persons with residual pain problems were included in the study and were randomized to either treatment for 8 weeks or to a control group who were invited to participate in a moderated online discussion forum. The participants had different chronic pain conditions, and a majority were women (72%). Twenty-two percent of the participants dropped out of the study before the post-treatment assessment. Intent-to-treat analyses demonstrated differences on the catastrophizing subscale of the Coping Strategies Questionnaire (Cohen's d = 0.70), in favour of the treatment group but a small within-group effect. Differences were also found on other measures of pain-related distress, anxiety and depressive symptoms. A 6-month follow-up exhibited maintenance of improvements. We conclude that Internet-delivered treatment can be partly effective for persons with residual problems after completed pain rehabilitation.",Buhrman M.; Fredriksson A.; Edström G.; Shafiei D.; Tärnqvist C.; Ljótsson B.; Hursti T.; Gordh T.; Andersson G.,2013.0,10.1002/j.1532-2149.2012.00244.x,0,0,
9134,Citalopram versus psychological training for depression and anxiety symptoms in hemodialysis patients.,"This study was designed to compare an antidepressant medication, citalopram, with psychological training in hemodialysis patients with symptoms of anxiety and depression. A total number of 44 hemodialysis patients scored 8 and more on the Hospital Anxiety and Depression Scale (HADS) were randomly allocated to two groups to receive citalopram, 20 mg/d, for 3 months or to attend 6 sessions of 1-hour psychological training. A nephrologist and a senior psychiatry resident were responsible for training of the patients, which contained explaining the anatomy of the kidneys, causes of kidney failure, treatment modalities, the mechanism involved in hemodialysis, the required care in hemodialysis patients, stages of adaptive reaction in human, and techniques of problem solving, stress management, and muscle relaxation. Both groups completed the HADS once before and once after the treatment. The final results of the two groups were compared. Citalopram administration led to a significant decrease in the patients' depression score (P = .001), anxiety score (P = .048), and total HADS score (P = .002). Psychological training sessions also decreased significantly depression (P = .04), anxiety (P = .03), and total HADS scores (P = .045). There was no significant difference in the amount of decrease in the scores of depression (P = .65), anxiety (P = .19), and the total HADS (P = .66) between the two groups. Psychological training and citalopram have similar effects on improving the symptoms of anxiety and depression in hemodialysis patients.",Hosseini SH.; Espahbodi F.; Mirzadeh Goudarzi SM.,2012.0,,0,0,
9135,The effect of modifying automatic action tendencies on overt avoidance behaviors.,"We used the Approach-Avoidance Task (AAT) to examine the role of automatic action tendencies. We hypothesized that, after manipulation of automatic action tendencies, participants would be more likely to approach feared objects when compared with participants in a control condition. Participants were instructed to push or pull a joystick, resulting in contamination-related and neutral pictures moving progressively away from or toward them, respectively. We manipulated approach by building a contingency between the arm movement and the picture type in the active condition but not in the control condition. Consistent with our hypothesis, participants in the active manipulation group showed facilitated automatic approach tendencies and reduced avoidance tendencies for contamination-related stimuli and completed more steps approaching their feared objects in a behavioral approach test compared with participants in the control group. Our results suggest that automatic action tendencies may play an important role in the maintenance of fear-related behavioral avoidance.",Amir N.; Kuckertz JM.; Najmi S.,2013.0,10.1037/a0030443,0,0,
9136,"Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study.","We report follow-up data evaluating the long-term outcomes for the first completed trial of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for chronic, treatment-resistant post-traumatic stress disorder (PTSD) (Mithoefer et al., 2011). All of the 19 subjects who received MDMA-assisted treatment in the original trial participated in the long-term follow-up (LTFU), with 16 out of 19 completing all of the long-term outcome measures, which were administered from 17 to 74 months after the original study's final MDMA session (mean = 45.4; SD = 17.3). Our primary outcome measure used was the Clinician-Administered PTSD Scale (CAPS). Secondary outcome measures were the Impact of Events Scale-Revised (IES-R) and the Neuroticism Extroversion Oppenness Personality Inventory-Revised (NEO PI-R) Personality Inventory. We also collected a long-term follow-up questionnaire. Results for the 16 CAPS completers showed there were no statistical differences between mean CAPS score at LTFU (mean = 23.7; SD = 22.8) (t (matched) = 0.1; df = 15, p = 0.91) and the mean CAPS score previously obtained at Study Exit (mean = 24.6, SD = 18.6). On average, subjects maintained statistically and clinically-significant gains in symptom relief, although two of these subjects did relapse. It was promising that we found the majority of these subjects with previously severe PTSD who were unresponsive to existing treatments had symptomatic relief provided by MDMA-assisted psychotherapy that persisted over time, with no subjects reporting harm from participation in the study.",Mithoefer MC.; Wagner MT.; Mithoefer AT.; Jerome L.; Martin SF.; Yazar-Klosinski B.; Michel Y.; Brewerton TD.; Doblin R.,2013.0,10.1177/0269881112456611,0,0,
9137,Moderators of treatment effectiveness for war-affected youth with depression in northern Uganda.,"As we build the evidence base of interventions for depression among war-affected youth, it is critical to understand factors moderating treatment outcomes. The current study investigated how gender and history of abduction by Lord's Resistance Army rebels moderated treatment outcomes for war-affected youth. The study-a three-armed, randomized, controlled trial-was conducted with internally displaced war-affected adolescents in northern Uganda. Participants with significant depression symptoms (N = 304; 57% female; 14-17 years of age) were randomly assigned to an interpersonal psychotherapy group (IPT-G), a creative play/recreation group, or a wait-list control condition. Secondary analyses were conducted on data from this randomized controlled trial. A history of abduction by Lord's Resistance Army rebels was reported by 42% of the sample. Gender and abduction history interacted to moderate the effectiveness of IPT-G for the treatment of depression. In the IPT-G intervention arm, treatment effectiveness was greatest among female subjects without an abduction history, with effect size = 1.06. IPT-G was effective for the treatment of depression for both male and female subjects with a history of abduction (effect size = .92 and .50, respectively). Male subjects with no abduction history in IPT-G showed no significant improvement compared with those in the control conditions. Abduction history and gender are potentially important moderators of treatment effects, suggesting that these factors need to be considered when providing interventions for war-affected youth. IPT-G may be an effective intervention for female subjects without an abduction history, as well as for both male and female former child soldiers, but less so for male subjects without an abduction history.",Betancourt TS.; Newnham EA.; Brennan RT.; Verdeli H.; Borisova I.; Neugebauer R.; Bass J.; Bolton P.,2012.0,10.1016/j.jadohealth.2012.02.010,0,0,
9138,Noninvasive mechanical ventilation in patients having declined tracheal intubation.,"Noninvasive ventilation (NIV) is a treatment option in patients with acute respiratory failure who are good candidates for intensive care but have declined tracheal intubation. The aim of our study was to report outcomes after NIV in patients with a do-not-intubate (DNI) order. Prospective observational cohort study in all patients who received NIV for acute respiratory failure in 54 ICUs in France and Belgium, in 2010/2011. Goals of care, comfort, and vital status were assessed daily. On day 90, a telephone interview with patients and relatives recorded health-related quality of life (HRQOL), posttraumatic stress disorder-related symptoms, and symptoms of anxiety and depression. Post-ICU burden was compared between DNI patients and patients receiving NIV with no treatment-limitation decisions (TLD). Of 780 NIV patients, 574 received NIV with no TLD, and 134 had DNI orders. Hospital mortality was 44 % in DNI patients and 12 % in the no-TLD group. Mortality in the DNI group was lowest in COPD patients compared to other patients in the DNI group (34 vs. 51 %, P = 0.01). In the DNI group, HRQOL showed no significant decline on day 90 compared to baseline; day-90 data of patients and relatives did not differ from those in the no-TLD group. Do-not-intubate status was present among one-fifth of ICU patients who received NIV. DNI patients who were alive on day 90 experienced no decrease in HRQOL compared to baseline. The prevalences of anxiety, depression, and PTSD-related symptoms in these patients and their relatives were similar to those seen after NIV was used as part of full-code management (clinicaltrial.govNCT01449331).",Azoulay E.; Kouatchet A.; Jaber S.; Lambert J.; Meziani F.; Schmidt M.; Schnell D.; Mortaza S.; Conseil M.; Tchenio X.; Herbecq P.; Andrivet P.; Guerot E.; Lafabrie A.; Perbet S.; Camous L.; Janssen-Langenstein R.; Collet F.; Messika J.; Legriel S.; Fabre X.; Guisset O.; Touati S.; Kilani S.; Alves M.; Mercat A.; Similowski T.; Papazian L.; Meert AP.; Chevret S.; Schlemmer B.; Brochard L.; Demoule A.,2013.0,10.1007/s00134-012-2746-2,0,0,
9139,Respiratory rehabilitation: a physiotherapy approach to the control of asthma symptoms and anxiety.,"The objectives of this study were to verify the degree of anxiety, respiratory distress, and health-related quality of life in a group of asthmatic patients who have experienced previous panic attacks. Additionally, we evaluated if a respiratory physiotherapy program (breathing retraining) improved both asthma and panic disorder symptoms, resulting in an improvement in the health-related quality of life of asthmatics. Asthmatic individuals were assigned to a chest physiotherapy group that included a breathing retraining program held once a week for three months or a paired control group that included a Subtle Touch program. All patients were assessed using the Diagnostic and Statistical Manual of Mental Disorders IV, the Sheehan Anxiety Scale, the Quality of Life Questionnaire, and spirometry parameter measurements. Both groups had high marks for panic disorder and agoraphobia, which limited their quality of life. The Breathing Retraining Group program improved the clinical control of asthma, reduced panic symptoms and agoraphobia, decreased patient scores on the Sheehan Anxiety Scale, and improved their quality of life. Spirometry parameters were unchanged. Breathing retraining improves the clinical control of asthma and anxiety symptoms and the health-related quality of life in asthmatic patients.",Laurino RA.; Barnabé V.; Saraiva-Romanholo BM.; Stelmach R.; Cukier A.; Nunes Mdo P.,2012.0,,0,0,
9140,Prospective examination of anxiety and depression before and during confirmed and pseudoexacerbations in patients with multiple sclerosis.,"This study was designed to determine whether pseudoexacerbations and confirmed MS exacerbations are preceded by or concurrent with increased anxiety or depressive symptoms. This was a secondary analysis of 121 patients with MS who were observed for 48 weeks during a randomized controlled trial. Participants completed monthly self-reports on depressive and anxiety symptoms. Patient-reported exacerbations were assessed through a telephone-administered symptom checklist and neurologic examination. Both pseudoexacerbations and confirmed exacerbations were associated with concurrent somatic depressive (β = .16 and β = .33, respectively; p values < .05), affective depressive (β = .17 [p = .02] and β = .12 [p = .06]), and anxiety symptoms (β = .24 and β = .20, p values < .01), controlling for baseline symptoms. Preexisting somatic and affective depressive symptoms predicted amplified relationships between concurrent confirmed exacerbations and these symptoms (β = .19 and β = .20, respectively; p values < .01). A standard deviation increase in anxiety symptoms relative to baseline predicted subsequent onset of pseudoexacerbations (odds ratio = 1.54, p = .02), whereas increased somatic depressive symptoms predicted confirmed exacerbations (odds ratio = 1.59, p = .01). Patients with MS experiencing pseudoexacerbations or confirmed exacerbations should be assessed and monitored for depressive and anxiety symptoms, and confirmed exacerbations are particularly concerning in patients with a history of depression. The psychological or psychiatric antecedents of MS exacerbations generate new hypotheses on etiologies of confirmed exacerbations and pseudoexacerbations. clinicaltrials.gov Identifier: NCT00147446.",Burns MN.; Nawacki E.; Siddique J.; Pelletier D.; Mohr DC.,2013.0,10.1097/PSY.0b013e3182757b2b,0,0,
9141,What explains post-traumatic stress disorder (PTSD) in UK service personnel: deployment or something else?,"In previous studies an association between deployment to Iraq or Afghanistan and an overall increased risk for post-traumatic stress disorder (PTSD) in UK armed forces has not been found. The lack of a deployment effect might be explained by including, in the comparison group, personnel deployed on other operations or who have experienced traumatic stressors unrelated to deployment. The sample comprised 8261 regular UK armed forces personnel who deployed to Iraq, Afghanistan or other operational areas or were not deployed. Participants completed the PTSD CheckList-Civilian Version (PCL-C) and provided information about deployment history, demographic and service factors, serious accidents and childhood experiences. Deployment to Iraq or Afghanistan [odds ratio (OR) 1.2, 95% confidence interval (CI) 0.6-2.2] or elsewhere (OR 1.1, 95% CI 0.6-2.0) was unrelated to PTSD although holding a combat role was associated with PTSD if deployed to Iraq or Afghanistan (OR 2.7, 95% CI 1.9-3.9). Childhood adversity (OR 3.3, 95% CI 2.1-5.0), having left service (OR 2.7, 95% CI 1.9-4.0) and serious accident (OR 2.1, 95% CI 1.4-3.0) were associated with PTSD whereas higher rank was protective (OR 0.3, 95% CI 0.12-0.76). For the majority of UK armed forces personnel, deployment whether to Iraq, Afghanistan or elsewhere confers no greater risk for PTSD than service in the armed forces per se but holding a combat role in those deployed to Iraq or Afghanistan is associated with PTSD. Vulnerability factors such as lower rank, childhood adversity and leaving service, and having had a serious accident, may be at least as important as holding a combat role in predicting PTSD in UK armed forces personnel.",Jones M.; Sundin J.; Goodwin L.; Hull L.; Fear NT.; Wessely S.; Rona RJ.,2013.0,10.1017/S0033291712002619,0,0,
9142,Neuroticism and post-traumatic stress disorder: a prospective investigation.,"Neuroticism has been consistently correlated with the post-traumatic stress disorder (PTSD) response to traumatic events. Interpretation of these findings is limited by the retrospective nature of these findings: neuroticism was measured after the trauma had occurred. The prospective association of neuroticism with PTSD has not been examined (the relationship of neuroticism with PTSD symptoms was examined in a few prospective studies). We evaluate prospectively the relationship of neuroticism, measured at baseline, with the cumulative occurrence of PTSD during the subsequent 10 years, using data from a longitudinal epidemiological study of young adults. A sample of 1007 young adults randomly selected from the membership of a large health maintenance organization in southeast Michigan was assessed at baseline and followed up at 3, 5 and 10 years later. We conducted a series of multinomial logistic regressions to estimate the relative risk (RR) of exposure to trauma and PTSD by neuroticism at baseline, adjusting for history of major depression (n = 990). During the 10-year follow-up, 50.2% of the sample experienced traumatic events and 5.2% developed PTSD. Neuroticism score at baseline increased significantly the RR of PTSD response to trauma. Additional analysis revealed that, among persons with history of major depression at baseline, RR for PTSD associated with neuroticism was equal to the null value of 1, but was increased significantly among those with no history of major depression. The results confirm the role of neuroticism as diathesis in the PTSD response to traumatic experiences.",Breslau N.; Schultz L.,2013.0,10.1017/S0033291712002632,0,0,
9143,A randomized trial of two forms of cognitive behaviour therapy for an older adult population with subclinical health anxiety.,"Seniors have been consistently under-represented in the health anxiety treatment literature. The aim of this study was to test the efficacy of a six-session enhanced cognitive behaviour therapy (ECBT) programme for subclinical health anxiety in seniors, and to examine whether the programme fostered therapeutic alliance and motivation for psychotherapy as compared to a standard cognitive behavioural therapy (SCBT) programme and wait-list control (WLC). Fifty-seven seniors with subclinical health anxiety were randomly assigned to six weeks of SCBT, ECBT, or WLC. At pre-treatment, post-treatment, and three-month follow-up, participants completed questionnaires on health anxiety and its dimensions, and other related psychological constructs. Therapeutic alliance and motivation measures were completed after Sessions 1, 3, and 6. At post-treatment, participants in the SCBT and ECBT groups showed significantly lower health anxiety when compared to WLC, with reductions on the subscale measuring disease fear/phobia. Significantly, more participants in the SCBT (66.7%) and ECBT (55.6%) conditions demonstrated clinically significant change on health anxiety compared to the WLC condition (11%). Gains were maintained at three months. There were minimal differences found between the SCBT and ECBT groups on therapeutic alliance and motivation. The findings indicated that both forms of CBT were efficacious for reducing some of the health anxious thoughts and beliefs in seniors.",Bourgault-Fagnou MD.; Hadjistavropoulos HD.,2013.0,10.1080/16506073.2012.717302,0,0,
9144,"Periloss dissociation, symptom severity, and treatment response in complicated grief.","Complicated grief (CG) is a bereavement-specific syndrome characterized by traumatic and separation distress lasting over 6 months. Little is known about the role of dissociation experienced during or immediately after the loss of a loved one (i.e., periloss dissociation [PLD]) in CG. The present study aimed to examine the psychometric properties of the PLD-adapted Peritraumatic Dissociative Experiences Questionnaire and its association with symptom severity, treatment response, and drop-out rate. PLD data collected as part of a randomized controlled trial of two loss-focused psychotherapy approaches for CG were examined. Treatment-seeking individuals with primary CG (n = 193) were assessed for PLD at the initial visit, 95 of whom were randomized and completed at least one treatment session. The PLD-adapted Peritraumatic Dissociative Experiences Questionnaire was found to be internally consistent (α = 0.91) with good convergent and divergent validity. After controlling for age, gender, time since loss, and current comorbid psychiatric diagnosis, self-reported PLD was associated with greater CG symptom severity (P < .01). However, contrary to our hypotheses, after controlling for age, baseline symptoms severity, psychiatric comorbidity, and treatment arm, PLD was predictive of better treatment response (P < .05) and lower study discontinuation (P < .01). PLD may be useful in identifying individuals at risk for CG and those who might respond to psychotherapy. Additional research should investigate the relationship of PLD with treatment outcome for different treatment approaches, and whether PLD prospectively predicts the development of CG.",Bui E.; Simon NM.; Robinaugh DJ.; Leblanc NJ.; Wang Y.; Skritskaya NA.; Mauro C.; Shear MK.,2013.0,10.1002/da.22029,0,0,
9145,An online stress management workbook for breast cancer.,"Cognitive behavioral stress management groups have been shown to be decrease psychological symptoms and increase adaptive coping in breast cancer patients, but dissemination of this effective intervention has been challenging. The goal of the present project was to develop an online cognitive behavioral stress management intervention for early stage breast cancer survivors and evaluate its effectiveness using a 2 group × 3 time randomized, waitlist-controlled design. Intervention and waitlist control group participants were assessed at three time points: at baseline; at 10 weeks, after which only intervention participants had used the workbook; and at 20 weeks, after which both groups had used the workbook. Results indicate that at 10 weeks intervention participants showed improved self-efficacy for coping with their cancer and for regulating negative mood and lower levels of cancer-related post-traumatic symptoms as compared to the control group, suggesting that an internet stress management intervention could be effective for helping breast cancer patients increase their confidence in their ability to cope with stress.",Carpenter KM.; Stoner SA.; Schmitz K.; McGregor BA.; Doorenbos AZ.,2014.0,10.1007/s10865-012-9481-6,0,0,
9146,Brief alcohol counseling improves mental health functioning in veterans with alcohol misuse: results from a randomized trial.,"Alcohol misuse occurs at high rates among U.S. Military Veterans presenting to primary care and is linked to numerous negative social and health consequences. The Veterans Health Administration has recently implemented brief alcohol interventions (BAI) in VA primary care settings. An emerging literature suggests that BAIs that target alcohol consumption may also have secondary health benefits such as reducing symptoms of depression and anxiety in civilian samples. The present study sought to examine whether secondary health benefits of BAIs observed in civilians generalize to a sample of alcohol misusing Veterans presenting to primary care. Veterans (N=167) screening positive for alcohol misuse during a routine primary care visit were randomized to receive treatment-as-usual (TAU) or TAU plus a web-delivered BAI. Assessment of overall mental health functioning, posttraumatic stress disorder, and depression occurred at baseline, three- and six-month post-treatment. Veterans receiving both BAI protocols demonstrated significant improvements in mental health functioning, depressive symptoms, and use of approach coping from baseline to six-month follow-up. No differential treatment effects on these outcomes were observed. Findings are limited by the lack of a no-treatment control group, and the potential impact of regression to the mean and assessment effects on outcomes. Our findings replicate prior studies suggesting that a single-dose BAI may have some secondary mental health benefits for Veterans presenting to primary care with alcohol misuse.",Cucciare MA.; Boden MT.; Weingardt KR.,2013.0,10.1016/j.jad.2012.11.028,0,0,
9147,"A randomized, double-blind trial of repetitive transcranial magnetic stimulation in obsessive-compulsive disorder with three-month follow-up.","Recent findings indicate that the motor and premotor cortices are hyperexcitable in obsessive-compulsive disorder (OCD). The authors have performed the first randomized, double-blind clinical trial of repetitive transcranial magnetic stimulation (rTMS) in OCD, with a 3-month follow-up. OCD patients (N=22) were assigned to either 2 weeks of active or sham rTMS to the supplementary motor area bilaterally. After 14 weeks, the response rate was 41% (7/12) with active and 10% (1/10) with sham treatment. At 14 weeks, patients receiving active rTMS showed, on average, a 35% reduction on the Y-BOCS, as compared with a 6.2% reduction in those receiving sham treatment.",Gomes PV.; Brasil-Neto JP.; Allam N.; Rodrigues de Souza E.,2012.0,10.1176/appi.neuropsych.11100242,0,0,
9148,CBT competence in novice therapists improves anxiety outcomes.,"This study explores the relationships between therapist variables (cognitive behavioral therapy [CBT] competence, and CBT adherence) and clinical outcomes of computer-assisted CBT for anxiety disorders delivered by novice therapists in a primary care setting. Participants were recruited for a randomized controlled trial of evidence-based treatment, including computer-assisted CBT, versus treatment as usual. Therapists (anxiety clinical specialists; ACSs) were nonexpert clinicians, many of whom had no prior experience in delivering psychotherapy (and in particular, very little experience with CBT). Trained raters reviewed randomly selected treatment sessions from 176 participants and rated therapists on measures of CBT competence and CBT adherence. Patients were assessed at baseline and at 6-, 12-, and 18-month follow-ups on measures of anxiety, depression, and functioning, and an average Reliable Change Index was calculated as a composite measure of outcome. CBT competence and CBT adherence were entered as predictors of outcome, after controlling for baseline covariates. Higher CBT competence was associated with better clinical outcomes whereas CBT adherence was not. Also, CBT competence was inversely correlated with years of clinical experience and trended (not significantly, though) down as the study progressed. CBT adherence was inversely correlated with therapist tenure in the study. Therapist competence was related to improved clinical outcomes when CBT for anxiety disorders was delivered by novice clinicians with technology assistance. The results highlight the value of the initial training for novice therapists as well as booster training to limit declines in therapist adherence.",Brown LA.; Craske MG.; Glenn DE.; Stein MB.; Sullivan G.; Sherbourne C.; Bystritsky A.; Welch SS.; Campbell-Sills L.; Lang A.; Roy-Byrne P.; Rose RD.,2013.0,10.1002/da.22027,0,0,
9149,Comparison of attention training and cognitive therapy in the treatment of social phobia: a preliminary investigation.,"Prominent models of social phobia highlight the role played by attentional factors, such as self-focused attention, in the development and maintenance of social phobia. Elevated self-focused attention is associated with increases in self-rated anxiety. Treatments that aim to modify and change attentional processes, specifically self-focused attention, will have a direct effect on social phobia symptoms. Thus, Attention Training targets attentional focus. The present study aimed to investigate the efficacy of Attention Training in comparison to an established treatment for social phobia, Cognitive Therapy. Participants (Intention-to-treat = 45; completers = 30) were allocated to either 6 weeks of Attention Training or Cognitive Therapy. It was hypothesized that both treatments would be effective in reducing social phobia symptoms, but that Attention Training would work primarily by reducing levels of self-focused attention. The results found an overall effectiveness of both treatment conditions in reducing social phobia symptoms. However, Attention Training significantly improved scores on the Self-Focused Attention questionnaire and the Brief Fear of Negative Evaluation questionnaire compared to Cognitive Therapy. Attention Training seems to be a promising treatment for social phobia.",Donald J.; Abbott MJ.; Smith E.,2014.0,10.1017/S1352465812001051,0,0,
9150,[Complex psycho-social intervention program complementing conventional antitumor therapy -- promising results].,"The aim of the research was to assess the effectiveness of a comprehensive, complex psycho-social intervention program, operating on different levels of spiritual plane, life management and behavioural health, among women with breast cancer. The general objective of the study was to help in coping, promote cognitive and emotional processing, encourage psychological and spiritual growth, improve the quality of life, and reduce the chances of remission. The research has been carried out in Budapest at the Radiology Diagnostic Department of the National Oncology Institute, involving 173 women treated for malignant breast tumour (C50) (experimental group: n=86, control group: n=87). Thirty-four women from the experimental group participated in the complex intervention program. We carried out two tests: one before the start and one after the end of the program. Research tools: Shortened Beck Depression Inventory, Quality of Life Questionnaire (EORTC QLQ-C30, QLQ-BR23), Spielberger's State-Trait Anxiety Inventory (STAI-T), the Revised Illness Perception Questionnaire (IPQ-R), the Posttraumatic Growth Inventory, and the Benefit Finding Questionnaire. The women participating the experimental program showed a significant positive change in comparison to the control group: in anxiety F (1, 65)=6.021, p=0.017; in depression: F(1, 72)=4.347, p=0.041; in experience of personal control: F(1, 69)=7.346, p=0.008; in EORTC General Health/Quality of Life Subscale F(1, 78)=7.531, p=0.008; in EORTC physical functioning F(1, 78)=4.874, p=0.014; in EORTC fatigue F(1, 78)=15.060, p=0.000; in BR23 body-image F(1, 79)=8.828, p=0.004; in BR23 arm symptoms F(1, 78)=7.229, p=0.009; in benefit finding F(1, 80)=21.171, p=0.000, and in posttraumatic growth F(1, 31)=24.186, p=0.000). The program has proven effective, its widespread use in practice is recommended.",Kovács Z.; Rigó A.; Kökönyei G.; Szabó E.; Kovács D.; Sebestyén A.; Balogh B.; Prezenszki Z.; Nagy M.,2012.0,MagyOnkol.2012.56.4.247,0,0,
9151,Sudden gains in cognitive therapy and interpersonal therapy for social anxiety disorder.,"The present study examined the effects of sudden gains on treatment outcome in a randomized controlled trial including individual cognitive therapy (CT) and interpersonal therapy (IPT) for social anxiety disorder (SAD). Participants were 67 individuals with SAD who received 16 treatment sessions. Symptom severity at each session was assessed using the Social Phobia Weekly Summary Scale (Clark et al., 2003). Results indicate that 22.4% of participants experienced a sudden gain during treatment. Individuals with sudden gains had significantly lower social anxiety symptoms at post-treatment and follow-up compared to individuals without sudden gains. Sudden gains in CT and IPT had similar magnitudes, frequencies, and timings. However, sudden gains resulted in lower levels of post-treatment symptoms in CT compared to IPT. Cognitive changes did not precede sudden gains, but sudden gains resulted in cognitive changes. Sudden gains in CT and IPT for SAD are predictive of long-term outcome. In addition, the effect of sudden gains may be greater in CT compared to IPT.",Bohn C.; Aderka IM.; Schreiber F.; Stangier U.; Hofmann SG.,2013.0,10.1037/a0031198,0,0,
9152,"Gender-specific effects of an augmented written emotional disclosure intervention on posttraumatic, depressive, and HIV-disease-related outcomes: a randomized, controlled trial.","Trauma histories and symptoms of PTSD occur at very high rates in people with HIV and are associated with poor disease management and accelerated disease progression. The authors of this study examined the efficacy of a brief written trauma disclosure intervention on posttraumatic stress, depression, HIV-related physical symptoms, and biological markers of HIV disease progression. HIV-infected men and women were randomized to four 30-min expressive writing sessions in either a treatment (trauma writing) or an attention control (daily events writing) condition. The disclosure intervention augmented the traditional emotional disclosure paradigm with probes to increase processing by focusing on trauma appraisals, self-worth, and problem solving. Outcomes were assessed at baseline, 1-, 6-, and 12-month follow-up. Hierarchical linear modeling (N = 244, intent-to-treat analyses) revealed no significant treatment effects for the group as a whole. Gender by treatment group interactions were significant such that women in the trauma-writing group had significantly reduced posttraumatic stress disorder (PTSD) symptoms (p = .017), depression (p = .009), and HIV-related symptoms (p = .022) compared with their controls. In contrast, men in the trauma-treatment condition did not improve more than controls on any outcome variables. Unexpectedly, men in the daily-event-writing control group had significantly greater reductions in depression then men in the trauma-writing group. Treatment effects were magnified in women when the analysis was restricted to those with elevated PTSD symptoms at baseline. A brief (4-session) guided written emotional disclosure intervention resulted in significant and meaningful reductions in PTSD, depression, and physical symptoms for women with HIV, but not for men.",Ironson G.; O'Cleirigh C.; Leserman J.; Stuetzle R.; Fordiani J.; Fletcher M.; Schneiderman N.,2013.0,10.1037/a0030814,0,0,
9153,Efficacy of combination of fluoxetine and cognitive behavioral therapy and fluoxetine alone for the treatment of obsessive compulsive disorder.,"A number of pharmacological approaches as well as psychological interventions are effective in the treatment of obsessive-compulsive disorder (OCD). The present study was conducted to see the relative efficacy of treatment approaches. 30 diagnosed cases of OCD were taken and divided into two groups. Each group consisted of 15 patients. Group A (N=15) received capsule fluoxetine and Group B (N=15) received capsule fluoxetine and CBT (13 weekly sessions). Twenty six participants completed the study (13 in each group). Dhaka University Obsessive-compulsive Scale (DUOCS) was used to measure the symptom severity. Symptom scores were measured at weeks 1, 5, 9 and 13. After 13 weeks, analysis of the data was done and the means of initial DUOCS score and 13th week score were compared. In both the groups the mean score changes were highly significant (p=0.000). Intra group analysis revealed that both the treatment approaches were highly efficacious. Inter-group analysis revealed that the response in combination group was significantly higher starting from 9th week, continuing up to 13th week. Mean symptom reduction and mean percentage reduction of symptoms were also higher in the case of combination group.",Giasuddin NA.; Nahar JS.; Morshed NM.; Balhara YP.; Sobhan MA.,2013.0,,0,0,
9154,2013 SYR Accepted Poster Abstracts.,"SYR 2013 Accepted Poster abstracts: 1. Benefits of Yoga as a Wellness Practice in a Veterans Affairs (VA) Health Care Setting: If You Build It, Will They Come? 2. Yoga-based Psychotherapy Group With Urban Youth Exposed to Trauma. 3. Embodied Health: The Effects of a MindÔøΩBody Course for Medical Students. 4. Interoceptive Awareness and Vegetable Intake After a Yoga and Stress Management Intervention. 5. Yoga Reduces Performance Anxiety in Adolescent Musicians. 6. Designing and Implementing a Therapeutic Yoga Program for Older Women With Knee Osteoarthritis. 7. Yoga and Life Skills Eating Disorder Prevention Among 5th Grade Females: A Controlled Trial. 8. A Randomized, Controlled Trial Comparing the Impact of Yoga and Physical Education on the Emotional and Behavioral Functioning of Middle School Children. 9. Feasibility of a Multisite, Community based Randomized Study of Yoga and Wellness Education for Women With Breast Cancer Undergoing Chemotherapy. 10. A Delphi Study for the Development of Protocol Guidelines for Yoga Interventions in Mental Health. 11. Impact Investigation of Breathwalk Daily Practice: CanadaÔøΩIndia Collaborative Study. 12. Yoga Improves Distress, Fatigue, and Insomnia in Older Veteran Cancer Survivors: Results of a Pilot Study. 13. Assessment of Kundalini Mantra and Meditation as an Adjunctive Treatment With Mental Health Consumers. 14. Kundalini Yoga Therapy Versus Cognitive Behavior Therapy for Generalized Anxiety Disorder and Co-Occurring Mood Disorder. 15. Baseline Differences in Women Versus Men Initiating Yoga Programs to Aid Smoking Cessation: Quitting in Balance Versus QuitStrong. 16. Pranayam Practice: Impact on Focus and Everyday Life of Work and Relationships. 17. Participation in a Tailored Yoga Program is Associated With Improved Physical Health in Persons With Arthritis. 18. Effects of Yoga on Blood Pressure: Systematic Review and Meta-analysis. 19. A Quasi-experimental Trial of a Yoga based Intervention to Reduce Stress and Promote Health and Well-being Among Middle School Educators. 20. A Systematic Review of Yoga-based Interventions for Objective and Subjective Balance Measures. 21. Disparities in Yoga Use: A Multivariate Analysis of 2007 National Health Interview Survey Data. 22. Implementing Yoga Therapy Adapted for Older Veterans Who Are Cancer Survivors. 23. Randomized, Controlled Trial of Yoga for Women With Major Depressive Disorder: Decreased Ruminations as Potential Mechanism for Effects on Depression? 24. Yoga Beyond the Metropolis: A Yoga Telehealth Program for Veterans. 25. Yoga Practice Frequency, Relationship Maintenance Behaviors, and the Potential Mediating Role of Relationally Interdependent Cognition. 26. Effects of Medical Yoga in Quality of Life, Blood Pressure, and Heart Rate in Patients With Paroxysmal Atrial Fibrillation. 27. Yoga During School May Promote Emotion Regulation Capacity in Adolescents: A Group Randomized, Controlled Study. 28. Integrated Yoga Therapy in a Single Session as a Stress Management Technique in Comparison With Other Techniques. 29. Effects of a Classroom-based Yoga Intervention on Stress and Attention in Second and Third Grade Students. 30. Improving Memory, Attention, and Executive Function in Older Adults with Yoga Therapy. 31. Reasons for Starting and Continuing Yoga. 32. Yoga and Stress Management May Buffer Against Sexual Risk-Taking Behavior Increases in College Freshmen. 33. Whole-systems Ayurveda and Yoga Therapy for Obesity: Outcomes of a Pilot Study. 34. WomenÔøΩs Phenomenological Experiences of Exercise, Breathing, and the Body During Yoga for Smoking Cessation Treatment. 35. Mindfulness as a Tool for Trauma Recovery: Examination of a Gender-responsive Trauma-informed Integrative Mindfulness Program for Female Inmates. 36. Yoga After Stroke Leads to Multiple Physical Improvements. 37. Tele-Yoga in Patients With Chronic Obstructive Pulmonary Disease and Heart Failure: A Mixed-methods Study of Feasibility, Acceptability, and Safety. 38. Effects of an Ashtanga Yoga-based Health and Wellness Curriculum on Physical and Emotional Well-being, Engagement Toward School, and Academic Performance of K-6 Students. 39. Yoga as a Facilitator for Participation Following an 8-week Yoga for Individuals With Chronic Stroke. 40. Standardization of Design and Reporting of Yoga Interventions for Musculoskeletal Conditions: A Delphi Approach. 41. Creating S.P.A.C.E. Through Yoga: Africa Yoga Project Teachers Promote Personal Transformation, Peaceful Communities, and Purpose-filled Service.",,2013.0,,0,0,
9155,Mindfulness therapy for somatization disorder and functional somatic syndromes: randomized trial with one-year follow-up.,"To conduct a feasibility and efficacy trial of mindfulness therapy in somatization disorder and functional somatic syndromes such as fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome, defined as bodily distress syndrome (BDS). We randomized 119 patients to either mindfulness therapy (mindfulness-based stress reduction and some cognitive behavioral therapy elements for BDS) or to enhanced treatment as usual (2-hour specialist medical care and brief cognitive behavioral therapy for BDS). The primary outcome measure was change in physical health (SF-36 Physical Component Summary) from baseline to 15-month follow-up. The study is negative as we could not demonstrate a different development over time for the two groups (F(3,2674)=1.51, P=.21). However, in the mindfulness therapy group, improvement was obtained toward the end of treatment and it remained present at the 15-month follow-up, whereas the enhanced treatment as usual group achieved no significant change until 15-month follow-up. The change scores averaged half a standard deviation which amounts to a clinically significant change, 29% changed more than 1 standard deviation. Significant between-group differences were observed at treatment cessation. Mindfulness therapy is a feasible and acceptable treatment. The study showed that mindfulness therapy was comparable to enhanced treatment as usual in improving quality of life and symptoms. Nevertheless, considering the more rapid improvement following mindfulness, mindfulness therapy may be a potentially useful intervention in BDS patients. Clinically important changes that seem to be comparable to a CBT treatment approach were obtained. Further research is needed to replicate or even expand these findings.",Fjorback LO.; Arendt M.; Ornbøl E.; Walach H.; Rehfeld E.; Schröder A.; Fink P.,2013.0,10.1016/j.jpsychores.2012.09.006,0,0,
9156,Metacognitive therapy in treatment-resistant psychosis: a multiple-baseline study.,"More effective psychological treatments for psychosis are required. Case series data and pilot trials suggest metacognitive therapy (MCT) is a promising treatment for anxiety and depression. Other research has found negative metacognitive beliefs and thought-control strategies may be involved in the development and maintenance of hallucinations and delusions. The potential of MCT in treating psychosis has yet to be investigated. Our aim was to find out whether a short number of MCT sessions would be associated with clinically significant and sustained improvements in delusions, hallucinations, anxiety, depression and subjective recovery in patients with treatment-resistant long-standing psychosis. Three consecutively referred patients, each with a diagnosis of paranoid schizophrenia and continuing symptoms, completed a series of multiple baseline assessments. Each then received between 11 and 13 sessions of MCT and completed regular assessments of progress, during therapy, post-therapy and at 3-month follow-up. Two out of 3 participants achieved clinically significant reductions across a range of symptom-based outcomes at end-of-therapy. Improvement was sustained at 3-month follow-up for one participant. Our study demonstrates the feasibility of using MCT with people with medication-resistant psychosis. MCT was acceptable to the participants and associated with meaningful change. Some modifications may be required for this population, after which a controlled trial may be warranted.",Hutton P.; Morrison AP.; Wardle M.; Wells A.,2014.0,10.1017/S1352465812001026,0,0,
9157,Effects of co-occurring depression on treatment for anxiety disorders: analysis of outcomes from a large primary care effectiveness trial.,"Co-occurring depression is common in patients seeking treatment for anxiety; however, the literature on the effects of depression on anxiety treatment outcomes is inconclusive. The current study evaluated prescriptive and prognostic effects of depression on anxiety treatment outcomes in a large primary care sample. Data were analyzed from a randomized controlled effectiveness trial that compared coordinated anxiety learning and management (CALM) to usual care. The study enrolled 1,004 patients between June 2006 and April 2008. Patients were referred by their primary care provider and met DSM-IV criteria for generalized anxiety disorder, panic disorder, posttraumatic stress disorder, and/or social anxiety disorder. They were treated for approximately 3 to 12 months with CALM (computer-assisted cognitive-behavioral therapy, medication management, or their combination) or usual care. Outcomes were evaluated by blinded assessment at 6, 12, and 18 months. Effects of baseline major depressive disorder (MDD) on anxiety symptoms, anxiety-related disability, and response/remission rates were evaluated using statistical models accounting for baseline anxiety and patient demographics. MDD did not moderate the effects of CALM (relative to usual care) on anxiety symptoms, anxiety-related disability, or response/remission rates. Greater improvements in anxiety symptoms and anxiety-related disability were observed in depressed patients, regardless of treatment assignment (P values < .005). However, cross-sectionally depressed patients displayed higher anxiety symptom and anxiety-related disability scores at baseline and all subsequent assessments (P values < .001). Depressed patients also displayed lower remission rates at each follow-up (P values < .001). CALM had comparable advantages over usual care for patients with and without MDD. Depressed patients displayed more severe anxiety symptoms and anxiety-related disability at baseline, but their clinical improvement was substantial and larger in magnitude than that observed in the nondepressed patients. Results support the use of empirically supported interventions for anxiety disorders in patients with co-occurring depression. ClinicalTrials.gov identifier: NCT00347269.",Campbell-Sills L.; Sherbourne CD.; Roy-Byrne P.; Craske MG.; Sullivan G.; Bystritsky A.; Lang AJ.; Chavira DA.; Rose RD.; Shaw Welch S.; Stein MB.,2012.0,10.4088/JCP.12m07955,0,0,
9158,Are neuroticism and extraversion associated with the antidepressant effects of repetitive transcranial magnetic stimulation (rTMS)? An exploratory 4-week trial.,"Several randomized, controlled trials have found high frequency repetitive transcranial magnetic stimulation (HF-rTMS) to be effective for treating major depressive disorder (MDD), but its antidepressant mechanisms have yet to be firmly understood. In this context, pre-treatment personality traits and subsequent changes in personality concomitant to treatment may be relevant for our understanding of these mechanisms. To investigate this issue we conducted a naturalistic trial in which 14 subjects with moderate to severe depression were treated with daily HF-rTMS over the left dorsolateral prefrontal cortex for 4 weeks. Objective depressive symptoms (as assessed by the HAM-D(21)) and the major personality dimensions of neuroticism and extraversion were measured pre-post HF-rTMS. Pre-rTMS levels of extraversion predicted subsequent decrease in depressive symptoms. Also, HF-rTMS treatment resulted in a decrease in neuroticism scores, and this relative decrease was associated with the relative decrease in depression. Our results suggest that HF-rTMS may positively affect the personality dimension of neuroticism. Also, pre-treatment levels of extraversion may predict the subsequent antidepressant response to HF-rTMS. However, further studies with larger samples and controlled designs are needed to better clarify these preliminary findings.",Berlim MT.; McGirr A.; Beaulieu MM.; Van den Eynde F.; Turecki G.,2013.0,10.1016/j.neulet.2012.12.029,0,0,
9159,Early rehabilitation of cancer patients - a randomized controlled intervention study.,"Faced with a life-threatening illness, such as cancer, many patients develop stress symptoms, i.e. avoidance behaviour, intrusive thoughts and worry. Stress management interventions have proven to be effective; however, they are mostly performed in group settings and it is commonly breast cancer patients who are studied. We hereby present the design of a randomized controlled trial (RCT) evaluating the effectiveness and cost-effectiveness of an individual stress-management intervention with a stepped-care approach in several cancer diagnoses. Patients (‚â• 18 years) with a recent diagnosis of breast cancer, colorectal cancer, lymphoma, prostate cancer or testicle cancer and scheduled for adjuvant/curative oncology treatment, will consecutively be included in the study. In this prospective longitudinal intervention study with a stepped-care approach, patients will be randomized to control, treatment as usual, or an individual stress-management intervention in two steps. The first step is a low-intensity stress-management intervention, given to all patients randomized to intervention. Patients who continue to report stress symptoms after the first step will thereafter be given more intensive treatment at the second step of the programme. In the intervention patients will also be motivated to be physically active. Avoidance and intrusion are the primary outcomes. According to the power analyses, 300 patients are planned to be included in the study and will be followed for two years. Other outcomes are physical activity level, sleep duration and quality recorded objectively, and anxiety, depression, quality of life, fatigue, stress in daily living, and patient satisfaction assessed using valid and standardized psychometric tested questionnaires. Utilization of hospital services will be derived from the computerized patient administration systems used by the hospital. The cost-effectiveness of the intervention will be evaluated through a cost-utility analysis. This RCT will provide empirical evidence of whether an individually administered stress-management programme in two steps can decrease stress as well as maintain or enhance patients' physical activity level, quality of life and psychological well-being. Further, this RCT, with a stepped-care approach, will provide knowledge regarding the cost-effectiveness of an individually administered stress-management programme whose aim is to help and support individual patients at the right level of care. ClinicalTrials.gov Identifier: NCT 01588262.",Arving C.; Thormodsen I.; Brekke G.; Mella O.; Berntsen S.; Nordin K.,2013.0,10.1186/1471-2407-13-9,0,0,
9160,Help-seeking from clergy and spiritual counselors among veterans with depression and PTSD in primary care.,"Little is known about the prevalence or predictors of seeking help for depression and PTSD from spiritual counselors and clergy. We describe openness to and actual help-seeking from spiritual counselors among primary care patients with depression. We screened consecutive VA primary care patients for depression; 761 Veterans with probable major depression participated in telephone surveys (at baseline, 7 months, and 18 months). Participants were asked about (1) openness to seeking help for emotional problems from spiritual counselors/clergy and (2) actual contact with spiritual counselors/clergy in the past 6 months. At baseline, almost half of the participants, 359 (47.2%), endorsed being ""very"" or ""somewhat likely"" to seek help for emotional problems from spiritual counselors; 498 (65.4%) were open to a primary care provider, 486 (63.9%) to a psychiatrist, and 409 (66.5%) to another type of mental health provider. Ninety-one participants (12%) reported actual spiritual counselor/clergy consultation. Ninety-five (10.3%) participants reported that their VA providers had recently asked them about spiritual support; the majority of these found this discussion helpful. Participants with current PTSD symptoms, and those with a mental health visit in the past 6 months, were more likely to report openness to and actual help-seeking from clergy. Veterans with depression and PTSD are amenable to receiving help from spiritual counselors/clergy and other providers. Integration of spiritual counselors/clergy into care teams may be helpful to Veterans with PTSD. Training of such providers to address PTSD specifically may also be desirable.",Bonner LM.; Lanto AB.; Bolkan C.; Watson GS.; Campbell DG.; Chaney EF.; Zivin K.; Rubenstein LV.,2013.0,10.1007/s10943-012-9671-0,0,0,
9161,Modeling and treating internalizing psychopathology in a clinical trial: a latent variable structural equation modeling approach.,"Clinical trials are typically designed to test the effect of a specific treatment on a single diagnostic entity. However, because common internalizing disorders are highly correlated ('co-morbid'), we sought to establish a practical and parsimonious method to characterize and quantify changes in a broad spectrum of internalizing psychopathology targeted for treatment in a clinical trial contrasting two transdiagnostic psychosocial interventions. Alcohol dependence treatment patients who had any of several common internalizing disorders were randomized to a six-session cognitive-behavioral therapy (CBT) experimental treatment condition or a progressive muscle relaxation training (PMRT) comparison treatment condition. Internalizing psychopathology was characterized at baseline and 4 months following treatment in terms of the latent structure of six distinct internalizing symptom domain surveys. Exploratory structural equation modeling (ESEM) identified a two-factor solution at both baseline and the 4-month follow-up: Distress (measures of depression, trait anxiety and worry) and Fear (measures of panic anxiety, social anxiety and agoraphobia). Although confirmatory factor analysis (CFA) demonstrated measurement invariance between the time-points, structural models showed that the latent means of Fear and Distress decreased substantially from baseline to follow-up for both groups, with a small but statistically significant advantage for the CBT group in terms of Distress (but not Fear) reduction. The approach demonstrated in this study provides a practical solution to modeling co-morbidity in a clinical trial and is consistent with converging evidence pointing to the dimensional structure of internalizing psychopathology.",Kushner MG.; Krueger RF.; Wall MM.; Maurer EW.; Menk JS.; Menary KR.,2013.0,10.1017/S0033291712002772,0,0,
9162,"A randomised controlled trial of the Flinders Program‚Ñ¢ of chronic condition management in Vietnam veterans with co-morbid alcohol misuse, and psychiatric and medical conditions.","To evaluate the efficacy of the Flinders Program‚Ñ¢ of chronic condition management on alcohol use, psychosocial well-being and quality of life in Vietnam veterans with alcohol misuse. This 9-month wait-list, randomised controlled trial used the Alcohol Use Disorders Identification Test (AUDIT) score ‚â• 8 as the entry criterion. Intervention veterans received the Flinders Program plus usual care and controls received usual care. The primary outcome measure was AUDIT score at baseline, 3, 6 and 9 months. Secondary measures included quality of life, alcohol dependence (DSM-IV), anxiety and depression. All measures were repeated at variable trial end dates between 9 and 18 months in the intervention group. Randomisation resulted in 46 intervention and 31 control participants. Intent-to-treat analyses showed AUDIT scores improved significantly from baseline to 9-month follow-up (p = 0.039) in the intervention group compared to control group. The control group had 1.46 times the risk of alcohol dependence than the intervention group at 9 months (p = 0.027). There were no significant differences between groups for secondary measures. Within-group analyses showed that both groups significantly improved in AUDIT (p < 0.001), anxiety and depression (p < 0.01), anger (p < 0.001), and post-traumatic stress (p < 0.01). Improvements in AUDIT (p < 0.001) and alcohol dependence were maintained in the intervention group to 18 months. Use of the Flinders Program in addition to usual care resulted in reduced alcohol use, reduced alcohol dependence, and global clinical improvement in Vietnam veterans with risky alcohol behaviours and chronic mental health problems. The findings demonstrate that the Flinders Program provides a structured framework for delivering self-management support, case management and coordinated care for people with chronic conditions. This clinical approach has the potential to bridge the gap between physical and mental illness service delivery for people with long-term conditions in Australia.",Battersby MW.; Beattie J.; Pols RG.; Smith DP.; Condon J.; Blunden S.,2013.0,10.1177/0004867412471977,0,0,6038
9163,The brain-derived neurotrophic factor Val66Met polymorphism predicts response to exposure therapy in posttraumatic stress disorder.,"The most effective treatment for posttraumatic stress disorder (PTSD) is exposure therapy, which aims to facilitate extinction of conditioned fear. Recent evidence suggests that brain-derived neurotrophic factor (BDNF) facilitates extinction learning. This study assessed whether the Met-66 allele of BDNF, which results in lower activity-dependent secretion, predicts poor response to exposure therapy in PTSD. Fifty-five patients with PTSD underwent an 8-week exposure-based cognitive behavior therapy program and provided mouth swabs or saliva to extract genomic DNA to determine their BDNF Val66Met genotype (30 patients with the Val/Val BDNF allele, 25 patients with the Met-66 allele). We examined whether BDNF genotype predicted reduction in PTSD severity following exposure therapy. Analyses revealed poorer response to exposure therapy in the PTSD patients with the Met-66 allele of BDNF compared with patients with the Val/Val allele. Pretreatment Clinician Administered PTSD Scale severity and BDNF Val66Met polymorphism predicted response to exposure therapy using hierarchical regression. This study provides the first evidence that the BDNF Val66Met genotype predicts response to cognitive behavior therapy in PTSD and is in accord with evidence that BDNF facilitates extinction learning.",Felmingham KL.; Dobson-Stone C.; Schofield PR.; Quirk GJ.; Bryant RA.,2013.0,10.1016/j.biopsych.2012.10.033,0,0,
9164,Group versus individual cognitive treatment for Obsessive-Compulsive Disorder: changes in non-OCD symptoms and cognitions at post-treatment and one-year follow-up.,"Current cognitive approaches postulate that obsessions and compulsions are caused and/or maintained by misinterpretations about their meaning. This assumption has led to the development of cognitive therapeutic (CT) procedures designed to challenge the dysfunctional appraisals and beliefs patients have about their obsessions. Nonetheless, few studies have compared the efficacy of individual and group CT in changing the dysfunctional cognitions that hypothetically underlie Obsessive-Compulsive Disorder (OCD). In this study, 44 OCD patients were assigned to individual (n=18) or group (n=24) CT. Sixteen completed the individual CT, and 22 completed the group CT. The effects of the two CT conditions on depression and worry tendencies were comparable. Individual treatment was more effective than group treatment in decreasing scores on dysfunctional beliefs (responsibility, overestimation of threat, and intolerance to uncertainty) and the use of suppression as a thought control strategy. The post-treatment changes were maintained one year later. The correlations between symptom improvement (OCD severity change) and belief changes were moderate: in the individual treatment the greatest associations were with beliefs about thoughts (importance and control), whereas in the group treatment the greatest associations were with beliefs related to anxiety in general (threat overestimation and intolerance to uncertainty).",Belloch A.; Cabedo E.; Carrió C.; Fernández-Alvarez H.; García F.; Larsson C.,2011.0,10.1016/j.psychres.2010.10.015,0,0,
9165,The impact of coping style on gaze duration.,"The understanding of individual differences in response to threat (e.g., attentional bias) is important to better understand the development of anxiety disorders. Previous studies revealed only a small attentional bias in high-anxious (HA) subjects. One explanation for this finding may be the assumption that all HA-subjects show a constant attentional bias. Current models distinguish HA-subjects depending on their level of tolerance for uncertainty and for arousal. These models assume that only HA-subjects with intolerance for uncertainty but tolerance for arousal (""sensitizers"") show an attentional bias, compared to HA-subjects with intolerance for uncertainty and intolerance for arousal (""fluctuating subjects""). Further, it is assumed that repressors (defined as intolerance for arousal but tolerance for uncertainty) would react with avoidance behavior when confronted with threatening stimuli. The present study investigated the influence of coping styles on attentional bias. After an extensive recruiting phase, 36 subjects were classified into three groups (sensitizers, fluctuating, and repressors). All subjects were exposed to presentations of happy and threatening faces, while recording gaze durations with an eye-tracker. The results showed that only sensitizer showed an attentional bias: they gazed longer at the threatening face rather than at the happy face during the first 500 ms. The results support the findings of the relationship between anxiety and attention and extend these by showing variations according to coping styles. The differentiation of subjects according to a multifaceted coping style allows a better prediction of the attentional bias and contributes to an insight into the complex interplay of personality, coping, and behavior.",Klucken T.; Brouwer AM.; Chatziastros A.; Kagerer S.; Netter P.; Hennig J.,2010.0,10.1371/journal.pone.0015395,0,0,
9166,Key steps in developing a cognitive vaccine against traumatic flashbacks: visuospatial Tetris versus verbal Pub Quiz.,"Flashbacks (intrusive memories of a traumatic event) are the hallmark feature of Post Traumatic Stress Disorder, however preventative interventions are lacking. Tetris may offer a 'cognitive vaccine' [1] against flashback development after trauma exposure. We previously reported that playing the computer game Tetris soon after viewing traumatic material reduced flashbacks compared to no-task [1]. However, two criticisms need to be addressed for clinical translation: (1) Would all games have this effect via distraction/enjoyment, or might some games even be harmful? (2) Would effects be found if administered several hours post-trauma? Accordingly, we tested Tetris versus an alternative computer game--Pub Quiz--which we hypothesized not to be helpful (Experiments 1 and 2), and extended the intervention interval to 4 hours (Experiment 2). The trauma film paradigm was used as an experimental analog for flashback development in healthy volunteers. In both experiments, participants viewed traumatic film footage of death and injury before completing one of the following: (1) no-task control condition (2) Tetris or (3) Pub Quiz. Flashbacks were monitored for 1 week. Experiment 1: 30 min after the traumatic film, playing Tetris led to a significant reduction in flashbacks compared to no-task control, whereas Pub Quiz led to a significant increase in flashbacks. Experiment 2: 4 hours post-film, playing Tetris led to a significant reduction in flashbacks compared to no-task control, whereas Pub Quiz did not. First, computer games can have differential effects post-trauma, as predicted by a cognitive science formulation of trauma memory. In both Experiments, playing Tetris post-trauma film reduced flashbacks. Pub Quiz did not have this effect, even increasing flashbacks in Experiment 1. Thus not all computer games are beneficial or merely distracting post-trauma - some may be harmful. Second, the beneficial effects of Tetris are retained at 4 hours post-trauma. Clinically, this delivers a feasible time-window to administer a post-trauma ""cognitive vaccine"".",Holmes EA.; James EL.; Kilford EJ.; Deeprose C.,2010.0,10.1371/journal.pone.0013706,0,0,
9167,[Complications of the finger osteosynthesis using Kirschner's wires in arterial inflow disorder].,"At an osteosynthesis of Kirshner wires to one of widespread complications is their spontaneous migration that leads to formation of bone deformation or to necessity of application of less effective kinds of an immobilization. In posttraumatic change of arterial inflow to hand and fingers leads to an oxygen level reduction in tissues, their chronic ischemia and to increase of a lactate and pyruvate contents in peripheral blood that can influence on Kirshner wires. Spontaneous migration of Kirshner wires from bones of fingers and decrease of their fixing in the bones is characteristic for patients with the expressed posttraumatic infringement of arterial inflow. This phenomenon can be explained, in particular, of acidity of peripheral blood change owing to considerable reduction arterial blood flow and secondary changes in bone and metal pin contact surface.",Furmanov AIu.,2010.0,,0,0,
9168,Preliminary evaluation of culturally sensitive CBT for depression in Pakistan: findings from Developing Culturally-sensitive CBT Project (DCCP).,"There is sufficient research evidence in favour of cognitive therapy in western world. However, only limited research has been carried out on its effectiveness in other countries. It is suggested that adaptations in content, format and delivery are needed before CBT can be employed in non-western cultures. We describe a preliminary evaluation of culturally adapted CBT for depression in Pakistan. We aimed to evaluate the efficacy of this culturally adapted CBT using a therapist manual. In a randomized controlled trial we compared combination of CBT and antidepressants with antidepressants alone (treatment as usual) in primary care. Referred patients with ICD-10 diagnosis of depression were invited to participate and randomized to the intervention and control groups. Hospital Anxiety and Depression Scale (HADS) and Bradford Somatic Inventory (BSI) were used to measure changes in depression, anxiety and somatic symptoms. Seventeen patients each were randomized to each arms of the trial. Except for financial status there were no differences between the two groups on various demographic variables. Patients receiving CBT showed statistically significant improvement on measures of depression (p < .001), anxiety (p < .001) and somatic symptoms (p < .000) as compared to antidepressant alone group. 82% patients attended six or more sessions of therapy. A culturally sensitive manualized CBT was effective in reducing symptoms of depression and anxiety in Pakistan.",Naeem F.; Waheed W.; Gobbi M.; Ayub M.; Kingdon D.,2011.0,10.1017/S1352465810000822,0,0,
9169,The COMTval158met polymorphism is associated with symptom relief during exposure-based cognitive-behavioral treatment in panic disorder.,"Cognitive behavioral therapy (CBT) represents a learning process leading to symptom relief and resulting in long-term changes in behavior. CBT for panic disorder is based on exposure and exposure-based processes can be studied in the laboratory as extinction of experimentally acquired fear responses. We have recently demonstrated that the ability to extinguish learned fear responses is associated with a functional genetic polymorphism (COMTval158met) in the COMT gene and this study was aimed at transferring the experimental results on the COMTval158met polymorphism on extinction into a clinical setting. We tested a possible effect of the COMTval158met polymorphism on the efficacy of CBT, in particular exposure-based treatment modules, in a sample of 69 panic disorder patients. We present evidence that panic patients with the COMTval158met met/met genotype may profit less from (exposure-based) CBT treatment methods as compared to patients carrying at least one val-allele. No association was found with the 5-HTTLPR/rs25531 genotypes which is presented as additional material. We were thus able to transfer findings on the effect of the COMTval158met polymorphism from an experimental extinction study obtained using healthy subjects to a clinical setting. Furthermore patients carrying a COMT val-allele tend to report more anxiety and more depression symptoms as compared to those with the met/met genotype. Limitations of the study as well as possible clinical implications are discussed. Clinical Trial Registry name: Internet-Versus Group-Administered Cognitive Behavior Therapy for Panic Disorder (IP2). Registration Identification number: NCT00845260, http://www.clinicaltrials.gov/ct2/show/NCT00845260.",Lonsdorf TB.; Rück C.; Bergström J.; Andersson G.; Ohman A.; Lindefors N.; Schalling M.,2010.0,10.1186/1471-244X-10-99,0,0,
9170,Efficacy of biofeedback for post-traumatic stress disorder.,"The authors investigated the potential effectiveness of biofeedback as a complementary treatment for PTSD. This exploratory study used heart variability biofeedback and determined its efficacy in treating PTSD through the use of two rating instruments, The Post-traumatic Stress Disorder Checklist (PCL)-Military version and the Zung Self-Rating Depression Scale. Active duty service members deployed to Iraq or Afghanistan were alternatively assigned to a treatment as usual control group and treatment as usual with the addition of biofeedback. The authors administered the two instruments before treatment and at the conclusion of three weeks of biofeedback therapy. Biofeedback did not produce a measurable improvement. A one way repeated measures analysis of variance (ANOVA) was used to examine change in PCL scores over time. There was a main effect for time, F(1, 36)=11.98, p<.001, indicating a decrease in PCL scores from baseline to three weeks for both the control and treatment group. Results demonstrated a nonsignificant main effect of group, F(1, 36)=.1.79, p=ns, and a nonsignificant group by time interaction, F(1, 36)=.2.59, p=ns. Similarly, for depression, results showed a significant main effect for time, F(1, 33)=10.26, p<.003, indicating a decrease in Zung scores from baseline to three weeks for both the control and treatment group. Results demonstrated a nonsignificant main effect of group, F(1, 33)=.385, p=ns, and a nonsignificant group by time interaction, F(1, 33)=3.52, p=ns. The addition of biofeedback did not produce a measurable improvement in PTSD or depression scores in this exploratory study.",Lande RG.; Williams LB.; Francis JL.; Gragnani C.; Morin ML.,2010.0,10.1016/j.ctim.2010.08.004,0,0,
9171,Integrating tobacco cessation into mental health care for posttraumatic stress disorder: a randomized controlled trial.,"Most smokers with mental illness do not receive tobacco cessation treatment. To determine whether integrating smoking cessation treatment into mental health care for veterans with posttraumatic stress disorder (PTSD) improves long-term smoking abstinence rates. A randomized controlled trial of 943 smokers with military-related PTSD who were recruited from outpatient PTSD clinics at 10 Veterans Affairs medical centers and followed up for 18 to 48 months between November 2004 and July 2009. Smoking cessation treatment integrated within mental health care for PTSD delivered by mental health clinicians (integrated care [IC]) vs referral to Veterans Affairs smoking cessation clinics (SCC). Patients received smoking cessation treatment within 3 months of study enrollment. Smoking outcomes included 12-month bioverified prolonged abstinence (primary outcome) and 7- and 30-day point prevalence abstinence assessed at 3-month intervals. Amount of smoking cessation medications and counseling sessions delivered were tested as mediators of outcome. Posttraumatic stress disorder and depression were repeatedly assessed using the PTSD Checklist and Patient Health Questionnaire 9, respectively, to determine if IC participation or quitting smoking worsened psychiatric status. Integrated care was better than SCC on prolonged abstinence (8.9% vs 4.5%; adjusted odds ratio, 2.26; 95% confidence interval [CI], 1.30-3.91; P = .004). Differences between IC vs SCC were largest at 6 months for 7-day point prevalence abstinence (78/472 [16.5%] vs 34/471 [7.2%], P < .001) and remained significant at 18 months (86/472 [18.2%] vs 51/471 [10.8%], P < .001). Number of counseling sessions received and days of cessation medication used explained 39.1% of the treatment effect. Between baseline and 18 months, psychiatric status did not differ between treatment conditions. Posttraumatic stress disorder symptoms for quitters and nonquitters improved. Nonquitters worsened slightly on the Patient Health Questionnaire 9 relative to quitters (differences ranged between 0.4 and 2.1, P = .03), whose scores did not change over time. Among smokers with military-related PTSD, integrating smoking cessation treatment into mental health care compared with referral to specialized cessation treatment resulted in greater prolonged abstinence. clinicaltrials.gov Identifier: NCT00118534.",McFall M.; Saxon AJ.; Malte CA.; Chow B.; Bailey S.; Baker DG.; Beckham JC.; Boardman KD.; Carmody TP.; Joseph AM.; Smith MW.; Shih MC.; Lu Y.; Holodniy M.; Lavori PW.;  .,2010.0,10.1001/jama.2010.1769,0,0,
9172,Clinical relevance of retrieval cues for attenuating context renewal of fear.,"The present studies investigated if retrieval cues (reminder objects) can attenuate context renewal of fear. In Study 1, 32 participants completed exposure in one of two contexts; 1-week follow-up testing occurred in a novel or the same context. Results indicated significant renewal of fear for those tested in a novel context. In Study 2, 40 participants completed exposure in one of these contexts; half were presented with cues. One week later, all were tested in a novel context with or without cues. Results indicated weak attenuation of context renewal for participants re-presented with cues. In Study 3, 18 participants completed exposure in one of two maximally distinct contexts; all with cues. One week later, participants were tested in a novel context with or without cues. Results indicated no group differences. These findings suggest that clinical relevance of this set of cues for attenuating context renewal may be limited.",Culver NC.; Stoyanova M.; Craske MG.,2011.0,10.1016/j.janxdis.2010.10.002,0,0,
9173,Results following gamma knife radiosurgical anterior capsulotomies for obsessive compulsive disorder.,"Obsessive compulsive disorder (OCD), in its severe form, can cause tremendous disability for affected patients. To evaluate the results following bilateral radiosurgical anterior capsulotomy for severe medically refractory OCD. We performed gamma knife anterior capsulotomy (GKAC) on 3 patients with extreme, medically intractable OCD. According to our protocol, all patients were evaluated by at least 2 psychiatrists who recommended surgery. The patient had to request the procedure, and had to have severe OCD according to the Yale-Brown Obsessive Compulsive Scale (YBOCS). Patient ages were 37, 55, and 40 years, and pre-radiosurgery YBOCS scores were 34/40, 39/40, and 39/40. Bilateral lesions were created with 2 4-mm isocenters to create an oval volume in the ventral internal capsule at the putaminal midpoint. A maximum dose of 140 or 150 Gy was used. There was no morbidity after the procedure, and all patients returned immediately to baseline function. All patients noted significant functional improvements, and reduction in OCD behavior. Follow-up was at 55, 42, and 28 months. The first patient reduced her YBOCS score from 34 to 24. One patient with compulsive skin picking and an open wound had later healing of the chronic wound and a reduction in the YBOCS score from 39 to 8. At 28 months, the third patient is living and working independently, and her YBOCS score is 18. Within a strict protocol, gamma knife radiosurgery provided improvement of OCD behavior with no adverse effects. This technique should be evaluated further in patients with severe and disabling behavioral disorders.",Kondziolka D.; Flickinger JC.; Hudak R.,2011.0,10.1227/NEU.0b013e3181fc5c8b,0,0,
9174,Treatment of pathological gambling with naltrexone pharmacotherapy and brief intervention: a pilot study.,"We explored the efficacy of the opiate antagonist, naltrexone, as a treatment for pathological gambling. Treatment seeking pathological gamblers (n = 39) (according to both South Oaks Gambling Screen and a screen based on the Diagnostic and Statistical Manual of Mental Disorders) participated into our treatment study during 2009. The subjects were instructed to use 50 mg of naltrexone before gambling or when feeling craving towards gambling. The protocol contained one initial doctor visit with motivational brief intervention. During period that were free of gambling, the subjects were instructed to practice other healthy behavioral alternatives to gambling. The primary outcome measure was the Yale Brown Obsessive Compulsive Scale adapted for Pathological Gambling. The other outcome measurements were the EQ-5D quality of life survey, the Alcohol Use Disorders Identification Test, and the Beck Depression Inventory. The average age of the subjects was 39 years; 80% were men. Highly significant (p < 0.01) decreases in reported obsessive-compulsive gambling and depressive symptoms and increases in the subjective quality of life developed in the study. These positive changes suggest that this simple, inexpensive treatment helps pathological gamblers. The role of naltrexone in the treatment effect, however, needs to be determined with a larger, placebo-controlled study.",Lahti T.; Halme JT.; Pankakoski M.; Sinclair D.; Alho H.,2010.0,,0,0,
9175,The impact of anxiety-inducing distraction on cognitive performance: a combined brain imaging and personality investigation.,"Previous investigations revealed that the impact of task-irrelevant emotional distraction on ongoing goal-oriented cognitive processing is linked to opposite patterns of activation in emotional and perceptual vs. cognitive control/executive brain regions. However, little is known about the role of individual variations in these responses. The present study investigated the effect of trait anxiety on the neural responses mediating the impact of transient anxiety-inducing task-irrelevant distraction on cognitive performance, and on the neural correlates of coping with such distraction. We investigated whether activity in the brain regions sensitive to emotional distraction would show dissociable patterns of co-variation with measures indexing individual variations in trait anxiety and cognitive performance. Event-related fMRI data, recorded while healthy female participants performed a delayed-response working memory (WM) task with distraction, were investigated in conjunction with behavioural measures that assessed individual variations in both trait anxiety and WM performance. Consistent with increased sensitivity to emotional cues in high anxiety, specific perceptual areas (fusiform gyrus--FG) exhibited increased activity that was positively correlated with trait anxiety and negatively correlated with WM performance, whereas specific executive regions (right lateral prefrontal cortex--PFC) exhibited decreased activity that was negatively correlated with trait anxiety. The study also identified a role of the medial and left lateral PFC in coping with distraction, as opposed to reflecting a detrimental impact of emotional distraction. These findings provide initial evidence concerning the neural mechanisms sensitive to individual variations in trait anxiety and WM performance, which dissociate the detrimental impact of emotion distraction and the engagement of mechanisms to cope with distracting emotions. Our study sheds light on the neural correlates of emotion-cognition interactions in normal behaviour, which has implications for understanding factors that may influence susceptibility to affective disorders, in general, and to anxiety disorders, in particular.",Denkova E.; Wong G.; Dolcos S.; Sung K.; Wang L.; Coupland N.; Dolcos F.,2010.0,10.1371/journal.pone.0014150,0,0,
9176,Obesity in the news: do photographic images of obese persons influence antifat attitudes?,"News coverage of obesity has increased dramatically in recent years, and research shows that media content may contribute to negative public attitudes toward obese people. However, no work has assessed whether photographic portrayals of obese people that accompany news stories affect attitudes. In the present study, the authors used a randomized experimental design to test whether viewing photographic portrayals of an obese person in a stereotypical or unflattering way (versus a nonstereotypical or flattering portrayal) could increase negative attitudes about obesity, even when the content of an accompanying news story is neutral. The authors randomly assigned 188 adult participants to read a neutral news story about the prevalence of obesity that was paired with 1 of 4 photographic portrayals of an obese adult (or no photograph). The authors subsequently assessed attitudes toward obese people using the Fat Phobia Scale. Participants in all conditions expressed a moderate level of fat phobia (M = 3.83, SD = 0.58). Results indicated that participants who viewed the negative photographs expressed more negative attitudes toward obese people than did those who viewed the positive photographs. Implications of these findings for the media are discussed, with emphasis on increasing awareness of weight bias in health communication and journalistic news reporting.",McClure KJ.; Puhl RM.; Heuer CA.,2011.0,10.1080/10810730.2010.535108,0,0,
9177,Assessment of the type D personality construct in the Korean population: a validation study of the Korean DS14.,"This study aimed to develop a Korean version of the Type D Personality Scale-14 (DS14) and evaluate the psychiatric symptomatology of Korean cardiac patients with Type D personality. Healthy control (n = 954), patients with a coronary heart disease (n = 111) and patients with hypertension and no heart disease (n = 292) were recruited. All three groups completed DS14, the Eysenck Personality Questionnaire (EPQ), the state subscale of Spielberger State and Trait Anxiety Inventory (STAI-S), the Center for Epidemiologic Studies Short Depression Scale (CESD), and the General Health Questionnaire (GHQ). The Korean DS14 was internally consistent and stable over time. 27% of the subjects were classified as Type D. Type D individuals had significantly higher mean scores on the STAI-S, CESD, and GHQ compared to non-Type D subjects in each group. The Korean DS14 was a valid and reliable tool for identifying Type D personality. The general population and cardiovascular patients with Type D personality showed higher rate of depression, anxiety and psychological distress regarding their health. Therefore, identifying Type D personality is important in clinical research and practice in chronic medical disorders, especially cardiovascular disease, in Korea.",Lim HE.; Lee MS.; Ko YH.; Park YM.; Joe SH.; Kim YK.; Han C.; Lee HY.; Pedersen SS.; Denollet J.,2011.0,10.3346/jkms.2011.26.1.116,0,0,
9178,Cell phone-supported cognitive behavioural therapy for anxiety disorders: a protocol for effectiveness studies in frontline settings.,"Reviews of randomized controlled trials (RCTs) of cognitive behavioural therapy (CBT) for anxiety disorders have reported large pre- to post-treatment within-group effect sizes on measures of anxiety when supplied in therapist consultations and in technology-supported settings. However, the stringent experimental control of RCTs results in a lack of external validity, which limits the generalizability of findings to real-world frontline clinical practice. We set out to examine the specification of a protocol for study of the effectiveness of cell phone-supported CBT for in situ management of anxiety disorders. Nominal group methods were used for requirements analysis and protocol design. Making a distinction between different forms of technology-supported therapy, examination of therapists' role, and implementing trials in existing organizational and community contexts were found to be the central requirements in the protocol. The resulting protocol (NCT01205191 at clinicaltrials.gov) for use in frontline clinical practice in which effectiveness, adherence, and the role of the therapists are analyzed, provides evidence for what are truly valuable cell phone-supported CBT treatments and guidance for the broader introduction of CBT in health services.",Ekberg J.; Timpka T.; Bång M.; Fröberg A.; Halje K.; Eriksson H.,2011.0,10.1186/1471-2288-11-3,0,0,
9179,"Psychotic depression, posttraumatic stress disorder, and engagement in cognitive-behavioral therapy within an outpatient sample of adults with serious mental illness.","Depression with psychotic features afflicts a substantial number of people and has been characterized by significantly greater impairment, higher levels of dysfunctional beliefs, and poorer response to psychopharmacologic and psychosocial interventions than nonpsychotic depression. Those with psychotic depression also experience a host of co-occurring disorders, including posttraumatic stress disorder (PTSD), which is not surprising given the established relationships between trauma exposure and increased rates of psychosis and between PTSD and major depression. To date, there has been very limited research on the psychosocial treatment of psychotic depression; and even less is known about those who also suffer from PTSD. The purpose of this study was to better understand the rates and clinical correlates of psychotic depression in those with PTSD. Clinical and symptom characteristics of 20 individuals with psychotic depression and 46 with nonpsychotic depression, all with PTSD, were compared before receiving cognitive-behavioral therapy for PTSD treatment or treatment as usual. Patients with psychotic depression exhibited significantly higher levels of depression and anxiety, a weaker perceived therapeutic alliance with their case managers, more exposure to traumatic events, and more negative beliefs related to their traumatic experiences, as well as increased levels of maladaptive cognitions about themselves and the world, compared with participants without psychosis. Implications for cognitive-behavioral therapy treatment aimed at dysfunctional thinking for this population are discussed.",Gottlieb JD.; Mueser KT.; Rosenberg SD.; Xie H.; Wolfe RS.,,10.1016/j.comppsych.2010.04.012,0,0,626
9180,Keep the brain cool--endovascular cooling in patients with severe traumatic brain injury: a case series study.,"As brain temperature is reported to be extensively higher than core body temperature in traumatic brain injury (TBI) patients, posttraumatic hyperthermia is of particular relevance in the injured brain. To study the influence of prophylactic normothermia on brain temperature and the temperature gradient between brain and core body in patients with severe TBI using an intravascular cooling system and to assess the relationship between brain temperature and intracranial pressure (ICP) under endovascular temperature control. Prospective case series study conducted in the neurologic intensive care unit of a tertiary care university hospital. Seven patients with severe TBI with a Glasgow Coma Scale score of 8 or less were consecutively enrolled. Prophylactic normothermia, defined as a target temperature of 36.5°C, was maintained using an intravascular cooling system. Simultaneous measurements of brain and urinary bladder temperature and ICP were taken over a 72-hour period. The mean bladder temperature in normothermic patients was 36.3 ± 0.4°C, and the mean brain temperature was determined as 36.4 ± 0.5°C. The mean temperature difference between brain and bladder was 0.1°C. We found a significant direct correlation between brain and bladder temperature (r = 0.95). In 52.4% of all measurements, brain temperature was higher than core body temperature. The mean ICP was 18 ± 8 mm Hg. Intravascular temperature management stabilizes both brain and body core temperature; prophylactic normothermia reduces the otherwise extreme increase of intracerebral temperature in patients with severe TBI. The intravascular cooling management proved to be an efficacious and feasible method to control brain temperature and to avoid hyperthermia in the injured brain. We could not find a statistically significant correlation between brain temperature and ICP.",Fischer M.; Lackner P.; Beer R.; Helbok R.; Klien S.; Ulmer H.; Pfausler B.; Schmutzhard E.; Broessner G.,2011.0,10.1227/NEU.0b013e318208f5fb,0,0,
9181,Response to induced relaxation during pregnancy: comparison of women with high versus low levels of anxiety.,"Relaxation exercises have become a standard intervention for individuals with anxiety disorders but little is known about their potential for anxiety relief during pregnancy. The purpose of this study was to examine psychoendocrine (i) baseline differences and (ii) changes after a standardized relaxation period in pregnant women with high versus low levels of anxiety. Thirty-nine third-trimester high and low anxious pregnant women performed active or passive relaxation while levels of anxiety, hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adrenal-medullary (SAM) system activity were assessed before and after the relaxation period. In women with high levels of trait anxiety, state anxiety (F(1,36) = 8.3, p = .007) and negative affect (F(1,36) = 7.99, p = .008) as well as ACTH (F(1,35) = 9.24, p = .002) remained elevated over the entire course of the experimental procedure, the last indicating increased HPA axis activity. In addition, norepinephrine showed a constricted decrease of relaxation reflecting lower response of the SAM-system (F(1,37) = 4.41, p = .043). Although relaxation exercises have become a standard intervention for individuals with anxiety, pregnant women with high levels of trait anxiety benefited less than women with low levels from a single standardized relaxation period.",Alder J.; Urech C.; Fink N.; Bitzer J.; Hoesli I.,2011.0,10.1007/s10880-010-9218-z,0,0,
9182,Personality and medication non-adherence among older adults enrolled in a six-year trial.,"Personality factors parsimoniously capture the variation in dispositional characteristics that affect behaviours, but their value in predicting medication non-adherence is unclear. We investigated the relationship between five-factor model personality factors (Conscientiousness, Neuroticism, Agreeableness, Extraversion, and Openness) and medication non-adherence among older participants during a six-year randomized placebo-controlled trial (RCT). Observational cohort data from 771 subjects aged ‚â• 72 years enrolled in the Ginkgo Evaluation of Memory study, a RCT of Ginkgo biloba for prevention of dementia. Random effects logistic regression analyses examined effects of NEO Five-Factor Inventory scores on medication non-adherence, determined via pill counts every 6 months (median follow-up 6.1 years) and defined as taking <80% of prescribed pills. Analyses adjusted for covariates linked with non-adherence in prior studies. Each 5 year increment in participant age was associated with a 6.7% greater probability of non-adherence (95% confidence interval, CI [2.4, 11.0]). Neuroticism was the only personality factor associated with non-adherence: a 1 SD increase was associated with a 3.8% increase in the probability of non-adherence (95% CI [0.4, 7.2]). Lower cognitive function was also associated with non-adherence: a 1 SD decrease in mental status exam score was associated with a 3.0% increase in the probability of non-adherence (95% CI [0.2, 5.9]). Neuroticism was associated with medication non-adherence over 6 years of follow-up in a large sample of older RCT participants. Personality measurement in clinical and research settings might help to identify and guide interventions for older adults at risk for medication non-adherence.",Jerant A.; Chapman B.; Duberstein P.; Robbins J.; Franks P.,2011.0,10.1348/135910710X524219,0,0,
9183,Internet-based treatment of social phobia: a randomized controlled trial comparing unguided with two types of guided self-help.,"Internet-based self-help for social phobia with minimal therapist support via email have shown efficacy in several controlled trials by independent research teams. The role and necessity of therapist guidance is, however, still largely unclear. The present study compared the benefits of a 10-week web-based unguided self-help treatment for social phobia with the same intervention complemented with minimal, although weekly, therapist support via email. Further, a third treatment arm was included, in which the level of support was flexibly stepped up, from no support to email or telephone contact, on demand of the participants. Eighty-one individuals meeting diagnostic criteria for social phobia were randomly assigned to one of the three conditions. Primary outcome measures were self-report measures of symptoms of social phobia. Secondary outcome measures included symptoms of depression, interpersonal problems, and general symptomatology. Measures were taken at baseline, post-treatment, and at 6-month follow-up. Data from a telephone-administered diagnostic interview conducted at post-treatment were also included. Results showed significant symptom reductions in all three treatment groups with large effect sizes for primary social phobia measures (Cohen's d=1.47) and for secondary outcome measures (d=1.16). No substantial and significant between-groups effects were found on any of the measures (Cohen's d=00-.36). Moreover, no difference between the three conditions was found regarding diagnosis-free status, clinically significant change, dropout rates, or adherence measures such as lessons or exercises completed. These findings indicate that Internet-delivered treatment for social phobia is a promising treatment option, whether no support is provided or with two different types of therapist guidance.",Berger T.; Caspar F.; Richardson R.; Kneubühler B.; Sutter D.; Andersson G.,2011.0,10.1016/j.brat.2010.12.007,0,0,
9184,A multidisciplinary primary care team consultation in a socio-economically deprived community: an exploratory randomised controlled trial.,"Psychosocial problems in socioeconomically deprived communities are not always amenable to traditional medical approaches. Mothers living in these areas are a particularly vulnerable group. The objective of this study was to evaluate the effectiveness of a lengthened multi-disciplinary team consultation in primary care in reducing anxiety and depression in mothers. This was a prospective randomised controlled trial of a multidisciplinary team consultation against normal care. 94 mothers were recruited from three general practices from an area of extreme socio-economic deprivation. Mothers randomised into the intervention group attended a multidisciplinary consultation with up to four case-specific health care professionals. Consultations addressed medical, psychological and social problems and lasted up to one hour. Conventional primary care continued to be available to the intervention families. Control group families received normal primary care services. The outcomes measured were anxiety and depression as using the Hospital Anxiety and Depression Scale (HADS), health status using SF36v2, and quality of life using the abbreviated Schedule for the Evaluation of Individual Quality of Life (SEIQoL-DW) at baseline, 6 months and 12 months. Ordered logistic regression was used to analyse the data. There was no significant difference found between intervention and control groups after 6 months and 12 months in all of the measured outcomes. The new lengthened multi-disciplinary team consultation did not have any impact on the mental health, general health, and quality of life of mothers after 6 and 12 months. Other methods of primary health care delivery in socio-economically deprived communities need to be evaluated.",Chan WS.; Whitford DL.; Conroy R.; Gibney D.; Hollywood B.,2011.0,10.1186/1472-6963-11-15,0,0,
9185,(Don't) panic in the scanner! How panic patients with agoraphobia experience a functional magnetic resonance imaging session.,"Although functional magnetic resonance imaging (fMRI) has gained increasing importance in investigating neural substrates of anxiety disorders, less is known about the stress eliciting properties of the scanner environment itself. The aim of the study was to investigate feasibility, self-reported distress and anxiety management strategies during an fMRI experiment in a comprehensive sample of patients with panic disorder and agoraphobia (PD/AG). Within the national research network PANIC-NET, n=89 patients and n=90 controls participated in a multicenter fMRI study. Subjects completed a retrospective questionnaire on self-reported distress, including a habituation profile and exploratory questions about helpful strategies. Drop-out rates and fMRI quality parameters were employed as markers of study feasibility. Different anxiety measures were used to identify patients particularly vulnerable to increased scanner anxiety and impaired data quality. Three (3.5%) patients terminated the session prematurely. While drop-out rates were comparable for patients and controls, data quality was moderately impaired in patients. Distress was significantly elevated in patients compared to controls; claustrophobic anxiety was furthermore associated with pronounced distress and lower fMRI data quality in patients. Patients reported helpful strategies, including motivational factors and cognitive coping strategies. The feasibility of large-scale fMRI studies on PD/AG patients could be proved. Study designs should nevertheless acknowledge that the MRI setting may enhance stress reactions. Future studies are needed to investigate the relationship between self-reported distress and fMRI data in patient groups that are subject to neuroimaging research.",Lueken U.; Muehlhan M.; Wittchen HU.; Kellermann T.; Reinhardt I.; Konrad C.; Lang T.; Wittmann A.; Ströhle A.; Gerlach AL.; Ewert A.; Kircher T.,2011.0,10.1016/j.euroneuro.2010.12.002,0,0,
9186,INSPIRE study: does stress management improve the course of inflammatory bowel disease and disease-specific quality of life in distressed patients with ulcerative colitis or Crohn's disease? A randomized controlled trial.,"The use of stress management psychotherapy is hypothesized to produce greater improvement in disease course and disease-specific quality of life (IBDQ) compared to usual medical care alone in patients with ulcerative colitis (UC) or Crohn's disease (CD) showing high levels of stress (based on the Perceived Stress Questionnaire [PSQ]). Fifty-eight patients with UC and 56 patients with CD who had experienced continuous disease activity or had relapsed over the previous 18 months, with an activity index for UC or CD ‚â• 4, a PSQ ‚â• 60, and without serious psychiatric disorders or other serious medical conditions were randomized to receive either treatment as usual (TAU) or TAU plus stress management psychotherapy. Psychotherapy consisted of three group sessions (psychoeducation, problem-solving, relaxation) and 6-9 individual sessions based on cognitive behavior therapy-related methods with 1-3 booster sessions at 6 and 12 months follow-up. Gastroenterologists blinded to intervention group assessed disease activity and course at baseline and at 3, 6, 12, and 18 months. Patients completed the IBDQ at baseline, 6, 12, and 18 months. The intervention did not improve disease or reduce relapse; however, it increased the IBDQ score (P = 0.009, mean differences 16.3 [SD 6.1]). On analysis of UC and CD separately, improvement of IBDQ was only found in the UC group. Stress management psychotherapy does not appear to improve disease course or reduce relapse in patients with IBD. It might improve quality of life, particularly in patients with UC.",Boye B.; Lundin KE.; Jantschek G.; Leganger S.; Mokleby K.; Tangen T.; Jantschek I.; Pripp AH.; Wojniusz S.; Dahlstroem A.; Rivenes AC.; Benninghoven D.; Hausken T.; Roseth A.; Kunzendorf S.; Wilhelmsen I.; Sharpe M.; Blomhoff S.; Malt UF.; Jahnsen J.,2011.0,10.1002/ibd.21575,0,0,
9187,The effectiveness of a trauma focused spiritually integrated intervention for veterans exposed to trauma.,"Building Spiritual Strength (BSS) is an 8-session, spiritually integrated group intervention designed to address religious strain and enhance religious meaning making for military trauma survivors. It is based upon empirical research on the relationship between spirituality and adjustment to trauma. To assess the intervention's effectiveness, veterans with histories of trauma who volunteered for the study were randomly assigned to a BSS group (n = 26) or a wait-list control group (n = 28). BSS participants showed statistically significant reductions in PTSD symptoms based on self-report measures as compared with those in a wait-list control condition. Further research on spiritually integrated interventions for trauma survivors is warranted.",Harris JI.; Erbes CR.; Engdahl BE.; Thuras P.; Murray-Swank N.; Grace D.; Ogden H.; Olson RH.; Winskowski AM.; Bacon R.; Malec C.; Campion K.; Le T.,2011.0,10.1002/jclp.20777,0,0,
9188,Penetrating keratoplasty and Verisyse iris-claw lens--is it safe for corneal graft?,"The loss of the corneal endothelial cells, especially in a first postoperative year, has been observed in patients who underwent penetrating keratoplasty (PK). The implantation of new generation of ""iris claw"" phakic IOL (Verisyse) in refractive cases has been shown to cause clinicaly insignificant endothelial cell loss. In our prospective case series we investigated the endothelial cell loss and clinical outcome in patients that either underwent PK and implantation of PCIOL or PK and implantation of Verisyse IOL. In the first group of 9 patients scheduled for PK, implantation of Verisyse was performed due to the absence of the posterior capsule support. 2 of these patients had angle supported ACIOL, 4 patients were aphakic and 3 had posttraumatic cataract with ruptured posterior capsule. The second group of 12 patients had standard ""triple"" procedure (PK + ECCE + PCIOL). BCVA of both groups of patients prior the operation was hand movement in 12 patients, light perception in 7 patients and 0.05 in 3 patients. The preoperative endothelial cell count of the donor grafts obtained from the eye bank was 2800 cells/mm2 on average. The follow up was 6-10 months. Six months after the operation all ""Verysise"" patients maintained transparent graft. Postoperative visual acuity improvement was recorded in 18 out of 21 eyes (85.7%). Best spectacle corrected visual acuity of > or = 0.3 was achived in 55.5% in the Verisyse group and in 50.0% of ""triple procedure"" group. The endothelial cell count and morphology were estimated on the specular microscope on a monthly basis. Mean endothelial cells loss in patients with PK and Verysise was 40 +/- 8% and in patients with ""triple"" procedure was 42 +/- 12% at 10 postoperative months. There was no significant difference in the endothelial cell loss and clinical outcome between the group of patients who had PK and Verysise as compared to those with implanted PCIOL.",Dekaris I.; Gabrić N.; Barisić A.; Mravicić I.; Pauk M.; Anticić M.,2010.0,,0,0,
9189,[Training in iterative hypothesis testing as part of psychiatric education. A randomized study].,"The improvement of medical education is at the center of efforts to reform the studies of medicine. Furthermore, an excellent teaching program for students is a quality feature of medical universities. Besides teaching of disease-specific contents, the acquisition of interpersonal and decision-making skills is important. However, the cognitive style of senior physicians leading to a diagnosis cannot easily be taught. Therefore, the following study aimed at examining whether specific training in iterative hypothesis testing (IHT) may improve the correctness of the diagnostic process. Seventy-one medical students in their 9th-11th terms were randomized to medical teaching as usual or to IHT training for 4 weeks. The intervention group received specific training according to the method of IHT. All students were examined by a multiple choice (MC) exam and additionally by simulated patients (SP). The SPs were instructed to represent either a patient with depression and comorbid anxiety and substance use disorder (SP1) or to represent a patient with depression, obsessive-compulsive disorder and acute suicidal tendencies (SP2). All students identified the diagnosis of major depression in the SPs, but IHT-trained students recognized more diagnostic criteria. Furthermore, IHT-trained students recognized acute suicide tendencies in SP2 more often and identified more comorbid psychiatric disorders. The results of the MC exam were comparable in both groups. An analysis of the satisfaction with the different training programs revealed that the IHT training received a better appraisal. Our results point to the role of IHT in teaching diagnostic skills. However, the results of the MC exam were not influenced by IHT training. Furthermore, our results show that students are in need of training in practical clinical skills.",Lampen-Imkamp S.; Alte C.; Sipos V.; Kordon A.; Hohagen F.; Schweiger U.; Kahl KG.,2012.0,10.1007/s00115-011-3252-4,0,0,7118
9190,"Reduction of claustrophobia during magnetic resonance imaging: methods and design of the ""CLAUSTRO"" randomized controlled trial.","Magnetic resonance (MR) imaging has been described as the most important medical innovation in the last 25 years. Over 80 million MR procedures are now performed each year and on average 2.3% (95% confidence interval: 2.0 to 2.5%) of all patients scheduled for MR imaging suffer from claustrophobia. Thus, prevention of MR imaging by claustrophobia is a common problem and approximately 2,000,000 MR procedures worldwide cannot be completed due to this situation. Patients with claustrophobic anxiety are more likely to be frightened and experience a feeling of confinement or being closed in during MR imaging. In these patients, conscious sedation and additional sequences (after sedation) may be necessary to complete the examinations. Further improvements in MR design appear to be essential to alleviate this situation and broaden the applicability of MR imaging. A more open scanner configuration might help reduce claustrophobic reactions while maintaining image quality and diagnostic accuracy. We propose to analyze the rate of claustrophobic reactions, clinical utility, image quality, patient acceptance, and cost-effectiveness of an open MR scanner in a randomized comparison with a recently designed short-bore but closed scanner with 97% noise reduction. The primary aim of this study is thus to determine whether an open MR scanner can reduce claustrophobic reactions, thereby enabling more examinations of claustrophobic patients without incurring the safety issues associated with conscious sedation. In this manuscript we detail the methods and design of the prospective ""CLAUSTRO"" trial. This randomized controlled trial will be the first direct comparison of open vertical and closed short-bore MR systems in regards to claustrophobia and image quality as well as diagnostic utility. ClinicalTrials.gov: NCT00715806.",Enders J.; Zimmermann E.; Rief M.; Martus P.; Klingebiel R.; Asbach P.; Klessen C.; Diederichs G.; Bengner T.; Teichgräber U.; Hamm B.; Dewey M.,2011.0,10.1186/1471-2342-11-4,0,0,
9191,One-session computer-based exposure treatment for spider-fearful individuals--efficacy of a minimal self-help intervention in a randomised controlled trial.,"Computer-based self-help treatments have been proposed to provide greater access to treatment while requiring minimum input from a therapist. The authors employed a randomised controlled trial to investigate the efficacy of one-session computer-based exposure (CBE) as a self-help treatment for spider-fearful individuals. Spider-fearful participants in a CBE group underwent one 27-min session of standardised exposure to nine fear-eliciting spider pictures. Treatment outcome was compared to spider-fearful control participants exposed to nine neutral pictures. Fear reduction was quantified on a subjective level by the Fear of Spiders Questionnaire (FSQ) and complemented with a behavioural approach test (BAT). Results demonstrate that compared to control participants, CBE participants showed greater fear reduction from pre- to posttreatment on both the subjective level (FSQ) and the behavioural level (BAT). Moreover, in contrast to the control group, the obtained subjective fear reduction effect remained stable in the CBE group at 1-month follow-up. These findings highlight the role of computer-based self-help as a minimal but effective intervention to reduce fear of spiders.",Müller BH.; Kull S.; Wilhelm FH.; Michael T.,2011.0,10.1016/j.jbtep.2010.12.001,0,0,
9192,"Quasi-experimental study on the effectiveness of psychoanalysis, long-term and short-term psychotherapy on psychiatric symptoms, work ability and functional capacity during a 5-year follow-up.","Psychotherapy is apparently an insufficient treatment for some patients with mood or anxiety disorder. In this study the effectiveness of short-term and long-term psychotherapies was compared with that of psychoanalysis. A total of 326 psychiatric outpatients with mood or anxiety disorder were randomly assigned to solution-focused therapy, short-term psychodynamic and long-term psychodynamic psychotherapies. Additionally, 41 patients suitable for psychoanalysis were included in the study. The patients were followed from the start of the treatment and assessed 9 times during a 5-year follow-up. The primary outcome measures on symptoms were the Beck Depression Inventory, the Hamilton Depression and Anxiety Rating Scales, and the Symptom Check List, anxiety scale. Primary work ability and functional capacity measures were the Work Ability Index, the Work-subscale of the Social Adjustment Scale, and the Perceived Psychological Functioning Scale. A reduction in psychiatric symptoms and improvement in work ability and functional capacity was noted in all treatment groups during the 5-year follow-up. The short-term therapies were more effective than psychoanalysis during the first year, whereas the long-term therapy was more effective after 3years of follow-up. Psychoanalysis was most effective at the 5-year follow-up, which also marked the end of the psychoanalysis. Psychotherapy gives faster benefits than psychoanalysis, but in the long run psychoanalysis seems to be more effective. Results from trials, among patients suitable for psychoanalysis and with longer follow-up, are needed before firm conclusions about the relative effectiveness of psychoanalysis and psychotherapy in the treatment of mood and anxiety disorders can be drawn.",Knekt P.; Lindfors O.; Laaksonen MA.; Renlund C.; Haaramo P.; Härkänen T.; Virtala E.;  .,2011.0,10.1016/j.jad.2011.01.014,0,0,
9193,A randomized controlled trial of cognitive behavior therapy tailored to psychological adaptation to an implantable cardioverter defibrillator.,"To evaluate a eight-session cognitive behavior therapy (CBT) intervention tailored to adaptation in implantable cardioverter defibrillator (ICD) patients; and to test for treatment group by gender interaction effects. Patients receiving their first ICD implant were randomized to CBT or usual cardiac care. Primary outcomes measured at baseline, 6-month, and 12-month follow-ups were symptoms of anxiety and depression (Hospital Anxiety and Depression Scale), posttraumatic stress disorder symptoms (Impact of Events Scale-Revised), and phobic anxiety (Crown-Crisp Experiential Index). Secondary outcomes were quality of life (Short Form-36 Physical Component Summary and Short Form-36 Mental Component Summary) and ICD shocks or antitachycardia pacing therapies. Of 292 eligible patients, 193 consented and were randomized to CBT (n = 96) or usual cardiac care (n = 97). Eighty percent were male; mean age was 64.4 years (standard deviation = 14.3); and 70% received an ICD for secondary prevention. No baseline differences were observed between the treatment conditions; however, women scored worse than men on all psychological and quality of life variables (p < .05). Eighty-three percent completed follow-up. Repeated-measures analyses of covariance revealed significantly greater improvement with CBT on posttraumatic stress disorder total and avoidance symptoms for men and women combined (p < .05) and significantly greater improvement in depressive symptoms and Short Form-36 Mental Component Summary only in women (p < .01). No differences were observed between treatment conditions on ICD therapies over follow-up. A CBT intervention to assist adaptation to an ICD enhanced psychological functioning over the first year post implant.",Irvine J.; Firestone J.; Ong L.; Cribbie R.; Dorian P.; Harris L.; Ritvo P.; Katz J.; Newman D.; Cameron D.; Johnson S.; Bilanovic A.; Hill A.; O'Donnell S.; Sears S.,2011.0,10.1097/PSY.0b013e31820afc63,0,0,
9194,Effectiveness randomized controlled trial of face to face versus Internet cognitive behaviour therapy for social phobia.,"To compare the effectiveness of Internet cognitive behaviour therapy (CBT) with face-to-face CBT in social phobia. Randomized controlled trial of 75 patients with social phobia referred to an anxiety disorders clinic. A total of 37 patients participated, and post-treatment data was obtained from 25 Subjects (Ss). An intention to treat analysis was used. The same therapist (M.D.) treated both groups. Both groups made significant progress on symptoms and disability measures. There were no significant differences in outcome between the Internet and face-to-face groups. The total amount of therapist time required was 18 min per patient for the Internet group and 240 min per patient for the face-to-face group. Both forms of treatment were equally effective and this is consistent with previous findings in depression and panic disorder. The difference in clinician time required was substantial. If Internet CBT was offered as 'standard of care' the staff time saved would permit a stepped care model in which in-depth therapy for the difficult to recover patients could be provided without an increase in staff.",Andrews G.; Davies M.; Titov N.,2011.0,10.3109/00048674.2010.538840,0,0,
9195,Change in reflective functioning during psychotherapy--a single-case study.,"It has been suggested that deficits in mentalization are a core problem of borderline personality disorder and that enhancement of mentalization represents a central mechanism of change in psychotherapy with this group of patients. The present single-case study investigates changes in mentalization measured by the Reflective Functioning Scale on the Adult Attachment Interview and its relationship with clinical measures of psychopathology during a long-term psychotherapy. The usefulness of evaluating RF along three subdimensions, the object, content and process of RF, is underlined. Furthermore, it is argued that there is a complex interaction between RF and symptomatology that becomes evident when evaluating RF along the different subdimensions. Areas for future research clarifying the relationship between mentalization, psychotherapy and psychopathology are suggested.",Gullestad FS.; Wilberg T.,2011.0,10.1080/10503307.2010.525759,0,0,
9196,Rumination and distraction periods immediately following a speech task: effect on postevent processing in social anxiety.,"The purpose of this study was to investigate social anxiety and the effect of rumination and distraction periods immediately following a speech task on subsequent postevent processing. A secondary aim was to examine the content of postevent rumination. Participants (N = 114 students) completed measures of social anxiety and depression, delivered a 3-minute speech, and were randomly assigned to complete (1) a rumination form about the speech (guided negative rumination condition) or (2) an anagram form (distraction condition). One week later participants completed measures of postevent processing related to the speech task. It was hypothesized that social anxiety would interact with condition in predicting levels of postevent processing. This hypothesis was supported in the prediction of positive thoughts such that at high levels of social anxiety the distraction condition led to more positive thoughts compared with the guided negative rumination condition, whereas at low levels of social anxiety conditions were similar with respect to positive thoughts. Irrespective of condition, both social anxiety and depression predicted greater postevent rumination and negative thoughts 1 week later. With respect to the content of postevent rumination, socially anxious individuals reported being more concerned about some aspects of the presentation (e.g. poor posture), whereas other concerns were equally noted regardless of social anxiety level (e.g. poor content). The present results highlight the potential clinical utility of distracting from social anxiety to allow for greater access to positive thoughts postevent.",Kocovski NL.; MacKenzie MB.; Rector NA.,2011.0,10.1080/16506073.2010.526631,0,0,
9197,"The implementation of computerized cognitive behavioural therapies in a service user-led, third sector self help clinic.","The efficacy and effectiveness of a computerized cognitive behavioural therapy (CCBT) package, Beating the Blues, has been demonstrated in a large randomized controlled trial and several pragmatic studies in the National Health Service (NHS). The current study tests the generalizability of this finding to the implementation of CCBT in a service user-led, third sector Self Help Clinic. 510 referrals for the Beating the Blues program were received over a 16 month period in routine care. The Patient Health Questionnaire Depression (PHQ-9) and Anxiety (GAD-7) Scales were administered pre-treatment and during each treatment session. The 10-item Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), Work and Social Adjustment Scale and Patient Experience Questionnaire were also administered pre-treatment and immediately on completing treatment. More than two-thirds of referrals were suitable for treatment and completed a baseline assessment; 84% of these started the Beating the Blues program. Two-hundred and twenty-six people meeting caseness criteria at baseline completed at least two sessions of CCBT. Of these, 50% met recovery criteria at their final point of measurement. Completer and intention-to-treat analysis also demonstrated statistically and clinically significant improvements on key outcome measures. CCBT can be effectively implemented in a service user-led, third sector Self Help Clinic, increasing access to psychological therapies to meet local needs for tier two interventions for depression and anxiety.",Cavanagh K.; Seccombe N.; Lidbetter N.,2011.0,10.1017/S1352465810000858,0,0,
9198,Cognitive-behavioral therapy for PTSD and depression symptoms reduces risk for future intimate partner violence among interpersonal trauma survivors.,"Women who develop symptoms of posttraumatic stress disorder (PTSD) and depression subsequent to interpersonal trauma are at heightened risk for future intimate partner violence (IPV) victimization. Cognitive-behavioral therapy (CBT) is effective in reducing PTSD and depression symptoms, yet limited research has investigated the effectiveness of CBT in reducing risk for future IPV among interpersonal trauma survivors. This study examined the effect of CBT for PTSD and depressive symptoms on the risk of future IPV victimization in a sample of women survivors of interpersonal violence. The current sample included 150 women diagnosed with PTSD secondary to an array of interpersonal traumatic events; they were participating in a randomized clinical trial of different forms of cognitive processing therapy for the treatment of PTSD. Participants were assessed at 9 time points as part of the larger trial: pretreatment, 6 times during treatment, posttreatment, and 6-month follow-up. As hypothesized, reductions in PTSD and in depressive symptoms during treatment were associated with a decreased likelihood of IPV victimization at a 6-month follow-up even after controlling for recent IPV (i.e., IPV from a current partner within the year prior to beginning the study) and prior interpersonal traumas. These findings highlight the importance of identifying and treating PTSD and depressive symptoms among interpersonal trauma survivors as a method for reducing risk for future IPV.",Iverson KM.; Gradus JL.; Resick PA.; Suvak MK.; Smith KF.; Monson CM.,2011.0,10.1037/a0022512,0,0,
9199,Cognitive-behavioral conjoint therapy for PTSD: pilot results from a community sample.,"Seven couples participated in an uncontrolled trial of cognitive-behavioral conjoint therapy for posttraumatic stress disorder (PTSD). Among the 6 couples who completed treatment, 5 of the patients no longer met criteria for PTSD and there were across-treatment effect size improvements in patients' total PTSD symptoms according to independent clinician assessment, patient report, and partner report (d = 1.32-1.69). Three of the 4 couples relationally distressed at pretreatment were satisfied at posttreatment. Partners reported statistically significant and large effect size improvements in relationship satisfaction; patients reported nonsignificant moderate to large improvements in relationship satisfaction. Patients also reported nonsignificant, but large effect size improvements in depression and state anger symptoms. Future directions for research and treatment of traumatized individuals and close others are offered.",Monson CM.; Fredman SJ.; Adair KC.; Stevens SP.; Resick PA.; Schnurr PP.; MacDonald HZ.; Macdonald A.,2011.0,10.1002/jts.20604,0,0,
9200,Therapist adherence to manualized cognitive-behavioral therapy for anger management delivered to veterans with PTSD via videoconferencing.,"Therapist adherence to a manualized cognitive-behavioral anger management group treatment (AMT) was compared between therapy delivered via videoconference (VC) and the traditional in-person modality, using data from a large, randomized controlled trial comparing the effectiveness of AMT for veterans with combat-related posttraumatic stress disorder. Therapist adherence was rated for the presence or absence of process and content treatment elements. Secondary analyses were conducted using a repeated measures ANOVA. Overall adherence to the protocol was excellent (M = 96%, SD = 1%). Findings indicate that therapist adherence to AMT is similar across delivery modalities and VC is a viable service delivery strategy that does not compromise a therapist's ability to effectively structure sessions and manage patient care.",Morland LA.; Greene CJ.; Grubbs K.; Kloezeman K.; Mackintosh MA.; Rosen C.; Frueh BC.,2011.0,10.1002/jclp.20779,0,0,
9201,Arthroscopic repair for combined Bankart and superior labral anterior posterior lesions: a comparative study between primary and recurrent anterior dislocation in the shoulder.,"The purpose of this study was to compare clinical outcomes between a primary dislocation group (group P) and a recurrent dislocation group (group R) with combined lesion of Bankart and type II SLAP lesions (type V SLAP lesion) and to evaluate incidence of type V SLAP lesion. In addition, the authors evaluated clinical outcomes of these patients by dividing two groups according to the sequence for Bankart and SLAP lesion suture. From May 2000 to May 2005, 310 patients who gave informed consent, underwent the diagnostic arthroscopy and magnetic resonance arthrography (MRA). One hundred and ten patients met the following criteria: (1) post-traumatic primary or recurrent anterior shoulder instability, (2) a normal contralateral shoulder, (3) a type V SLAP lesion, and (4) minimum follow-up of two years. Group P included 42 patients, and group R, 68 patients. Among all patients, 58 patients who had Bankart lesions sutured first were included in group B, and 52 who had their SLAP lesions sutured beforehand, group S. Visual analogue scale, range of motion, Rowe and Constant score were used to compare results between group P and group R, also group B and group S. The incidence rates of type V SLAP lesion were 42.8% in group P and 32.0% in group R. The overall treatment results in our study were good. Even if the difference between the two groups was statistically insignificant, group P showed greater recovery of range of motion than group R in external rotation. No significant difference was found between the two different operative methods according to suture sequence. The incidence rates of type V SLAP lesion were 42.8% in the primary dislocation group and 32.0% in the recurrent dislocation group. The overall treatment results in our study were good. Although there was no statistical significance in surgical time between the two groups, when both SLAP and Bankart lesions are present, the Bankart lesion must be sutured first to reduce surgical time.",Kim DS.; Yi CH.; Yoon YS.,2011.0,10.1007/s00264-011-1229-3,0,0,
9202,Training interpretation biases among individuals with symptoms of obsessive compulsive disorder.,"The current study tested the causal premise underlying cognitive models of obsessive compulsive disorder (OCD) that negative interpretations of intrusive thoughts lead to the distress and impairment associated with symptoms of OCD. Specifically, we sought to determine: (a) whether it was possible to train healthier (defined as more benign/less threatening) interpretations regarding the significance of intrusive thoughts; and (b) whether there was a link between modifying negative interpretations and subsequent emotional vulnerability to an OC stressor. A nonclinical sample of students high in OC symptoms completed either a Positive (n = 50) or Neutral (n = 50) interpretation training procedure designed to alter OC-relevant interpretations and beliefs. As expected, participants in the Positive (versus Neutral) training condition endorsed healthier OC-relevant interpretations and beliefs following training. Additionally, when controlling for baseline affect, participants in the Positive (versus Neutral) training condition reported less negative affect during the OC-stressor task (at the level of a non-significant trend) and reported less desire to perform neutralizing activities. In general, results provide some support for cognitive models of obsessions and suggest that negative interpretations of intrusive thoughts may be causally related to symptoms of OCD.",Clerkin EM.; Teachman BA.,2011.0,10.1016/j.jbtep.2011.01.003,0,0,
9203,Anxiety as a predictor of improvements in somatic symptoms and health anxiety associated with cognitive-behavioral intervention in hypochondriasis.,"Cognitive-behavioral therapy (CBT) has been shown to be beneficial in the treatment of hypochondriasis. In this study, we sought to determine whether there was a differential treatment effect for patients with greater levels of anxiety at the outset of treatment. A total of 182 hypochondriacal participants (139 women, mean = 42.1 years of age) were randomly assigned to a CBT or control group. All participants completed self-report measures of hypochondriasis that exceeded a predetermined threshold on 2 successive occasions. CBT consisted of 6, weekly 90-min sessions. The control subjects received the usual medical care during the same period. Three questionnaires (the Whiteley Index, the Health Anxiety Inventory, and the Somatic Symptom Inventory) were used to assess hypochondriacal symptoms, and the Symptom Checklist 90R was used to assess anxiety and other psychological symptoms. These were administered before the intervention and at 6 and 12 months after the completion of the intervention. Scores on the 3 measures of hypochondriasis were significantly decreased after treatment in the CBT compared with the control group. Anxiety and other psychological symptoms also showed significant reductions in the CBT group. High levels of pretreatment anxiety predicted decreases in the 3 hypochondriasis scores after controlling for the effects of depression, age, sex, educational level, employment status, and marital status. High anxiety at entry into the CBT program predicted a better treatment outcome.",Nakao M.; Shinozaki Y.; Ahern DK.; Barsky AJ.,2011.0,10.1159/000320122,0,0,
9204,Hurt people who hurt people: violence amongst individuals with comorbid substance use disorder and post traumatic stress disorder.,"The association between substance use disorder (SUD) and the perpetration of violence has been well documented. There is some evidence to suggest that the co-occurrence of post traumatic stress disorder (PTSD) may increase the risk for violence. This study aims to determine the prevalence of violence perpetration and examine factors related to violence amongst individuals with comorbid SUD and PTSD. Data was collected via interview from 102 participants recruited to a randomised controlled trial of an integrated treatment for comorbid SUD and PTSD. The interview addressed demographics, perpetration of violent crime, mental health including aggression, substance use, PTSD, depression, anxiety and borderline personality disorder. Over half of participants reported committing violence in their lifetime and 16% had committed violence in the past month. Bivariate associations were found between violence perpetration and trait aggression, higher levels of alcohol and cannabis use, lower levels of other opiate use, and experiencing more severe PTSD symptoms, particularly in relation to hyperarousal. When entered into a backward stepwise logistic regression however, only higher levels of physical aggression and more severe PTSD hyperarousal symptoms remained as independent predictors of violence perpetration. These findings highlight the importance of assessing for PTSD amongst those with SUD particularly in forensic settings. They also indicate that it is the hyperarousal symptoms of PTSD specifically that need to be targeted by interventions aimed at reducing violence amongst individuals with SUD and PTSD.",Barrett EL.; Mills KL.; Teesson M.,2011.0,10.1016/j.addbeh.2011.02.005,0,0,
9205,Two sessions of sleep-focused mind-body bridging improve self-reported symptoms of sleep and PTSD in veterans: A pilot randomized controlled trial.,"Sleep disturbance is highly prevalent among veterans. As an alternative to sleep medications with their undesirable side effects, nonpharmacological mind-body interventions may be beneficial for sleep management in primary care. The aim of this pilot study was to investigate whether a novel mind-body intervention, mind-body bridging (MBB), focusing on sleep, could improve self-reported sleep disturbance and comorbid symptoms in veterans. This pilot study was a randomized controlled trial at the Veterans Affairs Salt Lake City Health Care System in which 63 veterans with self-reported sleep disturbance received MBB or an active sleep education control. Both interventions were conducted in two sessions, once per week. Patient-reported outcomes included the following: primary-Medical Outcomes Study (MOS) Sleep Survey, MOS Short Form-36V; secondary-Center for Epidemiological Studies-Depression, PTSD Check List-Military, Five-Factor Mindfulness Questionnaire. At both Week 1 (1 week after the first session) and post-intervention assessments, while sleep disturbance decreased in both groups, MBB performed significantly better than did the control group. Furthermore, self-reported PTSD symptoms improved in MBB, while they remained unchanged in the control. Overall mindfulness increased in MBB, while it remained unchanged in the control. This study provides preliminary evidence that a brief sleep-focused MBB could be a promising intervention for sleep and potentially other comorbid symptoms (e.g., PTSD). MBB could help patients develop awareness skills to deal with sleep-related symptoms. Integration of MBB into primary care settings may enhance care of patients with sleep disturbance and co-morbid symptoms.",Nakamura Y.; Lipschitz DL.; Landward R.; Kuhn R.; West G.,2011.0,10.1016/j.jpsychores.2010.09.007,0,0,
9206,The role of mechanisms of buffering anxiety in HIV carriers. A study within the terror management theory paradigm.,"The paper concerns definition of the level of posttraumatic growth (PTG), the psychological adaptation mechanism occurring after extreme experiences in life, such as being informed of having HIV infection. The study is experimental, aiming to assess whether correlations between exposure to thoughts of stressful experiences and their psychological consequences are mediated by an efficient mechanism of buffering anxiety Fifty-four men and 26 women infected with HIV who underwent manipulated exposure to mortality according to the hypotheses of the terror management theory (TMT) were included. Subjects were randomly assigned to the control group (dental anxiety) or the experimental group (fear of dying). The results confirmed the assumptions of the terror management theory. The subjects had an efficient mechanism of alleviating the fear of dying, the so-called ""anxiety buffer."" The analysis revealed a high level of posttraumatic growth and advantages derived from the disease. The paper additionally characterizes the specific group of HIV-positive people, their functioning in society and the family. It touches on such issues as professional work, relations with relatives and friends, social life, and adherence. The study has shown that the specific group of people infected with HIV managed very well to adapt to the circumstances. One may say that as a consequence of acquiring the infection, the subjects have experienced significant changes of personality, which have ultimately led to an improvement of their lives and offered new possibilities for personal and social development to them. All the recorded changes fit into the TMT paradigm.",Kwiatkowska M.; Knysz B.; Gąsiorowski J.; Łuszczyńska A.; Gładysz A.,2011.0,,0,0,
9207,A randomized controlled trial of cognitive-behavioral therapy for generalized anxiety disorder with integrated techniques from emotion-focused and interpersonal therapies.,"Recent models suggest that generalized anxiety disorder (GAD) symptoms may be maintained by emotional processing avoidance and interpersonal problems. This is the first randomized controlled trial to test directly whether cognitive-behavioral therapy (CBT) could be augmented with the addition of a module targeting interpersonal problems and emotional processing. Eighty-three primarily White participants (mean age = 37) with a principle diagnosis of GAD were recruited from the community. Participants were assigned randomly to CBT plus supportive listening (n = 40) or to CBT plus interpersonal and emotional processing therapy (n = 43) within a study using an additive design. Doctoral-level psychologists with full-time private practices treated participants in an outpatient clinic. Using blind assessors, participants were assessed at pretreatment, posttreatment, 6-month, 1-year, and 2-year follow-up with a composite of self-report and assessor-rated GAD symptom measures (the Penn State Worry Questionnaire; T. J. Meyer, M. L. Miller, R. L. Metzger, & T. D. Borkovec, 1990; Hamilton Anxiety Rating Scale; M. Hamilton, 1959; assessor severity rating; State-Trait Anxiety Inventory-Trait Version; C. D. Spielberger, R. L. Gorsuch, R. Lushene, P. R. Vagg, & G. A. Jacobs, 1983) as well as with indices of clinically significant change. Mixed models analysis of all randomized participants showed very large within-treatment effect sizes for both treatments (CI = [-.40, -.28], d = 1.86) with no significant differences at post (CI = [-.09, .07], d = .07) or 2-year follow-up (CI = [-.01, .01]), d = .12). There was also no statistical difference between compared treatments on clinically significant change based on chi-square analysis. Interpersonal and emotional processing techniques may not augment CBT for all GAD participants. Trial Registry name: Clinical Trials.gov, Identifier: NCT00951652.",Newman MG.; Castonguay LG.; Borkovec TD.; Fisher AJ.; Boswell JF.; Szkodny LE.; Nordberg SS.,2011.0,10.1037/a0022489,0,0,
9208,Glucocorticoids enhance extinction-based psychotherapy.,"Behavioral exposure therapy of anxiety disorders is believed to rely on fear extinction. Because preclinical studies have shown that glucocorticoids can promote extinction processes, we aimed at investigating whether the administration of these hormones might be useful in enhancing exposure therapy. In a randomized, double-blind, placebo-controlled study, 40 patients with specific phobia for heights were treated with three sessions of exposure therapy using virtual reality exposure to heights. Cortisol (20 mg) or placebo was administered orally 1 h before each of the treatment sessions. Subjects returned for a posttreatment assessment 3-5 d after the last treatment session and for a follow-up assessment after 1 mo. Adding cortisol to exposure therapy resulted in a significantly greater reduction in fear of heights as measured with the acrophobia questionnaire (AQ) both at posttreatment and at follow-up, compared with placebo. Furthermore, subjects receiving cortisol showed a significantly greater reduction in acute anxiety during virtual exposure to a phobic situation at posttreatment and a significantly smaller exposure-induced increase in skin conductance level at follow-up. The present findings indicate that the administration of cortisol can enhance extinction-based psychotherapy.",de Quervain DJ.; Bentz D.; Michael T.; Bolt OC.; Wiederhold BK.; Margraf J.; Wilhelm FH.,2011.0,10.1073/pnas.1018214108,0,0,
9209,Become more optimistic by imagining a best possible self: effects of a two week intervention.,"Optimism is a personality trait which has repeatedly been shown to correlate with, and predict psychological and physical well-being. The present study investigated whether optimism can be increased by imagining a best possible self (BPS). Effects were compared to a control group in which participants imagined their daily activities (DA). In order to minimize inter-individual differences in content of imagery, participants constructed their BPS according to 3 domains, namely a personal, relational, and professional domain. All participants were instructed to practice their imagery exercise for 5 min per day over a period of two weeks. Effects on optimism and mood were measured after one session, after one week and after two weeks. Results indicated that BPS imagery led to significantly larger increases in optimism as compared to DA imagery, after one session and over a two week period. Effects on optimism remained after controlling for possible mediation by the change in positive mood. In order to test the effectiveness of our BPS imagery intervention we relied exclusively on self-report measures. The present study confirmed that imagining a BPS enhances levels of optimism, independent of the mood effect.",Meevissen YM.; Peters ML.; Alberts HJ.,2011.0,10.1016/j.jbtep.2011.02.012,0,0,
9210,Differences in treatment attitudes between depressed African-American and Caucasian veterans in primary care.,"Depressive disorders are common, and it is important to understand the factors that contribute to racial disparities in depression treatment. This primary care study of veterans with subsyndromal depression examined two hypotheses: that African Americans would be less likely than Caucasians to believe that medication is beneficial in depression treatment and would be more likely to believe that counseling or psychotherapy is beneficial. Primary care patients with subsyndromal depression were referred to the Philadelphia Department of Veterans Affairs Behavioral Health Laboratory and asked about past experiences and attitudes toward depression treatment. Among 111 African-American and 95 Caucasian participants, logistic regression analyses determined that African Americans were less likely to view medication as beneficial (odds ratio=.44). No racial differences were found in participants' attitude toward counseling or psychotherapy. The findings support the premise that clinicians treating patients with subsyndromal depressive syndromes should take into account racial differences in attitudes toward treatment.",Kasckow J.; Ingram E.; Brown C.; Tew JD.; Conner KO.; Morse JQ.; Haas GL.; Reynolds CF.; Oslin DW.,2011.0,10.1176/ps.62.4.pss6204_0426,0,0,
9211,The development of a brief psychodynamic intervention (dynamic interpersonal therapy) and its application to depression: a pilot study.,"This paper describes a protocol for a brief psychodynamic intervention (Dynamic Interpersonal Therapy; DIT) for use with depressed patients and a pilot study set out to test its acceptability and compatibility with session-by-session monitoring as a prelude to a future randomized controlled trial. Sixteen consecutively referred, depressed patients (aged 20-53) were offered 16 sessions of DIT. Patient outcomes were collected pre-post, and on a session-by-session basis, using the PHQ-9 and GAD-7. Therapist and supervision feedback indicates that this structured psychodynamic treatment could be effectively taught, and that the key competences involved were acquired and demonstrated in the clinical work supervised. Patients found the treatment acceptable and relevant to their problems. The treatment appeared compatible with session-by-session monitoring of symptoms of anxiety and depression. DIT was associated with a significant reduction in reported symptoms in all but one case, to below clinical levels in 70% of the patients. Random regression models revealed highly significant linear and quadratic components, confirming the decrease in reported symptom severity but cautioning about slight increase in symptoms around the ending phase of the treatment. The results suggest that DIT is promising in its acceptability and effectiveness with an unselected group of primary care patients, and is easily acquired by psychodynamically trained clinicians.",Lemma A.; Target M.; Fonagy P.,2011.0,10.1521/psyc.2011.74.1.41,0,0,
9212,Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: a randomized controlled non-inferiority trial.,"Cognitive behavioral group therapy (CBGT) is an effective, well-established, but not widely available treatment for social anxiety disorder (SAD). Internet-based cognitive behavior therapy (ICBT) has the potential to increase availability and facilitate dissemination of therapeutic services for SAD. However, ICBT for SAD has not been directly compared with in-person treatments such as CBGT and few studies investigating ICBT have been conducted in clinical settings. Our aim was to investigate if ICBT is at least as effective as CBGT for SAD when treatments are delivered in a psychiatric setting. We conducted a randomized controlled non-inferiority trial with allocation to ICBT (n=64) or CBGT (n=62) with blinded assessment immediately following treatment and six months post-treatment. Participants were 126 individuals with SAD who received CBGT or ICBT for a duration of 15 weeks. The Liebowitz Social Anxiety Scale (LSAS) was the main outcome measure. The following non-inferiority margin was set: following treatment, the lower bound of the 95 % confidence interval (CI) of the mean difference between groups should be less than 10 LSAS-points. Both groups made large improvements. At follow-up, 41 (64%) participants in the ICBT group were classified as responders (95% CI, 52%-76%). In the CBGT group, 28 participants (45%) responded to the treatment (95% CI, 33%-58%). At post-treatment and follow-up respectively, the 95 % CI of the LSAS mean difference was 0.68-17.66 (Cohen's d between group=0.41) and -2.51-15.69 (Cohen's d between group=0.36) favoring ICBT, which was well within the non-inferiority margin. Mixed effects models analyses showed no significant interaction effect for LSAS, indicating similar improvement across treatments (F=1.58; df=2, 219; p=.21). ICBT delivered in a psychiatric setting can be as effective as CBGT in the treatment of SAD and could be used to increase availability to CBT. ClinicalTrials.gov NCT00564967.",Hedman E.; Andersson G.; Ljótsson B.; Andersson E.; Rück C.; Mörtberg E.; Lindefors N.,2011.0,10.1371/journal.pone.0018001,0,0,
9213,Treatment of posttraumatic embitterment disorder with cognitive behaviour therapy based on wisdom psychology and hedonia strategies.,"Posttraumatic embitterment disorder (PTED) is a reaction to unjust or humiliating life events, including embitterment and impairment of mood, somatoform complaints, reduction in drive, withdrawal from social contacts, and even suicide and murder suicide. Patients have been shown to be nonresponders to many treatments. This paper gives an outline of cognitive behaviour therapy based on wisdom psychology and reports first data on treatment effects. In a first pilot study on psychotherapy for PTED, a cohort of 25 PTED inpatients was treated with routine multidimensional cognitive behaviour therapy. A second consecutive cohort of 28 patients was treated with PTED-specific cognitive behaviour therapy, which is based on wisdom psychology (wisdom psychotherapy) and another 29 patients with cognitive behaviour therapy based on wisdom psychology together with additional hedonia strategies (wisdom and hedonia psychotherapy). Treatment integrity was measured with special modules of the Behaviour Therapy Competency Checklist. The outcomes were measured in all 3 groups with the SCL-90 and a global clinical rating of patients and therapists on treatment outcome. There were significant and clinically meaningful reductions in the SCL score after wisdom therapy, as compared to routine treatment. In clinical ratings by therapists and patients, both specific treatments were judged as more effective than treatment as usual. Additional hedonia strategies did not lead to better treatment effects. The results of this pilot study suggest that wisdom psychology offers an approach to treat PTED and justify further randomized controlled outcome studies.",Linden M.; Baumann K.; Lieberei B.; Lorenz C.; Rotter M.,2011.0,10.1159/000321580,0,0,
9214,Long-term effectiveness of collaborative depression care in older primary care patients with and without PTSD symptoms.,"Depressed patients with comorbid post-traumatic stress disorder (PTSD) are more functionally impaired and may take longer to respond to depression treatment than patients without PTSD. This study examined the long-term effects of PTSD on depression severity, treatment response, and health care costs among older adults. Patients were recruited from 18 primary care clinics in five states. A total of 1801 patients aged 60 years or older with major depression or dysthymia were randomized to Improving Mood Promoting Access to Collaborative Treatment (IMPACT) collaborative care or usual care. The study included 191 (10.6%) subjects who screened positive for PTSD. Depression severity, assessed by the Hopkins Depression Symptom Checklist, was used to estimate depression-free days (DFDs) over 24 months. Total health care costs included inpatient, outpatient, and pharmacy costs. Depressed patients with PTSD had higher depression severity than patients without PTSD symptoms at baseline. Over 2 years, intervention patients with PTSD symptoms had relatively the same benefits from collaborative care (99 more DFDs than usual care patients) as patients without PTSD (108 more DFDs than usual care) (p = 0.85). Total health care costs did not differ significantly for depressed patients with and without PTSD symptoms. Depressed older adults with PTSD symptoms were more depressed at baseline, but collaborative care (compared to usual care) produced similar improvements in depression severity in both groups. This reduction of depression symptoms was observed for up to 12 months after the intervention ended, suggesting that long-term improvements in depression are possible with collaborative care in patients with and without PTSD symptoms.",Chan D.; Fan MY.; Unützer J.,2011.0,10.1002/gps.2606,0,0,
9215,Intimate partner violence exposure predicts PTSD treatment engagement and outcome in cognitive processing therapy.,"Intimate partner violence (IPV) exposure was examined as a predictor of treatment engagement (i.e., starting and completing therapy) and treatment outcome in 150 women taking part in a dismantling study of cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD; Resick et al., 2008). Results indicate that women in a current intimate relationship with recent IPV (i.e., past year) were less likely to begin treatment relative to women who reported past IPV only or no history of IPV. For women who began treatment, IPV exposure was not predictive of whether or not they completed treatment. Among women who began treatment, the frequency of IPV was associated with treatment outcome such that women who experienced more frequent IPV exhibited larger reductions in PTSD and depression symptoms over the course of treatment, but experienced similar levels of PTSD and depression severity at the 6-month follow-up. Findings highlight the importance of targeting treatment engagement among women who report recent IPV and suggest that women who have experienced frequent IPV respond well to CPT treatment in spite of their IPV experiences.",Iverson KM.; Resick PA.; Suvak MK.; Walling S.; Taft CT.,2011.0,10.1016/j.beth.2010.06.003,0,0,
9216,Specificity and generalization of attentional bias in sexual trauma victims suffering from posttraumatic stress disorder.,"The present study investigated specificity of attentional biases for trauma-related stimuli using an Emotional Stroop Task. Participants were 14 women suffering from posttraumatic stress disorder (PTSD) who had experienced a sexual trauma and 24 healthy non-traumatized women. They were asked to name print colors of 4 different word types: threatening sexual violence words and non-threatening sexual words, threatening accident trauma words, and positive words. Compared to control participants, PTSD patients displayed increased interference by threatening trauma-related, but not by accident trauma and positive words. Interference by non-threatening sexual words occurred as well, but only in those patients who suffered from more severe PTSD arousal symptoms. These findings suggest graded generalization of the attentional bias across stimuli of varying emotional valence, but specificity regarding the trauma topic. Results are discussed in light of current cognitive models of PTSD, and clinical implications are suggested.",Fleurkens P.; Rinck M.; van Minnen A.,2011.0,10.1016/j.janxdis.2011.03.014,0,0,
9217,"A randomised controlled trial to evaluate the effects of a self-help workbook intervention on distress, coping and quality of life after breast cancer diagnosis.","To evaluate the efficacy of an interactive self-help workbook in reducing distress, and improving quality of life (QOL) and coping for women recently diagnosed with breast cancer. Randomised controlled trial comparing the use of the workbook and that of an information booklet. 49 women with Stage 0 to II breast cancer diagnosed in the previous month and recruited from 1 February 2007 to 1 February 2008, in two urban Australian public hospitals. The primary outcome measures were depression, anxiety, and posttraumatic stress. Secondary outcomes included QOL, body image, and the coping styles helplessness/hopelessness, cognitive avoidance and anxious preoccupation. After controlling for baseline levels, interactions at 3-month follow-up showed that participants in the workbook group had significantly lower levels of posttraumatic stress (F[1,89] = 7.01; P = 0.01), helplessness/hopelessness (F [1,89] = 4.75; P = 0.03), and cognitive avoidance (F [1,89] = 4.95; P = 0.03) than those in the control (information booklet) group. However, women in the workbook group had significantly poorer body image than those in the control group (F [1,89] = 6.43; P = 0.01). At 6 months, only the body image interaction remained significant (F [1,93] = 7.44; P = 0.01). These results suggest that a self-help workbook can be an effective, short-term intervention for improving posttraumatic stress, cognitive avoidance, and certain depressive symptoms in women recently diagnosed with breast cancer. However, issues related to body image need to be dealt with differently. Australian New Zealand Clinical Trials Registry",Beatty LJ.; Koczwara B.; Rice J.; Wade TD.,2010.0,,0,0,
9218,Patterns of anxiety in critically ill patients receiving mechanical ventilatory support.,"Mechanical ventilation is one of the most frequently used technological treatments in critical care units and induces great anxiety in patients. Although mechanical ventilation and critical illness induce great anxiety and distress in hospitalized patients, little is known about anxiety ratings over the course of ventilatory support. Knowledge of anxiety ratings over time is needed to implement effective symptom management interventions. The purposes of this study were to describe anxiety ratings for a subgroup of mechanically ventilated patients over the duration of enrollment in a multisite clinical trial, to discern any pattern of change in anxiety ratings, to determine if anxiety decreases over time, and to explore the influence of sedative exposure on anxiety ratings. Participants were 57 mechanically ventilated patients who were randomly assigned to the usual care group of a randomized controlled trial designed to assess the efficacy of music interventions on anxiety of mechanically ventilated patients in intensive care units. Anxiety ratings were obtained at study entry and daily for up to 30 days. A 100-mm visual analog scale was used to measure anxiety. Visual Analog Scale-Anxiety scores were plotted as a function of study time in days for each participant to discern possible patterns of change. A mixed-models analysis was performed to assess the nature and magnitude of change over time (slope) using 251 observations on 57 patients. Results of the unconditional means model indicated that further modeling was appropriate. An autoregressive covariance structure with a random component for participant was chosen as the most appropriate covariance structure for modeling. An unconditional growth model indicated that the Visual Analog Scale-Anxiety ratings declined slowly over time: -.53 points per day (p = .09). Anxiety is an individual patient experience that requires ongoing management with appropriate assessment and intervention over the duration of mechanical ventilatory support.",Chlan L.; Savik K.,,10.1097/NNR.0b013e318216009c,0,0,6180
9219,Cognitive-behavioral intervention among women with slight menopausal symptoms: a pilot study.,"Menopause is associated with a considerable variety of physical, psychological and social symptoms that can be treated using cognitive-behavioral techniques. In the present study, 21 women took part in an eight-week group intervention consisting of weekly two-hour sessions to address their slight symptoms related to the climacteric stage of life. The intervention included: psycho education on menopause, relaxation techniques, nutrition and fitness exercises, Kegel exercises, and problem-solving techniques. A control group was included that did not receive treatment and consisted of 28 women. The results revealed a significant reduction in most symptoms (including depression and anxiety) after intervention as compared to the baseline period. No changes appeared in the control group. The relevance of this work lies in the potential element of prevention this therapeutic package could offer to relieve various symptoms, slight and incipient, during the perimenopausal stage.",Larroy García C.; Gómez-Calcerrada SG.,2011.0,,0,0,
9220,Further development and validation of the Unhelpful Thoughts and Beliefs About Stuttering (UTBAS) scales: relationship to anxiety and social phobia among adults who stutter.,"In an initial validation study, the Unhelpful Thoughts and Beliefs About Stuttering (UTBAS I) scale, demonstrated excellent psychometric properties as a self-report measure of the frequency of unhelpful cognitions associated with social anxiety for adults who stutter. The aim was to further validate the original UTBAS I scale, and to develop two additional scales to assess beliefs (UTBAS II) and anxiety (UTBAS III) associated with negative thoughts. A total of 140 adults seeking speech-restructuring treatment for stuttering completed the original UTBAS I scale, the newly developed UTBAS II and III scales, and self-report measures of psychological functioning. Participants also completed a first-stage screener for the presence of anxious personality disorder, and a diagnostic assessment to evaluate the presence of social phobia, according to criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the International Classification of Diseases (ICD-10). The mean UTBAS I score for the present sample did not differ significantly from the mean score reported in the original UTBAS I validation study. Convergent validity was confirmed by significant correlations between the UTBAS Total score and all anxiety-related measures. Discriminant validity was established by the absence of strong correlations between the UTBAS Total score and some of the self-report measures of unrelated constructs, although it was found to tap into the negative cognitions associated with depression and life problems. Approximately one-quarter of participants met criteria for a diagnosis of DSM-IV or ICD-10 social phobia (23.5% and 27.2% respectively), and nearly one-third met first-stage screening criteria for anxious personality disorder (30%). The mean UTBAS scores for participants who met criteria for these disorders were significantly higher than scores for participants who did not, confirming known-groups validity. The present study demonstrates the validity and utility of the UTBAS scales in assessing negative cognitions associated with speech-related anxiety among adults who stutter. Results also confirm previous evidence of a high rate of social phobia among adults who stutter, and reveal that the UTBAS discriminates between adults with and without social phobia. In terms of clinical applications, the UTBAS scales could be used to screen for indicators of social phobia among adults who stutter, and may prove useful in identifying negative cognitions which have the potential to impact treatment outcomes.",Iverach L.; Menzies R.; Jones M.; O'Brian S.; Packman A.; Onslow M.,,10.3109/13682822.2010.495369,0,0,
9221,The impact of short-term psycho-oncological interventions on the psychological outcome of cancer patients of a surgical-oncology department - a randomised controlled study.,"Anxiety and depression are the two most frequent comorbidities of tumour patients. At present, it is unclear to which degree a patient's psychological condition can be altered during the treatment period and if psycho-oncological support positively affects a patient's psychological condition. In a random sample analyses, 131 patients beginning inpatient treatment at a hospital specialising in surgical oncology were either classified as 'low-risk' or 'high-risk', according to the HADS. Patients from both categories were then randomly placed in either a low-threshold 'intervention' group or an 'observation' group. Anxiety and depression levels were measured again with the HADS scale prior to the patients discharge from the department of surgical oncology, and at a follow up 12 months after. Our findings showed a significant reduction of anxiety and depression in the high-risk patients who had undergone psycho-oncological intervention at the end of inpatient care and even a year after discharge from the hospital. The effects of psychological intervention could be observed in terms of anxiety and depression in the group of high-risk patients during the hospital stay. In the other three groups, no statistically significant changes could be measured. Cancer patients on a surgical ward benefit from psycho-oncological support especially at an early stage of therapy but also over a long time after discharge from the hospital. The aim of all interventions should be to decrease psychological distress and disorders and thereby improve the quality of life for cancer patients.",Goerling U.; Foerg A.; Sander S.; Schramm N.; Schlag PM.,2011.0,10.1016/j.ejca.2011.04.031,0,0,
9222,Attenuating memory distrust in a repeated checking task.,"Repeated checking has been demonstrated to lead to reductions in memory confidence in several previous studies using student and clinical samples. This process of reduced confidence in memory and detail for memory, are thought to arise from the inhibition of perceptual processing that develops during repeated checking. Our research investigated whether reduced memory confidence from repeated checking could be attenuated through the use of novel stimuli during the repeated checking task. Three groups were generated through random assignment of 65 undergraduate students. As seen in previous research, individuals who repeatedly checked a stimulus (a virtual stovetop) showed reduced memory confidence, vividness, and detail, when compared with individuals who repeatedly checked a different stimulus. A third group in which the colour of the repeatedly-checked stovetop changed every five trials showed no significant decline in memory confidence between the pre-test and post-test. Results suggest that increased memory distrust can be ameliorated through the use of stimuli with characteristics that are novel and distinctive. Findings are discussed in the context of the existing model of repeated checking and memory confidence, and implications for treatment methods are presented.",Boschen MJ.; Wilson KL.; Farrell LJ.,2011.0,10.1016/j.brat.2011.05.001,0,0,
9223,Anxiety and depression in multiple sclerosis patients around diagnosis.,"To prospectively identify anxiety and depressive symptoms, and their predictors, during the multiple sclerosis (MS) peridiagnostic period. The Hospital Anxiety and Depression Scale (HADS) was administered during diagnostic workup (baseline), and one and six months after diagnosis disclosure, to SIMS-Trial participants (ISRCTN81072971). Of 197 screened patients, 120 (61%) were diagnosed with MS. At baseline, median HADS anxiety (HADS-A) score was 7.0 (interquartile range [IQR] 5.0-9.5), ‚â•8 (anxiety cut-off) in 43% (95% confidence interval [CI] 34%-52%). Median HADS depression (HADS-D) was 3.0 (IQR 1.0-5.0), ‚â•8 (depression cut-off) in 11% (95% CI 5%-16%). Independent predictors of anxiety were female sex (odds ratio [OR] 2.8, 95% CI 1.1-7.2) and HADS-D score (OR 20.8, 95% CI 2.5-175.5). The only predictor of depressive symptoms was HADS-A score (OR 20.0, 95% CI 2.8-260.9). Anxiety symptoms had decreased slightly but significantly (p<0.001) at six months. Depressive symptoms remained low. Anxiety was prominent in the period surrounding MS diagnosis disclosure, particularly in women. A slight but significant reduction occurred six months after diagnosis disclosure. Depressive symptoms were less common and stable over time. In addition to sex, depressive symptoms were the only variable independently associated with anxiety.",Giordano A.; Granella F.; Lugaresi A.; Martinelli V.; Trojano M.; Confalonieri P.; Radice D.; Solari A.;  .,2011.0,10.1016/j.jns.2011.05.008,0,0,
9224,Identifying patterns of symptom change during a randomized controlled trial of cognitive processing therapy for military-related posttraumatic stress disorder.,"Cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) has been shown to reduce symptoms of PTSD in a veteran population. This study explored patterns of self-reported symptom change during CPT. Veterans (N = 60) with PTSD were randomized to receive CPT immediately or after 10 weeks. We hypothesized that those treated immediately would evidence initial symptom stability followed by decline compared with those who waited, whose PTSD symptoms would remain stable. The best model fit based on deviance statistics and Bayesian information criteria comparisons was one in which participants treated immediately showed more rapid initial decline followed by a slower rate of PTSD symptom improvement relative to those who waited, who showed a stable level of symptomatology. Findings suggest that CPT produces quick and maintained improvements in veterans. The effect sizes for change between those who received CPT immediately and those who waited were approximately medium sized. Implications of findings are discussed.",Macdonald A.; Monson CM.; Doron-Lamarca S.; Resick PA.; Palfai TP.,2011.0,10.1002/jts.20642,0,0,
9225,A controlled comparison of the effectiveness and efficiency of two psychological therapies for posttraumatic stress disorder: eye movement desensitization and reprocessing vs. emotional freedom techniques.,"The present study reports on the first ever controlled comparison between eye movement desensitization and reprocessing (EMDR) and emotional freedom techniques (EFT) for posttraumatic stress disorder. A total of 46 participants were randomized to either EMDR (n = 23) or EFT (n = 23). The participants were assessed at baseline and then reassessed after an 8-week waiting period. Two further blind assessments were conducted at posttreatment and 3-months follow-up. Overall, the results indicated that both interventions produced significant therapeutic gains at posttreatment and follow-up in an equal number of sessions. Similar treatment effect sizes were observed in both treatment groups. Regarding clinical significant changes, a slightly higher proportion of patients in the EMDR group produced substantial clinical changes compared with the EFT group. Given the speculative nature of the theoretical basis of EFT, a dismantling study on the active ingredients of EFT should be subject to future research.",Karatzias T.; Power K.; Brown K.; McGoldrick T.; Begum M.; Young J.; Loughran P.; Chouliara Z.; Adams S.,2011.0,10.1097/NMD.0b013e31821cd262,0,0,
9226,Anger suppression after imagined rejection among individuals with social anxiety.,"Individuals experiencing high levels of social anxiety report frequent and intense anger. Yet, little is known about how they manage this emotion. Despite general tendencies towards anger suppression, subsets of individuals with social anxiety regulate anger through outward expression. In this study, we investigated rejection as an antecedent to anger, examined how and when individuals with high social anxiety suppress anger, and evaluated experiential avoidance (EA) as a moderator of the relationship between social anxiety and anger suppression. 170 undergraduate students described their responses to everyday social situations that were designed to elicit anger; several situations reflected instances of social rejection. Our results suggest that rejection was a potent source of anger for most people and that social anxiety predicted both anger and EA in response to imagined rejection. In addition, as evidence of a moderation model, individuals with low social anxiety and low EA reported the least anger suppression; no significant differences were found for individuals with high social anxiety. We discuss the implications for understanding the interface of social anxiety and anger.",Breen WE.; Kashdan TB.,2011.0,10.1016/j.janxdis.2011.04.009,0,0,
9227,Effects of video-based therapy preparation targeting experiential acceptance or the therapeutic alliance.,"Preparation for psychotherapy may enhance the psychotherapeutic process, reduce drop-outs, and improve outcomes, but the effective mechanisms of such preparation are poorly understood. Previous studies have rarely targeted specific processes that are associated with positive therapy outcomes. This randomized experiment compared the effects of preparatory videos that targeted either the Therapeutic Alliance, Experiential Acceptance, or a Control video on early therapeutic process variables in 105 patients seen in individual therapy. Participants watched the videos just before their first therapy session. No significant differences were found between the Alliance and Experiential Acceptance videos on patient recommendations, immediate affective reactions, or working alliance and attrition after the first session. However, the Therapeutic Alliance video produced an immediate increase in negative mood relative to the Control video, whereas the Experiential acceptance video produced a slight increase in positive mood relative to the Alliance video. Surprisingly, patients who viewed the Alliance video were rated significantly lower than the control group on therapist-rated alliance after the first session. These findings suggest there may be specific process effects in the early phase of treatment based on the type of pretraining material used, and also indicate that video-based pretraining efforts could be counterproductive. Furthermore, this research contributes to the literature by providing insights into methodological considerations for future work on the use of technology in psychotherapy and challenges associated with preparing people for successful psychotherapy.",Johansen AB.; Lumley M.; Cano A.,2011.0,10.1037/a0022422,0,0,
9228,The brief cognitive-behavioral COPE intervention for depressed adolescents: outcomes and feasibility of delivery in 30-minute outpatient visits.,"Despite a U.S. prevalence of 9%, less than 25% of depressed adolescents receive treatment because of time constraints in clinical practice and lack of mental health providers available to deliver it. To assess the feasibility and effects of a brief manualized seven-session cognitive-behavioral skills building intervention entitled COPE (Creating Opportunities for Personal Empowerment) delivered to 15 depressed adolescents in routine 30-minute mental health medication management outpatient visits. A preexperimental one group pre- and posttest design was used. Adolescents reported significant decreases in depression, anxiety, anger, and destructive behavior as well as increases in self-concept and personal beliefs about managing negative emotions. Evaluations indicated that COPE was a positive experience for teens and parents. COPE is a promising brief cognitive-behavior therapy-based intervention that can be delivered within 30-minute individual outpatient visits. With this intervention, advanced practice nurses can work with practice time limitations and still provide evidence-based treatment for depressed teens.",Lusk P.; Melnyk BM.,,10.1177/1078390311404067,0,0,
9229,Hotspots in trauma memories and their relationship to successful trauma-focused psychotherapy: a pilot study.,"Imaginal exposure is an essential element of trauma-focused psychotherapies for posttraumatic stress disorder (PTSD). Exposure should in particular focus on the ""hotspots,"" the parts of trauma memories that cause high levels of emotional distress which are often reexperienced. Our aim was to investigate whether differences in the focus on hotspots differentiate between successful and unsuccessful trauma-focused psychotherapies. As part of a randomized trial, 45 PTSD patients completed brief eclectic psychotherapy for PTSD. We retrospectively assessed audio recordings of therapy sessions of 20 patients. Frequency of hotspots and the associated emotions, cognitions, and characteristics were compared for the most successful (n = 10) versus the least successful (n = 10) treatments. The mean number of unique hotspots per patient was 3.20, and this number did not differ between successful and unsuccessful treatments. In successful treatments, however, hotspots were more frequently addressed (r = .48), and they were accompanied by more characteristics of hotspots (r = .39), such as an audible change in affect, indicating medium- to large-sized effects. Repeatedly focusing on hotspots and looking for associated characteristics of hotspots may help clinicians to enhance the efficacy of imaginal exposure for patients who would otherwise show insufficient response to treatment.",Nijdam MJ.; Baas MA.; Olff M.; Gersons BP.,2013.0,10.1002/jts.21771,0,0,
9230,Anxiety treatment improves physical functioning with oblique scoring of the SF-12 short form health survey.,"No studies have found a positive effect of anxiety treatment on physical functioning, but recent investigations of the 12-item Short Form Health Questionnaire (SF-12), which is frequently used to assess physical functioning, have suggested that orthogonal scoring of the summary measure may distort representations of physical health. The current study reanalyzes whether anxiety treatment improves physical functioning using oblique scoring in the Coordinated Anxiety Learning and Management (CALM) randomized clinical trial for the treatment of anxiety disorders. Replication was tested in reanalysis of data from the earlier Collaborative Care for Anxiety and Panic (CCAP) randomized clinical trial for the treatment of panic disorder. The CALM study included 1004 primary care patients with panic, social anxiety, generalized anxiety or posttraumatic stress disorders. Patients received usual care (UC) or an evidence-based intervention (cognitive behavioral therapy, psychotropic medication or both; ITV). Physical functioning (SF-12v2) was assessed at baseline and at 6, 12 and 18 months. Oblique and orthogonal scoring methods for the physical functioning aggregate measure from SF-12 scale items were compared. In CALM, physical functioning improved to a greater degree in ITV than UC for oblique but not orthogonal scoring. Findings were replicated in the CCAP data. Evidence-based treatment for anxiety disorders in primary care improves physical functioning when measured using oblique scoring of the SF-12. Due to this scoring issue, effects of mental health treatment on physical functioning may have been understated.",Niles AN.; Sherbourne CD.; Roy-Byrne PP.; Stein MB.; Sullivan G.; Bystritsky A.; Craske MG.,,10.1016/j.genhosppsych.2012.12.004,0,0,6803
9231,Predictors of response to individual and group cognitive behaviour therapy of social phobia.,"Increased knowledge of factors that predict treatment outcome is important for planning and individualizing of treatment. This study analysed predictors of response to individual cognitive therapy (ICT), and intensive (3-week) group cognitive treatment (IGCT) for social phobia. Participants (n = 54) met diagnostic criteria for social phobia within a randomized controlled trial. Predictors assessed were fear of negative evaluation, anticipatory worry, self-directedness (SD) and cluster C personality disorder. Results were analysed by means of multiple regression analyses with both groups combined, and for each of the treatment groups. Anticipatory worry, an aspect of a harm-avoidance personality trait, was the strongest negative predictor of outcome in ICT and IGCT both at post-treatment and 1-year follow-up. Whereas low SD, signs of cluster C personality disorder and fear of negative evaluation were negative predictors of post-treatment outcome in ICT, the corresponding pattern of results was not to be found in IGCT. Anticipatory worry appears to be a particularly important trait for explaining variance in the outcome of social phobia. The finding is consistent with the assumed stability of such personality traits over time. Further studies are warranted to replicate the finding.",Mörtberg E.; Andersson G.,2014.0,10.1111/papt.12002,0,0,
9232,"Tai chi/yoga reduces prenatal depression, anxiety and sleep disturbances.","Ninety-two prenatally depressed pregnant women were randomly assigned to a tai chi/yoga or a waitlist control group at an average of 22 weeks gestation. The tai chi/yoga group participated in a 20-min group session per week for 12 weeks. At the end of the treatment period the tai chi/yoga group had lower summary depression (CES-D) scores, as well as lower negative affect and somatic/vegetative symptoms subscale scores on the CES-D, lower anxiety (STAI) scores and lower sleep disturbances scores.",Field T.; Diego M.; Delgado J.; Medina L.,2013.0,10.1016/j.ctcp.2012.10.001,0,0,
9233,The relationship between posttraumatic and depressive symptoms during prolonged exposure with and without cognitive restructuring for the treatment of posttraumatic stress disorder.,"In the present study, we examined the relationship between posttraumatic and depressive symptoms during prolonged exposure (PE) treatment with and without cognitive restructuring (CR) for the treatment of posttraumatic stress disorder (PTSD). Female assault survivors (N = 153) with PTSD were randomized to either PE alone or PE with added CR (PE/CR). During treatment, bi-weekly self-report measures of posttraumatic and depressive symptoms were administered. Multilevel mediational analyses indicated that during PE, changes in posttraumatic symptoms accounted for 80.3% of changes in depressive symptoms, whereas changes in depressive symptoms accounted for 45.0% of changes in posttraumatic symptoms. During PE/CR, changes in posttraumatic symptoms accounted for 59.6% of changes in depressive symptoms, and changes in depressive symptoms accounted for 50.7% of changes in posttraumatic symptoms. This pattern of results suggests that PE primarily affects posttraumatic symptoms, which in turn affect depressive symptoms. In contrast, PE/CR results in a more reciprocal relationship between posttraumatic and depressive symptoms.",Aderka IM.; Gillihan SJ.; McLean CP.; Foa EB.,2013.0,10.1037/a0031523,0,0,
9234,Subjective sleep quality in relation to inhibition and heart rate variability in patients with panic disorder.,"Patients with panic disorder (PD) are known to report impaired sleep quality and symptoms of insomnia. PD is an anxiety disorder characterised by deficient physiological regulation as measured by heart rate variability (HRV), and reduced HRV, PD and insomnia have all been related to impaired inhibitory ability. The present study aimed to investigate the interrelationships between subjectively reported sleep impairment, cognitive inhibition and vagally mediated HRV in a sample characterised by variability on measures of all these constructs. Thirty-six patients with PD with or without agoraphobia were included. Cognitive inhibition was assessed with the Color-Word Interference Test from the Delis-Kaplan Executive Function System (D-KEFS), HRV was measured using high frequency (HF) power (ms(2)), and subjectively reported sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Cognitive inhibition was related to both Sleep latency and Sleep disturbances, whereas HRV was only related to Sleep disturbances. These relationships were significant also after controlling for depression. Correlational design. Cognitive inhibition is related to key insomnia symptoms: sleep initiation and sleep maintenance. The data supports the psychobiological inhibition model of insomnia, and extends previous findings. Possible clinical implications of these findings are discussed.",Hovland A.; Pallesen S.; Hammar A.; Hansen AL.; Thayer JF.; Sivertsen B.; Tarvainen MP.; Nordhus IH.,2013.0,10.1016/j.jad.2012.12.017,0,0,
9235,Priming of courageous behavior: contrast effects in spider fearful women.,"Recently, researchers have called for therapeutic applications of behavioral primes (Shalev & Bargh, 2011). We evaluated whether courageous approach behavior might be facilitated through priming in a sample of spider fearful women. Undergraduate student women reporting elevated spider fear (N = 33, Age mean = 18.88) were recruited for this study. Participants completed self-report measures of spider fear and dispositional courage. They then completed either a courage or neutral word search prime, which was followed by a behavioral approach task involving a tarantula. Consistent with predictions, among those reporting lower dispositional courage, the courage prime led to reduced approach behavior relative to the neutral prime. However, no group differences were found among those high in dispositional courage. These findings point to the importance of self-perceptions in moderating the effects of behavioral primes and suggest limitations to the use of such interventions with individuals with psychological dysfunction.",Cougle JR.; Hawkins KA.,2013.0,10.1002/jclp.21961,0,0,
9236,Abducted by the illness: a qualitative study of traumatic stress in individuals with acute leukemia.,"Symptoms of traumatic stress are common in acute leukemia. The goal of the present qualitative study was to understand this traumatic stress, as perceived by patients. Participants were 43 patients with acute leukemia in Toronto, Canada. Participants were asked in serial interviews about their experience of diagnosis and treatment. A total of 65 interviews were analyzed utilizing the grounded theory method. Our findings provide insight into the traumatic experience of the diagnosis and treatment, as well as the initial psychological response to this trauma. Patients coped by surrendering control to the medical team, in whom they felt great trust. Patients also expressed a strong preference for limited information, with a preference to avoid discussions about overall prognosis. These results may inform interventions to relieve traumatic stress in this high risk population.",Nissim R.; Zimmermann C.; Minden M.; Rydall A.; Yuen D.; Mischitelle A.; Gagliese L.; Schimmer A.; Rodin G.,2013.0,10.1016/j.leukres.2012.12.007,0,0,
9237,Intolerance of uncertainty: a common factor in the treatment of emotional disorders.,"Intolerance of uncertainty (IU) is a characteristic predominantly associated with generalized anxiety disorder (GAD); however, emerging evidence indicates that IU may be a shared element of emotional disorders. This study aimed to examine IU across diagnostic categories, change in IU during transdiagnostic treatment, and the relationship between change in IU and treatment outcome. Patients diagnosed with heterogeneous anxiety and depressive disorders received up to 18 weeks of a transdiagnostic cognitive-behavioral therapy intervention. Patient self-reported IU and self-report and clinician-rated symptom/functioning measures were administered at pretreatment and posttreatment. When controlling for negative affectivity, IU correlated with measures of depressive symptoms and worry severity at pretreatment. Patients with GAD and panic disorder exhibited the highest pretreatment IU scores, yet IU scores did not differ significantly based on the presence or absence of a specific diagnosis. A significant decrease in IU was observed, and change in IU was related to reduced anxiety and depressive symptom levels at posttreatment across diagnostic categories. Change in IU can be observed across problem areas in transdiagnostic treatment and such change is correlated with treatment outcome.",Boswell JF.; Thompson-Hollands J.; Farchione TJ.; Barlow DH.,2013.0,10.1002/jclp.21965,0,0,
9238,Kyphosis correction after vertebroplasty in osteoporotic vertebral compression fractures.,Percutaneous vertebroplasty is a minimally invasive method of treating vertebral compression fractures aimed mainly at reduction of pain. It has been observed that fractured vertebral bodies filled in with cement might also influence the increase of their height and thus lead to reduction of post-traumatic spine kyphosis. The aim of the research was to assess the possibility of reducing the kyphotic deformation of operated spine through kyphosis measurement of vertebras adjacent to fracture. 24 patients underwent percutaneous vertebroplasty on account of compression fracture of 40 vertebral bodies in thoracic and lumbar regions. On digital x-ray spine images taken in patients before and after surgery the angle of kyphosis or lordosis of bodies above and below the fractured vertebra was measured with the use of the Cobb method. Vertebroplasty in the material examined caused reduction of kyphosis in 33 cases (80.48%) and correction by 5.78° on average. No regularity was found either between the occurrence of correction (and its level) and operated spine region or between the possibility of kyphosis correction and time that passed between fracture and surgery.,Dragan SF.; Urbański W.; Żywirski B.; Krawczyk A.; Kulej M.; Dragan SŁ.,2012.0,,0,0,
9239,Effects of behavioral stress reduction Transcendental Meditation intervention in persons with HIV.,"Stress is implicated in the pathogenesis and progression of HIV. The Transcendental Meditation (TM) is a behavioral stress reduction program that incorporates mind-body approach, and has demonstrated effectiveness in improving outcomes via stress reduction. We evaluated the feasibility of implementing TM and its effects on outcomes in persons with HIV. In this community-based single blinded Phase-I, randomized controlled trial, outcomes (psychological and physiological stress, immune activation, generic and HIV-specific health-related quality of life, depression and quality of well-being) were assessed at baseline and at six months, and were compared using parametric and nonparametric tests. Twenty-two persons with HIV were equally randomized to TM intervention or healthy eating (HE) education control group. Retention was 100% in TM group and 91% in HE control group. The TM group exhibited significant improvement in vitality. Significant between group differences were observed for generic and HIV-specific health-related quality of life. Small sample size may possibly limit the ability to observe significant differences in some outcomes. TM stress reduction intervention in community dwelling adults with HIV is viable and can enhance health-related quality of life. Further research with large sample and longer follow-up is needed to validate our results.",Chhatre S.; Metzger DS.; Frank I.; Boyer J.; Thompson E.; Nidich S.; Montaner LJ.; Jayadevappa R.,2013.0,10.1080/09540121.2013.764396,0,0,
9240,Promoting reintegration of National Guard veterans and their partners using a self-directed program of integrative therapies: a pilot study.,"This article reports pilot data from phase I of a project to develop and evaluate a self-directed program of integrative therapies for National Guard personnel and significant relationship partners to support reintegration and resilience after return from Iraq or Afghanistan. Data are reported on 43 dyads. Intervention was an integrated multimedia package of guided meditative, contemplative, and relaxation exercises (CD) and instruction in simple massage techniques (DVD) to promote stress reduction and interpersonal connectedness. A repeated measures design with standardized instruments was used to establish stability of baseline levels of relevant mental health domains (day 1, day 30), followed by the intervention and assessments 4 and 8 weeks later. Significant improvements in standardized measures for post-traumatic stress disorder, depression, and self-compassion were seen in both veterans and partners; and in stress for partners. Weekly online reporting tracked utilization of guided exercises and massage. Veterans reported significant reductions in ratings of physical pain, physical tension, irritability, anxiety/worry, and depression after massage, and longitudinal analysis suggested declining baseline levels of tension and irritability. Qualitative data from focus groups and implications for continued development and a phase II trial are discussed.",Collinge W.; Kahn J.; Soltysik R.,2012.0,,0,0,
9241,"Anxiety, social support, and physical health in a sample of spouses of OEF/OIF service members.","The goal of this study was to examine the relationships between heightened anxiety, social support, and physical health in a sample of spouses of returning Iraq and Afghanistan service members. 86 spouses were recruited nationally as part of a pilot trial of a military spouse telephone support group. Participants completed measures of physical and mental health via telephone including a screening tool for generalized anxiety disorder (GAD). Scores for social support and health outcomes were compared across two groups (positive vs. negative screens for GAD) using one-way analysis of variance analysis procedures. Path analytic techniques were used to evaluate the relative effects of anxiety and perceived social support on overall health and physical health comorbidities. A total of 38 participants screened positive for GAD. Participants with probable GAD reported having less social support than those screening negative for GAD. GAD participants also reported poorer overall health and more physical health comorbidities than their GAD-negative counterparts. Path analysis indicated that heightened anxiety is associated with worse overall health and social support does not buffer this interaction. The results suggest that anxiety-related health is a critical factor to be addressed in spouses of service members.",Fields JA.; Nichols LO.; Martindale-Adams J.; Zuber J.; Graney M.,2012.0,,0,0,
9242,Major depression and PTSD in pregnant smokers enrolled in nicotine gum treatment trial.,"Pregnant women face considerable barriers to smoking cessation. The purpose of this study was to determine the prevalence of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) and response to smoking cessation treatment in pregnant smokers participating in a randomized, placebo-controlled trial of nicotine gum. Participants were 194 low-income, ethnically diverse pregnant smokers. Utilizing a structured interview, 45% and 18% of the subjects met criteria for a lifetime diagnosis of MDD and PTSD, respectively. There was no difference in response to treatment, based on the presence of either of these psychiatric disorders. Cumulatively, these findings provide evidence of the high degree of unmet mental health needs in pregnant smokers. Pregnant women with a history of MDD and PTSD appear to be as likely to benefit from smoking cessation treatment as those without such a history.",Dornelas E.; Oncken C.; Greene J.; Sankey HZ.; Kranzler HR.,2013.0,10.1111/j.1521-0391.2013.12029.x,0,0,
9243,Mediated moderation in combined cognitive behavioral therapy versus component treatments for generalized anxiety disorder.,"This study examined (a) duration of generalized anxiety disorder (GAD) as a moderator of cognitive behavioral therapy (CBT) versus its components (cognitive therapy and self-control desensitization) and (b) increases in dynamic flexibility of anxious symptoms during the course of psychotherapy as a mediator of this moderation. Degree of dynamic flexibility in daily symptoms was quantified as the inverse of spectral power due to daily to intradaily oscillations in four-times-daily diary data (Fisher, Newman, & Molenaar, 2011). This was a secondary analysis of the data of Borkovec, Newman, Pincus, and Lytle (2002). Seventy-six participants with a principle diagnosis of GAD were assigned randomly to combined CBT (n = 24), cognitive therapy (n = 25), or self-control desensitization (n = 27). Duration of GAD moderated outcome such that those with longer duration showed greater reliable change from component treatments than they showed from CBT, whereas those with shorter duration fared better in response to CBT. Decreasing predictability in daily and intradaily oscillations of anxiety symptoms during therapy reflected less rigidity and more flexible responding. Increases in flexibility over the course of therapy fully mediated the moderating effect of GAD duration on condition, indicating a mediated moderation process. Individuals with longer duration of GAD may respond better to more focused treatments, whereas those with shorter duration of GAD may respond better to a treatment that offers more coping strategies. Importantly, the mechanism by which this moderation occurs appears to be the establishment of flexible responding during treatment.",Newman MG.; Fisher AJ.,2013.0,10.1037/a0031690,0,0,
9244,Augmenting cognitive behaviour therapy for post-traumatic stress disorder with emotion tolerance training: a randomized controlled trial.,"Many patients do not adhere to or benefit from cognitive behaviour therapy (CBT) for post-traumatic stress disorder (PTSD). This randomized controlled trial evaluates the extent to which preparing patients with emotion regulation skills prior to CBT enhances treatment outcome. A total of 70 adult civilian patients with PTSD were randomized to 12 sessions of either supportive counselling followed by CBT (Support/CBT) or emotion regulation training followed by CBT (Skills/CBT). Skills/CBT resulted in fewer treatment drop-outs, less PTSD and anxiety, and fewer negative appraisals at 6 months follow-up than Support/CBT. Between-condition effect size was moderate for PTSD severity (0.43, 95% confidence interval x0.04 to 0.90). More Skills/CBT (31%) patients achieved high end-state functioning at follow-up than patients in Support/CBT (12%) [Χ2(n=70)=3.67, p<0.05]. This evidence suggests that response to CBT may be enhanced in PTSD patients by preparing them with emotion regulation skills. High attrition of participants during the study limits conclusions from this study.",Bryant RA.; Mastrodomenico J.; Hopwood S.; Kenny L.; Cahill C.; Kandris E.; Taylor K.,2013.0,10.1017/S0033291713000068,0,0,
9245,Homework compliance counts in cognitive-behavioral therapy.,"Prior research has demonstrated that there is some association between treatment engagement and treatment outcome in behavioral therapy for anxiety disorders. However, many of these investigations have been limited by weak measurement of treatment engagement variables, failure to control for potentially important baseline variables, and failure to consider various treatment engagement variables simultaneously. The purpose of the present study is to examine the relationship between two treatment engagement variables (treatment expectancy and homework compliance) and the extent to which they predict improvement from cognitive-behavioral therapy (CBT) for anxiety disorders. 84 adults with a DSM-IV-defined principal anxiety disorder took part in up to 12 sessions of CBT or acceptance and commitment therapy. Pre- and post-treatment disorder severity was assessed using clinical severity ratings from a semi-structured diagnostic interview. Participants made ratings of treatment expectancy after the first session. Homework compliance was assessed each session by the treating clinician. Contrary to hypotheses, treatment expectancy and homework compliance were poorly correlated. Regression analyses revealed that homework compliance, but not treatment expectancy, predicted a significant portion of the variance in treatment outcome (10%). The present research suggests that although treatment expectation and homework compliance likely represent unique constructs of treatment engagement, homework compliance may be the more important treatment engagement variable for outcomes. The present research suggests that improvement of homework compliance has the potential to be a highly practical and effective way to improve clinical outcomes in CBT targeting anxiety disorders.",Lebeau RT.; Davies CD.; Culver NC.; Craske MG.,2013.0,10.1080/16506073.2013.763286,0,0,
9246,Predictors of treatment satisfaction among older adults with anxiety in a primary care psychology program.,"Increasing numbers of patients are treated in integrated primary care mental health programs. The current study examined predictors of satisfaction with treatment in patients from a randomized clinical trial of late-life generalized anxiety disorder (GAD) in primary care. Higher treatment satisfaction was associated with receiving CBT rather than enhanced usual care. Treatment credibility, treatment expectancies, social support, and improvements in depression and anxiety symptoms predicted higher treatment satisfaction in the total sample. In the CBT group, only credibility and adherence with treatment predicted satisfaction. This suggests that older patients receiving CBT who believe more strongly in the treatment rationale and follow the therapist's recommendations more closely are likely to report satisfaction at the end of treatment. In addition, this study found that adherence mediated the relationship between treatment credibility and treatment satisfaction. In other words, patients' perceptions that the treatment made sense for them led to greater treatment adherence which then increased their satisfaction with treatment.",Hundt NE.; Armento ME.; Porter B.; Cully JA.; Kunik ME.; Stanley M.,2013.0,10.1016/j.evalprogplan.2013.01.003,0,0,
9247,Uncovering phantom shocks in cardiac patients with an implantable cardioverter defibrillator.,"Implantable cardioverter defibrillator recipients sometimes report ""phantom shocks"" (PSs), defined as a reported shock lacking objective evidence. The aim of this study was to describe the subjective experience of PSs and their psychosocial correlates using a mixed methods approach. PS participants were matched on sex and age with individuals who received objective shocks only (OSO). Participants were interviewed and completed measures of posttraumatic stress disorder (PTSD Checklist-Civilian Version), depression and anxiety (Hospital Anxiety and Depression Scale), disease-specific distress (Cardiac Anxiety Questionnaire-CAQ), and social desirability (Socially Desirable Response Set-SDRS). Interviews were analyzed using interpretative phenomenological analysis (IPA). Seventeen male patients participated (PS: n = 9; OSO: n = 8). Three themes emerged from IPA: (1) PS as a somatic experience, (2) the emotional impact of PSs, and (3) searching for meaning. Quantitative analyses showed that both groups exhibited elevated trauma and anxiety levels. Effect size differences (ESD) suggested a medium ESD on depression (P = 0.176, ηp (2) = 0.118) and PTSD (avoidance: P = 0.383, ηp (2) = 0.055, numbing: P = 0.311, ηp (2) = 0.068), and a large ESD on SDRS (P = 0.081, ηp (2) = 0.189), where PS participants, comparatively, exhibited elevated levels. A medium ESD was detected on CAQ-fear (P = 0.237, ηp (2) = 0.092) where OSO participants exhibited greater heart-focused worry. The qualitative and quantitative findings of this mixed method study show convergence in terms of the emotional factors associated with the experience of PSs. PSs are often reported to be indistinguishable from objective shocks, evoking alarm, frustration, and confusion, forcing the individual to face the uncertainties of what to them is a novel and confusing experience.",Bilanovic A.; Irvine J.; Kovacs AH.; Hill A.; Cameron D.; Katz J.,2013.0,10.1111/pace.12116,0,0,
9248,Nonoperative treatment of the medial malleolus in bimalleolar and trimalleolar ankle fractures: a randomized controlled trial.,"To compare internal fixation with no fixation of the medial malleolus after open reduction and internal fixation of the lateral malleolus and if needed, the posterior malleolus. Randomized prospective trial. Level III trauma center in a metropolitan area. One hundred patients with bimalleolar or trimalleolar Orthopaedic Trauma Association type 44 ankle fractures and displacement of the medial malleolus less than 2 mm after open reduction and internal fixation of the lateral component. Internal fixation or nonoperative treatment of the medial malleolus. American Orthopaedic Foot and Ankle Society ankle hind foot score (AOFAS), The Olerud Molander Ankle (OMA) score, and visual analogue pain scale (VAS). Median follow-up time was 39 months (range: 24-72). There were no significant differences between the 2 groups with respect to OMA (P = 0.91), AOFAS (P = 0.85), VAS (P = 0.85), or development of osteoarthritis (P = 0.22). Reoperation and complication rates were also comparable, but 4 patients treated nonoperatively developed nonunion of the medial malleolus. These patients reported no functional disabilities and presented OMA, AOFAS, and VAS scores better than average. Our data indicate that nonoperative treatment of minimally displaced fractures of the medial malleolus after operative fixation of the fibula yields satisfactory results. However, long-term follow-up is needed due to increased risk of nonunion and uncertainty regarding the development of posttraumatic arthritis. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.",Hoelsbrekken SE.; Kaul-Jensen K.; M√∏rch T.; Vika H.; Clementsen T.; Paulsrud √ò.; Petursson G.; Stiris M.; Str√∏ms√∏e K.,2013.0,10.1097/BOT.0b013e31828e1bb7,0,0,
9249,Comorbidity and internet-delivered transdiagnostic cognitive behavioural therapy for anxiety disorders.,"Internet-delivered transdiagnostic anxiety interventions aim to reduce symptoms across several anxiety disorders using one treatment protocol. However, it is unclear whether comorbidity affects outcomes of such treatment. This study re-examined data from a recent randomised controlled trial (N = 129) that evaluated the efficacy of an Internet-delivered transdiagnostic cognitive behavioural therapy (iCBT) intervention for participants with principal diagnoses of generalised anxiety disorder (GAD), social phobia (SP) panic disorder and agoraphobia (PDA), of whom 72% met criteria for a comorbid anxiety disorder or depression. Participants were divided into two groups based on whether or not they had a comorbid disorder before treatment. Participants with comorbid conditions reported higher symptom levels at pre-treatment, post-treatment, and follow-up across a range of measures. Both groups showed significant reductions in symptoms over treatment; however, participants with comorbid disorders showed greater reductions in measures of GAD, PDA, SP, depression, and neuroticism. In addition, treatment significantly reduced the number of comorbid diagnoses at follow-up. These results indicate transdiagnostic iCBT protocols have the potential to reduce comorbidity.",Johnston L.; Titov N.; Andrews G.; Dear BF.; Spence J.,2013.0,10.1080/16506073.2012.753108,0,0,
9250,"Bad dream frequency in older adults with generalized anxiety disorder: prevalence, correlates, and effect of cognitive behavioral treatment for anxiety.","This study investigated the relation between generalized anxiety disorder (GAD) and frequency of bad dreams in older adults. A secondary analysis from a randomized clinical trial comparing cognitive behavioral therapy (CBT) for anxiety to enhanced usual care (EUC) assessed bad dream frequency at baseline, post treatment (3 months), and at 6, 9, 12, and 15 months. Of 227 participants (mean age = 67.4), 134 met GAD diagnostic criteria (CBT = 70, EUC = 64), with the remaining 93 serving as a comparison group. Patients with GAD had significantly more bad dreams than those without, and bad dream frequency was significantly associated with depression, anxiety, worry, and poor quality of life. CBT for anxiety significantly reduced bad dream frequency at post treatment and throughout follow up compared to EUC.",Nadorff MR.; Porter B.; Rhoades HM.; Greisinger AJ.; Kunik ME.; Stanley MA.,2014.0,10.1080/15402002.2012.755125,0,0,
9251,Subcallosal cingulate deep brain stimulation for treatment-refractory anorexia nervosa: a phase 1 pilot trial.,"Anorexia nervosa is characterised by a chronic course that is refractory to treatment in many patients and has one of the highest mortality rates of any psychiatric disorder. Deep brain stimulation (DBS) has been applied to circuit-based neuropsychiatric diseases, such as Parkinson's disease and major depression, with promising results. We aimed to assess the safety of DBS to modulate the activity of limbic circuits and to examine how this might affect the clinical features of anorexia nervosa. We did a phase 1, prospective trial of subcallosal cingulate DBS in six patients with chronic, severe, and treatment-refractory anorexia nervosa. Eligible patients were aged 20-60 years, had been diagnosed with restricting or binge-purging anorexia nervosa, and showed evidence of chronicity or treatment resistance. Patients underwent medical optimisation preoperatively and had baseline body-mass index (BMI), psychometric, and neuroimaging investigations, followed by implantation of electrodes and pulse generators for continuous delivery of electrical stimulation. Patients were followed up for 9 months after DBS activation, and the primary outcome of adverse events associated with surgery or stimulation was monitored at every follow-up visit. Repeat psychometric assessments, BMI measurements, and neuroimaging investigations were also done at various intervals. This trial is registered with ClinicalTrials.gov, number NCT01476540. DBS was associated with several adverse events, only one of which (seizure during programming, roughly 2 weeks after surgery) was serious. Other related adverse events were panic attack during surgery, nausea, air embolus, and pain. After 9 months, three of the six patients had achieved and maintained a BMI greater than their historical baselines. DBS was associated with improvements in mood, anxiety, affective regulation, and anorexia nervosa-related obsessions and compulsions in four patients and with improvements in quality of life in three patients after 6 months of stimulation. These clinical benefits were accompanied by changes in cerebral glucose metabolism (seen in a comparison of composite PET scans at baseline and 6 months) that were consistent with a reversal of the abnormalities seen in the anterior cingulate, insula, and parietal lobe in the disorder. Subcallosal cingulate DBS seems to be generally safe in this sample of patients with chronic and treatment-refractory anorexia nervosa. Klarman Family Foundation Grants Program in Eating Disorders Research and Canadian Institutes of Health Research.",Lipsman N.; Woodside DB.; Giacobbe P.; Hamani C.; Carter JC.; Norwood SJ.; Sutandar K.; Staab R.; Elias G.; Lyman CH.; Smith GS.; Lozano AM.,2013.0,10.1016/S0140-6736(12)62188-6,0,0,
9252,Family presence during cardiopulmonary resuscitation.,"The effect of family presence during cardiopulmonary resuscitation (CPR) on the family members themselves and the medical team remains controversial. We enrolled 570 relatives of patients who were in cardiac arrest and were given CPR by 15 prehospital emergency medical service units. The units were randomly assigned either to systematically offer the family member the opportunity to observe CPR (intervention group) or to follow standard practice regarding family presence (control group). The primary end point was the proportion of relatives with post-traumatic stress disorder (PTSD)-related symptoms on day 90. Secondary end points included the presence of anxiety and depression symptoms and the effect of family presence on medical efforts at resuscitation, the well-being of the health care team, and the occurrence of medicolegal claims. In the intervention group, 211 of 266 relatives (79%) witnessed CPR, as compared with 131 of 304 relatives (43%) in the control group. In the intention-to-treat analysis, the frequency of PTSD-related symptoms was significantly higher in the control group than in the intervention group (adjusted odds ratio, 1.7; 95% confidence interval [CI], 1.2 to 2.5; P=0.004) and among family members who did not witness CPR than among those who did (adjusted odds ratio, 1.6; 95% CI, 1.1 to 2.5; P=0.02). Relatives who did not witness CPR had symptoms of anxiety and depression more frequently than those who did witness CPR. Family-witnessed CPR did not affect resuscitation characteristics, patient survival, or the level of emotional stress in the medical team and did not result in medicolegal claims. Family presence during CPR was associated with positive results on psychological variables and did not interfere with medical efforts, increase stress in the health care team, or result in medicolegal conflicts. (Funded by Programme Hospitalier de Recherche Clinique 2008 of the French Ministry of Health; ClinicalTrials.gov number, NCT01009606.).",Jabre P.; Belpomme V.; Azoulay E.; Jacob L.; Bertrand L.; Lapostolle F.; Tazarourte K.; Bouilleau G.; Pinaud V.; Broche C.; Normand D.; Baubet T.; Ricard-Hibon A.; Istria J.; Beltramini A.; Alheritiere A.; Assez N.; Nace L.; Vivien B.; Turi L.; Launay S.; Desmaizieres M.; Borron SW.; Vicaut E.; Adnet F.,2013.0,10.1056/NEJMoa1203366,0,0,
9253,Combining attention training with cognitive-behavior therapy in Internet-based self-help for social anxiety: study protocol for a randomized controlled trial.,"Guided Internet-based cognitive-behavioral therapy (ICBT) has been found to be effective for social anxiety disorder (SAD) by several independent research groups. However, since the extent of clinically significant change demonstrated leaves room for improvement, new treatments should be developed and investigated. A novel treatment, which has generally been found to be effective, is cognitive bias modification (CBM). This study aims to evaluate the combination of CBM and ICBT. It is intended that two groups will be compared; one group randomized to receiving ICBT and CBM towards threat cues and one group receiving ICBT and control training. We hypothesize that the group receiving ICBT plus CBM will show superior treatment outcomes. Participants with SAD (N = 128), will be recruited from the general population. A composite score combining the scores obtained from three social anxiety questionnaires will serve as the primary outcome measure. Secondary measures include self-reported depression and quality of life. All treatments and assessments will be conducted via the Internet and measurement points will be baseline, Week 2, post-treatment, and 4 months post-treatment. There is no direct evidence of the effects of combining CBM and ICBT in SAD. Adding attention-training sessions to ICBT protocols could increase the proportion of participants who improve and recover through Internet-based self-help. ClinicalTrials.gov: NCT01570400.",Boettcher J.; Andersson G.; Carlbring P.;  .,2013.0,10.1186/1745-6215-14-68,0,0,
9254,Specificity of homework compliance effects on treatment outcome in CBT: evidence from a controlled trial on panic disorder and agoraphobia.,"Although homework assignments are an integral component of cognitive-behavioral therapy (CBT) and relate to positive therapy outcomes, it is unclear whether specific homework types and their completion have specific effects on outcome. Data from N = 292 patients (75% female, mean age 36 years) with panic disorder and agoraphobia and treated with standardized CBT were analyzed with homework compliance quality and quantity for different types of homework serving as predictors for different outcome variables. Quality ratings of homework completion were stronger outcome predictors than quantitative compliance ratings. Exposure homework was a better outcome predictor than homework relating to psychoeducation and self-monitoring. Different aspects of homework compliance and specific homework types might differentially relate to CBT outcome.",Cammin-Nowak S.; Helbig-Lang S.; Lang T.; Gloster AT.; Fehm L.; Gerlach AL.; Ströhle A.; Deckert J.; Kircher T.; Hamm AO.; Alpers GW.; Arolt V.; Wittchen HU.,2013.0,10.1002/jclp.21975,0,0,
9255,An evaluation of the effects of diagnostic composition on individual treatment outcome within transdiagnostic cognitive-behavioral group therapy for anxiety.,"Recently, studies have supported the efficacy of treating anxiety disorders utilizing a transdiagnostic, or non-diagnosis-specific, framework (Erickson, D. H. (2003). Group cognitive behavioural therapy for heterogeneous anxiety disorders. Cognitive Behaviour Therapy, 32, 179-186; Garcia, M. S. (2004). Effectiveness of cognitive-behavioural group therapy in patients with anxiety disorders. Psychology in Spain, 8, 89-97; Norton, P. J., & Hope, D. A. (2005). Preliminary evaluation of a broad-spectrum cognitive-behavioral group therapy for anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 36, 79-97). Transdiagnostic group treatment packages focus on the common aspects inherent across the anxiety disorders such as behavioral and cognitive avoidance, and faulty cognitive appraisals of threat potential or meaning (Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205-230). Although research supports the overall efficacy of transdiagnostic cognitive behavior therapy (CBT) for anxiety disorders (Norton, P. J., & Philipp, L. M. (2008). Transdiagnostic approaches to the treatment of anxiety disorders: A quantitative review. Psychotherapy: Theory, Research, Practice and Training, 45, 214-226), the effect of diagnostically mixed group composition on individual outcomes is less clear. This study investigated the relationship between group composition and treatment outcome within diagnostically heterogeneous groups with the purpose of determining if diagnostic heterogeneity differentially impacted treatment outcome for 84 individuals during a 12-week transdiagnostic cognitive-behavioral group anxiety treatment program (Norton, P. J. (2012a). Group cognitive-behavioral therapy of anxiety: A transdiagnostic treatment manual. New York: Guilford). The diagnostic makeup of the treatment group was examined at the beginning of treatment and at the end of treatment, and the results indicated that the diagnostic makeup of the treatment group had no significant impact on individual treatment outcome. These findings have direct implications for the delivery of transdiagnostic treatments, and are discussed in terms of their global implications for the transdiagnostic approach to the treatment of anxiety disorders.",Chamberlain LD.; Norton PJ.,2013.0,10.1080/16506073.2012.748090,0,0,
9256,The Y-Worri Project: study protocol for a randomised controlled trial.,"Anxiety disorders are one of the most common psychological problems in adolescents. The school system has been identified as an ideal setting for the implementation of prevention and early intervention programs for anxiety; however, few programs are routinely delivered in schools and little is known about the best delivery methods. The aim of the current project is two-fold: to test the effectiveness of an intervention program for anxiety relative to a control condition, and to compare two methods of implementing the program. This study is a three-arm cluster randomised controlled trial consisting of a wait-list control condition and two intervention conditions evaluating the effectiveness of an Internet-based program for preventing generalised anxiety. The first intervention condition will involve classroom teachers supervising student completion of the intervention program, while the second intervention condition will involve the classroom teacher and an education officer from the local youth mental health centre supervising the program's completion. At least 30 schools from across Australia will be recruited to the trial, with adolescents aged between 14 and 18 years invited to participate. Participants in the intervention conditions will complete the e-couch Anxiety and Worry program during class periods over six weeks. The primary outcome measure will be a scale reflecting the number and severity of generalised anxiety symptoms, while secondary outcomes will be symptoms of depression, social anxiety and anxiety sensitivity. Data will be collected at pre-intervention, post-intervention, 6- and 12-month follow-up. Intention-to-treat analyses will be conducted. If demonstrated effective, a new service delivery model for the implementation of mental health programs in schools could be indicated. Such a model would significantly contribute to the mental health of young people in Australia by providing preventive interventions for mental health problems and consequently reducing the need for clinical services. The Australian New Zealand Clinical Trials Registry ACTRN12610001103055.",Calear AL.; Christensen H.; Griffiths KM.; Mackinnon A.,2013.0,10.1186/1745-6215-14-76,0,0,
9257,A multi-method examination of the role of incompleteness in compulsive checking.,"Emerging evidence implicates an important relationship between feelings of incompleteness and compulsive checking. To date, this work has relied mostly on self-report measures and correlational research designs. We explored the relationship in three different studies using in vivo tasks. In Study 1, we found checking symptoms to be uniquely associated with negative affective response to a pile of clutter (an incompleteness induction). In Study 2, two different measures of incompleteness were predictive of urge to check following a stove checking task. In Study 3, following a stove checking task, participants were randomized to incompleteness induction or control conditions, and urge to check was assessed afterwards. Among those with elevated checking symptoms and dispositional incompleteness, the incompleteness induction led to greater urge to check than the control condition. No effect of condition was found among those low in checking symptoms and dispositional incompleteness. Together, these studies provide novel data in support of an important role for incompleteness in checking compulsions.",Cougle JR.; Fitch KE.; Jacobson S.; Lee HJ.,2013.0,10.1016/j.janxdis.2013.02.003,0,0,
9258,Allograft juvenile articular cartilage transplantation for treatment of talus osteochondral defects.,"Osteochondral (OCD) lesions of the talus are frequent sequelae of traumatic ankle injuries such as ankle sprains, fractures, and recurrent ankle instability. Initial management of talus lesions in most cases involves arthroscopy and microfracture/curettage. Tissue resulting from the microfracture is fibrocartilage. Clinical improvement in pain is seen in approximately 75% to 85% of people in a number of studies with long-term follow-up. Often, large lesions (>1 cm(2)) or those with cystic changes require secondary procedures such as talus allograft/autograft or autologous chondrocyte implantation. The use of a juvenile articular chondrocyte allograft is an option for large or refractory lesions and has the advantage of obviating the need for a tibial or fibular osteotomy. The purpose of this article is to describe a novel arthroscopic surgical technique for transplantation of juvenile chondrocytes as a treatment for talus OCD defects. Level IV.",Giza E.; Howell S.,2013.0,10.1177/1938640013479934,0,0,
9259,[Total hip arthroplasty with the cementless spiron femoral neck prosthesis].,"Cementless total hip arthroplasty with preservation of femoral neck and natural load transmission. Restoration of joint function and alleviation of pain. Osteoarthritis of the hip or femoral head necrosis in younger patients. Patients biologically > 65 years. Destructed or discontinued femoral neck. Pathologic hip formation: short femoral neck, severe enhanced or reduced CCD angle. Body mass index (BMI) > 30 (relative contraindication). Manifest osteoporosis. Necessity of immediate full weight bearing. Heavy smoking (relative contraindication). Ongoing chemotherapy. Anterolateral approach to the hip joint. Exposition of the femoral neck and resection of the femoral head at its lateral margin. Preparation of the acetabulum and insertion of a common acetabular component. Positioning of the center pin into the femoral neck. Face milling of the femoral neck butt. Preparation of the femoral neck with the Spiron drill bit. Insertion of the Spiron prosthesis. Trial reduction with a trial head. Substitution by the definitive head (cone 12/14 mm). Wound closure. Low centred X-ray of the pelvis and cross table view of the hip joint. Physiotherapy and partial weight bearing for 6 weeks. Prevention of deep vein thrombosis until achievement of full weight bearing. A total of 28 Spiron prosthesis were implanted in 26 patients (15 men, 11 women, mean age 51 years [range 34-64 years], mean BMI 28 kg/m(2) [range 21-39 kg/m(2)]) from August 2009 to January 2012. Diagnoses: 13 cases of primary osteoarthritis, 8 cases of secondary osteoarthritis, 5 cases of femoral head necrosis, and 2 cases of posttraumatic osteoarthritis. The mean surgery length was 93 min (range 70-121 min), the mean hospital stay was 9 days (range 6-16 days). Blood transfusion was not necessary in any of the cases. There were no immediate complications such as deep vein thrombosis, surgery requiring secondary bleeding, wound infection, nerve palsy, or dislocation of the hip. Postoperative radiologic examinations showed an average leg lengthening of 3 mm (range -10-19 mm). No varus deviation of the prosthesis was observed. The Harris Hip Score improved from 55.4 points (range 33.5-76.9 points) preoperative to 90.5 points (range 75.7-99.9 points) 3 months postoperative. In 1 case with aseptic loosening, replacement surgery was performed without complications.",Lugeder A.; Häring E.; Müller A.; Droste P.; Dorste P.; Zeichen J.,2013.0,10.1007/s00064-012-0163-x,0,0,
9260,Mental health disparities between Hispanic and non-Hispanic parents of childhood cancer survivors.,"Parents of childhood cancer survivors (CCS) experience considerable distress related to their child's cancer. However, little is known about cultural variation in this experience. We examine parental distress, specifically symptoms of post-traumatic stress (PTSS) and depression, comparing Hispanic and non-Hispanic parents of CCS. Seventy-nine Hispanic and 60 non-Hispanic parents of CCS (currently aged 14-25, off treatment ‚â•2 years) completed questionnaires assessing demographics, depression, PTSS, perceived stress, and child's health status/quality of life (QOL). t-Tests and chi-square statistics were used to compare differences in demographic characteristics between Hispanic and non-Hispanic parents and multivariable regression was used to determine independent risk factors associated with parental PTSS and depression. Hispanic parents were significantly younger, had less education, lower incomes and reported significantly more PTSS and depressive symptoms than non-Hispanic parents (all P-values < 0.0001). Among Hispanic parents, foreign birthplace predicted higher PTSS after controlling for other factors (P < 0.001). Hispanic parents, regardless of birthplace, reported more depressive symptoms than non-Hispanic parents (US-born, P < 0.05; foreign-born, P < 0.01). For PTSS and depression, there were positive relationships with parental stress and negative relationships with the child's psychosocial QOL. Hispanic and non-Hispanic CCS did not differ significantly on disease and treatment factors or health-related QOL. Hispanic parents of CCS may be at greater risk for poorer mental health outcomes. Ethnic-specific factors (e.g., acculturation, immigration status, and previous trauma) may influence parents' responses and adjustment to their child's cancer. Research is needed to determine how to meet the needs of the most vulnerable parents.",Meeske KA.; Sherman-Bien S.; Hamilton AS.; Olson AR.; Slaughter R.; Kuperberg A.; Milam J.,2013.0,10.1002/pbc.24527,0,0,
9261,Maladaptive social self-beliefs in alcohol-dependence: a specific bias towards excessive high standards.,"Emotional and interpersonal impairments associated with alcohol-dependence have been recently explored, but the distorted cognitive representations underlying these deficits remain poorly understood. The present study aims at exploring the presence of maladaptive social self-beliefs among alcohol-dependent individuals, as these biased self-beliefs have been recently shown to play a crucial role in the development and maintenance of other psychopathological states (social anxiety and depression). Twenty-five recently detoxified alcohol-dependent participants and 25 matched controls filled in self-report questionnaires evaluating maladaptive social self-beliefs, interpersonal problems and several comorbid states (anxiety, social anxiety, depression). As compared to controls, alcohol-dependent individuals showed higher scores than controls for the three subcategories of maladaptive social self-beliefs (high standards, conditional beliefs and unconditional beliefs). Our key finding was that when comorbidities were controlled for, alcohol-dependence was associated with a specific bias towards exaggerated high standards in social contexts. Moreover, these high standards beliefs were strongly correlated with interpersonal problems. These results provide the first insights into the influence of cognitive biases on interpersonal problems in addictive states, and suggest that maladaptive self-beliefs could have a central influence on the development and maintenance of alcohol-dependence.",Maurage P.; de Timary P.; Moulds ML.; Wong QJ.; Collignon M.; Philippot P.; Heeren A.,2013.0,10.1371/journal.pone.0058928,0,0,
9262,Imagery Rescripting as treatment for complicated PTSD in refugees: a multiple baseline case series study.,"This study tested the effectiveness of Imagery Rescripting (ImRs) for complicated war-related PTSD in refugees. Ten adult patients in long-term supportive care with a primary diagnosis of war-related PTSD and Posttraumatic Symptom Scale (PSS) score > 20 participated. A concurrent multiple baseline design was used with baseline varying from 6 to 10weeks, with weekly supportive sessions. After baseline, a 5-week exploration phase followed with weekly sessions during which traumas were explored, without trauma-focused treatment. Then 10 weekly ImRs sessions were given followed by 5-week follow-up without treatment. Participants were randomly assigned to baseline length, and filled out the PSS and the BDI on a weekly basis. Data were analyzed with mixed regression. Results revealed significant linear trends during ImRs (reductions of PSS and BDI scores), but not during the other conditions. The scores during follow-up were stable and significantly lower compared to baseline, with very high effect sizes (Cohen's d = 2.87 (PSS) and 1.29 (BDI)). One patient did clearly not respond positively, and revealed that his actual problem was his sexual identity that he couldn't accept. There were no dropouts. In conclusion, results indicate that ImRs is a highly acceptable and effective treatment for this difficult group of patients.",Arntz A.; Sofi D.; van Breukelen G.,2013.0,10.1016/j.brat.2013.02.009,0,0,
9263,Predicting adoption of exposure therapy in a randomized controlled dissemination trial.,"The present study examined organizational, client, and therapist characteristics as predictors of use of and proficiency in exposure therapy (ET) after training. Therapists naïve to ET (N=181) were randomized to: (1) online training (OLT), (2) OLT plus motivational enhancement (ME), or (3) OLT+ME plus a learning community. Twelve weeks after training, self-reported use of ET in clinical practice was high (87.5%) and therapists demonstrated moderate clinical proficiency. Use of ET was predicted by therapist degree, self-efficacy, and knowledge. Clinical proficiency was predicted by therapist anxiety sensitivity, attitudes, and knowledge, as well as organizational and client barriers. Several of these effects were moderated by training condition, indicating that therapists who received more comprehensive training were less impacted by barriers and showed enhanced adoption in the presence of facilitating factors. Overall, these results suggest that the primary barriers to the adoption of ET are therapist, not organizational or client, factors.",Harned MS.; Dimeff LA.; Woodcock EA.; Contreras I.,2013.0,10.1016/j.janxdis.2013.02.006,0,0,
9264,Effect of traumatic imagery on cerebrospinal fluid dopamine and serotonin metabolites in posttraumatic stress disorder.,"Dopaminergic mechanisms may be involved in the pathophysiology of posttraumatic stress disorder (PTSD), although the evidence for this is limited; serotonergic mechanisms are implicated largely by virtue of the modest efficacy of serotonergic drugs in the treatment of the disorder. Basal cerebrospinal fluid (CSF) dopamine and serotonin metabolite concentrations are normal in PTSD patients. However, in the present experiment, we postulated that perturbations in CSF dopamine and serotonin metabolites could be induced by acute psychological stress. Ten volunteers with war-related chronic PTSD underwent 6-h continuous lumbar CSF withdrawal on two occasions per patient (6-9 weeks apart), using a randomized, within subject-controlled, crossover design. During one session a 1-h video with trauma-related footage (traumatic video) was shown and in the other session subjects viewed a 1-h neutral video. We quantified the dopamine metabolite homovanillic acid (HVA) and the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in CSF at 10-min intervals, before, during, and after video provocation. Blood pressure, heart rate, and subjective anxiety and mood were monitored. Significant drop in mood and increases in anxiety and blood pressure occurred during the traumatic relative to the neutral movie. CSF HVA concentrations diminished significantly after the traumatic video (p < 0.05), in comparison with the neutral, while 5-HIAA tended to diminish (p < 0.10). We conclude that an acute decline in CNS HVA concentrations is associated with laboratory-induced symptoms in chronic PTSD patients. While further research is required to determine if the stress-induced dopaminergic changes are normative or pathological, the present data suggest that increasing dopaminergic neurotransmission be explored as a potential therapy, or adjunctive therapy, for PTSD.",Geracioti TD.; Jefferson-Wilson L.; Strawn JR.; Baker DG.; Dashevsky BA.; Horn PS.; Ekhator NN.,2013.0,10.1016/j.jpsychires.2013.01.023,0,0,
9265,Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity.,"Mindfulness meditation has met increasing interest as a therapeutic strategy for anxiety disorders, but prior studies have been limited by methodological concerns, including a lack of an active comparison group. This is the first randomized, controlled trial comparing the manualized Mindfulness-Based Stress Reduction (MBSR) program with an active control for generalized anxiety disorder (GAD), a disorder characterized by chronic worry and physiologic hyperarousal symptoms. Ninety-three individuals with DSM-IV-diagnosed GAD were randomly assigned to an 8-week group intervention with MBSR or to an attention control, Stress Management Education (SME), between 2009 and 2011. Anxiety symptoms were measured with the Hamilton Anxiety Rating Scale (HAMA; primary outcome measure), the Clinical Global Impressions-Severity of Illness and -Improvement scales (CGI-S and CGI-I), and the Beck Anxiety Inventory (BAI). Stress reactivity was assessed by comparing anxiety and distress during pretreatment and posttreatment administration of the Trier Social Stress Test (TSST). A modified intent-to-treat analysis including participants who completed at least 1 session of MBSR (n = 48) or SME (n = 41) showed that both interventions led to significant (P < .0001) reductions in HAMA scores at endpoint, but did not significantly differ. MBSR, however, was associated with a significantly greater reduction in anxiety as measured by the CGI-S, the CGI-I, and the BAI (all P values < .05). MBSR was also associated with greater reductions than SME in anxiety and distress ratings in response to the TSST stress challenge (P < .05) and a greater increase in positive self-statements (P = .004). These results suggest that MBSR may have a beneficial effect on anxiety symptoms in GAD and may also improve stress reactivity and coping as measured in a laboratory stress challenge. ClinicalTrials.gov identifier: NCT01033851.",Hoge EA.; Bui E.; Marques L.; Metcalf CA.; Morris LK.; Robinaugh DJ.; Worthington JJ.; Pollack MH.; Simon NM.,2013.0,10.4088/JCP.12m08083,0,0,
9266,"A genotype-specific, randomized controlled behavioral intervention to improve the neuroemotional outcome of cardiac surgery: study protocol for a randomized controlled trial.","Cardiac surgery is one of the most commonly performed surgical procedures worldwide with >700,000 surgeries in 2006 in the US alone. Cardiac surgery results in a considerable exposure to physical and emotional stress; stress-related disorders such as depression or post-traumatic stress disorder are the most common adverse outcomes of cardiac surgery, seen in up to 20% of patients. Using information from a genome-wide association study to characterize genetic effects on emotional memory, we recently identified a single nucleotide polymorphism of the glucocorticoid receptor gene (the Bcll single nucleotide polymorphism) as a significant genetic risk factor for traumatic memories from cardiac surgery and symptoms of post-traumaticstress disorder. The Bcll high-risk genotype (Bcll GG) has a prevalence of 16.6% in patients undergoing cardiac surgery and is associated with increased glucocorticoid receptor signaling under stress. Concomitant animal experiments have confirmed an essential role of glucocorticoid receptor activation for traumatic memory formation during stressful experiences. Early cognitive behavioral intervention has been shown to prevent stress-related disorders after heart surgery. The proposed study protocol is based on the above mentioned earlier findings from animal experiments and preclinical studies in volunteers. Patients (n = 872) will be genotyped for the Bcll single nucleotide polymorphism before surgery, which should result in 120 homozygous high-risk carriers of the Bcll GG allele and 240 randomly selected low-risk heterozygous or non-carriers of the single nucleotide polymorphism. All patients will then undergo randomization to either cognitive behavioral intervention or a control intervention consisting of non-specific general information about the role of stress in heart disease. The primary efficacy endpoint will be post-traumatic stress levels at one year after surgery as determined by a standardized questionnaire that has been specifically validated in patients after critical illness. The proposed randomized controlled trial intends to demonstrate that a preoperatively administered minimal cognitive behavioral intervention targeted to homozygous carriers of the Bcll *G high-risk allele reduces traumatic memories and post-traumatic stress disorder symptoms after heart surgery to a level seen in non-carriers of the mutation, and thus improves the neuroemotional outcome of cardiac surgery. The trial will be registered at http://www.clinicaltrials.gov/ before commencing with the study.",Hauer D.; Kolassa IT.; Laubender RP.; Mansmann U.; Hagl C.; Roozendaal B.; de Quervain DJ.; Schelling G.,2013.0,10.1186/1745-6215-14-89,0,0,
9267,"The effects of assertiveness training in patients with schizophrenia: a randomized, single-blind, controlled study.","In this study, we investigated the effects of group assertiveness training on assertiveness, social anxiety and satisfaction with interpersonal communication among patients with chronic schizophrenia. Only limited studies highlighted the effectiveness of group assertiveness training among inpatients with schizophrenia. Given the lack of group assertiveness training among patients with schizophrenia, further development of programmes focusing on facilitating assertiveness, self-confidence and social skills among inpatients with chronic schizophrenia is needed. This study used a prospective, randomized, single-blinded, parallel-group design. This study employed a prospective, randomized, parallel-group design. Seventy-four patients were randomly assigned to experimental group receiving 12 sessions of assertiveness training, or a supportive control group. Data collection took place for the period of June 2009-July 2010. Among patients with chronic schizophrenia, assertiveness, levels of social anxiety and satisfaction with interpersonal communication significantly improved immediately after the intervention and at the 3-month follow-up in the intervention group. The results of a generalized estimating equation (GEE) indicated that: (1) assertiveness significantly improved from pre- to postintervention and was maintained until the follow-up; (2) anxiety regarding social interactions significantly decreased after assertiveness training; and (3) satisfaction with interpersonal communication slightly improved after the 12-session intervention and at the 3-month follow-up. Assertivenss training is a non-invasive and inexpensive therapy that appears to improve assertiveness, social anxiety and interpersonal communication among inpatients with chronic schizophrenia. These findings may provide a reference guide to clinical nurses for developing assertiveness-training protocols.",Lee TY.; Chang SC.; Chu H.; Yang CY.; Ou KL.; Chung MH.; Chou KR.,2013.0,10.1111/jan.12142,0,0,
9268,Synergy between seeking safety and twelve-step affiliation on substance use outcomes for women.,"The Recovery Management paradigm provides a conceptual framework for the examination of joint impact of a focal treatment and post-treatment service utilization on substance abuse treatment outcomes. We test this framework by examining the interactive effects of a treatment for comorbid PTSD and substance use, Seeking Safety, and post-treatment Twelve-Step Affiliation (TSA) on alcohol and cocaine use. Data from 353 women in a six-site, randomized controlled effectiveness trial within the NIDA Clinical Trials Network were analyzed under latent class pattern mixture modeling. LCPMM was used to model variation in Seeking Safety by TSA interaction effects on alcohol and cocaine use. Significant reductions in alcohol use among women in Seeking Safety (compared to health education) were observed; women in the Seeking Safety condition who followed up with TSA had the greatest reductions over time in alcohol use. Reductions in cocaine use over time were also observed but did not differ between treatment conditions nor were there interactions with post-treatment TSA. Findings advance understanding of the complexities for treatment and continuing recovery processes for women with PTSD and SUDs, and further support the chronic disease model of addiction.",Morgan-Lopez AA.; Saavedra LM.; Hien DA.; Campbell AN.; Wu E.; Ruglass L.,2013.0,10.1016/j.jsat.2013.01.015,0,0,
9269,A qualitative analysis of beginning mindfulness experiences for women with post-traumatic stress disorder and a history of intimate partner violence.,"This article presents the beginning mindfulness experiences of low income, minority women with a history of intimate partner violence. Ten women participated in a Mindfulness-Based Stress Reduction group, three interviews and a focus group over 15 months. Using an interpretive phenomenological analysis approach, we derived the following themes: struggles to practice meditation; a vision of growing and helping; personal improvements, and interpersonal improvements. We share recommendations for clinical practice.",Bermudez D.; Benjamin MT.; Porter SE.; Saunders PA.; Myers NA.; Dutton MA.,2013.0,10.1016/j.ctcp.2013.02.004,0,0,
9270,Oxytocin enhances social persuasion during hypnosis.,"It has long been argued that hypnosis cannot promote behaviors that people will not otherwise engage in. Oxytocin can enhance trust in others, and may promote the extent to which a hypnotized person complies with the suggestion of a hypnotist. This double-blind placebo study administered oxytocin or placebo to high hypnotizable participants (N‚Ää=‚Ää28), who were then administered hypnotic suggestions for socially unorthodox behaviors, including swearing during the experiment, singing out loud, and dancing in response to a posthypnotic cue. Participants who received oxytocin were significantly more likely to swear and dance than those who received the placebo. This finding may be interpreted in terms of oxytocin increasing social compliance in response as a function of (a) increased trust in the hypnotist, (b) reduced social anxiety, or (c) enhanced sensitivity to cues to respond to experimental expectations. These results point to the potential role of oxytocin in social persuasion.",Bryant RA.; Hung L.,2013.0,10.1371/journal.pone.0060711,0,0,
9271,Minimal clinically important differences for the EQ-5D and QWB-SA in Post-traumatic Stress Disorder (PTSD): results from a Doubly Randomized Preference Trial (DRPT).,"To determine the minimal clinically important difference (MCID) for the health-utility measures EuroQol-5 dimensions (EQ-5D) and Quality of Well Being Self-Administered (QWB-SA) Scale in PTSD patients. Two hundred patients aged 18 to 65 years with PTSD enrolled in a doubly randomized preference trial (DRPT) examining the treatment and treatment-preference effects between cognitive behavioral therapy and pharmacotherapy with sertraline and completed the EQ-5D and QWB-SA at baseline and 10-week post-treatment. The anchor-based methods utilized a Clinical Global Impression-Improvement (CGI-I) and Clinical Global Impression-Severity. We regressed the changes in EQ-5D and QWB-SA scores on changes in the anchors using ordinary least squares regression. The slopes (beta coefficients) were the rates of change in the anchors as functions of change in EQ-5D and QWB, which represent our estimates of MCID. In addition, we performed receiver operating characteristic (ROC) curve analysis to examine the relationship between the changes in EQ-5D and QWB-SA scores and treatment-response status. The MCIDs were estimated from the ROC curve where they best discriminate between treatment responders and non-responders. The distribution-based methods used small to moderate effect size in terms of 0.2 and 0.5 of standard deviation of the pre-treatment EQ-5D and QWB-SA scores. The anchor-based methods estimated the MCID ranges of 0.05 to 0.08 for the EQ-5D and 0.03 to 0.05 for the QWB. The MCID ranges were higher with the distribution-based methods, ranging from 0.04 to 0.10 for the EQ-5D and 0.02 to 0.05 for the QWB-SA. The established MCID ranges of EQ-5D and QWB-SA can be a useful tool in assessing meaningful changes in patient's quality of life for researchers and clinicians, and assisting health-policy makers to make informing decision in mental health treatment. Clinicaltrials.gov; Identifier: NCT00127673.",Le QA.; Doctor JN.; Zoellner LA.; Feeny NC.,2013.0,10.1186/1477-7525-11-59,0,0,
9272,D-Cycloserine as an augmentation strategy with cognitive-behavioral therapy for social anxiety disorder.,"The authors examined whether D-cycloserine, a partial agonist at the glutamatergic N-methyl-d-aspartate receptor, augments and accelerates a full course of comprehensive cognitive-behavioral therapy (CBT) in adults with generalized social anxiety disorder. This was a multisite randomized placebo-controlled efficacy study with 169 medication-free adults with generalized social anxiety disorder, of whom 144 completed the 12-week treatment and 131 completed the three follow-up assessments. Patients were randomly assigned to receive 50 mg of D-cycloserine or placebo 1 hour before each of five exposure sessions that were part of a 12-session cognitive-behavioral group treatment. Response and remission status was determined at baseline, throughout treatment, at end of treatment, and at 1-, 3-, and 6-month follow-up assessments by assessors who were blind to treatment condition. D-Cycloserine-augmented and placebo-augmented CBT were associated with similar completion rates (87% and 82%), response rates (79.3% and 73.3%), and remission rates (34.5% and 24.4%) at the posttreatment assessment; response and remission rates were largely maintained at the follow-up assessments. Although D-cycloserine was associated with a 24%-33% faster rate of improvement in symptom severity and remission rates relative to placebo during the treatment phase, the groups did not differ in response and remission rates. D-Cycloserine did not augment a full course of comprehensive CBT for social anxiety disorder.",Hofmann SG.; Smits JA.; Rosenfield D.; Simon N.; Otto MW.; Meuret AE.; Marques L.; Fang A.; Tart C.; Pollack MH.,2013.0,10.1176/appi.ajp.2013.12070974,0,0,
9273,Suicidal ideation and risk factors in primary care patients with anxiety disorders.,"The presence of an anxiety disorder is associated with greater frequency of suicidal thoughts and behaviors. Given the high personal and societal costs of suicidal behaviors, suicide prevention is a priority. Understanding factors present within individuals with anxiety disorders that increase suicide risk may inform prevention efforts. The aims of the present study were to examine the prevalence of suicidal ideation and behaviors, as well as factors associated with suicide risk in patients with anxiety disorders in primary care. Data from a large scale randomized controlled study were analyzed to assess prevalence of suicidal thoughts and behaviors, as well as factors associated with suicide risk. Results revealed that suicidal ideation and behaviors were relatively common in this group. When examining mental and physical health factors jointly, presence of depression, mental health-related impairment, and social support each uniquely accounted for variance in suicide risk score. Methodological limitations include cross-sectional data collection and lack of information on comorbid personality disorders. Moreover, patients included were from a clinical trial with exclusion criteria that may limit generalizability. Results highlight the complex determinants of suicidal behavior and the need for more nuanced suicide assessment in this population, including evaluation of comorbidity and general functioning.",Bomyea J.; Lang AJ.; Craske MG.; Chavira D.; Sherbourne CD.; Rose RD.; Golinelli D.; Campbell-Sills L.; Welch SS.; Sullivan G.; Bystritsky A.; Roy-Byrne P.; Stein MB.,2013.0,10.1016/j.psychres.2013.03.017,0,0,
9274,[The criteria of choice of the surgical treatment method in the injured persons with intrapleural post-traumatic hemorrhage in the closed thoracic trauma].,The role of clinic-instrumental methods of investigation for establishment of criteria in the choice in the injured persons surgical treatment with intrapleural posttraumatic hemorrhage as a consequence of the closed thoracic trauma was studied up.,Boĭko VV.; Zamiatin PN.; Khashchina VA.; Zamiatin DP.,2012.0,,0,0,
9275,Altered top-down and bottom-up processing of fear conditioning in panic disorder with agoraphobia.,"Although several neurophysiological models have been proposed for panic disorder with agoraphobia (PD/AG), there is limited evidence from functional magnetic resonance imaging (fMRI) studies on key neural networks in PD/AG. Fear conditioning has been proposed to represent a central pathway for the development and maintenance of this disorder; however, its neural substrates remain elusive. The present study aimed to investigate the neural correlates of fear conditioning in PD/AG patients. The blood oxygen level-dependent (BOLD) response was measured using fMRI during a fear conditioning task. Indicators of differential conditioning, simple conditioning and safety signal processing were investigated in 60 PD/AG patients and 60 matched healthy controls. Differential conditioning was associated with enhanced activation of the bilateral dorsal inferior frontal gyrus (IFG) whereas simple conditioning and safety signal processing were related to increased midbrain activation in PD/AG patients versus controls. Anxiety sensitivity was associated positively with the magnitude of midbrain activation. The results suggest changes in top-down and bottom-up processes during fear conditioning in PD/AG that can be interpreted within a neural framework of defensive reactions mediating threat through distal (forebrain) versus proximal (midbrain) brain structures. Evidence is accumulating that this network plays a key role in the aetiopathogenesis of panic disorder.",Lueken U.; Straube B.; Reinhardt I.; Maslowski NI.; Wittchen HU.; Ströhle A.; Wittmann A.; Pfleiderer B.; Konrad C.; Ewert A.; Uhlmann C.; Arolt V.; Jansen A.; Kircher T.,2014.0,10.1017/S0033291713000792,0,0,
9276,Conquer fear: protocol of a randomised controlled trial of a psychological intervention to reduce fear of cancer recurrence.,"Up to 70% of cancer survivors report clinically significant levels of fear of cancer recurrence (FCR). Despite the known negative impact of FCR on psychological wellbeing and quality of life, little research has investigated interventions for high FCR. Our team has developed and piloted a novel intervention (Conquer Fear) based on the Self-Regulatory Executive Function Model and Relational Frame Theory and is evaluating Conquer Fear in a randomised controlled trial (RCT). We aim to compare the efficacy and cost-efficacy of the Conquer Fear Intervention and relaxation training in reducing the impact of FCR. This study is a multi-centre RCT with 260 participants randomised either to the Conquer Fear Intervention or relaxation training. Both interventions will be delivered in five sessions over 10 weeks by trained psychologists, psychiatrists and social workers with five or more years experience in oncology. Conquer Fear sessions use attentional training, detached mindfulness, meta-cognitive therapy, values clarification and psycho-education to help patients change the way they regulate and respond to thoughts about cancer recurrence. Relaxation training includes training in progressive and passive muscle relaxation, meditative relaxation, visualisation and ""quick relaxation"" techniques. Relaxation was chosen to control for therapist time and attention and has good face-validity as an intervention. The primary outcome is fear of cancer recurrence. Secondary outcomes include distress, quality of life, unmet needs, and health care utilisation. Participants complete questionnaires prior to starting the intervention, immediately after completing the intervention, 3 and 6 months later. Eligible participants are early-stage breast or colorectal cancer survivors who have completed hospital-based treatment between 2 months and 5 years prior to study entry and report a score in the clinical range on the Fear of Cancer Recurrence Inventory. The biostatistician is blinded to group allocation and participants are blinded to which intervention is being evaluated. Randomisation is computer generated, stratified by therapist, and uses sequentially numbered sealed envelopes. If successful, the study will provide an evidence-based intervention to reduce psychological morbidity in cancer survivors, and reduce overall health care costs due to more appropriate use of follow-up care and other health services in this very large population.  ACTRN12612000404820.",Butow PN.; Bell ML.; Smith AB.; Fardell JE.; Thewes B.; Turner J.; Gilchrist J.; Beith J.; Girgis A.; Sharpe L.; Shih S.; Mihalopoulos C.;  .,2013.0,10.1186/1471-2407-13-201,0,0,
9277,[Is distal femoral replacement an adequate therapeutic option after complex fractures of the distal femur?].,Modular distal femur replacements originally were developed for reconstructing a full weight-bearing and functional extremity after resection of primary bone tumours with large bony defects located in proximity to joints. The aim of this study was to examine the use of the modular distal femur replacements for complex fractures and severe post-traumatic sequelae of the distal femur in context to comparable studies. Fourteen patients with complex fractures or post-traumatic sequelae and extensive bone defects requiring distal femur replacement were analysed retrospectively. Median age of the patients at the time of distal femoral replacement was 77 years and median follow-up interval was 27 months. Median follow-up was 27.0 (IQB 13.5-37.5) months (range 10-49 months). The indication for distal femur replacement was a periprosthetic fracture in three cases. Three further periprosthetic fractures were treated with a megaendoprosthesis after failure of osteosynthesis. In eight patients a megaendoprosthesis was implanted due to complications following ostheosynthesis for distal femoral fractures. Distal femoral arthroplasty was performed as a two-stage procedure in five patients with implant-associated infections. A lateral approach was used in six patients and a medial arthrotomy was conducted in eight patients. The median Knee Society score (KSS) improved significantly from 20.0 (IQB 7.5-30.0) points preoperatively to 80.0 (IQB 62.3-89.0) points at follow-up (p < 0.001). Complications requiring surgical intervention were documented in seven of 14 patients (50 %). In two patients wound-healing disorders and superficial infections necessitated surgery. In one patient a rupture of the patellar tendon was diagnosed. This patient subsequently also sustained a periprosthetic fracture. Another patient developed early aseptic loosening of the femoral component. The most common complication was a periprosthetic fracture in four patients. Three patients died for reasons not related to distal femoral replacement. Distal femoral replacement is an important option in reconstituting a full weight-bearing and functional lower extremity after complex fractures and post-traumatic sequelae with massive bone destruction. Particularly elderly patients regain ambulatory ability in the vast majority of cases. The relatively high complication rate demands very thorough preoperative planning as well as prompt allocation of extensive surgical procedures in the case of an adverse event.,Fakler JK.; Hepp P.; Marquaß B.; von Dercks N.; Josten C.,2013.0,10.1055/s-0032-1328424,0,0,
9278,Shame and guilt in social anxiety disorder: effects of cognitive behavior therapy and association with social anxiety and depressive symptoms.,"Social anxiety disorder (SAD), characterized by fear of being scrutinized by others, has features that that are closely linked to the concept of shame. Despite this, it remains to be investigated whether shame is elevated in persons with SAD, and if cognitive behavior therapy (CBT) for SAD could reduce shame experience. In the present study, we focused on internal shame, i.e. the type of shame that pertains to how we judge ourselves. Although guilt is distinctly different from shame, we also viewed it as important to investigate its role in SAD as the two emotions are highly correlated. The aim of this study was to investigate: (I) if persons with SAD differ from healthy controls on shame and guilt, (II) if shame, guilt, depressive symptoms, and social anxiety are associated in persons with SAD, and (III) if CBT can reduce internal shame in patients with SAD. Firstly, we conducted a case-control study comparing a sample with SAD (n = 67) with two samples of healthy controls, a main sample (n = 72) and a replication sample (n = 22). Secondly, all participants with SAD were treated with CBT and shame, measured with the Test of Self-Conscious affect, was assessed before and after treatment. The results showed that shame was elevated in person with SAD compared to the control replication sample, but not to the main control sample. In addition, shame, social anxiety, and depressive symptoms were significantly associated among participants with SAD. After CBT, participants with SAD had significantly reduced their shame (Cohen's d = 0.44). Guilt was unrelated to social anxiety. We conclude that shame and social anxiety are associated and that it is likely that persons with SAD are more prone to experience shame than persons without SAD. Also, CBT is associated with shame reduction in the treatment of SAD.",Hedman E.; Ström P.; Stünkel A.; Mörtberg E.,2013.0,10.1371/journal.pone.0061713,0,0,
9279,Endovascular treatment of posttraumatic carotid-cavernous fistulas and pseudoaneurysms with covered stents.,"The treatment of posttraumatic direct carotid-cavernous fistulas (TCCFs) with detachable balloons (DBs) is associated with relatively high recanalization rate. The aim of this study was to evaluate the feasibility of using covered stents in patients with posttraumatic carotid-cavernous fistulas (CCFs) and pseudoaneurysms. Twelve patients with posttraumatic CCFs and 3 with pseudoaneurysms following detachable balloon deployment referred for treatment with covered stents were enrolled into this prospective study. Data on technical success, initial and final angiography results, mortality, morbidity, and the final clinical outcome, were retrospectively collected and analyzed at 1-, 3-, 6-, 12-months, and then annually. The navigation and deployment of the covered stents to the target CCF were technically successful in 14 of the 15 attempted stents, giving a successful technical rate of 93.3%. Angiography poststent placement showed complete occlusion in 11 patients with 11 CCFs, and incomplete occlusion in 3. Follow-up angiography revealed complete occlusion and no obvious in-stent stenosis in any patient. Clinical follow-up demonstrated full recovery in 13 patients, and an unchanged status in 1. These preliminary results indicate that the use of a covered stent is a feasible procedure for the treatment CCFs and pseudoaneurysms.",He XH.; Li WT.; Peng WJ.; Lu JP.; Liu Q.; Zhao R.,,10.1111/jon.12023,0,0,
9280,Childbirth and criteria for traumatic events.,"for some women childbirth is physically and psychologically traumatic and meets Criterion A1 (threat) and A2 (intense emotional response) for Posttraumatic Stress Disorder of the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV).This study differentiates Criterion A1 and A2 to explore their individual relationship to prevalence rates for posttraumatic stress, each other, and associated factors for childbirth trauma. women were recruited at three hospitals from October 2008 to October 2009. Questionnaires were completed at recruitment and at 14 days post partum. women in the third trimester of pregnancy (n=890) were recruited by a research midwife while waiting for their antenatal clinic appointment. Participants were over 17 years of age, expected to give birth to a live infant, not undergoing psychological treatment, and able to complete questionnaires in English. this study found 14.3% of women met criteria for a traumatic childbirth. When the condition of A2 was removed, the prevalence rate doubled to 29.4%. Approximately half the women who perceived threat in childbirth did not have an intense negative emotional response. Predictors of finding childbirth traumatic were pre-existing psychiatric morbidity, being a first time mother and experiencing an emergency caesarean section. the fear response is an important diagnostic criterion for assessing psychologically traumatic childbirth. The identification of risk factors may inform maternity service delivery to prevent traumatic birth and postpartum approaches to care to address long-term negative consequences. prevention and treatment of traumatic childbirth are improved through knowledge of potential risk factors and understanding the woman's subjective experience.",Boorman RJ.; Devilly GJ.; Gamble J.; Creedy DK.; Fenwick J.,2014.0,10.1016/j.midw.2013.03.001,0,0,
9281,Sudden gains in prolonged exposure and sertraline for chronic PTSD.,"Sudden gains are significant, rapid improvements in symptoms, larger than typical between-session symptom reduction.([8]) Sudden gains in a large sample of individuals with posttraumatic stress disorder (PTSD) have not been studied, and only one study has looked at it in pharmacotherapy, but not in PTSD. In the present study, we examined the occurrence of sudden gains in psychotherapy, specifically prolonged exposure (PE), and pharmacotherapy, specifically sertraline, for chronic PTSD. Sudden gains in PTSD symptoms (PTSD symptom scale self-report([25]) ) were assessed in 200 individuals with PTSD during 10 weeks of PE or sertraline. Individuals in both PE (42.2%) and sertraline (31%) exhibited sudden gains. Individuals in PE made more gains toward the end of treatment (7.2%) than sertraline (2%, OR = 3.82). However, individuals in sertraline made larger gains during early treatment (M = 18.35, SD = 8.15) than PE (M = 12.53, SD = 5.16, d = .85). Notably, those on sertraline were more likely to exhibit a reversal of sudden gains than those in PE (OR = .23). Pointing to clinical significance, the presence of a sudden gain was associated with better reduction in symptoms from pre- to posttreatment (β = -.49). Individuals in both PE and sertraline experienced gains, though sertraline was associated with earlier large but reversible gains, and PE was associated with later gains. This differential pattern of discontinuous change highlights potential differential mechanism for these therapies and marks important transition points for further detailed analyses of change mechanisms.",Jun JJ.; Zoellner LA.; Feeny NC.,2013.0,10.1002/da.22119,0,0,
9282,The relation between social anxiety and audience perception: examining Clark and Wells' (1995) model among adolescents.,"Clark and Wells' cognitive model of social anxiety proposes that socially anxious individuals have negative expectations of performance prior to a social event, focus their attention predominantly on themselves and on their negative self-evaluations during an event, and use this negative self-processing to infer that other people are judging them harshly. The present study tested these propositions. The study used a community sample of 161 adolescents aged 14-18 years. The participants gave a speech in front of a pre-recorded audience acting neutrally, and participants were aware that the projected audience was pre-recorded. As expected, participants with higher levels of social anxiety had more negative performance expectations, higher self-focused attention, and more negative perceptions of the audience. Negative performance expectations and self-focused attention were found to mediate the relationship between social anxiety and audience perception. The findings support Clark and Wells' cognitive model of social anxiety, which poses that socially anxious individuals have distorted perceptions of the responses of other people because their perceptions are coloured by their negative thoughts and feelings.",Blöte AW.; Miers AC.; Heyne DA.; Clark DM.; Westenberg PM.,2014.0,10.1017/S1352465813000271,0,0,
9283,"Prediction of treatment response and the effect of independent component neurofeedback in obsessive-compulsive disorder: a randomized, sham-controlled, double-blind study.","The goal of this study was to assess the effect of independent component neurofeedback (NFB) on EEG and clinical symptoms in patients with obsessive-compulsive disorder (OCD). Subsequently, we explored predictors of treatment response and EEG correlates of clinical symptoms. In a randomized, double-blind, parallel design, 20 inpatients with OCD underwent 25 sessions of NFB or sham feedback (SFB). NFB aimed at reducing EEG activity in an independent component previously reported abnormal in this diagnosis. Resting-state EEG recorded before and after the treatment was analyzed to assess its posttreatment changes, relationships with clinical symptoms and treatment response. Overall, clinical improvement in OCD patients was not accompanied by EEG change as assessed by standardized low-resolution electromagnetic tomography and normative independent component analysis. Pre- to posttreatment comparison of the trained component and frequency did not yield significant results; however, in the NFB group, the nominal values at the downtrained frequency were lower after treatment. The NFB group showed significantly higher percentage reduction of compulsions compared to the SFB group (p = 0.015). Pretreatment higher amount of delta (1-6 Hz) and low alpha oscillations as well as a lower amount of high beta activity predicted a worse treatment outcome. Source localization of these delta and high beta oscillations corresponded with previous EEG resting-state findings in OCD patients compared to healthy controls. Independent component NFB in OCD proved useful in percentage improvement of compulsions. Based on our correlation analyses, we hypothesize that we targeted a network related to treatment resistance.",Kopřivová J.; Congedo M.; Raszka M.; Praško J.; Brunovský M.; Horáček J.,2013.0,10.1159/000347087,0,0,
9284,Treatment of posttraumatic stress disorder reduces suicidal ideation.,"Suicide is a significant public health problem. Although various studies have found evidence of posttraumatic stress disorder (PTSD) as a risk factor for suicidal behaviors, no study has examined whether or not PTSD treatment decreases suicidal thoughts. This study aims to fill this gap in the literature by examining changes in suicidal ideation over the course of a randomized clinical trial, which compared two widely used treatments for PTSD-cognitive processing therapy (CPT) and prolonged exposure (PE). Data from 163 trial participants over five time points (pre- and posttreatment, 3 and 9 months posttreatment, and 5-10 years posttreatment) were examined using multilevel growth curve analyses to determine if reductions in PTSD symptoms during treatment were associated with reductions in suicidal ideation. Major depression diagnosis and hopelessness were controlled. Suicidal ideation decreased sharply during treatment with continued, but more subtle decreases, during the follow-up period. These decreases were associated with decreases in PTSD symptoms over the course of treatment. These associations were not accounted for by depression diagnoses at the start of the study or changes in hopelessness over the course of treatment. Two widely used, effective treatments for PTSD reduce suicidal ideation. CPT exhibited a larger influence on suicidal ideation than PE, although the magnitude of the difference was small in size. Inclusion of PTSD screening and treatment could enhance suicide prevention efforts.",Gradus JL.; Suvak MK.; Wisco BE.; Marx BP.; Resick PA.,2013.0,10.1002/da.22117,0,0,
9285,The widening of the gaze cone in patients with social anxiety disorder and its normalization after CBT.,"Gaze plays a crucial role in social interactions. Social Anxiety Disorder (SAD), which is associated with severe impairment of social interactions, is thus likely to exhibit disturbances of gaze perception. We conducted two experiments with SAD-patients and healthy control participants using a virtual head whose gaze could be interactively manipulated. We determined the subjective area of mutual gaze, the so-called gaze cone, and measured it prior to and after a psychotherapeutic intervention (Exp. 1). Patients exhibited larger gaze cones than control subjects. Exp. 2 varied the emotional expression of the virtual head. These data were validated using a real person (professional actor) as stimulus. Excellent reliability indices were found for our gaze cone measure. After Cognitive Behavioral Therapy, group differences in gaze cone width had disappeared. Emotional expressions were observed to modulate the gaze cone's width. Especially an angry expression caused the gaze cone to widen, possibly mediated by increased arousal. Finally, wider gaze cones in SAD-patients could be demonstrated for virtual and for real human heads confirming the ecological validity of virtual heads. The findings are of relevance for a more fine-grained understanding of perceptual processes in patients with SAD.",Harbort J.; Witthöft M.; Spiegel J.; Nick K.; Hecht H.,2013.0,10.1016/j.brat.2013.03.009,0,0,
9286,Mobile contingency management as an adjunctive smoking cessation treatment for smokers with posttraumatic stress disorder.,"Smokers with posttraumatic stress disorder (PTSD) smoke at higher prevalence rates and are more likely to relapse early in a quit attempt. Innovative methods are needed to enhance quit rates, particularly in the early quit period. Web-based contingency-management (CM) approaches have been found helpful in reducing smoking among other difficult-to-treat smoker populations but are limited by the need for computers. This pilot study builds on the web-based CM approach by evaluating a smartphone-based application for CM named mobile CM (mCM). Following a 2-week training period, 22 smokers with PTSD were randomized to a 4-week mCM condition or a yoked (i.e., noncontingent 4-week mCM condition). All smokers received 2 smoking cessation counseling sessions, nicotine replacement, and bupropion. Participants could earn up to $690 ($530 for mCM, $25.00 for assessments and office visits [up to 5], and $35.00 for equipment return). The average earned was $314.00. Compliance was high during the 2-week training period (i.e., transmission of videos) (93%) and the 4-week treatment period (92%). Compliance rates did not differ by group assignment. Four-week quit rates (verified with CO) were 82% for the mCM and 45% for the yoked controls. Three-month self-report quit rates were 50% in the mCM and 18% in the yoked controls. mCM may be a useful adjunctive smoking cessation treatment component for reducing smoking among smokers with PTSD, particularly early in a smoking quit attempt.",Hertzberg JS.; Carpenter VL.; Kirby AC.; Calhoun PS.; Moore SD.; Dennis MF.; Dennis PA.; Dedert EA.; Beckham JC.,2013.0,10.1093/ntr/ntt060,0,0,
9287,Pretreatment anxiety predicts patterns of change in cognitive behavioral therapy and medications for depression.,"Some studies report that initial anxiety is associated with equivocal or negative effects in depression treatment. In contrast, at least 4 studies of cognitive behavioral therapy (CBT) report that anxiety predicts greater or more rapid change in depression. Further exploration is needed to clarify the relationship between initial anxiety and depression change. Questions include the relationship between anxiety and patterns of change and time to relapse, as well as the specificity effects to CBT. The study assessed the relation of Beck Anxiety Inventory anxiety scores to early rapid change and overall change in Beck Depression Inventory-II depression scores during acute depression treatment. Participants were 178 individuals enrolled in a randomized controlled trial of CBT versus antidepressant medications (ADMs) for moderate to severe depression. They were 58% female and 83% Caucasian, with an average age of 40 (SD = 11.5). Thirty-four percent (34%) were married or cohabitating. Hierarchical linear models, including quadratic growth parameters, were used to model change. The relation of anxiety to the probability of posttreatment relapse was also examined. Findings indicate that higher levels of anxiety predict early rapid change, but not overall change, in both CBT and ADM. However, patients with higher levels of intake anxiety evidenced increased risk for relapse after CBT. Early rapid change predicted by anxiety occurs across different treatment conditions, but this early rapid response is not indicative of positive overall outcome in all cases. These findings might indicate that anxiety predicts a response to nonspecific ""common factors"" of treatment.",Forand NR.; Derubeis RJ.,2013.0,10.1037/a0032985,0,0,
9288,Seeking safety therapy for pathological gambling and PTSD: a pilot outcome study.,"This pilot study evaluated Seeking Safety (SS) therapy for seven outpatients with current comorbid pathological gambling (PG) and posttraumatic stress disorder (PTSD). This represents the first treatment outcome study of this population, and included both genders and 29% minorities. We found significant improvements in: PTSD/trauma (the PTSD Checklist criterion B symptoms; the Trauma Symptom Inventory overall mean and subscales anxiety, dissociation, sexual abuse trauma index, sex problems; and the World Assumptions Scale benevolence subscale); gambling (the Gamblers Beliefs Questionnaire overall mean and subscales illusion of control); functioning (the Basis-32 overall mean and depression/anxiety subscale); psychopathology (the Brief Symptom Inventory overall mean and subscales anxiety and depression; and the Addiction Severity Index, ASI, psychiatric composite score); self-compassion (the Self-Compassion Scale overall mean and subscales isolation, overidentified, and self-judgment); and helping alliance (the Helping Alliance Questionnaire overall mean). One variable indicated worsening (employment composite subscale on the ASI), possibly reflecting measurement issues. SS attendance was excellent. PTSD onset occurred prior to PG onset for most of the sample, and most believed the two disorders were related. Overall, we found that SS can be effectively conducted for comorbid PTSD and PG, with improvements in numerous domains and high acceptability. Limitations are discussed.",Najavits LM.; Smylie D.; Johnson K.; Lung J.; Gallop RJ.; Classen CC.,,10.1080/02791072.2013.763557,0,0,
9289,Neural predictors and mechanisms of cognitive behavioral therapy on threat processing in social anxiety disorder.,"Cognitive behavioral therapy (CBT) is ""gold standard"" psychotherapy for social anxiety disorder (SAD). Cognitive models posit that preferential processing of threat mediates excessive forms of anxiety, which is supported by exaggerated amygdala, insula, and cortical reactivity to threatening socio-emotional signals in SAD. However, little is known about neural predictors of CBT success or the mechanisms by which CBT exerts its therapeutic effects. Functional magnetic resonance imaging (fMRI) was conducted during responses to social signals of threat (fearful/angry faces) against positive signals (happy faces) in 14 patients with SAD before and after 12 weeks of CBT. For comparison, 14 healthy control (HC) participants also underwent two fMRI scans, 12 weeks apart. Whole-brain voxel-wise analyses showed therapeutic success was predicted by enhanced pre-treatment activation to threatening faces in higher-order visual (superior and middle temporal gyrus), cognitive, and emotion processing areas (dorsal anterior cingulate cortex, dorsomedial prefrontal cortex). Moreover, a group by time interaction was revealed in prefrontal regions (dorsomedial, medial gyrus) and insula. The interaction was driven by relatively greater activity during threat processing in SAD, which significantly reduced after CBT but did not significantly predict response to CBT. Therefore, pre-treatment cortical hyperactivity to social threat signals may serve as a prognostic indicator of CBT success in SAD. Collectively, CBT-related brain changes involved a reduction in activity in insula, prefrontal, and extrastriate regions. Results are consistent with cognitive models, which associate decreases in threat processing bias with recovery.",Klumpp H.; Fitzgerald DA.; Phan KL.,2013.0,10.1016/j.pnpbp.2013.05.004,0,0,
9290,"Comparison of palmar fixed-angle plate fixation with K-wire fixation of distal radius fractures (AO A2, A3, C1) in elderly patients.","The objective of this prospective, randomized, controlled trial was to compare the results of two operative techniques used for the treatment of unstable distal radius fractures in elderly patients classified as AO types A2, A3, and C1. Patients were treated with either fixed-angle volar plates or K-wires using a combined Kapandji and Willenegger technique. The functional results were determined after 3, 6, and 12 months. We included 40 patients aged over 65 years. Twenty-one patients were treated with plate fixation and 19 with K-wire fixation. The functional results, after 1 year, were nearly the same in both treatment groups, suggesting that either method is suitable for the treatment of unstable distal radius fractures of AO types A2, A3, and C1 in elderly patients. Sixteen of 21 patients with plate fixation and 17 of 19 patients with K-wire fixation present good results as assessed by the Castaing score. The median DASH score was three in both groups after 1 year. The patients with plate fixation were able to resume activities of daily living 4 weeks earlier. The most common complication was an intermediate post-traumatic median nerve irritation. Both methods are suitable for the treatment of elderly patients with unstable distal radius fractures of AO types A2, A3, and C1. If early functional post-operative care is important, palmar fixed-angle plate fixation is an ideal treatment approach. Otherwise, K-wire fixation is an effective, minimally invasive method with comparable clinical results.",Goehre F.; Otto W.; Schwan S.; Mendel T.; Vergroesen PP.; Lindemann-Sperfeld L.,2014.0,10.1177/1753193413489057,0,0,
9291,Reducing emotional reasoning: an experimental manipulation in individuals with fear of spiders.,"Emotional reasoning involves the tendency to use subjective responses to make erroneous inferences about situations (e.g., ""If I feel anxious, there must be danger"") and has been implicated in various anxiety disorders. The aim of this study of individuals with fear of spiders was to test whether computerised experimental training, compared to control training, would decrease emotional reasoning, reduce fear-related danger beliefs, and increase approach behaviour towards a fear-relevant stimulus. Effects were assessed shortly after the experimental manipulation and one day later. Results showed that the manipulation significantly decreased emotional reasoning in the experimental condition, not in the control condition, and resulted in lower danger estimates of a spider, which was maintained up to one day later. No differences in approach behaviour towards the spider were found. Reducing emotional reasoning may ultimately help patients with anxiety disorders attend more to objective situational information to correct erroneous danger beliefs.",Lommen MJ.; Engelhard IM.; van den Hout MA.; Arntz A.,2013.0,10.1080/02699931.2013.795482,0,0,
9292,Computerized dental injection fear treatment: a randomized clinical trial.,"One in four adults reports a clinically significant fear of dental injections, leading many to avoid dental care. While systematic desensitization is the most common therapeutic method for treating specific phobias such as fear of dental injections, lack of access to trained therapists, as well as dentists' lack of training and time in providing such a therapy, means that most fearful individuals are not able to receive the therapy needed to be able to receive necessary dental treatment. Computer Assisted Relaxation Learning (CARL) is a self-paced computerized treatment based on systematic desensitization for dental injection fear. This multicenter, block-randomized, dentist-blind, parallel-group study conducted in 8 sites in the United States compared CARL with an informational pamphlet in reducing fear of dental injections. Participants completing CARL reported significantly greater reduction in self-reported general and injection-specific dental anxiety measures compared with control individuals (p < .001). Twice as many CARL participants (35.3%) as controls (17.6%) opted to receive a dental injection after the intervention, although this was not statistically significant. CARL, therefore, led to significant changes in self-reported fear in study participants, but no significant differences in the proportion of participants having a dental injection.",Heaton LJ.; Leroux BG.; Ruff PA.; Coldwell SE.,2013.0,10.1177/0022034513484330,0,0,
9293,Reduced intra-individual reaction time variability during a Go-NoGo task in detoxified alcohol-dependent patients after one right-sided dorsolateral prefrontal HF-rTMS session.,"As alcohol dependency is characterized by severe executive function deficits, we examined the influence of high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) applied to the right dorsolateral prefrontal cortex (DLPFC) on executive functioning in recently detoxified alcohol-dependent patients. In this randomized, single blind, sham (placebo)-controlled, crossover study, we included 50 detoxified alcohol-dependent patients. We examined the effect of a single right DLPFC HF-rTMS session on commission errors, mean reaction times (RTs) and intra-individual reaction time variability (IIRTV) during a Go-NoGo task (50% Go/50% NoGo condition) in 29 alcohol-dependent patients. Patients completed this cognitive task immediately before and immediately after the stimulation session. In order to avoid carry-over effects between stimulation sessions, a 1-week inter-session interval was respected. Because rTMS treatment has been shown to affect subjective craving, all patients were also assessed with the Obsessive Compulsive Drinking Scale (OCDS). After both stimulation conditions, we observed a significant decrease of commission errors, without differences between active and sham HF-rTMS stimulation. No significant difference was observed between active and sham stimulation on mean RT. However, only active stimulation resulted in a significant decrease in IIRTV. No effects of stimulation were found for the craving measurements. Our findings suggest that in recently detoxified alcohol-dependent patients, one right-sided HF-rTMS session stabilizes cognitive performance during executive control tasks, implying that active stimulation reduces patients' proneness to attentional lapses.",Herremans SC.; Vanderhasselt MA.; De Raedt R.; Baeken C.,,10.1093/alcalc/agt054,0,0,
9294,"Training primary health care workers in mental health and its impact on diagnoses of common mental disorders in primary care of a developing country, Malawi: a cluster-randomized controlled trial.","Mental health problems are common in primary care, with prevalence rates of up to 40% reported in developing countries. The study aim was to evaluate the impact of a specially designed toolkit used to train primary health care (PHC) workers in mental health on the rates of diagnosed cases of common mental disorders, malaria and non-specific musculoskeletal pains in primary care in Malawi. Clinics with out-patient services in the designated district were randomly divided into control and intervention arms. Using a two-phase sampling process, Self-Reporting Questionnaire scores, data on diagnoses made by PHC workers and results of the Structured Clinical Interview for DSM-IV for depression were collected from 837 consecutively attending adult patients in the pre-intervention study and 2600 patients in the post-intervention study. The point prevalence rates for probable common mental disorder and depression were 28.8% and 19%, respectively. Rates for both anxiety and depression diagnoses by PHC workers at baseline were 0% in both arms. Following training, there were significant differences between the two arms in the rates of diagnosed cases of depression [9.2% v. 0.5%, odds ratio (OR) 32.1, 95% confidence interval (CI) 7.4-144.3, p ≤ 0.001], anxiety (1.2% v. 0%, p ≤ 0.001) and malaria (31% v. 40%, OR 0.62, 95% CI 0.43-0.89, p = 0.01). The intervention arm had more cases diagnosed with depression and anxiety while the control arm had more cases diagnosed with malaria. Training of PHC workers in mental health with an appropriate toolkit will contribute significantly to the quality of detection and management of patients seen in primary care in developing countries.",Kauye F.; Jenkins R.; Rahman A.,2014.0,10.1017/S0033291713001141,0,0,
9295,[Dance/movement therapy in oncological rehabilitation].,"Dance/movement therapy may be defined as a psychosocial and body-oriented art therapy, which uses dance for the expression of emotional and cognitive issues. Dance/movement therapy is an important intervention for cancer patients to enhance coping strategies. There are only few studies investigating dance therapy with cancer patients. The present study investigates effects of dance/movement therapy (n = 115) in the setting of inpatient rehabilitation based on a pre-post design with a control group as well as a follow-up 3 months later. Standardized questionnaires measuring quality of life, anxiety and depression, and self-concept (EORTC QLQ-C30, HADS, FSKN) were used. In addition, at the end of the inpatient rehabilitation program subjective expectations of the dance/movement therapy and the patients' subjective evaluation of the benefits of the intervention were measured by a new developed questionnaire. As process factors of dance/movement therapy, expression of emotions, enhancement of self-esteem, development of the personality, vitality, getting inner balance, and getting in touch with the body have been identified. In terms of quality of life and psychological well-being, the results showed significant improvements with medium to large effect sizes. Even though those effects may not be attributed to the intervention alone, the analysis of the data and the patients' subjective statements help to reveal therapeutic factors and process characteristics of dance/movement therapy within inpatient rehabilitation.",Mannheim EG.; Helmes A.; Weis J.,2013.0,10.1159/000346617,0,0,
9296,Group climate as predictor of short- and long-term outcome in group therapy for social phobia.,"A longitudinal study of 80 participants in cognitive and interpersonal group therapy for social phobia was conducted. The aim was to investigate the relationship between group climate and patients' short-term and long-term outcome. Group climate data was collected every other week during treatment, whereas social phobia symptoms were assessed at admission, discharge, and one year follow-up. Abbreviated symptom assessments were performed weekly. Regression analyses and mixed models were used in the analyses. Engagement predicted symptom reduction during treatment, from pretreatment to follow-up, and from posttreatment to follow-up. During treatment, avoidance predicted higher symptomatic distress. The results imply that group engagement should be emphasized for patients with social phobia. Avoidance, on the other hand, should be addressed as a process that interferes with treatment progress.",Bonsaksen T.; Borge FM.; Hoffart A.,2013.0,10.1521/ijgp.2013.63.3.394,0,0,
9297,"Efficacy of ""seeking safety"" in a Dutch population of traumatized substance-use disorder outpatients: study protocol of a randomized controlled trial.","Traumatic experiences and, more specifically, posttraumatic stress disorder (PTSD) are highly prevalent among substance use disorder (SUD) patients. This comorbidity is associated with worse treatment outcomes in substance use treatment programs and more crisis interventions. International guidelines advise an integrated approach to the treatment of trauma related problems and SUD. Seeking Safety is an integrated treatment program that was developed in the United States. The aim of the current study is to test the efficacy of this program in the Netherlands in an outpatient SUD population. A randomized controlled trial (RCT) will be used to test the efficacy of Seeking Safety compared to Cognitive Behavioral Therapy (CBT) in a population of SUD outpatients. Each treatment will consist of 12 group sessions. The primary outcome measure will be substance use severity. Secondary outcome measures are PTSD and trauma symptoms, coping skills, functioning, and cognitions. Questionnaires will be administered at the start of treatment, at the end of treatment (three months after the start of treatment) and at follow-up (six months after the start of treatment). This study protocol presents a RCT in which the efficacy of an integrated treatment for comorbid PTSD and SUD, Seeking Safety, is evaluated in a SUD outpatient population compared to CBT. It is expected that the intervention group will show significantly more improvement in substance use severity compared to the control group at end-of-treatment and at follow-up. Furthermore, a lower drop-out rate is expected for the intervention group. If the intervention proves to be effective, it can be implemented. A cost-effectiveness analysis will be conducted to evaluate the two treatments. The protocol for this study is registered with the Netherlands Trial Register with number NTR3084 and approved by the local medical ethical committee (METC\11270.haa).",Kok T.; de Haan HA.; van der Meer M.; Najavits LM.; DeJong CA.,2013.0,10.1186/1471-244X-13-162,0,0,
9298,Group trauma-focused cognitive-behavioural therapy with former child soldiers and other war-affected boys in the DR Congo: a randomised controlled trial.,"The Democratic Republic of Congo (DRC) has been home to the world's deadliest conflict since World War II and is reported to have the largest number of child soldiers in the world. Despite evidence of the debilitating impact of war, no group-based mental health or psychosocial intervention has been evaluated in a randomised controlled trial for psychologically distressed former child soldiers. A randomised controlled trial involving 50 boys, aged 13-17, including former child soldiers (n = 39) and other war-affected boys (n = 11). They were randomly assigned to an intervention group, or wait-list control group. The intervention group received a 15-session, group-based, culturally adapted Trauma-Focused Cognitive-Behavioural Therapy (TF-CBT) intervention. Assessment interviews were completed at baseline, postintervention and 3-month follow-up (intervention group). Analysis of Covariance (ANCOVA) demonstrated that, in comparison to the wait-list control group, the TF-CBT intervention group had highly significant reductions in posttraumatic stress symptoms, overall psychosocial distress, depression or anxiety-like symptoms, conduct problems and a significant increase in prosocial behaviour (p < .001 for all). Effect sizes were higher when former child soldier scores were separated for sub-analysis. Three-month follow-up of the intervention group found that treatment gains were maintained. A culturally modified, group-based TF-CBT intervention was effective in reducing posttraumatic stress and psychosocial distress in former child soldiers and other war-affected boys.",McMullen J.; O'Callaghan P.; Shannon C.; Black A.; Eakin J.,2013.0,10.1111/jcpp.12094,0,0,
9299,Randomized controlled trial of expressive writing for psychological and physical health: the moderating role of emotional expressivity.,"The current study assessed main effects and moderators (including emotional expressiveness, emotional processing, and ambivalence over emotional expression) of the effects of expressive writing in a sample of healthy adults. Young adult participants (N=116) were randomly assigned to write for 20 minutes on four occasions about deepest thoughts and feelings regarding their most stressful/traumatic event in the past five years (expressive writing) or about a control topic (control). Dependent variables were indicators of anxiety, depression, and physical symptoms. No significant effects of writing condition were evident on anxiety, depressive symptoms, or physical symptoms. Emotional expressiveness emerged as a significant moderator of anxiety outcomes, however. Within the expressive writing group, participants high in expressiveness evidenced a significant reduction in anxiety at three-month follow-up, and participants low in expressiveness showed a significant increase in anxiety. Expressiveness did not predict change in anxiety in the control group. These findings on anxiety are consistent with the matching hypothesis, which suggests that matching a person's naturally elected coping approach with an assigned intervention is beneficial. These findings also suggest that expressive writing about a stressful event may be contraindicated for individuals who do not typically express emotions.",Niles AN.; Haltom KE.; Mulvenna CM.; Lieberman MD.; Stanton AL.,2014.0,10.1080/10615806.2013.802308,0,0,
9300,Mechanisms of change in an exposure-based treatment for irritable bowel syndrome.,"The aim of this study was to identify mediators of change in a previously published randomized controlled trial that compared Internet-delivered cognitive behavioral treatment based on exposure exercises (ICBT) with Internet-delivered stress management (ISM) for irritable bowel syndrome (IBS). ICBT and ISM targeted distinct proposed mechanisms of illness maintenance and symptom exacerbation, gastrointestinal symptom-specific anxiety (GSA), and stress reactivity, respectively. The original study found that ICBT was more effective than ISM in improving IBS symptoms. Weekly measurements of GSA and stress reactivity (putative mediators) and treatment outcome were obtained from 195 participants with IBS, who had been randomized to ICBT or ISM. Parallel process growth mediational analyses revealed that the larger reduction of IBS symptoms from ICBT compared to ISM was mediated by changes in GSA, αβ = -0.42, 95% CI asymmetric [-0.71, -0.16]. In contrast, changes in stress reactivity did not mediate the difference in outcomes between treatments, αβ = 0.04, 95% CI asymmetric [-0.09, 0.20]. Analyses of the temporal sequence of week-to-week changes in process and outcome measures showed that only GSA displayed a pattern consistent with a causal model in which change in process preceded and contributed to symptom change. Furthermore, engagement in treatment specific activities was related to change in GSA but not to stress reactivity in the ICBT arm, whereas treatment specific activities were not related to change in any of the putative processes in the ISM arm. We conclude that ICBT works through directly targeting GSA, rather than by means of reducing stress reactivity.",Ljótsson B.; Hesser H.; Andersson E.; Lindfors P.; Hursti T.; Rück C.; Lindefors N.; Andersson G.; Hedman E.,2013.0,10.1037/a0033439,0,0,
9301,Relationship of childhood trauma to depression and smoking outcomes in pregnant smokers.,"We evaluated whether childhood trauma moderated the treatment effect on depression and smoking outcomes in pregnant smokers. The sample included pregnant smokers participating in a randomized trial evaluating the efficacy of a 10-session interpersonally focused therapy-cognitive behavioral analysis system of psychotherapy (CBASP)-versus a time-matched health and wellness control (HW) for smoking cessation and depression reduction. Women (N = 248) who completed the Childhood Trauma Questionnaire (CTQ) were included. On average, women were 25 years old (SD = 5.91) and smoked 10 (SD = 6.9) cigarettes per day. Depressive symptoms were assessed with the Center for Epidemiological Studies Depression Scale (CES-D), and women had an average score of 21 (SD = 11.03). Seventy-six percent of women had experienced some form of moderate to severe childhood trauma as assessed by the CTQ. In women with a history of moderate to severe childhood trauma, there was a dose-response association of treatment on depression outcome through 6 months postpartum; those with increasing amounts of childhood trauma benefitted more from CBASP, whereas those in the HW condition did not. Childhood trauma did not moderate the treatment effect on abstinence, although increasing amounts of trauma were associated with reduced likelihood of abstinence at 6 months posttreatment. An interpersonally focused therapy may be beneficial for the treatment of depression during the prenatal period in pregnant smokers with childhood trauma histories, and such treatment becomes increasingly more important with cumulative trauma experience. Childhood trauma increases risk for cessation failure in pregnant smokers. (PsycINFO Database Record (c) 2013 APA, all rights reserved).",Blalock JA.; Minnix JA.; Mathew AR.; Wetter DW.; McCullough JP.; Cinciripini PM.,2013.0,10.1037/a0033381,0,0,
9302,Who gets the most out of cognitive behavioral therapy for anxiety disorders? The role of treatment dose and patient engagement.,"The present study explored treatment dose and patient engagement as predictors of treatment outcome in cognitive behavioral therapy (CBT) for anxiety disorders. Measures of high versus low treatment dose and high versus low patient engagement in CBT were compared as predictors of 12- and 18-month outcomes for patients being treated for anxiety disorders with CBT (with or without concurrent pharmacotherapy) in primary care settings as part of a randomized controlled effectiveness trial of the Coordinated Anxiety Learning and Management (CALM) intervention. Measures of dose (attendance, exposure completion) and engagement in CBT (homework adherence, commitment) were collected throughout treatment, and blinded follow-up phone assessments of outcome measures (12-item Brief Symptom Inventory, Patient Health Questionnaire 8, Sheehan Disability Scale) were completed at 12 and 18 months. Propensity score weighting controlled for baseline differences in demographics and symptom severity between patients with high and low dose and engagement. These analyses included the 439 patients who selected CBT as treatment modality. Completing exposures, having high attendance, and being more adherent to completing homework predicted better outcomes across all measures at 12 and 18 months, and high CBT commitment predicted better outcomes on all measures at 18 months. This study found that higher treatment dose and patient engagement in CBT for anxiety disorders were stable and robust predictors of greater reductions in anxiety symptoms, depression symptoms, and functional disability.",Glenn D.; Golinelli D.; Rose RD.; Roy-Byrne P.; Stein MB.; Sullivan G.; Bystritksy A.; Sherbourne C.; Craske MG.,2013.0,10.1037/a0033403,0,0,
9303,Six-month follow-up of a randomized controlled trial augmenting serotonin reuptake inhibitor treatment with exposure and ritual prevention for obsessive-compulsive disorder.,"This article describes the long-term effects of augmenting serotonin reuptake inhibitors (SRIs) with exposure and ritual prevention or stress management training in patients with DSM-IV obsessive-compulsive disorder (OCD). Between November 2000 and November 2006, 111 OCD patients from 2 academic outpatient centers with partial SRI response were randomized to the addition of exposure and ritual prevention or stress management training, delivered twice weekly for 8 weeks (acute phase); 108 began treatment. Responders (38 of 52 in the exposure and ritual prevention condition, 11 of 52 in the stress management training condition) entered a 24-week maintenance phase. The Yale-Brown Obsessive Compulsive Scale (YBOCS) was the primary outcome measure. After 24 weeks, patients randomized to and receiving exposure and ritual prevention versus stress management training had significantly better outcomes (mean YBOCS scores of 14.69 and 21.37, respectively; t = 2.88, P = .005), higher response rates (decrease in YBOCS scores ≥ 25%: 40.7% vs 9.3%, Fisher exact test P < .001), and higher rates of excellent response (YBOCS score ≤ 12: 24.1% vs 5.6%, Fisher exact test P = .01). During the maintenance phase, the slope of change in YBOCS scores was not significant in either condition (all P values ≥ .55), with no difference between exposure and ritual prevention and stress management training (P > .74). Better outcome was associated with baseline variables: lower YBOCS scores, higher quality of life, fewer comorbid Axis I diagnoses, and male sex. Augmenting SRIs with exposure and ritual prevention versus stress management training leads to better outcome after acute treatment and 24 weeks later. Maintenance outcome, however, was primarily a function of OCD severity at entrance. Greater improvement during the acute phase influences how well patients maintain their gains, regardless of treatment condition.",Foa EB.; Simpson HB.; Liebowitz MR.; Powers MB.; Rosenfield D.; Cahill SP.; Campeas R.; Franklin M.; Hahn CG.; Hembree EA.; Huppert JD.; Schmidt AB.; Vermes D.; Williams MT.,2013.0,10.4088/JCP.12m08017,0,0,
9304,Feasibility and utility of screening for depression and anxiety disorders in patients with cardiovascular disease.,"Depression and anxiety in patients with cardiac disease are common and independently associated with morbidity and mortality. We aimed to explore the use of a 3-step approach to identify inpatients with cardiac disease with depression, generalized anxiety disorder (GAD), or panic disorder; understand the predictive value of individual screening items in identifying these disorders; and assess the relative prevalence of these disorders in this cohort. To identify depression and anxiety disorders in inpatients with cardiac disease as part of a care management trial, an iterative 3-step screening procedure was used. This included an existing 4-item (Coping Screen) tool in nursing data sets, a 5-item screen for positive Coping Screen patients (Patient Health Questionnaire-2 [PHQ-2], GAD-2, and an item about panic attacks), and a diagnostic evaluation using PHQ-9 and the Primary Care Evaluation of Mental Disorders anxiety disorder modules. Overall, 6210 inpatients received the Coping Screen, 581 completed portions of all 3 evaluation steps, and 210 received a diagnosis (143 depression, 129 GAD, 30 panic disorder). Controlling for age, sex, and the other screening items, PHQ-2 items independently predicted depression (little interest/pleasure: odds ratio [OR]=6.65, P<0.001; depression: OR=5.24, P=0.001), GAD-2 items predicted GAD (anxious: OR=4.09, P=0.003; unable to control worrying: OR=10.46, P<0.001), and the panic item predicted panic disorder (OR=49.61, P<0.001). GAD was nearly as prevalent as depression in this cohort, and GAD-2 was an effective screening tool; however, panic disorder was rare. These results support the use of 2-step screening for depression and GAD beginning with a 4-item scale (GAD-2 plus PHQ-2). Unique Identifier: NCT01201967. URL: http://www.clinicaltrials.gov/ct2/show/NCT01201967.",Celano CM.; Suarez L.; Mastromauro C.; Januzzi JL.; Huffman JC.,2013.0,10.1161/CIRCOUTCOMES.111.000049,0,0,
9305,Implementing panic-focused psychodynamic psychotherapy into clinical practice.,"To determine the effectiveness of manualized panic-focused psychodynamic psychotherapy (PFPP) in routine care in Germany. German psychoanalysts were trained according to the PFPP manual. Fifty-four consecutive outpatients with panic disorder (with or without agoraphobia) were randomly assigned in a 2:1 ratio to PFPP or cognitive-behavioural therapy (CBT) plus exposure therapy. Subjects (female 57.4%; mean age 36.2 years) had high rates of psychiatric (68.5%) and somatic (64.8%) comorbidity, and previous psychiatric treatments (57.4%). Assessments were performed pre- and posttreatment and at 6-month follow-up. The primary outcome measure was the Panic Disorder Severity Scale. Both treatments were highly effective. In patients randomized to PFPP, remission was achieved in 44.4% at termination and by 50% at follow-up (CBT 61.1% and 55.6%, respectively). No significant differences were found. Emotional awareness, a posited moderator of good outcome in psychotherapies, was significantly higher in the CBT group at baseline. It was found to be a strong moderator of treatment effectiveness in both treatments. After adjusting for initial Levels of Emotional Awareness Scale (LEAS) scores, effect sizes (ESs) for the primary outcome were Cohen d = 1.28, from pre- to posttreatment, and d = 1.03, from pretreatment to follow-up, for PFPP, and d = 1.81 and 1.28 for CBT, respectively. PFPP was implemented effectively into clinical practice by psychoanalysts in the community in a sample with severe mental illness with large ESs. Assessment of LEAS may facilitate the identification of patients suitable for short-term psychotherapy. ( German Clinical Trials Register, DRKS00000245; Universal Trial Number, U1111-1112-4245).",Beutel ME.; Scheurich V.; Knebel A.; Michal M.; Wiltink J.; Graf-Morgenstern M.; Tschan R.; Milrod B.; Wellek S.; Subic-Wrana C.,2013.0,10.1177/070674371305800604,0,0,
9306,"Initial evaluation of an integrated treatment for comorbid PTSD and smoking using a nonconcurrent, multiple-baseline design.","The present study examined an integrated treatment for comorbid posttraumatic stress disorder (PTSD) and smoking entitled ""Smoke-Free to Overcome PTSD: An Integrated Treatment"" (STOP IT program). A nonconcurrent multiple-baseline design was used with six community-recruited adult smokers with PTSD to investigate both patient acceptance of the treatment and its initial efficacy on both PTSD and smoking. Potential order effects of exposure-based and affect management components were also examined. A gold-standard assessment strategy that included the Clinician Administered PTSD Scale (Blake et al., 1995) and biochemical verification of self-reported smoking status was employed to measure primary targets of treatment. Results suggested that the STOP IT program was well tolerated. There were clinically significant improvements in PTSD outcomes, but only temporary reductions in smoking. Participants' relatively low posttreatment smoking levels increased by the follow-up assessment, although not to baseline levels. Treatment component order did not appear to affect treatment outcomes, but those who were assigned to the exposure-focused writing prior to affect management training condition appeared more likely to discontinue treatment before beginning exposure. These preliminary data support the safety, acceptability, and potential efficacy of the STOP IT program. Future investigation of the STOP IT program should include testing the incremental efficacy of increasing the dose of smoking-focused intervention, as well as randomized controlled tests of the treatment that employ gold standards for treatment outcome research.",Feldner MT.; Smith RC.; Monson CM.; Zvolensky MJ.,2013.0,10.1016/j.beth.2013.04.003,0,0,
9307,Avoidance and behavioural flexibility in obsessive compulsive disorder.,"Three experiments measured differences in responding between participants scoring either higher or lower on obsessive-compulsive trait measures. A Sidman avoidance procedure was employed in Experiment 1, in which participants were required to identify an avoidance response that postponed an aversive event, and noted that higher scorers maintained this response more successfully. Experiments 2 and 3 involved an operant variability procedure to differentiate between variable and rigid responding among participants demonstrating high versus low obsessive-compulsive traits, and revealed no differential sensitivity to rigid responding between the groups. The results provide insight into the nature of obsessive-compulsive behavioural traits, suggesting that avoidance but not stereotypy is primary in OCD.",Hassoulas A.; McHugh L.; Reed P.,2014.0,10.1016/j.janxdis.2013.05.002,0,0,
9308,A multisite analysis of the fluctuating course of posttraumatic stress disorder.,"Delayed-onset posttraumatic stress disorder (PTSD) accounts for approximately 25% of PTSD cases. Current models do not adequately explain the delayed increases in PTSD symptoms after trauma exposure. To test the roles of initial psychiatric reactions, mild traumatic brain injury (MTBI), and ongoing stressors on delayed-onset PTSD. In this prospective cohort study, patients were selected from recent admissions to 4 major trauma hospitals across Australia. A total of 1084 traumatically injured patients were assessed during hospital admission from April 1, 2004, through February 28, 2006, and 785 (72.4%) were followed up at 3, 12, and 24 months after injury. Severity of PTSD was determined at each assessment with the Clinician-Administered PTSD Scale. Of those who met PTSD criteria at 24 months, 44.1% reported no PTSD at 3 months and 55.9% had subsyndromal or full PTSD. In those who displayed subsyndromal or full PTSD at 3 months, PTSD severity at 24 months was predicted by prior psychiatric disorder, initial PTSD symptom severity, and type of injury. In those who displayed no PTSD at 3 months, PTSD severity at 24 months was predicted by initial PTSD symptom severity, MTBI, length of hospitalization, and the number of stressful events experienced between 3 and 24 months. These data highlight the complex trajectories of PTSD symptoms over time. This study also points to the roles of ongoing stress and MTBI in delayed cases of PTSD and suggests the potential of ongoing stress to compound initial stress reactions and lead to a delayed increase in PTSD symptom severity. This study also provides initial evidence that MTBI increases the risk of delayed PTSD symptoms, particularly in those with no acute symptoms.",Bryant RA.; O'Donnell ML.; Creamer M.; McFarlane AC.; Silove D.,2013.0,10.1001/jamapsychiatry.2013.1137,0,0,
9309,"The impact of group counseling on depression, post-traumatic stress and function outcomes: a prospective comparison study in the Peter C. Alderman trauma clinics in northern Uganda.","The effectiveness of group interventions for adults with mental distress in post-conflict settings is less clear in sub-Saharan Africa. To assess the impact of group counseling intervention on depression, post-traumatic stress and function outcomes among adults attending the Peter C. Alderman Foundation (PCAF) trauma clinics in northern Uganda. 631 War affected adults were enrolled into PCAF trauma clinics. Using a quasi-experimental design, assessments were conducted at baseline, at 3 and 6 months following initiation of care. Multivariate longitudinal regression models were used to determine change in depression, post-traumatic stress and function scores over time among group counseling participants and non-participants. In comparison to non-participants, participants had faster reduction in depression scores during the 6-month follow-up period [β=-1.84, 95%CI (-3.38 to -0.30), p=0.019] and faster reduction in post-traumatic stress scores during the 3-month follow-up period [β=-2.14, 95%CI (-4.21 to -0.10), p=0.042]. At 3-month follow up, participants who attended two or more sessions had faster increase in function scores [β=3.51, 95%CI (0.61-6.40), p=0.018] than participants who attended only one session. Selection bias due to the use of non-random samples. Substantial attrition rates and small sample sizes may have resulted in insufficient statistical power to determine meaningful differences. The group counseling intervention offered in the PCAF clinics may have considerable mental health benefits over time. There is need for more research to structure, standardize and test the efficacy of this intervention using a randomized controlled trial.",Nakimuli-Mpungu E.; Okello J.; Kinyanda E.; Alderman S.; Nakku J.; Alderman JS.; Pavia A.; Adaku A.; Allden K.; Musisi S.,2013.0,10.1016/j.jad.2013.05.055,0,0,
9310,The effects of mindfulness-based cognitive therapy in patients with bipolar disorder: a controlled functional MRI investigation.,"Preliminary research findings have shown that mindfulness-based cognitive therapy improves anxiety and depressive symptoms in bipolar disorder. In this study, we further investigated the effects of MBCT in bipolar disorder, in a controlled fMRI study. Twenty three patients with bipolar disorder underwent neuropsychological testing and functional MRI. Sixteen of these patients were tested before and after an eight-week MBCT intervention, and seven were wait listed for training and tested at the same intervals. The results were compared with 10 healthy controls. Prior to MBCT, bipolar patients reported significantly higher levels of anxiety and symptoms of stress, scored significantly lower on a test of working memory, and showed significant BOLD signal decrease in the medial PFC during a mindfulness task, compared to healthy controls. Following MBCT, there were significant improvements in the bipolar treatment group, in measures of mindfulness, anxiety and emotion regulation, and in tests of working memory, spatial memory and verbal fluency compared to the bipolar wait list group. BOLD signal increases were noted in the medial PFC and posterior parietal lobe, in a repeat mindfulness task. A region of interest analysis revealed strong correlation between signal changes in medial PFC and increases in mindfulness. The small control group is a limitation in the study. These data suggest that MBCT improves mindfulness and emotion regulation and reduces anxiety in bipolar disorder, corresponding to increased activations in the medial PFC, a region associated with cognitive flexibility and previously proposed as a key area of pathophysiology in the disorder.",Ives-Deliperi VL.; Howells F.; Stein DJ.; Meintjes EM.; Horn N.,2013.0,10.1016/j.jad.2013.05.074,0,0,
9311,Health-related dysfunctional beliefs and health anxiety: further evidence of cognitive specificity.,"The specificity of Salkovskis and Warwick's (2001) 4 health-related dysfunctional beliefs to health anxiety was examined. Specificity was examined using a medically healthy sample of community members recruited through the Internet (N = 410, mean age = 32.9 years, 55.4% female). Structural equation modeling was used to compare the equivalence of latent correlations and partial path coefficients that controlled for the overlap among the targeted dysfunctional beliefs. Health-related dysfunctional beliefs were significantly more strongly related to health anxiety than obsessive-compulsive symptoms. Further, health-related dysfunctional beliefs continued to share robust relations with health anxiety after controlling for related dysfunctional beliefs, although anxiety sensitivity appeared particularly relevant to health anxiety as well. These results support the specificity of Salkovskis and Warwick's health-related dysfunctional beliefs to health anxiety, as well as the importance given to dysfunctional beliefs within cognitive-behavioral models and treatments of health anxiety.",Fergus TA.,2014.0,10.1002/jclp.22012,0,0,
9312,Study protocol: trial of inflation osteoplasty in the management of tibial plateau fractures.,"Restoration of articular congruency is a key factor in preventing post-traumatic osteoarthritis following tibial plateau fractures. Current surgical techniques using a bone tamp carry the risk of joint perforation and comminution of the depressed fragments which affect patient outcome. Successful use of inflation osteoplasty has been reported in both in vitro studies (Broome et al. in J Orthopaed Traumatol 13(2):89-95, 2012; Mauffrey et al. in Patient Saf Surg 6:6, 2012) and case reports in the management of fractures of the calcaneus, cuboid, distal radius, tibial plateau and acetabulum (Gupta et al. in Foot Ankle Int 32(2):205-210, 2011; Heim et al. in Foot Ankle Int 29(11):1154-1157, 2008; Konig et al. in Case Rep Unfallchirurg 109(4):328-331, 2006; Reiley in J Orthop Trauma 17:141-163, 2006). The aim of our study is to assess whether the use of the balloon osteoplasty improves the quality of reduction of a depressed tibial plateau fracture when compared to traditional methods of fracture reduction. This is a single-centred randomised trial. We will recruit 24 adult patients admitted with either a depressed or split depressed tibial plateau fracture (medial or lateral) requiring surgical intervention. Consenting patients will be randomly allocated to the two treatment groups. Patients with concomitant injuries influencing the management of the tibial plateau fracture will be excluded from our study. The primary outcome measure is the quality of reduction based on the post-operative CT scan. Secondary outcome measures will be any surgical complication and patient satisfaction, measured using the Oxford Knee score and SF12 questionnaire at 3, 6 and 12 months. Principal analysis will be for the success of fracture reduction from the two techniques and the effect the operative technique had on patient satisfaction and the prevalence of surgical complications.",Jordan R.; Hao J.; Fader R.; Gibula D.; Mauffrey C.,2014.0,10.1007/s00590-013-1260-8,0,0,
9313,[Correction of posttraumatic lower leg deformities using the Taylor Spatial Frame].,"Correction of posttraumatic lower leg deformities using percutaneous osteotomy, external fixation with a ring fixator, and computer-assisted gradual correction with the Taylor Spatial Frame (TSF). Posttraumatic lower leg deformities not suitable for acute correction and internal fixation or deformities that are suitable but have a significantly increased risk for complications: deformities with poor soft tissue coverage, rigid deformities that require gradual correction, complex mulitplanar deformities, deformities with shortening, and periarticular juvenile deformities. Posttraumatic lower leg deformities which are suitable for acute correction and internal fixation are also suitable for deformity correction using the TSF. In these cases, however, we recommend acute correction and internal fixation in order to improve the patient comfort. Lack of patient compliance for self-contained correction and pin care. Percutaneous fixation of the TSF rings to the main fragments using transosseous K-wires and half pins (hybrid fixation). Percutaneous osteotomy of the tibia either by drilling across both cortices and completion of the osteotomy using an osteotome (DeBastiani method) or by using the Gigli saw with preservation of the periostal envelope. Connection of both rings with six oblique telescopic struts via universal joints (hexapod platform). Computer-assisted planning of the correction. Gradual postoperative correction of the deformity by changing the strut lengths according to the correction plan. Strut changes, if required. Osseous consolidation of the osteotomy site with the TSF or revision to internal fixation. The correction of posttraumatic lower leg deformities using the TSF was performed in 6 cases. The mean deformity was 15° (12-22°) in the frontal plane and 6° (4-8°) in the sagittal plane. The correction time was 19 days (14-22 days). The deviation between planned and achieved correction was 0-3° in the frontal plane and 0-2° in the sagittal plane. The osseous consolidation of the osteotomy site was carried out in the TSF in 5 cases with a mean external fixation time of 112 days (94-134 days). In one case, the TSF was removed after the correction and the osteotomy site was fixed using an intramedullary nail. Pin site infections were observed in 3 cases. There were no further complications. The treatment goal was achieved in all cases. The examination at final follow-up was performed after 1 year. All patients were able to walk without walking aids and with no pain at that time. They were able to perform all of their activities of the daily life and their leisure activities without limitations.",Krappinger D.; Zegg M.; Smekal V.; Huber B.,2014.0,10.1007/s00064-013-0233-8,0,0,
9314,Trajectories of change in anxiety severity and impairment during and after treatment with evidence-based treatment for multiple anxiety disorders in primary care.,"Coordinated Anxiety Learning and Management (CALM) is a model for delivering evidence-based treatment for anxiety disorders in primary care. Compared to usual care, CALM produced greater improvement in anxiety symptoms. However, mean estimates can obscure heterogeneity in treatment response. This study aimed to identify (1) clusters of participants with similar patterns of change in anxiety severity and impairment (trajectory groups); and (2) characteristics that predict trajectory group membership. The CALM randomized controlled effectiveness trial was conducted in 17 primary care clinics in four US cities in 2006-2009. 1,004 English- or Spanish-speaking patients age 18-75 with panic, generalized anxiety, social anxiety, and/or posttraumatic stress disorder participated. The Overall Anxiety Severity and Impairment Scale was administered repeatedly to 482 participants randomized to CALM treatment. Group-based trajectory modeling was applied to identify trajectory groups and multinomial logit to predict trajectory group membership. Two predicted trajectories, representing about two-thirds of participants, were below the cut-off for clinically significant anxiety a couple of months after treatment initiation. The predicted trajectory for the majority of remaining participants was below the cut-off by 9 months. A small group of participants did not show consistent improvement. Being sicker at baseline, not working, and reporting less social support were associated with less favorable trajectories. There is heterogeneity in patient response to anxiety treatment. Adverse circumstances appear to hamper treatment response. To what extent anxiety symptoms improve insufficiently because adverse patient circumstances contribute to suboptimal treatment delivery, suboptimal treatment adherence, or suboptimal treatment response requires further investigation.",Joesch JM.; Golinelli D.; Sherbourne CD.; Sullivan G.; Stein MB.; Craske MG.; Roy-Byrne PP.,2013.0,10.1002/da.22149,0,0,
9315,"Oxytocin and psychotherapy: a pilot study of its physiological, behavioral and subjective effects in males with depression.","Individual psychotherapy is an important treatment for a number of psychiatric conditions and involves a unique form of human attachment. This raises the question of whether oxytocin (OT), the paradigmatic ""attachment hormone"", may have benefits in this context. In this randomized, double-blind, crossover trial, we gave male psychiatric outpatients with major depressive disorder 40 IU intranasal OT or placebo before a videotaped session with a therapist and measured a number of subjective, physiological, and behavioral parameters. We report three main findings. Surprisingly - in contrast to prior reports of OT's anxiolytic properties - we found OT caused an increase in anxiety over the course of the therapy session. Secondly, though it had no main effect on cortisol, eye contact, or overall behavior, we did find that OT caused a decrease in nonverbal behaviors that cut off social contact, after controlling for level of depressive symptoms. Lastly, we replicated prior findings that OT improves social cognition (performance on the reading the mind in the eyes test (RMET)), albeit in a depressed patient group. These results inform future studies of oxytocin and psychotherapy and suggest that in certain clinical populations and contexts, OT has heterogeneous subjective effects which may include acute anxiogenesis. Moreover, the similarity of some of these acute effects to those of single-dose serotonergic antidepressants raises interesting questions about the potential antidepressant benefits of chronic OT administration.",MacDonald K.; MacDonald TM.; Brüne M.; Lamb K.; Wilson MP.; Golshan S.; Feifel D.,2013.0,10.1016/j.psyneuen.2013.05.014,0,0,
9316,An evaluation of the choices for well-being project.,"The relationship between mental health, self-esteem and unemployment is well established. Emerging research suggests that interventions such as Cognitive Behavioural Therapy (CBT) can counter the negative effects of unemployment and may improve re-employment. This study evaluated the effectiveness of a manual-based programme, which combines CBT with job skills training, in improving the psychological health and job- seeking skills of unemployed individuals within the UK. One hundred and nine unemployed individuals, suffering mild to moderate mental health problems, were referred to the programme. Of these, 47 completed the programme and 32 attended follow-up. The impact of the manualised course was evaluated using a randomised control trial with a waiting list control. On completion of the programme, participants showed improvements in mental health, self- esteem and job-search self-efficacy as well as a reduction in the occurrence of negative automatic thoughts. Twenty participants gained employment and improvements persisted at follow-up. Considering the initial levels of psychological distress and mental health problems among the unemployed sample, the need for adequate service provision for the unemployed is recommended.",Maguire N.; Hughes VC.; Bell L.; Bogosian A.; Hepworth C.,2014.0,10.1080/13548506.2013.806813,0,0,
9317,Change in quality of life and cost/utility analysis in open stage-related surgical treatment of elbow stiffness.,"The goals of this study were to examine the improvement in quality of life achieved after open surgical treatment of elbow stiffness and to verify the cost/utility ratio of surgery. Thirty-three patients (22 men and 11 women) underwent surgery. The etiologies of elbow stiffness were posttraumatic conditions (n=26), primary osteoarthritis (n=5), and rheumatoid arthritis (n=2). Surgery included 14 ulnohumeral arthroplasties, 6 ulnohumeral arthroplasties associated with radiocapitellar replacement, 5 ulnohumeral arthroplasties associated with radial head replacement, and 8 total elbow arthroplasties. All patients were evaluated pre- and postoperatively with the Mayo Elbow Performance Score, the Mayo Elbow Performance Index, the modified American Shoulder and Elbow Surgeons score, the Quick Disabilities of the Arm, Shoulder and Hand score, and the Short Form 36 after a mean follow-up of 26 months. Possible variables affecting clinical outcome and quality of life improvement were assessed. The cost/utility ratio was evaluated as diagnosis-related group reimbursement per quality-adjusted life year. Mayo Elbow Performance Scores and modified American Shoulder and Elbow Surgeons scores increased, on average, by 43 and 41 points, respectively (P<.0001). Quick Disabilities of the Arm, Shoulder and Hand scores decreased, on average, by 44 points (P<.0001). The improvement in the SF-36 physical and mental component summary score was 7.6 and 7, respectively (P=.0001 and .0018). The cost/utility ratio ranged between 670 and 817 Euro/quality-adjusted life year. A significant correlation was found between pain score and quality of life improvement. An inverse correlation emerged between pre- and postoperative quality of life score. The current study shows that open surgery significantly improves quality of life and elbow function. Selecting the surgical procedure that most effectively reduces pain appears to be the most relevant variable responsible for quality of life improvement. Surgery shows a satisfactory cost/utility ratio, justifying a health spending increase to reduce the social costs resulting from lingering elbow stiffness.",Giannicola G.; Bullitta G.; Sacchetti FM.; Scacchi M.; Polimanti D.; Citoni G.; Cinotti G.,2013.0,10.3928/01477447-20130624-24,0,0,
9318,Axis I psychopathology and the perpetration of intimate partner violence.,"Initial evidence suggests that individuals with specific psychiatric conditions may perpetrate intimate partner violence (IPV) at greater frequency than nondiagnosed comparison samples. The present investigation examined the relationship between IPV and specific clinical diagnoses. The current investigation utilized data provided by 190 (34% female) adult offenders during court-mandated substance use evaluations to investigate the incidence of past-year IPV among samples of dually diagnosed (bipolar, posttraumatic stress disorder [PTSD], and attention deficit-hyperactivity disorder [ADHD]) clients relative to 3 comparison samples matched on substance use and sociodemographic variables. Bipolar and PTSD diagnosed participants were more likely to perpetrate IPV than matched comparison and ADHD participants. Bipolar and PTSD diagnosed participants were equally likely to perpetrate IPV, as were ADHD and matched comparison samples. The frequency of IPV perpetration among bipolar and PTSD diagnosed clients may complicate interpersonal and relationship functioning. The development of integrated treatments for IPV and underlying psychopathology is recommended.",Crane CA.; Hawes SW.; Devine S.; Easton CJ.,2014.0,10.1002/jclp.22013,0,0,
9319,Novel treatment for geriatric hoarding disorder: an open trial of cognitive rehabilitation paired with behavior therapy.,"To investigate the feasibility of an age-adapted, manualized behavioral treatment for geriatric hoarding. Participants were 11 older adults (mean age: 66 years) with hoarding disorder. Treatment encompassed 24 individual sessions of psychotherapy that included both cognitive rehabilitation targeting executive functioning and exposure to discarding/not acquiring. Hoarding severity was assessed at baseline, mid-treatment, and posttreatment. Results demonstrated clinically and statistically significant changes in hoarding severity at posttreatment. No participants dropped out of treatment. Eight participants were classified as treatment responders, and three as partial responders. Partial responders reported severe/extreme hoarding and psychiatric comorbidities at baseline. The combination of cognitive rehabilitation and exposure therapy is a promising approach in the treatment of geriatric hoarding. Targeting neurocognitive deficits in behavioral therapy for these geriatric patients with hoarding disorder doubled response rates relative to our previous trial of cognitive behavior therapy alone.",Ayers CR.; Saxena S.; Espejo E.; Twamley EW.; Granholm E.; Wetherell JL.,2014.0,10.1016/j.jagp.2013.02.010,0,0,
9320,Spatial behavior reflects the mental disorder in OCD patients with and without comorbid schizophrenia.,"Resolving the entangled nosological dilemma of whether obsessive-compulsive disorder (OCD) with and without schizophrenia (schizo-OCD and OCD, respectively) are two independent entities or whether schizo-OCD is a combined product of its parent disorders. Studying motor activity in OCD and in schizo-OCD patients. Performance of the patients was compared with the performance of the same motor task by a matching control individual. Behavior in both schizo-OCD and OCD patients differed from controls in the excessive repetition and addition of acts, thus validating an identical OC facet. However, there was a significant difference in spatial behavior. Schizo-OCD patients traveled over a greater area with less focused activity as typical to schizophrenia patients and in contrast to OCD patients, who were more focused and traveled less in a confined area. While schizo-OCD and OCD patients share most of the OC ritualistic attributes, they differ in the greater spread of activity in schizo-OCD, which is related to schizophrenia disorder. It is suggested that the finding on difference in spatial behavior is a reflection of the mental differences between OCD and schizophrenia. In other words, this could be an overt and observable manifestation of the mental state, and therefore may facilitate the nosology of OC spectrum disorders and OCD. It seems as if both the OCD patients' focus on specific thoughts, and the contrasting wandering thoughts of schizophrenia patients, are reflected in the focused activity of the former and wandering from one place to the next of the latter.",Gershoni A.; Hermesh H.; Fineberg NA.; Eilam D.,2014.0,10.1017/S1092852913000424,0,0,
9321,The effectiveness of light/dark exposure to treat insomnia in female nurses undertaking shift work during the evening/night shift.,"The present study investigated whether bright light exposure during the first half of the evening/night shift combined with light attenuation in the morning is effective in improving sleep problems in nurses undertaking rotating shift work who suffer from clinical insomnia. This was a prospective, randomized control study. The Insomnia Severity Index (ISI) and the Hospital Anxiety Depression Scale (HADS) were used to evaluate insomnia and anxiety/depression severity, respectively. Female hospital nurses on rotating shifts during the evening or night shift with an ISI score > 14 were enrolled. Subjects in the treatment group (n = 46) were exposed to bright light at 7,000-10,000 lux for ‚â• 30 minutes. Exposure was continued for at least 10 days during 2 weeks, and the subjects avoided daytime outdoor sun exposure after work by wearing dark sunglasses. Subjects in the control group (n = 46) were not exposed to bright light, but also wore sunglasses after work. Statistical analyses were performed to examine group differences and differences across treatments. After treatment, the treatment group showed significant improvements in the ISI score and the HADS total and subscale scores as compared with pre-treatment. The ISI, HADS, and subscales of the HADS scores were significantly improved across treatments in the treatment group as compared with the control group. The design of this study is easy to put into practice in the real world. This is the first study to document that a higher intensity and briefer duration of bright light exposure during the first half of the evening/night shift with a daytime darkness procedure performed in rotating shift work female nurses suffering from clinical insomnia could improve their insomnia, anxiety, and depression severity.",Huang LB.; Tsai MC.; Chen CY.; Hsu SC.,2013.0,10.5664/jcsm.2824,0,0,
9322,Effectiveness of national implementation of prolonged exposure therapy in Veterans Affairs care.,"Posttraumatic stress disorder (PTSD) is a pervasive and often debilitating condition that affects many individuals in the general population and military service members. Effective treatments for PTSD are greatly needed for both veterans returning from Iraq and Afghanistan and veterans of other eras. Prolonged exposure (PE) therapy has been shown to be highly efficacious in clinical trials involving women with noncombat trauma, but there are limited data on its effectiveness in real-world clinical practice settings and with veterans. To evaluate the effectiveness of PE as implemented with veterans with PTSD in a large health care system. This evaluation included 1931 veterans treated by 804 clinicians participating in the Department of Veterans Affairs (VA) PE Training Program. After completing a 4-day experiential PE training workshop, clinicians implemented PE (while receiving consultation) with a minimum of 2 veteran patients who had a primary diagnosis of PTSD. Changes in PTSD and depression symptoms were assessed with the PTSD Checklist and the Beck Depression Inventory II, measured at baseline and at the final treatment session. Multiple and single imputation were used to estimate the posttest scores of patients who left treatment before completing 8 sessions. Demographic predictors of treatment dropout were also examined. Intent-to-treat analyses indicate that PE is effective in reducing symptoms of both PTSD (pre-post d = 0.87) and depression (pre-post d = 0.66), with effect sizes comparable to those reported in previous efficacy trials. The proportion of patients screening positive for PTSD on the PTSD Checklist decreased from 87.6% to 46.2%. Clinically significant reductions in PTSD symptoms were achieved among male and female veterans of all war eras and veterans with combat-related and non-combat-related PTSD. Results also indicate that PE is effective in reducing depression symptoms, even though depression is not a direct target of the treatment.",Eftekhari A.; Ruzek JI.; Crowley JJ.; Rosen CS.; Greenbaum MA.; Karlin BE.,2013.0,10.1001/jamapsychiatry.2013.36,0,0,
9323,Examining clinical supervision as a mechanism for changes in practice: a research protocol.,"This paper describes the research protocol for a study exploring if and how clinical supervision facilitates change in practice relating to psychosocial aspects of care for Health Professionals, who have been trained to deliver a psychosocial intervention to adults with cancer. There is a recognized need to implement care that is in line with clinical practice guidelines for the psychosocial care of adults with cancer. Clinical supervision is recommended as a means to support Health Professionals in providing the recommended psychosocial care. A qualitative design embedded within an experimental, stepped wedge randomized control trial. The study will use discourse analysis to analyse audio-recorded data collected in clinical supervision sessions that are being delivered as one element of a large randomized control trial. The sessions will be attended primarily by nurses, but including physiotherapists, radiation therapists, occupational therapists. The Health Professionals are participants in a randomized control trial designed to reduce anxiety and depression of distressed adults with cancer. The sessions will be facilitated by psychiatrists experienced in psycho-oncology and the provision of clinical supervision. The proposed research is designed specifically to facilitate exploration of the mechanisms by which clinical supervision enables Health Professionals to deliver a brief, tailored psychosocial intervention in the context of their everyday practice. This is the first study to use discourse analysis embedded within an experimental randomized control trial to explore the mechanisms of change generated within clinical supervision by analysing the discourse within the clinical supervision sessions.",Dilworth S.; Higgins I.; Parker V.; Kelly B.; Turner J.,2014.0,10.1111/jan.12211,0,0,
9324,A randomized double-blinded sham-controlled trial of α electroencephalogram-guided transcranial magnetic stimulation for obsessive-compulsive disorder.,"Obsessive-compulsive disorder (OCD) is a highly prevalent and devastating psychiatric condition. Repetitive transcranial magnetic stimulation (rTMS) is a potential and non-invasive treatment for OCD. Diverse efficacies of rTMS have been reported in different locations or frequencies of the stimulation. The main objective of this study was to assess the treatment effect for OCD with alpha electroencephalogram (αEEG)-guided TMS over dorsal lateral prefrontal cortex bilaterally. There were 25 OCD patients in the αTMS treatment group and 21 OCD patients in the sham control group. Each subject received 10 daily treatment sessions (5 days a week). The αTMS group had significant reduction in scores of Yale-Brown Obsessive Compulsive Scale and Hamilton Rating Scale for Anxiety (HAMA) compared with the control group at the end of 2-week treatment and 1-week follow-up. Analysis of variance with repeated measures was used to test the effects between the two groups. Significant difference in scores of obsession and HAMA were found between the two groups after treatment. No significant difference in scores of Hamilton Rating Scale for Depression was found between the two groups after the treatment, but statistical significance was shown at the end of 1-week follow-up. αEEG-guided TMS may be an effective treatment for OCD and related anxiety. Delayed response to αTMS in depression suggests that it might be secondary to the improvement of primary response in OCD and anxiety.",Ma X.; Huang Y.; Liao L.; Jin Y.,2014.0,,0,0,7194
9325,The adherence/resource priming paradigm--a randomised clinical trial conducting a bonafide psychotherapy protocol for generalised anxiety disorder.,"Bonafide psychotherapy is an effective treatment for generalised anxiety disorder compared to no-treatment. Rather than creating increasing numbers of new overall treatment-packets within a medical meta-model, an additional approach to investigating clinical research designs may be to increase the understanding of already effective psychotherapies. Treatment manuals and protocols allow a relatively high degree of freedom for the way therapists implement the overall treatment manuals. There is a systematic lack of knowledge on how therapists should customise these overall protocols. The present study experimentally examines three ways of conducting a bonafide psychotherapy based on a 15 session time-limited cognitive-behavioural therapy (CBT) protocol and their relation to the therapists' protocol adherence and treatment efficacy. This trial will investigate three different methods of customising a bonafide CBT-protocol using dyadic peer-tutoring methodology (primings). The individuals with GAD will be randomly assigned to one of three priming conditions (resource priming, supportive resource priming, or adherence priming). The participant treatment allocation will be performed randomly. Therapists will be assigned to a peer-tutoring partner and priming condition based on a mutual agreement. Treatment outcomes will be assessed at the following times: observer based in-session outcomes, session-by-session post-session outcomes, treatment outcome at post assessment and treatment outcome at 6-month follow-up. The proposed trial addresses the clinically relevant question of how to customise a bonafide psychotherapy protocol using tandem peer-tutoring methodology (three priming conditions). Through the development and testing of the proposed priming procedures, this study describes levels of adherence and how to conduct an overall treatment protocol in a more systematised way. From ClinicalTrials.gov Identifier: NCT02039193.",Flückiger C.,2014.0,10.1186/1471-244X-14-49,0,0,
9326,"Prospective associations among approach coping, alcohol misuse and psychiatric symptoms among veterans receiving a brief alcohol intervention.","Brief alcohol interventions (BAIs) target alcohol consumption and may exert secondary benefits including reduced depression and posttraumatic stress disorder (PTSD) symptoms among non-veteran and veteran populations. This study examined whether approach coping, alcohol misuse, and an interaction of these two factors prior to the administration of a BAI (i.e., baseline) would predict depression and PTSD symptoms 6-months post BAI (i.e., follow-up). Veterans (N=166) received a BAI after screening positive for alcohol misuse during a primary care visit and completed assessments of alcohol misuse, approach coping, and depression and PTSD symptoms at baseline and follow-up. Baseline substance misuse, but not approach coping, significantly predicted depression and PTSD symptoms at follow-up. Approach coping moderated associations between baseline alcohol misuse and psychiatric symptoms: Veterans reporting more alcohol misuse and more (relative to less) approach coping at baseline evidenced fewer psychiatric symptoms at follow-up after accounting for symptoms assessed at baseline.",Mason AE.; Boden MT.; Cucciare MA.,,10.1016/j.jsat.2014.01.006,0,0,7219
9327,Imagery-enhanced cognitive behavioural group therapy for social anxiety disorder: a pilot study.,"Cognitive behavioural group therapy (CBGT) for social anxiety disorder (SAD) is efficacious and effective, however a substantial proportion of patients remain in the clinical range so treatment innovations are required. Research suggests that working within the imagery mode may be more emotionally potent than traditional verbal-linguistic strategies. This study piloted an imagery-enhanced CBGT (IE-CBGT) protocol for SAD. It was hypothesised that IE-CBGT would be acceptable to patients, demonstrate large effect sizes, and compare favourably to historical controls who completed CBGT without the imagery-enhancements. Patients (N=19) were consecutive referrals to a community clinic specialising in anxiety and mood disorders. Primary outcomes were self-reported performance and social interaction anxiety. IE-CBGT was highly acceptable to patients with high attendance and completion rates. Effect sizes were large by mid-treatment and very large at post-treatment and follow-up. A high proportion of patients achieved reliable change. Outcomes compared favourably to published group and individual treatments for SAD but larger randomised controlled trials are now required.",McEvoy PM.; Saulsman LM.,2014.0,10.1016/j.brat.2014.01.006,0,0,
9328,A pilot randomized controlled trial of Dialectical Behavior Therapy with and without the Dialectical Behavior Therapy Prolonged Exposure protocol for suicidal and self-injuring women with borderline personality disorder and PTSD.,"This study evaluates the efficacy of integrating PTSD treatment into Dialectical Behavior Therapy (DBT) for women with borderline personality disorder, PTSD, and intentional self-injury. Participants were randomized to DBT (n=9) or DBT with the DBT Prolonged Exposure (DBT PE) protocol (n=17) and assessed at 4-month intervals during the treatment year and 3-months post-treatment. Treatment expectancies, satisfaction, and completion did not differ by condition. In DBT+DBT PE, the DBT PE protocol was feasible to implement for a majority of treatment completers. Compared to DBT, DBT+DBT PE led to larger and more stable improvements in PTSD and doubled the remission rate among treatment completers (80% vs. 40%). Patients who completed the DBT PE protocol were 2.4 times less likely to attempt suicide and 1.5 times less likely to self-injure than those in DBT. Among treatment completers, moderate to large effect sizes favored DBT+DBT PE for dissociation, trauma-related guilt cognitions, shame, anxiety, depression, and global functioning. DBT with the DBT PE protocol is feasible, acceptable, and safe to administer, and may lead to larger improvements in PTSD, intentional self-injury, and other outcomes than DBT alone. The findings require replication in a larger sample.",Harned MS.; Korslund KE.; Linehan MM.,2014.0,10.1016/j.brat.2014.01.008,0,0,
9329,Health service and medication use among veterans with persistent postconcussive symptoms.,"Persistent postconcussive symptoms (PPCS) are noted when a series of cognitive, emotional, and somatosensory complaints persist for months after a concussion. Clinical management of PPCS can be challenging in the veteran population because of the nonspecific nature of symptoms and co-occurrence with affective disturbances such as posttraumatic stress disorder (PTSD) and chronic pain. In this study, we compared health service and medication use patterns in a sample of 421 veterans with PPCS with an age-matched cohort of case controls. The results suggest that the veterans with PPCS showed high rates of medical and mental health service utilization during a mean treatment period of 2 years. Although chronic pain commonly co-occurs with PPCS in veterans, service use and medication prescribing trends seem to have been influenced more by the presence of PTSD than chronic pain. Our findings reinforce the overlap among PPCS, PTSD, and chronic pain and demonstrate the complexity inherent in treating these conditions in veterans.",King PR.; Wade MJ.; Beehler GP.,2014.0,10.1097/NMD.0000000000000103,0,0,
9330,Effects of cognitive behavioral therapy on insomnia of maintenance hemodialysis patients.,"The objective of the study was to evaluate the effects of cognitive behavioral therapy [sleep-related behavior modification and progressive muscle relaxation on insomnia of maintenance hemodialysis (MHD) patients] on improving insomnia of MHD patients. 103 MHD patients complicated with insomnia were randomly assigned to treatment (n = 52) and control (n = 51) groups. The control group was treated with conventional hemodialysis, and the treatment group was additionally treated with cognitive behavioral therapy for 3 months (sleep-related behavior modification and progressive muscle relaxation). All cases were assessed by Symptom Checklist 90 (SCL-90) and Pittsburgh Sleep Quality Index (PSQI) before and 2, 4, 6, 8, 10, and 12 weeks after treatment. Fifty-one patients in the treatment group and 47 patients in the control group completed the experiments. After treatment, the total mean scores were (1.94 ± 0.50/2.29 ± 0.31); scores of somatization, depression, anxiety, hostility, and additional items were (1.87 ± 0.58/2.56 ± 0.26), (2.25 ± 0.80/2.79 ± 0.50), (1.79 ± 0.26/2.37 ± 0.34), (1.71 ± 0.46/2.25 ± 0.43), and (1.91 ± 0.67/2.26 ± 0.59) in SCL-90, respectively. The total scores for PSQI were (12.63 ± 2.27/16.40 ± 2.16); scores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, hypnotics, and daytime dysfunction which were (1.98 ± 0.76/2.57 ± 0.58), (1.75 ± 0.59/2.60 ± 0.50), (2.10 ± 0.50/2.62 ± 0.53), (2.06 ± 0.47/2.57 ± 0.54), (2.04 ± 0.69/2.45 ± 0.72), (1.02 ± 0.79/1.51 ± 0.98), and (1.69 ± 0.55/2.09 ± 0.58), respectively, were significantly lower in the treatment group compared with the control group. However, there were no significant differences in the scores of factors of obsessive-compulsive (2.26 ± 0.62/2.32 ± 0.38), interpersonal sensitivity (2.23 ± 0.64/2.43 ± 0.47), phobic anxiety (1.98 ± 0.62/2.01 ± 0.67), paranoid ideation (1.55 ± 0.43/1.69 ± 0.39), and psychoticism (1.57 ± 0.46/1.66 ± 0.49). The conclusion is that sleep-related behavior modification in combination with progressive muscle relaxation effectively improved the mental state and sleep quality of MHD patients with insomnia.",Hou Y.; Hu P.; Liang Y.; Mo Z.,2014.0,10.1007/s12013-014-9828-4,0,0,
9331,Predictors of treatment response to an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder.,"Despite evidence for the efficacy of several treatments for deliberate self-harm (DSH) within borderline personality disorder (BPD), predictors of response to these treatments remain unknown. This study examined baseline demographic, clinical, and diagnostic predictors of treatment response to an adjunctive emotion regulation group therapy (ERGT) for DSH among women with BPD. A recent RCT provided evidence for the efficacy of this ERGT (relative to a treatment-as-usual only waitlist condition). Participants in this study include the full intent-to-treat sample who began ERGT (across treatment and waitlist conditions; n = 51). Baseline diagnostic and clinical data were collected at the initial assessment, and outcome measures of DSH and self-destructive behaviors, emotion dysregulation/avoidance, and BPD symptoms (among others) were administered at pretreatment, posttreatment, and 3- and 9-months posttreatment. Notably, both demographic variables and characteristics of participants' ongoing therapy in the community had minimal impact on treatment response. However, several indicators of greater severity in domains relevant to this ERGT (i.e., baseline emotion dysregulation and BPD criteria, lifetime and recent DSH, and past-year hospitalization and suicide attempts) predicted better responses during treatment and follow-up across the primary targets of treatment. Likewise, several co-occurring disorders (i.e., social phobia, panic disorder, and a cluster B personality disorder) predicted greater improvements in BPD symptoms during treatment or follow-up. Finally, although co-occurring generalized anxiety disorder, posttraumatic stress disorder, and cluster A and C personality disorders were associated with poorer treatment response during follow-up, most of these effects reflected a lack of continued improvements during this period (vs. worsening of symptoms).",Gratz KL.; Dixon-Gordon KL.; Tull MT.,2014.0,10.1037/per0000062,0,0,
9332,Expressive writing as a therapeutic process for drug-dependent women.,"Although women with substance use disorders (SUDs) have high rates of trauma and posttraumatic stress, many addiction programs do not offer trauma-specific treatments. One promising intervention is Pennebaker's expressive writing, which involves daily, 20-minute writing sessions to facilitate disclosure of stressful experiences. Women (N = 149) in residential treatment completed a randomized clinical trial comparing expressive writing with control writing. Repeated-measures analysis of variance was used to document change in psychological and physical distress from baseline to 2-week and 1-month follow-ups. Analyses also examined immediate levels of negative affect following expressive writing. Expressive writing participants showed greater reductions in posttraumatic symptom severity, depression, and anxiety scores, when compared with control writing participants at the 2-week follow-up. No group differences were found at the 1-month follow-up. Safety data were encouraging: although expressive writing participants showed increased negative affect immediately after each writing session, there were no differences in pre-writing negative affect scores between conditions the following day. By the final writing session, participants were able to write about traumatic/stressful events without having a spike in negative affect. Results suggest that expressive writing may be a brief, safe, low-cost, adjunct to SUD treatment that warrants further study as a strategy for addressing posttraumatic distress in substance-abusing women.",Meshberg-Cohen S.; Svikis D.; McMahon TJ.,2014.0,10.1080/08897077.2013.805181,0,0,
9333,Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases.,"A double-blind, randomized, active placebo-controlled pilot study was conducted to examine safety and efficacy of lysergic acid diethylamide (LSD)-assisted psychotherapy in 12 patients with anxiety associated with life-threatening diseases. Treatment included drug-free psychotherapy sessions supplemented by two LSD-assisted psychotherapy sessions 2 to 3 weeks apart. The participants received either 200 μg of LSD (n = 8) or 20 μg of LSD with an open-label crossover to 200 μg of LSD after the initial blinded treatment was unmasked (n = 4). At the 2-month follow-up, positive trends were found via the State-Trait Anxiety Inventory (STAI) in reductions in trait anxiety (p = 0.033) with an effect size of 1.1, and state anxiety was significantly reduced (p = 0.021) with an effect size of 1.2, with no acute or chronic adverse effects persisting beyond 1 day after treatment or treatment-related serious adverse events. STAI reductions were sustained for 12 months. These results indicate that when administered safely in a methodologically rigorous medically supervised psychotherapeutic setting, LSD can reduce anxiety, suggesting that larger controlled studies are warranted.",Gasser P.; Holstein D.; Michel Y.; Doblin R.; Yazar-Klosinski B.; Passie T.; Brenneisen R.,2014.0,10.1097/NMD.0000000000000113,0,0,
9334,Peroneal artery perforator-based flaps for reconstruction of middle and lower third post-traumatic defects of the leg.,"Grade IIIb open tibial fractures require local or free flaps for cover of the fracture site. Perforator flap surgery is an innovative method for wound cover in this setting. The anatomy of perforating vessels of the peroneal artery is well described. All patients who underwent peroneal artery perforator-based flap cover for acute Grade IIIb fracture tibia between December 2011 and March 2013 were prospectively studied. The wounds were located either in middle or in lower third of the tibia. Flaps were performed under loupe magnification after identifying perforators preoperatively with handheld Doppler. All flaps were of a hockey stick or J design, incorporating the peroneal skin territory and completely islanded. Patients were followed up until all wounds were epithelialized. Eleven patients were identified. Eleven flaps were performed, out of which 10 survived entirely and served the purpose of stable wound cover. One patient sustained partial flap necrosis, which was debrided, and another local flap was performed. More than one perforator could be identified and retained in six of these 11 patients. The peroneal artery perforator-based flap is reliable and reproducible in an acute post-traumatic setting. It should be considered as a suitable alternative for reconstruction for limited defects with exposed fractured tibia over the middle and lower third of the leg.",John JR.; Tripathy S.; Sharma RK.; Balan JR.; Jadhav C.; Bhattacharya S.,2015.0,10.1111/ans.12556,0,0,
9335,Changes in self-efficacy and outcome expectancy as predictors of anxiety outcomes from the CALM study.,"Although self-efficacy (SE) and outcome expectancy (OE) have been well researched as predictors of outcome, few studies have investigated changes in these variables across treatments. We evaluated changes in OE and SE throughout treatment as predictors of outcomes in a large sample with panic disorder, generalized anxiety disorder, social anxiety disorder, or posttraumatic stress disorder. We hypothesized that increases in SE and OE would predict reductions in anxiety and depression as well as improvement in functioning. Participants (mean age = 43.3 years, SD = 13.2, 71.1% female, 55.5% white) were recruited from primary care centers throughout the United States and were randomized to receive either Coordinated Anxiety Learning and Management (CALM) treatment - composed of cognitive behavioral therapy, psychotropic medication, or both - or usual care. SE and OE ratings were collected at each session for participants in the CALM treatment (n = 482) and were entered into a structural equation model as predictors of changes in Brief Symptom Inventory, Anxiety Sensitivity Index, Patient Health Questionnaire (PHQ), and Sheehan Disability Scale outcomes at 6, 12, and 18 months after baseline. The best-fitting models predict symptom levels from OE and SE and not vice versa. The slopes and intercept of OE significantly predicted change in each outcome variable except PHQ-8. The slope and intercept of SE significantly predicted change in each outcome variable. Over and above absolute level, increases in SE and OE were significant predictors of decreases in symptoms and increases in functioning. Implications for treatment are discussed, as well as future directions of research.",Brown LA.; Wiley JF.; Wolitzky-Taylor K.; Roy-Byrne P.; Sherbourne C.; Stein MB.; Sullivan G.; Rose RD.; Bystritsky A.; Craske MG.,2014.0,10.1002/da.22256,0,0,
9336,The reamer-irrigator-aspirator as a device for harvesting bone graft compared with iliac crest bone graft: union rates and complications.,"This study was performed to compare patient outcomes after Reamer-Irrigator-Aspirator (RIA)-harvested bone grafting with the current gold standard, either anterior or posterior iliac crest bone graft (ICBG). Prospective randomized controlled trial. Multicenter study at 3 geographically separate Level 1 trauma centers. One hundred thirty-three patients with nonunion or posttraumatic segmental bone defect requiring operative intervention. Patients were prospectively randomized to receive ICBG or RIA autograft. Supplemental internal fixation was performed per surgeon preference. Operative data included amount of graft, time of harvest, and associated surgical costs. The Short Musculoskeletal Functional Assessment and the Visual Analog Scale were used to document baseline and postoperative function and pain. Clinical and radiographic union was the defined end point; patients considered to have failed treatment if they either developed an infection requiring operative treatment or had a persistent nonunion of the grafted extremity. One hundred thirteen of the 133 enrolled patients were followed until union and included in the final analysis. Intraoperative data showed anterior ICBG to yield 20.7 ± 12.8 (5-60) cm of autograft with an average harvest time of 33.2 ± 16.2 minutes, posterior ICBG yielded 36.1 ± 21.3 (20-100) cm of autograft in 40.6 ± 11.2 minutes, and RIA yielded 37.7 ± 12.9 (5-90) cm in 29.4 ± 15.1 minutes. Anterior ICBG produced significantly less bone graft than either RIA or posterior ICBG (P < 0.001). The RIA harvest was completed in significantly less operative time compared with posterior ICBG (P = 0.005). At $738, the RIA setup was considerably more expensive than the ∼$100 cost of a bone graft tray; however, when compared with posterior ICBG, the longer operative time required for a posterior harvest came at an additional incremental cost of $990-1880, making RIA the less expensive option. Patients were followed for an average of 56.9 ± 42.1 (11-250) weeks. Forty-nine of 57 patients (86.0%) who received ICBG united in an average of 22.5 ± 13.2 weeks; 46 of 56 patients (82.1%) who received RIA healed in an average of 25.8 ± 17.0 weeks. Union rates and time to union were comparable between the 2 procedures. There was no difference in complications requiring reoperation for persistent nonunion or infection at the grafted site, nor there was any difference in donor-site complications. Postoperative follow-up showed that RIA patients had significantly lower donor-site pain scores throughout follow-up. When compared with autograft obtained from the iliac crest, autograft harvested using the RIA technique achieves similar union rates with significantly less donor-site pain. RIA also yields a greater volume of graft compared with anterior ICBG and has a shorter harvest time compared with posterior ICBG. For larger volume harvests, cost analysis favors using RIA. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.",Dawson J.; Kiner D.; Gardner W.; Swafford R.; Nowotarski PJ.,2014.0,10.1097/BOT.0000000000000086,0,0,
9337,"Pilot study of Creating Change, a new past-focused model for PTSD and substance abuse.","Creating Change (CC) is a new past-focused behavioral therapy model developed for comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD). It was designed to address current gaps in the field, including the need for a past-focused PTSD/SUD model that has flexibility, can work with complex clients, responds to the staffing and resource limitations of SUD and other community-based treatment programs, can be conducted in group or individual format, and engages clients and clinicians. It was designed to follow the style, tone, and format of Seeking Safety, a successful present-focused PTSD/SUD model. CC can be used in conjunction with SS and/or other models if desired. We conducted a pilot outcome trial of the model with seven men and women outpatients diagnosed with current PTSD and SUD, who were predominantly minority and low-income, with chronic PTSD and SUD. Assessments were conducted pre- and post-treatment. Significant improvements were found in multiple domains including some PTSD and trauma-related symptoms (eg, dissociation, anxiety, depression, and sexual problems); broader psychopathology (eg, paranoia, psychotic symptoms, obsessive symptoms, and interpersonal sensitivity); daily life functioning; cognitions related to PTSD; coping strategies; and suicidal ideation (altogether 19 variables, far exceeding the rate expected by chance). Effect sizes were consistently large, including for both alcohol and drug problems. No adverse events were reported. Despite study methodology limitations, CC is promising. Clients can benefit from past-focused therapy that addresses PTSD and SUD in integrated fashion.",Najavits LM.; Johnson KM.,,10.1111/j.1521-0391.2014.12127.x,0,0,
9338,A comparison between print vs. internet methods for a clinical trial recruitment--a pan European OCD study.,Recruitment for clinical studies presents a serious challenge in terms of meeting both time and budget constraints. The internet offers a potentially powerful means for quick and effective recruitment-either as an add-on or as alternative to traditional methods. We developed a Google search based solution which enhances patient recruitment. Recruitment via internet was associated with greater exposure to relevant applicants and better response to treatment as compared to traditional printed ads.,Carmi L.; Zohar J.,2014.0,10.1016/j.euroneuro.2014.01.021,0,0,
9339,[Courses of affects in an internet-based writing therapy for elderly war trauma survivors. A content analytic approach].,"The proven efficacy of the therapeutic approach of writing therapy for the treatment of post-traumatic stress disorder (PTSD) allows a broadening focus and an examination of therapeutic components as well as the written realisation of these on the word level. Prior content analyses showed that these primary data analyses provided valuable new findings allowing insights into the therapeutic process in addition to questionnaires. Therapeutic texts from 51 patients were analysed using content analysis (Affective Dictionary Ulm). The aim of this work is to show differences in therapeutic components on a textual basis. There were differences in the frequency of use of emotions in the therapeutic components. In texts of trauma exposure, a significant increase of use of stressful word categories (fear, depression, and anxiousness) has been identified compared to biographical reconstruction texts. In texts of cognitive restructuring, the highest affective density is found in comparison to biographic reconstruction but also compared to trauma exposure, based on negative (depression, anxiousness, and fear) and positive (love, satisfaction, pleasure) affects equally. Patient characteristics (gender, education, age, partnership) had no influence on the expression of the affective density. Quantitative content analysis seems to be a promising approach in identifying and distinguishing components of writing therapy on the affective vocabulary level. The presented approach represents a possible extension of current practice and research.",Böttche M.; Berth H.; Knaevelsrud C.; Kuwert P.,2014.0,10.1007/s00391-014-0628-7,0,0,
9340,Effect of virtual reality PTSD treatment on mood and neurocognitive outcomes.,"Virtual reality (VR) is an emerging tool to help treat posttraumatic stress disorder (PTSD). Previously published studies have shown that VR graded exposure therapy (VR-GET) treatment can result in improvements in PTSD symptoms. Less is known about the impact on depression, general anxiety, and neuropsychological functioning in patients with PTSD. This study examined changes in self-reports of PTSD, depression, and anxiety before and after treatment, and also examined neuropsychological functioning as assessed by a computerized test of simple reaction time, procedural reaction time, and performance on the congruent, incongruent, emotional, and neutral (match the color of the ""nonsense word"") Stroop tests. Results showed that subjects treated with VR-GET showed significant reductions in PTSD and anxiety severity and significant improvements on the emotional Stroop test. Changes in depression and other measures of neuropsychological function were not significant. Change scores on the emotional Stroop test did not correlate with changes in self-report measures of PTSD. Overall, these findings support the use of VR-GET as a treatment for PTSD but indicate that benefits may be narrowly focused. Additional treatments may be needed after or alongside VR-GET for service members with neuropsychological impairments.",McLay R.; Ram V.; Murphy J.; Spira J.; Wood DP.; Wiederhold MD.; Wiederhold BK.; Johnston S.; Reeves D.,2014.0,10.1089/cyber.2013.0383,0,0,
9341,A pilot investigation using global positioning systems into the outdoor activity of people with severe traumatic brain injury.,"Little is known about the post-discharge outdoor activities of people who have incurred severe traumatic brain injury (TBI). This study used a body-worn global positioning system (GPS) device to determine the outdoor activity per day performed by this population. Additionally, this study examined the association that mobility, time since injury and injury severity had with levels of outdoor physical activity. Seventeen people with TBI and 15 control subjects wore a GPS device for between 3-7 days to monitor their outdoor activity. Based on the individual's location and speed of movement the outdoor physical activity in minutes per day was derived. Assessments of duration of outdoor activity between groups, and the relationship that duration of outdoor activity had with results on the high-level mobility assessment tool, length of post-traumatic amnesia, and time since injury were performed. No significant (p = 0.153, effect size = 0.26) difference in time spent in outdoor physical activity was observed between the TBI (median[IQR]‚Äâ= 19[3-43]mins) and control (median[IQR]‚Äâ= 50[18-65]mins) group. Interestingly, 35% of TBI subjects performed <10 mins of outdoor activity per day compared to 13% of the control group. The TBI group also recorded three of the four highest values for outdoor physical activity. Higher levels of mobility were associated with more outdoor activity (Spearman's rho = 0.443, p = 0.038). No other significant associations were observed. While preliminary, our results indicate that a sub-group of people with TBI exists who restrict their outdoor activities. GPS has potential as an activity tracking tool, with implications for rehabilitation and exercise prescription.",Clark RA.; Weragoda N.; Paterson K.; Telianidis S.; Williams G.,2014.0,10.1186/1743-0003-11-37,0,0,
9342,Ambivalence and alliance ruptures in cognitive behavioral therapy for generalized anxiety.,"Client ambivalence about change (or motivation) is regarded as central to outcomes in cognitive behavioral therapy (CBT). However, little research has been conducted to examine the impact of client ambivalence about change on therapy process variables such as the therapeutic alliance. Given the demonstrated limitations of self-report measures of key constructs such as ambivalence and motivation, the present study instead employed a newly adapted observational measure of client ambivalence. Client statements regarding change (change talk (CT) and counter-change talk (CCT)) were coded in early (session 1 or 2) therapy sessions of CBT for generalized anxiety disorder. The frequency of CT and CCT was then compared between clients who later experienced an alliance rupture with their therapist, and clients who did not. The results showed that clients in dyads who later experienced an alliance rupture expressed significantly more CCT at the outset of therapy than clients who did not later experience an alliance rupture. However, CT utterances did not significantly differ between alliance rupture and no-rupture groups. CCT may strain the alliance because clients expressing higher levels of CCT early in therapy may be less receptive to therapist direction in CBT. Consequently, it is recommended that clients and therapists work together to carefully address these key moments in therapy so as to prevent alliance rupture and preserve client engagement in therapy.",Hunter JA.; Button ML.; Westra HA.,2014.0,10.1080/16506073.2014.899617,0,0,
9343,Treatment engagement and response to CBT among Latinos with anxiety disorders in primary care.,"In the current study, we compared measures of treatment outcome and engagement for Latino and non-Latino White patients receiving a cognitive behavioral therapy (CBT) program delivered in primary care. Participants were 18-65 years old and recruited from 17 clinics at 4 different sites to participate in a randomized controlled trial for anxiety disorders, which compared the Coordinated Anxiety Learning and Management (CALM) intervention (consisting of CBT, medication, or both) with usual care. Of those participants who were randomized to the intervention arm and selected CBT (either alone or in combination with medication), 85 were Latino and 251 were non-Latino White; the majority of the Latino participants received the CBT intervention in English (n = 77). Blinded assessments of clinical improvement and functioning were administered at baseline and at 6, 12, and 18 months after baseline. Measures of engagement, including attendance, homework adherence, understanding of CBT principles, and commitment to treatment, were assessed weekly during the CBT intervention. Findings from propensity-weighted linear and logistic regression models revealed no statistically significant differences between Latinos and non-Latino Whites on symptom measures of clinical improvement and functioning at almost all time points. There were significant differences on 2 of 7 engagement outcomes, namely, number of sessions attended and patients' understanding of CBT principles. These findings suggest that CBT can be an effective treatment approach for Latinos who are primarily English speaking and likely more acculturated, although continued attention should be directed toward engaging Latinos in such interventions.",Chavira DA.; Golinelli D.; Sherbourne C.; Stein MB.; Sullivan G.; Bystritsky A.; Rose RD.; Lang AJ.; Campbell-Sills L.; Welch S.; Bumgardner K.; Glenn D.; Barrios V.; Roy-Byrne P.; Craske M.,2014.0,10.1037/a0036365,0,0,
9344,Long-term effects of analysis of the patient-therapist relationship in the context of patients' personality pathology and therapists' parental feelings.,"Analysis of the patient-therapist relationship (relationship work) is considered a core active ingredient in dynamic psychotherapy. However, there are contradictory findings as for whom and under what circumstances these interventions are beneficial. This study investigates long-term effects of relationship work in the context of patients' level of personality pathology and therapists' self-reported parental feelings. One hundred outpatients seeking psychotherapy for depression, anxiety, and personality disorders were randomly assigned to weekly dynamic psychotherapy, either with or without relationship work, for 1 year. Personality pathology was evaluated before treatment as the sum of fulfilled personality disorder criteria items on the Structured Clinical Interview for DSM-III-R Personality Disorders. Therapist feelings were assessed using the Feeling Word Checklist-58. The outcome variables were the Psychodynamic Functioning Scales and Inventory of Interpersonal Problems, measured at pretreatment, midtreatment, posttreatment, 1 year, and 3 years after treatment termination. A significant interaction of treatment group (relationship work vs. no relationship work) by personality pathology by parental therapist feelings was present, indicating that parental feelings were differentially associated with long-term effects of relationship work, depending on the level of personality pathology. In the context of low parental feelings, relationship work was positive for all patients. However, when parental feelings were stronger, the specific effects of such interventions were even more positive for patients with high levels of personality pathology, but negative for patients with low levels of personality pathology. The interaction of parental therapist feelings and patients' personality pathology was strongly associated with the long-term specific effects of analysis of the patient-therapist relationship.",Dahl HS.; R√∏ssberg JI.; Crits-Christoph P.; Gabbard GO.; Hersoug AG.; Perry JC.; Ulberg R.; H√∏glend PA.,2014.0,10.1037/a0036410,0,0,
9345,Multiple white matter volume reductions in patients with panic disorder: relationships between orbitofrontal Gyrus volume and symptom severity and social dysfunction.,"Numerous brain regions are believed to be involved in the neuropathology of panic disorder (PD) including fronto-limbic regions, thalamus, brain stem, and cerebellum. However, while several previous studies have demonstrated volumetric gray matter reductions in these brain regions, there have been no studies evaluating volumetric white matter changes in the fiber bundles connecting these regions. In addition, although patients with PD typically exhibit social, interpersonal and occupational dysfunction, the neuropathologies underlying these dysfunctions remain unclear. A voxel-based morphometry study was conducted to evaluate differences in regional white matter volume between 40 patients with PD and 40 healthy control subjects (HC). Correlation analyses were performed between the regional white matter volumes and patients' scores on the Panic Disorder Severity Scale (PDSS) and the Global Assessment of Functioning (GAF). Patients with PD demonstrated significant volumetric reductions in widespread white matter regions including fronto-limbic, thalamo-cortical and cerebellar pathways (p<0.05, FDR corrected). Furthermore, there was a significant negative relationship between right orbitofrontal gyrus (OFG) white matter volume and the severity of patients' clinical symptoms, as assessed with the PDSS. A significant positive relationship was also observed between patients' right OFG volumes and their scores on the GAF. Our results suggest that volumetric reductions in widespread white matter regions may play an important role in the pathology of PD. In particular, our results suggest that structural white matter abnormalities in the right OFG may contribute to the social, personal and occupational dysfunction typically experienced by patients with PD.",Konishi J.; Asami T.; Hayano F.; Yoshimi A.; Hayasaka S.; Fukushima H.; Whitford TJ.; Inoue T.; Hirayasu Y.,2014.0,10.1371/journal.pone.0092862,0,0,
9346,A pilot study of a randomized controlled trial of yoga as an intervention for PTSD symptoms in women.,"Posttraumatic stress disorder (PTSD) is a debilitating condition that affects approximately 10% of women in the United States. Although effective psychotherapeutic treatments for PTSD exist, clients with PTSD report additional benefits of complementary and alternative approaches such as yoga. In particular, yoga may downregulate the stress response and positively impact PTSD and comorbid depression and anxiety symptoms. We conducted a pilot study of a randomized controlled trial comparing a 12-session Kripalu-based yoga intervention with an assessment control group. Participants included 38 women with current full or subthreshold PTSD symptoms. During the intervention, yoga participants showed decreases in reexperiencing and hyperarousal symptoms. The assessment control group, however, showed decreases in reexperiencing and anxiety symptoms as well, which may be a result of the positive effect of self-monitoring on PTSD and associated symptoms. Between-groups effect sizes were small to moderate (0.08-0.31). Although more research is needed, yoga may be an effective adjunctive treatment for PTSD. Participants responded positively to the intervention, suggesting that it was tolerable for this sample. Findings underscore the need for future research investigating mechanisms by which yoga may impact mental health symptoms, gender comparisons, and the long-term effects of yoga practice.",Mitchell KS.; Dick AM.; DiMartino DM.; Smith BN.; Niles B.; Koenen KC.; Street A.,2014.0,10.1002/jts.21903,0,0,
9347,Failures in bipolar fresh osteochondral allograft for the treatment of end-stage knee osteoarthritis.,"Bipolar fresh osteochondral allografts (BFOA) recently became a fascinating option for articular cartilage replacement, in particular in those young patients non-suitable for traditional replacement because of age. While the use of osteochondral allografts for the treatment of focal osteochondral lesions in the knee is well established, their use in the treatment of end-stage arthritis is far more controversial. The purpose of this paper is to describe our experience in a series of seven patients who underwent a resurfacing of both tibio-femoral and patello-femoral joints by BFOA. From 2005 to 2007, seven patients (mean age 35.2 ± 6.3 years) underwent BFOA for end-stage arthritis of the knee. Patients were evaluated clinically, radiographically and by CT scan preoperatively and at established intervals up to the final follow-up. No intra-operative complications occurred. Nevertheless, joint laxity and aseptic effusion, along with a progressive chondrolysis, lead to early BFOA failure in six patients, which were revised by total knee arthroplasty at 19.5 ± 3.9 months follow-up. Only one patient, who received the allograft to convert a knee arthrodesis, gained a satisfactory result at the last follow-up control. BFOA in the knee joint still remains an inapplicable option in the treatment of post-traumatic end-stage arthritis of the young patient, due to the high rate of failure. Further studies are necessary in order to investigate the causes of failure and improve the applicability of this method. Still, after extensive counselling with the patient, BFOA may represent a salvage procedure aimed to revise scarcely tolerated knee arthrodesis. Retrospective case series, Level IV.",Giannini S.; Buda R.; Ruffilli A.; Pagliazzi G.; Ensini A.; Grigolo B.; Desando G.; Vannini F.,2015.0,10.1007/s00167-014-2961-1,0,0,
9348,Comparison of clinician- and self-assessments of posttraumatic stress symptoms in older versus younger veterans.,"Assessment of posttraumatic stress disorder (PTSD) in older adults has received limited investigation. The purpose of this study was to compare the severity of PTSD symptoms in treatment-seeking older and younger U.S. veterans with PTSD. Participants were 360 male and 284 female veterans enrolled in 2 separate clinical trials of psychotherapy for PTSD. About 4% of the participants were age 60 years or older. Symptoms were assessed before treatment using clinician-rated and self-report measures. For men, only numbing symptoms were lower in older veterans; this was so in clinician ratings, d = 0.76, and self-reports, d = 0.65. For women, clinician-rated hyperarousal symptoms were lower in older veterans, d = 0.57. Clinician-rated and self-reported symptoms were strongly related, Bs = 0.95 and 0.80 in the male and female samples, respectively. Among men, clinician-rated and self-reported reexperiencing and hyperarousal symptoms were associated only in younger veterans. Accurate assessment of PTSD symptoms in older adults is essential to identifying and implementing effective treatment. Our findings suggest that some symptoms may be lower in older men, and that some symptoms of PTSD may be underdetected in older women. Future research should assess the combined effect of gender and age on PTSD symptom presentation.",Lunney CA.; Schnurr PP.; Cook JM.,2014.0,10.1002/jts.21908,0,0,
9349,The emergency department social work intervention for mild traumatic brain injury (SWIFT-Acute): a pilot study.,"To determine acceptability and preliminary effectiveness of Emergency Department (ED) Social Work Intervention for Mild Traumatic Brain Injury (SWIFT-Acute) on alcohol use, community functioning, depression, anxiety, post-concussive symptoms, post-traumatic stress disorder and service use. This study enrolled 64 patients who received head CT after mild traumatic brain injury (mTBI) and were discharged <24 hours from a Level 1 trauma centre ED. The cohort study compared outcomes for SWIFT-Acute (n‚Äâ=‚Äâ32) and Usual Care (n‚Äâ=‚Äâ32) 3 months post-injury. SWIFT-Acute includes education about symptoms and decreasing alcohol use, coping strategies, reassurance and education about recovery process and follow-up guidelines and resources. Alcohol Use Disorders Identification Test (AUDIT), Community Integration Questionnaire (CIQ), Patient Health Questionnaire-4, Rivermead Post-concussion Symptoms Questionnaire, PTSD Checklist-Civilian, acceptability and service use surveys. Paired t-test revealed SWIFT-Acute group maintained pre-injury community functioning; Usual Care significantly declined in functioning on the CIQ. Both groups reported 'hazardous' pre-injury drinking on AUDIT. Wilcoxon Signed Rank test showed the SWIFT-Acute group significantly reduced alcohol use; the Usual Care group did not. Both groups significantly increased medical service use. No statistically significant differences were found on other measures. Acceptability ratings were extremely high. SWIFT-Acute was acceptable to patients. There is preliminary evidence of effectiveness for reducing alcohol use and preventing functional decline. Future randomized studies are needed.",Moore M.; Winkelman A.; Kwong S.; Segal SP.; Manley GT.; Shumway M.,2014.0,10.3109/02699052.2014.890746,0,0,
9350,Comprehensive physiotherapy exercise programme or advice for chronic whiplash (PROMISE): a pragmatic randomised controlled trial.,"Evidence suggests that brief physiotherapy programmes are as effective for acute whiplash-associated disorders as more comprehensive programmes; however, whether this also holds true for chronic whiplash-associated disorders is unknown. We aimed to estimate the effectiveness of a comprehensive exercise programme delivered by physiotherapists compared with advice in people with a chronic whiplash-associated disorder. PROMISE is a two group, pragmatic randomised controlled trial in patients with chronic (>3 months and <5 years) grade 1 or 2 whiplash-associated disorder. Participants were randomly assigned by a computer-generated randomisation schedule to receive either the comprehensive exercise programme (20 sessions) or advice (one session and telephone support). Sealed opaque envelopes were used to conceal allocation. The primary outcome was pain intensity measured on a 0-10 scale. Outcomes were measured at baseline, 14 weeks, 6 months, and 12 months by a masked assessor. Analysis was by intention to treat, and treatment effects were calculated with linear mixed models. The trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12609000825257. 172 participants were allocated to either the comprehensive exercise programme (n=86) or advice group (n=86); 157 (91%) were followed up at 14 weeks, 145 (84%) at 6 months, and 150 (87%) at 12 months. A comprehensive exercise programme was not more effective than advice alone for pain reduction in the participants. At 14 weeks the treatment effect on a 0-10 pain scale was 0·0 (95% CI -0·7 to 0·7), at 6 months 0·2 (-0·5 to 1·0), and at 12 months -0·1 (-0·8 to 0·6). CNS hyperexcitability and symptoms of post-traumatic stress did not modify the effect of treatment. We recorded no serious adverse events. We have shown that simple advice is equally as effective as a more intense and comprehensive physiotherapy exercise programme. The need to identify effective and affordable strategies to prevent and treat acute through to chronic whiplash associated disorders is an important health priority. Future avenues of research might include improving understanding of the mechanisms responsible for persistent pain and disability, investigating the effectiveness and timing of drugs, and study of content and delivery of education and advice. The National Health and Medical Research Council of Australia, Motor Accidents Authority of New South Wales, and Motor Accident Insurance Commission of Queensland.",Michaleff ZA.; Maher CG.; Lin CW.; Rebbeck T.; Jull G.; Latimer J.; Connelly L.; Sterling M.,2014.0,10.1016/S0140-6736(14)60457-8,0,0,
9351,Impact of social challenges on gaining employment for veterans with posttraumatic stress disorder: an exploratory moderator analysis.,"To explore whether psychosocial challenges impact effects of vocational rehabilitation in Veterans with Posttraumatic Stress Disorder (PTSD). A post hoc exploratory analysis of possible moderators of treatment was conducted on outcomes from a randomized, controlled trial of Individual Placement and Support in Veterans with PTSD. When examining groups within each moderator, there was a greater IPS supportive employment benefit in gaining competitive employment for those with inadequate transportation (number needed to treat [NNT] = 1.5) and inadequate housing (NNT = 1.5) compared with the main finding of the pilot study (NNT = 2.07). Compared with the main finding of the pilot study, there was no greater advantage of IPS for those with adequate transportation (NNT = 2.4) or adequate housing (NNT = 2.4). Compared with the main finding in the pilot study, those without a family care burden had a greater benefit from IPS (NNT = 1.4) and those with family care burden had a reduced treatment effect (NNT = 3.3). These results are exploratory and are not intended to guide clinical decision-making, but rather offer a potentially useful strategy in the design of larger trials of IPS.",Davis LL.; Pilkinton P.; Poddar S.; Blansett C.; Toscano R.; Parker PE.,2014.0,10.1037/prj0000058,0,0,
9352,Health-related quality of life and productivity losses in patients with depression and anxiety disorders.,"To assess the explanatory power of disease severity and health-related quality of life (HRQOL) on absenteeism and presenteeism in a working population suffering from depression and/or anxiety disorders. We used data of a large, multicenter, randomized trial (n = 644). Pearson chi-squared tests, analysis of variance, and multinomial logistic regression analyses were performed to explore associations of the type of the disorder and HRQOL with different types of productivity losses. Multivariate regression analyses were performed to assess associations with the duration of absenteeism. The type of the disorder, disease severity, and HRQOL were associated with different types of productivity losses. Health-related quality of life and age were significantly associated with the duration of absenteeism. Our findings indicate that HRQOL may significantly explain the type of productivity loss as well as the duration of absenteeism.",Bouwmans CA.; Vemer P.; van Straten A.; Tan SS.; Hakkaart-van Roijen L.,2014.0,10.1097/JOM.0000000000000112,0,0,
9353,Validity of therapist self-report ratings of fidelity to evidence-based practices for adolescent behavior problems: correspondence between therapists and observers.,"Developing therapist-report fidelity tools to support quality delivery of evidence-based practices in usual care is a top priority for implementation science. This study tested the reliability and accuracy of two groups of community therapists who reported on their use of family therapy (FT) and motivational interviewing/cognitive-behavioral therapy (MI/CBT) interventions during routine treatment of inner-city adolescents with conduct and substance use problems. Study cases (n = 45) were randomized into two conditions: (a) Routine Family Therapy (RFT), consisting of a single site that featured family therapy as its standard of care for behavioral treatment; or (b) Treatment As Usual (TAU), consisting of five sites that featured non-family approaches. Therapists and trained observational raters provided FT and MI/CBT adherence ratings on 157 sessions (104 RFT, 53 TAU). Overall therapist reliability was adequate for averaged FT ratings (ICC = .66) but almost non-existent for MI/CBT (ICC = .06); moreover, both RFT and TAU therapists were more reliable in reporting on FT than on MI/CBT. Both groups of therapists overestimated the extent to which they implemented FT and MI/CBT interventions. Results offer support for the feasibility of using existing therapist-report methods to anchor quality assurance procedures for FT interventions in real-world settings, though not for MI/CBT.",Hogue A.; Dauber S.; Lichvar E.; Bobek M.; Henderson CE.,2015.0,10.1007/s10488-014-0548-2,0,0,
9354,An atypical anxious-impulsive pattern of social anxiety disorder in an adult clinical population.,"An atypical subgroup of Social Anxiety Disorder (SAD) with impulsive rather than inhibited traits has recently been reported. The current study examined whether such an atypical subgroup could be identified in a clinical population of 84 adults with SAD. The temperament dimensions harm avoidance and novelty seeking of the Temperament and Character Inventory, and the Liebowitz Social Anxiety Scale were used in cluster analyses. The identified clusters were compared on depressive symptoms, the character dimension self-directedness, and treatment outcome. Among the six identified clusters, 24% of the sample had atypical characteristics, demonstrating mainly generalized SAD in combination with coexisting traits of inhibition and impulsivity. As additional signs of severity, this group showed low self-directedness and high levels of depressive symptoms. We also identified a typically inhibited subgroup comprising generalized SAD with high levels of harm avoidance and low levels of novelty seeking, with a similar clinical severity as the atypical subgroup. Thus, higher levels of harm avoidance and social anxiety in combination with higher or lower levels of novelty seeking and low self-directedness seem to contribute to a more severe clinical picture. Post hoc examination of the treatment outcome in these subgroups showed that only 20 to 30% achieved clinically significant change.",Mörtberg E.; Tillfors M.; van Zalk N.; Kerr M.,2014.0,10.1111/sjop.12117,0,0,
9355,Cost-effectiveness of prolonged exposure therapy versus pharmacotherapy and treatment choice in posttraumatic stress disorder (the Optimizing PTSD Treatment Trial): a doubly randomized preference trial.,"Cost-effectiveness of treatment for posttraumatic stress disorder (PTSD) may depend on type of treatment (eg, pharmacotherapy vs psychotherapy) and patient choice of treatment. We examined the cost-effectiveness of treatment with prolonged exposure therapy versus pharmacotherapy with sertraline, overall treatment preference, preference for choosing prolonged exposure therapy, and preference for choosing pharmacotherapy with sertraline from the US societal perspective. Two hundred patients aged 18 to 65 years with PTSD diagnosis based on DSM-IV criteria enrolled in a doubly randomized preference trial. Patients were randomized to receive their treatment of choice (n = 97) or to be randomly assigned treatment (n = 103). In the choice arm, patients chose either prolonged exposure therapy (n = 61) or pharmacotherapy with sertraline (n = 36). In the no-choice arm, patients were randomized to either prolonged exposure therapy (n = 48) or pharmacotherapy with sertraline (n = 55). The total costs, including direct medical costs, direct nonmedical costs, and indirect costs, were estimated in 2012 US dollars; and total quality-adjusted life-year (QALY) was assessed using the EuroQoL Questionnaire-5 dimensions (EQ-5D) instrument in a 12-month period. This study was conducted from July 2004 to January 2009. Relative to pharmacotherapy with sertraline, prolonged exposure therapy was less costly (-$262; 95% CI, -$5,068 to $4,946) and produced more QALYs (0.056; 95% CI, 0.014 to 0.100) when treatment was assigned, with 93.2% probability of being cost-effective at $100,000/QALY. Independently, giving a choice of treatment also yielded lower cost (-$1,826; 95% CI, -$4,634 to $749) and more QALYs (0.010; 95% CI, -0.019 to 0.044) over no choice of treatment, with 87.0% probability of cost-effectiveness at $100,000/QALY. Giving PTSD patients a choice of treatment appears to be cost-effective. When choice is not possible, prolonged exposure therapy may provide a cost-effective option over pharmacotherapy with sertraline. ClinicalTrials.gov identifier: NCT00127673.",Le QA.; Doctor JN.; Zoellner LA.; Feeny NC.,2014.0,10.4088/JCP.13m08719,0,0,
9356,Effects of a multiple health behavior change intervention for colorectal cancer survivors on psychosocial outcomes and quality of life: a randomized controlled trial.,"Multiple health behavior change can ameliorate adverse effects of cancer. The purpose of this study was to determine the effects of a multiple health behavior change intervention (CanChange) for colorectal cancer survivors on psychosocial outcomes and quality of life. A total of 410 colorectal cancer survivors were randomized to a 6-month telephone-based health coaching intervention (11 sessions using acceptance and commitment therapy strategies focusing on physical activity, weight management, diet, alcohol, and smoking) or usual care. Posttraumatic growth, spirituality, acceptance, mindfulness, distress, and quality of life were assessed at baseline, 6 and 12 months. Significant intervention effects were observed for posttraumatic growth at 6 (7.5, p < 0.001) and 12 months (4.1, p = 0.033), spirituality at 6 months (1.8, p = 0.011), acceptance at 6 months (0.2, p = 0.005), and quality of life at 6 (0.8, p = 0.049) and 12 months (0.9, p = 0.037). The intervention improved psychosocial outcomes and quality of life (physical well-being) at 6 months with most effects still present at 12 months. ( ACTRN12608000399392).",Hawkes AL.; Pakenham KI.; Chambers SK.; Patrao TA.; Courneya KS.,2014.0,10.1007/s12160-014-9610-2,0,0,
9357,Reduced amygdala volume is associated with deficits in inhibitory control: a voxel- and surface-based morphometric analysis of comorbid PTSD/mild TBI.,"A significant portion of previously deployed combat Veterans from Operation Enduring Freedom and Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) are affected by comorbid posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). Despite this fact, neuroimaging studies investigating the neural correlates of cognitive dysfunction within this population are almost nonexistent, with the exception of research examining the neural correlates of diagnostic PTSD or TBI. The current study used both voxel-based and surface-based morphometry to determine whether comorbid PTSD/mTBI is characterized by altered brain structure in the same regions as observed in singular diagnostic PTSD or TBI. Furthermore, we assessed whether alterations in brain structures in these regions were associated with behavioral measures related to inhibitory control, as assessed by the Go/No-go task, self-reports of impulsivity, and/or PTSD or mTBI symptoms. Results indicate volumetric reductions in the bilateral anterior amygdala in our comorbid PTSD/mTBI sample as compared to a control sample of OEF/OIF Veterans with no history of mTBI and/or PTSD. Moreover, increased volume reduction in the amygdala predicted poorer inhibitory control as measured by performance on the Go/No-go task, increased self-reported impulsivity, and greater symptoms associated with PTSD. These findings suggest that alterations in brain anatomy in OEF/OIF/OND Veterans with comorbid PTSD/mTBI are associated with both cognitive deficits and trauma symptoms related to PTSD.",Depue BE.; Olson-Madden JH.; Smolker HR.; Rajamani M.; Brenner LA.; Banich MT.,2014.0,10.1155/2014/691505,0,0,
9358,Indirect effects of 12-session seeking safety on substance use outcomes: overall and attendance class-specific effects.,"This study examined in- and post-treatment mediation effects of a 12-session dose of Seeking Safety (SS)-an integrative cognitive behavioral treatment for comorbid PTSD and SUDs-on alcohol and cocaine outcomes in comparison to Women's Health Education (WHE) in a seven-site randomized controlled effectiveness trial. Women (n‚Äâ=‚Äâ353) enrolled in outpatient substance abuse treatment, who had experienced multiple traumas in childhood and/or adulthood and who had comorbid PTSD, were randomly assigned to receive SS or WHE delivered in open enrollment groups for 12 sessions in 6 weeks (unlike the full 25-topic SS protocol). Data were analyzed under two forms of longitudinal mediation analysis, each accounting for changes over time in group membership and group context, respectively. Women in SS, compared to WHE, showed significantly steeper decreases in PTSD frequency and severity, which in turn, showed significant impact in reducing both cocaine and alcohol use. This pattern was strongest for those who completed most of the treatment sessions, which was the majority of patients in the trial; these patterns only emerged during the in-treatment phase. Use of an integrated approach to PTSD/SUD such as SS can be helpful to more rapidly reduce PTSD, which consequently reduce SUD symptoms, particularly for those who attend most of the available treatment sessions. This is one of the first studies to illustrate such effects in treating comorbid PTSD and SUD in the context of a highly impaired population delivered by community-based providers. (Am J Addict 2014;23:218-225).",Morgan-Lopez AA.; Saavedra LM.; Hien DA.; Campbell AN.; Wu E.; Ruglass L.; Patock-Peckham JA.; Bainter SC.,,10.1111/j.1521-0391.2014.12100.x,0,0,7294
9359,A two-site pilot randomized 3 day trial of high dose left prefrontal repetitive transcranial magnetic stimulation (rTMS) for suicidal inpatients.,"Suicide attempts and completed suicides are common, yet there are no proven acute medication or device treatments for treating a suicidal crisis. Repeated daily left prefrontal repetitive transcranial magnetic stimulation (rTMS) for 4-6 weeks is a new FDA-approved treatment for acute depression. Some open-label rTMS studies have found rapid reductions in suicidality. This study tests whether a high dose of rTMS to suicidal inpatients is feasible and safe, and also whether this higher dosing might rapidly improve suicidal thinking. This prospective, 2-site, randomized, active sham-controlled (1:1 randomization) design incorporated 9 sessions of rTMS over 3 days as adjunctive to usual inpatient suicidality treatment. The setting was two inpatient military hospital wards (one VA, the other DOD). Research staff screened approximately 377 inpatients, yielding 41 adults admitted for suicidal crisis. Because of the funding source, all patients also had either post-traumatic stress disorder, mild traumatic brain injury, or both. Repetitive TMS (rTMS) was delivered to the left prefrontal cortex with a figure-eight solid core coil at 120% motor threshold, 10 Hertz (Hz), 5 second (s) train duration, 10 s intertrain interval for 30 minutes (6000 pulses) 3 times daily for 3 days (total 9 sessions; 54,000 stimuli). Sham rTMS used a similar coil that contained a metal insert blocking the magnetic field and utilized electrodes on the scalp, which delivered a matched somatosensory sensation. Primary outcomes were the daily change in severity of suicidal thinking as measured by the Beck Scale of Suicidal Ideation (SSI) administered at baseline and then daily, as well as subjective visual analog scale measures before and after each TMS session. Mixed model repeated measures (MMRM) analysis was performed on modified intent to treat (mITT) and completer populations. This intense schedule of rTMS with suicidal inpatients was feasible and safe. Minimal side effects occurred, none differing by arm, and the 3-day retention rate was 88%. No one died of suicide within the 6 month followup. From the mITT analyses, SSI scores declined rapidly over the 3 days for both groups (sham change -15.3 points, active change -15.4 points), with a trend for more rapid decline on the first day with active rTMS (sham change -6.4 points, active -10.7 points, P = 0.12). This decline was more pronounced in the completers subgroup [sham change -5.9 (95% CI: -10.1, -1.7), active -13 points (95% CI: -18.7, -7.4); P = 0.054]. Subjective ratings of 'being bothered by thoughts of suicide' declined non-significantly more with active rTMS than with sham at the end of 9 sessions of treatment in the mITT analysis [sham change -31.9 (95% CI: -41.7, -22.0), active change -42.5 (95% CI: -53.8, -31.2); P = 0.17]. There was a significant decrease in the completers sample [sham change -24.9 (95% CI: -34.4, -15.3), active change -43.8 (95% CI: -57.2, -30.3); P = 0.028]. Delivering high doses of left prefrontal rTMS over three days (54,000 stimuli) to suicidal inpatients is possible and safe, with few side effects and no worsening of suicidal thinking. The suggestions of a rapid anti-suicide effect (day 1 SSI data, Visual Analogue Scale data over the 3 days) need to be tested for replication in a larger sample. ClinicalTrials.gov Identifier: NCT01212848, TMS for suicidal ideation.",George MS.; Raman R.; Benedek DM.; Pelic CG.; Grammer GG.; Stokes KT.; Schmidt M.; Spiegel C.; Dealmeida N.; Beaver KL.; Borckardt JJ.; Sun X.; Jain S.; Stein MB.,,10.1016/j.brs.2014.03.006,0,0,
9360,Cognitive behavior therapy versus interpersonal psychotherapy for social anxiety disorder delivered via smartphone and computer: a randomized controlled trial.,"In this study, a previously evaluated guided Internet-based cognitive behavior therapy for social anxiety disorder (SAD) was adapted for mobile phone administration (mCBT). The treatment was compared with a guided self-help treatment based on interpersonal psychotherapy (mIPT). The treatment platform could be accessed through smartphones, tablet computers, and standard computers. A total of 52 participants were diagnosed with SAD and randomized to either mCBT (n=27) or mIPT (n=25). Measures were collected at pre-treatment, during the treatment, post-treatment and 3-month follow-up. On the primary outcome measure, the Liebowitz Social Anxiety Scale - self-rated, both groups showed statistically significant improvements. However, mCBT performed significantly better than mIPT (between group Cohen's d=0.64 in favor of mCBT). A larger proportion of the mCBT group was classified as responders at post-treatment (55.6% versus 8.0% in the mIPT group). We conclude that CBT for SAD can be delivered using modern information technology. IPT delivered as a guided self-help treatment may be less effective in this format.",Dagöö J.; Asplund RP.; Bsenko HA.; Hjerling S.; Holmberg A.; Westh S.; Öberg L.; Ljótsson B.; Carlbring P.; Furmark T.; Andersson G.,2014.0,10.1016/j.janxdis.2014.02.003,0,0,
9361,Collaborative care for depression and anxiety disorders in patients with recent cardiac events: the Management of Sadness and Anxiety in Cardiology (MOSAIC) randomized clinical trial.,"Depression and anxiety are associated with adverse cardiovascular outcomes in patients with recent acute cardiac events. There has been minimal study of collaborative care (CC) management models for mental health disorders in high-risk cardiac inpatients, and no prior CC intervention has simultaneously managed depression and anxiety disorders. To determine the impact of a low-intensity CC intervention for depression, generalized anxiety disorder, and panic disorder among patients hospitalized for an acute cardiac illness. Single-blind randomized clinical trial, with study assessors blind to group assignment, from September 2010 through July 2013 of 183 patients admitted to inpatient cardiac units in an urban academic general hospital for acute coronary syndrome, arrhythmia, or heart failure and found to have clinical depression, generalized anxiety disorder, or panic disorder on structured assessment. Participants were randomized to 24 weeks of a low-intensity telephone-based multicomponent CC intervention targeting depression and anxiety disorders (n‚Äâ=‚Äâ92) or to enhanced usual care (serial notification of primary medical providers; n‚Äâ=‚Äâ91). The CC intervention used a social work care manager to coordinate assessment and stepped care of psychiatric conditions and to provide support and therapeutic interventions as appropriate. Improvement in mental health-related quality of life (Short Form-12 Mental Component Score [SF-12 MCS]) at 24 weeks, compared between groups using a random-effects model in an intent-to-treat analysis. Patients randomized to CC had significantly greater estimated mean improvements in SF-12 MCS at 24 weeks (11.21 points [from 34.21 to 45.42] in the CC group vs 5.53 points [from 36.30 to 41.83] in the control group; estimated mean difference, 5.68 points [95% CI, 2.14-9.22]; P‚Äâ=‚Äâ.002; effect size, 0.61). Patients receiving CC also had significant improvements in depressive symptoms and general functioning, and higher rates of treatment of a mental health disorder; anxiety scores, rates of disorder response, and adherence did not differ between groups. A novel telephone-based, low-intensity model to concurrently manage cardiac patients with depression and/or anxiety disorders was effective for improving mental health-related quality of life in a 24-week trial. clinicaltrials.gov Identifier: NCT01201967.",Huffman JC.; Mastromauro CA.; Beach SR.; Celano CM.; DuBois CM.; Healy BC.; Suarez L.; Rollman BL.; Januzzi JL.,2014.0,10.1001/jamainternmed.2014.739,0,0,
9362,Efficacy of dignity therapy on depression and anxiety in Portuguese terminally ill patients: a phase II randomized controlled trial.,"Dignity therapy is a brief psychotherapy developed for patients living with a life-limiting illness. To determine the influence of dignity therapy on depression and anxiety in inpatients with a terminal illness and experiencing a high level of distress in a palliative care unit. A nonblinded phase II randomized controlled trial of 80 patients who were randomly assigned to one of two groups: intervention group (dignity therapy+standard palliative care [SPC]) or control group (SPC alone). The main outcomes were depression and anxiety scores, as measured with the Hospital Anxiety and Depression Scale, and assessed at baseline (T1), day 4 (T2), day 15 (T3), and day 30 (T4) of follow-up. This study is registered with www.controlled-trials.com/ISRCTN34354086. Of the final 80 participants, 41 were randomly assigned to SPC and 39 to dignity therapy. Baseline characteristics were similar between the two groups. Dignity therapy was associated with a decrease in depression scores (median, 95% confidence interval [CI]: -4.00, -6.00 to -2.00, p<0.0001; -4.00, -7.00 to -1.00, p=0.010; -5.00, -8.00 to -1.00, p=0.043, for T2, T3, and T4, respectively). Dignity therapy was similarly associated with a decrease in anxiety scores (median, 95% CI: -3.00, -5.00 to -1.00, p<0.0001; -4.00, -7.00 to -2.00, p=0.001; -4.00, -7.00 to -1.00, p=0.013, for T2, T3, and T4, respectively). Dignity therapy resulted in a beneficial effect on depression and anxiety symptoms in end-of-life care. The therapeutic benefit of dignity therapy was sustained over a 30-day period. Having established its efficacy, future trials of dignity therapy may now begin, comparing it with other psychotherapeutic approaches within the context of terminal illness.",Juli√£o M.; Oliveira F.; Nunes B.; Vaz Carneiro A.; Barbosa A.,2014.0,10.1089/jpm.2013.0567,0,0,
9363,Targeted prevention of common mental health disorders in university students: randomised controlled trial of a transdiagnostic trait-focused web-based intervention.,"A large proportion of university students show symptoms of common mental disorders, such as depression, anxiety, substance use disorders and eating disorders. Novel interventions are required that target underlying factors of multiple disorders. To evaluate the efficacy of a transdiagnostic trait-focused web-based intervention aimed at reducing symptoms of common mental disorders in university students. Students were recruited online (n=1047, age: M=21.8, SD=4.2) and categorised into being at high or low risk for mental disorders based on their personality traits. Participants were allocated to a cognitive-behavioural trait-focused (n=519) or a control intervention (n=528) using computerised simple randomisation. Both interventions were fully automated and delivered online (trial registration: ISRCTN14342225). Participants were blinded and outcomes were self-assessed at baseline, at 6 weeks and at 12 weeks after registration. Primary outcomes were current depression and anxiety, assessed on the Patient Health Questionnaire (PHQ9) and Generalised Anxiety Disorder Scale (GAD7). Secondary outcome measures focused on alcohol use, disordered eating, and other outcomes. Students at high risk were successfully identified using personality indicators and reported poorer mental health. A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up. Attrition was high across intervention groups, but comparable to other web-based interventions. Mixed effects analyses revealed that at 12-week follow up the trait-focused intervention reduced depression scores by 3.58 (p<.001, 95%CI [5.19, 1.98]) and anxiety scores by 2.87 (p=.018, 95%CI [1.31, 4.43]) in students at high risk. In high-risk students, between group effect sizes were 0.58 (depression) and 0.42 (anxiety). In addition, self-esteem was improved. No changes were observed regarding the use of alcohol or disordered eating. This study suggests that a transdiagnostic web-based intervention for university students targeting underlying personality risk factors may be a promising way of preventing common mental disorders with a low-intensity intervention. ControlledTrials.com ISRCTN14342225.",Musiat P.; Conrod P.; Treasure J.; Tylee A.; Williams C.; Schmidt U.,2014.0,10.1371/journal.pone.0093621,0,0,
9364,Adaptive and maladaptive emotion regulation strategies: interactive effects during CBT for social anxiety disorder.,"There has been a increasing interest in understanding emotion regulation deficits in social anxiety disorder (SAD; e.g., Hofmann, Sawyer, Fang, & Asnaani, 2012). However, much remains to be understood about the patterns of associations among regulation strategies in the repertoire. Doing so is important in light of the growing recognition that people's ability to flexibly implement strategies is associated with better mental health (e.g., Kashdan et al., 2014). Based on previous work (Aldao & Nolen-Hoeksema, 2012), we examined whether putatively adaptive and maladaptive emotion regulation strategies interacted with each other in the prediction of social anxiety symptoms in a sample of 71 participants undergoing CBT for SAD. We found that strategies interacted with each other and that this interaction was qualified by a three-way interaction with a contextual factor, namely treatment study phase. Consequently, these findings underscore the importance of modeling contextual factors when seeking to understand emotion regulation deficits in SAD.",Aldao A.; Jazaieri H.; Goldin PR.; Gross JJ.,2014.0,10.1016/j.janxdis.2014.03.005,0,0,
9365,Stereotype confirmation concern and fear of negative evaluation among African Americans and Caucasians with social anxiety disorder.,"Fear of negative evaluation is a central component of social anxiety. The current study examines the relation between fear of negative evaluation and fears of confirming stereotypes about social groups to which one belongs among people diagnosed with social anxiety disorder. Participants (N=94) with a primary diagnosis of social anxiety disorder who self-identified as either African American (n=41) or Caucasian (n=53) completed standardized self-report measures of stereotype confirmation concerns and fear of negative evaluation. Results from hierarchical logistical regression showed that stereotype confirmation concerns predicted fear of negative evaluation for both racial groups, with greater concern predicting greater fear. This association was moderated by race, B=-.24, t=-2.67, p<.01, such that stereotype confirmation concerns had a stronger association with fear of negative evaluation for Caucasians (b=.38, p<.01) than for African Americans (b=.14, p<.05). This study is the first to directly examine the relation between stereotypes and fear of negative evaluation within a socially anxious sample. Although we cannot identify the specific social group to which each participant's stereotype confirmation concerns apply, this study provides quantitative evidence that the social context within which socially anxious individuals view themselves impacts their fear of negative evaluation and highlights the need for further research in this area.",Johnson SB.; Anderson PL.,2014.0,10.1016/j.janxdis.2014.03.003,0,0,
9366,A contextual approach to experiential avoidance and social anxiety: evidence from an experimental interaction and daily interactions of people with social anxiety disorder.,"Experiential avoidance (EA), the tendency to avoid internal, unwanted thoughts and feelings, is hypothesized to be a risk factor for social anxiety. Existing studies of experiential avoidance rely on trait measures with minimal contextual consideration. In two studies, we examined the association between experiential avoidance and anxiety within real-world social interactions. In the first study, we examined the effect of experiential avoidance on social anxiety in everyday life. For 2 weeks, 37 participants with Social Anxiety Disorder (SAD) and 38 healthy controls provided reports of experiential avoidance and social anxiety symptoms during face-to-face social interactions. Results showed that momentary experiential avoidance was positively related to anxiety symptoms during social interactions and this effect was stronger among people with SAD. People low in EA showed greater sensitivity to the level of situational threat than high EA people. In the second study, we facilitated an initial encounter between strangers. Unlike Study 1, we experimentally created a social situation where there was either an opportunity for intimacy (self-disclosure conversation) or no such opportunity (small-talk conversation). Results showed that greater experiential avoidance during the self-disclosure conversation temporally preceded increases in social anxiety for the remainder of the interaction; no such effect was found in the small-talk conversation. Our findings provide insight into the association between experiential avoidance on social anxiety in laboratory and naturalistic settings, and demonstrate that the effect of EA depends upon level of social threat and opportunity.",Kashdan TB.; Goodman FR.; Machell KA.; Kleiman EM.; Monfort SS.; Ciarrochi J.; Nezlek JB.,2014.0,10.1037/a0035935,0,0,
9367,Predictors of post-traumatic psychological growth in the late years after lung transplantation.,"Although lung transplantation improves quality of life, most psychosocial research focuses on adverse psychological and social functioning outcomes. Positive effects, particularly in the late-term years as physical morbidities increase, have received little attention. We provide the first data on a psychological benefit - post-traumatic growth (PTG) - and we focused on long-term (>5 yr) survivors. Among 178 patients from a prospective study of mental health during the first two yr post-transplant, we recontacted survivors 6-11 yr post-transplant. We assessed PTG (i.e., positive psychological change resulting from the transplant) and examined its relationship to other patient characteristics with multivariable regression analyses. Sixty-four patients (86% of survivors) were assessed (M = 8.1 yr post-transplant, SD = 1.2). Mean PTG exceeded the scale's midpoint (M = 38.6, SD = 10.0; scale midpoint = 25). Recipients experiencing greater PTG were female (p = 0.022), less educated (p = 0.014), and had a history of post-transplant panic disorder (p = 0.005), greater friend support (p = 0.048), and better perceived health (p = 0.032). Neither other pre- or post-transplant mood and anxiety disorders nor transplant-related morbidities (acute rejection, bronchiolitis obliterans syndrome) predicted PTG. PTG exceeded levels observed in other chronic disease populations, suggesting that lung transplantation may uniquely foster positive psychological change in long-term survivors. PTG occurs despite physical and psychiatric morbidities. Whether PTG promotes other positive post-transplant psychosocial outcomes deserves attention.",Fox KR.; Posluszny DM.; DiMartini AF.; DeVito Dabbs AJ.; Rosenberger EM.; Zomak RA.; Bermudez C.; Dew MA.,2014.0,10.1111/ctr.12301,0,0,
9368,"The Content, Quality and Impact of Cognitive Behavioural Case Formulation During Treatment of Obsessive Compulsive Disorder.","Case formulation (CF) is considered a core component of cognitive behavioural therapy (CBT). Despite this, few studies have explored the content and quality of CFs in routine practice and any associated impact on treatment outcome. This study investigated (1) the content, timing and quality of CF for patients (N = 29) with Obsessive Compulsive Disorder; (2) the impact of CF on symptoms, distress and therapeutic alliance; and (3) the relationship between CF quality and treatment outcome. CF content and quality were assessed from audiotapes of routine CBT sessions using a validated coding manual and evaluated against treatment outcomes at different stages of therapy. CFs were developed early during treatment and contained strong behavioural and cognitive components, with a focus on symptoms and maintaining factors. CF quality ratings ranged from rudimentary to excellent. A significant improvement in distress and the therapeutic alliance occurred following the introduction of CF, but no significant relationship was found between CF quality and outcome at any stage of treatment. CF may be valuable in reducing patient attrition, due to its impact early in treatment. Further research is needed to explore the most important components of CF. Theoretically sound and disorder specific measurement tools for evaluating CFs are required.",Nattrass A.; Kellett S.; Hardy GE.; Ricketts T.,2015.0,10.1017/S135246581400006X,0,0,
9369,Does rTMS alter neurocognitive functioning in patients with panic disorder/agoraphobia? An fNIRS-based investigation of prefrontal activation during a cognitive task and its modulation via sham-controlled rTMS.,"Neurobiologically, panic disorder (PD) is supposed to be characterised by cerebral hypofrontality. Via functional near-infrared spectroscopy (fNIRS), we investigated whether prefrontal hypoactivity during cognitive tasks in PD-patients compared to healthy controls (HC) could be replicated. As intermittent theta burst stimulation (iTBS) modulates cortical activity, we furthermore investigated its ability to normalise prefrontal activation. Forty-four PD-patients, randomised to sham or verum group, received 15 iTBS-sessions above the left dorsolateral prefrontal cortex (DLPFC) in addition to psychoeducation. Before first and after last iTBS-treatment, cortical activity during a verbal fluency task was assessed via fNIRS and compared to the results of 23 HC. At baseline, PD-patients showed hypofrontality including the DLPFC, which differed significantly from activation patterns of HC. However, verum iTBS did not augment prefrontal fNIRS activation. Solely after sham iTBS, a significant increase of measured fNIRS activation in the left inferior frontal gyrus (IFG) during the phonological task was found. Our results support findings that PD is characterised by prefrontal hypoactivation during cognitive performance. However, verum iTBS as an ""add-on"" to psychoeducation did not augment prefrontal activity. Instead we only found increased fNIRS activation in the left IFG after sham iTBS application. Possible reasons including task-related psychophysiological arousal are discussed.",Deppermann S.; Vennewald N.; Diemer J.; Sickinger S.; Haeussinger FB.; Notzon S.; Laeger I.; Arolt V.; Ehlis AC.; Zwanzger P.; Fallgatter AJ.,2014.0,10.1155/2014/542526,0,0,
9370,Does dissociation moderate treatment outcomes of narrative exposure therapy for PTSD? A secondary analysis from a randomized controlled clinical trial.,"Dissociative symptoms, especially depersonalisation and derealisation, are often perceived as a contraindication for exposure-based treatments of posttraumatic stress disorder (PTSD) despite limited empirical evidence. The present paper examines whether derealisation and depersonalisation influence the treatment outcomes of narrative exposure therapy (NET) and treatment as usual (TaU) among severely traumatised asylum seekers and refugees. We performed a secondary analysis of a recently published randomized controlled multicentre trial comparing NET and TaU for the treatment of PTSD in asylum seekers and refugees. In order to investigate whether depersonalisation and derealisation moderate treatment outcomes, a number of moderated multiple, blockwise regression analyses were conducted. Missing data were handled with multiple imputation. The main finding from intention-to-treat analyses is that derealisation and depersonalisation overall do not moderate the treatment outcomes of either NET or TaU. The treatment condition was the most stable predictor of residual gain scores across outcome measures, with NET being associated with lower residual gain scores indicating better treatment outcomes. The present study substantiates and extends previous research indicating that dissociative symptoms such as derealisation and depersonalisation do not moderate the treatment outcome of exposure-based treatments for PTSD. NCT00218959.",Halvorsen J√ò.; Stenmark H.; Neuner F.; Nordahl HM.,2014.0,10.1016/j.brat.2014.03.010,0,0,
9371,"Behavioural, psychological, and temperamental predictors of risk suicide trend after brief psychodynamic psychotherapy.","Evidence has shown that psychotherapy is effective for depression, whereas the outcome for suicide risk is unclear. It was to investigate whether possible pre-treatment predictors of suicide risk (SR) decrease after a brief psychodynamic psychotherapy treatment and at follow-up. Forty-one patients were assessed at: baseline (T0) for clinical history, clinical family history, physical diseases, type of suffered abuse; after the treatment (T1); and, at six-month follow-up (T2) for mood ratings, temperamental features, and SR levels. The levels of depression and cyclothymia decreased at T1 and T2 compared to T0; however, the distribution of the patients with high SR level was similar between T0 and T1, and at T2 it increased. T1-T0 SR (Δ1SR) was correlated with suicidality in the last month and with depression levels at T0; T2-T0 SR (Δ2SR) was correlated with many historical, clinical, and temperamental variables; T2-T1 SR (Δ3SR) was correlated with the presence of previous psychotherapy, abuse, and anxiety. Linear regression models revealed that Δ1SR was predicted by the suicidality in the last month; Δ2SR was not significantly predicted by any variable; and, Δ3SR was predicted by anxiety. The treatment was able to decrease the depression but not the SR. Findings confirm the difficulty of affecting SR and the importance of carefully considering the anxiety and the previous experiences of abuse in order to manage the interruption of the psychotherapy.",Angeletti G.; D'onofrio M.; Lai C.; Tambelli R.; Aceto P.; Girardi P.,2014.0,,0,0,
9372,"Reductions in pain, depression, and anxiety symptoms after PTSD remediation in veterans.","A randomized controlled trial of veterans with clinical levels of PTSD symptoms found significant improvements after Emotional Freedom Techniques (EFT). Although pain, depression, and anxiety were not the primary targets of treatment, significant improvements in these conditions were noted. Subjects (N = 59) received six sessions of EFT coaching supplementary to primary care. They were assessed using the SA-45, which measures nine mental health symptom domains and also has two general scales measuring the breadth and depth of psychological distress. Anxiety and depression both reduced significantly, as did the breadth and depth of psychological symptoms. Pain decreased significantly during the intervention period (-41%, p < .0001). Subjects were followed up at three and six months, revealing significant relationships between PTSD, depression, and anxiety at several assessment points. At follow-up, pain remained significantly lower than at pretest. The results of this study are consistent with other reports showing that, as PTSD symptoms are reduced, general mental health improves, and pain levels drop. The ability of EFT to produce reliable and long-term gains after relatively brief interventions indicates its utility in reducing the estimated trillion-dollar cost of treating veteran mental health disorders in the coming years.",Church D.,,10.1016/j.explore.2014.02.005,0,0,6193
9373,Randomized controlled trial of two brief alcohol interventions for OEF/OIF veterans.,"The purpose of this study was to test the efficacy of 2 brief interventions for alcohol misuse in a sample of combat veterans of the wars in Iraq and Afghanistan. Participants were 68 combat veterans (91.2% male; 64.7% White, 27.9% Black) with a mean age of 32.31 years (SD = 8.84) who screened positive for hazardous drinking in a Veterans Affairs Medical Center primary care clinic using the Alcohol Use Disorders Identification Test (Babor, Higgins-Biddle, Saunders, & Monteiro, 2001). More than half of the sample (57.4%) met criteria for posttraumatic stress disorder (PTSD; based on the Clinician-Administered PTSD Scale; Blake et al., 1995). Eligible veterans who elected to participate completed a baseline assessment and were randomized to receive 1 of 2 interventions (personalized feedback delivered with or without a motivational interviewing counseling session). Both interventions included information on hazardous drinking, PTSD symptoms, depression, and coping. Follow-up assessments were conducted at 6 weeks and 6 months post-intervention. Both conditions resulted in statistically significant reductions in quantity and frequency of alcohol use as well as frequency of binge drinking and alcohol-related consequences. Within-group effect sizes (ds) were in the small to medium range (.21-.55) for quantity and frequency of alcohol use. There were no statistically significant Condition √ó Time interactions, suggesting that both interventions were similarly effective. PTSD and non-PTSD veterans responded equally well to both interventions, but veterans with PTSD assigned to feedback plus motivational interviewing reported greater reductions in weekly drinking at the 6-week follow-up. These findings suggest that brief interventions for alcohol misuse may be effective for reducing drinking, even in an Operation Enduring Freedom/Operation Iraqi Freedom veteran population with a high degree of PTSD.",McDevitt-Murphy ME.; Murphy JG.; Williams JL.; Monahan CJ.; Bracken-Minor KL.; Fields JA.,2014.0,10.1037/a0036714,0,0,
9374,An experimental manipulation of social comparison in social anxiety.,"Negative self-appraisal is thought to maintain social anxiety particularly when comparing oneself to others. Work on social comparison suggests that gender may moderate the effects of social comparison in social anxiety. Self-appraisals of the desirability of one's personality may be more important to women, whereas self-appraisal of signs of anxiety may be more important to men. Within each gender, those with high social anxiety are expected to report more negative self-appraisal when comparing themselves to someone else described as high achieving. This study is the first we are aware of that examined gender-based interactive effects after a social comparison manipulation. Participants read a bogus profile of a fellow student's adjustment to college. They were randomly assigned to read a profile suggesting that the fellow student was ""high achieving"" or more normative in his/her achievements. When comparing to a ""high achieving"" individual, men with high social anxiety reported the most negative self-appraisals of their signs of anxiety. In addition, greater social anxiety was associated with a poorer self-appraisal of personality only among men. The implications of the findings for conceptualizing the role of social comparison in social anxiety are discussed.",Mitchell MA.; Schmidt NB.,2014.0,10.1080/16506073.2014.914078,0,0,
9375,Frontal EEG asymmetry as predictor of physiological responses to aversive memories.,"Evidence suggests that asymmetry in frontal electrical activity predicts responses to aversive experiences, such that higher left-sided activity might dampen responses to trauma reminders. We measured frontal asymmetry at rest and during viewing of a trauma film, and assessed startle responses to film-reminder images. To explore potential moderators, we compared two films (Study 1; N‚Äâ=‚Äâ64) and modulated reappraisal (Study 2; N‚Äâ=‚Äâ72). As expected, left frontal activation during film viewing predicted dampened responses in individuals who viewed a staged road accident. However, this effect tended to be reversed when a genocide documentary was used. In Study 2, all participants viewed the genocide film. Left frontal activity at rest again predicted higher startle responses, while reappraisal did not moderate the effects. Thus, the type of trauma film plays a crucial role in the effects of frontal asymmetry, which warrants further critical investigation.",Meyer T.; Quaedflieg CW.; Giesbrecht T.; Meijer EH.; Abiad S.; Smeets T.,2014.0,10.1111/psyp.12230,0,0,
9376,The driving behavior survey as a measure of behavioral stress responses to MVA-related PTSD.,"Numerous treatments are available that address the core symptoms of posttraumatic stress disorder (PTSD). However, there are a number of related behavioral stress responses that are not assessed with PTSD measures, yet these behavioral stress responses affect quality of life. The goal of the current study was to investigate whether a recently developed measure of behavioral stress response, the Driving Behavior Survey (DBS), was sensitive to change associated with treatment among a group of participants diagnosed with PTSD. The DBS indexes anxious driving behavior, which is frequently observed among individuals with motor vehicle accident-related PTSD. Participants (n = 40) were racially diverse adults (M age = 40.78, 63% women) who met diagnostic criteria for motor vehicle accident-related PTSD. Hierarchical linear modeling analyses indicated that participants who were assigned to a brief, exposure-based intervention displayed significant reductions on the DBS subscales relative to participants assigned to the wait-list control condition (r = .41–.43). Moreover, mediational analyses indicated that the observed reductions on the DBS subscales were not better accounted for by reductions in PTSD. Taken together, these findings suggest that the DBS subscales are sensitive to changes associated with PTSD treatment and can be used to augment outcome assessment in PTSD treatment trials.",Baker AS.; Litwack SD.; Clapp JD.; Beck G.; Sloan DM.,2014.0,,0,0,
9377,Improving care for depression in obstetrics and gynecology: a randomized controlled trial.,"To evaluate an evidence-based collaborative depression care intervention adapted to obstetrics and gynecology clinics compared with usual care. A two-site, randomized controlled trial included screen-positive women (Patient Health Questionnaire-9 score of at least 10) who met criteria for major depression, dysthymia, or both (Mini-International Neuropsychiatric Interview). Women were randomized to 12 months of collaborative depression management or usual care; 6-month, 12-month, and 18-month outcomes were compared. The primary outcomes were change from baseline to 12 months in depression symptoms and functional status. Secondary outcomes included at least 50% decrease and remission in depressive symptoms, global improvement, treatment satisfaction, and quality of care. Participants were, on average, 39 years old, 44% were nonwhite, and 56% had posttraumatic stress disorder. Intervention (n=102) compared with usual care (n=103) patients had greater improvement in depressive symptoms at 12 months (P<.001) and 18 months (P=.004). The intervention group compared with usual care group had improved functioning over the course of 18 months (P<.05), were more likely to have at least 50% decrease in depressive symptoms at 12 months (relative risk [RR] 1.74, 95% confidence interval [CI] 1.11-2.73), greater likelihood of at least four specialty mental health visits (6-month RR 2.70, 95% CI 1.73-4.20; 12-month RR 2.53, 95% CI 1.63-3.94), adequate dose of antidepressant (6-month RR 1.64, 95% CI 1.03-2.60; 12-month RR 1.71, 95% CI 1.08-2.73), and greater satisfaction with care (6-month RR 1.70, 95% CI 1.19-2.44; 12-month RR 2.26, 95% CI 1.52-3.36). Collaborative depression care adapted to women's health settings improved depressive and functional outcomes and quality of depression care. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01096316. I.",Melville JL.; Reed SD.; Russo J.; Croicu CA.; Ludman E.; LaRocco-Cockburn A.; Katon W.,2014.0,10.1097/AOG.0000000000000231,0,0,
9378,How eye movements in EMDR work: changes in memory vividness and emotionality.,"Eye movements (EM) during recall of an aversive memory is a treatment element unique to Eye Movement Desensitization and Reprocessing (EMDR). Experimental studies have shown that EM reduce memory vividness and/or emotionality shortly after the intervention. However, it is unclear whether the immediate effects of the intervention reflect actual changes in memory. The aim of this study was to test whether immediate reductions in memory vividness and emotionality persist at a 24 h follow up and whether the magnitude of these effects is related to the duration of the intervention. Seventy-three undergraduates recalled two negative autobiographical memories, one with EM (""recall with EM"") and one without (""recall only""). Half of participants recalled each memory for four periods of 24 s, the other half for eight periods of 24 s. Memory vividness/emotionality were self-rated at a pre-test, an immediate post-test, and a 24 h follow-up test. In both duration groups, recall with EM, but not recall only, caused an immediate decrease in memory vividness. There were no immediate reductions in memory emotionality. Furthermore, only the 'eight periods' group showed that recall with EM, but not recall only, caused a decrease in both memory emotionality and memory vividness from the pre-test to the follow-up. Only self-report measures were used. The findings suggest that recall with EM causes 24-h changes in memory vividness/emotionality, which may explain part of the EMDR treatment effect, and these effects are related to intervention duration.",Leer A.; Engelhard IM.; van den Hout MA.,2014.0,10.1016/j.jbtep.2014.04.004,0,0,
9379,A Virtual Hope Box smartphone app as an accessory to therapy: proof-of-concept in a clinical sample of veterans.,"A ""Hope Box"" is a therapeutic tool employed by clinicians with patients who are having difficulty coping with negative thoughts and stress, including patients who may be at risk of suicide or nonsuicidal self-harm. We conducted a proof-of-concept test of a ""Virtual"" Hope Box (VHB)-a smartphone app that delivers patient-tailored coping tools. Compared with a conventional hope box integrated into VA behavioral health treatment, high-risk patients and their clinicians used the VHB more regularly and found the VHB beneficial, useful, easy to set up, and said they were likely to use the VHB in the future and recommend the VHB to peers.",Bush NE.; Dobscha SK.; Crumpton R.; Denneson LM.; Hoffman JE.; Crain A.; Cromer R.; Kinn JT.,2015.0,10.1111/sltb.12103,0,0,
9380,Twin parenthood: the midwife's role--a randomised controlled trial.,"To determine whether a midwife-led intervention improved preparation for twin parenting and maternal psychosocial outcome. Randomised controlled trial. Two maternity units in North East England. A cohort of 162 women with uncomplicated twin pregnancy. Self-completion questionnaire at multiple time points. The primary outcome was probable postnatal depression (measured with the Edinburgh Postnatal Depression Scale, EPDS) 26 weeks after delivery. Secondary outcomes included preparation for parenting, maternal anxiety, parenting stress, and maternal wellbeing. The mean maternal EPDS scores at 26 weeks after delivery were 5.4 (SD 4.5) in the twin intervention (TI) group and 6.9 (SD 5.5) in the twin control (TC) group, and the mean difference between the groups was 1.5 (95% confidence interval, 95% CI, -0.2 to 3.3). The relative risk (RR) of having probable depression in the TI group compared with the TC group at 26 weeks was 0.48 (95% CI 0.19-1.20) for mothers and 0.84 (95% CI 0.42-1.70) for fathers. There were no statistically significant differences in maternal anxiety or parenting stress. TI mothers reported increased maternal wellbeing, reaction to motherhood, family support, mood, and greater self-confidence 26 weeks after delivery, and felt more prepared for parenting. As a result of the limited sample size, the study was unable to detect a difference in maternal depression using the maternal EPDS mean score. The antenatal preparation for parenting programme did not improve postnatal maternal anxiety or parenting stress; however, it did improve postnatal maternal wellbeing, mood, self-confidence, reaction to motherhood, and better prepared mothers to parent twin infants. Midwives have a key role in preparing mothers to parent twins.",Carrick-Sen DM.; Steen N.; Robson SC.,2014.0,10.1111/1471-0528.12728,0,0,
9381,A randomized controlled trial of emotion recognition training after traumatic brain injury.,"To examine the effectiveness of 2 affect recognition interventions (Faces and Stories) in people with a traumatic brain injury. Postacute rehabilitation facilities. A total of 203 participants with moderate to severe traumatic brain injury were screened; 71 were eligible and randomized to the Faces (n = 24), Stories (n = 23), and Control interventions (n = 24). Participants were an average of 39.8 years of age and 10.3 years postinjury; 74% of participants were male. Randomized controlled trial with immediate, 3-month, and 6-month follow-up posttests. Interventions were 9 hours of computer-based training with a therapist. Diagnostic Assessment of Nonverbal Accuracy 2-Adult Faces; Emotional Inference From Stories Test; Empathy (Interpersonal Reactivity Index); and Irritability and Aggression (Neuropsychiatric Inventory). The Faces Intervention did significantly better than the Control Intervention on the Diagnostic Assessment of Nonverbal Accuracy 2-Adult Faces (P = .031) posttreatment; no time effect or group interaction was observed. No other significant differences were noted for the Faces Intervention. No significant differences were observed between the Stories and the Control Interventions; however, a significant time effect was found for the Emotional Inference From Stories Test. The Faces Intervention effectively improved facial affect recognition in participants with chronic post-traumatic brain injury, and changes were maintained for 6 months. Future work should focus on generalizing this skill to functional behaviors.",Neumann D.; Babbage DR.; Zupan B.; Willer B.,,10.1097/HTR.0000000000000054,0,0,6799
9382,Offering the opportunity for family to be present during cardiopulmonary resuscitation: 1-year assessment.,"To evaluate the psychological consequences among family members given the option to be present during the CPR of a relative, compared with those not routinely offered the option. Prospective, cluster-randomized, controlled trial involving 15 prehospital emergency medical services units in France, comparing systematic offer for a relative to witness CPR with the traditional practice among 570 family members. Main outcome measure was 1-year assessment included proportion suffering post-traumatic stress disorder (PTSD), anxiety and depression symptoms, and/or complicated grief. Among the 570 family members [intention to treat (ITT) population], 408 (72%) were evaluated at 1 year. In the ITT population (N = 570), family members had PTSD-related symptoms significantly more frequently in the control group than in the intervention group [adjusted odds ratio, 1.8; 95% confidence interval (CI) 1.1-3.0; P = 0.02] as did family members to whom physicians did not propose witnessing CPR [adjusted odds ratio, 1.7; 95% CI 1.1-2.6; P = 0.02]. In the observed cases population (N = 408), the proportion of family members experiencing a major depressive episode was significantly higher in the control group (31 vs. 23%; P = 0.02) and among family members to whom physicians did not propose the opportunity to witness CPR (31 vs. 24%; P = 0.03). The presence of complicated grief was significantly greater in the control group (36 vs. 21%; P = 0.005) and among family members to whom physicians did not propose the opportunity to witness resuscitation (37 vs. 23%; P = 0.003). At 1 year after the event, psychological benefits persist for those family members offered the possibility to witness the CPR of a relative in cardiac arrest.",Jabre P.; Tazarourte K.; Azoulay E.; Borron SW.; Belpomme V.; Jacob L.; Bertrand L.; Lapostolle F.; Combes X.; Galinski M.; Pinaud V.; Destefano C.; Normand D.; Beltramini A.; Assez N.; Vivien B.; Vicaut E.; Adnet F.,2014.0,10.1007/s00134-014-3337-1,0,0,
9383,If it makes you happy: engaging in kind acts increases positive affect in socially anxious individuals.,"Social anxiety is associated with low positive affect (PA), a factor that can significantly affect psychological well-being and adaptive functioning. Despite suggestions that individuals with high levels of social anxiety would benefit from PA enhancement, the feasibility of doing so remains an unanswered question. Accordingly, in the current study, individuals with high levels of social anxiety (N = 142) were randomly assigned to conditions designed to enhance PA (Kind Acts), reduce negative affect (NA; Behavioral Experiments), or a neutral control (Activity Monitoring). All participants engaged in the required activities for 4 weeks and completed prepost questionnaires measuring mood and social goals, as well as weekly email ratings of mood, anxiety, and social activities. Both the prepost and weekly mood ratings revealed that participants who engaged in kind acts displayed significant increases in PA that were sustained over the 4 weeks of the study. No significant changes in PA were observed in the other conditions. The increase in hedonic functioning was not due to differential compliance, frequency of social activities, or an indirect effect of NA reduction. In addition, participants who engaged in kind acts displayed an increase in relationship satisfaction and a decrease in social avoidance goals, whereas no significant changes in these variables were observed in the other conditions. This study is the first to demonstrate that positive affect can be increased in individuals with high levels of social anxiety and that PA enhancement strategies may result in wider social benefits. The role of PA in producing those benefits requires further study.",Alden LE.; Trew JL.,2013.0,10.1037/a0027761,0,0,
9384,Survey of providers' attitudes toward integrating smoking cessation treatment into posttraumatic stress disorder care.,"A survey was administered anonymously to 45 mental health providers who delivered smoking cessation treatment integrated into posttraumatic stress disorder care (integrated care) as part of a multisite clinical trial. Survey items assessed key factors associated with successful implementation of research-based practices from the perspective of treating providers. Factors assessed included prior experiences with cessation treatment, compatibility of integrated care with current practices, feasibility of adopting integrated care into regular practice, and adequacy of training. More than half of respondents reported that integrated care delivery was feasible, and they would be considerably or extremely likely to continue delivery in routine practice. Positive prestudy beliefs and more experience delivering cessation care were associated with stronger endorsement of delivering integrated care after the study. The most frequently cited obstacle to delivering integrated care involved time limitations. Future efforts should focus on developing treatment adaptations that address provider-identified barriers and identifying clinic- and administrative-level supports that facilitate delivery of integrated care and assist providers who incorporate integrated care into clinical practice.",Malte CA.; McFall M.; Chow B.; Beckham JC.; Carmody TP.; Saxon AJ.,2013.0,10.1037/a0028484,0,0,
9385,Transfer of manualized CBT for social phobia into clinical practice (SOPHO-PRAX): a study protocol for a cluster-randomized controlled trial.,"Cognitive-behavioral therapy (CBT) is generally known to be efficacious in the treatment of social phobia when applied in RCTs, namely when the treatment manual is based on the Clark-Wells approach. However, little is known about the efficacy of manualized treatments in routine clinical practice (Phase IV of psychotherapy research). The present study (SOPHO-PRAX) is a continuation of a large multicenter randomized clinical trial (SOPHO-NET) and analyzes the extent to which additional training practitioners in manualized procedures enhances treatment effect. Thirty-six private practitioners will be included in three treatment centers and randomly designated to either training in manualized CBT or no specific training. The treatment effects of the therapies conducted by both groups of therapists will be compared. A total of 162 patients (n=116 completers; n=58 per condition) will be enrolled. Liebowitz Social Anxiety Scale (LSAS) will serve as primary outcome measure. Remission from social phobia is defined as LSAS total ≤ 30 points. Data will be collected at treatment begin, after 8, 15, and 25 sessions (50 min each), at treatment completion, as well at 6 and 12 months post-treatment. The present CBT trial combines elements of randomized controlled trials and naturalistic studies in an innovative way. It will directly inform about the incremental effects of procedures established in a controlled trial into clinical practice. Study results are relevant to healthcare decisions and policy. They may serve to improve quality of treatment, and shorten the time frame between the development and widespread dissemination of effective methods, thereby reducing health cost expenditure.The results of this study will not only inform about the degree to which the new methods lead to an improvement of treatment course and outcome, but also about whether the effects of routine psychotherapeutic treatment are comparable to those of the controlled, strictly manualized treatments of the SOPHO-NET study. ClinicalTrials.gov identifier: NCT01388231. This study was funded by the German Federal Ministry of Education and Research (SOPHO-NET: BMBF 01GV0607; SOPHO-PRAX: BMBF 01GV1001).",Crawcour S.; Leibing E.; Ginzburg D.; Stangier U.; Wiltink J.; Hoyer J.,2012.0,10.1186/1745-6215-13-70,0,0,
9386,[Impacts of acupuncture and moxibustion on outcome indeices of depression patients' subjective reports].,"To assess the clinical efficacy of acupuncture and moxibustion on depression in view of the outcome indicators of the patient subjective reports. One hundred and sixty-three cases of depression being in compliance with the inclusive standards were randomized into a soothing-liver and regulating-mind group, an acupoint-shallow-puncturing group and a non-acupoint-shallow-puncturing group. In the soothing-liver and regulating-mind group, the conventional acupuncture was applied to the four-gate points [Hegu (LI 4) and Taichong (LR 3)], Baihui (GV 20) and Yintang (EX-HN 3), the direct moxibustion with moxa cone was applied to the four-flower points [Geshu (BL 17), Danshu (BL 19)]. Finally, the intradermal needling was used at Xinshu (BL 15) and Ganshu (BL 18). In the acupoint-shallow-puncturing group, the acupoints selected were same as those in the soothing-liver and regulating-mind group. But the needle insertion was shallower and the time of moxibustion was shorter. In the non-acupoint-shallow-puncturing group, the spots that were 10 mm lateral to those acupoints in the soothing-liver and regulating-mind group were selected. The operation was same as that in the acupoint-shallow-puncturing group. The treatment was given twice a week in three groups. Totally, 12 weeks of treatment were required. The score of symptom checklist 90 (SCL-90), the self-report symptom inventory was observed before treatment, 1 month and 3 months after treatment separately so as to assess the corresponding short-term, mid-term and long-term efficacies of the program of acupuncture and moxibustion for soothing the liver and regulating the mind. In each time-point after treatment, for the scores of somatization, obsessive-compulsive symptom, interpersonal sensitivity, depression, anxiety, hostility, paranoid ideation, psychoticism and the other 8 dimensionalities, in comparison between the soothing-liver and regulating-mind group and the non-acupoint-shallow-puncturing group, the differences were significant statistically (all P < 0.05). For the scores of depression, anxiety and hostility, in comparison between the soothing-liver and regulating-mind group and the acupoint-shallow-puncturing group, the differences were significant statistically (all P < 0.05). Acupuncture and moxibustion can improve the scores of SCL-90 scale for the patients with depression. The outcome indicators of the patient subjective reports can accurately assess the clinical efficacy.",Fan L.; Fu WB.; Xu NG.; Liu JH.; Fan L.; Ou AH.,2012.0,,0,0,
9387,Factors associated with sustained attention during an activity intervention in persons with dementia.,"Are the noncognitive factors of self-reported mood and personality related to sustained attention in nursing home residents with dementia during an activity intervention? Intervention data from a randomized clinical trial were used to address the aim of this project. Subjects were 128 nursing home residents who were assessed for mood, personality, behavioral indicators of attention, time on task and number of disengagements during an activity intervention. More positive self-reported mood was associated with greater behavioral displays of attention during activities, greater time spent engaged in the activities and less disengagement. To our knowledge, this is the first study to report on the association of mood, personality and sustained attention in nursing home residents with dementia. While the findings are preliminary, they can be used to inform the design of future research.",Kolanowski A.; Bossen A.; Hill N.; Guzman-Velez E.; Litaker M.,2012.0,10.1159/000338604,0,0,
9388,Longitudinal treatment mediation of traditional cognitive behavioral therapy and acceptance and commitment therapy for anxiety disorders.,"To assess the relationship between session-by-session putative mediators and treatment outcomes in traditional cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for mixed anxiety disorders. Session-by-session changes in anxiety sensitivity and cognitive defusion were assessed in 67 adult outpatients randomized to CBT (n = 35) or ACT (n = 32) for a DSM-IV anxiety disorder. Multilevel mediation analyses revealed significant changes in the proposed mediators during both treatments (p < .001, d = .90-1.93), with ACT showing borderline greater improvements than CBT in cognitive defusion (p = .05, d = .82). Anxiety sensitivity and cognitive defusion both significantly mediated post-treatment worry; cognitive defusion more strongly predicted worry reductions in CBT than in ACT. In addition, cognitive defusion significantly mediated quality of life, behavioral avoidance, and (secondary) depression outcomes across both CBT and ACT (p < .05, R(2) change = .06-.13), whereas anxiety sensitivity did not significantly mediate other outcomes. Cognitive defusion represents an important source of therapeutic change across both CBT and ACT. The data offered little evidence for substantially distinct treatment-related mediation pathways.",Arch JJ.; Wolitzky-Taylor KB.; Eifert GH.; Craske MG.,2012.0,10.1016/j.brat.2012.04.007,0,0,
9389,Self-estimates of intelligence: interaction effects of the comparison to a specific reference group and neuroticism.,"An experiment that investigated the interaction effect of Neuroticism and the comparison to different reference groups on self-estimates of intelligence is reported. University students (100 men, 15 women) were randomly assigned to two experimental groups and asked to rate their own intelligence on a one-item measure, in IQ points, having been provided with reference values for either the general population or a student sample. Analysis of data confirmed that the accuracy of self-estimates of intelligence was influenced by the variation of the instruction. Participants provided more accurate estimations when confronted with comparison information about fellow students than about the general population. Persons scoring high on Neuroticism estimated their intelligence lower, but only when their estimation was based on a general reference group. Theoretical and practical implications were discussed.",Bipp T.; Kleingeld A.,2012.0,10.2466/04.07.09.PR0.110.2.403-415,0,0,
9390,Impact of information about obesity genomics on the stigmatization of overweight individuals: an experimental study.,"Advances in genomic technologies are rapidly leading to new understandings of the roles that genetic variations play in obesity. Increasing public dissemination of information regarding the role of genetics in obesity could have beneficial, harmful, or neutral effects on the stigmatization of obese individuals. This study used an online survey and experimental design to examine the impact of genetic versus non-genetic information on obesity stigma among self-perceived non-overweight individuals. Participants (n = 396) were randomly assigned to read either genetic, non-genetic (environment), or gene-environment interaction obesity causal information. A total of 48% of participants were female; mean age was 42.7 years (range = 18-86 years); 75% were white; 45.2% had an annual household income of less than $40,000; mean BMI was 23.4 kg/m(2). Obesity stigma was measured using the Fat Phobia Scale - short form (FPS-S). After reading the experimental information, participants in the genetic and gene-environment conditions were more likely to believe that genetics increase obesity risk than participants in the non-genetic condition (both P < 0.05), but did not differ on obesity stigma. Obesity stigma was higher among whites and Asians than Hispanics and African Americans (P = 0.029), and associated with low self-esteem (P = 0.036). Obesity stigma was also negatively associated with holding 'germ or virus' (P = 0.033) and 'overwork' (P = 0.016) causal beliefs about obesity, and positively associated with 'diet or eating habits' (P = 0.001) and 'lack of exercise' (P = 0.004) causal beliefs. Dissemination of brief information about the role of genetics in obesity may have neither a beneficial nor a harmful impact on obesity stigmatization compared with non-genetic information among self-perceived non-overweight individuals.",Lippa NC.; Sanderson SC.,2012.0,10.1038/oby.2012.144,0,0,
9391,Long-term improvement in coping skills following multimodal treatment in war veterans with chronic PTSD.,"Due to the long-lasting and resistant symptoms characteristic of chronic combat posttraumatic stress disorder (PTSD), its treatment is complex and often requires a tailored therapeutic approach incorporating both psychotherapy and pharmacotherapy. A multimodal approach of psychoeducative, sociotherapeutic, and dynamically oriented trauma-focused groups is described. We assessed the short- and long-term effectiveness of this therapeutic program by monitoring its impact on PTSD symptoms, depression, neurotic symptoms, coping skills, and quality of life for three years. The findings revealed short-term reduction in the symptoms of PTSD and depression, while the long-term results were manifested as the increased use of all coping mechanisms and a greater level of obsession.",Britvić D.; Glučina D.; Antičevič V.; Kekez V.; Lapenda B.; Đogaš V.; Dodig G.; Urlić I.; Moro I.; Frančišković T.,2012.0,10.1521/ijgp.2012.62.3.418,0,0,
9392,"Behavioral activation and therapeutic exposure: an investigation of relative symptom changes in PTSD and depression during the course of integrated behavioral activation, situational exposure, and imaginal exposure techniques.","Effectiveness of exposure therapy for posttraumatic stress disorder (PTSD) may be adversely influenced by comorbid disorders. The present study investigated behavioral activation and therapeutic exposure (BA-TE), a new integrated treatment designed specifically for comorbid symptoms of PTSD and depression. Combat veterans with PTSD (N = 117) completed eight sessions of BA-TE that included two phases of treatment: (a) behavioral activation (BA) in which some activities involved situational exposures and (b) BA and situational exposures with imaginal exposures. Findings supported improvements in symptoms of PTSD, and overlapping symptoms of PTSD and depression, but not in nonoverlapping symptoms of depression. The findings also demonstrated a relatively consistent rate of change in PTSD and depression symptoms during BA-TE, despite the addition of imaginal exposures midway through the treatment. Together, these findings provide preliminary support for BA-TE as a treatment for PTSD and depression, and highlight the utility of transdiagnostic treatments in addressing comorbidity and symptom overlap.",Gros DF.; Price M.; Strachan M.; Yuen EK.; Milanak ME.; Acierno R.,2012.0,10.1177/0145445512448097,0,0,
9393,Analogue trauma results in enhanced encoding of threat information at the expense of neutral information.,"This study investigated whether trauma-related stimuli are preferentially processed at the expense of ongoing processing of neutral stimuli. Participants in the experimental group viewed negative pictures (Trauma) as an analogue trauma induction. Participants in the control group viewed visually similar neutral pictures (Neutral Match). In a Rapid Serial Visual Presentation (RSVP) task participants identified two target pictures. The first target (T1) was a neutral picture, whereas the second target (T2) was a familiar negative or neutral picture or a new neutral or negative picture. In line with hypotheses, only participants in the experimental group showed preferential processing of Trauma pictures. In the experimental group, negative T2 impaired the identification of (neutral) T1 if the T2 immediately followed the T1 in the RSVP stream. The results are consistent with a processing priority of trauma-related information, apparently at the expense of the ongoing processing of neutral information.",Krans J.; Reinecke A.; de Jong PJ.; Näring G.; Becker ES.,2012.0,10.1016/j.janxdis.2012.05.003,0,0,
9394,[Comparative estimation of rehabilitative abilities after organ preserving operations for severe eye damages].,Postoperative analysis of rehabilitative potentialities in 59 patients operated on occasion of severe eye trauma with the use of various methods of ophthalmosurgery has been presented. It has been demonstrated that the method of organ preserving complex vitreoretinal surgery provided evading enucleation and retaining the damaged eyeball in 96.4% of cases. In 82.1% of cases it has been succeeded in retaining some vision functions and raising considerably the indices of life quality. It has been determined that properly made silicone tamponade provides the support of the necessary ophthalmotone and prevention of progressive growing of posttraumatic eyeball subatrothy--the most frequent outcome of a severe eye trauma.,Boĭko EV.; Shamreĭ DV.; Sosnovskiĭ SV.; Kulikov AN.,2012.0,,0,0,
9395,Reducing substance use risk and mental health problems among sexually assaulted adolescents: a pilot randomized controlled trial.,"The current study reports results from a pilot randomized controlled trial evaluating the feasibility and efficacy of Risk Reduction through Family Therapy (RRFT) for reducing substance use risk and trauma-related mental health problems among sexually assaulted adolescents. Thirty adolescents (aged 13-17 years; M = 14.80; SD = 1.51) who had experienced at least one sexual assault and their caregivers were randomized to RRFT or treatment as usual (TAU) conditions. Participants completed measures of substance use, substance use risk factors (e.g., family functioning), mental health problems (i.e., posttraumatic stress disorder, depression, and general internalizing/externalizing symptoms) and risky sexual behavior at four time points (baseline, posttreatment, and 3- and 6-month follow-up). Mixed-effects regression models yielded significantly greater reductions in substance use, specific substance use risk factors, and (parent-reported) PTSD, depression, and general internalizing symptoms among youth in the RRFT condition relative to youth in the TAU condition. However, significant baseline differences in functioning between the two conditions warrant caution in interpreting between-groups findings. Instead, emphasis is placed on replication of feasibility findings and within-group improvements over time among the RRFT youth.",Danielson CK.; McCart MR.; Walsh K.; de Arellano MA.; White D.; Resnick HS.,2012.0,10.1037/a0028862,0,0,
9396,Transdermal nicotine during cue reactivity in adult smokers with and without anxiety disorders.,"Transdermal nicotine almost doubles tobacco cessation rates; however, little is known about what happens to smokers during the quit process when they are wearing the nicotine patch and are confronted with high-risk smoking triggers. This is particularly important for smokers with psychological disorders who disproportionately represent today's smokers and have more trouble quitting. Using a mixed between- and within-subjects design, smokers with anxiety disorders (n=61) and smokers without any current Axis I disorders (n=38) received transdermal nicotine (21 mg) or a placebo patch over two assessment days separated by 48 hr. Urge to smoke was evaluated during a 5-hr patch absorption period (reflecting general smoking deprivation) and during imaginal exposure to theoretically high-risk triggers containing smoking cues, anxiety cues, both, or neutral cues. No differences were observed between smokers with and without anxiety disorders. Significant Patch√óTime and Patch√óCue Content interactions were found. Both patch conditions experienced an increase in urge during the deprivation period, but postabsorption urge was significantly higher in the placebo condition, suggesting that transdermal nicotine attenuated the degree to which urge to smoke increased over time. During the cue reactivity trials, when participants received the nicotine patch, they experienced significantly lower urge in response to both smoking-only and neutral cues, but not when anxiety cues were present (alone or in combination with smoking cues). These data suggest that transdermal nicotine alleviates urge only under certain circumstances and that adjunctive interventions are likely necessary to address smoking urges in response to spikes in distress among smokers trying to quit.",Morissette SB.; Gulliver SB.; Kamholz BW.; Spiegel DA.; Tiffany ST.; Barlow DH.,2012.0,10.1037/a0028828,0,0,
9397,A pilot randomized controlled trial of brief cognitive-behavioral therapy for anxiety in patients with terminal cancer.,"Patients with terminal cancer often experience marked anxiety that is associated with poor quality of life. Although cognitive-behavioral therapy (CBT) is an evidence-based treatment for anxiety disorders, the approach needs to be adapted to address realistic concerns related to having cancer, such as worries about disease progression, disability, and death. In this pilot randomized controlled trial (clinicaltrials.gov identifier NCT00706290), we examined the feasibility and potential efficacy of brief CBT to reduce anxiety in patients with terminal cancer. We adapted CBT by developing treatment modules targeting skills for relaxation, coping with cancer worries, and activity pacing. Adults with incurable malignancies and elevated anxiety based on the Hamilton Anxiety Rating Scale (HAM-A) were randomly assigned to individual CBT or a waitlist control group. Primary outcomes included the number of completed CBT visits and the change in HAM-A scores from baseline to 8-week follow-up per a treatment-blind evaluator. The feasibility criterion was 75% adherence to the intervention. We randomized 40 patients with terminal cancers to CBT (n = 20) or waitlist control (n = 20) groups; 70% completed posttreatment assessments. Most patients who received CBT (80%) participated in at least five of the required six therapy sessions. Analysis of covariance models, adjusted for baseline scores, showed that those assigned to CBT had greater improvements in HAM-A scores compared to the control group, with an adjusted mean difference of -5.41 (95% confidence interval: -10.78 to -0.04) and a large effect size for the intervention (Cohen's d = 0.80). Providing brief CBT tailored to the concerns of patients with terminal cancer was not only feasible but also led to significant improvements in anxiety.",Greer JA.; Traeger L.; Bemis H.; Solis J.; Hendriksen ES.; Park ER.; Pirl WF.; Temel JS.; Prigerson HG.; Safren SA.,2012.0,10.1634/theoncologist.2012-0041,0,0,
9398,A randomized placebo-controlled trial of D-cycloserine and exposure therapy for posttraumatic stress disorder.,"D-Cycloserine (DCS) is a partial NMDA receptor agonist that has been shown to enhance therapeutic response to exposure-based treatments for anxiety disorders, but has not been tested in the treatment of combat-related posttraumatic stress disorder (PTSD). The aim of this randomized, double-blind, placebo-controlled trial was to determine whether DCS augments exposure therapy for PTSD in veterans returning from Iraq and Afghanistan and to test whether a brief six-session course of exposure therapy could effectively reduce PTSD symptoms in returning veterans. In contrast to previous trials using DCS to enhance exposure therapy, results indicated that veterans in the exposure therapy plus DCS condition experienced significantly less symptom reduction than those in the exposure therapy plus placebo condition over the course of the treatment. Possible reasons for why DCS was associated with poorer outcome are discussed. Clinicaltrials.gov Registry #: NCT00371176; A Placebo-Controlled Trail of D-Cycloserine and Exposure Therapy for Combat-PTSD; www.clinicaltrials.gov/ct2/results?term=NCT00371176.",Litz BT.; Salters-Pedneault K.; Steenkamp MM.; Hermos JA.; Bryant RA.; Otto MW.; Hofmann SG.,2012.0,10.1016/j.jpsychires.2012.05.006,0,0,
9399,Combining computerized home-based treatments for generalized anxiety disorder: an attention modification program and cognitive behavioral therapy.,"Generalized anxiety disorder (GAD) is a common and disabling condition associated with significant personal and societal costs. Although efficacious treatments exist for GAD, the majority of these individuals fail to access our most effective treatments. In the current paper, we report the results of an open trial that examined the efficacy of a computer-delivered home-based treatment program for GAD. Twenty-one individuals seeking treatment for GAD received a self-administered program over 6 weeks that comprised two components: (1) an Attention Modification Program (AMP) designed to facilitate attentional disengagement from threat-relevant stimuli and (2) brief computer-delivered cognitive and behavioral treatment modules (CCBT). Fourteen of the 21 enrolled participants (67%) completed the treatment program. Intent-to-treat and completer analyses revealed that AMP+CCBT resulted in significant reductions in clinician- and self-rated symptoms of anxiety, worry, depression, and functional impairment. Moreover, treatment completers displayed significant reductions in attentional bias for threat from pre- to postassessment. Change in attentional bias for threat from pre- to postassessment was associated with change in worry symptoms. Finally, 79% of participants no longer met DSM-IV criteria for GAD at postassessment and 36% were classified as remitted (Hamilton Rating Scale for Anxiety ≤7; Rickels et al., 2006). These results suggest that computer-delivered AMP+CCBT may serve as an effective and easily accessible treatment option for individuals with GAD.",Amir N.; Taylor CT.,2012.0,10.1016/j.beth.2010.12.008,0,0,
9400,Electrocardiographic anxiety profiles improve speech anxiety.,"The present study was to set out in efforts to determine the effect of electrocardiographic (ECG) feedback on the performance in speech anxiety. Forty-six high school students participated in a speech performance educational program. They were randomly divided into two groups, an experimental group with ECG feedback (N = 21) and a control group (N = 25). Feedback was given with video recording in the control, whereas in the experimental group, an additional ECG feedback was provided. Speech performance was evaluated by the Korean Broadcasting System (KBS) speech ability test, which determines the 10 different speaking categories. ECG was recorded during rest and speech, together with a video recording of the speech performance. Changes in R-R intervals were used to reflect anxiety profiles. Three trials were performed for 3-week program. Results showed that the subjects with ECG feedback revealed a significant improvement in speech performance and anxiety states, which compared to those in the control group. These findings suggest that visualization of the anxiety profile feedback with ECG can be a better cognitive therapeutic strategy in speech anxiety.",Kim PW.; Kim SA.; Jung KH.,2012.0,10.1007/s10484-012-9199-9,0,0,
9401,Craving as a predictor of treatment outcomes in heavy drinkers with comorbid depressed mood.,"Alcohol and depression comorbidity is high and is associated with poorer outcomes following treatment. The ability to predict likely treatment response would be advantageous for treatment planning. Craving has been widely studied as a potential predictor, but has performed inconsistently. The effect of comorbid depression on craving's predictive performance however, has been largely neglected, despite demonstrated associations between negative affect and craving. The current study examined the performance of craving, measured pre-treatment using the Obsessive subscale of the Obsessive Compulsive Drinking Scale, in predicting 18-week and 12-month post-treatment alcohol use outcomes in a sample of depressed drinkers. Data for the current study were collected during a randomized controlled trial (Baker, Kavanagh, Kay-Lambkin, Hunt, Lewin, Carr, & Connolly, 2010) comparing treatments for comorbid alcohol and depression. A subset of 260 participants from that trial with a Timeline Followback measure of alcohol consumption was analyzed. Pre-treatment craving was a significant predictor of average weekly alcohol consumption at 18 weeks and of frequency of alcohol binges at 18 weeks and 12 months, but pre-treatment depressive mood was not predictive, and effects of Baseline craving were independent of depressive mood. Results suggest a greater ongoing risk from craving than from depressive mood at Baseline.",Connolly JM.; Kavanagh DJ.; Baker AL.; Kay-Lambkin FJ.; Lewin TJ.; Davis PJ.; Quek LH.,2013.0,10.1016/j.addbeh.2012.06.003,0,0,
9402,"Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder.","Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in several controlled trials, but the mechanisms of change are largely unknown. Therapeutic alliance is a factor that has been studied in many psychotherapy trials, but the role of therapeutic alliance in ICBT is less well known. The present study investigated early alliance ratings in three separate samples. Participants from one sample of depressed individuals (N = 49), one sample of individuals with generalized anxiety disorder (N = 35), and one sample with social anxiety disorder (N = 90) completed the Working Alliance Inventory (WAI) modified for ICBT early in the treatment (weeks 3-4) when they took part in guided ICBT for their conditions. Results showed that alliance ratings were high in all three samples and that the WAI including the subscales of Task, Goal and Bond had high internal consistencies. Overall, correlations between the WAI and residualized change scores on the primary outcome measures were small and not statistically significant. We conclude that even if alliance ratings are in line with face-to-face studies, therapeutic alliance as measured by the WAI is probably less important in ICBT than in regular face-to-face psychotherapy.",Andersson G.; Paxling B.; Wiwe M.; Vernmark K.; Felix CB.; Lundborg L.; Furmark T.; Cuijpers P.; Carlbring P.,2012.0,10.1016/j.brat.2012.05.003,0,0,
9403,Psychological and physiological response of students to different types of stress management programs.,"To design, implement, and examine the psychoneuroendocrine responses of three different types of stress management programs. Randomly assigned. A pre/post experimental design comparing variables between three different programs and a control group. The first program included training in deep breathing, relaxation response, meditation, and guided imagery techniques (RRGI). The second program included training in cognitive behavioral techniques (CB). The third program included both RRGI and CB (RRGICB). The study was conducted at Buenos Aires University. Participants (N ‚Ää= 52) were undergraduate students. Anxiety, anger, hopelessness, neuroticism, respiration rate, and salivary cortisol levels were assessed. Wilcoxon signed rank test was used to investigate differences in pre and post variables. Subjects in the RRGI group showed significantly lower levels of anxiety (p < .011), anger (p < .012), neuroticism (p < .01), respiratory rate (p < .002), hopelessness (p < .01), and salivary cortisol (p < .002) after the treatment. Subjects in the CB group showed significantly lower levels of anxiety (p < .018), anger (p < .037), and neuroticism (p < .03) after the treatment. Subjects in the RRGICB group showed significantly lower levels of anxiety (p < .001), anger (p < .001), neuroticism (p < .008), hopelessness (p < .01), respiratory rate (p < .001), and salivary cortisol (p < .002) after the treatment. Subjects in the control group showed only one variable modification, a significant increase in cortisol levels (p < .004). The combination of deep breathing, relaxation response, meditation, and guided imagery techniques with CB seems to be effective at helping people to deal with stress.",Iglesias SL.; Azzara S.; Argibay JC.; Arnaiz ML.; de Valle Carpineta M.; Granchetti H.; Lagomarsino E.,,10.4278/ajhp.110516-QUAL-199,0,0,
9404,A randomized trial of ACT bibliotherapy on the mental health of K-12 teachers and staff.,"The mental health challenges of some vocations present a challenge for current intervention models. Bibliotherapy focused on transdiagnostic processes that might both prevent and alleviate a range of mental health distress could be an effective and practical approach. K-12 school personnel (N = 236; 91% female; 30-60 years old) responding to a wellness-oriented program announcement were randomized to receive an Acceptance and Commitment Therapy (ACT) self-help volume or to a waitlist. Three-fourths were above clinical cutoffs in general mental health, depression, anxiety, or stress. Participants read the book for two months, completed exercises and quizzes, and after post assessment were followed for 10 weeks; waitlist participants were then also given the book with two months to complete it. Overall, participants showed significant improvement in psychological health. Significant preventive effects for depression and anxiety were observed along with significant ameliorative effects for those in the clinical ranges of depression, anxiety and stress. Follow up general mental health, depression, and anxiety outcomes were related to the manner in which participants used the workbook and to post levels of psychological flexibility.",Jeffcoat T.; Hayes SC.,2012.0,10.1016/j.brat.2012.05.008,0,0,
9405,Evaluation of a spiritually focused intervention with older trauma survivors.,"This study evaluated the effectiveness of an 11-session, spiritually focused group intervention with older women survivors (age 55 years and older) of interpersonal trauma (child abuse, sexual assault, or domestic violence) in reducing trauma-related depressive symptoms, posttraumatic stress, and anxiety. Forty-three community-dwelling women survivors of interpersonal trauma were randomized into treatment (n = 21) or control (n = 22) groups. Participants in group psychotherapy discussed spiritual struggles related to abuse and developed spiritual coping resources. The treatment group had significantly lower depressive symptoms, anxiety, and physical symptoms at posttest compared with the control group. In a separate analysis, posttraumatic stress symptoms also dropped significantly in the treatment group. Gains were maintained at three-month follow-up. This study provides strong initial support for the effectiveness of spiritually focused group intervention for older survivors of interpersonal trauma from a Christian background.",Bowland S.; Edmond T.; Fallot RD.,2012.0,,0,0,
9406,Development and evaluation of an interprofessional communication intervention to improve family outcomes in the ICU.,"The intensive care unit (ICU), where death is common and even survivors of an ICU stay face the risk of long-term morbidity and re-admissions to the ICU, represents an important setting for improving communication about palliative and end-of-life care. Communication about the goals of care in this setting should be a high priority since studies suggest that the current quality of ICU communication is often poor and is associated with psychological distress among family members of critically ill patients. This paper describes the development and evaluation of an intervention designed to improve the quality of care in the ICU by improving communication among the ICU team and with family members of critically ill patients. We developed a multi-faceted, interprofessional intervention based on self-efficacy theory. The intervention involves a ""communication facilitator"" - a nurse or social worker - trained to facilitate communication among the interprofessional ICU team and with the critically ill patient's family. The facilitators are trained using three specific content areas: a) evidence-based approaches to improving clinician-family communication in the ICU, b) attachment theory allowing clinicians to adapt communication to meet individual family member's communication needs, and c) mediation to facilitate identification and resolution of conflict including clinician-family, clinician-clinician, and intra-family conflict. The outcomes assessed in this randomized trial focus on psychological distress among family members including anxiety, depression, and post-traumatic stress disorder at 3 and 6 months after the ICU stay. This manuscript also reports some of the lessons that we have learned early in this study.",Curtis JR.; Ciechanowski PS.; Downey L.; Gold J.; Nielsen EL.; Shannon SE.; Treece PD.; Young JP.; Engelberg RA.,2012.0,10.1016/j.cct.2012.06.010,0,0,
9407,Deep brain stimulation of anteromedial globus pallidus interna for severe Tourette's syndrome.,"Multiple anatomical targets for deep brain stimulation (DBS) have been proposed for the treatment of severe Tourette's syndrome. In this open study, the authors evaluated the effectiveness of DBS of the anteromedial globus pallidus interna on tic severity and common comorbidities. Eleven patients (eight of them men, mean age=39 years) with severe and medically intractable Tourette's syndrome underwent implantation of Medtronic quadripolar electrodes in the globus pallidus interna bilaterally. The primary outcome measure was the Yale Global Tic Severity Scale. Secondary outcome measures included the Yale-Brown Obsessive Compulsive Scale, the Hamilton Depression Rating Scale, the Gilles de la Tourette Syndrome-Quality of Life Scale, and the Global Assessment of Functioning Scale. Follow-up occurred at 1 month and then at a mean of 14 months after surgery (range=4-30 months). Ten patients (91%) reported improvement in tic severity soon after DBS. Overall, there was a 48% reduction in motor tics and a 56.5% reduction in phonic tics at final follow-up. Six patients (54.5%) had a more than 50% reduction, sustained for at least 3 months, in Yale Global Tic Severity Scale score. Only two patients required ongoing pharmacotherapy for tics after surgery, and patients improved significantly on all secondary measures. One patient did not tolerate DBS and discontinued treatment after 3 months. Greater anxiety in two patients and hardware malfunction in three patients were noteworthy adverse outcomes. The results suggest anteromedial globus pallidus interna DBS for Tourette's syndrome is an effective and well-tolerated treatment for a subgroup of patients with severe Tourette's syndrome.",Cannon E.; Silburn P.; Coyne T.; O'Maley K.; Crawford JD.; Sachdev PS.,2012.0,10.1176/appi.ajp.2012.11101583,0,0,
9408,Neurotherapy of traumatic brain injury/posttraumatic stress symptoms in OEF/OIF veterans.,"The Flexyx Neurotherapy System (FNS), a novel variant of EEG biofeedback, was adapted for intervention with seven treatment-refractory Afghanistan/Iraq war veterans, and brought about significant decreases in bothersome neurobehavioral and posttraumatic stress symptoms. FNS may help ameliorate mixed trauma spectrum syndromes.",Nelson DV.; Esty ML.,2012.0,10.1176/appi.neuropsych.11020041,0,0,
9409,Reduced risk-taking behavior as a trait feature of anxiety.,"Affect can have a significant influence on decision-making processes and subsequent choice. One particularly relevant type of negative affect is anxiety, which serves to enhance responses to threatening stimuli or situations. In its exaggerated form, it can lead to psychiatric disorders, with detrimental consequences for quality of life, including the ability to make choices. This study investigated, for the first time, how pathological anxiety affects risk-taking behavior. In this study, 20 anxious participants meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for either generalized anxiety disorder (n = 10) and for panic attack disorder (n = 10), as well as 20 matched nonanxious controls, performed a gambling task. To investigate the tendency toward either a risk-seeking or a risk-averse behavior, we employed a task that did not allow for learning from outcomes. Anxious participants made significantly fewer risky choices than matched nonanxious participants. Specifically, they become risk-avoidant after gains. Moreover, anxious participants not only were less happy after gains but were also less sad after losses, and they also evinced less desire to change their choices after losses than did nonanxious participants. Importantly, whereas the desire to switch choice was followed by actual choice switch for all participants, happiness directly predicted subsequent risky choices, particularly in the nonanxious participants. Further analyses revealed that the anxious participants' risk-avoidance behavior was independent of different types of anxiety disorder (panic attack disorder and generalized anxiety disorder) as well as of the effects of psychotropic drugs treatment. This study demonstrates a specific role for anxiety in individual decision making. In particular, hypersensitivity to potential threats and pessimistic evaluation of future events reduced risk-taking behavior.",Giorgetta C.; Grecucci A.; Zuanon S.; Perini L.; Balestrieri M.; Bonini N.; Sanfey AG.; Brambilla P.,2012.0,10.1037/a0029119,0,0,
9410,Intergroup anxiety effects on implicit racial evaluation and stereotyping.,"How does intergroup anxiety affect the activation of implicit racial evaluations and stereotypes? Given the common basis of social anxiety and implicit evaluative processes in memory systems linked to classical conditioning and affect, we predicted that intergroup anxiety would amplify implicit negative racial evaluations. Implicit stereotyping, which is associated primarily with semantic memory systems, was not expected to increase as a function of intergroup anxiety. This pattern was observed among White participants preparing to interact with Black partners, but not those preparing to interact with White partners. These findings shed new light on how anxiety, often elicited in real-life intergroup interactions, can affect the operation of implicit racial biases, suggesting that intergroup anxiety has more direct implications for affective and evaluative forms of implicit bias than for implicit stereotyping. These findings also support a memory-systems model of the interplay between emotion and cognition in the context of social behavior.",Amodio DM.; Hamilton HK.,2012.0,10.1037/a0029016,0,0,
9411,Neuropsychological predictors of response to randomized treatment in obsessive-compulsive disorder.,"To identify neuropsychological predictors of treatment response to cognitive-behavioral therapy (CBT) and fluoxetine in treatment-naïve adults with obsessive-compulsive disorder (OCD). Thirty-eight adult outpatients with OCD underwent neuropsychological assessment, including tasks of intellectual function, executive functioning and visual and verbal memory, before randomization to a 12-week clinical trial of either CBT or fluoxetine. Neuropsychological measures were used to identify predictors of treatment response in OCD. Neuropsychological measures that predicted a better treatment response to either CBT or fluoxetine were higher verbal IQ (Wechsler Abbreviated Scale of Intelligence) (p=0.008); higher verbal memory on the California Verbal Learning Test (p=0.710); shorter time to complete part D (Dots) (p<0.001), longer time to complete part W (Words) (p=0.025) and less errors on part C (Colors) (p<0.001) in the Victoria Stroop Test (VST). Fewer perseverations on the California Verbal Learning Test, a measure of mental flexibility, predicted better response to CBT, but worse response to fluoxetine (p=0.002). In general, OCD patients with better cognitive and executive abilities at baseline were more prone to respond to either CBT or fluoxetine. Our finding that neuropsychological measures of mental flexibility predicted response to treatment in opposite directions for CBT and fluoxetine suggests that OCD patients with different neuropsychological profiles may respond preferentially to one type of treatment versus the other. Further studies with larger samples of OCD patients are necessary to investigate the heuristic value of such findings in a clinical context.",D'Alcante CC.; Diniz JB.; Fossaluza V.; Batistuzzo MC.; Lopes AC.; Shavitt RG.; Deckersbach T.; Malloy-Diniz L.; Miguel EC.; Hoexter MQ.,2012.0,10.1016/j.pnpbp.2012.07.002,0,0,
9412,The effects of clinical aromatherapy for anxiety and depression in the high risk postpartum woman - a pilot study.,"The aim of this study was to determine if aromatherapy improves anxiety and/or depression in the high risk postpartum woman and to provide a complementary therapy tool for healthcare practitioners. The pilot study was observational with repeated measures. Private consultation room in a Women's center of a large Indianapolis hospital. 28 women, 0-18 months postpartum. The treatment groups were randomized to either the inhalation group or the aromatherapy hand m'technique. Treatment consisted of 15 min sessions, twice a week for four consecutive weeks. An essential oil blend of rose otto and lavandula angustifolia @ 2% dilution was used in all treatments. The non-randomized control group, comprised of volunteers, was instructed to avoid aromatherapy use during the 4 week study period. Allopathic medical treatment continued for all participants. All subjects completed the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder Scale (GAD-7) at the beginning of the study. The scales were then repeated at the midway point (two weeks), and at the end of all treatments (four weeks). Analysis of Variance (ANOVA) was utilized to determine differences in EPDS and/or GAD-7 scores between the aromatherapy and control groups at baseline, midpoint and end of study. No significant differences were found between aromatherapy and control groups at baseline. The midpoint and final scores indicated that aromatherapy had significant improvements greater than the control group on both EPDS and GAD-7 scores. There were no adverse effects reported. The pilot study indicates positive findings with minimal risk for the use of aromatherapy as a complementary therapy in both anxiety and depression scales with the postpartum woman. Future large scale research in aromatherapy with this population is recommended.",Conrad P.; Adams C.,2012.0,10.1016/j.ctcp.2012.05.002,0,0,
9413,A controlled study of agoraphobia and the independent effect of virtual reality exposure therapy.,"Past controlled clinical trials centred on virtual reality exposure therapy (VRET) for agoraphobia mostly used multicomponent therapy with success. However, the present paper aimed to evaluate the independent effect of VRET for agoraphobia. A controlled study involving 18 agoraphobic participants assigned to two groups: VRET only and VRET with cognitive therapy. Nine specific virtual environments were developed using an affordable game level editor. Questionnaires, behavioural tests and physiological measures indicated a positive effect of VRET. Correlations supported the predictive value of presence towards treatment outcome. The addition of cognitive therapy did not provide significant additional benefit. Overall, the isolated effects of VRET did not seem to be significantly less than the effects of VRET combined with cognitive therapy. Future research should explore the use of other components in addition to cognitive therapy and VRET for agoraphobia as well as its possible use in patients' homes.",Malbos E.; Rapee RM.; Kavakli M.,2013.0,10.1177/0004867412453626,0,0,
9414,Does a pre-treatment diagnostic interview affect the outcome of internet-based self-help for social anxiety disorder? a randomized controlled trial.,"Numerous studies suggest that Internet-based self-help treatments are effective in treating anxiety disorders. Trials evaluating such interventions differ in their screening procedures and in the amount of clinician contact in the diagnostic assessment phase. The present study evaluates the impact of a pre-treatment diagnostic interview on the outcome of an Internet-based treatment for Social Anxiety Disorder (SAD). One hundred and nine participants seeking treatment for SAD were randomized to either an interview-group (IG, N = 53) or to a non-interview group (NIG, N = 56). All participants took part in the same 10-week cognitive-behavioural unguided self-help programme. Before receiving access to the programme, participants of the IG underwent a structured diagnostic interview. Participants of the NIG started directly with the programme. Participants in both groups showed significant and substantial improvement on social anxiety measures from pre- to post-assessment (d IG = 1.30-1.63; d NIG = 1.00-1.28) and from pre- to 4-month follow-up assessment (d IG = 1.38-1.87; d NIG = 1.10-1.21). Significant between-groups effects in favour of the IG were found on secondary outcome measures of depression and general distress (d = 0.18-0.42). These findings suggest that Internet-based self-help is effective in treating SAD, whether or not a diagnostic interview is involved. However, the pre-treatment interview seems to facilitate change on secondary outcomes such as depression and general distress.",Boettcher J.; Berger T.; Renneberg B.,2012.0,10.1017/S1352465812000501,0,0,
9415,"Online screening for distress, the 6th vital sign, in newly diagnosed oncology outpatients: randomised controlled trial of computerised vs personalised triage.","This randomised controlled trial examined the impact of screening for distress followed by two different triage methods on clinically relevant outcomes over a 12-month period. Newly diagnosed patients attending a large tertiary cancer centre were randomised to one of the two conditions: (1) screening with computerised triage or (2) screening with personalised triage, both following standardised clinical triage algorithms. Patients completed the Distress Thermometer, Pain and Fatigue Thermometers, the Psychological Screen for Cancer (PSSCAN) Part C and questions on resource utilisation at baseline, 3, 6 and 12 months. In all, 3133 patients provided baseline data (67% of new patients); with 1709 (54.5%) retained at 12 months (15.4% deceased). Mixed effects models revealed that both groups experienced significant decreases in distress, anxiety, depression, pain and fatigue over time. People receiving personalised triage and people reporting higher symptom burden were more likely to access services, which was subsequently related to greater decreases in distress, anxiety and depression. Women may benefit more from personalised triage, whereas men may benefit more from a computerised triage model. Screening for distress is a viable intervention that has the potential to decrease symptom burden up to 12 months post diagnosis. The best model of screening may be to incorporate personalised triage for patients indicating high levels of depression and anxiety while providing computerised triage for others.",Carlson LE.; Waller A.; Groff SL.; Zhong L.; Bultz BD.,2012.0,10.1038/bjc.2012.309,0,0,
9416,Changes in dopamine D2-receptor binding are associated to symptom reduction after psychotherapy in social anxiety disorder.,"The dopamine system has been suggested to play a role in social anxiety disorder (SAD), partly based on molecular imaging studies showing reduced levels of striatal dopaminergic markers in patients compared with control subjects. However, the dopamine system has not been examined in frontal and limbic brain regions proposed to be central in the pathophysiology of SAD. In the present study, we hypothesized that extrastriatal dopamine D2-receptor (D2-R) levels measured using positron emission tomography (PET) would predict symptom reduction after cognitive behavior therapy (CBT). Nine SAD patients were examined using high-resolution PET and the high-affinity D2-R antagonist radioligand [(11)C]FLB 457, before and after 15 weeks of CBT. Symptom levels were assessed using the anxiety subscale of Liebowitz Social Anxiety Scale (LSAS(anx)). At posttreatment, there was a statistically significant reduction of social anxiety symptoms (P<0.005). Using a repeated measures analysis of covariance, significant effects for time and time × LSAS(anx) change on D2-R-binding potential (BP(ND)) were shown (P<0.05). In a subsequent region-by-region analysis, negative correlations between change in D2-R BP(ND) and LSAS(anx) change were found for medial prefrontal cortex and hippocampus (P<0.05). This is the first study to report a direct relationship between symptom change after psychological treatment and a marker of brain neurotransmission. Using an intra-individual comparison design, the study supports a role for the dopamine system in cortical and limbic brain regions in the pathophysiology of SAD.",Cervenka S.; Hedman E.; Ikoma Y.; Djurfeldt DR.; Rück C.; Halldin C.; Lindefors N.,2012.0,10.1038/tp.2012.40,0,0,
9417,Mental health training with soldiers four months after returning from Iraq: randomization by platoon.,"Military personnel report significant and increasing mental health problems in the months following return from combat. Nevertheless, studies have not assessed the impact of mental health training with this at-risk population. The present study evaluated the efficacy of a prototype mental health training module designed for U.S. soldiers 3-6 months after returning from combat; the module was a component of the Battlemind Training system. Soldiers (N = 1,645) were randomly assigned by platoon to 1 hour of training or a survey-only control group. Baseline surveys were conducted immediately before training; a training satisfaction survey was administered immediately after training, and a follow-up survey was administered 6 months later. Immediate postsession surveys were conducted with 681 subjects, and follow-up surveys were conducted with 542 soldiers. The Battlemind Training module received positive ratings from participants, and those who received it reported significantly better adjustment in terms of posttraumatic stress disorder symptoms, depression, and life satisfaction at follow-up compared to those in the survey-only control group. Changes in attitudes about the stigma of seeking mental health care were found immediately posttraining, but not at follow-up. The findings demonstrate that brief mental health training can be effective in reducing mental health systems with at-risk occupational groups.",Castro CA.; Adler AB.; McGurk D.; Bliese PD.,2012.0,10.1002/jts.21721,0,0,
9418,Extinction treatment in multiple contexts attenuates ABC renewal in humans.,"Renewal has been implicated as one of the underlying mechanisms in return of fear following exposure therapy. ABC renewal is clinically more relevant than ABA renewal and yet it is a weaker form of renewal, suggesting that conducting extinction treatment in multiple contexts may be sufficient to attenuate ABC renewal. Using self-reported expectancy of shock and startle blink responses the current study examined the effects of conducting extinction treatment in multiple contexts on ABC fear renewal. Participants (N = 68) received conditional stimulus (CS) and unconditional stimulus (US) pairings in one context (A) followed by extinction treatment (CS presentations alone) in either one other context (B) or three other contexts (BCD). Non-reinforced test trials in a novel context (E) resulted in renewal of extinguished conditioned behaviour for those who received extinction in only one context. However, renewal was attenuated for those who received extinction treatment in three contexts. No renewal was found for the control group that received the test trial in the same context as during extinction. Suggestions are provided for clinicians seeking to prevent or attenuate return of fear following exposure therapy.",Balooch SB.; Neumann DL.; Boschen MJ.,2012.0,10.1016/j.brat.2012.06.003,0,0,
9419,Treatment of panic in chest pain patients from emergency departments: efficacy of different interventions focusing on panic management.,"The aim was to assess the efficacy of two brief cognitive-behavioral therapy (CBT)-based interventions (7√ó1-h sessions and 1√ó2-h session) and a pharmacological treatment (paroxetine), compared to supportive usual care, initiated in the emergency department (ED) for individuals suffering from panic disorder (PD) with a chief complain of noncardiac chest pain (NCCP). We hypothesized that the interventions would be more efficacious than supportive usual care on all outcomes. A 12-month follow-up study of patients who received a diagnosis of NCCP in the ED and who met diagnostic criteria for PD (n=71) was performed. Assessments included several psychological questionnaires and a structured interview. A series of repeated-measures analyses of variances, using a split-plot design, were conducted, as well as planned comparisons to examine the differences. The seven-session CBT (n=19), one-session panic management (n=24) and pharmacotherapy (n=13) led to greater improvements in PD severity (primary outcome) compared to supportive usual care (n=15) at posttest, and no significant difference was noted between the three active interventions. On the other measures, patients improved in all conditions, and the therapeutic gains were maintained up to 1 year following the visit to the ED. These results suggests that early intervention, in particular seven sessions of CBT, one session of PM or pharmacotherapy (generic paroxetine), should be considered for the treatment of PD patients consulting the ED with a discharge diagnosis of NCCP.",Marchand A.; Belleville G.; Fleet R.; Dupuis G.; Bacon SL.; Poitras J.; Chauny JM.; Vadeboncoeur A.; Lavoie KL.,,10.1016/j.genhosppsych.2012.06.011,0,0,
9420,Differential prefrontal gray matter correlates of treatment response to fluoxetine or cognitive-behavioral therapy in obsessive-compulsive disorder.,"Nearly one-third of patients with obsessive-compulsive disorder (OCD) fail to respond to adequate therapeutic approaches such as serotonin reuptake inhibitors and/or cognitive-behavioral therapy (CBT). This study investigated structural magnetic resonance imaging (MRI) correlates as potential pre-treatment brain markers to predict treatment response in treatment-naïve OCD patients randomized between trials of fluoxetine or CBT. Treatment-naïve OCD patients underwent structural MRI scans before randomization to a 12-week clinical trial of either fluoxetine or group-based CBT. Voxel-based morphometry was used to identify correlations between pretreatment regional gray matter volume and changes in symptom severity on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Brain regional correlations of treatment response differed between treatment groups. Notably, symptom improvement in the fluoxetine treatment group (n=14) was significantly correlated with smaller pretreatment gray matter volume within the right middle lateral orbitofrontal cortex (OFC), whereas symptom improvement in the CBT treatment group (n=15) was significantly correlated with larger pretreatment gray matter volume within the right medial prefrontal cortex (mPFC). No significant a priori regional correlations of treatment response were identified as common between the two treatment groups when considering the entire sample (n=29). These findings suggest that pretreatment gray matter volumes of distinct brain regions within the lateral OFC and mPFC were differentially correlated to treatment response to fluoxetine versus CBT in OCD patients. This study further implicates the mPFC in the fear/anxiety extinction process and stresses the importance of lateral portions of the OFC in mediating fluoxetine's effectiveness in OCD. Clinical registration information: http://clinicaltrials.gov-NCT00680602.",Hoexter MQ.; Dougherty DD.; Shavitt RG.; D'Alcante CC.; Duran FL.; Lopes AC.; Diniz JB.; Batistuzzo MC.; Evans KC.; Bressan RA.; Busatto GF.; Miguel EC.,2013.0,10.1016/j.euroneuro.2012.06.014,0,0,
9421,Randomized sham controlled trial of repetitive transcranial magnetic stimulation to the dorsolateral prefrontal cortex for the treatment of panic disorder with comorbid major depression.,"In an open-label trial low-frequency repetitive transcranial magnetic stimulation (rTMS) to the right dorsolateral prefrontal cortex (DLPFC) significantly improved symptoms of panic disorder and major depression. Here we present data of a randomized double-blind study. Twenty-five patients were assigned 4 weeks of active or sham rTMS to the right DLPFC. rTMS parameters consisted of 1800 stimuli/day, 1-Hz, at 110% of resting motor threshold. Response was defined as a ‚â•40% decrease on the panic disorder severity scale and a ‚â•50% decrease on the Hamilton depression rating scale. At the end of the randomized phase, patients were offered the option of receiving open-label rTMS for an additional 4 weeks. Repeated-measures ANOVA revealed significantly better improvement in panic symptoms with active compared with sham rTMS, but no significant difference in depression. At 4 weeks, response rate for panic disorder was 50% with active rTMS and 8% with sham. After 8 weeks of active rTMS, response rate was 67% for panic and 50% for depressive symptoms. Repeated-measure ANOVA showed significant improvements in panic disorder, major depression, clinical global impression, and social adjustment. Clinical improvement was sustained at 6-month follow-up. Limitation of this study is the relatively small sample size. Although 4 weeks of rTMS was sufficient to produce a significant effect in panic symptoms, a longer course of treatment resulted in better outcomes for both panic disorder and major depression. These data suggest that inhibitory rTMS to the right DLPFC affects symptoms expression in comorbid anxiety and depression. ClinicalTrials.gov Identifier: NCT00521352.",Mantovani A.; Aly M.; Dagan Y.; Allart A.; Lisanby SH.,2013.0,10.1016/j.jad.2012.05.038,0,0,
9422,Predicting post-event processing in social anxiety disorder following two prototypical social situations: state variables and dispositional determinants.,"This study investigated self-reported state (anxiety, physical symptoms, cognitions, internally focused attention, safety behaviors, social performance) and trait (social anxiety, depressive symptoms, dysfunctional self-consciousness) predictors of post-event processing (PEP) subsequent to two social situations (interaction, speech) in participants with a primary diagnosis of social anxiety disorder (SAD) and healthy controls (HC). The speech triggered significantly more intense PEP, especially in SAD. Regardless of the type of social situation, PEP was best predicted by situational anxiety and dysfunctional cognitions among the state variables. If only trait variables were considered, PEP following both situations was accounted for by trait social anxiety. In addition, dysfunctional self-consciousness contributed to PEP-speech. If state and trait variables were jointly considered, for both situations, situational anxiety and dysfunctional cognitions were confirmed as the most powerful PEP predictors above and beyond trait social anxiety (interaction) and dysfunctional self-consciousness (speech). Hence, PEP as assessed on the day after a social situation seems to be mainly determined by state variables. Trait social anxiety and dysfunctional self-consciousness also significantly contribute to PEP depending on the type of social situation. The present findings support dysfunctional cognitions as a core cognitive mechanism for the maintenance of SAD. Implications for treatment are discussed.",Kiko S.; Stevens S.; Mall AK.; Steil R.; Bohus M.; Hermann C.,2012.0,10.1016/j.brat.2012.06.001,0,0,
9423,Isolated sternal fractures treated on an outpatient basis.,"The aim of this study is to investigate the need for admission of patients with isolated sternal fracture (ISF) by prospectively and randomly discharging or admitting them. Patients with ISF after the completion of investigations were randomly discharged or admitted. Investigations performed included lateral chest x-ray; chest computed tomography; electrocardiogram; cardiac ultrasound; definition of C-reactive protein; and cardiac enzymes, such as creatine phosphokinase, myocardial branch of creatine phosphokinase, and troponin I (cardiac specific). These investigations were repeated after 6 hours in the admission and the next day in both groups. Forty-two patients were included in the study. Twenty-one were admitted, whereas 21 were discharged. Electrocardiogram and ultrasound were normal in both groups upon presentation and the next day. Creatine phosphokinase and myocardial branch of creatine phosphokinase, although elevated at presentation, were normal the next day and similar in both groups. There was no morbidity, need for surgery, or mortality in both groups during a 6-month follow-up. Patients with ISF can be discharged safely as soon as investigations are completed. Extensive myocardial assessment is not needed on the posttraumatic period. Myocardial involvement seems unlikely in patients with ISF, who can be treated with oral analgesics.",Kouritas VK.; Zisis C.; Vahlas K.; Roussakis AG.; Bellenis I.,2013.0,10.1016/j.ajem.2012.05.027,0,0,
9424,Pain adversely affects outcomes to a collaborative care intervention for anxiety in primary care.,"Primary care patients with Panic Disorder (PD) and Generalized Anxiety Disorder (GAD) experience poorer than expected clinical outcomes, despite the availability of efficacious pharmacologic and non-pharmacologic treatments. A barrier to recovery from PD/GAD may be the co-occurrence of pain. To evaluate whether pain intensity interfered with treatment response for PD and/or GAD in primary care patients who had received collaborative care for anxiety disorders. A secondary data analysis of a randomized, controlled effectiveness trial comparing a telephone-delivered collaborative care intervention for primary care patients with severe PD and/or GAD to their doctor's ""usual"" care. Patients had to have a diagnosis of PD and/or GAD and a severe level of anxiety symptoms. The 124 patients randomized at baseline to the collaborative care intervention were analyzed. Participants were divided into two pain intensity groups based on their response to the SF-36 Bodily Pain scale (none or mild pain vs. at least moderate pain). Pain was assessed using the Bodily Pain scale of the SF-36. Anxiety symptoms were measured with the Hamilton Anxiety Rating Scale (HRS-A), Panic Disorder Severity Scale (PDSS) and Generalized Anxiety Disorder Severity Scale (GADSS). Measures were collected over 12 months. At baseline, patients with at least moderate pain were significantly more likely to endorse more anxiety symptoms on the HRS-A than patients with no pain or mild pain (P‚Äâ<‚Äâ.001). Among patients with severe anxiety symptoms, 65 % (80/124) endorsed experiencing at least moderate pain in the previous month. A significantly lesser number of patients achieved a 50 % improvement at 12 months on the HRS-A and GADSS if they had at least moderate pain as compared to patients with little or no pain (P‚Äâ=‚Äâ0.01 and P‚Äâ=‚Äâ0.04, respectively). Coexisting pain was common in a sample of primary care patients with severe PD/GAD, and appeared to negatively affect response to anxiety treatment.",Morone NE.; Belnap BH.; He F.; Mazumdar S.; Weiner DK.; Rollman BL.,2013.0,10.1007/s11606-012-2186-2,0,0,
9425,Protocol for diaphragm pacing in patients with respiratory muscle weakness due to motor neurone disease (DiPALS): a randomised controlled trial.,"Motor neurone disease (MND) is a devastating illness which leads to muscle weakness and death, usually within 2-3 years of symptom onset. Respiratory insufficiency is a common cause of morbidity, particularly in later stages of MND and respiratory complications are the leading cause of mortality in MND patients. Non Invasive Ventilation (NIV) is the current standard therapy to manage respiratory insufficiency. Some MND patients however do not tolerate NIV due to a number of issues including mask interface problems and claustrophobia. In those that do tolerate NIV, eventually respiratory muscle weakness will progress to a point at which intermittent/overnight NIV is ineffective. The NeuRx RA/4 Diaphragm Pacing System was originally developed for patients with respiratory insufficiency and diaphragm paralysis secondary to stable high spinal cord injuries. The DiPALS study will assess the effect of diaphragm pacing (DP) when used to treat patients with MND and respiratory insufficiency. 108 patients will be recruited to the study at 5 sites in the UK. Patients will be randomised to either receive NIV (current standard care) or receive DP in addition to NIV. Study participants will be required to complete outcome measures at 5 follow up time points (2, 3, 6, 9 and 12 months) plus an additional surgery and 1 week post operative visit for those in the DP group. 12 patients (and their carers) from the DP group will also be asked to complete 2 qualitative interviews. The primary objective of this trial will be to evaluate the effect of Diaphragm Pacing (DP) on survival over the study duration in patients with MND with respiratory muscle weakness. The project is funded by the National Institute for Health Research, Health Technology Assessment (HTA) Programme (project number 09/55/33) and the Motor Neurone Disease Association and the Henry Smith Charity. Current controlled trials ISRCTN53817913. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.",McDermott CJ.; Maguire C.; Cooper CL.; Ackroyd R.; Baird WO.; Baudouin S.; Bentley A.; Bianchi S.; Bourke S.; Bradburn MJ.; Dixon S.; Ealing J.; Galloway S.; Karat D.; Maynard N.; Morrison K.; Mustfa N.; Stradling J.; Talbot K.; Williams T.; Shaw PJ.,2012.0,10.1186/1471-2377-12-74,0,0,
9426,Opposing breathing therapies for panic disorder: a randomized controlled trial of lowering vs raising end-tidal P(CO‚ÇÇ).,"Teaching anxious clients to stop hyperventilating is a popular therapeutic intervention for panic. However, evidence for the theory behind this approach is tenuous, and this theory is contradicted by an opposing theory of panic, the false-suffocation alarm theory, which can be interpreted to imply that the opposite would be helpful. To test these opposing approaches by investigating whether either, both, or neither of the 2 breathing therapies is effective in treating patients with panic disorder. We randomly assigned 74 consecutive patients with DSM-IV-diagnosed panic disorder (mean age at onset = 33.0 years) to 1 of 3 groups in the setting of an academic research clinic. One group was trained to raise its end-tidal P(CO‚ÇÇ) (partial pressure of carbon dioxide, mm Hg) to counteract hyperventilation by using feedback from a hand-held capnometer, a second group was trained to lower its end-tidal P(CO‚ÇÇ) in the same way, and a third group received 1 of these treatments after a delay (wait-list). We assessed patients physiologically and psychologically before treatment began and at 1 and 6 months after treatment. The study was conducted from September 2005 through November 2009. Using the Panic Disorder Severity Scale as a primary outcome measure, we found that both breathing training methods effectively reduced the severity of panic disorder 1 month after treatment and that treatment effects were maintained at 6-month follow-up (effect sizes at 1-month follow-up were 1.34 for the raise-CO(2) group and 1.53 for the lower-CO(2) group; P < .01). Physiologic measurements of respiration at follow-up showed that patients had learned to alter their P(CO‚ÇÇ) levels and respiration rates as they had been taught in therapy. Clinical improvement must have depended on elements common to both breathing therapies rather than on the effect of the therapies themselves on CO(2) levels. These elements may have been changed beliefs and expectancies, exposure to ominous bodily sensations, and attention to regular and slow breathing. ClinicalTrials.gov identifier: NCT00183521.",Kim S.; Wollburg E.; Roth WT.,2012.0,10.4088/JCP.11m07068,0,0,6776
9427,Group music therapy for patients with persistent post-traumatic stress disorder--an exploratory randomized controlled trial with mixed methods evaluation.,"Not all patients with post-traumatic stress disorder (PTSD) respond to cognitive behavioural therapy (CBT). Literature suggests group music therapy might be beneficial in treating PTSD. However, feasibility and effectiveness have not been assessed. The study objectives were to assess whether group music therapy was feasible for patients who did not respond to CBT, and whether it has an effect on PTSD symptoms and depression. The study employed mixed methods comprising of an exploratory randomized controlled trial, qualitative content analysis of therapy, and patient interviews. Patients with significant PTSD symptoms (n = 17) following completion of CBT were randomly assigned to treatment (n = 9) or control groups (n = 8). The treatment group received 10 weeks of group music therapy after which exit interviews were conducted. Control group patients were offered the intervention at the end of the study. Symptoms were assessed on the Impact of Events Scale-Revised and Beck Depression Inventory II at the beginning and end of treatment. Treatment-group patients experienced a significant reduction in severity of PTSD symptoms (-20.18; 95% confidence interval [CI]: [-31.23, -9.12]) and a marginally significant reduction in depression (-11.92; 95%CI: [-24.05, 0.21]) at 10 weeks from baseline compared to the control. Patients viewed music therapy as helpful and reported experiences concur with current literature. Group music therapy appears feasible and effective for PTSD patients who have not sufficiently responded to CBT. Limitations include the small sample size and lack of blinding. Further research should address these limitations, test sustainability, and identify specific factors that address symptoms in treatment.",Carr C.; d'Ardenne P.; Sloboda A.; Scott C.; Wang D.; Priebe S.,2012.0,10.1111/j.2044-8341.2011.02026.x,0,0,
9428,[Total knee arthroplasty in post-traumatic osteoarthritis].,"This study aims to analyse the outcome and the complications after total knee arthroplasty in post-traumatic osteoarthritis in comparison to TKA in patients with degenerative osteoarthritis. In a period of six years 43 patients with a post-traumatic osteoarthritis were treated with a total knee arthroplasty (group PT). 38 (88 %) patients (age median 55 years, 22 female, 16 male) were investigated clinically and radiologically after an average follow-up time of 2.7 years. The OKS (Oxford Knee Score, max. 48 points), the Knee Society Scores ""function"" (max. 100 points) and ""knee"" (max. 100 points) as well as the visual analogue scale (VAS, 0 to 10 points) were recorded preoperatively and at follow-up. For comparison we chose a matched-pair selection of patients with degenerative osteoarthritis and TKA (group DO, age median 63 years, 22 female, 16 male). For statistical analysis we used common parametric tests (Wilcoxon and U test) and a level of significance of 0.05. In 19 patients (50 %) of the group PT the osteoarthritis was caused by a bone injury. Furthermore in 19 patients a meniscal and/or ligamentous injury led to osteoarthritis. Out of all patients of group PT, 10 patients showed a preoperative valgus malalignment higher than 10°. KSS knee and KSS function added up to 76.9 and 84.9 points. So they are significantly less than in the matched group (DO, knee: 86.1; function: 94.4). Similarly, the OKS is significantly less in group PT after follow-up (PT: 32.3; DO: 38.4, p ≤ 0.05) although the preoperative values are equal in both groups. The VAS value decreased significantly in both groups. Initial level of pain was significantly higher in the group DO compared to the group PT. Patients with osteoarthritis after trauma showed complications in 17 cases (^ = 44.7 %) that led to 28 revision operations (^ = 0.7 operations per knee). The group with valgus malalignment had a revision rate of 1.4 operations per knee. In the group DO 8 complications occurred (^ = 21,1 %) that led to 11 revision operations (^=0.3 per knee). The deviation from the ""ideal"" leg axis could be reduced from 3.8° varus to 1.7° varus in the group DO and from 1.3° valgus auf 1.2° valgus in the group PT. Patients with a preoperative valgus deviation > 10° were reduced from 13.6° (± 3.9°) valgus to 0.5° (± 9.2°) varus. Patients after TKA because of post-traumatic osteoarthritis show worse results concerning function and condition compared to patients with degenerative osteoarthritis. Heterogeneous pathogenesis and high rates of revision operations underline the complexity of this group of patients. The treatment has to be adjusted to the patient's requirements as well to the pathoanatomy.",Hepp P.; Klima S.; von Dercks N.; Marquass B.; Jung H.; Josten C.,2012.0,10.1055/s-0032-1314995,0,0,
9429,Effect of cognitive-behavioral therapy on neural correlates of fear conditioning in panic disorder.,"Learning by conditioning is a key ability of animals and humans for acquiring novel behavior necessary for survival in a changing environment. Aberrant conditioning has been considered a crucial factor in the etiology and maintenance of panic disorder with agoraphobia (PD/A). Cognitive-behavioral therapy (CBT) is an effective treatment for PD/A. However, the neural mechanisms underlying the effects of CBT on conditioning processes in PD/A are unknown. In a randomized, controlled, multicenter clinical trial in medication-free patients with PD/A who were treated with 12 sessions of manualized CBT, functional magnetic resonance imaging (fMRI) was used during fear conditioning before and after CBT. Quality-controlled fMRI data from 42 patients and 42 healthy subjects were obtained. After CBT, patients compared to control subjects revealed reduced activation for the conditioned response (CS+ > CS-) in the left inferior frontal gyrus (IFG). This activation reduction was correlated with reduction in agoraphobic symptoms from t1 to t2. Patients compared to control subjects also demonstrated increased connectivity between the IFG and regions of the ""fear network"" (amygdalae, insulae, anterior cingulate cortex) across time. This study demonstrates the link between cerebral correlates of cognitive (IFG) and emotional (""fear network"") processing during symptom improvement across time in PD/A. Further research along this line has promising potential to support the development and further optimization of targeted treatments.",Kircher T.; Arolt V.; Jansen A.; Pyka M.; Reinhardt I.; Kellermann T.; Konrad C.; Lueken U.; Gloster AT.; Gerlach AL.; Ströhle A.; Wittmann A.; Pfleiderer B.; Wittchen HU.; Straube B.,2013.0,10.1016/j.biopsych.2012.07.026,0,0,
9430,Effectiveness of deep transcranial magnetic stimulation combined with a brief exposure procedure in post-traumatic stress disorder--a pilot study.,"Post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder induced by traumatic experiences. To date, psychotherapy and drug treatment achieve only partial success, indicating need for further development of treatment strategies. Recent research has found that impaired acquired fear extinction capability serves as an important factor at the pathogenesis of the disorder. Medial prefrontal cortex (mPFC) hypo-activity has been implicated in this extinction impairment, providing insight as to why some trauma exposed individuals will develop PTSD. To test whether fear extinction can be facilitated and therapeutic effect achieved by repeated mPFC deep transcranial magnetic stimulation (DTMS) of PTSD patients resistant to standard treatment. In a double-blind study, 30 PTSD patients were enrolled and randomly assigned into 3 treatment groups: A) DTMS after brief exposure to the traumatic event with the script-driven imagery procedure; B) DTMS after brief exposure to a non-traumatic event; C) sham stimulation after brief exposure to the traumatic event. Significant improvement was demonstrated in the intrusive component of the CAPS scale in patients administered DTMS after exposure to the traumatic event script, while patients in the control groups showed no significant improvement. Similar trend was demonstrated in the Total-CAPS score as in the other rating scales. A significant reduction in the HR response to the traumatic script was evident in group A, further supporting the above results. Combining brief script-driven exposure with DTMS can induce therapeutic effects in PTSD patients. A wide multi-center study is suggested to substantiate these findings. ClinicalTrials.gov identifier: NCT00517400.",Isserles M.; Shalev AY.; Roth Y.; Peri T.; Kutz I.; Zlotnick E.; Zangen A.,2013.0,10.1016/j.brs.2012.07.008,0,0,
9431,Group therapy with male asylum seekers and refugees with posttraumatic stress disorder: a controlled comparison cohort study of three day-treatment programs.,"Studies on group treatment of posttraumatic stress disorder (PTSD) in asylum seekers and refugees are scarce. The aim of this study was to evaluate the effectiveness of three different trauma-focused day-treatment group programs for treatment of PTSD in male asylum seekers and refugees. Three treatment groups (n = 56) and a waitlisted control group (n = 16) of help-seeking Iranian and Afghani patients were assessed with a set of self-rated symptom checklists for PTSD, anxiety, depression, and psychoticism 1 week before and 2 weeks after treatment. There are no indications that the 2 days' group program with three nonverbal and two group psychotherapy sessions per week is less effective in reducing symptoms than the program with the same amount of sessions spread over 3 days per week. The trauma-focused day-treatment group seems a promising approach for treatment of PTSD among asylum seekers and refugees in industrialized settings.",Drožđek B.; Kamperman AM.; Bolwerk N.; Tol WA.; Kleber RJ.,2012.0,10.1097/NMD.0b013e318266f860,0,0,
9432,"Development of posttraumatic empyema in patients with retained hemothorax: results of a prospective, observational AAST study.","The natural history of retained hemothorax (RH), in particular factors contributing to the subsequent development of empyema, is not well known. The intent of our study was to establish the modern incidence of empyema among patients with trauma and RH and identify the independent predictors for development of this complication. An American Association for the Surgery of Trauma multicenter prospective observational trial was conducted, enrolling patients with placement of a thoracostomy tube within 24 hours of trauma admission, and subsequent development of RH was confirmed on computed tomography of the chest. Demographics, interventions, and outcomes were analyzed. Logistic regression analysis was used to identify the independent predictors for the development of empyema. Among 328 patients with posttraumatic RH from the 20 participating centers, overall incidence of empyema was 26.8% (n = 88). On regression analysis, the presence of rib fractures (adjusted odds ratio [OR], 2.3; 95% confidence interval [CI], 1.3-4.1; p = 0.006), Injury Severity Score of 25 or higher (adjusted OR, 2.4; 95% CI, 1.3-4.4; p = 0.005), and the need for any additional therapeutic intervention (adjusted OR, 28.8; 95% CI, 6.6-125.5; p < 0.001) were found to be independent predictors for the development of empyema for patients with posttraumatic RH. Patients with empyema also had a significantly longer adjusted intensive care unit stay (adjusted mean difference, 4.1; 95% CI, 1.3-6.9; p = 0.008) and hospital stay (adjusted mean difference, -7.9; 95% CI, -12.7 to -3.2; p = 0.01). Among patients with trauma and posttraumatic RH, the incidence of empyema was 26.8%. Independent predictors of empyema development after posttraumatic RH included the presence of rib fractures, Injury Severity Score of 25 or higher, and the need for additional interventions to evacuate retained blood from the thorax. Our findings highlight the need to minimize the risk associated with subsequent thoracic procedures among patients with critical illness and RH, through selection of the most optimal procedure for initial evacuation. Prognostic study, level III.",DuBose J.; Inaba K.; Okoye O.; Demetriades D.; Scalea T.; O'Connor J.; Menaker J.; Morales C.; Shiflett T.; Brown C.; Copwood B.;  .,2012.0,10.1097/TA.0b013e31825c1616,0,0,
9433,Effectiveness and cost-effectiveness of web-based treatment for phobic outpatients on a waiting list for psychotherapy: protocol of a randomised controlled trial.,"Phobic disorders are highly prevalent and constitute a considerable burden for patients and society. As patients wait for face-to-face psychotherapy for phobic disorders in outpatient clinics, this time can be used for guided self-help interventions. The aim of this study is to investigate a five week internet-based guided self-help programme of exposure therapy in terms of clinical effectiveness and impact on speed of recovery in psychiatric outpatients, as well as the cost-effectiveness of this pre-treatment waiting list intervention. A randomised controlled trial will be conducted among 244 Dutch adult patients recruited from waiting lists of outpatient clinics for face-to-face psychotherapy for phobic disorders. Patients suffering from at least one DSM-IV classified phobic disorder (social phobia, agoraphobia or specific phobia) are randomly allocated (at a 1:1 ratio) to either a five-week internet-based guided self-help program followed by face-to-face psychotherapy, or a control group followed by face-to-face psychotherapy. Waiting list status and duration are unchanged and actual need for further treatment is evaluated prior to face-to-face psychotherapy. Clinical and economic self-assessment measurements take place at baseline, post-test (five weeks after baseline) and at 3, 6, 9 and 12 months after baseline. Offering pre-treatment internet-based guided self-help efficiently uses time otherwise lost on a waiting list and may increase patient satisfaction. Patients are expected to need fewer face-to-face sessions, reducing total treatment cost and increasing speed of recovery. Internet-delivered treatment for phobias may be a valuable addition to psychotherapy as demand for outpatient treatment increases while budgets decrease. Netherlands Trial Register NTR2233.",Kok RN.; van Straten A.; Beekman A.; Bosmans J.; de Neef M.; Cuijpers P.,2012.0,10.1186/1471-244X-12-131,0,0,
9434,Efficacy of writing for recovery on traumatic grief symptoms of Afghani refugee bereaved adolescents: a randomized control trial.,"Effective evidence-based intervention for traumatic bereavement is one of the current major research issues in the field of Post Traumatic Stress Disorder (PTSD) in children and adolescents. The ""Writing for Recovery"" group intervention is a new treatment approach developed by the Children and War Foundation for traumatized and bereaved children and adolescents after disasters. The purpose of this project was an empirical examination of this intervention with 12- to 18-year-old war bereaved Afghani refugees. Eighty-eight war bereaved Afghani refugees were screened using the Traumatic Grief Inventory for Children (TGIC). From those with the highest total score, 61 were randomly assigned to either an experimental (n = 29) or control group (n = 32). The experimental group received six sessions of group training on 3 consecutive days in their school. The difference of TGIC scores between the experimental group in pretest and posttest was significant (p = 0.001). Results of analysis of covariance also showed a significant effect of Writing for Recovery on the experimental group (p < 0.001). It is concluded that ""Writing for Recovery"" is an effective group intervention for bereaved children and adolescents after disasters.",Kalantari M.; Yule W.; Dyregrov A.; Neshatdoost H.; Ahmadi SJ.,2012.0,10.2190/OM.65.2.d,0,0,
9435,"A comparison of cognitive bias modification for interpretation and computerized cognitive behavior therapy: effects on anxiety, depression, attentional control, and interpretive bias.","Computerized cognitive behavioral therapy (cCBT) and cognitive bias modification for interpretation (CBM-I) both have demonstrated efficacy in alleviating social anxiety, but how they compare with each other has not been investigated. The present study tested the prediction that both interventions would reduce anxiety relative to a no-intervention comparison condition, but CBM-I would be particularly effective at modifying threat-related cognitive bias under high mental load. Sixty-three primarily Caucasian adults (mean age = 22.7, SD = 5.87; 68.3% female) with high social anxiety, randomly allocated to 3 groups: CBM-I (n = 21), cCBT (n = 21), and a no-intervention control group (n = 21) provided complete data for analysis. Pre- and postintervention (4 sessions lasting 2 weeks, control participants only attended the pre-post sessions) self-report measures of anxiety, depression, attentional control, and threat-related interpretive bias were completed. In addition, interpretive bias under high versus low cognitive load was measured using the Scrambled Sentences Test. Both CBM-I and cCBT groups reported significantly reduced levels of social anxiety, trait anxiety, and depression and improved attentional control, relative to the control group, with no clear superiority of either active intervention. Although both active conditions reduced negative bias on the Scrambled Sentences Test completed under mental load, CBM-I was significantly more effective at doing so. The results suggest that although not differing in therapeutic efficacy, CBM-I and cCBT might differ in the resilience of their effects when under mental load.",Bowler JO.; Mackintosh B.; Dunn BD.; Mathews A.; Dalgleish T.; Hoppitt L.,2012.0,10.1037/a0029932,0,0,
9436,The explanatory models of depression and anxiety in primary care: a qualitative study from India.,"The biggest barrier to treatment of common mental disorders in primary care settings is low recognition among health care providers. This study attempts to explore the explanatory models of common mental disorders (CMD) with the goal of identifying how they could help in improving the recognition, leading to effective treatment in primary care. The paper describes findings of a cross sectional qualitative study nested within a large randomized controlled trial (the Manas trial). Semi structured interviews were conducted with 117 primary health care attendees (30 males and 87 females) suffering from CMD. Main findings of the study are that somatic phenomena were by far the most frequent presenting problems; however, psychological phenomena were relatively easily elicited on probing. Somatic phenomena were located within a biopsychosocial framework, and a substantial proportion of informants used the psychological construct of 'tension' or 'worry' to label their illness, but did not consider themselves as suffering from a 'mental disorder'. Very few gender differences were observed in the descriptions of symptoms but at the same time the pattern of adverse life events and social difficulties varied across gender. Our study demonstrates how people present their illness through somatic complaints but clearly link their illness to their psychosocial world. However they do not associate their illness to a 'mental disorder' and this is an important phenomenon that needs to be recognized in management of CMD in primary settings. Our study also elicits important gender differences in the experience of CMD.",Andrew G.; Cohen A.; Salgaonkar S.; Patel V.,2012.0,10.1186/1756-0500-5-499,0,0,
9437,A preliminary investigation of stimulus control training for worry: effects on anxiety and insomnia.,"For individuals with generalized anxiety disorder, worry becomes associated with numerous aspects of life (e.g., time of day, specific stimuli, environmental cues) and is thus under poor discriminative stimulus control (SC). In addition, excessive worry is associated with anxiety, depressed mood, and sleep difficulties. This investigation sought to provide preliminary evidence for the efficacy of SC procedures in reducing anxiety-, mood-, and sleep-related symptoms. A total of 53 participants with high trait worry were randomly assigned to receive 2 weeks of either SC training (consisting of a 30-min time- and place-restricted worry period each day) or a control condition called focused worry (FW; consisting of instructions to not avoid naturally occurring worry so that worry and anxiety would not paradoxically increase). At post-training, SC was superior to FW in producing reductions on measures of worry, anxiety, negative affect, and insomnia, but not on measures of depression or positive affect. Moreover, SC was superior to FW in producing clinically significant change on measures of worry and anxiety. Results provide preliminary support for the use of SC training techniques in larger treatment packages for individuals who experience high levels of worry.",McGowan SK.; Behar E.,2013.0,10.1177/0145445512455661,0,0,
9438,Ending homelessness among people with mental illness: the At Home/Chez Soi randomized trial of a Housing First intervention in Toronto.,"The At Home/Chez Soi (AH/CS) Project is a randomized controlled trial of a Housing First intervention to meet the needs of homeless individuals with mental illness in five cities across Canada. The objectives of this paper are to examine the approach to participant recruitment and community engagement at the Toronto site of the AH/CS Project, and to describe the baseline demographics of participants in Toronto. Homeless individuals (n‚Äâ=‚Äâ575) with either high needs (n‚Äâ=‚Äâ197) or moderate needs (n‚Äâ=‚Äâ378) for mental health support were recruited through service providers in the city of Toronto. Participants were randomized to Housing First interventions or Treatment as Usual (control) groups. Housing First interventions were offered at two different mental health service delivery levels: Assertive Community Treatment for high needs participants and Intensive Case Management for moderate needs participants. Demographic data were collected via quantitative questionnaires at baseline interviews. The effectiveness of the recruitment strategy was influenced by a carefully designed referral system, targeted recruitment of specific groups, and an extensive network of pre-existing services. Community members, potential participants, service providers, and other stakeholders were engaged through active outreach and information sessions. Challenges related to the need for different sectors to work together were resolved through team building strategies. Randomization produced similar demographic, mental health, cognitive and functional impairment characteristics in the intervention and control groups for both the high needs and moderate needs groups. The majority of participants were male (69%), aged >40 years (53%), single/never married (69%), without dependent children (71%), born in Canada (54%), and non-white (64%). Many participants had substance dependence (38%), psychotic disorder (37%), major depressive episode (36%), alcohol dependence (29%), post-traumatic stress disorder (PTSD) (23%), and mood disorder with psychotic features (21%). More than two-thirds of the participants (65%) indicated some level of suicidality. Recruitment at the Toronto site of AH/CS project produced a sample of participants that reflects the diverse demographics of the target population. This study will provide much needed data on how to best address the issue of homelessness and mental illness in Canada.",Hwang SW.; Stergiopoulos V.; O'Campo P.; Gozdzik A.,2012.0,10.1186/1471-2458-12-787,0,0,
9439,Comparing telehealth-based and clinic-based group cognitive behavioral therapy for adults with depression and anxiety: a pilot study.,"The primary objective of this pilot study was to demonstrate reliable adherence to a group cognitive behavioral (CBT) therapy protocol when delivered using on-line video conferencing as compared with face-to-face delivery of group CBT. A secondary aim was to show comparability of changes in subject depression inventory scores between on-line and face-to-face delivery of group CBT. We screened 31 individuals, 18 of whom met the criteria for a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) diagnosis of mood and/or anxiety disorder. All qualifying participants had the necessary equipment (computer, webcam, Internet) for participation in the study, but could exercise their preference for either the on-line or face-to-face format. Eighteen completed the 13 weekly session intervention program (ten face-to-face; eight video conferencing). We coded adherence to protocol in both intervention formats and generated pre-post changes in scores on the Beck Depression Inventory Second Edition (BDI-II) for each participant. Application of the CBT protocol coding system showed reliable adherence to the group CBT intervention protocol in both delivery formats. Similarly, qualitative analysis of the themes in group discussion indicated that both groups addressed similar issues. Pre-post intervention scores for the BDI-II were comparable across the two delivery formats, with 60% of participants in each group showing a positive change in BDI-II severity classification (eg, from moderate to low symptoms). This pilot study demonstrates that group CBT could be delivered in a technology-supported environment (on-line video conferencing) and can meet the same professional practice standards and outcomes as face-to-face delivery of the intervention program.",Khatri N.; Marziali E.; Tchernikov I.; Shepherd N.,2014.0,10.2147/CIA.S57832,0,0,
9440,A clinical trial of cranial electrotherapy stimulation for anxiety and comorbid depression.,"Anxiety disorders are among the most prevalent mental disorders and are usually treated with medication and/or psychotherapy. When anxiety disorders are accompanied with comorbid depression, this further complicates the treatment process. Medication compliance is a common problem due to adverse side effects and new and effective treatments that have minimal side effects are needed for the treatment of anxiety and depression. This study used a randomized, double-blind, sham controlled design to examine the effectiveness of CES as a treatment for anxiety disorders and comorbid depression in a primary care setting. The study was registered at clinicaltrials.gov, NCT01533415. One hundred and fifteen participants, age 18 years and over, with a primary diagnosis of an anxiety disorder were enrolled from February 2012 to December 2012 The Hamilton Rating Scale for Anxiety (HAM-A) and the Hamilton Depression Rating Scale17 (HAM-D17) were used for baseline and outcome measures at weeks one, three, and five. Response to treatment was defined as a reduction of ‚â•50% or more on these measures. Analysis of covariance revealed a significant difference between the active CES group and the sham CES group on anxiety (p=0.001, d=0.94) and on depression (p=0.001, d=0.78) from baseline to endpoint of study in favor of the active CES group. CES significantly decreases anxiety and comorbid depression. Subjects reported no adverse events during the study.",Barclay TH.; Barclay RD.,2014.0,10.1016/j.jad.2014.04.029,0,0,
9441,Psycho-echo-biofeedback: a novel treatment for anismus--results of a prospective controlled study.,"Anismus or non-relaxing puborectalis muscle (PRM), detectable with anal/vaginal ultrasound (US), is a cause of obstructed defecation (OD) and may be treated with biofeedback (BFB). Many patients with anismus are anxious and/or depressed. The aim of this prospective study was to evaluate the outcome of the novel procedure psycho-echo-BFB in patients with anismus and psychological disorders. Patients presenting at our unit with anismus and psychological disorders between January 2009 and December 2013, and not responding to conventional conservative treatment, were enrolled in the study. All underwent four sessions of psycho-echo-BFB, carried out by two psychologists and a coloproctologist, consisting of guided imagery, relaxation techniques and anal/vaginal US-assisted BFB. A validated score for OD was used, and PRM relaxation on straining measured before and after the treatment. PRM relaxation was also measured in a control group of 7 patients with normal bowel habits. Ten patients (8 females, median age 47 years, range 26-72 years) underwent psycho-echo-BFB. The OD score, evaluated prior to and at a median of 25 months (range 1-52 months) after the treatment, improved in 7 out of 10 patients, from 13.5 ± 1.2 to 9.6 ± 2.2 (mean ± standard error of the mean (SEM)), p = 0.06. At the end of the last session, PRM relaxed on straining in all cases, from 0 to 7.1 ± 1.1 mm, i.e., physiological values, not statistically different from those of controls (6.6 ± 1.5 mm). Two patients reported were cured, 3 improved and 5, all of whom had undergone prior anorectal surgery, unchanged. No side effects were reported. Psycho-echo-BFB is safe and inexpensive and allows all patients with anismus to relax PRM on straining. Previous anorectal surgery may be a negative predictor.",Del Popolo F.; Cioli VM.; Plevi T.; Pescatori M.,2014.0,10.1007/s10151-014-1154-8,0,0,
9442,Cognitive-behavioral therapy for panic disorder with agoraphobia in older people: a comparison with younger patients.,"Older adults with panic disorder and agoraphobia (PDA) are underdiagnosed and undertreated, while studies of cognitive-behavioral therapy (CBT) are lacking. This study compares the effectiveness of CBT for PDA in younger and older adults. A total of 172 patients with PDA (DSM-IV) received manualized CBT. Primary outcome measures were avoidance behavior (Mobility Inventory Avoidance scale) and agoraphobic cognitions (Agoraphobic Cognitions Questionnaire), with values of the younger (18-60 years) and older (≥ 60 years) patients being compared using mixed linear models adjusted for baseline inequalities, and predictive effects of chronological age, age at PDA onset and duration of illness (DOI) being examined using multiple linear regressions. Attrition rates were 2/31 (6%) for the over-60s and 31/141 (22%) for the under-60s group (χ(2) = 3.43, df = 1, P = .06). Patients in both age groups improved on all outcome measures with moderate-to-large effect sizes. Avoidance behavior had improved significantly more in the 60+ group (F = 4.52, df = 1,134, P = .035), with agoraphobic cognitions showing no age-related differences. Baseline severity of agoraphobic avoidance and agoraphobic cognitions were the most salient predictors of outcome (range standardized betas 0.59 through 0.76, all P-values < .001). Apart from a superior reduction of agoraphobic avoidance in the 60+ participants (β = -0.30, P = .037), chronological age was not related to outcome, while in the older patients higher chronological age, late-onset type and short DOI were linked to superior improvement of agoraphobic avoidance. CBT appears feasible for 60+ PDA-patients, yielding outcomes that are similar and sometimes even superior to those obtained in younger patients.",Hendriks GJ.; Kampman M.; Keijsers GP.; Hoogduin CA.; Voshaar RC.,2014.0,10.1002/da.22274,0,0,
9443,An open trial of videoconference-mediated exposure and ritual prevention for obsessive-compulsive disorder.,"The gold-standard treatment for OCD is exposure and ritual prevention (ERP), yet despite its well-established efficacy, only a small percentage of OCD patients have access to this treatment. Remote treatments (e.g., videoconferencing) are becoming increasingly popular avenues for treatment delivery and show promise in increasing patient access to evidence-based mental health care. The current pilot study utilized an open trial to examine the feasibility and preliminary efficacy of videoconference-mediated, twice weekly, ERP for adults (n=15) with OCD. Results revealed that ERP was associated with significant improvements in OCD symptoms and large within-group effect sizes. Among the 10 individuals who completed a 3-month follow-up assessment, 30% of participants no longer met DSM-IV-TR criteria for OCD and 80% of participants were rated as very much or much improved on the CGI. This study adds to the growing body of literature suggesting that videoconference-based interventions are viable alternatives to face-to-face treatment.",Goetter EM.; Herbert JD.; Forman EM.; Yuen EK.; Thomas JG.,2014.0,10.1016/j.janxdis.2014.05.004,0,0,
9444,Downtime after critical incidents in emergency medical technicians/paramedics.,"Effective workplace-based interventions after critical incidents (CIs) are needed for emergency medical technicians (EMT)/paramedics. The evidence for a period out of service post-CI (downtime) is sparse; however it may prevent posttraumatic stress disorder (PTSD) and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores). Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between <30 minutes and end of shift, with >1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.",Halpern J.; Maunder RG.; Schwartz B.; Gurevich M.,2014.0,10.1155/2014/483140,0,0,
9445,"Examining mechanisms of change in a yoga intervention for women: the influence of mindfulness, psychological flexibility, and emotion regulation on PTSD symptoms.","This study explored possible mechanisms through which symptoms of posttraumatic stress disorder (PTSD) were reduced in a randomized controlled trial comparing the effect of a yoga intervention with an assessment control. We examined whether changes in psychological flexibility, mindfulness, and emotion regulation strategies (expressive suppression and reappraisal) were associated with posttreatment PTSD symptoms for 38 women with Diagnostic and Statistical Manual of Mental Disorders Fourth Edition full or subthreshold PTSD. Hierarchical linear regression models revealed that expressive suppression significantly decreased for the yoga group relative to the assessment control. Psychological flexibility increased significantly for the control but not yoga group. However, increases in psychological flexibility were associated with decreases in PTSD symptoms for the yoga but not control group. Preliminary findings suggest that yoga may reduce expressive suppression and may improve PTSD symptoms by increasing psychological flexibility. More research is needed to replicate and extend these findings.",Dick AM.; Niles BL.; Street AE.; DiMartino DM.; Mitchell KS.,2014.0,10.1002/jclp.22104,0,0,
9446,Psychiatric and neurologic risk factors for incident cases of new-onset epilepsy in older adults: data from U.S. Medicare beneficiaries.,"Neurologic diseases such as stroke are risk factors for new-onset epilepsy in older adults. Recent evidence suggests that psychiatric disorders independently predict epilepsy in older male veterans. Our aim was to examine the relationship between these disorders in a population-based study of older adults that also included women and minorities. We used a national 5% random sample of 2005 Medicare beneficiaries including all 50 US states and Washington, DC. Beneficiaries were 65 years of age or older, with continuous Medicare Part A and Part B coverage and not in managed care plans. Epilepsy cases were identified from claims for physician visits, hospitalizations, and outpatient procedures. We used logistic regressions for the overall sample and stratified by gender to determine whether risk of new-onset epilepsy was associated with prior history of psychiatric (i.e., depression, psychosis, bipolar disorder, schizophrenia, posttraumatic stress disorder (PTSD), adjustment disorder, and substance abuse/dependence) and neurologic conditions (i.e., cerebrovascular disease, dementia, traumatic brain injury, brain tumor, metastatic cancer). Preexisting psychiatric disorders were significantly associated with new-onset epilepsy in the study population as were the neurologic conditions evaluated. Five of the seven psychiatric disorders examined were independently associated with new-onset epilepsy; substance abuse, psychosis, bipolar disorder, schizophrenia, and depression. Gender interaction effects were found for substance abuse/dependence and brain tumors. Both neurologic and psychiatric factors significantly predicted new-onset epilepsy in a population-based sample of male and female older adults. These results support earlier findings and extend the understanding of risk models for new-onset epilepsy in broader older adult populations.",Martin RC.; Faught E.; Richman J.; Funkhouser E.; Kim Y.; Clements K.; Pisu M.,2014.0,10.1111/epi.12649,0,0,
9447,The Indiana University Cognitive Health Outcomes Investigation of the Comparative Effectiveness of dementia screening (CHOICE) study: study protocol for a randomized controlled trial.,"Dementia affects over 4 million people in the US and is frequently unrecognized and underdiagnosed in primary care. Routine dementia screening in primary care is not recommended by the US Preventive Services Task Force due to lack of empirical data on the benefits and harms of screening. This trial seeks to fill this gap and contribute information about the benefits, harms, and costs of routine screening for dementia in primary care. Single-blinded, parallel, randomized controlled clinical trial with 1:1 allocation. A total of 4,000 individuals aged ‚â•65 years without a diagnosis of dementia, cognitive impairment, or serious mental illness receiving care at primary care practices within two cities in Indiana. Subjects will be randomized to either i) screening for dementia using the Memory Impairment Screen Telephone version or ii) no screening for dementia. Subjects who screen positive for dementia will be referred to the local Aging Brain Care program that delivers an evidence-based collaborative care model for dementia and depression. Research assistants will administer the 15-item Health Utility Index, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Medical Outcomes Study at baseline, 1, 6, and 12 months. Information about advanced care planning will be collected at baseline and 12 months. All enrollees' medical records will be reviewed to collect data on health care utilization and costs. We have two primary hypotheses; first, in comparison to non-screened subjects, those who are screened and referred to a dementia collaborative care program will have a higher health-related quality of life as measured by the Health Utility Index at 12 months post-screening. Second, in comparison to non-screened subjects, those who are screened and referred to a dementia collaborative care program will not have higher depression or anxiety at one month post-screening as measured by the Patient Health Questionnaire and Generalized Anxiety Disorder Scale scales. Our secondary hypothesis is that screened subjects will have an Incremental Cost-Effectiveness Ratio below the maximum acceptable threshold of $60,000 per quality adjusted life year saved at 12 months. Ongoing; registered on September 19, 2012. ClinicalTrials.gov Identifier: 2012 NCT01699503.",Fowler NR.; Harrawood A.; Frame A.; Perkins AJ.; Gao S.; Callahan CM.; Sachs GA.; French DD.; Boustani MA.,2014.0,10.1186/1745-6215-15-209,0,0,
9448,Aerobic Exercise Reduces Symptoms of Posttraumatic Stress Disorder: A Randomized Controlled Trial.,"Evidence suggests aerobic exercise has anxiolytic effects; yet, the treatment potential for posttraumatic stress disorder (PTSD) and responsible anxiolytic mechanisms have received little attention. Emerging evidence indicates that attentional focus during exercise may dictate the extent of therapeutic benefit. Whether benefits are a function of attentional focus toward or away from somatic arousal during exercise remains untested. Thirty-three PTSD-affected participants completed two weeks of stationary biking aerobic exercise (six sessions). To assess the effect of attentional focus, participants were randomized into three exercise groups: group 1 (attention to somatic arousal) received prompts directing their attention to the interoceptive effects of exercise, group 2 (distraction from somatic arousal) watched a nature documentary, and group 3 exercised with no distractions or interoceptive prompts. Hierarchal linear modeling showed all groups reported reduced PTSD and anxiety sensitivity (AS; i.e., fear of arousal-related somatic sensations) during treatment. Interaction effects between group and time were found for PTSD hyperarousal and AS physical and social scores, wherein group 1, receiving interoceptive prompts, experienced significantly less symptom reduction than other groups. Most participants (89%) reported clinically significant reductions in PTSD severity after the two-week intervention. Findings suggest, regardless of attentional focus, aerobic exercise reduces PTSD symptoms.",Fetzner MG.; Asmundson GJ.,2015.0,10.1080/16506073.2014.916745,0,0,
9449,Combined medication and CBT for generalized anxiety disorder with African American participants: reliability and validity of assessments and preliminary outcomes.,"Using data from a study of combined cognitive behavioral therapy (CBT) and venlafaxine XR in the treatment of generalized anxiety disorder (GAD), the current article examines the reliability and convergent validity of scales, and preliminary outcomes, for African American compared with European American patients. Internal consistency and short-term stability coefficients for African Americans (n=42) were adequate and similar or higher compared with those found for European Americans (n=164) for standard scales used in GAD treatment research. Correlations among outcome measures among African Americans were in general not significantly different for African Americans compared with European Americans. A subset of patients with DSM-IV-diagnosed GAD (n=24 African Americans; n=52 European Americans) were randomly selected to be offered the option of adding 12 sessions of CBT to venlafaxine XR treatment. Of those offered CBT, 33.3% (n=8) of the African Americans and 32.6% (n=17) of the European Americans accepted and attended at least one CBT treatment session. The outcomes for African Americans receiving combined treatment were not significantly different from European Americans receiving combined treatment on primary or secondary efficacy measures.",Markell HM.; Newman MG.; Gallop R.; Gibbons MB.; Rickels K.; Crits-Christoph P.,2014.0,10.1016/j.beth.2014.02.008,0,0,
9450,Theory of mind impairments in social anxiety disorder.,"Social anxiety disorder (SAD) is a common psychiatric disorder characterized by a persistent, excessive fear and avoidance of social and performance situations. Research on cognitive biases indicates individuals with SAD may lack an accurate view of how they are perceived by others, especially in social situations when they allocate important attentional resources to monitoring their own actions as well as external threat. In the present study, we explored whether socially anxious individuals also have impairments in theory of mind (ToM), or the ability to comprehend others' mental states, including emotions, beliefs, and intentions. Forty socially anxious and 40 non-socially-anxious comparison participants completed two ToM tasks: the Reading the Mind in the Eyes and the Movie for the Assessment of Social Cognition. Participants with SAD performed worse on ToM tasks than did non-socially-anxious participants. Relative to comparison participants, those with SAD were more likely to attribute more intense emotions and greater meaning to what others were thinking and feeling. These group differences were not due to interpretation bias. The ToM impairments in people with SAD are in the opposite direction of those in people with autism spectrum conditions whose inferences about the mental states of other people are absent or very limited. This association between SAD and ToM may have important implications for our understanding of both the maintenance and treatment of social anxiety disorder.",Hezel DM.; McNally RJ.,2014.0,10.1016/j.beth.2014.02.010,0,0,
9451,Cost utility analysis of a collaborative stepped care intervention for panic and generalized anxiety disorders in primary care.,"Generalized anxiety and panic disorders are a burden on the society because they are costly and have a significant adverse effect on quality of life. The aim of this study was to evaluate the cost-utility of a collaborative stepped care intervention for panic disorder and generalized anxiety disorder in primary care compared to care as usual from a societal perspective. The design of the study was a two armed cluster randomized controlled trial. In total 43 primary care practices in the Netherlands participated in the study. Eventually, 180 patients were included (114 collaborative stepped care, 66 care as usual). Baseline measures and follow-up measures (3, 6, 9 and 12 months) were assessed using questionnaires. We applied the TiC-P, the SF-HQL and the EQ-5D respectively measuring health care utilization, production losses and health related quality of life. The average annual direct medical costs in the collaborative stepped care group were 1854 Euro (95% C.I., 1726 to 1986) compared to €1503 (95% C.I., 1374 to 1664) in the care as usual group. The average quality of life years (QALYs) gained was 0.05 higher in the collaborative stepped care group, leading to an incremental cost effectiveness ratio (ICER) of 6965 Euro per QALY. Inclusion of the productivity costs, consequently reflecting the full societal costs, decreased the ratio even more. The study showed that collaborative stepped care was a cost effective intervention for panic disorder and generalized anxiety disorder and was even dominant when a societal perspective was taken. trialregister.nl, Netherlands Trial Register NTR107.",Goorden M.; Muntingh A.; van Marwijk H.; Spinhoven P.; Adèr H.; van Balkom A.; van der Feltz-Cornelis C.; Hakkaart-van Roijen L.,2014.0,10.1016/j.jpsychores.2014.04.005,0,0,
9452,Cognitive processing therapy for posttraumatic stress disorder delivered to rural veterans via telemental health: a randomized noninferiority clinical trial.,"To compare clinical and process outcomes of cognitive processing therapy-cognitive only version (CPT-C) delivered via videoteleconferencing (VTC) to in-person in a rural, ethnically diverse sample of veterans with posttraumatic stress disorder (PTSD). A randomized clinical trial with a noninferiority design was used to determine if providing CPT-C via VTC is effective and ""as good as"" in-person delivery. The study took place between March 2009 and June 2013. PTSD was diagnosed per DSM-IV. Participants received 12 sessions of CPT-C via VTC (n = 61) or in-person (n = 64). Assessments were administered at baseline, midtreatment, immediately posttreatment, and 3 and 6 months posttreatment. The primary clinical outcome was posttreatment PTSD severity, as measured by the Clinician-Administered PTSD Scale. Clinical and process outcomes found VTC to be noninferior to in-person treatment. Significant reductions in PTSD symptoms were identified at posttreatment (Cohen d = 0.78, P < .05) and maintained at 3- and 6-month follow-up (d = 0.73, P < .05 and d = 0.76, P < .05, respectively). High levels of therapeutic alliance, treatment compliance, and satisfaction and moderate levels of treatment expectancies were reported, with no differences between groups (for all comparisons, F < 1.9, P > .17). Providing CPT-C to rural residents with PTSD via VTC produced outcomes that were ""as good as"" in-person treatment. All participants demonstrated significant reductions in PTSD symptoms posttreatment and at follow-up. Results indicate that VTC can offer increased access to specialty mental health care for residents of rural or remote areas. ClinicalTrials.gov identifier: NCT00879255.",Morland LA.; Mackintosh MA.; Greene CJ.; Rosen CS.; Chard KM.; Resick P.; Frueh BC.,2014.0,10.4088/JCP.13m08842,0,0,
9453,PTSD is negatively associated with physical performance and physical function in older overweight military Veterans.,"This study examines the effect of posttraumatic stress disorder (PTSD) on function and physical performance in older overweight military Veterans with comorbid conditions. This is a secondary data analysis of older Veterans (mean age = 62.9 yr) participating in a physical activity counseling trial. Study participants with PTSD (n = 67) and without PTSD (n = 235) were identified. Self-reported physical function (36-item Short Form Health Survey) and directly measured physical performance (mobility, aerobic endurance, strength) were assessed. Multivariate analyses of variance controlling for demographic factors and psychiatric disorders demonstrated significant physical impairment among those with PTSD. PTSD was negatively associated with self-reported physical function, functioning in daily activities, and general health (p < 0.01). Those with PTSD also performed significantly worse on tests of lower-limb function (p < 0.05). Despite being significantly younger, Veterans with PTSD had comparable scores on gait speed, aerobic endurance, grip strength, and bodily pain compared with Veterans without PTSD. This study provides preliminary data for the negative association between PTSD and physical function in older military Veterans. These data highlight the importance of ongoing monitoring of physical performance among returning Veterans with PTSD and intervening in older overweight Veterans with PTSD, whose physical performance scores are indicative of accelerated risk of premature functional aging.",Hall KS.; Beckham JC.; Bosworth HB.; Sloane R.; Pieper CF.; Morey MC.,2014.0,10.1682/JRRD.2013.04.0091,0,0,
9454,Prospectively assessed clinical outcomes in concussive blast vs nonblast traumatic brain injury among evacuated US military personnel.,"Blast injury has been identified as the signature injury in the conflicts in Iraq and Afghanistan. However it remains to be determined whether fundamental differences may exist between blast-related traumatic brain injury (TBI) and TBI due to other mechanisms. To determine similarities and differences between clinical outcomes in US military personnel with blast-related vs. non-blast-related concussive TBI and to identify the specific domains of impairment that best correlate with overall disability. Prospective cohort study involving active duty US Military personnel evacuated from Iraq or Afghanistan to Landstuhl Regional Medical Center, in Landstuhl, Germany. Four groups of participants were enrolled from 2010 to 2013: (1) blast plus impact complex TBI (n=53), (2) non-blast related TBI with injury due to other mechanisms (n=29), (3) blast-exposed controls evacuated for other medical reasons (n=27) (4) non-blast-exposed controls evacuated for other medical reasons (n=69). All patients with TBI met Department of Defense criteria for concussive (mild) TBI. The study participants were evaluated 6-12 months after injury at Washington University in St Louis. In total, 255 subjects were enrolled in the study, and 183 participated in follow-up evaluations, 5 of whom were disqualified. In-person clinical examinations included evaluation for overall disability, a standardized neurological exam, headache questionnaires, neuropsychological test battery, combat exposure and alcohol use surveys, and structured interview evaluations for post-traumatic stress disorder (PTSD) and depression. Global outcomes, headache severity, neuropsychological performance, and surprisingly even PTSD severity and depression were indistinguishable between the two TBI groups, independent of mechanism of injury. Both TBI groups had higher rates of moderate to severe overall disability than the respective control groups: 41/53 (77%) of blast plus impact TBI and 23/29 (79%) of nonblast TBI vs. 16/27 (59%) of blast-exposed controls and 28/69 (41%) of non-blast-exposed controls. In addition, blast-exposed controls had worse headaches and more severe PTSD than non-blast-exposed controls. Self-reported combat exposure intensity was higher in the blast plus impact TBI group than in nonblast TBI group and was higher in blast-exposed controls than in non-blast-exposed controls. However, combat exposure intensity did not correlate with PTSD severity in the TBI groups, but a modest positive correlation was observed in the controls. Overall outcomes were most strongly correlated with depression, headache severity, and number of abnormalities on neuropsychological testing. However a substantial fraction of the variance in overall outcome was not explained by any of the assessed measures. One potential interpretation of these results is that TBI itself, independent of injury mechanism and combat exposure intensity, is a primary driver of adverse outcomes. Many other important factors may be as yet unmeasured, and adverse outcomes following war-time injuries are difficult to fully explain. clinicaltrials.gov Identifier: NCT01313130.",Mac Donald CL.; Johnson AM.; Wierzechowski L.; Kassner E.; Stewart T.; Nelson EC.; Werner NJ.; Zonies D.; Oh J.; Fang R.; Brody DL.,2014.0,10.1001/jamaneurol.2014.1114,0,0,
9455,[Polish adaptation and validation of the Agoraphobic Cognitions Questionnaire and the Body Sensations Questionnaire].,"The present study aimed at the adaptation and validation of two questionnaires assessing fear of bodily sensations (BSQ; suggested Polish name: Kwestionariusz Doznań Cielesnych [KDC]) and concerns specific to agoraphobics (ACQ; suggested Polish name: Kwestionariusz Myśli Towarzyszacych Agorafobii [KMTA]). The study included a total of 82 patients diagnosed with agoraphobia or panic disorder with agoraphobia according to the diagnostic criteria of the DSM-IV as well as 100 control subjects who did not show the presence of mental disorders. The results showed that both adapted questionnaires meet basic psychometric criteria. The Polish-language versions of the ACQ and BSQ are characterized by a high content validity, internal consistency and showed to be stable over a period of 28 days. Moreover, the factor structure of the Polish version of the ACQ showed to be highly similar to the original version. Polish-language versions of the ACQ and BSQ have been found to be reliable and valid research and diagnostic instruments for the assessment of fear for bodily sensations and agoraphobic cognitions. Due to their high efficiency and adequate psychometric characteristics these measures might be very useful in research as well as in the diagnosis and evaluation of therapeutic effects.",Michałowski JM.; Holas P.,,,0,0,
9456,Clinical effectiveness and cost-effectiveness of Internet- vs. group-based cognitive behavior therapy for social anxiety disorder: 4-year follow-up of a randomized trial.,"Social anxiety disorder (SAD) is common, debilitating and associated with high societal costs. The disorder can be effectively treated with Internet-based cognitive behavior therapy (ICBT), but no previous study has investigated the long-term clinical or health economic effects of ICBT for SAD in comparison to an evidence-based control treatment. The aim of the study was to investigate the clinical effectiveness and cost-effectiveness of ICBT compared to cognitive behavioral group therapy (CBGT) four years post-treatment. We conducted a 4-year follow-up study of participants who had received ICBT or CBGT for SAD within the context of a randomized controlled non-inferiority trial. The cost-effectiveness analyses were conducted taking a societal perspective. Participants in both treatment groups made large improvements from baseline to 4-year follow-up on the primary outcome measure (d = 1.34-1.48) and the 95% CI of the mean difference on the primary outcome was well within the non-inferiority margin. ICBT and CBGT were similarly cost-effective and both groups reduced their indirect costs. We conclude that ICBT for SAD yields large sustainable effects and is at least as long-term effective as CBGT. Intervention costs of both treatments are offset by net societal cost reductions in a short time.",Hedman E.; El Alaoui S.; Lindefors N.; Andersson E.; Rück C.; Ghaderi A.; Kaldo V.; Lekander M.; Andersson G.; Ljótsson B.,2014.0,10.1016/j.brat.2014.05.010,0,0,
9457,May Renal Resistive Index be an early predictive tool of postoperative complications in major surgery? Preliminary results.,"Patients who undergo high-risk surgery represent a large amount of post-operative ICU-admissions. These patients are at high risk of experiencing postoperative complications. Renal Resistive Index was found to be related with renal dysfunction, hypertension, and posttraumatic hemorrhagic shock, probably due to vasoconstriction. We explored whether Renal Resistive Index (RRI), measured after awakening from general anesthesia, could have any relationship with postoperative complications. In our observational, stratified dual-center trial, we enrolled patients who underwent general anesthesia for high-risk major surgery. After awakening in recovery room (or during awakening period in subjects submitted to cardiac surgery) we measured RRI by echo-color-Doppler method. Primary endpoint was the association of altered RRI (>0.70) and outcome during the first postoperative week. 205 patients were enrolled: 60 (29.3%) showed RRI > 0.70. The total rate of adverse event was 27 (18.6%) in RRI ≤ 0.7 group and 19 (31.7%) in RRI > 0.7 group (P = 0.042). Significant correlation between RRI > 0.70 and complications resulted in pneumonia (P = 0.016), septic shock (P = 0.003), and acute renal failure (P = 0.001) subgroups. Patients with RRI > 0.7 showed longer ICU stay (P = 0.001) and lasting of mechanical ventilation (P = 0.004). These results were confirmed in cardiothoracic surgery subgroup. RRI > 0.7 duplicates triplicates the risk of complications, both in general (OR 2.03 93 95% CI 1.02-4.02, P = 0.044) and in cardiothoracic (OR 2.62 95% CI 1.11-6.16, P = 0.027) population. Furthermore, we found RRI > 0.70 was associated with a triplicate risk of postoperative septic shock (OR 3.04, CI 95% 1.5-7.01; P = 0.002).",Giustiniano E.; Meco M.; Morenghi E.; Ruggieri N.; Cosseta D.; Cirri S.; Difrancesco O.; Zito PC.; Gollo Y.; Raimondi F.,2014.0,10.1155/2014/917985,0,0,
9458,A randomized trial comparing two low-intensity psychological interventions for distressed patients with cancer and their caregivers.,"To compare the effectiveness of two low-intensity approaches for distressed patients with cancer and caregivers who had called cancer helplines seeking support. Baseline distress was hypothesized as a moderator of intervention effect. Randomized trial. Community-based cancer helplines in Queensland and New South Wales, Australia. 354 patients with cancer and 336 caregivers. Participants were randomized to either a single session of nurse-led self-management intervention or a five-session psychologist cognitive behavioral intervention delivered by telephone. Assessments were undertaken at baseline (preintervention) and at 3, 6, and 12 months. Psychological and cancer-specific distress and post-traumatic growth. No significant moderation by baseline cancer-specific distress was noted. For low-education patients, only the psychologist intervention was associated with a significant drop in distress. For all other participants, distress decreased over time in both arms with small to large effect sizes (Cohen's ds = 0.05-0.82). Post-traumatic growth increased over time for all participants (Cohen's ds = 0.6-0.64). Many distressed patients with cancer and their caregivers may benefit significantly from a single session of a nurse psychoeducation intervention that can be delivered remotely by telephone and supported by self-management materials. Research is needed to develop an algorithm that moves beyond the use of distress as the only indicator for referral to specialist psychological services. Survivors and caregivers with low education and low literacy may require more in-depth and targeted support. Brief nurse psychoeducation and stress management for cancer survivors and caregivers should be considered as part of a tiered approach to psychosocial care.",Chambers SK.; Girgis A.; Occhipinti S.; Hutchison S.; Turner J.; McDowell M.; Mihalopoulos C.; Carter R.; Dunn JC.,2014.0,10.1188/14.ONF.E256-E266,0,0,
9459,"Anxiety, bulimia, drug and alcohol addiction, depression, and schizophrenia: what do you think about their aetiology, dangerousness, social distance, and treatment? A latent class analysis approach.","Mental illness stigma is a serious societal problem and a critical impediment to treatment seeking for mentally ill people. To improve the understanding of mental illness stigma, this study focuses on the simultaneous analysis of people's aetiological beliefs, attitudes (i.e. perceived dangerousness and social distance), and recommended treatments related to several mental disorders by devising an over-arching latent structure that could explain the relations among these variables. Three hundred and sixty university students randomly received an unlabelled vignette depicting one of six mental disorders to be evaluated on the four variables on a Likert-type scale. A one-factor Latent Class Analysis (LCA) model was hypothesized, which comprised the four manifest variables as indicators and the mental disorder as external variable. The main findings were the following: (a) a one-factor LCA model was retrieved; (b) alcohol and drug addictions are the most strongly stigmatized; (c) a realistic opinion about the causes and treatment of schizophrenia, anxiety, bulimia, and depression was associated to lower prejudicial attitudes and social rejection. Beyond the general appraisal of mental illness an individual might have, the results generally point to the acknowledgement of the specific features of different diagnostic categories. The implications of the present results are discussed in the framework of a better understanding of mental illness stigma.",Mannarini S.; Boffo M.,2015.0,10.1007/s00127-014-0925-x,0,0,
9460,"Robust impact of social anxiety in relation to coping motives and expectancies, barriers to quitting, and cessation-related problems.","Although social anxiety is related to smoking and nicotine dependence, few researchers have sought to identify factors that contribute to these relations. The current study examined whether social anxiety was associated with cognitive vulnerability factors related to smoking: perceived barriers for quitting, cessation-related problems, negative-affect-reduction-outcome expectancies, and negative-affect-reduction motives. Further, we tested whether social anxiety was robustly related to these factors after controlling for cigarettes smoked per day, gender, alcohol-use frequency, lifetime cannabis-use status, panic attack frequency, anxiety sensitivity, and negative affectivity. The sample consisted of 580 (38.6% female) treatment-seeking smokers. Social anxiety was associated with perceived barriers for quitting, cessation-related problems, negative-affect-reduction-outcome expectancies, and negative-affect-reduction motives. After controlling for covariates, social anxiety was robustly related to perceived barriers for quitting, cessation-related problems, and negative-affect-reduction-outcome expectancies. Social anxiety was robustly related to negative-affect-reduction motives among men, but not women. Results indicate that social anxiety is robustly related to cognitive vulnerability factors associated with poorer cessation outcomes, suggesting that social anxiety may be an important therapeutic target during smoking cessation.",Buckner JD.; Zvolensky MJ.; Jeffries ER.; Schmidt NB.,2014.0,10.1037/a0037206,0,0,
9461,Does seeking safety reduce PTSD symptoms in women receiving physical disability compensation?,"This secondary analysis investigated the impact of 12 sessions of Seeking Safety (SS) on reducing posttraumatic stress disorder (PTSD) symptoms in a sample of dually diagnosed women with physical disabilities versus nondisabled (ND) women. SS is an evidence-based and widely implemented manualized therapy for PTSD and/or substance use disorder. It is a present-focused model that promotes coping skills and psychoeducation. As part of the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN), 353 participants with current PTSD and substance use disorder (SUD) were randomly assigned to partial-dose SS or Women's Health Education (WHE) group therapy conducted in community-based substance abuse treatment programs. The women were categorized as participants with disabilities (PWD; n = 20) or ND (n = 333) based on the question, ""Do you receive a pension for a physical disability?"" PTSD was assessed on the Clinician-Administered PTSD Scale (CAPS) at baseline and follow-ups after treatment (1 week, 3 months, 6 months, and 12 months). PWD experienced sustained reductions in PTSD symptoms when treated with SS but not WHE. Indeed, PTSD symptoms of PWD in WHE returned to baseline levels of severity by 12-month follow-up. This pattern of results was not observed among ND women, who sustained improvements on PTSD in both treatment conditions. These results suggest strong potential for using SS to treat PTSD among women with physical disabilities, and speak to the genuine need to address trauma and PTSD more directly with PWD. Our results are also consistent with other findings from the NIDA CTN trial, in which virtually all significant results evidenced SS outperforming WHE.",Anderson ML.; Najavits LM.,2014.0,10.1037/a0036869,0,0,
9462,Testing a procedural variant of written imaginal exposure for generalized anxiety disorder.,"This experiment examined the degree to which it is more beneficial for individuals with generalized anxiety disorder (GAD) to engage in repeated exposure to mental imagery of the same feared scenario versus varying the exposure content. On three consecutive days, individuals with GAD (N=57) spent 20min writing about: (1) the same worst case scenario (consistent exposure; CE), (2) variations of their worst case scenario (varied exposure; VE), or (3) a neutral topic (neutral control; NC). Participants in the CE condition displayed significant decreases in worry, acute cognitive avoidance, and intolerance of uncertainty from baseline to 1-week follow-up; participants in the VE and NC conditions did not. Initial activation of self-reported anxiety (observed in the CE and VE conditions) and between-session reduction in anxiety (observed in the CE condition only) were associated with improvement in worry. Including more references to negative emotion and writing in the present tense were also associated with greater improvement in worry in the CE condition. These findings suggest that writing repeatedly about the same worst case scenario may benefit people with GAD. The study also provides information on potential mechanisms of change.",Fracalanza K.; Koerner N.; Antony MM.,2014.0,10.1016/j.janxdis.2014.05.011,0,0,
9463,Prospective study of police officer spouse/partners: a new pathway to secondary trauma and relationship violence?,"It has been reported that posttraumatic stress disorder (PTSD) is associated with secondary spouse/partner (S/P) emotional distress and relationship violence. To investigate the relationships between PTSD, S/P emotional distress and relationship violence among police recruits using a prospective design. Two hypotheses were tested in 71 S/Ps: (1) Police officer reports of greater PTSD symptoms after 12 months of police service will be associated with greater secondary trauma symptoms among S/Ps; (2) Greater secondary trauma symptoms among S/Ps at 12 months will be associated with S/P reports of greater relationship violence. 71 police recruits and their S/Ps were assessed at baseline and 12 months after the start of police officer duty. Using linear and logistic regression, we analyzed explanatory variables for 12 month S/P secondary traumatic stress symptoms and couple violence, including baseline S/P variables and couple violence, as well as exposure and PTSD reports from both S/P and officer. S/P perception of officer PTSD symptoms predicted S/P secondary traumatic stress. OS/P secondary trauma was significantly associated with both total couple violence (.34, p‚Ää=‚Ää.004) and S/P to officer violence (.35, p‚Ää=‚Ää.003). Although results from this relatively small study of young police officers and their S/Ps must be confirmed by larger studies in general populations, findings suggest that S/P perception of PTSD symptoms may play a key role in the spread of traumatic stress symptoms across intimate partner relationships and intimate partner violence in the context of PTSD.",Meffert SM.; Henn-Haase C.; Metzler TJ.; Qian M.; Best S.; Hirschfeld A.; McCaslin S.; Inslicht S.; Neylan TC.; Marmar CR.,2014.0,10.1371/journal.pone.0100663,0,0,
9464,Experiential virtual scenarios with real-time monitoring (interreality) for the management of psychological stress: a block randomized controlled trial.,"The recent convergence between technology and medicine is offering innovative methods and tools for behavioral health care. Among these, an emerging approach is the use of virtual reality (VR) within exposure-based protocols for anxiety disorders, and in particular posttraumatic stress disorder. However, no systematically tested VR protocols are available for the management of psychological stress. Our goal was to evaluate the efficacy of a new technological paradigm, Interreality, for the management and prevention of psychological stress. The main feature of Interreality is a twofold link between the virtual and the real world achieved through experiential virtual scenarios (fully controlled by the therapist, used to learn coping skills and improve self-efficacy) with real-time monitoring and support (identifying critical situations and assessing clinical change) using advanced technologies (virtual worlds, wearable biosensors, and smartphones). The study was designed as a block randomized controlled trial involving 121 participants recruited from two different worker populations-teachers and nurses-that are highly exposed to psychological stress. Participants were a sample of teachers recruited in Milan (Block 1: n=61) and a sample of nurses recruited in Messina, Italy (Block 2: n=60). Participants within each block were randomly assigned to the (1) Experimental Group (EG): n=40; B1=20, B2=20, which received a 5-week treatment based on the Interreality paradigm; (2) Control Group (CG): n=42; B1=22, B2=20, which received a 5-week traditional stress management training based on cognitive behavioral therapy (CBT); and (3) the Wait-List group (WL): n=39, B1=19, B2=20, which was reassessed and compared with the two other groups 5 weeks after the initial evaluation. Although both treatments were able to significantly reduce perceived stress better than WL, only EG participants reported a significant reduction (EG=12% vs. CG=0.5%) in chronic ""trait"" anxiety. A similar pattern was found for coping skills: both treatments were able to significantly increase most coping skills, but only EG participants reported a significant increase (EG=14% vs CG=0.3%) in the Emotional Support skill. Our findings provide initial evidence that the Interreality protocol yields better outcomes than the traditionally accepted gold standard for psychological stress treatment: CBT. Consequently, these findings constitute a sound foundation and rationale for the importance of continuing future research in technology-enhanced protocols for psychological stress management. ClinicalTrials.gov: NCT01683617; http://clinicaltrials.gov/show/NCT01683617 (Archived by WebCite at http://www.webcitation.org/6QnziHv3h).",Gaggioli A.; Pallavicini F.; Morganti L.; Serino S.; Scaratti C.; Briguglio M.; Crifaci G.; Vetrano N.; Giulintano A.; Bernava G.; Tartarisco G.; Pioggia G.; Raspelli S.; Cipresso P.; Vigna C.; Grassi A.; Baruffi M.; Wiederhold B.; Riva G.,2014.0,10.2196/jmir.3235,0,0,
9465,Coma Recovery Scale-Revised: evidentiary support for hierarchical grading of level of consciousness.,"To investigate the neurobehavioral pattern of recovery of consciousness as reflected by performance on the subscales of the Coma Recovery Scale-Revised (CRS-R). Retrospective item response theory (IRT) and factor analysis. Inpatient rehabilitation facilities. Rehabilitation inpatients (N=180) with posttraumatic disturbance in consciousness who participated in a double-blinded, randomized, controlled drug trial. Not applicable. Scores on CRS-R subscales. The CRS-R was found to fit factor analytic models adhering to the assumptions of unidimensionality and monotonicity. In addition, subscales were mutually independent based on residual correlations. Nonparametric IRT reaffirmed the finding of monotonicity. A highly constrained confirmatory factor analysis model, which imposed equal factor loadings on all items, was found to fit the data well and was used to estimate a 1-parameter IRT model. This study provides evidence of the unidimensionality of the CRS-R and supports the hierarchical structure of the CRS-R subscales, suggesting that it is an effective tool for establishing diagnosis and monitoring recovery of consciousness after severe traumatic brain injury.",Gerrard P.; Zafonte R.; Giacino JT.,2014.0,10.1016/j.apmr.2014.06.018,0,0,
9466,Obsessive Compulsive Treatment Efficacy Trial (OCTET) comparing the clinical and cost effectiveness of self-managed therapies: study protocol for a randomised controlled trial.,"UK National Institute of Health and Clinical Excellence guidelines for obsessive compulsive disorder (OCD) specify recommendations for the treatment and management of OCD using a stepped care approach. Steps three to six of this model recommend treatment options for people with OCD that range from low-intensity guided self-help (GSH) to more intensive psychological and pharmacological interventions. Cognitive behavioural therapy (CBT), including exposure and response prevention, is the recommended psychological treatment. However, whilst there is some preliminary evidence that self-managed therapy packages for OCD can be effective, a more robust evidence base of their clinical and cost effectiveness and acceptability is required. Our proposed study will test two different self-help treatments for OCD: 1) computerised CBT (cCBT) using OCFighter, an internet-delivered OCD treatment package; and 2) GSH using a book. Both treatments will be accompanied by email or telephone support from a mental health professional. We will evaluate the effectiveness, cost and patient and health professional acceptability of the treatments. This study will provide more robust evidence of efficacy, cost effectiveness and acceptability of self-help treatments for OCD. If cCBT and/or GSH prove effective, it will provide additional, more accessible treatment options for people with OCD. Current Controlled Trials: ISRCTN73535163. Date of registration: 5 April 2011.",Gellatly J.; Bower P.; McMillan D.; Roberts C.; Byford S.; Bee P.; Gilbody S.; Arundel C.; Hardy G.; Barkham M.; Reynolds S.; Gega L.; Mottram P.; Lidbetter N.; Pedley R.; Peckham E.; Connell J.; Molle J.; O'Leary N.; Lovell K.,2014.0,10.1186/1745-6215-15-278,0,0,
9467,Implementing evidence-based recommended practices for the management of patients with mild traumatic brain injuries in Australian emergency care departments: study protocol for a cluster randomised controlled trial.,"Mild head injuries commonly present to emergency departments. The challenges facing clinicians in emergency departments include identifying which patients have traumatic brain injury, and which patients can safely be sent home. Traumatic brain injuries may exist with subtle symptoms or signs, but can still lead to adverse outcomes. Despite the existence of several high quality clinical practice guidelines, internationally and in Australia, research shows inconsistent implementation of these recommendations. The aim of this trial is to test the effectiveness of a targeted, theory- and evidence-informed implementation intervention to increase the uptake of three key clinical recommendations regarding the emergency department management of adult patients (18 years of age or older) who present following mild head injuries (concussion), compared with passive dissemination of these recommendations. The primary objective is to establish whether the intervention is effective in increasing the percentage of patients for which appropriate post-traumatic amnesia screening is performed. The design of this study is a cluster randomised trial. We aim to include 34 Australian 24-hour emergency departments, which will be randomised to an intervention or control group. Control group departments will receive a copy of the most recent Australian evidence-based clinical practice guideline on the acute management of patients with mild head injuries. The intervention group will receive an implementation intervention based on an analysis of influencing factors, which include local stakeholder meetings, identification of nursing and medical opinion leaders in each site, a train-the-trainer day and standardised education and interactive workshops delivered by the opinion leaders during a 3 month period of time. Clinical practice outcomes will be collected retrospectively from medical records by independent chart auditors over the 2 month period following intervention delivery (patient level outcomes). In consenting hospitals, eligible patients will be recruited for a follow-up telephone interview conducted by trained researchers. A cost-effectiveness analysis and process evaluation using mixed-methods will be conducted. Sample size calculations are based on including 30 patients on average per department. Outcome assessors will be blinded to group allocation. Australian New Zealand Clinical Trials Registry ACTRN12612001286831 (date registered 12 December 2012).",Bosch M.; McKenzie JE.; Mortimer D.; Tavender EJ.; Francis JJ.; Brennan SE.; Knott JC.; Ponsford JL.; Pearce A.; O'Connor DA.; Grimshaw JM.; Rosenfeld JV.; Gruen RL.; Green SE.;  .,2014.0,10.1186/1745-6215-15-281,0,0,
9468,Long-term outcome of psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder.,"Relatively few studies have examined the long-term outcome of psychotherapy in social anxiety disorder. The authors previously reported findings of a clinical trial comparing cognitive-behavioral therapy (CBT), psychodynamic therapy, and a wait-list control. The purpose of the present study was to follow the participants' status over the ensuing 24 months. Outpatients with social anxiety disorder who were treated with CBT (N=209) or psychodynamic therapy (N=207) in the previous trial were assessed 6, 12, and 24 months after the end of therapy. Primary outcome measures were rates of remission and response. For both CBT and psychodynamic therapy, response rates were approximately 70% by the 2-year follow-up. Remission rates were nearly 40% for both treatment conditions. Rates of response and remission were stable or tended to increase for both treatments over the 24-month follow-up period, and no significant differences were found between the treatment conditions after 6 months. CBT and psychodynamic therapy were efficacious in treating social anxiety disorder, in both the short- and long-term, when patients showed continuous improvement. Although in the short-term, intention-to-treat analyses yielded some statistically significant but small differences in favor of CBT in several outcome measures, no differences in outcome were found in the long-term.",Leichsenring F.; Salzer S.; Beutel ME.; Herpertz S.; Hiller W.; Hoyer J.; Huesing J.; Joraschky P.; Nolting B.; Poehlmann K.; Ritter V.; Stangier U.; Strauss B.; Tefikow S.; Teismann T.; Willutzki U.; Wiltink J.; Leibing E.,2014.0,10.1176/appi.ajp.2014.13111514,0,0,
9469,Cognitive mediators of treatment for social anxiety disorder: comparing acceptance and commitment therapy and cognitive-behavioral therapy.,"To assess the relationship between session-by-session mediators and treatment outcomes in traditional cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for social anxiety disorder. Session-by-session changes in negative cognitions (a theorized mediator of CBT) and experiential avoidance (a theorized mediator of ACT) were assessed in 50 adult outpatients randomized to CBT (n=25) or ACT (n=25) for DSM-IV social anxiety disorder. Multilevel modeling analyses revealed significant nonlinear decreases in the proposed mediators in both treatments, with ACT showing steeper decline than CBT at the beginning of treatment and CBT showing steeper decline than ACT at the end of treatment. Curvature (or the nonlinear effect) of experiential avoidance during treatment significantly mediated posttreatment social anxiety symptoms and anhedonic depression in ACT, but not in CBT, with steeper decline of the Acceptance and Action Questionnaire at the beginning of treatment predicting fewer symptoms in ACT only. Curvature of negative cognitions during both treatments predicted outcome, with steeper decline of negative cognitions at the beginning of treatment predicting lower posttreatment social anxiety and depressive symptoms. Rate of change in negative cognitions at the beginning of treatment is an important predictor of change across both ACT and CBT, whereas rate of change in experiential avoidance at the beginning of treatment is a mechanism specific to ACT.",Niles AN.; Burklund LJ.; Arch JJ.; Lieberman MD.; Saxbe D.; Craske MG.,2014.0,10.1016/j.beth.2014.04.006,0,0,
9470,Shaking that icky feeling: effects of extinction and counterconditioning on disgust-related evaluative learning.,"Learned disgust appears to play an important role in certain anxiety disorders, and can be explained by the process of evaluative conditioning, in which an affective evaluative reaction evoked by an unconditional stimulus (US) is transferred to a conditional stimulus (CS). Much remains unknown about how disgust-related evaluative learning can be effectively eliminated. Study 1 of the present investigation examined the effects of extinction on reducing the negative evaluation of a CS that was acquired during disgust conditioning. Participants completed acquisition trials, with a disgusting picture as US and two neutral pictures as CS (CS+ was paired with the US; CS- was unpaired), followed by extinction trials (""CS only""; experimental condition) or a filler task (control condition). Extinction trials reduced acquired US expectancy to the CS+, but did not extinguish negative evaluations of the CS+. Study 2 examined the effects of counterconditioning on evaluative learned disgust. After disgust acquisition trials, counterconditioning trials followed in which the CS+ was paired with a pleasant US (experimental condition) or a filler task (control condition). Counterconditioning trials reduced acquired US expectancy to the CS+ and reduced evaluative conditioned disgust. Implications of the potential differential effects of extinction and counterconditioning on evaluative learning for exposure-based treatment of specific anxiety disorders are discussed.",Engelhard IM.; Leer A.; Lange E.; Olatunji BO.,2014.0,10.1016/j.beth.2014.04.003,0,0,
9471,The influence of anticipatory processing on attentional biases in social anxiety.,"Research on cognitive theories of social anxiety disorder (SAD) has identified individual processes that influence this condition (e.g., cognitive biases, repetitive negative thinking), but few studies have attempted to examine the interaction between these processes. For example, attentional biases and anticipatory processing are theoretically related and have been found to influence symptoms of SAD, but they rarely have been studied together (i.e., Clark & Wells, 1995). Therefore, the goal of the current study was to examine the effect of anticipatory processing on attentional bias for internal (i.e., heart rate feedback) and external (i.e., emotional faces) threat information. A sample of 59 participants high (HSA) and low (LSA) in social anxiety symptoms engaged in a modified dot-probe task prior to (Time 1) and after (Time 2) an anticipatory processing or distraction task. HSAs who anticipated experienced an increase in attentional bias for internal information from Time 1 to Time 2, whereas HSAs in the distraction condition and LSAs in either condition experienced no changes. No changes in biases were found for HSAs for external biases, but LSAs who engaged in the distraction task became less avoidant of emotional faces from Time 1 to Time 2. This suggests that anticipatory processing results in an activation of attentional biases for physiological information as suggested by Clark and Wells.",Mills AC.; Grant DM.; Judah MR.; White EJ.,2014.0,10.1016/j.beth.2014.04.004,0,0,
9472,Sudden gains in two psychotherapies for posttraumatic stress disorder.,"We examined sudden, large, and stable shifts in symptoms from one therapy session to the next in two treatments for posttraumatic stress disorder (PTSD). Shifts in a positive direction (sudden gains) have so far been more frequently analyzed than those in a negative direction (sudden losses). We analyzed data from 102 outpatients suffering from PTSD who received either a cognitive-behavioral or a Gestalt-based intervention. Sudden gains, at 22.5%, were more frequent than sudden losses (3.9% of patients). Participants who had experienced sudden gains had lower PTSD scores at posttreatment, but not at the 6-month follow-up. As sudden losses were so rare, they were not analyzed statistically. Sudden gains accounted for 52% of overall treatment gains or 26% of overall change in a positive direction. Among very successful patients, those with sudden gains were overrepresented, but in absolute terms, there were as many patients without sudden gains in this group. There was no connection between sudden gains and type of intervention or depressive symptoms. Sudden gains and sudden losses occurred in our sample of PTSD patients, but in the light of current results, their clinical importance seems to be limited.",König J.; Karl R.; Rosner R.; Butollo W.,2014.0,10.1016/j.brat.2014.06.005,0,0,
9473,Endogenous cortisol levels influence exposure therapy in spider phobia.,"Previous research in patients with phobia showed that the administration of glucocorticoids reduces fear in phobic situations and enhances exposure therapy. Glucocorticoids underlie a daily cycle with a peak in the morning and low levels during the evening and night. The aim of the present study was to investigate whether exposure is more effective when conducted in the morning when endogenous cortisol levels are high. Sixty patients meeting DSM IV criteria for specific phobia (animal type) were randomly assigned to one-session exposure treatment either at 08.00 a.m. (high cortisol group) or at 06.00 p.m. (low cortisol group). Participants returned for a posttreatment assessment one week after therapy and a follow-up assessment three months after therapy. Both groups showed good outcome, but patients treated in the morning exhibited significantly less fear of spiders in the behavioral approach test (BAT) and a trend for lower scores on the Fear of Spiders Questionnaire (FSQ) than patients treated in the evening. This effect was present at posttreatment and follow-up. Our findings indicate that exposure therapy is more effective in the morning than in the evening. We suggest that this may be due to higher endogenous cortisol levels in the morning group that enhance extinction memory.",Lass-Hennemann J.; Michael T.,2014.0,10.1016/j.brat.2014.06.009,0,0,
9474,Gamma ventral capsulotomy for obsessive-compulsive disorder: a randomized clinical trial.,"Select cases of intractable obsessive-compulsive disorder (OCD) have undergone neurosurgical ablation for more than half a century. However, to our knowledge, there have been no randomized clinical trials of such procedures for the treatment of any psychiatric disorder. To determine the efficacy and safety of a radiosurgery (gamma ventral capsulotomy [GVC]) for intractable OCD. In a double-blind, placebo-controlled, randomized clinical trial, 16 patients with intractable OCD were randomized to active (n = 8) or sham (n = 8) GVC. Blinding was maintained for 12 months. After unblinding, sham-group patients were offered active GVC. Patients randomized to active GVC had 2 distinct isocenters on each side irradiated at the ventral border of the anterior limb of the internal capsule. The patients randomized to sham GVC received simulated radiosurgery using the same equipment. Scores on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Clinical Global Impression-Improvement (CGI-I) Scale. Response was defined as a 35% or greater reduction in Y-BOCS severity and ""improved"" or ""much improved"" CGI-I ratings. Three of 8 patients randomized to active treatment responded at 12 months, while none of the 8 sham-GVC patients responded (absolute risk reduction, 0.375; 95% CI, 0.04-0.71). At 12 months, OCD symptom improvement was significantly higher in the active-GVC group than in the sham group (Y-BOCS, P = .046; Dimensional Y-BOCS, P = .01). At 54 months, 2 additional patients in the active group had become responders. Of the 4 sham-GVC patients who later received active GVC, 2 responded by post-GVC month 12. The most serious adverse event was an asymptomatic radiation-induced cyst in 1 patient. Gamma ventral capsulotomy benefitted patients with otherwise intractable OCD and thus appears to be an alternative to deep-brain stimulation in selected cases. Given the risks inherent in any psychiatric neurosurgery, such procedures should be conducted at specialized centers. clinicaltrials.gov Identifier: NCT01004302.",Lopes AC.; Greenberg BD.; Canteras MM.; Batistuzzo MC.; Hoexter MQ.; Gentil AF.; Pereira CA.; Joaquim MA.; de Mathis ME.; D'Alcante CC.; Taub A.; de Castro DG.; Tokeshi L.; Sampaio LA.; Leite CC.; Shavitt RG.; Diniz JB.; Busatto G.; Norén G.; Rasmussen SA.; Miguel EC.,2014.0,10.1001/jamapsychiatry.2014.1193,0,0,
9475,[Implantation of a Salto 2 total ankle prosthesis].,"Operative treatment of advanced primary and secondary arthritis of the ankle was carried out with the aim of achieving pain-free movement and retention of mobility. Surgery is indicated when conservative therapy is no longer sufficient for treatment of arthritis of the ankle with painful limited movement, sufficient bony joint conditions and correctable instability or axis malpositioning. Surgery is not recommended with general surgical or anesthesiological contraindications, rampant infections, severe disturbances of peripheral perfusion, bony defects in areas relevant for anchoring, unstable soft tissue conditions, talus necrosis >30 %, manifest osteoporosis and severe non-correctable instability or malpositioning. Tibial and talar bone resection was carried out via ventral access to the ankle through an incision and if present, soft tissue correction of instability after insertion of test components. Cement-free implantation of the original implants followed by subtle reconstruction of the extensor retinaculum and layer for layer closure of the wound. Additional measures were necessary on the periarticular soft tissues, the hindfoot and lower leg due to movement restrictions, instability and axis malpositioning which could be carried out in a one or two stage procedure depending on the extent and morphology. Between February 2009 and February 2010 a total of 115 patients (52 % with posttraumatic arthritis) received a cement-free implantation with a Salto 2 prosthesis. Additional corrective interventions were carried out in the presence of varus and valgus deformities. The degree of movement for dorsal extension and plantar flexion could be increased by an average of 8.3°. The interventions resulted in a significant reduction in pain from an average preoperative visual analogue pain scale (VAS) score of 7.8 (range 5-10) to an average postoperative score of 1.9 (range 0-6.1).",Lieske S.; Schenk K.; Neumann HW.; John M.,2014.0,10.1007/s00064-011-0107-x,0,0,
9476,Long-term efficacy of Internet-based cognitive behavior therapy for obsessive-compulsive disorder with or without booster: a randomized controlled trial.,"As relapse after completed cognitive behavior therapy (CBT) for obsessive-compulsive disorder (OCD) is common, many treatment protocols include booster programs to improve the long-term effects. However, the effects of booster programs are not well studied. In this study, we investigated the long-term efficacy of Internet-based CBT (ICBT) with therapist support for OCD with or without an Internet-based booster program. A total of 101 participants were included in the long-term follow-up analysis of ICBT. Of these, 93 were randomized to a booster program or no booster program. Outcome assessments were collected at 4, 7, 12 and 24 months after receiving ICBT. The entire sample had sustained long-term effects from pre-treatment to all follow-up assessments, with large within-group effect sizes (Cohen's d = 1.58-2.09). The booster group had a significant mean reduction in OCD symptoms compared to the control condition from booster baseline (4 months) to 7 months, but not at 12 or 24 months. Participants in the booster group improved significantly in terms of general functioning at 7, 12 and 24 months, and had fewer relapses. Kaplan-Meier analysis also indicated a significantly slower relapse rate in the booster group. The results suggest that ICBT has sustained long-term effects and that adding an Internet-based booster program can further improve long-term outcome and prevent relapse for some OCD patients.",Andersson E.; Steneby S.; Karlsson K.; Ljótsson B.; Hedman E.; Enander J.; Kaldo V.; Andersson G.; Lindefors N.; Rück C.,2014.0,10.1017/S0033291714000543,0,0,
9477,A longitudinal investigation of changes to social resources associated with psychological distress among Kurdish torture survivors living in Northern Iraq.,"Social resources can buffer against psychological distress following potentially traumatic events. Psychological distress can also lead to social resource deterioration. This longitudinal study evaluated whether baseline psychological distress symptoms and changes in these symptoms were associated with changes in social resources 5 months later among 96 adult male (52.6%) and female treatment-seeking torture survivors residing in Kurdistan, Iraq. Adapted versions of the Hopkins Symptom Checklist-25, Harvard Trauma Questionnaire, and a traumatic grief measure were used. Locally derived scales measured perceived social support, social integration, and frequency of social contact. Multinomial logistic regression models assessed the association between symptoms and loss or gain in social resources. We hypothesized that higher mental health symptoms would relate to decreased social resources. Higher baseline depression (adjusted conditional odds ratio [ACOR] = 1.14), posttraumatic stress disorder (PTSD; ACOR = 1.09), and traumatic grief symptoms (ACOR = 1.14) increased the odds of loss of social integration. For some, higher traumatic grief symptoms were associated with increased social integration (ACOR = 1.17). Increased anxiety (ACOR = 1.23) and PTSD symptoms (ACOR = 1.07) was associated with declines in social contact; decreased depression (ACOR = 1.06) and PTSD symptoms (ACOR = 1.04) were related to gaining social contact. This study highlights the complex relationship between mental health symptoms and losses and gains in social resources among torture survivors.",Hall BJ.; Bonanno GA.; Bolton PA.; Bass JK.,2014.0,10.1002/jts.21930,0,0,
9478,Working alliance in individual and group cognitive therapy for social anxiety disorder.,"The tripartite model of working alliance, including the therapeutic bond and agreement on tasks and goals, was examined in 54 patients who received individual or group cognitive behavior therapy (CBT) for social anxiety disorder (SAD) in a randomized trial. Alliance was significantly stronger in individual relative to group CBT but generally not related to outcome.",Mörtberg E.,2014.0,10.1016/j.psychres.2014.07.004,0,0,
9479,The impact of anxious symptoms in the remission of depressive symptoms in a clinical trial for depression: follow-up of six months.,"Studies show high comorbidity between anxiety disorder and depression. Little is known regarding how anxiety symptoms affect prognosis in depression treatment, suggesting the importance of studying the impact of anxiety symptoms in the treatment of depression. We evaluated the impact of anxiety symptoms in the remission of depressive symptoms after brief psychotherapies for depression. This randomized clinical trial of 18-29-year-old adults included individuals who met the diagnostic criteria for depression as assessed by the Structured Clinical Interview for DSM (SCID). Depressive symptoms were assessed using the Hamilton Rating Scale for Depression (HRSD); anxiety symptoms were assessed using the Hamilton Anxiety Rating Scale (HARS). The protocols of psychotherapy used were: Cognitive Narrative Psychotherapy (CNP) and Cognitive Behavioral Psychotherapy (CBP). Both treatments included seven sessions. At the end of the treatment and six-month follow-up, an evaluation was made with the HRSD and HARS. The sample included 97 patients divided between the protocols of psychotherapy. There was a significant, positive, moderate correlation between the severity of anxiety symptoms at baseline and the remission of depressive symptoms at post-intervention (r=0.38 p<0.001) as well as a significant, positive, low correlation at follow up (r=0.20 p=0.049). We found remission of anxiety symptoms and depressive symptoms after brief psychotherapies, and the remission persisted at follow up. We did not evaluate the diagnosis of anxiety disorders. The severity of anxiety symptoms did not compromise the treatment focused primarily on depressive symptoms.",de Azevedo Cardoso T.; Mondin TC.; Spessato BC.; de Avila Quevedo L.; de Mattos Souza LD.; da Silva RA.; Jansen K.,2014.0,10.1016/j.jad.2014.03.034,0,0,
9480,"Integrative testimonial therapy: an Internet-based, therapist-assisted therapy for German elderly survivors of the World War II with posttraumatic stress symptoms.","Trauma-focused cognitive behavioral treatments are known to be effective for posttraumatic stress disorder (PTSD) in adults. However, evidence for effective treatments for older persons with PTSD, particularly elderly war trauma survivors, is scarce. In an open trial, 30 survivors of World War II aged 65 to 85 years (mean, 71.73 years; SD, 4.8; n = 17 women) with PTSD symptoms were treated with a Web-based, therapist-assisted cognitive-behavioral/narrative therapy for 6 weeks. Intent-to-treat analyses revealed a significant decrease in PTSD severity scores (Cohen's d = 0.43) and significant improvements on secondary clinical outcomes of quality of life, self-efficacy, and posttraumatic growth from pretreatment to posttreatment. All improvements were maintained at a 3-month follow-up. The attrition rate was low (13.3%), with participants who completed the trial reporting high working alliance and treatment satisfaction. Results of this study suggest that integrative testimonial therapy is a well accepted and potentially effective treatment for older war trauma survivors experiencing PTSD symptoms.",Knaevelsrud C.; Böttche M.; Pietrzak RH.; Freyberger HJ.; Renneberg B.; Kuwert P.,2014.0,10.1097/NMD.0000000000000178,0,0,
9481,Participation in a 9-month selected physical exercise programme enhances psychological well-being in a prison population.,"There is general population evidence that physical exercise is effective in reducing the risk of depression and has positive effects on mood. Some prisons encourage exercise, but there is no evidence specific to this group on its benefits or the relative merits of different programmes. To test the effect of physical exercise on the psychological well-being of prisoners and to determine which mental disorders are most affected by physical activity. Sixty-four participants were randomly assigned across three groups: cardiovascular plus resistance training (CRT), high-intensity strength training (HIST) and no exercise. Before and after the 9-month experimental period, all participants completed the Symptom Checklist-90-Revised. Each form of exercise significantly reduced depression scale scores compared with those in the control group, in which average depression scale scores actually increased. The CRT group also showed a significant decrease in GSI scores on the Symptom Checklist-90 and on its interpersonal sensitivity scale, whereas the HIST group also significantly improved on the anxiety, phobic anxiety and hostility scale scores. Our evidence, taken together with general population studies, supports introduction of supervised, moderately intense exercise for at least 1 h per week for men in prison. They form a high risk group for mental disorders, and such exercise reduces depression and anxiety. Minimal special equipment is needed for CRT. Further research should replicate the study in a larger, multi-centre trial, and examine impact on shorter-term and longer-term prisoners, female prisoners and effects on recidivism.",Battaglia C.; di Cagno A.; Fiorilli G.; Giombini A.; Borrione P.; Baralla F.; Marchetti M.; Pigozzi F.,2015.0,10.1002/cbm.1922,0,0,
9482,Treatment of post traumatic stress disorder symptoms in emotionally distressed individuals.,"Older individuals with emotional distress and a history of psychologic trauma are at risk for post traumatic stress disorder (PTSD) and major depression. This study was an exploratory, secondary analysis of data from the study ""Prevention of Depression in Older African Americans"". It examined whether Problem Solving Therapy-Primary Care (PST-PC) would lead to improvement in PTSD symptoms in patients with subsyndromal depression and a history of psychologic trauma. The control condition was dietary education (DIET). Participants (n=60) were age 50 or older with scores on the Center for Epidemiologic Studies-Depression scale of 11 or greater and history of psychologic trauma. Exclusions stipulated no major depression and substance dependence within a year. Participants were randomized to 6-8 sessions of either PST-PC or DIET and followed 2 years with booster sessions every 6 months; 29 participants were in the PST-PC group and 31 were in the DIET group. Mixed effects models showed that improvement of PTSD Check List scores was significantly greater in the DIET group over two years than in the PST-PC group (based on a group time interaction). We observed no intervention‚Åétime interactions in Beck Depression Inventory or Brief Symptom Inventory-Anxiety subscale scores.",Kasckow J.; Morse J.; Begley A.; Anderson S.; Bensasi S.; Thomas S.; Quinn SC.; Reynolds CF.,2014.0,10.1016/j.psychres.2014.06.043,0,0,
9483,rTMS modulates reciprocal inhibition in patients with traumatic spinal cord injury.,"Randomized, double-blind, crossover, sham-controlled trial. Repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) leads to a significant reduction of spasticity in subjects with spinal cord injury (SCI), but the physiological basis of this effect is still not well understood. The purpose of this study was to evaluate the disynaptic reciprocal Ia inhibition of soleus motoneurons in SCI patients. Department of Neurology, Merano, Italy and TMS Laboratory, Paracelsus Medical University, Salzburg, Austria. Nine subjects with incomplete cervical or thoracic SCI received 5 days of daily sessions of real or sham rTMS applied over the contralateral M1. We compared the reciprocal inhibition, the Modified Ashworth Scale and the Spinal Cord Injury Assessment Tool for Spasticity at baseline, after the last session and 1 week later in the real rTMS and sham stimulation groups. We found that real rTMS significantly reduced lower limb spasticity and restored the impaired excitability in the disynaptic reciprocal inhibitory pathway. In a small proof-of-concept study, rTMS strengthened descending projections between the motor cortex and inhibitory spinal interneuronal circuits. This reversed a defect in reciprocal inhibition after SCI, and reduced leg spasticity.",Nardone R.; Höller Y.; Thomschewski A.; Brigo F.; Orioli A.; Höller P.; Golaszewski S.; Trinka E.,2014.0,10.1038/sc.2014.136,0,0,
9484,A randomized controlled trial of an internet-based therapist-assisted indicated preventive intervention for prolonged grief disorder.,"This trial assessed the feasibility, acceptability, tolerability, and efficacy of an Internet-based therapist-assisted cognitive-behavioral indicated prevention intervention for prolonged grief disorder (PGD) called Healthy Experiences After Loss (HEAL). Eighty-four bereaved individuals at risk for PGD were randomized to either an immediate treatment group (n = 41) or a waitlist control group (n = 43). Assessments were conducted at four time-points: prior to the wait-interval (for the waitlist group), pre-intervention, post-intervention, 6 weeks later, and 3 months later (for the immediate group only). Intent-to-treat analyses indicated that HEAL was associated with large reductions in prolonged grief (d = 1.10), depression (d = .71), anxiety (d = .51), and posttraumatic stress (d = .91). Also, significantly fewer participants in the immediate group met PGD criteria post-intervention than in the waitlist group. Pooled data from both groups also yielded significant reductions and large effect sizes in PGD symptom severity at each follow-up assessment. The intervention required minimal professional oversight and ratings of satisfaction with treatment and usability of the Internet interface were high. HEAL has the potential to be an effective, well-tolerated tool to reduce the burden of significant pre-clinical PGD. Further research is needed to refine HEAL and to assess its efficacy and mechanisms of action in a large-scale trial.",Litz BT.; Schorr Y.; Delaney E.; Au T.; Papa A.; Fox AB.; Morris S.; Nickerson A.; Block S.; Prigerson HG.,2014.0,10.1016/j.brat.2014.07.005,0,0,
9485,Effects of psychotherapy on DNA strand break accumulation originating from traumatic stress.,"Previous research reveals an association between traumatic stress and an increased risk for numerous diseases, including cancer. At the molecular level, stress may increase carcinogenesis via increased DNA damage and impaired DNA repair mechanisms. We assessed DNA breakage in peripheral blood mononuclear cells from individuals with post-traumatic stress disorder (PTSD) and measured the cellular capacity to repair single-strand breaks after exposure to ionizing X-radiation. We also investigated the effect of psychotherapy on both DNA breakage and DNA repair. In a first study we investigated DNA breakage and repair in 34 individuals with PTSD and 31 controls. Controls were subdivided into 11 trauma-exposed subjects and 20 individuals without trauma exposure. In a second study, we analysed the effect of psychotherapy (Narrative Exposure Therapy) on DNA breakage and repair. Thirty-eight individuals with PTSD were randomly assigned to either a treatment or a waitlist control condition. Follow-up was performed 4 months and 1 year after therapy. In study 1 we found higher levels of basal DNA breakage in individuals with PTSD and trauma-exposed subjects than in controls, indicating that traumatic stress is associated with DNA breakage. However, single-strand break repair was unimpaired in individuals with PTSD. In study 2, we found that psychotherapy reversed not only PTSD symptoms, but also DNA strand break accumulation. Our results show - for the first time in vivo - an association between traumatic stress and DNA breakage; they also demonstrate changes at the molecular level, i.e., the integrity of DNA, after psychotherapeutic interventions.",Morath J.; Moreno-Villanueva M.; Hamuni G.; Kolassa S.; Ruf-Leuschner M.; Schauer M.; Elbert T.; Bürkle A.; Kolassa IT.,2014.0,10.1159/000362739,0,0,
9486,Neurophysiological correlates of eye movement desensitization and reprocessing sessions: preliminary evidence for traumatic memories integration.,"We have investigated the potential role of eye movement desensitization and reprocessing (EMDR) in enhancing the integration of traumatic memories by measuring EEG coherence, power spectra and autonomic variables before (pre-EMDR) and after (post-EMDR) EMDR sessions during the recall of patient's traumatic memory. Thirteen EMDR sessions of six patients with post-traumatic stress disorder were recorded. EEG analyses were conducted by means of the standardized Low Resolution Electric Tomography (sLORETA) software. Power spectra, EEG coherence and heart rate variability (HRV) were compared between pre- and post-EMDR sessions. After EMDR, we observed a significant increase of alpha power in the left inferior temporal gyrus (T = 3.879; P = 0.041) and an increased EEG coherence in beta band between C3 and T5 electrodes (T = 6.358; P < 0.001). Furthermore, a significant increase of HRV in the post-EMDR sessions was also observed (pre-EMDR: 6.38 ± 6.83; post-EMDR: 2.46 ± 2.95; U-Test = 45, P = 0.043). Finally, the values of lagged coherence were negatively associated with subjective units of disturbance (r(24) = -0.44, P < 0.05) and positively associated with parasympathetic activity (r(24) = 0.40, P < 0.05). Our results suggest that EMDR leads to an integration of dissociated aspects of traumatic memories and, consequently, a decrease of hyperarousal symptoms [Correction made here after initial publication].",Farina B.; Imperatori C.; Quintiliani MI.; Castelli Gattinara P.; Onofri A.; Lepore M.; Brunetti R.; Losurdo A.; Testani E.; Della Marca G.,2015.0,10.1111/cpf.12184,0,0,
9487,An open trial of group metacognitive therapy for depression in Norway.,"Preliminary data support the implementation of individual metacognitive therapy (MCT) for depression. Given the focus of MCT on transpersonal processes, we hypothesized that this treatment should translate well to a group format. In this study, the effects and feasibility associated with group MCT for depression are reported. Eleven patients who were consecutively referred by general practitioners to a specialist psychiatric practice in Norway participated in an open trial of the effects and feasibility associated with group MCT for depression. All of the patients met the DSM-IV criteria for major depressive disorder (MDD) and were monitored in a baseline period before attending 90-min weekly treatment sessions of group MCT for 10 weeks. The primary symptom outcome measure was severity of depression whilst secondary outcome measures included levels of anxiety, rumination and metacognitive beliefs. We also assessed recovery rates and changes in comorbid Axis I and Axis II diagnoses. Large clinically significant improvements across all measures were detected at post-treatment and these were maintained at follow-up. Based on objectively defined recovery criteria, all patients were classified as recovered at post-treatment and 91% at 6 months follow-up. The intervention was also associated with significant reductions in comorbid diagnoses. These preliminary data indicate that group MCT in the treatment of depression is effective, well accepted and it extends clinical application of MCT for depression to group formats as a potential cost-effective intervention.",Dammen T.; Papageorgiou C.; Wells A.,2015.0,10.3109/08039488.2014.936502,0,0,
9488,Peeking into the black box: mechanisms of action for anger management treatment.,"We investigated potential mechanisms of action for anger symptom reductions, specifically, the roles of anger regulation skills and therapeutic alliance on changes in anger symptoms, following group anger management treatment (AMT) among combat veterans with posttraumatic stress disorder (PTSD). Data were drawn from a published randomized controlled trial of AMT conducted with a racially diverse group of 109 veterans with PTSD and anger symptoms residing in Hawaii. Results of latent growth curve models indicated that gains in calming skills predicted significantly larger reductions in anger symptoms at post-treatment, while the development of cognitive coping and behavioral control skills did not predict greater symptom reductions. Therapeutic alliance had indirect effects on all outcomes mostly via arousal calming skills. Results suggest that generalized symptom reduction may be mediated by development of skills in calming physiological arousal. In addition, arousal reduction skills appeared to enhance one's ability to employ other anger regulation skills.",Mackintosh MA.; Morland LA.; Frueh BC.; Greene CJ.; Rosen CS.,2014.0,10.1016/j.janxdis.2014.07.001,0,0,
9489,Measuring the role of psychological inflexibility in Trichotillomania.,"Psychological Inflexibility (PI) is a construct that has gained recent attention as a critical theoretical component of Acceptance and Commitment Therapy (ACT). PI is typically measured by the Acceptance and Action Questionnaire-II (AAQ-II). However, the AAQ-II has shown questionable reliability in clinical populations with specific diagnoses, leading to the creation of content-specific versions of the AAQ-II that show stronger psychometric properties in their target populations. A growing body of the literature suggests that PI processes may contribute to hair pulling, and the current study sought to examine the psychometric properties and utility of a Trichotillomania-specific version of the AAQ-II, the AAQ-TTM. A referred sample of 90 individuals completed a battery of assessments as part of a randomized clinical trial of Acceptance-Enhanced Behavior Therapy for Trichotillomania. Results showed that the AAQ-TTM has two intercorrelated factors, adequate reliability, concurrent validity, and incremental validity over the AAQ-II. Furthermore, mediational analysis between emotional variables and hair pulling outcomes provides support for using the AAQ-TTM to measure the therapeutic process. Implications for the use of this measure will be discussed, including the need to further investigate the role of PI processes in Trichotillomania.",Houghton DC.; Compton SN.; Twohig MP.; Saunders SM.; Franklin ME.; Neal-Barnett AM.; Ely L.; Capriotti MR.; Woods DW.,2014.0,10.1016/j.psychres.2014.08.003,0,0,
9490,Enhanced action tendencies in high versus low obsessive-compulsive symptoms: an event-related potential study.,"Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by repeated thoughts and behaviors. Inhibitory deficits are presumably related to the onset and maintenance of this disorder. The present study investigated whether obsessive-compulsive (OC) symptoms are related to enhanced response tendencies in reaction to external stimuli. Our goal was to search for direct evidence of an early response preparation process by examining the event-related potential (ERP) component of the readiness potential (RP). An enhanced response tendency might underlie inhibitory deficits in OCD. Response to novel stimuli was studied using a dishabituation paradigm in which a small number of schematic faces (angry or neutral) were presented. An analog sample of healthy subjects was divided into groups of high and low OC levels and high and low trait anxiety levels. The high OC group presented with a greater RP slope gradient that was enhanced under negative valence, compared to the low OC group. No such effect was found in the high versus low trait anxiety groups or in behavioral reaction times (ms). Results support the hypothesis that a stronger readiness for action might characterize subjects with OC symptoms, especially in the presence of threatening stimuli. This finding, specific to OC symptoms and not to anxiety symptoms, may underlie habitual and embodiment tendencies in OCD. This study suggests that early stages of motor preparation might be important to the etiology and maintenance of OC symptoms.",Dayan A.; Berger A.; Anholt GE.,2014.0,10.1016/j.pscychresns.2014.07.007,0,0,
9491,Functional magnetic resonance imaging as experienced by stroke survivors.,"Functional magnetic resonance imaging (fMRI), a noninvasive technique that measures brain activation, has been increasingly used in the past decade, particularly among older adults. Use of fMRI in research with stroke survivors in recent years has substantially contributed to researchers' understanding of the pathophysiology of stroke sequelae. However, despite the increasing popularity and use of fMRI, little is known about the patient experience of fMRI under research circumstances. The current research brief reports the findings of a pilot study undertaken to understand stroke survivors' experiences with fMRI under research circumstances. Nine ischemic stroke patients underwent two MRI sessions, each of which lasted 1.5 hours and included several fMRI tasks. Patients were asked about their experiences and to share any advice. All participants reported that they did not feel claustrophobic; in addition, the importance of educating participants about fMRI was a universal theme that emerged. Knowledge of participant experiences may help with enrollment strategies for fMRI studies and improve research outcomes related to the fMRI experience.",Hadidi NN.; Cullen KR.; Hall LM.; Lindquist R.; Buckwalter KC.; Mathews E.,,10.3928/19404921-20140820-01,0,0,5587
9492,Self-reported immature defense style as a predictor of outcome in short-term and long-term psychotherapy.,"Identification of pretreatment patient characteristics predictive of psychotherapy outcome could help to guide treatment choices. This study evaluates patients' initial level of immature defense style as a predictor of the outcome of short-term versus long-term psychotherapy. In the Helsinki Psychotherapy Study, 326 adult outpatients with mood or anxiety disorder were randomized to individual short-term (psychodynamic or solution-focused) or long-term (psychodynamic) psychotherapy. Their defense style was assessed at baseline using the 88-item Defense Style Questionnaire and classified as low or high around the median value of the respective score. Both specific (Beck Depression Inventory [BDI], Hamilton Depression Rating Scale [HDRS], Symptom Check List Anxiety Scale [SCL-90-Anx], Hamilton Anxiety Rating Scale [HARS]) and global (Symptom Check List Global Severity Index [SCL-90-GSI], Global Assessment of Functioning Scale [GAF]) psychiatric symptoms were measured at baseline and 3-7 times during a 3-year follow-up. Patients with high use of immature defense style experienced greater symptom reduction in long-term than in short-term psychotherapy by the end of the 3-year follow-up (50% vs. 34%). Patients with low use of immature defense style experienced faster symptom reduction in short-term than in long-term psychotherapy during the first year of follow-up (34% vs. 19%). Knowledge of patients' initial level of immature defense style may potentially be utilized in tailoring treatments. Further research on defense styles as outcome predictors in psychotherapies of different types is needed.",Laaksonen MA.; Sirkiä C.; Knekt P.; Lindfors O.,2014.0,10.1002/brb3.190,0,0,
9493,How does immediate recall of a stressful event affect psychological response to it?,"In forensic settings, individuals who experience a traumatic event are often encouraged to recall it soon afterwards to preserve their memory for it. Some theories of the development of post-traumatic stress disorder (PTSD) suggest that this may increase psychopathology. The primary aim of the study was to examine the effect of immediate recall of a trauma analogue video on psychopathology. Eighty-five undergraduate students were randomised to view a video of a car accident, described as either a real event (high stress) or training event (low stress). They then completed either the Self-Administered Interview (SAI©, Gabbert, Hope, & Fisher, 2009) or a filler task. All participants returned one week later to provide an account of the event. As predicted, participants in the SAI early recall task condition remembered the video content better one week after seeing the video, shown both by their greater recall of correct details and greater rejection of misinformation. However, completing the SAI resulted in higher anxiety immediately afterwards, and more severe PTSD-like symptoms one week later, compared to control condition. PTSD intrusion-like symptoms also predicted more accurate recall, while avoidance predicted poorer memory. While the trauma analogue video used in this study has been previously used, and did effectively trigger post-traumatic-like symptoms, it is unclear how well these results generalise to actual trauma situations. These results suggest the relationship between PTSD symptoms and memory might be more complex than previously recognised, with intrusive phenomena possibly promoting memory and avoidance symptoms compromising memory.",Gittins CB.; Paterson HM.; Sharpe L.,2015.0,10.1016/j.jbtep.2014.07.006,0,0,
9494,Personality disorder moderates outcome in short- and long-term group analytic psychotherapy: A randomized clinical trial.,"In a randomized clinical trial, short- and long-term psychodynamic group psychotherapy (STG and LTG, respectively) schedules were equally effective for the 'typical' patient during a 3-year study period. Although several studies have reported good effects for patients with personality disorders (PD) in diverse forms of psychotherapy, the significance of treatment duration is unclear. Therefore, we tested the hypothesis that PD patients would improve more during and after LTG than STG. A randomized, longitudinal, prospective study contrasting the outcomes during and after short- and long-term dynamic group psychotherapies. One hundred and sixty-seven outpatients with mood disorders, anxiety disorders, or PD were randomized to STG or LTG (respectively, 20 or 80 weekly sessions of 90 min each). Outcome measures are as follows: symptoms (SCL-90-R), interpersonal problems (IIP-C), and psychosocial functioning (GAF split version: GAF-Symptom and GAF-Function). PD pathology (number of PD criteria items) was selected a priori as a putative moderator of treatment effects. Change during the 3-year study period was assessed using linear mixed models. The study was registered at ClinicalTrials.gov as NCT 00021417. Our hypothesis was supported, as patients with PD improved significantly more regarding all outcome variables in LTG than STG. For patients without PD, the rate of change was similar across 3 years; however, the rate of change in symptoms and interpersonal problems was higher in STG during the first 6 months. The effectiveness of LTG is higher for patients with co-morbid PD. Patients without PD do not appear to experience additional gain from LTG. Clinical implications: LTG demonstrates better effectiveness than STG for patients with personality disorder co-morbidity (PD). Patients without PD do not appear to experience additional gain from attending LTG. Correct initial allocation to treatment duration may prevent disruptive breaks in relationships and lead to both human and economic cost savings. Limitations: Trials on mixed diagnostic samples may limit the ability to fully assess change for specific diagnostic groups. Therapists were unable to select patients and compose their own groups. Although this condition might increase the generalizability of the results, it may also have restricted the therapists and the clinical situation inadvertently.",Lorentzen S.; Ruud T.; Fjeldstad A.; H√∏glend PA.,2015.0,10.1111/bjc.12065,0,0,
9495,Impact of cognitive-behavioral therapy for social anxiety disorder on the neural bases of emotional reactivity to and regulation of social evaluation.,"We examined whether Cognitive-Behavioral Therapy (CBT) for social anxiety disorder (SAD) would modify self-reported negative emotion and functional magnetic resonance imaging brain responses when reacting to and reappraising social evaluation, and tested whether changes would predict treatment outcome in 59 patients with SAD who completed CBT or waitlist groups. For reactivity, compared to waitlist, CBT resulted in (a) increased brain responses in right superior frontal gyrus (SFG), inferior parietal lobule (IPL), and middle occipital gyrus (MOG) when reacting to social praise, and (b) increases in right SFG and IPL and decreases in left posterior superior temporal gyrus (pSTG) when reacting to social criticism. For reappraisal, compared to waitlist, CBT resulted in greater (c) reductions in self-reported negative emotion, and (d) increases in brain responses in right SFG and MOG, and decreases in left pSTG. A linear regression found that after controlling for CBT-induced changes in reactivity and reappraisal negative emotion ratings and brain changes in reactivity to praise and criticism, reappraisal of criticism brain response changes predicted 24% of the unique variance in CBT-related reductions in social anxiety. Thus, one mechanism underlying CBT for SAD may be changes in reappraisal-related brain responses to social criticism. NCT00380731. http://www.clinicaltrials.gov/ct2/show/NCT00380731?term=social+anxiety+cognitive+behavioral+therapy+Stanford&rank=1.",Goldin PR.; Ziv M.; Jazaieri H.; Weeks J.; Heimberg RG.; Gross JJ.,2014.0,10.1016/j.brat.2014.08.005,0,0,
9496,Non-suicidal self-injury during an exposure-based treatment in patients with posttraumatic stress disorder and borderline features.,"Patients with posttraumatic stress disorder (PTSD) and features of borderline personality disorder (BPD) often show non-suicidal self-injury (NSSI). However, patients with on-going NSSI are mostly excluded from PTSD treatments and NSSI during PTSD treatment has rarely been investigated. The aim of the present study was to evaluate the course of NSSI during an exposure-based PTSD treatment. This study focused on a subset (n = 34) of data from a randomised controlled trial that tested the efficacy of a residential PTSD programme (DBT-PTSD) in comparison to a treatment-as-usual wait-list. In this subset we compared a) NSSI during treatment between participants who had or had not engaged in NSSI pre-treatment and b) NSSI between treatment weeks that included exposure interventions vs. those that did not. We further compared the outcome between participants with vs. without NSSI at pre-treatment. At pre-treatment, 62% participants reported on-going NSSI. During treatment, the percentage of participants carrying out NSSI decreased to 38% (p = 0.003). The rates of NSSI were similar in treatment weeks with exposure compared to weeks without. Similar results were observed for the frequency of NSSI. At the end of treatment, participants showed comparable improvement in PTSD symptoms regardless of whether or not they had exhibited NSSI beforehand.",Krüger A.; Kleindienst N.; Priebe K.; Dyer AS.; Steil R.; Schmahl C.; Bohus M.,2014.0,10.1016/j.brat.2014.08.003,0,0,
9497,Stereotype confirmation concerns predict dropout from cognitive behavioral therapy for social anxiety disorder.,"There are high attrition rates observed in efficacy studies for social anxiety disorder, and research has not identified consistent nor theoretically meaningful predictors of dropout. Pre-treatment symptom severity and demographic factors, such as age and gender, are sometimes predictive of dropout. The current study examines a theoretically meaningful predictor of attrition based on experiences associated with social group membership rather than differences between social group categories--fear of confirming stereotypes. This is a secondary data analysis of a randomized controlled trial comparing two cognitive behavioral treatments for social anxiety disorder: virtual reality exposure therapy and exposure group therapy. Participants (N = 74) with a primary diagnosis of social anxiety disorder who were eligible to participate in the parent study and who self-identified as either ""African American"" (n = 31) or ""Caucasian"" (n = 43) completed standardized self-report measures of stereotype confirmation concerns (SCC) and social anxiety symptoms as part of a pre-treatment assessment battery. Hierarchical logistic regression showed that greater stereotype confirmation concerns were associated with higher dropout from therapy--race, age, gender, and pre-treatment symptom severity were not. Group treatment also was associated with higher dropout. These findings urge further research on theoretically meaningful predictors of attrition and highlight the importance of addressing cultural variables, such as the experience of stereotype confirmation concerns, during treatment of social anxiety to minimize dropout from therapy.",Johnson S.; Price M.; Mehta N.; Anderson PL.,2014.0,10.1186/s12888-014-0233-8,0,0,
9498,"Effects of anxiety sensitivity on alcohol problems: evaluating chained mediation through generalized anxiety, depression and drinking motives.","To test whether the relations between anxiety sensitivity (AS), a transdiagnostic risk factor, and alcohol problems are explained by chained mediation models, from AS through anxiety or depressive symptoms then drinking motives in an at-risk sample. It was hypothesized that AS would influence alcohol problems through generalized anxiety or depression symptoms and then through negatively reinforced drinking motives (i.e. drinking to cope with negative affect and drinking to conform). Cross-sectional single- and chained-mediation models were tested. Self-report measures were completed in clinics at Florida State University and the University of Vermont, USA. Participants consisted of 523 adult daily cigarette smokers [mean age‚Äâ=‚Äâ37.23, standard deviation (SD)‚Äâ=‚Äâ13.53; 48.6% female]. As part of a larger battery of self-report measures, participants completed self-report measures of AS, generalized anxiety, depression, drinking motives and alcohol problems. Chained mediation was found from AS to alcohol problems through generalized anxiety then through drinking to cope with negative affect [B‚Äâ=‚Äâ0.04, 90% confidence interval (CI)‚Äâ=‚Äâ0.004, 0.10)]. Chained mediation was also found from AS to alcohol problems through depression then through drinking to cope with negative affect (B‚Äâ=‚Äâ0.11, 90% CI‚Äâ=‚Äâ0.05, 0.21) and, separately, through socially motivated drinking (B‚Äâ=‚Äâ0.05, 90% CI‚Äâ=‚Äâ0.003, 0.11). Anxiety sensitivity and alcohol problems are indirectly related through several intervening variables, such as through generalized anxiety or depression and then through drinking to cope with negative affect.",Allan NP.; Albanese BJ.; Norr AM.; Zvolensky MJ.; Schmidt NB.,2015.0,10.1111/add.12739,0,0,
9499,Effects of an early intervention on maternal post-traumatic stress symptoms and the quality of mother-infant interaction: the case of preterm birth.,"Preterm birth may represent a traumatic situation for both parents and a stressful situation for the infant, potentially leading to difficulties in mother-infant relationships. This study aimed to investigate the impact of an early intervention on maternal posttraumatic stress symptoms, and on the quality of mother-infant interactions, in a sample of very preterm infants and their mothers. Half of the very preterm infants involved in the study (n=26) were randomly assigned to a 3-step early intervention program (at 33 and 42 weeks after conception and at 4 months' corrected age). Both groups of preterm infants (with and without intervention) were compared to a group of full-term infants. The impact of the intervention on maternal posttraumatic stress symptoms was assessed 42 weeks after conception and when the infants were 4 and 12 months of age. The impact of the intervention on the quality of mother-infant interactions was assessed when the infants were 4 months old. Results showed a lowering of mothers' posttraumatic stress symptoms between 42 weeks and 12 months in the group of preterm infants who received the intervention. Moreover, an enhancement in maternal sensitivity and infant cooperation during interactions was found at 4 months in the group with intervention. In the case of a preterm birth, an early intervention aimed at enhancing the quality of the mother-infant relationship can help to alleviate maternal post-traumatic stress symptoms and may have a positive impact on the quality of mother-infant interactions.",Borghini A.; Habersaat S.; Forcada-Guex M.; Nessi J.; Pierrehumbert B.; Ansermet F.; Müller-Nix C.,2014.0,10.1016/j.infbeh.2014.08.003,0,0,
9500,Therapygenetics: anterior cingulate cortex-amygdala coupling is associated with 5-HTTLPR and treatment response in panic disorder with agoraphobia.,"Variation in the 5'-flanking promoter region of the serotonin transporter gene SLC6A4, the 5-HTT-linked polymorphic region (5-HTTLPR) has been inconclusively associated with response to cognitive-behavioural therapy (CBT). As genomic functions are stronger related to neural than to behavioural markers, we investigated the association of treatment response, 5-HTTLPR and functional brain connectivity in patients with panic disorder with agoraphobia (PD/AG). Within the national research network PANIC-NET 231 PD/AG patients who provided genetic information underwent a manualized exposure-based CBT. A subset of 41 patients participated in a functional magnetic resonance imaging (fMRI) add-on study prior to treatment applying a differential fear conditioning task. Neither the treatment nor the reduced fMRI sample showed a direct effect of 5-HTTLPR on treatment response as defined by a reduction in the Hamilton Anxiety Scale score ≥50 % from baseline to post assessment. On a neural level, inhibitory anterior cingulate cortex (ACC)-amygdala coupling during fear conditioning that had previously been shown to characterize treatment response in this sample was driven by responders with the L/L genotype. Building upon conclusive evidence from basic and preclinical findings on the association of the 5-HTTLPR polymorphism with emotion regulation and related brain connectivity patterns, present findings translate these to a clinical sample of PD/AG patients and point towards a potential intermediate connectivity phenotype modulating response to exposure-based CBT.",Lueken U.; Straube B.; Wittchen HU.; Konrad C.; Ströhle A.; Wittmann A.; Pfleiderer B.; Arolt V.; Kircher T.; Deckert J.; Reif A.,2015.0,10.1007/s00702-014-1311-2,0,0,
9501,Response inhibition in a subclinical obsessive-compulsive sample.,"Inconsistent findings across studies challenge the viability of response inhibition (RI) as an endophenotype of obsessive-compulsive disorder (OCD). Contemporary conceptualization of endophenotypes in psychiatric disorders suggests that these markers vary continuously in the general population, highlighting the importance of analogue sample research. Although neuropsychological functions have been studied in subclinical obsessive-compulsive (OC) samples, no study to date had examined RI in the context of the go/no-go paradigm. A subclinical OC sample (HOC; n = 27) and a low OC symptoms control sample (LOC; n = 25), as determined by the Obsessive-Compulsive Inventory-Revised, completed a go/no-go task and clinical questionnaires. The groups did not differ on age, gender, or state anxiety. Controlling for depressive severity, the HOC group made significantly more commission errors and exhibited larger response time variability on the go/no-go task. However, standardized scores produced using population norms revealed that the HOC group performed within normative range. This study used a non-clinical sample and no structured clinical screening was performed. Compared to LOC participants, a psychometrically-defined subclinical OC sample exhibited deficient RI and sustained attention. However, when raw scores were converted to age and education adjusted standardized scores according to the test's population norms, the HOC group task performance was in the normative range. These results, are in line with findings in OCD samples, suggesting that moderate degree of RI deficiencies is associated with the presence of OC symptomatology regardless of clinical status. However, the conceptualization of RI underperformance as an OCD disorder-specific impairment, remains controversial.",Abramovitch A.; Shaham N.; Levin L.; Bar-Hen M.; Schweiger A.,2015.0,10.1016/j.jbtep.2014.09.001,0,0,
9502,Maternally administered interventions for preterm infants in the NICU: effects on maternal psychological distress and mother-infant relationship.,"Although studies have examined the effects of interventions focused on preterm infants, few studies have examined the effects on maternal distress (anxiety, depressive symptoms, post-traumatic stress symptoms, parenting stress) or parenting. This study examined the effects of the auditory-tactile-visual-vestibular (ATVV) intervention and kangaroo care (KC) on maternal distress and the mother-infant relationship compared to an attention control group. 240 mothers from four hospitals were randomly assigned to the three groups. Maternal characteristics in the three groups were similar: 64.1% of ATVV mothers, 64.2% of KC mothers, and 76.5% of control mothers were African American; maternal age averaged 26.3 years for ATVV mothers, 28.1 for KC mothers, and 26.6 for control mothers; and years of education averaged 13.6 for ATVV and KC mothers, and 13.1 for control mothers. Mothers only differed on parity: 68.4% of ATVV and 54.7% of KC mothers were first-time mothers as compared to 43.6% of control mothers. Their infants had a similar mean gestational ages (27.0 weeks for ATVV, 27.2 for KC, and 27.4 for control) and mean birthweights (993 g for ATVV, 1022 for KC, and 1023 for control). Mothers completed questionnaires during hospitalization, and at 2, 6 and 12 months corrected age on demographic characteristics, depressive symptoms, state anxiety, post-traumatic stress symptoms, parenting stress, worry about child health, and child vulnerability (only at 12 months). At 2 and 6 months, 45-min videotapes of mother-infant interactions were made, and the HOME Inventory was scored. Behaviors coded from the videotapes and a HOME subscale were combined into five interactive dimensions: maternal positive involvement and developmental stimulation and child social behaviors, developmental maturity, and irritability. Intervention effects were examined using general linear mixed models controlling for parity and recruitment site. The groups did not differ on any maternal distress variable. Kangaroo care mothers showed a more rapid decline in worry than the other mothers. The only interactive dimensions that differed between the groups were child social behaviors and developmental maturity, which were both higher for kangaroo care infants. Change over time in several individual infant behaviors was affected by the interventions. When mothers reported on the interventions they performed, regardless of group assignment, massage (any form including ATVV) was associated with a more rapid decline in depressive symptoms and higher HOME scores. Performing either intervention was associated with lower parenting stress. These findings suggest that as short-term interventions, KC and ATVV have important effects on mothers and their preterm infants, especially in the first half of the first year.",Holditch-Davis D.; White-Traut RC.; Levy JA.; O'Shea TM.; Geraldo V.; David RJ.,2014.0,10.1016/j.infbeh.2014.08.005,0,0,
9503,Contemplative self healing in women breast cancer survivors: a pilot study in underserved minority women shows improvement in quality of life and reduced stress.,"Among underserved, largely minority women who were breast cancer survivors, this pilot project was designed to evaluate the quality of life outcomes of a 20 week Contemplative Self-Healing Program. Women previously treated for stage I-III breast cancer were assessed before and after the 20 week program with the FACT-G, FACT-B, FACIT-Spirituality, ECOG, and the Impact of Events Scale. They participated in a 20-week intervention involving guided meditation and cognitive-affective-behavioral learning. With an average age of 63, 62% of the participants were African-American or Latino. With an average of 5.4 years since the diagnosis of breast cancer, 72% had an ECOG performance status of 1. 57% were currently working. Their baseline FACT-G was 80.5 ± 15.1, and their baseline Impact of Events Scale was 26.3 ± 18.9. The within-patient improvement on the FACT-G was 4.6 ± 10.9 (p = .01); in parallel the FACT-B improved by 2.8 ± 12.8 points (p = .03). The Impact of Events Scale improved by 6.6 ± 15.5 points (p = .01). There was significant within-patient improvement on both the avoidance scale (3.8 ± 9.2) and on the intrusion scale (2.9 ± 7.9). Patients who attended more sessions and conducted more home practice had greater improvements in quality of life. Persons receiving a 20-session contemplative self healing intervention showed improved quality of life, with a clinically and statistically significant increase in the FACT-G. In addition, this population showed a significant reduction in post-traumatic stress symptoms assessed by the Impact of Events Scale. Clinical Trials Gov NCT00278837.",Charlson ME.; Loizzo J.; Moadel A.; Neale M.; Newman C.; Olivo E.; Wolf E.; Peterson JC.,2014.0,10.1186/1472-6882-14-349,0,0,
9504,"Effects of mental health self-efficacy on outcomes of a mobile phone and web intervention for mild-to-moderate depression, anxiety and stress: secondary analysis of a randomised controlled trial.","Online psychotherapy is clinically effective yet why, how, and for whom the effects are greatest remain largely unknown. In the present study, we examined whether mental health self-efficacy (MHSE), a construct derived from Bandura's Social Learning Theory (SLT), influenced symptom and functional outcomes of a new mobile phone and web-based psychotherapy intervention for people with mild-to-moderate depression, anxiety and stress. STUDY I: Data from 49 people with symptoms of depression, anxiety and/or stress in the mild-to-moderate range were used to examine the reliability and construct validity of a new measure of MHSE, the Mental Health Self-efficacy Scale (MHSES). We conducted a secondary analysis of data from a recently completed randomised controlled trial (N‚Äâ=‚Äâ720) to evaluate whether MHSE effected post-intervention outcomes, as measured by the Depression, Anxiety and Stress Scales (DASS) and Work and Social Adjustment Scale (WSAS), for people with symptoms in the mild-to-moderate range. STUDY I: The data established that the MHSES comprised a unitary factor, with acceptable internal reliability (Cronbach's alpha‚Äâ=‚Äâ.89) and construct validity. The intervention group showed significantly greater improvement in MHSE at post-intervention relative to the control conditions (p's‚Äâ<‚Äâ= .000). MHSE mediated the effects of the intervention on anxiety and stress symptoms. Furthermore, people with low pre-treatment MHSE reported the greatest post-intervention gains in depression, anxiety and overall distress. No effects were found for MHSE on work and social functioning. Mental health self-efficacy influences symptom outcomes of a self-guided mobile phone and web-based psychotherapeutic intervention and may itself be a worthwhile target to increase the effectiveness and efficiency of online treatment programs. Australian New Zealand Clinical Trials Registry ACTRN12610000625077.",Clarke J.; Proudfoot J.; Birch MR.; Whitton AE.; Parker G.; Manicavasagar V.; Harrison V.; Christensen H.; Hadzi-Pavlovic D.,2014.0,10.1186/s12888-014-0272-1,0,0,
9505,The Diagnostic Apathia Scale predicts the ability to return to work following depression or anxiety.,"The aim of this study was to evaluate the validity of a new apathy rating scale in predicting the ability to return to work (RTW) in patients with depression or anxiety a year after discharge from a psychiatric hospital. We evaluated 56 patients with depression or anxiety, who participated in an on-going randomised clinical trial using RTW as primary outcome. The degree of apathy was measured by the Diagnostic Apathia Scale, which contains six items covering the following neuropsychological symptoms: concentration/memory problems, difficulties in decision making, lassitude, tiredness/fatigue, insomnia, and reduced ability to work and engage in personal interests. The scale was analysed for psychometric validity (scalability) and for its ability to predict RTW. Finally, the predictive validity of the Diagnostic Apathia Scale regarding RTW was compared with scales measuring severity of depression/anxiety symptoms, disability, and psychological well-being. The Diagnostic Apathia Scale displayed sufficient scalability, that is, the total score was a psychometrically valid measure of apathy. Only the Diagnostic Apathia Scale, and not the scales measuring severity of symptoms, disability, or psychological well-being, had predictive validity regarding RTW. Thus, 76% with 'clinically significant apathy' at baseline were unable to RTW versus 50% of the patients without apathy (p<0.05). The Diagnostic Apathia Scale was found to have an acceptable predictive validity in terms of patients' ability to RTW 1 year after discharge from hospitalisation for depression or anxiety.",Hellström LC.; Eplov LF.; Nordentoft M.; Østergaard SD.; Bech P.,2014.0,10.1017/neu.2014.23,0,0,
9506,"Therapist-guided, Internet-based cognitive-behavioural therapy for body dysmorphic disorder (BDD-NET): a feasibility study.","Cognitive-behavioural therapy (CBT) is an effective treatment for body dysmorphic disorder (BDD). However, most sufferers do not have access to this treatment. One way to increase access to CBT is to administer treatment remotely via the Internet. This study piloted a novel therapist-supported, Internet-based CBT program for BDD (BDD-NET). Uncontrolled clinical trial. Patients (N=23) were recruited through self-referral and assessed face to face at a clinic specialising in obsessive-compulsive and related disorders. Suitable patients were offered secure access to BDD-NET. BDD-NET is a 12-week treatment program based on current psychological models of BDD that includes psychoeducation, functional analysis, cognitive restructuring, exposure and response prevention, and relapse prevention modules. A dedicated therapist provides active guidance and feedback throughout the entire process. The clinician-administered Yale-Brown Obsessive Compulsive Scale for BDD (BDD-YBOCS). Symptom severity was assessed pretreatment, post-treatment and at the 3-month follow-up. BDD-NET was deemed highly acceptable by patients and led to significant improvements on the BDD-YBOCS (p=<0.001) with a large within-group effect size (Cohen's d=2.01, 95% CI 1.05 to 2.97). At post-treatment, 82% of the patients were classified as responders (defined as≥30% improvement on the BDD-YBOCS). These gains were maintained at the 3-month follow-up. Secondary outcome measures of depression, global functioning and quality of life also showed significant improvements with moderate to large effect sizes. On average, therapists spent 10 min per patient per week providing support. The results suggest that BDD-NET has the potential to greatly increase access to CBT, at least for low-risk individuals with moderately severe BDD symptoms and reasonably good insight. A randomised controlled trial of BDD-NET is warranted. Clinicaltrials.gov registration ID NCT01850433.",Enander J.; Ivanov VZ.; Andersson E.; Mataix-Cols D.; Ljótsson B.; Rück C.,2014.0,10.1136/bmjopen-2014-005923,0,0,
9507,Dialogical Exposure with Traumatically Bereaved Bosnian Women: Findings from a Controlled Trial.,"In this trial, we compared the relative efficacy of dialogical exposure group treatment using Gestalt empty-chair method with a supportive group in the treatment of symptoms stemming from traumatic loss in a post-war society. One-hundred and nineteen women whose husbands were either killed or registered as missing during the war in Bosnia and Herzegovina were quasi-randomized to seven sessions of group treatment with dialogical exposure or to an active control condition. Both interventions resulted in significant improvement from baseline to post-treatment for both kinds of loss, in terms of post-traumatic symptoms, general mental health and grief reactions, with the exception of depression and traumatic grief in the control condition. Regarding mean effect sizes (Cohen's d), pre-treatment to post-treatment improvements were moderate (d‚Äâ=‚Äâ0.56) for the dialogical exposure group and small (d‚Äâ=‚Äâ0.34) for the supportive group. Treatment gains were maintained at least until the 1-year follow-up. In controlled comparisons, dialogical exposure was superior concerning traumatic grief (Cohen's d‚Äâ=‚Äâ0.37) and post-traumatic avoidance (d‚Äâ=‚Äâ0.73) at post-treatment. Results show that short-term dialogical exposure group treatment was moderately effective in treating traumatically bereaved women. Research attests to high levels of symptoms among post-war civil populations, in particular, when a loved one was killed, which can lead not only to trauma reactions but also to severe separation distress. Grieving the loss of a loved one is hampered if the death remains unconfirmed. Unconfirmed loss could be conceptualized as unfinished business in terms of Gestalt therapy, which offers empty-chair dialogue for resolving unfinished business and grief. Dialogical exposure therapy (DET) supports the client in gaining awareness of and expressing his or her inner dialogues concerning the traumatic event, using Gestalt empty-chair method. Short-term DET was effective in treating traumatically bereaved women but showed little additional effects in comparison with a supportive group treatment, so further research is warranted.",Hagl M.; Powell S.; Rosner R.; Butollo W.,,10.1002/cpp.1921,0,0,6384
9508,Cognitive processing therapy for male veterans with military sexual trauma-related posttraumatic stress disorder.,"The current study examined 11 male veterans with military sexual trauma (MST)-related posttraumatic stress disorder (PTSD) who participated in a larger randomized control trial comparing cognitive processing therapy (CPT) to a well-established control treatment (Present Centered Therapy; PCT) among men and women with MST-related PTSD. All participants (n=11) completed a 12 session protocol of CPT. The Clinician Administered PTSD Scale (CAPS), PTSD Checklist (PCL), and Quick Inventory of Depressive Symptomatology (QIDS) were administered at baseline and post-treatment sessions 2, 4, and 6 months after CPT completion. Additionally, the PCL and QIDS were administered every two sessions during CPT treatment. Piecewise growth curve analyses revealed that significant change over time in both PTSD and depressive symptoms was associated with the active treatment phase and that participants maintained treatment gains over the 6-month follow-up period. CPT effectively reduced self-reported symptoms of PTSD as well as depressive symptoms for men with MST-related PTSD. Additionally, participants maintained the gains they made during treatment over a 6-month follow-up period. It is recommended that future studies examine patient characteristics that might impact outcome in order to improve understanding of who benefits the most from treatment.",Mullen K.; Holliday R.; Morris E.; Raja A.; Surís A.,2014.0,10.1016/j.janxdis.2014.09.004,0,0,
9509,Autonomic effects of cognitive reappraisal and acceptance in social anxiety: evidence for common and distinct pathways for parasympathetic reactivity.,"Few studies investigated the effects of emotion regulation strategies on autonomic parameters in socially anxious individuals. We asked 99 socially anxious participants to give an impromptu speech in front of an audience in a virtual reality environment. In the anticipation phase, they practiced an emotion regulation strategy: negative functional reappraisal, acceptance, negative dysfunctional reappraisal. All strategies led to decreases in parasympathetic activity and increases in heart rate during anticipation. Parasympathetic activity remained low in the recovery phase, while heart rate increased, indicating a possible rebound effect of social performance. Exploratory moderation analysis revealed that for subjects with higher social anxiety, acceptance led to increased parasympathetic activity in the anticipation and recovery phases than negative functional reappraisal. Our results indicate that although globally parasympathetic reactivity seems to be a more general marker of simply attempting to regulate emotions, it could help distinguish between emotion regulation strategies for some participant subgroups.",Cristea IA.; Valenza G.; Scilingo EP.; Szentágotai Tătar A.; Gentili C.; David D.,2014.0,10.1016/j.janxdis.2014.09.009,0,0,
9510,Can parent training for parents with high levels of expressed emotion have a positive effect on their child's social anxiety improvement?,"The role that parents' involvement may play in improving their child's social anxiety is still under debate. This paper aimed to investigate whether training parents with high expressed emotion (EE) could improve outcomes for adolescent social anxiety intervention. Fifty-two socially anxious adolescents (aged 13-18 years), whose parents exhibited high levels of expressed emotion, were assigned to either (a) a school-based intervention with an added parent training component, or (b) a school-based program focused solely on intervening with the adolescent (no parental involvement). Post-treatment and 12-month follow-up findings showed that school-based intervention with parent training was superior to the adolescent-specific program, yielding significant reductions in diagnosis remission, social and depressive symptomatology, particularly when the EE status of parents changed. Overall, the findings suggest that high-EE parents of children with social anxiety need to be involved in their child's therapy.",Garcia-Lopez LJ.; Díaz-Castela Mdel M.; Muela-Martinez JA.; Espinosa-Fernandez L.,2014.0,10.1016/j.janxdis.2014.09.001,0,0,
9511,Short-term effectiveness of web-based guided self-help for phobic outpatients: randomized controlled trial.,"Internet-based guided self-help has been successfully used in the general population, but it is unknown whether this method can be effectively used in outpatient clinics for patients waiting for face-to-face psychotherapy for phobias. The aim was to assess the clinical effectiveness of Phobias Under Control, an Internet-based intervention based on exposure therapy with weekly guidance. We conducted a randomized controlled trial, recruiting 212 outpatients scheduled to receive face-to-face psychotherapy for any type of phobia at an outpatient clinic. Participants suffering from at least 1 DSM-IV or ICD-10 classified phobia (social phobia, agoraphobia with or without panic disorder, and/or specific phobia as ascertained by a telephone interview at baseline) were randomly allocated to either a 5-week Internet-based guided self-help program based on exposure therapy with weekly student support followed by face-to-face psychotherapy (n=105) or a wait-list control group followed by face-to-face psychotherapy (n=107). Primary outcome was the Fear Questionnaire (FQ). Secondary outcomes were the Beck Anxiety Inventory (BAI) and Center of Epidemiological Studies-Depression scale (CES-D). Assessments took place by telephone at baseline (T0) and on the Internet at posttest (T1, self-assessment at 5 weeks after baseline). Missing data at T1 were imputed. At posttest, analysis of covariance on the intention-to-treat sample showed significant but small effect sizes between intervention and control groups on the FQ (d=0.35, P=.02), CES-D (d=0.34, P=.03), and a nonsignificant effect size on the BAI (d=0.28. P=.05). Although initial acceptance was good, high nonresponse was observed, with 86 of 212 participants (40.5%) lost to follow-up at T1 and only 14 of 105 (13.3%) intervention participants finishing all 5 weeks. Phobias Under Control is modestly effective in lowering phobic and depressive symptoms in a relatively short period and may be clinically beneficial when implemented in routine outpatient practice. Netherlands Trial Register NTR2233; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2233 (Archived by WebCite at http://www.webcitation.org/6O2ioOQSs).",Kok RN.; van Straten A.; Beekman AT.; Cuijpers P.,2014.0,10.2196/jmir.3429,0,0,
9512,"Prevention of generalized anxiety disorder using a web intervention, iChill: randomized controlled trial.","Generalized Anxiety Disorder (GAD) is a high prevalence, chronic disorder. Web-based interventions are acceptable, engaging, and can be delivered at scale. Few randomized controlled trials evaluate the effectiveness of prevention programs for anxiety, or the factors that improve effectiveness and engagement. The intent of the study was to evaluate the effectiveness of a Web-based program in preventing GAD symptoms in young adults, and to determine the role of telephone and email reminders. A 5-arm randomized controlled trial with 558 Internet users in the community, recruited via the Australian Electoral Roll, was conducted with 6- and 12-month follow-up. Five interventions were offered over a 10-week period. Group 1 (Active website) received a combined intervention of psycho-education, Internet-delivered Cognitive Behavioral Therapy (ICBT) for anxiety, physical activity promotion, and relaxation. Group 2 (Active website with telephone) received the identical Web program plus weekly telephone reminder calls. Group 3 (Active website with email) received the identical Web program plus weekly email reminders. Group 4 (Control) received a placebo website. Group 5 (Control with telephone) received the placebo website plus telephone calls. Main outcome measures were severity of anxiety symptoms as measured by the GAD 7-item scale (GAD-7) (at post-test, 6, and 12 months). Secondary measures were GAD caseness, measured by the Mini International Neuropsychiatric Interview (MINI) at 6 months, Centre for Epidemiologic Studies-Depression scale (CES-D), Anxiety Sensitivity Index (ASI), Penn State Worry Questionnaire (PSWQ), and Days out of Role. GAD-7 symptoms reduced over post-test, 6-month, and 12-month follow-up. There were no significant differences between Group 4 (Control) and Groups 1 (Active website), 2 (Active website with telephone), 3 (Active website with email), or 5 (Control with telephone) at any follow-up. A total of 16 cases of GAD were identified at 6 months, comprising 6.7% (11/165) from the Active groups (1, 2, 3) and 4.5% (5/110) from the Control groups (4, 5), a difference that was not significant. CES-D, ASI, and PSWQ scores were significantly lower for the active website with email reminders at post-test, relative to the control website condition. Indicated prevention of GAD was not effective in reducing anxiety levels, measured by GAD-7. There were significant secondary effects for anxiety sensitivity, worry, and depression. Challenges for indicated prevention trials are discussed. International Standard Randomized Controlled Trial Number (ISRCTN): 76298775; http://www.controlled-trials.com/ISRCTN76298775 (Archived by WebCite at http://www.webcitation.org/6S9aB5MAq).",Christensen H.; Batterham P.; Mackinnon A.; Griffiths KM.; Kalia Hehir K.; Kenardy J.; Gosling J.; Bennett K.,2014.0,10.2196/jmir.3507,0,0,
9513,An examination of the bidirectional relationship between functioning and symptom levels in patients with anxiety disorders in the CALM study.,"Patients with anxiety disorders suffer marked functional impairment in their activities of daily living. Many studies have documented that improvements in anxiety symptom severity predict functioning improvements. However, no studies have investigated how improvements in functioning simultaneously predict symptom reduction. We hypothesized that symptom levels at a given time point will predict functioning at the subsequent time point, and simultaneously that functioning at a given time point will predict symptom levels at a subsequent time point. Patients were recruited from primary-care centers for the Coordinated Anxiety Learning and Management (CALM) study and were randomized to receive either computer-assisted cognitive-behavioral therapy and/or medication management (ITV) or usual care (UC). A cross-lagged panel design examined the relationship between functional impairment and anxiety and depression symptom severity at baseline, 6-, 12-, and 18-month follow-up assessments. Prospective prediction of functioning from symptoms and symptoms from functioning were both important in modeling these associations. Anxiety and depression predicted functioning as strongly as functioning predicted anxiety and depression. There were some differences in these associations between UC and ITV. Where differences emerged, the UC group was best modeled with prospective paths predicting functioning from symptoms, whereas symptoms and functioning were both important predictors in the ITV group. Treatment outcome is best captured by measures of functional impairment as well as symptom severity. Implications for treatment are discussed, as well as future directions of research.",Brown LA.; Krull JL.; Roy-Byrne P.; Sherbourne CD.; Stein MB.; Sullivan G.; Rose RD.; Bystritsky A.; Craske MG.,2015.0,10.1017/S0033291714002062,0,0,
9514,Early intervention to protect the mother-infant relationship following postnatal depression: study protocol for a randomised controlled trial.,"At least 13% of mothers experience depression in the first postnatal year, with accompanying feelings of despair and a range of debilitating symptoms. Serious sequelae include disturbances in the mother-infant relationship and poor long-term cognitive and behavioural outcomes for the child. Surprisingly, treatment of maternal symptoms of postnatal depression does not improve the mother-infant relationship for a majority of women. Targeted interventions to improve the mother-infant relationship following postnatal depression are scarce and, of those that exist, the majority are not evaluated in randomised controlled trials. This study aims to evaluate a brief targeted mother-infant intervention, to follow cognitive behavioural therapy treatment of postnatal depression, which has the potential to improve developmental outcomes of children of depressed mothers. The proposed study is a two-arm randomised controlled trial with follow-up to 6 months. One hundred participants will be recruited via referrals from health professionals including maternal and child health nurses and general practitioners, as well as self-referrals from women who have seen promotional materials for the study. Women who meet inclusion criteria (infant aged <12 months, women 18+ years of age) will complete the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-IV-TR Axis I Disorders. Those with a clinical diagnosis of current major or minor depressive disorder and who do not meet exclusion criteria (that is, currently receiving treatment for depression, significant difficulty with English, medium to high suicide risk, current self-harm, current substance abuse, current post-traumatic stress disorder, current manic/hypomanic episode or psychotic symptoms) will be randomised to receive either a 4-session mother-infant intervention (HUGS: Happiness Understanding Giving and Sharing) or a 4-session attention placebo playgroup (Playtime) following a 12-session postnatal depression group treatment programme. Primary outcome measures are the Parenting Stress Index (self-report measure) and the Parent-child Early Relational Assessment (observational measure coded by a blinded observer). Measurements are taken at baseline, after the postnatal depression programme, post-HUGS/Playtime, and at 6 months post-HUGS/Playtime. This research addresses the need for specific treatment for mother-infant interactional difficulties following postnatal depression. There is a need to investigate interventions in randomised trials to prevent detrimental effects on child development and make available evidence-based treatments. Australia and New Zealand Clinical Trials Register: ACTRN12612001110875. Date Registered: 17 October 2012.",Milgrom J.; Holt C.,2014.0,10.1186/1745-6215-15-385,0,0,
9515,The effectiveness of an attention bias modification program as an adjunctive treatment for Post-Traumatic Stress Disorder.,"Attention bias modification (ABM) may be an effective treatment for anxiety disorders (Beard, Sawyer, & Hofmann, 2012). As individuals with PTSD possess an attentional bias towards threat-relevant information ABM may prove effective in reducing PTSD symptoms. We examined the efficacy of ABM as an adjunct treatment for PTSD in a real-world setting. We administered ABM in conjunction with prolonged exposure or cognitive-processing therapy and medication in a community inpatient treatment facility for military personnel diagnosed with PTSD. Participants were randomized to either ABM or an attention control condition (ACC). While all participants experienced reductions in PTSD symptoms, participants in the ABM group experienced significantly fewer PTSD and depressive symptoms at post-treatment when compared to the ACC group. Moreover, change in plasticity of attentional bias mediated this change in symptoms and initial attentional bias moderated the effects of the treatment. These results suggest that ABM may be an effective adjunct treatment for PTSD.",Kuckertz JM.; Amir N.; Boffa JW.; Warren CK.; Rindt SE.; Norman S.; Ram V.; Ziajko L.; Webb-Murphy J.; McLay R.,2014.0,10.1016/j.brat.2014.09.002,0,0,
9516,Attenuating fearful memories: effect of cued extinction on intrusions.,"Exposure-based therapies for posttraumatic stress disorder are thought to reduce intrusive memories through extinction processes. Methods that enhance extinction may translate to improved treatment. Rat research suggests retrieving a memory via a conditioned stimulus (CS) cue, and then modifying the retrieved memory within a specific reconsolidation window may enhance extinction. In humans, studies (e.g., Kindt & Soeter, 2013; Schiller et al., 2010) using basic learning paradigms show discrepant findings. Using a distressing film paradigm, participants (N = 148) completed fear acquisition and extinction. At extinction, they were randomized to 1 of 3 groups: CS cue within reconsolidation window, CS cue outside window, or non-CS cue within window. Intrusions were assessed 24 hr after extinction. Participants receiving the CS cue and completing extinction within the reconsolidation window had more intrusions (M = 2.40, SD = 2.54) than those cued outside (M = 1.65, SD = 1.70) or those receiving a non-CS cue (M = 1.24, SD = 1.26), F(2, 145) = 4.52, p = .01, d = 0.55. Consistent with the reconsolidation hypothesis, presenting a CS cue does appear to activate a specific period of time during which a memory can be updated. However, the CS cue caused increased, rather than decreased, frequency of intrusions. Understanding parameters of preextinction cueing may help us better understand reconsolidation as a potential memory updating mechanism.",Marks EH.; Zoellner LA.,2014.0,10.1037/a0037862,0,0,
9517,START (STrAtegies for RelaTives) study: a pragmatic randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of a manual-based coping strategy programme in promoting the mental health of carers of people with dementia.,"Two-thirds of people with dementia live at home, receiving most care from family carers, about 40% of whom have clinically significant depression or anxiety. This impacts on the person with dementia, families and society, predicting care breakdown. There are currently no clinically effective and cost-effective NHS family carer interventions. To assess the STrAtegies for RelaTives (START) intervention in the short (4 and 8 months) and long term (1 and 2 years) compared with treatment as usual (TAU). Randomised, parallel-group, superiority trial with blinded assessment recruiting participants 2:1 (intervention to TAU) to allow for therapist clustering. Three UK mental health services and one neurological service. Family carers of people with dementia. Eight-session manual-based coping intervention delivered by supervised psychology graduates to individuals. Affective symptoms [Hospital Anxiety and Depression Scale-total (HADS-T)] and cost-effectiveness. Secondary measures: anxiety and depression symptoms and caseness, quality of life (QoL), abusive behaviour and long-term care home admission. Two hundred and sixty participants were randomised (173 intervention, 87 TAU). We used intention-to-treat analysis in the short term (152 intervention, 77 TAU) and in the long term (140 intervention, 69 TAU). In the short term, the intervention group had lower HADS-T [mean difference -1.80, 95% confidence interval (CI) -3.29 to -0.31; p=0.02] and higher quality-adjusted life-years (QALYs) (mean difference 0.03, 95% CI -0.01 to 0.08). Costs were no different between groups [mean £ 252 (95% CI -£ 28 to £ 565) for intervention group]. The cost-effectiveness acceptability curve showed a greater than 99% chance of being cost-effectiveness at a £ 30,000/QALY willingness-to-pay threshold and a high probability of cost-effectiveness based on the HADS-T score. Carers in the intervention group had less case-level depression [odds ratio (OR) 0.24, 95% CI 0.07 to 0.76], a trend towards reduced case-level anxiety (OR 0.30, 95% CI 0.08 to 1.05), lower Hospital Anxiety and Depression Scale-anxiety (HADS-A) (-0.91, 95% CI -1.76 to -0.07; p = 0.03) and Hospital Anxiety and Depression Scale-depression (HADS-D) (-0.91, 95% CI -1.71 to -0.10; p = 0.03) and higher Health Status Questionnaire (HSQ) QoL (mean difference 4.09, 95% CI 0.34 to 7.83). Group differences in abusive behaviour (OR 0.48, 95% CI 0.18 to 1.27) and the person with dementia's quality of life-Alzheimer's disease (QoL-AD) (mean increase 0.59, 95% CI -0.72 to 1.89) were not significant. In the long term, the intervention group had lower HADS-T (mean difference -2.58, 95% CI -4.26 to -0.90; p = 0.03) and higher QALYs (mean difference 0.03, 95% CI -0.01 to 0.06). Carers in the intervention group had less case-level depression (OR 0.14, 95% CI 0.04 to 0.53), a trend towards reduced case-level anxiety (OR 0.57, 95% CI 0.26 to 1.24), lower HADS-A (-1.16, 95% CI -2.15 to -0.18) and HADS-D (1.45, 95% CI -2.32 to -0.57), and higher HSQ (mean difference 7.47, 95% CI 2.87 to 12.08). Thirty-two (18.7%) people with dementia in the intervention group and 17 (20.2%) in TAU were admitted to a care home (hazard ratio 0.83, 95% CI 0.44 to 1.56; p = 0.56). There were no significant differences between groups in abusive behaviour (OR 0.83, 95% CI 0.36 to 1.94), the person with dementia's QoL-AD (0.17, 95% CI -1.37 to 1.70) or costs (£ 336, 95% CI -£ 223 to £ 895) for intervention group. The probability that the intervention would be seen as cost-effective at £ 30,000/QALY threshold and cost-effectiveness on the HADS-T remained high. The START intervention was clinically effective and cost-effective in the short and longer term. The results are robust to the sensitivity analyses performed. Future work is needed to consider mechanism of action; the effects on people with dementia in clinical terms (cognition, neuropsychiatric symptoms, longer-term care home admission); and on health and social care costs. In addition, we will explore the effects of carer abusive behaviour on the care recipient's care home admission and if this then reduces abusive behaviour. We would also like to implement START and evaluate this implementation in clinical practice. Current Controlled Trials ISCTRN70017938.",Livingston G.; Barber J.; Rapaport P.; Knapp M.; Griffin M.; Romeo R.; King D.; Livingston D.; Lewis-Holmes E.; Mummery C.; Walker Z.; Hoe J.; Cooper C.,2014.0,10.3310/hta18610,0,0,
9518,Exposing clinicians to exposure: a randomized controlled dissemination trial of exposure therapy for anxiety disorders.,"The present study evaluated three technology-based methods of training mental health providers in exposure therapy (ET) for anxiety disorders. Training methods were designed to address common barriers to the dissemination of ET, including limited access to training, negative clinician attitudes toward ET, and lack of support during and following training. Clinicians naïve to ET (N=181, Mage=37.4, 71.3% female, 72.1% Caucasian) were randomly assigned to (a) an interactive, multimedia online training (OLT), (b) OLT plus a brief, computerized motivational enhancement intervention (OLT+ME), or (c) OLT+ME plus a Web-based learning community (OLT+ME+LC). Assessments were completed at baseline, posttraining, and 6 and 12weeks following training. Outcomes include satisfaction, knowledge, self-efficacy, attitudes, self-reported clinical use, and observer-rated clinical proficiency. All three training methods led to large and comparable improvements in self-efficacy and clinical use of ET, indicating that OLT alone was sufficient for improving these outcomes. The addition of the ME intervention did not significantly improve outcomes in comparison to OLT alone. Supplementing the OLT with both the ME intervention and the LC significantly improved attitudes and clinical proficiency in comparison to OLT alone. The OLT+ME+LC condition was superior to both other conditions in increasing knowledge of ET. Multicomponent trainings that address multiple potential barriers to dissemination appear to be most effective in improving clinician outcomes. Technology-based training methods offer a satisfactory, effective, and scalable way to train mental health providers in evidence-based treatments such as ET.",Harned MS.; Dimeff LA.; Woodcock EA.; Kelly T.; Zavertnik J.; Contreras I.; Danner SM.,2014.0,10.1016/j.beth.2014.04.005,0,0,
9519,Implementing collaborative primary care for depression and posttraumatic stress disorder: design and sample for a randomized trial in the U.S. military health system.,"War-related trauma, posttraumatic stress disorder (PTSD), depression and suicide are common in US military members. Often, those affected do not seek treatment due to stigma and barriers to care. When care is sought, it often fails to meet quality standards. A randomized trial is assessing whether collaborative primary care improves quality and outcomes of PTSD and depression care in the US military health system. The aim of this study is to describe the design and sample for a randomized effectiveness trial of collaborative care for PTSD and depression in military members attending primary care. The STEPS-UP Trial (STepped Enhancement of PTSD Services Using Primary Care) is a 6 installation (18 clinic) randomized effectiveness trial in the US military health system. Study rationale, design, enrollment and sample characteristics are summarized. Military members attending primary care with suspected PTSD, depression or both were referred to care management and recruited for the trial (2592), and 1041 gave permission to contact for research participation. Of those, 666 (64%) met eligibility criteria, completed baseline assessments, and were randomized to 12 months of usual collaborative primary care versus STEPS-UP collaborative care. Implementation was locally managed for usual collaborative care and centrally managed for STEPS-UP. Research reassessments occurred at 3-, 6-, and 12-months. Baseline characteristics were similar across the two intervention groups. STEPS-UP will be the first large scale randomized effectiveness trial completed in the US military health system, assessing how an implementation model affects collaborative care impact on mental health outcomes. It promises lessons for health system change.",Engel CC.; Bray RM.; Jaycox LH.; Freed MC.; Zatzick D.; Lane ME.; Brambilla D.; Rae Olmsted K.; Vandermaas-Peeler R.; Litz B.; Tanielian T.; Belsher BE.; Evatt DP.; Novak LA.; Unützer J.; Katon WJ.,2014.0,10.1016/j.cct.2014.10.002,0,0,
9520,The effect of rumination and reappraisal on social anxiety symptoms during cognitive-behavioral therapy for social anxiety disorder.,"There is growing interest in the role of transdiagnostic processes in the onset, maintenance, and treatment of mental disorders (Nolen-Hoeksema & Watkins, 2011). Two such transdiagnostic processes-rumination and reappraisal-are the focus of the present study. The main objective was to examine the roles of rumination (thought to be harmful) and reappraisal (thought to be helpful) in adults with social anxiety disorder (SAD). We conducted a randomized controlled trial of cognitive-behavioral therapy (CBT) with 75 adults with SAD and examined pre- to post-CBT changes as well as weekly fluctuations in rumination, reappraisal, and social anxiety symptoms. Socially anxious individuals' baseline rumination (brooding) scores predicted weekly levels of social anxiety, rumination, and reappraisal, whereas baseline reappraisal scores did not. Greater weekly rumination was associated with greater weekly social anxiety, but reappraisal was not related to social anxiety. These findings suggest that rumination may have a more significant role than reappraisal in understanding fluctuations in social anxiety during CBT for SAD.",Brozovich FA.; Goldin P.; Lee I.; Jazaieri H.; Heimberg RG.; Gross JJ.,2015.0,10.1002/jclp.22132,0,0,
9521,Domestic violence and mental health: a cross-sectional survey of women seeking help from domestic violence support services.,"Domestic violence and abuse (DVA) are associated with an increased risk of mental illness, but we know little about the mental health of female DVA survivors seeking support from domestic violence services. Domestic violence and abuse (DVA) are associated with an increased risk of mental illness, but we know little about the mental health of female DVA survivors seeking support from domestic violence services. Baseline data on 260 women enrolled in a randomized controlled trial of a psychological intervention for DVA survivors was analyzed. We report prevalence of and associations between mental health status and severity of abuse at the time of recruitment. We used logistic and normal regression models for binary and continuous outcomes, respectively. Mental health measures used were: Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), Patient Health Questionnaire, Generalized Anxiety Disorder Assessment, and the Posttraumatic Diagnostic Scale (PDS) to measure posttraumatic stress disorder. The Composite Abuse Scale (CAS) measured abuse. Exposure to DVA was high, with a mean CAS score of 56 (SD 34). The mean CORE-OM score was 18 (SD 8) with 76% above the clinical threshold (95% confidence interval: 70-81%). Depression and anxiety levels were high, with means close to clinical thresholds, and all respondents recorded PTSD scores above the clinical threshold. Symptoms of mental illness increased stepwise with increasing severity of DVA. Exposure to DVA was high, with a mean CAS score of 56 (SD 34). The mean CORE-OM score was 18 (SD 8) with 76% above the clinical threshold (95% confidence interval: 70-81%). Depression and anxiety levels were high, with means close to clinical thresholds, and all respondents recorded PTSD scores above the clinical threshold. Symptoms of mental illness increased stepwise with increasing severity of DVA.",Ferrari G.; Agnew-Davies R.; Bailey J.; Howard L.; Howarth E.; Peters TJ.; Sardinha L.; Feder G.,2014.0,,0,0,
9522,Self-monitoring of reexperiencing symptoms: a randomized trial.,"The efficacy of a brief intervention to self-monitor reexperiencing symptoms was evaluated in 137 U.S. combat veterans with PTSD who were enrolled in 5-week psychoeducation groups at a large Veterans Affairs Medical Center. Groups were randomized to psychoeducation alone (Education Control, n = 50) or psychoeducation plus intrusion monitoring (Education + Monitoring, n = 87). Education + Monitoring participants were asked to make a daily record of the number and content of nightmares, flashbacks, intrusive trauma-related thoughts, and physiological and emotional reactions to triggers. Avoidance symptoms were reduced in both conditions (η(2)  = .093), with no additional benefit from intrusion monitoring (η(2)  = .001). Compliance with intrusion monitoring was markedly low, which complicated the interpretation of the study findings. Even though intrusion monitoring has a strong theoretical foundation and may be an efficient and cost-effective alternative to more structured treatments for PTSD, the effect of intrusion monitoring will not be clearly understood until higher compliance can be achieved. Future work in this area should address barriers to compliance and investigate strategies for enhancing motivation to engage in self-monitoring.",Brown AJ.; Bollini AM.; Craighead LW.; Astin MC.; Norrholm SD.; Bradley B.,2014.0,10.1002/jts.21950,0,0,
9523,Treating prolonged grief disorder: a randomized clinical trial.,"Prolonged grief disorder (PGD) is a potentially disabling condition that affects approximately 10% of bereaved people. Grief-focused cognitive behavior therapy (CBT) has been shown to be effective in treating PGD. Although treatments for PGD have focused on exposure therapy, much debate remains about whether exposure therapy is optimal for PGD. To determine the relative efficacies of CBT with exposure therapy (CBT/exposure) or CBT alone for PGD. A randomized clinical trial of 80 patients with PGD attending the outpatient University of New South Wales Traumatic Stress Clinic from September 17, 2007, through June 7, 2010. All patients received 10 weekly 2-hour group therapy sessions that consisted of CBT techniques. Patients also received 4 individual sessions, in which they were randomized to receive exposure therapy for memories of the death or supportive counseling. Measures of PGD by clinical interview and self-reported measures of depression, cognitive appraisals, and functioning at the 6-month follow-up. Intention-to-treat analyses at follow-up indicated a significant quadratic time×treatment condition interaction effect (B [SE], 0.49 [0.16]; t120.16=3.08 [95% CI, 0.18-0.81]; P=.003), indicating that CBT/exposure led to greater PGD reductions than CBT alone. At follow-up, CBT/exposure led to greater reductions in depression (B [SE], 0.35 [0.12]; t112.65=2.83 [95% CI, 0.11-0.60]; P=.005), negative appraisals (B [SE], 0.68 [0.25]; t109.98=2.66 [95% CI, 0.17-1.18]; P=.009), and functional impairment (B [SE], 0.24 [0.08]; t111.40=3.01 [95% CI, 0.08-0.40]; P=.003) than CBT alone. In terms of treatment completers, fewer patients in the CBT/exposure condition at follow-up (14.8%) met criteria for PGD than those in the CBT condition (37.9%) (odds ratio, 3.51; 95% CI, 0.96-12.89; χ2=3.81; P=.04). Including exposure therapy that promotes emotional processing of memories of the death is an important component to achieve optimal reductions in PGD severity. Facilitating emotional responses to the death may promote greater changes in appraisals about the loss, which are associated with symptom reduction. Promotion of emotional processing techniques in therapies to treat patients with PGD is needed. anzctr.org.au Identifier: ACTRN12609000229279.",Bryant RA.; Kenny L.; Joscelyne A.; Rawson N.; Maccallum F.; Cahill C.; Hopwood S.; Aderka I.; Nickerson A.,2014.0,10.1001/jamapsychiatry.2014.1600,0,0,
9524,Neural changes with attention bias modification for anxiety: a randomized trial.,"Attention bias modification (ABM) procedures typically reduce anxiety symptoms, yet little is known about the neural changes associated with this behavioral treatment. Healthy adults with high social anxiety symptoms (n = 53) were randomized to receive either active or placebo ABM. Unlike placebo ABM, active ABM aimed to train individuals' attention away from threat. Using the dot-probe task, threat-related attention bias was measured during magnetic resonance imaging before and after acute and extended training over 4 weeks. A subset of participants completed all procedures (n = 30, 15 per group). Group differences in neural activation were identified using standard analyses. Linear regression tested predictive factors of symptom reduction (i.e., training group, baseline indices of threat bias). The active and placebo groups exhibited different patterns of right and left amygdala activation with training. Across all participants irrespective of group, individuals with greater left amygdala activation in the threat-bias contrast prior to training exhibited greater symptom reduction. After accounting for baseline amygdala activation, greater symptom reduction was associated with assignment to the active training group. Greater left amygdala activation at baseline predicted reductions in social anxiety symptoms following ABM. Further research is needed to clarify brain-behavior mechanisms associated with ABM training.",Britton JC.; Suway JG.; Clementi MA.; Fox NA.; Pine DS.; Bar-Haim Y.,2015.0,10.1093/scan/nsu141,0,0,
9525,"Post-traumatic growth, stressful life events, and relationships with substance use behaviors among alternative high school students: a prospective study.","A highly stressful life event (SLE) can elicit positive psychosocial growth, referred to as post-traumatic growth (PTG) among youth. We examined PTG and the number of SLEs for their influence on substance use behaviours among a sample of older, diverse alternative high school students participating in a drug prevention programme (n=564; mean age=16.8; 49% female; 65% Hispanic). Surveys assessed PTG, SLEs and substance use behaviours at the two-year follow-up. Multilevel regression models were run to examine the effect of PTG and the number of SLEs on frequency of substance use at the two-year follow-up, controlling for baseline substance use, sociodemographic variables, peer substance use, attrition propensity and treatment group. Greater PTG scores were associated with lower frequencies of alcohol use, getting drunk on alcohol, binge drinking, marijuana use and less substance abuse at the two-year follow-up, but not associated with cigarette or hard drug use. Also, PTG did not moderate the relationship between cumulative number of SLEs and substance use behaviours, rather PTG appears to be protective against negative effects of a single, life-altering SLE. Fostering PTG from a particularly poignant SLE may be useful for prevention programmes targeting alcohol, marijuana and substance abuse behaviours among high-risk youth.",Arpawong TE.; Sussman S.; Milam JE.; Unger JB.; Land H.; Sun P.; Rohrbach LA.,2015.0,10.1080/08870446.2014.979171,0,0,
9526,Integrated treatment of first episode psychosis with online training (e-learning): study protocol for a randomised controlled trial.,"The integrated treatment of first episode psychosis has been shown to improve functionality and negative symptoms in previous studies. In this paper, we describe a study of integrated treatment (individual psychoeducation complementary to pharmacotherapy) versus treatment as usual, comparing results at baseline with those at 6-month re-assessment (at the end of the study) for these patients, and online training of professionals to provide this complementary treatment, with the following objectives: 1) to compare the efficacy of individual psychoeducation as add-on treatment versus treatment as usual in improving psychotic and mood symptoms; 2) to compare adherence to medication, functioning, insight, social response, quality of life, and brain-derived neurotrophic factor, between both groups; and 3) to analyse the efficacy of online training of psychotherapists. This is a single-blind randomised clinical trial including patients with first episode psychosis from hospitals across Spain, randomly assigned to either a control group with pharmacotherapy and regular sessions with their psychiatrist (treatment as usual) or an intervention group with integrated care including treatment as usual plus a psychoeducational intervention (14 sessions). Training for professionals involved at each participating centre was provided by the coordinating centre (University Hospital of Álava) through video conferences. Patients are evaluated with an extensive battery of tests assessing clinical and sociodemographic characteristics (Positive and Negative Syndrome Scale, State-Trait Anxiety Inventory, Liebowitz Social Anxiety Scale, Hamilton Rating Scale for Depression, Scale to Assess Unawareness of Mental Disorders, Strauss and Carpenter Prognostic Scale, Global Assessment of Functioning Scale, Morisky Green Adherence Scale, Functioning Assessment Short Test, World Health Organization Quality of Life instrument WHOQOL-BREF (an abbreviated version of the WHOQOL-100), and EuroQoL questionnaire), and brain-derived neurotrophic factor levels are measured in peripheral blood at baseline and at 6 months. The statistical analysis, including bivariate analysis, linear and logistic regression models, will be performed using SPSS. This is an innovative study that includes the assessment of an integrated intervention for patients with first episode psychosis provided by professionals who are trained online, potentially making it possible to offer the intervention to more patients. NCT01783457 clinical trials.gov. Date of registration in primary registry 23 January 2013.",Barbeito S.; Vega P.; Ruiz de Azua S.; Balanza-Martinez V.; Colom F.; Lorente E.; Luengo A.; Cerrillo E.; Crespo JM.; González Pinto A.,2014.0,10.1186/1745-6215-15-416,0,0,
9527,Feasibility and acceptability of a resilience training program for intensive care unit nurses.,"The critical nursing shortage is particularly apparent in specialty areas such as intensive care units (ICUs). Some nurses develop resilient coping strategies and adapt to stressful work experiences, mitigating the development of common maladaptive psychological symptoms. To determine if a multimodal resilience training program for ICU nurses was feasible to perform and acceptable to the study participants. In a randomized and controlled 12-week intervention study, treatment and control groups completed demographic questions and measures of resilience, anxiety, depression, posttraumatic stress disorder (PTSD), and burnout syndrome before and after the intervention. The intervention included a 2-day educational workshop, written exposure sessions, event-triggered counseling sessions, mindfulness-based stress reduction exercises, and a protocolized aerobic exercise regimen. Nurses in the intervention arm also completed satisfaction surveys for each component of the intervention. This mulitmodal resilience training program was feasible to conduct and acceptable to ICU nurses. Both nurses randomized to the treatment group and nurses randomized to the control group showed a significant decrease in PTSD symptom score after the intervention. A multifaceted resilience training program for ICU nurses was both feasible and acceptable. A sufficiently powered, randomized clinical trial is needed to assess the effect of the intervention on improving individuals' level of resilience and improving psychological outcomes such as symptoms of anxiety, depression, burnout syndrome, and PTSD.",Mealer M.; Conrad D.; Evans J.; Jooste K.; Solyntjes J.; Rothbaum B.; Moss M.,2014.0,10.4037/ajcc2014747,0,0,
9528,Comparison of cognitive behavioral therapy and supportive psychotherapy for the treatment of depression following traumatic brain injury: a randomized controlled trial.,"To determine the efficacy of 2 different interventions (cognitive behavioral therapy [CBT] and supportive psychotherapy [SPT]) to treat post-traumatic brain injury (TBI) depression. A sample of 77 community-dwelling individuals with a TBI, and a diagnosis of depression. Participants were randomized into treatment conditions either CBT or SPT and received up to 16 sessions of individual psychotherapy. Participants completed the Structured Clinical Interview for DSM-IV and self-report measures of depression (Beck Depression Inventory-Second Edition), anxiety (State-Trait Anxiety Inventory), perceived social support (Interpersonal Support Evaluation List), stressful life events (Life Experiences Survey), and quality of life (QOL) before beginning and immediately following treatment. No significant differences were found at baseline between CBT and SPT groups on demographic factors (sex, age, education, race, and time since injury) or baseline measures of depression, anxiety, participation, perceived social support, stressful life events, or QOL. Analyses of variance revealed significant time effects for the Beck Depression Inventory-Second Edition, State-Trait Anxiety Inventory, and QOL outcome measures but no group effects. Intention-to-treat mixed effects analyses did not find any significant difference in patterns of scores of the outcome measures between the CBT and SPT intervention groups. Both forms of psychotherapy were efficacious in improving diagnoses of depression and anxiety and reducing depressive symptoms. These findings suggest that in this sample of individuals with TBI, CBT was not more effective in treating depression than SPT, though further research is needed with larger sample sizes to identify different components of these interventions that may be effective with different TBI populations. ClinicalTrials.gov Identifier: NCT00211835.",Ashman T.; Cantor JB.; Tsaousides T.; Spielman L.; Gordon W.,,10.1097/HTR.0000000000000098,0,0,6249
9529,Efficacy of a hybrid online training for panic symptoms and agoraphobia: study protocol for a randomized controlled trial.,"Recently, internet-based interventions have been proposed as effective treatments for people with panic disorder (PD). However, little is known about the clinical effects of integrating mobile technology into these interventions. Because users carry their smartphones with them throughout the day, we hypothesize that this technology can be used to significantly support individuals with monitoring and overcoming their PD symptoms. The aim of the present study is to evaluate the efficacy and cost-effectiveness of a newly developed hybrid intervention that combines internet/PC with smartphone delivery to treat the symptoms of PD. The intervention is based on cognitive behavioral therapy and consists of six modules over a total of six weeks. A two-arm randomized controlled trial (RCT) will be conducted to evaluate the effects of a hybrid online training module for PD. Based on a power calculation (d =0.60; 1-β of 80%; α =0.05), 90 participants with mild to moderate panic symptoms with or without agoraphobia (as assessed by the Panic and Agoraphobia Scale) will be recruited from the general population and randomly assigned to either the intervention group or a six-month waitlist control group. The primary outcome measure will be the severity of panic symptoms. Secondary outcomes will include depression, quality of life, and an observer-based rating of panic severity. Furthermore, data regarding acceptance and the usability of the smartphone app will be assessed. Assessments will take place at baseline as well as eight weeks, three months, and six months after randomization. Moreover, a cost-effectiveness analysis will be performed from a societal perspective. Data will be analyzed on an intention-to-treat basis and per protocol. To our knowledge, this RCT is one of the first to examine the efficacy of a hybrid online training for adult PD. This study seeks to contribute to the emerging field of hybrid online training. If the intervention is efficacious, then research on this hybrid online training should be extended. The cost-effectiveness analysis will also indicate whether online training is an economical tool for treating PD among adults. German Clinical Trial Register: DRKS00005223 (registered on 15 August 2013).",Ebenfeld L.; Kleine Stegemann S.; Lehr D.; Ebert DD.; Jazaieri H.; van Ballegooijen W.; Funk B.; Riper H.; Berking M.,2014.0,10.1186/1745-6215-15-427,0,0,
9530,Six-month outcomes from a randomized trial augmenting serotonin reuptake inhibitors with exposure and response prevention or risperidone in adults with obsessive-compulsive disorder.,"To compare outcomes after 6-month maintenance treatment of adults diagnosed with obsessive-compulsive disorder (OCD) based on DSM-IV criteria who responded to acute treatment with serotonin reuptake inhibitors (SRIs) augmented by exposure and response prevention (EX/RP) or risperidone. A randomized trial was conducted at 2 academic sites from January 2007 through December 2012. In the acute phase, 100 patients on therapeutic SRI dose with at least moderate OCD severity were randomized to 8 weeks of EX/RP, risperidone, or pill placebo. Responders entered the 6-month maintenance phase, continuing the augmentation strategy they received acutely (n = 30 EX/RP, n = 8 risperidone). Independent evaluations were conducted every month. The main outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Intent-to-treat analyses indicated that, after 6-month maintenance treatment, EX/RP yielded OCD outcomes that were superior to risperidone (Y-BOCS = 10.95 vs 18.70; t40 = 2.76, P = .009); more patients randomized to EX/RP met response criteria (Y-BOCS decrease ≥ 25%: 70% vs 20%; P < .001) and achieved minimal symptoms (Y-BOCS ≤ 12: 50% vs 5%; P < .001). During maintenance, OCD severity decreased slightly in both conditions (Y-BOCS decrease = 2.2 points, P = .020). Lower Y-BOCS at entry to maintenance was associated with more improvement in both conditions (r38 = 0.57, P < .001). OCD patients taking SRIs who responded to acute EX/RP or risperidone maintained their gains over 6-month maintenance. Because EX/RP patients improved more during acute treatment than risperidone-treated patients, and both maintained their gains during maintenance, EX/RP yielded superior outcomes 6 months later. The findings that 50% of patients randomized to EX/RP had minimal symptoms at 6-month maintenance, a rate double that of prior studies, suggests that EX/RP maintenance helps maximize long-term outcome. ClinicalTrials.gov identifier: NCT00389493.",Foa EB.; Simpson HB.; Rosenfield D.; Liebowitz MR.; Cahill SP.; Huppert JD.; Bender J.; McLean CP.; Maher MJ.; Campeas R.; Hahn CG.; Imms P.; Pinto A.; Powers MB.; Rodriguez CI.; Van Meter PE.; Vermes D.; Williams MT.,2015.0,10.4088/JCP.14m09044,0,0,
9531,Individualized Guided Internet-delivered Cognitive-Behavior Therapy for Chronic Pain Patients With Comorbid Depression and Anxiety: A Randomized Controlled Trial.,"Depression and anxiety are commonly seen in patients with chronic pain which affects the patient's daily life functioning. Although considerable attention has been devoted to explain why depression and anxiety are frequent comorbid with chronic pain, little empirical work has been conducted on interventions that target depression and anxiety and chronic pain. The present study was designed to test an individualized cognitive-behavioral treatment delivered through the internet for persons with chronic pain and emotional distress. A total of 52 patients with chronic pain and depression were included and randomized to either treatment for 8 weeks or to a control group that participated in a moderated online discussion forum. Intent-to-treat analyses showed significant decreases regarding depressive symptoms and pain disability in the treatment group. Results on the primary outcomes of depression and anxiety were in favor of the treatment group. Reductions were also found on pain catastrophizing. One-year follow-up showed maintenance of improvements. We conclude that an individualized guided internet-delivered treatment based on cognitive-behavior therapy can be effective for persons with chronic pain comorbid emotional distress.",Buhrman M.; Syk M.; Burvall O.; Hartig T.; Gordh T.; Andersson G.,2015.0,10.1097/AJP.0000000000000176,0,0,
9532,LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: a qualitative study of acute and sustained subjective effects.,"A recently published study showed the safety and efficacy of LSD-assisted psychotherapy in patients with anxiety associated with life-threatening diseases. Participants of this study were included in a prospective follow-up. 12 months after finishing LSD psychotherapy, 10 participants were tested for anxiety (STAI) and participated in a semi-structured interview. A Qualitative Content Analysis (QCA) was carried out on the interviews to elaborate about LSD effects and lasting psychological changes. None of the participants reported lasting adverse reactions. The significant benefits as measured with the STAI were sustained over a 12-month period. In the QCA participants consistently reported insightful, cathartic and interpersonal experiences, accompanied by a reduction in anxiety (77.8%) and a rise in quality of life (66.7%). Evaluations of subjective experiences suggest facilitated access to emotions, confrontation of previously unknown anxieties, worries, resources and intense emotional peak experiences à la Maslow as major psychological working mechanisms. The experiences created led to a restructuring of the person's emotional trust, situational understanding, habits and world view. LSD administered in a medically supervised psychotherapeutic setting can be safe and generate lasting benefits in patients with a life-threatening disease. Explanatory models for the therapeutic effects of LSD warrant further study.",Gasser P.; Kirchner K.; Passie T.,2015.0,10.1177/0269881114555249,0,0,
9533,Pilot trial of an expressive writing intervention with HIV-positive methamphetamine-using men who have sex with men.,"Among men who have sex with men (MSM), the co-occurrence of trauma and stimulant use has negative implications for HIV/AIDS prevention. HIV-positive, methamphetamine-using MSM were recruited to pilot test a 7-session, multicomponent resilient affective processing (RAP) intervention that included expressive writing exercises targeting HIV-related traumatic stress. An open-phase pilot with 10 participants provided support for feasibility of intervention delivery such that 99% of the RAP sessions were completed in a 1-month period. Subsequently, 23 additional participants were enrolled in a pilot randomized controlled trial of the RAP intervention (n = 12) versus an attention-control condition that included writing exercises about neutral topics (n = 11). Acceptability was evidenced by participants randomized to RAP expressing significantly more negative emotions in their writing and reporting greater likelihood of recommending expressive writing exercises to a friend living with HIV. Over the 3-month follow-up period, attention-control participants reported significant decreases in HIV-related traumatic stress while RAP intervention participants reported no significant changes. Compared to attention-control participants, those in the RAP intervention reported significant reductions in the frequency of methamphetamine use immediately following the 1-month RAP intervention period. Thematic analyses of RAP expressive writing exercises revealed that multiple negative life events characterized by social stigma or loss contribute to the complex nature of HIV-related traumatic stress. Findings support the feasibility and acceptability of an exposure-based intervention targeting HIV-related traumatic stress. However, more intensive intervention approaches that simultaneously target trauma and stimulant use will likely be needed to optimize HIV/AIDS prevention efforts with this population. (PsycINFO Database Record",Carrico AW.; Nation A.; Gómez W.; Sundberg J.; Dilworth SE.; Johnson MO.; Moskowitz JT.; Rose CD.,2015.0,10.1037/adb0000031,0,0,
9534,Cognitive behavioural treatment for the chronic post-traumatic headache patient: a randomized controlled trial.,"Chronic post-traumatic headache (CPTH) after mild head injury can be difficult to manage. Research is scarce and successful interventions are lacking.To evaluate the effect of a group-based Cognitive Behavioural Therapy (CBT) intervention in relation to headache, pain perception, psychological symptoms and quality of life in patients with CPTH. Ninety patients with CPTH according to ICHD-2 criteria were enrolled from the Danish Headache Center into a randomized, controlled trial. Patients were randomly assigned to either a waiting list group or to a nine-week CBT group intervention. At baseline and after 26 weeks all patients completed the Rivermead Post Concussion Symptoms Questionnaire, SF-36, SCL-90-R and a headache diary. The CBT had no effect on headache and pressure pain thresholds and only a minor impact on the CPTH patients' quality of life, psychological distress, and the overall experience of symptoms. The waiting-list group experienced no change in headache but, opposed to the treatment group, a significant decrease in somatic and cognitive symptoms indicating a spontaneous remission over time. Our primarily negative findings confirm that management of patients with CPTH still remains a considerable challenge. Psychological group therapy with CBT might be effective in an earlier stage of CPTH and in less severely affected patients but our findings strongly underline the need for randomized controlled studies to test the efficacy of psychological therapy.",Kjeldgaard D.; Forchhammer HB.; Teasdale TW.; Jensen RH.,2014.0,10.1186/1129-2377-15-81,0,0,
9535,"The role of safety behaviors in exposure-based treatment for panic disorder and agoraphobia: associations to symptom severity, treatment course, and outcome.","The potentially detrimental effects of safety behaviors during exposure therapy are still subject to debate. Empirical findings are inconsistent, and few studies have investigated effects of idiosyncratic safety behavior manifestations during exposure or in everyday life. These limitations might be due to a lack of appropriate measures that address individual safety behaviors. We examined psychometric properties and predictive value of the Texas Safety Maneuver Scale (TSMS), a questionnaire specifically targeting safety behaviors in panic disorder and agoraphobia. Effects of safety behavior use, both during everyday life and during therapy, were examined using data from a multicenter RCT of N=268 patients that aimed at evaluating efficacy and mechanisms of action of two variants of an exposure-based therapy. The TSMS total score demonstrated good internal consistency (α=0.89), and it showed significant correlations with selected measures of baseline anxiety and impairment. The proposed factor structure could not be replicated. Frequent safety behavior use at baseline was associated with actual safety behavior during exposure exercises. Pronounced in-situ safety behavior, but not baseline safety behavior was associated to detrimental treatment outcome. The results underline the relevance of a rigorous safety behavior assessment in therapy. The actual relationship between safety behavior use and treatment outcome is yet to determine.",Helbig-Lang S.; Richter J.; Lang T.; Gerlach AL.; Fehm L.; Alpers GW.; Ströhle A.; Kircher T.; Deckert J.; Gloster AT.; Wittchen HU.,2014.0,10.1016/j.janxdis.2014.09.010,0,0,
9536,Predictors of CBT outcome in older adults with GAD.,"The current study is a secondary analysis of data from a randomized controlled trial of CBT for late-life GAD (Stanley et al., 2014) which provided an opportunity to examine predictors of outcome among those who received CBT. Participants were 150 older adults who were randomized to receive 10 sessions of CBT. Completer analyses found that homework completion, number of sessions attended, lower worry severity, lower depression severity, and recruitment site predicted 6-month worry outcome on the PSWQ-A, whereas homework completion, credibility of the therapy, lower anxiety severity, and site predicted 6-month anxiety outcome on the STAI-T. In intent-to-treat multivariate analyses, however, only initial worry and anxiety severity, site, and number of sessions completed predicted treatment outcome. These results are largely consistent with predictors of outcome in younger adults and suggest that lower initial symptom severity and variables consistent with greater engagement in treatment predict outcome.",Hundt NE.; Amspoker AB.; Kraus-Schuman C.; Cully JA.; Rhoades H.; Kunik ME.; Stanley MA.,2014.0,10.1016/j.janxdis.2014.09.012,0,0,
9537,Posttraumatic stress disorder and alcohol dependence: does order of onset make a difference?,"Posttraumatic stress disorder (PTSD) and alcohol dependence (AD) are frequently comorbid and the order in which they develop may affect the clinical presentation and response to treatment. This study compared 73 treatment-seeking participants who developed PTSD prior to developing AD (""PTSD-first"") with 64 participants who developed AD prior to developing PTSD (""AD-first"") on demographics, clinical presentation, and response to treatment for PTSD and AD. All participants received BRENDA, a medication management and motivational enhancement intervention and were randomly assigned to either prolonged exposure (PE) for PTSD plus BRENDA or BRENDA alone and to either naltrexone (NAL) for AD or placebo (PBO). Results showed that participants with AD-first were more likely to report low income, meet criteria for antisocial or borderline personality disorder, report an index trauma of physical assault, compared to those with PTSD-first. Conversely, participants with PTSD-first were more likely to report an index trauma of sexual assault or a combat experience. Notably, no group differences were observed in treatment outcome despite some differences in clinical presentation.",McLean CP.; Su YJ.; Foa EB.,2014.0,10.1016/j.janxdis.2014.09.023,0,0,
9538,An attentional inhibitory deficit for irrelevant information in obsessive-compulsive disorder: evidence from ERPs.,"Previous studies on attentional bias have demonstrated that patients with obsessive-compulsive disorder (OCD) have an overall longer reaction time (RT) for various stimuli. It was hypothesized that this general slowness may indicate the presence of an attentional inhibition deficit in OCD. To test the hypothesis, event-related potentials (ERPs) were recorded in 31 non-medicated OCD patients and 29 age-, handedness- and sex-matched healthy controls while they performed an emotional Stroop task (EST). Relative to the control subjects, the OCD patients had similar interference effects for negative words, but an overall longer RT and larger P2 and P3 amplitudes to all words. These results support the notion that OCD is characterized by an attentional inhibitory dysfunction for irrelevant information.",Fan J.; Zhong M.; Zhu X.; Lei H.; Dong J.; Zhou C.; Liu W.,2014.0,10.1016/j.ijpsycho.2014.11.002,0,0,
9539,The utilization of unified protocols in behavioral cognitive therapy in transdiagnostic group subjects: A clinical trial.,"The practicing of protocols based on behavioral cognitive therapy (CBT) have been frequently used in the last decades and adapted to better manage the necessities of patients and providers. The goal is to build a treatment that is evidence-based - for that reason the unified protocol for multiple emotional disorders (transdiagnostics) have been utilized to simplify treatment - without losing scientific traits. The main goal of this study is to evaluate the unified protocol in groups of patients with depression and anxiety disorders. In a pool of 48 subjects, divided in two groups, one was submitted to 12 intervention sessions of the unified protocol while the other was solely given medication. MINI, BAI and BDI were the instruments used at the beginning and at the end of treatment. The results were highly significant (p<0.001) in as much as with the improvement of anxiety and depressive disorders as it was in the group which was treated with the unified protocol compared with the group which was only given medication Limitations of this study were the number of sample participants and the non-randomization of subjects in both groups. Group therapy has not been largely implemented though it is deemed very useful for treatments when the unified protocol is used in transdiagnostic patients. Not only does it allow for emotional stabilizing and socialization but it also enables subjects with an altruistic feeling amongst themselves.",de Ornelas Maia AC.; Nardi AE.; Cardoso A.,2015.0,10.1016/j.jad.2014.09.023,0,0,
9540,Tobacco use trajectories among a large cohort of treated smokers with posttraumatic stress disorder.,"This study identified distinct tobacco use trajectories across 18months in 943 veteran smokers with posttraumatic stress disorder (PTSD) in order to describe quit and relapse patterns, examine associations between trajectory groups on baseline characteristics and cessation service utilization, and explore group differences in mental health outcomes. Veterans who participated in a multisite, randomized trial of integrated smoking cessation care were grouped using k-means clustering based on reported daily tobacco use between baseline and 18months. Four trajectory clusters were identified: no reduction (62%), temporary reduction (11%), late sustained reduction (9%) and early sustained reduction (18%). Median quit times in the early, late, temporary, and no reduction groups were 451, 141.5, 97, and 2days, respectively. Compared to the early reduction group, the temporary reduction group exhibited higher baseline depression (p<0.01) and anxiety (p<0.01), but did not differ in treatment received, with both groups attending significantly more cessation visits (p<0.001) and more likely to receive recommended pharmacotherapy (p<0.001) than the no reduction group between baseline and 6months. The early reduction group exhibited lower depression relative to the no reduction (p<0.01) and temporary reduction (p<0.01) groups across all assessments between baseline and 18months. Differences were not observed between groups in depressive or PTSD symptom change over time between baseline and 18months. Tobacco use trajectories among treated smokers with PTSD vary distinctly. Characteristics of identified subgroups may lead to targeted interventions among smokers with PTSD and potentially other psychiatric disorders.",Malte CA.; Dennis PA.; Saxon AJ.; McFall M.; Carmody TP.; Unger W.; Beckham JC.,2015.0,10.1016/j.addbeh.2014.10.034,0,0,
9541,Intelligence as a predictor of outcome in short- and long-term psychotherapy.,"Intelligence has been suggested as a suitability factor for short-term therapy whereas its possible effect on short-term versus long-term therapy still is unknown. The aim of this study was to compare the prediction of intelligence on the level of psychiatric symptoms and psychosocial functioning in psychotherapies of different lengths. A total of 251 outpatients from the Helsinki Psychotherapy Study, aged 20–46 years, and suffering from mood or anxiety disorders were allocated to two long-term and two short-term therapies. Intelligence was assessed at baseline with the Wechsler Adult Intelligence Scale (WAIS-R). Psychiatric symptoms and psychosocial functioning were assessed 5–10 times during a 5-year follow-up using two primary symptom measures (HDRS and HARS) and one primary measure of psychosocial functioning (GAF). Short-term therapy was more effective than long-term therapy during the first year of follow-up. During the second to fourth follow-up year no differences between short- and long-term therapies or the intelligence groups were found. At the fifth follow-up year, however, long-term psychotherapy showed a statistically significantly larger change in all three primary measures compared to short-term therapy among those with higher intelligence. No differences between therapy groups were noted in those with lower intelligence. People with higher intelligence may benefit more from long-term than from short-term psychotherapy. These findings should be confirmed.",Knekt P.; Saari T.; Lindfors O.,2014.0,10.1016/j.psychres.2014.10.011,0,0,
9542,The effects of preventive and restorative safety behaviors on a single-session of exposure therapy for contamination fear.,"Recent research suggests that safety behaviors (SB) may not preclude treatment gains in exposure-based therapy for obsessive-compulsive disorder. However, it is relatively unknown what specific types of SBs may be detrimental to the therapeutic process, with some arguing that SBs be classified based on their function. The current study sought to examine the extent to which different SBs enhanced or weakened symptoms of contamination fear during a single session of exposure. Sixty-seven non-clinical students were randomly assigned to one of three conditions: (1) exposure with no SBs (NSB), (2) exposure with preventive SBs (PSB), or (3) exposure with restorative SBs (RSB). Among the primary outcome measures, greater reductions in fear and behavioral avoidance were found for RSB in comparison to PSB, and the gains made by RSB were generalizable to other sources of potential contamination. Furthermore, RSB resulted in more rapid reductions in fear and disgust across repeated exposure trials. Limitations include the use of a nonclinical student sample. Overall, the current study suggests that RSB may be beneficial as an adjunct to therapy whereas PSB are potentially detrimental. Results of the study are discussed in terms of exposure theories and the treatment of anxiety disorders.",Goetz AR.; Lee HJ.,2015.0,10.1016/j.jbtep.2014.10.003,0,0,
9543,"Concussion treatment after combat trauma: development of a telephone based, problem solving intervention for service members.","Military service members (SMs) and veterans who sustain mild traumatic brain injuries (mTBI) during combat deployments often have co-morbid conditions but are reluctant to seek out therapy in medical or mental health settings. Efficacious methods of intervention that are patient-centered and adaptable to a mobile and often difficult-to-reach population would be useful in improving quality of life. This article describes a new protocol developed as part of a randomized clinical trial of a telephone-mediated program for SMs with mTBI. The 12-session program combines problem solving training (PST) with embedded modules targeting depression, anxiety, insomnia, and headache. The rationale and development of this behavioral intervention for implementation with persons with multiple co-morbidities is described along with the proposed analysis of results. In particular, we provide details regarding the creation of a treatment that is manualized yet flexible enough to address a wide variety of problems and symptoms within a standard framework. The methods involved in enrolling and retaining an often hard-to-study population are also highlighted.",Bell KR.; Brockway JA.; Fann JR.; Cole WR.; St De Lore J.; Bush N.; Lang AJ.; Hart T.; Warren M.; Dikmen S.; Temkin N.; Jain S.; Raman R.; Stein MB.,2015.0,10.1016/j.cct.2014.11.001,0,0,
9544,The effectiveness of short- and long-term psychotherapy on personality functioning during a 5-year follow-up.,"Only few randomized trials comparing sustained effects of short- and long-term psychotherapies in personality functioning are available. In this study we compared the effects of two short-term therapies and long-term psychodynamic psychotherapy on patients' personality functioning during a 5-year follow-up. Altogether 326 patients of the Helsinki Psychotherapy Study, with anxiety or mood disorder, were randomly assigned to either short-term psychotherapy of about six months (solution-focused therapy (SFT, n=97) or short-term psychodynamic psychotherapy (SPP, n=101)), or to long-term psychodynamic psychotherapy (LPP, n=128), lasting on average three years. Outcomes in personality functioning (i.e., self-concept, defense style, interpersonal problems, and level of personality organization) were assessed five to seven times using, respectively, questionnaires (SASB, DSQ, IIP) and interview (LPO) during the 5-year follow-up from randomization. Personality functioning improved in all therapy groups. Both short-term therapies fared better than LPP during the first year of follow-up, by faster improvement in self-concept and decrease in immature defense style. SFT also showed more early reduction of interpersonal problems. However, LPP thereafter showed larger and more sustained benefits than SFT and SPP, through greater changes in self-concept. Additionally, LPP outperformed SFT at the end of the follow-up in IIP and LPO, after adjustment for auxiliary treatment. No differences were noted between the short-term therapies at any measurement point. Auxiliary treatment was used relatively widely which limits generalization to exclusive use of short- or long-term therapy. LPP seems to be somewhat more effective than short-term therapies in facilitating longterm changes in personality functioning.",Lindfors O.; Knekt P.; Heinonen E.; Härkänen T.; Virtala E.;  .,2015.0,10.1016/j.jad.2014.10.039,0,0,
9545,Increased anxiety levels predict a worse endothelial function in patients with lifetime panic disorder: results from a naturalistic follow-up study.,,Belem da Silva CT.; Vargas da Silva AM.; Costa M.; Sant'Anna RT.; Heldt E.; Manfro GG.,2015.0,10.1016/j.ijcard.2014.10.170,0,0,
9546,Does attention bias modification improve attentional control? A double-blind randomized experiment with individuals with social anxiety disorder.,"People with anxiety disorders often exhibit an attentional bias for threat. Attention bias modification (ABM) procedure may reduce this bias, thereby diminishing anxiety symptoms. In ABM, participants respond to probes that reliably follow non-threatening stimuli (e.g., neutral faces) such that their attention is directed away from concurrently presented threatening stimuli (e.g., disgust faces). Early studies showed that ABM reduced anxiety more than control procedures lacking any contingency between valenced stimuli and probes. However, recent work suggests that no-contingency training and training toward threat cues can be as effective as ABM in reducing anxiety, implying that any training may increase executive control over attention, thereby helping people inhibit their anxious thoughts. Extending this work, we randomly assigned participants with DSM-IV diagnosed social anxiety disorder to either training toward non-threat (ABM), training toward threat, or no-contingency condition, and we used the attention network task (ANT) to assess all three components of attention. After two training sessions, subjects in all three conditions exhibited indistinguishably significant declines from baseline to post-training in self-report and behavioral measures of anxiety on an impromptu speech task. Moreover, all groups exhibited similarly significant improvements on the alerting and executive (but not orienting) components of attention. Implications for ABM research are discussed.",Heeren A.; Mogoaşe C.; McNally RJ.; Schmitz A.; Philippot P.,2015.0,10.1016/j.janxdis.2014.10.007,0,0,
9547,Aerobic exercise training facilitates the effectiveness of cognitive behavioral therapy in panic disorder.,"Physical activity has been discussed as a therapeutic alternative or add-on for the treatment of anxiety disorders. We studied whether aerobic exercise compared to physical activity with low impact can improve the effect of cognitive behavioral therapy (CBT) in patients with panic disorder (PD) with/without agoraphobia. Forty-seven patients received group CBT treatment over 1 month, which was augmented with an 8-week protocol of either aerobic exercise (three times/week, 30 min, 70% VO(2) max; n = 24) or a training program including exercises with very low intensity (n = 23) in a randomized controlled double-blind design. The primary outcome measure was the total score on the Hamilton Anxiety Scale (Ham-A). A 2 × 3 analysis of covariance (ANCOVA) with baseline value as a covariate was conducted for data analysis. Time × group interaction for the Ham-A revealed a significant effect (P = .047, η(2) p = .072), which represented the significant group difference at a 7-month follow-up. For the other clinical outcome measures no statistical significance emerged, although improvement was more sustained in the exercise group. For patients with PD, regular aerobic exercise adds an additional benefit to CBT. This supports previous results and provides evidence about the intensity of exercise that needs to be performed.",Gaudlitz K.; Plag J.; Dimeo F.; Ströhle A.,2015.0,10.1002/da.22337,0,0,
9548,Cognitive behavior therapy for anxiety in people with dementia: a clinician guideline for a person-centered approach.,"This article describes a 10-session cognitive-behavioral therapy (CBT) used in a randomized controlled trial with people with anxiety and mild-to-moderate dementia. The aim of the therapy is to reduce symptoms of anxiety by increasing a sense of safety and self-efficacy. The therapy is characterized by a person-centered approach to CBT, using individual tailoring to accommodate for cognitive deficits and other challenges. Three phases of therapy are described: (a) socialization to model (including overcoming barriers to participation), goal setting, and formulation; (b) application of cognitive and behavioral change techniques to address unhelpful autonomic reactions, ""strategic"" reactions, ""rules for living,"" and interpersonal aspects; and (c) consolidation and ending in the context of chronic, deteriorating illness. The approach prioritizes direct work with the person with dementia, with the involvement of a ""supportive other"" where available and when necessary. The protocol is designed for use by therapists with prior experience in CBT.",Charlesworth G.; Sadek S.; Schepers A.; Spector A.,2015.0,10.1177/0145445514561317,0,0,
9549,Attentional bias modification facilitates attentional control mechanisms: evidence from eye tracking.,"Social anxiety is thought to be maintained by biased attentional processing towards threatening information. Research has further shown that the experimental attenuation of this bias, through the implementation of attentional bias modification (ABM), may serve to reduce social anxiety vulnerability. However, the mechanisms underlying ABM remain unclear. The present study examined whether inhibitory attentional control was associated with ABM. A non-clinical sample of participants was randomly assigned to receive either ABM or a placebo task. To assess pre-post changes in attentional control, participants were additionally administered an emotional antisaccade task. ABM participants exhibited a subsequent shift in attentional bias away from threat as expected. ABM participants further showed a subsequent decrease in antisaccade cost, indicating a general facilitation of inhibitory attentional control. Mediational analysis revealed that the shift in attentional bias following ABM was independent to the change in attentional control. The findings suggest that the mechanisms of ABM are multifaceted.",Chen NT.; Clarke PJ.; Watson TL.; MacLeod C.; Guastella AJ.,2015.0,10.1016/j.biopsycho.2014.12.002,0,0,
9550,Exploring Outcomes Related to Anxiety and Depression in Completers of a Randomized Controlled Trial of Complicated Grief Treatment.,"The present study examines a more fine-grained analysis of anxiety-related and depression-related outcomes amongst a sample of treatment completers who were assigned to complicated grief treatment (CGT) (n = 35) or interpersonal psychotherapy (IPT) (n = 34) in a previously reported randomized controlled trial. We examined effects of antidepressant use and measures of anxiety and depression, focusing especially on guilt related to the death or deceased and grief-related avoidance in order to further understand the differential effectiveness of CGT and IPT amongst participants who received the full course of treatment. Analyses showed that CGT produced greater reductions in anxiety and depressive symptoms including negative thoughts about the future and grief-related avoidance. CGT's advantage over IPT in lowering depression was most pronounced amongst those not taking antidepressants. Our results further elucidate CGT effects and support the idea that CG and major depressive disorder are distinct conditions. Targeted treatment for complicated grief (CG) produces benefits in associated mood and anxiety symptoms and CG symptoms. Amongst patients with CG, interpersonal psychotherapy seems relatively ineffective in ameliorating depressive symptoms. Grief-related depressive symptoms may not respond to standard treatments unless CG symptoms are also addressed. Reducing grief-related symptoms, such as anxieties about the future, guilt related to the death or deceased and avoidance of reminders of the loss may be important aspects in reducing CG.",Glickman K.; Shear MK.; Wall M.,,10.1002/cpp.1940,0,0,
9551,Predictors in Internet-delivered cognitive behavior therapy and behavioral stress management for severe health anxiety.,"Severe health anxiety can be effectively treated with exposure-based Internet-delivered cognitive behavior therapy (ICBT), but information about which factors that predict outcome is scarce. Using data from a recently conducted RCT comparing ICBT (n = 79) with Internet-delivered behavioral stress management (IBSM) (n = 79) the presented study investigated predictors of treatment outcome. Analyses were conducted using a two-step linear regression approach and the dependent variable was operationalized both as end state health anxiety at post-treatment and as baseline-to post-treatment improvement. A hypothesis driven approach was used where predictors expected to influence outcome were based on a previous predictor study by our research group. As hypothesized, the results showed that baseline health anxiety and treatment adherence predicted both end state health anxiety and improvement. In addition, anxiety sensitivity, treatment credibility, and working alliance were significant predictors of health anxiety improvement. Demographic variables, i.e. age, gender, marital status, computer skills, educational level, and having children, had no significant predictive value. We conclude that it is possible to predict a substantial proportion of the outcome variance in ICBT and IBSM for severe health anxiety. The findings of the present study can be of high clinical value as they provide information about factors of importance for outcome in the treatment of severe health anxiety.",Hedman E.; Andersson E.; Lekander M.; Ljótsson B.,2015.0,10.1016/j.brat.2014.11.009,0,0,
9552,[ANXIETY AND DEPRESSIVE DISORDERS IN FUNCTIONAL DYSPEPSIA: CAUSE OR CONSEQUENCE?].,"The aim of this study was to evaluate the frequency and importance of anxiety and depression in patients with functional dyspepsia (FD), the relationship between these psychological characteristics, symptom severity and the quality of life. We performed a cross-sectional study. 125 patients with FD according to the Rome criteria ill, as well as a control group of 30 healthy volunteers were investigated. All study participants filled out a scale to identify HADS anxiety-depressive disorder, an overall assessment of the quality of life, using a questionnaire SF-8 (standard 4-week form). FD patients were asked to rate the severity of epigastric pain (burning) or abdominal discomfort (early satiation or postprandial fullness) with LPDS scale (Leuven postprandial distress scale). All statistical analyzes were performed in the Medstat program. The results obtained with p < 0.05 and 95% CI were considered statistically significant. Anxiety and depression were observed in 50.4% and 42.4% of FD patients, respectively, and in 13.3% and 6.66% of healthy subjects, respectively (p < 0.001 for both). The mean HADS scores for anxiety and depression in lBS patients were 7.93 ± 3.75 and 6.94 ± 3.78, respectively. Both anxiety and depression were associated with self-reported symptom severity (LPDS) (p < 0.05). As determined by correlation analysis, symptom severity was the most important factor in the prediction of anxiety and depression. Self-reported symptom severity, anxiety and depression were clearly and independently associated with the overall health-related quality of life (HRQOL). Biopsychosocial model of FD explained the difficulties of the pathogenesis of this disease. Anxiety and de- pression were frequently observed in FD patients and were related to the severity of their symptoms and the impairment of the patient's HRQOL. Our data suggest that assessing anxiety and depression is important when evaluating FD patients.",Kugler TE.,2015.0,,0,0,
9553,The Effect of Holy Qur'an Recitation on Anxiety in Hemodialysis Patients: A Randomized Clinical Trial.,"Kidney disease and its related psychological costs have significantly increased in recent years. The aim of this study was to investigate the impact of Qur'an recitation on anxiety in hemodialysis patients. Sixty hemodialysis patients were randomized to either Qur'an recitation or a control group. Spielberger's State-Trait Anxiety Inventory (STAI) was completed by patients at baseline and 1 month afterward. The intervention involved listening to the recitation of the Qur'an in traditional cantillation voice. The control group received no intervention. The data were analyzed using Student's t test and general linear models. Recitation of the Qur'an was effective in reducing anxiety in the intervention group, decreasing STAI score at baseline from 128.5 (SD = 13.0) to 82.1 (SD = 11.3), compared to the control group which experienced no change in anxiety scores from baseline to follow-up (118.3, SD = 14.5, vs. 120.1, SD = 14.4, respectively. Between-subject comparison at follow-up, after adjusting for baseline differences, indicated a significant reduction in anxiety in the intervention versus the control group (F = 15.5, p = 0.0002, Cohen's d = 1.03). Listening to the Holy Qur'an being recited is an effective intervention for anxiety in patients undergoing hemodialysis in Iran.",Babamohamadi H.; Sotodehasl N.; Koenig HG.; Jahani C.; Ghorbani R.,2015.0,10.1007/s10943-014-9997-x,0,0,
9554,A comparison of the capacity of DSM-IV and DSM-5 acute stress disorder definitions to predict posttraumatic stress disorder and related disorders.,"This study addresses the extent to which DSM-IV and DSM-5 definitions of acute stress disorder (ASD) predict subsequent posttraumatic stress disorder (PTSD) and related psychiatric disorders following trauma. Patients with randomized admissions to 5 hospitals across Australia (N = 596) were assessed in hospital and reassessed for PTSD at 3 (n = 508), 12 (n = 426), 24 (n = 439), and 72 (n = 314) months using the Clinician-Administered PTSD Scale; DSM-IV definition of PTSD was used at each assessment, and DSM-5 definition was used at 72 months. The Mini-International Neuropsychiatric Interview (MINI) was used at each assessment to assess anxiety, mood, and substance use disorders. Forty-five patients (8%) met DSM-IV criteria, and 80 patients (14%) met DSM-5 criteria for ASD. PTSD was diagnosed in 93 patients (9%) at 3, 82 patients (10%) at 12, 100 patients (12%) at 24, and 26 patients (8%) at 72 months; 19 patients (6%) met DSM-5 criteria for PTSD at 72 months. Comparable proportions of those diagnosed with ASD developed PTSD using DSM-IV (3 months = 46%, 12 months = 39%, 24 months = 32%, and 72 months = 25%) and DSM-5 (43%, 42%, 33%, and 24%) ASD definitions. Sensitivity was improved for DSM-5 relative to DSM-IV for depression (0.18 vs 0.30), panic disorder (0.19 vs 0.41), agoraphobia (0.14 vs 0.40), social phobia (0.12 vs 0.44), specific phobia (0.24 vs 0.58), obsessive-compulsive disorder (0.17 vs 0.47), and generalized anxiety disorder (0.20 vs 0.47). More than half of participants with DSM-5-defined ASD had a subsequent disorder. The DSM-5 criteria for ASD results in better identification of people who will subsequently develop PTSD or another psychiatric disorder relative to the DSM-IV criteria. Although prediction is modest, it suggests that the new ASD diagnosis can serve a useful function in acute trauma settings for triaging those who can benefit from either early intervention or subsequent monitoring.",Bryant RA.; Creamer M.; O'Donnell M.; Silove D.; McFarlane AC.; Forbes D.,2015.0,10.4088/JCP.13m08731,0,0,
9555,Prognostic subgroups for remission and response in the Coordinated Anxiety Learning and Management (CALM) trial.,"Most patients with anxiety disorders receive treatment in primary care settings. Limited moderator data are available to inform clinicians of likely prognostic outcomes for individual patients. We identify baseline characteristics associated with outcome in adults seeking treatment for anxiety disorders. We conducted an exploratory moderator analysis from the Coordinated Anxiety Learning and Management (CALM) trial. In the CALM trial, 1,004 adults who met DSM-IV criteria for generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, and/or posttraumatic stress disorder (PTSD) were randomized to usual care (UC) or a collaborative care intervention (ITV) of cognitive-behavioral therapy and/or pharmacotherapy between June 2006 and April 2008. Logistic regression was used to examine baseline characteristics associated with remission and response overall and by treatment condition. Receiver operating curve (ROC) analyses identified subgroups associated with similar likelihood of response and remission of global anxiety symptoms. Remission was defined as score < 6 on the 12-item Brief Symptom Inventory (BSI-12) anxiety and somatization subscales. Response was defined as at least 50% reduction on BSI-12, or meeting remission criteria. Randomization to ITV over UC was often the strongest predictor of outcome. Several baseline patient characteristics were associated with poor treatment outcome including comorbid depression, increased severity of underlying anxiety disorder(s) (P < .001), low socioeconomic status (perceived [P < .001] and actual [P < .05]), and limited social support (P < .001). Patient characteristics associated with particular benefit from ITV were being female (P < .05), increased depression (P < .01)/GAD severity (P < .05), and low socioeconomic status (P < .05). ROC analysis demonstrated prognostic subgroups with large differences in response likelihood. Further research should focus on the effectiveness of implementing the ITV intervention of CALM in community treatment centers where patients typically are of low socioeconomic status and may particularly benefit from ITV. ClinicalTrials.gov identifier: NCT00347269.",Kelly JM.; Jakubovski E.; Bloch MH.,2015.0,10.4088/JCP.13m08922,0,0,
9556,Prognostic value of an immediate lateral standing X-ray with a TLSO in patients with a thoracolumbar burst fracture.,"The final collapse of a ""stable"" thoracolumbar burst fracture is difficult to predict. This collapse was prospectively studied radiologically in patients with T12 or L1 burst fractures who, after evaluating the admission x-rays and the CT scan with the patients themselves, opted for a rigid thoracolumbar brace with support in the sternal manubrium (TLSO). On the other hand, patients with rigid braces sometimes have low back pain on follow-up (due to overload of the L5-S1 joints). the standing lateral x-ray with only a TLSO for support (intrinsic mechanical stability) provides information on the final collapse and could also provide information on the low back pain. The study included 50 patients (20 males and 30 females, age: 63+14 years) admitted during 2011 and 2012, with 2 losses to follow-up. Farcy index and local kyphosis (Cobb at 3 vertebrae). X-Rays: admission, with TLSO (immediate: Rx0), and at 3 and 6 months. They were compared with the final clinical and radiological results. It was decided to surgically intervene in 4 patients after Rx0. There were no painful sequelae at the fracture level, and 16/44 (31%) had low back pain. Using linear regression mathematical models, the increase in the Farcy index (Rx0-Rx admission) was associated with the appearance of low back pain and with local kyphosis (Rx0-Rx admission), and with the final kyphosis. It is advisable to perform a lateral standing X-ray after TLSO for information on the final collapse of the fracture and the appearance of accompanying low back pain.",Díez-Ulloa MA.; Gallego-Goyanes A.,,10.1016/j.recot.2014.08.004,0,0,
9557,"Symbolic online exposure for spider fear: habituation of fear, disgust and physiological arousal and predictors of symptom improvement.","This research compared the effects of real versus hyper-real images on anxiety, disgust, and physiological arousal during internet-delivered exposure in high spider-fearfuls. Hyper-real images were digitally altered to highlight fearful aspects. A further aim was to examine self-reported and behavioural therapeutic outcomes and exposure-related predictors of these outcomes. Twenty-eight females were randomised to real (n = 14) or hyper-real (n = 14) treatment groups and nine participants were subsequently allocated to a wait-list control group. Treatment groups viewed an 8-stage exposure hierarchy of real or hyper-real spider images. Subjective anxiety and disgust ratings were taken during each stage (0, 60, 120, 180 s) with heart rate and skin conductance recorded throughout. Anxiety, disgust and physiological arousal habituated within each exposure stage, with no differential effect of real compared to hyper-real images. Both treatment groups but not controls demonstrated significant reductions in behavioural avoidance and self-reported phobic symptoms from pre-treatment to post-treatment with large effect sizes noted. The change in within-stage habituation of anxiety, disgust and heart rate, between the first and last stage, predicted improvement in behavioural avoidance at post-treatment. This suggests that generalisation of habituation to multiple images is an important predictor of improvement. While findings in relation to therapeutic outcome should be considered preliminary, clear relationships were found between exposure-related variables and outcome among those who undertook treatment. Findings provide evidence in support of the efficacy of online image-based exposure and have implications for informing further research into the underlying mechanisms of image-based exposure treatment.",Matthews A.; Naran N.; Kirkby KC.,2015.0,10.1016/j.jbtep.2014.12.003,0,0,
9558,"The strategy does not matter: Effects of acceptance, reappraisal, and distraction on the course of anticipatory anxiety in social anxiety disorder.","Anticipatory anxiety is a core feature of social anxiety disorder (SAD); however, there is a paucity of data on effective strategies for dealing with this affective state. The present study examined the effects of reappraisal, acceptance, and distraction on the course of anticipatory anxiety. The study used an experimental design, randomly assigning participants to one of three strategy groups. Participants were instructed to employ these strategies during the anticipation of an impromptu speech. Participants with SAD (n = 67) and healthy controls (n = 72) were compared with regard to their ability to adopt the prescribed strategies and with regard to the effects of strategy use on self-reported and psychophysiological markers of arousal. SAD participants reported more problems in adopting the assigned strategies than controls, although the time spent with each strategy did not differ by group. In both groups, acceptance was rated as more difficult to adopt than reappraisal and distraction. Subjective ratings of anxiety decreased during the first 10 min of anticipation regardless of diagnostic group or strategy, but anxiety increased again immediately prior to the speech. Psychophysiological parameters were largely unaffected by group or strategy. The results question whether there are differential benefits of different emotion regulation (ER) strategies in dealing with anticipatory anxiety. The observed rebound of anxiety prior to the social event calls into doubt the long-term effectiveness of these strategies, at least during the regulation of anticipatory anxiety. Coping with anticipatory anxiety is an important issue in treating SAD. Compared to healthy controls, individuals diagnosed with SAD experienced more problems in adopting prescribed ER strategies for dealing with anticipatory anxiety. We found no differences between acceptance, reappraisal, and distraction, calling into question that one strategy should be generally recommended by clinicians.",Helbig-Lang S.; Rusch S.; Rief W.; Lincoln TM.,2015.0,10.1111/papt.12053,0,0,
9559,Physical activity patterns of people affected by depressive and anxiety disorders as measured by accelerometers: a cross-sectional study.,"Exercise can relieve both depressive and anxiety disorders and it is therefore of importance to establish movement patterns of mildly to moderately affected sufferers to estimate the treatment potential. The aim is to describe the physical activity patterns of people affected by mild to moderate depressive and/or anxiety symptoms using objective measures of physical activity. The design of the study was cross-sectional using data from 165 people aged 18-65 years, with mild to moderate depressive and/or anxiety disorder symptoms (scoring ≥ 10 on the PHQ-9). Diagnoses were made using Mini International Neuropsychiatric Interview (MINI) and symptom severity was measured with the Montgomery-Åsberg Depression Rating Scale (MADRS). The participants wore accelerometers for a week to evaluate physical activity patterns. No statistically significant differences were detected between different diagnoses, though depressed participants tended to be less active and more sedentary. Only one-fifth of the sample followed public health guidelines regarding physical activity. Each one point increase in MADRS was associated with a 2.4 minute reduction in light physical activity, independent of moderate-to-vigorous physical activity and sedentary time. MADRS was positively associated with number of sedentary bouts. The physical activity pattern of people with depressive and/or anxiety disorders was characterized by large amounts of sedentary time and low fulfillment of physical activity guidelines. There is therefore a large treatment potential for this group by increasing exercise. The results suggest that instead of focusing exclusively on high intensity exercise for treating depressive and anxiety disorders, health care providers might encourage patients to reduce sedentary time by increasing light physical activity and decreasing the number of sedentary bouts, though further studies are needed that can determine directionality.",Helgadóttir B.; Forsell Y.; Ekblom Ö.,2015.0,10.1371/journal.pone.0115894,0,0,
9560,5HTT is associated with the phenotype psychological flexibility: results from a randomized clinical trial.,"Adaption to changing environments is evolutionarily advantageous. Studies that link genetic and phenotypic expression of flexible adjustment to one's context are largely lacking. In this study, we tested the importance of psychological flexibility, or goal-related context sensitivity, in an interaction between psychotherapy outcome for panic disorder with agoraphobia (PD/AG) and a genetic polymorphism. Given the established role of the 5HTT-LPR polymorphism in behavioral flexibility, we tested whether this polymorphism (short group vs. long group) impacted therapy response as a function of various endophenotypes (i.e., psychological flexibility, panic, agoraphobic avoidance, and anxiety sensitivity). Patients with PD/AG were recruited from a large multicenter randomized controlled clinical trial on cognitive-behavioral therapy. Pre- to post-treatment changes by 5HTT polymorphism were analyzed. 5HTT polymorphism status differentiated pre- to post-treatment changes in the endophenotype psychological flexibility (effect size difference d = 0.4, p < 0.05), but none of the specific symptom-related endophenotypes consistently for both the intent-to-treat sample (n = 228) and the treatment completers (n = 194). Based on the consistency of these findings with existing theory on behavioral flexibility, the specificity of the results across phenotypes, and the consistency of results across analyses (i.e., completer and intent to treat), we conclude that 5HTT polymorphism and the endophenotype psychological flexibility are important variables for the treatment of PD/AG. The endophenotype psychological flexibility may help bridge genetic and psychological literatures. Despite the limitation of the post hoc nature of these analyses, further study is clearly warranted.",Gloster AT.; Gerlach AL.; Hamm A.; Höfler M.; Alpers GW.; Kircher T.; Ströhle A.; Lang T.; Wittchen HU.; Deckert J.; Reif A.,2015.0,10.1007/s00406-015-0575-3,0,0,
9561,Exposure treatment in multiple contexts attenuates return of fear via renewal in high spider fearful individuals.,"Research has demonstrated that after exposure treatment, re-exposure to a previously feared stimulus outside of the treatment context can result in renewal of fear. The current study investigated whether conducting exposure treatment in multiple real-life contexts can attenuate renewal of fear. Forty-six moderate to high spider fearful individuals were randomly allocated to groups that received exposure treatment in either one context or three contexts. Follow-up testing was conducted one week and four weeks after exposure in the treatment context or a novel context. Renewal of fear was found for the single extinction context group when exposed to the feared object in a novel context with self-report of fear, heart rate, and behavioural avoidance. However, renewal of fear was attenuated for the multiple extinction context group. The sample included moderate to high spider fearful participants rather than clients with spider phobia, potentially limiting the generalisability of the findings to clinical populations. Using multiple extinction contexts in combination with other methods of attenuating renewal (e.g., context similarity) may provide a means to reduce the risk of renewal of fear.",Bandarian-Balooch S.; Neumann DL.; Boschen MJ.,2015.0,10.1016/j.jbtep.2014.12.006,0,0,
9562,Group metacognitive therapy for repetitive negative thinking in primary and non-primary generalized anxiety disorder: an effectiveness trial.,"Generalized anxiety disorder (GAD) is a common and highly comorbid anxiety disorder characterized by repetitive negative thinking (RNT). Treatment trials tend to exclude individuals with non-primary GAD, despite this being a common presentation in real world clinics. RNT is also associated with multiple emotional disorders, suggesting that it should be targeted regardless of the primary disorder. This study evaluated the acceptability and effectiveness of brief group metacognitive therapy (MCT) for primary or non-primary GAD within a community clinic. Patients referred to a specialist community clinic attended six, two-hour weekly sessions plus a one-month follow-up (N=52). Measures of metacognitive beliefs, RNT, symptoms, positive and negative affect, and quality of life were completed at the first, last, and follow-up sessions. Attrition was low and large intent-to-treat effects were observed on most outcomes, particularly for negative metacognitive beliefs and RNT. Treatment gains increased further to follow-up. Benchmarking comparisons demonstrated that outcomes compared favorably to longer disorder-specific protocols for primary GAD. No control group or independent assessment of protocol adherence. Brief metacognitive therapy is an acceptable and powerful treatment for patients with primary or non-primary GAD.",McEvoy PM.; Erceg-Hurn DM.; Anderson RA.; Campbell BN.; Swan A.; Saulsman LM.; Summers M.; Nathan PR.,2015.0,10.1016/j.jad.2014.12.046,0,0,
9563,Therapist awareness of client resistance in cognitive-behavioral therapy for generalized anxiety disorder.,"Clients' resistance relates negatively to their retention and outcomes in psychotherapy; thus, it has been increasingly identified as a key process marker in both research and practice. This study compared therapists' postsession ratings of resistance with those of trained observers in the context of 40 therapist-client dyads receiving 15 sessions of cognitive-behavioral therapy for generalized anxiety disorder. Therapist and observer ratings were then examined as correlates of proximal (therapeutic alliance quality and homework compliance) and distal (posttreatment worry severity) outcomes. Although there was reasonable concordance between rater perspectives, observer ratings were highly and consistently related to both proximal and distal outcomes, while therapist ratings were not. These findings underscore the need to enhance therapists' proficiency in identifying important and often covert in-session clinical phenomena such as the cues reflecting resistance and noncollaboration.",Hara KM.; Westra HA.; Aviram A.; Button ML.; Constantino MJ.; Antony MM.,2015.0,10.1080/16506073.2014.998705,0,0,
9564,Assignment refusal and its relation to outcome in a randomized controlled trial comparing Cognitive Therapy and Fluvoxamine in treatment-resistant patients with obsessive compulsive disorder.,"The effectiveness of Fluvoxamine was compared to that of Cognitive Therapy (CT) in a 12-week randomized controlled trial (RCT) in 48 patients with obsessive-compulsive disorder (OCD), who were treatment-resistant to a previous behavior therapy (BT). A considerable amount of patients did not comply with the assigned treatment and switched treatments. The aim of this study was to identify patient characteristics predictive of assignment compliance and to study whether these characteristics were related to outcome. A logistic model, based on psychological and social patient characteristics, in addition to or in interaction with the assignment, was used for the explanation of compliance with treatment assignment. Especially patients who have a higher score on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) tend to comply with the effective Fluvoxamine treatment. The same set of variables was related to both compliance and outcome of therapy received. Therefore, the logistic model of compliance could be used to reduce the positive bias of As-Treated analysis (AT). The difference between the results of Fluvoxamine and Cognitive Therapy remained statistically significant after correcting for the positive bias as the result of assignment refusal and after applying the assumption that two drop-out patients needed imputation of lesser results.",Landsheer JA.; Smit JH.; van Oppen P.; van Balkom AJ.,2015.0,10.1016/j.psychres.2014.12.050,0,0,
9565,Effects of stigma-reducing conditions on intention to seek psychological help among Korean college students with anxious-ambivalent attachment.,"This study aimed to examine whether stigma-reducing conditions (i.e., random assignment of participants to hypothetical scenarios with varying levels of stigma) effectively increase intention to seek help for Korean college students with anxious-ambivalent attachment style, depending on previous counseling experience. Three hundred thirty Korean college students participated and were randomly assigned to either a low or a high stigma-reducing manipulative condition group. Each group was provided with three possible strategies to reduce stigma: the location of a counseling center, contact with a mental health patient, and the media portrayal of mental illness. In the high-stigma group, the strategies were described in a way that was highly stigmatizing. In the other group, the 3 strategies were created in a way that was not as stigmatizing. In order to examine the effect of stigma-reducing scenarios through the conditions, participants were also instructed to remember a previous or current stressful situation before responding to the questionnaire. The results of multivariate analysis of variance showed a 3-way interaction effect (i.e., level of stigma based on stigma manipulative condition, level of attachment anxiety, and previous counseling experience) on the intentions score when the ""contact"" and the ""media"" strategies were applied. The results indicated that individuals who have a higher level of attachment anxiety and a previous experience of counseling were more sensitive to the stigma-reducing manipulative condition. These results highlight the importance of the ""contact"" and ""media"" strategies in reducing stigma of seeking counseling for mental health services.",Nam SK.; Choi SI.; Lee SM.,2015.0,10.1037/a0038713,0,0,
9566,Combining seeking safety with sertraline for PTSD and alcohol use disorders: A randomized controlled trial.,"The current study marks the first randomized controlled trial to test the benefit of combining Seeking Safety (SS), a present-focused cognitive-behavioral therapy for co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), with sertraline, a front-line medication for PTSD shown to also impact drinking outcomes. Sixty-nine participants (81% female; 59% African American) with primarily childhood sexual (46%) and physical (39%) trauma exposure, and drug dependence in addition to AUD were randomized to receive a partial-dose (12 sessions) of SS with either sertraline (n = 32; M = 7 sessions) or placebo (n = 37; M = 6 sessions). Assessments conducted at baseline, end-of-treatment, 6- and 12-months posttreatment measured PTSD and AUD symptom severity. Both groups demonstrated significant improvement in PTSD symptoms. The SS plus sertraline group exhibited a significantly greater reduction in PTSD symptoms than the SS plus placebo group at end-of-treatment (M difference = -16.15, p = .04, d = 0.83), which was sustained at 6- and 12-month follow-up (M difference = -13.81, p = .04, d = 0.71, and M difference = -12.72, p = .05, d = 0.65, respectively). Both SS groups improved significantly on AUD severity at all posttreatment time points with no significant differences between SS plus sertraline and SS plus placebo. Results support the combining of a cognitive-behavioral therapy and sertraline for PTSD/AUD. Clinically significant reductions in both PTSD and AUD severity were achieved and sustained through 12-months follow-up, Moreover, greater mean improvement in PTSD symptoms was observed across all follow-up assessments in the SS plus sertraline group. (PsycINFO Database Record",Hien DA.; Levin FR.; Ruglass LM.; López-Castro T.; Papini S.; Hu MC.; Cohen LR.; Herron A.,2015.0,10.1037/a0038719,0,0,
9567,Volume of hippocampal substructures in borderline personality disorder.,"Borderline personality disorder (BPD) may be associated with smaller hippocampi in comparison to hippocampal size in controls. However, specific pathology in hippocampal substructures (i.e., head, body and tail) has not been sufficiently investigated. To address hippocampal structure in greater detail, we studied 39 psychiatric inpatients and outpatients with a DSM-IV diagnosis of BPD and 39 healthy controls. The hippocampus and its substructures were segmented manually on magnetic resonance imaging scans. The volumes of hippocampal substructures (and total hippocampal volume) did not differ between BPD patients and controls. Exploratory analysis suggests that patients with a lifetime history of posttraumatic stress disorder (PTSD) may have a significantly smaller hippocampus - affecting both the hippocampal head and body - in comparison to BPD patients without comorbid PTSD (difference in total hippocampal volume: -10.5%, 95%CI -2.6 to -18.5, significant). Also, patients fulfilling seven or more DSM-IV BPD criteria showed a hippocampal volume reduction, limited to the hippocampal head (difference in volume of the hippocampal head: -16.5%, 95%CI -6.1 to -26.8, significant). Disease heterogeneity in respect to, for example, symptom severity and psychiatric comorbidities may limit direct comparability between studies; the results presented here may reflect hippocampal volumes in patients who are ""less"" affected or they may simply be a chance finding. However, there is also the possibility that global effects of BPD on the hippocampus may have previously been overestimated.",Kreisel SH.; Labudda K.; Kurlandchikov O.; Beblo T.; Mertens M.; Thomas C.; Rullkötter N.; Wingenfeld K.; Mensebach C.; Woermann FG.; Driessen M.,2015.0,10.1016/j.pscychresns.2014.11.010,0,0,
9568,Diagnostic terminology is not associated with contact-sport players' expectations of outcome from mild traumatic brain injury.,"To investigate the influence of the diagnostic terms 'concussion' and 'mild traumatic brain injury' (mTBI) on contact-sport players' injury perceptions and expected symptoms from a sport-related mTBI. It was hypothesized that contact-sport players would hold more negative injury perceptions and expect greater symptom disturbance from a sport-related injury that was diagnosed as an 'mTBI' compared to 'concussion' or an undiagnosed injury. One hundred and twenty-two contact-sport players were randomly allocated to one of three conditions in which they read a sport-related mTBI vignette that varied only according to whether the person depicted in the vignette was diagnosed with concussion (n‚Äâ=‚Äâ40), mTBI (n‚Äâ=‚Äâ41) or received no diagnosis (control condition; n‚Äâ=‚Äâ41). After reading the vignette, participants rated their injury perceptions (perceived undesirability, chronicity and consequences) and expectations of post-concussion syndrome (PCS) and post-traumatic stress disorder (PTSD) symptoms 6 months post-injury. There were no significant differences in contact-sport players' injury perceptions or symptom expectations from a sport-related mTBI when it was diagnosed as an mTBI, concussion or when no diagnosis was given. Diagnostic terminology does not appear to have a potent influence on symptom expectation and injury perceptions in contact-sport players.",Edmed SL.; Sullivan KA.,2015.0,10.3109/02699052.2014.998709,0,0,
9569,Countering fear renewal: changes in the UCS representation generalize across contexts.,"After treatment of anxiety disorders, fear often returns. Analogue studies show that outside the extinction context the conditional stimulus (CS) activates the acquisition memory (CS predicts unconditional stimulus; UCS), rather than the extinction memory (CS does not predict UCS). Conditioning theory postulates that fear also diminishes after a reduction in the subjective cost of the UCS, which can occur in absence of any changes in the CS-UCS association. We hypothesized that fear reduction via ""UCS deflation"" generalizes across context. Healthy students underwent acquisition in context A with neutral CSs and 100dB white noise as UCS. One group received post-conditioning UCS exposure, in which UCS intensity decreased over time (""ABAdefl""). Another group received UCS presentations at equal intensity (""ABActrl""). Two groups did a filler task (""ABB""; ""ABA""). Then, all groups underwent extinction in context B and were retested in context A (ABA-groups) or B (ABB-group). During each CS participants rated UCS expectancy and UCS cost. Results showed the typical increase in UCS expectancy following the context switch from extinction to test phase. In contrast, UCS deflation caused a reduction in cost ratings that was maintained after the context change. Findings suggest that UCS deflation techniques may reduce fear renewal.",Leer A.; Engelhard IM.,2015.0,10.1016/j.beth.2014.09.012,0,0,
9570,Visuospatial Memory Improvement after Gamma Ventral Capsulotomy in Treatment Refractory Obsessive-Compulsive Disorder Patients.,"Gamma ventral capsulotomy (GVC) radiosurgery is intended to minimize side effects while maintaining the efficacy of traditional thermocoagulation techniques for the treatment of refractory obsessive-compulsive disorder (OCD). Neuropsychological outcomes are not clear based on previous studies and, therefore, we investigated the effects of GVC on cognitive and motor performance. A double-blind, randomized controlled trial (RCT) was conducted with 16 refractory OCD patients allocated to active treatment (n=8) and sham (n=8) groups. A comprehensive neuropsychological evaluation including intellectual functioning, attention, verbal and visuospatial learning and memory, visuospatial perception, inhibitory control, cognitive flexibility, and motor functioning was applied at baseline and one year after the procedure. Secondary analysis included all operated patients: eight from the active group, four from the sham group who were submitted to surgery after blind was broken, and five patients from a previous open pilot study (n=5), totaling 17 patients. In the RCT, visuospatial memory (VSM) performance significantly improved in the active group after GVC (p=0.008), and remained stable in the sham group. Considering all patients operated, there was no decline in cognitive or motor functioning after one year of follow-up. Our initial results after 1 year of follow-up suggests that GVC not only is a safe procedure in terms of neuropsychological functioning but in fact may actually improve certain neuropsychological domains, particularly VSM performance, in treatment refractory OCD patients.",Batistuzzo MC.; Hoexter MQ.; Taub A.; Gentil AF.; Cesar RC.; Joaquim MA.; D'Alcante CC.; McLaughlin NC.; Canteras MM.; Shavitt RG.; Savage CR.; Greenberg BD.; Norén G.; Miguel EC.; Lopes AC.,2015.0,10.1038/npp.2015.33,0,0,
9571,Physical symptom attributions: a defining characteristic of somatoform disorders?,"We examined whether primary care patients were more likely to perceive a current health problem as 'physical illness only' as opposed to entailing psychological difficulties if they had a comorbid somatoform disorder compared to patients who had (a) both comorbid somatoform disorder and anxiety/depression or (b) comorbid anxiety and/or depression, and a reference group of (c) patients with well-defined physical disease. We examined whether attributions predicted future health expenditures. A total of 1209 of 1785 patients completed questions on patient-perceived illness. The physicians diagnosed the current health problem. A stratified subsample was interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. Health expenditure was obtained from registers for a 2-year period. The belief that the current health problem was only physical was endorsed by 86% of patients presenting physical disease, 58% of patients with somatoform disorders, 29% of patients with both somatoform disorders and anxiety/depression and 24% of patients with anxiety or depressive disorders (χ2=269.2, df=3, P<.0001). In a multiple regression model, a 'physical illness only' perception predicted lower health expenditures [β = -0.31, 95% confidence interval (-0.55; -0.07), P=.013]. The prevalent assumption that physical symptom attributions are a central aspect in somatoform disorders is not supported by the current study.",Frostholm L.; Ørnbøl E.; Fink PK.,,10.1016/j.genhosppsych.2015.01.002,0,0,6346
9572,Development and evaluation of a computerized intervention for low distress tolerance and its effect on performance on a neutralization task.,"A growing body of research has linked high distress intolerance (DI) to obsessions, but not other OCD symptom domains. However, existing research is correlational. Experimental studies are needed, but brief methods for reducing DI are lacking. To address these gaps in the literature, a brief, computerized intervention aimed at reducing DI was developed to determine if changing DI affected obsessional phenomena. Individuals reporting high DI were randomized to a treatment or waitlist control group (N = 53). Individuals in the treatment group received the DI treatment (i.e., a 2 h computerized intervention) over two weeks, and then underwent a post-assessment in which DI and obsession-relevant phenomena were measured. Individuals in the control group only received the post-assessment. Analyses revealed a greater reduction in self-reported DI on one measure and smaller decreases in behavioral DI in the intervention condition relative to the waitlist condition, as well as lower in-vivo urges to neutralize an intrusive thought; however, anxious reactivity to the intrusion and neutralization behavior were not affected. Further, bootstrapping analyses revealed that reductions in DI mediated the effect of the intervention on neutralization urges. A clinical sample and placebo control condition were not used. These results provide experimental evidence for the role of DI in obsessional phenomena, specifically in affecting urges to neutralize intrusions, findings consistent with negative reinforcement models of DI. Further, results revealed that DI can be reduced with a brief, computerized intervention, which has important implications for future experimental research and treatment development.",Macatee RJ.; Cougle JR.,2015.0,10.1016/j.jbtep.2015.01.007,0,0,
9573,Integrated primary care for patients with mental and physical multimorbidity: cluster randomised controlled trial of collaborative care for patients with depression comorbid with diabetes or cardiovascular disease.,"To test the effectiveness of an integrated collaborative care model for people with depression and long term physical conditions. Cluster randomised controlled trial. 36 general practices in the north west of England. 387 patients with a record of diabetes or heart disease, or both, who had depressive symptoms (‚â• 10 on patient health questionaire-9 (PHQ-9)) for at least two weeks. Mean age was 58.5 (SD 11.7). Participants reported a mean of 6.2 (SD 3.0) long term conditions other than diabetes or heart disease; 240 (62%) were men; 360 (90%) completed the trial. Collaborative care included patient preference for behavioural activation, cognitive restructuring, graded exposure, and/or lifestyle advice, management of drug treatment, and prevention of relapse. Up to eight sessions of psychological treatment were delivered by specially trained psychological wellbeing practitioners employed by Improving Access to Psychological Therapy services in the English National Health Service; integration of care was enhanced by two treatment sessions delivered jointly with the practice nurse. Usual care was standard clinical practice provided by general practitioners and practice nurses. The primary outcome was reduction in symptoms of depression on the self reported symptom checklist-13 depression scale (SCL-D13) at four months after baseline assessment. Secondary outcomes included anxiety symptoms (generalised anxiety disorder 7), self management (health education impact questionnaire), disability (Sheehan disability scale), and global quality of life (WHOQOL-BREF). 19 general practices were randomised to collaborative care and 20 to usual care; three practices withdrew from the trial before patients were recruited. 191 patients were recruited from practices allocated to collaborative care, and 196 from practices allocated to usual care. After adjustment for baseline depression score, mean depressive scores were 0.23 SCL-D13 points lower (95% confidence interval -0.41 to -0.05) in the collaborative care arm, equal to an adjusted standardised effect size of 0.30. Patients in the intervention arm also reported being better self managers, rated their care as more patient centred, and were more satisfied with their care. There were no significant differences between groups in quality of life, disease specific quality of life, self efficacy, disability, and social support. Collaborative care that incorporates brief low intensity psychological therapy delivered in partnership with practice nurses in primary care can reduce depression and improve self management of chronic disease in people with mental and physical multimorbidity. The size of the treatment effects were modest and were less than the prespecified effect but were achieved in a trial run in routine settings with a deprived population with high levels of mental and physical multimorbidity. ISRCTN80309252.",Coventry P.; Lovell K.; Dickens C.; Bower P.; Chew-Graham C.; McElvenny D.; Hann M.; Cherrington A.; Garrett C.; Gibbons CJ.; Baguley C.; Roughley K.; Adeyemi I.; Reeves D.; Waheed W.; Gask L.,2015.0,,0,0,
9574,Men and women from the STRIDE clinical trial: An assessment of stimulant abstinence symptom severity at residential treatment entry.,"Gender-specific factors associated with stimulant abstinence severity were examined in a stimulant abusing or dependent residential treatment sample (N‚Äâ=‚Äâ302). Bivariate statistics tested gender differences in stimulant abstinence symptoms, measured by participant-reported experiences of early withdrawal. Multivariate linear regression examined gender and other predictors of stimulant abstinence symptom severity. Women compared to men reported greater stimulant abstinence symptom severity. Anxiety disorders and individual anxiety-related abstinence symptoms accounted for this difference. African American race/ethnicity was predictive of lower stimulant abstinence severity. Women were more sensitive to anxiety-related stimulant withdrawal symptoms. Clinics that address anxiety-related abstinence symptoms, which more commonly occur in women, may improve treatment outcome.",Chartier KG.; Sanchez K.; Killeen TK.; Burrow A.; Carmody T.; Greer TL.; Trivedi MH.,2015.0,10.1111/ajad.12190,0,0,
9575,Rape survivors' trauma-related beliefs before and after Cognitive processing therapy: associations with PTSD and depression symptoms.,"This study examined whether cognitive distortions (i.e., assimilated and overaccommodated thoughts) and realistic (i.e., accommodated) thoughts assessed from impact statements written 5-10 years after completing cognitive processing therapy (CPT) accurately predicted posttreatment maintenance or decline in treatment gains during the same period. The sample included 50 women diagnosed with posttraumatic stress disorder (PTSD) secondary to rape who participated in a randomized clinical trial of CPT for PTSD. Cognitions were assessed via coding and analyses of participants' written impact statements at three time points: beginning of treatment, end of treatment, and at 5-10 years follow-up. Primary mental health outcomes were symptoms of PTSD (Clinician-Administered PTSD Scale) and depression (Beck Depression Inventory). Changes in trauma-related beliefs between the end of treatment and long-term follow-up were associated with concomitant changes in PTSD and depression symptoms (effect sizes ranging from r = .35-.54). Declines in accommodated thinking and increases in overaccommodated thinking were associated with elevations in symptomatology. Improvement in accommodated thinking and declines in overaccommodated thinking were associated with lower PTSD and depression symptoms during this same time period. Findings provided support for the role of changes in accommodated and overaccommodated thinking being associated with level of PTSD and depression many years after participating in CPT.",Iverson KM.; King MW.; Cunningham KC.; Resick PA.,2015.0,10.1016/j.brat.2015.01.002,0,0,
9576,Quantitative evaluation of the clinical efficacy of attention bias modification treatment for anxiety disorders.,"Attention bias modification treatment (ABMT) is a novel treatment for anxiety disorders. Although a number of other meta-analytic reviews exist, the purpose of the present meta-analysis is to examine issues unaddressed in prior reviews. Specifically, the review estimates the efficacy of ABMT in clinically anxious patients and examines the effect of delivery context (clinic vs. home) on symptom reduction. A literature search using PsychInfo and Web of Science databases was performed. Only randomized controlled trials (RCTs) examining dot-probe-based ABMT in clinically diagnosed anxious patients were included. From 714 articles located through the search, 36 ABMT studies were identified and 11 studies met inclusion criteria (N = 589 patients). ABMT was associated with greater clinician-rated reductions in anxiety symptoms relative to control training: between-groups effect (d = 0.42, P = .001, confidence interval (CI) = 0.18-0.66), contrast of within-group effects (Q = 7.25, P < .01). More patients in the treatment group no longer met formal diagnostic criteria for their anxiety disorder posttreatment relative to patients in the control condition (P < .05). Analyses of patients' self-reported anxiety were nonsignificant for the between-groups contrast (P = .35), and were at a trend level of significance for the contrast between the within-group effects (P = .06). Moderation analysis of the between-groups effect revealed a significant effect for ABMT delivered in the clinic (d = 0.34, P = 0.01, CI = 0.07-0.62), and a nonsignificant effect for ABMT delivered at home (d = -0.10, P = 0.40, CI = -0.33-0.13). The current meta-analysis provides support for ABMT as a novel evidenced-based treatment for anxiety disorders. Overall, ABMT effects are mainly evident when it is delivered in the clinic and when clinical outcome is evaluated by a clinician. More RCTs of ABMT in specific anxiety disorders are warranted.",Linetzky M.; Pergamin-Hight L.; Pine DS.; Bar-Haim Y.,2015.0,10.1002/da.22344,0,0,
9577,[Total wrist arthroplasty--indications and state of the art].,"For decades design and development of TWA has been accompanied by quite a few failures, so that it has been rejected by most surgeons until today. The difficult and complex anatomy of the wrist led to different ways of development and often ended in an impasse. Compared to knee and hip arthroplasties which could be conceived and developed further, a consistent method could not be applied. But in the last years some new concepts have established themselves, so that TWA is now not only applied in individual cases. The indications could be expanded and standardised. At the Hand-Center Lingen more than 400 TWAs have been performed since 2005. This article describes the mid-term results (5 years since operation) of TWA in 162 patients. 41 % suffered from rheumatoid arthritis, the remaining diseases consisted of osteoarthritis, post-traumatic arthritis and osteoarthritis following distal radius fracture, scaphoid non-union, scapholunate dissociation and Kienböck's disease. Three different types of TWA have been applied and their benefits and disadvantages were examined. In the follow-up we found an improvement in the Quick-Dash of 34 points and 5.8 points on the VAS. The range of motion decreased in patients with RA, but it increased in patients with other diseases. In both groups of patients we found an increase of force. On the whole there was a rate of complications in an average rate of holding time of 3.7 %. There was no necessity for TWA removal and secondary wrist arthrodesis. Our own very positive experience corresponds with the international comparison and it further encourages a standardised indication in TWA as an equivalent treatment.",Nicoloff M.,2015.0,10.1055/s-0034-1396239,0,0,
9578,Integrated Care Increases Treatment and Improves Outcomes of Patients With Chronic Hepatitis C Virus Infection and Psychiatric Illness or Substance Abuse.,"Patients with hepatitis C virus (HCV) infection with psychiatric disorders and/or substance abuse face significant barriers to antiviral treatment. New strategies are needed to improve treatment rates and outcomes. We investigated whether an integrated care (IC) protocol, which includes multidisciplinary care coordination and patient case management, could increase the proportion of patients with chronic HCV infection who receive antiviral treatment (a combination of interferon-based and direct-acting antiviral agents) and achieve a sustained virologic response (SVR). We performed a prospective randomized trial at 3 medical centers in the United States. Participants (n = 363 patients attending HCV clinics) had been screened and tested positive for depression, post-traumatic stress disorder, and/or substance use; they were assigned randomly to groups that received IC or usual care (controls) from March 2009 through February 2011. A midlevel mental health practitioner was placed at each HCV clinic to provide IC with brief mental health interventions and case management, according to formal protocol. The primary end point was SVR. Of the study participants, 63% were non-white, 51% were homeless in the past 5 years, 64% had psychiatric illness, 65% were substance abusers within 1 year before enrollment, 57% were at risk for post-traumatic stress disorder, 71% had active depression, 80% were infected with HCV genotype 1, and 23% had advanced fibrosis. Over a mean follow-up period of 28 months, a greater proportion of patients in the IC group began receiving antiviral therapy (31.9% vs 18.8% for controls; P = .005) and achieved a SVR (15.9% vs 7.7% of controls; odds ratio, 2.26; 95% confidence interval, 1.15-4.44; P = .018). There were no differences in serious adverse events between groups. Integrated care increases the proportion of patients with HCV infection and psychiatric illness and/or substance abuse who begin antiviral therapy and achieve SVRs, without serious adverse events. ClinicalTrials.gov # NCT00722423.",Ho SB.; Bräu N.; Cheung R.; Liu L.; Sanchez C.; Sklar M.; Phelps TE.; Marcus SG.; Wasil MM.; Tisi A.; Huynh L.; Robinson SK.; Gifford AL.; Asch SM.; Groessl EJ.,2015.0,10.1016/j.cgh.2015.02.022,0,0,
9579,Interpersonal Subtypes and Therapy Response in Patients Treated for Posttraumatic Stress Disorder.,"Interpersonal traits may influence psychotherapy success. One way of conceptualizing such traits is the interpersonal circumplex model. In this study, we analyse interpersonal circumplex data, assessed with the Inventory of Interpersonal Problems (Horowitz, Strauß, & Kordy, 1994) from a randomized study with 138 patients suffering from posttraumatic stress disorder after trauma in adulthood. The study compared cognitive processing therapy and dialogical exposure therapy, a Gestalt-based intervention. We divided the interpersonally heterogeneous sample according to the quadrants of the interpersonal circumplex. The division into quadrants yielded subgroups that did not differ in their general psychological distress, but the cold-submissive quadrant tended to exhibit higher posttraumatic stress disorder symptom severity and interpersonal distress than the other three. There was also a trend for patients in different quadrants to be affected differently by the treatments. Correlation analyses supported these results: in cognitive processing therapy, more dominant patients had more successful therapies, while in dialogical exposure therapy, success was not correlated with interpersonal style. Results indicate that especially patients with cold interpersonal styles profited differentially from the two treatments offered. Dividing samples according to the interpersonal circumplex quadrants seems promising. Interpersonal traits may contribute to psychotherapy outcome. Dividing the sample according to the quadrants of the interpersonal circumplex, as opposed to cluster analysis, yielded promising results. Patients higher in dominance fared better with cognitive processing therapy, while interpersonal style had no correlations with therapy success in dialogical exposure therapy.",König J.; Onnen M.; Karl R.; Rosner R.; Butollo W.,,10.1002/cpp.1946,0,0,7086
9580,The role of gender in moderating treatment outcome in collaborative care for anxiety.,"The aim of this study was to test whether gender moderates intervention effects in the Coordinated Anxiety Learning and Management (CALM) intervention, a 12-month, randomized controlled trial of a collaborative care intervention for anxiety disorders (panic disorder, generalized anxiety disorder, posttraumatic stress disorder, and social anxiety disorder) in 17 primary care clinics in California, Washington, and Arkansas. Participants (N=1,004) completed measures of symptoms (Brief Symptom Inventory [BSI]) and functioning (mental and physical health components of the 12-Item Short Form [MCS and PCS] and Healthy Days, Restricted Activity Days Scale) at baseline, six, 12, and 18 months. Data on dose, engagement, and beliefs about psychotherapy were collected for patients in the collaborative care group. Gender moderated the relationship between treatment and its outcome on the BSI, MCS, and Healthy Days measures but not on the PCS. Women who received collaborative care showed clinical improvements on the BSI, MHC, and Healthy Days that were significantly different from outcomes for women in usual care. There were no differences for men in collaborative care compared with usual care on any measures. In the intervention group, women compared with men attended more sessions of psychotherapy, completed more modules of therapy, expressed more commitment, and viewed psychotherapy as more helpful. These findings contribute to the broader literature on treatment heterogeneity, in particular the influence of gender, and may inform personalized care for people seeking anxiety treatment in primary care settings.",Grubbs KM.; Cheney AM.; Fortney JC.; Edlund C.; Han X.; Dubbert P.; Sherbourne CD.; Craske MG.; Stein MB.; Roy-Byrne PP.; Sullivan JG.,2015.0,10.1176/appi.ps.201400049,0,0,
9581,"Preoperative education on postoperative delirium, anxiety, and knowledge in pulmonary thromboendarterectomy patients.","Delirium is the most common postoperative psychiatric condition in intensive care settings and can lead to increased complications and costs. To evaluate the impact of multifaceted preoperative patient education on postoperative delirium, anxiety, and knowledge and to explore predictors of postoperative delirium, days of mechanical ventilation, and days in the intensive care unit (ICU) in patients undergoing pulmonary thromboendarterectomy. A prospective, randomized controlled trial was conducted on consented patients from October 2011 to April 2013. Patients were randomized in a 1 to 1 ratio to receive either an individualized 45-minute multifaceted preoperative education (experimental group, n = 63) or standard education (control group, n = 66). Participants completed the State-Trait Anxiety Inventory and Knowledge Test before and after the education. Data on incidence of delirium, days of mechanical ventilation, ICU days, and cardiopulmonary parameters were collected. The experimental group had significantly more knowledge about postoperative care (P< .001) and fewer days of mechanical ventilation (P = .04) than the control group. The 2 groups did not differ significantly in anxiety, incidence of delirium, or ICU days. In exploratory multivariate analyses, hearing impairment was a positive predictor for days of delirium (P = .009), days of mechanical ventilation (P< .001), and ICU days (P= .049), whereas the posttest knowledge was a negative predictor for days of mechanical ventilation (P = .02). The patient education appeared to be effective in improving knowledge and reducing days of mechanical ventilation. Hearing impairment was an unexpected predictor of adverse outcomes for patients but may be amenable to nursing intervention.",Chevillon C.; Hellyar M.; Madani C.; Kerr K.; Kim SC.,2015.0,10.4037/ajcc2015658,0,0,
9582,A discordant monozygotic-twin approach to potential risk factors for chronic widespread pain in females.,"Chronic widespread pain (CWP) is a common disorder affecting up to 15% of the general population. The objective of the present study was to explore the role of previously reported psychosocial and interpersonal risk factors on variation in CWP by investigating CWP discordant monozygotic (MZ) twins. This approach allows separation of cause and effect relationships, albeit imperfectly, as well the control for critical confounding variables such as common environment or genetics. In a total sample of N = 3,266 female twins aged 18-89 years, MZ (113 full pairs) and DZ twins (180 full pairs) discordant for CWP were selected. Items from the London fibromyalgia symptom screening questionnaire were used to discriminate cases from controls. To assess potential risk factors, including body mass index, anxiety sensitivity (AS), emotional intelligence, personality, obsessive-compulsive behavior, and coping, validated questionnaires were used. A set of univariate and multivariate logistic regression analyses were conducted. Of the variables showing significant links with CWP in the univariate individual-level analyses, including age, AS, and emotional intelligence, only emotional intelligence turned out to an independent predictor to the pathogenesis of CWP in both the individual level and discordant MZ analyses. These data indicate that in women having identical genetic risk, emotional intelligence seems to play a key role, although of small effect, in the development and/or maintenance of CWP. It further seems that many of the previously reported risk factors for CWP suffer from genetic confounding.",Burri A.; Lachance G.; Williams F.,2015.0,10.1017/thg.2015.7,0,0,
9583,Arterial puncture using insulin needle is less painful than with standard needle: a randomized crossover study.,"Arterial punctures are important procedures performed by emergency physicians in the assessment of ill patients. However, arterial punctures are painful and can create anxiety and needle phobia in patients. The pain score of radial arterial punctures were compared between the insulin needle and the standard 23-gauge hypodermic needle. In a randomized controlled crossover design, healthy volunteers were recruited to undergo bilateral radial arterial punctures. They were assigned to receive either the insulin or the standard needle as the first puncture, using blocked randomization. The primary outcome was the pain score measured on a 100-mm visual analogue scale (VAS) for pain, and secondary outcomes were rate of hemolysis, mean potassium values, and procedural complications immediately and 24 hours postprocedure. Fifty healthy volunteers were included in the study. The mean (±standard deviation) VAS score in punctures with the insulin needle was lower than the standard needle (23 ± 22 mm vs. 39 ± 24 mm; mean difference = -15 mm; 95% confidence interval = -22 mm to -7 mm; p < 0.001). The rates of hemolysis and mean potassium value were greater in samples obtained using the insulin needle compared to the standard needle (31.3% vs. 11.6%, p = 0.035; and 4.6 ±0.7 mmol/L vs. 4.2 ±0.5 mmol/L, p = 0.002). Procedural complications were lower in punctures with the insulin needle both immediately postprocedure (0% vs. 24%; p < 0.001) and at 24 hours postprocedure (5.4% vs. 34.2%; p = 0.007). Arterial punctures using insulin needles cause less pain and fewer procedural complications compared to standard needles. However, due to the higher rate of hemolysis, its use should be limited to conditions that do not require a concurrent potassium value in the same blood sample.",Ibrahim I.; Yau YW.; Ong L.; Chan YH.; Kuan WS.,2015.0,10.1111/acem.12601,0,0,
9584,Tailoring mind-body therapies to individual needs: patients' program preference and psychological traits as moderators of the effects of mindfulness-based cancer recovery and supportive-expressive therapy in distressed breast cancer survivors.,"Mindfulness-based cancer recovery (MBCR) and supportive-expressive therapy (SET) are well-validated psycho-oncological interventions, and we have previously reported health benefits of both programs. However, little is known about patients' characteristics or program preferences that may influence outcomes. Therefore, this study examined moderators of the effects of MBCR and SET on psychological well-being among breast cancer survivors. A multi-site randomized controlled trial was conducted between 2007 and 2012 in two Canadian cities (Calgary and Vancouver). A total of 271 distressed stage I-III breast cancer survivors were randomized into MBCR, SET or a 1-day stress management seminar (SMS). Baseline measures of moderator variables included program preference, personality traits, emotional suppression, and repressive coping. Outcome measures of mood, stress symptoms, quality of life, spiritual well-being, post-traumatic growth, social support, and salivary cortisol were measured pre- and post intervention. Hierarchical regression analyses were used to assess moderator effects on outcomes. The most preferred program was MBCR (55%). Those who were randomized to their preference improved more over time on quality of life and spiritual well-being post-intervention regardless of the actual intervention type received. Women with greater psychological morbidity at baseline showed greater improvement in stress symptoms and quality of life if they received their preferred versus nonpreferred program. Patients' program preference and baseline psychological functioning, rather than personality, were predictive of program benefits. These results suggest incorporating program preference can maximize the efficacy of integrative oncology interventions, and emphasize the methodological importance of assessing and accommodating for preferences when conducting mind-body clinical trials.",Carlson LE.; Tamagawa R.; Stephen J.; Doll R.; Faris P.; Dirkse D.; Speca M.,2014.0,10.1093/jncimonographs/lgu034,0,0,
9585,"Self-help relaxation for post-stroke anxiety: a randomised, controlled pilot study.","To consider relaxation as a potential treatment for anxiety in stroke survivors living in the community, including feasibility and acceptability. Randomised two group design (intervention and control). All participants (n = 21) were stroke survivors living in the community who reported experiencing anxiety (Hospital Anxiety and Depression Scale - Anxiety Subscale ‚©æ 6). The intervention group were asked to listen to a self-help autogenic relaxation CD, five times a week, for at least one month. Participants completed the Hospital Anxiety and Depression Scale at screening and then monthly for three months. At each assessment following screening, participants who received the relaxation training were significantly more likely to report reduced anxiety compared to those who had not received the training (Month 1 P = 0.002; Month 2 P < 0.001; Month 3 P = 0.001). After one month, seven of the intervention group (n = 10) had completed the relaxation training as directed and planned to continue using it. The intervention appeared practical to deliver and relatively inexpensive, with minimal adverse effects. Preliminary evidence suggests that autogenic relaxation training delivered in a self-help CD format is a feasible and acceptable intervention, and that anxiety is reduced in stroke survivors who received the intervention. Future studies should seek to recruit a larger and more heterogeneous sample of 70 participants.",Golding K.; Kneebone I.; Fife-Schaw C.,2016.0,10.1177/0269215515575746,0,0,
9586,Does positivity mediate the relation of extraversion and neuroticism with subjective happiness?,"Recent theories suggest an important role of neuroticism, extraversion, attitudes, and global positive orientations as predictors of subjective happiness. We examined whether positivity mediates the hypothesized relations in a community sample of 504 adults between the ages of 20 and 60 years old (females = 50%). A model with significant paths from neuroticism to subjective happiness, from extraversion and neuroticism to positivity, and from positivity to subjective happiness fitted the data (Satorra-Bentler scaled chi-square (38) = 105.91; Comparative Fit Index = .96; Non-Normed Fit Index = .95; Root Mean Square Error of Approximation = .060; 90% confidence interval = .046, .073). The percentage of subjective happiness variance accounted for by personality traits was only about 48%, whereas adding positivity as a mediating factor increased the explained amount of subjective happiness to 78%. The mediation model was invariant by age and gender. The results show that the effect of extraversion on happiness was fully mediated by positivity, whereas the effect of neuroticism was only partially mediated. Implications for happiness studies are also discussed.",Lauriola M.; Iani L.,2015.0,10.1371/journal.pone.0121991,0,0,
9587,A Feasibility study on Combining Internet-Based Cognitive Behaviour Therapy with Physical Exercise as Treatment for Panic Disorder--Treatment Protocol and Preliminary Results.,"Internet-based cognitive behaviour therapy (ICBT) is a recommended, cost-effective and efficacious treatment for panic disorder (PD). However, treatment effects in psychiatric settings indicate that a substantial proportion fail to achieve remission. Physical exercise improves symptoms in patients with PD, and acts through mechanisms that can augment the effect of ICBT. The feasibility of combining these two interventions has not previously been investigated, and this was the aim of this study. The intervention comprised guided ICBT combined with one weekly session of supervised and two weekly sessions of unsupervised physical exercise for a total of 12 weeks. Treatment rationale, procedures and protocols are presented together with preliminary results for four patients with PD who have currently finished treatment. Quantitative and qualitative results are reported on the feasibility of adhering to the treatments, treatment outcome as assessed by clinician rating and estimation of reliable and clinically significant change for outcome measures, and participants' satisfactions with the combined treatment. The preliminary results indicate that the combined treatment is feasible to complete, and that the combination is perceived by the participants as beneficial.",Hovland A.; Johansen H.; Sj√∏b√∏ T.; V√∏llestad J.; Nordhus IH.; Pallesen S.; Havik OE.; Martinsen EW.; Nordgreen T.,2015.0,10.1080/16506073.2015.1022596,0,0,
9588,Predictive validity of the Trauma Screening Questionnaire in detecting post-traumatic stress disorder in patients with psychotic disorders.,"Post-traumatic stress disorder (PTSD) is highly prevalent in patients with a psychotic disorder. Because a PTSD diagnosis is often missed in patients with psychosis in routine care, a valid screening instrument could be helpful. To determine the validity of the Trauma Screening Questionnaire (TSQ) as a screening tool for PTSD among individuals with psychotic disorders. Among 2608 patients with a psychotic disorder, the rate of trauma exposure was determined and the TSQ was administered to screen for PTSD. PTSD status was verified in 455 patients using the Clinician-Administered PTSD Scale (trial registration: ISRCTN 79584912). Trauma exposure was reported by 78.2% of the 2608 patients. PTSD prevalence was estimated at 16% (95% CI 14.6-17.4%) compared with 0.5% reported in the patients' clinical charts. A TSQ cut-off score of six predicted PTSD with 78.8% sensitivity, 75.6% specificity, 44.5% correct positives and 93.6% correct negatives. The TSQ seems to be a valid screening tool for PTSD in patients with a psychotic disorder.",de Bont PA.; van den Berg DP.; van der Vleugel BM.; de Roos C.; de Jongh A.; van der Gaag M.; van Minnen A.,2015.0,10.1192/bjp.bp.114.148486,0,0,
9589,Affect labeling enhances exposure effectiveness for public speaking anxiety.,"Exposure is an effective treatment for anxiety but many patients do not respond fully. Affect labeling (labeling emotional experience) attenuates emotional responding. The current project examined whether affect labeling enhances exposure effectiveness in participants with public speaking anxiety. Participants were randomized to exposure with or without affect labeling. Physiological arousal and self-reported fear were assessed before and after exposure and compared between groups. Consistent with hypotheses, participants assigned to Affect Labeling, especially those who used more labels during exposure, showed greater reduction in physiological activation than Control participants. No effect was found for self-report measures. Also, greater emotion regulation deficits at baseline predicted more benefit in physiological arousal from exposure combined with affect labeling than exposure alone. The current research provides evidence that behavioral strategies that target prefrontal-amygdala circuitry can improve treatment effectiveness for anxiety and these effects are particularly pronounced for patients with the greatest deficits in emotion regulation.",Niles AN.; Craske MG.; Lieberman MD.; Hur C.,2015.0,10.1016/j.brat.2015.03.004,0,0,
9590,A randomised controlled trial of group cognitive behavioural therapy for perfectionism.,"Perfectionism is associated with symptoms of anxiety disorders, eating disorders and mood disorders. Treatments targeting perfectionism may reduce the symptoms of these disorders (Egan, Wade, & Shafran, 2011). This study is the first randomised controlled trial to investigate the efficacy of group cognitive behavioural therapy (CBT) for perfectionism. Forty-two participants with elevated perfectionism and a range of anxiety, eating and mood disorders were randomised to group CBT for perfectionism or a waitlist control. The treatment group reported significantly greater pre-post reductions in perfectionism, symptoms of depression, eating disorders, social anxiety, anxiety sensitivity and rumination, as well as significantly greater pre-post increases in self-esteem and quality of life compared to the waitlist control group. The impact of treatment on most of these outcomes was mediated by pre-post change in perfectionism (Concern over Mistakes). Treatment gains were reliable and clinically significant, and were maintained at 6-month follow-up. Findings support group CBT for perfectionism being an efficacious treatment for perfectionism and related psychopathology, as well as increasing self-esteem and quality of life.",Handley AK.; Egan SJ.; Kane RT.; Rees CS.,2015.0,10.1016/j.brat.2015.02.006,0,0,
9591,Changes in negative cognitions mediate PTSD symptom reductions during client-centered therapy and prolonged exposure for adolescents.,"To assess whether changes in negative trauma-related cognitions play an important role in reducing symptoms of posttraumatic stress disorder (PTSD) and depression during prolonged exposure therapy for adolescents (PE-A). Secondary analysis of data from a randomized controlled trial comparing PE-A with client-centered therapy (CCT) for PTSD. Participants were 61 adolescent female sexual assault survivors ages 13-18 who received 8-14 weekly sessions of PE-A or CCT at a community rape crisis center. PTSD severity was assessed at baseline, mid-treatment, post-treatment, and 3-months post-treatment. Participants also completed self-report measures of negative posttraumatic cognitions and depressive symptoms at the same assessment points. Cross lag panel mediation analyses showed that change in negative trauma-related cognitions mediated change in PTSD symptoms and depressive symptoms whereas change in PTSD and depressive symptoms did not mediate change in negative cognitions. Our findings support EPT and suggest that change in negative trauma-related cognitions is a mechanism of both PE-A and CCT.",McLean CP.; Yeh R.; Rosenfield D.; Foa EB.,2015.0,10.1016/j.brat.2015.03.008,0,0,
9592,Psychological advocacy toward healing (PATH): study protocol for a randomized controlled trial.,"Domestic violence and abuse (DVA), defined as threatening behavior or abuse by adults who are intimate partners or family members, is a key public health and clinical priority. The prevalence of DVA in the United Kingdom and worldwide is high, and its impact on physical and mental health is detrimental and persistent. There is currently little support within healthcare settings for women experiencing DVA. Psychological problems in particular may be difficult to manage outside specialist services, as conventional forms of therapy such as counseling that do not address the violence may be ineffective or even harmful. The aim of this study is to assess the overall effectiveness and cost-effectiveness of a novel psychological intervention tailored specifically for survivors of DVA and delivered by domestic violence advocates based in third-sector organizations. This study is an open, pragmatic, parallel group, individually randomized controlled trial. Women ages 16 years and older experiencing domestic violence are being enrolled and randomly allocated to receive usual DVA agency advocacy support (control) or usual DVA agency support plus psychological intervention (intervention). Those in the intervention group will receive eight specialist psychological advocacy (SPA) sessions weekly or fortnightly, with two follow-up sessions, 1 month and then 3 months later. This will be in addition to any advocacy support sessions each woman receives. Women in the control group will receive usual DVA agency support but no additional SPA sessions. The aim is to recruit 250 women to reach the target sample size. The primary outcomes are psychological well-being and depression severity at 1 yr from baseline, as measured by the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) and the Patient Health Questionnaire (PHQ-9), respectively. Secondary outcome measures include anxiety, posttraumatic stress, severity and frequency of abuse, quality of life and cost-effectiveness of the intervention. Data from a subsample of women in both groups will contribute to a nested qualitative study with repeat interviews during the year of follow-up. This study will contribute to the evidence base for management of the psychological needs of women experiencing DVA. The findings will have important implications for healthcare commissioners and providers, as well as third sector specialist DVA agencies providing services to this client group. ISRCTN58561170.",Brierley G.; Agnew-Davies R.; Bailey J.; Evans M.; Fackrell M.; Ferrari G.; Hollinghurst S.; Howard L.; Howarth E.; Malpass A.; Metters C.; Peters TJ.; Saeed F.; Sardhina L.; Sharp D.; Feder GS.,2013.0,10.1186/1745-6215-14-221,0,0,
9593,Maximizing the efficacy of interoceptive exposure by optimizing inhibitory learning: a randomized controlled trial.,"Cognitive-behavioral treatments for panic disorder (PD) emphasize interoceptive exposure (IE) to target anxiety sensitivity (AS) but vary considerably in its manner of delivery. This randomized controlled trial was conducted to compare the efficacy of the low-dose delivery of IE exercises often prescribed in treatment protocols to an intensive form of IE hypothesized to optimize inhibitory learning. Participants (N = 120) with elevated AS were randomly assigned to one of four single-session interventions: (a) low-dose IE as prescribed in Barlow and Craske's Panic Control Treatment, (b) low-dose IE without controlled breathing or a lengthy between-trial rest period, (c) intensive IE, or (d) expressive writing control. Compared to the other conditions, intensive IE produced significantly greater reductions in AS and fearful responding to a straw breathing task from pretreatment to posttreatment. Maintenance of gains during the follow-up period did not differ between conditions. Changes in fear toleration and negative outcome expectancies fully mediated the superior efficacy of intensive IE over low-dose IE. The two low intensity IE conditions produced particularly high rates of fear sensitization on between-trial and outcome variables. The findings suggest that the intensive delivery of IE exercises has the potential to improve the efficacy of exposure-based treatments for PD.",Deacon B.; Kemp JJ.; Dixon LJ.; Sy JT.; Farrell NR.; Zhang AR.,2013.0,10.1016/j.brat.2013.06.006,0,0,
9594,Evaluation of a brief cognitive behavioral group therapy for psychological distress among female Icelandic University students.,"A study of a brief cognitive behavioral group therapy intervention for psychologically distressed Icelandic female university students was conducted using a pre-post test quasi-experimental design with intervention and control group conditions. Students were randomly allocated to control and intervention group conditions (n = 30). The intervention group received four sessions of cognitive behavioral group therapy, delivered by two advanced practice psychiatric nurses. Assessment of distress included self-reported depression and anxiety symptoms. Students in the intervention group experienced significantly lower levels of depression and anxiety symptoms compared to the control group post-test providing preliminary evidence concerning intervention effectiveness for Icelandic students.",Bernhardsdottir J.; Vilhjalmsson R.; Champion JD.,2013.0,10.3109/01612840.2013.773473,0,0,
9595,Examination of unmet treatment needs among persons with episodic migraine: results of the American Migraine Prevalence and Prevention (AMPP) Study.,"Despite the expanding therapeutic armamentarium, many people with episodic migraine (EM) have unmet acute treatment needs. To determine the relative frequency of prespecified types of ""unmet treatment needs"" in persons with EM in a US population-based sample. Eligible participants completed the 2009 American Migraine Prevalence and Prevention Study survey and met International Classification of Headache Disorders-2nd edition (ICHD-2) criteria for migraine with an average headache day frequency of <15 days per month (EM). We identified 5 domains of unmet treatment needs: (1) dissatisfaction with current acute treatment using 3 summary items from the Patient Perception of Migraine Questionnaire-revised edition (PPMQ-R); (2) moderate or severe headache-related disability defined by a Migraine Disability Assessment Scale score of ‚â•11; (3) excessive use of opioids or barbiturates defined as use on ‚â•4‚Äâdays/month or by meeting Diagnostic and Statistical Manual for Mental Disorders-4th edition criteria for dependence; (4) recurrent use of the emergency department or urgent care clinic for headache defined by ‚â•2 visits in the preceding year for headache; and (5) history of cardiovascular events indicating a possible contraindication to triptan use. For each respondent, we identified their unmet treatment needs in each category and classified them as having no unmet needs or 1 or more unmet needs. Of 5591 respondents with EM, 2274 (40.7%) had 1 or more unmet needs; 1467 (26.2%) had exactly 1 unmet need, and 807 (14.4%) had 2 or more unmet needs. Among those with at least 1 unmet need, 1069 (47.0%) had moderate or severe headache-related disability, 851 (37.4%) were dissatisfied with their acute treatment regimen, 728 (32.0%) had excessive opioid or barbiturate use and/or probable dependence, 595 (26.2%) had a history of cardiovascular events, and 129 (5.7%) reported ‚â•2 visits in the preceding year to the emergency department/urgent care clinic for headache. Persons with more headache days, depression, or generalized anxiety were more likely to have unmet treatment needs. In a population sample of individuals with EM, more than 40% have at least 1 unmet need in the area of acute treatment. The leading reasons for unmet needs, which include headache-related disability and dissatisfaction with current acute treatment, suggest opportunities for improving outcomes for persons with EM.",Lipton RB.; Buse DC.; Serrano D.; Holland S.; Reed ML.,2013.0,10.1111/head.12154,0,0,
9596,A cognitive-behavioral intervention for emotion regulation in adults with high-functioning autism spectrum disorders: study protocol for a randomized controlled trial.,"Adults with high-functioning autism spectrum disorders (ASD) have difficulties in social communication; thus, these individuals have trouble understanding the mental states of others. Recent research also suggests that adults with ASD are unable to understand their own mental states, which could lead to difficulties in emotion-regulation. Some studies have reported the efficacy of cognitive-behavioral therapy (CBT) in improving emotion-regulation among children with ASD. The current study will investigate the efficacy of group-based CBT for adults with ASD. The study is a randomized, waitlist controlled, single-blinded trial. The participants will be 60 adults with ASD; 30 will be assigned to a CBT group and 30 to a waitlist control group. Primary outcome measures are the 20-item Toronto Alexithymia Scale, the Coping Inventory for Stressful Situations, the Motion Picture Mind-Reading task, and an ASD questionnaire. The secondary outcome measures are the Center for Epidemiological Studies Depression Scale, the World Health Organization Quality of Life Scale 26-item version, the Global Assessment of Functioning, State-trait Anxiety Inventory, Social Phobia and Anxiety Inventory, and Liebowitz Social Anxiety Scale. All will be administered during the pre- and post-intervention, and 12 week follow-up periods. The CBT group will receive group therapy over an 8 week period (one session per week) with each session lasting approximately 100 minutes. Group therapy will consist of four or five adults with ASD and two psychologists. We will be using visual materials for this program, mainly the Cognitive Affective Training kit. This trial will hopefully indicate the efficacy of group-based CBT for adults with high- functioning ASD. This trial was registered in The University Hospital Medical Information Network Clinical Trials Registry No. UMIN000006236.",Kuroda M.; Kawakubo Y.; Kuwabara H.; Yokoyama K.; Kano Y.; Kamio Y.,2013.0,10.1186/1745-6215-14-231,0,0,
9597,Effects of medical comorbidity on anxiety treatment outcomes in primary care.,"To evaluate the effects of medical comorbidity on anxiety treatment outcomes. Data were analyzed from 1004 primary care patients enrolled in a trial of a collaborative care intervention for anxiety. Linear-mixed models accounting for baseline characteristics were used to evaluate the effects of overall medical comorbidity (two or more chronic medical conditions [CMCs] versus fewer than two CMCs) and specific CMCs (migraine, asthma, and gastrointestinal disease) on anxiety treatment outcomes at 6, 12, and 18 months. At baseline, patients with two or more CMCs (n = 582; 58.0%) reported more severe anxiety symptoms (10.5 [95% confidence interval {CI} = 10.1-10.9] versus 9.5 [95% CI = 9.0-10.0], p = .003) and anxiety-related disability (17.6 [95% CI = 17.0-18.2] versus 16.0 [95% CI = 15.3-16.7], p = .001). However, their clinical improvement was comparable to that of patients with one or zero CMCs (predicted change in anxiety symptoms = -3.9 versus -4.1 at 6 months, -4.6 versus -4.4 at 12 months, -4.9 versus -5.0 at 18 months; predicted change in anxiety-related disability = -6.4 versus -6.9 at 6 months, -6.9 versus -7.3 at 12 months, -7.3 versus -7.5 at 18 months). The only specific CMC with a detrimental effect was migraine, which was associated with less improvement in anxiety symptoms at 18 months (predicted change = -4.1 versus -5.3). Effectiveness of the anxiety intervention was not significantly affected by the presence of multiple CMCs; however, patients with migraine displayed less improvement at long-term follow-up. Trial Registration ClinicalTrials.com Identifier: NCT00347269.",Campbell-Sills L.; Stein MB.; Sherbourne CD.; Craske MG.; Sullivan G.; Golinelli D.; Lang AJ.; Chavira DA.; Bystritsky A.; Rose RD.; Welch SS.; Kallenberg GA.; Roy-Byrne P.,2013.0,10.1097/PSY.0b013e31829def54,0,0,
9598,Loving-kindness meditation for posttraumatic stress disorder: a pilot study.,"Loving-kindness meditation is a practice designed to enhance feelings of kindness and compassion for self and others. Loving-kindness meditation involves repetition of phrases of positive intention for self and others. We undertook an open pilot trial of loving-kindness meditation for veterans with posttraumatic stress disorder (PTSD). Measures of PTSD, depression, self-compassion, and mindfulness were obtained at baseline, after a 12-week loving-kindness meditation course, and 3 months later. Effect sizes were calculated from baseline to each follow-up point, and self-compassion was assessed as a mediator. Attendance was high; 74% attended 9-12 classes. Self-compassion increased with large effect sizes and mindfulness increased with medium to large effect sizes. A large effect size was found for PTSD symptoms at 3-month follow-up (d = -0.89), and a medium effect size was found for depression at 3-month follow-up (d = -0.49). There was evidence of mediation of reductions in PTSD symptoms and depression by enhanced self-compassion. Overall, loving-kindness meditation appeared safe and acceptable and was associated with reduced symptoms of PTSD and depression. Additional study of loving-kindness meditation for PTSD is warranted to determine whether the changes seen are due to the loving-kindness meditation intervention versus other influences, including concurrent receipt of other treatments.",Kearney DJ.; Malte CA.; McManus C.; Martinez ME.; Felleman B.; Simpson TL.,2013.0,10.1002/jts.21832,0,0,
9599,"An investigator-blinded, randomized study to compare the efficacy of combined CBT for alcohol use disorders and social anxiety disorder versus CBT focused on alcohol alone in adults with comorbid disorders: the Combined Alcohol Social Phobia (CASP) trial ","Alcohol use disorders and social anxiety disorder are common and disabling conditions that frequently co-exist. Although there are efficacious treatments for each disorder, only two randomized controlled trials of interventions for these combined problems have been published. We developed a new integrated treatment for comorbid Social Anxiety Disorder and Alcohol Use Disorder based on established Motivational Interviewing (MI) and Cognitive Behaviour Therapy (CBT) interventions for the separate disorders. Compared to established MI/CBT for alcohol use disorders this new intervention is hypothesised to lead to greater reductions in symptoms of social anxiety and alcohol use disorder and to produce greater improvements in quality of life. Higher levels of alcohol dependence will result in relatively poorer outcomes for the new integrated treatment. A randomised controlled trial comparing 9 sessions of individual integrated treatment for alcohol and social phobia with 9 sessions of treatment for alcohol use problems alone is proposed. Randomisation will be stratified for stable antidepressant use. Post treatment clinical assessments of alcohol consumption and diagnostic status at 3 and 6 month follow-up will be blind to allocation. The proposed trial addresses a serious gap in treatment evidence and could potentially define the appropriate treatment for a large proportion of adults affected by these problems. Australian New Zealand Clinical Trials Registry: ACTRN12608000228381.",Baillie AJ.; Sannibale C.; Stapinski LA.; Teesson M.; Rapee RM.; Haber PS.,2013.0,10.1186/1471-244X-13-199,0,0,
9600,Combining attention training with internet-based cognitive-behavioural self-help for social anxiety: a randomised controlled trial.,"Guided Internet-based cognitive-behavioural self-help (ICBT) has been proven to be effective for social anxiety disorder (SAD) by several independent research groups. However, as the proportion of clinical significant change has room for improvement, new treatments should be developed and investigated. A novel treatment is attention bias modification (ABM). This study aimed at evaluating the combination of ABM and ICBT. We compared two groups, one group receiving ICBT and ABM targeting attentional avoidance and the other group receiving ICBT and control training. ABM and control training tasks were both based on the dot-probe paradigm. A total of 133 participants, diagnosed with SAD, were randomised to these two groups. The attention training group (N = 66) received 2 weeks of daily attention training followed by 9 weeks of ICBT. The control group (N = 67) received 2 weeks of daily control training, also followed by 9 weeks of ICBT. Social anxiety measures as well as the attention bias were assessed at pre-assessment, at week 2, and at post-treatment. Results showed no significant differences between the attention training group and the control group. Both groups improved substantially on social anxiety symptoms from pre- to post-assessment (dwithin = 1.39-1.41), but showed no change in attention processes (dwithin = 0.10-0.17). In this trial, the attention modification training failed to induce differential change in attention bias. Results demonstrate that the applied ABM procedure with its focus on the reduction of attentional avoidance was ineffective in the Internet-based setting. The results do not suggest that adding ABM targeting attentional avoidance to ICBT results in better outcomes than ICBT alone.",Boettcher J.; Hasselrot J.; Sund E.; Andersson G.; Carlbring P.,2014.0,10.1080/16506073.2013.809141,0,0,
9601,Temporal patterns of change in panic disorder during cognitive behaviour therapy: an Indian study.,"CBT has been proven to be effective in the treatment of panic disorder; however, attempts to study the process of change are limited. The study evaluated the temporal patterns of change in the panic symptoms, cognitions, behaviours, and anxiety sensitivity in subjects with panic disorder being treated with CBT. Thirty subjects with panic disorder were allocated to two groups: Cognitive Behaviour Therapy (CBT, n = 15) and Behaviour Therapy (BT, n = 15). Assessments were carried out weekly for five consecutive weeks using the Semi-Structured Interview Schedule, the Anxiety Sensitivity Index, the Agoraphobic Cognitions Questionnaire, and the Texas Panic Attack Record Form. The CBT group received comprehensive CBT and the BT group received psycho-education and Applied Relaxation. Following intervention the change was continuous and gradual on all the variables in the CBT group and the scores reduced to a functional range after 4-5 weeks of therapy. Such a change was not evident in the BT group. Significant change was evident in cognitive domains following the introduction of the exposure and cognitive restructuring within the CBT group. Both cognitive and behavioural techniques contributed to the overall change. CBT had an impact on the cognitive domains and significant changes were evident corresponding to the addition of cognitive restructuring and exposure techniques in the 3rd to 5th week. Both cognitive and behavioural components are therefore crucial for overall improvement to occur.",Manjula M.; Prasadarao PS.; Kumaraiah V.; Raguram R.,2014.0,10.1017/S1352465813000635,0,0,
9602,"Accuracy of MMPI-2-RF validity scales for identifying feigned PTSD symptoms, random responding, and genuine PTSD.","The Minnesota Multiphasic Personality Inventory-2-RF (MMPI-2-RF) validity scales were evaluated to determine accuracy when differentiating honest responding, random responding, genuine posttraumatic stress disorder (PTSD), and feigned PTSD. Undergraduate students (n = 109), screened for PTSD, were randomly assigned to 1 of 4 instructional groups: honest, feign PTSD, half random, and full random. Archival data provided clinical MMPI-2-RF profiles consisting of 31 veterans diagnosed with PTSD. Veterans were diagnosed with PTSD using a structured interview and had passed a structured interview for malingering. Validity scales working as a group had correct classification rates of honest (96.6%), full random (88.9%), genuine PTSD (80.7%), fake PTSD (73.1%), and half random (44.4%). Results were fairly supportive of the scales' ability to discriminate feigning and full random responding from honest responding of normal students as well as veterans with PTSD. However, the RF validity scales do not appear to be as effective in detecting partially random responding.",Mason LH.; Shandera-Ochsner AL.; Williamson KD.; Harp JP.; Edmundson M.; Berry DT.; High WM.,2013.0,10.1080/00223891.2013.819512,0,0,
9603,Attentional bias in older adults: effects of generalized anxiety disorder and cognitive behavior therapy.,"Attentional biases are known to play a contributing, and perhaps even causal role in the etiology of anxiety and other negative affective states. The prevalence of anxiety disorders in the older cohort is growing, and there are both theoretical and empirical reasons to suspect that age-related factors could moderate attentional bias effects in the context of late-life anxiety. The current study included one of the most widely-used measures of attentional bias, the dot-probe task (Mathews & MacLeod, 1985). Participants were older adults who were either nonanxious or diagnosed with generalized anxiety disorder. The patient subsample also completed cognitive behavior therapy (CBT) or an equivalent wait list condition, after which the dot probe was administered a second time. Results showed that clinical anxiety had no particular importance for the deployment of attention, casting doubt on the universality of biased attention in older anxiety patients. Although there were no maladaptive biases detected toward either threat or depression words at pretreatment, there was nevertheless a marginally significant differential reduction in bias toward threat words following CBT. This reduction did not occur among those in the wait list condition. Implications are discussed.",Mohlman J.; Price RB.; Vietri J.,2013.0,10.1016/j.janxdis.2013.06.005,0,0,
9604,Profile and predictors of global distress: can the DT guide nursing practice in prostate cancer?,"This study examines the ability of the distress thermometer to accurately identify patients with higher symptoms, unmet needs and psychological morbidity. Baseline data collected as part of a randomized controlled trial evaluating a nurse-led supportive care intervention for men with prostate cancer commencing radiotherapy at a specialist cancer hospital in Melbourne, Australia. Measures assessed global distress (DT), anxious and depressive symptomatology (HADS), prostate-cancer specific quality of life (EPIC-26), unmet supportive care needs (SCNS-SF34R) and cancer treatment-related concerns (CATS). Following descriptive and correlational analysis, hierarchical multiple regression was employed to examine the contribution of variable sets to explaining variance in DT scores. Less than 20% of men reported DT scores of 4 or higher, indicating overall low distress. The DT accurately identified almost all men reporting HADS score indicative of anxious or depressive symptomatology, suggesting it accurately identifies psychological morbidity. Importantly, the DT identified a further group of distressed men, not identified by HADS, whose distress related to unmet needs and prostate cancer-specific issues, indicating the DT is superior in identifying other forms of distress. While the hierarchical multiple regression confirmed anxious and depressive symptomatology as the best predictor of distress score, many other scales are also good predictors of DT scores, supporting the argument that distress is multi-determined. Nurses can be confident that the DT accurately identifies patients with psychological morbidity and importantly identifies other patients with distress who may require intervention. A distress score of 4 or higher identified participants with higher physical symptomatology, higher unmet needs, more concerns about treatment and poorer quality of life. The low prevalence of distress reaching cut off scores suggests nurses would not be overwhelmed by the outcomes of screening and could use the score to prioritise the patients who need greater attention at entry to radiotherapy services.",Lotfi-Jam K.; Gough K.; Schofield P.; Aranda S.,2014.0,10.1017/S1478951513000060,0,0,
9605,Efficacy of nursing interventions in reducing social and occupational disabilities among patients with neurosis.,"Individuals suffering from neurosis suffer from social and occupational disabilities similar to that of psychoses. Though understanding of disabilities in neurosis is essential in management of the clients, the relevant interventional studies are very limited. The present study attempted to evaluate the effect of nursing interventions in reducing social and occupational disabilities in neurotic patients. Sixty neurotic patients diagnosed as per ICD 9 criteria were randomly assigned to experimental and control groups followed by pre-assessment by Groningen social disability schedule. Of the 10 sessions of nursing intervention, 3 were individual sessions with clients, 5 with clients and family members and 2 with small group of clients with similar problems; nursing intervention group and non-nursing intervention group received the routine drug treatment at rural community mental health centre, NIMHANS, Bengaluru. The post-assessment was carried out first, second, and the third month followed by the nursing intervention. The findings revealed statistically significant reduction in social and occupational disabilities. A community-based psychosocial intervention led by community health nurses catering to the needs of neurotic patients is indicated by the results.",Nagarajaiah .; Jothimani G.; Parthasarathi R.; Reddemma K.; Giri AT.,,,0,0,
9606,Concurrent naltrexone and prolonged exposure therapy for patients with comorbid alcohol dependence and PTSD: a randomized clinical trial.,"Alcohol dependence comorbid with posttraumatic stress disorder (PTSD) has been found to be resistant to treatment. In addition, there is a concern that prolonged exposure therapy for PTSD may exacerbate alcohol use. To compare the efficacy of an evidence-based treatment for alcohol dependence (naltrexone) plus an evidence-based treatment for PTSD (prolonged exposure therapy), their combination, and supportive counseling. A single-blind, randomized clinical trial of 165 participants with PTSD and alcohol dependence conducted at the University of Pennsylvania and the Philadelphia Veterans Administration. Participant enrollment began on February 8, 2001, and ended on June 25, 2009. Data collection was completed on August 12, 2010. Participants were randomly assigned to (1) prolonged exposure therapy plus naltrexone (100 mg/d), (2) prolonged exposure therapy plus pill placebo, (3) supportive counseling plus naltrexone (100 mg/d), or (4) supportive counseling plus pill placebo. Prolonged exposure therapy was composed of 12 weekly 90-minute sessions followed by 6 biweekly sessions. All participants received supportive counseling. The Timeline Follow-Back Interview and the PTSD Symptom Severity Interview were used to assess the percentage of days drinking alcohol and PTSD severity, respectively, and the Penn Alcohol Craving Scale was used to assess alcohol craving. Independent evaluations occurred prior to treatment (week 0), at posttreatment (week 24), and at 6 months after treatment discontinuation (week 52). Participants in all 4 treatment groups had large reductions in the percentage of days drinking (mean change, -63.9% [95% CI, -73.6% to -54.2%] for prolonged exposure therapy plus naltrexone; -63.9% [95% CI, -73.9% to -53.8%] for prolonged exposure therapy plus placebo; -69.9% [95% CI, -78.7% to -61.2%] for supportive counseling plus naltrexone; and -61.0% [95% CI, -68.9% to -53.0%] for supportive counseling plus placebo). However, those who received naltrexone had lower percentages of days drinking than those who received placebo (mean difference, 7.93%; P‚Äâ=‚Äâ.008). There was also a reduction in PTSD symptoms in all 4 groups, but the main effect of prolonged exposure therapy was not statistically significant. Six months after the end of treatment, participants in all 4 groups had increases in percentage of days drinking. However, those in the prolonged exposure therapy plus naltrexone group had the smallest increases. In this study of patients with alcohol dependence and PTSD, naltrexone treatment resulted in a decrease in the percentage of days drinking. Prolonged exposure therapy was not associated with an exacerbation of alcohol use disorder. clinicaltrials.gov Identifier: NCT00006489.",Foa EB.; Yusko DA.; McLean CP.; Suvak MK.; Bux DA.; Oslin D.; O'Brien CP.; Imms P.; Riggs DS.; Volpicelli J.,2013.0,10.1001/jama.2013.8268,0,0,
9607,"Operative versus nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial.","We conducted a prospective, randomized, controlled multicenter trial to compare operative with nonoperative treatment of displaced intra-articular calcaneal fractures. Eighty-two patients who presented to five trauma centers from 1994 to 1998 with an intra-articular calcaneal fracture with ‚â•2 mm of displacement (as verified by computed tomography) were randomized to operative or nonoperative treatment. Independent observers followed the two groups radiographically and clinically at one year and eight to twelve years. The primary outcome measures were a visual analog scale (VAS) for pain and function and the self-administrated Short Form (SF)-36 general health outcome questionnaire. The secondary outcome measures were residual pain evaluated with a VAS, the American Orthopaedic Foot & Ankle Society (AOFAS) scale, and the Olerud-Molander (OM) scale. Forty-two patients in the operative treatment group and forty in the nonoperative group were included. The two groups were comparable with respect to age, sex, and fracture types. Seventy-six patients were available for follow-up at one year and fifty-eight at eight to twelve years. The primary and secondary outcome measures did not differ significantly between the two treatment groups at one year of follow-up. At eight to twelve years of follow-up, there was a trend toward better scores on the patient-reported primary VAS score for pain and function (p = 0.07) and the physical component of the SF-36 (p = 0.06) in the operative group. The prevalence of radiographically evident posttraumatic subtalar arthritis was lower in the operative group (risk reduction, 41%). Operative treatment was not superior in managing displaced intra-articular calcaneal fractures at one year of follow-up but appeared to have some benefits at eight to twelve years. Operative treatment was associated with a higher risk of complications but a reduced prevalence of posttraumatic arthritis evident on follow-up radiographs. Therapeutic level II. See instructions for authors for a complete description of levels of evidence.",Agren PH.; Wretenberg P.; Sayed-Noor AS.,2013.0,10.2106/JBJS.L.00759,0,0,
9608,Telemedicine: a cost-reducing means of delivering psychotherapy to rural combat veterans with PTSD.,"Although effective psychotherapies for posttraumatic stress disorder (PTSD) exist, high percentages of Veterans in need of services are unable to access them. One particular challenge to providing cost-effective psychological treatments to Veterans with PTSD involves the difficulty and high cost of delivering in-person, specialized psychotherapy to Veterans residing in geographically remote locations. The delivery of these services via clinical videoteleconferencing (CVT) has been presented as a potential solution to this access to care problem. This study is a retrospective cost analysis of a randomized controlled trial investigating telemedicine service delivery of an anger management therapy for Veterans with PTSD. The parent trial found that the CVT condition provided clinical results that were comparable to the in-person condition. Several cost outcomes were calculated in order to investigate the clinical and cost outcomes associated with the CVT delivery modality relative to in-person delivery. The CVT condition was significantly associated with lower total costs compared with the in-person delivery condition. The delivery of mental health services via CVT enables Veterans who would not normally receive these services access to empirically based treatments. Additional studies addressing long-term healthcare system costs, indirect cost factors at the patient and societal levels, and the use of CVT in other geographic regions of the United States are needed. The results of this study provide evidence that CVT is a cost-reducing mode of service delivery to Veterans with PTSD relative to in-person delivery.",Morland LA.; Raab M.; Mackintosh MA.; Rosen CS.; Dismuke CE.; Greene CJ.; Frueh BC.,2013.0,10.1089/tmj.2012.0298,0,0,
9609,Attentional bias and emotional reactivity as predictors and moderators of behavioral treatment for social phobia.,"Cognitive behavioral therapy (CBT) is a well-established treatment for anxiety disorders, and evidence is accruing for the effectiveness of acceptance and commitment therapy (ACT). Little is known about factors that relate to treatment outcome overall (predictors), or who will thrive in each treatment (moderators). The goal of the current project was to test attentional bias and negative emotional reactivity as moderators and predictors of treatment outcome in a randomized controlled trial comparing CBT and ACT for social phobia. Forty-six patients received 12 sessions of CBT or ACT and were assessed for self-reported and clinician-rated symptoms at baseline, post treatment, 6, and 12 months. Attentional bias significantly moderated the relationship between treatment group and outcome with patients slow to disengage from threatening stimuli showing greater clinician-rated symptom reduction in CBT than in ACT. Negative emotional reactivity, but not positive emotional reactivity, was a significant overall predictor with patients high in negative emotional reactivity showing the greatest self-reported symptom reduction.",Niles AN.; Mesri B.; Burklund LJ.; Lieberman MD.; Craske MG.,2013.0,10.1016/j.brat.2013.06.005,0,0,
9610,Outcomes of Prolonged Exposure therapy for veterans with posttraumatic stress disorder.,"Prolonged Exposure (PE) is an evidenced-based psychotherapy for posttraumatic stress disorder (PTSD) that is being disseminated nationally within the U.S. Department of Veterans Affairs (VA) with promising initial results. Empirical evidence, however, regarding the effectiveness of PE for treatment of PTSD in military veterans is limited. Building on previous treatment outcome research, the current study investigated the effectiveness of PE in a diverse veteran sample. One-hundred fifteen veterans were enrolled in PE at an urban VA medical center and its surrounding outpatient clinics. PTSD and depression symptoms as well as quality of life were measured before and after treatment. Several baseline patient characteristics were examined as predictors of treatment response. Eighty-four participants completed treatment. Participants experienced a 42% reduction in PTSD symptoms, a 31% reduction in depression symptoms, and an increase in quality of life following PE. Veterans not prescribed psychotropic medication reported greater PTSD symptom reduction than veterans prescribed such medication. The implications of these results for treatment programs targeting PTSD in veterans are discussed.",Goodson JT.; Lefkowitz CM.; Helstrom AW.; Gawrysiak MJ.,2013.0,10.1002/jts.21830,0,0,
9611,Guided self-help for the management of worry in Parkinson's disease: a pilot study.,"Anxiety disorder and anxiety symptomatology are common in Parkinson's disease (PD), with up to 25% patients experiencing significant worry. There is no systematic evidence base for the management of anxiety or anxiety related symptoms such as worry in PD. To investigate whether cognitive therapy, delivered as bibliotherapy, is an effective intervention for worry in PD. 54 participants were randomly allocated to a guided reading group and a control group. The guided reading group were given a CBT based self-help resource called What? Me Worry!?! to work through over eight weeks, with telephone support at two week intervals. Controls were given information about worry only, and one phone call. Measures of worry, intolerance of uncertainty, metacognitions and health status were taken at baseline and after 3 months. Analysable data were obtained for 15 controls and 17 from the guided reading group. Worry and intolerance of uncertainty were significantly reduced in the guided reading group. However, no significant differences were found for the follow up measures between the groups. Bibliotherapy has the potential to be useful and cost effective as a management strategy for the treatment of worry in people with PD.",Lawson RA.; Millar D.; Brown RG.; Burn DJ.,2013.0,10.3233/JPD-120156,0,0,
9612,The weight of cognitions in panic: the link between misinterpretations and panic attacks.,"In cognitive theory it is hypothesized that panic attacks are provoked by catastrophic misinterpretations of bodily sensations. The aim of the present study was to investigate the ability of associated word pairs referring to catastrophic thinking (e.g. palpitations-heart attack) in producing panic attacks. Patients with PD (n‚Ää=‚Ää20), patients with mixed anxiety disorders (n‚Ää=‚Ää20), and a healthy control group (n‚Ää=‚Ää30) participated in the present study. To enhance ecological validity we first conducted a stimulus validation experiment. Subsequently, nine suitable panic and neutral word pairs were presented in block to the participants. Anxiety levels were assessed before and after the presentation. PD patients were more anxious when reading these word pairs, compared to neutral word pairs. However, none of the participants experienced a panic attack upon reading the word pairs. From the present results it seems that catastrophic thinking is rather related to the anticipatory anxiety for panic attacks, but not necessarily with the occurrence of the panic attacks themselves.",De Cort K.; Hermans D.; Noortman D.; Arends W.; Griez EJ.; Schruers KR.,2013.0,10.1371/journal.pone.0070315,0,0,
9613,Internet-based early intervention to prevent posttraumatic stress disorder in injury patients: randomized controlled trial.,"Posttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms. To determine whether Trauma TIPS is effective in preventing the onset of PTSD symptoms in injury patients. Adult, level 1 trauma center patients were randomly assigned to receive the fully automated Trauma TIPS Internet intervention (n=151) or to receive no early intervention (n=149). Trauma TIPS consisted of psychoeducation, in vivo exposure, and stress management techniques. Both groups were free to use care as usual (nonprotocolized talks with hospital staff). PTSD symptom severity was assessed at 1, 3, 6, and 12 months post injury with a clinical interview (Clinician-Administered PTSD Scale) by blinded trained interviewers and self-report instrument (Impact of Event Scale-Revised). Secondary outcomes were acute anxiety and arousal (assessed online), self-reported depressive and anxiety symptoms (Hospital Anxiety and Depression Scale), and mental health care utilization. Intervention usage was documented. The mean number of intervention logins was 1.7, SD 2.5, median 1, interquartile range (IQR) 1-2. Thirty-four patients in the intervention group did not log in (22.5%), 63 (41.7%) logged in once, and 54 (35.8%) logged in multiple times (mean 3.6, SD 3.5, median 3, IQR 2-4). On clinician-assessed and self-reported PTSD symptoms, both the intervention and control group showed a significant decrease over time (P<.001) without significant differences in trend. PTSD at 12 months was diagnosed in 4.7% of controls and 4.4% of intervention group patients. There were no group differences on anxiety or depressive symptoms over time. Post hoc analyses using latent growth mixture modeling showed a significant decrease in PTSD symptoms in a subgroup of patients with severe initial symptoms (n=20) (P<.001). Our results do not support the efficacy of the Trauma TIPS Internet-based early intervention in the prevention of PTSD symptoms for an unselected population of injury patients. Moreover, uptake was relatively low since one-fifth of individuals did not log in to the intervention. Future research should therefore focus on innovative strategies to increase intervention usage, for example, adding gameplay, embedding it in a blended care context, and targeting high-risk individuals who are more likely to benefit from the intervention. International Standard Randomized Controlled Trial Number (ISRCTN): 57754429; http://www.controlled-trials.com/ISRCTN57754429 (Archived by WebCite at http://webcitation.org/6FeJtJJyD).",Mouthaan J.; Sijbrandij M.; de Vries GJ.; Reitsma JB.; van de Schoot R.; Goslings JC.; Luitse JS.; Bakker FC.; Gersons BP.; Olff M.,2013.0,10.2196/jmir.2460,0,0,
9614,"Treatment response, symptom remission, and wellness in obsessive-compulsive disorder.","Obsessive-compulsive disorder (OCD) is defined both by intrusive, unwanted thoughts, images, or impulses and by repetitive behavioral or mental acts that are often performed to try to alleviate anxiety. The ultimate goal of treatment for OCD is to reduce the symptoms as well as help patients achieve ""wellness."" Currently, however, there are no widely accepted, empirically supported criteria for determining wellness in OCD. Building on previous research, the current study examined the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score that most reliably identified patients who responded to treatment, those who achieved symptom remission, and those who achieved wellness. The current study pooled data from 4 randomized controlled OCD treatment trials (N = 288), which took place between 1990 and 2011 at 2 academic sites. Participants (mean age = 36.8 years) had a primary diagnosis of DSM-IV-TR OCD (mean Y-BOCS score = 25.9). Signal detection analyses showed that a pretreatment-to-posttreatment reduction of ≥ 35% on the Y-BOCS was most predictive of treatment response as defined by the Clinical Global Impressions (CGI)-Improvement scale. A posttreatment Y-BOCS score of ≤ 14 was the best predictor of symptom remission, whereas a score of ≤ 12 was the best predictor of wellness, as defined by symptom remission (defined by the CGI-Severity scale), good quality of life (as measured by the Quality of Life Enjoyment and Satisfaction Questionnaire), and a high level of adaptive functioning (as assessed by the Social Adjustment Scale-Self-Report). Because efficiency (0.86) and specificity (0.88) were highest at the cutoff of ≤ 12, this cutoff score was determined to be the best indicator of wellness. The present findings support the convergent validity of the Y-BOCS with other measures of well-being (quality of life, adaptive functioning) and highlight the utility of a Y-BOCS score ≤ 12 as a solo indicator of wellness in outcome studies. The use of empirically supported criteria for defining wellness in OCD is recommended to facilitate comparisons across treatment outcome studies and to inform clinical treatment planning. Pooled data analyzed in this study were from 4 clinical trials, 3 of which are registered at ClinicalTrials.gov (identifiers: NCT00045903, NCT00389493, NCT00316316).",Farris SG.; McLean CP.; Van Meter PE.; Simpson HB.; Foa EB.,2013.0,10.4088/JCP.12m07789,0,0,
9615,Impact of cognitive behavioral therapy for social anxiety disorder on the neural dynamics of cognitive reappraisal of negative self-beliefs: randomized clinical trial.,"Cognitive behavioral therapy (CBT) for social anxiety disorder (SAD) is thought to enhance cognitive reappraisal in patients with SAD. Such improvements should be evident in cognitive reappraisal-related prefrontal cortex responses. To determine whether CBT for SAD modifies cognitive reappraisal-related prefrontal cortex neural signal magnitude and timing when implementing cognitive reappraisal with negative self-beliefs. DESIGN Randomized clinical trial of CBT for SAD vs wait-list control group during a study that enrolled patients from 2007 to 2010. University psychology department. Seventy-five patients with generalized SAD randomly assigned to CBT or wait list. Sixteen sessions of individual CBT for SAD. Negative emotion ratings and functional magnetic resonance imaging blood oxygen-level dependent signal when reacting to and cognitively reappraising negative self-beliefs embedded in autobiographical social anxiety situations. RESULTS During reactivity trials, compared with wait list, CBT produced (1) greater reduction in negative emotion ratings and (2) greater blood oxygen-level dependent signal magnitude in the medial prefrontal cortex. During cognitive reappraisal trials, compared with wait list, CBT produced (3) greater reduction in negative emotion ratings, (4) greater blood oxygen level-dependent signal magnitude in the dorsolateral and dorsomedial prefrontal cortex, (5) earlier temporal onset of dorsomedial prefrontal cortex activity, and (6) greater dorsomedial prefrontal cortex-amygdala inverse functional connectivity. Modulation of cognitive reappraisal-related brain responses, timing, and functional connectivity may be important brain changes that contribute to the effectiveness of CBT for social anxiety. This study demonstrates that clinically applied neuroscience investigations can elucidate neurobiological mechanisms of change in psychiatric conditions. clinicaltrials.gov Identifier: NCT00380731.",Goldin PR.; Ziv M.; Jazaieri H.; Hahn K.; Heimberg R.; Gross JJ.,2013.0,10.1001/jamapsychiatry.2013.234,0,0,
9616,A randomized controlled trial to assess the effect of self-paced walking on task-specific anxiety in cardiac rehabilitation patients.,"Cardiac rehabilitation can reduce overall anxiety. However, task-specific anxiety is yet to be investigated in the cardiac patient. This study investigates the effect of an outdoor walking intervention (WI) in alleviating the high degree of task-specific anxiety in cardiac patients. Participants (N = 22, mean age ± SD = 62.0 ± 10.8 years, 9 women), who had experienced a cardiac event and exhibited a moderate to high level of anxiety for outdoor walking (anxiety score ≥ 7 on a modified version of the Hospital Anxiety and Depression Scale), were initially assessed during an incremental shuttle walk test and a self-paced 1-mile walk. Heart rate and the ratings of perceived exertion were monitored during both tests. Participants also completed an exercise self-efficacy (ESE) questionnaire. Following this, participants were randomized to either a 3 sessions per week, 4 weeks, self-paced WI on a predetermined variable topographic course, or to a control group (CG; 30-minute stationary cycling, 3 sessions per week for 4 weeks). Identical assessments (Incremental Shuttle Walk Test, Self-Paced 1-Mile Walk, Hospital Anxiety and Depression Scale, ESE) were used postintervention. The 2 groups were compared for anxiety, ESE, and fitness by analysis of variance. The WI group exhibited a significantly greater decrease in task-specific anxiety (51%; P < .01), increased self-efficacy (6.6%; P < .001) and improved fitness (P < .05) in comparison with CG. This study demonstrated that task familiarization reduced the task-specific anxiety associated with outdoor walking in cardiac patients and, as such, may help in changing exercise behavior patterns in patients undergoing cardiac rehabilitation.",Faulkner J.; Westrupp N.; Rousseau J.; Lark S.,,10.1097/HCR.0b013e3182a0295c,0,0,6318
9617,Association of anxiety and depression with pulmonary-specific symptoms in chronic obstructive pulmonary disease.,"To examine the association of anxiety and depression with pulmonary-specific symptoms of Chronic Obstructive Pulmonary Disease (COPD), and to determine the extent to which disease severity and functional capacity modify this association. Patients (N = 162) enrolled in the INSPIRE-II study, an ongoing randomized, clinical trial of COPD patients and their caregivers who received either telephone-based coping skills training or education and symptom monitoring. Patients completed a psychosocial test battery including: Brief Fatigue Inventory, St. George's Respiratory Questionnaire, UCSD Shortness of Breath Questionnaire, State-Trait Anxiety Inventory, and Beck Depression Inventory. Measures of disease severity and functional capacity (i.e., FEV1 and six-minute walk test) were also obtained. After covariate adjustment, higher anxiety and depression levels were associated with greater fatigue levels (ps < .001, deltaR2 = 0.16 and 0.29, respectively), shortness of breath (ps < .001, deltaR2 = 0.12 and 0.10), and frequency of COPD symptoms (ps < .001, deltaR2 = 0.11 and 0.13). In addition, functional capacity was a moderator of anxiety and pulmonary-specific COPD symptoms. The association between anxiety and shortness of breath (p = 0.009) and frequency of COPD symptoms (p = 0.02) was greater among patients with lower functional capacity. Anxiety and depression were associated with higher levels of fatigue, shortness of breath, and frequency of COPD symptoms. It is important for clinicians to be aware of the presence of anxiety and depression in COPD patients, which appears to correlate with pulmonary-specific COPD symptoms, especially in patients with lower functional capacity. Prospective design studies are needed to elucidate the causal relationships between anxiety and depression and pulmonary-specific symptoms in COPD patients.",Doyle T.; Palmer S.; Johnson J.; Babyak MA.; Smith P.; Mabe S.; Welty-Wolf K.; Martinu T.; Blumenthal JA.,2013.0,10.2190/PM.45.2.g,0,0,
9618,Treating generalized anxiety disorder using complementary and alternative medicine.,"The high comorbidity rate of generalized anxiety disorders (GADs) with other diagnoses-such as panic disorder, depression, alcohol abuse, posttraumatic stress disorder, insomnia, and obsessive compulsive disorder- make it one of the most common diagnoses found in primary care, with women predominantly affected. It is estimated that 5.4%-7.6% of primary care visits are associated with GAD and in addition to impairments in mental health there is additional impairment in pain, function, and activities of daily life, accelerating the need to reconsider the medical management of this disorder and move from the traditional medical model to a more holistic approach, focusing on self-care. The study intended to investigate the effectiveness of a pilot program that used multiple complementary and alternative medicine (CAM) therapies, focusing on self-care behaviors for treatment of GAD. The study used a quasi-experimental, pretestposttest design to evaluate the benefits of the multitherapy program for one group of individuals with GAD. The study occurred at a military treatment facility in the Pacific Northwest. Participants were a convenience sample of volunteers seeking treatment at the military treatment facility. The study enrolled participants (N = 37) if they had a documented history of GAD or met screening criteria for GAD using the GAD-7. Participants received acupuncture treatments once/wk for 6 wks and engaged in yogic breathing exercises, self- and/or partner-assisted massage therapy using scented oils, episodic journaling, nutrition counseling, and exercise. The primary outcome of interest was the reduction in anxiety as measured by the anxiety subscale on the Depression Anxiety Stress Scale-21 (DASS-21), which assesses three negative affective states: (1) depression (DASS-D), (2) anxiety (DASS-A), and (3) stress (DASS-S). The research team also measured preand post-GAD-7 scores since it used them as a screening criterion for enrollment. In addition, the team assessed participants' levels of pain on a Likert scale. Of the originally enrolled participants, 68% completed the program (n = 25). The study found significant reductions in anxiety pre- and posttest using GAD-7 and identified overall and individual subscale reductions on the DASS-21. While not specifically targeted for treatment, secondary exploratory outcomes included reductions in use of anxiolytic medication and in the pain scale. The study considered the burden of use of multiple therapies upon participants; however, participation in the study's therapies was high. The findings in this pilot study suggest multimodal interventions focusing on self-care behaviors may be feasible for patients seeking therapies that are adjunct or alternative to conventional treatments. The study also suggested that this type of patient will participate in multitherapy options, and it offers support for expanding the conceptualization of and treatment for GAD by integrating CAM into existing cognitive-behavioral models.",McPherson F.; McGraw L.,,,0,0,
9619,Shifting the focus of one's attention mediates improvement in cognitive therapy for social anxiety disorder.,"Cognitive therapy is an effective treatment for social anxiety disorder but little is known about the mechanisms by which the treatment achieves its effects. This study investigated the potential role of self-focused attention and social phobia related negative automatic thoughts as mediators of clinical improvement. Twenty-nine patients with social phobia received individual cognitive therapy (ICT) in a randomized controlled trial. Weekly process and outcome measures were analysed using multilevel mediation models. Change from self-focused to externally focused attention mediated improvements in social anxiety one week later. In contrast, change in frequency of, or belief in, negative social phobia related negative automatic thoughts did not predict social anxiety one week later. Change in self-focused attention mediate therapeutic improvement in ICT. Therapists should therefore target self-focused attention.",Mörtberg E.; Hoffart A.; Boecking B.; Clark DM.,2015.0,10.1017/S1352465813000738,0,0,
9620,Neural substrates of treatment response to cognitive-behavioral therapy in panic disorder with agoraphobia.,"Although exposure-based cognitive-behavioral therapy (CBT) is an effective treatment option for panic disorder with agoraphobia, the neural substrates of treatment response remain unknown. Evidence suggests that panic disorder with agoraphobia is characterized by dysfunctional safety signal processing. Using fear conditioning as a neurofunctional probe, the authors investigated neural baseline characteristics and neuroplastic changes after CBT that were associated with treatment outcome in patients with panic disorder with agoraphobia. Neural correlates of fear conditioning and extinction were measured using functional MRI before and after a manualized CBT program focusing on behavioral exposure in 49 medication-free patients with a primary diagnosis of panic disorder with agoraphobia. Treatment response was defined as a reduction exceeding 50% in Hamilton Anxiety Rating Scale scores. At baseline, nonresponders exhibited enhanced activation in the right pregenual anterior cingulate cortex, the hippocampus, and the amygdala in response to a safety signal. While this activation pattern partly resolved in nonresponders after CBT, successful treatment was characterized by increased right hippocampal activation when processing stimulus contingencies. Treatment response was associated with an inhibitory functional coupling between the anterior cingulate cortex and the amygdala that did not change over time. This study identified brain activation patterns associated with treatment response in patients with panic disorder with agoraphobia. Altered safety signal processing and anterior cingulate cortex-amygdala coupling may indicate individual differences among these patients that determine the effectiveness of exposure-based CBT and associated neuroplastic changes. Findings point to brain networks by which successful CBT in this patient population is mediated.",Lueken U.; Straube B.; Konrad C.; Wittchen HU.; Ströhle A.; Wittmann A.; Pfleiderer B.; Uhlmann C.; Arolt V.; Jansen A.; Kircher T.,2013.0,10.1176/appi.ajp.2013.12111484,0,0,
9621,Music therapy for prisoners: pilot randomised controlled trial and implications for evaluating psychosocial interventions.,"Mental health problems are common among prison inmates. Music therapy has been shown to reduce mental health problems. It may also be beneficial in the rehabilitation of prisoners, but rigorous outcome research is lacking. We compared group music therapy with standard care for prisoners in a pilot randomised controlled trial that started with the establishment of music therapy services in a prison near Bergen in 2008. In all, 113 prisoners agreed to participate. Anxiety (STAI-State [State-Trait Anxiety Inventory], STAI-Trait), depression (HADS-D [Hospital Anxiety and Depression Scale]), and social relationships (Quality of Life Enjoyment and Satisfaction Questionnaire [Q-LES-Q]) were assessed at baseline; every 2 weeks in the experimental group; after 1, 3, and 6 months in the control group; and at release. No restrictions were placed on the frequency, duration, or contents of music therapy. Duration of stay in the institution was short (62% stayed less than 1 month). Only a minority reached clinical cutoffs for anxiety and depression at baseline. Between-group analyses of effects were not possible. Music therapy was well accepted and attractive among the prisoners. Post hoc analysis of within-group changes suggested a reduction of state anxiety after 2 weeks of music therapy (d = 0.33, p = .025). Short sentences and low baseline levels of psychological disturbance impeded the examination of effects in this study. Recommendations for planning future studies are given, concerning the careful choice of participants, interventions and settings, comparison condition and design aspects, choice of outcomes, and integration of research approaches. Thus, the present study has important implications for future studies evaluating interventions for improving prisoners' mental health. ISRCTN22518605.",Gold C.; Assmus J.; Hj√∏rnevik K.; Qvale LG.; Brown FK.; Hansen AL.; Waage L.; Stige B.,2014.0,10.1177/0306624X13498693,0,0,
9622,Cognitive-coping therapy for obsessive-compulsive disorder: a randomized controlled trial.,"Pharmacotherapy and cognitive-behavioral therapy (CBT) are widely used to treat obsessive-compulsive disorder (OCD). These treatments have helped many patients with OCD, but there still is room for improvement. Recently, a promising psychotherapy for OCD, cognitive-coping therapy (CCT), has been developed. Pharmacotherapy plus CCT (PCCT) demonstrates higher efficacy in a shorter period of time and lower relapses than pharmacotherapy or pharmacotherapy plus CBT. In this randomized controlled trial, we investigated the efficacy of CCT for OCD treatment. One hundred and forty-five OCD patients were randomly assigned into two groups: pharmacotherapy (N = 72) and PCCT (N = 73). In each group, drug-resistant (DR) and non-drug-resistant (NDR) OCD were further analyzed to examine the efficacy of CCT. Some clinical features and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) were blindly assessed pre-treatment and post-treatment at week 1, 2, 3, 4, and 12. The Y-BOCS scores were significantly lower in PCCT than in the pharmacotherapy group at any post-treatment time-point (P < 0.001). Compared with pre-treatment, the Y-BOCS scores were significantly reduced at any time-point (P < 0.001) in PCCT group, but only at week 12 (P < 0.001) in the pharmacotherapy group. In the PCCT group, there were no differences between DR and NDR groups' Y-BOCS scores at any post-treatment time-point. The response rates and remission rates were higher in PCCT than in the pharmacotherapy group. Three variables, the number of weeks of treatment, insight, and disregarding of obsessions, were significantly correlated with the Y-BOCS score. Therefore, CCT might be a potential treatment for OCD.",Ma JD.; Wang CH.; Li HF.; Zhang XL.; Zhang YL.; Hou YH.; Liu XH.; Hu XZ.,2013.0,10.1016/j.jpsychires.2013.08.002,0,0,
9623,"Early PTSD symptom trajectories: persistence, recovery, and response to treatment: results from the Jerusalem Trauma Outreach and Prevention Study (J-TOPS).","Uncovering heterogeneities in the progression of early PTSD symptoms can improve our understanding of the disorder's pathogenesis and prophylaxis. To describe discrete symptom trajectories and examine their relevance for preventive interventions. Latent Growth Mixture Modeling (LGMM) of data from a randomized controlled study of early treatment. LGMM identifies latent longitudinal trajectories by exploring discrete mixture distributions underlying observable data. Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity. Adult survivors of potentially traumatic events consecutively admitted to the hospital's emergency department (ED) were assessed ten days and one-, five-, nine- and fifteen months after ED admission. Participants with data at ten days and at least two additional assessments (n = 957) were included; 125 received cognitive behavioral therapy (CBT) between one and nine months. We used LGMM to identify latent parameters of symptom progression and tested the effect of CBT on these parameters. CBT consisted of 12 weekly sessions of either cognitive therapy (n = 41) or prolonged exposure (PE, n = 49), starting 29.8±5.7 days after ED admission, or delayed PE (n = 35) starting at 151.8±42.4 days. CBT effectively reduced PTSD symptoms in the entire sample. Latent trajectories of PTSD symptoms; effects of CBT on these trajectories. THREE TRAJECTORIES WERE IDENTIFIED: Rapid Remitting (rapid decrease in symptoms from 1- to 5-months; 56% of the sample), Slow Remitting (progressive decrease in symptoms over 15 months; 27%) and Non-Remitting (persistently elevated symptoms; 17%). CBT accelerated the recovery of the Slow Remitting class but did not affect the other classes. The early course of PTSD symptoms is characterized by distinct and diverging response patterns that are centrally relevant to understanding the disorder and preventing its occurrence. Studies of the pathogenesis of PTSD may benefit from using clustered symptom trajectories as their dependent variables.",Galatzer-Levy IR.; Ankri Y.; Freedman S.; Israeli-Shalev Y.; Roitman P.; Gilad M.; Shalev AY.,2013.0,10.1371/journal.pone.0070084,0,0,
9624,Sensorimotor control deficiency in recurrent anterior shoulder instability assessed with a stabilometric force platform.,"Deficiencies in both afferent proprioceptive information and efferent motor responses have been independently reported in patients with recurrent anterior shoulder instability. We used a validated force platform method to analyze the association between the stabilometric parameters of the upper limb as representative of the shoulder's sensorimotor control and clinical glenohumeral joint instability. We enrolled 32 patients with unilateral recurrent anterior post-traumatic shoulder dislocation, on the dominant side in 13 patients (DIG) and the non-dominant side in 19 patients (NDIG) and 16 healthy nonathletic subjects (CG). Displacements of the Center of Pressure were measured by a Win-Posturo Medicapteurs force platform in the upper limb weight-bearing position with the lower limbs resting on a table up to the anterior superior iliac spines. The association between stabilometric values and clinical shoulder instability was analyzed by side-to-side comparisons and comparisons to a control group. For CG and NDIG, there were no side-to-side differences. For DIG, stabilometric values were significantly higher on the dominant pathological shoulder side than on the healthy contralateral non-dominant side (P < .01). The percentage of side-to-side differences was higher in DIG than CG (P < .01). Sensorimotor control deficiency was associated with recurrent anterior shoulder instability, especially in patients with the pathological shoulder on their dominant side. Using a force platform to assess sensorimotor control of the shoulder is feasible in patients with shoulder instability, and can allow assessment of the global sensorimotor control deficiency present in unstable shoulders.",Edouard P.; Gasq D.; Calmels P.; Degache F.,2014.0,10.1016/j.jse.2013.06.005,0,0,
9625,"Learning to obtain reward, but not avoid punishment, is affected by presence of PTSD symptoms in male veterans: empirical data and computational model.","Post-traumatic stress disorder (PTSD) symptoms include behavioral avoidance which is acquired and tends to increase with time. This avoidance may represent a general learning bias; indeed, individuals with PTSD are often faster than controls on acquiring conditioned responses based on physiologically-aversive feedback. However, it is not clear whether this learning bias extends to cognitive feedback, or to learning from both reward and punishment. Here, male veterans with self-reported current, severe PTSD symptoms (PTSS group) or with few or no PTSD symptoms (control group) completed a probabilistic classification task that included both reward-based and punishment-based trials, where feedback could take the form of reward, punishment, or an ambiguous ""no-feedback"" outcome that could signal either successful avoidance of punishment or failure to obtain reward. The PTSS group outperformed the control group in total points obtained; the PTSS group specifically performed better than the control group on reward-based trials, with no difference on punishment-based trials. To better understand possible mechanisms underlying observed performance, we used a reinforcement learning model of the task, and applied maximum likelihood estimation techniques to derive estimated parameters describing individual participants' behavior. Estimations of the reinforcement value of the no-feedback outcome were significantly greater in the control group than the PTSS group, suggesting that the control group was more likely to value this outcome as positively reinforcing (i.e., signaling successful avoidance of punishment). This is consistent with the control group's generally poorer performance on reward trials, where reward feedback was to be obtained in preference to the no-feedback outcome. Differences in the interpretation of ambiguous feedback may contribute to the facilitated reinforcement learning often observed in PTSD patients, and may in turn provide new insight into how pathological behaviors are acquired and maintained in PTSD.",Myers CE.; Moustafa AA.; Sheynin J.; Vanmeenen KM.; Gilbertson MW.; Orr SP.; Beck KD.; Pang KC.; Servatius RJ.,2013.0,10.1371/journal.pone.0072508,0,0,
9626,"[Effect of a non-pharmacological intervention, Voix d'Or(®), on behavior disturbances in Alzheimer disease and associated disorders].","An innovative non-pharmacological intervention called Voix d'Or(®) (Golden Voice) was proposed in the Cognitive behavioral unit (CBU) of the Memory center at the Hospices civils in Lyon. Voix d'Or(®) offers eight sound activities disseminated via an audio device based on different approaches sociotherapeutic (music therapy, reminiscence, relaxation, reorientation in reality). The aim of this study was to test the effects of the Voix d'Or(®) program on behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer's disease hospitalized in the CBU. Twenty four patients with agitation and/or apathy and/or anxiety and/or depression were included. Patients were randomly selected in the intervention group exposed to Voix d'Or versus a control group exposed to usual occupational activities. Patients were assessed before (T0) and after (T1) the intervention period. Several variables were measured: frequency and severity of behavioral disorders, anxiety, depression, agitation and apathy. A significant improvement of anxiety level between T0 and T1was observed in the group with Voix d'Or(®) compared to the control group. This study suggests that this non-pharmacological intervention may be beneficial on anxiety in patients with Alzheimer's disease.",Delphin-Combe F.; Rouch I.; Martin-Gaujard G.; Relland S.; Krolak-Salmon P.,2013.0,10.1684/pnv.2013.0421,0,0,6230
9627,Comparison of short- and long-term dynamic group psychotherapy: randomised clinical trial.,"There are no randomised clinical trials comparing the outcomes of short- with long-term psychodynamic group psychotherapy. To compare differences in outcome during and after short- and long-term group psychotherapy. In total, 167 out-patients with mood, anxiety and personality disorders were randomised to short- or long-term group therapy (20 or 80 weekly, 90 min sessions). Outcome measures were: symptoms (Symptom Checklist 90 - Revised), interpersonal problems (Inventory of Interpersonal Problems - Circumplex) and psychosocial functioning (Global Assessment of Functioning (GAF) split version: GAF-Symptom and GAF-Function). Change over the 3-year study period was assessed using linear mixed models. The study was registered in clinicalTrials.gov as NCT00521417. Patients in both groups made significant gains. A significantly larger symptomatic change over time was found for long-term compared with short-term therapy, but no significant differences were detected for the three remaining outcome variables. There was a higher number of premature terminations in the long-term (33.3%) compared with the short-term group (8.6%). Short- and long-term therapy seem equally effective for typical out-patients seeking group psychotherapy, except for symptomatic distress.",Lorentzen S.; Ruud T.; Fjeldstad A.; H√∏glend P.,2013.0,10.1192/bjp.bp.112.113688,0,0,
9628,Outcomes of specialized residential treatment for adults with obsessive-compulsive disorder.,"Cognitive-behavioral therapy (CBT) utilizing exposure and response prevention for obsessive- compulsive disorder (OCD) has typically been studied in the context of time-limited treatment conducted in outpatient settings. However, in practice, patients vary in their response to such treatment, and some require more prolonged participation to obtain optimal benefit. An intensive residential program is one alternative for patients who do not improve in traditional outpatient treatment. This naturalistic study evaluated 46 patients with a primary diagnosis of OCD who received intensive residential treatment between 2004 and 2008. Patients entering the program completed assessments at admission and at discharge. Results indicated statistically significant improvements on all outcome measures, with 60.9% of patients meeting criteria for clinically reliable change in OCD severity and 37% achieving high end-state functioning. Specialized residential treatment seems effective for treatment-refractory OCD, although future controlled trials with larger samples are needed.",Björgvinsson T.; Hart AJ.; Wetterneck C.; Barrera TL.; Chasson GS.; Powell DM.; Heffelfinger S.; Stanley MA.,2013.0,10.1097/01.pra.0000435043.21545.60,0,0,
9629,The effect of hyperbaric oxygen on persistent postconcussion symptoms.,"The high incidence of persistent postconcussion symptoms in service members with combat-related mild traumatic brain injury has prompted research in the use of hyperbaric oxygen (HBO2) for management. The effects of HBO2 on persistent postconcussion symptoms in 60 military service members with at least 1 combat-related mild traumatic brain injury were examined in a single-center, double-blind, randomized, sham-controlled, prospective trial at the Naval Medicine Operational Training Center at Naval Air Station Pensacola. Over a 10-week period, subjects received a series of 40, once-daily, hyperbaric chamber compressions at 2.0 atmospheres absolute (ATA). During each session, subjects breathed 1 of 3 preassigned oxygen fractions (10.5%, 75%, or 100%) for 60 minutes, resulting in an oxygen exposure equivalent to breathing surface air, 100% oxygen at 1.5 ATA, or 100% oxygen at 2.0 ATA, respectively. Individual, subscale and total item responses on the Rivermead Postconcussion Symptom Questionnaire and individual and total Posttraumatic Disorder Checklist-Military Version were measured just prior to intervention and immediately postintervention. Between-group testing of pre- and postintervention means revealed no significant differences on individual or total scores on the Posttraumatic Disorder Checklist-Military Version or Rivermead Postconcussion Symptom Questionnaire, demonstrating a successful randomization and no significant main effect for HBO2 at 1.5 or 2.0 ATA equivalent compared with the sham compression. Within-group testing of pre- and postintervention means revealed significant differences on several individual items for each group and difference in the Posttraumatic Disorder Checklist-Military Version total score for the 2.0 ATA HBO2 group. The primary analyses of between group differences found no evidence of efficacy for HBO2. The scattered within group differences are threatened by Type 2 errors and could be explained by nonspecific effects. This study demonstrated that HBO2 at either 1.5 or 2.0 ATA equivalent had no effect on postconcussion symptoms after mild traumatic brain injury when compared with sham compression.",Cifu DX.; Hart BB.; West SL.; Walker W.; Carne W.,,10.1097/HTR.0b013e3182a6aaf0,0,0,6195
9630,The effects of venlafaxine and cognitive behavioral therapy alone and combined in the treatment of co-morbid alcohol use-anxiety disorders.,"The effects of the antidepressant venlafaxine (VEN-225 mg daily) and transdiagnostic cognitive behavioral treatment (CBT) alone and in combination on alcohol intake in subjects with co-morbid alcohol use disorders (AUDs) and anxiety disorders were compared. Drinking outcomes and anxiety were assessed for 81 subjects treated for 11 weeks with one of 4 conditions: 1) VEN-CBT, 2) VEN-Progressive Muscle Relaxation therapy (PMR), 3) Placebo (PLC)-CBT and 4) a comparison group of PLC-PMR. For subjects who reported taking at least one dose of study medication, the Time√óGroup interaction was significant for percent days of heavy drinking and drinks consumed per day. For the measure of percent days heavy drinking, the paired comparison of PLC-CBT versus PLC-PMR group indicated that the PLC-CBT group had greater drinking reductions, whereas other groups were not superior to the comparison group. In Week 11, the proportion of subjects in the PLC-CBT group that had a 50% reduction from baseline in percent days heavy drinking was significantly greater than those in the comparison group. Of the 3 ""active treatment"" groups only the PLC-CBT group had significantly decreased heavy drinking when contrasted to the comparison group. This finding suggests that the transdiagnostic CBT approach of Barlow and colleagues may have value in the management of heavy drinking in individuals with co-morbid alcoholism and anxiety.",Ciraulo DA.; Barlow DH.; Gulliver SB.; Farchione T.; Morissette SB.; Kamholz BW.; Eisenmenger K.; Brown B.; Devine E.; Brown TA.; Knapp CM.,2013.0,10.1016/j.brat.2013.08.003,0,0,
9631,Deployment and post-deployment experiences in OEF/OIF veterans: relationship to gray matter volume.,"Combat-related PTSD has been associated with reduced gray matter volume in regions of the prefrontal and temporal cortex, hippocampus, insula, and amygdala. However, the relationship between gray matter volume and specific deployment and post-deployment experiences has not been investigated. The aim of this study was to delineate how such experiences may contribute to structural brain changes for combat veterans. Operation Iraqi Freedom/Operation Enduring Freedom veterans (N‚Ää=‚Ää32) completed magnetic resonance imaging, the Deployment Risk and Resilience Inventory, Alcohol Use Disorders Identification Test, and Clinical Administered PTSD Scale. Voxel-wise Huber robust multiple regressions were used to quantify the relationship between gray matter volume and deployment experiences (combat experiences, military social support) and post-deployment symptoms (PTSD, alcohol use). There was an interaction between severity of combat experiences and military social support for orbitofrontal gyrus gray matter volume. Specifically, individuals with more orbitofrontal gyrus gray matter volume reported less combat experiences and higher unit support. Individuals with more severe PTSD symptoms showed reduced gray matter volume within a large temporal region (inferior temporal and parahippocampal gyrus). The identified association between unit support and orbitofrontal gyrus volume supports two potential resilience mechanisms to be delineated with future longitudinal studies. First, individuals with larger orbitofrontal gyrus may engage in greater quality of social interactions and thus experience combat as less stressful. Second, individuals who experience greater unit support may preserve a larger orbitofrontal gyrus, serving to ""protect"" them from aversive consequences of combat.",Aupperle RL.; Connolly CG.; Stillman AN.; May AC.; Paulus MP.,2013.0,10.1371/journal.pone.0075880,0,0,
9632,A randomized controlled trial of ecological momentary intervention plus brief group therapy for generalized anxiety disorder.,"Momentary intervention has been proposed as a cost-effective, generalizable, and ecologically valid method to increase the efficiency of face-to-face cognitive-behavioral therapy (CBT). The purpose of the current pilot study was to evaluate the efficacy of a six-session palmtop computer-assisted Group CBT for generalized anxiety disorder (GAD) (CAGT6) in comparison with a six-session Group CBT for GAD without the computer (CBGT6) and typical (12 session) Group CBT for GAD (CBGT12) in a randomized controlled trial. Thirty-four individuals with a primary diagnosis of GAD were randomized to one of the three conditions and completed measures of GAD and anxiety before therapy, after therapy, and at 6-, and 12-month follow-ups. Results indicated that CAGT6 was superior to CBGT6 at posttreatment, but not significantly different from CBGT12. At 6- and 12-month follow-ups, CAGT6 was neither significantly different from CBGT6, nor from CBGT12. Percentages of individuals achieving reliable change on two of the three GAD measures favored CAGT6 over CBGT6 at posttreatment, suggesting promise for the added value of the mobile technology.",Newman MG.; Przeworski A.; Consoli AJ.; Taylor CB.,2014.0,10.1037/a0032519,0,0,
9633,"Predicting response to cognitive therapy and interpersonal therapy, with or without antidepressant medication, for major depression: a pragmatic trial in routine practice.","Identifying patient characteristics that predict response within treatments (prognostic) or between treatments (prescriptive) can inform clinical decision-making. In this study, we sought to identify predictors of response to evidence-based treatments in a sample of depressed patients seeking help in routine practice. Data come from a pragmatic trial of 174 patients with major depression who received an evidence-based treatment of their own choice: cognitive therapy (CT), interpersonal therapy (IPT), antidepressant medication (ADM) alone or in combination with either of the two psychotherapies. Patient characteristics measured at baseline were examined to see if they predicted subsequent response as measured with the Beck Depression Inventory (BDI) over the course of 26 weeks of treatment, using mixed regression modeling. Higher agoraphobia scores at baseline predicted more change in depression scores across treatments, irrespective of the treatment received. Physical functioning moderated the response to treatment: patients with high physical functioning fared better in combined treatment than patients with low physical functioning, whereas physical functioning did not predict a differential response in the psychotherapy group. Moreover, the lowest levels of physical functioning predicted an increase of depressive symptoms in combined treatment. A relatively small sample size, and selection of several predictors that were less theory-driven, which hampers the translation to clinical practice. If replicated, the prognostic and prescriptive indices identified in this study could guide decision-making in routine practice. Development of more uniform requirements for the analysis and reporting of prediction studies is recommended.",Huibers MJ.; van Breukelen G.; Roelofs J.; Hollon SD.; Markowitz JC.; van Os J.; Arntz A.; Peeters F.,2014.0,10.1016/j.jad.2013.08.027,0,0,
9634,Brief Internet-based intervention reduces posttraumatic stress and prolonged grief in parents after the loss of a child during pregnancy: a randomized controlled trial.,"The loss of a child during pregnancy causes significant psychological distress for many women and their partners, and may lead to long-lasting psychiatric disorders. Internet-based interventions using exposure techniques and cognitive restructuring have proved effective for posttraumatic stress disorder (PTSD) and prolonged grief. This study compared the effects of an Internet-based intervention for parents after prenatal loss with a waiting list condition (WLC). The Impact of Event Scale - Revised assessed symptoms of PTSD; the Inventory of Complicated Grief and the Brief Symptom Inventory assessed depression, anxiety, and general mental health. The 228 participants (92% female) were randomly allocated to a treatment group (TG; n = 115) or a WLC group (n = 113). The TG received a 5-week cognitive behavioral intervention including (1) self-confrontation, (2) cognitive restructuring, and (3) social sharing. The TG showed significantly reduced symptoms of posttraumatic stress, prolonged grief, depression, and anxiety relative to the WLC control group. Intention-to-treat analysis revealed treatment effects of between d = 0.84 and d = 1.02 for posttraumatic stress and prolonged grief from pre- to posttreatment time points. Further significant improvement in all symptoms of PTSD and prolonged grief was found from the posttreatment evaluation to the 12-month follow-up. The attrition rate of 14% was relatively low. The Internet-based intervention proved to be a feasible and cost-effective treatment, reducing symptoms of posttraumatic stress, grief, depression, anxiety, and general mental health after pregnancy loss. Low-threshold e-health interventions should be further evaluated and implemented routinely to improve psychological support after pregnancy loss.",Kersting A.; Dölemeyer R.; Steinig J.; Walter F.; Kroker K.; Baust K.; Wagner B.,2013.0,10.1159/000348713,0,0,
9635,Altered neural correlates of affective processing after internet-delivered cognitive behavior therapy for social anxiety disorder.,"Randomized controlled trials have yielded promising results for internet-delivered cognitive behavior therapy (iCBT) for patients with social anxiety disorder (SAD). The present study investigated anxiety-related neural changes after iCBT for SAD. The amygdala is a critical hub in the neural fear network, receptive to change using emotion regulation strategies and a putative target for iCBT. Twenty-two subjects were included in pre- and post-treatment functional magnetic resonance imaging at 3T assessing neural changes during an affective face processing task. Treatment outcome was assessed using social anxiety self-reports and the Clinical Global Impression-Improvement (CGI-I) scale. ICBT yielded better outcome than ABM (66% vs. 25% CGI-I responders). A significant differential activation of the left amygdala was found with relatively decreased reactivity after iCBT. Changes in the amygdala were related to a behavioral measure of social anxiety. Functional connectivity analysis in the iCBT group showed that the amygdala attenuation was associated with increased activity in the medial orbitofrontal cortex and decreased activity in the right ventrolateral and dorsolateral (dlPFC) cortices. Treatment-induced neural changes with iCBT were consistent with previously reported studies on regular CBT and emotion regulation in general.",Månsson KN.; Carlbring P.; Frick A.; Engman J.; Olsson CJ.; Bodlund O.; Furmark T.; Andersson G.,2013.0,10.1016/j.pscychresns.2013.08.012,0,0,
9636,Modulation of motor cortex excitability in obsessive-compulsive disorder: an exploratory study on the relations of neurophysiology measures with clinical outcome.,"Low-frequency repetitive transcranial magnetic stimulation (rTMS) to supplementary motor area (SMA) showed clinical benefit in obsessive-compulsive disorder (OCD). Here we tested whether clinical improvement was associated with enhanced cortical inhibition as measured by single and paired-pulse TMS variables. In 18 OCD patients receiving 4 weeks of either active or sham rTMS in a double-blind randomized trial, we assessed bilateral resting and active motor thresholds (RMT and AMT), cortical silent period (CSP), short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF). We tested correlations between changes in Yale-Brown Obsessive Compulsive Scale-Self-report (Y-BOCS-SR), Clinical Global Impression-Severity subscale (CGI-S) and cortical excitability measures. Active rTMS increased right hemisphere RMT whose change correlated with Y-BOCS-SR improvement. Baseline RMT hemispheric asymmetry, defined as the difference between left and right hemispheres RMT, and its normalization after active rTMS correlated with Y-BOCS-SR and CGI-S improvements. Active rTMS also increased right hemisphere SICI whose change correlated with Y-BOCS-SR and CGI-S at week 4, and with normalization of baseline RMT hemispheric asymmetry. Treatment-induced changes in cortical excitability measures are consistent with an inhibitory action of SMA rTMS on dysfunctional motor circuits in OCD. Correlations of neurophysiology measures with therapeutic outcome are supportive of the role of SMA in the modulation of OCD symptoms.",Mantovani A.; Rossi S.; Bassi BD.; Simpson HB.; Fallon BA.; Lisanby SH.,2013.0,10.1016/j.psychres.2013.08.054,0,0,
9637,Randomised controlled trial of a cognitive narrative intervention for complicated grief in widowhood.,"The implementation of bereavement interventions is frequently requested, and its effectiveness has been controversial. The aim of this study is to evaluate the effectiveness of a cognitive narrative intervention for complicated grief (CG) for controlling post-traumatic and depressive issues. The study is a randomised controlled trial and uses the Socio Demographic Questionnaire (SDQ), the Inventory of Complicated Grief (ICG), the Beck Depression Inventory (BDI) and the Impact of Events Scale-Revised (IES-R). There were three phases in the study: (1) The SDQ and CG evaluations were applied to bereaved elders (n = 82). The bereaved elders with the 40 highest ICG values (‚â•25) were randomly allocated into two groups: the intervention group (n = 20) and control group (n = 20); (2) participants were evaluated using the BDI and IES-R and the IG gave informed consent to participate in an intervention with four weekly 60-min sessions addressing recall, emotional and cognitive subjectivation, metaphorisation and projecting. (3) Two months later, the ICG, BDI and IES-R assessments were repeated. Outcome measures showed a statistically significant reduction of CG, depressive and traumatic symptoms compared to the controls. Very high effect sizes for the ICG, BDI and IES-R reflect the effectiveness of the intervention along the longitudinal profile. These results reinforce the importance of brief interventions that combine a reduced number of sessions with lower costs, which is reflected in an increased adherence to the programme along with high effectiveness.",Barbosa V.; S√° M.; Carlos Rocha J.,2014.0,10.1080/13607863.2013.833164,0,0,
9638,Do comorbid anxiety disorders moderate the effects of psychotherapy for bipolar disorder? Results from STEP-BD.,"At least 50% of individuals with bipolar disorder have a lifetime anxiety disorder. Individuals with both bipolar disorder and a co-occurring anxiety disorder experience longer illness duration, greater illness severity, and poorer treatment response. The study explored whether comorbid lifetime anxiety in bipolar patients moderates psychotherapy treatment outcome. In the Systematic Treatment Enhancement Program randomized controlled trial of psychotherapy for bipolar depression, participants received up to 30 sessions of intensive psychotherapy (family-focused therapy, interpersonal and social rhythm therapy, or cognitive-behavioral therapy) or collaborative care, a three-session comparison treatment, plus pharmacotherapy. Using the number needed to treat, we computed effect sizes to analyze the relationship between lifetime anxiety disorders and rates of recovery across treatment groups after 1 year. A total of 269 patients (113 women) with a comorbid lifetime anxiety disorder (N=177) or without a comorbid lifetime anxiety disorder (N=92) were included in the analysis. Participants with a lifetime anxiety disorder were more likely to recover with psychotherapy than with collaborative care (66% compared with 49% recovered over 1 year; number needed to treat=5.88, small to medium effect). For patients without a lifetime anxiety disorder, there was no difference between rates of recovery in psychotherapy compared with collaborative care (64% compared with 62% recovered; number needed to treat=50, small effect). Participants with one lifetime anxiety disorder were likely to benefit from intensive psychotherapy compared with collaborative care (84% compared with 53% recovered; number needed to treat=3.22, medium to large effect), whereas patients with multiple anxiety disorders exhibited no difference in response to the two treatments (54% compared with 46% recovered; number needed to treat=12.5, small effect). Depressed patients with bipolar disorder and comorbid anxiety may be in particular need of additional psychotherapy for treating acute depression. These results need to be replicated in studies that stratify bipolar patients to treatments based on their anxiety comorbidity status.",Deckersbach T.; Peters AT.; Sylvia L.; Urdahl A.; Magalh√£es PV.; Otto MW.; Frank E.; Miklowitz DJ.; Berk M.; Kinrys G.; Nierenberg A.,2014.0,10.1176/appi.ajp.2013.13020225,0,0,
9639,Design and baseline data from the Management of Sadness and Anxiety in Cardiology (MOSAIC) randomized controlled trial.,"Depression and anxiety in cardiac patients are independently associated with adverse cardiovascular outcomes, including mortality. Collaborative care (CC) programs, which use care managers to assess patients, coordinate care, and perform therapeutic interventions, have proven effective in managing depression in this population. However, no prior CC intervention has simultaneously managed depression and anxiety disorders, and there has been minimal study of CC in high-risk cardiac inpatients. The Management of Sadness and Anxiety in Cardiology (MOSAIC) study was a prospective randomized trial of a low-intensity CC intervention, compared to enhanced usual care, for patients hospitalized for acute coronary syndrome, heart failure, or arrhythmia, and diagnosed with depression, generalized anxiety disorder (GAD), or panic disorder (PD). The primary outcome measure for MOSAIC was mental health-related quality of life (HRQoL), measured using the Medical Outcomes Study Short Form-12. Additional outcomes included psychological, functional, and medical outcomes, including rehospitalizations. A total of 183 eligible participants were enrolled (92 collaborative care, 91 enhanced usual care); 94% of depressed patients reported being depressed for >1month, and 53% of those with GAD reported clinically significant anxiety for >1year. One hundred thirty-three patients had depression, 118 had GAD, and 19 had PD; 74 participants (40%) had two or more of the disorders. The MOSAIC trial will provide data regarding whether an intervention that concurrently manages these common psychiatric disorders results in meaningful improvements in HRQoL, psychiatric symptoms, and medical outcomes in cardiac patients at high risk for adverse outcomes.",Huffman JC.; Beach SR.; Suarez L.; Mastromauro CA.; DuBois CM.; Celano CM.; Rollman BL.; Januzzi JL.,2013.0,10.1016/j.cct.2013.09.012,0,0,
9640,Self-concept and quality of object relations as predictors of outcome in short- and long-term psychotherapy.,"Quality of object relations and self-concept reflect clinically relevant aspects of personality functioning, but their prediction as suitability factors for psychotherapies of different lengths has not been compared. This study compared their prediction on psychiatric symptoms and work ability in short- and long-term psychotherapy. Altogether 326 patients, 20-46 years of age, with mood and/or anxiety disorder, were randomized to short-term (solution-focused or short-term psychodynamic) psychotherapy and long-term psychodynamic psychotherapy. The Quality of Object Relations Scale (QORS) and the Structural Analysis of Social Behavior (SASB) self-concept questionnaire were measured at baseline, and their prediction on outcome during the 3-year follow-up was assessed by the Symptom Check List Global Severity Index and the Anxiety Scale, the Beck Depression Inventory and by the Work Ability Index, Social Adjustment Scale work subscale and the Perceived Psychological Functioning scale. Negative self-concept strongly and self-controlling characteristics modestly predicted better 3-year outcomes in long-term therapy, after faster early gains in short-term therapy. Patients with a more positive or self-emancipating self-concept, or more mature object relations, experienced more extensive benefits after long-term psychotherapy. The importance of length vs. long-term therapy technique on the differences found is not known. Patients with mild to moderate personality pathology, indicated by poor self-concept, seem to benefit more from long-term than short-term psychotherapy, in reducing risk of depression. Long-term therapy may also be indicated for patients with relatively good psychological functioning. More research is needed on the relative importance of these characteristics in comparison with other patient-related factors.",Lindfors O.; Knekt P.; Heinonen E.; Virtala E.,2014.0,10.1016/j.jad.2013.09.011,0,0,1518
9641,Visual causal models enhance clinical explanations of treatments for generalized anxiety disorder.,"A daily challenge in clinical practice is to adequately explain disorders and treatments to patients of varying levels of literacy in a time-limited situation. Drawing jointly upon research on causal reasoning and multimodal theory, the authors asked whether adding visual causal models to clinical explanations promotes patient learning. Participants were 86 people currently or formerly diagnosed with a mood disorder and 104 lay people in Boston, Massachusetts, USA, who were randomly assigned to receive either a visual causal model (dual-mode) presentation or auditory-only presentation of an explanation about generalized anxiety disorder and its treatment. Participants' knowledge was tested before, immediately after, and 4 weeks after the presentation. Patients and lay people learned significantly more from visual causal model presentations than from auditory-only presentations, and visual causal models were perceived to be helpful. Participants retained some information 4 weeks after the presentation, although the advantage of visual causal models did not persist in the long term. In conclusion, dual-mode presentations featuring visual causal models yield significant relative gains in patient comprehension immediately after the clinical session, at a time when the authors suggest that patients may be most willing to begin the recommended treatment plan.",Kim NS.; Khalife D.; Judge KA.; Paulus DJ.; Jordan JT.; Yopchick JE.,2013.0,10.1080/10810730.2013.829136,0,0,
9642,Mental imagery and post-event processing in anticipation of a speech performance among socially anxious individuals.,"The present study investigated whether post-event processing (PEP) involving mental imagery about a past speech is particularly detrimental for socially anxious individuals who are currently anticipating giving a speech. One hundred fourteen high and low socially anxious participants were told they would give a 5 min impromptu speech at the end of the experimental session. They were randomly assigned to one of three manipulation conditions: post-event processing about a past speech incorporating imagery (PEP-Imagery), semantic post-event processing about a past speech (PEP-Semantic), or a control condition, (n=19 per experimental group, per condition [high vs low socially anxious]). After the condition inductions, individuals' anxiety, their predictions of performance in the anticipated speech, and their interpretations of other ambiguous social events were measured. Consistent with predictions, high socially anxious individuals in the PEP-Imagery condition displayed greater anxiety than individuals in the other conditions immediately following the induction and before the anticipated speech task. They also interpreted ambiguous social scenarios in a more socially anxious manner than socially anxious individuals in the control condition. High socially anxious individuals made more negative predictions about their upcoming speech performance than low anxious participants in all conditions. The impact of imagery during post-event processing in social anxiety and its implications are discussed.",Brozovich FA.; Heimberg RG.,2013.0,10.1016/j.beth.2013.07.001,0,0,
9643,Treating PTSD in patients with psychosis: a within-group controlled feasibility study examining the efficacy and safety of evidence-based PE and EMDR protocols.,"The present study uses a within-group controlled design to examine the efficacy and safety of two psychological approaches to posttraumatic stress disorder (PTSD) in 10 patients with a concurrent psychotic disorder. Patients were randomly assigned either to prolonged exposure (PE; N=5) or eye movement desensitization and reprocessing (EMDR; N=5). Before, during, and after treatment, a total of 20 weekly assessments of PTSD symptoms, hallucinations, and delusions were carried out. Twelve weekly assessments of adverse events took place during the treatment phase. PTSD diagnosis, level of social functioning, psychosis-prone thinking, and general psychopathology were assessed pretreatment, posttreatment, and at three-month follow-up. Throughout the treatment, adverse events were monitored at each session. An intention-to-treat analysis of the 10 patients starting treatment showed that the PTSD treatment protocols of PE and EMDR significantly reduced PTSD symptom severity; PE and EMDR were equally effective and safe. Eight of the 10 patients completed the full intervention period. Seven of the 10 patients (70%) no longer met the diagnostic criteria for PTSD at follow-up. No serious adverse events occurred, nor did patients show any worsening of hallucinations, delusions, psychosis proneness, general psychopathology, or social functioning. The results of this feasibility trial suggest that PTSD patients with comorbid psychotic disorders benefit from trauma-focused treatment approaches such as PE and EMDR.",de Bont PA.; van Minnen A.; de Jongh A.,2013.0,10.1016/j.beth.2013.07.002,0,0,
9644,Mechanisms of change in cognitive behavioral therapy for panic disorder: the unique effects of self-efficacy and anxiety sensitivity.,"The present study examined temporal dependencies of change of panic symptoms and two promising mechanisms of change (self-efficacy and anxiety sensitivity) during an 11-session course of cognitive-behavior therapy (CBT) for Panic Disorder (PD). 361 individuals with a principal diagnosis of PD completed measures of self-efficacy, anxiety sensitivity, and PD symptoms at each session during treatment. Effect size analyses indicated that the greatest changes in anxiety sensitivity occurred early in treatment, whereas the greatest changes in self-efficacy occurred later in treatment. Results of parallel process latent growth curve models indicated that changes in self-efficacy and anxiety sensitivity across treatment uniquely predicted changes in PD symptoms. Bivariate and multivariate latent difference score models indicated, as expected, that changes in anxiety sensitivity and self-efficacy temporally preceded changes in panic symptoms, and that intraindividual changes in anxiety sensitivity and self-efficacy independently predicted subsequent intraindividual changes in panic symptoms. These results provide strong evidence that changes in self-efficacy and anxiety sensitivity during CBT influence subsequent changes in panic symptoms, and that self-efficacy and anxiety sensitivity may therefore be two distinct mechanisms of change of CBT for PD that have their greatest impact at different stages of treatment.",Gallagher MW.; Payne LA.; White KS.; Shear KM.; Woods SW.; Gorman JM.; Barlow DH.,2013.0,10.1016/j.brat.2013.09.001,0,0,
9645,Internet-based attention bias modification for social anxiety: a randomised controlled comparison of training towards negative and training towards positive cues.,"Biases in attention processes are thought to play a crucial role in the aetiology and maintenance of Social Anxiety Disorder (SAD). The goal of the present study was to examine the efficacy of a programme intended to train attention towards positive cues and a programme intended to train attention towards negative cues. In a randomised, controlled, double-blind design, the impact of these two training conditions on both selective attention and social anxiety were compared to that of a control training condition. A modified dot probe task was used, and delivered via the internet. A total of 129 individuals, diagnosed with SAD, were randomly assigned to one of these three conditions and took part in a 14-day programme with daily training/control sessions. Participants in all three groups did not on average display an attentional bias prior to the training. Critically, results on change in attention bias implied that significantly differential change in selective attention to threat was not detected in the three conditions. However, symptoms of social anxiety reduced significantly from pre- to follow-up-assessment in all three conditions (dwithin ‚Ää=‚Ää0.63-1.24), with the procedure intended to train attention towards threat cues producing, relative to the control condition, a significantly greater reduction of social fears. There were no significant differences in social anxiety outcome between the training condition intended to induce attentional bias towards positive cues and the control condition. To our knowledge, this is the first RCT where a condition intended to induce attention bias to negative cues yielded greater emotional benefits than a control condition. Intriguingly, changes in symptoms are unlikely to be by the mechanism of change in attention processes since there was no change detected in bias per se. Implications of this finding for future research on attention bias modification in social anxiety are discussed. ClinicalTrials.gov NCT01463137.",Boettcher J.; Leek L.; Matson L.; Holmes EA.; Browning M.; MacLeod C.; Andersson G.; Carlbring P.,2013.0,10.1371/journal.pone.0071760,0,0,
9646,"Anxiety disorders in patients with implantable cardioverter defibrillators: frequency, course, predictors, and patients' requests for treatment.","To determine (1) the frequency and course of anxiety disorders in patients with implantable cardioverter defibrillators (ICDs), (2) the predictors of anxiety, (3) the treatment situation and patients' requests for therapy. Quantitative and qualitative methods in a prospective design. At baseline, 327 ICD outpatients completed validated self-report questionnaires (participation rate = 77%). Five months later, a predefined subsample of patients (n = 108, participation rate = 81%) consisting of all patients with (n = 58) and a randomly selected subsample of patients without (n = 50) elevated symptoms of anxiety at baseline, was reassessed using a structured diagnostic interview, the baseline questionnaires, and open-ended questions. At baseline, 19.2% of patients suffered from at least some form of clinically relevant anxiety with an overall remission rate of 56.5% at follow-up. Predictive for anxiety at follow-up were higher levels of stress (odds ratio [OR], 1.52, P < 0.001), depression (OR, 1.26, P < 0.001), somatic symptom severity (OR, 1.25, P < 0.001), more perceived ICD-related constraints (OR, 2.4, P = 0.007), lower quality of life (physical health: OR, 0.91, P = 0.004; mental health: OR, 0.87, P = 0.001), and a higher New York Heart Association class (OR, 7.99, P = 0.002) at baseline. Only 35.3% of patients received an evidenced-based treatment for their anxiety disorder. A supervised ICD patient group was the most preferred treatment (51.1%). Most patients seemed to adapt well to ICD therapy. Patients suffering from additional psychological strains and reporting more negative ICD-related attitudes were at risk for developing an anxiety disorder. Special tailored interventions, such as a supervised ICD patient group, could reduce the gap between treatment needs and the treatment situation.",Lang S.; Becker R.; Wilke S.; Hartmann M.; Herzog W.; Löwe B.,2014.0,10.1111/pace.12276,0,0,
9647,Comparison of non-directive counselling and cognitive behaviour therapy for patients presenting in general practice with an ICD-10 depressive episode: a randomized control trial.,"Most evidence in the UK on the effectiveness of brief therapy for depression concerns cognitive behaviour therapy (CBT). In a trial published in 2000, we showed that non-directive counselling and CBT were equally effective in general practice for patients with depression and mixed anxiety and depression. Our results were criticized for including patients not meeting diagnostic criteria for a depressive disorder. In this reanalysis we aimed to compare the effectiveness of the two therapies for patients with an ICD-10 depressive episode. Patients with an ICD-10 depressive episode or mixed anxiety and depression were randomized to counselling, CBT or usual general practitioner (GP) care. Counsellors provided nondirective, interpersonal counselling following a manual that we developed based on the work of Carl Rogers. Cognitive behaviour therapists provided CBT also guided by a manual. Modelling was carried out using generalized estimating equations with the multiply imputed datasets. Outcomes were mean scores on the Beck Depression Inventory, Brief Symptom Inventory, and Social Adjustment Scale at 4 and 12 months. A total of 134 participants were randomized to CBT, 126 to counselling and 67 to usual GP care. We undertook (1) an interaction analysis using all 316 patients who were assigned a diagnosis and (2) a head-to-head comparison using only those 130 (41%) participants who had an ICD-10 depressive episode at baseline. CBT and counselling were both superior to GP care at 4 months but not at 12 months. There was no difference in the effectiveness of the two psychological therapies. We recommend that national clinical guidelines take our findings into consideration in recommending effective alternatives to CBT.",King M.; Marston L.; Bower P.,2014.0,10.1017/S0033291713002377,0,0,
9648,A multifaith spiritually based intervention versus supportive therapy for generalized anxiety disorder: a pilot randomized controlled trial.,"We have previously reported that a multifaith spiritually based intervention (SBI) may have efficacy in the treatment of generalized anxiety disorder (GAD). This randomized pilot trial tested whether the SBI had greater efficacy than a nonspecific control condition in GAD. Twenty-three participants with GAD of at least moderate severity were randomized to 12 individual sessions of the SBI (n = 11) or supportive psychotherapy (SP)--our control condition (n = 12). Intent-to-treat analysis revealed the SBI fared better than SP in decreasing blind clinician ratings of anxiety and illness severity and self-report worry and intolerance of uncertainty, with large between-group effect sizes. The SBI also produced greater changes in spiritual well-being. Results remained the same when supplementary analyses were performed on the completer sample. Treatment gains were maintained at 3-months follow-up. This small pilot trial demonstrates that a nondenominational SBI has greater efficacy than a rigorous control in improving symptoms of GAD and enhancing spiritual well-being. These results are encouraging and further research on the efficacy of the SBI and its underlying mechanisms is warranted.",Koszycki D.; Bilodeau C.; Raab-Mayo K.; Bradwejn J.,2014.0,10.1002/jclp.22052,0,0,
9649,Myocardial Infarction - Stress PRevention INTervention (MI-SPRINT) to reduce the incidence of posttraumatic stress after acute myocardial infarction through trauma-focused psychological counseling: study protocol for a randomized controlled trial.,"Posttraumatic Stress Disorder (PTSD) may occur in patients after exposure to a life-threatening illness. About one out of six patients develop clinically relevant levels of PTSD symptoms after acute myocardial infarction (MI). Symptoms of PTSD are associated with impaired quality of life and increase the risk of recurrent cardiovascular events. The main hypothesis of the MI-SPRINT study is that trauma-focused psychological counseling is more effective than non-trauma focused counseling in preventing posttraumatic stress after acute MI. The study is a single-center, randomized controlled psychological trial with two active intervention arms. The sample consists of 426 patients aged 18 years or older who are at 'high risk' to develop clinically relevant posttraumatic stress symptoms. 'High risk' patients are identified with three single-item questions with a numeric rating scale (0 to 10) asking about 'pain during MI', 'fear of dying until admission' and/or 'worrying and feeling helpless when being told about having MI'. Exclusion criteria are emergency heart surgery, severe comorbidities, current severe depression, disorientation, cognitive impairment and suicidal ideation. Patients will be randomly allocated to a single 45-minute counseling session targeting either specific MI-triggered traumatic reactions (that is, the verum intervention) or the general role of psychosocial stress in coronary heart disease (that is, the control intervention). The session will take place in the coronary care unit within 48 hours, by the bedside, after patients have reached stable circulatory conditions. Each patient will additionally receive an illustrated information booklet as study material. Sociodemographic factors, psychosocial and medical data, and cardiometabolic risk factors will be assessed during hospitalization. The primary outcome is the interviewer-rated posttraumatic stress level at three-month follow-up, which is hypothesized to be at least 20% lower in the verum group than in the control group using the t-test. Secondary outcomes are posttraumatic stress levels at 12-month follow-up, and psychosocial functioning and cardiometabolic risk factors at both follow-up assessments. If the verum intervention proves to be effective, the study will be the first to show that a brief trauma-focused psychological intervention delivered within a somatic health care setting can reduce the incidence of posttraumatic stress in acute MI patients. ClinicalTrials.gov: NCT01781247.",Meister R.; Princip M.; Schmid JP.; Schnyder U.; Barth J.; Znoj H.; Herbert C.; von Känel R.,2013.0,10.1186/1745-6215-14-329,0,0,
9650,Psychological treatment of social anxiety disorder improves body dysmorphic concerns.,"Social anxiety disorder and body dysmorphic disorder are considered nosologically distinct disorders. In contrast, some cognitive models suggest that social anxiety disorder and body dysmorphic disorder share similar cognitive maintenance factors. The aim of this study was to examine the effects of psychological treatments for social anxiety disorder on body dysmorphic disorder concerns. In Study 1, we found that 12 weekly group sessions of cognitive-behavioral therapy led to significant decreases in body dysmorphic symptom severity. In Study 2, we found that an attention retraining intervention for social anxiety disorder was associated with a reduction in body dysmorphic concerns, compared to a placebo control condition. These findings support the notion that psychological treatments for individuals with primary social anxiety disorder improve co-occurring body dysmorphic disorder symptoms.",Fang A.; Sawyer AT.; Aderka IM.; Hofmann SG.,2013.0,10.1016/j.janxdis.2013.07.005,0,0,
9651,The course of the working alliance during virtual reality and exposure group therapy for social anxiety disorder.,"Psychoanalytic theory and some empirical research suggest the working alliance follows a ""rupture and repair"" pattern over the course of therapy, but given its emphasis on collaboration, cognitive behavioral therapy may yield a different trajectory. The current study compares the trajectory of the working alliance during two types of cognitive behavioral therapy for social anxiety disorder - virtual reality exposure therapy (VRE) and exposure group therapy (EGT), one of which (VRE) has been proposed to show lower levels of working alliance due to the physical barriers posed by the technology (e.g. no eye contact with therapist during exposure). Following randomization, participants (N = 63) diagnosed with social anxiety disorder received eight sessions of manualized EGT or individual VRE and completed a standardized self-report measure of working alliance after each session. Hierarchical linear modeling showed overall high levels of working alliance that changed in rates of growth over time; that is, increases in working alliance scores were steeper at the beginning of therapy and slowed towards the end of therapy. There were no differences in working alliance between the two treatment groups. Results neither support a rupture/repair pattern nor the idea that the working alliance is lower for VRE participants. Findings are consistent with the idea that different therapeutic approaches may yield different working alliance trajectories.",Ngai I.; Tully EC.; Anderson PL.,2015.0,10.1017/S135246581300088X,0,0,
9652,Measuring motivation: change talk and counter-change talk in cognitive behavioral therapy for generalized anxiety.,"How clients talk about change early in treatment has been found to be a potent predictor of their subsequent treatment success. Studies examining such client motivational language (arguments for and against change) have typically been conducted in the context of motivational interviewing for addictions. This study examined the capacity of client motivational language to predict treatment outcomes in the context of cognitive behavioral therapy (CBT) for generalized anxiety. Client early in-session statements against change (counter-change talk) were found to be robust predictors of post-treatment worry scores and differentiated treatment responders from nonresponders. Moreover, client motivational language predicted outcomes beyond initial symptom severity and self-report measures of motivation. These results strongly support the relevance of client motivational language outcomes in CBT and provide a foundation for advancing research on motivation for change in a CBT context.",Lombardi DR.; Button ML.; Westra HA.,2014.0,10.1080/16506073.2013.846400,0,0,
9653,The effect of focused attention and open monitoring meditation on attention network function in healthy volunteers.,"Mindfulness meditation techniques are increasingly popular both as a life-style choice and therapeutic adjunct for a range of mental and physical health conditions. However, little is known about the mechanisms through which mindfulness meditation and its constituent practices might produce positive change in cognition and emotion. Our study directly compared the effects of Focused Attention (FA) and Open-Monitoring (OM) meditation on alerting, orienting and executive attention network function in healthy individuals. Participants were randomized to three intervention groups: open-focused meditation, focused attention, and relaxation control. Participants completed an emotional variant of the Attention Network Test (ANT) at baseline and post-intervention. OM and FA practice improved executive attention, with no change observed in the relaxation control group. Improvements in executive attention occurred in the absence of change in subjective/self-report mood and cognitive function. Baseline levels of dispositional/trait mindfulness were positively correlated with executive control in the ANT at baseline. Our results suggest that mindfulness meditation might usefully target deficits in executive attention that characterise mood and anxiety disorders.",Ainsworth B.; Eddershaw R.; Meron D.; Baldwin DS.; Garner M.,2013.0,10.1016/j.psychres.2013.09.002,0,0,
9654,Exercise heart rate monitors for anxiety treatment in a rural primary care setting: a pilot study.,"Rural patients with anxiety often lack access to traditional biofeedback modalities. Exercise heart rate monitors (HRMs) are tools used in the fitness industry to provide athletes with feedback on heart rate and regulatory breathing strategies. HRMs are inexpensive, discrete, and publicly accessible. This randomized controlled pilot study explored whether use of HRMs for biofeedback during guided mindfulness, diaphragmatic breathing, and progressive muscle relaxation techniques could facilitate anxiety reduction as compared to these techniques alone. Fifty-three rural anxiety patients were randomized to HRM or control groups for four weekly 20-minute, scripted sessions with a non-behaviorist wherein they practiced these techniques; the HRM group received feedback on their heart rate response. The HRM group had significantly greater improvement in state anxiety (State-Trait Anxiety Inventory) and self-efficacy (General Self Efficacy Scale), and a greater percentage of the group indicated that they ""felt in control of their anxiety."" This pilot study demonstrates that this novel, inexpensive, and accessible tool may be a useful clinical intervention for anxiety and can be easily incorporated by both behaviorists and non-behaviorist primary care clinicians into individual or group biofeedback treatment for patients with anxiety. This tool has additional potential for patients to use for anxiety self-management. Further study with a larger sample and blinded design is warranted.",Houser MM.; Rosen L.; Seagrave MP.; Grabowski D.; Matthew JD.; Craig WA.,2013.0,,0,0,
9655,Cognitive processes as mediators of the relation between mindfulness and change in social anxiety symptoms following cognitive behavioral treatment.,"The present study examined whether pretreatment mindfulness exerts an indirect effect on outcomes following cognitive-behavioral therapy (CBT). Cognitive processes of probability and cost bias (i.e., overestimations of the likelihood that negative social events will occur, and that these events will have negative consequences when they do occur) were explored as potential mediators of the relation between mindfulness and social anxiety symptom change. People with higher levels of mindfulness may be better able to benefit from treatments that reduce biases because mindfulness may aid in regulation of attention. Sixty-seven individuals with a primary diagnosis of social phobia identifying public speaking as their greatest fear received eight sessions of one of two types of exposure-based CBT delivered according to treatment manuals. Participants completed self-report measures of mindfulness, probability bias, cost bias, and social anxiety symptoms. Mediation hypotheses were assessed by a bootstrapped regression using treatment outcome data. Pretreatment mindfulness was not related to change in social anxiety symptoms from pre- to posttreatment. However, mindfulness had an indirect effect on treatment outcome via its association with probability bias, but not cost bias, at midtreatment. These findings were consistent across three metrics of social anxiety symptoms. Mindfulness may play a role in response to CBT among individuals with social phobia through its relation with probability bias--even when the treatment does not target mindfulness.",Morgan JR.; Price M.; Schmertz SK.; Johnson SB.; Masuda A.; Calamaras M.; Anderson PL.,2014.0,10.1080/10615806.2013.839988,0,0,
9656,Predictors of completion of exposure therapy in OEF/OIF veterans with posttraumatic stress disorder.,"Despite large-scale dissemination and implementation efforts of evidence-based psychotherapy to veterans from Operation Enduring/Iraqi Freedom (OEF/OIF), little is known regarding the factors that contribute to the successful completion of these treatments in this high-risk population. The present study investigated predictors of treatment completion during a standardized exposure-based psychotherapy for PTSD. Ninety-two OEF/OIF combat veterans enrolled in a randomized controlled trial for an eight session exposure-based psychotherapy for PTSD. All participants completed structured clinical interviews and several background and symptom questionnaires. Of the initial 92 participants, 28% of the sample (n = 26) discontinued treatment prior to completion of the trial. Predictors of discontinuation of treatment were assessed with a hierarchical logistic regression. Disability status was positively associated with treatment discontinuation, and postdeployment social support was negatively associated with discontinuation. In contrast to previous findings, other factors, such as age and PTSD symptomatology, were not identified as significant predictors. The present study suggested that disability status at the start of treatment increases the risk for treatment discontinuation whereas increased social support buffers against discontinuation. Together, these findings highlight the importance of increased assessment and early intervention when these factors are present to potentially reduce treatment discontinuation and improve treatment outcomes in OEF/OIF veterans with PTSD.",Gros DF.; Price M.; Yuen EK.; Acierno R.,2013.0,10.1002/da.22207,0,0,
9657,Vertebral split fractures: technical feasibility of percutaneous vertebroplasty.,"The treatment of vertebral split fractures remains controversial, consisting of either corset or internal fixation. The aim of this study was to evaluate the technical feasibility of CT- and fluoroscopy-guided percutaneous vertebroplasty in the treatment of vertebral split fractures. Institutional review board approval and informed consent were obtained for this study. Sixty-two consecutive adult patients who had post-traumatic vertebral split fractures (A2 according to the AO classification) without neurological symptoms were prospectively treated by percutaneous vertebroplasty. All these procedures were performed by an interventional radiologist under computed tomography (CT) and fluoroscopy guidance by using only local anaesthesia. Postoperative outcome was assessed using the visual analogue scale (VAS) and Oswestry disability index (ODI) scores. Vertebroplasty was performed on thoracic and lumbar vertebrae, creating a cement bridge between the displaced fragment and the rest of the vertebral body. Seven discal cement leakages (11%) were observed, without occurrence of adjacent vertebral compression fractures. The mean VAS measurements ± standard deviation (SD) significantly decreased from 7.9 ± 1.5 preoperatively to 3.3 ± 2.1 at 1 day, 2.2 ± 2.0 at 1 month, and 1.8 ± 1.4 at 6 months (P<0.001). The mean ODI scores ± SD had also a significant improvement: 62.3 ± 17.2 preoperatively and 15.1 ± 6.0 at the 6-month follow-up (P<0.001). This study suggests that type A2 vertebral fractures could be successfully treated by CT- and fluoroscopy-guided percutaneous vertebroplasty.",Huwart L.; Foti P.; Andreani O.; Hauger O.; Cervantes E.; Brunner P.; Boileau P.; Amoretti N.,2014.0,10.1016/j.ejrad.2013.09.020,0,0,
9658,Time to improve and recover from depressive symptoms and interpersonal problems in a clinical trial.,"Results from an earlier clinical trial comparing narrative therapy with cognitive-behavioural therapy (Lopes et al., 2013) suggested that narrative therapy is efficacious for depression. However, there were significant differences in symptom reduction on the Beck Depression Inventory-II, favouring cognitive-behavioural therapy, if dropouts were included in the analysis, suggesting that time to recovery or improvement would differ in both treatments. Contrarily, results showed that treatment assignment was not a predictor for differential effect. Using a survival analytic approach, it was found that four sessions were necessary for 50% improvement and 16 sessions for 50% recovery. Additionally, depressive symptoms changes occurred significantly faster than interpersonal changes, again regardless of treatment assignment. These results support previous findings of the dose-response literature and of the phase model of change, with the advantage of being specific to psychotherapy with depressive clients.",Lopes RT.; Gonçalves MM.; Fassnacht D.; Machado PP.; Sousa I.,,10.1002/cpp.1873,0,0,
9659,Arthroscopic versus conservative treatment of first anterior dislocation of the shoulder in adolescents.,"Conservative treatment of posttraumatic antero-inferior shoulder instability leads to a high failure rate in a young and active population. However, treatment in an adolescent age group is not well documented. We conducted a prospective study with adolescent patients (age 15 to 18 y) who suffered a first traumatic anterior dislocation of the shoulder. Two groups of patients were formed. The first group was treated with early arthroscopic stabilization and the second was treated conservatively. There were 43 shoulders in the operative group and 29 shoulders in the conservative group. The rehabilitation protocol was the same for both groups. All patients were followed up prospectively after 12, 24, and 36 months using Rowe Score. A total of 38 shoulders in the surgical group and 27 shoulders in the conservative group could be completely evaluated. From the conservative group, 19 patients (70.3%) suffered a recurrence of the instability. From the arthroscopic group, 5 patients (13.1%) suffered a recurrence of the instability. In an adolescent population (15 to 18 y), conservative treatment after first traumatic shoulder dislocation including immobilization in internal rotation leads to a significantly higher and unacceptable high failure rate compared with early arthroscopic stabilization. Level II-prospective comparative study.",Gigis I.; Heikenfeld R.; Kapinas A.; Listringhaus R.; Godolias G.,2014.0,10.1097/BPO.0000000000000108,0,0,
9660,"Testing a model of the relationship between childhood sexual abuse and psychosis in a first-episode psychosis group: the role of hallucinations and delusions, posttraumatic intrusions, and selective attention.","Several theories suggest that posttraumatic intrusive symptoms are central to the relationship between childhood trauma (CT) and hallucinations and delusions in psychosis. Biased selective attention has been implicated as a cognitive process underlying posttraumatic intrusions. The current study sought to test theories of the relationship between childhood sexual abuse (CSA), hallucinations and delusions, posttraumatic intrusions, and selective attention in first-episode psychosis (FEP). Twenty-eight people with FEP and 21 nonclinical controls were assessed for CT and psychotic and posttraumatic stress symptoms and completed an emotional Stroop test using CSA-related and other words. Those with FEP and CSA had more severe hallucinations and delusions than those with FEP and without CSA. They also reported posttraumatic intrusions at clinical levels and showed selective attention to CSA-related words. The results are consistent with the posttraumatic intrusions account of hallucinations and delusions in those with CSA and psychosis.",Bendall S.; Hulbert CA.; Alvarez-Jimenez M.; Allott K.; McGorry PD.; Jackson HJ.,2013.0,10.1097/NMD.0000000000000033,0,0,
9661,Prescriptive variables for d-cycloserine augmentation of exposure therapy for posttraumatic stress disorder.,"In recent years, several studies have demonstrated efficacy of d-cycloserine (DCS) enhanced exposure therapy across anxiety disorders. In this study we examined person-level variables that predicted response to DCS enhanced exposure therapy in a chronic, mixed trauma PTSD sample. The sample consisted of 67 treatment-seeking individuals, randomly allocated to receive exposure therapy augmented with DCS (50 mg) or identical looking placebo. We examined the following baseline predictors of treatment response: (1) demographic characteristics (age, gender, marital status, and education); (2) clinical characteristics (initial PTSD symptom severity, Axis I comorbidity, depression symptom severity, and antidepressants use); (3) personality characteristics (openness, conscientiousness, extraversion, agreeableness, and neuroticism). Outcome was measured with the PTSD Symptom Scale, Self-Report, which was assessed weekly during treatment. Two prescriptive variables were identified: conscientiousness and extraversion. For high conscientious participants, those who received DCS showed better outcome than those who received placebo. And for low extraversion, DCS showed superior outcome relative to placebo. Education was identified as a prognostic variable, it predicted response across both groups: higher education was related to worse outcome. Our results provide support for the influence of personality traits on DCS augmented exposure outcome and give more insight into possible working mechanisms of this novel treatment strategy. Ultimately, this may contribute to treatment matching strategies in order to improve treatment efficacy of exposure therapy for PTSD.",de Kleine RA.; Hendriks GJ.; Smits JA.; Broekman TG.; van Minnen A.,2014.0,10.1016/j.jpsychires.2013.10.008,0,0,
9662,Long-term stability of cognitive behavioral therapy effects for panic disorder with agoraphobia: a two-year follow-up study.,"Cognitive-behavioral therapy (CBT) aims to help patients establish new behaviors that will be maintained and adapted to the demands of new situations. The long-term outcomes are therefore crucial in testing the durability of CBT. A two-year follow-up assessment was undertaken on a subsample of n = 146 PD/AG patients from a multicenter randomized controlled trial. Treatment consisted of two variations of CBT: exposure in situ in the presence of the therapist (T+) or on their own following therapist preparation (T-). Both variations of CBT had high response rates and, overall, maintained the level of symptomatology observed at post-treatment with high levels of clinical significance. Effect sizes 24 months following treatment were somewhat lower than at the 6-month follow up. Once patients reached responder status, they generally tended to remain responders at subsequent assessments. Differences were observed for patients that obtained additional treatment during the follow-up period. Expert opinion and subjective appraisal of treatment outcome differed. No robust baseline predictors of 2-year outcome were observed. Most patients maintain clinically meaningful changes two years following treatment across multiple outcome measures. Approximately 1/3 of patients continued to experience meaningful residual problems.",Gloster AT.; Hauke C.; Höfler M.; Einsle F.; Fydrich T.; Hamm A.; Sthröhle A.; Wittchen HU.,2013.0,10.1016/j.brat.2013.09.009,0,0,
9663,Timing matters: change depends on the stage of treatment in cognitive behavioral therapy for panic disorder with agoraphobia.,"The mechanisms of action underlying treatment are inadequately understood. This study examined 5 variables implicated in the treatment of panic disorder with agoraphobia (PD/AG): catastrophic agoraphobic cognitions, anxiety about bodily sensations, agoraphobic avoidance, anxiety sensitivity, and psychological flexibility. The relative importance of these process variables was examined across treatment phases: (a) psychoeducation/interoceptive exposure, (b) in situ exposure, and (c) generalization/follow-up. Data came from a randomized controlled trial of cognitive behavioral therapy for PD/AG (n = 301). Outcomes were the Panic and Agoraphobia Scale (Bandelow, 1995) and functioning as measured in the Clinical Global Impression scale (Guy, 1976). The effect of process variables on subsequent change in outcome variables was calculated using bivariate latent difference score modeling. Change in panic symptomatology was preceded by catastrophic appraisal and agoraphobic avoidance across all phases of treatment, by anxiety sensitivity during generalization/follow-up, and by psychological flexibility during exposure in situ. Change in functioning was preceded by agoraphobic avoidance and psychological flexibility across all phases of treatment, by fear of bodily symptoms during generalization/follow-up, and by anxiety sensitivity during exposure. The effects of process variables on outcomes differ across treatment phases and outcomes (i.e., symptomatology vs. functioning). Agoraphobic avoidance and psychological flexibility should be investigated and therapeutically targeted in addition to cognitive variables.",Gloster AT.; Klotsche J.; Gerlach AL.; Hamm A.; Ströhle A.; Gauggel S.; Kircher T.; Alpers GW.; Deckert J.; Wittchen HU.,2014.0,10.1037/a0034555,0,0,
9664,Patterns of therapeutic alliance: rupture-repair episodes in prolonged exposure for posttraumatic stress disorder.,"To better understand the role of therapeutic alliance in posttraumatic stress disorder (PTSD) treatment, we examined patterns of and shifts in alliance. First, we identified individuals with repaired ruptures, unrepaired ruptures, and no ruptures in alliance. Then, we explored group differences in these alliance events for clients with common clinical correlates (i.e., co-occurring depression and childhood abuse history) and whether or not the presence of these events influenced treatment outcome. At pretreatment, clients (N = 116)-76.1% female, 66% Caucasian, age M = 36.7 years (SD = 11.3)--completed measures assessing PTSD diagnosis and severity (PTSD Symptom Scale Interview and Self-Report), depression diagnosis and severity (Structured Clinical Interview for DSM-IV and Beck Depression Inventory), and trauma history. During 10 weeks of prolonged exposure therapy, alliance (California Psychotherapy Alliance Scale) measures were completed. At posttreatment, PTSD and depression were reassessed. Ruptures in alliance were quite common (46%). No significant differences emerged in the frequency of repaired ruptures, unrepaired ruptures, or no ruptures between those with and without co-occurring major depressive disorder, χ²(2, N = 82) = 2.69, p = .26, or those with and without a history of childhood abuse, χ²(2, N = 81) = 0.57, p = .75. Unrepaired ruptures predicted worse treatment outcome (β = .44, p = .001). The current study underscores the importance of attending to discontinuities in alliance throughout treatment.",McLaughlin AA.; Keller SM.; Feeny NC.; Youngstrom EA.; Zoellner LA.,2014.0,10.1037/a0034696,0,0,
9665,Embodied terror management: interpersonal touch alleviates existential concerns among individuals with low self-esteem.,"Individuals with low (rather than high) self-esteem often struggle with existential concerns. In the present research, we examined whether these existential concerns may be alleviated by seemingly trivial experiences of both real and simulated interpersonal touch. A brief touch on the shoulder by a female experimenter led individuals with low self-esteem to experience less death anxiety (Study 1) and more social connectedness after a death reminder (Study 2). Reminding individuals with low self-esteem of death increased their desire for touch, as indicated by higher value estimates of a teddy bear, a toy animal that simulates interpersonal touch (Study 3). Finally, holding a teddy bear (vs. a cardboard box) led individuals with low self-esteem to respond to a death reminder with less defensive ethnocentrism (Study 4). Individuals with high self-esteem were unaffected by touch (Studies 1-4). These findings highlight the existential significance of embodied touch experiences, particularly for individuals with low self-esteem.",Koole SL.; Tjew A Sin M.; Schneider IK.,2014.0,10.1177/0956797613483478,0,0,
9666,The SCIentinel study--prospective multicenter study to define the spinal cord injury-induced immune depression syndrome (SCI-IDS)--study protocol and interim feasibility data.,"Infections are the leading cause of death in the acute phase following spinal cord injury and qualify as independent risk factor for poor neurological outcome (""disease modifying factor""). The enhanced susceptibility for infections is not stringently explained by the increased risk of aspiration in tetraplegic patients, neurogenic bladder dysfunction, or by high-dose methylprednisolone treatment. Experimental and clinical pilot data suggest that spinal cord injury disrupts the balanced interplay between the central nervous system and the immune system. The primary hypothesis is that the Spinal Cord Injury-induced Immune Depression Syndrome (SCI-IDS) is 'neurogenic' including deactivation of adaptive and innate immunity with decreased HLA-DR expression on monocytes as a key surrogate parameter. Secondary hypotheses are that the Immune Depression Syndrome is i) injury level- and ii) severity-dependent, iii) triggers transient lymphopenia, and iv) causes qualitative functional leukocyte deficits, which may endure the post-acute phase after spinal cord injury. SCIentinel is a prospective, international, multicenter study aiming to recruit about 118 patients with acute spinal cord injury or control patients with acute vertebral fracture without neurological deficits scheduled for spinal surgery. The assessment points are: i) <31 hours, ii) 31-55 hours, iii) 7 days, iv) 14 days, and v) 10 weeks post-trauma. Assessment includes infections, concomitant injury, medication and neurological classification using American Spinal Injury Association impairment scale (AIS) and neurological level. Laboratory analyses comprise haematological profiling, immunophenotyping, including HLA-DR expression on monocytes, cytokines and gene expression of immune modulators. We provide an administrative interim analysis of the recruitment schedule of the trial. The objectives are to characterize the dysfunction of the innate and adaptive immune system after spinal cord injury and to explore its proposed 'neurogenic' origin by analyzing its correlation with lesion height and severity. The trial protocol considers difficulties of enrolment in an acute setting, and loss to follow up. The administrative interim analysis confirmed the feasibility of the protocol. Better understanding of the SCI-IDS is crucial to reduce co-morbidities and thereby to attenuate the impact of disease modifying factors to protect neurological ""outcome at risk"". This putatively results in improved spinal cord injury medical care. DRKS00000122 (German Clinical Trials Registry).",Kopp MA.; Druschel C.; Meisel C.; Liebscher T.; Prilipp E.; Watzlawick R.; Cinelli P.; Niedeggen A.; Schaser KD.; Wanner GA.; Curt A.; Lindemann G.; Nugaeva N.; Fehlings MG.; Vajkoczy P.; Cabraja M.; Dengler J.; Ertel W.; Ekkernkamp A.; Martus P.; Volk HD.; Unterwalder N.; Kölsch U.; Brommer B.; Hellmann RC.; Saidy RR.; Laginha I.; Prüss H.; Failli V.; Dirnagl U.; Schwab JM.,2013.0,10.1186/1471-2377-13-168,0,0,
9667,Attention bias modification for reducing speech anxiety.,"The mechanisms mediating the anxiolytic effects of attention bias modification (ABM) remain unclear. Accordingly, we randomly assigned speech-anxious subjects to receive four sessions of one of three training conditions: ABM, inverse ABM, and control. In the ABM condition, subjects viewed pairs of photographs of models displaying facial expressions of disgust and joy on a computer screen. Probes always replaced the positive face, and subjects pushed a button to indicate the identity of the probe (E or F) as rapidly as possible. In the inverse condition, the probes always replaced the negative face, and in the control condition, the probes replaced each face type equally often. After four training sessions, all groups exhibited statistically indistinguishable, but significant, reductions on self-report, behavioral, and physiological measures of speech anxiety. Self-report and behavioral measures of attentional control improved likewise. Contrary to early studies, ABM was not superior to control procedures in producing reductions on measures of social anxiety.",McNally RJ.; Enock PM.; Tsai C.; Tousian M.,2013.0,10.1016/j.brat.2013.10.001,0,0,
9668,The implementation of an analgesia-based sedation protocol reduced deep sedation and proved to be safe and feasible in patients on mechanical ventilation.,"Deep sedation in critically ill patients is associated with a longer duration of mechanical ventilation and a prolonged length of stay in the intensive care unit. Several protocols have been used to improve these outcomes. We implement and evaluate an analgesia-based, goal-directed, nurse-driven sedation protocol used to treat critically ill patients who receive mechanical ventilation. We performed a prospective, two-phase (before-after), non-randomized multicenter study that involved 13 intensive care units in Chile. After an observational phase (observational group, n=155), we designed, implemented and evaluated an analgesia-based, goal-directed, nurse-driven sedation protocol (intervention group, n=132) to treat patients who required mechanical ventilation for more than 48 hours. The primary outcome was to achieve ventilator-free days by day 28. The proportion of patients in deep sedation or in a coma decreased from 55.2% to 44.0% in the interventional group. Agitation did not change between the periods and remained approximately 7%. Ventilator-free days to day 28, length of stay in the intensive care unit and mortality were similar in both groups. At one year, post-traumatic stress disorder symptoms in survivors were similar in both groups. We designed and implemented an analgesia-based, goal-directed, nurse-driven sedation protocol in Chile. Although there was no improvement in major outcomes, we observed that the present protocol was safe and feasible and that it resulted in decreased periods of deep sedation without increasing agitation.",Bugedo G.; Tobar E.; Aguirre M.; Gonzalez H.; Godoy J.; Lira MT.; Lora P.; Encalada E.; Hernandez A.; Tomicic V.; Castro J.; Jara J.; Andresen M.; Ugarte H.,,10.5935/0103-507X.20130034,0,0,
9669,D-cycloserine augmentation of exposure therapy for post-traumatic stress disorder: a pilot randomized clinical trial.,"Viewing post-traumatic stress disorder (PTSD) as a disorder of emotional learning, this study used a cognitive enhancer synergistically with virtual reality exposure (VRE) therapy for the treatment of PTSD. The main objective was to determine if a novel pharmacotherapy, D-cycloserine (DCS), enhanced the efficacy of the psychotherapy. Pre-clinical studies suggest that when fear extinction occurs during DCS administration, neuroplasticity may be enhanced. VRE therapy is a particularly promising format to test the hypothesis that DCS enhances extinction learning, as sensory fear cues are standardized across patients. In a pilot randomized, double-blind, placebo-controlled trial, 100‚Äâmg of DCS or placebo was administered 90‚Äâmin before each weekly VRE session, to ensure peak plasma concentrations during the sessions in 25 patients with chronic PTSD. The primary outcome measure was the Clinician Administered PTSD Scale (CAPS). Secondary outcome measures included the Beck Depression Inventory-II and the State-Trait Anger Expression Inventory-2. Assessments occurred at pre-treatment, following sessions 3, 6, 10, post-treatment, and at 6 months. The difference in CAPS between the VRE-DCS (n=13) and VRE-placebo (n=12) groups increased over time beginning at 6 weeks, with medium to large between-group effect sizes immediately post-treatment and 6 months later (d=0.68 and d=1.13, respectively). A similar pattern was observed for depression, anger expression, and sleep. PTSD remission rates were significantly greater for the VRE-DCS group (46% vs 8% at post-treatment; 69% vs 17% at 6 months). Patients in the VRE-DCS group showed earlier and greater improvement in PTSD symptoms compared with the VRE-placebo group. These results suggest a promising new treatment for PTSD.",Difede J.; Cukor J.; Wyka K.; Olden M.; Hoffman H.; Lee FS.; Altemus M.,2014.0,10.1038/npp.2013.317,0,0,
9670,The acceptability and outcomes of a peer- and health-professional-led Stanford self-management program for Vietnam veterans with alcohol misuse and their partners.,"The purpose of this study was to determine the acceptability of peer- and health-professional-led self-management education using the Stanford Program with Australian veterans and their partners. The 6-week program taught problem-solving and decision-making skills to activate healthful behaviors, including action-planning and goal-setting. The evaluation included a participant and facilitator postprogram questionnaire; group interview; and alcohol, posttraumatic stress disorder, anxiety, depression, anger, relationship, and quality-of-life measures as part of a randomized controlled study. Participants included 25 male veterans with comorbid alcohol dependency, psychiatric and medical conditions, and 18 female partners (n = 43), 61.5% of who reported a chronic condition. The primary outcome was a self-reported improvement in self-management of their conditions in 69% of participants, with another 22.2% reporting that their confidence to self-manage had improved. There was an improvement in all measures at 9 months. The program resulted in improvements in lifestyle and confidence in self-management for Vietnam veterans, a cohort difficult to engage in healthy behaviors. Most participants were also accompanied by their partners. The program is a valuable resource for providing self-management education to veterans with alcohol dependency and various chronic conditions and needs to be considered in the suite of rehabilitation programs available to Defense Force personnel, veterans, and their partners.",Beattie J.; Battersby MW.; Pols RG.,2013.0,10.1037/prj0000031,0,0,
9671,Predictors and moderators of internet- and group-based cognitive behaviour therapy for panic disorder.,"Internet-based cognitive behaviour therapy (ICBT) can be equally effective as traditional face-to-face cognitive behaviour therapy (CBT) for treating panic disorder (PD). However, little is known about the predictors and moderators of outcome of ICBT when delivered in psychiatric outpatient settings. This study investigated a selection of outcome predictors and moderators of ICBT for panic disorder based on data from a randomised controlled trial where therapist-guided ICBT was compared with group CBT (GCBT) for panic disorder. Participants (N = 104) received 10 weeks of ICBT or GCBT and were assessed before and after treatment, and after six months. Multiple regression analyses were used to test for significant predictors of treatment outcome. Predictors of positive treatment response for both modalities were having low levels of symptom severity and work impairment. In addition, anxiety sensitivity was found to have a small negative relationship with treatment outcome, suggesting that anxiety sensitivity may slightly enhance treatment response. Treatment modality had a moderating effect on the relationship between domestic impairment and outcome and on the relationship between initial age of onset of panic symptoms and treatment outcome, favouring ICBT for patients having had an early onset of PD symptoms and for patients having a high domestic functional impairment. These results suggest that both ICBT and GCBT are effective treatment modalities for PD and that it is possible to predict a significant proportion of the long-term outcome variance based on clinical variables.",El Alaoui S.; Hedman E.; Ljótsson B.; Bergström J.; Andersson E.; Rück C.; Andersson G.; Lindefors N.,2013.0,10.1371/journal.pone.0079024,0,0,
9672,"Integrated care for comorbid alcohol dependence and anxiety and/or depressive disorder: study protocol for an assessor-blind, randomized controlled trial.","A major barrier to successful treatment in alcohol dependence is psychiatric comorbidity. During treatment, the time to relapse is shorter, the drop-out rate is increased, and long-term alcohol consumption is greater for those with comorbid major depression or anxiety disorder than those with an alcohol use disorder with no comorbid mental disorder. The treatment of alcohol dependence and psychological disorders is often the responsibility of different services, and this can hinder the treatment process. Accordingly, there is a need for an effective integrated treatment for alcohol dependence and comorbid anxiety and/or depression. We aim to assess the effectiveness of a specialized, integrated intervention for alcohol dependence with comorbid anxiety and/or mood disorder using a randomized design in an outpatient hospital setting. Following a three-week stabilization period (abstinence or significantly reduced consumption), participants will undergo complete formal assessment for anxiety and depression. Those patients with a diagnosis of an anxiety and/or depressive disorder will be randomized to either 1) integrated intervention (cognitive behavioral therapy) for alcohol, anxiety, and/or depression; or 2) usual counseling care for alcohol problems. Patients will then be followed up at weeks 12, 16, and 24. The primary outcome measure is alcohol consumption (total abstinence, time to lapse, and time to relapse). Secondary outcome measures include changes in alcohol dependence severity, depression, or anxiety symptoms and changes in clinician-rated severity of anxiety and depression. The study findings will have potential implications for clinical practice by evaluating the implementation of specialized integrated treatment for comorbid anxiety and/or depression in an alcohol outpatient service. ClinicalTrials.gov Identifier: NCT01941693.",Morley KC.; Baillie A.; Sannibale C.; Teesson M.; Haber PS.,2013.0,10.1186/1940-0640-8-19,0,0,
9673,Internet-based exposure treatment versus one-session exposure treatment of snake phobia: a randomized controlled trial.,"In this study, the authors compared guided Internet-delivered self-help with one-session exposure treatment (OST) in a sample of snake phobic patients. A total of 30 patients were included following a screening on the Internet and a structured clinical interview. The Internet treatment consisted of four weekly text modules which were presented on a web page, a video in which exposure was modelled, and support provided via Internet. The OST was delivered in a three-hour session following a brief orientation session. The main outcome was the behavioural approach test (BAT), and as secondary measures questionnaires measuring anxiety symptoms and depression were used. Results showed that the groups did not differ at post-treatment or follow-up, with the exception of a significant interaction for the BAT in favour of the OST. At post-treatment, 61.5% of the Internet group and 84.6% of the OST group achieved a clinically significant improvement on the BAT. At follow-up, the corresponding figures were 90% for the Internet group and 100% for the OST group (completer sample). Within-group effect sizes for the Snake Phobia Questionnaire were large (d = 1.63 and d = 2.31 for the Internet and OST groups, respectively, at post-treatment). It is concluded that guided Internet-delivered exposure treatment is a potential treatment option in the treatment of snake phobia, but that OST probably is better.",Andersson G.; Waara J.; Jonsson U.; Malmaeus F.; Carlbring P.; Ost LG.,2013.0,10.1080/16506073.2013.844202,0,0,
9674,Prediction of symptomatic improvement after exposure-based treatment for irritable bowel syndrome.,"Several studies show that psychological treatments relieve symptoms for patients suffering from irritable bowel syndrome (IBS). However, there are no consistent findings that show what patient characteristics make a psychological treatment more or less likely to result in improvement. We have previously conducted a study of a newly developed internet-delivered cognitive behavioral therapy (ICBT) that emphasized exposure to IBS symptoms and IBS-related situations and reduced symptom-related avoidance. The study showed that the treatment led to improvement in IBS symptoms compared to a waiting list and that treatment gains were maintained over a 15-18 month follow-up period. The aim of the present study was to investigate several possible predictors of short- and long-term treatment outcome in terms of symptom improvement, based on data collected in the previously conducted treatment trial. Demographics, comorbid psychological distress, IBS-related fear and avoidance behaviors, and IBS-related disability were investigated as predictors of treatment outcome in the sample consisting of 79 participants diagnosed with IBS who had undergone 10 weeks of ICBT. Predictors that were significantly correlated with symptom levels at post-treatment and follow-up were entered into multiple regression analyses that controlled for pre-treatment symptom levels. There were measures within each domain, i.e., comorbid psychological distress, IBS-related fear and avoidance behaviors, and IBS-related disability, with the exception of demographic data, that were correlated with the symptom levels at post-treatment and follow-up. However, when these were entered into a multiple regression analyses that controlled for pre-treatment levels, none remained a significant predictor of the post-treatment and follow-up symptomatic status. The study did not find any individual characteristics that made patients more or less likely to respond to the exposure-based ICBT. The finding that comorbid psychological distress did not predict outcome is in accordance with previous studies. Reliable predictors for response to any type of psychological treatment for IBS remain to be established.",Ljótsson B.; Andersson E.; Lindfors P.; Lackner JM.; Grönberg K.; Molin K.; Norén J.; Romberg K.; Andersson E.; Hursti T.; Hesser H.; Hedman E.,2013.0,10.1186/1471-230X-13-160,0,0,
9675,[LUCL reconstruction using a triceps tendon graft to treat posterolateral rotatory instability of the elbow].,"Re-establishment of radial stability within the elbow joint in cases of arthroscopically or clinically confirmed posterolateral rotatory instability. Posttraumatic or chronic degenerative posterolateral rotatory instability at least grade I-II according to O'Driscoll. Elbow stiffness or elbow arthritis and lateral epicondylitis, if a posterolateral rotatory instability has been excluded as the reason for the symptoms. Reconstruction or augmentation of the insufficient lateral ulnar collateral ligament (LUCL) with an autologous triceps tendon graft. A stripe of the triceps tendon is fixed at the epicondylus humeri radialis and at the base of the annular ligament at the proximal radial ulna with tenodesis screws or buttons, then the extensor origins, which were detached before are fixated as well. Postoperative treatment with an elbow orthesis for 6 weeks, in the first 4 weeks limitation of complete extension and flexion, full weight bearing after 3 months. Retrospective analysis of 47 LUCL reconstructions from 2008-2010 with good results concerning pain reduction and acceptance, improvement of the Mayo Elbow Performance Score from 49 to 82, low complication rate with one elbow stiffness, one temporary ulnar nerve lesion, and one recurrent instability.",Dehlinger FI.; Ries C.; Hollinger B.,2014.0,10.1007/s00064-012-0182-7,0,0,
9676,Genetic polymorphisms in monoamine systems and outcome of cognitive behavior therapy for social anxiety disorder.,"The role of genetics for predicting the response to cognitive behavior therapy (CBT) for social anxiety disorder (SAD) has only been studied in one previous investigation. The serotonin transporter (5-HTTLPR), the catechol-o-methyltransferase (COMT) val158met, and the tryptophan hydroxylase-2 (TPH2) G-703T polymorphisms are implicated in the regulation of amygdala reactivity and fear extinction and therefore might be of relevance for CBT outcome. The aim of the present study was to investigate if these three gene variants predicted response to CBT in a large sample of SAD patients. Participants were recruited from two separate randomized controlled CBT trials (trial 1: n = 112, trial 2: n = 202). Genotyping were performed on DNA extracted from blood or saliva samples. Effects were analyzed at follow-up (6 or 12 months after treatment) for both groups and for each group separately at post-treatment. The main outcome measure was the Liebowitz Social Anxiety Scale Self-Report. At long-term follow-up, there was no effect of any genotype, or gene × gene interactions, on treatment response. In the subsamples, there was time by genotype interaction effects indicating an influence of the TPH2 G-703T-polymorphism on CBT short-term response, however the direction of the effect was not consistent across trials. None of the three gene variants, 5-HTTLPR, COMTval158met and TPH2 G-703T, was associated with long-term response to CBT for SAD. ClinicalTrials.gov (ID-NCT0056496).",Andersson E.; Rück C.; Lavebratt C.; Hedman E.; Schalling M.; Lindefors N.; Eriksson E.; Carlbring P.; Andersson G.; Furmark T.,2013.0,10.1371/journal.pone.0079015,0,0,
9677,Cognitive-behavioural therapy with post-session D-cycloserine augmentation for paediatric obsessive-compulsive disorder: pilot randomised controlled trial.,"A partial N-methyl-D-aspartate agonist, D-cycloserine, enhances fear extinction when given before or shortly after exposure to feared stimuli in animals. In this pilot double-blind placebo-controlled trial (trial number: ISRCTN70977225), 27 youth with obsessive-compulsive disorder were randomised to either 50 mg D-cycloserine or placebo administered immediately after each of ten cognitive-behavioural therapy (CBT) sessions, primarily consisting of exposure and ritual prevention. Both groups improved significantly and maintained their gains at 1-year follow-up, with no significant advantage of D-cycloserine over placebo at any time point. The effects of CBT may not be augmented or accelerated when D-cycloserine is administered after sessions.",Mataix-Cols D.; Turner C.; Monzani B.; Isomura K.; Murphy C.; Krebs G.; Heyman I.,2014.0,10.1192/bjp.bp.113.126284,0,0,
9678,Association between maternal behavior in infancy and adult mental health: a 30-year prospective study.,"Existing theories suggest that the mother-infant relationship has a potentially significant effect on long-term adult mental health, but there are few empirical data to support this view. Even fewer prior studies have examined the specific dynamics of the mother-infant relationship and their association with adult mental health. A total of 1752 inner-city infants born between 1960 and 1965 were followed prospectively as a part of the Collaborative Perinatal Project (CPP) and the Johns Hopkins Pathways to Adulthood Study. Multiple observations of development and an extensive adult interview were performed. Maternal behavior was observed and systematically rated at the infant's 4-month pediatric neurological evaluation and at 8 months by a developmental psychologist. Factor analysis was used to organize the maternal behavior variables into different types of dysfunctional mother-infant relationships. Adult mental health was assessed at the follow-up interview, when the infant had reached the age of 27-33 years, by the General Health Questionnaire (GHQ) and self-perception of current mental health. There was a significant association between unsupportive maternal behavior at 8 months and subsequent poor adult mental health (Fisher's exact test, p=0.026). There was no association between overly involved maternal behavior and poor mental health as an adult. After adjustment for potential confounding variables, the elevated rates of poor adult mental health in children of mothers who exhibited unsupportive maternal behavior at 8 months persisted (OR=1.41 [95% CI=1.00-1.97], p<0.05). Infants who experience unsupportive maternal behavior at 8 months have an increased risk for developing psychological sequelae later in life.",Fan AP.; Buka SL.; Kosik RO.; Chen YS.; Wang SJ.; Su TP.; Eaton WW.,2014.0,10.1016/j.comppsych.2013.08.024,0,0,
9679,[Ankle arthrodesis with an posterolateral approach using a polyaxial angle stable Talarlock® plate].,"Safe arthrodesis of the ankle as well as load carrying capacity free of pain. Painful arthritis of the ankle joint occurring idiopathic or posttraumatic, resulting from rheumatoid arthritis or neuromuscular diseases. Extensive bony defects in varus or valgus ankle deformities and after failed prosthesis. Complex hindfoot deformities in neurological disease, paralysis and instabilities. Joint destruction after infection. Active osteitis, extensive skin ulcers in the approach area, periphery artery occlusive disease. Posterolateral skin incision. Sparing cartilage resection. Penetrating sclerosis zones. Reorientating anatomic positioning of the talus thereby correcting axis deformities. Talarlock(®) plate positioning and tibiotalar arthrodesis. Full weight bearing in an arthodesis boot for 6 weeks. After bone grafting partial weight bearing (20 kg) in an arthrodesis boot for 8 weeks. Full weight bearing after 10weeks. Ten patients were operated on using this procedure. The follow-up time was 1 year. There were no complications requiring further surgical procedures. Ankle fusion and a good clinical outcome could be achieved in all cases.",Gutteck N.; Lebek S.; Zeh A.; Gradl G.; Delank KS.; Wohlrab D.,2013.0,10.1007/s00064-013-0253-4,0,0,
9680,Properties of the Driving Behavior Survey among individuals with motor vehicle accident-related posttraumatic stress disorder.,"Data suggest anxious drivers may engage in problematic behaviors that place themselves and others at increased risk of negative traffic events. Three domains of problematic behavior--exaggerated safety/caution, performance deficits, and hostile/aggressive behaviors--previously were identified during development of the Driving Behavior Survey (DBS), a novel measure of anxiety-related behavior. Extending this research, the current study examined the psychometric properties of DBS scores among individuals with posttraumatic stress disorder (PTSD) subsequent to motor vehicle trauma (N=40). Internal consistencies and 12-week test-retest reliabilities for DBS scales ranged from good to excellent. Comparison of scores to normative student data indicated dose-response relationships for safety/caution and performance deficit subscales, with increased frequency of anxious behavior occurring within the PTSD sample. Associations with standard clinical measures provide additional evidence for anxiety-related driving behavior as a unique marker of functional impairment, distinct from both avoidance and disorder-specific symptoms.",Clapp JD.; Baker AS.; Litwack SD.; Sloan DM.; Beck JG.,2014.0,10.1016/j.janxdis.2013.10.008,0,0,
9681,Left hemispheric lateral preference and high neuroticism predict disinhibition in two go/no-go experiments.,"Although disinhibition is widely implicated in impulse-control-related psychopathologies, debate remains regarding the underlying approach and avoidance processes of this construct. In two studies, we simultaneously tested three competing models in which varying levels of extraversion, neuroticism, and hemispheric lateral preference are associated with disinhibition. In both studies (Study 1, N‚Äâ=‚Äâ92; Study 2, N‚Äâ=‚Äâ124), undergraduate students were randomly allocated to one of two versions of the go/no-go task: one where participants were primed through reward to make more ""go"" responses and another where no such priming occurred. Neuroticism, extraversion, and hemispheric lateral preference measures were also collected. Across both studies, disinhibition was greatest in individuals who reported both a left hemispheric lateral preference and high neuroticism. This pattern was only found for those who were primed through reward to make more ""go"" responses. There was no association with extraversion. Contrary to previous research, our results suggest that left hemispheric asymmetry and neuroticism and not extraversion drive disinhibited approach, following the establishment of a prepotent approach response set. This has salient implications for the theoretical understanding of disinhibited behavior, as well as for the study of continued maladaptive approach behavior.",Gardiner E.; Jackson CJ.; Loxton NJ.,2015.0,10.1111/jopy.12084,0,0,
9682,The effect of social anxiety on urge and craving among smokers with and without anxiety disorders.,"Despite the often social nature of smoking, relatively little research has been conducted on the relationship between smoking and social anxiety disorder (SAD). Participants (N=99) included 34 smokers without current mental health disorders, 37 smokers with SAD, and 28 smokers who met criteria for other anxiety disorder diagnoses (e.g., panic disorder or generalized anxiety disorder, but not SAD). Nicotine and placebo patches were administered to participants in a counterbalanced manner across two assessment days. Urge and craving were assessed before and after a 5-h nicotine absorption/deprivation period. Compared to smokers without current mental health disorders, smokers with SAD did not report greater nicotine dependence, but did endorse greater motivation to use nicotine to avoid negative outcomes. In addition, after controlling for demographic variables, smoking characteristics, pre-deprivation urge and craving, and other anxiety/depression symptoms, social anxiety symptoms uniquely predicted urge and craving in the placebo patch condition; however, social anxiety had no influence on urge and craving in the nicotine patch condition. These findings suggest that one potential reason that smokers with SAD may have worse cessation outcomes is that they may experience higher levels of craving and urge to smoke during quit attempts. Thus, during a quit attempt, particularly in the absence of nicotine replacement therapy, smokers with SAD are likely to benefit from additional treatment aimed at managing or reducing their social anxiety symptoms.",Kimbrel NA.; Morissette SB.; Gulliver SB.; Langdon KJ.; Zvolensky MJ.,2014.0,10.1016/j.drugalcdep.2013.11.002,0,0,
9683,Biological explanations of generalized anxiety disorder: effects on beliefs about prognosis and responsibility.,"Biological explanations of psychopathology can reduce the extent to which people with mental disorders are blamed for their symptoms but can also yield prognostic pessimism--the belief that psychiatric conditions are relatively immutable. However, few studies have examined whether these effects occur among persons who actually have psychiatric symptoms. This study sought to address this question. Adults living in the United States (N=351) were recruited online in January and February 2012 and assessed for symptoms of generalized anxiety disorder. The participants were randomly assigned to two groups: a biological condition, in which participants (N=176) were provided a description of generalized anxiety disorder and a biological explanation of the etiology of the disorder, and a control condition, in which participants (N=175) were provided the same description without any explanation of etiology. Dependent measures of treatability, duration of symptoms, and responsibility for symptoms were used to gauge beliefs regarding the prognosis and personal responsibility of a typical person with generalized anxiety disorder. Among participants with and without symptoms of generalized anxiety disorder, the biological condition was associated with decreased ascriptions of personal responsibility for anxiety (p=.02) and expectations of increased duration of symptoms of generalized anxiety disorder (p=.01). This finding has important social and clinical implications, especially because biological conceptualizations of psychopathology are increasingly prevalent. By causing prognostic pessimism about generalized anxiety disorder, including among those with symptoms of the disorder, biological explanations could negatively affect treatment seeking and outcomes. Efforts to dispel the link between biological explanations and prognostic pessimism are needed.",Lebowitz MS.; Pyun JJ.; Ahn WK.,2014.0,10.1176/appi.ps.201300011,0,0,
9684,[Effects of interdisciplinary functional restoration treatment with cognitive behavior therapy in patients with chronic back pain: healthcare research in the context of selective contracts].,"The efficacy of functional restoration programs for the treatment of chronic back pain is well documented. Nevertheless, there are only a few such centres in Germany and few trials have been conducted in German-speaking regions to demonstrate that implementing such programs in everyday clinical settings with large numbers of patients is just as effective as in a research setting. The present study examined whether the positive effects of such programs can also be observed in the clinically relevant context of a standardized day clinic treatment regimen. A total of 681 back pain patients in 2 German cities were examined at 4 measurement points (before and immediately after the program, as well as 6 and 12 months after treatment) using a comprehensive questionnaire on perceived pain and symptoms of anxiety and depression, as well as the work situation. In both cities significant and long-term improvements in back pain, pain-related impairment and degree of chronification were observed, as well as a high return-to-work rate after treatment. Hence, the quality of such programs was also confirmed for a large patient population.",Hafenbrack K.; Heinrich M.; Müller G.; Marnitz U.; Mallwitz J.; Klinger R.,2013.0,10.1007/s00482-013-1377-z,0,0,6382
9685,[Evaluation of the German new back school: pain-related and psychological characteristics].,"Results related to the outcome of the classical back schools are inconsistent. Accordingly, a reformulation of the program integrating psychological and social aspects was performed as a necessary step for the development of the new back school in Germany. The aim of this study was to assess the effectiveness and sustainability of the new back school in subjects with non-specific back pain in the prevention setting. In a modified waiting design, individuals were investigated with respect to demographical, pain-related and psychological characteristics 3 months before the start, at the start and at the end of the back school and as well as 12 months after completion. In addition, predictors for a successful participation were analyzed. A total of 88 subjects with back pain initially participated in the study. In the short and long-term course, low to moderate effects were detected; however, during follow-up a reduction of pain showed high effects. Depression as assessed by the hospital anxiety and depression scale (HADS) and passive coping strategies assessed using the coping strategies questionnaire (CSQ) were identified as predictors for response to the intervention. On the basis of the sample studied, the new back school proved to be an effective treatment for short and long-term reduction of pain-related stress and associated psychological aspects. Maladaptive, passive coping strategies and higher depression scores were associated with a higher probability of success in terms of pain reduction and functional improvement.",Borys C.; Nodop S.; Tutzschke R.; Anders C.; Scholle HC.; Strauß B.,2013.0,10.1007/s00482-013-1370-6,0,0,
9686,Perceived social support mediates anxiety and depressive symptom changes following primary care intervention.,"The current study tested whether perceived social support serves as a mediator of anxiety and depressive symptom change following evidence-based anxiety treatment in the primary care setting. Gender, age, and race were tested as moderators. Data were obtained from 1004 adult patients (age M = 43, SD = 13; 71% female; 56% White, 20% Hispanic, 12% Black) who participated in a randomized effectiveness trial (coordinated anxiety learning and management [CALM] study) comparing evidence-based intervention (cognitive-behavioral therapy and/or psychopharmacology) to usual care in the primary care setting. Patients were assessed with a battery of questionnaires at baseline, as well as at 6, 12, and 18 months following baseline. Measures utilized in the mediation analyses included the Abbreviated Medical Outcomes (MOS) Social Support Survey, the Brief Symptom Index (BSI)-Somatic and Anxiety subscales, and the Patient Health Questionnaire (PHQ-9). There was a mediating effect over time of perceived social support on symptom change following treatment, with stronger effects for 18-month depression than anxiety. None of the mediating pathways were moderated by gender, age, or race. Perceived social support may be central to anxiety and depressive symptom changes over time with evidence-based intervention in the primary care setting. These findings possibly have important implications for development of anxiety interventions.",Dour HJ.; Wiley JF.; Roy-Byrne P.; Stein MB.; Sullivan G.; Sherbourne CD.; Bystritsky A.; Rose RD.; Craske MG.,2014.0,10.1002/da.22216,0,0,
9687,Post-traumatic stress disorder and the outcome of dialectical behaviour therapy for borderline personality disorder.,"Individuals with borderline personality disorder (BPD) and comorbid post-traumatic stress disorder (PTSD) have a worse prognosis than individuals with BPD alone. A common view is that the emotional instability and impulsivity of BPD should be treated before attempting to address trauma. However, PTSD symptoms may interfere with patients' ability to benefit from such 'stabilizing' treatments. The effect of BPD-PTSD comorbidity on self-harm and BPD symptom outcomes was evaluated in 89 patients receiving dialectical behaviour therapy, using multilevel modelling. Patients with comorbid BPD-PTSD showed a trend towards elevated BPD symptoms throughout the treatment year (β = 2.12, 95% CI = -0.21-4.44, p = 0.07). There was a three-way interaction between PTSD comorbidity, treatment completion and time, whereby PTSD comorbidity was associated with less reduction in self-harm frequency over time, but only in those completing the full 12 months of treatment (incident risk ratio = 1.16, 95% CI = 1.04-1.30, p < 0.01). Patients with comorbid PTSD had a poorer outcome from dialectical behaviour therapy than those with BPD alone, possibly because of the negative impact of unaddressed trauma. The results provide further grounds for recently developed treatments targeting BPD traits and PTSD symptoms simultaneously.",Barnicot K.; Priebe S.,2013.0,10.1002/pmh.1227,0,0,
9688,"A randomized, placebo-controlled trial of N-acetylcysteine plus imaginal desensitization for nicotine-dependent pathological gamblers.","Pathological gambling is associated with elevated proportions of nicotine dependence, and tobacco smoking in pathological gamblers has been associated with increased problem-gambling severity. This study examined the addition of N-acetylcysteine to imaginal desensitization in adults with co-occurring nicotine dependence and pathological gambling. Twenty-eight individuals with co-occurring DSM-IV nicotine dependence and pathological gambling who were receiving behavioral therapy were recruited from December 2009 to February 2012 and randomized to augmentation with N-acetylcysteine or placebo in an 12-week, double-blind trial. Subjects were assessed with measures of nicotine and gambling severity and followed for 3 months after treatment. The primary outcomes were the Fagerström Test for Nicotine Dependence and the pathological gambling adaptation of the Yale-Brown Obsessive-Compulsive Scale. During the first 6 weeks, there was a significant benefit of N-acetylcysteine treatment versus placebo on Fagerström Test for Nicotine Dependence total scores (t = -2.224; P = .031). After the initial 6 weeks, all subjects significantly (P < .001) benefited from imaginal desensitization. During the 3-month follow-up, there was a significant additional benefit for N-acetylcysteine versus placebo on measures of problem-gambling severity (t = 2.069; P = .043). N-acetylcysteine treatment during therapy facilitates long-term application of behavioral therapy techniques once patients are in the community after therapy has been completed. ClinicalTrials.gov identifier: NCT00967005.",Grant JE.; Odlaug BL.; Chamberlain SR.; Potenza MN.; Schreiber LR.; Donahue CB.; Kim SW.,2014.0,10.4088/JCP.13m08411,0,0,
9689,The clinical course over the first year of whiplash associated disorders (WAD): pain-related disability predicts outcome in a mildly affected sample.,"Different recovery patterns are reported for those befallen a whip-lash injury, but little is known about the variability within subgroups. The aims were (1) to compare a self-selected mildly affected sample (MILD) with a self-selected moderately to severely affected sample (MOD/SEV) with regard to background characteristics and pain-related disability, pain intensity, functional self-efficacy, fear of movement/(re)injury, pain catastrophising, post-traumatic stress symptoms in the acute stage (at baseline), (2) to study the development over the first year after the accident for the above listed clinical variables in the MILD sample, and (3) to study the validity of a prediction model including baseline levels of clinical variables on pain-related disability one year after baseline assessments. The study had a prospective and correlative design. Ninety-eight participants were consecutively selected. Inclusion criteria; age 18 to 65 years, WAD grade I-II, Swedish language skills, and subjective report of not being in need of treatment due to mild symptoms. A multivariate linear regression model was applied for the prediction analysis. The MILD sample was less affected in all study variables compared to the MOD/SEV sample. Pain-related disability, pain catastrophising, and post-traumatic stress symptoms decreased over the first year after the accident, whereas functional self-efficacy and fear of movement/(re)injury increased. Pain intensity was stable. Pain-related disability at baseline emerged as the only statistically significant predictor of pain-related disability one year after the accident (Adj r² = 0.67). A good prognosis over the first year is expected for the majority of individuals with WAD grade I or II who decline treatment due to mild symptoms. The prediction model was not valid in the MILD sample except for the contribution of pain-related disability. An implication is that early observations of individuals with elevated levels of pain-related disability are warranted, although they may decline treatment.",Åsenlöf P.; Bring A.; Söderlund A.,2013.0,10.1186/1471-2474-14-361,0,0,
9690,Visual search attentional bias modification reduced social phobia in adolescents.,"An attentional bias for negative information plays an important role in the development and maintenance of (social) anxiety and depression, which are highly prevalent in adolescence. Attention Bias Modification (ABM) might be an interesting tool in the prevention of emotional disorders. The current study investigated whether visual search ABM might affect attentional bias and emotional functioning in adolescents. A visual search task was used as a training paradigm; participants (n = 16 adolescents, aged 13-16) had to repeatedly identify the only smiling face in a 4 √ó 4 matrix of negative emotional faces, while participants in the control condition (n = 16) were randomly allocated to one of three placebo training versions. An assessment version of the task was developed to directly test whether attentional bias changed due to the training. Self-reported anxiety and depressive symptoms and self-esteem were measured pre- and post-training. After two sessions of training, the ABM group showed a significant decrease in attentional bias for negative information and self-reported social phobia, while the control group did not. There were no effects of training on depressive mood or self-esteem. No correlation between attentional bias and social phobia was found, which raises questions about the validity of the attentional bias assessment task. Also, the small sample size precludes strong conclusions. Visual search ABM might be beneficial in changing attentional bias and social phobia in adolescents, but further research with larger sample sizes and longer follow-up is needed.",De Voogd EL.; Wiers RW.; Prins PJ.; Salemink E.,2014.0,10.1016/j.jbtep.2013.11.006,0,0,
9691,"The effect of IPS-modified, an early intervention for people with mood and anxiety disorders: study protocol for a randomised clinical superiority trial.","Anxiety and affective disorders can be disabling and have a major impact on the ability to work. In Denmark, people with a mental disorder, and mainly non-psychotic disorders, represent a substantial and increasing part of those receiving disability pensions. Previous studies have indicated that Individual Placement and Support (IPS) has a positive effect on employment when provided to people with severe mental illness. This modified IPS intervention is aimed at supporting people with recently diagnosed anxiety or affective disorders in regaining their ability to work and facilitate their return to work or education. To investigate whether an early modified IPS intervention has an effect on employment and education when provided to people with recently diagnosed anxiety or affective disorders in a Danish context. The trial is a randomised, assessor-blinded, clinical superiority trial of an early modified IPS intervention in addition to treatment-as-usual compared to treatment-as-usual alone for 324 participants diagnosed with an affective disorder or anxiety disorder living in the Capital Region of Denmark. The primary outcome is competitive employment or education at 24 months. Secondary outcomes are days of competitive employment or education, illness symptoms and level of functioning including quality of life at follow-up 12 and 24 months after baseline. If the modified IPS intervention is shown to be superior to treatment-as-usual, a larger number of disability pensions can probably be avoided and long-term sickness absences reduced, with major benefits to society and patients. This trial will add to the evidence of how best to support people's return to employment or education after a psychiatric disorder. NCT01721824.",Hellström L.; Bech P.; Nordentoft M.; Lindschou J.; Eplov LF.,2013.0,10.1186/1745-6215-14-442,0,0,
9692,Prolonged exposure vs supportive counseling for sexual abuse-related PTSD in adolescent girls: a randomized clinical trial.,"Evidence-based treatments for posttraumatic stress disorder (PTSD) have not been established for adolescents despite high prevalence of PTSD in this population. To examine the effects of counselor-delivered prolonged exposure therapy compared with supportive counseling for adolescents with PTSD. A single-blind, randomized clinical trial of 61 adolescent girls with PTSD using a permuted block design. Counselors previously naive to prolonged exposure therapy provided the treatments in a community mental health clinic. Data collection lasted from February 2006 through March 2012. Participants received fourteen 60- to 90-minute sessions of prolonged exposure therapy (n‚Äâ=‚Äâ31) or supportive counseling (n‚Äâ=‚Äâ30). All outcomes were assessed before treatment, at mid-treatment, and after treatment and at 3-, 6-, and 12-month follow-up. The primary outcome, PTSD symptom severity, was assessed by the Child PTSD Symptom Scale-Interview (range, 0-51; higher scores indicate greater severity). Secondary outcomes were presence or absence of PTSD diagnosis assessed by the DSM-IV Schedule for Affective Disorders and Schizophrenia for School-Age Children and functioning assessed by the Children's Global Assessment Scale (range, 1-100; higher scores indicate better functioning). Additional secondary measures, PTSD severity assessed by the Child PTSD Symptom Scale-Self-Report (range, 0-51; higher scores indicate greater severity) and depression severity assessed by the Children's Depression Inventory (range, 0-54; higher scores indicate greater severity), were also assessed weekly during treatment. Data were analyzed as intent to treat. During treatment, participants receiving prolonged exposure demonstrated greater improvement on the PTSD symptom severity scale (difference between treatments in improvement, 7.5; 95% CI, 2.5-12.5; P‚Äâ<‚Äâ.001) and on all secondary outcomes (loss of PTSD diagnosis: difference, 29.3%, 95% CI, 20.2%-41.2%; P‚Äâ=‚Äâ.01; self-reported PTSD severity: difference, 6.2; 95% CI, 1.2-11.2; P‚Äâ=‚Äâ.02; depression: difference, 4.9; 95% CI, 1.6-8.2; P‚Äâ=‚Äâ.008; global functioning: difference, 10.1; 95% CI, 3.4-16.8; P‚Äâ=‚Äâ.008). These treatment differences were maintained through the 12-month follow-up: for interviewer-assessed PTSD (difference, 6.0; 95% CI, 1.6-10.4; P‚Äâ=‚Äâ.02), loss of PTSD diagnosis (difference, 31.1; 95% CI, 14.7-34.8; P‚Äâ=‚Äâ.01), self-reported PTSD (difference, 9.3; 95% CI, 1.2-16.5; P‚Äâ=‚Äâ.02), depression (difference, 7.2; 95% CI, 1.4-13.0; P‚Äâ=‚Äâ.02), and global functioning (difference, 11.2; 95% CI, 4.5-17.9; P‚Äâ=‚Äâ.01). Adolescents girls with sexual abuse-related PTSD experienced greater benefit from prolonged exposure therapy than from supportive counseling even when delivered by counselors who typically provide supportive counseling. clinicaltrials.gov Identifier: NCT00417300.",Foa EB.; McLean CP.; Capaldi S.; Rosenfield D.,2013.0,10.1001/jama.2013.282829,0,0,
9693,Moderation and mediation of the effect of attention training in social anxiety disorder.,"While attention modification programs (AMP) have shown promise as laboratory-based treatments for social anxiety disorder, trials of internet-delivered AMP have not yielded significant differences between active and control conditions. To address these inconsistencies, we examined the moderational and mediational role of attention bias in the efficacy of attention training. We compared data reported by Carlbring et al. (2012) to an identical AMP condition, with the exception that participants were instructed to activate social anxiety fears prior to each attention training session (AMP + FACT; n = 39). We also compared all attention training groups to an internet-delivered cognitive-behavioral therapy (iCBT) condition (n = 40). Participants in the AMP + FACT group experienced greater reductions in social anxiety symptoms than both active (n = 40) and control (n = 39) groups reported by Carlbring et al., and did not differ in symptom reductions from the iCBT group. Higher attention bias predicted greater symptom reductions for participants who completed AMP, but not for the control group. Moreover, change in attention bias mediated the relationship between AMP group (active condition reported by Carlbring et al. versus AMP + FACT) and change in social anxiety symptoms. These results suggest the importance of interpreting findings related to symptom change in attention training studies in the context of bias effects. ISRCTN01715124.",Kuckertz JM.; Gildebrant E.; Liliequist B.; Karlström P.; Väppling C.; Bodlund O.; Stenlund T.; Hofmann SG.; Andersson G.; Amir N.; Carlbring P.,2014.0,10.1016/j.brat.2013.12.003,0,0,
9694,"Service use, drop-out rate and clinical outcomes: a comparison between high and low intensity treatments in an IAPT service.","The IAPT services provide high and low intensity psychological treatments for adults suffering from depression and anxiety disorders using a stepped care model. The latest national evaluation study reported an average recovery rate of 42%. However, this figure varied widely between services, with better outcomes associated with higher ""step-up"" rates between low and high intensity treatments. This study aimed to compare the two intensity groups in an IAPT service in Suffolk. This study adopted a between groups design. A sample of 100 service users was randomly selected from the data collected from an IAPT service in Suffolk between May 2008 and February 2011. The treatment outcomes, drop-out rate, and other characteristics were compared between those who received high and low intensity treatments. The high intensity group received, on average, more sessions and contact time. They received more CBT sessions and less guided self-help. There were no group differences in terms of the drop-out and appointment cancellation rates. Analyses on clinical outcomes suggested no group difference but demonstrated an overall recovery rate of 52.6% and significant reduction in both depression and anxiety symptoms. Despite methodological limitations, this study concludes that the service as a whole achieved above-average clinical outcomes. Further research building upon the current study in unpacking the relative strengths and weaknesses for the high and low intensity treatments would be beneficial for service delivery.",Chan SW.; Adams M.,2014.0,10.1017/S1352465813000544,0,0,
9695,High-field open versus short-bore magnetic resonance imaging of the spine: a randomized controlled comparison of image quality.,"The purpose of the present study was to compare the image quality of spinal magnetic resonance (MR) imaging performed on a high-field horizontal open versus a short-bore MR scanner in a randomized controlled study setup. Altogether, 93 (80% women, mean age 53) consecutive patients underwent spine imaging after random assignement to a 1-T horizontal open MR scanner with a vertical magnetic field or a 1.5-T short-bore MR scanner. This patient subset was part of a larger cohort. Image quality was assessed by determining qualitative parameters, signal-to-noise (SNR) and contrast-to-noise ratios (CNR), and quantitative contour sharpness. The image quality parameters were higher for short-bore MR imaging. Regarding all sequences, the relative differences were 39% for the mean overall qualitative image quality, 53% for the mean SNR values, and 34-37% for the quantitative contour sharpness (P<0.0001). The CNR values were also higher for images obtained with the short-bore MR scanner. No sequence was of very poor (nondiagnostic) image quality. Scanning times were significantly longer for examinations performed on the open MR scanner (mean: 32±22 min versus 20±9 min; P<0.0001). In this randomized controlled comparison of spinal MR imaging with an open versus a short-bore scanner, short-bore MR imaging revealed considerably higher image quality with shorter scanning times. ClinicalTrials.gov NCT00715806.",Enders J.; Rief M.; Zimmermann E.; Asbach P.; Diederichs G.; Wetz C.; Siebert E.; Wagner M.; Hamm B.; Dewey M.,2013.0,10.1371/journal.pone.0083427,0,0,
9696,Diagnostic utility of the impact of event scale-revised in two samples of survivors of war.,"The study aimed at examining the diagnostic utility of the Impact of Event Scale-Revised (IES-R) as a screening tool for post-traumatic stress disorder (PTSD) in survivors of war. The IES-R was completed by two independent samples that had survived the war in the Balkans: a sample of randomly selected people who had stayed in the area of former conflict (n = 3,313) and a sample of refugees to Western European countries (n = 854). PTSD was diagnosed using the MINI International Neuropsychiatric Interview. Prevalence of PTSD was 20.1% in the Balkan sample and 33.1% in the refugee sample. Results revealed that when considering a minimum value of specificity of 0.80, the optimally sensitive cut-off score for screening for PTSD in the Balkan sample was 34. In both the Balkan sample and the refugee sample, this cut-off score provided good values on sensitivity (0.86 and 0.89, respectively) and overall efficiency (0.81 and 0.79, respectively). Further, the kappa coefficients for sensitivity for the cut-off of 34 were 0.80 in both samples. Findings of this study support the clinical utility of the IES-R as a screening tool for PTSD in large-scale research studies and intervention studies if structured diagnostic interviews are regarded as too labor-intensive and too costly.",Morina N.; Ehring T.; Priebe S.,2013.0,10.1371/journal.pone.0083916,0,0,
9697,CAM and energy psychology techniques remediate PTSD symptoms in veterans and spouses.,"Male veterans and their spouses (N = 218) attending one of six-week-long retreats were assessed for posttraumatic stress disorder (PTSD) symptoms pre- and postintervention. Participants were evaluated using the PTSD checklist (PCL), on which, a score of >49 indicates clinical symptom levels. The mean pretest score was 61.1 (SD ± 12.5) for veterans and 42.6 (SD ± 16.5) for spouses; 83% of veterans and 29% of spouses met clinical criteria. The multimodal intervention used Emotional Freedom Techniques and other energy psychology (EP) methods to address PTSD symptoms and a variety of complementary and alternative medicine (CAM) modalities for stress reduction and resource building. Interventions were delivered in group format as well as individual counseling sessions. Data were analyzed for each retreat, as well as for the six retreats as a whole. Mean post-test PCL scores decreased to 41.8 (SE ± 1.2; p < .001) for veterans, with 28% still clinical. Spouses demonstrated substantial symptom reductions (M = 28.7, SE ± 1.0; p < .001), with 4% still clinical. A follow-up assessment (n = 63) found PTSD symptom levels dropping even further for spouses (p < .003), whereas gains were maintained for veterans. The significant reduction in PTSD symptoms is consistent with other published reports of EP treatment, though counter to the usual long-term course of the condition. The results indicate that a multimodal CAM intervention incorporating EP may offer benefits to family members as well as veterans suffering from PTSD symptoms. Recommendations are made for further research to answer the questions posed by this study.",Church D.; Brooks AJ.,,10.1016/j.explore.2013.10.006,0,0,
9698,"Prevention of post-stroke generalized anxiety disorder, using escitalopram or problem-solving therapy.","This study examined the efficacy of antidepressant treatment for preventing the onset of generalized anxiety disorder (GAD) among patients with recent stroke. Of 799 patients assessed, 176 were randomized, and 149 patients without evidence of GAD at the initial visit were included in this double-blind treatment with escitalopram (N=47) or placebo (N=49) or non-blinded problem-solving therapy (PST; 12 total sessions; N=53). Participants given placebo over 12 months were 4.95 times more likely to develop GAD than patients given escitalopram and 4.00 times more likely to develop GAD than patients given PST. Although these results should be considered preliminary, the authors found that both escitalopram and PST were effective in preventing new onset of post-stroke GAD.",Mikami K.; Jorge RE.; Moser DJ.; Arndt S.; Jang M.; Solodkin A.; Small SL.; Fonzetti P.; Hegel MT.; Robinson RG.,2014.0,10.1176/appi.neuropsych.11020047,0,0,
9699,Amelioration of psychiatric symptoms through exposure to music individually adapted to brain rhythm disorders - a randomised clinical trial on the basis of fundamental research.,"This pilot study examined, whether long-term exposure of psychiatric patients to music that was individually adapted to brain rhythm disorders associated with psychoticism could act to ameliorate psychiatric symptoms. A total of 50 patients with various psychiatric diagnoses were randomised in a 1:1 ratio to listen to CDs containing either music adapted to brain rhythm anomalies associated with psychoticism - measured via a specific spectral analysis - or standard classical music. Participants were instructed to listen to the CDs over the next 18 months. Psychiatric symptoms in both groups were assessed at baseline and at 4, 8 and 18 months, using the Brief Symptom Inventory (BSI). At 18 months, patients in the experimental group showed significantly decreased BSI scores compared to control patients. Intriguingly, this effect was not only seen for symptoms of psychoticism and paranoia but also for anxiety, phobic anxiety and somatisation. Exposure to the adapted music was effective in ameliorating psychotic, anxiety and phobic anxiety symptoms. Based on the theories of neuroplasticity and brain rhythms, it can be hypothesised that this intervention may be enhancing brain-rhythm synchronisation and plasticity in prefrontal-hippocampal circuits that are implicated in both psychosis/paranoia and anxiety/phobic anxiety.",Müller W.; Haffelder G.; Schlotmann A.; Schaefers AT.; Teuchert-Noodt G.,2014.0,10.1080/13546805.2013.879054,0,0,
9700,Is cognitive behaviour therapy of benefit for melancholic depression?,"This paper seeks to determine the relevance and likely salience of cognitive behaviour therapy (CBT) as a treatment for melancholic depression. The findings of a randomised trial comparing 12-week outcome of 18 patients with melancholic depression receiving antidepressant medication and 11 receiving CBT were evaluated, and qualitative explanations for the outcomes were provided principally by the treating CBT practitioners. In the trial, CBT showed no improvement in depression severity in the first four weeks and then some level of improvement over the subsequent eight weeks. Outcome was superior for those receiving antidepressant medication at 12 weeks and was first demonstrated at four weeks. The benefits of CBT appeared to be in settling anxiety, dealing with cognitive processing of having a melancholic depression and addressing any personality vulnerabilities. While a pilot study, our qualitative reports indicate that CBT may provide a useful role in managing melancholia as an adjunct to antidepressant medication. Future studies examining such a combination treatment model should seek to determine if indicative data provided here argue for a sequencing model of CBT being introduced after medication has addressed core biological underpinnings.",Gilfillan D.; Parker G.; Sheppard E.; Manicavasagar V.; Paterson A.; Blanch B.; McCraw S.,2014.0,10.1016/j.comppsych.2013.12.017,0,0,
9701,Self-talk as a regulatory mechanism: how you do it matters.,"Does the language people use to refer to the self during introspection influence how they think, feel, and behave under social stress? If so, do these effects extend to socially anxious people who are particularly vulnerable to such stress? Seven studies explored these questions (total N = 585). Studies 1a and 1b were proof-of-principle studies. They demonstrated that using non-first-person pronouns and one's own name (rather than first-person pronouns) during introspection enhances self-distancing. Studies 2 and 3 examined the implications of these different types of self-talk for regulating stress surrounding making good first impressions (Study 2) and public speaking (Study 3). Compared with the first-person group, the non-first-person group performed better according to objective raters in both studies. They also displayed less distress (Studies 2 and 3) and engaged in less maladaptive postevent processing (Study 3). Studies 4 and 5 examined how these different forms of self-talk influence the way people appraise social-anxiety-provoking events. They demonstrated that non-first-person language use (compared with first-person language use) leads people to appraise future stressors in more challenging and less threatening terms. Finally, a meta-analysis (Study 6) indicated that none of these findings were moderated by trait social anxiety, highlighting their translational potential. Together, these findings demonstrate that small shifts in the language people use to refer to the self during introspection consequentially influence their ability to regulate their thoughts, feelings, and behavior under social stress, even for vulnerable individuals.",Kross E.; Bruehlman-Senecal E.; Park J.; Burson A.; Dougherty A.; Shablack H.; Bremner R.; Moser J.; Ayduk O.,2014.0,10.1037/a0035173,0,0,
9702,Comparing the distress thermometer (DT) with the patient health questionnaire (PHQ)-2 for screening for possible cases of depression among patients newly diagnosed with advanced cancer.,"Distress screening guidelines call for rapid screening for emotional distress at the time of cancer diagnosis. The purpose of this study was to examine the distress thermometer's (DT) ability to screen in patients in treatment for advanced cancer who may be depressed. Using cross-sectional data collected from patients within 30 days of diagnosis with advanced cancer, this study used ROC analysis to determine the optimal-cutoff point of the distress thermometer (DT) for screening for depression as measured by the physician health questionnaire (PHQ)-9; inter-test reliability analysis to compare the DT with the PHQ-2 for screening in possible cases of depression, and multivariate analysis to examine associations among the DT emotional problem list (EPL) items with cases of depression. The average age of the 123 patients in the study was 59.9 (12.9) years. Seventy (56.9%) were female. All had Stage 3 or 4 cancers (40% gastrointestinal, 19% gynecologic, 20% head and neck, 21% lung). The mean DT score was 4 (2.7)/10; and 56 (43%) were depressed as measured by the PHQ-9 ‚â• 5. The optimal DT cut-off score to screen in possible cases of depression was ‚â• 2/10, with a sensitivity of .96, compared to a sensitivity of .32 of the PHQ-2 ‚â• 2. Correlation coefficients for the DT ‚â• 2 and the PHQ-2 with the PHQ-9 ‚â• 5 were 0.4 and -0.2, respectively. EPL items associated with cases of depression were Depression (OR = 0.15, 0.02-0.85) and Sadness (OR = 0.21, 0.06-0.72). The optimal DT threshold for identifying possible cases of depression at the time of diagnosis is ‚â• 2; this threshold is more sensitive than the PHQ-2 ‚â• 2. EPL items may be used with the DT score to triage patients for evaluation.",Lazenby M.; Dixon J.; Bai M.; McCorkle R.,2014.0,10.1017/S1478951513000394,0,0,
9703,Sensory profiles of patients with neuropathic pain based on the neuropathic pain symptoms and signs.,"This manuscript aimed to characterize the clinical profile of various neuropathic pain (NeP) disorders and to identify whether patterns of sensory symptoms/signs exist, based on baseline responses on the Neuropathic Pain Symptom Inventory (NPSI) questionnaire and the quantitative sensory testing (QST). These post hoc analyses were based on data from 4 randomized, double-blind, placebo-controlled clinical studies of pregabalin (150-600mg/day) in patients with NeP syndromes: central poststroke pain, posttraumatic peripheral pain, painful HIV neuropathy, and painful diabetic peripheral neuropathy. The NPSI questionnaire includes 10 different pain symptom descriptors. QST was used to detect sensory thresholds of accurately calibrated sensory stimuli and to quantify the intensity of evoked sensation. To identify symptoms/signs clusters and select the number of clusters, a principal component analysis (PCA) and hierarchical clustering methods with clinical input were used. Analysis of the NPSI pain qualities and individual QST measures at baseline indicated no clear association between particular symptoms/signs profiles and etiologies. Based on NPSI symptoms, PCA identified 3 pain dimensions: provoked, deep, and pinpoint. A hierarchical cluster analysis identified 3 clusters with distinct pain characteristics profiles independent of NeP syndrome. Based on QST signs, PCA identified 2 pain dimensions: evoked by cold and evoked by touch. A hierarchical cluster analysis identified 4 clusters with distinct pain characteristics profiles. These ""trans-etiological"" profiles may reflect distinct pathophysiological mechanisms and therefore, potential differential responses to treatment.",Freeman R.; Baron R.; Bouhassira D.; Cabrera J.; Emir B.,2014.0,10.1016/j.pain.2013.10.023,0,0,
9704,Changes in sleep disruption in the treatment of co-occurring posttraumatic stress disorder and substance use disorders.,"Sleep disruption appears not only to reflect a symptom of posttraumatic stress disorder (PTSD), but also a unique vulnerability for its development and maintenance. Studies examining the impact of psychosocial treatments for PTSD on sleep symptoms are few and no studies to date of which we are aware have examined this question in samples with co-occurring substance use disorders. The current study is a secondary analysis of a large clinical trial comparing 2 psychological treatments for co-occurring PTSD and substance use disorders. Women (N = 353) completed measures of PTSD at baseline, end of treatment, and 3-, 6-, and 12-month follow-ups. Results indicated that the prevalence of insomnia, but not nightmares, decreased during treatment, and that 63.8% of participants reported at least 1 clinical-level sleep symptom at the end of treatment. Improvement in sleep symptoms during treatment was associated with better overall PTSD outcomes over time, χ(2) (1) = 33.81, p < .001. These results extend the existing literature to suggest that residual sleep disruption following PTSD treatment is common in women with co-occurring PTSD and substance use disorders. Research on the benefits of adding sleep-specific intervention for those with residual sleep disruption in this population may be a promising future direction.",McHugh RK.; Hu MC.; Campbell AN.; Hilario EY.; Weiss RD.; Hien DA.,2014.0,10.1002/jts.21878,0,0,
9705,Personality dimensions and deep repetitive transcranial magnetic stimulation (DTMS) for treatment-resistant depression: a pilot trial on five-factor prediction of antidepressant response.,"Prognostication is poor in repetitive transcranial magnetic stimulation (rTMS) treatment for major depressive disorder (MDD). Personality traits, particularly extraversion and neuroticism, have attracted increasing attention for both trait- and state-dependent characteristics in predicting response to pharmacotherapy, psychotherapy, and more recently to therapeutic neuromodulation for MDD. The advent of deep rTMS (DTMS) allows stimulation of deeper cortical regions, and we aimed to prospectively characterize personality dimensions and antidepressant response to DTMS in treatment-resistant MDD. A convenience sample of 15 patients with treatment-resistant MDD received four weeks of daily sessions of DTMS (20 Hz, 3000 pulses/session) of the left dorsolateral prefrontal cortex (DLFPC). At baseline and at the conclusion of treatment, patients completed the Big Five Inventory, a five-factor assessment of major personality dimensions. Clinical response was measured using the 21-item Hamilton Depression Rating Scale. Four weeks of DTMS treatment were not associated with changes in personality measures. Clinical remission was associated with higher baseline levels of agreeableness (score ‚â• 29:100% sensitive and 72.7% specific) and conscientiousness (score ‚â• 30:75% sensitive and 81.8% specific). Levels of agreeableness and extraversion were linearly associated with antidepressant response. Neuroticism was not associated with the antidepressant effects of DTMS in this cohort. Five-factor personality assessment may have prognostic value in DTMS for resistant MDD. Agreeableness, extraversion, and conscientiousness are associated with decreases in depressive symptoms during treatment with DTMS.",McGirr A.; Van den Eynde F.; Chachamovich E.; Fleck MP.; Berlim MT.,2014.0,10.1016/j.neulet.2014.01.037,0,0,
9706,Increasing engagement in evidence-based PTSD treatment through shared decision-making: a pilot study.,"Within the Veterans Health Administration, post-traumatic stress disorder (PTSD) treatment decisions are left to the patient and provider, allowing substantial variability in the way treatment decisions are made. Theorized to increase treatment engagement, shared decision-making interventions provide a standardized framework for treatment decisions. This study sought to develop (phase 1) and pilot test the feasibility and potential effectiveness (phase 2) of a brief shared decision-making intervention to promote engagement in evidence-based PTSD treatment. An initial version of the intervention was developed and then modified according to stakeholder feedback. Participants in the pilot trial were 27 Iraq and Afghanistan Veterans recruited during an intake assessment at a Veterans Affairs PTSD clinic. Participants randomized to the intervention condition (n = 13) participated in a 30-minute shared decision-making session, whereas patients randomized to the usual care condition (n = 14) completed treatment planning during their intake appointment, per usual clinic procedures. Among the 20 study completers, a greater proportion of participants in the intervention condition preferred an evidence-based treatment and received an adequate (‚â•9 sessions) dose of psychotherapy. Results provide preliminary support for the feasibility and potential effectiveness of the intervention and suggest that larger-scale trials are warranted.",Mott JM.; Stanley MA.; Street RL.; Grady RH.; Teng EJ.,2014.0,10.7205/MILMED-D-13-00363,0,0,
9707,"Effectiveness RCT of a CBT intervention for youths who lost parents in the Sichuan, China, earthquake.","Many children who lost parents in the 2008 earthquake in Sichuan Province, China, experienced symptoms of posttraumatic stress disorder (PTSD) and depression. This randomized controlled study compared the treatment effectiveness of short-term cognitive-behavioral therapy (CBT) with a general supportive intervention and with a control group of nontreatment. METHODS; Thirty-two Chinese adolescents were randomly assigned to three treatment groups. Participants were compared for psychological resilience (Connor-Davidson Resilience Scale), symptoms of PTSD (Children's Revised Impact of Events Scale), and depression (Center for Epidemiologic Studies Depression Scale) at baseline, after treatment, and three-month follow-up. CBT was effective in reducing PTSD and depressive symptoms and improved psychological resilience. General support was more effective than no intervention in improving psychological resilience. Short-term CBT group intervention seems to be a robust intervention for natural disaster victims. Short-term CBT group intervention was more effective than the general supportive intervention and the no-treatment group in enhancing psychological resilience and reducing PTSD and depression among adolescents who had lost parents in the earthquake. The general supportive intervention was effective only in improving psychological resilience.",Chen Y.; Shen WW.; Gao K.; Lam CS.; Chang WC.; Deng H.,2014.0,10.1176/appi.ps.201200470,0,0,
9708,Using SMS reminders in psychology clinics: a cautionary tale.,"As healthcare services become progressively more stretched, there is increasing discussion of ways in which technological adjuncts may be used to deliver more cost-efficient services. Before widespread implementation, however, the use of these adjuncts requires proper scrutiny of their effects on psychological practice. This research examined the effectiveness of SMS reminders on client appointment attendance and dropout in a psychological treatment setting. It was predicted that the reminders would result in increased initial appointment attendance, increased total appointment attendance, and decreased client dropout. A randomized controlled trial investigated the impact of SMS appointment reminders (two levels: present or absent) on client attendance (three levels: attended, rescheduled, or did not attend) and dropout (two levels: completed treatment or terminate early). Participants (N = 140) at an outpatient psychology clinic were randomly allocated to either receive an SMS appointment reminder one day before their scheduled appointment, or to receive no reminder. No significant differences were found between the SMS and no SMS conditions in relation to appointment attendance. There were more client dropouts in the SMS compared to the no SMS condition. The SMS appointment reminders were not effective at increasing appointment attendance. The current research suggests that there is more to client non-attendance in psychological settings than the simple forgetting of appointments. Technological adjuncts may be useful in increasing the cost-efficiency of current services; however, this research highlights the importance of understanding the effects of technology before widespread implementation.",Clough BA.; Casey LM.,2014.0,10.1017/S1352465813001173,0,0,
9709,Postoperative pain and subsequent PTSD-related symptoms in patients undergoing lung resection for suspected cancer.,"Because lung cancer resection is at the crossroad between cancer and high-risk surgery, we hypothesized that the patients undergoing lung resection for cancer are exposed to develop a post-traumatic stress disorder (PTSD) syndrome-related symptoms. Forty-seven adult patients were included in the study. Patients were eligible for inclusion if they underwent lung resection for suspected cancer, if they were able to speak and read French, and if they agreed to be reached for a telephone interview. We assessed before, immediately after, and 3 months after surgery the presence of symptoms of anxiety and depression (Hospital Anxiety and Depression Scale) and PTSD-related symptoms (impact of events scale revised [IES-R]). At the 3-month assessment, an IES-R score > 22 was used as criteria for predicting the patients at risk of PTSD-related symptoms. We identified an IES-R score higher than 22 in 24 participants (51%). Patients with a preoperatory Hospital Anxiety and Depression Scale(anxiety) score more than 7 (T0) and a maximal visual analogic scale score more than 40 during the first 24 hours after surgery were more likely to develop PTSD-related symptoms at 3-months with odd ratios at 4.61 [1.20-17.73] (p = 0.03) and 1.34 [1.05-1.75] (p = 0.02). The prevalence of PTSD-related symptoms after lung cancer resection is high, showing that lung cancer patients undergoing surgical resection are at high risk of postprocedure burden. The presence of preoperative symptoms of anxiety and acute procedural pain during the early postoperative period are strong predictors for developing PTSD-related symptoms after lung cancer surgery.",Jeantieu M.; Gaillat F.; Antonini F.; Azoulay E.; Martin C.; Thomas P.; Leone M.,2014.0,10.1097/JTO.0000000000000084,0,0,
9710,Telephone-delivered psychotherapy for rural-dwelling older adults with generalized anxiety disorder: study protocol of a randomized controlled trial.,"Generalized Anxiety Disorder (GAD), characterized by excessive and uncontrollable worry, has a negative impact on the health, well-being, and functioning of older adults. Cognitive behavioral therapy has demonstrated efficacy in reducing anxiety and worry in older adults, but the generalizability of these findings to community-dwelling older adults is unknown. The aim of the current study is to examine the efficacy of a cognitive-behavioral intervention delivered by telephone in reducing anxiety and worry in rural community-dwelling older adults with GAD. We propose a randomized controlled trial comparing telephone-delivered cognitive behavioral therapy (CBT-T) with nondirective supportive therapy (NST-T). One hundred seventy six adults 60 years and older diagnosed with GAD will be randomized to one of the two treatment conditions. The primary outcomes are self-report worry and clinician-rated anxiety. Secondary outcomes include depressive symptoms, sleep, quality of life, and functional status. It is hypothesized that CBT-T will be superior to NST-T in reducing anxiety and worry among older adults with GAD. Further, CBT-T is hypothesized to be superior to NST-T in reducing problems with depressive symptoms, sleep, functional status and quality of life. If this program is successful, it could be implemented as a low-cost program to treat late-life anxiety, especially in rural areas or in circumstances where older adults may not have access to qualified mental health providers. clinicaltrials.gov Identifier: NCT01259596.",Brenes GA.; Danhauer SC.; Lyles MF.; Miller ME.,2014.0,10.1186/1471-244X-14-34,0,0,
9711,The impact of hypervigilance: evidence for a forward feedback loop.,"A number of prominent theories suggest that hypervigilance and attentional bias play a central role in anxiety disorders and PTSD. It is argued that hypervigilance may focus attention on potential threats and precipitate or maintain a forward feedback loop in which anxiety is increased. While there is considerable data to suggest that attentional bias exists, there is little evidence to suggest that it plays this proposed but critical role. This study investigated how manipulating hypervigilance would impact the forward feedback loop via self-reported anxiety, visual scanning, and pupil size. Seventy-one participants were assigned to either a hypervigilant, pleasant, or control condition while looking at a series of neutral pictures. Those in the hypervigilant condition had significantly more fixations than those in the other two groups. These fixations were more spread out and covered a greater percentage of the ambiguous scene. Pupil size was also significantly larger in the hypervigilant condition relative to the control condition. Thus the study provided support for the role of hypervigilance in increasing visual scanning and arousal even to neutral stimuli and even when there is no change in self-reported anxiety. Implications for the role this may play in perpetuating a forward feedback loop are discussed.",Kimble M.; Boxwala M.; Bean W.; Maletsky K.; Halper J.; Spollen K.; Fleming K.,2014.0,10.1016/j.janxdis.2013.12.006,0,0,
9712,Social support as a predictor of the outcome of depressive and anxiety disorder in short-term and long-term psychotherapy.,"Social support is known to be important for well-being of individuals, but it is not clear how it predicts psychotherapy outcome in patients suffering from depressive or anxiety disorders. The aim of the present study was to study the prediction of social support on the outcome of short-term and long-term psychotherapy. In the Helsinki Psychotherapy Study, 326 psychiatric outpatients, aged 20-46 years, and suffering from depressive or anxiety disorders, were randomly assigned to short-term psychotherapy (short-term psychodynamic or solution-focused) or long-term psychodynamic psychotherapy. The level of social support at baseline was assessed using the Brief Inventory of Social Support and Integration (BISSI). Psychiatric symptoms were assessed with the Symptom Check List, Global Severity Index (SCL-90-GSI) at baseline and four times during a 3-year follow-up. Patients with a high level of social support before treatment benefitted more from long-term than short-term therapy at the 3-year follow-up, whereas patients with a low level of social support experienced no such benefit. Pretreatment social support seems to predict differentially short- and long-term psychotherapy and thus needs to be acknowledged when evaluating patient's resources and treatment options. More research is needed to verify these findings.",Lindfors O.; Ojanen S.; Jääskeläinen T.; Knekt P.,2014.0,10.1016/j.psychres.2013.12.050,0,0,
9713,"Differentiating emotions across contexts: comparing adults with and without social anxiety disorder using random, social interaction, and daily experience sampling.","The ability to recognize and label emotional experiences has been associated with well-being and adaptive functioning. This skill is particularly important in social situations, as emotions provide information about the state of relationships and help guide interpersonal decisions, such as whether to disclose personal information. Given the interpersonal difficulties linked to social anxiety disorder (SAD), deficient negative emotion differentiation may contribute to impairment in this population. We hypothesized that people with SAD would exhibit less negative emotion differentiation in daily life, and these differences would translate to impairment in social functioning. We recruited 43 people diagnosed with generalized SAD and 43 healthy adults to describe the emotions they experienced over 14 days. Participants received palmtop computers for responding to random prompts and describing naturalistic social interactions; to complete end-of-day diary entries, they used a secure online website. We calculated intraclass correlation coefficients to capture the degree of differentiation of negative and positive emotions for each context (random moments, face-to-face social interactions, and end-of-day reflections). Compared to healthy controls, the SAD group exhibited less negative (but not positive) emotion differentiation during random prompts, social interactions, and (at trend level) end-of-day assessments. These differences could not be explained by emotion intensity or variability over the 14 days, or to comorbid depression or anxiety disorders. Our findings suggest that people with generalized SAD have deficits in clarifying specific negative emotions felt at a given point of time. These deficits may contribute to difficulties with effective emotion regulation and healthy social relationship functioning.",Kashdan TB.; Farmer AS.,2014.0,10.1037/a0035796,0,0,
9714,"The influence of injury cause, contact-sport participation, and personal knowledge on expectation of outcome from mild traumatic brain injury.","This study investigated the influence of injury cause, contact-sport participation, and prior knowledge of mild traumatic brain injury (mTBI) on injury beliefs and chronic symptom expectations of mTBI. A total of 185 non-contact-sport players (non-CSPs) and 59 contact-sport players (CSPs) with no history of mTBI were randomly allocated to one of two conditions in which they read either a vignette depicting a sport-related mTBI (mTBIsport) or a motor-vehicle-accident-related mTBI (mTBIMVA). The vignettes were otherwise standardized to convey the same injury parameters (e.g., duration of loss of consciousness). After reading a vignette, participants reported their injury beliefs (i.e., perceptions of injury undesirability, chronicity, and consequences) and their expectations of chronic postconcussion syndrome (PCS) and posttraumatic stress disorder (PTSD) symptoms. Non-CSPs held significantly more negative beliefs and expected greater PTSD symptomatology and greater PCS affective symptomatology from an mTBIMVA vignette thann mTBIsport vignette, but this difference was not found for CSPs. Unlike CSPs, non-CSPs who personally knew someone who had sustained an mTBI expected significantly less PCS symptomatology than those who did not. Despite these different results for non-CSPs and CSPs, overall, contact-sport participation did not significantly affect injury beliefs and symptom expectations from an mTBIsport. Expectations of persistent problems after an mTBI are influenced by factors such as injury cause even when injury parameters are held constant. Personal knowledge of mTBI, but not contact sport participation, may account for some variability in mTBI beliefs and expectations. These factors require consideration when assessing mTBI outcome.",Edmed SL.; Sullivan KA.,2014.0,10.1080/13803395.2013.877124,0,0,
9715,Effects of self-compassion workbook training on trauma-related guilt in a sample of homeless veterans: a pilot study.,"The present pilot study examined the effects of a 4-week-long self-administered self-compassion training on trauma-related guilt and compared it to a stress inoculation control group. A total of 47 homeless male veterans who were living in transitional housing facilities volunteered to participate in this study. Participants were randomly assigned to either a self-compassion (N = 13) or a stress inoculation (N = 14) group and were asked to complete pre-, mid-, and postintervention assessments measuring changes in self-compassion, trauma-related guilt, and posttraumatic stress disorder severity. Participants in both interventions reported increased levels of self-compassion and equal reductions in trauma-related guilt. No other significant changes were noted. The results from this pilot study provide preliminary evidence for the use of self-compassion and stress inoculation trainings as effective interventions for trauma-related guilt. The findings also suggest that self-administered trainings in the form of workbooks may be a viable, cost-effective form of intervention for disadvantaged populations, such as homeless veterans in transitional housing, who may lack resources or access to professionals or paraprofessionals. The effects of both self-compassion training and stress inoculation training on the study variables and directions for future research on self-compassion and trauma-related guilt are discussed.",Held P.; Owens GP.,2015.0,10.1002/jclp.22170,0,0,
9716,A diary-based modification of symptom attributions in pathological health anxiety: effects on symptom report and cognitive biases.,"To examine whether a 2-week attribution modification training (AMT) changes symptom severity, emotional evaluation of health-threatening stimuli, and cognitive biases in pathological health anxiety. We randomized 85 patients with pathological health anxiety into an electronic diary-based AMT group (AMTG; n = 42) and a control group without AMT (CG; n = 43). Self-report symptom measures, emotional evaluation, attentional bias, and memory bias toward symptom and illness words were assessed with an emotional Stroop task, a recognition task, and an emotional rating task for valence and arousal. After the 2-week period, the AMTG compared with the CG reported lower symptoms of pathological health anxiety, F(1, 82) = 10.94, p < .01, η2p = .12, rated symptom, F(1, 82) = 5.56, p = .02, η2p = .06, and illness words, F(1, 82) = 4.13, p = .045, η2p = .05, as less arousing, and revealed a smaller memory response bias toward symptom words in the recognition task F(1, 82) = 12.32, p < .01, η2p = .13. However, no specific AMT effect was observed for the attentional bias. The results support the efficacy of a comparatively short cognitive intervention in pathological health anxiety as a possible add-on intervention to existing treatment approaches to reduce symptom severity, as well as abnormalities in health-related emotional evaluation and memory processes.",Kerstner T.; Witthöft M.; Mier D.; Diener C.; Rist F.; Bailer J.,2015.0,10.1037/a0039056,0,0,
9717,Intranasal oxytocin administration prior to exposure therapy for arachnophobia impedes treatment response.,"Recent years have seen the emergence of a new paradigm for treatment of anxiety disorders focusing on development of drugs that facilitate psychotherapies via targeted effects on neuroplasticity. One compound that has generated interest in this regard is oxytocin (OT), a mammalian neuropeptide that modulates activity of the neurocircuit mediating fear extinction and memory processes. Recent research in healthy humans has suggested that intranasal OT administered prior to fear extinction training enhances fear extinction performance, supporting its potential to augment exposure-based psychotherapy. Here, we tested the hypothesis that OT treatment would facilitate response to exposure therapy in patients with specific phobia. We conducted a small proof-of-concept trial investigating the effect of pretreatment intranasal OT administration on a brief, single-session exposure treatment for arachnophobia (fear of spiders). The study was randomized, double-blind, and placebo controlled (n = 13 placebo, 11 females; n = 10 OT, 8 females) with 1-week and 1-month follow-up assessments. Dependent measures attended to arachnophobia symptoms (self-report), phobic behavior (behavioral avoidance of spider task), and treatment credibility/therapeutic alliance. Administration of OT prior to exposure therapy tended to impede treatment response as measured by self-report of symptoms at both follow-up periods. OT treatment did not significantly affect behavioral measures of fear. Immediately after OT administration but before therapy, the OT group trended toward less confidence in the treatment. The OT group also trended toward lower ratings of therapeutic alliance than placebo. These results suggest that OT administration effects on extinction may vary depending on conditions and population.",Acheson DT.; Feifel D.; Kamenski M.; Mckinney R.; Risbrough VB.,2015.0,10.1002/da.22362,0,0,
9718,[Effectiveness of intensive group psychotherapy in treatment of neurotic and personality disorders].,"The aim of this study was to analyze the effectiveness of intensive (150 - 210 sessions), short-term (10 - 14 weeks) group psychotherapy in the treatment of neurotic disorders, and selected personality disorders. The study involved 145 patients treated in day hospital due to neurotic disorders and selected personality disorders. The measurements were performed twice - at the beginning and at the end of hospitalization. The effectiveness of psychotherapy in the reduction of symptoms of neurotic disorders was measured with symptom checklist ""0"". The change in the severity of personality traits characteristic for neurotic disorders was examined using Neurotic Personality Questionnaire KON-2006. A significant reduction in symptoms of neurotic disorders was found in 84% of patients (85,7% women and 80,8% men). 70,3% of the examined patients obtained in the measurement at the end of treatment results indicating the level of severity of neurotic disorders symptoms below the cutoff point separating population of healthy individuals from patients. A significant reduction in the severity of personality traits characteristically occurring in patients suffering from neurotic disorders was found in 76% of patients (74.5% women and 78.7% men). 42.8% of the examined patients obtained in the measurement at the end of the treatment the value of neurotic personality traits index (X-KON) typical for healthy population. Intensive, short-term group psychotherapy with elements of individual therapy is an effective treatment for neurotic disorders. The majority of treated persons obtains a significant symptomatic improvement and a reduction in the severity of neurotic personality traits.",Mielimąka M.; Rutkowski K.; Cyranka K.; Sobański J.; Müldner-Nieckowski Ł.; Dembińska E.; Smiatek-Mazgaj B.; Klasa K.,,10.12740/PP/26093,0,0,
9719,Race/Ethnicity and Treatment Outcome in a Randomized Controlled Trial for Trichotillomania (Hair-Pulling Disorder).,"Treatment outcome was compared among non-Hispanic White and racial/ethnic minority participants with trichotillomania (TTM), or hair-pulling disorder. Symptom severity, quality of life, and TTM-related disability were compared in a behavior therapy trial with a stepped care approach: web-based self-help and then individual behavior therapy. The sample comprised 72% (n = 38) non-Hispanic White participants and 28% (n = 15) minority participants. The ethnic groups responded differently to treatment, with fewer minority participants showing improvement during web-based self-help. Response rates were equivalent between ethnic groups during the in-person behavior therapy. These results should be interpreted with caution because of the small sample size of minorities in the study and consequent inability to analyze results for each racial/ethnic group individually. Future studies should focus on the investigation of factors that may enable or hinder racial and ethnic minority participants to benefit from online and/or self-help behavior therapy for TTM.",Falkenstein MJ.; Rogers K.; Malloy EJ.; Haaga DA.,2015.0,10.1002/jclp.22171,0,0,
9720,A preliminary study of an internet-based intervention for OEF/OIF veterans presenting for VA specialty PTSD care.,"This preliminary study sought to evaluate the feasibility and potential effectiveness of a cognitive-behavioral, web-based intervention for posttraumatic stress in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans who are not able to participate, or not eligible to participate, in evidence-based posttraumatic stress disorder (PTSD) treatments. The study used an uncontrolled pre-posttest design with a sample of 24 OEF/OIF veterans presenting to a VA PTSD specialty clinic. Participants used the afterdeployment.org, Post-Traumatic Stress (PTS) Workshop, which was supplemented with brief weekly telephone calls. Half of the participants (n = 12) completed at least 5 of the 8 workshop sessions. At posttreatment, 40.0% of completers demonstrated reliable reductions on PTSD symptoms and overall d = 1.04. Treatment satisfaction and acceptability was generally positive based on Likert ratings. This web-based intervention for PTS appears to be a feasible and potentially helpful intervention for veterans who may not otherwise receive psychosocial interventions. Given the minimal resources required and the potential reach, this web-based intervention could be a viable addition to services provided to OEF/OIF veterans seeking PTSD specialty care. Efforts to further develop and more rigorously evaluate this approach are warranted.",Belsher BE.; Kuhn E.; Maron D.; Prins A.; Cueva D.; Fast E.; France D.,2015.0,10.1002/jts.21994,0,0,
9721,Short-term cost-effectiveness of psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: Results from the SOPHO-NET trial.,"To investigate the short-term cost-effectiveness of cognitive-behavioral therapy (CBT) and psychodynamic therapy (PDT) compared to waiting list (WL). The analysis was conducted alongside the SOPHO-NET multi-center efficacy trial. Patients were randomly assigned to CBT (n=209), PDT (n=207), or WL (n=79). Resource use was assessed prior and during treatment to determine direct and absenteeism costs. Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated based on remission and response rates. To visualize statistical uncertainty, cost-effectiveness acceptability curves (CEACs) were constructed based on adjusted net-benefit regression. Different values for the society׳s willingness to pay (WTP) were assumed. Both interventions were more efficacious than WL but were associated with increased direct costs besides intervention costs. Unadjusted ICERs per responder were €3615 for CBT and €4958 for PDT. Unadjusted ICERs per remitted patient were €5788 and €10,733. CEACs revealed a high degree of uncertainty: applying the 97.5% probability threshold, CBT proved cost-effective at a WTP ≥€16,100 per responder and ≥€26,605 per remitted patient. Regarding PDT cost-effectiveness only was certain for response at a WTP ≥€27,290. The WL condition is assumed to represent untreated patients, although the expectation to start treatment in the near future probably affects symptom severity and health care utilization. At the end of treatment cost-effectiveness of CBT and PDT compared to WL is uncertain and depends on the societal WTP. The interventions may induce a more adequate utilization of other health care services - involving increased costs. Development of costs and effects in the long-run should be considered.",Egger N.; Konnopka A.; Beutel ME.; Herpertz S.; Hiller W.; Hoyer J.; Salzer S.; Stangier U.; Strauss B.; Willutzki U.; Wiltink J.; Leichsenring F.; Leibing E.; König HH.,2015.0,10.1016/j.jad.2015.03.037,0,0,
9722,"Clinical Significance of Pain at Hospital Discharge Following Traumatic Orthopedic Injury: General Health, Depression, and PTSD Outcomes at 1 Year.","The purpose of this study was to determine whether pain at hospital discharge is associated with general health and depression and posttraumatic stress disorder (PTSD) at 1 year following traumatic orthopedic injury. This study prospectively enrolled 213 patients, 19 to 86 years of age, admitted to an academic level 1 trauma center for surgical treatment of a traumatic lower-extremity or upper-extremity orthopedic injury. Pain at hospital discharge was measured with the Brief Pain Inventory. At 1-year follow-up, physical and mental health was assessed with the SF-12 and depressive and PTSD symptoms with the 9-item Patient Health Questionnaire (PHQ-9) and PTSD Checklist-Civilian Version (PCL-C), respectively. Cut-off scores of 10 on the PHQ-9 and 44 on the PCL-C classified patients as having depression or PTSD. A total of 133 patients (62%) completed follow-up at 1 year. Responders and nonresponders did not differ significantly on baseline characteristics. Multivariable regression found that increased pain at discharge was significantly associated with depression (odds ratio=3.3; P<0.001) and PTSD (odds ratio=1.4; P=0.03) at 1 year, after controlling for age, education, injury severity score, and either depressive or PTSD symptoms at hospital discharge. Early postoperative pain was not a significant risk factor for long-term physical and mental health. Findings highlight the importance of early screening for uncontrolled postoperative pain to identify patients at high risk for poor psychological outcomes and who could benefit from more aggressive pain management. Results suggest early interventions are needed to address pain severity in patients with orthopedic trauma.",Archer KR.; Heins SE.; Abraham CM.; Obremskey WT.; Wegener ST.; Castillo RC.,2016.0,10.1097/AJP.0000000000000246,0,0,
9723,A web-based self-help intervention for partners of cancer patients based on Acceptance and Commitment Therapy: a protocol of a randomized controlled trial.,"There is a growing recognition that cancer not only affects the lives of the patients, but also the lives of their partners. Partners of cancer patients are highly involved in the illness trajectory by providing informal care and they often experience distress. However, supporting interventions for this group are scarce and existing interventions bear several limitations. On the basis of the need for theory- and evidence-based supportive interventions for partners of cancer patients, the web-based self-help intervention Hold on, for each other has been developed. This intervention is based on Acceptance and Commitment Therapy. The primary objective of the RCT is to investigate the (cost-) effectiveness of the intervention. Additional goals are (1) to examine if psychological flexibility, self-compassion, mastery, supportive behavior, posttraumatic growth and resilience are mediators of the intervention's effects on the partners' mental health; (2) to examine the moderating effects of the socio demographics (age, gender, education, working situation, family situation) and disease-related characteristics of the patients (sort of cancer, stage of disease, duration and treatment of cancer); and (3) to investigate to what extend participants are satisfied with the intervention, which parts of the intervention are mostly used, and how adherent the users are. A three-armed randomized controlled trial (RCT) will be conducted to compare two versions of the intervention Hold on, for each other with a waiting list control condition. Both intervention conditions contain the same content and differ only with regard to the form of professional support (personal support versus automatic support). Adult partners of cancer patients with mild to moderate depressive and anxiety symptoms, will be recruited through a multi-component strategy. Online measurements by self-assessment will be made on four measurement points (prior to randomization (baseline-measurement) and 3, 6 and 12 months after baseline). When proven effective, Hold on, for each other can be an invaluable contribution to the healthcare system and it could be offered to all partners of cancer patients who are in need for additional support. Dutch Trial Register, trial registration number NTR4035, date of registration: 17 March 2013.",Köhle N.; Drossaert CH.; Schreurs KM.; Hagedoorn M.; Verdonck-de Leeuw IM.; Bohlmeijer ET.,2015.0,10.1186/s12889-015-1656-y,0,0,
9724,Are 60-minute prolonged exposure sessions with 20-minute imaginal exposure to traumatic memories sufficient to successfully treat PTSD? A randomized noninferiority clinical trial.,"The study aims to determine whether 60-minute sessions of prolonged exposure (PE) that include 20 minutes of imaginal exposure (IE) are noninferior to the standard 90-minute sessions that include 40 minutes of IE in treating posttraumatic stress disorder (PTSD) and to explore the relationship of treatment outcome to within- and between-session habituation and change in negative cognitions. Thirty-nine adult veterans with chronic PTSD were randomly assigned to 90-minute (n=19) or 60-minute (n=20) sessions of PE. PTSD symptoms were assessed by an unaware independent evaluator before and after treatment and at 6-month follow-up. Self-reports of depression and negative cognitions were assessed before and after treatment. Participants in both conditions showed significant reductions in PTSD symptoms. Sixty-minute sessions were found to be noninferior to 90-minute sessions in reducing PTSD symptoms, as the upper bound of the 95% confidence interval for the difference between conditions in the PTSD Symptom Scale-Interview (posttreatment: 6.00; follow-up: 6.77) was below the predefined noninferiority margin (7.00). Participants receiving shorter sessions showed less within- and between-session habituation than those receiving longer sessions, but no group differences in reductions in negative cognitions were found. The current findings indicate that the outcomes of 60-minute sessions of PE do not differ from those of 90-minute sessions. In addition, change in trauma-related cognitions and between-session habituation are both potential mechanisms of PE.",Nacasch N.; Huppert JD.; Su YJ.; Kivity Y.; Dinshtein Y.; Yeh R.; Foa EB.,2015.0,10.1016/j.beth.2014.12.002,0,0,
9725,The development of the Short Defeat and Entrapment Scale (SDES).,"Previous research has suggested that defeat (conceptualized as a failed social struggle) and entrapment (conceptualized as a perceived inability to escape from aversive situations) form a single construct that reliably predicts psychopathological outcomes in clinical and community settings. However, scales designed to assess defeat and entrapment measure the constructs separately, whereas recent evidence suggests a single scale would be appropriate. Existing scales may also be too lengthy to have clinical utility. The present study developed and evaluated a scale that measured both defeat and entrapment. Exploratory and confirmatory factor analyses demonstrated that defeat and entrapment were best defined by a single factor, and 8 items were selected that best represented this construct to form the short scale. The scale had high internal consistency (α = .88 to .94), showed criterion validity with hopelessness (r = .45 to .93) and incremental validity for caregiver burden when controlling for depression and positive symptoms of psychosis when controlling for hopelessness (β = .45 to .60). Additionally, the scale had excellent test-retest reliability using single measures absolute agreement intraclass correlation coefficients across 12 months (ricc = .88 to .92) within 4 samples: people with posttraumatic stress disorder, people with psychosis, care home employees, and people from community settings. The scale demonstrated known group validity through discrimination between clinical and nonclinical groups of participants. This scale could be implemented within therapeutic settings to help clinicians identify patients experiencing defeat and entrapment, and incorporate these factors into their clinical assessment and case formulations for treatment.",Griffiths AW.; Wood AM.; Maltby J.; Taylor PJ.; Panagioti M.; Tai S.,2015.0,10.1037/pas0000110,0,0,
9726,Effectiveness of case management-based aftercare coordination by phone for patients with depressive and anxiety disorders: study protocol for a randomized controlled trial.,"Depressive and anxiety disorders are highly prevalent, but only a small percentage (approximately 50%) of patients receive appropriate treatment. Relevant barriers include communication and coordination gaps between different providers that result from the lack of integration between different care-giving systems. Aftercare following inpatient treatment represents one of these gaps because systematic follow-up care does not exist. Case management-based aftercare coordination by phone might be a promising approach to overcoming this gap and improving long-term treatment outcomes. Case management is a patient-centered and situation-based approach comprising systematic tracking and support of patients by a case manager. The aim of this study is to evaluate the effectiveness of aftercare coordination by phone for patients with depressive and anxiety disorders. The effectiveness of aftercare coordination will be investigated in a prospective randomized controlled trial in four psychotherapeutic inpatient routine care units (St. Franziska-Stift Bad Kreuznach, MediClin Seepark Klinik Bad Bodenteich, Segeberger Kliniken Gruppe Bad Segeberg and Luisenklinik Bad Dürrheim). The patients receiving aftercare coordination (intervention group; IG) will be compared with those who receive treatment as usual (TAU control group; CG). Eligible patients will be required to have a diagnosis of an anxiety and/or depressive disorder and a recommendation for follow-up outpatient psychotherapy. The aftercare coordination consists of six phone contacts at intervals of two weeks that are performed by therapists in the inpatient units. The patients will complete questionnaires at discharge (t1), 3 months after discharge (i.e., at the end of the intervention (t2)) and 9 months after discharge (t3). The primary outcome will be change in symptom severity from t1 to t3, the secondary outcomes will be health-related quality of life and the proportion of patients who manage to begin outpatient psychotherapy by t3. This study will determine whether case management-based aftercare coordination by phone is an adequate approach for overcoming treatment barriers in the clinical pathways of patients with depressive and anxiety disorders. If proven effective, an accessible supplementary treatment approach that will help to maintain and even improve long-term treatment outcomes will be made available for patients following inpatient treatment. ClinicalTrials.gov: ( NCT02044913 ).",Kivelitz L.; Schulz H.; Melchior H.; Watzke B.,2015.0,10.1186/s12888-015-0469-y,0,0,
9727,The influence of patients' attributions of the immediate effects of treatment of depression on long-term effectiveness of behavioural activation and antidepressant medication.,"Patients' attributions of effects of treatment are important, as these can affect long-term outcome. Most studies so far focused on the influence of attributions to medication for anxiety and depression disorders. We investigated the effects of patients' attributions made after acute treatment on the long-term outcome of antidepressant medication (ADM) and psychological treatment (behavioural activation, BA). Data are based on a randomized trial testing the effectiveness of BA vs. ADM for major depression (MDD) in Iran. Patients with MDD (N = 100) were randomized to BA (N = 50) or ADM (N = 50). Patients' attributions were assessed at post-test (after completion of the treatments). Scores on an attribution questionnaire were factor analysed, and factor scores were retained as predictors of depressive symptoms at 1-year follow-up. Regression analysis was used to test whether attributions predicted depressive symptoms at 1-yr follow-up, controlling for symptom level, condition, and their interaction at post-test. Belief in coping efficacy was the only attribution factor significantly predicting 1-year HRSD scores, controlling for condition, post-test HRSD and their interaction. It also mediated the condition differences at follow-up. Credit to self was the single attribution factor that predicted BDI follow-up scores, controlling for condition, posttest BDI, and their interaction. It partially mediated the condition differences on the BDI at follow-up. Attribution to increased coping capacities and giving credit to self appear essential. In the long-term (at 1 year follow-up), the difference in outcome between BA and ADM (with BA being superior to ADM) is at least partially mediated by attributions.",Moradveisi L.; Huibers MJ.; Arntz A.,2015.0,10.1016/j.brat.2015.04.007,0,0,
9728,[Clinical intervention research on mental stress-induced myocardial ischemia].,"To observe the impact of Xinkeshu on top of standard medication on psychological stress-related emotional and biophysiological parameters in patients with mental stress-induced myocardial ischemia (MSIMI). A randomized controlled clinical trial was conducted on 40 patients with MSIMI and patients were randomized into treatment group (n = 21) and control group (n = 19) by random number table method. Patients in the treatment group received Xinkeshu (12 capsules/d) on top of standard therapy, and the control group received placebo on top of standard therapy. Serum homocysteine (Hcy), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were compared between the groups at baseline and after 8 weeks therapy. (1) Baseline data were similar between the 2 groups (all P > 0.05). (2) After 8 weeks, LVFS was significantly increased (from (34.62 ± 5.76)% to (35.90 ± 4.99) %, P = 0.027) and serum Hcy (from (18.08 ± 1.81) µmol/L to (16.06 ± 10.10) µmol/L), PHQ-9 (from 8.14 ± 3.98 to 6.28 ± 2.87) and GAD-7 (from 9.52 ± 4.98 to 6.48 ± 3.84) were significantly reduced in treatment group (all P < 0.05) compared to baseline. In the control group, only GAD-7 was significantly reduced (from 8.89 ± 5.06 to 6.74 ± 4.80, P = 0.003) after 8 weeks therapy compared to baseline (P < 0.05) while other parameters remained unchanged (all P > 0.05). Xinkeshu on the top of standard therapy can improve the emotional state and left ventricular systolic function in patients with MSIMI.",Liu M.; Liu M.,2015.0,,0,0,
9729,Impact of Anodal and Cathodal Transcranial Direct Current Stimulation over the Left Dorsolateral Prefrontal Cortex during Attention Bias Modification: An Eye-Tracking Study.,"People with anxiety disorders show an attentional bias for threat (AB), and Attention Bias Modification (ABM) procedures have been found to reduce this bias. However, the underlying processes accounting for this effect remain poorly understood. One explanation suggests that ABM requires the modification of attention control, driven by the recruitment of the dorsolateral prefrontal cortex (DLPFC). In the present double-blind study, we examined whether modifying left DLPFC activation influences the effect of ABM on AB. We used transcranial direct current stimulation (tDCS) to directly modulate cortical excitability of the left DLPFC during an ABM procedure designed to reduce AB to threat. Anodal tDCS increases excitability, whereas cathodal tDCS decreases it. We randomly assigned highly trait-anxious individuals to one of three conditions: 1) ABM combined with cathodal tDCS, 2) ABM combined with anodal tDCS, or 3) ABM combined with sham tDCS. We assessed the effects of these manipulations on both reaction times and eye-movements on a task indexing AB. Results indicate that combining ABM and anodal tDCS over the left DLPFC reduces the total duration that participants' gaze remains fixated on threat, as assessed using eye-tracking measurement. However, in contrast to previous studies, there were no changes in AB from baseline to post-training for participants that received ABM without tDCS. As the tendency to maintain attention to threat is known to play an important role in the maintenance of anxiety, the present findings suggest that anodal tDCS over the left DLPFC may be considered as a promising tool to reduce the maintenance of gaze to threat. Implications for future translational research combining ABM and tDCS are discussed.",Heeren A.; Baeken C.; Vanderhasselt MA.; Philippot P.; de Raedt R.,2015.0,10.1371/journal.pone.0124182,0,0,
9730,"In the wake of a possible mistake: Security motivation, checking behavior, and OCD.","In previous experiments, OCD washers did not differ significantly from controls in their initial level of activation in response to the potential threat of contamination; however, they were less able to reduce their activation by engaging in hand-washing, suggesting that the key problem in OCD is a faulty stopping mechanism. The main objectives of the present experiments were to develop a similar experimental paradigm for investigating checking behavior, and to use it to test the hypothesis that a faulty stopping mechanism also underlies OCD checking. Participants sorted pills under the guise of beta testing a new medication system and then were given suggestions of the possibility of having made mistakes with potentially serious consequences. Later, participants engaged in a 90-s checking period and an unlimited period of checking. At baseline and three other times during the experiment, security motivation was measured with respiratory sinus arrhythmia (RSA) and subjective ratings of confidence. Experiment 1 established the parameters of the paradigm in non-patient participants, and Experiment 2 contrasted OCD checkers with OCD washers and non-patients. Results for both subjective and physiological measures of security motivation closely replicated previous findings for washing behavior. Groups did not differ significantly in initial activation, but the OCD checkers were unable to reduce their activation by engaging in period of checking that was ample for returning controls to baseline. The sample size for the patient groups was modest. These results lend further support to the security-motivation theory of OCD.",Hinds AL.; Woody EZ.; Schmidt LA.; Van Ameringen M.; Szechtman H.,2015.0,10.1016/j.jbtep.2015.03.016,0,0,
9731,Mindfulness and acceptance-based group therapy and traditional cognitive behavioral group therapy for social anxiety disorder: Mechanisms of change.,"The present study investigated mechanisms of change for two group treatments for social anxiety disorder (SAD): cognitive behavioral group therapy (CBGT) and mindfulness and acceptance-based group therapy (MAGT). Participants were treatment completers (n = 37 for MAGT, n = 32 for CBGT) from a randomized clinical trial. Cognitive reappraisal was the hypothesized mechanism of change for CBGT. Mindfulness and acceptance were hypothesized mechanisms of change for MAGT. Latent difference score (LDS) analysis results demonstrate that cognitive reappraisal coupling (in which cognitive reappraisal is negatively associated with the subsequent rate of change in social anxiety) had a greater impact on social anxiety for CBGT than MAGT. The LDS bidirectional mindfulness model (mindfulness predicts subsequent change in social anxiety; social anxiety predicts subsequent change in mindfulness) was supported for both treatments. Results for acceptance were less clear. Cognitive reappraisal may be a more important mechanism of change for CBGT than MAGT, whereas mindfulness may be an important mechanism of change for both treatments.",Kocovski NL.; Fleming JE.; Hawley LL.; Ho MH.; Antony MM.,2015.0,10.1016/j.brat.2015.04.005,0,0,
9732,Auricular acupuncture for sleep disturbance in veterans with post-traumatic stress disorder: a feasibility study.,"The purpose of this study was to examine the feasibility and acceptability of an auricular acupuncture (AA) insomnia regimen among Operation Iraqi Freedom and Operation Enduring Freedom veterans with post-traumatic stress disorder and sleep disturbance. Secondarily, this study examined the effect of an AA insomnia regimen on objective sleep times by wrist actigraphy, subjective sleep times by sleep diary, and sleep quality ratings utilizing the Pittsburg Sleep Quality Index. Veterans (n = 30) were randomized to receive a 3-week AA insomnia regimen. Veterans receiving the AA insomnia regimen reported it as a more acceptable treatment for sleep disturbance than subjects in the control group (AA group median = 5 vs. control group median = 3, p = 0.004). Significant differences between groups were found on the sleep quality and daytime dysfunction components of the Pittsburgh Sleep Quality Index (p = 0.003, p = 0.004). No other significant differences between groups were found for objective and subjective sleep measures. These results suggest that an AA insomnia regimen may improve sleep quality and daytime dysfunction among veterans with post-traumatic stress disorder. Future, large-scale, prospective clinical trials are needed to examine AA effects on sleep.",King HC.; Spence DL.; Hickey AH.; Sargent P.; Elesh R.; Connelly CD.,2015.0,10.7205/MILMED-D-14-00451,0,0,
9733,Cost-Effectiveness of Integrating Tobacco Cessation Into Post-Traumatic Stress Disorder Treatment.,"We examined the cost-effectiveness of smoking cessation integrated with treatment for post-traumatic stress disorder (PTSD). Smoking veterans receiving care for PTSD (N = 943) were randomized to care integrated with smoking cessation versus referral to a smoking cessation clinic. Smoking cessation services, health care cost and utilization, quality of life, and biochemically-verified abstinence from cigarettes were assessed over 18-months of follow-up. Clinical outcomes were combined with literature on changes in smoking status and the effect of smoking on health care cost, mortality, and quality of life in a Markov model of cost-effectiveness over a lifetime horizon. We discounted cost and outcomes at 3% per year and report costs in 2010 US dollars. The mean of smoking cessation services cost was $1286 in those randomized to integrated care and $551 in those receiving standard care (P < .001). There were no significant differences in the cost of mental health services or other care. After 12 months, prolonged biochemically verified abstinence was observed in 8.9% of those randomized to integrated care and 4.5% of those randomized to standard care (P = .004). The model projected that Integrated Care added $836 in lifetime cost and generated 0.0259 quality adjusted life years (QALYs), an incremental cost-effectiveness ratio of $32 257 per QALY. It was 86.0% likely to be cost-effective compared to a threshold of $100 000/QALY. Smoking cessation integrated with treatment for PTSD was cost-effective, within a broad confidence region, but less cost-effective than most other smoking cessation programs reported in the literature.",Barnett PG.; Jeffers A.; Smith MW.; Chow BK.; McFall M.; Saxon AJ.,2016.0,10.1093/ntr/ntv094,0,0,
9734,AN OPEN TRIAL OF EMOTION REGULATION THERAPY FOR GENERALIZED ANXIETY DISORDER AND COOCCURRING DEPRESSION.,"Although CBT is efficacious for a wide variety of psychiatric conditions, relatively fewer GAD patients achieve high endstate functioning as compared to patients receiving CBTs for other disorders. Moreover, GAD trials that utilized patient samples without prominent depression have tended to report that effect sizes for depressive outcomes were small or diminished to pretreatment levels in the follow-up period. Emotion regulation therapy (ERT) integrates principles from traditional and contemporary cognitive behavioral treatments with basic and translational findings from affect science to offer a blueprint for improving intervention by focusing on motivational, regulatory, and contextual learning mechanisms. The purpose of this investigation was to provide initial support for the efficacy of ERT in an open trial of patients with GAD and cooccurring depressive symptoms. Twenty-one patients received a 20-session version of ERT delivered in weekly individual sessions. Standardized clinician ratings and self-report measures were assessed at pre-, mid-, and posttreatment as well as at three- and nine-month follow-ups. Intent-to-treat analyzes were utilized. GAD patients, half with comorbid major depression, evidenced statistically, and clinically meaningful improvements in symptom severity, impairment, quality of life, and in model-related outcomes including emotional/motivational intensity, mindful attending/acceptance, decentering, and cognitive reappraisal. Patients maintained gains across the three and nine month follow-up periods. These findings, although preliminary, provide additional evidence for the role of emotion dysregulation in the onset, maintenance, and now treatment of conditions such as GAD and cooccurring depressive symptoms.",Mennin DS.; Fresco DM.; Ritter M.; Heimberg RG.,2015.0,10.1002/da.22377,0,0,
9735,[Help-seeking behavior and pathways to care for patients with obsessive-compulsive disorders].,"Obsessive-compulsive disorder (OCD) is a chronic and debilitating disorder that is relatively common and is associated with a wide range of functional impairments. This is partly associated with delayed help-seeking behavior of OCD patients, which shows a lag of up to 10 years after onset of the obsessive-compulsive symptoms to the first attempt at seeking professional treatment. The reasons for the delay in initial help-seeking behavior by OCD patients are manifold but still not clear. Early detection and early treatment might, however, have beneficial effects on the treatment-seeking behavior. The aim of the study was to examine the help-seeking behavior and the pathways to care of patients with OCD using a modified version of the structured pathways to care questionnaire initially designed for research into schizophrenia. For the 40 outpatients with OCD who completed the interview retrospectively, the latent period between symptom onset and first seeking professional contact was on average 6.5 years, while the median delay to a third attempt at seeking treatment was nearly 15 years. Although the majority of participants consulted a professional neurological and psychotherapeutic practice even at the first attempt and 90% complained of specific OCD symptoms, only 20% received the standard treatment consisting of cognitive behavioral therapy and medication with a selective serotonin reuptake inhibitor (SSRI). The most common reason for delaying seeking treatment was that the patient was not convinced of having a mental illness such as OCD and of the necessity for treatment. Even so, approximately 40% of the participants reported fear of stigmatization and discrimination as a major reason for the delay in the first attempt at seeking help. Psychoeducation and broad utilization of evidence-based treatment still appears necessary and can contribute to improvement in the help-seeking behavior of OCD patients.",Mavrogiorgou P.; Siebers F.; Kienast T.; Juckel G.,2015.0,10.1007/s00115-015-4298-5,0,0,
9736,D-Cycloserine vs Placebo as Adjunct to Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder and Interaction With Antidepressants: A Randomized Clinical Trial.,"It is unclear whether d-cycloserine (DCS), a partial N-methyl-d-aspartate agonist that enhances fear extinction, can augment the effects of exposure-based cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD). To examine whether DCS augments the effects of CBT for OCD and to explore (post hoc) whether concomitant antidepressant medication moderates the effects of DCS. A 12-week, double-blind randomized clinical trial with 3-month follow-up conducted at an academic medical center between September 4, 2012, and September 26, 2013. Participants included 128 adult outpatients with a primary diagnosis of OCD and a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of 16 or higher. Concurrent antidepressant medication was permitted if the dose had been stable for at least 2 months prior to enrollment and remained unchanged during the trial. The main analysis was by intention-to-treat population. All participants received a previously validated Internet-based CBT protocol over 12 weeks and were randomized to receive either 50 mg of DCS or placebo, administered 1 hour before each of 5 exposure and response prevention tasks. Clinician-administered Y-BOCS score at week 12 and at 3-month follow-up. Remission was defined as a score of 12 or lower on the Y-BOCS. In the primary intention-to-treat analyses, DCS did not augment the effects of CBT compared with placebo (mean [SD] clinician-rated Y-BOCS score, DCS: 13.86 [6.50] at week 12 and 12.35 [7.75] at 3-month follow-up; placebo: 11.77 [5.95] at week 12 and 12.37 [6.68] at 3-month follow-up) but showed a significant interaction with antidepressants (clinician-rated Y-BOCS, B = -1.08; Z = -2.79; P = .005). Post hoc analyses revealed that antidepressants significantly impaired treatment response in the DCS group but not the placebo group, at both posttreatment and follow-up (clinician-rated Y-BOCS: t62 = -3.00; P = .004; and t61 = -3.49; P < .001, respectively). In the DCS group, a significantly greater proportion of antidepressant-free patients achieved remission status at follow-up (60% [95% CI, 45%-74%]) than antidepressant-medicated patients (24% [95% CI, 9%-48%]) (P = .008). Antidepressants had no effect in the placebo group (50% [95% CI, 36%-64%] remission rate in both groups). The findings suggest that antidepressants may interact with DCS to block its facilitating effect on fear extinction. Use of DCS may be a promising CBT augmentation strategy but only in antidepressant-free patients with OCD. clinicaltrials.gov Identifier: NCT01649895.",Andersson E.; Hedman E.; Enander J.; Radu Djurfeldt D.; Ljótsson B.; Cervenka S.; Isung J.; Svanborg C.; Mataix-Cols D.; Kaldo V.; Andersson G.; Lindefors N.; Rück C.,2015.0,10.1001/jamapsychiatry.2015.0546,0,0,
9737,"Impact of a Yoga Intervention on Physical Activity, Self-Efficacy, and Motivation in Women with PTSD Symptoms.","Studies using yoga have demonstrated initial efficacy for treating symptoms across anxiety disorders, including posttraumatic stress disorder. Understanding how interventions influence participants' physical activity and what determinants affect continued physical activity behavior change is important because maintenance of the behavior may be critical to continued mental health gains and symptom reduction. This study investigated change in physical activity and possible psychological mechanisms of physical activity behavior change, including self-efficacy and regulatory motivation, in a randomized controlled trial of yoga for women with post-traumatic stress disorder symptoms (n=38). Growth curve modeling results showed no significant changes in physical activity or self-efficacy for either group, whereas external motivation decreased significantly in the yoga group but not in the control group. Investigators of future yoga interventions may want to focus on increasing self-efficacy and internal regulatory motivation, so that physical activity and resultant symptom relief can be maintained.",Martin EC.; Dick AM.; Scioli-Salter ER.; Mitchell KS.,2015.0,10.1089/acm.2014.0389,0,0,
9738,Scalable Options for Extended Skill Building Following Didactic Training in Cognitive-Behavioral Therapy for Anxious Youth: A Pilot Randomized Trial.,"A sizable gap exists between the availability of evidence-based psychological treatments and the number of community therapists capable of delivering such treatments. Limited time, resources, and access to experts prompt the need for easily disseminable, lower cost options for therapist training and continued support beyond initial training. A pilot randomized trial tested scalable extended support models for therapists following initial training. Thirty-five postdegree professionals (43%) or graduate trainees (57%) from diverse disciplines viewed an initial web-based training in cognitive-behavioral therapy (CBT) for youth anxiety and then were randomly assigned to 10 weeks of expert streaming (ES; viewing weekly online supervision sessions of an expert providing consultation), peer consultation (PC; non-expert-led group discussions of CBT), or fact sheet self-study (FS; weekly review of instructional fact sheets). In initial expectations, trainees rated PC as more appropriate and useful to meet its goals than either ES or FS. At post, all support programs were rated as equally satisfactory and useful for therapists' work, and comparable in increasing self-reported use of CBT strategies (b = .19, p = .02). In contrast, negative linear trends were found on a knowledge quiz (b = -1.23, p = .01) and self-reported beliefs about knowledge (b = -1.50, p < .001) and skill (b = -1.15, p < .001). Attrition and poor attendance presented a moderate concern for PC, and ES was rated as having the lowest implementation potential. Preliminary findings encourage further development of low-cost, scalable options for continued support of evidence-based training.",Chu BC.; Carpenter AL.; Wyszynski CM.; Conklin PH.; Comer JS.,,10.1080/15374416.2015.1038825,0,0,
9739,The effects of aggression on symptom severity and treatment response in a trial of cognitive behavioral therapy for panic disorder.,"Previous research suggests that patients with panic disorder exhibit higher levels of aggression than patients with other anxiety disorders. This aggression is associated with more severe symptomatology and interpersonal problems. However, few studies have examined whether higher levels of aggression are associated with a worse treatment response in this population. The present study sought to examine the association of aggression with panic disorder symptom severity in a sample of 379 patients who participated in a trial examining long-term strategies for the treatment of panic disorder. We found that aggression was significantly associated with higher baseline levels of panic disorder symptoms, anxiety, depression, and functional impairment. Further, we found that patients higher in aggression did not achieve the same level of improvement in general anxiety symptoms during treatment compared to patients lower in aggression, even when controlling for baseline anxiety symptom severity. These results suggest that more research is needed concerning patients with anxiety disorders with higher aggression, as they may be a group in need of additional treatment considerations.",Cassiello-Robbins C.; Conklin LR.; Anakwenze U.; Gorman JM.; Woods SW.; Shear MK.; Barlow DH.,2015.0,10.1016/j.comppsych.2015.04.012,0,0,
9740,Effect of low frequency transcutaneous magnetic stimulation on sensory and motor transmission.,"Peripheral nerve injury diminishes fast conducting large myelinated afferent fibers transmission but enhances smaller pain transmitting fibers firing. This aberrant afferent neuronal behavior contributes to development of chronic post-traumatic peripheral neuropathic pain (PTP-NP). Non-invasive dynamic magnetic flux stimulation has been implicated in treating PTP-NP, a condition currently not adequately addressed by other therapies including transcutaneous electrical nerve stimulation (TENS). The current study assessed the effect of low frequency transcutaneous magnetic stimulation (LFTMS) on peripheral sensory thresholds, nerve conduction properties, and TENS induced fast afferent slowing effect as measured by motor and sensory conduction studies in the ulnar nerve. Results indicated sham LFTMS with TENS (Sham‚Äâ+‚ÄâTENS) significantly (P‚Äâ=‚Äâ0.02 and 0.007, respectively) reduces sensory conduction velocity (CV) and increases sensory onset latency (OL), and motor peak latency (PL) whereas, real LFTMS with TENS (Real‚Äâ+‚ÄâTENS) reverses effects of TENS on sensory CV and OL, and significantly (P‚Äâ=‚Äâ0.036) increases the sensory PL. LFTMS alone significantly (P‚Äâ<‚Äâ0.05) elevates sensory PL and onset-to-peak latency. LFTMS appears to reverse TENS slowing effect on fast conducting fibers and casts a selective peripheral modulatory effect on slow conducting pain afferent fibers.",Leung A.; Shukla S.; Lee J.; Metzger-Smith V.; He Y.; Chen J.; Golshan S.,2015.0,10.1002/bem.21921,0,0,
9741,[10-Year Follow-Up of the NexGen CR Total Knee Prosthesis].,"The purpose of this study was to evaluate long-term clinical and radiological results as well as survival rates of the NexGen® CR posterior cruciate retaining prosthesis. We evaluated a consecutive series of 761 total knee replacements performed on 716 patients from 1999 to 2001 at our institution. All patients had been recorded prospectively in our in-house arthroplasty register. Follow-up data were available for 379 patients at 10 years postoperatively. Functional outcome was evaluated using the Knee Society score. An additional radiographic evaluation was performed on 224 patients at 10 years. The mean age of the patients at the time of surgery was 71 years. 75 % of the patients were female, 25 % were male. Mean BMI of the patients was 29.2 kg/m(2). The preoperative diagnosis was osteoarthritis in 91 %, rheumatoid arthritis in 5,5 % and posttraumatic osteoarthritis in 2 %. Patella resurfacing was performed in 4 %. All components were cemented. Mean Knee Society clinical score improved from 26.7 points preoperatively to 88.5 points at the time of the latest follow-up, and mean Knee Society function score improved from 48.3 to 55.2 points. Flexion improved from a mean of 106.7° preoperatively to 111.4° at 10 years. Patellofemoral pain was indicated by 66 % of the patients before surgery and 4 % at the latest follow-up. 96 % were satisfied with the result of the surgery at 10 years. Radiographic evaluation was performed on 224 patients at the time of the latest follow-up. 203 patients (91 %) had normal radiographic findings, 21 patients (9 %) showed pathological findings. Radiolucencies were seen in 18 patients on the AP view of the tibia, 1 patient had an additional femoral radiolucency. There was an osteolysis located in the lateral tibia seen in 1 patient and an occurrence of heterotopic ossification in another patient. One knee showed a patella subluxation. No patient had radiographic evidence of loosening. 17 knees had required revision surgery with exchange of at least one of the components up to 10 years after the index procedure. 5 of the patients had revision for a deep infection, 2 for periprosthetic fractures of the distal femur with loosening of the prosthesis, 1 for fracture of the proximal tibia due to osteoporosis, 4 for aseptic loosening, 3 for instability and 2 for severe pain. Kaplan-Meier survival of all components using revision for any reason as the end point was 97.8 % at 10 years. The good clinical and radiological long-term results as well as the satisfactory survival rate after total knee replacement with the NexGen CR® prosthesis are comparable with the results of other long-term studies using the NexGen CR® and assimilable prosthesis. Our results demonstrate that quality of life was improved by the implantation of the NexGen CR® prosthesis even a long time after the index procedure despite old age and comorbidity of the patients.",Hack J.; Mai S.; Siebert W.,2015.0,10.1055/s-0035-1546040,0,0,
9742,"Horticultural therapy: a pilot study on modulating cortisol levels and indices of substance craving, posttraumatic stress disorder, depression, and quality of life in veterans.","Horticultural therapy (HT) is a subgroup of occupational therapy (OT). Both HT and OT have been successful as adjunctive treatment modalities in substance abuse treatment. Studies have indicated that gardening promotes neuroendocrine and affective restoration from stress. The study intended to assess the effect of HT versus nonhorticultural OT on cortisol levels, depression, symptoms of posttraumatic stress disorder (PTSD), alcohol cravings, and quality of life. The research team designed a randomized pilot study. The study was open for participation from July 2012-October 2012. It took place during multiple occurrences of a 28-d treatment programs for substance use disorder at a Veterans Affairs medical center. Participants • Participants were 49 veterans, averaging 46.4 y old (SD = 11.9); the dropout rate was 37%. Participants were randomly assigned to the HT or the OT group. They attended supervised HT and OT groups 5 h/d for 3 wk. Outcome Measures • Pre- and posttreatment, participants completed the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF), the Alcohol Craving Questionnaire (ACQ-NOW), the Posttraumatic Stress Disorder Checklist Civilian Version (PCLC), and the Center for Epidemiologic Studies Depression Scale (CES-D). Salivary cortisol samples were taken at wk 1, 2, and 3. A repeated measures analysis of variance (ANOVA) (F2,20 = 0.878) revealed that the HT performed was associated with a 12% reduction in salivary cortisol levels from wk 1 to wk 3, but the difference was not statistically significant (P = .43). Separate 1-way analyses of covariance (ANCOVAs) revealed no statistically significant differences in the self-administered tests, although both the Q-LES-Q-SF and CES-D showed a trend toward improving quality of life and depressive symptoms in the HT group compared with the OT group. Additional analysis of the nonbiologic tests suggests that most participants in the HT and OT had some benefit from the programmed activities. The trends suggest that HT may modulate stress in veterans, as evidenced by decreased cortisol levels and depressive symptoms, and may improve quality of life more than the programs in which the OT group participated. Further investigation with larger samples, including a nontreatment control group, is needed to determine whether the observed trends are treatment effects or due to abstinence.",Detweiler MB.; Self JA.; Lane S.; Spencer L.; Lutgens B.; Kim DY.; Halling MH.; Rudder TC.; Lehmann LP.,,,0,0,6235
9743,Telephone-based goal management training for adults with mild traumatic brain injury: study protocol for a randomized controlled trial.,"Approximately 1 million individuals experience a mild traumatic brain injury (TBI) and cost the United States nearly $17 billion each year. Many trauma survivors with mild TBI have debilitating and long-term physical, emotional, and cognitive impairments that are unrecognized at trauma centers. Early intervention studies are needed to address these impairments, especially cognitive deficits in executive functioning. Goal management training (GMT) is a structured cognitive rehabilitation program that has been found to improve executive functioning in patients with moderate to severe TBI. The current study adapted the GMT program for telephone delivery in order to improve the accessibility of rehabilitation services in a patient population with multiple barriers to care and significant yet unrecognized cognitive impairment. The primary objective of this study is to examine the efficacy of telephone-based GMT for improving executive functioning, functional status, and psychological health in trauma survivors with mild TBI. This study is a three-group randomized controlled trial being conducted at a Level I trauma center. Ninety trauma survivors with mild TBI and cognitive deficits in executive functioning will be randomized to receive telephone-based GMT, telephone-based education, or usual care. GMT and education programs will be delivered by a physical therapist. The first in-person session is 1 h and the remaining six telephone sessions are 30 min. A battery of well-established cognitive tests will be conducted and validated questionnaires will be collected that measure executive functioning, functional status, and depressive and posttraumatic stress disorder symptoms at 6 weeks, 4 months, and 7 months following hospital discharge. This study supports a telephone-delivery approach to rehabilitation services in order to broaden the availability of evidence-based cognitive strategies. This trial was registered with Clinicaltrials.gov on 10 October 2012, registration number: NCT01714531.",Archer KR.; Coronado RA.; Haislip LR.; Abraham CM.; Vanston SW.; Lazaro AE.; Jackson JC.; Ely EW.; Guillamondegui OD.; Obremskey WT.,2015.0,10.1186/s13063-015-0775-1,0,0,
9744,Validation of the yale-brown obsessive compulsive scale modified for binge eating.,"Establish the Yale-Brown obsessive compulsive scale modified for binge eating (YBOCS-BE) as a fit for purpose measure of treatment benefit in clinical trials of binge eating disorder (BED). YBOCS-BE psychometric properties were evaluated with data from a Phase 2 randomized controlled trial of lisdexamfetamine dimesylate in 260 adults with BED. Assessments included: Cohen's effect size estimates of item-level sensitivity and scale-level external responsiveness; item-to-total correlations; Cronbach's alpha for internal consistency reliability; Spearman correlations against reference measures for construct validity; known-groups analyses for discriminating ability; t tests of within-group differences between baseline and post baseline visits for internal responsiveness; and multiple anchor-based approaches to estimate minimum clinically important change (MCIC). No significant distribution anomalies were seen. Items appear sensitive to treatment group differences. Item-to-total correlations were positive. Internal consistency is 0.81. Large correlations (>0.50) were seen between YBOCS-BE score change and the Clinical Global Impression-Improvement (CGI-I; 0.58) and score changes for the following; number of binge days (0.38), Clinical Global Impression-Severity (CGI-S; 0.57), the disinhibition (0.57) and hunger (0.52) subscales of the Three-Factor Eating Questionnaire (TFEQ), and the Barratt Impulsiveness Scale (BIS-11; 0.58). MCIC estimates range from -4 to -17. The YBOCS-BE was found to be a reliable and valid measure of an important and unique concept in BED-related clinical studies. Study limitations include using protocol-defined BED severity level and the exclusion of psychiatric comorbidities.",Deal LS.; Wirth RJ.; Gasior M.; Herman BK.; McElroy SL.,2015.0,10.1002/eat.22407,0,0,
9745,The Effect of Combination of Video Feedback and Audience Feedback on Social Anxiety: Preliminary Findings.,"Although video feedback (VF) is shown to improve appraisals of social performance in socially anxious individuals, its impact on state anxiety during a social situation is mixed. The current study investigated the effect of combined video feedback and audience feedback (AF) on self-perceptions of performance and bodily sensations as well as state anxiety pertaining to a speech task. Forty-one socially anxious students were randomly allocated to combined video feedback with audience feedback (VF + AF), video feedback only (VF), audience feedback only (AF), or a control condition. Following a 3-min speech, participants in the VF + AF, VF, and AF conditions watched the videotape of their speech with cognitive preparation in the presence of three confederates who served as audience, and/or received feedback from the confederates, while the control group watched their videotaped speech without cognitive preparation. Both VF + AF and AF conditions improved distorted appraisal of performance and bodily sensations as well as state anxiety. The clinical implications of these findings are discussed.",Chen J.; Mak R.; Fujita S.,2015.0,10.1177/0145445515587087,0,0,
9746,"Effects of therapeutic relationship, expectancy, and credibility in breathing therapies for anxiety.","The authors investigated the effects of the quality of the therapeutic alliance, expectancy of improvement, and credibility of treatment on the outcome of two breathing therapies for anxiety and panic. Data were collected during a randomized clinical trial evaluating the efficacy of two theoretically opposing, end-tidal pCO2 feedback-assisted breathing therapies for patients experiencing anxiety attacks. In this study, five weekly individual breathing therapy sessions were administered for the patients who were experiencing anxiety attacks as symptoms of various anxiety disorders. The outcome of this trial indicated that regardless of the opposing breathing instructions (raise or lower pCO2) used in the two breathing therapies, patients in both treatment groups improved equally after treatment. Nonspecific factors rather than the different directions of pCO2 changes could have played a role in the improvement. Regression analyses showed that for both therapies patient-rated therapeutic alliance was predictive of improvement at the 1-month follow-up, and that patient-rated confidence that the therapy would produce improvement, an aspect of its credibility, accounted for almost half of the variance in improvement at the 6-month follow-up. Thus, two factors usually considered nonspecific were identified to be potent predictors of treatment outcome.",Kim S.; Roth WT.; Wollburg E.,2015.0,10.1521/bumc.2015.79.2.116,0,0,
9747,Intolerance of uncertainty as a mediator of reductions in worry in a cognitive behavioral treatment program for generalized anxiety disorder.,"Growing evidence suggests that intolerance of uncertainty (IU) is a cognitive vulnerability that is a central feature across diverse anxiety disorders, including generalized anxiety disorder (GAD). Although cognitive behavioral therapy (CBT) has been shown to reduce IU, it remains to be established whether or not reductions in IU mediate reductions in worry. This study examined the process of change in IU and worry in a sample of 28 individuals with GAD who completed CBT. Changes in IU and worry, assessed bi-weekly during treatment, were analyzed using multilevel mediation models. Results revealed that change in IU mediated change in worry (ab = -0.20; 95% CI [-.35, -.09]), but change in worry did not mediate change in IU (ab = -0.16; 95% CI [-.06, .12]). Findings indicated that reductions in IU accounted for 59% of the reductions in worry observed over the course of treatment, suggesting that changes in IU are not simply concomitants of changes in worry. Findings support the idea that IU is a critical construct underlying GAD.",Bomyea J.; Ramsawh H.; Ball TM.; Taylor CT.; Paulus MP.; Lang AJ.; Stein MB.,2015.0,10.1016/j.janxdis.2015.05.004,0,0,
9748,Alterations of Gray and White Matter Networks in Patients with Obsessive-Compulsive Disorder: A Multimodal Fusion Analysis of Structural MRI and DTI Using mCCA+jICA.,"Many of previous neuroimaging studies on neuronal structures in patients with obsessive-compulsive disorder (OCD) used univariate statistical tests on unimodal imaging measurements. Although the univariate methods revealed important aberrance of local morphometry in OCD patients, the covariance structure of the anatomical alterations remains unclear. Motivated by recent developments of multivariate techniques in the neuroimaging field, we applied a fusion method called ""mCCA+jICA"" on multimodal structural data of T1-weighted magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) of 30 unmedicated patients with OCD and 34 healthy controls. Amongst six highly correlated multimodal networks (p < 0.0001), we found significant alterations of the interrelated gray and white matter networks over occipital and parietal cortices, frontal interhemispheric connections and cerebella (False Discovery Rate q ≤ 0.05). In addition, we found white matter networks around basal ganglia that correlated with a subdimension of OC symptoms, namely 'harm/checking' (q ≤ 0.05). The present study not only agrees with the previous unimodal findings of OCD, but also quantifies the association of the altered networks across imaging modalities.",Kim SG.; Jung WH.; Kim SN.; Jang JH.; Kwon JS.,2015.0,10.1371/journal.pone.0127118,0,0,
9749,The Pain Course: a randomised controlled trial examining an internet-delivered pain management program when provided with different levels of clinician support.,"The present study evaluated an internet-delivered pain management program, the Pain Course, when provided with different levels of clinician support. Participants (n = 490) were randomised to 1 of 4 groups: (1) Regular Contact (n = 143), (2) Optional Contact (n = 141), (3) No Contact (n = 131), and (4) a treatment-as-usual Waitlist Control Group (n = 75). The treatment program was based on the principles of cognitive behaviour therapy and comprised 5 internet-delivered lessons provided over 8 weeks. The 3 Treatment Groups reported significant improvements (between-group Cohen's d; avg. reduction) in disability (ds ‚â• 0.50; avg. reduction ‚â• 18%), anxiety (ds ‚â• 0.44; avg. reduction ‚â• 32%), depression (ds ‚â• 0.73; avg. reduction ‚â• 36%), and average pain (ds ‚â• 0.30; avg. reduction ‚â• 12%) immediately posttreatment, which were sustained at or further improved to 3-month follow-up. High treatment completion rates and levels of satisfaction were reported, and no marked or consistent differences were observed between the Treatment Groups. The mean clinician time per participant was 67.69 minutes (SD = 33.50), 12.85 minutes (SD = 24.61), and 5.44 minutes (SD = 12.38) for those receiving regular contact, the option of contact, and no clinical contact, respectively. These results highlight the very significant public health potential of carefully designed and administered internet-delivered pain management programs and indicate that these programs can be successfully administered with several levels of clinical support.",Dear BF.; Gandy M.; Karin E.; Staples LG.; Johnston L.; Fogliati VJ.; Wootton BM.; Terides MD.; Kayrouz R.; Perry KN.; Sharpe L.; Nicholas MK.; Titov N.,2015.0,10.1097/j.pain.0000000000000251,0,0,
9750,Untangling attention bias modification from emotion: A double-blind randomized experiment with individuals with social anxiety disorder.,"Uncertainty abounds regarding the putative mechanisms of attention bias modification (ABM). Although early studies showed that ABM reduced anxiety proneness more than control procedures lacking a contingency between cues and probes, recent work suggests that the latter performed just as well as the former did. In this experiment, we investigated a non-emotional mechanism that may play a role in ABM. We randomly assigned 62 individuals with a DSM-IV diagnosis of social anxiety disorder to a single-session of a non-emotional contingency training, non-emotional no-contingency training, or control condition controlling for potential practice effects. Working memory capacity and anxiety reactivity to a speech challenge were assessed before and after training. Consistent with the hypothesis of a practice effect, the three groups likewise reported indistinguishably significant improvement in self-report and behavioral measures of speech anxiety as well as in working memory. Repeating the speech task twice may have had anxiolytic benefits. The temporal separation between baseline and post-training assessment as well as the scope of the training sessions could be extended. The current findings are at odds with the hypothesis that the presence of visuospatial contingency between non-emotional cues and probes produces anxiolytic benefits. They also show the importance of including a credible additional condition controlling for practice effects.",Heeren A.; Coussement C.; McNally RJ.,2016.0,10.1016/j.jbtep.2015.05.005,0,0,
9751,Gender Differences in Service Utilization among OEF/OIF Veterans with Posttraumatic Stress Disorder after a Brief Cognitive-Behavioral Intervention to Increase Treatment Engagement: A Mixed Methods Study.,"Women veterans who served in Iraq and Afghanistan (Operation Enduring Freedom and Operation Iraqi Freedom [OEF/OIF]) have a moderately higher risk of developing posttraumatic stress disorder (PTSD) than male veterans. However, gender disparities in treatment engagement may prevent women veterans from initiating the care they need. Understanding gender differences in predictors of and barriers to treatment is essential to improving engagement and mental health outcomes. The purpose of this study was to examine gender differences in treatment utilization after a brief, cognitive-behavioral therapy (CBT) intervention among male and female OEF/OIF veterans. Participants were assigned randomly to either the intervention or control conditions. Intervention participants received the telephone-based CBT intervention. Participants were 35 female and 238 male OEF/OIF veterans who screened positive for PTSD and had never initiated PTSD treatment. Participants were asked about treatment utilization, beliefs about PTSD treatment, and symptoms at months 1, 3, and 6 months subsequent to the baseline telephone assessment. The PTSD Checklist-Military Version was used to assess PTSD and the Patient's Health Questionnaire was used to assess symptoms of depression. Female veterans who received an intervention were significantly more likely to have attended treatment over the 6-month follow-up period than male veterans who received an intervention (χ(2) = 7.91; df = 3; odds ratio, 3.93; p = .04). The CBT intervention may be a critical mechanism to engage female veterans in treatment. Further research is needed to understand how to engage male veterans with PTSD in treatment.",Gallegos AM.; Wolff KB.; Streltzov NA.; Adams LB.; Carpenter-Song E.; Nicholson J.; Stecker T.,,10.1016/j.whi.2015.04.008,0,0,6353
9752,Adult attachment as a moderator of treatment outcome for generalized anxiety disorder: Comparison between cognitive-behavioral therapy (CBT) plus supportive listening and CBT plus interpersonal and emotional processing therapy.,"To determine whether baseline dimensions of adult insecure attachment (avoidant and anxious) moderated outcome in a secondary analysis of a randomized controlled trial comparing cognitive-behavioral therapy (CBT) plus supportive listening (CBT + SL) versus CBT plus interpersonal and emotional processing therapy (CBT + I/EP). Eighty-three participants diagnosed with generalized anxiety disorder (GAD) were recruited from the community and assigned randomly to CBT + SL (n = 40) or to CBT + I/EP (n = 43) within a study using an additive design. PhD-level psychologists treated participants. Blind assessors evaluated participants at pretreatment, posttreatment, 6-month, 12-month, and 2-year follow-up with a composite of self-report and assessor-rated GAD symptom measures (Penn State Worry Questionnaire, Hamilton Anxiety Rating Scale, Clinician's Severity Rating). Avoidant and anxious attachment were assessed using self-reported dismissing and angry states of mind, respectively, on the Perceptions of Adult Attachment Questionnaire. Consistent with our prediction, at all assessments higher levels of dismissing styles in those who received CBT + I/EP predicted greater change in GAD symptoms compared with those who received CBT + SL for whom dismissiveness was unrelated to the change. At postassessment, higher angry attachment was associated with less change in GAD symptoms for those receiving CBT + I/EP, compared with CBT + SL, for whom anger was unrelated to change in GAD symptoms. Pretreatment attachment-related anger failed to moderate outcome at other time points and therefore, these moderation effects were more short-lived than the ones for dismissing attachment. When compared with CBT + SL, CBT + I/EP may be better for individuals with GAD who have relatively higher dismissing styles of attachment.",Newman MG.; Castonguay LG.; Jacobson NC.; Moore GA.,2015.0,10.1037/a0039359,0,0,
9753,Lifetime trauma victimization and PTSD in relation to psychopathy and antisocial personality disorder in a sample of incarcerated women and men.,"Antisocial personality disorder (ASPD) and psychopathy are similar, but distinct, psychiatric conditions that are common in male and female inmates; a segment of the population with high rates of trauma exposure. It is unclear whether specific types of lifetime trauma are associated with ASPD and psychopathy in incarcerated women and men. Furthermore, the unique roles of post-traumatic stress disorder (PTSD) symptom severity and trauma victimization in antisocial personality disturbance are not well-understood. The paper aims to discuss these issues. This study investigated associations between trauma variables (different kinds of traumatic experiences and PTSD) and antisocial personality variables (ASPD and psychopathy) in a sample of incarcerated women and men who participated in a randomized clinical trial for major depressive disorder. In total, 88 incarcerated men and women were assessed for ASPD diagnosis, psychopathy severity, PTSD symptom severity, and history of physical, sexual, and crime-related trauma. Regression analyses predicted ASPD or psychopathy from trauma variables, controlling for gender. Physical trauma was the only form of trauma that was significantly related to psychopathy. Physical trauma and crime-related trauma were associated with ASPD. PTSD symptom severity was not associated with psychopathy or ASPD. There are associations between some kinds of lifetime trauma exposure and current ASPD/psychopathy in the target sample, but these associations do not appear to be mediated through current PTSD symptoms.",Gobin RL.; Reddy MK.; Zlotnick C.; Johnson JE.,2015.0,10.1108/IJPH-06-2014-0016,0,0,
9754,Personality Profile of Male Adolescents With Tourette Syndrome: A Controlled Study.,"Tourette syndrome is a neurodevelopmental disorder characterized by multiple tics and commonly associated with behavioral problems, especially obsessive-compulsive disorder and attention-deficit hyperactivity disorder (ADHD). The presence of specific personality traits has been documented in adult clinical populations with Tourette syndrome but has been underresearched in younger patients. We assessed the personality profiles of 17 male adolescents with Tourette syndrome and 51 age- and gender-matched healthy controls using the Minnesota Multiphasic Personality Inventory-Adolescent version, along with a standardized psychometric battery. All participants scored within the normal range across all Minnesota Multiphasic Personality Inventory-Adolescent version scales. Patients with Tourette syndrome scored significantly higher than healthy controls on the Obsessiveness Content Scale only (P = .046). Our findings indicate that younger male patients with Tourette syndrome do not report abnormal personality traits and have similar personality profiles to healthy peers, with the exception of obsessionality traits, which are likely to be related to the presence of comorbid obsessive compulsive symptoms rather than tics.",Balottin L.; Selvini C.; Luoni C.; Mannarini S.; Chiappedi M.; Seri S.; Termine C.; Cavanna AE.,2016.0,10.1177/0883073815589762,0,0,
9755,Stepped care versus face-to-face cognitive behavior therapy for panic disorder and social anxiety disorder: Predictors and moderators of outcome.,"To investigate predictors and moderators of treatment outcome by comparing immediate face-to-face cognitive behavioral therapy (FtF-CBT) to a Stepped Care treatment model comprising three steps: Psychoeducation, Internet-delivered CBT, and FtF-CBT for panic disorder (PD) and social anxiety disorder (SAD). Patients (N = 173) were recruited from nine public mental health out-patient clinics and randomized to immediate FtF-CBT or Stepped Care treatment. Characteristics related to social functioning, impairment from the anxiety disorder, and comorbidity was investigated as predictors and moderators by treatment format and diagnosis in multiple regression analyses. Lower social functioning, higher impairment from the anxiety disorder, and a comorbid cluster C personality disorder were associated with significantly less improvement, particularly among patients with PD. Furthermore, having a comorbid anxiety disorder was associated with a better treatment outcome among patients with PD but not patients with SAD. Patients with a comorbid depression had similar outcomes from the different treatments, but patients without comorbid depression had better outcomes from immediate FtF-CBT compared to guided self-help. In general, the same patient characteristics appear to be associated with the treatment outcome for CBT provided in low- and high-intensity formats when treated in public mental health care clinics. The findings suggest that patients with lower social functioning and higher impairment from their anxiety disorder benefit less from these treatments and may require more adapted and extensive treatment. CLINICALTRIALS.GOV: Identifier: NCT00619138.",Haug T.; Nordgreen T.; Öst LG.; Kvale G.; Tangen T.; Andersson G.; Carlbring P.; Heiervang ER.; Havik OE.,2015.0,10.1016/j.brat.2015.06.002,0,0,
9756,Cognitive risk profiles for anxiety disorders in a high-risk population.,"The purpose of the present study was to identify subgroups of participants who may be at particularly high risk for anxiety pathology based on specific combinations of demographic characteristics and higher-order cognitive abilities in a population at disproportionate risk for deficits in cognitive abilities (i.e., smokers within the criminal justice system). Participants (N=495) provided demographic information, were administered a semi-structured diagnostic interview, and completed a number of measures assessing cognitive abilities. A receiver-operating characteristic (ROC) model using signal detection theory indicated that the strongest predictor of anxiety disorder diagnosis was race, with White participants having a 30.6% likelihood of diagnosis and participants in the non-White category (97% of which identified as Black/African American) having a 18.9% likelihood of diagnosis. Interestingly, the individual risk profile associated with the highest probability of having a current anxiety disorder was characterized by White participants with impaired response inhibition (58.6%), and the lowest probability of having a current anxiety disorder was among non-White males (13.9%). The findings, which indicated that White individuals with impaired response inhibition are at a disproportionately high risk for anxiety disorders, suggest a potential target for prevention and intervention.",Bardeen JR.; Stevens EN.; Clark CB.; Lahti AC.; Cropsey KL.,2015.0,10.1016/j.psychres.2015.05.020,0,0,
9757,Relaxation training assisted by heart rate variability biofeedback: Implication for a military predeployment stress inoculation protocol.,"Decreased heart rate variability (HRV) is associated with posttraumatic stress disorder (PTSD) and depression symptoms, but PTSD's effects on the autonomic stress response and the potential influence of HRV biofeedback in stress relaxation training on improving PTSD symptoms are not well understood. The objective of this study was to examine the impact of a predeployment stress inoculation training (PRESTINT) protocol on physiologic measures of HRV in a large sample of the military population randomly assigned to experimental HRV biofeedback-assisted relaxation training versus a control condition. PRESTINT altered the parasympathetic regulation of cardiac activity, with experimental subjects exhibiting greater HRV, that is, less arousal, during a posttraining combat simulation designed to heighten arousal. Autonomic reactivity was also found to be related to PTSD and self-reported use of mental health services. Future PRESTINT training could be appropriate for efficiently teaching self-help skills to reduce the psychological harm following trauma exposure by increasing the capacity for parasympathetically modulated reactions to stress and providing a coping tool (i.e., relaxation method) for use following a stressful situation.",Lewis GF.; Hourani L.; Tueller S.; Kizakevich P.; Bryant S.; Weimer B.; Strange L.,2015.0,10.1111/psyp.12455,0,0,
9758,Altered pain modulation in patients with persistent postendodontic pain.,"Persistent pain may follow nerve injuries associated with invasive therapeutic interventions. About 3% to 7% of the patients remain with chronic pain after endodontic treatment, and these are described as suffering from painful posttraumatic trigeminal neuropathy (PTTN). Unfortunately, we are unable to identify which patients undergoing such procedures are at increased risk of developing PTTN. Recent findings suggest that impaired endogenous analgesia may be associated with the development of postsurgical chronic pain. We hypothesized that patients with PTTN display pronociceptive pain modulation, in line with other chronic pain disorders. Dynamic (conditioned pain modulation, temporal summation) and static (response to mechanical and cold stimulation) psychophysical tests were performed intraorally and in the forearm of 27 patients with PTTN and 27 sex- and age-matched controls. The dynamic sensory testing demonstrated less efficient conditioned pain modulation, suggesting reduced function of the inhibitory endogenous pain-modulatory system, in patients with PTTN, mainly in those suffering from the condition for more than a year. The static sensory testing of patients with PTTN demonstrated forearm hyperalgesia to mechanical stimulation mainly in patients suffering from the condition for less than a year and prolonged painful sensation after intraoral cold stimulus mainly in patients suffering from the condition for more than a year. These findings suggest that PTTN is associated more with the inhibitory rather than the facilitatory arm of pain modulation and that the central nervous system has a role in PTTN pathophysiology, possibly in a time-dependent fashion.",Nasri-Heir C.; Khan J.; Benoliel R.; Feng C.; Yarnitsky D.; Kuo F.; Hirschberg C.; Hartwell G.; Huang CY.; Heir G.; Korczeniewska O.; Diehl SR.; Eliav E.,2015.0,10.1097/j.pain.0000000000000265,0,0,
9759,Time course of treatment dropout in cognitive-behavioral therapies for posttraumatic stress disorder.,"A substantial minority of people drop out of cognitive-behavioral therapies (CBTs) for posttraumatic stress disorder (PTSD). There has been considerable research investigating who drops out of PTSD treatment; however, the question of when dropout occurs has received far less attention. The purpose of the current study was to examine when individuals drop out of CBT for PTSD. Women participants (N = 321) were randomized to 1 of several PTSD treatment conditions. The conditions included prolonged exposure (PE), cognitive processing therapy (CPT), CPT-cognitive only (CPT-C), and written accounts (WA). Survival analysis was used to examine temporal pattern of treatment dropout. Thirty-nine percent of participants dropped out of treatment, and those who dropped out tended to do so by midtreatment. Moreover, the pattern of treatment dropout was consistent across CBT conditions. Additional research is needed to examine if treatment dropout patterns are consistent across treatment modalities and settings.",Gutner CA.; Gallagher MW.; Baker AS.; Sloan DM.; Resick PA.,2016.0,10.1037/tra0000062,0,0,
9760,Development of a novel remote-controlled and self-contained audiovisual-aided interactive system for immobilizing claustrophobic patients.,"In radiotherapy, only a few immobilization systems, such as open-face mask and head mold with a bite plate, are available for claustrophobic patients with a certain degree of discomfort. The purpose of this study was to develop a remote-controlled and self-contained audiovisual (AV)-aided interactive system with the iPad mini with Retina display for intrafractional motion management in brain/H&amp;N (head and neck) radiotherapy for claustrophobic patients. The self-contained, AV-aided interactive system utilized two tablet computers: one for AV-aided interactive guidance for the subject and the other for remote control by an operator. The tablet for audiovisual guidance traced the motion of a colored marker using the built-in front-facing camera, and the remote control tablet at the control room used infrastructure Wi-Fi networks for real-time communication with the other tablet. In the evaluation, a programmed QUASAR motion phantom was used to test the temporal and positional accuracy and resolution. Position data were also obtained from ten healthy volunteers with and without guidance to evaluate the reduction of intrafractional head motion in simulations of a claustrophobic brain or H&amp;N case. In the phantom study, the temporal and positional resolution was 24 Hz and 0.2 mm. In the volunteer study, the average superior-inferior and right-left displacement was reduced from 1.9 mm to 0.3 mm and from 2.2 mm to 0.2 mm with AV-aided interactive guidance, respectively. The superior-inferior and right-left positional drift was reduced from 0.5 mm/min to 0.1 mm/min and from 0.4 mm/min to 0.04 mm/min with audiovisual-aided interactive guidance. This study demonstrated a reduction in intrafractional head motion using a remote-controlled and self-contained AV-aided interactive system of iPad minis with Retina display, easily obtainable and cost-effective tablet computers. This approach can potentially streamline clinical flow for claustrophobic patients without a head mask and also allows patients to practice self-motion management before radiation treatment delivery.",Ju H.; Kim S.; Read P.; Trifiletti D.; Harrell A.; Libby B.; Kim T.,2015.0,,0,0,
9761,An Evaluation of the Feasibility and Safety of a Home-Based Telemental Health Treatment for Posttraumatic Stress in the U.S. Military.,"Although home-based telemental health options have the potential to greatly expand the range of services available to U.S. military service members, there remains a need to demonstrate that home-based care is technically feasible, safe, and effective and meets the military health system's standards of care before widespread implementation can be achieved. The purpose of this preliminary study was to evaluate the feasibility and safety of providing U.S. military service members with a behavioral health treatment delivered directly to the home using videoconferencing. Ten previously deployed soldiers volunteered to complete eight sessions of a novel behavioral activation treatment for posttraumatic stress disorder. The primary clinical outcomes assessed included symptoms of posttraumatic stress and depression. Patient safety data and attitudes about seeking mental health services, treatment satisfaction, treatment adherence, and treatment compliance were also assessed. Clinically significant reductions in posttraumatic stress symptom severity and depression symptoms were observed. Soldiers indicated high levels of satisfaction with the treatment, and there were no adverse events requiring activation of emergency safety procedures. Technical problems associated with the network were observed but successfully mitigated. The results provide initial support for the feasibility and safety of telemental health treatments delivered by videoconferencing to the homes of soldiers. The optimal technical infrastructure needs to be determined to support expansion of synchronous videoconferencing capabilities to the home. The findings provide preliminary evidence of the feasibility, safety, and high user satisfaction with home-based telemental health in the military setting.",Luxton DD.; Pruitt LD.; O'Brien K.; Kramer G.,2015.0,10.1089/tmj.2014.0235,0,0,
9762,Dose timing of D-cycloserine to augment cognitive behavioral therapy for social anxiety: Study design and rationale.,"The use of D-cycloserine (DCS) as a cognitive enhancer to augment exposure-based cognitive-behavioral therapy (CBT) represents a promising new translational research direction with the goal to accelerate and optimize treatment response for anxiety disorders. Some studies suggest that DCS may not only augment extinction learning but could also facilitate fear memory reconsolidation. Therefore, the effect of DCS may depend on fear levels reported at the end of exposure sessions. This paper presents the rationale and design for a randomized controlled trial examining the relative efficacy of tailoring DCS administration based on exposure success (i.e. end fear levels) during a 5-session group CBT protocol for social anxiety disorder (n = 156). Specifically, tailored post-session DCS administration will be compared against untailored post-session DCS, untailored pre-session DCS, and pill placebo in terms of reduction in social anxiety symptoms and responder status. In addition, a subset of participants (n = 96) will undergo a fear extinction retention experiment prior to the clinical trial in which they will be randomly assigned to receive either DCS or placebo prior to extinguishing a conditioned fear. The results from this experimental paradigm will clarify the mechanism of the effects of DCS on exposure procedures. This study aims to serve as the first step toward developing an algorithm for the personalized use of DCS during CBT for social anxiety disorder, with the ultimate goal of optimizing treatment outcome for anxiety disorders.",Hofmann SG.; Carpenter JK.; Otto MW.; Rosenfield D.; Smits JA.; Pollack MH.,2015.0,10.1016/j.cct.2015.06.015,0,0,
9763,Dexamethasone-suppressed cortisol awakening response predicts treatment outcome in posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) has been associated with several alterations in the neuroendocrine system, including enhanced cortisol suppression in response to the dexamethasone suppression test. The aim of this study was to examine whether specific biomarkers of PTSD predict treatment success in trauma-focused psychotherapy. Data were collected in the context of a randomized controlled trial comparing two forms of trauma-focused psychotherapy. Basal cortisol and dehydroepiandrosterone sulfate levels, and the response to the dexamethasone suppression test were assessed pre-treatment in 24 PTSD patients. Treatment success was measured by pre- to post-treatment decrease in self-reported PTSD severity. A more suppressed cortisol curve after dexamethasone significantly predicted greater PTSD symptom decrease in trauma-focused psychotherapy, independent of the effects of gender, pre-treatment PTSD symptom severity, and trauma history. Basal early morning cortisol and dehydroepiandrosterone sulfate did not predict treatment response. The number of participants who completed the neuroendocrine measurements was small and a significant number of participants fulfilled criteria of co-morbid major depressive disorder. This study suggests the use of the dexamethasone-suppression test for the cortisol awakening response as a biomarker for treatment response to trauma-focused psychotherapy. Measures of HPA-axis sensitivity appear to be an important predictor of positive clinical response in PTSD patients, and may lead to biomarker-based treatment matching in the future.",Nijdam MJ.; van Amsterdam JG.; Gersons BP.; Olff M.,2015.0,10.1016/j.jad.2015.05.058,0,0,
9764,Effects of an unloader knee brace on knee-related symptoms and function in people with post-traumatic knee osteoarthritis after anterior cruciate ligament reconstruction.,"This pilot study evaluated the immediate and four-week effects of an unloader knee brace on knee-related symptoms and performance-based function in people with knee osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR). Individuals with knee OA, five to 20years post-ACLR, were recruited for two within-subject randomized studies: immediate effects (n=18) and four-week effects (n=11). Patient-reported knee-related symptoms (knee pain, perceived task difficulty, confidence, stability) were assessed during hop for distance and step-down tests, while performance-based function was assessed with hopping distance under three conditions: i) no brace; ii) unadjusted brace (sagittal plane support); and iii) adjusted brace (sagittal plane support with varus/valgus readjustment). Participants in the four-week brace effect study were randomized to wear the unadjusted or adjusted brace for four weeks after baseline (no brace) testing, and repeated tests in their allocated brace at four-week follow-up. Friedman tests evaluated differences between the three brace conditions for each variable for the immediate brace effect study (p<0.05), and Wilcoxon signed-rank tests evaluated differences between no brace and allocated brace for the four-week study (p<0.05). The adjusted and unadjusted unloader braces produced immediate improvements in knee confidence during hop for distance, and knee pain during step-down. Following the four-week brace intervention, the allocated brace improved knee confidence, perceived task difficulty and stability during hop for distance; and knee pain, perceived task difficulty, confidence, and stability during step-down. The unloader knee brace, adjusted or unadjusted, has the potential to improve knee-related symptoms associated with knee OA after ACLR.",Hart HF.; Crossley KM.; Ackland DC.; Cowan SM.; Collins NJ.,2016.0,10.1016/j.knee.2015.05.006,0,0,
9765,Extinction learning as a moderator of d-cycloserine efficacy for enhancing exposure therapy in posttraumatic stress disorder.,"Augmentation of exposure therapy with d-cycloserine (DCS) has proven efficacious across anxiety disorders, although results in PTSD have been mixed. Work in animals and anxiety-disordered patients suggest that the potentiating effects of DCS are dependent on the level of extinction learning during extinction training and exposure treatment, respectively. The aim of the current study was to replicate and extend previous work by examining the association between the degree of extinction learning and DCS efficacy in our randomized clinical trial on DCS (50 mg) versus placebo enhancement of exposure therapy in a chronic mixed-trauma PTSD sample (N=67; de Kleine, Hendriks, Kusters, Broekman, & van Minnen, 2012). The decline in subjective units of distress ratings collected during and across the exposure sessions were evaluated as indices of extinction learning. First, we examined whether extinction learning during an exposure session moderated DCS effects on self-reported PTSD symptoms at the next session. Second, we examined whether averaged extinction learning over the course of treatment interacted with group assignment to predict change over time and post treatment outcome. We did not find evidence that DCS effects were moderated by the degree of extinction learning, although, extinction learning was related to outcome regardless of group assignment. In PTSD, not one extinction-learning index has been consistently linked to DCS enhanced exposure treatment outcome. More (experimental) work needs to been done to unravel the complex interplay between extinction learning and DCS enhancement, especially in PTSD patients.",de Kleine RA.; Smits JA.; Hendriks GJ.; Becker ES.; van Minnen A.,2015.0,10.1016/j.janxdis.2015.06.005,0,0,
9766,PACES in epilepsy: Results of a self-management randomized controlled trial.,"Self-management challenges facing adults with epilepsy include limited understanding of the condition and treatment, associated psychosocial issues, and lack of community integration. Self-management interventions improve patients' medical, life role, and emotional management. Previous interventions, developed from expert opinion, indicated issues with participant engagement/retention, and limited follow-up periods. PACES in Epilepsy addressed methodologic concerns by utilizing patient needs assessment data (n = 165) to derive self-management content and program features for evaluation via randomized controlled trial (RCT). Participants were adults with chronic epilepsy (n = 83), without serious mental illness or substantive intellectual impairment, who were recruited from two epilepsy centers. Participants were assigned randomly to intervention or treatment-as-usual groups. Outcomes included the Epilepsy Self-Management Scale (ESMS), Epilepsy Self-Efficacy Scale (ESES), Quality of Life in Epilepsy-31 (QOLIE-31), Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7), administered at baseline, postintervention (8 weeks), and 6 months postintervention. The intervention was an 8-week group of 6-8 adults co-led by a psychologist and trained peer with epilepsy that met one evening per week at a hospital for 75 min. Topics included medical, psychosocial, cognitive, and self-management aspects of epilepsy, in addition to community integration and optimizing epilepsy-related communication. The treatment group provided satisfaction ratings regarding program features. PACES participants (n = 38) improved relative to controls (n = 40) on the ESMS (p < 0.001) and subscales [Information (p < 0.001); Lifestyle (p < 0.002)]; ESES (p < 0.001); and QOLIE-31 (p = 0.002). At 6-month follow up, PACES participants remained improved on the ESMS (p = 0.004) and Information subscale (p = 0.009); and Energy/Fatigue (p = 0.032) and Medication Effects (p = 0.005) of the QOLIE-31. Attrition in both groups was low (8% in each group) and all program satisfaction ratings exceeded 4.0/5.0, with leadership (4.76), topics (4.53), and location (4.30) as the most highly rated aspects. A consumer generated epilepsy self-management program appears to be a promising intervention from multiple perspectives, particularly in relation to disability management.",Fraser RT.; Johnson EK.; Lashley S.; Barber J.; Chaytor N.; Miller JW.; Ciechanowski P.; Temkin N.; Caylor L.,2015.0,10.1111/epi.13052,0,0,
9767,Targeting relational aggression in veterans: the Strength at Home Friends and Family intervention.,"We evaluated the effectiveness of Strength at Home Friends and Families (SAH-F), a dyadic group intervention to prevent relational aggression and its negative consequences, in a community-based sample of service members/veterans and significant others who reported relational difficulties. Participants included 70 veterans and their loved ones. Recruitment was conducted from October 2010 through March 2012. Participants completed an initial assessment that included measures of relational aggression and functioning, depressive symptoms, and posttraumatic stress disorder (PTSD) symptoms. Participants were enrolled in the 10-week SAH-F targeting social information-processing mechanisms hypothesized to underlie the relationship between trauma and aggression and were reassessed at program completion and 3 months after intervention. Significant reductions in psychological aggression were seen both at program completion and at 3-month follow-up for both veterans (standardized mean gain effect size [ESsg] = -0.45, P < .05) and significant others (ESsg = -0.30, P < .05). Perpetration of physical aggression remained low after pretreatment and did not increase. Relationship adjustment reported by significant others, but not veterans, indicated a significant improvement from pretreatment to program completion (ESsg = 0.33, P < .05). Significant (P < .05) decreases in depressive symptoms were observed from pretreatment to program completion for veterans (ESsg = -0.30, P < .05) and significant others (ESsg = -0.55, P < .05), and significant decreases in PTSD symptoms were observed from pretreatment to follow-up for veterans and significant others (ESsg = -0.52, P < .05). Results provide support for the effectiveness of SAH-F in reducing relational aggression in military member/significant other dyads and enhancing relationship quality and mental health.",Hayes MA.; Gallagher MW.; Gilbert KS.; Creech SK.; DeCandia CJ.; Beach CA.; Taft CT.,2015.0,10.4088/JCP.14m09155,0,0,
9768,A Yoga Intervention Program for Patients Suffering from Symptoms of Posttraumatic Stress Disorder: A Qualitative Descriptive Study.,"To understand how individuals with symptoms of posttraumatic stress disorder (PTSD) perceive a trauma-sensitive Kundalini yoga (KY) program. Digitally recorded telephone interviews 30-60 minutes in duration were conducted with 40 individuals with PTSD participating in an 8-week KY treatment program. Interviews were transcribed verbatim and analyzed using qualitative thematic analysis techniques. Qualitative analysis identifies three major themes: self-observed changes, new awareness, and the yoga program itself. Findings suggest that participants noted changes in areas of health and well-being, lifestyle, psychosocial integration, and perceptions of self in relation to the world. Presented are practical suggestions for trauma-related programming. There is a need to consider alternative and potentially empowering approaches to trauma treatment. Yoga-related self-care or self-management strategies are widely accessible, are empowering, and may address the mind-body elements of PTSD.",Jindani FA.; Khalsa GF.,2015.0,10.1089/acm.2014.0262,0,0,
9769,Evaluating changes in judgmental biases as mechanisms of cognitive-behavioral therapy for social anxiety disorder.,"Reductions in judgmental biases concerning the cost and probability of negative social events are presumed to be mechanisms of treatment for SAD. Methodological limitations of extant studies, however, leave open the possibility that, instead of causing symptom relief, reductions in judgmental biases are correlates or consequences of it. The present study evaluated changes in judgmental biases as mechanisms explaining the efficacy of CBT for SAD. Participants were 86 individuals who met DSM-IV-TR criteria for a primary diagnosis of SAD, participated in one of two treatment outcome studies of CBT for SAD, and completed measures of judgmental (i.e., cost and probability) biases and social anxiety at pre-, mid-, and posttreatment. Treated participants had significantly greater reductions in judgmental biases than not-treated participants; pre-to-post changes in cost and probability biases statistically mediated treatment outcome; and probability bias at midtreatment was a significant predictor of treatment outcome, even when modeled with a plausible rival mediator, working alliance. Contrary to hypotheses, cost bias at midtreatment was not a significant predictor of treatment outcome. Results suggest that reduction in probability bias is a mechanism by which CBT for SAD exerts its effects.",Calamaras MR.; Tully EC.; Tone EB.; Price M.; Anderson PL.,2015.0,10.1016/j.brat.2015.06.006,0,0,
9770,"Anti-anxiety efficacy of Sudarshan Kriya Yoga in general anxiety disorder: A multicomponent, yoga based, breath intervention program for patients suffering from generalized anxiety disorder with or without comorbidities.","Surdashan Kriya Yoga (SKY) is a procedure that in various studies, has shown evidences of efficacy in alleviating Depression and Anxiety disorders, but in Europe and USA it has not been studied yet on a Caucasian population as an adjunct therapy for psychiatric Disorders. The study involved a sample of consenting women and men (n = 69) who received SKY therapy for a six-month time period. They were assessed at recruitment, after two weeks, after three months and after six months using Hamilton Rating Scale for Anxiety (HRSA), Hamilton Rating Scale for Depression (HRSD), Zung Self-Rating Anxiety Scale (ZSAS), Zung Self-Rating Depression Scale (ZSDS) and Symptom Checklist-90 (SCL-90). All the analyses have shown that SKY therapy significantly reduces the scores of Anxiety and Depression. This is plain, especially after the initial SKY treatment, which is followed by a long plateau phase that seems to verge on no Anxiety/Depression scores. It was found that SKY effects lead to a significant convergence between the self-assessment (Zung Self-Rating Scale) and hetero-assessment (Hamilton Rating Scale). The study should be replicated on a larger clinical sample in a controlled trial to learn more about the effectiveness of SKY Protocol. Participation in SKY adjunct therapy ten days intense workshop and follow-ups, coupled with daily individual and independent practice of a simplified protocol of breathing techniques (30 min), can lead to significant reduction in levels of Anxiety and Depression.",Doria S.; de Vuono A.; Sanlorenzo R.; Irtelli F.; Mencacci C.,2015.0,10.1016/j.jad.2015.06.011,0,0,
9771,Latent classes of childhood trauma exposure predict the development of behavioral health outcomes in adolescence and young adulthood.,"To develop latent classes of exposure to traumatic experiences before the age of 13 years in an urban community sample and to use these latent classes to predict the development of negative behavioral outcomes in adolescence and young adulthood. A total of 1815 participants in an epidemiologically based, randomized field trial as children completed comprehensive psychiatric assessments as young adults. Reported experiences of nine traumatic experiences before age 13 years were used in a latent class analysis to create latent profiles of traumatic experiences. Latent classes were used to predict psychiatric outcomes at age ‚©æ13 years, criminal convictions, physical health problems and traumatic experiences reported in young adulthood. Three latent classes of childhood traumatic experiences were supported by the data. One class (8% of sample), primarily female, was characterized by experiences of sexual assault and reported significantly higher rates of a range of psychiatric outcomes by young adulthood. Another class (8%), primarily male, was characterized by experiences of violence exposure and reported higher levels of antisocial personality disorder and post-traumatic stress. The final class (84%) reported low levels of childhood traumatic experiences. Parental psychopathology was related to membership in the sexual assault group. Classes of childhood traumatic experiences predict specific psychiatric and behavioral outcomes in adolescence and young adulthood. The long-term adverse effects of childhood traumas are primarily concentrated in victims of sexual and non-sexual violence. Gender emerged as a key covariate in the classes of trauma exposure and outcomes.",Ballard ED.; Van Eck K.; Musci RJ.; Hart SR.; Storr CL.; Breslau N.; Wilcox HC.,2015.0,10.1017/S0033291715001300,0,0,
9772,Life Adaptation Skills Training (LAST) for persons with depression: A randomized controlled study.,"To investigate the efficacy of the ""Life Adaptation Skills Training (LAST)"" program for persons with depression. Sixty-eight subjects with depressive disorder were recruited from psychiatric outpatient clinics in Taipei city and were randomly assigned to either an intervention group (N=33), or a control group (N=35). The intervention group received 24-sessions of the LAST program, as well as phone contact mainly related to support for a total of 24 times. The control group only received phone contact 24 times. The primary outcome measure utilized was the World Health Organization Quality of Life-BREF-Taiwan version. Secondary outcome measures included the Occupational self-assessment, the Mastery scale, the Social support questionnaire, the Beck anxiety inventory, the Beck depression inventory-II, and the Beck scale for suicide ideation. The mixed-effects linear model was applied to analyze the incremental efficacy of the LAST program, and the partial eta squared (ηp(2)) was used to examine the within- and between- group effect size. The subjects who participated in the LAST program showed significant incremental improvements with moderate to large between-group effect sizes on their level of anxiety (-5.45±2.34, p<0.05; ηp(2)=0.083) and level of suicidal ideation (-3.09±1.11, p<0.01; ηp(2)=0.157) when compared to the control group. The reduction of suicidal ideations had a maintenance effect for three months after the end of intervention (-3.44±1.09, p<0.01), with moderate between-group effect sizes (ηp(2)=0.101). Both groups showed significant improvement on overall QOL, overall health, physical QOL, psychological QOL, level of anxiety, and level of depression. The within-group effect sizes achieved large effects in the intervention group (ηp(2)=0.328-0.544), and were larger than that of the control group. A small sample size in the study, a high dropout rate, lower compliance rates for the intervention group, and lacking of true control group. The occupation-based LAST program, which focuses on lifestyle rearrangement and coping skills enhancement, could significantly improve the level of anxiety and suicidal ideations for persons with depression.",Chen YL.; Pan AW.; Hsiung PC.; Chung L.; Lai JS.; Shur-Fen Gau S.; Chen TJ.,2015.0,10.1016/j.jad.2015.06.022,0,0,
9773,Randomized trial on the effectiveness of long- and short-term psychotherapy on psychosocial functioning and quality of life during a 5-year follow-up.,"Knowledge is incomplete on whether long-term psychotherapy is more effective than short-term therapy in treating mood and anxiety disorder, when measured by improvements in psychosocial functioning and life quality. In the Helsinki Psychotherapy Study, 326 outpatients with mood or anxiety disorder were randomized to solution-focused therapy (SFT), short-term psychodynamic psychotherapy (SPP), or long-term psychodynamic psychotherapy (LPP), and followed up for 5 years from the start of treatment. The outcome measures comprised 4 questionnaires on psychosocial functioning, assessing global social functioning (Social Adjustment Scale (SAS-SR), sense of coherence (Sense of Coherence Scale (SOC)), perceived competence (Self-Performance Survey), dispositional optimism (Life Orientation Test (LOT)), and 1 questionnaire assessing quality of life (Life Situation Survey (LSS)). Short-term therapies improved psychosocial functioning and quality of life more than LPP during the first year. The only exceptions were LOT and perceived competence, which did not differ between SPP and LPP. Later in the follow-up, SOC and perceived competence showed significantly more improvement in LPP than in the short-term therapy groups. No direct differences between SFT and SPP were noted. Short-term therapy has consistently more short-term effects on psychosocial functioning and quality of life than LPP, whereas LPP has some additional long-term benefits on psychosocial functioning.",Knekt P.; Heinonen E.; Härkäpää K.; Järvikoski A.; Virtala E.; Rissanen J.; Lindfors O.; Helsinki Psychotherapy Study Group .,2015.0,10.1016/j.psychres.2015.05.113,0,0,
9774,Mindfulness and relaxation treatment reduce depressive symptoms in individuals with psychosis.,"Self-help is increasingly accepted for the treatment of mental disorders, including psychosis, as both a provisional first step and a way to bridge the large treatment gap. Though mindfulness-based interventions do not belong to first line treatment strategies in psychosis and randomized controlled trials are lacking, encouraging preliminary findings speak for the usefulness of this approach. For the present study, we examined whether patients with psychosis benefit from mindfulness bibliotherapy. A sample of 90 patients with psychosis (including a subsample with a verified diagnosis of schizophrenia) took part in the study via the Internet. Following baseline assessment, participants were randomized to either a mindfulness group or a Progressive Muscle Relaxation (PMR) control group and received the respective self-help manual including accompanying audio files. Symptom change was measured six weeks after the baseline assessment with self-rating scales including the Paranoia Checklist. The retention rate was 71%. The quality of the online dataset was confirmed by various strategies (e.g., psychosis lie scale; examination of response biases). The trial was registered at the ISRCTN registry (ISRCTN86762253). No changes across time or between groups were noted for the Paranoia Checklist. Both conditions showed a decline in depressive and obsessive-compulsive symptoms at a medium effect size (per protocol and intention to treat analyses). The study provided partial support for the effectiveness of self-help mindfulness and PMR for depression in psychosis. Whether mindfulness delivered by a licensed therapist might lead to improved treatment adherence and a superior outcome relative to PMR remains to be established. The results underscore that bibliotherapy is a worthwhile approach to narrow the large treatment gap seen in psychosis.",Moritz S.; Cludius B.; Hottenrott B.; Schneider BC.; Saathoff K.; Kuelz AK.; Gallinat J.,2015.0,10.1016/j.eurpsy.2015.05.002,0,0,
9775,[Dwyer osteotomy : Lateral sliding osteotomy of calcaneus].,"To correct the underlying inframalleolar varus deformity and to restore physiologic biomechanics of the hindfoot. Neurologic, posttraumatic, congenital, and idiopathic cavovarus deformity. In patients with end-stage ankle osteoarthritis with varus heel malposition as additional single-stage procedure complementing total ankle replacement. Severe peroneal tendinopathy with concomitant cavovarus deformity. General surgical or anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy (e. g., Charcot arthropathy), end-stage osteoarthritis of the subtalar joint, severely reduced bone quality, high age, insulin-dependent diabetes mellitus, smoking. The lateral calcaneus cortex is exposed using a lateral incision. The osteotomy is performed through an oscillating saw. The posterior osteotomy fragment is manually mobilized and shifted laterally. If needed, a laterally based wedge can be removed and/or the osteotomy fragment can be translated cranially. The osteotomy is stabilized with two cannulated screws, followed by wound closure. A soft wound dressing is used. Thromboprophylaxis is recommended. Patient mobilization starts on postoperative day 1 with 15 kg partial weight bearing using a stabilizing walking boot or cast for 6 weeks. Following clinical and radiographic follow-up at 6 weeks, full weight bearing is initiated step by step. Between January 2009 and June 2013, a Dwyer osteotomy was performed in 31 patients with a mean age of 45.7 ± 16.3 years (range 21.5-77.4 years). All patients had a substantial inframalleolar cavovarus deformity with preoperative moment arm of the calcaneus of -17.9 ± 3.3 mm (range -22.5 to -10.5 mm), which has been improved significantly to 1.6 ± 5.9 mm (range -16.9 to 9.9 mm). Significant pain relief from 6.3 ± 1.9 (range 4-10) to 1.1 ± 1.1 (range 0-4) using the visual analogue scale was observed. The American Orthopaedic Foot and Ankle Society score significantly improved from 33.1 ± 14.2 (range 10-60) to 78.0 ± 10.5 (range 55-95).",Barg A.; Hörterer H.; Jacxsens M.; Wiewiorski M.; Paul J.; Valderrabano V.,2015.0,10.1007/s00064-015-0409-5,0,0,
9776,Effects of Approach-Avoidance Training on the Extinction and Return of Fear Responses.,"Exposure therapy for anxiety involves confronting a patient with fear-evoking stimuli, a procedure based partially on Pavlovian extinction. Exposure and other extinction-based therapies usually lead to (partial) reduction of fear symptoms, but a substantial number of patients experience a return of fear after treatment. Here we tested whether the combination of fear extinction with modification of approach-avoidance tendencies using an Approach-Avoidance Task (AAT) would result in the further reduction of conditioned fear and/or help prevent return of fear after extinction. Two groups of participants underwent a fear acquisition procedure during which pictures of one neutral object were sometimes paired with shock (CS+), whereas pictures of another neutral object were not (CS-). The next day, in a fear extinction procedure, both objects were presented without shock. During the subsequent joystick AAT, one group primarily pulled CS+ pictures towards themselves and pushed CS- pictures away from themselves; reversed contingencies applied for the other group. Approach training was effective in modifying conditioned action tendencies, with some evidence for transfer to a different approach/avoidance task. No group differences in subjective fear or physiological arousal were found during subsequent post- training and return-of-fear testing. No reliable return-of-fear was observed in either group for either subjective or physiological fear measures. Our results suggest that approach training may be of limited value for enhancing the short- and long-term effects of extinction-based interventions.",Krypotos AM.; Arnaudova I.; Effting M.; Kindt M.; Beckers T.,2015.0,10.1371/journal.pone.0131581,0,0,
9777,[Lateral column lengthening osteotomy of calcaneus].,"Lengthening of the lateral column for adduction of forefoot and restoration of the medial arch. Stabilization of the ankle joint complex. Supple flatfoot deformity (posterior tibial tendon dysfunction stage II). Instability of the medial ankle joint complex (superficial deltoid and spring ligament). Posttraumatic valgus and pronation deformity of the foot. Rigid flatfoot deformity (posterior tibial tendon dysfunction stage III and IV). Talocalcaneal and naviculocalcaneal coalition. Osteoarthritis of calcaneocuboid joint. Exposition of calcaneus at sinus tarsi. Osteotomy through sinus tarsi and widening until desired correction of the foot is achieved. Insertion of bone graft. Screw fixation. Immobilization in a cast for 6 weeks. Weight-bearing as tolerated from the beginning. In the majority of cases, part of hindfoot reconstruction. Reliable and stable correction. Safe procedure with few complications.",Hintermann B.,2015.0,10.1007/s00064-015-0408-6,0,0,
9778,Effect of Attention Training on Attention Bias Variability and PTSD Symptoms: Randomized Controlled Trials in Israeli and U.S. Combat Veterans.,"Attention allocation to threat is perturbed in patients with posttraumatic stress disorder (PTSD), with some studies indicating excess attention to threat and others indicating fluctuations between threat vigilance and threat avoidance. The authors tested the efficacy of two alternative computerized protocols, attention bias modification and attention control training, for rectifying threat attendance patterns and reducing PTSD symptoms. Two randomized controlled trials compared the efficacy of attention bias modification and attention control training for PTSD: one in Israel Defense Forces veterans and one in U.S. military veterans. Both utilized variants of the dot-probe task, with attention bias modification designed to shift attention away from threat and attention control training balancing attention allocation between threat and neutral stimuli. PTSD symptoms, attention bias, and attention bias variability were measured before and after treatment. Both studies indicated significant symptom improvement after treatment, favoring attention control training. Additionally, both studies found that attention control training, but not attention bias modification, significantly reduced attention bias variability. Finally, a combined analysis of the two samples suggested that reductions in attention bias variability partially mediated improvement in PTSD symptoms. Attention control training may address aberrant fluctuations in attention allocation in PTSD, thereby reducing PTSD symptoms. Further study of treatment efficacy and its underlying neurocognitive mechanisms is warranted.",Badura-Brack AS.; Naim R.; Ryan TJ.; Levy O.; Abend R.; Khanna MM.; McDermott TJ.; Pine DS.; Bar-Haim Y.,2015.0,10.1176/appi.ajp.2015.14121578,0,0,
9779,Randomized controlled equivalence trial comparing videoconference and in person delivery of cognitive processing therapy for PTSD.,"In an effort to improve access to and utilization of health care, the Veterans Health Administration (VHA) continues to investigate the effectiveness of video-teleconferencing (VTC) technologies for service delivery. While previous research focused on the efficacy of VTC treatment for post-traumatic stress disorder (PTSD) in Vietnam era veterans, few studies have evaluated the efficacy of this modality and treatment for the Iraq/Afghanistan era veterans. The aim of this randomized clinical trial was to evaluate equivalence between in person and VTC psychotherapy for PTSD in this newer cohort. Veterans of the Iraq/Afghanistan conflict from two VHA hospitals in the United States were recruited and randomized to receive cognitive processing therapy (CPT) for PTSD either in person (IP) or over VTC. Clinician-administered and self-report measures were collected before, during, and after treatment. A trend was observed which suggested that CPT over VTC may be equivalent to the treatment delivered in person, as suggested by previous studies. Regardless of treatment, veterans who received the intervention in both conditions reported significant decreases on post-treatment measures. This study highlighted research and clinical challenges in providing services to the newest veteran generation in general as well as unique challenges with VTC. One complicating factor to the statistical power of this study was a treatment dropout rate twice the original estimate. Factors that could have influenced this high dropout rate are explored.",Maieritsch KP.; Smith TL.; Hessinger JD.; Ahearn EP.; Eickhoff JC.; Zhao Q.,2016.0,10.1177/1357633X15596109,0,0,
9780,Predictors of outcome of an Internet-based cognitive-behavioural therapy for post-traumatic stress disorder in older adults.,"The aim of this study was to evaluate the role of resource-oriented variables such as self-efficacy, locus of control (LOC) and post-traumatic growth (PTG) in predicting treatment response in older adults with post-traumatic stress. Fifty-eight older adults with subsyndromal or greater severity of war-associated post-traumatic stress disorder (PTSD) symptoms completed a randomized controlled Internet-based cognitive-behavioural therapy (CBT) with immediate and delayed treatment groups. Assessments of PTSD severity and resource-oriented variables of self-efficacy, LOC and PTG were conducted at baseline, post-treatment and at a 6-month follow-up. Results revealed that pre-treatment scores on measures of internal LOC and PTG predicted PTSD symptom severity at post-treatment, even after controlling for initial PTSD. At a 6-month follow-up, internal LOC continued to predict PTSD symptom severity. In addition, repeated-measures analyses of variance revealed that, relative to older adults with low internal LOC and PTG, older adults with high internal LOC and PTG, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. These findings suggest that greater locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Assessment of these constructs may be useful in identifying trauma survivors who are most likely to respond to CBT. Greater internal locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Older adults with initial high internal locus of control and post-traumatic growth, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. It could be assumed that patients with initial functional appraisals could benefit easier and faster from a trauma-focused cognitive-behavioural therapy compared to individuals with lower internal locus of control and post-traumatic growth.",Böttche M.; Kuwert P.; Pietrzak RH.; Knaevelsrud C.,2016.0,10.1111/papt.12069,0,0,
9781,TELEMEDICINE VERSUS IN-PERSON DELIVERY OF COGNITIVE PROCESSING THERAPY FOR WOMEN WITH POSTTRAUMATIC STRESS DISORDER: A RANDOMIZED NONINFERIORITY TRIAL.,"This study examined the effectiveness of telemedicine to provide psychotherapy to women with posttraumatic stress disorder (PTSD) who might be unable to access treatment. Objectives were to compare clinical and process outcomes of PTSD treatment delivered via videoteleconferencing (VTC) and in-person (NP) in an ethnically diverse sample of veteran and civilian women with PTSD. A randomized controlled trial of Cognitive Processing Therapy, an evidence-based intervention for PTSD, was conducted through a noninferiority design to compare delivery modalities on difference in posttreatment PTSD symptoms. Women with PTSD, including 21 veterans and 105 civilians, were assigned to receive psychotherapy delivered via VTC or NP. Primary treatment outcomes were changes in PTSD symptoms in the completer sample. Improvements in PTSD symptoms in the VTC condition (n = 63) were noninferior to outcomes in the NP condition (n = 63). Clinical outcomes obtained when both conditions were pooled together (N = 126) demonstrated that PTSD symptoms declined substantially posttreatment (mean = -20.5, 95% CI -29.6 to -11.4) and gains were maintained at 3- (mean = -20.8, 95% CI -30.1 to -11.5) and 6-month followup (mean = -22.0, 95% CI -33.1 to -10.9. Veterans demonstrated smaller symptom reductions posttreatment (mean = -9.4, 95% CI -22.5 to 3.7) than civilian women (mean = -22.7, 95% CI -29.9 to -15.5. Providing psychotherapy to women with PTSD via VTC produced outcomes comparable to NP treatment. VTC can increase access to specialty mental health care for women in rural or remote areas.",Morland LA.; Mackintosh MA.; Rosen CS.; Willis E.; Resick P.; Chard K.; Frueh BC.,2015.0,10.1002/da.22397,0,0,
9782,Evaluating the efficacy of a self-guided Web-based CBT intervention for reducing cancer-distress: a randomised controlled trial.,"This study evaluated the efficacy of a self-guided Web-based cognitive behaviour therapy (CBT) intervention compared to an attention control in improving cancer-related distress, health-related quality of life (HRQOL), and maladaptive coping, among people recently diagnosed with cancer. Sixty individuals with cancer diagnosed in the previous 6 months and receiving treatment with curative intent were randomised to receive either the 6-week intervention Cancer Coping Online (CCO: n = 30) or the 6-week Web-based attention control (n = 30). Outcome measures, including cancer distress (the Posttraumatic Stress Scale - Self-Report), general distress (Depression Anxiety Stress Scale), quality of life (EORTC QLQ-C30), and coping (mini-MAC), were administered at baseline, immediately post-intervention, and at 3 and 6 months post-intervention. Significant main effects for time were found for cancer distress, global QOL, physical function, role function, social function, and anxious preoccupation. Post hoc between-group comparisons showed CCO participants had statistically significantly higher physical functioning compared to controls at 3 months of follow-up (d = -0.52, p = 0.02). Furthermore, compared to controls, post hoc comparisons found moderate between-group effect sizes favouring CCO post-intervention for cancer distress (d = 0.43) and anxious preoccupation (d = 0.38), and at 6 months of follow-up for global QOL (d = -0.43). These results provide preliminary support for the potential efficacy of a self-guided Web-based CBT programme in improving aspects of HRQOL, cancer-related distress, and anxious preoccupation after cancer diagnosis. This paper provides justification for, and will help inform the development of, subsequent larger multi-site studies.",Beatty L.; Koczwara B.; Wade T.,2016.0,10.1007/s00520-015-2867-6,0,0,
9783,E-virtual reality exposure therapy in acrophobia: A pilot study.,"Virtual reality therapy is already used for anxiety disorders as an alternative to in vivo and in imagino exposure. To our knowledge, however, no one has yet proposed using remote virtual reality (e-virtual reality). The aim of the present study was to assess e-virtual reality in an acrophobic population. Six individuals with acrophobia each underwent six sessions (two sessions per week) of virtual reality exposure therapy. The first three were remote sessions, while the last three were traditional sessions in the physical presence of the therapist. Anxiety (STAI form Y-A, visual analog scale, heart rate), presence, technical difficulties and therapeutic alliance (Working Alliance Inventory) were measured. In order to control the conditions in which these measures were made, all the sessions were conducted in hospital. None of the participants dropped out. The remote sessions were well accepted. None of the participants verbalized reluctance. No major technical problems were reported. None of the sessions were cancelled or interrupted because of software incidents. Measures (anxiety, presence, therapeutic alliance) were comparable across the two conditions. e-Virtual reality can therefore be used to treat acrophobic disorders. However, control studies are needed to assess online feasibility, therapeutic effects and the mechanisms behind online presence.",Levy F.; Leboucher P.; Rautureau G.; Jouvent R.,2016.0,10.1177/1357633X15598243,0,0,
9784,Highly efficacious cognitive-coping therapy for overt or covert compulsions.,"Pharmacotherapy and cognitive-behavioral therapy (CBT) present limitations when they are used to treat obsessive-compulsive disorder (OCD), a severe and debilitating psychiatric disorder. To search for more efficacious treatment, we investigated the effects of pharmacotherapy plus cognitive-coping therapy (pCCT) on adult OCD patients with overt or covert compulsions. Two hundred and fifteen OCD patients were randomized into pharmacotherapy plus psychological support (PPS, n=107) and pCCT (n=108). The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to measure severity of symptoms in the OCD patients. The Y-BOCS scores were significantly lower in pCCT than in PPS in both acute term (<3 months) and long-term follow-up. In pCCT, severity of symptoms was not different between those with covert compulsions and those with overt compulsions, but was significantly reduced at any post-treatment time-point. Y-BOCS scores in the two subtype compulsions were significantly lower in pCCT than in PPS at any post-treatpost-treatment time-point. Compared with PPS, effect size, response rate and remission rate were significantly higher in pCCT. Our findings corroborated with the hypothesis that pCCT could efficaciously treat OCD with overt compulsions or covert compulsion, suggesting that pCCT might be a potential option for adult OCD.",Hu XZ.; Ma JD.; Huang P.; Shan XW.; Zhang ZH.; Zhang JH.; Ouyang H.; Kou SJ.; Li ZR.; Wang SF.; Zhao HZ.; Wang H.; Wang CH.,2015.0,10.1016/j.psychres.2015.08.010,0,0,
9785,Using the WHODAS 2.0 to Assess Functioning Among Veterans Seeking Compensation for Posttraumatic Stress Disorder.,"One of the major changes in DSM-5 was removal of the Global Assessment of Functioning (GAF). To determine whether the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a suitable replacement for the GAF, this study compared how well the WHODAS 2.0 and the GAF measured functional impairment and other phenomena related to posttraumatic stress disorder (PTSD) among veterans applying for financial compensation (service connection) for PTSD. Clinicians evaluating veteran claimants administered the Clinician Administered PTSD Scale (CAPS) and the WHODAS 2.0 to 177 veterans during their evaluations. Veterans also completed the Inventory of Psychosocial Functioning (IPF), a self-report measure of functional impairment, and received a GAF rating from the examiner. Actual benefit determinations and ratings were obtained. Confirmatory factor analyses demonstrated that the WHODAS 2.0 and the IPF were stronger indicators of a latent variable reflecting functioning compared with the GAF. In receiver operating characteristic curve analyses, the WHODAS 2.0, IPF, and GAF all displayed similar ability to identify veterans with PTSD-related impairment assessed by the CAPS. Compared with the GAF, the WHODAS 2.0 and IPF were less strongly related to PTSD symptom severity and disability ratings by the U.S. Department of Veterans Affairs, but these variables are typically influenced by GAF scores. The WHODAS 2.0 and IPF are acceptable replacements for the GAF and can be used to assess functional impairment among veterans seeking compensation for PTSD.",Marx BP.; Wolf EJ.; Cornette MM.; Schnurr PP.; Rosen MI.; Friedman MJ.; Keane TM.; Speroff T.,2015.0,10.1176/appi.ps.201400400,0,0,
9786,Acceptance and commitment group therapy (ACT-G) for health anxiety: a randomized controlled trial.,"Severe health anxiety is frequent and costly, yet rarely diagnosed or treated. Earlier treatment studies show problems with recruitment, dropout and recovery. In the current study, the authors aimed to test the effect of acceptance and commitment group therapy (ACT-G) compared to waitlist in patients with severe health anxiety. During March 2010 to April 2012, 126 consecutively referred patients meeting research criteria for severe health anxiety were block-randomized (1:1) to ACT-G or a 10 months' waitlist (Clinicaltrials.gov, no. NCT01158430). Patients allocated to ACT-G were treated in seven groups of nine patients between December 2010 and October 2012 and received nine weekly 3-h group sessions and a booster session consisting of ACT techniques. The primary outcome was decided a priori as the mean change in self-reported illness worry on the Whiteley-7 Index (WI) from baseline to 10 months' follow-up. Secondary outcomes were improvement in emotional distress and health-related quality of life at 10 months' follow-up. Intention-to-treat analysis showed a statistically significant mean difference of 20.5 points [95% confidence interval (CI) 11.7-29.4, p < 0.001] on the WI between the groups at 10 months, and the between-group effect sizes were large (Cohen's d = 0.89, 95% CI 0.50-1.29). The number needed to treat was 2.4 (95% CI 1.4-3.4, p < 0.001). Diagnosis and treatment were well accepted by the patients. ACT-G seems feasible, acceptable and effective in treating severe health anxiety.",Eilenberg T.; Fink P.; Jensen JS.; Rief W.; Frostholm L.,2016.0,10.1017/S0033291715001579,0,0,
9787,Adherence and competence in two manual-guided therapies for co-occurring substance use and posttraumatic stress disorders: clinician factors and patient outcomes.,"The challenges of implementing and sustaining evidence-based therapies into routine practice have been well-documented. This study examines the relationship among clinician factors, quality of therapy delivery, and patient outcomes. Within a randomized controlled trial, 121 patients with current co-occurring substance use and posttraumatic stress disorders were allocated to receive either manualized Integrated Cognitive Behavioral Therapy (ICBT) or Individual Addiction Counseling (IAC). Twenty-two clinicians from seven addiction treatment programs were trained and supervised to deliver both therapies. Clinician characteristics were assessed at baseline; clinician adherence and competence were assessed over the course of delivering both therapies; and patient outcomes were measured at baseline and 6-month follow-up. Although ICBT was delivered at acceptable levels, clinicians were significantly more adherent to IAC (p‚Äâ<‚Äâ0.05). At session 1, clinical female gender (p‚Äâ<‚Äâ0.05) and lower education level (p‚Äâ<‚Äâ0.05) were predictive of increased clinician adherence and competence across both therapies. Adherence and competence at session 1 in either therapy were significantly predictive of positive patient outcomes. ICBT adherence (p‚Äâ<‚Äâ0.05) and competence (p‚Äâ<‚Äâ0.01) were predictive of PTSD symptom reduction, whereas IAC adherence (p‚Äâ<‚Äâ0.01) and competence (p‚Äâ<‚Äâ0.01) were associated with decreased drug problem severity. The differential impact of adherence and competence for both therapy types is consistent with their purported primary target: ICBT for PTSD and IAC for substance use. These findings also suggest the benefits of considering clinician factors when implementing manual-guided therapies. Future research should focus on diverse clinician samples, randomization of clinicians to therapy type, and prospective designs to evaluate models of supervision and quality monitoring.",Meier A.; McGovern MP.; Lambert-Harris C.; McLeman B.; Franklin A.; Saunders EC.; Xie H.,2015.0,10.3109/00952990.2015.1062894,0,0,
9788,Psychological Outcomes After a Sexual Assault Video Intervention: A Randomized Trial.,"Sexual assault survivors are at risk for a number of mental and physical health problems, including posttraumatic stress disorder and anxiety. Unfortunately, few seek physical or mental health services after a sexual assault (Price, Davidson, Ruggiero, Acierno, & Resnick, 2014). Mitigating the impact of sexual assault via early interventions is a growing and important area of research. This study adds to this literature by replicating and expanding previous studies (e.g., Resnick, Acierno, Amstadter, Self-Brown, & Kilpatrick, 2007) examining the efficacy of a brief video-based intervention that provides psychoeducation and modeling of coping strategies to survivors at the time of a sexual assault nurse examination. Female sexual assault survivors receiving forensic examinations were randomized to standard care or to the video intervention condition (N = 164). The participants completed mental health assessments 2 weeks (n = 69) and 2 months (n = 74) after the examination. Analyses of covariance revealed that women in the video condition had significantly fewer anxiety symptoms at the follow-up assessments. In addition, of those participants in the video condition, survivors reporting no previous sexual assault history reported significantly fewer posttraumatic stress symptoms 2 weeks after the examination than those with a prior assault history. Forensic nurses have the unique opportunity to intervene immediately after a sexual assault. This brief video intervention is a cost-effective tool to aid with that process.",Miller KE.; Cranston CC.; Davis JL.; Newman E.; Resnick H.,,10.1097/JFN.0000000000000080,0,0,7276
9789,Long-term effects of cognitive therapy on biological rhythms and depressive symptoms: A randomized clinical trial.,"To evaluate the effect of cognitive therapy on biological rhythm and depressive and anxious symptoms in a twelve-month follow-up period. In addition, correlations between the reduction of depression and anxiety symptoms and the regulation of biological rhythm were observed. This was a randomized clinical trial with young adults from 18 to 29 years of age who were diagnosed with depression. Two models of psychotherapy were used: Cognitive Behavioral Therapy (CBT) and Narrative Cognitive Therapy (NCT). Biological rhythm was assessed with the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN). Severity of depressive and anxious symptoms was assessed by the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS), respectively. The sample included 97 patients who were divided within the protocols of psychotherapy. There was a significant reduction in depressive and anxious symptoms (p<0.001) and an increase on regulation of biological rhythm (p<0.05) at the twelve-month follow-up. Moreover, we showed a positive correlation between the reduction of depressive symptoms and regulation of biological rhythm (r=0.638; p<0.001) and between the reduction of anxious symptoms and regulation of biological rhythm (r=0.438; p<0.001). Both models showed that cognitive therapy was effective on the reduction of depressive and anxious symptoms and on the regulation of biological rhythm at a twelve-month follow-up evaluation. This study highlights the association between biological rhythm and symptoms of depression and anxiety. We did not assess genetic, hormonal or neurochemical factors and we did not include patients under pharmaceutical treatment or those with severe symptomatology.",Mondin TC.; Cardoso Tde A.; Jansen K.; Silva Gdel G.; Souza LD.; Silva RA.,2015.0,10.1016/j.jad.2015.08.014,0,0,
9790,"No effects of 20 Hz-rTMS of the primary motor cortex in vegetative state: A randomised, sham-controlled study.","We assessed the effects of a non-invasive neuromodulatory intervention with repetitive transcranial magnetic stimulation (rTMS) of the motor cortex in patients with vegetative state (VS) by a randomised, sham-controlled study with a cross-over design. Eleven patients classified as being in VS (9 post-anoxic, 2 post-traumatic, time elapsed from the injury 9-85 months) were included in the study. Real or sham 20 Hz rTMS were applied to the left primary motor cortex (M1) for 5 consecutive days. Primary outcome measures were changes in the JFK Coma Recovery Scale-Revised (CRS-R) scale total score and Clinical Global Impression Improvement (CGI-I) scale. Additional measures were EEG changes and impression of the patients' relatives using the CGI-I scale. Evaluations were blindly performed at baseline, after the first day of treatment, immediately after the end of the 5-days treatment, 1 week and 1 month later. Slight changes observed in the CRS-R and CGI-I scores did not significantly differ between real or sham stimulation conditions. EEG was not significantly changed on average, although spots of brain reactivity were occasionally found underneath the stimulation point. Findings did not provide evidence of therapeutic effect of 20 Hz rTMS of the M1 in chronic VS, at least with conventional coils and current safety parameters. Therefore, they might be useful to better allocate human and financial resources in future trials.",Cincotta M.; Giovannelli F.; Chiaramonti R.; Bianco G.; Godone M.; Battista D.; Cardinali C.; Borgheresi A.; Sighinolfi A.; D'Avanzo AM.; Breschi M.; Dine Y.; Lino M.; Zaccara G.; Viggiano MP.; Rossi S.,2015.0,10.1016/j.cortex.2015.07.027,0,0,
9791,An experimental Investigation of the Impact of Personality Disorder Diagnosis on Clinicians: Can We See Past the Borderline?,"There is concern that diagnostic labels for psychiatric disorders may invoke damaging stigma, stereotypes and misunderstanding. This study investigated clinicians' reactions to diagnostic labelling by examining their positive and negative reactions to the label borderline personality disorder (BPD). Mental health professionals (n = 265) viewed a videotape of a patient suffering from panic disorder and agoraphobia undergoing assessment. Prior to viewing the videotape, participants were randomly allocated to one of three conditions and were given the following information about the patient: (a) general background information; (b) additional descriptive information about behaviour corresponding to BPD; and (c) additional descriptive information about behaviour corresponding to BPD, but explicitly adding BPD as a possible comorbid diagnostic label. All participants were then asked to note things they had seen in the videotape that made them feel optimistic or pessimistic about treatment outcome. Participants in the group that were explicitly informed that the patient had a BPD diagnostic label reported significantly fewer reasons to be optimistic than the other two groups. Diagnostic labels may negatively impact on clinicians' judgments and perceptions of individuals and therefore clinicians should think carefully about whether, and how, they use diagnoses and efforts should be made to destigmatize diagnostic terms.",Lam DC.; Poplavskaya EV.; Salkovskis PM.; Hogg LI.; Panting H.,2016.0,10.1017/S1352465815000351,0,0,
9792,The Influence of Posttraumatic Stress Disorder on Treatment Outcomes of Patients With Borderline Personality Disorder.,"The aim of this study was to determine the influence of posttraumatic stress disorder (PTSD) on treatment outcomes in patients with borderline personality disorder (BPD). Participants were 180 individuals diagnosed with BPD enrolled in a randomized controlled trial that compared the clinical and cost effectiveness of dialectical behavior therapy (DBT) and general psychiatric management (GPM). Multilevel linear models and generalized linear models were used to compare clinical outcomes of BPD patients with and without PTSD. BPD patients with comorbid PTSD reported significantly higher levels of global psychological distress at baseline and end of treatment compared to their non-PTSD counterparts. Both groups evidenced comparable rates of change on suicide attempts and non-suicidal self-injury (NSSI), global psychological distress, and BPD symptoms over the course of treatment and post-treatment follow-up. DBT and GPM were effective for BPD patients with and without PTSD across a broad range of outcomes.",Boritz T.; Barnhart R.; McMain SF.,2016.0,10.1521/pedi_2015_29_207,0,0,
9793,Relationships among adaptive and maladaptive emotion regulation strategies and psychopathology during the treatment of comorbid anxiety and alcohol use disorders.,"Both maladaptive and adaptive emotion regulation strategies have been linked with psychopathology. However, previous studies have largely examined them separately, and little research has examined the interplay of these strategies cross-sectionally or longitudinally in patients undergoing psychological treatment. This study examined the use and interplay of adaptive and maladaptive emotion regulation strategies in 81 patients receiving cognitive-behavioral interventions for comorbid alcohol use and anxiety disorders. Patients completed measures of emotion regulation strategy use and symptoms of psychopathology pre- and post-treatment. Cross-sectionally, higher use of maladaptive strategies (e.g., denial) was significantly related to higher psychopathology pre- and post-treatment, whereas higher use of adaptive strategies (e.g., acceptance) only significantly related to lower psychopathology post-treatment. Prospectively, changes in maladaptive strategies, but not changes in adaptive strategies, were significantly associated with post-treatment psychopathology. However, for patients with higher pre-treatment maladaptive strategy use, gains in adaptive strategies were significantly associated with lower post-treatment psychopathology. These findings suggest that psychological treatments may maximize efficacy by considering patient skill use at treatment outset. By better understanding a patient's initial emotion regulation skills, clinicians may be better able to optimize treatment outcomes by emphasizing maladaptive strategy use reduction predominately, or in conjunction with increasing adaptive skill use.",Conklin LR.; Cassiello-Robbins C.; Brake CA.; Sauer-Zavala S.; Farchione TJ.; Ciraulo DA.; Barlow DH.,2015.0,10.1016/j.brat.2015.08.001,0,0,
9794,Mindfulness-based cognitive therapy (MBCT) for multiple chemical sensitivity (MCS): Results from a randomized controlled trial with 1 year follow-up.,"Multiple chemical sensitivity (MCS) is a medically unexplained condition characterized by symptoms from multiple organ systems following the perception of common odorants. The condition can cause severe functional impairment for afflicted individuals. The aim of this study was to assess the effects of mindfulness-based cognitive therapy (MBCT) for individuals with MCS. The intention-to-treat sample (ITT) included 69 individuals who had been randomized to either MBCT or treatment as usual (TAU). The primary outcome measure was the Quick Environmental Exposure and Sensitivity Inventory (QEESI), which measures the following aspects of impact of MCS on daily life, symptoms, and reactions following chemical exposures. Secondary outcome measures included the Brief Illness Perception Questionnaire (BIPQ) and the anxiety and depression subscales of the symptom checklist 92 (SCL-92). Participants were assessed at baseline and post treatment, and at follow-up periods of 6- and 12-months. We found no effect of MBCT on the primary outcome, nor did we find an effect on levels of depression or anxiety. We did, however, find positive changes in illness perceptions, which were sustained at 12-month follow-up. Dropout rates were low, suggesting MBCT was well received and regarded as an acceptable intervention by individuals with MCS. Overall, these results suggest that MBCT does not change overall illness status in individuals with MCS, but that MBCT positively changes emotional and cognitive representations. Possible explanations for these results are discussed.",Hauge CR.; Rasmussen A.; Piet J.; Bonde JP.; Jensen C.; Sumbundu A.; Skovbjerg S.,2015.0,10.1016/j.jpsychores.2015.06.010,0,0,
9795,"Trauma-focused cognitive behaviour therapy and exercise for chronic whiplash: protocol of a randomised, controlled trial.","As a consequence of a road traffic crash, persistent pain and disability following whiplash injury are common and incur substantial personal and economic costs. Up to 50% of people who experience a whiplash injury will never fully recover and up to 30% will remain moderately to severely disabled by the condition. The reason as to why symptoms persist past the acute to sub-acute stage and become chronic is unclear, but likely results from complex interactions between structural injury, physical impairments, and psychological and psychosocial factors. Psychological responses related to the traumatic event itself are becoming an increasingly recognised factor in the whiplash condition. Despite this recognition, there is limited knowledge regarding the effectiveness of psychological interventions, either delivered alone or in combination with physiotherapy, in reducing the physical and pain-related psychological factors of chronic whiplash. Pilot study results have shown positive results for the use of trauma-focused cognitive behaviour therapy to treat psychological factors, pain and disability in individuals with chronic whiplash. The results have indicated that a combined approach could not only reduce psychological symptoms, but also pain and disability. The primary aim of this randomised, controlled trial is to investigate the effectiveness of combined trauma-focused cognitive behavioural therapy, delivered by a psychologist, and physiotherapy exercise to decrease pain and disability of individuals with chronic whiplash and post-traumatic stress disorder (PTSD). The trial also aims to investigate the effectiveness of the combined therapy in decreasing post-traumatic stress symptoms, anxiety and depression. A total of 108 participants with chronic whiplash-associated disorder (WAD) grade II of > 3 months and < 5 years duration and PTSD (diagnosed with the Clinician Administered PTSD Scale (CAPS) according to the DSM-5) will be recruited for the study. Participants will be assessed via phone screening and in person at a university research laboratory. Interventions will take place in southeast Queensland, Australia and southern Denmark. Psychological therapy will be delivered once a week over 10 weeks, with participants randomly assigned to either trauma-focused cognitive behavioural therapy or supportive therapy, both delivered by a clinical psychologist. Participants will then receive ten sessions of evidence-based physiotherapy exercise delivered over a 6-week period. The primary outcome measure is neck disability (Neck Disability Index). Secondary outcomes focus on: pain intensity; presence and severity of PTSD (CAPS V and PTSD Checklist 5); psychological distress (Depression, Anxiety Stress Scale 21); patient perceived functionality (SF-12, Tampa Scale of Kinesiophobia, and Patient-Specific Functional Scale); and pain-specific self-efficacy and catastrophising (Pain Self-Efficacy Questionnaire and Pain Catastrophizing Scale). After psychotherapy (10 weeks after randomisation) and physiotherapy (16 weeks after randomisation), as well as at the 6-month and 12-month follow-ups, a blind assessor will measure the outcomes. All analyses will be conducted on an intention-to-treat basis. The primary and secondary outcomes that are measured will be analysed using linear mixed and logistic regression models. Any effect of site (Australia or Denmark) will be evaluated by including a site-by-treatment group-by-time interaction term in the mixed models analyses. Effect modification will only be assessed for the primary outcome of the Neck Disability Index. This study will provide a definitive evaluation of the effects of adding trauma-focused cognitive behaviour therapy to physiotherapy exercise for individuals with chronic WAD and PTSD. This study is likely to influence the clinical management of whiplash injury and will have immediate clinical applicability in Australia, Denmark and the wider international community. The study will also have implications for both health and insurance policy makers in their decision-making regarding treatment options and funding.",Campbell L.; Kenardy J.; Andersen T.; McGregor L.; Maujean A.; Sterling M.,2015.0,10.1016/j.jphys.2015.07.003,0,0,
9796,Value-based cognitive-behavioural therapy for the prevention of chronic whiplash associated disorders: protocol of a randomized controlled trial.,"Whiplash injury is the most common traffic-related injury affecting thousands of people every year. Conservative treatments have not proven effective in preventing persistent symptoms and disability after whiplash injury. Early established maladaptive pain behaviours within the first weeks after the injury may explain part of the transition from acute to chronic whiplash associated disorder (WAD). Hence, early targeting of psychological risk factors such as pain catastrophizing, fear-avoidance-beliefs, depression, and symptoms of posttraumatic stress disorder (PTSD) may be important in preventing the development of chronic WAD. Some evidence exists that targeting fear-avoidance beliefs and PTSD with exposure strategies and value-based actions may prevent development of persistent disability after whiplash injury. Yet, the results have to be tested in a randomized controlled trial (RCT). The primary objective of the present study is to test whether a specifically tailored value-based cognitive-behavioural therapy program (V-CBT) is able to prevent the development of persistent disability, pain, and psychological distress if delivered within the first three months after a whiplash injury. The current study is a two-armed randomized controlled study with a crossover design. Group A is scheduled for V-CBT within one week of randomization and group B with a delayed onset 3 months after randomization. If the study detects significant effects of V-CBT as a preventive intervention, the study will provide new insights of preventive treatment for patients with WAD and thereby serve as an important step towards preventing the chronic condition. Current Controlled Trials Registration September 19, 2014: NCT02251028.",Andersen TE.; Ravn SL.; Roessler KK.,2015.0,10.1186/s12891-015-0687-y,0,0,
9797,Response to psychotherapy for posttraumatic stress disorder: the role of pretreatment verbal memory performance.,"Neuropsychological studies have consistently demonstrated impaired verbal memory in posttraumatic stress disorder (PTSD). Trauma-focused treatment for PTSD is thought to rely on memory, but it is largely unknown whether treatment outcome is influenced by memory performance. The aim of the study, therefore, was to examine the relationship between verbal memory performance and treatment response to trauma-focused psychotherapy. Participants were referred to our outpatient clinic and recruited between December 2003 and January 2009 upon diagnosis of PTSD according to DSM-IV. Secondary analyses of a randomized controlled trial comparing eye movement desensitization and reprocessing therapy (n = 70) and brief eclectic psychotherapy (n = 70), a cognitive-behavioral intervention, are reported. Response to treatment was measured by self-reported PTSD symptom severity (Impact of Event Scale-Revised) over 17 weeks. Pretreatment verbal memory measures (California Verbal Learning Test, Rivermead Behavioral Memory Test) were included in the mixed linear model analyses in order to investigate the influence of memory on treatment outcome. Pretreatment encoding, short-term retrieval, long-term retrieval, and recognition performance were significantly associated with treatment response in terms of self-reported PTSD symptom severity for both treatments (P ≤ .013). Receiver operating characteristic curves predicting treatment response with pretreatment memory indices showed that 75.6% of the patients could be correctly classified as responder. Poor verbal memory performance represents a risk factor for worse treatment response to trauma-focused psychotherapy. Memory measures can be helpful in determining which patients are unable to benefit from trauma-focused psychotherapy. Future research should explore how treatment perspectives of patients with poor verbal memory can be improved. ISRCTN.com identifier: ISRCTN64872147.",Nijdam MJ.; de Vries GJ.; Gersons BP.; Olff M.,2015.0,10.4088/JCP.14m09438,0,0,
9798,Managing Cancer And Living Meaningfully: study protocol for a randomized controlled trial.,"We have developed a novel and brief semi-structured psychotherapeutic intervention for patients with advanced or metastatic cancer, called Managing Cancer And Living Meaningfully. We describe here the methodology of a randomized controlled trial to test the efficacy of this treatment to alleviate distress and promote well-being in this population. The study is an unblinded randomized controlled trial with 2 conditions (intervention plus usual care versus usual care alone) and assessments at baseline, 3 and 6 months. The site is the Princess Margaret Cancer Centre, part of the University Health Network, in Toronto, Canada. Eligibility criteria include: ‚â• 18 years of age; English fluency; no cognitive impairment; and diagnosis of advanced cancer. The 3-6 session intervention is manualized and allows for flexibility to meet individual patients' needs. It is delivered over a 3-6 month period and provides reflective space for patients (and their primary caregivers) to address 4 main domains: symptom management and communication with health care providers; changes in self and relations with close others; sense of meaning and purpose; and the future and mortality. Usual care at the Princess Margaret Cancer Centre includes distress screening and referral as required to in-hospital psychosocial and palliative care services. The primary outcome is frequency of depressive symptoms and the primary endpoint is at 3 months. Secondary outcomes include diagnosis of major or minor depression, generalized anxiety, death anxiety, spiritual well-being, quality of life, demoralization, attachment security, posttraumatic growth, communication with partners, and satisfaction with clinical interactions. Managing Cancer And Living Meaningfully has the potential to relieve distress and promote psychological well-being in patients with advanced cancer and their primary caregivers. This trial is being conducted to determine its benefit and inform its dissemination. The intervention has cross-national relevance and training workshops have been held thus far with clinicians from North and South America, Europe, the Middle East, Asia and Africa. ClinicalTrials.gov NCT01506492 4 January 2012.",Lo C.; Hales S.; Rydall A.; Panday T.; Chiu A.; Malfitano C.; Jung J.; Li M.; Nissim R.; Zimmermann C.; Rodin G.,2015.0,10.1186/s13063-015-0811-1,0,0,
9799,"A Randomised, Double-Blind, Placebo-Controlled Trial of As-Needed Naltrexone in the Treatment of Pathological Gambling.","Effective treatment strategies are needed for the treatment of pathological gambling (PG). The efficacy of as-needed naltrexone was assessed in a single-centre, randomised, double-blind, placebo-controlled trial. The participants (n = 101) received either as-needed placebo or naltrexone (50 mg) and psychosocial support for 20 weeks. The primary outcome measure was the severity of PG assessed by the Yale-Brown Obsessive Compulsive Scale adapted for PG (PG-YBOCS). Secondary gambling-related outcome measures included thoughts/urges and behaviour subscales of PG-YBOCS as well as the highest daily expenditure and gambling frequency. In addition, RAND-36 scales of emotional well-being and social functioning were used as outcomes. The results were analysed using the intention-to-treat principle and linear random effects modelling. No significant treatment group differences were found. In an exploratory analysis, emotional well-being increased in a subgroup of participants with AA genotype of opioid receptor, mu 1 (OPRM1) A118G polymorphism (p = 0.02). Overall, the as-needed naltrexone may not provide substantial additional benefit for PG patients receiving psychosocial support. Replication by larger scale studies is warranted to further evaluate naltrexone administration schedules for the treatment of PG and the role of OPRM1.",Kovanen L.; Basnet S.; Castrén S.; Pankakoski M.; Saarikoski ST.; Partonen T.; Alho H.; Lahti T.,2016.0,10.1159/000435876,0,0,
9800,COLLABORATIVE CARE FOR PERINATAL DEPRESSION IN SOCIOECONOMICALLY DISADVANTAGED WOMEN: A RANDOMIZED TRIAL.,"Both antenatal and postpartum depression have adverse, lasting effects on maternal and child well-being. Socioeconomically disadvantaged women are at increased risk for perinatal depression and have experienced difficulty accessing evidence-based depression care. The authors evaluated whether ""MOMCare,""a culturally relevant, collaborative care intervention, providing a choice of brief interpersonal psychotherapy and/or antidepressants, is associated with improved quality of care and depressive outcomes compared to intensive public health Maternity Support Services (MSS-Plus). A randomized multisite controlled trial with blinded outcome assessment was conducted in the Seattle-King County Public Health System. From January 2010 to July 2012, pregnant women were recruited who met criteria for probable major depression and/or dysthymia, English-speaking, had telephone access, and ≥18 years old. The primary outcome was depression severity at 3-, 6-, 12-, 18-month postbaseline assessments; secondary outcomes included functional improvement, PTSD severity, depression response and remission, and quality of depression care. All participants were on Medicaid and 27 years old on average; 58% were non-White; 71% were unmarried; and 65% had probable PTSD. From before birth to 18 months postbaseline, MOMCare (n = 83) compared to MSS-Plus participants (n = 85) attained significantly lower levels of depression severity (Wald's χ(2) = 6.09, df = 1, P = .01) and PTSD severity (Wald's χ(2) = 4.61, df = 1, P = .04), higher rates of depression remission (Wald's χ(2) = 3.67, df = 1, P = .05), and had a greater likelihood of receiving ≥4 mental health visits (Wald's χ(2) = 58.23, df = 1, P < .0001) and of adhering to antidepressants in the prior month (Wald's χ(2) = 10.00, df = 1, P < .01). Compared to MSS-Plus, MOMCare showed significant improvement in quality of care, depression severity, and remission rates from before birth to 18 months postbaseline for socioeconomically disadvantaged women. Findings suggest that evidence-based perinatal depression care can be integrated into the services of a county public health system in the United States. ClinicalTrials.govNCT01045655.",Grote NK.; Katon WJ.; Russo JE.; Lohr MJ.; Curran M.; Galvin E.; Carson K.,2015.0,10.1002/da.22405,0,0,
9801,Resilience following spinal cord injury: A prospective controlled study investigating the influence of the provision of group cognitive behavior therapy during inpatient rehabilitation.,"To examine change in resilience in people with spinal cord injury (SCI) when group cognitive behavior therapy (GCBT) was added to routine psychosocial rehabilitation (RPR). A prospective repeated-measures cohort design was used to determine the efficacy of the addition of GCBT (n = 50). The control group consisted of individuals receiving RPR, which included access to individual CBT (ICBT) when required (n = 38). Groups were assessed on 3 occasions: soon after admission, within 2 weeks of discharge, and 6-months postdischarge. Measures included sociodemographic, injury, and psychosocial factors. The outcome variable was resilience, considered an important outcome measure for recovery. To adjust for baseline differences in self-efficacy, depressive mood and anxiety between the 2 groups, these factors were entered into a repeated measures multivariate analysis of covariance (MANCOVA) as covariates. Latent class analysis was used to determine the best-fitting model of resilience trajectories for both groups. The MANCOVA indicated that the addition of GCBT to psychosocial rehabilitation did not result in improved resilience compared with the ICBT group. Trajectory data indicated over 60% were demonstrating acceptable resilience irrespective of group. Changes in resilience mean scores suggest the addition of GCBT adds little to resilience outcomes. Latent class modeling indicated both groups experienced similar trajectories of improvement and deterioration. Results highlight the importance of conducting multivariate modeling analysis that isolates subgroups of related cases over time to understand complex trajectories. Further research is needed to clarify individual differences in CBT intervention preference as well as other factors which impact on resilience.",Guest R.; Craig A.; Nicholson Perry K.; Tran Y.; Ephraums C.; Hales A.; Dezarnaulds A.; Crino R.; Middleton J.,2015.0,10.1037/rep0000052,0,0,
9802,"Effects of music listening on stress, anxiety, and sleep quality for sleep-disturbed pregnant women.","Prenatal sleep disturbance has been associated with undesirable birthing outcomes. To determine the effectiveness of listening to music at home in improving sleep quality, 121 Taiwanese pregnant women with poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] score > 5) were systematically assigned, with a random start to music listening (n = 61) or control (n = 60) group. Participants in the music listening group self-regulated listening to music in addition to receiving general prenatal care similar to that in the control group for 2 weeks. The PSQI and State-Anxiety Inventory were used to assess outcomes. ANCOVA analyses were used with the pretest scores as covariates and showed significant improvement in sleep quality, stress, and anxiety in the music listening group compared with the control group. The most frequently used music genre by participants in the experimental group was lullabies, followed by classical music and crystal baby music. This study supported the theory that 2-week music listening interventions may reduce stress, anxiety, and yield better sleep quality for sleep-disturbed pregnant women. The analysis of participants' journals also implied that the expectant mothers' choices of musical genres may correlate more with perceived prenatal benefits or the desire to interact with their unborn child.",Liu YH.; Lee CS.; Yu CH.; Chen CH.,2016.0,10.1080/03630242.2015.1088116,0,0,
9803,Short-term effectiveness of spinal manipulative therapy versus functional technique in patients with chronic nonspecific low back pain: a pragmatic randomized controlled trial.,"Chronic low back pain (LBP) is a prevalent condition associated with pain, disability, decreased quality of life, and fear of movement. To date, no studies have compared the effectiveness of spinal manipulation and functional technique for the management of this population. This study aimed to compare the effectiveness of spinal manipulation and functional technique on pain, disability, kinesiophobia, and quality of life in patients with chronic LBP. A single-blind pragmatic randomized controlled trial conducted in a university research clinic was carried out. Sixty-two patients (62% female, age: 45±7) with chronic LBP comprised the patient sample. Data on disability (Roland-Morris Disability Questionnaire [RMQ], Oswestry Low Back Pain Disability Index [ODI]), pain intensity (Numerical Pain Rate Scale [NPRS]), fear of movement (Tampa Scale of Kinesiophobia [TSK]), quality of life (Short Form-36 [SF-36] quality of life questionnaire), isometric resistance of abdominal muscles (McQuade test), and spinal mobility in flexion (finger-to-floor distance) were collected at baseline immediately after the intervention phase and at 1 month postintervention by an assessor blinded to group allocation of the patients. Patients were randomly assigned to the spinal manipulative therapy group or the functional technique group and received three once-weekly sessions. In comparison to patients receiving functional technique, those receiving spinal manipulation experienced statistically, although not clinically, significant greater reductions in terms of RMQ (standardized mean difference in score changes between groups at post-treatment: 0.1; at 1 month: 0.1) and ODI (post-treatment: 2.9; at 1 month: 1.4). Linear longitudinal analysis showed a significant improvement in both groups over time for RMQ (manipulative: F=68.51, p<.001; functional: F=28.58, p<.001) and ODI (manipulative: F=104.66, p<.001; functional: F=32.15, p=.001). However, significant treatment-by-time interactions were not detected for pain intensity (p=.488), TSK (p=.552), any domains of the SF-36 quality of life questionnaire (p≤.164), McQuade test (p=.512), and finger-to-floor distance (p=.194). Differences between and within groups were not clinically meaningful in any of the reported measures. In comparison to functional technique, spinal manipulative therapy showed greater reduction in disability in patients with chronic LBP, but not in terms of pain, fear of movement, quality of life, isometric resistance of trunk flexors, or spinal mobility. However, differences in disability were not clinically meaningful; therefore, spinal manipulative therapy did not result in any clinically important short-term benefits over functional technique therapy. In addition, as neither group met the threshold for minimum clinically important difference following treatment, neither treatment resulted in a clinically meaningful benefit.",Castro-Sánchez AM.; Lara-Palomo IC.; Matarán-Peñarrocha GA.; Fernández-de-Las-Peñas C.; Saavedra-Hernández M.; Cleland J.; Aguilar-Ferrándiz ME.,2016.0,10.1016/j.spinee.2015.08.057,0,0,
9804,A preliminary investigation of a novel training to target cognitive biases towards negative social stimuli in Anorexia Nervosa.,Patients with Anorexia Nervosa (AN) experience high levels of social difficulties and anxiety. These problems might be underpinned by negatively biased processing of social stimuli. The aim of this study was to examine the feasibility of using a novel Cognitive Bias Modification (CBM) training to target information processing biases in patients with AN. Twenty-eight patients with AN completed a baseline and end of intervention assessment of mood and social appraisals. The CBM training consisted of 5 sessions and included an attentional probe task to train attention towards positive social stimuli and an ambiguous scenarios task to train benign or neutral interpretations of ambiguous social scenarios. At baseline patients displayed an attention and interpretation bias towards negative social stimuli. At the end of intervention there was a medium sized increase in attention to positive faces and fewer negative interpretations of ambiguous social stimuli. There were also lower levels of anxiety and higher levels of self-compassion in response to a judgemental video clip. The lack of a control group is the main limitation to this preliminary study as the changes obtained may have resulted from non-specific aspects of the inpatient treatment. A novel CBM training is associated with more positive processing of social information in AN. It would be of interest to test the hypothesis that reducing cognitive biases towards social stimuli impacts on wider features of an eating disorder.,Cardi V.; Esposito M.; Bird G.; Rhind C.; Yiend J.; Schifano S.; Hirsch C.; Treasure J.,2015.0,10.1016/j.jad.2015.08.019,0,0,
9805,"Stigmatisation, perceived barriers to care, help seeking and the mental health of British Military personnel.","The relationship between mental health symptoms, stigmatising beliefs about mental health and help seeking is complex and poorly understood. 1636 UK Armed Forces personnel provided study data immediately after deployment (T1) and approximately 6 months later (T2). Stigmatising beliefs were assessed using an eight-item scale previously used in studies of UK military personnel. Symptoms of probable common mental disorder, probable post-traumatic stress disorder and subjective stressful, emotional, relationship and family problems were evaluated at T1 and T2. Help seeking during deployment was assessed at T1 and post-deployment help seeking at T2. Alcohol use and subjective alcohol problems were assessed at T2 only. Reporting a probable mental health disorder or potentially harmful alcohol use following deployment was both significantly associated with higher levels of stigmatising beliefs. The reported degree of stigma was associated with changes in mental health symptom levels; compared to those who were never classified as a probable mental health disorder case, recovered cases experienced significantly lower levels of stigmatisation, whereas new onset cases reported significantly higher levels. The way that individuals report mental health stigmatisation is not static; rather stigma fluctuates in proportion to the frequency and severity of psychological symptoms. These results suggest that public health stigma-reduction strategies which aim to promote engagement with mental health services should be focused towards people who are experiencing worsening mental health. Our results suggest that willing volunteers who have recovered from a mental-ill-health episode may be well placed to assist in the delivery of such a strategy.",Jones N.; Keeling M.; Thandi G.; Greenberg N.,2015.0,10.1007/s00127-015-1118-y,0,0,
9806,[Ligament reconstruction for trapeziometacarpal joint instability].,"Restoring stability and preventing subluxation/dislocation of the trapeziometacarpal (first carpometacarpal = CMC-I) joint while preserving mobility. Posttraumatic, acquired or congenital instability of the CMC-I joint. Existence of osteoarthritis of the CMC-I joint. Neurogenic or muscular origin dysfunction of thenar muscles and other contractures the CMC-I area. Infections. Radiopalmar approach to the CMC-I joint, reduction, and transosseous ligament reconstruction with a distally pedicled tendon strip from the abductor pollicis longus muscle. Splint immobilization for 5 weeks. This procedure generally results in good or very good outcomes. Of 24 patients, only one patient experienced rupture of the ligament reconstruction. Ligament reconstruction for the carpometacarpal joint of the thumb relieves pain and restores stability while preserving functional range of motion in patients with chronic instability.",Langer MF.; Wieskötter B.; Herrmann K.; Oeckenpöhler S.,2015.0,10.1007/s00064-015-0418-4,0,0,
9807,Randomized Trial of Communication Facilitators to Reduce Family Distress and Intensity of End-of-Life Care.,"Communication with family of critically ill patients is often poor and associated with family distress. To determine if an intensive care unit (ICU) communication facilitator reduces family distress and intensity of end-of-life care. We conducted a randomized trial at two hospitals. Eligible patients had a predicted mortality greater than or equal to 30% and a surrogate decision maker. Facilitators supported communication between clinicians and families, adapted communication to family needs, and mediated conflict. Outcomes included depression, anxiety, and post-traumatic stress disorder (PTSD) among family 3 and 6 months after ICU and resource use. We identified 488 eligible patients and randomized 168. Of 352 eligible family members, 268 participated (76%). Family follow-up at 3 and 6 months ranged from 42 to 47%. The intervention was associated with decreased depressive symptoms at 6 months (P‚Äâ=‚Äâ0.017), but there were no significant differences in psychological symptoms at 3 months or anxiety or PTSD at 6 months. The intervention was not associated with ICU mortality (25% control vs. 21% intervention; P‚Äâ=‚Äâ0.615) but decreased ICU costs among all patients (per patient: $75,850 control, $51,060 intervention; P‚Äâ=‚Äâ0.042) and particularly among decedents ($98,220 control, $22,690 intervention; P‚Äâ=‚Äâ0.028). Among decedents, the intervention reduced ICU and hospital length of stay (28.5 vs. 7.7 d and 31.8 vs. 8.0 d, respectively; P‚Äâ<‚Äâ0.001). Communication facilitators may be associated with decreased family depressive symptoms at 6 months, but we found no significant difference at 3 months or in anxiety or PTSD. The intervention reduced costs and length of stay, especially among decedents. This is the first study to find a reduction in intensity of end-of-life care with similar or improved family distress. Clinical trial registered with www.clinicaltrials.gov (NCT 00720200).",Curtis JR.; Treece PD.; Nielsen EL.; Gold J.; Ciechanowski PS.; Shannon SE.; Khandelwal N.; Young JP.; Engelberg RA.,2016.0,10.1164/rccm.201505-0900OC,0,0,
9808,Fear of Losing Emotional Control Is Associated With Cognitive Processing Therapy Outcomes in U.S. Veterans of Afghanistan and Iraq.,"Evidence-based treatments for posttraumatic stress disorder (PTSD) can reduce symptoms and improve veterans' psychological health. Unfortunately, many veterans leave treatment before receiving maximum benefit. Fear of emotions is related to severity of PTSD, and changes in fear of emotions are correlated with changes in PTSD symptoms. This study built upon the literature linking greater fear of emotions to PTSD severity by examining whether pretreatment fear of emotions, measured by the Affect Control Scale, was associated with completion of cognitive processing therapy (CPT) and severity of posttreatment PTSD in a sample of 89 U.S. veterans who had served in Afghanistan and Iraq. About 60% of veterans completed 10 or more therapy sessions. A logistic regression on 51 of the 89 subjects that more fear of anxiety at pretreatment was associated with decreased likelihood of completing treatment, OR = 0.93, 95% CI [0.87, 1.00]. Of those veterans who completed treatment, higher fear of anger at pretreatment was negatively related to severity of PTSD posttreatment (β = -.29, p = .037), in a model with the other predictors. Assessing veterans for fear of anxiety and anger before CPT and teaching emotion regulation skills to those in need may reduce treatment dropout.",Miles SR.; Smith TL.; Maieritsch KP.; Ahearn EP.,2015.0,10.1002/jts.22036,0,0,
9809,Resilience Training: A Pilot Study of a Mindfulness-Based Program with Depressed Healthcare Professionals.,"Mindfulness-based programs have been primarily used to target anxiety or the prevention of relapse in recurrent depression; however, limited research has been conducted on the use of mindfulness programs for relief of current depressive symptoms. To investigate the potential effect of resilience training (RT) on symptom relief for current or recurrent depression, and other psychological/behavioral outcomes. Wait-list comparison pilot study. Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN. A total of 40 actively working healthcare professionals age 18-65 years. RT is an eight-week mindfulness-based program that synergizes elements of mindfulness meditation with nutrition and exercise. The first 20 consecutive individuals meeting all eligibility criteria were assigned to the RT group. The next 20 consecutive eligible individuals were placed into the wait-list control group and had an eight-week waiting period before starting the RT program. Psychological/behavioral outcomes were measured before and after completion of the RT program and two months after completion. Wait-list participants also had measures taken just before starting on the wait-list. The RT group exhibited a 63-70% (P ≤ .01) reduction in depression, a 48% (P ≤ .01) reduction in stress, a 23% (P ≤ .01) reduction in trait anxiety, and a 52% (P ≤ .01) reduction in presenteeism (a per-employee savings of $1846 over the eight-week program). All outcomes were statistically significantly different from the wait-list group. Most improvements persisted up to two months after completion of the RT program. Further replication with a larger sample size, and enhanced control group is warranted.",Johnson JR.; Emmons HC.; Rivard RL.; Griffin KH.; Dusek JA.,,10.1016/j.explore.2015.08.002,0,0,
9810,A brief intervention for posttraumatic stress disorder in persons with a serious mental illness.,"Posttraumatic stress disorder (PTSD) is common in people with a serious mental illness, but it is often not diagnosed or treated. Recent progress has been made in developing and validating interventions for PTSD in this population, but dropout from treatment can be problematic. The present study evaluated the feasibility and clinical outcomes of a Brief program (three sessions) for the treatment of PTSD in persons with a serious mental illness. An open clinical trial was conducted to evaluate the Brief program, which comprises three individual weekly sessions and includes education about trauma and PTSD, as well as instruction in breathing retraining for the self-management of anxiety. Eighteen predominantly minority persons with serious mental illness and PTSD were enrolled in the Brief program and assessed at baseline, 1-month posttreatment, and 3-month follow-up. Acceptability and tolerability of the program were high, with 15 of 18 (83%) study participants completing all three sessions. Interview-based and self-report assessments indicated significant reductions in PTSD symptoms, depression, and other symptoms at posttreatment, with treatment gains maintained at the 3-month follow-up. The results suggest the Brief program may be clinically beneficial to persons with serious mental illnesses and PTSD and indicate that more rigorous research is needed to evaluate the program.",Nishith P.; Mueser KT.; Morse GA.,2015.0,10.1037/prj0000158,0,0,
9811,The Effectiveness of Visual Short-Time Neurofeedback on Brain Activity and Clinical Characteristics in Alcohol Use Disorders: Practical Issues and Results.,"The present study was carried out to examine the efficacy of alpha/theta neurofeedback (NF) with a new visual paradigm in a cohort of alcohol use disordered (AUD) patients (n = 25) treated in an Austrian therapeutic community center. The experimental study design focused on changes in absolute and relative resting EEG band power as well as in clinical variables, including depression (Beck Depresion Inventory [BDI-V]), psychiatric symptoms (Brief Symptom Inventory [BSI], coping (Freiburg Questionnaire on Coping with Illness [FKV-lis]), psychotherapy motivation (Therapy Motivation Questionnaire [FPTM-23]), sense of coherence (Sense of Coherence Scale [SOC-13]), posttraumatic growth (Posttraumatic Growth Inventory [PPR]), and alcohol cravings (Alcohol Craving Questionnaire [ACQ]). For measuring training effects, participants were randomly allocated to 2 groups: an experimental group (EG, n = 13) and a control group (CG, n = 12). Patients in EG received 12 sessions of visual NF training over a period of 6 weeks to enhance alpha (8-12 Hz) and theta (4-7 Hz) frequency band power in addition to the standard treatment program of the rehabilitation center. Participants in CG received no additional NF intervention. The multivariate analysis of covariance (MANCOVA) showed a change by trend in absolute alpha and theta power in the EG. Even though no MANCOVA effects were found in the clinical scales, AUD patients reported increasing control of their brain activity during the course of NF. However, changes in several clinical scales (BDI-V, BSI, FKV-lis, PPR) from pre- to posttest were observed only in the EG contrary to the CG. The findings of this pilot study provide first evidence for the practicality and effectiveness of visual short-term NF as an additive intervention in the therapeutic community.",Lackner N.; Unterrainer HF.; Skliris D.; Wood G.; Wallner-Liebmann SJ.; Neuper C.; Gruzelier JH.,2016.0,10.1177/1550059415605686,0,0,
9812,"Weight acceptance versus body dissatisfaction: Effects on stigma, perceived self-esteem, and perceived psychopathology.","It is unknown whether weight acceptance or body dissatisfaction impact anti-fat stigma. Therefore, this study utilized a 2√ó2 between-subject experimental design to examine of the relationship between body acceptance and stigmatization. Participants were university undergraduates (N=394, 70% women, mean age=20.8 years, mean BMI=23.61 kg/m(2)) who were randomly assigned to read vignettes describing an obese or normal-weight target described as either accepting or not accepting of her weight. Participants completed measures of stigma (the Fat Phobia Scale (FPS), the modified Anti-fat Attitudes Scale (AFA)), perceived self-esteem (assessed with the modified Rosenberg Self-Esteem Scale (RSE)), and perceived psychopathology. Analyses revealed significant main effects for acceptance. Notably, targets who accepted their weight were less stigmatized on the FPS (F(1, 354)=66.82, p<.001) and the AFA willpower subscale (F(1, 373)=37.90, p<.001), and they were perceived as having better self esteem (F(1, 371)=166.16, p<.001) and fewer psychological problems (F(1, 381)=123.19, p<.001) than those who did not accept their weight. Results from this study suggest that size acceptance, even when practiced by obese targets, was significantly less stigmatized than body dissatisfaction and associated with better perceived self esteem and mental health.",Murakami JM.; Latner JD.,2015.0,10.1016/j.eatbeh.2015.09.010,0,0,
9813,The marriage of surgical simulation and telementoring for damage-control surgical training of operational first responders: A pilot study.,"Hemorrhage is the leading cause of preventable posttraumatic death. Many such deaths may be potentially salvageable with remote damage-control surgical interventions. As recent innovations in information technology enable remote specialist support to point-of-care providers, advanced interventions, such as remote damage-control surgery, may be possible in remote settings. An anatomically realistic perfused surgical training mannequin with intrinsic fluid loss measurements (the ""Cut Suit"") was used to study perihepatic packing with massive liver hemorrhage. The primary outcome was loss of simulated blood (water) during six stages, namely, incision, retraction, direction, identification, packing, and postpacking. Six fully credentialed surgeons performed the same task as 12 military medical technicians who were randomized to remotely telementored (RTM) (n = 7) or unmentored (UTM) (n=5) real-time guidance by a trauma surgeon. There were no significant differences in fluid loss between the surgeons and the UTM group or between the UTM and RTM groups. However, when comparing the RTM group with the surgeons, there was significantly more total fluid loss (p = 0.001) and greater loss during the identification (p = 0.002), retraction (p = 0.035), direction (p = 0.014), and packing(p = 0.022) stages. There were no significant differences in fluid loss after packing between the groups despite differences in the number of sponges used; RTM group used more sponges than the surgeons and significantly more than the UTM group (p = 0.048). However, mentoring significantly increased self-assessed nonsurgeon procedural confidence (p = 0.004). Perihepatic packing of an exsanguinating liver hemorrhage model was readily performed by military medical technicians after a focused briefing. While real-time telementoring did not improve fluid loss, it significantly increased nonsurgeon procedural confidence, which may augment the feasibility of the concept by allowing them to undertake psychologically daunting procedures.",Kirkpatrick AW.; Tien H.; LaPorta AT.; Lavell K.; Keillor J.; Wright Beatty HE.; McKee JL.; Brien S.; Roberts DJ.; Wong J.; Ball CG.; Beckett A.,2015.0,10.1097/TA.0000000000000829,0,0,
9814,Defining treatment response in trichotillomania: a signal detection analysis.,"The Massachusetts General Hospital Hairpulling Scale (MGH-HPS) and the NIMH Trichotillomania Severity Scale (NIMH-TSS) are two widely used measures of trichotillomania severity. Despite their popular use, currently no empirically-supported guidelines exist to determine the degrees of change on these scales that best indicate treatment response. Determination of such criteria could aid in clinical decision-making by defining clinically significant treatment response/recovery and producing accurate power analyses for use in clinical trials research. Adults with trichotillomania (N=69) participated in a randomized controlled trial of psychotherapy and were assessed before and after treatment. Response status was measured via the Clinical Global Impressions-Improvement Scale, and remission status was measured via the Clinical Global Impressions-Severity Scale. For treatment response, a 45% reduction or 7-point raw score change on the MGH-HPS was the best indicator of clinically significant treatment response, and on the NIMH-TSS, a 30-40% reduction or 6-point raw score difference was most effective cutoff. For disorder remission, a 55-60% reduction or 7-point raw score change on the MGH-HPS was the best predictor, and on the NIMH-TSS, a 65% reduction or 6-point raw score change was the best indicator of disorder remission. Implications of these findings are discussed.",Houghton DC.; Capriotti MR.; De Nadai AS.; Compton SN.; Twohig MP.; Neal-Barnett AM.; Saunders SM.; Franklin ME.; Woods DW.,2015.0,10.1016/j.janxdis.2015.09.008,0,0,
9815,Can Low-Cost Strategies Improve Attendance Rates in Brief Psychological Therapy? Double-Blind Randomized Controlled Trial.,"To assess if telephone text message appointment reminders and orientation leaflets can increase the proportion of patients who attend brief interventions after being assessed as suitable for guided self-help following cognitive behavioral therapy principles. Attendance was operationally defined as having accessed at least 1 therapy appointment. A secondary outcome was the proportion of attenders who completed or dropped out of therapy. After initial assessment, 254 patients with depression and anxiety disorders were randomly assigned to 1 of 3 groups: (a) usual waitlist control, (b) leaflet, (c) leaflet plus text message. Differences in the proportions of patients who started and completed therapy across groups were assessed using chi-square and logistic regression analyses. Overall, 63% of patients in this sample attended therapy. Between-group differences were not significant for attendance, x(2) (2) = 3.94, p = .14, or completion rates, x(2) (2) = 2.98, p = .23. These results were not confounded by demographic or clinical characteristics. Low-cost strategies appear to make no significant difference to therapy attendance and completion rates.",Delgadillo J.; Moreea O.; Murphy E.; Ali S.; Swift JK.,2015.0,10.1002/jclp.22228,0,0,
9816,EXPLORING PERSONALITY DIAGNOSIS STABILITY FOLLOWING ACUTE PSYCHOTHERAPY FOR CHRONIC POSTTRAUMATIC STRESS DISORDER.,"Axis I comorbidity complicates diagnosing axis II personality disorders (PDs). PDs might influence Axis I outcome. No research has examined psychotherapy effects on PDs of treating Axis I comorbidity. Secondary analysis of a randomized controlled trial examined PD diagnostic stability after brief psychotherapy of chronic posttraumatic stress disorder (PTSD). Patients with chronic PTSD were randomly assigned to 14 weeks of prolonged exposure, interpersonal psychotherapy, or relaxation therapy. Assessments included the Structured Clinical Interview for DSM-IV, Patient Version (SCID-P) and Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) at baseline, week 14, and for treatment responders (‚â•30% clinician-administered PTSD scale improvement, defined a priori) at week 26 follow-up. We hypothesized patients whose PTSD improved would retain fewer baseline PD diagnoses posttreatment, particularly with personality traits PTSD mimics, e.g. paranoid and avoidant. Forty-seven (47%) of 99 SCID-II patients evaluated at baseline received a SCID-II diagnosis: paranoid (28%), obsessive-compulsive (27%), and avoidant (23%) PDs were most prevalent. Among 78 patients who repeated SCID-II evaluations posttreatment, 45% (N = 35) had baseline PD diagnoses, of which 43% (N = 15/35) lost at week 14. Three (7%) patients without baseline PDs acquired diagnoses at week 14; 10 others shifted diagnoses. Treatment modality and PTSD response were unrelated to PD improvement. Of treatment responders reevaluated at follow-up (N = 44), 56% with any baseline Axis II diagnosis had none at week 26. This first evaluation of Axis I psychotherapy effects on personality disorder stability found that acutely treating a chronic state decreased apparent trait-across most PDs observed. These exploratory findings suggest personality diagnoses may have limited prognostic meaning in treating chronic PTSD.",Markowitz JC.; Petkova E.; Biyanova T.; Ding K.; Suh EJ.; Neria Y.,2015.0,10.1002/da.22436,0,0,
9817,A lifestyle intervention for primary care patients with depression and anxiety: A randomised controlled trial.,"This study aimed to evaluate the efficacy of a diet and exercise lifestyle intervention on mental health outcomes for patients currently being treated for depression and/or anxiety in primary care. Patients (n=119) referred by general practitioners to the 12-week randomised controlled trial were assigned to either an intervention of six visits to a dual qualified dietitian/exercise physiologist (DEP) where motivational interviewing and activity scheduling were used to engage patients in individually-tailored lifestyle change (focussed on diet and physical activity), or an attention control with scheduled telephone contact. Assessments conducted at baseline (n=94) and 12 weeks (n=60) were analysed with an intent-to-treat approach using linear mixed modelling. Significant improvement was found for both groups on Depression, Anxiety and Stress Scale (DASS) scores, measures of nutrient intake and total Australian modified Healthy Eating Index (Aust-HEI) scores. Significant differences between groups over time were found only for iron intake and body mass index. Patients participating in individual consultations with a dietitian were more likely to maintain or improve diet quality than those participating in an attention control. This study provides initial evidence to support the role of dietitians in the management of patients with depression and/or anxiety.",Forsyth A.; Deane FP.; Williams P.,2015.0,10.1016/j.psychres.2015.10.001,0,0,
9818,Impaired trial-by-trial adjustment of cognitive control in obsessive compulsive disorder improves after deep repetitive transcranial magnetic stimulation.,"Adaptive decision making requires the adjustment of behaviour following an error. Some theories suggest that repetitive thoughts and behaviours in obsessive compulsive disorder (OCD) are driven by malfunctioning error monitoring. This malfunction may relate to demonstrated hyperactivity in the medial prefrontal cortex (mPFC), including the dorsal anterior cingulate cortex. In this study, we measured aspects of error monitoring in individuals with OCD and administered deep low frequency repetitive transcranial magnetic stimulation (rTMS) in an attempt to modulate error monitoring capacity. For this pilot study, ten OCD patients and 10 aged-matched healthy controls completed modified versions of the Eriksen Flanker task before and after one session of deep 1 Hz rTMS (1200 pulses) over the mPFC (Brodmann areas 24 and 32). OCD patients received nine additional sessions of daily rTMS to assess their clinical response. Flanker tasks were repeated with patients post-treatment. Overall error rates were higher for patients compared to controls. When subjects were asked to report their errors, OCD patients were able to report fewer of their errors than the control group. In contrast to controls, patients did not demonstrate a normal post-error slowing (PES) phenomenon. This abnormal PES was mainly driven by abnormally slow response times (RTs) following correct responses rather than a failure to slow down after errors. Patients' symptoms and slowed RTs following correct responses improved after ten sessions of rTMS. Certain aspects of error monitoring, namely conscious error report and post error slowing, are impaired in OCD. These impairments can at least be partly corrected by 1 Hz deep rTMS over the mPFC. Simultaneous improvement of OCD symptoms by this method might suggest a correlation between error monitoring impairment and OCD pathophysiology. ClinicalTrials.gov NCT02541812; 09/02/2015.",Modirrousta M.; Meek BP.; Sareen J.; Enns MW.,2015.0,10.1186/s12868-015-0205-z,0,0,
9819,Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for generalized anxiety disorder and comorbid disorders: A randomized controlled trial.,"Generalized anxiety disorder (GAD) can be treated effectively with either disorder-specific cognitive behavior therapy (DS-CBT) or transdiagnostic CBT (TD-CBT). The relative benefits of DS-CBT and TD-CBT for GAD and the relative benefits of delivering treatment in clinician guided (CG-CBT) and self-guided (SG-CBT) formats have not been examined. Participants with GAD (n=338) were randomly allocated to receive an internet-delivered TD-CBT or DS-CBT intervention delivered in either CG-CBT or SG-CBT formats. Large reductions in symptoms of GAD (Cohen's d ‚â• 1.48; avg. reduction ‚â• 50%) and comorbid major depressive disorder (Cohen's d ‚â• 1.64; avg. reduction ‚â• 45%), social anxiety disorder (Cohen's d ‚â• 0.80; avg. reduction ‚â• 29%) and panic disorder (Cohen's d ‚â• 0.55; avg. reduction ‚â• 33%) were found across the conditions. No substantive differences were observed between DS-CBT and TD-CBT or CG-CBT and SG-CBT, highlighting the public health potential of carefully developed TD-CBT and SG-CBT.",Dear BF.; Staples LG.; Terides MD.; Karin E.; Zou J.; Johnston L.; Gandy M.; Fogliati VJ.; Wootton BM.; McEvoy PM.; Titov N.,2015.0,10.1016/j.janxdis.2015.09.003,0,0,
9820,Does successful smoking cessation reduce anxious arousal among treatment-seeking smokers?,"There is limited work that has examined the effect of quitting smoking on anxious arousal, an underlying dimension of anxiety symptoms and psychopathology. Smokers (n=185, 54.1% female) enrolled in a smoking cessation treatment trial were monitored post-cessation in terms of abstinence status (biochemically verified; at Weeks 1, 2, and Month 1 post-quit) and severity of panic-relevant symptoms (self-reported; at Month 1 and 3 post-quit). Structural equation models were conducted, adjusting for participant sex, age, treatment condition, and pre-cessation nicotine dependence, presence of depressive/anxiety disorders, anxious arousal, and anxiety sensitivity. After adjusting for covariates, participants who remained abstinent for one month (n=80; 43.2%) relative to those who did not (n=105; 56.8%) demonstrated significant reductions in anxious arousal at Month 1 (β=-.26, p=.04) and Month 3 post-quit (β=-.36, p=.006); abstinence status had a non-significant effect on anxious arousal severity at Month 3 after controlling for Month 1 anxious arousal (β=-.18, p=.09). Findings align with theoretical models of smoking-anxiety interplay and suggest that smoking cessation can result in reductions in anxious arousal.",Farris SG.; Allan NP.; Morales PC.; Schmidt NB.; Zvolensky MJ.,2015.0,10.1016/j.janxdis.2015.07.009,0,0,
9821,"Effect of Nurse-Led Telephone Follow ups (Tele-Nursing) on Depression, Anxiety and Stress in Hemodialysis Patients.","Depressive and anxious patients on hemodialysis have a higher risk of death and hospitalizations. The aim of this study was to evaluate the effect of nurse-led telephone follow ups (tele-nursing) on depression, anxiety and stress in hemodialysis patients. The subjects of the study who were selected based on double blind randomized clinical trial consisted of 60 patients with advanced chronic renal disease treated with hemodialysis. The patients were placed in two groups of 30 individuals. Before the intervention, a questionnaire was completed by patients.  There was no telephone follow up in the control group and the patients received only routine care in the hospital. The participants allocated to the intervention group received telephone follow-up 30 days after dialysis shift, in addition to conventional treatment. Every session lasted 30 minutes, as possible. Then the DASS scale was filled out by the patients after completion of study by two groups. Significant differences were observed between the two groups in the posttest regarding the dimensions scores of DASS scale. The result of this trial is expected to provide new knowledge to support the effective follow-up for hemodialysis patient in order to improve their emotional and health status.",Kargar Jahromi M.; Javadpour S.; Taheri L.; Poorgholami F.,2015.0,10.5539/gjhs.v8n3p168,0,0,
9822,Patterns of psychological distress in mothers of preterm infants.,"Mothers of preterm infants experience significant psychological distress, with elevated levels of inter-correlated depressive, stress, anxiety and post-traumatic stress symptoms. In a sample of racially and ethnically diverse mothers of preterm infants, we identified differing patterns of psychological distress during infant hospitalization and examined the effect of these psychological distress patterns on longitudinal trajectories of each psychological distress measure and on maternal perceptions of the child over the first year of the infant's life. Mothers of preterm infants (N=232) completed five questionnaires assessing depressive symptoms, anxiety, post-traumatic stress symptoms, stress due to infant appearance, and stress due to parental role alteration during enrollment during the neonatal hospitalization, discharge, and at 2, 6, and 12 months of age adjusted for prematurity. Latent class analysis on the enrollment psychological distress variables allowed us to identify five sub-groups of mothers exhibiting similar patterns of psychological distress, differing primarily in degree and type: low distress, moderate distress, high NICU-related distress, high depressive and anxiety symptoms, and extreme distress. These classes continued to show different longitudinal trajectories for the psychological distress measures through 12 months corrected age. Mothers in the extreme distress class and, to a lesser degree, mothers in the high depressive and anxiety symptom class remained at risk of significant psychological distress one year after discharge and had less positive perceptions of their child (greater worry and higher perceptions of child vulnerability). In conclusion, distinctive sub-groups of mothers during hospitalization had different patterns of psychological distress throughout the 12-month period and may require different interventions in the NICU.",Holditch-Davis D.; Santos H.; Levy J.; White-Traut R.; O'Shea TM.; Geraldo V.; David R.,2015.0,10.1016/j.infbeh.2015.10.004,0,0,
9823,Positive valence reduces susceptibility to return of fear and enhances approach behavior.,"Although exposure therapy is highly efficacious for anxiety disorders, many individuals do not respond. Drawing from the science of fear extinction and reinstatement, the current study evaluated whether a training designed to increase valence of the feared stimulus improved the longevity of treatment outcomes. Participants were 61 undergraduate students with fear of spiders (>10 on Spider Phobia Questionnaire, M = 20.45, SD = 3.98) who were randomized to receive positive valence training or control training. Participants completed exposure over two days, with training conditions at the end of the first day. Tests of spontaneous recovery and reinstatement were conducted one week later. Compared to control, the Positive Valence Training group demonstrated significantly less subjective fear at test of spontaneous recovery and less behavioral avoidance after reinstatement. Change in valence predicted subjective fear at spontaneous recovery and after reinstatement but did not predict behavioral avoidance after reinstatement. Due to the relatively small size and homogeneity of the sample, as well as the limited methods of training (i.e., film clips only) and outcome measurement (i.e., self-report and behavioral measures), current results should be interpreted with caution. Adjunct positive valence training may enhance the longevity of exposure treatment.",Dour HJ.; Brown LA.; Craske MG.,2016.0,10.1016/j.jbtep.2015.09.010,0,0,
9824,Evaluation of a hybrid treatment for Veterans with comorbid traumatic brain injury and posttraumatic stress disorder: Study protocol for a randomized controlled trial.,"Comorbidity of posttraumatic stress disorder (PTSD) and history of traumatic brain injury (TBI) is high among Veterans of Operation Iraqi Freedom/Enduring Freedom/New Dawn (OIF/OEF/OND). Cognitive processing therapy (CPT) is empirically supported for the treatment of PTSD, but it is not specifically designed to accommodate the memory, attention, or problem solving deficits that are experienced by many Veterans with comorbid PTSD and TBI. Compensatory cognitive rehabilitation, including cognitive symptom management and rehabilitation therapy (CogSMART), is effective for cognitive deficits stemming from a variety of etiologies, including TBI. We have integrated components of CogSMART into CPT in order to address the unique challenges faced by Veterans with ongoing cognitive complaints related to PTSD and a history of mild TBI. Here we describe an ongoing randomized controlled trial investigating the efficacy of our novel hybrid treatment, SMART-CPT, as compared to standard CPT, for OIF/OEF/OND Veterans with PTSD and a history of mild to moderate TBI. We describe the development of this hybrid treatment as well as implementation of the randomized controlled trial.",Jak AJ.; Aupperle R.; Rodgers CS.; Lang AJ.; Schiehser DM.; Norman SB.; Twamley EW.,2015.0,10.1016/j.cct.2015.10.009,0,0,
9825,Partner accommodation moderates treatment outcomes for couple therapy for posttraumatic stress disorder.,"Partner accommodation of posttraumatic stress disorder (PTSD) symptoms (i.e., altering one's own behaviors to minimize patient distress and/or relationship conflict due to patients' PTSD symptoms) has been shown to be positively associated with patient and partner psychopathology and negatively associated with patient and partner relationship satisfaction cross-sectionally. However, the prognostic value of partner accommodation in treatment outcomes is unknown. The goals of the present study were to determine if partner accommodation decreases as a function of couple therapy for PTSD and if pretreatment partner accommodation moderates the efficacy of couple therapy for PTSD. Thirty-nine patients with PTSD and their intimate partners (n = 39) were enrolled in a randomized controlled trial of cognitive-behavioral conjoint therapy (CBCT) for PTSD (Monson & Fredman, 2012) and received CBCT for PTSD immediately or after 3 months of waiting. Blinded assessors determined clinician-rated PTSD symptoms and patient-rated PTSD and depressive symptoms and relationship satisfaction at baseline, midtreatment/4 weeks of waiting, and posttreatment/12 weeks of waiting. Contrary to expectation, partner accommodation levels did not change over time for either treatment condition. However, baseline partner accommodation significantly moderated treatment outcomes. Higher levels of partner accommodation were associated with greater improvements in PTSD, depressive symptoms, and relationship satisfaction among patients receiving CBCT for PTSD compared with waiting list. At lower levels of partner accommodation, patients in both groups improved or remained at low levels of these outcomes. Individuals with PTSD who have more accommodating partners may be particularly well-suited for couple therapy for PTSD.",Fredman SJ.; Pukay-Martin ND.; Macdonald A.; Wagner AC.; Vorstenbosch V.; Monson CM.,2016.0,10.1037/ccp0000061,0,0,
9826,A Pilot Randomized Controlled Trial of Cognitive-Behavioral Therapy for Adolescents With Body Dysmorphic Disorder.,"Body dysmorphic disorder (BDD) typically starts in adolescence, but evidence-based treatments are yet to be developed and formally evaluated in this age group. We designed an age-appropriate cognitive-behavioral therapy (CBT) protocol for adolescents with BDD and evaluated its acceptability and efficacy in a pilot randomized controlled trial. Thirty adolescents aged 12 to 18 years (mean = 16.0, SD = 1.7) with a primary diagnosis of BDD, together with their families, were randomly assigned to 14 sessions of CBT delivered over 4 months or a control condition of equivalent duration, consisting of written psycho-education materials and weekly telephone monitoring. Blinded evaluators assessed participants at baseline, midtreatment, posttreatment, and at 2-month follow-up. The primary outcome measure was the Yale-Brown Obsessive-Compulsive Scale Modified for BDD, Adolescent Version (mean baseline score = 37.13, SD = 4.98, range = 24-43). The CBT group showed a significantly greater improvement than the control group, both at posttreatment (time × group interaction coefficient [95% CI] = -11.26 [-17.22 to -5.31]; p = .000) and at 2-month follow-up (time × group interaction coefficient [95% CI] = -9.62 [-15.74 to -3.51]; p = .002). Six participants (40%) in the CBT group and 1 participant (6.7%) in the control condition were classified as responders at both time points (χ(2) = 4.658, p = .031). Improvements were also seen on secondary measures, including insight, depression, and quality of life at posttreatment. Both patients and their families deemed the treatment as highly acceptable. Developmentally tailored CBT is a promising intervention for young people with BDD, although there is significant room for improvement. Further clinical trials incorporating lessons learned in this pilot study and comparing CBT and pharmacological therapies, as well as their combination, are warranted. Cognitive-Behaviour Therapy for Adolescents With Body Dysmorphic Disorder; http://www.isrctn.com/; ISRCTN67699666.",Mataix-Cols D.; Fernández de la Cruz L.; Isomura K.; Anson M.; Turner C.; Monzani B.; Cadman J.; Bowyer L.; Heyman I.; Veale D.; Krebs G.,2015.0,10.1016/j.jaac.2015.08.011,0,0,
9827,Treatment Engagement: Female Survivors of Intimate Partner Violence in Treatment for PTSD and Alcohol Use Disorder.,"Treatment engagement rates are low for individuals with comorbid posttraumatic stress disorder (PTSD) and alcohol use disorders across available interventions and treatment modalities. A better understanding of who does and does not engage in treatment can help improve retention, completion, and subsequent treatment outcomes. Forty female survivors of intimate partner violence with PTSD and alcohol use disorder participated in a randomized controlled trial comparing twenty-five 90-minute sessions of either modified Seeking Safety or Facilitated Twelve-Step in a community-based outpatient clinic. This study examined differences in demographics and pre-treatment PTSD symptoms and alcohol use between participants who engaged in treatment (attended ‚â• 6 sessions, n = 18) and those who dropped out (n = 22). There were no significant differences in PTSD or alcohol use disorder symptoms between treatment conditions. Women who engaged in therapy versus those who did not were significantly older (M = 46.2, SD = 9.14 vs. M = 38.95, SD = 10.49, respectively; p =.027), and had fewer dependents (M =.17, SD =.38, range = 0-1 vs. M =.95, SD = 1.66, range = 1-7, respectively; p =.046). Greater avoidance/numbing PTSD symptoms (OR = 1.13, p =.028, 95% CI [1.02-1.25]) and more years of heavy drinking (OR = 1.04, p =.03, 95% CI [1.00-1.07]) were also significantly associated with treatment engagement. This study replicates previous findings suggesting a need for additional retention strategies for younger women with dependents in comorbid PTSD and alcohol use disorder treatment. This is an analysis of data collected as part of a clinical trial registered as NCT00607412, at www.clinicaltrials.gov.",Myers US.; Browne KC.; Norman SB.,2015.0,10.1080/15504263.2015.1113762,0,0,
9828,Internet-Based Exposure and Behavioral Activation for Complicated Grief and Rumination: A Randomized Controlled Trial.,"This study examined the effectiveness and feasibility of therapist-guided Internet-delivered exposure (EX) and behavioral activation (BA) for complicated grief and rumination. Forty-seven bereaved individuals with elevated levels of complicated grief and grief rumination were randomly assigned to three conditions: EX (N=18), BA (N=17), or a waiting-list (N=12). Treatment groups received 6 homework assignments over 6 to 8weeks. Intention-to-treat analyses showed that EX reduced complicated grief, posttraumatic stress, depression, grief rumination, and brooding levels relative to the control group at posttreatment (d=0.7-1.2). BA lowered complicated grief, posttraumatic stress, and grief rumination levels at posttreatment (d=0.8-0.9). At 3-month follow-up, effects of EX were maintained on complicated grief and grief rumination (d=0.6-1.2), and for BA on complicated grief, posttraumatic stress, and grief rumination (d=0.8-0.9). EX reduced depression more strongly than BA (d=0.6). Completers analyses corroborated results for EX, and partially those for BA, but no group differences were detected. BA suffered from high dropout (59%), relative to EX (33%) and the waiting-list (17%). Feasibility appeared higher for EX than BA. Results supported potential applicability of online exposure but not behavioral activation to decrease complicated grief and rumination.",Eisma MC.; Boelen PA.; van den Bout J.; Stroebe W.; Schut HA.; Lancee J.; Stroebe MS.,2015.0,10.1016/j.beth.2015.05.007,0,0,
9829,Manipulating Attention to Nonemotional Distractors Influences State Anxiety: A Proof-of-Concept Study in Low- and High-Anxious College Students.,"Anxious individuals have difficulty inhibiting attention to salient, but nonemotional, distracting stimuli. The exact nature of this relationship remains unclear, however. In the present study, we tested the hypothesis that increasing attention to salient, but nonemotional, distracting stimuli would lead to increases in state anxiety by manipulating attentional strategies during a visual search task. We randomly assigned students low and high in trait anxiety to either a 1-session singleton detection training group or a feature search group. Singleton detection training increases distraction by salient, nonemotional stimuli whereas feature search training protects attention against distracting stimuli. Findings revealed that singleton detection training not only increased distraction by salient, nonemotional stimuli but also increased state anxiety. Moreover, this increase in state anxiety was most pronounced among high trait-anxious individuals. In contrast, feature search training protected attention against distracting stimuli and against increases in state anxiety, particularly in the high trait-anxious individuals. Together, the current findings provide initial support for the notion that distraction by salient, nonemotional stimuli can increase state anxiety levels. Furthermore, these results suggest that individuals already vulnerable to experience anxiety are most likely to be affected by distraction by salient, nonemotional stimuli, and that training anxious individuals to focus on specific shape features may be a viable attention modification intervention.",Moser JS.; Moran TP.; Leber AB.,2015.0,10.1016/j.beth.2015.07.001,0,0,
9830,Self-Rated Mental Health: Screening for Depression and Posttraumatic Stress Disorder Among Women Exposed to Perinatal Intimate Partner Violence.,"The purpose of the current study was to evaluate the validity of a single-item, self-rated mental health (SRMH) measure in the identification of women at risk for depression and posttraumatic stress disorder (PTSD). Baseline data of 239 low-income women participating in an intimate partner violence (IPV) intervention study were analyzed. PTSD was measured with the Davidson Trauma Scale. Risk for depression was determined using the Edinburgh Postnatal Depression Scale. SRMH was assessed with a single item asking participants to rate their mental health at the time of the baseline interview. Single-item measures can be an efficient way to increase the proportion of patients screened for mental health disorders. Although SRMH is not a strong indicator of PTSD, it may be useful in identifying pregnant women who are at increased risk for depression and need further comprehensive assessment in the clinical setting. Future research examining the use of SRMH among high-risk populations is needed.",Kastello JC.; Jacobsen KH.; Gaffney KF.; Kodadek MP.; Bullock LC.; Sharps PW.,2015.0,10.3928/02793695-20151021-02,0,0,
9831,The cost-effectiveness of short-term and long-term psychotherapy in the treatment of depressive and anxiety disorders during a 5-year follow-up.,"Both short-term and long-term psychotherapies are used extensively in treating different mental disorders, but there have been practically no attempts to compare their cost-effectiveness. The aim of this study, which is part of the Helsinki Psychotherapy Study, is to assess the cost-effectiveness of two short-term therapies compared to that of a long-term therapy. In this study 326 outpatients suffering from mood or anxiety disorder were randomized to solution-focused therapy (SFT), short-term psychodynamic psychotherapy (SPP) or to long-term psychodynamic psychotherapy (LPP). Psychiatric symptoms and working ability were assessed at baseline and then 4-9 times during a 5-year follow-up using eight widely used measures including e.g. Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), Symptom Check List, anxiety scale (SCL-90-Anx), Hamilton Anxiety Rating Scale (HARS), Symptom Check List, Global Severity Index (SCL-90-GSI), and the Work-subscale (SAS-Work) of the Social Adjustment Scale (SAS-SR). Both direct and indirect costs were measured. During the 5-year follow-up period statistically significant improvements were observed in all health indicators in all therapy groups. At first the recovery was faster in the short-term therapy groups than in the LPP group, but taking the whole follow-up period into account, the effectiveness of the LPP was somewhat greater than that of the short-term therapies. Especially the direct costs were, however, much higher in the LPP group than in the short-term therapy groups. Thus the long-term therapy can hardly be regarded as cost-effective compared to short-term therapies when patients are randomized to the therapy groups.",Maljanen T.; Knekt P.; Lindfors O.; Virtala E.; Tillman P.; Härkänen T.;  .,2016.0,10.1016/j.jad.2015.09.065,0,0,
9832,Adult Congenital Heart Disease-Coping And REsilience (ACHD-CARE): Rationale and methodology of a pilot randomized controlled trial.,"One-third of North American adults with congenital heart disease (CHD) have diagnosable mood or anxiety disorders and most do not receive mental health treatment. There are no published interventions targeting the psychosocial needs of patients with CHD of any age. We describe the development of a group psychosocial intervention aimed at improving the psychosocial functioning, quality of life, and resilience of adults with CHD and the design of a study protocol to determine the feasibility of a potential full-scale randomized controlled trial (RCT). Drawing upon our quantitative and qualitative research, we developed the Adult CHD-Coping And REsilience (ACHD-CARE) intervention and designed a feasibility study that included a 2-parallel arm non-blinded pilot RCT. Eligible participants (CHD, age ‚â• 18 years, no planned surgery, symptoms suggestive of a mood and/or anxiety disorder) were randomized to the ACHD-CARE intervention or Usual Care (1:1 allocation ratio). The group intervention was delivered during eight 90-minute weekly sessions. Feasibility will be assessed in the following domains: (i) process (e.g. recruitment and retention), (ii) resources, (iii) management, (iv) scientific outcomes, and (v) intervention acceptability. This study underscores the importance of carefully developing and testing the feasibility of psychosocial interventions in medical populations before moving to full-scale clinical trials. At study conclusion, we will be poised to make one of three determinations for a full-scale RCT: (1) feasible, (2) feasible with modifications, or (3) not feasible. This study will guide the future evaluation and provision of psychosocial treatment for adults with CHD.",Kovacs AH.; Bandyopadhyay M.; Grace SL.; Kentner AC.; Nolan RP.; Silversides CK.; Irvine MJ.,2015.0,10.1016/j.cct.2015.11.002,0,0,
9833,"The Tree Theme Method® (TTM), an occupational therapy intervention for treating depression and anxiety: study protocol of a randomized controlled trial.","Depression and anxiety disorders are increasing among the general population in the Western world. Individuals may need several kinds of treatment in order to maintain health, such as cognitive behavioural therapy (CBT) and drug treatment. However, having an everyday life that ""works"" is also important, suggesting a need for interventions based on activities that facilitate a satisfying everyday life. There is still lack of such evidence-based interventions. The Tree Theme Method(®) (TTM) is an occupational therapy intervention designed for a client-centred context in which an individual develops strategies to become an actor in his or her everyday life. Previous studies of the TTM have focused on process evaluation; therefore, further studies are needed to evaluate the method's effects. The aim of this paper is to outline an intervention that can evaluate the effects of the TTM in terms of psychological symptoms, as well as everyday occupations and well-being, in patients suffering from depression and anxiety. This randomized clinical trial includes patients from three Swedish counties randomized to either intervention or treatment as usual. Men and women aged 18-65 years who have been diagnosed with either depression or anxiety are eligible for inclusion. Data collection is carried out at baseline, and outcomes are assessed at the end of intervention, as well as at 3 months and 12 months after intervention ends. The outcomes measured are psychological symptoms, everyday activities, and health-related factors. Depression and anxiety may create difficulties for individuals in the activities of their everyday lives to the extent that they require diagnosis and intervention. Despite this reality, evidence-based interventions that focus on everyday activities are lacking. Therefore, it would be useful to design a specific method for occupational therapy intervention that does precisely that. This study provides insight into the effects of the TTM, comparing it to occupational therapy treatment as usual. ClinicalTrials.gov: NCT01980381; registered November 2013.",Gunnarsson AB.; Wagman P.; Håkansson C.; Hedin K.,2015.0,10.1186/s40359-015-0097-9,0,0,
9834,Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches.,"Headache is one of the most common debilitating chronic pain conditions in either active or retired military personnel with mild traumatic brain injury (MTBI). This study assessed the effect of repetitive transcranial magnetic stimulation (rTMS) in alleviating MTBI-related headache (MTBI-HA). Veterans with MTBI-HA were randomized to receive either real rTMS (REAL group) at 10 hz for a total of 2000 pulses divided into 20 trains with one-sec inter-train interval or sham rTMS (SHAM group) at the left motor cortex (LMC) with brain magnetic resonance imaging neuronavigation guidance. Pretreatment, posttreatment one-week and four-week headache and neuropsychological assessments were conducted. Thirty veterans were screened and twenty four (21 men and 3 women with average year-old ± SD at 14.3 ± 12.6) subjects' data were analyzed. A two-factor (visit × treatment) repeated measures analysis of variance (RM-ANOVA) indicated a close to significant (p = 0.06) trend of interaction between pretreatment and posttreatment one-week assessment with the intensity of the persistent daily headache decreasing from 5.7 ± 1.9 to 2.2 ± 2.7 and 4.6 ± 1.3 to 3.5 ± 2.0 for the REAL and SHAM groups, respectively. Subsequent analyses indicated REAL group demonstrated a significantly (p = 0.041) higher % of reduction in persistent headache intensity than the SHAM group (56.3 ± 48.2% vs.15.4 ± 43.6%) at the posttreatment one-week assessment and the trend continued to the four-week assessment. Overall, a significantly (p = 0.035) higher percentage of the subjects in the REAL group (58.3%) demonstrated at least a 50% headache intensity reduction at posttreatment one-week assessment compared with the SHAM group (16.6%). The overall composite score of functionally debilitating headache exacerbation is significantly (p = 0.017) reduced in REAL group at the posttreatment four-week assessment in comparison with the SHAM group. No major sustained change in neuropsychological assessments was noted. The studied rTMS protocol appears to be a clinically feasible and effective treatment option in managing MTBI-HA.",Leung A.; Shukla S.; Fallah A.; Song D.; Lin L.; Golshan S.; Tsai A.; Jak A.; Polston G.; Lee R.,2016.0,10.1111/ner.12364,0,0,
9835,A Telephone-Based Program to Provide Symptom Monitoring Alone vs Symptom Monitoring Plus Care Management for Late-Life Depression and Anxiety: A Randomized Clinical Trial.,"Mental health (MH) conditions are undertreated in late life. It is important to identify treatment strategies that address variability in treatment content and delivery and take individual-specific symptoms into account, particularly among low-income, community-dwelling older adults. To evaluate program feasibility and MH outcomes among community-dwelling older adults randomized to 1 of 2 treatment arms of varying intensity of evidence-based, collaborative MH care management services (ie, the Supporting Seniors Receiving Treatment and Intervention [SUSTAIN] program) that provide standardized, measurement-based, software-aided MH assessment and symptom monitoring and connection to community resources via telephone. Trial participants were 1018 older, community-dwelling, low-income adults prescribed an antidepressant or anxiolytic by a primary care or non-MH professional and experiencing clinically significant MH symptoms at intake. The participant subsample was drawn from a larger parent sample of older adults enrolled in the SUSTAIN program. Individuals were randomized to receive MH symptom monitoring alone (hereafter monitoring alone) or MH symptom monitoring plus care management (hereafter care management) provided by an MH professional. Baseline characteristics were examined, and changes in clinical MH outcomes were evaluated at 3-month and 6-month follow-up. The study dates were August 5, 2010, to May 5, 2014. Monitoring alone or care management delivered by an MH professional. Overall MH functioning (primary) and depressive and anxiety symptoms. A total of 509 participants were randomized to the monitoring alone group and 509 to the care management group; 377 and 401 completed ≥2 research assessments in the monitoring alone and case management groups, respectively. Compared with those randomized to monitoring alone, individuals randomized to care management showed greater improvements in the 3 domains of MH functioning (β [SE], 0.36 [0.12]; 95% CI, 0.12 to 0.60; P = .004), depressive symptoms (β [SE], -0.20 [0.06]; 95% CI, -0.32 to -0.09; P < .001), and anxiety symptoms (β [SE], -0.23 [0.05]; 95% CI, -0.33 to -0.14; P < .001) over time. The SUSTAIN program, which provides assessment, monitoring, care management, and brief therapies for MH symptoms and needs in primary care settings, is feasible and scalable. A more intense level of care (ie, symptom monitoring plus care management) is associated with more favorable individual outcomes for low-income, community-dwelling older adults experiencing clinically significant MH symptoms. clinicaltrials.gov Identifier: NCT02440594.",Mavandadi S.; Benson A.; DiFilippo S.; Streim JE.; Oslin D.,2015.0,10.1001/jamapsychiatry.2015.2157,0,0,
9836,Impaired sustained attention and lapses are present in patients with mild obstructive sleep apnea.,"Severe obstructive sleep apnea (OSA) directly affects the quality of life, mood, and sustained attention of individuals, but it has not yet been established in the literature, if these changes also affect patients with mild OSA. The purpose of this study was to investigate such negative effects on the parameters described above. A controlled study was held at the Universidade Federal de Sao Paulo, Department of Psychobiology. Thirty-nine mild OSA patients and 25 controls were included. Volunteers could be of both genders with body mass index (BMI) ≤35 kg/m(2) and age between 18 and 65 years. Both groups were subjected to full-night polysomnography (PSG), the subjective assessment of mood (Beck Inventory of Anxiety and Depression), Functional Outcomes of Sleep Questionnaire (FOSQ), and the psychomotor vigilance task (PVT) five times during the day. We considered mild OSA patients those with apnea-hypopnea index (AHI) score between 5 and 15. The control group included subjects with AHI scores <5, respiratory disturbance index (RDI) scores ≤5, arousal index values ≤15, and Epworth Sleepiness Scale (ESS) values ≤9. Mild OSA patients were older and more obese than the controls. After adjusting for age, BMI, and schooling years, there was an increased number of total lapses (3.90 ± 4.16 and 2.43 ± 5.55, p = 0.004). Patients with mild OSA showed increased sustained attention lapses compared with normal subjects.",Luz GP.; Guimarães TM.; Weaver TE.; Nery LE.; E Silva LO.; Badke L.; Coelho G.; Millani-Carneiro A.; Tufik S.; Bittencourt L.,2016.0,10.1007/s11325-015-1279-7,0,0,
9837,"Economic evaluation of schema therapy and clarification-oriented psychotherapy for personality disorders: a multicenter, randomized controlled trial.","To compare from a societal perspective the cost-effectiveness and cost-utility of schema therapy, clarification-oriented psychotherapy, and treatment as usual for patients with avoidant, dependent, obsessive-compulsive, paranoid, histrionic, and/or narcissistic personality disorder. A multicenter, randomized controlled trial, single-blind parallel design, was conducted between May 2006 and December 2011 in 12 Dutch mental health institutes. Data from 320 patients (diagnosed according to DSM-IV criteria) randomly assigned to schema therapy (n = 145), treatment as usual (n = 134), or clarification-oriented psychotherapy (n = 41) were analyzed. Costs were repeatedly measured during 36 months by interview and patient registries. Primary outcome measures were proportion of recovered patients as measured with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders for the cost-effectiveness analysis, and quality-adjusted life-years (QALYs) for the cost-utility analysis. Bootstrap replications in the cost-effectiveness and the cost-utility planes were used to estimate the probability that one treatment was more cost-effective than the other. Mixed gamma regression on net monetary benefit for different levels of willingness to pay for extra effects was used as sensitivity analysis. Additional sensitivity analyses were done to assess robustness of the results. Due to higher clinical effects and lower costs, schema therapy was dominant over the other treatments in the cost-effectiveness analyses. Schema therapy has the probability of being the most cost-effective treatment (78% at €0 to 96% at €37,500 [$27,375] willingness to pay per extra recovery). Treatment as usual was more cost-effective than clarification-oriented psychotherapy due to lower costs. In the cost-utility analysis, schema therapy had a stable 75% probability of being cost-effective. Sensitivity analyses confirmed these findings. The results support the cost-effectiveness of schema therapy but not of clarification-oriented psychotherapy. Netherlands Trial Register NTR566.",Bamelis LL.; Arntz A.; Wetzelaer P.; Verdoorn R.; Evers SM.,2015.0,10.4088/JCP.14m09412,0,0,
9838,THE EFFECTS OF EXPRESSIVE WRITING ON POSTPARTUM DEPRESSION AND POSTTRAUMATIC STRESS SYMPTOMS.,"This study investigated whether an Expressive Writing intervention decreased depression and posttraumatic stress symptoms after childbirth. 113 women (M age = 31.26 yr., SD = 4.42) were assessed at Time 1 for depression (Beck Depression Inventory) and PTS (Perinatal PTSD Questionnaire) in the first days after childbirth, then randomized to either expressive writing or neutral writing conditions and reassessed at Time 2, 3 months later. The results (ANCOVAs, regression models) show that at 3 mo. depressive and posttraumatic symptoms were lower in women who performed the expressive writing task than in the neutral writing group. Moreover, the intervention condition was associated significantly with decreased depression at the high and at the mean levels of baseline depression at Time 1. Regarding PTSD, the results showed that the intervention condition was linked significantly to reductions of the symptoms at all levels of baseline PTSD. Mainly, these outcomes suggest that Expressive Writing can be a helpful early and low-cost universal intervention to prevent postpartum distress for women.",Blasio PD.; Camisasca E.; Caravita SC.; Ionio C.; Milani L.; Valtolina GG.,2015.0,10.2466/02.13.PR0.117c29z3,0,0,
9839,Enthusiasm for homework and improvement of psychological distress in subthreshold depression during behavior therapy: secondary analysis of data from a randomized controlled trial.,"Cognitive behavioral therapy (CBT) usually involves homework, the completion of which is a known predictor of a positive outcome. The aim of the present study was to examine the session-by-session relationships between enthusiasm to complete the homework and the improvement of psychological distress in depressed people through the course of therapy. Working people with subthreshold depression were recruited to participate in the telephone CBT (tCBT) program with demonstrated effectiveness. Their enthusiasm for homework was enhanced with motivational interviewing techniques and was measured by asking two questions: ""How strongly do you feel you want to do this homework?"" and ""How confident do you feel you can actually accomplish this homework?"" at the end of each session. The outcome was the K6 score, which was administered at the start of each session. The K6 is an index of psychological distress including depression and anxiety. We used structural equation modeling (SEM) to elucidate the relationships between enthusiasm and the K6 scores from session to session. The best fitting model suggested that, throughout the course of behavior therapy (BT), enthusiasm to complete the homework was negatively correlated with the K6 scores for the subsequent session, while the K6 score measured at the beginning of the session did not influence the enthusiasm to complete the homeworks assigned for that session. Empirical data now support the practitioners of BT when they try to enhance their patient's enthusiasm for homework regardless of the participant's distress, which then would lead to a reduction in distress in the subsequent week. ClinicalTrials.gov NCT00885014 . April 20, 2009.",Hayasaka Y.; Furukawa TA.; Sozu T.; Imai H.; Kawakami N.; Horikoshi M.;  .,2015.0,10.1186/s12888-015-0687-3,0,0,
9840,Exposure and response prevention helps adults with obsessive-compulsive disorder who do not respond to pharmacological augmentation strategies.,"Serotonin reuptake inhibitors (SRIs) are a first-line treatment for obsessive-compulsive disorder (OCD). Yet, most patients with OCD who are taking SRIs do not show excellent response. Recent studies show that augmenting SRIs with risperidone benefits a minority of patients. We evaluated the effectiveness of exposure and response prevention (EX/RP) among nonresponders to SRI augmentation with 8 weeks of risperidone or placebo. The study was conducted from January 2007 to August 2012. Nonresponders to SRI augmentation with risperidone or pill placebo (N = 32) in a randomized controlled trial for adults meeting DSM-IV-TR criteria for OCD were offered up to 17 twice-weekly EX/RP sessions. Independent evaluators, blind to treatment, evaluated patients at crossover baseline (week 8), midway through crossover treatment (week 12), post-EX/RP treatment (week 16), and follow-up (weeks 20, 24, 28, and 32). The primary outcome was OCD severity, measured with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Secondary outcomes were depression, quality of life, insight, and social functioning. Between crossover baseline and follow-up, nonresponders to SRI augmentation with risperidone or placebo who received EX/RP showed significant reductions in OCD symptoms and depression, as well as significant increases in insight, quality of life, and social functioning (all P < .001). Exposure and response prevention is an effective treatment for patients who have failed to respond to SRI augmentation with risperidone or placebo. This study adds to the body of evidence supporting the use of EX/RP with patients who continue to report clinically significant OCD symptoms after multiple pharmacologic trials. ClinicalTrials.gov Identifier: NCT00389493.",McLean CP.; Zandberg LJ.; Van Meter PE.; Carpenter JK.; Simpson HB.; Foa EB.,2015.0,10.4088/JCP.14m09513,0,0,
9841,Cognitive distortions mediate depression and affective response to social acceptance and rejection.,"The emotional context insensitivity (ECI) hypothesis suggests individuals with depression have blunted affective responses to both positive and negative events. We tested ECI in a social context to examine how depression relates to affective responses to social acceptance and rejection outcomes. Furthermore, we aimed to identify cognitive mechanisms linking depression with affective response to social feedback. Finally, we tested whether these processes are similar for social anxiety. 90 participants (age 18-26 years; 53 women) completed the two-visit Chatroom task. At Visit 1 they rated their expectations about being liked by 60 peers. At Visit 2 they completed self-reports of depressive and social anxiety symptoms, and of cognitive flexibility, then received acceptance or rejection feedback from each peer and rated their affective response. Greater depressive symptoms related to negative expectancy bias, lower cognitive flexibility, and less positive affective response to acceptance, but did not relate to rejection. Negative expectations and cognitive flexibility mediated the relationship between depressive symptoms and affective response for acceptance; only negative expectations mediated rejection responses. These cognitive mechanisms were not related to social anxiety. A community sample was used to assess depression. Rumination and current mood state were omitted as potential predictors of affective response. Findings support the ECI framework. Depression but not social anxiety interferes with positive and negative affect through cognitively mediated dampening of emotional response to social acceptance and rejection. Emotion regulation strategies in depression therapy can target social flexibility to improve alignment of affective reactions to social outcomes.",Caouette JD.; Guyer AE.,2016.0,10.1016/j.jad.2015.11.015,0,0,
9842,Motivational Interviewing as an Adjunct to Cognitive Behavioral Therapy for Anxiety.,"This study examined the effect of a single session motivational interviewing (MI) intervention on engagement in a 12-week transdiagnostic group cognitive behavioral therapy (CBT) treatment for anxiety. Participants were randomized to MI (N = 20) or non-MI (N = 19) conditions before enrolling in a 12-week group CBT program. Participants in the MI condition received an individual 50-minute MI session adapted from the longer MI pretreatment protocol, developed by Westra and Dozois () and Westra (). Rates of treatment initiation and treatment expectancies were significantly higher among participants who received the MI pretreatment intervention. Results indicate substantial reduction in clinician-rated anxiety severity after transdiagnostic group CBT, with no significant differences between MI and non-MI conditions. These findings suggest that a single MI pretreatment session may have positive effects on proximal measures of treatment engagement, but that these effects may not affect the severity of anxiety symptoms over the course of CBT.",Barrera TL.; Smith AH.; Norton PJ.,2016.0,10.1002/jclp.22239,0,0,
9843,Letting go of yesterday: Effect of distraction on post-event processing and anticipatory anxiety in a socially anxious sample.,"According to cognitive models, post-event processing (PEP) is a key factor in the maintenance of social anxiety. Given that decreasing PEP can be challenging for socially anxious individuals, it is important to identify potentially useful strategies. Although distraction may help to decrease PEP, the findings have been equivocal. The primary purpose of this study was to examine whether a brief distraction period immediately following a speech would lead to less PEP the next day. The secondary aim was to examine the effect of distraction following an initial speech on anticipatory anxiety for a second speech, via reductions in PEP. Participants (N = 77 undergraduates with elevated social anxiety; 67.53% female) delivered a speech and were randomly assigned to a distraction, rumination, or control condition. The following day, participants reported levels of PEP in relation to the first speech, as well as anxiety regarding a second, upcoming speech. As expected, those in the distraction condition reported less PEP than those in the rumination and control conditions. Additionally, distraction following the first speech was indirectly related to anticipatory anxiety for the second speech, via PEP. Distraction may represent a potentially useful strategy for reducing PEP and other maladaptive processes that may maintain social anxiety.",Blackie RA.; Kocovski NL.,2016.0,10.1080/16506073.2015.1104383,0,0,
9844,Evidence-based psychotherapy (EBP) non-initiation among veterans offered an EBP for posttraumatic stress disorder.,"Current efforts to disseminate evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD) in Veterans Affairs Medical Centers (VAMCs) have made effective treatment options more available throughout the system. Yet many veterans identified as likely to benefit from such services choose not to utilize them. The evidence base regarding factors that contribute to treatment initiation among those offered EBPs is still in its early stages. The present study investigated clinical presentation, patient demographics, and environment of care factors as potential predictors of EBP treatment initiation among veterans offered such care. The sample consisted of 324 veterans (62% Operation Enduring Freedom [OEF]/Operation Iraqi Freedom [OIF]; 77% male; age M = 42.95, SD = 12.57 years), who attended an intake evaluation at a VAMC outpatient PTSD Clinical Team, were diagnosed with PTSD, and offered a course of EBP. Overall, 72% of veterans (n = 232) who were offered an EBP initiated such treatment, and 28% of veterans (n = 92) did not initiate treatment. Veterans who initiated treatment were significantly older. Treatment initiation did not significantly differ by ethnicity, gender, or baseline PTSD severity. Significantly more veterans referred from mental health clinics initiated treatment than did veterans referred from primary care. This study examined treatment initiation among veterans who were offered EBP for PTSD. Rates of initiation differed across subgroups of veterans. Clinically, this suggests the need to tailor outreach efforts to younger veterans, OEF/OIF veterans, and veterans referred from primary care, and potentially including programming and education aimed at primary care referrers, to increase help-seeking. (PsycINFO Database Record",Keller SM.; Tuerk PW.,2016.0,10.1037/ser0000064,0,0,
9845,The Happy Older Latinos are Active (HOLA) health promotion and prevention study: study protocol for a pilot randomized controlled trial.,"Results of previous studies attest to the greater illness burden of common mental disorders (anxiety and depression) in older Latinos and the need for developing preventive interventions that are effective, acceptable, and scalable. Happy Older Latinos are Active (HOLA) is a newly developed intervention that uses a community health worker (CHW) to lead a health promotion program in order to prevent common mental disorders among at-risk older Latinos. This pilot study tests the feasibility and acceptability of delivering HOLA to older, at-risk Latinos. HOLA is a multi-component, health promotion intervention funded by the National Institute of Mental Health (NIMH). This prevention approach will be tested against a fotonovela, an enhanced psychoeducation control condition, in a sample of Latino elderly with minor or subthreshold depression or anxiety. A total of 60 older Latinos (aged 60+) will be randomized to receive HOLA or the fotonovela. The primary outcomes of interest are recruitment, adherence, retention, and acceptability. Data will also be collected on: preemption of incident and recurrent major depression, generalized anxiety, and social phobia; reduction in depression and anxiety symptom severity; physical functioning; sedentary behaviors; social engagement; and self-efficacy. The results of this study could have implications for other high-risk, highly disadvantaged populations. The development of a health promotion intervention designed to prevent common mental disorders could be a means of addressing multiple disparities (for example, mental health outcomes, mental health service use, stigma) among racial/ethnic minority elderly. CLINICALTRIALS. NCT02371954 . Date of registration: 21 January 2015.",Jimenez DE.; Reynolds CF.; Alegría M.; Harvey P.; Bartels SJ.,2015.0,10.1186/s13063-015-1113-3,0,0,
9846,Augmenting cognitive processing therapy to improve sleep impairment in PTSD: A randomized controlled trial.,"Despite the success of empirically supported treatments for posttraumatic stress disorder (PTSD), sleep impairment frequently remains refractory after treatment. This single-site, randomized controlled trial examined the effectiveness of sleep-directed hypnosis as a complement to an empirically supported psychotherapy for PTSD (cognitive processing therapy [CPT]). Participants completed either 3 weeks of hypnosis (n = 52) or a symptom monitoring control condition (n = 56) before beginning standard CPT. Multilevel modeling was used to investigate differential patterns of change to determine whether hypnosis resulted in improvements in sleep, PTSD, and depression. An intervening variable approach was then used to determine whether improvements in sleep achieved during hypnosis augmented change in PTSD and depression during CPT. After the initial phase of treatment (hypnosis or symptom monitoring), the hypnosis condition showed significantly greater improvement than the control condition in sleep and depression, but not PTSD. After CPT, both conditions demonstrated significant improvement in sleep and PTSD; however, the hypnosis condition demonstrated greater improvement in depressive symptoms. As sleep improved, there were corresponding improvements in PTSD and depression, with a stronger relationship between sleep and PTSD. Hypnosis was effective in improving sleep impairment, but those improvements did not augment gains in PTSD recovery during the trauma-focused intervention. (PsycINFO Database Record",Galovski TE.; Harik JM.; Blain LM.; Elwood L.; Gloth C.; Fletcher TD.,2016.0,10.1037/ccp0000059,0,0,
9847,"Mindfulness-Oriented Recovery Enhancement versus CBT for co-occurring substance dependence, traumatic stress, and psychiatric disorders: Proximal outcomes from a pragmatic randomized trial.","In many clinical settings, there is a high comorbidity between substance use disorders, psychiatric disorders, and traumatic stress. Novel therapies are needed to address these co-occurring issues efficiently. The aim of the present study was to conduct a pragmatic randomized controlled trial comparing Mindfulness-Oriented Recovery Enhancement (MORE) to group Cognitive-Behavioral Therapy (CBT) and treatment-as-usual (TAU) for previously homeless men residing in a therapeutic community. Men with co-occurring substance use and psychiatric disorders, as well as extensive trauma histories, were randomly assigned to 10 weeks of group treatment with MORE (n = 64), CBT (n = 64), or TAU (n = 52). Study findings indicated that from pre-to post-treatment MORE was associated with modest yet significantly greater improvements in substance craving, post-traumatic stress, and negative affect than CBT, and greater improvements in post-traumatic stress and positive affect than TAU. A significant indirect effect of MORE on decreasing craving and post-traumatic stress by increasing dispositional mindfulness was observed, suggesting that MORE may target these issues via enhancing mindful awareness in everyday life. This pragmatic trial represents the first head-to-head comparison of MORE against an empirically-supported treatment for co-occurring disorders. Results suggest that MORE, as an integrative therapy designed to bolster self-regulatory capacity, may hold promise as a treatment for intersecting clinical conditions.",Garland EL.; Roberts-Lewis A.; Tronnier CD.; Graves R.; Kelley K.,2016.0,10.1016/j.brat.2015.11.012,0,0,
9848,Working alliance and competence as predictors of outcome in cognitive behavioral therapy for social anxiety and panic disorder in adults.,"The research on the association between the working alliance and therapist competence/adherence and outcome from cognitive behavioral therapy (CBT) is limited and characterized by inconclusive findings. This study investigates the working alliance and competence/adherence as predictors of outcome of CBT for social anxiety disorder (SAD) and panic disorder (PD). Eighty-two clinically referred patients (58.5% female; age: M = 33.6 years, SD = 10.3) with PD (n = 31) or SAD (n = 51) were treated with 12 sessions of manualized CBT by 22 clinicians with limited CBT experience in a randomized controlled effectiveness trial. Independent assessors rated the CBT competence/adherence of the therapists using a revised version of the Cognitive Therapy Adherence and Competence Scale, and the patients rated the quality of the working alliance using the Working Alliance Inventory-short form in therapy sessions 3 and 8. The outcome was assessed by independent assessors as well as by patients self-report. A total of 20.7% of the patients (27.5% SAD, 9.7% PD) dropped out during treatment. The association between the alliance, competence/adherence, outcome and dropout was investigated using multiple regression analyses. Higher therapist' competence/adherence early in the therapy was associated with a better outcome among PD patients, lower competence/adherence was associated with dropout among SAD patients. Higher rating of the alliance late in the therapy was associated with a better outcome, whereas lower alliance rating late in the therapy was associated with dropout. The findings indicate that the therapist competence/adherence and the working alliance have independent contributions to the outcome from CBT for anxiety disorders, but in different phases of the treatment.",Haug T.; Nordgreen T.; Öst LG.; Tangen T.; Kvale G.; Hovland OJ.; Heiervang ER.; Havik OE.,2016.0,10.1016/j.brat.2015.12.004,0,0,
9849,Drinking to cope with negative emotions moderates alcohol use disorder treatment response in patients with co-occurring anxiety disorder.,"Epidemiological studies and theory implicate drinking to cope (DTC) with anxiety as a potent moderator of the association between anxiety disorder (AnxD) and problematic alcohol use. However, the relevance of DTC to the treatment of alcohol use disorder (AUD) in those with a co-occurring AnxD has not been well studied. To address this, we examined whether DTC moderates the impact of two therapies: (1) a cognitive behavioral therapy (CBT) designed to reduce DTC and anxiety symptoms; (2) a progressive muscle relaxation training (PMRT) program designed to reduce anxiety symptoms only. Patients undergoing a standard AUD residential treatment with a co-occurring AnxD (N=218) were randomly assigned to also receive either the CBT or PMRT. DTC in the 30 days prior to treatment was measured using the Unpleasant Emotions subscale of the Inventory of Drinking Situations. Confirming the predicted moderator model, the results indicated a significant interaction between treatment group and level of pre-treatment DTC behavior. Probing this interaction revealed that for those reporting more pre-treatment DTC behavior, 4-month alcohol outcomes were superior in the CBT group relative to the PMRT group. For those reporting less pre-treatment DTC behavior, however, 4-month alcohol outcomes were similar and relatively good in both treatment groups. These findings establish a meaningful clinical distinction among those with co-occurring AUD-AnxD based on the degree to which the symptoms of the two disorders are functionally linked through DTC. Those whose co-occurring AUD-AnxD is more versus less strongly linked via DTC are especially likely to benefit from standard AUD treatment that is augmented by a brief CBT designed to disrupt this functional link.",Anker JJ.; Kushner MG.; Thuras P.; Menk J.; Unruh AS.,2016.0,10.1016/j.drugalcdep.2015.11.031,0,0,
9850,"Guided, internet-based, rumination-focused cognitive behavioural therapy (i-RFCBT) versus a no-intervention control to prevent depression in high-ruminating young adults, along with an adjunct assessment of the feasibility of unguided i-RFCBT, in the REdu","Depression is a global health challenge. Prevention is highlighted as a priority to reduce its prevalence. Although effective preventive interventions exist, the efficacy and coverage can be improved. One proposed means to increase efficacy is by using interventions to target specific risk factors, such as rumination. Rumination-focused CBT (RFCBT) was developed to specifically target depressive rumination and reduces acute depressive symptoms and relapse for patients with residual depression in a randomised controlled trial. Preliminary findings from a Dutch randomised prevention trial in 251 high-risk 15- to 22-year-old subjects selected with elevated worry and rumination found that both supported internet-RFBCT and group-delivered RFCBT equally reduced depressive symptoms and the onset of depressive cases over a period of 1 year, relative to the no-intervention control. A phase III randomised controlled trial following the Medical Research Council (MRC) Complex Interventions Framework will extend a Dutch trial to the United Kingdom, with the addition of diagnostic interviews, primarily to test whether guided internet-RFCBT reduces the onset of depression relative to a no-intervention control. High-risk young adults (aged 18 to 24 years), selected with elevated worry/rumination and recruited through university and internet advertisement, will be randomised to receive either guided internet-RFCBT, supported by clinical psychologists or mental health paraprofessionals, or a no-intervention control. As an adjunct arm, participants are also randomised to unguided internet-RFCBT self-help to provide an initial test of the feasibility and effect size of this intervention. While participants are also randomised to unguided internet-RFCBT, the trial was designed and powered as a phase III trial comparing guided internet-RFCBT versus a no-intervention control. In the comparison between these two arms, the primary outcomes are as follows: a) onset of major depressive episode over a 12-month period, assessed with a Structured Clinical Interview for Diagnosis at 3 months (post-intervention), 6 months and 15 months after randomisation. The following secondary outcomes will be recorded: the incidence of generalized anxiety disorder, symptoms of depression and anxiety, and levels of worry and rumination, measured at baseline and at the same follow-up intervals. In relation to the pilot investigation of unguided internet-RFCBT (the adjunct intervention arm), we will assess the feasibility and acceptability of the data-collection procedures, levels of attrition, effect size and acceptability of the unguided internet-RFCBT intervention. Widespread implementation is necessary for effective prevention, suggesting that the internet may be a valuable mode of delivery. Previous research suggests that guided internet-RFCBT reduces incidence rates relative to controls. We are also interested in developing and evaluating an unguided version to potentially increase the availability and reduce the costs. Current Controlled Trials ISRCTN12683436 . Date of registration: 27 October 2014.",Cook L.; Watkins E.,2016.0,10.1186/s13063-015-1128-9,0,0,
9851,Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury.,"Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.",Hoffer ME.; Szczupak M.; Kiderman A.; Crawford J.; Murphy S.; Marshall K.; Pelusso C.; Balaban C.,2016.0,10.1371/journal.pone.0146039,0,0,
9852,Economic Evaluation of Concise Cognitive Behavioural Therapy and/or Pharmacotherapy for Depressive and Anxiety Disorders.,"Depressive and anxiety disorders cause great suffering and disability and are associated with high health care costs. In a previous conducted pragmatic randomised controlled trial, we have shown that a concise format of cognitive behavioural- and/or pharmacotherapy is as effective as standard care in reducing depressive and anxiety symptoms and in improving subdomains of general health and quality of life in secondary care psychiatric outpatients. In this economic evaluation, we examined whether a favourable cost-utility of concise care compared to standard care was attained. The economic evaluation was performed alongside a pragmatic randomised controlled trial. Health-related quality of life was measured using the Short-Form (SF-36) questionnaire. Cost of healthcare utilization and productivity loss (absenteeism and presenteeism) were assessed using the Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness (TiC-P). A cost-utility analysis, using cost-effectiveness acceptability curves, comparing differences in societal costs and Quality-Adjusted Life Years (QALYs) at 1 year was performed. One year after study entry, the difference in mean cost per patient of the two primary treatments was not significant between both groups. No significant differences in other healthcare and non- healthcare costs could be detected between patients receiving concise care and standard care. Also, QALYs were not statistically different between the groups during the study period. From both the societal and healthcare perspective, the probability that concise care is more cost-effective compared to standard care remains below the turning point of 0.5 for all acceptable values of the willingness to pay for a QALY. The economic evaluation suggests that concise care is unlikely to be cost-effective compared to standard care in the treatment for depressive- and anxiety disorders in secondary mental health care during a one year follow up period. Total costs and QALYs were not significantly different between standard and concise care, with no evidence for cost-effectiveness of concise care in the first year. The longer impact of concise care for patients with mild to moderate symptoms of depressive and/or anxiety disorders compared to standard care in secondary care needs to be further studied. This economic evaluation failed to find significant differences in cost between concise and standard care over the study period of one year. Replication of our economic evaluation might benefit from an extended follow-up period and strict adherence to the study protocol. If concise care will be found to be cost-effective in the long term, this would have major implications for recommendations how to optimize secondary mental health care in the treatment of depressive -- and anxiety disorders.",Meuldijk D.; Carlier IV.; van Vliet IM.; van Hemert AM.; Zitman FG.; van den Akker-van Marle ME.,2015.0,,0,0,
9853,Mindfulness-based therapy and behavioral activation: A randomized controlled trial with depressed college students.,"Major Depressive Disorder (MDD) manifests in 20-30% of college students, with increased incidence in recent decades. Very limited research has assessed the efficacy of evidence-based interventions for MDD in college students. Mindfulness-Based Therapy (MBT) and Behavioral Activation (BA) are two interventions with significant potential to meet demands of college counseling clinics and effectively treat college students with MDD. This study utilized a randomized controlled research design (n = 50) to examine the efficacy of four-sessions of abbreviated MBT and BA relative to a wait-list control condition with depressed college students. Intent-to-treat data analyses on depression outcome measures suggested both treatments were superior to the control group. There were significant pre-post treatment improvements across measures of depression, rumination, stress, and mindfulness, gains largely maintained at 1-month follow-up. Neither active treatment effectively reduced somatic anxiety. Both treatments generally had moderate-strong effect sizes relative to the control group, and based on depression response and remission criteria, 56-79% of patients exhibited clinically significant improvement. Based on reliable change indices, 75-85% experienced clinically significant reductions in depression. There was strong therapist competence and adherence to treatment protocols and high patient satisfaction with both interventions. Study limitations and implications for the assessment and treatment of depressed college students are discussed.",McIndoo CC.; File AA.; Preddy T.; Clark CG.; Hopko DR.,2016.0,10.1016/j.brat.2015.12.012,0,0,
9854,"Cognitive Behavioral Social Rhythm Group Therapy for Veterans with posttraumatic stress disorder, depression, and sleep disturbance: Results from an open trial.","Cognitive Behavioral Social Rhythm Therapy (CBSRT) is a group psychotherapy tailored for Veterans with Posttraumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD), and sleep disturbances. The aims of this study were to introduce and present initial outcomes of Cognitive Behavioral Social Rhythm Therapy (CBSRT), a 12-week skills group therapy designed to improve sleep and mood by reducing chaotic or isolated lifestyles in Veterans with PTSD. Twenty-four male Veterans with at least moderate PTSD and MDD participated in this open trial. Main outcomes were the daily sleep diary for sleep disturbances, the Clinician-Administered PTSD Scale (CAPS) for PTSD, and the Hamilton Depression Rating scale for MDD. Veterans improved on all measures (a) with large within subject effects on PTSD symptoms, MDD symptoms, and sleep quality, and (b) with 46-58% of the sample receiving clinically significant benefits on MDD and PTSD symptoms respectively. The consistency of social rhythms was associated with the average reduction in global CAPS scores over time. Only 13% of participants dropped-out of the group therapy prematurely suggesting that this new group therapy is relatively well-tolerated by Veterans. Future research that employs a control condition is necessary to establish efficacy of CBSRT. Data from this initial pilot study demonstrate that CBSRT may be an effective group treatment option for Veterans presenting with all three symptom complaints. These data also suggest that daily routine may be an important mechanism to consider in the treatment of PTSD symptoms comorbid with depression.",Haynes PL.; Kelly M.; Warner L.; Quan SF.; Krakow B.; Bootzin RR.,2016.0,10.1016/j.jad.2015.12.012,0,0,
9855,Short-Term Cognitive-Behavioural Group Treatment for Hoarding Disorder: A Naturalistic Treatment Outcome Study.,"The study aim was to test whether a 12-week publically rebated group programme, based upon Steketee and Frost's Cognitive Behavioural Therapy-based hoarding treatment, would be efficacious in a community-based setting. Over a 3-year period, 77 participants with clinically significant hoarding were recruited into 12 group programmes. All completed treatment; however, as this was a community-based naturalistic study, only 41 completed the post-treatment assessment. Treatment included psychoeducation about hoarding, skills training for organization and decision making, direct in-session exposure to sorting and discarding, and cognitive and behavioural techniques to support out-of-session sorting and discarding, and nonacquiring. Self-report measures used to assess treatment effect were the Savings Inventory-Revised (SI-R), Savings Cognition Inventory, and the Depression, Anxiety and Stress Scales. Pre-post analyses indicated that after 12 weeks of treatment, hoarding symptoms as measured on the SI-R had reduced significantly, with large effect sizes reported in total and across all subscales. Moderate effect sizes were also reported for hoarding-related beliefs (emotional attachment and responsibility) and depressive symptoms. Of the 41 participants who completed post-treatment questionnaires, 14 (34%) were conservatively calculated to have clinically significant change, which is considerable given the brevity of the programme judged against the typical length of the disorder. The main limitation of the study was the moderate assessment completion rate, given its naturalistic setting. This study demonstrated that a 12-week group treatment for hoarding disorders was effective in reducing hoarding and depressive symptoms in an Australian clinical cohort and provides evidence for use of this treatment approach in a community setting. Copyright © 2016 John Wiley & Sons, Ltd. A 12-week group programme delivered in a community setting was effective for helping with hoarding symptoms with a large effect size. Hoarding beliefs (emotional attachment and responsibility) and depression were reduced, with moderate effect sizes. A third of all participants who completed post-treatment questionnaires experienced clinically significant change. Suggests that hoarding CBT treatment can be effectively translated into real-world settings and into a brief 12-session format, albeit the study had a moderate assessment completion rate.",Moulding R.; Nedeljkovic M.; Kyrios M.; Osborne D.; Mogan C.,2017.0,10.1002/cpp.2001,0,0,
9856,Anxiety trajectories in response to a speech task in social anxiety disorder: Evidence from a randomized controlled trial of CBT.,"The subjective experience of anxiety plays a central role in cognitive behavioral models of social anxiety disorder (SAD). However, much remains to be learned about the temporal dynamics of anxiety elicited by feared social situations. The aims of the current study were: (1) to compare anxiety trajectories during a speech task in individuals with SAD (n=135) versus healthy controls (HCs; n=47), and (2) to compare the effects of CBT on anxiety trajectories with a waitlist control condition. SAD was associated with higher levels of anxiety and greater increases in anticipatory anxiety compared to HCs, but not differential change in anxiety from pre- to post-speech. CBT was associated with decreases in anxiety from pre- to post-speech but not with changes in absolute levels of anticipatory anxiety or rates of change in anxiety during anticipation. The findings suggest that anticipatory experiences should be further incorporated into exposures.",Morrison AS.; Brozovich FA.; Lee IA.; Jazaieri H.; Goldin PR.; Heimberg RG.; Gross JJ.,2016.0,10.1016/j.janxdis.2015.12.006,0,0,
9857,Social anxiety is related to increased dwell time on socially threatening faces.,"Identification of reliable targets for therapeutic interventions is essential for developing evidence-based therapies. Threat-related attention bias has been implicated in the etiology and maintenance of social anxiety disorder. Extant response-time-based threat bias measures have demonstrated limited reliability and internal consistency. Here, we examined gaze patterns of socially anxious and nonanxious participants in relation to social threatening and neutral stimuli using an eye-tracking task, comprised of multiple threat and neutral stimuli, presented for an extended time-period. We tested the psychometric properties of this task with the hope to provide a solid stepping-stone for future treatment development. Eye gaze was tracked while participants freely viewed 60 different matrices comprised of eight disgusted and eight neutral facial expressions, presented for 6000ms each. Gaze patterns on threat and neutral areas of interest (AOIs) of participants with SAD, high socially anxious students and nonanxious students were compared. Internal consistency and test-retest reliability were evaluated. Participants did not differ on first-fixation variables. However, overall, socially anxious students and participants with SAD dwelled significantly longer on threat faces compared with nonanxious participants, with no difference between the anxious groups. Groups did not differ in overall dwell time on neutral faces. Internal consistency of total dwell time on threat and neutral AOIs was high and one-week test-retest reliability was acceptable. Only disgusted facial expressions were used. Relative small sample size. Social anxiety is associated with increased dwell time on socially threatening stimuli, presenting a potential target for therapeutic intervention.",Lazarov A.; Abend R.; Bar-Haim Y.,2016.0,10.1016/j.jad.2016.01.007,0,0,
9858,Integrating Motivational Interviewing Into a Home Telehealth Program for Veterans With Posttraumatic Stress Disorder Who Smoke: A Randomized Controlled Trial.,"We evaluated integrating a motivational interviewing (MI)-based smoking cessation curricula and MI counseling into a posttraumatic stress disorder (PTSD) home telehealth care management program to determine if smoking behaviors improved. We randomized 178 Veterans with PTSD to a 90-session MI-based home telehealth program or to usual care. Outcome measures included self-reported 24-hour quit attempts, seven-day point prevalence abstinence, progression along the stages of change, and mental health symptoms. Favorable smoking cessation rates were observed in both groups. There was no statistical difference in self-reported 24-hour quit attempts, seven-day point prevalence smoking abstinence or progression along the stages of change. The intervention group showed improved depression and PTSD symptoms. Integrating MI-based smoking cessation treatment into PTSD home telehealth is an effective method to help Veterans with PTSD quit smoking. Further research is needed to understand how to optimize MI integration into home telehealth to achieve sustained smoking cessation rates.",Battaglia C.; Peterson J.; Whitfield E.; Min SJ.; Benson SL.; Maddox TM.; Prochazka AV.,2016.0,10.1002/jclp.22252,0,0,
9859,Open trial of exposure therapy for PTSD among patients with severe and persistent mental illness.,"There are few empirical data regarding effective treatment of trauma-related symptoms among individuals with severe mental illness (SMI; e.g., bipolar disorder, schizophrenia). This under-examined clinical issue is significant because rates of trauma and PTSD are higher among individuals with SMI relative to the general population, and there are sufficient data to suggest that PTSD symptoms exacerbate the overall course and prognosis of SMI. 34 veterans with SMI received prolonged exposure (PE) for PTSD using an open trial study design. Data suggest that PE is feasible to implement, well-tolerated, and results in clinically significant decreases in PTSD severity in patients with SMI. Mean CAPS scores improved 27.2 points from baseline to immediate post [95% CI for mean change: -44.3, - 10.1; p = 0.002, paired t-test, and treatment gains were maintained at 6 months [mean change from baseline to 6-months, -16.1; 95% CI: -31.0, -1.2; p = 0.034, paired t-test]. The current data support the use of exposure-based interventions for PTSD among individuals with SMI and highlight the need for rigorous randomized efficacy trials investigating frontline PTSD interventions in this patient population.",Grubaugh AL.; Clapp JD.; Frueh BC.; Tuerk PW.; Knapp RG.; Egede LE.,2016.0,10.1016/j.brat.2015.12.006,0,0,
9860,"Does Pregnenolone Enhance Exposure Therapy in Obsessive-Compulsive Disorder? - A Pilot, Interim Report of a Randomized, Placebo-Controlled, Double-Blind Study.","Exposure therapy is an effective cognitive-behavioral treatment for patients with obsessive-compulsive disorder (OCD). However, a further amelioration of symptoms by additional drugs that enhance extinction learning is desirable. An interesting candidate is pregnenolone, which positively modulates NMDA and GABAA receptors in preclinical studies and influences amygdala and prefrontal activity in humans. We present pilot data showing high acceptance and good tolerability of pregnenolone given 2‚Äâh before exposure sessions in OCD patients. As per our interim analyses, exposure treatment resulted in significantly improved main outcome parameters, but no effects of pregnenolone vs. placebo pretreatment were detectable thus far.",Kellner M.; Nowack S.; Wortmann V.; Yassouridis A.; Wiedemann K.,2016.0,10.1055/s-0035-1569371,0,0,
9861,The power of positive thinking: Pathological worry is reduced by thought replacement in Generalized Anxiety Disorder.,"Worry in Generalized Anxiety Disorder (GAD), takes a predominantly verbal form, as if talking to oneself about possible negative outcomes. The current study examined alternative approaches to reducing worry by allocating volunteers with GAD to conditions in which they either practiced replacing the usual form of worry with images of possible positive outcomes, or with the same positive outcomes represented verbally. A comparison control condition involved generating positive images not related to worries. Participants received training in the designated method and then practiced it for one week, before attending for reassessment, and completing follow-up questionnaires four weeks later. All groups benefited from training, with decreases in anxiety and worry, and no significant differences between groups. The replacement of worry with different forms of positive ideation, even when unrelated to the content of worry itself, seems to have similar beneficial effects, suggesting that any form of positive ideation can be used to effectively counter worry.",Eagleson C.; Hayes S.; Mathews A.; Perman G.; Hirsch CR.,2016.0,10.1016/j.brat.2015.12.017,0,0,
9862,Alleviating Emotional Distress in Adolescent and Young Adult Cancer Survivors: An Open Trial of Metacognitive Therapy.,"Metacognitive therapy (MCT) is an effective psychological treatment for a range of emotional disorders. However, the applicability of MCT to treating emotional distress in physical health populations has yet to be tested. The present study examined the potential of MCT for alleviating emotional distress in adolescent and young adult cancer (AYAC) survivors. Twelve AYAC survivors, aged 18-23, who had completed acute medical treatment participated in this pilot open trial with 6 months follow-up. Each participant completed a baseline period followed by 8-14 sessions of MCT that targeted perseverative thinking (worry and rumination), attentional control, and metacognitive beliefs. The primary outcome variable was severity of depression and anxiety symptoms as measured by the Hospital Anxiety and Depression Scale (HADS). MCT was associated with large and statistically significant reductions in anxiety, depression, trauma symptoms, and metacognitive beliefs and processes. In the intention-to-treat sample, 50% of participants met standardized criteria for recovery on the HADS at posttreatment and these gains were maintained through to 6-month follow-up. MCT is a promising transdiagnostic approach to treating different forms of emotional distress in AYAC survivors. Further investigation in controlled trials is now warranted.",Fisher PL.; McNicol K.; Young B.; Smith E.; Salmon P.,2015.0,10.1089/jayao.2014.0046,0,0,
9863,"Treatment Attendance Among Veterans With Depression, Substance Use Disorder, and Trauma.","Low attendance in psychotherapy, particularly among individuals with comorbid disorders, is a pervasive challenge. The present study examined predictors of treatment attendance in a sample of veterans with depression, substance use disorder, and trauma. This is an analysis of data collected as part of a larger clinical trial involving outpatients at a Veterans Administration dual diagnosis clinic. Individuals were excluded if they had significant memory deficits, schizophrenia, bipolar disorder, or substantial travel constraints. Participants (N = 146) received 12 weeks of group-delivered integrated cognitive behavioral therapy for depression and substance use, followed by randomization to 12 additional weeks of individually delivered cognitive behavioral therapy (n = 62) or cognitive processing therapy (n = 61) modified to address substance use and trauma. Participants, therapists, and researchers were not blinded to group assignment. For this study, we included only the 123 participants who were randomized into the second phase, analyzing predictors of treatment attendance categorized into predisposing factors, enabling factors, and need factors. Participants were primarily male (89%) and Caucasian (76%) and averaged 47 years old (SD = 12). Forty-four percent had alcohol use disorder, 16% had drug use disorder, and 40% had polysubstance use disorder. Most met criteria for PTSD (82%), with 44% having combat-related trauma, 33% sexual trauma, and 28% other trauma. Treatment attendance did not differ between groups. More education was associated with increased group (r = .19, p = .04) and individual session attendance (r = .28, p = .002). Individuals with chronic housing problems attended fewer group sessions (r = -.19, p = .04), while individuals with sexual trauma, compared to those with other traumas, attended more individual sessions (r = .23, p = .01). Number of group sessions attended was positively associated with individual session attendance. Few variables were significantly predictive of treatment attendance, possibly due to the complex nature of comorbid disorders. Including a focus on trauma was not associated with lower attendance. Special consideration may need to be given to education level, homelessness, and trauma when trying to engage and retain patients with comorbid disorders in treatment. This clinical trial is registered at www.clinicaltrials.gov as NCT00958217.",Cui R.; Haller M.; Skidmore JR.; Goldsteinholm K.; Norman S.; Tate SR.,2016.0,10.1080/15504263.2016.1146384,0,0,
9864,Single-session gamified virtual reality exposure therapy for spider phobia vs. traditional exposure therapy: study protocol for a randomized controlled non-inferiority trial.,"Traditional one-session exposure therapy (OST) in which a patient is gradually exposed to feared stimuli for up to 3 h in a one-session format has been found effective for the treatment of specific phobias. However, many individuals with specific phobia are reluctant to seek help, and access to care is lacking due to logistic challenges of accessing, collecting, storing, and/or maintaining stimuli. Virtual reality (VR) exposure therapy may improve upon existing techniques by facilitating access, decreasing cost, and increasing acceptability and effectiveness. The aim of this study is to compare traditional OST with in vivo spiders and a human therapist with a newly developed single-session gamified VR exposure therapy application with modern VR hardware, virtual spiders, and a virtual therapist. Participants with specific phobia to spiders (N = 100) will be recruited from the general public, screened, and randomized to either VR exposure therapy (n = 50) or traditional OST (n = 50). A behavioral approach test using in vivo spiders will serve as the primary outcome measure. Secondary outcome measures will include spider phobia questionnaires and self-reported anxiety, depression, and quality of life. Outcomes will be assessed using a non-inferiority design at baseline and at 1, 12, and 52 weeks after treatment. VR exposure therapy has previously been evaluated as a treatment for specific phobias, but there has been a lack of high-quality randomized controlled trials. A new generation of modern, consumer-ready VR devices is being released that are advancing existing technology and have the potential to improve clinical availability and treatment effectiveness. The VR medium is also particularly suitable for taking advantage of recent phobia treatment research emphasizing engagement and new learning, as opposed to physiological habituation. This study compares a market-ready, gamified VR spider phobia exposure application, delivered using consumer VR hardware, with the current gold standard treatment. Implications are discussed. ClinicalTrials.gov identifier NCT02533310. Registered on 25 August 2015.",Miloff A.; Lindner P.; Hamilton W.; Reuterskiöld L.; Andersson G.; Carlbring P.,2016.0,10.1186/s13063-016-1171-1,0,0,
9865,Neuroplasticity in response to cognitive behavior therapy for social anxiety disorder.,"Patients with anxiety disorders exhibit excessive neural reactivity in the amygdala, which can be normalized by effective treatment like cognitive behavior therapy (CBT). Mechanisms underlying the brain's adaptation to anxiolytic treatments are likely related both to structural plasticity and functional response alterations, but multimodal neuroimaging studies addressing structure-function interactions are currently missing. Here, we examined treatment-related changes in brain structure (gray matter (GM) volume) and function (blood-oxygen level dependent, BOLD response to self-referential criticism) in 26 participants with social anxiety disorder randomly assigned either to CBT or an attention bias modification control treatment. Also, 26 matched healthy controls were included. Significant time × treatment interactions were found in the amygdala with decreases both in GM volume (family-wise error (FWE) corrected P(FWE) = 0.02) and BOLD responsivity (P(FWE) = 0.01) after successful CBT. Before treatment, amygdala GM volume correlated positively with anticipatory speech anxiety (P(FWE)=0.04), and CBT-induced reduction of amygdala GM volume (pre-post) correlated positively with reduced anticipatory anxiety after treatment (P(FWE) ⩽ 0.05). In addition, we observed greater amygdala neural responsivity to self-referential criticism in socially anxious participants, as compared with controls (P(FWE) = 0.029), before but not after CBT. Further analysis indicated that diminished amygdala GM volume mediated the relationship between decreased neural responsivity and reduced social anxiety after treatment (P=0.007). Thus, our results suggest that improvement-related structural plasticity impacts neural responsiveness within the amygdala, which could be essential for achieving anxiety reduction with CBT.",Månsson KN.; Salami A.; Frick A.; Carlbring P.; Andersson G.; Furmark T.; Boraxbekk CJ.,2016.0,10.1038/tp.2015.218,0,0,
9866,Therapist guided internet based cognitive behavioural therapy for body dysmorphic disorder: single blind randomised controlled trial.,"To evaluate the efficacy of therapist guided internet based cognitive behavioural therapy (CBT) programme for body dysmorphic disorder (BDD-NET) compared with online supportive therapy. A 12 week single blind parallel group randomised controlled trial. Academic medical centre. 94 self referred adult outpatients with a diagnosis of body dysmorphic disorder and a modified Yale-Brown obsessive compulsive scale (BDD-YBOCS) score of ≥ 20. Concurrent psychotropic drug treatment was permitted if the dose had been stable for at least two months before enrolment and remained unchanged during the trial. Participants received either BDD-NET (n=47) or supportive therapy (n=47) delivered via the internet for 12 weeks. The primary outcome was the BDD-YBOCS score after treatment and follow-up (three and six months from baseline) as evaluated by a masked assessor. Responder status was defined as a ≥ 30% reduction in symptoms on the scale. Secondary outcomes were measures of depression (MADRS-S), global functioning (GAF), clinical global improvement (CGI-I), and quality of life (EQ5D). The six month follow-up time and all outcomes other than BDD-YBOCS and MADRS-S at 3 months were not pre-specified in the registration at clinicaltrials.gov because of an administrative error but were included in the original trial protocol approved by the regional ethics committee before the start of the trial. BDD-NET was superior to supportive therapy and was associated with significant improvements in severity of symptoms of body dysmorphic disorder (BDD-YBOCS group difference -7.1 points, 95% confidence interval -9.8 to -4.4), depression (MADRS-S group difference -4.5 points, -7.5 to -1.4), and other secondary measures. At follow-up, 56% of those receiving BDD-NET were classed as responders, compared with 13% receiving supportive therapy. The number needed to treat was 2.34 (1.71 to 4.35). Self reported satisfaction was high. CBT can be delivered safely via the internet to patients with body dysmorphic disorder. BDD-NET has the potential to increase access to evidence based psychiatric care for this mental disorder, in line with NICE priority recommendations. It could be particularly useful in a stepped care approach, in which general practitioner or other mental health professionals can offer treatment to people with mild to moderate symptoms at low risk of suicide.Trial registration ClinicalTrials.gov ID: NCT02010619.",Enander J.; Andersson E.; Mataix-Cols D.; Lichtenstein L.; Alström K.; Andersson G.; Ljótsson B.; Rück C.,2016.0,,0,0,
9867,The Effects of Transdiagnostic Group CBT for Anxiety on Insomnia Symptoms.,"Insomnia is a common feature among individuals with anxiety disorders. Studies of cognitive behavioral therapy (CBT) for anxiety report moderate effects on concomitant insomnia symptoms, but further research is still needed especially toward understanding how CBT for anxiety renders beneficial effects on insomnia. The current study examined changes in insomnia symptoms reported by 51 Veterans who participated in a group-based transdiagnostic CBT for anxiety intervention. In addition, insomnia symptoms were examined in relation to symptoms of general distress (GD), anhedonic depression (AD), and anxious arousal (AA) pre- to post-treatment. Results revealed a small, though statistically significant (p < .05) beneficial effect on insomnia symptoms. When changes in GD, AD, and AA were simultaneously examined in relation to changes in insomnia, change in AA was the only significant predictor of insomnia symptoms. The current study highlights the role of AA in the relationship between anxiety disorders and insomnia and demonstrates that reductions in insomnia during transdiagnostic CBT for anxiety can be largely attributed to changes in AA.",McGowan SK.; Espejo EP.; Balliett N.; Werdowatz EA.,2016.0,10.1080/16506073.2015.1134639,0,0,
9868,"Ecological momentary assessment versus standard assessment instruments for measuring mindfulness, depressed mood, and anxiety among older adults.","As mobile data capture tools for patient-reported outcomes proliferate in clinical research, a key dimension of measure performance is sensitivity to change. This study compared performance of patient-reported measures of mindfulness, depression, and anxiety symptoms using traditional paper-and-pencil forms versus real-time, ambulatory measurement of symptoms via ecological momentary assessment (EMA). Sixty-seven emotionally distressed older adults completed paper-and-pencil measures of mindfulness, depression, and anxiety along with two weeks of identical items reported during ambulatory monitoring via EMA before and after participation in a randomized trial of Mindfulness-Based Stress Reduction (MBSR) or a health education intervention. We calculated effect sizes for these measures across both measurement approaches and estimated the Number-Needed-to-Treat (NNT) in both measurement conditions. Study outcomes greatly differed depending on which measurement method was used. When EMA was used to measure clinical symptoms, older adults who participated in the MBSR intervention had significantly higher mindfulness and significantly lower depression and anxiety than participants in the health education intervention at post-treatment. However, these significant changes in symptoms were not found when outcomes were measured with paper-and-pencil measures. The NNT for mindfulness and depression measures administered through EMA were approximately 25-50% lower than NNTs derived from paper-and-pencil administration. Sensitivity to change in anxiety was similar across administration modes. In conclusion, EMA measures of depression and mindfulness substantially outperformed paper-and-pencil measures with the same items. The additional resources associated with EMA in clinical trials would seem to be offset by its greater sensitivity to detect change in key outcome variables.",Moore RC.; Depp CA.; Wetherell JL.; Lenze EJ.,2016.0,10.1016/j.jpsychires.2016.01.011,0,0,
9869,Mindful attention increases and mediates psychological outcomes following mantram repetition practice in veterans with posttraumatic stress disorder.,"Several evidence-based treatments are available to veterans diagnosed with posttraumatic stress disorder (PTSD). However, not all veterans benefit from these treatments or prefer to engage in them. The current study explored whether (1) a mantram repetition program (MRP) increased mindful attention among veterans with PTSD, (2) mindful attention mediated reduced PTSD symptom severity and enhanced psychological well-being, and (3) improvement in mindful attention was due to the frequency of mantram repetition practice. Data from a randomized controlled trial comparing MRP plus treatment as usual (MRP+TAU) or TAU were analyzed using hierarchical linear models. A total of 146 veterans with PTSD from military-related trauma were recruited from a Veterans Affairs outpatient PTSD clinic (71 MRP+TAU; 75 TAU). The Clinician Administered PTSD Scale (CAPS), PTSD Checklist (PCL), the Brief Symptom Inventory-18 depression subscale, Health Survey SF-12v2, and Mindfulness Attention Awareness Scale (MAAS) were used. Frequency of mantram repetition practice was measured using wrist-worn counters and daily logs. Intent-to-treat analyses indicated greater increases in mindful attention, as measured by the MAAS, for MRP+TAU as compared with TAU participants (P<0.01). Mindful attention gains mediated previously reported treatment effects on reduced PTSD symptoms (using both CAPS and PCL), reduced depression, and improved psychological well-being. Frequency of mantram repetition practice in turn mediated increased mindful attention. The MRP intervention and specifically, mantram practice, improved mindful attention in veterans with PTSD, yielding improved overall psychological well-being. MRP may be a beneficial adjunct to usual care in veterans with PTSD.",Bormann JE.; Oman D.; Walter KH.; Johnson BD.,2014.0,10.1097/MLR.0000000000000200,0,0,
9870,Randomized effectiveness trial of a brief course of acupuncture for posttraumatic stress disorder.,"Initial posttraumatic stress disorder (PTSD) care is often delayed and many with PTSD go untreated. Acupuncture appears to be a safe, potentially nonstigmatizing treatment that reduces symptoms of anxiety, depression, and chronic pain, but little is known about its effect on PTSD. Fifty-five service members meeting research diagnostic criteria for PTSD were randomized to usual PTSD care (UPC) plus eight 60-minute sessions of acupuncture conducted twice weekly or to UPC alone. Outcomes were assessed at baseline and 4, 8, and 12 weeks postrandomization. The primary study outcomes were difference in PTSD symptom improvement on the PTSD Checklist (PCL) and the Clinician-administered PTSD Scale (CAPS) from baseline to 12-week follow-up between the 2 treatment groups. Secondary outcomes were depression, pain severity, and mental and physical health functioning. Mixed model regression and t test analyses were applied to the data. Mean improvement in PTSD severity was significantly greater among those receiving acupuncture than in those receiving UPC (PCLΔ=19.8±13.3 vs. 9.7±12.9, P<0.001; CAPSΔ=35.0±20.26 vs. 10.9±20.8, P<0.0001). Acupuncture was also associated with significantly greater improvements in depression, pain, and physical and mental health functioning. Pre-post effect-sizes for these outcomes were large and robust. Acupuncture was effective for reducing PTSD symptoms. Limitations included small sample size and inability to parse specific treatment mechanisms. Larger multisite trials with longer follow-up, comparisons to standard PTSD treatments, and assessments of treatment acceptability are needed. Acupuncture is a novel therapeutic option that may help to improve population reach of PTSD treatment.",Engel CC.; Cordova EH.; Benedek DM.; Liu X.; Gore KL.; Goertz C.; Freed MC.; Crawford C.; Jonas WB.; Ursano RJ.,2014.0,10.1097/MLR.0000000000000237,0,0,
9871,Decentering as a potential common mechanism across two therapies for generalized anxiety disorder.,"The purpose of this study was to examine decentering as a potential mechanism of action across 2 treatments for generalized anxiety disorder: an acceptance-based behavioral therapy (ABBT) and applied relaxation (AR). Sixty-four individuals who completed at least half of the 16 total sessions of either ABBT or AR (65.6% female; 79.7% identified as White; average age = 34.41 years) completed measures of decentering (Experiences Questionnaire) and of symptoms of anxiety (Depression Anxiety Stress Scale-Stress subscale) at 5 time points over the course of therapy, and a measure of worry (Penn State Worry Questionnaire) at pre- and posttreatment. Initial growth curve models showed that decentering increased significantly over therapy (z = 7.09), and this increase was associated with a decrease in worry symptoms (Penn State Worry Questionnaire) at posttreatment (z = -8.51). The rate of change did not significantly vary across treatments, Δχ2/Δdf = 0.16/1, p = .69. Further, a series of bivariate latent difference score models indicated that the best-fitting model was one in which decentering was a leading indicator of change in symptoms (DASS-Stress). Allowing this coupling to vary across treatments did not significantly improve the fit of the model, Δχ2/Δdf = 0.71/1, p = .40. In this sample, results suggest that increased decentering was associated with decreases in anxiety and that changes in decentering appear to precede changes in symptoms within both ABBT and AR, indicating that decentering may be an important common mechanism of action. (PsycINFO Database Record",Hayes-Skelton SA.; Calloway A.; Roemer L.; Orsillo SM.,2015.0,10.1037/a0038305,0,0,
9872,The treatment of posttraumatic stress disorder and related psychosocial consequences of burn injury: a pilot study.,"Burn injuries are unique in their medical and psychological impact, yet there has been little exploration of psychiatric treatment for this population. This uncontrolled pilot study assessed feasibility, acceptability, and preliminary efficacy of a treatment protocol designed to address posttraumatic stress disorder, depression, coping with scarring, and community integration among adult burn survivors. A 14-session, manualized treatment protocol was created using cognitive-behavioral interventions including imaginal exposure, behavioral activation, cognitive restructuring, modeling, and in vivo exposure. Responses were measured using the Clinician Administered PTSD Scale, Beck Depression Index, Community Integration Questionnaire, Oswestry Disability Questionnaire, and Burn Specific Health Scale. Nine of 10 enrolled patients (60% women; mean = 42 years old) completed treatment. Burn size was 0.5% to 65%; mechanism of injury included flame (4), scald (5), and contact (1) burns. Mean acute hospitalization was 30.1 days (range = 13-87); mean time from injury to treatment was 3.2 months (range = 1-7). Baseline mean posttraumatic stress score was 68 on the Clinician Administered PTSD Scale (severe); scores decreased by 36% to a mean of 45.3 at posttreatment, with a large effect size. Baseline self-reported depression was 21 (moderate) on the Beck Depression Index, decreasing by 47% to a mean of 12 posttreatment (nonclinical). Change in community reintegration score was significant and large, and body image showed significant improvement. The protocol showed promise in the treatment of posttraumatic stress disorder, depression, self-image, and community reintegration following burn injury. These findings suggest that coping may improve with treatment and symptoms should not be dismissed as unavoidable consequences of burn injury.",Cukor J.; Wyka K.; Leahy N.; Yurt R.; Difede J.,,10.1097/BCR.0000000000000177,0,0,
9873,Predicting treatment response to cognitive behavioral therapy in panic disorder with agoraphobia by integrating local neural information.,"Although neuroimaging research has made substantial progress in identifying the large-scale neural substrate of anxiety disorders, its value for clinical application lags behind expectations. Machine-learning approaches have predictive potential for individual-patient prognostic purposes and might thus aid translational efforts in psychiatric research. To predict treatment response to cognitive behavioral therapy (CBT) on an individual-patient level based on functional magnetic resonance imaging data in patients with panic disorder with agoraphobia (PD/AG). We included 49 patients free of medication for at least 4 weeks and with a primary diagnosis of PD/AG in a longitudinal study performed at 8 clinical research institutes and outpatient centers across Germany. The functional magnetic resonance imaging study was conducted between July 2007 and March 2010. Twelve CBT sessions conducted 2 times a week focusing on behavioral exposure. Treatment response was defined as exceeding a 50% reduction in Hamilton Anxiety Rating Scale scores. Blood oxygenation level-dependent signal was measured during a differential fear-conditioning task. Regional and whole-brain gaussian process classifiers using a nested leave-one-out cross-validation were used to predict the treatment response from data acquired before CBT. Although no single brain region was predictive of treatment response, integrating regional classifiers based on data from the acquisition and the extinction phases of the fear-conditioning task for the whole brain yielded good predictive performance (accuracy, 82%; sensitivity, 92%; specificity, 72%; P < .001). Data from the acquisition phase enabled 73% correct individual-patient classifications (sensitivity, 80%; specificity, 67%; P < .001), whereas data from the extinction phase led to an accuracy of 74% (sensitivity, 64%; specificity, 83%; P < .001). Conservative reanalyses under consideration of potential confounders yielded nominally lower but comparable accuracy rates (acquisition phase, 70%; extinction phase, 71%; combined, 79%). Predicting treatment response to CBT based on functional neuroimaging data in PD/AG is possible with high accuracy on an individual-patient level. This novel machine-learning approach brings personalized medicine within reach, directly supporting clinical decisions for the selection of treatment options, thus helping to improve response rates.",Hahn T.; Kircher T.; Straube B.; Wittchen HU.; Konrad C.; Ströhle A.; Wittmann A.; Pfleiderer B.; Reif A.; Arolt V.; Lueken U.,2015.0,10.1001/jamapsychiatry.2014.1741,0,0,
9874,The ROARI project - Road Accident Acute Rehabilitation Initiative: a randomised clinical trial of two targeted early interventions for road-related trauma.,"To determine the effectiveness of an Early Rehabilitation Intervention (ERI ) versus a Brief Education Intervention (BEI) following road trauma. return to work or usual activities at 12 weeks (for minor/moderate injury) and 24 weeks for major injury. Reduction in pain, anxiety, depression, disability and incidence of Post Traumatic Stress Disorder and improved quality of life. A multi-site single-blinded stratified randomized clinical trial (RCT). 184 patients (92 in each arm) were recruited over 18 months and followed for 12 weeks (minor/moderate injury) and 24 weeks (major injury). Screening questionnaires at 2-4 weeks and follow-up interviews by phone for all outcome measures were undertaken. For those in the ERI group with a positive screen for high risk of persistent symptoms, an early assessment and intervention by a Rehabilitation Physician was offered. Those in the BEI group were sent written information and advised to see their GP. 89.4% of injuries were mild in this cohort. At 12 weeks 73.8% and 69.1% of patients in the ERI and the BEI groups respectively had returned to work or usual activities. There were no significant differences between the two intervention groups with respect to the primary or any secondary outcome measures. This is the first RCT of an ERI following road trauma in Australia. A targeted ERI is as effective as a BEI in assisting those with mild/moderate trauma to return to work or usual activities.",Faux SG.; Kohler F.; Mozer R.; Klein LA.; Courtenay S.; D'Amours SK.; Chapman J.; Estell J.,2015.0,10.1177/0269215514552083,0,0,
9875,Livestock/animal assets buffer the impact of conflict-related traumatic events on mental health symptoms for rural women.,"In the context of multiple adversities, women are demonstrating resilience in rebuilding their futures, through participation in microfinance programs. In addition to the economic benefits of microfinance, there is evidence to suggest that it is an effective vehicle for improving health. The parent study is a community-based trial to evaluate the effectiveness of a livestock microfinance intervention, Pigs for Peace (PFP), on health and economic outcomes with households in 10 villages in eastern Democratic Republic of Congo. The analysis for this manuscript includes only baseline data from female participants enrolled in the ongoing parent study. Multiple regression analysis was used to examine if livestock/animal asset value moderates the relationship between conflict-related traumatic events and current mental health symptoms. The majority of women are 25 years or older, married, have on average 4 children in the home and have never attended school. Nearly 50% of women report having at least one livestock/animal asset at baseline. Over the past 10 years, women report on average more than 4 (M = 4.31, SD 3·64) traumatic events (range 0-18). Women reported symptoms consistent with PTSD with a mean score of ·2.30 (SD = 0·66 range 0-4) and depression with a mean score of 1.86 (SD = 0·49, range 0-3.47). The livestock/animal asset value by conflict-related traumatic events interaction was significant for both the PTSD (p = 0·021) and depression (p = 0·002) symptom models. The study provides evidence of the moderating affect of livestock/animal assets on mental health symptoms for women who have experienced conflict. The findings supports evidence about the importance of livestock/animal assets to economics in rural households but expands on previous research by demonstrating the psychosocial effects of these assets on women's health. clinicaltrials.gov NCT02008708.",Glass N.; Perrin NA.; Kohli A.; Remy MM.,2014.0,10.1371/journal.pone.0111708,0,0,
9876,Benefits of belonging: experimental manipulation of social inclusion to enhance psychological and physiological health parameters.,"Acute changes in social belonging are important triggers for alterations in health and well-being, yet research has emphasised the negative effects of 'exclusion' at the expense of evaluating the potentially positive effects of 'inclusion'. This study examined the impact of acute belonging on physiological and psychological outcomes. A healthy population (N‚Äâ=‚Äâ138) were randomly allocated to 'included' or 'excluded' conditions. Condition-dependent differences in pre/during-task heart rate and pre/post-task self-reports of negative/positive mood, and social self-esteem, were assessed. Included participants showed decreased heart rate and negative mood, and increased social self-esteem. No inclusion-related change in positive mood was shown. An increase in heart rate was observed in excluded participants though no changes in negative/positive mood or social self-esteem were shown. Shifts in social self-esteem acted as a mechanism through which inclusion/exclusion impacted upon negative and positive mood alterations. Results remained significant in presence of covariates (sex, global self-esteem, rumination and social anxiety). Findings suggest that acting to enhance belonging through 'inclusion' resulted in adaptive physiological and psychological outcomes. Neutral and potentially protective responses were observed in the immediate aftermath of 'exclusion'. Self-esteem served as one route through which these effects were transmitted.",Begen FM.; Turner-Cobb JM.,2015.0,10.1080/08870446.2014.991734,0,0,
9877,Personality change following internet-based cognitive behavior therapy for severe health anxiety.,"Personality traits have traditionally been viewed as stable, but recent studies suggest that they could be affected through psychological treatment. Internet-based cognitive behavior therapy (ICBT) for severe health anxiety (DSM-IV hypochondriasis) has been shown to be effective in reducing health anxiety, but its effect on measures of personality traits has not been investigated. The main aim of this study was to investigate the impact of ICBT on personality traits in the three broad dimensions--neuroticism, extraversion and aggression. We hypothesized that participants in ICBT would reduce their level of neuroticism compared to controls that did not receive the active treatment. No specific predictions were made regarding extraversion and aggression. Data from a randomized controlled trial were used in which participants were allocated to 12 weeks of ICBT (n = 40) or to a basic attention control condition (n = 41). Personality traits were assessed with the Swedish Universities Scales of Personality and the primary outcome of health anxiety was the Health Anxiety Inventory. There was a significant interaction effect of group and time on neuroticism-related scales, indicating larger pre- to post-treatment reductions in the Internet-based CBT group compared to the control condition. Analyses at 6-month follow-up showed that changes were stable. Traits relating to extraversion and aggression were largely unchanged. This study is the first to demonstrate that a brief ICBT intervention for severe health anxiety causes long-term changes in measures of personality traits related to neuroticism. The treatment thus has a broader impact than just reducing health anxiety. Clinicaltrials.gov (ID NCT00828152).",Hedman E.; Andersson G.; Lindefors N.; Gustavsson P.; Lekander M.; Rück C.; Andersson E.; Ljótsson B.,2014.0,10.1371/journal.pone.0113871,0,0,
9878,Domestic violence and mental health: a cross-sectional survey of women seeking help from domestic violence support services.,"Domestic violence and abuse (DVA) are associated with increased risk of mental illness, but we know little about the mental health of female DVA survivors seeking support from domestic violence services. Our goal was to characterise the demography and mental health of women who access specialist DVA services in the United Kingdom and to investigate associations between severity of abuse and measures of mental health and health state utility, accounting for important confounders and moderators. Baseline data on 260 women enrolled in a randomized controlled trial of a psychological intervention for DVA survivors were analysed. We report the prevalence of and associations between mental health status and severity of abuse at the time of recruitment. We used logistic and normal regression models for binary and continuous outcomes, respectively. The following mental health measures were used: Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM), Patient Health Questionnaire, Generalised Anxiety Disorder Assessment, and the Posttraumatic Diagnostic Scale to measure posttraumatic stress disorder (PTSD). The Composite Abuse Scale (CAS) measured abuse. Exposure to DVA was high, with a mean CAS score of 56 (SD 34). The mean CORE-OM score was 18 (SD 8) with 76% above the clinical threshold (95% confidence interval: 70-81%). Depression and anxiety levels were high, with means close to clinical thresholds, and more than three-quarters of respondents recorded PTSD scores above the clinical threshold. Symptoms of mental illness increased stepwise with increasing severity of DVA. Women DVA survivors who seek support from DVA services have recently experienced high levels of abuse, depression, anxiety, and especially PTSD. Clinicians need to be aware that patients presenting with mental health conditions or symptoms of depression or anxiety may be experiencing or have experienced DVA. The high psychological morbidity in this population means that trauma-informed psychological support is needed for survivors who seek support from DVA services.",Ferrari G.; Agnew-Davies R.; Bailey J.; Howard L.; Howarth E.; Peters TJ.; Sardinha L.; Feder GS.,2016.0,,0,0,
9879,"A Single-blinded, Randomized Clinical Trial of How to Implement an Evidence-based Treatment for Generalized Anxiety Disorder [IMPLEMENT]--Effects of Three Different Strategies of Implementation.","Despite long-standing calls to disseminate evidence-based treatments for generalized anxiety (GAD), modest progress has been made in the study of how such treatments should be implemented. The primary objective of this study was to test three competing strategies on how to implement a cognitive behavioral treatment (CBT) for out-patients with GAD (i.e., comparison of one compensation vs. two capitalization models). For our three-arm, single-blinded, randomized controlled trial (implementation of CBT for GAD [IMPLEMENT]), we recruited adults with GAD using advertisements in high-circulation newspapers to participate in a 14-session cognitive behavioral treatment (Mastery of your Anxiety and Worry, MAW-packet). We randomly assigned eligible patients using a full randomization procedure (1:1:1) to three different conditions of implementation: adherence priming (compensation model), which had a systematized focus on patients' individual GAD symptoms and how to compensate for these symptoms within the MAW-packet, and resource priming and supportive resource priming (capitalization model), which had systematized focuses on patients' strengths and abilities and how these strengths can be capitalized within the same packet. In the intention-to-treat population an outcome composite of primary and secondary symptoms-related self-report questionnaires was analyzed based on a hierarchical linear growth model from intake to 6-month follow-up assessment. This trial is registered at ClinicalTrials.gov (identifier: NCT02039193) and is closed to new participants. From June 2012 to Nov. 2014, from 411 participants that were screened, 57 eligible participants were recruited and randomly assigned to three conditions. Forty-nine patients (86%) provided outcome data at post-assessment (14% dropout rate). All three conditions showed a highly significant reduction of symptoms over time. However, compared with the adherence priming condition, both resource priming conditions indicated faster symptom reduction. The observer ratings of a sub-sample of recorded videos (n = 100) showed that the therapists in the resource priming conditions conducted more strength-oriented interventions in comparison with the adherence priming condition. No patients died or attempted suicide. To our knowledge, this is the first trial that focuses on capitalization and compensation models during the implementation of one prescriptive treatment packet for GAD. We have shown that GAD related symptoms were significantly faster reduced by the resource priming conditions, although the limitations of our study included a well-educated population. If replicated, our results suggest that therapists who implement a mental health treatment for GAD might profit from a systematized focus on capitalization models. Swiss Science National Foundation (SNSF-Nr. PZ00P1_136937/1) awarded to CF.",Flückiger C.; Forrer L.; Schnider B.; Bättig I.; Bodenmann G.; Zinbarg RE.,2016.0,10.1016/j.ebiom.2015.11.049,0,0,6334
9880,Differential treatment response trajectories in individuals with subclinical and clinical PTSD.,"Subclinical presentations of posttraumatic stress disorder (PTSD), wherein patients are one or two symptom criteria short of the full disorder, are prevalent and associated with levels of distress and impaired functioning approximating that of full PTSD. Nonetheless, research examining treatment efficacy for this group is in the nascent stage. The purpose of the present study was to examine whether the subclinical PTSD group would: (1) show a greater reduction in PTSD symptoms at pre and post treatment in response to an exposure based treatment and (2) show a greater rate of change over the course of treatment, when compared to the full criteria PTSD group. We also examined whether differences would emerge when examining PTSD symptom clusters. Consistent with predictions, the subclinical PTSD group demonstrated a greater reduction in PTSD symptoms at post-treatment (29%) than those with a PTSD diagnosis (14%). Further, the groups had different treatment trajectories, with the subclinical PTSD group showing a marginally greater rate of change during the course of treatment. Findings also varied by symptom cluster with the subclinical group showing a greater rate of change in the intrusions, hypervigilance, and avoidance symptom clusters. There was not a significant between group difference in the numbing symptom cluster. This study provides preliminary evidence that treating PTSD symptoms at the subclinical level may result in a larger, and more rapid symptom reduction, and thus has implications supporting treatment earlier in the developmental trajectory of the disorder.",Korte KJ.; Allan NP.; Gros DF.; Acierno R.,2016.0,10.1016/j.janxdis.2016.01.006,0,0,
9881,Qualitative examination of cognitive change during PTSD treatment for active duty service members.,"The current study investigated changes in service members' cognitions over the course of Cognitive Processing Therapy (CPT) for posttraumatic stress disorder (PTSD). Sixty-three active duty service members with PTSD were drawn from 2 randomized controlled trials of CPT-Cognitive Only (CPT-C). Participants wrote an impact statement about the meaning of their index trauma at the beginning and again at the end of therapy. Clauses from each impact statement were qualitatively coded into three categories for analysis: assimilation, accommodation, and overaccommodation. The PTSD Checklist, Posttraumatic Symptom Scale-Interview Version, and the Beck Depression Inventory-II were administered at baseline and posttreatment. Repeated measures analyses documented a significant decrease in the percentage of assimilated or overaccommodated statements and an increase in the percentage of accommodated statements from the beginning to the end of treatment. Changes in accommodated statements over the course of treatment were negatively associated with PTSD and depression symptom severity, while statements indicative of overaccommodation were positively associated with both PTSD and depression symptom severity. Treatment responders had fewer overaccommodated and more accommodated statements. Findings suggest that CPT-C changes cognitions over the course of treatment. Methodological limitations and the lack of association between assimilation and PTSD symptom severity are further discussed.",Dondanville KA.; Blankenship AE.; Molino A.; Resick PA.; Wachen JS.; Mintz J.; Yarvis JS.; Litz BT.; Borah EV.; Roache JD.; Young-McCaughan S.; Hembree EA.; Peterson AL.;  .,2016.0,10.1016/j.brat.2016.01.003,0,0,
9882,In Vivo versus Augmented Reality Exposure in the Treatment of Small Animal Phobia: A Randomized Controlled Trial.,"Although in vivo exposure is the treatment of choice for specific phobias, some acceptability problems have been associated with it. Virtual Reality exposure has been shown to be as effective as in vivo exposure, and it is widely accepted for the treatment of specific phobias, but only preliminary data are available in the literature about the efficacy of Augmented Reality. The purpose of the present study was to examine the efficacy and acceptance of two treatment conditions for specific phobias in which the exposure component was applied in different ways: In vivo exposure (N = 31) versus an Augmented Reality system (N = 32) in a randomized controlled trial. ""One-session treatment"" guidelines were followed. Participants in the Augmented Reality condition significantly improved on all the outcome measures at post-treatment and follow-ups. When the two treatment conditions were compared, some differences were found at post-treatment, favoring the participants who received in vivo exposure. However, these differences disappeared at the 3- and 6-month follow-ups. Regarding participants' expectations and satisfaction with the treatment, very positive ratings were reported in both conditions. In addition, participants from in vivo exposure condition considered the treatment more useful for their problem whereas participants from Augmented Reality exposure considered the treatment less aversive. Results obtained in this study indicate that Augmented Reality exposure is an effective treatment for specific phobias and well accepted by the participants.",Botella C.; Pérez-Ara MÁ.; Bretón-López J.; Quero S.; García-Palacios A.; Baños RM.,2016.0,10.1371/journal.pone.0148237,0,0,
9883,[Subtalar arthrodesis].,"Realignment and stabilization of the hindfoot by subtalar joint arthrodesis. Idiopathic/posttraumatic arthritis, inflammatory arthritis of the subtalar joint with/without hindfoot malalignment. Optional flatfoot/cavovarus foot reconstruction. Inflammation, vascular disturbances, nicotine abuse. Approach dependent on assessment. Lateral approach: Supine position. Incision above the sinus tarsi. Exposure of subtalar joint. Removal of cartilage and breakage of the subchondral sclerosis. In valgus malalignment, interposition of corticocancellous bone segment; in varus malalignment resection of bone segment from the calcaneus. Reposition and temporarily stabilization with Kirschner wires. Imaging of hindfoot alignment. Stabilization with cannulated screws. Posterolateral approach: Prone position. Incision parallel to the lateral Achilles tendon border. Removal of cartilage and breakage of subchondral sclerosis. Medial approach: Supine position. Incision just above and parallel to the posterior tibial tendon. Removal of cartilage and breakage of subchondral sclerosis. Stabilization with screws. Lower leg walker with partial weightbearing. Active exercises of the ankle. After a 6‑week X‑ray, increase of weightbearing. Full weightbearing not before 8 weeks; with interpositioning bone grafts not before 10-12 weeks. Stable walking shoes. Active mobilization of the ankle. Of 43 isolated subtalar arthrodesis procedures, 5 wound healing disorders and no infections developed. Significantly improved AOFAS hindfood score. Well-aligned heel observed in 34 patients; 5 varus and 2 valgus malalignments. Sensory disturbances in 8 patients; minor ankle flexion limitations. Full bone healing in 36 subtalar joints, pseudarthrosis in 4 patients.",Fuhrmann RA.; Pillukat T.,2016.0,10.1007/s00064-016-0438-8,0,0,
9884,Impact of the condolence letter on the experience of bereaved families after a death in intensive care: study protocol for a randomized controlled trial.,"As intensive care mortality is high, end of life is a subject of major concern for intensivists. In this context, relatives are particularly vulnerable and prone to post-ICU syndrome, in the form of high levels of anxiety, depression, post-traumatic stress, and complicated grief. Grieving families suffer from a feeling of abandonment and evoke the need to get back in touch with the team to ask questions and remove doubts, but very few actually do. Aiding families during the grieving process is an important aspect of palliative care. A condolence letter represents an opportunity to recognize the pain of the family member and the strong tie that linked the family member to the ICU team, and to offer additional information if necessary. The goal of the study is to measure the impact of the condolence letter on the experience of bereaved families after a death in the ICU. Our hypothesis is that a post-death follow-up in the form of a condolence letter sent by the ICU physician who was in charge of the patient may help to reduce the risks of presenting symptoms of anxiety/depression, post-traumatic stress, and complicated grief. This is a randomized, controlled, multicenter study. Research will compare two groups of bereaved family members: one group that does not receive a condolence letter (control) and one group that receives a condolence letter 15 days after the death (intervention). Each of the 22 participating centers will include 12 relatives. Participating relatives will be followed up by phone with a call at 1 month and one at 6 months to complete questionnaires, permitting evaluation of post-ICU burden. The main outcome is anxiety and depression measured at 1 month. Other outcomes include evaluation of quality of dying and death, post-traumatic stress, and complicated grief. This study will allow us to assess if sending a condolence letter can reduce the risks of presenting symptoms of anxiety and depression, complicated grief, and symptoms of post-traumatic stress disorder after the death of a loved one in the ICU.  Clinicaltrials.gov NCT02325297 (23 December 2014).",Kentish-Barnes N.; Chevret S.; Azoulay E.,2016.0,10.1186/s13063-016-1212-9,0,0,
9885,The impact of treatment condition and the lagged effects of PTSD symptom severity and alcohol use on changes in alcohol craving.,"Given the high rates of comorbidity between posttraumatic stress disorder (PTSD) and substance use disorder (SUD), we investigated an integrated treatment for these disorders. Individuals with comorbid PTSD and alcohol dependence were randomized to receive naltrexone or placebo, with or without prolonged exposure (PE). All participants also received BRENDA (supportive counseling). The naltrexone plus PE group showed a greater decline in alcohol craving symptoms than those in the placebo with no PE group. The PE plus placebo and the naltrexone without PE groups did not differ significantly from the placebo with no PE group in terms of alcohol craving. No treatment group differences were found for percentage of drinking days. Alcohol craving was moderated by PTSD severity, with those with higher PTSD symptoms showing faster decreases in alcohol craving. Both PTSD and alcohol use had a lagged effect on alcohol craving, with changes in PTSD symptoms and percentage of days drinking being associated with subsequent changes in craving. These results support the relationship between greater PTSD symptoms leading to greater alcohol craving and suggest that reducing PTSD symptoms may be beneficial to reducing craving in those with co-occurring PTSD/SUD.",Kaczkurkin AN.; Asnaani A.; Alpert E.; Foa EB.,2016.0,10.1016/j.brat.2016.02.001,0,0,
9886,A Novel Brief Therapy for Patients Who Attempt Suicide: A 24-months Follow-Up Randomized Controlled Study of the Attempted Suicide Short Intervention Program (ASSIP).,"Attempted suicide is the main risk factor for suicide and repeated suicide attempts. However, the evidence for follow-up treatments reducing suicidal behavior in these patients is limited. The objective of the present study was to evaluate the efficacy of the Attempted Suicide Short Intervention Program (ASSIP) in reducing suicidal behavior. ASSIP is a novel brief therapy based on a patient-centered model of suicidal behavior, with an emphasis on early therapeutic alliance. Patients who had recently attempted suicide were randomly allocated to treatment as usual (n = 60) or treatment as usual plus ASSIP (n = 60). ASSIP participants received three therapy sessions followed by regular contact through personalized letters over 24 months. Participants considered to be at high risk of suicide were included, 63% were diagnosed with an affective disorder, and 50% had a history of prior suicide attempts. Clinical exclusion criteria were habitual self-harm, serious cognitive impairment, and psychotic disorder. Study participants completed a set of psychosocial and clinical questionnaires every 6 months over a 24-month follow-up period. The study represents a real-world clinical setting at an outpatient clinic of a university hospital of psychiatry. The primary outcome measure was repeat suicide attempts during the 24-month follow-up period. Secondary outcome measures were suicidal ideation, depression, and health-care utilization. Furthermore, effects of prior suicide attempts, depression at baseline, diagnosis, and therapeutic alliance on outcome were investigated. During the 24-month follow-up period, five repeat suicide attempts were recorded in the ASSIP group and 41 attempts in the control group. The rates of participants reattempting suicide at least once were 8.3% (n = 5) and 26.7% (n = 16). ASSIP was associated with an approximately 80% reduced risk of participants making at least one repeat suicide attempt (Wald χ21 = 13.1, 95% CI 12.4-13.7, p < 0.001). ASSIP participants spent 72% fewer days in the hospital during follow-up (ASSIP: 29 d; control group: 105 d; W = 94.5, p = 0.038). Higher scores of patient-rated therapeutic alliance in the ASSIP group were associated with a lower rate of repeat suicide attempts. Prior suicide attempts, depression, and a diagnosis of personality disorder at baseline did not significantly affect outcome. Participants with a diagnosis of borderline personality disorder (n = 20) had more previous suicide attempts and a higher number of reattempts. Key study limitations were missing data and dropout rates. Although both were generally low, they increased during follow-up. At 24 months, the group difference in dropout rate was significant: ASSIP, 7% (n = 4); control, 22% (n = 13). A further limitation is that we do not have detailed information of the co-active follow-up treatment apart from participant self-reports every 6 months on the setting and the duration of the co-active treatment. ASSIP, a manual-based brief therapy for patients who have recently attempted suicide, administered in addition to the usual clinical treatment, was efficacious in reducing suicidal behavior in a real-world clinical setting. ASSIP fulfills the need for an easy-to-administer low-cost intervention. Large pragmatic trials will be needed to conclusively establish the efficacy of ASSIP and replicate our findings in other clinical settings. ClinicalTrials.gov NCT02505373.",Gysin-Maillart A.; Schwab S.; Soravia L.; Megert M.; Michel K.,2016.0,10.1371/journal.pmed.1001968,0,0,
9887,Audio Feedback with Reduced Self-focus as an Intervention for Social Anxiety: An Experimental Study.,"Socially anxious individuals tend to underestimate their performance largely due to attentional bias. Video and audio feedback (AF) with cognitive preparation (CP) have shown to improve socially anxious individuals' evaluation of their performance in previous studies. In the present study, it was hypothesized that one of the three steps in CP, reduced self-focus (RS), is sufficient to cause an improved voice evaluation after AF. This was tested in a single-session randomized controlled experiment. Forty-one socially anxious participants were asked to give a speech, then to listen to and evaluate a taped recording of their performance. Half of the sample were instructed to reduce their self-focus prior to AF, the rest received AF only. RS involved asking participants to listen to the audio recording as though they were listening to a stranger. Generalization effects were assessed by a second speech. AF with RS led to more improved voice evaluations than AF-only after the first speech, and the effects remained in the evaluation of the second speech. More positive speech evaluations were associated with corresponding reductions of performance anxiety. small sample, analogue study. One component of cognitive preparation-(RS)-appears to be sufficient to cause significant effects on voice evaluation in socially anxious individuals. If the results are replicated in clinical samples, AF with RS may be a promising intervention in the treatment of social anxiety.",Nilsson JE.; Lundh LG.,2016.0,10.1080/16506073.2015.1126633,0,0,
9888,Impact of Proactive Nurse Participation in ICU Family Conferences: A Mixed-Method Study.,"To investigate family perceptions of having a nurse participating in family conferences and to assess the psychologic well being of the same families after ICU discharge. Mixed-method design with a qualitative study embedded in a single-center randomized study. Twelve-bed medical-surgical ICU in a 460-bed tertiary hospital. One family member for each consecutive patient who received more than 48 hours of mechanical ventilation in the ICU. Planned proactive participation of a nurse in family conferences led by a physician. In the control group, conferences were led by a physician without a nurse. Of the 172 eligible family members, 100 (60.2%) were randomized; among them, 88 underwent semistructured interviews at ICU discharge and 86 completed the Peritraumatic Dissociative Experiences Questionnaire at ICU discharge and then the Hospital Anxiety Depression Questionnaire and the Impact of Event Scale (for posttraumatic stress-related symptoms) 3 months later. The intervention and control groups were not significantly different regarding the prevalence of posttraumatic stress-related symptoms (52.3 vs 50%, respectively; p = 0.83). Anxiety and depression subscale scores were significantly lower in the intervention group. The qualitative data indicated that the families valued the principle of the conference itself. Perceptions of nurse participation clustered into four main themes: trust that ICU teamwork was effective (50/88; 56.8%), trust that care was centered on the patient (33/88; 37.5%), trust in effective dissemination of information (15/88; 17%), and trust that every effort was made to relieve anxiety in family members (12/88; 13.6%). Families valued the conferences themselves and valued the proactive participation of a nurse. These positive perceptions were associated with significant anxiety or depression subscale scores but not with changes in posttraumatic stress-related symptoms.",Garrouste-Orgeas M.; Max A.; Lerin T.; Grégoire C.; Ruckly S.; Kloeckner M.; Brochon S.; Pichot E.; Simons C.; El-Mhadri M.; Bruel C.; Philippart F.; Fournier J.; Tiercelet K.; Timsit JF.; Misset B.,2016.0,10.1097/CCM.0000000000001632,0,0,
9889,"Gender-informed, psychoeducational programme for couples to prevent postnatal common mental disorders among primiparous women: cluster randomised controlled trial.","Interventions to prevent postpartum common mental disorders (PCMD) among unselected populations of women have had limited success. The aim was to determine whether What Were We Thinking (WWWT) a gender-informed, psychoeducational programme for couples and babies can prevent PCMD among primiparous women 6 months postpartum. Cluster-randomised controlled trial. 48 Maternal and Child Health Centres (MCHCs) from 6 Local Government Areas in Melbourne, Australia were allocated randomly to usual care (24) or usual care plus WWWT (24). English-speaking primiparous women receiving primary care at trial MCHCs were recruited to the intervention (204) and control (196) conditions. Of these, 187 (91.7%) and 177 (90.3%) provided complete data. WWWT is a manualised programme comprising primary care from a trained nurse, print materials and a face-to-face seminar. Data sources were standardised and study-specific measures collected in blinded computer-assisted telephone interviews at 6 and 26 weeks postpartum. The primary outcome was PCMD assessed by Composite International Diagnostic Interviews and Patient Health Questionnaire (PHQ) Depression and Generalised Anxiety Disorder modules. In intention-to-treat analyses the adjusted OR (AOR) of PCMD in the intervention compared to the usual care group was 0.78 (95% CI 0.38 to 1.63, ns), but mild to moderate anxiety symptoms (AOR 0.58, 95% CI 0.35 to 0.97) and poor self-rated health (AOR 0.46, 95% CI 0.22 to 0.97) were significantly lower. In a per protocol analysis, comparing the full (three component) intervention and usual care groups, the AOR of PCMD was 0.36, (95% CI 0.14 to 0.95). The WWWT seminar was appraised as salient, comprehensible and useful by >85% participants. No harms were detected. WWWT is readily integrated into primary care, enables inclusion of fathers and addresses modifiable risks for PCMD directly. The full intervention appears a promising programme for preventing PCMD, optimising family functioning, and as the first component of a stepped approach to mental healthcare. ACTRN12613000506796; Results.",Fisher J.; Rowe H.; Wynter K.; Tran T.; Lorgelly P.; Amir LH.; Proimos J.; Ranasinha S.; Hiscock H.; Bayer J.; Cann W.,2016.0,10.1136/bmjopen-2015-009396,0,0,
9890,Mindfulness-Based Exposure Strategies as a Transdiagnostic Mechanism of Change: An Exploratory Alternating Treatment Design.,"The present study explored whether distress reduction in response to strong negative emotions, a putative transdiagnostic mechanism of action, is facilitated by mindfulness strategies. Seven patients (mean age=31.14years, SD=12.28, range 19-48 years, 43% female, 86% Caucasian) with heterogeneous anxiety disorders (i.e., panic disorder with or without agoraphobia, social anxiety, generalized anxiety) were assigned a randomized order of weeklong blocks utilizing either mindfulness- or avoidance-based strategies while ascending a 6-week emotion exposure hierarchy. Participants completed three exposures per block and provided distress and avoidance use ratings following each exposure. Anxiety severity, distress aversion, and distraction/suppression tendencies were also assessed at baseline and the conclusion of each block. Visual, descriptive, and effect size results showing exposures utilizing mindfulness were associated with higher overall distress levels, compared with those utilizing avoidance. Within blocks, the majority of participants exhibited declining distress levels when employing mindfulness strategies, as opposed to more static distress levels in the avoidance condition. Systematic changes in anxiety severity, distress aversion, and distraction/suppression were not observed. These results suggest mindfulness strategies may be effective in facilitating emotion exposure; however, a minimum dosage may be necessary to overcome initial distress elevation. Potential transdiagnostic change mechanisms and clinical implications are discussed.",Brake CA.; Sauer-Zavala S.; Boswell JF.; Gallagher MW.; Farchione TJ.; Barlow DH.,2016.0,10.1016/j.beth.2015.10.008,0,0,
9891,Reducing primary and secondary traumatic stress symptoms among educators by training them to deliver a resiliency program (ERASE-Stress) following the Christchurch earthquake in New Zealand.,"The current investigation evaluated the impact of a universal school-based resiliency intervention (ERASE-Stress) on educators who were working with elementary schoolchildren exposed to the Canterbury earthquake in New Zealand. In the context of major disasters, educators may suffer from ""dual trauma""; they can experience symptoms of both primary trauma (as a result of the disaster itself) and secondary trauma (as a result of working with traumatized students). Sixty-three educators were randomly assigned to either the ERASE-Stress intervention or an alternative Managing Emergencies and Traumatic Incidents (METI) program which served as a control group. Efficacy of the program was evaluated at the end of the training as well as at 8 months follow-up. Compared with educators in the control group, those in the ERASE-Stress intervention significantly reduced their posttraumatic distress and secondary traumatization symptoms, improved their perceived level of professional self-efficacy as a helper of earthquake survivors, developed an optimistic outlook regarding their personal future and enhanced their sense of hope, and honed some of their positive coping strategies and reduced the utilization of some maladaptive coping methods. These beneficial consequences of the ERASE-Stress training make it a potentially useful tool for educators working with traumatized students in the context of major disasters. (PsycINFO Database Record",Berger R.; Abu-Raiya H.; Benatov J.,2016.0,10.1037/ort0000153,0,0,
9892,The Bipolar II Depression Questionnaire: A Self-Report Tool for Detecting Bipolar II Depression.,"Bipolar II (BP-II) depression is often misdiagnosed as unipolar (UP) depression, resulting in suboptimal treatment. Tools for differentiating between these two types of depression are lacking. This study aimed to develop a simple, self-report screening instrument to help distinguish BP-II depression from UP depressive disorder. A prototype BP-II depression questionnaire (BPIIDQ-P) was constructed following a literature review, panel discussions and a field trial. Consecutively assessed patients with a diagnosis of depressive disorder or BP with depressive episodes completed the BPIIDQ-P at a psychiatric outpatient clinic in Hong Kong between October and December 2013. Data were analyzed using discriminant analysis and logistic regression. Of the 298 subjects recruited, 65 (21.8%) were males and 233 (78.2%) females. There were 112 (37.6%) subjects with BP depression [BP-I = 42 (14.1%), BP-II = 70 (23.5%)] and 182 (62.4%) with UP depression. Based on family history, age at onset, postpartum depression, episodic course, attacks of anxiety, hypersomnia, social phobia and agoraphobia, the 8-item BPIIDQ-8 was constructed. The BPIIDQ-8 differentiated subjects with BP-II from those with UP depression with a sensitivity/specificity of 0.75/0.63 for the whole sample and 0.77/0.72 for a female subgroup with a history of childbirth. The BPIIDQ-8 can differentiate BP-II from UP depression at the secondary care level with satisfactory to good reliability and validity. It has good potential as a screening tool for BP-II depression in primary care settings. Recall bias, the relatively small sample size, and the high proportion of females in the BP-II sample limit the generalization of the results.",Leung CM.; Yim CL.; Yan CT.; Chan CC.; Xiang YT.; Mak AD.; Fok ML.; Ungvari GS.,2016.0,10.1371/journal.pone.0149752,0,0,
9893,Muscle contracture diagnosis: the role of sonoelastography.,"Sonoelastography plays today a major role in musculoskeletal disease, showing minor muscle injuries not well appreciable in conventional B-mode ultrasonography and integrating it in major muscle injuries diagnosis. The aim of this study was to demonstrate the ability of elastosonography in the diagnosis of muscular contracture in football players presenting negative basic echography. We examined twenty-two football players using basic echography and elastosonography approximately 24-48 hours after the traumatic event and we subsequently re-evaluated them after two weeks. Conventional echography showed, in the early stage, no muscle injuries; in twenty-two out of twenty-two patients, sonoelastography had instead underlined a heterogeneous colorimetric map, related to decreased elasticity in the area of the muscle contracture. An evaluation effected 1-2 weeks later showed a clear improvement of the sonoelastographic appearance. This information will be useful for prognostication, post-traumatic monitoring and to detect subclinical changes in MIs even before there are changes on the routine B-mode ultrasound.",Bruschetta D.; Milardi D.; Trimarchi F.; DI Mauro D.; Valenti A.; Arrigo A.; Valenti B.; Santoro G.; Cascio F.; Vaccarino G.; Cacciola A.,2016.0,,0,0,
9894,"Effects of 3,4-Methylenedioxymethamphetamine on Patient Utterances in a Psychotherapeutic Setting.","3,4-Methylenedioxymethamphetamine (MDMA) administered as an adjunct to talk therapy influences patient speech content and increases improvement in treatment-resistant posttraumatic stress disorder (PTSD). Data came from the recordings of Mithoefer et al. (2011). In the third therapeutic session studied, patients were assigned, double blind, to an MDMA or a placebo group. Condition-blind scorers listened to therapy recordings and scored utterances where patients initiated topics that were empathic (regarding others' emotions), entactic (requesting or appreciating physical touch), or ensuic (describing a change in their sense of themselves). Patients who received MDMA produced high levels of ensuic, empathic, and entactic utterances compared with those who received the placebo. Interrater discourse scoring was reliable. The relationship between the number of scored utterances and the Clinician Administered PTSD Scale scores measuring PTSD severity after the treatment was significant, and reanalysis grouped bimodally into ""many"" or ""few"" such utterances remained significant. MDMA assisted these patients in having meaningful and disorder-resolving thoughts and discourse in talk therapy.",Corey VR.; Pisano VD.; Halpern JH.,2016.0,10.1097/NMD.0000000000000499,0,0,
9895,Trauma-Informed Mindfulness-Based Stress Reduction for Female Survivors of Interpersonal Violence: Results From a Stage I RCT.,"This pilot randomized controlled trial evaluated a novel trauma-informed model of mindfulness-based stress reduction (TI-MBSR) as a phase I trauma intervention for female survivors of interpersonal violence (IPV). A community-based sample of women (mean age = 41.5, standard deviation = 14.6) with a history of IPV was randomly assigned to an 8-week TI-MBSR intervention (n = 23) or a waitlist control group (n = 22). Symptoms of posttraumatic stress disorder (PTSD) and depression as well as anxious and avoidant attachment were assessed pre- and postintervention. Relative to the control group, participation in TI-MBSR was associated with statistically and clinically significant decreases in PTSD and depressive symptoms and significant reductions in anxious attachment. Retention in the intervention was high, with most participants completing at least 5 of the 8 sessions for the intervention. Minutes of mindfulness practice per week significantly predicted reductions in PTSD symptoms. TI-MBSR appears to be a promising and feasible phase I intervention for female survivors of interpersonal trauma.",Kelly A.; Garland EL.,2016.0,10.1002/jclp.22273,0,0,
9896,Disorder-specific versus transdiagnostic and clinician-guided versus self-guided internet-delivered treatment for panic disorder and comorbid disorders: A randomized controlled trial.,"Transdiagnostic cognitive behaviour therapy (TD-CBT) aims to target the symptoms of multiple disorders whereas disorder-specific CBT (DS-CBT) targets the symptoms of principal disorders. This study compared the relative benefits of internet-delivered TD-CBT and DS-CBT when provided in clinician-guided (CG-CBT) and self-guided (SG-CBT) formats for people with a principal diagnosis of Panic Disorder (PD). Participants (n=145) were randomly allocated to receive TD-CBT or DS-CBT and CG-CBT or SG-CBT. Large reductions in symptoms of PD (Cohen's d ‚â• 0.71; avg. reduction ‚â• 36%) and moderate-to-large reductions in symptoms of comorbid depression (Cohen's d ‚â• 0.71; avg. reduction ‚â• 33%), generalised anxiety disorder (Cohen's d ‚â• 0.91; avg. reduction ‚â• 34%) and social anxiety disorder (Cohen's d ‚â• 0.50; avg. reduction ‚â• 15%) were found over the 24-month follow-up period. Highlighting their efficacy and acceptability, no marked and consistent differences were observed between TD-CBT and DS-CBT or CG-CBT and DS-CBT.",Fogliati VJ.; Dear BF.; Staples LG.; Terides MD.; Sheehan J.; Johnston L.; Kayrouz R.; Dear R.; McEvoy PM.; Titov N.,2016.0,10.1016/j.janxdis.2016.03.005,0,0,
9897,The Effects of Aroma Foot Massage on Blood Pressure and Anxiety in Japanese Community-Dwelling Men and Women: A Crossover Randomized Controlled Trial.,"The aim of this study was to investigate the effects of aroma foot massage on blood pressure, anxiety, and health-related quality of life (QOL) in Japanese community-dwelling men and women using a crossover randomized controlled trial. Fifty-seven eligible participants (5 men and 52 women) aged 27 to 72 were randomly divided into 2 intervention groups (group A: n = 29; group B: n = 28) to participate in aroma foot massages 12 times during the 4-week intervention period. Systolic and diastolic blood pressure (SBP and DBP, respectively), heart rate, state anxiety, and health-related QOL were measured at the baseline, 4-week follow-up, and 8-week follow-up. The effects of the aroma foot massage intervention on these factors and the proportion of participants with anxiety were analyzed using a linear mixed-effect model for a crossover design adjusted for participant and period effects. Furthermore, the relationship between the changes in SBP and state anxiety among participants with relieved anxiety was assessed using a linear regression model. Aroma foot massage significantly decreased the mean SBP (p = 0.02), DBP (p = 0.006), and state anxiety (p = 0.003) as well as the proportion of participants with anxiety (p = 0.003). Although it was not statistically significant (p = 0.088), aroma foot massage also increased the score of mental health-related QOL. The change in SBP had a significant and positive correlation with the change in state anxiety (p = 0.01) among participants with relieved anxiety. The self-administered aroma foot massage intervention significantly decreased the mean SBP and DBP as well as the state anxiety score, and tended to increase the mental health-related QOL scores. The results suggest that aroma foot massage may be an easy and effective way to improve mental health and blood pressure. University Hospital Medical Information Network 000014260.",Eguchi E.; Funakubo N.; Tomooka K.; Ohira T.; Ogino K.; Tanigawa T.,2016.0,10.1371/journal.pone.0151712,0,0,
9898,Transcranial Magnetic Stimulation of the Supplementary Motor Area in the Treatment of Obsessive-Compulsive Disorder: A Multi-Site Study.,"Recently, strategies beyond pharmacological and psychological treatments have been developed for the management of obsessive-compulsive disorder (OCD). Specifically, repetitive transcranial magnetic stimulation (rTMS) has been employed as an adjunctive treatment in cases of treatment-refractory OCD. Here, we investigate six weeks of low frequency rTMS, applied bilaterally and simultaneously over the sensory motor area, in OCD patients in a randomized, double-blind placebo-controlled clinical trial. Twenty-two participants were randomly enrolled into the treatment (ACTIVE = 10) or placebo (SHAM = 12) groups. At each of seven visits (baseline; day 1 and weeks 2, 4, and 6 of treatment; and two and six weeks after treatment) the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was administered. At the end of the six weeks of rTMS, patients in the ACTIVE group showed a clinically significant decrease in Y-BOCS scores compared to both the baseline and the SHAM group. This effect was maintained six weeks following the end of rTMS treatment. Therefore, in this sample, rTMS appeared to significantly improve the OCD symptoms of the treated patients beyond the treatment window. More studies need to be conducted to determine the generalizability of these findings and to define the duration of rTMS' clinical effect on the Y-BOCS. Clinical Trial Registration Number (NCT) at www.clinicaltrials.gov: NCT00616486.",Hawken ER.; Dilkov D.; Kaludiev E.; Simek S.; Zhang F.; Milev R.,2016.0,10.3390/ijms17030420,0,0,
9899,Randomized controlled trial of multidisciplinary team stress and performance in immersive simulation for management of infant in shock: study protocol.,"Human error and system failures continue to play a substantial role in adverse outcomes in healthcare. Simulation improves management of patients in critical condition, especially if it is undertaken by a multidisciplinary team. It covers technical skills (technical and therapeutic procedures) and non-technical skills, known as Crisis Resource Management. The relationship between stress and performance is theoretically described by the Yerkes-Dodson law as an inverted U-shaped curve. Performance is very low for a low level of stress and increases with an increased level of stress, up to a point, after which performance decreases and becomes severely impaired. The objectives of this randomized trial are to study the effect of stress on performance and the effect of repeated simulation sessions on performance and stress. This study is a single-center, investigator-initiated randomized controlled trial including 48 participants distributed in 12 multidisciplinary teams. Each team is made up of 4 persons: an emergency physician, a resident, a nurse, and an ambulance driver who usually constitute a French Emergency Medical Service team. Six multidisciplinary teams are planning to undergo 9 simulation sessions over 1 year (experimental group), and 6 multidisciplinary teams are planning to undergo 3 simulation sessions over 1 year (control group). Evidence of the existence of stress will be assessed according to 3 criteria: biological, electrophysiological, and psychological stress. The impact of stress on overall team performance, technical procedure and teamwork will be evaluated. Participant self-assessment of the perceived impact of simulations on clinical practice will be collected. Detection of post-traumatic stress disorder will be performed by self-assessment questionnaire on the 7(th) day and after 1 month. We will concomitantly evaluate technical and non-technical performance, and the impact of stress on both. This is the first randomized trial studying repetition of simulation sessions and its impact on both clinical performance and stress, which is explored by objective and subjective assessments. We expect that stress decreases team performance and that repeated simulation will increase it. We expect no variation of stress parameters regardless of the level of performance. ClinicalTrials.gov registration number NCT02424890.",Ghazali DA.; Ragot S.; Breque C.; Guechi Y.; Boureau-Voultoury A.; Petitpas F.; Oriot D.,2016.0,10.1186/s13049-016-0229-0,0,0,
9900,Promising effects of treatment with flotation-REST (restricted environmental stimulation technique) as an intervention for generalized anxiety disorder (GAD): a randomized controlled pilot trial.,"During Flotation-REST a person is floating inside a quiet and dark tank, filled with heated salt saturated water. Deep relaxation and beneficial effects on e.g. stress, sleep difficulties, anxiety and depression have been documented in earlier research. Despite that treatments for generalized anxiety disorder (GAD) are effective; it is till the least successfully treated anxiety disorder, indicating that treatment protocols can be enhanced. The use of Flotation-REST as a treatment of GAD has not been researched. The aim of the present study was to conduct an initial evaluation of the effects in a self-diagnosed GAD sample. This study was a randomized, parallel group, non-blinded trial with 1:1 allocation ratio to waiting list control group (n = 25) or to a twelve session treatment with flotation-REST (n = 25). Inclusion criteria's were: 18-65 years and GAD (as defined by self-report measures). The primary outcome was GAD-symptomatology, and secondary outcomes were depression, sleep difficulties, emotion regulation difficulties and mindfulness. Assessments were made at three time points (baseline, four weeks in treatment, post-treatment), and at six-month follow-up. The main data analyses were conducted with a two-way MANOVA and additional t-tests. Forty-six participants (treatment, n = 24; control, n = 22) were included in the analyses. A significant Time x Group interaction effect for GAD-symptomatology [F (2,88) = 2.93, p < .001, η p (2)  = .062] was found. Further analyses showed that the GAD-symptomatology was significantly reduced for the treatment group (t (23) = 4.47, p < .001), but not for the waiting list control group (t(21) = 0.98, p > .05), when comparing baseline to post-treatment scoring. Regarding clinical significant change, 37 % in the treatment group reached full remission at post-treatment. Significant beneficial effects were also found for sleep difficulties, difficulties in emotional regulation, and depression, while the treatment had ambiguous or non-existent effects on pathological worry and mindfulness. All improved outcome variables at post-treatment, except for depression, were maintained at 6-months follow. No negative effects were found. The findings suggest that the method has potential as a complementary treatment alongside existing treatment for GAD. More studies are warranted to further evaluate the treatments efficacy. Australian New Zealand Clinical Trial Registry: ACTRN12613001105730 , Date of registration: 03/10/2013.",Jonsson K.; Kjellgren A.,2016.0,10.1186/s12906-016-1089-x,0,0,
9901,Insomnia Symptoms Following Treatment for Comorbid Panic Disorder With Agoraphobia and Generalized Anxiety Disorder.,"Patients with panic disorder with agoraphobia (PDA) or generalized anxiety disorder (GAD) frequently also suffer from insomnia. However, the impact of cognitive-behavioral therapy (CBT) for anxiety disorders on insomnia has been understudied. Furthermore, comorbidity between anxiety disorders is common. Our main objective was to assess the impact of CBT for PDA or GAD on insomnia. In a quasi-experimental design, 86 participants with PDA and GAD received conventional CBT for their primary disorder or combined CBT for both disorders. Overall, CBTs had a significant impact on reducing insomnia symptoms (η = 0.58). However, among people with insomnia at pretest (67%), 33% still had an insomnia diagnosis, and the majority (63%) had clinically significant residual insomnia following treatment. In conclusion, the CBTs had a positive effect on the reduction of insomnia, but a significant proportion of participants still had insomnia problems following treatment. Clinicians should address insomnia during CBT for PDA and GAD.",Cousineau H.; Marchand A.; Bouchard S.; Bélanger C.; Gosselin P.; Langlois F.; Labrecque J.; Dugas MJ.; Belleville G.,2016.0,10.1097/NMD.0000000000000466,0,0,
9902,"A Randomized, Controlled Pilot Study of a Single-Session Psychoeducation Treatment for Urban, Culturally Diverse, Trauma-Exposed Adults.","This randomized pilot study aimed to determine whether a single session of psychoeducation improved mental health outcomes, attitudes toward treatment, and service engagement among urban, impoverished, culturally diverse, trauma-exposed adults. Sixty-seven individuals were randomly assigned to a single-session psychoeducation treatment or a delayed treatment comparison control group. The control group was found to be superior to the treatment group at posttest with respect to symptoms of posttraumatic stress disorder, anxiety, and occupational and family disability. At follow-up, all participants had completed the psychoeducation treatment, and a mixed-effects model indicated significant improvements over time in symptoms of posttraumatic stress disorder, anxiety, depression, somatization, and attitudes toward treatment. Ninety-eight percent of the participants reported the psychoeducation was helpful at follow-up. Participants also reported a 19.1% increase in mental health service utilization at follow-up compared with baseline. Implications for treatment and future research are discussed.",Ghafoori B.; Fisher D.; Korosteleva O.; Hong M.,2016.0,10.1097/NMD.0000000000000512,0,0,
9903,Targeting Recovery in Persistent Persecutory Delusions: A Proof of Principle Study of a New Translational Psychological Treatment (the Feeling Safe Programme).,"Many patients do not respond adequately to current pharmacological or psychological treatments for psychosis. Persistent persecutory delusions are common in clinical services, and cause considerable patient distress and impairment. Our aim has been to build a new translational personalized treatment, with the potential for wide use, that leads to high rates of recovery in persistent persecutory delusions. We have been developing, and evaluating individually, brief modular interventions, each targeting a key causal factor identified from our cognitive model. These modules are now combined in ""The Feeling Safe Programme"". To test the feasibility of a new translational modular treatment for persistent persecutory delusions and provide initial efficacy data. 12 patients with persistent persecutory delusions in the context of non-affective psychosis were offered the 6-month Feeling Safe Programme. After assessment, patients chose from a personalized menu of treatment options. Four weekly baseline assessments were carried out, followed by monthly assessments. Recovery in the delusion was defined as conviction falling below 50% (greater doubt than certainty). 11 patients completed the intervention. One patient withdrew before the first monthly assessment due to physical health problems. An average of 20 sessions (SD = 4.4) were received. Posttreatment, 7 out of 11 (64%) patients had recovery in their persistent delusions. Satisfaction ratings were high. The Feeling Safe Programme is feasible to use and was associated with large clinical benefits. To our knowledge this is the first treatment report focused on delusion recovery. The treatment will be tested in a randomized controlled trial.",Freeman D.; Bradley J.; Waite F.; Sheaves B.; DeWeever N.; Bourke E.; McInerney J.; Evans N.; Černis E.; Lister R.; Garety P.; Dunn G.,2016.0,10.1017/S1352465816000060,0,0,
9904,Threat expectancy bias and treatment outcome in patients with panic disorder and agoraphobia.,"Previous studies suggest that patients with panic disorder and agoraphobia (PD/A) tend to overestimate the associations between fear-relevant stimuli and threat. This so-called threat expectancy bias is thought to play a role in the development and treatment of anxiety disorders. The current study tested 1) whether patients with PD/A (N = 71) show increased threat expectancy ratings to fear-relevant and fear-irrelevant stimuli relative to a comparison group without an axis I disorder (N=65), and 2) whether threat expectancy bias before treatment predicts treatment outcome in a subset of these patients (n = 51). In a computerized task, participants saw a series of panic-related and neutral words and rated for each word the likelihood that it would be followed by a loud, aversive sound. Results showed higher threat expectancy ratings to both panic-related and neutral words in patients with PD/A compared to the comparison group. Threat expectancy ratings did not predict treatment outcome. This study only used expectancy ratings and did not include physiological measures. Furthermore, no post-treatment expectancy bias task was added to shed further light on the possibility that expectancy bias might be attenuated by treatment. Patients show higher expectancies of aversive outcome following both fear-relevant and fear-irrelevant stimuli relative to the comparison group, but this does not predict treatment outcome.",Duits P.; Klein Hofmeijer-Sevink M.; Engelhard IM.; Baas JM.; Ehrismann WA.; Cath DC.,2016.0,10.1016/j.jbtep.2016.03.014,0,0,
9905,Improving distress in dialysis (iDiD): a feasibility two-arm parallel randomised controlled trial of an online cognitive behavioural therapy intervention with and without therapist-led telephone support for psychological distress in patients undergoing ha,"Psychological distress is common in end-stage kidney disease (ESKD) and is associated with poorer health outcomes. Cognitive behavioural therapy (CBT) is recommended in UK clinical guidelines for the management of depression in people with long-term conditions. Access to skilled therapists competent in managing the competing mental and physical health demands of ESKD is limited. Online CBT treatments tailored to the needs of the ESKD population offers a pragmatic solution for under-resourced services. This study examines the feasibility and acceptability of implementing a two-arm parallel randomised controlled trial of online CBT with (intervention arm) and without (control arm) therapist support to improve psychological distress in patients undergoing haemodialysis. Patients will be screened for depression and anxiety while attending for their haemodialysis treatments. We aim to recruit 60 adult patients undergoing haemodialysis who meet criteria for mild to moderately severe symptoms of depression and/or anxiety. Patients will be randomised individually (using a 1:1 computerised sequence ratio) to either online CBT with therapist telephone support (intervention arm), or online CBT with no therapist (control arm). Outcomes include feasibility and acceptability descriptive data on rates of recruitment, randomisation, retention and treatment adherence. Self-report outcomes include measures of depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), quality of life (Euro-QoL), service use (client service receipt inventory) and illness cognitions (brief illness perception questionnaire). A qualitative process evaluation will also be conducted. The statistician will be blinded to treatment allocation. A National Health Service (NHS) research ethics committee approved the study. Data from this study will provide essential information for the design and testing of further interventions to ameliorate distress in patients undergoing dialysis. Any amendments to the protocol will be submitted to the NHS committee and study sponsor. NCT023528702; Pre-results.",Hudson JL.; Moss-Morris R.; Game D.; Carroll A.; McCrone P.; Hotopf M.; Yardley L.; Chilcot J.,2016.0,10.1136/bmjopen-2016-011286,0,0,
9906,Repetitive transcranial magnetic stimulation in the treatment of obsessive-compulsive disorders: Double blind randomized clinical trial.,"Repetitive transcranial magnetic stimulation (rTMS) has become widely used as a therapeutic tool in psychiatric research. The aim of this study was to evaluate the impact of different frequencies of rTMS over right dorsolateral prefrontal cortex (DLPFC) in OCD. Forty five patients with OCD participated in the study. Patients were evaluated using: Yale-Brown obsessive compulsive scale (Y-BOCS), Hamilton Anxiety Rating Scale (HAM-A), and Clinical Global Impression-Severity scale (CGI-S). They were randomly classified into three groups: 1st group received 1Hz rTMS; 2nd group received 10Hz rTMS; and 3rd group received sham stimulation all at 100% of the resting motor threshold for 10 sessions. They were followed up after the last treatment session and 3 months later. There was a significant ""time""√ó""group"" interaction for 1Hz versus Sham but not for 10Hz versus Sham. 1Hz versus 10Hz groups showed a significant interaction for Y-BOCS and HAM-A (P=0.001 and 0.0001 respectively). 1Hz rTMS has a greater clinical benefit than 10Hz or Sham. There was also a significantly larger percentage change in GCI-S in the 1Hz group versus either 10Hz or sham. We conclude that 1Hz-rTMS, targeting right DLPFC is a promising tool for treatment of OCD.",Elbeh KA.; Elserogy YM.; Khalifa HE.; Ahmed MA.; Hafez MH.; Khedr EM.,2016.0,10.1016/j.psychres.2016.02.031,0,0,
9907,Effects of attention bias modification with short and long stimulus-duration: A randomized experiment with individuals with subclinical social anxiety.,"This study investigated the differential effects of two attention bias modification (ABM) with different stimulus durations. Seventy-two undergraduates with subclinical social anxiety were randomly assigned to one of four conditions: an ABM condition with either a 100-ms or a 500-ms stimulus duration (ABM-100/ ABM-500) or an attention placebo (AP) condition with either a 100-ms or a 500-ms stimulus duration (AP-100/ AP-500). Participants completed the pre-assessments, eight attentional training sessions, and post-assessments. A modified Posner paradigm was used to assess changes in attentional processing. After completion of attentional training, the ABM-100 group significantly speeded up their responses to 100-ms invalid trials, regardless of the word type. The ABM-100 group also exhibited significant reduced latencies to 500-ms invalid social threat trials and a marginally significant reduced latencies to 500-ms invalid neutral trials. The ABM-500 group showed significant reduced latencies to 500-ms invalid social threat trials. Both ABMs significantly reduced participants' fear of negative evaluations and interactional anxiousness relative to their comparative AP. The effects on social anxiety did not differ between the two ABMs. This study suggests that although both ABMs using short and long stimulus durations reduce some aspects of social anxiety, they influence participants' attentional disengagement in different ways.",Liang CW.; Hsu WY.,2016.0,10.1016/j.psychres.2016.04.019,0,0,
9908,Comorbidity and quality of life in adults with hair pulling disorder.,"Hair pulling disorder (HPD; trichotillomania) is thought to be associated with significant psychiatric comorbidity and functional impairment. However, few methodologically rigorous studies of HPD have been conducted, rendering such conclusions tenuous. The following study examined comorbidity and psychosocial functioning in a well-characterized sample of adults with HPD (N=85) who met DSM-IV criteria, had at least moderate hair pulling severity, and participated in a clinical trial. Results revealed that 38.8% of individuals with HPD had another current psychiatric diagnosis and 78.8% had another lifetime (present and/or past) psychiatric diagnosis. Specifically, HPD showed substantial overlap with depressive, anxiety, addictive, and other body-focused repetitive behavior disorders. The relationships between certain comorbidity patterns, hair pulling severity, current mood and anxiety symptoms, and quality of life were also examined. Results showed that current depressive symptoms were the only predictor of quality of life deficits. Implications of these findings for the conceptualization and treatment of HPD are discussed.",Houghton DC.; Maas J.; Twohig MP.; Saunders SM.; Compton SN.; Neal-Barnett AM.; Franklin ME.; Woods DW.,2016.0,10.1016/j.psychres.2016.02.063,0,0,
9909,Sleep-wake disorders persist 18 months after traumatic brain injury but remain underrecognized.,"This study is a prospective, controlled clinical and electrophysiologic trial examining the chronic course of posttraumatic sleep-wake disturbances (SWD). We screened 140 patients with acute, first-ever traumatic brain injury of any severity and included 60 patients for prospective follow-up examinations. Patients with prior brain trauma, other neurologic or systemic disease, drug abuse, or psychiatric comorbidities were excluded. Eighteen months after trauma, we performed detailed sleep assessment in 31 participants. As a control group, we enrolled healthy individuals without prior brain trauma matched for age, sex, and sleep satiation. In the chronic state after traumatic brain injury, sleep need per 24 hours was persistently increased in trauma patients (8.1 ± 0.5 hours) as compared to healthy controls (7.1 ± 0.7 hours). The prevalence of chronic objective excessive daytime sleepiness was 67% in patients with brain trauma compared to 19% in controls. Patients significantly underestimated excessive daytime sleepiness and sleep need, emphasizing the unreliability of self-assessments on SWD in trauma patients. This study provides prospective, controlled, and objective evidence for chronic persistence of posttraumatic SWD, which remain underestimated by patients. These results have clinical and medicolegal implications given that SWD can exacerbate other outcomes of traumatic brain injury, impair quality of life, and are associated with public safety hazards.",Imbach LL.; Büchele F.; Valko PO.; Li T.; Maric A.; Stover JF.; Bassetti CL.; Mica L.; Werth E.; Baumann CR.,2016.0,10.1212/WNL.0000000000002697,0,0,
9910,Assessing fidelity of cognitive behavioral therapy in rural VA clinics: design of a randomized implementation effectiveness (hybrid type III) trial.,"Broadly disseminating and implementing evidence-based psychotherapies with high fidelity, particularly cognitive behavioral therapy (CBT), has proved challenging for many health-care systems, including the Department of Veterans Affairs, especially in primary care settings such as small or remote clinics. A computer-based tool (based on the coordinated anxiety learning and management (CALM) program) was designed to support primary care-based mental health providers in delivering CBT. The objectives of this study are to modify the CALM tool to meet the needs of mental health clinicians in veterans affairs (VA) community-based outpatient clinics (CBOCs) and rural ""veterans"", use external facilitation to implement CBT and determine the effect of the CALM tool versus a manualized version of CALM to improve fidelity to the CBT treatment model, and conduct a needs assessment to understand how best to support future implementation of the CALM tool in routine care. Focus groups will inform the redesign of the CALM tool. Mental health providers at regional VA CBOCs; CBT experts; VA experts in implementation of evidence-based mental health practices; and veterans with generalized anxiety disorder, panic disorder, social anxiety disorder, posttraumatic stress disorder, ""with or without"" depression will be recruited. A hybrid type III design will be used to examine the effect of receiving CBT training plus either the CALM tool or a manual version of CALM on treatment fidelity. External facilitation will be used as the overarching strategy to implement both CBT delivery methods. Data will also be collected on symptoms of the targeted disorders. To help prepare for the future implementation of the CALM tool in VA CBOCs, we will perform an implementation need assessment with mental health providers participating in the clinical trial and their CBOC directors. This project will help inform strategies for delivering CBT with high fidelity in VA CBOCs to veterans with anxiety disorders and PTSD with or without depression. If successful, results of this study could be used to inform a national rollout of the CALM tool in VA CBOCs including providing recommendations for optimizing the adoption and sustained use of the computerized CALM tool among mental health providers in this setting. ClinicalTrials.gov, NCT02488551.",Cucciare MA.; Curran GM.; Craske MG.; Abraham T.; McCarthur MB.; Marchant-Miros K.; Lindsay JA.; Kauth MR.; Landes SJ.; Sullivan G.,2016.0,10.1186/s13012-016-0432-4,0,0,
9911,"Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder: A Randomized, Double-Blind, Controlled Trial.","In this study, we aimed to determine if stellate ganglion block (SGB) could reduce symptoms of posttraumatic stress disorder (PTSD) in comparison with sham therapy in military service members. In a randomized trial in which both participants and assessors were blind, participants with PTSD received either an SGB or a sham procedure. Posttraumatic stress disorder symptoms were measured using the CAPS (Clinician-Administered PTSD Scale) and self-report measures of PTSD, depression, anxiety, and pain. Subjects underwent assessment before the procedure and at 1 week, 1 month, and 3 months after the procedure. Patients receiving sham injections were allowed to cross over to the treatment group, and participants who maintained criteria for PTSD were allowed to receive a second SGB treatment. Posttraumatic stress disorder, anxiety, and depression scores all showed improvement across time, but there was no statistically or clinically relevant difference in outcomes between the active and control groups. Individuals who crossed over from sham treatment to SGB similarly showed no greater improvement with the SGB treatment. Improvement in CAPS was greater with a second SGB treatment than after the first treatment. Although previous case series have suggested that SGB offers an effective intervention for PTSD, this study did not demonstrate any appreciable difference between SGB and sham treatment on psychological or pain outcomes. Future studies should examine if differences in treatment methods or patient population could allow individuals with PTSD to benefit from SGB, but current evidence does not support widespread or indiscriminant clinical use of the procedure for PTSD.",Hanling SR.; Hickey A.; Lesnik I.; Hackworth RJ.; Stedje-Larsen E.; Drastal CA.; McLay RN.,,10.1097/AAP.0000000000000402,0,0,6387
9912,Randomized-controlled trial of mindfulness-based cancer recovery versus supportive expressive group therapy among distressed breast cancer survivors (MINDSET): long-term follow-up results.,"Mindfulness-based cancer recovery (MBCR) and supportive expressive group therapy (SET) are two well-validated psychosocial interventions, but they have not been directly compared, and little is known about long-term outcomes. This comparative effectiveness study measured the effects of these two interventions immediately following the groups and for 1 year thereafter in distressed breast cancer survivors. Two hundred fifty-two distressed Stage I-III breast cancer survivors were randomized into either MBCR or SET. Women completed questionnaires addressing mood, stress symptoms, quality of life, social support, spirituality and post-traumatic growth before and after the interventions, and 6 and 12 months later. Immediately following the intervention, women in MBCR reported greater reduction in mood disturbance (primarily fatigue, anxiety and confusion) and stress symptoms including tension, sympathetic arousal and cognitive symptoms than those in SET. They also reported increased emotional and functional quality of life, emotional, affective and positive social support, spirituality (feelings of peace and meaning in life) and post-traumatic growth (appreciation for life and ability to see new possibilities) relative to those in SET, who also improved to a lesser degree on many outcomes. Effect sizes of the time × group interactions were small to medium, and most benefits were maintained over 12 months of follow-up. This study is the first and largest to demonstrate sustained benefits of MBCR in distressed breast cancer survivors relative to an active control. MBCR was superior to SET for improving psychological well-being with lasting benefits over 1 year, suggesting these women gained long-lasting and efficacious tools to cope with cancer. Registered on clinicaltrials.gov number NCT00390169, October 2006. Copyright © 2016 John Wiley & Sons, Ltd.",Carlson LE.; Tamagawa R.; Stephen J.; Drysdale E.; Zhong L.; Speca M.,2016.0,10.1002/pon.4150,0,0,
9913,Peer-counseling for women newly diagnosed with breast cancer: A randomized community/research collaboration trial.,"We conducted a randomized controlled trial of peer-counseling for newly diagnosed breast cancer (BC) patients as a community/research collaboration testing an intervention developed jointly by a community-based-organization serving women with cancer and university researchers. We recruited 104 women newly diagnosed with BC at any disease stage. Prior to randomization, all received a one-time visit with an oncology nurse who offered information and resources. Afterwards, we randomized half to receive a match with a Navigator with whom they could have contact for up to 6 months. We recruited, trained, and supervised 30 peer counselors who became ""Navigators."" They were at least one-year post-diagnosis with BC. Controls received no further intervention. We tested the effect of intervention on breast-cancer-specific well-being and trauma symptoms as primary outcomes, and several secondary outcomes. In exploratory analyses, we tested whether responding to their diagnosis as a traumatic stressor moderated outcomes. We found that, compared with the control group, receiving a peer-counseling intervention significantly improved breast-cancer-specific well-being (p=0.01, Cohen's d=0.41) and maintained marital adjustment (p=0.01, Cohen's d=0.45) more effectively. Experiencing the diagnosis as a traumatic stressor moderated outcomes: those with a peer counselor in the traumatic stressor group improved significantly more than controls on well-being, trauma and depression symptoms, and cancer self-efficacy. Having a peer counselor trained and supervised to recognize and work with trauma symptoms can improve well-being and psychosocial morbidity during the first year following diagnosis of BC. Cancer 2016;122:2408-2417. © 2016 American Cancer Society.",Giese-Davis J.; Bliss-Isberg C.; Wittenberg L.; White J.; Star P.; Zhong L.; Cordova MJ.; Houston D.; Spiegel D.,2016.0,10.1002/cncr.30036,0,0,
9914,[An exploratory study of 'blended' cognitive behavioural therapy (CBT) for patients with a panic disorder: results and patients' experiences].,"Digital technology (e-health or 'blended' care), combined with evidence-based face-to-face CBT, is becoming increasingly implemented into mental health care and is expected to result in improved effectiveness and efficiency. To explore the feasibility of blended CBT for patients with a panic disorder. Nine face-to-face sessions of blended CBT (n = 18), supplemented with the digital support of a tabletcomputer and three e-mail contacts, were compared with 12 weekly sessions of regular CBT (n = 18). Primary outcomes were panic frequency and avoidance behaviour; the secondary outcome was general functioning. Patients' experiences of the treatment were collected in the form of a structured interview. The effect sizes found in both the regular and the blended CBT were medium to high (Cohen's d 0.42-1.60). In both types of treatment there was a significant reduction in patients' symptoms. There were no big differences in patient satisfaction regarding the treatment received. The therapists registered 39 face-to-face minutes in the blended treatment but they registered in total 41 fewer face-to-face minutes; this represented a time reduction of 4%. Blended CBT with help of a tablet computer seems to be a suitable method for treating panic disorder psychologically, although the time saved is only moderate. Much more research is needed to ascertain the feasibility and the cost effectiveness of blended CBT.",Bruinsma A.; Kampman M.; Exterkate CC.; Hendriks GJ.,2016.0,,0,0,
9915,The relationship of body image with symptoms of depression and anxiety in patients with anorexia nervosa during outpatient psychotherapy: Results of the ANTOP study.,"Body image disturbance represents a central characteristic of anorexia nervosa (AN). Depression and anxiety are the most common mental comorbidities in patients with AN. This study aims to investigate the relationship of body image with symptoms of depression and anxiety during outpatient psychotherapy in AN. Analyses were conducted using the data set of the Anorexia Nervosa Treatment Outpatient Study (ANTOP) randomized controlled trial. The ANTOP study included N = 242 females with AN between 18 and 56 years of age. The trial was designed to compare enhanced cognitive behavioral therapy (CBT-E) and focal psychodynamic therapy (FPT) with optimized treatment as usual (TAU-O) for patients with AN. The analyses on body image dimensions were conducted using measures of correlations and multiple linear regression analyses to assess the relationship and longitudinal prediction of symptoms of depression and anxiety by body image dimensions. Results showed that body image perceptions were significantly associated with symptoms of depression and anxiety in patients with AN at all treatment stages. In addition, body image dimensions at early treatment stages predict depression and anxiety in follow-up measurements. The correlation of symptoms of depression and anxiety by body image perceptions increased along treatment course. The persistence of body image disturbance, while body mass index increases under treatment (persistency effect), may constitute a relevant factor contributing to the course of the most common affective comorbidities of depression and anxiety in patients with AN. Body image disturbances in patients with AN should therefore be explicitly targeted within the specialized psychotherapy of affected patients. (PsycINFO Database Record",Junne F.; Zipfel S.; Wild B.; Martus P.; Giel K.; Resmark G.; Friederich HC.; Teufel M.; de Zwaan M.; Dinkel A.; Herpertz S.; Burgmer M.; Tagay S.; Rothermund E.; Zeeck A.; Ziser K.; Herzog W.; Löwe B.,2016.0,10.1037/pst0000064,0,0,
9916,"Repetitive Transcranial Magnetic Stimulation Improved Symptoms of Obsessive-Compulsive Disorder, but Also Cognitive Performance: Results from a Randomized Clinical Trial with a Cross-Over Design and Sham Condition.","There is some evidence that repetitive transcranial magnetic stimulation (rTMS) is an effective method of treating patients suffering from obsessive-compulsive disorder (OCD). Here, we tested the hypothesis that rTMS has a positive impact both on symptom severity and cognitive performance in such patients. Specifically, short-term verbal processing speed and flexibility were assessed. Ten patients suffering from refractory OCD and treated with standard medication were randomly assigned either to a treatment-first or to a sham-first condition. At baseline and after 2 and 4 weeks, symptom severity (experts' ratings) and cognitive performance (auditory perception, visual perception, short-term memory, and processing speed) were assessed. After 2 weeks, the treatment condition switched to the sham condition, and the sham condition switched to the treatment condition. Under treatment but not under sham conditions, symptom severity reduced. Moreover, cognitive performance improved in parallel. rTMS is a safe and efficient treatment for patients suffering from refractory OCD; symptoms and cognitive performance improved in parallel.",Jahangard L.; Haghighi M.; Shyayganfard M.; Ahmadpanah M.; Sadeghi Bahmani D.; Bajoghli H.; Holsboer-Trachsler E.; Brand S.,2016.0,10.1159/000446287,0,0,
9917,Limited Impact of Music Therapy on Patient Anxiety with the Large Loop Excision of Transformation Zone Procedure - a Randomized Controlled Trial.,"Many studies have pointed to strategies to cope with patient anxiety in colposcopy. Evidence shows that patients experienced considerable distress with the large loop excision of transformation zone (LLETZ) procedure and suitable interventions should be introduced to reduce anxiety. This study aimed to investigate the effects of music therapy in patients undergoing LLETZ. A randomized controlled trial was conducted with patients undergoing LLETZ performed under local anesthesia in an out patient setting at Ramathibodi Hospital, Bangkok, Thailand, from February 2015 to January 2016. After informed consent and demographic data were obtained, we assessed the anxiety level using State Anxiety Inventory pre and post procedures. Music group patients listened to classical songs through headphones, while the control group received the standard care. Pain score was evaluated with a visual analog scale (VAS). Statistical analysis was conducted using Pearson Chi-square, Fisher's Exact test and T-Test and p-values less than 0.05 were considered statistically significant. A total of 73 patients were enrolled and randomized, resulting in 36 women in the music group and 37 women in the non-music control group. The preoperative mean anxiety score was higher in the music group (46.8 VS 45.8 points). The postoperative mean anxiety scores in the music and the non-music groups were 38.7 and 41.3 points, respectively. VAS was lower in music group (2.55 VS 3.33). The percent change of anxiety was greater in the music group, although there was no significant difference between two groups. Music therapy did not significantly reduce anxiety in patients undergoing the LLETZ procedure. However, different interventions should be developed to ease the patients' apprehension during this procedure.",Kongsawatvorakul C.; Charakorn C.; Paiwattananupant K.; Lekskul N.; Rattanasiri S.; Lertkhachonsuk AA.,2016.0,,0,0,
9918,Effect of Palliative Care-Led Meetings for Families of Patients With Chronic Critical Illness: A Randomized Clinical Trial.,"Family caregivers of patients with chronic critical illness experience significant psychological distress. To determine whether family informational and emotional support meetings led by palliative care clinicians improve family anxiety and depression. A multicenter randomized clinical trial conducted from October 2010 through November 2014 in 4 medical intensive care units (ICUs). Adult patients (aged ‚â•21 years) requiring 7 days of mechanical ventilation were randomized and their family surrogate decision makers were enrolled in the study. Observers were blinded to group allocation for the measurement of the primary outcomes. At least 2 structured family meetings led by palliative care specialists and provision of an informational brochure (intervention) compared with provision of an informational brochure and routine family meetings conducted by ICU teams (control). There were 130 patients with 184 family surrogate decision makers in the intervention group and 126 patients with 181 family surrogate decision makers in the control group. The primary outcome was Hospital Anxiety and Depression Scale symptom score (HADS; score range, 0 [best] to 42 [worst]; minimal clinically important difference, 1.5) obtained during 3-month follow-up interviews with the surrogate decision makers. Secondary outcomes included posttraumatic stress disorder experienced by the family and measured by the Impact of Events Scale-Revised (IES-R; total score range, 0 [best] to 88 [worst]), discussion of patient preferences, hospital length of stay, and 90-day survival. Among 365 family surrogate decision makers (mean age, 51 years; 71% female), 312 completed the study. At 3 months, there was no significant difference in anxiety and depression symptoms between surrogate decision makers in the intervention group and the control group (adjusted mean HADS score, 12.2 vs 11.4, respectively; between-group difference, 0.8 [95% CI, -0.9 to 2.6]; P‚Äâ=‚Äâ.34). Posttraumatic stress disorder symptoms were higher in the intervention group (adjusted mean IES-R score, 25.9) compared with the control group (adjusted mean IES-R score, 21.3) (between-group difference, 4.60 [95% CI, 0.01 to 9.10]; P‚Äâ=‚Äâ.0495). There was no difference between groups regarding the discussion of patient preferences (intervention, 75%; control, 83%; odds ratio, 0.63 [95% CI, 0.34 to 1.16; P‚Äâ=‚Äâ.14]). The median number of hospital days for patients in the intervention vs the control group (19 days vs 23 days, respectively; between-group difference, -4 days [95% CI, -6 to 3 days]; P‚Äâ=‚Äâ.51) and 90-day survival (hazard ratio, 0.95 [95% CI, 0.65 to 1.38], P‚Äâ=‚Äâ.96) were not significantly different. Among families of patients with chronic critical illness, the use of palliative care-led informational and emotional support meetings compared with usual care did not reduce anxiety or depression symptoms and may have increased posttraumatic stress disorder symptoms. These findings do not support routine or mandatory palliative care-led discussion of goals of care for all families of patients with chronic critical illness. clinicaltrials.gov Identifier: NCT01230099.",Carson SS.; Cox CE.; Wallenstein S.; Hanson LC.; Danis M.; Tulsky JA.; Chai E.; Nelson JE.,2016.0,10.1001/jama.2016.8474,0,0,
9919,Kinesiophobia and its relation to pain characteristics and cognitive affective variables in older adults with chronic pain.,"The contribution of kinesiophobia (fear of movement) to the pain experience among older adults has been poorly evaluated. The aim of this study was to study prevalence at baseline, development over a 12-month period and cognitive-affective variables of kinesiophobia in a population-based sample of older adults with chronic pain. The study included 433 older adults (+65 years) with chronic pain (mean age 74.8 years) randomly selected using a Swedish register of inhabitants. Kinesiophobia was measured at baseline and 12-month follow-up with the 11-item version of the Tampa Scale of Kinesiophobia (TSK-11). Associations of demographic-, cognitive affective - and pain-related variables to kinesiophobia were analysed with linear regression analyses. The mean level of kinesiophobia was low. Worsening and recovering from kinesiophobia occurred over time, but the mean level of kinesiophobia remained unchanged (p = 0.972). High levels of kinesiophobia (TSK ≥35) were found among frailer and older adults predominately living in care homes, but not dependent on sex. Poor self-perceived health (OR = 8.84) and high pain intensity (OR = 1.22) were significantly associated with kinesiophobia. Results indicate that potential interventions regarding kinesiophobia among older adults should aim to decrease pain intensity and strengthen health beliefs.",Larsson C.; Ekvall Hansson E.; Sundquist K.; Jakobsson U.,2016.0,10.1186/s12877-016-0302-6,0,0,
9920,[Quality of life and symptoms in patients with chronic depression and anxiety after a self-management training: a randomised controlled trial].,"Evidence-based interventions aimed at patient rehabilitation are not readily available in outpatient mental health care for patients with chronic anxiety and/or depression. To evaluate the effects that the program 'Rehabilitation through self-management' had on the life and symptoms of patients who had received this programme for six months in an outpatient mental health care setting. As part of a randomised controlled trial, patients were assigned to receive the programme (intervention group) or care as usual (control group). After six months we evaluated the change in the quality of life (World Health Organisation Quality of Life assessment, Brief version (WHOQOL-BREF)) and the change in anxiety symptoms (Beck Anxiety Inventory (BAI)) and depressive symptoms (Patient Health Questionnaire (PHQ-9)) using linear mixed models analysis. We included 141 patients from 12 participating mental health care institutions. We found no significant difference between the quality of life or symptoms of patients in the intervention group and those in the control groups. Differences in change scores on the WHOQOL-BREF, BAI and PHQ-9 were 0.74 (p=0.63), 0.39 (p=0.81) and -0.07 (p=0.95) respectively. Higher scores on the BAI and PHQ-9 had a negative influence on the effect of the intervention. After six months the programme had no significant effect on patients' quality of life or symptoms. These results reflect the chronicity of symptoms and the relation between symptoms and the quality of life in this patient population.",Muntingh A.; Laheij M.; Sinnema H.; Zoun M.; van Balkom A.; Schene A.; Spijker J.,2016.0,,0,0,
9921,"Psychological Mechanisms Mediating Effects Between Trauma and Psychotic Symptoms: The Role of Affect Regulation, Intrusive Trauma Memory, Beliefs, and Depression.","Evidence suggests a causal role for trauma in psychosis, particularly for childhood victimization. However, the establishment of underlying trauma-related mechanisms would strengthen the causal argument. In a sample of people with relapsing psychosis (n = 228), we tested hypothesized mechanisms specifically related to impaired affect regulation, intrusive trauma memory, beliefs, and depression. The majority of participants (74.1%) reported victimization trauma, and a fifth (21.5%) met symptomatic criteria for Posttraumatic Stress Disorder. We found a specific link between childhood sexual abuse and auditory hallucinations (adjusted OR = 2.21, SE = 0.74, P = .018). This relationship was mediated by posttraumatic avoidance and numbing (OR = 1.48, SE = 0.19, P = .038) and hyperarousal (OR = 1.44, SE = 0.18, P = .045), but not intrusive trauma memory, negative beliefs or depression. In contrast, childhood emotional abuse was specifically associated with delusions, both persecutory (adjusted OR = 2.21, SE = 0.68, P = .009) and referential (adjusted OR = 2.43, SE = 0.74, P = .004). The link with persecutory delusions was mediated by negative-other beliefs (OR = 1.36, SE = 0.14, P = .024), but not posttraumatic stress symptoms, negative-self beliefs, or depression. There was no evidence of mediation for referential delusions. No relationships were identified between childhood physical abuse and psychosis. The findings underline the role of cognitive-affective processes in the relationship between trauma and symptoms, and the importance of assessing and treating victimization and its psychological consequences in people with psychosis.",Hardy A.; Emsley R.; Freeman D.; Bebbington P.; Garety PA.; Kuipers EE.; Dunn G.; Fowler D.,2016.0,10.1093/schbul/sbv175,0,0,
9922,Psychotherapies for Panic Disorder: A Tale of Two Sites.,"To compare cognitive-behavioral therapy (CBT), panic-focused psychodynamic psychotherapy (PFPP), and applied relaxation training (ART) for primary DSM-IV panic disorder with and without agoraphobia in a 2-site randomized controlled trial. 201 patients were stratified for site and DSM-IV agoraphobia and depression and were randomized to CBT, PFPP, or ART (19-24 sessions) over 12 weeks in a 2:2:1 ratio at Weill Cornell Medical College (New York, New York) and University of Pennsylvania (""Penn""; Philadelphia, Pennsylvania). Any medication was held constant. Attrition rates were ART, 41%; CBT, 25%; and PFPP, 22%. The most symptomatic patients were more likely to drop out of ART than CBT or PFPP (P = .013). Outcome analyses revealed site-by-treatment interactions in speed of Panic Disorder Severity Scale (PDSS) change over time (P = .013). At Cornell, no differences emerged on improvement on the primary outcome, estimated speed of change over time on the PDSS; at Penn, ART (P = .025) and CBT (P = .009) showed greater improvement at treatment termination than PFPP. A site-by-treatment interaction (P = .016) for a priori-defined response (40% PDSS reduction) showed significant differences at Cornell: ART 30%, CBT 65%, PFPP 71% (P = .007), but not at Penn: ART 63%, CBT 60%, PFPP 48% (P = .37). Penn patients were more symptomatic, differed demographically from Cornell patients, had a 7.2-fold greater likelihood of taking medication, and had a 28-fold greater likelihood of taking benzodiazepines. However, these differences did not explain site-by-treatment interactions. All treatments substantially improved panic disorder with or without agoraphobia, but patients, particularly the most severely ill, found ART less acceptable. CBT showed the most consistent performance across sites; however, the results for PFPP showed the promise of psychodynamic psychotherapy for this disorder. ClinicalTrials.gov identifier: NCT00353470.",Milrod B.; Chambless DL.; Gallop R.; Busch FN.; Schwalberg M.; McCarthy KS.; Gross C.; Sharpless BA.; Leon AC.; Barber JP.,2016.0,10.4088/JCP.14m09507,0,0,
9923,Contamination-Focused Exposure as a Treatment for Disgust-Based Fears: A Preliminary Test in Spider-Fearful Women.,"Disgust is thought to play a prominent role in multiple anxiety disorders and fears, including spider phobia, though little attention has been given to specific treatment strategies that may be effective for multiple disgust-based fears. In the present study, we evaluated contamination-focused exposure as a potential transdiagnostic treatment strategy for disgust-based fears in a spider fearful sample. Women with significant spider fear were randomized to three 30-minute sessions of exposure therapy involving repeated contact with a dirt mixture (n=17) or a waitlist control condition (n=17). Assessments of spider fear and disgust were administered at baseline and at one-week posttreatment. At high (but not low) levels of pretreatment disgust propensity, exposure led to lower in vivo spider fear and perceived danger than waitlist, though exposure had no effects on spider-related disgust. Similar effects of exposure on spider fear were found at high levels of pretreatment spider-related disgust. Exposure also reduced fear and danger perceptions, but not disgust, related to a separate contamination assessment (touching a toilet). No effects of treatment were found on self-report measures of spider fear or disgust propensity. These findings suggest contamination-focused exposure therapy may be an effective transdiagnostic treatment strategy for individuals with elevated disgust propensity. Limitations and directions for future research are discussed.",Cougle JR.; Summers BJ.; Harvey AM.; Dillon KH.; Allan NP.,2016.0,10.1017/S1352465816000333,0,0,
9924,One-Visit Behavioral Intervention for Older Primary Care Patients with Mild to Moderate Depressive Symptoms.,"We pilot tested a one-visit behavioral intervention with telephone follow-up for older primary care patients with mild to moderate depressive symptoms. A total of 16 English-speaking primary care patients aged 60 years and older who scored 5 to 14 on the Patient Health Questionnaire-9 (PHQ-9) engaged in the intervention visit. Outcomes were assessed at baseline and 4 weeks: activity goals, readiness to change (University of Rhode Island Change Assessment), PHQ-9, Generalized Anxiety Disorder-7, World Health Organization Disability Assessment Schedule 2.0, and satisfaction. The 14 participants who completed the study met or exceeded 73% of activity goals on average. They also improved on all outcomes (P < 0.05) with medium (University of Rhode Island Change Assessment, GAD-7) to large effect sizes (PHQ-9, World Health Organization Disability Assessment Schedule 2.0), and they were satisfied. This pilot study provided preliminary evidence that a one-visit behavioral activation intervention is acceptable and feasible and improves outcomes. If findings are confirmed, then this intervention could be integrated into existing collaborative care programs.",Gum AM.; Schonfeld L.; Tyler S.; Fishleder S.; Guerra L.,2016.0,10.14423/SMJ.0000000000000497,0,0,
9925,A Comparison of Psychoanalytic Therapy and Cognitive Behavioral Therapy for Anxiety (Panic/Agoraphobia) and Personality Disorders (APD Study): Presentation of the RCT Study Design.,"Anxiety disorders, most notably panic disorders and agoraphobia, are common mental disorders, and there is a high comorbidity with personality disorders. Randomized controlled trails addressing this highly relevant group of patients are missing. The multicenter Anxiety and Personality Disorders (APD) study investigates 200 patients with panic disorder and/or agoraphobia with comorbid personality disorder in a randomized control-group comparison of psychoanalytic therapy (PT) and cognitive behavioral therapy (CBT), including 100 patients in each group. Each patient will be examined over a period of six years, regardless of the duration of the individual treatment. The main issues that are addressed in this study are the comparison of the efficacy of PT and CBT in this special patient population, the comparison of the sustainability of the effects of PT and CBT, the comparison of the long-term cost-benefit-ratios of PT and CBT as well as the investigation of prescriptive patient characteristics for individualized treatment recommendations (differential indication). The APD study compares efficacy, sustainability, and cost-benefit-ratios of CBT and PT for anxiety plus personality disorders in a randomized controlled trail. The study design meets the requirements for an efficacy study for PT, which were recently defined. Current Controlled Trials ISRCTN12449681.",Benecke C.; Huber D.; Staats H.; Zimmermann J.; Henkel M.; Deserno H.; Wiegand-Grefe S.; Schauenburg H.,2016.0,10.13109/zptm.2016.62.3.252,0,0,
9926,Randomized Controlled Trial of a Cognitive Narrative Crisis Intervention for Bereavement in Primary Healthcare.,"As there are known risks of retraumatization through bereavement crisis interventions, we tailored a new intervention lowering the degree of direct emotional activation. However, we need some evidence on the effects of depression and psychotraumatic symptoms between 1 and 6 months after a loss. We conducted a randomized controlled trial with two groups: control group (n = 18) and experimental group (n = 11) in two assessments (1 and 6 months after loss); both included a semi-structured interview (Socio-Demographic Questionnaire, Beck Depression Inventory and the Impact of Events Scale-Revised-IES-R). The experimental group had a cognitive-narrative program with four sessions: recalling; cognitive and emotional subjectivization; metaphorization; and projecting sessions. Participants in the experimental and control groups have lower levels of depression and traumatic stress 6 months after a loss. Statistically significant results in emotional numbing IES-R sub-scale are observed. A brief narrative-based cost-effective intervention has a positive effect on depression, controlling the traumatic stress and time after a loss.",Andrade AS.; Moreira M.; S√° M.; Pacheco D.; Almeida V.; Rocha JC.,2017.0,10.1017/S1352465816000345,0,0,
9927,Serum concentrations of TNF-α and its soluble receptors during psychotherapy in German soldiers suffering from combat-related PTSD.,"Changes in serum concentrations of tumor necrosis factor-α (TNF-α) and its soluble receptors (sTNF-R) p55 and p75 have been shown to be associated with various psychiatric treatments. Before and after treatment, serum levels of TNF-α, sTNF-R p55 and sTNF-R p75 were measured in 38 German soldiers who had been deployed abroad and suffered from combat-related post-traumatic stress disorder (PTSD). Patients were randomized either to inpatient psychotherapy (N=21) including eye movement desensitization and reprocessing (EMDR) or to outpatient clinical management (N=17). Symptoms of PTSD were measured using the Post-traumatic Stress Diagnostic Scale (PDS). The PDS score significantly decreased across time in both groups. Serum concentrations of TNF-α increased, while sTNF-R p55 and sTNF-R p75 levels decreased significantly. After the treatment period, we could not detect any significant difference regarding TNF-α, sTNF-R p55 or sTNF-R p75 levels between the inpatient psychotherapy group and the outpatient clinical management control group. This relatively small clinical study suggests that specific inpatient psychotherapy but also non-specific supportive outpatient treatment for PTSD are associated with changes in the TNF-α system. This may represent an immunological effects or side effects of psychotherapy.",Himmerich H.; Willmund GD.; Zimmermann P.; Wolf JE.; Bühler AH.; Kirkby KC.; Dalton B.; Holdt LM.; Teupser D.; Wesemann U.,2016.0,,0,0,
9928,Neuropsychological Changes in Primary Hyperparathyroidism after Parathyroidectomy.,"Neuropsychiatric symptoms (NPSs) of sporadic primary hyperparathyroidism (PHPT) are often subtle and effects of parathyroidectomy (PTX) on symptoms remains poorly characterized. Our aim was to evaluate effects of PTX on NPS in patients with PHPT. A prospective questionnaire was distributed to all patients undergoing PTX and to a thyroidectomy (TX) control group. The questionnaire included the validated scales Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) to assess for depression and anxiety respectively, as well as questions modified from Pasieka's Parathyroid Assessment of Symptoms (M-PAS). Point values were assigned to questionnaire answers to create a score, with a maximum of 63. Fifty-eight patients underwent PTX (58.6%) and 41 TX (41.4%). Mean preoperative scores were greater in PTX versus TX patients in total score, PHQ-9, GAD-7, and M-PAS (all P < 0.05). Post-PTX scores were lower than pre-PTX in total score, PHQ-9, GAD-7, and M-PAS (all P < 0.05), but not in pre- and post-TX. Post-PTX 69.0 and 82.8 per cent of patients showed no symptoms of depression and anxiety, respectively, compared with 37.9 and 56.9 per cent pre-PTX. A total of 16.2 and 10.3 per cent of patients had moderately severe to severe depression and anxiety, which fell to 0 per cent post-PTX. NPSs are more common in patients with PHPT when compared with TX. Patients undergoing PTX have improvements in NPS. NPS scoring should occur in all patients with PHPT and severity of NPS should be considered a relative indication for PTX.",Liu JY.; Saunders ND.; Chen A.; Weber CJ.; Sharma J.,2016.0,,0,0,
9929,Psychometric Validation of the English and French Versions of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5).,"The purpose of this study is to assess the psychometric properties of a French version of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), a self-report measure of posttraumatic stress disorder (PTSD) symptoms, and to further validate the existing English version of the measure. Undergraduate students (n = 838 English, n = 262 French) completed the PCL-5 as well as other self-report symptom measures of PTSD and depression online. Both the English and French versions PCL-5 total scores demonstrated excellent internal consistency (English: α = .95; French: α = .94), and strong convergent and divergent validity. Strong internal consistency was also observed for each of the four subscales for each version (α's > .79). Test-retest reliability for the French version of the measure was also very good (r = .89). Confirmatory factor analysis indicated that the four-factor DSM-5 model was not a good fit of the data. The seven-factor hybrid model best fit the data in each sample, but was only marginally superior to the six-factor anhedonia model. The French version of the PCL-5 demonstrated the same psychometric qualities as both the English version of the same measure and previous versions of the PCL. Thus clinicians serving French-speaking clients now have access to this highly used screening instrument. With regards to the structural validity of the PCL-5 and of the new PTSD diagnostic structure of the DSM-5, additional research is warranted. Replication of our results in clinical samples is much needed.",Ashbaugh AR.; Houle-Johnson S.; Herbert C.; El-Hage W.; Brunet A.,2016.0,10.1371/journal.pone.0161645,0,0,
9930,The Effects of an Exercise Program on Anxiety Levels and Metabolic Functions in Patients With Anxiety Disorders.,"The purpose of this study was to evaluate the effects of a home-based (HB) exercise program on anxiety levels and metabolic functions in patients with anxiety disorders in Taiwan. Purposive sampling was used to recruit 86 participants for this randomized, experimental study. Participants were asked to complete a pretest before the 3-month exercise program, a posttest at 1 week, and a follow-up test at 3 months after the exercise program. Study measures included four Self-Report Scales and biophysical assessments to collect and assess personal data, lifestyle behaviors, anxiety levels, and metabolic control functions. Of the 86 study participants, 83 completed the posttest and the 3-month follow-up test, including 41 in the experimental group and 42 in the control group. Participants in the experimental group showed significant improvements in body mass index, high-density lipoprotein cholesterol levels, and the level of moderate exercise after the program relative to the control group, as analyzed by generalized estimating equations mixed-model repeated measures. State and trait anxiety levels were also significantly improved from pretest to follow-up test in the experimental group. Finally, the prevalence of metabolic syndrome declined for participants in the experimental group. The HB exercise program produced positive effects on the metabolic indicators and anxiety levels of Taiwanese adults with anxiety disorders. Health providers should consider using similar HB exercise programs to help improve the mental and physical health of patients with anxiety disorders in their communities.",Ma WF.; Wu PL.; Su CH.; Yang TC.,2017.0,10.1177/1099800416672581,0,0,
9931,"A Double-Blind, Randomized, Controlled Pilot Trial of N-Acetylcysteine in Veterans With Posttraumatic Stress Disorder and Substance Use Disorders.","The antioxidant N-acetylcysteine is being increasingly investigated as a therapeutic agent in the treatment of substance use disorders (SUDs). This study explored the efficacy of N-acetylcysteine in the treatment of posttraumatic stress disorder (PTSD), which frequently co-occurs with SUD and shares impaired prefrontal cortex regulation of basal ganglia circuitry, in particular at glutamate synapses in the nucleus accumbens. Veterans with PTSD and SUD per DSM-IV criteria (N = 35) were randomly assigned to receive a double-blind, 8-week course of N-acetylcysteine (2,400 mg/d) or placebo plus cognitive-behavioral therapy for SUD (between March 2013 and April 2014). Primary outcome measures included PTSD symptoms (Clinician-Administered PTSD Scale, PTSD Checklist-Military) and craving (Visual Analog Scale). Substance use and depression were also assessed. Participants treated with N-acetylcysteine compared to placebo evidenced significant improvements in PTSD symptoms, craving, and depression (β values < -0.33; P values < .05). Substance use was low for both groups, and no significant between-group differences were observed. N-acetylcysteine was well tolerated, and retention was high. This is the first randomized controlled trial to investigate N-acetylcysteine as a pharmacologic treatment for PTSD and SUD. Although preliminary, the findings provide initial support for the use of N-acetylcysteine in combination with psychotherapy among individuals with co-occurring PTSD and SUD. ClinicalTrials.gov identifier: NCT02499029.",Back SE.; McCauley JL.; Korte KJ.; Gros DF.; Leavitt V.; Gray KM.; Hamner MB.; DeSantis SM.; Malcolm R.; Brady KT.; Kalivas PW.,2016.0,10.4088/JCP.15m10239,0,0,
9932,A pragmatic randomized control trial and realist evaluation on the implementation and effectiveness of an internet application to support self-management among individuals seeking specialized mental health care: a study protocol.,"Mental illness is a substantial and rising contributor to the global burden of disease. Access to and utilization of mental health care, however, is limited by structural barriers such as specialist availability, time, out-of-pocket costs, and attitudinal barriers including stigma. Innovative solutions like virtual care are rapidly entering the health care domain. The advancement and adoption of virtual care for mental health, however, often occurs in the absence of rigorous evaluation and adequate planning for sustainability and spread. A pragmatic randomized controlled trial with a nested comparative effectiveness arm, and concurrent realist process evaluation to examine acceptability, effectiveness, and cost-effectiveness of the Big White Wall (BWW) online platform for mental health self-management and peer support among individuals aged 16 and older who are accessing mental health services in Ontario, Canada. Participants will be randomized to 3 months of BWW or treatment as usual. At the end of the 3 months, participants in the intervention group will have the opportunity to opt-in to an intervention extension arm. Those who opt-in will be randomized to receive an additional 3 months of BWW or no additional intervention. The primary outcome is recovery at 3 months as measured by the Recovery Assessment Scale-revised (RAS-r). Secondary outcomes include symptoms of depression and anxiety measured with the Personal Health Questionnaire-9 item (PHQ-9) and the Generalized Anxiety Disorder Questionnaire-7 item (GAD-7) respectively, quality of life measured with the EQ-5D-5L, and community integration assessed with the Community Integration Questionnaire. Cost-effectiveness evaluations will account for the cost of the intervention and direct health care costs. Qualitative interviews with participants and stakeholders will be conducted throughout. Understanding the impact of virtual strategies, such as BWW, on patient outcomes and experience, and health system costs is essential for informing whether and how health system decision-makers can support these strategies system-wide. This requires clear evidence of effectiveness and an understanding of how the intervention works, for whom, and under what circumstances. This study will produce such effectiveness data for BWW, while simultaneously exploring the characteristics and experiences of users for whom this and similar online interventions could be helpful. Clinicaltrials.gov NCT02896894 . Registered on 31 August 2016 (retrospectively registered).",Hensel JM.; Shaw J.; Jeffs L.; Ivers NM.; Desveaux L.; Cohen A.; Agarwal P.; Wodchis WP.; Tepper J.; Larsen D.; McGahan A.; Cram P.; Mukerji G.; Mamdani M.; Yang R.; Wong I.; Onabajo N.; Jamieson T.; Bhatia RS.,2016.0,10.1186/s12888-016-1057-5,0,0,
9933,Myocardial function at the early phase of traumatic brain injury: a prospective controlled study.,"The concept of brain-heart interaction has been described in several brain injuries. Traumatic brain injury (TBI) may also lead to cardiac dysfunction but evidences are mainly based upon experimental and clinical retrospective studies. We conducted a prospective case-control study in a level I trauma center. Twenty consecutive adult patients with severe TBI were matched according to age and gender with 20 control patients. The control group included adult patients undergoing a general anesthesia for a peripheral trauma surgery. Conventional and Speckle Tracking Echocardiography (STE) was performed within the first 24 post-traumatic hours in the TBI group and PRE/PER-operative in the control group. The primary endpoint was the left ventricle ejection fraction (LVEF) measured by the Simpson's method. Secondary endpoints included the diastolic function and the STE analysis. We found similar LVEF between the TBI group and the PER-operative control group (61 % [56-76]) vs. 62 % [52-70]). LV morphological parameters and the systolic function were also similar between the two groups. Regarding the diastolic function, the isovolumic relaxation time was significantly higher in the TBI cohort (125 s [84-178] versus 107 s [83-141], p = 0.04), suggesting a subclinical diastolic dysfunction. Using STE parameters, we observed a trend toward higher strains in the TBI group but only the apical circumferential strain and the basal rotation reached statistical significance. STE-derived parameters of the diastolic function tended to be lower in TBI patients. No systematic myocardial depression was found in a cohort of severe TBI patients. STE revealed a correct adaptation of the left systolic function, while the diastolic function slightly impaired. NCT02380482.",Cuisinier A.; Maufrais C.; Payen JF.; Nottin S.; Walther G.; Bouzat P.,2016.0,10.1186/s13049-016-0323-3,0,0,
9934,"A Novel Therapy for Chronic Sleep-Onset Insomnia: A Retrospective, Nonrandomized Controlled Study of Auto-Adjusting, Dual-Level, Positive Airway Pressure Technology.","Evidence indicates that behavioral or drug therapy may not target underlying pathophysiologic mechanisms for chronic insomnia, possibly due to previously unrecognized high rates (30%-90%) of sleep apnea in chronic insomnia patients. Although treatment studies with positive airway pressure (PAP) demonstrate decreased severity of chronic sleep maintenance insomnia in patients with co-occurring sleep apnea, sleep-onset insomnia has not shown similar results. We hypothesized advanced PAP technology would be associated with decreased sleep-onset insomnia severity in a sample of predominantly psychiatric patients with comorbid sleep apnea. We reviewed charts of 74 severe sleep-onset insomnia patients seen from March 2011 to August 2015, all meeting American Academy of Sleep Medicine Work Group criteria for a chronic insomnia disorder and all affirming behavioral and psychological origins for insomnia (averaging 10 of 18 indicators/patient), as well as averaging 2 or more psychiatric symptoms or conditions: depression (65.2%), anxiety (41.9%), traumatic exposure (35.1%), claustrophobia (29.7%), panic attacks (28.4%), and posttraumatic stress disorder (20.3%). All patients failed continuous or bilevel PAP and were manually titrated with auto-adjusting PAP modes (auto-bilevel and adaptive-servo ventilation). At 1-year follow-up, patients were compared through nonrandom assignment on the basis of a PAP compliance metric of > 20 h/wk (56 PAP users) versus < 20 h/wk (18 partial PAP users). PAP users showed significantly greater decreases in global insomnia severity (Hedges' g = 1.72) and sleep-onset insomnia (g = 2.07) compared to partial users (g = 1.04 and 0.91, respectively). Both global and sleep-onset insomnia severity decreased below moderate levels in PAP users compared to partial users whose outcomes persisted at moderately severe levels. In a nonrandomized controlled retrospective study, advanced PAP technology (both auto-bilevel and adaptive servo-ventilation) were associated with large decreases in insomnia severity for sleep-onset insomnia patients who strongly believed psychological factors caused their sleeplessness. PAP treatment of sleep-onset insomnia merits further investigation.",Krakow B.; Ulibarri VA.; McIver ND.; Nadorff MR.,2016.0,10.4088/PCC.16m01980,0,0,
9935,Feasibility trial of a scalable psychological intervention for women affected by urban adversity and gender-based violence in Nairobi.,"Living in conditions of chronic adversity renders many women more vulnerable to experiencing gender-based violence (GBV). In addition to GBV's physical and social consequences, the psychological effects can be pervasive. Access to evidence-based psychological interventions that seek to support the mental health of women affected by such adversity is rare in low- and middle-income countries. The current study evaluates a brief evidence-informed psychological intervention developed by the World Health Organization for adults impacted by adversity (Problem Management Plus; PM+). A feasibility randomised control trial (RCT) was conducted to inform a fully powered trial. Community health workers delivered the intervention to 70 women residing in three peri-urban settings in Nairobi, Kenya. Women, among whom 80% were survivors of GBV (N = 56), were randomised to receive five sessions of either PM+ (n = 35) by community health workers or enhanced treatment as usual (ETAU; n = 35). PM+ was not associated with any adverse events. Although the study was not powered to identify effects and accordingly did not identify effects on the primary outcome measure of general psychological distress, women survivors of adversity, including GBV, who received PM+ displayed greater reductions in posttraumatic stress disorder symptoms following treatment than those receiving ETAU. This feasibility study suggests that PM+ delivered by lay health workers is an acceptable and safe intervention to reach women experiencing common mental disorders and be inclusive for those affected by GBV and can be studied in a RCT in this setting. The study sets the stage for a fully powered, definitive controlled trial to assess this potentially effective intervention. ACTRN12614001291673 , 10/12/2014, retrospectively registered during the recruitment phase.",Dawson KS.; Schafer A.; Anjuri D.; Ndogoni L.; Musyoki C.; Sijbrandij M.; van Ommeren M.; Bryant RA.,2016.0,10.1186/s12888-016-1117-x,0,0,
9936,Predicting post-traumatic stress disorder treatment response in refugees: Multilevel analysis.,"Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of which are largely unknown. This study aimed at improving PTSD treatment for adult refugees by identifying PTSD treatment response predictors. A prospective longitudinal multilevel modelling design was used to predict PTSD severity scores over time. We analysed data from a randomized controlled trial with pre-, post-, and follow-up measurements of the safety and efficacy of eye movement desensitization and reprocessing and stabilization in asylum seekers and refugees suffering from PTSD. Lack of refugee status, comorbid depression, demographic, trauma-related and treatment-related variables were analysed as potential predictors of PTSD treatment outcome. Treatment outcome data from 72 participants were used. The presence (B = 6.5, p = .03) and severity (B = 6.3, p < .01) of a pre-treatment depressive disorder predicted poor treatment response and explained 39% of the variance between individuals. Refugee patients who suffer from PTSD and severe comorbid depression benefit less from treatment aimed at alleviating PTSD. Results highlight the need for treatment adaptations for PTSD and comorbid severe depression in traumatized refugees, including testing whether initial targeting of severe depressive symptoms increases PTSD treatment effectiveness. There are differences in post-traumatic stress disorder (PTSD) treatment response between traumatized refugees. Comorbid depressive disorder and depression severity predict poor PTSD response. Refugees with PTSD and severe depression may not benefit from PTSD treatment. Targeting comorbid severe depression before PTSD treatment is warranted. This study did not correct for multiple hypothesis testing. Comorbid depression may differentially impact alternative PTSD treatments.",Haagen JF.; Ter Heide FJ.; Mooren TM.; Knipscheer JW.; Kleber RJ.,2017.0,10.1111/bjc.12121,0,0,
9937,Sexual Problems Predict PTSD and Depression Symptom Change Among Male OEF/OIF Veterans Completing Exposure Therapy.,"A growing literature documents frequent sexual problems among Operations Enduring/Iraqi Freedom (OEF/OIF) veterans with post-traumatic stress disorder (PTSD). However, there has been no examination of how (1) sexual problems may be affected by evidenced-based psychotherapy for PTSD or (2) how the presence of sexual problems might impact effectiveness of evidenced-based psychotherapy for PTSD. As such, the present study investigated associations among symptoms of PTSD, depression, and problems with sexual desire and arousal among 45 male OEF/OIF veterans receiving behavioral activation and therapeutic exposure (BA-TE), an evidence-based behavior therapy targeting co-occurring symptoms of PTSD and depression. Participants completed clinical interviews and several questionnaires including measures of sexual arousal, sexual desire, PTSD symptoms, and depression symptoms at baseline and after completion of 8 sessions of BA-TE treatment. A records review was also conducted to assess for relevant medication use. Overall, sexual desire and sexual arousal problems did not improve during the course of treatment. Moreover, veterans with co-occurring sexual problems at baseline evidenced significantly less improvement in symptoms of PTSD and depression across treatment as compared to veterans without sexual problems. These findings suggest that veterans with co-occurring symptoms of PTSD and sexual problems may require additional assessment and treatment considerations in order to improve their treatment outcomes for both primary psychiatric symptoms as well as sexual problems. Future research on combination treatments of medication for sexual problems and psychotherapy for PTSD is needed.",Badour CL.; Gros DF.; Szafranski DD.; Acierno R.,2016.0,10.1080/00332747.2016.1142774,0,0,
9938,A Randomized Trial of Collaborative Care for Perinatal Depression in Socioeconomically Disadvantaged Women: The Impact of Comorbid Posttraumatic Stress Disorder.,"The comorbidity of posttraumatic stress disorder (PTSD) with antenatal depression poses increased risks for postpartum depression and may delay or diminish response to evidence-based depression care. In a secondary analysis of an 18-month study of collaborative care for perinatal depression, the authors hypothesized that pregnant, depressed, socioeconomically disadvantaged women with comorbid PTSD would show more improvement in the MOMCare intervention providing Brief Interpersonal Psychotherapy and/or antidepressants, compared to intensive public health Maternity Support Services (MSS-Plus). A multisite randomized controlled trial with blinded outcome assessment was conducted in the Seattle-King County Public Health System, July 2009-January 2014. Pregnant women were recruited who met criteria for a probable diagnosis of major depressive disorder (MDD) on the Patient Health Questionnaire-9 and/or dysthymia on the MINI-International Neuropsychiatric Interview (5.0.0). The primary outcome was depression severity at 3-, 6-, 12-and 18-month follow-ups; secondary outcomes included functional improvement, PTSD severity, depression response and remission, and quality of depression care. Sixty-five percent of the sample of 164 met criteria for probable comorbid PTSD. The treatment effect was significantly associated with PTSD status in a group-by-PTSD severity interaction, controlling for baseline depression severity (Wald χ²₁ = 4.52, P = .03). Over the 18-month follow-up, those with comorbid PTSD in MOMCare (n = 48), versus MSS-Plus (n = 58), showed greater improvement in depression severity (Wald χ²₁ = 8.51, P < .004), PTSD severity (Wald χ²₁ = 5.55, P < .02), and functioning (Wald χ²₁ = 4.40, P < .04); higher rates of depression response (Wald χ²₁ = 4.13, P < .04) and remission (Wald χ²₁ = 5.17, P < .02); and increased use of mental health services (Wald χ²₁ = 39.87, P < .0001) and antidepressant medication (Wald χ²₁ = 8.07, P < .005). Participants without comorbid PTSD in MOMCare (n = 33) and MSS-Plus (n = 25) showed equivalent improvement on these outcomes. Collaborative depression care had a greater impact on perinatal depressive outcomes for socioeconomically disadvantaged women with comorbid PTSD than for those without PTSD. Findings suggest that a stepped care treatment model for high-risk pregnant women with both MDD and PTSD could be integrated into public health systems in the United States. ClinicalTrials.gov identifier: NCT01045655.",Grote NK.; Katon WJ.; Russo JE.; Lohr MJ.; Curran M.; Galvin E.; Carson K.,2016.0,10.4088/JCP.15m10477,0,0,
9939,Feasibility of Training Frontline Therapists in Prolonged Exposure: A Randomized Controlled Pilot Study of Treatment of Complex Trauma in Diverse Victims of Crime and Violence.,"The study aims were to determine whether prolonged exposure (PE) improved mental health and was feasible to implement by frontline clinicians in a culturally diverse sample with complex trauma. Seventy-one individuals were randomly assigned to PE or person-centered therapy (PCT). Outcome measures were administered at baseline and sessions 3, 6, 9, and 12. Mixed modeling was used to regress outcome measures on time, treatment group, and number of visits. Individuals who received PE showed significant moderate association with decline in reported posttraumatic stress disorder (PTSD) symptoms as noted by the PTSD Checklist for DSM-5 (p = 0.05) compared with PCT. Results indicated improved scores on all measures at each follow-up time point compared with baseline (p ≤ 0.01). PE was feasible, shown by positive recruitment and ability of clinicians to effectively implement and maintain treatment fidelity. Findings suggest that PE can be effective for treating complex trauma when used by clinicians in community settings.",Ghafoori B.; Hansen MC.; Garibay E.; Korosteleva O.,2017.0,10.1097/NMD.0000000000000659,0,0,
9940,Effect of a condolence letter on grief symptoms among relatives of patients who died in the ICU: a randomized clinical trial.,"Family members of patients who die in the intensive care unit (ICU) may experience symptoms of stress, anxiety, depression, posttraumatic stress disorder (PTSD), and/or prolonged grief. We evaluated whether grief symptoms were alleviated if the physician and the nurse in charge at the time of death sent the closest relative a handwritten condolence letter. Multicenter randomized trial conducted among 242 relatives of patients who died at 22 ICUs in France between December 2014 and October 2015. Relatives were randomly assigned to receiving (n = 123) or not receiving (n = 119) a condolence letter. The primary endpoint was the Hospital Anxiety and Depression Score (HADS) at 1 month. Secondary endpoints included HADS, complicated grief (ICG), and PTSD-related symptoms (IES-R) at 6 months. Observers were blinded to group allocation. At 1 month, 208 (85.9%) relatives completed the HADS; median score was 16 [IQR, 10-22] with and 14 [8-21.5] without the letter (P = 0.36). Although scores were higher in the intervention group, there were no significant differences regarding the HADS-depression subscale (8 [4-12] vs. 6 [2-12], mean difference 1.1 [-0.5 to 2.6]; P = 0.09) and prevalence of depression symptoms (56.0 vs. 42.4%, RR 0.76 [0.57-1.00]; P = 0.05). At 6 months, 190 (78.5%) relatives were interviewed. The intervention significantly increased the HADS (13 [7-19] vs. 10 [4-17.5], P = 0.04), HADS-depression subscale (6 [2-10] vs. 3 [1-9], P = 0.02), prevalence of depression symptoms (36.6 vs. 24.7%, P = 0.05) and PTSD-related symptoms (52.4 vs. 37.1%, P = 0.03). In relatives of patients who died in the ICU, a condolence letter failed to alleviate grief symptoms and may have worsened depression and PTSD-related symptoms. Trial registration Clinicaltrials.gov Identifier: NCT02325297.",Kentish-Barnes N.; Chevret S.; Champigneulle B.; Thirion M.; Souppart V.; Gilbert M.; Lesieur O.; Renault A.; Garrouste-Orgeas M.; Argaud L.; Venot M.; Demoule A.; Guisset O.; Vinatier I.; Troché G.; Massot J.; Jaber S.; Bornstain C.; Gaday V.; Robert R.; Rigaud JP.; Cinotti R.; Adda M.; Thomas F.; Calvet L.; Galon M.; Cohen-Solal Z.; Cariou A.; Azoulay E.;  .,2017.0,10.1007/s00134-016-4669-9,0,0,
9941,"A Randomized, Head-to-Head Study of Virtual Reality Exposure Therapy for Posttraumatic Stress Disorder.","Virtual reality exposure therapy (VRET) is one of the few interventions supported by randomized controlled trials for the treatment of combat-related posttraumatic stress disorder (PTSD) in active duty service members. A comparative effectiveness study was conducted to determine if virtual reality technology itself improved outcomes, or if similar results could be achieved with a control exposure therapy (CET) condition. Service members with combat-related PTSD were randomly selected to receive nine weeks of VRET or CET. Assessors, but not therapists, were blinded. PTSD symptom improvement was assessed one week and 3 months after the conclusion of treatment using the clinician-administered PTSD scale (CAPS). A small crossover component was included. Results demonstrated that PTSD symptoms improved with both treatments, but there were no statistically significant differences between groups. Dropout rates were higher in VRET. Of those who received VRET, 13/42 (31%) showed >30% improvement on the CAPS, versus 16/43 (37%) who received CET. Three months after treatment, >30% improvement was seen in 10/33 (30%) of VRET participants and 12/33 (36%) in CET. Participants who crossed over (n‚Äâ=‚Äâ11) showed no statistically significant improvements in a second round of treatment, regardless of condition. This study supported the utility of exposure therapy for PTSD, but did not support additional benefit by the inclusion of virtual reality.",McLay RN.; Baird A.; Webb-Murphy J.; Deal W.; Tran L.; Anson H.; Klam W.; Johnston S.,2017.0,10.1089/cyber.2016.0554,0,0,
9942,The effects of implementing a point-of-care electronic template to prompt routine anxiety and depression screening in patients consulting for osteoarthritis (the Primary Care Osteoarthritis Trial): A cluster randomised trial in primary care.,"This study aimed to evaluate whether prompting general practitioners (GPs) to routinely assess and manage anxiety and depression in patients consulting with osteoarthritis (OA) improves pain outcomes. We conducted a cluster randomised controlled trial involving 45 English general practices. In intervention practices, patients aged ‚â•45 y consulting with OA received point-of-care anxiety and depression screening by the GP, prompted by an automated electronic template comprising five questions (a two-item Patient Health Questionnaire-2 for depression, a two-item Generalized Anxiety Disorder-2 questionnaire for anxiety, and a question about current pain intensity [0-10 numerical rating scale]). The template signposted GPs to follow National Institute for Health and Care Excellence clinical guidelines for anxiety, depression, and OA and was supported by a brief training package. The template in control practices prompted GPs to ask the pain intensity question only. The primary outcome was patient-reported current pain intensity post-consultation and at 3-, 6-, and 12-mo follow-up. Secondary outcomes included pain-related disability, anxiety, depression, and general health. During the trial period, 7,279 patients aged ‚â•45 y consulted with a relevant OA-related code, and 4,240 patients were deemed potentially eligible by participating GPs. Templates were completed for 2,042 patients (1,339 [31.6%] in the control arm and 703 [23.1%] in the intervention arm). Of these 2,042 patients, 1,412 returned questionnaires (501 [71.3%] from 20 intervention practices, 911 [68.0%] from 24 control practices). Follow-up rates were similar in both arms, totalling 1,093 (77.4%) at 3 mo, 1,064 (75.4%) at 6 mo, and 1,017 (72.0%) at 12 mo. For the primary endpoint, multilevel modelling yielded significantly higher average pain intensity across follow-up to 12 mo in the intervention group than the control group (adjusted mean difference 0.31; 95% CI 0.04, 0.59). Secondary outcomes were consistent with the primary outcome measure in reflecting better outcomes as a whole for the control group than the intervention group. Anxiety and depression scores did not reduce following the intervention. The main limitations of this study are two potential sources of bias: an imbalance in cluster size (mean practice size 7,397 [intervention] versus 5,850 [control]) and a difference in the proportion of patients for whom the GP deactivated the template (33.6% [intervention] versus 27.8% [control]). In this study, we observed no beneficial effect on pain outcomes of prompting GPs to routinely screen for and manage comorbid anxiety and depression in patients presenting with symptoms due to OA, with those in the intervention group reporting statistically significantly higher average pain scores over the four follow-up time points than those in the control group. ISRCTN registry ISRCTN40721988.",Mallen CD.; Nicholl BI.; Lewis M.; Bartlam B.; Green D.; Jowett S.; Kigozi J.; Belcher J.; Clarkson K.; Lingard Z.; Pope C.; Chew-Graham CA.; Croft P.; Hay EM.; Peat G.,2017.0,10.1371/journal.pmed.1002273,0,0,
9943,"Intensive Short-Term Dynamic Psychotherapy Trial Therapy: Effectiveness and Role of ""Unlocking the Unconscious"".","This study examined the effects of trial therapy interviews using intensive short-term dynamic psychotherapy with 500 mixed sample, tertiary center patients. Furthermore, we investigated whether the effect of trial therapy was larger for patients who had a major unlocking of the unconscious during the interview compared with those who did not. Outcome measures were the Brief Symptom Inventory (BSI) and the Inventory of Interpersonal Problems (IIP), measured at baseline and at 1-month follow-up. Significant outcome effects were observed for both the BSI and the IIP with small to moderate preeffect/posteffect sizes, Cohen's d = 0.52 and 0.23, respectively. Treatment effects were greater in patients who had a major unlocking of the unconscious compared with those who did not. The trial therapy interview appears to be beneficial, and its effects may relate to certain therapeutic processes. Further controlled research is warranted.",Abbass A.; Town J.; Ogrodniczuk J.; Joffres M.; Lilliengren P.,2017.0,10.1097/NMD.0000000000000684,0,0,
9944,Chemotherapy and Post-traumatic Stress in the Causation of Cognitive Dysfunction in Breast Cancer Patients.,"Cancer-related cognitive dysfunction has mostly been attributed to chemotherapy; this explanation, however, fails to account for cognitive dysfunction observed in chemotherapy-naïve patients. In a controlled, longitudinal, multisite study, we tested the hypothesis that cognitive function in breast cancer patients is affected by cancer-related post-traumatic stress. Newly diagnosed breast cancer patients and healthy control subjects, age 65 or younger, underwent three assessments within one year, including paper-and-pencil and computerized neuropsychological tests, clinical diagnostics of post-traumatic stress disorder (PTSD), and self-reported cognitive function. Analysis of variance was used to compare three groups of participants-patients who did or did not receive chemotherapy and healthy control subjects-on age- and education-corrected cognitive performance and cognitive change. Differences that were statistically significant after correction for false discovery rate were investigated with linear mixed-effects models and mediation models. All statistical tests were two-sided. Of 226 participants (166 patients and 60 control subjects), 206 completed all assessment sessions (attrition: 8.8%). Patients demonstrated overall cognitive decline (group*time effect on composite z -score: -0.13, P = .04) and scored consistently worse on Go/Nogo errors. The latter effect was mediated by PTSD symptoms (mediation effect: B = 0.15, 95% confidence interval = 0.02 to 0.38). Only chemotherapy patients showed declined reaction time on a computerized alertness test. Overall cognitive performance correlated with self-reported cognitive problems at one year ( T = -0.11, P = .02). Largely irrespective of chemotherapy, breast cancer patients may encounter very subtle cognitive dysfunction, part of which is mediated by cancer-related post-traumatic stress. Further factors other than treatment side effects remain to be investigated.",Hermelink K.; Bühner M.; Sckopke P.; Neufeld F.; Kaste J.; Voigt V.; Münzel K.; Wuerstlein R.; Ditsch N.; Hellerhoff K.; Rjosk-Dendorfer D.; Braun M.; von Koch FE.; Härtl K.; Hasmüller S.; Bauerfeind I.; Debus G.; Herschbach P.; Mahner S.; Harbeck N.,2017.0,10.1093/jnci/djx057,0,0,
9945,Some effects of chlordiazepoxide and meprobamate with psychiatric outpatients.,,McNair DM.; Goldstein AP.; Lorr M.; Cibelli LA.; Roth I.,1965.0,,0,0,
9946,A correlational comparison of the Wolpe-Lang fear survey schedule and Taylor manifest anxiety scale.,,Grossberg JM.; Wilson HK.,1965.0,,0,0,
9947,Studies of the I.P.A.T. neuroticism scale questionnaire (NSQ).,,Kear-Colwell JJ.,1965.0,,0,0,
9948,Differences in intermediary metabolism in mental illness.,,Atson G.,1965.0,10.2466/pr0.1965.17.2.563,0,0,
9949,Brief-contact therapy and drugs in outpatient treatment.,,Koegler RR.,1966.0,,0,0,
9950,[Dixyrazine (Esucos) in the treatment of anxiety neuroses].,,Hakola ML.; Hakola P.,1966.0,,0,0,
9951,[Diagnosis of neurocirculatory dystonia and the initial stage of hypertension].,,Nakhapetov BA.,1966.0,,0,0,
9952,Response bias in the semantic differential.,,Arthur AZ.,1966.0,,0,0,
9953,Reduction in symptomatology in ambulatory patients. The combined effects of a tranquilizer and psychotherapy.,,Jacobs MA.; Globus G.; Heim E.,1966.0,,0,0,
9954,The role of relaxation in systematic desensitization.,,Lomont JF.; Edwards JE.,1967.0,,0,0,
9955,Extraversion and the self-description of endurance.,,Farley FH.,1968.0,,0,0,
9956,[Indomethacin and psychic changes].,,Naess K.,1968.0,,0,0,
9957,"Implosive, eclectic verbal and bibliotherapy in the treatment of fears of snakes.",,Hogan RA.; Kirchner JH.,1968.0,,0,0,
9958,Systematic desensitization: distribution of practice and symptom substitution.,,Lanyon RI.; Manosevitz M.; Imber RR.,1968.0,,0,0,
9959,Verbal conditioning as a measure of interpersonal influence in psychiatric interviews.,,Gelder MG.,1968.0,,0,0,
9960,[Current research trends in clinical psychiatry].,,Mentzos S.,1968.0,,0,0,
9961,Hypnosis and desinsitization for Phobias: a controlled prospective trial.,,Marks IM.; Gelder MG.; Edwards G.,1968.0,,0,0,
9962,"Psychological factors, operative procedures, and results of surgery for duodenal ulcer.",,Glen AI.; Cox AG.,1968.0,,0,0,
9963,Controlled trials in behaviour therapy.,,Marks IM.; Gelder MG.,1969.0,,0,0,
9964,The EPI and scales of rigidity and dogmatism.,,Drakeford GC.,1969.0,,0,0,
9965,The generalization of anxiety reduction following systematic desensitization of snake anxiety.,,Cotler SB.; Garlington WK.,1969.0,,0,0,
9966,Psycho-physiological investigations of brief relaxation training.,,Mathews AM.; Gelder MG.,1969.0,,0,0,
9967,The transfer gap in systematic desensitization: an analogue study.,,Barlow DH.; Leitenberg H.; Agras WS.; Wincze JP.,1969.0,,0,0,
9968,Client-therapist relationship factor in systematic desensitization.,,Krapfl JE.; Nawas MM.,1969.0,,0,0,
9969,An experimental investigation of the implosion technique.,,Hodgson RJ.; Rachman S.,1970.0,,0,0,
9970,"Effects of systematic desensitization, programmed fantasy and bibliotherapy on a specific fear.",,Crowder JE.; Thornton DW.,1970.0,,0,0,
9971,The use of modeling to increase independent behavior.,,Goldstein AP.; Martens J.; Hubben J.; van Belle HA.; Schaaf W.; Wiersma H.; Goedhart A.,1973.0,,0,0,
9972,Systematic versus semantic desensitization and implosive therapy: a comparative study.,,Hekmat H.,1973.0,,0,0,
9973,[The orthostatic test in neurocirculatory asthenia].,,Mann A.; Wintner I.; Kellermann JJ.,1973.0,,0,0,
9974,Boundary conditions of false heart-rate feedback effects on avoidance behavior: a resolution of discrepant results.,,Borkovec TD.; Glasgow RE.,1973.0,,0,0,
9975,Hostility and neuroticism among unselected essential hypertensives.,,Cochrane R.,1973.0,,0,0,
9976,Electrosleep therapy. A controlled double blind study.,,Feighner JP.; Brown SL.; Olivier JE.,1973.0,,0,0,
9977,Generalization of extinction effects in fear scene hierarchies.,,Grossberg JM.,1973.0,,0,0,
9978,"Outcome effects of receiving a preferred, randomly assigned, or nonpreferred therapy.",,Devine DA.; Fernald PS.,1973.0,,0,0,
9979,The role of attention-placebo influences in the efficacy of systematic desensitization.,,McReynolds WT.; Barnes AR.; Brooks S.; Rehagen NJ.,1973.0,,0,0,
9980,Semi-automated desensitization as a treatment for genuinely fearful subjects.,,McGlynn FD.; Williamson LM.; Davis DJ.,1973.0,,0,0,
9981,The managment of severe agoraphobia: a comparison of iproniazid and systematic desensitization.,,Lipsedge MS.; Hajioff J.; Huggins P.; Napier L.; Pearce J.; Pike DJ.; Rich M.,1973.0,,0,0,
9982,Phenelzine in phobic states.,,Kelly D.,1973.0,,0,0,
9983,Dimensions of personality and meaning in self-ratings of personality.,,Gray JE.,1973.0,,0,0,
9984,Arousal levels and attribution effects in diazepam-assisted flooding.,,Johnston D.; Gath D.,1973.0,,0,0,
9985,Emotional arousal and persuasion effects in flooding.,,Mathews A.; Shaw P.,1973.0,,0,0,
9986,Semi-automated desensitization: a controlled clinical trial.,,Evans PD.; Kellam AM.,1973.0,,0,0,
9987,Skin conductance responses to real and imagined snakes among avoidant and non-avoidant college students.,,McGlynn FD.; Puhr JJ.; Gaynor R.; Perry JW.,1973.0,,0,0,
9988,Serpent versus surrogate and other determinants of runway fear differences.,,Feist JR.; Rosenthal TL.,1973.0,,0,0,
9989,A comparison of systematic desensitization and reinforced practice procedures in fear reduction.,,Hamilton M.; Schroeder HE.,1973.0,,0,0,
9990,Role of expectancy manipulation in systematic desensitization.,,Brown HA.,1973.0,,0,0,
9991,Ego function assessment of analytic psychotherapy combined with drug therapy.,,Bellak L.; Chassan JB.; Gediman HK.; Hurvich M.,1973.0,,0,0,
9992,The therapeutic effect of short-term oral diazepam treatment on acute clinical anxiety in a crisis centre.,,Dasberg H.; van Praag HM.,1974.0,,0,0,
9993,Are neurotic patients in psychotropic drug trials representative? A comparison of study and non-study patients in four family practices.,,Hesbacher P.; Rickels K.; Clark EL.; Perloff MM.; Rosenfeld H.,1974.0,,0,0,
9994,The modification of personality and Lie scale scores by special 'honesty' instructions.,,Eysenck SB.; Eysenck HJ.; Shaw L.,1974.0,,0,0,
9995,Effects of a therapeutic modeling film on cognitive and emotional components of anxiety.,,Morris LW.; Spiegler MD.; Liebert RM.,1974.0,,0,0,
9996,Therapist warmth as a factor in automated systematic desensitization.,,Morris RJ.; Suckerman KR.,1974.0,,0,0,
9997,"Drive level, incentive conditions and systematic densensitization.",,Kass W.; Gilner FH.,1974.0,,0,0,
9998,The effects of pulse ECT in neurotic and endogenous depression.,,Carney MW.; Sheffield BF.,1974.0,,0,0,
9999,The use of the weight discrimination test in a psychiatric setting.,,Langlois J.,1974.0,,0,0,
10000,A collaborative research model in family practice.,,Hesbacher P.; Rickels K.; Zamostien B.; Perloff M.; Jenkins W.,1974.0,,0,0,
10001,"Transfer, behavioral improvement, and anxiety reduction in systematic desensitization.",,Kennedy TD.; Kimura HK.,1974.0,,0,0,
10002,Therapeutic components of psychotherapy. A 25-year progress report of research.,,Frank JD.,1974.0,,0,0,
10003,Manipulation of avoidance behavior as a function of increased or decreased demand on repeated behavioral tests.,,Bernstein DA.,1974.0,,0,0,
10004,Susceptibility to the acquisition of a conditioned response in relation to the menstrual cycle.,,Asso D.; Beech HR.,1975.0,,0,0,
10005,A double-blind study of electrosleep for anxiety and insomnia.,"Despite largely negative findings, several subjects reported a remarkable improvement in their symptoms some two to three weeks after electrosleep (ES) treatment was concluded, so that it remains unclear whether or not ES may be an effective treatment. The clinical experience reported suggests that five half-hour ES treatments may not be sufficient to produce significant changes in the patient's anxiety and insomnia. Further investigations are required to examine the effects of varying durations of treatment.",Moore JA.; Mellor CS.; Standage KF.; Strong H.,1975.0,,0,0,
10006,Pharmacotherapy and psychotherapy: paradoxes problems and progress. Formulated by the Committee on Research.,,,1975.0,,0,0,
10007,Brief hospitalization of patients with families: initial results.,"A total of 175 newly admitted inpatients who lived with families were randomly assigned to three treatment groups: standard inpatient care (discharge at the therapist's discretion), brief hospitalization (one week or less) with transitional day care available, and brief hospitalization without day care. Outpatient aftercare was offered to all patients. The three groups showed no significant differences as to amount of improvement in levels of psychopathology at 3 and 12 weeks, but the briefly hospitalized patients were able to resume their vocational roles sooner. There were no significant differences among the groups in readmission rates.",Herz MI.; Endicott J.; Spitzer RL.,1975.0,10.1176/ajp.132.4.413,0,0,
10008,Eye movements during REM sleep: the influence of personality and presleep conditions.,"Male subjects scoring high (n=17) or low (n=14) on the Maudsley Neuroticism scale were randomly assigned to a positive (n=17) or negative (ego threat) (n=14) presleep condition and then slept a single night in the laboratory. The negative condition elicited significantly more rapid eye movement activity (REM density) than did the positive condition (pless than.03). There was a significant interaction for Groups X Conditions (pless than.007) indicating that low neuroticism subjects had greater REM density in the negative condition, and less REM density in the positive condition, compared to high neuroticism subjects under either condition. The low neuroticism subjects in the negative condition showed a discrepancy between greater REM density but less admission of stress on a presleep mood questionnaire compared to high neuroticism subjects. These results support the hypothesis that REM density is a correlate of stress-induced arousal that is subject to the modifying effects of individual differences.",Cohen DB.,1975.0,,0,0,
10009,[Prognosis of neurotic patients under ambulatory care].,"The prognosis of neurotic patients followed on a outpatient service was determined by calculation of probabilities of ""improvement"", ""worsening"" or ""lack of changes"" on successive examinations. These criteria were established for evaluation of 157 patients, 20 to 59 years old, who entered the study during a 12 month observation period.",Moreira da Silva L.; Moreira da Silva L.,1975.0,,0,0,
10010,Short vs long hospitalization. A controlled study: III. Inpatient results for nonschizophrenics.,"A controlled, prospective, two-year follow-up study examined the relative effectiveness of short-term vs long-term psychiatric hospitalization. Results of the inpatient phase for a sample of 74 nonschizophrenic patients are reported here. About four weeks after admission the patients hospitalized for a short stay were discharged, and at that time were functioning better than the patients in the long-stay group. When the patients hospitalized for a long stay were discharged, three to fur months after admission, they were then functioning as well as, but not noticeably better than, the patients in the short-stay group had been at their earlier time of discharge. Patients with affective disorders were more impaired at admission and improved more than patients with other diagnoses, regardless of length of stay.",Glick ID.; Hargreaves WA.; Drues J.; Showstack JA.,1976.0,,0,0,
10011,"Exposure in vivo of agoraphobics: contributions of diazepam, group exposure, and anxiety evocation.","Fifty-seven chronic agoraphobic outpatients were treated by 12 hours of exposure in vivo on four days over two weeks to check the effects of oral diazepam versus placebo during group exposure, group versus individual exposure, and high versus medium anxiety arousal during individual exposure. The controlled parallel design allowed comparative evaluation of each treatment condition to six months follow-up. Assessment was blind with respect to drug and psychological treatment. Patients in all treatment conditions improved significantly in phobias and in related life areas. Outcome to group exposure on phobias and other measures was similar in all three drug conditions (placebo, waning diazepam, peak diazepam) with no significant differences between them. Diazepam patients had significantly less discomfort than placebo patients during group exposure treatment. Group exposure patients improved slightly but significantly more than individual exposure patients on non-phobic measures, though group exposure was accompanied by more panics during treatment yet was easier to run by the therapist. Individual exposure under high anxiety arousal was no more therapeutic than with lower anxiety. Diazepam is a mild palliative during group exposure but does not facilitate outcome to treatment. Group exposure in vivo is mildly facilitatory for outcome compared with individual exposure. Anxiety evocation during treatment was not therapeutically helpful.",Hafner J.; Marks I.,1976.0,,0,0,
10012,Clomipramine (Anafranil) and behaviour therapy in obsessive-compulsive and phobic disorders.,"In a comparative study of three treatment regimens in patients with obsessive-compulsive or phobic manifestations, the most favourable therapeutic findings were seen in the clomipramine (Anafranil, Geigy Pharmaceuticals) plus behaviour therapy group and the least favourable therapeutic findings in the clomipramine plus simulated behaviour therapy group. The findings that a combination of behaviour therapy and clomipramine results in more favourable therapeutic changes than either of the two treatments alone is in line with reported studies in the literature.",Amin MM.; Ban TA.; Pecknold JC.; Klingner A.,1977.0,,0,0,
10013,[Hypnosis against dental phobias].,,Kevesäter R.,1977.0,,0,0,
10014,Short vs long hospitalization: a prospective controlled study. VII. Two-year follow-up results for nonschizophrenics.,"A controlled, prospective study examined the relative effectiveness of short-term versus long-term psychiatric hospitalization. Results of a two-year follow-up of a sample of 74 nonschizophrenic subjects are reported here. Two years after admission there were no statistically reliable differences in functioning between short-term and long-term subjects with diagnoses of either affective disorders, or neurosis and personality disorders (including hysterical personality disorder). The findings reported do not support extended hospitalization for patients with these diagnoses. Caution regarding these findings is suggested by an anecdotal impression that short-term hospitalization may not have allowed for proper diagnosis and treatment for some persons in the affective disorder group.",Glick ID.; Hargreaves WA.; Drues J.; Showstack JA.; Katzow JJ.,1977.0,,0,0,
10015,[Relationship between obsessive and depressive syndromes; therapeutic implications].,,Garralda Hualde NE.,,,0,0,
10016,Self-directed contact desensitization.,,Moss MK.; Arend RA.,1977.0,,0,0,
10017,Contribution of pretesting to several measures of semantic desensitization effectiveness.,,Israel AC.; Becker RE.; Neilans TH.,1977.0,,0,0,
10018,[A comparative study on the therapeutic results between respiratory feedback (RFB) and a placebo treatment].,"In a controlled study 24 patients with neurotic and psychosomatic symptoms were treated with Respiratory Feedback (RFB) in 12 consecutive sessions. The observed changes were compared with the results of a control group. Its members were subjected to a nonsystematic treatment causing them to relax (placebo-group). In this group the physical symptoms of three quarters of the patients changed for the worse whereas significant psychic changes were not observed. In the RFB-group, however, significant improvements were to be found in regard to the physical as well as the psychic condition of the patients. The most distictive changes were reduction in the disposition to exhaustion, a decrease of the vegetative symptoms, and a decline of the compleints about heart trouble, poor circulation and pains in parts of the stomach and intestinal system. Psychologically a distinct reduction of fear, neuroticism, increased extraversion scores and a positive change of mood followed. It is being discussed if the observed changes in the RFB-group can be attributed to specific effects of the Respiratory-Feedback (RFB).",Jung F.; Klapsing-Hessenbruch A.,,,0,0,
10019,Responses given by A and B quasi-therapists to differing sexual roles in an intropunitive-neurotic prototype: an analogue study.,"Twenty-four male undergraduate students were selected on the basis of their A--B status. Six Ss of each type were assigned randomly to one of two videotaped stimulus conditions, an adequate or an inadequate sexual role variant of an intropunitive neurotic prototype. Two dependent measures, response time and number of confrontations, were used and conceptualized in terms of an approach-avoidance continuum. Differential responding on the basis of the Ss' A--B status was not supported in this study.",de Socarraz ML.; Randolph DL.,1978.0,,0,0,
10020,An evaluation of hospital in-patient treatment in adolescent school phobia.,"Thirty-two school-phobic youngsters of mean age 13 years were randomly allocated to two treatment groups after stratifying for sex. Length of in-patient management in a psychiatric hospital unit for young adolescents was evaluated. One group was admitted for three months and the other for six. Care was taken to ensure that cases had been fairly distributed between the groups by comparing them on a variety of clinical features. Follow-up assessments were carried out in a reliable fashion at six months, one year and two years after discharge. Outcome, overall, was similar to that found in a previous follow-up study for the same unit, in that symptoms of emotional disturbance and social impairment tended to persist in a considerable proportion of cases over the period of review. Length of stay in hospital did not affect outcome as far as the boys were concerned; the findings in relation to the girls was less certain and it seems likely that longer in-patient treatment improves outcome in school-phobic girls.",Berg I.; Fielding D.,1978.0,,0,0,
10021,Systems releasing action therapy with alcoholics: an experimental evaluation.,"Described Systems Releasing Action Therapy (SRAT) and a controlled study that evaluated its effectiveness. The therapy combines physical and fantasy exercises and has its roots in the Bioenergetic and Gestalt traditions. To evaluate its effectiveness, 56 patients who were receiving treatment for alcoholism were assigned randomly to therapy and control groups. On 3-week follow-up, the therapy sample showed significantly more improvement than the controls on measures of blood pressure, physical symptoms, anxiety, hysteroid tendencies, disturbed feelings and self-image. Suggestive differences (interactions significant only at the .20 level) in favor of the therapy group also appeared on measures of vital capacity withdrawal, excessive drinking, anhedonia and four neurosis-oriented MMPI scales. However, 6-month follow-up data were relatively unimpressive. The results suggest this type of therapy is an effective one, at least for the short term.",Moran M.; Watson CG.; Brown J.; White C.; Jacobs L.,1978.0,,0,0,
10022,Conjoint marital therapy: a controlled outcome study.,"Forty-two couples with marital problems were randomly allocated to conjoint therapy of (i) a directive, (ii) an interpretative or (iii) a supportive (control) type. Self and independent assessment at the end of treatment showed the directive significantly superior to the control procedure on several measures. This superiority was maintained to 18 months' follow-up, when the interpretative procedure also showed some superiority over the control.",Crowe MJ.,1978.0,,0,0,
10023,Flooding with Brevital in the treatment of agoraphobia: countereffective?,,Chambless DL.; Foa EB.; Groves GA.; Goldstein AJ.,1979.0,,0,0,
10024,Psychological rehabilitation after myocardial infarction.,"The value of psychological counselling in rehabilitating patients after myocardial infarction was assessed. A total of 143 men who had recently had a myocardial infarction were randomly allocated to either a group receiving intensive rehabilitation or a control group, their outcome being examined after six months. Patients with neurotic, introverted personalities had a poor outcome in the control group but a satisfactory outcome when rehabilitated. Neurotic personalities responded to help, and rehabilitative measures did not increase neurosis. In addition all patients with a negative attitude towards their illness and future had a poor outcome but those with a positive attitude did well. Selection by simple methods of patients who would benefit from psychological rehabilitation seems desirable.",Naismith LD.; Robinson JF.; Shaw GB.; MacIntyre MM.,1979.0,,0,0,
10025,"Comparison of the clinical effectiveness of ""short"" versus ""long"" stay psychiatric hospitalization. IV. Predictors of differential benefit.","One hundred seventy-three patients were randomly assigned to LT (long term, unlimited length of stay, mean 179 days) vs. ST (short term, 90-day limit) psychiatric hospitalization. Three-year follow-up results showed few between-group differences, although LT patients tended to be rehospitalized more and had superior relative ratings of psychopathology. Demographic and clinical data did not predict differential benefit from LT or ST hospitalization. Diagnosis did not generally predict differential benefit either, except that clinically diagnosed personality disorders, given LT as opposed to ST hospitalization, had poorer role functioning and less psychiatric treatments after discharge. Patients with a history of drug abuse did worse if given LT hospitalization in terms of role functioning and rehospitalization. Overall, this study agrees with other relevant studies in indicating that hospitalization should be kept as short as feasible.",Mattes JA.; Klein DF.; Millan D.; Rosen B.,1979.0,,0,0,
10026,An experimental evaluation of crisis intervention.,,Bordow S.; Porritt D.,1979.0,,0,0,
10027,[Effectiveness of psychotherapy--methods and research].,,Aleksandrowicz JW.; Czabała JC.,,,0,0,
10028,The effectiveness of time-limited psychotherapy in a university counseling center.,"Investigated the effects of eight-session, time-limited therapy on clients' self-concepts. Fourty-two students who sought psychotherapy or personal counseling at the university counseling center were assigned randomly to either time-limited, time-unlimited, or control groups after screening with the MMPI to eliminate the most severely disturbed clients. The Bills Index of Adjustment and Values was administered pre- and post-therapy. Results of a two-way repeated measures analysis indicated significant improvement in both time-limited and unlimited groups, but not in the controls. The two treatment groups did not differ in improvement. A 2 1/2 year follow-up of 18 of the former clients suggested that treatment gains were maintained and were equivalent for those who received time-limited and open-ended therapy.",Keilson MV.; Dworkin FH.; Gelso CJ.,1979.0,,0,0,
10029,A comparative trial of home and hospital psychiatric care. One-year follow-up.,"The effectiveness of community-based treatment stressing home care was compared with hospital-based psychiatric care. One hundred and fifty-five patients destined for inpatient psychiatric care were randomly assigned to Home Care (76 patients) and to Hospital Care (79 patients). Symptoms, role functioning, and psychosocial burden on the family were similar at admission, one month, three months, six months, and one year. The mean in-hospital stay of Hospital Care patients was 41.7 days compared with a mean stay of 14.5 days for Home Care patients. The difference in the amount of ambulatory care received by patients in the two groups was not significant. The evidence is consistent: community-based psychiatric care is an effective alternative to hospital-based care for many but not all severely disabled patients. The active ingredients of successful community treatment are known, yet the lag in implementing these programs persists.",Fenton FR.; Tessier L.; Struening EL.,1979.0,,0,0,
10030,A comparison of response exaggeration techniques.,"Compared the effectiveness of several response exaggeration techniques. Socially anxious college males (N = 34) were instructed to exaggerate some component of social anxiety onset. One group exaggerated their attending to manifestations of their anxiety, two groups exaggerated either a relevant or irrelevant anxiety response, a fourth group imagined an exaggerated consequence of their anxiety, and a fifth group served as a placebo control. All groups reported a greater willingness to initiate and maintain an interaction with a female and displayed less anxiety in a role-playing situation; no differential treatment effects were found. These findings fail to support results from other studies that attested to the efficacy of response exaggeration techniques.",Gottlieb BS.; McNamara JR.,1979.0,,0,0,
10031,Massed vs. spaced exposure sessions in the treatment of agoraphobia.,,Foa EB.; Jameson JS.; Turner RM.; Payne LL.,1980.0,,0,0,
10032,Transdiagnostic cognitive behavioural treatment and the impact of co-morbidity: An open trial in a cohort of primary care patients.,"The development of initiatives to improve access to psychological therapies has been driven by the realization that untreated anxiety and depression are both very common and costly to individuals as well as society. Effective and efficient treatments, mostly in the form of cognitive behavioural therapies (CBT), can be used in ways which enhance their acceptability and accessibility. To date, numbers of group therapies have been developed to improve cost efficiency, but in spite of growing interest in transdiagnostic approaches, group therapies have so far mostly been diagnosis specific. This study is aimed at evaluating a brief transdiagnostic cognitive behavioural group therapy (TCBGT) designed to treat both anxiety and depression among patients in primary care. The participants were 287 adult patients in primary care with diagnoses of depression and/or anxiety disorders. They underwent a 5-week TCBGT. A mixed design ANOVA was used to evaluate differential effects of treatment according to diagnostic groups (anxiety versus depression) and number of diagnoses (co-morbidity). Pre-post differences were significant and the treatment was equally effective for both anxiety disorders and depression. Number of diagnoses did not affect the outcome. The study indicates feasibility of the brief transdiagnostic group therapy for a wide range of mood and anxiety disorders in primary care. The results indicate that low intensity, brief transdiagnostic group therapies may be a feasible way to improve access to psychological therapies for a large number of patients.",Kristjánsdóttir H.; Salkovskis PM.; Sigurdsson BH.; Sigurdsson E.; Agnarsdóttir A.; Sigurdsson JF.,2016.0,10.3109/08039488.2015.1081404,0,0,
10033,Social interactions in virtual reality exposure therapy: A proof-of-concept pilot study.,"Research on virtual reality exposure therapy (VRET) has demonstrated good treatment efficacy with regards to several anxiety disorders. Yet, there is lack of knowledge about the value of integrating interaction between clients and virtual humans in VRET. Such interaction might prove effective in treating psychological complaints that involve social interactions, such as social anxiety. A VRET system specifically designed to expose clients with social anxiety disorder to anxiety provoking social situations was applied to 16 and 18 individuals with high and low levels of social anxiety, respectively. Participants engaged in two exposure sessions in several free speech dialogues with virtual humans while being monitored by a therapist. Participants with high levels of social anxiety reported significantly lower levels of social anxiety three months after exposure to two virtual reality interaction sessions than before treatment (p < 0.01). In the group with low levels of social anxiety, no significant change of social anxiety was reported between pre-treatment and follow-up. Additionally, participants in both groups reported higher self-efficacy three months after treatment than before treatment (ps ≤ 0.001). These findings indicate that virtual reality technology that incorporates social interactions may be successfully applied for therapeutic purposes.",Morina N.; Brinkman WP.; Hartanto D.; Kampmann IL.; Emmelkamp PM.,2015.0,10.3233/THC-151014,0,0,
10034,Clomipramine and exposure for obsessive-compulsive rituals: i.,"Forty chronic obsessive-compulsive ritualizers were randomly assigned to treatment with oral clomipramine or placebo for 8 months. During weeks 4 to 7 these two groups were each randomly split into treatment by relaxation or by exposure in vivo, and during weeks 7 to 10 all patients had exposure in vivo. Double blind assessments were made at weeks 4, 7, 10, 18, 36, 62 and 114. Results are reported to one year. Clomipramine produced significant improvement in rituals, mood and social adjustment, but only in those patients who initially had depressed mood. The clomipramine effect was maximum from weeks 10 to 18 and diminished thereafter. On stopping clomipramine patients often relapsed and improved again on restarting the drug. Relaxation produced little change. Exposure produced significant lasting improvement in rituals, but less change in mood; improvement generalized to social adjustment at follow-up. Clomipramine plus exposure had a slight additive but not interactional effect. Clomipramine enhanced compliance both with exposure and with relaxation. Clomipramine is useful for compulsive ritualizers with depressed mood, but may need continuation for over a year and combination with exposure in vivo. Exposure in vivo remains the treatment of choice for rituals without depressed mood.",Marks IM.; Stern RS.; Mawson D.; Cobb J.; McDonald R.,1980.0,,0,0,
10035,Treatment of obsessive-compulsive patients: the contribution of self-instructional training to the effectiveness of exposure.,,Emmelkamp PM.; van der Helm M.; van Zanten BL.; Plochg I.,1980.0,,0,0,
10036,Imagery processing and fear reduction during repeated exposure to two types of phobic imagery.,,Anderson MP.; Borkovec TD.,1980.0,,0,0,
10037,Psychophysiological assessment of imagery in obsessive-compulsives: a pilot study.,,Grayson JB.; Nutter D.; Mavisskalian M.,1980.0,,0,0,
10038,[Chronic post-traumatic osteomyelitis. Animal experiments and clinical studies of an oral antibacterial vaccination].,,Lob G.,1980.0,,0,0,
10039,Agoraphobia: the long-term follow-up of behavioural treatment.,Sixty-six agoraphobic patients were followed up five to nine years after their treatment in three clinical trials of behaviour therapy. The main outcome measures used in the original trials were repeated by an assessor who interviewed the patients. Ninety-five per cent of patients were interviewed and partial information was obtained on a further two patients. The measures taken at follow-up were compared with those obtained prior to treatment and six months after treatment ended. On most measures of agoraphobia the patients were much better at follow-up than they had been before treatment. The assessor's ratings suggested that there had been little change in the patients' agoraphobia since six months after treatment. Some of the patients' self-ratings showed evidence of a slight improvement over this period. No evidence of symptom substitution was found.,Munby M.; Johnston DW.,1980.0,,0,0,
10040,Effect of counselling on the psychiatric morbidity associated with mastectomy.,"A controlled trial was conducted to determine whether counselling by a specialist nurse prevented the psychiatric morbidity associated with mastectomy and breast cancer. Seventy-five patients were counselled by the nurse and monitored during follow-up, while 77 patients received only the care normally given by the surgical unit. Counselling failed to prevent morbidity, but the nurse's regular monitoring of the women's progress led her to recognise and refer 76% of those who needed psychiatric help. Only 15% of the control group whose condition warranted help were recognised and referred. Consequently, 12 to 18 months after mastectomy there was much less psychiatric morbidity in the counselled group (12%) than in the control group (39%). These findings highlight the high degree of psychiatric morbidity in patients who have undergone mastectomy and indicate the need to find ways of reducing this morbidity.",Maguire P.; Tait A.; Brooke M.; Thomas C.; Sellwood R.,1980.0,,0,0,
10041,The relative efficacy of thought-stopping and covert assertion.,,Arrick MC.; Voss J.; Rimm DC.,1981.0,,0,0,
10042,A controlled outcome study of phobias in mentally retarded adults.,,Matson JL.,1981.0,,0,0,
10043,Return of fear: the role of inhibition.,,Grey SJ.; Rachman S.; Sartory G.,1981.0,,0,0,
10044,Employing paradoxical intention in the treatment of agoraphobia.,,Ascher LM.,1981.0,,0,0,
10045,Psychiatric diagnoses (Research Diagnostic Criteria) in symptomatic volunteers.,"Symptomatic volunteers (SVs) are increasingly used as subjects for clinical research studies. A total of 362 SVs were recruited, psychiatric diagnoses were made according to Research Diagnostic Criteria (RDC), and standard symptom scale scores on the Hopkins Symptom Check list (HSCL) for the individual diagnostic categories were computed. Of these subjects, 221 were classified as having a depressive disorder (three categories), 112 as having an anxiety disorder (three categories), and 29 as having some other RDC disorder. The HSCL scale scores for the depressive- and anxiety-disorder subject groups were consistent with those for actual patient groups. There were significant differences in HSCL scores for some RDC categories within the broader depressive- or anxiety-disorder groupings. Individual RDC categories should be kept separate in reporting treatment results for depressive or anxiety disorders.",Barrett J.,1981.0,,0,0,
10046,"Behavior of high, moderate, and low test anxious students during an actual test situation.",,Galassi JP.; Frierson HT.; Sharer R.,1981.0,,0,0,
10047,The treatment of social phobia. Real-life rehearsal with nonprofessional therapists.,"Sixteen socially phobic outpatients underwent a 4-week course of social skills training that attempted to maximize rehearsal in real-life settings. The therapy was largely conducted by nonprofessional volunteers after a 2-hour training workshop. It consisted of multiple role-played practice in the clinic, followed immediately by rehearsal in a real-life setting in the company of a nonprofessional therapist and a fellow patient. Subsequently, patients were randomly paired to perform further rehearsals between sessions. Drug therapy was controlled by double blind assignment to propranolol or inert placebo throughout the course of treatment. Measures of specific fears, generalized social anxiety, self-image, and global tension and anxiety were administered 1 month before treatment, immediately before and after treatment, and at 6 months follow-up. During a 4-week drug-free period prior to active treatment no improvement was noted on any measures. After the 4-week treatment period significant improvement had occurred on all outcome measures. Propranolol and placebo subgroups showed very similar results. Treatment gains were sustained at follow-up. It was concluded that repeated behavior rehearsal, both in the clinic and in real life is a cost-effective treatment procedure for many social phobias. The approach is straightforward and can be applied by nonprofessionals, including the patients themselves, after limited training and with minimal supervision.",Falloon IR.; Lloyd GG.; Harpin RE.,1981.0,,0,0,
10048,"Review of behavioral psychotherapy, I: Obsessive-compulsive disorders.","Obsessive-compulsive ritualizers have maintained their improvement after exposure in vivo for up to 3 years' follow-up in the United States, Britain, Greece, and Australia. Unlike exposure in vivo, relaxation is of little value. Early gains in treatment predict long-term outcome. Exposure therapy is usually on an outpatient basis and takes 1-30 sessions. Self-exposure homework is critical. Sessions at home are also required, together with relatives cooperating as exposure cotherapists. Some patients can treat themselves almost unaided, while others need extensive assistance. Clomipramine is helpful for ritualizers with coexisting depression, but depression tends to recur when clomipramine therapy is stopped.",Marks IM.,1981.0,10.1176/ajp.138.5.584,0,0,
10049,Reduction of anxiety in aquaphobics.,"The purpose of this study was to determine which of the three treatments: systematic desensitization ""in vivo"", systematic desensitization ""in imagination"" or ""no treatment"" control brought about a significant improvement in adult aquaphobics. Thirty-eight adult aquaphobics were randomly assigned to the ""three treatments"". A battery of four tests, three state-anxiety and one trait anxiety were administered to the subjects pre and post treatment. ANCOVA was used to find out if a significant difference existed among the treatment groups post treatment. A significant difference at the .05 level of confidence was obtained for the three state-anxiety test but not for the trait anxiety test. A post hoc test (Scheffé), applied to the data indicated a significant difference between ""in vivo"" treatment and the other two treatments but no significant difference between the ""in imagination"" treatment and the ""no treatment"" control at the .05 level of confidence. ANOVA was applied to the data to ascertain if any of the improvements were significant. The results indicated that ""in vivo"" treatment brought about a significantly greater improvement (reduction in anxiety) than either of the other two treatments as measured by the three state-anxiety tests but no improvement differential was indicated by the trait anxiety test at the .05 level of significance.",Egan S.,1981.0,,0,0,
10050,The effects of an expectancy state on the fate of applications and psychotherapy in an outpatient setting.,"This study describes an attempt to influence the outcome of outpatient psychotherapy by offering pretherapy information to application. The sample consisted of more than 1,300 applicants; the pretherapy information, in the form of a printed leaflet, was included with the application blank for alternate cases. The results suggest that the pretherapy information tended to discourage the completing of application blanks. Among those patients who eventually participated in psychotherapy, pretherapy information had no effect on the duration of treatment or on treatment outcomes as rated by the therapists. Incidentally, the data indicate that having health insurance has a strong, positive effect on the number of treatment interviews.",Levitt EE.; Fisher WP.,1981.0,,0,0,
10051,Interpersonal variables in behavioural group therapy.,"Attraction towards the group as a whole and to male and female co-leaders was self-rated after each of 10 sessions of behavioural group therapy. Fifty-one patients with specific interpersonal skills deficits completed the course after being randomly assigned to nine small groups employing either (a) role rehearsal and modelling, or (b) guided discussion. Higher levels of attraction were obtained in role-rehearsal groups. This was associated with improved self-esteem and a reduction of specific social fears at the end of treatment. Drop-outs showed less attraction and tended to leave the groups at critical stages in their development. The findings suggest that greater attention to specific interpersonal variables may enhance the effectiveness of group therapies.",Falloon IR.,1981.0,,0,0,
10052,Modifying shyness-related social behavior through symptom misattribution.,"An experimental misattribution paradigm proved to be a significant intervention treatment of altering social participation among dispositionally shy women. When specific arousal symptoms previously associated with their social anxiety were misattributed to a nonpsychological source, high-frequency noise, these extremely shy women behaved as if they were not shy. Their verbal fluency and interactional assertiveness resembled that of not-shy comparison women given the same treatment. Moreover, their scores on these measures were significantly elevated from the low levels recorded by shy controls who had been led to expect shyness-irrelevant ""side effects"" from their exposure to noise. A male partner (a confederate) accurately perceived whether or not the women in the two control groups were shy, but he misjudged as ""not shy"" the shy women in the misattribution group. The greater enjoyment of the interaction by those in this latter group, despite high-frequency noise bombardment, was also reflected in their stronger preference for further affiliation than that shown by either comparison group. The continuously monitored heart rate data provide grounds for speculation as to the relationship of physiological arousal and behavior. However, a paradoxical placebo finding emerged when it appeared that the non-shy women in this same misattribution condition experienced a higher level of arousal, and this anxiety-like arousal was associated with preferences for nonaffiliation.",Brodt SE.; Zimbardo PG.,1981.0,,0,0,
10053,Treatment of phobic disorders using cognitive and exposure methods: a self-efficacy analysis.,,Biran M.; Wilson GT.,1981.0,,0,0,
10054,Treatment of chronic obsessive compulsive states with stereotactic anterior capsulotomy or cingulotomy.,"A neuropsychological model on how to evaluate patients subjected to stereotactic psychosurgery is presented. Four patients with chronic obsessive compulsive neurosis were randomly assigned to either stereotactic anterior capsulotomy or cingulotomy, and assessed pre-, peri-, and postoperatively according to this model. The best immediate and long-term follow-up results in reducing obsessional symptoms were obtained in the two capsulotomized patients. Psychosurgery should only be performed by a multidisciplinary team of specialists, with objective evaluation, adequate information on patients, and reliable test instruments.",Fodstad H.; Strandman E.; Karlsson B.; West KA.,1982.0,,0,0,
10055,Impact of client and therapist gender on psychotherapy process and outcome.,,Jones EE.; Zoppel CL.,1982.0,,0,0,
10056,Patient satisfaction with community psychiatric nursing: a prospective controlled study.,A sample of patients allocated to receive either community psychiatric nursing or out-patient psychiatrist follow-up was interviewed at 6-month intervals for a total period of 18 months. Two dimensions of patient satisfaction are discussed: a cross-sectional analysis of the quality of the perceived therapeutic relationship and an analysis over time of attitudes to aspects of the mental health care received. The satisfaction expressed with elements of the therapeutic relationship revealed that patients find nurses more approachable and more sympathetic. The satisfaction expressed by patients receiving the nursing mode of follow-up was superior to that expressed by out-patient psychiatrist patients. Particularly positive were responses made by nursing patients to domiciliary visiting. The greater levels of satisfaction with nursing follow-up increased over time.,Mangen SP.; Griffith JH.,1982.0,,0,0,
10057,Cognitive restructuring and exposure with a compulsive washer: a test of reciprocal inhibition.,"Reciprocal inhibition was tested with a compulsive washer using the affect elicited by rational self-statements as the response competitor to anxiety. Three conditions, CS alone, CS plus irrational self-statements, and CS plus rational self-statements, were randomly and continuously repeated over six trials. The CS was presented both imaginally and in vivo. It was hypothesized: (1) that subjective anxiety in all conditions would substantially diminish by the experiment's end; (2) that the rational self-statement condition would reduce (inhibit) subjective anxiety to a significantly greater degree than the other two conditions; and (3) that significant anxiety reduction would occur only during the rational restructuring trials. All three hypotheses were supported by the results.",Giles TR.,1982.0,,0,0,
10058,Progress in the treatment of female sexual dysfunction.,"Over a decade of research since the publication of Human Sexual Inadequacy by Masters and Johnson has confirmed the effectiveness of psychological treatment for sexual problems, but has not advanced our understanding of aetiology very much. It is generally assumed that anxiety blocks normal function in sexual disorders such as impotence or frigidity, although hormonal changes have also been suggested. Evidence for either proposition is lacking. Our own attempts to understand mechanisms have included the use of a dismantling strategy to investigate the effective components of psychological treatment, and latterly the role of exogenous androgens. In our first study, brief treatment modelled on that of Masters and Johnson proved superior to another version of graded practice in sexual contact which lacked the counselling component. Similarly, the fuller version had more effect than did imaginal desensitization, suggesting that sexual dysfunctions cannot be treated like phobic anxiety. A second study focused on women complaining of little sexual interest or enjoyment. The use of a minor tranquillizer was compared with that of androgen (testoral) in the hope that different treatments would be shown to be best for different types of disorder. Unexpectedly, the androgen proved best overall while another variable, monthly vs weekly sessions, did not produce any differences in effect. In the most recent study, a further 48 women were given androgens or placebo, and were seen weekly or monthly for four months by either one or two therapists. There were few significant differences, the most consistent being greater subjective improvement by the women being seen at weekly intervals. The failure to find a positive hormone effect in comparison with placebo raises the possibility that the anxiolytic used earlier may have been counter-productive. If so, it seems unlikely that either excessive anxiety or simple androgen deficiency is an adequate aetiological explanation for female sexual dysfunction.",Mathews A.,1983.0,,0,0,
10059,Comparative studies on benzodiazepines and psychotherapies.,"BZD may have some temporary palliative value in reducing anxiety over the short-term, but have not yet been shown to be of lasting value for neuroses either on their own or with any form of psychotherapy. When the drug is withdrawn, at best the effects do not persist and at worst there are severe side effects after withdrawal. 3 controlled studies of diazepam have been completed in phobics having exposure. In two of these there was a slight temporary gain when diazepam was combined with exposure, but the only study to have followup found that this gain dissipated within a month. Uncontrolled evidence suggests that high doses of BZD might actually impede improvement during exposure treatment of phobics . In contrast, exposure treatment is enduringly effective and can often be self-administered with minimum guidance from the therapist.",Marks I.,1983.0,,0,0,
10060,Postmastectomy couple counseling: an outcome study of a structured treatment protocol.,"The evidence suggests that medical treatment of breast cancer produces psychosocial trauma in both the patient and her husband due to the loss of the breast and/or physical disfigurement. This study evaluated the effects of a structured couples treatment program on the psychosocial discomfort following a mastectomy. Twenty couples were randomly assigned to experimental and control conditions and were administered an assessment battery before and after treatment that measured change in marital happiness, sexual satisfaction, depression, self-esteem, helplessness, anxiety, alienation, and emotional discomfort. An analysis of variance yielded no significant difference between experimental and control conditions on any of the dependent variables. A supplemental analysis of covariance using the pretest as a covariate found that the treatment reduced emotional discomfort in both partners, reduced depression in the patient, and increased sexual satisfaction for both spouses. Recommendations were made for further study of the treatment, controlling for the subject's level of distress prior to treatment.",Christensen DN.,1983.0,10.1080/00926238308410913,0,0,
10061,Treatment of phobias. II. Behavior therapy and supportive psychotherapy: are there any specific ingredients?,"Systematic hierarchical desensitization (behavior therapy [BT]) was compared with supportive psychotherapy (ST) during a 26-week treatment trial of patients with agoraphobia, mixed phobia, or simple phobia. We found essentially no difference in effectiveness, not because patients treated with BT had done badly, but because patients receiving ST had done well. A detailed methodologic review concludes that this finding is entirely compatible with the major critical reviews of the psychotherapy literature. Is the active ingredient in psychotherapy simply the generation of hopeful expectancies? This is necessary but not sufficient. For phobics, the psychotherapy session serves primarily as an instigator. The specific corrective activity occurs outside of the formal session in the form of maintained exposure in vivo. Supposed differences between therapies may be entirely due to the rapidly with which the instigational function becomes effective.",Klein DF.; Zitrin CM.; Woerner MG.; Ross DC.,1983.0,,0,0,
10062,Imipramine and brief therapists-aided exposure in agoraphobics having self-exposure homework.,"Forty-five chronic agoraphobics were randomly assigned to treatment by placebo or imipramine in doses up to 200 mg/day for 28 weeks. All patients also had systematic self-exposure homework with an instruction manual. In addition, half of each drug group had therapist-aided exposure and half had therapist-aided relaxation, each totalling three hours. Patients in both drug groups improved substantially and maintained their gains for one year of follow-up. Imipramine had no significant therapeutic effect despite satisfactory plasma levels and significant drug side effects. Patients' low initial Hamilton depression scores might explain the absence of any drug effect. Antidepressants may be ineffective for agoraphobics who have normal mood. Brief therapist-aided exposure improved phobias and panics to a significant but limited extent, and is a useful adjuvant to self-exposure homework, which can be a powerful therapeutic agency by itself.",Marks IM.; Gray S.; Cohen D.; Hill R.; Mawson D.; Ramm E.; Stern RS.,1983.0,,0,0,
10063,Cost-effectiveness of community psychiatric nurse or out-patient psychiatrist care of neurotic patients.,"In a prospective controlled investigation chronic patients, the majority with neurotic conditions, were randomly allocated either to community psychiatric nurses (CPN) as the main therapist or to routine out-patient psychiatrist follow-up. There was no statistically significant difference in the mean public expenditure for the two modes of care. The direct costs of psychiatric care comprised a small proportion of total public expenditure and were initially greater in the nursing group. Subsequently, and over the whole 18-month study period, nursing was the cheaper option in terms of these direct costs. Clinical and social outcomes were comparable in both follow-up groups. Consumer satisfaction was significantly greater among CPN patients. On balance, these results confirm the benefit of community psychiatric nursing for this patient group.",Mangen SP.; Paykel ES.; Griffith JH.; Burchell A.; Mancini P.,1983.0,,0,0,
10064,Pharmacological treatment of agoraphobia: imipramine versus imipramine with programmed practice.,Eighteen agoraphobic patients with randomly assigned to 12 week treatment with imipramine (I) or imipramine and programmed in-vivo exposure practice (I+BT) to investigate the contribution of behavioural instructions to the clinical effects of pharmacotherapy. Significantly greater improvement on phobic measures was found in the I+BT group compared to the I group. Differences were less marked on measures of panic and anxiety. The results suggest that imipramine possesses an antiphobic effect which can be substantially enhanced with programmed practice. Controlled large-scale investigations of the pharmacological and instructional effects of the phamacotherapy of agoraphobia are needed for a definitive evaluation of the specific antiphobic effect of antidepressant drugs.,Mavissakalian M.; Michelson L.; Dealy RS.,1983.0,,0,0,
10065,"A comparison of subliminal, supraliminal and faded phobic cine-films in the treatment of agoraphobia.","Thirty-two agoraphobic patients were randomly allocated to four groups and treated by repeated exposure to cine-films at twice weekly intervals for three weeks. Three of the groups saw the same cine-film, comprising a range of agoraphobic scenes, and a control group saw a potter working on his wheel. The three groups seeing the phobic cine-film included one who viewed it at an illumination level below the visual threshold (subliminal group), one seeing it under normal conditions (supraliminal group) and one which underwent graduated exposure from subliminal to supraliminal viewing levels as the study proceeded (faded group). The faded group showed significantly greater improvement than the control and supraliminal groups and this improvement was maintained over twelve weeks.",Lee I.; Tyrer P.; Horn S.,1983.0,,0,0,
10066,"Minor tranquilizers, personality inventory, and EMG feedback with chronic anxious patients.",,Lamontagne Y.; Lavallée YJ.; Annable L.,,,0,0,
10067,Participant modeling with or without cognitive treatment for phobias.,,Ladouceur R.,1983.0,,0,0,
10068,Does escape behaviour strengthen agoraphobic avoidance? A preliminary study.,,de Silva P.; Rachman S.,1984.0,,0,0,
10069,"Thought-induced change in phobic beliefs: sometimes it helps, sometimes it hurts.","Derived two predictions from Tesser's (1978) work on thought-induced polarization. First, the longer individuals thought in a constrained manner about a phobic object, the more strongly they would believe that they were able to cope with the object. Second, the longer individuals thought in an unconstrained manner about a phobic object, the more strongly they would believe that they were unable to cope with the object. It was also predicted that, in both cases, the relationship between thought and belief change would be monotonic. These hypotheses were tested by randomly assigning phobic individuals (N = 20) to one of two treatment conditions: Constrained thought or unconstrained thought. Beliefs about extra-laboratory behavior were used to assess the effects of treatment, and results supported all predictions.",Leone C.,1984.0,,0,0,
10070,Effects of stimulus representation and cue category level on exposure (flooding) therapy.,"The present study was an attempt to examine the role of cue category level (symptom-contingent vs. hypothesized cues) and mode of stimulus presentation (in vivo vs. imaginal) in exposure (flooding) therapy. Sixty-four speech phobics were randomly assigned to one of eight conditions. Exposed to either one of the two cue category conditions, subjects received either two sessions of in vivo exposure, two sessions of imaginal exposure, or two sessions consisting of either an imaginal followed by an in vivo exposure or vice versa. Results support the predictions of Levis & Hare (1977) that the inclusion of hypothesized cues is not necessary in the treatment of analogue phobias or simple clinical cases. These data also support and extend several previous findings that in vivo exposure produces more rapid anxiety decrement than imaginal exposure. Finally, a variant of the usual in vivo procedure is described which apparently is effective, yet does not require the assemblage of a large audience for each in vivo exposure.",Mannion NE.; Levine BA.,1984.0,,0,0,
10071,Two-year follow-up of agoraphobics after exposure and imipramine.,"Forty-five agoraphobic out-patients were randomly assigned to treatment with imipramine or placebo, and also to brief therapist-aided exposure or relaxation. All patients did systematic self-exposure homework and recorded this in a diary. Forty of these patients were followed-up two years later with self-ratings and ratings by interviewers blind to their treatment conditions. About two-thirds of the patients remained improved or much improved in their phobias, with no significant difference between any of the four treatment conditions. Spontaneous panics also remained improved. The absence of an imipramine effect may reflect the lack of initial dysphoria (anxiety-depression) in this sample compared with other studies where drug-effects have been found. The post-treatment superiority (evident at week 28) of patients who had therapist-aided exposure was no longer present at the two-year follow-up; the others had caught up, presumably because of their self-exposure homework.",Cohen SD.; Monteiro W.; Marks IM.,1984.0,,0,0,
10072,A two-year follow-up of a comparative trial of the cost-effectiveness of home and hospital psychiatric treatment.,"The manpower and operating cost of home-based treatment was compared with the manpower and operating cost of hospital-based treatment during the second year and at the end of two years of treatment. Of the 155 patients destined to receive inpatient treatment, 76 were randomly assigned to home treatment, 79 to hospital treatment. The two groups were similar as to important social, demographic, and clinical characteristics, including psychiatric diagnosis. The manpower and operating cost of treatment, measured in two ways, was similar in the two groups during the second year. However, over the 2-year period hospital-based treatment of patients in each of the three diagnostic groups was more expensive than home-based treatment. Also, regardless of which treatment was given, the cost of treating schizophrenics was higher than the cost of treating manic-depressives which, in turn, was higher than the cost of treating individuals with depressive neurosis. Treatment failures were discussed. Over the 2-year period, failures in home-based treatment accounted for 39.1% of the total manpower and operating cost of home-based treatment, calculated according to Cost Model 1, and for 67.1% of the cost calculated according to Cost Model 2. The concept of failure in hospital-based treatment is also discussed.",Fenton FR.; Tessier L.; Struening EL.; Smith FA.; Benoit C.; Contandriopoulos AP.; Nguyen H.,1984.0,,0,0,
10073,A comparison of in-vivo and imaginal participant modeling.,"Recent research indicates that effective treatments of phobic reactions are often performance-based and involve exposure to the phobic object. The present study was designed to determine whether both of these components were necessary for the effectiveness of participant modeling procedures (N = 26). Phobic individuals were assigned randomly to one of two forms of participant modeling: In-vivo vs. imaginal. Both treatment analogues were identical except that the in-vivo version involved actual exposure to a phobic object, while the imaginal version simply required individuals to imagine that the phobic object was physically present. Results on behavioral and self-report measures indicated that both in-vivo and imaginal participant modeling were effective in generating increased approach behavior, but neither produced generalization beyond the laboratory setting. Explanations were discussed.",Minor SW.; Leone C.; Baldwin RT.,1984.0,,0,0,
10074,Controlled study of self-exposure treatment for phobics: preliminary communication.,"Patients with phobic disorder (mainly agoraphobics ) of minimum one year duration were treated by self-administered exposure in vivo treatment. Seventy-one patients were randomly assigned to one of three groups: (A) book-instructed, (B) computer-instructed, or (C) therapist-instructed. All three groups improved significantly to a similar extent on various phobic measures at the end of the treatment and maintained their treatment gains at 6-month follow up. Mean clinicians' time spent with each patient was 40 minutes, 4.2 hours and 3.2 hours in group A, B and C respectively. Similar small numbers of patients defaulted from each group.",Ghosh A.; Marks IM.; Carr AC.,1984.0,,0,0,
10075,Cost-benefit analysis of a controlled trial of nurse therapy for neuroses in primary care.,"In a randomized, controlled trial neurotic patients (mainly phobics and obsessive-compulsives) in primary care were assigned to behavioural psychotherapy from a nurse therapist or to routine care from their general practitioner. At the end of one year clinical outcome was significantly better in patients cared for by the nurse therapist. Economic outcome to one year, compared with the year before entering the trial, showed a slight decrease in the use of resources by the nurse therapist group (N = 22), and an increase in resource usage in the GP-treated group (N = 28), mainly due to the latter's increased absence from work and more hospital treatment and drugs. On the reasonable assumptions that nurse therapists treat 46 patients a year and that such patients treated behaviourally maintain their gains for 2 years, the economic benefits to society from nurse therapists treating such patients may outweigh the costs. This excludes any monetary value on the substantial clinical gains such as reduction in fear and anxiety. However, the numbers are small, few economic differences were significant, and many patients either did not complete the trial or waiting-list periods or they failed to return economic data. Conclusions must thus be tempered with caution, even though pre-treatment demographic and clinical data of non-returners were comparable with those of returners, and though the few drop-outs who could be rated at one year had not improved. The findings cannot be extrapolated to other types of clinical problem and treatment.",Ginsberg G.; Marks I.; Waters H.,1984.0,,0,0,
10076,Enhanced adaptive behavioural response in agoraphobic patients pretreated with breathing retraining.,"Patients with clinically diagnosed agoraphobia to whom it had been demonstrated that a standard hyperventilation provocation could produce their feared symptoms were alternately allocated to two treatment groups: 7 patients were treated with two sessions of breathing retraining followed by 7 weekly sessions of real-life exposure to the feared situation, and 5 patients were treated with 9 weekly sessions of real-life exposure without breathing retraining. At discharge and at 1 month's follow-up the two groups of patients showed similar degrees of improvement in frequency of panic attacks and other psychophysiological scores. At 6 months' follow-up the patients treated with real-life exposure alone were beginning to show a fall-off in relearned adaptive behaviour (learning decrement), whereas those given breathing retraining showed further improvement. This suggests that patients pretreated with breathing retraining are less likely to need further treatment.",Bonn JA.; Readhead CP.; Timmons BH.,1984.0,,0,0,
10077,The process of exposure in vivo: cognitive and physiological changes during treatment of acrophobia.,,Emmelkamp PM.; Felten M.,1985.0,,0,0,
10078,Social phobia: a comparative evaluation of cognitive and behavioral interventions.,,Emmelkamp PM.; Mersch PP.; Vissia E.; van der Helm M.,1985.0,,0,0,
10079,Male and female agoraphobia: are they different?,,Mavissakalian M.,1985.0,,0,0,
10080,[Psychotherapy of irritable colon].,"16 patients with an irritable colon were examined psychologically and independent of the result of the diagnostics of neuroses additionally distributed to two groups of treatment. One group was treated symptomatically, the other additionally psychotherapeutically (above all with autogenous training). Two thirds of the patients showed a neurosis. Psychotherapy was very useful only in those patients with a neurosis, measured as the result of the treatment one year after the beginning of the therapy. When an obstinate irritable colon is present, a diagnostics of neuroses is indicated. If a neurosis is proved, an individual psychotherapy is indicated, in which case the autogenous training as basis therapy apparently stood the test.",Berndt H.; Maercker W.,1985.0,,0,0,6085
10081,Obsessive-compulsive disorder.,"Obsessive-compulsive disorder is a heterogeneous cluster of syndromes that share aspects of both anxiety and affective disorders. Obsessive-compulsive disorder is epidemiologically and phenomenologically distinct from the compulsive character. Although both genetic and neuropsychological data suggest some biologic basis to obsessive-compulsive disorder, there is still insufficient information in both of these areas. Treatment with clomipramine, a tricyclic antidepressant, has proved useful for obsessional patients either as an adjunct to behavior therapy or as a primary treatment for patients who are not amenable to behavioral interventions.",Insel TR.,1985.0,,0,0,
10082,Imipramine in the treatment of panic disorder and its complications.,"The recognition of the efficacy of imipramine for treating panic disorder and its complications has had major implications for clinical practice, diagnostic classification, theoretic understanding, and research strategies in the anxiety disorders. It has also resulted in benefit for a great number of affected individuals and promises to yield even greater relief of suffering as the findings become more widely disseminated.",Liebowitz MR.,1985.0,,0,0,
10083,Controlled trial of psychiatric nurse therapists in primary care.,In a randomised controlled clinical trial neurotic patients (mainly phobic and obsessive-compulsive) did significantly better up to one year follow up after receiving behavioural psychotherapy from a nurse therapist rather than routine treatment from a general practitioner. At the end of the year control patients who had not improved had crossover behavioural treatment from the nurse and then improved. Those who dropped out or refused therapy did not show worthwhile gains. Patients preferred being treated in the primary care setting rather than in hospital. Placing nurse therapists in primary care is not only viable but may save more health care resources than it consumes.,Marks I.,1985.0,,0,0,
10084,Social phobia. Review of a neglected anxiety disorder.,"While other anxiety disorders have recently become the subjects of increasing investigation, social phobia remains, except among behavior therapists, relatively unstudied. As a result, major uncertainties exist concerning classification, prevalence, severity, etiology, assessment, and treatment of social phobia. Existing findings do suggest that in its own right and as a comparison for other anxiety disorders, social phobia should prove a fertile area for psychobiological and clinical investigation.",Liebowitz MR.; Gorman JM.; Fyer AJ.; Klein DF.,1985.0,,0,0,
10085,DDAVP as a possible method to enhance positive benefit of behaviour therapy.,,Greenberg D.; Belmaker RH.,1985.0,,0,0,
10086,Psychopharmacology and psychotherapy in the treatment of anxiety.,,Freedman AM.,1986.0,,0,0,
10087,Clinically significant improvement in agoraphobia research.,,Mavissakalian M.,1986.0,,0,0,
10088,Exposure in vivo of obsessive-compulsives under distracting and attention-focusing conditions: replication and extension.,,Grayson JB.; Foa EB.; Steketee GS.,1986.0,,0,0,
10089,A prospective randomised trial of the value of rehousing on the grounds of mental ill-health.,"A prospective randomised trial of medical priority for rehousing in local authority accommodation for those claiming such priority on the grounds of mental ill-health, showed a clear benefit to mental health as a result of rehousing up to a year after that rehousing.",Elton PJ.; Packer JM.,1986.0,,0,0,
10090,Individual response patterns and the effects of different behavioral methods in the treatment of dental phobia.,,Jerremalm A.; Jansson L.; Ost LG.,1986.0,,0,0,
10091,"[A comparison of dynamic psychotherapy, psychoanalysis and analytic group psychotherapy].","Three groups of patients (N = 30) distributed as well as possible according to indication among standard psychoanalytic therapy, analytic group therapy and dynamic psychotherapy were submitted to testing in order to investigate the risk indices for stress factors (Dührssen) and to factor analysis with the aid of the Freiburg Personality Inventory, the Giessen-Test, and the Extended Giessen Complaint Sheet. A fourth group of Patients (N = 30), originally assigned to group therapy but having discontinued treatment, was used as control group. It was found that among patients assigned to any of these types of therapy the stress index was significantly higher than among patients seeing the physician for merely an initial examination and the taking of their case histories. Furthermore, the different groups showed different indices for stress factors: Patients in dynamic psychotherapy had by far the highest index of stress, followed by the patients who had discontinued group therapy. Group therapy patients who completed their treatment had again a slightly higher risk index than those who had been assigned to standard psychoanalytic therapy. Application of the above mentioned tests or complaint sheets revealed significant differences between the specific groups. But therapy also resulted in significant improvement of isolated aspects. An investigation concerned with the number of days of hospitalization and the number of days of disablement in a randomly selected group of patients in 1977 showed a statistically significant reduction of these numbers in the five-year period following therapy when compared to the last five years prior to therapy. On the whole the investigation has made it apparent that any comparative psychotherapy study is more or less futile when the patients under observation are parallelized merely according to age, sex, and symptoms while the respective risk indices with the accompanying stress factors in childhood and adolescence are being neglected.",Dührssen A.,1986.0,,0,0,
10092,An investigation into the matching of specific agoraphobic anxiety response characteristics with specific types of treatment.,,Mackay W.; Liddell A.,1986.0,,0,0,
10093,The role of hospice in reducing the impact of bereavement.,"Survivors of patients in a randomized controlled trial of a hospital-based hospice were followed for 18 months after the patient's death. There were no significant differences in the anxiety or depression between hospice survivors (N = 56) and controls (N = 40). Neither were there significant differences in bed days, physician visits or scores on a 6-item health scale, even when the survivor's initial health status was held constant. No clear pattern of differences emerged in social participation, contacts with friends or relatives, smoking or drinking behaviors. We conclude that hospice care did not provide any protective effect for the bereavement period.",Kane RL.; Klein SJ.; Bernstein L.; Rothenberg R.,1986.0,,0,0,
10094,The Fear Questionnaire: a validity study.,,Mavissakalian M.,1986.0,,0,0,
10095,The relationship of marital adjustment to agoraphobia treatment outcome.,,Himadi WG.; Cerny JA.; Barlow DH.; Cohen S.; O'Brien GT.,1986.0,,0,0,
10096,Agoraphobia: relative and combined effectiveness of therapist-assisted in vivo exposure and imipramine.,"Sixty-two chronically agoraphobic patients completed a controlled study to assess the effects of 1) imipramine up to 200 mg/day (mean = 130 mg/day), 2) 12 weekly therapist-assisted in vivo exposure sessions (flooding), and 3) imipramine plus flooding. The control group received systematic therapeutic instructions for self-directed in vivo exposure (programmed practice). Clinical measures of global severity, phobia, panic, anxiety, depression, and behavioral performance tests were administered before treatment and at Weeks 4, 8, and 12 of treatment. Results revealed significant improvement in all groups on all measures over the course of treatment; almost a third of the control patients showed marked improvement. Imipramine had significant effects on improvement of phobias and markedly increased clinical response rates in patients receiving 150-200 mg/day. Less chronicity and severity of condition also predicted better clinical outcome. Flooding had limited effects above and beyond programmed practice, and no imipramine-flooding interactions effects were found.",Mavissakalian M.; Michelson L.,1986.0,,0,0,
10097,Cognitive processes in anxiety and depression: discussion paper.,,Mathews A.,1986.0,10.1177/014107688607900309,0,0,
10098,Psychiatric morbidity after screening for breast cancer.,"One hundred and thirty two women with normal breast screening results were interviewed six months after their attendance at the Edinburgh Breast Screening Clinic. Eight percent of women said screening had made them more anxious about developing breast cancer. Thirty eight percent said they were more aware of the disease since screening but they regarded this as advantageous. Seventy percent of the women were still practising breast self-examination. There was no difference in the psychiatric morbidity of the screened sample when compared with a matched random sample community control group. Neither was there any difference in the General Health Questionnaire case rates before and after screening. Screening does not appear to increase the prevalence of psychiatric morbidity. Twenty nine percent of the interview sample were examining their breasts more than once a month--21% once a week or more. However, these frequent self-examiners did not have a greater prevalence of psychiatric morbidity than their matched controls.",Dean C.; Roberts MM.; French K.; Robinson S.,1986.0,,0,0,
10099,Clomipramine: an antiobsessive drug.,"In the past decade, various investigators have attempted to find new pharmacological agents for the treatment of obsessive disorders. Of these, the drug which has attracted attention and has been most promising is clomipramine. This paper attempts to review the usefulness of clomipramine in the treatment of obsessive disorder. Accidentally, it was discovered that clomipramine was effective in alleviating obsessive symptoms in depressed patients by a Spanish psychiatrist, Lopez-Ibor. Initial studies carried out mainly on patients with major depression reported that obsessive symptomatology benefited with clomipramine therapy. A number of uncontrolled and controlled studies confirmed the efficacy of this drug in obsessive neurosis. The drug improves the obsessive symptoms. Discontinuation of the drug is followed by a relapse. The efficacy, dosage, duration and side effects of treatment with clomipramine are discussed in this paper.",Ananth J.,1986.0,,0,0,
10100,Rating depression in normals and depressives: observer versus self-rating scales.,"Different methods of assessing depression and anxiety were tested in 20 patients suffering from a major depressive disorder with melancholia and 20 matched control subjects. Depressives were assessed before and after treatment with amitriptyline and normals were retested at the same interval. The scales used were: Paykel's Clinical Interview for Depression--which is an expanded version of the Hamilton Depression Rating Scale; the Brief Depression Rating Scale; and Symptom Questionnaire (SQ). All scales discriminated sensitively between patients and normals and the scores changed substantially with treatment. Except for the well-being subscales of the SQ, the scales showed an adequate test-retest reliability in normals. Although all scales were suitable for the measurement of depression, they differed in psychometric properties. For example, the Depression subscale of the SQ showed an unusually high test-retest reliability in normals, whereas the Contentment subscale was unreliable. Yet, the latter has been found to be highly sensitive in detecting differences between the effects of psychotropic drugs and placebo in drug trials, so it appears to measure sensitively a fleeting mood. The combined use of all three scales in patients with affective disorders yields information that might not be revealed if only one scale is used.",Fava GA.; Kellner R.; Lisansky J.; Park S.; Perini GI.; Zielezny M.,,,0,0,
10101,Two-year follow-up of exposure and imipramine treatment of agoraphobia.,"Sixty-two agoraphobic patient who had completed a controlled study of therapist-assisted in vivo exposure (flooding) and imipramine were assessed 1 month, 6 months, 1 year, and 2 years later. Overall, improvement during treatment was maintained throughout follow-up. At 1 month but not subsequently, imipramine and flooding had significant effects on central measures of agoraphobia. Patients who were marked treatment responders had a favorable clinical course and did not experience secondary depression, unlike patients who had not responded markedly to treatment. These findings suggest that treatments which evoke maximum therapeutic benefit initially are likely to foster long-term maintenance and reduce subsequent depressive sequelae.",Mavissakalian M.; Michelson L.,1986.0,10.1176/ajp.143.9.1106,0,0,
10102,Prospective randomized evaluation of antishock MAST in post-traumatic hypotension.,"During an 18-month period, among 35,000 injured patients presenting to an urban trauma center, more than 3,500 were admitted, and 1,500 underwent surgery on the General Surgical Service. Three hundred fifty-two patients with prehospital systolic blood pressures of less than 90 mm Hg were randomized on an alternate day basis to receive treatment with 'MAST' (163 patients) or 'No-MAST' (189 patients). Age, mechanism of injury, prehospital management times, prehospital trauma scores, prehospital fluids administered, Injury Severity Scores, emergency center treatment, operative protocol, and calculated probability of survival were virtually identical for both groups. Eighty-eight per cent of the injuries were produced by penetrating wounds. The predominant injury area was the abdomen in 40%, the thorax in 37%, and the extremities in 13%. There was no statistically significant difference in evaluation and outcome data between the groups. Within a controlled catchment, only 2.5% of injured patients and 22% of those undergoing operation qualified for prehospital use of MAST. We conclude that for penetrating trauma with prehospital times of 30 minutes or less, MAST provide no advantage with regard to survival, length of hospital stay, or reduced hospital costs.",Mattox KL.; Bickell WH.; Pepe PE.; Mangelsdorff AD.,1986.0,,0,0,
10103,Stress inoculation therapy with anxiety and stress disorders of acute psychiatric inpatients.,"Twenty-six consecutive inpatient psychiatric admissions with severe stress and anxiety disorders were assigned to three treatment groups: stress inoculation therapy; a combination of stress inoculation and medication therapy; and medication therapy. The dependent measures indicate that stress inoculation therapy was superior to chemotherapy from pre- to post-testing and from baseline to posttesting in reducing symptoms of depression, anxiety, and overall subjective distress. In a 3-year follow-up, subjects in the stress inoculation therapy group tended to require fewer readmissions for psychiatric problems than the other treatment groups. It is proposed that stress inoculation therapy is effective in reducing symptoms of severe anxiety and stress reactions of acute psychiatric inpatients and that medication sometimes may have an inhibitive effect upon possible gains through psychotherapy.",Holcomb WR.,1986.0,,0,0,
10104,Psychological impact of adjuvant chemotherapy in the first two years after mastectomy.,"Psychological symptoms were assessed over two years in a randomised trial of three forms of treatment given to women after mastectomy for stage II breast cancer. The treatments were: three weeks' radiotherapy; one year's adjuvant chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil; and radiotherapy followed by chemotherapy. Analysis of the results on an intention to treat basis showed no substantial differences in depression or anxiety among groups at one, three, or six months after the operation. At 13 months, however, patients who had been allocated chemotherapy had significantly more symptoms, especially depression, than control patients treated with radiotherapy alone. Conditioned reflex nausea and vomiting increased considerably during the second six months of chemotherapy and persisted for up to a year afterwards. The psychological morbidity of adjuvant chemotherapy could be substantially reduced if courses of treatment were restricted to about six months.",Hughson AV.; Cooper AF.; McArdle CS.; Smith DC.,1986.0,,0,0,
10105,Effects of breast conservation on psychological morbidity associated with diagnosis and treatment of early breast cancer.,"Psychiatric morbidity was assessed in 101 women treated for early breast cancer (T0,1,2,N0,1,M0). Patients had expressed no strong preference for treatment, so were randomised to either mastectomy or breast conservation. The incidence of anxiety states or depressive illness, or both, among women who underwent mastectomy was high (33%) and comparable with that found in other studies. Slightly more of the patients who underwent a lumpectomy followed by radiotherapy had affective disorders, 38% having an anxiety state, depressive illness, or both. These findings question the view that mutilating treatment is predominantly responsible for the measurable psychiatric morbidity reported previously. Counselling services should be provided for all women treated for breast cancer, not just those who undergo mastectomy.",Fallowfield LJ.; Baum M.; Maguire GP.,1986.0,,0,0,
10106,Combination of psychotherapy and drugs in the treatment of neurosis. A controlled comparison of bromazepam and thioridazine.,"Eighty out-patients with neurotic disorders were studied in an integrated treatment model combining psychotherapy and psychotropics in a ""conjoint marital therapy"" setting. The spouses, who seemed a healthy group, were used as reporters, as controls and as participants in the psychotherapy. The pharmacological trial was a double-blind, cross-over study, comparing bromazepam and thioridazine after a placebo period. Bromazepam was more effective in controlling different anxiety symptoms and demonstrated more potent activating properties than thioridazine. Hostility symptoms, however, responded better to thioridazine. These findings were confirmed by ratings performed by patients, spouses and the investigator. Differences in drug preference and drop-out rate showed the same tendency. Nine weeks' continuous treatment did not change the differences found in the cross-over study. No pharmacological rebound symptoms were observed after drug withdrawal. The personality of the spouses was related to the outcome in the patients. Moreover, there was an obvious positive interaction between the psychotherapy given and the drug treatment.",Dencker SJ.; Fasth BG.,1986.0,,0,0,
10107,Self-perception of personality at midlife in elderly people: continuity and change.,"This study examined the extent of self-perceived continuity and change in personality in older people. Two visits were made to 362 elderly female and male volunteers, randomly assigned to either an experimental or control condition. In the first visit, the subjects completed a life interview and psychological battery including the Eysenck Personality Inventory. In the second visit, the experimental subjects had their life circumstances at age 40 reviewed and were asked to complete the personality inventory again, this time answering as if they were aged 40. Control subjects completed the personality inventory twice under standard directions. The dominant pattern for individuals in both conditions was one of personality continuity, however, subjects in the experimental group had significant differences between scores in the two test administrations, while the scores of control group subjects did not change significantly. Current personality scores were the major predictors of perceived personality at midlife, although ratings of financial adequacy and subjective age were also significant but minor predictors in the experimental condition.",Gold D.; Andres D.; Schwartzman A.,1987.0,10.1080/03610738708259325,0,0,
10108,Specificity in response to treatment: a study of interpersonal anxiety.,,McCann BS.; Woolfolk RL.; Lehrer PM.,1987.0,,0,0,
10109,Cognitive therapy vs behaviour therapy in the treatment of chronic general anxiety.,,Durham RC.; Turvey AA.,1987.0,,0,0,
10110,Effects of induced hyperventilation on electrodermal response habituation to agoraphobia-relevant stimuli.,"The role of hyperventilation in the aetiology of anxiety disorders was investigated in an analogue study. It was hypothesised that induced hyperventilation would alter subsequent subjective and physiological responses to visually presented agoraphobic material. Three groups (N = 16) of students were used and each was divided into two sub-groups which were presented with slides of either potentially agoraphobic or neutral content. During the first phase of the experiment, subjects were exposed to 10 slides whilst their breathing rate was manipulated. Group FB was instructed to hyperventilate by asking the subjects to breathe fast and deeply, Group SB was instructed to breathe at a slow rate and Group NB breathed normally. After a recovery phase, subjects were re-exposed to the same visual stimuli as used in the first phase of the experiment. Measures of skin conductance response amplitude were obtained for each stimulus in the series. In addition, heart rate and respiration were monitored, and subjective measures of somatic and affective states were obtained. Subjects also rated the pleasantness of the stimuli. The hyperventilation instructions resulted in delayed electrodermal habituation relative to the other groups. This finding could not be accounted for in terms of group differences in either physiological or subjective 'arousal'.",Kartsounis LD.; Turpin G.,1987.0,,0,0,
10111,Effects of cigarette smoking on phobic anxiety.,"Smokers report that smoking reduces anxiety. However, experimental research on the anxiety-reducing effects of smoking is limited to two self-report studies, both of which have methodological problems. We tested the effects of smoking on self-reported anxiety and avoidance behavior in a behavioral avoidance test (BAT) using a large white rat. In a counterbalanced within subjects design, 20 rat phobic female smokers smoked or were smoking deprived in two separate administrations of the BAT. A second group of 20 rat phobic nonsmokers also received two BATs. Subjects manifested substantial anxiety during BATs. However, neither smoking condition nor smoker versus nonsmoker status affected self-reported or motoric anxiety. Although smoking did not reduce anxiety in this study, smoking may affect anxiety in other situations, such as social settings, where the stimulus is more diffuse or less intense. It may also affect anxiety in individuals who are heavier smokers than our subjects, who smoked only 10-20 cigarettes per day.",Fleming SE.; Lombardo TW.,1987.0,,0,0,
10112,Cognitive behavioral treatment of agoraphobia.,,Marchione KE.; Michelson L.; Greenwald M.; Dancu C.,1987.0,,0,0,
10113,The placebo effect in agoraphobia.,"This paper presents two sets of data that suggests a weak but specific placebo response in agoraphobia. First, analyses in 20 agoraphobic patients given single-blind placebo over a 2-week period, without the customary confound of instructions for exposure to phobic situations, revealed a statistically significant reduction in panic and phobic symptoms. However, symptoms remained in the moderate to severe range and functioning was virtually unchanged. Second, comparisons between six agoraphobic patients receiving double-blind placebo and six others receiving ""no pills,"" matched for age, sex and exposure treatment, revealed a significant placebo effect over an 8-week period. Implications for clinical research are briefly discussed.",Mavissakalian M.,1987.0,,0,0,
10114,Micturition and the mind: psychological factors in the aetiology and treatment of urinary symptoms in women.,"The mental state of 211 women attending a urodynamic clinic was assessed using questionnaires. Patients with genuine stress incontinence had scores comparable with other patients with longstanding physical complaints. Patients with sensory urgency were more anxious than those with genuine stress incontinence. Patients with detrusor instability were as anxious as patients with sensory urgency and in addition had higher scores on the hysteria scale. A subset of patients (roughly a quarter of the total) was identified, comprising members of all three diagnostic groups, for whom urinary symptoms rendered life intolerable. These patients were as anxious, depressed, and phobic as psychiatric inpatients, emphasising the serious psychological morbidity experienced by patients with urinary symptoms. Fifty patients with detrusor instability or sensory urgency entered a randomised trial comparing psychotherapy, bladder drill, and propantheline. The psychotherapy group significantly improved on measures of urgency, incontinence, and nocturia, though not on frequency. Bladder training was an effective treatment for frequency and patients became less anxious and depressed. There was a modest improvement in frequency of micturition in patients given propantheline. Frequency may be a learnt disorder which responds to the direct symptom oriented approach of bladder training. Patients with urgency and nocturia predominating might derive more benefit from psychotherapy.",Macaulay AJ.; Stern RS.; Holmes DM.; Stanton SL.,1987.0,,0,0,
10115,Panic and avoidance in agoraphobia. Application of path analysis to treatment studies.,"We explored a causal sequence between panic and avoidance to provide recommendations for psychotherapy, pharmacotherapy, and their combination in treating agoraphobia. We produced a two-way [( imipramine hydrochloride vs placebo] by [office-based behavioral therapy vs in vivo exposure]) design by amalgamating two studies. We assessed agoraphobic patients for panic and avoidance at these time points: baseline (week 0), midcourse (week 13), and termination (week 26). The causal sequence model was tested by path analysis. Imipramine was superior to placebo in lowering panic and avoidance at both postbaseline time points. Exposure was superior to office-based treatment in lowering avoidance only at week 13. Exposure appeared to produce quicker improvement of avoidance than office-based therapy, but relapse occurred if this improvement was not supported by medication. Exposure did not benefit panic. We believe patients should be informed that imipramine is superior to exposure in inducing a panic-free state. Exposure without imipramine is of benefit only in reducing avoidance, but adding imipramine to exposure is necessary for panic control and substantially improves exposure and exposure maintenance.",Klein DF.; Ross DC.; Cohen P.,1987.0,,0,0,
10116,Ethanol retards desensitisation of simple phobias in non-alcoholics.,"Twenty non-alcoholic patients with DSM-III defined simple phobias for small animals received behavioural approach tests and exposure therapy while under the influence of a moderately intoxicating dose of ethanol or after placebo administration. Ethanol did not demonstrate any acute anti-anxiety effect, but retarded the rate of behavioural in vivo desensitisation, without changing the final treatment outcome. State-dependent effects of ethanol on anxiety were not demonstrated. This study supports prior research indicating no anti-anxiety or 'tension-reducing' effects of ethanol for simple phobias.",Cameron OG.; Liepman MR.; Curtis GC.; Thyer BA.,1987.0,,0,0,
10117,Agoraphobics 5 years after imipramine and exposure. Outcome and predictors.,"Five years after treatment in a controlled trial, in which all had received self-exposure homework, a group of 40 agoraphobic outpatients retained marked improvement in agoraphobia, mood, and free-floating anxiety. Frequency of spontaneous panics decreased as much in those who had placebo and self-exposure as in those who received imipramine and self-exposure. Few patients, however, were completely well at 5 years and over half had received further treatment for agoraphobia during the follow-up. Patients who were still highly phobic at the end of the clinical trial were more often prescribed psychotropic medication during follow-up and remained phobic at 5 years. Phobic improvement had generalized more in those patients with very low than in those with moderate pretreatment Hamilton depression scores. Frequency of initial spontaneous panics did not predict outcome. Improvement in agoraphobia was associated with improved marital adjustment. Those who began with the best marital, work, and social adjustment were more improved in their phobias 5 years later.",Lelliott PT.; Marks IM.; Monteiro WO.; Tsakiris F.; Noshirvani H.,1987.0,,0,0,
10118,Posttraumatic stress disorder in Israeli combat veterans. Effect of phenelzine treatment.,"Twenty-five Israeli combat veterans fulfilling DSM-III criteria for posttraumatic stress disorder (PTSD) participated in an open, prospective trial of phenelzine sulfate administration (median daily dose, 60 mg; range, 30 to 90 mg); three patients withdrew early due to side effects. Treatment was continued for at least four weeks in 22 cases and thereafter for as long as it was felt to be of benefit. Therapeutic efficacy was rated using a new PTSD scale, the Hamilton Depression Scale, and the Hamilton Anxiety Scale administered at four weekly intervals. Six patients completed four to eight weeks of phenelzine treatment; seven patients, nine to 13 weeks; and nine patients, 14 to 18 weeks. Comparison of mean prediscontinuation scores with pretreatment ratings showed, at best, only small (23% to 38%) differences (on the PTSD and Hamilton Anxiety scales) in the group treated for nine to 13 weeks. Two patients with a concurrent diagnosis of panic disorder and two with a concurrent diagnosis of dysthymic disorder were the most improved symptomatically but fell short of clinically significant remission. Although statistically significant improvement was observed on seven of the 12 items of the PTSD scale, sleep disturbance was the only symptom showing a clinically impressive change. These results only partially support previous positive reports of phenelzine treatment of PTSD.",Lerer B.; Bleich A.; Kotler M.; Garb R.; Hertzberg M.; Levin B.,1987.0,,0,0,
10119,"[Separation anxiety and anxiety attack disorders (""panic disorder""). A comparative study].",,Ayuso Gutiérrez JL.; Alfonso Suárez S.; Rivera Villaverde A.,,,0,0,
10120,Behavioral indices of habituation and sensitization during exposure to phobic stimuli.,,Marshall WL.,1988.0,,0,0,
10121,Susceptibility of Rorschach distress correlates to malingering.,"This study examined whether faking depression can affect Rorschach variables associated with distress. Fifty-eight nondepressed undergraduates were randomly assigned to experimental and control groups of 29 subjects each. All subjects took the Minnesota Multiphasic Personality Inventory (MMPI) Depression Scale, Rorschach Inkblot Test, and Beck Depression Inventory (BDI) under standard administration procedures. Immediately before taking the Rorschach and BDI, experimental group subjects were: (a) instructed to fake depression, (b) provided with a clinical description of the disorder, and (c) offered a cash incentive for the most convincing test display of depression. These conditions increased scores on the BDI, p less than .0001, Morbid Special Score, p less than .05, Bl, p less than .005, and reduced R, p less than .05, but affected no determinants. Power to detect a clinically significant effect of faking on the sum of gray-black determinants was .99 (alpha = .05). Major implications are: (a) abnormal frequencies of determinants should not be attributed to malingering, and (b) Rorschach content measures of depression are affected by impression management strategies.",Meisner S.,1988.0,10.1207/s15327752jpa5203_19,0,0,
10122,Predicting response to anxiety management in patients with generalised anxiety disorders.,,Butler G.; Anastasiades P.,1988.0,,0,0,
10123,12-year follow-up study of the Hamburg short psychotherapy experiment: an overview.,"In 1971/72 eighty-seven psychoneurotic and psychosomatic patients of the Psychosomatic Outpatient Department at the University Clinic of Hamburg-Eppendorf attained an indication for short-term psychotherapy. Nineteen patients did not accept our offer despite a sufficient prognosis; they form the nontreated control group. The remaining 68 patients were assigned at random to a psychodynamic conflict-centered (n = 34) or to a client-centered therapy (n = 34), each with a maximum of 30 sessions. In spite of this long interval of 12 years we gained information about 82.5% of our patients. The follow-up program consisted of a multidimensional approach to describe the posttreatment development of our patients: psychological tests, self-rating by the patient and assessments by the follow-up interviewer and independent ratings of experts. The efficacy of short psychotherapy is seen in the test scale 'extraversion' for both treatment groups, for 'depression' only for the client-centered therapy; for the psychodynamic therapy there is a tendency for late changes. The clinical ratings show no significant differences between the treatment and the control groups. Sex combination in the therapeutic dyads (i.e. same sex vs. opposite sex) is important for patients' posttherapeutic development.",Meyer AE.; Stuhr U.; Wirth U.; Rüster P.,1988.0,,0,0,
10124,Therapist contact and outcome of self-exposure treatment for phobias. A controlled study.,"Eighty-four chronic phobic patients were randomly assigned to self-exposure in vivo instructed by either a psychiatrist, a computer or a book; mean therapy time per patient was respectively 3.1, 3.2 and 0 hours. Seventy-one patients completed treatment. All three groups improved substantially and similarly to 6 months follow-up, with no significant difference between them; self-exposure treatment was effective even without therapist contact. Among the three groups, initial expectation of help and positive attitude to the psychiatrist were equally high and related to subsequent rating of help received. All three groups rated the psychiatrist as more tolerant, reliable, and understanding than the computer or book, but these attitudes did not relate to outcome, were initially similar among all three groups, and changed minimally at 6 months follow-up.",Ghosh A.; Marks IM.; Carr AC.,1988.0,,0,0,
10125,"The differential effects of inductions of worry, somatic anxiety, and depression on emotional experience.","One-hundred and twenty-eight subjects underwent inductions of emotions designed to elicit worrisome, depressed, somatically anxious, or neutral emotional states, and then they completed the Multiple Affect Adjective Checklist. Induction of worry was found to produce (a) moderate degrees of both anxiety and depression, (b) emotional profiles more highly correlated with those of depression and somatic anxiety than the correlation of depression and somatic anxiety profiles with each other, and (c) a subjective state containing no unique emotional features separate from that induced in depression and somatic anxiety. Whereas a discriminant function analysis correctly classified 70-85% of the subjects in the other three conditions, subjects who underwent the induction of worry were correctly classified at only chance level.",Andrews V.; Borkovec TD.,1988.0,,0,0,
10126,Treatment of severe social phobia: effects of guided exposure with and without cognitive restructuring.,,Mattick RP.; Peters L.,1988.0,,0,0,
10127,Home-based treatment of obsessive-compulsive patients: intersession interval and therapist involvement.,In a 2 x 2 factorial design massed vs spaced and therapist vs self-controlled exposure were compared with obsessive-compulsive patients. Intersession interval was varied keeping constant the length of exposure time and number of exposure sessions. Treatment in all conditions was home based. Treatment led to highly statistical and significant improvements on all measures. Massed exposure was as effective as spaced exposure; self-controlled exposure proved to be as effective as therapist-controlled exposure.,Emmelkamp PM.; van Linden van den Heuvell C.; Rüphan M.; Sanderman R.,1989.0,,0,0,
10128,"Breathing retraining, exposure and a combination of both, in the treatment of panic disorder with agoraphobia.","The present study investigates the differential effectiveness of three treatment packages for agoraphobia. Patients suffering from panic disorder with agoraphobia (DSM-III-R) received one of three treatments: Breathing Retraining with Cognitive Restructuring (BRCR), graded self-exposure in vivo (EXP), or a combination of BRCR and EXP. Treatments consisted of 8 sessions. Assessment consisted of self-report measures for panic, phobic anxiety and avoidance, depression, general anxiety, somatic complaints and fear of body sensations, and of two respiratory measures (respiratory rate and alveolar pCO2). The treatments resulted in a reduction in symptomatology on all self-report measures, except panic frequency, and in a decrease in respiratory rate. There was no evidence for a differential efficacy for any of the treatments on any of the variables. Contrary to expectation, and at odds with findings from earlier studies, BRCR had no significant effect on panic frequency. A detailed comparison of sample characteristics of patients in our study and previous studies, did not yield insight into possible causes for the failure to replicate earlier results. The limited effectiveness of breathing retraining in reducing panic, as observed in the present study, leads us to conclude that the role of hyperventilation in panic is less important than previously thought.",de Ruiter C.; Ryken H.; Garssen B.; Kraaimaat F.,1989.0,,0,0,
10129,Instructions to focus upon or distract from internal cues during exposure treatment of agoraphobic avoidance.,"Instructions to focus upon feared somatic sensations were compared to instructions to engage in distracting tasks, while practising in vivo exposure to feared agoraphobic situations. Thirty individuals assigned a primary diagnosis of Panic Disorder with moderate to severe Agoraphobia were assigned randomly to one of the two treatment conditions. Assessments were conducted pre, post and 6 months following treatment completion, using subjective, behavioral and clinician-rated measures of change. Composite outcome criteria indicated a trend for distracted exposure to yield a higher percentage of improvement than focused exposure, at post assessment. However, focused exposure group members improved to a greater extent over the follow-up interval than members of the distracted group. These trends were relatively weak, given the absence of significant group by time interactions in terms of individual variable analyses. The results were discussed with reference to the role of distraction in fear reduction.",Craske MG.; Street L.; Barlow DH.,1989.0,,0,0,
10130,Social phobia: individual response patterns and the effects of behavioral and cognitive interventions.,"In the present study, the role of individual response patterns in the treatment of social phobic patients was investigated. Seventy-four patients were diagnosed as social phobics. On the basis of extreme scores on a behavioral test (the Simulated Social Interaction Test) and on a cognitive measure (the Rational Behavior Inventory), the response patterns of 39 patients were analyzed, and the patients themselves were classified as either 'behavioral reactors' or 'cognitive reactors'. Half of the patients with each response pattern received a behavioral focused treatment, i.e. social skills training (SST), while the other half received a cognitive oriented treatment, i.e. rational emotive therapy (RET). Patients received group therapy in eight weekly sessions. Within-group differences showed a considerable improvement in all treatment groups. Between-group differences failed to lend support to the hypothesis that treatment that fits a response pattern (i.e. SST for behavioral reactors and RET for cognitive reactors) will result in a greater improvement than one that does not.",Mersch PP.; Emmelkamp PM.; Bögels SM.; van der Sleen J.,1989.0,,0,0,
10131,Respiratory control: its contribution to the treatment of panic attacks. A controlled study.,"Patients who experienced panic attacks, with or without avoidance, were treated for two weeks with either training in controlled breathing or a placebo treatment. Subsequently, both groups received a limited period of conventional anxiety treatments, most commonly in vivo exposure. Patients were subdivided into 'hyperventilators' and 'non-hyperventilators' on the basis of the conventional provocation test. Observer ratings of anxiety showed a greater improvement for the group that received breathing training, but there was no evidence that 'hyperventilators' benefited more from respiratory training than 'non-hyperventilators'. Self-report measures of anxiety, avoidance, and depression/dysphoria showed no difference between treatments. These findings suggest that training in controlled breathing is not of specific benefit for those identified as 'hyperventilators' by the provocation test, but that it may have a non-specific effect in the treatment of patients with panic attacks.",Hibbert GA.; Chan M.,1989.0,,0,0,
10132,Prospective evaluation of combined high-frequency ventilation in post-traumatic patients with adult respiratory distress syndrome refractory to optimized conventional ventilatory management.,"This study explores the value of combined high-frequency ventilation (CHFV) in a prospective clinical trial of 35 patients suffering from severe post-traumatic and/or septic adult respiratory distress syndrome (ARDS) who were refractory to conventional controlled mechanical ventilatory (CMV) support. The severity of ARDS was quantified by lung mechanics and gas exchange variables and the patients were classified on clinical grounds as well as on the basis of their respiratory index/pulmonary shunt relationship [RI/(Qsp/Qt)]. During the same time period as the CHFV study, data from these patients were compared to those from 88 ARDS patients who had quantitatively similar degrees of respiratory insufficiency, but who were treated only with controlled mechanical ventilation (CMV). The use of CHFV in the 35 CMV refractory patients resulted in an increase in expired tidal volume (VTE) by reducing the CMV inspired tidal volume (VTI) while increasing the volume component derived from high-frequency ventilation (HFV). This procedure appeared to reveal potentially salvageable ARDS patients who were refractory to CMV. In these patients, CHFV significantly reduced pulmonary mean airway pressure (Paw). The RI also decreased significantly and it was possible to reduce significantly the FIO2. In surviving ARDS patients treated with CHFV, an improvement in blood gases at reduced FIO2, without decreased cardiac output, was produced. The CHFV technique was used for less than or equal to 25 days and resulted in 23% survival of patients who were clinically and physiologically indistinguishable from the patients in the ARDS nonsurvivor group who were treated by CMV only. In surviving CHFV patients the decrease in Paw permitted a sustained, or increased, cardiac output with a rise in the oxygen delivery/oxygen consumption ratio, thus allowing for a higher PaO2 for any given level of pulmonary shunt.",Borg UR.; Stoklosa JC.; Siegel JH.; Wiles CE.; Belzberg H.; Blevins S.; Cotter K.; Laghi F.; Rivkind A.,1989.0,,0,0,
10133,Quality of life in panic disorder.,"Data from the Epidemiologic Catchment Area study showed that a lifetime Diagnostic Interview Schedule/DSM-III diagnosis of panic disorder was associated with pervasive social and health consequences similar to or greater than those associated with major depression. These consequences included subjective feelings of poor physical and emotional health, alcohol and other drug abuse, increased likelihood of suicide attempts, impaired social and marital functioning, financial dependency, and increased use of psychoactive medications, health services, and the hospital emergency department for emotional problems. Comorbidity of panic disorder with major depression, agoraphobia, and alcohol or other drug abuse did not explain these findings. The social and health consequences of panic disorder (quality of life) should be considered, as risks and benefits of currently available acute and maintenance treatments are evaluated. Clinical trials of panic disorder, whether of drugs or behavioral treatment, should include quality of life assessments as outcome measures. Long-term prospective studies based on clinical samples of patients with panic disorder are indicated to relate the illness more precisely to social morbidity.",Markowitz JS.; Weissman MM.; Ouellette R.; Lish JD.; Klerman GL.,1989.0,,0,0,
10134,Is the match/mismatch model based on a statistical artefact?,"In the match/mismatch model, recently formulated by Rachman and coworkers, it is stated that incorrectly predicted aversive experiences are generally followed by an immediate adjustment of the predictions concerning aversiveness of the next experience. This model can be considered to reflect a psychological process of the formation of expectations. In the present article it is argued that a simple H0 model, assuming that predictions are completely randomly generated by the subject, may account for the same effects. This H0 model is used in a stringent test of empirical data to determine if there are any effects of the discrepancy between prediction and experience on next prediction that exceed the effects explained by the H0 model. Although the H0 model produces effects very similar to the empirically observed effects, there is clear support for the hypothesized influence of the discrepancy between prediction and experience. Therefore, the model appears to reflect 'real' psychological processes and not chance findings.",Arntz A.; van den Hout MA.; Lousberg R.; Schouten E.,1990.0,,0,0,
10135,"What is presented, and what prevented, in cue exposure and response prevention with alcohol dependent subjects?","The following questions, pertaining to cue reactivity in alcoholics, are discussed: (a) What cues are relevant to alcoholics' drinking? Previous research has been concerned with the obvious: bottles, glasses, pub/bar environments, and other visual cues. Presumably more potent cues, that is, smell, taste and internal effects, subtle stimuli like social climate, shifts in conversations, also influence drinking. The effects of mood states on alcoholics' urges and behavior are rarely integrated into experimental studies. (b) What is the CR? Given that drinking is a very complex social behavior, ""the drug effect"" becomes problematic to disentangle from the effects of other factors, such as bio-medical states, social setting and learning history. This is further complicated by the fact that drugs affect physiological and cognitive systems differently at different dose levels and with rising and falling Blood Alcohol Levels. Moreover, it has been found that alcohol cues may elicit responses that are in the same and in the opposite direction to the drug response. (c) If such responses are reliably tied to alcohol cues (as opposed to novelty of the experimental situation), the impact of the conditioned responses on craving for alcohol and relapse becomes an issue. (d) Another question relates to the analogy between fear in phobias and craving in substance abuse since, unlike phobics, substance abusers do not fear the substance they are responding to. (e) A further issue is the effectiveness of extinction procedures, as opposed to changes in efficacy expectations, as a therapeutic mechanism for the cue exposure paradigm. Examples of recent research at the Hjellestad Clinic are presented.",Laberg JC.,1990.0,,0,0,
10136,Symptom reporting during voluntary hyperventilation and mental load: implications for diagnosing hyperventilation syndrome.,"Hyperventilation is considered an important factor in the production of a variety of somatic symptoms. This complex of symptoms is called the Hyperventilation Syndrome (HVS). Recognition of symptoms during the hyperventilation provocation test (HVPT) is a widely used criterion for diagnosing HVS. The validity of this criterion is tested in the present study. Twenty-three patients suspected of HVS performed a HVPT (hyperventilation during 3 min) and a mental load task (Stroop Color Word Test; CWT). It appeared that about the same number of patients (61%) recognized symptoms during the HVPT as during the CWT (52%), despite severe hypocapnia in the first test and normocapnia in the second. Reporting of symptoms was significantly related to psychological state and trait measures (SCL-90 and STAI scores) and unrelated to the degree of hypocapnia. These data have far reaching consequences, as they not only undermine the validity of the HVPT, but also question the tenability of the concept of HVS.",Hornsveld H.; Garssen B.; Dop MF.; van Spiegel P.,1990.0,,0,0,
10137,An obsessive-compulsive view of obesity and its treatment.,"It was hypothesized that some obese individuals who are obsessed with food and who eat compulsively may not respond to the stimulus control techniques widely used in treating obesity. Sixty-eight participants were administered a measure of obsessive tendencies and randomly assigned to three treatment modalities: (a) Exposure and response prevention; (b) Stimulus control; (c) Control. Results indicated that participants who scored high on the Eating Obsessive Compulsive questionnaire (EOC) maintained weight loss significantly better with exposure and response prevention (ERP) training than did either the stimulus control or the control group. It was concluded that for the obsessive-compulsive eater, ERP training is the treatment of choice.",Mount R.; Neziroglu F.; Taylor CJ.,1990.0,,0,0,
10138,Changing the psychiatric knowledge of primary care physicians. The effects of a brief intervention on clinical diagnosis and treatment.,"This research examined the malleability of physicians' knowledge about psychiatric disorders (and their recommended treatments) based on a brief educational intervention. Primary care physicians were randomly assigned to a single-session intervention dealing with selected DSM-IIIR affective and anxiety disorders or to a wait-list control group. Posttest (vs. pretest) measures indicated that experimental physicians showed greater increases than controls in diagnostic accuracy on relevant disorders, specifically, major depression, dysthymic disorder, and agoraphobia with panic attacks. Treatment recommendations were also influenced, specifically, for major depression and panic disorder. Interestingly, treatment recommendations were also influenced for certain somatic disorders not addressed in the intervention, suggesting ""halo"" effects for these disorders. Overall, the intervention was effective in increasing diagnostic knowledge and altering treatment recommendations. Implications for research on psychiatric interventions among physicians are discussed.",Andersen SM.; Harthorn BH.,1990.0,,0,0,
10139,"Neurotic, stress-related and somatoform disorders (section F4) and physiological dysfunction associated with mental or behavioural factors (section F5): results of the ICD-10 field trial.","The results of the ICD-10 field trial in German-speaking countries relevant to sections F4 (neurotic, stress-related and somatoform disorders) and F5 (physiological dysfunction associated with mental or behavioural factors) show a comparatively low level of acceptance. Interrater-reliability in various diagnostic categories is not always adequate. In particular the allocation of some of the ""old"" diagnostic entities of ICD-9 to various sections of ICD-10, and in part unsatisfactory classificatory distinctions gave rise to certain problems.",Freyberger HJ.; Stieglitz RD.; Berner P.,1990.0,10.1055/s-2007-1014558,0,0,
10140,A comparative study of family-based and patient-based behavioural management in obsessive-compulsive disorder.,"Thirty obsessive-compulsive patients were randomly allocated to two treatment conditions. In group A a significant family member was trained to act as cotherapist at home, whereas in group B, only the patient was seen and given home assignments. All 30 patients received a similar treatment regime of systematic desensitisation, exposure, and response prevention. The family-based approach resulted in greater improvement in anxiety, depression, obsessive symptoms, and in social adjustment in occupational and household responsibilities. The personality pattern of the family members also appeared to influence outcome.",Mehta M.,1990.0,,0,0,
10141,"Treatment of obsessive compulsive disorder: psychotherapies, drugs, and other somatic treatment.","Ninety percent of obsessive compulsive patients can be helped by treatment with behavior therapy and drug treatment, used sequentially or concurrently. The effectiveness of these treatments has been demonstrated in controlled clinical trials and is superior to electroconvulsive therapy and dynamic or cognitive psychotherapies for this disorder. Potent serotonin uptake inhibiting drugs, from the class of heterocyclic antidepressants, are the most effective antiobsessional medications currently available. Although these drugs usually do not induce complete remission, they can reduce obsessive compulsive symptoms by 30% to 42%. Behavior therapy combines exposure and response prevention, which the patient first learns with the therapist and then practices independently. With behavior therapy, patients confront the triggers for their anxiety and then delay, diminish, or discontinue their rituals. Reduction in symptoms with behavior therapy averages 50% or greater. Behavior therapy is usually not effective in patients who are substantially depressed, are delusional, fail to comply, or undermine therapy with covert rituals or avoidance techniques. The rare patient with very severe obsessive compulsive disorder who does not respond to behavior or drug therapy may be a candidate for psychosurgery. Modern psychosurgical procedures are quite safe and can improve symptoms in the majority of otherwise unresponsive patients.",Greist JH.,1990.0,,0,0,
10142,A contribution of fluorescent lighting to agoraphobia.,"Under three types of artificial lighting 24 women with chronic agoraphobia and 24 female control subjects assessed their mood and bodily symptoms, and their heart rate was measured. One of the three types of lighting was incandescent. The other two were fluorescent, one pulsating in the conventional manner 100 times per second and the other relatively steady. Both were provided by a single fluorescent lamp controlled from one of two circuits. When exposed to the conventional pulsating fluorescent light under double-blind conditions the agoraphobic group showed a higher heart rate and reported more anomalous visual effects in response to an epileptogenic pattern. Control subjects reported more bodily symptoms under the conventional fluorescent light than under the two other lighting conditions.",Hazell J.; Wilkins AJ.,1990.0,,0,0,
10143,Psychological treatment for atypical non-cardiac chest pain: a controlled evaluation.,"Thirty-one patients with atypical non-cardiac chest pain which had persisted despite negative medical investigation were treated in a controlled trial of cognitive-behavioural therapy. The average duration of pain was 4.7 years. Patients were randomized to either immediate treatment or as a control to assessment only. Treatment involved teaching patients how to anticipate and control symptoms, and modification of inappropriate health beliefs. The average number of sessions given was 7.2. There were significant reductions in chest pain. limitations and disruption of daily life, autonomic symptoms, distress and psychological morbidity in the treated group as compared with the control group who were unchanged. The assessment-only group were treated subsequently and showed comparable changes. Improvements were fully maintained by both treated groups at four- to six-months follow-up.",Klimes I.; Mayou RA.; Pearce MJ.; Coles L.; Fagg JR.,1990.0,,0,0,
10144,Emotional processing and fear measurement synchrony as indicators of treatment outcome in fear of flying.,"Minimal-therapist-involvement stress inoculation training was used to treat flying phobics. Relative to no-treatment controls, treatment subjects reported more fear reduction, were more likely to participate in an exposure session, and flew more during a two-month follow-up period. Subjects who exhibited synchronous changes in heart rate and report of anxiety during exposure had greater fear reduction than subjects showing less synchrony. Subjects who voluntarily took plane flights in the two months following treatment showed greater indications of emotional processing during in vivo exposure. Relative to flight avoiders, fliers had higher mean heart rate in the plane, a greater reduction in heart rate from the beginning to the end of the flight, and greater reported fear reduction from pre- to post-flight.",Beckham JC.; Vrana SR.; May JG.; Gustafson DJ.; Smith GR.,1990.0,,0,0,
10145,Treatment of panic and agoraphobia. An integrative review.,"There is now agreement about the clinical features of panic disorder and agoraphobia but less agreement about treatment because of controversy over whether the disorder is primarily biological or psychological. The authors were requested to produce an impartial review for continuing education and peer review. We chose to do this by using a quantitative review procedure, by providing a bibliography of studies, and by a literature review. We found that symptoms of panic and phobia did not change significantly while on wait-list control or while receiving placebo. The evidence for the efficacy of the low-potency benzodiazepines or of monoamine oxidase inhibitors was limited. It was also clear that only limited improvement can be expected from behavior therapies that do not involve exposure to the symptoms of panic or to the feared situation. Symptoms of panic, as well as the frequency of spontaneous panic, were shown to be substantially improved following imipramine, high-potency benzodiazepines such as alprazolam, exposure in vivo (especially if a cognitive anxiety management procedure was used), and the combination of imipramine and exposure in vivo. The effects on panic produced by the exposure therapies (with or without imipramine) were maintained over long follow-up periods. Imipramine, alprazolam, exposure therapy, and imipramine plus exposure each produced significant improvements in phobias. In the short term and in the long term, the larger improvements in phobias were associated with exposure therapy, particularly if used in combination with imipramine. We conclude that it would be unwise to theorize about the etiology of this disorder on the basis of response to a specific treatment because, both at the meta-analytic level and from the review of individual studies, it is clear that both drug and nondrug therapies can produce substantial and long-lasting changes in panic and in phobias.",Mattick RP.; Andrews G.; Hadzi-Pavlovic D.; Christensen H.,1990.0,,0,0,
10146,Reduction of post-traumatic swelling and compartment pressure by impulse compression of the foot.,"Following the discovery of a powerful venous pump in the foot that is activated by weight-bearing independently of muscular action, a pneumatic impulse device was developed to actuate this pump artificially. In a multicentre international trial the device was shown to reduce post-traumatic and postoperative swelling; pain also was alleviated. Evidence is also presented that dangerously high compartment pressures may be reduced to acceptable levels and fasciotomy avoided. We present an explanation of the clinical effects of activation of the venous footpump, based on recent improved understanding of the physiology of the microcirculation. The hyperaemic response that follows the liberation of endothelial-derived relaxing factor (EDRF) by sudden changes of pressure after weight-bearing or impulse compression is particularly important.",Gardner AM.; Fox RH.; Lawrence C.; Bunker TD.; Ling RS.; MacEachern AG.,1990.0,,0,0,
10147,Effects of paced respiration on anxiety reduction in a clinical population.,"The purpose of this study was to examine the effects of paced respiration on autonomic and self-report indices of affect within a clinical population. Thirty-six alcohol-dependent inpatients scoring high in trait anxiety were randomly assigned to either a pacing or attention control group. The paced subjects received 10 minutes of slow-breathing training during the first experimental session, while control subjects simply counted the pacing tones. In a second session, paced subjects were asked to breathe at the same lowered rate (10 cycles per minute) on their own, while the remaining subjects were instructed to relax. Prior to and following each session, self-ratings of tension level and state anxiety were collected. As expected, paced subjects evidenced greater reductions in self-rated tension, state anxiety, and skin conductance levels compared to the control subjects. It was concluded that respiratory pacing is an easily learned self-control strategy and potentially may be a useful therapeutic tool.",Clark ME.; Hirschman R.,1990.0,,0,0,
10148,Distressed high utilizers of medical care. DSM-III-R diagnoses and treatment needs.,"Among a sample of 767 high utilizers of health care, 51% were identified as distressed by an elevated score on the SCL anxiety and depression scales, the SCL somatization scale, or by their primary-care physician. These distressed high utilizers were found to have a high prevalence of chronic medical problems and significant limitation of activities caused by illness. In the prior year, they made an average of 15 medical visits and 15 telephone calls to the clinic. The Diagnostic Interview Schedule was completed on 119 distressed high utilizers randomly assigned to an intervention group in a controlled trial of psychiatric consultation. The following DSM-III-R disorders were most common: major depression 23.5%, dysthymic disorder 16.8%, generalized anxiety disorder 21.8%, and somatization disorder 20.2%. Two thirds had a lifetime history of major depression. The examination resulted in an improved diagnostic assessment for 40% of intervention patients and a revised treatment plan for 67%.",Katon W.; Von Korff M.; Lin E.; Lipscomb P.; Russo J.; Wagner E.; Polk E.,1990.0,,0,0,
10149,[Transcranial electric stimulation therapy in the treatment of neurocirculatory asthenia].,"Transcranial electric stimulation (TES), a combination of direct and pulse current totally up to 5 mA, rectangular impulses lasting 3-4 ms at a frequency of 75-80 Mz, via frontal and retromastoid electrodes was carried out for 30 minutes every other day. The treatment consisted of 7 to 10 sessions. Overall 189 patients suffering from vegetovascular dystonia were examined. Of these, 114 persons (group I) received pharmacotherapy and TES, 61 TES (group II), and 14 were on placebo. 83% of the group I patients and 80.3% of the group II patients manifested an appreciable improvement of the well-being which was supported by the data of its general estimation. 22 patients were examined for blood beta-endorphin. It has been shown that its concentration increased and returned to normal during TES.",Akimov GA.; Zabolotnykh VA.; Lebedev VP.; Zabolotnykh II.; Chuprasova TV.; Afoshin SA.; Rozanov SI.; Kassin PL.; Preobrazhenskaia SL.,1991.0,,0,0,
10150,Cognitive therapy with obsessive-compulsive disorder: a comparative evaluation.,"After a 4-week waiting period 21 obsessive-compulsives were randomly allocated to two treatment conditions (1) Rational Emotive Therapy (RET) and (2) exposure in vivo. RET consisted of analysing irrational thoughts; exposure in vivo was self-controlled. After six sessions and another 4-week waiting period all patients received six sessions of exposure in vivo. Both treatments resulted in significant improvement on anxiety/discomfort, Maudsley Obsessional Compulsive Inventory, and Dutch Obsessional Compulsive Questionnaire and in a reduction of scores on the Irrational Beliefs Test. Results were maintained to a follow-up 6 months later. No significant differences were found between the two conditions.",Emmelkamp PM.; Beens H.,1991.0,,0,0,
10151,The effect of concordance in the treatment of clients with dental anxiety.,"This study followed from an earlier case study in which an agoraphobic client was treated daily for a period of four weeks by in vivo exposure. Ratings of his perceived anxiety responses in the behavioural, cognitive, and physiological systems were monitored throughout treatment. Concordance between these ratings was associated with positive outcome. This study was an attempt to replicate some of these findings. A group programme involving four sessions in which clients were taught anxiety management skills, exposed in imagination to situations relating, to dentistry, and given homework assignments was carried out with clients presenting with disproportionate dental anxiety. The subjects were obtained by means of local newspaper and radio advertisements and randomly assigned to a massed or spaced treatment condition. It was predicted that the massed condition involving shorter intersession intervals would be superior at producing habituation and concordance than the spaced condition. The results failed to show differences between the massed and spaced treatment condition with regard to concordance and outcome. However, it was confirmed, once more, that concordance between the three modes of anxiety responding was positively related to outcome.",Ning L.; Liddell A.,1991.0,,0,0,
10152,Referral and screening patterns at a clinic for anxiety disorders; implications for the planning of clinical studies.,"During a two year period (1988-1990), 302 patients who were referred to our anxiety disorder clinic were evaluated and diagnosed according to a screening procedure which will be described. Of these initial referrals, 171 met a DSM-3-R diagnosis of panic disorder (with or without agorophobia) or generalized anxiety disorder; 81 patients (27% of the initial referrals) participated in a double blind placebo controlled clinical trial with a dropout rate of 12%. The implications for the planning and design of referral and screening strategies at research oriented specialized clinics are discussed.",Klein E.; Zillberman I.; Lenox RH.; Cnaani E.; Becker D.; Collin V.,1991.0,,0,0,
10153,Covariation bias and electrodermal responding in spider phobics before and after behavioural treatment.,"The present study investigated whether a covariation bias is present in severe spider phobics and whether such bias is modified by successful treatment. In addition, this study sought to examine whether a covariation bias is linked to differential autonomic responding. Subjects were 20 untreated phobics, 19 treated phobics, and 18 no-fear controls. Subjects were exposed to a series of 72 slides comprising three categories: spiders (fear-relevant), mushrooms, and flowers. At slide offset one of three possible outcomes occurred: a shock, a tone, or nothing at all. All slide-outcome combinations occurred equally frequent. The results show that an equally strong covariation bias is present in severe spider phobics, in successfully treated phobics, and in no-fear controls. Thus, the present data only partially sustain earlier findings of Tomarken, A. J., Mineka, S. & Cook, M. (1989) (Journal of Abnormal Psychology, 98, 381-394). The covariation bias appeared to be mimicked by differentially heightened autonomic responding. The current data suggest that both the covariation bias and the heightened physiological responding reflect a ""beloningness"" between spider slides and aversive outcome.",de Jong P.; Merckelbach H.,1991.0,,0,0,
10154,Social phobia: individual response patterns and the long-term effects of behavioral and cognitive interventions. A follow-up study.,"In this study the long-term effectiveness of Social Skills Training (SST) and Rational Emotive Therapy (RET), on social phobia was studied, as well as the differential influence of patient characteristics on treatment effectiveness. Fifty-seven patients were assessed 14 months after the post-test. Results showed that long-term effectiveness was independent of the response-pattern of the patients. Comparisons between methods, irrespective of the response-pattern of the patients, showed no differences in effectiveness in favor of either SST or RET. Explorative analysis indicated the potential predictive power for treatment-outcome of confederate ratings of overt behavior on the SSIT. Patients who needed additional treatment appeared to perform significantly worse on this measure at the pretest. No factors could be traced that predict relapse after a relatively successful treatment.",Mersch PP.; Emmelkamp PM.; Lips C.,1991.0,,0,0,
10155,The base for exposure treatment in agoraphobia: some indicators for nurse therapists and community psychiatric nurses.,"This study examines, using a randomised control trial, the question of the optimum base for exposure treatment with agoraphobic clients. The results have relevance for community psychiatric nurses and nurse behaviour therapists working with such problems and indeed for other behavioural practitioners. While the results confirm the already extensive evidence for the efficacy of exposure in vivo for agoraphobic clients, the results show that in general there is no difference between outcome of treatment delivered from the patient's own home and the out-patient clinic. There are, however, a small number of clients who will not attend psychiatric out-patient clinics for treatment but who will subsequently do well with home-based treatment. The reasons for the experimental findings and implications for psychiatric nurses are discussed.",Gournay KJ.,1991.0,,0,0,
10156,Controlled comparison of day-patient and out-patient treatment for persistent anxiety and depression.,"The effectiveness of day care versus out-patient care in the treatment of persistent severe anxiety and depression was compared in a controlled clinical trial. Of 96 consecutively referred patients meeting the entry criteria, 92 were followed up for six months. Patients were randomised to day care or out-patient care, and assessed at entry and at six months using the Standardised Psychiatric Interview and in terms of their time structuring and socialisation. Marked improvement in all three measures was seen for most of the day patients, but for few of the out-patients: this difference was highly significant for each measure. Day patients also rated themselves as coping more effectively and as more satisfied with their treatment. These differences could not be explained by differences in use of medication. Day treatment should remain an option for patients with persistent anxiety and depression resistant to outpatient treatment.",Dick PH.; Sweeney ML.; Crombie IK.,1991.0,,0,0,
10157,"How ""blind"" are double-blind studies?","Psychopharmacological studies usually attempt to eliminate ""nonspecific"" influences on outcome by double-blind designs. In a randomized, double-blind comparison of alprazolam, imipramine, and placebo, the great majority of panic disorder patients (N = 59) and their physicians were able to rate accurately whether active drug or placebo had been given. Moreover, physicians could distinguish between the two types of active drugs. Inasmuch as correct rating was possible halfway through treatment, concerns about the internal validity of the double-blind strategy arise.",Margraf J.; Ehlers A.; Roth WT.; Clark DB.; Sheikh J.; Agras WS.; Taylor CB.,1991.0,,0,0,
10158,"[Sinusitis in long-term intubated, intensive care patients: nasal versus oral intubation].","Discussion of paranasal sinusitis as a nosocomial infection in the mechanically ventilated intensive care (ICU) patient has recently been intensified. Some authors have emphasized nasotracheal intubation as a possible pathogenetic pathway. The aim of this study was to investigate the impact of nasotracheal or orotracheal intubation on the development of sinusitis in ICU patients. In a prospective study, we followed 44 patients who required mechanical ventilation (greater than 24 h) in the ICU because of prolonged recovery from abdominal, thoracic, or posttraumatic surgery. Twenty patients were intubated nasotracheally and 24 orotracheally. Assignment to the groups was random. All were provided with a nasogastric tube and initially treated with systemic antibiotics. They received local antimicrobial prophylaxis of the nose, oropharynx, and stomach. Daily a-scan examinations of the maxillary sinuses were performed from the day of admission to the ICU until extubation, tracheotomy, death, or transfer. The average observation period was 6.9 days in the oral group and 7.1 days in the nasal group. In the case of a pathologic finding, aspiration of the antral sinus was carried out. In this study sinusitis indicated a sonographic finding; it did not necessarily imply a bacterial infection. At the beginning of the observation period, 6 patients in the oral group and 4 in the nasal group already had a pathologic maxillary sinus finding. At the end, in 15 of 24 in the oral group and 19 of 20 in the nasal group unilateral or bilateral sinusitis could be demonstrated. Development of bilateral sinusitis (13/20 in the nasotracheal group, 8/24 in the orotracheal group) was mainly observed after the appearance of unilateral sinusitis. The site corresponded to the site of the nasal tube in 65%. Unilateral paranasal infection was observed in nasotracheally and orotracheally intubated patients after an average of 2.8 and 2.6 days, respectively, whereas bilateral sinusitis had an average time delay of 4.5 and 5.7 days. Aspiration of the maxillary sinus was performed in 22 of 34 cases with sinusitis. Pathogenic organisms could be demonstrated in 7 of 13 nasotracheally intubated patients but only 2 of 9 with orotracheal tubes. We found that patients intubated orotracheally developed significantly less sinusitis than those intubated nasotracheally. Edema, local infection of the nasal mucosa, or mechanical obstruction of sinus drainage pathways by the tube are possible explanations. The fact that 63% of orally intubated patients had a pathologic maxillary sinus finding as well suggests that in addition to other reasons, an increased central venous pressure, positive pressure ventilation, and the supine position must be regarded as predisposing factors that increase the incidence of sinusitis. We conclude that the conditions of critically ill patients predispose to the development of sinusitis. Nasotracheal intubation is to be regarded as an additional risk, and therefore oral intubation should be preferred.",Michelson A.; Kamp HD.; Schuster B.,1991.0,,0,0,5949
10159,Clomipramine in obsessive compulsive disorder.,,Lee S.,1991.0,,0,0,
10160,Confirmation of endosonographic detection of external anal sphincter defects by simultaneous electromyographic mapping.,"Anal endosonography was performed in 13 consecutive patients with post-traumatic faecal incontinence. Thirteen acoustic defects in the external anal sphincter (two hyperechoic, four of mixed echogenicity and seven hypoechoic) were analysed electromyographically by locating under ultrasound guidance the tip of a concentric needle within the defect. The electromyographic activity in this zone was compared with ultrasonically normal muscle. Eleven of 13 sonographic defects showed no electrical activity on electromyography, there was one technical electromyography failure, and one defect was too deep to be reached by the electromyography needle. The electromyographic response was normal in each case within ultrasonically normal muscle. Anal endosonography is recommended as the initial investigation to locate defects, which may be confirmed electromyographically thereby limiting the number of painful needle insertions required for complete mapping of the external anal sphincter.",Burnett SJ.; Speakman CT.; Kamm MA.; Bartram CI.,1991.0,,0,0,
10161,The assessment and treatment of performance anxiety in musicians.,"Performance anxiety in musicians may be severe enough to require intervention but has been the subject of relatively little clinical research. The authors' objectives were to describe the results of a comprehensive clinical and laboratory assessment and to perform a double-blind, placebo-controlled study comparing buspirone, cognitive-behavior therapy, and the combination of these treatments for performance anxiety. Ninety-four subjects were recruited by mass media announcements and were seen in a university-based outpatient psychiatric clinic. Assessments were 1) questionnaires for all 94 subjects, 2) diagnostic interview of 50 subjects, and 3) laboratory performance of 34 subjects. Treatment conditions were 1) 6 weeks of buspirone, 2) 6 weeks of placebo, 3) a five-session, group cognitive-behavior therapy program with buspirone, or 4) the cognitive-behavior therapy program with placebo. Treatment outcome measures included subjective anxiety ratings and heart rate measures during a laboratory performance, a questionnaire measure of performance confidence, and a blind rating of musical performance quality. All subjects fulfilled criteria for DSM-III-R social phobia. Of the 15 full-time professional musicians, ten had tried propranolol and three had stopped performing. Most of the subjects had substantial anxiety and heart rate increases during laboratory speech and musical performances. Cognitive-behavior therapy resulted in statistically significant reductions in subjective anxiety, improved quality of musical performance, and improved performance confidence. Buspirone was not an effective treatment. Cognitive-behavior therapy is a viable treatment approach for performance anxiety in musicians.",Clark DB.; Agras WS.,1991.0,10.1176/ajp.148.5.598,0,0,
10162,Opioid antagonist impedes exposure.,"Exposure is a rapid and effective treatment for simple phobias. This study tested the assumption that endorphin release may be involved in exposure to a feared situation. Thirty spider-phobic Ss underwent exposure to 17 phobic-related, graded performance tasks. Half the Ss were randomly assigned to naltrexone, an opioid antagonist, and half to a placebo. Measures of heart rate, blood pressure, self-efficacy, anxiety, and cognitions were obtained during treatment. Six of the 15 Ss in the naltrexone group dropped out after the 10th step in the treatment compared with 1 of the 15 Ss in the placebo group, chi 2(1, N = 30) = 4.7, p = .03. The naltrexone group took significantly longer to complete the first 10 steps (the last step that included all Ss) compared with the placebo group, F(9, 252) = 2.17, p = .024. Maximum heart rate and anxiety were significantly greater at Step 10 in the naltrexone group, but no differences were found for self-efficacy or cognitions. The study provides further evidence that the endogenous opioid system may be involved in the process of exposure.",Merluzzi TV.; Taylor CB.; Boltwood M.; Götestam KG.,1991.0,,0,0,
10163,A randomized clinical trial of alprazolam versus progressive muscle relaxation in cancer patients with anxiety and depressive symptoms.,"A randomized nonblinded study was performed in three cancer centers to test over a 10-day period the efficacy of (1) a triazolobenzodiazepine, alprazolam, 0.5 mg three times a day and (2) use of a behavioral technique in which patients were trained in progressive muscle relaxation at an initial session with a behavioral psychologist and then asked to listen at home to an audiotape of the session three times a day. Of 147 cancer patients who met entry levels of distress and completed the study, uncontrolled for site or disease stage, 70 were randomized to drug, 77 to relaxation. Four measures of anxiety and depression were used: Covi, Raskin, Affects Balance, and Symptoms Checklist-90 (SCL-90). Results showed that both treatment arms resulted in significant (P less than .001) decrease in observer and patient-reported anxious and depressed mood symptoms. Although both treatment arms were effective, patients receiving the drug showed a slightly more rapid decrease in anxiety and greater reduction of depressive symptoms. These findings confirm efficacy of both alprazolam and relaxation to reduce cancer-related anxiety and depression. As safe, inexpensive, and effective interventions, physicians should consider their use in cancer patients experiencing anxiety and depressive symptoms.",Holland JC.; Morrow GR.; Schmale A.; Derogatis L.; Stefanek M.; Berenson S.; Carpenter PJ.; Breitbart W.; Feldstein M.,1991.0,10.1200/JCO.1991.9.6.1004,0,0,
10164,The failure of exposure treatment in agoraphobia: implications for the practice of nurse therapists and community psychiatric nurses.,"There are no systematic studies of the failure of psychiatric nursing interventions and few very such studies in the psychological/psychiatric outcome literature. This study reports a controlled study of exposure treatment with agoraphobic clients who were treated by nurse therapists and psychologists. This includes an analysis of the four categories of treatment failure (i.e. treatment refusers, treatment dropouts, failures and relapsers). The analysis consisted of an examination of the outcome data of clients who met a priori criteria for the categories of failure and an examination of questionnaire responses. The results have implications for psychiatric nursing practice, particularly with regard to preparation for treatment. Additionally, the results indicate that much more research needs to be carried out on treatment methods and that exposure alone produces a significant but limited effect. Finally, the paper suggests that outcome research is a priority in psychiatric nursing.",Gournay KJ.,1991.0,,0,0,
10165,The effect of humorous distraction on preoperative anxiety. A pilot study.,,Gaberson KB.,1991.0,,0,0,
10166,[Catamnesis of neuroses after 11 years of treatment with 3 different therapeutic programs].,"A total of 266 of 331 neurotics included to controlled comparison of further course and outcome of three therapeutic and preventive programmes of different duration of the contact with therapeutic environment (full inpatient, day center and walk-in clinic treatment) was reexamined 11 years after inclusion to the core (N = 239) and verification (N = 92) study. Results of multivariate analysis of relations between the characteristic of the episode of inclusion and seven criteria of further course and outcome follow-up confirmed the previous (6 and 12 months' follow-up) statements of no relationship neither between the type of the programme, the patient has been randomly assigned to, nor between the duration of the contacts with the therapeutic environment and with further course and outcome of the neurosis. Personality characteristics seem to be more important that the actual neurotic symptomatology and potential predictor of course and outcome. Only hysterical and psychiasthenic syndrome proved to be related to the level of subjective worries and life dissatisfaction at time of the 11 years follow-up, but even these syndromes are usually claimed to be rather relatively stable pattern of personality reactions. Prevailing positive evaluation of the former programme by the followed-up patients provided the clinical workers with an unexpected satisfaction.",Bouchal M.; Skoda C.,1991.0,,0,0,6110
10167,Acute posttraumatic renal failure: a multicenter perspective.,"Acute renal failure (ARF) following trauma is rare. Historically, ARF has been associated with a high mortality rate. To investigate this entity we conducted a retrospective review of 72,757 admissions treated at nine regional trauma centers over a 5-year period. Seventy-eight patients (0.098%) developed acute renal failure requiring hemodialysis. Detailed demographic, clinical, and outcome data were collected. Patients with pre-existing medical conditions (group I) had a 70% increase in mortality over those without pre-existing conditions (p less than 0.004). Twenty-four patients (31%) developed ARF less than 6 days after injury (group II). The remainder (group III) developed late renal failure (mean time to first dialysis, 23 days). The predominant cause of death was multiple organ failure (82%). There were no differences in mortality because of multiple organ failure among the three groups of patients. Of the 33 survivors, six (18%) were discharged with renal insufficiency, three (9%) were discharged on dialysis, 23 (70%) were discharged home or to rehabilitation, and 27 (82%) had no significant evidence of renal insufficiency. Posttraumatic renal failure requiring hemodialysis is rare (incidence, 107 per 100,000 trauma center admissions), but the mortality rate remains high (57%). Two thirds of the cases of posttraumatic renal failure develop late and are secondary to multiple organ failure; one third of the cases of posttraumatic renal failure develop early and may result from inadequate resuscitation.",Morris JA.; Mucha P.; Ross SE.; Moore BF.; Hoyt DB.; Gentilello L.; Landercasper J.; Feliciano DV.; Shackford SR.,1991.0,,0,0,
10168,The naturalistic course of anxiety and depressive disorders.,,Keller MB.,1992.0,,0,0,
10169,Cognitive-behavioral approaches to panic disorder and social phobia.,"In the past several years, substantial progress has been made in developing relatively efficient and seemingly effective brief psychosocial treatments for anxiety disorders. Knowledge has advanced along both biological and psychological fronts, although the greater effort has been put into understanding the neurobiological basis of anxiety disorders and developing appropriate, effective pharmacological treatment. Nevertheless, psychological knowledge has also advanced, and a more recent trend is to integrate psychological and biological advances at the level of psychopathology and treatment. The author highlights recent developments in understanding the psychological basis of two anxiety disorders: panic disorder and social phobia. He then describes psychosocial treatment protocols for these disorders that have been developed at the Center for Stress and Anxiety Disorders at the State University of New York at Albany, and reviews data on their effectiveness.",Barlow DH.,1992.0,,0,0,
10170,"A factor analysis of dyspnea ratings, respiratory muscle strength, and lung function in patients with chronic obstructive pulmonary disease.","The purpose of this study was to demonstrate that clinical ratings of dyspnea and physiologic function are separate dimensions underlying the pathophysiology of chronic obstructive pulmonary disease (COPD). We used principal-components factor analysis to confirm these dimensions using data collected prospectively in 86 symptomatic patients with COPD. Three different instruments were used to rate dyspnea: a modified Medical Research Council (MRC) scale, the oxygen cost diagram (OCD), and the baseline dyspnea index (BDI). Measures of physiologic function included standard spirometric measures (forced vital capacity [FVC] and forced expiratory volume in one second [FEV1]) and maximal inspiratory (PImax) and expiratory (PEmax) mouth pressures. Age of the 65 male and 21 female subjects was 62.9 +/- 1.2 yr (mean +/- SEM). All three clinical scales were significantly correlated with physiologic function (range of r values, 0.32 to 0.45; p less than 0.05), except for the relationship between the MRC scale and PEmax (r = -0.14; p = NS). The factor analysis yielded three factors that accounted for 71.9% of the total variance of the data: clinical ratings of dyspnea (MRC scale, OCD, and BDI) loaded on the first factor; maximal respiratory pressures and gender loaded on the second factor; and lung function and age loaded on the third factor. Additional post hoc factor analysis provided similar results when the sample was divided into two subgroups by randomization, by severity of dyspnea ratings, or by severity of airflow obstruction. We conclude that dyspnea ratings, maximal respiratory pressures, and lung function are separate factors or quantities that independently characterize the condition of patients with COPD.(ABSTRACT TRUNCATED AT 250 WORDS)",Mahler DA.; Harver A.,1992.0,10.1164/ajrccm/145.2_Pt_1.467,0,0,
10171,[The clinico-epidemiological characteristics of burn trauma].,"Analysis of medical and sociopsychological factors in 231 burn victims was provided during 4-year randomized study. Groups of burn-prone (working class males, alcohol abusers, burned drunk, violating safety measures, with concomitant somatic and brain disorders and maladjustment) and non-prone individuals were elucidated. Shifts in Spielberger's state and trait anxiety scores depend on the damage of their somatic and nervous ""underground"". Beck's depression and trait anxiety high scores in all subgroups were found.",Kachalov PV.; Gel'fand VB.; Astasheva NG.,1992.0,,0,0,6511
10172,Combining writing block treatments: theory and research.,"Four traditional formats of treatment for writing blocks (automaticity, regimen, self-control, and social skills training) proved insufficient to maintain unblocking in professorial writers for periods of an academic year. A combined application of the four historically prominent interventions was clearly more effective in terms of stable productivity, manuscripts finished and submitted, and manuscripts accepted for publication. Because writing blocks are too often conceptualized and treated by way of lore, a theory of blocking is proposed that clarifies the fundamental steps in effecting lasting unblocking.",Boice R.,1992.0,,0,0,
10173,A randomized trial of psychiatric consultation with distressed high utilizers.,"This study reports the results of a randomized trial of a psychiatric consultation intervention with distressed, high utilizing patients of 18 physicians in two primary care clinics. Psychiatric consultation was associated with a significant increase in the use of antidepressants in intervention patients compared with controls in the first 6 months after intervention. Intervention patients were also significantly more likely to continue antidepressant treatment than control patients. The primary care physicians receiving psychiatric consultations increased the rate of prescribing antidepressant medications in their practice from 32 prescriptions filled per 1,000 visits before their participation in four consultations to 44 new prescriptions per 1,000 visits in the 12-month period after. There were no significant differences between intervention patients and controls at 6 and 12 months after randomization in psychiatric distress, functional disability, or utilization of health care (ambulatory visits, radiographic and laboratory testing services, admissions to inpatient medical care).",Katon W.; Von Korff M.; Lin E.; Bush T.; Russo J.; Lipscomb P.; Wagner E.,1992.0,,0,0,
10174,A randomized controlled study of psychiatric consultation guided by screening in general medical inpatients.,"The purpose of the study was to test the hypothesis that psychiatric consultation would reduce health care utilization during and after medical hospitalization. A randomized, double-controlled clinical trial of psychiatric consultation was conducted on the general medical inpatient services of a university hospital. After meeting inclusion criteria, 1,541 patients were screened for depression, anxiety, confusion, and pain over a period of 21 months. The 741 patients with high levels of psychopathology or pain were subdivided into baseline control subjects (N = 232), contemporaneous control subjects (N = 253), and an experimental consultation group (N = 256). The major outcome measures were length of hospital stay and hospital costs. Secondary outcome measures were posthospital health status, rehospitalization rates, and use of outpatient medical care. This study did not demonstrate an effect of experimental psychiatric consultation on hospital resource use or posthospital medical care utilization after adjustment was made for disease severity. Hospital resource use decreased in the entire sample over the 21-month duration of the study. The brief, efficient screen for anxiety, depression, confusion, and pain identified a group of patients who also used more hospital resources, but a single experimental psychiatric consultation did not reduce costs. The double-controlled nature of the design proved essential to avoid being misled by background changes in hospital resource use.",Levenson JL.; Hamer RM.; Rossiter LF.,1992.0,10.1176/ajp.149.5.631,0,0,
10175,The reduction of claustrophobia--I.,"The purpose of this study was to investigate the process of change during three interventions for claustrophobia, with particular reference to cognitive changes. Forty-eight participants, recruited from the community through the local media, were randomly assigned to one of four groups: pure exposure, exposure to the sensations of anxiety (interoceptive exposure), modification of negative cognitions, or a control group. All interventions were given over three sessions. The exposure group proved superior to the control on a wide range of measures. In the cognitive group, scores of reported fear and panic, declined significantly. The interoceptive group made some modest gains. An analysis of the timing of fear reduction and of treatment generalization, provides some indications of the mechanism of change.",Booth R.; Rachman S.,1992.0,,0,0,
10176,Neurocirculatory asthenia revisited: elevated arterial pressure at presentation is a marker for subsequent hypertension.,"Neurocirculatory asthenia (NCA) is a fairly common functional disorder often encountered among military recruits. Symptoms in NCA tend to appear in waves, and are believed to disappear completely with the passage of time. Elevated arterial pressure is known to occur as part of the various haemodynamic manifestations of NCA. However, the exact prevalence of hypertension, as well as its long-term prognosis, is still unknown. The present case-control study was designed to address these two issues. The target population consisted of 370 patients with NCA representing two separate cohorts: patients diagnosed in 1979, 10 years prior to this study, and patients diagnosed in 1983-84, 5 years prior to the study. An overall 20% prevalence rate of mild hypertension at diagnosis was calculated for the entire study population. In total, 100 patients representing equal numbers of hypertensive and matched normotensive subjects from each cohort were re-evaluated. At follow-up, hypertension was present in 27% (1979 cohort) and 30% (1983-84 cohort) of patients originally considered to be hypertensive. Hypertension was either non-existent (1979 cohort) or limited to a single case (1983-84 cohort) among originally normotensive individuals. In parallel, resting heart rate was higher in the hypertensive subjects of the 1979 cohort both at presentation (85.5 +/- 3.2 vs. 73.7 +/- 2.4 beats min-1; P less than 0.005) and at follow-up (79.6 +/- 3.2 vs. 70.0 +/- 2.5 beats min-1; P less than 0.01). These results indicate that hypertension complicates the diagnosis of NCA in 20% of patients and that, contrary to common belief, it cannot be regarded as another transient manifestation of this condition. Thus hypertension in this context is, as in the younger members of the population in general, a major risk factor for lifelong hypertension, rather than an inconsequential phenomenon.",Lev E.; Tordjman K.; Pines A.; Fisman EZ.; Drory Y.; Stern N.,1992.0,,0,0,
10177,The Galway Study of Panic Disorder. I: Clomipramine and lofepramine in DSM III-R panic disorder: a placebo controlled trial.,"Among 79 volunteer, unpaid, family doctor-referred psychiatric out patients with DSM III-R panic disorder, with and without agoraphobia, 66 completed a six week placebo-controlled trial of lofepramine versus clomipramine and 57 survivors were followed up for 6 months. All subjects received one hour per week concurrent behavioural counselling in the acute phase. Of 13 dropouts in the first 3 weeks, 9 (of 27) were on clomipramine, 2 (of 26) were on lofepramine and 2 (of 26) were on placebo. The high (30%) early dropout from the clomipramine group was largely due to medication intolerance. Both drugs were superior to placebo by the end of week 6 on several standard rating scales but not on panic attack frequency. No significant differences in efficacy were found between the two drugs tested to the end of 6 months. No tendency for relapse was noted in the three months following taper-off of medication from week 12 to week 24. The study provides evidence that both drugs, in the dosages used, are superior to placebo in the acute phase of panic disorder in treatment-naive subjects concurrently receiving appropriate psychotherapy.",Fahy TJ.; O'Rourke D.; Brophy J.; Schazmann W.; Sciascia S.,1992.0,,0,0,
10178,A crossover study of focused cognitive therapy for panic disorder.,"This study sought to determine the short- and long-term effects of focused cognitive therapy for panic disorder. Thirty-three psychiatric outpatients with the DSM-III diagnosis of panic disorder were randomly assigned to either 12 weeks of individual, focused cognitive therapy or 8 weeks of brief supportive psychotherapy based on principles of client-centered therapy. The patients who received supportive psychotherapy were subsequently given the opportunity to cross over to cognitive therapy for 12 weeks. Patients were rated for panic and depression before therapy, after 4 and 8 weeks of therapy, and at 6-month and 1-year follow-up. Clinician ratings and self-ratings of panic frequency and intensity indicated that the focused cognitive therapy group achieved significantly greater reductions in panic symptoms and general anxiety after 8 weeks of treatment than did the group that received brief supportive psychotherapy. At 8 weeks, 71% of the cognitive therapy group were panic free, compared to 25% of the psychotherapy group. Moreover, 94% of the psychotherapy patients elected to cross over to 12 weeks of cognitive therapy. At 1-year follow-up, 87% of the group that received cognitive therapy only and 79% of the group that crossed over into cognitive therapy remained free of panic attacks. Focused cognitive therapy offers a promising nonpharmacological alternative for the treatment of panic disorder.",Beck AT.; Sokol L.; Clark DA.; Berchick R.; Wright F.,1992.0,10.1176/ajp.149.6.778,0,0,
10179,Relaxation to reduce dyspnea and anxiety in COPD patients.,"The purpose of this study was to test the effectiveness of a taped relaxation message in reducing dyspnea and anxiety in chronic obstructive pulmonary disease (COPD) patients. Twenty-six adult COPD patients with dyspnea were randomly assigned to two groups. The treatment group was taught relaxation using a prerecorded tape while the control group was instructed to sit quietly. Skin temperature, heart rate, and respiratory rate were recorded for all subjects during a total of four weekly sessions. Anxiety, dyspnea, and airway obstruction were measured at the beginning and end of the study. The relaxation group achieved the preset relaxation criteria. Dyspnea, anxiety, and airway obstruction were reduced in the relaxation group while the control group remained the same or became worse.",Gift AG.; Moore T.; Soeken K.,,,0,0,6371
10180,Treatment of depressive and obsessive-compulsive symptoms in OCD by imipramine and behaviour therapy.,"The efficacy of behavioural treatment of obsessive-compulsive disorder (OCD) has been well documented. However, severely depressed OCD patients showed fewer short- and long-term benefits than less depressed patients. The present study tested the hypothesis that reduction of depression by imipramine prior to behaviour therapy would enhance the effects of behavioural therapy on depressed OC patients. Thirty-eight patients were divided into highly and mildly depressed groups according to their scores on the Beck Depression Inventory; half of each group received imipramine and half received placebo for six weeks. All patients then received three weeks of daily behavioural treatment (exposure and response prevention) followed by 12 weekly sessions of supportive psychotherapy. Results indicated that although imipramine improved depressive symptoms in depressed patients, it did not affect OC symptoms. Behaviour therapy markedly reduced OC symptoms but, contrary to our hypothesis, imipramine did not potentiate the effects of behaviour therapy. No differences between highly depressed and mildly depressed patients on OC symptoms were found in their responses to behavioural or supportive therapy.",Foa EB.; Kozak MJ.; Steketee GS.; McCarthy PR.,1992.0,,0,0,
10181,Hyperventilation syndrome and the assessment of treatment for functional cardiac symptoms.,"Three methods of breathing retraining (guided breathing retraining, guided breathing retraining with physiologic monitoring of thoracic and abdominal movement plus peripheral temperature, and guided breathing retraining with physiologic monitoring of thoracic and abdominal movement, peripheral temperature and end-tidal carbon dioxide) were compared with a no-treatment control group to determine the effectiveness of breathing retraining on modifying respiratory physiology and reducing functional cardiac symptoms in subjects with signs associated with hyperventilation syndrome. Of 41 subjects studied, 16 were diagnosed with mitral valve prolapse. Results demonstrated that all 3 methods of breathing retraining were equally effective in modifying respiratory physiology and reducing the frequency of functional cardiac symptoms. Results determined that respiratory rate and subject's perception that training had generalized were the best predictors of treatment success. Furthermore, it was found that subjects with mitral valve prolapse responded as well to treatment as did those without prolapse.",DeGuire S.; Gevirtz R.; Kawahara Y.; Maguire W.,1992.0,,0,0,
10182,Psychopathology and pain in medical in-patients predict resource use during hospitalization but not rehospitalization.,"The authors investigated the relationship between psychopathology and resource use in general medical in-patients during hospitalization and rehospitalization. Between 1 July 1987, and 30 April 1989, 1020 in-patients were prospectively screened for depression, anxiety, cognitive dysfunction, and pain. Overall, the screen identified 47% of patients as having high psychopathology or pain, including 25.7% depressed, 21.8% anxious, 17.6% with cognitive dysfunction, and 5.2% with high pain. There were no measured differences in demographics or disease severity between high and low psychopathology groups. High psychopathology patients had longer stays and higher costs during the index hospitalization but there were no differences during subsequent hospitalizations. Length of stay declined overall during the study period, but there were no changes over time in the association between high psychopathology or pain with increased resource use. The measured symptoms of psychopathology and pain we measured are associated with increased short-term utilization of health care resources, but the increase does not extend to subsequent hospitalizations. Outcome studies aiming to reduce psychopathology in medical in-patients should pay particular attention to short term costs.",Levenson JL.; Hamer RM.; Rossiter LF.,1992.0,,0,0,
10183,Covariation detection in treated and untreated spider phobics.,"Twenty treated and 18 untreated spider phobics were exposed to a series of 72 slides. Three different categories of slides were used: phobia-relevant slides (spiders), alternative fear-relevant slides (weapons), and neutral slides (flowers). Slides were randomly paired with either a shock, a tone, or nothing at all. Despite the absence of a systematic correlation between slides and outcomes, untreated phobics strongly overestimated the covariation between spider slides and shock. Treated phobics did not show a covariation bias, suggesting that such bias can be modulated by behavioral treatment. In addition, untreated subjects were more confident about their contingency estimates than were treated subjects. The present results fit with earlier studies.",de Jong PJ.; Merckelbach H.; Arntz A.; Nijman H.,1992.0,,0,0,
10184,Effect of prone versus supine patient positioning on pelvic magnetic resonance image quality.,"Magnetic resonance imaging (MRI) of the pelvis in the prone position has been proposed as a means of reducing motion-related image blurring. The authors performed a randomized controlled trial to determine if patient positioning affects image quality. All women undergoing pelvic MRI during a 7-month period, who could lie both prone and supine, were randomized to the supine or prone position. The quality of axial T2-weighted spin-echo images was rated by two radiologists using a 1-to-4 scale (1 = marked blurring to 4 = sharp definition of pelvic structures). Of 78 eligible women, 61 were randomized. Two patients could not complete the examination. The mean image quality rating of 2.8 for the 32 patients imaged prone was not significantly different from the mean rating of 2.9 for the 27 patients imaged supine (P = .5, Mann-Whitney U test). Patient positioning did not significantly affect pelvic MRI quality. The choice of patient position should be based on other considerations, such as patient comfort or ease of patient positioning.",McCauley TR.; Wright JG.; Bell SM.; McCarthy S.,1992.0,,0,0,
10185,Attentional bias and spider phobia: conceptual and clinical issues.,"Experimental evidence indicates that anxious subjects show an attentional bias for threat-relevant information. Foa and McNally (1986) (Cognitive Therapy and Research, 10, 477-485) and Watts et al. (1986) (British Journal of Psychology, 77, 97-108) reported that behaviour therapy can eliminate this attentional bias. A replication study was carried out in order to increase the evidence for exposure being the crucial component in reducing attentional bias. Moreover, in this study some conceptual and clinical issues are explored. The theoretical and clinical implications of the results are discussed.",Lavy E.; van den Hout M.; Arntz A.,1993.0,,0,0,
10186,A controlled family study in panic disorder.,"There are only a few family studies in panic disorder. Although there is some evidence that panic disorder is familial, the exact figures of the familial risk for this disorder are at variance across different studies; the impact of comorbidity and of the gender of relatives is also unclear. Family studies in panic disorder controlling for the comorbidity in probands are therefore indicated. This study presents the morbid risks in families of 40 ""pure"" panic disorder probands (DSM-III-R) without a history of psychotic disorders, major depression or alcoholism compared with families of 80 controls recruited in the general population. The relative frequency of panic disorder (DSM-III-R) in the first-degree relatives of panic disorder probands was 5.7% (the age corrected morbid risk is 7.9%) compared to 1.8% in relatives of healthy controls (age corrected morbid risk 2.3%). Agoraphobia segregated predominantly among female relatives of agoraphobic probands. An increased familial risk of major depression and of alcoholism was also observed. Comorbidity with alcoholism and major affective disorders was excluded in panic disorder probands by definition; therefore, these findings indicate that the etiological factors underlying panic disorder may overlap with those of alcoholism and those of unipolar major depression.",Maier W.; Lichtermann D.; Minges J.; Oehrlein A.; Franke P.,1993.0,,0,0,
10187,"A comparison of fluvoxamine, cognitive therapy, and placebo in the treatment of panic disorder.","Seventy-five outpatients with moderate to severe panic disorder were randomly assigned to receive 8 weeks of fluvoxamine, cognitive therapy, or placebo. Fifty-five patients completed the treatment protocol. Fluvoxamine was found to be an effective and well-tolerated treatment for panic using clinician- and patient-rated variables. Subjects receiving cognitive therapy also showed improvement, but this improvement did not significantly differ from the experience of the placebo-treated group for most comparisons. Fluvoxamine was superior to cognitive therapy for many ratings, but cognitive therapy was not superior to fluvoxamine on any rating. Fluvoxamine also produced improvement earlier than cognitive therapy. At the main comparison point (week 4), 57% (13/23) of patients receiving fluvoxamine were rated moderately improved or better vs 40% (8/20) of the group given cognitive therapy and 22% (5/23) of the placebo-treated group. At that point, 43% (10/23) of the fluvoxamine recipients vs 25% (5/20) of cognitive therapy and 4% (1/23) of placebo recipients were free of panic attacks.",Black DW.; Wesner R.; Bowers W.; Gabel J.,1993.0,,0,0,
10188,A standardized desensitization program applicable to group and individual treatments.,,Nawas MM.; Fishman ST.; Pucel JC.,1970.0,,0,0,
10189,Control of aversive stimulus termination in systematic desensitization.,,Miller HR.; Nawas MM.,1970.0,,0,0,
10190,"The comparative effectiveness of pairing aversive imagery with relaxation, neutral tasks and muscular tension in reducing snake phobia.",,Nawas MM.; Welsch WV.; Fishman ST.,1970.0,,0,0,
10191,"An experimental analysis of the effectiveness of ""shaping"" in reducing maladaptive avoidance behavior: an analoguestudy.",,Barlow DH.; Agras WS.; Leitenberg H.; Wincze JP.,1970.0,,0,0,
10192,Systematic desensitization of snake-avoidance following three types of suggestion.,,McGlynn FD.; Mapp RH.,1970.0,,0,0,
10193,Methohexitone-assisted desensitisation in treatment of phobias.,,Mawson AB.,1970.0,,0,0,
10194,The relationship between social comments as unconditioned stimuli and fear responding.,,Gale EN.; Jacobson MB.,1970.0,,0,0,
10195,Some data on the Persian translation of the EPI.,,Mehryar AH.,1970.0,,0,0,
10196,Effects of progressive relaxation on autonomic processes.,,Edelman RI.,1970.0,,0,0,
10197,The generalization of vicarious extinction effects.,,Blanchard EB.,1970.0,,0,0,
10198,[Psychiatric outpatient treatment. Demographic study of patients treated at the university psychiatric polyclinic of Lausanne].,,Masson D.,1971.0,,0,0,
10199,Global ratings compared to rating scales in evaluating trifluoperazine-amobarbital in anxious psychoneurotic outpatients.,,Bercel NA.,,,0,0,
10200,Individual versus standardized hierarchies in the systematic desensitization of snake-avoidance.,,McGlynn FD.,1971.0,,0,0,
10201,The effects of varying short visual exposure times to a phobic test stimulus on subsequent avoidance behavior.,,Miller BV.; Levis DJ.,1971.0,,0,0,
10202,Systematic desensitization with pre-treatment and intra-treatment therapeutic instructions.,,McGlynn FD.; Reynolds EJ.; Linder LH.,1971.0,,0,0,
10203,Superiority of flooding (implosion) to desensitisation for reducing pathological fear.,,Boulougouris JC.; Marks IM.; Marset P.,1971.0,,0,0,
10204,Psychoactive drugs in outpatient therapy.,,Gottschalk LA.,1971.0,,0,0,
10205,Behavior modification through covert semantic desensitization.,,Hekmat H.; Vanian D.,1971.0,,0,0,
10206,Experimental desensitization of mouse-avoidance following two schedules of semi-automated relaxation training.,,Linder IH.; McGlynn FD.,1971.0,,0,0,
10207,Gibson spiral maze and MPI scores: a comparison using normal adolescent subjects.,,McDonald KG.; Parker AD.,1971.0,,0,0,
10208,Psychiatric treatment of eczema: a controlled trial.,"Seventy-two patients with eczema were randomly allotted to one of two treatment groups: A, those receiving dermatological treatment only, and B, those receiving the same dermatological treatment plus psychiatric treatment, limited where possible to four months. Cases were followed up at six-monthly dermatological assessments, 57 (79%) for 18 months. The findings suggest that in the presence of overt emotional disturbance, of new psychological or psychophysiological symptoms preceding the rash by up to a year, and of high motivation for it, brief psychiatric treatment improves the outcome in eczema (the proportion clear at 18 months was about doubled), whereas in their absence such treatment may worsen it, especially in the short term.",Brown DG.; Bettley FR.,1971.0,,0,0,
10209,Sensitivity to phobic imagery: a sensory decision theory analysis.,,Chapman CR.; Feather BW.,1971.0,,0,0,
10210,Cognitive factors in systematic desensitization.,,Lomont JF.; Brock L.,1971.0,,0,0,
10211,Stimulus hierarchy generalization in systematic desensitization.,,Lomont JF.; Brock L.,1971.0,,0,0,
10212,The comparison of two methods of assessing fear and avoidance behavior.,,Borkovec TD.; Craighead WE.,1971.0,,0,0,
10213,A study of worrying.,,Breznitz S.,1971.0,,0,0,
10214,Flooding versus desensitization in the treatment of phobic patients: a crossover study.,,Marks I.; Boulougouris J.; Marset P.,1971.0,,0,0,
10215,Group preprogrammed systematic desensitization without the simultaneous presentation of aversive scenes with relaxation training.,,Aponte JF.; Aponte CE.,1971.0,,0,0,
10216,Experimental desensitization following three types of instructions.,,McGlynn FD.,1971.0,,0,0,
10217,Effects of neuroticism on intra-treatment responsivity to group desensitization of test anxiety.,,Mitchell KR.,1971.0,,0,0,
10218,Arousal and attitude change in neurotic patients.,,Hoehn-Saric R.; Liberman B.; Imber SD.; Stone AR.; Pande SK.; Frank JD.,1972.0,,0,0,
10219,Imagery in desensitization.,,McLemore CW.,1972.0,,0,0,
10220,A trial of group psychotherapy for neurotics.,,Bovill D.,1972.0,,0,0,
10221,A further assessment of attention-placebo effects and demand characteristics in studies of systematic desensitization.,,McReynolds WT.; Tori C.,1972.0,,0,0,
10222,Experimental desensitization of snake-avoidance after an instructional manipulation.,,McGlynn FD.; Gaynor R.; Puhr J.,1972.0,,0,0,
10223,The contribution of therapeutic instructions to systematic desensitization.,,Miller SB.,1972.0,,0,0,
10224,Self-report and overt behavioral measures of fear with changes in aversive stimuli.,,Mac R.; Fazio AF.,1972.0,,0,0,
10225,Instructions and the extinction of a learned fear in the content of taped implosive therapy.,,Dee C.,1972.0,,0,0,
10226,Systematic desensitization under two conditions of induced expectancy.,,McGlynn FD.,1972.0,,0,0,
10227,Recurring assessment of changes in phobic behavior during the course of systematic desensitization.,,Kimura HK.; Kennedy TD.; Rhodes LE.,1972.0,,0,0,
10228,Enhanced relief of phobias by flooding during waning diazepam effect.,,Marks IM.; Viswanathan R.; Lipsedge MS.; Gardner R.,1972.0,,0,0,
10229,"Time-limited desensitisation, implosion and shaping for phobic patients: a crossover study.",,Crowe MJ.; Marks IM.; Agras WS.; Leitenberg H.,1972.0,,0,0,
10230,Modelling therapy for test anxiety: the role of model affect and consequences.,,Jaffe PG.; Carlson PM.,1972.0,,0,0,
10231,The role of mental relaxation in experimental desensitization.,,Marshall WL.; Strawbridge H.; Keltner A.,1972.0,,0,0,
10232,Orthogonal factors vs. interdependent variables as predictors of drug treatment response in anxious outpatients.,,Downing RW.; Rickels K.; Dreesmann H.,1973.0,,0,0,
10233,How antagonistic can doctor's bias be on drug effect? Oxazepam as an anti-anxiety agent.,,Edelstein EL.; Isac M.; Stein J.,1973.0,,0,0,
10234,Simultaneous mesoridazine and psychodrama in neurotics.,,Lapierre YD.; Lavallée J.; Tétreault L.,1973.0,,0,0,
10235,Galvanic skin response and reported anxiety during systematic desensitization.,,Hyman ET.; Gale EN.,1973.0,,0,0,
10236,A comparison of 'flooding' and 'successive approximation' in the treatment of agoraphobia.,,Everaerd WT.; Rijken HM.; Emmelkamp PM.,1973.0,,0,0,
10237,Reciprocal inhibition of a laboratory conditioned fear.,,Bellack A.,1973.0,,0,0,
10238,Predicting outcome after treatment for generalised anxiety disorder.,"A previous paper, Butler and Anastasiades (Behaviour Research and Therapy 26, 531-534, 1988) presented evidence for three reliable predictors of response to Anxiety Management in patients with generalised anxiety disorder. It was argued there that these reflected severity of anxiety, demoralisation and depression. A second study (Butler, Fennell, Robson & Gelder, Journal of Consulting and Clinical Psychology, 59, 167-175, 1991) has compared two treatments for GAD: Behaviour Therapy and Cognitive Behaviour Therapy. Data from this study is used here to answer two questions: (i) do the same three variables predict outcome in the second study? The answer to this question is 'no'; and (ii) which variables contribute to prediction of outcome when these two treatments are compared? Information presented here suggests that this depends partly on the nature of the treatment given. Outcome after behaviour therapy is predicted by initial levels of anxiety only, but the gains made are also relatively modest. Outcome after cognitive behaviour therapy is predicted by the degree to which ambiguous (external) information is interpreted as threatening. Thus a cognitive variable contributes reliably to the prediction of outcome after a cognitive treatment, but does not predict in the same way to outcome after a behavioural treatment.",Butler G.,1993.0,,0,0,
10239,The revised Stroop color-naming task in social phobics.,"Information processing was examined in a sample of social phobic individuals using a revised version of the Stroop color-naming task. In the first of two experiments, the response latencies of social phobics and matched community controls were compared when color-naming socially threatening words, physically threatening words and color words. Social phobics demonstrated greater response latencies regardless of type of stimulus word and additional interference in color-naming social threat words compared to the control group. The second experiment examined the cognitive structural change that has been hypothesized to accompany successful treatment of individuals with an anxiety disorder. Social phobics who were treated with cognitive-behavioral group therapy, phenelzine or pill placebo were classified as treatment responders or nonresponders, and their latencies to color-naming on the Stroop task were compared. Treatment responders showed a significant reduction in latencies to color-name social threat words (vs matched control words) while nonresponders did not. This effect was not demonstrated with color words or physically threatening words. Clinical implications and future research directions are discussed.",Mattia JI.; Heimberg RG.; Hope DA.,1993.0,,0,0,
10240,The role of worrisome thinking in the suppression of cardiovascular response to phobic imagery.,Speech-fearful subjects repeatedly imagined a phobic image while heart rate and subjective reports of fear were monitored. Subject groups differed according to the type of mental activity that preceded each image. One group thought about a relaxing situation (Relaxation) and one group engaged in worrisome thinking (General-Worry). Three other groups were pre-trained to worry during their pre-image mentation periods with an emphasis on: (a) the thoughts; (b) the images; or (c) the affect experienced during worry. Cardiovascular effects occurred only on the first image presentation. Thought-Worry produced significantly less heart rate response than did Relaxation; the other worry conditions fell nonsignificantly between these two groups. Within-group correlations between heart rate response to the image and the reported predominance of thought relative to imagery during the preceding mentation period showed that: (a) greater worrisome thinking in General-Worry was related to less cardiovascular response; and (b) greater relaxed thinking in Relaxation was associated with greater cardiovascular response. These results support the hypothesis that it is the worrisome thinking aspect of worry that may inhibit the emotional processing of phobic material and that Gray's mismatch theory of anxiety elicitation may account for these effects.,Borkovec TD.; Lyonfields JD.; Wiser SL.; Deihl L.,1993.0,,0,0,
10241,Assessing reliable and clinically significant change in social phobia: validity of the social phobia and anxiety inventory.,"The ability of the Social Phobia and Anxiety Inventory (SPAI) to measure change as a function of treatment for social phobia was assessed. In addition to determining treatment sensitivity of the SPAI, changes over the course of treatment were examined to determine if they were reliable and clinically significant. The results indicated that although a number of measures showed statistically significant change, only on the SPAI was that change reliable and clinically significant. The use of outcome measures that are reliable and clinically significant for social phobia as well as other disorders is discussed.",Beidel DC.; Turner SM.; Cooley MR.,1993.0,,0,0,
10242,Alcohol and social anxiety in women and men: pharmacological and expectancy effects.,"A replication study was conducted to determine pharmacological and expectancy effects of alcohol on self-reported anxiety in a social interaction situation. Thirty-two male and thirty-two female social drinkers were randomly assigned to four conditions in a 2 x 2 factorial balanced placebo design, controlling for drink content and expectations. Results show that in women alcohol expectancy reduced self-reported anxiety, whereas in men there was no significant effect of expectancy. Alcohol consumption reduced anxiety in both men and women. Controlling for beliefs increased some of the effects we found. We conclude that although cognitive factors do mediate the effects of alcohol on self-reported anxiety, this influence seems to be different for men and women and the role of pharmacological factors might be more crucial.",de Boer MC.; Schippers GM.; van der Staak CP.,,,0,0,
10243,Clinical applications of a pneumatic intermittent impulse compression device after trauma and major surgery to the foot and ankle.,"A prospective study was designed to evaluate the effect of a pneumatic intermittent impulse device in the treatment of postsurgical and posttraumatic swelling of the adult foot and ankle. Two groups of patients and their respective controls were studied. Group A consisted of 19 patients and 19 controls with acute swelling of the foot and ankle after major elective or posttraumatic surgery. Group B comprised 18 patients and 16 controls with chronic postsurgical or posttraumatic swelling. The pneumatic intermittent impulse device was used according to a predetermined daily regimen in both the control and experimental groups. The control patients were treated identically, except that their impulse device was modified to prevent effective compression. Reduction in swelling was measured by volumetric analysis with water displacement at selected intervals for each group. When compared with their respective controls, those patients who used an active impulse device had a statistically significant reduction in swelling. We conclude that this device is effective in the control of both acute and chronic swelling after trauma and surgery of the foot and ankle.",Myerson MS.; Henderson MR.,1993.0,,0,0,
10244,"Anxiety, attention and pain.","In a within-subject design the hypothesis was tested that focus of attention rather than anxiety influences pain. Twenty-four spider phobics received a moderately painful electrical stimulation in each of four conditions: low anxiety/attention directed towards pain; low anxiety/attention distracted from pain; high anxiety/attention directed towards pain; high anxiety/attention distracted from pain. Anxiety was induced by means of exposure to a spider. Subjective pain ratings strongly supported the hypothesis: pain was rated lower when the subject diverted attention away from than when the subject attended to the pain stimulus, regardless of level of anxiety. The Skin Conductance Response to the first pain stimulus of the series of four in each condition was, however, higher when the subject distracted than when the subject attended to the pain stimulus. There were no experimental effects on later Skin Conductance Responses. Most importantly, there was no influence of anxiety on any of the pain responses. Attentional focus rather than anxiety per se seems to influence pain.",Arntz A.; de Jong P.,1993.0,,0,0,
10245,[A controlled study of food behavior and emotional manifestation in a population of obese female adolescents].,"Obesity is a major Public Health problem in developed countries. It is frequently associated with psychological difficulties that may interfere with treatment. 22 obese female adolescents, aged 13 to 19 years, and 24 age-matched female controls, were compared with regard to emotional pathology (anxiety, depression), eating behaviors, self-esteem, body image and parental history of depression. The evaluation was both categorical (DSM III-R criteria) and dimensional for depression and anxiety. It also included a self-esteem scale and questionnaires. The obese adolescents had more depressive symptoms, more prevalent anxiety disorders, more frequent histories of parental depression, eating behaviors characterized by over-eating and/or restricted intake, lower self-esteem and dissatisfaction with their body image, leading to avoidance behaviors in some of them. Psychological manifestations, although they are still insufficiently documented, especially in adolescents, may aggravate obesity and interfere with treatment.",Isnard-Mugnier P.; Vila G.; Nollet-Clemencon C.; Vera L.; Rault G.; Mouren-Simeoni MC.,,,0,0,
10246,Drug treatment of panic disorder. Further comment.,,Marks IM.; Başoğlu M.; Noshirvani H.; Greist J.; Swinson RP.; O'Sullivan G.,1993.0,,0,0,
10247,Opioid antagonist affects behavioral effects of exposure in vivo.,"This study tested the hypothesis that endogenous opioids are involved in the extinction of phobic fear through exposure in vivo. Forty-eight spider phobics participated in a 2-hr therapist-directed exposure in vivo treatment. Sixteen Ss were assigned to placebo, 16 to a low dose of naltrexone, and 16 to a high dose of naltrexone. Before intervention, after treatment, and at a 1-wk follow-up test, self-report, physiological, and behavioral measures of phobic fear were completed. At 1-wk follow-up, naltrexone was significantly related, in a dose-dependent way, to a greater relapse on avoidance measures but not on emotional, cognitive, and physiological measures. Endogenous opioids may be specifically involved in the extinction of avoidance behavior but not in the extinction of all aspects of phobic fear.",Arntz A.; Merckelbach H.; de Jong P.,1993.0,,0,0,
10248,"Exposure therapy, fluvoxamine, or combination treatment in obsessive-compulsive disorder: one-year followup.","Sixty outpatients with obsessive-compulsive disorder (OCD, 22 men, 38 women) were randomized to receive 6 months of antiexposure therapy with fluvoxamine (group F), exposure therapy with fluvoxamine (group Fe), or exposure therapy with placebo (group Pe). Patients in group F did not comply with antiexposure therapy, so it was in fact a neutral condition. Patients began with depressed mood (mean Hamilton depression score = 19). Fifty patients were reevaluated at week 8, 44 at week 24 (posttest), 37 at week 48, and 33 at 18 months, 1 year posttreatment (group F, n = 10; group Fe, n = 12; group Pe, n = 11). The three groups improved on rituals and depression. There was a drug effect on rituals at week 8 and on depression at week 24; both these effects disappeared at week 48. The 33 18-month completers had been comparable at baseline to those not followed up, apart from having more severe behavioral avoidance. At 18-month followup, patients as a whole remained improved with no between-group differences; over 80% of the Fe and Pe patients versus 40% of the F patients were not receiving antidepressant treatment (Fe vs. F: p < 0.04; Pe vs. F: p = 0.053; Fe vs. Pe: NS). In OCD fluvoxamine and exposure therapy were synergistic in the short term, and exposure reduced subsequent need for antidepressants in the followup year after they had been stopped.",Cottraux J.; Mollard E.; Bouvard M.; Marks I.,1993.0,,0,0,
10249,Deformity correction and arthrodesis of the midfoot with a medial plate.,"Nine feet in eight patients undergoing tarsometatarsal (Lisfranc) or other midfoot arthrodeses for posttraumatic or degenerative arthritis were reviewed retrospectively. All patients were treated using a medial one-third tubular plate spanning the midfoot joints to be fused. Three feet underwent fusion in situ while six feet underwent correction of residual planus, planovalgus, or cavovarus deformity at the time of fusion. All patients achieved fusion within 12 weeks. A good or excellent result was achieved in seven of nine feet. There was no radiographic or clinical evidence of pseudarthrosis or medial hardware failure in any patient. No patient to date has required hardware removal for a painful or prominent implant. The talus first metatarsal angle was improved an average of 15.5 degrees in the lateral plane and 10 degrees in the AP plane in patients undergoing deformity correction. The technique of using a medial plate for midfoot arthrodesis allows for reliable fusion in patients who require salvage for midfoot arthritis. This technique also allows for correction of deformity in patients with residual midfoot deformity.",Horton GA.; Olney BW.,,,0,0,
10250,Panic disorder with agoraphobia.,,Klein DF.,1993.0,,0,0,
10251,Cognitive-behavioral therapy of panic disorder with secondary major depression: a preliminary investigation.,"Controlled studies indicate that cognitive-behavioral therapy eliminates panic attacks in greater than 80% of patients who suffer from panic disorder. However, because most of the screening procedures used in those studies called for excluding patients who were depressed, a question arises as to the extent to which these results apply to patients who are clinically depressed in addition to having panic attacks. Accordingly, an attempt was made in the present study to determine whether or not panic patients who are clinically depressed could be treated as successfully as those who are not clinically depressed. Two multiple baseline A-A1-A-B across-subjects designs were used, one to test 8 panic Ss with major depression and the second to test 7 panic Ss without major depression. In Baseline (A), Ss monitored their panic attacks daily. During the A1 phase, a program of information on panic attacks presented as psychotherapy was instituted to assess the effects of nonspecific factors, followed by a second baseline phase (A). Cognitive-behavioral therapy (B) was then introduced. Results showed that cognitive-behavioral therapy was significantly superior to information-based therapy in the reduction of panic attacks. No significant differences were found between depressed and nondepressed patients.",Laberge B.; Gauthier JG.; Côté G.; Plamondon J.; Cormier HJ.,1993.0,,0,0,
10252,Hostility and irritable mood in panic disorder with agoraphobia.,"Twenty patients suffering from panic disorder with agoraphobia were administered the hostility subscale of Kellner's Symptom Questionnaire and the irritability scales of Paykel's Clinical Interview for Depression and of Kellner's Anxiety Rating Scale before and after behavioral treatment of agoraphobia. A matched control group of normal subjects had the same assessments at two similar points in time. Hostility and irritable mood decreased and friendliness increased in patients with panic disorder after treatment; upon recovery, there were no significant differences in hostility between patients and controls, whereas such differences were striking during the illness. The results suggest that increased hostility and irritable mood may be symptoms of panic disorder and improve with the treatment of agoraphobia.",Fava GA.; Grandi S.; Rafanelli C.; Saviotti FM.; Ballin M.; Pesarin F.,1993.0,,0,0,
10253,Outcome of panic disorder with or without concomitant depression: A 2-year prospective follow-up study.,"In a prospective 2-year follow-up study, 32 patients with panic disorder alone and 20 with panic disorder and concomitant depression were investigated. After controlled treatment with either imipramine or doxepin, patients received naturalistic treatment with antidepressants, benzodiazepines, and supportive psychotherapy. They were evaluated for anxiety, depression, and social disability at least every 3 months during the follow-up period. The data showed fluctuation of symptoms in both groups and a less favorable outcome for the patients with comorbid conditions. However, the overall outcome was better than that reported in other studies and indicates that panic disorder is quite responsive to appropriate treatment.",Albus M.; Scheibe G.,1993.0,10.1176/ajp.150.12.1878,0,0,
10254,Clomipramine in the treatment of agoraphobic inpatients resistant to behavioral therapy.,"Both behavior-modification methods and antidepressants have proved to be effective in the treatment of agoraphobia. The authors examined the effects of clomipramine on agoraphobia in patients who failed to respond to exposure-based behavioral treatment. Eighteen patients with panic disorder with agoraphobia who had not responded to previous inpatient behavioral treatment were recruited to a 12-week, placebo-controlled, double-blind crossover study of clomipramine, at top doses of 150 mg/day for 3 weeks. The patients were assessed on measures of phobic avoidance, agoraphobic cognitions, panic, state and trait anxiety, subjective anxiety, and depression. One patient dropped out of the study after 6 weeks. On most outcome measures, the 17 study completers had significantly (p < .05) lower symptom scores at posttest in the active drug period than at posttest in the placebo period; however, the clinical gains were modest. The short-term efficacy of clomipramine for agoraphobic patients who failed to respond lastingly to behavioral treatment was demonstrated. It remains to be shown that clomipramine can lead to clinically significant and lasting benefits in these patients.",Hoffart A.; Due-Madsen J.; Lande B.; Gude T.; Bille H.; Torgersen S.,1993.0,,0,0,
10255,Effect of psychiatric labels on attitudes toward mental illness in a Turkish sample.,"The influence of specific psychiatric labels and types of psychopathology on various attitudes were investigated in a sample (N = 84) of visitors of patients in a Turkish hospital. Vignettes representing two types of psychopathology with and without labels were used as the stimulus material and the attitudes toward those descriptions were assessed with the use of a questionnaire. Statistical analyses showed that labels had significant influence on recognition of mental illness, social distance, expected physical burden, and perception of treatment necessity. Type of psychopathology significantly influenced recognition of mental illness, social distance, expected physical burden, prognosis, and treatment choice. The results were discussed within the context of previous findings and the need for research pointed out.",Arkar H.; Eker D.,1994.0,10.1177/002076409404000306,0,0,
10256,Neurosurgical treatment for refractory obsessive-compulsive disorder: implications for understanding frontal lobe function.,"A minority of patients with obsessive-compulsive disorder (OCD) have a chronic course and extreme disability, with symptoms refractory to pharmacological and psychological treatment. Considerable uncontrolled evidence suggests such cases may respond to neurosurgical intervention. The authors update current stereotactic procedures and their efficacy, safety, and side effect profiles. The design of an ongoing placebo-controlled trial of Gamma Knife capsulotomy for refractory OCD is outlined. Drug treatment of OCD may be assumed to affect a proposed functional imbalance between the frontal lobes and other parts of the brain. As for neurosurgical treatments, both the effects and side effects may be viewed as expressions of their influence on this functional imbalance.",Mindus P.; Rasmussen SA.; Lindquist C.,1994.0,10.1176/jnp.6.4.467,0,0,
10257,Should treatment distinguish anxiogenic from anxiolytic obsessive-compulsive ruminations? Results of a pilot controlled study and of a clinical audit.,"In a small pilot controlled study over 8 weeks, 12 obsessive-compulsive ruminators listened for 2 h daily to their own audiotaped voice either (1) describing their anxiogenic thoughts (exposure) but omitting anxiolytic thoughts (mental/cognitive rituals), or (2) reading neutral prose or poetry. Taking all patients, both groups improved similarly. However, exposure patients who became anxious early in exposure slightly more improved. Consistent with this, in a clinical audit of 57 ruminators treated by trainee clinicians over 12 years, outcome improved significantly once practice changed so that exposure only involved anxiogenic thoughts, not anxiolytic thoughts, the latter being stopped.",Lovell K.; Marks IM.; Noshirvani H.; O'Sullivan G.,1994.0,,0,0,
10258,Efficacy of psychiatric day treatment. Course and outcome of psychiatric disorders in a randomised trial.,"The course of the psychopathology and social functioning in an experimental day-treatment group referred for inpatient psychiatric treatment is compared with that of a control group receiving standard inpatient care. During a follow-up period of 2 years subjects were interviewed three times. The interview comprised information about psychiatric symptoms, psychological functions, psychiatric diagnosis and social-role functioning. Apart from these discrete assessments an effort was made to map episodes of illness throughout the follow-up period. Upon entry the groups did not differ in terms of psychopathology or social functioning. At follow-up both groups had improved significantly with respect to symptomatology, psychological and social functioning. The extent to which the groups improved did not differ significantly regarding pathology, but self-care improved more in the experimental group. The average duration of episodes of illness was similar for the experimental and control group. During the 2-year follow-up patients suffered from a well-defined disorder during an average of 11 months. The fact that approximately 40% of them were still a psychiatric case after 2 years further underscores the severity of their pathology.",Nienhuis FJ.; Giel R.; Kluiter H.; Rüphan M.; Wiersma D.,1994.0,,0,0,
10259,Peptides and anxiety: a dose-response evaluation of pentagastrin in healthy volunteers.,"A large body of data suggest that brain cholecystokinin (CCK) systems are involved in the regulation of anxiety, and numerous studies have demonstrated that CCK-4, a CCKB agonist, reliably induces panic attacks in patients with panic disorder. Recently, pentagastrin, a commercially available CCKB agonist, has been reported to have similar anxiogenic properties. To further explore the utility of pentagastrin as a challenge agent and to determine whether its effects are dose-related, a dose-response study was conducted in ten healthy volunteers. Pentagastrin (0.2 microgram/kg, 0.6 microgram/kg and 1.0 microgram/kg) and inactive placebo were infused over one minute on four separate challenge days in a double-blind fashion. Subjects received pentagastrin while participating in a structured social interaction task. Repeated measures of anxiety, blood pressure, pulse, ACTH, and cortisol were taken at baseline and postinfusion. Pentagastrin administration led to increases in anxiety, pulse, ACTH, cortisol and physical symptoms of panic, in a dose-related manner. Participation in the social interaction task led to increases in measures of anxiety as well as increases in pulse and blood pressure. Few differences were found between the 0.2 microgram/kg dose of pentagastrin and placebo, or between the 0.6 microgram/kg and the 1.0 microgram/kg doses of pentagastrin. These findings support the notion that CCK systems are involved in the regulation of anxiety, and suggest that the 0.6 microgram/kg dose may be optimal for increasing symptoms of anxiety while minimizing unpleasant side effects. The powerful anxiogenic effects of the social interaction task underscore the importance of contextual variables in challenge studies.",McCann UD.; Slate SO.; Geraci M.; Uhde TW.,,,0,0,7235
10260,Criticisms of Sanderson and Carpenter's study on eye movement desensitization.,,Greenwald R.,1994.0,,0,0,
10261,Predictors of short-term treatment response in 66 patients with panic disorder.,"Short-term treatment response in panic disorder was studies in 66 subjects who had completed 3 weeks of treatment with fluvoxamine (n = 23), cognitive therapy (n = 20), or placebo (n = 23). Clinical and self-rated assessments were gathered at baseline, during, and after treatment. Using multiple logistic regression, treatment with fluvoxamine, a low panic attack severity score, and absence of a comorbid personality disorder were identified as significant predictors of recovery. Personality disorder was an important negative predictor to outcome with cognitive therapy. The results support the efficacy of fluvoxamine, and show that patients with low symptom severity and a normal personality respond well to treatment.",Black DW.; Wesner RB.; Gabel J.; Bowers W.; Monahan P.,1994.0,,0,0,
10262,"Haloperidol addition in fluvoxamine-refractory obsessive-compulsive disorder. A double-blind, placebo-controlled study in patients with and without tics.","To determine the efficacy of adding haloperidol to the treatment of patients with obsessive-compulsive disorder (OCD), with or without a comorbid chronic tic disorder, who were refractory to adequate treatment with the serotonin-uptake inhibitor fluvoxamine alone. It was hypothesized that OCD patients with a concurrent chronic tic disorder would preferentially respond to this treatment. Sixty-two patients with a primary DSM-III-R diagnosis of OCD received placebo fluvoxamine for 1 week, followed by 8 weeks of active fluvoxamine. Thirty-four of these patients were refractory to fluvoxamine and were randomized in a double-blind fashion to 4 weeks of treatment with either haloperidol (n = 17) or placebo (n = 17) added to ongoing fluvoxamine treatment. The placebo-treated group included five women and 12 men, six inpatients and 11 outpatients, and eight patients with a comorbid chronic tic disorder. The haloperidol-treated group consisted of two women and 15 men, three inpatients and 14 outpatients, and seven patients with a comorbid chronic tic disorder. All 34 patients completed the entire study. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Clinical Global Impression scale were the principal measures of treatment outcome. Haloperidol addition was significantly better than placebo in reducing the severity of obsessive-compulsive symptoms as measured by the Y-BOCS. Eleven of 17 patients responded to the haloperidol, compared with none of 17 patients given placebo. Eight of eight patients with comorbid chronic tic disorders, such as Tourette's disorder, responded to double-blind haloperidol addition to ongoing fluvoxamine treatment. Haloperidol addition was of little benefit in treating OCD patients without tics. Fluvoxamine blood levels were not related to treatment response. The results of this study suggest that OCD patients with a comorbid chronic tic disorder constitute a clinically meaningful subtype of OCD that might require conjoint serotonin-uptake inhibitor/neuroleptic therapy for effective symptom reduction.",McDougle CJ.; Goodman WK.; Leckman JF.; Lee NC.; Heninger GR.; Price LH.,1994.0,,0,0,
10263,Assessing psychiatric disorder with a human interviewer or a computer.,"To compare a self administered computerised assessment of neurotic psychiatric disorder (psychiatric morbidity) with an identical assessment administered by a human interviewer. In particular, to discover whether a computerised assessment overestimates or underestimates the prevalence of psychiatric morbidity in relation to a human interviewer. A health centre in south east London, UK. A non-consecutive series of health centre attenders. Complete data were available on 92 subjects. All subjects received both assessments on the same occasion but were randomised to receive either the computerised assessment first or the human interview first. The mean total score on the assessment was the same for both methods of administration; computer 8.77 v human 8.69 (95% confidence interval for difference -0.70, 0.87). The correlation between the human and interviewer assessments was 0.91. Self administered computerised assessments are valid, unbiased measures of psychiatric morbidity. In addition to their use as a research tool, they have potential uses in primary care including screening for psychiatric morbidity and in forming the basis for clinical guidelines.",Lewis G.,1994.0,,0,0,
10264,The susceptibility of the Rorschach Inkblot Test to malingering of combat-related PTSD.,"The ability of subjects to alter their responses on the Rorschach and self-report measures to fake the symptoms of combat-related Posttraumatic Stress Disorder (PTSD) was investigated. Subjects were 40 White male undergraduates, randomly assigned to either a control or role-informed malingerer group, and 20 White Vietnam veterans with PTSD. Subjects were administered the Rorschach, MMPI-2 validity scales, and Mississippi Scale for Combat-Related PTSD. Results indicated that malingerers were able to achieve scores similar to the PTSD patients on the Mississippi Scale and some Rorschach variables. However, they evidenced significant differences on the MMPI-2 validity scales and several important Rorschach variables. Malingerers typically gave responses that were overly dramatic and less complicated, less emotionally restrained, and indicated an exaggerated sense of impaired reality testing as compared to PTSD patients. Behavioral differences were also noted between the groups. Findings are discussed in the context of the study's limitations and the practical detection of malingered PTSD in clinical settings.",Frueh BC.; Kinder BN.,1994.0,10.1207/s15327752jpa6202_9,0,0,
10265,"Relationship of panic, anticipatory anxiety, agoraphobia and global improvement in panic disorder with agoraphobia treated with alprazolam and exposure.","In a controlled trial of alprazolam and exposure in 154 patients with panic disorder with agoraphobia, relations between panic, anticipatory anxiety, and phobic avoidance were examined. The three symptoms were independent of one another at baseline and improved largely independently during treatment; only early improvement in avoidance predicted global improvement after treatment. Global improvement was more related to reduction of avoidance than a decrease in panics. Panic was not a valuable outcome measure in panic disorder with agoraphobia.",Başoğlu M.; Marks IM.; Kiliç C.; Swinson RP.; Noshirvani H.; Kuch K.; O'Sullivan G.,1994.0,,0,0,
10266,Alprazolam and exposure for panic disorder with agoraphobia. Attribution of improvement to medication predicts subsequent relapse.,"Patients with panic disorder plus agoraphobia had 8 weeks of drug treatment (alprazolam or placebo) plus psychological treatment (exposure or relaxation). At the end of treatment at week 8, 40 patients who had become much/very much improved rated how much their gains were attributable to medication or to their own efforts. During the tapering-off to week 16, and treatment-free follow-up to week 43, patients who at week 8 had attributed their gains to medication and felt less confident in coping without tablets had more severe withdrawal symptoms and greater loss of gains than did patients who at week 8 had attributed their gains to their own efforts during treatment. Baseline illness severity, greater age, higher expectations from drug treatment, and more side-effects of drugs during treatment all predicted more external attributions (i.e. to the effect of drugs) but did not independently predict relapse. Patients on alprazolam compared with placebo had more drug attributions. Though drug attributions predicted relapse in both alprazolam and placebo groups, predictions were stronger in the alprazolam group.",Başoğlu M.; Marks IM.; Kiliç C.; Brewin CR.; Swinson RP.,1994.0,,0,0,
10267,Remission and relapse in subjects with panic disorder and panic with agoraphobia: a prospective short-interval naturalistic follow-up.,"This article reports on the course of uncomplicated panic disorder and panic with agoraphobia on 309 patients participating in the Harvard/Brown Anxiety Research Project, a prospective longitudinal study of patients with DSM-III-R-defined anxiety disorders. At 1 year, there was a .39 probability of full remission for uncomplicated panic disorder and a .17 probability of full remission for panic disorder with agoraphobia Similar differences in time to remission for these syndromes were still found when criteria for remission were made less stringent. However, even requiring less improvement for remission left a large percentage of subjects in an episode, and for those that remitted, relapse occurred quickly, indicating a chronic and recurrent course of illness. This is the first longitudinal, prospective, naturalistic study on a large cohort of subjects with anxiety disorders to have regular, structured, short-interval follow-up. Our results are consistent with the view that panic disorder has a chronic course with high rates of relapse after remission and longer episodes when agoraphobia is a part of the constellation of symptoms.",Keller MB.; Yonkers KA.; Warshaw MG.; Pratt LA.; Gollan JK.; Massion AO.; White K.; Swartz AR.; Reich J.; Lavori PW.,1994.0,,0,0,
10268,The experimental induction of depersonalization and derealization in panic disorder and nonanxious subjects.,"The present study evaluated the efficacy of three tasks in inducing depersonalization (DP) and derealization (DR) in three different groups: (a) panic disorder patients who report these symptoms while panicking (PD + DD; n = 10); (b) panic disorder patients never experiencing these symptoms during panic attacks (PD; n = 10); and (c) nonanxious controls (NC; n = 10). Clinical features of the PD+DD and PD Ss were compared as well. Relative to PD Ss, PD + DD Ss evidenced higher levels of depression, trait anxiety, more fear of panic, and had a briefer duration of their disorder. A substantial proportion of NC Ss reported past DP and DR experiences. DP and DR induction procedures were the following: staring at a dot on the wall, staring in a mirror, and silent repetition of one's name. Results indicated two tasks (mirror and dot) successfully elicited these sensations above baseline levels with DP reported more frequently and intensely than DR for all Ss. The PD + DD Ss evidenced greater baseline-to-task increases in DP and DR relative to the other two groups and exhibited a differential fear response, particularly on the dot task, with 30% of these Ss intentionally distracting themselves or terminating the induction.",Miller PP.; Brown TA.; DiNardo PA.; Barlow DH.,1994.0,,0,0,
10269,The effects of therapeutic touch and relaxation therapy in reducing anxiety.,"This study examines the effects of two noninvasive procedures on experienced anxiety. Thirty-one inpatients of a Veterans Administration psychiatric facility were randomly assigned to one of two treatment conditions, (therapeutic touch and relaxation therapy) or to a therapeutic touch placebo condition. An additional 13 patients were excluded because of failure to meet criteria for the study or failure to complete the procedures. Each subject completed a self-report anxiety measure and was rated for amount of motor activity before and after each of two 15-minute treatment sessions in a 24-hour period. Subjects' belief in the effectiveness of the intervention was measured. Expectancy did not correlate with outcome and was not analyzed further. Multivariate analysis of variance (MANOVA) showed that whereas relaxation therapy provided significant reduction of anxiety on the self-report measure and the movement measure, the nursing intervention of therapeutic touch resulted in significant reductions of reported anxiety. The control group showed small but nonsignificant effects. Results suggests that both relaxation and therapeutic touch are effective palliatives to experienced anxiety. Implications for nursing theory are discussed.",Gagne D.; Toye RC.,1994.0,,0,0,
10270,"A blinded, controlled evaluation of anxiety and depressive symptoms in patients with fibromyalgia, as measured by standardized psychometric interview scales.","The objective of the study was to evaluate the presence of psychopathology in fibromyalgia patients compared with a control group of other rheumatologic patients with pain. Forty-nine fibromyalgia patients and 33 control patients were interviewed blinded, using standardized psychometric scales. Pain was scored on a visual analogue scale. Fibromyalgia patients scored significantly higher than the controls on the Bech-Rafaelsen Melancholia Scale, the Atypical Depression Scale and the Hamilton Anxiety Rating Scale. On the Newcastle Depression Scale there was no difference. In both groups a correlation was found between pain score and psychometric scoring. The fibromyalgia patients scored significantly higher on pain than the controls. After correcting for this difference, the fibromyalgia patients still scored higher on anxiety and depression.",Krag NJ.; N√∏rregaard J.; Larsen JK.; Danneskiold-Sams√∏e B.,1994.0,,0,0,
10271,Religious psychotherapy in anxiety disorder patients.,"Religious patients with generalized anxiety disorder were given religious psychotherapy in addition to supportive psychotherapy anxiolytic drugs. Those receiving religious psychotherapy showed significantly more rapid improvement in anxiety symptoms than those who received supportive psychotherapy and drugs only. Thus, religious patients may require a different form of psychotherapy.",Azhar MZ.; Varma SL.; Dharap AS.,1994.0,,0,0,
10272,Computerized and clinician assessment of depression and anxiety: respondent evaluation and satisfaction.,"This investigation examined differences in subjects' satisfaction and reaction to computer- and clinician-administered versions of the Hamilton Depression and Anxiety Rating Scales in outpatients with affective disorders (n = 121), anxiety disorders (n = 52), other psychiatric disorders (n = 7), and adults without psychiatric disorders (n = 76). Subjects' reactions to clinician- and computer-administered interviews were similar in the areas of overall comfort level and ease in answering questions. Clinicians were rated more positively with regard to determining how subjects really felt, sensitivity to their needs, and asking questions specific to their feelings. Subjects felt less embarrassed giving information to the computer. We found psychiatric subjects to prefer the clinician-administered interview, whereas nonpsychiatric subjects indicated no preference.",Kobak KA.; Reynolds WM.; Griest JH.,1994.0,10.1207/s15327752jpa6301_14,0,0,
10273,[Semantic interference and pathological anxiety: experimental approach in generalized anxiety].,"Patients with D.S.M. III-R generalized anxiety disorder and normal controls performed a computerized Stroop color naming-task in which they named colors of threat-related, positive and neutral words. Compared to controls, generalized anxious patients revealed a longer response latency for threat-related words, without correlation with anxious measures on Spielberger State-Trait Anxiety Inventory. In normal control group, response delay to emotional words was correlated to anxious score on STAI-Trait. There was no difference between the two groups in a recognition memory task. The results suggest existence of different semantic interference in categorical and normal anxiety, without implication of explicit memory.",Azaïs F.; Granger B.; Debray Q.,,,0,0,
10274,"The effects of alcohol, expectancy, and alcohol beliefs on anxiety and self-disclosure in women: do beliefs moderate alcohol effects?","This study investigates the effects of alcohol, expectancy, and alcohol-related beliefs on self-reported anxiety and self-disclosure behavior in a social interaction situation. Seventy-two female social drinkers were assigned to eight conditions in a 2 x 2 x 2 factorial balanced-placebo design, controlling for drink content, expectancy, and beliefs. Results show that alcohol expectancy resulted in an anxiety reduction in subjects who believed that alcohol has a positive influence on social behavior, whereas expectancy had no effect in subjects with negative alcohol beliefs. Furthermore, subjects who expected alcohol were less anxious when they had positive alcohol beliefs than when they had negative beliefs, whereas beliefs made no difference in subjects who expected tonic. Our results suggest that the effect of alcohol expectancy on social anxiety in women is moderated by differences in the content of their alcohol-related beliefs. We conclude that the inconsistency in previous results about the effect of alcohol expectancy on social behavior might be explained by differences in subjects' alcohol beliefs. Finally, as neither of the three factors had any effect on self-disclosure behavior, we suggest that this behavioral measure is unrelated to self-reported anxiety.",de Boer MC.; Schippers GM.; van der Staak CP.,,,0,0,
10275,Eye movement desensitization across subjects: subjective and physiological measures of treatment efficacy.,"Eye movement desensitization (EMD) was investigated in an experimental multiple baseline across subjects design. Six subjects who met the diagnostic criteria for Posttraumatic Stress Disorder (PTSD) were included in the study. While the EMD technique advanced by Shapiro has been reported to be clinically effective, major methodological issues have been raised which remain to be addressed. One issue raised is whether exposure to the traumatic image is sufficient to account for the reported clinical effects of EMD or whether the addition of saccadic eye movements is central to the treatment. This study attempted to address this concern by comparing two EMD-based procedures: a Non-saccade phase (without the saccadic eye movements) which functioned as a control and a second that included saccadic eye movements. Dependent variables included self-report information (SUDs, behavioral symptoms reports) and physiological data (heart rate and systolic blood pressure). The results showed no significant decreases in SUDs level with the EMD minus the saccadic eye movements procedure. However, five of the six subjects reported clinically significant decreases in their SUDs levels with the inclusion of the saccadic eye movements. This study appears to corroborate previous work employing single-case design as well as pre and postcomparisons.",Montgomery RW.; Ayllon T.,1994.0,,0,0,
10276,Buspirone treatment of anxious alcoholics. A placebo-controlled trial.,"Symptoms of anxiety are common in alcoholics and may contribute to relapse following initiation of abstinence. Buspirone hydrochloride, a serotonin1A partial agonist, has a pharmacologic profile that may be particularly suited to the treatment of anxious alcoholics. We conducted a randomized, 12-week, placebo-controlled trial of buspirone in 61 anxious alcoholics, all of whom also received weekly relapse prevention psychotherapy. Outcomes were measured at the end of treatment and at a 6-month follow-up evaluation. Buspirone therapy was associated with greater retention in the 12-week treatment trial, reduced anxiety, a slower return to heavy alcohol consumption, and fewer drinking days during the follow-up period. Buspirone appears to have a useful role in the treatment of anxious alcoholics. Further research is needed to clarify which patient characteristics and concomitant treatments result in optimal response to buspirone therapy.",Kranzler HR.; Burleson JA.; Del Boca FK.; Babor TF.; Korner P.; Brown J.; Bohn MJ.,1994.0,,0,0,
10277,Quantification of real-time confocal images of the human cornea.,"Real-time confocal microscopy was used to obtain images of the surface cells of the cornea in vivo in human subjects and in non-human primates. The surface cells represent the barrier between the tear layer and the internal cellular environment and as such, the state of these cells is indicative of the health of the cornea. In our study, confocal microscopy of the surface cells revealed prominent, centrally located nuclei. With the use of a series of image analysis procedures, the nuclei were located automatically and distances to the nearest neighbors were determined. Comparison of these procedures in 8 human corneas and 1 non-human primate cornea showed that unaided computer analysis of the surface cells was as accurate as manual location of the cell nuclei. The distribution of nearest-neighbor distances was found to be best fitted by a gamma distribution. Simulation of a condition marked by loss of surface cells demonstrated that the alpha (shape) and beta (scale) parameters could be used to compare the distribution of nearest-neighbor distances. Thus, confocal microscopy coupled with these image analysis and statistical procedures could provide an objective, quantitative approach to monitoring the epithelial barrier under clinical and experimental conditions, for example during post-surgical or post-traumatic healing or in the evaluation of the efficacy of topical therapeutic agents.",Beuerman RW.; Laird JA.; Kaufman SC.; Kaufman HE.,1994.0,,0,0,
10278,Control and attention during exposure influence arousal and fear among insect phobics.,"Heart beats, skin conductance, and subjective fear levels were recorded among eight pairs of DSM-III-R spider-phobic subjects (Experiment 1) and among eight pairs of DSM-III-R cockroach-phobic subjects (Experiment 2) who were exposed simultaneously to an approaching specimen during eight 4-minute trials. Control over the approach of the specimen alternated between subjects over trials. On different trials, both subjects were instructed either to attend closely to the features of the specimen or to attend closely to their bodily fear reactions. Among spider-phobic subjects (Experiment 1), Self-Control over the specimen produced higher skin conductance during exposure than did Partner-Control over the specimen; instructions to attend closely to the features of the specimen produced higher skin-conductance than did instructions to attend closely to one's bodily fear reactions. Among cockroach-phobic subjects (Experiment 2), Self-Control over the specimen produced higher skin conductance and higher self-reported fear than did Partner-Control over the specimen during the early exposures. Instructions to attend closely to the specimen produced higher skin conductance and higher self-reported fear throughout the experiment and higher heart rates early during the experiment than did instructions to attend to one's bodily reactions. Empirical generalizations based on these data are intended as contributions toward a fund of experimental information that, in due course, will be used to conceptualize the means by which exposure to feared stimuli leads to fear reduction.",McGlynn FD.; Rose MP.; Lazarte A.,1994.0,10.1177/01454455940184001,0,0,
10279,Necessary but not sufficient: the effect of screening and feedback on outcomes of primary care patients with untreated anxiety.,"To consider the impact on primary care patient outcomes of using both a screener to determine elevated anxiety levels among patients with previously undetected anxiety and a physician intervention to inform physicians of their patients' conditions. Participating physicians were randomized to either the demonstration or the control arm, and patients were assigned to a study arm based on the randomization of their physicians. The patients were followed for change in outcome measures during the five-month study period. A mixed-model health maintenance organization serving approximately 110,000 enrollees in central Colorado. 573 patients who had unrecognized and untreated anxiety identified from the approximately 8,000 patients who completed the waiting room screening questionnaire. A physician intervention served the dual function of 1) providing an educational demonstration of anxiety in the primary care setting and 2) providing a reporting system for summarizing the anxiety symptom levels and functioning status of the patients enrolled in the study. Patient outcomes were measured as changes in global anxiety scores, functioning and well-being, and patients' reports of global improvements. The findings indicate that this method of reporting symptoms and functioning status to primary care physicians did not significantly change patient outcomes. Improvement in outcomes appeared to be more closely associated with the patient's severity of psychological distress.",Mathias SD.; Fifer SK.; Mazonson PD.; Lubeck DP.; Buesching DP.; Patrick DL.,1994.0,,0,0,
10280,Validation of two anxiety scales in a university primary care clinic.,"Psychometric scales for the assessment of anxiety disorders have not been validated in primary care settings. We undertook a study to validate two brief, self-administered anxiety scales, Sheehan's Patient-Rated Anxiety Scale and Beck's Cognition Checklist, in a university primary care clinic. The two scales were compared with a diagnostic standard, the Structured Clinical Interview for the revised third edition of the Diagnostic and Statistical Manual (SCID). Of 87 randomly selected patients, 25 had an anxiety disorder by the SCID. Anxious patients scored statistically higher on both scales than nonanxious persons on both the Beck and Sheehan scales. Based on receiver operating characteristics curve analysis, we found that these two scales correctly classified 72% to 77% of anxious patients. Of the two scales, the Sheehan scale performed better, with a specificity of 94% and positive predictive value of 75%. Our results suggest that these instruments may be useful in the assessment of the anxiety disorders in medical populations.",Kick SD.; Bell JA.; Norris JM.; Steiner JF.,,,0,0,6551
10281,Optic internal urethrotomy under transrectal ultrasonographic guide and suprapubic fiberoscopic aid.,"Optic internal urethrotomy is the initial treatment of choice for most urethral strictures because of the relatively low morbidity and ease of accomplishment. However, the procedure is difficult and frustrating if a severe stricture or complete disruption of the urethra is encountered. Transrectal ultrasonography of the urethra offers good anatomical visualization, and defines the exact length and extent of bulbous and posterior urethral strictures, which could ensure a more accurate and aggressive incision of the stricture. Eleven patients (8 with posttraumatic and 3 with iatrogenic strictures) with complete obliteration of the bulbous and posterior urethra were successfully treated by optic internal urethrotomy with the aid of transrectal ultrasonography and a suprapubic fiberscope. After 1 year of followup, 5 of the 8 posttraumatic urethral strictures required further management, while the remaining patients had satisfactory results. Although the recurrence rate is high in the posttraumatic patients, transrectal ultrasound and the suprapubic fiberoscope afford a reliable and satisfactory aid during optic internal urethrotomy.",Chuang CK.; Lai MK.; Chu SH.,1994.0,,0,0,
10282,Predictors of treatment outcome in the behavioural treatment of obsessive-compulsive disorder.,"An investigation to determine which prognostic variables are associated with behavioural treatment failure in obsessive-compulsive disorder (OCD). Empirically established prognostic variables measured at the start of treatment may lead to adjusted treatment programmes for these patients. Forty patients, diagnosed with OCD, received a standardised treatment consisting of 18 sessions in vivo exposure and response prevention. Compulsive behaviour (MOCI) and obsessive fear (ADS) were the outcome measures. Prognostic variables included were initial severity of OC complaints, initial level of depression, problem duration, patients' motivation for treatment, quality of the therapeutic relationship, and marital dissatisfaction. Greater initial severity of complaints (P < 0.01), and depression (P = 0.03) predicted poorer outcome for compulsive behaviour. Greater initial severity of complaints (P < 0.01), and the conjoint variables higher level of depression, longer problem duration, poorer motivation for treatment, and dissatisfaction with the therapeutic relationship predicted poorer outcome for obsessive fear (P < 0.01). The complaint-related variables of initial severity, initial depression, and problem duration, and the non-specific treatment variables of patients' motivation and quality of the therapeutic relationship, affect behavioural treatment outcome in OCD.",Keijsers GP.; Hoogduin CA.; Schaap CP.,1994.0,,0,0,
10283,P300 in posttraumatic stress disorder.,"In the present study, P300 has been recorded in 26 subjects (15 women) 1 month after an aggression without organic complications. Among our sample, 16 subjects fulfilled DSM-III-R criteria for posttraumatic stress disorder (PTSD) and 10 did not. P300 amplitude was significantly lower in the 16 PTSD subjects as compared to the 10 subjects without PTSD. This study supports information processing disturbances in PTSD.",Charles G.; Hansenne M.; Ansseau M.; Pitchot W.; Machowski R.; Schittecatte M.; Wilmotte J.,1995.0,,0,0,
10284,Cognitive assessment in the acute care setting: reliability and validity of the Levels of Cognitive Functioning Assessment Scale (LOCFAS).,"Nurses have responsibility for accurate assessment of cognitive functioning for traumatic brain injured (TBI) patients early in the posttrauma period to enhance rehabilitation with appropriate care planning. To meet this need the Levels of Cognitive Functioning Assessment Scale (LOCFAS) was adapted from the Rancho Los Amigo Levels of Cognitive Functioning instrument. One validity and three reliability studies were conducted using videotapes of five TBI patients at different levels of cognitive functioning. Interrater and intrarater reliability was assessed using coefficient kappa. With raters experienced in assessing cognitive functioning, agreement among cognitive levels was 1.00 with a mean agreement of .997 (SD = .006) for individual items. With inexperienced raters in cognitive assessment, mean agreement for levels was .839 (SD = .120) and for individual items, .830 (SD = .052) Intrarater reliability, after a two-week interval, yielded a mean agreement of .860 (SD = .088) for levels. Criterion-related validity of the LOCFAS was demonstrated by correlating it with the Rancho Los Amigos Levels of Cognitive Functioning scale. The resultant Pearson r correlation was .929. Implications for nursing practice and nursing education are discussed.",Flannery J.,1995.0,,0,0,
10285,Psychiatric disorders in relatives of probands with obsessive-compulsive disorder and co-morbid major depression or generalized anxiety.,"The authors report findings from a blind, controlled study of obsessive-compulsive disorder (OCD). Prevalence rates of generalized anxiety disorder (GAD) and major depressive disorder (MDD) were compared among first-degree relatives of probands with OCD and co-morbid GAD or MDD, respectively. Rates of MDD were not increased in relatives of probands with OCD and MDD; neither were rates of GAD increased in relatives of probands with OCD and GAD, although rates of GAD were increased among relatives of probands with OCD compared to relatives of healthy controls. The authors explore the implications of the findings.",Black DW.; Goldstein RB.; Noyes R.; Blum N.,1995.0,,0,0,
10286,Assessment of comorbidity in the diagnosis of psychosomatic and neurotic disorders: results from the ICD-10 field trials with the diagnostic criteria for research in Germany.,"Operational diagnostic systems like ICD-10, Chapter V (F) are introducing the concept of comorbidity covering the symptomatology of patients with multiple descriptive diagnoses. Focusing on this concept, the relevance of rater variables in the diagnostic assessment with ICD-10 is studied. Based on data from the German ICD-10 Research Criteria Study in 11 centres of psychosomatic medicine, diagnostic ratings of 129 clinicians for 20 patients are discussed. Significant differences concerning the agreement of the clinicians with expert main diagnoses are correlated with their familiarity with DSM-III-R, the age of the clinicians and subjective ratings of the diagnostic process. Clinicians with a greater familiarity with DSM-III-R and ICD-10 and older diagnosticians with more professional experience in psychosomatic medicine show a better ability to cover comorbidity in their diagnostic assessments. Furthermore, behavioural therapists are assessing comorbidity more adequately than psychoanalytic therapists.",Freyberger HJ.; Schneider W.; Malchow CP.,1995.0,,0,0,
10287,DSM-IV field trial: obsessive-compulsive disorder.,"Three issues relevant to revising the DSM-III-R criteria for obsessive-compulsive disorder were examined in a field trial: 1) the requirement that symptoms of obsessive-compulsive disorder be viewed by the patient as excessive or unreasonable, 2) the presence of mental compulsions in addition to behavioral compulsions, and 3) ICD-10 subcategories. The authors studied symptom patterns of obsessive-compulsive disorder as well as strength of obsessive belief among 431 patients with obsessive-compulsive disorder at seven hospital outpatient clinics. Two methods of subject selection were used: consecutive entry of everyone who contacted the clinics for evaluation of obsessive-compulsive disorder and entry of patients with obsessive-compulsive disorder who had continuing contact with the clinics since before the field trial and who were still symptomatic. Primary measures were the Yale-Brown Obsessive Compulsive Scale and face-valid questions about fixity of obsessive-compulsive beliefs. The large majority of patients were uncertain about whether their obsessive-compulsive symptoms were unreasonable or excessive, and most had both mental and behavioral compulsions. Results on the ICD-10 subcategories were equivocal. The present results converge with previous findings to indicate a broad range of insight among patients with obsessive-compulsive disorder. The DSM-III-R requirement for insight should be de-emphasized in DSM-IV, and mental rituals should be included in the definition of compulsions.",Foa EB.; Kozak MJ.; Goodman WK.; Hollander E.; Jenike MA.; Rasmussen SA.,1995.0,10.1176/ajp.152.1.90,0,0,
10288,Implicit and explicit memory bias in anxiety: a conceptual replication.,"Williams, Watts, MacLeod and Mathews' (1988) [Cognitive psychology and the emotional disorders. Chichester, Wiley] model of anxiety and cognition leads to the prediction that anxious subjects will show an implicit, but not an explicit, memory advantage for threat-related information. Mathews, Mogg, May and Eysenck (1989) [Journal of Abnormal Psychology, 98, 401-407] obtained marginally significant support for this prediction in an experiment that tested memory using word stem completion tasks following a self-referent encoding procedure. However, neither the reliability nor generality of these findings have been established. The current experiment was designed to provide a conceptual replication of Mathews et al.'s study, using different tests of implicit memory (i.e. tachistoscopic identification) and explicit memory (i.e. recognition) and an alternative type of encoding task (i.e. colour naming stimulus words). 16 generalised anxiety disorder patients, and 16 non-anxious control subjects were tested. As predicted, the anxiety patients showed a relative implicit memory advantage for threat-related stimulus words, while the two subject groups did not differ in their pattern of explicit memory performance. These results support the predictions generated by Williams et al.'s model of anxiety and cognition.",MacLeod C.; McLaughlin K.,1995.0,,0,0,
10289,Heartbeat perception and panic disorder: possible explanations for discrepant findings.,"Results on cardiac awareness in panic disorder are inconsistent. The present study attempted to clarify whether differences in instructions or the inclusion of patients taking antidepressant medication could account for these inconsistencies. 112 patients with panic disorder with agoraphobia were compared to 40 normal controls on the heartbeat perception task developed by Schandry (1981) [Schandry, R., Psychophysiology, 18, 483-488] using a standard instruction (""count all heartbeats you feel in your body"") and a strict instruction (""count only those heartbeats about which you are sure""). Superior heartbeat perception for patients was only found with the standard instruction. Similarly, only with the standard instruction, patients taking medication affecting the cardiovascular system performed worse than patients without medication, as expected based on the relationship between stroke volume and heartbeat perception. The pattern of group differences indicates that agoraphobic patients have a better feeling for how fast their heart is beating than controls although these differences may be due to a tendency to interpret weak sensations as heartbeats. Furthermore, we tested in a subgroup of 40 patients whether cardiac awareness changes with exposure treatment. No changes in heartbeat perception were observed.",Ehlers A.; Breuer P.; Dohn D.; Fiegenbaum W.,1995.0,,0,0,
10290,The East York Health Needs Study. I: Prevalence of DSM-III-R psychiatric disorder in a sample of Canadian women.,"This study reports the prevalence of psychiatric disorder in women from a Canadian community. The GHQ and the CES-D were compared for their utility. A thousand women over the age of 18 were mailed the GHQ and the CES-D. Our return rate was 44.4%; 24% were personally interviewed by interviews blind to screening information. The CIDI was used to establish DSM-III-R diagnoses. Four versions of the GHQ and one version of the CES-D were calibrated against the CIDI. The prevalence of general psychiatric disorder was estimated as between 15% and 19%, anxiety disorders between 10% and 13%, and depression occurring with anxiety between 3% and 4%. The calibrated GHQ was the most reliable instrument. Prevalence of DSM-III-R psychiatric disorder can be reliably determined with the calibrated GHQ. Anxiety disorders are most prevalent in this community, and were best detected using calibrated versions of the longer form GHQ.",Katz R.; Stephen J.; Shaw BF.; Matthew A.; Newman F.; Rosenbluth M.,1995.0,,0,0,
10291,Endoscopic treatment of posttraumatic urethral obliteration: experience in 396 patients.,"Of 396 patients with posttraumatic posterior urethral strictures treated endoscopically during 10 years 352 had no vesical displacement (group 1) and 44 had marked displacement (group 2). Group 1 patients were treated by suprapubic diversion and delayed optical urethrotomy. Exploration and railroad alignment to the urethra were done in group 2 and followup internal urethrotomy was performed in 33 patients. Eleven patients in group 2 and 68 in group 1 were considered failures due to complete short segment urethral obliteration. These 79 patients who failed initial visual urethrotomy underwent endoscopic resection of the stricture, that is core through optical urethrotomy. After 6 to 55 months (average 2 years) 46 patients (58.2%) were voiding satisfactorily (4 had stress incontinence). The 33 patients (41.8%) with failed minor or major endoscopic treatment due to persistent obstruction were treated with open urethroplasty. We conclude that posttraumatic posterior urethral obliteration can be treated by simple or major endoscopic techniques and that core through optical urethrotomy is a reasonable alternative to urethroplasty in patients with an impassable short stricture.",el-Abd SA.,1995.0,10.1097/00005392-199501000-00025,0,0,
10292,Fluctuation of symptoms and social functioning in panic disorder with or without concomitant depression. A 5-year prospective follow-up.,"After controlled treatment with either imipramine or doxepin with additional psychotherapy, 30 patients with pure panic disorder and 20 with concomitant depression were followed under ordinary treatment conditions over a 5-year period. While the overall level of illness severity was mild in both groups (slightly worse in the group with comorbidity), social impairment as well as fluctuation of symptoms were similar in both groups. Therefore, comorbidity of panic disorder and depression does not necessarily imply a poorer outcome in a self-referred patient sample initially treated with psychotropic drugs combined with supportive psychotherapy.",Albus M.; Scheibe G.; Scherer J.,1995.0,,0,0,
10293,[Evaluation of fear and analysis of personality structure of women at risk for premature and after term labor].,"Psychological studies were performed in 57 pregnant women at risk for premature labour and 36 at risk for after term labour. The level of fear was evaluated using the Spielberger STAI questionnaire. The structure of fear and restlessness was studied using the R.B. Cattell's five factor Self-estimation Sheet. The analysis of personality structure was performed on the basis of results of the MMPI-WISKAD test. In the patients in both studied groups, groups an increased level of situational and persistent fear was found. Women at risk for premature labour are characterized by higher level of fear of neurotic character resulting from disharmonious personality. In women delivered after term the fear is of reactive character. Women at risk for after term labour are characterized by a higher degree of personality integration and more effective ability to control fear. Women at risk for premature labour are characterized by disharmonious personality and simultaneously they use more primitive protective mechanisms. Women delivered after term are characterized by higher degree of personality integration and more effective ability to control fear.",Kwaśniewska A.; Wartacz E.; Kwaśniewski SW.; Grudzień M.; Robak J.,,,0,0,
10294,Treatment of claustrophobias and snake/spider phobias: fear of arousal and fear of context.,"Forty-nine individuals with fears of snakes or spiders, and 21 individuals with claustrophobic fear were assigned randomly to two sessions of either in vivo exposure plus relaxation or in vivo exposure plus disconfirmation of misappraisals of bodily sensations. Behavioral, subjective and physiological assessments were conducted pre and post treatment, and 4 weeks later. As hypothesized, disconfirmation of misappraisals of bodily sensations benefited claustrophobic fear reduction, but had little effect on fears of snakes or spiders. However, differential treatment effects failed to generalize to nontargetted phobic situations, or generalize over time. In addition, the two treatments affected basic beliefs about arousal sensations equally.",Craske MG.; Mohlman J.; Yi J.; Glover D.; Valeri S.,1995.0,,0,0,
10295,"Covariation bias in phobic women: the relationship between a priori expectancy, on-line expectancy, autonomic responding, and a posteriori contingency judgment.","Thirty-eight people with spider phobias (19 untreated and 19 treated) were exposed to a series of 72 slides of pictures of spiders, weapons, and flowers that were randomly paired with either a shock, a siren, or nothing. A posteriori, untreated participants reported an illusory correlation (IC) between spiders and shock. Although the IC was not significantly smaller in treated as compared to untreated participants, no significant IC could be shown in treated participants. For untreated people enhanced shock expectancies were already present on the first spider trials. The IC was paralleled by heightened skin conductance responses (UCRs) on shocks that were preceded by spider slides compared to shocks preceded by other slides. There were positive correlations between IC, on-line expectancies, and UCRs.",de Jong PJ.; Merckelbach H.; Arntz A.,1995.0,,0,0,
10296,Encouraging discussion of psychosocial issues at student health visits.,"In a pilot study, the authors distributed a brief questionnaire dealing with psychosocial concerns to 200 students awaiting treatment in the student health service at a large urban university. They hypothesized that a questionnaire administered immediately before students visited the physician or family nurse practitioner would encourage the students to discuss problems such as anxiety and depression during the medical session. Using the questionnaire, they found, led to the practitioner's discovery of a condition requiring treatment or explaining a problem the student had not discussed in previous visits. Such a questionnaire, the authors suggest, could be a valuable means for identifying psychosocial concerns significant enough to require treatment or further evaluation.",Cowan PF.; Morewitz SJ.,1995.0,10.1080/07448481.1995.9940476,0,0,
10297,Effects of relaxation training on fear and arousal during in vivo exposure to a caged snake among DSM-III-R simple (snake) phobics.,"Eight pairs of DSM-III-R snake phobic subjects (Ss) were exposed to a caged snake while seated in front of a package-conveyor apparatus during eight 4-minute trials. Heart rates and skin-conductance levels were recorded before and during each of the eight trials. Self-reports of fear were obtained after each trial. One S in each pair controlled the conveyor on alternating trials. One subject (S) in each pair had received a representative regimen of relaxation training beforehand. Heart-rate decreased more in Ss controlling the conveyor than in their yoked partners. Ss who had received relaxation training showed lower heart-rate change, lower skin-conductance change, and lower self-reports of fear after the exposure trials. Relaxed Ss also moved the snake closer to themselves than did unrelaxed subjects on some trials.",McGlynn FD.; Moore PM.; Rose MP.; Lazarte A.,1995.0,,0,0,
10298,Self selection and sample selection in a treatment study of social phobia.,"The external validity or generalizability of a treatment outcome study may be influenced by the choices patients make (self-selection) and by study requirements intended to increase internal validity or protect subject welfare (e.g. sample selection). Although these effects are well-known, they have rarely been studied, and little is known about the impact they may have on generalizability of findings. In this study, subjects accepting random assignment to a larger study examining pharmacologic and cognitive-behavioral treatments for social phobia were compared with subjects refusing random assignment (i.e. self-selected) and excluded subjects (i.e. ""sample-selected""). ""Acceptors"" differed from ""refusers"" on some measures suggesting that they have a lower annual income and may have fewer social supports. Therefore, they may have fewer available resources and might be more willing to accept help wherever it is offered. Despite these differences, acceptors differed from refusers on just one pretreatment measure of clinical functioning. Excluded subjects did not differ from refusers or acceptors on demographic or pretreatment clinical measures. Refusers and excluded subjects were treated with the same cognitive-behavioral treatment used in the comparative outcome study, and their posttreatment data were compared with the subgroup of acceptors who were randomly assigned to that treatment. Again, there were few significant differences. These results suggest that while self-selection and sample selection may have influenced some characteristics of the sample in this comparative outcome study, the three groups of subjects were clinically similar and responded similarly to cognitive-behavioral treatment of social phobia.",Juster HR.; Heimberg RG.; Engelberg B.,1995.0,,0,0,
10299,Life events and panic disorder/agoraphobia.,"A patient-rated checklist adapted from the Psychiatric Epidemiology Research Interview was used to assess frequency and desirability of life events in the 12 months preceding an index evaluation of a large sample of patients with a DSM-III diagnosis of panic disorder or agoraphobia with panic, on average 12 years after onset of illness. A total of 1,360 events were reported; 25% were considered most undesirable, whereas 22% were estimated to be most desirable. Negative life events were predominantly health-related issues and interpersonal conflicts. Making new friends, having significant success at work, and taking up a new activity were examples of positive events. Correlations of life events with clinical and demographic variables and with symptom rating scales were also analyzed. Negative life events were associated with greater psychopathology and neuroticism scores. Positive life events were associated with greater extraversion scores, more years of education, better employment status, and less functional impairment due to symptoms. This exploratory study does not allow interpretation from an etiologic perspective. It begins to shed light on the possible role of life events in the course of the disorder.",Lteif GN.; Mavissakalian MR.,,,0,0,
10300,Persistence of chronic mood disorders: a 2 year follow-up.,"Chronic mood disorder patients who remain frequent and long-term users of psychiatric facilities constitute a major clinical concern today. A 2 year naturalistic prospective follow-up study was conducted on a cohort (n = 40) randomly extracted out of 335 such patients. Longitudinal data involving semi-structured interviews, observer-rated scales and self-report measures were available for 37 patients (93%). While three (8%) remitted completely, the cohort on the average showed no statistically significant change in the severity of depression, social adjustment or global functions during the 2 years under observation. Two baseline features that characterized ameliorated patients were the absence of panic disorder and lower level of education.",Furukawa T.; Awaji R.; Nakazato H.; Sumita Y.,1995.0,,0,0,
10301,Osteoporotic vertebral collapse with late neurological complications.,"This paper describes 27 patients who had a spinal fracture and underwent an anterior or a posterior spinal decompression, with or without spinal instrumentation, for late neurological compromise secondary to post-traumatic vertebral collapse associated with osteoporosis. Five males and 22 females were studied, with an average follow-up of 3.7 years. The patients developed delayed neurological compromise due to osteoporotic vertebral collapse 1 month to 1.5 years following insignificant spinal fractures. Abnormal hypermobility at the collapsed spinal level with gradual retropulsion of fracture fragments into the spinal canal appeared to contribute to late paralysis. This pathology is treated surgically either anteriorly or posteriorly, but we recommend transpedicular posterolateral decompression and stabilization with a screw-rod construct because of technical ease and minimum invasion.",Baba H.; Maezawa Y.; Kamitani K.; Furusawa N.; Imura S.; Tomita K.,1995.0,10.1038/sc.1995.64,0,0,
10302,Posttraumatic nonunion of the distal tibial metaphysis. Treatment using the Ilizarov circular external fixator.,"Ten nonunions of the distal tibial metaphysis were treated by using the Ilizarov circular external fixator. Original fractures were classified in terms of the Association for the Study of Internal Fixation as AO type A (4 cases), type B (5 cases), and type C (1 case). Six patients had a history of osteomyelitis. Bifocal compression-distraction lengthening osteosynthesis was performed in all cases. Proximal metaphyseal corticotomy was combined with resection and compression of the distal nonunion site in five cases, and compression alone in three patients. Ankle arthrodesis, in addition to nonunion resection, was performed in two patients. Follow-up averaged 48 months (range, 26 to 81). Eight nonunions healed (80%). Limb length was completely corrected in five cases; angular and rotational alignment was corrected to within 5 degrees in seven patients (70%). Based on an objective and subjective scale, the results were considered good-to-excellent in seven cases and poor in three. Despite the high complication rate and relatively low success rate (70%), the use of the circular frame with small-diameter, tensioned wires may provide an alternative method for the treatment of the very difficult problems associated with complex low distal tibial metaphyseal nonunions.",Lonner JH.; Koval KJ.; Golyakhovsky V.; Frankel VH.,1995.0,,0,0,
10303,"Treatment of panic disorder with agoraphobia: comparison of fluvoxamine, placebo, and psychological panic management combined with exposure and of exposure in vivo alone.","The purpose of this comparative outcome study was to investigate whether the effects of exposure in vivo treatment for panic disorder with agoraphobia could be enhanced by adding interventions specifically for panic attacks before the start of exposure treatment. The additional effect of two types of treatment for panic attacks--pharmacological (fluvoxamine) and psychological (repeated hyperventilation provocations and respiratory training)--was examined. Thus, the combined treatment of panic interventions with exposure in vivo could be compared to exposure in vivo alone. Ninety-six patients were randomly assigned to four treatment conditions: double-blind, placebo-controlled fluvoxamine followed by exposure in vivo, psychological panic management followed by exposure, and exposure in vivo alone. Outcome was assessed by self-report measures, a standardized multitask behavioral avoidance test, and continuous monitoring of panic attacks. Seventy-six patients completed the study. All four treatments were effective and resulted in a significant decrease of agoraphobic avoidance. Moreover, the combination of fluvoxamine and exposure in vivo demonstrated efficacy superior to that of the other treatments and had twice as large an effect size (difference between pre- and posttreatment scores) on self-reported agoraphobic avoidance. The other treatments did not differ among each other in effectiveness. Results of the study indicate that the short-term outcome of exposure in vivo treatment can be enhanced by adding fluvoxamine treatment. Psychological panic management combined with exposure was not superior to exposure alone of equal duration.",de Beurs E.; van Balkom AJ.; Lange A.; Koele P.; van Dyck R.,1995.0,10.1176/ajp.152.5.683,0,0,
10304,A comparison of cognitive and guided mastery therapy of agoraphobia.,"The aim of this study was to compare the efficacy of cognitive and performance-based therapy of agoraphobia. Fifty-two patients suffering from panic disorder with moderate or severe agoraphobia and considering agoraphobia as their main problem were randomly assigned to receive either cognitive therapy or guided mastery therapy in a six-week inpatient group program. Significantly more of the cognitive therapy patients attained high endstate functioning, whereas the proportion of responders in the two groups did not differ. An overall test revealed no differences between the two treatment groups on the continuous outcome measures at posttreatment. As predicted from the cognitive model of panic with agoraphobia, self-efficacy scores increased with the reduction of catastrophic belief scores in the cognitive therapy group. Inconsistent with the self-efficacy model, catastrophic belief scores did not change with the increase of self-efficacy scores in the guided mastery group. Overall, the superiority of one of the treatment methods over the other was not clearly demonstrated.",Hoffart A.,1995.0,,0,0,
10305,[Relaxation therapy in patients with anxiety and somatoform disorders in primary care].,"To study the effect of relaxation therapy on the symptomology of patients with anxiety and somatoform disorders. An experimental prospective study, controlled through random assignation, using evaluation scales. Mn. Jaume Soler Health Centre, Cornellà (Barcelona). 31 patients (8 men and 23 women), diagnosed with anxiety or previously untreated somatoform disorders, for whom combined anti-depressive and relaxation therapy over a 5-month period was established. The results were compared with those of a control group (n = 17) with identical diagnoses, which only received antidepressive medication. The STAI tests and two pain scales were administered at 0, 15, 30, 45, 60 and 150 days and the HRS and SCL-90-R at 0 and 150 days. The possible impact of the psychiatric diagnosis, age, gender, married status, existence of concomitant physical illness, SRE, present employment status and the presence of children or not were all considered. The results pointed to a significant improvement over the period in the analogue-visual scale of pain (p = .009) and in the HRS (p = .046) for the group comprised of those complying with the relaxation therapy independently of the psychiatric diagnosis. The benefit of relaxation in anxious and somatoform patients, when pain--and not anxiety--is the principal symptom, was confirmed. Depression improved when antidepressants were administered simultaneously, whereas anxiety varied little, at least during the time the trial lasted.",Bernal i Cercós A.; Fusté i Vallverdú R.; Urbieta Solana R.; Montesinos Molina I.,1995.0,,0,0,6082
10306,Panic disorder with or without concomitant depression 5 years after treatment: a prospective follow-up.,"50 patients with panic disorder (30 without and 20 with concomitant depression) were enrolled in a controlled treatment study using either imipramine or doxepin in addition to supportive psychotherapy and were then studied under naturalistic treatment conditions over a 5-year period. While patients with concomitant depression scored higher in overall measures of illness severity (as measured by HAMA, HAMD and GAS), no differences were detected between the groups with regard to panic disorder symptoms and degree of impairment. Our data suggest that comorbidity of panic disorder and depression is no prerequisite for poorer long-term outcome compared with panic disorder without depression.",Albus M.; Scheibe G.; Scherer J.,1995.0,,0,0,
10307,Brief cognitive-behavioral versus nondirective therapy for panic disorder.,"Thirty panic disorder patients were assigned randomly to four weekly sessions of either cognitive-behavioral therapy or nondirective, supportive therapy. Dependent variables included clinician ratings, standardized self-report questionnaires, and self-monitoring. Cognitive-behavioral therapy led to significant reductions in worry about the recurrence of panic, and in overall ratings of phobic distress. Nondirective supportive therapy did not produce significant effects. In addition, proportionately more patients who were actively panicking at preassessment and underwent cognitive-behavioral treatment were free of panic after treatment. More than one third (38%) of patients who received cognitive-behavioral treatment were sufficiently improved that they withdrew from the pharmacological trial and/or did not meet criteria for panic disorder by the end of the four weeks.",Craske MG.; Maidenberg E.; Bystritsky A.,1995.0,,0,0,
10308,Social phobia and social appraisal in successful and unsuccessful social interactions.,"32 generalized social phobic outpatients and 32 matched nonclinical control subjects participated in a dyadic 'getting acquainted' interaction with an experimental assistant who engaged in either positive or negative social behavior. The accuracy of social phobics' and control subjects' perceptions of themselves and their partners were compared in the two conditions. Relative to observers' ratings, the social phobics displayed a negative bias in their appraisals of some, but not all, aspects of their social performance. These results suggested that social phobics may have particular difficulty gauging the nonverbal aspects of their social behavior. The phobics discounted their social competence to the same extent in the positive interaction, where their behavior was more skillful, as in the negative interaction. The social phobics were also less accurate than nonclinical controls in their appraisals of their partners, however, these phobic subjects displayed a positive bias when appraising their partner's performance.",Alden LE.; Wallace ST.,1995.0,,0,0,
10309,[Ultrasound criteria of fresh rupture of the anterior cruciate ligament].,"In a prospective, controlled, monocentric clinical study 193 recently traumatized knee joints, suspicious of a ruptured anterior cruciate ligament, were examined sonographically. Three indirect signs of rupture were analyzed and compared to the results of the clinical tests of stability (Lachmann). Arthroscopy and arthrotomy were regarded as approved methods of reference. The sonographic pattern of an echo-free mass in the area of the femoral insertion of the anterior cruciate ligament proved to be more informative (sensitivity 0.91, specificity 0.78, effectivity 0.84) than the clinical signs of instability. A standardized sonographic examination of the knee joint should be a constant component of the posttraumatic examination. It is an inexpensive method, easy to learn and to perform, and is more reliable in the diagnosis of the ruptured anterior cruciate ligament than the clinical evaluation of instability.",Chylarecki C.; Hierholzer G.; Tabertshofer H.,1995.0,,0,0,
10310,Does imagined exposure to the consequences of not ritualising enhance live exposure for OCD? A controlled study. I. Main outcome.,"This randomised controlled study tested whether adding imagined to live exposure plus ritual prevention would enhance gains in obsessive-compulsive disorder (OCD). Out-patients with OCD were randomly allocated to either have nine sessions of daily live self-exposure and ritual prevention to external cues alone (Ex) (n = 23) or to have, in addition to Ex, daily self-exposure to the imagined internal cues of the consequences of not ritualising (group Exi) (n = 23). All patients had the same sessional exposure time of 1 h 30 min (Exi 1 h live, 30 min imagined; Ex 1 h 30 min live), and had to practise either Exi or Ex daily for the same duration and to keep diaries of that self-exposure homework throughout treatment. Patients were followed up to week 32. Outcome measures were YBOCS for rituals and obsessions, compulsion checklist, target rituals and obsession, general anxiety, depression (Beck, Hamilton), work and social disability, clinical global impression (CGI). At weeks 4, 9, 20 and 32 the two groups improved similarly with no significant difference between them, neither for washers nor for checkers. Imagined exposure was more difficult to do than live exposure and there were more drop-outs. Daily imaged exposure to internal cues did not enhance exposure to external cues. Perhaps longer imagined exposure would have been more enhancing.",de Araujo LA.; Ito LM.; Marks IM.; Deale A.,1995.0,,0,0,
10311,Does imagined exposure to the consequences of not ritualising enhance live exposure for OCD? A controlled study. II. Effect on behavioural v. subjective concordance of improvement.,"This study tested whether adding imagined exposure to live exposure would increase the concordance between behavioural and subjective improvement in obsessive-compulsive disorder (OCD). 46 OCD out-patients were randomly allocated to 9 weekly sessions of either combined live+imagined exposure/ritual prevention (Exi, n = 23), or only live exposure/ritual prevention (Ex, n = 23). Patients were asked to do 90 min of daily self-exposure at home (corresponding to Exi or Ex). Measures were: (A) behavioural; (B) subjective; (C) clinical global impression (CGI). After 9 weeks of treatment, improvement was greater on behavioural than subjective measures (similar for the Exi and Ex groups). At 20 weeks (3-month follow-up) each group had improved slightly more on subjective measures and slightly less on behavioural ones. Two subjective measures improved less during Exi than Ex, but this difference disappeared at follow-up. The greater difference between behavioural and subjective improvement scores in Exi than in Ex did not relate to clinical outcome at the end of treatment or follow-up. Compared to live exposure alone, combined imagined plus live exposure did not enhance behavioural/subjective concordance.",Ito LM.; Marks IM.; de Araujo LA.; Hemsley D.,1995.0,,0,0,
10312,Mismatch negativity to auditory stimulus change recorded directly from the human temporal cortex.,"Mismatch negativity (MMN) is an event-related potential (ERP) component elicited by any discernible change in a repetitive sound even in the absence of attention. Previous studies have established that MMN is generated by change detection in a process comparing the deviant sensory input with the neural memory trace encoding the physical features of the repetitive sound. In the present study, we recorded MMNs to tonal frequency changes directly from the human temporal cortex of patients with electrodes implanted in the brain for diagnosis and therapy. The intracranially recorded MMN was found to be attention independent and modality specific. It was confined to a rather small area in temporal cortex, which was different from the structures where attention-dependent N2 and P3 responses to the frequency change could be recorded.",Kropotov JD.; Näätnen R.; Sevostianov AV.; Alho K.; Reinikainen K.; Kropotova OV.,1995.0,,0,0,
10313,Perceived responsibility and compulsive checking: an experimental analysis.,"An experiment was carried out on 30 Ss who qualified for the DSM-IIIR diagnosis of OCD in order to test the hypothesis, derived from cognitive theory, that changes in perceived responsibility are followed by corresponding changes in the urge to check compulsively. The manipulation succeeded in increasing/decreasing perceived responsibility, as required for the experiment. Decreased responsibility was followed by significant declines in discomfort and in the urge to carry out the compulsive checking. Increased responsibility was followed by corresponding increases in discomfort and urges, but these failed to reach a statistically significant level. Additionally, two types of OCD-related cognitive biases were encountered.",Lopatka C.; Rachman S.,1995.0,,0,0,
10314,Analysis of the terms used by general practitioners to characterize patients considered by them as depressed. A prospective study on 682 patients.,"The aim of the study was to investigate the terms used by general practitioners (GPs) to describe the patients considered by them to be depressed. 682 patients were diagnosed as depressed by 79 GPs selected at random in four regions of France. The frequency of the diagnosis of depression made by GPs in the total patient population was 3.6-5%. The GPs were asked to describe the main symptoms of these patients on a plain chart. The percentage of use of each term was calculated in each region. In all the regions, the most frequent symptoms were insomnia (31.8%), fatigue (29.9%) and anxiety (24.6%). The results suggest that the three main terms used by GPs to describe depression differ from those used by psychiatrists.",Cremniter D.; Guelfi JD.; Fourestié V.; Fermanian J.,1995.0,,0,0,
10315,Fear-potentiated startle in posttraumatic stress disorder.,"Exaggerated startle is reputed to be one of the cardinal symptoms of posttraumatic stress disorder (PTSD); however, objective studies have given conflicting results as to whether or not startle is increased in PTSD. The present study investigated startle in PTSD during the threat of shock (fear-potentiated startle). The eyeblink component of the startle reflex was measured at various times preceding and following the anticipation of unpleasant electric shocks in 9 PTSD subjects and 10 age-matched, healthy controls. Startle amplitude was significantly greater during baseline and during shock anticipation in the PTSD subjects, compared to the controls. Habituation of the startle reflex was normal. Because other studies in the literature, as well as in our own laboratory, have failed to find exaggerated startle at baseline (i.e., absence of stress) in PTSD patients, it is unlikely that the present results reflect a chronic elevation of startle in this group. Instead, the higher levels of startle in the PTSD group probably resulted from a greater conditioned emotional response in this group, triggered by anticipation of electric shocks that generalized to the unfamiliar experimental context in which testing occurred. Hence, emotionally charged test procedures may be especially informative in distinguishing PTSD patients from other psychiatric diagnostic groups.",Morgan CA.; Grillon C.; Southwick SM.; Davis M.; Charney DS.,1995.0,10.1016/0006-3223(94)00321-S,0,0,
10316,Effects of a model on food neophobia in humans.,"In study 1, subjects who were high and low in trait food neophobia made a series of choices between novel or familiar foods in the presence of no model, a neophilic model who chose mostly novel foods, or a neophobic model who chose mostly familiar foods and made another series of choices in private from foods which were not modeled. Subjects who were low (but not high) in trait neophobia behaved in accordance with the behavior of the neophilic (but not neophobic) model in the model's presence (but not absence). Study 2 clarified the results of study 1, revealing that the phenomenon was modeling and not conformity, that even highly neophobic subjects can be influenced by a stronger modeling manipulation, that food neophobia can be both increased and decreased, and that the reduced neophobia induced by exposure to a neophilic model does not generalize to non-modeled foods.",Hobden K.; Pliner P.,1995.0,10.1006/appe.1995.0046,0,0,
10317,Experimental manipulations of responsibility: an analogue test for models of obsessive-compulsive disorder.,"Several authors attribute excessive responsibility a predominant role in Obsessive-Compulsive Disorder (OCD) [Salkovskis, P. M. (1985) Behaviour Research and Therapy, 23, 571-583; Rachman, S. (1993) Behaviour Research and Therapy, 31, 149-154; van Oppen, P. & Arntz, A. (1994) Behaviour Research and Therapy, 32, 79-87]. The present studies aimed at demonstrating the link between different levels of perceived responsibility and checking behaviors by experimentally manipulating responsibility in non-clinical Ss. In the first study, a sound recognition task was used to compare checking behaviors in Ss with high (HR) and low (LR) perceived responsibility. Only one variable was significantly different, Ss from the HR group reporting more anxiety during the task than Ss from the LR group. Results did not support a link between responsibility and checking behavior. In a second study HR and LR Ss were compared on a manual classification task. Subjects from the HR group hesitated and checked more, and reported more preoccupation with errors and anxiety during the task than Ss from the LR group. Since perceived severity of the outcome was the most variable affected by the manipulation, the implications for current models of OCD are discussed and an alternative explanation is attempted. Finally, clinical implications are examined and suggestions are made for future directions of research.",Ladouceur R.; Rhéaume J.; Freeston MH.; Aublet F.; Jean K.; Lachance S.; Langlois F.; de Pokomandy-Morin K.,1995.0,,0,0,
10318,Expectations about arousal and nocturnal panic.,"Expectations about arousal were examined in relation to nocturnal panic (NP). Eighteen panic disorder patients suffering from NP attacks and 18 control individuals were assigned randomly to conditions in which they were informed that audio feedback signals reflected heightened arousal that was either (a) expected and harmless or (b) unexpected. Participants relaxed and slept for 45 to 60 min, followed by presentation of periodic audio feedback signals. Physiological recording was continuous while subjective measures were collected at completion of the signals phase. NP patients in the unexpected--no reassurance condition were significantly more anxious and symptomatic than their counterparts in the expected reassurance condition, whereas control individuals did not differ across the 2 conditions. Physiological and behavioral data were less consistent than subjective measures. The results are interpreted as supportive of a cognitive-behavioral model of NP.",Craske MG.; Freed S.,1995.0,,0,0,
10319,A controlled study of cognitive behaviour therapy with buspirone or placebo in panic disorder with agoraphobia.,"This multicentre study compared a 16-week buspirone treatment with placebo in patients presenting with panic disorder with agoraphobia and also receiving cognitive behaviour therapy (CBT). Double-blind testing was maintained until week 68, but not tested; 91 patients were included; 14 placebo-responders excluded; 77 patients randomised; 48 reached week 16 and 41 reached week 68. At week 16, within-group analysis showed significant improvements in agoraphobia, panic attacks, and depression in both groups. Generalised anxiety improved only in CBT+buspirone. Between-group comparisons showed buspirone to have an effect on generalised anxiety and agoraphobia. Changes in degree of agoraphobia and depression were correlated in subjects on CBT+buspirone only. A significantly higher proportion of women, and of subjects showing high avoidance dropped out. Positive expectations regarding medication predicted success in both groups. At week 68, improvement was retained without significant buspirone effect. Buspirone enhanced the effects of cognitive behaviour therapy on generalised anxiety and agoraphobia in the short term.",Cottraux J.; Note ID.; Cungi C.; Légeron P.; Heim F.; Chneiweiss L.; Bernard G.; Bouvard M.,1995.0,,0,0,
10320,The effects of description clarity and disorder type on MMPI-2 FAKE-BAD validity indices.,"Simulation research indicates that the MMPI-2 validity scales easily detect faked-bad profiles that follow vague, but not specific, instructions. The present study compared the fake-bad validity scales (i.e., F, F-Back, F-K, Fake-Bad Scale, critical items, and O-S scales) for differences among one authentic and four simulation (fake-bad) groups. The simulation groups differed according to the type of disorder simulated (neurotic or psychotic) and the clarity of the behavioral descriptions they received (clear or unclear descriptions). Results indicated that the validity scales together could discriminate (a) clear from unclear description profiles; (b) neurotic from psychotic simulation profiles; and (c) authentic from simulated profiles. Actuarial analyses indicated that participants given clear character descriptions were more likely to escape detection than were participants given unclear character descriptions. Future research on incentive and punishment is considered.",Cramer KM.,1995.0,,0,0,
10321,Evaluation of a brief cognitive-behavioral program for the prevention of chronic PTSD in recent assault victims.,"The efficacy of a brief prevention program (BP) aimed at arresting the development of chronic PTSD was examined with 10 recent female victims of sexual and nonsexual assault who received 4 sessions of a cognitive-behavioral program shortly after the assault. Their PTSD and depression severity was compared with that of 10 matched recent female assault victims who received repeated assessments of their trauma-related psychopathology (assessment control; AC). The BP program consisted of education about common reactions to assault and cognitive-behavioral procedures. Two months postassault, victims who received the BP program had significantly less severe PTSD symptoms than victims in the control condition; 10% of the former group met criteria for PTSD versus 70% of the latter group. Five and a half months postassault, victims in the BP group were significantly less depressed than victims in the AC group and had significantly less severe reexperiencing symptoms.",Foa EB.; Hearst-Ikeda D.; Perry KJ.,1995.0,,0,0,
10322,Impact of Cluster C personality disorders on outcomes of contrasting brief psychotherapies for depression.,"Twenty-seven of 114 depressed clients, stratified for severity of depression, obtained a Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; DSM-III; American Psychiatric Association, 1980) diagnosis of Cluster C personality disorder--that is, avoidant, obsessive-compulsive or dependent personality disorder (PD clients)--whereas the remaining 87 did not (non-personality-disorder [NPD] clients). All clients completed either 8 or 16 sessions of cognitive-behavioral (CB) or psychodynamic-interpersonal (PI) psychotherapy. On most measures, PD clients began with more severe symptomatology than NPD clients. Among those who received PI therapy, PD clients maintained this difference posttreatment and at 1-year follow-up. Among those who received CB therapy, posttreatment differences between PD and NPD groups were not significant. Treatment length did not influence outcome for PD clients. PD clients whose depression was also relatively severe showed significantly less improvement after treatment than either PD clients with less severe depression or NPD clients.",Hardy GE.; Barkham M.; Shapiro DA.; Stiles WB.; Rees A.; Reynolds S.,1995.0,,0,0,
10323,Cognitive mediators of situational fear in agoraphobia.,"The aim of this study was to examine cognitive mediators of situational fear in agoraphobia. Patients suffering from panic disorder with moderate or severe agoraphobia were randomly assigned to receive either cognitive therapy or guided mastery therapy in a 6-week inpatient group program. The results were consistent with a self-efficacy model of agoraphobia. Across test occasions, and when the other cognitive variables were controlled for, self-efficacy made a significant contribution to the prediction of situational fear or changes in situational fear in 5 out of 5 cases. Catastrophic beliefs were related to situational fear in 1 of the 5 cases.",Hoffart A.,1995.0,,0,0,
10324,Psychophysiological therapy vs. hypnotherapy in the treatment of patients with dental phobia.,"The aim of this study was to compare two different modes of behaviorally-oriented therapies for dental fear. The subjects were chosen consecutively from the waiting-list of a Dental Fears Research and Treatment Clinic. In addition, a control group was selected from patients treated under general anesthesia to compare levels of dental and general fear with the experimental groups. Twenty-two women, with a mean age of 31.8 yr, were included and randomly assigned to two groups. The median time of avoidance of dental care was 9.5 yr. One group received hypnotherapy (HT) and one group a behavioral treatment based on psychophysiological principles (PP). Both therapies included eight sessions followed by standardized conventional dental test treatments. Pre- and posttreatment measures were dental fear, general fear, mood, and patient behavior. Nine patients were not able to conclude the treatment sessions (6 HT and 3 PP); these patients did not differ significantly from the remaining patients before treatment. The PP group reported a statistically significant decrease in dental fear as well as a rise in mood during dental situations, as opposed to the HT group. General fear levels decreased but not significantly. Eleven patients completed conventional dental treatment according to a dentist's behavioral rating scale, indicating that they were relaxed, and no problems occurred during the treatments. These patients were referred to general practitioners within the community dental service. In conclusion, this small size study showed that a majority of the patients, who accomplished the behavioral therapy and the dental test treatments, became less fearful of dental care and were able to manage conventional dental care, including changing dentist.",Hammarstrand G.; Berggren U.; Hakeberg M.,1995.0,,0,0,
10325,Eye movement and electrodermal responses to threat stimuli in post-traumatic stress disorder.,"A core feature of post-traumatic stress disorder (PTSD) is hypervigilence to threatening material. This study measured processing of threat material in PTSD with simultaneously acquired initial eye movements and electrodermal activity, following presentation of threatening and neutral words. Ten PTSD subjects and 10 controls were presented with 4 words in parafoveal range. On trials in which a threat word was present, PTSD subjects demonstrated initial eye fixations on the threat word more than controls. PTSD subjects also demonstrated more orienting responses on all trials than controls. These results suggest that processing of threat information in PTSD can be usefully investigated with convergent psychophysiological methodologies.",Bryant RA.; Harvey AG.; Gordon E.; Barry RJ.,1995.0,,0,0,
10326,Gender and age differences in the prevalence of specific fears and phobias.,"Point prevalence of specific fears and phobias was determined in 704 respondents of 1000 randomly selected adults aged 18-70 yr. A phobia for lightning, enclosed spaces, darkness, flying, heights, spiders, snakes, injections, dentists and/or injuries was defined if subjects reported a fear that was out of conscious control, interfered with life and lead to the avoidance of the feared object [American Psychiatric Association, 1994. Diagnostic and statistical manual of mental disorders (4th edn). Washington, DC: American Psychiatric Press.] Fear intensity was assessed using visual analogue scales. A factor analysis generally supported the classification of fears and phobias into: (1) situational phobias (lightning, enclosed spaces, darkness, flying and heights); (2) animal phobias (spiders and snakes); and (3) mutilation phobias (injections, dentists, injuries). Total point prevalence of any specific phobia was 19.9% (26.5% for females and 12.4% for males). In total, 21.2% women and 10.9% men met criterias for any single specific phobia. Multiple phobias was reported by 5.4% of the females and 1.5% of the males. Animal phobia had a prevalence of 12.1% in women and 3.3% in men. Point prevalence of situational phobia was 17.4% in women and 8.5% in men. For mutilation phobia no gender difference was observed, being presented in 3.2% of the women and 2.7% of the men. Women as compared to men gave higher fear ratings for all objects and situations. Inanimate object fears and phobias were more common in older than younger individuals. Animal fears were more intense in younger than in older individuals. Fear of flying increased and fear of injections decreased as a function of age in women but not in men. Thus, specific fears and phobias are heterogeneous with respect to sex and age distribution.",Fredrikson M.; Annas P.; Fischer H.; Wik G.,1996.0,,0,0,
10327,[Psychological characteristics of patients with infarction: results of the GISSI-2. Italian Group for the Study of Survival in Myocardial Infarction (GISSI)].,"To provide a thorough psychological examination of patients with documented myocardial infarction (MI) enrolled in a multicenter randomized clinical trial (GISSI-2). The psychosocial variables examined include: state variables (anxiety, health-related fears, depression), psychophysical well-being in the three months preceding the acute event (depressive mood, impaired sense of well-being, perceived stress) and trait variables (Type-A Behavior (TAB), neuroticism, introversion/extroversion, social anxiety and feelings of guilt in interpersonal relationships). A total of 2705 patients (12.5% females) admitted to 166 Italian Coronary Care Units. Patients were administered the CBA-H, a standardized questionnaire with dichotomous responses (true/false), for a total of 152-item grouped into 16 scales. For each scale, the frequency of scores above cut-off values was computed and compared to patients' clinical and sociodemographic profile. Over one third of all patients scored above the clinical cut-off for anxiety and health-related fears, and 15% showed a depressive pattern. Forty percent of patients reported depressive mood and a diminished sense of well-being in the past three months preceding MI, and more than half perceived themselves as stressed. About one third of the sample overtly exhibited TAB traits and half reported neuroticism scores in the clinical range. One half of our sample could be identified as extrovert, and 14% as introverted. Feelings of guilt and social anxiety were registered respectively in 40% and 12% of the sample. A worse psychological profile was associated to female gender, older age, lower education, living alone and a worse cardiac asset. The study has documented the association between clinical, sociodemographic and psychological variables in a large sample of patients with IMA. While the impact of psychological variables upon patients' clinical outcome is to be evaluated, these data may be helpful in promoting the comprehensive and effective care of IMA patients.",Labbrozzi D.; Carinci F.; Nicolucci A.; Bettinardi O.; Zotti AM.; Tognoni G.,1996.0,,0,0,7112
10328,Personality disorder in obsessive compulsive disorder: a controlled study.,"In order to assess Axis II pathology in Obsessive Compulsive Disorder patients as compared to other anxiety disorder patients, the Personality Disorder Examination was administered to 258 anxiety disorder patients. In contrast to a number of recent reports, a low rate of personality disorder diagnoses were found in the OCD sample as well as the anxiety disorder control subjects. The findings of the current investigation are discussed in terms of state-trait confounding.",Crino RD.; Andrews G.,,,0,0,
10329,Knee joint proprioception in patients with posttraumatic recurrent patella dislocation.,"In 30 healthy volunteers with clinically inconspicuous knee joints and nine patients with posttraumatic recurrent patella dislocation, the proprioceptive abilities of the knee joint were evaluated by an angle reproduction test. The results of the control group showed no gender- or dominant-specific difference. The patient group showed a significant deterioration of proprioceptive capability in the injured knee joint. Even in the contralateral, uninjured knee joint, the angle reproduction test result was significantly reduced compared with the control group. After applying an elastic knee bandage, the control group and the patients with patella dislocation showed a significant improvement of the proprioceptive capability.",Jerosch J.; Prymka M.,1996.0,,0,0,
10330,Does exposure to internal cues enhance exposure to external cues in agoraphobia with panic? A pilot controlled study of self-exposure.,"The value of internal (interoceptive) cues for exposure is under debate and so was tested in a pilot controlled study. Outpatients with panic disorder and severe agoraphobia were randomised to 10 weeks of self-exposure to either (1) both internal (interoceptive) and external cues (n = 12) or (2) external cues only (n = 14). Both groups were trained in slow deep breathing and asked to carry out daily self-exposure homework. Neither group had cognitive restructuring. By post-treatment and follow-up all outcome measures improved significantly in both treatment groups. The two groups did not differ significantly in outcome, though slightly more patients who had exposure to both internal and external cues improved 50% or more on phobic avoidance and fear. A larger controlled study is now worthwhile to tell if such small differences can be significant.",Ito LM.; Noshirvani H.; Başoğlu M.; Marks IM.,1996.0,,0,0,
10331,Course of panic disorder during pregnancy and the puerperium: a preliminary study.,"Pregnancy has been referred to as a time of well-being for patients with psychiatric disorder. However, this impression is derived primarily from anecdotal reports and retrospective studies, rather than systematic prospective evaluation. In this study, 10 pregnant women with previous histories of panic disorder were evaluated prospectively across pregnancy and the postpartum period using the Structured Clinical Interview for DSM-III-R and the Clinical Global Impression. Information regarding pharmacotherapy received was also recorded. Seven of 10 subjects continued to meet DSM-III-R criteria for panic disorder at all trimester visits. Symptoms persisted for some patients even in the context of treatment with antipanic medications. Most subjects (n = 9) met DSM-III-R criteria at 1-3 months postpartum despite nearly uniform intensification of antipanic treatment. Although some women may experience diminished symptoms of panic during pregnancy, in this sample most continued to experience panic attacks and to require antipanic treatment to control symptoms.",Cohen LS.; Sichel DA.; Faraone SV.; Robertson LM.; Dimmock JA.; Rosenbaum JF.,1996.0,10.1016/0006-3223(95)00300-2,0,0,
10332,Comparison of obsessions and compulsions in patients with anorexia nervosa and obsessive compulsive disorder.,"Patients with anorexia nervosa (n = 18) and patients with obsessive-compulsive disorder (OCD) (n = 16) had similar scores on the Yale-Brown Obsessive Compulsive Scale (19 + or - 9 vs. 22 + or - 6). This suggests that these disorders have similar magnitude of impairment from obsessions and compulsions; however, OCD patients endorsed a wide variety of obsessions and compulsions, whereas anorexics tended to endorse symptoms that were related to symmetry and order.",Bastiani AM.; Altemus M.; Pigott TA.; Rubenstein C.; Weltzin TE.; Kaye WH.,1996.0,10.1016/0006-3223(95)00306-1,0,0,
10333,The Nottingham Study of Neurotic Disorder: influence of cognitive therapists on outcome.,"In previously published papers from the Nottingham Study of Neurotic Disorder a short treatment package of cognitive-behaviour therapy was no more effective than placebo drug treatment after 10 weeks' assessment in a cohort of 210 patients with neurotic disorders. This paper examines the outcome over two years of the patients treated by cognitive-behaviour therapy separated into two therapist groups, those who were competent in administering treatment and those of uncertain competence. The therapists (mainly community psychiatric nurses) of 70 patients with an original DSM-III diagnosis of either dysthymic, panic or generalised anxiety disorder were separated into two groups on the basis of their perceived competence by their supervisor (DK). Ratings of psychopathology were made at regular intervals over two years by assessors blind to knowledge of treatment or therapist. The patients treated by competent therapists (n = 30) generally showed greater improvement than those allocated to therapists of uncertain competence (n = 40), mainly with respect to depressive symptoms, and the difference persisted over two years, long after the cognitive-behaviour therapy had been completed. Cognitive-behaviour therapy given by competent therapists over a 10 week period is of lasting benefit in neurotic disorder.",Kingdon D.; Tyrer P.; Seivewright N.; Ferguson B.; Murphy S.,1996.0,,0,0,
10334,Life events and panic disorder/agoraphobia: a comparison at two time periods.,"Semistructured interviews of 187 patients with a DSM-III diagnosis of panic disorder or agoraphobia with panic attacks were conducted an average of 12 years after onset of the disorder. Interviews solicited life events that occurred in the year before onset and in the year preceding index evaluation. The number and type of life events were found to be similar at onset and at the later evaluation. However, the results showed that a tendency for increased reporting of life events before onset in a subgroup of patients was counterbalanced by a tendency for decreased reporting in another subgroup. Attention to individual differences rather than group means may be more important in future prospective studies.",Lteif GN.; Mavissakalian MR.,,,0,0,
10335,Respiratory psychophysiology and anxiety: cognitive intervention in the doxapram model of panic.,"The goals of this study were to: a) confirm prior evidence that the respiratory stimulant doxapram induces panic attacks and produces excessive hyperventilation in patients with panic disorder and b) explore the impact of cognitive mediators on symptom and respiratory responses. Thirty-two subjects (16 patients and 16 controls) received doxapram (0.5 mg/kg) and placebo infusions while symptom, respiratory, and heart rate responses were monitored. Subjects were randomly assigned to receive either a standard introduction or a cognitive intervention designed to reduce the panic responses of panic patients to laboratory challenges. Doxapram was a potent and specific panicogenic agent, inducing panic in 75% of patients and 12.5% of controls. Compared with controls, patients also showed a greater decrease in end tidal carbon dioxide (CO2) and greater increases in minute ventilation, respiratory frequency, and heart rate. The cognitive intervention substantially attenuated the excessive hyperventilatory response of patients but did not fully normalize their breathing patterns. Tidal volume was the only respiratory measure not significantly altered by the cognitive intervention. In patients with panic disorder, doxapram (0.5 mg/kg) triggers panic attacks about as potently as 7% CO2 and more potently than 5% CO2 or lactate. Psychological factors can modulate the appearance of ventilatory abnormalities in panic patients, but persistent respiratory disturbances were still seen. Psychological factors and respiratory physiology both appear to be important phenomena in laboratory panic.",Abelson JL.; Nesse RM.; Weg JG.; Curtis GC.,,,0,0,
10336,Obsessive compulsive disorder and depression--first results of a prospective study on 74 patients.,"1. Seventy-four patients who met DSM-III-R criteria for Obsessive Compulsive Disorder received a serotonin reuptake inhibitor and cognitive behavior therapy for 6 months (baseline to follow-up I). 2. In order to maximize therapeutic effects, different kinds of treatment were applied between follow-up I and follow-up II (12 months). 3. Patients were followed-up twice with respect to long-term outcome of obsessive compulsive disorder and depression. Forty % of the sample showed marked improvement at follow-up. No specific variant of treatment could be identified to be significantly more effective. 4. Cross-sectional investigations showed significant correlations between extent of depressive and obsessive compulsive symptomatology (admission, follow-up I and II).",Demal U.; Zitterl W.; Lenz G.; Zapotoczky HG.; Zitterl-Eglseer K.,1996.0,,0,0,
10337,Written disclosure in posttraumatic stress disorder: is it beneficial for the patient?,,Gidron Y.; Peri T.; Connolly JF.; Shalev AY.,1996.0,,0,0,
10338,"The relationship between symptoms of post-traumatic stress disorder and pain, affective disturbance and disability among patients with accident and non-accident related pain.","Recent studies have reported a high prevalence of symptoms of post-traumatic stress disorder (PTSD) among individuals with chronic pain. Studies suggest that persons with pain and PTSD also display higher levels of affective disturbance. In the present study we examined self-reports of pain, affective disturbance, and disability among pain patients with and without symptoms of PTSD. Patients without PTSD symptoms were further subdivided into persons whose pain was the result of an accident or insidious in onset. Thus, three groups were examined: (1) persons with accident related pain and high PTSD symptoms (Accident/High PTSD); (2) persons with no or few symptoms of PTSD whose pain was accident related (Accident/Low PTSD); and (3) patients whose pain was not accident related and did not have PTSD symptoms (No Accident). No Accident patients were older than persons with accident related injuries, and both accident related pain groups were more likely than No Accident patients to be involved in litigation or receiving compensation. Thus, these variables were controlled for in the statistical analyses. Self-report of pain was also included as a covariate in the analyses examining group differences in affective disturbance and disability. Accident/High PTSD patients displayed higher levels of self-reported pain compared to the other two groups. The Accident/High PTSD group also had the highest levels of affective disturbance. Both accident groups tended to report greater disability compared to patients whose pain was not accident related. These findings suggest that PTSD symptoms in chronic pain patients are associated with increased pain and affective distress. Accident related pain, even without the presence of PTSD symptoms, appears to be associated with greater disability. The results indicate that the identification and treatment of PTSD symptoms in refractory pain patients may be a critical albeit subtle factor in the effective management of suffering and disability in this population.",Geisser ME.; Roth RS.; Bachman JE.; Eckert TA.,1996.0,,0,0,
10339,The effects of behavioural relaxation on cognitive performance in adults with severe intellectual disabilities.,"Behavioural relaxation training has been found to be effective in the treatment of generalized anxiety in people with intellectual disability. The present study is designed to assess whether or not these techniques can help individuals in more generalized aspects of their life. Two groups of 10 adults with a severe intellectual disability formed a relaxation group and a control group. The relaxation group were given a course in behavioural relaxation training and the control group were given a quiet reading period for the same amount of time. Each subject was given a digit span test, a test of long-term memory and an incidental learning test after each session. Results suggest behavioural relaxation training has a beneficial effect on performance on tests of short-term memory and incidental learning, but no effect upon long-term memory.",Lindsay WR.; Morrison FM.,1996.0,,0,0,
10340,Emotional expression and physical health: revising traumatic memories or fostering self-regulation?,"Health benefits derived from personal trauma disclosure are well established. This study examined whether disclosing emotions generated by imaginative immersion in a novel traumatic event would similarly enhance health and adjustment. College women, preselected for trauma presence, were randomly assigned to write about real traumas, imaginary traumas, or trivial events. Yoked real-trauma and imaginary-trauma participants wrote about real-trauma participants' experiences. Imaginary-trauma participants were significantly less depressed than real-trauma participants at immediate posttest, but they were similarly angry, fearful, and happy. Compared with control group participants, both trauma groups made significantly fewer illness visits at 1-month follow-up; however, real-trauma participants reported more fatigue and avoidance than did the other groups. Imaginary-trauma group effects could reflect catharsis, emotional regulation, or construction of resilient possible selves.",Greenberg MA.; Wortman CB.; Stone AA.,1996.0,,0,0,
10341,Event-related potentials in post-traumatic stress disorder of combat origin.,"Visual event-related potentials (ERPs) of primary interest in this study of post-traumatic stress disorder (PTSD) were N1, N2, P2, and P3. Forty Israeli combat veterans consisting of 20 PTSD sufferers and 20 normal controls were evaluated. ERPs were recorded in response to three sets of computer-generated visual stimuli, presented in the form of a modified oddball paradigm. These stimuli included: domestic animal pictures (targets), emotionally neutral pictures of furnishings (nontargets), and combat-related pictures (nontarget probes). Subjects were required to discriminate between target and nontarget stimuli by pressing a button in response to target stimuli only. Subjects were instructed to ignore all nontarget stimuli. As expected, target stimuli evoked accentuated P3 amplitudes in both controls and PTSD patients. The nontarget combat-related pictures elicited enhanced P3 and N1 amplitudes in the PTSD patients only. N2 amplitudes were accentuated in PTSD patients for both targets and combat-related pictures. P3 latencies and reaction times to target stimuli were prolonged in PTSD patients. The same tendency was observed for N1 latencies. These results may indicate that an altered state of early and late cognitive selective attention processing exists in PTSD patients in addition to a vulnerability to traumatic reminiscences.",Attias J.; Bleich A.; Furman V.; Zinger Y.,1996.0,10.1016/0006-3223(95)00419-X,0,0,
10342,Lifetime anxiety disorders in women with bulimia nervosa.,"We examined the prevalence and ages at onset of additional childhood and adult psychiatric disorders in women with bulimia nervosa and evaluated the differential impact of a mood or anxiety disorder on the presentation of bulimia nervosa. One hundred fourteen women participating in a clinical trial of cognitive-behavioral therapy for bulimia nervosa were assessed at pretreatment with structured diagnostic methodology. Although mood disorders were the most frequently occurring additional psychiatric disorder (75%), 64% experienced an additional anxiety disorder. Age at onset of the anxiety disorders was markedly earlier than age at onset of bulimia nervosa or other comorbid conditions. Stratification of the sample on the presence of a mood or anxiety disorder revealed no differences in the core bulimic symptoms across groups. The presence of a mood disorder was associated with greater body dissatisfaction, lower Global Assessment of Functioning Scales (GAFS) score, more externalizing disorders of childhood, and, as expected, higher Hamilton Depression Rating Scale (HDRS) scores. The presence of an anxiety disorder was related to a history of anorexia nervosa and earlier age at onset of drug or alcohol dependence. Early-onset anxiety disorders are prevalent and may represent one potential pathway to bulimia nervosa.",Bulik CM.; Sullivan PF.; Carter FA.; Joyce PR.,,,0,0,
10343,"Measuring effectiveness of eye movement desensitization and reprocessing (EMDR) in non-clinical anxiety: a multi-subject, yoked-control design.","Twenty-eight subjects from a university's subject pool were paired on sex, age, severity, and type of stressful or traumatic incident. One subject in each pair was selected to receive EMDR; the experimental partner spent the same amount of time receiving a visual (non-movement) placebo. Subjective units of discomfort (SUD) scores and physiological measurements were taken prior to and following treatment. Analysis of physiological measurements and self-reported levels of stress were performed within and between each group. While the EMDR group showed significant reductions of stress, EMDR was no better than a placebo. This suggests EMDR's specific intervention involving eye movement may not be a necessary component of the treatment protocol.",Dunn TM.; Schwartz M.; Hatfield RW.; Wiegele M.,1996.0,,0,0,
10344,State of the peripheral nervous system in patients with hypothalamic insufficiency.,"An investigation was carried out by non-invasive techniques of the state of the peripheral nervous system in patients with a constitutional-acquired form of hypothalamic insufficiency. Ten healthy individuals were included in the control group. The presence of subclinical parasympathetic vegetative insufficiency was identified by cardiovascular tests. It was more marked in patients with an early onset of the neuroendocrine disturbances and longer course of the disease. In the opinion of the authors, this suggests the constitutional-acquired character of the vegetative disturbances. In addition, a slowing of the speed of conduction through the sudomotor preganglionic sympathetic fibers in the upper and lower extremities and the predominance of these disturbances in the group of patients with pronounced dysraphic status were identified. The latter suggests a defect of the laying down of these peripheral vegetative fibers. This investigation makes it possible to hypothesize that subclinical peripheral insufficiency is one of the factors governing the occurrence of both permanent (tachycardia, elevations of AP, hyperhidrosis) and paroxysmal vegetative disturbances (panic attacks, migraine) in hypothalamic insufficiency.",Filatova EG.; Solov'eva AD.; Kanavets EV.; Rogovina EG.,,,0,0,
10345,Treatment outcomes for primary care patients with major depression and lifetime anxiety disorders.,"Major depression occurs with generalized anxiety disorder and panic disorder in up to 60% of psychiatric and primary care patients. This comorbidity has been associated with greater severity of depression, poorer psychosocial functioning, and poorer treatment outcomes in psychiatric samples. This study examined the clinical outcomes for depressed primary care patients with and without a lifetime anxiety disorder. A total of 157 primary care patients who met criteria for major depression were randomly assigned to standardized interpersonal psychotherapy or pharmacotherapy with nortriptyline and were assessed at baseline and at 4 and 8 months on severity of depression, psychosocial functioning, and health-related functioning. Depressed patients with a comorbid anxiety disorder presented with significantly more psychopathology and tended to prematurely terminate treatment more frequently than patients with major depression alone. Both standardized depression-specific treatments were effective for depressed patients with and without a comorbid generalized anxiety disorder, although time to recovery was longer for the former. Patients with lifetime panic disorder showed poor recovery in response to psychotherapy or pharmacotherapy. Standardized psychotherapy and pharmacotherapy are effective for patients with major depression with and without a generalized anxiety disorder. However, the longer time to recovery for the former group and lack of response to these treatments by patients with lifetime panic disorder suggest that primary care physicians should carefully assess history of anxiety disorder among depressed patients so as to select a proper intervention.",Brown C.; Schulberg HC.; Madonia MJ.; Shear MK.; Houck PR.,1996.0,10.1176/ajp.153.10.1293,0,0,
10346,The role of avoidance and obsessiveness in matching patients to cognitive and interpersonal psychotherapy: empirical findings from the treatment for depression collaborative research program.,"This article examines the hypothesis that cognitive therapy (CT) is more effective than interpersonal therapy (IPT) for treatment of depressed patients with an elevated level of avoidant personality, whereas the reverse holds for depressed patients with elevated level of obsessive personality. This hypothesis was derived in part from the preliminary results of previous unpublished pilot work, which examined the course of dynamic and cognitive therapies for avoidant and obsessive-compulsive personality disorders. With the ""completer"" data set available from the Treatment for Depression Collaborative Research Program (I. Elkin et al., 1989), the expected significant interactions between treatment (CT vs. IPT) and avoidance and between treatment and obsessiveness were found. A significant interaction was also found between marital status and treatment, indicating that married patients did better after CT, whereas single and noncohabiting patients improved more after IPT. Similar patterns of results were found using the Hamilton Rating Scale for Depression and the Beck Depression Inventory. A matching factor formula of patients to CT vs. IPT is presented.",Barber JP.; Muenz LR.,1996.0,,0,0,
10347,Opposite asymmetries in blind locomotor orientation of patients with panic agoraphobia compared to those with generalized anxiety.,"Panic agoraphobic subjects constantly struggle with the accurate registration of everyday space-time dimension. They are hindered in the exploration of their surroundings by constant self-directed attention. In our investigations we examined whether during experimental goal-directed locomotion orientation insecurity would appear. The accuracy of target-directed motion, i.e. the degree of lateral deviation, was recorded in three diagnostic groups, panic agoraphobics (15 subjects), generalized anxiety patients (15 subjects), and normal controls (15 subjects), and normal controls (15 subjects). According to our results the approach vector of the panic agoraphobics deviated to the right, while in the case of generalized anxiety patients it deviated to the left, while normal controls did not deviate significantly from the middle line. Results are compatible with previous literature which associated panic with an overactivity of left-sided functions, and generalised anxiety with an overactivity of right-sided functions.",Kállai J.; Szabados Z.; Varga J.; Ozsváth K.; Molnár P.; Kóczán G.,1996.0,,0,0,
10348,[Synovial cyst of the cruciate ligament. Findings with magnetic resonance in 8 symptomatic cases].,"Intraarticular ganglion cysts are uncommon findings: only 30 cases have been reported since the first paper by Caan in 1924 and they were all associated with cruciate ligaments. Many different cystic or pseudocystic lesions are found in articular knee conditions: the most common cystic lesions are popliteal cysts (Baker's cysts), followed by synovial pseudocysts of the posterior cruciate ligament, meniscal cysts and, finally, ganglion cysts of the cruciate ligaments. In our series of 1600 knee MR exams carried out in our MR department since June, 1994, we have found 8 ganglion cysts of the cruciate ligaments. MR studies are always performed on a dedicated 0.2-T permanent magnet (Artoscan, Esaote Biomedica, Genoa, Italy). Five patients were operated on with arthroscopy. The ganglion cysts affected the anterior cruciate ligaments in 4 cases and the posterior cruciate ligaments in 4 cases. The symptoms were mainly pain radiating to the medial side and worsening in forced flexion or extension. The diagnostic suspicion was meniscal tears in 4 patients, chondral lesions in 3 and a loose intraarticular body in one patient. The shape and structure of ganglion cysts in the cruciate ligaments are clearly depicted with MRI. The ganglion cysts in the anterior cruciate ligaments are usually spindle-shaped and within the ligament, while those in the posterior cruciate ligaments have a well-defined outline, with multilocular appearance, and they are usually localized along the ligament, most often on the dorsal aspect. MR signal studies show intermediate signal intensity on SE T1-weighted images and markedly increased signal intensity on SE T2-weighted images. These typical patterns may change depending on lesion content, for instance in the presence of hemoglobin due to an associated angioma. The origin of ganglion cysts in the cruciate ligaments is still unknown, even though many theories have been suggested, including a synovial herniation in ligament fibers, the ectopic inclusion of synovial tissue, a posttraumatic connectival degeneration and, finally, the proliferation of totipotent mesenchymal cells. From a histologic point of view, ""synovial ganglion"" is a much better definition than ""synovial ganglion cyst"", because the typical wall of real synovial cysts is missing. The MR patterns are typical of the morphological features described and of the presence of high protein fluid content.",Bellelli A.; De Luca F.; Maresca G.; Nardis P.,1996.0,,0,0,
10349,Memory for conversation.,"Memory for conversation is treated as a source of coherence in social encounters and its connections with social competence are tested in a study of problem-solving conversations. As predicted, accurate recall is found to correlate positively with social competence and negatively with social anxiety. Partners have better memory for their own contributions than for each other's, and this difference is exacerbated by topic importance. Differences in recall are also found for differing amounts of involvement in the conversations. Results are explained in terms of resource allocation during conversation.",Miller JB.; deWinstanley P.; Carey P.,1996.0,10.1080/741940999,0,0,
10350,Olfactory identification ability in patients with panic disorder.,"Deficits in olfactory identification ability have been reported in some groups of psychiatric patients, but not others. Our study examined olfactory identification ability in patients with panic disorder. Results indicate that this ability is intact in this population and, further, that psychotropic medications appear not to interfere with olfaction.",Kopala LC.; Good KP.,1996.0,,0,0,
10351,"Magnetic resonance imaging study of hippocampal volume in chronic, combat-related posttraumatic stress disorder.","This study used quantitative volumetric magnetic resonance imaging techniques to explore the neuroanatomic correlates of chronic, combat-related posttraumatic stress disorder (PTSD) in seven Vietnam veterans with PTSD compared with seven nonPTSD combat veterans and eight normal nonveterans. Both left and right hippocampi were significantly smaller in the PTSD subjects compared to the Combat Control and Normal subjects, even after adjusting for age, whole brain volume, and lifetime alcohol consumption. There were no statistically significant group differences in intracranial cavity, whole brain, ventricles, ventricle:brain ratio, or amygdala. Subarachnoidal cerebrospinal fluid was increased in both veteran groups. Our finding of decreased hippocampal volume in PTSD subjects is consistent with results of other investigations which utilized only trauma-unexposed control groups. Hippocampal volume was directly correlated with combat exposure, which suggests that traumatic stress may damage the hippocampus. Alternatively, smaller hippocampi volume may be a pre-existing risk factor for combat exposure and/or the development of PTSD upon combat exposure.",Gurvits TV.; Shenton ME.; Hokama H.; Ohta H.; Lasko NB.; Gilbertson MW.; Orr SP.; Kikinis R.; Jolesz FA.; McCarley RW.; Pitman RK.,1996.0,10.1016/S0006-3223(96)00229-6,0,0,
10352,Delayed surgery of traumatic aortic rupture. Role of magnetic resonance imaging.,"Traumatic aortic rupture (TAR) is a pathological entity with a high mortality, both spontaneous and perioperative. Delayed surgical repair has been proposed when associated lesions are stabilized. The aim of this study was to validate MRI for detecting both the presence and type of TAR and to monitor posttraumatic aneurysm and associated lesions. Twenty-four consecutive patients with acute chest trauma and suspected aortic rupture, as suggested by emergency CT or chest radiographs, were subjected to MRI and/or angiography in random order. Such parameters as the presence and type of lesion; presence of periaortic, pericardial, mediastinal, or pleural effusion; and presence of associated lesions were considered in every patient. Follow-up imaging was performed exclusively by MRI every 1 to 2 months. TAR was present in 20 patients. No patient underwent surgery in the acute phase; 14 patients underwent surgery at 6.8 +/- 2.7 months; 5 are waiting for surgery; and 1 healed spontaneously. There was no overall mortality. For detection of TAR, the accuracy of MRI was 100%; angiography, 84%; and CT, 69%. In detecting the type of lesion, the diagnostic accuracy of MRI was 92%. During follow-up, a significant increase in the posttraumatic aneurysm was observed in 2 patients, and surgical repair was initiated. In chest trauma patients, MRI provides complete anatomic data to assess the severity of aortic and thoracic lesions. Moreover, along with the concept of delayed surgical repair of TAR, MRI is the ideal modality to monitor and follow TAR before surgical repair.",Fattori R.; Celletti F.; Bertaccini P.; Galli R.; Pacini D.; Pierangeli A.; Gavelli G.,1996.0,,0,0,
10353,Early compliance and other factors predicting outcome of exposure for obsessive-compulsive disorder.,Identifying predictors of treatment outcome can suggest ways to improve treatment delivery and understanding of its mechanism of action. Predictors of treatment outcome were sought among 46 out-patients with obsessive-compulsive disorder who completed a nine-week randomised controlled trial of two forms of exposure therapy with ritual prevention. In both exposure conditions the best predictor of good outcome at the end of treatment (week 9) and of follow-up (week 32) was early compliance in doing exposure homework within a week of starting treatment. A weaker predictor of good outcome at follow-up was within-session reduction in anxiety from weeks 0 to 4. The strongest and most consistent predictor of better outcome to weeks 9 and 32 was compliance with exposure and ritual prevention in the first week of treatment.,De Araujo LA.; Ito LM.; Marks IM.,1996.0,,0,0,
10354,A randomised controlled trial of psychological debriefing for victims of road traffic accidents.,,Hobbs M.; Mayou R.; Harrison B.; Worlock P.,1996.0,,0,0,
10355,Study and course of the psychological profile in 77 patients expressing panic disorder with agoraphobia after cognitive behaviour therapy with or without buspirone.,"The change of psychopathological dimensions during treatment of panic disorder is attracting increasing interest. A population of subjects experiencing panic disorder with agoraphobia is evaluated with the French version of the factor structure of the Symptom Checklist 90 R (SCL 90 R). Two groups of patients are compared: a group receiving cognitive behaviour therapy (CBT) combined with buspirone and a group receiving cognitive behaviour therapy combined with placebo. Comparative analysis of pre- and post-test changes between both groups completing treatment showed that the combination cognitive behaviour therapy plus buspirone provided better results than those in patients who had received cognitive behaviour therapy plus placebo. This difference between treatments did not persist at the 1-year follow-up, since, while results had been effectively maintained in the CBT plus buspirone group, the CBT plus placebo group continued to improve significantly for the target dimensions of treatment. Psychopathological dimensions on the SCL 90 R show that combination of buspirone and cognitive behaviour therapy accelerates the behaviour modification process only in the short term.",Bouvard M.; Mollard E.; Guerin J.; Cottraux J.,1997.0,,0,0,
10356,Body dysmorphic disorder: a preliminary evaluation of treatment and maintenance using exposure with response prevention.,"In recent investigations, body dysmorphic disorder (BDD) has been shown to share common etiological and symptom presentation to obsessive-compulsive disorder (OCD). When treating BDD, there have been some investigations suggesting that exposure with response prevention is effective in alleviating symptoms. Ten patients diagnosed with BDD participated in a study examining the effects of treatment and maintenance using exposure with response prevention. They received a standard behavior therapy protocol which consisted of exposure in vivo and in imagery, with response prevention. Symptom severity, depression, anxiety, and avoidance were assessed weekly during treatment. Following treatment, a 6-month maintenance program was instituted for five patients, with the other five serving as controls. Patients in the maintenance program were assessed bi-weekly with all measures and a 6-month follow-up was conducted. Patients improved for measures of avoidance, BDD symptoms, depression and anxiety when using exposure with response prevention. Although all patients remained symptom free at follow-up, those in the maintenance program continued to improve. Based on these results, BDD appears to be amenable to exposure with response prevention treatment. Additional treatment gains can be obtained when structured maintenance programs are implemented.",McKay D.; Todaro J.; Neziroglu F.; Campisi T.; Moritz EK.; Yaryura-Tobias JA.,1997.0,,0,0,
10357,Static respiratory pressures in patients with post-traumatic tetraplegia.,The purpose of this study was to examine ventilatory muscle strength as represented by static respiratory pressures in 30 tetraplegic patients with a complete lesion between the fifth and the eighth cervical vertebrae. The Inspiratory/Expiratory Pressure Meter was used to obtain maximum static expiratory mouth pressure (PEmax) and maximum static inspiratory mouth pressure (PImax) measurements. The PEmax was measured at vital capacity and the PImax at residual volume. The measurements were effected while the patient was in the supported sitting position. The mean PEmax for the group was 50 cm H2O and the mean PImax was -65 cm H2O. There was a significant difference between the PEmax and PImax values. Unlike normal individuals most tetraplegic subjects in this study showed PImax values to be much higher than their PEmax values.,Gounden P.,1997.0,,0,0,
10358,Seeking the source of emotional Stroop interference effects in PTSD: a study of P3s to traumatic words.,"We investigated the source of emotional Stroop interference effects in posttraumatic stress disorder (PTSD) by measuring reaction times and P3 latencies and amplitudes to personal traumatic, personal positive, and neutral words in a modified Stroop paradigm. Individuals with PTSD were slower to indicate word color, especially for traumatic words, thereby replicating emotional Stroop interference in PTSD. Individuals with PTSD also had significantly reduced and delayed P3 components across word types. Across diagnostic groups, frontal P3 amplitudes were larger to personal positive and traumatic words compared to standard neutral words. However, the absence of Diagnosis x Word Type interactions for P3 measures suggests that individuals with PTSD do not differ from individuals without PTSD in the encoding and recognition of the color of traumatic relative to nontraumatic words, and that Stroop interference does not occur during these early stages of processing.",Metzger LJ.; Orr SP.; Lasko NB.; McNally RJ.; Pitman RK.,,,0,0,
10359,Sustained attention in combat-related posttraumatic stress disorder.,"There is substantial evidence that PTSD patients have information processing abnormalities for stimuli that are highly relevant to the traumas they have endured. The goal of the present study was to examine whether this extends to neutral stimuli as well. Twenty-four male Vietnam combat veterans with PTSD were compared to fifteen normal male comparison subjects on their performance on a sensitive measure of sustained attention, the Continuous Performance Test-Identical Pairs version (CPT-IP). PTSD subjects did not differ from controls in their ability to discriminate target stimuli from background noise on the CPT. Additionally they performed as well as controls, even in the presence of external distraction. Thus, this study did not find a generalized deficit in attention associated with PTSD on the CPT-IP. Nevertheless, further clarification of the nature of the information processing disturbance in PTSD is warranted.",Golier J.; Yehuda R.; Cornblatt B.; Harvey P.; Gerber D.; Levengood R.,,,0,0,
10360,Personality traits among panic disorder with agoraphobia patients before and after symptom-focused treatment.,"The first aim of this study was to examine the relationship between change of the agoraphobic state during treatment and personality change. The second aim was to examine the potential effect of PD traits on symptom change during and after treatment. Patients (N = 46) suffering from panic disorder with moderate or severe agoraphobia and considering agoraphobia as their main problem were randomly assigned to receive either cognitive therapy or guided mastery therapy in a 6-week inpatient group program. From before to 1 year after the end of treatment, the number of avoidant and dependent traits decreased significantly. Among changes during treatment on various symptom and cognitive variables, only change in catastrophic beliefs was significantly related to reduction in avoidant and dependent traits. Number of dependent traits at pretreatment was related to less improvement from pretreatment to 1-year follow-up on the symptom and cognitive scales.",Hoffart A.; Hedley LM.,,,0,0,6443
10361,Structured interview for PTSD (SIP): psychometric validation for DSM-IV criteria.,,Davidson JR.; Malik MA.; Travers J.,1997.0,,0,0,
10362,Measurement of panic disorder by a modified panic diary.,"The psychometric characteristics of panic diary measures were investigated in a sample of 37 patients suffering from panic disorder with agoraphobia. Following recommendations made in the recent consensus development conference on the assessment of panic disorder, daily ratings included not only the occurrence of panic attacks but also fear of panic, expectancy of panic, and expected aversiveness of panic. These new measures were reliable and, on the whole, demonstrated good divergent and convergent validity. Further, adding such measures increased the incremental validity of panic disorder assessment.",de Beurs E.; Chambless DL.; Goldstein AJ.,1997.0,,0,0,
10363,Diagnosing posttraumatic stress disorder in multicultural patients in a Stockholm psychiatric clinic.,"Our objective was to test the assessment of posttraumatic stress disorder (PTSD) and associated symptoms in a multicultural immigrant/refugee population at a psychiatric out-patient clinic. The pilot study included volunteer patients who were randomly assigned to an intervention group (N = 33), who received SCID diagnosis and a battery of life event questionnaires, and a referent group (N = 30), who received the standard diagnostic program. All were followed-up for 1 year. Forty percent of the intervention group, but none in the referent group, were judged to have PTSD. In the intervention group, positive significant correlations were found between HTQ and HSCL-25 and SCID, Axis I PTSD. Experience of trauma influenced the ill-health in the psychometric indices, and the psychometric indices correlated negatively with present and optimal functioning. A targeted trauma approach toward multicultural psychiatric patients using a multidisciplinary team and validated psychometric tools provided sensitive and accurate diagnostic information for this group.",Ekblad S.; Roth G.,1997.0,,0,0,
10364,Interoceptive exposure versus breathing retraining within cognitive-behavioural therapy for panic disorder with agoraphobia.,"This study compared two components of a cognitive-behavioural treatment for panic disorder. Thirty-eight individuals with panic disorder and agoraphobia were randomly assigned to (a) cognitive restructuring, interoceptive exposure (i.e. repeated exposure to feared bodily sensations) and in vivo exposure to agoraphobic situations; or (b) cognitive restructuring, breathing retraining and in vivo exposure to agoraphobic situations. Assessments were conducted at pre-treatment, post-treatment and six months later. The treatments were equally effective on many measures. However, treatment that included interoceptive exposure was more effective at post-treatment in terms of panic frequency, overall severity and functioning, and more effective at six-month follow-up in terms of panic frequency, phobic fears and general anxiety and functioning. Follow-up results were limited due to attrition.",Craske MG.; Rowe M.; Lewin M.; Noriega-Dimitri R.,1997.0,,0,0,
10365,On predicting improvement and relapse in generalized anxiety disorder following psychotherapy.,"This paper concerns an investigation of outcome predictors in a clinical trial of psychological therapies for generalized anxiety disorder. A variety of information of potential predictive value was obtained at three stages of patient contact: the initial referral, a screening interview and early sessions of therapy. Three measures of the clinical significance of change over a 12-month follow-up period were used to construct a composite measure which categorized outcome in terms of sustained improvement, relapse and no consistent change. Logistic regression was used to examine the validity of predictors identified in previous research and the relative importance of data obtained from the three different stages. Seventy-one per cent of patients were correctly classified as improved or not from initial data with a significant increase in accuracy with information from the screening interview (77 per cent) and early sessions (82 per cent). Patients who relapsed or not were predicted with considerable accuracy from initial data (90 per cent) and there was no significant increase in predictive power with additional information. The most powerful and robust predictors were: type of treatment received, marital status, marital tension and complexity of clinical presentation in terms of axis 1 co-morbidity. A conceptual framework for prediction is outlined.",Durham RC.; Allan T.; Hackett CA.,1997.0,,0,0,
10366,Interventions and service need following mild and moderate head injury: the Oxford Head Injury Service.,"To describe the interventions given by the Oxford Head Injury Service (OXHIS) to patients seen after head injury, predominantly mild or moderate, over the first six months after their injuries. Descriptive data of the amounts of early intervention provided by OXHIS in relation to severity of head injury and the amount of service need identified at six month follow-up. OXHIS aimed to register all patients aged 16-65 with a head injury of any severity, resident in Oxfordshire. It contacted and provided interventions for a random half of those registered at 7-10 days post-injury as part of a randomized controlled trial to investigate the effectiveness of early follow-up. At six months post-injury, independent assessment of all those registered was undertaken to evaluate outcome and identify continuing service needs. The data come from the 579 patients (of the 1156 registered), randomized to receive the new service at 7-10 days post-injury. All but eight of these received some form of service, and 252 of the randomized patients were available for interview at six months post-injury to assess their continuing service need. In the first five months after head injury: 240 patients received postal information alone and were not otherwise in contact with the service; 127 had telephone contact, advice and information; 93 were seen in person, assessed and given advice and information; 78 needed more help and support from the OXHIS team over the telephone; and 33 required further face-to-face contact either from OXHIS or other services. Extensive use was made of standardized leaflets but only accompanied by individualized assessment and advice. At six months 252 of the 579 patients were interviewed: 101 had no problems; 136 needed further reassurance; and 15 required further intervention. Patients with longer periods of post-traumatic amnesia (PTA) were more likely to receive a higher level of service, but the majority of patients who received the more extensive services were those with 'mild' and 'moderate' head injuries. Although the amount of service provided at 7-10 days post-injury increased with severity of head injury, most service was in fact given to patients with milder head injuries which were much more common. The majority of patients seen at six months post-injury needed reassurance, advice or other services, and monitoring of patients for some time after their head injuries does seem warranted. A population of 560,000 people could receive service from three whole-time equivalent (WTE) staff using these assessment and management protocols.",King NS.; Crawford S.; Wenden FJ.; Moss NE.; Wade DT.,1997.0,10.1177/026921559701100104,0,0,
10367,Fear and avoidance in dysfunctional chronic back pain patients.,"Two studies that assess fear and avoidance in patients with chronic pain are presented. In the first study, 200 patients with chronic back pain were classified, using the Multidimensional Pain Inventory (Kerns et al., 1985) clustering procedure, as dysfunctional (n = 53), interpersonally distressed (n = 37), and adaptive copers (n = 62). Groups were compared on common measures of anxiety, fear and avoidance. Multivariate analysis of variance indicated that the groups differed significantly across measures. Univariate follow-up revealed that there were no differences between groups on agoraphobic, blood/injury, social fears, or anxiety sensitivity; however, patients classified as dysfunctional reported more pain-specific fear and avoidance than did those classified as interpersonally distressed or adaptive copers. In the second study, pain-specific fear and avoidance measures were used in a discriminant function analysis to predict the MPI classification of an independent sample of 55 patients with chronic pain. The measures correctly classified 76.5% of the dysfunctional group and 71.1% of a composite group of interpersonally distressed and adaptive copers. The implications of these findings are discussed.",Asmundson GJ.; Norton GR.; Allerdings MD.,1997.0,,0,0,
10368,Comparison of palmtop-computer-assisted brief cognitive-behavioral treatment to cognitive-behavioral treatment for panic disorder.,"In the present study, the authors sought to determine whether the efficiency and cost-effectiveness of cognitive-behavioral treatment (CBT) for panic disorder could be improved by adjunctive computer-assisted therapy. Eighteen participants who met Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; American Psychiatric Association, 1987) criteria for panic disorder were randomly assigned to a 12-session CBT (CBT 12) condition (D. H. Barlow & M. G. Craske, 1989) or to a 4-session computer-assisted CBT (CBT4-CA) condition. Palmtop computers, with a program developed to incorporate basic principles of CBT, were used by CBT4-CA clients whenever they felt anxious or wanted to practice the therapy techniques and were used by all participants as a momentary assessment tool. CBT4-CA clients carried the computer at all times and continued to use it for 8 weeks after termination of therapy. Analyses of clinically significant changes showed superiority of CBT12 at posttest on some measures; however, there were no differences at follow-up.",Newman MG.; Kenardy J.; Herman S.; Taylor CB.,1997.0,,0,0,
10369,Cognitive-behavioral treatment for severe anger in posttraumatic stress disorder.,"With a randomized group design, a 12-session anger treatment was evaluated with severely angry Vietnam War veterans suffering combat-related posttraumatic stress disorder (PTSD). Eight participants in anger treatment and 7 in a routine clinical care control condition completed multiple measures of anger control, anger reaction, and anger disposition, as well as measures of anxiety, depression, and PTSD at pre- and posttreatment. Controlling for pretreatment scores, significant effects were found on anger reaction and anger control measures but not on anger disposition or physiological measures. Eighteen-months follow-up (for both completers and dropouts) supported the posttreatment anger control findings. The challenges of treatment research with this refractory population are discussed.",Chemtob CM.; Novaco RW.; Hamada RS.; Gross DM.,1997.0,,0,0,
10370,Postdisaster psychosocial intervention: a field study of the impact of debriefing on psychological distress.,"Following a catastrophic natural disaster, the authors evaluated whether brief psychological intervention (debriefing 6 months later) reduced disaster-related psychological distress as measured by the Impact of Event Scale. Two groups of subjects who had been exposed to Hurricane Iniki in Hawaii were assessed before and after participating in a multihour debriefing group. The intervention aimed to provide ventilation of feelings, normalization of responses, and education about normal psychological reactions to the disaster in a context of group support. To provide a partial control for the passage of time, the pretreatment assessment of the second group was concurrent with the posttreatment assessment of the first group. A repeated measures analysis of variance indicated that Impact of Event Scale scores were reduced in both groups after the treatment. There is preliminary empirical support for the effectiveness of postdisaster psychological intervention and for the feasibility of treatment research in postdisaster environments.",Chemtob CM.; Tomas S.; Law W.; Cremniter D.,1997.0,10.1176/ajp.154.3.415,0,0,
10371,Sleep in the wake of complicated grief symptoms: an exploratory study.,"Our aim was to explore the concept that the symptoms of complicated grief may be a form of posttraumatic distress, rather than depression, and thus may have different effects on sleep. Sixty-five recently bereaved elders with varying levels of symptoms of complicated grief and depression were stratified by high versus low levels of symptoms; a two-way analysis of variance examined main effects of level of complicated grief symptoms and depressive symptoms on selected sleep measures, as well as interactions. Complicated grief symptoms were independently associated with mild subjective sleep impairment but showed no main effects on electroencephalographic (EEG) sleep measures. In a multiple regression analysis, complicated grief symptoms interacted with depressive symptoms to increase REM sleep percent. Thus, it appears that complicated grief symptoms do not entail the changes of EEG sleep physiology seen in depression, with the possible exception of an interaction with coexisting depression to enhance REM sleep percent.",McDermott OD.; Prigerson HG.; Reynolds CF.; Houck PR.; Dew MA.; Hall M.; Mazumdar S.; Buysse DJ.; Hoch CC.; Kupfer DJ.,1997.0,10.1016/S0006-3223(96)00118-7,0,0,
10372,Cognitive-behavioral treatment of panic attacks in chronic schizophrenia.,"Although panic attacks have been described as relatively common in schizophrenia, few studies have examined treatments for this problem. Because cognitive-behavioral therapy (CBT) has demonstrated efficacy for panic disorder without schizophrenia, the authors conducted an open clinical trial of CBT for the treatment of panic attacks in schizophrenic patients. Eight patients meeting DSM-III-R criteria for schizophrenia and panic disorder were given a 16-week clinical trial of CBT. Ratings after treatment demonstrated both a statistically significant reduction in panic symptoms and a diminution in the number of panic attacks compared with baseline ratings. These results suggest use of CBT in the integrated treatment of patients with a diagnosis of schizophrenia and panic disorder is a promising approach that merits further investigation.",Arlow PB.; Moran ME.; Bermanzohn PC.; Stronger R.; Siris SG.,1997.0,,0,0,
10373,Misinterpretation of body sensations in panic disorder.,"Cognitive accounts of panic predict that panic disorder patients will be particularly prone to misinterpret autonomic sensations. Several studies have produced results consistent with this prediction, but each is open to alternative interpretation. To clarify matters, 2 studies administered the Body Sensations Interpretation Questionnaire (BSIQ) to panic patients and controls. Panic patients were more likely to interpret ambiguous autonomic sensations as signs of immediately impending physical or mental disaster and were more likely than other anxiety disorder patients and nonpatients to believe these interpretations. In a 3rd study, a brief version of the BSIQ was shown to have satisfactory test-retest reliability, to change with treatment, and to discriminate treatments that varied in their effects on panic.",Clark DM.; Salkovskis PM.; Ost LG.; Breitholtz E.; Koehler KA.; Westling BE.; Jeavons A.; Gelder M.,1997.0,,0,0,
10374,Outcome of psychotherapy among early adolescents after trauma.,"The authors evaluated the effectiveness of brief trauma/grief-focused psychotherapy among early adolescents exposed to the 1988 earthquake in Armenia. Posttraumatic stress and depressive reactions among treated and not treated subjects were evaluated pre- and postintervention, at 1 1/2 and 3 years after the earthquake, respectively. Severity of posttraumatic stress symptoms significantly decreased among the subjects given psychotherapy, while severity of these symptoms increased significantly among the subjects not treated with psychotherapy. The improvement in posttraumatic stress symptoms was attributable to improvement in all three symptom categories (intrusion, avoidance, and arousal) of posttraumatic stress disorder (PTSD). There was no change in severity of depressive symptoms among subjects given psychotherapy. However, depressive symptoms among subjects not treated with psychotherapy significantly worsened over time. The changes in severity of posttraumatic stress and depressive symptoms were positively correlated within both groups. The findings demonstrate the efficacy of trauma/grief-focused brief psychotherapy in alleviating PTSD symptoms and preventing the worsening of comorbid depression among early adolescents after a catastrophic disaster. The results support the broad use of such school-based interventions after major disasters and demonstrate the cross-cultural applicability of Western psychotherapeutic approaches.",Goenjian AK.; Karayan I.; Pynoos RS.; Minassian D.; Najarian LM.; Steinberg AM.; Fairbanks LA.,1997.0,10.1176/ajp.154.4.536,0,0,
10375,Overcoming resistance to exposure in panic disorder with agoraphobia.,"The issue of panic disorder resistant to treatment (whether pharmacological or psychological) has attracted little research attention, despite its clinical frequency and importance. The aim of this study was to compare three treatment modalities, namely exposure alone (E), exposure associated with imipramine (EI) and cognitive therapy supplementing exposure (EC), in a sample of 21 patients with DSM-IV panic disorder and agoraphobia, who failed to respond to a first standard course of individual behavioural treatment based on exposure in vivo. Treatments were administered according to a cross-over, controlled design (E-EI-EC, EI-EC-E, EC-E-EI). Twelve of the 21 patients achieved remission (panic-free status) during the trial. In 8 cases this occurred after exposure alone (E) and in two cases each after the other treatments (EI and EC). The results revealed a significant effect of the factor time on a number of variables, and the superiority of exposure alone compared to other treatment modalities with regard to some variables. These findings suggest that long-term behavioural treatment based on exposure may be necessary in some patients, and may induce clinical remission. However, patients who do not respond to exposure show poor tolerance of and compliance with pharmacological treatment, and are unlikely to achieve remission with imipramine or cognitive therapy, even though this may occur in individual cases.",Fava GA.; Savron G.; Zielezny M.; Grandi S.; Rafanelli C.; Conti S.,1997.0,,0,0,
10376,Excessive responsibility in obsessional concerns: a fine-grained experimental analysis.,"Excessive responsibility has been suggested as a central cognitive variable associated with Obsessive-Compulsive Disorder (OCD) (Rachman, 1993, Behaviour Research and Therapy, 31, 149-154; Salkovskis, 1985, Behaviour Research and Therapy, 23, 571-583; Salkovskis, 1989, Behaviour Research and Therapy, 27, 677-682; Salkovskis, 1995, Current controversies in the anxiety disorders). Several studies using questionnaires (e.g. Rhéaume, Freeston, Dugas, Letarte & Ladouceur, 1995, Behaviour Research and Therapy, 33, 785-794) and experimental manipulations (Ladouceur et al., 1995, Behaviour Research and Therapy, 33, 937-946; Lopatka & Rachman, 1995, Behaviour Research and Therapy, 33, 673-684) have shown evidence for such a link between responsibility and obsessive-compulsive symptoms. Responsibility has been defined as the belief of possessing a pivotal power to provoke or preventing crucial negative consequences (Salkovskis et al., 1992 cited in Salkovskis, 1995, Current controversies in the anxiety disorders). This definition emphasizes two related cognitive distortions: personal influence and potential negative consequences. The respective roles of each component and their potential interaction need to be clarified. The present study tests the effects of an experimental manipulation of both influence and negative consequences on perceived responsibility and checking behavior during a classification task. Seventy-seven subjects were divided into four experimental conditions: the Combined condition, the Influence condition, the Negative Consequences condition and the Control condition. After the experimental manipulation, subjects from each condition had to classify capsules in semi-transparent bottles. Results showed that personal influence is the best predictor of perceived responsibility. Although increased potential negative consequences were sufficient to trigger hesitations, combined influence and negative consequences were necessary to produce modifications. These results are consistent with the results obtained by the questionnaires (e.g. Rhéaume, Ladouceur, Freeston & Letarte, 1995a, Behaviour Research and Therapy, 33, 159-169) and previous manipulations (e.g. Ladouceur et al., 1995).",Ladouceur R.; Rhéaume J.; Aublet F.,1997.0,,0,0,
10377,[Assessment of cerebral blood flow velocity changes by transcranial Doppler examination in patients with closed craniocerebral trauma].,"24 patients after minor or moderate, closed isolated head injuries and 10 patients of control group were included to this study. Right after admission blood flow velocities of both middle cerebral arteries (MCAs) by using transcranial Doppler method (TCD) and blood flow velocities of both extracranial parts of internal carotid arteries (ICAs) by ""duplex-scan method"" were examined. Changes in mean flow velocities (MFVs) in MCAs and ICAs, VMCA/VICA ratio were analysed. 40% of patients who had minor or moderate head injury demonstrated increase of MCA velocity homolateral to the trauma or bilateral. We observed cerebral hyperemia in 16.7% of patients and posttraumatic vasospasm (TVSP) in 25% of patients. There is a high risk of occurring TVSP in patients with CT shows evidence of subdural or intracerebral hematoma.",Kaspera W.; Maliszewski M.; Majchrzak H.; Stepień T.,,,0,0,
10378,Effect of prefrontal repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: a preliminary study.,"Prefrontal mechanisms are implicated in obsessive-compulsive disorder. The authors investigated whether prefrontal repetitive transcranial magnetic stimulation influenced obsessive-compulsive disorder symptoms. Twelve patients with obsessive-compulsive disorder were given repetitive transcranial magnetic stimulation (80% motor threshold, 20 Hz/2 seconds per minute for 20 minutes) to a right lateral prefrontal, a left lateral prefrontal, and a midoccipital (control) site on separate days, randomized. The patients' symptoms and mood were rated for 8 hours afterward. Compulsive urges decreased significantly for 8 hours after right lateral prefrontal repetitive transcranial magnetic stimulation, but there were nonsignificant increases in compulsive urges after repetitive transcranial magnetic stimulation of the midoccipital site. A shorter-lasting (30 minutes), modest, and nonsignificant reduction in compulsive urges occurred after left lateral prefrontal repetitive transcranial magnetic stimulation. Mood improved during and 30 minutes after right lateral prefrontal stimulation. These preliminary results suggest that right prefrontal repetitive transcranial magnetic stimulation might affect prefrontal mechanisms involved in obsessive-compulsive disorder.",Greenberg BD.; George MS.; Martin JD.; Benjamin J.; Schlaepfer TE.; Altemus M.; Wassermann EM.; Post RM.; Murphy DL.,1997.0,10.1176/ajp.154.6.867,0,0,
10379,Effects of varying levels of positive end-expiratory pressure on intracranial pressure and cerebral perfusion pressure.,"To determine the influence of positive end-expiratory pressure (PEEP) on intracranial pressure and cerebral perfusion pressure. Neurosurgical intensive care patients requiring intracranial pressure monitoring and mechanical ventilation were studied in a randomized, controlled study. Tertiary care, neurosurgical intensive care unit. Eighteen patients were enrolled in the study. Patients had posttraumatic head injuries (n = 9), subarachnoid hemorrhage (n = 7), obstructive hydrocephalus (n = 1), and intracerebral hemorrhage of unknown cause (n = 1). Patients had PEEP levels of 5, 10, and 15 cm H2O applied to their lungs. Changes in intracranial pressure, mean arterial pressure, and cerebral perfusion pressure were measured. The results were analyzed separately for patients with normal and increased intracranial pressure (> 15 mm Hg). PEEP at 5 cm H2O had no effect on intracranial pressure in the group with normal intracranial pressure. However, PEEP at 10 and 15 cm H2O produced a significant (p < .05) increase in intracranial pressure (1.9 and 1.5 mm Hg, respectively). In the group with increased intracranial pressure, no significant change in intracranial pressure occurred at any of the PEEP levels used. In both groups, cerebral perfusion pressure was unchanged throughout. In patients with normal intracranial pressure, PEEP at 5 cm H2O did not significantly alter intracranial pressure. The clinical relevance of the intracranial pressure increase at PEEP levels of 10 and 15 cm H2O is questionable because cerebral perfusion pressure did not change and remained > 60 mm Hg. In patients with increased intracranial pressure, higher levels of PEEP did not significantly change intracranial pressure or cerebral perfusion pressure.",McGuire G.; Crossley D.; Richards J.; Wong D.,1997.0,,0,0,
10380,Interpersonal problems among patients suffering from panic disorder with agoraphobia before and after treatment.,"The aim of this study was to examine interpersonal problems among panic disorder with agoraphobia patients before and after treatment. Patients (N = 46) suffering from panic disorder with moderate or severe agoraphobia and considering agoraphobia as their main problem were randomly assigned to receive either cognitive therapy or guided mastery therapy in a six-week in-patient group programme. The Inventory of Interpersonal Problems (IIP) and various symptom measures were administered at pretreatment and at one-year follow-up. Two IIP subscales were derived from factor analysis of the present data: affiliation problems and power problems. The overall pattern of results supported a state model of interpersonal problems. At pre-treatment, the scores on the affiliation problems subscale were clearly related to non-specific state characteristics, that is, to depression and general anxiety. From pre-treatment to follow-up, levels of interpersonal problems decreased significantly. Pre-treatment depression was a powerful predictor of change in interpersonal problems from pre-treatment to one-year follow-up. On the other hand, interpersonal problems at pre-treatment failed to predict the change in levels on various symptom scales.",Hoffart A.,1997.0,,0,0,
10381,The effect of fixation condition manipulations on antisaccade performance in schizophrenia: studies of diagnostic specificity.,"This series of studies evaluated (1) hypotheses that poor antisaccade performance is attributable to confounding variables (e.g., visual attention deficits, incomplete understanding of task demands) and (2) the specificity of poor antisaccade performance to schizophrenia. In addition to self-correcting errors before being cued to do so, schizophrenia patients also showed the expected saccadic reaction time changes to fixation condition manipulations: decreased latencies for gap and increased latencies for overlap trials. These data suggest that schizophrenia patients are adequately engaged in and understand the antisaccade task. Schizophrenia patients made fewer correct antisaccade responses than other psychiatric patients (obsessive-compulsive and bipolar disorder) and normal subjects. The first-degree relatives of schizophrenia patients also generated a decreased proportion of correct antisaccade responses compared with normal subjects. For schizophrenia patients who performed below the range of normal subjects, 26% of their relatives also performed below the normal range. Conversely, patients who performed normally did not have a single poor-performing relative. These data suggest that increased antisaccade error rates may index a liability for schizophrenia within a subset of families.",McDowell JE.; Clementz BA.,1997.0,,0,0,
10382,Self-directed treatment with minimal therapist contact: preliminary findings for obsessive-compulsive disorder.,"The efficacy of a brief intervention for obsessive-compulsive disorder (OCD) was examined with nine clients. Treatment consisted of five meetings with the therapists, readings from When once is not enough (Steketee & White, 1990), and self-directed exposure with response prevention. The self-report version of the Yale-Brown Obsessive-Compulsive Scale was the primary dependent measure. Participants who received treatment after a 6-week delay showed stability of severity of OCD over the waiting period. As a group, participants showed statistically significant improvement on the main outcome measures. One-third of the clients met criteria for clinically significant improvement indicating that some individuals suffering with OCD can be helped with a brief intervention.",Fritzler BK.; Hecker JE.; Losee MC.,1997.0,,0,0,
10383,Group therapy for somatization disorders in general practice: effectiveness of a short cognitive-behavioural treatment model.,"The objective of this study was to evaluate the effect of a short cognitive behavioural group therapy programme for somatization disorder in primary care. The treatment model was focused on patient education and stress relaxation. A controlled and prospective study design was used with repeated assessments of the patients' perception of their psychosocial problems, psychological distress and medication usage. The results were analysed up to 6 months after treatment and showed the treated patients to be moderately but significantly improved with respect to physical illness and somatic preoccupation, hypochondriasis, and medication usage. In a control group of untreated patients no such improvements were observed. In summary, the short group treatment programme used in this study may be beneficial for patients with somatization disorders. With some modifications it might be useful to practitioners in primary care for the management of psychosomatic disorders.",Lidbeck J.,1997.0,,0,0,
10384,Relaxation-induced EEG alterations in panic disorder patients.,"Based on previous reports of relaxation-induced panic attacks in panic disorder patients, quantitative electroencephalographic (EEG) profiles and subjective anxiety ratings were assessed in panic disorder patients and normal controls listening to neutral and relaxation audiotapes. Regardless of tape condition, patients exhibited a greater frequency and severity of panic-related symptoms. Relaxation failed to alter panic-related symptom ratings or anxiety ratings in patients and controls. Theta and alpha increments were observed during relaxation, but only in normal controls. High frequency beta activity was less evident in patients, regardless of tape conditions. Results are discussed in relation to arousal and treatment issues in panic disorder.",Knott V.; Bakish D.; Lusk S.; Barkely J.,,,0,0,7078
10385,[Autonomic regulation of cardiac activity in patients with ischemic heart disease and neurocirculatory dystonia: asymmetry of cardiac rhythmograms].,"Thirty-six males with the cardiologic syndrome were examined to compare the autonomic regulation of cardiac performance in patients with coronary heart disease and neurocirculatory dystonia. The standard analysis of autonomic specimens indicated a relative reduction in a response of the parasympathetic link of the autonomic nervous system in patients with coronary heart disease than in those with neurocirculatory dystonia. A new approach was proposed to analyze the specimens with deep slow respiration, which included the construction of rhythmograms, followed by the determination of an asymmetry coefficient and a reduction index. Patients with coronary heart disease were found to have an asymmetric rhythmogram while those with neurocirculatory dystonia had a symmetric one.",Drozdov DV.; Murashko SS.; Bogdanova EA.,,,0,0,
10386,Randomised controlled trial of psychological debriefing for victims of acute burn trauma.,"Psychological debriefing (PD) is widely used following major traumatic events in an attempt to reduce psychological sequelae. One hundred and thirty-three adult burn trauma victims entered the study. After initial questionnaire completion, participants were randomly allocated to an individual/couple PD group or a control group who received no intervention; 110 (83%) were interviewed by an assessor blind to PD status three and 13 months later. Sixteen (26%) of the PD group had PTSD at 13-month follow-up, compared with four (9%) of the control group. The PD group had higher initial questionnaire scores and more severe dimensions of burn trauma than the control group, both of which were associated with a poorer outcome. This study seriously questions the wisdom of advocating one-off interventions post-trauma, and should stimulate research into more effective initiatives.",Bisson JI.; Jenkins PL.; Alexander J.; Bannister C.,1997.0,,0,0,
10387,Experience with 30 posttraumatic rectourethral fistulas: presentation of posterior transsphincteric anterior rectal wall advancement.,"We present the challenging problems involving the treatment of rectourethral fistulas, especially those caused by war wounds. Various existing techniques used by a single surgeon are compared in this study. The method of posterior transsphincteric anterior rectal wall advancement is described as the treatment of choice. We emphasize the importance of fecal and urinary diversion. To our knowledge this series is the largest in the literature. From 1981 to 1994 we treated 30 men 18 to 50 years old (mean age 34) with posttraumatic rectourethral fistulas, including 23 (76.5%) caused by missiles. Urethroscopy with digital examination under anesthesia was the most reliable diagnostic study. End sigmoid colostomy and suprapubic cystostomy were performed in all patients. In 14 patients (46.5%) the fistula healed after double diversion but 16 (53.5%) required reconstruction for repair. Of the 6 procedures using established techniques in 5 patients 3 (50%) failed and 3 were successful but a urethral stricture developed after 2 (66%). On the other hand, in all patients (100%) who underwent repair via posterior transsphincteric anterior rectal wall advancement the fistula resolved and a stricture developed in 3 (27%). Fistula size and extent of fibrosis affected treatment, while etiology did not. Urethral obstruction complicated only the missile wounds. Double diversion has resulted in resolution of approximately half of the small, less fibrous fistulas. Early repair is recommended for large fibrous fistulas. Anterior rectal wall advancement through a posterior transsphincteric incision offers a new option that has proved to be successful and safe, and causes fewer urethral complications. It also provided good visualization with minimal bleeding and was less painful. Double diversion is a prerequisite to reconstruction.",al-Ali M.; Kashmoula D.; Saoud IJ.,1997.0,,0,0,
10388,Object relations as a predictor of treatment outcome with chronic posttraumatic stress disorder.,"The role of object relations as a predictor of outcome was evaluated in inpatient posttraumatic stress disorder (PTSD) treatment. Cohort outcome at discharge on psychometric indices was mixed, with limited evidence of reliable or clinically significant change. Treatment was associated with an overall reduction in utilization of inpatient psychiatric and residential domiciliary services. However, moderate (vs. low) levels of object relations were predictive of reliable change outcome, independent of demographics, Axis II diagnosis, symptomatic severity, or early childhood or war zone trauma exposure. The findings suggest that consideration should be given both to the manner in which patients seeking treatment for PTSD are screened and matched with a range of treatment or rehabilitation services and to how treatment outcome is conceptualized beyond symptom reduction. Rehabilitation of chronic posttraumatic symptomatology and associated psychosocial impairment may be facilitated by assessment, treatment design, and client-treatment matching on the basis of multidimensional psychological indices.",Ford JD.; Fisher P.; Larson L.,1997.0,,0,0,
10389,Determinants of pain expression in hospitalized burn patients.,"This study examines the relationship between extent of injury, degree and type of psychological distress and self-report of pain in burn survivors. One hundred eighty burn patients were interviewed within 2 weeks of their burn trauma. Using a visual analogue scale to assess subjective pain and pain relief, and self-report measures of post-traumatic stress symptoms and general psychological distress, we assessed the relationship between PTSD symptoms, general distress and pain. Subjective pain was unrelated to sex, ethnicity, or total body surface area burned. The most important correlate of subjective pain was general psychological distress. Intrusive PTSD symptoms had no independent power to predict the variance in pain scores. However, among women, more severe avoidant symptoms were associated with greater subjective pain.",Difede J.; Jaffe AB.; Musngi G.; Perry S.; Yurt R.,1997.0,,0,0,
10390,"Double-blindness procedures, rater blindness, and ratings of outcome. Observations from a controlled trial.","We determined whether blindness in a double-blind randomized controlled trial of alprazolam and exposure therapies in patients with panic disorder and agoraphobia was maintained in assessors and patients, what were the factors related to ""unblinding,"" and whether unblinding was associated with clinical outcome. In 129 patients with panic disorder and agoraphobia who were randomized to alprazolam-exposure, placebo-exposure, alprazolam-relaxation, or placebo-relaxation conditions, blindness was tested at the end of treatment by the independent assessors' and patients' classification of the treatment condition. Assessors' classifications were correct in 82% of the alprazolam group and 78% of the placebo group; corresponding figures for patients' classifications were 73% and 70%, respectively. Factors associated with unblinding included drug side effects but not assessors' ratings of treatment outcome. Judgment of the validity of the outcome of a randomized controlled trial is easier if the report notes not only the use of a double-blindness procedure but also details how blind the raters remained and how any unblinding affected their ratings of clinical outcome.",Başoğlu M.; Marks I.; Livanou M.; Swinson R.,1997.0,,0,0,
10391,Controlled trial of exposure and response prevention in obsessive-compulsive disorder.,"Exposure and response prevention is considered a treatment of choice for obsessive-compulsive disorder (OCD). Yet there have been very few randomised controlled trials employing credible placebo conditions. This study compares exposure and response prevention with a general anxiety management intervention. Eighteen patients meeting DSM-IV criteria for OCD were randomly assigned to either exposure and response prevention or anxiety management. Both treatments involved approximately 15 hours of therapy over a three-week period. There was a significant reduction in obsessive-compulsive symptoms following treatment with exposure and response prevention, while no change occurred in the control group. This was found to be statistically significant using a composite measure of OCD symptom severity, patient ratings of interference and therapist ratings of symptom severity. These findings suggest that the symptom reductions associated with behaviour therapy for OCD are a result of the specific techniques of exposure and response prevention, rather than non-specific aspects of the therapy process. General anxiety management techniques are not effective in the treatment of OCD.",Lindsay M.; Crino R.; Andrews G.,1997.0,,0,0,
10392,Endogenous opiate system and systematic desensitization.,,Egan KJ.; Carr JE.; Hunt DD.; Adamson R.,1988.0,,0,0,
10393,"Clomipramine, self-exposure and therapist-aided exposure for obsessive-compulsive rituals.","A randomised treatment design for 49 chronically obsessive-compulsive ritualising patients was devised and three controlled comparisons were made. 1. During 7 weeks of self-exposure instructions, clomipramine treatment improved some measures of rituals and depression significantly more than did placebo medication; this effect was transient and disappeared as drug treatment and exposure were continued for a further 15 weeks. 2. During 11-16 weeks of clomipramine treatment, self-exposure instructions yielded highly significantly more patient improvement than did anti-exposure instructions on nearly all measures of rituals and some of social adjustment. 3. Adding therapist-aided exposure (1.3 hours) to self-exposure instructions (3 hours) after 8 weeks had a barely significant transient effect of dubious clinical value, which was lost by the end of exposure (at week 23) and during follow-up assessments to week 52. We conclude that of the three therapeutic factors tested, self-exposure was the most potent; clomipramine played a limited adjuvant role, and therapist-aided exposure a marginal one.",Marks IM.; Lelliott P.; Basoglu M.; Noshirvani H.; Monteiro W.; Cohen D.; Kasvikis Y.,1988.0,,0,0,
10394,"Induction and reversal of depression, anxiety, and hostility.","Anxiety, hostility, and depression were induced and reversed by use of the Velton (1968) Mood Induction Procedure. Forty subjects were assigned randomly to one of four induction groups: Anxiety, Depression, Hostility, or Neutral. Mood states, measured by the Multiple Affect Adjective Check List (MAACL) were obtained before induction, after induction, and after reversal of moods. All mood induction treatments increased levels of all moods, but did not differentially increase a specific mood. Induced moods were reversed by using statements opposite to the induction ones. Mood induction was not correlated with previously administered Internal-External Locus of Control and Profile of Mood States questionnaires, but a high baseline MAACL score was correlated with low mood induction. Questions amenable to future research were raised.",Cairns SL.; Norton GR.,1988.0,,0,0,
10395,Client perceptions of significant events in prescriptive and exploratory periods of individual therapy.,"This study compared the impact of helpful and hindering events, as perceived by 40 clients, in two forms of psychotherapy: an exploratory, relationship-oriented therapy, and a prescriptive, cognitive/behavioural therapy. All clients received eight sessions of each type of treatment in a crossover design. Events were obtained by self-report both during and at the end of each period, and content analysed for type of therapeutic impact by three trained raters. Results showed that during treatment the most commonly occurring helpful impacts across both types of treatments were 'problem solution', 'awareness' and 'reassurance', while the most commonly occurring hindering impact was 'unwanted thoughts'. Similar impacts were reported at the end of each period, with the addition of 'personal contact'. In addition, it was found that 'problem solution' and 'reassurance' impacts were more commonly reported in prescriptive treatment, whereas 'awareness' and 'personal contact' impacts were more prevalent in exploratory treatment. Only the prevalence of 'unwanted thoughts' was correlated (negatively) with outcome. Some possible reasons for the lack of correlation between reported impacts and outcome are suggested.",Llewelyn SP.; Elliott R.; Shapiro DA.; Hardy G.; Firth-Cozens J.,1988.0,,0,0,
10396,Obsessive-compulsive beliefs and treatment outcome.,"Of 49 compulsive ritualizers one-third perceived their obsessive thoughts as a rational and felt that their rituals warded off some unwanted or feared event (the content of their obsessions). The more bizarre the obsessive belief the more strongly it was defended and 12% of cases made no attempt to resist the urge to ritualize. Neither fixity of belief nor resistance to compulsive urges were related to duration of illness. Patients with bizarre and fixed obsessive beliefs responded as well to treatment (all but three received exposure), as did patients whose obsessions were less bizarre and recognized as senseless. There was no difference in outcome between patients who initially found it hard to control their obsessions or never resisted the urge to ritualize and those who initially could control obsessions or resist rituals. One year after starting treatment, patients whose obsessions and compulsions had improved with treatment recognized their irrationality more readily and controlled their compulsive urges more easily. Beliefs appeared to normalize as a function of habituation.",Lelliott PT.; Noshirvani HF.; Başoğlu M.; Marks IM.; Monteiro WO.,1988.0,,0,0,
10397,Avoidance behaviour and major depression in panic disorder: a report from the Cross-National Collaborative Panic Study.,"Avoidance behaviour and secondary major depression are both frequent in clinical samples of patients with panic disorder. Their status is unclear: indicators of severity of panic disorder or indicators of separate psychiatric disorders. Among the data of the Cross-National Collaborative Panic Study (n = 1,168) we found that especially avoidance behaviour defines more severe states of panic disorder (earlier age at onset, higher frequency of panic attacks and higher level of psychopathology); co-occurrence of major depression is less clearly associated with more severe panic disorder. The results are compatible with the DSM-III-R concepts of comorbidity of panic disorder and major depression and of subtyping panic disorder by avoidance behaviour.",Maier W.; Rosenberg R.; Argyle N.; Buller R.; Roth M.; Brandon S.; Benkert O.,1989.0,,0,0,
10398,[The randomization problem in psychotherapy studies].,"In a research project comparing inpatient and outpatient psychotherapeutic treatment for patients suffering from anxiety disorders, 132 subjects were allocated to both treatments by means of randomisation. Because of the patients' voluntary agreement or refusal of the proposed treatment, the subsamples are markedly affected in their homogeneity. It seems that more disturbed patients agreed to inpatient psychotherapy, whereas less disturbed patients refused that form of treatment. Bias toward or against a given form of treatment turned out to be the most potent predictor in multivariate analysis. The influence of this distortion of the samples is discussed with regard to the generalisation of the results. Proposed countermeasures have their shortcomings, and in the end it seems that randomisation should be avoided in psychotherapeutic research.",Krauthauser H.; Bassler M.,1997.0,,0,0,7095
10399,The Panic Appraisal Inventory: psychometric properties.,"We examined the reliability and validity of the Panic Appraisal Inventory (PAI) in a sample of 47 outpatients with DSM-III-R panic disorder. Results showed excellent internal consistency and treatment sensitivity. We found good convergent validity; divergent validity vis-a-vis depression and social adjustment was adequate. Taken together, the current results provide good initial support for the reliability and validity of the PAI, though tests of the instrument's factorial validity, stability over time, and criterion-related validity have yet to be conducted.",Feske U.; de Beurs E.,1997.0,,0,0,
10400,Follow-up study of concentration camp survivors from Bosnia-Herzegovina: three years later.,"Concentration camp survivors from Bosnia-Herzegovina, now refugees in the Netherlands, were given early outpatient treatment for posttraumatic stress disorder (PTSD) for 6 months. They were tested with the Watson Questionnaire before entering therapy, after 6 months and 3 years later when a structured interview designed to obtain information on psychosocial status was administered. Data were analyzed with PCA-STAT 1.1 statistical package. The treatment was effective on a short-term basis with some long-term effects. Elderly people were no more vulnerable to the onset of PTSD than younger ones but were more resistant to therapy. Psychosocial factors had neither protective nor risk value for the development of PTSD in this group.",Drozdek B.,1997.0,,0,0,
10401,Effect of antipanic treatment on response to carbon dioxide.,"Disordered breathing among patients with panic disorder, including hyperventilation during attacks and increased anxiogenic response to carbon dioxide (CO2) inhalation, is well established. We wished to assess whether there is a change in the physiological response to CO2 after patients have undergone antipanic therapy with either tricyclic antidepressants or cognitive behavioral therapy (CBT). Twenty-nine patients with panic disorder underwent baseline CO2 sensitivity testing using the traditional Read rebreathing method and then received either antidepressant treatment (n = 21) or CBT (n = 8). After completing treatment, CO2 testing was repeated. A comparison sample of 14 normal volunteers also had two CO2 sensitivity tests, separated by an average of 21.6 (SD = 8.8) weeks. Using a liberal standard, in which all CO2 sensitivity tests whose correlations between minute ventilation and end-tidal CO2 were at least .75 were used, patients, but not controls, demonstrated a significant reduction in CO2 sensitivity between the first and second test. Using a more conservative .90 correlation standard reduced the sample size available and resulted in trend reduction in patients but no significant change in controls. There was a suggestion that the change was most pronounced in treatment responders, although the number of patient nonresponders is extremely small in this sample. These data indicate that treatment reduces CO2 sensitivity in patients with panic disorder. We speculate that manipulation of the serotonergic and noradrenergic neurotransmission systems, both known to play a role in the control of respiration, may have a specific effect in reducing respiratory hyperactivity in panic disorder.",Gorman JM.; Browne ST.; Papp LA.; Martinez J.; Welkowitz L.; Coplan JD.; Goetz RR.; Kent J.; Klein DF.,1997.0,,0,0,
10402,Auditory event-related potentials to tone stimuli in combat-related posttraumatic stress disorder.,"This study attempted to replicate findings of abnormal auditory event-related potentials (ERPs) in posttraumatic stress disorder (PTSD) in a sample of Vietnam combat veterans. Veterans with combat-related PTSD, divided into unmedicated (unmed-PTSD, n = 12) and medicated (med-PTSD, n = 22) groups, and veterans without PTSD (non-PTSD, n = 10) completed a three-tone ""oddball"" target detection task while ERPs were measured. Individuals with comorbid panic disorder (PD) were excluded from the primary analyses. Parietal P3 amplitude to the target tone was significantly smaller in unmed-PTSD compared to med-PTSD and non-PTSD groups. These differences did not remain significant when an adjustment was made for level of depression. Parietal P3 amplitude was also negatively correlated with state anxiety. Secondary analyses within the unmed-PTSD group indicated that participants with comorbid PD (n = 3) had the largest parietal P3 amplitudes to target tones. Results are consistent with attentional or concentration deficits in PTSD and highlight the importance of considering comorbid diagnoses. The absence of ERP differences between med-PTSD and non-PTSD participants suggests that psychotropic medication may normalize these deficits.",Metzger LJ.; Orr SP.; Lasko NB.; Pitman RK.,1997.0,,0,0,
10403,"Personality, chronic medical morbidity, and health-related quality of life among older persons.","This article examines the main and moderating effects of 3 personality characteristics on the association between chronic medical morbidity and health-related quality of life (HRQL) in a large (N = 5,279) community-based older sample. Reasonably high unique contributions of neuroticism, mastery, and self-efficacy to HRQL were found. The additional amounts of variance explained beyond and above medical morbidity and age vary from about 4% (bodily pain) to above 30% (mental health). Little empirical evidence was found for the moderating effects of personality. In conclusion, personality characteristics such as neuroticism, mastery, and self-efficacy influence the reported levels of HRQL. The extent to which this is due to an influence of personality on true versus perceived levels of HRQL is unclear.",Kempen GI.; Jelicic M.; Ormel J.,1997.0,,0,0,
10404,Prediction of outcome and early vs. late improvement in OCD patients treated with cognitive behaviour therapy and pharmacotherapy.,"In this study, follow-up results of cognitive-behaviour therapy and of a combination of cognitive-behaviour therapy with a serotonergic antidepressant were determined. The study also examined factors that can predict this treatment effect, both in the long term and in the short term. In addition, it investigated whether differential prediction is possible for cognitive-behaviour therapy vs. a combination of cognitive-behaviour therapy with a serotonergic antidepressant. A total of 99 patients were included in the study. Treatment lasted 16 weeks, and a naturalistic follow-up measurement was made 6 months later. Of the 70 patients who completed the treatment, follow-up information was available for 61 subjects. Significant time effects were found on all outcome measures at both post-treatment measurement and follow-up. No differences in efficacy were found between the treatment conditions. Effectiveness at post-treatment measurement appears to predict success at follow-up. However, 17 of the 45 non-responders at the post-treatment measurement had become responders by the follow-up. The severity of symptoms, motivation for treatment and the dimensional score on the PDQ-R for cluster A personality disorder appear to predict treatment outcome. No predictors were found that related specifically to cognitive-behaviour therapy or combined treatment. These results indicate that the effectiveness of cognitive-behaviour therapy or a combination of cognitive-behaviour therapy and fluvoxamine at the post-treatment measurement is maintained at follow-up. However, non-response at post-treatment does not always imply non-response at follow-up. Patients with more severe symptoms need a longer period of therapy to become responders. Although predictors for treatment success were found, no evidence was found to determine the choice of one of the treatment modalities.",de Haan E.; van Oppen P.; van Balkom AJ.; Spinhoven P.; Hoogduin KA.; Van Dyck R.,1997.0,,0,0,
10405,An evaluation of the effectiveness of a consultation-liaison psychiatry service in general practice.,"This study evaluated the 6-month outcome of patients referred by their general practitioner (GP) to a consultation-liaison (C-L) psychiatry service provided to eight group general practices. Over a 12-month period, there were 307 referrals to the C-L psychiatry service of whom 86 consented to take part in an outcome study. Two different control groups were examined comprising patients seen by the same GPs but not referred to the C-L service, who were matched with the C-L referrals on the basis of either demographic characteristics (n = 86) or initial symptomatology (n = 59). Clinical interviews were conducted at recruitment to the outcome study using the Composite International Diagnostic Interview (CIDI), while postal questionnaires were used at both the initial and 6-month assessments. Data reported include DSM-III-R clinical audit and CIDI diagnoses, changes in current symptomatology (SCL-90-R) and changes in global ratings of physical health, emotional health, social relationships and ability to perform everyday duties. Consultation-liaison referrals without symptom-matched controls (n = 27), being patients with higher levels of symptoms initially, were more likely to be referred to other psychiatric services for treatment. They also showed more marked improvement over time on the selected outcome measures. However, there were no significant differences in the patterns of change over time between symptom-matched C-L referrals and their non-referred controls. The findings from the 6-month outcome study raise doubts about the overall benefit of the current C-L service relative to usual GP care. Improving the quality of psychiatric care in general practice is likely to require a range of interrelated strategies, including C-L psychiatry services, GP education and well-functioning links with public mental health services.",Carr VJ.; Lewin TJ.; Reid AL.; Walton JM.; Faehrmann C.,1997.0,10.3109/00048679709062685,0,0,
10406,Personality disorders do not influence the results of cognitive and behavior therapy for obsessive compulsive disorder.,"This study examined whether categorical or dimensional personality disorder variables affected treatment outcome in a sample of 52 patients with obsessive compulsive disorder who followed a standardized cognitive behavior therapy program. Treatment consisted of 12 weekly sessions and was completed by 43 patients. The Structured Clinical Interview for DSM-III-R personality disorders (SCID-II) was taken before the start of treatment by an independent rater. The treatment outcome measures included questionnaires and a Behavioral Assessment Test. Measurements were taken before and after treatment, and at 1 and 6 month follow-up tests. After the first follow-up test, further treatment was provided if clinically indicated. Neither categorical, nor dimensional personality disorder variables affected treatment outcome significantly. The inclusion of drop-outs in the analyses, did not change these results. Therefore, patients with obsessive compulsive disorder and concomitant personality disorder pathology should not be excluded from cognitive or behavior therapy for their obsessive compulsive complaints. Attributing therapy failure to concomitant Axis II pathology should be approached with caution.",Dreessen L.; Hoekstra R.; Arntz A.,,,0,0,6275
10407,The effects of anxiety and distraction on sexual arousal in a nonclinical sample of heterosexual women.,"The effects of anxiety and distraction on sexual arousal in a nonclinical sample of heterosexual women between the ages of 19 and 35 were studied. Using a dichotic listening paradigm, the study extended Geer and Fuhr's (1976) research by examining the effects of distraction on sexual arousal in women. Results indicated that both vaginal pulse amplitude and subjective measures of sexual arousal vary as a function of distraction level, with increased distraction leading to decreased arousal. However, the data failed to support Masters and Johnson's (1970) assertion that anxiety decreases sexual arousal. Although no significant effect for anxiety emerged using a physiological measure of sexual arousal, a significant Anxiety x Distraction interaction was observed using a subjective measure of sexual arousal. Several competing interpretations of this interaction are discussed.",Elliott AN.; O'Donohue WT.,1997.0,,0,0,
10408,Sleep deprivation in panic disorder and obsessive-compulsive disorder.,,Labbate LA.; Johnson MR.; Lydiard RB.; Brawman-Mintzer O.; Emmanuel N.; Crawford M.; Kapp R.; Ballenger JC.,1997.0,10.1177/070674379704200918,0,0,
10409,Pretreatment attrition in a comparative treatment outcome study on panic disorder.,"Whereas the fact of attrition during the course of treatment is well documented, little is known about the factors that affect sample selection before the beginning of a study (""pretreatment attrition""). The present study reports on the degree and sources of pretreatment attrition at two sites of a multicenter study on panic disorder that compared treatment outcomes for imipramine and cognitive behavior therapy. Data were collected at two clinical research sites, one with a pharmacological treatment orientation (N = 420) and one with a psychosocial treatment orientation (N = 208). The main source of pretreatment attrition was participant refusal. At both research sites, eligible patients most often refused participation because they were either unwilling to start treatment with imipramine (30.6% and 47.4%, respectively) or discontinue their current medication (22.6% and 35.1%, respectively). Results from comparative treatment outcome studies are limited not only to people who meet the study criteria but also to those who are willing to begin a medication treatment and discontinue their current medication.",Hofmann SG.; Barlow DH.; Papp LA.; Detweiler MF.; Ray SE.; Shear MK.; Woods SW.; Gorman JM.,1998.0,10.1176/ajp.155.1.43,0,0,
10410,Possible role of sweating in the pathophysiology of panic attacks.,"In recent years the role of hyperventilation in the generation of panic attacks has attracted a considerable amount of interest. According to these studies hyperventilation can elicit the somatic symptoms of panic due to systemic alkalosis. We suggest that since in the case of panic, sweating might cause alkalosis, it could also contribute to the generation of panic attacks. In light of this hypothesis we made a statistical analysis of the panic symptoms of 111 panic patients diagnosed according to DSM-III criteria. The analysis revealed that: (1) there was a well identified group of panic patients who had minor breathing difficulties with heavy sweating; and (2) that all the patients sampled had either severe breathing, or sweating symptoms, or both. We conclude that in the absence of the intensive physical activity of the 'flight or fight' reaction, sweating as well as hyperventilation can cause alkalosis, which in turn might generate panic attacks.",Janszky I.; Szedmák S.; Istók R.; Kopp M.,1997.0,,0,0,
10411,Traumatic onset of temporomandibular disorders: positive effects of a standardized conservative treatment program.,"To compare presenting problems and response to treatment of chronic temporomandibular (TMD) patients who perceive the onset of their symptoms to be related to trauma with those who report symptoms of unknown origin. Prospective treatment outcome study. Outpatient multidisciplinary pain treatment center at a university medical center. A total of 361 were evaluated initially, including 103 who perceived traumatic onset of symptoms and 258 who did not perceive onset to be related to trauma. Two hundred thirty-three (59 trauma and 174 nontrauma) returned for follow-up evaluation 6 months after the conclusion of treatment. Standardized six-session treatment program consisting of intraoral appliance, biofeedback, and stress management training. Clinical changes in muscle pain, temporomandibular joint pain, and mandibular opening. Self-report of change in perceived pain severity (MPQ--short form), depressive symptoms (BDI), catastrophizing about pain (CSQ--catastrophizing scale), MPI--interference scale, oral parafunctional habits, global evaluation of improvement, and use of pain medications at follow-up. Regression of onset type on pretreatment variables indicated that a small but statistically significant proportion of pretreatment variability (8.7%) could be accounted for by onset. Both traumatic and nontraumatic onset groups showed positive outcomes following treatment. No significant differences between groups were found for any of the clinical or self-reported outcome measures with the exception that a significantly higher percentage of the trauma group reported using pain medication at follow-up. These findings are in contrast with previous suggestions that post-traumatic TMD patients show poorer response to treatment than nontrauma TMD patients.",Greco CM.; Rudy TE.; Turk DC.; Herlich A.; Zaki HH.,1997.0,,0,0,
10412,Cocaine dependence with and without PTSD among subjects in the National Institute on Drug Abuse Collaborative Cocaine Treatment Study.,"This study examined the prevalence of lifetime traumatic events and current symptoms of posttraumatic stress disorder (PTSD) among treatment-seeking cocaine-dependent outpatients and compared patients with and without PTSD on current substance use, psychopathology, and sociodemographic characteristics. The subjects were 122 adult cocaine-dependent outpatients participating in a treatment outcome study of psychosocial therapy. In addition to standard self-report and interview measures of psychopathology and substance use, the subjects completed the Trauma History Questionnaire and the PTSD Checklist before entering treatment. These patients experienced a large number of lifetime traumatic events (mean = 5.7); men experienced more general disasters and crime-related traumas than women, and women experienced more physical and sexual abuse than men. According to self-report measures, 20.5% of the subjects currently met the DSM-III-R criteria for PTSD; the rate of PTSD was 30.2% among women and 15.2% among men. Patients with PTSD had significantly higher rates of co-occurring axis I and axis II disorders, interpersonal problems, medical problems, resistance to treatment, and psychopathology symptoms than patients without PTSD. Psychopathology symptoms represented the most consistent difference between the two groups and provided the best prediction of PTSD status in a logistic regression. However, the groups did not differ significantly in current substance use or sociodemographic characteristics. These findings underscore the value of screening substance abusers for PTSD, because it can identify a small but substantial number who might require additional treatment. Further studies of the relationship between PTSD and substance abuse appear warranted.",Najavits LM.; Gastfriend DR.; Barber JP.; Reif S.; Muenz LR.; Blaine J.; Frank A.; Crits-Christoph P.; Thase M.; Weiss RD.,1998.0,10.1176/ajp.155.2.214,0,0,
10413,Measurement of dissociative states with the Clinician-Administered Dissociative States Scale (CADSS).,"The purpose of this study was to develop an instrument for the measurement of present-state dissociative symptoms, the Clinician Administered Dissociative States Scale (CADSS). Reported here are interrater reliability and internal consistency of the CADSS, validity as assessed by comparisons with other instruments for the assessment of dissociation, and sensitivity of the CADSS to discriminate patients with dissociative disorders from patients with other psychiatric disorders and healthy subjects. Initial analyses indicated good interrater reliability and construct validity for the CADSS. Scores on the CADSS discriminated patients with dissociative disorders from the other groups.",Bremner JD.; Krystal JH.; Putnam FW.; Southwick SM.; Marmar C.; Charney DS.; Mazure CM.,1998.0,10.1023/A:1024465317902,0,0,
10414,Convergent validity of three posttraumatic symptoms inventories among adult sexual abuse survivors.,"We examined the convergent validity of three posttraumatic symptoms inventories, the civilian version of the Mississippi Scale for Combat-Related PTSD (CM-PTSD), the Trauma Symptom Checklist-40 (TSC-40), and the Response to Childhood Incest Questionnaire (RCIQ), in a sample of 52 adult sexual abuse survivors. The significant and moderate to strong correlations (r = .6 or higher) among these inventories supported their convergent validity. Comparison with other studies also suggests that these instruments can adequately discriminate clinical from nonclinical populations.",Gold JW.; Cardeña E.,1998.0,10.1023/A:1024425603790,0,0,
10415,[Psychiatric disorders after political imprisonment in the Soviet occupation zone and in the GDR from 1945-1972].,"In an exploratory study, 54 persons, were examined who were imprisoned--for at least six months--for political reasons first in the Soviet Occupation Zone and/or later in the German Democratic Republic (East Germany) between 1945 and 1972. Conditions of imprisonment included means that may be classified as psychological torture. Biographical data, experiences of imprisonment, factors helpful for coping, and influence of imprisonment on the persons' life were investigated in a semistructured interview. Symptoms were self-rated on a combined form of the von Zerssen Complaints List, psychiatric disorders were assessed in the computerised WHO composite International Diagnostic Interview. In 29 persons no psychiatric disorder was diagnosed. In 25 persons mostly anxiety disorders and depressive disorders were found. 21 of the latter reported that the onset of symptoms was during imprisonment or within a one-year period following it. Many persons had some symptoms of post traumatic stress disorder while only one fulfilled all criteria for diagnosing it. Only a few variables were significantly correlated with the severity of self-rated symptoms or with the existence of a psychiatric disorder. The shared variance was limited. Former prisoners with a better vocational integration had less often a psychiatric disorder and fewer symptoms. When interviewes stated some positive implications of imprisonment for their life thereafter and when they had more social contacts, this was also associated with a lower severity of self-rated symptoms.",Denis D.; Eslam J.; Priebe S.,1997.0,10.1055/s-2007-996359,0,0,
10416,Predictors of acute stress following mild traumatic brain injury.,"The aim of this study was to investigate the predictors of acute stress disorder (ASD) following mild traumatic brain injury (MTBI). Patients who sustained MTBI following a motor vehicle accident (n = 48) were assessed with a structured interview within 18 days of the trauma for the presence of ASD and administered the Beck Depression Inventory (BDI), Coping Style Questionnaire, Dissociative Experiences Scale, and the Eysenck Personality Inventory. ASD was diagnosed in 14.6% of patients and 4.2% were diagnosed with sub-syndromal ASD. BDI scores and avoidant coping were significant predictors of ASD and acute stress severity. This study provides further evidence that traumatic stress reactions occur following MTBI and highlights the possibility of identifying those who may benefit from early intervention.",Harvey AG.; Bryant RA.,1998.0,,0,0,
10417,Bipolar disorder in adult patients with Tourette's syndrome: a clinical study.,"Although recent clinical and epidemiological studies indicate that Tourette's syndrome (TS) is associated with a higher than expected rate of bipolar disorder (BPD), the clinical characteristics of BPD in patients with TS have not been widely investigated. Thirty adult TS patients with comorbid BPD were selected from a consecutive series of 90 referred TS patients and examined using structured psychiatric rating scales. The full clinical spectrum of BPD was found, including bipolar I disorder, schizoaffective bipolar disorder, bipolar II disorder, and cyclothymic disorder. Atypical vegetative depressive symptoms, rapid cycling patterns, and seasonal patterns of recurrence were also documented. In the present clinical sample, BPD mainly occurred in patients with mild tic symptoms and was invariably associated with a high lifetime prevalence of general psychopathology, including generalized anxiety disorder, obsessive-compulsive disorder, panic, phobias, eating disorders, self-injurious behavior, attention-deficit hyperactivity disorder, impulse control disorders, and personality disorders. The results of this clinical study indicate that BPD and nonaffective psychopathology may be prominent comorbid disorders in a subpopulation of patients with TS.",Berthier ML.; Kulisevsky J.; Campos VM.,1998.0,,0,0,
10418,Neuropsychological performance in body dysmorphic disorder.,"Fourteen patients with body dysmorphic disorder (BDD) were assessed with neuropsychological measures, including tests of executive, mnestic, and motor functions. Performance in these patients was compared to 10 patients with obsessive-compulsive disorder (OCD), 14 patients with schizophrenia, and 24 normal controls. Findings indicated normal performance of the BDD group on measures of mnestic and motor function, but poor performance of this group on tests of executive function (p < .05). The overall performance of the BDD and OCD groups on the neuropsychological measures was similar, while the schizophrenic groups showed a wider spectrum of neuropsychological deficits to these groups. These findings are discussed in terms of current theories of executive functions and the possible relationship between BDD and OCD.",Hanes KR.,1998.0,,0,0,
10419,Retrograde memory deficits in severe closed-head injury patients.,"A battery of tests evaluating different aspects of retrograde memory (autobiographical, public events, semantic knowledge) was administered to a group of 20 patients who had suffered from a severe closed-head injury (CHI) and who had recovered from the post-traumatic amnesia period and to a group of sex-, age- and education-matched normal controls. Results document a high prevalence of retrograde memory deficits among CHI individuals. The deficit involves both autobiographical and public events memories and extends to early acquired basic and cultural knowledge. The severity of the deficit does not vary according to some kind of temporal gradient or according to a presumed hierarchical or modality organization of the semantic system. However, in the domain of basic knowledge it more severely affects information pertaining to living than nonliving categories of objects. With the exception of a more severe deficit in retrieving autobiographical events occurred in the last year before trauma in a subgroup of patients with focal lesions restricted to the right hemisphere as compared to left lesioned patients, no clear relationship emerges between severity of the retrograde memory deficit and locus of focal cerebral lesions as demonstrated by neuroradiological exams.",Carlesimo GA.; Sabbadini M.; Bombardi P.; Di Porto E.; Loasses A.; Caltagirone C.,1998.0,,0,0,
10420,[Clinical effects of supplemental enteral nutrition solution in severe polytrauma].,"Previous studies in critically ill patients have shown the beneficial effects of early enteral nutrition supplemented with arginine, omega-3 fatty acids and nucleotides (Impact) on immunological response, infection rate and length of stay in hospital. No specific data exist for patients with severe multiple injury, who represent a high risk group for systemic inflammatory response syndrome (SIRS), septic complications and multiple organ failure (MOF). In this prospective, randomized, double-blind controlled clinical study on patients after severe trauma (ISS ca. 40) the primary study endpoints were incidence of SIRS and MOF [definitions according to Am Soc Crit Care Med (5) and Goris (23), Sauaia (43)]. Thirty-two patients enrolled in the study, and 29 were eligible for analysis: test (Impact) (n = 16), control (n = 13). Both groups were comparable according to age, body mass index and severity of trauma (PTS-test: 38.8 +/- 12.5, PTS-control: 40.8 +/- 15.5, ISS-test: 39.6 +/- 11.4, ISS-control: 40.5 +/- 9.2). Patients were randomized to receive either Impact (test) or an isonitrogenous isocaloric diet (control). Feeding was started on the 2nd day after trauma via endoscopically placed nasoduodenal or jejunal feeding tubes. The experimental diet was safe and well tolerated. During the 1st week the enteral feeding amount was about 2000 ml without significant difference. Test-fed patients developed SIRS significantly less frequently between day 1 and day 28 (8 vs 13.3; P < 0.05) and especially between day 8 and day 14 (3 vs 6.2; P < 0.001). In the control group the Goris score was significantly worse (P < 0.05) on days 3, 4, 6, 7, 10, 11, 16 and 17 and the Sauaia score on days 8, 9, 10 and 11 (P < 0.05; P < 0.01). Mortality rate did not significantly differ (test 2/16, control 4/13), nor did length of ICU or hospital stay. With regard to the acute-phase response, C-reactive protein was significantly lower on day 4 in the test group (test: 131 +/- 67 mg/l, control: 221 +/- 110 mg/l) as was fibrinogen on day 12 (6.6 +/- 1.4 vs 7.5 +/- 1.4 g/l) and day 14 (7.1 +/- 1.3 vs 7.8 +/- 0.8 g/l). No significant difference could be observed for CD4/CD8 ratio, CD45 isotope on activated T-cells and lymphocytic interleukin (II)-2-receptor- and II-6 level. However, HLA-DR antigen presentation on peripheral monocytes was significantly elevated on day 7 in the test group (P < 0.05). According to the results, arginine, omega-3 fatty acids and nucleotides-enriched diet during early enteral feeding leads to reduction of SIRS after severe multiple injury. There is evidence for improvement of post-traumatic immunological response which helps to overcome the immunological depression after trauma.",Bastian L.; Weimann A.; Bischoff W.; Meier PN.; Grotz M.; Stan C.; Regel G.,1998.0,,0,0,6035
10421,"The role of self-directed in vivo exposure in combination with cognitive therapy, relaxation training, or therapist-assisted exposure in the treatment of panic disorder with agoraphobia.","The effects of self-directed in vivo exposure in the treatment of panic disorder with agoraphobia were examined. Seventy-four chronic and severe agoraphobic subjects were randomly assigned to Cognitive Therapy plus graded exposure. Relaxation Training plus graded exposure, or therapist-assisted graded exposure alone. Treatment consisted of 16 weekly 2.5-hour sessions. All subjects received programmed practice instructions for engaging in self-directed exposure as a concomitant strategy to their primary treatment. All subjects were instructed to keep systematic behavioral diary recordings of all self-directed exposure practice. The diary data were analyzed across and within treatments and assessment phases. Statistically significant findings were obtained across all diary measure domains with powerful repeated measures effects observed across all treatments. Significant between group effects and treatment x repeated measures interactions were obtained across the diary measure domains. Multiple linear regressions of in vivo anxiety levels and, to a lesser extent, frequency of self-directed exposure practice were found to be significantly associated with global assessment of severity at posttreatment and 3-month follow-up assessments. Furthermore, depression and marital satisfaction were significantly associated with in vivo anxiety. These and other findings are discussed with regard to their conceptual and clinical implications.",Murphy MT.; Michelson LK.; Marchione K.; Marchione N.; Testa S.,,,0,0,7310
10422,Traumatic brain injury and posttraumatic stress disorder: a preliminary investigation of neuropsychological test results in PTSD secondary to motor vehicle accidents.,This study investigated the effect of traumatic brain injury on the development of posttraumatic stress disorder (PTSD). Subjects were 107 motor vehicle accident survivors including 38 individuals who were diagnosed with posttraumatic stress disorder (PTSD). Neuropsychological testing was administered to all subjects during an initial diagnostic evaluation. Results showed that subjects who had lost consciousness during their MVA had greater impairment on speed dependent tests and delayed recall of verbal material. Subjects who suffered traumatic brain injury (TBI) were also found to have developed PTSD as often as those who had not reported TBI. Implications for future research and clinical utility are discussed.,Hickling EJ.; Gillen R.; Blanchard EB.; Buckley T.; Taylor A.,1998.0,,0,0,
10423,Well-being therapy. A novel psychotherapeutic approach for residual symptoms of affective disorders.,"There is increasing awareness of the prognostic value of residual symptomatology in affective disorders and of the need for specific therapeutic strategies in this phase of illness. The aims of the study were to apply a novel, short-term psychotherapeutic approach for increasing well-being, based on Ryff's conceptual model, to remitted patients with affective disorders and to compare the results with those obtained with symptom-oriented cognitive behavioural strategies. Twenty patients with affective disorders (major depression, panic disorder with agoraphobia, social phobia, generalized anxiety disorder, obsessive-compulsive disorder) who had been successfully treated by behavioural or pharmacological methods were randomly assigned to a well-being enhancing therapeutic strategy (well-being therapy) or cognitive-behavioural treatment of residual symptoms. Both well-being and cognitive-behavioural therapies were associated with a significant reduction of residual symptoms. However, a significant advantage of well-being therapy over cognitive-behavioural strategies was observed with observer-rated methods. These preliminary results suggest the feasibility of well-being therapy in the residual stage of affective disorders. Further research should determine its value as a relapse-preventive strategy in specific mood and anxiety disorders.",Fava GA.; Rafanelli C.; Cazzaro M.; Conti S.; Grandi S.,1998.0,,0,0,
10424,Facial EMG responses to combat-related visual stimuli in veterans with and without posttraumatic stress disorder.,"Veterans with (n = 10) and without (n = 10) posttraumatic stress disorder (PTSD) participated in an exploratory study of facial reactivity to neutral slides and to slides depicting unpleasant combat-related material that were previously determined to be emotionally evocative. It was found that the zygomaticus major (cheek), masseter (jaw), and lateral frontalis (forehead) muscles were especially reactive to the combat slides in the veterans with PTSD, suggesting the importance of facial emotional expression in this disorder. The PTSD participants' self-reports of overall distress paralleled these effects. However, autonomic reactivity did not reflect general arousal effects due to the visual stimuli, showing both the sensitivity of facial muscle assessment in this context and the need for further research on the relationship between stimulus modality and physiological trauma reactions. Additional directions for research in this area are discussed including efforts to correlate subjective and physiological reactions.",Carlson JG.; Singelis TM.; Chemtob CM.,1997.0,,0,0,
10425,[Late results of the Harrington treatment method for posttraumatic injuries of the thoracic and lumbar spine].,"At Stołeczne Centrum Rehabilitacji Harrington method along with Weiss spring alloplasty has been introduced for fractured spine stabilization in the early seventies. A modified Bacal-Wierusz (BW) distractor has been mainly used to stabilize the spine after trauma related fracture. The paper presents neurological and radiological results of Harrington method used within thoracic and lumbar spine in 86 patients between 1973 and 1993. There were 36 cases of plegia, 44 paretic patients and 6 cases with no neurological impairment. Thoraco-lumbar spine has been involved in 66% and lumbar spine in 17%. Mean follow-up was 6 years. Loss of the correction achieved at the surgery has been determined after analysis of the final radiographs. In radiological evaluation 66% results were rated good. Neurological improvement occurred in 37% and remarkable improvement in 16% of cases. The authors believe Harrington method does not provide good, triplanar stabilization for the spine.",Krasuski M.; Kiwerski JE.,1998.0,,0,0,
10426,Interpersonal consequences of the pursuit of safety.,"Socially anxious (N = 41) and non-anxious (N = 41) individuals participated in a getting acquainted situation that was based on the reciprocity self-disclosure paradigm. Subjects' appraisals of the situation were manipulated to be either positive or negative by highlighting the likelihood of positive or negative social outcomes. Subjects' social goals and use of safety behaviors were assessed, as were others' reaction to the subjects. As predicted, socially anxious individuals elicited significantly more negative responses from others in the negative appraisal condition, where they employed safety behaviors, than in the positive appraisal condition, where they did not. The results supported a cognitive model of social anxiety, rather than alternative explanations.",Alden LE.; Bieling P.,1998.0,,0,0,
10427,Self-treatment for obsessive compulsive disorder using a manual and a computerized telephone interview: a U.S.-U.K. study.,"Bt steps is a patient-centered behavioral therapy program that uses a manual and a computer-driven interactive voice response system to assess and treat obsessive compulsive disorder. This nine-step program contains a self-assessment module and a self-treatment module that provides teaching on exposure and ritual prevention. The patient reads about the steps in a manual and then uses a touch-tone telephone to contact the program, in which a recorded voice conducts the interview. Of 40 patients in an open 12-week trial in the United States and London, 35 completed the self-assessment module, and 17 completed at least two sessions of exposure and ritual prevention. The system produced statistically significant improvements on measures of obsessive compulsive disorder.",Greist JH.; Marks IM.; Baer L.; Parkin JR.; Manzo PA.; Mantle JM.; Wenzel KW.; Spierings CJ.; Kobak KA.; Dottl SL.; Bailey TM.; Forman L.,,,0,0,
10428,Does the SCL 90-R obsessive-compulsive dimension identify cognitive impairments?,"To investigate the relevance of the Symptom Checklist 90-R Obsessive-Compulsive subscale to cognition in individuals with brain tumor. A prospective study of patients assessed with a neuropsychological test battery. A university medical center. Nineteen adults with biopsy-confirmed diagnoses of malignant brain tumors were assessed prior to aggressive chemotherapy. Included in the assessment were the Mattis Dementia Rating Scale, California Verbal Learning Test, Trail Making Test B, Symptom Checklist 90-R, Mood Assessment Scale, Beck Anxiety Inventory, and Chronic Illness Problem Inventory. The SCL 90-R Obsessive-Compulsive subscale was not related to objective measures of attention, verbal memory, or age. It was related significantly to symptoms of depression (r = .81, P < .005), anxiety (r = .66, P < .005), and subjective complaints of memory problems (r = .75, P < .005). Multivariate analyses indicated that reported symptoms of depression contributed 66% of the variance in predicting SCL 90-R Obsessive-Compulsive Scores, whereas symptoms of anxiety contributed an additional 6% (P < .0001). Our data suggest that the SCL 90-R is best viewed as an indicator of unidimensional emotional distress and somatic effects of structural brain injury.",Kaplan CP.; Miner ME.,1998.0,,0,0,
10429,A randomized controlled trial and economic evaluation of counselling in primary care.,"Counselling in primary care settings remains largely unevaluated. Such evaluation has been strongly recommended. To determine the relative effectiveness and cost-effectiveness of generic counselling and usual general practitioner (GP) care for patients with minor mental health problems. A randomized controlled trial and health economic evaluation were carried out in nine general practices. Access to generic counselling (brief counselling, generally involving up to six 50-minute sessions) was compared with usual GP care. A total of 162 patients aged 16 years and over with diverse mental health problems (excluding phobic conditions and psychoses) were randomized. The Hospital Anxiety and Depression (HAD) scale, COOP/WONCA (World Organization of Family Doctors) functional health assessment charts, and the delighted-terrible faces scale were used to assess outcome four months after randomization. The two groups were similar at baseline. There were significant improvements in both groups between randomization and follow-up for most outcome measures, but no significant differences between the study arms. The 95% confidence limits were narrow and excluded clinically significant effects. Under various assumptions concerning the cost of secondary care referrals and of counselling time, no clear cost advantage was associated with either intervention. This pragmatic trial demonstrates no difference in functional or mental health outcome at four months between subjects offered access to counselling and those given usual care by their GP. There is no clear difference in the cost-effectiveness of the two interventions. Purchasers should take account of these findings in allocating resources within primary care.",Harvey I.; Nelson SJ.; Lyons RA.; Unwin C.; Monaghan S.; Peters TJ.,1998.0,,0,0,
10430,[Brief psychotherapy versus general practice management--on the efficacy of treatment and patient satisfaction].,,Götzmann L.,1998.0,,0,0,6608
10431,Prediction of recovery from post-traumatic vegetative state with cerebral magnetic-resonance imaging.,"The early post-traumatic vegetative state (VS) is compatible with recovery. Various clinical and laboratory tests have failed to predict recovery so we assessed the value of cerebral magnetic-resonance imaging (MRI) in prediction of recovery. 80 adult patients in post-traumatic VS had cerebral MRI between 6 weeks and 8 weeks after injury. MRIs were reviewed by three neuroradiologists for the number, sizes, and location of brain lesions. Three neurologists assessed the patients at the time of MRI and at 2 months, 3 months, 6 months, 9 months, and 12 months after injury using the Glasgow Outcome Scale. At 12 months, 38 patients had recovered while 42 patients remained in the VS. The demographic characteristics and causes and severity of injury were similar in patients in persistent VS (PVS) and those who recovered (NPVS). An average of 6.1 different brain areas were injured in patients in PVS compared with 4.6 areas in patients who had NPVS. Patients in PVS revealed a significantly higher frequency of corpus callosum, corona radiata, and dorsolateral brainstem injuries than did patients who recovered. Logistic regression analysis showed that corpus callosum and dorsolateral brainstem injuries were predictive of non-recovery. The adjusted odds ratios for non-recovery of patients with a corpus callosum lesion and dorsolateral brainstem injury were 213.8 (95% CI 14.2-3213.3), and 6.9 (11-42.9), respectively. In contrast, clinical characteristics, such as initial score on the Glasgow Coma Scale, age, and pupillary abnormalities failed to predict recovery. Cerebral MRI findings in the subacute stage after head injury can predict the outcome of the post-traumatic VS. Corpus callosum and dorsolateral brainstem lesions are highly significant in predicting non-recovery.",Kampfl A.; Schmutzhard E.; Franz G.; Pfausler B.; Haring HP.; Ulmer H.; Felber S.; Golaszewski S.; Aichner F.,1998.0,10.1016/S0140-6736(97)10301-4,0,0,
10432,Successful treatment of facial blushing by endoscopic transthoracic sympathicotomy.,"Facial blushing is one of the cardinal symptoms of social phobia and has a strong negative impact on the quality of life. Traditional therapeutic options are psychotherapy and pharmacological treatment. The results of these treatments on facial blushing are poorly documented. To investigate whether endoscopic bilateral transection of the upper thoracic sympathetic chain is efficient in the treatment of facial blushing, 244 consecutive patients were treated with bilateral endoscopic transthoracic sympathicotomy (ETS). The results were evaluated by questionnaire and symptoms assessed with visual analogue scales (0-10). There was no mortality nor conversion to open surgery. No Horner's syndrome occurred. Two patients with postoperative pneumothorax were treated with intercostal drainage and one small pulmonary embolus was detected. The questionnaire was answered by 219 patients (90%) a mean (+/- SEM) of 8 months (+/- 9 days) after surgery. Facial blushing (mean +/- SEM) was reduced from 8.7 +/- 0.1 to 2.2 +/- 0.2, P < 0.0001, by the operation. Heart palpitations in stressful situations were also reduced (3.7 +/- 0.3 to 1.3 +/- 0.1, P < 0.0001). The quality of life was substantially improved. The main side-effect was redistribution of sweating from the upper to the lower part of the body. Increased sweating of the trunk occurred in 75% of the patients. Overall, 85% of the patients were satisfied with the result and 15% were to some degree dissatisfied, mainly due to insufficient effect, but only four patients (2%) regretted the operation. As this is an open study, the results must be viewed with caution. ETS, however, appears to be an efficient, safe and minimally invasive surgical method for the treatment of facial blushing.",Drott C.; Claes G.; Olsson-Rex L.; Dalman P.; Fahlén T.; Göthberg G.,1998.0,,0,0,
10433,No superior perception of hyperventilatory sensations in panic disorder.,It has been argued that panic disorder patients may be more skilled at detecting changes in actual physiology than others. The present study investigated if panic patients are better than controls in perceiving sensations produced by light hyperventilation. Twelve panic patients and 28 control subjects underwent a procedure in which they were exposed 12 times to 1 min of light hyperventilation or 1 min of 'placebo' hyperventilation (isocapnia). Differences in sensations reported during real hyperventilation were compared to sensations reported during 'placebo' hyperventilation. Results demonstrated an absence of superior perception of hyperventilatory sensations in panic patients.,Kroeze S.; van den Hout MA.,1998.0,,0,0,
10434,Recognition bias for safe faces in panic disorder with agoraphobia.,"Panic patients with agoraphobia were compared with normal controls on tasks of face recognition. The subjects were presented with 20 photos, and were required to make a judgement of the persons on the photos; shortly afterwards they were unexpectedly presented with a recognition task. In the first study, one task was to judge whether the persons on the photos were critical or accepting: unlike social phobics (Lundh and Ost, 1996b, Behaviour Research and Therapy, 34, 787-794), panic patients showed no bias for critical vs accepting faces on the recognition task. In a secondary study, the task was to judge whether the persons on the photos were 'safe' or 'unsafe', i.e. whether they could be relied on if the subject would need help in some situation. The results showed a recognition bias for safe vs neutral faces in panic patients. The index of recognition bias for safe faces correlated with avoidance of feared situations when accompanied by others, as measured by the Mobility Inventory. The possibility that memory bias in emotional disorders is a function of basic concern, or functional importance, rather than positive/negative valence is discussed. The results are also discussed in terms of degree of elaboration, exposure duration of the stimuli, and the generality of the findings.",Lundh LG.; Thulin U.; Czyzykow S.; Ost LG.,1998.0,,0,0,
10435,Effect of transcranial magnetic stimulation in posttraumatic stress disorder: a preliminary study.,"Transcranial magnetic stimulation (TMS) has become, over the last few years, a promising avenue for new research in affective disorders. In this study we have evaluated the clinical effect of slow TMS on posttraumatic stress disorder (PTSD) symptoms. Ten PTSD patients were given one session of slow TMS with 30 pulses of 1 m/sec each, 15 to each side of the motor cortex. Symptoms of PTSD were assessed by using three psychological assessment scales, at four different time points. In this first, pilot, open study, TMS was found to be effective in lowering the core symptoms of PTSD: avoidance (as measured by the Impact of Event Scale), anxiety, and somatization (as measured by the Symptom Check List-90). A general clinical improvement was found (as measured by the Clinical Global Impression scale); however, the effect was rather short and transient. The present study showed TMS to be a safe and tolerable intervention with possibly indications of therapeutic efficacy for PTSD patients.",Grisaru N.; Amir M.; Cohen H.; Kaplan Z.,1998.0,,0,0,
10436,[Development of the AMDP module for identification of obsessive- compulsive symptoms. Conceptualization and empirical results].,"Results of epidemiology and comorbidity studies have recently demonstrated the psychopathological relevance of obsessive-compulsive symptoms. Therefore the ""Arbeitsgemeinschaft für Methodik und Diagnostik in der Psychiatrie"" (AMDP) has started to develop a rating scale for a quick and precise assessment of obsessive-compulsive symptoms. The actual version of the scale comprises 20 items on the dimensions ""description"", ""distress and impairment"" and ""emotion and cognition"". The results of a first empirical study (n = 137, psychiatric in- and outpatients) demonstrated excellent internal consistency (Cronbach's alpha = 0.92), a split-half reliability of 0.89 (Spearman-Brown), a test-retest reliability of r = 0.86 and good convergent validity with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Hamburger Zwangsinventar (HZI). The factor-analytical distribution of the 20 items revealed a 4-factor structure of the scale. The results are presented and their implications on further steps of the development of the scale are discussed.",Grabe HJ.; Hartschen V.; Welter-Werner E.; Thiel A.; Freyberger HJ.; Kathmann N.; Boerner R.; Hoff P.,1998.0,10.1055/s-2007-995256,0,0,
10437,Computer-administered rating scales for social anxiety in a clinical drug trial.,"Computer-administered versions of two clinician-administered symptom rating scales for social anxiety (the Liebowitz Social Anxiety Scale [LSAS] and the Brief Social Phobia Scale [BSPS]) and one paper-and-pencil scale (the Fear Questionnaire) were developed and utilized in a clinical trial for social phobia. The reliability and validity of the computer versions were examined, as were their equivalence to the traditional versions. Correlations between the computer and original versions were high at baseline, and remained high throughout the study. The internal consistency reliability of the computer scales was also high, and almost identical to the original versions. Mean score differences between computer and original versions were not significant at baseline, and no significant differences were found between computer and traditional versions on the amount of change detected from baseline to endpoint. Seventy-seven percent of subjects felt that the computer did not interfere with their visit at baseline and a plurality (36%) preferred the computer, with 30% preferring the clinician and 34% having no preference. By the end of the study, the plurality (41%) had no preference, with 27% preferring the computer and 32% preferring the clinician. Results support the use of these computer-administered symptom rating scales of social anxiety as a viable alternative to the clinician-administered versions with this subset of patients, which should offer researchers and clinicians a reliable and cost-effective method for evaluating social phobia.",Kobak KA.; Schaettle SC.; Greist JH.; Jefferson JW.; Katzelnick DJ.; Dottl SL.,1998.0,,0,0,
10438,Simple phobia as a comorbid anxiety disorder.,"This study sought to describe clinical and demographic characteristics differentiating patients with DSM-III-R simple phobias comorbid with one or more of five DSM-III-R index anxiety disorders as compared with those with the index diagnoses alone. From 711 subjects participating in a multicenter, longitudinal, naturalistic study of anxiety disorders, 115 subjects with comorbid simple phobias were compared with 596 subjects without simple phobias in terms of demographic data, comorbidity with other disorders, somatic and psychosocial treatment received, and quality of life. In addition, episode characteristics, types of simple phobias found, and course of illness were specified. Subjects with simple phobias had more additional comorbid anxiety disorders by history than did those without. Mean length of intake episode was 22.43 years and severity was typically moderate. Fears of heights and animals were the most commonly represented simple phobias. Subjects with uncomplicated panic disorder were less likely to have comorbid simple phobias than were subjects with other index diagnoses, and subjects with simple phobia were more likely to have comorbid posttraumatic stress disorder than were these without simple phobia. Subjects with and without simple phobias did not differ by somatic or psychosocial treatment received or in terms of quality of life. Simple phobia appeared in this study to be a chronic illness of moderate severity for which behavioral treatment methods of recognized efficacy were not being frequently utilized. Uncomplicated panic disorder may reflect some type of resistance to phobia development.",Goisman RM.; Allsworth J.; Rogers MP.; Warshaw MG.; Goldenberg I.; Vasile RG.; Rodriguez-Villa F.; Mallya G.; Keller MB.,1998.0,,0,0,
10439,Intrusive thought in obsessive-compulsive disorder: appraisal differences.,,Calamari JE.; Janeck AS.,1998.0,,0,0,
10440,Muscle atrophy is prevented in patients with acute spinal cord injury using functional electrical stimulation.,"Severe muscle atrophy occurs rapidly following traumatic spinal cord injury (SCI). Previous research shows that neuromuscular or 'functional' electrical stimulation (FES), particularly FES-cycle ergometry (FES-CE) can cause muscle hypertrophy in individuals with chronic SCI (> 1 year post-injury). However, the modest degree of hypertrophy in these already atrophied muscles has lessened earlier hopes that FES therapy would reduce secondary impairments of SCI. It is not known whether FES treatments are effective when used to prevent, rather than reverse, muscle atrophy in individuals with acute SCI. This study explored whether unloaded isometric FES contractions (FES-IC) or FES-CE decreased subsequent muscle atrophy in individual with acute SCI (< 3 months post-injury). Twenty-six subjects, 14-15 weeks post-traumatic SCI, were assigned to control, FES-IC, or FES-CE against progessively increasing resistance. Subjects were involved in the study for 3 or 6 months. Total body lean body mass (TB-LBM), lower limb lean body mass (LL-LBM), and gluteal lean body mass (G-LBM) were determined before the study, and at 3 and 6 months using dual energy X-ray absorptiometry (DEXA). Controls lost an average of 6.1%, 10.1%, 12.4%, after 3 months and 9.5%, 21.4%, 26.8% after 6 months in TB-LBM, LL-LBM and G-LBM respectively. Subjects in the FES-IC group consistently lost less lean body mass than controls, however, only 6 month G-LBM loss was significantly attenuated in this group relative to the controls. In the FES-CE group, LL-LBM and G-LBM loss were prevented at both 3 and 6 months, and TB-LBM loss was prevented at 6 months. In addition, FES-CE significantly increased G-LBM and LL-LBM after 6 months of training relative to pre-training levels. Within the control group, there was no significant relationship between LL-LBM loss (3 and 6 months) and the number of days between injury and baseline measurement. In summary, this study shows that FES-CE, but not FES-IC, training prevents muscle atrophy in acute SCI after 3 months of training, and causes significant hypertrophy after 6 months. The magnitude of differences in regionalized LBM between controls and FES-CE subject raises hopes that such treatment may indeed be beneficial in preventing secondary impairments of SCI if employed before extensive post-injury atrophy occurs.",Baldi JC.; Jackson RD.; Moraille R.; Mysiw WJ.,1998.0,,0,0,
10441,CARL: a LabVIEW 3 computer program for conducting exposure therapy for the treatment of dental injection fear.,"This paper describes CARL (Computer Assisted Relaxation Learning), a computerized, exposure-based therapy program for the treatment of dental injection fear. The CARL program operates primarily in two different modes; in vitro, which presents a video-taped exposure hierarchy, and in vivo, which presents scripts for a dentist or hygienist to use while working with a subject. Two additional modes are used to train subjects to use the program and to administer behavioral assessment tests. The program contains five different modules, which function to register a subject, train subjects to use physical and cognitive relaxation techniques, deliver an exposure hierarchy, question subjects about the helpfulness of each of the therapy components, and test for memory effects of anxiolytic medication. Nine subjects have completed the CARL therapy program and 1-yr follow-up as participants in a placebo-controlled clinical trial examining the effects of alprazolam on exposure therapy for dental injection phobia. All nine subjects were able to receive two dental injections, and all reduced their general fear of dental injections. Initial results therefore indicate that the CARL program successfully reduces dental injection fear.",Coldwell SE.; Getz T.; Milgrom P.; Prall CW.; Spadafora A.; Ramsay DS.,1998.0,,0,0,
10442,Danger ideation reduction therapy (DIRT) for obsessive-compulsive washers. A controlled trial.,"Twenty-one OCD sufferers with washing/contamination concerns took part in a controlled treatment trial at the Anxiety Disorders Clinic, University of Sydney. Eleven of the subjects received danger ideation reduction therapy (DIRT) over eight, 1 h weekly group sessions conducted by the second author. Ten subjects were placed on a wait list and did not receive DIRT or any other treatment. DIRT procedures were solely directed at decreasing danger-related expectancies concerning contamination and did not include exposure, response prevention or behavioral experiments. Components of DIRT include attentional focusing, filmed interviews, corrective information, cognitive restructuring, expert testimony, microbiological experiments and a probability of catastrophe assessment task. All subjects were assessed at pre-treatment, post-treatment and three-month follow-up using the Maudsley Obsessional-Compulsive Inventory, Leyton Obsessionality Inventory, Beck Depression Inventory and a Self Rating of Severity Scale. Changes from pre-treatment to after treatment (post-treatment and follow-up scores averaged) were significantly greater in the DIRT condition than in the control condition for all measures. No significant differences were obtained between groups on post-treatment to follow-up change on any measure. The implications of these findings for theoretical models of OCD and its management are discussed.",Jones MK.; Menzies RG.,1998.0,,0,0,
10443,Cognitive-behavioral group therapy for panic disorder in the general clinical setting: a naturalistic study with 1-year follow-up.,"Cognitive-behavioral therapy (CBT) is well documented in the treatment of panic disorder. As most investigators have studied selected patients without comorbid disorders, it is less clear how well the treatment will perform in the usual clinical setting for patients with comorbid disorders and with physicians who do not have training in CBT. During the last 6 years, we have offered CBT in outpatient groups for patients with panic disorder and agoraphobia. The purpose of this prospective study was to assess the outcome of group treatment and compare the results with those of studies that used individual treatment. We wanted to identify variables that might predict outcome at follow-up and to assess the number and characteristics of dropouts. Eighty-three consecutive patients with DSM-III-R panic disorder (56 women and 27 men; mean age = 34.5 years) were studied. Mean duration of panic disorder was 7.5 years. There was a high degree of comorbid major depression, social phobia, and psychoactive substance abuse/dependence. Treatment consisted of 4-hour group sessions conducted once a week for 11 weeks. More than half of the patients used antidepressant drugs. Degree of phobic avoidance, bodily sensations, anxiety cognitions, and depression were assessed at pretreatment, baseline, and end of treatment and at follow-up after 3 and 12 months. There was a large decrease in scores from start to end on all assessments. Sixty-three (89%) of 73 completers responded (> or = 50% reduction in Phobic Avoidance Rating Scale scores). Gains were maintained and even improved upon at follow-up. The results are comparable with studies that used individual therapy. A high depression score at the end of treatment predicted poor outcome at 1-year follow-up. Twelve (14%) of 83 did not complete the program. The presence of severe personality disorders and ongoing alcohol or substance abuse or dependence was associated with poor outcome and high dropout rate. CBT appears to be effective in the usual clinical setting, even in the hands of therapists without formal competence. Group therapy is a feasible arrangement, and the results from group treatment are comparable to those of individual approaches. Precise diagnosis and treatment of comorbid depression are of utmost importance. Patients with additional substance abuse or dependence, as well as severe personality disorders, may find this treatment modality less helpful.",Martinsen EW.; Olsen T.; T√∏nset E.; Nyland KE.; Aarre TF.,1998.0,,0,0,
10444,Psychological and family characteristics of adolescents with vocal cord dysfunction.,"Vocal cord dysfunction (VCD) is a respiratory disorder often confused with asthma. Although previous case reports have implicated family and/or individual psychopathology in the etiology of this condition, this is the first paper to present prospective, case-control empirical data on a group of pediatric patients with VCD. A case-control methodology was employed to examine patients in terms of both family and individual functioning. Results indicate that patients with VCD were not different from asthmatic controls on measures of family functioning. However, they did experience significantly higher levels of anxiety and received a higher number of anxiety-related diagnoses such as separation anxiety and generalized anxiety disorder on a structured psychiatric interview. The nature of the relation between VCD and psychological symptoms in children is discussed. Etiologic and treatment issues are examined in the context of the findings.",Gavin LA.; Wamboldt M.; Brugman S.; Roesler TA.; Wamboldt F.,1998.0,,0,0,
10445,Efficacy of Psychoeducational Group Therapy in reducing symptoms of posttraumatic stress disorder among multiply traumatized women.,"The role of group therapy in treatment of posttraumatic stress disorder (PTSD) has been traditionally restricted to issues of self-esteem and interpersonal relationships, rather than primary symptoms of the disorder. In this study, the authors examined the effectiveness of a 16-week trauma-focused, cognitive-behavioral group therapy, named Interactive Psychoeducational Group Therapy, in reducing primary symptoms of PTSD in five groups (N=29) of multiply traumatized women diagnosed with chronic PTSD. The authors made assessments at baseline, at 1-month intervals during treatment, at termination, and at 6-month follow-up by using self-report and structured interview measures of PTSD and psychiatric symptoms. The absence of a control group limits the conclusions drawn from the study. At termination, subjects showed significant reductions in all three clusters of PTSD symptoms (i.e., reexperiencing, avoidance, and hyperarousal) and in depressive symptoms; they showed near-significant reductions in general psychiatric and dissociative symptoms, at termination. These improvements were sustained at 6-month follow-up. The role of group therapy in PTSD treatment should not be prematurely restricted to addressing self-esteem and interpersonal dimensions only. The use of structured, cognitive-behavioral elements within the group format may allow for more targeted treatment of core symptoms of the disorder.",Lubin H.; Loris M.; Burt J.; Johnson DR.,1998.0,10.1176/ajp.155.9.1172,0,0,
10446,Psychological morbidity and quality of life in Australian women with early-stage breast cancer: a cross-sectional survey.,"To determine the prevalence of psychological morbidity and describe quality of life in women with early-stage breast cancer. Cross-sectional descriptive study (3 months after conservative breast surgery or mastectomy) of patients from nine general hospitals in Melbourne, Victoria, October 1994 to March 1997. 303 women with early-stage breast cancer entering a randomised trial of adjuvant psychological group therapy; mean age, 46 years (SD, 8). Diagnostic and Statistical Manual of Mental Health (DSM)-IV psychiatric diagnoses generated by the Monash Interview for Liaison Psychiatry; quality-of-life data based on the the European Organization for Research and Treatment of Cancer quality-of-life questionnaire (QLQ)-C30 (core) and QLQ-BR23 (breast module) instruments. 45% of the women (135/303) had a psychiatric disorder; 42% (127) of the sample had depression or anxiety, or both; there was minor depression in 82 (27.1%), an anxiety disorder in 26 (8.6%), major depression in 29 (9.6%) and a phobic disorder in 21 (6.9%). 20% of women (61) had more than one disorder. On quality-of-life measures nearly one-third of the women felt less attractive and most had lost interest in sexual activity. There was substantial distress about hair loss. Symptoms of lymphoedema were described by 13 women (4.3%). Breast conservation surgery was associated with a better body image (P<0.01). Women recently diagnosed with early-stage breast cancer have high rates of psychiatric and psychological disturbance. Quality of life is substantially affected. Clinicians should actively explore their patients' psychological adjustment to enable early recognition and treatment of these disorders.",Kissane DW.; Clarke DM.; Ikin J.; Bloch S.; Smith GC.; Vitetta L.; McKenzie DP.,1998.0,,0,0,
10447,Illusory correlation and social anxiety.,"An illusory correlation (IC) experiment examined the presence of a phobia-relevant covariation bias in the context of social anxiety. Low (n = 28) and high (n = 32) social anxious women were shown a series of slides comprising pictures of angry, happy and neutral faces which were randomly paired with either a shock, a siren or nothing. One half of the participants were shown women faces, whereas the other half were shown men faces. Participants indicated outcome expectancies on a trial by trial basis. After the experiment proper they estimated the contingencies of all slide/outcome combinations. Participants showed both an a priori and an a posteriori IC between angry faces and shock. This covariation bias was similar for men and women faces and independent of prior fear. The pattern of results is consistent with the idea that ICs arise from initial expectancies that survive extinction.",de Jong PJ.; Merckelbach H.; Bögels S.; Kindt M.,1998.0,,0,0,
10448,Traumatic intrusions as 'worse case scenario's'.,"While some clinicians assume that traumatic intrusions are historically accurate revisualizations of traumatic incidents, others have suggested that these types of intrusions may represent a worse case scenario (i.e. exaggerated) version of the trauma. To explore this issue, a survey was conducted among undergraduate students (N = 189). Of the 69 respondents who had been the victim of or witness to a relatively recent trauma, 15 (22%) reported an exaggerated perception of the traumatic incident. Exaggerated intrusions were found to have more flashback qualities and tended to have a higher frequency than 'realistic' intrusions. These findings are well in line with the idea that intrusions are not necessarily veridical copies of traumatic events.",Merckelbach H.; Muris P.; Horselenberg R.; Rassin E.,1998.0,,0,0,
10449,Substance use disorder-PTSD comorbidity. Patients' perceptions of symptom interplay and treatment issues.,"Forty-two patients with both a current substance use disorder (SUD) and posttraumatic stress disorder (PTSD) were asked about the interrelationship of their two disorders, their treatment preferences and experiences, as well as possible deterrents to receiving PTSD treatment. Patients perceived their two disorders to be functionally related. They reported that when one disorder worsened, their other disorder was more likely to worsen; when one disorder improved, the other disorder similarly improved. Consistent with these perceptions, SUD-PTSD patients favored simultaneous treatment of their two disorders. The majority of SUD-PTSD patients were never referred to PTSD treatment. Although several possible deterrents to PTSD treatment were identified, only lack of trust appeared to differentiate PTSD treatment compliers versus noncompliers. Implications of these findings on referral and treatment practices are discussed.",Brown PJ.; Stout RL.; Gannon-Rowley J.,,,0,0,
10450,Effects of panic disorder treatments on personality disorder characteristics.,"Ninety-three patients with panic disorder and mild or no agoraphobia were treated for their panic disorder by using either 11 sessions of individual cognitive-behavior therapy or imipramine. Before and after treatment, their panic disorder symptomatology was assessed, and a self-report measure was administered to measure personality disorder characteristics [Klein et al., 1990: Wisconsin Personality Disorders Inventory]. In addition, some patients received this personality assessment again after six monthly maintenance sessions. Both treatments were equally effective in reducing panic disorder symptomatology, and both treatments had a positive influence on personality disorder characteristics. Personality disorder characteristics did not predict treatment outcome in either group. The implications of the findings for the assessment of personality and the treatment of panic disorder are discussed.",Hofmann SG.; Shear MK.; Barlow DH.; Gorman JM.; Hershberger D.; Patterson M.; Woods SW.,1998.0,,0,0,
10451,Effect of a novel environment on resting heart rate in panic disorder.,"Several studies have found higher resting heart rate among patients with panic disorder compared to healthy controls, whereas others have found no differences. It has been suggested that these differences may result from anticipatory anxiety. The purpose of this study was to compare the resting heart rates of 10 patients with panic disorder, 11 patients with social phobia, and 13 healthy controls during two consecutive visits to our laboratory. There were no significant differences between groups on resting heart rate on either day. However, patients with panic disorder did have significantly higher resting heart rates on day 1 versus day 2. This suggests that patients with panic disorder may experience greater anticipatory anxiety which is manifested in a higher resting heart rate than patients with social phobia or healthy controls. Implications for previous and future reports on resting heart rate measures in patients with panic disorder are discussed.",Larsen DK.; Asmundson GJ.; Stein MB.,1998.0,,0,0,
10452,Evidence from three fearful samples for a poor insight type in specific phobia.,,Menzies RG.; Harris LM.; Jones MK.,1998.0,,0,0,
10453,Associations with subsyndromal panic and the validity of DSM-IV criteria.,"The purpose of this study was to compare subsyndromal panic--infrequent panic (IP) and limited symptom attacks (LSA)--with panic disorder (PD) in psychiatric comorbidity, quality of life (QOL), and health care utilization and to assess validity of DSM-III-R criteria for panic disorder. Randomly selected adults were screened for the presence of PD, IP, and LSA by using the Structured Clinical Interview of the DSM-IIIR. Subjects with panic symptoms and matched controls completed a structured interview concerning comorbidity, QOL, and utilization. Although PD and IP subjects reported more psychiatric comorbidity than did LSA subjects, LSA subjects had more comorbid conditions than did controls. Differences in utilization were limited to PD subjects. Although subsyndromal panic was associated with poor QOL, panic-related work disability was primarily seen in PD subjects. Regression analyses demonstrated little difference between LSA and IP subjects, but interaction analysis supported the distinction between LSA and full-blown panic attacks. Compared with controls, LSA and IP subjects had more psychiatric comorbidity. PD subjects also had poorer QOL and more utilization. Interaction analysis supports DSM-IV criteria for panic disorder.",Katerndahl DA.; Realini JP.,1998.0,,0,0,
10454,[Diagnostic reliability of 0.2 Tesla dedicated MRI low-field strength equipment in traumatology].,"Anatomical dedicated low-field-strength MR imaging (non-whole-body-systems) has been developed for examinations of the peripheral joints. It has several advantages compared to high-field-strength MR imaging (whole-body-systems). The dimensions are small, the noise is not as bad as in whole body systems and people do not suffer of claustrophobic attacks. However, our results of a prospective blinded study in 56 patients with three different kinds of peripheral joint injuries demonstrated that the 0.2 T dedicated system showed a significant lower rate of diagnostic accuracy compared to middle and high-field-strength MR imaging and scored with obvious lower image quality ratings.",Gäbler C.; Kukla C.; Breitenseher MJ.; Vögele T.; Bankier A.; Rand T.; Vécsei V.,1998.0,,0,0,
10455,Psychodynamic-supportive group therapy model for elderly Holocaust survivors.,"The physical and mental consequences of the Holocaust combined with difficult present events and the problems of old age can have devastating effects on survivors. Our clinic has recently introduced a psychodynamic-supportive group therapy model for elderly Holocaust survivors. The model includes specific integrative interventions, which are based on Horowitz's model of mourning and coping with stress and the leaders' clinical experience. The aim of the group is to improve the patients' homeostasis and enhance their ego functions and adaptation to inner and outer worlds. The theory and working model are described.",Müller U.; Barash-Kishon R.,1998.0,,0,0,
10456,Demographic/socioeconomic factors in mental disorders associated with tuberculosis in southwest Nigeria.,"In spite of the high prevalence of tuberculosis worldwide, there are few studies on its psychiatric complications. The mental state of 53 patients with pulmonary tuberculosis seen in a Nigerian chest clinic was examined using the 30-item General Health Questionnaire (GHQ-30), the Present State Examination (PSE), and a clinical evaluation based on the International Classification of Disease, tenth edition (ICD-10). Results were compared with two comparison groups: (1) a group of 20 long-stay orthopedic patients with lower limb fractures; and (2) a group of 20 apparently healthy controls. The sociodemographic characteristics of the groups were also compared. A significantly higher prevalence of psychiatric disorders was found in the tuberculosis group (30.2%) than in the orthopedic group (15%) and the apparently healthy controls (5%). The types of psychiatric disorders encountered included mild depressive episode, generalized anxiety disorder, and adjustment disorder (ICD-10). Psychiatric morbidity was higher in tuberculosis patients with low educational attainment, and did not show a statistically significant relationship with other sociodemographic parameters. Ways of improving the mental health of tuberculosis patients are discussed.",Aghanwa HS.; Erhabor GE.,1998.0,,0,0,
10457,Effects of chundosunbup Qi-training on psychological adjustments: a cross-sectional study.,"This cross-sectional investigation evaluated the trend of psychological changes by ChunDoSunBup (CDSB) Qi-training using a self-report inventory of emotional distress, Symptom Check List-90-Revision (SCL-90-R). 41 normal healthy subjects (mean age = 20.98 +/- 5.39) and 123 CDSB Qi-trainees (divided into three groups, Q1, Q2 and Q3) participated in this study. Group Q1 has received 1-4 months CDSB Qi-training (age 21.95 +/- 7.82, n = 41); Q2 has 5-12 months Qi-training (age 20.0 +/- 7.75, n = 41); and Q3 has more than 13 months Qi-training (age 22.68 +/- 6.72, n = 41). Our results show that Qi-trainees over 13 months had significantly lower scores compared to controls. A significant negative correlation was found between the Qi-training period and all SCL-90-R subscales except phobic anxiety. These results suggest that CDSB Qi-training is effective in protection as well as reduction of psychological symptomatology.",Lee MS.; Jeong SM.; Oh SW.; Ryu H.; Chung HT.,1998.0,10.1142/S0192415X98000270,0,0,
10458,Treatment of acute stress disorder: a comparison of cognitive-behavioral therapy and supportive counseling.,"Acute stress disorder (ASD) is a precursor of chronic posttraumatic stress disorder (PTSD). Twenty-four participants with ASD following civilian trauma were given 5 sessions of either cognitive-behavioral therapy (CBT) or supportive counseling (SC) within 2 weeks of their trauma. Fewer participants in CBT (8%) than in SC (83%) met criteria for PTSD at posttreatment. There were also fewer cases of PTSD in the CBT condition (17%) than in the SC condition (67%) 6 months posttrauma. There were greater statistically and clinically significant reductions in intrusive, avoidance, and depressive symptomatology among the CBT participants than among the SC participants. This study represents the 1st demonstration of successful treatment of ASD with CBT and its efficacy in preventing chronic PTSD.",Bryant RA.; Harvey AG.; Dang ST.; Sackville T.; Basten C.,1998.0,,0,0,
10459,An open trial of EMDR as treatment for chronic PTSD.,"In a prepilot study, eight adults with chronic PTSD underwent three 90-minute sessions of eye movement desensitization and reprocessing (EMDR) at one-week intervals in an open trial. None of the seven who completed treatment met criteria for current PTSD two months later. Significant decreases in measures of pathology and disturbance were recorded. A controlled trial of EMDR is under way.",Lazrove S.; Triffleman E.; Kite L.; McGlashan T.; Rounsaville B.,1998.0,,0,0,
10460,Psychophysiologic responsivity in posttraumatic stress disorder: generalized hyperresponsiveness versus trauma specificity.,"Clinically, subjects with posttraumatic stress disorder (PTSD) are viewed as hyperresponsive to a variety of stimuli. Psychophysiologic studies, however, have demonstrated hyperresponsiveness only to stimuli that are closely related to the original trauma. This set of experiments uses a variety of stimuli that vary in trauma-relatedness, arousal level, sensory modality stimulated, and degree of cognitive processing demanded to assess the extent of generalization of physiologic responses. Heart rate (HR), frontal electromyogram (EMG), and skin conductance (EDG) responses were measured during presentation of each stimulus. PTSD subjects (n = 15) had an elevated baseline EDG and increased HR and EMG responses to the trauma-related stimulus (combat sounds) compared to normal control subjects (n = 11) and combat control subjects (n = 10). No significant differences were noted between PTSD and control groups in response to non-trauma-related arousing stimuli. These results suggest that the physiologic hyperresponsivity of PTSD subjects is limited to stimuli closely associated with the inciting trauma.",Casada JH.; Amdur R.; Larsen R.; Liberzon I.,1998.0,,0,0,
10461,Analysis of heart rate variability in posttraumatic stress disorder patients in response to a trauma-related reminder.,"Spectral analysis of heart rate variability has recently been shown to be a reliable noninvasive test for quantitative assessment of cardiovascular autonomic regulatory responses, providing a dynamic map of sympathetic and parasympathetic interaction. In a prior study exploring the state of hyperarousal characterizing the posttraumatic stress disorder (PTSD) syndrome, the authors described standardized heart rate analysis carried out in 9 PTSD patients at rest, which demonstrated clear-cut evidence of a baseline autonomic hyperarousal state. To examine the dynamics of this hyperarousal state, standardized heart rate analysis was carried out in 9 PTSD patients compared to a matched control group of 9 healthy volunteers. Twenty-minute recordings of electrocardiogram in response to a trauma-related cue as opposed to a resting state were performed and analyzed. The PTSD patients were asked to recount the presumed triggering traumatic event, and the control subjects recounted a significant stressful negative life event. Our results show that, whereas the control subjects demonstrated significant autonomic responses to the stressogenic stimulus supplied by the recounting of a major stressful experience, the PTSD patients demonstrated almost no autonomic response to the recounting of the triggering stressful event. The PTSD patients demonstrated a degree of autonomic dysregulation at rest which was comparable to that seen in the control subjects' reaction to the stress model. The lack of response to the stress model applied in the study appears to imply that PTSD patients experience so great a degree of autonomic hyperactivation at rest, that they are unable to marshal a further stress response to the recounting of the triggering trauma, as compared to control subjects.",Cohen H.; Kotler M.; Matar MA.; Kaplan Z.; Loewenthal U.; Miodownik H.; Cassuto Y.,1998.0,,0,0,
10462,Elevated awaking thresholds during sleep: characteristics of chronic war-related posttraumatic stress disorder patients.,"Sleep disturbances are one of the hallmarks of posttraumatic stress disorder (PTSD); however, sleep laboratory studies have provided inconsistent evidence of the existence of objective sleep disturbances in PTSD patients. Reports that awaking thresholds from sleep in war-related PTSD patients were significantly elevated compared to normals are discordant with complaints of insomnia. The present study investigated the relationship between awaking threshold from REM sleep in war-related PTSD patients and their dream recall, dream content, and clinical condition. After informed consent was obtained from 12 PTSD patients and 12 controls, they were investigated by polysomnographic recordings for 4 nights. Awaking thresholds to clicks were determined during 1 night, and dreams were collected during 2 nights. Patients' symptoms were assessed by the Zung and Beck depression scales, Impact of Events Scale, State and Trait Anxiety, and Symptom Check List questionnaires. Although there were no significant differences between sleep data of patients and controls, PTSD patients had significantly higher awaking thresholds. Awaking thresholds were significantly positively related to depression and anxiety scores. Patients' dreams were significantly more aggressive and hostile, and in 6 patients they included explicit war-related contents. The severity of the clinical picture was significantly related to the dreams' scores of aggression-hostility, and to sleep quality variables. Elevated awaking thresholds from sleep are a characteristic finding in chronic war-related PTSD patients, which may help to explain the diverse sleep laboratory findings in this syndrome.",Lavie P.; Katz N.; Pillar G.; Zinger Y.,1998.0,,0,0,
10463,Polysomnographic sleep is not clinically impaired in Vietnam combat veterans with chronic posttraumatic stress disorder.,"Because sleep is typically disturbed in posttraumatic stress disorder (PTSD), this study was undertaken to evaluate a group of Vietnam combat veterans with the disorder using clinical polysomnographic techniques. Eighteen Vietnam combat veterans with PTSD and 10 healthy non-combat-exposed Vietnam era veterans participated in 2 nights of polysomnographic study and a multiple sleep latency test. No significant differences between subjects and controls were noted except for greater sleep onset latency to stage 2 (p < .03), and lower arousals/hour from stages 3 & 4 (p < .04) on night 2, and lower subjectively estimated total sleep time on night 1 (p < .005) in the case of PTSD subjects. Otherwise, results from the second night served to replicate those from the first, and no significant differences appeared on 2 successive nights for any polysomnographic variable. No daytime hypersomnolence was detected. Polysomnographically recorded sleep was notably better than expected in the presence of clinically significant PTSD with typical histories of disrupted sleep. In these subjects, there is no clinically significant sleep disorder or typical pattern of sleep disturbance detectable by standard polysomnography.",Hurwitz TD.; Mahowald MW.; Kuskowski M.; Engdahl BE.,1998.0,,0,0,
10464,Effects of experimental context and explicit threat cues on acoustic startle in Vietnam veterans with posttraumatic stress disorder.,"The hypothesis that exaggerated startle in Vietnam veterans with posttraumatic stress disorder (PTSD) reflects an anxiogenic response to stressful contexts was tested. Thirty-four nonmedicated Vietnam veterans with PTSD, and 17 combat and 14 civilian non-PTSD controls participated in two testing sessions over separate days. Acoustic startle stimuli were delivered alone or in a test of prepulse inhibition. In the first session, startle was assessed without experimental stress. In the second session, startle was investigated during a stressful ""threat of shock"" experiment, when subjects anticipated the administration of shocks during threat periods and during safe periods when no shocks were anticipated. The magnitude of startle did not differ significantly among the three groups in the first session, but was increased throughout the threat of shock experiment in the PTSD veterans in the second session. The actual increase in startle in the threat compared to the safe condition did not significantly differ among the three groups. Prepulse inhibition was reduced in the PTSD veterans, compared to the non-PTSD civilians, but not compared to the non-PTSD veterans. Exaggerated startle in Vietnam veterans with PTSD reflects an anxiogenic response to an environment that is experienced as stressful.",Grillon C.; Morgan CA.; Davis M.; Southwick SM.,1998.0,,0,0,
10465,Combination of behaviour therapy with fluvoxamine in comparison with behaviour therapy and placebo. Results of a multicentre study.,"We investigated whether the combination of multi-modal behaviour therapy (BT) with fluvoxamine is superior to BT and placebo in the acute treatment of severely ill in-patients with obsessive-compulsive disorder (OCD). In a randomised, double-blind design, 30 patients were treated for nine weeks with BT plus placebo and 30 patients with BT plus fluvoxamine (maximum dosage 300 mg, mean dose 288.1 mg). BT included exposure with response prevention, cognitive restructuring and development of alternative behaviours. Both groups showed a highly significant symptom reduction after treatment. There were no significant differences between the groups concerning compulsions. Obsessions were significantly more reduced in the fluvoxamine and BT group than in the placebo and BT group. Furthermore, the group BT plus fluvoxamine showed a significantly higher response rate (87.5 v. 60%) according to a previously defined response criterion. Severely depressed patients with OCD receiving BT plus placebo presented a significantly worse treatment outcome (Y-BOCS scores) than all other groups. The results suggest that BT should be combined with fluvoxamine when obsessions dominate the clinical picture and when a secondary depression is present.",Hohagen F.; Winkelmann G.; Rasche-Rüchle H.; Hand I.; König A.; Münchau N.; Hiss H.; Geiger-Kabisch C.; Käppler C.; Schramm P.; Rey E.; Aldenhoff J.; Berger M.,1998.0,,0,0,
10466,Pretreatment patient factors predicting attrition from a multicenter randomized controlled treatment study for panic disorder.,"This study examined pretreatment factors associated with attrition from a clinical trial for panic disorder. The study group consisted of 162 patients who began 11-visit treatments. Six domains (demography, panic disorder severity, psychiatric comorbidity, illness/treatment attributions, coping styles, and personality styles) with 52 variables were used to predict attrition. One hundred twenty-two patients completed and 40 dropped out from treatment. Final multivariate regression analyses showed that the following two variables were independently associated with attrition: lower household income and negative treatment attitudes; attributing the panic disorder to life stressors and greater age were independently associated with attrition at the trend level. Preliminary analyses suggested, in addition, associations between attrition and lower education, shorter length of prior treatment, higher anxiety sensitivity, lower agoraphobic avoidance, and a coping style of seeking social support that were not confirmed by best predictor analysis. Psychiatric comorbidity and personality styles were unrelated to attrition. The implications of these findings for future research and clinical practice are discussed.",Grilo CM.; Money R.; Barlow DH.; Goddard AW.; Gorman JM.; Hofmann SG.; Papp LA.; Shear MK.; Woods SW.,,,0,0,
10467,Catastrophic worrying: personal inadequacy and a perseverative iterative style as features of the catastrophizing process.,"This article describes 6 studies that have used a catastrophizing interview technique to investigate some of the characteristics of catastrophic worrying. The main findings were (a) worriers were willing to catastrophize both a positive aspect of their life and a new hypothetical worry significantly more than nonworriers, (b) worriers were more likely than nonworriers to rate catastrophizing steps for a new worry as containing information relevant to existing worries, (c) worriers displayed a general iterative style that was independent of the valency of the iterative task, and (d) worriers tended to couch their worries in terms of personal inadequacies, and personal inadequacy became a feature of their catastrophizing regardless of the worry topic. Worriers' tendency to couch worries and catastrophizing steps in terms of personal inadequacies and their perseverative iterative style are both important contributors to the unresolved catastrophic thought experienced by chronic worriers.",Davey GC.; Levy S.,1998.0,,0,0,
10468,Rorschach patterns of response in Vietnam veterans with posttraumatic stress disorder versus combat and normal controls.,"To further evaluate Rorschach indicators of posttraumatic stress disorder (PTSD), test protocols of 16 combat veterans so diagnosed were compared with those of 9 combat controls and 12 noncombat subjects. Results replicated Rorschach abnormalities previously associated with this disorder, including signs of low stress tolerance, poor affect modulation, perceptual distortion, and interpersonal disengagement. However, only two indicators, EB (Erlebnistypus) and CC (combat-related content), differentiated PTSD subjects from controls (P < .05). Examination of negative findings revealed that all three groups similarly deviated from Exner nonpatient norms (Exner, 1993: The Rorschach, Vol 1. New York: John Wiley and Sons) on many Rorschach variables. Possible explanations for these findings are considered, and the need for control subjects in Rorschach investigation is underscored.",Goldfinger DA.; Amdur RL.; Liberzon I.,1998.0,,0,0,
10469,"Psychophysiologic responses to the Rorschach in PTSD patients, noncombat and combat controls.","While psychophysiologic studies of posttraumatic stress disorder (PTSD) have investigated the effects of trauma-related stimuli on arousal, none have explored the development of intrusive imagery and affect states in the absence of such specific cues. The present study compares autonomic arousal during PTSD-related Rorschach responses in PTSD veterans vs. combat controls and noncombat controls. It was found that Rorshach responses containing traumatic content were found only in the PTSD group, and that these responses showed elevations in skin conductance (SC) and heart rate (HR). Our data also suggest that PTSD patients are more easily hyperaroused, especially under conditions of experienced stress and helplessness. Finally, combat control subjects exhibited lower baseline SC and HR than their counterparts, as well as decelerated HR during trauma- and stress-related Rorschach responses, suggesting a physiologic resilience in this group.",Goldfinger DA.; Amdur RL.; Liberzon I.,1998.0,,0,0,
10470,Role of perceived danger in the mediation of obsessive-compulsive washing.,"The role of danger expectancies in sub-clinical Obsessive-Compulsive Disorder (OCD) was examined in 18 undergraduate students who had displayed washing/contamination concerns. The perceived level of danger in a Behavioural Avoidance Test (BAT) involving a compound stimulus of potting soil, animal hair, food scraps, and raw meat was manipulated by varying the instructions participants were given at the commencement of the BAT. Participants were randomly allocated into a high-danger instruction condition or a low-danger instruction condition. Participants in the higher-danger instruction condition had higher mean ratings for anxiety and urge in wash, showed greater avoidance, and spent longer washing their hands at the completion of the task than participants in the low-danger instruction condition. However, only the differences in avoidance scores and post-BAT washing were statistically significant. These findings are discussed in relation to danger-based models of OCD.",Jones MK.; Menzies RG.,1998.0,,0,0,
10471,Subjective symptoms and breathing pattern at rest and following hyperventilation in anxiety and somatoform disorders.,"The purpose of the present study was to investigate the diagnostic specificity of bodily symptoms and respiratory behavior at rest and after a hyperventilation provocation test (HVPT) in patients that were either grouped according to the DSM classification or diagnosed as suffering from hyperventilation syndrome. Nine hundred three anxiety and somatoform patients, showing symptoms supposedly caused by psychogenic hyperventilation, and 170 healthy subjects, were studied. Breathing pattern and end-tidal CO2 concentration were recorded during breathing at rest and following a HVPT. Subjective symptoms in daily life and after HVPT were measured. A principal-components analysis was performed on both the symptoms and breathing variables and their specificity levels were compared in the two classifications of patients. Some symptoms in daily life were grouped together with the same symptoms after the HVPT, other symptoms were not. This suggests that the HVPT elicited partly specific symptoms, and partly reproduced the symptoms experienced in daily life. Similar findings were observed with respect to the breathing variables. Patients with panic differed from other patients with anxiety disorders by an increased level of symptoms and a FETCO2 decline at rest. The HVPT may be informative for diagnosis because it provokes some of the typical somatic and psychological symptoms, and it identifies the breathing instability that is characteristic of both patients with HVS and with anxiety. The same symptoms and breathing variables characterized the patients, whatever their classification. Overall, the specificity of breathing variables is rather low.",Han JN.; Stegen K.; Schepers R.; Van den Bergh O.; Van de Woestijne KP.,1998.0,,0,0,
10472,FDG-PET predictors of response to behavioral therapy and pharmacotherapy in obsessive compulsive disorder.,"In subjects with obsessive-compulsive disorder (OCD), lower pre-treatment metabolism in the right orbitofrontal cortex (OFC) and anterior cingulate gyrus (AC) has been associated with a better response to clomipramine. We sought to determine pre-treatment metabolic predictors of response to behavioral therapy (BT) vs. pharmacotherapy in subjects with OCD. To do this, [18F]fluorodeoxyglucose positron emission tomography scans of the brain were obtained in subjects with OCD before treatment with either BT or fluoxetine. A Step-Wise Variable Selection was applied to normalized pre-treatment glucose metabolic rates in the OFC, AC, and caudate by treatment response (change in Yale-Brown Obsessive-Compulsive Scale) in the larger BT group. Left OFC metabolism (normalized to the ipsilateral hemisphere) alone was selected as predicting treatment response in the BT-treated group (F = 6.07, d.f. = 1,17, P = 0.025). Correlations between normalized left OFC metabolism and treatment response revealed that higher normalized metabolism in this region was associated with greater improvement in the BT-treated group (tau = 0.35, P = 0.04), but worse outcome (tau = -0.57, P = 0.03) in the fluoxetine-treated group. These results suggest that subjects with differing patterns of metabolism preferentially respond to BT vs. medication.",Brody AL.; Saxena S.; Schwartz JM.; Stoessel PW.; Maidment K.; Phelps ME.; Baxter LR.,1998.0,,0,0,
10473,Anxiety as a predictor of response to interpersonal psychotherapy for recurrent major depression: an exploratory investigation.,"Major depression and anxiety frequently co-occur, but the implications for psychological treatments have rarely been studied. We examined predictors of acute response to interpersonal psychotherapy in 134 consecutively treated female outpatients with recurrent unipolar depression. Women who failed to remit with interpersonal psychotherapy alone experienced higher levels of somatic anxiety, were more likely to meet criteria for lifetime panic disorder, were more likely to meet criteria for nonendogenous or nonmelancholic depression, and reported greater vocational impairment, higher levels of global severity, a longer duration of the index episode, and, somewhat surprisingly, lower levels of social impairment at pretreatment evaluation. A series of backwards stepping logistic regression analyses showed higher levels of baseline somatic anxiety and social functioning to be the most consistent predictors of nonresponse. Our findings strengthen existing evidence that concomitant anxiety can adversely affect the outcome of interpersonal therapy for depression.",Feske U.; Frank E.; Kupfer DJ.; Shear MK.; Weaver E.,1998.0,,0,0,
10474,Utility of psychophysiological measurement in the diagnosis of posttraumatic stress disorder: results from a Department of Veterans Affairs Cooperative Study.,"This multisite study tested the ability of psychophysiological responding to predict posttraumatic stress disorder (PTSD) diagnosis (current, lifetime, or never) in a large sample of male Vietnam veterans. Predictor variables for a logistic regression equation were drawn from a challenge task involving scenes of combat. The equation was tested and cross-validated demonstrating correct classification of approximately 2/3 of the current and never PTSD participants. Results replicate the finding of heightened psychophysiological responding to trauma-related cues by individuals with current PTSD, as well as differences in a variety of other domains between groups with and without the disorder. Follow-up analyses indicate that veterans with current PTSD who do not react physiologically to the challenge task manifest less reexperiencing symptoms, depression, and guilt. Discussion addresses the value of psychophysiological measures for assessment of PTSD.",Keane TM.; Kolb LC.; Kaloupek DG.; Orr SP.; Blanchard EB.; Thomas RG.; Hsieh FY.; Lavori PW.,1998.0,,0,0,
10475,When is less treatment better? The role of social anxiety in matching methadone patients to psychosocial treatments.,"In response to a need to match drug users to the most appropriate and cost-effective level of care, it was hypothesized the socially anxious methadone-maintained patients would attain greater benefit from coping skills training provided in the context of a low-intensity enhanced standard methadone maintenance intervention (E-STD) than in the context of a high-intensity, socially demanding day treatment program (DTP). Social anxiety was assessed in 307 methadone-maintained patients using the Social Anxiety and Distress Scale prior to randomization to either E-STD or DTP. The hypothesis was supported: Socially anxious patients were drug free longer during treatment, were more likely to be abstinent at treatment completion, and had greater reductions in HIV risk behaviors if assigned to the lower intensity intervention, which was provided at 1/3 the cost of the DTP.",Avants SK.; Margolin A.; Kosten TR.; Rounsaville BJ.; Schottenfeld RS.,1998.0,,0,0,
10476,Prediction of posttraumatic stress disorder by immediate reactions to trauma: a prospective study in road traffic accident victims.,"Road traffic accidents often cause serious physical and psychological sequelae. Specialists of various medical faculties are involved in the treatment of accident victims. Little is known about the factors which might predict psychiatric disorders, e.g. Posttraumatic Stress Disorder (PTSD) after accidents and how psychological problems influence physical treatment. In a prospective study 179 unselected, consecutively admitted road traffic accident victims were assessed a few days after the accident for psychiatric diagnoses, severity of injury and psychopathology. All were inpatients and had to be treated for bone fractures. At 6-months follow-up assessment 152 (85%) of the patients were interviewed again. Of the patients, 18.4% fulfilled the criteria for Posttraumatic Stress Disorder (DSM-III-R) within 6 months after the accident. Patients who developed PTSD were injured more severely and showed more symptoms of anxiety, depression and PTSD a few days after the accident than patients with no psychiatric diagnosis. Patients with PTSD stayed significantly longer in the hospital than the other patients. Multiple regression analysis revealed that the length of hospitalization was due mainly to a diversity of factors such as severity of injury, severity of accident, premorbid personality and psychopathology. Posttraumatic stress disorder is common after road traffic accidents. Patients with PTSD at follow-up can be identified by findings from early assessment. Untreated psychological sequelae such as PTSD cause longer hospitalization and therefore more costs than in non-PTSD patients.",Frommberger UH.; Stieglitz RD.; Nyberg E.; Schlickewei W.; Kuner E.; Berger M.,1998.0,,0,0,
10477,Age-related changes in the prevalence of smell/taste problems among the United States adult population. Results of the 1994 disability supplement to the National Health Interview Survey (NHIS).,"Information about the prevalence of disorders of the chemical senses has been limited. In the late 1970s, the consensus among experts convened by the National Institutes of Health (NIH) was that more than 2 million adults in the United States had a disorder of smell or taste. A large, nonrandom survey conducted by the National Geographic Society in 1987 found that 1% of their 1.2 million respondents could not smell 3 or more of 6 odorants using a 'scratch and sniff' test. Age was an important factor, with a decline beginning in the second decade of life. No comparable data have been available for taste, although it has been suggested that the sense of taste remains more robust with age. The National Institute on Deafness and Other Communication Disorders (NIDCD), NIH, began collaborating with the National Center for Health Statistics (NCHS) in 1993 to acquire information on the prevalence of smell/taste problems using the Disability Supplement to the National Health Interview Survey (NHIS). This survey was administered to approximately 42,000 randomly-selected households (representing about 80,000 adults over 18 years of age) in 1994. Adjusted national estimates derived from this survey showed a prevalence of 2.7 million (1.4%) U.S. adults with an olfactory problem. Also, 1.1 million (0.6%) adults reported a gustatory problem. When smell or taste problems were combined, 3.2 million (1.65%) adults indicated a chronic chemosensory problem. The prevalence rates increased exponentially with age. Almost 40% with a chemosensory problem (1.5 million) were 65 years of age or greater. In a multivariate analysis, the individual's overall health status, other sensory impairments, functional limitations (including difficulty standing or bending), depression, phobia, and several other health-related characteristics were associated with an increase in the rate of chemosensory disorders.",Hoffman HJ.; Ishii EK.; MacTurk RH.,1998.0,,0,0,
10478,Enhancing medication compliance for people with serious mental illness.,,Cramer JA.; Rosenheck R.,1999.0,,0,0,
10479,Suicide risk and coping styles in posttraumatic stress disorder patients.,"Suicide and suicidal behavior have been found to be increased among posttraumatic stress disorder (PTSD) patients. The present study examined suicide risk and Plutchik's coping styles in PTSD patients. 47 PTSD patients were compared with 42 patients with mixed non-PTSD anxiety disorders and 50 healthy control subjects, matched for age and gender, on a measure of suicide risk. The PTSD patients scored significantly higher than the two control groups on the suicide risk measure. Furthermore, in the PTSD group, suicide risk was significantly negatively correlated with the coping mechanisms of mapping, minimization and replacement and positively correlated with the coping style of suppression. Furthermore, the coping styles significantly explained the variance of the suicide risk measure for all three groups. The cognitive map of PTSD patients highly resembles other populations with high suicide risk. Clinicians treating victims of traumatic events should focus on problem-solving therapies in order to help these patients deal less rigidly with everyday stresses and by this decrease the suicide risk.",Amir M.; Kaplan Z.; Efroni R.; Kotler M.,,12316,0,0,
10480,Relationship of cosmetic disfigurement to the severity of posttraumatic stress disorder in burn injury or digital amputation.,"The purpose of this study was to examine the relationships of physical factors including physical functioning and cosmesis to posttraumatic stress disorder (PTSD) symptoms in patients with burn injury and in patients with digital amputation. Subjects were 56 patients with burn injury and 26 patients with digital amputation. In addition to assessments of physical factors, psychiatric interviews were administered to examine mental disorders including PTSD and major depression. The prevalence rates of PTSD and major depression were 33.9 and 7.1% in burn-injured patients and 18.5 and 7.4% in patients with digital amputation respectively. Multivariate analysis of variance (MANOVA) revealed that, regardless of the severity of burn injury such as percentage of total body surface burned, female victims with cosmetic disfigurement (i.e., facial burn) exhibited PTSD symptoms, in particular PTSD symptoms of avoidance and emotional numbing. For subjects with digital amputation, MANOVA indicated that, regardless of the degree of physical functioning after replantation, female victims with cosmetic disfigurement exhibited PTSD symptoms. These findings suggest that, in female victims with burn injury and/or digital amputation, the degree of cosmetic disfigurement is related to the manifestation of PTSD symptoms of avoidance and emotional numbing.",Fukunishi I.,,12317,0,0,
10481,Disorders of extreme stress following war-zone military trauma: associated features of posttraumatic stress disorder or comorbid but distinct syndromes?,"Disorders of extreme stress not otherwise specified (DESNOS) and posttraumatic stress disorder (PTSD) were found to be comorbid but distinct among military veterans seeking inpatient PTSD treatment: 31% qualified for both conditions, 29% were diagnosed PTSD only, 26% were classified DESNOS only, and 13% met criteria for neither. PTSD diagnosis was associated with elevated levels of war-zone trauma exposure and witnessing atrocities and with impairment on the Mississippi Scale for Combat-Related PTSD and the Penn Inventory. DESNOS classification (but not PTSD) was associated with (a) early childhood trauma and participation in war-zone atrocities, (b) extreme levels of intrusive trauma reexperiencing, (c) impaired characterological functioning (object relations), and (d) use of intensive psychiatric services. PTSD and DESNOS may be comorbid but distinct posttraumatic syndromes and, as such, warrant careful clinical and scientific investigation.",Ford JD.,1999.0,,0,0,
10482,Cognitive-behavioral therapy helps prevent relapse and recurrence of panic disorder following alprazolam discontinuation: a long-term follow-up of the Peoria and Dartmouth studies.,"The present research evaluated patients from 2 previous studies (1 conducted in Peoria, the other at Dartmouth) during a 2- to 5-year posttreatment period. Results showed that 75% of the Peoria sample and 76% of the Dartmouth sample were able to discontinue alprazolam therapy, remain abstinent of any type of treatment for panic disorder, and maintain their acute-treatment clinical gains over this follow-up period. The degree to which patients' anxiety sensitivity declined during treatment predicted relapse versus survival during the 1st 6 months of follow-up, when most relapses occurred. Implications of these findings for benzodiazepine discontinuation, combined pharmacotherapy and psychotherapy, and relapse prevention in panic disorder are discussed.",Bruce TJ.; Spiegel DA.; Hegel MT.,1999.0,,0,0,
10483,Validity of the Obsessive Compulsive Drinking Scale (OCDS): does craving predict drinking behavior?,"The Obsessive Compulsive Drinking Scale (OCDS), a 14-item, self-report questionnaire, was developed to measure alcohol-related craving. The OCDS may provide a measure of the state of illness among alcohol-dependent individuals and may have value in predicting subsequent drinking behavior. The present study was conducted to evaluate the factor structure and the concurrent, construct, and predictive validity of the OCDS. Data on desire to drink and on drinking behavior were obtained from 127 alcohol-dependent subjects who participated in a 12-week outpatient pharmacotherapy trial and a 3-month posttreatment follow-up. Principal components analysis of the OCDS indicated that three factors best described its structure: obsessions, drinking control and consequences, and alcohol consumption. Data also supported the concurrent and discriminant validity of the OCDS. However, the OCDS total score showed limited validity in predicting drinking during a posttreatment follow-up period. Furthermore, the only empirically derived factor that predicted drinking during this period was the alcohol consumption factor. As might be expected, the OCDS questions on drinking behavior predict subsequent drinking behavior. However, the instrument does not appear to provide a general measure of alcohol-related illness. The utility of the OCDS in studies of alcoholism treatment outcome requires clearer definition.",Kranzler HR.; Mulgrew CL.; Modesto-Lowe V.; Burleson JA.,1999.0,,0,0,
10484,Core through urethrotomy with the neodymium:YAG laser for posttraumatic obliterative strictures of the bulbomembranous urethra.,"We studied the safety and efficacy of core through urethrotomy with the neodymium (Nd):YAG laser for posttraumatic obliterative strictures of the bulbomembranous urethra. Eight patients a mean of 27.5 years old with posttraumatic (motor vehicle accidents) obliterative strictures of the bulbomembranous urethra were treated from May to December 1997. Laser treatment selection criteria were stricture length 2.0 cm. or less, good alignment between the urethral ends and no history of rectal injury or erectile dysfunction. All patients underwent core through urethrotomy with the Nd:YAG contact laser delivered with the 600 micro bare fiber at 15 to 25 W. The urethrotomy was guided only by a metal sound introduced through the suprapubic tract. Blood loss was negligible and excellent visualization was maintained throughout the procedure. Operating time ranged from 45 to 70 minutes. There were no perioperative complications. Hospital stay was 24 hours in the first case and 6 to 8 hours in subsequent cases. All patients returned to work within 5 days. Urethroscopy was performed 4 and 12 weeks after catheter removal in all patients. Only 1 patient required repeat internal urethrotomy. Voiding cystourethrography revealed a stricture-free urethra in 7 cases. At last followup 7 to 14 months (mean 10.25) after the procedure mean maximum flow rate was 18.6 ml. per second (range 16.5 to 22.4) in the patients who were stricture-free and 11.8 ml. per second in 1 with recurrent stricture. Core through urethrotomy with the contact Nd:YAG laser seems to be a safe and effective treatment option for select strictures. The hospital stay is remarkably short and complications are negligible. Re-stricture rates are likely to be low but more experience and longer follow-up are needed.",Dogra PN.; Aron M.; Rajeev TP.,1999.0,,0,0,
10485,[Fat tissue in the treatment of tympanic membrane perforations].,"Adipose myringoplasty is presented as a simple and effective technique in managing tympanic membrane perforations. A review of 34 fat plug myringoplasties performed in 28 patients with drum perforations over a 4-year period was done. Twenty-two myringoplasties were postinflammatory, five--posttraumatic and three--postinflammatory in temporalis fascia. Criteria for selection, operative technique and results are discussed.",Chodynicki S.; Rózańska-Kudelska M.,1998.0,,0,0,
10486,Long-term outcome of pharmacological and psychological treatment for panic disorder with agoraphobia: a 2-year naturalistic follow-up.,"Two years after completion of a controlled outcome study of treatments for panic disorder with agoraphobia, patients were revisited and interviewed about their complaints. In the initial study, four treatments had been compared: (i) fluvoxamine combined with exposure; (ii) placebo medication plus exposure; (iii) psychological panic management plus exposure; and (iv) exposure alone. Comparison of the results at post-test had revealed superior efficacy of fluvoxamine combined with exposure over the other three treatments in reducing agoraphobic avoidance. The current naturalistic follow-up study investigated the long-term efficacy of the treatments with regard to abatement of complaints and reduced demand for further treatment. In addition, we examined whether patients were able to taper off the study medication without a recurrence of complaints. In total, 71 of the 76 patients of the original trial (93%) were interviewed. Comparison of the mean level of psychopathology at follow-up revealed no difference between the original treatment groups. The effect in the fluvoxamine plus exposure group was maintained, but was no longer superior, due to further improvements in the other treatment groups. Most patients received additional treatment during the follow-up period, usually because the 12 treatment sessions in the controlled study had yielded insufficient improvement. There was a trend for patients who received the fluvoxamine plus exposure treatment to require less aftercare than those who received the other treatments. Finally, almost 50% of the patients who had received medication in the original trial were able to taper off the use of fluvoxamine without a recurrence of complaints.",de Beurs E.; van Balkom AJ.; Van Dyck R.; Lange A.,1999.0,,0,0,
10487,Explicit memory in anxiety disorders.,"Two experiments were conducted to study selective memory bias favoring anxiety-relevant materials in patients with anxiety disorders. In the 1st experiment, 32 patients with generalized anxiety disorder (GAD), 30 with social phobia (speaking anxiety), and 31 control participants incidentally learned GAD-relevant words, speech anxiety-relevant words, strongly pleasant words, and words with a neutral valence. Participants did not show any explicit memory bias for threatening materials. Thirty patients suffering from panic disorder (PD) with agoraphobia and 30 controls took part in the 2nd experiment. The design was similar to the 1st experiment. This time a highly specific selective memory bias for threatening words was found. Words describing symptoms of anxiety were better recalled by PD patients. Results are consistent with previous findings but are inexplicable by existing theories.",Becker ES.; Roth WT.; Andrich M.; Margraf J.,1999.0,,0,0,
10488,Selective attention in obsessive-compulsive disorder.,"Recent information-processing studies have suggested that a selective attention deficit may be involved in the symptomatology of obsessive-compulsive disorder (OCD). In this study, individuals diagnosed with OCD were distinguished from those with panic disorder and from control participants by their relatively poorer performance on a series of psychometric tasks of selective attention. These results are interpreted as supporting the hypothesis of a diminished ability of people with OCD to selectively ignore competing external (sensory) and internal (cognitive) stimuli, especially intrusive thoughts.",Clayton IC.; Richards JC.; Edwards CJ.,1999.0,,0,0,
10489,Fear-potentiated startle conditioning to explicit and contextual cues in Gulf War veterans with posttraumatic stress disorder.,"Aversive conditioning to explicit and contextual cues was examined in Gulf War veterans with and without posttraumatic stress disorder (PTSD) by use of the startle reflex methodology. Veterans participated in a differential aversive conditioning experiment consisting of 2 sessions separated by 4 or 5 days. Each session comprised two startle habituation periods, a preconditioning phase, a conditioning phase, and a postconditioning extinction test. In contrast to the non-PTSD group, the PTSD group showed a lack of differential startle response in the presence of a conditioned stimulus with or without an unconditioned stimulus in Session 1 and an increase in the baseline startle response during Session 2. The PTSD group also exhibited normal differential conditioning following reconditioning in Session 2. These data suggest that individuals with PTSD tend to generalize fear across stimuli and are sensitized by stress.",Grillon C.; Morgan CA.,1999.0,,0,0,
10490,Lesion topography and outcome after thermocapsulotomy or gamma knife capsulotomy for obsessive-compulsive disorder: relevance of the right hemisphere.,"Obsessive-compulsive disorder is a common mental disorder, notorious for its chronicity and intractability. Stereotactic lesions within the anterior limb of the internal capsule have been shown to provide symptomatic relief in such refractory cases, but only few systematic evaluations have correlated anatomic lesion location with individual postoperative outcome. Between 1976 and 1989, extremely disabled and otherwise intractable patients with a chronic deteriorating clinical course of obsessive-compulsive disorder underwent bilateral thermocapsulotomy (n = 22) or radiosurgical gamma knife capsulotomy (n = 13) at the Karolinska Hospital, Stockholm. Clinical morbidity was monitored prospectively pre- and postoperatively by using standardized psychiatric rating scales. In 29 patients (thermocapsulotomy, n = 19; gamma knife capsulotomy, n = 10), both psychiatric and magnetic resonance imaging follow-up data (median, 8.4 yr) were available. A right-sided anatomically defined lesion volume was identified in all successfully treated patients. This common topographic denominator was defined in the approximate middle of the anterior limb of the internal capsule on the plane parallel to the anterior commissure-posterior commissure line at the level of the foramen of Monro and 4 mm above on the plane defined by the internal cerebral vein. This region was unaffected in patients with poor outcomes. On the left side, no particular lesion topography was associated with clinical outcome. Topographic differences of lesion overlap between good and poor outcome groups were significant for the right side (Fisher's exact test, P < 0.005). The current anatomic long-term analysis after thermocapsulotomy or gamma knife capsulotomy for obsessive-compulsive disorder reveals common topographic features within the right-sided anterior limb of the internal capsule independent of treatment modality.",Lippitz BE.; Mindus P.; Meyerson BA.; Kihlström L.; Lindquist C.,1999.0,,0,0,
10491,Cardiac and mood-related changes during short-term abstinence from crack cocaine: the identification of possible withdrawal phenomena.,"Studies assessing withdrawal phenomenon during short-term abstinence from chronic cocaine use have been limited. Although cocaine abusers are reported to be at increased risk for cardiac disorders, little research has assessed cardiac parameters in cocaine abusers and subsequent changes in these parameters that may be associated with the discontinuation of cocaine use. In this study, we categorize 441 chronic cocaine abusers into three groups based on self-reported length of abstinence from cocaine use at entry into a trial approved by the National Institute on Drug Abuse (NIDA) assessing the use of pergolide mesylate in treating relapse and craving in crack cocaine abuse. Electrocardiogram (ECG) PR intervals were found to be correlated positively with length of abstinence, returning to normal population levels within 30 days. In addition, levels of generalized anxiety, nervousness, and heart racing were found to be correlated negatively with length of abstinence from crack cocaine. This work provides preliminary evidence of cardiac and mood-related parameters that are associated with cocaine abstinence and that may indicate specific withdrawal phenomena in chronic users. In addition, these results suggest that the risk of cardiomyopathies associated with abnormal atrial-ventricular polarization may dissipate relatively quickly in abusing individuals.",Kajdasz DK.; Moore JW.; Donepudi H.; Cochrane CE.; Malcolm RJ.,1999.0,,0,0,
10492,Attitudes towards pain and return to work in young immigrants on long- term sick leave.,"To explore attitudes towards pain and returning to work in young immigrants on long-term sick leave because of chronic pain. As a part of a randomised-controlled rehabilitation programme for immigrants 16-45 years of age on sick leave > 6 weeks, the participants in the experimental group were interviewed about their attitudes towards their pain. A primary health care centre in an immigrant district in Stockholm, Sweden. Twenty-six first generation immigrants with long-standing musculoskeletal or imprecise pain. Semi-structured interviews of explanatory models of pain. The content of the interviews was abstracted and categorised, with the focus on factors that might influence the rehabilitation process and especially cause pain anxiety. The majority of the interviewees were Turks and Southern Europeans with a median age of 38.5 years and a median sick leave of 12.0 months. Nearly all assessed themselves as having no capacity to work and two-thirds reported pain anxiety. The shared characteristics of the attitude to pain were that rest is the best treatment and that occupational work is the main etiological factor for the pain. A difference was found regarding the meaning of the pain, with one cluster of interviewees focusing on a disorder (Type I attitudes) and the other cluster focusing on the pain sensation itself (Type II attitudes). These clusters were equally large and there were no significant differences regarding ethnicity, religion, or other data between them. However, persons in the Type II cluster were generally more fatalistic about their future health and significantly more were working, at least part-time, at the 3 (p < 0.05) and 8 month (p < 0.01) follow-ups. Differences in attitudes towards pain and in qualities of pain anxiety, either focusing on the meaning of pain and its consequences or on the immediate experience of pain, might influence rehabilitation.",Löfvander M.,1999.0,,0,0,
10493,The assessment and treatment of concerns and anxiety in patients undergoing presurgical monitoring for epilepsy.,"This study investigated the impact of a treatment information package on patients being monitored for possible surgical treatment for temporal lobe epilepsy. One hundred patients were randomly assigned to either a high- or low-information preparation condition. Levels of anxiety were tested soon after admission by using the Hospital Anxiety and Depression Scale (HADS), The State-Trait Anxiety Inventory (STAI), and a newly devised questionnaire to assess specific concerns and anxieties of epilepsy patients presenting for monitoring and surgery, the Concerns About Epilepsy Monitoring Questionnaire (CAEMQ). Dispositional desire for information was assessed by the Miller Behavioural Style Scale (MBSS) to investigate whether coping disposition affected coping styles in the hospital setting. Patients assigned to the high-information condition were exposed to an intervention package, which included viewing a video depicting two separate interviews with patients who had undergone surgery as well as an information package, which described the various tests that the patient would undergo in the course of the monitoring procedure. Patients assigned to the low-information group were given information that the hospital provided to all patients in their care. All subjects were then retested on anxiety levels a few days later. Those in the high-information group showed a significant decrease in anxiety and depression levels compared with those in the low-information group. Within the main findings, an effect of dispositional style was found. Identification as either a monitor or blunter on the MBSS showed different coping strategies on arrival in hospital as measured by the CAEMQ, indicating that the level of information given to patients with epilepsy on arrival needs to be mediated by awareness of these two dispositional styles so that they obtain maximal benefit from the information to which patients with epilepsy are exposed.",Andrewes D.; Camp K.; Kilpatrick C.; Cook M.,1999.0,,0,0,
10494,Millon multiaxial personality patterns differentiate depressed and anxious outpatients.,"Ninety-three patients, including 47 patients with Generalized Anxiety Disorder (GAD) and 46 patients with Major Depression (MD), were entered into recent clinical trials. Clinicians acknowledge that during the initial screening process, clear separation between depressed and anxious patients may be difficult. By using the DSM-IV criteria, the Hamilton Depression and Anxiety Scales, and a variety of other structured evaluations, patients were divided into the two diagnostic groups. The Millon Multiaxial Inventory (MCMI-III) was administered to all 93 patients as part of their initial assessment, but was not used in the diagnostic decision making process or in assignment to a particular clinical study. Upon completion of these studies, the Millon data were analyzed utilizing a cutoff score of 75, conforming to previous studies. Statistically significant differences in Millon personality patterns between MD and GAD patients included dependent, obsessive-compulsive, self-defeating, and borderline traits. Patients exhibiting dependent, self-defeating, and borderline patterns were statistically more likely to be included in clinical trials of MD rather than GAD. Also, patients with MD were more likely to disclose clinical information and exhibit self-critical behavior when compared to those with GAD. These results suggest that the MCMI-III may detect personality differences between anxious and depressed outpatients presenting for clinical trials.",Freeman AM.; Kablinger AS.; Rolland PD.; Brannon GE.,1999.0,,0,0,
10495,Naltrexone and cognitive behavioral therapy for the treatment of outpatient alcoholics: results of a placebo-controlled trial.,"The opiate antagonist drug naltrexone has been shown in a few studies with limited sample sizes to be effective when combined with psychosocial therapies for the treatment of alcohol dependence. The goal of this study was to obtain additional information regarding its efficacy in pertinent alcoholic populations and with a well-defined therapy. In this study, 131 recently abstinent alcohol-dependent outpatients were treated with 12 weekly sessions of manual-guided cognitive behavioral therapy and either 50 mg/day of naltrexone (N = 68) or placebo (N = 63) (with riboflavin added as a marker of compliance) in a double-blind, randomized clinical trial. Alcohol consumption, craving, adverse events, and urinary riboflavin levels were assessed weekly. Levels of blood markers of alcohol abuse were also ascertained during the trial. The study completion, therapy participation, and medication compliance rates in the trial were high, with no differences between treatment groups. Naltrexone-treated subjects drank less, took longer to relapse, and had more time between relapses. They also exhibited more resistance to and control over alcohol-related thoughts and urges, as measured by a subscale of the Obsessive Compulsive Drinking Scale. Over the study period, 62% of the naltrexone group did not relapse into heavy drinking, in comparison with 40% of the placebo group. Motivated individuals with moderate alcohol dependence can be treated with greater effectiveness when naltrexone is used in conjunction with weekly outpatient cognitive behavioral therapy. Naltrexone increases control over alcohol urges and improves cognitive resistance to thoughts about drinking. Thus, the therapeutic effects of cognitive behavioral therapy and naltrexone may be synergistic.",Anton RF.; Moak DH.; Waid LR.; Latham PK.; Malcolm RJ.; Dias JK.,1999.0,10.1176/ajp.156.11.1758,0,0,
10496,Treating acute stress disorder: an evaluation of cognitive behavior therapy and supportive counseling techniques.,"Acute stress disorder permits an early identification of trauma survivors who are at risk of developing chronic posttraumatic stress disorder (PTSD). This study aimed to prevent PTSD by an early provision of cognitive behavior therapy. Specifically, this study indexed the relative efficacy of prolonged exposure and anxiety management in the treatment of acute stress disorder. Forty-five civilian trauma survivors with acute stress disorder were given five sessions of 1) prolonged exposure (N = 14), 2) a combination of prolonged exposure and anxiety management (N = 15), or 3) supportive counseling (N = 16) within 2 weeks of their trauma. Forty-one trauma survivors were assessed at the 6-month follow-up. Fewer patients with prolonged exposure (14%, N = 2 of 14) and prolonged exposure plus anxiety management (20%, N = 3 of 15) than supportive counseling (56%, N = 9 of 16) met the criteria for PTSD after treatment. There were also fewer cases of PTSD in the prolonged exposure group (15%, N = 2 of 13) and the prolonged exposure plus anxiety management group (23%, N = 3 of 13) than in the supportive counseling group (67%, N = 10 of 15) 6 months after the trauma. Chronic PTSD in the supportive counseling condition was characterized by greater avoidance behaviors than in the prolonged exposure condition or the prolonged exposure plus anxiety management condition. These findings suggest that PTSD can be effectively prevented with an early provision of cognitive behavior therapy and that prolonged exposure may be the most critical component in the treatment of acute stress disorder.",Bryant RA.; Sackville T.; Dang ST.; Moulds M.; Guthrie R.,1999.0,10.1176/ajp.156.11.1780,0,0,
10497,Open trial of interpersonal psychotherapy for the treatment of social phobia.,"Interpersonal psychotherapy is a time-limited treatment initially developed to treat depression. It has not been studied for the treatment of anxiety disorders. Interpersonal psychotherapy was modified and tested in a 14-week, open trial of nine patients with DSM-IV social phobia. At termination, seven (78%) were independently rated as much or very much improved on overall social phobia symptoms. Nearly all clinician ratings and self-ratings of social phobia symptoms significantly improved. Changes approximated those of established treatments for social phobia. Interpersonal psychotherapy may have efficacy for the treatment of social phobia. Further study in a comparison trial is warranted.",Lipsitz JD.; Markowitz JC.; Cherry S.; Fyer AJ.,1999.0,10.1176/ajp.156.11.1814,0,0,
10498,Depressive and anxiety symptoms in patients with schizophrenia and schizophreniform disorder.,"Symptoms of depression and anxiety are frequently encountered in the course of schizophrenia and are of considerable clinical importance. They may compromise social and vocational functioning, and they are associated with an increased risk of relapse and suicide. Various treatment approaches have been reported to be successful. The sample comprised 177 patients with DSM-III-R or DSM-IV schizophrenia or schizophreniform disorder who were participants in multinational clinical drug trials at our academic psychiatric unit over a 7-year period and who were assessed by means of the Positive and Negative Syndrome Scale (PANSS). Analysis was performed on baseline PANSS scores. The depression/anxiety score was compared in the men and women, first-episode and multiple-episode patients, and those with predominantly positive and negative syndromes. Correlations were sought between depression/anxiety scores and age, total PANSS score, positive score, negative score, general psychopathology score, and treatment outcome. Multivariate analysis was applied to determine contributions of individual variables toward depression/anxiety and outcome scores. Depression and anxiety symptoms were more severe in women (p = .007), first-episode patients (p = .02), and those with predominantly positive symptoms (p < .0001). Depression/anxiety scores were significantly correlated to age (r = -0.31, p < .0001), PANSS positive scores (r = 0.39, p < .0001), and treatment outcome (r = 0.25, p = .006). Multivariate analysis bore out these results, with the exception that first episode was not a significant predictor of depression and anxiety scores. PANSS depressive/anxiety scores were generally low in our sample, perhaps because patients with schizoaffective disorder were excluded. The finding that these symptoms were more prominent in women and first-episode patients is in keeping with previous literature. The higher scores in first-episode patients are likely due to the higher positive symptom scores in these patients. The association between depressive/anxiety scores and positive symptoms but not with negative symptoms points to a specific relationship between affective symptoms and the positive symptom domain of schizophrenia. The presence of depressive and anxiety symptoms may predict a more favorable outcome to treatment, although this may only apply to the acute exacerbations of the illness.",Emsley RA.; Oosthuizen PP.; Joubert AF.; Roberts MC.; Stein DJ.,1999.0,,0,0,
10499,[Complex diagnostics and treatment of patients with neurocirculatory dystonia by bioregulation of the heart rate].,,Bogdanova TA.; Iakovlev NM.; Klimenko VM.,1999.0,,0,0,
10500,Specific phobia 10-16 years after treatment.,"Twenty eight participants, initially treated for specific phobia as part of a comparative treatment study, were evaluated 10 to 16 years (X = 12 years) later. A comprehensive, in-person, semi-structured diagnostic interview was utilized, which also assessed comorbid disorders. Of 21 patients who had been rated as responders (much improved or very much improved) at treatment termination, 13 (62%) had clinically significant avoidance or endurance with dread subsequent to treatment. Among a subgroup of these responders who had been considered completely recovered (n = 11), 5 (45%) had clinically significant symptoms following treatment. None of the seven subjects who had been considered unimproved at treatment termination recovered from phobia symptoms in the intervening years. Positive response to treatment was associated with better long term outcome. Clinical characteristics, such as phobia subtype, age of onset, baseline severity, and lifetime comorbidity of other psychiatric disorders were not associated with long term outcome in this sample. Type of treatment was not associated with long term outcome. Results challenge the notion that recovery from specific phobia following treatment is characterized by complete and enduring cessation of symptoms.",Lipsitz JD.; Mannuzza S.; Klein DF.; Ross DC.; Fyer AJ.,1999.0,,0,0,
10501,Influence of median sternotomy on the psychosomatic outcome in coronary artery single-vessel bypass grafting.,"New less invasive surgical techniques for the treatment of coronary artery single-vessel disease have been developed by either avoiding median sternotomy or cardiopulmonary bypass or both, however, until now no prospective randomized trial has been carried out to compare these techniques to the conventional approach with special respect to the psychosomatical effects. In a prospective randomized trial four different surgical techniques were compared. Group 1: conventional technique (median sternotomy, cardiopulmonary bypass) in ten patients (eight male, two female, age 59.6 +/- 11.0 years); Group 2: off-pump coronary artery bypass with median sternotomy in nine patients (six male, three female, age 65.7 +/- 11.1 years); Group 3: lateral minithoracotomy and cardiopulmonary bypass in eight patients (five male, three female, age 62.3 +/- 9.9 years). Group 4: off-pump procedure and lateral minithoracotomy in nine patients (eight male, one female, age 63.8 +/- 11.3 years). All patients due to coronary artery single-vessel disease. The tests used for psychosomatic situation were post-traumatic stress disorders scale, pain behavior rating scale, pain visual analog scale, and 6' walking-distance. For detection of false results due to surgical technical failures 3-month follow-up was undertaken including echocardiography and coronary angiogram. There were no deaths or major complications. Operative time was longer in lateral minithoracotomy procedures, but intensive care unit stay and hospitalization were equal in all groups. Pain visual analog scale and pain behavior rating scale showed a peak on post-operative day 4 in median sternotomy procedures. Post-traumatic stress disorder scale revealed higher values on post-operative day 4 and equalizing with lateral minithoracotomy procedures 1 month post-operatively. Six-minutes walking distance on post-operative day 4 was longer in the group with lateral minithoracotomy. Three-month follow-up revealed patency of all grafts. Even if surgery is successful in all procedures, operative time is longer in lateral minithoracotomy procedures without compromising intensive care unit stay and hospital stay. More pain with multiple post-traumatic stress disorders is related to median sternotomy, and post-operative convalescence is superior for lateral minithoracotomy procedures.",Gulielmos V.; Eller M.; Thiele S.; Dill HM.; Jost T.; Tugtekin SM.; Schueler S.,1999.0,,0,0,
10502,Relaxation training inhibits fear and arousal during in vivo exposure to phobia-cue stimuli.,"Twenty carefully selected snake phobics were exposed to a caged snake for eight trials via a conveyor apparatus. During the first and eighth trials the subjects brought the snake toward themselves as closely as tolerable; records were kept of the end-of-trial distances remaining between the subject and the snake. For the six intervening trials the experimenter placed the snake a standard distance away; records were kept of the subjects' heart rates and skin-conductance levels before and during the exposures, and of their self-reported fear intensities after the exposures. Half of the subjects had received six sessions of progressive relaxation training before the exposures occurred. The results for subjects who had received relaxation training versus subjects who had not received relaxation training showed clearly that the training served to attenuate arousal and fear in the context of in vivo exposure. The results showed also that relaxation worked by lowering arousal throughout the course of exposure, not by hastening or facilitating arousal decrement during exposure. Some implications of the results are discussed.",McGlynn FD.; Moore PM.; Lawyer S.; Karg R.,1999.0,,0,0,
10503,"Predictors of emotional numbing, revisited: a replication and extension.","Litz et al. (1997), theorizing that emotional numbing (EN) is the result of emotional depletion caused by chronic hyperarousal, demonstrated that a cluster of hyperarousal symptoms was a robust predictor of EN symptoms. In the present study, these findings were replicated and extended in two multiple regression analyses of data from a large, multisite investigation (T. M. Keane et al., 1998) of psychophysiological responding by male combat veterans. The arousal (D) cluster of symptoms was again the most robust predictor of EN symptoms, whereas physiological indices of arousal and reactivity accounted for negligible amounts of variance in both regression equations. These findings underscore the possible link between disturbances related to arousal and the capacity of traumatized individuals to express and experience pleasant feelings.",Flack WF.; Litz BT.; Hsieh FY.; Kaloupek DG.; Keane TM.,2000.0,10.1023/A:1007806132319,0,0,
10504,[A trial of using psychotherapy in the sanatorium on servicemen with psychosomatic pathology of the cardiac system].,"Administration of rehabilitation psychotherapy, including pathogenetic and symptomatic psychotherapy, raises efficacy of combined sanatorium treatment of early stages of such cardiological diseases as ischemic heart disease, angina of effort class I, essential hypertension stage I. Psychotherapy also promotes relief of psychoemotional stress, anxiety, frustration, rigidity, aggression, alexithymia, asthenia being primary and secondary prophylaxis of psychosomatic disorders.",Gvazava VE.; Fedenko AI.; Vinokurov IuV.; Kataeva EM.; Bulyshchenko GN.; Sheina SG.,,,0,0,
10505,Preplanned correction of enophthalmos using diced cartilage grafts.,"A simple technique for correcting post-traumatic enophthalmos is presented. Autogenous costal cartilage was chopped into small pieces and used to fill up the medial orbital wall defect in five patients. The measured degrees of enophthalmos ranged from 2 to 4 mm, and 3-5. 5 ml of filler material was introduced into the periorbital space. A conservative approach via upper and lower eyelid incisions was used. It was found that 1.37-1.5 ml of graft material results in 1 mm advancement of globe position. This correlation appears to be a useful treatment guideline for medial orbital wall blow-out fractures. Transient diplopia developed in three cases, but settled within 4 months. There were no other major sequelae after the operation. The follow-up period ranged from 8 months to 3 years. The improved appearance and the stable results confirm the validity of this approach.",Lee J.,2000.0,10.1054/bjps.1999.3244,0,0,
10506,A specific attentional bias in suicide attempters.,"Selective attention in patients after an attempted suicide was investigated to find out whether a specific attentional bias for suicide-related materials exists and to clarify the possible role of emotions in the bias. Thirty-one patients who had previously attempted to commit suicide and 31 control participants took part in a modified Stroop task. The suicidal patients took significantly longer to name the colors of suicide-related words compared with other words, whereas color naming times of the control participants did not differ for suicide-related, neutral, positive, or negative words. Therefore, the attentional bias exhibited by suicidal patients was highly specific. There was no relation between the bias and measures of anxiety, depression, or hopelessness, whereas suicidal ideation correlated significantly with the attentional bias.",Becker ES.; Strohbach D.; Rinck M.,1999.0,,0,0,
10507,Motor cortex stimulation for chronic neuropathic pain: a preliminary study of 10 cases.,"There is growing evidence to support the use of motor cortex stimulation (MCS) in the management of patients with chronic neuropathic pain. A prospective audit of ten patients using a modified staged technique for motor cortex implantation provides further evidence for the analgesic effectiveness of this technique. Ten patients suffering from phantom limb pain (n=3), post stroke pain (n=5), post traumatic neuralgia secondary to gunshot injury to the brain stem (n=1) and brachyalgia secondary to neuro-fibromatosis (n=150% pain relief) and long-term benefit in 4/5 of patients who initially responded to intermittent cortical stimulation (longest follow up 31 months after implantation). Of those patients who benefited two had post stroke pain, two phantom limb pain and one post-traumatic neuralgia. We conclude that motor cortex stimulation is an effective analgesic intervention in some patients with chronic neuropathic pain, but it is difficult if not impossible to predict those patients who may respond to treatment prior to implantation. Randomised controlled trials are now urgently needed to test the effectiveness of motor cortex stimulation under double-blind conditions.",Carroll D.; Joint C.; Maartens N.; Shlugman D.; Stein J.; Aziz TZ.,2000.0,,0,0,
10508,Effects of an outreach intervention on use of mental health services by veterans with posttraumatic stress disorder.,"The study examined the effectiveness of an outreach intervention designed to increase access to mental health treatment among veterans disabled by chronic posttraumatic stress disorder (PTSD) and identified patient-reported barriers to care associated with failure to seek the treatment offered. Participants were 594 male Vietnam veterans who were not enrolled in mental health care at a Department of Veterans Affairs (VA) medical center but who were receiving VA disability benefits for PTSD. Half the sample was randomly assigned to an outreach intervention, and the other half was assigned to a control group. Veterans in the intervention group received a mailing that included a brochure describing PTSD treatment available at an urban VA medical center, along with a letter informing them about how to access care. Participants in the intervention group were subsequently telephoned by a study coordinator who encouraged them to enroll in PTSD treatment and who administered a survey assessing barriers to care. Veterans in the intervention group were significantly more likely than those in the control group to schedule an intake appointment (28 percent versus 7 percent), attend the intake (23 percent versus 7 percent), and enroll in treatment (19 percent versus 6 percent). Several patient-identified barriers were associated with failure to seek VA mental health care, such as personal obligations that prevented clinic attendance, inconvenient clinic hours, and current receipt of mental health treatment from a non-VA provider. Utilization of mental health services among underserved veterans with PTSD can be increased by an inexpensive outreach intervention, which may be useful with other chronically mentally ill populations.",McFall M.; Malte C.; Fontana A.; Rosenheck RA.,2000.0,10.1176/appi.ps.51.3.369,0,0,
10509,Prevalence and symptomatology of comorbid obsessive-compulsive disorder among bulimic patients.,"This study sought to assess the prevalence and symptomatology of comorbid obsessive-compulsive disorder (OCD) among Japanese subjects who met the DSM-III-R criteria for bulimia nervosa (BN). The Structured Clinical Interview for DSM-III-R Patient Version was used to distinguish 26 BN patients with concurrent OCD from 52 BN patients without OCD. Obsessive-compulsive symptoms in BN subjects with concurrent OCD were evaluated using the Japanese version of the Yale-Brown Obsessive-Compulsive Scale. There were no differences in the prevalence of concurrent OCD between BN subjects with and without a lifetime history of anorexia nervosa. Among BN subjects with concurrent OCD, symptoms related to symmetry and order were most frequently identified, followed by contamination and aggressive obsessions, and checking and cleaning/washing compulsions. Bulimia nervosa subjects with concurrent OCD were more likely than subjects without OCD to have more severe mood and core eating disorder psychopathology. Comorbid OCD is a common phenomenon in Japanese bulimics (33%) similar to that suggested in BN subjects in the Western countries. Obsessive-compulsive symptoms related to symmetry and order were most frequently observed in BN subjects with concurrent OCD, which was a similar finding to that reported among restricting anorexic subjects.",Matsunaga H.; Kiriike N.; Miyata A.; Iwasaki Y.; Matsui T.; Fujimoto K.; Kasai S.; Kaye WH.,1999.0,10.1046/j.1440-1819.1999.00622.x,0,0,
10510,Autonomic function in the early stage of panic disorder: power spectral analysis of heart rate variability.,"Previous studies of autonomic nervous system (ANS) function in panic disorder (PD) patients have yielded conflicting results. We speculate that these differences might result from the variety of clinical stages of PD. In order to investigate this, we compared ANS activity in untreated patients in the early stage of PD with control subjects using power spectral analysis of electrocardiogram R-R intervals (PSR-R) in supine rest and during head-up tilt, which was performed according to the maximum entropy method (MEM). It recognizes two main components: high-frequency power (HF), which mainly reflects cardiac parasympathetic activity, and low-frequency power (LF), which reflects both cardiac sympathetic and parasympathetic activity. The patients with PD had significantly higher values for all components of PSR-R only in tilt position total power (TP), LF, and HF than did the control subjects (P<0.01, <0.01, <0.02, respectively). However, the LF/HF ratio which indicated sympathovagal balance did not differ significantly between the two groups in tilt position. Our findings suggest that patients with PD in the early stage of illness have co-activation of sympathetic and parasympathetic nervous systems, which might act to maintain a balance between the two autonomic systems.",Ito T.; Inoue Y.; Sugihara T.; Yamada H.; Katayama S.; Kawahara R.,1999.0,10.1046/j.1440-1819.1999.00623.x,0,0,
10511,The efficacy of habituation in decreasing subjective distress among high anxiety-sensitive college students.,"While there is mounting evidence that the concept of anxiety sensitivity (AS) is linked to the expression of anxiety (specifically, panic), there has been little research comparing the efficacy of interoceptive exposure alone with interoceptive exposure coupled with cognitive restructuring among high AS participants. The present investigation addressed this issue in a sample of high anxiety-sensitive college students (scores above 29 on the Anxiety Sensitivity Index). Participants were randomly assigned to receive either five consecutive trials of voluntary hyperventilation or five consecutive trials of hyperventilation with cognitive restructuring instructions. It was expected that while repeated hyperventilation would be associated with a significant reduction in self-reported anxiety, catastrophic cognitions, and somatic sensations across trials, the greatest reduction in symptoms would occur with the addition of cognitive restructuring. These predictions were partially supported. As expected, high AS participants evidenced significant decreases in anxiety symptoms when habituation was accompanied by cognitive restructuring. Contrary to predictions, however, interoceptive exposure alone was not effective in reducing anxious symptoms. These results suggest that brief habituation alone may not be an effective strategy for high AS participants and are discussed as providing further support for a cognitive model of anxiety.",Carter MM.; Marin NW.; Murrell KL.,,,0,0,5504
10512,The use of the Panic and Agoraphobia Scale in a clinical trial.,"A new scale for assessing severity in PDA (Panic Disorder with/without Agoraphobia) has recently been developed: the Panic and Agoraphobia Scale [P & A (Bandelow, 1995)]. The objective of this study was to test whether the scale is sensitive to changes during a treatment trial. Thirty-seven patients (mean age, 32.7; S.D., 6.3) with PDA were treated with imipramine (75-150 mg/day) for 8 weeks in an open prospective trial. Patients with concurrent agoraphobia were instructed in practising self-exposure to agoraphobic situations. The total scores on the P & A, the Hamilton Anxiety Scale (HAMA) and the Clinical Global Impression Scale (CGI) were used as the main efficacy criteria. Treatment results were excellent, as could be shown by a decrease in the average severity scores of the P & A observer-rated version from 28.9 (S.D., 8.1) to 13.3 (S.D., 11.8; rank statistic T(N) = 6.7; P < 0.0001). The largest effect size r(w) of all clinician-rated scales was seen with the observer-rated version of the P & A, although closely followed by the CGI and the HAMA. Among the self-rated scales, the P & A (self-rated version) also showed the largest effect size. All five subscores of the P & A showed significant improvements. The highest treatment effect sizes could be seen in the 'panic attacks' subscore, followed by the 'anticipatory anxiety' subscore. The new Panic and Agoraphobia Scale (P & A) is a useful tool for measuring treatment efficacy in panic disorder trials.",Bandelow B.; Brunner E.; Broocks A.; Beinroth D.; Hajak G.; Pralle L.; Rüther E.,1998.0,,0,0,
10513,"Cognitive-behavioral stress management intervention effects on anxiety, 24-hr urinary norepinephrine output, and T-cytotoxic/suppressor cells over time among symptomatic HIV-infected gay men.","The present study tested the effects of a multimodal cognitive-behavioral stress management (CBSM) intervention on anxious mood, perceived stress, 24-hr urinary catecholamine levels, and changes in T-lymphocyte subpopulations over time in symptomatic HIV+ gay men. Seventy-three men were randomized to either a group-based CBSM intervention (n = 47) or a wait-list control (WLC) condition (n = 26). Men assigned to CBSM showed significantly lower posttreatment levels of self-reported anxiety, anger, total mood disturbance, and perceived stress and less norepinephrine (NE) output as compared with men in the WLC group. At the individual level, anxiety decreases paralleled NE reductions. Significantly greater numbers of T-cytotoxic/suppressor (CD3+CD8+) lymphocytes were found 6 to 12 months later in those assigned to CBSM. Moreover, greater decreases in NE output and a greater frequency of relaxation home practice during the 10-week CBSM intervention period predicted higher CD3+CD8+ cell counts at follow-up.",Antoni MH.; Cruess DG.; Cruess S.; Lutgendorf S.; Kumar M.; Ironson G.; Klimas N.; Fletcher MA.; Schneiderman N.,2000.0,,0,0,
10514,Olfactory function evaluated by SPECT.,"Few articles on neuroimaging techniques in the study of central and peripheral olfactory pathways are present in the literature. By Single Photon Emission Computed Tomography (SPECT), cortical perfusion increment after sensorial stimulation can be evaluated objectively. In the present research, 10 healthy adults underwent SPECT by CER.TO.96 cerebral tomograph, before and after olfactory stimulation with lavender-water. A variable degree of cortical activation was detected in all patients. Gyrus rectus (+24.5%), orbito-frontal cortex (right +26.6%, left +25.6%), and superior temporal (right +9.9%, left +5.5%) cortical areas were always activated. A slight perfusion increase was present in middle temporal (right +3.2%, left +2.1%) and parieto-occipital (right +0.4%, left +2%) regions. Five patients affected by posttraumatic anosmia were also investigated: they showed a perfusion increment markedly inferior to 0.5% in every olfactory area. SPECT is a rather diffused, easily performed technique which yields objective semi-quantitative information on brain perfusion. Hence, it can be regarded as a promising contribution in the fields of smell neurophysiology, clinical olfactometry, and medicolegal queries.",Di Nardo W.; Di Girolamo S.; Galli A.; Meduri G.; Paludetti G.; De Rossi G.,,,0,0,
10515,Recurrent detoxification may elevate alcohol craving as measured by the Obsessive Compulsive Drinking scale.,"Research has demonstrated a relationship between the number of previous alcohol detoxifications and increased severity of the alcohol withdrawal syndrome (AWS) that is hypothesized to be similar to an electrophysiologic ""kindling process."" Application of a ""kindling"" model to AWS suggests that neuroadaptation of the central nervous system to repeated detoxifications may also cause neurobehavioral alterations that may affect ""craving."" This study examined craving as assessed by the Obsessive Compulsive Drinking Scale (OCDS) in 67 adult outpatients meeting DSM-IV criteria (American Psychiatric Association, 1994) for alcohol dependence and AWS having either < 2 and > or = 2 previous detoxifications. Results of ANCOVA revealed that patients with > or = 2 previous detoxifications had higher scores on a scale that measures obsessive thoughts about alcohol, drinking urges and behaviors, and a composite of these scores after controlling for alcohol dependence severity, depressive symptoms and number of drinks 2 weeks prior to the study. Findings emphasize the need to address craving and other psychological variables with respect to treatment of AWS.",Malcolm R.; Herron JE.; Anton RF.; Roberts J.; Moore J.,2000.0,,0,0,
10516,Measurement properties of the Galveston Orientation and Amnesia Test (GOAT) and improvement patterns during inpatient rehabilitation.,"To determine the measurement properties of the Galveston Orientation and Amnesia Test (GOAT) using the Rasch model and rating scale analysis (RSA). Calibration of data collected weekly during rehabilitation. Six inpatient rehabilitation facilities. 77 patients admitted for their first rehabilitation after traumatic brain injury. Rescoring the items as dichotomies, three strata of posttraumatic amnesia (PTA) were identified. All items cohered to define a single construct and the item hierarchy confirmed their hypothesized ordering. Equal-interval measures of PTA were developed that exhibited good reliability and validity. A self-scoring key was developed to more efficiently assess PTA.",Bode RK.; Heinemann AW.; Semik P.,2000.0,,0,0,
10517,Are there diurnal rhythms of anxiety?,,Hopkins MB.; Brown FM.; Borkovec TD.,2000.0,,0,0,
10518,The treatment of social phobia in general practice. is exposure therapy feasible?,"Exposure therapy is an effective treatment for generalized social phobia. Most patients with social phobia are treated in primary care, but family doctors are not usually trained to perform exposure therapy. We have conducted a study in primary care of the effect of exposure therapy alone or in combination with sertraline on generalized social phobia. The purpose of this article is to describe the training of GPs and the application of the treatment programme in general practice. Forty-five GPs were trained for approximately 30 h in assessing patients with social phobia and conducting exposure therapy. The training programme included scoring of videotaped interviews of five patients on several social phobia scales, and a videotape demonstrating different steps of an exposure therapy was used as a model for role play in group training. All of the GPs completed the training programme. The doctors expressed satisfaction with the programme and also found it useful in the treatment of patients with conditions other than social phobia. There was a significant difference in response between the treatment groups (P = 0.001), and the combination of exposure therapy and sertraline seemed to be particularly beneficial.",Haug TT.; Hellstr√∏m K.; Blomhoff S.; Humble M.; Madsbu HP.; Wold JE.,2000.0,,0,0,
10519,[Acupuncture in patients with minor depressive episodes and generalized anxiety. Results of an experimental study].,"In a placebo-controlled, randomized, modified double-blind study we investigated the effects of body needle acupuncture (n = 10) in 43 patients with minor depression (ICD 10 F32.0, F32.1) and 13 patients with generalized anxiety disorders (ICD10 F41.1). The severity of the disease was assessed by the Clinical Global Impression Scale (CGI). Treatment response was defined as a significant improvement in CGI. An intent-to-treat analysis was performed to compare treatment responses between verum- and placebo acupuncture. After completing an total of 10 acupuncture sessions the verum acupuncture group (n = 28) showed a significantly larger clinical improvement compared to the placebo group (Mann-Whitney test, p < 0.05). There were significantly more responders in the verum-compared to the placebo group (60.7% vs. 21.4%; chi-square test, p < 0.01). In contrast, no differences in the response rates were evident just after 5 acupuncture sessions. A multivariate analysis with the independent factor acupuncture (verum vs. placebo) and the results of the results of the additional rating scales (total score of HAMA, HAMD, Bf-S, BL) as dependent variables (ANOVA, 1:54 D.F.) revealed a clear trend towards lower HAMA scores in the verum group after completing 10 acupunctures (F3.29, p = 0.075). This corresponds well to the high response rate of 85.7% in patients with generalized anxiety disorders, in whom verum acupuncture was applied. Our results indicate that needle acupuncture (Du.20, Ex.6, He.7, Pe.6, Bl.62) leads to a significant clinical improvement as well as to a remarkable reduction in anxiety symptoms in patients with minor depression or with generalized anxiety disorders. The total sum of acupuncture sessions and the specific location of acupuncture needle insertions might be important factors for bringing about therapeutic success.",Eich H.; Agelink MW.; Lehmann E.; Lemmer W.; Klieser E.,2000.0,10.1055/s-2000-11624,0,0,6288
10520,Preventing psychological trauma in soldiers: the role of operational stress training and psychological debriefing.,"Armed conflict is associated with significant long-term psychiatric morbidity. Interventions to reduce the incidence of psychiatric disorder following psychological trauma may be classified into three categories. Primary prevention includes the selection, preparation and training of individuals likely to be exposed to potentially traumatizing events. Secondary prevention comprises a variety of brief psychological techniques immediately or shortly after traumatizing life events, the best known of which is Psychological Debriefing. Tertiary interventions comprise the treatment of established PTSD and others. Psychiatric morbidity was studied in 106 British soldiers returning from UN peace-keeping duties in the former Republic of Yugoslavia. All 106 soldiers received an Operational Stress Training Package prior to their deployment and a randomly selected group also received a post-operational PD. Very low rates of PTSD and other psychopathology were found overall and the Operational Stress Training Package may have contributed to this. Elevated CAGE scores suggestive of significant alcohol misuse were observed in both groups and chemical avoidance behaviours arising from this may have masked psychopathology. CAGE scores diminished significantly in the debriefed group by the end of the follow-up period suggesting that PD may have been of benefit despite the apparent absence of PTSD. This study also demonstrates that a high incidence of psychiatric morbidity is not an inevitable consequence of military conflict.",Deahl M.; Srinivasan M.; Jones N.; Thomas J.; Neblett C.; Jolly A.,2000.0,,0,0,6633
10521,The influence of occupational debriefing on post-traumatic stress symptomatology in traumatized police officers.,"Certain individuals, such as police officers, are exposed to traumatic events as part of their occupational roles. In an effort to prevent psychological illnesses, notably the post-traumatic stress disorder, from arising out of work-related traumatic incidents, psychological interventions have been developed such as Critical Incident Stress Debriefing (Mitchell, 1983; Mitchell & Everly, 1996). The present study tests the hypothesis that debriefing reduces the psychological morbidity caused by work-related incidents. Because debriefing techniques were not designed for application on a 'one-off' basis (Robinson & Mitchell, 1993), the procedure studied here consisted of three successive debriefing sessions (at 24 hours, 1 month and 3 months post-trauma), which included traumatic stress education. In a sample of 243 traumatized police officers, a subgroup of debriefed officers (N = 86) was compared with non-debriefed internal (N = 82) and external (N = 75) control groups. No differences in psychological morbidity were found between the groups at pre-test, at 24 hours or at 6 months post-trauma. One week post-trauma, debriefed subjects exhibited significantly more post-traumatic stress disorder symptomatology than non-debriefed subjects. High levels of satisfaction with debriefing were not reflected in positive outcomes. The findings are translated into recommendations for the future use of debriefing in police practice.",Carlier IV.; Voerman AE.; Gersons BP.,2000.0,,0,0,
10522,Use of percutaneous electrical nerve stimulation (PENS) in the short-term management of headache.,"To evaluate the short-term effects of percutaneous electrical nerve stimulation (PENS) in the management of three types of chronic headache. Traditional electroanalgesic therapies have been reported to be effective in the management of acute headache symptoms. However, no controlled studies have been performed in patients with chronic headache. Thirty patients with either tension headache, migraine, or posttraumatic headache symptoms of at least 6 months' duration were randomized to receive PENS (needles with electricity) or ""needles alone"" according to a crossover study design. All treatments were administered for 30 minutes, three times a week for 2 consecutive weeks with 1 week off between the two different treatments. For the PENS treatments, an alternating electrical stimulation frequency of 15 and 30 Hz was used. Pain, activity, and sleep scores were assessed using a 10-cm visual analog scale, with 0 corresponding to the best and 10 to the worst, during the 48-hour period prior to the beginning of the two treatments, immediately before and after each treatment session, and 48 hours after completing each treatment modality. Compared with the needles alone, PENS therapy was significantly more effective in decreasing the overall VAS pain scores for tension-type headache, migraine and posttraumatic headache (58%, 59%, and 52% versus 20%, 15%, and 20%, respectively). Similarly, PENS therapy produced greater improvement in the patients' physical activity (41% to 58% for PENS versus 11% to 21% for needles only) and quality of sleep (41% to 48% for PENS versus 12% to 20% for needles only). However, there were no differences in the pattern of the response to PENS therapy among the three headache groups. Percutaneous electrical nerve stimulation appears to be a useful complementary therapy to analgesic and antimigraine drugs for the short-term management of headache. Interestingly, the analgesic response to PENS therapy appears to be independent of the origin of the headache symptoms.",Ahmed HE.; White PF.; Craig WF.; Hamza MA.; Ghoname ES.; Gajraj NM.,2000.0,,0,0,
10523,"[Disturbances in interpersonal functioning and levels of anxiety, depression and aggression in persons persecuted for political reasons in Poland in the years 1944-1956].","The article presents the results of comparison of 30 victims of political persecution in Poland in the years 1944-1956 (with a diagnosis of PTSD) with a control group in regard to the styles of interpersonal functioning, anxiety, depression and aggression. The examined persons manifest changes in the quality of social contacts--increased results on the scales of hostility syndrome, helplessness, and appeal for help, and decreased results on the scales examining pro-social tendencies. The examined persons are characterized by low affiliation, high level of indifference as well as features developed on the ground of anxiety: lack of self-acceptance, suspiciousness, aggression and negative self-evaluation in comparison with others. They are also characterized by high level of depression, readiness to react with fear or anxiety as the actual state during examination. These categories determine the psychological results of injuries suffered by the examined persons in the past.",Czaja I.; Gierowski JK.,,,0,0,
10524,Absorbable implants for open shoulder stabilization: a clinical and serial radiographic evaluation.,"Eighteen consecutive patients who had recurrent, unidirectional, post-traumatic shoulder instability were included. All the patients underwent surgery with a standardized open Bankart technique involving absorbable suture anchors. No redislocations occurred during the study period of 31 months (range 25 to 38 months). The Rowe and Constant scores were 86 points (range 61 to 98 points) and 89 points (range 73 to 99 points), respectively. The strength measurements revealed 8.6 kg (range 3.8 to 15 kg) in 90 degrees abduction compared with 9.3 kg (range 2.2 to 16.5 kg) in the control shoulders (not significant). The external rotation in abduction was 65 degrees (range 20 degrees to 90 degrees) compared with 91 degrees (range 80 degrees to 105 degrees) in the control group (P < .001). RADIOGRAPHIC RESULTS: Signs of minor or moderate degeneration were found in 10 of 18 patients on the preoperative radiographs, in 15 of 18 at 7 months, and in 16 of 18 at 33 months (P < .05 before surgery vs 33 months). From the preoperative examination to the 7-month control, 7 of 18 patients had an increase in degenerative changes, and from the 7-month to the 33-month control, an increase was found in 8 of 18 (P = .008, before surgery vs 7 months; P = .005, 7 months vs 33 months). At the 7-month control, 8 of 18 patients had invisible or hardly visible drill holes, and 10 of 18 had visible or cystic drill holes at the site of implantation for the absorbable suture anchors. At the 33-month control, 10 of 18 patients had invisible or hardly visible drill holes, and 8 of 18 had visible or cystic drill holes (not significant, 7 months vs 33 months). The method resulted in stable shoulders in 17 of 18 patients. Degenerative changes were present on the radiographs in most of the patients and appeared to increase over time. Visible drill holes or drill holes with cystic changes were seen on the radiographs in a significant number of patients at the 7-month and the 33-month control and did not appear to heal during the follow-up period.",Ejerhed L.; Kartus J.; Funck E.; Köhler K.; Sernert N.; Karlsson J.,,,0,0,
10525,Subjective imagery in obsessive-compulsive disorder before and after exposure therapy. Pilot randomised controlled trial.,"Distressing mental imagery is hard to study experimentally in obsessive--compulsive disorder (OCD). To develop a way to assess mental imagery in OCD during functional magnetic resonance imaging (fMRI). A small randomised study, controlled for type and order of mental imagery and for treatment condition (exposure therapy guided by a computer or by a therapist, or relaxation guided by audio-tape). Before and after treatment, during fMRI scanning, patients imagined previously-rehearsed scenarios that evoked an urge to ritualise or non-OCD anxiety or a neutral state, and rated their discomfort during imagery. The method evoked greater discomfort during OCD imagery and anxiety (non-OCD) imagery than during neutral imagery. Discomfort was reduced by cancelling imagery. Discomfort during OCD imagery (but not during anxiety non-OCD imagery) fell after exposure therapy but not after relaxation. Results showed differences between OCD and non-OCD images and their change after successful treatment, and confirmed clinical suggestions that cancelling images reduced OCD discomfort. The method's success paves the way for further studies of mental imagery in OCD: for instance, during fMRI.",Marks IM.; O'Dwyer AM.; Meehan O.; Greist J.; Baer L.; McGuire P.,2000.0,,0,0,
10526,Anxiety as a correlate of response to the acute treatment of bipolar I disorder.,"Given the adverse impact of anxiety on treatment outcome in unipolar depression and the paucity of data on the role of anxiety in bipolar disorder, the authors sought to determine the effect of anxiety on the acute treatment response of patients with bipolar I disorder. The authors examined the correlates of response to the acute treatment of 124 consecutively treated patients with bipolar I disorder. Measures of anxiety included history of panic attacks and a composite variable reflecting current or past anxiety symptoms. History of panic attacks proved to be a significant correlate of nonremission. Anxiety, as assessed with the composite variable, was associated with longer time to remission, as was the treatment of depressive versus manic symptoms and mixed versus manic symptoms. Patients with anxiety as assessed with the composite variable and patients with a history of panic attacks reported more severe medication side effects. They also required a greater number of medications, either sequentially or in combination, in order to achieve remission. The findings suggest that anxiety is a clinically meaningful correlate of poor outcome in the acute treatment of bipolar I disorder.",Feske U.; Frank E.; Mallinger AG.; Houck PR.; Fagiolini A.; Shear MK.; Grochocinski VJ.; Kupfer DJ.,2000.0,10.1176/appi.ajp.157.6.956,0,0,
10527,Cognitive-behavioral group therapy for social phobia in female adolescents: results of a pilot study.,"To examine the efficacy of cognitive-behavioral group therapy for adolescents (CBGT-A) in females with social phobia and the effect of this treatment on the risk for major depression. Female adolescents with social phobia (N = 35) were randomly assigned to treatment (n = 12) or no treatment (n = 23) groups. Assessments were conducted at baseline, after treatment, and at a 1-year follow-up. Eleven subjects completed treatment. Sixteen weeks of treatment produced a significant improvement in interference and reduction in symptoms of social anxiety. There was a significant reduction in the number of subjects meeting DSM-IV criteria for social phobia in the CBGT-A versus the untreated group; however, at the 1-year follow-up there were no significant differences by treatment condition. There was also suggestive evidence that treatment of social phobia lowers the risk for relapse of major depression among those with a history of major depression. Combining social phobia and major depression as the outcome produced more robust treatment effects in the 1-year follow-up. This pilot study provides evidence for a moderate short-term effect of CBGT-A for treating female adolescents suffering from social phobia and indicates that treatment of social phobia may result in a reduction of major depression.",Hayward C.; Varady S.; Albano AM.; Thienemann M.; Henderson L.; Schatzberg AF.,2000.0,10.1097/00004583-200006000-00010,0,0,
10528,Recurrent images and early memories in social phobia.,"A recent model [Clark, D. M. & Wells, A. (1995). A cognitive model of social phobia. In R. Heimberg, M. Liebowitz, D. A. Hope & F. R. Schneier (Eds.), Social phobia: diagnosis, assessment and treatment (pp. 69-93). New York: Guildford Press] suggests that a distorted image of one's public self lies at the heart of social phobia. A previous study of spontaneous imagery [Hackmann, A., Surawy, C. & Clark, D. M. (1998) Seeing yourself through others' eyes: a study of spontaneously occurring images in social phobia. Behavioural and Cognitive Psychotherapy, 26, 3-12] confirmed that patients with social phobia frequently report experiencing negative, distorted, observer-perspective images when in anxiety provoking social situations. In the present study, 22 patients with social phobia were given a semistructured interview which aimed to further explore the nature of social phobic imagery. All participants were able to identify negative spontaneous images that were recurrent in the sense that their content appeared to be relatively stable over time and across different feared social situations. Most recurrent images involved several sensory modalities. Most recurrent images were linked to memories of adverse social events that clustered in time around the onset of the disorder. Taken together, the results suggest that in patients with social phobia, early unpleasant experiences may lead to the development of excessively negative images of their social selves that are repeatedly activated in subsequent social situations and fail to update in the light of subsequent, more favourable experiences. Implications of the findings for the understanding and treatment of social phobia are discussed.",Hackmann A.; Clark DM.; McManus F.,2000.0,,0,0,
10529,Cognitive behavioral therapy of minor depressive symptoms in elderly Chinese Americans: a pilot study.,"There is a high prevalence of suicide among elderly Chinese, and particularly among elderly Chinese women in Mainland China with a prevalence of 19.6 per hundred thousand. Since Chinese individuals may much more highly value education, a cognitive-behavioral package originated by Ricardo Munoz, Ph.D. was adapted for Chinese American subjects. The material was videotaped in eight sessions, approximately 25 minutes in length, to be shown to community subjects who were at least 40 years and over. In addition, a videotape of muscular relaxation techniques was made. A manual written in Chinese about the content of each class, was given to each subject when he/she attended. The experimental group showed significant improvement in the scores in the Hamilton Depression Scale, including the Somatic Subscale in the Hamilton Anxiety Scale. There was no significant improvement in the control group on any of the measures. Thus the study suggests the efficacy of psychoeducational classes in reducing symptoms of depression in non-patient community elderly. Other studies are being conducted among Korean Americans and Japanese Americans in the United States, and also in the Orient among Japanese elderly.",Dai Y.; Zhang S.; Yamamoto J.; Ao M.; Belin TR.; Cheung F.; Hifumi SS.,1999.0,,0,0,
10530,Influence of panic-agoraphobic spectrum symptoms on treatment response in patients with recurrent major depression.,"The authors tested the hypothesis that a lifetime history of panic-agoraphobic spectrum symptoms predicts a poorer response to depression treatment. A threshold for clinically meaningful panic-agoraphobic spectrum symptoms was defined by means of receiver operating characteristic curve analysis of total scores on the Structured Clinical Interview for Panic-Agoraphobic Spectrum in a group of 88 outpatients with and without panic disorder. This threshold was then applied to a group of 61 women with recurrent major depression, who completed a self-report version of the same instrument, in order to compare treatment outcomes for patients above and below this clinical threshold. Women with high scores (> or =35) on the Panic-Agoraphobic Spectrum Self-Report were less likely than women with low scores (<35) to respond to interpersonal psychotherapy alone (43.5% versus 68.4%, respectively). Women with high scores also took longer (18.1 versus 10.3 weeks) to respond to a sequential treatment paradigm (adding a selective serotonin reuptake inhibitor when depression did not remit with interpersonal psychotherapy alone). This effect was only partially accounted for by the higher likelihood that patients with high scores required the addition of antidepressants. Although four domains from the Panic-Agoraphobic Spectrum Self-Report were individually associated with a longer time to remission, only stress sensitivity emerged as significant in multivariate regression analyses. A lifetime burden of panic-agoraphobic spectrum symptoms predicted a poorer response to interpersonal psychotherapy and an 8-week delay in sequential treatment response among women with recurrent depression. These results lend clinical validity to the spectrum construct and highlight the need for alternate psychotherapeutic and pharmacologic strategies to treat depressed patients with panic spectrum features.",Frank E.; Shear MK.; Rucci P.; Cyranowski JM.; Endicott J.; Fagiolini A.; Grochocinski VJ.; Houck P.; Kupfer DJ.; Maser JD.; Cassano GB.,2000.0,10.1176/appi.ajp.157.7.1101,0,0,
10531,Sonographic imaging of the distal phalanx.,"To investigate the potential role of ultrasonography (US) with very high frequency transducers in assessing distal phalanx involvement in some rheumatic diseases. We performed sonographic evaluation with an Esaote AU-4 Idea (Esaote Biomedica, Genoa, Italy) equipped with a 13-MHz linear transducer. The images were obtained in asymptomatic healthy subjects and representative patients with psoriatic arthritis, osteoarthritis of the distal interphalangeal joint (Heberden's nodes), erosive osteoarthritis, gout, rheumatoid arthritis, systemic sclerosis, and posttraumatic synovial cyst. US with very high frequency transducers allowed a careful identification of the following anatomic details: joint space, extensor and flexor tendons, bone margin, periarticular and peritendinous soft tissues, nail, and blood vessels. Several pathological changes were depicted in different rheumatic disorders. These included joint space widening, tendon sheath widening, dislocation of the joint surfaces, irregularity of the bone margin, and urate and calcium deposits within periarticular soft tissues. Very high frequency US is able to depict the anatomic substrate of distal phalanx involvement in several rheumatic diseases, adding useful information to clinical examination of the hand.",Grassi W.; Filippucci E.; Farina A.; Cervini C.,2000.0,,0,0,
10532,Factors associated with symptomatic improvement and recovery from major depression in primary care patients.,"This article describes a post-hoc analysis of clinical and psychosocial factors and beliefs about health associated with treatment outcome in a sample of depressed primary care patients (N=181) randomly assigned to a standardized treatment or physician's usual care (UC). Different factors were found to predict clinical outcomes for treatment modality [UC vs. interpersonal psychotherapy (IPT) or nortriptyline (NT)] and the type of outcome evaluated (i.e., depressive symptoms at 8 months or symptomatic and functional recovery at 8 months). Factors associated with treatment-specific outcomes are also described. Consistent with prior studies, lower depressive symptom severity at 8 months was associated with higher baseline functioning, minimal medical co-morbidity, race, and standardized pharmacologic or psychotherapeutic treatment. Additionally, an interaction between treatment modality and health locus of control indicated that individuals perceiving more self-control of their health and who received a standardized treatment experienced greater depressive symptom reduction at 8 months. Factors associated with symptomatic and functional recovery from the depressive episode were also examined. Patients who received a standardized treatment (IPT or NT) perceived greater control of their health and lacked a lifetime generalized anxiety disorder or panic disorder were more likely to recover by month 8 than those who received usual care. While clinical severity and treatment adequacy play an important role in both symptomatic improvement and full recovery from a depressive episode, other key factors such as health beliefs and non-depressive psychopathology also influence recovery.",Brown C.; Schulberg HC.; Prigerson HG.,,,0,0,6127
10533,Visuo-spatial attention processes in panic disorder with agoraphobia: a pilot study using a visual target discrimination task.,"Panic attacks can be observed in a wide range of situations, but most common are those providing complex and unstructured stimulations, suggesting an impairment in attentional processing of visuo-spatial information. This study evaluated agoraphobics' attentional processing of neutral (i.e., not anxiety-provoking) visuo-spatial stimulation. Twelve patients suffering from panic attacks with agoraphobia were compared with 22 normal controls on a computerized visual target discrimination task specifically designed for this study. Psychometric measures assessed the phobic avoidance, the level of depression and anxiety. The numbers of errors and reaction times were analysed with a three-way ANOVA (Group x target modality x number of stimulations). No between-group significant difference was found for the reaction time performance and the mean number of detection errors. However, an interaction effect was observed for this last variable depending on the target modality: agoraphobic patients made fewer omission errors than control subjects when the target was present among distractors, while they made more commission errors when the target was absent. Outcomes are discussed in terms of attentional hyperactivation related to anxiety and perseverative decision process in agoraphobic patients.",Dupont H.; Mollard E.; Cottraux J.,2000.0,,0,0,
10534,Attempting suppression of traumatic memories over extended periods in acute stress disorder.,"This study investigated the influence of attempted suppression and thought control strategies on traumatic memories. Survivors of civilian trauma with acute stress disorder (ASD; n = 20) and without ASD (n = 20) monitored their trauma-related thoughts for three 24-h periods. In period 1, participants were instructed to think about anything. In period 2, participants were administered suppression or nonsuppression instructions relating to thoughts of the trauma. In period 3, participants were again instructed to think about anything. The results revealed no evidence for an increase in trauma-related thoughts following suppression instructions. Punishment and worry thought control strategies correlated significantly with both anxiety and suppression ratings. Frequency of intrusions was associated with a distraction cognitive strategy. These findings point to the importance of traumatised individuals' cognitive strategies in mediating the management and occurrence of posttraumatic intrusions.",Guthrie R.; Bryant R.,2000.0,,0,0,
10535,Experimental manipulation of intolerance of uncertainty: a study of a theoretical model of worry.,"Intolerance of uncertainty has been identified as an important variable related to worry and Generalized Anxiety Disorder (GAD) [Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: a preliminary test of a conceptual model. Behaviour Research and Therapy, 36, 215-226; Ladouceur, R., Dugas, M. J., Freeston, M. H., Rhéaume, J., Blais, F., Boisvert, J.-M., Gagnon, F., & Thibodeau, N. (1999). Specificity of Generalized Anxiety Disorder symptoms and processes. Behavior Therapy, 30, 197-207]. The goal of the present study was to clarify the relationship between this cognitive process and worry by experimentally manipulating intolerance of uncertainty. A gambling procedure was used to increase intolerance of uncertainty in one group (N = 21) and to decrease intolerance of uncertainty in another group (N = 21). The results indicate that participants whose level of intolerance of uncertainty was increased showed a higher level of worry, compared to participants whose level of intolerance of uncertainty was decreased. These results provide some initial clarifications as to the causal nature of the link between intolerance of uncertainty and worry. These results are coherent with our theoretical model of worry and GAD (Dugas et al., 1998), which stipulates that intolerance of uncertainty plays a key role in the acquisition and maintenance of excessive worry.",Ladouceur R.; Gosselin P.; Dugas MJ.,2000.0,,0,0,
10536,Cognitive therapy by allocation versus cognitive therapy by preference in the treatment of panic disorder.,"Little is known about the influence of preference for a given therapy or preference against a modality of treatment on the outcome of that treatment. Results so far have been conflicting. The primary aim of this study was to investigate possible differences in outcome between panic disorder patients treated with preferred cognitive therapy and patients treated by randomization with the same intervention. A 12-week study comparing 35 patients treated by allocation with 31 patients treated by preference. There were no differences at pretest between the two conditions on demographic or outcome measures. Outcome was assessed with measurements rating the panic frequency and severity of agoraphobia, general anxiety and depression. Both conditions improved significantly on nearly all ratings. There were no significant differences demonstrable between the two conditions on any of the outcome measures. Preference for a given therapy is not a powerful moderator of effect in the psychological treatment of panic disorder.",Bakker A.; Spinhoven P.; van Balkom AJ.; Vleugel L.; van Dyck R.,,12402,0,0,
10537,"Cognitive and family therapies for adolescent depression: treatment specificity, mediation, and moderation.","The specificity of cognitive and family therapies, and potential treatment mediators and moderators, was examined in a randomized clinical trial for adolescent depression. After acute treatment, cognitive-behavioral therapy (CBT) exerted specific effects on cognitive distortions relative to either systemic-behavioral family therapy (SBFT) or nondirective supportive therapy (NST). At 2-year follow-up, SBFT was found to impact family conflict and parent-child relationship problems more than CBT; NST and CBT tended to show a greater reduction in anxiety symptoms than SBFT. Nonspecific therapist variables qualified few outcome analyses. No measures of cognitive distortion or family dysfunction mediated or moderated treatment outcome. As in adult studies, relatively few areas of treatment specificity or mediation were identified. The implications of these findings for clinical treatment and research in adolescent depression are discussed.",Kolko DJ.; Brent DA.; Baugher M.; Bridge J.; Birmaher B.,2000.0,,0,0,
10538,A controlled trial of cognitive behavioral treatment of panic in alcoholic inpatients with comorbid panic disorder.,"Patients entering a 4-week inpatient alcoholism treatment program were screened for anxiety symptoms. Those with panic disorder with or without agoraphobia were randomly assigned to two groups. The treatment group received 12 hours of cognitive-behavioral treatment (CBT) for panic disorder in addition to the regular alcoholism treatment program: the control group received the regular program. Dropouts from the treatment group were also followed. Problem drinking and anxiety symptoms were measured at the start of the study, and at 3, 6, and 12 months posttreatment. Abstinence from drinking, and anxiety and mood symptoms improved after treatment in all of the groups; there were few differences in outcome between the groups. We concluded that this particular intervention had not been more effective than the regular alcohol treatment program in reducing problem drinking in those with panic disorder.",Bowen RC.; D'Arcy C.; Keegan D.; Senthilselvan A.,,,0,0,
10539,Psychological debriefing for road traffic accident victims. Three-year follow-up of a randomised controlled trial.,"Psychological debriefing is widely used for trauma victims but there is uncertainty about its efficacy. We have previously reported a randomised controlled trial which concluded that at 4 months it was ineffective. To evaluate the 3-year outcome in a randomised controlled trial of debriefing for consecutive subjects admitted to hospital following a road traffic accident. Patients were assessed in hospital by the Impact of Event Scale (IES), Brief Symptom Inventory (BSI) and questionnaire and re-assessed at 3 months and 3 years. The intervention was psychological debriefing as recommended and described in the literature. The intervention group had a significantly worse outcome at 3 years in terms of general psychiatric symptoms (BSI), travel anxiety when being a passenger, pain, physical problems, overall level of functioning, and financial problems. Patients who initially had high intrusion and avoidance symptoms (IES) remained symptomatic if they had received the intervention, but recovered if they did not receive the intervention. Psychological debriefing is ineffective and has adverse long-term effects. It is not an appropriate treatment for trauma victims.",Mayou RA.; Ehlers A.; Hobbs M.,2000.0,,0,0,
10540,Influence of height on the spatial orientation and equilibrium of the body.,"The sway of the center of gravity for 30 seconds with a stabilometer was examined in 30 volunteers under 3 visual conditions (eyes open with and without fixation and eyes closed) at heights of 0, 1, and 2 m and under 2 visual conditions (eyes open with fixation and eyes closed) at a height of 10 m 22 cm. Eight of the subjects had acrophobia. The sway worsened at 10 m 22 cm but showed no change at 1 or 2 m. The acrophobic group became clearly worse at 10 m 22 cm. In another group of 12 volunteers, the subjects were guided to the roof with the eyes closed, and sway was measured. Sway was also measured with the eyes uncovered and open and again with the eyes closed. The first measurement with the eyes closed showed worse sway, and the second with the eyes open was better, except in 2 subjects who were acrophobic.",Nakahara H.; Takemori S.; Tsuruoka H.,2000.0,10.1067/mhn.2000.107316,0,0,
10541,[A clinical study of posttraumatic hydrocephalus].,"From 1989 to 1998, 721 patients with head injury were admitted to our department and 22 (3.1%) of them developed posttraumatic hydrocephalus. These patients included 16 males and 6 females, ranging in age from 17 to 86 years (mean age, 66 yrs) with peak incidence in the eighth decade. CT scan on admission immediately after head injury showed subarachnoid hemorrhage (SAH) in 18 cases. The other 4 cases without SAH had once suffered head injuries severe enough to give rise to consciousness disturbance. The typical clinical symptoms of hydrocephalus were observed in only 5 (23%) patients, and in the other 17 cases prolonged or deteriorated of consciousness disturbance were the main symptoms. Hydrocephalus was diagnosed between 1 and 3 months in 15 cases and in 7 cases after 4 months. Clinical improvement has been seen in 17 (77%) cases and marked recovery of consciousness was achieved in 12 cases after V-P shunt, but 5 cases with severe disturbance of consciousness revealed no improvement of clinical signs even after decrease of ventricular size. These results indicate that elderly patients with traumatic SAH should be followed up for at least 4 to 5 months, paying attention to development of hydrocephalus, and V-P shunt would be effective to improve consciousness disturbance in most of the cases.",Matsushita H.; Takahashi K.; Maeda Y.; Mandai S.; Gohda Y.; Kawauchi M.; Matsumoto Y.,2000.0,,0,0,
10542,Treatment of osteoarthritis of the elbow: a comparison of open and arthroscopic debridement.,"To assess the effectiveness of open and minimally invasive techniques in the debridement of osteoarthritis of the elbow, we compared the Outerbridge-Kashiwagi (O-K) procedure with an arthroscopic modification in which arthroscopic debridement and fenestration of the olecranon fossa was performed. The study took the form of a nonrandomized control trial in which subjects were allocated to a treatment depending on the hospital of presentation. Assessment using the Mayo Clinic elbow function chart enabled comparison of the outcome in 18 cases treated by the O-K procedure and 26 patients treated by arthroscopic debridement and fenestration of the olecranon fossa. Mean follow-up was 35.3 months (minimum 12 months). Of the patients treated by the O-K procedure, 14 were men and 4 were women with a mean age of 55 years. In 83% of patients, the diagnosis was primary osteoarthritis, with the remainder post-traumatic arthritis. The patients treated by arthroscopic debridement and fenestration of the olecranon fossa included 24 men and 2 women with a mean age of 46 years, and a diagnosis of primary osteoarthritis in 91% and post-traumatic arthritis in the remainder. No patients were excluded from the study or refused to be included. Both procedures were shown to be effective, with no major complications. Patients treated by arthroscopic debridement and fenestration of the olecranon fossa achieved better relief of pain (P <.10), whereas those patients undergoing the O-K procedure achieved significantly greater improvement in range of flexion (P <.05). No difference between the procedures in terms of patient-perceived overall effectiveness of the surgery was found. In conclusion, in the treatment of osteoarthritis of the elbow, arthroscopic debridement and fenestration of the olecranon fossa may be a more suitable procedure when painful symptoms predominate. In contrast, the O-K procedure is a significantly better procedure for improving the range of flexion where this is a particular problem.",Cohen AP.; Redden JF.; Stanley D.,2000.0,,0,0,
10543,The Sauvé-Kapandji procedure for posttraumatic wrist disorders: further experience.,"A prospective survey was conducted to evaluate the outcome of the Sauvé-Kapandji procedure for posttraumatic wrist disorders. Eighty four patients were treated, all with posttraumatic disorders of the distal radioulnar joint, 73 as an isolated procedure, 11 in combination with another wrist procedure. There was significant pain decrease and high patient satisfaction (74%). The range of motion increased in the flexion/extension arc from 109 degrees to 124 degrees (p = 0.006) and, in those with limited forearm rotation, from 71 degrees to 134 degrees (p = 0.006). According to the Mayo Clinic wrist score, we obtained 20 excellent, 34 good, 18 fair and 12 poor results. Complications were rare.",De Smet LA.; Van Ransbeeck H.,2000.0,,0,0,
10544,Open trial of psychodynamic psychotherapy for panic disorder: a pilot study.,"This report contains preliminary data from an open trial of brief psychodynamic psychotherapy for panic disorder. Fourteen patients with primary DSM-IV panic disorder completed a 24-session, twice-weekly course of psychodynamic psychotherapy. Other psychiatric treatment was not permitted throughout the 12-week treatment period and the 6-month follow-up. Symptoms were assessed at baseline, treatment termination, and 6-month posttermination follow-up (40 weeks). Statistically significant, clinically meaningful improvements appeared in panic, depression, anxiety, and functional impairment both at treatment termination and at 6-month follow-up. Psychodynamic monotherapy can be used successfully to retain and treat patients with panic disorder. Psychodynamic interventions warrant further study for patients with panic disorder.",Milrod B.; Busch F.; Leon AC.; Shapiro T.; Aronson A.; Roiphe J.; Rudden M.; Singer M.; Goldman H.; Richter D.; Shear MK.,2000.0,10.1176/appi.ajp.157.11.1878,0,0,
10545,"Counterconditioning in the treatment of spider phobia: effects on disgust, fear and valence.","From the perspective that disgust is a core feature of spider phobia, we investigated whether the treatment efficacy could be improved by adding a counterconditioning procedure. Women with a clinically diagnosed spider phobia (N = 34) were randomly assigned to the regular one-session exposure condition (EXP) or to the exposure with counterconditioning condition (CC). In the CC-condition tasty food-items were used during the regular exposure exercises and the participants' favourite music was played. Both treatment conditions appeared very effective in reducing avoidance behaviour and self-reported fear of spiders, strongly attenuated the disgusting properties of spiders and altered the affective evaluations in a positive direction. CC was not more effective in altering the affective valence of spiders than EXP and was not superior with respect to the long term treatment efficacy at 1 year follow up. Apparently, regular exposure treatment is already quite effective in altering the affective-evaluative component of spider phobia and it remains to be seen whether it is possible to further improve treatment outcome by means of procedures which are specifically designed to reduce the spiders' negative affective valence.",de Jong PJ.; Vorage I.; van den Hout MA.,2000.0,,0,0,
10546,The perceived efficacy of homeopathy and orthodox medicine: a vignette-based study.,"This study examined whether people thought neurotics were more likely to 'get better' when using CAM rather than orthodox medicine. A total of 165 participants completed a four part questionnaire, in which they were required to read eight vignettes (each about 70 words long) describing a British male patient who either visits a Homeopath or General Practitioner with a specific and different medical problem. In the vignette the patient gets better after treatment or remains unwell and they are described as either emotionally balanced (stable) or slightly neurotic in character (2 x 2 x 2 design). Participants were required to rate each vignette on criteria such as, did they think the treatment was effective, and did they think the person would remain feeling better. Homeopathy was perceived as more effective for treating patients with unstable psychological characteristics and orthodox medicine was seen as more effective for treating patients with stable psychological characteristics. Homeopathy was perceived as more effective by participants who themselves used complementary medicine. Participants who had visited a complementary therapist felt more strongly that psychological factors were important in illness than participants who had never consulted a complementary practitioner. Non-complementary medicine users perceived orthodox medicine to be more effective than complementary users.",Furnham A.; Bond C.,2000.0,10.1054/ctim.2000.0381,0,0,
10547,Transthoracic endoscopic sympathectomy for craniofacial hyperhidrosis: analysis of 46 cases.,"Craniofacial hyperhidrosis may result in social phobia and has a strong negative impact on the quality of life. The traditional therapeutic options are psychotherapy and pharmacologic treatment, but these often fail. We wished to investigate whether transthoracic endoscopic sympathectomy (TES) of the lower part of the stellate ganglion is efficient and safe in the treatment of craniofacial hyperhidrosis. Between July 1995 and September 1999, a total of 21 men and 25 women with a mean age of 41.2 years (range 22-58 years) underwent TES for craniofacial hyperhidrosis. All patients were placed in a semisitting position under single-lumen intubated anesthesia. We ablated the lower part of the stellate ganglion at the second rib using a storz 8-mm 0 degrees thoracoscope via one 0.8-cm incision just below each axilla. Questionnaires were sent to all patients postoperatively. Among these 46 patients, 92 sympathectomies were performed. Usually, TES was accomplished within 15 minutes (range 7-20 minutes). The surgical complications were minimal: one segmental atelectasis of the lung (2%). There was no surgical mortality. With a mean postoperative follow-up of 32.1 months (range 3-51 months), the results of TES were highly satisfactory in most patients although 37 (80%) developed compensatory sweating of the trunk and lower limbs, the distribution being the axillae in 15 (33%), back in 36 (78%), lower chest and abdomen in 22 (48%), lower limbs in 34 (74%) and sole in 1. The recurrence rates of craniofacial hyperhidrosis were 0 in the first and the second years and 2% each in the third and fourth years. Transthoracic endoscopic sympathectomy is a safe and effective method for treating craniofacial hyperhidrosis.",Lin TS.; Fang HY.,2000.0,10.1089/lap.2000.10.243,0,0,
10548,A second look at comorbidity in victims of trauma: the posttraumatic stress disorder-major depression connection.,"We examine whether traumatic events increase the risk for major depression independent of their effects on posttraumatic stress disorder (PTSD). Data come from the Epidemiologic Study of Young Adults in southeast Michigan (N = 1007). Retrospective and prospective data were used to estimate the risk of major depression in persons with PTSD and persons exposed to trauma with no PTSD, compared with persons who did not experience a trauma. National Comorbidity Survey data were used to evaluate the influence of trauma type. In the retrospective lifetime data, hazard ratios were, for first-onset major depression in exposed persons with PTSD, 2.8 and, in exposed persons with no PTSD, 1.3 (not significant), as compared with persons who were not exposed. Corresponding estimates from the prospective data were 11.7 and 1.4 (not significant). The difference in the risk for depression associated with PTSD versus exposure without PTSD is unlikely to be due to differences in trauma type. The findings of a markedly increased risk for major depression in persons with PTSD, but not in exposed persons without PTSD, do not support the hypothesis that PTSD and major depression in trauma victims are influenced by separate vulnerabilities.",Breslau N.; Davis GC.; Peterson EL.; Schultz LR.,2000.0,,0,0,
10549,"Randomised controlled trial of non-directive counselling, cognitive-behaviour therapy and usual general practitioner care in the management of depression as well as mixed anxiety and depression in primary care.","The aim of this study was to determine both the clinical and cost-effectiveness of usual general practitioner (GP) care compared with two types of brief psychological therapy (non-directive counselling and cognitive-behaviour therapy) in the management of depression as well as mixed anxiety and depression in the primary care setting. The design was principally a pragmatic randomised controlled trial, but was accompanied by two additional allocation methods allowing patient preference: the option of a specific choice of treatment (preference allocation) and the option to be randomised between the psychological therapies only. Of the 464 patients allocated to the three treatments, 197 were randomised between the three treatments, 137 chose a specific treatment, and 130 were randomised between the psychological therapies only. The patients underwent follow-up assessments at 4 and 12 months. The study was conducted in 24 general practices in Greater Manchester and London. A total of 464 eligible patients, aged 18 years and over, were referred by 73 GPs and allocated to one of the psychological therapies or usual GP care for depressive symptoms. The interventions consisted of brief psychological therapy (12 sessions maximum) or usual GP care. Non-directive counselling was provided by counsellors who were qualified for accreditation by the British Association for Counselling. Cognitive-behaviour therapy was provided by clinical psychologists who were qualified for accreditation by the British Association for Behavioural and Cognitive Psychotherapies. Usual GP care included discussions with patients and the prescription of medication, but GPs were asked to refrain from referring patients for psychological intervention for at least 4 months. Most therapy sessions took place on a weekly basis in the general practices. By the 12-month follow-up, GP care in some cases did include referral to mental healthcare specialists. The clinical outcomes included depressive symptoms, general psychiatric symptoms, social function and patient satisfaction. The economic outcomes included direct and indirect costs and quality of life. Assessments were carried out at baseline during face-to-face interviews as well as at 4 and 12 months in person or by post. At 4 months, both psychological therapies had reduced depressive symptoms to a significantly greater extent than usual GP care. Patients in the psychological therapy groups exhibited mean scores on the Beck Depression Inventory that were 4-5 points lower than the mean score of patients in the usual GP care group, a difference that was also clinically significant. These differences did not generalize to other measures of outcome. There was no significant difference in outcome between the two psychological therapies when they were compared directly using all 260 patients randomised to a psychological therapy by either randomised allocation method. At 12 months, the patients in all three groups had improved to the same extent. The lack of a significant difference between the treatment groups at this point resulted from greater improvement of the patients in the GP care group between the 4- and 12-month follow-ups. At 4 months, patients in both psychological therapy groups were more satisfied with their treatment than those in the usual GP care group. However, by 12 months, patients who had received non-directive counselling were more satisfied than those in either of the other two groups. There were few differences in the baseline characteristics of patients who were randomised or expressed a treatment preference, and no differences in outcome between these patients. Similar outcomes were found for patients who chose either psychological therapy. Again, there were no significant differences between the two groups at 4 or 12 months. Patients who chose counselling were more satisfied with treatment than those who chose c",King M.; Sibbald B.; Ward E.; Bower P.; Lloyd M.; Gabbay M.; Byford S.,2000.0,,0,0,
10550,Fear reduction in patients with dental treatment phobia.,"In a clinical trial, we examined short- and medium-term reduction of dental fear in patients with dental phobia. Ninety-one patients selected one of two treatments or no intervention before oral surgery (control group). One group comprised a one-session psychological treatment and included 25 patients. The second group chose oral selected midazolam and included 30 patients. Thirty-six patients chose the control group. In total, 50 patients completed the study (10 controls, 20 in the midazolam group, an d 20 in the treated group). The degree of fear was assessed by the Corah Dental Anxiety Scale. Before the operation, both interventions caused the degree of fear to fall significantly compared with the control group. Two months later, the midazolam group showed a return to baseline fear, whereas the psychologically treated group showed further improvement. Medium-term results after one year showed that compliance and reduction of fear remained only in the psychologically treated group.",Jöhren P.; Jackowski J.; Gängler P.; Sartory G.; Thom A.,2000.0,10.1054/bjom.2000.0531,0,0,
10551,"Randomised controlled trial of non-directive counselling, cognitive-behaviour therapy, and usual general practitioner care for patients with depression. II: cost effectiveness.","To compare the cost effectiveness of general practitioner care and two general practice based psychological therapies for depressed patients. Prospective, controlled trial with randomised and patient preference allocation arms. General practices in London and greater Manchester. 464 of 627 patients presenting with depression or mixed anxiety and depression were suitable for inclusion. Usual general practitioner care or up to 12 sessions of non-directive counselling or cognitive-behaviour therapy provided by therapists. Beck depression inventory scores, EuroQol measure of health related quality of life, direct treatment and non-treatment costs, and cost of lost production. 197 patients were randomly assigned to treatment, 137 chose their treatment, and 130 were randomised only between the two psychological therapies. At four months, both non-directive counselling and cognitive-behaviour therapy reduced depressive symptoms to a significantly greater extent than usual general practitioner care. There was no significant difference in outcome between treatments at 12 months. There were no significant differences in direct costs, production losses, or societal costs between the three treatments at either four or 12 months. Sensitivity analyses did not suggest that the results depended on particular assumptions in the statistical analysis. Within the constraints of available power, the data suggest that both brief psychological therapies may be significantly more cost effective than usual care in the short term, as benefit was gained with no significant difference in cost. There are no significant differences between treatments in either outcomes or costs at 12 months.",Bower P.; Byford S.; Sibbald B.; Ward E.; King M.; Lloyd M.; Gabbay M.,2000.0,,0,0,
10552,Specificity of neuropsychological impairment in obsessive-compulsive disorder: a comparison with social phobic and normal control subjects.,"Specificity of neuropsychological dysfunction in obsessive-compulsive disorder (OCD) was assessed by comparing neuropsychological performance in 65 OCD patients, 17 social phobic patients, and 32 normal control subjects. Although both patient groups showed visual constructional impairment relative to normal subjects, only patients with social phobia showed executive dysfunction. Nonconcurrent state anxiety did not correlate with neuropsychological performance. Among anxiety disorders, neuropsychological dysfunction may not be specific to OCD, but the functions implicated may differ across patient groups.",Cohen LJ.; Hollander E.; DeCaria CM.; Stein DJ.; Simeon D.; Liebowitz MR.; Aronowitz BR.,1996.0,10.1176/jnp.8.1.82,0,0,
10553,Ulnar shortening osteotomy in posttraumatic ulnar impaction syndrome.,"Twenty-eight patients (average age 45 years) with posttraumatic ulnar impaction syndrome underwent ulnar shortening osteotomy of 3-15 mm. Contributing factors were malunited fractures of the distal radius in 20, diaphyseal fractures of the ulna and radius in 6, resection of the radial head and a traumatic tear of the triangular fibrocartilage in 1 patient each. Evaluation at an average follow-up of 20 months showed a high rate of satisfied patients (89%), but according to Chun's modification of the Gartland-Werley score there were 1 excellent (3.5%), 11 good (39.5%), 11 fair (39.5%) and 5 poor (17.5%) results. Degenerative changes of the distal radioulnar joint were associated with fair and poor results, and ulnar shortening osteotomy is only recommended in ulnocarpal impaction with an intact distal radioulnar joint. Osteotomy fixation with 3.5 mm dynamic compression plates enabled immediate postoperative mobilisation and resulted in a low complication rate. There was no advantage for the technically more demanding oblique as compared with a transverse osteotomy.",Fricker R.; Pfeiffer KM.; Troeger H.,1996.0,,0,0,
10554,Arthroscopically assisted arthrodesis of the ankle joint.,"In 26 patients we performed an arthroscopically assisted arthrodesis of the ankle. The patients' ages ranged from 31 to 69 years. The male:female ratio. Sixteen patients had posttraumatic degenerative joint disease, three patients suffered from a previous infection, four patients had rheumatoid arthritis, and three patients had an osteochondritis dissecans in their past history. The time taken for surgery ranged from 65 to 135 min. Compared with open procedures we documented less postoperative swelling and minor use of analgesics. Time of follow-up was a minimum of 6 months and a maximum of 75 months. In 22 patients we found solid fusion at the time of followup. Fusion was accomplished by 2 months postoperatively in four patients, by 3 months in nine patients, by 4 months in another six patients, and by 6 months in 3 patients. Three patients did not evidence any bony fusion, but they were free of pain. In one patient an open revision was necessary. According to our experience, we recommend arthroscopically assisted arthrodesis of the ankle in patients with degenerative joint disease without rotational or varus/valgus malalignment, severe bone defects or neuropathic disease.",Jerosch J.; Steinbeck J.; Schroder M.; Reer R.,1996.0,,0,0,
10555,The Zurich Study: XXII. Epidemiology of gastrointestinal complaints and comorbidity with anxiety and depression.,"A representative cohort of Swiss adults recruited at age 20 years and interviewed at ages 23, 28 and 30 years was studied regarding the symptomatology, prevalence and longitudinal course of functional gastrointestinal symptoms and their association with psychiatric syndromes. A functional gastrointestinal complaint was identified if a proband reported symptoms at least eight times in the past year or for a duration of at least 2 weeks without medical explanation and with a moderate degree of distress. Of the population, 9.4-17.7% was found to suffer from functional stomach complaints and 4.9-16% from functional intestinal complaints. Women reported functional gastrointestinal complaints two to three times more often than men, and increasingly so with age. The overlap of stomach and intestinal complaints was modest with 2.0-6.7%. Cross sectionally, functional stomach complaints were significantly associated with major depression (DSM-III-R), recurrent brief depression (RBD), subthreshold RBD and dysthymia, and with subthreshold panic disorder, agoraphobia, social phobia and recurrent brief anxiety. Functional intestinal complaints showed a consistently significant association with RBD, dysthymia, major depression, subthreshold RBD, panic disorder, subthreshold panic disorder, agoraphobia, simple and social phobia and generalized anxiety disorder. Individuals who at younger ages suffered from functional gastrointestinal complaints did not show an increased risk for a subsequent development of an anxiety or depressive disorder. Functional gastrointestinal complaints reflect an unspecific concomitant vegetative disturbance common to depression and anxiety; they do not reflect a risk factor for the development of a specific anxiety or depressive disorder.",Hochstrasser B.; Angst J.,1996.0,,0,0,
10556,Cognitive-behavioral prevention of postconcussion syndrome.,"The symptoms of postconcussion syndrome (PCS) are persistent, and no empirically tested treatment is available. The treatment group (n = 29) in this study received a printed manual and met with a therapist prior to hospital discharge to review the nature and incidence of expected symptoms, the cognitive-behavioral model of symptom maintenance and treatment, techniques for reducing symptoms, and instructions for gradual resumption of premorbid activities. The control group (n = 29) received routine hospital treatment and discharge instructions. Both groups had sustained mild head injuries characterized by Glascow Coma Scale scores of 13-15 on admission without any measurable period of posttraumatic amnesia. Group assignment was random. Groups did not differ significantly on age, Glascow scores, litigation status, gender, or initial number of PCS symptoms. Patients were contacted 6 months following injury by an interviewer who was unaware of group assignment to obtain outcome data. Treated patients reported significantly shorter average symptom duration (33 vs. 51 days) and significantly fewer of the 12 symptoms at followup (1.6 vs. 3.1). Subjects were also asked how often each symptom had occurred in the previous week, and how severe the symptom typically was. The treatment group experienced significantly fewer symptomatic days (.5 vs. 1.3) and lower mean severity levels. Results suggest that brief, early psychological intervention can reduce the incidence of PCS.",Mittenberg W.; Tremont G.; Zielinski RE.; Fichera S.; Rayls KR.,1996.0,,0,0,
10557,The obsessive compulsive drinking scale: A new method of assessing outcome in alcoholism treatment studies.,"the 14-item Obsessive Compulsive Drinking Scale (OCDS) is a quick and reliable self-rating instrument that provides a total and two subscale scores that measure some cognitive aspects of alcohol ""craving"". This study validated further its utility as an alcoholism severity and treatment outcome instrument. Alcoholism severity and analogue craving scales were administered at baseline, and the OCDS was given at baseline and weekly to 41 alcohol-dependent individuals who participated in a 12-week pharmacologic and cognitive-behavioral treatment trial. Repeated-measures analysis of variance was used to examine group differences in the OCDS scores of those individuals who remained abstinent or drank during the trial. At baseline, the OCDS was correlated with the alcohol composite score of the addiction severity index (r=.48), the alcohol dependence scale (r=.42), the analogue craving measures (range r=.40 to .57), and prestudy alcohol consumption (r=.60). Most importantly the OCDS total and subscale scores were significantly different between individuals who had relapse drinking, who had ""slip"" drinking, and who remained abstinent, with relapsers showing the highest scores. The OCDS scores appear to be sensitive to alcoholism severity and change during abstinence and relapse drinking. Since the shared variance with analogue craving measures is only about 20% to 30%, it appears to be measuring a largely independent dimension of alcohol dependence. Its ease of use (5 minutes per self-rating), reliability, validity, and analytic capabilities support its utility as a tool to measure severity and improvement during alcoholism treatment trials.",Anton RF.; Moak DH.; Latham PK.,1996.0,,0,0,
10558,Effect of repeated visual traumatic stimuli on the event related P3 brain potential in post-traumatic stress disorder.,"Post-Traumatic Stress Disorder (PTSD) patients are characterized by a hypersensitivity to traumatic stimuli which may be expressed as an automatic and involuntary cognitive response. Electrophysiologically this can be recorded as an augmented visual P3 (P300) event related potential (ERP). This study examined P3 changes in response to repeated traumatic pictorial stimuli presented in the form of a visual discrimination oddball paradigm to 40 Israeli combat veterans with and without PTSD. Subjects were asked to press a button when target stimuli (domestic animal pictures) appeared, and to ignore all non-target stimuli (irrelevant pictures of furnishings/flowers and traumatic combat related pictures). On average, P3 in response to combat related pictures was earlier and approximately 5 times greater in amplitude for the PTSD patients as compared to the controls. Repeated combat related pictures stimuli presentation resulted in a rapid and appreciable P3 amplitude reduction and latency prolongation. This effect was not observed for the target stimuli. These findings suggest that a gradually reduced amount of attentional resource is required and allocated to the processing of repeated CRP stimuli. This may occur as a consequence of the activation of an inhibitory mechanism related to the cognitive processing of traumatic stimuli.",Bleich AV.; Attias J.; Furman V.,1996.0,,0,0,
10559,The influence of psychological debriefing on emotional adaptation in women following early miscarriage: a preliminary study.,"About a fifth of pregnancies end in miscarriage, leading to emotional consequences, such as anxiety and depression, which may last for a number of months. Despite this, women are not routinely provided with follow-up care. Anecdotal evidence suggests that follow-up focusing on emotional experiences may have beneficial effects. This study tests the hypothesis that the psychological debriefing process has a positive influence on emotional adaptation. Women were assessed, using the Hospital Anxiety and Depression Scale and Impact of Events Scale, at one week and four months post-miscarriage. Half the women also received psychological debriefing at two weeks. Intrusion and avoidance scores were initially as high as those of post-trauma victims, but had significantly decreased by four months. Depression was not detected at any time point, but anxiety was significantly higher than community sample estimates at one week and four months. Psychological debriefing was perceived to be helpful, but did not influence emotional adaptation. A number of hypotheses are provided to explain these results. Outcome scores at one week significantly predicted outcome at four months, suggesting that early assessment would be important in determining which women should be offered intervention.",Lee C.; Slade P.; Lygo V.,1996.0,,0,0,
10560,Effect of verbal self-disclosure on natural killer cell activity: moderating influence of cynical hostility.,"One objective of the present research was to examine the immunological effects of self-disclosing personal information regarding a traumatic or stressful experience. A second objective was to examine the hypothesis that the effect of self-disclosure on immune function is moderated by individual differences in cynical hostility. Forty-three male college undergraduates, classified as high or low on the Cook-Medley Hostility scale were randomly assigned to either a verbal self-disclosure or a nondisclosure discussion condition. Task-induced change in natural killer (NK) cell activity (i.e., cytotoxicity) served as the dependent variable. As predicted, a significant interaction between discussion condition and hostility was obtained. Among subjects in the self-disclosure condition, high hostility subjects exhibited a significantly greater increase in NK cell cytotoxicity than low hostility subjects. The effect of self-disclosure on NK cell activity is moderated by an individual's level of cynical hostility. The greater short term enhancement in NK cell activity observed for hostile persons is a likely correlate of a more pronounced acute arousal response elicited by the self-disclosure task.",Christensen AJ.; Edwards DL.; Wiebe JS.; Benotsch EG.; McKelvey L.; Andrews M.; Lubaroff DM.,,,0,0,6185
10561,Exposure versus cognitive restructuring in the treatment of panic disorder with agoraphobia.,"The aim of this study was to assess the rate of change on clinical, behavioral and cognitive variables during exposure therapy and cognitive restructuring in the treatment of panic disorder with agoraphobia. A total of 28 Ss who received a diagnosis of panic disorder with agoraphobia were randomly assigned to either of two treatment conditions: exposure therapy or cognitive restructuring. Treatment conditions were kept as distinct as possible from each other. Subjects were assessed on five occasions: pretreatment, after 5, 10, and 15 (posttreatment) sessions of treatment and at a 6-month follow-up. Analyses of outcome data revealed strong and significant time effects on all measures. However, no group x time interaction reached statistical significance, suggesting that both strategies operate at the same pace. Furthermore, power analyses suggest that any difference that might exist in the rate of improvement between exposure and cognitive restructuring in the treatment of panic disorder with agoraphobia is marginal.",Bouchard S.; Gauthier J.; Laberge B.; French D.; Pelletier MH.; Godbout C.,1996.0,,0,0,
10562,A controlled positron emission tomography study of obsessive and neutral auditory stimulation in obsessive-compulsive disorder with checking rituals.,"Ten nondepressed patients with obsessive-compulsive disorder (OCD) who were characterized by predominant checking rituals were compared with 10 age- and sex-matched control subjects. Hemispheric and regional cerebral blood flow levels (rCBF) were measured with positron emission tomography (H2 15O) across four conditions: rest, auditory stimulation with idiosyncratic normal or abnormal obsession, auditory stimulation with neutral verbal stimuli, and rest. Order of neutral and obsessive stimulation was randomized. Higher subjective responses to obsessive than to neutral stimulation were found in both groups; subjective response was higher in OCD patients when obsessive stimulation was presented first. A four-way analysis of variance (group x stimulation order x hemisphere x condition [neutral or obsessive stimulation]) was performed on stimulation minus rest normalized rCBF values. Control subjects had significantly higher rCBF in the thalamus and putamen. A trend toward higher rCBF in OCD patients was found in the superior temporal regions. When neutral stimulation was presented first, rCBF was significantly higher in the caudate region of control subjects. Obsessive stimulation was associated with higher rCBF than neutral stimulation in orbitofrontal regions in both groups of subjects. Under obsessive stimulation, superior temporal and orbitofrontal activities were correlated in OCD patients but not in control subjects. Our study suggests specific abnormalities of information processing in the basal ganglia and temporal structures of compulsive checkers.",Cottraux J.; Gérard D.; Cinotti L.; Froment JC.; Deiber MP.; Le Bars D.; Galy G.; Millet P.; Labbé C.; Lavenne F.; Bouvard M.; Mauguière F.,1996.0,,0,0,
10563,Crying in separated and non-separated newborns: sound spectrographic analysis.,"During the first 1-2 h after birth crying occurs during separation from the mother and stops on reunion. In rats, such ""separation distress calls"" have distinct phonetic properties. We examined this early crying by sound spectrography in 29 healthy, full-term, vaginally delivered babies, randomly assigned either to be kept in a cot or to be placed in body contact with the mother during the 90 min following birth. The former babies cried almost 10 times more than the latter ones. The duration of the cry signal (the smallest element of a cry analysed by spectrography) in both groups was 0.8-09s; the melody contour was flat or slightly rising--falling with a fundamental frequency of around 500 hertz. The cry is provisionally characterized as a discomfort cry, elicited mainly by separation from the mother.",Michelsson K.; Christensson K.; Rothgänger H.; Winberg J.,1996.0,,0,0,
10564,Alternation learning in obsessive-compulsive disorder.,"The Wisconsin Card Sorting Test (WCST) and an alternation learning task were administered to 15 women with obsessive-compulsive disorder (OCD) and 15 age-, sex-, education-, and intelligence-matched healthy controls. OCD patients were significantly slower on the WCST as compared to the controls. Their performance on the alternation learning task was impaired relative to the control group, though this difference was diminished when we used education as a covariate. We found a significant positive correlation between performance on the alternation task and severity of symptoms in the OCD group. Performance of similar alternation tasks is impaired by damage to the orbitofrontal cortex in nonhuman primates. Therefore the data presented support the hypothesis of orbitofrontal cortex dysfunction in OCD.",Gross-Isseroff R.; Sasson Y.; Voet H.; Hendler T.; Luca-Haimovici K.; Kandel-Sussman H.; Zohar J.,1996.0,10.1016/0006-3223(95)00179-4,0,0,
10565,Effects of Outward Bound Experience as an adjunct to inpatient PTSD treatment of war veterans.,"There is a paucity of studies on Outward Bound Experiences (OBE) with adult psychiatric populations and, more notably, with trauma victims. This study evaluates the efficacy of OBE as an adjunct to specialized inpatient PTSD treatment with survivors of chronic combat-related PTSD (N = 219) at two Veterans Administration Medical Centers. On several measures of PTSD and general adaptation, results showed that the five-day OBE did not differ from standard treatment of PTSD survivors. Two other issues were addressed: identification of successful and non-successful subjects as a result of OBE, and exploration of objective versus subjective measures among this chronic group. Finally, as a post-study analysis, inferred curative components of the OBE were discussed as each appeared to impact on the participants.",Hyer L.; Boyd S.; Scurfield R.; Smith D.; Burke J.,1996.0,10.1002/(SICI)1097-4679(199605)52:3<263::AID-JCLP3>3.0.CO;2-T,0,0,
10566,Outcome of intensive inpatient treatment for combat-related posttraumatic stress disorder.,"This study analyzed the outcome of a 4-month intensive inpatient program for combat-related posttraumatic stress disorder (PTSD) among Vietnam veterans. The subjects were 51 male veterans with PTSD who completed the inpatient treatment program. Comprehensive measures of PTSD and psychiatric symptoms, as well as social functioning, were assessed at admission, discharge, and 6, 12, and 18 months after discharge. The overall study group showed an increase in symptoms from admission to follow-up and a decrease in violent actions and thoughts and legal problems. Family and interpersonal relationships and overall morale were improved at discharge but then returned to pretreatment levels at 18 months. Patient evaluations also indicated that the program affected morale and interpersonal relationships but not symptoms. The chronic nature of combat-related PTSD among Vietnam veterans is evident. The study raises the possibility that long-term intensive inpatient treatment is not effective, and other forms of treatment should be considered after rigorous study of such variables as length of stay, trauma versus rehabilitation focus, and patient characteristics.",Johnson DR.; Rosenheck R.; Fontana A.; Lubin H.; Charney D.; Southwick S.,1996.0,10.1176/ajp.153.6.771,0,0,
10567,Interpretive work in short-term individual psychotherapy: an analysis using hierarchical linear modeling.,"""Work"" and ""resistance"" responses to interpretation in short-term individual (STI) psychotherapy were examined using a hierarchical linear modeling (HLM) procedure. The relationships between interpretation characteristics and patient responses within therapy were considered. Process data were drawn from 60 STI therapy cases, 30 patients with low quality of object relations (QOR), and 30 patients with high QOR. In 4 instances, the relationships between technique and response were found to vary significantly across cases. One was identified for low QOR patients, and 3 were identified for high QOR patients. Individual differences in initial disturbance and outcome were used to account for the variation of technique-response relationships. Significant findings were limited to the high QOR sample. Initial disturbance was directly related to work in response to a transference-oriented approach. The transference focus-work relationship was found to be inversely related to outcome. The results extend previous findings regarding transference technique in STI therapy with high QOR patients. Through capitalizing on within-case variation, HLM can be used to illuminate process-outcome relationships in psychotherapy.",Joyce AS.; Piper WE.,1996.0,,0,0,
10568,[Occult or unknown traumatic osteochondral lesions of the knee. Assessment of 19 cases studied with conventional radiology and magnetic resonance].,"Occult fractures of the knee represent a major cause of posttraumatic knee pain in patients with negative plain films. These injuries can cause severe sequelae if they are not properly diagnosed and rapidly treated. In our series of 1330 exams of the knee we found 19 traumatic osteochondral injuries (1.5%). MR studies were performed with a dedicated permanent magnet (0.2 T) (Artoscan, Esaote Biomedica, Genoa, Italy). All the patients were submitted to conventional radiography (AP and LL projections). In 14 patients oblique plain films were also performed. The following osteochondral injuries were found: 2 purely chondral fractures, 5 occult fractures (4 tibial and 1 of the medial femoral condyle) and 12 plateau fractures of the tibial posterior margin (8 lateral and 4 medial). CT of the knee was performed in 3 patients only. In 19 patients MRI correctly showed the traumatic injury and depicted: fracture site, the morphologic characteristics of fracture line, cortical bone and articular cartilage involvement, the exact extent of marrow signal changes, the associated injury of menisci or cruciate ligaments. To conclude, MR sensitivity and diagnostic accuracy are excellent in the patients with traumatic injuries of the knee. In the patients with posttraumatic knee joint pain, MRI appears to be an extremely useful tool in the detection and assessment of bone and cartilage disorders.",Bellelli A.; Nardis P.,1996.0,,0,0,
10569,Effects of distraction and guided threat reappraisal on fear reduction during exposure-based treatments for specific fears.,"To test predictions derived from the emotional processing theory of fear reduction, claustrophobics (N = 58) were randomized to one of four exposure conditions: (a) exposure with guided threat reappraisal, (b) exposure with a cognitive load distracter task, (c) exposure with both guided threat reappraisal and cognitive load distracter task and (d) exposure without guided threat reappraisal or cognitive load distracter task. We hypothesized that self-guided in vivo exposure would lead to less fear reduction if performed simultaneously with a cognitive load distracter task that severely taxes information processing resources. In contrast, we hypothesized that focusing on core threats during exposure would enhance fear reduction. The main findings were largely consistent with predictions. The cognitive load task (regardless of focus of available attention) had a detrimental effect on fear reduction, while guided threat reappraisal (regardless of cognitive load) had a facilitative effect. The greatest level of fear reduction and the lowest level of return of fear were observed in the exposure condition involving guided threat reappraisal without cognitive load. Clinical implications and directions for future research are discussed.",Kamphuis JH.; Telch MJ.,2000.0,,0,0,
10570,Social anxiety and self-impression: cognitive preparation enhances the beneficial effects of video feedback following a stressful social task.,"Negative and distorted images of the observable self are important in the development and maintenance of social phobia. Previous research has shown that video feedback has potential to correct the distorted self-perception [Rapee, R. M. & Hayman, K. (1996). The effects of video feedback on the self-evaluation of performance in socially anxious subjects. Behaviour Research and Therapy, 34, 315-322]. The present experiment investigated whether the construction of a self-image prior to viewing the video may enhance the therapeutic effects of video feedback. High and low socially anxious individuals gave a speech and then viewed the video of their performance. Half of the sample were given cognitive preparation prior to viewing the video. Cognitive preparation involved asking participants to (1) predict in detail what they will see in the video, (2) form an image of themselves giving the speech and (3) watch the video as though they were watching a stranger. Participants who received cognitive preparation prior to the video feedback made higher ratings of their overall performance and of specific aspects of their performance compared to those who were not given cognitive preparation and compared to the same ratings made prior to the video feedback. These results suggest that the therapeutic effects of video feedback can be enhanced by careful cognitive preparation which maximises the perceived discrepancy between self and video images.",Harve AG.; Clark DM.; Ehlers A.; Rapee RM.,2000.0,,0,0,
10571,[Evaluation of anxiety and depression in patients with vascular brain damage].,"In 90 patients with vascular damage to the CNS an assessment was carried out of the intensity of anxiety on the basis of Anxiety State and Trait Inventory, of the degree of symptom intensity of depression syndrome on the basis of Hamilton Depression Scale and of personality and socioeconomic conditions on the basis of history data in' and Eysenck Personality Inventory. In the studies the hemispheric laterality of brain damage was taken into account. The results were analysed statistically comparing them with those obtained in the control group of healthy men aged 18-24 years. On the basis of the studies and calculations the following conclusions were drawn: 1--the intensity of anxiety and depression in patients treated for vascular CNS damage is greater than in the control group. 2--statistically higher depression intensity was found in patients with left hemisphere damage as compared with the group with right hemisphere damage. 3--in patients living in good social conditions and regarding their family relations as good, the intensity of anxiety and depression was statistically lower than in the group of patients with poor family and socioeconomic conditions.",Lyczak P.; Zabielski W.; Magiera K.; Filipkiewicz A.,1999.0,,0,0,
10572,Post-traumatic stress symptoms and distress 1 year after burn injury.,"The occurrence and predictors of post-traumatic stress symptoms 1 year after a burn injury were assessed in a large prospective sample (N = 172). Participants completed a self-report post-traumatic stress symptom checklist at 3 time points: within 24 hours of admission to a burn center, 1 month after the injury, and 1 year after the injury. A notable number of participants had a range of post-traumatic stress symptoms both at 1 month and at 1 year after the burn injury. More than half of the sample reported recurrent intrusive recollections of the burn injury at 1 month and at 1 year. Other commonly endorsed symptoms were sleep disturbance, avoidance of thoughts or feelings associated with the burn, and distress at reminders of the burn. The number of post-traumatic stress symptoms endorsed at 1 month was the only significant predictor of post-traumatic stress symptoms at 1 year. These results suggest that it is common for patients to have some post-traumatic symptoms 1 year after a burn injury and that early experiences of post-traumatic stress symptoms may be associated with the development or maintenance of post-traumatic stress disorder. We recommend that burn care professionals identify and intervene with patients who have clinically significant distress as a result of their burn injuries.",Ehde DM.; Patterson DR.; Wiechman SA.; Wilson LG.,,,0,0,
10573,Electroencephalographic comparison of veterans with combat-related post-traumatic stress disorder and healthy subjects.,"Various investigations prove the biological basis for post-traumatic stress disorder (PTSD). There are only a few quantitative electroencephalographic (qEEG) studies of patients with PTSD. The aim of this investigation is to find out whether there are differences in qEEG parameters between PTSD patients and healthy subjects. The experimental group was comprised of 18 veterans with PTSD, and 20 healthy non-veterans were included in the control group. After informed consent was obtained, they were investigated by qEEG recordings. The artifact-free EEG epoch was analyzed by fast Fourier transformation (FFT). Power values of particular frequency bands (delta, theta, alpha 1, alpha 2, beta 1, beta 2) were observed on the regions: Fp I, Fp2, F3, F4, F7, F8, C3, C4, T3, T4, T5, T6, P3, P4, O1 and O2. PTSD patients had increased theta activity over central regions, and increased beta activity. Beta 1 activity increased over frontal, central and left occipital regions; beta 2 activity increased over frontal regions. No significant differences were noted between the PTSD and control group in delta and alpha activity. These results suggest a neurobiological basis for PTSD. Increased theta activity may help to explain changes in hippocampal volume. Various explanations (cortical hyperexcitability, prolonged wakefulness, or attention disturbances) have been offered for the beta activity increase observed in PTSD subjects.",Begić D.; Hotujac L.; Jokić-Begić N.,2001.0,,0,0,
10574,Improvement of agitation and anxiety in demented patients after psychoeducative group intervention with their caregivers.,"It has been convincingly demonstrated that in dementia, psychoeducative group intervention with caregivers positively impacts on motivation for care and satisfaction of the caregivers. It has, however, been neglected to examine the effect of psychoeducative group intervention on the behavioural and psychological symptoms of the demented patients. In a 3-month, expert-based and conceptualized group intervention with caregiving relatives of demented patients we investigated whether behavioural and psychological symptoms may improve and which of a set of independent variables may predict improvement. The 3-month group intervention yielded a significant improvement in agitation and anxiety of the demented patients. The presence of an additional somatic disease in the patients and male gender predicted a less positive outcome of the intervention related to the presence of agitation. This study demonstrated that psychoeducative group intervention with the caregivers of demented patients is helpful for the demented patients themselves. This evidence of a positive mediator effect of the group intervention on the behavioural and psychological symptoms of the patients underscores the importance of nonpharmacological strategies in the treatment of dementia.",Haupt M.; Karger A.; Jänner M.,2000.0,,0,0,
10575,Effect of manual lymph drainage as described by Vodder on oedema of the hand after fracture of the distal radius: a prospective clinical study.,"The aim of this study was to evaluate the efficacy of manual lymph drainage, as described by Vodder, in reducing oedema in the hand after a traumatic injury. During a period of 10 months in 1996-7, a total of 26 consecutive patients with a fracture of the distal radius that was treated by external fixation were included in the study. Patients were randomised into an experimental (n = 12) and a control group (n = 14). Treatment started 11 days after application of the external fixator. All patients had the same conventional treatment with exercises, movement, oedema control, and education. The experimental group was given 10 treatments of manual lymph drainage in addition. Oedema was measured four times with the volumeter, and the injured hand was always compared with the uninjured one. The first measurement was made three days after removal of the external fixation. The difference in hand volume showed that the experimental group had significantly less oedema in the injured hand. This result indicates that manual lymph drainage is a useful method for reducing post-traumatic oedema in the hand.",Härén K.; Backman C.; Wiberg M.,2000.0,,0,0,
10576,Errors in diagnosing post-traumatic stress disorder after traumatic brain injury.,"Evidence to support the view that post-traumatic stress disorder (PTSD) can occur after traumatic brain injury (TBI) continues to grow. However, the reported incidence of cases with both diagnoses ranges widely, from less than 1% to more than 50%. Given that the incidence of TBI is high, a more precise incidence has to be established if screening and treatment resources are to be considered. Are cases being missed or are they over-diagnosed? The single case report presented here does not definitively answer this question, but illustrates the potential shortcomings of diagnosing PTSD using questionnaire measures alone (Impact of Events Scale, Post-traumatic Stress Diagnostic Scale and General Health Questionnaire) and indicates a need for a conjoint interview which takes into account the common effects of TBI and the symptom overlap between PTSD and TBI.",McMillan TM.,2001.0,,0,0,
10577,Treatment of school refusal: one-year follow-up.,"To conduct a 1-year follow-up of anxious-depressed school-refusing adolescents who participated in an 8-week study of imipramine versus placebo, each in combination with cognitive-behavioral therapy. Sixty-five percent (41 of 63) of the randomly assigned subjects returned for follow-up evaluation, which consisted of diagnostic interviews, clinician rating scales for anxiety and depression, family functioning measure, and a questionnaire regarding interim treatments and school programs. From the adolescent and/or parent perspective, 64.1% met criteria for an anxiety disorder and 33.3% met criteria for a depressive disorder. Remission rates and acquisition rates for specific anxiety and depressive disorders were determined. In the follow-up period, 67.5% received at least one psychotropic medication trial and 77.5% had outpatient therapy. Higher level of somatic complaints on the Anxiety Rating for Children-Revised Physiological subscale at baseline predicted more severe depression on the Children's Depression Rating Scale-Revised at follow-up (p = .029). In this naturalistic follow-up study, there was high utilization of mental health interventions. In addition, a substantial number of subjects met criteria for anxiety and/or depressive disorders 1 year after treatment. Investigation of duration of acute treatments and evaluation of maintenance treatments for school refusal is needed.",Bernstein GA.; Hektner JM.; Borchardt CM.; McMillan MH.,2001.0,10.1097/00004583-200102000-00015,0,0,
10578,Functional status examination: a new instrument for assessing outcome in traumatic brain injury.,"The Functional Status Examination (FSE) is a new measure designed to evaluate change in activities of everyday life as a function of an event or illness, including traumatic brain injury. The measure covers physical, social, and psychological domains. The FSE is based on a structured interview and includes levels of functioning that accommodate the full spectrum of possible outcomes, from death through recovery to preinjury functioning. Based on 133 prospectively studied patients with moderate to severe traumatic brain injury, the FSE has favorable psychometric properties including good test-retest reliability (r = 0.80) and close correspondence of assessments provided by the patient and their significant other (SO; r = 0.80). The FSE correlated significantly with each of three severity indices with closest relationships occurring between the FSE assessed by the SO and posttraumatic amnesia (r = 0.76). The FSE assessed by the SO was significantly (p < 0.05) more closely related to each severity index than the Glasgow Outcome Scale (GOS) or Sickness Impact Profile and, for two of the three indices, than the SF-36. All measures showed significant change from 1 to 6 months after injury with the FSE showing the largest effect sizes. The FSE is significantly related to important constructs such as family burden, SO depression, and sacrifices the family makes, as well as overall indices of recovery and satisfaction with level of functioning. The latter relationships are significantly stronger than for the GOS. The FSE has demonstrated good reliability, validity, and sensitivity, and appears to be a promising instrument for monitoring recovery and assessing functional status in clinical trials.",Dikmen S.; Machamer J.; Miller B.; Doctor J.; Temkin N.,2001.0,10.1089/08977150150502578,0,0,
10579,Seasonal depression: the dual vulnerability hypothesis revisited.,"In DSM-IV, winter seasonal affective disorder (SAD) is classified as a seasonal pattern of recurrent major depressive episodes in winter with full remission of symptoms in summer. However, other groups with ""winter depression"" have been identified, including patients with incomplete summer remission (ISR) and subsyndromal SAD (sub-SAD, winter depressive symptoms that do not meet criteria for major depression). In this study, we compare the clinical characteristics of these three seasonal groups and their response to light therapy. 558 patients assessed at a specialized SAD Clinic were diagnosed using DSM-III-R or DSM-IV criteria. Clinical information was recorded using a checklist at index assessment. A subset of patients (N=192) were treated with an open, 2 week trial of light therapy using a 10000 lux fluorescent light box for 30 min per day in the early morning. Patients were assessed before and after treatment with the 29 item modified Hamilton Depression Rating Scale and clinical response was defined as greater than 50% improvement in scores. The rates of some melancholic symptoms, anxiety, panic, suicidal ideation, and family history of mood disorder were lowest in the sub-SAD group. The clinical response rates to light therapy were highest in the sub-SAD group (N=32, 78%), intermediate in the SAD group (N=113, 66%), and lowest in the ISR group (N=47, 51%). This was a retrospective study of patients seen in a specialty clinic, although information was obtained in a standardized format. The light therapy trial had an open design so that placebo response could not be determined. There are differences in both the patterns of clinical symptoms and the response to light therapy in these three groups with winter depression. These results are consistent with a dual vulnerability hypothesis that considers these groups to result from interaction of separate factors for seasonality and depression.",Lam RW.; Tam EM.; Yatham LN.; Shiah IS.; Zis AP.,2001.0,,0,0,
10580,Longitudinal follow-up of naturalistic treatment outcome in patients with trichotillomania.,"Little is known about the longitudinal course of treatment outcome in patients with trichotillomania. The authors conducted a second follow-up assessment on a cohort of hair pullers previously studied. Forty-four subjects completed a hair-pulling questionnaire and paper-and-pencil measures of hair-pulling severity and impact, psychosocial functioning, depression, anxiety, and self-esteem. Mean time elapsed between the first and second follow-up assessment was 2.5 years (index evaluation to first follow-up = 3.5 years). Twenty-seven subjects (61.4%) had active treatment since the first follow-up. No significant changes in hair pulling, depression, anxiety, or psychosocial functioning were reported from first to second follow-up. Self-esteem scores significantly worsened during this period (p = .000). A trend toward worsening also existed for psychosocial impact scores. Comparison of scores at index evaluation with second follow-up still showed significant improvement over time for hair pulling (p = .001) but significant worsening in self-esteem (p = .000). Treatment and responder status were unrelated to clinical functioning, with the exception of depression and psychosocial impact. Although hair pullers exhibit initial improvement with treatment, scale scores plateau or worsen by second follow-up. Significant worsening in self-esteem at second follow-up may be related to the absence of further improvements in hair-pulling severity. Future research should focus on the interrelationships among self-esteem, depression, and hair pulling during treatment for this disorder.",Keuthen NJ.; Fraim C.; Deckersbach T.; Dougherty DD.; Baer L.; Jenike MA.,2001.0,,0,0,
10581,The effect of UCS inflation and deflation procedures on 'fear' conditioning.,"Davey (1992: Classical conditioning and the acquisition of human fears and phobias: a review and synthesis of the literature. Advances in Behaviour Research and Therapy, 14, 29-66) hypothesized that subjective revaluation of an unconditioned stimulus (UCS) would determine the strength of the autonomic conditioned response (CR) in the fear conditioning paradigm. The purpose of the present study was to examine the effect of UCS aversiveness on the CR strength in the fear conditioning paradigm. The UCS aversiveness was controlled by the UCS intensity; that is, the UCS intensity was increased for the inflation group or decreased for the deflation group. Thirty subjects were randomly assigned to the inflation or the deflation group, and they participated under both experimental and control conditions. All subjects went through the pretest, the acquisition of classical conditioning, the UCS intensity operation, and the test sessions. The indices of the CR were skin conductance responses (SCRs) and a subjective aversion to the conditioned stimulus (CS). The main results were as follows. (1) The CR strength measured by SCR was increased by the UCS inflation and decreased by the UCS deflation. (2) The subjective aversiveness of the CS was not sensitive to both manipulations of UCS intensity. These results suggested that the autonomic CR strength might be influenced by the subjective revaluation of UCS, as Davey (1992) described. The result from the test of the subjective aversiveness of the CS, however, could not support Davey's model. The difference between expressions of the SCR and the subjective aversiveness of the CS might be caused by different learning systems.",Hosoba T.; Iwanaga M.; Seiwa H.,2001.0,,0,0,
10582,Combining ondansetron and naltrexone reduces craving among biologically predisposed alcoholics: preliminary clinical evidence.,"Previously, we have reported that the combination of ondansetron (a 5-HT3 antagonist) and naltrexone (a mu opioid antagonist) appears to act synergistically at improving the drinking outcomes of early onset alcoholics (EOA). a subtype of alcoholic characterized by developing problem-drinking earlier, antisocial behaviors, high familial loading, and biological disease predisposition. Presumably, this medication combination counteracts the interaction between activated central 5-HT3 receptors and the endogenous opioid system during the mediation of alcohol-induced reward. We now hypothesize further that an important mechanism by which the combination diminishes alcohol consumption is through a reduction in craving. To determine whether the combination of naltrexone and ondansetron is superior to a placebo at reducing craving among EOA, and the relationship between craving and drinking behavior in both treatment groups. We conducted an 8-week double-blind placebo-controlled clinical trial in which 10 EOA were randomized to receive ondansetron (4 microg/kg b.i.d.) + naltrexone (25 mg b.i.d.) and 10 EOA had a placebo (total n=20) as an adjunct to weekly standardized group cognitive behavioral therapy. Craving was measured by using the obsessive compulsive drinking scale (OCDS). Craving ratings were scored on four subscales which where derived empirically by principal component structure analysis of the OCDS. EOA who received the medication combination, compared with the placebo, had significantly lower scores on ""automaticity of drinking"" and ""alcohol consumption "". Reduction in automaticity of drinking was correlated with self-reported drinking for only the medication combination group. By reducing automaticity of drinking, the medication combination presumably decreased drinking salience and intensity. Larger scale studies testing these medications, both alone and together, among alcoholic subtypes are needed to establish and extend these promising findings.",Ait-Daoud N.; Johnson BA.; Prihoda TJ.; Hargita ID.,2001.0,,0,0,
10583,Persistent respiratory irregularity in patients with panic disorder.,"Dysregulated respiratory control may play a role in the pathophysiology of panic disorder. This could be due to abnormalities in brain stem respiratory nuclei or to dysregulation at higher brain levels. Results from previous studies using the doxapram model of panic have yielded an unclear picture. A brief cognitive manipulation reduced doxapram-induced hyperventilation in patients, suggesting that higher level inputs can substantially alter their respiratory patterns. However, respiratory abnormalities persisted, including a striking irregularity in breathing patterns. To directly study respiratory irregularity, breath-by-breath records of tidal volume (V(t)) and frequency (f) from previously studied subjects were obtained. Irregularity was quantified using von Neumann's statistic and calculation of ""sigh"" frequency in 16 patients and 16 matched control subjects. Half of each group received a standard introduction to the study and half received a cognitive intervention designed to reduce anxiety/distress responses to the doxapram injection. Patients had significantly greater V(t) irregularity relative to control subjects. Neither the cognitive intervention nor doxapram-induced hyperventilation produced significant changes in V(t) irregularity. The V(t) irregularity was attributable to a sighing pattern of breathing that was characteristic of panic patients but not control subjects. Patients also had somewhat elevated f irregularity relative to control subjects. The irregular breathing patterns in panic patients appear to be intrinsic and stable, uninfluenced by induced hyperventilation or cognitive manipulation. Further study of V(t) irregularity and sighs are warranted in efforts to localize dysregulated neural circuits in panic to brain stem or midbrain levels.",Abelson JL.; Weg JG.; Nesse RM.; Curtis GC.,2001.0,,0,0,
10584,Violent traumatic events and drug abuse severity.,"We examined the occurrence of violent traumatic events, DSM-III-R diagnosis of posttraumatic stress disorder (PTSD), and PTSD symptoms, and the relationship of these variables to drug abuse severity. One-hundred fifty opioid-dependent drug abusers who were participants in a randomized trial of two methadone treatment interventions were interviewed using the Diagnostic Interview Schedule, the Addiction Severity Index, and the Beck Depression Inventory. Twenty-nine percent met diagnostic criteria for PTSD. With the exception of rape, no gender differences in the prevalence of violent traumatic events were observed. The occurrence of PTSD-related symptoms was associated with greater drug abuse severity after controlling for gender, depression, and lifetime diagnosis of PTSD. The high rate of PTSD among these methadone patients, the nature of the traumatic events to which they are exposed, and subsequent violence-related psychiatric sequelae have important implications for identification and treatment of PTSD among those seeking drug abuse treatment.",Clark HW.; Masson CL.; Delucchi KL.; Hall SM.; Sees KL.,2001.0,,0,0,
10585,UPBEAT: the impact of a psychogeriatric intervention in VA medical centers. Unified Psychogeriatric Biopsychosocial Evaluation and Treatment.,"The Unified Psychogeriatric Biopsychosocial Evaluation and Treatment (UPBEAT) program provides individualized interdisciplinary mental health treatment and care coordination to elderly veterans whose comorbid depression, anxiety, or alcohol abuse may result in overuse of inpatient services and underuse of outpatient services. To determine whether proactive screening of hospitalized patients can identify unrecognized comorbid psychiatric conditions and whether comprehensive assessment and psychogeriatric intervention can improve care while reducing inpatient use. Randomized trial. Veterans aged 60 and older hospitalized for nonpsychiatric medical or surgical treatment in 9 VA sites (UPBEAT, 814; usual care, 873). The Mental Health Inventory (MHI) anxiety and depression subscales, the Alcohol Use Disorder Identification Test (AUDIT) scores, RAND 36-Item Health Survey Short Form (SF-36), inpatient days and costs, ambulatory care clinic stops and costs, and mortality and readmission rates. Mental health and general health status scores improved equally from baseline to 12-month follow-up in both groups. UPBEAT increased outpatient costs by $1,171 (P <0.001) per patient, but lowered inpatient costs by $3,027 (P = 0.017), for an overall savings of $1,856 (P = 0.156). Inpatient savings were attributable to fewer bed days of care (3.30 days; P = 0.016) rather than fewer admissions. Patients with 1 or more pre-enrollment and postenrollment hospitalizations had the greatest overall savings ($6,015; P = 0.069). UPBEAT appears to accelerate the transition from inpatient to outpatient care for acute nonpsychiatric admissions. Care coordination and increased access to ambulatory psychiatric services produces similar improvement in mental health and general health status as usual care.",Kominski G.; Andersen R.; Bastani R.; Gould R.; Hackman C.; Huang D.; Jarvik L.; Maxwell A.; Moye J.; Olsen E.; Rohrbaugh R.; Rosansky J.; Taylor S.; Van Stone W.,2001.0,,0,0,
10586,Supportive-expressive group therapy and distress in patients with metastatic breast cancer: a randomized clinical intervention trial.,"Metastatic breast cancer carries with it considerable psychosocial morbidity. Studies have shown that some patients with metastatic breast cancer experience clinically significant anxiety and depression and traumatic stress symptoms. Supportive-expressive group psychotherapy was developed to help patients with cancer face and adjust to their existential concerns, express and manage disease-related emotions, increase social support, enhance relationships with family and physicians, and improve symptom control. Of 125 women with metastatic breast cancer recruited into the study, 64 were randomized to the intervention and 61 to the control condition. Intervention women were offered 1 year of weekly supportive-expressive group therapy and educational materials. Control women received educational materials only. Participants were assessed at baseline and every 4 months during the first year. Data at baseline and from at least 1 assessment were collected from 102 participants during this 12-month period, and these participants compose the study population. Primary analyses based on all available data indicated that participants in the treatment condition showed a significantly greater decline in traumatic stress symptoms on the Impact of Event Scale (effect size, 0.25) compared with the control condition, but there was no difference in Profile of Mood States total mood disturbance. However, when the final assessment occurring within a year of death was removed, a secondary analysis showed a significantly greater decline in total mood disturbance (effect size, 0.25) and traumatic stress symptoms (effect size, 0.33) for the treatment condition compared with the control condition. Supportive-expressive therapy, with its emphasis on providing support and helping patients face and deal with their disease-related stress, can help reduce distress in patients with metastatic breast cancer.",Classen C.; Butler LD.; Koopman C.; Miller E.; DiMiceli S.; Giese-Davis J.; Fobair P.; Carlson RW.; Kraemer HC.; Spiegel D.,2001.0,,0,0,
10587,One session cognitive behavioural therapy for elderly patients with chronic obstructive pulmonary disease.,"We hypothesized that compared to an educational intervention, a single 2 h session of cognitive behavioural therapy (CBT), with 6-week follow-up, would reduce anxiety and depression, improve physical and mental functioning, and lead to a better quality of life and greater satisfaction with treatment in older patients with chronic obstructive pulmonary disease (COPD). Fifty-six subjects were recruited from a large, urban, academically affiliated Veterans Affairs (VA) Hospital, a non-profit private hospital, and a local newspaper, for a single blind randomized controlled clinical trial. One 2 h session of group CBT was designed to reduce symptoms of anxiety, with specific components including relaxation training, cognitive interventions, and graduated practice, followed by homework and weekly calls for 6 weeks. This was compared to a group that received 2 h of COPD education, followed by weekly calls. Pre- and post-intervention subjects in both groups were administered SF-36, Geriatric Depression Scale, Beck Anxiety Inventory, 6 min walk test, and the FEV-1. Following the intervention, both groups completed the Client Satisfaction Questionnaire. When compared with a group that received education about COPD, 2 h CBT group showed decreased depression and anxiety. Contrary to our hypothesis, despite the decrease in depression and anxiety, there was no change in the physical functioning of the patients. Twenty to 40% of patients with COPD have high levels of anxiety and depression. Our study finds that as little as 2 h of CBT administered in a group setting is able to reduce these anxious and depressive symptoms.",Kunik ME.; Braun U.; Stanley MA.; Wristers K.; Molinari V.; Stoebner D.; Orengo CA.,2001.0,,0,0,
10588,Vestibular rehabilitation for patients with agoraphobia and vestibular dysfunction: a pilot study.,"This study examined whether physical therapy with vestibular rehabilitation exercises would benefit patients with agoraphobia and vestibular dysfunction. Nine patients went through a 2-week no-treatment baseline phase, a 4-week behavioral treatment phase focusing on self-directed exposure, and an 8-12-week vestibular rehabilitation phase (weekly sessions). On the main outcome measure, clinical global impressions (CGI) ratings of severity, behavioral treatment was accompanied by a reduction in severity (effect size d=0.8; P<.10). On the supplementary measures, the Hamilton Anxiety Scale (Hamilton-A) and the Chambless Mobility Inventory (MI), no significant improvements were noted. After vestibular rehabilitation therapy, further improvement occurred in CGI severity (d=0.65; two-tailed P<.10), and significant improvements occurred in the supplementary measures. The physical therapist identified motion-induced dizziness and disturbances in balance in most patients. These improved with rehabilitation. Although the results can be attributed to other explanations, they are not inconsistent with the hypothesis that vestibular dysfunction maintains agoraphobic symptoms in some patients.",Jacob RG.; Whitney SL.; Detweiler-Shostak G.; Furman JM.,,,0,0,
10589,Prophylactic hemofiltration in severely traumatized patients: effects on post-traumatic organ dysfunction syndrome.,"To evaluate the effects of prophylactic veno-venous hemofiltration (CVVH) in the absence of renal failure on multiple organ dysfunction syndrome after severe multiple trauma. Prospective, randomized study. Intensive care unit (ICU) in a university hospital. Twenty-four patients with severe multiple trauma (injury severity score > or = 27), no renal failure on admission and no contraindication for moderate heparinization. Twelve patients received conventional treatment while 12 patients were treated additionally with isovolemic CVVH for 5 days starting within 24 h following trauma. Signs of organ dysfunction were assessed daily including monitoring of systemic hemodynamic by means of pulmonary artery catheterization during the first 5 days after trauma. Prophylactic CVVH did not affect the overall severity of organ dysfunction as assessed by MOF or APACHE II scores. However, the pattern of impaired organ systems was influenced by CVVH: while the post-traumatic decrease in platelet count in patients subjected to CVVH was more pronounced than in controls (e.g. day 4: control: 115,080 +/- 15,087, CVVH: 57,383 +/- 4,201 microliters-1; p < 0.05) the development of hyperdynamic circulatory failure was simultaneously attenuated, as reflected by a limited increased in cardiac output and an attenuated decrease in systemic vascular resistance and oxygen extraction ratio (e.g. systemic vascular resistance on day 4: control: 624.3 +/- 46.17, CVVH: 842.7 +/- 79.24 dyn.s.cm-5; p < 0.005). CVVH blunts the cardiovascular response to multiple trauma and increases tissue oxygen extraction. However, the concomitant decrease in platelet counts represents a limitation for the use of prophylactic CVVH in surgical patients.",Bauer M.; Marzi I.; Ziegenfuss T.; Riegel W.,2001.0,,0,0,
10590,Neuropsychological assessment of response inhibition in adults with ADHD.,"Several theoretical models suggest that the core deficit of ADHD is a deficiency in response inhibition. While neuropsychological deficits in response inhibition are well documented in ADHD children, research on these deficits in adult ADHD populations is minimal. Twenty-five adult ADHD patients, 15 anxiety-disordered adult patients, and 30 normal adults completed three neuropsychological tests of response inhibition: the Continuous Performance Test, Posner Visual Orienting Test, and the Stop Signal Task. ADHD adults demonstrated response inhibition performance deficits when compared to both normal adults and anxiety disordered adults only on the Continuous Performance Test. A similar pattern of differences was not observed on the other two neuropsychological tests. Differing results between tasks may be due to differences in test reliability, task parameters, or the targeted area of brain functioning assessed by each test.",Epstein JN.; Johnson DE.; Varia IM.; Conners CK.,2001.0,10.1076/jcen.23.3.362.1186,0,0,
10591,Barriers to help seeking for mental disorders in a rural impoverished population.,"This study examined barriers to seeking mental health care reported by individuals in a rural impoverished population, by screening 646 randomly selected adults for depression, anxiety, and alcohol abuse. Respondents who screened positive were randomly assigned to one of three groups: (1) no intervention, (2) an educational intervention alone, or (3) the educational intervention in the presence of a significant other. Those who screened positive for disorders cited barriers to care at significantly higher rates than respondents who screened negative. Respondents who received the educational intervention endorsed several barriers at significantly lower rates in the follow-up telephone call (subsequent to the intervention) than in the original interview (prior to the intervention). Virtually all respondents in a subsample of 142 subjects (99.3%) said they would seek mental health care if they thought mental health services would help them.",Fox JC.; Blank M.; Rovnyak VG.; Barnett RY.,2001.0,,0,0,
10592,"Randomised controlled general practice trial of sertraline, exposure therapy and combined treatment in generalised social phobia.","No controlled trial of treatment of generalised social phobia has been conducted in general practice. To examine the efficacy of sertraline or exposure therapy, administered alone or in combination in this setting. Study was of a randomised, double-blind design. Patients (n = 387) received sertraline 50-150 mg or placebo for 24 weeks. Patients were additionally randomised to exposure therapy or general medical care. Sertraline-treated patients were significantly more improved than non-sertraline-treated patients (chi(2)=12.53, P<0.001; odds ratio=0.534; 95% Cl 0.347-0.835). No significant difference was observed between exposure- and non-exposure-treated patients (chi(2)=2.18, P=0.140; odds ratio=0.732; 95% Cl 0.475-1.134). In the pairwise comparisons, combined sertraline and exposure (chi(2)=12.32; P<0.001) and sertraline (chi(2)=10.13; P=0.002) were significantly superior to placebo. Sertraline is an effective treatment for generalised social phobia. Combined treatment with sertraline and exposure therapy, conducted by the general practitioner, may enhance the treatment efficacy in primary care.",Blomhoff S.; Haug TT.; Hellström K.; Holme I.; Humble M.; Madsbu HP.; Wold JE.,2001.0,,0,0,
10593,Cross-validation of the SCL-27: a short psychometric screening instrument for chronic pain patients.,"We constructed a short multidimensional screening instrument for chronic pain patients based on the items contained in the Symptom Check List-90-Revised (SCL-90-R). The proposed dimensional structure of the SCL-90-R was recently shown to be irreproducible in chronic pain patients. As a consequence, the use of the Global Severity Index (GSI) was recommended, although it did not capture all information contained in the many items of the SCL-90-R. Based on an exploratory factor analysis, a six-dimensional structure using 27 items from the SCL-90-R was explored utilizing the data of 2780 chronic pain patients. A short form was prospectively tested on 581 patients in the same setting. Criteria for item selection were high convergent and low discriminant correlations. The assessment of the dimensions was kept short, but a minimum of four items were retained. A questionnaire yielding the dimensions (I) depressive symptoms, (II) dysthymic symptoms, (III) vegetative symptoms, (IV) agoraphobic symptoms, (V) symptoms of social phobia, and (VI) symptoms of mistrust was obtained. Additionally, the GSI of the SCL-90-R could be estimated precisely (r =0.96). The SCL-27 can be used for screening psychopathology in chronic pain patients. The scoring algorithm of the SCL-27 can be used for the 90-item form as well.",Hardt J.; Gerbershagen HU.,2001.0,10.1053/eujp.2001.0231,0,0,
10594,Effect of timing of critical incident stress debriefing (CISD) on posttraumatic symptoms.,"Seventy-seven civilian employees who were victims of robbery were randomly assigned to either an immediate (< 10 hr) or delayed (> 48 hr) debriefing group, using the J. Mitchell (1983) CISD protocol. Scores on the Posttraumatic Stress Diagnostic Scale were obtained at 4 time intervals: debrief, 2 and 4 days post-debrief, and 2 weeks postrobbery. The number and severity of symptoms did not differ at debrief, but were lower for the immediate than for the delayed group at each subsequent time interval. The number and severity of symptoms declined across time intervals; however, although this reduction was pronounced for the immediate group it was minimal for the delayed group. The results supported use of immediate debriefing with this type of incident and victim.",Campfield KM.; Hills AM.,2001.0,10.1023/A:1011117018705,0,0,
10595,Long-term follow-up and predictors of clinical outcome in obsessive-compulsive patients treated with serotonin reuptake inhibitors and behavioral therapy.,"The objective of this study was to examine the long-term course of obsessive-compulsive disorder (OCD) in patients treated with serotonin reuptake inhibitors (SRIs) and behavioral therapy and to identify predictors of clinical outcome. Sixty outpatients meeting DSM-II-R or DSM-IV criteria for OCD were followed up for 1 to 5 years (mean = 2.5 years). All of them received prolonged pharmacologic therapy with an SRI. Thirty-seven patients (61.7%) completed an adequate behavioral treatment. At long-term assessment, 22 patients (36.7%) exhibited a global Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score greater than 16 or a final reduction in Y-BOCS global score of less than 35% and were considered nonresponders. Patients who completed behavioral therapy showed a significant decrease in Y-BOCS compulsions subscale score (p = .01), whereas no significant differences in either Y-BOCS global or obsessions subscale scores between those who did and those who did not undergo behavioral therapy were detected. Obsessions of sexual/religious content were the unique factor related to a poorer long-term outcome. A substantial number of OCD patients showed persistent disabling symptoms at the long-term follow-up in spite of combined pharmacologic and behavioral treatment. Major benefits from behavioral therapy appeared to be the improvement of ritualistic behaviors. Sexual/religious obsessions predicted poorer long-term outcome, whereas short-term response to SRI treatment failed to achieve predictive value in the long-term course of OCD.",Alonso P.; Menchon JM.; Pifarre J.; Mataix-Cols D.; Torres L.; Salgado P.; Vallejo J.,2001.0,,0,0,
10596,[Central relationship patterns in comparison with different objects].,"In the present study the Relationship Episode Paradigm Interviews of 70 female patients with different psychoneurotic diseases were analysed with respect to object-specific patterns with the CCRT method. The most frequent categories are the same in all relationship episodes and in subsamples of relationship episodes with mother and father. These categories are also predominant in episodes with women and men. Relationship episodes with mother do not differ from episodes with father, and relationship episodes with women are not different from episodes with men. But there are substantial differences in relationship episodes with the mother and women and between episodes with the father and men. Patients recount much more positive relationship patterns with women and men than with their parents. This could be understood as a hint of interpersonal resources.",Albani C.; Villmann T.; Blaser G.; Körner A.; Reulecke M.; Pokorny D.; Geyer M.; Kächele H.,2001.0,,0,0,
10597,Predisposition to vasovagal syncope in subjects with blood/injury phobia.,"Most subjects with blood/injury phobia experience syncope or presyncope as part of the phobic response. We tested the hypothesis that these subjects have a constitutional autonomic dysregulation that predisposes them to vasovagal syncope during head-up tilt. We studied 11 subjects (9 females, 2 males) who had a history of syncope or presyncope only in response to a blood or injury stimulus and 11 healthy matched controls (10 females, 1 male) without a history of syncope. Blood pressure (BP) and heart rate (HR) were measured during a 15-minute baseline period with subjects in the supine position and then during 45 minutes of head-up tilt to 70 degrees. Measurements at rest did not differ between the blood phobic and control subjects. During tilt, 9 (82%) of the 11 blood phobic subjects experienced presyncope or syncope, leading to termination of the study after 22+/-17 minutes of tilt. Only 1 (9%) of the 11 control subjects experienced presyncope (chi(2)=11.7, P=0.001). Hemodynamic responses to tilt were consistent with a vasovagal mechanism in the blood phobic subjects, with simultaneous decreases in BP and HR during tilt. During tilt, systolic BP fell by 21+/-15 mm Hg (P=0.001), and HR fell by 22+/-25 bpm (P=0.01). By contrast, BP and HR were very stable in the control group. Subjects with syncope related to blood/injury phobia have an underlying autonomic dysregulation predisposing them to neurally mediated syncope, even in the absence of any blood or injury stimulus. Fainting related to these stimuli may in large part be due to dysfunction in neural circulatory control, which may secondarily lead to the phobia because of repeated syncopal events.",Accurso V.; Winnicki M.; Shamsuzzaman AS.; Wenzel A.; Johnson AK.; Somers VK.,2001.0,,0,0,
10598,Repeated exposure of flight phobics to flights in virtual reality.,"The present study examined the effects of repeated exposure of flight phobics to flights in virtual reality (VR). Flight phobics were randomly assigned either to complete one VR test flight followed by four VR exposure flights (VR group; N=15) in one lengthy session or to complete one VR test flight followed by a lengthy relaxation training session (relaxation group; N=15). All participants completed a second VR test flight at the end of the session. Fear reports and physiological fear reactions (heart rate, skin conductance level) during VR exposures were registered, and fear of flying was assessed psychometrically from 3 weeks before to 3 months after exposure. Exposure to VR flights elicited subjective and physiological fear responses in flight phobics, and these responses attenuated within and across VR flights. Fear reduction associated with repeated VR exposure was greater than fear reduction caused by relaxation training. Fear of flying improved in both treatment groups, but several outcome measures indicated greater effects in the VR treated group than in the relaxation group. These findings indicate that exposure in virtual reality may offer a new and promising approach for the treatment of fear of flying.",Mühlberger A.; Herrmann MJ.; Wiedemann GC.; Ellgring H.; Pauli P.,2001.0,,0,0,
10599,"[Analysis and comparative evaluations of the costs of supports and treatments of schizophrenia, affective psychosis, paranoia and neurosis].","The aim of the study was to show, trough the calculation of the direct costs of supports and treatments actually provided by a NHS Mental Health Department, the presence of associations between four diagnostic groups (schizophrenia, affective psychosis, paranoia and neurotic disorders) and their overall and items (community care, rehabilitation facilities and in-patients services) costs. Mental Health Department and CSM ""Scalo"" (NHS Mental Centre), AUSL ""Città di Bologna"", Emilia-Romagna Region. Yearly direct costs were calculated for a sample (n = 75) of all patients (N = 745) who during 365 days had more than four contacts with CSM and also for four randomised diagnostic groups (n = 30 per group). We calculated unit costs of 15 types of services provided by CSM, selected according to the yearly number of services provided and the time spent by each health professional, and the in patient-cost per all days spent in a public or private sector hospital for psychiatric care. The statistic analysis, performed with the help of the Kruskal-Wallis test, showed significantly higher overall costs for the schizophrenic patients than the sample-group and the neurotic disorders-group; besides a significant difference in the item costs for rehabilitation facilities was found between the schizophrenic group and the paranoia, neurotic disorders groups and the sample one, whereas no significant differences in costs of inpatients services and drugs administration were tested between the groups. The results of our study allow to demonstrate that there are cost differences between the diagnosis (direct costs are highest for schizophrenic patients and lowest for those with neurotic disorders) and that the costs evaluation can be used to ensure appropriate provisions to Mental Health Department for support and treatment of a wide range of psychiatric disorders.",Grassi A.; Bruni R.; Pileggi F.; Chiappelli M.; Boldrini M.; Franceschi E.; Scarafoni D.,,,0,0,6612
10600,[Post-partum as a specific risk factor for the onset of obsessive-compulsive disorder: clinical-controlled study].,"The aim of this study is to evaluate the presence of triggering life-events for the onset of Obsessive-Compulsive Disorder in women (OCD). Clinical controlled study. Service for depressive and anxiety disorders; Department of Neuroscience, Psychiatric Unit, University of Turin. The study compares twenty-nine women with OCD (DSM-IV criteria) with twenty-nine healthy control women matched for demographic features and with twenty-nine women with Bulimia Nervosa (DSM-IV criteria) matched for age, age at onset, education and marital status. All patients were assessed with the Clinical Structured Interview for DSMIII-R (SCID) and with the Interview for Recent Life Event by Paykel. Moreover, OCD patients were assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and bulimic patients with the Eating Disorder Inventory (EDI). The study demonstrates that the only specific life event that is significantly associated with the onset of OCD is ""having a new born child"" No significant differences in frequency and severity of stressing life events were found in the three groups. The results confirms the findings of our previous study: post partum is the only risk factor for the onset of OCD in female population, compared to healthy control. Furthermore, this research points-out the importance and the specificity of this association showing that post partum is not a risk factor in all psychiatric disorders.",Maina G.; Vaschetto P.; Ziero S.; Di Lorenzo R.; Bogetto F.,,,0,0,
10601,Respiratory biofeedback-assisted therapy in panic disorder.,"The authors describe a new methodologically improved behavioral treatment for panic patients using respiratory biofeedback from a handheld capnometry device. The treatment rationale is based on the assumption that sustained hypocapnia resulting from hyperventilation is a key mechanism in the production and maintenance of panic. The brief 4-week biofeedback therapy is aimed at voluntarily increasing self-monitored end-tidal partial pressure of carbon dioxide (PCO2) and reducing respiratory rate and instability through breathing exercises in patients' environment. Preliminary results from 4 patients indicate that the therapy was successful in reducing panic symptoms and other psychological characteristics associated with panic disorder. Physiological data obtained from home training, 24-hour ambulatory monitoring pretherapy and posttherapy, and laboratory assessment at follow-up indicate that patients started out with low resting PCO2 levels, increased those levels during therapy, and maintained those levels at posttherapy and/or follow-up. Partial dissociation between PCO2 and respiratory rate questions whether respiratory rate should be the main focus of breathing training in panic disorder.",Meuret AE.; Wilhelm FH.; Roth WT.,2001.0,10.1177/0145445501254006,0,0,
10602,Does bullying cause emotional problems? A prospective study of young teenagers.,"To establish the relation between recurrent peer victimisation and onset of self reported symptoms of anxiety or depression in the early teen years. Cohort study over two years. Secondary schools in Victoria, Australia. 2680 students surveyed twice in year 8 (aged 13 years) and once in year 9. Self reported symptoms of anxiety or depression were assessed by using the computerised version of the revised clinical interview schedule. Incident cases were students scoring >/=12 in year 9 but not previously. Prior victimisation was defined as having been bullied at either or both survey times in year 8. Prevalence of victimisation at the second survey point in year 8 was 51% (95% confidence interval 49% to 54%), and prevalence of self reported symptoms of anxiety or depression was 18% (16% to 20%). The incidence of self reported symptoms of anxiety or depression in year 9 (7%) was significantly associated with victimisation reported either once (odds ratio 1.94, 1.1 to 3.3) or twice (2.30, 1.2 to 4.3) in year 8. After adjustment for availability of social relations and for sociodemographic factors, recurrent victimisation remained predictive of self reported symptoms of anxiety or depression for girls (2.60, 1.2 to 5.5) but not for boys (1.36, 0.6 to 3.0). Newly reported victimisation in year 9 was not significantly associated with prior self report of symptoms of anxiety or depression (1.48, 0.4 to 6.0). A history of victimisation and poor social relationships predicts the onset of emotional problems in adolescents. Previous recurrent emotional problems are not significantly related to future victimisation. These findings have implications for how seriously the occurrence of victimisation is treated and for the focus of interventions aimed at addressing mental health issues in adolescents.",Bond L.; Carlin JB.; Thomas L.; Rubin K.; Patton G.,2001.0,,0,0,
10603,The pharmacologic and expectancy effects of alcohol on social anxiety in individuals with social phobia.,"Individuals with social phobia are at an increased risk for alcohol problems. Individuals with social phobia could increase their risk for pathological alcohol use if they drink as a means of coping with anxiety-provoking social situations. Providing a circumscribed test of this view, we evaluate the effect of alcohol on the intensity of social phobia anxiety responses. Sixty-one individuals with social phobia gave two speech challenges in front of a group ('social anxiety challenge'), one occurring before and one after they consumed either: (a) an alcoholic drink they were told contained alcohol ('alcohol group'), (b) a non-alcoholic drink they were told contained alcohol ('placebo group'), or, (c) a non-alcoholic drink they were told contained no alcohol ('control group'). Both the alcohol group and the placebo group showed greater reduction in performance anxiety from the first to the second speech challenge than did the control group. Further, there was a strong trend in the data for the alcohol group to show greater reduction in performance anxiety from the first to the second speech challenge than did the placebo group. We concluded from these findings that the pharmacologic effects of alcohol and the belief that one consumed alcohol decrease social performance anxiety in an additive fashion. These results provide direct support for the negatively reinforcing properties of alcohol and are consistent with the view that symptom reduction may motivate alcohol use among socially phobic individuals.",Abrams K.; Kushner M.; Medina KL.; Voight A.,2001.0,,0,0,
10604,Is voice therapy an effective treatment for dysphonia? A randomised controlled trial.,"To assess the overall efficacy of voice therapy for dysphonia. Single blind randomised controlled trial. Outpatient clinic in a teaching hospital. 204 outpatients aged 17-87 with a primary symptom of persistent hoarseness for at least two months. After baseline assessments, patients were randomised to six weeks of either voice therapy or no treatment. Assessments were repeated at six weeks on the 145 (71%) patients who continued to this stage and at 12-14 weeks on the 133 (65%) patients who completed the study. The assessments at the three time points for the 70 patients who completed treatment and the 63 patients in the group given no treatment were compared. Ratings of laryngeal features, Buffalo voice profile, amplitude and pitch perturbation, voice profile questionnaire, hospital anxiety and depression scale, clinical interview schedule, SF-36. Voice therapy improved voice quality as assessed by rating by patients (P=0.001) and rating by observer (P<0.001). The treatment effects for these two outcomes were 4.1 (95% confidence interval 1.7 to 6.6) points and 0.82 (0.50 to 1.13) points. Amplitude perturbation showed improvement at six weeks (P=0.005) but not on completion of the study. Patients with dysphonia had appreciable psychological distress and lower quality of life than controls, but voice therapy had no significant impact on either of these variables. Voice therapy is effective in improving voice quality as assessed by self rated and observer rated methods.",MacKenzie K.; Millar A.; Wilson JA.; Sellars C.; Deary IJ.,2001.0,,0,0,
10605,Emotional change processes in music-assisted reframing.,"Affective processes are critical to understanding and promoting lasting therapeutic change. Using a sample of 40 anxious adults, the researchers examined the use of music to increase affective modification and emotional restructuring in a cognitive reframing intervention. Subjects were assigned to either a typical reframing intervention or a music-assisted reframing intervention. Using the State-Trait Anxiety Inventory, Subjective Units of Distress Scale, Depression Adjective Checklist, and a Think-Aloud measure, the groups were compared on basis of anxiety-reduction, affective modification, and imagery vividness. Results indicate that the music-assisted reframing intervention was more efficacious than the typical reframing intervention in reducing anxiety, modifying affect, and promoting imagery-vividness.",Kerr T.; Walsh J.; Marshall A.,2001.0,,0,0,
10606,Effect of distraction and coping style on in vivo exposure for specific phobia of spiders.,"Recent studies have generated mixed findings regarding the effects of distraction on exposure-based treatments. Results have also been inconsistent regarding the effects of monitoring and blunting coping styles on outcome. The present study attempted to integrate these two areas of research. We hypothesized that the effect of distraction on treatment outcome might depend on coping style. Specifically, we predicted that for blunters (i.e.. individuals who tend to avoid threat-related information), distraction would interfere with the effects of exposure. However, we predicted that distraction might benefit monitors (i.e., individuals who tend to seek out threat-related information). Sixty individuals with a specific phobia of spiders underwent a single, two-hour session of exposure treatment. During the first hour, half of the participants were distracted by listening to an audiotape and the other half underwent exposure without distraction. In the second hour, all participants underwent focused exposure. Based on measures of heart rate, subjective fear, and behavioral testing, participants improved after one hour of treatment, and improved further during the second hour. However, neither distraction, coping style, nor their interaction had a significant effect on outcome. The present study provides support for the benefits of behavioral treatment for specific phobias. However, our hypotheses regarding distraction and coping style were not confirmed.",Antony MM.; McCabe RE.; Leeuw I.; Sano N.; Swinson RP.,2001.0,,0,0,
10607,Fear of blushing: effects of task concentration training versus exposure in vivo on fear and physiology.,"Patients with fear of blushing as the predominant complaint (N = 31) were randomly assigned to (1) exposure in vivo (EXP), or (2) task concentration training (TCT), in order to test the effect of redirecting attention above exposure only. In addition, it was investigated whether treatment reduced actual blush behavior; therefore, physiological parameters of blushing were measured during two behavioral tests. Half of the patients served as waiting-list controls first. Assessments were held before and after treatment, at 6-weeks, and at 1-year follow-up. Both treatments appeared to be effective in reducing fear of blushing and realizing cognitive change. Yet, at posttest, TCT tended to produce better results with respect to fear of blushing. At 6-weeks follow-up, TCT produced significantly more cognitive change. At 1-year follow-up, patients further improved, while differential effects had disappeared. The reduction in fear of blushing was not paralleled by a reduction in actual blush behavior during the behavioral assessments. Thus, it seems that fear of blushing reflects a fearful preoccupation, irrespective of actual facial coloration.",Mulken S.; Bögels SM.; de Jong PJ.; Louwers J.,,,0,0,
10608,[Personality disorders and psychiatric comorbidity in obsessive-compulsive disorder and anorexia nervosa].,"The aim of this prospective longitudinal study was to examine the course of adolescent anorexia nervosa and obsessive-compulsive disorder (OCD) (fulfilling DSM-III-R criteria) to compare psychiatric comorbidity and personality disorders of both groups. Because anorexia nervosa patients are mainly female, we compared them only with female OCD patients. Ten years after discharge the whole sample (32 female patients; 100%) of a group of 39 (32 female; 7 male) anorexia nervosa patients could be reexamined personally. 25 (61%) female patients of a group of 116 patients (41 female; 75 male) with obsessive-compulsive disorder were also reexamined. The anorexia nervosa patients were interviewed using the Structured Interview for Anorexia and Bulimia nervosa (SIAB [39]) to assess eating disorder symptomatology. To examine comorbid psychiatric disorders we used the Composite International Diagnostic Interview, WHO [44] and SCID-II [45] for personality disorders. One fourth of the patients with anorexia nervosa (AN) and 20% of the patients with obsessive-compulsive disorder had a personality disorder according to DSM-III-R. Most of them were ""Cluster C""-personality disorders (AN: 28%; OCD: 20%). In the group of the female OCD patients 8% schizoid, 4% schizotype and 12% paranoid personality disorders were observed. The most prevalent psychiatric disorders were anxiety (AN: 28%; OCD: 20%) and affective disorders (AN: 16%; OCD: 16%). Our results support the view that in the course of anorexia nervosa and in obsessive-compulsive disorder there is a high prevalence of psychiatric comorbidity and ""Cluster C""-personality disorders according to DSM-III-R. These results might confirm a model of a high vulnerability of the serotonergic neurotransmitter system in patients with anorexia nervosa or OCD.",Müller B.; Wewetzer C.; Jans T.; Holtkamp K.; Herpertz SC.; Warnke A.; Remschmidt H.; Herpertz-Dahlmann B.,2001.0,10.1055/s-2001-16511,0,0,
10609,A randomized controlled trial of cognitive therapy versus intensive behavior therapy in obsessive compulsive disorder.,"The study was designed to compare cognitive therapy (CT) with intensive behavior therapy (BT) in obsessive-compulsive disorder (OCD) and to study their change process. Sixty-five outpatients with DSM-4 OCD were randomized into 2 groups for 16 weeks of individual treatment in 3 centers. Group 1 received 20 sessions of CT. Group 2 received a BT program of 20 h in two phases: 4 weeks of intensive treatment (16 h), and 12 weeks of maintenance sessions (4 h). No medication was prescribed. Sixty-two patients were evaluated at week 4, 60 at week 16 (post-test), 53 at week 26 and 48 at week 52 (follow-up). The response rate was similar in the 2 groups. The Beck Depression Inventory (BDI) was significantly more improved by CT (p = 0.001) at week 16. The baseline BDI and Obsessive Thoughts Checklist scores predicted a therapeutic response in CT, while the baseline BDI score predicted a response in BT. At week 16, only the changes in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and a scale measuring the interpretation of intrusive thoughts correlated in CT, while the changes in Y-BOCS, BDI, and interpretation of intrusive thoughts correlated in BT. Improvement was retained at follow-up without a between-group difference. The intent-to-treat analysis (last observation carried forward) found no between-group differences on obsessions, rituals and depression. CT and BT were equally effective on OCD, but at post-test CT had specific effects on depression which were stronger than those of BT. Pathways to improvement may be different in CT and BT. The outcomes are discussed in the light of an effect size analysis.",Cottraux J.; Note I.; Yao SN.; Lafont S.; Note B.; Mollard E.; Bouvard M.; Sauteraud A.; Bourgeois M.; Dartigues JF.,,56269,0,0,6661
10610,A pilot open trial of brief psychodynamic psychotherapy for panic disorder.,"This is a complete report of an open trial of manualized psychodynamic psychotherapy for treatment of panic disorder, Panic-Focused Psychodynamic Psychotherapy (PFPP). Twenty-one patients with PD were entered into a trial of twice-weekly, 24-session treatment. Sixteen of 21 experienced remission of panic and agoraphobia. Treatment completers with depression also experienced remission of depression. Improvements in symptoms and in quality of life were substantial and consistent across all measured areas. Symptomatic gains were maintained over 6 months. This report was prepared specifically to describe 6-month follow-up on these patients. Psychodynamic psychotherapy appears to be a promising nonpharmacological treatment for panic disorder.",Milrod B.; Busch F.; Leon AC.; Aronson A.; Roiphe J.; Rudden M.; Singer M.; Shapiro T.; Goldman H.; Richter D.; Shear MK.,2001.0,,0,0,
10611,Minimization of zygomatic complex fracture treatment.,"The aims of this non-randomized prospective study were to establish and justify minimized therapy for zygomatic complex fractures. Fifty-two consecutive patients were examined and classified with conventional routine radiographs. Preoperative symptoms were recorded. Treatment of zygomatic fractures was by percutaneous hook reduction and miniplate fixation along the frontozygomatic suture. Exploration of the orbital floor was carried out only in cases of primary diplopia or comminuted fractures. Postoperatively, patients were followed for 12 months. Clinical and radiologic assessment of reduction was symmetric and stable in all cases. Preoperative symptoms disappeared completely except for sensitivity disturbance in five patients. Patients with no post-trauma diplopia did not develop eye motility disturbances or enophthalmos. The treatment of a zygomatic fracture is possible by the described technique. Exploration of the orbital floor is indicated only in cases of preoperative diplopia. Therefore, a patient with a zygomatic fracture and diplopia should be classified as having a orbitozygomatic fracture. In cases of comminuted fractures, exploration of the orbital floor remains mandatory.",Kov√°cs AF.; Ghahremani M.,2001.0,10.1054/ijom.2001.0131,0,0,
10612,Three-dimensional structure of the Hospital Anxiety and Depression Scale in a large French primary care population suffering from major depression.,"Few studies have been specifically carried out to characterize the dimensional structure of the Hospital Anxiety and Depression Scale (HADS) and those that have, have yielded contradictory results. We have examined the factor structure and sensitivity to change of the HADS in a large French outpatient primary care population treated with sertraline for major depression (DSM-IV criteria). Factor analysis of the HADS was performed in 2669 outpatients and in subsamples using a principal component procedure with Varimax rotation. Concurrent change sensitivity of the HADS was compared with that for the Hamilton Depression Rating Scale (HDRS) after at least 45 days of sertraline treatment. Three distinct factors emerged from the HADS factor analysis: a ""depression"" factor and two separate anxiety subscales: ""psychic anxiety"" and ""psychomotor agitation"" whose mean reductions in scores from baseline were significantly correlated (0.36-0.45) with the reduction of the HDRS baseline score. These new data provide support for the use of the HADS's three-dimensional structure to measure improvement of selected symptoms of anxiety during antidepressant therapy.",Friedman S.; Samuelian JC.; Lancrenon S.; Even C.; Chiarelli P.,2001.0,,0,0,
10613,An analysis of the validity of the Hospital Anxiety and Depression scale as a screening tool in patients with advanced metastatic cancer.,"Depression is difficult to diagnose in the terminally ill patient. As a result, it frequently is not treated. This has can have an adverse effect on quality of life and make the palliation of physical symptoms more difficult. In an effort to improve the detection of depression, many palliative care teams are using the Hospital Anxiety and Depression (HAD) scale as a screening tool. The HAD was devised for use in general medical settings and has not been validated for use in palliative care patients. One hundred patients receiving palliative care with an estimated prognosis of 6 months or less were invited to complete the HAD and a semi-structured psychiatric interview, the Present State Examination. The depression and anxiety subscales of the HAD showed poor efficacy for screening when used alone. The optimum threshold was at a combined cut-off of 19, which had a sensitivity of 68% and specificity of 67%. The major construct of the HAD is anhedonia, which may be present at the end of life due to increasing physical illness and may not be pathognomic of a depressive illness in this population. We recommend, therefore, that if the HAD is used as a screening tool in palliative care, it should be as a combined scale, but low sensitivity and specificity may lead to poor efficacy as a screening tool.",Lloyd-Williams M.; Friedman T.; Rudd N.,2001.0,,0,0,
10614,Comparison of two treatments for traumatic stress: a community-based study of EMDR and prolonged exposure.,"This pilot study compared the efficacy of two treatments for postraumatic stress disorder (PTSD): Eye Movement Desensitization and Reprocessing (EMDR) and Prolonged Exposure (PE). Data were analyzed for 22 patients from a university-based clinic serving the outside community (predominantly rape and crime victims) who completed at least one active session of treatment after three preparatory sessions. Results showed both approaches produced a significant reduction in PTSD and depression symptoms, which were maintained at three-month follow-up. Successful treatment was faster with EMDR as a larger number of people (7 of 10) had a 70% reduction in PTSD symptoms after three active sessions compared to 2 of 12 with PE. EMDR appeared to be better tolerated as the dropout rate was significantly lower in those randomized to EMDR versus PE (0 of 10 vs. 3 of 10). However all patients who remained in treatment with PE had a reduction in PTSD scores. Finally, Subjective Units of Distress (SUDS) ratings decreased significantly during the initial session of EMDR, but changed little during PE. Postsession SUDS were significantly lower for EMDR than for PE. Suggestions for future research are discussed.",Ironson G.; Freund B.; Strauss JL.; Williams J.,2002.0,,0,0,
10615,Respiratory variability in panic disorder.,"Disordered breathing may play an important role in the pathophysiology of panic disorder. Several studies have now indicated that panic disorder patients have greater respiratory variability than normal controls. In this study, we examine baseline respiratory measures in four diagnostic groups to determine whether greater respiratory variability is specific to panic disorder and whether effective anti-panic treatment alters respiratory variability. Patients with panic disorder, major depression, or premenstrual dysphoric disorder, and normal control subjects underwent two respiratory exposures (5% and 7% CO(2) inhalation), while in a canopy system. Panic disorder patients returned after 12 weeks of either anti-panic medication or cognitive behavioral therapy, and were retested. Normal control subjects were also retested after a period of 12 weeks. Panic disorder patients had significantly greater respiratory variability at baseline than normal control subjects and patients with major depression. The premenstrual dysphoric patients also had greater variability than the normal control group. Panic disorder patients who panicked to 7% CO(2) inhalation had significantly greater baseline variability than panic disorder patients who did not panic. Anti-panic treatment did not significantly alter baseline respiratory variability. Our data suggest that increased respiratory variability may be an important trait feature for some panic disorder patients and may make them more vulnerable to CO(2)-induced panic.",Martinez JM.; Kent JM.; Coplan JD.; Browne ST.; Papp LA.; Sullivan GM.; Kleber M.; Perepletchikova F.; Fyer AJ.; Klein DF.; Gorman JM.,2001.0,,0,0,
10616,"Interapy, treatment of posttraumatic stress through the Internet: a controlled trial.","On-line therapy offers many advantages over face-to-face settings. Interapy includes psycho-education, screening, effect measures and protocol-driven treatment via the Internet for clients. The present paper reports the results of a controlled trial on the Interapy treatment of posttraumatic stress and grief in students, gaining course credits. The participants in the experimental condition (n = 13) improved significantly than the participants in the waiting-list control condition (n = 12), on trauma-related symptoms and general psychopathology. The effect sizes were large. Eighty percent of the treated participants showed clinically significant improvement after treatment. The possibilities for future research with Interapy, including studies into moderating variables, are discussed.",Lange A.; van de Ven JP.; Schrieken B.; Emmelkamp PM.,2001.0,,0,0,
10617,Translating research findings to PTSD prevention: results of a randomized-controlled pilot study.,"Based on therapeutic studies revealing positive prognostic factors and on research findings revealing how trauma is processed, we developed the memory structuring intervention (MSI) in attempt to prevent posttraumatic stress disorder (PTSD). The MSI attempts to shift processing of traumatic memory from uncontrollable somatosensory and affective processes to more controlled linguistic and cognitive processes by providing patients organization, labeling, and causality. In a single-blind randomized-controlled pilot study, 17 traffic accident victims at risk for PTSD (heart rate >94 BPM) were assigned to two MSI or two supportive-listening control sessions. Three months later, MSI patients reported significantly less frequent intrusive, arousal, and total PTSD symptoms than controls. A replication study with a larger sample is underway.",Gidron Y.; Gal R.; Freedman S.; Twiser I.; Lauden A.; Snir Y.; Benjamin J.,2001.0,10.1023/A:1013046322993,0,0,
10618,The effect of dissociation at encoding on intrusive memories for a stressful film.,"The occurrence of memory intrusions after a trauma has been linked to peri-traumatic dissociation. In this study, we attempted to induce dissociation experimentally and investigate the impact on intrusive memories. A total of 39 undergraduates were randomly assigned to watch a stressful film under standard conditions or under a dual-task condition in which they simultaneously performed a tapping task. They rated their distress post-film and again after 2 weeks, and kept a diary of intrusive memories. Contrary to prediction, there were no differences in levels of distress or explicit memory between the two conditions, and the dual-task condition was followed by significantly fewer memory intrusions. Dual-task conditions may not provide a good analogue to naturally occurring dissociation. The possible preventive effects of the tapping task are discussed in terms of the dual-representation theory of post-traumatic stress disorder.",Brewin CR.; Saunders J.,2001.0,,0,0,
10619,[The effects of different postoperative analgesic procedure on stress response].,,Chen SY.; Zhang YM.; Luo L.,2002.0,,0,0,6173
10620,Short Form 36 and Hospital Anxiety and Depression Scale. A comparison based on patients with testicular cancer.,"The aim of this study was to compare the scorings of anxiety and depression assessed by the Hospital Anxiety and Depression Scale (HADS-A [Anxiety] and HADS-D [Depression]) with the scorings on the eight subscales of Short Form 36 (SF-36) and the Physical (PCS) and Mental Component Summary (MCS) assessed by the same patients. In a cross-sectional study 736 long-term survivors after treatment for testicular cancer (TC) completed HADS and SF-36. Pearson's correlation coefficients were calculated on item and scale level to assess the associations between the HADS and the SF-36 scales and, in particular, between HADS and PCS and MCS, respectively. Independent predictors for PCS and MCS were identified by linear regression analysis. HADS-A and HADS-D were significantly associated with the SF-36 summary scales. HADS-A explained 5% of the variance of PCS and 49% of the variance of MCS. The comparable figures for HADS-D were 10% and 45%, respectively. In the multivariate analysis the HADS-D scoring independently predicted the level of PCS together with the patients' educational level, long-lasting working disability and age (variance: 30%). Both HADS-D and HADS-A remained independent parameters for MCS (variance: 58%) together with the patient's civil status. HADS-D item D4 (""slowed down"") was similarly associated with both PCS and MCS. In univariate analyses HADS-D and HADS-A were statistically associated with PCS and MCS. The highest r values were observed for the associations between HADS and MCS, in particular between HADS-A and MCS. In the multivariate analyses HADS-D, but not HADS-A, contributed to PCS, whereas both HADS-A and HADS-D were associated with MCS. This pattern of different predictions of the summary scales of SF-36 supports a clinical practice that anxiety and depression should be assessed separately. Additional use of a self-rating instrument for depression and anxiety, such as HADS, is recommended when SF-36 is used for quality of life (QL) assessment.",Fosså SD.; Dahl AA.,2002.0,,0,0,
10621,Effect of nonoperative treatment on the outcome of patients with posttraumatic hydrocephalus.,"To compare the outcome of non-operative treatment with the outcome of surgical intraventricular drainage for patients with posttraumatic hydrocephalus including complications, mortality and favorable outcome. Thirty-nine patients were assigned to a nonoperative treatment group and 38 patents to a surgical intraventricular drainage group. Each patient's outcome was evaluated 3 years after treatment by using Glasgow Outcome Scale. In the nonoperative treatment group the rate of favor able outcome (good recovery or mild disability) was 89.74% (35 of 39 patients) and the mortality was 2.56% (1 of 39 patients). In the surgical intraventricular drainage group the rate of favorable outcome was 71.05% (27 of 38 patients) and the mortality was 13.16% (5 of 38 patients; P<0.05). Mortality was not significantly different between the two groups. Nonoperative treatment may be better than surgical intraventricular drainage for patients with posttraumatic hydrocephalus.",Fu L.; Tang Y.; Wang S.,2002.0,,0,0,
10622,Perception of illness: nonspecificity of postconcussion syndrome symptom expectation.,"A growing number of studies show postconcussion syndrome (PCS) symptom report is influenced by factors other than head injury, suggesting symptoms typically associated with PCS may not be specific to head injury. Given the role that symptom expectation has been hypothesized to play in PCS symptom etiology, a comparison of symptoms expected for various disorders seems overdue. The present study asked 82 undergraduates to report the symptoms they currently experience, and then to report the symptoms they would expect to experience if they had had suffered either a head injury, an orthopedic injury, posttraumatic stress, or depression. No current differences in overall symptoms or in symptom subscales emerged. Results showed individuals portraying head injury, posttraumatic stress, and depression expected an increase in total symptoms, though individuals portraying an orthopedic injury did not expect such an increase. Results also showed simulators of head injury, posttraumatic stress, and depression expected equivalent rates of overall symptoms, memory/cognitive complaints, somatic concerns, and distracter symptoms, though head-injured individuals reported fewer affective symptoms than those portraying psychological disorders. In all, these findings suggest that individuals have a relative lack of specificity in symptom expectation for various disorders, with the implication that symptom checklists for ""PCS"" may not be useful for diagnosis.",Gunstad J.; Suhr JA.,2002.0,,0,0,
10623,[Changes in the autonomic status in vegetovascular dystonia syndrome during exposure to permanent magnetic field ].,"Permanent magnetic field was applied by placing two magnetic discs (induction 60 mT) in the projection of great arteries on both sides symmetrically. The treatment was given to hypertensive patients with vegetovascular asthenia. A course of such magnetic treatment affects pathogenetic mechanisms of vegetative disorders due to the ability of permanent magnetic field to restore vegetative homeostasis, normalize sympathicotony and vegetative regulation.",Anan'in NN.; Levitskiĭ EF.; Klemenkov SV.; Kolesnikova IV.,,,0,0,6020
10624,"Beliefs, sense of control and treatment outcome in post-traumatic stress disorder.","Few studies have shown that maladaptive beliefs relate to treatment outcome. In a randomized controlled study, 87 patients with post-traumatic stress disorder (PTSD) had exposure therapy alone or cognitive restructuring alone, or both combined, or relaxation. Independent blind assessors assessed patients at pre-, mid- and post-treatment and at follow-up; at those times patients rated cognitive, behavioural and emotional aspects of their disorder. Baseline beliefs about mistrust, helplessness, meaninglessness and unjustness of the world related to baseline PTSD symptoms but did not predict treatment outcome, though improvement in certain beliefs correlated with more symptom improvement. Several 'key' beliefs changed after, and none before, symptoms improved. At post-treatment, sense of control and attribution of gains to personal efforts predicted maintenance of gains at follow-up. Baseline beliefs and improvement in beliefs did not predict outcome. Post-treatment sense of control/internal attribution predicted maintenance of gains at follow-up. How much sense of control is produced by or causes improvement deserves testing.",Livanou M.; Başoglu M.; Marks IM.; De SP.; Noshirvani H.; Lovell K.; Thrasher S.,2002.0,,0,0,
10625,Posttraumatic amnesia and recall of a traumatic event following traumatic brain injury.,"The relationship between posttraumatic amnesia (PTA) and symptoms of posttraumatic stress disorder (PTSD) was examined in 282 outpatients at a mean of 53 days after traumatic brain injury (TBI). Patients were assessed for TBI severity, intrusive and avoidant PTSD-type symptoms, and psychological distress, and were stratified into four comparison groups by duration of PTA. Levels of PTSD-type symptoms and psychological distress did not differ significantly between groups. Even patients with PTA >1 week reported intrusive and avoidant PTSD-type symptoms. However, when patients were stratified into those with PTA of <1 hour or >1 hour, the former were more likely to report such symptoms. TBI patients with brief PTA are more likely to experience PTSD-type reactions, but severe TBI with prolonged PTA is not incompatible with such reactions in a subset of patients. Possible mechanisms that could account for this finding are discussed.",Feinstein A.; Hershkop S.; Ouchterlony D.; Jardine A.; McCullagh S.,2002.0,10.1176/jnp.14.1.25,0,0,
10626,Physical self-regulation training for the management of temporomandibular disorders.,"To evaluate the long-term effectiveness of a brief skills training program for the management of chronic facial muscle pain. This program of physical self-regulation (PSR) involved primarily training in breathing, postural relaxation, and proprioceptive re-education. Physical self-regulation training was presented by a dentist during two 50-minute sessions spaced at 3-week intervals and was compared to a standard dental care (SDC) program that included a flat-plane intraoral appliance and self-care instructions provided by a dentist. Participants (n = 44) were initially evaluated by a dentist experienced in the diagnosis and management of orofacial pain and were determined to have myofascial pain (Type 1a and 1b diagnoses per the Research Diagnostic Criteria) prior to random assignment to either the PSR or SDC conditions. Posttreatment evaluations 6 weeks and 26 weeks after treatment had begun were conducted by a dentist who was not aware of which treatment the participants received. Initial results indicated that pain severity and life interference from pain were reduced in both groups (P < 0.001), while perception of control was increased (P < 0.001), as was incisal opening without pain (P < 0.05). At the 26-week follow-up, the PSR group reported less pain (P < 0.04) and greater incisal opening, both with (P < 0.04) and without (P < 0.01) pain, than the SDC group. There were also significant decreases (P < 0.05) in affective distress, somatization, obsessive-compulsive symptoms, tender point sensitivity, awareness of tooth contact, and sleep dysfunction for both groups over time. The findings support the use of PSR for the short- and long-term management of muscle pain in the facial region. These results are discussed in terms of the potential mechanisms by which self-regulation treatment strategies are effective for the management of these pain disorders.",Carlson CR.; Bertrand PM.; Ehrlich AD.; Maxwell AW.; Burton RG.,2001.0,,0,0,
10627,Selective attention for hyperventilatory sensations in panic disorder.,"According to cognitive theories, panic patients are assumed to display selective attention for feared bodily sensations. To date there has only been indirect evidence for this based on performance on reaction time tasks such as the modified Stroop task and the dot probe detection task. In the present study a more direct attempt was made to investigate whether panic patients show selective attention for feared sensations, in particular hyperventilatory sensations. A group of patients with panic disorder and a group of normal controls were compared on their performance on a reaction time task in which tones of different length had to be discriminated. During the task subjects were asked either to hyperventilate, to overbreathe under isocapnic conditions, or to make a neutral movement. No evidence for selective attention for hyperventilatory sensations was found. The article also discusses whether lack of finding interference during hyperventilation might be due to methodological issues.",Kroeze S.; van Den Hout MA.,,,0,0,
10628,Self-reported and actual physiological responses in social phobia.,"The aim of the current study was to compare physiological reactions and self-reports of bodily sensations for social phobics, clinically anxious and non-anxious controls across four tasks. A within-group design was used in which each participant took part in four tasks. Two were designed to be demanding, either physically (riding an exercise bicycle) or mentally (mental arithmetic task), while two, a mental imagery task (personally relevant situation) and a social conversation, were designed specifically to be anxiety provoking. Of the 54 participants, 18 were generalized social phobics, 18 were clinically anxious but not socially phobic (8 with panic disorder, 6 with generalized anxiety disorder and 4 simple phobics), and 18 were non-anxious. Heart rate, skin conductance, and facial and neck temperatures were recorded continuously during four different tasks and rest periods with corresponding self-report ratings of bodily sensations taken to reflect 13 sampling points. There were no group differences on any of the physiological measures during any of the four tasks. However, there were a number of between-group differences with regard to ratings of bodily sensations. Both clinical groups had higher ratings of racing heart than the non-anxious control group during the imagery task. In addition, social phobics had significantly higher ratings of racing heart during the social conversation in relation to both comparison groups. With regard to ratings of body heat, the anxious group had greater ratings than the non-anxious controls during the imagery task. Finally with regard to ratings of sweaty hands, both clinical groups had higher ratings than the non-anxious controls during the social conversation. All three groups were generally inaccurate in their ratings of bodily sensations.",Edelmann RJ.; Baker SR.,2002.0,,0,0,
10629,[The German short version of the interpersonal guilt questionnaire--Validation in a population-based sample and clinical application].,"The present study describes the development of the German short version ""Fragebogen zu interpersonellen Schuldgefühlen"" (FIS) of the ""Interpersonal Guilt Questionnaire"" (IGQ) developed by O'Connor et al. The questionnaire was used in a representative sample of 652 eastern and 1283 western Germans. Woman show higher scores on the subscales ""Seperation Guilt"" and ""Omnipotent Responsibility Guilt"" than man. Eastern Germans mark higher scores on the subscale ""Omnipotent Responsibility Guilt"" than western Germans. Correlations between interpersonal guilt and social anxiety and differences between a non-clinical and a clinical sample show that maladaptive aspects of guilt feelings can be assessed by the ""Interpersonal Guilt Questionnaire"".",Albani C.; Blaser G.; Körner A.; Geyer M.; Volkart R.; O'Connor L.; Berry J.; Brähler E.,,10.1055/s-2002-24952,0,0,
10630,Common changes in cerebral blood flow in patients with social phobia treated with citalopram or cognitive-behavioral therapy.,"Neurofunctional changes underlying effective antianxiety treatments are incompletely characterized. This study explored the effects of citalopram and cognitive-behavioral therapy on regional cerebral blood flow (rCBF) in social phobia. By means of positron emission tomography with oxygen 15-labeled water, rCBF was assessed in 18 previously untreated patients with social phobia during an anxiogenic public speaking task. Patients were matched for sex, age, and phobia severity, based on social anxiety questionnaire data, and randomized to citalopram medication, cognitive-behavioral group therapy, or a waiting-list control group. Scans were repeated after 9 weeks of treatment or waiting time. Outcome was assessed by subjective and psychophysiological state anxiety measures and self-report questionnaires. Questions were readministered after 1 year. Symptoms improved significantly and roughly equally with citalopram and cognitive-behavioral therapy, whereas the waiting-list group remained unchanged. Four patients in each treated group and 1 waiting-list patient were classified as responders. Within both treated groups, and in responders regardless of treatment approach, improvement was accompanied by a decreased rCBF-response to public speaking bilaterally in the amygdala, hippocampus, and the periamygdaloid, rhinal, and parahippocampal cortices. Between-group comparisons confirmed that rCBF in these regions decreased significantly more in treated groups than control subjects, and in responders than nonresponders, particularly in the right hemisphere. The degree of amygdalar-limbic attenuation was associated with clinical improvement a year later. Common sites of action for citalopram and cognitive-behavioral treatment of social anxiety were observed in the amygdala, hippocampus, and neighboring cortical areas, ie, brain regions subserving bodily defense reactions to threat.",Furmark T.; Tillfors M.; Marteinsdottir I.; Fischer H.; Pissiota A.; Långström B.; Fredrikson M.,2002.0,,0,0,
10631,"[The ""AMDP-rating scale for obsessive-compulsive symptoms"": The 2nd version].","The ""Association of Methodology and Documentation in Psychiatry"" (AMDP) has developed the 2nd version of a new observer-rated scale for a quick and precise assessment of obsessive-compulsive symptoms. The first version of the scale comprised 20 items on the dimensions ""description"", ""distress and impairment"" and ""emotion and cognition"". The item pool of the 2. version was enlarged to 44 items to accomplish a differentiated assessment of obsessions and compulsions and to assess the associated passive avoidance behaviour. The results of an empirical study (n = 141) demonstrated excellent internal consistency (Cronbach's alpha = 0,93), a split-half reliability of 0,83 (Spearman-Brown), a test-retest reliability of r = 0,84, a high interrater-reliability, a high differential validity and good convergent validity with the Hamburger Zwangsinventar (HZI) and the SCL-90-R. The results are presented and their implications on the final steps of the development of the scale will be discussed.",Grabe HJ.; Parschau A.; Thiel A.; Kathmann N.; Boerner R.; Hoff P.; Freyberger HJ.,2002.0,10.1055/s-2002-28429,0,0,
10632,Health-related quality of life associated with irritable bowel syndrome: comparison with other chronic diseases.,"Despite the rapidly growing body of literature on health-related quality of life (HRQoL). placing the results in a context that is meaningful to clinicians and patients is often overlooked. This study sought to quantify the impact of irritable bowel syndrome (IBS) on HRQoL by comparing the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) scores of IBS patients with normative US data and with the scores of patients having other chronic gastrointestinal (GI) and non-GI disorders. Two IBS reference groups were identified from the published literature: a largely untreated community sample of health maintenance organization (HMO) members (N = 92) and a sample of patients with IBS recruited through clinics and in the community (N = 140). SF-36 scores for these groups were compared with published US population norms (N = 2474) and with published scores for 3 other IBS samples (N = 464); a sample with other chronic GI disorders (dyspepsia [N = 126], gastroesophageal reflux disease [GERD] [N = 516]); and samples with other chronic episodic disorders (asthma [N = 375], migraine [N = 303], panic disorder [N = 73], rheumatoid arthritis [N = 693]). The scores of patients in both IBS reference groups were significantly lower on several SF-36 domains than those of the US normative population (P < 0.003). Scores on several SF-36 scales were also significantly lower in the IBS reference groups compared with the GERD, asthma, and migraine samples (P < 0.003). Depending on the IBS sample used, scores did not differ or were higher compared with those in the sample with dyspepsia. Relative to the samples with panic disorder and rheumatoid arthritis, the IBS groups had significantly higher scores on most SF-36 domains (P < 0.003). Scores for the HMO reference group were generally higher than those for the clinic/community reference group. Based on the results of this analysis, IBS is associated with impairment of HRQoL relative to US population norms and to populations with GERD, asthma, or migraine. HRQoL appears to be greater in patients with IBS than in those with panic disorder or rheumatoid arthritis, although the relative symptom severity in these samples was not known.",Frank L.; Kleinman L.; Rentz A.; Ciesla G.; Kim JJ.; Zacker C.,2002.0,,0,0,
10633,"Behavioural disorders, Parkinson's disease and subthalamic stimulation.","to analyse 24 parkinsonian patients successfully treated by bilateral STN stimulation for the presence of behavioural disorders. patients were evaluated retrospectively for adjustment disorders (social adjustment scale, SAS), psychiatric disorders (comparison of the results of psychiatric interview and the mini international neuropsychiatric inventory) and personality changes (IOWA scale of personality changes). parkinsonian motor disability was improved by 69.5% and the levodopa equivalent daily dosage was reduced by 60.5%. Social adjustment (SAS) was considered good or excellent in nine patients, moderately (n=14), or severely (n=1) impaired in 15 patients. Psychiatric disorders consisted of amplification or decompensation of previously existing disorders that had sometimes passed unnoticed, such as depressive episodes (n=4), generalised anxiety (n=18), and behavioural disorders with drug dependence (n=2). Appearance of mild to moderate emotional hyperreactivity was reported in 15 patients. Personality traits (IOWA scale) were improved in eight patients, unchanged in seven, and aggravated in eight Improvement in parkinsonian motor disability induced by STN stimulation is not necessarily accompanied by improvement in psychic function and quality of life. Attention is drawn to the possible appearance of personality disorders and decompensation of previous psychiatric disorders in parkinsonian patients who are suitable candidates for neurosurgery. We suggest that a careful psychological and psychiatric interview be performed before surgery, and emphasise the need for psychological follow up to ensure the best possible outcome.",Houeto JL.; Mesnage V.; Mallet L.; Pillon B.; Gargiulo M.; du Moncel ST.; Bonnet AM.; Pidoux B.; Dormont D.; Cornu P.; Agid Y.,2002.0,,0,0,
10634,"Symptomatic and syndromal anxiety in chronic forms of major depression: effect of nefazodone, cognitive behavioral analysis system of psychotherapy, and their combination.","Limited information is available on treatment response of anxiety symptoms in chronic forms of major depression. Concurrent anxiety disorders are prevalent in chronic depression, but the responsiveness of patients with such comorbidity to different treatments is largely unknown. This study investigated the comparative efficacy of nefazodone, Cognitive Behavioral Analysis System of Psychotherapy (CBASP), and their combination in improving anxiety symptoms in patients with chronic forms of major depression, including those with a concurrent anxiety disorder. 681 patients with chronic major depressive disorder (DSM-IV criteria) participated in a multicenter study of 12 weeks of acute treatment with nefazodone (N = 226), CBASP (N = 228), or the combination (N = 227). The Hamilton Rating Scale for Anxiety (HAM-A), the HAM-A psychic anxiety factor, and the anxiety/arousal subscale of the 30-item Inventory for Depressive Symptomatology-Self Report (IDS-SR-30) were used to assess anxiety symptoms. In the full sample. without controlling for change in depressive symptoms, combination therapy was superior to both monotherapies on all 3 anxiety measures both in the rate of change and at endpoint. When change in depressive symptoms was controlled for, there were no treatment differences in rate of change from baseline to week 12 on any of the 3 anxiety measures. In those patients with a concurrent anxiety disorder, however, the combination was superior to CBASP on the HAM-A and the IDS-SR-30. Nefazodone alone and combination therapy were both superior to CBASP on the HAM-A psychic anxiety factor. For patients with chronic depression, combination therapy is superior to CBASP or nefazodone alone. Among patients with a concurrent anxiety disorder, nefazodone. either alone or in combination with CBASP, improves anxiety symptoms faster than CBASP alone, independent of depressive symptom reduction.",Ninan PT.; Rush AJ.; Crits-Christoph P.; Kornstein SG.; Manber R.; Thase ME.; Trivedi MH.; Rothbaum BO.; Zajecka J.; Borian FE.; Keller MB.,2002.0,,0,0,
10635,"Teaching medical students exposure therapy for phobia/panic - randomized, controlled comparison of face-to-face tutorial in small groups vs. solo computer instruction.","To compare the teaching value of one session of computer-guided solo instruction in exposure therapy for phobias with that of one face-to-face small-group tutorial. Non-blind, randomized, controlled study. King's College Hospital Medical School, London. Thirty-seven third-year medical students and 11 behaviour therapists. Seventy-five true/false multiple choice questions relating to (b) below answered at pre- and post-teaching by students and just once by behaviour therapists to obtain 'expert' scores; pre- and post-teaching ratings of interest in behaviour therapy and post-teaching ratings of educational and enjoyment value. EDUCATIONAL INTERVENTIONS: (a) All students had a 20-minute group lecture on basic concepts and historical aspects just before randomization to: (b) 90 min of either solo computer or group face-to-face tutorial teaching. Computer instruction used a short version of 'FearFighter'- a self-help computer system for people suffering from phobias. Solo computer instruction taught exposure therapy principles effectively but improved multiple choice question scores marginally less than did small-group tutorial teaching. Tutorial teaching required 5 times more teacher time but led to knowledge scores that did not differ significantly from those of behaviour therapists. Students clearly rated face-to-face small-group tutorial teaching as more enjoyable. The knowledge gain from a solo computer session resembled that from a small-group face-to-face tutorial, and required far less teacher time, but was less enjoyable. Enjoyment might rise if the computer session was group-oriented and aimed at students rather than patients. In general computer teaching might be best used to complement rather than replace conventional teaching.",McDonough M.; Marks IM.,2002.0,,0,0,
10636,Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia.,"The aim of the present study was to evaluate the effectiveness of low-budget virtual reality (VR) exposure versus exposure in vivo in a between-group design in 33 patients suffering from acrophobia. The virtual environments used in treatment were exactly copied from the real environments used in the exposure in vivo program. VR exposure was found to be as effective as exposure in vivo on anxiety and avoidance as measured with the Acrophobia Questionnaire (AQ), the Attitude Towards Heights Questionnaire (ATHQ) and the Behavioral Avoidance Test (BAT). Results were maintained up to six months follow-up. The present study shows that VR exposure can be effective with relatively cheap hardware and software on stand-alone computers currently on the market. Further studies into the effectiveness of VR exposure are recommended in other clinical groups as agoraphobics and social phobics and studies in which VR exposure is compared with more emerging virtual worlds as presented in CAVE-type systems.",Emmelkamp PM.; Krijn M.; Hulsbosch AM.; de Vries S.; Schuemie MJ.; van der Mast CA.,2002.0,,0,0,
10637,The role of optimism in the process of schema-focused cognitive therapy of personality problems.,"The aim of this study was to examine the determinants and effects of optimism in the process of schema-focused cognitive therapy of personality problems. The sample consisted of 35 patients with panic disorder and/or agoraphobia and DSM-IV Cluster C personality traits who participated in an 11-week residential program with one symptom-focused and one personality-focused phase. This study examines the role played by optimism during the individual sessions of the second phase, using a time series approach. Decreased patient's belief in his/her primary Early Maladaptive Schema and increased patient-experienced empathy from the therapist in a session predicted increased patient-rated optimism before the subsequent session. Increased patient-rated optimism in turn predicted decreased schema belief and distress and increased insight, empathy, and therapist-rated optimism. The slope of optimism across sessions was related to change in most of the overall outcome measures. There appears to be a positive feedback in the process of schema-focused cognitive therapy between decreased schema belief and increased optimism. In addition, optimism appears to mediate the effects of schema belief and therapist empathy on overall improvement, and to serve as an antecedent to decreased distress and to increased empathy, insight, and therapist's optimism.",Hoffart A.; Sexton H.,2002.0,,0,0,
10638,Panic disorder and obsessive compulsive disorder in a hyperventilation challenge test.,"Stress-induced hyperventilation produces symptoms that people are prone to misinterpret as life-threatening if they are unaware of the consequences of overbreathing. Our aim was to observe the induction of panic attacks by a hyperventilation challenge test in a series of panic disorder and obsessive compulsive disorder (OCD) patients (DSM-IV). We randomly selected 28 panic disorder patients, 21 OCD patients and 28 normal volunteers. All patients were drug free for a week. They were induced to hyperventilate (30 breaths/min) for 4 min. Anxiety scales were applied before and after the test. A total of 64.3% (n=18) panic disorder patients, 9.5% (n=2) OCD patients and 3.6% (n=1) of control subjects had a panic attack after hyperventilating (chi(2)=3.99, d.f.=2, P=0.026). The hyperventilation challenge test has a low sensitivity for panic disorder. In this challenge test the panic disorder patients were more sensitive to hyperventilation than OCD patients and normal volunteers. The induction of panic attacks by voluntary hyperventilation may be an easy test for validating the diagnosis in certain panic disorder patients.",Nardi AE.; Valença AM.; Nascimento I.; Zin WA.,2002.0,,0,0,
10639,A randomized controlled trial of a brief educational and psychological intervention for patients presenting to a cardiac clinic with palpitation.,"We sought to determine whether a brief psycho-educational intervention reduced disability in patients with benign palpitation. In a pragmatic randomized controlled trial within a cardiology clinic at a district general hospital, 80 consecutive patients diagnosed as having benign palpitation--either palpitation due to awareness of extrasystoles or sinus rhythm--with associated distress or disability were randomized to an intervention group (usual care plus nurse-delivered intervention based on cognitive-behavioural principles) or to a control group (usual care). Principal outcome was difference in proportion of participants with good or excellent researcher-rated activity levels at 3 months. Subsidiary outcomes were self-rated symptoms, distress and disability, researcher-rated unmet treatment needs. The principal outcome showed a statistically and clinically significant benefit for the intervention group, with a number needed to treat of 3 (95% CIs 2 to 7). All but one subsidiary outcomes also showed a difference in favour of the intervention group, and several differences reached statistical significance. Significantly more of the control group had unmet treatment needs at 3 months. A brief, nurse-delivered, psycho-educational intervention, was an effective treatment for benign palpitation. Further evaluation, including assessment of cost-effectiveness, is needed. The findings have application to the care of patients presenting with other types of 'unexplained' medical symptoms.",Mayou R.; Sprigings D.; Birkhead J.; Price J.,2002.0,,0,0,
10640,School-based treatment for anxious african-american adolescents: a controlled pilot study.,"To evaluate the feasibility and effectiveness of a school-based group cognitive-behavioral treatment (CBT) for anxiety disorders with African-American adolescents. Twelve adolescents (mean age = 15.6 years) with anxiety disorders were randomly assigned to CBT (n = 6) or a group attention-support control condition (AS-Control; n = 6). Both groups met for 10 sessions in the same high school. Key treatment ingredients in CBT involved exposure, relaxation, social skills, and cognitive restructuring. Key ingredients in AS-Control involved therapist and peer support. At pre- and posttreatment, diagnostic interviews were conducted, and adolescents completed self-report measures of anxiety. At posttreatment and among those who attended more than one treatment session, 3/4 adolescents in CBT no longer met diagnostic criteria for their primary anxiety disorder, compared with 1/5 in AS-Control. Clinician ratings of impairment and self-report levels of overall anxiety were significantly lower at posttreatment in CBT compared with AS-Control. Teenagers in both groups reported lower levels of social anxiety from pre- to posttreatment. Findings support the feasibility of implementing a manual-based CBT in an urban school setting. Responder rates among African-American adolescents were similar to those found in studies with white youths.",Ginsburg GS.; Drake KL.,2002.0,10.1097/00004583-200207000-00007,0,0,
10641,Effectiveness of bed rest after mild traumatic brain injury: a randomised trial of no versus six days of bed rest.,"Outcome after mild traumatic brain injury (MTBI) is determined largely by the appearance of post-traumatic complaints (PTC). The prevalence of PTC after six months is estimated to be between 20 and 80%. Bed rest has been advocated to prevent PTC but its effectiveness has never been established. To evaluate the effect of bed rest on the severity of PTC after MTBI. Patients presenting with MTBI to the emergency room were randomly assigned to two intervention strategies. One group was advised not to take bed rest (NO) and the other to take full bed rest (FULL) for six days after the trauma. The primary outcome measures were severity of PTC on a visual analogue scale and physical and mental health on the medical outcomes study 36 item short form health survey (SF-36) at two weeks and three and six months after the trauma. Between October 1996 and July 1999, 107 (54 NO, 53 FULL) patients were enrolled. Outcome variables in both groups clearly improved between two weeks and six months. After adjustment for differences in baseline variables, most PTC tended to be somewhat more severe in the FULL group six months after the trauma, but no significant differences were found. Neither were there any significant differences in the outcome parameters between the two groups after three months. Two weeks after the trauma, most PTC in the FULL group were slightly less severe than those in the NO group, and physical subscores of the SF-36 in the FULL group were slightly better. These differences were not significant. Patients in the FULL group reported significantly less dizziness during the intervention period. As a means of speeding up recovery of patients with PTC after MTBI, bed rest is no more effective than no bed rest at all. Bed rest probably has some palliative effect within the first two weeks after the trauma.",de Kruijk JR.; Leffers P.; Meerhoff S.; Rutten J.; Twijnstra A.,2002.0,,0,0,
10642,A placebo-controlled study of Kava kava in generalized anxiety disorder.,"We assessed the efficacy and safety of a botanical anxiolytic, Kava kava (Piper methysticum), in treating generalized anxiety disorder (GAD). Thirty-seven adults with DSM-IV GAD were randomly assigned to 4 weeks of double-blind treatment with kava or a matching placebo. Weekly efficacy assessments [Hamilton Anxiety Scale, Hospital Anxiety and Depression Scale (HADS), Self Assessment of Resilience and Anxiety (SARA)] and safety evaluations were conducted. Improvement was observed with both treatments but no differences were found in the principal analysis. Post-hoc analyses revealed significant differences based on baseline anxiety severity, whereby kava was superior on the SARA in low anxiety and placebo was superior on the HADS and SARA in high anxiety. Both treatments were well tolerated. Although kava was not superior to placebo, it would be premature to rule it out as efficacious in GAD.",Connor KM.; Davidson JR.,2002.0,,0,0,
10643,Subchondral contusion of the knee caused by axial loading from dashboard impact: detection by magnetic resonance imaging.,"We studied the occurrence of ""bone bruises"" of the knee resulting from dashboard impaction and detected by magnetic resonance imaging (MRI). We chose 21 knees of 20 front seat occupants in head-on motor vehicle collisions. To ensure all knees had received a significant axial load, patients selected had ipsilateral posterior hip dislocations and/or posterior wall acetabular fractures. Anteroposterior and lateral knee radiographs were negative for fracture in all cases. T1-weighted axial and sagittal MRI of each knee with a 1.5-T magnetron scanner revealed signal changes consistent with subchondral microfracture or bone bruise in 8 of the 21 knees. Previous cadaveric, animal, and MRI studies have suggested that such changes may be precursors of posttraumatic osteoarthritis. With the increasing incidence of serious lower extremity injury as a result of motor vehicle accidents, these occult injuries may significantly affect individuals and society.",Bealle D.; Johnson DL.,2000.0,,0,0,
10644,Psychological distress among abused minority women with sexually transmitted diseases.,"To describe psychological distress among abused minority women with sexually transmitted diseases (STDs) and to identify needs for psychotherapeutic intervention for reduction in abuse, sexual risk behavior and STD. A controlled randomized trial of the effects of a behavioral intervention on STD recurrence. Eligibility was limited to English speaking Mexican-American and African-American women with a current non-viral STD confirmed by laboratory testing (gonorrhea, chlamydia, syphilis or trichomonas). All eligible women who could be contacted were recruited from public-health clinics in San Antonio. T-tests, Chi square and correlation were used to analyze the data. Women with STD and a history of abuse reported more symptoms of current psychological distress than nonabused women. This psychological distress was present in all dimensions of the SCL-90-R, including somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism. Increased current psychological distress and correlation was found not only for women with reports of sexual abuse but also forms of physical or psychological abuse. The majority of abuse was reportedly experienced during a relationship with a boyfriend or friend/acquaintance. Abused women with STD may benefit from the identification and assessment of abuse history and psychological distress so that appropriate psychological treatment can accompany medical treatment. The prevalence of woman abuse within a population of women with STD mandates the inclusion of violence in STD prevention programs.",Champion JD.; Shain RN.; Piper J.; Perdue ST.,2002.0,,0,0,
10645,"Long-term survival differences among low-anxious, high-anxious and repressive copers enrolled in the Montreal heart attack readjustment trial.","This study reports 5-year outcomes from the Montreal Heart Attack Readjustment Trial, a randomized, controlled trial of monthly telephone monitoring of psychological distress and home nursing visits in a sample of 1376 patients. It focuses on differences in long-term program impact associated with patients' sex and baseline anxiety/repressor coping styles. The potential mediating roles of medications, medical care utilization, and changes in negative emotions over the program are also explored. Three subgroups were defined using median splits on the State Anxiety Inventory and Marlowe-Crowne Scale administered at baseline: truly low anxious, repressors, and high anxious. Quebec medicare data were used to track survival through 5 years. The trend toward worse prognosis in women in the treatment group and no evidence of treatment impact in men that were seen during the program year were maintained during the follow-up. Analysis of results in terms of coping styles showed a significant long-term survival benefit of treatment in highly anxious men, for whom reductions in somatic symptoms of depression mediated program impact. However, the program was also associated with significantly worse survival in repressors of both sexes. By the end of the program, repressors in the treatment group were more likely to be prescribed benzodiazepines and to have visited emergency rooms without being readmitted than those in the control group, suggesting that the program may have increased distress in repressors. Patients' coping style is important in determining outcomes of psychosocial treatments and should be taken into account when tailoring interventions.",Frasure-Smith N.; Lespérance F.; Gravel G.; Masson A.; Juneau M.; Bourassa MG.,,,0,0,6338
10646,Effect of early induction of hypothermia on severe head injury.,"Although therapeutic hypothermia for patients with head injury has improved the outcome, the results in the most severe cases (GCS 3-6) have not been satisfactory so far. We induced hypothermia in head injury patients within 3 hours after the trauma, and compared the outcome of the treatment without hypothermia. Fourteen patients with GCS less than 6 were entered into this study (age range 13 to 58, mean 27.0 years). Seven of them were treated by hypothermia and 6 by the conventional method. The patients undergoing hypothermia were cooled to 34 degrees C within 3 hours after injury, kept at 32-34 degrees C for 48 hours, and then rewarmed. The outcome was evaluated at 6 months post-trauma, and the results were compared in the two groups. Therapeutic hypothermia dramatically suppressed brain swelling on CT in 3 of 7 patients. Four patients including these 3 showed a favorable outcome (good or moderate disability) and 3 died in the hypothermia group. In the conventional treatment group, only 1 patient was moderately disabled and 6 exhibited an unfavorable outcome (severely disabled, vegetative, or death). Early induction of hypothermia can improve the outcome in patients with severe head injury by reducing the severe brain swelling.",Hayashi S.; Inao S.; Takayasu M.; Kajita Y.; Ishiyama J.; Harada T.; Yoshida J.,2002.0,,0,0,
10647,The neuropsychiatry of carbon monoxide poisoning in attempted suicide: a prospective controlled study.,"There are few prospective comprehensive controlled studies of the neuropsychiatric outcome in people who attempt suicide with carbon monoxide (CO). The present study aimed to evaluate this. A consecutive series of 41 adults (81% men) with CO exposure presenting over 3 years, and 20 matched controls, were evaluated with instruments to assess orientation, attention, concentration, speed of information processing, verbal memory, premorbid intellect, executive function (working memory, verbal fluency and set-switching), mood disorder, psychotic disorder, alcohol dependence and obsessive-compulsive disorder, levels of depression, hopelessness, suicide intent, anxiety, neurobehavioural function and social and interpersonal functioning. At 2 months follow-up, the neuropsychological battery was extended to include further tests of executive function (including problem-solving) and memory (including visual memory), At initial assessment, control subjects showed similar levels of cognitive impairment as CO-exposed subjects (except in the case of four CO subjects with very severe impairment), but were more depressed. At 2-months follow-up, the trends were generally towards improvement in all subjects, with no between-group differences. Indirect effects on cognitive state may be at least as great as direct CO neurotoxicity in suicide attempters. The study did not support CO exposure exacerbating mood disorder in this sample.",Hay PJ.; Denson LA.; van Hoof M.; Blumenfeld N.,2002.0,,0,0,
10648,Sleep Dynamic Therapy for Cerro Grande Fire evacuees with posttraumatic stress symptoms: a preliminary report.,"Sleep disturbance is common among disaster survivors with posttraumatic stress symptoms but is rarely addressed as a primary therapeutic target. Sleep Dynamic Therapy (SDT), an integrated program of primarily evidence-based, nonpharmacologic sleep medicine therapies coupled with standard clinical sleep medicine instructions, was administered to a large group of fire evacuees to treat posttraumatic insomnia and nightmares and determine effects on posttraumatic stress severity. The trial was an uncontrolled, prospective pilot study of SDT for 66 adult men and women, 10 months after exposure to the Cerro Grande Fire. SDT was provided to the entire group in 6, weekly, 2-hour sessions. Primary and secondary outcomes included validated scales for insomnia, nightmares, posttraumatic stress, anxiety, and depression, assessed at 2 pretreatment baselines on average 8 weeks apart, weekly during treatment, posttreatment, and 12-week follow-up. Sixty-nine participants completed both pretreatment assessment, demonstrating small improvement in symptoms prior to starting SDT. Treatment and posttreatment assessments were completed by 66 participants, and 12-week follow-up was completed by 59 participants. From immediate pretreatment (second baseline) to posttreatment, all primary and secondary scales decreased significantly (all p values < .0001) with consistent medium-sized effects (Cohen's d = 0.29 to 1.09), and improvements were maintained at follow-up. Posttraumatic stress disorder subscales demonstrated similar changes: intrusion (d = 0.56), avoidance (d = 0.45), and arousal (d = 0.69). Fifty-three patients improved, 10 worsened, and 3 reported no change in posttraumatic stress. In an uncontrolled pilot study, chronic sleep symptoms in fire disaster evacuees were treated with SDT, which was associated with substantive and stable improvements in sleep disturbance, posttraumatic stress, anxiety, and depression 12 weeks after initiating treatment.",Krakow BJ.; Melendrez DC.; Johnston LG.; Clark JO.; Santana EM.; Warner TD.; Hollifield MA.; Schrader R.; Sisley BN.; Lee SA.,2002.0,,0,0,
10649,Predictors of response to treatment for chronic fatigue syndrome.,"Controlled trials have shown that psychological interventions designed to encourage graded exercise can facilitate recovery from chronic fatigue syndrome. To identify predictors of response to psychological treatment for chronic fatigue syndrome. Of 114 patients assigned to equally effective treatment conditions in a randomised, controlled trial, 95 completed follow-up assessments. Relationships between variables measured prior to randomisation and changes in physical functioning and subjective handicap at 1 year were evaluated by multiple regression. Poor outcome was predicted by membership of a self-help group, being in receipt of sickness benefit at the start of treatment, and dysphoria as measured by the Hospital Anxiety and Depression scale. Severity of symptoms and duration of illness were not predictors of response. Poor outcome in the psychological treatment of chronic fatigue syndrome is predicted by variables that indicate resistance to accepting the therapeutic rationale, poor motivation to treatment adherence or secondary gains from illness.",Bentall RP.; Powell P.; Nye FJ.; Edwards RH.,2002.0,,0,0,
10650,Treatment of PTSD: stress inoculation training with prolonged exposure compared to EMDR.,"The effectiveness of Stress Inoculation Training with Prolonged Exposure (SITPE) was compared to Eye Movement Desensitization and Reprocessing (EMDR). Twenty-four participants who had a diagnosis of Post Traumatic Stress Disorder (PTSD) were randomly assigned to one of the treatment conditions. Participants were also their own wait-list control. Outcome measures included self-report and observer-rated measures of PTSD, and self-report measures of depression. On global PTSD measures, there were no significant differences between the treatments at the end of therapy. However on the subscale measures of the degree of intrusion symptoms, EMDR did significantly better than SITPE. At follow-up EMDR was found to lead to greater gains on all measures.",Lee C.; Gavriel H.; Drummond P.; Richards J.; Greenwald R.,2002.0,10.1002/jclp.10039,0,0,
10651,Effects of a long-term psychosocial nursing intervention on adolescents exposed to catastrophic stress.,"This research tested the effects of a long-term psychosocial nursing intervention designed to decrease mental distress in adolescents following a catastrophic event. Advanced Practice Psychiatric Nurses conducted the Catastrophic Stress Intervention (CSI) in two South Carolina high schools for three years following Hurricane Hugo. The CSI consisted of nine protocols designed to decrease adolescents' mental distress by increasing their understanding of stress and by enhancing their self-efficacy and social support. Adolescents (N = 1030) were randomized to intervention or control groups and completed one baseline and five postintervention measures of mental distress, self-efficacy, and social support. The hypothesis was that intervention adolescents would have less mental distress than control adolescents. The research also addressed the particular time points at which differences between intervention and control adolescents might be shown. Repeated measures multivariate analysis of variance, with exposure to the hurricane, self-efficacy, and social support as control variables, showed that intervention adolescents reported less mental distress than control adolescents at 12, 18, and 24 months but that this difference dissipated by 30 and 36 months. Implications for the CSI and timing of interventions with adolescents after a catastrophic event are discussed.",Hardin SB.; Weinrich S.; Weinrich M.; Garrison C.; Addy C.; Hardin TL.,2002.0,10.1080/01612840290052712,0,0,
10652,Medical (fluoxetine) and psychological (cognitive-behavioural therapy) treatment for premenstrual dysphoric disorder: a study of treatment processes.,"To investigate (i) the differential changes in premenstrual symptoms, mood, cognitions, and coping strategies during two treatments [cognitive-behavioural therapy (CBT) and fluoxetine] for premenstrual dysphoric disorder (PMDD) and (ii) the characteristics of those with good vs. poor outcome post treatment and at 1 year follow-up. Premenstrual symptoms, mood (Hospital Anxiety and Depression Scale, HADS), causal attributions, and use of cognitive and behavioural coping strategies were examined during 6 months of both treatments. The two treatment groups were then combined and divided on the basis of good vs. poor outcome posttreatment and at 1 year follow-up. Baseline measures were used to predict posttreatment outcome, and baseline and posttreatment measures were examined when attempting to predict outcome at 1 year follow-up. Both treatments were equally effective at the end of 6 months (prospective daily diary measure). Fluoxetine treatment had a more rapid effect and greater impact upon anxiety symptoms, while CBT was associated with increased use of cognitive and behavioural coping strategies and a shift from a biomedical to a biopsychosocial causal attribution of premenstrual symptoms. Depressed mood at baseline assessment was associated with poorer response to both treatments, and learning active behavioural coping strategies was associated with a good outcome at 1 year follow-up. These results provide evidence of differential treatment effects of fluoxetine and CBT for PMDD and offer information that will enhance clinical decision-making.",Hunter MS.; Ussher JM.; Cariss M.; Browne S.; Jelley R.; Katz M.,2002.0,,0,0,
10653,Event-related potentials to auditory stimuli in female Vietnam nurse veterans with posttraumatic stress disorder.,"Individuals with posttraumatic stress disorder (PTSD) have been found to show several event-related brain potential (ERP) abnormalities including reduced target P3b amplitude, P50 suppression, and P2 amplitude/intensity slope. Female Vietnam nurse veterans with (n = 29) and without (n = 38) current PTSD completed P50 paired-click, three-tone ""oddball"" and four-tone stimulus-intensity modulation procedures. Opposite to previous findings, the current PTSD group had larger target P3b amplitudes and increased P2 amplitude/intensity slopes. Reduced P50 suppression was associated with increased severity of general psychopathology, but not with PTSD diagnosis. Findings suggest that target P3b amplitude and P2 amplitude/intensity slope abnormalities reflect different pathophysiological processes. Future research is needed to determine whether the opposite ERP abnormalities observed in this PTSD sample reflect gender-, trauma-, or sample-specific findings.",Metzger LJ.; Carson MA.; Paulus LA.; Lasko NB.; Paige SR.; Pitman RK.; Orr SP.,2002.0,10.1017/S0048577202001002,0,0,
10654,Obsessive-compulsive symptom dimensions as predictors of compliance with and response to behaviour therapy: results from a controlled trial.,"Recent factor-analytic studies in obsessive-compulsive disorder (OCD) identified consistent symptom dimensions. Support for the validity of these dimensions comes from studies of psychiatric comorbidity, functional brain imaging, genetic transmission, and treatment response to medications. This study examined whether previously identified OCD symptom dimensions are associated with treatment compliance and response to behaviour therapy (BT) for OCD. One hundred and fifty-three OCD outpatients who participated in a multi-centre randomised controlled trial of computer- versus clinician-guided BT for OCD were included in the study. Logistic and multiple regression models tested for significant predictors of compliance with and response to BT and relaxation. The patients studied were phenomenologically comparable (including the presence of 'pure' obsessions and mental rituals) to those in previous serotonin reuptake inhibitor (SRI) trials and those in clinical epidemiology studies. High scorers on the 'hoarding' dimension were more likely to drop out prematurely from the study and tended to improve less. For those completing treatment, the strongest predictor of outcome was pre-treatment severity. Initial depression scores were unrelated to outcome. After controlling for symptom severity, higher scores on the 'sexual/religious obsessions' factor predicted poorer outcome with BT, especially when computer-guided. BT is especially indicated for OCD patients with aggressive/checking, contamination/cleaning and symmetry/ordering symptoms. Previous accounts of unsuccessful BT in patients with hoarding symptoms may be due in part to their propensity to drop out earlier from treatment. Patients with sexual/religious obsessions, but not those with mental rituals, might respond less well to traditional BT techniques. Existing treatments need to be refined and/or new treatments developed to improve these patients' adherence and response to treatment.",Mataix-Cols D.; Marks IM.; Greist JH.; Kobak KA.; Baer L.,,,0,0,7220
10655,Predictors of willingness to consider medication and psychosocial treatment for panic disorder in primary care patients.,"The purpose of this investigation was to identify demographic and clinical patient characteristics related to willingness to consider panic disorder treatments in the primary care setting. Given the prevalence of anxiety disorders and the increased provision of mental health treatments in general medical settings, patients were selected from primary care settings. An unselected sample of 4,198 patients completed a brief questionnaire containing questions about demographic characteristics, physical health status, and symptoms of panic disorder, social phobia and PTSD. The 1,043 patients indicating a recent panic attack episode answered additional questions about their willingness to consider both medication and psychosocial forms of intervention for panic. Of these panic patients, 64% reported willingness to consider medication and 67% reported willingness to consider a psychosocial intervention for their panic. Logistic regression analyses for these panic patients revealed that willingness to consider medication treatment for panic was associated with older age, lower education, poorer health status and the presence of social phobia and/or PTSD symptoms. In addition, Asian and African American patients were less likely than Caucasian patients to indicate willingness to consider medication treatment for their panic. However, only the presence of comorbid social phobia and PTSD symptoms predicted willingness to consider a psychosocial intervention. Results suggest that acceptability of psychosocial treatment is unrelated to demographic and physical health factors, while primary care patients with certain demographic characteristics, good physical health, or who suffer from fewer comorbid mental health conditions may need additional encouragement to begin medication treatment for panic.",Hazlett-Stevens H.; Craske MG.; Roy-Byrne PP.; Sherbourne CD.; Stein MB.; Bystritsky A.,,,0,0,
10656,Decompression of the spinal subarachnoid space as a solution for syringomyelia without Chiari malformation.,"Review and analysis of seven cases of syringomyelia treated surgically. To demonstrate the beneficial role of decompressive surgery for the altered cerebrospinal fluid (CSF) flow dynamics in syringomyelia not associated with Chiari I malformation. A comparison between the pre- and post-operative syrinx size and CSF flow in the subarachnoid space was made using cine-mode magnetic resonance imaging (cine-MRI) and then correlated with clinical improvement. University Hospital, Seoul, Korea. Conventional spinal MRI and cine-MRI were performed in the region of CSF flow obstruction preoperatively in seven patients with syringomyelia not associated with Chiari I malformation. The group consisted of one case of syrinx with post-traumatic compression fracture, one case of post-traumatic arachnoiditis, two cases of holocord syrinx associated with hydrocephalus without Chiari malformation, one case of syrinx with post-traumatic pseudomeningeal cyst, one case of post-laminectomy kyphosis-associated syringomyelia and one case of post-tuberculous arachnoiditis syringomyelia. Based on the preoperative cine-MRI, the types of surgery appropriate to correct the CSF flow obstruction were chosen: decompressive laminectomy-adhesiolysis and augmentation duraplasty in arachnoiditis cases, ventriculoperitoneal shunt for hydrocephalus, cyst extirpation in pseudomeningeal cyst and both anterior and posterior decompression-fusion in the case of post-laminectomy kyphosis. A syrinx-draining shunt operation was performed in three cases; where the syringomyelia was associated with post-traumatic compression fracture refractory to a previous decompression, where hydrocephalus was present in which the decompression by ventriculoperitoneal shunt was insufficient and where post-traumatic arachnoiditis was present in which the decompression was impossible due to diffuse adhesion. Change in syrinx size was evaluated with post-operative MRI in all seven cases and restoration of flow dynamics was evaluated with cine-MRI in three of the cases, two patients with clinical improvement and one patient with no change of clinical status, respectively. Four out of seven patients showed symptomatic improvement after each decompressive operation. In the remaining three cases, reconstruction of the spinal subarachnoid space was not possible due to diffuse adhesion or was not the main problem as in the patient with syrinx associated with hydrocephalus who had to undergo a shunt operation. One of these three patients showed clinical improvement after undergoing syringosubarachnoid shunt. A decrease of syrinx size was observed in only two out of the five patients who showed clinical improvement after treatment. Of these five patients, two patients underwent post-operative cine-MRI and the restoration of normal CSF flow dynamics was noted in both patients. Of the remaining two patients, one underwent post-operative cine-MRI and there was no change in the CSF flow dynamics evident. These results suggest that the restoration of CSF flow dynamics between the syrinx and the subarachnoid space by decompressive operation is more effective than simple drainage of the syrinx cavity itself in the treatment of syringomyelia without Chiari malformation.",Lee JH.; Chung CK.; Kim HJ.,2002.0,10.1038/sj.sc.3101322,0,0,
10657,Virtual reality in the treatment of spider phobia: a controlled study.,"This study explored whether virtual reality (VR) exposure therapy was effective in the treatment of spider phobia. We compared a treatment condition vs. a waiting list condition in a between group design with 23 participants. Participants in the VR treatment group received an average of four one-hour exposure therapy sessions. VR exposure was effective in treating spider phobia compared to a control condition as measured with a Fear of Spiders questionnaire, a Behavioural Avoidance Test (BAT), and severity ratings made by the clinician and an independent assessor. Eighty-three percent of patients in the VR treatment group showed clinically significant improvement compared with 0% in the waiting list group, and no patients dropped out. This study shows that VR exposure can be effective in the treatment of phobias.",Garcia-Palacios A.; Hoffman H.; Carlin A.; Furness TA.; Botella C.,2002.0,,0,0,
10658,[Is a dynamic or stable technique needed for metacarpophalangeal joints of the hand in ulnar nerve palsy?].,"It seems interesting to choose between the dynamic and the static techniques for the rehabilitation of the hand suffering from an ulnar nerve palsy on the basis of the grasp (F1) and pinch (F2) strengths which are important in this rehabilitation. From june 1997 to december 2001, 30 ulnar palsies all post traumatic with non complicated claw deformities have been collected and distributed in three groups of ten patients. In the group A only the static techniques have been used on the MP joints of the fourth and fifth digits and the thumb; in the group B only the dynamic techniques have been used on the fourth and fifth digits, on the flexor pollicis brevis and on the first dorsal interosseous muscle; in the group C, the MP joint of the thumb has been stabilized and dynamic techniques have been used on these two muscles, the MP joints of the fourth and fifth digits have been only stabilized. The techniques used in this study were among the most popular. The grasp and pinch strengths were measured by a mechanical dynamometer at the preoperative period and at third and sixth postoperative month. At sixth month, in the group A, F1 didn't change and F2 has increased by 9%; in the group B, F1 has decreased by 24% without recovery of the preoperative value and F2 has increased by 13%; in the group C, F2 has increased by 19%. For a reconstruction of an useful hand in an ulnar nerve palsy, the best solutions seem: for the fourth and fifth digits: simple stabilization of the MP joints for the thumb: an association of this stabilization and a rehabilitation of some muscles involved in the pinch prehension.",Belmahi AM.; Gharib N.; el Mazouz S.; Assiobow A.; Oufkir A.,2002.0,,0,0,
10659,"A randomized, double-blind, placebo-controlled study of the effects of adjunctive paroxetine in panic disorder patients unsuccessfully treated with cognitive-behavioral therapy alone.","Both cognitive-behavioral therapy and treatment with selective serotonin reuptake inhibitors (SSRIs) have proved to be effective in the treatment of panic disorder. The present study examined the effects of paroxetine added to continued cognitive-behavioral therapy in patients who were unsuccessfully treated with initial cognitive-behavioral therapy alone. 161 patients with panic disorder with or without agoraphobia (DSM-IV criteria) underwent a manual-guided cognitive-behavioral therapy of 15 sessions. Forty-three unsuccessfully treated patients from this group were included in a double-blind, placebo-controlled, next-step treatment study consisting of continued cognitive-behavioral therapy plus adjunctive paroxetine at a dose of 40 mg/day or continued cognitive-behavioral therapy plus placebo. Overall, patients in the cognitive-behavioral therapy plus paroxetine condition improved significantly on agoraphobic behavior (p < .05) and anxiety discomfort (p < .01), whereas patients in the cognitive-behavioral therapy plus placebo condition did not. Effect sizes in the cognitive-behavioral therapy plus paroxetine condition ranged from 1.0 to 1.8 and in the cognitive-behavioral therapy plus placebo condition, from 0.4 to 1.0. Patients with panic disorder who are unsuccessfully treated with initial cognitive-behavioral therapy may benefit from the addition of an SSRI as a second treatment modality. The importance of timely evaluation of treatment results is emphasized.",Kampman M.; Keijsers GP.; Hoogduin CA.; Hendriks GJ.,2002.0,,0,0,
10660,Clinical significance of lifetime panic spectrum symptoms in the treatment of patients with bipolar I disorder.,"Given the observed association between panic disorder and bipolar disorder and the potential negative influence of panic symptoms on the course of bipolar illness, we were interested in the effects of what we have defined as ""panic spectrum"" conditions on the clinical course and treatment outcome in patients with bipolar I (BPI) disorder. We hypothesized that lifetime panic spectrum features would be associated with higher levels of suicidal ideation and a poorer response to acute treatment of the index mood episode in this patient population. A sample of 66 patients with BPI disorder completed a self-report measure of lifetime panic-agoraphobic spectrum symptoms. Patients falling above and below a predefined clinical threshold for panic spectrum were compared for clinical characteristics, the presence of suicidal ideation during acute treatment, and acute treatment response. Half of this outpatient sample reported panic spectrum features above the predefined threshold. These lifetime features were associated with more prior depressive episodes, higher levels of depressive symptoms, and greater suicidal ideation during the acute-treatment phase. Patients with BPI disorder who reported high lifetime panic-agoraphobic spectrum symptom scores took 27 weeks longer than those who reported low scores to remit with acute treatment (44 vs 17 weeks, respectively). The presence of lifetime panic spectrum symptoms in this sample of patients with BPI disorder was associated with greater levels of depression, more suicidal ideation, and a marked (6-month) delay in time to remission with acute treatment. Alternate treatment strategies are needed for patients with BPI disorder who endorse lifetime panic spectrum features.",Frank E.; Cyranowski JM.; Rucci P.; Shear MK.; Fagiolini A.; Thase ME.; Cassano GB.; Grochocinski VJ.; Kostelnik B.; Kupfer DJ.,2002.0,,0,0,
10661,Comparability of telephone and face-to-face interviews in assessing patients with posttraumatic stress disorder.,"Structured clinical interviews are very important in the area of mental health research and services. Prior research comparing the reliability and validity of face-to-face and phone interviews has found high levels of agreement. This project compared the results of face-to-face and phone interviews for two widely used measures: The Clinician-Administered PTSD Scale (CAPS) for assessing posttraumatic stress disorder diagnostic status and symptom severity and the Hamilton Rating Scale for Depression (Ham-D) to determine the severity of major depressive disorder. Subjects were 34 veterans recruited from applicants to the PTSD Assessment and Intervention program at the Cincinnati VA Medical Center. Order of interview (in-person or phone) was determined using random assignment within a counterbalanced framework. After attaining satisfactory levels of interrater reliability, four clinicians independently and blindly evaluated the subjects. Pearson correlation coefficients between face-to-face and phone interviews revealed high consistency (CAPS r = 0.745, HAM-D r = 0.748). The level of agreement between the two methods was 82% for the CAPS and 85% for the HAM-D. Diagnostic thresholds for the CAPS and HAM-D, after adjusting for the interview order and time elapsed between interviews, did not differ between the two groups (p = 0.31 for the CAPS and p = 0.96 for the HAM-D). High levels of agreement were achieved between the two methods (kappa = 0.75 for the CAPS using a cutoff of 65 and 0.70 for the HAM-D). The high sensitivity, specificity, and predictive values support the reliability of the phone-interview method. Phone interviews are a reliable method of interviewing for use in assessing patients for posttraumatic stress disorder and major depressive disorder.",Aziz MA.; Kenford S.,2004.0,,0,0,
10662,The use of paroxetine and cognitive-behavioral therapy in postpartum depression and anxiety: a randomized controlled trial.,"Approximately 10% to 16% of women experience a major depressive episode after childbirth. A significant proportion of these women also suffer from comorbid anxiety disorders. The purpose of this study was to evaluate whether the addition of cognitive-behavioral therapy (CBT) to standard antidepressant therapy offers additional benefits in the treatment of post-partum depression with comorbid anxiety disorders. Thirty-five women referred to a tertiary care hospital outpatient program with a DSM-IV diagnosis of postpartum depression with comorbid anxiety disorder were randomly assigned to 1 of 2 treatment groups-paroxetine-only monotherapy group (N = 16) or paroxetine plus 12 sessions of CBT combination therapy group (N = 19)-for a 12-week trial. Progress was monitored by a psychiatrist blinded to treatment group, using the Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety, Yale-Brown Obsessive Compulsive Scale, Clinical Global Impressions scale, and Edinburgh Postnatal Depression Scale. Data were analyzed using 2-tailed statistical tests at an alpha level of.05. The study was conducted from April 1, 2002, to June 30, 2003. Both treatment groups showed a highly significant improvement (p <.01) in mood and anxiety symptoms. Groups did not differ significantly in week of recovery, dose of paroxetine at remission, or measures of depression, anxiety, and obsessive-compulsive symptoms at outcome. Antidepressant monotherapy and combination therapy with antidepressants and CBT were both efficacious in reducing depression and anxiety symptoms. However, in this sample of acutely depressed/anxious postpartum women, there were no additional benefits from combining the 2 treatment modalities. Further research into the efficacy of combination therapy in the treatment of moderate-to-severe depression with comorbid disorders in postpartum women is recommended.",Misri S.; Reebye P.; Corral M.; Milis L.,2004.0,,0,0,
10663,Psychological support counselling improves gluten-free diet compliance in coeliac patients with affective disorders.,"Anxiety and depression are common features of coeliac disease. Depression is cause of non-compliance to treatment in chronic illness. To evaluate the useful of psychological support counselling to improve affective disorders and gluten-free diet adherence in coeliac disease with anxiety and depression. A total of 66 coeliac disease patients with state anxiety and current depression were enrolled. Patients were randomized in two groups: in group A psychological support was started at the beginning of gluten-free diet, while group B was free of psychological support. Both groups were followed every 2 weeks for 6 months. State and Trait Anxiety Inventory test Y-1 and the modified Zung self-rating depression scale were administered before (T0) and after 6 months of gluten-free diet (T1). At T1 no difference was found between groups in the percentage of state anxiety, while a significant lower percentage of depressed subjects was found in group A with respect to group B (15.1% vs. 78.8%; P=0.001). In the follow-up period, a significant lower compliance to gluten-free diet was found in group B with respect to group A (39.4% vs. 9.1%; P=0.02). In coeliac disease patients with affective disorders psychological support seems to be able to reduce depression and to increase gluten-free diet compliance.",Addolorato G.; De Lorenzi G.; Abenavoli L.; Leggio L.; Capristo E.; Gasbarrini G.,2004.0,10.1111/j.1365-2036.2004.02193.x,0,0,
10664,[Usefulness of osteometric radiological indices to evaluate the effectiveness of surgery treatment of posttraumatic fractures of cervical vertebral column with dislocation].,"The aim of this study was to evaluate the effectiveness of surgery treatment in patients with posttraumatic fractures with dislocation of the cervical spine. A retrospective review was carried out in 24 patients suffering from posttraumatic fractures of cervical spine segments with dislocation treated surgically at the Department and Clinic of Neurosurgery and Neurotraumatology, University of Medical Sciences in Poznań between 1998-2002. The study included 19 (79.2%) males and 5 (20.8%) females, aged from 16 to 60 years (the average age was 35.5). Traumatic lesions of cervical vertebral segments were localized as follows: level C3-C4 - 3 cases; C4-C6 - 17 cases; and at C6-Th1 - 4 cases. A three-grade scale was used to assess the severity of spinal cord trauma. On admission a complete transverse spinal cord syndrome was observed in 6 patients. Radiological investigations included X-ray (24 cases), CT (2 cases) and MRI (22 cases). With this in mind, the osteometric indices of the spine axis deformity were established: the index of anterior displacement of the vertebrae, the angle of local kyphosis (assessed by the Cobb's technique) and the lordosis curvature index. In all cases the operation was performed using the anterior approach. Surgery included anterior decompression and stabilization of the cervical spine by means of a bone graft or acrylic cement and trapezoidal or ""S"" plate. The postoperative neurological condition improved in 21 (87.5) patients and correction of the cervical axis was achieved in 24 (100%) cases. Postoperative neurological deficits were intensified in 2 cases and were regressive. The mortality rate was 4.2% (1 case). Osteometric radiological indices enable the bone structure posttraumatic lesions of the cervical vertebral column to be evaluated. This type of internal stabilization makes it possible to restore the alignment of the anterior column and immobilization of the appropriate vertebral segments.",Moskal J.; Gmerek Ł.; Jankowski R.; Kmieć A.; Czerniejewska H.; Gruca K.,,,0,0,
10665,"Breast cancer and problems with medical interactions: relationships with traumatic stress, emotional self-efficacy, and social support.","This investigation examined relationships between breast cancer patients' psychosocial characteristics (impact of the illness, traumatic stress symptoms, emotional self-efficacy, and social support) and problems they perceived in their medical interactions and their satisfaction with their physicians. Participants were 352 women enrolled in a multicenter trial of the effects of group therapy for women with recently diagnosed primary breast cancer. The findings reported here are from a cross-sectional analysis of baseline data gathered prior to randomization. Problems interacting with physicians and nurses were associated with greater levels of cancer-related traumatic stress (p < 0.01), less emotional self-efficacy for cancer (p < 0.05), less satisfaction with informational support from family, friends, and spouse, and a tendency to perceive those sources of support as more aversive (p < 0.05). Women who were less satisfied with emotional support from their family, friends and spouse were less likely to feel satisfied with their physicians (p < 0.05). These patient characteristics identify women with primary breast cancer who are likely to experience difficulty in their interactions with nurses and physicians and to be less satisfied with their physicians.",Han WT.; Collie K.; Koopman C.; Azarow J.; Classen C.; Morrow GR.; Michel B.; Brennan-O'Neill E.; Spiegel D.,2005.0,10.1002/pon.852,0,0,
10666,The efficacy of the A-V Impulse system in the treatment of posttraumatic swelling following ankle fracture: a prospective randomized controlled study.,"To determine whether the use of the A-V Impulse ""in-cast"" system conveyed any clinical benefit in the treatment of post-traumatic swelling following ankle fracture. A prospective randomised study comparing the effectiveness of the A-V Impulse ""in-cast"" system to that of elevation and plaster in the treatment of preoperative swelling. Clinical management in a large level 2 trauma center. Sixty-four adult patients were recruited to the study who had sustained closed unilateral ankle fractures requiring internal fixation, but for whom immediate surgery was not possible. All fractured ankles were treated with initial application of a plaster back-slab splint. Patients were randomized to either a control group of limb elevation or to a study group in whom an A-V Impulse bladder was fitted under the arch of the foot within the plaster back-slab and intermittent pneumatic pedal compression provided until surgery. Daily circumferential ankle girth measurements were performed. The time taken for swelling to resolve sufficiently to permit surgery, the development of skin complications, and the duration of hospitalisation were recorded. Ten patients were withdrawn from the study. Twenty-seven patients in each group were followed up until discharge from outpatient care. Statistical analysis revealed a significant reduction in time taken for ankle swelling to settle prior to surgery (P = 0.01) in the study group, together with a reduction in wound and skin complications (P < 0.01) and final preoperative ankle swelling (P = 0.03). The A-V Impulse ""in-cast"" system demonstrated significant benefit in the management of adults with isolated ankle fractures who could not undergo immediate open reduction and internal fixation.",Caschman J.; Blagg S.; Bishay M.,2004.0,,0,0,
10667,The sciatic nerve block in emergency settings: a comparison between a new anterior and the classic lateral approaches.,"Anterior and lateral approaches to the sciatic nerve block are performed with the patient in the supine position. This could be an important advantage when mobilization to the limb involved is limited or painful, particularly in emergency conditions. The aim of this prospective, randomized study was to compare these two sciatic nerve blockades performed in an emergency setting. 59 patients undergoing post-traumatic lower extremity surgery under a sciatic nerve block were randomly assigned to either a lateral or an anterior approach. After appropriate positioning of the 150-mm insulated needle using a nerve stimulator, 25 ml of ropivacaine 0.75% were injected. Time to perform the block, sciatic nerve depth, success rate, and patient's comfort were analyzed. The mean time to perform the block was 4.9+/-4.0 min in the anterior group and 6.1+/-6.9 min in the lateral group (NS). The mean depth of sciatic nerve localization was 107+/-17 mm in the anterior group and 91+/-20 mm in the lateral group (P<0.05). Although the success was similar in both group (77% in the anterior group vs 79% in the lateral group), the number of technical failure (sciatic nerve stimulation impossible) was higher with the anterior approach (86% vs 33%; p<0.05). These data suggest that both techniques are of similar value in an emergency setting.",Fuzier R.; Fuzier V.; Albert N.; Barbero C.; Villaceque E.; Samii K.; Olivier M.,2004.0,,0,0,
10668,[Eppendorf Schizophrenia Inventory (ESI) vs. Frankfurt Complaint Questionnaire (FCQ). Direct comparison in a clinical trial].,"This study is the first to directly compare two clinical questionnaires which are both aimed at self-experienced cognitive dysfunctions of schizophrenia: Eppendorf Schizophrenia Inventory (ESI) and Frankfurt Complaint Questionnaire (FCQ). Evaluated were (a) diagnostic validity, (b) psychometric properties, (c) scale intercorrelations, and (d) factor analytic stability. Ad (a): schizophrenic subjects (n=36) show highly significant increases in the ESI scales and sum score when compared to other clinical groups (patients with depression, alcohol dependence, or obsessive-compulsive disorder, n>30, respectively); on the other hand, the FCQ yields no systematic group differences. Ad (b): mean of reliability coefficients (Cronbach alpha) of the ESI scales is r(tt)=0.86, mean of reliability coefficients of the FCQ scales is significantly lower. Ad (c): the mean intercorrelation between ESI and FCQ scales amounts to r(xy)=0.56 (minimum 0.29, maximum 0.73), corresponding to an average shared variance of about 31%. Ad (d): factor analysis yielded an ESI factor and a FBF factor; one-way ANOVA with the factor scores confirms the diagnostic validity of the ESI. ESI and FCQ measure essentially different aspects of schizophrenic psychopathology. Regarding reliability and diagnostic validity, the ESI is superior to the FCQ.",Mass R.,2005.0,10.1007/s00115-004-1809-1,0,0,
10669,[Temperament and character in persons with borderline personality disorder].,"High comorbidity, suicidal ideation, difficult temperament, and character are key symptoms of persons with borderline personality disorder (BPD). We investigated 478 persons, 40 of whom had a BPD according SCID-II, self-rating. Participants were examined with a semistructured interview and several self-rating questionnaires in their households. Taking the high comorbidity of persons with BPD into account, we compared the BPD group with four control groups with different axis 1 or personality disorders and one nonclinical group. Persons with BPD showed high comorbidity with affective, anxiety, and alcohol use disorders. With respect to suicidality, 75% reported that they wish to be dead at least sometimes, and about one-third said that they had already attempted suicide. Regarding temperament and character dimensions, our analyses revealed higher novelty seeking for persons with BPD compared to participants without BPD, although this difference was primarily attributable to males with BPD. Additionally, participants with BPD reported higher harm avoidance compared to control groups, while this was more distinctive for females. Finally, we found that persons with BPD had very low levels of self-directedness. This effect was independent from gender and was found in all group comparisons. Therapy of BPD should take into account high comorbidity and suicidality of patients. Moreover, our results show that low self-directedness seems to be specific for persons with BPD. Therefore, therapy must address those deficits by focusing on skills training as well as on aspects of maturation.",Barnow S.; Rüge J.; Spitzer C.; Freyberger HJ.,2005.0,10.1007/s00115-004-1810-8,0,0,
10670,[Post-traumatic torsional differences and functional tests following antegrade or retrograde intramedullary nailing of the distal femoral diaphysis].,"Previous studies have compared the functional outcome and torsional differences following closed intramedullary nailing of femoral fractures. Rotational deformity following intramedullary nailing may cause symptoms and require surgical correction by osteotomy. Until now studies were designed to evaluate the correct torsional differences by examining every patient following antegrade or retrograde femoral nailing. The series included 13 women and 28 men, average age 44.5 years, who suffered a fracture of the distal femoral diaphysis. Postoperatively we established the diagnosis by three-dimensional determination of the torsion and length of the lower extremities by ultrasound measurement. Furthermore, we performed the clinical examination according to the Tegner and Lysholm score and the Merle d'Aubigne score. There were no significant differences in torsional deformity and length found. The functional outcome showed no significant differences between the two groups. The functional examination exhibited a reduction of flexion in knee motion in the retrograde group. In the antegrade group the motion of the hip was decreased. A correlation between the functional outcome and the torsional deformity was not found. The possible advantage of positioning by using the retrograde femoral nail was not verified.",Maier DG.; Reisig R.; Keppler P.; Kinzl L.; Gebhard F.,2005.0,10.1007/s00113-004-0838-3,0,0,
10671,Cognitive-Behavioral Couple's Treatment for posttraumatic stress disorder: initial findings.,"This pilot study was an initial investigation of Cognitive-Behavioral Couple's Treatment (CBCT) for posttraumatic stress disorder (PTSD). Seven couples in which the husband was diagnosed with PTSD secondary to Vietnam combat experiences completed the treatment. According to independent clinician assessment and partner report, the veterans had substantial improvements in their PTSD symptoms. The veterans reported less dramatic improvements in their PTSD symptoms, but endorsed significant improvements in their depression and anxiety. The partners reported improved relationship satisfaction, whereas the veterans' relationship satisfaction was unchanged across treatment. The current findings are compared with findings on other forms of empirically validated treatment for PTSD and previous studies of CBCT for various individual problems. Theoretical implications and future directions are offered.",Monson CM.; Schnurr PP.; Stevens SP.; Guthrie KA.,2004.0,10.1023/B:JOTS.0000038483.69570.5b,0,0,
10672,The adjustment to illness in patients with generalized anxiety disorder is poorer than that in patients with end-stage renal disease.,"Although generalized anxiety disorder (GAD) is associated with significant occupational disability, it has, however, received little attention with regard to adjustment to illness. Subjects included 102 chronic dialysis (CD) patients, 58 kidney transplant (KT) patients, and 42 GAD patients. The evaluations included the Psychosocial Adjustment to Physical Illness Scale (PAIS), the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale (HAM-D). Preanxiolytic treatment GAD patients had the most anxiety and depressive symptoms, followed by CD patients and KT patients. KT patients and anxiolytic-treated GAD patients showed similar anxiety and depressive symptoms. These two groups were both better than CD patients. However, the adjustment to illness of GAD patients after treatment is still worse than the other two groups (108.0+/-16.3(GAD), 102.0+/-14.5(CD), 81.4+/-22.2(KT); P<.001). The CD patients had a high rate of psychiatric morbidity and a low rate of psychiatric intervention (3%); however, end-stage renal disease (ESRD) patients received only one assessment while the GAD group received two in this study. In light of the chronicity of GAD, pharmacological treatment is not sufficient by itself. Clinicians should keep these in mind when treating either GAD or ESRD.",Lieh Yeh T.; Liang Huang C.; Kuang Yang Y.; Dar Lee Y.; Cheng Chen C.; See Chen P.,2004.0,10.1016/S0022-3999(03)00606-8,0,0,
10673,Psychometric properties of disability measures among patients with social anxiety disorder.,"Although recognition of the importance of disability as a construct has increased in recent years, there has been little examination of the reliability and validity of disability measures. This study examined three disability measures, the Liebowitz Self-Rated Disability Scale (LSRDS), the clinician-rated Disability Profile (DP), and the Sheehan Disability Scale (SDS) among patients with a primary diagnosis of social anxiety disorder. The disability measures correlated strongly with each other, as well as with measures of social anxiety, depressive symptoms, and patients' subjectively-evaluated quality of life. The LSRDS and DP were more internally consistent than the SDS Total Score. All measures discriminated between patients with generalized and non-generalized social anxiety disorder. However, the LSRDS and DP also showed greater sensitivity to ecological indicators of distress than the SDS. Social anxiety symptoms accounted for significant variance in disability, above and beyond that accounted for by depressive symptoms. Overall, the LSRDS, DP, and SDS appear to be valid tools in the study of disability in social anxiety disorder, although the LSRDS and the DP appear to be somewhat more sensitive to the experiences of socially anxious patients.",Hambrick JP.; Turk CL.; Heimberg RG.; Schneier FR.; Liebowitz MR.,2004.0,10.1016/j.janxdis.2003.10.004,0,0,
10674,Is posttraumatic benign paroxysmal positional vertigo different from the idiopathic form?,"Although head trauma is considered a common cause of benign paroxysmal positional vertigo (BPPV), clinical presentation and outcome of traumatic BPPV (t-BPPV) have not been systematically evaluated. To compare the clinical presentation, patient's response to physical treatment, and outcome of patients with t-BPPV with those with the idiopathic form (i-BBPV). Tertiary referral neuro-otology outpatient clinic. We reviewed the clinical records of 247 consecutive patients with posterior canal BPPV during the years 1997 to 2000. All patients were diagnosed using the Dix-Hallpike test and treated using the particle repositioning maneuver. Patients with an onset of positional vertigo within 3 days of well-documented head trauma were included in the t-BPPV group. The outcome was compared with the outcome of 42 patients with i-BPPV who were similarly treated and followed up. Twenty-one (8.5%) of the 247 patients with BPPV fulfilled the diagnostic criteria for t-BPPV. The most common cause of head trauma was motor vehicle crash, documented in 57% of the cases; half of the patients additionally suffered from a whiplash injury. While the other causes were diverse, common falls were predominant. Only 2 of the patients involved in motor vehicle crashes experienced brief loss of consciousness. Sixty-seven percent of patients with t-BPPV required repeated physical treatments for complete resolution of signs and symptoms in comparison to 14% of patients with i-BPPV (P<.001). During a mean +/-SD follow-up of 21.7 +/- 9.7 months, 57% of t-BPPV patients and 19% of i-BPPV controls had recurrent attacks (P<.004). The nature and severity of the traumas causing t-BPPV are diverse, ranging from minor head injuries to more severe head and neck trauma with brief loss of consciousness. It appears that t-BPPV is more difficult to treat than i-BPPV, and also has a greater tendency to recur.",Gordon CR.; Levite R.; Joffe V.; Gadoth N.,2004.0,10.1001/archneur.61.10.1590,0,0,
10675,Cognitive changes during prolonged exposure versus prolonged exposure plus cognitive restructuring in female assault survivors with posttraumatic stress disorder.,"The authors report on changes in cognitions related to posttraumatic stress disorder (PTSD) among 54 female survivors of sexual and nonsexual assault with chronic PTSD who completed either prolonged exposure alone or in combination with cognitive restructuring. Treatment included 9-12 weekly sessions, and assessment was conducted at pretreatment, posttreatment, and a modal 12-month follow-up. As hypothesized, treatment that included prolonged exposure resulted in clinically significant, reliable, and lasting reductions in negative cognitions about self, world, and self-blame as measured by the Posttraumatic Cognitions Inventory. The hypothesis that the addition of cognitive restructuring would augment cognitive changes was not supported. Reductions in these negative cognitions were significantly related to reductions in PTSD symptoms. The addition of cognitive restructuring did not significantly augment the cognitive changes. Theoretical implications of the results are discussed.",Foa EB.; Rauch SA.,2004.0,10.1037/0022-006X.72.5.879,0,0,
10676,"[The ""necktie lasso"": a new technique for the simultaneous treatment of Wartenberg's sign and claw deformities in the hand due to ulnar nerve palsy].","The ""necktie lasso"" is a new technique that allows the simultaneous active treatment, of both Wartenberg's sign and claw deformity of the fifth and the fourth digits in the hand with ulnar nerve palsy. The flexor sublimis of the fourth digit is taken by a palmar approach. It is then divided into two strips up to the proximal part of the palm; The radial strip is used as a classical ""direct lasso"" to treat the claw deformity of the fourth digit; The ulnar strip is wound around the base of the fifth digit by a palmar and dorsal approaches at the level of the proximal phalanx, like a necktie, being medial to its radial pedicle, dorsal and superficial to its extensor apparatus, then lateral to its ulnar pedicle; It is then recovered in the palm and sutured to itself. From September 1998 to April 2003, this technique has been used in eight patients aged between 21 and 35 years old and suffering from post traumatic low ulnar nerve palsy. It was always very effective in dealing with Wartenberg's sign: the active adduction of the fifth digit appearing at the start of flexion. The claw deformity of the fourth and fifth digits was equally actively corrected. No complications are reported in this series. With a mean follow-up of 3 years there was no recurrence of any of the deformities.",Belmahi AM.; Gharib NE.; El Mazouz S.,2004.0,,0,0,
10677,The effect of the decreased safety behaviors on anxiety and negative thoughts in social phobics.,"In order to examine the effect of the decreased safety behaviors on social anxiety and negative thoughts and explore the mechanism underlying this effect, this study compared three types of exposure namely, exposure with decreased safety behaviors under cognitive rationale, exposure with decreased safety behaviors under extinction rationale, and exposure with no change in safety behavior. Forty-five social phobics were randomly assigned to one of three exposure groups. Results showed that exposure with decreased safety behaviors under cognitive rationale produced significantly greater reductions in anxiety and belief ratings for feared outcomes than exposure with decreased safety behaviors under extinction rationale and exposure with no change in safety behaviors. These results imply that exposure could be more effective if social phobics are encouraged to drop their safety behaviors in the feared social situation, and that the cognitive process of disconfirmation of negative thoughts is the critical element in determining effectiveness of decreased safety behaviors.",Kim EJ.,2005.0,10.1016/j.janxdis.2003.11.002,0,0,
10678,Telemedicine and coping skills groups for Pacific Island veterans with post-traumatic stress disorder: a pilot study.,"Patients with post-traumatic stress disorder (PTSD) were randomly assigned to either an eight-week videoconferencing PTSD coping skills group or a traditional face-to-face PTSD coping skills group. Levels of attrition and compliance, patient satisfaction, clinician satisfaction and patients' retention of information were compared between the two conditions. Of the 41 referred veterans, 20 were eligible and agreed to participate in the study. Three of these participants withdrew from the study before randomization. By the end of the study, 89% of the patients remained in the videoconferencing group, whereas only 50% remained in the face-to-face group. Patients in the face-to-face group attended an average of 4.9 sessions and patients in the videoconferencing group attended 6.3 sessions (this difference was not significant). There was no difference between levels of patient satisfaction or clinician satisfaction at weeks 4 or 8. Patients' retention of information was similar in the two groups. The results show that videoconferencing can be used to provide coping skills groups for veteran patients with PTSD who reside in remote rural locations.",Morland LA.; Pierce K.; Wong MY.,2004.0,10.1258/1357633042026387,0,0,
10679,Prevention of suture knot exposure in posterior chamber intraocular lens implantation by 4-point scleral fixation technique.,"The results and complications of posterior chamber intraocular lens (IOL) implantation by a 4-point scleral fixation technique are described. Fifty eyes of 47 patients who underwent scleral-fixated IOL implantation were retrospectively evaluated. Twenty-one (42%) eyes had a history of trauma and 29 (58%) eyes had previously undergone cataract surgery. In all cases, IOL implantation by 4-point scleral fixation was performed and the knots of fixation sutures were rotated and buried in the globe. The IOL position was adjusted by suture rotation for best centration. The mean follow-up time was 7 +/- 4 months. Four (8%) eyes had minimal corneal edema preoperatively. Cystoid macular edema was noted in 2 (6.8%) eyes in the cataract surgery group and 8 (38%) eyes in the posttraumatic group. Two (9.5%) eyes in the posttraumatic group had atrophic macular changes and 1 (4.7%) had corneal scarring, which impaired vision. No complications such as knot exposure, tilting of the IOL, decentralization, or endophthalmitis were noted postoperatively. Postoperative mean corrected visual acuity was 0.4 +/- 0.3 in the posttraumatic group and 0.4 +/- 0.2 in the cataract surgery group. The 4-point scleral fixation technique resulted in no serious postoperative complications such as suture exposure and endophthalmitis. Because the knot can be rotated and buried in the globe, knot exposure is less likely to occur. This procedure is more effective than other techniques regarding IOL centralization.",Baykara M.; Avci R.,,,0,0,
10680,Comparison of behavioral and cognitive-behavioral one-session exposure treatments for small animal phobias.,"This study evaluated the efficacy of behavioral and cognitive-behavioral one-session exposure treatment procedures with and without programmed generalization for participants with small animal phobias. Forty participants were randomly assigned to the treatment and generalization conditions. Both treatments produced significant improvements from pre-test to post-test and these results were maintained for 1 year. The treatment effect sizes ranged from large to very large across behavioral, self-report, and subjectively rated measures. Participants in the behavioral treatment condition reported that the treatment was significantly more intrusive than participants in the cognitive-behavioral treatment group. The programmed generalization condition did not produce additional measured benefit. The results are discussed in terms of the overall effectiveness of one-session exposure treatment components for small animal phobias.",Koch EI.; Spates CR.; Himle JA.,2004.0,10.1016/j.brat.2003.10.005,0,0,
10681,[Specific vestibular exercises in the treatment of vestibular neuritis].,"Vestibular neuritis rapidly damages unilateral vestibular periphery, inducing severe balance disorders. In most cases, such vestibular imbalance is gradually restored to within the normal level after clinical therapies. This successive clinical recovery occurs due to regeneration of vestibular periphery and/or accomplishment of central vestibular compensation. The program of vestibular rehabilitation presents a major achievement in the field of treatment of balance disorders. Vestibular compensation is associated with central sensory reintegration and bilaterally equalizes the vestibular tonus over a period of time. In this retrospective study of a series of cases authors present their results in 58 patients undergoing a program of vestibular rehabilitation. Patients were divided into two groups. Thirty patients were in group I, and 28 in group II. Specific vestibular exercises were conducted in group I, and non-specific exercises in group II. Analysis of effects of vestibular compensation was made due electronystagmography. Results were satisfactory in both groups of patients. Absence of spontaneous nystagmus was detected in 83.3% of patients in group I (specific vestibular exercises) and in 53.5% of patients in group II (non-specific exercises), with an average treatment time of up to 2 months. Harmonization of pendular stimulation was detected in 83.3% and 60.7% of patients in groups I and II, respectively. Early physiotherapeutic vestibular rehabilitation supports the vestibular compensation mechanism. At the same time vestibular rehabilitation may prevent panic disorder caused by hyperventilation syndrome.",Komazec Z.; Lemajić S.,,,0,0,
10682,Modification of attentional biases in chronic pain patients: a preliminary study.,"Research suggests that chronic pain patients demonstrate cognitive biases towards pain-related information and that such biases predict patient functioning. This study examined the degree to which a successful cognitive-behavioural program was able to reduce the observed attentional bias towards sensory pain words. Forty-two patients with chronic pain conditions for more than three months were recruited prior to commencing a cognitive-behavioural pain management program. Participants were assessed before the program, after the program and at one-month follow-up. Results confirmed that chronic pain patients exhibited biased attention towards sensory pain-related words at pre-treatment. These biases were still evident at post-treatment, but were no longer statistically significant at follow-up. Multiple regression analyses indicated that the changes in attentional bias towards sensory words between post-treatment and follow-up were predicted by pre- to post-treatment changes in fear of movement (Tampa Scale for Kinesiophobia) but not other relevant variables, such fear of pain or anxiety sensitivity. These results demonstrate that successful cognitive-behavioural treatments can reduce selective attention, thought to be indicative of hypervigilance towards pain. Moreover, these biases appear to be changed by reducing the fear associated with movement. Theoretically, these results provide support for the fear of (re)injury model of pain. Clinically, this study supports the contention that fear of (re)injury and movement is an appropriate target of pain management and that reducing these fears causes patients to attend less to pain-related stimuli.",Dehghani M.; Sharpe L.; Nicholas MK.,2004.0,10.1016/j.ejpain.2004.02.003,0,0,
10683,Mental pollution: feelings of dirtiness without physical contact.,"An experiment was carried out in order to test the hypothesis that feelings of mental pollution can be induced without physical contact. A sample of 121 female university undergraduates were asked to imagine experiencing a non-consensual kiss at a party, as described on an audiotape, or a consensual kiss described on a comparable audiotape. The manipulation succeeded and participants in the non-consensual kiss condition reported significant feelings of mental pollution, negative emotions and cognitions, as well as the urge to wash. Further, eight participants in the non-consensual kiss condition engaged in washing/rinsing behaviour to counteract feelings of mental pollution. The results are consistent with the hypothesis and with reports from an earlier study of victims of sexual assault, a majority of whom described feelings of mental pollution post-assault. The results are also compatible with case descriptions of the onset of mental pollution and OCD subsequent to sexual trauma. Some possible implications of the results, clinical and theoretical are adumbrated.",Fairbrother N.; Newth SJ.; Rachman S.,2005.0,10.1016/j.brat.2003.12.005,0,0,
10684,Covariation bias and its physiological correlates in panic disorder patients.,"A covariation bias, i.e., the overestimation of random contingencies between fear-relevant stimuli and aversive consequences, seems to characterize anxiety disorders. Panic patients (n=30) and healthy controls (n=25) were exposed to panic-relevant, neutral, and phobia-relevant but panic-irrelevant picture stimuli, followed randomly be aversive consequences (acoustic startle stimuli). While covariation estimates reflected objective contingencies in both groups, only panic patients revealed a more negative Contingent Negative Variation (CNV) to panic-relevant than to phobia-relevant and neutral pictures. For startle reflex, only main effects of picture category were found, indicating that valence effects of picture stimuli were not specifically distorted in panic patients. CNV presumably reflects a biased processing of disorder-relevant stimuli by panic patients, perhaps with the expectation that aversive consequences will follow these stimuli.",Amrhein C.; Pauli P.; Dengler W.; Wiedemann G.,2005.0,10.1016/j.janxdis.2004.01.004,0,0,
10685,Covariation bias for ambiguous social stimuli in generalized social phobia.,"The authors investigated whether the negative interpretation bias in generalized social phobia (GSP) reflects and is maintained by illusory correlations. Participants were exposed to descriptions of ambiguous social events, situations involving fear-relevant animals and nature scenes that were randomly paired with negative, positive, or neutral emotional facial expressions. Prior to the experiment, the GSP participants overestimated the contingency social situations-negative outcome, whereas the controls judged negative outcomes as least likely. A posteriori, the GSP participants exhibited an illusory correlation specifically between social cues and negative outcomes. During the experiment, only the controls showed distorted outcome predictions for social situations. Hence, illusory correlations--possibly resulting from acquired associations between social cues and negative consequences--may contribute to a negative interpretation bias in GSP.",Hermann C.; Ofer J.; Flor H.,2004.0,10.1037/0021-843X.113.4.646,0,0,
10686,An investigation into the effectiveness of bibliotherapy and minimal contact interventions in the treatment of panic attacks.,"The present study investigated the effectiveness of bibliotherapy and minimal therapist-contact interventions in the treatment of panic attacks. Individuals were randomly assigned to one of three conditions: (1) bibliotherapy alone (BT); (2) bibliotherapy plus phone contact (BT+PC); or (3) phone contact alone (PC). Assessment (pre- and post-treatment) and treatment (8 weeks in duration) were conducted via mail and phone. Individuals receiving BT and BT+PC exhibited significant reductions from pre- to post-treatment on panic cognitions and fear of having a panic attack. Individuals receiving BT+PC exhibited significant reductions from pre- to post-treatment on panic symptoms and avoidance. In addition, individuals in the BT and BT+PC groups were more likely to exhibit clinically significant improvement on most dependent measures relative to PC alone. On some measures, individuals in the BT+PC group did clinically better than individuals in the BT group. Results of the present study also suggest that diagnosis may play some role in outcome.",Febbraro GA.,2005.0,10.1002/jclp.20097,0,0,
10687,Surgical treatment of common peroneal nerve injuries: indications and results. A series of 62 cases.,"Common peroneal nerve (CPN) injuries represent the most common nerve lesions of the lower limb and can be due to several causative mechanisms. Although in most cases they recover spontaneously, an irreversible damage of the nerve is also likely to occur. Nerve regeneration following CPN repair is poorer if compared to other peripheral nerves and this can explain the reluctant attitude of many physicians towards the surgical treatment of these patients. Among the several factors advocated to explain the poor outcome following surgery, it has been suggested that reinnervation might be obstacled by the force imbalance between the functioning flexors and the paralysed extensors that eventually results in the fixed equinism of the foot, due to the excessive contracture of the active muscles and the shortening of the heel cord. Therefore the early correction of these forces might favour nerve regeneration. Following such hypothesis, the authors treat irreversible CPN injuries performing a one-stage procedure of nerve repair and tibialis tendon transfer. We report our experience, describing the indications to surgical treatment, the operative technique and the postoperative clinical outcome correlated with the causative mechanisms of the injuries. A 62-patient series controlled over a period of 15 years with a post-traumatic palsy of the CPN is reported. All the patients underwent surgery. In open wounds, when a nerve transection was suspected, surgery was performed at emergency (2 cases). In closed injuries, operative treatment was advised when no spontaneous regeneration occurred 3-4 months after the injury. From 1988 till 1991, 9 patients were elected for surgery : in 6 cases treatment consisted of neuroma resection and nerve repair by means of a graft. In 3 patients it was performed only a CPN decompression at the fibular neck. Since 1991, surgical treatment has always consisted of nerve repair associated with a tendon transfer during the same procedure. Fifty-three patients were elected for surgery. Nerve repair was achieved by direct suture in 1 case and by means of a graft in 46 patients. Decompression of the CPN at the fibular neck was performed in 6 patients where nerve continuity was demonstrated. In the first group of patients, nerve repair outcome was highly disapponting: no recovery in 5 cases, reinnervation occurred in 1 patient only (M1-2). CPN decompression was followed by complete recovery in 2 cases, no improvement was observed in 1 case. Nerve repair associated with tibialis tendon transfer dramatically improved the postoperative outcome: at 2 year follow-up, neural regeneration was demonstrated in 90% of the patients. Surgical outcome depends on the causative mechanisms of the lesion: sharp injuries and severe dislocations of the knee had an excellent recovery, while in crush injuries and gunshot wounds good recovery was less common. Surgical treatment of CPN injuries can nowadays be highly rewarding. CPN palsies in open wounds should undergo surgical exploration at emergency. In close injuries with no spontaneous recovery within 4 months after the injury, patients should be advised to seek surgical treatment regardless the causative mechanism of the lesion. According to our experience, the association of a transfer procedure to nerve repair enhances neural regeneration, dramatically improving the surgical outcome of these injuries.",Garozzo D.; Ferraresi S.; Buffatti P.,2004.0,,0,0,
10688,Enhancing patient satisfaction and increasing treatment compliance: patient education as a fundamental component of PTSD treatment.,"Posttraumatic Stress Disorder (PTSD) is the modal mental health problem afflicting combat veterans. In addition to the significant distress resulting from the disorder itself, PTSD has been associated with significant medical comorbidity and increased utilization of medical services. Interventions have historically focused on targeting symptoms directly, with comparatively little attention to systematically educating patients about the etiology and maintenance of the disorder and associated features and treatment issues. This descriptive study summarizes an eight-week PTSD patient education and orientation group. Seventeen patients admitted consecutively to the PTSD Clinic at a large VA hospital completed surveys of patient satisfaction with services and motivation to comply with treatment regimens upon completion of the group. Participants reported very high satisfaction with services, increased awareness of PTSD treatment options, greater optimism and symptom improvement and enhanced motivation to continue with treatment as a result of attending the group.",Gray MJ.; Elhai JD.; Frueh BC.,2004.0,,0,0,
10689,The effect of successful treatment on the emotional and physiological response to carbon dioxide inhalation in patients with panic disorder.,"A number of studies have shown that patients with panic disorder are more likely to have panic attacks during carbon dioxide inhalation than are normal comparison subjects. Some studies have shown that antipanic medications can reduce the anxiogenic response to carbon dioxide, but none have shown if this is the case for cognitive behavioral therapy or if successful treatment reduces the respiratory physiologic response to carbon dioxide. Twenty-five patients with panic disorder and 13 normal comparison subjects underwent baseline testing with 5% and 7% carbon dioxide inhalation. The patients were then retested after at least 12 weeks of treatment with either antipanic medication or cognitive behavioral therapy. Comparison subjects were retested after a similar interval. Successful treatment resulted in lower panic rates, and reduced anxiogenic response. Treatment had no effect, however, on the respiratory physiologic response. There is dissociation in treatment response between the subjective and objective responses to carbon dioxide inhalation in panic disorder patients, with the former but not the latter showing positive change. We hypothesize that the strengthening of higher cortical control over subcortical fear-related structures, whether via medication or cognitive behavioral therapy treatment, results in less anxiety and fear in response to provoked symptoms reminiscent of naturally occurring panic.",Gorman JM.; Martinez J.; Coplan JD.; Kent J.; Kleber M.,2004.0,10.1016/j.biopsych.2004.08.016,0,0,
10690,"Trauma, resilience and saliostasis: effects of treatment in post-traumatic stress disorder.","There has been growing interest in the concept of resilience and the question as to whether psychotropic medications or psychosocial treatments might have resilience-enhancing effects. This pilot study investigates resilience in a sample of patients with post-traumatic stress disorder (PTSD) before and after treatment. Effects of treatment with tiagabine, fluoxetine, sertraline alone, and sertraline with cognitive behavioural therapy on resilience were assessed using the Connor-Davidson Resilience Scale (CD-RISC). Changes in resilience after treatment were measured and response to treatment was predicted from demographic, resilience and baseline disability measures. Changes in resilience following treatment were statistically significant. Items that showed the greatest change related to confidence, control, coping, knowing where to turn for help and adaptability. Items showing the least change related to religious and existential aspects of resiliency, effort, acting on a hunch, decision-making and goals. In linear and logistic regression models, gender, baseline CD-RISC score, baseline Sheehan Disability Scale score and an individual item from the CD-RISC scale, 'Sense of Humor', were significant predictors of response to treatment. Treatment of PTSD significantly improved resilience and reduced symptoms in this sample. Further controlled studies are indicated.",Davidson JR.; Payne VM.; Connor KM.; Foa EB.; Rothbaum BO.; Hertzberg MA.; Weisler RH.,2005.0,,0,0,
10691,Roles of cognitive characteristics in tinnitus patients.,"To investigate the cognitive characteristics that affect the emotional and functional distress caused by tinnitus and to decide and test the model to explain their relations, 167 patients with tinnitus, who visited Samsung Medical Center, Seoul, Korea between March 2001 and May 2002 were recruited. To examine their features related to tinnitus, the following scales were administered; Tinnitus-related basic questionnaire including dysfunctional beliefs, Tinnitus Handicap Inventory, State-Trait Anxiety Inventory, Anxious Thought and Tendencies, Self-Consciousness Scale, and modified 'catastrophic thought' from Coping Strategies Questionnaire. The results showed that the duration of experiencing tinnitus was 4.7 +/-7.1 yr, those who complained of hearing one sound were the most common (45.5%), and hearing sounds similarly described to whistling were the most common (22.5%). Also, there were significant correlations among tinnitus features, cognitive characteristics, and distresses from tinnitus. As a result of testing the model, Normed fit index, Incremental fit index, Tucker-Lewis index, and Comparative fit index were over .90, indicating that it is a good model, and Root mean square error of approximation showed a reasonable fit. Also, the direct effects of the trait or severity of tinnitus on distress did not appear to be significant, thus it appeared to be affecting indirectly through the cognitive characteristics. This result shows that cognitive interventions can be important for the psychological adaptations of tinnitus patients.",Lee SY.; Kim JH.; Hong SH.; Lee DS.,2004.0,10.3346/jkms.2004.19.6.864,0,0,
10692,"Posttraumatic stress disorder, supported employment, and outcomes in people with severe mental illness.","To evaluate whether posttraumatic stress disorder (PTSD) is related to outcomes in persons with severe mental illness (SMI) participating in a study of vocational rehabilitation programs. PTSD is a common comorbid disorder in people with SMI, but it is unknown whether PTSD interferes with the ability to benefit from rehabilitation programs such as supported employment. The relationships between PTSD and symptoms, health, quality of life, and work outcomes was examined in 176 clients with SMI participating in a 2-year randomized controlled trial of three vocational rehabilitation programs: supported employment based on the Individual Placement and Support model, a psychosocial rehabilitation program based on transitional employment, and standard services. The overall rate of current PTSD in the sample was 16 percent. Compared with clients without PTSD, clients with PTSD had more severe psychiatric symptoms, worse reported health, lower self-esteem, and lower subjective quality of life. Clients with PTSD who participated in the Individual Placement and Support model (the most effective vocational model of the three studied) also had worse employment outcomes over the 2-year study period than clients without PTSD, with lower rates of competitive work, fewer hours worked, and fewer wages earned. Employment outcomes did not differ between clients with PTSD versus without PTSD in the other two vocational rehabilitation approaches. The findings suggest that PTSD may contribute to worse work outcomes in clients participating in supported employment programs. Effective treatment of these clients with PTSD may improve their ability to benefit from supported employment.",Mueser KT.; Essock SM.; Haines M.; Wolfe R.; Xie H.,2004.0,,0,0,
10693,A pilot study of interpersonal psychotherapy for posttraumatic stress disorder.,"This article describes pilot testing of interpersonal psychotherapy adapted for posttraumatic stress disorder (PTSD). Unlike most psychotherapies for PTSD, interpersonal psychotherapy is not exposure-based, focusing instead on interpersonal sequelae of trauma. Fourteen consecutively enrolled subjects with chronic PTSD (DSM-IV) from various traumas received an open, 14-week interpersonal psychotherapy trial. Treatment was well tolerated: 13 subjects (93%) completed therapy. After 14 weeks, 12 of 14 subjects no longer met diagnostic criteria for PTSD, 69% responded (50% Clinician Administered PTSD Scale score decrement), and 36% remitted (score < or =20). Thirteen subjects reported declines in PTSD symptoms across all three symptom clusters. Depressive symptoms, anger reactions, and interpersonal functioning also improved. Treating interpersonal sequelae of PTSD appears to improve other symptom clusters. Interpersonal psychotherapy may be an efficacious alternative for patients who refuse repeated exposure to past trauma. This represents an exciting extension of interpersonal psychotherapy to an anxiety disorder.",Bleiberg KL.; Markowitz JC.,2005.0,10.1176/appi.ajp.162.1.181,0,0,
10694,Well-being therapy of generalized anxiety disorder.,"There is increasing awareness that the goal of treatment in generalized anxiety disorder (GAD) should not simply be a response, but restoration of normal function. The aim of this study was to apply a novel psychotherapeutic approach for increasing the level of remission in GAD. Twenty patients with DSM-IV GAD devoid of comorbid conditions were randomly assigned to 8 sessions of cognitive behavioral therapy (CBT) or the sequential administration of 4 sessions of CBT followed by other 4 sessions of well-being therapy (WBT). Assessment methods included the Anxiety and Depression Scales of Paykel's Clinical Interview for Depression, Ryff's Psychological Well-being Scales and Kellner's Symptom Questionnaire. A one-year follow-up was undertaken. Significant advantages of the CBT-WBT sequential combination over CBT only were observed with both observer and self-rated methods after treatment. Such gains were maintained at follow-up. These preliminary results suggest the feasibility and clinical advantages of adding WBT to the treatment of GAD. They lend support to a sequential use of treatment components for achieving a more sustained recovery.",Fava GA.; Ruini C.; Rafanelli C.; Finos L.; Salmaso L.; Mangelli L.; Sirigatti S.,2005.0,10.1159/000082023,0,0,
10695,CBT for Vietnamese refugees with treatment-resistant PTSD and panic attacks: a pilot study.,"We examined the feasibility, acceptability, and therapeutic efficacy of a culturally adapted cognitive-behavior therapy (CBT) for twelve Vietnamese refugees with treatment-resistant posttraumatic stress disorder (PTSD) and panic attacks. These patients were treated in two separate cohorts of six with staggered onset of treatment. Repeated measures Group x Time ANOVAs and between-group comparisons indicated significant improvements, with large effect sizes (Cohen's d) for all outcome measures: Harvard Trauma Questionnaire (HTQ; d = 2.5); Anxiety Sensitivity Index (ASI: d = 4.3); Hopkins Symptom Checklist-25 (HSCL-25), anxiety subscale (d = 2.2); and Hopkins Symptom Checklist-25, depression subscale (d = 2.0) scores. Likewise, the severity of (culturally related) headache-and orthostasis-cued panic attacks improved significantly across treatment",Hinton DE.; Pham T.; Tran M.; Safren SA.; Otto MW.; Pollack MH.,2004.0,10.1023/B:JOTS.0000048956.03529.fa,0,0,
10696,"Impaired procedural learning in obsessive-compulsive disorder and Parkinson's disease, but not in major depressive disorder.","The striatum has been consistently implicated in the pathophysiology of obsessive-compulsive disorder (OCD), yet, studies assessing the performance of OCD patients in procedural learning tasks, assumed to rely on the intact functioning of the striatum, have yielded inconsistent results. Recently, Rauch et al. [Rauch SL, Savage CR, Alpert NM, Dougherty D, Kendrick A, Curran T, et al. Probing striatal function in obsessive-compulsive disorder: a PET study of implicit sequence learning. J Neuropsychiatry Clin Neurosci 1997;9:568-73] have obtained evidence suggesting that seemingly intact performance of OCD patients in such tasks may be achieved by recruiting systems which in normal subjects are reserved for explicit or declarative, rather than implicit or procedural, processing. The present study assessed procedural learning in OCD patients using a card betting task in which explicit processing impairs, rather than assists, acquisition. In addition, we tested a group of Parkinson's disease (PD) patients, in order to better establish the dependence of the task on procedural learning, and a group of major depressive disorder (MDD) patients, in order to test the possibility that impaired learning in the card betting task may be a result of concurrent depression. The majority of OCD (15/18) and PD patients (14/16) did not acquire the task, whereas MDD patients acquired the task similarly to normal control subjects. These results demonstrate that OCD patients are impaired on a procedural learning task in which explicit processing impairs acquisition. Two different interpretations are suggested: that the striatal system is dysfunctional in OCD, or that inappropriate explicit processing in OCD interferes with the functioning of the striatal system.",Joel D.; Zohar O.; Afek M.; Hermesh H.; Lerner L.; Kuperman R.; Gross-Isseroff R.; Weizman A.; Inzelberg R.,2005.0,10.1016/j.bbr.2004.07.006,0,0,
10697,St. John's wort versus placebo in social phobia: results from a placebo-controlled pilot study.,"Recognition of social anxiety disorder (social phobia) as a common and disabling condition has led to new advances in its pharmacotherapy. Limitations with selective seroton reuptake inhibitors (side effects) and behavior therapy (scarcity of trained therapists), coupled with the tendency for patients with the disorder to self-medicate with alternative treatments, have led to the interest in Saint John's wort (SJW) (Hypericum perforatum) for this disorder. Although the literature is mixed, SJW has demonstrated efficacy in several double-blind depression trials, and some open-label studies with anxiety disorders. There is pharmacokinetic evidence for the serotonergic, domaminergic, and GABAminergic activity of hypericum, all of which are implicated in social anxiety disorder. This study was designed to generate pilot data to examine the potential efficacy of SJW in generalized social anxiety disorder. Forty subjects were randomized to 12 weeks of treatment with a flexible dose (600-1800 mg) of SJW (n = 20) or placebo (n = 20). Subjects with comorbid depression (clinician HAMD > 16) were excluded. Results found no significant difference between mean change on the Liebowitz Social Anxiety Scale with SJW (11.4) and placebo (13.2), P = 0.27, effect size = -0.09. Post-hoc analyses found larger effects sizes associated with increased baseline severity, omitting patients with variable scores (+/-30%) during the first week, and use of self-report HAMD scores for exclusion. Results of the study fail to provide evidence for the efficacy of SJW in social phobia. The impact of methodologic improvements on signal detection, while suggestive of improvement, remains to be established.",Kobak KA.; Taylor LV.; Warner G.; Futterer R.,2005.0,,0,0,
10698,"Alprazolam (Xanax, and others) revisited.","Alprazolam, a widely prescribed benzodiazepine, is effective for treatment of anxiety and panic disorder but sedation, withdrawal symptoms and abuse are common. SSRIs are also effective and safer. Cognitive-behavioral therapy is probably more effective in the long term.",,2005.0,,0,0,
10699,Change in post-traumatic stress symptoms following psychosocial treatment for breast cancer.,"The diagnosis of cancer is a traumatic experience, which may result in post-traumatic stress symptoms, such as arousal, re-experiencing the diagnostic process and avoidance. Changes in post-traumatic symptoms were assessed in 181 women with breast cancer who participated in either a standard support group or complementary/alternative (CAM) oriented intervention. At baseline 26 women were classified as having significant PTSD symptoms. After the 12-week sessions, significant decreases in the number of women with PTSD was seen in both interventions, however it was more evident in the Standard group where there was a 91% reduction in the number of women with PTSD versus an 80% reduction in the CAM group. For women with PTSD both groups showed significant decreases in overall PTSD symptoms and arousal. However, only the women in the Standard support group showed significant decreases in re-experiencing and avoidance symptoms. For the entire sample only women in the Standard group had significant decreases in overall PTSD, re-experiencing, and arousal. These results indicate that PTSD symptoms can be prevalent among women with breast cancer, and that while psychosocial interventions can be effective in reducing this type of distress, a support group might be more effective than a more complementary/alternative oriented intervention.",Levine EG.; Eckhardt J.; Targ E.,2005.0,10.1002/pon.882,0,0,
10700,Reduced size and abnormal asymmetry of parietal cortex in women with borderline personality disorder.,"Evidence is accumulating that suggests borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) are related to small hippocampal size. Psychotic symptoms are frequent in both disorders. Psychotic spectrum disorders are known to be related to abnormalities of temporoparietal cortices. Using structural magnetic resonance imaging (3D-MRI), parietal cortex and hippocampal volumes were assessed in 30 young women with BPD who had been exposed to severe childhood sexual and physical abuse and in 25 healthy control subjects. Compared with control subjects, BPD subjects had significantly smaller right parietal cortex (-11%) and hippocampal (-17%) volumes. The parietal cortex of borderline subjects showed a significantly stronger leftward asymmetry when compared with control subjects. Stronger psychotic symptoms and schizoid personality traits in borderline subjects were significantly related to reduced leftward asymmetry. Stronger trauma-related clinical symptoms and neuropsychologic deficits were significantly related to smaller hippocampal size. Our results are consistent with previous findings of small hippocampal size in BPD and PTSD. Reduced right parietal cortex size in individuals with BPD may reflect a neurodevelopmental deficit of the right hemisphere.",Irle E.; Lange C.; Sachsse U.,2005.0,10.1016/j.biopsych.2004.10.004,0,0,
10701,Impact of comorbid panic and posttraumatic stress disorder on outcomes of collaborative care for late-life depression in primary care.,"Comorbid anxiety disorders may result in worse depression treatment outcomes. The authors evaluated the effect of comorbid panic disorder and posttraumatic stress disorder (PTSD) on response to a collaborative-care intervention for late-life depression in primary care. A total of 1,801 older adults with depression were randomized to a collaborative-care depression treatment model versus usual care and assessed at baseline, 3, 6, and 12 months, comparing differences among participants with comorbid panic disorder (N=262) and PTSD (N=191) and those without such comorbid anxiety disorders. At baseline, patients with comorbid anxiety reported higher levels of psychiatric and medical illness, greater functional impairment, and lower quality of life. Participants without comorbid anxiety who received collaborative care had early and lasting improvements in depression compared with those in usual care. Participants with comorbid panic disorder showed similar outcomes, whereas those with comorbid PTSD showed a more delayed response, requiring 12 months of intervention to show a significant effect. At 12 months, however, outcomes were comparable. Interactions of intervention status by comorbid PTSD or panic disorder were not statistically significant, suggesting that the collaborative-care model performed significantly better than usual care in depressed older adults both with and without comorbid anxiety. Collaborative care is more effective than usual care for depressed older adults with and without comorbid panic disorder and PTSD, although a sustained treatment response was slower to emerge for participants with PTSD. Intensive and prolonged follow-up may be needed for depressed older adults with comorbid PTSD.",Hegel MT.; Unützer J.; Tang L.; Areán PA.; Katon W.; Noël PH.; Williams JW.; Lin EH.,2005.0,10.1176/appi.ajgp.13.1.48,0,0,
10702,Assessment of trauma symptoms among adolescent assault victims.,"To identify and evaluate the effectiveness of an assessment tool that could be used to assess the psychological needs of youth injured by community violence. The Trauma Symptom Checklist for Children (TSCC) was administered to 120 adolescents participating in Project Ujima, a hospital-based program providing Emergency Department support and home-based psychosocial follow-up to victims of violent crime (mean age = 14.8 years; 72% male; 70% African-American, 19% white, 8% Latino). Participants' TSCC scores were compared with normative data using one-sample, two-tailed, Student's t-tests. Comparisons of TSCC scale scores were also made based on participant age, gender, ethnicity, and injury type using one-way multivariate analysis of variance. Seventeen percent of the participants scored in the clinical range on the Underreporting Scale of the TSCC, reflecting a tendency to deny common thoughts, emotions, and behaviors. Elevations on all clinical scales were modest. Males showed elevations on Underreporting and decreased trauma symptoms, in comparison to normative data and to females in the sample. The reported low levels of symptomatology among this sample of youth may be due, in part, to a defensive response style.",McCart MR.; Davies WH.; Harris R.; Wincek J.; Calhoun AD.; Melzer-Lange MD.,2005.0,10.1016/j.jadohealth.2004.03.004,0,0,
10703,Increased MEG activation in OCD reflects a compensatory mechanism specific to the phase of a visual working memory task.,"We examined spatio-temporal patterns of evoked magnetoencephalographic signals (MEG) in patients with obsessive-compulsive disorder (OCD) during the Encoding, Retention, and Retrieval phases of a Delayed Matching-to-Sample working memory task (DMST). The question was whether the mechanisms of abnormally increased cortical excitability, frequently reported in OCD, relate to a global cortical disinhibition and unselective over-processing of stimuli or, alternatively, to a compensatory mechanism of effortful enhanced inhibitory control. The DMST-related network of activation in OCD was found similar to that of Controls, and to that reported in other neuroimaging studies. The pattern of increased MEG activation in OCD patients was phase specific. During the Encoding phase, the activation was enhanced in the region of anterior insula and reduced in the posterior-inferior parietal cortex. During Retention, the activation was reduced in the occipital, parietal, superior temporal sulcus, and dorsolateral prefrontal cortex (BA 6/8/9). During Retrieval, a significant increase of activation was found in the right anterior insula extending towards the orbital region and right superior temporal sulcus, along with reduced activation in the left parietal cortex. The performance accuracy was high in OCD and comparable to Controls, although the RTs were prolonged. The results are discussed as being consistent with the hypothesis of a compensatory mechanism of effortful inhibitory control. This mechanism may be a major contributor to the increased cortical activation during Encoding and, in particular, Retrieval of the DMST task in patients suffering OCD. The findings do not support the concept of a faulty working memory mechanism per se in OCD.",Ciesielski KT.; Hämäläinen MS.; Lesnik PG.; Geller DA.; Ahlfors SP.,2005.0,10.1016/j.neuroimage.2004.10.018,0,0,
10704,Emotional memory is perceptual.,"In two experiments it was investigated which aspects of memory are influenced by emotion. Using a framework proposed by Roediger (American Psychologist 45 (1990) 1043-1056), two dimensions relevant for memory were distinguished the implicit-explicit distinction, and the perceptual versus conceptual distinction. In week 1, subjects viewed a series of slides accompanied with a spoken story in either of the two versions, a neutral version, or a version with an emotional mid-phase. In week 2, memory performance for the slides and story was assessed unexpectedly. A free recall test revealed superior memory in the emotional condition for the story's mid-phase stimuli as compared to the neutral condition, replicating earlier findings. Furthermore, memory performance was assessed using tests that systematically assessed all combinations of implicit versus explicit and perceptual versus conceptual memory. Subjects who had listened to the emotional story had superior perceptual memory, on both implicit and explicit level, compared to those who had listened to the neutral story. Conceptual memory was not superior in the emotional condition. The results suggest that emotion specifically promotes perceptual memory, probably by better encoding of perceptual aspects of emotional experiences. This might be related to the prominent position of perceptual memories in traumatic memory, manifest in intrusions, nightmares and reliving experiences.",Arntz A.; de Groot C.; Kindt M.,2005.0,10.1016/j.jbtep.2004.11.003,0,0,
10705,Prospective PC-interactive pressure algesimetry of post-traumatic neck pain after whiplash injury.,"Cervical pain is a prominent symptom in both acute whiplash injury and late whiplash syndrome. However, no systematic analysis of post-traumatic pain development covering several weeks has yet been performed in whiplash patients. It was the aim of the present study to analyse the duration and course of post-traumatic muscle pain due to whiplash injury in a prospective follow-up examination with short investigation intervals. A recovery of initially increased muscle pain after whiplash injury within 1 month was hypothesized. Pressure pain of the splenius and trapezius muscles was recorded using PC-interactive pressure algesimetry. Whiplash patients were investigated during the acute injury stage and after 3, 4, and 6 weeks and compared with matched controls. We found significantly increased pressure pain of the splenius and trapezius muscles in the acute stage of whiplash injury. After 4 weeks patients' scores of pain parameters were comparable to those of healthy control subjects. Within the patient group the first changes of pressure pain were observed within 3 (splenius) and 4 weeks (trapezius). For most patients the recovery dynamics lasted 4-6 weeks. A minority of patients did not show any improvement after 6 weeks. The present study shows that the dynamics of pressure pain due to whiplash injury can be quantified by means of PC-interactive pressure algesimetry. Our results confirm the clinical experience that the acute post-traumatic cervical syndrome normally subsides within weeks.",Nebel K.; Stude P.; Lüdecke C.; Wiese H.; Diener HC.; Keidel M.,2005.0,10.1111/j.1468-2982.2004.00842.x,0,0,
10706,Inflated responsibility and perseverative checking: the effect of negative mood.,"This article reports the results of 2 experiments designed to test predictions from the mood-as-input hypothesis on the role of inflated responsibility in perseverative checking. Through the use of an analog checking task in both experiments, the authors showed that perseveration, as indicated by a range of measures relevant to compulsive checking, was affected by a combination of the level of inflated responsibility and the valency of mood at the outset of checking. In particular, inflated responsibility significantly facilitated checking perseveration only in the context of a negative mood and was not a sufficient condition for checking perseveration to occur. These effects of the various configurations of inflated responsibility and mood valency are predicted by the mood-as-input hypothesis.",MacDonald B.; Davey GC.,2005.0,10.1037/0021-843X.114.1.176,0,0,
10707,Pilot study of community-based cognitive behavioral group therapy for adolescents with social phobia.,"A pilot study to evaluate the efficacy of a cognitive-behavioral group therapy program for adolescents with social phobia, simplified both in terms of time and labor intensity from a previously studied program (Social Effectiveness Therapy for Children and Adolescents) to be more appropriate for a community outpatient psychiatric setting. Twelve adolescents with social phobia (ages 13-18), diagnosed by DSM-IV criteria and confirmed with Anxiety Disorders Interview Schedule for Children assessment, were randomly assigned to treatment (n=6) and waitlist (n=6) groups. The waitlist group was subsequently treated, and results were included in the data analysis. Assessments, including Anxiety Disorders Interview Schedule for Children interviews and self-report Social Phobia and Anxiety Inventory and Beck Depression Inventory II questionnaires, were performed at baseline and immediately after treatment or waitlist. All subjects completed the treatment program. Compared with the waitlist group, treated subjects showed significantly greater improvement in both examiner-evaluated (Anxiety Disorders Interview Schedule for Children) and self-reported (Social Phobia and Anxiety Inventory) symptoms of social anxiety (effect sizes [d], 1.63 and 0.85, respectively). No significant change was seen in Beck Depression Inventory II scores for treatment or waitlist groups. This study provides support for the use of simplified cognitive-behavioral interventions for adolescents with social phobia that are practical for community psychiatric settings.",Baer S.; Garland EJ.,2005.0,10.1097/00004583-200503000-00010,0,0,
10708,Deep brain stimulation for refractory obsessive-compulsive disorder.,"Neurosurgery (anterior capsulotomy) has been beneficial to many patients with debilitating, refractory obsessive-compulsive disorder (OCD), but the irreversibility of the procedure is an important limitation to its use. Nondestructive, electrical stimulation (deep brain stimulation; DBS) has proven an effective alternative to ablative surgery for neurological indications, suggesting potential utility in place of capsulotomy for OCD. The effects of DBS for OCD were examined in four patients in a short-term, blinded, on-off design and long-term, open follow-up. The patients had incapacitating illness, refractory to standard treatments. Hardware developed for movement disorder treatment was surgically implanted, with leads placed bilaterally in the anterior limbs of their internal capsules. Patients received stimulation in a randomized ""on-off"" sequence of four 3-week blocks. Ongoing, open stimulation was continued in consenting patients after the controlled trial. Patients tolerated DBS well. Dramatic benefits to mood, anxiety, and OCD symptoms were seen in one patient during blinded study and open, long-term follow-up. A second patient showed moderate benefit during open follow-up. It appears that DBS has potential value for treating refractory psychiatric disorders, but additional development work is needed before the procedure is utilized outside of carefully controlled research protocols.",Abelson JL.; Curtis GC.; Sagher O.; Albucher RC.; Harrigan M.; Taylor SF.; Martis B.; Giordani B.,2005.0,10.1016/j.biopsych.2004.11.042,0,0,
10709,[Effect of different variables on the outcome of various cognitive-behavioral treatment modalities for panic disorder with agoraphobia].,"The efficacy of cognitive-behavioral therapy (CBT) is clearly demonstrated in the treatment of panic-disorder with agoraphobia (PDA). Between 70% and 90% of people with PDA obtain an higher global functioning level after CBT, yet symptoms remain in 10 to 30% of participants after treatment termination. The goal of the present study is to find which variables have an effect on different CBT modalities (individual, group, self-help) for persons with moderate and high PDA. Eighty-four persons were randomly assigned to one of three treatment modalities. Evaluations were made before treatment, immediately after and one year later. Results show that sex, number of years with agoraphobia and anxiety level significantly predict outcome at post-test for the individual modality. However, only the number of years with agoraphobia is a strong predictor one year later for this treatment modality. For the self-help modality, no predictor is significant neither at post-test nor one year later. For the group modality, the agoraphobic avoidance predicts outcome at post-test whereas symptoms severity predicts outcome one year later.",Marchand A.; Germain V.,,,0,0,7208
10710,"Surgical management of chronic, unreduced posterior dislocation of the shoulder.","Four patients with chronic posterior dislocation of the shoulder underwent surgical treatment after an average delay of 10 months from injury. They were examined clinically and radiographically at an average follow-up of 32 months. Treatment consisted of subscapularis tendon transfer (McLaughlin procedure) into the humeral defect in one case, transfer of the lesser tuberosity (McLaughlin modified procedure) in two cases, and in the fourth case-a patient with a 19-month missed dislocation and 50% humeral head lesion-a transposition of the coracoid process and conjoined tendon was performed. X-rays and CT scan excluded avascular necrosis or severe post-traumatic arthrosis. All patients achieved complete pain relief without limitation of daily or work activities. A slight limitation of anterior elevation and external rotation was present in all patients. Our results confirm that McLaughlin's original or modified procedure is suggested in cases of chronic, unreduced posterior dislocation of the shoulder (type I according to Randelli). The transposition of the coracoid process is a valid alternative to prosthesis and to autologous or homologous bone graft implants.",Delcogliano A.; Caporaso A.; Chiossi S.; Menghi A.; Cillo M.; Delcogliano M.,2005.0,10.1007/s00167-004-0524-6,0,0,
10711,Ankylosing neurogenic myositis ossificans of the hip. An enhanced volumetric CT study.,"Neurogenic myositis ossificans is a disabling condition affecting the large joints of patients with severe post-traumatic impairment of the central nervous system. It can result in ankylosis of the joint and vascular or neural compression. Surgery may be hazardous with potential haemorrhage, neurovascular injury, iatrogenic fracture and osteochondral injury. We undertook pre-operative volumetric CT assessment of 45 ankylosed hips with neurogenic myositis ossificans which required surgery. Helical CT with intravenous contrast, combined with two- and three-dimensional surface reconstructions, was the only pre-operative imaging procedure. This gave good differentiation of the heterotopic bone from the adjacent vessels. We established that early surgery, within 24 months of injury, was neither complicated by peri-operative fracture nor by the early recurrence of neurogenic myositis ossificans. Surgical delay was associated with a loss of joint space and a greater degree of bone demineralisation. Enhanced volumetric CT is an excellent method for the pre-operative assessment of neurogenic myositis ossificans and correlates well with the operative findings.",Carlier RY.; Safa DM.; Parva P.; Mompoint D.; Judet T.; Denormandie P.; Vallée CA.,2005.0,,0,0,
10712,"Prevalence and distinct correlates of anxiety, substance, and combined comorbidity in a multi-site public sector sample with bipolar disorder.","Recent data indicate high prevalence of both anxiety and substance comorbidity in bipolar disorder. However, few studies have utilized public sector samples, and only one has attempted to separate contributions of each type of comorbidity. 328 inpatient veterans with bipolar disorder across 11 sites were assessed using selected Structured Clinical Interview for DSM-IV modules and self-reports. Comorbidity was common (current: 57.3%; lifetime: 78.4%), with multiple current comorbidities in 29.8%. Substance comorbidity rate was comparable to rates typically reported in non-veteran inpatient samples (33.8% current, 72.3% lifetime). Selected anxiety comorbidity rates exceeded those in other inpatient samples and appeared more chronic than episodic/recurrent (38.3% current, 43.3% lifetime). 49% of PTSD was due to non-combat stressors. Major correlates of current substance comorbidity alone were younger age, worse marital status, and higher current employability. Correlates of current anxiety comorbidity alone were early age of onset, greater number of prior-year depressive episodes, higher rates of disability pension receipt, and lower self-reported mental and physical function. Combined comorbidity resembled anxiety comorbidity. This is a cross-sectional analysis of acutely hospitalized veterans. Distinct patterns of substance and anxiety comorbidity are striking, and may be subserved by distinct neurobiologic mechanisms. The prevalence, chronicity and functional impact of anxiety disorders indicate the need for improved recognition and treatment of this other dual diagnosis group is warranted. Clinical and research interventions should recognize these divergent comorbidity patterns and provide individualized treatment built ""from the patient out.""",Bauer MS.; Altshuler L.; Evans DR.; Beresford T.; Williford WO.; Hauger R.;  .,2005.0,10.1016/j.jad.2004.11.009,0,0,
10713,The effects of personal construct group therapy on breast cancer survivors.,"In this study, the authors evaluated the effects of a brief personal construct group therapy on breast cancer survivors (N=42) randomly assigned to either the treatment or wait-list control condition. The Gottschalk Gleser Content Analysis Scales were used to measure the effects for group across time (pre- and posttreatment, pretreatment, and 3-month posttreatment) on the personal construct states of threat, threat to existence, dislocation, and hope. Analyses showed that the beneficial effects of therapy achieved posttreatment were maintained at 3-month follow-up. The therapeutic group factors (I. D. Yalom, 1995) identified by the therapy group members as helpful in achieving these outcomes are also reported.",Lane LG.; Viney LL.,2005.0,10.1037/0022-006X.73.2.284,0,0,
10714,The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder.,"This research represents the first controlled treatment study of hypnosis and cognitive- behavioral therapy (CBT) of acute stress disorder (ASD). Civilian trauma survivors (N=87) who met criteria for ASD were randomly allocated to 6 sessions of CBT, CBT combined with hypnosis (CBT-hypnosis), or supportive counseling (SC). CBT comprised exposure, cognitive restructuring, and anxiety management. CBT-hypnosis comprised the CBT components with each imaginal exposure preceded by a hypnotic induction and suggestions to engage fully in the exposure. In terms of treatment completers (n=69), fewer participants in the CBT and CBT-hypnosis groups met criteria for posttraumatic stress disorder at posttreatment and 6-month follow-up than those in the SC group. CBT-hypnosis resulted in greater reduction in reexperiencing symptoms at posttreatment than CBT. These findings suggest that hypnosis may have use in facilitating the treatment effects of CBT for posttraumatic stress.",Bryant RA.; Moulds ML.; Guthrie RM.; Nixon RD.,2005.0,10.1037/0022-006X.73.2.334,0,0,
10715,Preliminary evidence for lymphocyte distribution differences at rest and after acute psychological stress in PTSD-symptomatic women.,"This study investigated circulating natural killer (NK), CD4+ and CD8+ cells in response to acute psychological challenge among mothers of child cancer survivors with and without posttraumatic stress symptoms (PTSS). Control mothers of healthy children (n=9) were compared to 17 cancer mothers with (PTSS: n=9) and without PTSS (No PTSS: n=7) under conditions of rest, after a generic stressor (MAT: mental arithmetic task) and a personalized stressor (script-driven trauma imagery), and after recovery from each stressor. Results indicate the PTSS group had higher percentage CD4+ and lower CD8+ levels than non-symptomatic women and blunted NK reactivity to generic challenge. Multiple regression analyses indicated PTSS effects were independent of self-reported distress. Contrary to expectations, cancer mothers without PTSS were not significantly different from controls on tonic or phasic immune outcomes. Also unlike predictions, reactivity to challenge was greatest to the non-social MAT stressor compared to the personalized challenge for all groups. Conclusions are constrained by study limitations (e.g., small sample size and potential phase order effects). Nonetheless, results are consistent with an emerging literature on PTSS-associated immune differences and further suggest these effects may be distinct from that associated with subjective distress more generally.",Glover DA.; Steele AC.; Stuber ML.; Fahey JL.,2005.0,10.1016/j.bbi.2004.08.002,0,0,
10716,Cortical hyperexcitability in post-traumatic stress disorder secondary to minor accidental head trauma: a neurophysiologic study.,"We applied paired transcranial magnetic stimulation (pTMS) to patients with post-traumatic stress disorder (PTSD) secondary to minor accidental head trauma. Our purpose was to determine the potential abnormality of motor cortex excitability in this pathologic condition. pTMS stimulation, according to the conditioning-test paradigm employing interstimulus intervals (ISIs) of 1-6 ms, was used to investigate intracortical inhibition in control subjects and patients with PTSD. The study population consisted of 14 patients who had developed PTSD following minor head trauma, 12 healthy volunteers without a clinical history of head trauma and 11 healthy subjects who had reported accidental minor head trauma 1-4 months before the study. This clinical electrophysiologic study was performed at the Department of Neuroscience, University of Rome ""Tor Vergata."" All patients with PTSD exhibited a significantly lower motor evoked potential (MEP) inhibition than controls at 2 ms, 3 ms and 4 ms ISI. The statistical analysis of the pTMS protocol showed a significant effect (F2,36 = 25.63, p < 0.001) of the factor ""group,"" because patients with PTSD showed a mean conditioned MEP amplitude higher than that observed in both control groups for all 6 ISIs analyzed. The ""ISI"" factor was also significant (F5,180 = 89.85, Greenhouse-Geisser epsilon = 0.35; p < 0.001), with the mean conditioned MEP amplitude increasing from 22.5% to 127.8% as the ISI increased from 1 ms to 6 ms. Finally, the interaction of group with ISI was also significant (F10,180 = 8.97, p < 0.001), showing that the condition of PTSD secondary to head trauma was able to affect the MEP amplitude at different ISIs. Our results demonstrate that PTSD can give rise to abnormalities in intracortical inhibition. Our results provide further evidence that alterations in cortical inhibitory circuits may underlie specific forms of neuroticism in humans.",Centonze D.; Palmieri MG.; Boffa L.; Pierantozzi M.; Stanzione P.; Brusa L.; Marciani M.; Siracusano A.; Bernardi G.; Caramia M.,2005.0,,0,0,
10717,Helping parents cope with the trauma of premature birth: an evaluation of a trauma-preventive psychological intervention.,"To ascertain whether a trauma-preventive psychological intervention program for parents of premature infants during hospitalization in a level III NICU may reduce the severity of symptomatic response to the traumatic impact of premature birth. Mothers of premature infants were enrolled consecutively in a sequential control group design. Intervention group mothers received a structured psychological intervention in the first days after birth. Each mother could make use of additional psychological support if required and was actively approached at critical times during her infant's NICU stay. Control group mothers did not receive psychological intervention but could ask for counseling by the hospital minister. At discharge, mothers of both groups answered a questionnaire covering key outcome variables (symptoms of traumatization, emotions at discharge, and sample and control variables). At discharge, intervention group mothers (N = 25) showed significantly lower levels of symptomatic response to the traumatic stressor ""premature birth"" than those in the control group (N = 25; mean overall symptom level 25.2 [SD: 13.9] vs 37.5 [SD: 19.2]). This intervention program for parents after premature birth, combining early crisis intervention, psychological aid throughout the infant's hospitalization, and intense support at critical times, reduced the symptoms of traumatization relating to premature birth.",Jotzo M.; Poets CF.,2005.0,10.1542/peds.2004-0370,0,0,
10718,Corticolimbic blood flow in posttraumatic stress disorder during script-driven imagery.,"Functional neuroimaging experiments targeting personal recall of emotional events may help elucidate neural substrates underlying posttraumatic stress disorder (PTSD). Studies suggest that limbic and paralimbic function might be altered in PTSD, as compared with trauma-exposed control subjects; however, little is known about functional changes resulting from traumatic experience itself. The present study examined both PTSD-specific and trauma-specific regional cerebral blood flow (rCBF) patterns during script-driven imagery. Sixteen combat veterans with PTSD (PP); 15 combat veterans without PTSD (CC); and 14 healthy, aged-matched noncombat control subjects (NC) underwent [15O] H20 positron emission tomography (PET) scanning during script-driven imagery of emotionally evocative and neutral autobiographic events. Differential patterns of activation were detected in amygdala and medial frontal cortex. Past trauma experience was associated with decreased amygdala activity (i.e., less activity than healthy control subjects); however, combat control subjects deactivated this region (i.e., greater activity to neutral scripts). All subjects deactivated medial frontal cortex; PTSD patients had greater rostral anterior cingulate (rACC) deactivation compared with control groups, who deactivated ventromedial prefrontal cortex (vmPFC). Trauma-specific patterns may represent potential compensatory changes to traumatic reminders, while patterns observed only in the PTSD group may reflect neural substrates specific to PTSD pathophysiology.",Britton JC.; Phan KL.; Taylor SF.; Fig LM.; Liberzon I.,2005.0,10.1016/j.biopsych.2004.12.025,0,0,
10719,Thoracic outlet syndrome due to hyperextension-hyperflexion cervical injury.,"Posttraumatic brachial plexus entrapment in fibrotic scarring tissue is taken into consideration as the cause of complaints for patients who suffered a hyperextension-hyperflexion cervical injury. All 54 patients included in this analysis where symptom-free before the accident and subsequently complained for pain, paresthesia and slight weakness in the arm. In 14 neurological signs of brachial plexus entrapment were observed. Electroneurophysiological, summary index testing was positive for a brachial plexus involvement in all cases. Conservative measures, comprising physical therapy and vasoactive drugs were applied for a period of 6 to 12 (mean 8.4) months; surgical procedure of neurolysis was then proposed in 39 cases to solve the problem. Thirty-two patients were operated on. Twenty of these had a neat improvement on a 6-month to 1-year follow-up. Seven patients had refused surgery; of these 6 patients had clinical worsening at the same follow-up period while 1 remained unchanged. All patients with clinical symptoms not reversed after some time post-injury should be investigated for a possible brachial plexus entrapment.",Alexandre A.; Corò L.; Azuelos A.; Pellone M.,2005.0,,0,0,
10720,Cognitive assessment of social anxiety: a comparison of self-report and thought listing methods.,"The goal of the present study was to compare 2 cognitive assessment methods for social anxiety: a thought listing and a self-report method. The focus of this study was on the convergent and divergent validity of these methods using a multi-trait multi-method approach. Furthermore, treatment sensitivity was explored. Fifty-eight patients with social phobia completed thought listings followed by 2 different social stress tasks before and after an exposure group treatment (n = 33), or following a waiting period (n = 25). One task consisted of speaking in front of 2 confederates while the other task involved initiating a conversation with an opposite-sex confederate. Two questionnaires measuring positive and negative self-statements regarding public speaking and social interactions were also completed. To compare the balance of positive and negative thoughts, the State of Mind ratio [positive thoughts/(positive+negative thoughts)] was calculated for both cognitive assessment methods. Results demonstrate that methods related to social interaction anxiety showed better convergent validity than methods related to public speaking anxiety; however, public speaking methods captured treatment effects better than methods related to social interaction anxiety. This study questions the common assumption that different cognitive assessment methods measure the same construct.",Heinrichs N.; Hofmann SG.,2005.0,10.1080/16506070410030106,0,0,
10721,Impaired prepulse inhibition of acoustic startle in obsessive-compulsive disorder.,"Animal and clinical studies suggest that impaired sensorimotor gating, as assessed with the prepulse inhibition (PPI) paradigm, may result from dysfunctional frontostriatal brain circuits and from neurochemical alterations which are also implied in the pathophysiology of obsessive-compulsive disorder (OCD). However, there is only preliminary evidence about impaired PPI in OCD so far. Acoustic PPI was measured in 30 OCD patients and 30 matched healthy controls with a paradigm using different prepulse intensities. Psychopathology assessment included ratings for obsessions, compulsions, and depression. PPI was reduced in OCD patients, and this deficit was most pronounced for most intense (16 dB(A)) prepulses, where mean PPI was 39.6% in unmedicated patients (n = 4), 45.8% in medicated patients, and 58.9% in controls. No group differences were observed with regard to the habituation of acoustic startle magnitude. Startle measures were generally not associated with clinical measures, although such associations may have been obscured by medication effects. The present study confirms deficient central inhibitory functioning in patients with OCD and supports the model of deficient frontostriatal circuits in OCD. The relationship of PPI deficits to pharmacological and behavioral treatment and to possible subtypes of OCD merits further study.",Hoenig K.; Hochrein A.; Quednow BB.; Maier W.; Wagner M.,2005.0,10.1016/j.biopsych.2005.01.040,0,0,
10722,"The impact of an exercise program on posttraumatic stress disorder, anxiety, and depression.","This preliminary study assessed the impact of a 12-session aerobic exercise program on symptoms of Posttraumatic Stress Disorder (PTSD), anxiety, and depression. Overall results show no symptom reduction during baseline phases but significant reductions in PTSD, anxiety, and depression following the exercise intervention. Reductions were maintained during a 1 month follow-up. Results suggest that exercise programs may be valuable resources for managing treatment-resistant participants with PTSD and may also have a beneficial effect on anxiety and depression.",Manger TA.; Motta RW.,2005.0,,0,0,
10723,Evolution of lesions of the labrum-ligament complex in posttraumatic anterior shoulder instability: a prospective study.,"The aim of this study was to evaluate the evolution of intraarticular disease in posttraumatic shoulder instability. Ninety-one patients with posttraumatic shoulder instability were examined arthroscopically. The intraarticular disease was recorded on a special documentation sheet (containing 67 descriptive items). The patients were divided into 5 subgroups: first-time dislocation (n = 9); first or second recurrence (n = 12); 3 to 5 recurrences (n = 23); 6 or more recurrences (n = 32); and chronic subluxations (n = 15). All data were examined statistically. Each lesion was correlated with stage of evolution, age, and number of recurrences. The most frequent lesions were regrouped into ""lesion families."" The initial and most constant lesion was the periosteal disinsertion of the anteroinferior labrum (single lesion). The labral detachment was succeeded in a second stage by the disinsertion of the glenohumeral ligament complex (double lesion). With additional recurrences, stress mechanisms altered the detached structures through tissue damage (triple lesion). The fourth stage saw the extension of the degenerative process, which led to failure at the insertion site and destruction of the labrum-ligament complex (quadruple lesion). This study reveals that recurrences progressively damage stabilizing structures. A pathophysiological classification into 4 stages is proposed, however, that would permit a precise therapeutic strategy for arthroscopic shoulder stabilization.",Habermeyer P.; Gleyze P.; Rickert M.,,,0,0,
10724,PTSD in ambulant RTA victims: a randomized controlled trial of debriefing.,"This report examines initial distress levels, course of symptoms, incidence of posttraumatic stress disorder (PTSD), predictors of short-term outcome, and value of prophylactic counseling in a consecutive series of 40 ambulant trauma clinic attenders with minor road traffic accident (RTA) injuries. Subjects were randomly allocated to intervention and monitoring groups following assessment at a mean of 7 days posttrauma and reassessed at 3 months using a variety of standard rating scales. Seventy-five percent reported significant levels of distress at 1 week posttrauma. By 3 months this had decreased sharply to 35%, and 22% were significantly impaired by clinical assessment. Incidence of PTSD over 3 months was estimated at 19% and point prevalence at 3 months posttrauma was 9%. High initial distress, increasing age, and high levels of perceived threat were significant independent predictors of morbidity, and no significant differences in outcome were found between intervention and monitoring groups at 3 months.",Conlon L.; Fahy TJ.; Conroy R.,1999.0,,0,0,
10725,Quality-of-life changes among patients with obsessive-compulsive disorder in a partial hospitalization program.,"Thirty treatment-resistant patients with a primary DSA-IV diagnosis of obsessive-compulsive disorder were assessed at admission to and discharge from a partial hospitalization program to determine whether improvement in symptoms of the disorder was associated with improvements in patients' quality of life. Symptom severity was measured using the Yale-Brown Obsessive Compulsive Scale (YBOCS). Quality of life was measured using Lehman's Quality of Life (QOL) scale, which includes several objective and subjective indexes. YBOCS scores significantly improved with treatment, as did scores on the majority of the QOL subjective indexes and on the objective social, health, and activity indexes. No significant association between changes in YBOCS scores and QOL scores was found.",Bystritsky A.; Saxena S.; Maidment K.; Vapnik T.; Tarlow G.; Rosen R.,1999.0,10.1176/ps.50.3.412,0,0,
10726,"Differential diagnosis of PTSD, schizophrenia, and depression with the MMPI-2.","This study used 102 male, veteran, psychiatric inpatients to describe patterns of MMPI-2 clinical and content scales that most accurately discriminate among patients diagnosed with PTSD, schizophrenia, and depression. Single scale accuracy classification using scales PK and PS was unacceptably low. Optimally weighted scales, including PK, Sc, BIZ, and ANX, correctly classified 70% of the patients. Suggestions for facilitating the use of formal decision rules are offered.",Greenblatt RL.; Davis WE.,1999.0,,0,0,
10727,A comparison of manual and semi-automated methods in the assessment of axonal injury.,"Diffuse axonal injury (DAI) in the central nervous system is a common cause of post-traumatic coma and may result in varying degrees of disability up to and including the vegetative state. Experimental studies in man and animals have previously relied upon semi-quantitative grading systems for determining the relationship between the extent of DAI and the clinical features of patients. Using beta-amyloid precursor protein immunocytochemistry for the detection of DAI in sections of corpus callosum from 15 cases of fatal head injury, we have developed a quantitative image analysis technique for the assessment of axonal injury. This new method is objective and reproducible and should allow better correlation with biomechanical, radiological, and clinical parameters to increase our understanding of DAI.",Gentleman SM.; McKenzie JE.; Royston MC.; McIntosh TK.; Graham DI.,1999.0,,0,0,
10728,Application of a new statistical approach to evaluate a clinical trial with panic disorder patients.,"In clinical trials in psychiatry, changes in severity are usually measured with ordinal level scales which are applied repeatedly during the trial, showing a constant decline in psychopathology scores as treatment leads to improvement. Previous non-parametric tests for repeated measures in factorial designs did not test the hypothesis that scale scores decrease constantly during the trial. A recently developed ""rank test for ordered alternatives in a mixed model"" was developed and applied to the data of a clinical trial in panic disorder. Thirty-seven outpatients with panic disorder and agoraphobia (PDA) were treated with imipramine (75-150 mg/day) in an 8-week open, prospective trial. Patients with intercurrent agoraphobia were instructed in practising self-exposure in their agoraphobic situations. The total score on the Panic and Agoraphobia Scale, the Hamilton Anxiety Scale (HAMA) and the Clinical Global Impression Scale (CGI) were used as the main efficacy measures. The new rank test showed significant treatment results in all scales applied. Treatment results were excellent, as was shown by a decrease in the average Panic and Agoraphobia Scale severity scores from 28.9 (range 14-45) to 13.3 (range 0-37; rank statistic Tn = 6.7; p < 0.0001). The largest effect size r(w) of all clinician-rated scales was seen with the observer-rated version of the Panic and Agoraphobia Scale, although closely followed by the CGI and the HAMA. Among the self-rated scales, the Panic and Agoraphobia Scale also showed the largest effect size. All five subscores of the Panic and Agoraphobia Scale showed significant improvements. The highest treatment effect sizes were seen in the ""panic attacks"" subscore, followed by the ""anticipatory anxiety"" subscore. The new statistical test applied in this study, which has some advantages in comparison with previously applied tests, is suitable for psychiatric treatment evaluations since it can also be applied in the case of discrete repeated measurements.",Bandelow B.; Brunner E.; Beinroth D.; Pralle L.; Broocks A.; Hajak G.; Rüther E.,1999.0,,0,0,
10729,Anxiety and adherence to breast self-examination in women with a family history of breast cancer.,"Previous research has indicated low rates of adherence to monthly breast self-examination (BSE) in women with a family history of breast cancer, and anxiety has been identified as a major factor that may interfere with regular self-examination. However, the direction of the relationship between anxiety and BSE frequency remains unclear, with some studies indicating that high anxiety promotes adherence and others indicating that it leads to avoidance. The aim of the present study was to clarify the relationship between anxiety and adherence to breast self-examination by comparing the impact of general anxiety with that of cancer-specific anxiety on BSE frequency. A sample of at-risk women (N=833) completed a questionnaire regarding BSE frequency, general anxiety, breast cancer worries, perceived risk of breast cancer, and family history of breast cancer. Women who self-examined infrequently (N=211), appropriately (N=462), or excessively (N=156) were compared on these variables. Statistical analyses indicated that general anxiety differentiated only between excessive self-examiners and less frequent self-examiners, with excessive self-examiners reporting significantly higher general anxiety. Breast cancer worries differentiated between all three groups in a linear fashion, with increasing cancer worries associated with higher levels of BSE. In some at-risk women, high cancer anxiety may lead to high general anxiety and precipitate hypervigilant breast self-examination rather than avoidance. These findings are discussed in relation to psychoeducational interventions and genetic counseling services for women with a family history of breast cancer.",Brain K.; Norman P.; Gray J.; Mansel R.,,,0,0,6117
10730,Segment transport employing intramedullary devices in tibial bone defects following trauma and infection.,"To compare two different methods of segment transport in posttraumatic and postseptic tibial defects by employing intramedullary tibial nails as the fixation system and to evaluate differences in the complication rate between external fixation and wire towropes as the transport system. Randomized, prospective, nonblinded study. Level 1 trauma center. Thirty patients with posttraumatic or postseptic defects of the tibial shaft were admitted at our center between January 1994 and December 1995. For study purposes, they were divided into two groups with fifteen patients in each. All thirty patients underwent a standardized therapy protocol consisting of three phases: (a) eradication of infection, (b) restoration of soft tissue defects, and (c) bone segment transport. The first two phases were identical for both groups. The third phase was different: in Group A transport of the segment was performed with a combination of intramedullary nail and wire towrope; in Group B the intramedullary nail was combined with an external fixation device. We then evaluated both subjective data (patient comfort, restrictions in physiotherapy) and objective data (mobility of knee and ankle joint, transport time, reoperations, complications) to determine treatment success. Both methods are useful for segment transport in patients with tibial shaft defects following trauma and infection. The relative transport time was shorter in Group A than in Group B (12.2 versus 13.7 days/centimeter; p = 0.002). Group B also recorded a significantly higher complication rate than did Group A (septic complications, twenty-six versus six events; necessary recorticotomies, four versus zero events). An intramedullary nail and wire towrope proves to be a reliable combination for segment transport in tibial defects following trauma and infection and provides a relatively high patient comfort rate and a low complication rate.",Hofmann GO.; Gonschorek O.; Bühren V.,,,0,0,5655
10731,Early prediction of persisting post-concussion symptoms following mild and moderate head injuries.,"King (1996) reported that a combination of emotional, organic and neuropsychological measures taken at 7-10 days following mild and moderate head injury may significantly help predict patients most likely to suffer persisting post-concussion symptoms (PCS) at three months post-injury. This study investigated a cross-validation sample (N = 57) to determine whether the results would be replicated for the early prediction of longer-term sufferers (i.e. those with persisting symptoms at 6 months post-injury). Multiple regression analyses were used in which scores on the Hospital Anxiety and Depression Scale, Impact of Event Scale, Short Orientation Memory and Concentration Test, Rivermead Post-Concussion Symptoms Questionnaire and Post-Traumatic Amnesia taken at 7-10 days post-injury were the independent measures. Scoring on the Rivermead Post-Concussion Symptoms Questionnaire taken at 6 months post-injury was the dependent measure. Sixty-six consecutive patients admitted to any trauma ward in Oxfordshire with a mild or moderate head injury were recruited from a largescale randomized controlled sample. The assessment measures were administered at 7-10 days post-injury and the Rivermead Post-Concussion Symptoms Questionnaire at 6 months post-injury. Nine patients were unable to be followed up, leaving an active sample of 57. The cross-validation data confirmed that a similar combination of measures to that found in the original study best predicted persisting PCS but that the strength of prediction diminished for the longer term prediction (i.e. 6 months post-injury). The Hospital Anxiety and Depression Scale, Impact of Even Scale and Post-Traumatic Amnesia in combination are recommended as useful prognostic screening instruments for predicting persisting PCS, but great caution is required if they are used to aid predictions beyond 3 months post-injury.",King NS.; Crawford S.; Wenden FJ.; Caldwell FE.; Wade DT.,1999.0,,0,0,
10732,Order of scale administration and concurrent validity of the Anxiety Rating Scale.,"The Anxiety Rating Scale-2 and the Competitive State Anxiety Inventory-2 were administered to 100 male university intramural volleyball players 15 min. before a match began. For 50 participants, the above order of presentation was used; for the other 50 the order was reversed. Correlations for cognitive anxiety, somatic anxiety, and self-confidence between the two inventories were .47, .63, and .67, respectively, for scores from Order 1 and .56, .75, and .84 for Order 2.",Cox RH.; Robb M.; Russell WD.,1999.0,10.2466/pms.1999.88.1.271,0,0,
10733,Primitive defense mechanisms in schizophrenics and borderline patients.,"In this study, patients with neurotic disorders, borderline patients, acute schizophrenics, and chronic schizophrenics were studied with regard to primitive defense mechanisms. Primitive defense mechanisms were assessed by means of the Lerner Defense Scale (LDS). In this study, the LDS was applied to the Holtzman Inkblot Technique. With the exception of primitive idealization, borderline patients used all primitive defense mechanisms significantly more frequently than patients with neurotic disorders, that is, splitting, projective identification, primitive denial, and primitive devaluation. Compared with both acute and chronic schizophrenics, borderline patients used primitive devaluation at a significantly higher degree of frequency. Both acute and chronic schizophrenics differed from patients with neurotic disorders by using splitting and projective identification significantly more frequently. However, there were differences concerning primitive devaluation and idealization. The defense structure of chronic schizophrenics was heterogenous. Except for primitive idealization, all primitive defense mechanisms correlated significantly with self-report measures of identity diffusion and impaired reality testing, which is consistent with theoretical assumptions. By a discriminant analysis, 90% of the borderline patients, 80% of the patients with neurotic disorders, 76% of the acute schizophrenics, and 92% of the chronic schizophrenics were classified correctly.",Leichsenring F.,1999.0,,0,0,
10734,Recurrent post-traumatic anterior shoulder dislocation--open versus arthroscopic repair.,"A total of 41 consecutive patients (11 women and 30 men, median age 29 (18-51) years) with unilateral, isolated, posttraumatic, recurrent anterior shoulder dislocation and a Bankart lesion were operatively repaired, either by an arthroscopic technique including a capsular plication, or by an open procedure with Mitec anchors. All the patients were followed prospectively and evaluated after a median of 36 (30-52) months follow-up by a ""blind"" observer. Nineteen patients in each group had excellent or good results, and one in each group was graded as fair. One patient in the arthroscopic group had a traumatic dislocation 5 months after the operation and was graded as poor. Three patients experienced subluxations postoperatively, one in the arthroscopic and two in the open group. There was no significant difference in anterior-posterior shoulder laxity measured objectively with Donjoy. The open Bankart repair group had a statistically significantly longer hospitalization (P = 0.001), a slight decrease in external range of motion, and more frequent cosmetic complaints. Apart from this, the results revealed no major differences between the two methods after a median of 36 months in this selected group of patients with longstanding problems.",J√∏rgensen U.; Svend-Hansen H.; Bak K.; Pedersen I.,1999.0,10.1007/s001670050133,0,0,
10735,Assessment of obsessive-compulsive disorder.,"Self-report assessment devices of obsessive-compulsive symptoms are widely used by behavior therapists. In the present investigation, psychometric characteristics and concurrent, discriminant, and factorial validity of the Maudsley Obsessional Compulsive Inventory (MOCI) were studied in clinical samples. Test-retest reliability was high. The internal consistency was high for the total score and moderate for the subscales, checking and cleaning. The slowness and doubting subscales appeared to be less useful. The MOCI was found to reliably discriminate between obsessional patients on one hand and normals, patients with anorexia nervosa and anxiety disorders, on the other, but failed to discriminate obsessionals from depressives. Concurrent validity and factorial validity were satisfactory. The MOCI may be used to evaluate effects of treatment, but it is less sensitive than target ratings of obsessional problems.",Emmelkamp PM.; Kraaijkamp HJ.; van den Hout MA.,1999.0,10.1177/0145445599232005,0,0,
10736,The relative efficacy and treatment distress of EMDR and a cognitive-behavior trauma treatment protocol in the amelioration of posttraumatic stress disorder.,"The growing body of research into treatment efficacy with Posttraumatic Stress Disorder (PTSD) has, by-and-large, been limited to evaluating treatment components or comparing a specific treatment against wait-list controls. This has led to two forms of treatment, Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive-Behavior Therapy (CBT), vying for supremacy without a controlled study actually comparing them. The present research compared EMDR and a CBT variant (Trauma Treatment Protocol; TTP) in the treatment of PTSD, via a controlled clinical study using therapists trained in both procedures. It was found that TTP was both statistically and clinically more effective in reducing pathology related to PTSD and that this superiority was maintained and, in fact, became more evident by 3-month follow-up. These results are discussed in terms of past research. Directions for future research are suggested.",Devilly GJ.; Spence SH.,,,0,0,
10737,Effects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy.,"Fatigue is a common and often severe problem in cancer patients undergoing chemotherapy. The authors postulated that physical activity training can reduce the intensity of fatigue in this group of patients. A group of cancer patients receiving high dose chemotherapy followed by autologous peripheral blood stem cell transplantation (training group; n = 27) followed an exercise program during hospitalization. The program was comprised of biking on an ergometer in the supine position following an interval training pattern for 30 minutes daily. Patients in the control group (n = 32) did not train. Psychologic distress was assessed at hospital admission and discharge with the Profile of Mood States and Symptom Check List 90. By the time of hospital discharge, fatigue and somatic complaints had increased significantly in the control group (P for both < 0.01) but not in the training group. Furthermore, by the time of hospital discharge, the training group had a significant improvement in several scores of psychologic distress (obsessive-compulsive traits, fear, interpersonal sensitivity, and phobic anxiety) (P value for all scores < 0.05); this outcome was not observed in the control group. The current study found that aerobic exercise can reduce fatigue and improve psychologic distress in cancer patients undergoing chemotherapy.",Dimeo FC.; Stieglitz RD.; Novelli-Fischer U.; Fetscher S.; Keul J.,1999.0,,0,0,
10738,Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale.,"The psychometric properties of the Italian version of the Hospital Anxiety and Depression Scale and its utility as a screening instrument for anxiety and depression in a non-psychiatric setting were evaluated. The questionnaire was administered twice to 197 breast cancer patients randomised in a phase III adjuvant clinical trial: before the start of chemotherapy and at the first follow-up visit. The presence of psychiatric disorders was evaluated at the follow-up visit using the Structured Clinical Interview for DSM-III-R in 132 patients. Factor analyses identified two strictly correlated factors. Crohnbach's alpha for the anxiety and depression scales ranged between 0.80 and 0.85. At follow-up, 50 patients (38%) were assigned a current DSM-III-R diagnosis, in most cases adjustment disorders (24%) or major depressive disorder (10%). Receiver operating characteristics (ROC) analysis was used to test the discriminant validity for both anxiety and depressive disorders. The comparison of the areas under the curve (AUC) between the two scales did not show any difference in identifying either anxiety (P = 0.855) or depressive disorders (P = 0.357). The 14-item total scale showed a high internal consistency (alpha = 0.89 and 0.88) and a high discriminating power for all the psychiatric disorders (AUC = 0.89; 95% CI = 0.83-0.94). The cut-off point that maximised sensitivity (84%) and specificity (79%) was 10. These results suggest that the total score is a valid measure of emotional distress, so that the Italian version of HADS can be used as a screening questionnaire for psychiatric disorders. The use of the two subscales as a 'case identifier' or as an outcome measure should be considered with caution.",Costantini M.; Musso M.; Viterbori P.; Bonci F.; Del Mastro L.; Garrone O.; Venturini M.; Morasso G.,1999.0,,0,0,
10739,The Illness Attitude Scales in chest pain patients: a study of psychometric properties.,"The main aim of the study was to assess the factorial structure of the Illness Attitude Scales (IAS). The study population comprised 199 patients referred to cardiological out-patient investigation because of chest pain. The factor analysis revealed three factors of the IAS. Accordingly, we found three subscales, interpreted as health anxiety (HA), illness behavior (IB), and health habits (HH). The internal consistency of the subscales, measured by Cronbach's alpha coefficient, were 0.92, 0.80, and 0.49, respectively. The HA and IB scores were significantly intercorrelated (r = 0.39, p < 0.001), but HH was not significantly correlated with either HA or IB. The HA and IB subscales discriminated between patients with and without panic disorder. The results support previous findings, namely that the IAS comprise two subscales with psychometrically sound properties. Correlational analysis indicated validity of the two subscales. Further studies are needed to confirm the validity.",Dammen T.; Friis S.; Ekeberg O.,1999.0,,0,0,
10740,"The concept of ""sense of coherence"" and the development of posttraumatic stress disorder in traffic accident victims.","According to the ""sense of coherence"" concept, those subjects who can give meaning to a traumatic event can comprehend what has happened and have a sense of manageability of the sequelae, are able to cope better with the traumatic event itself. In the present study, this concept was applied to traffic accident victims. Severely injured traffic accident victims were assessed a few days after the accident and at 6-month follow-up. At follow-up, patients filled in the 29-item version of the Sense of Coherence (SOC) self-rating scale. The results show that the SOC total score correlated negatively with the development of: (i) posttraumatic psychopathology; (ii) psychological disorders (i.e., posttraumatic stress disorder after the accident); and (iii) anxious cognitions. The personality trait of neuroticism correlated negatively and extraversion and frustration tolerance correlated positively with SOC total score. Previous hypotheses are supported by our findings.",Frommberger U.; Stieglitz RD.; Straub S.; Nyberg E.; Schlickewei W.; Kuner E.; Berger M.,1999.0,,0,0,
10741,Personality dimensions in chronic fatigue syndrome and depression.,"Chronic fatigue syndrome (CFS) is a poorly understood condition. Possible etiological factors include infectious agents, psychiatric disorders, and personality characteristics. We examined personality dimensions in 30 nondepressed patients with CFS, 20 patients with major depressive disorder (MDD), and 15 healthy controls. On the NEO-FFI, patients with CFS scored significantly lower than healthy controls on the extroversion subscale. On the neuroticism dimension of the Eysenck Personality Questionnaire (EPQ), patients with MDD scored higher than those with CFS, who in turn scored significantly higher than the healthy controls. CFS patients rated themselves as higher on neuroticism and less extroverted when ill than when they were well. Our results suggest that high scores on neuroticism and low scores on extroversion in CFS could be a reaction to chronic illness.",Buckley L.; MacHale SM.; Cavanagh JT.; Sharpe M.; Deary IJ.; Lawrie SM.,1999.0,,0,0,
10742,Patterns of remission and relapse in obsessive-compulsive disorder: a 2-year prospective study.,"This study examined the course of illness in patients with obsessive-compulsive disorder (OCD) over a 2-year period. Sixty-six patients with a primary diagnosis of DSM-III-R OCD were followed prospectively for 2 years. Baseline information was collected on demographic characteristics, Axis I and II diagnoses, and severity of OCD symptoms. Follow-up measures obtained at 3, 6, 12, and 24 months after baseline assessment included information on symptomatic and diagnostic status as well as behavioral and somatic treatments received. The probability of full remission from OCD over the 2-year period was 12%. The probability of partial remission was 47%. After achieving remission from OCD, the probability of relapse was 48%. No factors were identified that significantly predicted full or partial remission. Seventy-seven percent (N = 51) of the subjects received a serotonin reuptake inhibitor (SRI) for > or =12 weeks, and 68% (N = 45) received medium-to-high doses of SRIs for > or =12 weeks. Only 18% received a full trial of behavior therapy. Despite exposure to at least 1 adequate trial of an SRI, the likelihood of full remission of OCD in this study was low. Results of this study also suggest that behavior therapy may be under-utilized.",Eisen JL.; Goodman WK.; Keller MB.; Warshaw MG.; DeMarco LM.; Luce DD.; Rasmussen SA.,1999.0,,0,0,
10743,Higher abnormal leukocyte and lymphocyte counts 20 years after exposure to severe stress: research and clinical implications.,"Research suggests that individuals with posttraumatic stress disorder (PTSD) are more likely to develop medical conditions and other stress-related psychiatric disorders. Given these findings and others suggesting that PTSD victims may have altered neuroendocrine and immune systems, the hypothesis that Vietnam veterans with PTSD have abnormally high leukocyte and lymphocyte counts was tested. The leukocyte and lymphocyte status of male Vietnam ""theater"" veterans with current partial posttraumatic stress (N = 286), anxiety (N = 274), and depression disorders (N = 192) were compared with those of Vietnam veterans without these disorders 20 years after military service (N = 2190), controlling for intelligence, race, age, income, education, type of enlistment, Vietnam volunteer status, region of birth, cigarette smoking, illicit drug use, body mass index, and alcohol consumption. Abnormal values were defined using standard laboratory reference ranges. Adjusted mean differences also were compared. Based on the results of two-tailed tests, PTSD-positive veterans are more likely to have adjusted leukocyte (OR = 1.83, p = .04) and T-cell (OR = 1.82, p = .045) counts above the normal range and higher mean adjusted leukocyte (p = .042), lymphocyte (p = .01), T-cell (p = .008), and CD4 cell (p = .027) counts. Those with anxiety disorders have adjusted lymphocyte (OR = 1.68, p = .048) and T-cell (OR = 2.06, p = .011) counts above range. They also have test results indicating reactive delayed cutaneous hypersensitivity (OR = 1.77, p = .006), which suggests the presence of highly sensitized T-cell lymphocytes. Finally, depressed veterans are less likely to have B-cell counts above the reference range (OR = 0.55, p = .006). Results of one-tailed tests further suggest that PTSD-positive men also have abnormally high CD4 and CD8 T-cell lymphocyte counts as well (p < .05). Our findings suggest that chronic, primarily combat-related PTSD is associated with clinically elevated leukocyte and total T-cell counts. Those with current anxiety also have some of these abnormalities in addition to highly sensitized T-cell lymphocytes. Additional research is needed to specify the mechanisms involved here and to investigate the health risks associated with these findings.",Boscarino JA.; Chang J.,,,0,0,
10744,Cognitions in generalized anxiety disorder and panic disorder patients. A prospective approach.,"Self-observations of cognitions during episodes of anxiety were examined in 38 patients with generalized anxiety disorder and 36 patients with panic disorder. Two independent observers who where blind to the diagnoses categorised the cognitions. The inter-rater reliability was high (mean kappa 0.82). The GAD-patients had significantly more cognitions in the following categories: interpersonal confrontation, competence, acceptance, concern about others and worry over minor matters, while the PD-patients had significantly more cognitions in the physical catastrophe category. Furthermore, GAD-patients with a comorbidity of social phobia reported more cognitions regarding social embarrassment than did GAD-patients with other or no (axis-I) comorbidity. The results of this study support the cognitive theory regarding the cognitive specificity of anxiety disorders. The implications of these results are discussed, along with the issues of reliability and validity of the instrument used.",Breitholtz E.; Johansson B.; Ost LG.,1999.0,,0,0,
10745,[Influencing factors of different durations of behavioral therapy in in-patients with anxiety disorders].,"In this study, the influencing factors of different durations of in-patient therapy were examined. We investigated 1173 patients with anxiety disorders who were treated in the psychosomatic clinic of Bad Pyrmont with behavioural therapy. Patients with anxiety disorders have an average treatment duration of 52.4 days with a minimum of less than one week and a maximum of more than five months. The duration of treatment depends on the one hand on sociodemographic variables such as age, marital status, partnership, residential status, and professional activity, but not on gender or education. The duration of treatment also depends on factors of severity of the disorder, such as the number of in-patient or psychotherapeutic treatments, duration of disorder and disability, and the number of psychiatric diagnoses, but not on the number of somatic diagnoses. There is a positive correlation between duration of treatment and effect of therapy as well as recovery of fitness for work.",Borgart EJ.; Meermann R.,,,0,0,
10746,Effects of mode of writing on emotional narratives.,"The authors hypothesized that writing longhand about a stressful experience, compared to typing, arouses greater negative emotion. Eighty college students were randomly assigned to describe either a neutral or stressful topic by typing or writing longhand, in a 2 x 2 factorial design. Students describing the stressful topic, compared to the neutral topic, wrote for a longer period, used more words, and reported greater negative and less positive affect. Consistent with prediction, writing about a stressful experience longhand induced greater negative affect than typing, and led to more self-rated disclosure. These findings suggest a method whereby therapists can help patients control their levels of negative affect when producing a trauma narrative.",Brewin CR.; Lennard H.,1999.0,10.1023/A:1024736828322,0,0,
10747,Excessive daytime sleepiness in myotonic dystrophy.,"The aim of the present study was to assess whether or not there is any correlation between magnetic resonance imaging (MRI) abnormalities and excessive daytime sleepiness (EDS) in a consecutive series of patients with myotonic dystrophy (MD). The influences of nocturnal breathing abnormalities and sleep morphology on EDS were also evaluated. Ten MD patients were studied by means of an all-night polysomnographic recording, the multiple sleep latency test (MSLT) and MRI. Diagnosis of MD was established on the basis of the clinical and electrophysiological evidence of myotonia as well as of the characteristic genetic pattern. No patient had respiratory failure. Polysomnography and MSLT were also evaluated in ten healthy age-matched controls under the same environmental conditions. The mean MSLT value was significantly lower in patients than in controls. Five of the ten patients were found to have pathological EDS. The quantitative sleep variables and the nocturnal apnoeas in these five patients were not significantly different from those of the patients without EDS. As two patients did not undergo MRI because of claustrophobia, the MRI data were considered in eight patients. Corpus callosum (CC) atrophy was detected in four patients, whereas three patients showed hyperintense areas in the white matter. No correlation was found between EDS and MRI indexes of subcortical atrophy as well as volume of the hyperintense areas. By contrast, a correlation was found between the MSLT value and the reduction in the anterior area of the CC. Our data suggest that CC atrophy might occur in MD patients, and that the size of the CC anterior area might be associated with EDS.",Giubilei F.; Antonini G.; Bastianello S.; Morino S.; Paolillo A.; Fiorelli M.; Ferretti C.; Fieschi C.,1999.0,,0,0,
10748,Dysthymia among the community-dwelling elderly.,"There are few data on the clinical features of dysthymia among the community-dwelling elderly. Forty elderly individuals with dysthymic disorder were identified following screening in the community with GMS-AGECAT. A detailed clinical history was obtained and DSM-IV checklists and standardized scales were used, at a second interview. Comparisons were made with a group of 630 non-depressed elderly from the same community. Dysthymia was predominately of late onset (93%) and associated with a major stressor in 65% of cases. Comorbid axis 1 disorders were present in 15% of dysthymics and an axis 2 disorder in 10%. The dysthymic group had significantly higher degrees of physical impairment than the non-depressed elderly. The symptom profile demonstrated prominent anxiety and functional features. Eighty-three per cent of the elderly with dysthymia had presented to their GP with anxiety/depressive symptoms at some stage during the dysthymic disorder. The presentation of dysthymia in older people differs from that in earlier life. Late life dysthymia is less associated with axes 1 and 2 comorbidity but is associated with significant degrees of physical impairment. Dysthymia in older people presents to primary care, rather than specialist services, and interventions must be delivered at this level.",Kirby M.; Bruce I.; Coakley D.; Lawlor BA.,1999.0,,0,0,
10749,Avoidant personality disorder and implicit schema-congruent information processing bias: a pilot study with a pragmatic inference task.,"Cognitive theory of personality disorders hypothesizes that each personality disorder is characterized by typical maladaptive schemes and that these schemas direct the processing of information resulting in schema-congruent biases. With regard to the avoidant personality disorder, these hypotheses were put to an initial test in a pilot study, using a self-report questionnaire to asses DSM-III-R personality pathology, a belief questionnaire to assess avoidant schemas and a pragmatic inference task to assess schema-congruent implicit attributional bias. Participants were students (n = 57) who scored high or low on DSM-III-R avoidant personality pathology. As predicted from cognitive theory, DSM-III-R avoidant personality pathology was associated with avoidant beliefs (t(45.1) = 4.68, p < 0.001) and avoidant beliefs were associated with schema-congruent information processing bias (t(55) = 2.17, p = 0.02, one-tailed test). However, DSM-III-R avoidant personality pathology was not associated with schema-congruent information processing bias (t(55) = 0.17, p = 0.43, one-tailed test). In addition to avoidant beliefs, low self-esteem was also related to the information processing bias. Social phobia and general personality pathology, two other control variables, were not. The findings warrant further study using the pragmatic inference task in a clinical group.",Dreessen L.; Arntz A.; Hendriks T.; Keune N.; van den Hout M.,1999.0,,0,0,
10750,Anxiety sensitivity and the five-factor model of personality.,"Relations between anxiety sensitivity (AS) and the higher-order and lower-order dimensions of the 'Big Five' model of personality were examined in 317 university students. AS was significantly associated with a number of personality domains and facets of the NEO-PI-R. Regression analyses indicated that only the higher-order domains of neuroticism and extraversion (negatively) and the lower-order N facets of anxiety and self-consciousness, significantly predicted AS. Three lower-order factors within AS were identified and were also compared to NEO-PI-R domains and facets. In a hierarchical regression, the three AS factors significantly predicted variance in a measure of panic-related anxiety after the effects of the six N facets were statistically controlled. Results are discussed in the context of previous work with a Big Three taxonomy of personality and implications for understanding the nature and possible origins of AS are outlined.",Cox BJ.; Borger SC.; Taylor S.; Fuentes K.; Ross LM.,1999.0,,0,0,
10751,Interpretive biases for ambiguous stimuli in social anxiety.,"A growing body of literature suggests that individuals with high levels of general anxiety form threatening interpretations of ambiguous events. Although theoretical formulations of pathological social anxiety emphasize the importance of a negative interpretive-style in the etiology and maintenance of the disorder, we are unaware of any study that documents this presumed phenomenon. To address this issue, we assessed for possible interpretive biases in a group of high and low socially-anxious students. The results indicated that socially-anxious subjects showed more threatening interpretations of ambiguous, interpersonal events when compared to the low-anxious participants. However, this bias was marked not so much by an outright negative interpretation style, but rather by a failure of the socially-anxious subjects to show a positive interpretation as was evinced by the low-anxious individuals. These group differences in interpretive style appeared to be influenced by trait aspects of social anxiety rather than differences in current mood state. No group differences emerged in interpretations of events that involved non-personal stimuli suggesting there is content specificity in the interpretive biases associated with social-anxiety.",Constans JI.; Penn DL.; Ihen GH.; Hope DA.,1999.0,,0,0,
10752,"[Dimensions of bizarre, idiosyncratic thinking. Relationship between thought disorders and affect].","In the present study disorders of thinking were studied in normals, patients with neurotic disorders, borderline patients and both acute and chronic schizophrenics. Disorders of thinking were assessed by the Holtzman Inkblot Technique. By a factor analysis, different dimensions of disordered thinking characteristic of the different diagnostic groups could be identified. Among others two dimensions of schizophrenic thought disorder and one of borderline thought disorder could be identified. This latter dimension showed high correlations with anxiety and hostility. This was true for a dimension of productive schizophrenics thought disorders, but not for a dimension of negative schizophrenics thought disorders.",Leichsenring F.,1999.0,,0,0,
10753,[Evoked motor and sensory potentials in syringomyelia].,"Seventy nine patients were admitted for syringomyelia. Fifty-nine had a malformative syringomyelia, 15 a post-traumatic syrinx and 5 a syringomyelia related to a meningitis. For all the patients, the diagnosis of syringomyelia was performed by MRI with measures of syrinx extension and transverse diameter. Posterior tibial somato sensory evoked potentials (PT SEP), median (M SEP), trigeminal (V3 SEP), brain stem auditory evoked potentials (BEAP), cortical and cervical motor evoked potentials (MEP) were correlated with clinical and radiological findings. SEP abnormalities were not correlated with the duration of symptoms. PT SEP proved to be more sensitive than M SEP, MEP abnormalities were very frequent (72% of the cases), even without clinical motor deficit. Trigeminal SEP were more sensitive than BAEP which were not related to the presence of associated cranio vertebral abnormalities. No significant relationship between clinical and radiological results was observed. There was a positive relationship between electrophysiological and radiological results. Nevertheless, a good correlation was observed between lateral clinical, MRI and electrophysiological results. Abnormal trigeminal SEP were detected in 46.6% of the patients with high cervical syringomyelia. In all cases, trigeminal SEP and MEP should be done in association with M and PT SEP as both of them detect subclinical evidence of spinal cord dysfunction in syringomyelia.",Hort-Legrand C.; Emery E.,1999.0,,0,0,
10754,[Dynamic MRI in the evaluation of syringomyelic cysts].,"We report the results of a MR velocity study of the cerebrospinal fluid including 36 patients with syringomyelic cysts (25 with a foraminal syringomyelia, 7 with a post-traumatic cyst, 2 with a tumoral spinal cord cyst, 2 with a spinal arachnoiditis). Velocity measurements were performed in the cysts and in the pericystic subarachnoid spaces and compared with clinical data, evolutive pattern of the disease, cyst volume, degree of stenosis of the cranio-cervical junction (in patients with Chiari I) or of the spinal canal (in post-traumatic cases), and with the extension of the cyst (post-traumatic cases). Cyst velocities correlated in the pre operative course with the clinical status of the patients and with the volume of the cyst. Correlation with the degree of foraminal stenosis was uncertain and no correlation was found with the duration of the disease course. In the post-operative course cyst velocity decreased and velocity of the subarachnoid spaces increased. Onset of the systolic peak occurred sooner in the cyst than in the subarachnoid spaces. We believe that this point may be important in the pathogenesis of the disease. We consider that systolic and diastolic cyst velocities respectively greater than 2.3 cm/s and 1.5 cm/s in the post-operative course may characterize aggressive cysts. In the future comparison of velocity measurements in patients with Chiari I without syrinx and patients with Chiari I related syringomyelia may be helpful for a better understanding of the natural history of the syringomyelia.",Brugières P.; Iffenecker C.; Hurth M.; Parker F.; Fuerxer F.; Idy-Peretti I.; Bittoun J.,1999.0,,0,0,
10755,Comparability of telephone and In-person structured clinical interview for DSM-III-R (SCID) diagnoses.,"The SCID was administered twice, once by telephone and once in person (1 week later) to 41 college age men. For major depression (lifetime k =.64, current k =.66), results indicated good agreement. The lifetime occurrence estimate based on the telephone SCID diagnosis was lower than the in-person SCID estimate. Kappas for specific diagnoses were calculable for simple phobia (lifetime k =. 47, current k = .03) and social phobia (lifetime k =.29). Base rates were less than 10% for all individual diagnoses except lifetime major depression; therefore, the kappas may be unstable. For all diagnoses where there were any positive cases, percentages of negative agreement and specificity were high, whereas percentages of positive agreement and sensitivity were lower. Overall agreement was fair for specific lifetime diagnoses but poor for current diagnoses. These results suggest caution in assuming comparability of in-person and telephone SCID diagnoses. Circumstances under which a telephone SCID may be useful and ways to improve reliability are discussed.",Cacciola JS.; Alterman AI.; Rutherford MJ.; McKay JR.; May DJ.,1999.0,10.1177/107319119900600304,0,0,
10756,"Randomised placebo-controlled trial of moclobemide, cognitive-behavioural therapy and their combination in panic disorder with agoraphobia.","In the treatment of panic disorder with agoraphobia, the efficacy of pharmacological, psychological and combined treatments has been established. Unanswered questions concern the relative efficacy of such treatments. To demonstrate that moclobemide and cognitive-behavioural therapy (CBT) are effective singly and more effective in combination. Fifty-five patients were randomly assigned to an eight-week treatment of: moclobemide plus CBT; moclobemide plus clinical management ('psychological placebo'); placebo plus CBT; or placebo plus clinical management. Comparisons between treatments revealed strong effects for CBT. Moclobemide with clinical management was not superior to placebo. The combination of moclobemide with CBT did not yield significantly better short-term results than CBI with placebo. The CBT results remained stable during a six-month follow-up, although a substantial proportion of patients treated with placebo plus CBT needed additional treatment. CBT was highly effective in the treatment of panic disorder with agoraphobia and reduced agoraphobia to levels that were comparable to those of non-clinical controls.",Loerch B.; Graf-Morgenstern M.; Hautzinger M.; Schlegel S.; Hain C.; Sandmann J.; Benkert O.,1999.0,,0,0,
10757,Prevalence of headache syndromes in panic disorder.,"We investigated the prevalence of headache in a group of patients attending a psychiatric clinic because suffering from panic disorder, according to DSM-IV criteria. The psychopathological assessment was performed with the 'Panic Disorder/Agoraphobia Questionnaire' and the presence of headache was evaluated according to the criteria of the International Headache Society. The results showed that two-thirds of patients met the criteria for a diagnosis of headache, with migraine without aura being the most frequent form, followed by tension headache, while two patients only were affected by migraine with aura. When we compared panic patients with and without headache, those with headache had a longer duration of panic disorder, a higher number of attacks and a heavier family loading for panic disorder and headache. This suggests that the comorbidity of headache with panic disorder renders this condition more severe and possibly responsive to different treatments compared to panic disorder alone.",Marazziti D.; Toni C.; Pedri S.; Bonuccelli U.; Pavese N.; Lucetti C.; Nuti A.; Muratorio A.; Cassano GB.,1999.0,,0,0,
10758,Does reducing safety behaviours improve treatment response in patients with social phobia?,"This study assessed the efficacy of instructions to drop 'safety behaviours' during exposure tasks in a cognitive-behaviour therapy (CBT) group treatment program for social phobia. Fourteen subjects with social phobia received a standardised CBT treatment program and were compared to 16 subjects with social phobia who were given additional instructions to drop safety behaviours. Repeated measures of ANOVA between groups on a specific social phobia measure (SPAI) demonstrated significant benefit when instructions to drop safety behaviours were added to the treatment program. The addition of instruction to drop safety behaviours in exposure tasks in the course of CBT treatment for social phobia may be useful. This result supports the cognitive model of social phobia developed by Clark and Wells (1995), which postulates that anxiety and negative beliefs about social situations are in part maintained by engaging in safety behaviours. Further replication with larger samples is required and warranted on the basis of the present study.",Morgan H.; Raffle C.,1999.0,10.1080/j.1440-1614.1999.00599.x,0,0,
10759,"Social desirability, anonymity, and Internet-based questionnaires.","It has been argued that behavior on the Internet differs from similar behavior in the ""real world"" (Joinson, 1998a). In the present study, participants completed measures of self-consciousness, social anxiety, self-esteem, and social desirability, using either the World-Wide Web (WWW) or pen and paper, and were assigned to either an anonymous or a nonanonymous condition. It was found that people reported lower social anxiety and social desirability and higher self-esteem when they were anonymous than when they were nonanonymous. Furthermore, participants also reported lower social anxiety and social desirability when they were using the Internet than when they were using paper-based methods. Contrast analyses supported the prediction that participants using the WWW anonymously would show the lowest levels of social desirability, whereas participants answering with pen and paper nonanonymously would score highest on the same measure. Implications for the use of the Internet for the collection of psychological data are discussed.",Joinson A.,1999.0,,0,0,
10760,Effectiveness of partial hospitalization in the treatment of borderline personality disorder: a randomized controlled trial.,"This study compared the effectiveness of psychoanalytically oriented partial hospitalization with standard psychiatric care for patients with borderline personality disorder. Thirty-eight patients with borderline personality disorder, diagnosed according to standardized criteria, were allocated either to a partially hospitalized group or to a standard psychiatric care (control) group in a randomized controlled design. Treatment, which included individual and group psychoanalytic psychotherapy, was for a maximum of 18 months. Outcome measures included the frequency of suicide attempts and acts of self-harm, the number and duration of inpatient admissions, the use of psychotropic medication, and self-report measures of depression, anxiety, general symptom distress, interpersonal function, and social adjustment. Data analysis used repeated measures analysis of covariance and nonparametric tests of trend. Patients who were partially hospitalized showed a statistically significant decrease on all measures in contrast to the control group, which showed limited change or deterioration over the same period. An improvement in depressive symptoms, a decrease in suicidal and self-mutilatory acts, reduced inpatient days, and better social and interpersonal function began at 6 months and continued until the end of treatment at 18 months. Psychoanalytically oriented partial hospitalization is superior to standard psychiatric care for patients with borderline personality disorder. Replication is needed with larger groups, but these results suggest that partial hospitalization may offer an alternative to inpatient treatment.",Bateman A.; Fonagy P.,1999.0,10.1176/ajp.156.10.1563,0,0,
10761,Chronic treatment with haloperidol induces deficits in working memory and feedback effects of interval timing.,"Normal participants (n=5) having no experience with antipsychotic drugs and medicated participants (n=5) with clinical experience with chronic low doses of haloperidol (3-10 mg/day for 2-4 months) in the treatment of neuroses were evaluated for the effects of inter-trial interval (ITI) feedback on a discrete-trials peak-interval timing procedure. Feedback was presented during the ITI in the form of a histogram showing the distribution of the responses participants made on the previous trial plotted on a relative time scale. As feedback concerning the accuracy and precision of a reproduced duration (e.g., 7- and 14-s visual signals) became more remote in time, reproduced intervals gradually lengthened in duration. This rightward horizontal shift in peak time increased as a function of the probability of feedback and was enhanced by chronic treatment with haloperidol in a manner that was proportional to the duration of the signal. Our data suggest a gradual change in the underlying representation of the signal duration as a function of the remoteness of ITI feedback that is dependent upon both changes in working memory and the speed of the internal clock used to time durations in the seconds-to-minutes range.",Lustig C.; Meck WH.,2005.0,10.1016/j.bandc.2004.09.005,0,0,
10762,Can a subgroup of OCD patients with motor abnormalities and poor therapeutic response be identified?,"In a subgroup of patients with obsessive-compulsive disorder (OCD), motor soft signs, tics and other movement disorders can be observed, indicating a special pathogenetic involvement of basal ganglia. The main objective of this study was to verify the hypothesis that such motor dysfunction characterises a subgroup of OCD patients with poor treatment response. For assessing even subtle motor dysfunction, a new method for kinematical analysis of hand movements has been applied. We examined the performance of 45 in-patients who met the DSM-IV criteria for OCD before and under therapy (sertraline and behaviour therapy) using a digitising tablet and kinematical analysis of simple handwriting and drawing movements. All subjects wrote a sentence, their signature and letter sequences. Moreover, they drew circles under different conditions. Three kinematical parameters (stroke duration, variation coefficient of peak velocity, stroke length) were calculated to quantify hand-motor performance. Prior to therapy, non-responders wrote with significantly smaller amplitudes than responders. Additionally, non-responders drew significantly larger circles with the non-dominant hand at baseline, as compared to responders. Disturbances of handwriting were more frequent in non-responders than in responders. Kinematical analysis of handwriting movements seems to be interesting for the prediction of poor response to treatments in OCD patients.",Mergl R.; Mavrogiorgou P.; Juckel G.; Zaudig M.; Hegerl U.,2005.0,10.1007/s00213-004-2115-0,0,0,
10763,Obsessive-compulsive symptoms in schizophrenia: prevalance and clinical correlates.,"Obsessive-compulsive symptoms (OCS) have been observed in a substantial proportion of schizophrenic patients. In this study, the rate of occurrence of OCS and obsessive-compulsive disorder (OCD) in schizophrenic patients, and also the interrelationship between OCS and schizophrenic symptoms and depressive symptoms were assessed. A total of 100 subjects with a diagnosis of schizophrenia from the 4th edition of the Diagnostic and Statistical Manual (DSM-IV) were evaluated by the structured and clinical interview for axis-1 DSM-IV disorders-patient edition (SCID-P), the Positive and Negative Syndrome Scale (PANSS), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and the Calgary Depression Rating Scale for Schizophrenia. The prevalance of OCS in individuals meeting criteria for schizophrenia was 64%. A total of 30 of these patients (Y-BOCS total score > or =7) also met the DSM-IV criteria for OCD. The total score on Y-BOCS was significantly correlated with total score on PANSS, Positive-PANSS score, General-PANSS score and total score on Calgary Depression Rating Scale for Schizophrenia. OCS and OCD relatively frequent in schizophrenic patients and OCS are significantly correlated with the severity of psychosis, positive symptoms, and depressive symptoms in schizophrenic patients. These findings provide further evidence for the importance of OCS in schizophrenia.",Kayahan B.; Ozturk O.; Veznedaroglu B.; Eraslan D.,2005.0,10.1111/j.1440-1819.2005.01373.x,0,0,
10764,Event-related brain potentials and affective responses to threat in spider/snake-phobic and non-phobic subjects.,"We investigated cortical responses and valence/arousal ratings of spider phobic, snake phobic, and healthy subjects while they were processing feared, fear-relevant, emotional neutral, and pleasant stimuli. Results revealed significantly larger amplitudes of late ERP components (P3 and late positive complex, LPC) but not of early components (N1, P2, N2) in phobics when subjects were processing feared stimuli. This fear-associated increase of amplitudes of late ERP components in phobic subjects was maximal at centro-parietal and occipital brain sites. Furthermore, phobics but not controls rated feared stimuli to be more negative and arousing than fear-relevant, emotional neutral, and pleasant stimuli. Since late ERP components and valence/arousal ratings were only significantly increased when phobic subjects but not when healthy controls were processing feared stimuli, the present data suggest that P3 and LPC amplitudes represent useful neural correlates of the emotional significance and meaning of stimuli.",Miltner WH.; Trippe RH.; Krieschel S.; Gutberlet I.; Hecht H.; Weiss T.,2005.0,10.1016/j.ijpsycho.2005.01.012,0,0,
10765,"Traumatic stress, perceived global stress, and life events: prospectively predicting quality of life in breast cancer patients.","The authors investigated the relationship between stress at initial cancer diagnosis and treatment and subsequent quality of life (QoL). Women (n = 112) randomized to the assessment-only arm of a clinical trial were initially assessed after breast cancer diagnosis and surgery and then reassessed at 4 months (during adjuvant treatment) and 12 months (postadjuvant treatment). There were 3 types of stress measured: number of stressful life events (K. A. Matthews et al., 1997), cancer-related traumatic stress symptoms (M. J. Horowitz, N. Wilner, & W. Alvarez, 1979), and perceived global stress (S. Cohen, T. Kamarck, & R. Mermelstein, 1983). Using hierarchical multiple regressions, the authors found that stress predicted both psychological and physical QoL (J. E. Ware, K. K. Snow, & M. Kosinski, 2000) at the follow-ups (all ps < .03). These findings substantiate the relationship between initial stress and later QoL and underscore the need for timely psychological intervention.",Golden-Kreutz DM.; Thornton LM.; Wells-Di Gregorio S.; Frierson GM.; Jim HS.; Carpenter KM.; Shelby RA.; Andersen BL.,2005.0,10.1037/0278-6133.24.3.288,0,0,
10766,Factors associated with being a false positive on the General Health Questionnaire.,"The General Health Questionnaire (GHQ) has been used extensively in community and primary care research as an alternative to longer, time-consuming and more expensive assessments of the common mental disorders of depression and anxiety. The sensitivity and specificity of the GHQ compared with longer more detailed assessments is between 70 and 80%. Though satisfactory, this raises the concern about the possibility of bias in relation to longer assessments. We studied socio-demographic factors that were associated with being a false positive on the GHQ in order to investigate any ascertainment bias in relation to more detailed assessments. A total of 7,357 consecutive patients aged 16 and over, in five general practices in Cardiff, Bristol and Pontypridd, were invited to complete the 12-item GHQ. Of these, 1,154 patients scored 3 or more, our case definition on the GHQ, and completed a computerised version of the Revised Clinical Interview Schedule (CIS-R) together with a short socio-demographic questionnaire. Of the 1,154 subjects who were cases on the GHQ, 344 (30 %) (95% CI 27%-32%) were false positive and were not cases on the CIS-R. After adjustment for the other variables, including GHQ score, false positive subjects were more likely to be employed [odds ratio (OR) 2.7, 95% CI 1.4-5.3], owner-occupiers (OR 1.6, 95% CI 1.0-2.4) and to have a close friend or relative to talk to about personal problems (OR 2.2, 95 % CI 1.4-3.5). Our results suggest that in this study there was an ascertainment bias on the GHQ in relation to the CIS-R. Studies that use the GHQ to study the relationship between socio-economic status and common mental disorder could lead to biased estimates of association compared to studies that use the CIS-R. It is likely that the GHQ will lead to a higher estimate of prevalence than the CIS-R in subjects who are better off financially and who have better social support.",Bell T.; Watson M.; Sharp D.; Lyons I.; Lewis G.,2005.0,10.1007/s00127-005-0881-6,0,0,
10767,Serum brain-derived neurotrophic factor (BDNF) levels in patients with panic disorder: as a biological predictor of response to group cognitive behavioral therapy.,"Little is known about biological predictors of treatment response in panic disorder. Our previous studies show that the brain-derived neurotrophic factor (BDNF) may play a role in the pathophysiology of major depressive disorders and eating disorders. Assuming that BDNF may be implicated in the putative common etiologies of depression and anxiety, the authors examined serum BDNF levels of the patients with panic disorder, and its correlation with therapeutic response to group cognitive behavioral therapy (CBT). Group CBT (10 consecutive 1 h weekly sessions) was administered to the patients with panic disorder after consulting the panic outpatient special service. Before treatment, serum concentrations of BDNF and total cholesterol were measured. After treatment, we defined response to therapy as a 40% reduction from baseline on Panic Disorder Severity Scale (PDSS) score as described by [Barlow, D.H., Gorman, J.M., Shear, M.K., Woods, S.W., 2000. Cognitive-behavioral therapy, imipramine, or their combination for panic disorder: A randomized controlled trial. JAMA. 283, 2529-2536]. There were 26 good responders and 16 poor responders. 31 age- and sex-matched healthy normal control subjects were also recruited in this study. The serum BDNF levels of the patients with poor response (25.9 ng/ml [S.D. 8.7]) were significantly lower than those of the patients with good response (33.7 ng/ml [S.D. 7.5]). However, there were no significant differences in both groups of the patients, compared to the normal controls (29.1 ng/ml [S.D. 7.1]). No significant differences of other variables including total cholesterol levels before treatment were detected between good responders and poor responders. These results suggested that BDNF might contribute to therapeutic response of panic disorder. A potential link between an increased risk of secondary depression and BDNF remains to be investigated in the future.",Kobayashi K.; Shimizu E.; Hashimoto K.; Mitsumori M.; Koike K.; Okamura N.; Koizumi H.; Ohgake S.; Matsuzawa D.; Zhang L.; Nakazato M.; Iyo M.,2005.0,10.1016/j.pnpbp.2005.04.010,0,0,
10768,[Capacity for sport and the sensorimotor system after stabilization of the shoulder in overhead athletes].,"The anterior capsulolaboral reconstruction according to Jobe is a modification of the Bankart operation, performing the capsular shift via a subscapularis-split approach avoiding any incision into the musculature. A total of 24 overhead athletes with posttraumatic, chronic anterior shoulder instability underwent surgery. Twenty-two patients were examined after an average follow-up of 2.8 +/- 0.7 years. On average, a Constant-Murley-Score of 93.7 +/- 5.3 points and an ASES-Score of 95.0 +/- 5.1 points were achieved. The relaxation rate was 9 %. The study demonstrated, that despite the good clinical results, only 12 out of 22 (55 %) of patients were able to return to their previous sports activity level. This relevant problem is in agreement with other similar studies so that it was further addressed by determination of proprioception and electromyographic muscle activity. Postoperatively, a persisting proprioceptive deficit as well as an altered EMG pattern was found with a significant reduction in activity of the deltoideus muscle on the operated side. The analysis of the data of each patient showed that there was a significant relation between the restitution of proprioception and ability to return to the previous sports activity level. In contrast, the relation between EMG pattern and full recovery to completely unrestricted shoulder function was not significant.",Fremerey RW.; Bosch U.; Lobenhoffer P.; Stalp M.; Wippermann B.,2005.0,10.1055/s-2005-858214,0,0,
10769,Resolution of trauma-related guilt following treatment of PTSD in female rape victims: a result of cognitive processing therapy targeting comorbid depression?,"Although Resick et al. [Resick, P.A., Nishith, P., Weaver, T.L., Astin, M.C., Feuer, C.A., 2002. A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. J. Consult. Clin. Psychol. 70, 867-879.] reported comparable results for treating rape-related posttraumatic stress disorder (PTSD) using either cognitive-processing therapy (CPT) or prolonged exposure (PE), there was some suggestion that CPT resulted in better outcomes than PE for certain aspects of trauma-related guilt. The present study revisited these findings to examine whether this effect was a function of improvement in a subset of participants with both PTSD and major depressive disorder (MDD). Results indicated that CPT was just as effective in treating ""pure"" PTSD and PTSD with comorbid MDD in terms of guilt. Clinical significance testing underscored that CPT was more effective in reducing certain trauma-related guilt cognitions than PE. Findings cannot be generalized to men, and only one measure of guilt was used. The observed superiority of CPT over PE for treating certain guilt cognitions was not due to participant comorbidity. Further research is recommended to untangle the relationship between guilt, depression and differential response to treatment in PTSD following sexual assault trauma.",Nishith P.; Nixon RD.; Resick PA.,2005.0,10.1016/j.jad.2005.02.013,0,0,
10770,Cognitive modulation of the endocrine stress response to a pharmacological challenge in normal and panic disorder subjects.,"The hypothalamic-pituitary-adrenal (HPA) axis may mediate the deleterious effects of stress on health. It is sensitive to cognitive and emotional aspects of organism-environment interactions, such as familiarity, control, and social support. Scientific study of how such factors moderate human HPA axis activity has been limited. Their relevance to HPA axis disturbances in psychiatric patients is largely unexplored. To determine whether cognitive manipulation can alter HPA axis activity in laboratory studies and whether patients with panic disorder are differentially sensitive to the manipulated factors. Pharmacological activation paradigm (cholecystokinin-B agonist pentagastrin) by which we examined symptom and endocrine effects on subjects randomly assigned to a standard introduction or a cognitive intervention. Clinical research center. Recruited from university clinic and newspaper advertisements. Fourteen patients with panic disorder and 14 controls, individually matched for age and sex. Intervention Half of each group received a 9-minute cognitive intervention designed to reduce novelty, increase cognitive coping, and provide a sense of control. Corticotropin (ACTH) and cortisol levels. The cognitive intervention significantly reduced cortisol (P = .02) and ACTH (P = .01) levels, despite pentagastrin's robust stimulation of both hormones (P<.001). The intervention effect was evident in patients and controls, who did not differ in basal HPA axis activity or response to pentagastrin. They did differ in panic symptom responses, which were unaffected by the intervention, and in ACTH effects of the intervention. Patients' exaggerated anxiety responses to pentagastrin were normalized by the intervention. Cognitive/emotional manipulation can substantially modulate HPA axis responses to pharmacological activation in humans, and HPA disturbances in panic disorder may be secondary to manipulable cognitive/emotional sensitivities. Further study of such factors as novelty, control, and coping may help clarify the origins of HPA axis disturbance in psychiatric disorders and the mediators linking psychosocial stress to disease.",Abelson JL.; Liberzon I.; Young EA.; Khan S.,2005.0,10.1001/archpsyc.62.6.668,0,0,
10771,Mining the posterior cingulate: segregation between memory and pain components.,"We present a general method for automatic meta-analyses in neuroscience and apply it on text data from published functional imaging studies to extract main functions associated with a brain area-the posterior cingulate cortex (PCC). Abstracts from PubMed are downloaded, words extracted and converted to a bag-of-words matrix representation. The combined data are analyzed with hierarchical non-negative matrix factorization. We find that the prominent themes in the PCC corpus are episodic memory retrieval and pain. We further characterize the distribution in PCC of the Talairach coordinates available in some of the articles. This shows a tendency to functional segregation between memory and pain components where memory activations are predominantly in the caudal part and pain in the rostral part of PCC.",Nielsen FA.; Balslev D.; Hansen LK.,2005.0,10.1016/j.neuroimage.2005.04.034,0,0,
10772,[Synovialitis score: histopathological grading system for chronic rheumatic and non-rheumatic synovialitis].,"Standardization of the histopathological assessment of synovial membrane specimens might facilitate the diagnosis of chronic rheumatic and non-rheumatic joint diseases. We would like to propose a histological graduation scheme (""synovialitis score""), which is applicable to all forms of synovitis, irrespective of its etiology. This score evaluates the three compartments of chronic synovialitis [enlargement of lining cell layer, activation of synovial stroma (i. e. resident cells), leukocytic infiltrate] semiquantitatively (from 0=absent to 3=strong). Each compartment is graded separately, and the sum resembles the synovialitis score, which is interpreted as follows: 0-1: no synovialitis, 2- 3: slight synovialitis, 4-6: moderate synovialitis, 7-9: strong synovialitis (for sample photos see also www.charite.de/ch/patho/Webpage/pages/forschung/arbeitsgruppen/ag-krenn/index.htm). A total of 483 synovial specimens (resections n=462, biopsies n=21) were graded by two independent observers. Clinical diagnoses were osteoarthrosis (OA; n=153), posttraumatic arthritis (PtA; n=31), rheumatoid arthritis (RA; n=239), psoriatic arthritis (PsA; n=32), reactive arthritis (ReA; n=7), and controls (Co, n=21) from necropsies of patients without joint damage. The correlation between two observers was high (p<0.001). The correlation coefficient between the different samples from the same joint in n=112 cases was between 0.86 and 0.95. Median synovialitis scores when correlated with clinical diagnoses were: Co 0.5, OA 2, PtA 3, PsA 3, ReA 4, RA 5. The differences in scores between Co and all other groups were highly significant (p<0.001). A synovialitis score of 4 points and more was strongly associated with rheumatic joint diseases (sensitivity 73%, specificity 86%). Validation of the synovialitis score by gene expression data showed good correlations for the lining cell enlargement with MMP1 (0.685), for the leukocytic infiltrate with CD3 (0.754) and CD138 (0.744) and for the stroma activation with CD14 (0.744). The proposed synovialitis score is based on well definable histopathologic criteria and contributes to the diagnosis of rheumatic and non-rheumatic joint diseases.",Krenn V.; Morawietz L.; Burmester GR.; Häupl T.,2005.0,10.1007/s00393-005-0704-x,0,0,
10773,Neural-cardiac coupling in threat-evoked anxiety.,"Anxiety is a debilitating symptom of many psychiatric disorders including generalized anxiety disorder, mood disorders, schizophrenia, and autism. Anxiety involves changes in both central and peripheral biology, yet extant functional imaging studies have focused exclusively on the brain. Here we show, using functional brain and cardiac imaging in sequential brain and cardiac magnetic resonance imaging (MRI) sessions in response to cues that predict either threat (a possible shock) or safety (no possibility of shock), that MR signal change in the amygdala and the prefrontal and insula cortices predicts cardiac contractility to the threat of shock. Participants with greater MR signal change in these regions show increased cardiac contractility to the threat versus safety condition, a measure of the sympathetic nervous system contribution to the myocardium. These findings demonstrate robust neural-cardiac coupling during induced anxiety and indicate that individuals with greater activation in brain regions identified with aversive emotion show larger magnitude cardiac contractility increases to threat.",Dalton KM.; Kalin NH.; Grist TM.; Davidson RJ.,2005.0,10.1162/0898929054021094,0,0,
10774,"Psychiatric morbidity, quality of life, and disability in mesial temporal lobe epilepsy patients before and after anterior temporal lobectomy.","Considerable interest has been focused on the psychiatric complications of medically refractory temporal lobe epilepsy (TLE) before and after epilepsy surgery. The aim of the present study was to evaluate the psychiatric status, quality of life, and level of disability in medically refractory mesial temporal lobe epilepsy (MTLE) patients, a homogenous subgroup of patients with TLE, before and after anterior temporal lobectomy (ATL). The study population consisted of 22 patients with medically refractory MTLE who were candidates for ATL. Patients were examined before surgery as well as in the third and sixth months of the postoperative period. Psychiatric diagnosis was determined by using SCID-I. To rate the severity of psychiatric disorders, BPRS, HDRS, and HARS were employed on each visit. WHO-DAS-II and WHOQOL-BREF were used to determine the level of disability and quality of life. Preoperatively, six patients had a psychiatric diagnosis. Three months after surgery, six of the patients had psychiatric diagnoses. Five of these six patients had not been previously diagnosed. There was no significant difference between preoperative and postoperative follow-up evaluations in terms of HDRS, HARS, and BPRS ratings. With respect to the total scores and domains of WHO-DAS-II, the change in pre- and postoperative evaluations was statistically significant only for the social life attendance domain. There was no significant difference in the mean scores on the WHOQOL-BREF domains or on the first question about general evaluation of quality of life. For the second question on the level of satisfaction with health, the difference between the three ratings was statistically significant. Preoperative and postoperative rates of psychiatric disorders in our sample were low. While social phobia was frequently seen preoperatively, the postoperative period was spearheaded by major depressive disorder. The decrease in disability in attendance to social life and improvement in the quality of health were in concordance with the literature, indicating the positive results of surgical treatment of epilepsy on quality of life. This study suggests that surgical intervention might be one of the causes of postoperative psychiatric disorders in patients with MTLE.",Cankurtaran ES.; Ulug B.; Saygi S.; Tiryaki A.; Akalan N.,2005.0,10.1016/j.yebeh.2005.03.019,0,0,
10775,"Physical, mental, and social catastrophic cognitions as prognostic factors in cognitive-behavioral and pharmacological treatments for panic disorder.","The authors explored the prognostic value of 3 different types of catastrophic cognitions in the treatment of panic disorder with and without mild-to-moderate agoraphobia using a sample of 143 participants who received either cognitive-behavioral therapy (CBT) or imipramine in a randomized controlled trial. Stronger fears of social catastrophes both prior to and following treatment with CBT or imipramine were associated with a poorer outcome. In contrast, cognitions involving physical or mental catastrophes were unrelated to outcome, regardless of whether these thoughts were measured prior to or following treatment. These findings are consistent with the notion that although the intensity of physical catastrophe cognitions may best discriminate between panic disorder and other anxiety disorders, it is the intensity of social catastrophe cognitions that is most closely tied to success in treating this disorder.",Hicks TV.; Leitenberg H.; Barlow DH.; Gorman JM.; Shear MK.; Woods SW.,2005.0,10.1037/0022-006X.73.3.506,0,0,
10776,Repetitive transcranial magnetic stimulation (rTMS) in the treatment of obsessive-compulsive disorder (OCD) and Tourette's syndrome (TS).,"There is evidence that motor and premotor cortex are hyperexcitable in obsessive-compulsive disorder (OCD) and Tourette's syndrome (TS). We tested whether low-frequency repetitive transcranial magnetic stimulation (rTMS) could normalize overactive motor cortical regions and thereby improve symptoms. Subjects with OCD or TS were treated with active rTMS to the supplementary motor area (SMA) for 10 daily sessions at 1 Hz, 100% of motor threshold, 1200 stimuli/day. Suggestions of clinical improvement were apparent as early as the first week of rTMS. At the second week of treatment, statistically significant reductions were seen in the YBOCS, YGTSS, CGI, HARS, HDRS, SAD, BDI, SCL-90, and SASS. Symptoms improvement was correlated with a significant increase of the right resting motor threshold and was stable at 3 months follow-up. Slow rTMS to SMA resulted in a significant clinical improvement and a normalization of the right hemisphere hyperexcitability, thereby restoring hemispheric symmetry in motor threshold.",Mantovani A.; Lisanby SH.; Pieraccini F.; Ulivelli M.; Castrogiovanni P.; Rossi S.,2006.0,10.1017/S1461145705005729,0,0,
10777,Posttraumatic syringomyelia--a serious complication in tetra- and paraplegic patients.,"Post-traumatic syringomyelia (PTS) is relatively rare, but its complications can be serious. In the beginning of the operative treatment (1900-1930), scarring could be reduced to a certain degree. In modern treatment (1980 1990) a shunt implantation showed also little effect in long-term follow-up studies. Influenced by the work of B. Williams, 58 PTS patients underwent surgery to create a pseudomeningomyelocele, an artificial CSF reservoir, performed to normalize the CSF flow. In a 10-year-postoperative follow-up study (minimum observation two years), good results were obtained in more than 70%.",Jaksche H.; Schaan M.; Schulz J.; Bosczcyk B.,2005.0,,0,0,
10778,Motivation for therapy and the results of inpatient treatment of patients with a generalized anxiety disorder: a prospective study.,"Whether the primary motivation for entering therapy significantly influences the results of inpatient psychotherapeutic treatment is subject to debate. The purpose of this study was to examine this question in women with generalized anxiety disorder. The monitored results from 54 female inpatients (29 who were highly motivated to enter therapy and 25 who were minimally motivated) were compared. The questionnaire for measuring psychotherapy motivation (FMP), the symptom checklist (SCL-90-R) and the questionnaire for measuring change of experience and behavior (VEV) were used to assess motivation and results of treatment. The patients were tested at admission and after the fourth and sixth weeks of therapy, at which time the patients with high primary motivation showed a significantly more marked reduction of anxiety symptoms (SCL-90-R, P < 0.01). These patients also had better test results on the VEV (P < 0.01). However, both quantitative and qualitative improvements in motivation for therapy were observed among the less motivated patients, and this improvement did not differ from that of the highly motivated group on most scales of the FMP (P < 0.05 to P = 0.43). Highly motivated patients with generalized anxiety disorder can profit significantly more from inpatient psychosomatic treatment than those who have less primary motivation. However, less motivated patients can show significant positive changes in developing motivation for therapy, as well as in the final results of treatment. Establishing and developing motivation prior to hospitalization might contribute to more efficient and cost-effective clinical treatment.",Nickel C.; Tritt K.; Kettler C.; Lahmann C.; Loew T.; Rother W.; Nickel M.,2005.0,,0,0,
10779,Improving the rates of quitting smoking for veterans with posttraumatic stress disorder.,"Smoking is highly prevalent and refractory among people with posttraumatic stress disorder (PTSD). This study aimed to improve the rate of quitting smoking for veterans with PTSD by integrating treatment for nicotine dependence into mental health care. Smokers undergoing treatment for PTSD (N=66) were randomly assigned to 1) tobacco use treatment delivered by mental health providers and integrated with psychiatric care (integrated care) versus 2) cessation treatment delivered separately from PTSD care by smoking-cessation specialists (usual standard of care). Seven-day point prevalence abstinence was the primary outcome, measured at 2, 4, 6, and 9 months after random assignment. Data were analyzed by using a generalized estimating equations approach following the intent-to-treat principle. Subjects assigned to integrated care were five times more likely than subjects undergoing the usual standard of care to abstain from smoking across follow-up assessment intervals (odds ratio=5.23). Subjects in the integrated care condition were significantly more likely than subjects in usual standard of care to receive transdermal nicotine and nicotine gum. They also received a greater number of smoking-cessation counseling sessions. Stopping smoking was not associated with worsening symptoms of PTSD or depression. Smoking-cessation interventions can be safely incorporated into routine mental health care for PTSD and are more effective than treatment delivered separately by a specialized smoking-cessation clinic. Integrating cessation treatment into psychiatric care may have the potential for improving smoking quit rates in other populations of chronically mentally ill smokers.",McFall M.; Saxon AJ.; Thompson CE.; Yoshimoto D.; Malte C.; Straits-Troster K.; Kanter E.; Zhou XH.; Dougherty CM.; Steele B.,2005.0,10.1176/appi.ajp.162.7.1311,0,0,
10780,Analog validation of German-language symptom validity tests and the influence of coaching.,"Although symptom validity testing is an integral part of the repertory of neuropsychologists in a number of countries, this is not yet true for Germany. The German adaptations of two effort tests, the Medical Symptom Validity Test (MSVT) by Green and the Amsterdam Short-Term Memory Test (ASTM) by Schmand et al., were investigated with a German-language sample. An analog study was performed with 18 healthy experimental malingerers and 18 controls with a mean age of 25.4 years. The scenario contained detailed information about mild post-traumatic cognitive impairment, as well as an explicit warning against symptom exaggeration. In addition to MSVT and ASTM, the Trail Making Test (TMT), the Complex Figure Test (CFT), and Digit Span were performed. Half of the sample were also given Rey's 15-Item-Test (FIT). Both groups were significantly different in all effort and performance measures, with the exception of the ratio TMT-B:TMT-A. With MSVT and ASTM, correct classification of group membership was between 97 and 100%. For the ratio TMT-B:TMT-A, there was a considerable overlap in the test scores for the two groups and the sensitivity of the FIT was too low. Although the ASTM and the MSVT were identified by a number of subjects as possible effort measures, both tests obtained very good results within this analog design.",Merten T.; Green P.; Henry M.; Blaskewitz N.; Brockhaus R.,2005.0,10.1016/j.acn.2005.04.004,0,0,
10781,Neural networks of information processing in posttraumatic stress disorder: a functional magnetic resonance imaging study.,"Neuroimaging studies report reduced medial prefrontal cortical (particularly anterior cingulate) but enhanced amygdala response to fear signals in posttraumatic Stress Disorder (PTSD). We investigated whether anterior cingulate-amygdala dysregulation in PTSD would generalize to salient, but nonthreat related signals. Individuals with PTSD (n = 14) and age and sex-matched nontraumatized controls (n = 14) completed an auditory oddball paradigm adapted to functional magnetic resonance imaging at a 1.5-T field strength. Controls displayed bilateral activation in ventral anterior cingulate and amygdala networks, and PTSD subjects showed bilateral dorsal anterior cingulate and amygdala activation to targets relative to nontargets. Compared to controls, PTSD subjects showed enhanced responses to targets in the dorsal and rostral anterior cingulate, and left amygdala. Whole-brain analyses confirmed the expected pattern of distributed prefrontal-parietal responses to targets in the oddball task. Greater activity in posterior parietal somatosensory regions was observed in PTSD. Our findings of enhanced anterior cingulate responses in PTSD contrast with reports of reduced activity for threat stimuli, suggesting that the latter may be specific to processing of threat-related content. Activation in rostral and dorsal anterior cingulate, left amygdala and posterior parietal networks in response to salient, nonthreatening stimuli may reflect generalized hypervigilance.",Bryant RA.; Felmingham KL.; Kemp AH.; Barton M.; Peduto AS.; Rennie C.; Gordon E.; Williams LM.,2005.0,10.1016/j.biopsych.2005.03.021,0,0,
10782,Size versus shape differences: contrasting voxel-based and volumetric analyses of the anterior cingulate cortex in individuals with acute posttraumatic stress disorder.,"Two studies found morphological differences in the anterior cingulate cortex (ACC) of individuals with chronic posttraumatic stress disorder (PTSD). We sought to replicate and extend these findings in a sample of individuals with acute PTSD. The ACCs of individuals with acute PTSD (n = 14) and matched healthy control subjects (n = 14) were compared using voxel-based morphometry (VBM), semi-automated volumetric analyses, and probabilistic maps. Posttraumatic stress disorder diagnosis was ascertained by a psychologist using a structured interview. Voxel-based morphometry analyses revealed significantly less gray-matter density in the right pregenual ACC and in the left insula of the PTSD group. However, volumetric analyses of the ACC revealed no significant differences between groups. Probabilistic maps of the labels of the pregenual ACC indicated that the difference between groups in gray matter density was due to shape differences. Although there are no volumetric differences in the ACC of acute PTSD individuals compared with normal control subjects, significant shape differences exist, which might indicate volumetric differences in the surrounding structures.",Corbo V.; Clément MH.; Armony JL.; Pruessner JC.; Brunet A.,2005.0,10.1016/j.biopsych.2005.02.032,0,0,
10783,One-year follow-up of pharmacotherapy-resistant patients with panic disorder treated with cognitive-behavior therapy: Outcome and predictors of remission.,"Non-response to pharmacotherapy for panic disorder (PD) is a well-documented problem. However, little information exists to guide next-step strategies for these non-responders. In addition to pharmacologic augmentation strategies, several studies support the efficacy of cognitive-behavior therapy (CBT) for these patients, although data on long-term outcomes has been lacking. In this study, we provide one-year outcomes on a sample of 63 patients who completed group CBT for PD after failing to respond adequately to previous pharmacotherapy. Sustained significant benefit was found for all dimensional outcome scores, and nearly two-thirds of the sample met remission criteria. This occurred with reductions in medication use over the follow-up period. Negative predictors of remission status included comorbid dysthymia, social phobia, and generalized anxiety disorder. These results provide additional evidence for the efficacy of CBT for medication non-responders with PD.",Heldt E.; Gus Manfro G.; Kipper L.; Blaya C.; Isolan L.; Otto MW.,2006.0,10.1016/j.brat.2005.05.003,0,0,
10784,A randomized controlled trial of Japanese patients with obsessive-compulsive disorder--effectiveness of behavior therapy and fluvoxamine.,"The aim of this study was to confirm and compare the efficacy of fluvoxamine (the only licensed SSRI for treatment for OCD in Japan) and behavior therapy in treating Japanese patients with OCD. In addition, we investigated predictors of these treatments. Thirty-one outpatients meeting the DSM-III-R criteria for OCD without any axis I disorder were randomly assigned to one of three treatment conditions: BT (behavior therapy +/- pill placebo), FLV [autogenic training (a psychological placebo for OCD) +/- fluvoxamine] and control group [autogenic training (psychological placebo) +/- pill placebo] for 12 weeks of treatment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Clinical Global Impression-Improvement Scale (CGI-I) were administered blindly at baseline and week 4, 8 and 12. Twenty-eight patients completed this study. Patients in the BT and FLV groups showed significantly more improvement than those in the control group in the mean score of total Y-BOCS; moreover, the BT group showed significantly more reduction in total Y-BOCS score at the end of treatment than the FLV group (BT > FLV, p < 0.01). Patients with lower baseline total Y-BOCS, past history of a major depressive episode and absence of cleaning compulsion improved more with fluvoxamine. We confirmed the effectiveness of behavior therapy and fluvoxamine for Japanese patients with OCD. Behavior therapy improved the condition of OCD patients more than fluvoxamine.",Nakatani E.; Nakagawa A.; Nakao T.; Yoshizato C.; Nabeyama M.; Kudo A.; Isomura K.; Kato N.; Yoshioka K.; Kawamoto M.,2005.0,10.1159/000086317,0,0,
10785,Effects of group experiential cognitive therapy for the treatment of panic disorder with agoraphobia.,"A treatment protocol, called experiential cognitive therapy (ExCT), was developed. It integrated traditional cognitive behavior therapy (CBT) with virtual reality exposure for the treatment of panic disorder with agoraphobia (PDA). The objective of this study was to test the efficacy of short-term (four sessions) ExCT compared with a traditional 12-session panic control program (PCP) for the treatment of PDA. Forty patients diagnosed as having PDA by the diagnostic criteria of DSM-IV were randomly assigned to ExCT and PCP groups of 20 patients each. The treatment effects were measured with self-report questionnaires, including the BDI, STAI, ASI, PBQ, ACQ, and BSQ. The authors also assessed high end-state functioning (HES), including the success rate of stopping or reducing medication at post-treatment and 6-month follow-up. In all ratings, both ExCT and PCP groups showed significant improvement post-treatment compared with pre-treatment scores. There were no significant differences between the two treatment groups in HES and medication discontinuation at post-treatment, but there was a significant difference in medication discontinuation at 6-month follow-up. These results suggested that although short-term effectiveness of ExCT might be comparable to the effectiveness of PCP, long-term effectiveness of ExCT might be relatively inferior to the effectiveness of PCP.",Choi YH.; Vincelli F.; Riva G.; Wiederhold BK.; Lee JH.; Park KH.,2005.0,10.1089/cpb.2005.8.387,0,0,
10786,Sexual and physical abuse in women with fibromyalgia syndrome: a test of the trauma hypothesis.,"According to the trauma hypothesis, women with fibromyalgia syndrome (FMS) are more likely to report a history of sexual and/or physical abuse than women without FMS. In this study, we rely on a community sample to test this hypothesis and the related prediction that women with FMS are more likely to have posttraumatic stress disorder than women without FMS. Eligibility for the present study was limited to an existing community sample in which FMS and major depressive disorder were prevalent. The unique composition of the original sample allowed us to recruit women with and without FMS from the community. A total of 52 female participants were enrolled in the present FMS group and 53 in the control (no FMS) group. Sexual and physical abuse were assessed retrospectively using a standardized telephone interview. Except for rape, sexual and physical abuse were reported equally often by women in the FMS and control groups. Women who reported rape were 3.1 times more likely to have FMS than women who did not report rape (P<0.05). There was no evidence of increased childhood abuse in the FMS group. Women with FMS were more likely to have posttraumatic stress disorder symptoms (intrusive thoughts and arousal) as well as posttraumatic stress disorder diagnosis (P<0.01). With the exception of rape, no self-reported sexual or physical abuse event was associated with FMS in this community sample. In accord with the trauma hypothesis, however, posttraumatic stress disorder was more prevalent in the FMS group. Chronic stress in the form of posttraumatic stress disorder but not major depressive disorder may mediate the relationship between rape and FMS.",Ciccone DS.; Elliott DK.; Chandler HK.; Nayak S.; Raphael KG.,,,0,0,
10787,The Nottingham study of neurotic disorder: predictors of 12 year costs.,"To examine the relationship between clinical, demographic and socio-economic characteristics and the long-term costs of a cohort of neurotic patients. Analysis of the costs of a cohort of 210 people entered in the Nottingham study of neurotic disorders, a randomized controlled evaluation of five treatments for neurotic disorders. Service use data were collected at 5 and 12 years after study entry. Multiple regression analyses were conducted. The total cost per patient over the 12-year follow-up period was calculated to be $11,940 (SD $15,520) ( pound7450, SD pound9690). Higher costs were significantly associated with the presence of general neurotic syndrome, an initial diagnosis of dysthymia and a recurrent episode of illness. The total costs of care for a range of neurotic disorders are broadly comparable with other estimates of costs reported in the literature for similar populations. Those responsible for higher costs in the longer-term have comorbid anxiety, depressive and personality disorders.",Knerer G.; Byford S.; Johnson T.; Seivewright H.; Tyrer P.,2005.0,10.1111/j.1600-0447.2005.00552.x,0,0,
10788,Autologous osteochondral transplantation for the treatment of chondral defects of the knee.,"Full-thickness chondral defects of weight-bearing articular surfaces of the knee are a difficult condition to treat. Our aim is to evaluate the mid- and long-term functional outcome of the treatment of osteochondral defects of the knee with autologous osteochondral transplantation with the OATS technique. Thirty-six patients (37 procedures) were included in this study. Twenty-three patients were male and thirteen were female with a mean age of 31.9 years (range: 18-48 years). The cause of the defect was OCD in 10 cases, AVN in 2, lateral patellar maltracking in 7, while in the remaining 17 patients the defect was post-traumatic. The lesion was located on the femoral condyles in 26 cases and the patellofemoral joint in the remaining 11. The average area covered was 2.73 cm(2) (range: 0.8-12 cm(2)) and patients were followed for an average of 36.9 months (range: 18-73 months). The average score in their Tegner Activity Scale was 3.76 (range: 1-8), while their score in Activities of Daily Living Scale of the Knee Outcome Survey ranged from 18 to 98 with an average of 72.3. Thirty-two out of 37 patients (86.5%) reported improvement of their pre-operative symptoms. All but 5 patients returned to their previous occupation while 18 went back to sports. No correlation was found between patient age at operation, the size or site of the chondral lesion and the functional outcome. We believe that autologous osteochondral grafting with the OATS technique is a safe and successful treatment option for focal osteochondral defects of the knee. It offers a very satisfactory functional outcome and does not compromise the patient's future options.",Karataglis D.; Green MA.; Learmonth DJ.,2006.0,10.1016/j.knee.2005.05.006,0,0,
10789,[Internal fixation of sacroiliac joint disruption].,"Stabilization of the completely disrupted sacroiliac (SI) joint with two three-hole DC plates. Definitive treatment of the posterior pelvic ring in type C injuries (AO classification) with complete SI joint disruption, transiliac or transsacral fracture-dislocation of the SI joint with an insignificant, small fragment. Emergency stabilization of the SI joint following a laparotomy. Poor general health of patient. Local soft-tissue damage. Rotationally unstable type B pelvic injuries. Supine. Anterolateral approach to the iliac crest. Subperiosteal detachment of the iliac muscle. Debridement of the SI joint and reduction under direct vision. Stabilization of the SI joint with two three-hole DC plates inserted at an angle of 70-90 degrees. Partial weight bearing on the injured side at 15 kg for 8-12 weeks with two forearm crutches. Implant removal 6-12 months after injury provided ankylosis has not occurred. In 27 patients with disruption of the SI joint consistent with a type C injury, the average displacement of the affected SI joint was 16 mm (8-30 mm). Complications relating to the osteosynthesis occurred as a deep infection in one patient, originating from a concomitant acetabular osteosynthesis. Iatrogenic nerve damage (lateral femoral cutaneous nerve) was present in two patients. 16 patients were followed up using radiologic techniques (pelvic, possibly inlet and outlet views, computed tomography). 13 SI joints healed in anatomic position. The malalignments observed were relatively slight (2-4 mm). There was no secondary implant failure. Almost all patients (n = 14) showed posttraumatic changes of the SI joint (osteophytes, arthrosis, ankylosis).",Gänsslen A.; Pohlemann T.; Krettek C.,2005.0,10.1007/s00064-005-1133-3,0,0,
10790,An emotional mediation theory of differential age effects in episodic and semantic memories.,"Although there is a large decrement in central episodic memory processes as adults age, there is no appreciable decrement in central semantic memory processes (Allen et al., Journal of Gerontology: Psychological Sciences, 57B, P173-P186, 2002; Allen et al., Experimental Aging Research, 28, 111-142, 2002; Mitchell, Journal of Experimental Psychology: Learning, Memory, and Cognition, 15, 31-49, 1989). The authors develop a theory of episodic memory's connections to cognitive, emotional, and motivational systems to explain these differential age effects. The theory is discussed within the context of the cognitive neuroscience research regarding limbic system connectivity in conjunction with Damasio's notion of somatic markers (Descartes' error: Emotion, reason, and the human brain, New York: Grosset/Putnam, 1994). The central hypothesis is that elements of limbic system circuitry, including portions of the medial temporal lobes and frontal cortex, are associated with both working and long-term episodic memory performance, and by extension, with the capacity to engage in emotion-guided, self-regulatory processes that depend heavily on episodic memory. In contrast, the semantic memory system may have less shared interface with episodic and affective networks (i.e., the limbic-related system), and therefore remain independent of neurocognitive changes impacting emotional states and episodic-type memory processes. Accordingly, this framework may account for the pattern of age-related declines in episodic relative to semantic memory, particularly if older adults experience less emotional activation, and therefore fewer somatic markers, than younger adults. An initial empirical examination of this emotional mediation theory is presented, using preexisting data that include indicators of age, chronic tendency to focus on negative emotional stimuli (neuroticism), and working memory performance.",Allen PA.; Kaut KP.; Lord RG.; Hall RJ.; Grabbe JW.; Bowie T.,,10.1080/03610730500206642,0,0,
10791,Effects of psychotherapy on hippocampal volume in out-patients with post-traumatic stress disorder: a MRI investigation.,"Magnetic resonance imaging (MRI) studies have especially reported smaller hippocampal volume in patients with post-traumatic stress disorder (PTSD), most of them war or sexual abuse victims. The present study compares the hippocampal volumes of out-patients with PTSD who had low co-morbidity rates to those of trauma-exposed control subjects without PTSD, and measures hippocampal volume changes in these patients after brief eclectic psychotherapy. We hypothesized that smaller hippocampal volumes are specific to PTSD and that hippocampal volume changes after effective psychotherapy would be measurable. Eighteen patients with PTSD and 14 traumatized control subjects were examined with MRI. In a randomized clinical trial, the PTSD patients were assigned to treatment (n = 9) or waiting-list group (n = 9). After the former received psychotherapy for 4 months, the MRI was repeated on both PTSD groups. Three temporal lobe structures were manually segmented: hippocampus, amygdala, and parahippocampal gyrus. Volumetric analysis was used to measure grey matter, white matter, and cerebrospinal fluid. PTSD patients had significantly smaller hippocampal volumes at baseline (total 13.8%, right 13.5%, left 14.1%) compared to the control subjects. After effective psychotherapy, however, no volume changes were found in the smaller hippocampi. We confirmed previous findings of smaller hippocampal volume in PTSD in a new population made up of out-patients who experienced different types of traumas, reducing co-morbidity to a minimum. Smaller hippocampal volumes did not change after effective psychotherapy, even while symptoms resolved.",Lindauer RJ.; Vlieger EJ.; Jalink M.; Olff M.; Carlier IV.; Majoie CB.; Den Heeten GJ.; Gersons BP.,2005.0,10.1017/S0033291705005246,0,0,
10792,Documenting the efficacy of virtual reality exposure with psychophysiological and information processing measures.,"Many outcome studies have been conducted to assess the efficacy of virtual reality in the treatment of specific phobias. However, most studies used self-report data. The addition of objective measures of arousal and information processing mechanisms would be a valuable contribution in order to validate the usefulness of virtual reality in the treatment of anxiety disorders. The goal of this study was to document the impact of virtual reality exposure (VRE) on cardiac response and automatic processing of threatening stimuli. Twenty-eight adults suffering from arachnophobia were assessed and received an exposure-based treatment using virtual reality. General outcome and specific processes measures included a battery of standardized questionnaires, a pictorial emotional Stroop task, a behavioral avoidance test and a measure of participants' inter-beat intervals (IBI) while they were looking at a live tarantula. Assessment was conducted before and after treatment. Repeated measures ANOVAs revealed that therapy had a positive impact on questionnaire data, as well as on the behavioral avoidance test. Analyses made on the pictorial Stroop task showed that information processing of spider-related stimuli changed after treatment, which also indicates therapeutic success. Psychophysiological data also showed a positive change after treatment, suggesting a decrease in anxiety. In sum, VRE led to significant therapeutic improvements on objective measures as well as on self-report instruments.",Côté S.; Bouchard S.,2005.0,10.1007/s10484-005-6379-x,0,0,
10793,"Betrayal trauma: relationship to physical health, psychological distress, and a written disclosure intervention.","In the current study we sought, first, to distinguish associations with health arising from types of trauma as indicated by betrayal trauma theory (Freyd, 1996, 2001), and, second, to investigate the impact of disclosing a trauma history in survey form and/or writing essays about betrayal traumas. We recruited 99 community adults reporting at least 12 months of chronic medical illness or pain, 80 of whom completed all four sessions of this six-month longitudinal intervention study. Participants were randomly assigned to write about betrayal traumas or neutral events, and they were randomly assigned to complete an extensive trauma survey or a long personality inventory, producing four groups of participants. All 99 participants were assessed at their initial visit for trauma history using the Brief Betrayal Trauma Survey (BBTS) and physical and mental symptoms. The BBTS assesses exposure to both traumas high in betrayal (such as abuse by a close other) and traumas low in betrayal but high in life-threat (such as an automobile accident). Exposure to traumas with high betrayal was significantly correlated with number of physical illness, anxiety, dissociation, and depression symptoms. Amount of exposure to other types of traumas (low betrayal traumas) did not predict symptoms over and above exposure to betrayal trauma. While neither the survey manipulation nor the writing intervention led to main effects on change in symptoms over time, there were interactions between betrayal trauma history and condition such that participants with many betrayal traumas fared better in the control conditions while participants with fewer betrayal traumas had better outcomes if they were placed in the trauma writing and/or survey conditions. We discuss ongoing and future research aimed at evaluating the role of increased structure in writing assignments as beneficial for those with severe histories of betrayal trauma.",Freyd JJ.; Klest B.; Allard CB.,2005.0,10.1300/J229v06n03_04,0,0,
10794,Brief scheduled phone support from a clinician to enhance computer-aided self-help for obsessive-compulsive disorder: randomized controlled trial.,"Treatment-resistant obsessive-compulsive disorder (OCD) patients from around the United Kingdom who employed computer-guided self-help by using BTSteps over 17 weeks were randomized to have brief live phone support from a clinician either (1) in nine Scheduled clinician-initiated calls or (2) only in calls Requested by the patient (n=22 per condition). Call content and mean duration were similar across conditions. Scheduled-support patients dropped out significantly less often, did more homework of self-exposure and self-imposed ritual prevention (95% vs. 57%), and showed more improvement in OCD symptoms and disability. Mean total support time per patient over 17 weeks was 76 minutes for Scheduled and 16 minutes for Requested patients. Giving brief support proactively by phone enhanced OCD patients' completion of and improvement with computer-aided self-help.",Kenwright M.; Marks I.; Graham C.; Franses A.; Mataix-Cols D.,2005.0,10.1002/jclp.20204,0,0,
10795,Impact of depressive symptoms on the treatment of generalized social anxiety disorder.,"Patients with depression are often excluded from studies on the treatment of social anxiety disorder (SAD), leaving gaps in our knowledge about the impact of depressive affect on treatment for SAD. Patients participated in a randomized, placebo-controlled study of treatment for SAD. As in previous studies, patients were excluded from the study if they met criteria for major depressive disorder in the past 6 months. This exclusion notwithstanding, patients who enrolled in the study exhibited a range of depressive symptoms, permitting an examination of the impact of depressive symptoms on treatment outcome for SAD. Assessment measures included the Clinical Global Impression Scale, Hamilton Rating Scale for Depression, Brief Social Phobia Scale, and Beck Depression Inventory. Higher levels of depressive symptoms were related to more severe social anxiety overall, and to less change in social anxiety symptoms over the course of the study. Patients who were deemed nonresponders to treatment had higher levels of depressive symptoms at pretreatment than those who responded. In addition, patients who dropped out of the study had higher levels of depressive symptoms at pretreatment than those who completed the study. These results suggest that modifications should be made to existing treatments to improve outcomes and decrease attrition in the substantial proportion of patients with SAD who also evidence depressive symptoms. Such modifications are likely to be more important when treating patients with SAD and comorbid major depressive disorder.",Ledley DR.; Huppert JD.; Foa EB.; Davidson JR.; Keefe FJ.; Potts NL.,2005.0,10.1002/da.20121,0,0,
10796,A brief motivational intervention for treatment-refusing OCD patients.,"Cognitive behavioral therapy involving exposure and response prevention (ERP) is the psychosocial treatment of choice for obsessive-compulsive disorder (OCD). Despite this, ERP is not widely used by mental health practitioners, and so dissemination of ERP and other empirically supported treatment (ESTs) has become a priority. Even so, utilization of ESTs such as ERP remains below 50% even among therapists who self-identify as having a cognitive behavioral orientation. Barriers to the acceptance of ERP include practical obstacles such as lack of training and the cost of treatment, but also patient variables such as treatment refusal. It has been estimated that approximately 25% of OCD patients refuse ERP. This paper describes a brief, 4-session readiness intervention (RI) designed to decrease ERP refusal among patients with OCD. In this study, 12 patients with OCD who had refused ERP were randomized to RI or wait-list (WL). 86% of participants in the RI condition and 20% of participants in WL condition agreed to begin ERP following the 4-week period. ERP following RI, but not WL, was associated with a decrease in OCD symptoms comparable to that observed in OCD patients who did not refuse ERP. However, ERP following RI was associated with a high drop-out rate (50%), a figure that exceeds that typically seen in OCD treatment studies. Techniques to reduce drop-out as well as directions for future research are discussed.",Maltby N.; Tolin DF.,2005.0,10.1080/16506070510043741,0,0,
10797,Lack of effects on core obsessive-compulsive symptoms of tryptophan depletion during symptom provocation in remitted obsessive-compulsive disorder patients.,"Pharmacological evidence support that enhancement of serotonin (5-HT) neurotransmission is critical for treatment efficacy in obsessive-compulsive disorder (OCD). Surprisingly, acute tryptophan depletion (ATD), a procedure known to reduce 5-HT neurotransmission, carried out in remitted OCD patients on selective serotonin reuptake inhibitors (SSRIs) failed to worsen obsessive-compulsive (OC) symptoms. We hypothesized that the putative symptom exacerbation resulting from ATD would only be observed during symptom provocation but not at rest. Double-blind placebo-controlled ATD study conducted in 16 OCD patients with stable improvement under either SSRI (n = 8) or specialized cognitive behavior therapy alone (n = 8), coupled with gradual symptom provocation, performed 5 hours after drink ingestion. Acute tryptophan depletion markedly reduced total and free plasma tryptophan levels but did not significantly increase obsessions or compulsions at rest or following symptom provocation. However, subjective distress in response to triggering situations was significantly higher during ATD; significant mood lowering was also present during ATD. These results are consistent with the view that relapses in OC core symptoms in remitted OCD patients may not depend solely on short-term changes in presynaptic 5-HT availability. In contrast to its apparent lack of effect on core OC symptoms, ATD affected the patient's mood and distress level resulting from provocation.",Berney A.; Sookman D.; Leyton M.; Young SN.; Benkelfat C.,2006.0,10.1016/j.biopsych.2005.08.023,0,0,
10798,Does the addition of cognitive behavioral therapy improve panic disorder treatment outcome relative to medication alone in the primary-care setting?,"Randomized clinical trials indicate a benefit from combining medications with cognitive behavioral therapy (CBT) relative to medication alone for panic disorder. Using an as-treated analysis, we evaluated whether the addition of CBT enhanced outcomes for panic disorder relative to medications alone in the primary-care setting. Primary-care patients with panic disorder reported on their receipt of CBT and medications over the 3 months following baseline assessment. The degree to which outcomes for those who used anti-panic medications were enhanced by the receipt of at least one component of CBT was analyzed using a propensity score model that took into account observable baseline patient characteristics influencing both treatment selection and outcomes. The addition of CBT resulted in statistically and clinically significant improvements at 3 months on anxiety sensitivity, social avoidance, and disability. Also, patients receiving CBT in the first 3 months of the study were more improved at 12 months than patients who took medications only during the first 3 months of the study. The clinical utility of the findings are discussed in terms of the importance of primary-care physicians encouraging their panic disorder patients to receive CBT as well as medications.",Craske MG.; Golinelli D.; Stein MB.; Roy-Byrne P.; Bystritsky A.; Sherbourne C.,2005.0,10.1017/S003329170500557X,0,0,
10799,Cognitive-behavioral therapy for management of anxiety and medication taper in older adults.,"The authors hypothesized that patients with late-life anxiety undergoing cognitive-behavioral therapy plus medical management for medication taper (CBT-MM) would realize greater reduction in medication use and greater improvement in psychological symptoms than a control group undergoing medical management alone (MM). Forty-two patients (age >60) who wanted to reduce anxiolytic medication were allocated to the two groups (CBT-MM versus MM), using a randomization plus difference-minimization procedure (to equate for medication use). CBT-MM completers significantly reduced medication use, but not at a greater rate than MM completers. At the same time, CBT-MM completers experienced significantly greater alleviation of psychological symptoms than did MM completers. Some, but not all, treatment gains were maintained at 6-month follow-up. Intention-to-treat analyses using the mixed-effects model showed similar, but weaker, treatment effects than completer analyses. Cognitive-behavioral therapy can alleviate psychological symptoms in elderly patients with anxiety even as patients reduce anxiolytic medication.",Gorenstein EE.; Kleber MS.; Mohlman J.; Dejesus M.; Gorman JM.; Papp LA.,2005.0,10.1176/appi.ajgp.13.10.901,0,0,
10800,Randomised controlled trial of community debriefing following operative delivery.,"The aim of this study was to determine if two debriefing sessions following an operative delivery could reduce a woman's fear of future childbirth. Prospective randomised controlled trial (RCT) with two arms comparing debriefing, aimed to reduce fear of future childbirth, with standard care after birth. District General Hospital with 2500 deliveries per year. Three hundred and nineteen mothers who delivered a first child by operative delivery (i.e. forceps, vacuum or emergency caesarean section). The study took place at Huddersfield Royal Infirmary, from January 2002 to July 2003. Debriefing by community midwives specifically trained in postpartum debriefing at 10 days and 10 weeks. Fear of childbirth was assessed using the Wijma Delivery Expectancy Scale (WDEQ). WDEQ scores were measured 10 days, 10 weeks and 20 weeks following delivery. Fear of childbirth as measured by the WDEQ was lower throughout the study for the debriefing group. However, it never reached statistical significance in the short term [10 days debriefing = 94.5, control = 97.5 (P= 0.295), 10 weeks debriefing = 92.0, control = 97.9 (P= 0.076), 20 weeks debriefing = 90.9, control = 97.4 (P= 0.057)]. This study shows in the short term there was no significant difference in the WDEQ fear of childbirth scores. The debriefing group were showing a tendency for lower scores. Long term follow up of these cases may be more relevant.",Kershaw K.; Jolly J.; Bhabra K.; Ford J.,2005.0,10.1111/j.1471-0528.2005.00723.x,0,0,
10801,"Task concentration training versus applied relaxation, in combination with cognitive therapy, for social phobia patients with fear of blushing, trembling, and sweating.","Social phobia patients with fear of blushing, trembling, sweating and/or freezing as main complaint (N = 65) were randomly assigned to either task concentration training (TCT) or applied relaxation (AR) both followed by cognitive therapy (CT). Measurements took place before and after wait-list, after TCT or AR (within-test), after CT (post-test), at 3-months and at 1-year follow-up. Effects were assessed on fear of showing bodily symptoms (the central outcome variable), social phobia, other psychopathology, social skills, self-consciousness, self-focused attention, and dysfunctional beliefs. No changes occurred during wait-list. Both treatments were highly effective. TCT was superior to AR in reducing fear of bodily symptoms and dysfunctional beliefs at within-test. This difference disappeared after CT, at post-test and at 3-months follow-up. However, at 1-year follow-up the combination TCT-CT was superior to AR-CT in reducing fear of bodily symptoms, and effect sizes for TCT-CT reached 3. Furthermore, at all assessment moments TCT or the combination TCT-CT was superior to AR-CT in reducing self-consciousness and self-focused attention. The superior long-term effect of TCT on fear of showing bodily symptoms is explained by lasting changes in attentional focus.",Bögels SM.,2006.0,10.1016/j.brat.2005.08.010,0,0,
10802,[Reorientational arthrodesis of the ankle joint using four screws].,"Arthrodesis of the ankle has gained wide acceptance as a first-line treatment option for painful posttraumatic osteoarthritis. The technique using four to five lag screws for internal osteosynthesis is a safe and biomechanically stable method to obtain a sound ankle fusion with good to excellent long-term results in the majority of patients. Malalignment hazards are minimized by preservation of the ankle mortise. The meticulous resection of all cartilage and sclerotic bone as well as an atraumatic surgical technique are essential for preventing major complications. The need for revision surgery is minimized by correction of talar malalignment, fusion with the foot in a 90 degrees position and preoperative evaluation of the subtalar joint. In a series of 40 ankle fusions fixed with the lag screw technique, 82.5% good to excellent results were obtained after 5.6 (4.8-7.6) years. No infection, stress fracture or non-union was seen. In cases of osteitis, osteonecrosis, osteoporosis, and poor soft-tissue condition, external fixation techniques are preferred. In the presence of severe loss of bone stock at the distal tibia, stability can be achieved by using a compression nail for tibiotalar fusion without additional subtalar arthrodesis.",Grass R.; Rammelt S.; Endres T.; Zwipp H.,2005.0,10.1007/s00132-005-0863-0,0,0,
10803,Cognitive behavioral therapy for public-speaking anxiety using virtual reality for exposure.,"This study used an open clinical trial to test a cognitive-behavioral treatment for public-speaking anxiety that utilized virtual reality as a tool for exposure therapy. Treatment was completed by participants (n = 10) meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria for social phobia, or panic disorder with agoraphobia in which public speaking was the predominantly feared stimulus. Treatment was conducted by a licensed psychologist in an outpatient clinic. Treatment consisted of eight individual therapy sessions, including four sessions of anxiety management training and four sessions of exposure therapy using a virtual audience, according to a standardized treatment manual. Participants completed standardized self-report questionnaires assessing public-speaking anxiety at pre-treatment, post-treatment, and 3-month follow-up. Participants were asked to give a speech to an actual audience at pre- and post-treatment. Results showed decreases on all self-report measures of public-speaking anxiety from pre- to post-treatment, which were maintained at follow-up (n = 8; all P = 05). Participants were no more likely to complete a speech post-treatment than at pre-treatment. This study provides preliminary evidence that a cognitive-behavioral treatment using virtual reality for exposure to public speaking may reduce public-speaking anxiety and suggests that further research with a controlled design is needed.",Anderson PL.; Zimand E.; Hodges LF.; Rothbaum BO.,2005.0,10.1002/da.20090,0,0,
10804,Random systematic sextant biopsy versus power doppler ultrasound-guided target biopsy in the diagnosis of prostate cancer: positive rate and clinicopathological features.,"To determine the efficacy of power Doppler ultrasound (PDU)in the diagnosis of prostate cancer, the rate of detection of cancer with PDU-guided target biopsy and sextant biopsy, the clinicopathological features of cancer positive specimens, and the relation between these two findings were studied. From January 1998 through March 2000, 302 men suspected to have prostate cancer underwent sextant biopsy in association with additional PDU-guided target biopsy. Cases with positive biopsy results were divided into 9 groups as follows: T0: sextant biopsy was positive, but target biopsy was negative; S0: all sextant biopsies were negative, but target biopsy was positive; S1 approximately S6: both sextant biopsy and target biopsy were positive (number indicates number of positive sextant biopsy); Tx: sextant biopsy was positive, but no target biopsy was performed owing to a lack of echogenic abnormalities. The Gleason score (GS) and percent organ confined disease (%OCD) were compared between these 9 groups. Cancer was pathologically detected in 143 of 302 patients (47.4%). PDU detected 39 of 49 digital rectal examination-negative cancers (79.6%) and 5 of 13 transrectal ultrasound-negative isoechoic cancers (38.5%). Of 143 biopsy-positive cases, 6 were in the T0 group (4.2%), 10 in S0 (7.0%), 119 in S1 approximately S6 (83.2%), and 8 in Tx (5.6%). Target biopsy missed 14 (sum of T0 and Tx) cancers, and sextant biopsy missed 10 (S0). The average GS in the Tx group was significantly lower than that in the other groups; consequently, the %OCD was significantly higher. Retrospective analysis revealed that the failure to obtain cancer tissue in 4 of the 6 cases in the T0 group is most likely due to technical failure in obtaining specimens. The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PDU were 90.2%, 77.4%, 78.2%, 89.8% and 83.4%, respectively. PDU in association with sextant biopsy is a useful tool for increasing the rate of detection of prostate cancer. Further advances in ultrasound technology may enable the detection of prostate cancer by target biopsy alone and consequently may reduce the number of unnecessary biopsies. However, PDU-guided target biopsy alone is insufficient for cancer detection at the present time because of possible technical failure in obtaining specimens and the existence of PDU-negative cancer. Although more evidence is required, PDU-negative cancer is suggested to be less aggressive clinically, possibly justifying a watch and wait policy.",Kimura G.; Nishimura T.; Kimata R.; Saito Y.; Yoshida K.,2005.0,,0,0,
10805,[Clinical study on treatment of obsessive compulsive neurosis by acupoint stimulating control].,"To study the clinical effect of acupoint stimulating control (ASC) in treating obsessive compulsive neurosis. The comparative study was conducted in 65 patients with obsessive compulsive neurosis, they were divided into two groups, the 33 patients in the control group treated with chlorimipramine and the 32 in the tested group treated with ASC. The therapeutic efficacy and adverse reaction were assessed according to the standard for clinical efficacy evaluation by Yale-Brown scale for obsession (Y-BOCS)and adverse reaction scale. The curative rate and markedly effective rate in the control group was 24.2% (8/33) and 27.3% (19/33), which in the tested group was 37.5% (12/32) and 34.4% (11/32) respectively. Significant difference was shown in comparison of Y-BOCS score between the two groups from the end of the 4th week of treatment (P < 0.05), indicating the efficacy in the tested group was better than that in the control group. Moreover, the occurrence of adverse reaction was higher in the control group than that in the tested group. ASC is a treatment with good effect, less adverse reaction and favourable safety superior to the treatment by chlorimipramine.",Feng B.; Liu LY.; Xu FZ.; Chen J.; Wang P.; Chen W.; Yu E.,2005.0,,0,0,6322
10806,Clinical presentations and treatment outcomes of peacekeeper veterans with PTSD: preliminary findings.,"Despite evidence of potential psychiatric sequelae following peacekeeping operations, no data have appeared on treatment outcome for this population. This study examined intake and treatment outcome data for a group of peacekeepers with posttraumatic stress disorder (PTSD). Participants were 63 Australian Vietnam veterans and 66 Australian peacekeepers attending specialized PTSD treatment units. Measures of PTSD, depression, anxiety, alcohol use, and anger were obtained at intake and 3-month follow-up. PTSD scores were more severe for peacekeepers than Vietnam veterans at intake, primarily in reexperiencing symptoms. In terms of comorbidity, only anger was higher among peacekeepers. No differences were apparent in treatment outcome. Initial anger predicted change in PTSD severity for peacekeepers. The finding of differences between peacekeepers and Vietnam veterans in anger and reexperiencing symptoms, in addition to the attenuating role of anger on treatment outcome, suggests that modification to standard PTSD treatment models may be warranted for peacekeepers.",Forbes D.; Bennett N.; Biddle D.; Crompton D.; McHugh T.; Elliott P.; Creamer M.,2005.0,10.1176/appi.ajp.162.11.2188,0,0,
10807,Quality of life in obsessive-compulsive disorder before and after treatment.,"The assessment of Quality of Life (QoL) is an important tool for elucidating target symptoms that are particularly bothersome to patients. The present study was designed to explore predictors of decreased QoL in obsessive-compulsive disorder (OCD) patients and to explore which aspects of QoL are most affected in OCD. Furthermore, the study investigated changes in QoL after treatment and the association between QoL change scores with symptomatic outcome. In line with prior research, it was expected that low QoL in OCD patients would be most pronounced for the emotional and social aspects of the construct. Seventy-nine OCD patients were initially recruited. Patients were assessed with the SF-36 both before and after treatment. Norm values were derived from the general population to characterize status of impairment. OCD patients were contrasted with published SF-36 scores from 2 OCD samples as well as a newly recruited psychiatric and healthy control sample. Correlations with QoL were most pronounced for depression severity and number of OCD symptoms. Apart from low social and emotional QoL in the majority of patients, a large subgroup also reported lower physical well-being. Decreased scores on this subscale were mainly associated with length of illness, depression, and number of compulsions. Overall, QoL was significantly improved in therapy responders relative to nonresponders. The results largely correspond to previous findings showing that OCD patients share severely compromised well-being. Somewhat unexpected from previous research, QoL deficits were not restricted to emotional and social aspects of QoL but extended to somatic domains. The present results suggest that clinicians should thoroughly explore for depression as well as physical impairments in OCD patients, which, when present, may be additionally targeted to achieve comprehensive treatment success.",Moritz S.; Rufer M.; Fricke S.; Karow A.; Morfeld M.; Jelinek L.; Jacobsen D.,,10.1016/j.comppsych.2005.04.002,0,0,
10808,Deciding who gets treatment for depression and anxiety: a study of consecutive GP attenders.,"Most research has focused on recognition by GPs of the common mental disorders: depression and anxiety. However, less is known about the factors that determine whether patients with those disorders that are recognised receive any active treatment. To investigate factors associated with receiving active treatment among consecutive attenders identified by GPs as having a common mental disorder. Data were collected as part of a cluster randomised controlled trial in 30 general practices in the south of Bristol, UK, on the impact of mental health guidelines in primary care. We studied 439 consecutive general practice attenders aged 16-64 years who were given a diagnosis of depression, anxiety, or chronic mixed anxiety and depression by their GP. The main outcome measure was the provision of any active treatment, whether pharmacological or psychological, for these disorders. Patient, GP, and practice level data, including sociodemographic, clinical, and administrative data were explored as predictors in a logistic regression model. Huber White variance estimates were used to account for hierarchical clustering. Of those patients identified as having a common mental disorder by the GP, 54% were offered active treatment. Higher symptom score, as measured by the General Health Questionnaire (GHQ) (odds ratio [OR] = 1.09; 95% confidence interval [CI] = 1.06 to 1.13; P<0.001) and being male (OR = 1.54; 95% CI = 1.13 to 2.09; P = 0.006), were both associated with an increased likelihood of being offered active treatment. Patients with anxiety (OR = 0.24; 95% = CI 0.14 to 0.41; P<0.001), or chronic mixed anxiety/depression (OR = 0.41; 95% CI = 0.23 to 0.73; P = 0.003) were less likely to be offered active treatment than those considered to have depression. When deciding to offer active treatment for common mental disorders, GPs appear to be influenced by the severity of symptoms rather than their 'understandability' in relation to recent life stresses or the social context of distress. Further research is needed to investigate why men are more likely and those with an anxiety disorder less likely, to be offered active treatment.",Hyde J.; Evans J.; Sharp D.; Croudace T.; Harrison G.; Lewis G.; Araya R.,2005.0,,0,0,
10809,Using augmented reality to treat phobias.,,Juan MC.; Alcañiz M.; Monserrat C.; Botella C.; Baños RM.; Guerrero B.,,,0,0,
10810,School-based intervention for adolescents with social anxiety disorder: results of a controlled study.,"Social anxiety disorder, whose onset peaks in adolescence, is associated with significant impairment. Despite the availability of effective treatments, few affected youth receive services. Transporting interventions into schools may circumvent barriers to treatment. The efficacy of a school-based intervention for social anxiety disorder was examined in a randomized wait-list control trial of 35 adolescents (26 females). Independent evaluators, blind to treatment condition, evaluated participants at preintervention, postintervention, and 9 months later. Adolescents in the intervention group demonstrated significantly greater reductions than controls in social anxiety and avoidance, as well as significantly improved overall functioning. In addition, 67% of treated subjects, compared to 6% of wait-list participants, no longer met criteria for social phobia following treatment. Findings support the possible efficacy of school-based intervention for facilitating access to treatment for socially anxious adolescents.",Masia-Warner C.; Klein RG.; Dent HC.; Fisher PH.; Alvir J.; Albano AM.; Guardino M.,2005.0,10.1007/s10802-005-7649-z,0,0,
10811,Changes in depression and anxiety after resective surgery for epilepsy.,"To determine changes in depression and anxiety after resective surgery. Data from subjects enrolled in a prospective multicenter study of resective epilepsy surgery were reviewed with the Beck Psychiatric Symptoms Scales (Beck Depression Inventory [BDI] and Beck Anxiety Inventory [BAI]) and Composite International Diagnostic Interview (CIDI) up to a 24-month period. chi2 analyses were used to correlate proportions. A total of 358 presurgical BDI and 360 BAI results were reviewed. Moderate and severe levels of depression were reported in 22.1% of patients, and similar levels of anxiety were reported by 24.7%. Postoperative rates of depression and anxiety declined at the 3-, 12-, and 24-month follow-up periods. At the 24-month follow-up, moderate to severe levels of depression symptoms were reported in 17.6 and 14.7% of the patients who continued to have postoperative seizures. Moderate to severe depression and anxiety were found in 8.2% of those who were seizure-free. There was no relationship, prior to surgery, between the presence or absence of depression and anxiety and the laterality or location of the seizure onset. There were no significant relationships between depression or anxiety at 24-month follow-up and the laterality or location of the surgery. Depression and anxiety in patients with refractory epilepsy significantly improve after epilepsy surgery, especially in those who are seizure-free. Neither the lateralization nor the localization of the seizure focus or surgery was associated with the risk of affective symptoms at baseline or after surgery.",Devinsky O.; Barr WB.; Vickrey BG.; Berg AT.; Bazil CW.; Pacia SV.; Langfitt JT.; Walczak TS.; Sperling MR.; Shinnar S.; Spencer SS.,2005.0,10.1212/01.wnl.0000187114.71524.c3,0,0,
10812,[Effect of nasal obstruction on subjective assessment of sleep quality by the patients with obstructive sleep apnea].,"In 52 patients with Obstructive Sleep Apnea Syndrome (OSAS) and nasal obstruction due to nasal septum deformation, hypertrophy of inferior nasal concha or posttraumatic external nose deformity the evaluation of the day somnolence using the Epworth Scale was carried out. The patients were randomly divided in to two groups. The first group consisted of 40 patients who were subjected to appropriate corrective surgery of the nasal obstruction. The remaining 12 patients constituted the control group. After 3 month each of the patients was asked to fill in the same questionnaire. Among the patients who underwent the surgical procedure day somnolence intensity was decreased approximately 2 times whereas in the control group no significant changes were observed. Results of this study could be crucial for the discussion concerning the complex influence of the nasal obstruction on the pathomechanism and symptomatology of obstructive breathing disorders during sleep.",Balcerzak J.; Arcimowicz M.; Byśkiniewicz K.; Bielicki P.; Korczyński P.; Niemczyk K.; Chazan R.,2005.0,,0,0,5320
10813,Worrying about chronic pain. An examination of worry and problem solving in adults who identify as chronic pain sufferers.,"Worry is a common feature of chronic pain. The purpose of this study was to examine the extent of worry experienced by adults with chronic pain, and to explore features of problem solving associated with worry and chronic pain. A further purpose was to investigate whether there were differences in worry and problem solving for those presenting at a pain clinic for treatment, compared to those who identified as chronic pain sufferers but who were not presenting for treatment. A final purpose was to examine whether the extent of worry and problem solving attitudes helped to predict the primary clinical features of chronic pain such as intensity, disability and depressive mood. One hundred and eighty five adults with chronic pain provided completed questionnaires assessing worrying, problem solving, pain severity, disability, catastrophic thinking and depressive mood. Analyses showed that worry and problem solving approaches sampled in this study were not abnormal. Furthermore, no differences were found between the clinical and non-clinical sample for worrying and problem solving. In relation to the predictive value of worrying and problem solving, analyses revealed that only worrying had a unique contribution in explaining depressive mood. The results are discussed within a context of a model of worry and chronic pain, in which worry about chronic pain may be functioning to promote awareness of an insoluble problem.",De Vlieger P.; Crombez G.; Eccleston C.,2006.0,10.1016/j.pain.2005.10.022,0,0,
10814,Hypnotherapy and cognitive behaviour therapy of acute stress disorder: a 3-year follow-up.,"The long-term benefits of cognitive behaviour therapy (CBT) for trauma survivors with acute stress disorder were investigated by assessing patients 3 years after treatment. Civilian trauma survivors (n=87) were randomly allocated to six sessions of CBT, CBT combined with hypnosis, or supportive counselling (SC), 69 completed treatment, and 53 were assessed 2 years post-treatment for post-traumatic stress disorder (PTSD) with the Clinician-Administered PTSD Scale. In terms of treatment completers, 2 CBT patients (10%), 4 CBT/hypnosis patients (22%), and 10 SC patients (63%) met PTSD criteria at 2-years follow-up. Intent-to-treat analyses indicated that 12 CBT patients (36%), 14 CBT/hypnosis patients (46%), and 16 SC patients (67%) met PTSD criteria at 2-year follow-up. Patients who received CBT and CBT/hypnosis reported less re-experiencing and less avoidance symptoms than patients who received SC. These findings point to the long-term benefits of early provision of CBT in the initial month after trauma.",Bryant RA.; Moulds ML.; Nixon RD.; Mastrodomenico J.; Felmingham K.; Hopwood S.,2006.0,10.1016/j.brat.2005.04.007,0,0,
10815,"An Internet-based self-change program for traumatic event related fear, distress, and maladaptive coping.","This study compared the efficacy of an Internet-based, 8-week self-help program for traumatic event-related consequences (SHTC) (n = 13) to a wait-list (WL) condition (n = 14). The SHTC consisted of cognitive-behavioral modules that progressed from the least anxiety-provoking component (i.e., information) to the most anxiety-provoking (i.e., exposure). Participants were those who had experienced a traumatic event and had been experiencing subclinical levels of symptoms associated with the event. Participants mastered the material in each module before proceeding to the next module. Pre- and post-treatment assessments revealed that SHTC participants decreased avoidance behavior, frequency of intrusive symptoms, state anxiety, and depressive symptoms, and increased coping skills and coping self-efficacy significantly more than WL participants. SHTC participants demonstrated more clinically significant improvement than WL individuals.",Hirai M.; Clum GA.,2005.0,10.1002/jts.20071,0,0,
10816,Panic disorder with and without agoraphobia: comorbidity within a half-year of the onset of panic disorder.,"The present study was performed to compare the clinical features of patients with panic disorder with and without agoraphobia. The subjects were 233 outpatients with panic disorder (99 males and 134 females) diagnosed according to DSM-IV criteria. Sixty-three patients met the criteria for panic disorder without agoraphobia, and 170 met the criteria for panic disorder with agoraphobia. Patients with agoraphobia showed a significantly longer duration of panic disorder and higher prevalence of generalized anxiety disorder. However, there were no significant differences in prevalence of major depressive episodes, in current severity of panic attacks, or in gender ratio between the two groups. The second aim of the present study was to investigate the effects of onset age and sex differences on the development of agoraphobia within a half-year. The subjects were divided into two groups according to their self-report: patients who did or did not develop agoraphobia within 24 weeks of onset of panic disorder. A total of 40.6% of the patients developed agoraphobia within 24 weeks of the onset of panic disorder, and onset age and sex differences had no robust effect on the development of agoraphobia within 24 weeks.",Kikuchi M.; Komuro R.; Oka H.; Kidani T.; Hanaoka A.; Koshino Y.,2005.0,10.1111/j.1440-1819.2005.01430.x,0,0,
10817,[Chronic post-traumatic headache and brain perfusion changes assessed using magnetic resonance imaging].,"Headache after a head injury is one of the most frequent symptoms in patients after craniocerebral trauma. The aim of the study was to investigate changes in brain perfusion in patients with chronic post-traumatic headache a long time after craniocerebral trauma. PWI gives us the exact information about the brain circulation. Clinical measures included 52 patients (24 women and 28 men) aged from 20 to 56 years (mean age 42.3 years) suffering from chronic post-traumatic headache after moderate and severe craniocerebral trauma, 6-18 months after the head injury. The Glasgow Coma Scale (GCS) and Abbreviated Injury Scale (AIS) were used to evaluate the severity of the head injury. The PWI (Perfusion Weighted Imaging) study was made in all patients. In the study group in the PWI study the domination of perfusion disturbances in frontal lobes were seen in 38 patients (59.6%). Statistical analysis showed no significant correlation between character, intensity, localization of headache and changes in the PWI. In 22 patients with localized headache the highest percentage of changes in PWI matched with localization of headache were observed in frontal lobes--40.9% in the right frontal lobe, 31.8% in the left frontal lobe, and in the right temporal lobe--22.7%. In accessible references no publications concerning changes in the PWI in chronic post-traumatic headache were found. The results suggest the occurrence of brain perfusion disturbances a long time after craniocerebral trauma, which were most marked in frontal lobes, without any statistically significant correlation with chronic post-traumatic headache.",Lyczak P.; Lyczak-Rucińska M.,2005.0,,0,0,
10818,Written emotional expression and religion: effects on PTSD symptoms.,"Previous research has found an association between writing about traumatic events and well-being. This study examined the effects of taking a religious perspective during a trauma-writing exercise. Participants included 177 college students who were assigned randomly to either a conventional trauma writing or a religious trauma writing condition. Participants in the conventional writing condition were instructed to write about a traumatic experience, while participants in the religious writing condition were instructed to write about the trauma from a religious/spiritual perspective. Well-being was assessed by symptoms of PTSD at one-month follow-up. Writing condition was found to interact with trauma severity and gender to affect PTSD symptoms at follow-up. Conventional writing was more effective (in reducing PTSD symptoms) for participants reporting lower trauma severity than for those who reported higher trauma severity. Effects of religious writing on PTSD symptoms were not influenced by trauma severity. Also, women benefited more from religious writing than men did with regard to reductions in PTSD symptoms. It appears possible to adapt the conventional written emotional expression procedure in a way that encourages individuals to take a religious perspective, thereby augmenting effects on distress. These findings support further investigation of integrating religion into trauma interventions, particularly for individuals exposed to highly traumatic events.",Chen YY.,2005.0,10.2190/2X0U-0CTB-Y877-5DRQ,0,0,
10819,Uncertainty management intervention for older African American and caucasian long-term breast cancer survivors.,"The survivor uncertainty management intervention study is a randomized controlled study designed to test the efficacy of an intervention that combines training in audiotaped cognitive behavioral strategies to manage uncertainty about cancer recurrence with a self-help manual designed to help women understand and manage long-term treatment side effects and other symptoms. Specifically, women were taught to recognize their own personal triggers of uncertainty (places, events or surroundings, that bring back memories, feelings, or concerns about breast cancer), and then use coping skills such as relaxation, distraction, and calming self-talk to deal with uncertainty. Also, women were taught to use the manual as a resource for dealing with fatigue, lymphedema, pain and other symptoms. Treatment outcome data (Mishel et al., in press) indicated that the uncertainty management intervention resulted in improvements in cognitive reframing, cancer knowledge, social support, knowledge of symptoms and side effects, and coping skills when compared to a control condition. The purpose of the present paper was to report on the use and helpfulness of the intervention components by the 244 women who were in the intervention. Findings indicated that women regularly used the intervention components to deal with triggers of breast cancer recurrence and long-term treatment side effects and most women found the strategies very helpful.",Gil KM.; Mishel MH.; Germino B.; Porter LS.; Carlton-LaNey I.; Belyea M.,2005.0,,0,0,
10820,[Duration effect on neuropsychological function and treatment response of OCD].,"Because of inconsistency among previous reports that examined neuropsychological function and treatment response of OCD patients, we here consider the heterogeneity of OCD; for example: symptom-based clusters, degree of insight, age of onset, and comorbid diagnoses. In this study, we examined neuropsychological function and the treatment response of OCD patients. Thirty-two OCD patients participated in this study. We examined their clinical symptoms by Y-BOCS, MOCI and other scales, and examined their cognitive function with several neuropsychological tests including: WAIS-R, Stroop test, WCST, WMS-R and R-OCFT. We then randomly assigned them to three treatment packages including: behavior therapy, pharmacotherapy by fluvoxamine, and controlled therapy. The patients were divided into two groups by duration of illness: short to middle range group (Group S, n=17, 5.5+/-3.1 years), and long range group (Group L, n=15, 20.3+/-6.1 years). The mean age of Group L was higher than that of Group S (Group S: 30.6+/-9.7 years old, Group L: 36.1+/-6.2 years old). There was no significant group difference in sex ratio or number of years of education. The mean age of onset of Group L was significantly lower than that of Group S (Group S; 25.5+/-10.2 years old, Group L; 15.3+/-7.1 years old). The total Y-BOCS mean score and MOCI score showed no group differences. These two groups showed similar clinical characteristics such as the severity of OC symptom, OC subtypes, and comorbid depression. Group S, however, demonstrated significantly more obsession with the need for correction. Group L had significantly higher levels of anxiety and compulsion. There were also no group differences in the mean HDRS or STAI scores. As a result, compared to Group S, Group L showed significant attention deficit in the Stroop test and the WMS-R though other neuropsychological dysfunctions such as intellectual level, executive function, verbal memory, and nonverbal memory were found in this group. Concerning treatment response, Group L showed little improvement by pharmacotherapy. Behavior therapy brought significant improvement to all patients of both groups. Long duration of the illness might cause attention deficit and a lowered pharmaceutical response in OCD patients.",Nakao T.; Nakatani E.; Nabeyama M.; Yoshioka K.; Tomita M.; Nakagawa A.,2005.0,,0,0,6785
10821,[Effectiveness of treatment in day hospital versus inpatient ward evaluated by patients' psychopathological symptoms and subjective quality of life (QoL) analysis].,"The authors analyzed patients' psychopathological symptoms and subjective quality of life (QoL) for evaluating the effectiveness of treatment in day hospital versus inpatient wards. Analyses concerned patients from Wrocław and recruited within the framework of an EU funded multi-centre study EDEN. 238 patients admitted to the Psychiatric Hospital in Wrocław were randomly assigned to treatment in either day hospital (n=l15) or inpatient ward (n=123). Patients were interviewed at 4 time-points comprising their stay in hospital. Differences between settings in terms of dynamics of psychopathological symptoms and subjective QoL were expressed in mean scores of BPRS subscales and MANSA. Two parameters of effectiveness were considered: the static--the score on the scale at a given time-point and average score level, and the dynamic--describing dynamics of changes (gradients). Statistical methods included ANOVA and ANCOVA with co-variables. In terms of manic and excitement symptoms inpatient wards proved to be more effective as measured at discharge, no differences in dynamics between settings were found. Day hospital was superior in alleviating negative symptoms during treatment but improvement in that respect was quicker in the inpatient ward. In terms of alleviating positive symptoms, the inpatient ward was more effective only at the beginning of the treatment. Day hospital was more effective in handling symptoms of depression and anxiety but only at the beginning of treatment. Dynamics of subsiding of the symptoms at the beginning of hospitalization was better for the inpatient ward. No differences in QoL in both settings were found. Taking into consideration the static and the dynamic parameters of effectiveness of treatment, the superiority of inpatient treatment over day hospital has not been, therefore, definitely proven.",Adamowski T.; Hadryś T.; Rymaszewska J.; Kiejna A.,,,0,0,6001
10822,Retrospective cross-evaluation of an histological and deformable 3D atlas of the basal ganglia on series of Parkinsonian patients treated by deep brain stimulation.,"In functional neurosurgery, there is a growing need for accurate localization of the functional targets. Since deep brain stimulation (DBS) of the Vim thalamic nucleus has been proposed for the treatment of Parkinson's disease, the target has evolved toward the globus pallidus and subthalamic nucleus (STN) and the therapeutic indications have enlarged to include psychiatric disorders such as Tourette syndrome or obsessive compulsive disorders. In these pathologies, the target has been restrained to smaller functional subterritories of the basal ganglia, requiring more refined techniques to localize smaller and smallerbrain regions, often invisible in routine clinical MRI. Different strategies have been developed to identify such deep brain targets. Direct methods can identify structures in the MRI itself, but only the larger ones. Indirect methods are based on the use of anatomical atlases. The present strategy comprised a 3D histological atlas and the MRI of the same brain specimen, and deformation methodology developped to fit the atlas toward the brain of any given patient. In this paper, this method is evaluated in the aim of being applied to further studies of anatomo-clinical correlation. The accuracy of the method is first discussed, followed by the study of short series of Parkinsonian patients treated by DBS, allowing to compare the deformed atlas with various per- and post-operative data.",Bardinet E.; Dormont D.; Malandain G.; Bhattacharjee M.; Pidoux B.; Saleh C.; Cornu P.; Ayache N.; Agid Y.; Yelnik J.,2005.0,,0,0,
10823,Introversion and individual differences in middle ear acoustic reflex function.,A growing body of psychophysiological evidence points to the possibility that individual differences in early auditory processing may contribute to social withdrawal and introverted tendencies. The present study assessed the response characteristics of the acoustic reflex arc of introverted-withdrawn and extraverted-sociable individuals. Introverts displayed a greater incidence of abnormal middle ear acoustic reflexes and lower acoustic reflex amplitudes than extraverts. These findings were strongest for stimuli presented at a frequency of 2000 Hz. Results are discussed in light of the controversy concerning the anatomic loci (peripheral vs. central neuronal activity) of the individual differences between introverts and extraverts in early auditory processing.,Bar-Haim Y.,2002.0,,0,0,
10824,Feasibility of ultrasound examination in posterior ligament complex injury of thoracolumbar spine fracture.,"A prospective study of 12 patients with thoracolumbar spinal fractures was conducted. To assess the feasibility of ultrasound examination for posterior ligament complex injury in thoracolumbar spinal fractures. In posterior ligament complex injury of thoracolumbar spine fracture, the reliability of magnetic resonance imaging (MRI) for diagnosis has been reported. Nevertheless the usefulness of ultrasound for diagnosis has not been studied, whereas diagnostic ultrasound has been applied in the musculoskeletal system. Two healthy volunteers without a history of spinal trauma were recruited for pilot examination of the ultrasound procedure to access normal findings of the posterior ligament complex. This study investigated 12 thoracolumbar spine fractures. Four were flexion distraction injury; six were stable or unstable burst fractures; and two were simple compression fractures. Osteoporotic spine fractures were excluded from this study. Ultrasound was performed over the injured area by an experienced musculoskeletal radiologist in addition to radiography and MRI. Five patients underwent operative procedures to stabilize the fractured spine. Imaging data and operative findings were correlated with ultrasound examination. In the patients who did not undergo surgery, agreement in diagnosis between MRI and ultrasound was moderate (5 of 7). Difficulty evaluating ligament status was encountered when the region of interest was the lower thoracic level (T10, T11, T12) because of long overlapping spinous processes. In the patients who underwent surgery, correlation between MRI, ultrasound, and operative findings was excellent, especially in diagnosing the status of the supraspinous and interspinous ligaments. Nevertheless, it is impossible to visualize deep-seated structures (i.e., ligamentum flavum, deep muscles of the spine, and facet joint) with ultrasound. This study demonstrated the excellent diagnostic ability of ultrasound to detect the status of the supraspinous and interspinous ligaments, especially in patients who undergo surgery. Although ultrasound examination appears to be less sensitive than MRI in predicting ligament status, the cost effectiveness of ultrasound and its use as an alternative to MRI in special situations (i.e., patients with pacemaker, ferromagnetic implant, or severe claustrophobia) should be emphasized. More clinical data concerning the sensitivity, specificity, and accuracy of ultrasound examination should be addressed in future studies.",Moon SH.; Park MS.; Suk KS.; Suh JS.; Lee SH.; Kim NH.; Lee HM.,2002.0,10.1097/01.BRS.0000025688.94630.70,0,0,
10825,The role of bibliotherapy in health anxiety: an experimental study.,"Despite its high prevalence and implications for health care resources, health anxiety is generally considered difficult and expensive to manage. Structured self-help materials (bibliotherapy) using a cognitive behaviour therapy (CBT) treatment approach have been shown to be clinically effective. This experimental study investigated the effects of bibliotherapy on patients who had been identified as demonstrating health concerns. The 40 participants (patients drawn from GP surgeries) were randomly allocated to two groups, one receiving bibliotherapy and the other not. Half the patients had a medically diagnosed problem. Anxiety was assessed before and after the bibliotherapy intervention, which took the form of a cognitive-behavioural self-help booklet for health anxiety sufferers. Patients in the bibliotherapy group showed reduced levels of anxiety at post-test, even when they also had an identifiable physical problem. These results are consistent with the idea that self-help materials can be an effective and accessible intervention in CBT, although further research is recommended.",Jones FA.,2002.0,,0,0,
10826,Using acupuncture to treat premenstrual syndrome.,"More than 60% of the women in both groups suffered from premenstrual syndrome (PMS) symptoms, such as anxiety, mastalgia, insomnia, nausea and gastrointestinal disorders, whereas a smaller number of women suffered from phobic disorders, premenstrual headaches and migraines. There were three women from the first group and seven women from the second group who continued the medication treatment with progestins, whereas one woman from the first group and nine women from the second group continued to take fluoxetine. In the first group, nine women stopped having PMS symptoms after two AP treatments, eight women stopped having them after three treatments and one woman stopped having them after four treatments. In four women from the first group and 16 women from the second group, PMS symptoms appeared during the following period (cycle) or continued even after four treatments, so the medication was continued. In the first group, one woman had a smaller subcutaneous hematoma after the AP acupoint Ren 6. There was a statistical and relevant reduction in PMS symptoms with the AP treatments in the first group (P<0.001), whereas their reduction was irrelevant in the placebo AP group (P>0.05). The success rate of AP in treating PMS symptoms was 77.8%, whereas it was 5.9%. in the placebo group. The positive influence of AP in treating PMS symptoms can be ascribed to its effects on the serotoninergic and opioidergic neurotransmission that modulates various psychosomatic functions. The initial positive results of PMS symptoms with a holistic approach are encouraging and AP should be suggested to the patients as a method of treatment.",Habek D.; Habek JC.; Barbir A.,2002.0,10.1007/s00404-001-0270-7,0,0,
10827,A test of the phase model of psychotherapy change.,"A comparative trial of 2 forms (interpretive and supportive) of short-term, time-limited individual (STI) therapy provided data that were used to test the propositions of the Howard and others phase model of psychotherapy change. Patients completed the Integra Outpatient Tracking Assessment Form on 5 occasions during the 20-session treatments. The measure assesses 3 dimensions: subjective well-being, current symptoms, and current life dysfunction. Howard and others regard these as dimensions that represent successive phases in the therapy change process (that is, well-being improves first, followed by resolution of symptoms, and finally by change in long-standing life dysfunction). We conducted a test of their model, using their approach to data analysis. The comparative trial data provided no support for the phase model. Possible explanations for the absence of confirmatory findings are considered.",Joyce AS.; Ogrodniczuk J.; Piper WE.; McCallum M.,2002.0,10.1177/070674370204700807,0,0,
10828,Relationship between fluid intelligence and ability to benefit from cognitive-behavioural therapy in older adults: a preliminary investigation.,"The aim of this study was to conduct a preliminary evaluation of the hypothesis that fluid intelligence in older adults is associated with the ability to benefit from cognitive-behavioural therapy (CBT), but unrelated to the ability to benefit from non-directive supportive counselling (SC). A sample of 32 older adults who had completed a randomized controlled trial course of either CBT (N = 16) or SC (N = 16) for anxiety disorders took part in the study. The Raven's Coloured Progressive Matrices (RCPM) test was used to assess fluid intelligence. The Beck Anxiety Inventory change scores between pre-treatment and post-treatment were used as an index of ability to benefit from therapy. A measure of depressive symptomatology was also administered to control statistically for the effects of depression on intellectual functioning. The results for the SC group showed a significant and positive association between fluid intelligence scores and anxiety change scores, such that older adults with higher levels of fluid intelligence demonstrated the most benefit from this intervention. In contrast, there was no significant association between level of fluid intelligence and ability to benefit from therapy in the CBT group. CBT for anxiety disorders is suitable for older adults, irrespective of their fluid intelligence, while the nature of SC may render it more sensitive to level of fluid intelligence.",Doubleday EK.; King P.; Papageorgiou C.,2002.0,,0,0,
10829,"Treatment of generalised anxiety disorder with a short course of psychological therapy, combined with buspirone or placebo.","Very few studies have examined the combination of drug and psychological treatment in generalised anxiety disorder (GAD). Theoretically, buspirone should be a useful drug to combine with a learning-based therapy. Sixty patients with GAD were randomly assigned to treatment with buspirone or placebo, combined with anxiety management training or non-directive therapy for a period of 8 weeks. Forty-four patients with a mean Hamilton Anxiety Scale score of 28 completed treatment. There were no significant differences between treatment groups. All groups showed significant improvement after 8 weeks compared to baseline. There were no baseline differences between those who completed the trial and those who did not but patients given buspirone were more likely to drop out. A short course of psychological therapy, whether or not accompanied by active medication, was an effective treatment for patients diagnosed as having quite severe symptoms of GAD. CLINICAL IMPLICATIONS AND LIMITATIONS: Dropouts led to a sample size which may have been too small to detect group differences. Cognitive therapy may have been more effective.",Bond AJ.; Wingrove J.; Valerie Curran H.; Lader MH.,2002.0,,0,0,
10830,Syndrome profiles in alcoholism and panic disorder with or without agoraphobia: an explorative family study.,"It is proposed that alcoholism and panic disorder/agoraphobia demonstrate in part common genetic and environmental origins. Shared subthreshold symptom patterns in the parents' generation could confirm the proposed genetic role in alcoholism and panic disorder/agoraphobia, even if the parents do not fulfil the diagnostic criteria for a primary psychiatric diagnosis. This is the first family study of exploratively analyzing subthreshold symptoms in both disorders. The authors investigated families with panic disorder/agoraphobia and/or alcoholism with the Munich-Composite International Diagnostic Interview (M-CIDI). We documented the diagnoses according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and subdivided the answers of the probands into 16 subthreshold diagnostic groups comprising 259 single items. We found statistically significant correlations of subthreshold syndrome profiles in the parents of patients with panic disorder/agoraphobia and alcoholism. The presented method of analyzing syndrome profiles in a family study seems to be a possibility to demonstrate references to genetic links between patients and parents in anxiety- and alcohol-related disorders.",Davids E.; Müller MJ.; Rollmann N.; Burkart M.; Regier-Klein E.; Szegedi A.; Benkert O.; Maier W.,2002.0,,0,0,
10831,Treating medication-resistant panic disorder: predictors and outcome of cognitive-behavior therapy in a Brazilian public hospital.,"In Brazil, treatment of panic disorder is most frequently initiated with pharmacotherapy, but only half of the patients can be expected to be panic free after medication. Studies have suggested that individual or group cognitive-behavior therapy (CBT) is an effective treatment strategy for panic patients who have failed to respond to pharmacotherapy. Thirty-two patients diagnosed with panic disorder with agoraphobia having residual symptoms despite being on an adequate dose of medication were treated with 12 weeks of group CBT. The outcome was evaluated for panic frequency and severity, generalized anxiety, and global severity. Comorbid conditions, a childhood history of anxiety, and defense mechanism styles were assessed as potential predictors of treatment response. Twenty-nine patients completed the 12-week protocol. Treatment was associated with significant reductions in symptom severity on all outcome measures (p < 0.001). Patients with depression had a poorer outcome of the treatment (p = 0.01) as did patients using more neurotic (p = 0.002) and immature defenses (p = 0.05). Consistent with previous reports, we found that CBT was effective for our sample of treatment-resistant patients. Among these patients, depression as well as neurotic defense style was associated with a poorer outcome. The use of CBT in Brazil for treatment-resistant and other panic patients is encouraged.",Heldt E.; Manfro GG.; Kipper L.; Blaya C.; Maltz S.; Isolan L.; Hirakata VN.; Otto MW.,,67188,0,0,
10832,Cost-effectiveness and cost offset of a collaborative care intervention for primary care patients with panic disorder.,"A collaborative care (CC) intervention for patients with panic disorder that provided increased patient education and integrated a psychiatrist into primary care was associated with improved symptomatic and functional outcomes. This report evaluates the incremental cost-effectiveness and potential cost offset of a CC treatment program for primary care patients with panic disorder from the perspective of the payer. We randomly assigned 115 primary care patients with panic disorder to a CC intervention that included systematic patient education and approximately 2 visits with an on-site consulting psychiatrist, compared with usual primary care. Telephone assessments of clinical outcomes were performed at 3, 6, 9, and 12 months. Use of health care services and costs were assessed using administrative data from the primary care clinics and self-report data. Patients receiving CC experienced a mean of 74.2 more anxiety-free days during the 12-month intervention (95% confidence interval [CI], 15.8-122.0). The incremental mental health cost of the CC intervention was $205 (95% CI, -$135 to $501), with the additional mental health costs of the intervention explained by expenditures for antidepressant medication and outpatient mental health visits. Total outpatient cost was $325 (95% CI, -$1460 to $448) less for the CC than for the usual care group. The incremental cost-effectiveness ratio for total ambulatory cost was -$4 (95% CI, -$23 to $14) per anxiety-free day. Results of a bootstrap analysis suggested a 0.70 probability that the CC intervention was dominant (eg, lower costs and greater effectiveness). A CC intervention for patients with panic disorder was associated with significantly more anxiety-free days, no significant differences in total outpatient costs, and a distribution of the cost-effectiveness ratio based on total outpatient costs that suggests a 70% probability that the intervention was dominant, compared with usual care.",Katon WJ.; Roy-Byrne P.; Russo J.; Cowley D.,2002.0,,0,0,
10833,"Cognitive processing, memory, and the development of PTSD symptoms: two experimental analogue studies.","Memory deficits are implicated in the development of posttraumatic stress disorder (PTSD). Intentional recall of trauma memories is frequently disorganised or incomplete, whilst involuntary memory fragments are easily triggered by perceptual cues. Ehlers and Clark (Behaviour Research and Therapy 38 (2000) 319-345) propose that a predominance of data-driven processing (i.e., processing sensory impressions) during the trauma contributes to the development of this memory pattern, and therefore, predicts PTSD symptoms after trauma. Two experimental studies examined these hypotheses. Student volunteers viewed a distressing videotape as an analogue for a traumatic event. In Study 1, cognitive processing was manipulated; in Study 2, extreme scorers on a processing screening questionnaire were pre-selected. The results indicated that data-driven processing is associated with the development of PTSD-like memories and analogue symptoms.",Halligan SL.; Clark DM.; Ehlers A.,2002.0,,0,0,
10834,Repetitive transcranial magnetic stimulation for Tourette syndrome.,"In a single-blinded, placebo-controlled, crossover repetitive transcranial magnetic stimulation (rTMS) trial, 16 patients with Gilles de la Tourette syndrome (GTS) received in random sequence 1 Hz motor, premotor, and sham rTMS, which each consisted of two 20-minute rTMS sessions applied on 2 consecutive days. In the 12 patients who completed the trial, there was no significant improvement of symptoms after any of the rTMS conditions as assessed with the Motor tic, Obsessions and compulsions, Vocal tic Evaluation Survey.",Münchau A.; Bloem BR.; Thilo KV.; Trimble MR.; Rothwell JC.; Robertson MM.,2002.0,,0,0,
10835,The Trauma Recovery and Empowerment Model (TREM): conceptual and practical issues in a group intervention for women.,"This article describes the Trauma Recovery and Empowerment Model (TREM), a manualized group intervention designed for women trauma survivors with severe mental disorders, and discusses key issues in its conceptualization and implementation. TREM recognizes the complexity of long-term adaptation to trauma and addresses a range of difficulties common among survivors of sexual and physical abuse. Focusing primarily on the development of specific recovery skills and current functioning, TREM utilizes techniques shown to be effective in trauma recovery services. The group's content and structure are also informed by the role of gender in the ways women experience and cope with trauma.",Fallot RD.; Harris M.,2002.0,,0,0,
10836,Theories of general personality and mental disorder.,"A major shortcoming of current research into personality is its failure to explore the relationship between theories of general personality and mental disorder. To provide preliminary data to address this deficit. In the first of two studies, we examined the relationship between the Neuroticism, Extraversion and Other - Five-Factor Inventory (NEO-FFI) and DSM personality disorders in a consecutive series of mentally disordered offenders. In the second, we sought to separate the personality dimension neuroticism from symptoms of depressive disorder in a sample of subjects with current depression. Factors from the NEO-FFI were associated with different personality disorders in a predictable manner (first study). It was possible to identify a component of neuroticism (i.e. 'worry') that could be separated from depressive symptoms (second study). Theories of general personality theory can enlighten and refine descriptions of abnormal mental states by informing both their aetiology and their prognosis.",Duggan C.; Milton J.; Egan V.; McCarthy L.; Palmer B.; Lee A.,2003.0,,0,0,
10837,[Effect of group psychotherapy on changes in symptoms and personality traits in patients with anxiety syndromes].,"Psychotherapy remains the most efficient form of treatment in neurotic and personality disorders. It is a process whereby the therapist can influence and change the patient's personality. As a result, patients are able to better understand their experiences and behavior and are given a chance to be freed from symptoms. The goal of the present study was to establish the relationship between group psychotherapy and specific symptom clusters, and to follow changes in the personality structure of patients of both genders diagnosed according to ICD-10 classification. The Symptoms Questionnaire and the Personality Factor test were used to determine the severity of symptoms and study personality traits. The study group consisted of 115 patients (76 women and 39 men) with neurotic or personality disorders, participating in group therapy at the Day Care Unit of the Department of Psychiatry, Pomeranian Academy of Medicine in Szczecin between 1992 and 1998. Four groups were formed depending on the diagnosis according to ICD-10 classification: anxiety disorders--F41; somatic disorders--F45; neurotic disorders--F48; and personality disorders--F60 (Table 1). Treatment started and ended with a CV Questionnaire, Symptoms Questionnaire and Personality Factor test. Group psychotherapy was in the open form and the duration of treatment was 12 weeks with 2 sessions per day. In order to detect any improvement in mental health and symptoms, patients were given the Symptoms Questionnaire on a weekly basis. Statistics were done with the SPSS software package. It was found that the global intensity of symptoms before treatment was highest in patients with somatic form of the disorder. In this group after therapy, the intensity of symptoms was lowest, probably because of conversion of primary to secondary anxiety. A considerable decrease in the intensity of symptoms may also be explained by stronger motivation of these patients to benefit from therapy because of their severe symptoms. A link between the clinical diagnosis according to ICD-10 and some symptoms reported by the patients was noted. Thus, the Symptoms Questionnaire could be a useful tool precisely revealing specific symptoms in some disorders. No statistically significant differences on the Symptoms Questionnaire scale based on ICD-10, nor any differences in personality traits were found. The personality traits were different for men and women before and after therapy. As for hysterical symptoms, improvement was greater in women. After psychotherapy, the structure of personality traits improved in both sexes (Fig. 1). An essential alleviation of symptoms was found at the beginning and at the end of treatment (Table 2). The main conclusions are: 1. Group psychotherapy is an efficient method of treatment for patients who suffer from anxiety-related disorders. 2. The Symptoms Questionnaire and Personality Factor test were very useful for assessing the results of psychotherapy. 3. Alleviation of symptoms during treatment differed between men and women in 3 out of 13 symptom clusters and no significant differences between disorders according to ICD-10 were found. Consequently, these criteria are of little value for preliminary evaluation of therapeutic success. 4. Alleviation of symptoms was observed at the beginning and end of treatment. Symptom severity remained constant in the middle part of treatment.",Kamiński R.,2001.0,,0,0,
10838,Spontaneous decay of compulsive urges: the case of covert compulsions.,"It is well established that many patients with obsessive-compulsive disorder have covert, or internal, compulsions. Empirical studies of this phenomenon, however, are limited. The present study followed the paradigm developed by Rachman and his colleagues for the study of overt compulsions. Patients with urges to carry out covert compulsions underwent an experimental procedure in which their compulsive urges were provoked, followed by a period of response prevention. The strength of the compulsive urges and associated discomfort were monitored. There was marked, and relatively rapid, spontaneous decay of both the compulsive urges and the discomfort. Implications of these results are discussed.",de Silva P.; Menzies RG.; Shafran R.,2003.0,,0,0,
10839,Interpersonal deficits meet cognitive biases: memory for facial expressions in depressed and anxious men and women.,"Memory biases for negatively vs. positively valenced linguistic information in depression are well documented. However, no study so far has examined the relationship between depression and memory for facial expressions. We examined memory for neutral, happy, sad, and angry facial expressions in individuals suffering from comorbid depression and anxiety (COMs, N=23) or from anxiety disorders (ANXs, N=20) and in normal controls (NACs, N=23). Two main hypotheses were examined. First, we expected COMs, but not NACs, to exhibit an enhanced memory for sad and angry vs. happy expressions (negativity hypothesis). Second, we postulated that this bias would be specific to depression (disorder-specificity hypothesis). Data supported both these hypotheses. Specifically, COMs exhibited enhanced recognition of angry compared to happy expressions; in contrast, ANXs and NACs did not exhibit such enhancement. We also found that men showed a significantly better memory for angry vs. sad expressions, whereas women did not exhibit such a difference. The implications of these findings for the interpersonal processes involved in the maintenance of depression and anxiety are discussed.",Gilboa-Schechtman E.; Erhard-Weiss D.; Jeczemien P.,2002.0,,0,0,
10840,Electronic support groups for breast carcinoma: a clinical trial of effectiveness.,"A recent Pew Charitable Trust study found that 52,000,000 individuals used the Internet to obtain health/medical information. Clinical trials of face-to-face breast carcinoma support groups show evidence of 1) improvement in quality of life, 2) reduction of psychologic symptoms, 3) improvement in coping responses, and 4) a reduction in pain. To the authors' knowledge, a few studies published to date have investigated Internet-delivered electronic support groups (ESGs) for cancer. The most sophisticated is the Comprehensive Health Enhancement Support System (CHESS) program, which provides integrated information, referral, and a newsgroup-based social support program. However, to the authors' knowledge, no studies published to date have examined the impact of a breast carcinoma ESG in a clinical trial. Sixty-seven women completed the initial baseline questionnaires, 32 of whom accepted the authors' invitation and began the groups. With regard to geographic location, 49% lived in rural/small towns, 41% lived in medium-sized cities, and 10% lived in large cities. Diagnostic stages of disease were: Stage I, 22%; Stage II, 56%; Stage III, 12%; and other forms, 10%. There were 4 intervention groups, of which 8 participants led by trained Wellness Community (TWC) (a national agency) leaders met for 1.5 hours once a week for 16 weeks. Student t tests for paired outcome data were computed using baseline and postgroup scores. The results of the current study indicated that breast carcinoma patients significantly reduced depression (Center for Epidemiologic Studies-Depression [CES-D] scale) and Reactions to Pain. They also demonstrated a trend toward increases on The Posttraumatic Growth Inventory (PTGI) in two subscales: New Possibilities and Spirituality. Counterintuitively, breast carcinoma patients appeared to demonstrate an increase in emotional suppression. Postinterview results indicated that approximately 67% of patients found the group to be beneficial. Those who withdrew from the groups (20%) demonstrated low scores in their ability to contain anxiety and appeared to be more likely to suppress their thoughts and feelings regarding their illness. The findings of the current study are encouraging, particularly because it was conducted through TWC, a national agency willing to make this type of intervention readily available at no cost. A limitation of the current study was the lack of randomization and a control group comparison. Although the authors were not able to demonstrate effectiveness without the addition of a control condition, the analysis of pregroup and postgroup outcomes suggests that a randomized trial is worthwhile. Women with a devastating disease will join and commit themselves to an online support group. In addition, because a large percentage of these women were from rural locations, this type of intervention may hold promise for those who have limited access to support groups.",Lieberman MA.; Golant M.; Giese-Davis J.; Winzlenberg A.; Benjamin H.; Humphreys K.; Kronenwetter C.; Russo S.; Spiegel D.,2003.0,10.1002/cncr.11145,0,0,
10841,"A double-blind, placebo-controlled trial of clonazepam in obsessive-compulsive disorder.","Selective serotonin reuptake inhibitors (SSRIs) are currently the first-line pharmacological agents in treating obsessive-compulsive disorder (OCD). Appropriate treatment for OCD also involves cognitive behavioural therapy (CBT), including exposure and response prevention. As there is a time delay in seeing full therapeutic response, and not all patients tolerate SSRIs, there remains an unmet need for additional treatment approaches in OCD. In addition, most responders report only a partial reduction in symptoms. Clonazepam has demonstrated effectiveness in several preliminary reports in treating OCD. Twenty-seven patients with OCD were entered into a 10 week, double-blind, parallel design trial of clonazepam vs. placebo. Overall, only 3 out of 25 patients who had >/= 1 rating on clonazepam/placebo were judged to be treatment responders, by scoring a 1 (very much improved) or 2 (much improved) on the CGI improvement scale. Responders included 2 of 9 in the placebo group and 1 of 16 in the clonazepam group. No significant difference was found between clonazepam and placebo groups on responder/non responder status (Chi(2 )=1.39, df =1,24, p=0.238), nor on change in YBOCS, Ham-A, Ham-D or NIMH scales from beginning to last evaluation carried forward. These findings suggest that clonazepam is not effective as monotherapy in treating OCD. Its effectiveness in specific subgroups of OCD patients with co-morbid anxiety disorders or as an augmentation strategy added to SSRIs remains to be determined.",Hollander E.; Kaplan A.; Stahl SM.,2003.0,,0,0,
10842,The head-up tilt test with haemodynamic instability score in diagnosing chronic fatigue syndrome.,"Studying patients with chronic fatigue syndrome (CFS), we have developed a method that uses a head-up tilt test (HUTT) to estimate BP and HR instability during tilt, expressed as a 'haemodynamic instability score' (HIS). To assess HIS sensitivity and specificity in the diagnosis of CFS. Prospective controlled study. Patients with CFS (n=40), non-CFS chronic fatigue (n=73), fibromyalgia (n=41), neurally mediated syncope (n=58), generalized anxiety disorder (n=28), familial Mediterranean fever (n=50), arterial hypertension (n=28), and healthy subjects (n=59) were evaluated with a standardized head-up tilt test (HUTT). The HIS was calculated from blood pressure (BP) and heart rate (HR) changes during the HUTT. The tilt was prematurely terminated in 22% of CFS patients when postural symptoms occurred and the HIS could not be calculated. In the remainder, the median(IQR) HIS values were: CFS +2.14(4.67), non-CFS fatigue -3.98(5.35), fibromyalgia -2.81(2.62), syncope -3.7(4.36), generalized anxiety disorder -0.21(6.05), healthy controls -2.66(3.14), FMF -5.09(6.41), hypertensives -5.35(2.74) (p<0.0001 vs. CFS in all groups, except for anxiety disorder, p=NS). The sensitivity for CFS at HIS >-0.98 cut-off was 90.3% and the overall specificity was 84.5%. There is a particular dysautonomia in CFS that differs from dysautonomia in other disorders, characterized by HIS >-0.98. The HIS can reinforce the clinician's diagnosis by providing objective criteria for the assessment of CFS, which until now, could only be subjectively inferred.",Naschitz JE.; Rosner I.; Rozenbaum M.; Naschitz S.; Musafia-Priselac R.; Shaviv N.; Fields M.; Isseroff H.; Zuckerman E.; Yeshurun D.; Sabo E.,2003.0,,0,0,
10843,Cognitive trauma therapy for battered women with PTSD: preliminary findings.,"This paper describes a treatment-outcome study of Cognitive Trauma Therapy for Battered Women (CTT-BW) with PTSD. Derived from psychological learning principles, CTT-BW emphasizes the role of irrational beliefs and evaluative language in chronic PTSD. CTT-BW includes trauma history exploration, PTSD psychoeducation, stress management, psychoeducation about dysfunctional self-talk and self-monitoring of self-talk, exposure to abuse reminders, Cognitive Therapy for Trauma-Related Guilt (E. S. Kubany & F. P. Manke, 1995), and modules on assertiveness, managing contacts with former partners, self-advocacy strategies, and avoiding revictimization. Thirty-seven ethnically diverse women were assigned to Immediate or Delayed CTT-BW. PTSD remitted in 30 of 32 women who completed CTT-BW. Gains were maintained at 3-month follow-up. CTT-BW was efficacious across ethnic backgrounds. Issues related to disseminability of CTT-BW are discussed.",Kubany ES.; Hill EE.; Owens JA.,2003.0,10.1023/A:1022019629803,0,0,
10844,Alcohol craving predicts drinking during treatment: an analysis of three assessment instruments.,"The purpose of this investigation was to examine the utility of thee craving instruments to predict drinking during treatment. The three assessments used were the Penn Alcohol Craving Scale (PACS), the Alcohol Urge Questionnaire (AUQ) and Items 1-6 of the Obsessive subscale (OBS) of the Obsessive Compulsive Drinking Scale (OCDS). The three instruments were administered during the course of a 9-month, double-blind, placebo-controlled trial of 100 mg/day of naltrexone, and a manual-based psychosocial intervention using the BRENDA manual conducted at the University of Pennsylvania's Treatment Research Center. Participants (133 men and 50 women at the initiation of the study) used these instruments to self-report craving on a weekly or biweekly basis. The weekly number of drinks was reported using the Timeline Followback interview. The data were analyzed with generalized estimating equations using craving scores at 1 week as the independent variable and number of drinks in the subsequent treatment week as the dependent variable. Each of the three scales predicted drinking during the subsequent treatment week. The PACS was the strongest predictor followed closely by the OBS and then the AUQ. Most important, craving as measured by the three scales was a stronger predictor of subsequent drinking than was drinking during the prior treatment week. Craving assessment provides a useful means of predicting drinking during treatment. Such information would be helpful in designing clinical trials and for many treatment modalities.",Flannery BA.; Poole SA.; Gallop RJ.; Volpicelli JR.,2003.0,,0,0,
10845,The effect of pharmacotherapist characteristics on treatment outcome in panic disorder.,"A large number of studies suggest that individual characteristics of psychotherapists affect the outcome of psychosocial treatments for psychiatric illness, but little work has been done to see if this is also the case for pharmacotherapy. In the context of a multicenter study that compared psychosocial and medication treatments for panic disorder, we assessed whether such characteristics as age of the psychiatrist, number of years of experience, and gender influence the outcome of treatment with the antipanic drug imipramine. Data were examined by multiple and logistic regression analyses for eight psychiatrists who treated a total of 57 patients with panic disorder. More physician experience, measured as years since completing residency, was associated with better response to imipramine on one of two main dichotomous measures (the Clinical Global Impression-Improvement Scale) and on six of nine continuous measure rating scales. Associations between psychiatrist age and outcome and between psychiatrist gender and outcome were also present but on fewer measures. Although these are post-hoc analyses that were not planned when the multicenter study was originally designed and therefore there are limitations in the information available about the psychiatrists' characteristics, the findings suggest that even in the context of a clinical trial that employs a specific protocol and single medication, physician experience may influence patient outcome. Depression and Anxiety 17:88-93, 2003.",Gorman JM.; Martinez JM.; Goetz R.; Huppert JD.; Ray S.; Barlow DH.; Shear MK.; Woods SW.,2003.0,10.1002/da.10087,0,0,
10846,[Does acupuncture influence the cardiac autonomic nervous system in patients with minor depression or anxiety disorders?].,"We undertook this study to evaluate the effects of needle acupuncture on cardiac autonomic nervous system (ANS) function in patients with minor depression or anxiety disorder. Patients (n = 36) were randomly distributed into a verum acupuncture (VA) group (needles were applied at classical acupuncture points, e. g. He7, Pe6, Du20, Bl62, Ex6) or a placebo (PL) group (needles were applied only epidermal at non-acupuncture points). Both groups underwent standardized measurements of the 5-minute resting heart rate variability (HRV), which were performed before the first and after the 9th acupuncture session of an acupuncture series, and also three times (before the start and 5, respectively, 15 minutes after needle application) during the third acupuncture session. Demographic data between the VA and PL group did not differ. Before the start of acupuncture there were also no significant differences in HRV data between these groups. Compared to PL the VA group showed a significant decrease of the mean resting heart rate both, 5 and 15 minutes after needle application, combined with a trend towards an increase of the high frequency (HF; 0.15 - 0.4 Hz) and a decrease of the low frequency (LF; 0.04 - 0.15 Hz) spectral power. The latter effects resulted in an overall significant decrease of the mean LF/HF ratio in VA compared to PL treated patients. This pattern of findings suggests that in patients with minor depression or anxiety only verum acupuncture 1.) leads to a relative increase of cardiovagal modulation of heart rate and 2.) facilitates the physiological regulatory ANS function in response to alterations of external or internal environment. Clinical implications of these findings are discussed.",Agelink MW.; Sanner D.; Eich H.; Pach J.; Bertling R.; Lemmer W.; Klieser E.; Lehmann E.,2003.0,10.1055/s-2003-37756,0,0,6004
10847,Development in pain and neurologic complaints after whiplash: a 1-year prospective study.,"To prospectively examine the course of pain and other neurologic complaints in patients with acute whiplash injury and in controls with acute ankle injury. Patients with acute whiplash (n = 141) and ankle-injured controls (n = 40) were consecutively sampled, and underwent interview and examination after 1 week and 1, 3, 6, and 12 months. Outcome measures were pain intensity, pain frequency, and associated symptoms. Initial overall pain intensity above lower extremities (pain in neck, head, shoulder-arm, and low back) was similar in patients with whiplash (median Visual Analogue Scale [VAS](0-100) of 20 [25th and 75th percentile, 4, 39]) and ankle-injured controls (median VAS(0-100) of 15 [5, 34]). Whiplash-injured patients reported median overall VAS(0-100) pain intensity above lower extremities of 23 (12, 40) after 11 days and 14 (12, 40) after 1 year. Controls reported pain intensity of 0 (0, 4) after 12 days and 0 (0, 9) after 1 year. Reported overall pain frequency above lower extremities was 96% after 11 days and 74% after 1 year in whiplash-injured patients and 33% after 12 days and 47% after 1 year in controls. Associated neurologic symptoms were two to three times more common after whiplash injury. Correlation was found between pain intensity and associated symptoms in whiplash-injured patients but not controls. Pain occurs with high frequency but low intensity after whiplash and ankle injury. Associated neurologic symptoms were not correlated to pain in ankle-injured controls, but were correlated to pain in patients with whiplash injury. Persistent symptoms in whiplash-injured patients may be caused by both specific neck injury-related factors and nonspecific post-traumatic reactions. Disability was only encountered in the whiplash group.",Kasch H.; Bach FW.; Stengaard-Pedersen K.; Jensen TS.,2003.0,,0,0,
10848,Cognitive behaviour therapy of acute stress disorder: a four-year follow-up.,"The aim of this study was to index the long-term benefits of early provision of cognitive behavior therapy to trauma survivors with acute stress disorder. Civilian trauma survivors (n = 80) with acute stress disorder were randomly allocated to either cognitive behavior therapy (CBT) or supportive counseling (SC) - 69 completed treatment, and 41 were assessed four years post-treatment for post-traumatic stress disorder (PTSD) with the Clinician Administered PTSD Scale. Two CBT patients (8%) and four SC patients (25%) met PTSD criteria at four-year follow-up. Patients who received CBT reported less intense PTSD symptoms, and particularly less frequent and less avoidance symptoms, than patients who received SC. These findings suggest that early provision of CBT in the initial month after trauma has long-term benefits for people who are at risk of developing PTSD.",Bryant RA.; Moulds ML.; Nixon RV.,2003.0,,0,0,
10849,"[Therapy goals, change of goals and goal attainment in the process of psychoanalytically oriented and behavior long-term therapy--a comparative study from the private practices of insurance-registered psychotherapists].","In a prospective naturalistic design 31 patients with long-term behavior therapy (average 63 treatment hours) and 31 patients with psychoanalytically-oriented long-term therapy (average 185 treatment hours) were compared. All patients were examined by extern interviewers with the Structured Clinical Interview for Diagnosis (SCID) before they were included in the study. Only patients that showed DSM-III-R criteria of a depressive or anxiety disorder were included. At four times the patient goals in therapy and the actual state was examined: At the beginning of treatment, after 1, after 2,5 and after 3,5 years. At all times the patients could formulate new goals and release old ones. The symptoms were registered by SCL-90-R and the interpersonal problems were recorded by IIP-D. After 3,5 years a follow-up interview was conducted. Although all patients were comparable in their diagnoses the patients in behavior therapy and those in psychoanalytically-oriented therapy differed in a number of characteristics, for example by the way they gained access to therapy (doctors' subscription versus personal initiative for an appointment), the education, the consuming of psychotropic medication and the strain of symptoms. The patients did not differ remarkably in their goals in therapy. The symptoms as a goal did not have the highest priority in both groups, but the category ""self-worth-problems"" was found in both groups with a high priority. About one third of therapy goals were redefined by the patients in both groups within one year. After 2,5 years the number of goals in the category ""interpersonal conflicts"" increases remarkably in both treatment groups. For both groups we found the extent of reaching aimed goals in therapy (recorded by GAS) was significant over time. The results seem to prove that psychotherapy under naturalistic conditions aims more at improving the general level of functioning than at reducing the symptoms.",Brockmann J.; Schlüter T.; Eckert J.,,10.1055/s-2003-38006,0,0,
10850,[Relationship of sick leave before treatment to severity of symptoms and treatment outcome in in-patients with anxiety disorders].,"The aim of this study is to explore whether or not being already on sick leave at admission to a psychosomatic clinic indicates a higher level of severity of symptoms in patients with anxiety disorders, and whether or not this has an impact on therapy outcome. We examined 194 in-patients at 8 psychosomatic clinics upon admission and discharge by interview and psychometric testing. Being on sick leave before admission proved to be an indicator for higher global symptom distress as well as a higher severity of anxiety symptoms. Treatment duration was longer for the sick leave group than for the patients that had not been on sick leave, but each group experienced the same degree of change in pre-and-post treatment symptoms. We conclude that sick leave before admission does give information about illness severity and need of treatment in patients with anxiety disorders.",Geiser F.; Bassler M.; Bents H.; Carls W.; Joraschky P.; Kriebel R.; Michelitsch B.; Ullrich J.; Liedtke R.,,10.1055/s-2003-38007,0,0,
10851,Anterior cingulotomy for refractory obsessive-compulsive disorder.,"This study was designed to prospectively investigate the efficacy and cognitive adverse effects of stereotactic bilateral anterior cingulotomy as a treatment for refractory obsessive-compulsive (OCD) patients for 12 months. Patients were eligible if they had severe OCD and rigorous treatments had been unsuccessful. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Clinical Global Impression (CGI) and neuropsychological tests were used to assess the efficacy and cognitive changes of cingulotomy before and 12 months after operation. The mean improvement rate of the Y-BOCS scores achieved from baseline was 36.0%. Out of 14 patients six met responder criteria; 35% or higher improvement rate on Y-BOCS and CGI improvement of very much or much better at 12-month follow-up. There was no significant cognitive dysfunction after cingulotomy. Anterior cingulotomy shows few cognitive adverse effects, with about half of the OCD patients demonstrating significant symptomatic improvement.",Kim CH.; Chang JW.; Koo MS.; Kim JW.; Suh HS.; Park IH.; Lee HS.,2003.0,,0,0,
10852,Exposure therapy and sertraline in social phobia: I-year follow-up of a randomised controlled trial.,"Maintenance of treatment effect is important for the choice of treatment for social phobia. To examine the effect of exposure therapy and sertraline 28 weeks after cessation of medical treatment. In this study 375 patients with social phobia were randomised to treatment with sertraline or placebo for 24 weeks, with or without the addition of exposure therapy. Fifty-two weeks after inclusion, 328 patients were evaluated by the same psychometric tests as at baseline and the end of treatment (24 weeks). The exposure therapy group and the placebo group had a further improvement in scores on social phobia during follow-up: mean change in the Clinical Global Impression - Social Phobia overall severity score was 0.45 (95% CI 0.16-0.65, P < 0.01) for the exposure group, and 0.25 (95% CI 0.00-0.48, P < 0.05) for the placebo group. At week 52 the sertraline plus exposure group and the sertraline-alone group had a significant deterioration on the 36-item Short Form Health Survey compared with exposure alone. Exposure therapy alone yielded a further improvement during follow-up, whereas exposure therapy combined with sertraline and sertraline alone showed a tendency towards deterioration after the completion of treatment.",Haug TT.; Blomhoff S.; Hellstr√∏m K.; Holme I.; Humble M.; Madsbu HP.; Wold JE.,2003.0,,0,0,
10853,Relationship between MPQ and VAS in 962 patients. A rationale for their use.,"1) To analyse the information provided both by the Visual Analogue Scale (VAS) and by the McGill Pain Questionnaire (MPQ) in a cross-sectional study with patients affected by different kinds of pain and to study the relationship between VAS and MPQ scores in the same patient sample. 962 patients affected by different kinds of pain (i.e. neuropathic pain, acute post-traumatic pain, chronic musculo-skeletal pain, headache, and cancer pain) were enrolled into the study during the first visit for pain management. The horizontal 10cm VAS and the Italian version of the MPQ were administered. VAS scores proved to be significantly lower in acute post traumatic and in chronic musculo- skeletal pain compared to headache and neuropathic pain. VAS scores were signi- ficantly higher in neuropathic pain compared to cancer pain. MPQ total score (Pain Rating Index, PRI) related to neuropathic pain was significantly higher than scores reported in the other pain groups, with the exception of cancer pain. Cancer pain MPQ total score was higher than acute post-traumatic and chronic musculo-skeletal PRI pain scores. Different patterns of MPQ dimensions emerged within each pain group. The association between VAS and PRI, analysed by means of stepwise multiple regression analyses was significantly different among the groups (p<0.0001). The percentage of VAS variance explained by MPQ PRI score ranged from 6% (headache) to 32% (neuro-pathic pain). Several differences emerged among the pain groups. VAS and MPQ resulted to address pain aspects only partially overlapping. In some clinical conditions (headache and cancer) the MPQ can provide more detailed and clinically useful information about patients' pain experience.",Majani G.; Tiengo M.; Giardini A.; Calori G.; De Micheli P.; Battaglia A.,,,0,0,
10854,"A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee.","Autologous chondrocyte implantation (ACI) and mosaicplasty are both claimed to be successful for the repair of defects of the articular cartilage of the knee but there has been no comparative study of the two methods. A total of 100 patients with a mean age of 31.3 years (16 to 49) and with a symptomatic lesion of the articular cartilage in the knee which was suitable for cartilage repair was randomised to undergo either ACI or mosaicplasty; 58 patients had ACI and 42 mosaicplasty. Most lesions were post-traumatic and the mean size of the defect was 4.66 cm2. The mean duration of symptoms was 7.2 years and the mean number of previous operations, excluding arthroscopy, was 1.5. The mean follow-up was 19 months (12 to 26). Functional assessment using the modified Cincinatti and Stanmore scores and objective clinical assessment showed that 88% had excellent or good results after ACI compared with 69% after mosaicplasty. Arthroscopy at one year demonstrated excellent or good repairs in 82% after ACI and in 34% after mosaicplasty. All five patellar mosaicplasties failed. Our prospective, randomised, clinical trial has shown significant superiority of ACI over mosaicplasty for the repair of articular defects in the knee. The results for ACI are comparable with those in other studies, but those for mosaicplasty suggest that its continued use is of dubious value.",Bentley G.; Biant LC.; Carrington RW.; Akmal M.; Goldberg A.; Williams AM.; Skinner JA.; Pringle J.,2003.0,,0,0,
10855,Anxiety disorders in subjects seeking treatment for eating disorders: a DSM-IV controlled study.,"Women who were referred with an eating disorder (ED) were compared with a matched normal control group to answer the following questions: What are the frequencies of anxiety disorders in cases of anorexia and bulimia nervosa diagnosed according to DSM-IV criteria? Are anxiety disorders significantly more frequent among women with an eating disorder than among women from the community? We assessed the frequencies of six specific anxiety disorders among 271 women with a current diagnosis of anorexia or bulimia nervosa and 271 controls, using the Mini-International Neuropsychiatric Interview, French DSM-IV version. A lifetime comorbidity with at least one anxiety disorder was found in 71% of both the anorexic and the bulimic subjects, significantly higher than the percentage of controls with an anxiety disorder. The prevalence was significantly higher in the eating disorder groups than in controls for most types of anxiety disorder, and between 41.8 and 53.3% of comorbid cases had an anxiety disorder preceding the onset of the eating disorder. Anxiety disorders are significantly more frequent in subjects with eating disorders than in volunteers from the community, a finding that has important etiological and therapeutic implications.",Godart NT.; Flament MF.; Curt F.; Perdereau F.; Lang F.; Venisse JL.; Halfon O.; Bizouard P.; Loas G.; Corcos M.; Jeammet P.; Fermanian J.,2003.0,,0,0,
10856,Response of patients with panic disorder and symptoms of hypomania to cognitive behavior therapy for panic.,"The purpose of this cohort study was to determine in patients with Panic Disorder (PD): (1). the prevalence of subsyndromal symptoms of hypomania, and (2). whether subsyndromal hypomania symptoms affect the outcome of cognitive behavior therapy (CBT) for panic. Using the Diagnostic Interview Schedule, and DSM-III-R criteria we identified 18 individuals with a history of symptoms of hypomania among 56 patients with PD. Patients were treated in an open CBT group program. They were assessed before treatment and 6 and 12 months later. We used the Brief Symptom Inventory (BSI), the Perceived Stress Scale (PSS), the Pearlin-Schooler Mastery Scale (PMS), and the Social Adjustment Scale (SAS) at all assessments. The total group significantly improved on all measures. The Clinically Significant Change was 71.4% and the Reliable Change Index 48.2%. Between 6 and 12 months, there was a trend for the hypomania symptom subgroup (PH) to continue to improve on the BSI Depression Scale, the Perceived Stress Scale, the Pearlin-Schooler Mastery Scale, and the Social Adjustment Scale but to lose gains on the BSI Phobic Anxiety and Somatization subscales compared with the group without symptoms of hypomania (PNH). Thirty-two percent of patients with PD had symptoms of hypomania. With CBT for panic, patients with PD and symptoms of hypomania improve as much as those without hypomania symptoms. The presence or absence of symptoms of hypomania might help explain the inconsistent effects of depression and personality disorders on the treatment of PD.",Bowen RC.; D'Arcy C.,2003.0,,0,0,
10857,Reduction of motion sickness in prehospital trauma care.,"Motion sickness adds to the discomfort of many patients being transported by ambulance. Recent research has demonstrated the effectiveness of oxygen therapy in reducing motion sickness during transport to hospital. However, patients reported negative reactions to wearing a facemask, which produced feelings of claustrophobia and anxiety. We therefore tested the hypothesis that supplemental oxygen inhaled from a new oxygen delivery device OxyArm, which avoids direct contact with the patient's skin, may reduce the incidence of motion sickness and increase patient satisfaction. Forty patients suffering from minor trauma were included in a prospective, randomised trial. Twenty patients received oxygen administered using a conventional Venturi mask (group 1), and 20 patients received oxygen using the new OxyArm device (group 2). Measurements made included oxygen saturation (SaO2), heart rate, systolic and diastolic blood pressures, and patients' subjective score of satisfaction with smell of the device, claustrophobia, inconvenience produced by the oxygen inhalation device and nausea were scored using a visual analogue scale. All patients were haemodynamically stable and comparable between the two groups. Peripheral SaO2 increased in both groups. The scores of nausea and claustrophobia were significantly lower in the OxyArm group, in addition, satisfaction with the OxyArm device was significantly higher. In conclusion, the use of OxyArm device produced a lower incidence of motion sickness combined with the additional benefit of greater patient satisfaction, when compared with a conventional facemask, during prehospital transfer of trauma patients.",Fleischhackl R.; Dörner C.; Scheck T.; Fleischhackl S.; Hafez J.; Kober A.; Bertalanffy P.; Hoerauf K.,2003.0,,0,0,
10858,On-site training in applied muscle tension to reduce vasovagal reactions to blood donation.,"Vasovagal reactions significantly complicate the blood collection process and, more importantly, discourage people who might otherwise donate blood many times from returning. Applied muscle tension is a simple behavioral technique that may reduce vasovagal reactions by maintaining blood pressure. It has been successfully used to treat patients with blood and injury phobias, but has not been applied in the more general, time-limited context of blood collection clinics. Thirty-seven inexperienced blood donors (maximum number of prior donations = 2) attending mobile blood collection clinics were asked to practice applied tension after watching a 2-min instructional video presented on a notebook computer. They were compared with 94 untreated donors with similar donation experience and 47 more experienced blood donors. Treatment reduced the number of symptoms reported on a postdonation questionnaire. It also significantly reduced the amount of medical treatment required (chair reclining) among those who practiced applied tension for the entire period they were in the donation chair.",Ditto B.; Wilkins JA.; France CR.; Lavoie P.; Adler PS.,2003.0,,0,0,
10859,Processing angry and neutral faces in post-traumatic stress disorder: an event-related potentials study.,"This study examined evoked response potentials (ERPs) to angry and neutral faces in 15 individuals with post-traumatic stress disorder (PTSD) and 15 age and sex-matched controls over temporal (T5,T6) and occipital (O1,O2) regions. Twenty faces with an angry expression were alternated with 20 faces with a neutral emotional expression. There were significantly larger early negative (N110) and late negative (N650) ERP components in controls to the angry compared to the neutral faces. The PTSD group did not display ERP differences between angry and neutral faces, and the amplitude of their negative waveforms were reduced relative to controls. These findings may reflect adaptive, rapid responding to potential threat in the controls, and a reduced capacity to discriminate between non-threat and generalized threat stimuli in PTSD.",Felmingham KL.; Bryant RA.; Gordon E.,2003.0,10.1097/01.wnr.0000065509.53896.e3,0,0,
10860,Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety?,"Although anxiety disorders are documented in the literature for new mothers (but less so for fathers), rates of postpartum caseness tend to include only those with depression when diagnostic interviews or self-report measures validated on such interviews are used. This methodology therefore underestimates the true percentage of women and men who experience significant psychological difficulties postpartum. This has implications for assessment, treatment and screening for postnatal mood disorders. Two studies were conducted on a total of 408 women and 356 men expecting their first child. They were recruited antenatally, and interviewed at 6 weeks postpartum using the Diagnostic Interview Schedule. DSM-IV criteria were applied to determine the presence since birth of depression (major or minor), panic disorder, acute adjustment disorder with anxiety (meeting the criteria for generalised anxiety disorder except for the duration criterion), and phobia. The inclusion of diagnostic assessment for panic disorder and acute adjustment disorder with anxiety increased the rates of caseness by between 57 and 100% for mothers, and 31-130% for fathers, over the rates for major or minor depression. Inclusion of assessment for phobia further increased the rates of disorder in both samples. Couple concordance rates were between 6.6 and 11.1%, with no significant difference between rates for depressive or depressive and anxious caseness. For women, a previous history of an anxiety disorder appears to be a greater risk factor for a postnatal mood disorder (i.e. depression or anxiety) than a history of a depressive disorder. These results clearly show the need to assess for both depression and anxiety in new and expectant parents, and we believe the term 'postnatal mood disorder' (PMD), rather than postnatal depression, more accurately reflects significant adjustment difficulties in new parents.",Matthey S.; Barnett B.; Howie P.; Kavanagh DJ.,2003.0,,0,0,
10861,Internal versus external attention in social anxiety: an investigation using a novel paradigm.,"Several cognitive models propose that social anxiety is associated with increased self-focused attention. Indirect evidence for this hypothesis has been provided by questionnaire studies, and by cognitive psychology paradigms that have demonstrated reduced processing of external information during feared social-evaluative situations. However, no studies have simultaneously measured on-line attention to internal and external events. A probe detection task that aimed to measure the balance of attention between internal and external stimuli was developed. High and low socially anxious individuals were instructed to detect two probes. The external probe was superimposed on pictures of faces (happy, neutral, angry) or household objects that were presented on a VDU. The 'internal' probe was a pulse to the finger which participants were led to believe represented significant changes in their physiology. Compared to low speech anxious individuals, high speech anxious individuals showed an internal attentional bias, that was specific to conditions of social-evaluative threat.",Mansell W.; Clark DM.; Ehlers A.,2003.0,,0,0,
10862,Brief report: does posttraumatic stress apply to siblings of childhood cancer survivors?,"To investigate whether adolescent siblings of childhood cancer survivors experience posttraumatic stress (PTS). Participants included 78 adolescent siblings of adolescent cancer survivors who completed self-report measures of anxiety, PTS, and perceptions of the cancer experience. Nearly half (49%) of our sample reported mild PTS and 32% indicated moderate to severe levels. One fourth of siblings thought their brother/sister would die during treatment; over half found the cancer experience scary and difficult. These perceptions were related to PTS. Siblings reported more PTS symptoms than a reference group of nonaffected teens but had similar levels of general anxiety. Levels of PTS are elevated for siblings of childhood cancer survivors. Thus, PTS may be a useful model for understanding siblings' long-term reactions to cancer. Future research and clinical efforts should consider the needs of siblings of childhood cancer survivors in a family context.",Alderfer MA.; Labay LE.; Kazak AE.,2003.0,,0,0,
10863,Long-term efficacy of exposure and ritual prevention therapy and serotonergic medications for obsessive-compulsive disorder.,"What is the long-term outcome of patients with obsessive-compulsive disorder (OCD) who are treated with exposure and response (ritual) prevention (EX/RP) alone, serotonergic medications alone, or their combination? How is the long-term outcome of these patients affected by the discontinuation? Follow-up assessments were conducted with 62 patients treated for OCD an average of 17 months posttreatment (range: 6-43 months). Patients received one of three treatments: serotonergic medications (fluvoxamine or clomipramine), intensive behavior therapy involving EX/RP, or intensive EX/RP with concurrent antidepressant medication. At follow-up, no differences in OCD symptom severity were found among the three treatment groups. However, when current medication use was taken into consideration, differences among the three treatment groups emerged. Among patients who were medication-free at the time of follow-up assessment (n=37), those in the EX/RP-alone and EX/RP-with-medication groups had lower symptom severity ratings than those in the medication-only group on 4 out of 6 measures. There were no differences in OCD severity ratings among patients taking medications at follow-up (n=25). Although these findings are interpreted with caution due to the uncontrolled nature of the study, results suggested that long-term outcome may be superior following EX/RP than following serotonergic medications, after discontinuation. For patients who remain on medications, the treatment produced benefits equivalent to EX/RP.",Hembree EA.; Riggs DS.; Kozak MJ.; Franklin ME.; Foa EB.,2003.0,,0,0,
10864,Quantitative EEG analysis in obsessive compulsive disorder.,"Quantitative analysis of the EEG (q-EEG) in patients with obsessive compulsive disorder (OCD) showed a decreased beta and an increased theta power at frontotemporal regions. The patients who had higher scores in doubting test (Maudsley Obsessive Compulsive Questionnaire) and more severely ill patients shared similar q-EEG features. The relative theta powers were significantly increased and alpha powers were significantly decreased in these patients, particularly in the frontotemporal region. It was suggested that the q-EEG may be useful in investigating the OCD patients with heterogeneous characteristics.",Karadag F.; Oguzhanoglu NK.; Kurt T.; Oguzhanoglu A.; Ateşci F.; Ozdel O.,2003.0,DOI: 10.1080/00207450390200963,0,0,
10865,Acute stress reactions to recent life events among women and men living with HIV/AIDS.,"This study examined the prevalence of acute stress reactions to recent life events among persons living with HIV/AIDS. A second aim was to investigate the relationship of acute stress reactions among HIV-infected men and women to posttraumatic stress disorder (PTSD) symptoms to previous traumatic life events. Participants included 64 HIV-seropositive persons (33 men and 31 women) drawn from a larger study examining the effects of group therapy on quality of life and health behavior. These individuals were assessed at baseline on demographic and medical status characteristics and (PTSD) symptoms andthen randomly assigned to either receive group therapy plus education or education alone. Three months later they were assessed for acute stress reactions to recent life events. Nearly a third (31.3 percent) of the participants reported levels of acute stress reactions to recent life events that met all symptom criteria for the diagnosis of acute stress disorder. However, only 9.4 percent of the respondents described a recent stressful life event that was threatening to the life or physical integrity of themselves or others. Acute stress reactions to recent life events were significantly and positively related to experiencing PTSD symptoms to prior traumatic life events. Acute stress did not differ significantly by gender, AIDS status, or whether or not participants had received 12 weeks of group therapy. A subset of individuals with HIV/AIDS experience high levels of acute stress reactivity to life events considered non-traumatic. HIV-infected individuals who react strongly to ongoing life stressors are more likely to have developed PTSD symptoms in response to previous traumatic life events.",Koopman C.; Gore-Felton C.; Azimi N.; O'Shea K.; Ashton E.; Power R.; De Maria S.; Israelski D.; Spiegel D.,2002.0,10.2190/CK2N-33NV-3PVF-GLVR,0,0,
10866,A brief behavioural treatment of chronic post-traumatic stress disorder in earthquake survivors: results from an open clinical trial.,"Natural disasters such as earthquakes affect large numbers of people. Given the extent of the mental health problem following earthquakes, brief, effective and cost-effective treatment interventions are urgently needed. The present study examined whether cognitive-behavioural treatment could be shortened to a minimum number of sessions without undermining its effectiveness in post-traumatic stress disorder (PTSD). The study participants (N=231) were consecutive referrals to five project sites in the earthquake region in Turkey a mean of 13 months after the disaster. A modified behavioural treatment (BT) was used, which involved self-exposure instructions based on an enhancement of 'sense of control' rather than a habituation rationale and minimal cognitive interventions. The duration of treatment was variable, involving as many sessions as required for clinical improvement. Survival analysis was used to explore the minimum number of sessions required for clinical improvement, and multiple regression analysis to examine the predictors of outcome. The survivors received a mean of 4-3 sessions. Significant treatment effects and clinically meaningful effect sizes were noted on all measures. The treatment improved all PTSD and depression symptoms. The cumulative proportion of improved cases was 76% after one session and 88% after two sessions. No baseline variable predicted treatment outcome. The modified BT appears to be promising as an effective one- or two-session intervention for earthquake survivors. It may be particularly useful in large-scale disasters as a cost-effective treatment that can be relatively easily disseminated to mass populations. Further research is needed to clarify the possible role of a treatment focus on sense of control in rapid recovery from traumatic stress.",Başoğlu M.; Livanou M.; Salcioğlu E.; Kalender D.,2003.0,,0,0,
10867,The effects of homeopathic Argentum nitricum on test anxiety.,"(1) To replicate a study of the efficacy of Argentum nitricum 12X in the reduction of test anxiety as demonstrated previously. (2) To investigate the correlation between individuals identified to match the A. nitricum profile and the reduction of test anxiety. To compare traditionally prepared homeopathic A. nitricum 12X with radionically-prepared A. nitricum 12X and placebo. A double blind, placebo-controlled, randomised clinical trial with three arms. The study was conducted at Southern Cross University, Lismore, Australia. Sixty-two test anxious university students. Subjects were randomised to one of three groups: traditionally prepared homeopathic A. nitricum 12X, radionically-prepared A. nitricum 12X, or placebo. After screening, each group received treatment twice a day for 4 days after which they were re-tested. Primary: The Revised Test Anxiety Scale. Secondary: The Test Anxiety Scale; 36-item A. nitricum questionnaire. The results of this study did not replicate the Stanton study. No correlation between the reduction of test anxiety and the A. nitricum profile was demonstrated. No significant differences between treatments were demonstrated. This study demonstrated that homeopathic A. nitricum 12X does not reduce test anxiety in a general population of university students.",Baker DG.; Myers SP.; Howden I.; Brooks L.,2003.0,,0,0,
10868,Bilateral eye movements enhance the retrieval of episodic memories.,"Two experiments examining effects of eye movements on episodic memory retrieval are reported. Thirty seconds of horizontal saccadic eye movements (but not smooth pursuit or vertical eye movements) preceding testing resulted in selective enhancement of episodic memory retrieval for laboratory (Experiment 1) and everyday (Experiment 2) events. Eye movements had no effects on implicit memory. Eye movements were also associated with more conservative response biases relative to a no eye movement condition. Episodic memory improvement induced by bilateral eye movements is hypothesized to reflect enhanced interhemispheric interaction, which is associated with superior episodic memory (S. D. Christman & R. E. Propper, 2001). Implications for neuropsychological mechanisms underlying eye movement desensitization and reprocessing (F. Shapiro, 1989, 2001), a therapeutic technique for posttraumatic stress disorder, are discussed.",Christman SD.; Garvey KJ.; Propper RE.; Phaneuf KA.,2003.0,,0,0,
10869,The illusion of presence in immersive virtual reality during an fMRI brain scan.,"The essence of immersive virtual reality (VR) is the illusion it gives users that they are inside the computer-generated virtual environment. This unusually strong illusion is theorized to contribute to the successful pain reduction observed in burn patients who go into VR during woundcare (www.vrpain.com) and to successful VR exposure therapy for phobias and post-traumatic stress disorder (PTSD). The present study demonstrated for the first time that subjects could experience a strong illusion of presence during an fMRI despite the constraints of the fMRI magnet bore (i.e., immobilized head and loud ambient noise).",Hoffman HG.; Richards T.; Coda B.; Richards A.; Sharar SR.,2003.0,10.1089/109493103321640310,0,0,
10870,Effect of cognitive behavioral therapy on heart rate variability during REM sleep in female rape victims with PTSD.,Six female rape victims with posttraumatic stress disorder (PTSD) were assessed for sleep disturbances. Five responded to cognitive-behavioral therapy (CBT) and one did not complete treatment. Sympatho-vagal balance was measured using heart rate variability (HRV) during rapid eye movement (REM) sleep. The treatment responders significantly decreased on HRV while the noncompleter increased. The responders also significantly decreased on sleep disturbances. The noncompleter remained unchanged. Thus a remission in PTSD symptoms following CBT accompanied a reduction in the HRV indicator of sympathetic predominance in REM sleep.,Nishith P.; Duntley SP.; Domitrovich PP.; Uhles ML.; Cook BJ.; Stein PK.,2003.0,10.1023/A:1023791906879,0,0,
10871,Sensitivity and specificity of the PTSD checklist in detecting PTSD in female veterans in primary care.,"PTSD affects a substantial number of women in medical settings and is associated with significant distress and impairment. There are effective methods of treating trauma-related distress, but a minority seek such care. Thus, primary care is an important setting in which to identify individuals with PTSD. We sent questionnaires, including the PTSD Checklist--Civilian Version (PCL-C), to 419 female veterans who were seen in our primary care clinic in 1998; 56% (N = 221) returned the measures. A random subset (n = 49) was interviewed to establish psychiatric diagnoses. The results provide qualified support for the use of the PCL-C total score with a lowered cutoff score as a screening measure for PTSD in female veterans in primary care.",Lang AJ.; Laffaye C.; Satz LE.; Dresselhaus TR.; Stein MB.,2003.0,10.1023/A:1023796007788,0,0,
10872,An emotional Stroop effect to malingering-related words.,"This study was designed to elicit an emotional Stroop effect in simulators of malingering. Student participants (mostly women) either did or did not feign mild brain trauma. A modified Stroop test was administered, using neutral and ""malingering"" words. Controls showed no difference on malingering versus neutral words; simulators performed significantly worse on malingering words. Further research must specify the best method of administration to elicit a malingering Stroop effect and assess the additional discriminative power it may provide when combined with other malingering-detection strategies.",Cannon BJ.,2003.0,10.2466/pms.2003.96.3.827,0,0,
10873,Outcome after single technique ankle arthrodesis in patients with rheumatoid arthritis.,"The established treatment for severe rheumatoid arthritis in the ankle is arthrodesis. Numerous reports in the literature describe outcomes in patients with degenerative and posttraumatic arthrosis and rheumatoid disease. This has led to results that are difficult to interpret. In addition, in the few studies that have evaluated patients with rheumatoid disease many techniques of arthrodesis are reported, further confounding assessment of one fusion method. One technique of 20 ankle fusions in patients with rheumatoid disease was evaluated. A modified Wagner arthrodesis was used through a transfibular approach using parallel compression screws. The scoring systems of Mazur et al, Moran et al, and the Short-Form-36 were used to evaluate the outcome. The mean time to followup was 3 years 10 months. Eighteen of 20 fusions obtained a solid talocrural union (90%). No correlation was found between the scores of Mazur et al and Moran et al. Correlation was achieved between the scores for the Short Form-36 and Moran et al. The modified Wagner ankle arthrodesis is a simple, reliable, reproducible technique with a 90% union rate. The value of the technique has been confirmed in patients with rheumatoid arthritis by evaluating the outcome using a scoring system that is validated and relevant to this population.",Kennedy JG.; Harty JA.; Casey K.; Jan W.; Quinlan WB.,2003.0,10.1097/01.blo.0000071755.41516.a0,0,0,
10874,Classification of frequency distributions of diagnostic criteria scores in twelve personality disorders by the curve fitting method.,"The purpose of the present study was to investigate whether each personality disorder (PD) has a different frequency distribution of diagnostic criteria, and to classify the distribution of each PD on the basis of shape by the curve fitting method. A total of 4740 male subjects in early adulthood completed the Korean version of the Personality Diagnostic Questionnaire (4th revision; PDQ-4+). The frequency distribution of scores in each PD was specified to the best fitted model by the curve estimation procedure. Twelve distributions of PD criteria were fitted to three types of curve models (quadratic, cubic, and logistic). The quadratic model included obsessive-compulsive and histrionic PD. The cubic model included borderline, narcissistic, avoidant, passive-aggressive, paranoid, and schizotypal PD. The logistic model contained dependent, depressive, schizoid, and antisocial PD. The results suggest that each PD has a different type of distribution and each distribution of PD might be classified to a specific curve model. Also, the results suggest that the issue of continuities between PD and the normal group could not be generalized to all PD, but should be considered individually for each PD.",Lyoo IK.; Youn T.; Ha TH.; Park HS.; Kwon JS.,2003.0,10.1046/j.1440-1819.2003.01141.x,0,0,
10875,Psychosocial intervention for rural women with breast cancer: The Sierra-Stanford Partnership.,"This study was initiated by breast cancer survivors living in a rural community in California. They formed a partnership with academic researchers to develop and evaluate a low-cost, community-based Workbook-Journal (WBJ) for improving psychosocial functioning in geographically and economically isolated women with primary breast cancer. A randomized controlled trial was used to compare the WBJ intervention plus educational materials to educational materials alone (usual care). One rural cancer center and several private medical, surgical, and radiation oncology practices in 7 rural counties in the Sierra Nevada Foothills of California. One hundred women with primary breast cancer who were either within 3 months of diagnosis or within 3 months of completing treatment. A community-initiated, theoretically-based Workbook-Journal, designed by rural breast cancer survivors and providers as a support group alternative. It included compelling personal stories, local rural resources, coping strategies, and messages of hope. Community recruiters enrolled 83% of the women referred to the study. Retention at 3-month follow-up was 98%. There were no main effects for the WBJ. However, 3 significant interactions suggested that women who were treated in rural practices reported decreased fighting spirit and increased emotional venting and posttraumatic stress disorder symptoms if they did not receive the WBJ. Among women who receive the WBJ, 74% felt emotionally supported. This community-based Workbook-Journal may be an effective psychosocial intervention for rural, isolated, and low-income women with breast cancer. Community involvement was essential to the success of this project.",Angell KL.; Kreshka MA.; McCoy R.; Donnelly P.; Turner-Cobb JM.; Graddy K.; Kraemer HC.; Koopman C.,2003.0,,0,0,
10876,Sensing the invisible: differential sensitivity of visual cortex and amygdala to traumatic context.,"To what extent does emotional traumatic context affect sensory processing in the brain? A striking example of emotional impact on sensation is manifested in posttraumatic stress disorder (PTSD), in which a severe emotional trauma produces recurrent and vivid unpleasant sensory recollections. Here we report on an fMRI study exploring the sensory processing of trauma-related pictures in the visual cortex and amygdala in respect to PTSD. The impact of traumatic experience on brain responses was tested in relation to stimuli content and its level of recognition in a parametric factorial design. Twenty combat veterans, 10 with and 10 without PTSD, viewed backward-masked images of combat and noncombat content, presented at below, near, and above recognition thresholds. The response to combat content evoked more activation in the visual cortex in PTSD subjects than in non-PTSD subjects, only when images were presented at below recognition threshold. By contrast, the amygdala demonstrated increased activation in PTSD subjects irrespective of content and recognition threshold of the images. These intriguing findings are compatible with the notion that in PTSD, emotional traumatic experience could modify visual processing already at the preattentive level. On the other hand, lack of content specificity in the amygdala point to a possible predisposed mechanism for pathological processing of traumatic experience. The differential sensitivity of the amygdala and visual cortex to traumatic context implies distinct roles of limbic and sensory regions in the registration and recollection of emotional experience in the brain.",Hendler T.; Rotshtein P.; Yeshurun Y.; Weizmann T.; Kahn I.; Ben-Bashat D.; Malach R.; Bleich A.,2003.0,,0,0,
10877,A group-based patient education programme for high-anxiety patients with Crohn disease or ulcerative colitis.,"The inflammatory bowel diseases (IBD) ulcerative colitis (UC) and Crohn disease (CD) affect a person's health-related quality of life (HRQOL). IBD patients report high levels of anxiety, which correlates with the degree of perceived dissatisfaction with the information on disease-related themes provided in routine health care. The aim of this study was to evaluate changes in anxiety after participation in a group-based educational intervention for IBD patients screened for high anxiety. The programme consisted of 8 sessions, and 49 patients participated. Anxiety was assessed using the Hospital Anxiety and Depression (HAD) Scale at baseline and 6 months after intervention. HRQOL was assessed with the Inflammatory Bowel Disease Questionnaire (IBDQ) and the SF-36 health survey. Participant satisfaction with education was measured using a study-specific questionnaire. No significant change on the HAD anxiety score was found at the 6-month follow-up for those who participated in the education programme despite the fact that the participants reported they had gained better knowledge of disease-related items. Furthermore, there were no significant changes over time regarding bowel symptoms, systemic symptoms, emotional functioning and social functioning of the IBDQ or generic HRQOL (SF-36). IBD patients with a high anxiety level reported improved satisfaction with information about disease-related items, but did not indicate any benefits in terms of reduced anxiety or improved HRQOL after participating in the education programme, not at least in the short-term perspective. In this selected group of patients, psychosocial problems other than disease-related concerns were found that warrant other approaches.",Larsson K.; Sundberg Hjelm M.; Karlbom U.; Nordin K.; Anderberg UM.; Lööf L.,2003.0,,0,0,
10878,Anxiety and psychoactive substance use disorder comorbidity in anorexia nervosa or depression.,"This study considered whether the prevalence and type of anxiety and psychoactive substance use disorder (PSUD) diagnoses differ between women with spectrum anorexia nervosa (AN) (N=40) and women with major depressive disorder (N = 58) participating in outpatient clinical trials. Anxiety and PSUD diagnoses (according to criteria in the 3rd Rev. ed. of the Diagnostic and Statistical Manual of Mental Disorders) were assessed using structured clinical interviews. Comparisons were made between AN subtypes (restricting or binge eating/purging) and by history of depression within the AN sample. A high prevalence of obsessive-compulsive disorder (OCD) was found in women with AN. However, social phobia, simple phobia, and PSUD were significantly elevated in both women with depression and women with AN. Prevalences were similar for anxiety and PSUD diagnoses between AN subtypes. Women with anorexia or depression were comparable in all respects, except for the elevated OCD prevalence in AN, emphasizing the need to use clinical comparison groups to avoid inadvertently attributing elevated prevalences of comorbid conditions to specific disorders.",Jordan J.; Joyce PR.; Carter FA.; Horn J.; McIntosh VV.; Luty SE.; McKenzie JM.; Mulder RT.; Bulik CM.,2003.0,10.1002/eat.10177,0,0,
10879,Styles of coping with stress among patients with allergic diseases.,"Each man has his own characteristic and individual mode of coping in stress circumstances. The mode constitutes a permanent, personal inclination to a certain form of struggling with difficult situations. A mode of coping is at the same time a set of strategies applied in real confrontation with stress. The objective of the study is an attempt at analyzing the sources and the level of intensity of stress among patients with allergic diseases. The large majority, as many as 88.5% of the respondents claimed that their ability to cope with experienced stress was low or very low. Only 10.6% of the total number of the patients answered that they could cope with stress in this situation.",Latalski M.; Makara-Studzińska M.; Gajewska M.; Rudnicka-Drozak E.,2002.0,,0,0,
10880,The correlation of US and CT values in the diagnostics of giant pseudo-cysts of the liver.,"The aim of the study was a comparative assessment of the value of US and CT examinations in the diagnostics of giant hepatic pseudo-cysts. The material comprises 15 cases of complex hepatic pseudo-cysts with diameter exceeding 5 cm, which in 6 cases had traumatic etiology, in 4 neoplastic (cystoadenomas and cystoid adenocarcinomas) and in 5 cases infectious (postinflammatory and parasitic). Considerable disproportions in US and CT pictures of liver cysts were revealed. Posttraumatic cysts showed smooth inner contours in CT while in US irregular contours with thin septa intussuscepting to the inside were found. In 2 cases of neoplastic cysts thin inner septa were only shown with US examination. In parasitic cysts CT visualized only a part of septa visible in US. It was found out that considerable disproportions of US and CT pictures of complex hepatic cysts require combination of both imaging methods in their diagnostics. US shows high sensitivity in revealing septa, determining internal contours and wall thickness. CT reveals calcifications and after contrast enhancement vascularised walls, septa and tissue component. CT is useful in determining topographic relations of big hepatic cysts.",Krupski W.; Szafranek J.; Pasławski M.; Złomaniec J.,2002.0,,0,0,
10881,"Long-term adjustment of survivors of early-stage breast carcinoma, 20 years after adjuvant chemotherapy.","The long-term impact of breast carcinoma and its treatment was assessed in 153 breast carcinoma survivors previously treated on a Phase III randomized trial (Cancer and Leukemia Group B [CALGB 7581]) a median of 20 years after entry to CALGB 7581. Survivors were interviewed by telephone using the following standardized measures: Brief Symptom Inventory (BSI), PostTraumatic Stress Disorder Checklist with the trauma defined as survivors' response to having had cancer (PCL-C), Conditioned Nausea, Vomiting and Distress, European Organization for Research and Treatment of Cancer QLQ-C30 (quality of life), Life Experience Survey (stressful events), MOS Social Support Survey, comorbid conditions (Older Americans Resources and Services Questionnaire), and items developed to assess long-term breast carcinoma treatment side effects and their interference with functioning. Only 5% of survivors had scores that were suggestive of clinical levels of distress (BSI), 15% reported 2 or more posttraumatic stress disorder (PTSD) symptoms (PCL-C) that were moderately to extremely bothersome, 1-6% reported conditioned nausea, emesis, and distress as a consequence of sights, smells, and tastes triggered by reminders of their treatment, 29% reported sexual problems attributed to having had cancer, 39% reported lymphedema, and 33%, reported numbness. Survivors who reported greater lymphedema and numbness that interfered with functioning had significantly worse PTSD (PCL-C; P = 0.008) com- pared with survivors who reported less lymphedema and numbness. Survivors with a lower level of education (P = 0.026), less adequate social support (P = 0.0033), more severe negative life events (P = 0.0098), and greater dissatisfaction with their medical care (P = 0.037) had worse PTSD compared with other survivors. Twenty years after the initial treatment, the impact of breast carcinoma on survivors' adjustment was minimal. However, the higher prevalence of PTSD symptoms in response to having had cancer is indicative of continuing psychologic sequelae long after treatment completion. Findings related to lymphedema and numbness and continued symptoms of PTSD suggest that the long-term psychologic and medical sequelae on adjustment may be underrecognized. To establish in more detail whether survivors' overall psychologic state is any different from that of individuals without cancer, a population of community residents without cancer would need to be studied.",Kornblith AB.; Herndon JE.; Weiss RB.; Zhang C.; Zuckerman EL.; Rosenberg S.; Mertz M.; Payne D.; Jane Massie M.; Holland JF.; Wingate P.; Norton L.; Holland JC.,2003.0,10.1002/cncr.11531,0,0,
10882,Reducing reactions to blood donation with applied muscle tension: a randomized controlled trial.,"Unpleasant blood donation-related symptoms may discourage otherwise healthy, altruistic individuals from becoming repeat donors. This study examined a behavioral technique called applied muscle tension (AMT) that might reduce reactions. A total of 605 donors at mobile clinics were assigned to either an AMT treatment condition, a no-treatment control condition, or a placebo control condition. AMT involves repeated tensing of major muscles and was taught using an instructional video. Participants in the placebo control group watched the same video but were told to practice the technique only from the time they got on the donation chair until insertion of the needle, without being told that reactions are unlikely during this period. There were no differences between men assigned to the three conditions. Women donors assigned to the AMT condition reported significantly fewer donation-related symptoms, required less chair reclining for reactions, and were more likely to produce a full unit of blood than women in both the no-treatment and placebo control conditions. Women in the AMT condition also said they would be more likely to recommend it to a friend who was going to give blood, but there were no significant effects of AMT on the rated probability of giving blood again or blood pressure change. Although it was not universally effective and the mechanisms of its effects are unclear, AMT is a simple behavioral technique that may be useful in reducing reactions to blood donation.",Ditto B.; France CR.; Lavoie P.; Roussos M.; Adler PS.,2003.0,,0,0,
10883,Gender differences in borderline personality disorder: findings from the Collaborative Longitudinal Personality Disorders Study.,"A majority of the literature on borderline personality disorder (BPD) focuses on its occurrence in women or does not specifically assess for gender differences in clinical presentations. Some studies report that men with BPD may be more likely to be diagnosed with substance use disorders, as well as paranoid, passive-aggressive, narcissistic, sadistic, and antisocial personality disorders (PDs). Additionally, women with BPD appear to be more likely to report histories of adult physical and sexual abuse and to meet diagnostic criteria for post-traumatic stress disorder (PTSD) and eating disorders. The purpose of the present study was to further examine gender differences in BPD. Using baseline data from the Collaborative Longitudinal Personality Disorders Study (CLPS), men and women who met criteria for BPD were compared on current axis I and II disorders, BPD diagnostic criteria, childhood trauma histories, psychosocial functioning, temperament, and personality traits. Men with BPD were more likely to present with substance use disorders, and with schizotypal, narcissistic, and antisocial PDs, while women with BPD were more likely to present with PTSD, eating disorders, and the BPD criterion of identity disturbance. Generally speaking, women and men with BPD displayed more similarities than differences in clinical presentations. The differences that did emerge are consistent with those found in epidemiological studies of psychopathology and therefore do not appear unique to BPD. Additionally, many gender differences traditionally found in epidemiological samples did not emerge in BPD subjects. For example, no difference was found in rates of major depressive disorder, a condition that is more prevalent in females. Thus, BPD pathology may be a prevailing characterization that can attenuate usual gender-based distinctions.",Johnson DM.; Shea MT.; Yen S.; Battle CL.; Zlotnick C.; Sanislow CA.; Grilo CM.; Skodol AE.; Bender DS.; McGlashan TH.; Gunderson JG.; Zanarini MC.,,10.1016/S0010-440X(03)00090-7,0,0,
10884,Imaginal exposure alone and imaginal exposure with cognitive restructuring in treatment of posttraumatic stress disorder.,"This study investigated the extent to which providing cognitive restructuring (CR) with prolonged imaginal exposure (IE) would lead to greater symptom reduction than providing IE alone for participants with posttraumatic stress disorder (PTSD). Fifty-eight civilian survivors of trauma with PTSD were randomly allocated to IE/CR, IE, or supportive counseling (SC). Treatment involved 8 individual weekly sessions with considerable homework. Independent assessments were conducted pretreatment, posttreatment, and at 6-month follow-up. IE/CR and IE resulted in reduced PTSD and depression compared with SC at posttreatment and follow-up. Further, IE/CR participants had greater reductions in PTSD and maladaptive cognitive styles than IE participants at follow-up. These findings suggest that providing CR in combination with IE may enhance treatment gains.",Bryant RA.; Moulds ML.; Guthrie RM.; Dang ST.; Nixon RD.,2003.0,,0,0,
10885,Alcohol detoxification and social anxiety symptoms: a preliminary study of the impact of mirtazapine administration.,"Social anxiety disorder is fairly prevalent among alcohol abusing/dependent subjects. The objective of the present study was to investigate: (a) the incidence of social anxiety symptoms in inpatient alcoholics, (b) the effect of alcohol detoxification on these symptoms, and (c) whether a combined psychotherapeutic/mirtazapine treatment during the post-detoxification phase of alcoholism has a greater impact on the aforementioned symptoms than a non-pharmacological approach. Social anxiety symptoms were assessed through the Liebowitz Social Anxiety Scale (LSAS) following a 4-5-week detoxification period in two groups: group A (n=21) that followed a detoxification protocol of cognitive-behavioral orientation and group B (n=33) that was assigned to mirtazapine in addition to the standard protocol. Concomitant psychopathology was monitored through the HARS and HDRS, and level of functioning through the GAS. A marked reduction of social anxiety symptoms was evidenced in both groups. However, patients on mirtazapine improved significantly more compared to controls. A single measure of social anxiety, i.e., the LSAS was used. Also, a longer follow-up period is needed to ascertain remission of social anxiety symptoms. The present study found a rather high incidence of social anxiety symptoms in inpatient alcoholics which subsided following alcohol detoxification; moreover, it provides preliminary evidence that a combined psychotherapeutic/mirtazapine treatment (30-60 mg/daily) has a greater impact on the aforementioned symptoms than non-pharmacological treatment alone.",Liappas J.; Paparrigopoulos T.; Tzavellas E.; Christodoulou G.,2003.0,,0,0,
10886,The psychophysiology of anxiety disorder: fear memory imagery.,"Psychophysiological response to fear memory imagery was assessed in specific phobia, social anxiety disorder, panic disorder with agoraphobia, post-traumatic stress disorder (PTSD), and healthy controls. Heart rate, skin conductance, and corrugator muscle were recorded as participants responded to tone cues signaling previously memorized descriptor sentences. Image contents included personal fears, social fears, fears of physical danger, and neutral (low arousal) scenes. Reactions to acoustic startle probes (eyeblink) were assessed during recall imagery and nonsignal periods. Participants were significantly more reactive (in physiology and report of affect) to fear than neutral cues. Panic and PTSD patients were, however, less physiologically responsive than specific phobics and the socially anxious. Panic and PTSD patients also reported the most anxiety and mood symptoms, and were most frequently comorbidly depressed. Overall, physiological reactivity to sentence memory cues was greatest in patients with focal fear of specific objects or events, and reduced in patients characterized by generalized, high negative affect.",Cuthbert BN.; Lang PJ.; Strauss C.; Drobes D.; Patrick CJ.; Bradley MM.,2003.0,,0,0,
10887,"[Total elbow arthroplasty. Indications, operative technique and results after implantation of an Acclaim elbow prosthesis].","Total elbow arthroplasty has become a reliable treatment option for patients with rheumatoid arthritis as well as primary or posttraumatic arthrosis. The aim of this study is to present the indications, operative technique and results for the implantation of an Acclaim elbow prosthesis. Case reports are given to demonstrate the indications for prosthesis implantation. Furthermore, the follow-up results are reported for 65 patients after implantation of an Acclaim prosthesis. Pre- and postoperative pain were evaluated using the visual analogue scale. The pain level decreased from 8.0 to 2.3 postoperatively. After implantation of an elbow prosthesis, there was a significant improvement in the range of motion. The mean flexion increased from 103 degrees preoperatively to 140 degrees postoperatively. An increase of 10 degrees was found for both supination and pronation. Complications included temporary ulnary nerve irritation in seven patients, intraoperative fractures in four cases and postoperative elbow dislocation in one case. In conclusion, total elbow arthroplasty results in a reduction of pain and an improvement in elbow movement. However, selection of the right patient is important. Patients are advised not to lift heavy objects or to perform hard physical work. If patients' compliance can not be ensured preoperatively, no total elbow arthroplasty should be performed.",Lerch K.; Tingart M.; Trail I.; Grifka J.,2003.0,10.1007/s00132-003-0526-y,0,0,
10888,[Anxiety patients before and after hospitalization for psychotherapy - from a psychophysiological standpoint].,"Psychophysiological course studies are still the exception in AP hospitalized for psychotherapy. The aim of this study was to perform a more precise psychophysiological analysis of anxiety patients (AP) before and after hospital treatment. From a sample of 28 AP, 13 were psychophysiologically and psychodiagnostically examined and compared to controls (CG) at the beginning and end of in-patient psychotherapy and 4 months later. APs showed higher heart rate (HR) and electrodermal spontaneous fluctuation (SF) than control patients but did not differ in their resting systolic (SBP) and diastolic blood pressure (DBP). Under cognitive stress, the controls had a significantly stronger HR and SBP reaction, while the AP showed more SF during the tone sequence and while being asked about their subjectively experienced anxiety. Following inpatient psychotherapy, the two groups showed correlation in their vegetative reaction patterns. The study clearly demonstrates the effectiveness of the applied depth psychology-oriented multimodal therapy from a psychophysiological standpoint.",Deter HC.; Luck H.,2003.0,,0,0,
10889,Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).,"Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement.",Connor KM.; Davidson JR.,2003.0,10.1002/da.10113,0,0,
10890,[Treatment of acrophobia in a virtual environment].,"Specific phobias are one of the most frequent mental health problems and can lead to years of personal suffering. The most effective treatment is exposure therapy. Our aim was to proof the feasibility and efficacy of virtual environments in treating acrophobia patients using a manually guided exposure therapy. Our pilot study was designed as a crossover intervention with a waiting list condition as a control group. After treatment, our results show that exposure in virtual environments is a feasible technique, can provoke anxiety, and leads to a therapeutic effect.",Kuntze MF.; Störmer R.; Mager R.; Müller-Spahn F.; Bullinger A.,2003.0,,0,0,7108
10891,Interapy: a controlled randomized trial of the standardized treatment of posttraumatic stress through the internet.,"Online therapy offers many advantages over face-to-face therapy. Interapy includes psychoeducation, screening, effect measures, and a protocol-driven treatment via the Internet for people suffering from posttraumatic stress. The present article reports the results of a controlled trial on the Internet-driven treatment of posttraumatic stress and grief in a group of people who manifested mild to relatively severe trauma symptoms. Participants in the treatment condition (n=69) improved significantly more than participants in the waiting-list control condition (n=32) on trauma-related symptoms and general psychopathology. The effect sizes were large. On most subscales, more than 50% of the treated participants showed reliable change and clinically significant improvement, with the highest percentages being found for depression and avoidance.",Lange A.; Rietdijk D.; Hudcovicova M.; van de Ven JP.; Schrieken B.; Emmelkamp PM.,2003.0,10.1037/0022-006X.71.5.901,0,0,
10892,"Rehabilitation after critical illness: a randomized, controlled trial.","To evaluate the effectiveness of a rehabilitation program following critical illness to aid physical and psychological recovery. Randomized controlled trial, blind at follow-up with final assessment at 6 months. Two district general hospitals and one teaching hospital. Patients were 126 consecutively admitted intensive care patients meeting the inclusion criteria. Control patients received ward visits, three telephone calls at home, and clinic appointments at 8 wks and 6 months. Intervention patients received the same plus a 6-wk self-help rehabilitation manual. We measured levels of depression and anxiety (Hospital Anxiety and Depression Scale), phobic symptoms (Fear Index), posttraumatic stress disorder (PTSD)-related symptoms (Impact of Events Scale), and scores on the Short-Form Health Survey physical dimension 8 wks and 6 months after intensive care unit (ICU) treatment. Memory for ICU was assessed at 2 wks post-ICU discharge using the ICU Memory Tool.The intervention group improved, compared with the control patients, on the Short-Form Health Survey physical function scores at 8 wks and 6 months (p =.006), and there was a trend to a lower rate of depression at 8 wks (12% vs. 25%). However, there were no differences in levels of anxiety and PTSD-related symptoms between the groups. The presence of delusional memories was correlated significantly with both anxiety and Impact of Events Scale scores. A self-help rehabilitation manual is effective in aiding physical recovery and reducing depression. However, in those patients recalling delusional memories from the ICU, further psychological care may be needed to reduce the incidence of anxiety and PTSD-related symptoms.",Jones C.; Skirrow P.; Griffiths RD.; Humphris GH.; Ingleby S.; Eddleston J.; Waldmann C.; Gager M.,2003.0,10.1097/01.CCM.0000089938.56725.33,0,0,
10893,[Comparison of dorso-lateral and dorso-ventral stabilization procedures in the treatment of vertebral fractures].,"The radiological and clinical outcome of surgical treated thoracolumbal fractures were followed up after 6.7 years. The study encompassed 97 patients. The degrees of the bony deformation and the local kyphosis were measured on the lateral view X-ray at 4 different time points: post trauma, after the operation, before implant removal and at the follow up examination. The clinical outcome was evaluated by the Oswestry score. 74 fractures were treated with a fixateur intern and a dorsal fusion by apposition of autologous bone postero-laterally. 23 fractures were fused in a combined dorso-ventral manner by intervertebral fusion with tricortical autologous bone. The lateral X-rays showed a loss of correction up to 48 % in the dorsal fused group and 10 % loss of correction in the combined group. The local kyphosis increased up to 84 % in the dorsal operated group due to degeneration of the injured disk. The clinical Oswestry score showed no significant difference in both groups. The additional ventral surgery should be evaluated carefully.",Bertram R.; Bessem H.; Diedrich O.; Wagner U.; Schmitt O.,,10.1055/s-2003-42841,0,0,
10894,Response to thermal stress and personality.,"Tolerance to cold and heat exposure shows large variations for which there is still insufficient explanation. On the other hand the relationship between the responses to mental stress and individual personality is well documented. The aim of this study was then to find if personality traits have some influence on the responses to environmental temperature exposure. A group of 20 young adults were exposed for 90 min to cold (10 degrees C) while skin temperature (Ts), oxygen consumption and discomfort rating were recorded. In a second experiment they were exposed to heat (40 degrees C) for 90 min when the sweat rate and the discomfort rating were recorded. Prior to these tests the Big Five Personality Test was used to measure the personality traits of the subjects. The results show significant negative correlation between neuroticism and the O(2) consumed, the discomfort rating and Ts for the test in the cold, while extraversion was positively related to O(2) consumption but not to Ts and discomfort rating. In response to heat, neuroticism predominance was associated with greater discomfort, reduced tolerance and diminished sweat rate. The discomfort rating, in this case, was negatively related to extraversion. It is proposed that the reduced O(2) consumption in the cold and the lower rate of sweating in the heat observed with neuroticism, are caused by enhanced activity of the sympathetic nervous system. Further investigation is required to assess the validity of this proposal. Overall, the present investigation shows that physical environmental stresses, in common with mental stress, could be in some ways related to personality traits.",LeBlanc J.; Ducharme MB.; Pasto L.; Thompson M.,2003.0,,0,0,
10895,Effects of attenuation correction and reconstruction method on PET activation studies.,"The outcome of Statistical Parametric Mapping (SPM) analyses of PET activation studies depends among others, on the quality of reconstructed data. In general, filtered back-projection (FBP) is used for reconstruction in PET activation studies. There is, however, increasing interest in iterative reconstruction algorithms such as ordered subset expectation maximization (OSEM) algorithms. The aim of the present study was to investigate the effects of reconstruction techniques and attenuation correction (AC) on the detection of activation foci following statistical analysis with SPM. First, a replicate study was performed to assess the effects of the reconstruction method on pixel variance. Second, a phantom study was performed to evaluate the influence of both locations of an activated area and applied reconstruction method on SPM outcome. A volumetric method was used to compute the number of false positive voxels for all reconstructions. In addition, average t values within activation foci and for false positive voxels were calculated. For the assessment of the effects of reconstruction on clinical data, a group of 11 patients was studied. For all reconstructions SPM maps were created and compared. Both the clinical and the phantom data showed that use of iterative reconstruction methods reduced false positive results, while showing similar SPM results within activated areas as FBP. Reconstruction of data without attenuation correction reduced noise for FBP only, but did not affect the quality of SPM results for OSEM. It is concluded that OSEM is a good alternative for FBP reconstructions providing SPM results with less noise.",Mesina CT.; Boellaard R.; van den Heuvel OA.; Veltman DJ.; Jongbloed G.; van der Vaart AW.; Lammertsma AA.,2003.0,10.1016/S1053-8119(03)00379-3,0,0,
10896,Autonomic recovery and habituation in social anxiety.,"Growing evidence suggests that, contrary to expectation, high trait socially anxious (HTSA) and low trait socially anxious (LTSA) individuals show comparable autonomic reactivity during stressful speech tasks. To test the hypothesis that autonomic differences between groups might emerge during recovery or habituation, 35 HTSA and LTSA participants gave two impromptu speeches. Measures of anxiety experience as well as cardiovascular, electrodermal, respiratory, and vagal activation were obtained. Despite greater reports of anxiety experience in the HTSA versus the LTSA participants, autonomic measures showed comparable reactivity, habituation, and recovery in the two anxiety groups. These results suggest minimal autonomic differences between HTSA and LTSA individuals, thus supporting theories of social anxiety that emphasize cognitive factors.",Mauss IB.; Wilhelm FH.; Gross JJ.,2003.0,,0,0,
10897,Rates and symptoms of PTSD among cocaine-dependent patients.,"This study evaluated lifetime traumatic events and current posttraumatic stress disorder (PTSD) symptoms in a substance abuse sample. Participants in the study consisted of 558 (75.1% male) cocaine-dependent individuals who completed self-report measures of trauma and PTSD symptoms prior to entry into treatment. Results showed a high number of lifetime traumatic events, even among those without PTSD. General disaster was the most prevalent. Current PTSD was found in 10.9% of the participants, with a significantly higher rate among women (21.6%) than among men (7.2%). For those with PTSD, the most prominent PTSD symptom cluster was arousal, and the most common symptoms were restricted affect, detachment and irritability. Participants with PTSD endorsed a large number of symptoms, almost double that needed to meet diagnostic criteria; however, neither number of traumas nor type of trauma was associated with their level of PTSD symptoms. Even among those not meeting PTSD criteria, subthreshold symptoms were found, with avoidance the most prominent cluster. Sociodemographic and recent cocaine use variables did not differentiate the PTSD from non-PTSD groups. PTSD is present in a sizeable percentage of cocaine-dependent treatment-seeking patients, particularly women. Clinicians might address arousal symptoms in particular, which were the most prominent symptom cluster, and which may be exacerbated by cocaine use. Even among those without PTSD, lifetime trauma is substantial and subthreshold PTSD symptoms are common. Vulnerability to PTSD needs further study, as sociodemographic and cocaine use variables did not distinguish between PTSD and non-PTSD groups.",Najavits LM.; Runkel R.; Neuner C.; Frank AF.; Thase ME.; Crits-Christoph P.; Blaine J.,2003.0,,0,0,
10898,Negative self-imagery blocks inferences.,"Previous research has shown that, unlike non-anxious individuals, people with social phobia fail to generate non-threatening inferences when ambiguous social information is first encountered (i.e. 'on-line'; Hirsch and Mathews Journal of Abnormal Psychology, 109 (2000) 705-712). Patients with social phobia also report negative self-imagery in social situations, while individuals without high social anxiety do not. The negative self-imagery in social phobia may prevent the generation of non-threatening inferences. If so, then training non-anxious individuals to hold in mind a negative self-image should remove the 'on-line' non-threat inferential bias normally evident in this population. In the present study, low anxious volunteers were allocated to negative image training or a control task that did not manipulate self-imagery. Following negative image training, or the control task, volunteers read descriptions of job interviews and at certain points during the text performed lexical decisions. Some decisions were made after ambiguous text that could have been interpreted in both a threatening and a non-threatening manner. In a baseline condition, decisions were made following the text for which there was only one possible inference (either threat or non-threat). The results for the control group replicated earlier findings of a non-threat inferential bias for non-anxious individuals. In contrast, and as predicted, non-anxious volunteers who were trained to hold a negative image in mind lacked any non-threatening inferential bias, and also experienced higher levels of state anxiety.",Hirsch CR.; Mathews A.; Clark DM.; Williams R.; Morrison J.,2003.0,,0,0,
10899,Imagery rehearsal in the treatment of posttraumatic nightmares in Australian veterans with chronic combat-related PTSD: 12-month follow-up data.,"Nightmares are often a distressing symptom for veterans with chronic combat-related posttraumatic stress disorder (PTSD). A psychological treatment that has recently shown considerable promise is Imagery Rehearsal Therapy (IRT). In a pilot study by the current authors, IRT was demonstrated to be effective in the treatment of posttraumatic nightmares in a group of combat veterans up to 3-month posttreatment. This study reports the 12-month follow-up data of the pilot study, examining the longer term outcome of the IRT treatment. Twelve Australian Vietnam veterans with chronic combat-related PTSD were treated with 6 once weekly sessions of imagery rehearsal and assessed using standardised measures of nightmare frequency and intensity, PTSD, depression, anxiety and broader symptomatology at intake, posttreatment, and 3-and 12-month follow-up. Significant improvements in targeted nightmare frequency and intensity were evident to 12-month posttreatment. Similarly, improvements in overall PTSD, depression, anxiety, and broader based symptomatology were also maintained to 12 months. This study provides preliminary evidence that the positive treatment effects of IRT on posttraumatic nightmares, PTSD, and broader symptomatology in males with chronic combat-related PTSD are maintained in the longer term.",Forbes D.; Phelps AJ.; McHugh AF.; Debenham P.; Hopwood M.; Creamer M.,2003.0,10.1023/A:1025718830026,0,0,
10900,The clinical relevance of a partial remission specifier for posttraumatic stress disorder.,"The clinical relevance of a partial remission specifier for posttraumatic stress disorder (PTSD) was examined. Using a subgroup of outpatients from the Rhode Island Methods to Improve Diagnostic Assessment and Services project who met criteria for lifetime PTSD (N = 261), participants with current PTSD, PTSD in partial remission, and PTSD in full remission were compared on various indices of impairment. A substantial number (n = 75) of patients met criteria for PTSD in partial remission (28.7%). Outpatients in partial remission of PTSD displayed comparable levels of social and employment functioning as those with current PTSD, and over half of these patients requested treatment for their symptoms. Results support the clinical utility of a partial remission specifier for PTSD.",Johnson DM.; Zlotnick C.; Zimmerman M.,2003.0,10.1023/A:1025770814096,0,0,
10901,Good treatment outcomes in late-life depression with comorbid anxiety.,"Late-life depression studies have found that comorbid anxiety, as a symptom or comorbid disorder, is associated with poorer treatment response and increased likelihood of dropout. This study evaluated the impact of comorbid anxiety on response, dropouts, and side effects, in elderly subjects treated for depression. We analyzed data from a 12-week trial comparing nortriptyline and paroxetine in 116 patients aged 60 and older with depression. Subjects classified as having anxious depression were compared to those with nonanxious depression in terms of treatment response rate, time to response, dropout rate, and early side effects. The analysis was replicated with another study, in which 125 subjects aged 69 and older were treated openly with paroxetine and interpersonal psychotherapy. Anxious and nonanxious groups did not differ in terms of response rates, time to response, dropout rates, or time to dropout. Side effects declined more quickly and more significantly in the anxious group than in the nonanxious group. Subjects were treated in a specialty mental health setting, and the findings may not apply in other settings. We found no association between comorbid anxiety and a poorer prognosis during acute treatment of late-life depression. For elderly patients with anxious depression, standardized treatment in the mental health sector is associated with a good response.",Lenze EJ.; Mulsant BH.; Dew MA.; Shear MK.; Houck P.; Pollock BG.; Reynolds CF.,2003.0,,0,0,
10902,Symptom presentation and outcome of cognitive-behavioral therapy for obsessive-compulsive disorder.,"Previous researchers have classified obsessive-compulsive disorder (OCD) patients by the themes of their obsessions and compulsions (e.g., washing, checking); however, mental compulsions have not been adequately assessed in these studies. The authors conducted 2 studies using a large sample of OCD patients (N=132). In the 1st study, they categorized patients on the basis of symptom presentation, giving adequate consideration to mental compulsions. Five patient clusters were identified: harming, contamination, hoarding, unacceptable thoughts, and symmetry. Mental compulsions were most prevalent among patients with intrusive, upsetting religious, violent, or sexual thoughts. In the 2nd study, they compared response to cognitive-behavioral therapy across symptom categories, finding poorer outcomes among patients with hoarding symptoms compared with those with other symptom themes.",Abramowitz JS.; Franklin ME.; Schwartz SA.; Furr JM.,2003.0,10.1037/0022-006X.71.6.1049,0,0,
10903,Study refusal and exclusion from a randomized treatment study of generalized social phobia.,"We examine treatment exclusion and refusal rates as well as reasons for non-participation in a sub-sample of phone interviews conducted to determine eligibility for a randomized study of treatments for generalized social phobia (GSP). This study compared group comprehensive cognitive behavioral therapy (CCBT) to fluoxetine (FLU), placebo (PLA), or their combination. Results suggest that the major exclusion for the study was due to comorbid depression, followed by having a different diagnosis as primary. Patient refusal to enter the study was also common, with the most frequently reported reason being not wanting to take medication. Notably, few people who refused stated an objection to entering CCBT or PLA. These results suggest that there is a need to develop and evaluate a treatment for social anxiety with comorbid depression and to systematically study reasons for reluctance to take medication among individuals with GSP.",Huppert JD.; Franklin ME.; Foa EB.; Davidson JR.,2003.0,,0,0,
10904,Effects of motivational interviewing on smoking cessation in adolescents with psychiatric disorders.,"To test the hypothesis that among adolescent smokers hospitalised for psychiatric and substance use disorders, motivational interviewing (MI) would lead to more and longer quit attempts, reduced smoking, and more abstinence from smoking over a 12 month follow up. Randomised control trial of MI versus brief advice (BA) for smoking cessation, with pre- and post-intervention assessment of self efficacy and intentions to change, and smoking outcome variables assessed at one, three, six, nine, and 12 month follow ups. A private, university affiliated psychiatric hospital in Providence, Rhode Island, USA. Consecutive sample (n = 191) of 13-17 year olds, admitted for psychiatric hospitalisation, who smoked at least one cigarette per week for the past four weeks, had access to a telephone, and did not meet DSM-IV criteria for current psychotic disorder. MI versus BA. MI consisted of two, 45 minute individual sessions, while BA consisted of 5-10 minutes of advice and information on how to quit smoking. Eligible participants in both conditions were offered an eight week regimen of transdermal nicotine patch upon hospital discharge. Point prevalence abstinence, quit attempts, changes in smoking rate and longest quit attempt. Proximal outcomes included intent to change smoking behaviour (upon hospital discharge), and self efficacy for smoking cessation. MI did not lead to better smoking outcomes compared to BA. MI was more effective than BA for increasing self efficacy regarding ability to quit smoking. A significant interaction of treatment with baseline intention to quit smoking was also found. MI was more effective than BA for adolescents with little or no intention to change their smoking, but was actually less effective for adolescents with pre-existing intention to cut down or quit smoking. However, the effects on these variables were relatively modest and only moderately related to outcome. Adolescents with comorbid substance use disorders smoked more during follow up while those with anxiety disorders smoked less and were more likely to be abstinent. The positive effect of MI on self efficacy for quitting and the increase in intention to change in those with initially low levels of intentions suggest the benefits of such an intervention. However, the effects on these variables were relatively modest and only moderately related to outcome. The lack of overall effect of MI on smoking cessation outcomes suggests the need to further enhance and intensify this type of treatment approach for adolescent smokers with psychiatric comorbidity.",Brown RA.; Ramsey SE.; Strong DR.; Myers MG.; Kahler CW.; Lejuez CW.; Niaura R.; Pallonen UE.; Kazura AN.; Goldstein MG.; Abrams DB.,2003.0,,0,0,
10905,Personality influences limbic-cortical interactions during sad mood induction.,"The current study examined limbic-cortical activation under transient emotional stress as a function of personality style. A ventral cingulate (Cg25)-centred limbic-cortical network was identified using positron emission tomography (PET) measures of regional cerebral blood flow (rCBF) during a sad mood challenge that demonstrated differences for individuals selected for specific patterns of Negative and Positive emotional traits, indexed by the NEO Personality Inventory-Revised. Healthy subjects scoring both low on the dispositional Depression facet of Neuroticism (N3) and high on the Positive Emotions facet of Extraversion (E6) were compared to those scoring high on the Depression facet (N3) and low on Positive Emotions (E6), a combination of traits previously linked to normal variations in mood reactivity. Scan analyses were designed to further characterize known variations in Cg25 activity previously reported in studies of negative mood in both healthy subjects and depressed patients. A multivariate technique, partial least squares (PLS) demonstrated a divergent Cg25-mediated network that differentiated temperamentally negative (NAS) from temperamentally positive (PAS) subjects providing a potential neural link between these specific combinations of trait affective styles and vulnerability to depression.",Keightley ML.; Seminowicz DA.; Bagby RM.; Costa PT.; Fossati P.; Mayberg HS.,2003.0,,0,0,
10906,Cognitive trauma therapy for battered women with PTSD (CTT-BW).,"This article describes a second treatment-outcome study of cognitive trauma therapy for battered women with posttraumatic stress disorder (PTSD; CTT-BW). CTT-BW includes trauma history exploration: PTSD education; stress management; exposure to abuse and abuser reminders; self-monitoring of negative self-talk; cognitive therapy for guilt; and modules on self-advocacy, assertiveness, and how to identify perpetrators. One hundred twenty-five ethnically diverse women were randomly assigned to immediate or delayed CTT-BW. PTSD remitted in 87% of women who completed CTT-BW, with large reductions in depression and guilt and substantial increases in self-esteem. White and ethnic minority women benefited equally from CTT-BW. Similar treatment outcomes were obtained by male and female therapists and by therapists with different levels of education and training. Gains were maintained at 3- and 6-month follow-ups.",Kubany ES.; Hill EE.; Owens JA.; Iannce-Spencer C.; McCaig MA.; Tremayne KJ.; Williams PL.,2004.0,10.1037/0022-006X.72.1.3,0,0,
10907,Application of a latent class analysis to empirically define eating disorder phenotypes.,"Diagnostic criteria for eating disorders influence how we recognize, research, and treat eating disorders, and empirically valid phenotypes are required for revealing their genetic bases. To empirically define eating disorder phenotypes. Data regarding eating disorder symptoms and features from 1179 individuals with clinically significant eating disorders were submitted to a latent class analysis. The resulting latent classes were compared on non-eating disorder variables in a series of validation analyses. Multinational, collaborative study with cases ascertained through diverse clinical settings (inpatient, outpatient, and community). Members of affected relative pairs recruited for participation in genetic studies of eating disorders in which probands met DSM-IV-TR criteria for anorexia nervosa (AN) or bulimia nervosa and had at least 1 biological relative with a clinically significant eating disorder. Main Outcome Measure Number and clinical characterization of latent classes. A 4-class solution provided the best fit. Latent class 1 (LC1) resembled restricting AN; LC2, AN and bulimia nervosa with the use of multiple methods of purging; LC3, restricting AN without obsessive-compulsive features; and LC4, bulimia nervosa with self-induced vomiting as the sole form of purging. Biological relatives were significantly likely to belong to the same latent class. Across validation analyses, LC2 demonstrated the highest levels of psychological disturbance, and LC3 demonstrated the lowest. The presence of obsessive-compulsive features differentiates among individuals with restricting AN. Similarly, the combination of low weight and multiple methods of purging distinguishes among individuals with binge eating and purging behaviors. These results support some of the distinctions drawn within the DSM-IV-TR among eating disorder subtypes, while introducing new features to define phenotypes.",Keel PK.; Fichter M.; Quadflieg N.; Bulik CM.; Baxter MG.; Thornton L.; Halmi KA.; Kaplan AS.; Strober M.; Woodside DB.; Crow SJ.; Mitchell JE.; Rotondo A.; Mauri M.; Cassano G.; Treasure J.; Goldman D.; Berrettini WH.; Kaye WH.,2004.0,10.1001/archpsyc.61.2.192,0,0,
10908,Comparing traditional and Rasch analyses of the Mississippi PTSD Scale: revealing limitations of reverse-scored items.,"This study examined whether Rasch analysis could provide more information than true score theory (TST) in determining the usefulness of reverse-scored items in the Mississippi Scale for Posttraumatic Stress Disorder (M-PTSD). Subjects were 803 individuals in inpatient PTSD units at 10 VA sites. TST indicated that the M-PTSD performed well and could be improved slightly by deleting one item. Factor analysis using raw scores indicated that the reverse-scored items formed the second factor and had poor relationships with normally scored items. However, since item-total correlations supported their usefulness, they were kept. The subsequent Rasch analysis indicated that five of the seven worst fitting items were reverse-scored items. We concluded that using reversed items with disturbed patients can cause confusion that reduces reliability. Deleting them improved validity without loss of reliability. The study supports the use of Rasch analysis over TST in health research since it indicated ways to reduce respondent burden while maintaining reliability and improving validity.",Conrad KJ.; Wright BD.; McKnight P.; McFall M.; Fontana A.; Rosenheck R.,2004.0,,0,0,
10909,Orienting attention in obsessive-compulsive disorder.,"Obsessive-compulsive disorder (OCD) is characterized by recurrent obsessions and/or compulsions that affect daily functioning. This study aimed to ascertain whether OCD patients have problems in orienting attention, via the use of a vibrotactile choice reaction time task. Participants were required to depress a button in response to a vibration delivered to the index finger of either the right or left hand. Prior to the stimulus, one of three precues was administered: valid (precue delivered to the same hand as stimulus), invalid (precue delivered to opposite hand to stimulus), or neutral (precue delivered simultaneously to both hands). Obsessive-compulsive disorder participants were overall slower and less accurate than controls. Contrary to our predictions, OCD participants did not show increased costs or benefits. However, unlike controls, patients did not show the normal pattern of faster reaction times on neutral compared with invalid precues, which may reflect a problem in inhibiting irrelevant information. Both patients and controls may benefit from the provision of directed attention in tactile tasks when difficulty levels are maximal. OCD patients may have problems with inhibitory control.",Georgiou-Karistianis N.; Howells D.; Bradshaw J.,2003.0,,0,0,
10910,Post-traumatic stress disorder-related symptoms in relatives of patients following intensive care.,"To evaluate the effectiveness of the provision of information in the form of a rehabilitation program following critical illness in reducing psychological distress in the patients' close family. Randomised controlled trial, blind at follow-up with final assessment at 6 months. Two district general hospitals and one teaching hospital. The closest family member of 104 recovering intensive care unit (ICU) patients. Ward visits, ICU clinic appointments at 2 and 6 months. Relatives and patients received the rehabilitation program at 1 week after ICU discharge. The program comprised a 6-week self-help manual containing information about recovery from ICU, psychological information and practical advice. Psychological recovery of relatives was assessed by examining the rate of depression, anxiety, and post-traumatic stress disorder (PTSD)-related symptoms by 6 months after ICU. The proportion of relatives scoring in the range >19 on the Impact of Events Scale (cause for concern) was high in both groups at 49% at 6 months. No difference was shown in the rate of depression, anxiety, or PTSD-related symptoms between the study groups. A high incidence of psychological distress was evident in relatives. Written information concerning recovery from ICU provided to the patient and their close family did not reduce this. High levels of psychological distress in patients were found to be correlated with high levels in relatives.",Jones C.; Skirrow P.; Griffiths RD.; Humphris G.; Ingleby S.; Eddleston J.; Waldmann C.; Gager M.,2004.0,10.1007/s00134-003-2149-5,0,0,
10911,"Attention to phobic stimuli during exposure: the effect of distraction on anxiety reduction, self-efficacy and perceived control.","To replicate and extend the finding that distraction facilitates between session anxiety reduction (), 27 spider phobics underwent three 10-min sessions of in vivo exposure followed by one 10-min exposure session at a 4-week follow-up, while having either stimulus-relevant focused conversation or stimulus-irrelevant distracting conversation with the experimenter. Physiological arousal and subjective anxiety were measured during exposure, and self-efficacy, perceived control and performance on a behavioural task were measured at pre-treatment, post session-3, and follow-up. Monitoring and blunting coping styles were also measured at pre-treatment to assess their impact on treatment outcome. Despite equal physiological activation between the groups, those who underwent distracted exposure showed greater reductions in subjective fear within and between sessions, and showed greater increases in self-efficacy ratings, internal perceived control and performance on a behavioural task. Coping style did not interact with the effect of distraction or focusing during exposure, however blunters had less subjective anxiety reduction overall, particularly when they underwent focused exposure. Results are discussed in terms of the emotional processing model and self-efficacy theory.",Johnstone KA.; Page AC.,2004.0,10.1016/S0005-7967(03)00137-2,0,0,
10912,Effects of aerobic exercise on anxiety sensitivity.,"Anxiety sensitivity is a known precursor to panic attacks and panic disorder, and involves the misinterpretation of anxiety-related sensations. Aerobic exercise has been shown to reduce generalized anxiety, and may also reduce anxiety sensitivity through exposure to feared physiological sensations. Accordingly, 54 participants with elevated anxiety sensitivity scores completed six 20-min treadmill exercise sessions at either a high-intensity aerobic ( n = 29 ) or low-intensity ( n = 25 ) level. Self-ratings of anxiety sensitivity, fear of physiological sensations associated with anxiety, and generalized anxiety were obtained at pre-treatment, post-treatment, and one-week follow-up. Results indicated that both high- and low-intensity exercise reduced anxiety sensitivity. However, high-intensity exercise caused more rapid reductions in a global measure of anxiety sensitivity and produced more treatment responders than low-intensity exercise. Only high-intensity exercise reduced fear of anxiety-related bodily sensations. The implications of these findings are discussed.",Broman-Fulks JJ.; Berman ME.; Rabian BA.; Webster MJ.,2004.0,10.1016/S0005-7967(03)00103-7,0,0,
10913,Treatment of acrophobia in virtual reality: the role of immersion and presence.,In this study the effects of virtual reality exposure therapy (VRET) were investigated in patients with acrophobia. Feelings of presence in VRET were systematically varied by using either a head-mounted display (HMD) (low presence) or a computer automatic virtual environment (CAVE) (high presence). VRET in general was found to be more effective than no treatment. No differences were found in effectiveness between VRET using an HMD or CAVE. Results were maintained at 6 months follow-up. Results of VRET were comparable with those of exposure in vivo (Cyberpsychology and Behavior 4 (2001) 335). In treatment completers no relationship was found between presence and anxiety. Early drop-outs experienced less acrophobic complaints and psychopathology in general at pre-test. They also experienced less presence and anxiety in the virtual environment used in session one as compared to patients that completed VRET.,Krijn M.; Emmelkamp PM.; Biemond R.; de Wilde de Ligny C.; Schuemie MJ.; van der Mast CA.,2004.0,10.1016/S0005-7967(03)00139-6,0,0,
10914,"Trauma films, information processing, and intrusive memory development.","Three experiments indexed the effect of various concurrent tasks, while watching a traumatic film, on intrusive memory development. Hypotheses were based on the dual-representation theory of posttraumatic stress disorder (C. R. Brewin, T. Dalgleish, & S. Joseph, 1996). Nonclinical participants viewed a trauma film under various encoding conditions and recorded any spontaneous intrusive memories of the film over the following week in a diary. Changes in state dissociation, heart rate, and mood were also measured. As predicted, performing a visuospatial pattern tapping task at encoding significantly reduced the frequency of later intrusions, whereas a verbal distraction task increased them. Intrusive memories were largely unrelated to recall and recognition measures. Increases in dissociation and decreases in heart rate during the film were also associated with later intrusions.",Holmes EA.; Brewin CR.; Hennessy RG.,2004.0,10.1037/0096-3445.133.1.3,0,0,
10915,Testimony method to ameliorate post-traumatic stress symptoms. Community-based intervention study with Mozambican civil war survivors.,"The effectiveness of the testimony method has not been established in rural communities with survivors of prolonged civil war. To examine the effectiveness and feasibility of a testimony method to ameliorate post-traumatic stress symptoms. Participants (n=206) belonged to former war zones in Mozambique. They were divided into a case (n=137) and a non-case group (n=69). The case group was randomly divided into an intervention (n=66) and a control group (n=71). Symptoms were measured during baseline assessment, post-intervention and at an 11-month follow-up. Post-intervention measurements demonstrated significant symptom reduction in both the intervention and the control group. No significant differences were found between the intervention and the control group. Follow-up measurements showed sustained lower levels of symptoms in both groups, and some indications of a positive intervention effect in women. A remarkable drop in symptoms could not be linked directly to the intervention. Feasibility of the intervention was good, but controlling the intervention in a small rural community appeared to be a difficult task to accomplish.",Igreja V.; Kleijn WC.; Schreuder BJ.; Van Dijk JA.; Verschuur M.,2004.0,,0,0,
10916,"Repetitive transcranial magnetic stimulation of the right dorsolateral prefrontal cortex in posttraumatic stress disorder: a double-blind, placebo-controlled study.","The efficacy of repetitive transcranial magnetic stimulation (rTMS) of the right prefrontal cortex was studied in patients with posttraumatic stress disorder (PTSD) under double-blind, placebo-controlled conditions. Twenty-four patients with PTSD were randomly assigned to receive rTMS at low frequency (1 Hz) or high frequency (10 Hz) or sham rTMS in a double-blind design. Treatment was administered in 10 daily sessions over 2 weeks. Severity of PTSD, depression, and anxiety were blindly assessed before, during, and after completion of the treatment protocol. The 10 daily treatments of 10-Hz rTMS at 80% motor threshold over the right dorsolateral prefrontal cortex had therapeutic effects on PTSD patients. PTSD core symptoms (reexperiencing, avoidance) markedly improved with this treatment. Moreover, high-frequency rTMS over the right dorsolateral prefrontal cortex alleviated anxiety symptoms in PTSD patients. This double-blind, controlled trial suggests that in PTSD patients, 10 daily sessions of right dorsolateral prefrontal rTMS at a frequency of 10 Hz have greater therapeutic effects than slow-frequency or sham stimulation.",Cohen H.; Kaplan Z.; Kotler M.; Kouperman I.; Moisa R.; Grisaru N.,2004.0,10.1176/appi.ajp.161.3.515,0,0,
10917,Interrater reliability between scorers from eight European sleep laboratories in subjects with different sleep disorders.,"Interrater variability of sleep stage scorings is a well-known phenomenon. The SIESTA project offered the opportunity to analyse interrater reliability (IRR) between experienced scorers from eight European sleep laboratories within a large sample of patients with different (sleep) disorders: depression, general anxiety disorder with and without non-organic insomnia, Parkinson's disease, period limb movements in sleep and sleep apnoea. The results were based on 196 recordings from 98 patients (73 males: 52.3 +/- 12.1 years and 25 females: 49.5 +/- 11.9 years) for which two independent expert scorings from two different laboratories were available. Cohen's kappa was used to evaluate the IRR on the basis of epochs and intraclass correlation was used to analyse the agreement on quantitative sleep parameters. The overall level of agreement when five different stages were distinguished was kappa = 0.6816 (76.8%), which in terms of kappa reflects a 'substantial' agreement (Landis and Koch, 1977). For different groups of patients kappa values varied from 0.6138 (Parkinson's disease) to 0.8176 (generalized anxiety disorder). With regard to (sleep) stages, the IRR was highest for rapid eye movement (REM), followed by Wake, slow-wave sleep (SWS), non-rapid eye movement 2 (NREM2) and NREM1. The results of regression analysis showed that age and sex only had a statistically significant effect on kappa when the (sleep) stages are considered separately. For NREM2 and SWS a statistically significant decrease of IRR with age has been observed and the IRR for SWS was lower for males than for females. These variations of IRR most probably reflect changes of the sleep electroencephalography (EEG) with age and gender.",Danker-Hopfe H.; Kunz D.; Gruber G.; Klösch G.; Lorenzo JL.; Himanen SL.; Kemp B.; Penzel T.; Röschke J.; Dorn H.; Schlögl A.; Trenker E.; Dorffner G.,2004.0,,0,0,
10918,Manipulation of responsibility in non-clinical subjects: does expectation of failure exacerbate obsessive-compulsive behaviors?,"An exaggerated sense of responsibility is currently considered as the ground for the obsessive-compulsive disorder. Obsessive-like behaviors, such as hesitations and checks, may be induced in non-clinical subjects by increasing perceived responsibility (i.e., perceived personal influence on negative outcomes). In line with Salkovskis' proposal [The cognitive approach to anxiety: threat beliefs, safety-seeking behavior, and the special case of health anxiety and obsessions, in: P.M. Salkovskis (Ed.), Frontiers of Cognitive Therapy, Guilford, New York], we tested the hypothesis that reduced coping abilities (i.e., an exaggerated expectation of failure) are another effectual factor contributing to obsessive-like behaviors. We examined 47 normal volunteers in a visuo-spatial memory task, and manipulated their perceived personal influence and expectation of failure by giving differential instructions and feedback about their performance. Increase of perceived personal influence induced slowness, hesitations and checks without enhancing performance. Expectation of failure exacerbated obsessive-like behaviors, again without affecting performance. These results confirm the role of responsibility in obsessive-like behavior and indicate that reduced coping abilities may contribute to worsen dysfunctional strategies.",Mancini F.; D'Olimpio F.; Cieri L.,2004.0,10.1016/S0005-7967(03)00153-0,0,0,
10919,Cross-sectional 7-year follow-up of anxiety in primary care patients.,"We describe the longitudinal patterns of anxiety symptoms and mental health treatment among patients recruited from a primary care clinic, and provide a naturalistic view of anxiety symptoms, disorders, and treatment at two time periods 7 years apart. Study participants were originally identified in a primary care setting in 1992 as positive but untreated for the presence of anxiety and/or depressive symptoms and disorders. Data were collected through telephone interviews assessing current psychological status for anxiety and depression symptoms, disorders, and general functioning and well being. There were no planned interventions. Participants were re-interviewed after 7 years. Two hundred seventy-one of the identified 1992 population of 784 patients were followed up by interview in 1999. Comparisons of the scores demonstrated that respondents were less symptomatic in 1999 than in 1992, with 45% of respondents reporting no symptoms whatsoever at follow-up. Severity of symptom status in 1992 was indicative of follow-up symptom severity. Most respondents (68%) had not received mental health treatment over the 7 years, largely because they wanted to handle problems on their own. This study demonstrates the tendency of anxiety to remain or reappear years after originally identified, with 55% of patients reporting symptoms after 7 years. Initially untreated and underdiagnosed anxiety is associated with continued impairment in functional status and quality of life and continued underrecognition and undertreatment.",Colman SS.; Brod M.; Potter LP.; Buesching DP.; Rowland CR.,2004.0,10.1002/da.10140,0,0,
10920,Mastery of Your Anxiety and Panic and brief therapist contact in the treatment of panic disorder.,"Twenty-eight individuals with panic disorder were provided with a copy of Mastery of Your Anxiety and Panic II and received either four sessions of group cognitive-behavior therapy (Group) or one meeting with a therapist plus three telephone contacts (Telephone). Between group repeated measures analyses revealed significant improvement over the course of treatment and maintenance of gains over the follow-up period with few treatment by trials interactions. A higher percentage of participants in the Telephone condition achieved high end-state functioning status at posttreatment compared to those who participated in group CBT (72% vs. 24%), but this difference disappeared at 6 months posttreatment (45% vs. 55%). Participants with characteristics of either borderline, dependent, or depressive personality disorders, as assessed by the MCMI-III, were unlikely to achieve high end-state functioning status at posttreatment. Trends in the data suggest that participants who met criteria for panic disorder with agoraphobia, and those with comorbid generalized anxiety disorder, were also less likely to achieve clinically significant outcome. These findings add to the growing literature indicating that self-directed treatment with brief therapist contact is a viable option for many people with panic disorder. Furthermore, the study provides preliminary data suggesting that certain comorbid conditions negatively impact self-directed treatment outcome.",Hecker JE.; Losee MC.; Roberson-Nay R.; Maki K.,2004.0,10.1016/S0887-6185(02)00241-4,0,0,
10921,Effect of psychological treatment on cognitive bias in motor vehicle accident-related Posttraumatic Stress Disorder.,"The modified or ""emotional"" Stroop paradigm has been frequently employed in previous evaluations of information processing models of Posttraumatic Stress Disorder (PTSD) and other anxiety disorders. These studies have frequently documented an attentional bias to trauma-specific threatening stimuli in PTSD patients. However, the response of the Stroop color-naming interference effect to psychological treatment has yet to be tested in a trauma population. The present study evaluated the effects of three treatment conditions on the Stroop interference effect in motor vehicle accident (MVA) survivors with PTSD. Following treatment, participants were classified as either treatment responders or nonresponders. Participants named the color of three types of stimuli: MVA trauma-specific words, neutral words, and nonwords. Results showed that change in selective color-naming interference for trauma cues was unrelated to treatment response or modality at either posttreatment or follow-up. Findings cast doubt on the clinical utility of the modified Stroop test as a measure of treatment outcome in this population.",Devineni T.; Blanchard EB.; Hickling EJ.; Buckley TC.,2004.0,10.1016/S0887-6185(02)00247-5,0,0,
10922,Framing social information and generalized social phobia.,"Patients with generalized social phobia (GSP, N = 33) and matched community controls (N = 31) engaged in a social interaction that was constructed to go well, and then received feedback that framed social cues reflecting either the absence of negative outcomes or the presence of positive outcomes. Following feedback that framed positive social cues, the GSP group predicted they would experience more anxiety in a subsequent interaction than did non-phobic controls. In contrast, following feedback framing the absence of negative outcomes, the GSP group did not differ from controls in their anxiety predictions. The results demonstrated that framing paradigms and methods can be usefully applied to the study of cognitive processes in social phobia and indicated that research to examine how GSP patients process specific types of social information is needed.",Alden LE.; Mellings TM.; Laposa JM.,2004.0,10.1016/S0005-7967(03)00163-3,0,0,
10923,[Effect of antenatal gymnastics on childbirth: a study on 50 sedentary women in the Republic of Benin during the second and third quarters of pregnancy].,"Antenatal gymnastics is a form of non-pharmacological childbirth preparation methods. It helps maintain rachidian statics and to relieve painful syndromes (joints, lumbar pains) during pregnancy. It also helps correct gravidic problems (leg cramps, back ache, weight increase, etc.). It is both a physical and psychological training method in accordance with the natural mechanisms of childbirth, implying personal involvement on the part of the parturient. Fifty (50) pregnant women of Benin (apart from pathological pregnancies) divided into two groups of 25 subjects (experimental group) and 25 subjects (control group) voluntarily took part in the study after having given their written assent. Each involved subject is paired with a counterpart of control following the same criteria: age of the gestante, parity, characteristic of the pelvis. Subjects aged from 17 to 42 trained twice a week with a minimum of 24 hours rest between two sessions; the training period intensity of exercise is limited to 60% of the maximum heart frequency and each training session lasts 45 min. The results show a lower number of caesareans and a significant lower number of untorn perineas in the experimental group. Apgar scores are also statistically higher in the children of trained women. This study confirms that sedentary pregnant women without any medical counter-indications (repetitive miscarriages, premature births, placenta praevia, cervical gaping, cardiac diseases, hypertension, narrow pelvis) can participate in antenatal gymnastics at a moderated rhythm, for their own benefit and that of their babies. Muscular force improvement (quality of the abdominal pushing), psychological control (absence of stress and panic), and good body form, can be noticed in trained mothers. However, abnormal presentation of baby, fetal suffering and the inherent characteristics of the pelvis (narrow) are factors requiring a caesarean. On the whole, antenatal gymnastics is an effective non-pharmacological means to avoid complications in childbirth. This method might be one of the solutions which could benefit pregnant women in Africa, considering its low cost compared to the exorbitant cost of medicines and hospitalisation.",Lawani MM.; Alihonou E.; Akplogan B.; Poumarat G.; Okou L.; Adjadi N.,,,0,0,
10924,Impact of personality disorders on treatment outcome for female assault survivors with chronic posttraumatic stress disorder.,"This study examined the impact of comorbid personality disorders on the outcome of cognitive behavioral treatment for women with chronic posttraumatic stress disorder (PTSD). Seventy-five adult women with PTSD resulting from rape or nonsexual assault in adulthood or sexual abuse in childhood were treated with prolonged exposure with or without cognitive restructuring. Assessment of personality disorders found that 39% of participants met DSM-IV criteria for some personality disorder diagnosis. No difference was found between women with and without personality disorders on the prevalence of PTSD at the end of treatment. Participants with a personality disorder were less likely to attain good end-state functioning, but this may be attributable to the fact that they started off slightly worse than those without personality disorders. Finally, the comorbid patients treated by community therapists fared as well or better than those treated by cognitive behavioral treatment experts in posttreatment prevalence of PTSD and end-state functioning.",Hembree EA.; Cahill SP.; Foa EB.,2004.0,,0,0,
10925,Neurological soft signs in obsessive-compulsive disorder.,"Neurological soft signs (NSSs) are defined as abnormal motor or sensory findings, including involuntary movements, a variety of dispraxia, difficulties in performing rapid alternating movements, difficulties in two-point discrimination, and graphesthesia in a person without a neurological disorder which can be determined as its focus. to investigate the relationship of NSSs with obsessive-compulsive disorder (OCD). This study was designed in the Psychiatry Polyclinic of Ondokuz Mayis University Hospital. After signing an informed consent form, all the subjects were divided into 2 groups: (1) the patient group and (2) the control group. Thirty consecutive patients presenting with DSM-IV OCD were included in this study. The control group consisted of 30 healthy subjects without a psychiatric/neurological disorder. All subjects underwent a physical and neurological examination for soft signs (PANESS). The Mann-Whitney U test was used for statistical analysis of data. It was seen that graphesthesia, two-point discrimination, and total PANESS scores were significantly higher in the group with OCD than the control group. In other NSSs, there was no significant difference between the patient and control groups. Unlike some studies, in the present study, the difference between the groups in graphesthesia compared to other NSSs was significant. The results of this preliminary study suggest that there is a relationship between NSSs and OCD. We think that NSSs may point to a structural brain abnormality in patients with OCD.",Guz H.; Aygun D.,2004.0,,0,0,
10926,Personality disorder and social anxiety predict delayed response in drug and behavioral treatment of panic disorder.,"The aim of this study was to analyze the impact of pretreatment characteristics and personality disorders on the onset of response in the treatment of panic disorder. The data of 73 out-patients with panic disorder who had completed at least 6 weeks of a randomized trial of 24 weeks of either paroxetine only or paroxetine combined with cognitive group-therapy were analyzed in a Cox proportional hazards model. The likelihood of having responded to treatment (defined by a CGI rating of improvement) was more than twice as high for patients without a personality disorder or social phobia than for Patients with a personality disorder or social phobia. We suggest that patients with these characteristics do benefit from prolonged treatment, and they may profit from an additional treatment focused on social anxiety.",Berger P.; Sachs G.; Amering M.; Holzinger A.; Bankier B.; Katschnig H.,2004.0,10.1016/S0165-0327(03)00043-0,0,0,
10927,Delivering cognitive-behavior therapy for panic disorder with agoraphobia in videoconference.,"Delivering psychotherapy by videoconference could significantly increase the accessibility of empirically validated treatments. The aim of this study was to compare the effectiveness of cognitive-behavior therapy (CBT) for panic disorder with agoraphobia (PDA) when the therapy is delivered either face-to-face or by videoconference. A sample of 21 participants was treated either face-to-face or by videoconference. Results showed that CBT delivered by videoconference was as effective as CBT delivered face-to-face. There was a statistically significant reduction in all measures, and the number of panic-free participants among those receiving CBT by videoconference was 81% at post-treatment and 91% at the 6-month follow-up. None of the comparisons with face-to-face psychotherapy suggested that CBT delivered by videoconference was less effective. These results were confirmed by analyses of effect size. The participants reported the development of an excellent therapeutic alliance in videoconference as early as the first therapy session. The importance of these results for treatment accessibility is discussed. Hypotheses are proposed to explain the rapid creation of strong therapeutic alliances in videoconferencing.",Bouchard S.; Paquin B.; Payeur R.; Allard M.; Rivard V.; Fournier T.; Renaud P.; Lapierre J.,2004.0,10.1089/153056204773644535,0,0,
10928,Evaluation of a short-term group intervention for informal carers of patients attending a home palliative care service.,"Despite evidence of high psychological distress and unmet needs, evaluated interventions for informal caregivers in palliative care are few. This study involved an observational outcome evaluation of attendees, and a comparison group, in specialist home palliative care. The measures included carer psychological status and patient physical status at baseline, 8 weeks, and 20 weeks. Qualitative data were collected regarding content, satisfaction with, and impact of intervention. Process data described the uptake, resources, and group activity. The intervention combined informal multiprofessional teaching with facilitated peer exchange and support, and was delivered over 6 sessions of 90 minutes per week. The uptake rate was 25%; carers were less likely to accept if they were in paid employment (OR=0.26, P=0.06), and more likely to accept if they utilized avoidance coping (OR=1.13, P=0.04) or their patient had worse physical status (OR=2.1, P=0.03). Attendees described significant support and knowledge gains from the multiprofessional input and peer group. Most relied on social comparison processes to appraise their situation. Potential detection of significant effects on global psychological scores (i.e. anxiety, depression, and burden) using multivariate analysis was disallowed due to attrition. This acceptable and accessible intervention provided information and support; further outcome studies are needed for a range of interventions. Short-term interventions are unlikely to affect global psychological scores, and future evaluations should include additional time points of data collection to demonstrate support during attendance.",Harding R.; Higginson IJ.; Leam C.; Donaldson N.; Pearce A.; George R.; Robinson V.; Taylor L.,2004.0,10.1016/j.jpainsymman.2003.09.012,0,0,
10929,Souter arthroplasty for elbows with severe destruction.,"One hundred fifty-eight primary Souter elbow arthroplasties were done on 134 patients (121 women) with severe joint destruction (Larsen Grade 5) or large bone defects or both. Joint replacement operations were done at our institution from 1985-1997. The study group comprised 156 joints in 132 patients with rheumatoid arthritis or other variants of chronic inflammatory joint disease, one in a patient with osteoarthritis, and one patient with posttraumatic arthrosis. The mean age of the patients at the time of surgery was 57 years (range, 26-81 years) and the mean disease duration was 27 years (tinge, 2-70 years). Radiographically, severe bone defects were detected in 100 humeri and 134 ulnas. Retentive (snap-fit) ulnar components were implanted in 110 joints, and bone grafts were used on 26 humeri and 14 ulnas. Major complications led to five early and 16 late reoperations in 19 patients. Four reoperations were done because of dislocation and eight because of aseptic loosening. One reoperation was done because of early infection and five were done because of late infection. One patient had reoperation because of superficial infection in the bursa olecrani and one triceps tendon rupture also was repaired. One patient had wound repair because of marginal necrosis. In the survival analysis, the cumulative success rate without revision for aseptic loosening at 5 years followup was 97%. Despite the demanding nature of these arthroplasties, the primary results are encouraging. Technically, it is possible to do elbow replacement, even on elbows where the humeral condyles or olecranon or both are missing, if there is sufficient bone left on the diaphyseal areas for primary stem fixation. However, in these extreme cases, the poor general condition of the patient or the difficult soft tissue problems in the elbow region may prove to be a contraindication for joint replacement.",Ikävalko M.; Belt EA.; Kautiainen H.; Lehto MU.,2004.0,,0,0,
10930,Characterization of event related potentials using information theoretic distance measures.,"Analysis of event-related potentials (ERPs) using signal processing tools has become extremely widespread in recent years. Nonstationary signal processing tools such as wavelets and time-frequency distributions have proven to be especially effective in characterizing the transient phenomena encountered in event-related potentials. In this paper, we focus on the analysis of event-related potentials collected during a psychological experiment where two groups of subjects, spider phobics and snake phobics, are shown the same set of stimulus: A blank stimulus, a neutral stimulus and a spider stimulus. We introduce a new approach, based on time-frequency distributions, for analyzing the ERPs. The difference in brain activity before and after a stimulus is presented is quantified using distance measures as adapted to the time-frequency plane. Three different distance measures, including a new information theoretic distance measure, are applied on the time-frequency plane to discriminate between the responses of the two groups of subjects. The results illustrate the effectiveness of using distance measures combined with time-frequency distributions in differentiating between the two classes of subjects and the different regions of the brain.",Aviyente S.; Brakel LA.; Kushwaha RK.; Snodgrass M.; Shevrin H.; Williams WJ.,2004.0,10.1109/TBME.2004.824133,0,0,
10931,Event-related potentials and EMDR treatment of post-traumatic stress disorder.,"Ten patients suffering from post-traumatic stress disorder (PTSD) following a severe traumatic event, were assessed with event-related brain potentials (ERPs) in a modified oddball paradigm containing auditory standard, target, and novel tones. ERPs were assessed before and after a treatment session using the eye movement desensitization and reprocessing method. Compared to a control group that underwent sham treatment, ERPs of the patients showed a reduction of the P3a component in the post-treatment recording, suggesting a reduced orienting to novel stimuli and reduced arousal level after the treatment. Moreover, psychometric assessment revealed a marked improvement of the PTSD symptoms after treatment.",Lamprecht F.; Köhnke C.; Lempa W.; Sack M.; Matzke M.; Münte TF.,2004.0,10.1016/j.neures.2004.02.013,0,0,
10932,Social attitudes toward traumatized men and women: a vignette study.,"This study investigated social beliefs about gender-appropriate reactions to trauma. Ninety-three men and 179 women completed vignette measures of attitudes toward victims, the Bem Sex Role Inventory, and the Trauma History Questionnaire. Participants evaluated male victims less favorably than female victims. Women responded more positively toward all victims than men. Participants regarded female crime victims more positively than their male counterparts, but did not distinguish between male and female natural disaster victims. Feminine-sex-typed women rated victims more favorably than masculine-sex-typed individuals. There was a positive relation between personal trauma exposure and attitudes toward male victims among male participants. These findings contribute to an understanding of factors influencing the social reactions experienced by traumatized men and women, and have implications for clinical practice and psychoeducation.",Mendelsohn M.; Sewell KW.,2004.0,10.1023/B:JOTS.0000022616.03662.2f,0,0,
10933,The role of subclinical paranoia on social perception and behavior.,"The purpose of this study was to investigate the effects of subclinical paranoia on social perception and behavior. Two groups of participants, those high and low in subclinical paranoia, were identified based on extreme scores on the Paranoia Scale (PS). As expected, persons high in subclinical paranoia had greater depression, social anxiety, self-consciousness, and lower self-esteem compared to persons low in subclinical paranoia. In addition, persons high in subclinical paranoia performed worse than persons low in subclinical paranoia on laboratory measures of emotion perception and on an in vivo social perception task. Finally, behavioral differences between these two groups were revealed: Persons high in subclinical paranoia sat further away from the examiner and took longer to read the consent form than low-paranoia persons. These behavioral differences were not due to the group differences in clinical functioning, indicating that level of paranoia generally accounted for these findings.",Combs DR.; Penn DL.,2004.0,10.1016/S0920-9964(03)00051-3,0,0,
10934,Cognitive behavioral group therapy in panic disorder patients: the efficacy of CBGT versus drug treatment.,"The aim of our study was to evaluate the effectiveness of Cognitive Behavioral Group Therapy (CBGT) in the treatment of Panic Disorder (PD) and to compare the treatment outcome of CBGT versus Paroxetine pharmacotherapy. Fifty seven patients referred to our anxiety disorder clinic for the treatment of PD were randomly allocated to receive either CBGT or Paroxetine. Follow up was done by a masked rater after four and twelve weeks of treatment in order to compare the efficacy of CBGT versus Paroxetine. CBGT and Paroxetine were both effective in the short-term treatment of PD. Assessments at weeks four and twelve of treatment showed no statistically significant differences between the two groups in terms of treatment outcome. Treatment with CBGT alone for the acute phase of PD appears to be equally efficacious to treatment with Paroxetine alone. Our study shows that CBGT produced beneficial results, for it was associated with a reduction in the number and frequency of panic attacks and with an improved feeling of well-being.",Dannon PN.; Gon-Usishkin M.; Gelbert A.; Lowengrub K.; Grunhaus L.,,,0,0,
10935,Correlative analysis of the results of surgical treatment of thoracolumbar injuries with long Texas Scottish rite hospital construct: is the use of pedicle screws versus hooks advantageous in the lumbar spine?,"This is a prospective, randomized study to compare the efficacy of two similar ""long-segment"" Texas Scottish Rite Hospital instrumentations with the use of hooks in the thoracic spine and pedicle screws versus laminar hook claw in the lumbar spine for thoracolumbar A3, B, and C injuries. Forty consecutive patients with such thoracolumbar fractures (T11-L1) associated with spinal canal encroachment underwent early operative postural reduction and stabilization. The patients were randomly sampled into two groups: Twenty patients received hooks in ""claw configuration"" in both the thoracic and the lumbar spine (group A), and 20 patients received hooks in the thoracic vertebrae and pedicle screws in the lumbar vertebrae (group B). Pre- and postoperative plain roentgenograms and computed tomography scans were used to evaluate any changes in Gardner post-traumatic kyphotic deformity, anterior and posterior vertebral body height at the fracture level, and spinal canal clearance (SCC). All patients were followed for an average period of 52 months (range 42-71 months). The correction of anterior vertebral body height was significantly more (P < 0.01) in the spines of group B (33%) than in group A (16%), with a subsequent 11% loss of correction at the latest evaluation in group A and no loss of correction in group B. There were no significant differences in the changes of posterior vertebral body height and Gardner angle between the two groups. The SCC was significantly more (P < 0.05) immediately postoperatively in the spine of group B (32%) than in group A (19%). In the latest evaluation, there was a 9% loss of the immediately postoperatively achieved SCC in group A, while SCC was furthermore increased at 10.5% in group B. All patients with incomplete neurologic lesions in groups A and B were postoperatively improved at 1.1 and 1.7 levels, respectively. There were two hook dislodgements in the thoracic spine, one in each group, while there was no screw failure in group B. There was neither pseudarthrosis nor neurologic deterioration following surgery. Visual Analog Pain Scale and Short Form-36 scores were equally improved and did not differ between the two groups. The use of pedicle screws in the lumbar spine to stabilize the lowermost end of a long rigid construct applied for A3, B, and C thoracolumbar injuries was advantageous when compared with that using hook claws in the lumbar spine because the constructs with screws restored and maintained the fractured anterior vertebral body height better than the hooks without subsequent loss of correction and safeguarded postoperatively a continuous SCC at the injury level.",Korovessis P.; Baikousis A.; Koureas G.; Zacharatos S.,2004.0,,0,0,
10936,Electroconvulsive therapy in patients with depression and fibromyalgia.,"The effect of electroconvulsive therapy (ECT) on depression and other symptoms of fibromyalgia was studied in a prospective 3-month trial in 13 patients with fibromyalgia and concomitant depression. All the patients met the DSM-IV diagnostic criteria for Major Depressive Disorder and fulfilled the American College of Rheumatology diagnostic criteria for fibromyalgia. The Montgomery and Asberg Depression Rating Scale (MADRS) and the clinical global impression scale (CGI) were used to assess the severity of depression and the clinical change of the patients. The fibromyalgia impact questionnaire (FIQ) was used to evaluate the severity of the fibromyalgia symptoms. The intensity of pain was evaluated using a 6-point scale (0=no pain, 5=very severe pain), and tender point palpation. All assessments were performed at baseline and at follow-up visits, which took place one week, one month and three months after ECT. There was a significant improvement in depression after ECT according to MADRS. Using CGI, six patients were much or very much improved, while four patients were minimally improved and three patients had no change. There was significant improvement in four out of ten FIQ item scores, ""feel good"", ""fatigue"", ""anxiety"" and ""depression"". No significant change was found in the FIQ item scores ""physical function"", ""pain"", ""stiffness"" and ""morning tiredness"" or number of tender points and self-reported pain. We conclude that ECT is a safe and effective treatment for depression in fibromyalgia patients, but has no effect on the pain or other physical symptoms of these patients.",Huuhka MJ.; Haanpää ML.; Leinonen EV.,2004.0,10.1016/j.ejpain.2003.11.001,0,0,
10937,Peripheral stimulation for treatment of trigeminal postherpetic neuralgia and trigeminal posttraumatic neuropathic pain: a pilot study.,"Trigeminal neuropathic pain (TNP) after facial trauma or herpes zoster infection is often refractory to treatment. Peripheral nerve stimulation has been used to treat occipital neuralgia; however, efficacy in controlling facial TNP or postherpetic neuralgia is unknown. A retrospective case series of patients who underwent subcutaneous placement of stimulating electrodes for treatment of V(1) or V(2) TNP secondary to herpetic infection or facial trauma is presented. Ten patients received implanted subcutaneous pulse generators and quadripolar electrodes for peripheral stimulation of the trigeminal nerve supraorbital or infraorbital branches. Long-term treatment results were determined by retrospective review of medical records (1998-2003) and by independent observers interviewing patients using a standard questionnaire. Surgical complication rate, preoperative symptom duration, degree of pain relief, preoperative and postoperative work status, postoperative changes in medication usage, and overall degree of therapy satisfaction were assessed. Mean follow-up was 26.6 +/- 4.7 months. Peripheral nerve stimulation provided at least 50% pain relief in 70% of patients with TNP or postherpetic neuralgia. Medication use declined in 70% of patients, and 80% indicated that they were mostly or completely satisfied with treatment overall. There were no treatment failures (<50% pain relief and a lack of decrease in medication use) in the posttraumatic group, and two failures (50%) occurred in the postherpetic group. The complication rate requiring reoperation was 30%. Peripheral nerve stimulation of the supraorbital or infraorbital branches of the trigeminal nerve is an effective method for relief of TNP after facial trauma or herpetic infection. A prospective trial using this novel approach to treat these disorders is thus warranted.",Johnson MD.; Burchiel KJ.,2004.0,,0,0,
10938,"Perinatal loss, trauma, and dream reports.","This study investigated correlations among dream characteristics and measures of trauma and perinatal bereavement as reported by women who have experienced perinatal loss. 37 women who had experienced perinatal loss were randomly selected from a perinatal support group and administered the Impact of Event Scale, the Perinatal Grief Scale, and the KJP Dream Inventory. Scores on the Impact of Events Scale (IES) correlated with Emotional Pain (.41), Despair (.37), Dreams of Death (.31), Dreams of Water (-.29), and Dreams of Being Famous (-.36). Subjects who reported higher Social Support and Emotional Expressiveness throughout their trauma showed lower scores on IES Total scores (-.52), Despair (-.62), and reported dreaming more in color (.41). Results are discussed in terms of the hypothesized role dreams may play in the grief-recovery process.",Kroth J.; Garcia M.; Hallgren M.; LeGrue E.; Ross M.; Scalise J.,2004.0,10.2466/pr0.94.3.877-882,0,0,
10939,[Reduction of technology fears in psychosomatic rehabilitation--concepts and results based on a computer training for older employees].,"A computer training program was developed specifically oriented toward middle-aged employees, their learning needs and their computer-related fears. This program was based on a pilot study showing a high degree of stresses associated with the introduction of computer technology at the workplace in this age group (50-59 years). A survey of 623 patients confirmed that these persons experienced technological change predominantly as disadvantageous or threatening. Based on 114 patients, concepts and results of the computer training are presented. Participation reduced avoidance behaviors, fears and increased interest and initiative based both on the patients' and their trainers' perspectives.",Beutel ME.; Gerhard C.; Wagner S.; Bittner HR.; Bleicher F.; Schattenburg L.; Knickenberg R.; Freiling T.; Kreher S.; Martin H.,2004.0,10.1007/s00391-004-0184-7,0,0,
10940,Public and private heart rate feedback in social phobia: a manipulation of anxiety visibility.,"According to cognitive behavioural models of social phobia, bodily symptoms are the main source of information concerning social evaluation for social phobics. Experience and perception of bodily symptoms therefore play an important role in social anxiety. In this study we evaluated the effects of anxiety visibility on patients and controls using feedback of veridical heart sounds. A total of 32 social phobics and 32 controls were asked twice to sit in a chair and appear relaxed while being evaluated. Half of the participants heard their heart sounds first via headphones and then via loudspeakers which were also audible to observers. The presentation order of the heart sound was reversed for the other half of the subjects. Social phobics reported substantially more anxiety than controls. Both groups showed habituation in heart rate from the first to the second presentation, and both groups reported perception of a higher heart rate, but only social phobics reported significantly more anxiety and were more worried about their heart rates in the public than in the private condition. These effects were in excess of actual heart rate differences. In conclusion, social phobics worried about the broadcast of a bodily anxiety symptom, whereas controls did not. Information about arousal made public has a strong potential to increase anxiety levels in social phobics.",Gerlach AL.; Mourlane D.; Rist F.,2004.0,10.1080/16506070310014682,0,0,
10941,Burden of medical illness in women with depression and posttraumatic stress disorder.,"Depression and posttraumatic stress disorder (PTSD) are important women's health issues. Depression is known to be associated with poor physical health; however, associations between physical health and PTSD, a common comorbidity of depression, have received less attention. To examine number of medical symptoms and physical health status in women with PTSD across age strata and benchmark them against those of women with depression alone or with neither depression nor PTSD. A random sample of Veterans Health Administration enrollees received a mailed survey in 1999-2000 (response rate, 63%). The 30 865 women respondents were categorized according to whether a health care provider had ever told them that they had PTSD, depression (without PTSD), or neither. Outcomes were self-reported medical conditions and physical health status measured with the Veterans SF-36 instrument, a version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) modified for use in veteran populations. Across age strata, women with PTSD (n = 4348) had more medical conditions and worse physical health status (physical functioning, role limitations due to physical problems, bodily pain, and energy/vitality scales from the Veterans SF-36) than women with depression alone (n = 7580) or neither (n = 18 937). In age-adjusted analyses, the Physical Component Summary score was on average 3.4 points lower in women with depression alone and 6.3 points lower in women with PTSD than in women with neither (P<.001). Posttraumatic stress disorder is associated with a greater burden of medical illness than is seen with depression alone. The presence of PTSD may account for an important component of the excess medical morbidity and functional status limitations seen in women with depression.",Frayne SM.; Seaver MR.; Loveland S.; Christiansen CL.; Spiro A.; Parker VA.; Skinner KM.,2004.0,10.1001/archinte.164.12.1306,0,0,
10942,Cost-effectiveness of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial.,"Cognitive-behavioural therapy (CBT) is effective for treating anxiety and depression in primary care, but there is a shortage of therapists. Computer-delivered treatment may be a viable alternative. To assess the cost-effectiveness of computer-delivered CBT. A sample of people with depression or anxiety were randomised to usual care (n=128) or computer-delivered CBT (n=146). Costs were available for 123 and 138 participants, respectively. Costs and depression scores were combined using the net benefit approach. Service costs were 40 British pounds (90% CI - 28 British pounds to 148 British pounds) higher over 8 months for computer-delivered CBT. Lost-employment costs were 407 British pounds (90% CI 196 British pounds to 586 British pounds) less for this group. Valuing a 1-unit improvement on the Beck Depression Inventory at 40 British pounds, there is an 81% chance that computer-delivered CBT is cost-effective, and it revealed a highly competitive cost per quality-adjusted life year. Computer-delivered CBT has a high probability of being cost-effective, even if a modest value is placed on unit improvements in depression.",McCrone P.; Knapp M.; Proudfoot J.; Ryden C.; Cavanagh K.; Shapiro DA.; Ilson S.; Gray JA.; Goldberg D.; Mann A.; Marks I.; Everitt B.; Tylee A.,2004.0,,0,0,
10943,The moderating effects of tension-reduction alcohol outcome expectancies on placebo responding in individuals with social phobia.,"We conjectured that individual differences in tension-reduction alcohol outcome expectancies (TR-AOEs) could produce widely varying responses to manipulations in alcohol-placebo studies and tested this idea by having individuals with social phobia give speeches in front of a group. One speech occurred before and one after participants consumed either a placebo beverage or a control beverage (i.e., a nonalcoholic drink described as containing no alcohol). Study results indicate that the placebo manipulation reduced cognitive and affective symptoms of anxiety to a greater extent for males with high TR-AOEs than for males with low TR-AOEs. This pattern was not found for women in the placebo group or for individuals in the control group. These findings demonstrate a moderating effect of TR-AOEs on the association between the consumption of a placebo beverage and response to an anxiety challenge and highlight the importance of accounting for gender and outcome expectancies when evaluating psychoactive substances.",Abrams K.; Kushner MG.,2004.0,10.1016/j.addbeh.2004.03.020,0,0,
10944,Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200- to 2199-gram newborns.,"Conventional care of prematurely born infants involves extended maternal-infant separation and incubator care. Recent research has shown that separation causes adverse effects. Maternal-infant skin-to-skin contact (SSC) provides an alternative habitat to the incubator, with proven benefits for stable prematures; this has not been established for unstable or newborn low-birthweight infants. SSC from birth was therefore compared to incubator care for infants between 1200 and 2199 g at birth. This was a prospective, unblinded, randomized controlled clinical trial; potential subjects were identified before delivery and randomized by computerized minimization technique at 5 min if eligible. Standardized care and observations were maintained for 6 h. Stability was measured in terms of a set of pre-determined physiological parameters, and a composite cardio-respiratory stabilization score (SCRIP). 34 infants were analysed in comparable groups: 3/18 SSC compared to 12/13 incubator babies exceeded the pre-determined parameters (p < 0.001). Stabilization scores were 77.11 for SSC versus 74.23 for incubator (maximum 78), mean difference 2.88 (95% CI: 0.3-5.46, p = 0.031). All 18 SSC subjects were stable in the sixth hour, compared to 6/13 incubator infants. Eight out of 13 incubator subjects experienced hypothermia. Newborn care provided by skin-to-skin contact on the mother's chest results in better physiological outcomes and stability than the same care provided in closed servo-controlled incubators. The cardio-respiratory instability seen in separated infants in the first 6 h is consistent with mammalian ""protest-despair"" biology, and with ""hyper-arousal and dissociation"" response patterns described in human infants: newborns should not be separated from their mothers.",Bergman NJ.; Linley LL.; Fawcus SR.,2004.0,,0,0,
10945,A concise measure of anger in combat-related posttraumatic stress disorder.,"There is a need for a brief specific measure of anger for use in assessment of posttraumatic mental health problems. One unpublished short scale is the Dimensions of Anger Reactions (DAR; R. Novaco, 1975). This study examined the psychometric properties of the DAR using intake and 12-month data for 192 Australian Vietnam veterans with combat-related PTSD. Results showed the DAR to be unidimensional, reliable, and sensitive to change over time, and removal of two items improved the scale's properties. The DAR measures anger disposition directed towards others. Assessment of convergent validity indicated that the DAR primarily measures Trait Anger. Results suggest that the DAR is a psychometrically strong measure, potentially useful for the evaluation of anger in PTSD.",Forbes D.; Hawthorne G.; Elliott P.; McHugh T.; Biddle D.; Creamer M.; Novaco RW.,2004.0,10.1023/B:JOTS.0000029268.22161.bd,0,0,
10946,Post-event processing and the retrieval of autobiographical memories in socially anxious individuals.,"Individuals with social anxiety often report considerable ruminative thoughts following ambiguous social events (post-event processing). The purpose of this study was to determine whether post-event processing affects retrieval of autobiographical memories rated as negative, anxious and shameful in a sample of socially anxious individuals and controls. Results indicated that, compared to controls, socially anxious individuals recalled memories that were rated as significantly more negative and shameful regardless of the type of post-event processing engaged in. Unexpectedly, after negative post-event processing socially anxious individuals recalled memories that although anxious and shameful, were rated as significantly more calming than after other types of post-event processing. The results imply that post-event processing may have some adaptive benefit that could explain why it persists in socially anxious individuals.",Field AP.; Psychol C.; Morgan J.,2004.0,10.1016/j.janxdis.2003.08.004,0,0,
10947,"Improving access to geriatric mental health services: a randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use.","The authors sought to determine whether integrated mental health services or enhanced referral to specialty mental health clinics results in greater engagement in mental health/substance abuse services by older primary care patients. This multisite randomized trial included 10 sites consisting of primary care and specialty mental health/substance abuse clinics. Primary care patients 65 years old or older (N=24,930) were screened. The final study group consisted of 2,022 patients (mean age=73.5 years; 26% female; 48% ethnic minority) with depression (N=1,390), anxiety (N=70), at-risk alcohol use (N=414), or dual diagnosis (N=148) who were randomly assigned to integrated care (mental health and substance abuse providers co-located in primary care; N=999) or enhanced referral to specialty mental health/substance abuse clinics (i.e., facilitated scheduling, transportation, payment; N=1,023). Seventy-one percent of patients engaged in treatment in the integrated model compared with 49% in the enhanced referral model. Integrated care was associated with more mental health and substance abuse visits per patient (mean=3.04) relative to enhanced referral (mean=1.91). Overall, greater engagement was predicted by integrated care and higher mental distress. For depression, greater engagement was predicted by integrated care and more severe depression. For at-risk alcohol users, greater engagement was predicted by integrated care and more severe problem drinking. For all conditions, greater engagement was associated with closer proximity of mental health/substance abuse services to primary care. Older primary care patients are more likely to accept collaborative mental health treatment within primary care than in mental health/substance abuse clinics. These results suggest that integrated service arrangements improve access to mental health and substance abuse services for older adults who underuse these services.",Bartels SJ.; Coakley EH.; Zubritsky C.; Ware JH.; Miles KM.; Are√°n PA.; Chen H.; Oslin DW.; Llorente MD.; Costantino G.; Quijano L.; McIntyre JS.; Linkins KW.; Oxman TE.; Maxwell J.; Levkoff SE.;  .,2004.0,10.1176/appi.ajp.161.8.1455,0,0,
10948,"Differential response to placebo among patients with social phobia, panic disorder, and obsessive-compulsive disorder.","Placebo effects in treatment of three anxiety disorders were compared. Treatment response and patients' treatment expectancy were examined by using data from 70 patients with obsessive-compulsive disorder, social phobia, or panic disorder who received placebo in three randomized, controlled trials comparing cognitive behavior therapy, medication, and their combination to placebo. Patients with obsessive-compulsive disorder were less likely to respond to placebo than patients with generalized social phobia or panic disorder. Differential expectancy did not account for these findings. Further examination of the placebo effect across the anxiety disorders may elucidate maintenance mechanisms of these disorders and have implications for development of more effective treatments.",Huppert JD.; Schultz LT.; Foa EB.; Barlow DH.; Davidson JR.; Gorman JM.; Shear MK.; Simpson HB.; Woods SW.,2004.0,10.1176/appi.ajp.161.8.1485,0,0,
10949,Reduced anxiety level by therapeutic interventions and cell-mediated immunity in panic disorder patients.,"This study examined the relationship between reduced anxiety level by therapeutic interventions and cell-mediated immunity (CMI) in patients with panic disorder. The subjects consisted of 42 patients with panic disorder and 42 normal gender- and age-matched controls. Among the patients, 21 were randomly assigned to a combined treatment of cognitive-behavioral therapy and the benzodiazepine antianxiety agent ethyl loflazepate (2 mg daily), and 21 were assigned to the antianxiety agent only. The treatment lasted for 6 weeks. Cell-mediated immune function was measured by the lymphocyte proliferative response to phytohemagglutinin (PHA) and interleukin-2 (IL-2) production. The anxiety level was assessed by the Hamilton Rating Scale for Anxiety and the anxiety subscale of the Symptom Checklist-90 Revised. Prior to treatment, the panic disorder patients had significantly lower IL-2 production and blastogenic response to PHA than the normal controls. However, no significant differences in CMI were found between the pretreatment and posttreatment period in either the patient group receiving medication only or the combined treatment group, though after treatment, patients were significantly less anxious than before treatment in both intervention groups. The delta change (posttreatment value minus pretreatment value) in the self-reported anxiety level was significantly associated with the delta change in the blastogenic response in the combined treatment group. These findings suggest that panic disorder may be associated with decreased CMI, and the reduced level of self-reported anxiety in the patients who underwent combined therapeutic intervention is likely to increase the blastogenic response. Further studies are needed to evaluate the long-term effects of treatment on immune function.",Koh KB.; Lee Y.,,10.1159/000078845,0,0,
10950,Is early enteral nutrition a risk factor for gastric intolerance and pneumonia?,"Early enteral nutrition (EN) after injury reduces septic complications, but upper digestive intolerance (UDI) occurring immediately post-trauma is a risk factor for pneumonia. Our study aimed to determine whether early intragastric feeding may lead to gastric intolerance and subsequent pneumonia in ventilated multiply injured patients. This prospective study involved two groups of patients randomized either to immediate intragastric EN, or to delayed intragastric EN started later than 24 h after admission. UDI was diagnosed when gastric residual volume, measured with a 50-ml syringe after stopping the feeding for 2 h, exceeded 200 ml at least at two consecutive measurements, and/or when vomiting occurred. Out of 52 patients, 27 were included in the early EN group, and 25 in the delayed-EN group. On day 4, the early EN group received a greater amount of feeding because of intolerance problems occurring in the delayed-EN group (1175 +/- 485 ml vs. 803 +/- 545 ml). Twenty-five subjects--33% of the early EN patients and 64% of the delayed-EN patients--met the criteria for pneumonia (P = 0.050). On average, patients with pneumonia were older, more severely injured, and therefore required more ventilator days and a longer stay in the intensive care unit than patients without pneumonia. If properly administered, early enteral nutrition can decrease the incidence of upper intestinal intolerance and nosocomial pneumonia in patients with multiple injuries.",Kompan L.; Vidmar G.; Spindler-Vesel A.; Pecar J.,2004.0,10.1016/j.clnu.2003.09.013,0,0,
10951,[Anxiety disorders comorbid with unipolar depression. Clinical diagnoses versus standardized diagnostic interview].,"Anxiety disorders frequently co-occur with affective disorders. It is well-known that such comorbid anxiety disorders are more frequently diagnosed with standardized interviews than during the ""daily routine."" In 117 consecutive inpatients with major depression we assessed the frequency of DSM-IV anxiety disorders and compared it to the routine diagnoses of the discharge letters to analyze underlying principles of such diagnostic strategies. According to SCID-I (DSM-IV) 36 patients fulfilled criteria for a comorbid anxiety disorder, while this was only true for 17 patients according to discharge letters. Logistic regression revealed that clinically recognized cases had higher anxiety levels (higher diagnostic threshold). At the same time, in patients with higher depression scores anxiety syndromes tended not to be seen as separate disorders. This strategy is in line with ""classic psychopathology,"" where severe depression (or melancholia) ""included"" anxiety symptoms. The borderline between depressive disorders and anxiety disorders is not as clear-cut as DSM-IV and ICD-10 try to indicate.",Brieger P.; Marneros A.,2005.0,10.1007/s00115-004-1768-6,0,0,
10952,Changes in self-perception during treatment of social phobia.,"Ninety individuals with social phobia were randomly assigned to a waitlist control group, a cognitive-behavioral therapy group, or an exposure therapy group without explicit cognitive intervention. Two independent raters classified more than 2,000 thoughts that were reported by participants while anticipating socially stressful situations at pretest and posttest. Each thought was classified on the basis of its valence (positive, negative, or neutral) and attentional focus (self or other). The 2 treatments demonstrated a greater reduction in the frequency of negative self-focused thoughts than the control group. Changes in negative self-focused thoughts and changes in social anxiety were significantly correlated only in the cognitive-behavioral therapy group. The implications of these findings for the cognitive model of social phobia are discussed.",Hofmann SG.; Moscovitch DA.; Kim HJ.; Taylor AN.,2004.0,10.1037/0022-006X.72.4.588,0,0,
10953,"Randomized, controlled trial of three levels of critical incident stress intervention.","Stress debriefing following exposure to a critical incident is becoming more prevalent. Its aim is to prevent or minimize the development of excessive stress response symptoms that lead to loss of productivity or effectiveness in the workplace or at home. There is little evidence that any form of psychological debriefing is effective. This study evaluated the effectiveness of three intervention strategies, and attempted to correlate the symptoms with the severity of the incident and level of intervention. A randomized, controlled trial of three levels of critical stress intervention was conducted in the British Columbia Ambulance Service (BCAS), in British Columbia, Canada, among paramedics and emergency medical technicians (EMTs), reporting critical incident stress. Outcomes were measured at one week (Stanford Acute Stress Reaction Questionnaire (SASRQ), the Life Impact Score (LIS), and Schedule of Recent Events (SRE)), and at three months and six months following the intervention (Impact of Events (IE), Coping Mechanisms, LIS, and SRE). Fifty calls were received during the 26-month study period (<1 per 10,000 BCAS response calls): 23 were by third parties, but the involved EMT did not call; nine were placed by crew unwilling to participate in the study; 18 subjects enrolled, but six completed no forms. No correlation was found between severity of the incident and scores on the SASRQ, IE, or LIS, or between any of these scores. There was no consistent pattern in the stress scores over time. Requests for critical incident stress intervention were uncommon. The need for intervention may not be as great as generally is assumed. Further randomized trials, ideally multicenter studies, are indicated.",Macnab A.; Sun C.; Lowe J.,,,0,0,7196